治肢体受凉疼痛，或有凝寒阻遏血脉，麻木不仁。
鲜姜自然汁（一斤） 明亮水胶（四两）
上二味同熬成稀膏，摊于布上，贴患处，旬日一换。凡因受寒肢体疼痛，或因受寒肌肉麻木不仁者，贴
之皆可治愈。即因受风，而筋骨疼痛，或肌肉麻木者，贴之亦可治愈。惟有热肿疼者，则断不可用。
盖此等证心中无病，原宜外治。鲜姜之辛辣开通，热而能散，故能温暖肌肉，深透筋骨，以除其凝寒痼
冷，而涣然若冰释
也。用水胶者，借其粘滞之力，然后可熬之成膏也。若证因受风而得者，拟用细辛细末掺于膏药之中，或用他
祛风猛悍之药，掺于其中，其奏效当更捷也。
有人因寝凉炕之上，其右腿外侧时常觉凉，且有时疼痛。用多方治之不效。语以此方，贴至二十日全愈。
又有人常在寒水中捕鱼，为寒水所伤。自膝下被水浸处皆麻木，抑搔不知疼痒，渐觉行动乏力。语以此方，
俾用长条布摊药膏缠于腿上，其足趺、足底皆贴以此膏，亦数换而愈。
治膈食（“论胃病噎膈治法及反胃治法”宜参看）。
潞党参（六钱） 天门冬（四钱） 生赭石（八钱，轧细） 清半夏（三钱） 淡苁蓉（四钱） 知母（五钱）
当归身（三钱） 柿霜饼（五钱，服药后含化徐徐咽之）
人之一身，自飞门以至魄门，一气主之，亦一气悬之。故人之中气充盛，则其贲门（胃之上口）宽展，自
能容受水谷，下通幽门（胃之下口）以及小肠、大肠，出为二便，病何由而作？若中气衰惫，不能撑悬于内，
则贲门缩小，以及幽门、小肠、大肠皆为之紧缩。观膈证之病剧者，大便如羊矢，固因液短，实亦肠细也。况
中气不旺，胃气不能息息下降，而冲气转因胃气不降，而乘虚上干，致痰涎亦随逆气上并，以壅塞贲门。夫此
时贲门已缩如藕孔，又加逆气痰涎以壅塞其间，又焉能受饮食以下达乎？故治此证者，当以大补中气为主，方
中之人参是也。以降逆安冲为佐，以清痰理气为使，方中之赭石、半夏、柿霜是也。又虑人参性热、半夏性燥，
故又加知母、天冬、当归、柿霜、以清热润燥、生津生血也。用苁蓉者，以其能补肾，即能敛冲，冲气不上冲，
则胃气易于下降。且患此证者，多有便难之虞，苁蓉与当归、赭石并用，其润便通结之功，又甚效也。若服数
剂无大效，当系贲门有瘀血，宜加三棱、桃仁各二钱。
仲景《伤寒论》有旋复代赭石汤，原治伤寒发汗，若吐若下解后，心下痞硬，噫气不除者。周扬俊、喻嘉
言皆谓治膈证甚效。拙拟此方，重用赭石，不用旋复花者，因旋复花《神农本草经》原言味咸，今坊间所鬻旋
复花，苦而不咸，用之似无效验。惟邑武帝台为汉武帝筑台望海之处，地多咸卤，周遭所产旋复花，大于坊间
鬻者几一倍。其味咸而兼辛，以治膈食甚效。
或问∶《神农本草经》旋复花，未言苦亦未言辛。药坊之苦者，既与《神农本草经》之气味不合，岂武帝
台之辛者，独与《神农本草经》之气味合乎？答曰∶古人立言尚简，多有互文以见义者。《神农本草经》为有
文本后第一书，其简之又简可知。故读《神农本草经》之法，其主治未全者，当于气味中求之；其气味未全
者，即可于主治中求之。旋复花《神农本草经》载其主结气，胁下满，惊悸、除水、去五脏间寒热，补中下气。
三复《神农本草经》主治之文，则复花当为平肝降气之要药，应借辛味，以镇肝木，其味宜咸而兼辛明矣。至
于苦味，性多令人涌吐，是以旋复花不宜兼此味也。其味不至甚苦，亦可斟酌加入也。
一叟，年六十余得膈证，向愚求方。自言犹能细嚼焦脆之物，用汤水徐徐送下，然一口咽之不顺，即呕吐
不能再食，且呕吐之时，带出痰涎若干。诊其脉关后微弱，关前又似滑实，知其上焦痰涎壅滞也。用此汤加邑
武帝台所产旋复花二钱，连服四剂而愈。
一人，年四十六，素耽叶子戏，至废寝食。初觉有气上冲咽喉，浸至妨碍饮食，时或呕吐不能下行。其脉
弦长而硬，左右皆
然。知系冲气挟胃气上冲。治以此汤，加武帝台旋复花二钱、生芡实四钱，降其冲逆之气而收敛之，连服十剂而愈。
族家姑，年五旬有六，初觉饮食有碍，后浸增重，惟进薄粥，其脉弦细无力。盖生平勤俭持家，自奉甚薄，
劳心劳力又甚过。其脉之细也，因饮食菲薄而气血衰，其脉之弦也，因劳心过度而痰饮盛也。姑上有两姊，皆
以此疾逝世，气同者其病亦同，惴惴自恐不愈。愚毅然以为可治，投以此汤，加白术二钱、龙眼肉三钱，连服
十余剂全愈。
堂侄女，年四十八岁，素羸弱多病。因自理家务，劳心过度，恒彻夜不寐。于癸卯夏日得膈证。时愚远出，
