中恶者。入庙登冢。吊死问疾。飞尸鬼击。故为中恶。其症牙关紧急。昏不知人。似乎中痰。但头面青黑。肌肤
粟起。可以知其中恶也。内经云。大凡外邪之入。必与内邪相合。中恶之人。先有痰食在胃。正气不旺。然后
鬼昧得以犯之。治是症者。当以安神化痰为先。俟其气顺痰消。方可议补。薛立斋云。中恶先因正气大虚。然后
为恶所中。治当大补元气。勿以痰治。然初起必先化痰。不可顾母失子也。
安神化痰汤
茯神 远志 陈皮 半夏 杏仁 石菖蒲 麦冬 桔梗 甘草
有食加枳壳浓朴。
方书云。人迎紧盛伤于寒。气口紧盛伤于食。以是知伤食之脉。专以气口为主也。然诊视之时。有气口脉沉伏者。
有气口脉滑大者。又有人迎气口俱弦数者。纷纷不一。不可以一说拘也。夫人迎气口脉俱弦数。外症日晡
寒热。头亦微痛。全与风寒无异。但神气如故。身无疼痛。可以为别也。脾胃
之气禀于命门。命门凝然不动。下焦为之臣使。宣布其气。行至中焦。入于
脾胃。乃能化食。今因饮食郁遏。少阳三焦之气不得宣通。故生寒热诸症。医者不识。呼为寒疾。误人多矣。宜用
柴胡化滞汤。通表里而双解之。食重者宜下。若外无寒热表症。但觉胸膈不宽者。痰裹食而不化也。宜用加味
二陈汤。又有生冷伤脾者。脉来沉缓无力。（审脉之有力无力而定虚实之治）宜用香砂理中汤。更有胸腹不觉。咳嗽气急。
四肢无力。大便不甚通畅。脉沉弦细。按之无力。下焦虽是虚寒。中焦又有浮热。先以养血健
脾汤。开其痰食。再以八味地黄丸。实其下焦。方为得法。至若饮食积久。或伤之太过。中气闭塞。以致猝
然僵仆。昏不知人。名为食厥。甚则四肢拘挛。状如中痰。亦用加味二陈汤。
脉沉细缓者。宜加姜桂。不可误认痰症。妄用痰剂。
柴胡化滞汤
柴胡 黄芩 半夏 甘草 枳壳 浓朴 山楂 苏子 桔梗
伤食而用柴胡。以其能升少阳之气也。
加味二陈汤
陈皮 半夏 白茯 甘草 枳壳 浓朴 杏仁 山楂 苏子 桔梗
大凡消食化痰。必须顺气。胸中不宽。故用苏桔。若在脐腹以下。宜用青皮香附。
香砂理中汤
人参 白术 炮姜 甘草 砂仁 香附 藿香
滞重去白术。加枳壳。浓朴。寒甚加肉桂。
养血健脾汤 方见脾胃门。
冲和丸
陈皮 半夏 枳壳 浓朴 神曲 杏仁（各一两） 黄芩 桔梗（各五钱）
脾居中央。寒之不觉其寒。热之不觉其热。饮食易化。百病不生。故云冲和。今为饮食所伤。失其旧职。
用此消其积滞。复其冲和之旧矣。故以冲和为名。痰滞胶固者。再加莪术。
物性相制药
索粉不化。宜加杏仁。狗肉亦用。牛肉伤加红曲。鱼伤加橄榄。面食豆腐。加萝卜子。粽子粘食。加白酒药。
肉食加山楂。果子菜蔬。加麝香。煎炒浓味。加淡豆豉。
中恶，是指进入庙宇、登上坟墓，或去吊唁死者、探望病人时，因接触“飞尸鬼击”等邪气而引发的疾病。其症状表现为牙关紧闭、昏迷不醒，看似中痰之证。但患者头面部呈现青黑色，肌肤起鸡皮疙瘩，据此可以判断为中恶。《内经》云：“大凡外邪入侵，必与内邪相合。”中恶之人，胃中先有痰食停滞，正气虚弱，然后邪气才得以侵犯。治疗此症，应当以安神化痰为首要任务，待其气机顺畅、痰浊消除后，方可考虑补益。薛立斋说：“中恶首先是因为正气极度虚弱，然后才被邪气所中。”治疗应当大补元气，不要单纯按痰证治疗。然而初起时必须先化痰，不可只顾补虚而忽略了祛邪（即“顾母失子”）。
安神化痰汤
药物组成：茯神、远志、陈皮、半夏、杏仁、石菖蒲、麦冬、桔梗、甘草。
若有食积，加枳壳、厚朴。
方书记载：“人迎脉紧盛为伤于寒，气口脉紧盛为伤于食。”由此可知，诊断伤食的脉象主要观察气口。然而在诊视时，有的患者气口脉沉伏，有的气口脉滑大，还有的人迎和气口脉都呈弦数之象，情况纷繁不一，不能拘泥于一种说法。如果人迎和气口脉俱见弦数，外在症状表现为傍晚时分寒热往来，头部轻微疼痛，这与风寒感冒无异。但患者神气如常，身体无疼痛感，以此作为鉴别点。脾胃之气禀受于命门，命门凝然不动，下焦作为臣使，宣发其气，运行至中焦，进入脾胃，才能消化食物。如今因饮食郁结阻滞，导致少阳三焦之气不得宣通，从而产生寒热等症状。医者若不识此理，称之为寒疾，误人甚多。适宜使用柴胡化滞汤，疏通表里并双解病邪。食积严重者宜用攻下法。若外部没有寒热表证，仅感觉胸膈不宽畅，这是痰裹食积而不消化的表现，适宜使用加味二陈汤。又有因生冷食物损伤脾气的，脉象沉缓无力。（需审察脉象有力无力来确定虚实治法），适宜使用香砂理中汤。还有出现胸腹部无明显不适，但咳嗽气急，四肢无力，大便不甚通畅，脉象沉弦细，重按无力者。虽然下焦属虚寒，但中焦又有浮热。应先使用养血健脾汤，开通痰食；再使用八味地黄丸，充实下焦，这才是得法的治疗方案。至于饮食积滞日久，或受伤过重，导致中气闭塞，以致突然僵倒昏迷不醒，名为食厥。严重时四肢拘挛，状如中痰，也使用加味二陈汤。若脉象沉细缓，宜加入生姜、肉桂。不可误认为痰证，妄用化痰药剂。
柴胡化滞汤
药物组成：柴胡、黄芩、半夏、甘草、枳壳、厚朴、山楂、苏子、桔梗。
伤食而用柴胡，是因为柴胡能升发少阳之气。
加味二陈汤
药物组成：陈皮、半夏、白茯苓、甘草、枳壳、厚朴、杏仁、山楂、苏子、桔梗。
大凡消食化痰，必须顺气。胸中不宽畅，故用紫苏子和桔梗。若在脐腹以下部位，适宜使用青皮、香附。
香砂理中汤
药物组成：人参、白术、炮姜、甘草、砂仁、香附、藿香。
食滞重者去掉白术，加枳壳、厚朴。寒邪甚者加肉桂。
冲和丸
药物组成：陈皮、半夏、枳壳、厚朴、神曲、杏仁（各一两）、黄芩、桔梗（各五钱）。
脾脏居于中央，不受寒则不觉其寒，受热则不觉其热，饮食易于消化，百病不生，所以称为“冲和”。如今因饮食所伤，失去了原有的职能，使用此方消除积滞，恢复其冲和的旧职，因此命名为冲和丸。若痰滞胶固难化，再加莪术。
物性相制药
索粉（粉丝）不消化，适宜加杏仁，狗肉亦可用此法。牛肉损伤加红曲。鱼类损伤加橄榄。面食、豆腐损伤加萝卜子。粽子等粘腻食物损伤加白酒药。肉食损伤加山楂。果子、菜蔬损伤加麝香。煎炒浓味食物损伤加淡豆豉。
