寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Vomiting

Guto

한글 구토  ·  Pinyin Ou Tu

Retching, vomiting and hiccup; and the three blockages — dysphagia, diaphragm blockage and stomach reflux

嘔吐

Two illnesses share this chapter. The first is ordinary vomiting, divided three ways by what comes up and what sound is made: 嘔 with both sound and matter, 吐 with matter and no sound, 噦 with sound and nothing brought up. The Bogam's treatment of it is good practical medicine — ginger and pinellia as the two chief drugs, the cold and hot patterns told apart by the colour of the face and whether the food comes back at once or hours later, and a careful note that a vomiting patient must not be purged.

The second is 噎膈反胃 — dysphagia, blockage at the diaphragm, and stomach reflux — and it is the gravest thing in the Miscellaneous Disorders. The description is unmistakable: food will not go down, or goes down and comes back hours later undigested; the stool turns to pellets like a sheep's; the patient wastes. Dansim locates the trouble at three levels by where the dryness lies — the gullet, the cardia, the pylorus — and that is a tolerably accurate anatomy of oesophageal and gastric outlet obstruction. What the chapter is describing, in most cases, is cancer of the oesophagus or the stomach, and it knew the prognosis: 年高者不治, where the patient is old there is no treating it.

The formulas divide the same way. Those for vomiting are mild and sensible. Those for the blockages run to quicklime, mercury, arsenic and croton, and are recorded here as history rather than as medicine; several carry a warning. The one treatment in the group a modern reader will recognize as sound is Yunjang-go, a thick syrup of oil and honey taken a spoonful at a time, because that is how an obstructed patient is fed.

2.1 The Causes of Vomiting 嘔吐之因

2.1.1
Source원문

內經曰, 諸嘔吐逆衝上, 皆屬於火.

Translation영역
The Inner Classic says: all retching, vomiting and counterflow surging upward belongs to fire.
Clinical note임상 주석
Two of the nineteen disease mechanisms of 審病 2.6 run together — 諸逆衝上皆屬於火 and 諸嘔吐酸暴注下迫皆屬於熱 — and the chapter opens with them because they set the default: vomiting is to be read as heat until something says otherwise. The passages that follow immediately qualify it.

Naegyeong 內經

2.1.2
Source원문

胃膈熱甚則爲嘔, 火氣炎上之象也. 《河間》

Translation영역
When the heat in the stomach and diaphragm is severe there is retching; it is the image of fire qi blazing upward.

Hagan 河間

2.1.3
Source원문

嘔ㆍ吐ㆍ噦者俱屬於胃. 胃者總司也, 以其氣血多少爲異耳. 嘔者陽明也, 陽明多血多氣, 故有聲有物, 氣血俱病也. 吐者太陽也, 太陽多血少氣, 故有物無聲, 乃血病也. 有食入則吐, 有食已則吐, 以橘紅爲主. 噦者少陽也, 少陽多氣少血, 故有聲無物, 乃氣病也, 以半夏爲主. 究其三者之源, 皆因脾氣虛弱, 或因寒氣客胃, 或因飮食所傷而致. 宜以丁香ㆍ藿香ㆍ半夏ㆍ茯苓ㆍ陳皮ㆍ生薑之類主之. 《東垣》

Translation영역
Retching, vomiting and hiccup all belong to the stomach, the stomach being the general office; they differ only in how much qi and blood there is. Retching is yang brightness: yang brightness has much blood and much qi, and so there is both sound and matter, and both qi and blood are ill. Vomiting is greater yang: greater yang has much blood and little qi, and so there is matter without sound, and it is an illness of the blood. In some the food is vomited as it goes in, in others once it is down; tangerine peel is the chief drug for it. Hiccup is lesser yang: lesser yang has much qi and little blood, and so there is sound without matter, and it is an illness of the qi; pinellia is the chief drug for it. Trace the source of all three and it is weakness of the spleen qi, or cold qi lodging in the stomach, or injury from food and drink. They should be governed with such drugs as cloves, patchouli, pinellia, poria, tangerine peel and fresh ginger.
Clinical note임상 주석
The chapter's working classification, and it is made by what the examiner can observe: sound and matter together, matter alone, sound alone. 噦 here is hiccup or dry retching — a sound with nothing brought up — and the division gives each its chief drug, tangerine peel for vomiting and pinellia for hiccup, which is how the formulas in 2.3 are built. The three-way scheme matters clinically because it separates vomiting from retching with an empty stomach, and that distinction still bears on the cause: an empty retch belongs to irritation or to the nervous control of the stomach rather than to anything in it.

Dongwon 東垣

2.1.4
Source원문

濕嘔者有物有聲, 食已則嘔; 乾嘔者空嘔無物. 總屬陽明氣血俱病, 故嘔比吐爲重也. 《入門》

Translation영역
In wet retching there is both matter and sound and the patient retches once the food is down; in dry retching there is an empty retch with no matter. Both belong to yang brightness with qi and blood ill together, and so retching is graver than vomiting.

Immun 入門

2.1.5
Source원문

劉河間謂嘔者火氣炎上, 此特一端耳. 有痰隔中焦食不得下者, 有氣逆者, 有寒氣鬱於胃口者, 有食滯心肺之分新食不得下而反出者, 有胃中有火與痰而嘔者. 《丹心》

Translation영역
Liu Hagan's saying that retching is fire qi blazing upward is only one side of it. There are cases where phlegm blocks the middle burner so that food cannot go down; cases of qi counterflow; cases where cold qi is depressed at the mouth of the stomach; cases where food is stagnant in the region of the heart and lung so that newly eaten food cannot get down and comes back up; and cases where there is both fire and phlegm in the stomach and the patient retches.
Clinical note임상 주석
Dansim's correction of the chapter's own opening, and the five causes he lists are what the treatment section actually works from. 此特一端耳 — this is only one side of it — is the sort of plain disagreement with an authority that the Bogam prints without resolving, and the sequence 內經 · 河間 · 東垣 · 丹心 across these five passages is a debate rather than a doctrine.

Dansim 丹心

2.1.6
Source원문

嘔家雖有陽明證, 愼不可下, 逆之故也. 《仲景》

Translation영역
Though a vomiting patient may have yang brightness signs, take care not to purge: it would be going against the direction of things.
Clinical note임상 주석
The rule the chapter returns to at 2.9 and then qualifies. Yang brightness signs — fever, a full abdomen, constipation — would ordinarily call for a purgative, and Junggyeong forbids it in a vomiting patient because the qi is already moving the wrong way. 2.9 argues the opposite case, that a vomiting patient whose bowel is shut must be opened downward, and names the condition under which the prohibition is lifted.

Junggyeong 仲景

2.2 Pulse Method 脉法

2.2.1
Source원문

寸口脉數, 其人卽吐.

Translation영역
A rapid pulse at the inch opening: the patient vomits.

Maekgyeong 脉經

2.2.2
Source원문

寸口脉細而數, 數則爲熱, 細則爲寒, 數爲嘔吐. 《脉經》

Translation영역
A pulse at the inch opening fine and rapid: rapid means heat, fine means cold, and rapid means vomiting.

Maekgyeong 脉經

2.2.3
Source원문

問曰, 病人脉數, 數爲熱, 當消穀引食, 而反吐者何也. 師曰, 過發其汗, 令陽氣微ㆍ膈氣虛, 脉乃數. 數爲客熱, 不能消穀, 胃中虛冷, 故吐也. 《仲景》

Translation영역
It is asked: the patient's pulse is rapid, and rapid means heat, which should consume the grain and draw in food — why then does he vomit instead? The master says: the sweating was pushed too far, so that the yang qi became faint and the diaphragm qi vacuous, and the pulse is therefore rapid. The rapidity is a guest heat, which cannot consume grain; the stomach is vacuous and cold, and so he vomits.
Clinical note임상 주석
客熱, guest heat — a rapid pulse that does not mean heat. The case described is iatrogenic: a patient sweated too hard for a fever is left with a fast pulse and a cold stomach, and an examiner who reads the pulse alone will treat the wrong thing. It is the same trap as 辨證 3.21's, and Junggyeong's answer is to weigh the pulse against what the patient can digest.

Junggyeong 仲景

2.2.4
Source원문

陽脉緊ㆍ陰脉數, 其人食已卽吐.

Translation영역
The yang pulse tight and the yin pulse rapid: the patient vomits as soon as he has eaten.

Maekgyeong 脉經

2.2.5
Source원문

寸緊尺澁, 其人胸滿不能食而吐. 《脉經》

Translation영역
The inch tight and the cubit rough: the patient's chest is full, he cannot eat, and he vomits.

Maekgyeong 脉經

2.2.6
Source원문

脉滑爲嘔吐. 《脉訣》

Translation영역
A slippery pulse means vomiting.

Maekgyeol 脉訣

2.2.7
Source원문

嘔吐無他, 寸緊滑數. 微數血虛, 單浮胃薄, 芤則有瘀, 最忌澁弱. 《回春》

Translation영역
In vomiting there is nothing else to it: the inch is tight, slippery and rapid. Faint and rapid means blood vacuity; floating alone means the stomach is thin; hollow means there is static blood; and rough and weak is worst of all.

