Formulas · Text · Donguibogam 東醫寶鑑

Internal Damage

Naesang

한글 내상 · Pinyin Nei Shang

Damage from within — food, drink and taxation, and the two causes that must never be treated alike

內傷

The longest chapter in the volume and the one a practitioner reaches for most. It opens not with a disease but with a principle: the body is kept by food, and illness is relieved by medicine, and a physician who does not know which comes first cannot preserve a life. From there the chapter makes the division everything else rests on. Internal damage has two causes — food and drink on one side, taxation and fatigue on the other — and Wang Andao's passage at 1.4 insists they must not be confounded. Taxation damage is pure insufficiency; food damage carries insufficiency and surplus together, and the two are sorted by asking what happened and by pressing below the heart, which hurts in food damage and does not in taxation. Dongwon's whole formulary follows from that. What comes after is a long and practical middle: what food damage looks like, how to disperse it and when instead to supplement, then drink and its diseases, then taxation and the raising formulas, then the failures of appetite, then the complaints that grow out of all of it — acid swallowing, clamouring, belching, dysphagia, stomach reflux. The chapter ends with regimen, diet, thirty-seven simples and the acupuncture method.

1.1 Food and Medicine in the Treatment of Disease 食藥療病

1.1.1

Source원문

安身之本, 必須於食, 救疾之道, 惟在於藥. 不知食宜者, 不足以全生, 不明藥性者, 不能以除病. 故食能排邪而安藏府, 藥能恬神養性以資血氣. 爲人子者, 不可不知此二事. 是故君父有疾, 期先命食以療之, 食療不愈, 然後命藥. 故孝子深知食藥二性可也. 《千金》

Translation영역

The root of settling the body lies necessarily in food; the way of rescuing from disease lies only in medicine. One who does not know what food is fitting is not equal to preserving a life; one who does not understand the natures of medicines cannot remove disease. Food can drive off evil and settle the viscera and bowels; medicine can calm the spirit and nourish the nature so as to supply the blood and qi. A son must not fail to know these two things. Therefore when a ruler or a father falls ill, food should first be ordered to treat it, and only when treatment by food does not cure is medicine ordered. A filial son should therefore know deeply the natures of both food and medicine.

Clinical note임상 주석

The chapter opens by setting food before medicine, and the order is not rhetorical: food is ordered first, and medicine only when food has failed. Sun Simiao states it as a rule of practice, and the whole of this chapter follows from it — the treatment sections at 1.7 and 1.9 keep returning to whether a patient should be dispersed or simply fed. The framing is filial rather than professional. The reader addressed is a son caring for a parent, not a physician, which is why the passage insists on knowing both natures.

Cheongeum 千金

1.2 Water and Grain Are the Root of Nourishing Life 水穀爲養命之本

1.2.1

Source원문

天地間養人性命者惟五穀耳, 備土之德, 得氣之中和. 故其味淡甘而性和平, 大補而滲泄, 乃可久食而無厭, 是大有功於人者. 在藥則不然, 雖參ㆍ芪性亦偏, 況攻擊者乎. 《丹心》

Translation영역

Between heaven and earth, what nourishes human nature and life is the five grains alone. They possess the virtue of earth and obtain the centred harmony of qi, and so their flavour is bland and sweet and their nature harmonious and level; they greatly supplement while percolating away, and may be eaten long without weariness. In this they are of great merit to people. With medicines it is not so: even ginseng and astragalus are partial in nature — how much more those that attack.

Clinical note임상 주석

雖參ㆍ芪性亦偏 — even ginseng and astragalus are partial — is the sentence to carry. The argument is that every medicine leans one way and grain does not, which is why grain can be eaten daily for a lifetime and medicine cannot. Danxi is warning against the long-term tonic taken as food, and the point still holds where patients take supplementing formulas indefinitely.

Dansim 丹心

1.2.2

Source원문

世俗以肉爲補性之物, 然肉無補性, 惟補陽. 而今之虛損者, 不在於陽而在於陰, 以肉補陰, 猶緣木而求魚也. 《丹心》

Translation영역

Common opinion takes meat for a thing that supplements the nature. But meat has no supplementing nature; it supplements only the yang. And those who suffer vacuity detriment today are deficient not in yang but in yin — to supplement yin with meat is like climbing a tree to seek fish.

Clinical note임상 주석

緣木求魚, climbing a tree to seek fish, is from the Mencius and means an effort wrongly directed rather than merely wasted. Danxi's position throughout is that his contemporaries were yin-deficient and treated themselves as though they were yang-deficient.

Dansim 丹心

1.2.3

Source원문

諺有之曰, 人無根本, 水食爲命. 盖脾胃屬土, 主納水穀, 人之根本也. 《丹心》

Translation영역

There is a saying: a person has no root of their own; water and food are their life. For the spleen and stomach belong to earth and govern the taking in of water and grain, and they are the root of a person.

Dansim 丹心

1.3 The Essence of Water and Grain Transforms into Yin and Yang and Moves the Construction and Defence 水穀之精化陰陽行榮衛

1.3.1

Source원문

食氣入胃, 濁氣歸心, 淫精於脉. 脉氣流經, 經氣歸於肺, 肺朝百脉, 輸精於皮毛. 毛脉合精, 行氣於府, 府精神明, 留於四藏, 氣歸於權衡, 權衡以平, 氣口成寸, 以決死生.

Translation영역

The qi of food enters the stomach; the turbid qi returns to the heart and floods essence into the vessels. The vessel qi flows through the channels, the channel qi returns to the lung, the lung holds audience with the hundred vessels and conveys essence to the skin and body hair. Hair and vessel join their essence and move qi to the bowels; the essence of the bowels, spirit-bright, lodges in the four viscera; the qi returns to the balance, and the balance being level, the qi opening forms the inch, by which life and death are decided.

Naegyeong 內經

1.3.2

Source원문

飮入於胃, 游溢精氣, 上輸於脾. 脾散精, 上歸於肺, 通調水道, 下輸膀胱. 水精四布, 五經幷行, 合於四時五藏陰陽, 揆度以爲常也. 《內經》

Translation영역

Drink enters the stomach, the essential qi floats and overflows, and is conveyed upward to the spleen. The spleen scatters the essence, which returns upward to the lung; the lung frees and regulates the waterways and conveys downward to the bladder. The water essence spreads in the four directions, the five channels move together, and this accords with the four seasons and the yin and yang of the five viscera. Measured and reckoned, it is taken as the norm.

Clinical note임상 주석

The Suwen's account of fluid metabolism, and the sequence is the one the Oedema and Phlegm- Rheum chapters both build on: stomach to spleen, spleen to lung, lung to bladder. Where any step fails, fluid stands — which is why the Oedema chapter treats the lung and spleen for a disease of water.

Naegyeong 內經

1.3.3

Source원문

帝曰, 榮衛之行, 柰何. 伯高曰, 穀始入于胃, 其精微者, 先出于胃, 之兩焦, 以漑五藏, 別出兩行, 榮衛之道. 其大氣之薄而不行者, 積于胸中, 命曰氣海, 出于肺, 循咽喉, 故呼則出, 吸則入. 天地之精氣, 其大數常出三入一. 故穀不入, 半日則氣衰, 一日則氣少矣. 《靈樞》

Translation영역

The Yellow Emperor said: how do the construction and defence travel? Bo Gao said: grain first enters the stomach, and its essential and subtle part comes out of the stomach first, goes to the two burners and irrigates the five viscera; then it divides and issues in two courses, the paths of construction and defence. What is thin in the great qi and does not travel gathers in the chest and is called the sea of qi; it issues from the lung and follows the throat, so that on exhaling it goes out and on inhaling it comes in. Of the essential qi of heaven and earth, the general reckoning is that three parts go out for one that comes in. Therefore if grain does not enter, in half a day the qi declines, and in a day it is scant.

Clinical note임상 주석

穀不入, 半日則氣衰, 一日則氣少 — if grain does not enter, in half a day the qi declines and in a day it is scant. The Lingshu puts a timescale on it, and the figure of three parts spent for one taken in is the reason: the body is always running at a deficit that food alone makes good. This is the physiological ground for the chapter's insistence that a patient who cannot eat is in urgent trouble however well they look.

Yeongchu 靈樞

1.3.4

Source원문

平人穀入於胃, 脉道乃行, 水入於經, 其血乃成. 水去則榮散, 穀消則衛亡, 榮散衛亡, 神無所依. 《綱目》

Translation영역

In a normal person, grain enters the stomach and the vessel pathways then move; water enters the channels and the blood is then formed. Water gone, the construction scatters; grain consumed, the defence perishes; construction scattered and defence perished, the spirit has nothing to rest on.

Gangmok 綱目

1.3.5

Source원문

水穀入胃, 其濁者爲渣滓, 下出幽門, 達大小腸而爲糞, 以出於穀道. 其淸者, 倏然而化爲氣, 依脾氣而上升於肺. 其至淸而至精者, 由肺而灌漑乎四體, 而爲汗涎津唾, 助血脉益氣力, 爲生生不息之運用也. 其淸中之濁者, 下入膀胱而爲尿, 以出乎小便耳. 其未入而在膀胱之外者, 尙爲濁氣, 旣入而在膀胱之內者, 卽化爲水也. 《正傳》

Translation영역

Water and grain enter the stomach. What is turbid becomes dregs, passes down through the dark gate, reaches the large and small intestines and becomes stool, issuing by the grain path. What is clear is transformed in an instant into qi and rises with the spleen qi to the lung. What is clearest and most essential passes from the lung to irrigate the four limbs, becoming sweat, drool, humour and spittle, aiding the blood vessels and boosting the strength of the qi — the working of an engendering that does not cease. What is turbid within the clear descends into the bladder and becomes urine, issuing by the small passage. What has not yet entered and lies outside the bladder is still turbid qi; once it has entered and lies within the bladder, it is at once transformed into water.

Clinical note임상 주석

The last clause is the chapter's most literal statement of a doctrine that puzzles readers: urine does not flow into the bladder but is transformed into water at the moment of entering it. That is why the tradition treats urinary retention as a failure of qi transformation rather than of plumbing, and why the Oedema chapter's formulas warm the qi to make water pass.

Jeongjeon 正傳

1.4 Internal Damage Has Two Causes — Food Damage and Taxation Damage 內傷有飮食傷勞倦傷二因

1.4.1

Source원문

飮養陽氣, 食養陰氣. 飮食無過, 則入於口, 達於脾胃, 入於鼻, 藏於心肺, 氣味相承, 陰陽和調, 神乃自生. 盖精順五氣以爲靈, 若食氣相惡, 則傷其精神. 受五味以成體, 若食味不調, 則傷其形也. 《入門》

Translation영역

Drink nourishes the yang qi; food nourishes the yin qi. Where food and drink are not excessive, they enter by the mouth and reach the spleen and stomach, enter by the nose and are stored in the heart and lung; qi and flavour succeed one another, yin and yang are harmonious and regulated, and the spirit is engendered of itself. For the essence follows the five qi to become spirit-light, and if the qi of food is at odds with it, the essence and spirit are damaged. It receives the five flavours to form the body, and if the flavours of food are not regulated, the form is damaged.

Immun 入門

1.4.2

Source원문

夫胃爲淸純冲和之氣, 人之所賴以爲生者也. 若謀慮神勞, 動作形苦, 嗜慾無節, 思想不遂, 飮食失宜, 藥餌違法, 皆能致傷. 旣傷之後, 須用調補. 恬不知怪, 而乃恣意犯禁, 舊染之證, 尙未消遣, 方生之證, 與日俱積. 吾見醫藥將日不暇給, 而傷敗之胃氣無復完全之望, 去死近矣. 《東垣》

Translation영역

The stomach is a qi clear, pure and harmonious, on which a person depends for life. If planning and worry tax the spirit, if movement and labour distress the form, if appetites and desires have no measure, if what is longed for is not attained, if food and drink lose what is fitting, if medicines are taken against the rules — all of these can bring damage. Once damaged, regulating and supplementing must be used. But calmly finding nothing strange in it, people give free rein to their wishes and break the prohibitions; the old contracted pattern has not yet been dispelled and new patterns accumulate by the day. I have seen medicine and treatment left with no spare day, while the damaged and ruined stomach qi has no further hope of being made whole — and death is near.

Clinical note임상 주석

Six causes of damage in one list — worry, overwork, appetite, frustrated longing, irregular eating and wrongly taken medicine — and the last of them names the physician's own contribution. 恬不知怪 — calmly finding nothing strange in it — describes the patient who does not regard their habits as the problem, and Dongwon's complaint is that treatment then never catches up.

Dongwon 東垣

1.4.3

Source원문

王安道曰, 勞倦傷飮食傷, 二者不可混而爲一. 勞倦傷, 誠不足也. 飮食傷, 尤當於不足之中, 分其有餘不足也. 何者, 盖飢餓不飮食, 與飮食太過, 雖皆失節, 然必明其兩者之分. 夫飢餓不飮食者, 胃氣空虛, 此爲不足, 固失節也. 飮食自倍而停滯者, 胃氣受傷, 此不足之中兼有餘, 亦失節也. 《東垣》

Translation영역

Wang Andao said: taxation damage and food damage — the two must not be confounded into one. Taxation damage is truly insufficiency. Food damage, moreover, must within its insufficiency have its surplus and insufficiency distinguished. Why so? Going hungry and not eating, and eating to great excess, both lose their measure, yet the division between the two must be made plain. One who goes hungry and does not eat has the stomach qi empty and void, and this is insufficiency, certainly a loss of measure. One who doubles their food so that it stands and stagnates has the stomach qi damaged, and this is a surplus within insufficiency, likewise a loss of measure.

Clinical note임상 주석

The passage the chapter is built on. Taxation damage is insufficiency and nothing else; food damage is insufficiency with a surplus inside it, because the stomach is weakened by the very thing that has accumulated. That is why the treatment sections split as they do: 1.7 disperses, 1.9 supplements, and 1.7.2 says most cases need both at once. Treating food damage as pure repletion empties the patient; treating it as pure vacuity feeds the accumulation.

Dongwon 東垣

1.4.4

Source원문

勞倦傷亦有二焉. 勞力純乎傷氣, 勞心兼傷乎血. 房勞傷腎, 與勞倦相似, 七情動氣, 脉與飮食無二.

Translation영역

Taxation damage is also of two kinds. Taxation of strength damages the qi purely; taxation of the heart damages the blood as well. Sexual taxation damages the kidney and resembles taxation fatigue; and where the seven affects stir the qi, the pulse is no different from that of food damage.

Clinical note임상 주석

The last clause is a warning about the limits of the pulse: emotional disturbance produces the same pulse as food damage. Where the two cannot be told apart at the wrist, the history and the abdomen decide — which is what the next passage supplies.

Immun 入門

1.4.5

Source원문

勞倦傷, 手按心口不痛, 飮食傷, 手按心口刺痛. 《入門》

Translation영역

In taxation damage, pressing below the heart with the hand gives no pain; in food damage, pressing below the heart gives stabbing pain.

Clinical note임상 주석

One manoeuvre, and it settles the chapter's central question. Press the epigastrium: pain means food, no pain means taxation. It is the most useful line in the chapter and the one that makes Wang Andao's distinction usable at the bedside. The Cold Damage chapter's differentiation at 1.36 turns on the same finding.

Immun 入門

1.5 Pulse Method 脉法

1.5.1

Source원문

趺陽脉浮而數, 浮則傷胃, 數則傷脾. 邪氣獨留心中卽飢, 邪熱不殺穀, 潮熱發渴.

Translation영역

Where the instep yang pulse is floating and rapid, floating means the stomach is damaged and rapid means the spleen is damaged. The evil qi lodging alone, there is hunger in the centre of the chest; the evil heat does not kill the grain, and there is tidal fever with thirst.

Junggyeong 仲景

1.5.2

Source원문

寸口脉弱而遲, 弱者, 衛氣微, 遲者, 榮中寒. 榮爲血, 血寒則發熱. 衛爲氣, 氣微者心內飢, 飢而虛滿, 不能食也.

Translation영역

Where the inch opening pulse is weak and slow, weak means the defence qi is faint and slow means there is cold within the construction. The construction is blood, and blood cold brings fever. The defence is qi, and where the qi is faint there is hunger within the heart — hunger with vacuous fullness, so that the patient cannot eat.

Clinical note임상 주석

飢而虛滿, 不能食 — hungry with a vacuous fullness so that the patient cannot eat — is a precise description and a common one: the appetite is present but the first mouthful is refused. The chapter reads it as qi too faint to receive rather than as obstruction.

Junggyeong 仲景

1.5.3

Source원문

寸口脉弱而緩, 弱者, 陽氣不足, 緩者, 衛氣有餘. 噫而呑酸, 食卒不下, 氣塡於膈上也. 註曰, 胃中有未消穀, 故噫而呑酸.

Translation영역

Where the inch opening pulse is weak and moderate, weak means the yang qi is insufficient and moderate means the defence qi is in surplus. There is belching with acid swallowing, food suddenly will not go down, and qi stuffs the region above the diaphragm. The commentary says: there is undigested grain in the stomach, and hence belching with acid swallowing.

Junggyeong 仲景

1.5.4

Source원문

寸口脉緊, 胸中有宿食不化.

Translation영역

Where the inch opening pulse is tight, there is retained food in the chest that has not been transformed.

Junggyeong 仲景

1.5.5

Source원문

脉緊如轉索無常者, 有宿食也. 《仲景》

Translation영역

Where the pulse is tight like a twisting rope, without constancy, there is retained food.

Clinical note임상 주석

如轉索 — like a twisting rope — is a rope being turned under the finger rather than lying still: tense and rolling. It is the Shanghan tradition's standing image for the retained-food pulse, and 無常, without constancy, is the part that distinguishes it from ordinary tightness.

Junggyeong 仲景

1.5.6

Source원문

陽脉滑而緊, 滑則胃氣實, 緊則脾氣傷, 得食不消者, 此脾不和也.

Translation영역

Where the yang pulse is slippery and tight, slippery means the stomach qi is replete and tight means the spleen qi is damaged; food taken is not digested, and this is the spleen out of harmony.

Dongwon 東垣

1.5.7

Source원문

脉浮滑而疾者, 食不消, 脾不磨也. 《東垣》

Translation영역

Where the pulse is floating, slippery and hurried, food is not digested — the spleen does not grind.

