噤口者，下痢不食，或呕不能食也。痢而能食，知胃未病，今不食者，缘于脾家湿热，壅塞胃口而然；又
有误服利药，犯其胃气者；止涩太早，留邪于中者；脾胃虚寒，湿邪干犯者；气机闭塞，热邪阻隔者；秽
积在下，恶气熏蒸者；肝木所胜，乘其脾胃者；又有宿食不消者，水饮停蓄者，皆能使人噤口也。拟用
调中开噤法，随证加减，缓缓服之，冀其有效。然噤口之因，非审其脉不能明晰，如右部浮濡沉细，或缓怠
无力，胃虚也；洪大急滑，火热也；浑浑浮大或浮弦，浊气上壅也；沉而滑，或右涩滞，宿食停积也；迟
细者，胃寒也；弦急者，木胜也。细别其脉而治之，更为确当。倘或绝不思食，下痢无度，不可治也，惟
有独参汤合陈廪米浓煎频服，幸冀万一耳。
孔以立曰∶予尝治噤口痢，以藕汁煮熟稍和砂糖频服，兼进多年陈米稀糜，调其胃气必效，即石莲子之意
也。古治噤口痢多有用黄连者，苦而且降，不能升提，非胃虚所宜。大抵初痢噤口，为热瘀在胃口，故宜苦
燥。若久痢口噤不食，此胃气告匮，非比初痢噤口，尚有浊气可破，积滞可驱，惟大剂参术，佐以茯苓、甘
草、藿香、木香、煨葛之属，大补胃气，兼行津液乃可耳。但得胃气一复，饮食稍进，便宜独参汤，略加
陈皮，或制香附，缓缓调补，兼行气滞，方为合剂。如茯苓之淡渗，木香之耗气，干葛之行津，皆当屏除也。
江诚曰∶斯论超出乎众，谓初痢之噤口，宜以苦燥；久则
胃虚，必以大剂参术为君，苦燥之黄连，又在禁用，此洵为治噤口不易之良法也。
“噤口”是指下痢且不能进食，或者呕吐导致无法进食的症状。如果患痢疾但还能进食，说明胃气未受病邪侵害；如今不能进食，是因为脾脏有湿热，壅塞了胃口所致；又有因误服通利药物，损伤了胃气的；或因过早使用止涩药，使邪气留滞于体内的；或因脾胃虚寒，湿邪侵犯的；或因气机闭塞，热邪阻隔的；或因秽浊积滞在下焦，恶气熏蒸上逆的；或因肝木过盛，克制乘袭脾胃的；又有因宿食不消化的，或因水饮停蓄的，这些情况都能导致人出现噤口的症状。拟定采用调中开噤法，根据具体证候进行加减，缓缓服用，希望能见效。然而，导致噤口痢的原因，如果不仔细诊察脉象就不能明晰判断：例如右部脉象浮濡沉细，或缓怠无力，这是胃虚的表现；脉象洪大急滑，是火热的表现；脉象浑浑浮大或浮弦，是浊气上壅的表现；脉象沉而滑，或右脉涩滞，是宿食停积的表现；脉象迟细，是胃寒的表现；脉象弦急，是肝木过盛的表现。细致辨别脉象后进行治疗，更为确切恰当。倘若患者完全不想吃东西，下痢无度，这就属于不可治愈的情况，只有用独参汤配合陈廪米浓煎后频繁服用，侥幸希望能有一线生机。
孔以立说：我曾经治疗噤口痢，用藕汁煮熟后稍微调和砂糖，频繁服用，同时进服多年的陈米稀粥，调理胃气必定有效，这也就是石莲子的用意所在。古代治疗噤口痢多有用到黄连的，因为黄连味苦性降，不能升提阳气，不适合胃虚的患者。大抵初起患痢疾出现的噤口，是因为热邪瘀滞在胃口，所以适宜用苦燥的药物。如果是久痢导致的口噤不食，这是胃气衰竭的表现，不同于初起患痢疾的噤口，那时还有浊气可以破除，积滞可以驱除，此时只有用大剂量的人参、白术，佐以茯苓、甘草、藿香、木香、煨葛根之类的药物，大补胃气，兼行津液才可以。只要胃气一旦恢复，饮食稍微能进，就应当改用独参汤，略微加入陈皮，或者制香附，缓缓调补，兼行气滞，这才是合适的方剂。像茯苓的淡渗利湿，木香的耗气，干葛的行津，都应当摒弃不用。
江诚说：这篇论述超出了众人的见解，认为初起患痢疾的噤口，适宜用苦燥之法；时间久了则胃虚，必须以大剂量的人参、白术为君药，苦燥的黄连又在禁用之列，这确实是治疗噤口痢不易改变的良法。
"Jinkou" (Throat-closed dysentery) refers to the condition of having dysentery and being unable to eat, or vomiting to the extent that one cannot eat. If one suffers from dysentery but can still eat, it indicates that the Stomach Qi has not been diseased; the current inability to eat is due to damp-heat in the Spleen obstructing the stomach opening; there are also cases caused by mistakenly taking purgative medicines, which damage Stomach Qi; cases where astringents were used too early, leaving pathogenic factors inside; cases of deficiency-cold of the Spleen and Stomach invaded by dampness; cases where Qi mechanism is blocked by heat pathogen; cases where filth and accumulation in the lower jiao cause foul qi to steam upwards; cases where Liver Wood overacts and attacks the Spleen and Stomach; as well as cases of undigested food retention or fluid retention. All these conditions can cause Jinkou. It is proposed to use the Method of Regulating the Middle and Opening the Throat, modifying according to the syndrome, and taking slowly, hoping for efficacy. However, the causes of Jinkou cannot be clearly understood without careful pulse diagnosis: for instance, if the right-side pulse is floating, soft, deep, and fine, or slow, slack, and powerless, it indicates Stomach deficiency; if the pulse is surging, large, rapid, and slippery, it