夫酒者大热有毒瓦斯味俱阳乃无形之物也若伤之止当发散汗出则愈矣此最妙法其次莫如利
小
便二者乃上下分消其湿何酒病之有今之酒病者往往服酒蒸丸大热之药下之又有用牵牛大黄下
之者是无形元气受病反下有形阴血乖误甚矣酒性大热已伤元气而复重泻之况亦损肾水真阴及
有形阴血俱为不足如此则阴血已虚真水愈弱阳毒之热大旺反增其阴火是谓元气消亡七神何根据
折人长命不然则虚损之病成矣金匮要略云酒疸下之久久为黑疸慎不可犯此戒不若令上下分消
其湿解酲汤主之
谨按酒者是有形之物即水饮同体也今言无形元气受病不得伤于有形阴血者盖谓酒者湿热
之物
入胃则脏气俱热逐气升降之际而半有消耗之矣至伤于肠胃则升之不散降之不下郁于气分无形
之地位故言无形之物非若水饮然体全降于肠胃中也若今人之饮醇酒则便少此其可验是以伤则
宜汗之泄之不得用重峻下剂盖此等药不能入气分反伤有形阴血尔但斯意隐然使人不能无疑故
或有辨之者兹不复具然昔人有用下剂者盖或有酒饮伤积日久而汗之泄之不能愈则重峻下剂而
或可哉故用者自宜对证详审勿以辞害意可也
解云盛食填塞于胸中为之窒塞两手寸脉当主事两尺脉不见其理安在胸中有食故以吐出之
食者
物也物者坤土也是足太阴之号也胸中者肺也为物所伤肺者手太阴金也金主杀伐也与坤土俱在
于上而旺于天金能克木故肝水生发之气伏于地下非木郁而何吐去上焦阴土之物木得舒畅则郁
结去矣食塞于上脉绝于下若不明天地之道无由违此至理水火者阴阳之征兆天地之别名也故曰
独阳不生独阴不长天之用在于地下则万物生长矣地之用在于天上则万物收藏矣此乃天地交而
万物通矣此天地相根之道也故阳火之根本于地下阴水之源本于天上故曰水出高源故人五脏主
有形之物物者阴也阴者水也上三部脉主之偏见于寸口食塞在上是绝五脏之源源绝则水不下流
两尺竭绝此其理也何疑之有
酒这种物质，性质大热且有毒，其气与味均属阳，属于无形的物质。如果饮酒过量导致损伤，只应当采用发散的方法，使汗液排出，病就好了，这是最妙的方法。其次不如通过利小便来治疗，这两种方法分别是从上、下两个途径分消体内的湿气，那么酒邪引起的疾病又会有什么残留呢？
现在患酒病的人，往往服用酒蒸丸这类大热的药物进行攻下，或者使用牵牛子、大黄等泻下药。这种做法是错误的，因为酒邪伤害的是无形的元气，反而用攻下有形阴血的药物，这是极大的乖误。酒的性质大热，已经损伤了元气，如果再重重地泻下，况且也会损耗肾水真阴以及有形的阴血，使得两者都变得不足。像这样，阴血已经虚弱，真水更加微弱，阳毒之热就会大旺，反而增加阴火，这叫做元气消亡，七神（精神意识）无所依托，要么折损人的寿命，否则就会形成虚损的病证。《金匮要略》说：“酒疸若误用下法，久而久之会变成黑疸。”千万不可触犯这个禁忌。不如让湿气上下分消，以解酲汤为主治方剂。
谨按：酒实际上是有形的物质，与水饮同类。文中说“无形元气受病，不得伤于有形阴血”，大概是指酒是湿热之物，进入胃中后，脏腑之气都会受热，在气机升降的过程中，元气被消耗了一半。等到伤害到肠胃时，清气不升，浊气不降，郁结在气分这一无形的位置，所以说它是“无形之物”，不像水饮那样完全沉降在肠胃之中。比如现在人喝浓酒，小便就会减少，这就是可以验证的例子。所以受伤时适宜用发汗、泄浊的方法，不能使用重峻猛烈的泻下剂。因为这类药物不能进入气分，反而会伤害有形的阴血。然而这个意思隐含其中，使人容易产生疑问，所以有人对此进行辩驳，这里不再详细列举。但是过去也有人使用下剂的，大概是如果有饮酒积滞日久，用发汗、泄浊的方法不能治愈，那么使用重峻下剂或许是可以的。因此使用者自然应当仔细审察证候，不要因为拘泥文字而误解了本意。
注释说：食物堆积堵塞在胸中，造成窒塞感，两手寸脉应当反映病情，但两尺脉却不见，其中的道理在哪里呢？是因为胸中有食积，所以应当用催吐的方法将其吐出。
食物，是物体；物体，对应坤土，这是足太阴脾经的称号。胸中，是肺脏所在；肺受到食物的伤害，肺属于手太阴金。金主杀伐，与坤土都位于上部，且在天气旺盛之时，金能克木，所以肝木生发之气潜伏在地下，这不是木气郁结是什么？通过呕吐去除上焦阴土（脾胃）的食物，木气得以舒畅，郁结就去除了。食物堵塞在上部，导致下部脉象断绝，如果不明白天地的道理，就无法违背这一至理。
水和火，是阴阳的征兆，也是天地的别名。所以说“独阳不生，独阴不长”。天的作用在于地下，则万物生长；地的作用在于天上，则万物收藏。这是天地交泰而万物通达的道理，也是天地相互根本的道理。所以阳火的根本在于地下，阴水的源头在于天上，所以说“水出高源”。人的五脏主管有形的物质，物体属阴，阴属水，由上三部脉所主，偏见于寸口。食物堵塞在上部，就是断绝五脏的源头，源头断绝则水液不能向下流动，导致两尺脉竭绝，这就是其中的道理，有什么可怀疑的呢？
Wine is a substance that is extremely hot and toxic, with both its qi (vital energy) and flavor belonging to Yang. It is considered an "formless" entity. If injury occurs due to excessive consumption, the only appropriate treatment is to induce dispersion through sweating; once sweat is excreted, the condition resolves. This is the most excellent method. The next best approach is to promote urination. These two methods eliminate dampness from the upper and lower pathways respectively, leaving no room for wine-induced pathology.
