罗谦甫治博儿赤马刺。因猎得兔以火炙食过多。抵暮困倦。渴饮潼乳斗余。是夜腹胀如
鼓。疼痛闷乱。吐泻不得。躁扰欲死。其脉气口大二倍于人迎。右关尤有力。盖炙肉干燥。
多食以致发渴。畅饮潼乳。肉得湿而胀滂。肠胃俱填塞。无更虚更实传化之理。内经云。阴
气者。静则神藏。躁则消亡。饮食自倍。肠胃乃伤。今因饮食太过。使阴气躁乱。神不能藏
死在旦夕矣。若非峻急之剂。岂能斩关夺门。遂以备急丸十粒。分二次服。又与无忧散五
钱。须臾大吐大下。约去二斗余。腹中渐空快。次日以粥饮调理而愈。
茶商李。富人也。啖马肉过伤。腹胀。医以大黄巴豆治之。转剧。抱一翁项彦章后至诊
之。寸口脉促。而两尺将绝。彦章曰。胸有新邪。故脉促。宜引之上达。今反夺之。误矣。
饮以涌剂。且置李中座。使人环旋。顿吐宿肉。仍进神芎丸大下之。病去。众咸服。
孙东宿治大宗伯董浔老。年六十七。向有脾胃疾。暑月以过啖瓜果而胸膈胀痛。诊其脉
寸关弦紧。观其色。神藏气固。考其所服药。不过二陈平胃加查、芽等。不知此伤于瓜果
寒湿淫胜也。经云。寒淫所胜。治以辛温。而瓜果非麝香肉桂不能消。前方所以无效耳。
乃用高良姜、香附各一两。肉桂五钱。麝香一钱。为末。每服二钱。酒调下之。两三日。则
胸膈宽而知饿矣。
龚云林治一人。腊月赌食羊肉数斤。被羊肉冷油冻住。堵塞在胸膈不下。胀闷欲死。诸
医掣肘。龚见其六脉俱有。用黄酒一大坛。温热。入大缸内。令患人坐于中。众手轻轻乱拍
胸腹背心。令二人吹其耳。又将热烧酒灌之。次服万亿丸。得吐泻而愈。
震按缪仲淳治老人伤冷食及难化之物。用老姜紫苏煎汤。置浴锅内。令病患浸其中。以
热汤揉心胃肚腹。气通而食化。与此法同。
石顽治幼科汪五符。夏月伤食。呕吐。发热颅胀。自利黄水。遍体肌肉。扪之如刺。六
脉模糊。指下寻之。似有如无。足胫不温。自认阴寒而服五积散一服。其热愈炽。昏卧不省
第三日。自利不止。时常谵语。至夜尤甚。乃舅叶阳生以为伤暑。而与香薷饮。遂头面污
出如蒸。喘促不宁。足冷下逆。歙医程郊倩以其证大热而脉息模糊。按之殊不可得。以为阳
脱亡之候。欲猛进人参、附子。云间沈明生以为阴证断无汗出如蒸之理。脉虽虚而证大热。
当用人参白虎。争持未决。取证于石顽。诊其六脉。虽皆涩弱模糊。而心下按之大痛。舌上
灰刺如芒。乃食填中宫。不能鼓运其脉。往往多此。当与凉膈散下之。诸医正欲藉此脱手。
听其用药。一下而神思大清。脉息顿起。当知伤食之脉。虽当气口滑盛。若屡伤不已。每致
涩数模糊。乃脾不消运之兆也。此证设非下夺而与参附助其壮热。顷刻立毙。可不详慎而妄
叶新宇停食感冒。而两寸关皆涩数模糊。两尺皆沉弦。而按之益坚。虽其人尚能行走。
而脉少冲和。此必向有陈气在少腹。询之。果患寒疝数年。因缓辞不便用药。是夜即腹暴满
而逝。门人问曰。叶子偶抱小恙。何以知其必死而辞之。曰。凡人胃满则肠虚。肠满则胃虚
更实更虚。其气乃居。今胸有食而腹有积。上下俱困。能保其不交攻为患乎。当知厥疝入
腹。香港脚冲心等疾。皆是阴邪搏结。郁积既久。则挟阴火之势而上升。若胸中阳气有权。则
阴邪仍归阴位而止。今胸中先为宿食填塞。腹中陈气。不逆则已。逆则上下俱满。正气无容
身之地。往往有暴绝之虞。所以不便用药。实未知其即死也。故凡诊六部中。病脉有不相应
处。即当审其有无宿病。不可轻忽以招诽谤也。
震按伤食原非重病。故所选不多。然诸法咸备。靡巧不臻。毋庸买菜求益矣。
罗谦甫治疗博儿赤马刺。此人因打猎得到兔子，用火烤着吃，吃得过多。到了傍晚感到困倦乏力。口渴时喝了一斗多热牛奶。当天夜里腹部胀得像鼓一样。疼痛且胸闷烦躁。想吐又吐不出来，想泻又泻不出去。躁动不安，痛苦得想要死去。他的脉象气口比人迎大二倍，右关脉尤其有力。这是因为烤肉干燥，多吃导致口渴，畅饮热牛奶后，肉类遇湿而膨胀，肠胃都被填塞，失去了虚实交替、传导消化的生理规律。《内经》说：阴气，安静时神志就内守，躁动时神志就消亡。饮食过量一倍，肠胃就会受伤。现在因为饮食太过，使阴气躁乱，神不能内守，恐怕旦夕之间就要死亡了。如果不是用峻猛急迫的药剂，怎么能斩关夺门（迅速攻下积滞）呢？于是给他服用备急丸十粒，分两次服下。又给予无忧散五钱。不久之后，他剧烈呕吐和腹泻，大约排出两斗多的积滞物。腹中逐渐感到空虚轻松。第二天用米粥调养而痊愈。