Zhong'e (Sudden Collapse due to Evil Qi) refers to a condition caused by exposure to pathogenic factors such as "Feishi Guiji" (Flying Corpse and Ghost Strike, metaphorical terms for sudden severe pathogens or environmental toxins) when entering temples, visiting graves, mourning the dead, or visiting the sick. The symptoms include lockjaw, unconsciousness, resembling Phlegm Stroke. However, the patient's face appears cyanotic and blackish, and the skin exhibits gooseflesh, which allows one to diagnose Zhong'e. The *Neijing* states: "Generally, when external pathogens invade, they must combine with internal pathogens." Patients with Zhong'e first have phlegm and food stagnation in the stomach, and their healthy Qi is weak, allowing the pathogen to invade. Treatment of this condition should prioritize calming the mind and resolving phlegm. Only after the Qi mechanism becomes smooth and phlegm dissipates can tonification be considered. Xue Lizhai stated: "Zhong'e occurs primarily because of extreme deficiency of Healthy Qi, followed by invasion by evil." Treatment should focus on greatly tonifying Yuan Qi (Original Qi), rather than treating it solely as a phlegm disorder. However, at the initial stage, phlegm must be resolved first; one must not focus only on tonifying the root while neglecting the branch (i.e., "caring for the mother but losing the child").
Anshen Huatan Decoction (Calming the Mind and Resolving Phlegm Decoction)
Ingredients: Fushen (Poria with Hostwood), Yuanzhi (Polygalae Radix), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Xingren (Armeniacae Semen Amarum), Shichangpu (Acori Tatarinowii Rhizoma), Maidong (Ophiopogonis Radix), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
If there is food stagnation, add Zhike (Aurantii Fructus) and Houpo (Magnoliae Officinalis Cortex).
Medical texts state: "A tight and full Renying (Carotid Artery pulse point) indicates injury by Cold; a tight and full Qikou (Radial Artery pulse point) indicates injury by Food." From this, we know that the pulse diagnosis for food injury focuses primarily on the Qikou. However, during examination, some patients have a deep and hidden Qikou pulse, others have a slippery and large Qikou pulse, and some have both Renying and Qikou pulses appearing wiry and rapid. These variations are numerous and cannot be restricted to a single explanation. If both Renying and Qikou pulses are wiry and rapid, and the external symptoms include alternating chills and fever in the late afternoon, along with slight