呵欠者必伸腰，故又名欠伸。《经》谓∶卫气昼行于阳，夜行于阴，阴主夜、
卧。阳主上，阴主下，故阴气积于下，阳气未尽入行于阴，阳引而上，阴引而下，
阴阳相引，故数欠。此从阳之阴，由动入静之机也。一人病吐血斗余，烦躁不得卧，
证甚危迫。延予至时，已半夜，闻其欠声，予曰∶不死矣。知阴犹在也，药之而愈。
《经》曰∶阳气和利，满于心，出于鼻，故嚏。河间谓∶鼻中痒，因气喷作声。
鼻为肺窍，痒为火化，（火甚则痛，微则痒也。）火干于肺，发于鼻，故痒而嚏也。或以物扰
鼻亦嚏者，扰者亦属火也。或视日而嚏者，太阳火曜于目，热气内通于鼻，痒而嚏
也。仲景云∶其人清涕出、发热、色和者，善嚏。（即伤风浅证，风在皮毛，郁其阳气于肺，气
盛化涕以出，郁勃而嚏也。色和，谓病浅耳。）可见嚏由气盛，郁勃使然，故阳虚者无嚏，得嚏则
为佳兆。
（此以饮食过度，留积不化者言。若饮食衰少不足之证，见下劳倦篇。）
饮者或寒或热或过饱，皆能伤人。
饮者水也，在人身属无形之气分。多饮则气逆，（水载气上浮也，观浴者水浸至胸则气喘可
见。盖水满于下，则逼气上浮，如油在水面是也。）饮冷则伤肺，（水之寒气上射于肺，则肺气受伤。）为喘咳，
为肿，（浸淫于肌肤则肿。）为泻。（下趋则泻。）轻者发汗利小便，上下中外分消之。重而蓄满者，
芫花、大戟、甘遂、牵牛之属利下之。（言不独利小便。须二便兼利也。）
酒者其质则湿，其气则热。饮之而昏醉狂易者热也，宜以汗去之。既醒则热去
而湿存，宜利小便以去之，葛花解酲汤主之。若不先汗而遽利小便，则炎焰不肯下
行，湿去热不去。若动大便尤谬，盖酒之热乃无形之气也，病在阳分而妄下之，以
伤其阴分，是谓诛伐无过。汗以辛温，（从其上炎外达之性也。）佐以苦寒。（清其热也。）酒疸下
之，久则为黑疸，尤宜切戒。（见疸门。）伤酒恶心呕逆，昏眩头痛，冲和汤，即参苏饮
加木香、半夏茯苓汤（见痰）、理中汤（见中寒）加干葛，或附子理中汤（见中寒）和缩脾饮（见中暑）。酒
渴缩脾饮，或干葛煎汤调五苓散。（见伤湿）久因于酒成酒积，腹痛泄泻，或暴饮有灰
酒亦能致之，并酒煮黄连丸。（见伤暑。）多饮结成酒癖，腹中有块，随气上下，冲和
汤加蓬术五分。停为痰饮者，枳实半夏汤加神曲、麦芽，或冲和汤加半夏、茯苓。解
酒毒，枳 子最妙。喻嘉言曰∶钱小鲁善饮，饮必醉，岁无虚日。呕吐，寒热兼作，
骨节烦痛，脉洪大促急，身 着席不能动展，左腿痛如刀刺，鼻煤，从病起至是总
未大便，此痈疽之候也。有谓燥金司令，酒客素伤热湿，至是而发，热被敛束，不
得外越，津液干枯，大肠失润，以清金润燥治之。或曰不然，酒毒大发，肠胃如焚，
能俟掘井取水乎？必以大下为急。余曰∶下法果胜，但酒客胃气素为多呕所伤，药
入胃中，必致上涌，不能下达，掘井固难，开渠亦不易。夫酒者，清烈之物，不随
浊秽下行，惟喜渗入者也。先从胃入胆，胆为清净之腑，同气相求故也。然胆之摄
受无几，其次从胃入肠、膀胱，渗之化溺为独多焉。迨至化溺，则所存者，酒之余
质，其烈性实惟胆独当之。是以酒至半酣，虽懦夫有挥拳骂座，罔顾余生之胆。（酒
性极热而亲上，心肺受之，不独胆也。酒入则气强，故无所畏。气之降者属肺，升者属肝胆，肝阴胆阳，酒气乃阳
升之极者，故属之胆耳。）胆之腑原无输泻，而胆之热他入，可移于脑，浊涕从鼻窍源源而
出，亦少杀其势。若小鲁则阳分之阳过旺，阳分之阴甚衰，发 全无，直似南方不
毛之地，热也极矣，肯受胆之移热乎？幸其头间多汗，脑热暗泄，不为大患。乃胆
热既无可宣，又继以酒之热，时之燥，热淫内炽，故胆之热汁满而溢出于外，以渐
渗于经络，则身目皆黄，以其渗而出也。亦可转驱而纳之膀胱，从溺道而消也。今
病独攻环跳之穴，腿痛如刀刺，则病结于胆之本经，不能驱使从膀胱出矣。即欲针
之，此久伤之穴，有难于扶泻者，吾更有虑焉。有身以后，全赖谷气充养，谷气即
元气也。谷入素少之人，又即藉酒为元气，今以病而废饮，何所恃为久世之资耶？
吾谛思一法，先搐脑中黄水出鼻，次针胆穴之络脑间者数处，务期胆中之热移从脑
鼻而出，庶乎上泄则下宽，环跳穴中结邪渐运，而肠胃之枯槁渐回。然后以泻胆热
之药入酒中，每日仍痛饮一醉，饮法同而酒性异，始得阴行而妙其用。盖其以生平
之偏造为坚垒，必藕酒转为乡导，乃克有济也。岂清金润燥与下夺之法，能了其
局乎？
食者物也，在人身属有形之血分。伤食则胸腹痞满，恶心咽酸，噫败卵臭，恶
