经云∶调寝食在医药之先。即圣人治未病之说，夫色声既受，非安谷不能生精与气，非
安枕
不能养血与神。是以百病阽危，必首论云浆粥能进否，验其胃气之败与不败，寤寐如常否，
察其神思之宁与不宁。不食少卧病也，多食嗜卧亦病也。卫生却病者，能不谛当于寝食间哉
？不能食之证，有伤寒而痞满呕恶呕食者，有气滞而痛楚妨食者，有痰聚而不能容食者，有
能食而食入反出者，有忧恐太过郁结而不思食者，有孕妇胎成而恶阻者，有脾胃热而胃脘寒
，虽饥不嗜食者，有脾胃自虚而不能健运者，有火不生土无由熟腐者，有大病后中气虚，恶
闻食气者，有胃脘干槁而勺粒不入者。大抵因多食而顿不能食者为实，从少食而渐不能食者
为虚。多食之证，有火伏阴分，胃热善消谷，或大肠移热于胃，胃移热于胆。善食而瘦谓之
食，亦名息中者。有伤寒入脏，厥冷下利，当不食而反能食，名曰除中者。有中风风木自
盛克脾，脾土受克求助而多食者。有一脏之虚，必偏嗜一味，如怀孕之肝虚嗜酸者；有虫积
为患，好食茶叶、生米、泥炭、草纸之类者；有病后胃虚之极，而饱食易饥者。大抵多食易
化，责在阳明之火，火食难化，责在太阴之虚。不得卧之证，若劳神忧虑，耗其阴血，惺惺
不
寐，病在心也。若神气衰微，疑神疑鬼，怔忡悸怯，独处无睡，病在肝胆也。若水气上逆，
喘嗽有音，不能仰卧，病在肺也。若因有惊恐，神出舍空，痰乘虚入，则谵妄不寐
病在心胞络也。若气血不足，病后虚烦，则
，略睡而醒
，病在脾也。若伤寒阳明府病，内有燥屎，则热甚而卧不安，病在胃也。若年高之人，气虚
血减，肌肉渐涩，昼不精而夜不瞑，病在营卫也。故心、脾、肝、胆、营、卫之不卧，多属
不足。肺、胃、胞、络之不卧，多属有余也。嗜卧之证，若肝气受热，或浊火乱其神明，多
睡少醒，由于热也。若脉缓怠惰，四肢不收，体重泄泻而嗜卧，由于湿也。若头重身热而昏
愦不醒，属于风也。若劳役之余，及脱血下痢之后，精神未复而酣然沉困，属虚也。若其人
天禀有余，肠胃大而皮肤涩。大者，卫气留于阴分者久；涩者，卫气行于阳分者迟。既久
且
迟，卫气不达而多眠卧，属于阳不胜阴也。若饮食才入，辄生困倦，精神昏冒，呵欠欲睡者
，由于脾倦，或兼湿热也。然伤寒邪入少阴，则脉微细但欲寐也。故神间而甘寝者，人之常
。
神惫而嗜卧者，人之病。以上诸条，寝食不调之候，可谓略具，别证既明，则治法可从而推
广，然此皆为已病而设也。若未病豫调之说，在养生家说述甚伙，吾有取于侗初张氏之言曰
∶凡饮食之节，减满受虚，故当饥而食，节其满未饱，先止留其虚。睡卧之法，先睡心，后
睡眼。睡心是止法，睡眼是观法。能斯二者，始可与言养生。然世复有寝食无节之流，顾不
食而纵酒，不寐而渔色，是又疾不干人，人来求疾。是以庄生云，人之可畏者，在衽席饮食
之际，信矣。
《黄帝内经》说：调理睡眠和饮食应在药物治疗之前。这正是圣人“治未病”的理论。既然人的形体已经受到外界声色等刺激的影响，那么如果不能安稳地进食，就不能化生精微与气；如果不能安稳地睡觉，就不能滋养血与神。因此，当各种疾病发展到危险阶段时，必须首先询问患者能否喝进流质粥汤，以此检验其胃气是否败绝或尚存；观察其睡眠和觉醒是否正常，以此察知其神志是否安宁。不能进食且睡眠少是病态，吃得过多且嗜睡也是病态。想要养生防病的人，难道能不审慎地对待睡眠和饮食吗？
关于不能进食的证候，有因伤寒导致痞满、呕吐恶心甚至吐出食物的；有因气机阻滞导致疼痛妨碍进食的；有因痰饮聚集导致无法容纳食物的；有能进食但吃进去又反吐出来的；有因过度忧愁恐惧导致气郁结而不想进食的；有孕妇胎成后出现妊娠恶阻的；有脾胃有热而胃脘寒冷，虽然饥饿但不喜欢进食的；有脾胃自身虚弱而不能正常运化的；有命门火衰不能温煦脾土导致食物无法熟腐消化的；有大病之后中气虚弱，厌恶闻到食物气味的；有胃脘干枯萎缩导致连勺粒食物都吃不下的。大抵而言，因为暴饮暴食突然导致不能进食的属于实证，从吃得少逐渐发展到不能进食的属于虚证。
关于进食过多的证候，有火热伏于阴分，胃热善于消化谷物，或者大肠的热邪移注于胃，胃的热邪移注于胆的。善于进食却身体消瘦，称为“食瘕”，也叫“息贲”。有伤寒邪气传入脏，出现四肢厥冷、下利，本应不能进食反而能进食的，称为“除中”。有中风导致肝木之气过盛克制脾土，脾土受克求助于同类（按五行相生相克理论，此处指脾虚求助或代偿性亢进）而导致多食的。有一脏虚弱时，必然偏嗜某种味道，例如怀孕时肝虚而嗜酸的；有虫积为患，喜好食用茶叶、生米、泥土炭块、草纸之类的；有病后胃气极度虚弱，吃饱后又容易感到饥饿的。大抵而言，多吃容易消化，责任在于阳明经的火盛；吃了难消化，责任在于太阴经的脾虚。