茶商李某，是个富人。吃马肉过多导致损伤。出现腹胀症状。医生用大黄、巴豆来治疗，病情反而加重。抱一翁项彦章后来为他诊察。寸口脉急促，而两尺脉几乎摸不到。项彦章说：胸中有新的邪气，所以脉象急促，应该引导邪气向上发散。现在反而用攻下的方法，这是错误的。让他饮用催吐剂，并且让李某坐在中间，让人围绕着他旋转。顿时吐出隔夜未消化的肉食。接着再服用神芎丸进行强力泻下。病就好了。众人都很佩服。
孙东宿治疗大宗伯董浔老。年龄六十七岁。向来有脾胃疾病。在暑天因为吃过多的瓜果而导致胸膈胀痛。诊察他的脉象，寸部和关部弦紧。观察他的面色，神气内藏，正气稳固。考察他所服用的药物，不过是二陈汤、平胃散加上山楂、麦芽等。不知道这是被瓜果的寒湿之邪所胜。经书说：寒邪过盛，要用辛温的方法治疗。而瓜果不是麝香、肉桂就不能消化。前面的方子所以无效，就是这个原因。于是使用高良姜、香附各一两，肉桂五钱，麝香一钱，研成粉末。每次服用二钱，用酒调服。两三天后，胸膈宽舒并且知道饿了。
龚云林治疗一个人。腊月里赌博时吃了几斤羊肉，被羊肉的冷油冻住，堵塞在胸膈处下不去。胀闷得快要死了。其他医生束手无策。龚云林看到他的六脉都有，就用一大坛黄酒，加热后放入大缸内，让病人坐在里面。众人用手轻轻拍打病人的胸部、腹部和背部。让两个人吹他的耳朵。又将热烧酒灌下去。随后服用万亿丸，通过呕吐和腹泻而痊愈。
俞震按语：缪仲淳治疗老人伤于冷食及难消化的食物。用老姜、紫苏煎汤，放在浴锅内，让病患浸泡在其中，用热汤揉搓心、胃、肚、腹部位，气机通畅后食物得以消化。这与上面的方法相同。
石顽治疗儿科汪五符。夏天伤食，呕吐，发热，头部胀痛，自行拉出黄色水样便。全身肌肉，触摸起来像针刺一样痛。六脉模糊，手指下寻找，似有似无。足胫不温暖。自己认为是阴寒证而服用五积散一剂，其热势更加炽盛，昏睡不省人事。到了第三天，自利不止，时常胡言乱语，到夜晚尤其严重。他的舅舅叶阳生认为是伤暑，给予香薷饮。于是头面部出汗如蒸笼一般，喘促不安，脚冷且寒气上逆。歙县医生程郊倩认为此证大热而脉息模糊，按之很难找到，认为是阳气脱失死亡的征兆，想要猛进人参、附子。云间沈明生认为阴证绝对不会有汗出如蒸的道理，脉虽然虚但证候大热，应当用人参白虎汤。争论不决，向石顽取证。石顽诊察他的六脉，虽然都涩弱模糊，但心下按压时非常疼痛，舌上有灰刺像芒刺一样，这是食积填塞中焦，不能鼓动血脉，这种情况往往很多见。应当用凉膈散攻下它。各位医生正想借此机会推卸责任，听凭他用药。一下药后神思非常清爽，脉息顿时显现出来。应当知道伤食的脉象，虽然通常是气口滑盛，如果屡次受伤不停止，往往会导致涩数模糊，这是脾脏不能消化运化的征兆。这个病症如果不是用攻下的方法，反而给予人参、附子助长壮热，顷刻间就会立即死亡。怎能不详细审慎而妄加用药呢？
叶新宇停食感冒，而两寸关脉皆涩数模糊，两尺脉皆沉弦，按之更加坚实。虽然那人还能行走，但脉象缺少冲和之气。这必定是向有陈旧的积气在少腹。询问他，果然患有寒疝数年。因为拖延推辞不便用药。那天晚上就腹部暴满而去世。门人问他说：“叶子偶尔患小病，为什么知道他必死而推辞不治病？”回答说：“凡是人的胃充满则肠空虚，肠充满则胃空虚，虚实交替，气机才能正常运行。现在胸中有食积而腹中有积滞，上下都受困，能保证它们不互相攻击为患吗？应当知道厥疝入腹，香港脚冲心等疾病，都是阴邪搏结，郁积久了，就挟带阴火之势而上行。如果胸中阳气有权力，那么阴邪仍会回到阴位而停止。现在胸中先被宿食填塞，腹中陈旧之气，不逆升则已，一旦逆升则上下俱满，正气没有容身之地，往往有突然断绝的危险。所以不便用药，实际上是不知道他即将死亡。所以凡是诊察六部脉中，病脉有不相应的地方，就应当审查有没有宿疾，不可轻忽以招致诽谤。”
俞震按语：伤食原本不是重病，所以选录的不多。然而各种治疗方法都具备，没有不精妙的，不需要再寻求额外的益处了。