遂延他医调治，屡次无效。及愚旋里，病势已剧。其脉略似滑实，重按无力。治以此汤，加龙眼肉五钱，两剂
见轻，又服十余剂全愈。
奉天北镇县萧叟，年六十七岁，得膈证延医治不愈。迁延五六月，病浸加剧，饮水亦间有难下之时。来院
求为延医。其脉弦长有力，右部尤甚。知其冲气上冲过甚，迫其胃气不下降也。询其大便，干燥不易下，多日
不行，又须以药通之。投以参赭培气汤，赭石改用一两。数剂后，饮食见顺，脉亦稍和，觉胃口仍有痰涎杜塞。
为加清半夏三钱，连服十剂，饮食大顺，脉亦复常，大便亦较易。遂减赭石之半，又服数剂，大便一日两次。
遂去赭石、柿霜饼、当归、知母，加于术三钱，数剂后自言，觉胃中消化力稍弱，此时痰涎已清，又觉胃口似
有疙瘩，稍碍饮食之路。遂将于术改用六钱，又加生鸡内金（捣细）二钱，佐于术以健运脾胃，即借以消胃口
之障碍，连服十余剂全愈。
友人吴××治姜姓叟，年六十余，得膈食证。屡次延医调治，服药半载，病转增进。吴××投以参赭培气汤，
为其脉甚弦硬，知其冲气上冲，又兼血液枯少也，遂加生芡实以收敛冲气，龙眼肉以滋润血液，一剂能进饮食，
又连服七八剂，饮食遂能如常。
附录∶
奉天义县马××来函∶
去岁（乙丑）舍侄××患膈食，延医延医，年余无效。及病至垂危，诸医束手无策，有旧戚赠一良方，言
系《衷中参西录》所载之方，名参赭培气汤，服之立见功效。连服十剂，其病全愈。
奉天法库县万××来函∶
邱××之女，年十五，天癸已至，因受惊而经闭。两阅月，发现心热、心跳、膨胀等证，经医治疗未效，
更添翻胃吐食、便燥、自汗等证。又经两月，更医十数，病益剧。适友人介绍为之诊视，脉浮数而濡，尺弱于
寸，面色枯槁，肢体消瘦，不能起床；盖两月间食入即吐，或俟半日许亦必吐出，不受水谷之养，并灼热耗阴，
无怪其支离若是也。思之再四，此必因受惊气乱而血亦乱，遂至遏其生机，且又在童年，血分未充，即不能应
月而潮，久之不下行，必上逆，气机亦即上逆，况冲为血海，隶属阳明，阳明有升无降，冲血即随之上逆，瘀
而不行，以至作灼作胀。其心跳者，为上冲之气血所扰也。其出汗吐食者，为上冲之气血所迫也。其津液因汗
吐过多而消耗，所以大便干燥也。势非降逆、滋阴，镇心、解瘀之药并用不可。查参赭镇气汤及参赭培气汤二
方，实为治斯证之津梁，爰即二方加减，赭石两半，当归、净萸肉、龙骨、牡蛎各五钱，白芍、肉苁蓉、党参、
天冬、生鸡内金各三钱，磨取铁锈之水煎服。一剂病似觉甚，病家哗然，以为药不对证，欲另延医。惟介绍人
主持甚力，勉又邀生再诊，此中喧变生固未之知也。既诊脉如故，决无病进之象。后闻有如此情形，生亦莫解。
因反复思之，恍悟∶此必胃虚已极，兼胃气上逆过甚，遽投以如此重剂，其胃虚不能运化，气逆更多冲激，想
有一番瞑眩，故病似加重也。于斯将原方减半，煎汤一盅，又分
两次温服下，并送服柿霜三钱。其第一次服，仍吐药一半，二次即不吐，服完此剂后，略进薄粥，亦未吐，病
家始欢然相信。又连服三剂，汗与吐均止，心跳膨胀亦大见轻。惟灼热犹不甚减，遂去净萸肉、龙骨、牡蛎，
加生地、玄参各四钱，服五剂后，灼热亦愈强半。如此加减服之，一月后遂能起床矣。嘱其仍守服原方，至诸
病全愈后可停药勿服，月事至期亦当自至也。
治疗肢体受寒引起的疼痛，或者因凝滞的寒气阻碍血脉运行，导致肢体麻木、失去知觉。
鲜姜自然汁（一斤） 明亮水胶（四两）
以上两味药一同熬制成稀薄的膏状，涂抹在布上，贴敷于患处，每十天更换一次。凡是因受寒导致的肢体疼痛，或因受寒导致的肌肉麻木不仁者，贴敷此膏均可治愈。即使是因受风引起的筋骨疼痛，或肌肉麻木者，贴敷此膏也能治愈。只有出现热性肿胀疼痛的情况，则绝对不可使用。
因为这类病症心中并无大碍，原本就适宜采用外治法。鲜姜味道辛辣，具有开通散结的作用，性热能够发散，所以能温暖肌肉，深入筋骨，以消除凝滞的寒气和顽固的冷邪，使症状像冰融化一样消散。使用水胶，是借助其粘滞的特性，才能将其熬制成膏。如果病症是因受风引起的，建议将细辛研成细末掺入膏药中，或者掺入其他祛风猛烈的药物，这样疗效应当更加迅速。
有人因为睡在凉炕上，右腿外侧时常感觉发凉，并且有时伴有疼痛。尝试多种治疗方法均无效。告知使用此方，贴敷二十日后完全痊愈。
又有一人经常在冷水中捕鱼，被寒水所伤。从膝盖以下被水浸泡的部位全部麻木，抓挠也不知道疼痛和瘙痒，逐渐感到行动乏力。告知使用此方，让他用长条布将药膏缠绕在腿上，脚背和脚底都贴以此膏，经过几次更换后痊愈。
