饮食过伤,变为异常急暴之症,人多不识。尝有一壮年人,忽得暴病,如中风状,口不能言语,目不
识人,四肢不举,急投苏合香丸,不效。予偶过闻之,因询其由,曰适方陪客饮食后,忽得此症。遂教以煎
生姜淡盐汤,多饮探吐之,吐出数碗而醒,后服白术、陈皮、半夏、麦芽调理而愈。大抵此等症,多因
饮食醉饱之后,或感风寒,或着气恼,而致饮食填塞,胃气不行,内伤特重。若误作中风、中气症,而
用驱风解表、行气散气之药,则胃气重伤,死在旦夕。《内经》虽有暴病暴死之症,但恐多有因于食者,
前辈不曾明言,故人不识耳!今后遇有此等急症,须要审问明白。若方饮食醉饱,或累伤饮食,重复受
伤,但觉胸膈有食滞,只作伤食治之。
愚尝治赵吏部,患吐物出皆酸味,其脉气口大于人迎者二、三倍。僚友速余投剂,余曰∶此实邪在
上,候其吐尽酸味,不药自愈。翌早吐止而安。
一妇人,饮食后因怒忽患血崩,四肢逆冷,抽搐,口噤,如发痉然,吐痰如涌,灌以二陈、柴胡、
山栀、枳壳,吐出酸味,神思稍醒,药止,次日进薄粥少许,但乳胁胀痛,寒热,欲呕,四肢倦怠。余以
为悉属肝火炽盛,致脾气不能运化。先用六君、柴胡、山栀、钩藤钩,诸症顿退,惟四肢不遂,血崩如
初。或又以为肝火未息,欲投清肝凉血之剂,余以为肝脾气血俱弱,先用补中益气汤培其脾土,而血气归
经,又用四物、参、术、柴胡养肝筋,而四肢便利。(余见异症名要。)
饮食过量导致损伤,会引发异常急骤暴烈的病症,人们大多不了解。曾经有一个壮年人,突然患上急病,症状像中风一样,口不能说话,眼睛不认识人,四肢无法抬起,急忙服用苏合香丸,没有效果。我偶然路过听到这件事,于是询问病因,回答说刚刚陪客人吃完饭,突然得了这个病。于是教他煎生姜淡盐汤,大量饮用并探喉催吐,吐出几碗后苏醒,后来服用白术、陈皮、半夏、麦芽调理而痊愈。大抵这类病症,多因在饮食醉饱之后,或者感受风寒,或者遭遇气恼,而导致饮食填塞,胃气运行不畅,内伤特别严重。如果误认为是中风、中气病症,而使用驱风解表、行气散气的药物,就会使胃气受到严重伤害,性命危在旦夕。《内经》虽然记载了暴病暴死的病症,但恐怕有很多是因为饮食引起的,前辈没有明确说明,所以人们不了解罢了!今后遇到这类急症,必须仔细审问明白。如果刚吃完喝足,或者多次饮食损伤,再次受伤,只要觉得胸膈有食滞,就只按伤食来治疗。
我曾经治疗赵吏部,患呕吐物都是酸味,他的脉象气口比人迎大二、三倍。同僚朋友急忙让我开药,我说:这是实邪在上,等待他吐尽酸味,不吃药也能自愈。第二天早上呕吐停止而平安无事。
一个妇人,饮食后因发怒突然患上血崩(非经期阴道大量出血),四肢逆冷,抽搐,牙关紧闭,像发生痉病一样,吐痰如涌,灌服二陈汤、柴胡、山栀、枳壳,吐出酸味后,神志稍微清醒,停药后,第二天进少量薄粥,但出现乳胁胀痛,寒热往来,想呕吐,四肢倦怠。我认为这些都属于肝火炽盛,导致脾气不能运化。先用六君子汤、柴胡、山栀、钩藤钩,各种症状顿时减退,只有四肢不能随意运动,血崩如初。有人又认为肝火未息,想要投用清肝凉血的药剂,我认为肝脾的气血都虚弱,先用补中益气汤培补脾土,从而使气血回归经脉,又用四物汤、人参、白术、柴胡滋养肝筋,从而使四肢便利。(我见于《异症名要》。)
Excessive intake of food and drink causing injury can transform into abnormal, acute, and violent syndromes, which most people do not recognize. I once encountered a robust young man who suddenly fell ill with an acute condition resembling stroke (Zhong Feng), unable to speak, failing to recognize people, and unable to move his four limbs. He was urgently administered Suhexiang Wan (Styrax Pill), but it was ineffective. By chance, I passed by and heard of this, so I inquired about the cause. He replied that he had just finished dining with guests when he suddenly developed this syndrome. I then instructed him to decoct ginger light salt soup, drink it in large quantities, and induce vomiting by stimulating the throat. After vomiting several bowls, he regained consciousness. Later, he took Baizhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), and Maiya (Hordei Fructus Germinatus) for conditioning and recovered. Generally speaking, such syndromes are mostly caused by dietary stagnation after overeating or drinking to excess, compounded by exposure to wind-cold or emotional anger, leading to food blocking the stomach qi's movement, resulting in severe internal injury. If mistakenly treated as stroke or qi stagnation, and drugs for expelling wind, releasing the exterior, moving qi, or dispersing qi are used, the stomach qi will be severely damaged, and death may occur within a day or two. Although the *Neijing* (Classic of Internal Medicine) records syndromes of sudden illness and sudden death, many are likely due to food issues. Previous experts did not explicitly state this, hence people's lack of understanding! In the future, when encountering such acute syndromes, one must inquire carefully. If the patient has just eaten or drunk to fullness, or has suffered repeated dietary injuries, and feels food stagnation in the chest and diaphragm, treat it solely as food injury (Shang Shi).
I once treated Censor Zhao, who vomited acidic substances. His pulse at the Qi Kou (Radial Artery Point) was two to three times larger than that at the Ren Ying (Carotid Artery Point). Colleagues urgently asked me to prescribe medication. I said: "This is excess pathogen located above; wait until he vomits all the acid, and he will recover without medication." The next morning, vomiting ceased, and he was safe.
A woman, after eating and drinking, became angry and suddenly suffered from blood flooding (Xue Beng - massive uterine bleeding outside the menstrual period). Her four limbs were cold, she experienced convulsions, lockjaw, and symptoms resembling spasm (Jing Bing), with profuse expectoration of phlegm. She was given Erchen Tang (Two-Cured Decoction), Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus), and Zhike (Aurantii Fructus Pericarpium). After vomiting acidic fluid, her mental state slightly improved. Medication was stopped. The next day, she consumed a small amount of thin porridge but presented with distending pain in the breasts and hypochondrium, alternating chills and fever, desire to vomit, and limb fatigue. I considered all these symptoms to belong to blazing liver fire (Gan Huo), causing the spleen qi to fail in transformation and transportation. I first used Liujunzi Tang (Six-Gentlemen Decoction), Chaihu, Zhizi, and Goutenggou (Uncariae Ramulus cum Uncis) to quickly alleviate various symptoms. However, only inability to move the four limbs freely and blood flooding remained as before. Others argued that the liver fire had not subsided and wanted to administer formulas for clearing liver heat and cooling blood. I believed that both liver and spleen qi and blood were weak. I first used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to nourish spleen earth, allowing qi and blood to return to their vessels. Then, I used Siwu Tang (Four-Substance Decoction), Renshen (Ginseng Radix), Baizhu, and Chaihu to nourish liver sinews, thereby facilitating free movement of the four limbs. (As seen in *Yi Zheng Ming Yao*.)