indicates fire-heat; if the pulse is chaotic, floating, large, or floating and wiry, it indicates turbid Qi obstructing upwards; if the pulse is deep and slippery, or the right-side pulse is choppy and stagnant, it indicates retained undigested food; if the pulse is slow and fine, it indicates Stomach cold; if the pulse is wiry and urgent, it indicates Liver Wood overaction. Treating based on detailed pulse differentiation is more accurate. If the patient absolutely does not desire food and has unceasing dysentery, it is incurable; only by using Du Shen Tang (Ginseng Decoction) combined with thick decoction of aged rice, taken frequently, might there be a faint hope of survival.
Kong Yili stated: I once treated Jinkou dysentery by boiling lotus root juice, mixing it slightly with brown sugar, and administering it frequently, while also consuming thin congee made from aged rice for many years to regulate Stomach Qi, which would surely be effective; this aligns with the intent of Shi Lian Zi (Flos Nelumbinis). In ancient times, Huang Lian (Coptidis Rhizoma) was often used to treat Jinkou dysentery; however, since it is bitter and descending, it cannot lift Yang, making it unsuitable for Stomach deficiency. Generally, Jinkou occurring at the onset of dysentery is due to heat stagnation at the stomach opening, so bitter-drying methods are appropriate. If Jinkou and anorexia persist after long-term dysentery, this indicates exhaustion of Stomach Qi; unlike initial Jinkou where turbid Qi can be broken down and accumulation expelled, here one must use large doses of Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma), assisted by Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Huo Xiang (Agastaches Herba), Mu Xiang (Aucklandiae Radix), and Wei Ge Gen (Prepared Puerariae Lobatae Radix) to greatly tonify Stomach Qi and promote fluid circulation. Once Stomach Qi recovers slightly and intake of food increases, one should switch to Du Shen Tang (Ginseng Decoction), adding slight amounts of Chen Pi (Citri Reticulatae Pericarpium) or Zhi Xiang Fu (Cyperi Rhizoma Preparatum), to slowly tonify and regulate Qi stagnation; this is the appropriate formula. Ingredients such as Fu Ling (Poria), which is bland and leaching; Mu Xiang (Aucklandiae Radix), which consumes Qi; and Gan Ge (Puerariae Lobatae Radix), which moves fluids, should all be excluded.
Jiang Cheng stated: This discussion surpasses common views, asserting that Jinkou at the onset of dysentery should be treated with bitter-drying methods; later, when Stomach deficiency occurs, large doses of Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) must serve as the sovereign drugs, and bitter-drying Huang Lian (Coptidis Rhizoma) is strictly contraindicated. This is indeed an unchangeable excellent method for treating Jinkou.