孙文垣治程氏子，年十五，夏月患痢。医治弥月，痢止而筋骨肿痛，痛处发热，昼轻夜重，肌肉消，饮食
减。有作白虎历节风治者，有作鹤膝鼓槌风治者，痛甚。诊之，脉皆细涩，曰∶此痢后风也。盖由治痢不善，
以致寒湿秽瘀凝滞经络，日久血气为痛所伤。此症虚虚实实，极难认，处方亦不易。欲补虚则肿愈剧，欲疏通
则痛愈甚，惟《局方》大防风汤可用。防风、熟地、黄 、人参、白芍、当归、杜仲各一钱，白术一钱五分，
羌活、牛膝、甘草、茴香各五分，川芎七分，加姜三片，服三十帖而安。
陈三农治一士，痢后腰腿挛痛，不能俯仰。此肾虚风寒湿所乘也，用独活寄生汤二剂愈。
窦材治一人，慵懒，饮食即卧，致宿结于中焦，不能饮食，四肢倦怠，令灸中脘五十壮，服分气丸、丁香丸即愈。
一人脾气虚，好食冷物，不消，常觉口中出败卵臭，服草神丹即愈。若服全真金液亦效。（原注∶脾胃既为
食所伤，不可再施消克。惟治以温化，则自健运矣。）
一人暑月饮食冷物，伤肺气，致咳嗽胸膈不利，先服金液丹百粒，泄去一行，痛减三分，又服五膈散而安。
但觉常发，后五年复大发，灸中府穴五百壮，方有极臭下气难闻，自后永不再发。（世医不审病因，动云暑月热气
伤肺，一派寒凉，致水气不消，变成大病。原注。）
汪 曰∶一人好食烧鹅炙爆，日常不缺，人咸防其生痈疽，后卒不病。访知其人每夜必啜煎茶一碗，乃知
茶能解炙爆之毒也。
龚子才治一人，劳后吃红柿十数枚，又饮凉水数碗，少顷，又食热面数碗，遂心腹大痛。诊之六脉沉微，
气口稍盛，此寒热相搏所致。以附子、干姜、肉桂、枳实、山楂、神曲、莪术、香附，一服立止。后浑身发热，
又以小柴胡一剂而安。
一人腊月赌吃羊肉数斤，被羊肉冷油凝结，堵塞胸膈不下，胀闷欲死，诸医束手。诊之，六脉俱有，乃用
黄酒一大坛，煮热入大缸内，令患人坐其中，众手轻轻乱拍胸腹背心，令二人吹其耳，及将热烧酒灌之，次服
万亿丸，遂得吐泻而愈。
陶节庵治一人患病，因食羊肉涉水，结于胸中。门人请曰∶此病下之不能，吐之不得出，当用何法治之？
陶曰∶宜食砒一钱。门人未之信也，乃以他药试之，百计不效。卒根据陶语，一服而吐遂愈。门人问曰∶砒性杀
人，何能治病？陶曰∶羊血犬血，大能解砒毒，羊肉得砒而吐，而砒得羊肉，则不能杀人，是以知其可愈。
（《杭州府志》。）
唐守元治一妇人，食羊闻呼，未及吞而应，逾月病发，淹及两年。唐曰∶此必胸有宿物。家人曰∶两年不
愈矣。曰∶试以我药投之。既而大吐，痰块中裹羊肉一脔，遂愈。（《平湖县志》。）
王海藏治秦生，好服天生茶及冷物，成积而痼寒。脉非浮非沉，上下内外按举极有力，坚而不柔，触指突
出肤表，往来不可以至数名，纵横不可以巨细状，此阴症鼓击脉也。一身流行之火萃于胸中，寒气逼之，故搏
大有力。与真武、四逆、理中等汤丸，佐以白芍、茴香，使不潜上，每日服百丸，夜汗出而愈。
孙文垣治董浔阳，年六十七，有脾胃疾，以过啖瓜果，胸膈胀痛，诸医不愈。脉之，寸关弦紧，曰∶病伤
瓜果，而为寒湿淫胜。经云，寒淫所胜，治以辛温。然瓜果非麝香、肉桂不能消。以高良姜、香附各一两为君，肉
桂五钱为臣，麝香一钱为佐，每服二钱，酒调下。药下咽，胸次便宽，再而知饿，三服而巾栉交接宾客，如未病者。
马二尹迪庵，年五十五，以过食鳗鱼卷饼，心腹胀痛，医不知吐法，遽以硝、黄下之。大便不行，胀痛愈
甚，又用木香槟榔丸，继又有下以大小承气汤者。十余日，病益加，便既不行，食亦不进，小水仅点滴，又服
白饼子五日，备急丸三日，胀痛遂不可当。又服甘遂、芫花、大戟、牵牛之属三日，并小便之点滴亦无矣。又
灸中脘三十余壮，亦无验。孙至，视其色苍黑，神藏不露，声音亮，惟腹大如箕，不能反侧。脉之，两手皆滑
大，两尺尤有力。曰∶此病初时食在膈上，法当用吐，《素问》云，在上者，因而越之，易易也。乃误下伤脾，
失其健运，是以愈下愈胀。又以峻利益下之，致展转增剧。今先用六君子汤以醒其脾，加木香、砂仁助其运动。
再用吐法，吐出前药，弗虑大便不行，独虑行之不止耳。计所服药，硝、黄五斤，巴豆、白饼五六两，又加诸
悍之剂，幸而药性未行，尚可为计。否则如瓶水底脱，倾泻无余矣。今伤在上中二焦，下元未损，故两尺尚
有神，色苍气固，根本未动，尚可为也。服药后，腹加大痛，知药力已至，改用人参芦、防风芦、升麻、桔梗
各三钱，煎服。少顷，用鹅翎探之，涌出前药约十余碗。病者曰∶目前光矣。时巳刻也，孙谓酉时大便必行，
宜备人参数斤以待。至午刻，进至宝丹一帖，以温中气。未申间，腹中浊气下注，觉少宽。至晚，大便行一次，
小水略通，即用参、术各五钱，炮姜三钱，茯苓二钱，木香、甘草各五分，陈皮一钱，煎服。四鼓，又行一次，
小水亦行，次日连泻十余次，以理中为丸，与煎剂兼服，胀全消，食渐进。凡泻七十二日，服参二斤余乃愈。
吴九宜，每早晨腹痛泄泻者半年，粪色青，腹臌胀。咸谓脾胃泻，为灸关元三十壮，服补脾肾之药，皆不
效。自亦知医，谓尺寸俱无脉，惟两关沉滑，大以为忧，疑久泻而六脉皆绝也。孙诊之曰∶毋恐，此中焦食积
痰泻也。积胶于中，故尺寸隐伏不见，法当下去其积，而反用补，误矣。以丹溪保和丸二钱，加备急丸三粒，
五更服之，巳刻下稠积半桶，胀痛随愈。次日六脉齐见，再以东垣木香化滞汤，调理而安。
汪氏妇腹大如箕，坚如石，时或作痛，杂治月余，转胀急，小水不通。或用温补下元之剂，则胀急欲裂，
自经求尽。脉之，两关洪滑鼓指，按之不下，乃有余之候也。症虽重，可生。其致病之由，因母家常令女奴袖
熟鸡、牛舌之类私授之，因数食冷物，积成胀满，误作虚治，宜增剧也。乃用积块丸，三治而胀消积去。以保
和丸调理一月而愈。
黄履素曰∶余在临江时，误用浓朴伤中气之后，偶食犬肉一块，遂觉停滞。时中气正虚，不敢加山楂等药。
考本草食犬肉不消，煮芦根汁饮之可消。如法煎饮，觉右胁下微痛，次日大痛，殊不可解。自是日甚一日，坐
卧皆妨，反侧痛如刀割，右胁下按之有物如鸡子。方书言∶右胁痛属食积痰积。有谓须攻治者，有谓不宜攻，
必须助正以消邪者。时有医主攻治，谓不攻治成痞块。余以为不然，确守助正之说。当痛极时，不敢服药，静
以守之，俟痛小定，气稍平，即用六君子加木香等行气之药，以渐调之，竟得痊可。若误信攻伐，不知死所矣。（
黄公禀体虚寒，故专尚温补，未可以为定论。即其所用，仍是半补半消之剂，故能取效，亦非纯补者可比。）