headache, it resembles Wind-Cold. However, the patient's spirit remains normal, and there is no body pain, which serves as the distinguishing factor. The Qi of the Spleen and Stomach is derived from Mingmen (Gate of Life). Mingmen remains still and unmoving, while the Lower Jiao acts as its minister, distributing Qi. This Qi travels to the Middle Jiao, enters the Spleen and Stomach, and enables digestion. Now, due to dietary obstruction, the Qi of Shaoyang Sanjiao (Triple Burner) fails to circulate freely, generating symptoms such as chills and fever. Physicians who do not understand this may misdiagnose it as a Cold disease, causing much harm. It is appropriate to use Chaihu Huazhi Decoction (Bupleurum Decoction for Removing Stagnation) to unblock the exterior and interior and resolve both simultaneously. For severe food accumulation, purgation is indicated. If there are no external chills/fever or exterior symptoms, but only a sensation of chest and diaphragm fullness, it indicates phlegm enclosing undigested food. Jiawei Erchen Tang (Modified Two-Aged Powder) is appropriate. There are also cases where raw/cold foods injure the Spleen, presenting with a deep, slow, and forceless pulse. (One must examine whether the pulse is forceful or forceless to determine deficiency/excess treatment). Xiangsha Lizhong Tang (Amomum and Amomum-Cardamom Decoction for Regulating the Middle) is appropriate. In other cases, there may be no obvious discomfort in the chest or abdomen, but there is coughing, shortness of breath, weakness in the four limbs, and slightly unsmooth bowel movements. The pulse is deep, wiry, fine, and forceless upon heavy pressure. Although the Lower Jiao is deficient and cold, there is floating heat in the Middle Jiao. One should first use Yangxue Jianpi Tang (Nourishing Blood and Strengthening Spleen Decoction) to open up phlegm and food stagnation, and then use Bawei Dihuang Wan (Eight-Ingredient Pill with Rehmannia) to solidify the Lower Jiao. This is the correct method. Regarding long-standing food accumulation or excessive injury leading to closure of Middle Qi, resulting in sudden collapse and unconsciousness, it is named Shijue (Food Syncope). In severe cases, there may be limb spasms resembling Phlegm Stroke. Jiawei Erchen Tang is also used here. If the pulse is deep, fine, and slow, add Shengjiang (Zingiberis Rhizoma Recens) and Rougui (Cinnamomi Cortex). Do not mistake it for a phlegm disorder and wrongly use phlegm-resolving agents.
