膈噎之症。内经止有三阳结谓之膈一句。子和从而释之。谓三阳者。大小
肠膀胱也。结则二阴不利。津液不行。故逆反而上。其言病机则得矣。而三
阳所以致结之故。则未始推及。至张鸡峰云是神思间病。惟内观静养。可
以却之。斯乃切中病情。盖此恙多由忧愁思虑。伤于心脾。血液不生。日渐
煎熬。肝火弥炽。肾水益枯。五脏之阴既竭。六腑之阳安得独足。于是槁在
上而为噎。槁在下而为膈。譬之江河阻塞。而饷道不通。有仰食不获而待
命矣。此时而浚其流。不若疏其源。然后水从天际而下。飞FS 立送。复循故
道也。故患膈噎者。欲嘘既槁之血液而复生之。莫若屏七情。绝嗜好。远帏
幕。心似已灰木。身如不系舟。奴枯禅老寂。而后静能胜动。水升火降。津液
渐行。庶出约有常。长享天命。谁谓治膈之大丹。不取诸身而足哉。舍此而
欲他求。惟有养血生津。开郁理气。佐以降火。或一法也。李绛兵部手集。用
人参三两取汁。入粟米鸡子白薤白。煮粥与啖。取其润滑而通阳明。最称
神效。至王太仆以食刹即出。食入反出。分有火无火之别。尤当参而调之。
毕竟此疾多得于忧患之人。而安逸者未尝有。则知药石之不胜病也。夏审矣。
地髓煎 治血枯便燥结。
生地黄（一斤） 鹿角胶（二两四钱） 生姜（八钱绞汁） 白蜜（二合） 酒（四合） 紫苏子（四钱酒研）
文武火煮地黄成膏。去滓。即以酒研苏子入煎。一二十沸下胶。胶化。下
姜汁蜜再煎。候稠。瓦器盛之。酒化下。
大半夏汤 治胃反呕吐痰盛者。
半夏（五钱） 人参（三钱） 白蜜（二钱）
水二钟。和蜜扬之百遍。煎服。
和胃汤
人参（一钱半） 黄连（六分土炒） 当归（一钱） 黄芩（七分土炒） 白芍药（一钱酒炒）
茯神（一钱） 石菖蒲（五分） 神曲（七分） 半夏（七分） 枳实（麸炒四分） 红花（三分） 苏子（一钱五分）
用陈壁土研细。搅入长流水。澄清煎药。入姜汁白蜜少许。童便一二匙和服。
膈噎这一病症，《黄帝内经》中只有一句记载：“三阳结谓之膈”。刘河间（名完素，号守真，金元四大家之一，此处原文作“子和”，实为误记或通假，通常指刘河间或张从正，但根据后文“子和从而释之”及内容风格，多指张从正《儒门事亲》中的观点，然张从正字子和。此处依原文翻译）接着对此进行解释。他说所谓的“三阳”，是指大肠、小肠和膀胱。如果这三腑气机郁结，就会导致二阴（前阴和后阴）排泄不利，津液无法正常运行，因此气逆而上行。这种说法在阐述病机方面是准确的，但对于三阳之所以会郁结的原因，却未曾深入推究。到了张鸡峰（张杲，字季明，号鸡峰山人）说这是精神情志方面的疾病，只有通过内省观察、静心修养，才能消除它。这确实切中了病情的要害。大概这种病症多由忧愁思虑引起，损伤心脾，导致血液生成不足，日久煎熬，肝火更加炽盛，肾水日益枯竭。五脏的阴气既然已经耗尽，六腑的阳气怎么能单独充足呢？于是上面干枯就形成噎证，下面干枯就形成膈证。这就好比江河阻塞，粮道不通，有人仰面进食却无法获得，只能等待命运安排。在这个时候，疏通下游的水流，不如疏浚上游的源头，然后雨水从天际落下，飞流直下，重新遵循旧的河道。所以患有膈噎的人，想要让已经干枯的血液重新生长，不如摒弃七情（喜、怒、忧、思、悲、恐、惊），断绝嗜好，远离声色犬马，使心境像死灰枯木一样平静，身体像无系之舟一样自在，像奴仆侍奉禅宗老人那样寂静清苦，这样之后静止能战胜躁动，肾水上升，心火下降，津液逐渐运行，庶几能符合自然规律，长久享有天命。谁说治疗膈噎的大丹，不取自于自身修养就足够了呢？舍弃这些而想要向其他地方寻求治疗方法，只有养血生津，开郁理气，辅助以降火，或许是一种方法。李绛兵部的手集里，用人参三两取汁，加入小米、鸡蛋清、薤白，煮粥给病人吃，取其润滑以通畅阳明经，最为称颂神效。至于王太仆（王冰，唐代医家，注《黄帝内经素问》）认为食入即出与食入反出，分为有火和无火的区别，尤其应当参考并调和。毕竟这种疾病多得于忧患之人，而安逸的人从未有过，由此可知药物石疗不能完全胜过疾病，道理已经很明白了。
地髓煎：治疗血枯导致的便秘燥结。
生地黄（一斤）、鹿角胶（二两四钱）、生姜（八钱，绞取汁液）、白蜜（二合）、酒（四合）、紫苏子（四钱，用酒研磨）。
用文武火煮地黄成膏状，去掉渣滓，随即用酒研磨的苏子加入煎煮，沸腾一二十次后加入胶，胶融化后，加入姜汁和蜂蜜再煎，等到稠厚时，用瓦器盛装。服用时用酒化开送服。
大半夏汤：治疗胃反呕吐且痰湿盛者。
半夏（五钱）、人参（三钱）、白蜜（二钱）。
用水二钟，混合蜂蜜搅拌一百遍，煎煮后服用。
和胃汤
人参（一钱半）、黄连（六分，土炒）、当归（一钱）、黄芩（七分，土炒）、白芍药（一钱，酒炒）、茯神（一钱）、石菖蒲（五分）、神曲（七分）、半夏（七分）、枳实（麸炒四分）、红花（三分）、苏子（一钱五分）。
用陈壁土研细，搅入长流水，澄清后煎药，加入少许姜汁和白蜜，再用童便一二匙混合服用。
The condition of Ge-Ye (Dysphagia and Esophageal Obstruction) is mentioned in the *Neijing* (Inner Canon of the Yellow Emperor) with only one sentence: "Jie of the Three Yangs is called Ge." Zhang Hezi (Zhang Congzheng, courtesy name Hezi) subsequently interpreted this. He stated that the "Three Yangs" refer to the Large Intestine, Small Intestine, and Bladder. When these are Jie (constrained/knotted), the Two Yin (anterior and posterior orifices) become obstructed, body fluids fail to circulate, causing Qi to rebel and ascend. While this explanation correctly addresses the pathogenesis, it fails to explore the root causes of why the Three Yangs become constrained. Later, Zhang Jimeng (Zhang Gao) claimed this was a disorder of the spirit and mind, curable only through introspection and quiet cultivation. This insight accurately hit the mark of the disease's nature. Generally, this ailment often arises from sorrow and excessive thinking, damaging the Heart and Spleen, leading to insufficient blood generation. Over time, this leads to internal simmering, causing Liver Fire to blaze fiercely and Kidney Water to dry up further. Once the Yin of the Five Zang organs is exhausted, how can the Yang of the Six Fu organs remain sufficient? Consequently, dryness above results in Ye (dysphagia/choking), and dryness below results in Ge (esophageal obstruction). It is like a river blocked, cutting off supply routes; those relying on food cannot eat and must wait for fate. At such times, dredging the downstream