张景岳治一上舍，年及三旬，因午刻食水煮面角，及至初更，小腹下至右角间见痛，遂停积不行，而坚突
如拳，大如鹅卵，其痛之剧，莫可名状。察其明系面积，显而无疑。然计其已入大肠，此正通则不痛之症也。
乃与木香槟榔丸，其痛如故。因疑药力之缓，犹未及病，及更投神授丸以泻之，又不效。因谓此药性皆寒，故
滞而不行也。再投备急丸，虽连得大泻，而坚痛毫不为减。斯时也，张计穷矣。因潜思其由，不过因面，岂无
所以制之，今既逐之不及，使非借气以行之不可也。且计面滞非大蒜不杀，气滞非木香不行。又其滞深直远，
非精锐之向导不能达。乃用火酒磨木香，令其嚼生蒜一大瓣，而以木香酒送之。一服后，觉痛稍减。三四服后，
痛渐止，而食渐进，而小腹之块仍在，后至半年许，始得消尽。由是知欲消食滞，即大黄、巴豆犹有所不能及，
而惟宜行气为先也。且知饮食下行之道，乃必由小腹下右角间，而后出于广肠，此自古无言及者。
按∶就此观之，景岳平生临症，遗憾多矣。夫面角由胃入肠，已至小腹之角，岂能作痛如是，而又如
拳如卵耶？必其人素有疝，偶因面食之湿热发之，或兼当日之房劳，遂乃决张如是，故推荡之亦不应，得
木香火酒一派辛热香窜而痛止耳。至谓食由小腹下右角，而后出广肠，谓自古无言及者，更堪捧腹。经谓
大小肠，皆盘屈十六曲，则左旋右折可知，岂如筒如袋，而直下乎？嘻！
张路玉治叶某停食感冒，两寸关俱涩数模糊，两尺皆沉，按之益坚。虽其人尚能行走，而脉少冲和，此必
向有陈气在少腹。询之，果患寒疝数年。因婉辞不用药，是夜腹满而逝矣。或问此人小恙，何以知其必死？曰∶
凡人胃满则肠虚，肠满则胃虚，更实更虚，其气乃居。今胸有瘕而肠有积，上下俱困，能保其不交攻为患乎？
当知厥痛入腹，香港脚冲心等疾，皆是阴邪相搏，结郁既久，则挟阴火之势而上升。若胸中元气有权，则其邪下
伏。今既为宿食填塞，逆则上下俱满，正气无容身之地，往往有暴绝之虞，所以不便用药，实未知其即死也。
（《伤寒论》病患素有痞积，及病传入三阴则死，谓之脏结。盖新邪与旧邪合并也。）
幼科汪五符，夏月伤食呕吐，发热颅胀，自利黄水，遍体肌肉扪之如刺。六脉模糊，指下似有如无，足胫
不温。自谓阴寒，服五积散一剂，热愈炽，昏卧不省。第三日利不止，时谵语，至夜尤甚。或以为伤暑，与香
薷饮，遂头面汗出如蒸，喘促不宁，足冷下逆。或以为大寒，而脉息模糊，按之殊不可得，以为阳脱之候，欲
猛进参、附。或以为阴症，断无汗出如蒸之理，脉虽虚而症则大热，当用人参白虎，争持未决。张诊之曰∶六
脉如此，而心下按之大痛，舌上灰刺如芒，乃食填中宫，不能鼓运，其脉往往如此。与凉膈散下之，一剂神思
顿清，脉亦顿起。倘投参、附，其能免乎？
癸卯元夕，周徐二子过石顽斋头饮，次日皆病酒不能起。欲得葛花汤解醒，张曰∶此汤虽为伤酒专剂，然
人禀赋，各有不同，周子纵饮则面热多渴，此酒气行阳肌肉之分，多渴则知热伤胃气，岂可重令开泻，以耗津
液？与四君子汤去甘草，加藿香、木香、煨葛根、泽泻，下咽即愈。徐子久患精滑，饮则面色愈青，此素常肝
胆用事，肾气亦伤，酒气皆行筋骨，所以上潮于面。葛花胃药，用之何益？与五苓散加人参，倍肉桂，服后食
顷，溲便如皂角汁而安。（用药须相人体气，不可胶执成方。凡病皆然，不独为伤酒说法也。）
柴屿青治中翰陈雯山，壮热神昏，为时医所误者累日，势甚危笃。诊得人迎脉缓，自无外感，惟气口洪实，
舌苔甚浓。重按其胸，皱眉呼痛，此胸中停食，屡进发表，相去迳庭，无怪病增剧也。用小承气汤连下二次，
即神清热退而安。
张飞畴治谢元海，夏月常饮火酒，致善食易饥，半月后腹渐胀满，大便艰涩，食亦日减。医用刻削清火俱
不效。左脉细数，右脉涩滞，此始为火助胃强而善食，继为火灼胃液而艰运，艰运则食滞而胀满，胀满则食减。
今宜断食辛热，乘元气未离，祛其滞而回其液，日久则费调理也。用枳实导滞汤去黄连、白术，加葛根，一服，
大便通利而滞行，又用健脾理气。三日后，以小剂生脉加葳蕤、煨葛根，半月而愈。
张三锡治一人，发热头痛，七日不止。诊之，左脉平和，右寸关俱弦急有力，乃内伤宿食为患也。以二陈
加枳实、浓朴、楂炭、柴胡，三剂，再加黄芩，头痛除。但热不净，投枳实导滞丸百粒，更衣而愈。
一妇每夜分即发热，天明渐止，自投四物汤，反加呕恶。诊得左关微急，而右寸关弦数有力。询之，经后
食梨，午后遂热起，正丹溪所谓胃虚过食冷物，抑遏阳气于脾土之中。此病皆因血虚而得者，遂以升阳散火汤，
一服热已。后用四物去地黄，加枳、术、陈皮，健脾养血，调理而愈。
张三锡曰∶余初识缪仲淳时，见袖中出弹丸咀嚼。问之，曰∶此得之秘传。饥者服之即饱，饱者服之即饥。
因疏其方，名资生丸。余大喜之，而颇不信其消食之功。已于醉饱后，顿服二丸，径投枕卧。夙兴，了无停滞，
始信此方之神也。资生丸∶白扁豆一两，山药一两五钱，人参三两，白术土炒三两，莲肉一两，芡实一两五钱，
橘红二两，桔梗五钱，炙甘草五钱，白蔻仁三钱五分，浓朴一两，山楂肉二两，川黄连三钱五分，神曲二两，
藿香五钱，茯苓一两五钱，泽泻三钱五分，薏苡仁三两，麦芽一两五钱，炼蜜丸，每丸二钱，每服一丸，醉饱
后二丸。王晋三曰∶《易》曰，至哉坤元，万物资生。取以名方，因三焦五脏之生生之气，全资脾胃而输化也。
盖土居乎中，而位寄乎五行，三焦分受其气于五脏，故理脾胃而仍理三焦也。白扁豆、山药，补金中之土也；
人参、白术，补其正土也；莲肉、芡实，补水中之土也；橘红、桔梗、甘草、豆蔻，运上焦之气而使之输也；
麦芽、苡仁、茯苓、泽泻，理下焦之气，而使之化也。三焦气行，五脏气充，而生勃然矣。
孙文垣治疗程氏的儿子，十五岁，夏季患痢疾。医生治疗了一个月，痢疾停止后出现筋骨肿痛，疼痛部位发热，白天轻晚上重，肌肉消瘦，饮食减少。有人主张按白虎历节风治疗，有人主张按鹤膝鼓槌风治疗，疼痛非常剧烈。诊察发现脉象都细涩，孙文垣说：这是痢后风。大概是因为治疗痢疾不当，导致寒湿秽浊瘀血凝滞经络，日久气血被疼痛所伤。这个病症虚实夹杂，极难辨认，处方也不容易。想要补虚则肿胀更严重，想要疏通则疼痛更剧烈，只有《局方》的大防风汤可以使用。防风、熟地黄、黄芩、人参、白芍、当归、杜仲各一钱，白术一钱五分，羌活、牛膝、甘草、茴香各五分，川芎七分，加生姜三片，服用三十帖后痊愈。
陈三农治疗一位读书人，痢疾后腰腿拘挛疼痛，不能俯仰。这是肾虚受风寒湿邪侵袭所致，用独活寄生汤两剂治愈。
