【歌】胸膨嗳气为伤食，气口紧盛端可识。所伤仍辨热和寒，元气要分虚与实。
【论】经云∶饮食自倍，肠胃乃伤。故伤食者，气口脉紧盛，左手脉平和，胸膈痞塞，噫气如败卵臭，头
疼发热，绝类伤寒，但身不疼为异耳。所伤之物，有辛辣、香燥、炙爆、酒、面、热物者；有伤生冷、鱼腥、
水果、寒凉等物者；有壮实人纵饮大嚼者；有虚弱人多食不克化者之不同。更审其所伤多少，酌其元气虚实而
消之、导之、攻之、补之，则万举万全而无诛伐太过之失也。
【脉】气口紧盛，为伤于食。食不消化，浮滑而疾。
伤冷物
所伤一切冷物，如鱼腥、瓜果之类，胸中痞满者，二陈汤加香附、砂仁、神曲、红豆，或治中汤，或木香
见丸，仍用炒麸皮熨之。
二陈汤（方见痰证。）
治中汤（方见脾胃。）
木香见 丸
巴豆霜（五分） 京三棱（一两） 神曲（炒黄，一两） 木香（二钱） 香附（五钱，炒熟） 石三
棱（五钱，去皮，与京三棱共煨） 升麻（三钱） 柴胡（三钱） 草豆蔻（面裹，烧熟，取仁五钱）
上为细末，汤浸 饼为丸，如绿豆大，每服二十丸，白汤下，量所伤多少服之。
伤热物
所伤热物，如姜、椒、蒜、韭、酒、面、炙爆、煎炒、犬肉、辛辣之类，致心下痞满作痛者，三黄枳实汤，
或二陈加芩、连、山楂、枳实、神曲、麦芽。食已下，大便不通，大承气汤下之。
三黄枳实汤
黄芩（一钱） 黄连（一钱） 大黄（煨，一钱） 枳实（二钱） 浓朴（五分）
甘草（五分）
上锉，一剂，水二盏，煎八分，空心热服。
二陈汤（见痰证。）
大承气汤
大黄（三钱） 芒硝（三钱） 浓朴（一钱五分） 枳实（一钱五分）
上锉，一剂，水二大钟，煎至八分，热服，以利为度。
按∶经曰∶脾胃者，仓廪之官，无物不受，一有停滞，则气不顺而生痞、满、燥、实、坚。是方也，浓朴
苦温以去痞，枳实苦寒以泻浊，芒硝咸寒以润燥软坚，大黄苦寒以泻实去热，此土郁则夺之之意也。
虚人伤食
虚弱人食不化，痞满者，六君子汤加神曲、麦 、山楂。大便不通者，加枳实、浓朴，或枳术丸加曲、 、
橘、半、山楂。虚甚者加茯苓、人参。
六君子汤
即四君子汤合二陈汤。（四君子见脾胃，二陈见痰证。）
枳术丸（方见脾胃。）
实人伤食
气壮人伤食，痞满不消者，保和丸。大便闭结不通，胀满者，木香槟榔丸。
保和丸
治食积。
山楂肉（二两，蒸熟） 神曲（炒，一两） 半夏（一两） 茯苓（一两） 莱菔子（五钱） 陈皮（五
钱） 连翘（五钱）
上为末，神曲糊丸，如桐子大，每服三钱，空心米汤下。
加白术名大安丸。
木香槟榔丸
治一切气滞，心腹痞满，胁肋胀痛，大、小便结滞不利者。
木香（一两） 槟榔（一两） 蓬术（一两） 青皮（一两） 陈皮（一两） 枳壳（一两） 黄连（一
两） 香附（三两） 大黄（炒，三两） 牵牛（生，取头末，三两）
上为末，水发为丸，食后姜汤送下四、五十丸，以利为度。
【歌诀】胸部胀满、嗳气是伤食的表现，气口脉象紧盛即可明确诊断。需要辨别所伤食物属热还是属寒，元气要区分虚与实。
【论述】《内经》说：“饮食加倍，肠胃就会受伤。”所以伤食的人，气口脉象紧盛，左手脉象平和，出现胸膈部痞塞感，打嗝有像臭鸡蛋一样的气味，头痛发热，症状极像伤寒，只是身体不疼痛作为区别。所伤的食物，有辛辣、香燥、烧烤、酒类、面食、热性食物等；有生冷、鱼腥、水果、寒凉食物等；有身体壮实之人纵情饮酒、大口吃肉的情况；也有身体虚弱之人多吃导致无法消化的情况，各不相同。更要审视所伤食物的多少，斟酌元气的虚实，分别采用消导、通导、攻下、补益的方法，就能万无一失，避免过度攻伐的错误。
