经义
人以水谷为本，故人绝水谷则死。○食气入胃，散精于肝，淫气于筋。食气入胃，浊气归心，淫精于脉，
脉气流经，经气归于肺，肺朝百脉，输精于皮毛；毛脉合精，行气于元腑，腑精神明，留于四脏，气归于权衡。
饮入于胃，游溢精气，上输于脾，脾气
散精，上归于肺，通调水道，下输膀胱；水精四布，五经并行。○食入于阴，长气于阳。○饮食自倍，肠胃乃伤。
○水谷之邪气感，则害于六腑。○胃者，水谷之海，六腑之大源也。五味入口，藏于胃，以养五脏气。○五味
入胃，各归所喜。故酸先入肝，苦先入心，甘先入脾，辛先入肺，咸先入肾。久而增气，物化之常也。气增而久，
夭之由也。○肝色青，宜食甘，粳米、牛肉、枣、葵皆甘。心色赤，宜食酸，小豆、犬肉、李、韭皆酸。肺色
白，宜食苦，麦、羊肉、杏、薤皆苦。脾色黄，宜食咸，大豆、豕肉、栗、藿皆咸。肾色黑，宜食辛，黄黍、
鸡肉、桃、葱皆辛。辛散，酸收，甘缓，苦坚，咸软。毒药攻邪，五谷为养，五果为助，五畜为益，五菜为充，
气味合而服之，以补精益气。○辛走气，气病无多食辛；咸走血，血病无多食咸；苦走骨，骨病无多食苦；
甘走肉，肉病无多食甘；酸走筋，筋病无多食酸。○阴之所生，本在五味；阴之五宫，伤在五味。味过于酸，
肝气以津，脾气乃绝；味过于咸，大骨气劳，短肌，心气抑；味过于甘，心气喘满，色黑，肾气不衡；味过于
苦，脾气不濡，胃气乃浓；味过于辛，筋脉沮弛，精神乃央。○多食咸，则脉凝泣而变色；多食苦，则皮槁而
毛拔；多食辛，则筋急而爪枯；多食酸，则肉胝KT 而唇揭；多食甘，则骨痛而发落。（《素问》）
帝曰∶怯士之得酒，怒不避勇士者，何脏使然？少俞曰∶酒者，水谷之精，熟谷之液也；其气 悍，其入
于胃中则胃胀，气上逆满于胸中，肝浮胆横；当是之时，固比于勇士，气衰则悔，名曰酒悖也。（《灵枢》）
哲言
《经》云∶水谷之寒热感则害于六腑。又云∶阴气者，静则神藏，躁则消亡。饮食自倍，肠胃乃伤。此乃
浑言之也。分之为二∶饮也，食也。饮者水也，无形也。《经》又云∶因而大饮则气逆，形寒饮冷则伤肺。肺
病则为喘咳、为肿、为泻，轻则发
汗，利小便，使上下分消其湿；重而蓄积为满者，利下之。食者物也，有形也。《经》云∶因而饱食，筋脉
横解，肠 为痔。又云∶食伤太阴厥阴，气口大于人迎两三倍者，或呕吐、痞满，或下利肠 。治分寒热轻重，
轻则内消，重则除下，亦有宜吐者。《经》云∶在上者因而越之。然不可过剂，过则反伤脾胃。盖先因饮食自
伤，又加之以药过，脾胃复伤，气愈不化，食愈难消矣。（李东垣）
水谷入胃，其浊者为渣滓，下出幽门，达大小肠而为粪，出于谷道；其清者化而为气，上升于肺；其至清
而至精者，由肺灌溉乎四体，而为汗液津唾，助血脉，益气力，为生生不息之运用也；其清中之浊者，下入膀
胱而为尿，出于小便；其未入而在膀胱之外者，尚为浊气，既入而在膀胱之内者，即化为水也。（《医学正传》）
百谷入胃，虽酸、苦、甘、辛、咸、淡者，味必变酸，而酸为木味，谷初入胃，亦若春生故耳。吾见食入
顷而吐者必酸，再顷之必苦矣。苦是夏令，而味已二变矣。又再之必甘，是化成之天也。于兹时，清者为气、
为津、为液、为髓、为血，浊者为便、为溺，已判然于其间。得秋味辛散，则内外上下，各得其所。若不及秋
辛者，其溲如蜜，是失四变矣。若气血各归其道，是得冬藏，其味合咸；而汗，而血，而眵，而涕，而溲，皆
咸者，是五变其味，谷化成始成终者也。《经》谓仓廪之官，五味出焉者，此之谓乎。（卢不远）
伤饮
酒为水谷之液，血亦水谷之液；酒入中焦，必求同类，故直走血分。《经》曰∶饮酒者，卫气先行皮肤，
先充络脉，此之谓也。然血者神气也，血属阴而性和；酒者淫气也，酒属阳而性悍。凡酒入血分，血欲静而酒
动之，血欲藏而酒逐之，故饮酒者，身面皆赤，此入血之征，亦散血之征也。○酒本狂药，大损真阴，
惟少饮之，未必无益，多饮之，难免无伤，而耽饮之，则受其害者，十之八九焉。且凡人之禀赋，脏有阴阳，
而酒之性质，亦有阴阳。盖酒成于酿，其性则热，汁化于水，其质则寒。若阴虚者纵饮之，则质不足以滋阴，
而性偏动火，故热者愈热，而病为吐血、衄血、便血、尿血、喘嗽、躁烦、狂悖等证，此酒性伤阴而然也。若
阳虚者纵饮之，则性不足以扶阳，而质留为水，故寒者愈寒，而病为鼓胀、泄泻、腹痛、吞酸、少食、亡阳、
暴脱等证，此酒质伤阳而然也。故纵酒者，既能伤阴，尤能伤阳，害有如此。（张景岳）
夫酒者清冽之物，不随浊秽下行，惟喜渗入者也。渗入之区，先从胃入胆，胆为清净之腑，同气相求，
然胆之摄受无几；其次从胃入肠，膀胱渗之，化溺为多。逮至化溺，则所存者，酒之余质，其烈性，惟胆独当
之。每见善饮者，必浅斟缓酌，以俟腹中之渗，若连飞数觥，则倾囊而出耳。（喻嘉言）
酒者，五谷之津液，米曲之华英，虽能益人，亦能损人，何者？酒有大热大毒。大寒凝海，惟酒不冰，是
其热也；饮之易昏，易人本性，是其毒也。若避风寒，宣血脉，消邪气，引药势，无过于酒也。若醉饮过度，
盆倾斗量，毒瓦斯攻心，穿肠腐胁，神昏志谬，目不见人，此则丧生之本也。（《医方类聚》）
补编
酒者，大热有毒，气味俱阳，乃无形之物也。若伤之，止当发散，汗出则愈，其次莫如利小便，使上下
分消其湿。今治酒病，用酒症丸，及牵牛、大黄下之，是无形元气受病，反下有形阴血，乖误甚矣。（《兰室秘藏》）
治酒病，宜发汗。若利小便，炎焰不肯下行。故曰∶火郁则发之，以辛温散之，是从其体性也。是知利
小便，则湿去热不去。若动大便，尤为疏陋。盖大便者有形之物，酒者无形之物，从汗发之，是为近理，湿热
俱去。故治以苦温，发其火也；佐以苦寒，除其