食，头痛发热恶寒。（食郁成热，上攻头痛，外蒸身热，气不达于表故恶寒。）证似伤寒，但气口脉倍
大于人迎，及身不痛为异耳。轻则消导，重则吐下。在上脘者吐之，瓜蒂散之
属。已下肠中者下之。其证热，所伤之物亦热者，承气汤（见大便不通，）其证寒，所伤之
物亦寒者，小七香丸料一帖，姜引水煎，吞感应丸或备急丸。《经》曰∶上部有脉，（指
头部三候言。）下部无脉，（指足部三候言。）其人当吐，不吐则死。东垣谓其理同木郁，
宜吐以达之。以为食塞胸中，太阴肺金之部分也。肝木之气为食所遏，不得上升，
伏于脾土之中，若受金之克伐者然。（以食在胸中肺部，阻遏木气不得升也。）故曰木郁吐之，则
木得舒。又谓∶肺为清阳之分，如天。食壅于上，则天气不得下交于地而成否。地
中之水源于天气，故曰水出高原。气隔于上，则源绝而水不下流，故下部无脉。其
说迂曲。大抵食在胃脘之上，未入于肠，故宜从上越之耳。又上部之气，在食之上，
不受遏则能营运，故上部之脉亦通。（脉随气行。）下部之气为食所遏，不能营运，故下
部无脉也。伤寒物者，半夏、神曲、干姜、三棱、广术、巴豆之类。治中汤加砂仁
一钱，下红丸子；小七香丸；半夏枳术丸。寒热不调，每服加上二黄丸十丸，或用
木香干姜枳术丸、丁香烂饭丸。伤热物者，枳实、白术、青陈、麦芽、黄连、大黄
之类。上二黄丸、枳术导滞丸。寒热通用保和丸、枳术丸、曲 枳术丸、木香枳术
丸、槟榔丸。伤湿热不化，痞满闷乱，枳实导滞丸。伤肉食湿面，辛辣浓味，三黄
枳术丸。伤热食痞闷，兀兀欲吐，上二黄丸。伤湿面，心腹满闷，支体沉重，
除湿益气丸。伤豆粉湿面油腻，白术丸。食索粉片积，用紫苏浓煎汁，和杏仁
泥服之即散。食狗肉不消，心下坚，或腹胀、口干、发热，煮芦根汁饮之，杏仁治
狗肉。食鱼脍生肉不化，每成 瘕，捣马鞭草汁及生姜汁饮之。大抵神曲、麦芽消
谷食，莱菔化面食， 砂、阿魏、山楂消肉食，紫苏化鱼蟹毒，麝香消酒、果积。
如伤冷物一分热物二分，则用寒药二停热药一停，随时消息。面色青黑，脉浮沉不
一，弦而弱者，伤在厥阴，（肝经受寒物之郁也。）当归四逆汤（见厥）加吴茱萸或生姜之类主之。
面红赤，脉浮沉不一，细而微者，伤在少阴，（肾受寒物所伤，逼火于上，故面红。）通脉四
逆汤（见厥）。面色黄，脉浮沉不一，缓（软也）而迟者，伤在太阴，理中丸汤（见中寒）主之。（此条
皆温药。）凡脾脉微洪（属火），伤苦物，（苦为火味也。此等皆以五行相配，然勿泥。）咸胜苦；微弦伤冷
硬物，温以克之；弦紧伤酸硬物，辛胜酸；微涩伤辛辣物，苦胜辛；微滑伤腥咸物，
甘胜咸；洪缓伤甜烂物，酸胜甘。微迟伤冷痰，积聚恶物，温胃化痰。单伏主物不
消化，曲、柏、三棱、广术之类。洪浮而数，乃中酒，葛根、陈皮、茯苓。伤食作
泻不止，于药中加肉豆蔻、益智仁收固之。伤食兼感风寒，证与前同，但添身疼、
气口人迎并盛，生料五积散（见中寒）、养胃汤、芎芷香苏饮（见香港脚）、和解散。凡伤食主平
胃散，伤谷食者加谷芽、麦芽、神曲，肉食加山楂，面滞加莱菔子，快膈加枳实。
若脾胃虚弱不能化，六君子汤（见气）加丁藿、木香、建莲、浓朴、缩砂、麦芽、神曲。
脾气下陷，补中益气汤。（见气。）肝火乘脾，脾伤不运，左金丸（见发热）、归脾汤（见血）。肾火乘
脾，六味丸（见虚损）。命门火衰，不能生土，八味丸（见虚损）。或疑正当饱满，难于用补，
不知用补自有法疏启其中，竣补其下。少用则助壅于上，多用则峻补于下，以人参
一两，少加升麻，一服即愈，所谓塞因塞用也。有胃强脾弱者，能食而不能化
也，平胃散加炒盐、胡椒、山楂、麦芽、神曲、白蒺藜丸服，更节饮食。
呵欠时必然要伸展腰部，所以又叫做“欠伸”。《黄帝内经》说：卫气白天运行于阳分，夜晚运行于阴分。阴分主夜间、睡眠；阳分主上部。阴气积聚在下部，阳气尚未完全进入阴分运行，阳气牵引身体向上，阴气牵引身体向下，阴阳相互牵引，所以频频打呵欠。这是从阳转入阴，由动转静的机制。有一人患吐血病，吐血量达一斗多，烦躁不安无法入睡，病情非常危急。请我诊治时，已是半夜，听到他打呵欠的声音，我说：“他不会死了。”因为我知道他的阴气还在，用药治疗后痊愈了。《黄帝内经》说：阳气调和顺畅，充满于心，出于鼻，所以打喷嚏。刘河间认为：鼻子发痒，因气体喷出而发出声音。鼻是肺的窍道，痒是由火邪化生（火邪盛则痛，轻微则痒）。火邪侵犯肺脏，表现于鼻，所以发痒而打喷嚏。有人用物体扰动鼻子也会打喷嚏，扰动也属于火邪的作用。有人看太阳会打喷嚏，是因为太阳之火照耀眼睛，热气内部通达于鼻，发痒而打喷嚏。张仲景说：病人流清鼻涕、发热、面色正常，善于打喷嚏。（这就是伤风的轻浅证候，风邪在皮毛，郁闭肺气，气盛化为涕液排出，郁勃而打喷嚏。面色正常，说明病位浅。）可见打喷嚏是由于气盛，郁勃所致，所以阳虚的人不会打喷嚏，如果打了喷嚏则是佳兆。
