癸丑岁。予随王府承应至瓜忽都地面住冬。有博兔赤马刺。约年三旬有余。因猎得兔。以火炙
食之。各人皆食一枚。惟马刺独食一枚半。抵暮至营。极困倦渴。饮 乳斗余。是夜腹胀如鼓。
疼痛闷乱。卧而欲起。起而复卧。欲吐不吐。欲泻不泻。手足无所措。举家惊慌。请予治之。具说饮
食之由。诊其脉。气口大一倍于人迎。乃应食伤太阴经之候也。右手关脉又且有力。盖烧肉干燥。因而多食则致渴饮。
干肉得 乳之湿。是以滂满于肠胃。肠胃乃伤、非峻急之剂则不能去。遂以备急丸五粒。觉腹中转失气。欲利不
利。复投备急丸五粒。又与无忧散五钱。须臾大吐。又利十余行。皆物与清水相合而下。约二斗余
。腹中空快。渐渐气调。至平旦。以薄粥饮少少与之。三日后。再以参术之药调其中气。七日而愈
。或曰。用峻急之药。汝家平日所戒。今反用之何也。予对曰。理有当然。不得不然。内经曰。水
谷入口。则胃实而肠虚。食下则肠实而胃虚。更虚更实。此肠胃传化之理也。今饮食过节。肠胃俱
实。胃气不能腐熟。脾气不能运化。三焦之气不能升降。故成伤也。大抵内伤之理。伤之微者。但
减食一二日。所伤之物自得消化。此良法也。若伤之稍重者。以药。内消之。伤之大重者。以药除下
之。痹论有云、阴气者静则神藏。躁则消亡。饮食自倍。肠胃乃伤。今因饮食太过。使阴气躁乱。
神不能藏。死在旦夕矣。孟子云。若药不瞑眩。厥疾弗瘳。峻急之剂。何不可用之有。或者然之。
癸丑年，我跟随王府的差役前往瓜忽都地区过冬。那里有一位名叫赤马刺的猎兔人，年龄三十多岁。他因为打猎抓到兔子，用火烤熟后食用。每个人都吃了一只，只有赤马刺一个人吃了一只半。到了傍晚回到营地时，他感到极度疲倦和口渴，喝了一斗多牛奶。当晚，他的腹部胀得像鼓一样，疼痛且心烦意乱，想躺下又想起来，想吐吐不出来，想拉拉不出来，手足无措，全家惊慌失措，请我去诊治。他详细说明了饮食经过。诊察他的脉象，气口脉比人迎脉大一倍，这是饮食损伤太阴经的典型脉候。右手关脉又显得有力，这是因为烤肉干燥，多吃导致口渴饮水；干肉遇到牛奶的湿气，因此在肠胃中膨胀充满。肠胃因此受伤，非用峻猛急迫的药物不能去除病邪。于是给他服用了五粒备急丸，感觉腹中有肠鸣排气，但想排便却排不出。又给他服用五粒备急丸，随后又给予五钱无忧散。不久后，他剧烈呕吐，接着腹泻十多次，排出物都是食物残渣与清水混合，大约两斗多。腹部变得空虚轻快，气息逐渐调和。到了第二天清晨，少量多次地喂他喝稀薄的米粥。三天后，再用党参、白术等药物调理中焦之气，七天后痊愈。有人问：使用峻猛急迫的药物，是你家平日所忌讳的，现在反而使用，为什么呢？我回答说：道理本该如此，不得不这样做。《内经》说：“水谷入口，则胃实而肠虚；食下，则肠实而胃虚。”虚实交替，这是肠胃传导消化的规律。如今饮食过量，肠胃都变得充实，胃气不能腐熟食物，脾气不能运化水谷，三焦之气不能正常升降，所以造成损伤。大抵内伤的机理，损伤轻微的，只要减少饮食一两天，所伤之物自然能消化，这是良法。如果损伤稍重的，用药在内消散解；损伤非常严重的，用药攻下排除。《痹论》中说：“阴气者，静则神藏，躁则消亡。”饮食加倍，肠胃就会受伤。如今因饮食太过，使阴气躁动紊乱，神气不能潜藏，死亡就在旦夕之间了。孟子说：“如果服药后没有瞑眩反应，那种重病就不会痊愈。”峻猛急迫的药物，有什么不可以用的呢？那人认为我说得对。
In the year of Guichou, I accompanied the attendants of the Prince's mansion to spend the winter in the region of Guhudu. There was a rabbit hunter named Chima Ci, who was over thirty years old. Having caught rabbits through hunting, he roasted them over fire and ate them. Each person ate one rabbit, but Chima Ci alone ate one and a half. By dusk, upon returning to the camp, he felt extremely exhausted and thirsty, drinking more than a dou of milk. That night, his abdomen became distended like a drum, accompanied by pain, restlessness, and confusion. He wanted to lie down yet also wanted to get up; he wanted to vomit but could not, and wanted to defecate but could not. His hands and feet were at a loss. The whole family was panicked and summoned me for treatment. He detailed the circumstances of his diet. Upon examining his pulse, the Qi Kou pulse was twice as large as the Ying Shou pulse, which is the characteristic sign of food injury affecting the Taiyin Meridian. The Guan pulse on the right hand was also forceful, likely because the roasted meat was dry; consuming too much led to thirst and excessive drinking of milk. The dry meat combined with the dampness of the milk, causing it to swell and fill the intestines and stomach. The stomach and intestines were thus injured, and only harsh and urgent remedies could eliminate the pathogen. Therefore, I administered five pills of Beijji Wan (Emergency Rescue Pill). He felt gas moving in his abdomen and desired to defecate but could not. I then administered another five pills of Beijji Wan, followed by five qian of Wuyou San (Worry-Free Powder). Shortly after, he experienced severe vomiting, followed by more than ten episodes of diarrhea. The excreta consisted of undigested food mixed with clear water, totaling approximately two dou. His abdomen felt empty and relieved, and his qi gradually harmonized. By dawn, I fed him thin rice gruel in small amounts repeatedly. Three days later, I used herbs such as Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome) to regulate the middle jiao qi. He recovered completely after seven days. Someone asked, "Using harsh and urgent medicines is something your family usually forbids. Why use them now?" I replied, "The principle dictates this necessity. The *Neijing* states: 'When water and grain enter the mouth, the stomach becomes full while the intestines are empty; when food is swallowed, the intestines become full while the stomach is empty.' This alternation of emptiness and fullness is the mechanism of digestion and transportation in the stomach and intestines. Now, due to excessive eating, both the stomach and intestines are overly full. The Stomach Qi cannot rot and ripen the food, the Spleen Qi cannot transform and transport nutrients, and the Qi of the Triple Burner cannot ascend and descend properly, resulting in injury. Generally speaking, regarding the pathology of internal injury: if the injury is slight, reducing food intake for one or two days allows the damaged matter to digest naturally, which is a good method. If the injury is moderate, medicine should be used to resolve it internally. If the injury is severe, medicine should be used to purge it downwards. The *Bilun* chapter states: 'Yin Qi, when still, keeps the spirit contained; when agitated, the spirit dissipates.' When food intake doubles, the stomach and intestines are injured. Now, due to excessive diet, the Yin Qi has become agitated and chaotic, and the spirit cannot be contained, leading to imminent death. Mencius said, 'If the medicine does not cause dizziness and vertigo (mingxuan reaction), the serious disease will not be cured.' What is wrong with using harsh and urgent medicines?" The person agreed with my reasoning.