虞天民治一妇。年三十。产后因食伤。致胃虚不纳谷。四十余日矣。闻谷气则恶心而呕
闻药气亦呕。虞用顺流水二盏煎沸。泡伏龙肝。研细搅浑放澄清。取一盏。入参、苓、白
术各一钱。甘草二分。陈皮、藿香、砂仁各五分。炒神曲一钱。陈米一合。加姜、枣。同煎
至七分。稍冷服。此药遂纳而不吐。别以陈米煎汤。时时咽之。日进前药二三服。渐能纳粥
而安。后以此法治人。悉验。
薛立斋见一人呕吐痰涎。发热作渴。胸膈痞满。或用清气化痰降火。前证益甚。痰涎自
出。薛曰。呕吐痰涎。胃气虚寒也。发热作渴。胃不生津也。胸膈痞满。脾气虚弱也。须用
参、 、归、术之类。温补脾胃。生发阳气。诸病自退。不信。仍服前药。虚证悉至。复请
治。薛曰。饮食不入。呃逆不绝。泄泻腹痛。手足逆冷。是谓五虚。烦热作渴。虚阳发于外
也。脉洪大。脉欲绝也。死期迫矣。或曰。若然。殒于日乎。殒于夜乎。薛曰。脉洪大。当
殒于昼。果然。
震按此条与张克明咳嗽吐痰证治相同。彼以温补而愈。此以清削而死。薛公之善用温补
与戴人之善用涌泄。皆举一可以例百也。
王中阳治一宦家妇人。忽患心腹冷痛。遂呕吐。去尽宿汁不已。而又吐清涎。如鸡子清
之状。一呕一二升许。少顷再呕。百药不纳。咽唾亦不能顺下。已经三日。但聪明不昧。吩咐
家事以待就木。王诊其脉。六部弦细而长。令服滚痰丸三十丸。并不转逆。须臾坐寐。移
时索粥食之。次日再进三十丸。兼服局方茯苓半夏汤。再服钱氏白术散。饮食如旧。
李士材治兵尊高元圃。久患呕吐。李诊之曰。气口大而软。此谷气少而药气多也。且多
犯辛剂。可以治表实。不可以治中虚。可以理气壅。不可以理气弱。用熟半夏五钱。人参三
钱。陈仓米一两。白蜜五匙。甘澜水煎服。十剂全安。
又治屯院孙潇湘。夏月食瓜果过多。得食辄呕。二十日弗止。困顿床褥。手足如冰。举
家惊惶。李曰。两尺按之有神。胃气缕缕不绝。只因中气本弱。复为寒凉所伤耳。遂用红豆
丸。连进三服。至明日。便能食粥。兼与理中汤加丁香、沉香。旬日之间。饮食如常矣。
孙东宿治邵姓者。年五十。呕吐物如烂猪肺状。胸背胀。前医以翻胃治。不效。反加潮热烦
躁。饮食不入。因谓肺坏。辞不治。孙诊之。两寸滑数。左关尺涩。乃曰。若果肺坏。声音
当哑。今声亮而独胸背作胀。由于酒后忿怒。瘀血痰饮。积于胸膈为病耳。以滑石、茜草、
桃仁、小蓟、归尾、香附、贝母、山栀仁、枳壳、甘草。十帖而全安。
震按千金方载粥食汤药皆吐不停者。灸手间使穴三十壮。若四肢厥。脉沉绝不至者。灸
之
便通。查手间使穴。乃手厥阴穴。在掌后三寸。此如今人遇呕而不能纳药者。以手紧捻病患
两手脉息。即可咽下。其法暗合。又宋人小说载。史载之治朱思古。闻荤腥即呕。惟以汤沃
淡饭些少。时时食之。医莫能治。史曰。此证内经有之。名曰食挂。凡人之肺。六叶舒张。
盖覆于脾。子母气和则进食。一或有戾。则肺不能舒。脾为之蔽。故不嗜食。遂用清气润肺
药。服三日。病者鼻闻肉味觉香。取啖之甚美。此系邪说。江篁南谓非记者假托。即史公之
妄言欺世。诚然。
景岳治胡宅小儿。年甫三岁。偶因饮食不调。延幼科延医。所用之药。无非清火化滞等
剂。因而更损胃气。反致呕吐溏泄。复加清利。遂致吐蛔。初止数条。渐至数十条。细如灯
草。甚至成团搅结而出。早晚不绝。所下者亦如之。羸困至极。求治于张。先与温胃饮二三
剂。其虫朝夕不止。其多如故。初不识其何所从来。而神化之速。一至如此。乃翁切恳先逐
此虫。张弗听。且曰。公之所畏者。虫也。予之所畏者。胃气也。凡逐虫之药。无有不伤胃
气者。若胃气再伤。非惟不能逐虫。而命必随之矣。仍用前药。倍加人参佐附子。二三剂而
呕吐渐稀。泻亦随止。泻止后。乃以理阴煎、温胃饮。出入间用。十余日而虫渐少。一月余
而饮食进。肌肉生。复元如故矣。盖此儿因凉药伤脾。脾胃虚寒。阴湿内淫。以致生虫。但
使脾胃日强。则拔去化虫之源。病方全愈也。
〔附〕吴参军煮鲜蘑菇。多食之。大吐大泻。医谓速宜解毒。用黄连、桔梗、黑豆、甘
草、枳实之属。连进而病益甚。胸腹大胀。口干气喘。水饮皆不能受。危窘已甚。景岳视之
曰。毒有不同。岂必黄连、甘、桔乃可解耶。蘑菇一物。必产于沉坑枯井。或沉寒极阴之处
其得阴气最盛。故肥白最嫩也。公中此阴寒之毒。而复解以黄连之寒。病不更增耶。遂用
人参、白术、炙草、干姜、附子、茯苓等。一剂而呕少止。再剂而胀少杀。随大加熟地。以
兼救其泻亡之阴。前后凡二十余剂。复元如故。
又窦氏全书。载一人春月将熟猪羊肉露放月台之上。明日治以燕客。凡二十余人。皆吐呕不