湿也。○按酒之为物，气热而质湿，饮之而昏醉易狂者热也，宜以汗去之；既醒则热去而湿留，止宜利小便而
已。二者酌而用之，葛花解酲汤备矣。（王好古）
酒性虽热，体同于水。东垣乃谓饮者无形之物，此亦不能无疑；既待发汗利小便以去之，其可谓无形之
物乎？（朱丹溪）
《准绳》书中，载有人伤酒发热，治以补剂加葛根，犹不禁其散，极言鸡距子之妙。赵以德治酒病，用
鸡距子而愈，即此物也。苏州呼为“密六曲”，徽州呼为“金钩子”，九月有之。（《折肱漫录》）
伤食
食之欲也，思盐梅之状，则辄有所唾，而不能禁；见盘肴之盛，则若有所吞，而不能遏。饥思啖牛，渴
思饮海，故欲之于人也如贼，人之于欲也如战。（谭子）
食物有三化∶烹煮糜烂日火化，细嚼缓咽曰口化，蒸变传送曰胃化。（秦西水）
宜少毋食多，宜饥毋食饱，宜迟毋食速，宜热毋食冷，宜零毋食顿，宜软毋食硬。此六者，调理脾胃之
要法也。（《冯氏锦囊》）
恶食者，心下痞闷，见食恶食，甚则恶闻食臭。不能食者，心下不痞满，自不能食。饥不欲食者，心下
自不嗜食，若饥状。（《医阶辨证》）
冷食伤血，热食伤气，饱食伤胃，饥食伤脾；着气而食伤肝，食而着气伤脾；不意食而食伤脾，倍于常
而食伤肠胃。○人寤食而寐则否者何？人目张则卫气出外，目闭则卫气入内。卫气出外，主一身之动静云为，
而脏腑空虚，故须饮食以助之；卫气入内，则百骸皆逸，其气默行于脏腑，故不食。是以寤食而寐则否也。（《医参》）
食则易饥，非火也。盖脾胃以气为主，气属阳，脾胃之阳已虚，又被苦寒之药，以泻其阳，则阳愈虚，
而内空竭，须假谷气
以扶助之，故易饥而欲食，食亦不生饥肉也。《经》曰∶饮食自倍，肠胃乃伤。又曰∶饮食不为肌肤。其斯之
谓欤？（汪石山）
胃主受纳，脾司运化，故不食皆为中土受病。然胃之土，体阳而用阴；脾之土，体阴而用阳。胃实则痞满、
气胀，胃虚则饮食不甘；胃热则饥不能食，胃寒则胀满不食。○夫胃满则肠虚，肠满则胃虚，更实更虚，其气
乃居。若醉饱过度，或感风寒，或着气恼，以致填塞胸中，胃气不行，忽然厥逆昏迷，口不能言，肢不能举，
此名食厥。（《张氏医通》）
有胃气则生，无胃气则死。故诸病若能食者，势虽重尚可挽救；不能食者，势虽轻必致延剧。然有当禁食
与不当禁食之两途∶如伤寒邪传阳明，胃有燥热昏谵者；又如干霍乱之上下不通；或正值吐泻之际；或斑痧未
透于表；或瘟疫邪客膜原；或疟邪交战之时；或六淫之邪，充塞弥漫，呕恶痞胀；或伤食恶食等证，凡此禁其
谷食可也。其余诸证不食者，当责之胃阳虚、胃阴虚，或湿热阻气，或命门火衰。要知淡饮淡粥，人皆恶之；
或辛或咸，人所喜也。或其人素好之物，亦可酌而投之，以醒胃气，惟酸腻甜浊不可进。（《临证指南》）
补编
下利不欲食者，有宿食也，当下之。○宿食在上脘，当吐之，宜瓜蒂散。（《金匮》）
食在上者吐之。《经》曰∶上部有脉，下部无脉，其人当吐不吐者死。盖阳火之根，本于地下；阴水之源，
本于天上，故曰水出高源。食填闷乱，则两寸必盛；源塞流穷，则两尺自绝。吐去上焦之物，则金能生水，而
肝木发生之气，亦得畅达耳。○食在中者消之。食既下膈入胃，则不可吐，强吐之亦不能尽出；又不宜遽用下药，
下早则伤中气，而清纯冲和之气，并为之下陷矣。故杂病酒积，下早每作痞气，当健脾消导为主。○食在下者
下之。如有食积，肠腹绞痛，手不可按者，不得不下。寒积用热药下
之，热积用寒药下之。（《证治准绳》）
凡水谷入胃，随阳道而上升，则化液化精；随阴道而下溜，只完水完谷。○脾气不健，水谷挟冷而填及
太阴，非真实可知。此处邪正分争扰攘，甚而拒关，则阴阳之往来于上下者，遂惊惶错乱，各抵关而奔还，势
使然也。乱实起于中焦，故乃抚其中焦，但求复我少火之阳，不必祛彼冷食之伤，以既伤在食，不可更伤以药，
此清净画一之治也。○食填太阴，抑遏少阳之气，碍其升路，则腹之胀痛，多连及胁。食填胃口，阻住膻中之
气，碍其降路，则腹之胀痛，多连及心。部署虽殊，总宜酌以卑监之土则温之，敦阜之土则平之。○五味入胃，
五脏皆争欲得之，所恃为之作陈平，而各归其所喜。攻使得长养于五脏者，胃肠之力也。胃肠一虚，即为失宰，
以致所喜非所得，所得非所喜，口中滋味，何由得美？稼穑既不作甘，又何由归形归化，以补精益气欤？所
以滋味一失，寒热辄生，以中气虚寒，阳从外徙，无有定处故也。意欲招回此阳，使得温里宣外，仍宰厥职，
则非理中不可。○脾虚不磨，由胃阳之不运也。凡阳虚者，诸阴皆得凑之，冷食之伤，阴邪内犯，而寒中也。
故散寒行滞，燥湿舒脾，可以兼施，要莫外于温者为是也。（程郊倩）
饮食虽入中焦，其变化精微，实赖少火上蒸。中年之后，大病之余，元阳亏损，不能熟腐水谷，因而衰
馁，易于停食，作痞作痛，为呕为泻，宜补火生土。譬之釜底加薪，水谷易熟也。（《玉机微义》）
虚人饮食所伤，及外感暴病新愈之后，当用六君子汤，理胃为主。内伤劳倦，及久病之后，当用补中益
气汤，理脾为主。理脾则百病不生，不理脾则诸病续起。○老人、虚人，易于伤食，或膨胀痞闷，或腹满作泻，
当消补兼施，宜常服资生丸。○伤食后，健脾须用枳术丸，合天行健之意。健者动也，内有枳实之动，能助脾
之消磨运动耳。（李东垣）
夫饥饿不饮食与饮食太过，虽皆失节，然必明其二者之分∶饥饿胃虚，此为不足；饮食停滞，此为有余。
惟其不足，故宜补益；惟其有余，故宜消导，人之盛衰不同也。又有物滞气伤，必须补益消导兼行者；亦有物
暂滞而气不甚伤，宜消导独行，不须补益者；亦有既停滞而复自化，不须消导，但当补益者。易老枳术丸，虽
曰消导，固有补益之意存乎其间。若有形之物，非枳术丸所能去，则备急丸之属推逐而去之。观此则知消导补