【脉诊】气口脉象紧盛，是伤于食物。食物不消化，脉象浮滑且快。
伤冷物
凡是损伤了冷物，如鱼腥、瓜果之类，导致胸中痞闷胀满的，用二陈汤加入香附、砂仁、神曲、红豆，或者使用治中汤，或者木香见丸，同时用炒过的麸皮熨烫患处。
二陈汤（方剂见痰证章节。）
治中汤（方剂见脾胃章节。）
木香见丸
巴豆霜（五分） 京三棱（一两） 神曲（炒至黄，一两） 木香（二钱） 香附（五钱，炒熟） 石三棱（五钱，去皮，与京三棱共同煨制） 升麻（三钱） 柴胡（三钱） 草豆蔻（用面包裹，烧熟，取仁五钱）
以上研为细末，用水浸透的面饼和药粉制成丸药，大小如绿豆，每次服用二十丸，白开水送服，根据所伤食物的多少调整剂量。
伤热物
凡是损伤了热物，如姜、椒、蒜、韭菜、酒、面食、烧烤、煎炒、狗肉、辛辣之类，导致心下部痞闷胀满疼痛的，用三黄枳实汤，或者在二陈汤基础上加入黄芩、黄连、山楂、枳实、神曲、麦芽。如果进食后大便不通，用大承气汤攻下。
三黄枳实汤
黄芩（一钱） 黄连（一钱） 大黄（煨制，一钱） 枳实（二钱） 浓朴（五分）
甘草（五分）
以上切碎，一剂药，加水两盏，煎至八分，空腹热服。
二陈汤（见痰证章节。）
大承气汤
大黄（三钱） 芒硝（三钱） 浓朴（一钱五分） 枳实（一钱五分）
以上切碎，一剂药，加水两大钟，煎至八分，热服，以大便通畅为度。
按语：《内经》说：“脾胃是仓廪之官，没有什么是它不能接受的，一旦有停滞，气就不顺，从而产生痞、满、燥、实、坚的症状。”这个方子中，浓朴苦温以消除痞满，枳实苦寒以泻除浊气，芒硝咸寒以润燥软坚，大黄苦寒以泻实清热，这是“土郁则夺之”的意思。
虚人伤食
身体虚弱的人食物不消化，出现痞满的，用六君子汤加入神曲、麦芽、山楂。如果大便不通，加入枳实、浓朴，或者枳术丸加入神曲、麦芽、陈皮、半夏、山楂。虚损严重的加入茯苓、人参。
六君子汤
即四君子汤合二陈汤。（四君子汤见脾胃章节，二陈汤见痰证章节。）
枳术丸（方剂见脾胃章节。）
实人伤食
气血壮实的人伤食，痞满不消的，用保和丸。如果大便闭结不通，胀满的，用木香槟榔丸。
保和丸
治疗食积。
山楂肉（二两，蒸熟） 神曲（炒，一两） 半夏（一两） 茯苓（一两） 莱菔子（五钱） 陈皮（五钱） 连翘（五钱）
以上研为末，用神曲糊制作丸药，大小如梧桐子，每次服用三钱，空腹米汤送服。
加入白术名为大安丸。
木香槟榔丸
治疗一切气滞，心腹痞满，胁肋胀痛，大、小便结滞不利的情况。
木香（一两） 槟榔（一两） 蓬术（莪术，一两） 青皮（一两） 陈皮（一两） 枳壳（一两） 黄连（一两） 香附（三两） 大黄（炒，三两） 牵牛（生用，取头末，三两）
以上研为末，用水泛丸，饭后姜汤送服四五十丸，以大便通畅为度。
[Verse] Chest distension and belching indicate food stagnation; a tight and full pulse at the Qi Kou (radial artery) confirms the diagnosis. One must distinguish whether the ingested food is hot or cold, and assess whether the Yuan Qi (Original Qi) is deficient or excess.