Clinical note임상 주석

脾不磨, the spleen does not grind, is the tradition's plainest image for the spleen's work: a millstone rather than an organ of absorption. The formulas for food damage are accordingly named for dispersing and conducting rather than for digesting.

Dongwon 東垣

1.5.8

Source원문

氣口緊盛, 爲傷於食, 食不消化, 浮滑而疾. 《脉訣》

Translation영역

Where the qi opening is tight and exuberant, it is damage from food; where food is not digested, the pulse is floating, slippery and hurried.

Maekgyeol 脉訣

1.5.9

Source원문

內傷勞役豁大不禁, 若損胃氣隱而難尋, 內傷飮食滑疾浮沈. 《脉訣》

Translation영역

In internal damage from taxation and labour the pulse is open and large without restraint; where the stomach qi is detrimented it is hidden and hard to find; in internal damage from food and drink it is slippery, hurried, floating and sunken.

Maekgyeol 脉訣

1.5.10

Source원문

右寸氣口脉, 急大而數, 時一代而澁, 此飮食失節, 勞役過甚, 太過之脉也.

Translation영역

Where the right inch qi opening pulse is urgent, large and rapid, at times intermittent and rough, this is food and drink losing their measure with taxation and labour carried to excess — a pulse of surplus.

Jeongjeon 正傳

1.5.11

Source원문

右關胃脉損弱, 甚則隱而不見. 但內顯脾脉之大數微緩時一代, 此飮食不節, 寒溫失所之脉也.

Translation영역

Where the right bar stomach pulse is detrimented and weak, and in severe cases hidden and not seen, but within it the spleen pulse appears large and rapid, faintly moderate and at times intermittent — this is a pulse of food and drink unregulated, with cold and warmth losing their proper places.

Jeongjeon 正傳

1.5.12

Source원문

右關脉沈而滑, 此宿食不消之脉也. 《正傳》

Translation영역

Where the right bar pulse is sunken and slippery, this is the pulse of retained food not digested.

Jeongjeon 正傳

1.5.13

Source원문

宿食不消, 則獨右關脉沈而滑. 經云, 脉滑者, 有宿食也. 《丹心》

Translation영역

Where retained food is not digested, the right bar pulse alone is sunken and slippery. The classic says: a slippery pulse means there is retained food.

Clinical note임상 주석

Ten of these thirteen lines read the right hand — the inch for the qi opening, the bar for the spleen and stomach. That concentration is the section's real content: internal damage is read on the right where external contraction is read on the left. 獨右關脉沈而滑 — the right bar alone — is the finding that confirms retained food when everything else is unremarkable.

Dansim 丹心

1.6 The Patterns of Food Damage 食傷證

1.6.1

Source원문

飮食自倍, 腸胃乃傷.

Translation영역

Where food and drink are doubled, the intestines and stomach are damaged.

Naegyeong 內經

1.6.2

Source원문

水穀之寒熱, 感則害人六府.

Translation영역

The cold and heat of water and grain, when contracted, harm a person's six bowels.

Naegyeong 內經

1.6.3

Source원문

因而飽食, 筋脉橫解, 腸澼爲痔.

Translation영역

Eating to repletion, the sinews and vessels slacken crosswise, and intestinal afflux becomes haemorrhoids.

Naegyeong 內經

1.6.4

Source원문

陰之所生, 本在五味, 陰之五宮, 傷在五味. 註曰, 陰謂五藏也. 《內經》

Translation영역

What engenders the yin has its root in the five flavours; the five palaces of yin are damaged by the five flavours. The commentary says: yin means the five viscera.

Clinical note임상 주석

The same five flavours both engender the viscera and damage them, and the difference is only measure. That symmetry is the Neijing's argument for regulation rather than avoidance, and the chapter's dietary section at 1.32 develops it flavour by flavour.

Naegyeong 內經

1.6.5

Source원문

傷食之證, 氣口脉必緊盛, 胸膈必痞塞, 噫氣如敗卵氣臭, 亦有頭痛身熱, 但身不痛爲異耳. 《丹心》

Translation영역

In the pattern of food damage, the qi opening pulse must be tight and exuberant, the chest and diaphragm must be blocked with glomus, and the belching smells like a rotten egg. There may also be headache and fever, but the body not aching is what distinguishes it.

Clinical note임상 주석

但身不痛爲異 — the body not aching is what distinguishes it — separates food damage from an exterior contraction that presents the same way. Fever and headache belong to both; generalized body ache belongs only to the exterior pattern. 噫氣如敗卵, belching like a rotten egg, is sulphurous eructation from fermenting food, and it is the confirmatory sign. The section at 1.36 uses the same pair of findings.

Dansim 丹心

1.6.6

Source원문

傷食因多飡. 飮食不能運化, 停於胸腹, 飽悶惡食不食, 噯氣作酸, 下泄臭屁, 或腹痛吐瀉. 重則發熱頭痛, 左手關脉平和, 右手關脉緊盛, 此傷食也.

Translation영역

Food damage comes of eating much. Food and drink cannot be moved and transformed but stand in the chest and abdomen; there is oppressive fullness, aversion to food and refusal to eat, belching that turns acid, foul wind passed below, or abdominal pain with vomiting and diarrhoea. In severe cases there is fever and headache. The left bar pulse is harmonious and level while the right bar pulse is tight and exuberant — this is food damage.

Clinical note임상 주석

惡食不食 — aversion to food and refusal to eat — is the distinguishing symptom, and it is stronger than poor appetite. A patient with food damage is repelled by food; one with taxation damage would eat if they could. The two-hand comparison is the practical test: left bar normal, right bar tight.

Hoechun 回春

1.6.7

Source원문

盖食物飽甚, 耗氣非一. 或食不下而上涌, 嘔吐以耗靈源, 或飮不消而作痰, 咯唾以耗神水. 大便頻數而泄, 耗穀氣之化生, 溲便滑利而濁, 耗源泉之浸潤. 至於精淸冷而下漏, 汗淋瀝而自泄, 莫不由食物之過傷, 滋味之太厚也. 《回春》

Translation영역

Eating to great repletion wastes the qi in more ways than one. Food that will not go down surges upward, and vomiting wastes the spirit source; drink that is not digested becomes phlegm, and hawking and spitting waste the spirit water. Stool frequent and loose wastes the engendering transformation of grain qi; urine slippery and turbid wastes the soaking and moistening of the source spring. Even essence thin and cold leaking below, and sweat dripping and pouring out of itself, all come of damage from excess of food and richness of flavour.

Clinical note임상 주석

Six routes of loss traced to one cause — vomiting, spitting, loose stool, turbid urine, seminal leakage and spontaneous sweat. The chapter's claim is that overeating does not merely burden the stomach but drains the body through whatever channel lies open.

Hoechun 回春

1.6.8

Source원문

凡飽則傷肺, 飢則傷氣. 《得效》

Translation영역

In general, repletion damages the lung and hunger damages the qi.

Deukhyo 得效

1.7 The Treatment Method for Food Damage 食傷治法

1.7.1

Source원문

食者, 有形之物, 傷之則宜損其穀. 其次莫若消導. 丁香爛飯丸ㆍ枳朮丸之類主之. 稍重則攻化, 三稜消積丸ㆍ木香見睍丸之類主之. 尤重則或吐之, 或下之. 《丹心》

Translation영역

Food is a thing that has form; where it has caused damage, the grain should be reduced. Next to that, nothing is better than dispersing and conducting — Clove Overcooked Rice Pill and Bitter Orange and Atractylodes Pill and their kind govern it. Somewhat more severe, attack and transform: Sparganium Disperse Accumulation Pill and Costus See the Sun Pill and their kind govern it. More severe still, either induce vomiting or purge.

Clinical note임상 주석

Four degrees in one line, and the first is not a medicine: reduce the food. Only when that fails does the chapter reach for dispersing formulas, then attacking ones, then emesis or purging. That ladder governs the whole formulary of 1.8, and it is the practical form of the principle stated at 1.1 — food first, medicine after.

Dansim 丹心

1.7.2

Source원문

夫飢餓不飮食, 與飮食太過, 雖皆失節, 然必明其兩者之分. 夫飢餓胃虛, 此爲不足, 飮食停滯者, 此爲有餘. 惟其不足故補益, 惟其有餘故消導, 人之盛衰不同, 又有物滯氣傷, 必須補益消導兼行者. 亦有物暫滯而氣不甚傷, 宜消導獨行, 不須補益者. 亦有旣停滯而復自化, 不須消導, 但當補益者. 易老枳朮丸, 東垣橘皮枳朮丸, 雖曰消導, 固有補益之意存乎其間. 若所滯之物, 非枳朮丸所能去, 則備急丸方見救急ㆍ煮黃丸, 當推逐而去之. 觀乎此, 則知消導補益之理矣. 《東垣》

Translation영역

Going hungry and not eating, and eating to great excess, both lose their measure, yet the division between the two must be made plain. Going hungry leaves the stomach vacuous, and this is insufficiency; food standing and stagnating is surplus. Because it is insufficiency, supplement and boost; because it is surplus, disperse and conduct. People's exuberance and decline are not alike, and there are cases where the substance stagnates and the qi is damaged, and supplementing and dispersing must go together. There are also cases where the substance stagnates briefly and the qi is not much damaged, where dispersing alone is fitting and supplementing is not needed. And there are cases where what stagnated has transformed of itself, where dispersing is not needed and only supplementing is called for. Yi Lao's Bitter Orange and Atractylodes Pill and Dongwon's Tangerine Peel version, though called dispersing and conducting, have in them the intention of supplementing and boosting. If what has stagnated is not such as the Bitter Orange and Atractylodes Pill can remove, then Prepare for Urgency Pill formula in the Emergency chapter and Boiled Yellow Pill should drive it out. Looking at this, the principle of dispersing and supplementing is known.

Clinical note임상 주석

Three cases and three answers: stagnation with damaged qi needs both methods; brief stagnation with sound qi needs dispersing only; stagnation already resolved needs supplementing only. The remark about the Jichul-hwan family is the key to the whole formulary — these are called dispersing formulas but carry white atractylodes as chief, so they supplement while they disperse. That is why Dongwon reaches for them first and for the drastic purgatives only when they fail.

Dongwon 東垣

1.7.3

Source원문

傷食則必惡食, 胸中有物. 宜導痰補脾, 二陳湯方見痰飮, 加白朮ㆍ山査ㆍ川芎ㆍ蒼朮. 《丹心》

Translation영역

Where there is food damage there must be aversion to food, with a sense of something in the chest. Phlegm should be abducted and the spleen supplemented: Two Matured Ingredients Decoction formula in the Phlegm-Rheum chapter with white atractylodes, hawthorn, chuanxiong and atractylodes lancea added.

Dansim 丹心

1.7.4

Source원문

補脾胃藥內必用心經藥, 盖火能生土故也. 古方用益智仁, 正是此意. 《丹心》

Translation영역

Within medicines that supplement the spleen and stomach, a heart channel medicinal must be used, for fire can engender earth. The old formulas use alpinia, and this is precisely that intention.

Clinical note임상 주석

火能生土 — fire engenders earth — applied to prescribing rather than to theory. Alpinia is a heart medicinal and is added to spleen formulas to supply the fire the earth needs, which is why it turns up in Gyungi-hwan at 1.27.5 and throughout the supplementing section. The same reasoning stands behind Bojin-hwan at 1.21.2, where the kidney fire is warmed so that the spleen earth can work.

Dansim 丹心

1.7.5

Source원문

傷寒物者, 半夏ㆍ神麴ㆍ乾薑ㆍ三稜ㆍ蓬朮ㆍ巴豆之類主之. 傷熱物者, 枳實ㆍ白朮ㆍ靑皮ㆍ陳皮ㆍ麥芽ㆍ黃連ㆍ大黃之類主之. 《東垣》

Translation영역

Where the damage is from cold things, pinellia, medicated leaven, dry ginger, sparganium, curcuma and croton and their kind govern it. Where the damage is from hot things, bitter orange fruit, white atractylodes, green tangerine peel, tangerine peel, barley sprout, coptis and rhubarb and their kind govern it.

Clinical note임상 주석

The medicinals are chosen against the temperature of what was eaten rather than against the patient's constitution. Cold food gets warm medicines; hot food gets cool ones. That is a different axis from the rest of the chapter and worth keeping separate: here the question is what was eaten, not who ate it.

Dongwon 東垣

1.7.6

Source원문

食傷有消導補益兩法, 當分而治之. 《東垣》

Translation영역

Food damage has the two methods of dispersing and of supplementing, and treatment should divide between them.

Dongwon 東垣

1.7.7

Source원문

有吐法下法, 詳見于下.

Translation영역

There are the vomiting method and the purging method, treated in fuller detail below.

Donguibogam · Naesang

1.8 Medicines That Disperse and Conduct in Food Damage 食傷消導之劑

1.8.1

Source원문

食積在中下脘者, 宜下以逐之, 木香見睍丸ㆍ丁香脾積丸方見腹部. 宿食吐下後未淨者, 紅元子方見積聚ㆍ保和丸ㆍ大安丸二方幷見積聚ㆍ平補枳朮丸卽竹瀝枳朮丸也. 方見痰飮.

Translation영역

Where food accumulation lies at the middle and lower venter, it should be purged to drive it out: Costus See the Sun Pill and Clove Spleen Accumulation Pill formula in the Abdomen chapter. Where retained food is not cleared after vomiting and purging: Red Pill formula in the Accumulations chapter, Preserve Harmony Pill and Great Peace Pill both formulas in the Accumulations chapter, and Level Supplementing Bitter Orange and Atractylodes Pill that is, the Bamboo Sap version; formula in the Phlegm-Rheum chapter.

Immun 入門

1.8.2

Source원문

傷肉多腹脹, 三補丸方見火門, 加香附ㆍ半夏麴, 蒸餠和丸服. 《入門》

Translation영역

Where damage from meat brings much abdominal distension, Three Supplements Pill formula in the Fire chapter with cyperus and fermented pinellia added, made into pills with steamed cake and taken.

Immun 入門

1.8.3

Source원문

宿食消化, 宜用枳朮丸ㆍ橘皮枳朮丸ㆍ木香枳朮丸ㆍ半夏枳朮丸ㆍ麴糵枳朮丸ㆍ橘半枳朮丸ㆍ橘連枳朮丸ㆍ三黃枳朮丸ㆍ平胃散方見五藏ㆍ香砂平胃散ㆍ加味平胃散ㆍ棗肉平胃散ㆍ內消散ㆍ消滯丸ㆍ加減保和丸ㆍ七香元ㆍ枳實導滯丸ㆍ木香化滯湯ㆍ豆蔲橘紅散ㆍ香殼丸ㆍ二黃丸ㆍ三稜消積丸ㆍ穀神元. 《諸方》

Translation영역

To digest retained food, Bitter Orange and Atractylodes Pill, Tangerine Peel Bitter Orange and Atractylodes Pill, Costus Bitter Orange and Atractylodes Pill, Pinellia Bitter Orange and Atractylodes Pill, Leaven and Sprout Bitter Orange and Atractylodes Pill, Tangerine Peel and Pinellia Bitter Orange and Atractylodes Pill, Tangerine Peel and Coptis Bitter Orange and Atractylodes Pill, Three Yellows Bitter Orange and Atractylodes Pill, Calm the Stomach Powder formula in the Five Viscera chapter, Costus and Amomum Calm the Stomach Powder, Augmented Calm the Stomach Powder, Jujube Flesh Calm the Stomach Powder, Internal Dispersing Powder, Disperse Stagnation Pill, Modified Preserve Harmony Pill, Seven Aromatics Pill, Bitter Orange Fruit Abduct Stagnation Pill, Costus Transform Stagnation Decoction, Cardamom and Red Tangerine Peel Powder, Cyperus and Bitter Orange Pill, Two Yellows Pill, Sparganium Disperse Accumulation Pill and Grain Spirit Pill are used.

Clinical note임상 주석

Twenty-three formulas, and eight of them are Jichul-hwan with one or two additions. That family is the backbone of the chapter's dispersing method: bitter orange fruit to break, white atractylodes to supplement, and whatever the case requires added on top — tangerine peel for qi, pinellia for phlegm, coptis for heat, the three yellows for heat in all three burners. The Pyeongwi-san group follows the same pattern at the next level of force.

Jebang 諸方

1.8.4

Source원문

食麥多令人腹脹, 煖酒和薑汁, 飮一兩盃卽消. 《得效》

Translation영역

Eating much wheat makes a person's abdomen distend; warm wine mixed with ginger juice, one or two cups drunk, and it disperses at once.

Clinical note임상 주석

A household remedy for one specific food, and it is the kind of entry that shows what these chapters were used for. Wheat was held to be cool and binding; warm wine with ginger answers both qualities.

Deukhyo 得效

1.8.1 Bitter Orange and Atractylodes Pill 枳朮丸

1.8.1.1

Source원문

本仲景方, 枳朮湯也. 至易老, 改爲丸, 名曰枳朮丸. 《東垣》

Translation영역

Originally Zhongjing's formula, the Bitter Orange and Atractylodes Decoction. Coming to Yi Lao, it was changed into a pill and named the Bitter Orange and Atractylodes Pill.

Clinical note임상 주석

A note on transmission rather than on treatment, and the chapter gives it its own heading because so much of the formulary descends from this one prescription. Zhang Yuansu's change from decoction to pill was not cosmetic: a pill dissolves slowly and acts on the stomach over hours, which suits a formula meant to disperse what is standing there.

Dongwon 東垣

1.9 Medicines That Supplement and Boost in Food Damage 食傷補益之劑

1.9.1

Source원문

脾胃弱而飮食難任者, 不可一槪用剋伐之藥, 宜錢氏異功散補之, 自然能食. 設或嗜食大過, 傷脾痞滿者, 權用枳實丸卽枳實導滯丸, 勿多服. 《綱目》

Translation영역

Where the spleen and stomach are weak and food and drink are hard to bear, medicines that subdue and attack must not be used across the board; Qian's Extraordinary Merit Powder should supplement, and the patient naturally becomes able to eat. Should appetite be indulged to great excess so that the spleen is damaged with glomus and fullness, use the Bitter Orange Fruit Pill that is, the Abduct Stagnation Pill as an expedient, and do not take much of it.