治疗膈食证（关于“论胃病噎膈治法及反胃治法”的内容，请参考相关章节）。
潞党参（六钱） 天门冬（四钱） 生赭石（八钱，轧碎） 清半夏（三钱） 淡苁蓉（四钱） 知母（五钱）
当归身（三钱） 柿霜饼（五钱，服药后含化，慢慢咽下）
人的身体，从最上面的飞门（口唇）到最下面的魄门（肛门），都由一气来主持，也由一气来维系。所以如果人的中气充盛，那么贲门（胃的上口）就会宽展，自然能够容纳接受水谷，向下通达幽门（胃的下口）以及小肠、大肠，排出二便，疾病从何产生呢？如果中气衰败疲惫，不能在内部支撑维系，那么贲门就会缩小，进而幽门、小肠、大肠都会随之紧缩。观察膈证病情严重者，大便像羊屎一样干硬，固然因为津液短少，实际上也是因为肠道狭窄。况且中气不旺盛，胃气不能持续下降，而冲气反而因为胃气不降，乘虚向上干扰，导致痰涎也随着逆乱之气向上汇聚，从而壅塞贲门。此时贲门已经收缩得像藕孔一样小，再加上逆气痰涎壅塞在其中，怎么能接受饮食并使其下行呢？所以治疗此证，应当以大补中气为主，方中的人参就是起这个作用的。以降逆平冲为辅助，以清热化痰理气为使药，方中的赭石、半夏、柿霜就是起这个作用的。又担心人参性热、半夏性燥，所以又加入知母、天冬、当归、柿霜，用来清热润燥、生津养血。使用肉苁蓉，是因为它能补肾，肾气固摄则冲气得以收敛，冲气不上冲，胃气就容易下降。而且患此病的人，多有排便困难的担忧，肉苁蓉与当归、赭石并用，润肠通便的功效非常显著。如果服用几剂后没有明显效果，可能是因为贲门有瘀血，应当加入三棱、桃仁各二钱。
张仲景《伤寒论》中有旋复代赭石汤，原本用于治疗伤寒发汗后，经过催吐或泻下治疗解除表里之邪后，心下痞硬，嗳气不止的症状。周扬俊、喻嘉言都认为此方治疗膈证非常有效。我拟定的这个方子，重用赭石，不用旋复花，是因为《神农本草经》记载旋复花味咸，而现在市面上售卖的旋复花，味道苦而不咸，使用它似乎没有疗效。只有我县武帝台是汉武帝筑台望海的地方，土地多盐碱，周围出产的旋复花，比市面上售卖的大近一倍。其味道咸而兼辛，治疗膈食证非常有效。
有人问：《神农本草经》记载旋复花，没说苦也没说辛。药坊卖的苦味的，既然与《神农本草经》的气味不符，难道武帝台产的辛味的，就独独与《神农本草经》的气味相符吗？回答说：古人著书立说崇尚简约，多有通过互文见义的手法。《神农本草经》是有文本以来的第一部书，其文字之简略可想而知。所以阅读《神农本草经》的方法，对于主治未全列出的，应当在气味中去寻求；对于气味未全列出的，就可以从主治中去寻求。《神农本草经》记载旋复花主治结气，胁下胀满，惊悸，除水气，去五脏间的寒热，补中益气。反复研读《神农本草经》的主治条文，那么旋复花应当是平肝降气的要药，应该借助辛味来镇肝木，其味道宜咸而兼辛，这是很明显的。至于苦味，性质多令人涌吐，所以旋复花不宜兼有苦味。其味道不至于太苦，也可以斟酌加入。
一位六十多岁的老人得了膈证，向我求方。他自己说还能细细咀嚼焦脆的食物，用汤水慢慢送下，但一旦吞咽不顺，就会呕吐不能再进食，且呕吐时带出若干痰涎。诊察他的脉象，关后微弱，关前又似滑实，知道他是上焦痰涎壅滞。使用此汤加我县武帝台所产的旋复花二钱，连续服用四剂而痊愈。
一人，四十六岁，平时沉迷于叶子戏（一种赌博游戏），以至于废寝忘食。起初觉得有气上冲咽喉，逐渐妨碍饮食，时而呕吐不能下行。他的脉象弦长而硬，左右手都一样。知道这是冲气挟带胃气上冲。用此汤治疗，加武帝台旋复花二钱、生芡实四钱，以降其冲逆之气并收敛之，连续服用十剂而痊愈。
族家的姑母，五十六岁，起初觉得饮食有阻碍，后来逐渐加重，只能进薄粥，她的脉象弦细无力。大概她生平勤俭持家，对自己要求很低，劳心劳力又过度。她的脉细，是因为饮食菲薄导致气血衰弱；她的脉弦，是因为劳心过度导致痰饮旺盛。姑母上面有两个姐姐，都因这种病去世，体质相同所以病也相同，她惴惴不安，担心自己不能痊愈。我毅然认为可以治疗，投以此汤，加白术二钱、龙眼肉三钱，连续服用十余剂完全痊愈。
堂侄女，四十八岁，素来瘦弱多病。因为自理家务，劳心过度，经常整夜不睡觉。在癸卯年夏天得了膈证。当时我远行在外，于是请其他医生调理治疗，屡次无效。等我回家时，病情已经很严重了。她的脉象略似滑实，重按无力。用此汤治疗，加龙眼肉五钱，两剂后症状减轻，又服用十余剂完全痊愈。
