人赖水谷以生。水谷敷布则五脏安和。水谷阻逆。则百病丛生。水谷废绝。则性命倾危。以
胃为水谷之海。五脏之本也。惟是病邪 结于胃。不能行出纳之令者。切勿强与。以益病邪。以
胃中邪热蕴隆。痰食阻滞。故虽一旬一气不食。不足为虑。非若无病之人。脾气时时消磨。不可
旦晚缺食也。故越人有平人不食水谷七日则死之说。而最为切禁者。伤寒之无汗脉紧。为寒伤营
证。及汗不得出而烦躁之营卫俱病。其胃中营气为寒邪所伤。既郁遏而为热矣。若不夺其饮食。
必转助邪为虐。为害不浅。更有挥霍撩乱胃气反戾之证。误进谷气。祸不旋踵。至于自汗脉缓之
风伤卫证。虽同感客邪。只传经络。不传胃府。便无禁食之例。观仲景桂枝汤后云。啜热稀粥以
助药力。于此可见。不当概
为禁止也。非特桂枝汤用热稀粥以助药力也。即寒伤营之尺中微弱者。用小建中。取胶饴之稼穑
作甘。引桂枝之辛温。留恋中焦。以助胃祛邪。即是热稀粥之变法。且酿去渣滓。无质滞着。则
不助邪热。故寒伤营亦得用之。较热稀粥之法。更进一层矣。仲景为伤寒立法之祖。必无诞妄之
言。欺误后世之理。只缘圣法久湮。故近世医流。凡遇发热头痛。有似外感之类。无论病之虚实。
证之表里。热之真假。概以伤寒目之。必先禁止饮食。混与通套疏风消克之药。在质壮气实人得
之。虽未中 。稍借行表之势。便可热退身凉。安知胃气有权者。感邪不深。虽不服药。自能蒸
发正汗。所谓壮者气行则已也。苟元气虚人。胃中津液本少。且复夺其饮食。药虽中病。尚难作
汗。况堪恣行表药。重伤本虚之胃气乎。曷知脾胃之气。全赖水谷资其转运。与车轮戽水不异。
今以既病垂绝之胃。尚欲俟其胸膈开爽。始进谷气。犹埋轮旱麓。待水涨而后戽之。则苗之不槁
也几希矣。纵侥幸不死。元气削伐殆尽。少年者日渐 羸。多成虚损。高年者暗损元神。促其天
年。皆由习俗好用攻克。罔顾正气所致。盖病之有发热头痛者。未必尽为伤寒。假如内伤劳倦。
阴虚火炎。概以伤寒法治之。是速其夭扎也。予业擅伤寒专科。六十年来。目击误夺饮食。至剧
致毙者。未遑枚举。尝见饿久之人。脾气不运。虽经旬累月。愈不思食。庸工不知。以为尚有宿
食。猛进宽胸破气之药。每每激其虚阳。上浮外泛。而致头面不时哄热。医者复认表邪未尽。重
与发散。硝、黄、柴、葛、枳、橘之属。恣无忌惮。不死不已。亦有肠胃久绝谷气。大便枯竭不
行。而欲妄议攻下者。此胃气虚极。无论攻伐之药不能胜任。即调补药亦难胜任。但当频与粥汤。
微助胃气。以俟津回。庶或可救。而饿久之人。粥食到口。虽极甘美。然多有食下作呕者。或食
下少顷作酸者。或膈间迷迷不爽者。或腹中隐隐作痛者。或肠中声响不已者。此皆三脘闭约。痰
气阻碍之故。病家不明此理。往往
惑于师巫及亲朋左右之言。犹豫不敢进食。因循日久。终成不救者多矣。曷知胃气久虚之人。即
有不时哄热。非助以谷气。则虚火不除。则有胸膈痞满。非助以谷气。则大气不运。即有大便枯
约。非助以谷气。则津液不回。盖新谷气运。则宿滞始能下通。若能认定关头。频与稀糜。俟胃
气稍复。渐以独参、保元、四君、异功之类调之。如此而获保全者。亦颇不少。但不可猛进强进。
及添水复热者。搪塞一时。重伤衰竭之胃气。反归咎于调治也。经云。浆粥入胃。则虚者活。所
以往往令其勿药。以收十全之功耳。
飞畴治一妇。呕恶胸满身热。六脉弦数无力。形色倦怠。渴不甚饮。云自游虎邱晕船吐后。
汗出发热头痛。服发散四剂。头痛虽缓。但胀晕不禁。复用消导三四剂。胸膈愈膨。闻谷气则呕