Hoechun 回春

2.2.8
Source원문

趺陽脉浮而澁, 浮則爲虛, 澁則傷脾. 脾傷則不磨, 朝食暮吐, 暮食朝吐, 完穀不化, 名曰胃反. 《脉經》

Translation영역
The instep yang pulse floating and rough: floating means vacuity, rough means the spleen is injured. When the spleen is injured it does not grind, so that food taken in the morning is vomited at evening and food taken at evening is vomited in the morning, and the grain comes up undigested. This is called stomach reflux.
Clinical note임상 주석
完穀不化 — the grain coming up undigested — is the cardinal sign of the second half of the chapter, and here it is given its mechanism: 脾傷則不磨, an injured spleen does not grind. Vomiting of recognizable food eaten many hours earlier means it never left the stomach, which is gastric outlet obstruction; the Bogam's name for it, 胃反, says the stomach has turned back on itself. 趺陽, the instep yang pulse, is taken at the dorsum of the foot over the anterior tibial artery, and it is the stomach's own pulse. Palpating it in a patient with vomiting and wasting is not a bad habit: an absent or feeble foot pulse in such a patient says something about the state of the circulation.

Maekgyeong 脉經

2.2.9
Source원문

脉緊而澁, 其病難治.

Translation영역
A pulse tight and rough: the illness is hard to treat.

Maekgyeong 脉經

2.2.10
Source원문

脉弦者虛也, 胃氣無餘, 朝食暮吐, 暮食朝吐. 《脉經》

Translation영역
A stringlike pulse means vacuity, the stomach qi having nothing to spare: food taken in the morning is vomited at evening, and food taken at evening is vomited in the morning.

Maekgyeong 脉經

2.2.11
Source원문

反胃噎膈, 寸緊尺澁. 《回春》

Translation영역
In stomach reflux and dysphagia with blockage, the inch is tight and the cubit rough.

Hoechun 回春

2.2.12
Source원문

噎膈反胃, 脉浮緩者生, 沉澁者死. 脉澁而小, 血不足; 脉大而弱, 氣不足. 《醫鑑》

Translation영역
In dysphagia with blockage and stomach reflux, a pulse floating and moderate means the patient lives, one sunken and rough that he dies. A pulse rough and small means the blood is insufficient; one large and weak that the qi is insufficient.

Uigam 醫鑑

2.3 Treatment of Vomiting 嘔吐治法

2.3.1
Source원문

嘔吐有冷熱二證. 冷者面靑ㆍ手足厥冷ㆍ食久乃吐, 宜加味二陳湯ㆍ丁香安胃湯ㆍ加減理中湯.

Translation영역
Vomiting has two patterns, cold and hot. In the cold the face is blue-green, the hands and feet cold in reversal, and the food is vomited long after it is eaten; Supplemented Two Matured Ingredients Decoction, Clove Settle the Stomach Decoction and Modified Regulate the Centre Decoction are appropriate.
Clinical note임상 주석
The discrimination is made by two things an examiner sees at once — the colour of the face and the temperature of the hands — and by one thing the patient reports, how long the food stayed down. Food vomited long after eating with cold hands is the cold pattern; food vomited at once with a red face is the hot. It is the same timing rule 2.6 builds its three burners on, and it is as good a bedside discrimination as the chapter offers.

Immun 入門

2.3.2
Source원문

熱者面赤ㆍ手足熱ㆍ食已卽吐, 宜保中湯ㆍ和中桔梗湯ㆍ黃連竹茹湯ㆍ淸熱二陳湯, 或葛根竹茹湯ㆍ加味橘皮竹茹湯.

Translation영역
In the hot pattern the face is red, the hands and feet hot, and the food is vomited as soon as it is eaten; Protect the Centre Decoction, Harmonize the Centre and Platycodon Decoction, Coptis and Bamboo Shavings Decoction and Clear Heat Two Matured Ingredients Decoction are appropriate, or Pueraria and Bamboo Shavings Decoction and Supplemented Tangerine Peel and Bamboo Shavings Decoction.

Immun 入門

2.3.3
Source원문

大病後胃熱虛煩而嘔者, 竹葉石膏湯方見寒門加薑汁服卽止. 《入門》

Translation영역
Where after a great illness there is stomach heat with vacuity vexation and retching, Bamboo Leaf and Gypsum Decoctionthe formula is given in the Cold chapter with ginger juice added stops it at once.

Immun 入門

2.3.4
Source원문

時常口吐淸水, 或冷涎自下涌上者, 脾熱所致也. 二陳湯加白朮ㆍ白芍藥ㆍ升麻ㆍ神麯ㆍ麥芽ㆍ乾生薑ㆍ土炒芩連ㆍ梔子, 或水煎服, 或蒸餠爲丸服. 《入門》

Translation영역
Where clear water is brought up from the mouth from time to time, or cold drool wells up from below of itself, it is caused by heat in the spleen. Two Matured Ingredients Decoction with white atractylodes, white peony, cimicifuga, leaven, malt, dried fresh ginger, earth-fried scutellaria and coptis and gardenia added, taken either decocted in water or made into pills with steamed cake.
Clinical note임상 주석
口吐淸水 — clear water brought up from the mouth — is water brash, the sudden welling of thin saliva or gastric fluid, and the chapter gives it its own treatment twice over, here and at 2.11 under talc. Attributing it to spleen heat sits oddly with the cold drool in the same sentence; what the formula does is dry the damp with atractylodes and leaven and take the heat out with scutellaria, coptis and gardenia, which covers both readings.

Immun 入門

2.3.5
Source원문

肝火出胃逆上嘔吐, 宜抑靑丸方見火門

Translation영역
Where liver fire comes out into the stomach and surges upward with vomiting, Restrain the Green Pillthe formula is given in the Fire chapter is appropriate

Immun 入門

2.3.6
Source원문

半夏ㆍ橘皮ㆍ生薑爲嘔家主藥. 若胃虛而嘔者, 宜推揚穀氣, 四味藿香湯ㆍ加減四君子湯主之. 《綱目》

Translation영역
Pinellia, tangerine peel and fresh ginger are the chief drugs for a vomiting patient. But where the stomach is vacuous and the patient retches, the grain qi should be lifted and carried, and Four Ingredient Patchouli Decoction and Modified Four Gentlemen Decoction govern it.
Clinical note임상 주석
The three chief drugs named in one line, and they are the three the whole chapter is built on: pinellia for the phlegm and the water, tangerine peel for the qi, ginger for both and as pinellia's corrective. 推揚穀氣 — lifting and carrying the grain qi — is the opposite approach, for the patient whose stomach is too weak to work, and it is the one the supplementing formulas take.

Gangmok 綱目

2.3.7
Source원문

久病胃虛嘔吐, 宜藿香安胃散ㆍ藿香平胃散ㆍ比和飮.

Translation영역
For vomiting from stomach vacuity in a long illness, Patchouli Settle the Stomach Powder, Patchouli Level the Stomach Powder and Harmonize and Match Decoction are appropriate.

Immun 入門

2.3.8
Source원문

痰飮嘔吐, 宜茯苓半夏湯ㆍ小半夏湯《入門》ㆍ大半夏湯方見痰門

Translation영역
For vomiting from phlegm fluid, Poria and Pinellia Decoction, Minor Pinellia Decoction and Major Pinellia Decoctionthe formula is given in the Phlegm chapter are appropriate

Immun 入門

2.3.9
Source원문

神朮丸治嘔吐淸水如神方見痰門

Translation영역
Divine Atractylodes Pill treats the vomiting of clear water wonderfully wellthe formula is given in the Phlegm chapter

Immun 入門

2.3.10
Source원문

停水而嘔者, 心下怔忡. 先渴後嘔者, 宜赤茯苓湯方見胸門; 先嘔後渴者, 宜猪苓散; 水入卽吐者, 宜五苓散方見寒門. 《入門》

Translation영역
Where water has halted and the patient retches, there is fearful throbbing below the heart. Where thirst comes first and retching after, Red Poria Decoctionthe formula is given in the Chest chapter is appropriate; where retching comes first and thirst after, Polyporus Powder; where water is vomited as soon as it goes in, Five Ingredient Powder with Poriathe formula is given in the Cold chapter.
Clinical note임상 주석
Three water-vomiting cases told apart by the order of thirst and vomiting, and the third is the sharpest: 水入卽吐, water vomited the instant it is drunk. That is the sign the classical literature treats as diagnostic of water held in the stomach, and Oryeong-san is the formula for it from Junggyeong onward.

Immun 入門

2.3.11
Source원문

嘔家聖藥是生薑, 千金之說信矣. 然氣逆作嘔, 生薑散之; 痰水作嘔, 半夏逐之. 生薑於寒證最佳, 若遇熱嘔, 不可無烏梅也. 《醫鑑》

Translation영역
That fresh ginger is the sage medicine for a vomiting patient — the Cheongeumbang's saying — is to be believed. But where qi counterflow makes the vomiting, ginger disperses it; where phlegm water makes it, pinellia drives it out. Ginger is best of all in a cold pattern, and where one meets a hot vomiting there is no doing without smoked plum.
Clinical note임상 주석
The chapter's most useful single paragraph, because it says when its own chief drug is the wrong one. Ginger for the cold vomiting, pinellia for the watery one, smoked plum for the hot — and ginger, which is warm, withheld from the hot case. Sour fruit for hot vomiting is the same reasoning as 霍亂's salted plum, and it is what makes a nauseated patient able to drink.

Uigam 醫鑑

2.3.12
Source원문

嘔吐宜服薤白粥.

Translation영역
For vomiting, Scallion Gruel should be taken.

Deukhyo 得效

2.3.13
Source원문

嘔家有癰膿, 不須治嘔, 膿盡自愈矣. 《仲景》

Translation영역
Where a vomiting patient has an abscess with pus, there is no need to treat the vomiting; when the pus is all out it heals of itself.
Clinical note임상 주석
A contraindication, and a good one: the vomiting is the body clearing pus, and stopping it would keep the pus in. What Junggyeong is describing is a pulmonary or gastric abscess discharging, and the principle — do not suppress an evacuation that is doing the work — is the same one 霍亂 1.4 argues for vomiting and diarrhoea.

