治宿食结于肠间，不能下行，大便多日不通。其证或因饮食过度，或因恣食生冷，或因寒火凝结，或因呕
吐既久，胃气冲气，皆上逆不下降。
生赭石（二两，轧细） 朴硝（五钱） 干姜（二钱） 甘遂（一钱半，轧细药汁送服）
热多者，去干姜。寒多者，酌加干姜数钱。呕多者，可先用赭石一两、干姜半钱煎服，以止其呕吐。呕
吐止后，再按原方煎汤，送甘遂末服之。
朴硝虽能软坚，然遇大便燥结过甚，肠中毫无水气者，其软坚之力，将无所施。甘遂辛窜之性，最善行
水，能引胃中之水直达燥结之处，而后朴硝因水气流通，乃得大施其软坚之力，燥结虽久，亦可变为溏粪，顺
流而下也。特是甘遂力甚猛悍，以攻决为用，能下行亦能上达，若无以驾驭之，服后恒至吐泻交作。况此证多
得之涌吐之余，或因气机不能下行，转而上逆，未得施其
攻决之力，而即吐出者。故以赭石之镇逆，干姜之降逆，协力下行，以参赞甘遂成功也。且干姜性热，朴硝性
寒，二药并用，善开寒火之凝滞。寒火之凝滞于肠间者开，宿物之停滞于肠间者亦易开也。愚用此方救人多矣，
即食结中脘下脘，亦未有不随手奏效者。
乙卯之岁，客居广平，忽有车载病患，造寓求诊者。其人年过五旬，呻吟不止，言自觉食物结于下脘，甚
是痛楚，数次延医调治，一剂中大黄用至两半不下。且凡所服之药，觉行至所结之处，即上逆吐出，饮食亦然。
此时上焦甚觉烦躁，大便不通者已旬日矣。诊其脉，虽微弱，至数不数，重按有根。知犹可任攻下，因谓之曰∶
此病易治，特所服药中，有猛悍之品，服药时，必吾亲自监视方妥。然亦无须久淹，能住此四点钟，结处即通
下矣。遂用此汤去干姜，方中赭石改用三两，朴硝改用八钱。服后须臾，腹中作响，迟两点半钟，大便通下而
愈。后月余，又患结证如前，仍用前方而愈。
附录∶
山东德州卢××来函∶
族侄孙××，患肠结证，缠绵两月有余。更医数十人，服药百余剂，不但无效，转大增剧。伊芳亦以为无人
能治，无药可医。气息奄奄，殓服已备。后接先生来信（曾为去信服衷中参西录中赭遂攻结汤），即携《衷中
参西录》往视，幸伊芳心神未昏，将赭遂攻结汤方查出示之。伊芳素知医，卧观一小时，即猛起一手拍腑，言我病
即愈，幸不当死。立急派人取药，服后片刻，腹中大响一阵，自觉其结已开，随即大泻两三盆，停约两句钟，
又泻数次，其病竟愈。随即食山药粉稀粥两茶杯，继用补益濡润之药数剂以善其后。
治疗宿食停滞在肠道之间，无法向下传导，导致多日大便不通。这种病症可能是因为饮食过量，或者恣意食用生冷食物，或者是寒邪与火邪凝结所致，也有可能是因为长期呕吐，导致胃气和冲气都向上逆行而不能下降。
生赭石（二两，碾碎） 朴硝（五钱） 干姜（二钱） 甘遂（一钱半，用药物煎煮后的汁液送服粉末）
如果热象较多，去掉干姜。如果寒象较多，酌情增加几钱干姜。如果呕吐严重，可以先用一两赭石、半钱干姜煎汤服用，以止住呕吐。待呕吐停止后，再按照原方煎汤，送服甘遂末。
朴硝虽然能够软化坚结，但如果遇到大便燥结过于严重，肠道中完全没有津液的情况，它软化坚结的力量就无法施展。甘遂具有辛散走窜的药性，最善于通行水湿，能引导胃中的津液直达燥结的部位，之后朴硝借助流通的津液，才能充分发挥其软化坚结的作用，即使燥结时间很久，也能变为稀便，顺着水流而下。只是甘遂药力非常猛烈强悍，以攻破决裂为功效，既能下行也能上行，如果没有药物来驾驭它，服用后往往会导致吐泻同时发作。况且此病多因剧烈呕吐之后产生，或者因为气机不能下行反而上逆，还没等到甘遂发挥攻下的力量，就已经被吐出。因此用赭石的镇降逆气、干姜的降逆作用，协力推动药力下行，以辅助甘遂取得成功。而且干姜性热，朴硝性寒，两药并用，善于开通寒火凝结的阻滞。寒火凝结在肠间的得以开通，停滞在肠间的宿食也易于消散。我使用这个方子救人很多，即使是食物结在中脘和下脘部位，也没有不立刻见效的。
乙卯年（1915年），我客居广平，突然有人用车载着病人到寓所求诊。这个人五十多岁，呻吟不止，说自己感觉食物结在下脘部位，非常疼痛，多次请医生调理治疗，其中一剂药中大黄用到了一两半却排不下来。而且凡是服用的药物，感觉到到达结滞的部位，就向上逆行吐出，饮食也是如此。此时上焦感到非常烦躁，大便不通已经十天了。诊察他的脉象，虽然微弱，但至数不快，重按有根底。知道还可以承受攻下法，于是对他说：这个病容易治疗，只是所服的药中有猛烈的成分，服药时，必须我亲自监视才稳妥。但也无需拖延太久，能在这里停留四个小时，结滞之处就会通畅并排出。于是使用这个汤剂去掉干姜，方中赭石改为三两，朴硝改为八钱。服用后不久，腹中作响，过了两个半小时，大便通畅而痊愈。一个月后，他又患结滞证如前，仍然用前方而痊愈。
附录：
山东德州卢××来信：
族侄孙××，患有肠结证，缠绵两个多月。更换了几十位医生，服药一百多剂，不但无效，病情反而大大加重。他也认为没有人能治，没有药可医。气息奄奄，寿衣都已准备好。后来接到先生的信（曾推荐服用《衷中参西录》中的赭遂攻结汤），就带着《衷中参西录》去查看，幸好他心神还没有昏迷，将赭遂攻结汤的方子查出来给他看。他平时懂医，躺着观察了一小时，突然猛地坐起拍着腹部说我的病就好了，庆幸不会死。立即派人取药，服用后片刻，腹中大响一阵，自觉结滞已开，随即大泻了两三盆，停了约两个小时，又泻了几次，病竟然痊愈了。随即吃了两茶杯山药粉稀粥，接着用补益濡润的药物几剂来善后调理。
Treats retained food stagnating in the intestines, unable to descend, resulting in constipation for many days. The syndrome may arise from overeating, excessive consumption of raw and cold foods, condensation of cold and fire pathogens, or prolonged vomiting causing both Stomach Qi (Stomach Energy) and Chong Qi (Penetrating Vessel Energy) to rebel upward instead of descending.