（这一段讲的是饮食过度，停留积聚不消化的情况。如果是饮食减少不足的证候，见下面的劳倦篇。）
饮水或寒或热或过饱，都能伤害人体。
饮是水，在人身属于无形的气分。多饮则气逆乱（水携带气上浮，观察洗澡时水浸至胸口就会气喘可以看出。大概水满于下，则逼迫气上浮，就像油浮在水面上一样），喝冷水则伤肺（水的寒气上射于肺，则肺气受伤），导致喘咳，导致水肿（水湿浸淫肌肤则肿），导致泄泻（水湿下趋则泻）。轻症用发汗和利小便的方法，上下中外分消水湿。重症且蓄积胀满的，用芫花、大戟、甘遂、牵牛子等药攻下利水。（这里不仅指利小便，必须大小便同时通利。）
酒的本质是湿，其性是热。饮酒后昏醉狂乱的，是热邪所致，宜用发汗法去除。酒醒后热去而湿存，宜用利小便法去除，以葛花解酲汤为主治方。如果不先发汗而直接利小便，则炎上的火势不肯下行，湿去而热不去。如果用通便法更是错误，因为酒的火热是无形的之气，病在阳分而妄用攻下，会损伤阴分，这叫做诛伐无罪。发汗用辛温药（顺应其向上炎外达的性质），佐以苦寒药（清除其热）。酒疸误用攻下，日久会变成黑疸，尤其应当严禁。（见黄疸门）饮酒过量致恶心呕吐，昏眩头痛，可用冲和汤，即参苏饮加木香、半夏、茯苓汤（见痰饮）、理中汤（见中寒）加干葛，或者附子理中汤（见中寒）合缩脾饮（见中暑）。酒后口渴用缩脾饮，或者干葛煎汤调服五苓散。（见伤湿）长期饮酒形成酒积，腹痛泄泻，或者暴饮含有灰渣的酒也能导致此病，均用酒煮黄连丸。（见伤暑）多饮结成酒癖，腹中有肿块，随气机上下移动，用冲和汤加蓬术五分。停滞成为痰饮的，用枳实半夏汤加神曲、麦芽，或者冲和汤加半夏、茯苓。解酒毒，枳椇子最妙。喻嘉言说：钱小鲁善于饮酒，每次必醉，天天如此。出现呕吐，寒热交替发作，骨节烦痛，脉象洪大而急促，身体沉重着席不能动弹，左腿痛如刀刺，鼻孔干燥如煤，从发病到现在始终未大便，这是痈疽的征候。有人说燥金当令，酒客素来损伤热湿，至此发作，热被敛束，不得外越，津液干枯，大肠失润，应用清金润燥法治之。有人说不对，酒毒大发，肠胃如火烧，能等到掘井取水吗？必须以大下法为急务。我说：下法果然有效，但酒客胃气素来因多呕而受损，药入胃中，必定导致上涌，不能下达，掘井固然困难，开渠也不容易。酒是清烈之物，不随浊秽下行，只喜欢渗入。先从胃入胆，胆为清净之腑，同气相求的缘故。然而胆的摄受有限，其次从胃入肠、膀胱，渗透化为尿液最多。等到化为尿液，所剩下的就是酒的余质，其烈性实在只有胆独自承担。所以酒喝到半酣，即使是懦夫也有挥拳骂座、不顾性命的大胆行为。（酒性极热而亲上，心肺受之，不独胆也。酒入则气强，故无所畏惧。气的降者属肺，升者属肝胆，肝阴胆阳，酒气乃阳气上升的极致，所以归属于胆。）胆的腑原无输泻通道，而胆的热邪传入他处，可移于脑，浊涕从鼻窍源源而出，也能稍微减轻其势头。像钱小鲁这样，阳分的阳气过旺，阳分的阴气甚衰，出汗全无，简直像南方不毛之地，热到了极点，肯接受胆的移热吗？幸好他头部多汗，脑热暗中宣泄，才没有成为大患。既然胆热无可宣泄，又继之以酒的余热、时令的燥热，热邪内炽，所以胆中的热汁满溢而出，逐渐渗入经络，则身目皆黄，因为它是渗透而出的。也可以转而驱赶进入膀胱，从尿道消除。现在病邪独攻环跳穴，腿痛如刀刺，则病结于胆的本经，不能驱使病邪从膀胱排出。即使想针刺，这个穴位久已受伤，难以扶正泻邪，我更担心的是：人出生后，全赖谷气充养，谷气就是元气。平时进食少的人，又借助酒作为元气，现在因病戒酒，依靠什么作为长久的资本呢？我仔细思考了一个方法，先搐鼻引出脑中黄水从鼻出，其次针刺胆穴与脑之间联络的几处穴位，务必使胆中之热从脑鼻而出，这样上泄则下宽，环跳穴中的结邪逐渐运化，而肠胃的枯槁逐渐恢复。然后用泻胆热的药混入酒中，每天仍痛饮至醉，饮用方法相同而酒性改变，始得阴行而发挥奇妙作用。大概因为他平生的偏嗜形成了坚固壁垒，必须借酒转为向导，才能成功。难道清金润燥与攻下之法，能解决这个局面吗？
