丹溪云膈者膈在心脾之间上下不通若拒格之状也由气郁痰搏而然久则渐妨饮食而为膈也
噎者饮食之际气猝阻滞饮食不下而为噎也翻胃者或朝食而暮吐暮食而朝吐或食已即吐是也
戴云翻胃年高者不治粪如羊屎者不治是大肠无血故也
寸关脉数而无力为血虚 缓而无力为气虚
数而有力为热 数而滑者有痰
脉诀云翻胃之脉浮缓者生 沉涩者死
丹溪云此症切不可用香燥之药若服之必死宜薄滋味可也盖此病属热香能散气燥能耗血滋
味助火而生痰也 又云年高者不治盖少年血气未虚用药劫去痰火病不生也老年气血已虚虽得
渐愈其病复作所以然者气虚不能运化而生痰血虚则不能滋润而生火虽云病去而脾胃尚弱随啖
肥甘之味故难克化而病复作也
一气虚宜用 四君子汤加姜汁服
一血虚宜用 四物汤加羊乳韭服
一有火热宜用清凉解毒之药 或抑青丸
一因痰而作逆者宜用 二陈汤加 竹沥 或透膈汤
一阴虚火上炎而反胃者作阴虚治
一痰嗽喘满脾胃壅滞宜用 人参利膈丸
一气不通有痰宜用 木香通气饮
一脾胃虚弱翻胃不食宜用 太仓丸
方见中风门 治气虚
方见中风门 治血虚
方见痰门 治因痰作逆
治脾胃不和中脘气滞胸膈满闷噎塞不通噫气吞酸胁肋刺痛呕逆酸涎饮食不下
木香 白豆蔻 砂仁 槟榔 枳壳 浓朴 半夏 青皮 陈皮 大黄 朴硝 甘草 姜
三片红枣一枚食远服
丹溪说：膈证，病位在心与脾之间，上下气机不通畅，呈现出一种被阻隔拒纳的状态。这是由于气机郁滞、痰浊搏结所致，日久逐渐妨碍饮食摄入，从而形成膈证。
噎证，是指在进食过程中，气机突然阻滞，导致饮食无法下咽的症状。
翻胃（反胃），是指早晨吃的食物晚上吐出来，晚上吃的食物早上吐出来，或者吃完后立即呕吐的情况。
戴云说：年老患翻胃者难以治愈；大便像羊屎一样干结者也难以治愈，这是因为大肠缺乏阴血滋润的缘故。
脉象快而有力，属于热证；脉象快而滑利，说明体内有痰。
《脉诀》说：翻胃的脉象如果是浮缓的，预后良好可生；如果是沉涩的，预后不良主死。
丹溪说：此症切不可使用香燥性质的药物，如果服用必然致死。适宜清淡的饮食。因为此病属于热证，香药能耗散气机，燥药能损伤阴血，滋腻厚味的食物会助长火邪并滋生痰浊。
又说：年老患者难以治愈。因为年轻人气血尚未虚弱，用药攻伐痰火后，疾病便不再复发。老年人气血已经虚弱，虽然病情可能逐渐好转，但容易复发。之所以这样，是因为气虚不能运化水湿而生痰，血虚不能滋润脏腑而生内热。虽然看似病邪已去，但脾胃依然虚弱，稍吃肥甘厚味之物，就难以消化，因此疾病再次发作。
对于气机不通且有痰者，适宜使用木香通气饮。
（注：以下方剂见中风门，治气虚）
（注：以下方剂见中风门，治血虚）
（注：以下方剂见火门，治有火热）
（注：以下方剂见痰门，治因痰作逆）
以上方剂用于治疗脾胃不和、中脘气滞、胸膈满闷、噎塞不通、嗳气吞酸、胁肋刺痛、呕逆酸涎、饮食不下等症状。
药材组成：木香、白豆蔻、砂仁、槟榔、枳壳、浓朴、半夏、青皮、陈皮、大黄、朴硝、甘草，生姜三片，红枣一枚。饭后服用。
Danyu stated: Ge syndrome (obstruction syndrome) occurs between the heart and spleen, where the upward and downward flow of qi is blocked, presenting a sensation of rejection or obstruction. It arises from qi stagnation and phlegm accumulation. Over time, it gradually hinders food intake, resulting in Ge syndrome.