奉天北镇县的萧老先生，六十七岁，得膈证请医生治疗未愈。拖延了五六个月，病情逐渐加剧，喝水也有时候难以下咽。来到医院请求我为他延医诊治。他的脉象弦长有力，右部尤其明显。知道这是冲气上冲过于厉害，逼迫胃气不能下降。询问他的大便，干燥不易排出，多天不行，还需要用药通导。投以参赭培气汤，赭石改用一两。数剂后，饮食变得顺畅，脉象也稍平和，但感觉胃口仍有痰涎堵塞。为此加入清半夏三钱，连续服用十剂，饮食大大顺畅，脉象也恢复正常，大便也比较容易了。于是减半赭石的用量，又服用数剂，大便一天两次。于是去掉赭石、柿霜饼、当归、知母，加入于术三钱，数剂后他自己说，感觉胃中消化力稍弱，此时痰涎已清除，又感觉胃口似乎有个疙瘩，稍微阻碍饮食之路。于是将于术改用六钱，又加生鸡内金（捣碎）二钱，佐助于术以健运脾胃，借此消除胃口处的障碍，连续服用十余剂完全痊愈。
友人吴××治疗一位姓萧的老先生，六十多岁，得了膈食证。屡次请医生调理治疗，服药半年，病情反而加重。吴××投以参赭培气汤，因为其脉象非常弦硬，知道这是冲气上冲，又兼血液枯少，于是加生芡实以收敛冲气，龙眼肉以滋润血液，一剂就能进食，又连续服用七八剂，饮食便能恢复正常。
附录：
奉天义县马××来信：
去年（乙丑年）我的侄子××患膈食证，请医生治疗了一年多无效。等到病情危重，众医束手无策，有一位旧亲戚赠送一个良方，说是《衷中参西录》所载的方子，名叫参赭培气汤，服用后立即见效。连续服用十剂，病完全痊愈。
奉天法库县万××来信：
邱××的女儿，十五岁，月经初潮，因受惊吓而导致闭经。过了两个月，出现心热、心跳、腹胀等症状，经医生治疗无效，更增添了翻胃吐食、大便干燥、自汗等症状。又过了两个月，换了十几个医生，病情更加严重。恰好朋友介绍我去为她诊视，脉象浮数而濡，尺脉弱于寸脉，面色枯槁，肢体消瘦，不能起床；大概这两个月间吃进去就吐，或者等半天左右也一定会吐出来，不接受水谷的滋养，并且灼热耗伤阴液，难怪身体支离破碎如此。深思熟虑，这一定是因为受惊导致气机紊乱，血也随之紊乱，遂至遏制生机，而且又在童年，血分未充盈，就不能按时来潮，久了不下行，必然上逆，气机也随之上逆，况且冲脉为血海，隶属阳明，阳明有升无降，冲血即随之上逆，瘀滞不行，以至产生灼热和胀感。心跳，是被上冲的气血扰乱所致。出汗吐食，是被上冲的气血逼迫所致。津液因汗吐过多而消耗，所以大便干燥。形势非降逆、滋阴，镇心、解瘀的药物并用不可。查阅参赭镇气汤及参赭培气汤两个方子，实在是治疗此证的津梁，于是对这两个方子进行加减，赭石一两半，当归、净山茱萸、龙骨、牡蛎各五钱，白芍、肉苁蓉、党参、天冬、生鸡内金各三钱，磨取铁锈水煎服。一剂后病似乎加重，病家哗然，认为药不对症，想另请医生。只有介绍人极力主张，勉强又邀请我再诊，其中的喧嚣变化我并不知情。既然后来听说有如此情形，我也不解。因此反复思考，恍然领悟：这一定是胃虚到了极点，兼胃气上逆过甚，突然投以如此重剂，胃虚不能运化，气逆更多冲激，想必有一番瞑眩反应，所以病似乎加重了。于是将原方减半，煎成一盅汤，又分两次温服下，并送服柿霜三钱。第一次服用，仍吐出一半药，第二次就不吐了，服完此剂后，稍微吃点薄粥，也没有吐，病家才开始欢然相信。又连续服用三剂，汗和吐都停止，心跳腹胀也大大减轻。只是灼热仍然不太减退，于是去掉净山茱萸、龙骨、牡蛎，加生地、玄参各四钱，服用五剂后，灼热也好了大半。如此加减服用，一个月后就能起床了。嘱咐她仍守服原方，直到诸病全愈后可停药不服，月经到期也会自然到来。
Treat pain in the limbs caused by cold exposure, or numbness and loss of sensation due to congealed cold obstructing the blood vessels.
Fresh Ginger Juice (1 jin) / Colla Corii Asini (Si Miao Shui Jiao, 4 liang)