窦材治疗一个人，懒惰倦怠，吃完就躺下，导致宿食结聚在中焦，不能进食，四肢倦怠，让他灸中脘穴五十壮，服用分气丸、丁香丸即愈。另有一人脾气虚弱，喜欢吃冷物，消化不良，常觉得口中散发臭鸡蛋味，服用草神丹即愈。如果服用全真金液丹也有效。（原注：脾胃既然被食物所伤，不可再用消导攻伐之法。只有用温化法治疗，脾胃自然健运。）
又有一人在暑月吃冷物，损伤肺气，导致咳嗽胸膈不畅，先服用金液丹一百粒，排泄一次大便，疼痛减轻三分，又服用五膈散而安。只是感觉经常发作，五年后再次大发，灸中府穴五百壮，随后排出极臭且难闻的浊气，从此永不复发。（世医不审病因，动不动就说暑月热气伤肺，一派寒凉药，导致水气不消，变成大病。原注。）
汪氏说：有一人喜欢食用烧鹅烤肉，每天不断，大家都担心他生痈疽，后来最终没生病。打听得知他每晚必喝一碗煎茶，才知道茶能解烤肉之毒。
龚子才治疗一个人，劳累后吃柿子十几枚，又喝几碗凉水，一会儿，又吃几碗热面，于是心腹大痛。诊察六脉沉微，气口脉稍盛，这是寒热相搏所致。用附子、干姜、肉桂、枳实、山楂、神曲、莪术、香附，一服药立即止痛。后来浑身发热，又用小柴胡汤一剂而安。
又有一人在腊月赌吃羊肉数斤，因羊肉冷油凝结，堵塞胸膈不下，胀闷欲死，众医生束手无策。诊察六脉俱在，于是用一大坛黄酒，煮热倒入大缸内，让病人坐在其中，众人用手轻轻乱拍病人的胸腹背心，让两个人吹他的耳朵，并将热烧酒灌下去，接着服用万亿丸，于是得吐泻而愈。
陶节庵治疗一个人患病，因为吃羊肉涉水，结于胸中。门人请教说：这个病不能用下法，也不能吐出，该用什么方法治疗？陶节庵说：适宜吃一钱砒霜。门人不相信，于是用其他药尝试，百计无效。最终依从陶节庵的话，一服药后呕吐遂愈。门人问：砒霜性杀人，怎么能治病？陶节庵说：羊血狗血，大能解砒霜毒，羊肉得砒霜而吐，而砒霜得羊肉，则不能杀人，因此知道可以痊愈。（《杭州府志》。）
唐守元治疗一个妇人，吃羊肉时听到呼唤，来不及吞下就应答，过一个月发病，拖延两年。唐守元说：这一定是胸中有宿食。家人说：两年不愈了。唐守元说：试着用我的药投服。不久大吐，痰块中裹着一块羊肉，于是痊愈。（《平湖县志》。）
王海藏治疗秦生，喜欢服用天生茶及冷物，形成积滞且顽固性寒证。脉象非浮非沉，上下内外按举极有力，坚硬而不柔，触指突出肤表，往来无法以“至数”计数，纵横无法以大小形容，这是阴症鼓击脉。一身流行之火萃集于胸中，寒气逼迫它，所以搏动大而有力。给予真武汤、四逆汤、理中汤等汤丸，佐以白芍、茴香，使火不潜上，每日服用百丸，夜间出汗而愈。
孙文垣治疗董浔阳，六十七岁，有脾胃疾病，因为过量吃瓜果，胸膈胀痛，众医不愈。诊脉，寸关弦紧，说：病由伤瓜果引起，属于寒湿淫胜。经书说，寒淫所胜，治以辛温。然而瓜果非麝香、肉桂不能消除。用高良姜、香附各一两为君药，肉桂五钱为臣药，麝香一钱为佐药，每服二钱，酒调下。药下咽，胸次便宽舒，第二天知道饿，第三次服药后就能梳洗接待宾客，像没病的人一样。
马二尹迪庵，五十五岁，因为过量吃鳗鱼卷饼，心腹胀痛，医生不知道用吐法，急忙用硝石、大黄攻下。大便不行，胀痛更甚，又用木香槟榔丸，接着又有用大小承气汤攻下的。十多天，病更加重，大便既不行，饮食也不进，小便仅点滴，又服用白饼子五天，备急丸三天，胀痛遂不可忍受。又服用甘遂、芫花、大戟、牵牛之类三天，连小便的点滴也没有了。又灸中脘三十多壮，也无验效。孙文垣到，看其面色苍黑，神气内藏不外露，声音洪亮，只有腹部大如簸箕，不能翻身侧卧。诊脉，两手皆滑大，两尺部尤其有力。说：这个病起初食滞在膈上，法当用吐，《素问》说，在上者，因而越之，很容易。却误用下法伤了脾，失去健运功能，所以越下越胀。又用峻猛利药攻下，导致辗转加重。现在先用六君子汤来醒脾，加木香、砂仁助其运动。再用吐法，吐出前药，不用担心大便不行，只担心泻个不停。计算所服药量，硝石、大黄五斤，巴豆、白饼五六两，又加诸悍烈之剂，幸好药性未行，还可以想办法。否则就像瓶底脱漏，倾泻无余。现在伤在上中二焦，下元未损，所以两尺尚有神气，面色苍黑气固，根本未动，还可以救治。服药后，腹部加大痛，知道药力已至，改用人参芦、防风芦、升麻、桔梗各三钱，煎服。一会儿，用鹅翎探喉，涌出前药约十余碗。病人说：眼前光亮了。当时是巳时，孙文垣说酉时大便必行，宜备人参数斤以待。到午时，进至宝丹一帖，以温中气。未申间，腹中浊气下注，觉得稍宽。到了晚上，大便行一次，小便略通，即用人参、白术各五钱，炮姜三钱，茯苓二钱，木香、甘草各五分，陈皮一钱，煎服。四鼓，又行一次，小便也通，次日连泻十余次，以理中丸为丸，与煎剂兼服，胀全消，饮食渐进。凡泻七十二日，服人参二斤多才愈。
吴九宜，每早晨腹痛泄泻半年，粪色青，腹臌胀。大家都说是脾胃泻，为他灸关元三十壮，服用补脾肾的药，都不见效。他自己也懂医，说尺寸部都无脉，只有两关沉滑，非常担忧，怀疑久泻导致六脉皆绝。孙文垣诊察说：不要怕，这是中焦食积痰泻。积滞胶着于中焦，所以尺寸部隐伏不见，法当下去其积，反而用补，错了。用丹溪保和丸二钱，加备急丸三粒，五更时分服用，巳时下稠积半桶，胀痛随即痊愈。次日六脉齐现，再用东垣木香化滞汤，调理而安。
汪氏妇女腹部大如簸箕，坚如石头，时而作痛，杂治月余，转胀急，小便不通。或用温补下元的药剂，则胀急欲裂，自己寻求尽方。诊脉，两关洪滑鼓指，按之不下，是有余的征候。症虽重，可生。其致病原因，因母亲家常令女奴袖藏熟鸡、牛舌之类私下给她吃，因多次吃冷物，积成胀满，误作虚证治疗，应该加重病情。于是用积块丸，三次治疗而胀消积去。用保和丸调理一月而愈。
黄履素说：我在临江时，误用浓朴伤中气之后，偶然吃一块犬肉，遂觉停滞。当时中气正虚，不敢加山楂等药。考本草记载食犬肉不消，煮芦根汁饮之可消。依法煎饮，觉得右胁下微痛，次日大痛，殊不可解。自此日甚一日，坐卧皆妨，反侧痛如刀割，右胁下按之有物如鸡蛋。方书说：右胁痛属食积痰积。有的说要攻治，有的说不宜攻，必须助正以消邪。当时有医主攻治，说不攻治成痞块。我认为不然，确守助正之说。当痛极时，不敢服药，静以守之，等痛小定，气稍平，即用六君子汤加木香等行气药，以渐调之，竟得痊愈。若误信攻伐，不知死在哪里了。（黄公禀体虚寒，故专尚温补，未可以为定论。即其所用，仍是半补半消之剂，故能取效，亦非纯补者可比。）