眩。因热不退。医禁粥食已半月。惟日饮清茶三四瓯。今周身骨肉楚痛。转侧眩晕呕哕。予曰。
当风呕汗。外感有之。已经发散矣。吐则饮食已去。胃气从逆。消克则更伤脾气。脾虚故胀甚。
今无外感可散。无饮食可消。脾绝谷气则呕。土受水克则晕。即使用药。亦无胃气行其药力。惟
与米饮。继进稀糜。使脾胃有主。更议补益可也。因确守予言。竟不药而愈。
人依赖水谷（饮食）来维持生命。水谷精微布散全身，则五脏安和。若水谷运化受阻逆，则百病丛生。若水谷断绝，则性命危殆。因为胃是水谷之海，是五脏的根本所在。然而，如果病邪结聚于胃，导致胃不能行使受纳和排泄的功能时，切勿强行喂食，以免助长病邪。
由于胃中邪热蕴盛，痰湿和食积阻滞，所以即使十天半个月不吃东西，也不必担忧。这与没有疾病的人不同，无病之人脾气时刻在消磨水谷，不能早晚缺食。所以扁鹊（越人）有“平人（健康人）不食水谷七日就会死亡”的说法，这是最为切中的禁忌。但是，对于伤寒病中无汗、脉紧的寒伤营分证，以及出汗后仍烦躁的营卫俱病证，其胃中的营气被寒邪所伤，已经郁遏而化为热邪。如果不控制饮食，必然转而帮助邪气肆虐，危害不小。更有那种霍乱般撩乱、胃气反常乖戾的证候，误进食物，灾祸立刻降临。至于自汗、脉缓的风伤卫分证，虽然同样感受外邪，但只传变到经络，不传入胃腑，就没有禁止饮食的例子。看张仲景在桂枝汤服用后的医嘱说：“喝热稀粥以助药力”，由此可见，不应一概禁止饮食。
不仅桂枝汤用热稀粥来助药力，即使是寒伤营分且尺脉微弱的情况，使用小建中汤，也是取饴糖（胶饴）的稼穑作甘之性，引导桂枝的辛温之气，留恋于中焦，以辅助胃气祛除邪气。这其实就是热稀粥法的变法。而且熬煮去渣滓后，没有质碍滞留，就不会助长邪热，所以寒伤营证也可以使用。这比单纯的热稀粥法又进了一层。张仲景是确立伤寒治疗法则的祖师，必定不会有荒诞妄言之语来欺误后世。只是因为圣人的法度久已湮没，所以近世的医流，凡遇到发热头痛，类似外感的情况，无论疾病的虚实、证候的表里、热象的真假，一概当作伤寒看待。必定先禁止饮食，胡乱给予通用的疏风消导攻伐药物。对于体质壮实、正气充足的人，服药虽未完全对症，稍借发表之势，便可热退身凉。他们哪里知道，胃气有权（强盛）的人，感受邪气不深，即使不服药，也能自然蒸发出正汗。这就是所谓“壮者气行则已”。如果是元气虚弱的人，胃中津液本少，如果再剥夺其饮食，药物虽然对症，尚且难以发出汗来，何况还能承受肆意使用发表药物，严重损伤本就虚弱的胃气呢？
怎么不知道脾胃之气，全赖水谷资生以转运，就像车轮戽水一样。现在对于已经生病、濒临衰竭的胃，还想要等到胸膈清爽之后，才进食谷物，这就像把轮子埋在旱地的山麓，等待水涨起来后再戽水，那么禾苗不枯死的机会就很少了。纵然侥幸不死，元气也被削伐殆尽。年轻人日渐消瘦，多成为虚损之症；老年人暗中损伤元神，缩短寿命。这都是因为习俗好用攻伐克削之法，不顾护正气的缘故。大概生病有发热头痛的，未必尽是伤寒。假如是内伤劳倦，阴虚火炎，一概用治伤寒的方法治疗，这是加速其夭折。我业专攻伤寒专科，六十年来，亲眼目睹因错误地剥夺饮食，导致病情加剧至死亡的，来不及一一列举。