Raw Hematite (Ochre Stone) [Sheng Zhe Shi] (2 liang, finely crushed) Mirabilite [Pu Xiao] (5 qian) Dried Ginger [Gan Jiang] (2 qian) Kansui Root [Gan Sui] (1.5 qian, administered as powder with decoction liquid).
If heat predominates, remove Dried Ginger. If cold predominates, add several qian of Dried Ginger as appropriate. If vomiting is frequent, first decoct 1 liang of Raw Hematite and half a qian of Dried Ginger to stop the vomiting. After vomiting ceases, decoct the original prescription and administer Kansui Root powder with it.
Although Mirabilite can soften hardness, when fecal dryness is extremely severe and there is no intestinal fluid, its softening power will be ineffective. Kansui Root has a pungent and penetrating nature, best at promoting water movement; it can guide fluids from the Stomach directly to the site of dryness. Subsequently, Mirabilite utilizes this flowing fluid to fully exert its softening effect. Even if the dryness persists for a long time, it can transform into loose stool and flow down smoothly. However, Kansui Root is very potent and fierce, acting by breaking through obstructions; it can move downward and upward. Without something to control it, ingestion often leads to simultaneous vomiting and diarrhea. Moreover, this condition often arises after violent vomiting, or because Qi mechanism fails to descend and rebels upward, causing expulsion before the breaking-through power can take effect. Therefore, the rebellious-nature-suppressing property of Raw Hematite and the rebellious-nature-descending property of Dried Ginger work together to assist Kansui Root in achieving success. Furthermore, Dried Ginger is hot in nature, while Mirabilite is cold; using them together effectively opens up stagnation caused by cold-fire condensation. Once the cold-fire condensation in the intestines is resolved, the retained matter stagnating in the intestines also becomes easier to disperse. I have used this formula to save many people; even when food stagnation occurs in the Zhongwan (CV12) and Xiawan areas, it invariably produces immediate results.
In the year Yimao (1915), residing temporarily in Guangping, a patient was suddenly brought by cart to my residence for consultation. He was over fifty years old, groaning incessantly, stating that he felt food stuck in his Xiawan area, causing severe pain. Several doctors had treated him; one prescription contained up to 1.5 liang of Rhubarb [Da Huang], yet it failed to produce bowel movements. Furthermore, any medicine taken would rebel upward and be vomited once it reached the site of stagnation, including food and drink. At this time, he felt extreme irritability in the upper Jiao (Upper Burner), and had been constipated for ten days. His pulse was weak but not rapid in rate, and firm upon deep pressure. Knowing he could still tolerate purgation, I told him: "This disease is easy to treat, but since the medication contains potent ingredients, I must personally supervise the administration to ensure safety. However, it need not drag on; within four hours here, the obstruction should clear." Thus, I prescribed this decoction without Dried Ginger, increasing Raw Hematite to 3 liang and Mirabilite to 8 qian. Shortly after ingestion, rumbling sounds were heard in the abdomen. Two and a half hours later, a bowel movement occurred, and he recovered. A month later, he suffered from similar stagnation again and recovered using the same formula.
Appendix:
Letter from Lu XX of Dezhou, Shandong:
My clan nephew's grandson suffered from Intestinal Obstruction Syndrome for over two months. Dozens of doctors were consulted, and over a hundred doses of medicine were taken, but with no effect; the condition worsened significantly. He believed no one could cure him and no medicine could help. His breath was faint, and burial clothes were already prepared. Later, he received a letter from you (which recommended taking Zhe Sui Gong Jie Tang from *Records of Medicine Integrating Chinese and Western*). He brought the book to check, fortunately, his mind was still clear. He found the prescription for Zhe Sui Gong Jie Tang and showed it to me. Being knowledgeable about medicine himself, he observed it lying down for an hour, then suddenly sat up, slapped his abdomen, and said, "My illness is cured; luckily I won't die." He immediately sent someone to fetch the medicine. Moments after ingestion, loud noises erupted in his abdomen. He felt the obstruction had opened, followed by massive diarrhea of two or three basins. After resting for about two hours, he defecated several more times, and the illness was completely cured. He then consumed two teacups of thin millet porridge made with Chinese Yam [Shan Yao] powder, followed by several doses of tonifying and moistening herbs to conclude treatment.