Boil these two ingredients together into a thin paste, spread it on cloth, and apply it to the affected area. Change once every ten days. This application can cure limb pain caused by cold exposure, as well as muscle numbness and loss of sensation caused by cold. Even for bone and joint pain or muscle numbness caused by wind exposure, this application can also be curative. However, it is absolutely contraindicated for cases involving hot swelling and pain.
This is because such conditions do not involve internal organ pathology and are originally suitable for external treatment. The pungency of fresh ginger promotes circulation and disperses; its heat can dissipate cold. Thus, it can warm the muscles, penetrate deeply into the bones and sinews, eliminate congealed cold and stubborn chill, and cause symptoms to disperse like melting ice. Colla Corii Asini is used for its sticky and viscous properties, which allow it to be boiled into a paste. If the condition is caused by wind, it is recommended to mix fine powder of Xixin (Asari Radix et Rhizoma) into the plaster, or mix other potent wind-dispelling herbs into it, which would yield faster results.
A person felt coldness in the lateral aspect of their right leg after sleeping on a cold kang (heated brick bed), accompanied by occasional pain. Various treatments were ineffective. Upon using this formula applied externally, they were completely cured after twenty days.
Another person frequently fished in cold water and was injured by it. The area from the knees downward, submerged in water, became numb, insensitive to scratching regarding pain or itchiness, and gradually felt weak in movement. Upon using this formula, wrapping the medicated plaster around the legs with long strips of cloth, and applying it to the dorsum and sole of the feet, they were cured after several changes.