Luo Qianfu treated Bo'erchici Maci. This patient, after hunting and obtaining a rabbit, roasted it over fire and ate too much. By evening, he felt drowsy and fatigued. Thirsty, he drank more than one dou of hot milk. That night, his abdomen became distended like a drum. He suffered from pain, chest tightness, and restlessness. He was unable to vomit or defecate. He was agitated and in such agony that he wished to die. His pulse at the Qi Kou (radial artery proximal to the wrist crease) was twice as large as that at the Ren Ying (carotid artery), with the Right Guan position being particularly forceful. This is because roasted meat is dry; excessive consumption led to thirst, and drinking copious amounts of hot milk caused the meat to swell upon contact with moisture. The intestines and stomach were completely blocked, losing the physiological mechanism of alternating emptiness and fullness for digestion and transmission. The *Neijing* states: "Yin Qi, when quiet, stores the Shen (Spirit); when restless, the Shen dissipates." Excessive food intake damages the intestines and stomach. Now, due to excessive diet, the Yin Qi has become restless, and the Shen cannot be stored. Death may occur within a day or two. If not using a potent and urgent formula, how could one break through the gates (rapidly purge the accumulation)? Therefore, he administered ten pills of Beiji Wan (Emergency Pill), divided into two doses. Then, he gave Wuyou San (Worry-Free Powder) five qian. Shortly after, the patient experienced severe vomiting and purging, expelling more than two dou of accumulated material. His abdomen gradually felt empty and relieved. The next day, he recovered after regulating his diet with rice gruel.