Junggyeong 仲景

2.4 Nausea and Dry Retching 惡心乾嘔

2.4.1
Source원문

惡心者, 欲吐不得吐, 見飮食則心便惡之. 二陳湯方見痰門加白豆蔲ㆍ香附子ㆍ縮砂煎服. 《入門》

Translation영역
In nausea the patient wants to vomit and cannot, and at the sight of food and drink the heart turns against it. Two Matured Ingredients Decoctionthe formula is given in the Phlegm chapter with round cardamom, cyperus and cardamom added, decocted.

Immun 入門

2.4.2
Source원문

惡心者, 欲吐不吐也. 胃口有熱有痰, 二陳湯加薑炒芩連. 《丹心》

Translation영역
Nausea is wanting to vomit and not vomiting. There is heat and there is phlegm at the mouth of the stomach: Two Matured Ingredients Decoction with ginger-fried scutellaria and coptis added.

Dansim 丹心

2.4.3
Source원문

乾嘔者, 有聲無物也. 乾嘔或手足厥冷者, 宜生薑橘皮湯. 《活人》

Translation영역
Dry retching is sound without matter. For dry retching, or with cold reversal of the hands and feet, Fresh Ginger and Tangerine Peel Decoction is appropriate.

Hwarinseo 活人

2.4.4
Source원문

惡心者, 無聲無物, 但心中兀兀然無奈, 欲吐不吐, 欲嘔不嘔. 雖曰惡心, 實非心經之病, 皆在胃口上, 宜用生薑. 又曰, 惡心吐淸水, 胃口有痰ㆍ有熱ㆍ有虛, 皆用生薑, 宜生薑半夏湯. 《仲景》

Translation영역
In nausea there is neither sound nor matter, only an unsettled helplessness within, wanting to vomit and not vomiting, wanting to retch and not retching. Though it is called nausea — a loathing in the heart — it is in truth no illness of the heart channel but lies entirely at the mouth of the stomach, and fresh ginger should be used. It is said again: for nausea with the bringing up of clear water, whether there is phlegm, heat or vacuity at the mouth of the stomach, fresh ginger is used in every case, and Fresh Ginger and Pinellia Decoction is appropriate.
Clinical note임상 주석
雖曰惡心, 實非心經之病 — though it is called a loathing in the heart, it is no illness of the heart channel — is a point of terminology made for the sake of treatment: the name misleads, and the organ to treat is the stomach. 兀兀然無奈, an unsettled helplessness, is as exact a description of nausea as a classical text contains, and the chapter's insistence that it has neither sound nor matter distinguishes it from the retching of 2.1.

Junggyeong 仲景

2.4.5
Source원문

乾嘔吐涎沫, 宜半夏乾薑散. 《仲景》

Translation영역
For dry retching with the spitting of frothy saliva, Pinellia and Dried Ginger Powder is appropriate.

Junggyeong 仲景

2.4.6
Source원문

胃中素有熱, 惡心乾嘔不止者, 宜梔子竹茹湯. 《醫鑑》

Translation영역
Where there has long been heat in the stomach and the nausea and dry retching will not stop, Gardenia and Bamboo Shavings Decoction is appropriate.

Uigam 醫鑑

2.5 Food Impediment with Vomiting of Food 食痺吐食

2.5.1
Source원문

食痺, 謂食已心下痛, 陰陰然不可名也, 不可忍也, 吐出痛乃止. 此爲胃氣逆而不下行也. 《內經》

Translation영역
Food impediment means that when the food is eaten there is pain below the heart, a dull obscure pain that cannot be named and cannot be borne, and when the food is vomited up the pain stops. This is the stomach qi running counter and not travelling downward.
Clinical note임상 주석
Pain after eating, relieved by vomiting: the chapter has already used the same sign at 2.7 to localize an obstruction at the cardia. 陰陰然不可名 — a dull obscure pain that cannot be named — is the classical phrase for visceral as opposed to somatic pain, and it is accurate about how such pain is felt.

Naegyeong 內經

2.5.2
Source원문

痛而嘔爲寒. 經云, 寒氣客於腸胃, 厥逆上出, 故痛而嘔也. 《綱目》

Translation영역
Pain with retching means cold. The classic says: cold qi lodges in the stomach and intestines and comes out upward in reversal, and so there is pain with retching.

Gangmok 綱目

2.5.3
Source원문

嘔吐而脉弦者, 肝勝于脾也, 由風痰覊絆于脾胃之間, 故惡心欲吐ㆍ飮食不下. 當先實其脾土, 宜茯苓半夏湯ㆍ麥天湯ㆍ白朮茯苓湯ㆍ金花丸ㆍ水煮金花丸. 《東垣》

Translation영역
Vomiting with a stringlike pulse is the liver overcoming the spleen; it comes of wind phlegm tethered between the spleen and stomach, and so there is nausea with a wish to vomit and food that will not go down. The spleen earth should be made replete first, and Poria and Pinellia Decoction, Ophiopogon and Gastrodia Decoction, White Atractylodes and Poria Decoction, Golden Flower Pill and Water-Boiled Golden Flower Pill are appropriate.
Clinical note임상 주석
A stringlike pulse in a vomiting patient read as the liver overriding the spleen, and the instruction that follows is the characteristic Dongwon move: 當先實其脾土, make the spleen earth replete first, rather than attacking the liver. All five formulas named are atractylodes-and-poria formulas with gastrodia or arisaema for the wind.

Dongwon 東垣

2.5.4
Source원문

風邪在胃, 翻翻不定, 或鬱酸水全不入食, 宜不換金正氣散方見寒門, 或安脾丸. 不宜輕用參朮. 惟久病脇痛者, 木剋土也, 宜六君子湯方見痰門加靑皮ㆍ白芍藥ㆍ柴胡ㆍ升麻ㆍ川芎ㆍ砂仁ㆍ神麴煎服. 《入門》

Translation영역
Where a wind evil is in the stomach, so that it turns and turns without settling, or sour water is depressed there and no food goes in at all, Unchangeable Gold Correct Qi Powderthe formula is given in the Cold chapter or Settle the Spleen Pill is appropriate. Ginseng and atractylodes are not to be used lightly. Only where there is flank pain in a long illness, which is wood restraining earth, is Six Gentlemen Decoctionthe formula is given in the Phlegm chapter appropriate, with unripe tangerine peel, white peony, bupleurum, cimicifuga, chuanxiong, cardamom and leaven added, decocted.
Clinical note임상 주석
不宜輕用參朮 — ginseng and atractylodes are not to be used lightly — is a caution against the treatment the passage before it recommends, and the two stand next to each other unreconciled. The Immun's point is that a stomach full of sour water and refusing food is blocked rather than empty, and supplementing it makes the blockage worse; the exception it allows is the long case with flank pain, where the liver really is the problem. 翻翻不定, turning and turning without settling, is the sensation of a stomach that will not be still — closer to what a modern patient would call churning than to nausea.

Immun 入門

2.6 Vomiting Illness Has Three Kinds 吐病有三

2.6.1
Source원문

氣爲上膈, 屬上焦, 食已暴吐者, 今世謂之嘔吐也.

Translation영역
Qi makes the upper blockage, which belongs to the upper burner; where the food is vomited violently as soon as it is eaten, this is what the present age calls retching and vomiting.

Gangmok 綱目

2.6.2
Source원문

食飮入而還出爲下膈, 食晬時乃反出之, 屬中下二焦.

Translation영역
Food and drink going in and coming back out makes the lower blockage: the food comes back after a full day, and this belongs to the middle and lower burners.

Gangmok 綱目

2.6.3
Source원문

朝食暮吐, 暮食朝吐, 今世謂之膈氣反胃也. 《綱目》

Translation영역
Food taken in the morning vomited at evening and food taken at evening vomited in the morning: this is what the present age calls diaphragm qi and stomach reflux.

Gangmok 綱目

2.6.4
Source원문

吐有三因, 乃氣ㆍ積ㆍ寒也, 皆從三焦論之. 上焦在胃口, 上通天氣, 主納而不出; 中焦在中脘, 上通天氣, 下通地氣, 主腐熟水穀; 下焦在臍下, 下通地氣, 主出而不納.

Translation영역
Vomiting has three causes — qi, accumulation and cold — and all are discussed by the three burners. The upper burner is at the mouth of the stomach, communicating above with heaven's qi, and governs taking in without putting out. The middle burner is at the middle duct, communicating above with heaven's qi and below with earth's, and governs the rotting and ripening of water and grain. The lower burner is below the navel, communicating below with earth's qi, and governs putting out without taking in.

Yi Lao 易老

2.6.5
Source원문

上焦吐者皆從於氣. 氣者天之陽也. 其脉浮而洪, 其證食已暴吐ㆍ渴欲飮水ㆍ大便燥結ㆍ氣上衝胸而發痛. 其治當降氣和中.

Translation영역
Upper-burner vomiting all follows from the qi, the qi being heaven's yang. Its pulse is floating and surging; its signs are violent vomiting as soon as the food is eaten, thirst with a wish to drink water, a dry bound stool, and qi surging up into the chest with pain. The treatment should bring the qi down and harmonize the centre.