[Discussion] The *Classic of Internal Medicine* states: "If food and drink are doubled, the intestines and stomach will be injured." Therefore, in cases of food stagnation, the pulse at the Qi Kou is tight and full, while the left-hand pulse remains peaceful. Symptoms include a sensation of obstruction in the chest and diaphragm, belching with an odor resembling rotten eggs, headache, and fever. These symptoms closely resemble Taiyang disease (Cold Damage), except for the absence of body pain. The types of food causing injury vary: spicy, aromatic, dry, roasted, fried, alcoholic, wheat-based foods, and hot-natured foods; or raw, cold, fishy, fruity, and cooling foods. There are differences between robust individuals who overindulge in drinking and eating, and weak individuals whose digestion cannot handle large amounts of food. It is essential to examine the quantity of ingested food and evaluate the deficiency or excess of Yuan Qi (Original Qi), then apply methods of resolving, guiding, purging, or tonifying accordingly. This ensures success in every case and avoids the error of excessive attack.
[Pulse Diagnosis] A tight and full pulse at the Qi Kou indicates food injury. Undigested food presents as a floating, slippery, and rapid pulse.
Injury from Cold Foods
For injuries caused by any cold foods, such as fish, shellfish, melons, and fruits, resulting in chest oppression and fullness, use Erchen Tang (Two-Aged Decoction) added with Xiangfu (Cyperus Rhizome), Sharen (Amomum Fruit), Shenqu (Medicated Leaven), and Hongdou (Adzuki Bean). Alternatively, use Zhizhong Tang (Regulate the Middle Decoction) or Muxiang Jian Wan (Aucklandia Pill). Additionally, apply warm compresses using stir-fried bran.
Erchen Tang (See formula under Phlegm Syndrome.)
Zhizhong Tang (See formula under Spleen and Stomach.)
Muxiang Jian Wan
Baiduoshuang (Croton Seed Frost) (5 fen)
Jingsanleng (Kansui Rhizome? No, Burreed Tuber - *Sparganium stoloniferum*) (1 liang)
Shenqu (Stir-fried until yellow, 1 liang)
Muxiang (Vladimiria Root) (2 qian)
Xiangfu (Cyperus Rhizome) (5 qian, stir-fried)
Shisanleng (Curcuma Zedoaria? No, Curcuma Phaeocaulis - *Curcuma phaeocaulis*) (5 qian, peeled, stewed together with Jingsanleng)
Shengma (Cimicifuga Rhizome) (3 qian)
Chaihu (Bupleurum Root) (3 qian)
Caodoukou (Grass Cardamom) (wrapped in flour, roasted, take the kernel 5 qian)
Grind all into fine powder. Mix with water-soaked dough to form pills the size of mung beans. Take 20 pills per dose with plain warm water, adjusting the dosage according to the amount of food ingested.
Injury from Hot Foods
For injuries caused by hot foods, such as ginger, pepper, garlic, leeks, wine, wheat products, roasted/fried items, dog meat, and spicy substances, leading to epigastric oppression, fullness, and pain, use Sanhuang Zhishi Tang (Three-Yellow Immature Bitter Orange Decoction) or Erchen Tang (Two-Aged Decoction) added with Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Shanzha (Hawthorn Fruit), Zhishi (Immature Bitter Orange), Shenqu (Medicated Leaven), and Maiya (Sprouted Grain). If bowel movement does not occur after eating, purge with Dachengqi Tang (Major Order the Qi Decoction).
Sanhuang Zhishi Tang
Huangqin (Scutellaria Root) (1 qian)
Huanglian (Coptis Rhizome) (1 qian)
Dahuang (Rhubarb Root) (roasted, 1 qian)
Zhishi (Immature Bitter Orange) (2 qian)
Nongpo (Magnolia Bark) (5 fen)
Gancao (Licorice Root) (5 fen)
Cut into pieces. For one dose, add two cups of water, decoct to eight-tenths strength, and take hot on an empty stomach.
Erchen Tang (See under Phlegm Syndrome.)
