凡生冷、坚硬难化之物过食，停于胃脘，以致发热、气喘、胸口结痛拒按、大便秘结，
有五
六日、十余日不动者，全似结胸，而断不可以大、小陷胸法治也。陷胸是因误下，邪气内陷
，与内痰相裹；此乃初起即见结痛，是有形之物阻塞气化，非气化壅结也。若根据陷胸治之，
洞肠穿胃，形气俱伤矣。其证两侧头痛，是食阻少阳之生气也。舌苔或白浓，或黄浓，而上
覆以黑，是胃脘之血为冷食所逼而停凝也。舌尖起小红粟累累，甚则紫黑，延及两边，心热
如焚，口干索水而不欲咽，是胃阳不能斡运而上越，又挟有死血也。故小儿伤食寒热，病愈
后，多有吐血数口，及下血一二次者，此也。凡寒热证及内痈证，多挟死血也。三五日，有
饮水无度者，是宿食蒸腐化热也。此时遍身 热，神识昏迷，胸高气粗，若误作温毒，治以
凉解，阳气泄伤，食转不化而洞下矣。亦有肢冷额热，困倦无力，呼吸不续，自汗盗汗者，
若误作阴虚，治以滋补，中气愈郁，痞满愈甚，甚者化为肠痈、胃痈，积为肺痈，轻亦传为
痢疾矣。此病阳明胃腑形气俱困，太阴肺脏气化大伤，更有先伤他物，未及消化，旋又加以
生硬者，其势尤重，是胃之上下脘俱困矣。治之失法，死生反掌，故东垣首竞竞于此也。近
时小儿最多此证，或当风乳食，或谷果杂下。其初起身忽大热，面颊尤甚，腹痛夭 ；旋变
寒热往来，入夜即热，五更为甚，天明即止，额与手心常热，爪尖时冷，肚腹膨胀，渐见胸
高气急， 溏不畅，或先水泻。禀赋弱者，不能化热，即致洞下不起；化热者，痰生于内，
壅肺迫心，传为惊风。病家、医家以为既经泄泻，不疑有食，起手则发表以虚其中气，继则
清热以冰其胃阳，久则或以为慢惊而坠痰，或以为阴虚而养肾，又以为气虚而健脾补肺，亦
有与槟榔、木香者。病家畏而不服，或服之而不知善其后，杂投攻补，而儿已胸过于头，肚
大于箕，不可为矣。此焦楂、桃仁、陈皮、紫菀一二剂之事耳!而众医集议，迁延无策，目
睹情形，可笑可慨!
凡是过食生冷、坚硬难消化的食物，停滞在胃脘部，导致发热、气喘、胸口结聚疼痛且拒绝按压、大便秘结，持续五六天甚至十余天没有排便的，完全像是结胸证，但绝对不能用大陷胸汤或小陷胸汤来治疗。陷胸证是因为误用下法，邪气内陷，与体内的痰浊相互搏结；而此证是初起就出现结聚疼痛，是有形的实物阻塞了气化功能，并非气化壅滞结聚。如果按照陷胸证的方法治疗，会导致肠道穿孔、胃壁受损，形体与正气都会受到严重伤害。
该病症两侧头痛，是因为食积阻滞了少阳经的生发之气。舌苔有的白厚腻，有的黄厚腻，上面还覆盖着黑色，这是胃脘部的血液被冷食逼迫而停凝所致。舌尖长出许多小红米粒状突起，严重时呈紫黑色，并蔓延至两侧，心中烦热如火烧，口干想喝水但不想咽下，这是胃阳不能正常运化而上越，又兼有瘀血（死血）的缘故。所以小儿伤食引起的寒热病，痊愈后，常有吐出几口血，或大便出血一两次的情况，就是这种原因。凡是寒热证及体内痈肿证，大多兼夹瘀血。
发病三五天后，如果有大量饮水无节制的情况，这是因为宿食蒸腾腐败化为热邪。此时全身发热，神识昏迷，胸部高耸呼吸粗重，如果误认为是温毒，用清凉解表的方法治疗，会损伤阳气，使食物更加无法消化而导致腹泻不止。也有四肢冰冷、额头发热、困倦无力、呼吸微弱断续、自汗盗汗的情况，如果误认为是阴虚，用滋补的方法治疗，中气会更加郁结，痞满症状更加严重，严重的会转化为肠痈、胃痈，积聚成肺痈，轻的也会传变为痢疾。
此病导致阳明胃腑的形质与正气都陷入困境，太阴肺脏的气化功能严重受损。更有甚者，先吃了其他东西未能消化，紧接着又吃生冷坚硬之物，病情尤其严重，这是胃的上部和下部都陷入了困境。治疗方法不当，生死只在顷刻之间，所以李东垣对此格外谨慎。近来小儿患此证的最多，有的是迎风哺乳进食，有的是谷物水果混杂吞下。起初突然高热，面颊尤为明显，腹痛剧烈；随即变为寒热往来，入夜即发热，五更时分最甚，天亮时停止，额头和手心常热，指甲尖端时常发冷，腹部膨胀，逐渐出现胸部高耸气急，大便溏薄不畅，或者先出现水样腹泻。禀赋虚弱者，不能化热，就会导致腹泻不止不起身；能化热者，痰液生于体内，壅塞肺部压迫心脏，传变为惊风。
家属和医生认为既然已经发生泄泻，就不怀疑有食积，起手就用发表药来耗其中气，接着用清热药来冰伏其胃阳，时间久了，有的以为是慢惊风而使用坠痰药，有的以为是阴虚而滋养肾阴，还有的以为是气虚而健脾补肺，也有给予槟榔、木香的。家属因畏惧而不服用，或者服用了却不知道如何善后，杂乱地投用攻伐与补益药物，等到孩子胸部高过头顶，肚子大如簸箕时，就已经无法救治了。这本来只是焦山楂、桃仁、陈皮、紫菀一二剂就能解决的事！然而众医集议，拖延无策，目睹此种情形，真是既可笑又可悲感叹！
Whenever excessive consumption of raw, cold, or hard-to-digest foods causes stagnation in the epigastrium, leading to fever, asthma (wheezing), chest oppression with pain that is tender to pressure, and constipation persisting for five to six days or even more than ten days without bowel movement, it closely resembles Jie Xiong syndrome (Chest Binding Syndrome). However, it absolutely must not be treated with Da Xian Xiong Tang (Major Intra-thoracic Decoction) or Xiao Xian Xiong Tang (Minor Intra-thoracic Decoction). The etiology of Jie Xiong syndrome involves pathogenic factors sinking inward due to improper use of purgatives, where they bind with internal phlegm. In contrast, this condition presents with binding pain from the onset, caused by tangible food obstruction blocking Qi transformation, rather than a blockage of Qi dynamics itself. Treating it according to the protocol for Jie Xiong would perforate the intestines and damage the stomach, injuring both form and Qi.