Yi Lao 易老

2.6.6
Source원문

中焦吐者皆從於積, 有陰有陽, 食與氣相假爲積而痛. 其脉浮而弦, 其證或先吐而後痛, 或先痛而後吐. 治法當以小毒藥去其積, 木香ㆍ檳榔和其氣宜紫沉丸消積

Translation영역
Middle-burner vomiting all follows from accumulation, which may be yin or yang, food and qi borrowing from each other to make an accumulation, with pain. Its pulse is floating and stringlike; its signs are either vomiting first and pain after, or pain first and vomiting after. The method of treatment is to remove the accumulation with a slightly poisonous drug and to harmonize the qi with costus and arecaPurple Sinking Pill is appropriate, to disperse the accumulation

Yi Lao 易老

2.6.7
Source원문

下焦吐者皆從于寒, 地道也. 其脉沉而遲, 其證朝食暮吐ㆍ暮食朝吐ㆍ小便淸利ㆍ大便秘而不通. 治法宜以毒藥通其閉塞ㆍ溫其寒氣, 大便漸通, 復以中焦藥和之, 不令大府結閉而自安也. 《易老》

Translation영역
Lower-burner vomiting all follows from cold, which is earth's way. Its pulse is sunken and slow; its signs are food taken in the morning vomited at evening, food taken at evening vomited in the morning, clear free urine, and a stool bound and not passing. The method of treatment is to open the blockage with a poisonous drug and warm the cold qi; when the stool begins to pass, harmonize with a middle-burner medicine, so that the great bowel is not left closed and the patient settles of himself.
Clinical note임상 주석
The chapter's most clinically organized passage, and it works downward: vomiting at once, vomiting after hours, vomiting after half a day, with a pulse and a treatment for each. The three correspond tolerably well to what a modern examiner would separate as gastric irritation, gastric stasis and distal obstruction, and the diagnostic hinge is the same — how long the food stays down. 毒藥 and 小毒藥, the poisonous and slightly poisonous drugs, are named as a class and assigned to the two lower kinds: croton frost in Jachim-hwan for the middle, croton with arsenolite in Buja-hwan for the lower. **Both are recorded as history. A patient with absolute constipation vomiting food eaten half a day before needs imaging and surgical assessment, not a purgative.**

Yi Lao 易老

2.7 The Causes of Dysphagia, Diaphragm Blockage and Stomach Reflux 噎膈反胃病因

2.7.1
Source원문

內經曰, 三陽結謂之膈. 註曰, 三陽者, 大小腸俱熱結也. 盖小腸熱結則血脉燥, 大腸熱結則不能便, 膀胱熱結則津液涸. 三陽熱結, 脉必洪數有力, 前後閉塞, 下旣不通, 必反而上行, 所以噎食不下, 縱下復出, 乃陽火上行而不下降也. 《入門》

Translation영역
The Inner Classic says: the three yang bound is called blockage. The commentary says: the three yang means that the large and small intestine are both bound with heat. Now when the small intestine is bound with heat the blood and vessels go dry; when the large intestine is bound with heat the stool cannot pass; when the bladder is bound with heat the fluids dry up. With the three yang bound by heat the pulse is certainly surging, rapid and forceful, front and back are shut and blocked, and since nothing passes below it must turn and travel upward — which is why the food is blocked and will not go down, and even when it goes down comes back up. It is yang fire travelling upward and not descending.

Immun 入門

2.7.2
Source원문

內經曰, 少陽所至爲嘔ㆍ涌溢ㆍ食不下. 此理明矣. 《入門》

Translation영역
The Inner Classic says: where lesser yang arrives there is retching, welling overflow, and food that will not go down. This reasoning is clear.

Immun 入門

2.7.3
Source원문

又曰, 食不下者, 胃脘隔也. 《入門》

Translation영역
It says again: where food will not go down, the stomach duct is blocked.

Immun 入門

2.7.4
Source원문

血液俱耗, 胃脘乾槁. 其槁在上近咽之下, 水飮可行, 食物難入, 間或可入, 入亦不多, 名之曰噎. 其槁在下與胃相近, 食雖可入, 難盡入胃, 良久復出, 名之曰膈, 亦曰反胃. 大便秘少, 若羊屎然. 名雖不同, 病出一體.

Translation영역
Blood and fluid are both consumed and the stomach duct is dry and withered. Where the withering is above, just below the throat, water and drink can get through but solid food can hardly go in; now and then some may go in, and not much even then: this is called dysphagia. Where the withering is below, near the stomach, food can go in but hardly all of it reaches the stomach and after a long while it comes back up: this is called blockage, and also stomach reflux. The stool is bound and scanty, like a sheep's droppings. The names differ but the illness comes of one body.
Clinical note임상 주석
The three anatomical levels, and this is as precise as classical Chinese medicine gets about them. Liquids passing while solids will not is the cardinal symptom of an oesophageal stricture, and it is named here as the upper kind; food that goes in and returns after a long while is the lower kind. 大便秘少若羊屎然 — the stool scanty and like sheep's droppings — is the sign of a patient who has eaten almost nothing for weeks. What the chapter is describing is in most cases carcinoma of the oesophagus or stomach. **Progressive difficulty in swallowing, worse for solids than for liquids, with weight loss, requires endoscopy without delay.**

Dansim 丹心

2.7.5
Source원문

其槁在賁門, 食下則胃脘當心而痛, 須臾吐出, 食出痛乃止, 此上焦之噎膈也. 或食物可下, 難盡入胃, 良久復出, 其槁在幽門, 此中焦之噎膈也. 其或朝食暮吐ㆍ暮食朝吐, 其槁在闌門, 此下焦之噎膈也. 《丹心》

Translation영역
Where the withering is at the cardia, the food goes down and the stomach duct aches over the heart, and in a moment it is vomited up, and when the food is out the pain stops: this is upper-burner dysphagia with blockage. Where food can go down but hardly all of it reaches the stomach and after a long while it comes back, the withering is at the pylorus: this is middle-burner dysphagia with blockage. Where food taken in the morning is vomited at evening and food taken at evening in the morning, the withering is at the ileocaecal gate: this is lower-burner dysphagia with blockage.
Clinical note임상 주석
賁門, 幽門 and 闌門 are the cardia, the pylorus and the ileocaecal junction, and Dansim assigns a symptom to each: retrosternal pain relieved by vomiting for the cardia, delayed return of food for the pylorus, and vomiting half a day later for the lowest. The first two map onto what endoscopy finds. The third does not — vomiting a day's food points to gastric outlet obstruction rather than to anything at the ileocaecal valve — but the attempt to localize an obstruction by the timing of the vomit is the right method.

Dansim 丹心

2.7.6
Source원문

飮食不下而大便不通, 名曰膈噎. 膈者有拒格之意, 卽膈食反胃也. 《入門》

Translation영역
Food and drink not going down with the stool not passing is called blockage dysphagia. Blockage carries the sense of being barred and held off: it is blocked food and stomach reflux.

Immun 入門

2.7.7
Source원문

噎膈有五. 五膈者, 憂ㆍ恚ㆍ寒ㆍ熱ㆍ氣也, 在心脾之間, 上下不通, 或結於咽喉, 時覺有所妨碍, 吐之不出, 嚥之不下, 由氣鬱痰結而然. 五噎者, 憂ㆍ食ㆍ勞ㆍ氣ㆍ思也, 飮食卒然阻滯而不下. 反胃也ㆍ膈也ㆍ噎也, 受病皆同. 《醫鑑》

Translation영역
Dysphagia with blockage has five kinds. The five blockages are grief, rage, cold, heat and qi; they lie between the heart and the spleen so that above and below do not communicate, or they knot in the throat, where something is felt in the way from time to time which cannot be spat out or swallowed down. This comes of depressed qi and knotted phlegm. The five dysphagias are grief, food, taxation, qi and thought; food and drink are suddenly obstructed and will not go down. Stomach reflux, blockage and dysphagia all take their illness from the same source.
Clinical note임상 주석
吐之不出, 嚥之不下 — it cannot be spat out or swallowed down — is the classical description of the globus sensation, and the chapter is careful to distinguish it from true obstruction by its cause: 氣鬱痰結, depressed qi and knotted phlegm, which is the 梅核氣 of the 咽喉 chapter. Four of the five blockages and four of the five dysphagias are emotional states, which is the Bogam placing this condition among illnesses of feeling.

Uigam 醫鑑

2.7.8
Source원문

張雞峯曰, 噎當是神思間病, 惟內觀自養可以治之. 其言深中病情. 《丹心》

Translation영역
Jang Gyebong said: dysphagia must be an illness of the spirit and the thoughts, and only inward contemplation and self-nurture can treat it. His words go deep into the condition.
Clinical note임상 주석
惟內觀自養可以治之 — only inward contemplation and self-nurture can treat it — endorsed by Dansim as going deep into the condition. For the globus and the emotional 五噎 this is sound enough, and it is the Bogam's usual recommendation for illnesses it attributes to feeling. **For the obstructive 噎膈 described two passages earlier it is not: a patient whose solid food will not pass needs investigation, and treating it as a disorder of the spirit loses the time in which something can be done.**

Dansim 丹心

2.7.9
Source원문

膈噎之證, 不屬虛ㆍ不屬實ㆍ不屬冷ㆍ不屬熱, 乃神氣中一點病耳. 《醫林》

Translation영역
The pattern of blockage dysphagia belongs neither to vacuity nor to repletion, neither to cold nor to heat: it is a single point of illness within the spirit qi.

Uirim 醫林

2.7.10
Source원문

噎病皆生於血枯, 血枯則燥矣. 得病情合經旨者, 丹溪一人而已. 《綱目》

Translation영역
Dysphagia always arises from withered blood, and when the blood is withered there is dryness. Of those who have grasped the condition in a way that agrees with the classics, Dansim is the only one.

Gangmok 綱目

2.8 Treatment of Dysphagia, Diaphragm Blockage and Stomach Reflux 噎膈反胃治法

2.8.1
Source원문

噎病生於血乾. 夫血者陰氣也, 陰主靜. 內外兩靜, 則藏府之火不起, 而金水二氣有養, 陰血自生, 腸胃津液傳化合宜, 何噎之有.