益之理矣。（朱丹溪）
当今方家，以平胃散出入增减，为调脾胃之准绳。盖平胃者，胃中高阜，则使平之，一平即止，不可过剂，
过剂则反成坎矣。而枳术丸尤甚，今人以此丸为补脾之药，朝服暮饵，更益橘、半、香、砂，则又甚矣。至若
山楂、神曲、麦芽，世常用之，山楂能化肉积，产妇儿枕痛者，煎服立化。不可轻用曲 者，以米与水在瓷缸
中，藉曲以酿成酒，藉 以酿成糖；人身脾胃非瓷缸比，原有化食之能，今食不化，其所能者病也，只补助
其能而自化。（《赵氏医贯》）
【经文要义】
人依靠水谷（饮食）作为生存的根本，所以人如果断绝了水谷的摄入就会死亡。○食物进入胃中，其精微物质散布到肝脏，滋养筋脉；食物进入胃中，其浓稠的精微物质归于心，渗入脉管；脉气流经经脉，经气汇聚于肺，肺朝会全身百脉，将精微输布到皮毛；毛脉中的精气结合，运行气机于六腑，六腑精气神明，留驻于五脏，气机归于平衡协调的状态。
饮水进入胃中，游溢出的精气，向上输送给脾，脾气散播精微，向上归于肺，通调水道，向下输送到膀胱；水液精微向四周布散，五条经脉并行运行。○食物进入人体阴分，能助长阳气的生长。○饮食过量一倍，肠胃就会受到损伤。○水谷的邪气侵袭，就会伤害六腑。○胃是水谷汇聚的大海，也是六腑化生之源。五味入口，藏留在胃中，用来滋养五脏之气。○五味进入胃后，各自趋向它所喜好的脏腑。所以酸味先入肝，苦味先入心，甘味先入脾，辛味先入肺，咸味先入肾。长期食用会使相应脏腑之气增加，这是事物变化的常态。但如果气机过度增加且持续很久，就是导致早夭的原因。○肝色青，适宜吃甘味食物，如粳米、牛肉、枣、冬葵菜都是甘味的。心色赤，适宜吃酸味食物，如小豆、犬肉、李子、韭菜都是酸味的。肺色白，适宜吃苦味食物，如麦、羊肉、杏、薤白都是苦味的。脾色黄，适宜吃咸味食物，如大豆、猪肉、栗子、豆叶都是咸味的。肾色黑，适宜吃辛味食物，如黄黍、鸡肉、桃、葱都是辛味的。辛味能发散，酸味能收敛，甘味能缓和，苦味能坚燥，咸味能软坚。毒药攻伐邪气，五谷作为滋养，五果作为辅助，五畜作为补益，五菜作为充养，气味配合服用，以补充精益气。○辛味走气，气病不要多吃辛味；咸味走血，血病不要多吃咸味；苦味走骨，骨病不要多吃苦味；甘味走肉，肉病不要多吃甘味；酸味走筋，筋病不要多吃酸味。○阴精的生成，根本在于五味；阴精的五脏，损伤也在于五味。味道过于酸，肝气就会泛滥，脾气就会衰竭；味道过于咸，大骨的气机劳损，肌肉短缩，心气被抑制；味道过于甘，心气喘促胀满，面色发黑，肾气失去平衡；味道过于苦，脾气不湿润，胃气变得浓浊；味道过于辛，筋脉松弛败坏，精神受损。○多吃咸味，则血脉凝涩而面色改变；多吃苦味，则皮肤枯槁而毫毛脱落；多吃辛味，则筋脉拘急而指甲枯焦；多吃酸味，则肌肉增厚起茧而口唇翻揭；多吃甘味，则骨痛而头发脱落。（出自《素问》）
黄帝问道：胆小的人喝了酒，发怒时连勇士都不躲避，这是哪个脏腑的作用呢？少俞回答说：酒是 water谷的精微，是熟谷的液体；它的气味剽悍，进入胃中则使胃胀，气机上逆充满胸中，肝气浮越，胆气横逆；在这个时候，人的气势确实比勇士还要强盛，但气衰之后就会后悔，这叫做“酒悖”。（出自《灵枢》）
【哲人言论】
《内经》说：水谷的寒热性质侵袭，就会伤害六腑。又说：阴气安静则神志内守，躁动则神志消亡。饮食过量一倍，肠胃就会受伤。这是笼统的说法。将其分为两类：饮和食。饮是水，没有固定形状。《内经》又说：如果大量饮酒会导致气逆，形体受寒又喝冷饮则会伤肺。肺病表现为喘咳、水肿、泄泻，轻症用发汗、利小便的方法，使湿气从上到下分消；重症如果积聚成胀满，则用泻下的方法治疗。食是实物，有固定形状。《内经》说：如果饱食过度，会导致筋脉弛缓，肠道形成痔疮。又说：饮食损伤太阴、厥阴经，如果寸口脉比人迎脉大三两倍，或者出现呕吐、痞满，或者下利肠鸣等症状。治疗要区分寒热轻重，轻症用内消法，重症用泻下法，也有适宜用催吐法的。《内经》说：病在上部的，用催吐法使其吐出。但是药物不可过量，过量反而会损伤脾胃。因为原本就是饮食自伤，再加上用药过量，脾胃再次受伤，气更加不能运化，食物更加难以消化。（李东垣）
水谷进入胃中，其中浑浊的部分变成渣滓，从幽门下行，到达大小肠成为粪便，从肛门排出；其中清的部分化为气，上升到肺；其中最清最精的部分，由肺灌溉到四肢，成为汗液、津液、唾液，帮助血脉，益气力，这是生生不息的运作；其中清中之浊的部分，下行进入膀胱成为尿液，从小便排出；还没有进入膀胱而在膀胱之外的，还是浊气，已经进入膀胱之内的，就化为水了。（《医学正传》）
各种谷物进入胃中，虽然酸、苦、甘、辛、咸、淡味道不同，但最终都会变为酸味，因为酸属木味，谷物刚进入胃时，就像春天万物生发一样。我看见食物吃下去一会儿就吐出来的，一定是酸的，再过一会儿一定变苦了。苦对应夏天，味道已经变了两次。再经过一段时间一定变甘，这是化成天的阶段。在这个时候，清的部分化为气、津、液、髓、血，浊的部分化为便、尿，已经明显区分开了。得到秋天的辛散之气，则内外上下各得其所。如果不具备秋天的辛散，那么小便像蜜一样甜，这是失去了第四次变化。如果气血各归其道，这是得到了冬天的收藏，味道合于咸；而汗、血、眼屎、鼻涕、小便，都是咸味的，这是第五次变化味道，谷物化成过程始末完成。《内经》说仓廪之官（脾胃），五味由此产生，说的就是这个道理。（卢不远）
【伤酒】