张景岳治疗一位上舍，年近三十，因为中午吃水煮面角，等到初更（晚上七点到九点），小腹下至右角间见痛，遂停积不行，而坚突如拳，大如鹅卵，其痛之剧，莫可名状。观察其明显是面积（食积），显而无疑。但估计其已入大肠，这正是通则不痛的症候。于是给木香槟榔丸，其痛如故。因疑药力太缓，还未及病，于是再投神授丸以泻之，又不效。因谓此药性皆寒，所以滞而不行。再投备急丸，虽然连得大泻，而坚痛毫不为减。此时，张景岳计穷了。于是潜思其由，不过是面食，难道没有东西制它吗？现在既逐之不及，如果不借气以行之不可。并且估计面滞非大蒜不杀，气滞非木香不行。而且其滞深直远，非精锐之向导不能达。于是用火酒磨木香，令他嚼生蒜一大瓣，而以木香酒送之。一服后，觉得痛稍减。三四服后，痛渐止，而饮食渐进，而小腹之块仍在，后至半年许，始得消尽。由此知道欲消食滞，即使大黄、巴豆犹有所不能及，而惟宜行气为先。并且知道饮食下行之道，乃必由小腹下右角间，而后出于广肠，这是自古无言及的。
按语：就此观之，张景岳平生临症，遗憾多矣。夫面角由胃入肠，已至小腹之角，岂能作痛如是，而又如拳如卵耶？必定其人素有疝气，偶因面食之湿热发之，或兼当日之房劳，遂乃决张如是，故推荡之亦不应，得木香火酒一派辛热香窜而痛止耳。至于说食由小腹下右角，而后出广肠，谓自古无言及者，更堪捧腹。经书说大小肠，皆盘屈十六曲，则左旋右折可知，岂如筒如袋，而直下乎？唉！
张路玉治疗叶某停食感冒，两寸关俱涩数模糊，两尺皆沉，按之益坚。虽然其人尚能行走，而脉少冲和，这必定向有陈气在少腹。询问，果患寒疝数年。于是婉辞不用药，是夜腹满而逝。有人问此人小恙，何以知其必死？说：凡人胃满则肠虚，肠满则胃虚，更实更虚，其气乃居。今胸有瘕而肠有积，上下俱困，能保其不交攻为患乎？当知厥痛入腹，香港脚冲心等疾，皆是阴邪相搏，结郁既久，则挟阴火之势而上升。若胸中元气有权，则其邪下伏。今既为宿食填塞，逆则上下俱满，正气无容身之地，往往有暴绝之虞，所以不便用药，实未知其即死也。（《伤寒论》病患素有痞积，及病传入三阴则死，谓之脏结。盖新邪与旧邪合并也。）
儿科汪五符，夏月伤食呕吐，发热颅胀，自利黄水，遍体肌肉扪之如刺。六脉模糊，指下似有如无，足胫不温。自认为阴寒，服五积散一剂，热愈炽，昏卧不省。第三日利不止，时谵语，至夜尤甚。有人认为伤暑，给香薷饮，遂头面汗出如蒸，喘促不宁，足冷下逆。有人认为大寒，而脉息模糊，按之殊不可得，认为是阳脱之候，欲猛进参、附。有人认为阴症，断无汗出如蒸之理，脉虽虚而症则大热，当用人参白虎汤，争持未决。张景岳诊察说：六脉如此，而心下按之大痛，舌上灰刺如芒，乃食填中宫，不能鼓运，其脉往往如此。给凉膈散下之，一剂神思顿清，脉亦顿起。倘若投参、附，其能免乎？
癸卯年元宵节，周徐二子过石顽斋头饮酒，次日皆病酒不能起。想要葛花汤解醒，张景岳说：此汤虽为伤酒专剂，然人禀赋各有不同，周子纵饮则面热多渴，此酒气行阳肌肉之分，多渴则知热伤胃气，岂可重令开泻，以耗津液？给四君子汤去甘草，加藿香、木香、煨葛根、泽泻，下咽即愈。徐子久患精滑，饮则面色愈青，此素常肝胆用事，肾气亦伤，酒气皆行筋骨，所以上潮于面。葛花是胃药，用之何益？给五苓散加人参，倍肉桂，服后食顷，溲便如皂角汁而安。（用药须相人体气，不可胶执成方。凡病皆然，不独为伤酒说法也。）
柴屿青治疗中翰陈雯山，壮热神昏，为时医所误者累日，势甚危笃。诊得人迎脉缓，自无外感，惟气口洪实，舌苔甚浓。重按其胸，皱眉呼痛，此胸中停食，屡进发表，相去迳庭，无怪病增剧也。用小承气汤连下二次，即神清热退而安。
张飞畴治疗谢元海，夏月常饮火酒，致善食易饥，半月后腹渐胀满，大便艰涩，食亦日减。医生用刻削清火俱不效。左脉细数，右脉涩滞，这是始为火助胃强而善食，继为火灼胃液而艰运，艰运则食滞而胀满，胀满则食减。今宜断食辛热，乘元气未离，祛其滞而回其液，日久则费调理也。用枳实导滞汤去黄连、白术，加葛根，一服，大便通利而滞行，又用健脾理气。三日后，以小剂生脉散加葳蕤、煨葛根，半月而愈。
张三锡治疗一个人，发热头痛，七日不止。诊察，左脉平和，右寸关俱弦急有力，乃内伤宿食为患也。用二陈汤加枳实、浓朴、楂炭、柴胡，三剂，再加黄芩，头痛除。但热不净，投枳实导滞丸百粒，更衣而愈。
一妇人每夜分即发热，天明渐止，自投四物汤，反加呕恶。诊得左关微急，而右寸关弦数有力。询问，经后食梨，午后遂热起，正是丹溪所谓胃虚过食冷物，抑遏阳气于脾土之中。此病皆因血虚而得者，遂以升阳散火汤，一服热已。后用四物汤去地黄，加枳、术、陈皮，健脾养血，调理而愈。
张三锡说：我初识缪仲淳时，见他袖中出弹丸咀嚼。问他，说：这是得之秘传。饥者服之即饱，饱者服之即饥。于是疏其方，名资生丸。我非常高兴，但颇不信其消食之功。已在醉饱后，顿服二丸，径投枕卧。早起，了无停滞，始信此方之神也。资生丸：白扁豆一两，山药一两五钱，人参三两，白术土炒三两，莲肉一两，芡实一两五钱，橘红二两，桔梗五钱，炙甘草五钱，白蔻仁三钱五分，浓朴一两，山楂肉二两，川黄连三钱五分，神曲二两，藿香五钱，茯苓一两五钱，泽泻三钱五分，薏苡仁三两，麦芽一两五钱，炼蜜丸，每丸二钱，每服一丸，醉饱后二丸。王晋三说：《易经》曰，至哉坤元，万物资生。取以名方，因三焦五脏之生生之气，全资脾胃而输化也。盖土居乎中，而位寄乎五行，三焦分受其气于五脏，故理脾胃而仍理三焦也。白扁豆、山药，补金中之土也；人参、白术，补其正土也；莲肉、芡实，补水中之土也；橘红、桔梗、甘草、豆蔻，运上焦之气而使之输也；麦芽、苡仁、茯苓、泽泻，理下焦之气，而使之化也。三焦气行，五脏气充，而生勃然矣。