Clinical note임상 주석

不可一槪用剋伐之藥 — attacking medicines must not be used across the board — is the section's thesis, and the word 權, expedient, in the second half is the qualification: where the weak patient has also overeaten, the dispersing pill is a temporary measure and not the treatment.

Gangmok 綱目

1.9.2

Source원문

宿食吐下後氣虛, 宜補四君子湯方見氣門ㆍ六君子湯方見痰飮ㆍ補中益氣湯. 《入門》

Translation영역

Where the qi is vacuous after retained food has been vomited or purged, supplement: Four Gentlemen Decoction formula in the Qi chapter, Six Gentlemen Decoction formula in the Phlegm-Rheum chapter and Supplement the Centre and Boost the Qi Decoction.

Immun 入門

1.9.3

Source원문

食傷胃弱, 宜用醒脾育胃湯ㆍ參朮健脾湯ㆍ七珍散ㆍ八珍散ㆍ健胃保和元ㆍ養脾丸ㆍ八味理中丸ㆍ滋脾丸ㆍ異功散方見五藏ㆍ健脾丸ㆍ參苓壯脾元ㆍ千金養脾元.

Translation영역

Where food damage has left the stomach weak, Rouse the Spleen and Rear the Stomach Decoction, Ginseng and Atractylodes Fortify the Spleen Decoction, Seven Treasures Powder, Eight Treasures Powder, Fortify the Stomach and Preserve Harmony Pill, Nourish the Spleen Pill, Eight Flavours Rectify the Centre Pill, Enrich the Spleen Pill, Extraordinary Merit Powder formula in the Five Viscera chapter, Fortify the Spleen Pill, Ginseng and Poria Strengthen the Spleen Pill and Qianjin Nourish the Spleen Pill are used.

Donguibogam · Naesang

1.10 Damage from Drink 酒傷

1.10.1

Source원문

內經曰, 酒入於胃, 則絡脉滿而經脉虛. 脾主爲胃行其津液者也. 陰氣虛則陽氣入, 陽氣入則胃不和, 胃不和則精氣竭, 精氣竭則不營其四肢也.

Translation영역

The Neijing says: when wine enters the stomach, the network vessels fill and the channel vessels empty. The spleen governs the moving of the fluids for the stomach. The yin qi being vacuous, the yang qi enters; the yang qi entering, the stomach is not harmonious; the stomach not harmonious, the essential qi is exhausted; the essential qi exhausted, it does not nourish the four limbs.

Naegyeong 內經

1.10.2

Source원문

醉飽入房, 則氣聚脾中而不得散, 酒氣與穀氣相薄, 熱盛於中. 故熱遍於身, 內熱而尿赤也. 《內經》

Translation영역

Where one enters the bedchamber drunk and full, the qi gathers in the spleen and cannot scatter; the wine qi and the grain qi press against one another and heat becomes exuberant within. Hence heat spreads through the body, there is internal heat, and the urine is red.

Naegyeong 內經

1.10.3

Source원문

因而大飮則, 氣逆. 註曰, 飮多則肺布葉擧, 故氣逆而上奔也. 《內經》

Translation영역

Drinking greatly, the qi counterflows. The commentary says: drinking much, the lung's lobes spread and lift, and so the qi counterflows and rushes upward.

Naegyeong 內經

1.10.4

Source원문

酒者, 五穀之津液, 米麴之華英, 雖能益人, 亦能損人. 何者, 酒有大熱大毒. 大寒凝海, 惟酒不氷, 是其熱也. 飮之, 昏亂易人本性, 是其毒也. 若辟風寒, 宣血脉, 消邪氣, 引藥勢, 無過於酒也. 若醉飮過度, 盆傾斗量, 毒氣攻心, 穿腸腐脇, 神昏錯謬, 目不見物, 此則喪生之本也. 《類聚》

Translation영역

Wine is the fluid of the five grains, the flower of rice and leaven; though it can benefit a person it can also harm them. Why so? Wine has great heat and great toxin. In great cold the sea congeals, yet wine alone does not freeze — this is its heat. Drinking it, the mind is clouded and disordered and a person's basic nature is altered — this is its toxin. For warding off wind and cold, diffusing the blood vessels, dispersing evil qi and conducting the force of medicines, nothing surpasses wine. But where drunken drinking passes all measure, basins tipped and pecks measured out, the toxic qi assails the heart, bores through the intestines and rots the ribside; the spirit is clouded and confused and the eyes do not see things — and this is the root of losing life.

Clinical note임상 주석

惟酒不氷 — wine alone does not freeze — is offered as proof of its heat, and it is a real observation put to a theoretical use. Ethanol does depress the freezing point. The passage is even-handed in a way the chapter's later sections are not: wine's uses are named before its harms, and both are traced to the same great heat. 穿腸腐脇, boring through the intestines and rotting the ribside, describes what the chapter elsewhere calls alcohol jaundice and drum distension.

Yuchwi 類聚

1.10.5

Source원문

酒者, 大熱有毒, 氣味俱陽, 乃無形之物也. 若傷之, 止當發散, 汗出則愈矣. 其次莫如利小便, 使上下分消其濕可也. 葛花解酲湯主之. 《東垣》

Translation영역

Wine is greatly hot and has toxin; its qi and flavour are both yang, and it is a thing without form. Where it has caused damage, only effusing and scattering is proper, and when sweat comes out the patient recovers. Next to that, nothing is as good as disinhibiting the urine, so that the damp is dispersed above and below. Pueraria Flower Relieve Hangover Decoction governs it.

Dongwon 東垣

1.10.6

Source원문

酒雖與水同體, 然傷於腸胃, 則升之不散, 降之不下, 鬱於氣分無形之位, 盖逐氣升降, 而半有消耗之矣. 今人飮醇酒則小便少, 此其可驗. 故治法, 宜汗宜利小便爲上策. 東垣以爲無形之物, 固不可, 後人以傷飮食同治, 亦不可. 《丹心》

Translation영역

Though wine shares its substance with water, once it has damaged the intestines and stomach, raising it does not scatter it and lowering it does not bring it down; it is depressed in the formless position of the qi aspect, following the qi up and down, and half of it is consumed. People today who drink strong wine pass little urine, and this may be taken as proof. Therefore in the treatment method, sweating and disinhibiting the urine are the best course. Dongwon's holding it to be a thing without form is certainly not right; and later people's treating it the same as food damage is likewise not right.

Clinical note임상 주석

今人飮醇酒則小便少, 此其可驗 — people who drink strong wine pass little urine, and this may be taken as proof. Danxi argues from an observable fact against two received positions at once. The observation is correct in its particulars: alcohol suppresses vasopressin and produces diuresis at first, but heavy drinking with vomiting and poor intake leaves a patient dehydrated and oliguric. What Danxi saw was the second state.

Dansim 丹心

1.10.7

Source원문

酒性雖熱, 體同於水. 今東垣乃謂飮者無形之氣, 此亦不能無疑也. 旣待發汗利小便以去之, 其可謂無形之氣乎. 《丹心》

Translation영역

Though wine's nature is hot, its substance is the same as water. That Dongwon should now call what is drunk a formless qi cannot be without doubt. If one must wait on promoting sweat and disinhibiting urine to remove it, can it be called a formless qi?

Clinical note임상 주석

A direct argument against Dongwon by the test of his own treatment: a thing removed by sweat and urine must have form. The chapter records the disagreement in full rather than choosing, which is its usual practice where two authorities differ on mechanism but agree on method.

Dansim 丹心

1.11 Prohibitions in Drinking 飮酒禁忌

1.11.1

Source원문

酒客病, 不可服桂枝湯. 得湯則嘔, 以酒客不喜甘故也. 凡甘物皆宜忌之. 《仲景》

Translation영역

In the disease of a drinker, Cinnamon Twig Decoction must not be given. Taking the decoction they vomit, because a drinker does not favour the sweet. All sweet things should be avoided.

Clinical note임상 주석

Zhongjing's rule, and it is specific: a habitual drinker with an exterior pattern still must not have Gyeji-tang, because the sweetness makes them vomit. The prohibition is about the patient's constitution rather than about the presenting illness.

Junggyeong 仲景

1.11.2

Source원문

勿飮濁酒食麪, 使塞氣孔. 《入門》

Translation영역

Do not drink turbid wine and eat wheat food, for it stops up the pores of qi.

Immun 入門

1.11.3

Source원문

凡面白人, 不可多飮酒, 耗血故也. 《丹心》

Translation영역

A person of pale face must not drink much wine, for it wastes the blood.

Dansim 丹心

1.11.4

Source원문

酒不過三盃. 多則傷五藏, 亂性發狂. 《活人心》

Translation영역

Wine not beyond three cups. More damages the five viscera, disorders the nature and brings on mania.

Hwarinsim 活人心

1.11.5

Source원문

飮酒不欲過多, 多則速吐之爲佳.

Translation영역

In drinking one should not wish for excess; where it is excessive, vomiting it up quickly is best.

Deukhyo 得效

1.11.6

Source원문

醉後不可强食, 或發癰疽.

Translation영역

After drunkenness one must not force food, or abscesses may break out.

Deukhyo 得效

1.11.7

Source원문

醉臥當風, 使人失音.

Translation영역

Lying drunk in a draught makes a person lose their voice.

Deukhyo 得效

1.11.8

Source원문

醉飽不可走車馬及跳越.

Translation영역

Drunk and full, one must not ride in carts or on horses, nor leap and vault.

Deukhyo 得效

1.11.9

Source원문

醉不可入房, 小者, 面䵟咳嗽, 大者, 傷絶藏脉損壽命. 《得效》

Translation영역

Drunk, one must not enter the bedchamber: in the lesser case there are blemishes on the face and cough, in the greater the visceral vessels are damaged and cut off and the lifespan is detrimented.

Deukhyo 得效

1.11.10

Source원문

酒雖可以陶性情通血脉, 自然招風敗腎爛腸腐脇, 莫過於此. 飽食之後, 尤宜忌之. 飮酒不宜麄及速, 恐傷破肺也. 當酒未醒, 大渴之際, 不可喫水及啜茶. 多被酒引入腎藏, 爲停毒之水, 令腰脚重墜, 膀胱冷痛, 兼水腫, 消渴, 攣躄之疾. 《活人心》

Translation영역

Though wine can mould the temper and free the blood vessels, nothing so surely invites wind, ruins the kidney, festers the intestines and rots the ribside. After eating to fullness it should be especially avoided. Drinking should not be coarse or quick, for fear of damaging and breaking the lung. While the wine has not yet worn off and thirst is great, one must not drink water or sip tea: much of it is drawn by the wine into the kidney organ and becomes a standing toxic water, making the lumbus and legs heavy and sinking, the bladder cold and painful, together with water swelling, wasting thirst and diseases of cramping and lameness.

Clinical note임상 주석

當酒未醒, 大渴之際, 不可喫水及啜茶 — while still drunk and greatly thirsty, do not drink water or tea. The prohibition runs against instinct and against modern advice, and the reason given is that the wine draws the water into the kidney where it stands as toxin. What the observation may rest on is real: heavy drinkers who take large volumes of water while still intoxicated can develop hyponatraemia, and the swelling, thirst and heaviness described are consistent with it. The mechanism given is not, but the caution was drawn from something seen.

Hwarinsim 活人心

1.12 Alcohol Toxin Changing into the Various Diseases 酒毒變爲諸病

1.12.1

Source원문

醇酒之性, 大熱有大毒. 淸香美味, 旣適於口, 行氣和血, 亦宜於體. 由是飮者不自覺其過於多也. 不知酒性喜升, 氣必隨之, 痰鬱於上, 尿澁於下, 肺受賊邪, 金體必燥, 恣飮寒涼, 其熱內鬱, 肺氣得熱, 必大傷耗. 其始也病淺, 或嘔吐, 或自汗, 或瘡痍, 或鼻㾴, 或自泄, 或心脾痛, 尙可發散而去之. 及其久而病深, 則爲消渴, 爲黃疸, 爲肺痿, 爲內痔, 爲鼓脹, 爲失明, 爲哮喘, 爲勞嗽, 爲癲癎, 爲難明之疾. 倘非具眼, 未易處治, 可不謹乎. 《丹心》

Translation영역

The nature of strong wine is greatly hot with great toxin. Clear in fragrance and fine in flavour, it suits the mouth; moving qi and harmonizing blood, it suits the body too. For these reasons the drinker is not aware of going to excess. They do not know that wine's nature loves to rise and the qi must follow it: phlegm is depressed above, urine is rough below, the lung receives the robbing evil, and the metal body must become dry. Drinking cold and cooling things without restraint, the heat is depressed within; the lung qi meeting heat must be greatly damaged and wasted. At the beginning the disease is shallow — vomiting, or spontaneous sweating, or sores, or a red nose, or spontaneous diarrhoea, or pain of heart and spleen — and it may still be effused and scattered away. But when it has lasted and the disease has gone deep, it becomes wasting thirst, becomes jaundice, becomes lung wilting, becomes internal haemorrhoids, becomes drum distension, becomes loss of sight, becomes wheezing and panting, becomes taxation cough, becomes epilepsy, becomes a disease hard to make out. Unless one has the eye for it, treatment is not easy — how can one not be careful?

Clinical note임상 주석

The chapter's map of where drinking ends, and most of the destinations have their own chapters in this book: wasting thirst, jaundice, drum distension, lung wilting, haemorrhoids, wheezing, taxation cough. The early list is worth keeping because it is what a physician sees first — vomiting, sweating, skin sores, a red nose, loose stool, epigastric pain. 鼻㾴, the red nose, is rhinophyma, and the chapter treats it as an early rather than a late sign. **The late conditions named — jaundice, ascites, blindness, seizures — correspond to alcoholic liver disease, Wernicke encephalopathy and withdrawal seizures. All require medical care.**

Dansim 丹心

1.12.2

Source원문

久飮酒者, 藏府積毒, 致令蒸筋, 傷神, 損壽. 《得效》

Translation영역

In one who drinks long, toxin accumulates in the viscera and bowels, so that the sinews are steamed, the spirit damaged and the lifespan detrimented.

Deukhyo 得效

1.13 The Treatment Method for Diseases of Drink 酒病治法

1.13.1

Source원문

飮酒過多成病, 宜葛花解酲湯ㆍ酒蒸黃連丸方見血門ㆍ百杯丸ㆍ對金飮子ㆍ解酒化毒散ㆍ葛黃丸方見血門ㆍ升麻葛根湯方見寒門. 中酒頭痛, 嘔吐眩暈, 補中益氣湯, 去白朮, 加半夏ㆍ白芍藥ㆍ黃芩ㆍ黃柏ㆍ乾葛ㆍ川芎. 或對金飮子, 加乾葛ㆍ赤茯苓ㆍ半夏各一錢, 煎服. 《入門》

Translation영역

Where drinking to excess has made a disease, Pueraria Flower Relieve Hangover Decoction, Wine-Steamed Coptis Pill formula in the Blood chapter, Hundred Cups Pill, Facing Gold Drink, Resolve Wine and Transform Toxin Powder, Pueraria and Rhubarb Pill formula in the Blood chapter and Cimicifuga and Pueraria Decoction formula in the Cold Damage chapter are appropriate. Where wine has struck with headache, vomiting and dizziness, Supplement the Centre and Boost the Qi Decoction with white atractylodes removed and pinellia, white peony, scutellaria, phellodendron, dried pueraria and chuanxiong added; or Facing Gold Drink with dried pueraria, red poria and pinellia 1 don each added, decocted and taken.

Immun 入門

1.13.2

Source원문

酒後傷風, 身熱, 頭痛如破, 防風通聖散方見風門, 加黃連二錢, 連鬚葱白十根, 煎服立愈. 此藥能治傷酒熱毒. 《活人心》

Translation영역

Where wind is contracted after drinking, with fever and a headache as though the head would split, Saposhnikovia Sage-Inspired Powder formula in the Wind chapter with 2 don of coptis and ten scallion whites with their roots added, decocted and taken, and it is cured at once. This medicine can treat the heat toxin of wine damage.

Hwarinsim 活人心

1.13.3

Source원문

酒後煩渴, 飮五豆湯方見消渴最妙. 《丹心》

Translation영역

For vexing thirst after drinking, taking Five Beans Decoction formula in the Wasting Thirst chapter is best of all.

Dansim 丹心

1.13.4

Source원문

善飮酒, 每朝長噯不吐者, 小調中湯方見痰飮最妙. 一月三五服亦可. 《入門》

Translation영역

For one who drinks well and belches long every morning without vomiting, Minor Regulate the Centre Decoction formula in the Phlegm-Rheum chapter is best of all. Three or five doses in a month will also serve.

Clinical note임상 주석

每朝長噯不吐 — belching long every morning without vomiting — is morning retching in a heavy drinker, and the chapter treats it as its own presentation rather than as part of a hangover. Three or five doses a month is maintenance rather than treatment.

Immun 入門

1.13.5

Source원문

醉飽行房得病, 宜用人參散. 或致蓄血, 胃口作痛者, 宜大調中湯方見痰飮, 或八物湯方見虛勞, 加縮砂煎服. 《入門》

Translation영역

Where disease is got from intercourse while drunk and full, Ginseng Powder is used. Where it has brought about amassed blood with pain at the mouth of the stomach, Major Regulate the Centre Decoction formula in the Phlegm-Rheum chapter, or Eight Substances Decoction formula in the Vacuity Taxation chapter with amomum added, decocted and taken.

Clinical note임상 주석

蓄血, amassed blood, with pain at the mouth of the stomach after drinking is upper gastrointestinal bleeding, and the chapter reaches this presentation by the same route the Jaundice chapter takes at 5.6.2. **Epigastric pain after heavy drinking, especially with black stool or vomited blood, is a medical emergency.**

Immun 入門

1.14 Sobering from Drink and Not Becoming Drunk 醒酒令不醉

1.14.1

Source원문

酒醉, 宜以熱湯漱口, 盖其毒在齒也. 大醉則以熱湯於密室洗面數次, 梳頭數十遍卽醒. 《丹心》

Translation영역

When drunk with wine, the mouth should be rinsed with hot water, for the toxin lies in the teeth. In great drunkenness, wash the face several times with hot water in a closed room and comb the hair several tens of strokes, and sobriety returns at once.