食是物质，在人身属于有形的血分。伤食则胸腹痞满，恶心咽酸，嗳气有败卵臭味，厌恶食物，头痛发热恶寒。（食郁积成热，上攻头部致头痛，外蒸体表致身热，气不达于表故恶寒。）证候类似伤寒，但气口脉倍大于人迎脉，以及身体不痛，这是不同之处。轻症用消导法，重症用吐下法。病邪在上脘的用吐法，用瓜蒂散之类。病邪已下入肠中的用下法。证候属热，所伤之物亦属热的，用承气汤（见大便不通）；证候属寒，所伤之物亦属寒的，用小七香丸料一帖，姜引水煎，吞服感应丸或备急丸。《黄帝内经》说：上部有脉（指头部三部脉），下部无脉（指足部三部脉），其人应当呕吐，不吐则死。李东垣认为其原理同于木郁，宜用吐法以疏导。认为是食物堵塞胸中，属于太阴肺金的部位。肝木之气为食物所遏制，不得上升，伏于脾土之中，如同受到金之克伐一样。（因为食物在胸中肺部，阻遏木气不得升发。）所以说木郁吐之，则木气得舒。又说：肺为清阳之分，如天。食物壅塞于上，则天气不得下交于地而成否塞。地中之水源于天气，所以说水出高原。气隔于上，则水源断绝而水不下流，所以下部无脉。这种说法迂回曲折。大致是食物在胃脘之上，未进入肠道，所以宜从上越出。另外上部之气，在食物的上方，不受遏制则能营运，所以上部的脉也通畅。（脉随气行。）下部之气为食物所遏制，不能营运，所以下部无脉。
治疗伤食的药物有：半夏、神曲、干姜、三棱、莪术、巴豆之类。治中汤加砂仁一钱，送服红丸子；小七香丸；半夏枳术丸。寒热不调，每服加上二黄丸十丸，或者用木香干姜枳术丸、丁香烂饭丸。
伤热物者，用枳实、白术、青皮陈皮、麦芽、黄连、大黄之类。上二黄丸、枳术导滞丸。
寒热通用保和丸、枳术丸、曲蘖枳术丸、木香枳术丸、槟榔丸。
伤湿热不化，痞满闷乱，用枳实导滞丸。
伤肉食、湿面、辛辣浓味，用三黄枳术丸。
伤热食痞闷，欲吐不出，用上二黄丸。
伤湿面，心腹满闷，肢体沉重，用除湿益气丸。
伤豆粉、湿面、油腻，用白术丸。
食索粉片积滞，用紫苏浓煎汁，和杏仁泥服之即散。
食狗肉不消，心下坚硬，或腹胀、口干、发热，煮芦根汁饮之，杏仁可治狗肉。
食鱼脍、生肉不化，每成瘕聚，捣马鞭草汁及生姜汁饮之。
大致神曲、麦芽消谷食，莱菔化面食，砂仁、阿魏、山楂消肉食，紫苏化鱼蟹毒，麝香消酒、果积。
如伤冷物一分热物二分，则用寒药二份、热药一份，随时斟酌。
面色青黑，脉浮沉不一，弦而弱者，伤在厥阴（肝经受寒物之郁），用当归四逆汤（见厥证）加吴茱萸或生姜之类主治。
面红赤，脉浮沉不一，细而微者，伤在少阴（肾受寒物所伤，逼火于上，故面红），用通脉四逆汤（见厥证）。
面色黄，脉浮沉不一，缓（软也）而迟者，伤在太阴，用理中丸汤（见中寒）主治。（这一条都是温药。）
凡脾脉微洪（属火），伤苦物（苦为火味。这些都以五行相配，但不要拘泥），咸胜苦；脉微弦伤冷硬物，温以克之；脉弦紧伤酸硬物，辛胜酸；脉微涩伤辛辣物，苦胜辛；脉微滑伤腥咸物，甘胜咸；脉洪缓伤甜烂物，酸胜甘。脉微迟伤冷痰，积聚恶物，用温胃化痰法。单伏脉主物不消化，用曲、柏、三棱、莪术之类。脉洪浮而数，是中酒，用葛根、陈皮、茯苓。
伤食作泻不止，于药中加肉豆蔻、益智仁收固之。
伤食兼感风寒，证候与前同，但添身疼、气口人迎脉并盛，用生料五积散（见中寒）、养胃汤、芎芷香苏饮（见脚气）、和解散。
凡伤食主方用平胃散，伤谷食者加谷芽、麦芽、神曲，肉食加山楂，面滞加莱菔子，快膈加枳实。
若脾胃虚弱不能化，用六君子汤（见气虚）加丁香、藿香、木香、建莲、厚朴、缩砂、麦芽、神曲。
脾气下陷，用补中益气汤（见气虚）。
肝火乘脾，脾伤不运，用左金丸（见发热）、归脾汤（见血虚）。
肾火乘脾，用六味丸（见虚损）。
命门火衰，不能生土，用八味丸（见虚损）。
有人怀疑正当饱满时，难于用补，不知道用补自有法度，疏启其中，峻补其下。少用则助壅于上，多用则峻补于下，用人参一两，少加升麻，一服即愈，这就是所谓的“塞因塞用”。
有胃强脾弱的，能食而不能化，用平胃散加炒盐、胡椒、山楂、麦芽、神曲、白蒺藜丸服，更要节制饮食。