Treat Ge Syndrome (Dysphagia/Regurgitation) (For methods treating stomach diseases, dysphagia, and regurgitation, please refer to relevant chapters).
Dangshen (Codonopsis Radix, 6 qian) / Tianmendong (Asparagi Radix, 4 qian) / Sheng Zhe shi (Raw Ochre, 8 qian, crushed) / Qing Banxia (Pinelliae Rhizoma Preparatum, 3 qian) / Dan Congrong (Cistanches Herba, 4 qian) / Zhi mu (Anemarrhenae Rhizoma, 5 qian)
Danggui Shen (Angelicae Sinensis Radix, body part, 3 qian) / Shishuang Bing (Persimmon Frost Cake, 5 qian, dissolve slowly in mouth after taking medicine and swallow)
The human body, from the Feimen (mouth/lips) at the top to the Pomen (anus) at the bottom, is governed and sustained by one Qi. Therefore, if the Middle Qi is abundant, the Benmen (upper opening of the stomach) will expand, naturally accepting food and drink, and allowing them to pass down through the Youmen (lower opening of the stomach) to the small and large intestines, exiting as urine and feces. How could disease arise? If Middle Qi is deficient and exhausted, unable to support and suspend internally, the Benmen will shrink, causing the Youmen, small intestine, and large intestine to contract as well. In severe cases of Ge syndrome, stool resembles sheep droppings; this is not only due to fluid deficiency but also because the intestines are narrowed. Moreover, when Middle Qi is weak, Stomach Qi cannot descend continuously, causing Chong Qi to rise vacuously and interfere upwards. Phlegm-fluids then follow the rebellious Qi upward, congesting the Benmen. At this time, the Benmen has shrunk like an lotus root hole, and with rebellious Qi and phlegm-fluids congesting it, how can it accept food and drink to descend? Therefore, treating this syndrome should focus primarily on greatly tonifying Middle Qi, represented by Renshen (Ginseng Radix et Rhizoma) in the formula. Descending rebellion and calming Chong Qi serves as the assistant, while clearing phlegm and regulating Qi serves as the guide, represented by Zhe shi (Ochre), Banxia (Pinelliae Rhizoma), and Shishuang (Persimmon Frost) in the formula. Fearing that Renshen is hot and Banxia is drying, Zhimu (Anemarrhenae Rhizoma), Tianmen dong (Asparagi Radix), Danggui (Angelicae Sinensis Radix), and Shishuang (Persimmon Frost) are added to clear heat, moisten dryness, generate fluids, and nourish blood. Congrong (Cistanches Herba) is used because it tonifies the Kidney; tonifying the Kidney helps constrain Chong Qi. When Chong Qi does not rush upward, Stomach Qi descends easily. Furthermore, patients with this condition often suffer from difficult defecation. The combination of Congrong (Cistanches Herba), Danggui (Angelicae Sinensis Radix), and Zhe shi (Ochre) has excellent effects in moistening the bowels and unblocking constipation. If there is no significant effect after several doses, it may be due to blood stasis in the Benmen; in this case, add Sanleng (Sparganii Rhizoma) and Taoren (Pruni Semen), each 2 qian.
Zhang Zhongjing’s *Shanghan Lun* contains Xuanfu Daizhe Shi Tang, originally used to treat post-sweating, post-emetic, or post-purgative stages of Cold Damage, characterized by epigastric fullness and hardness, and persistent belching. Zhou Yangjun and Yu Jiayan both considered it very effective for treating Ge syndrome. My proposed formula uses a heavy dose of Zhe shi (Ochre) and excludes Xuanfuhua (Inulae Flos) because *Shennong Bencao Jing* states Xuanfuhua tastes salty, whereas current market varieties taste bitter and unsalty, showing little efficacy. Only in Wudi Tai village in my county, where Emperor Wu of Han built a terrace to view the sea, is the soil saline. The Xuanfuhua (Inulae Flos) produced there is nearly double the size of market varieties. It tastes salty and slightly pungent, making it very effective for treating Ge syndrome.
Question: *Shennong Bencao Jing* does not mention Xuanfuhua being bitter or pungent. Since the bitter variety sold in pharmacies contradicts the text, does the pungent variety from Wudi Tai uniquely conform to it? Answer: Ancient texts were concise, often using mutual context to reveal meaning. *Shennong Bencao Jing*, being the first extant materia medica, is extremely concise. Thus, when reading it, if indications are incomplete, seek them in the flavors; if flavors are incomplete, seek them in the indications. *Shennong Bencao Jing* records Xuanfuhua treating Qi stagnation, hypochondriac fullness, palpitations, removing water retention, eliminating cold-heat between the five zang organs, and tonifying the middle while directing Qi downward. Repeatedly studying these indications reveals that Xuanfuhua is a key herb for pacifying the Liver and descending Qi. It should rely on its pungent flavor to subdue Liver Wood; thus, its flavor should be salty and slightly pungent, which is evident. Regarding bitterness, flavors that are bitter often induce vomiting, so Xuanfuhua should not possess this flavor. If the flavor is not excessively bitter, it can be酌情 (discretionarily) included.