Clinical note임상 주석

其毒在齒 — the toxin lies in the teeth — is a claim about where alcohol lingers, and the measures that follow are all applied to the head: rinse the mouth, wash the face, comb the hair. Combing the scalp repeatedly is used elsewhere in the Bogam to rouse the clear yang, and here it is being used to clear the head literally.

Dansim 丹心

1.14.2

Source원문

酒食傷積, 或被人勸過傷. 以鹽花擦牙, 溫水漱下, 不過三次卽爲通快. 《醫鑑》

Translation영역

Where wine and food have damaged by accumulation, or one has been pressed by others to drink beyond measure: rub the teeth with salt crystals and rinse down with warm water, and in not more than three times there is relief and ease.

Clinical note임상 주석

被人勸過傷 — damaged by being pressed to drink by others — names the social circumstance rather than the appetite, and the chapter records it without comment as one of the ways people come to harm.

Uigam 醫鑑

1.14.3

Source원문

一方, 靑皮(炒) 二兩, 葛根一兩, 縮砂五錢. 右爲細末, 濃茶調一二錢, 服之能醒酒消食. 《丹心》

Translation영역

Another formula: green tangerine peel (stir-fried) 2 nyang, pueraria 1 nyang, amomum 5 don. Grind to a fine powder and take 1 or 2 don stirred into strong tea; it can sober from wine and disperse food.

Dansim 丹心

1.14.4

Source원문

醒酒不醉, 宜萬盃不醉丹ㆍ神仙不醉丹ㆍ醉鄕寶屑ㆍ益脾丸ㆍ龍腦湯ㆍ葛花散ㆍ三豆解酲湯.

Translation영역

To sober from wine and not become drunk, Ten Thousand Cups Without Drunkenness Elixir, Immortals' Not Drunk Elixir, Treasure Powder of the Land of Drunkenness, Boost the Spleen Pill, Borneol Decoction, Pueraria Flower Powder and Three Beans Relieve Hangover Decoction are appropriate.

Clinical note임상 주석

A whole section given to drinking without becoming drunk, with seven formulas for it. That the Bogam includes this at all, between the section on alcohol's diseases at 1.12 and the section on taxation damage at 1.15, shows what its readers were asking for. The names are worth noting — Ten Thousand Cups Without Drunkenness, the Land of Drunkenness — and so is the fact that they sit in a chapter whose previous section lists blindness, seizures and ascites among drink's consequences.

Donguibogam · Naesang

1.15 Taxation Damage 勞倦傷

1.15.1

Source원문

黃帝曰, 陰虛生內熱, 柰何. 岐伯曰, 有所勞倦, 形氣衰少, 穀氣不盛, 上焦不行, 下脘不通而胃氣熱, 熱氣熏胸中, 故內熱. 《內經》

Translation영역

The Yellow Emperor said: yin vacuity engenders internal heat — how so? Qi Bo said: where there has been taxation and fatigue, the form and qi decline and diminish, the grain qi is not exuberant, the upper burner does not move, the lower venter is not free and the stomach qi becomes hot; the hot qi steams the chest, and hence there is internal heat.

Naegyeong 內經

1.15.2

Source원문

此內傷之原也. 此陰虛, 盖指身中之陰氣與水穀之味耳. 《入門》

Translation영역

This is the origin of internal damage. The yin vacuity here means the yin qi within the body together with the flavours of water and grain.

Clinical note임상 주석

A gloss that heads off a misreading. 陰虛 in this passage does not mean the kidney yin deficiency of the Vacuity Taxation chapter; it means the substantial part of the body kept up by what is eaten. Read the other way, the whole of Dongwon's method would make no sense.

Immun 入門

1.15.3

Source원문

喜怒不節, 起居不時, 有所勞倦, 皆損其氣. 氣衰則火旺, 火旺則乘脾土. 脾主四肢, 故困熱無氣以動, 懶於言語, 動作喘乏, 表熱自汗, 心煩不安. 當安心靜坐, 以養其氣, 以甘寒瀉其熱火, 酸味收其散氣, 甘溫調其中氣. 《東垣》

Translation영역

Joy and anger without measure, activity and rest without hours, and taxation and fatigue all detriment the qi. The qi declining, fire becomes effulgent; fire effulgent, it overwhelms the spleen earth. The spleen governs the four limbs, and so there is heat with fatigue and no qi to move with, reluctance to speak, panting and exhaustion on exertion, surface heat with spontaneous sweating, and vexation of the heart without ease. One should quiet the heart and sit still to nourish the qi; drain the hot fire with the sweet and cold, gather the scattered qi with the sour, and regulate the centre qi with the sweet and warm.

Clinical note임상 주석

The clinical picture of Dongwon's 氣虛發熱 — fever from qi vacuity — and the whole rationale of Bojungikgi-tang is in the last sentence: sweet and cold to drain the fire, sour to gather what has scattered, sweet and warm to rebuild the centre. 當安心靜坐 — quiet the heart and sit still — is prescribed before any medicinal, and it is not a pleasantry: the condition is caused by expenditure, and rest is the first correction.

Dongwon 東垣

1.15.4

Source원문

勞則氣散氣短, 喘且汗出, 內外皆越, 故氣耗矣. 《內經》

Translation영역

In taxation the qi scatters and the breath shortens, there is panting with sweating, and both inside and out the qi passes beyond its bounds — and so the qi is wasted.

Naegyeong 內經

1.16 Distinguishing the Patterns of Internal and External Damage 辨內外傷證

1.16.1

Source원문

外感內傷, 乃病之大關鍵, 於此昧焉, 何足云醫. 丹溪云, 內傷證皆以補元氣爲主, 看所挾而兼用藥. 但先生之言, 引而不發, 予今補之. 如內傷挾外感者, 則於補中益氣湯內, 春加川芎ㆍ防風ㆍ柴胡ㆍ荊芥ㆍ紫蘇ㆍ薄荷, 夏加乾葛ㆍ石膏ㆍ麥門冬ㆍ薄荷ㆍ倍升ㆍ柴, 秋加羌活ㆍ防風ㆍ荊芥, 冬加麻黃ㆍ桂枝ㆍ乾薑之類. 《方廣》

Translation영역

External contraction and internal damage are the great hinge of disease; one who is in the dark here — how can he be called a physician? Danxi said that in internal damage patterns, supplementing the origin qi is always the mainstay, and one looks at what is carried with it and uses medicines accordingly. But the master drew the bow without loosing the arrow, and I now supply what is wanting. Where internal damage carries an external contraction, then within Supplement the Centre and Boost the Qi Decoction add, in spring, chuanxiong, saposhnikovia, bupleurum, schizonepeta, perilla and mint; in summer, dried pueraria, gypsum, ophiopogon, mint, with the cimicifuga and bupleurum doubled; in autumn, notopterygium, saposhnikovia and schizonepeta; in winter, ephedra, cinnamon twig and dry ginger and their kind.

Clinical note임상 주석

引而不發 — drawing the bow without loosing the arrow — is from the Mencius and means stating a principle without working it out. Fang Guang says Danxi left the method unfinished and then finishes it himself, season by season. The scheme is practical: one base formula, four sets of additions according to the time of year. Where internal damage is complicated by a contraction, the contraction is met with whatever the season calls for while the centre is supplemented throughout.

Banggwang 方廣

1.16.2

Source원문

或外感挾內傷, 內傷挾外感, 或食積類傷寒, 當明辨治之.

Translation영역

Whether an external contraction carries internal damage, or internal damage carries an external contraction, or food accumulation resembles cold damage, treatment must distinguish them clearly.

Immun 入門

1.16.3

Source원문

若顯內證多者, 則是內傷重而外感輕, 當以補養爲先, 宜陶氏補中益氣湯ㆍ十味和解散ㆍ加味益氣湯三方幷見寒門.

Translation영역

Where the internal signs shown are the more numerous, internal damage is the heavier and the external contraction the lighter; supplementing and nourishing should come first — Tao's Supplement the Centre and Boost the Qi Decoction, Ten Flavours Harmonize and Resolve Powder, and Augmented Boost the Qi Decoction all three formulas in the Cold Damage chapter are appropriate.

Immun 入門

1.16.4

Source원문

若顯外證多者, 則是外感重而內傷輕, 宜以發散爲急, 宜九味羌活湯ㆍ人參養胃湯ㆍ參蘇飮三方幷見寒門.

Translation영역

Where the external signs shown are the more numerous, the external contraction is the heavier and the internal damage the lighter; effusing and scattering is urgent — Nine Ingredients Notopterygium Decoction, Ginseng Nourish the Stomach Decoction and Ginseng and Perilla Drink all three formulas in the Cold Damage chapter are appropriate.

Clinical note임상 주석

The rule is arithmetical rather than doctrinal: count the signs on each side and treat the heavier first. The thirteen subsections that follow exist to make that count possible.

Immun 入門

1.16.5

Source원문

食積類傷寒, 宜用陶氏平胃散. 《入門》

Translation영역

Where food accumulation resembles cold damage, Tao's Calm the Stomach Powder is used.

Immun 入門

1.16.1 Distinguishing Aversion to Cold 辨惡寒

1.16.1.1

Source원문

傷寒惡寒, 雖近猛火不除.

Translation영역

In cold damage, the aversion to cold is not removed even by going near a fierce fire.

Immun 入門

1.16.1.2

Source원문

內傷惡寒, 稍就溫暖卽止, 但見風寒便惡之也.

Translation영역

In internal damage, the aversion to cold stops as soon as a little warmth is approached; only on meeting wind or cold is there aversion.

Clinical note임상 주석

The first and most useful of the thirteen. Aversion to cold that warmth does not relieve is an exterior pattern; aversion that a warm room settles at once is internal. The distinction survives translation entirely and can be made from the history alone.

Immun 入門

1.16.2 Distinguishing Aversion to Wind 辨惡風

1.16.2.1

Source원문

傷寒惡風, 不耐一切風寒.

Translation영역

In cold damage, the aversion to wind is such that no wind or cold at all can be borne.

Immun 入門

1.16.2.2

Source원문

內傷惡風, 偏惡些少賊風, 避居密室則不惡矣.

Translation영역

In internal damage, the aversion to wind is only to a slight thieving draught; withdrawing into a closed room, there is no aversion.

Immun 入門

1.16.3 Distinguishing Fever 辨發熱

1.16.3.1

Source원문

外感發熱, 無休歇, 日晡轉劇, 直待汗下, 方退.

Translation영역

In external contraction the fever has no remission and worsens toward dusk, and only on sweating or purging does it retreat.

Immun 入門

1.16.3.2

Source원문

內傷發熱, 時作時止, 或自袒裸, 亦便淸涼矣.

Translation영역

In internal damage the fever comes and goes; baring the body, one is at once cool again.

Clinical note임상 주석

時作時止 — coming and going — against a fever with no remission. The second half adds an observation that only comes from watching a patient: in internal damage, throwing off the covers cools them immediately, which a febrile patient with an exterior pattern cannot do.

Immun 入門

1.16.4 Distinguishing Body Pain 辨身痛

1.16.4.1

Source원문

外感筋骨疼痛, 或百節皆痛.

Translation영역

In external contraction the sinews and bones ache, or all the hundred joints hurt.

Immun 入門

1.16.4.2

Source원문

內傷但四肢不收, 困怠嗜臥而已.

Translation영역

In internal damage the four limbs merely will not gather themselves, with fatigue and a liking for lying down — no more than that.

Immun 入門

1.16.5 Distinguishing Cold and Heat 辨寒熱

1.16.5.1

Source원문

外感, 寒熱齊作, 而無間以甚.

Translation영역

In external contraction, cold and heat arise together and are severe without interval.

Immun 入門

1.16.5.2

Source원문

內傷, 寒熱微而間作, 或不齊.

Translation영역

In internal damage, cold and heat are slight and come at intervals, or do not arise together.

Immun 入門

1.16.6 Distinguishing Headache 辨頭痛

1.16.6.1

Source원문

外感頭痛, 常常有之, 直待傳經入裏方罷.

Translation영역

In external contraction the headache is constantly present and ceases only when the disease has passed through the channels and entered the interior.

Immun 入門

1.16.6.2

Source원문

內傷頭痛, 有時而作, 有時而止.

Translation영역

In internal damage the headache arises at times and stops at times.

Immun 入門

1.16.7 Distinguishing Strength 辨氣力

1.16.7.1

Source원문

外感, 邪氣有餘, 壯厲有力.

Translation영역

In external contraction the evil qi is in surplus, and the patient is vigorous and forceful.

Immun 入門

1.16.7.2

Source원문

內傷, 神思昏怠, 氣弱困懶.

Translation영역

In internal damage the spirit and thought are clouded and listless, the qi weak and the patient fatigued and indolent.

Clinical note임상 주석

The patient's bearing rather than any symptom. Someone with an acute contraction still has force in them; someone internally damaged does not. It is the sign a physician registers before asking anything.

Immun 入門

1.16.8 Distinguishing the Palms 辨手心

1.16.8.1

Source원문

外感, 手背熱而手心不熱.

Translation영역

In external contraction the backs of the hands are hot and the palms are not.

Immun 入門

1.16.8.2

Source원문

內傷, 手心熱而手背不熱.

Translation영역

In internal damage the palms are hot and the backs of the hands are not.

Clinical note임상 주석

The most concrete of the thirteen and the one most often quoted. Touch the back of the hand and then the palm: heat on the back is exterior, heat in the palm is interior. It is used across the tradition well beyond this chapter, and it is the origin of treating palm heat as a sign of vacuity heat.

Immun 入門

1.16.9 Distinguishing Vexing Thirst 辨煩渴

1.16.9.1

Source원문

外感, 邪氣傳經入裏, 則大渴.

Translation영역

In external contraction, when the evil qi passes through the channels and enters the interior, there is great thirst.

Immun 入門

1.16.9.2

Source원문

內傷, 邪在血脉中, 間有渴亦不甚.

Translation영역

In internal damage the evil lies within the blood vessels; there is thirst at times, but not severe.

Immun 入門

1.16.10 Distinguishing the Taste in the Mouth 辨口味

1.16.10.1

Source원문

外感, 雖不能食, 而知穀肉之味.

Translation영역

In external contraction, though the patient cannot eat, they know the taste of grain and meat.

Immun 入門

1.16.10.2

Source원문

內傷, 雖飮食, 而不知其味.

Translation영역

In internal damage, though the patient eats and drinks, they do not know the taste of it.

Clinical note임상 주석

A single question distinguishes the two: can you taste your food? Loss of appetite with taste preserved is exterior; eating without tasting is internal. The chapter returns to this at 1.19.4, where it is read as a sign of whether yin or yang is deficient.

Immun 入門

1.16.11 Distinguishing the Breath of the Nose 辨鼻息

1.16.11.1

Source원문

外感, 鼻塞流涕, 聲重氣壅.

Translation영역

In external contraction the nose is blocked and runs, the voice is heavy and the qi congested.

Immun 入門

1.16.11.2

Source원문

內傷, 鼻息和緩, 但不調.

Translation영역

In internal damage the breath of the nose is harmonious and easy, only not well regulated.

Immun 入門

1.16.12 Distinguishing Speech 辨言語

1.16.12.1

Source원문

外感, 言語高厲有力, 先輕後重.

Translation영역

In external contraction the speech is loud and sharp and has force, light at first and heavy after.

Immun 入門

1.16.12.2

Source원문

內傷, 言語困弱無力, 懶於言語.

Translation영역

In internal damage the speech is laboured and weak and without force, and the patient is reluctant to speak at all.

Immun 入門

1.16.13 Distinguishing the Pulse 辨脉候

1.16.13.1

Source원문

外感, 則人迎脉浮緊, 或洪大而數.

Translation영역

In external contraction the Inyeong pulse is floating and tight, or surging, large and rapid.

Immun 入門

1.16.13.2

Source원문

內傷, 則氣口脉緊盛, 或滑而疾.

Translation영역

In internal damage the qi opening pulse is tight and exuberant, or slippery and hurried.

Clinical note임상 주석

The thirteen close at the pulse rather than opening with it, which is the section's arrangement throughout: history and observation first, the wrist last. 人迎 and 氣口 here are the left and right inch positions in the Bogam's usage — left for external contraction, right for internal damage — and the section at 1.5 reads the right hand almost exclusively for the same reason.

Immun 入門

1.17 The Treatment Method for Taxation Damage 勞倦傷治法

1.17.1

Source원문

內經曰, 勞者溫之, 損者益之. 夫勞則動之太過, 而神不寧矣, 故溫之. 溫也者, 養也. 溫之者, 所以調其飮食, 適其起居, 澄心息慮, 從容以待其眞氣之復常也. 禮記所謂柔色以溫之, 正同此義. 今東垣乃以溫爲溫涼之溫, 謂宜溫藥以補元氣而瀉火邪. 又易損者益之, 爲損者溫之. 又以溫能除大熱爲內經所云, 而遍攷內經, 幷無此語, 不能無疑也. 又經曰, 形不足者, 溫之以氣. 其溫字亦是滋養之義, 非指溫藥也. 《泝洄》

Translation영역

The Neijing says: what is taxed, warm it; what is detrimented, boost it. Taxation means moving to excess so that the spirit is not at rest, and therefore it is warmed. To warm is to nourish. Warming means regulating the food and drink, making activity and rest fitting, clearing the heart and stilling the thoughts, and waiting unhurriedly for the true qi to return to its constancy. What the Liji calls warming with a gentle countenance is precisely this sense. But Dongwon takes warm in the sense of warm as against cool, and says warm medicines should supplement the origin qi and drain the fire evil. He also alters 'what is detrimented, boost it' into 'what is detrimented, warm it'. And he takes 'warmth can remove great heat' for a saying of the Neijing — yet searching the Neijing throughout, there is no such phrase, and this cannot be without doubt. The classic also says: where the form is insufficient, warm it with qi. There too the word warm carries the sense of nourishing, and does not point to warm medicines.

