伤食病。必有胸闷吞酸嗳腐腹胀腹痛等症。直以平胃散。如麦芽谷芽山楂神曲萝卜子消
之。或以所伤之物。烧灰加入为引导。如初伤时食尚在膈。服此汤。以手探吐。如伤之已久。
腹满拒按。宜以三一承气汤下之。愈后服香砂六君子汤。加干姜调养。若无吞酸嗳腐等症。
但见头痛恶寒发热。是外感症。切不可误用消导之品。致外邪陷入。变症百出。伤寒不禁
食。故桂枝汤啜粥是开章第一义。读仲景书自明。西北之人。一遇头痛恶寒发热之症。便云
有食。即服神曲山楂等药。往往误事。余为活人计。不得不大声疾呼也。
脉滑而实。 时书以右关之上为气口。谓气口紧盛伤于食者。妄也。
张景岳云。偶病之人。多有非食而疑食者。曰某日曾食某物。或某肉某面。其日即病。
医理不论虚实。但闻此言。且见胃口不开。必先治食。夫未病之人。谁有不食。岂必预为停
食。以待病至者。斯可信其无食乎。及其病也。则或因劳倦。或因风寒。或因七情。病发不
测。而且无胀无滞。与食何干。药有对病而妄行剥削。必反增病。此斯道之莫须有也。由此
推之。则凡无据无证。而妄行胡猜者。皆其类也。良可慨矣。
黄履素（着折肱漫录。）云。五谷皆养补脾气之物。一 成炭。反能消食者何。盖火能
软
坚化物。烬从火化故也。诸炭能消食。亦能伤脾。功用不减于山楂神曲。不可忽之。以为食
物而多服常服也。
愚按今人用白术炒焦不知其伤脾地黄烧灰。不知其伤肾。当以先生之言正之。
伤食病，必然会出现胸闷、吞酸、嗳气有腐臭味、腹胀、腹痛等症状。应当直接使用平胃散（燥湿运脾，行气和胃的方剂），加入麦芽、谷芽、山楂、神曲、萝卜子等药物来消食导滞。或者将所伤的食物烧成灰，加入药中作为引导。如果是在受伤初期，食物还在膈部，服用此汤后，可以用手指探喉催吐。如果受伤时间已久，腹部胀满且拒按，适宜使用三一承气汤（峻下热结的方剂）攻下。痊愈后服用香砂六君子汤（益气健脾，行气化湿的方剂），并加入干姜进行调养。如果没有吞酸、嗳气有腐臭味等症状，只见到头痛、恶寒、发热，这是外感症，切不可误用消导的药物，导致外邪陷入体内，变证百出。伤寒病患者不禁食，所以桂枝汤（解肌发表，调和营卫的方剂）服后喝热粥是开篇的第一要义。研读张仲景的书籍自然明白。西北地方的人，一遇到头痛、恶寒、发热的症状，就说是有食积，立即服用神曲、山楂等药物，往往耽误病情。我为了救人，不得不大声疾呼。
脉象滑而实。当时的医书认为右手关脉之上为气口，说气口脉紧盛是伤于食，这是荒谬的。
张景岳说，偶然生病的人，多有并非因食积却怀疑是食积的，说“某日曾吃了某物，或是某种肉或面食”，当天就病了。医理不论虚实，只要听到这话，又看到胃口不开，就一定先治食积。然而没生病的人，谁有不吃饭的？难道一定要预先让食物停滞在体内，等待疾病到来吗？这怎么能相信是没有食积呢？等到发病时，可能是因为劳累疲倦，可能是因为风寒侵袭，可能是因为七情内伤，疾病发作出乎意料，而且没有腹胀和停滞的感觉，这与食物有什么关系？药物如果对病症不对症而妄加攻伐剥削，必定反而加重病情。这是医学领域中莫须有的罪名。由此推论，那么凡是没有任何依据和证据而胡乱猜测的，都属于这一类，实在令人感慨。
黄履素（著有《折肱漫录》）说，五谷都是滋养补益脾气的事物，一旦烧成炭，反而能消食，为什么呢？因为火能使坚硬之物软化并转化物质，灰烬是从火中变化而来的。各种炭类药物能消食，也能损伤脾气，其功效不亚于山楂、神曲，不可轻视它们，当作普通食物而多服、常服。
Food stagnation disease necessarily presents with symptoms such as chest tightness, acid regurgitation, belching with a putrid odor, abdominal distension, and abdominal pain. One should directly use Pingwei San (Calm the Stomach Powder) [Pingwei San (Stomach-Calming Powder)], adding Maiya (Sprouted Hordei Fructus), Guya (Sprouted Oryzae Fructus), Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata), and Luobozhi (Radish Seed) to promote digestion and resolve stagnation. Alternatively, the ingested food can be burned to ash and added to the prescription as a guiding agent. If it is the initial stage of injury and the food remains in the diaphragm region, after taking this decoction, one can induce vomiting by probing the throat with fingers. If the injury has persisted for a long time, accompanied by abdominal fullness and tenderness upon pressure, it is appropriate to purge using Sanyi Chengqi Tang (Three-One Purging Decoction) [Sanyi Chengqi Tang (Three-One Cathartic Decoction)]. After recovery, Xiangsha Liujunzi Tang (Aucklandia and Amomum Six Gentlemen Decoction) [Xiangsha Liujunzi Tang (Six Gentlemen Decoction with Aucklandia and Amomum)] should be taken, with Ganjiang (Dried Ginger) added for conditioning. If there are no symptoms such as acid regurgitation or putrid belching, but only headache, aversion to cold, and fever are observed, this indicates an external contraction syndrome. One must absolutely