关于不能入睡的证候，如果是劳神忧虑，耗伤了阴血，导致清醒而无法入睡，病位在心。如果是神气衰微，疑神疑鬼，心悸胆怯，独处时无处安睡，病位在肝胆。如果是水气上逆，喘息咳嗽有声，不能仰卧，病位在肺。如果是因为惊恐，神气外越导致心舍空虚，痰邪乘虚而入，导致胡言乱语、无法入睡，病位在心包络。如果是气血不足，病后虚烦，则睡眠浅易醒，病位在脾。如果是伤寒阳明腑病，体内有燥屎，则热势严重而卧不安稳，病位在胃。如果是年老之人，气虚血少，肌肉日渐枯涩，白天精神不振，晚上无法入睡，病在营卫之间。所以，心、脾、肝、胆、营、卫导致的失眠，多属于虚证不足；肺、胃、心包、络脉导致的失眠，多属于实证有余。
关于嗜睡的证候，如果是肝气受热，或者浊火扰乱神明，导致多睡少醒，是由于热邪所致。如果是脉象缓怠惰，四肢无力收持，身体沉重、腹泻且嗜睡，是由于湿邪所致。如果是头重身热且昏沉不醒，属于风邪所致。如果是劳累之余，以及失血、下痢之后，精神尚未恢复而酣然沉睡困倦，属于虚证。如果是其人天资禀赋有余，肠胃宽大而皮肤致密涩滞。肠胃大，意味着卫气在阴分停留的时间长；皮肤涩，意味着卫气行于阳分的速度慢。既停留时间长又运行速度慢，卫气不能通达体表而多眠卧，属于阳气不胜阴气。如果是刚吃完东西，就产生困倦，精神昏蒙，打哈欠想睡觉，是由于脾倦，或者兼夹湿热。然而，伤寒邪气侵入少阴经，会出现脉象微细、只想睡觉的症状。所以，神志清爽而安睡，是常人的常态；神疲乏力而嗜睡，是病人的病态。以上诸条，关于睡眠和饮食不调的征候，可以说大致具备了。其他证候既然明确，治疗方法就可以据此推广。然而，这些都是针对已经生病的情况设立的。至于未病之前预先调养的学说，在养生家的论述中非常多。我赞同侗初张氏的话说：凡是饮食的节制，要减少饱胀，接受虚损，所以在饥饿时才进食，节制到未满未饱时就停止，先留出一些虚空。睡觉的方法，先让心静下来，再闭上眼睛。让心静下来是“止法”，闭上眼睛是“观法”。能做到这两点，才可以和他谈论养生。然而世间还有那些睡眠饮食没有节制的流派，不顾忌饮食而纵情饮酒，不顾忌睡眠而贪恋女色，这又是疾病不找上门，人自己去找疾病。所以庄子说，人值得畏惧的，正是在床席饮食之间啊，确实如此。
The *Classic of Internal Medicine* states: Regulating sleep and diet should precede medical treatment. This is precisely the theory of "treating disease before it arises" advocated by the sages. Since the physical form has already been subjected to external stimuli such as sounds and colors, if one cannot eat peacefully, essence and qi cannot be generated; if one cannot sleep peacefully, blood and spirit cannot be nourished. Therefore, when various diseases reach a critical stage, it is essential first to inquire whether the patient can consume liquid porridge, thereby verifying whether the stomach qi is exhausted or intact; observing whether their wakefulness and sleep are normal, thereby inspecting whether their mental state is tranquil. Inability to eat with little sleep is a pathological condition, just as excessive eating with lethargy is also a pathological condition. Those who wish to preserve health and prevent disease must surely exercise caution regarding sleep and diet.