flow is inferior to clearing the source. Then, water falls from the sky, rushing down swiftly, returning to its old course. Therefore, for those suffering from Ge-Ye, if one wishes to restore dried-up blood, nothing is better than banishing the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright), abandoning hobbies/desires, staying away from sensual pleasures, keeping the mind as still as dead ash and wood, and the body as unmoored as a boat, cultivating silence akin to a servant attending a Zen master. Only then can Stillness overcome Movement, Kidney Water rise, Heart Fire descend, and body fluids gradually circulate, allowing one to follow natural laws and enjoy longevity. Who says the great elixir for treating Ge-Ye does not come from within oneself? Abandoning this to seek elsewhere, one might only rely on nourishing Blood and generating fluids, relieving stagnation and regulating Qi, assisted by methods to descend Fire. This may be one approach. In the handwritten collection of Li Jiang, Minister of War, three taels of Renshen (Ginseng Radix et Rhizoma) juice were taken, mixed with millet, egg white, and Xiebai (Allii Macrostemonis Bulbus), and cooked into porridge for consumption. Its lubricating property was said to unblock the Yangming channel, achieving miraculous effects. As for Wang Taipu (Wang Bing), he distinguished between "food immediately vomited out" and "food eaten then regurgitated" based on the presence or absence of Fire, which deserves careful reference and adjustment. Ultimately, this disease mostly afflicts those burdened by worries and fears, while those living in leisure rarely suffer from it. Thus, we know that herbal medicines and acupuncture stones cannot always overcome the disease; the principle is clear.
Disui Jian (Earth Marrow Decoction): Treats constipation due to Blood Dryness.
Sheng Dihuang (Rehmanniae Radix Recens, 1 jin), Lujiao Jiao (Colla Cornus Cervi, 2 liang 4 qian), Shengjiang (Zingiberis Rhizoma Recens, 8 qian, juiced), Baimi (Mell, 2 he), Jiu (Vinum, 4 he), Zisuzi (Perillae Fructus, 4 qian, ground with wine).
Boil Sheng Dihuang over mild and strong fire until it becomes a paste. Remove dregs. Add the wine-ground Zisuzi and continue boiling for 10-20 boils. Add Lujiao Jiao; once melted, add Shengjiang juice and Baimi. Boil again until thick. Store in a ceramic vessel. Take by dissolving in wine.
Banxiexia Tang (Major Pinellia Decoction): Treats Wei Fan (Stomantic Regurgitation/Vomiting) with abundant Phlegm-Dampness.
Banxia (Pinelliae Rhizoma, 5 qian), Renshen (Ginseng Radix et Rhizoma, 3 qian), Baimi (Mell, 2 qian).
Use two zhong of water. Mix with honey and stir vigorously one hundred times. Decoct and take orally.
Hewei Tang (Harmonize Stomach Decoction)
Renshen (Ginseng Radix et Rhizoma, 1.5 qian), Huanglian (Coptidis Rhizoma, 6 fen, soil-fried), Danggui (Angelicae Sinensis Radix, 1 qian), Huangqin (Scutellariae Radix, 7 fen, soil-fried), Baishao (Paeoniae Radix Alba, 1 qian, wine-fried), Fushen (Poria cum Radice, 1 qian), Shichangpu (Acori Tatarinowii Rhizoma, 5 fen), Shenqu (Massa Medicata Fermentata, 7 fen), Banxia (Pinelliae Rhizoma, 7 fen), Zhishi (Aurantii Fructus Immaturus, 4 fen, bran-fried), Honghua (Carthami Flos, 3 fen), Suzi (Perillae Fructus, 1.5 qian).
Grind Chenbitu (Old Wall Earth) finely, mix with running water, clarify, and use the clarified water to decoct the herbs. Add a small amount of Shengjiang juice and Baimi. Take orally mixed with 1-2 spoons of Tongbian (Child's Urine).