Clinical note임상 주석

A sustained philological argument, and the most pointed disagreement in the chapter. Wang Lü says Dongwon has misread a single graph: 溫 in the Neijing means to nourish and tend, not to use warm medicines, and the whole edifice of warm supplementing rests on that misreading. The check he applies is textual — 遍攷內經, 幷無此語, searching the Neijing throughout, there is no such phrase — and he is right that 溫能除大熱 is not in the Suwen or the Lingshu. That Heo Jun places this at the head of the treatment section, before the formulas that follow Dongwon's method, is characteristic. The objection is recorded in full and the practice is kept.

Sohoe 泝洄

1.17.2

Source원문

飮食失時, 勞役過度, 脾胃虛弱, 中氣不足, 以補中益氣湯爲主. 如益胃升陽湯ㆍ升陽順氣湯ㆍ調中益氣湯ㆍ升陽益胃湯ㆍ淸神益氣湯ㆍ黃芪人參湯方見暑門ㆍ參朮調中湯方見咳嗽ㆍ人參飮, 皆可選用.

Translation영역

Where food and drink have lost their times and taxation and labour have passed all measure, the spleen and stomach weak and the centre qi insufficient, Supplement the Centre and Boost the Qi Decoction is the mainstay. Boost the Stomach and Raise the Yang Decoction, Raise the Yang and Normalize the Qi Decoction, Regulate the Centre and Boost the Qi Decoction, Raise the Yang and Boost the Stomach Decoction, Clear the Spirit and Boost the Qi Decoction, Astragalus and Ginseng Decoction formula in the Summerheat chapter, Ginseng and Atractylodes Regulate the Centre Decoction formula in the Cough chapter and Ginseng Drink may all be chosen from.

Immun 入門

1.17.3

Source원문

勞倦亦有二焉. 勞力純乎傷氣, 而無汗者, 補中益氣湯.

Translation영역

Taxation damage is also of two kinds. Where taxation of strength has damaged the qi purely and there is no sweating, Supplement the Centre and Boost the Qi Decoction.

Immun 入門

1.17.4

Source원문

勞心兼傷乎血, 而有汗者, 黃芪建中湯. 心力俱勞, 氣血皆傷者, 雙和湯二方幷見虛勞.

Translation영역

Where taxation of the heart has damaged the blood as well and there is sweating, Astragalus Construct the Centre Decoction. Where heart and strength are both taxed and qi and blood both damaged, Double Harmony Decoction both formulas in the Vacuity Taxation chapter.

Clinical note임상 주석

Sweating is the sign that divides the two. Taxation of strength without sweat gets Bojungikgi-tang; taxation of the heart with sweat gets Hwanggigeonjung-tang, because sweat means the blood and the construction are involved. Where both are present the chapter names Ssanghwa-tang, which is the formula a Korean practitioner still reaches for in exactly this presentation.

Immun 入門

1.17.5

Source원문

房勞傷腎證, 與勞倦相似, 均一內傷發熱證也. 勞倦因陽氣之下陷, 宜補其氣以升提之, 房勞因陽火之上升, 宜滋其陰以降下之. 一升一降, 逈然不同.

Translation영역

The pattern of sexual taxation damaging the kidney resembles taxation fatigue, both being patterns of fever from internal damage. But taxation fatigue comes of the yang qi falling downward, and the qi should be supplemented so as to raise and lift it; sexual taxation comes of the yang fire rising upward, and the yin should be enriched so as to bring it down. One raises, one lowers — utterly unlike.

Clinical note임상 주석

Two conditions that present identically and are treated in opposite directions. The chapter states the danger plainly by stating the difference: 一升一降, 逈然不同. Giving Bojungikgi-tang to a patient whose fever comes from sexual taxation would drive the fire further up. The discriminating question is not in the signs but in the history.

Immun 入門

1.17.6

Source원문

七情動氣脉, 與飮食無二. 盖飮食七情俱能閉塞三焦, 熏蒸肺胃淸道. 肺爲氣主, 由是而失其傳化之常, 所以氣口脉獨緊且盛. 其證嘔泄痞滿, 腹痛亦相似. 但傷食則惡食, 七情則雖作飽, 亦不惡食. 《入門》

Translation영역

The pulse stirred by the seven affects is no different from that of food. For food and the seven affects can both block the three burners and steam the clear pathways of lung and stomach. The lung governs qi, and by this it loses the constancy of its conveying and transforming, so that the qi opening pulse alone is tight and exuberant. The patterns of vomiting, diarrhoea, glomus fullness and abdominal pain are likewise alike. But in food damage there is aversion to food, while with the seven affects, though there is a sense of fullness, there is no aversion to food.

Clinical note임상 주석

The same pulse and the same symptoms from two causes, separated by one question: does the patient turn away from food? Emotional cause leaves the appetite intact even where the belly feels full. This is the third time the chapter has used aversion to food as the discriminating sign — at 1.6.6, at 1.7.3 and here.

Immun 入門

1.17.7

Source원문

如氣浮心亂, 以朱砂安神丸方見神門鎭固之, 卽愈. 《東垣》

Translation영역

Where the qi floats and the heart is disordered, settle and secure it with Cinnabar Quiet the Spirit Pill formula in the Spirit chapter, and it is cured at once.

Dongwon 東垣

1.18 Vacuity and Repletion of the Spleen and Stomach in Internal Damage 內傷病脾胃虛實

1.18.1

Source원문

脾胃俱實, 則過時而不飢, 多食而不傷.

Translation영역

Where spleen and stomach are both replete, the hour passes without hunger and much is eaten without damage.

Hoechun 回春

1.18.2

Source원문

脾胃俱虛, 則不能食而瘦, 與食則少食, 不與則不思食, 飢飽不知.

Translation영역

Where spleen and stomach are both vacuous, the patient cannot eat and is thin; given food they eat little, not given it they do not think of food, and they do not know hunger from fullness.

Clinical note임상 주석

飢飽不知 — not knowing hunger from fullness — is the sign that marks the severest spleen and stomach vacuity. The appetite has not merely fallen but has stopped reporting, and the patient eats or does not according to what is put in front of them.

Hoechun 回春

1.18.3

Source원문

食少而肥者, 雖肥而四肢不擧, 盖脾困邪勝也.

Translation영역

One who eats little yet is stout — though stout, the four limbs will not lift, for the spleen is beset and the evil prevails.

Hoechun 回春

1.18.4

Source원문

食多而瘦者, 胃伏火邪於氣分則能食, 雖多食而不能生肌肉也. 《回春》

Translation영역

One who eats much yet is thin — the stomach has a hidden fire evil in the qi aspect and so can eat, but though eating much cannot engender flesh.

Clinical note임상 주석

Two presentations that look like contradictions and are read as opposite faults: stout on little food is spleen failure, thin on much food is stomach fire. The second describes a patient who eats well and still loses weight, which in modern terms points to hyperthyroidism, diabetes or malabsorption. **Weight loss despite a good appetite requires medical investigation.**

Hoechun 回春

1.19 Internal Damage to the Spleen and Stomach Brings No Thought of Food and No Liking for It 內傷脾胃則不思食不嗜食

1.19.1

Source원문

脉小而寒者不嗜食. 《靈樞》

Translation영역

Where the pulse is small and there is cold, there is no liking for food.

Yeongchu 靈樞

1.19.2

Source원문

太陰所謂惡聞食臭者, 胃無氣, 故惡食臭也. 《內經》

Translation영역

What is called in the greater yin an aversion to smelling the smell of food: the stomach has no qi, and so there is aversion to the smell of food.

Naegyeong 內經

1.19.3

Source원문

惡聞食臭者, 膀胱移熱於小腸也. 《入門》

Translation영역

Aversion to smelling the smell of food is the bladder transferring heat to the small intestine.

Immun 入門

1.19.4

Source원문

口多嗜味, 陰虛火動故也. 陰虛則口中有味, 陽虛則口中無味. 《入門》

Translation영역

A mouth with much liking for flavour comes of yin vacuity with fire stirring. Yin vacuous, there is taste in the mouth; yang vacuous, there is no taste in the mouth.

Clinical note임상 주석

The rule the differentiation at 1.16.10 rests on: tastelessness is yang vacuity, heightened taste is yin vacuity with fire. A patient who reports that food has no savour is telling the physician which side they are on.

Immun 入門

1.19.5

Source원문

惡食者, 胸中有物, 宜導痰補脾, 二陳湯, 加蒼朮ㆍ白朮ㆍ川芎ㆍ山査肉. 《丹心》

Translation영역

Where there is aversion to food, there is something in the chest; phlegm should be abducted and the spleen supplemented — Two Matured Ingredients Decoction with atractylodes lancea, white atractylodes, chuanxiong and hawthorn flesh added.

Dansim 丹心

1.19.6

Source원문

憂抑傷脾, 不思飮食, 黃連(炒)ㆍ白芍藥(酒炒)ㆍ香附子ㆍ淸六丸末方見暑門. 右爲末, 薑汁浸蒸餠作丸服. 《丹心》

Translation영역

Where grief and oppression have damaged the spleen so that there is no thought of food: coptis (stir-fried), white peony (wine-fried), cyperus and powdered Clear Six Pill formula in the Summerheat chapter. Powder them, make pills with steamed cake soaked in ginger juice, and take.

Clinical note임상 주석

憂抑傷脾 — grief and oppression damaging the spleen — is given its own formula, and the composition is telling: coptis and peony for the heat that depression generates, cyperus to move the bound qi, and nothing that supplements. The chapter treats anorexia from low mood as a condition of constraint rather than of weakness, which is the opposite of how it treats the anorexia of 1.21.

Dansim 丹心

1.19.7

Source원문

不思飮食, 宜平胃散ㆍ養胃進食丸方見五藏ㆍ寬中進食丸ㆍ生胃丹ㆍ參苓白朮丸方見下ㆍ啓脾丸ㆍ二麴元ㆍ香砂六君子湯ㆍ香砂養胃湯ㆍ人參開胃湯ㆍ安胃散ㆍ穀神湯.

Translation영역

Where there is no thought of food, Calm the Stomach Powder, Nourish the Stomach and Advance Food Pill formula in the Five Viscera chapter, Relax the Centre and Advance Food Pill, Engender the Stomach Elixir, Ginseng and Poria White Atractylodes Pill formula below, Open the Spleen Pill, Two Leavens Pill, Costus and Amomum Six Gentlemen Decoction, Costus and Amomum Nourish the Stomach Decoction, Ginseng Open the Stomach Decoction, Quiet the Stomach Powder and Grain Spirit Decoction are appropriate.

Donguibogam · Naesang

1.19.8

Source원문

勞役失食, 胃虛甚者, 益胃升陽湯方見上ㆍ參苓白朮散方見下.

Translation영역

Where labour has caused meals to be missed and the stomach is severely vacuous, Boost the Stomach and Raise the Yang Decoction formula above and Ginseng and Poria White Atractylodes Powder formula below.

Donguibogam · Naesang

1.19.11 The Spleen Bound So That Food Is Refused 脾結不食

1.19.11.1

Source원문

一室女, 因事忤意, 鬱結在脾, 半年不食, 但日食熟菱棗數枚, 遇喜食饅頭彈子大, 深惡粥飯. 予意脾氣實, 非枳實不能開. 以溫膽湯方見夢門, 去竹茹, 與數十貼而安. 《丹心》

Translation영역

A maiden, crossed in some matter, had depression bound in the spleen and did not eat for half a year, taking daily only a few boiled water-chestnuts and jujubes; when pleased she would eat a steamed bun the size of a pellet, but she deeply loathed congee and rice. I judged that the spleen qi was replete and that nothing but bitter orange fruit could open it. I gave Warm the Gallbladder Decoction formula in the Dreams chapter with the bamboo shavings removed, several tens of packets, and she was at ease.

Clinical note임상 주석

A case history, and the detail is what makes it useful. Half a year without eating; a few water-chestnuts and jujubes daily; a steamed bun when in good spirits; a deep loathing of congee and rice specifically. 遇喜食 — eating when pleased — is the observation that told Danxi this was constraint rather than weakness, and 深惡粥飯, loathing plain food in particular, confirmed it. A depleted patient would take congee and refuse the bun; this one did the opposite. The presentation would now be recognized as an eating disorder arising after a specific reverse, and Danxi's reading — that the spleen qi is replete and bound, not empty — is why he opened rather than supplemented.

Dansim 丹心

1.19.12 Thought Bound So That Food Is Refused 思結不食

1.19.12.1

Source원문

詳見神門.

Translation영역

Treated in fuller detail in the Spirit chapter.

Donguibogam · Naesang

1.20 Clouding and Fatigue After Eating 食後昏困

1.20.1

Source원문

食入則困倦, 精神昏冒而欲睡者, 脾虛弱也. 《東垣》

Translation영역

Where food goes in and there is fatigue, the spirit clouded and veiled with a desire to sleep, the spleen is vacuous and weak.

Dongwon 東垣

1.20.2

Source원문

若脾胃不節, 損其胃氣, 不能剋化, 散於肝, 歸於心, 溢於肺, 食入則昏冒欲睡. 得臥則食在一邊, 氣暫得舒, 是知升發之氣不行也. 宜參朮湯. 《東垣》

Translation영역

Where the spleen and stomach are unregulated and the stomach qi detrimented so that it cannot subdue and transform, scatter to the liver, return to the heart and overflow to the lung, then food goes in and there is clouding with a desire to sleep. On lying down the food settles to one side and the qi is briefly eased — by this it is known that the raising and effusing qi does not move. Ginseng and Atractylodes Decoction is appropriate.

Clinical note임상 주석

得臥則食在一邊, 氣暫得舒 — on lying down the food settles to one side and the qi is briefly eased. That is an observation from patients, and it is offered as the proof that the raising qi has failed rather than that the food is excessive. Post-prandial somnolence is common and usually benign; the chapter reads it as spleen qi insufficient to lift after a meal.

Dongwon 東垣

1.20.3

Source원문

勞傷者, 過於勞役, 耗損元氣, 脾胃虛衰, 不任風寒, 故昏冒. 宜用補中益氣湯. 《回春》

Translation영역

In taxation damage, labour beyond measure wastes and detriments the origin qi, the spleen and stomach grow vacuous and decline and cannot bear wind and cold, and hence there is clouding. Supplement the Centre and Boost the Qi Decoction is used.

Hoechun 回春

1.20.4

Source원문

食後昏困, 宜用參芪湯ㆍ升陽補氣湯.

Translation영역

For clouding and fatigue after eating, Ginseng and Astragalus Decoction and Raise the Yang and Supplement the Qi Decoction are used.

Donguibogam · Naesang

1.21 No Liking for Food from Decline of the Yang in the Lower Origin 不嗜飮食由下元陽衰

1.21.1

Source원문

不進食, 服補脾藥不效者, 盖腎氣怯弱, 眞元衰削, 是以不能消化飮食. 譬之鼎釜之中, 置諸米穀, 下無火力, 終日米不熟, 其何能化. 黃魯直服兎絲子, 日挑數匙, 以酒下, 十日外, 飮啖如湯沃雪. 亦知此理也.

Translation영역

Where food is not taken and medicines that supplement the spleen have no effect, it is that the kidney qi is timid and weak and the true origin declined and pared away, and therefore food and drink cannot be digested. Compare it to a cauldron: put grain in it, and with no fire beneath, the rice will not cook the whole day through — how could it be transformed? Huang Luzhi took cuscuta, several spoonfuls scooped out daily and sent down with wine, and after ten days ate and drank as hot water melts snow. He too knew this principle.

Clinical note임상 주석

服補脾藥不效者 — where medicines that supplement the spleen have had no effect — is the indication, and it is defined by failure. The section exists for the patient in whom the obvious treatment has already been tried. The cauldron image is the clearest statement of the argument Bojin-hwan makes at 1.21.2: the grain is in the pot and the pot is sound, but there is no fire under it. Supplementing the spleen adds more grain; what is needed is fire from the kidney. 飮啖如湯沃雪, eating as hot water melts snow, is the same image the Accumulations chapter uses for an accumulation that dissolves.

Dansim 丹心

1.21.2

Source원문

宜用二神丸方見大便ㆍ補眞丸. 《丹心》

Translation영역

Two Spirits Pill formula in the Stool chapter and Supplement the True Pill are used.

Dansim 丹心

1.22 Internal Damage Begins as Heat in the Centre and Ends as Cold in the Centre 內傷病始爲熱中終爲寒中

1.22.1

Source원문

凡內傷脾胃之證, 始則四肢困熱, 無氣以動, 表熱自汗, 心煩不安, 胃氣熱, 熱氣熏胸中, 爲內熱之證. 宜以甘溫補中.

Translation영역

In patterns of internal damage to the spleen and stomach, at the beginning the four limbs are fatigued and hot with no qi to move, there is surface heat with spontaneous sweating and vexation of the heart without ease; the stomach qi is hot and the hot qi steams the chest — a pattern of internal heat. The sweet and warm should supplement the centre.

Immun 入門

1.22.2

Source원문

內傷病始爲熱中, 宜補中益氣湯ㆍ益胃升陽湯二方見上ㆍ參朮調中湯方見咳嗽ㆍ凝神散ㆍ當歸補血湯ㆍ三補枳朮丸. 《入門》

Translation영역

Where internal damage disease begins as heat in the centre, Supplement the Centre and Boost the Qi Decoction, Boost the Stomach and Raise the Yang Decoction both formulas above, Ginseng and Atractylodes Regulate the Centre Decoction formula in the Cough chapter, Congeal the Spirit Powder, Angelica Supplement the Blood Decoction and Three Supplements Bitter Orange and Atractylodes Pill are appropriate.

Immun 入門

1.22.3

Source원문

凡脾胃之證, 調治差誤, 或妄下之, 則末傳爲寒中. 復遇時寒, 則四肢厥逆, 心胃絞痛, 冷汗出. 夫六氣之勝, 皆能爲病, 惟寒毒最重, 陰主殺故也. 沈香溫胃丸主之. 《東垣》

Translation영역

In patterns of the spleen and stomach, where the regulating and treating has gone astray, or purging has been used recklessly, the end transmission is cold in the centre. Meeting seasonal cold again, the four limbs are reverse-cold, the heart and stomach gripe with pain, and cold sweat comes out. Of the prevailings of the six qi all can make disease, but cold toxin is the gravest, for yin governs killing. Aloeswood Warm the Stomach Pill governs it.