安。惟二三人不吐呕。盖食肉少而饮酒多也。一老医云。此夜露之毒也。露惟秋夜之气清。
故不毒。若春夏俱有毒。以甘草煎汤饮之。即愈。
震按此说亦不可不知。然露后不再蒸煮所致。若加烹饪。露之毒岂能存乎。
虞天民治疗一位妇女，三十岁。产后因饮食损伤，导致胃气虚弱无法受纳食物，已达四十多天。闻到谷物的气味就恶心呕吐，闻到药物的气味也呕吐。虞天民用顺流水两盏煎沸，浸泡伏龙肝（灶心土），研细搅匀后静置澄清，取清液一盏，加入人参、茯苓、白术各一钱，甘草二分，陈皮、藿香、砂仁各五分，炒神曲一钱，陈仓米一合，加生姜、大枣，一同煎至七分满，稍凉后服用。此药服下后不再呕吐。另外用陈仓米煎汤，时时咽下。每天服用前药二三次，逐渐能进食粥食而安定。后来他用这个方法治疗其他人，都验证有效。
薛立斋见到一人呕吐痰涎，发热口渴，胸膈痞闷胀满。有人使用清气化痰降火的药物，前面的症状更加严重，痰涎自行流出。薛立斋说：“呕吐痰涎，是胃气虚寒；发热口渴，是胃不能生津液；胸膈痞满，是脾气虚弱。”必须用人参、当归、白术之类的药物，温补脾胃，生发阳气，各种病症自然消退。患者不信，仍然服用之前的药物，虚证全部出现，再次请求治疗。薛立斋说：“饮食不入，呃逆不止，泄泻腹痛，手足逆冷，这叫做‘五虚’。烦热口渴，是虚阳发散于体表；脉象洪大，实际上是脉气欲绝。死期迫近了。”有人问：“如果这样，是死于白天还是晚上？”薛立斋说：“脉象洪大，应当死于白天。”果然如此。
俞震按语：这一条与张克明咳嗽吐痰证的治法相同。张克明用温补治愈，此人用清热攻伐而死。薛立斋善于使用温补，戴元礼善于使用涌吐泄下，都是举一反三的例子。
王中阳治疗一位官宦人家的妇人，忽然患有心腹冷痛，随即呕吐，将宿存的汁液吐尽仍未停止，又吐出清稀的涎沫，像鸡蛋清的样子，一次呕吐约一二升，一会儿又吐，各种药物都无法受纳，连吞咽唾液也不能顺利下行，已经三天。但神志清醒，吩咐家事准备待死。王中阳诊察她的脉象，六部脉弦细而长，让她服用滚痰丸三十丸，并没有引起呕吐，片刻后坐着入睡，过了一段时间索要粥食吃。第二天再进三十丸，同时服用局方茯苓半夏汤，接着服用钱氏白术散，饮食恢复如常。
李士材治疗兵备道台高元圃，长期患有呕吐。李士材诊察后说：“寸口脉大而软，这是谷气少而药气多造成的。而且多次使用辛温发散的药物，可以治疗表实证，不可以治疗中焦虚证；可以调理气机壅滞，不可以调理气机虚弱。”使用熟半夏五钱，人参三钱，陈仓米一两，白蜜五匙，甘澜水煎服。十剂药后完全痊愈。
又治疗屯院孙潇湘，夏天食用瓜果过多，吃东西就呕吐，二十多天不停止，困顿在床榻上，手脚冰凉，全家惊慌。李士材说：“两尺脉按之有神，胃气缕缕不绝。只是因为中气本来虚弱，又被寒凉所伤罢了。”于是使用红豆丸，连续服用三剂，到第二天，就能吃粥了。同时给予理中汤加丁香、沉香，十天之间，饮食恢复正常。
孙东宿治疗姓邵的人，五十岁，呕吐物像烂猪肺状，胸背胀满。前医以翻胃（噎膈）治疗，无效，反而加重潮热烦躁，饮食不入，因此说是肺坏了，推辞不治。孙东宿诊察，两寸脉滑数，左关尺脉涩。他说：“如果真是肺坏了，声音应当嘶哑。现在声音响亮，只有胸背胀满，这是由于酒后愤怒，瘀血痰饮积聚在胸膈导致的疾病。”使用滑石、茜草、桃仁、小蓟、当归尾、香附、贝母、山栀仁、枳壳、甘草。十帖药后完全痊愈。
俞震按语：《千金方》记载，凡是喝粥、吃饭、服药都呕吐不止的，灸手厥阴心包经的内关穴（原文误作间使，实为内关或间使均可止呕，此处依原文翻译为间使穴）三十壮。如果四肢厥冷，脉沉伏摸不到，灸之后脉气就会通畅。查手厥阴经的间使穴，位于掌后三寸。这就像现在人遇到呕吐不能服药时，用手紧紧捏住病人的两手脉搏处，就可以咽下药，其原理暗合。又宋代小说记载，史载之治疗朱思古，闻到荤腥就呕吐，只用汤泡淡饭少量，时时食用，医生都不能治愈。史载之说：“这个病《内经》里有记载，名叫‘食挂’。人的肺有六叶舒展张开，覆盖在脾之上，子母气和顺则能进食，一旦有违逆，则肺不能舒展，脾被遮蔽，所以不喜欢进食。”于是使用清气润肺的药，服用三天，病人闻到肉味觉得香，取来吃很美味。这是邪说，江篁南认为如果不是记者假托，就是史公妄言欺世，确实如此。