Li, a tea merchant and wealthy man, injured himself by eating too much horse meat. He developed abdominal distension. Physicians treated him with Dahuang (Rhubarb Root and Rhizome) and Badou (Croton Seed), but his condition worsened. Bao Yi Weng, Xiang Yanzhang, later examined him. The Cun Kou (radial pulse at the wrist) was rapid and hurried, while the two Chi positions (distal radial pulses) were nearly imperceptible. Xiang Yanzhang said: "There is new pathogenic factor in the chest, hence the rapid pulse. It should be guided upward. Now, instead, purgatives are used, which is a mistake." He administered an emetic agent. Li was seated in the center while attendants rotated around him. He immediately vomited up undigested meat. Subsequently, Shenxiong Wan (Shenxiong Pill) was given to induce strong purgation. The illness resolved, and everyone admired the treatment.
Sun Dongsu treated Dong Xunlao, Grand Secretary of Rites. He was 67 years old and had a history of spleen and stomach disorders. In the summer heat, after consuming excessive melons and fruits, he suffered from chest and diaphragm distension and pain. His pulse at the Cun and Guan positions was wiry and tight. His complexion showed that the Shen was stored and Qi was solid. Reviewing his previous medications, they consisted merely of Erchen Tang (Two-Cured Decoction) and Pingwei San (Calm the Stomach Powder) plus Shanzha (Hawthorn Fruit) and Maiya (Germinated Barley). He did not realize this injury was caused by the excess cold-dampness of melons and fruits. The classics state: "When Cold dominates, treat with Acrid-Warm methods." Melons and fruits cannot be digested without Shexiang (Musk) and Rougui (Cinnamon Bark). This explains why the previous formulas were ineffective. Thus, he prescribed Gaoliangjiang (Galangal Rhizome) and Xiangfu (Cyperus Rhizome), each one liang, Rougui five qian, and Shexiang one qian, ground into powder. Each dose was two qian, taken with wine. Within two to three days, his chest and diaphragm felt relaxed, and he regained his appetite.
Gong Yunlin treated a man who, in the twelfth lunar month, ate several jin of lamb meat while gambling. The cold oil from the lamb froze and blocked the chest and diaphragm, preventing downward movement. He was severely distended and suffocating, on the verge of death. Other physicians were helpless. Gong observed that all six pulses were present. He took a large jar of yellow wine, heated it, and placed it in a large vat. The patient sat inside the vat. Attendants gently slapped his chest, abdomen, and back. Two people blew into his ears. Hot liquor was then forced down his throat. Finally, Wanli Wan (Ten Thousand Pill) was administered. He recovered through vomiting and purging.
Yu Zhen's commentary: Miao Zhongchun treated an elderly person injured by cold food and indigestible substances. He decocted Laojiang (Old Ginger) and Zisu (Perilla Leaf), placed the liquid in a bath tub, and let the patient soak in it. He then rubbed the heart, stomach, abdomen, and belly with hot water. Once the Qi flowed freely, the food was digested. This method is similar to the one described above.