The headache on both sides indicates that food stagnation has obstructed the ascending Qi of the Shaoyang channel. The tongue coating may be thick white or thick yellow, covered with black, signifying that blood in the epigastrium has been forced to coagulate by cold food. Small red millet-like papules appearing on the tip of the tongue, which may turn purple-black and spread to the sides, accompanied by intense heart heat as if burning, dry mouth desiring water but unwillingness to swallow, indicate that Stomach Yang fails to govern transportation and ascends improperly, compounded by the presence of dead blood (stasis). Therefore, after children recover from febrile diseases caused by food injury, they often vomit a few mouthfuls of blood or pass blood once or twice in stool; this is the cause. Generally, febrile diseases and internal abscess syndromes are frequently complicated by blood stasis.
Within three to five days, if there is uncontrolled drinking of water, it is because retained food steams and rots, transforming into heat. At this stage, the whole body is hot, consciousness is clouded, the chest is elevated, and breathing is coarse. If mistakenly diagnosed as Wen Du (Warm Toxicity) and treated with cooling and resolving methods, Yang Qi will be damaged, causing the food to become undigested and leading to profuse diarrhea. There are also cases with cold limbs, a hot forehead, fatigue and weakness, intermittent breathing, spontaneous sweating, and night sweats. If mistakenly diagnosed as Yin Deficiency and treated with tonification, Middle Qi will become more depressed, and fullness/stagnation will worsen. Severe cases may transform into Chang Yong (Intestinal Abscess) or Wei Yong (Stomach Abscess), accumulate into Fei Yong (Lung Abscess), or mildly transmit as Li Ji (Dysentery).
This disease confines both the form and Qi of the Yangming Stomach Fu organ and severely damages the Qi transformation of the Taiyin Lung Zang. Even worse, if other foods were consumed first and not digested, followed immediately by raw and hard foods, the condition is particularly severe, indicating that both the upper and lower parts of the Stomach are confined. Improper treatment can lead to death or survival in an instant; thus, Li Dongyuan was always vigilant regarding this. Recently, many children suffer from this syndrome, either from nursing/eating while exposed to wind or from mixing grains and fruits. Initially, there is sudden high fever, especially on the cheeks, and severe abdominal pain; this soon changes to alternating chills and fever, with heat starting at night, peaking at Wu Geng (3-5 AM), and subsiding at dawn. The forehead and palms are often hot, while the nail tips are sometimes cold. The abdomen becomes distended, gradually leading to an elevated chest and rapid breathing, loose stools that are difficult to pass, or initially watery diarrhea. Children with weak constitution who cannot transform heat will suffer from persistent diarrhea and failure to rise; those who do transform heat will generate internal phlegm, which congests the Lungs and presses on the Heart, transmitting as Jing Feng (Convulsive Disease).
Parents and physicians, assuming that since diarrhea has occurred, food stagnation is ruled out, begin by using exterior-releasing formulas to deplete Middle Qi, followed by heat-clearing formulas to freeze Stomach Yang. Over time, some treat it as Man Jing Feng (Slow Convulsion) using phlegm-resolving sedatives, others as Yin Deficiency nourishing Kidney Yin, or as Qi Deficiency strengthening Spleen and Lung. Some administer Bing Lang (Areca Seed) and Mu Xiang (Aucklandia Root). Parents may refuse medication out of fear, or take it without proper follow-up, leading to chaotic administration of attacking and tonifying agents. By the time the child's chest protrudes above the head and the abdomen is larger than a winnowing basket, it is incurable. This condition could have been resolved with one or two doses of Jiao Zha (Charred Hawthorn Fruit), Tao Ren (Peach Kernel), Chen Pi (Tangerine Peel), and Zi Wan (Aster Root)! Yet, collective medical deliberation led to delay and lack of strategy; witnessing such situations is both laughable and lamentable.