Sun Wenyuan treated the son of the Cheng family, aged fifteen, who suffered from dysentery in summer. After a month of treatment by other doctors, the dysentery stopped but was followed by swelling and pain in the bones and tendons, with heat at the painful sites, milder during the day and heavier at night, muscle wasting, and reduced appetite. Some advocated treating it as Baihu Lijie Feng (White Tiger Joint Pain Wind), others as Hexi Guchui Feng (Crane Knee Drumstick Wind), causing severe pain. Upon examination, the pulse was fine and choppy in both hands. Sun said: This is Post-Dysentery Wind (Feng syndrome occurring after dysentery). It is likely due to improper treatment of dysentery, leading to stagnation of cold-dampness, filth, and blood stasis in the meridians. Over time, Qi and Blood are damaged by the pain. This condition involves both deficiency and excess, making it extremely difficult to diagnose and prescribe. If tonifying deficiency, the swelling worsens; if promoting circulation, the pain intensifies. Only Da Fangfeng Tang (Great Saposhnikovia Decoction) from *Ju Fang* can be used. The prescription consists of Fangfeng (Radix Saposhnikoviae), Shudi Huang (Prepared Rhizoma Dioscoreae Hypoglaucae), Huang Qin (Radix Scutellariae), Renshen (Radix Ginseng), Baishao (Radix Paeoniae Alba), Danggui (Radix Angelicae Sinensis), and Duzhong (Cortex Eucommiae), each 1 qian; Baizhu (Rhizoma Atractylodis Macrocephalae) 1.5 qian; Qianghuo (Rhizoma et Radix Notopterygii), Niuxi (Radix Achyranthis Bidentatae), Gancao (Radix Glycyrrhizae), and Huixiang (Fructus Foeniculi), each 0.5 qian; Chuanxiong (Rhizoma Chuanxiong) 0.7 qian; plus three slices of Shengjiang (Rhizoma Zingiberis Recens). After taking thirty doses, he recovered.
Chen Sansan treated a scholar who, after dysentery, suffered from spasmodic pain in the lower back and legs, unable to bend or straighten. This was caused by Kidney deficiency allowing invasion of Wind-Cold-Dampness. He was cured with two doses of Duhuo Jisheng Tang (Angelica Pubescens and Dogwood Decoction).
Dou Cai treated a man who was lethargic and lay down immediately after eating, causing food retention in the Middle Jiao, inability to eat, and limb fatigue. Dou prescribed fifty moxa cones on Zhongwan (CV 12), along with Fenqi Wan (Qi-Dispersing Pill) and Dingxiang Wan (Clove Pill), resulting in recovery. Another patient with Spleen-Qi deficiency liked cold foods, which were indigestible, and often had breath smelling like rotting eggs. He was cured by Caoshen Dan (Grass God Elixir). Quanzhen Jin Ye Dan (Complete True Golden Fluid Elixir) would also have been effective. (Original note: Since the Spleen and Stomach are injured by food, one must not use digestive or purgative methods again. Only by using warming and transforming methods will the Spleen and Stomach regain their normal transportation.)
