嗝噎证，年高者不可治，以其气血俱虚故也。（余见未满六旬，按法治之而守戒慎者，
亦愈。惟不忌浓味并房劳忧思者，必危。）粪如羊粪者，不可治。（大肠无血故也。）吐痰
如蟹沫者，不可治。（戴氏曰∶气血俱虚者，则口中多唾沫。但见沫大出者，必死不治。）
腹中 嘈，痛如刀割者，不治。治噎大法，用人参、黄 以补元气，御米、粟米解毒实胃，
竹沥、姜汁以清痰散结，牛羊乳、韭汁以养血润液，蜜汁、当归以润燥。用此数者为主治，
其余因证而增损之，无不愈者。
丹溪云∶凡治嗝噎反胃，悉当用二陈汤加姜汁、竹沥、童便、韭汁之类为主。（愚谓半夏
用之豁痰，其性甚燥，嗝噎证多因燥气所成，为津液干槁所致，半夏必是痰盛者，少
少用之，无痰不可用。）嗝噎病，肥胖之人鲜有之。间病者用二陈加人参、白术之
类。血虚瘦弱之人，用四物合二陈加桃仁、红花、韭汁、童便、牛乳、羊乳之类，盖不可缺。
七情郁结而成嗝噎，二陈合香附、抚芎、木香、槟榔、栝蒌、砂仁之类。嗝噎大便结燥
之甚，必用大黄，乃急则治其标之法也，仍用四物汤加桃仁、童便、韭汁，多饮牛羊乳为上
策，但不可服人乳。盖人乳为饮食浓味，烹饵之火及七情之火皆存于中，故不可服也。
饮酒人患嗝噎，以二陈加黄连、砂仁、砂糖、驴屎入内服。胸膈有热加土炒黄连、黄
芩、桔梗、栝蒌之类。
朝食暮吐，暮食朝吐，或食下须臾即吐，此为反胃。所谓胃可容而脾不能传送故也，
或大小肠秘结不通，食返而上奔也，二陈加桃仁、酒蒸大黄以润之。脾不磨者，加神曲、
砂仁、麦芽之类，以助消导。丹溪治一人嗝噎，照常法服药，每日仍饮牛乳中加姜汁、韭
汁，日三四次，或口干与甘蔗汁少许而愈。
又治一人，服金石药而益甚，以御米、竹沥作粥送下而不吐，复以长流水煮粥少加竹
沥服，以四物汤加陈皮益血顺气。
一人咽膈间常觉有物闭闷，饮食妨碍，脉涩稍沉，形色如常，乃饮酒所致，以韭汁每
服半盏日三服，至二升愈。
一人不能顿食，惟频顿细食，一日忽咽膈壅塞，大便结燥，以四物汤加白术、陈皮、
桃仁十二粒研煎沸饮之，令多食诸血以助药力，至五十帖便润，七十帖而食进，不百帖全愈。
噎膈证，年高者不可治，因为其气血都虚弱的原因。（我见到未满六十岁的人，按照正确方法治疗并遵守禁忌谨慎调养的人，也能痊愈。只有那些不忌口浓味食物并且房劳忧思的人，必定危险。）大便像羊粪一样干燥的，不可治。（因为大肠没有血液滋润的缘故。）呕吐痰液像螃蟹泡沫一样的，不可治。（戴氏说：气血都虚弱的人，口中就会多唾沫。但只见沫大量涌出的，必定死亡无法治愈。）腹中嘈杂，疼痛像刀割一样的，不治。治疗噎膈的大法，用人参、黄芪来补元气，御米（粟米）、粟米解毒实胃，竹沥、姜汁来清痰散结，牛羊乳、韭汁来养血润液，蜜汁、当归来润燥。用这几样作为主治，其余根据症状增减，没有不愈的。
丹溪说：凡是治疗噎膈反胃，都应当用二陈汤加姜汁、竹沥、童便、韭汁之类为主。（我认为半夏用来豁痰，其性质很燥，噎膈证多因燥气所成，为津液干槁所致，半夏必须是痰盛的人，少量使用，无痰不可用。）噎膈病，肥胖的人很少有。间或有患病的，用二陈汤加人参、白术之类。血虚瘦弱的人，用四物汤合二陈汤加桃仁、红花、韭汁、童便、牛乳、羊乳之类，大概不可缺少。七情郁结而成噎膈，二陈汤合香附、抚芎、木香、槟榔、栝蒌、砂仁之类。噎膈大便结燥得很厉害，必须用大黄，这是急则治其标的方法，仍用四物汤加桃仁、童便、韭汁，多饮牛羊乳为上策，但不可服人乳。盖人乳为饮食浓味，烹饵之火及七情之火皆存于其中，所以不可服用。
饮酒的人患噎膈，用二陈汤加黄连、砂仁、砂糖、驴屎入内服。胸膈有热加土炒黄连、黄芩、桔梗、栝蒌之类。
朝食暮吐，暮食朝吐，或者食下须臾即吐，这叫反胃。所谓胃能容纳而脾不能传送的缘故，或者大小肠秘结不通，食返而上奔也，二陈汤加桃仁、酒蒸大黄来润之。脾不磨食的，加神曲、砂仁、麦芽之类，以助消导。丹溪治一人噎膈，照常法服药，每日仍饮牛乳中加姜汁、韭汁，日三四次，或口干给甘蔗汁少许而愈。
又治一人，服金石药而更严重，用御米、竹沥作粥送下而不吐，再用长流水煮粥少加竹沥服，用四物汤加陈皮益血顺气。
一人咽膈间常觉有物闭闷，饮食妨碍，脉涩稍沉，形色如常，乃饮酒所致，用韭汁每服半盏日三服，至二升愈。
一人不能顿食，惟频顿细食，一日忽然咽膈壅塞，大便结燥，用四物汤加白术、陈皮、桃仁十二粒研煎沸饮之，令多食诸血以助药力，至五十帖便润，七十帖而食进，不百帖全愈。
**Yi Ge Syndrome (Dysphagia and Obstruction of the Esophagus)**: In elderly patients, it is incurable due to the deficiency of both Qi and Blood. (I have observed that those under sixty years old can recover if treated according to proper methods and strictly observing dietary and lifestyle precautions. However, those who do not avoid rich flavors and engage in sexual excess or excessive worry and thought will face critical danger.) Stools resembling sheep dung are incurable, as this indicates a lack of blood nourishment in the Large Intestine. Vomiting phlegm resembling crab foam is incurable. (Master Dai stated: When both Qi and Blood are deficient, there is excessive saliva in the mouth. If large amounts of foam suddenly appear, death is inevitable and untreatable.) A sensation of burning discomfort in the abdomen accompanied by pain like knife-cutting is incurable.