我曾见过饥饿很久的人，脾气不运，即使经过十天累月，越发不想吃东西。庸医不知此理，以为还有宿食，猛用宽胸破气的药物，每每激发其虚阳上浮外泛，导致头面不时烘热。医者又认为是表邪未尽，重用发散药物，硝石、大黄、柴胡、葛根、枳实、橘皮之类，肆无忌惮地使用，不死不休。也有肠胃长期断绝谷气，大便干枯不行，却想妄议攻下的。这是胃气极度虚弱，无论攻伐的药物还是调补的药物都难以胜任。只应当频频给予粥汤，微微辅助胃气，以等待津液回复，或许可以挽救。而饥饿很久的人，粥食送到嘴边，虽然极甘美，但大多吃下去会呕吐，或吃下去不久反酸，或胸膈间迷闷不爽，或腹中隐隐作痛，或肠中声响不已。这些都是三脘（上、中、下脘）闭约，痰气阻碍的缘故。病人家属不明白这个道理，往往被师巫及亲朋左右的话所迷惑，犹豫不敢进食，因循日久，最终成为不可救治的情况很多。
怎么不知道胃气久虚的人，即使有不时烘热，不辅助以谷气，则虚火不能消除；有胸膈痞满，不辅助以谷气，则大气不能运转；即有大便干枯约束，不辅助以谷气，则津液不能回复。盖新谷气运转，则宿滞才能下行通畅。若能认定这个关键时机，频频给予稀糜，等待胃气稍微恢复，逐渐用独参汤、保元汤、四君子汤、异功散之类调理。像这样获得保全的，也颇不少。但不可猛进强进，以及加水复热（指反复加热或不当处理），搪塞一时，重伤衰竭的胃气，反而归咎于调治不当。《内经》说：“浆粥入胃，则虚者活。”所以往往令其不要服药，以收十全之功。
飞畴治疗一位妇人，呕吐恶心，胸满身热，六脉弦数无力，形色倦怠，口渴但不甚饮水。她说自从游览虎丘晕船呕吐后，出汗并出现发热头痛。服用了四剂发散药，头痛虽缓解，但胀痛眩晕不禁。又用了三四剂消导药，胸膈更加膨满，闻到谷气就呕吐眩晕。因为热不退，医生禁止喝粥吃饭已经半个月，只每天喝清茶三四碗。现在周身骨肉酸痛，转侧时眩晕呕哕。我说：当风呕吐出汗，确实有外感的情况，但已经发散了。呕吐则饮食已去，胃气从逆。消导攻伐则更伤脾气，脾虚故胀甚。现在没有外感可散，没有饮食可消，脾绝谷气则呕吐，土受水克则眩晕。即使用药，也没有胃气来运行药力。只给予米饮，继进稀糜，使脾胃有所主宰，再议补益即可。于是严格遵守我的建议，竟不服药而痊愈。
Human life depends on water and grain (dietary intake). When the essence of water and grain is distributed throughout the body, the five zang organs remain harmonious. If the transformation and transportation of water and grain are obstructed or reversed, myriad diseases will arise. If water and grain are cut off, life becomes perilous. This is because the stomach is the sea of water and grain and the root of the five zang organs. However, if pathogenic factors accumulate in the stomach, preventing it from performing its functions of receiving and discharging, one must not force-feed the patient, as this would only exacerbate the pathogenic factors.