Translation영역
Dysphagia arises from dryness of the blood. Blood is the yin qi, and yin governs stillness. When both within and without are still, the fire of the viscera and bowels does not rise, the two qi of metal and water are nourished, the yin blood is engendered of itself, and the fluids of stomach and intestines are transformed and passed on as they should be — and where then is any dysphagia?

Dansim 丹心

2.8.2
Source원문

曰, 胃脘乾槁, 果可治乎. 曰, 古方用人參以補肺ㆍ御米以解毒ㆍ竹瀝以淸痰ㆍ乾薑以養血ㆍ粟米以實胃ㆍ蜜以潤燥ㆍ薑以去穢, 正是此意.

Translation영역
It is asked: when the stomach duct is dry and withered, can it really be treated? The answer: the old formulas use ginseng to supplement the lung, poppy to resolve toxins, bamboo sap to clear phlegm, dried ginger to nourish the blood, millet to make the stomach replete, honey to moisten dryness, and ginger to dispel the foul — and this is exactly the intention.
Clinical note임상 주석
Seven drugs with a reason given for each, and read as a whole they are a feeding prescription rather than a medicine: millet and honey for calories, bamboo sap and poppy for the pain and the retching, ginger to make it tolerable. The chapter arrives at the same place as 2.11's milk case — what the patient needs is something that will go down.

Dansim 丹心

2.8.3
Source원문

噎膈反胃, 大率屬血虛ㆍ氣虛ㆍ有痰ㆍ有熱. 血虛四物湯, 氣虛四君子湯, 痰用二陳湯, 熱用解毒湯卽黃連解毒湯, 氣血俱虛八物湯主之. 必和以童便ㆍ竹瀝ㆍ韭汁ㆍ薑汁, 且多飮牛羊乳爲上策. 但不可以人乳代之, 盖有七情烹飪之火故也. 切不可用香燥藥, 宜薄滋味.

Translation영역
Dysphagia with blockage and stomach reflux mostly belong to blood vacuity, qi vacuity, phlegm or heat. For blood vacuity, Four Substances Decoction; for qi vacuity, Four Gentlemen Decoction; for phlegm, Two Matured Ingredients Decoction; for heat, Resolve Toxins Decoctionthat is, Coptis Resolve Toxins Decoction; and where qi and blood are both vacuous, Eight Substances Decoction governs it. They must be harmonized with a boy's urine, bamboo sap, Chinese chive juice and ginger juice, and drinking cow's or sheep's milk freely is the best policy. Human milk, however, must not be used in its place, since it carries the fire of the seven affects and of cooking. Aromatic and drying medicines must on no account be used, and the flavours of the diet should be thin.
Clinical note임상 주석
多飮牛羊乳爲上策 — drinking cow's or sheep's milk freely is the best policy — is the chapter's soundest advice and the one its own case report at 2.11 confirms. For a patient with a partly obstructed gullet, milk is a liquid, it is dense in calories and protein, and it goes down when nothing else will. 切不可用香燥藥 — aromatic and drying medicines on no account — is a real contraindication within the system: the aromatic drugs that serve for ordinary vomiting would dry a patient whose trouble is dryness. The reason given for refusing human milk, that it carries the fire of the emotions and of cooking, is of its period.

Dansim 丹心

2.8.4
Source원문

飮酒者加砂糖ㆍ驢尿入內服, 以防生蟲. 《丹心》

Translation영역
For a drinker, add sugar and donkey's urine and have him take it, to prevent the breeding of worms.
Clinical note임상 주석
**Donkey's urine is recorded here as the text gives it and is not to be prepared.** The 2.11 entry on it carries the Boncho's own warning that it is somewhat poisonous. 以防生蟲, to prevent the breeding of worms, is the chapter's reason, and the worms belong to the period's understanding of what obstructs a gullet.

Dansim 丹心

2.8.5
Source원문

噎膈宜用平鯽丸ㆍ神仙奪命丹ㆍ丁香透膈湯ㆍ五膈寬中散ㆍ棗肉平胃散方見內傷ㆍ瓜蔞實丸ㆍ神奇散ㆍ當歸養血湯ㆍ生津補血湯ㆍ聖灰散ㆍ八仙膏.

Translation영역
For dysphagia with blockage, Flattened Crucian Carp Pill, Divine Immortal Seize Life Elixir, Clove Pierce the Diaphragm Decoction, Five Blockages Loosen the Centre Powder, Jujube Flesh Level the Stomach Powderthe formula is given in the Inward Damage chapter, Trichosanthes Fruit Pill, Divine Marvel Powder, Chinese Angelica Nourish the Blood Decoction, Engender Fluid and Supplement the Blood Decoction, Sacred Lime Powder and Eight Immortals Paste should be used.

Jebang 諸方

2.8.6
Source원문

反胃宜用硫汞丸ㆍ狗米平胃丸ㆍ杵糠丸ㆍ九仙奪命丹ㆍ順氣和中湯ㆍ安中調氣丸ㆍ回生養胃丹ㆍ定生丹ㆍ安胃湯ㆍ太倉丸ㆍ奪命丹ㆍ附子散. 《諸方》

Translation영역
For stomach reflux, Sulphur and Mercury Pill, Dog Millet Level the Stomach Pill, Pestle Bran Pill, Nine Immortals Seize Life Elixir, Order the Qi and Harmonize the Centre Decoction, Settle the Centre and Regulate the Qi Pill, Return to Life Nourish the Stomach Elixir, Settle Life Elixir, Settle the Stomach Decoction, Great Granary Pill, Seize Life Elixir and Aconite Powder should be used.
Clinical note임상 주석
Twelve formulas for stomach reflux and a reader should know what is in them before going to the entries: mercury and sulphur in one, arsenic sulfide and cinnabar in two, a calcined dung ball in another, a pig's stomach and hearth earth in a fifth. **Most of this group is recorded as history and is not to be prepared; each entry carries its own warning.** The exceptions are the three plain decoctions — Sungihwajung-tang, Angwi-tang and Anjungjogi-hwan — which are ordinary phlegm-and-qi formulas, and Taechang-hwan, which is chiefly roasted rice.

Jebang 諸方

2.9 In Vomiting, Dysphagia and Stomach Reflux the Stool Should Be Freed 嘔吐噎膈反胃宜通大便

2.9.1
Source원문

病人欲吐者, 切不可下, 逆之故也. 《仲景》

Translation영역
Where a patient is about to vomit, on no account purge: it would be going against the direction of things.

Junggyeong 仲景

2.9.2
Source원문

陽明之氣下行則順, 今逆而上行, 謹不可泄固也. 然嘔吐者每每大便秘結, 上下壅遏, 氣不流行, 盍思所以區畫而利導之. 《直指》

Translation영역
The qi of yang brightness travels downward when all is well, and here it is running counter and travelling upward, so that one must indeed be careful not to drain. Yet a vomiting patient is again and again bound and constipated, with above and below both dammed and the qi not travelling — why not then consider how to divide the problem and lead it out?
Clinical note임상 주석
The section is an argument with 2.1's rule, and it is conducted properly: the prohibition is quoted first, then the objection, then the condition under which the prohibition does not hold. 盍思所以區畫而利導之 — why not consider how to divide the problem and lead it out — is the hinge, and what follows settles it by cases.

Jikji 直指

2.9.3
Source원문

陰虛邪氣逆上窒塞, 嘔噦不足之病也. 此地道不通, 當用生地黃ㆍ當歸ㆍ桃仁ㆍ紅花, 兼用甘草, 微加大黃ㆍ芒硝以通其閉, 大便利則嘔吐噦自止矣. 《東垣》

Translation영역
Where the yin is vacuous and the evil qi runs counter upward and stops things up, the retching and hiccup are an illness of insufficiency. Here earth's way is not passing: raw rehmannia, Chinese angelica, peach kernel and carthamus should be used, with licorice, and a little rhubarb and mirabilite added to open the blockage; when the stool passes freely, the vomiting and hiccup stop of themselves.
Clinical note임상 주석
Dongwon's answer is to open the bowel but to do it on a base of blood-nourishing and blood-moving drugs, with only a little rhubarb and mirabilite — 微加, a little added. In a wasted and dehydrated patient that is the right instinct: the purgative is a small part of the prescription rather than the whole of it.

Dongwon 東垣

2.9.4
Source원문

嘔吐證忌用利藥, 此言其常. 只嘔吐而大小便不秘澁者, 利藥所當忌也. 若大小腸ㆍ膀胱熱結不通, 上爲嘔吐隔食, 若不用利藥開通發泄, 則嘔吐何由而止乎. 古人用三一承氣湯, 正是此意. 《丹心》

Translation영역
That in a vomiting pattern disinhibiting medicines are to be avoided states the ordinary rule. Where there is only vomiting and neither urine nor stool is bound and sluggish, disinhibiting medicines are indeed to be avoided. But where the large and small intestine and the bladder are bound with heat and will not pass, so that above there is vomiting and blocked food, if disinhibiting medicines are not used to open and discharge it, by what means is the vomiting to stop? The ancients used Three-in-One Qi-Coordinating Decoction, and this is exactly the intention.
Clinical note임상 주석
The condition is stated exactly: the prohibition holds for vomiting alone, and is lifted when the bowel and bladder are shut as well. That is the right distinction, and it is the one a modern clinician makes between vomiting from gastritis and vomiting from obstruction — in the second the problem is downstream, and nothing upstream will settle until it is relieved.