Another patient ate cold foods in summer, injuring Lung Qi, leading to cough and chest oppression. He first took one hundred Jin Ye Dan (Golden Fluid Elixir) pills, resulting in one bowel movement and a reduction of pain by three points, then took Wuge San (Five Obstructions Powder) for recovery. However, symptoms recurred frequently. Five years later, a severe relapse occurred. After five hundred moxa cones applied to Zhongfu (LU 1), foul-smelling flatulence was expelled, and the disease never returned. (Physicians of the world fail to investigate the cause, often claiming that summer heat injures the Lung, prescribing a batch of cold-natured drugs, leading to water retention and serious illness. Original note.)
Wang stated: There was a person who loved roasted goose and grilled meats, consuming them daily. Everyone feared he would develop carbuncles and sores, but he eventually did not fall ill. It was learned that he drank a bowl of boiled tea every night, revealing that tea can resolve the toxicity of grilled meats.
Gong Zicai treated a man who, after labor, ate over ten persimmons, then drank several bowls of cold water, and shortly after, ate several bowls of hot noodles. This resulted in severe abdominal pain. Examination revealed deep and faint pulses in all six positions, with the Qi Kou (cun position of the radial artery) slightly full. This was caused by the struggle between Cold and Heat. He was given Fuzi (Radix Aconiti Lateralis Preparata), Ganjiang (Rhizoma Zingiberis), Rougui (Cortex Cinnamomi), Zhishi (Fructus Aurantii Immaturus), Shanzha (Fructus Crataegi), Shenqu (Massa Medicata Fermentata), Ezhu (Rhizoma Curcumae Longae), and Xiangfu (Rhizoma Cyperi), and the pain stopped after one dose. Later, when his whole body became feverish, he was given Xiao Chaihu Tang (Minor Bupleurum Decoction) for one dose and recovered.
Another patient ate several jin of lamb meat in December. The cold fat from the lamb solidified and blocked the chest and diaphragm, causing severe distension and suffocation. All physicians were helpless. Examination showed pulses present in all six positions. A large jar of yellow wine was heated and poured into a large vat. The patient sat inside while people gently slapped his chest, abdomen, and back. Two people blew into his ears, and hot liquor was forced down his throat. Then, Wan Yi Wan (Ten Thousand Billion Pill) was administered, leading to vomiting and diarrhea, and recovery.
Tao Jian'an treated a patient whose illness was caused by eating lamb and wading through water, causing stagnation in the chest. A disciple asked: "This disease cannot be treated with purgatives, nor can it be induced to vomit. What method should be used?" Tao said: "It is suitable to take one qian of Pi (Arsenic)." The disciple did not believe it and tried other medicines without success. Finally, following Tao's advice, one dose induced vomiting and cured the disease. The disciple asked: "Arsenic kills people; how can it cure diseases?" Tao said: "Sheep blood and dog blood greatly resolve arsenic toxicity. Lamb meat combined with arsenic induces vomiting, and arsenic combined with lamb loses its killing power. Therefore, I know it can be cured." (*Hangzhou Fu Zhi*).
Tang Shouyuan treated a woman who, while eating lamb, heard a call and responded before swallowing. A month later, the disease started, lasting two years. Tang said: "There must be retained food in the chest." The family said: "It has lasted two years." Tang said: "Try my medicine." Soon, she vomited heavily, expelling a piece of lamb wrapped in phlegm, and recovered. (*Pinghu County Gazetteer*).
Wang Haizang treated Qin Sheng, who liked to consume Tian Sheng Cha (Natural Tea) and cold foods, forming accumulation and stubborn cold. The pulse was neither floating nor sunken, extremely forceful upon pressing up and down, inside and out, hard and unyielding, protruding against the finger, impossible to count beats, and impossible to describe size. This is the Yin Syndrome Drumming Pulse. Fire circulating in the body gathered in the chest, pressured by cold Qi, thus beating strongly and forcefully. He was given Zhenwu Tang (True Warrior Decoction), Sini Tang (Frigid Extremities Decoction), Lizhong Tang (Regulate the Middle Decoction) and pills, assisted by Baishao (Radix Paeoniae Alba) and Huixiang (Fructus Foeniculi) to prevent fire from rising abnormally. Taking one hundred pills daily, he sweated at night and recovered.
Sun Wenyuan treated Dong Xunyang, aged sixty-seven, who had Spleen and Stomach disorders. Due to excessive consumption of melons and fruits, he suffered from chest and epigastric distension and pain, unresponsive to other doctors. The pulse at Cun and Guan was wiry and tight. Sun said: "The injury from melons and fruits results in an excess of Cold-Dampness. The Classics state: 'When Cold invades excessively, treat with Acrid-Warm.' However, melons and fruits cannot be resolved without Mosher (Shexiang) and Cinnamon Bark (Rougui). Using Gaoliangjiang (Rhizoma Alpiniae Officinarum) and Xiangfu (Rhizoma Cyperi) each 1 liang as Sovereign, Rougui (Cortex Cinnamomi) 5 qian as Minister, and Shexiang (Moschus) 1 qian as Assistant, taken 2 qian per dose mixed with wine. After swallowing, the chest felt relaxed. By the next day, he felt hungry. After three doses, he could groom himself and receive guests as if healthy.