Yawning (yawn) is always accompanied by stretching the waist, hence it is also called "yawning and stretching". The *Classic* states: Wei Qi (Defensive Qi) circulates in the Yang aspects during the day and in the Yin aspects at night. Yin governs night and sleep; Yang governs the upper part. When Yin Qi accumulates in the lower part and Yang Qi has not yet fully entered to circulate in the Yin, Yang pulls the body upward while Yin pulls it downward. The mutual attraction of Yin and Yang causes frequent yawning. This represents the transition from Yang to Yin, from movement to stillness. A patient suffered from hematemesis (vomiting blood) of over one dou, with restlessness and inability to sleep, presenting a critical condition. When I arrived for consultation at midnight, I heard him yawning and said, "He will not die." Knowing that his Yin Qi was still present, he recovered after medication. The *Classic* says: When Yang Qi is harmonious and smooth, filling the heart and emerging from the nose, sneezing occurs. Liu Hejian stated: Itching in the nose causes gas to spray out making a sound. The nose is the orifice of the Lung; itching is caused by Fire transformation (excessive Fire causes pain, mild Fire causes itching). When Fire invades the Lung and manifests in the nose, itching and sneezing occur. Sneezing can also be induced by disturbing the nose with an object, as disturbance belongs to Fire. Sneezing upon looking at the sun occurs because Solar Fire shines on the eyes, and heat internally communicates to the nose, causing itching and sneezing. Zhang Zhongjing stated: If a person has clear nasal discharge, fever, and normal complexion, they tend to sneeze. (This is a mild form of wind-cold injury where wind is in the skin and hair, obstructing Lung Qi; excess Qi transforms into mucus for expulsion, and obstruction leads to sneezing. Normal complexion indicates a superficial disease.) Thus, sneezing results from excess Qi and obstruction, so those with Yang deficiency do not sneeze; sneezing is a good omen.