酒是水谷的液体，血也是水谷的液体；酒进入中焦，必然寻求同类，所以直接走向血分。《内经》说：饮酒者，卫气先行于皮肤，先充盈络脉，说的就是这个意思。然而血属于神气，血属阴而性质柔和；酒属于淫乱之气，酒属阳而性质剽悍。凡是酒进入血分，血想静止而酒扰动它，血想潜藏而酒追逐它，所以喝酒的人，身体面部都发红，这是酒入血的征象，也是散血的征象。○酒本来是狂乱之药，大大损伤真阴，只有少量饮用，未必没有益处，大量饮用，难免受到伤害，而如果沉溺于饮酒，那么受害的人十有八九。而且每个人的禀赋，脏腑有阴阳之分，而酒的性质，也有阴阳。酒酿成，其性质则是热的，汁液化于水，其质地则是寒的。如果阴虚的人放纵饮酒，那么酒的质地不足以滋阴，而酒的性质偏于动火，所以热证更热，而出现吐血、鼻衄、便血、尿血、喘嗽、烦躁、狂悖等证候，这是酒性损伤阴液所致。如果阳虚的人放纵饮酒，那么酒的性质不足以扶阳，而酒的质地留滞成为水湿，所以寒证更寒，而出现鼓胀、泄泻、腹痛、吞酸、少食、亡阳、暴脱等证候，这是酒质损伤阳气所致。所以放纵饮酒的人，既能伤阴，更能伤阳，危害如此之大。（张景岳）
酒是清冽之物，不随浊秽下行，只喜欢渗透。渗透的区域，先从胃进入胆，胆是清净之腑，同气相求，然而胆的容纳量很少；其次从胃进入肠，膀胱渗透，化尿较多。等到化为尿液，所剩下的就是酒的残余物质，其烈性，只有胆独自承担。常见善于饮酒的人，一定浅斟慢酌，以等待腹中的渗透，如果连续快速干杯，则酒液倾囊而出。（喻嘉言）
酒，是五谷的津液，米曲的精华，虽然能益人，也能损人，为什么呢？酒有大热大毒。大寒凝结海水，只有酒不结冰，这就是它的热性；喝了容易昏沉，容易让人丧失本性，这就是它的毒性。如果避开风寒，宣通血脉，消除邪气，引导药势，没有什么比得上酒。如果醉酒过度，盆斗计量般豪饮，毒瓦斯攻心，穿肠腐胁，神志昏迷错乱，看不见人，这是丧生的根本原因。（《医方类聚》）
【补编】
酒，大热有毒，气味都属于阳，是无形的东西。如果伤了酒，只应当发散，出汗就好了，其次不如利小便，使湿气从上到下分消。现在治疗酒病，用酒症丸，以及牵牛子、大黄泻下，这是无形的元气生病，反而用泻下有形的阴血，错误非常严重。（《兰室秘藏》）
治疗酒病，宜发汗。如果利小便，火热之焰不肯下行。所以说：火郁结则发散它，用辛温药散发它，这是顺从其体性。由此可知利小便，则湿去热不去。如果动大便，尤为粗疏浅陋。因为大便是有形之物，酒是无形之物，从汗发散，比较合理，湿热俱去。所以治疗用苦温药，发散其火；佐以苦寒药，清除其湿。○按酒这种东西，气热而质湿，喝了昏醉易狂是因为热，宜用汗法去除；醒来后热去而湿留，只宜利小便而已。两者斟酌使用，葛花解酲汤备齐了。（王好古）
酒性虽热，体同于水。李东垣却说饮酒者是无形的东西，这也让人不能不怀疑；既然需要发汗利小便来去除它，怎么能说是无形的东西呢？（朱丹溪）
《准绳》书中，记载有人伤酒发热，治疗用补剂加葛根，仍然不禁其发散，极力称赞鸡距子的妙处。赵以德治疗酒病，用鸡距子而痊愈，就是这种植物。苏州叫它“密六曲”，徽州叫它“金钩子”，九月时有。（《折肱漫录》）
【伤食】
吃东西的欲望，想到盐梅的样子，就会流口水而不能禁止；看到盘中菜肴丰盛，就好像要吞咽而不能遏制。饿了想吃牛肉，渴了想喝海水，所以欲望对于人来说像贼一样，人对于欲望来说像战争一样。（谭子）
食物有三种消化：烹煮糜烂叫火化，细嚼缓咽叫口化，蒸变传送叫胃化。（秦西水）
应该少吃不要多吃，应该饥饿时吃不要吃饱时吃，应该慢吃不要快吃，应该热吃不要冷吃，应该零碎吃不要一顿吃，应该软吃不要硬吃。这六点，是调理脾胃的重要方法。（《冯氏锦囊》）
厌恶进食的人，心下痞闷，看见食物厌恶进食，严重时厌恶闻食物的气味。不能进食的人，心下不痞满，自己不能吃。饿了但不想吃的人，心下自然不喜欢吃，像饿的样子。（《医阶辨证》）
冷食伤血，热食伤气，饱食伤胃，饥食伤脾；带着怒气吃饭伤肝，吃饭时生气伤脾；意想不到的情况下吃饭伤脾，比平常加倍吃饭伤肠胃。○人醒着吃饭睡觉就不吃是怎么回事？人睁眼则卫气出外，闭眼则卫气入内。卫气出外，主管全身的动静行为，而脏腑空虚，所以需要饮食来辅助；卫气入内，则全身骨骼都安逸，气在脏腑中默默运行，所以不吃。因此醒着吃饭而睡觉就不吃了。（《医参》）
吃完饭容易饿，不是因为有火。因为脾胃以气为主，气属阳，脾胃的阳气已经虚弱，又被苦寒的药物，泻其阳气，则阳气更虚，而内部空竭，必须借助谷气来扶助，所以容易饿想吃东西，吃了也不能长出肌肉。《内经》说：饮食过量一倍，肠胃就会受伤。又说：饮食不能转化为肌肤。说的就是这个意思吧？（汪石山）
胃主受纳，脾司运化，所以不想吃东西都是中土（脾胃）生病。然而胃的土，体阳而用阴；脾的土，体阴而用阳。胃实则痞满、气胀，胃虚则饮食不甘；胃热则饥但不能食，胃寒则胀满不食。○胃满则肠虚，肠满则胃虚，虚实交替，气机才能正常运行。如果醉酒饱食过度，或感受风寒，或情绪恼怒，以致填塞胸中，胃气不行，忽然厥逆昏迷，口不能言，肢不能举，这名叫食厥。（《张氏医通》）
有胃气则生，无胃气则死。所以各种疾病如果能吃东西的，病情虽然重还可以挽救；不能吃东西的，病情虽然轻必定会拖延加重。然而有应当禁食和不应当禁食两种情况：比如伤寒邪气传入阳明，胃有燥热神昏谵语的；又如干霍乱的上下不通；或者正值吐泻之际；或者斑痧未透发于体表；或者瘟疫邪气客居膜原；或者疟邪交战之时；或者六淫邪气，充塞弥漫，呕恶痞胀；或者伤食恶食等证候，凡此种种禁止谷物食物是可以的。其余各种疾病不吃的，应当责之于胃阳虚、胃阴虚，或湿热阻气，或命门火衰。要知道淡饮淡粥，人都讨厌；或者辛或者咸，是人喜欢的。或者这个人平时喜欢的东西，也可以酌情给予，以唤醒胃气，只有酸腻甜浊不可进用。（《临证指南》）