The general principle for treating Yi Ge involves using *Renshen* (Ginseng Radix) and *Huangqi* (Astragali Radix) to tonify Original Qi; *Yumi* (Setaria Italica / Millet) and millet to detoxify and strengthen the Stomach; *Zhuli* (Bamboo Sap) and *Jiangzhi* (Ginger Juice) to clear phlegm and dissipate nodules; cow or goat milk and *Jiu Zhi* (Chinese Chive Juice) to nourish Blood and moisten dryness; honey juice and *Danggui* (Angelicae Sinensis Radix) to moisten dryness. Using these as the main treatment, with additions or subtractions based on specific symptoms, ensures recovery.
Danxi stated: "In all cases of Yi Ge and Fan Wei (Regurgitation), one should primarily use *Er Chen Tang* (Two-Cured Decoction) supplemented with ginger juice, bamboo sap, child's urine, and chive juice." (I believe that while *Banxia* (Pinelliae Rhizoma) is used to resolve phlegm, its nature is very drying. Since Yi Ge is often caused by dryness and depletion of body fluids, *Banxia* should only be used in small amounts for patients with abundant phlegm; it is contraindicated if there is no phlegm.) Yi Ge rarely occurs in obese individuals. If it does, *Er Chen Tang* combined with *Renshen* and *Baizhu* (Atractylodis Macrocephalae Rhizoma) is used. For emaciated and weak patients with Blood deficiency, *Siwu Tang* (Four Substance Decoction) combined with *Er Chen Tang*, plus *Taoren* (Persicae Semen), *Honghua* (Carthami Flos), chive juice, child's urine, cow milk, and goat milk is essential. For Yi Ge caused by emotional stagnation, *Er Chen Tang* is combined with *Xiangfu* (Cyperi Rhizoma), *Fuxiong* (Ligustici Chuanxiong Rhizoma), *Muxiang* (Aucklandiae Radix), *Binglang* (Arecae Semen), *Gualou* (Trichosanthis Fructus), and *Sharen* (Amomi Fructus). If constipation is severe, *Dahuang* (Rhei Radix et Rhizoma) must be used as an urgent measure to treat the branch symptoms; however, *Siwu Tang* with *Taoren*, child's urine, and chive juice, along with copious intake of cow or goat milk, is the superior strategy. Human milk should not be taken because it retains the heat from cooking and the fire of emotions, making it unsuitable.
For drinkers suffering from Yi Ge, *Er Chen Tang* is added with *Huanglian* (Coptidis Rhizoma), *Sharen*, sugar, and donkey dung. If there is heat in the chest and diaphragm, earth-fried *Huanglian*, *Huangqin* (Scutellariae Radix), *Jiegeng* (Platycodonis Radix), and *Gualou* are added.
Vomiting food eaten in the morning in the evening, or food eaten in the evening in the morning, or vomiting immediately after eating, is called Fan Wei. This occurs because the Stomach can receive but the Spleen cannot transport, or due to constipation in the Small and Large Intestines causing food to reflux upward. Treatment involves *Er Chen Tang* with *Taoren* and wine-steamed *Dahuang* to moisten. If the Spleen fails to digest, *Shenqu* (Massa Medicata Fermentata), *Sharen*, and *Maiya* (Hordei Fructus Germinatus) are added to aid digestion. Danxi treated a patient with Yi Ge by administering standard medicine daily, along with cow milk mixed with ginger juice and chive juice, three to four times a day. If the patient felt thirsty, a little sugarcane juice was given, leading to recovery.
He also treated another patient whose condition worsened after taking mineral drugs. He prescribed porridge made from *Yumi* and bamboo sap to prevent vomiting, followed by porridge boiled with long-flowing water and a little bamboo sap. *Siwu Tang* with *Chenpi* (Citri Reticulatae Pericarpium) was used to nourish Blood and regulate Qi.
Another patient felt a sensation of obstruction in the throat and diaphragm, hindering diet, with a choppy and slightly deep pulse, yet normal appearance. This was caused by drinking alcohol. He was treated with half a cup of chive juice three times a day until two cups were consumed, resulting in recovery.
A patient who could not eat large meals at once but ate frequently in small portions suddenly experienced complete obstruction in the throat and diaphragm with severe constipation. He was treated with *Siwu Tang* plus *Baizhu*, *Chenpi*, and twelve crushed *Taoren* seeds, boiled and drunk hot. He was instructed to consume various types of blood products to assist the medicinal power. After fifty doses, his bowels became moist; after seventy doses, he could eat; and within less than a hundred doses, he fully recovered.