(This section discusses excessive dietary intake leading to retention and indigestion. For conditions of insufficient dietary intake, see the chapter on Fatigue and Overwork.)
Drinking water, whether cold, hot, or excessive, can all harm the body.
Water belongs to the formless Qi aspect in the human body. Excessive drinking causes Qi rebellion (water carries Qi floating upward; this can be observed when bathing with water up to the chest, causing panting. Water filling the lower part forces Qi upward, like oil floating on water). Drinking cold water injures the Lung (cold energy of water shoots upward to the Lung, injuring Lung Qi), leading to wheezing and coughing, edema (water dampness infiltrating muscles and skin causes swelling), and diarrhea (water dampness moving downward causes diarrhea). Mild cases are treated with diaphoresis and promoting urination to disperse water from above, below, inside, and outside. Severe cases with accumulation and fullness are treated with emetics or purgatives such as Genkwa Flos (Yuanhua), Datura Seed (Daji), Kansui Radix (Gansui), and Morning Glory Seed (Qianniu) to promote bowel movements. (This implies not just promoting urination, but must promote both urination and defecation.)
Wine's substance is dampness, its nature is heat. Intoxication and madness caused by drinking are due to heat, which should be expelled via sweating. After sobering up, heat dissipates but dampness remains, requiring promotion of urination to remove it, primarily using Ge Hua Jie Cheng Tang (Pueraria Flower Decoction to Relieve Intoxication). If one does not induce sweating first but directly promotes urination, the flaming heat will not descend; dampness leaves but heat remains. Using purgatives is even more erroneous, as wine's heat is formless Qi; attacking the Yang aspect with purgatives damages the Yin aspect, which is punishing the innocent. Diaphoresis uses acrid-warm herbs (following their ascending and exterior-releasing nature), assisted by bitter-cold herbs (clearing heat). If jaundice from wine is treated with purgatives, it may turn into black jaundice over time, which must be strictly avoided. (See Jaundice Section.) For nausea and vomiting due to alcohol, dizziness, and headache, use Chonghe Tang (Harmonizing Decoction), which is Shen Su Yin (Ginseng and Perilla Decoction) plus Aucklandiae Radix (Muxiang), Pinellia Rhizome (Banxia), and Poria (Fuling); or Lizhong Tang (Regulate the Middle Decoction) plus Puerariae Radix (Gegen); or Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) combined with Suopi Yin (Spleen-Constricting Drink). For post-drinking thirst, use Suopi Yin or Puerariae Radix decoction mixed with Wuling San (Five-Ingredient Powder with Poria). Long-term alcohol consumption forming wine accumulation, abdominal pain, and diarrhea, or binge drinking muddy wine, are treated with Jiuzhu Huanglian Wan (Alcohol-Boiled Coptis Pill). Excessive drinking forming wine masses, abdominal lumps moving with Qi, is treated with Chonghe Tang plus Curcuma Zedoaria Rhizome (Ezhu) 5 fen. Stagnation transforming into phlegm-fluid retention is treated with Zhishi Banxia Tang (Immature Bitter Orange and Pinellia Decoction) plus Medicated Leaven (Shenqu) and Malt (Maiya), or Chonghe Tang plus Pinellia and Poria. To resolve alcohol toxicity, Ziziphus Spinosae Semen (Zhizi/Jujube seed, specifically the stalk/fruit used for detox here often refers to Hovenia Dulcis but text says Zhizi, likely referring to specific detox properties or typo for Huaihua/Zhizi context, sticking to text: Zhizi) is best. Yu Jiayan stated: Qian Xiaolu was skilled at drinking, getting drunk every day without fail. He presented with vomiting, alternating chills and fever, bone joint irritability and pain, surging and rapid pulse, body heavy unable to move on the mat, left leg pain like knife stabbing, coal-black nostrils, and no bowel movement since onset. This is a sign of carbuncle and sore. Some argued that Dry Metal rules the season, and wine drinkers usually suffer from heat-dampness; now heat is constrained, cannot vent outward, fluids dry up, large intestine loses moisture, so treat with clearing Metal and moistening dryness. Others disagreed, saying alcohol toxin flares up, intestines and stomach are burning, how can one wait to dig a well for water? Urgent large purgation is needed. I said: Although purgation might work, wine drinkers' Stomach Qi is already damaged by chronic vomiting; medicine entering the stomach will cause regurgitation and fail to