【补编】
下利不想吃东西的，有宿食，应当泻下。○宿食在上脘，应当催吐，适宜用瓜蒂散。（《金匮要略》）
食物在上部的用吐法。《内经》说：上部有脉，下部无脉，其人应当吐而不吐的会死。因为阳火的根，本于地下；阴水的源，本于天上，所以说水出高源。食物填塞闷乱，则两寸脉必盛；源头堵塞水流穷尽，则两尺脉自绝。吐去上焦的食物，则金能生水，而肝木发生之气，也能畅达。○食物在中部的用消法。食物既已下膈进入胃，就不能吐，强行吐也不能全部吐出；也不宜立即用下药，下得太早则伤中气，而清纯冲和之气，一并随之陷下。所以杂病酒积，下得太早常做成痞气，应当以健脾消导为主。○食物在下部的用下法。如果有食积，肠腹绞痛，手不能按压的，不得不泻下。寒积用热药泻下，热积用寒药泻下。（《证治准绳》）
凡是水谷进入胃中，随着阳道上升，则化为液化为精；随着阴道下滑，只是完好的水和完好的谷物。○脾气不健，水谷挟带寒气填塞太阴，这不是真实的情况可以知道的。此处邪正分争扰攘，甚至拒关，则阴阳在上下往来的人，于是惊慌错乱，各抵关卡而奔还，形势使然。混乱实在起于中焦，所以安抚其中焦，只求恢复我少火之阳，不必祛除那冷食之伤，因为既然伤在食物，不可以再用药物伤害，这是清净画一的治疗原则。○食物填塞太阴，抑遏少阳之气，阻碍其升路，则腹部的胀痛，多连及胁部。食物填塞胃口，阻住膻中之气，阻碍其降路，则腹部的胀痛，多连及心部。部署虽然不同，总宜斟酌以卑监之土则温之，敦阜之土则平之。○五味进入胃，五脏都争着想要得到它，所依赖的是脾胃作调和，而各自归于它所喜好。攻使得长养于五脏的，是胃肠的力量。胃肠一虚，就成为失宰，以致所喜非所得，所得非所喜，口中的滋味，怎么能够甜美？稼穑既不作甘味，又怎么能够归形归化，以补精益气呢？所以滋味一旦失去，寒热就容易产生，因为中气虚寒，阳气向外迁徙，没有定处。意欲招回此阳，使得温里宣外，仍主宰其职，则非理中汤不可。○脾虚不磨，是由于胃阳不运。凡是阳虚的人，诸阴都得以凑集，冷食的损伤，阴邪内犯，而寒中。所以散寒行滞，燥湿舒脾，可以兼施，要紧的不外乎以温法为主是正确的。（程郊倩）
饮食虽然进入中焦，其变化精微，实际依赖少火上蒸。中年之后，大病之余，元阳亏损，不能熟腐水谷，因而衰馁，易于停食，作痞作痛，为呕为泻，宜补火生土。譬如釜底加薪，水谷容易煮熟。（《玉机微义》）
虚人饮食所伤，及外感暴病新愈之后，当用六君子汤，以理胃为主。内伤劳倦，及久病之后，当用补中益气汤，以理脾为主。理脾则百病不生，不理脾则诸病续起。○老人、虚人，易于伤食，或膨胀痞闷，或腹满作泻，当消补兼施，宜常服资生丸。○伤食后，健脾须用枳术丸，合天行健之意。健者动也，内有枳实之动，能助脾之消磨运动耳。（李东垣）
饥饿不饮食与饮食太过，虽然都失节，然而必须明白二者的区别：饥饿胃虚，此为不足；饮食停滞，此为有余。正因为不足，所以宜补益；正因为有余，所以宜消导，人的盛衰不同。又有物滞气伤，必须补益消导兼行的；也有物暂滞而气不甚伤，宜消导独行，不须补益的；也有既停滞而复自化，不须消导，但当补益的。易老枳术丸，虽然说消导，固有补益之意存乎其间。若有形之物，非枳术丸所能去，则备急丸之类推逐而去之。观此则知消导补益的道理了。（朱丹溪）
当今医生，以平胃散出入增减，作为调脾胃的准则。所谓平胃，就是胃中高阜，则使之平，一平即止，不可过量，过量则反成坎陷。而枳术丸尤其严重，今人以此丸为补脾的药，朝服暮饵，再加橘皮、半夏、香附、砂仁，那就更严重了。至于山楂、神曲、麦芽，世人常用，山楂能化肉积，产妇儿枕痛的，煎服立化。不可轻用神曲的，因为米和水在瓷缸中，借曲以酿成酒，借麴以酿成糖；人身脾胃非瓷缸可比，原有化食之能，今食不化，其所能者病也，只补助其能而自化。（《赵氏医贯》）
[Scriptural Principles]
Human beings rely on water and grain (diet) as the foundation of life; therefore, if a person is deprived of water and grain, they will die. ○ When food enters the stomach, its refined essence is dispersed to the Liver, nourishing the sinews; when food enters the stomach, its turbid essence returns to the Heart, permeating the vessels; vessel qi flows through the meridians, and meridian qi converges in the Lungs; the Lungs direct all vessels, distributing essence to the skin and hair; the essence of the skin and vessels combines, circulating qi through the six Fu organs; the Fu organs' spirit and brightness remain in the five Zang organs, and qi returns to a state of balance and coordination.