Dansim 丹心

2.9.5
Source원문

通利大便以開下焦之壅塞, 宜用紫沉丸ㆍ厚朴丸ㆍ附子丸ㆍ人參利膈丸ㆍ三一承氣湯ㆍ四子調中湯ㆍ香白元ㆍ大黃湯ㆍ潤腸膏. 《諸方》

Translation영역
To free the stool and so open the blockage of the lower burner, Purple Sinking Pill, Magnolia Bark Pill, Aconite Pill, Ginseng Disinhibit the Diaphragm Pill, Three-in-One Qi-Coordinating Decoction, Four Seeds Regulate the Centre Decoction, Costus and White Pill, Rhubarb Decoction and Moisten the Intestines Paste should be used.

Jebang 諸方

2.9.6
Source원문

嘔吐家多大便秘結, 虛冷者用蘇感元溫而利之方見大便. 若大便熱結, 用蜜導法方見大便, 或猪膽汁和醋灌入下部妙. 《直指》

Translation영역
Vomiting patients are often bound and constipated; where there is vacuity cold, use Perilla and Response Pill to warm and so disinhibit itthe formula is given in the Stool chapter. Where the stool is bound by heat, use the honey suppository methodgiven in the Stool chapter, or pig's gall mixed with vinegar poured into the lower part, which is excellent.
Clinical note임상 주석
The section ends with the two rectal measures, and they are the sensible ones: a honey suppository for a heat-bound stool and a gall-and-vinegar enema. For a vomiting patient who cannot keep anything down, giving the laxative by the other end is the obvious answer, and the honey suppository of the 大便 chapter is a glycerine suppository in all but name.

Jikji 直指

2.10 Signs Hard to Treat and Not to Be Treated 難治不治證

2.10.1
Source원문

嘔吐脉弱ㆍ小便自利ㆍ身微熱而厥者, 虛極難治. 《脉經》

Translation영역
Vomiting with a weak pulse, urine passing freely of itself, a slight fever and cold reversal: the vacuity is extreme and it is hard to treat.

Maekgyeong 脉經

2.10.2
Source원문

凡吐如淸菜汁者死. 此是乍然嘔吐, 非反胃比也. 《入門》

Translation영역
Where the vomit is like clear vegetable juice, the patient dies. This is a sudden vomiting, not to be compared with stomach reflux.

Immun 入門

2.10.3
Source원문

噎膈反胃證, 年高者不治年五十以上者不治

Translation영역
In the pattern of dysphagia with blockage and stomach reflux, where the patient is old there is no treating itin a patient over fifty there is no treating it
Clinical note임상 주석
年高者不治 with the gloss setting the line at fifty. For the condition the chapter is describing — obstructing cancer of the oesophagus or stomach — the age cut-off tracks the incidence rather than the prognosis: it was the older patients in whom the obstruction was malignant. The judgment was correct in its own terms and the modern position is the opposite: **progressive dysphagia at any age, and above all over fifty, is an indication for urgent endoscopy, and the treatable cases are found by looking.**

Dansim 丹心

2.10.4
Source원문

糞如羊屎者不治大腸無血故也

Translation영역
Where the stool is like sheep's droppings there is no treating itbecause the large intestine has no blood

Dansim 丹心

2.10.5
Source원문

不淡飮食ㆍ不斷房室者不治.

Translation영역
One who will not keep his food and drink plain, and will not give up the bedchamber, is not to be treated.

Dansim 丹心

2.10.6
Source원문

氣血俱虛者, 則口中多出沫. 但見沫多出者必死. 《丹心》

Translation영역
Where qi and blood are both vacuous, much froth comes out of the mouth; and where much froth is seen coming out, the patient must die.
Clinical note임상 주석
Frothy saliva pouring from the mouth in a patient with dysphagia is the sign of a complete obstruction: the saliva has nowhere to go. It is the finding that tells a modern clinician nothing is passing at all, and the chapter reads it the same way — as the end.

Dansim 丹心

2.10.7
Source원문

反胃吐白沫者可治, 吐黃沫者不可治. 《種杏》

Translation영역
In stomach reflux, one who vomits white froth can be treated; one who vomits yellow froth cannot.
Clinical note임상 주석
The distinction is between saliva and bile. White froth is swallowed saliva coming back; yellow means bile is in the vomit, which with an obstruction means it lies below the entry of the bile duct — a lower and worse obstruction. The observation is sound and so is the inference drawn from it.

Jonghaeng 種杏

2.11 Simple Medicinals 單方

2.11.1
Source원문

凡三十種. 有螺泥丸.

Translation영역
Thirty kinds in all. There is Snail Mud Pill.

Donguibogam · Guto

2.11.2
Source원문

黃丹 治反胃. 黃丹 一兩ㆍ白礬 二兩, 同入罐內火煆, 放冷爲末, 蒸餠和丸梧子大, 溫酒下五丸至七丸. 《綱目》

Translation영역
Minium (黃丹): Treats stomach reflux. Minium, 1 nyang, and alum, 2 nyang, put together in a crucible and calcined; let it cool, powder it, make pills the size of a paulownia seed with steamed cake, and give five to seven pills down with warm wine.
Clinical note임상 주석
**Minium is lead tetroxide. This must not be prepared.** Lead compounds taken by mouth cause cumulative poisoning — abdominal colic, anaemia, neuropathy — and the colic itself would be mistaken for the illness being treated.

Gangmok 綱目

2.11.3
Source원문

黑鉛 吐蟲而嘔者. 黑鉛炒成灰ㆍ檳榔等分爲末, 空心米飮調下. 《丹心》

Translation영역
Black lead (黑鉛): For one who vomits worms and retches. Black lead dry-fried to an ash, and areca, in equal parts, powdered and given stirred into rice water on an empty stomach.
Clinical note임상 주석
**Lead. This must not be prepared.** The indication — vomiting of worms — is real, and areca is a genuine anthelmintic; the lead was there because metals were thought to weigh the qi down. Modern anthelmintics are safe and effective.

Dansim 丹心

2.11.4
Source원문

滑石 治反胃積飮. 滑石末ㆍ生薑自然汁澄淸白脚, 和丸, 時時服之. ○暴吐逆, 滑石末溫水服二錢妙. 《本草》

Translation영역
Talc (滑石): Treats stomach reflux with accumulated fluid. Talc powder with the white settlings of the natural juice of fresh ginger, made into pills and taken from time to time. ○ For sudden vomiting with counterflow, 2 don of talc powder in warm water is excellent.

Boncho 本草

2.11.5
Source원문

赤石脂 治痰飮吐水成反胃. 石脂水飛, 每一錢, 空心以水ㆍ酒任下, 加至二三錢. 無則以好赤土代之. 《本草》

Translation영역
Halloysite (赤石脂): Treats phlegm fluid with vomiting of water that has become stomach reflux. Levigate the halloysite; 1 don each time on an empty stomach, taken down with water or wine as preferred, increasing to 2 or 3 don. If it is not to be had, good red earth may be used instead.

Boncho 本草

2.11.6
Source원문

人參 治反胃垂死者. 人參末 三錢ㆍ薑汁 五合ㆍ粟米 一合, 煮粥, 空心食之. ○又人參剉 二兩, 水煎頓服, 日再. 《本草》

Translation영역
Ginseng (人參): Treats stomach reflux where the patient is at the point of death. Ginseng powder, 3 don; ginger juice, 5 hop; millet, 1 hop — boil them to a gruel and have him eat it on an empty stomach. ○ Again, cut up 2 nyang of ginseng, decoct in water and give it all at once, twice a day.
Clinical note임상 주석
Ginseng powder boiled into a millet gruel with ginger juice: a medicated food rather than a medicine, and for a patient at the point of death from a condition that is starving him it is the right instinct. The second method, 2 nyang of ginseng decocted twice a day, is a very large dose by any standard.

Boncho 本草

2.11.7
Source원문

生薑 凡嘔吐皆因氣逆, 故用生薑之辛以散之. ○反胃嘔吐, 生薑汁煮粟米粥食之. ○乾嘔, 服薑汁一升卽差. 《本草》

Translation영역
Fresh ginger (生薑): All vomiting comes of qi counterflow, and so the acridity of fresh ginger is used to disperse it. ○ For stomach reflux with vomiting, boil a millet gruel with ginger juice and have the patient eat it. ○ For dry retching, a seung of ginger juice taken brings relief at once.
Clinical note임상 주석
Ginger for nausea is the one piece of the chapter that has gone into modern practice on its own terms: it is a recognized antiemetic, used in pregnancy sickness and postoperative nausea, and the dose in trials is a good deal smaller than a seung of the juice.

Boncho 本草

2.11.8
Source원문

半夏 凡嘔噦用半夏者, 散結氣也. ○反胃嘔吐, 半夏 一兩(製)ㆍ生薑 二兩, 剉, 分二貼, 水煎服. ○嘔家用半夏, 以去其水, 水去則嘔自止. 《金匱》

Translation영역
Pinellia (半夏): Pinellia is used in all retching and hiccup to disperse the knotted qi. ○ For stomach reflux with vomiting, processed pinellia, 1 nyang, and fresh ginger, 2 nyang, cut up and divided into two packets, decocted in water. ○ In a vomiting patient pinellia is used to remove the water, and when the water is gone the vomiting stops of itself.
Clinical note임상 주석
Pinellia with ginger, in a two-to-one ratio of ginger to pinellia, is Sobanha-tang, the oldest antiemetic in the tradition and the ancestor of most of the chapter's formulas. The ginger is not only an adjuvant — it is the standard corrective for pinellia's toxicity, and the two are always given together for that reason. **Pinellia is toxic in the raw state and must be properly processed.**

Geumgwe 金匱

2.11.9
Source원문

蘆根 治乾嘔ㆍ噦及五噎ㆍ煩悶. 蘆根 五兩, 水煎頓服一升, 不過三升卽差. 《本草》

Translation영역
Reed root (蘆根): Treats dry retching and hiccup, and the five dysphagias with vexed oppression. Reed root, 5 nyang, decocted in water; give a seung at once, and no more than three seung are needed for relief.