reach downward. Digging a well is hard, digging a canal is also difficult. Wine is a clear and potent substance, not descending with turbidity, but preferring to infiltrate. It enters the Gallbladder from the Stomach first; the Gallbladder is a pure and clear organ, seeking similar Qi. However, the Gallbladder's capacity is limited; next it enters the Intestines and Bladder, where infiltration into urine is most prominent. Once transformed into urine, only the residual quality of wine remains, and its potency is borne solely by the Gallbladder. Hence, at half-intoxication, even cowards show boldness. (Wine nature is extremely hot and tends upward; Heart and Lung receive it, not just Gallbladder. Wine strengthens Qi, causing fearlessness. Descending Qi belongs to Lung, ascending to Liver and Gallbladder. Liver is Yin, Gallbladder is Yang; wine Qi is extreme Yang ascent, thus attributed to Gallbladder.) The Gallbladder orifice has no direct outlet, but Gallbladder heat transferring to the brain causes turbid mucus to flow from the nose, slightly reducing the momentum. In Qian Xiaolu's case, Yang aspect Yang is excessive, Yang aspect Yin is deficient, no sweating, resembling barren southern lands, extreme heat, rejecting Gallbladder heat transfer. Fortunately, head sweating allows hidden brain heat release, avoiding major disaster. Since Gallbladder heat cannot be vented, compounded by wine heat and seasonal dryness, internal heat blazes, causing Gallbladder bile to overflow and infiltrate meridians, turning body and eyes yellow. It could also be driven to the Bladder for elimination via urine. Now pathology attacks Huantiao (GB30) point, leg pain like knife stabbing, indicating pathology rooted in Gallbladder channel, unable to exit via Bladder. Even acupuncture is difficult due to long-term injury at this point. My greater concern is: Post-natal life relies on Grain Qi for nourishment, which is Yuan Qi (Source Qi). Those who eat little rely on wine as Source Qi. Abandoning wine due to illness leaves no long-term resource. I devised a method: First, stimulate nose to expel yellow fluid from brain; second, needle several points connecting Gallbladder and brain, ensuring Gallbladder heat exits via brain and nose. Upper drainage relieves lower pressure, Huantiao blockage resolves, intestinal dryness recovers. Then, add Gallbladder-clearing herbs to wine, drink to intoxication daily. Same method, different wine nature, allowing Yin circulation and miraculous effect. His lifelong bias formed a fortress; wine must act as guide. Can clearing Metal/moistening dryness or purgation solve this?
Food is substance, belonging to the formless Blood aspect in the body. Food stagnation causes chest and abdominal fullness, nausea, sour regurgitation, belching with rotten egg odor, food aversion, headache, fever, and aversion to cold. (Food stagnation generates heat, attacking head causing headache, steaming exterior causing fever, Qi failing to reach surface causing aversion to cold.) Symptoms resemble Taiyang disease, but differ by Qi Kou pulse being double Ren Ying pulse and absence of body pain. Mild cases use digestion-promoting methods; severe cases use emesis or purgation. Pathogens in Upper Jiao use emesis, e.g., Genti San (Melon Sepal Powder). Pathogens in Intestines use purgation. If symptoms and ingested food are Heat-type, use Chengqi Tang (Major Order the Qi Decoction); if Cold-type, use Xiao Qixiang Wan (Small Seven-Aroma Pill) decocted with ginger water, swallowed with Yinggan Wan or Beiji Wan. The *Classic* states: Pulse present at upper part (head), absent at lower part (feet), patient should vomit; if not, death ensues. Li Dongyuan explained this is similar to Wood Depression, requiring emesis to unblock. Food blocking chest affects Taiyin Lung Metal. Liver Wood Qi is suppressed by food, unable to ascend, hiding in Spleen Earth, resembling Metal suppression. Thus, emesis for Wood depression allows Wood to舒展 (expand). Also, Lung is Clear Yang, like Heaven. Food obstruction prevents Heaven Qi from descending to Earth, causing Pi (stagnation). Earth water originates from Heaven Qi ("Water comes from high plateau"). Qi blockage at top cuts off source, water doesn't flow down, hence lower pulse absent. This theory is convoluted. Basically, food in upper Stomach, not yet in Intestines, should be expelled upward. Upper Qi above food, if unblocked, circulates, so upper pulse exists (pulse follows Qi). Lower Qi blocked by food, cannot circulate, so lower pulse absent.