An elderly man in his sixties suffered from Ge syndrome and sought my prescription. He stated he could still chew crisp foods carefully and swallow them slowly with soup, but any difficulty in swallowing led to vomiting and inability to eat further, bringing up phlegm-fluids during vomiting. His pulse was weak behind the Guan position and slippery-solid ahead of it, indicating congestion of phlegm-fluids in the Upper Jiao. I prescribed this decoction plus 2 qian of Xuanfuhua (Inulae Flos) produced in Wudi Tai village. After four doses, he was cured.
A forty-six-year-old man, addicted to gambling, neglected sleep and food. Initially, he felt Qi rushing up to the throat, gradually hindering eating, with occasional vomiting preventing downward passage. His pulse was wiry, long, and hard on both sides. This indicated Chong Qi carrying Stomach Qi rebelling upward. I treated him with this decoction, adding 2 qian of Xuanfuhua (Inulae Flos) from Wudi Tai and 4 qian of Sheng Qianshi (Euryales Semen) to descend and constrain the rebellious Qi. After ten doses, he was cured.
My clan aunt, fifty-six years old, initially felt obstruction to eating, which worsened until she could only consume thin porridge. Her pulse was wiry, thin, and powerless. She was frugal throughout her life, working hard mentally and physically. Her thin pulse resulted from poor diet leading to Qi and Blood deficiency; her wiry pulse resulted from excessive mental labor leading to abundant phlegm-fluids. Her two elder sisters died of the same disease; fearing she would share their fate, she was anxious. I confidently declared it treatable and administered this decoction with 2 qian of Baizhu (Atractylodis Macrocephalae Rhizoma) and 3 qian of Longyanrou (Longan Aril). After more than ten doses, she was fully cured.
My cousin’s daughter, forty-eight years old, was constitutionally weak and prone to illness. Due to managing household affairs and excessive mental labor, she often suffered insomnia. In the summer of the Gui Mao year, she developed Ge syndrome. I was away, so other doctors treated her without success. Upon my return, her condition was severe. Her pulse was slightly slippery-solid but powerless upon deep pressure. I treated her with this decoction plus 5 qian of Longyanrou (Longan Aril). Symptoms improved after two doses, and she was fully cured after another ten-plus doses.
Old Mr. Xiao from Beizhen County, Fengtian, sixty-seven years old, had Ge syndrome untreated by other doctors. After five to six months, the condition worsened, making even drinking water difficult at times. He came to the clinic for treatment. His pulse was wiry, long, and forceful, especially on the right side. This indicated excessive Chong Qi rebellion forcing Stomach Qi not to descend. His stool was dry and difficult to pass, requiring laxatives. I prescribed Shen Zhe Pei Qi Tang, increasing Zhe shi (Ochre) to 1 liang. After several doses, eating smoothed out, and the pulse relaxed somewhat, though he felt phlegm-fluids blocking the stomach entrance. I added 3 qian of Qing Banxia (Pinelliae Rhizoma Preparatum). After ten doses, eating was smooth, the pulse normalized, and defecation improved. I then halved the Zhe shi (Ochre) dose. After several more doses, he defecated twice daily. I removed Zhe shi (Ochre), Shishuang Bing (Persimmon Frost Cake), Danggui (Angelicae Sinensis Radix), and Zhimu (Anemarrhenae Rhizoma), adding 3 qian of Yuzhu (Bletillae Rhizoma - *Note: Context implies Bai Zhu/Atractylodes based on 'Yu Zhu' typo in original or specific local usage, but standard interpretation of 'Yu Zhu' usually refers to Bletilla or Atractylodes macrocephala depending on dialect. Given 'Jian Yun Pi Wei', Bai Zhu is likely intended, but text says 'Yu Zhu'. I will stick to literal translation of entity 'Yu Zhu' or assume Bai Zhu if context strongly suggests. Actually, 'Yu Zhu' often refers to Bletilla striata, but here 'Jian Yun Pi Wei' suggests Spleen tonic. However, strictly following text: 'Yu Zhu'. Wait, looking at common typos, 'Yu Zhu' might be 'Bai Zhu'. But I must extract entities as they appear. The text says 'Yu Zhu'. I will list 'Yu Zhu' as herb.*) ... Correction: The text says "于术" (Yu Zhu), which is a variety of Bai Zhu (Atractylodis Macrocephalae Rhizoma). So Herb is Yu Zhu/Bai Zhu.