Regarding conditions of inability to eat, there are cases where cold damage (*Shanghan*) causes fullness in the epigastrium, nausea, vomiting, and even regurgitation of food; cases where stagnant qi causes pain that hinders eating; cases where phlegm accumulation prevents the容纳 (acceptance) of food; cases where food is eaten but immediately vomited back up; cases where excessive worry and fear cause qi depression and loss of appetite; pregnant women experiencing morning sickness due to fetal formation; cases where heat exists in the spleen and stomach while cold resides in the epigastrium, causing hunger without desire to eat; cases of inherent spleen and stomach deficiency failing to transport and transform effectively; cases where fire fails to generate earth, leaving no means to cook and decompose food; cases of middle qi deficiency after severe illness, leading to aversion to the smell of food; and cases of dryness and atrophy in the epigastrium preventing even spoonfuls of food from entering. Generally speaking, sudden inability to eat due to overeating belongs to excess syndromes (*Shi*), while gradual inability to eat starting from reduced intake belongs to deficiency syndromes (*Xu*).
Regarding conditions of excessive eating, there are cases where fire hides in the yin aspect, stomach heat digests grain well, or heat transfers from the large intestine to the stomach, and from the stomach to the gallbladder. Excessive eating with emaciation is called "food mass" (*Shi Xia*), also known as "breath accumulation" (*Xi Ben*). There are cases where cold damage pathogens enter the zang organs, causing cold limbs and diarrhea; although they should not be able to eat, they suddenly can, which is called "removal of the center" (*Chu Zhong*). There are cases of wind-stroke where liver wood qi becomes excessive and overacts on spleen earth; the spleen earth, being overacted upon, seeks assistance and results in increased eating. When one zang organ is deficient, there is often a specific craving for a certain taste, such as craving sour foods during pregnancy due to liver deficiency. Parasitic accumulation may cause cravings for tea leaves, raw rice, mud, charcoal, or paper. After an illness, extreme stomach deficiency may lead to feeling full yet quickly hungry again. Generally, easy digestion despite large intake is attributed to the fire of the Yangming channel; difficulty digesting food is attributed to the deficiency of the Taiyin channel.
Regarding conditions of insomnia, if mental labor and worry deplete yin blood, causing wakefulness and inability to sleep, the pathology lies in the Heart. If spirit and qi are weak, accompanied by paranoia, palpitations, timidity, and loneliness without sleep, the pathology lies in the Liver and Gallbladder. If water qi rebels upward, causing wheezing, coughing with sound, and inability to lie flat, the pathology lies in the Lung. If caused by fright, with spirit wandering and the heart residence empty, allowing phlegm to enter due to deficiency, resulting in delirium and insomnia, the pathology lies in the Pericardium Collateral. If qi and blood are insufficient, causing post-illness vexation, leading to light sleep and frequent waking, the pathology lies in the Spleen. If Yangming fu-organ disease from cold damage involves dry feces internally, causing intense heat and restless sleep, the pathology lies in the Stomach. In elderly individuals, qi deficiency and blood reduction lead to increasingly rough muscles, lack of vitality during the day, and inability to sleep at night; the pathology lies in Ying and Wei. Thus, insomnia caused by the Heart, Spleen, Liver, Gallbladder, Ying, and Wei mostly belongs to deficiency. Insomnia caused by the Lung, Stomach, Pericardium, and Collaterals mostly belongs to excess.
Regarding conditions of hypersomnia, if liver qi is heated or turbid fire disturbs the spirit, causing long sleep and short wakefulness, it is due to heat. If the pulse is slow and sluggish, limbs are flaccid, body is heavy with diarrhea and hypersomnia, it is due to dampness. If the head feels heavy, body is hot, and consciousness is clouded, it belongs to wind. If following overwork, hemorrhage, or dysentery, the spirit has not recovered but deep sleep ensues, it belongs to deficiency. If a person has innate abundance, with large intestines/stomach and tight skin, the largeness means Wei qi stays in the yin aspect for a long time; the tightness means Wei qi moves slowly in the yang aspect. Being both long and slow, Wei qi fails to reach the exterior, resulting in hypersomnia, which belongs to yang failing to overcome yin. If drowsiness, mental fog, and yawning occur immediately after eating, it is due to spleen fatigue or combined damp-heat. However, when cold damage pathogens enter the Shaoyin channel, the pulse is faint and fine, and there is only a desire to sleep. Therefore, clear-mindedness with peaceful sleep is the norm for humans; exhaustion with hypersomnia is the pathology of the sick. The above items cover the manifestations of sleep and diet imbalance. Once other symptoms are clarified, treatment methods can be extended accordingly. However, these are established for existing diseases. Regarding preventive regulation before disease onset, there are numerous discussions among health preservation experts. I endorse the words of Zhang Tongchu: "In terms of dietary moderation, reduce fullness and accept emptiness; therefore, eat only when hungry, stop before becoming fully satisfied, leaving some void." Regarding sleeping methods, calm the mind first, then close the eyes. Calming the mind is the method of "stopping"; closing the eyes is the method of "observing." Only by mastering these two can one discuss health preservation. Yet, there are those in the world who have no discipline in sleep and diet, indulging in alcohol despite satiety and seeking sexual gratification despite fatigue. This is inviting disease rather than having disease invite them. Thus, Zhuangzi said, "What is to be feared in humans occurs between the bedclothes and the dining table," which is truly so.