Due to the accumulation of pathogenic heat in the stomach and obstruction by phlegm and food retention, even if a person does not eat for ten days or more, there is no need to worry. This differs from healthy individuals whose spleen qi constantly digests food; they cannot go without food day or night. Thus, Bian Que (Yue Ren) stated that a healthy person who does not consume water and grain for seven days will die, which is a critical prohibition. However, in cases of *Shanghan* (Cold Damage) characterized by anhidrosis and a tight pulse, indicating cold injuring the Ying level, or cases where sweating fails to relieve restlessness, indicating simultaneous disease of Ying and Wei levels, the Ying qi in the stomach has been injured by cold pathogens and constrained into heat. If diet is not restricted, it will inevitably aid the pathogens in causing havoc, leading to significant harm. Furthermore, in conditions resembling cholera with chaotic Qi rebellion, ingesting food can lead to immediate disaster. In contrast, for Wind-injuring-the-Wei level syndromes characterized by spontaneous sweating and a slow pulse, although external pathogens are contracted, the disease transmits only through the meridians and does not enter the Stomach Fu organ; thus, there is no prohibition against eating. As Zhang Zhongjing noted after administering Guizhi Tang (Cinnamon Twig Decoction), "drink hot thin porridge to assist the medicinal power," demonstrating that dietary restriction should not be universal.
Not only does Guizhi Tang use hot thin porridge to assist its efficacy, but even in Cold-injuring-Ying cases with a weak Chi pulse, Xiao Jianzhong Tang is used. It utilizes the sweet nature of maltose (Jiaoyi) to guide the acrid-warm properties of Cinnamon Twig (Guizhi) to linger in the Middle Jiao, assisting the Stomach in expelling pathogens. This is essentially a variation of the hot porridge method. Since the dregs are removed during decoction, there is no cloying residue to aggravate pathogenic heat, making it suitable for Cold-injuring-Ying cases. This approach is superior to simply using hot porridge. Zhang Zhongjing, the ancestor of *Shanghan* therapeutic laws, would certainly not make absurd claims to deceive future generations. The reason lies in the fact that these sacred methods have long been obscured. Consequently, modern practitioners, upon encountering symptoms like fever and headache resembling external contraction, indiscriminately diagnose them as *Shanghan*, regardless of deficiency or excess, exterior or interior, true or false heat. They invariably prohibit diet and administer generic wind-dispersing and food-resolving drugs. For robust individuals with strong Zheng Qi, although the medication may not be perfectly targeted, the slight exterior-releasing effect may suffice to reduce fever and cool the body. They fail to realize that those with strong Stomach Qi, having contracted shallow pathogens, can naturally generate correct sweat even without medication. As the saying goes, "When the vigorous ones move their Qi, the illness resolves." Conversely, for individuals with deficient Yuan Qi and scant Stomach fluids, depriving them of diet makes it difficult to produce sweat even with appropriate medication, let alone tolerate excessive exterior-releasing drugs that severely damage the already weak Stomach Qi.
How can one ignore that Spleen and Stomach Qi rely entirely on dietary intake for transformation and transport, much like a wheel drawing water? Now, for a diseased and near-collapse Stomach, waiting for the chest and diaphragm to feel clear before allowing food intake is like burying a wheel at a dry mountain foot and waiting for water to rise before drawing it; the chances of the seedlings surviving are slim. Even if death is avoided, Yuan Qi is depleted. Young people become emaciated, developing deficiency consumptive diseases; the elderly suffer hidden damage to their primordial spirit, shortening their lifespan. These outcomes result from the custom of favoring attacking and purging methods while neglecting the protection of Righteous Qi. Fever and headache do not always indicate *Shanghan*. If internal injury from overwork or Yin deficiency with fire flaring is treated as *Shanghan*, it accelerates premature death. I have specialized in *Shanghan* for sixty years and have witnessed numerous deaths caused by erroneous dietary deprivation, too many to list.