Chaihu Huazhi Decoction (Bupleurum Decoction for Removing Stagnation)
Ingredients: Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Banxia (Pinelliae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Zhike (Aurantii Fructus), Houpo (Magnoliae Officinalis Cortex), Shanzha (Crataegi Fructus), Suzi (Perillae Fructus), Jiegeng (Platycodonis Radix).
Shangshi (Food Injury) is treated with Chaihu because it can ascend the Qi of Shaoyang.
Jiawei Erchen Tang (Modified Two-Aged Powder)
Ingredients: Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Baifu (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Zhike (Aurantii Fructus), Houpo (Magnoliae Officinalis Cortex), Xingren (Armeniacae Semen Amarum), Shanzha (Crataegi Fructus), Suzi (Perillae Fructus), Jiegeng (Platycodonis Radix).
Generally, to resolve food and phlegm, one must regulate Qi. If the chest is not open, Suzi and Jiegeng are used. If the issue is below the umbilicus and abdomen, Qingpi (Tangerine Peel, Green) and Xiangfu (Cyperi Rhizoma) are appropriate.
Xiangsha Lizhong Tang (Amomum and Cardamom Decoction for Regulating the Middle)
Ingredients: Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Paojiang (Zingiberis Rhizoma Preparatum), Gancao (Glycyrrhizae Radix et Rhizoma), Sharen (Amomi Fructus), Xiangfu (Cyperi Rhizoma), Huoxiang (Agastaches Herba).
For heavy stagnation, remove Baizhu and add Zhike and Houpo. For severe cold, add Rougui (Cinnamomi Cortex).
Yangxue Jianpi Tang (Nourishing Blood and Strengthening Spleen Decoction) - See the Spleen and Stomach section for the formula.
Chonghe Wan (Harmonizing Pill)
Ingredients: Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Zhike (Aurantii Fructus), Houpo (Magnoliae Officinalis Cortex), Shenqu (Massa Medicata Fermentata), Xingren (Armeniacae Semen Amarum) (each 1 liang); Huangqin (Scutellariae Radix), Jiegeng (Platycodonis Radix) (each 5 qian).
The Spleen resides in the center; unaffected by cold, it does not feel cold; unaffected by heat, it does not feel heat. Food digests easily, and diseases do not arise. Hence it is called "Chonghe" (Harmonious/Moderate). Now, injured by diet, it has lost its original function. This formula eliminates stagnation and restores its harmonious state, hence the name Chonghe Wan. If phlegm and stagnation are stubborn and fixed, add Ezhu (Curcumae Rhizoma).
Drug Property Counteracting Agents
If vermicelli (Suofen) is not digesting, add Xingren; this also applies to dog meat. For beef injury, add Hongqu (Red Yeast Rice). For fish injury, add Ganlan (Canarium album seed). For wheat noodles and tofu injury, add Luobozhi (Raphani Semen). For sticky foods like Zongzi, add Baijiuyao (White Wine Yeast). For meat injury, add Shanzha. For fruits and vegetables, add Shexiang (Musk). For fried and strong-flavored foods, add Dandouchi (Fermented Soybean).