Shi Wen treated Wang Wufu, a pediatric case. In summer, he suffered from food stagnation, vomiting, fever, head distension and pain, and spontaneous passage of yellow watery stool. His whole-body muscles felt like pricks when touched. The six pulses were vague; searching under the fingers, they seemed present yet absent. His lower legs and shins were cold. Believing it to be a Yin-Cold syndrome, he took one dose of Wuji San (Five Accumulations Powder), but his heat intensified. He fell into a coma and lost consciousness. On the third day, diarrhea continued incessantly. He frequently spoke deliriously, worse at night. His uncle, Ye Yangsheng, diagnosed it as Summerheat injury and prescribed Xiangru Yin (Elsholtzia Decoction). Consequently, sweat poured from his head and face like steam. He panted and was restless. His feet were cold, and cold Qi reversed upward. Cheng Jiaoqian, a physician from She County, noted the severe heat and vague pulse, difficult to palpate, diagnosing it as Yang collapse impending death. He wanted to aggressively administer Renshen (Ginseng Root) and Fuzi (Aconite Lateral Root). Shen Mingsheng from Yunjian argued that Yin syndromes never present with sweating like steaming. Although the pulse was deficient, the symptoms indicated severe heat, so he advocated for Renshen Baihu Tang (Ginseng White Tiger Decoction). The debate remained unresolved, so they sought Shi Wen's opinion. Shi Wen palpated the six pulses; although all were choppy, weak, and vague, pressing below the heart caused severe pain. There were gray prickles on the tongue resembling thorns. This indicated food filling the Middle Jiao, failing to drive the pulse. Such cases are common. He advised using Liangge San (Cool the Chest Powder) to purge. The other physicians, eager to shift responsibility, agreed to his prescription. After one administration, the patient's mental clarity greatly improved, and the pulse instantly became distinct. One must know that while the pulse for food stagnation is typically slippery and full at the Qi Kou, repeated injuries often lead to choppy, rapid, and vague pulses, signaling the Spleen's failure to digest and transport. If this case had not been treated with purgation, but instead with Renshen and Fuzi to support the hyperthermia, death would have occurred instantly. How can one prescribe recklessly without careful deliberation?
Ye Xinyu suffered from food stagnation complicated by wind-cold. Both Cun and Guan pulses were choppy, rapid, and vague. Both Chi pulses were deep and wiry, becoming firmer upon pressure. Although he could still walk, the pulse lacked harmony. This indicated pre-existing stagnant Qi in the lower abdomen. Inquiry confirmed he had suffered from Han Shan (Cold Hernia) for years. He delayed treatment, citing inconvenience. That night, his abdomen suddenly became fully distended, and he died. A disciple asked: "Master Ye had only a minor ailment. Why did you predict certain death and refuse treatment?" I replied: "Normally, when the Stomach is full, the Intestines are empty; when the Intestines are full, the Stomach is empty. Alternating fullness and emptiness allows Qi to reside properly. Now, there is food stagnation in the chest and accumulation in the abdomen. Both upper and lower are obstructed. Can we guarantee they will not attack each other causing disaster? One must know that diseases like Jue Shan entering the abdomen or Hong Kong Foot rushing to the heart involve Yin pathogens knotting together. After long stagnation, they carry the momentum of Yin Fire upward. If Yang Qi in the chest is strong, Yin pathogens remain in their proper Yin positions. However, here the chest is first blocked by retained food, and the abdomen contains old stagnation. If it does not reverse upward, fine; if it does, both upper and lower are full, leaving no room for Healthy Qi. There is often a risk of sudden collapse. Thus, treatment was inadvisable, as I actually knew he would die soon. Therefore, whenever examining the six pulse positions, if pathological pulses do not correspond appropriately, one must investigate whether there are chronic conditions. Do not neglect this, lest you invite slander."
Yu Zhen's commentary: Food stagnation is originally not a serious disease, so few cases are selected. However, all methods are complete, and no subtlety is lacking. There is no need to seek further advantages.