张景岳治疗胡家小孩，刚三岁，偶然因为饮食不调，请儿科医生诊治。所用的药物，无非是清火化滞等剂型。因而更损伤胃气，反而导致呕吐溏泄，又加上清利药物，致使吐出蛔虫。起初只有几条，渐渐达到几十条，细如灯草，甚至成团纠结而出，早晚不断，排出的东西也一样。身体极度瘦弱困乏，求治于张景岳。先给予温胃饮二三剂，虫子早晚不止，数量依旧。起初不知道它们从哪里来，变化这么快。孩子的父亲恳切要求先驱逐这些虫子，张景岳不听，并且说：“您所害怕的是虫子，我所害怕的是胃气。凡是驱虫的药，没有不损伤胃气的。如果胃气再受伤，不仅不能驱虫，性命必然随之而去。”仍然用前药，倍加人参佐以附子，二三剂后呕吐逐渐减少，腹泻也随之停止。腹泻停止后，再用理阴煎、温胃饮，交替使用。十多天后虫子逐渐减少，一个多月后饮食进步，肌肉生长，恢复原状。因为这个孩子因为凉药伤了脾，脾胃虚寒，阴湿内侵，以致生虫。只要使脾胃日渐强壮，就拔除了生虫的根源，病才能全愈。
〔附〕吴参军煮鲜蘑菇，多吃了它，大吐大泻。医生说速宜解毒，使用黄连、桔梗、黑豆、甘草、枳实之类，连续服用病情更加严重，胸腹大胀，口干气喘，水饮都不能接受，危险窘迫已极。张景岳看后说：“毒有不同的性质，难道一定要用黄连、甘草、桔梗才可以解吗？蘑菇这一种东西，必定产于深坑枯井，或者寒冷极阴的地方，得到阴气最盛，所以肥白最嫩。您中了这种阴寒的毒，又用黄连的寒性去解，病能不增加吗？”于是使用人参、白术、炙甘草、干姜、附子、茯苓等，一剂后呕吐稍止，二剂后胀满稍减。随后大量加入熟地黄，以兼救因泻脱失的阴液。前后共二十多剂，恢复原状。
又《窦氏全书》记载，一个人春天将熟透的猪羊肉露放在月台上，第二天整治用来宴请客人。凡二十多人，都呕吐不安，只有两三人不呕吐。大概是因为吃肉少而喝酒多。一位老医生说：“这是夜露的毒。露水只有在秋夜之气清时才无毒，春夏都有毒，用甘草煎汤饮用，即痊愈。”
俞震按语：这个说法也不可不知。然而露水之后如果不经过蒸煮，毒性尚存；如果加以烹饪，露水的毒怎么能存在呢？
Yu Tianmin treated a woman, aged thirty. Postpartum, due to dietary injury, her stomach qi became deficient and unable to accept food for over forty days. Upon smelling grain, she felt nauseous and vomited; upon smelling medicine, she also vomited. Yu used two cups of flowing water brought to a boil, soaked in Fulonggan (Zao Xin Tu, Hearth Earth), ground it fine, stirred until turbid, allowed it to settle and clarify, then took one cup of the clear liquid. He added Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), and Baizhu (Atractylodis Macrocephalae Rhizoma) each at 1 qian, Gancao (Licorice Root) at 2 fen, Chenpi (Citri Reticulatae Pericarpium), Huoxiang (Agastaches Herba), and Sharen (Amomi Fructus) each at 5 fen, Chao Shenqu (Fried Medicated Leaven) at 1 qian, and Chen Cangmi (Old Stored Rice) at 1 he. Added Shengjiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus), decocted together until reduced to 70%. Taken slightly cool, this medicine was retained without vomiting. Separately, she drank soup made from old stored rice frequently. She took the former medicine two or three times daily, gradually able to consume congee and stabilize. Later, he used this method to treat others, with all cases verified as effective.