Boncho 本草

2.11.10
Source원문

竹茹 主嘔啘. 取靑竹茹一升, 水煎頓服. ○嘔ㆍ噦用竹茹者, 澁胃解煩也. 《入門》

Translation영역
Bamboo shavings (竹茹): Governs retching and dry heaving. Take a seung of green bamboo shavings, decoct in water and give it all at once. ○ Bamboo shavings are used in retching and hiccup because they astringe the stomach and resolve vexation.

Immun 入門

2.11.11
Source원문

鯽魚 治反胃. 取大鯽魚, 去腸留膽, 入綠礬滿腹, 以火灸焦爲末, 每一錢, 米飮下, 日三. ○諸魚灰並主哽噎. 《本草》

Translation영역
Crucian carp (鯽魚): Treats stomach reflux. Take a large crucian carp, remove the gut but leave the gall, fill the belly with melanterite, roast it over the fire until charred and powder it; 1 don each time, taken down with rice water, three times a day. ○ The ash of any fish governs choking dysphagia.

Boncho 本草

2.11.12
Source원문

蚌蛤粉 治反胃吐食. 取爛粉, 米飮下一二錢. ○蜆爛殼ㆍ馬刀爛殼ㆍ田螺爛殼, 並主反胃, 燒灰和飮服. 《本草》

Translation영역
Clam shell powder (蚌蛤粉): Treats stomach reflux with vomiting of food. Take the weathered powder and give 1 or 2 don down with rice water. ○ Weathered corbicula shell, weathered razor-clam shell and weathered field-snail shell all govern stomach reflux: burn them to an ash and give it stirred into a drink.
Clinical note임상 주석
Burnt shell is calcium carbonate, and a chalky powder in rice water is an antacid. Given for reflux it would have done something for the heartburn, which is probably why the entry lists four different shells as interchangeable — what mattered was the lime, not the animal.

Boncho 本草

2.11.13
Source원문

蝟 主反胃吐逆. 取肉淹五味灸食; 皮燒灰和酒服亦可, 煮汁飮. 《本草》

Translation영역
Hedgehog (蝟): Governs stomach reflux with vomiting and counterflow. Take the flesh, season it with the five flavours, roast it and eat it; or the skin may be burnt to an ash and taken in wine, or boiled and the liquid drunk.

Boncho 本草

2.11.14
Source원문

橘皮 治反胃嘔吐. 橘皮用日照西方壁土末同炒香, 取皮爲末, 每二錢, 淡薑湯煎服. 《直指》

Translation영역
Tangerine peel (橘皮): Treats stomach reflux with vomiting. Dry-fry the tangerine peel with powdered earth from a west-facing sunlit wall until fragrant, take the peel and powder it, and give 2 don each time decocted in weak ginger decoction.

Jikji 直指

2.11.15
Source원문

木瓜 止嘔逆. 煮汁飮之佳, 生薑同煎服尤妙. ○榠樝去惡心乾嘔, 煎服之. 《本草》

Translation영역
Quince (木瓜): Stops vomiting with counterflow. Boiling it and drinking the liquid is good, and decocting it with fresh ginger is better still. ○ Chinese quince dispels nausea and dry retching; decoct it and take it.

Boncho 本草

2.11.16
Source원문

蒲萄根 止嘔噦. 濃煎取汁, 細細飮之佳. 《本草》

Translation영역
Grape root (蒲萄根): Stops retching and hiccup. Decoct it strong, strain, and it is good drunk a little at a time.

Boncho 本草

2.11.17
Source원문

獼猴桃 治熱壅反胃. 取汁和薑汁服之. ○藤汁至滑, 主胃閉吐逆, 煎取汁和薑汁服之甚佳. 《本草》

Translation영역
Kiwi fruit (獼猴桃): Treats stomach reflux from heat blockage. Take the juice and give it mixed with ginger juice. ○ The juice of the vine is extremely slippery and governs a closed stomach with vomiting and counterflow; decoct it, strain and give the liquid mixed with ginger juice, which is very good.
Clinical note임상 주석
至滑, extremely slippery, is why the vine juice is chosen: a mucilaginous liquid for a patient whose gullet will not pass anything. It is the same reasoning as Yunjang-go's, and the same instinct a modern dietitian follows in thickening or lubricating what a dysphagic patient swallows.

Boncho 本草

2.11.18
Source원문

杵頭糠 主噎食不下ㆍ咽喉塞. 取細糠蜜丸彈子大, 含化嚥之. ○又細糠 一兩, 白粥淸調服. 《入門》

Translation영역
Pestle-head bran (杵頭糠): Governs food blocked and not going down, and a stopped throat. Take the fine bran, make pills the size of a bullet with honey, and let the patient hold one in the mouth to dissolve and swallow it. ○ Again, 1 nyang of the fine bran, stirred into the clear of a white gruel and taken.

Immun 入門

2.11.19
Source원문

甖子粟 治反胃食不下. 和竹瀝煮作粥食之, 大佳. 《本草》

Translation영역
Poppy seed (甖子粟): Treats stomach reflux with food not going down. Boil it with bamboo sap into a gruel and have the patient eat it; very good.
Clinical note임상 주석
甖子粟 is the seed of the opium poppy, and 2.8's own account of the treatment names it as 御米, used 以解毒. The seed itself carries only traces of the alkaloids, so a gruel of it is food rather than an opiate — but in a patient with an obstructed gullet the relief of pain would not have gone unnoticed. **Poppy preparations are controlled substances.**

Boncho 本草

2.11.20
Source원문

蓴 和鯽魚作羹食之, 主反胃食不下, 止嘔. 《本草》

Translation영역
Water shield (蓴): Made into a soup with crucian carp and eaten, it governs stomach reflux with food not going down, and stops retching.

Boncho 本草

2.11.21
Source원문

老牛口中涎 主反胃噎膈. 取少許和水服之, 終身不噎. ○口中齝丑之切草絞取汁服, 止噎. 《本草》

Translation영역
The drool from an old ox's mouth (老牛口中涎): Governs stomach reflux and dysphagia with blockage. Take a little, mix it with water and give it, and the patient will never be choked again. ○ The cudread chi from its mouth, wrung out for the juice and given, stops the choking.
Clinical note임상 주석
**Not to be prepared.** Ruminant saliva and cud carry a range of pathogens, and the patient this is offered to is already unable to eat.

Boncho 本草

2.11.22
Source원문

驢尿 主反胃吐不止ㆍ朝夕垂絶. 取熱尿服二合, 再服便定, 七日永差. 稍有毒, 不可多服. 《本草》

Translation영역
Donkey's urine (驢尿): Governs stomach reflux with unceasing vomiting, where the patient is at the point of expiring from one day to the next. Take 2 hop of the urine warm; a second dose settles it, and in seven days there is a lasting cure. It is somewhat poisonous and must not be taken in quantity.
Clinical note임상 주석
稍有毒, 不可多服 — somewhat poisonous, not to be taken in quantity — is the Boncho's own warning, and 2.8 repeats the material with a reason attached: 飮酒者加砂糖驢尿入內服以防生蟲, against worms. **Not to be prepared.**

Boncho 本草

2.11.23
Source원문

牛乳 治反胃噎膈要藥. 韭汁 二盞ㆍ牛乳 一盞ㆍ竹瀝 半盞ㆍ童便 一盞ㆍ生薑 半兩(取汁), 右和勻頓服. 《醫鑑》 ○一人病反胃大便燥, 此精血耗竭也. 先以甘蔗汁煮六君子湯方見痰門加附子ㆍ大黃服, 且令飮牛乳, 勿食諸物, 半月大便潤而愈. 《丹心》

Translation영역
Cow's milk (牛乳): An essential drug for stomach reflux and dysphagia with blockage. Chinese chive juice, 2 cups; cow's milk, 1 cup; bamboo sap, half a cup; a boy's urine, 1 cup; fresh ginger, half a nyang, for its juice — mix them evenly and give all at once. ○ A man was ill with stomach reflux and a dry stool, which was the exhaustion of his essence and blood. He was first given Six Gentlemen Decoctionthe formula is given in the Phlegm chapter boiled with sugarcane juice, with aconite and rhubarb added, and was made to drink cow's milk and eat nothing else; in half a month the stool was moistened and he was cured.
Clinical note임상 주석
A case report, and the treatment that worked in it was the diet: milk and nothing else for half a month. For a patient with a partial obstruction who was starving and constipated, an exclusively liquid high-calorie diet is exactly right, and the chapter has arrived at it empirically. 2.8 says the same thing in the form of a recommendation — 多飮牛羊乳爲上策, drinking cow's or sheep's milk freely is the best policy.

Dansim 丹心

2.11.24
Source원문

田螺 治反胃. 大田螺多取, 新水養之, 待吐出泥, 澄去淸水, 以灰鋪篩上, 用皮紙覆灰上, 傾此泥於紙上, 待半乾, 作丸梧子大, 每三十丸, 藿香湯呑下立愈, 名曰螺泥丸. 其螺放於水中, 殺食無效. 《綱目》

Translation영역
Field snail (田螺): Treats stomach reflux. Take a quantity of large field snails and keep them in fresh water until they void their mud; pour off the clear water, spread ash on a sieve, cover the ash with a sheet of bark paper, pour the mud onto the paper, and when it is half dry make pills the size of a paulownia seed. Thirty pills each time, swallowed down with patchouli decoction, and the patient is cured on the spot; it is called Snail Mud Pill. The snails are to be put back in the water; killing and eating them has no effect.