However, those suffering from wine-related ailments often administer Jiuzheng Wan (Alcohol-Steamed Pill), a formula of extreme heat, or employ purgatives such as Qian Niu Zi (Pharbitidis Semen) and Da Huang (Rhei Radix et Rhizoma). This constitutes a grave error: since wine pathogen affects the formless Yuan Qi (Primordial Qi), using purgatives that target formless Yin Blood is fundamentally misguided. Wine's extreme heat already damages Yuan Qi; further aggressive purgation additionally depletes Kidney Water (True Yin) and formless Yin Blood, rendering both deficient. In this state, with Yin Blood already weak and True Water further diminished, Yang Toxic Heat flares up excessively, thereby intensifying Yin Fire. This leads to the exhaustion of Yuan Qi, causing the Seven Spirits (Shen, Hun, Po, Yi, Zhi, Jing, and Shen - mental faculties) to lose their foundation, resulting either in premature death or the development of deficiency-consumption diseases. *Jin Gui Yao Lue* states: "If Jaundice from Wine is treated with purgatives, it may eventually transform into Black Jaundice." One must strictly avoid this contraindication. Instead, one should facilitate the dispersion of dampness through upper and lower pathways, primarily utilizing Jie Cheng Tang (Dreg-Resolving Decoction).
Commentary notes: Wine is actually a tangible substance, sharing the same nature as water and fluid retention. The statement that "formless Yuan Qi is affected, not formless Yin Blood," implies that wine is a damp-heat substance. Upon entering the Stomach, it heats the Qi of the Zang organs. During the process of ascending and descending Qi, Yuan Qi is consumed by half. When it injures the Intestines and Stomach, clear Qi fails to ascend and turbid Qi fails to descend, stagnating in the Qi level—a position devoid of form. Hence, it is termed "formless," unlike water retention which fully settles in the Intestines and Stomach. For instance, when modern individuals consume strong wine, urine output decreases, which serves as verifiable evidence. Therefore, upon injury, diaphoresis (sweating) and resolving turbidity are indicated; heavy and harsh purgatives must not be used. Such drugs cannot enter the Qi level but instead damage formless Yin Blood. However, this implication has caused doubt, leading some to refute it, though detailed refutations are omitted here. Historically, some physicians did use purgatives. This might be applicable if wine accumulation persists for a long time and diaphoresis/resolution fails to cure the condition; in such cases, harsh purgatives might be considered. Thus, practitioners must carefully examine the syndrome and not let literal interpretations obscure the underlying intent.
Annotation explains: When food accumulates and blocks the chest, causing obstruction, the Cun (Inch) pulses at both wrists should reflect the pathology, while the Chi (Cubit) pulses may be absent. What is the rationale? Because food stagnation exists in the chest, emesis (vomiting) is indicated to expel it.
Food represents matter; matter corresponds to Kun Earth, which is associated with the Foot Taiyin Spleen Meridian. The chest is the domain of the Lung. Food injuring the Lung involves Hand Taiyin Metal. Metal governs severing and cutting. Since both Kun Earth and Metal reside in the upper jiao and flourish under Heavenly Qi, and Metal controls Wood, the generating Qi of Liver Wood is suppressed underground. Is this not Wood Depression? By vomiting out the Yin Earth (Spleen/Stomach) matter from the Upper Jiao, Wood Qi becomes free to flow smoothly, resolving the depression. Food blockage in the upper part causes the absence of pulses in the lower part. Without understanding the Dao of Heaven and Earth, one cannot grasp this principle.
Water and Fire are manifestations of Yin and Yang, and alternative names for Heaven and Earth. Thus, it is said: "Solitary Yang does not generate; solitary Yin does not grow." The function of Heaven lies within the Earth, promoting the growth of all things; the function of Earth lies within Heaven, facilitating the storage of all things. This is the communication of all things through the interaction of Heaven and Earth, the way Heaven and Earth root each other. Therefore, the root of Yang Fire lies in the Earth, and the source of Yin Water lies in Heaven; hence, "Water flows from high sources." The Five Zang Organs govern tangible substances. Matter is Yin; Yin is Water. These are governed by the upper three pulse positions, predominantly visible at the Cun Kou (Radial Artery). Food blockage in the upper region severs the source of the Five Zang Organs. Once the source is severed, Water cannot flow downward, leading to the exhaustion of the Chi pulses. This is the logic; what is there to doubt?