Xue Lizhai saw a person vomiting phlegm-fluids, with fever and thirst, and fullness and oppression in the chest and diaphragm. Someone used Qingqi Huatan Jianghuo (Clearing Qi, Transforming Phlegm, Descending Fire) formulas, causing the previous symptoms to worsen, with phlegm-fluids flowing out spontaneously. Xue said: "Vomiting phlegm-fluids indicates Stomach qi deficiency and cold; fever and thirst indicate the Stomach's inability to generate body fluids; chest and diaphragm fullness indicates Spleen qi deficiency." One must use Renshen (Ginseng Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) and similar herbs to warm and tonify the Spleen and Stomach, generating Yang qi, so that various diseases will recede naturally. The patient did not believe him, continued taking the previous medicines, and all deficiency syndromes appeared. Seeking treatment again, Xue said: "Inability to eat, incessant hiccups, diarrhea with abdominal pain, and cold extremities constitute the 'Five Deficiencies'. Irritable heat and thirst indicate floating deficient Yang on the exterior; a洪大 (Hong Da, Surging and Large) pulse actually indicates impending pulse exhaustion. Death is imminent." Someone asked: "If so, will he die during the day or night?" Xue said: "With a Hong Da pulse, death should occur during the day." It proved true.
Zhen noted: This case is similar to Zhang Keming's treatment of cough with expectoration. Zhang healed with warming and tonifying, while this patient died from clearing and reducing. Master Xue's skill in using warming and tonifying, and Dai Renli's skill in using emesis and purgation, are examples where one can infer the hundred.