Clinical note임상 주석

調治差誤, 或妄下之 — the treating has gone astray, or purging has been used recklessly. The cold end of internal damage is here attributed to the physician, and the chapter names it rather than describing it as a natural course. That is the third place in this volume where an iatrogenic category is given its own section, after yin jaundice at Hwangdal 5.7 and the damp warmth warning at Seup 3.8.6.1.

Dongwon 東垣

1.22.4

Source원문

末傳爲寒中, 宜神聖復氣湯ㆍ白朮附子湯ㆍ草豆蔲丸方見胸部ㆍ守中金元. 《東垣》

Translation영역

Where the end transmission is cold in the centre, Spirit-Sagely Restore the Qi Decoction, White Atractylodes and Aconite Decoction, Tsaoko Pill formula in the Chest chapter and Guard the Centre Golden Pill are appropriate.

Dongwon 東垣

1.23 Internal Damage Changing into the Various Diseases 內傷變爲諸病

1.23.1

Source원문

夫氣之初病也, 其端甚微. 或因些少飮食不謹, 或外冒六氣, 或內感七情, 或食味過厚, 偏助陽氣, 積成膈熱, 或資稟素實, 表密無汗, 或性急多怒, 陰火炎上, 以致津液不行, 淸濁相干, 氣爲之病. 或痞, 或痛, 或不思食, 或噎噫腐氣, 或呑酸, 或嘈雜, 或膨滿. 不求其原, 便認爲寒, 遽以辛香燥熱之劑投之, 舊疾被劫暫開, 濁液易於攢聚, 或半月或一月, 前病復作. 如此蔓延, 自氣成積, 自積成痰. 此爲痰, 爲飮, 爲呑酸之由也. 良工未遇, 謬藥又行, 痰挾汚血, 遂成窠囊. 於是爲痞, 爲痛, 爲嘔, 爲吐, 爲噎嗝反胃之次第也. 《丹心》

Translation영역

When the qi first falls ill, its beginning is very slight. It may come of some small carelessness in food and drink, or of braving the six qi without, or of being moved by the seven affects within, or of flavours too rich so that the yang qi is one-sidedly assisted and heat accumulates at the diaphragm, or of a constitution replete from the first with the surface closed and no sweating, or of a hasty temper and much anger so that the yin fire flames upward — and thereby the fluids do not move, clear and turbid interfere with one another, and the qi becomes diseased. There may be glomus, or pain, or no thought of food, or dysphagia and belching of putrid qi, or acid swallowing, or clamouring, or swelling and fullness. Not seeking the origin, people take it at once for cold and hastily throw acrid, aromatic, drying and hot medicines at it; the old complaint is plundered and opens briefly, the turbid humour gathers the more readily, and in half a month or a month the former disease returns. Spreading in this way, from qi it becomes accumulation and from accumulation it becomes phlegm. This is how phlegm, rheum and acid swallowing come about. A skilled hand not being met with, mistaken medicines are used again; phlegm carries foul blood with it and forms a nest and pocket. And thence come glomus, pain, retching, vomiting, and in order dysphagia and stomach reflux.

Clinical note임상 주석

The chapter's account of how a small fault becomes an intractable disease, and the mechanism it names is treatment rather than neglect. Warming medicines given for what is not cold open the complaint briefly, and the relief is what persuades everyone to continue. 自氣成積, 自積成痰 — from qi to accumulation, from accumulation to phlegm — and then, once phlegm takes up blood, 窠囊, a nest and pocket, which the tradition treats as no longer reversible. The Accumulations chapter uses the same word at 1.7 for a mass that has settled. The order at the end is a prognosis: glomus, pain, retching, vomiting, dysphagia, stomach reflux. Danxi is describing progression to oesophageal and gastric obstruction, and he names the physician's part in reaching it.

Dansim 丹心

1.24 Acid Swallowing and Acid Vomiting 呑酸吐酸

1.24.1

Source원문

呑酸者, 水刺心也. 吐酸者, 吐出酸水也. 《回春》

Translation영역

Acid swallowing is water stabbing the heart. Acid vomiting is vomiting out sour water.

Clinical note임상 주석

The two are separated at the outset: in one the acid rises and is swallowed back, stinging; in the other it is brought up. The distinction governs the whole section and decides which formulas are used at 1.24.10.

Hoechun 回春

1.24.2

Source원문

濕熱在胃口上, 飮食入胃, 被濕熱鬱遏, 其食不得傳化, 故作酸也. 如穀肉在器, 久則易爲酸也. 《丹心》

Translation영역

Damp heat lies above the mouth of the stomach; food and drink enter the stomach and are depressed and hemmed in by the damp heat so that they cannot be conveyed and transformed, and hence they turn sour. It is as grain and meat in a vessel: left long, they readily turn sour.

Clinical note임상 주석

Fermentation as the analogy, and it is apt: warmth, moisture and time turn food sour in a jar and in a stomach alike. The Dampness chapter uses the same image at 3.1.1 for how damp heat produces yellowing.

Dansim 丹心

1.24.3

Source원문

內經病機曰, 諸嘔吐酸, 皆屬於熱. 傷寒論曰, 嘔家雖有陽明證, 愼不可下. 以雜病論之, 嘔吐酸水者, 甚則酸水浸其心, 不任其苦, 其次則吐出酸水, 令上下牙酸澁, 不能相對. 以辛熱熱劑療之, 必差矣, 若以病機之法作熱攻之者, 誤矣. 《東垣》

Translation영역

The Neijing's disease mechanisms say that all retching and acid vomiting belongs to heat. The Shanghanlun says that in one who retches, though there be a yang brightness pattern, one must take care not to purge. Speaking of it as a miscellaneous disease: where sour water is vomited, in severe cases the sour water soaks the heart and the suffering cannot be borne; in lesser cases sour water is vomited out, setting the upper and lower teeth on edge so that they cannot be brought together. Treating it with acrid and hot medicines will certainly cure it; treating it as heat by the method of the disease mechanisms is an error.

Clinical note임상 주석

令上下牙酸澁, 不能相對 — setting the teeth on edge so that they cannot be brought together — is the most vivid line in the section and needs no gloss. It is what acid does to enamel and to the sensation of biting. Dongwon here contradicts the Neijing outright and says so.

Dongwon 東垣

1.24.4

Source원문

呑酸與吐酸不同, 吐酸是吐出酸水如醋. 盖平時津液隨上升之氣鬱積而成. 鬱積之久, 濕中生熱, 故從木化, 遂作酸味, 非熱而何. 其不能自涌而出, 伏於肺胃之間, 咯不出, 嚥不下. 肌表得風寒則內鬱, 愈鬱而酸味刺心. 肌表得溫煖, 或得香熱湯丸, 亦可暫解. 內經言熱者, 言其本也. 東垣言寒者, 言其末也. 《丹心》

Translation영역

Acid swallowing and acid vomiting are not the same; acid vomiting is vomiting out sour water like vinegar. In ordinary times the fluids follow the rising qi and are depressed into accumulation. Depressed and accumulated long, heat is engendered within the damp and it transforms according to wood, so that a sour flavour is made — if this is not heat, what is it? Where it cannot well up and out of itself, it lies hidden between the lung and the stomach, not to be hawked up nor swallowed down. Where the surface meets wind and cold, the depression turns inward, and the more depressed it is the more the sour flavour stabs the heart. Where the surface meets warmth, or a fragrant and hot decoction or pill is taken, it may also be briefly relieved. What the Neijing calls heat speaks of its root; what Dongwon calls cold speaks of its branch.

Clinical note임상 주석

Danxi's resolution of the dispute, and it is the most elegant passage in the chapter: the Neijing describes the root and Dongwon the branch, so both are right about different things. The clinical observation behind it is exact — reflux worsens in cold and eases briefly with something warm — and that brief easing is precisely what misleads a physician into calling it cold.

Dansim 丹心

1.24.5

Source원문

木味爲酸, 如飮食熱則易爲酸也. 《河間》

Translation영역

The flavour of wood is sour; where food and drink are hot they readily turn sour.

Hagan 河間

1.24.6

Source원문

內經, 以諸嘔吐酸, 皆屬於熱. 惟李東垣, 獨以爲寒, 誠一偏之見也. 河間原病式曰, 酸者, 肝木之味也. 由火盛制金, 不能平木, 則肝木自甚, 故爲酸. 是以肝熱則口酸也. 所以中酸, 不宜食粘滑油膩者, 謂能令氣鬱不通暢. 故宜飡糲食菜蔬者, 能令氣之通利也. 《正傳》

Translation영역

The Neijing takes all retching and acid vomiting to belong to heat. Only Li Dongwon alone held it to be cold, which is truly a one-sided view. Hejian's Yuanbingshi says: sourness is the flavour of the liver wood. Because fire is exuberant it restrains metal, which cannot then level wood, so the liver wood becomes excessive of itself and hence there is sourness. Therefore where the liver is hot the mouth is sour. For this reason one with acid in the centre should not eat sticky, slippery, oily and greasy things, which are said to make the qi depressed and not free; coarse grain and vegetables are fitting, which make the qi flow freely.

Clinical note임상 주석

The dietary advice at the end is the practical residue of the argument and it is sound whatever one makes of the five-phase reasoning: avoid fatty and rich food, eat plainly. Fat delays gastric emptying and worsens reflux.

Jeongjeon 正傳

1.24.7

Source원문

宿食留飮, 酸蜇心痛, 牙齒亦酸, 宜麴朮丸. 專吐淸水者, 朮苓湯.

Translation영역

Where retained food and lodged rheum bring sour stinging with pain at the heart and the teeth also set on edge, Leaven and Atractylodes Pill is appropriate. For one who vomits only clear water, Atractylodes and Poria Decoction.

Immun 入門

1.24.8

Source원문

痰火停食一日半日, 腐化酸水, 吐出黃臭, 或醋心不安, 宜四味茱連丸ㆍ九味茱連丸ㆍ淸痰丸.

Translation영역

Where phlegm fire holds food a day or half a day so that it rots into sour water and is vomited up yellow and foul, or there is vinegar in the heart without ease, Four Flavours Evodia and Coptis Pill, Nine Flavours Evodia and Coptis Pill and Clear Phlegm Pill are appropriate.

Immun 入門

1.24.9

Source원문

朝食甘美, 至晡時心腹刺酸吐出, 此血虛火盛. 宜四物湯, 加陳皮ㆍ黃芩ㆍ黃連ㆍ桃仁ㆍ紅花ㆍ麻仁ㆍ甘草.

Translation영역

Where the morning meal is sweet and pleasant but toward dusk there is sour stabbing of heart and abdomen with vomiting, this is blood vacuity with fire exuberant. Four Substances Decoction with tangerine peel, scutellaria, coptis, peach kernel, safflower, hemp seed and licorice added is appropriate.

Clinical note임상 주석

The diurnal pattern is the diagnosis: food taken in the morning is well tolerated and the trouble comes at dusk. The chapter reads the timing as blood vacuity, since dusk is when the yin should take over and cannot. The same reasoning appears at Changman 3.4.3 for grain distension, where morning and evening divide the same way.

Immun 入門

1.24.10

Source원문

呑酸大便閉者, 透膈湯, 大便利者, 參萸丸. 《入門》

Translation영역

In acid swallowing where the stool is bound, Penetrate the Diaphragm Decoction; where the stool is free, Ginseng and Evodia Pill.

Immun 入門

1.24.11

Source원문

呑酸, 宜節厚味, 必蔬食自養, 則病易安. 《正傳》呑酸吐酸, 宜茱連丸ㆍ蒼連丸ㆍ蒼連湯ㆍ黃連淸化丸ㆍ增味二陳湯ㆍ平肝順氣保中丸, 又一方.

Translation영역

In acid swallowing, rich flavours should be moderated and vegetable food taken to nourish oneself, and the disease is then easily settled. For acid swallowing and acid vomiting, Evodia and Coptis Pill, Atractylodes and Coptis Pill, Atractylodes and Coptis Decoction, Coptis Clear and Transform Pill, Augmented Two Matured Ingredients Decoction and Level the Liver, Normalize the Qi and Protect the Centre Pill, and one further formula.

Jeongjeon 正傳

1.24.12

Source원문

一田父, 病因留飮, 嘔酸水十餘年, 藥餌鍼艾俱不效. 戴人以苦劑越之, 吐涎如膠二三升, 談笑而愈. 《子和》

Translation영역

A farmer, ill from lodged rheum, vomited sour water for more than ten years; medicines, needling and moxa had all failed. Dai Ren surpassed it with a bitter medicine; he vomited two or three seung of drool like glue, and recovered talking and laughing.

Clinical note임상 주석

Zhang Congzheng's case, and it is recorded here as much for the ten years of failed treatment as for the cure. 談笑而愈 — recovered talking and laughing — is his characteristic flourish. Two or three seung of glue-like drool is a great deal, and the case belongs to his school's insistence that what has lodged must be expelled rather than supplemented around.

Jahwa 子和

1.25 Clamouring of the Stomach 嘈雜

1.25.1

Source원문

嘈雜之證, 似飢不飢, 似痛不痛, 而有懊憹不自寧之況者, 是也. 其證或兼噯氣, 或兼痞滿, 或兼惡心, 漸至胃脘作痛, 皆痰火之爲患也.

Translation영역

The pattern of clamouring: like hunger and not hunger, like pain and not pain, with a state of anguish and no ease in oneself — this is it. The pattern may carry belching, or glomus fullness, or nausea, and gradually comes to pain at the stomach venter. All of it is the trouble made by phlegm fire.

Clinical note임상 주석

似飢不飢, 似痛不痛 — like hunger and not hunger, like pain and not pain. The definition works by negation because the sensation has no positive name, and any patient with functional dyspepsia recognizes it at once. The chapter treats it as a condition in its own right rather than as a minor symptom, and gives it seven passages and eight formulas.

Dansim 丹心

1.25.2

Source원문

治法, 以南星ㆍ半夏ㆍ橘紅之類, 消其痰, 芩ㆍ連ㆍ梔子ㆍ石膏ㆍ知母之類, 降其火, 蒼朮ㆍ白朮ㆍ芍藥之類, 健脾行濕, 壯其本元則安, 宜用化痰淸火湯.

Translation영역

The treatment method: with arisaema, pinellia and red tangerine peel and their kind disperse the phlegm; with scutellaria, coptis, gardenia, gypsum and anemarrhena and their kind downbear the fire; with atractylodes lancea, white atractylodes and peony and their kind fortify the spleen and move damp — strengthening the root origin, and there is ease. Transform Phlegm and Clear Fire Decoction is used.

Dansim 丹心

1.25.3

Source원문

此乃食鬱有熱, 乃必用之藥也. 《丹心》

Translation영역

This is food depression with heat, and these are the medicines that must be used.

Dansim 丹心

1.25.4

Source원문

嘈雜, 只是痰因火而動, 令人心嘈, 似飢非飢, 有積有熱也. 《丹心》

Translation영역

Clamouring is only phlegm stirred by fire, making the heart clamour — like hunger and not hunger, with accumulation and with heat.

Dansim 丹心

1.25.5

Source원문

胃中痰火動而嘈者, 二陳湯, 加(薑炒)芩ㆍ連ㆍ梔子ㆍ南星.

Translation영역

Where phlegm fire in the stomach stirs and clamours, Two Matured Ingredients Decoction with ginger-fried scutellaria, coptis, gardenia and arisaema added.

Dansim 丹心

1.25.6

Source원문

嘈雜, 俗謂之心嘈也. 宜香砂平胃散方見上ㆍ消食淸鬱湯ㆍ淸鬱二陳湯卽上增味二陳湯也ㆍ平胃分消飮ㆍ朮連丸ㆍ淸痰丸方見上ㆍ三聖丸ㆍ平肝順氣保中丸方見上ㆍ交泰丸.

Translation영역

Clamouring is commonly called clamouring of the heart. Costus and Amomum Calm the Stomach Powder formula above, Disperse Food and Clear Depression Decoction, Clear Depression Two Matured Ingredients Decoction that is, the Augmented Two Matured Ingredients Decoction above, Calm the Stomach and Divide and Disperse Drink, Atractylodes and Coptis Pill, Clear Phlegm Pill formula above, Three Sages Pill, Level the Liver, Normalize the Qi and Protect the Centre Pill formula above and Communicate with Peace Pill are appropriate.

Donguibogam · Naesang

1.25.7

Source원문

五更心嘈者, 思慮傷心, 血虛也. 宜養血四物湯ㆍ當歸補血湯. 《回春》

Translation영역

Clamouring of the heart at the fifth watch is thought and worry damaging the heart, with blood vacuity. Nourish the Blood Four Substances Decoction and Angelica Supplement the Blood Decoction are appropriate.

Clinical note임상 주석

五更, the fifth watch, is the hours before dawn, and clamouring at that time is read as blood vacuity rather than as phlegm fire — the same timing rule the section uses at 1.24.9. Waking before dawn with epigastric gnawing is a recognizable complaint, and the chapter assigns it to worry rather than to diet.

Hoechun 回春

1.26 Anguish 懊憹

1.26.1

Source원문

乃虛煩之劇者. 懊者, 懊惱之懊, 憹者, 鬱悶之貌. 卽心中懊懊惱惱, 煩煩憹憹, 鬱鬱然不舒暢, 憤然無柰, 比之煩悶而甚者也. 許學士, 所謂懊憹, 終夕不得臥, 心中無曉會處者, 是也. 《綱目》

Translation영역

This is the severest form of vacuity vexation. 懊 is the 懊 of vexed distress; 憹 is the look of depressed oppression. That is to say, within the heart there is vexation upon vexation and distress upon distress, depressed and not opened out, indignant and without recourse — compared with mere vexed oppression it is the more severe. What Xu Shuwei called anguish, lying awake the whole night with nothing in the heart that can be made out, is this.

Clinical note임상 주석

The section defines a word by unpacking both its graphs, which the Bogam does only for terms it expects to be misread. 心中無曉會處 — nothing in the heart that can be made out — is Xu Shuwei's phrase for a distress the patient cannot locate or name. What is described is a restless nocturnal anguish with an epigastric component, and the chapter places it here rather than in the Spirit chapter because it arises from the stomach.