Added 2 qian of raw Jineijin (Galli Gigerii Endothelium Corneum, crushed) to assist Yu Zhu (Atractylodis Macrocephalae Rhizoma) in strengthening the Spleen and Stomach, thereby resolving the obstruction at the stomach entrance. After more than ten doses, he was fully cured.
Friend Wu XX treated an old Mr. surnamed Xiao, over sixty, with Ge syndrome. After half a year of medical treatment, the condition worsened. Wu XX prescribed Shen Zhe Pei Qi Tang. Noting his pulse was very wiry and hard, indicating Chong Qi rebellion and blood deficiency, he added Sheng Qianshi (Euryales Semen) to constrain Chong Qi and Longyanrou (Longan Aril) to nourish blood. After one dose, he could eat; after seven to eight more doses, his diet returned to normal.
Appendix:
Letter from Ma XX of Yixian County, Fengtian:
Last year (Yi Chou), my nephew XX suffered from Ge syndrome. Medical treatment for over a year was ineffective. When critical, doctors were helpless. An old relative gave a good prescription, said to be from *Zhongzhong Canxi Lu*, named Shen Zhe Pei Qi Tang. It showed immediate effect. After ten doses, he was completely cured.
Letter from Wan XX of Fakuku County, Fengtian:
Qiu XX’s daughter, fifteen, began menstruation but stopped due to fright. Two months later, she developed heart heat, palpitations, and distension. Treatment failed, and she added regurgitation, dry stools, and spontaneous sweating. After two more months, seeing many doctors, the condition worsened. A friend introduced me to examine her. Pulse was floating, rapid, and soggy; Chi pulse weaker than Cun. Face was sallow, body emaciated, bedridden. For two months, she vomited immediately after eating or after half a day, receiving no nourishment, and heat consumed Yin. No wonder she was so debilitated. I reasoned that fright disrupted Qi and Blood, suppressing vitality. Being young, her Blood was insufficient to flow monthly. Stagnant Blood rose upward, dragging Qi with it. Chong Mai (Penetrating Vessel) is the Sea of Blood, affiliated with Yangming. Yangming tends to ascend rather than descend, so Chong Blood rebelled upward, causing stasis, heat, and distension. Palpitations were disturbed by rising Qi and Blood. Sweating and vomiting were forced by rising Qi and Blood. Fluid loss from sweat and vomiting caused dry stools. Non-descending rebellion, Yin-nourishing, Heart-calming, and stasis-resolving herbs were needed together. Consulting *Shen Zhe Zhen Qi Tang* and *Shen Zhe Pei Qi Tang*, I saw them as the bridge for this syndrome. I modified them: Zhe shi (Ochre) 1.5 liang, Danggui (Angelicae Sinensis Radix), Jing Yurou (Corni Fructus) 5 qian each, Longgu (Fossilia Ossis Mastodi et Scapulae), Muli (Concha Ostreae) 5 qian each, Baishao (Paeoniae Radix Alba), Rou Congrong (Cistanches Herba), Dangshen (Codonopsis Radix), Tiandong (Asparagi Radix), Sheng Jineijin (Galli Gigerii Endothelium Corneum) 3 qian each. Decocted in rust-water. After one dose, symptoms seemed worse. Family panicked, claiming wrong diagnosis, wanting another doctor. The introducer insisted, urging a second visit. I was unaware of the commotion. Pulse remained unchanged, showing no deterioration. Later hearing this, I pondered: The Stomach was extremely deficient, and Qi rebellion severe. Suddenly administering such a heavy dose overwhelmed the deficient Stomach, exacerbating rebellion, likely causing a "Mingxuan" (medicinal reaction/healing crisis). Thus, symptoms appeared worse. I halved the original formula, decocted one cup, divided into two warm doses, and gave 3 qian of Shishuang (Persimmon Frost) to swallow. First dose: half vomited. Second dose: none vomited. After finishing, she ate thin porridge without vomiting. Family believed. Three more doses stopped sweating and vomiting, reducing palpitations and distension significantly. Heat persisted. I removed Jing Yurou (Corni Fructus), Longgu (Fossilia Ossis Mastodi et Scapulae), Muli (Concha Ostreae), added Shengdi Huang (Rehmanniae Radix) and Xuanshen (Scrophulariae Radix) 4 qian each. After five doses, heat reduced by half. With such modifications, she could get out of bed after one month. Advised continuing the original formula until all diseases resolved, then stop. Menstruation would naturally resume.