窦梦麟曰。隆庆三年正月。盐商胡小溪家人媳妇。年二十三岁。怀娠九月矣。一日食鱼
鱼哽喉间。至半日。呕吐。继之以血碗许。鱼骨尚在喉中。忽吐出一条。约有二尺余。形
如小肠。阔五分。内有所食鱼菜粉皮饭未化。家人为推入口中。尚余五寸。其夫复纳入之遂
昏
倦。自此呕吐不止。汤亦不能进。延予治之。即将炭火一盆放病榻前。以好醋一碗沃之。使
醋气盈满其室。以清其神。用牛黄清心丸一服。觉腹有微痛。再用四物汤加人参、阿胶、红
花、丹皮。五六帖。病全愈。盖此妇所吐之肠。有类于肠耳。若肠出而断。顷刻立毙。岂有
得生之理。此吐出者。肺之系也。因呕吐太甚。被气冲逆。而断其连肺之一头。随吐而出。
今既纳入。复吐不已。气不平耳。故用醋汤以醒其神。牛黄丸以清其心。煎剂以补其气血。
自然安妥。医者意也。全在活法。书此以为世劝。
震按此案治法颇佳。但云吐出者为肺系则谬。夫谷肉果菜由食管入胃。岂由肺系入肺。
即如刀伤者。断食管可治。断气管必死。今云断其连肺之一头。是人安得活。观其叙证。曰
家人推纳入口。则原未断也。然究系何物。或者即食管耶。又不详明骨哽何以脱去。疏漏殊
多矣。只缘类案骨哽门无有义理可取者。所载橄榄细嚼。及核磨汁。与贯众煎汁。或白饧糖
吞咽之。治鱼骨哽。俱叙其方之所自来耳。南硼砂含咽。治火肉骨哽亦然。然以斯种入集。
又不胜收矣。故鱼骨哽者。有楮叶捣汁频咽。水老鸦翅羽烧灰水服。及其干屎研末水服。并
以水和涂喉外。水獭爪爬喉咙下。皆妙法也。而皂角末吹鼻中。得嚏即出为尤妙。昔贤云。
凡诸骨并竹木刺。哽塞咽喉不出者。不可频以干物压下。若刺骨坚利者。愈压则愈深入矣。
惟以鹅翎微蘸桐油。入喉探吐。则刺必随吐顺拔而出。为势最顺。或以韭菜之类勿切。煮半
熟略嚼咽下。少顷探吐。势必牵挂而出。斯真大有义理。宝公所治之证。其哽骨谅亦随呕吐
去。只存呕吐所伤之病。应如是治。
窦梦麟说：隆庆三年正月，盐商胡小溪家儿的媳妇，二十三岁，怀孕九个月。有一天吃鱼时，鱼刺卡在喉咙里。过了半天，她呕吐起来，接着吐出一碗左右的血，鱼骨还在喉咙中。忽然她吐出一条东西，大约有二尺多长，形状像小肠，宽五分，里面还有未消化的鱼、菜、粉皮和饭。家人把它推回她口中，还剩下五寸。她的丈夫又把它塞回去，于是她昏迷疲倦。从此呕吐不止，连汤水都不能喝。请我去诊治。我立刻在病床前放一盆炭火，倒一碗好醋进去，让醋气充满整个房间，用来清心醒神。服用一剂牛黄清心丸，感觉腹部有轻微疼痛。再用四物汤加入人参、阿胶、红花、丹皮，服了五六帖后，病完全痊愈。大概这位妇女吐出的肠子，类似于肺系（连接肺部的组织）。如果是肠子脱出并断裂，顷刻就会死亡，哪有存活的道理？这吐出来的是肺的系带。因为呕吐太剧烈，被逆冲之气冲击，导致其连接肺部的一端断裂，随呕吐排出。现在既然已经纳入，却又呕吐不停，是因为气机不平顺罢了。所以用醋汤来醒神，牛黄丸来清心，煎剂来补益气血，自然就能安妥。医者的治疗在于意会，全凭灵活变通。写下此案以劝诫世人。
俞震按语：此案的治法相当好。但说吐出的是肺系则是错误的。谷物、肉类、水果和蔬菜由食管进入胃，难道是由肺系进入肺吗？就像刀伤患者，切断食管可以治愈，切断气管必死无疑。现在说断开了连接肺部的一端，人怎么能活呢？看他的叙述，说家人将其推纳入口中，说明原本并没有断。然而究竞是什么东西？或许是食管吧？又不详细明确鱼骨是如何脱去的，疏漏非常多。只因为类案中的“骨哽”门类没有可取的义理，所记载的如橄榄细嚼、核磨汁、贯众煎汁，或吞咽白饴糖，治疗鱼骨哽喉，都只是叙述这些方子的来源而已。南硼砂含咽，治疗火肉骨哽也是如此。然而把这类内容收入集子，又收录不完。所以对于鱼骨哽，有用楮叶捣汁频频吞咽的，有用水老鸦翅羽烧成灰用水送服的，有用其干屎研末用水送服的，并用和水调和涂在喉外，用水獭爪抓挠喉咙下方，都是妙法。而用皂角末吹入鼻中，打喷嚏即出，尤为奇妙。先贤说：凡是各种骨头以及竹木刺，卡在咽喉出不来的，不可频繁用干物往下压。如果刺骨坚硬锋利，越压就越深入。只有用鹅毛翎蘸少许桐油，伸入喉咙探吐，那么刺必然随着呕吐顺势拔出而出，这是最顺畅的方法。或者用韭菜之类不切段的蔬菜，煮至半熟略嚼后咽下，过一会儿探吐，势必牵挂着刺一起出来，这才是真正大有义理的。宝公（窦梦麟）治疗的这个病例，其卡住的骨头估计也是随着呕吐排出的，只留下了呕吐所损伤的病证，应该这样治疗。
Dou Menglin said: In the first month of the third year of Longqing, the wife of a salt merchant named Hu Xiaoxi's family member, aged twenty-three and nine months pregnant, ate fish one day. A fish bone got stuck in her throat. After half a day, she vomited, followed by vomiting about a bowlful of blood, while the fish bone remained in her throat. Suddenly, she vomited out a piece of tissue, approximately two chi (approx. 60-70 cm) long, shaped like the small intestine (Xiaochang), with a width of five fen. Inside were undigested remnants of fish, vegetables, vermicelli, and rice. Her family members pushed it back into her mouth, leaving five cun remaining. Her husband then inserted it again, causing her to fall into a coma and feel fatigued. From then on, she vomited incessantly, unable to even take in soup or water. I was invited to treat her. I immediately placed a basin of charcoal fire in front of the sickbed and poured a bowl of good vinegar into it, allowing the vinegar vapor to fill the room to clear the mind and awaken the spirit. She took one dose of Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill). She felt slight abdominal pain. Then, using Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Root), Ejiao (Donkey-Hide Gelatin), Honghua (Carthamus Flower), and Danpi (Moutan Cortex), after taking five or six doses, the illness was completely cured. The intestine-like tissue vomited by this woman resembles the lung system (Feixi, tissues