Ma Er Yin Di'an, aged fifty-five, suffered from heart and abdominal distension and pain due to excessive consumption of eel rolls. Physicians failed to use emesis and hastily used Xiaoshi (Natrii Sulfas) and Dahuang (Radix et Rhizoma Rhei) to purge. Bowels remained obstructed, and pain worsened. Muxiang Binglang Wan (Aucklandia and Areca Nut Pill) was used, followed by Dachengqi Tang (Major Order the Qi Decoction) and Xiaochengqi Tang (Minor Order the Qi Decoction). For over ten days, the condition deteriorated; no stool or food intake, urine only drops. Baibingzi (White Cake Pill) was taken for five days, Beiji Wan (Emergency Pill) for three days, yet pain became unbearable. Gan Sui (Radix Kansui), Yuan Hua (Flos Genkwa), Daji (Radix Euphorbiae Pekinensis), and Qianniu (Semen Pharbitidis) were taken for three days, stopping even the few drops of urine. Thirty-plus moxa cones on Zhongwan (CV 12) were ineffective. Sun arrived, observing dark complexion, hidden spirit, loud voice, but a belly large as a basket, unable to turn. Pulses were slippery and large in both hands, especially strong at Chi. Sun said: "Initially, food was stuck above the diaphragm. The method should be emesis. The *Suwen* says: 'For what is above, induce vomiting.' It is easy. But mistaken purging injured the Spleen, losing its transport function, hence more purging led to more distension. Harsh purgatives made it worse. Now, use Liujunzi Tang (Six Gentlemen Decoction) to awaken the Spleen, adding Muxiang (Radix Aucklandiae) and Sharen (Fructus Amomi) to aid movement. Then use emesis to expel previous medicines. Do not worry about constipation, only worry about uncontrollable diarrhea. Calculating the ingested drugs: Xiaoshi and Dahuang 5 jin, Badou (Semen Crotonis) and Baibingzi 5-6 liang, plus harsh agents. Fortunately, the drug action hasn't fully proceeded, so there is still hope. Otherwise, it would be like a bottle with the bottom removed, pouring out everything. The injury is in the Upper and Middle Jiao, Lower Yuan is intact, hence Chi pulses show spirit. Complexion is dark, Qi is solid, root is unmoved, salvageable. After medication, severe abdominal pain indicated drug efficacy. Switched to Ren Shen Lu (Deer Antler of Ginseng), Fangfeng Lu (Deer Antler of Saposhnikovia), Shengma (Rhizoma Cimicifugae), and Jiegeng (Radix Platycodonis) each 3 qian, decocted. Shortly after, goose feather probed the throat, vomiting out over ten bowls of previous medicine. Patient said: 'I see light now.' It was Si hour. Sun predicted stool at You hour, advised preparing several jin of Renshen. At Wu hour, Zhibao Dan (Treasure of Life Elixir) was given to warm Middle Qi. Between Wei and Shen hours, turbid Qi descended, feeling slightly relieved. By evening, one bowel movement, slight urination. Prescribed Renshen and Baizhu 5 qian each, Paojiang (Prepared Ginger) 3 qian, Fuling (Poria) 2 qian, Muxiang 0.5 qian, Gancao 0.5 qian, Chenpi (Pericarpium Citri Reticulatae) 1 qian, decocted. At Fourth Watch, another bowel movement, urination resumed. Next day, over ten diarrheal episodes. Lizhong Wan (Regulate the Middle Pill) and decoction were taken together. Distension vanished, appetite returned. After seventy-two days of diarrhea and over two jin of Renshen, he recovered.
Wu Jiuyi suffered morning abdominal pain and diarrhea for half a year, green stool, abdominal distension. Everyone diagnosed Spleen-Stomach diarrhea, moxa Guanyuan (CV 4) thirty times, took Spleen-Kidney tonics, all ineffective. He knew medicine, noting absent pulses at Cun and Chi, only deep and slippery at Guan, worrying about chronic diarrhea causing pulse disappearance. Sun diagnosed: "Fear not, this is Phlegm-Food Accumulation Diarrhea in Middle Jiao. Accumulation blocks the middle, hiding Cun and Chi pulses. Method: purge accumulation. Tonifying was wrong." Given Baohe Wan (Preserve Harmony Pill) 2 qian plus three Beiji Wan pills at dawn. By Si hour, half a bucket of thick accumulation passed, pain resolved. Next day, all pulses appeared. Treated with Dongyuan Muxiang Huazhi Tang (Aucklandia Regulating Stagnation Decoction) for regulation and recovery.
Wang's wife had a belly large as a basket, hard as stone, occasional pain. Mixed treatments for a month worsened distension and urinary retention. Warming Lower Yuan tonics caused bursting distension. She sought remedies desperately. Pulses at Guan were flooding, slippery, and forceful, unyielding to pressure, indicating Excess. Though severe, curable. Cause: Mother secretly fed her cooked chicken and ox tongue via maids. Frequent cold food intake caused accumulation and distension, mistakenly treated as Deficiency, worsening the condition. Jikuai Wan (Accumulation Mass Pill) was used three times, resolving distension and mass. Baohe Wan regulated for a month until recovery.
Huang Lusù said: While in Linjiang, after mistakenly using Houpo (Cortex Magnoliae Officinalis) damaging Middle Qi, I accidentally ate a piece of dog meat and felt stagnation. With weak Middle Qi, I dared not add Shanzha etc. Materia Medica states dog meat is indigestible, but decocting Genlu Gen (Radix Asparagi) juice helps digestion. Following this, mild right hypochondriac pain occurred, escalating to severe pain the next day, unbearable. Sitting and lying were difficult, turning caused knife-like pain. Palpation revealed a mass like an egg in the right hypochondrium. Formulas say right hypochondriac pain belongs to Food or Phlegm accumulation. Some advocate attacking, others supporting Righteous Qi to eliminate Evil. One doctor advocated attacking, warning of mass formation. I disagreed, adhering to supporting Righteous Qi. During extreme pain, I avoided medicine, resting quietly. When pain subsided slightly and Qi stabilized, I used Liujunzi Tang plus Muxiang to regulate gradually, achieving recovery. Had I believed in attacking, I might have died. (Mr. Huang has a deficient-cold constitution, preferring warming tonics; this is not a universal rule. His prescriptions were half-tonic, half-draining, hence effective, unlike pure tonics.)
Zhang Jingyue treated a Shangshe (scholar-official), nearly thirty, who ate boiled dumplings at noon. By early evening (Chu Geng), pain appeared below the lower abdomen to the right corner, stagnating and hardening like a fist, size of a goose egg, excruciating. Clearly Food Accumulation. Estimated it entered the Large Intestine, where "Unblocked means no pain." Given Muxiang Binglang Wan, pain persisted. Suspected slow drug action, gave Shenshou Wan to purge, ineffective. Concluded cold nature of drugs caused stagnation. Gave Beiji Wan, resulting in heavy diarrhea, but hardness and pain remained. Zhang was at a loss. Reflecting, he reasoned: Dough stagnation requires Garlic to kill; Qi stagnation requires Muxiang to move. Deep stagnation needs sharp guides. Used Huojiu (Fire Wine) to grind Muxiang, instructed chewing a large raw garlic clove, washed down with Muxiang wine. One dose reduced pain slightly. Three to four doses stopped pain, appetite returned, but abdominal mass remained. Dissipated after half a year. Thus, to resolve food stagnation, even Dahuang and Badou may fail; moving Qi is priority. Also learned dietary passage goes from lower abdomen right corner to Changchang (Large Intestine), unknown before.
Commentary: Observing this, Zhang Jingyue had many regrets in practice. Dumplings entering stomach/intestines reaching lower abdomen corner shouldn't cause such pain or form fist/egg masses. Likely pre-existing Hernia (Han Shan), triggered by damp-heat from dough or sexual exertion that day, causing rupture. Hence purging failed, but acrid-warm aromatic Muxiang and Fire Wine stopped pain. Claiming food passes directly from lower abdomen right corner to Large Intestine is laughable. Classics state Small and Large Intestines coil sixteen times; they twist and turn, not like tubes or bags going straight down. Alas!