Herbs for damaging foods: Pinellia, Shenqu, Dried Ginger, Burreed Tuber (Sanleng), Curcuma (Ezhu), Croton Seed (Badou). Zhizhong Tang plus Amomum Cardamomum (Sharen) 1 qian, followed by Hongwanzi; Xiao Qixiang Wan; Banxia Zhizhu Wan. For cold-heat disharmony, add Shang'erhuang Wan 10 pills per dose, or Muxiang Ganjiang Zhizhu Wan, Dingxiang Lanfan Wan.
For heat-damaging foods: Zhishi, Baizhu, Qingpi/Chenpi, Maiya, Huanglian, Dahuang. Shang'erhuang Wan, Zhizhu Daoshi Wan.
General for cold/heat: Baohe Wan, Zhizhu Wan, Qu Zhizhu Wan, Muxiang Zhizhu Wan, Binglang Wan.
For damp-heat indigestion with fullness/confusion: Zhishi Daoshi Wan.
For meat, wet noodles, spicy/rich flavors: Sanhuang Zhizhu Wan.
For heat-food stagnation with retching: Shang'erhuang Wan.
For wet noodles with chest/abdominal fullness/heavy limbs: Chushi Yiqi Wan.
For bean powder, wet noodles, grease: Baizhu Wan.
For noodle sheet accumulation: Strong decoction of Perilla Folium (Zisu) mixed with Almond paste.
For undigested dog meat with epigastric hardness/bloating/dry mouth/fever: Rehumax Rhizome (Lugen) juice; Apricot Seed (Xingren) treats dog meat.
For raw fish/meat causing masses: Purslane Juice (Biancao) and Ginger juice.
Generally: Shenqu/Maiya digest grains; Radish (Laifu) digests wheat; Sha Ren, Asafetida (Awei), Hawthorn (Shanzha) digest meat; Perilla (Zisu) resolves fish/crab toxicity; Musk (Shexiang) resolves wine/fruit accumulation.
Ratio of cold/hot damage dictates herb ratio (e.g., 1 part cold, 2 parts heat -> 2 parts cold herbs, 1 part warm herbs).
Complexion cyan/black, pulse floating/sinking irregular, wiry/weak: Jueyin injury (Liver cold stagnation), Guisii Nixi Tang plus Evodia (Wuzhuyu) or Ginger.
Complexion red, pulse irregular/fine/faint: Shaoyin injury (Kidney cold forcing fire up), Tongmai Sini Tang.
Complexion yellow, pulse irregular/slow/soft: Taiyin injury, Lizhong Wan/Tang. (All warming herbs).
Spleen pulse slight surging (Fire): Damage from bitter substances (Fire flavor); Salty overcomes Bitter.
Pulse slight wiry: Damage from cold/hard; Warmth overcomes.
Pulse wiry-tight: Damage from sour/hard; Acrid overcomes Sour.
Pulse slight choppy: Damage from spicy; Bitter overcomes Acrid.
Pulse slight slippery: Damage from fishy/salty; Sweet overcomes Salty.
Pulse surging-slow: Damage from sweet/soft; Sour overcomes Sweet.
Pulse slight slow: Cold-phlegm/stagnation, warm Stomach/resolve phlegm.
Hidden pulse: Indigestion, use Shenqu, Bohe, Sanleng, Ezhu.
Surging-floating-rapid: Alcohol intoxication, Gegen, Chenpi, Fuling.
Diarrhea from food stagnation: Add Nutmeg (Roudoukou) and Alpinia Oxyphylla (Yizhiren) to secure.
Food stagnation with Wind-Cold: Add body ache, Qi Kou/Ren Ying pulses strong. Use Shengliao Wuji San, Yangwei Tang, Xiong Zhi Xiangsu Yin, Hejie San.
General formula for food stagnation: Pingwei San. Add Guya/Maiya/Shenqu for grains; Shanzha for meat; Laifuzi for wheat; Zhishi for distension.
If Spleen/Stomach weak: Liujunzi Tang plus Dingxiang, Huoxiang, Muxiang, Jianlian, Houpo, Suosha, Maiya, Shenqu.
Spleen Qi sinking: Buzhong Yiqi Tang.
Liver Fire invading Spleen: Zuojin Wan, Guipi Tang.
Kidney Fire invading Spleen: Liuwei Wan.
Mingmen Fire decline failing to generate Earth: Bawei Wan.
Some doubt tonification during fullness; but tonification has method:疏通 middle, tonify lower. Small dose aids upper congestion, large dose tonifies lower strongly. Ginseng 1 liang plus slight Shengma cures instantly. This is "treating obstruction with obstruction" (Sei Yin Sei Yong).
Stomach strong/Spleen weak (eat but cannot digest): Pingwei San plus fried salt, pepper, Shanzha, Maiya, Shenqu, Tribulus (Bijili) pills. Restrict diet.