Gangmok 綱目

2.11.25
Source원문

螃蛤 治反胃噎膈. 取螃蛤洗淨, 入水中高四指, 以香油小酒鍾入水中二指, 捻白麪撒水上, 涎卽出. 次日去蛤留水, 晒乾, 涎爲末, 每服 五分, 淡燒酒調下卽效. 《醫鑑》

Translation영역
Freshwater clam (螃蛤): Treats stomach reflux and dysphagia with blockage. Wash the clams clean and put them in water four fingers deep; add two fingers' depth of sesame oil from a small wine cup into the water, sprinkle a pinch of white flour on the surface, and the slime comes out at once. Next day take the clams out, keep the water, dry it in the sun, powder the slime, and give 5 fun each dose stirred into weak distilled spirits; it works at once.

Uigam 醫鑑

2.11.26
Source원문

馬剝兒 一名馬匏兒, 卽王瓜也. 治噎膈反胃. 燒存性爲末, 每一錢, 和棗肉平胃散 二錢, 溫酒調服, 食則可下, 然後隨證調理. ○一方, 只燒存性, 米飮調服二錢. 《正傳》

Translation영역
Snake gourd (馬剝兒), also called mapoa, that is, wanggwa: treats dysphagia with blockage and stomach reflux. Burn it with its nature preserved and powder it; 1 don each time with 2 don of Jujube Flesh Level the Stomach Powder, given stirred into warm wine, and then food can go down, after which treat according to the pattern. ○ One formula: simply burn it with its nature preserved and give 2 don stirred into rice water.

Jeongjeon 正傳

2.11.27
Source원문

炊乾飯 治膈噎久不納穀. 取隔年炊乾飯, 以急流順水煮爛, 取汁時時飮之, 待能食以藥調治. 《正傳》

Translation영역
Dried cooked rice (炊乾飯): Treats blockage dysphagia where no grain has been taken for a long while. Take rice cooked and dried the year before, boil it soft in swift downstream water, and let the patient drink the liquid from time to time; when he can eat, treat with medicines.
Clinical note임상 주석
Rice water sipped continuously until the patient can eat, and only then medicine. In a chapter full of arsenic and quicklime this is the entry that reads like modern management: keep the calories and fluid going by the route that still works, and leave the treatment until the patient can take it.

Jeongjeon 正傳

2.11.28
Source원문

雞穀袋 治噎. 取袋不以多少, 不可失包內一物, 用泥固濟, 火煆存性, 每袋一箇, 入薑炒香附末 半兩ㆍ神麴糊和丸梧子大, 薑湯呑下, 空心. 《綱目》

Translation영역
Chicken crop (雞穀袋): Treats dysphagia. Take as many crops as you like, taking care to lose nothing of what is inside them, seal them with clay, and calcine them in the fire with their nature preserved; to each crop add half a nyang of cyperus powder dry-fried with ginger, make pills the size of a paulownia seed with leaven paste, and swallow them down with ginger decoction on an empty stomach.

Gangmok 綱目

2.11.29
Source원문

猫胎衣 治反胃. 取猫生子胎衣, 陰乾燒爲末, 酒調服甚效. 猫生子急取之, 稍遲則猫食之矣. 《種杏》

Translation영역
Cat's placenta (猫胎衣): Treats stomach reflux. Take the placenta of a cat that has just given birth, dry it in the shade, burn it to a powder and give it stirred into wine; very effective. Take it quickly when the cat has littered, for if you are slow the cat will eat it.
Clinical note임상 주석
**Not to be prepared.** Cat tissue carries Toxoplasma gondii, among other organisms, and the placenta is the most heavily infected part.

Jonghaeng 種杏

2.11.30
Source원문

狗膽 治反胃吐黃沫. 辰砂 一兩ㆍ大黃 二兩爲末, 狗膽浸二日, 乾再爲末, 麪糊和丸梧子大, 空心鹽湯下三十丸. 《種杏》

Translation영역
Dog's gall (狗膽): Treats stomach reflux with vomiting of yellow froth. Cinnabar, 1 nyang, and rhubarb, 2 nyang, powdered and steeped two days in dog's gall, dried and powdered again, made into pills the size of a paulownia seed with flour paste; thirty pills on an empty stomach with salt water.
Clinical note임상 주석
**Contains cinnabar, which is mercuric sulfide. This must not be prepared.** The indication is the yellow froth of 2.10's last passage, which the chapter has just called untreatable.

Jonghaeng 種杏

2.11.31
Source원문

蝎虎 治噎食反胃. 取活蝎虎一箇, 入燒酒內浸七日, 火上溫之, 去蝎虎飮酒卽愈. ○又雄雞餓一日, 却取蝎虎切爛與雞喫, 取其糞焙乾爲末, 每一錢, 燒酒調下. 《回春》

Translation영역
Gecko (蝎虎): Treats dysphagia with blockage and stomach reflux. Take one live gecko, steep it seven days in distilled spirits, warm it over the fire, remove the gecko and drink the spirits, and the patient is cured. ○ Again, starve a cock for a day, then chop a gecko up and let the cock eat it; take its droppings, bake them dry and powder them, and give 1 don each time stirred into distilled spirits.
Clinical note임상 주석
**Not to be prepared.** The second method — feeding a gecko to a starved cock and giving the bird's droppings — is the furthest the chapter goes, and it belongs with the dung-ball elixir of 2.8 as a measure of how little could be done for this illness.

Hoechun 回春

2.12 Needling and Moxa Methods 鍼灸法

2.12.1
Source원문

嘔吐無度幷乾嘔不止, 尺澤ㆍ大陵皆灸三壯; 又灸乳下 一寸三十壯; 又灸間使三十壯. 若四肢厥冷ㆍ脉沉絶, 灸間使便通, 此回生起死之法. 《得效》

Translation영역
For vomiting without measure and dry retching that will not stop, give three cones of moxa at cheokteak and at daereung both; also thirty cones one inch below the nipple; also thirty cones at gansa. If the four limbs are cold in reversal and the pulse sunken and cut off, moxa at gansa opens it through — this is the method of calling the dying back to life.
Clinical note임상 주석
Cheokteak is LU-5 at the elbow crease, daereung PC-7 at the wrist, gansa PC-5 on the forearm; all three are on the arm, which is where the chapter needles for vomiting. The point one inch below the nipple is the 乳根 region, ST-18.

Deukhyo 得效

2.12.2
Source원문

善嘔ㆍ嘔有苦者, 邪在膽, 逆在胃, 取三里ㆍ陽陵泉. 《內經》

Translation영역
One who retches often and whose retching is bitter has the evil in the gallbladder and the counterflow in the stomach: take samni and yangneungcheon.
Clinical note임상 주석
嘔有苦 — the retching is bitter — is bile in the vomit, and the Inner Classic reads it precisely as the gallbladder's involvement with the vomiting itself in the stomach. The two points chosen are ST-36 samni, the stomach's own, and GB-34 yangneungcheon, the gallbladder's, which is the diagnosis turned straight into a prescription.

Naegyeong 內經

2.12.3
Source원문

吐食不化, 取上脘ㆍ中脘ㆍ下脘. 《東垣》

Translation영역
For vomiting of food undigested, take sangwan, junggwan and hagwan.

Dongwon 東垣

2.12.4
Source원문

反胃神效, 膏肓兪灸百壯, 亶中ㆍ三里各灸七壯. 《回春》

Translation영역
For stomach reflux, wonderfully effective: a hundred cones of moxa at gohwangyu, and seven each at danjung and samni.

Hoechun 回春

2.12.5
Source원문

又取勞宮ㆍ中魁ㆍ腕骨ㆍ心兪ㆍ中脘. 《綱目》

Translation영역
Again, take nogung, junggoe, wangol, simyu and junggwan.

Gangmok 綱目

2.12.6
Source원문

今日食明日吐, 取心兪ㆍ膈兪ㆍ亶中ㆍ巨闕ㆍ中脘. 《綱目》

Translation영역
Where food eaten today is vomited tomorrow, take simyu, gyeogyu, danjung, geogwol and junggwan.

Gangmok 綱目

2.12.7
Source원문

五噎ㆍ五膈, 取天突ㆍ亶中ㆍ心兪ㆍ上脘ㆍ中脘ㆍ下脘ㆍ脾兪ㆍ胃兪ㆍ通關ㆍ中魁ㆍ大陵ㆍ三里. 《綱目》

Translation영역
For the five dysphagias and five blockages, take cheondol, danjung, simyu, sangwan, junggwan, hagwan, biyu, wiyu, tonggwan, junggoe, daereung and samni.

Gangmok 綱目

2.12.8
Source원문

反胃, 灸肩井三壯卽愈, 乃神灸也. 《回春》

Translation영역
For stomach reflux, three cones of moxa at gyeonjeong cure it at once; this is a divine moxibustion.

Hoechun 回春

2.12.9
Source원문

又取水分ㆍ氣海灸之. 《資生》

Translation영역
Again, take subun and gihae and moxa them.
Clinical note임상 주석
The points through the section run down the front of the trunk — CV-22 cheondol at the throat, CV-17 danjung between the nipples, CV-13 sangwan, CV-12 junggwan and CV-10 hagwan over the stomach, CV-9 subun and CV-6 gihae below the navel — with their matching points on the back, 心兪 BL-15, 膈兪 BL-17, 脾兪 BL-20 and 胃兪 BL-21. The front-and-back pairing over the stomach is the standard arrangement for a visceral complaint, and 膏肓兪 BL-43 with a hundred cones is the chapter's one heroic prescription.

Jasaeng 資生

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 5, Vomiting chapter. The Chinese text is collated against the Kyujanggak transcription of the 1613 edition; collation notes are given on the passages they concern. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.