I have seen individuals starved for long periods whose Spleen Qi fails to transform. Despite going days or months without appetite, quacks mistakenly assume food retention and aggressively prescribe Qi-moving and chest-opening drugs. This often stirs up deficient Yang, causing flushing of the head and face. Physicians then misinterpret this as residual exterior pathogens and heavily prescribe dispersing agents such as Natrii Sulfas (Xiaoshi), Rheum Radix et Rhizoma (Dahuang), Bupleuri Radix (Chaihu), Puerariae Radix (Gegen), Aurantii Fructus Immaturus (Zhishi), and Citri Reticulatae Pericarpium (Ju Pi) without restraint, until death ensues. Others have intestines and stomachs devoid of grain for a long time, with dry stool constipation, yet physicians rashly consider purgation. This indicates extreme Stomach Qi deficiency; neither attacking nor tonifying drugs are well-tolerated. One should frequently provide rice soup to gently support Stomach Qi while awaiting fluid recovery, which might save the patient. However, for those starved for long periods, even delicious porridge may induce vomiting upon ingestion, acid regurgitation shortly after eating, chest oppression, dull abdominal pain, or borborygmus. These are due to constriction of the three Xi (Upper, Middle, Lower Epigastrium) and obstruction by Phlegm-Qi. Unaware of this, families hesitate to feed the patient based on advice from shamans or relatives, delaying treatment until it becomes incurable.
One must understand that in chronic Stomach Qi deficiency, intermittent flushing requires dietary support to extinguish deficient fire; chest fullness requires dietary support to move Grand Qi; and dry stool requires dietary support to restore fluids. Only when new Grain Qi moves can old stagnation descend. By seizing this critical moment and frequently providing thin gruel, once Stomach Qi recovers slightly, one can gradually regulate with Dushen Tang (Single Ginseng Decoction), Baoyuan Tang (Preserve the Origin Decoction), Sijunzi Tang (Four Gentlemen Decoction), or Yigong San (Extraordinary Efficacy Powder). Many are saved this way. However, one must not force-feed excessively or serve improperly reheated food, which merely delays the inevitable and further damages the failing Stomach Qi, leading to blame on the treatment. The Classic states: "When gruel enters the Stomach, the deficient survive." Therefore, sometimes abstaining from medication yields perfect results.
Feichou treated a woman with vomiting, nausea, chest distension, body heat, wiry-rapid-deficient pulses, and fatigue. She reported that after seasickness and vomiting during a trip to Tiger Hill, she sweated and developed fever, headache, and dizziness. After four doses of dispersing herbs, her headache eased, but distension and dizziness persisted. Three to four doses of resolving herbs worsened her chest distension, causing vomiting and dizziness at the smell of food. Her fever persisted, and doctors had prohibited porridge and solid food for half a month; she drank only 3-4 cups of clear tea daily. Now, her whole body ached, and turning caused dizziness and retching. I said: Vomiting and sweating after wind exposure suggests exterior contraction, but it has already been dispersed. Vomiting removes dietary content, causing Stomach Qi to rebel. Resolving drugs further injure Spleen Qi, causing severe distension due to Spleen deficiency. There is now no exterior to disperse and no food to resolve. Spleen failure to receive grain causes vomiting; Earth overwhelmed by Water causes dizziness. Medication cannot act without Stomach Qi to transport it. Provide rice drink, then thin gruel, to establish Spleen and Stomach dominance, followed by tonification. Strictly following this advice, she recovered without taking any medicine.