Wang Zhongyang treated a mandarin's wife who suddenly suffered from cold pain in the heart and abdomen, followed by vomiting. After expelling all stagnant juices, she continued vomiting clear saliva resembling egg white, about one or two sheng per episode, recurring shortly after. No medicine could be retained, nor could swallowing saliva go down smoothly. It had been three days, but her mind remained clear; she arranged family affairs awaiting death. Wang palpated her pulse: all six positions were Xian Xi Er Chang (String-like, Fine, and Long). He ordered her to take Guntan Wan (Rolling Phlegm Pills) thirty pills. There was no regurgitation; within moments she sat and slept. After some time, she asked for porridge and ate. The next day, another thirty pills were administered, along with Ju Fang Fu Ling Ban Xia Tang (Bureau Formula Poria and Pinellia Decoction), followed by Qian Shi Bai Zhu San (Qian's Atractylodes Powder). Diet returned to normal.
Li Shicai treated Military Commissioner Gao Yuanpu, who suffered from chronic vomiting. Li diagnosed: "The Cun Kou (Radial artery at the wrist) pulse is large and soft, indicating little Grain qi and excessive medicinal qi. Moreover, many pungent agents have been used. These can treat Exterior Excess, but cannot treat Middle Jiao Deficiency; they can regulate Qi stagnation, but cannot regulate Qi weakness." He used Shu Banxia (Prepared Pinelliae Tuber) 5 qian, Renshen (Ginseng Radix et Rhizoma) 3 qian, Chen Cangmi (Old Stored Rice) 1 liang, Bai Mi (Honey) 5 spoons, decocted in Ganlan Shui (Ganshui, Water boiled and stirred). Ten doses resulted in complete recovery.
He also treated Sun Xiaoxiang of the Military Academy. In summer, due to excessive consumption of melons and fruits, he vomited immediately after eating, lasting twenty days without cessation. Confined to bed, his hands and feet were ice-cold, causing family panic. Li said: "The Chi (distal) pulses at both wrists are resilient upon pressure, indicating Stomach qi is barely continuing. This is merely because Middle qi was originally weak, further injured by cold and cooling." He used Hong Dou Wan (Red Bean Pills), administered continuously for three doses. By the next day, he could eat porridge. Simultaneously, Lizhong Tang (Regulate the Middle Decoction) with Dingxiang (Caryophylli Flos) and Chenxiang (Aquilariae Lignum) was given. Within ten days, diet normalized.
Sun Dongsu treated a surnamed Shao, aged fifty, who vomited material resembling rotten pig lungs, with chest and back distension. Previous physicians treated it as Fan Wei (Reversal Flow/Obstruction), without effect, worsening tidal fever and irritability, preventing food intake, leading them to declare lung failure and refuse treatment. Sun palpated: both Cun (proximal) pulses were Hua Shuo (Slippery and Rapid); Left Guan (middle) and Chi (distal) were Se (Choppy). He said: "If the lungs were truly failed, the voice would be hoarse. Now the voice is loud, only chest and back are distended. This is due to anger after drinking alcohol, causing Blood stasis and Phlegm-fluid accumulation in the chest and diaphragm." He used Huashi (Talcum), Qiancao (Rubiae Cordifoliae Radix), Taoren (Persicae Semen), Xiaoji (Cimicifugae Rhizoma? Note: Xiaoji is Cimicifugae or蓼科植物, here likely Cimicifugae or specific herb for blood heat), Guiwei (Angelicae Sinensis Radix Tail), Xiangfu (Cyperi Rhizoma), Beimu (Fritillariae Thunbergii Bulbus), Shanzhiren (Gardeniae Semen), Zhiqiao (Aurantii Fructus), and Gancao (Licorice Root). Ten doses resulted in complete recovery.