When drink enters the stomach, its floating and overflowing refined essence is transported upward to the Spleen; the Spleen disperses the essence, sending it upward to return to the Lungs; [the Lungs] regulate the water passages, transporting it downward to the Bladder; water essence distributes to all four directions, and the five channels run in parallel. ○ Food entering the Yin aspect promotes the growth of Yang qi. ○ If diet doubles in quantity, the intestines and stomach will be injured. ○ Pathogenic factors from water and grain, when invaded, will harm the six Fu organs. ○ The Stomach is the sea of water and grain, and the great source of the six Fu organs. The five flavors enter the mouth, are stored in the Stomach, and nourish the Qi of the five Zang organs. ○ After the five flavors enter the Stomach, each returns to its preferred organ. Thus, sourness first enters the Liver, bitterness first enters the Heart, sweetness first enters the Spleen, acridity first enters the Lungs, and saltiness first enters the the Kidneys. Long-term consumption increases the Qi of the corresponding organs, which is the normal law of transformation. However, if Qi increases excessively and persists for a long time, it becomes the cause of premature death. ○ The Liver's color is green, and it is suitable to eat sweet foods; rice, beef, dates, and okra are all sweet. The Heart's color is red, and it is suitable to eat sour foods; adzuki beans, dog meat, plums, and leeks are all sour. The Lungs' color is white, and it is suitable to eat bitter foods; wheat, mutton, apricots, and wild garlic are all bitter. The Spleen's color is yellow, and it is suitable to eat salty foods; soybeans, pork, chestnuts, and bean leaves are all salty. The Kidneys' color is black, and it is suitable to eat acrid foods; yellow millet, chicken, peaches, and scallions are all acrid. Acridity disperses, sourness astringes, sweetness moderates, bitterness hardens, and saltiness softens. Toxic drugs attack pathogens, five grains provide nourishment, five fruits assist, five meats benefit, and five vegetables fill. Consuming them with combined flavors supplements essence and benefits Qi. ○ Acridity moves Qi; in Qi diseases, do not consume much acridity. Saltiness moves Blood; in Blood diseases, do not consume much saltiness. Bitterness moves to the bones; in bone diseases, do not consume much bitterness. Sweetness moves to the flesh; in flesh diseases, do not consume much sweetness. Sourness moves to the sinews; in sinew diseases, do not consume much sourness. ○ The generation of Yin essence originates from the five flavors; the injury to the five palaces of Yin also comes from the five flavors. Excessive sourness causes Liver Qi to overflow and Spleen Qi to fail; excessive saltiness causes fatigue of the large bones, shortening of muscles, and suppression of Heart Qi; excessive sweetness causes Heart Qi panting and fullness, black complexion, and imbalance of Kidney Qi; excessive bitterness causes Spleen Qi to lack moisture and Stomach Qi to become thick; excessive acridity causes sinews and vessels to relax and deteriorate, and spirit to be damaged. ○ Excessive saltiness causes blood vessels to coagulate and change color; excessive bitterness causes dry skin and falling hair; excessive acridity causes tight sinews and withered nails; excessive sourness causes calloused flesh and everted lips; excessive sweetness causes bone pain and hair loss. (From *Su Wen*)
The Yellow Emperor asked: When a timid person drinks wine and becomes angry without avoiding brave warriors, which Zang organ causes this? Shao Yu replied: Wine is the essence of water and grain, the liquid of cooked grain; its Qi is fierce. When it enters the Stomach, it causes Stomach distension, and Qi rebels upward, filling the chest; the Liver floats and the Gallbladder spreads horizontally. At this time, one's momentum is indeed stronger than that of a brave warrior, but after the Qi declines, regret follows. This is called "wine rebellion" (Jiu Bei). (From *Ling Shu*)
[Philosophical Remarks]
The *Classic* states: Cold and heat from water and grain, when invaded, harm the six Fu organs. It also states: Yin Qi, when quiet, stores the spirit; when agitated, the spirit perishes. Doubling the diet injures the intestines and stomach. This is a general statement. Dividing it into two: Drink and Food. Drink is water, formless. The *Classic* further states: Drinking excessively causes Qi rebellion; cold form and cold drink injure the Lungs. Lung disease manifests as wheezing, coughing, edema, and diarrhea. Mild cases use sweating and diuresis to eliminate dampness from top to bottom; severe cases with accumulation and fullness use purgation. Food is substance, formed. The *Classic* states: Overeating leads to relaxed sinews and vessels, and hemorrhoids in the intestines. It also states: Food injuring the Taiyin and Jueyin meridians, where the Cun Kou pulse is two to three times larger than the Ren Ying pulse, or presenting with vomiting, stuffiness and fullness, or diarrhea and borborygmus. Treatment distinguishes between cold and heat and severity. Mild cases use internal resolution; severe cases use purgation; some are suitable for emesis. The *Classic* states: For pathogens above, use emesis to expel them. However, medication must not be overdosed; overdose will damage the Spleen and Stomach. Since the injury was originally caused by diet, adding excessive medication re-injures the Spleen and Stomach, making Qi transformation even more difficult and digestion harder. (Li Dongyuan)
When water and grain enter the Stomach, the turbid part becomes dregs, exits through the pylorus, reaches the large and small intestines to become feces, and exits via the anus; the clear part transforms into Qi, rising to the Lungs; the clearest and most refined part, irrigated by the Lungs to the four limbs, becomes sweat, fluid, saliva, assisting the blood vessels and benefiting strength, constituting the endless operation of life; the turbid part within the clear descends into the Bladder to become urine, exiting via the urethra; what has not entered and remains outside the Bladder is still turbid Qi, while what has entered inside the Bladder transforms into water. (*Yi Xue Zheng Zhuan*)
Various grains entering the Stomach, although initially sour, bitter, sweet, acrid, salty, and bland, eventually transform into sourness, as sour belongs to Wood. Just as grains enter the Stomum, it is like spring generation. I have seen food vomited shortly after eating is necessarily sour; after another interval, it becomes bitter. Bitter corresponds to summer, and the flavor has changed twice. After another interval, it becomes sweet, representing the heaven of transformation. At this time, the clear part becomes Qi, Jin, Ye, Marrow, and Blood; the turbid part becomes stool and urine, clearly distinguished. Receiving the autumn acrid dispersal, everything inside and outside, above and below, finds its place. If lacking autumn acridity, urine will be like honey, losing the fourth transformation. If Qi and Blood each return to their paths, this is winter storage, and the flavor harmonizes with saltiness; sweat, blood, eye discharge, nasal mucus, and urine are all salty. This is the fifth flavor transformation, completing the beginning and end of grain transformation. The *Classic* says the official of granaries (Spleen/Stomach) produces the five flavors; this is what is meant. (Lu Buyuan)
[Alcohol Injury]