Dachengqi Tang (Major Order the Qi Decoction)
Dahuang (Rhubarb Root) (3 qian)
Mangxiao (Mirabilite) (3 qian)
Nongpo (Magnolia Bark) (1.5 qian)
Zhishi (Immature Bitter Orange) (1.5 qian)
Cut into pieces. For one dose, add two large cups of water, decoct to eight-tenths strength, and take hot. Stop when bowel movement occurs.
Commentary: The *Classic of Internal Medicine* states: "The spleen and stomach are the officials of the granaries; they accept all things. If stagnation occurs, Qi becomes obstructed, leading to sensations of obstruction (Pi), fullness (Man), dryness (Zao), excess (Shi), and hardness (Jian)." In this formula, Nongpo (Magnolia Bark) is bitter and warm to resolve obstruction; Zhishi (Immature Bitter Orange) is bitter and cold to drain turbidity; Mangxiao (Mirabilite) is salty and cold to moisten dryness and soften hardness; Dahuang (Rhubarb Root) is bitter and cold to drain excess and clear heat. This embodies the principle of "draining Earth stagnation."
Food Injury in Deficient Individuals
When weak individuals suffer from indigestion accompanied by obstruction and fullness, use Liujunzi Tang (Six-Gentlemen Decoction) added with Shenqu (Medicated Leaven), Maiya (Sprouted Grain), and Shanzha (Hawthorn Fruit). If there is constipation, add Zhishi (Immature Bitter Orange) and Nongpo (Magnolia Bark), or use Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill) added with Shenqu (Medicated Leaven), Maiya (Sprouted Grain), Chenpi (Tangerine Peel), Banxia (Pinellia Tuber), and Shanzha (Hawthorn Fruit). For severe deficiency, add Fuling (Poria) and Renshen (Ginseng Root).
Liujunzi Tang (Six-Gentlemen Decoction)
This is Si Junzi Tang (Four-Gentlemen Decoction) combined with Erchen Tang (Two-Aged Decoction). (Si Junzi Tang see Spleen and Stomach; Erchen Tang see Phlegm Syndrome.)
Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill) (See formula under Spleen and Stomach.)
Food Injury in Robust Individuals
For robust individuals with food stagnation causing persistent obstruction and fullness, use Baohe Wan (Preserve Harmony Pill). If there is fecal impaction and abdominal distension, use Muxiang Binglang Wan (Aucklandia and Areca Nut Pill).
Baohe Wan (Preserve Harmony Pill)
Treats food accumulation.
Shanzha Rou (Hawthorn Flesh) (2 liang, steamed)
Shenqu (Medicated Leaven) (stir-fried, 1 liang)
Banxia (Pinellia Tuber) (1 liang)
Fuling (Poria) (1 liang)
Laifuzi (Radish Seed) (5 qian)
Chenpi (Tangerine Peel) (5 qian)
Lianqiao (Forsythia Fruit) (5 qian)
Grind into powder. Use Shenqu paste to form pills the size of paulownia seeds. Take 3 qian per dose with rice water on an empty stomach.
Adding Baizhu (Atractylodes Macrocephala Rhizome) creates Da'an Wan (Great Peace Pill).
Muxiang Binglang Wan (Aucklandia and Areca Nut Pill)
Treats all forms of Qi stagnation, including epigastric and abdominal obstruction/fullness, hypochondriac distension and pain, and constipation or difficult urination/defecation.
Muxiang (Vladimiria Root) (1 liang)
Binglang (Areca Seed) (1 liang)
Pengzhu (Curcuma Zedoaria Rhizome) (1 liang)
Qingpi (Green Tangerine Peel) (1 liang)
Chenpi (Tangerine Peel) (1 liang)
Zhike (Aurantii Fructus Immaturus) (1 liang)
Huanglian (Coptis Rhizome) (1 liang)
Xiangfu (Cyperus Rhizome) (3 liang)
Dahuang (Rhubarb Root) (stir-fried, 3 liang)
Qianniu (Morning Glory Seed) (raw, take the first powder, 3 liang)
Grind into powder. Form pills using water. Take 40-50 pills after meals with ginger-infused water, stopping when bowel movement occurs.