avoid mistakenly using digestive-promoting agents, which would cause external pathogens to sink inward, leading to myriad complications. Patients with Shanghan (Cold Damage) [Shanghan (Cold Damage)] cannot abstain from food; therefore, drinking hot porridge after taking Guizhi Tang (Cinnamon Twig Decoction) [Guizhi Tang (Cinnamon Twig Decoction)] is the primary principle stated at the beginning of Zhang Zhongjing's work. Reading Zhang Zhongjing's books will make this clear. People in the northwest regions, upon encountering symptoms of headache, aversion to cold, and fever, immediately claim it is food stagnation and take medicines like Shenqu and Shanzha, often causing mishaps. For the sake of saving lives, I feel compelled to raise my voice loudly.
The pulse is slippery and solid. Contemporary medical texts assert that the area above the right Guan position is the Qi Kou (Qi Gate), stating that a tight and vigorous Qi Kou pulse indicates food stagnation; this is absurd.
Zhang Jingyue said: Individuals suffering from occasional illnesses often suspect food stagnation when none exists, claiming, "On a certain day, I ate something, perhaps a specific meat or noodle dish," and fell ill on that very day. Regardless of whether the pathology is deficiency or excess, if the physician hears this statement and observes poor appetite, they invariably treat for food stagnation first. However, who does not eat when healthy? Must one pre-store stagnant food in the body waiting for illness to arrive? How can one believe there is no food stagnation? When illness occurs, it may be due to fatigue, wind-cold invasion, or emotional disturbances. The onset is unpredictable, yet there is no abdominal distension or stagnation. What does this have to do with food? Medications that attack without addressing the actual condition will inevitably exacerbate the illness. This is a baseless accusation in the medical field. By extension, any wild guessing without evidence or symptoms falls into this category, which is truly lamentable.
Huang Lvsu (author of *Zhe Gong Man Lu* / *Random Records of Broken Bones*) stated: The five grains are substances that nourish and tonify Spleen Qi. Why does charring them transform their function to digest food? Fire softens hardness and transforms matter; ashes result from fire transformation. Various charred herbs can digest food but also damage Spleen Qi. Their efficacy is no less than Shanzha and Shenqu. They should not be neglected or treated as ordinary food for frequent or excessive consumption.
My commentary: Nowadays, people stir-fry Baizhu (Atractylodis Macrocephalae Rhizoma) until scorched without realizing it damages Spleen Qi; they burn Dihuang (Rehmanniae Radix Praeparata) to ash without realizing it damages Kidney Qi. These practices should be corrected according to Mr. Huang's words.