Wine is the liquid of water and grain, and blood is also the liquid of water and grain; wine entering the Middle Jiao seeks its kind, thus going directly to the Blood level. The *Classic* says: Those who drink wine, Wei Qi first travels through the skin, first filling the collaterals; this is what is meant. However, blood is the spirit and Qi; blood belongs to Yin and is gentle in nature. Wine is licentious Qi; wine belongs to Yang and is fierce in nature. Whenever wine enters the Blood level, Blood desires stillness but Wine agitates it; Blood desires storage but Wine pursues it. Therefore, drinkers have red bodies and faces; this is the sign of wine entering Blood, and also the sign of dispersing Blood. ○ Wine is essentially a drug of madness, severely damaging True Yin. Only drinking moderately may have benefits; drinking excessively inevitably causes harm; indulging in drinking results in harm nine or ten times out of ten. Moreover, everyone's constitution has Yin and Yang in the Zang organs, and wine's nature also has Yin and Yang. Wine is formed by fermentation; its nature is hot, but its juice transforms from water, so its quality is cold. If a Yin-deficient person indulges in drinking, the quality cannot nourish Yin, but the nature偏 (deviates) to move Fire, so heat becomes hotter, leading to hematemesis, epistaxis, hematochezia, hematuria, wheezing/cough, irritability, and madness. This is due to wine nature damaging Yin. If a Yang-deficient person indulges in drinking, the nature cannot support Yang, but the quality remains as water-dampness, so cold becomes colder, leading to drum distension, diarrhea, abdominal pain, acid regurgitation, anorexia, Yang collapse, and sudden collapse. This is due to wine quality damaging Yang. Thus, indulging in wine damages both Yin and Yang, causing such great harm. (Zhang Jingyue)
Wine is a clear and cool substance, not descending with turbidity, but preferring to penetrate. The area of penetration starts from the Stomach entering the Gallbladder; the Gallbladder is a pure and clear Fu organ, seeking similar Qi, but the Gallbladder's capacity is small; next, from the Stomach entering the Intestines, the Bladder penetrates, transforming mostly into urine. Once transformed into urine, what remains is the residual quality of wine, whose烈性 (fierce nature) is borne solely by the Gallbladder. I often see good drinkers sipping slowly to wait for abdominal penetration; if they gulp several cups in succession, the wine pours out like an empty bag. (Yu Jiayan)
Wine is the fluid of five grains, the flower of rice and yeast; although it can benefit people, it can also harm them. Why? Wine has great heat and great toxicity. In great cold that freezes the sea, only wine does not freeze; this is its heat. Drinking easily causes dizziness and alters one's true nature; this is its toxicity. To avoid wind and cold, promote blood circulation, eliminate pathogens, and guide medicinal potency, nothing surpasses wine. But if drunk to excess, measured in basins and dou, toxic vapors attack the heart, corroding intestines and ribs, causing confusion and delirium, blindness, this is the root of death. (*Yi Fang Lei Ju*)
[Supplement]
Wine is greatly hot and toxic, with flavors belonging entirely to Yang, and is a formless entity. If injured by wine, one should only disperse; sweating cures it. Next best is promoting urination to eliminate dampness from top to bottom. Currently, treating wine disease with Jiu Zheng Wan, or using Qian Niu (Pharbitis Seed) and Da Huang (Rhubarb) to purge, treats formless Yuan Qi illness but wrongly purges formed Yin Blood; this is a grave error. (*Lan Shi Mi Cang*)
Treating wine disease should involve sweating. If promoting urination, the flame of fire refuses to go down. Thus it is said: Fire郁 (stagnation) should be dispersed; use acrid-warm herbs to disperse, following its nature. Knowing this, promoting urination removes dampness but not heat. Moving the bowels is even more crude. Bowel movements are formed substances; wine is a formless substance. Dispersing via sweat is reasonable, eliminating both dampness and heat. Thus treat with bitter-warm to disperse fire; assist with bitter-cold to remove dampness. ○ Regarding wine: Qi is hot, quality is damp. Dizziness and drunkenness from drinking are due to heat; use sweat to remove it. After waking, heat is gone but dampness remains; only promote urination. Use both appropriately; Ge Hua Jie Cheng Tang is complete. (Wang Haogu)
Although wine nature is hot, its body is like water. Li Dongyuan said drinkers are formless entities; this is doubtful. If it needs sweating and diuresis to remove, how can it be called formless? (Zhu Danxi)
The book *Zhun Sheng* records a case of alcohol-induced fever treated with tonics plus Ge Gen (Kudzu Root), yet dispersion was not stopped, highly praising the efficacy of Ji Ju Zi (Caltrop Fruit). Zhao Yi De cured wine disease with Ji Ju Zi, which is this plant. Called "Mi Liu Qu" in Suzhou, "Jin Gou Zi" in Huizhou, available in September. (*Zhe Gong Man Lu*)
[Food Injury]
The desire for food: thinking of the shape of salt and plum causes salivation uncontrollably; seeing abundant dishes makes one feel like swallowing uncontrollably. Hungry, one wants to eat beef; thirsty, one wants to drink the sea. Thus desire is like a thief to humans, and humans are like warriors against desire. (Tan Zi)
Food has three transformations: cooking until soft is Fire Transformation; chewing slowly is Mouth Transformation; steaming and transporting is Stomach Transformation. (Qin Xishui)
Prefer less over more; prefer eating when hungry over eating when full; prefer slow eating over fast eating; prefer hot over cold; prefer small frequent meals over large single meals; prefer soft over hard. These six points are key methods for regulating Spleen and Stomach. (*Feng Shi Jin Nang*)
Those who dislike eating have epigastric stuffiness and fullness, dislike seeing food, and in severe cases dislike the smell of food. Those who cannot eat have no epigastric fullness but simply cannot eat. Those who are hungry but do not want to eat have no desire in the epigastrium, appearing hungry. (*Yi Jie Bian Zheng*)
Cold food injures Blood; hot food injures Qi; overeating injures the Stomach; eating while hungry injures the Spleen; eating while angry injures the Liver; getting angry while eating injures the Spleen; unexpected eating injures the Spleen; doubling usual intake injures the intestines and stomach. ○ Why do people eat when awake and not when asleep? When eyes are open, Wei Qi goes out; when closed, Wei Qi goes in. When Wei Qi goes out, it governs movement and action of the whole body, leaving Zang-Fu empty, requiring food to assist; when Wei Qi goes in, all bones rest, and Qi silently circulates in Zang-Fu, hence no eating. Thus, eating when awake and not when asleep. (*Yi Can*)
Easily becoming hungry after eating is not due to Fire. Spleen and Stomach are dominated by Qi; Qi belongs to Yang. If Spleen-Stomach Yang is already deficient, and bitter-cold medicines drain Yang, Yang becomes more deficient, and the interior empties, requiring Grain Qi to assist, hence easy hunger and desire to eat, though eating does not generate flesh. The *Classic* says: Doubling diet injures intestines and stomach. It also says: Diet does not become flesh. This is what is meant. (Wang Shishan)
Stomach receives and holds; Spleen transports and transforms; thus anorexia is always a disease of the Central Earth (Spleen/Stomach). However, Stomach Earth is Yang in body and Yin in function; Spleen Earth is Yin in body and Yang in function. Stomach excess causes stuffiness and distension; Stomach deficiency makes food tasteless. Stomach heat causes hunger but inability to eat; Stomach cold causes distension and inability to eat. ○ Full Stomach means empty Intestines; full Intestines mean empty Stomach; alternating excess and emptiness allows Qi to reside. If overeating/drinking, or catching wind-cold, or emotional anger causes blockage in the chest, Stomach Qi fails to move, suddenly leading to syncope, coma, inability to speak, and inability to move limbs; this is named Food Syncope (Shi Jue). (*Zhang Shi Yi Tong*)