Gangmok 綱目

1.26.2

Source원문

懊憹, 心中不自如也. 比煩燥更甚. 傷寒表證誤下, 陽氣內陷, 心下固硬者, 則爲結胸. 若胃氣空虛, 客熱在膈, 短氣煩躁微疼則爲懊憹. 懊憹者, 煩不得眠, 飢不能食也. 治同嘈雜. 兼見寒門《入門》

Translation영역

Anguish is the heart not being at ease in itself, more severe than vexation and agitation. Where an exterior pattern in cold damage has been wrongly purged and the yang qi has fallen inward with hardness below the heart, it becomes chest bind. Where the stomach qi is empty and void and visiting heat lies at the diaphragm, with shortness of breath, vexed agitation and slight pain, it becomes anguish. In anguish there is vexation without sleep, and hunger without being able to eat. Treatment is the same as for clamouring. see also the Cold Damage chapter

Clinical note임상 주석

煩不得眠, 飢不能食 — vexation without sleep, hunger without being able to eat — is the pair that names it, and it is again iatrogenic in origin: an exterior pattern wrongly purged. The distinction from chest bind is by palpation: hardness below the heart is 結胸, slight pain without hardness is 懊憹.

Immun 入門

1.27 Belching 噫氣

1.27.1

Source원문

噫飽氣, 俗作噯氣.

Translation영역

Belching of the full qi; in common usage written as eructation.

Donguibogam · Naesang

1.27.2

Source원문

噫屬心脾. 《綱目》

Translation영역

Belching belongs to the heart and spleen.

Gangmok 綱目

1.27.3

Source원문

足太陰之脉病, 是動則病腹脹善噫.

Translation영역

Where the vessel of the foot greater yin is diseased, when it stirs there is abdominal distension and frequent belching.

Yeongchu 靈樞

1.27.4

Source원문

帝曰, 人之噫者, 何氣使然. 岐伯曰, 寒氣客于胃, 厥逆從下上散, 復出于胃, 故爲噫. 補足太陰陽明. 《靈樞》

Translation영역

The Yellow Emperor said: a person's belching — what qi brings it about? Qi Bo said: cold qi lodges as a guest in the stomach, and reversal counterflow scatters from below upward and issues again from the stomach, and hence there is belching. Supplement the foot greater yin and yang brightness.

Yeongchu 靈樞

1.27.5

Source원문

太陰病所謂上走心爲噫者, 陰盛而上走於陽明, 陽明絡屬心, 故上走而爲噫也. 又曰, 心爲噫. 《內經》

Translation영역

In greater yin disease, what is called running upward to the heart and becoming belching: the yin being exuberant it runs upward to the yang brightness, and the yang brightness network belongs to the heart, so it runs upward and becomes belching. It is also said: the heart makes belching.

Naegyeong 內經

1.27.6

Source원문

寸脉緊, 寒之實也. 寒在上焦胸中, 必滿而噫. 《脉經》

Translation영역

A tight inch pulse is the repletion of cold. Cold lying in the upper burner and chest, there must be fullness with belching.

Maekgyeong 脉經

1.27.7

Source원문

上焦竭善噫, 何也. 師曰, 上焦受中焦氣未和, 不能消, 故能噫耳.

Translation영역

The upper burner exhausted with frequent belching — how so? The master said: the upper burner receives the middle burner qi before it is harmonized and cannot digest it, and so there is belching.

Junggyeong 仲景

1.27.8

Source원문

上焦不歸者, 噫而呑酸, 不歸, 不至也. 上焦之氣不至其部, 則物不能傳化, 故噫而酢呑.

Translation영역

Where the upper burner does not return there is belching with acid swallowing; not returning means not arriving. Where the qi of the upper burner does not arrive at its division, things cannot be conveyed and transformed, and hence there is belching with sour swallowing.

Junggyeong 仲景

1.27.9

Source원문

寸口脉弱而緩, 弱者, 陽氣不足, 緩者, 胃氣有餘, 噫而呑酸, 食卒不下, 氣塡於膈上. 《仲景》

Translation영역

Where the inch opening pulse is weak and moderate, weak means the yang qi is insufficient and moderate means the stomach qi is in surplus; there is belching with acid swallowing, food suddenly will not go down, and qi stuffs above the diaphragm.

Junggyeong 仲景

1.27.10

Source원문

傷寒噫氣, 何氣使然. 答曰, 胸中氣不交故也. 少陰經至胸中, 交於厥陰, 水火相傳而有聲, 故噫氣也. 如聖湯卽桔梗湯. 方見咽喉加枳實主之. 《活人》

Translation영역

Belching in cold damage — what qi brings it about? The answer: the qi in the chest does not intersect. The lesser yin channel reaches the chest and intersects with the reverting yin; water and fire pass to one another and there is sound, and hence belching. Sagely Decoction that is, Platycodon Decoction; formula in the Throat chapter with bitter orange fruit added governs it.

Hwarinseo 活人

1.27.11

Source원문

噫氣者, 轉出食氣也. 胃中鬱火, 膈上稠痰, 飮食鬱成, 宜祛痰火丸.

Translation영역

Belching is the turning out of food qi. Depressed fire in the stomach, thick phlegm above the diaphragm, formed by food and drink depressed — Dispel Phlegm and Fire Pill is appropriate.

Immun 入門

1.27.12

Source원문

氣實噫者, 食罷噫轉腐氣, 甚則物亦噫, 濕熱所致. 宜二陳湯, 加蒼朮ㆍ神麴ㆍ麥芽ㆍ(薑炒)黃連.

Translation영역

In belching from qi repletion, after eating the belching turns up putrid qi, and in severe cases matter is belched too; damp heat brings it about. Two Matured Ingredients Decoction with atractylodes lancea, medicated leaven, barley sprout and ginger-fried coptis added is appropriate.

Immun 入門

1.27.13

Source원문

氣虛噫者, 濁氣塡胸也. 不因飮食常噫者, 虛也. 盖胃有濁氣, 膈有濕痰, 俱能發噫, 六君子湯方見痰飮, 加沈香爲君, 厚朴ㆍ蘇葉爲臣, 吳茱萸爲使煎服. 《入門》

Translation영역

In belching from qi vacuity, turbid qi stuffs the chest. Where there is constant belching not occasioned by food and drink, it is vacuity. The stomach having turbid qi and the diaphragm damp phlegm, both can bring on belching: Six Gentlemen Decoction formula in the Phlegm-Rheum chapter with aloeswood added as chief, magnolia bark and perilla leaf as deputy and evodia as envoy, decocted and taken.

Clinical note임상 주석

不因飮食常噫者, 虛也 — belching that is not occasioned by eating is vacuity. That is the discriminating question for the whole section: does the belching follow meals or not? Following meals it is repletion and dispersed; independent of meals it is vacuity and supplemented. The two formulas named at 1.27.12 and here go in opposite directions on that one point.

Immun 入門

1.27.14

Source원문

痰在中焦, 作噫氣呑酸, 胃脘當心而痛, 或嘔淸水惡心, 二陳湯, 加蒼朮ㆍ白朮ㆍ神麴ㆍ麥芽ㆍ川芎ㆍ縮砂ㆍ草豆蔲ㆍ枳實ㆍ猪苓ㆍ澤瀉ㆍ黃連ㆍ吳茱萸ㆍ梔子ㆍ木香ㆍ檳榔之類. 或煎服, 或丸服. 《正傳》

Translation영역

Where phlegm lies in the middle burner making belching with acid swallowing, the stomach venter painful over against the heart, or clear water vomited with nausea: Two Matured Ingredients Decoction with atractylodes lancea, white atractylodes, medicated leaven, barley sprout, chuanxiong, amomum, tsaoko, bitter orange fruit, polyporus, alisma, coptis, evodia, gardenia, costus and areca and their kind added, decocted or taken as pills.

Jeongjeon 正傳

1.27.15

Source원문

噫氣, 宜用星半湯ㆍ順氣和中湯方見嘔吐ㆍ枳殼散ㆍ破鬱丹ㆍ勻氣丸.

Translation영역

For belching, Arisaema and Pinellia Decoction, Normalize the Qi and Harmonize the Centre Decoction formula in the Vomiting chapter, Bitter Orange Powder, Break Depression Elixir and Even the Qi Pill are used.

Donguibogam · Naesang

1.27.16

Source원문

善飮酒, 每朝長噫不吐者, 小調中湯方見痰飮最妙. 《入門》

Translation영역

For one who drinks well and belches long every morning without vomiting, Minor Regulate the Centre Decoction formula in the Phlegm-Rheum chapter is best of all.

Immun 入門

1.28 Dysphagia and Diaphragmatic Blockage 噎嗝

1.28.1

Source원문

幷見嘔吐門.

Translation영역

Both treated in the Vomiting chapter.

Clinical note임상 주석

A heading with a cross-reference only. Dysphagia and stomach reflux are the endpoint Danxi names at 1.23, and the chapter keeps their places in its order while sending the treatment elsewhere.

Donguibogam · Naesang

1.29 Stomach Reflux 反胃

1.29.1

Source원문

幷見嘔吐門.

Translation영역

Both treated in the Vomiting chapter.

Donguibogam · Naesang

1.30 Quieting and Nourishing the Heart Spirit, Regulating and Treating the Spleen and Stomach 安養心神調治脾胃

1.30.1

Source원문

夫心者, 君主之官, 神明出焉. 凡喜怒悲忿憂思恐懼, 皆損元氣. 心者, 神之舍, 心君不寧, 化而爲火, 火者, 七神之賊也. 故曰, 陰火太盛, 經營之氣, 不能頤養於神, 乃脉病也. 人心之神, 眞氣之別名也. 得血則生, 血生則脉旺. 脉者, 神之舍. 若心生凝滯, 則七神離形, 而脉中惟有火矣. 善治斯病者, 惟在調和脾胃, 使心無凝滯. 或生歡欣, 或逢喜事, 或天氣暄暖, 或居溫和, 或食滋味, 或見可欲事, 則慧然如無病矣. 盖胃中元氣得舒伸故也. 《東垣》

Translation영역

The heart is the office of the sovereign, and the spirit brightness issues from it. Joy, anger, grief, indignation, worry, thought, fear and dread all detriment the origin qi. The heart is the dwelling of the spirit; when the heart sovereign is not at peace it transforms into fire, and fire is the robber of the seven spirits. Therefore it is said: where the yin fire is too exuberant, the qi of the construction cannot cherish and nourish the spirit, and this is a disease of the vessels. The spirit of a person's heart is another name for the true qi. Obtaining blood it lives; blood engendered, the vessels are effulgent. The vessels are the dwelling of the spirit. If congealing and stagnation arise in the heart, the seven spirits leave the form and there is only fire within the vessels. One who treats this disease well does so only by regulating and harmonizing the spleen and stomach so that the heart has no congealing. Whether gladness arises, or a happy matter is met with, or the weather turns mild and warm, or one dwells in warmth and harmony, or eats savoury food, or sees something one may desire — then all at once one is bright as though there were no disease. For the origin qi in the stomach has been able to stretch and unfold.

Clinical note임상 주석

The chapter's most humane passage, and its argument runs against its own method: the way to treat the heart is to regulate the stomach, and the proof offered is that a patient brightens at good news, mild weather, a warm room or a good meal. 慧然如無病 — bright all at once as though there were no disease — is offered as evidence rather than as consolation. If circumstances can lift the condition, the condition is not fixed in the tissue, and what lifts it is the origin qi being allowed to unfold. Dongwon lists eight emotions at the start and says all of them detriment the origin qi. The section is placed immediately after the chapter's account of chronic progression at 1.23, which is where a reader most needs it.

Dongwon 東垣

1.31 The Method of Regimen in Internal Damage 內傷將理法

1.31.1

Source원문

服藥後若喜食, 恐胃再傷. 須少進美食, 助其藥力, 益升浮之氣, 而滋其胃氣, 愼不可淡食以損藥力, 而助邪氣之降沈也. 可以少役形體, 使胃氣得轉運升發, 愼勿大勞役, 使氣復傷. 若脾胃得安靜尤佳. 若胃氣稍强, 少食果以助穀藥之力. 經曰, 五穀爲養, 五果爲助, 是也. 《東垣》

Translation영역

If appetite returns after taking medicine, there is fear that the stomach will be damaged again. A little good food should be taken to assist the medicine's force, boost the rising and floating qi and enrich the stomach qi; take care not to eat blandly, which would detriment the medicine's force and assist the evil qi in sinking. The body may be exercised a little so that the stomach qi can turn and move, rise and effuse; take care not to labour greatly, which would damage the qi again. If the spleen and stomach can be quiet and still, that is better still. If the stomach qi is somewhat stronger, eat a little fruit to assist the force of grain and medicine. The classic says: the five grains for nourishing, the five fruits for assisting — this is it.

Clinical note임상 주석

服藥後若喜食, 恐胃再傷 — if appetite returns after the medicine, there is fear the stomach will be damaged again. The warning is against the patient who feels better and eats as before, and it is the commonest way recovery is lost. 愼不可淡食 — take care not to eat blandly — runs against the usual advice and is deliberate: food too thin does not support the rising qi the treatment is trying to raise.

Dongwon 東垣

1.31.2

Source원문

帝曰, 胃惡熱而喜淸冷, 大腸惡淸冷而喜熱, 兩者不和, 何以調之. 岐伯曰, 調此者, 飮食衣服, 亦欲適寒溫, 寒無凄凔, 暑無出汗, 飮食熱無灼灼, 寒無凔凔. 寒溫中適, 故氣將持, 乃不致邪僻也. 《靈樞》

Translation영역

The Yellow Emperor said: the stomach loathes heat and favours what is clear and cold; the large intestine loathes what is clear and cold and favours heat. The two being out of accord, how are they to be regulated? Qi Bo said: in regulating this, food and drink and clothing should likewise be made fitting in cold and warmth. In cold, do not be chilled through; in heat, do not let sweat pour out. Food and drink hot, but not scalding; cold, but not chilling. Cold and warmth being fitting in the middle, the qi is held, and evil and deviance do not come about.

Clinical note임상 주석

The problem is stated as a genuine conflict — two organs with opposite preferences — and the answer is not to satisfy either but to keep everything moderate. 寒溫中適 is the whole of it.

Yeongchu 靈樞

1.31.3

Source원문

五味淡薄, 令人神爽氣淸. 《養性書》

Translation영역

Flavours bland and thin make a person's spirit fresh and their qi clear.

Yangseongseo 養性書

1.31.4

Source원문

飮食欲相接而溫和, 宜食多而肉少.

Translation영역

Food and drink should follow on one another and be warm and mild; grain should be much and meat little.

Deukhyo 得效

1.31.5

Source원문

一切肉, 惟須煮爛, 停冷食之, 食畢當漱口數過. 勿食生肉傷胃. 《得效》

Translation영역

All meat must be boiled until soft and left to cool before eating, and after eating the mouth should be rinsed several times. Do not eat raw meat, which damages the stomach.

Deukhyo 得效

1.31.6

Source원문

茶之爲物, 四時皆不可多喫, 令人下焦虛冷. 惟飽食後, 煖飮一兩盞不妨, 盖能消食故也.

Translation영역

Tea as a substance must not be drunk much in any of the four seasons, for it makes the lower burner vacuous and cold. Only after eating to fullness, one or two warm cups do no harm, for it can disperse food.

Hwarinsim 活人心

1.31.7

Source원문

茹性至冷, 菜苽雖治氣, 又能暗人耳目. 此等物, 四時皆不可多食, 老人尤宜忌之.

Translation영역

Vegetables are of an extremely cold nature; greens and melons, though they regulate the qi, can also dim a person's ears and eyes. Such things must not be eaten much in any of the four seasons, and the elderly should especially avoid them.

Hwarinsim 活人心

1.31.8

Source원문

脾好音樂. 夜食多則脾不磨. 周禮曰, 樂以侑食. 盖脾好音聲絲竹, 耳纔聞, 脾卽磨矣. 《活人心》

Translation영역

The spleen favours music. Eating much at night, the spleen does not grind. The Zhouli says: music to accompany food. The spleen favours the sound of strings and pipes; as soon as the ear hears it, the spleen grinds.

Clinical note임상 주석

The one entry in the chapter's regimen that prescribes neither food nor rest. 耳纔聞, 脾卽磨 — as soon as the ear hears it, the spleen grinds — and the Zhouli is cited to show the practice is ancient. Whatever is made of the mechanism, eating in a relaxed and pleasant setting does aid digestion, and the chapter's other regimen entries make the same point by different means.

Hwarinsim 活人心

1.31.9

Source원문

每食訖, 以手摩面及腹數百遍, 又行步躊躇, 計使中數里來, 則食易消, 令人能飮食, 無百病.

Translation영역

After every meal, rub the face and abdomen with the hand several hundred times, and walk about unhurriedly, reckoning to cover some few li; then food is easily digested, a person is able to eat and drink, and there are none of the hundred diseases.

Deukhyo 得效

1.31.10

Source원문

飽食卽臥, 或不消成積聚.

Translation영역

Lying down at once after eating to fullness, food may not be digested and becomes accumulation and gathering.

Deukhyo 得效

1.31.11

Source원문

又夜勿過醉飽. 《得效》

Translation영역

And at night do not go beyond measure in drink and fullness.

Deukhyo 得效

1.31.12

Source원문

行住坐臥, 各得其宜, 不可至疲倦. 《東垣》

Translation영역

In walking, standing, sitting and lying, let each obtain what is fitting to it, and do not come to exhaustion.

Clinical note임상 주석

Twelve passages of regimen, and the practical residue is consistent: eat warm and moderately, favour grain over meat, walk after meals, do not lie down on a full stomach, do not eat heavily at night, keep the setting pleasant. None of it has dated.

Dongwon 東垣

1.32 Excess of the Five Flavours Making Disease 五味過傷爲病

1.32.1

Source원문

酸走筋, 多食之, 令人癃小便不通也.

Translation영역

The sour runs to the sinews; eaten much, it makes a person dribble with urine that does not pass.

Yeongchu 靈樞

1.32.2

Source원문

醎走血, 多食之, 令人渴.

Translation영역

The salty runs to the blood; eaten much, it makes a person thirsty.

Clinical note임상 주석

The one of the five that holds without qualification: salt makes a person thirsty. The chapter's other flavour correspondences are schematic, but this is a plain observation and it sits among them unremarked.