Ye syndrome (choking syndrome) refers to the sudden obstruction of qi during eating, causing food and drink to fail to go down.
Fanwei syndrome (regurgitation syndrome) is characterized by vomiting food eaten in the morning in the evening, or food eaten in the evening in the morning, or vomiting immediately after eating.
Dai Yun stated: Fanwei syndrome in elderly patients is difficult to cure; if the stool resembles sheep dung, it is also difficult to cure, as this indicates a lack of blood in the large intestine.
A rapid but forceless pulse at the Cun (inch) and Guan (middle) positions indicates Blood Deficiency. A slow but forceless pulse indicates Qi Deficiency.
A rapid and forceful pulse indicates Heat. A rapid and slippery pulse indicates the presence of Phlegm.
The Mai Jue (Pulse Classic) states: For Fanwei syndrome, a floating and moderate pulse suggests survival, while a deep and choppy pulse indicates death.
Danyu stated: This condition must absolutely not be treated with aromatic and drying herbs; doing so will inevitably lead to death. A light and bland diet is advisable. This disease belongs to Heat patterns; aromatic herbs disperse Qi, drying herbs consume Blood, and rich flavors aid Fire and generate Phlegm.
He further stated that elderly patients are difficult to cure. Young people have not yet experienced deficiency in Qi and Blood; when medication clears Phlegm and Fire, the disease does not recur. In the elderly, Qi and Blood are already deficient. Although the condition may gradually improve, it tends to relapse. The reason is that Qi deficiency fails to transform fluids, generating Phlegm, while Blood deficiency fails to moisten, generating internal Heat. Although the pathogenic factors seem to have been eliminated, the Spleen and Stomach remain weak. Consequently, any consumption of rich and sweet foods leads to indigestion, causing the disease to recur.
For Qi Deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) with ginger juice is appropriate.
For Blood Deficiency, Si Wu Tang (Four Substance Decoction) with sheep milk and Chinese chive is appropriate.
For Heat patterns, cooling and detoxifying medications, or Yi Qing Wan (Suppress Blue Pill), are appropriate.
For regurgitation caused by Phlegm, Er Chen Tang (Two-Cured Decoction) with bamboo sap, or Tou Ge Tang (Penetrating Obstruction Decoction), is appropriate.
For regurgitation caused by Yin Deficiency with Hyperactive Fire, treat according to Yin Deficiency principles.
For conditions involving Phlegm cough, wheezing, fullness, and Spleen-Stomach congestion, Ren Shen Li Ge Wan (Ginseng Obstruction-Relieving Pill) is appropriate.
For Qi blockage accompanied by Phlegm, Mu Xiang Tong Qi Yin (Costus Qi-Circulating Drink) is appropriate.
For Spleen-Stomach weakness leading to Fanwei and anorexia, Tai Cang Wan (Grand Granary Pill) is appropriate.
(See Zhong Feng Men for formulas treating Qi Deficiency)
(See Zhong Feng Men for formulas treating Blood Deficiency)
(See Huo Men for formulas treating Heat)
(See Tan Men for formulas treating Phlegm-induced Regurgitation)
These formulas are used to treat Spleen-Stomach disharmony, Qi stagnation in the middle jiao, chest and diaphragm fullness and oppression, obstruction and choking, belching with acid reflux, stabbing pain in the hypochondrium, vomiting of sour saliva, and inability to eat.
Ingredients: Aucklandiae Radix (Muxiang), Amomi Fructus Rotundus (Baidoukou), Amomi Fructus (Sharen), Arecae Semen (Binglang), Aurantii Fructus Immaturus (Zhiqiao), Magnoliae Officinalis Cortex (Noupu), Pinelliae Rhizoma Preparatum (Banxia), Citri Reticulatae Pericarpium Viride (Qingpi), Citri Reticulatae Pericarpium (Chenpi), Rheum Palmatum Radix et Rhizoma (Dahuang), Natrii Sulfas (Pu Xiao), Glycyrrhizae Radix et Rhizoma (Gancao), Zingiberis Recens Rhizoma (Shengjiang) three slices, Jujubae Fructus (Hongzao) one piece. Take after meals.