Zhang Luyu treated Ye Mou with Food Retention and Cold, pulses at Cun and Guan rough, rapid, and blurred, Chi deep and hardening on pressure. Able to walk, but pulse lacked harmony, indicating old Qi in Lower Abdomen. Inquiry confirmed years of Cold Hernia. Declined medication. Died that night from abdominal fullness. Asked why death was predicted for minor illness: "When Stomach is full, Intestines are empty; when Intestines are full, Stomach is empty. Alternating fullness and emptiness allows Qi to reside. Now, mass in Chest, accumulation in Intestines, both upper and lower trapped. Can we ensure they don't attack each other? Know that Jue Tong entering abdomen, Hongjiao (Gout) rushing to Heart, etc., are all Yin Evil struggling. Long stagnation carries Yin Fire upward. If Yuan Qi in Chest is strong, Evil stays down. Now filled with retained food, reversing causes fullness above and below, leaving no room for Righteous Qi, risking sudden collapse. Hence avoiding medication, though unaware of immediate death." (*Shanghan Lun*: Patients with pre-existing masses dying when disease enters Three Yin is called Zang Jie, merging new and old evils.)
Pediatrician Wang Wufu treated summer food retention with vomiting, fever, head distension, spontaneous yellow diarrhea, skin prickling sensation. Six pulses blurred, faint, feet cold. Self-diagnosed Yin Cold, took Wuji San (Five Accumulations Powder), fever intensified, coma. Day 3: continuous diarrhea, delirium, worse at night. Some suspected Summerheat, gave Xiangru Yin (Elsholtzia Decoction), causing steaming sweat on head/face, panting, cold feet. Some suspected Extreme Cold, but blurred pulses suggested Yang Collapse, wanting aggressive Renshen and Fuzi. Others suspected Yin Syndrome, denying steaming sweat possibility, noting pulse void but symptoms hot, suggesting Renshen Baihu Tang. Debate unresolved. Zhang Jingyue diagnosed: "With such pulses, but severe pain on pressing Epigastrium, and gray thorns on tongue, it is Food filling the Center, failing to circulate, causing such pulses." Gave Liangge San (Cooling膈 Powder) to purge. One dose cleared mind, pulses rose. If Renshen/Fuzi given, outcome uncertain?
Guimao Lantern Festival, Zhou and Xu sons drank at Shiwan's study, fell ill with hangover next day. Wanted Ge Hua Tang (Flos Sophorae Immaturis Decoction) for detoxification. Zhang said: "Though specific for alcohol injury, constitutions vary. Zhou drank heavily, face hot, thirsty. Alcohol Qi moves to Yang/Muscle levels. Thirst indicates Heat injuring Stomach Qi. Releasing further consumes fluids." Prescribed Sijunzi Tang minus Gancao, adding Huoxiang (Herba Agastaches), Muxiang, Weige Gen (Prepared Radix Puerariae), Ze Xie (Rhizoma Alismatis). Recovered instantly. Xu had chronic spermatorrhea, face turned blue after drinking. Liver/Gallbladder active, Kidney Qi injured, Alcohol Qi moved to sinews/bones, rising to face. Ge Hua is Stomach herb, useless here. Prescribed Wuling San (Five Ingredient Powder with Poria) plus Renshen, doubled Rougui. After eating time, urine looked like soap pod juice, recovered. (Medication must match constitution, not stick to fixed formulas. Applies to all diseases, not just alcohol.)
Chai Yuqing treated Hanlin Academician Chen Wenshan, high fever and coma, misdiagnosed by contemporary physicians for days, critical. Renying pulse slow, no external pathogen. Qi Kou flooding and solid, thick tongue coating. Pressing chest caused grimacing pain, indicating Food Retention in Chest. Repeated exterior-releasing drugs were contrary to pathology, explaining worsening. Xiaochengqi Tang purged twice, clearing spirit and fever.
Zhang Feichou treated Xie Yuanhai, who drank Huojia (Fire Liquor) in summer, leading to good appetite and easy hunger. Half month later, abdominal distension, dry stool, reduced intake. Draining/Clearing Fire drugs failed. Left pulse fine/rapid, Right pulse rough/stagnant. Initially Fire strengthened Stomach (good appetite), then Fire scorched Stomach Fluids (difficult transport), causing stagnation/distension/reduced intake. Stop spicy/hot foods. While Yuan Qi remains, remove stagnation and restore fluids. Long-term regulation needed. Zhishi Daozhi Tang minus Huanglian/Baizhu, plus Ge Gen. One dose opened bowels/moved stagnation. Then Spleen-strengthening/Qi-regulating. Three days later, small Shengmai San plus Weirui/Weige Gen. Recovered in half month.
Zhang Sanxi treated a man with fever/headache for seven days. Left pulse peaceful, Right Cun/Guan wiry/tight/forceful, internal injury from retained food. Erchen Tang plus Zhishi, Houpo, Zhata (Charred Hawthorn), Chaihu. Three doses, plus Huangqin, headache resolved. Fever lingered. Zhishi Daozhi Wan 100 pills, bowel movement, recovered.
A woman had nightly fever starting at midnight, fading at dawn. Took Siwu Tang, worsened with vomiting. Left Guan slightly tense, Right Cun/Guan wiry/rapid/forceful. Inquired: Ate pear after menstruation, fever started afternoon. Exactly Danxi's description: Stomach Weakness, excessive cold food suppressing Yang Qi in Spleen Earth. Disease due to Blood Deficiency. Shengyang Sanhuo Tang (Raise Yang Scatter Fire Decoction), one dose fever gone. Then Siwu Tang minus Dihuang, plus Zhishi/Zhuren/Chenpi, Spleen-strengthening/Blood-nourishing, recovered.
Zhang Sanxi said: When I first met Miao Zhongchun, he chewed pill-sized objects from his sleeve. Asked, he said: Secret recipe. Hungry become full, full become hungry. Prescribed it, named Zisheng Wan. I was delighted but skeptical of its digesting power. Took two pills after heavy meal, slept. Woke up, no stagnation, believed in its efficacy. Zisheng Wan Composition: Baidoudou 1 liang, Shanyao 1.5 liang, Renshen 3 liang, Baizhu (Earth-fried) 3 liang, Lianrou 1 liang, Qianshi 1.5 liang, Juhong 2 liang, Jiegeng 0.5 liang, Zhigancao 0.5 liang, Baixiangren 0.35 liang, Houpo 1 liang, Shanzha Rou 2 liang, Huanglian 0.35 liang, Shenqu 2 liang, Huoxiang 0.5 liang, Fuling 1.5 liang, Zexie 0.35 liang, Yiyiren 3 liang, Maiya 1.5 liang. Honey pills, 2 qian each, one dose normally, two after meals. Wang Jinsan said: *I Ching* says, "Great is the Kun Yuan, all things depend on Sheng (Life/Nourishment)." Named formula accordingly. San Jiao and Five Zang Sheng Qi rely entirely on Spleen/Stomach for transformation. Earth resides in center, associated with Five Elements. San Jiao receives Qi from Five Zang. Thus regulating Spleen/Stomach regulates San Jiao. Baidoudou/Shanyao tonify Metal-Earth; Renshen/Baizhu tonify Central Earth; Lianrou/Qianshi tonify Water-Earth; Juhong/Jiegeng/Gancao/Doukou move Upper Jiao Qi for transmission; Maiya/Yiyiren/Fuling/Zexie regulate Lower Jiao Qi for transformation. San Jiao Qi moves, Five Zang Qi fills, life flourishes.