Yeongchu 靈樞

1.32.3

Source원문

辛走氣, 多食之, 令人洞心心液爲汗, 洞心謂汗出也.

Translation영역

The acrid runs to the qi; eaten much, it makes a person's heart run through the heart's humour is sweat, and heart running through means sweating.

Yeongchu 靈樞

1.32.4

Source원문

苦走骨, 多食之, 令人變嘔.

Translation영역

The bitter runs to the bones; eaten much, it makes a person retch and change.

Yeongchu 靈樞

1.32.5

Source원문

甘走肉, 多食之, 令人悗心. 《靈樞》

Translation영역

The sweet runs to the flesh; eaten much, it makes a person's heart oppressed.

Yeongchu 靈樞

1.32.6

Source원문

五味稍薄, 則能養人令人神爽, 稍厚則能傷人, 令人昏悶. 《養性》

Translation영역

Where the five flavours are somewhat thin they can nourish a person and make the spirit fresh; somewhat rich, they can damage a person and make them clouded and oppressed.

Yangseong 養性

1.33 The Disease of Not Agreeing with the Water and Soil Is the Same as Internal Damage 不伏水土病與內傷同

1.33.1

Source원문

四方之氣, 溫涼不同, 隨方嗜欲, 因以成性. 若移其舊土, 多不習伏. 必因飮食以入腸胃, 腸胃不習, 疾病必生, 故曰, 不伏水土也. 《病源》

Translation영역

The qi of the four quarters differs in warmth and coolness, and appetites follow the place and thereby form a nature. If one is moved from the old soil, mostly one does not become accustomed. Since it must enter the intestines and stomach by way of food and drink, and the intestines and stomach are not accustomed to it, disease must arise — and so it is called not agreeing with the water and soil.

Clinical note임상 주석

A whole section on what happens when a person moves, and the aetiology is entirely dietary: the gut has formed its habits and the new food does not suit it. The condition is real and familiar — travellers' dyspepsia and diarrhoea — and the chapter's reading, that it is the same disorder as internal damage, is why it sits here.

Byeongwon 病源

1.33.2

Source원문

不伏水土之疾, 與瘴同源. 夫平原土堅水熱, 山谷土潤水冷. 俱以平胃散ㆍ棗肉平胃散方見內傷, 或加減正氣散方見濕門ㆍ不換金正氣散ㆍ藿香正氣散, 皆可隨水土風氣冷熱, 加減用之. 然以扶脾胃爲本. 凡縱酒色, 及食魚肉, 果菜, 笋蕨, 生冷, 糯飯, 燒酒, 及油炒ㆍ醬煿, 雞鵝, 麪食, 過飢過飽, 歇臥處有穢氣, 半夜失盖, 早行沾露, 空腹出外, 皆能發瘴. 仕宦商賈遊外, 俱宜節飮食愼起居以防之. 大槪與濕瘴同治. 《入門》

Translation영역

The disease of not agreeing with the water and soil has the same origin as miasma. On the plains the soil is firm and the water warm; in the mountain valleys the soil is moist and the water cold. In both, Calm the Stomach Powder and Jujube Flesh Calm the Stomach Powder formulas in the Internal Damage chapter, or Modified Correct the Qi Powder formula in the Dampness chapter, Unchangeable Gold Correct the Qi Powder and Agastache Correct the Qi Powder may all be used with additions and subtractions according to the cold and heat of the water, soil and wind qi. But supporting the spleen and stomach is the root. Giving free rein to drink and sex; eating fish and meat, fruit and greens, bamboo shoots and bracken, raw and cold things, glutinous rice, distilled spirits, things fried in oil or scorched in sauce, chicken and goose, and wheat foods; going too hungry or too full; a resting place with foul air; losing the covers at midnight; travelling early through the dew; going out on an empty stomach — all of these can bring on miasma. Officials, merchants and those travelling abroad should all regulate their food and drink and be careful in activity and rest, to prevent it. Broadly it is treated the same as damp miasma.

Clinical note임상 주석

A travel medicine, and the audience is named: 仕宦商賈遊外, officials, merchants and those travelling abroad. What it lists is a long catalogue of circumstances that bring illness on the road — bad sleeping quarters, going uncovered at night, setting out through the dew, leaving on an empty stomach. The Dampness chapter treats the miasma side of this at 3.2, and the two sections agree that the root of prevention is the spleen and stomach rather than any prophylactic.

Immun 入門

1.34 Medicines That Regulate and Supplement in Internal Damage 內傷調補藥

1.34.1

Source원문

內傷脾胃, 調理常服藥, 宜參苓白朮丸ㆍ參苓白朮散ㆍ瑞蓮丸ㆍ太和丸ㆍ雲林潤身丸ㆍ補眞膏ㆍ參朮調元膏ㆍ白朮和胃丸ㆍ異功散方見五藏ㆍ九仙王道糕ㆍ秘傳三仙糕ㆍ茯苓造化糕ㆍ白雪糕ㆍ砂糖丸ㆍ天眞元ㆍ還元丹ㆍ助元散ㆍ蒼朮膏ㆍ白朮膏.

Translation영역

For internal damage to the spleen and stomach, medicines to be taken regularly for regulation: Ginseng and Poria White Atractylodes Pill, Ginseng and Poria White Atractylodes Powder, Auspicious Lotus Pill, Great Harmony Pill, Yunlin Moisten the Body Pill, Supplement the True Paste, Ginseng and Atractylodes Regulate the Origin Paste, White Atractylodes Harmonize the Stomach Pill, Extraordinary Merit Powder formula in the Five Viscera chapter, Nine Immortals Kingly Way Cake, Secretly Transmitted Three Immortals Cake, Poria Transformation Cake, White Snow Cake, Sugar Pill, Heavenly Truth Pill, Restore the Origin Elixir, Assist the Origin Powder, Atractylodes Lancea Paste and White Atractylodes Paste.

Clinical note임상 주석

調理常服藥 — medicines to be taken regularly for regulation — names what this section is: not treatment for an episode but daily supplementation for a weakened digestion. Five of the nineteen are cakes or pastes rather than decoctions or pills, which is why the section reads more like a diet than a formulary. The three cakes descend in cost from ginseng-and-butter to rice and sugar alone.

Donguibogam · Naesang

1.35 Food Reversal 食厥

1.35.1

Source원문

凡人卒然暈倒, 口噤不能言, 目不識人, 四肢不擧等證, 多因飮食過度, 變爲異常之疾, 必須審問. 若果因飮食之後, 或着氣惱, 多用薑鹽湯多灌, 探吐之後, 服加味六君子湯卽愈. 《回春》

Translation영역

Where a person suddenly faints and falls, the jaw clenched and unable to speak, the eyes not recognizing people, the four limbs not lifting and the like, it is mostly because food and drink have passed all measure and changed into an unusual disease; one must question closely. If it proves to be after eating, or after a fit of vexation, give much ginger and salt decoction, pour it in freely, and after probing to induce vomiting give Augmented Six Gentlemen Decoction, and it is cured.

Clinical note임상 주석

必須審問 — one must question closely — is the instruction that matters. The presentation is indistinguishable from wind stroke, and only the history separates them. **Sudden collapse with loss of consciousness is a medical emergency. Pouring liquid into an unconscious person and inducing vomiting risks fatal aspiration and must not be attempted.**

Hoechun 回春

1.36 Food Accumulation Resembling Cold Damage 食積類傷寒

1.36.1

Source원문

凡傷食成積, 亦能發熱頭痛, 證似傷寒, 宜用陶氏平胃散. 《入門》

Translation영역

Where food damage has formed an accumulation, it can also bring fever and headache, the pattern resembling cold damage; Tao's Calm the Stomach Powder is used.

Clinical note임상 주석

The section exists because sweating such a patient is the standing error. The discriminating signs are at 1.6.5 — body not aching, belching like a rotten egg — and at 1.4.5, where pressing the epigastrium hurts.

Immun 入門

1.37 In Internal Damage from Food, Vomiting Is Indicated 內傷飮食宜吐

1.37.1

Source원문

宿食在上脘, 當吐之. 宜瓜蔕散方見吐門. 《仲景》食塞胸中, 上部有脉, 下部無脉, 其人當吐, 不吐者死, 宜瓜蔕散. 《東垣》

Translation영역

Where retained food lies in the upper venter, it should be vomited; Melon Stalk Powder formula in the Vomiting chapter is appropriate. Where food blocks the chest, the pulse present in the upper position and absent in the lower, that person should vomit; one who does not vomit dies — Melon Stalk Powder is appropriate.

Clinical note임상 주석

上部有脉, 下部無脉 — pulse present above and absent below — is a grave finding, and the chapter's claim that a patient who does not vomit dies is meant literally. **This describes circulatory collapse. It is a medical emergency; inducing vomiting in such a patient is dangerous and the presentation requires urgent care.**

Junggyeong 仲景

1.37.2

Source원문

尋常飮食過飽, 在膈不下, 不必用瓜蔕散. 但以手或以雞翎探吐之, 鹽湯吐法更佳. 《東垣》

Translation영역

Where in the ordinary way food and drink have been taken to excess and lie at the diaphragm without going down, Melon Stalk Powder need not be used; probe with the hand or with a chicken feather to induce vomiting, and the salt decoction method of vomiting is better still.

Clinical note임상 주석

不必用瓜蔕散 — Melon Stalk Powder need not be used — is a piece of restraint worth noting. For ordinary overeating the chapter refuses the toxic emetic and reaches for a feather and salt water instead.

Dongwon 東垣

1.37.3

Source원문

飮食不消, 在胸膈間, 兀兀反覆欲吐, 甚者, 用瓜蔕散, 輕者, 以物探吐之. 《綱目》

Translation영역

Where food is not digested and lies between the chest and diaphragm, with a heaving to and fro and a wish to vomit: in severe cases use Melon Stalk Powder, in light cases probe with something to induce vomiting.

Gangmok 綱目

1.37.4

Source원문

飮酒過多, 速吐之爲佳. 《得效》

Translation영역

Where drink has been taken to excess, vomiting it up quickly is best.

Deukhyo 得效

1.37.5

Source원문

吐出宿食, 宜用陰陽湯或溫鹽湯多飮, 探吐之. 《入門》

Translation영역

To vomit out retained food, Yin and Yang Decoction or warm salt decoction drunk freely, then probing to induce vomiting.

Clinical note임상 주석

**Inducing vomiting is no longer recommended in poisoning or overdose, and is dangerous where consciousness is impaired or a corrosive has been swallowed. A large salt dose can itself be fatal.**

Immun 入門

1.38 In Internal Damage from Food, Purging Is Indicated 內傷飮食宜下

1.38.1

Source원문

人病有宿食, 何以別之. 曰脉浮而大, 按之反澁, 故知有宿食. 宜大承氣湯方見寒門下之.

Translation영역

How is it distinguished that a person's disease has retained food in it? It is said: the pulse is floating and large, and pressing it is on the contrary rough — by this retained food is known. Major Order the Qi Decoction formula in the Cold Damage chapter should purge it.

Clinical note임상 주석

浮大 at the surface and 澁 under pressure — a pulse that promises fullness and delivers roughness. The finding turns on pressing firmly, which is the same manoeuvre that inverts the reading in Danggwibohyeol-tang's indication.

Junggyeong 仲景

1.38.2

Source원문

脉數而滑者, 此有宿食, 宜下之愈. 用大ㆍ小承氣湯方見寒門. 宿食潮熱, 用小承氣湯. 《仲景》

Translation영역

Where the pulse is rapid and slippery there is retained food, and purging cures it. Use Major or Minor Order the Qi Decoction formulas in the Cold Damage chapter. Where retained food brings tidal fever, use the Minor.

Junggyeong 仲景

1.38.3

Source원문

傷寒物或熱物者, 宜備急丸方見救急ㆍ除源散. 《入門》

Translation영역

Where the damage is from cold things or hot things, Prepare for Urgency Pill formula in the Emergency chapter and Remove the Source Powder are appropriate.

Immun 入門

1.38.4

Source원문

食在中下脘者, 宜下以逐之. 木香見睍丸ㆍ丁香脾積丸方見腹部ㆍ感應元方見大便, 選用. 《入門》

Translation영역

Where food lies at the middle and lower venter, it should be purged to drive it out: Costus See the Sun Pill, Clove Spleen Accumulation Pill formula in the Abdomen chapter and Responsive Pill formula in the Stool chapter, chosen from.

Immun 入門

1.38.5

Source원문

下食積, 宜用泝源散ㆍ煮黃丸ㆍ丁香脾積丸方見大便ㆍ神應丸卽感應元一名ㆍ枳實大黃湯.

Translation영역

To purge food accumulation, Trace the Source Powder, Boiled Yellow Pill, Clove Spleen Accumulation Pill formula in the Stool chapter, Spirit Response Pill that is, another name for the Responsive Pill and Bitter Orange Fruit and Rhubarb Decoction are used.

Donguibogam · Naesang

1.39 Prohibitions 禁忌法

1.39.1

Source원문

凡飮食中, 忌食大醎, 大辛, 蒜ㆍ韭, 五辢, 醋大料物, 薑ㆍ桂之類, 皆傷元氣.

Translation영역

In food and drink generally, avoid what is very salty or very acrid, garlic and garlic chives, the five pungents, vinegar and strong condiments, ginger and cinnamon and their kind — all of them damage the origin qi.

Dongwon 東垣

1.39.2

Source원문

藥中澤瀉ㆍ茯苓ㆍ猪苓ㆍ燈心ㆍ琥珀ㆍ通草ㆍ木通ㆍ滑石之類, 皆瀉陽氣, 勿服之. 《東垣》

Translation영역

Among medicines, alisma, poria, polyporus, juncus, amber, tetrapanax, akebia and talc and their kind all drain the yang qi; do not take them.

Clinical note임상 주석

A prohibition on the whole percolating and draining class, and it follows from Dongwon's method: where the trouble is that the clear yang has sunk, anything that leads downward makes it worse. This sits directly against the Dampness chapter, where those same medicinals are the mainstay at 3.11. The two chapters are treating opposite faults and the contradiction is only apparent — but a practitioner holding both in mind needs to know which patient is in front of them.

Dongwon 東垣

1.40 Guiding and Pulling Methods 導引法

1.40.1

Source원문

凡酒食中毒, 正坐仰天, 呼出酒食醉飽之氣, 立飢且醒. 《病源》

Translation영역

In poisoning from drink and food, sit upright facing the sky and breathe out the qi of wine, food, drunkenness and fullness; hunger returns at once and sobriety with it.

Byeongwon 病源

1.41 Simple Medicinals 單方

1.41.1

Source원문

凡三十七種. 有寬中丸ㆍ獨醒湯ㆍ雙花散.

Translation영역

Thirty-seven kinds in all. Among them are the Relax the Centre Pill, the Sober Alone Decoction and the Twin Flowers Powder.

Donguibogam · Naesang

1.42 Acupuncture and Moxibustion Methods 鍼灸法

1.42.1

Source원문

胃弱不思飮食, 取三里ㆍ三陰交.

Translation영역

Where the stomach is weak with no thought of food, take Samni (三里, ST36) and Sameumgyo (三陰交, SP6).

Gangmok 綱目

1.42.2

Source원문

三焦邪熱, 不嗜食, 取關元. 《綱目》

Translation영역

Where evil heat in the three burners brings no liking for food, take Gwanwon (關元, CV4).

Gangmok 綱目

1.42.3

Source원문

全不思食, 取然谷出血, 立飢.

Translation영역

Where there is no thought of food at all, take Yeongok (然谷, KI2) and let blood; hunger returns at once.

Clinical note임상 주석

立飢 — hunger returns at once — is claimed for bleeding a single point on the kidney channel. The chapter makes the same claim for the breathing exercise at 1.40 and for cuscuta at 1.21.1, and in each case the measure of success is that the patient wants to eat.

Dongwon 東垣

1.42.4

Source원문

飢不能食, 飮食不下, 取章門ㆍ期門. 《東垣》

Translation영역

Where there is hunger without being able to eat and food will not go down, take Jangmun (章門, LR13) and Gimun (期門, LR14).

Dongwon 東垣

1.42.5

Source원문

飮食不多, 心腹彭脹, 面色萎黃, 世謂脾腎病, 宜灸中脘. 《資生》

Translation영역

Where food is little, the heart and abdomen swollen and distended and the complexion withered and yellow — what the world calls a disease of spleen and kidney — moxa Jungwan (中脘, CV12).

Jasaenggyeong 資生

1.42.6

Source원문

食多身瘦, 名曰食晦, 先取脾兪, 後取章門ㆍ太倉. 《資生》

Translation영역

Where much is eaten and the body is thin, it is called food darkening; first take Bisu (脾兪, BL20), then Jangmun (章門, LR13) and Taechang (太倉, CV12).

Clinical note임상 주석

食晦, food darkening, is the same presentation the chapter describes at 1.18.4 — eating much and still growing thin — and it is given a name here that appears nowhere else in these chapters. **Weight loss despite a good appetite requires medical investigation.**

Jasaenggyeong 資生

1.42.7

Source원문

飮食不下, 嗝塞不通, 邪在胃脘, 刺法, 在上脘, 則抑而下之, 在下脘, 則散而去之. 《靈樞》

Translation영역

Where food will not go down and there is blockage at the diaphragm that does not free, the evil lies in the stomach venter. In the needling method: where it is in the upper venter, press it down; where it is in the lower venter, scatter and remove it.

Yeongchu 靈樞

1.42.8

Source원문

胃病, 飮食不下, 取三里. 《東垣》

Translation영역

In stomach disease where food will not go down, take Samni (三里, ST36).

Dongwon 東垣

1.42.9

Source원문

吐宿汁, 呑酸, 取章門ㆍ神光. 《東垣》

Translation영역

For vomiting retained juices and acid swallowing, take Jangmun (章門, LR13) and Singwang (神光).

Clinical note임상 주석

Samni, Jungwan and Jangmun carry most of this section — the stomach's lower uniting point, the front collecting point of the stomach, and the front collecting point of the spleen. The chapter closes on the same complaint it opened its middle with, acid swallowing, which is the presentation its readers brought most often.

Dongwon 東垣

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 4, Internal Damage chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.