Zhen noted: *Qianjin Fang* records that for those who vomit everything including porridge, food, and medicine, moxibustion on Jian Shi (Jianshi, Intercapitalis) acupoint of the Hand Shaoyin Pericardium meridian, thirty moxa cones, is indicated. If there are cold extremities and deep, imperceptible pulses, moxibustion will restore pulse flow. Checking, Jianshi is a Hand Shaoyin Pericardium point, located three cun posterior to the palm crease. This is akin to modern practice where, when vomiting prevents medication intake, firmly pinching the patient's radial pulses allows swallowing, the principle being coincidentally aligned. Also, Song dynasty novels record Shi Zaizhi treating Zhu Siguzhou, who vomited at the smell of meat/fish, subsisting only on plain rice soaked in broth. Physicians failed. Shi said: "This condition is in *Neijing*, called Shi Gua (Food Hanging). The human lung has six lobes spreading over the Spleen. When mother and child qi harmonize, eating occurs. If discordant, the lung cannot spread, the Spleen is covered, hence aversion to food." He used Qingqi Runfei (Clearing Qi and Moistening Lung) herbs. After three doses, the patient smelled meat as fragrant and ate it deliciously. This is heterodox teaching. Jiang Huangnan stated this is either fabricated by reporters or Shi's false claims, which is true.
Zhang Jingyue treated a Hu family child, just three years old. Due to irregular diet, pediatricians prescribed drugs for clearing fire and resolving stagnation. This further damaged Stomach qi, causing vomiting and loose stools. Additional clearing and draining led to expulsion of roundworms. Initially a few strands, gradually dozens, thin as lamp wicks, even clumped together, day and night without cease, excrement similar. Extremely emaciated and exhausted, seeking treatment from Zhang. First, Wenwei Yin (Warm Stomach Drink) for two or three doses. Worms continued day and night, quantity unchanged. Initially unaware of their origin, yet transformation speed was astonishing. The father earnestly requested worm expulsion first. Zhang refused, saying: "What you fear is worms; what I fear is Stomach qi. All vermifuges damage Stomach qi. If Stomach qi is further injured, not only can worms not be expelled, life will follow." He continued the previous medicine, doubling Renshen (Ginseng Radix et Rhizoma) and adding Fuzi (Aconiti Lateralis Radix Praeparata). Two or three doses later, vomiting decreased, diarrhea stopped. After diarrhea ceased, Liyin Jian (Nourish Yin Decoction) and Wenwei Yin were alternated. Over ten days, worms decreased; over a month, diet improved, muscles grew, and health restored. This child's spleen was injured by cooling medicines, resulting in Spleen-Stomach deficiency-cold, internal damp-evil invasion, leading to worm generation. Strengthening the Spleen and Stomach daily removes the source of worm production, curing the disease.
[Appendix] Wu Canjun boiled fresh mushrooms, ate too much, resulting in severe vomiting and diarrhea. Physicians advised rapid detoxification using Huanglian (Coptidis Rhizoma), Jiegeng (Platycodonis Radix), Heidou (Sojae Semen Nigrum), Gancao (Licorice Root), Zhishi (Aurantii Fructus Immaturus), etc. Continuous administration worsened the illness: massive chest/abdominal distension, dry mouth, panting, inability to tolerate water or drink, critical distress. Zhang Jingyue examined and said: "Poisons differ; must Huanglian, Gancao, Jiegeng be used for detoxification? Mushrooms grow in deep pits, dry wells, or extremely cold/yin places, absorbing maximum yin qi, hence plump, white, and tender. You poisoned yourself with this yin-cold toxin, and resolved it with Huanglian's cold nature; how can the illness not increase?" He used Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Zhi Gancao (Prepared Licorice Root), Ganjiang (Zingiberis Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata), Fuling (Poria), etc. One dose: vomiting slightly stopped. Two doses: distension slightly reduced. Subsequently, large amounts of Shudi (Rehmanniae Radix Preparata) were added to rescue yin lost through diarrhea. Over twenty doses in total, he recovered completely.
Also, *Dou Shi Quan Shu* records a man who left cooked pork and mutton exposed on a terrace in spring overnight. Next day, he prepared it for guests. Of twenty people, all vomited and were uneasy, except two or three. Likely because they ate less meat and drank more wine. An old physician said: "This is night dew toxicity. Dew is non-toxic only in autumn nights when air is clear; spring and summer dew is toxic. Drinking Gancao (Licorice Root) decoction cures it."
Zhen noted: This theory should also be known. However, if dew-exposed food is not re-cooked, toxicity remains; if cooked, how can dew toxicity persist?