connecting the lungs). If the intestine had prolapsed and severed, death would have occurred instantly; how could survival be possible? What was vomited out was the lung system. Due to severe vomiting, it was impacted by counterflowing Qi, causing its connection to the lung to sever and be expelled with the vomit. Now that it has been reinserted but vomiting continues, it is because the Qi mechanism is not smooth. Therefore, vinegar decoction was used to awaken the spirit, Niuhuang Wan to clear the heart, and herbal decoctions to tonify Qi and Blood, naturally leading to stability. Medical treatment relies on intuitive understanding and flexibility. This case is recorded to advise future generations.
Yu Zhen commented: The treatment method in this case is quite excellent. However, stating that what was vomited was the lung system is incorrect. Food, meat, fruits, and vegetables enter the stomach via the esophagus; do they enter the lungs via the lung system? Just as in knife injuries, severing the esophagus can be treated, but severing the trachea leads to certain death. How could one survive if the end connected to the lung was severed? Observing his description, he stated that family members pushed it back into the mouth, implying it was originally intact. So, what exactly was it? Perhaps it was the esophagus? He did not clarify how the fish bone was expelled, leaving many omissions. It is merely because the "Bone Stuck" category in case collections lacks theoretical merit. Entries such as chewing olives finely, grinding pits for juice, decocting Guanzhong (Aconitum carmichaelii root), or swallowing white maltose to treat fish bones stuck in the throat merely narrate the origins of these prescriptions. Holding Nanpingsha (Borax) in the mouth and swallowing it works similarly for meat bones stuck in the throat. However, including such types of content in a collection would be endless. Therefore, for fish bones stuck in the throat, there are methods such as frequently swallowing juice from捣碎 Ficus pumila leaves, taking ash from burned feathers of the Water Crow (Shuilao Ya) with water, taking powder from dried excrement mixed with water, applying water-mixed paste externally on the throat, scratching below the throat with otter claws—all are excellent methods. Blowing powder of Gleditsia sinensis (Zaojiao) into the nose to induce sneezing, thereby expelling the object, is particularly wonderful. Ancients said: For any bones, bamboo, or wood splinters stuck in the throat and unable to come out, one must not frequently press them down with dry substances. If the splinter is hard and sharp, pressing harder drives it deeper. Only by dipping an goose feather quill slightly in tung oil and inserting it into the throat to induce vomiting will the splinter be pulled out smoothly with the vomit, which is the most favorable approach. Alternatively, using uncut leeks, cooking them until half-done, chewing slightly, and swallowing them; after a short while, inducing vomiting will likely drag the splinter out with them. This truly possesses great rationale. In the case treated by Bao Gong (Dou Menglin), the stuck bone was likely expelled along with the vomit, leaving only the injury caused by vomiting, which should be treated as described.