Having Stomach Qi means life; lacking Stomach Qi means death. Thus, in all diseases, if the patient can eat, even if severe, it can be saved; if unable to eat, even if mild, it will worsen. However, there are indications for fasting and non-fasting. For example, in Shanghan transmitting to Yangming with dry-heat, confusion, and delirium; or Gan Huoluan (dry cholera) with upper/lower blockage; or during vomiting/diarrhea; or when macules/rashes have not erupted; or plague pathogens in Mo Yuan; or Malaria pathogen battle; or six excess pathogens filling and diffusing, causing vomiting, nausea, stuffiness, and distension; or food injury and aversion to food; in these cases, withholding grain/food is appropriate. For other diseases where patients cannot eat, blame Stomach Yang deficiency, Stomach Yin deficiency, damp-heat blocking Qi, or Mingmen Fire decline. Know that light drinks and light porridge are disliked by all; spicy or salty foods are liked. Or familiar foods of the person can be given酌情 (appropriately) to awaken Stomach Qi; only sour, greasy, sweet, and turbid foods should be avoided. (*Lin Zheng Zhi Nan*)
[Supplement]
Diarrhea with loss of appetite indicates retained food; purgation is indicated. ○ Retained food in the Upper Jiao requires emesis; Gua Di San (Melon Peduncle Powder) is suitable. (*Jin Gui Yao Lue*)
Food in the upper part uses emesis. The *Classic* says: Pulse present above, absent below; if the person should vomit but does not, they die. Because the root of Yang Fire is underground; the source of Yin Water is heavenly; thus "Water comes from high source." Food blockage causes fullness/confusion, making both Cun pulses strong; source blocked, flow exhausted, making both Chi pulses vanish. Vomiting upper Jiao substances allows Metal to generate Water, and Liver Wood generating Qi to flow freely. ○ Food in the middle part uses resolution. Once food passes the diaphragm into the Stomach, it cannot be vomited; forced vomiting won't expel all; nor should purgatives be used hastily; early purgation injures Middle Qi, and pure/harmonious Qi sinks with it. Thus, miscellaneous diseases with wine accumulation, if purged too early, often become Pi Qi (stuffiness masses); focus on strengthening Spleen and resolving stagnation. ○ Food in the lower part uses purgation. If food accumulation causes colic and abdominal pain, unpressable, purgation is necessary. Cold accumulation uses warm purgatives; heat accumulation uses cold purgatives. (*Zheng Zhi Zhun Sheng*)
Whenever water and grain enter the Stomach, ascending via Yang Dao transforms into fluid and essence; descending via Yin Dao remains as complete water and complete grain. ○ If Spleen Qi is not robust, water and grain carrying cold fill the Taiyin; this is not truly known. Here, evil and righteous Qi struggle and disturb; if rejecting the gate, the interaction of Yin and Yang above and below becomes panicked and chaotic, rushing back at the gates, driven by circumstances. Chaos actually arises in the Middle Jiao; thus soothe the Middle Jiao, seeking only to restore my Shao Huo (Ministerial Fire) Yang; do not need to dispel the cold food injury, because since it is injured by food, do not injure further with medicine; this is the treatment of purity and unity. ○ Food filling Taiyin suppresses Shaoyang Qi, hindering its ascent, causing abdominal distension/pain often extending to hypochondrium. Food filling Stomach opening blocks Tan Zhong Qi, hindering its descent, causing abdominal distension/pain often extending to the heart. Although deployment differs, generally use Bei Jian Earth to warm, Dun Fu Earth to level. ○ Five flavors entering the Stomach, all five Zang organs compete to obtain them; relying on the Spleen/Stomach as mediators to return each to its preference. What nourishes the five Zang organs is the power of intestines and stomach. If intestines/stomach are deficient, the master is lost, so what is preferred is not obtained, and what is obtained is not preferred; how can taste be sweet? If Spleen/Stomach do not produce sweetness, how can forms transform to supplement essence and benefit Qi? Thus, once taste is lost, cold/heat arise easily, because Middle Qi is deficient and cold, Yang shifts outward without fixed location. Intent to召回 (recall) this Yang to warm interior and disseminate exterior, resuming its duty, requires Li Zhong Tang. ○ Spleen deficiency failing to grind is due to Stomach Yang failing to transport. All Yang-deficient persons allow Yin to gather; cold food injury, Yin evil invading internally, causes Cold Middle. Thus, dispersing cold, moving stagnation, drying dampness, and relaxing Spleen can be combined; primarily warming is correct. (Cheng Jiaoqian)
Although diet enters the Middle Jiao, its transformation into refined essence relies on Shao Huo steaming upward. After middle age, or after major illness, Yuan Yang is depleted, unable to cook/rotten water and grain, leading to decline, easy food retention, forming Pi masses and pain, vomiting and diarrhea; suitable to tonify Fire to generate Earth. Like adding fire to the stove, water and grain cook easily. (*Yu Ji Wei Yi*)
For deficient persons injured by diet, or newly recovered from acute external contraction, use Liu Jun Zi Tang (Six Gentlemen Decoction), focusing on regulating Stomach. For internal injury from fatigue, or after chronic illness, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), focusing on regulating Spleen. Regulating Spleen prevents hundred diseases; failing to regulate Spleen leads to continuous diseases. ○ Elderly and deficient persons easily suffer food injury, or distension/stuffiness, or abdominal fullness/diarrhea; combine resolving and tonifying, regularly服用 (take) Zi Sheng Wan. ○ After food injury, strengthening Spleen requires Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Pill), incorporating the meaning of Tian Xing Jian (Heavenly Movement Strength). Jian means movement; containing Zhi Shi (Immature Bitter Orange) movement assists Spleen's digestion and motion. (Li Dongyuan)
Hunger/not eating and overeating are both irregularities, but distinguish them: Hunger/Stomach deficiency is insufficiency; Food stagnation is excess. Because insufficiency, tonification is suitable; because excess, resolution is suitable; human prosperity/decline differs. Some have material stagnation and Qi injury, requiring combined tonification and resolution; some have temporary material stagnation with slight Qi injury, requiring resolution alone without tonification; some have stagnation that self-resolves, requiring no resolution, only tonification. Yi Lao's Zhi Zhu Wan, though called resolution, contains intent of tonification. If formed substances cannot be removed by Zhi Zhu Wan, then Bei Ji Wan type pushes them out. Observing this reveals the principles of resolution and tonification. (Zhu Danxi)
Current physicians use Ping Wei San (Calm the Stomach Powder) with modifications as the standard for regulating Spleen/Stomach. "Ping" (Calm) means flattening the high mounds in the Stomach; flatten once and stop, do not overdose; overdose creates depression. Zhi Zhu Wan is especially problematic; moderns use it as a Spleen-tonifying pill, taking morning and evening, adding Chen Pi (Tangerine Peel), Ban Xia (Pinellia), Xiang Fu (Cyperus), and Sha Ren (Amomum); this is even worse. As for Shan Zha (Hawthorn), Shen Qu (Medicated Leaven), and Mai Ya (Malt), commonly used by world: Shan Zha resolves meat accumulation; for postpartum childbed pain decoction, it dissolves immediately. Do not lightly use Shen Qu; rice and water in porcelain jars use Qu to brew wine, use Qu to brew sugar; human Spleen/Stomach are not porcelain jars, originally having the ability to digest food; now food not digested, the ability is diseased; only assist the ability and it self-digests. (*Zhao Shi Yi Guan*)