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In the *Shanghan Lun* (Treatise on Cold Damage), under the section regarding "Chest Fullness" (Xiong Man), it is stated that when there is vexing heat and a sensation of obstruction in the chest, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) should be used. There is also a clause stating that if there is a sensation of fullness and hardness in the chest, with Qi rushing to the throat causing difficulty in breathing, emesis (vomiting) should be induced.

These two clauses describe fullness and stuffiness in the chest and stomach area: one focuses on clearing Stomach Heat as the primary treatment, while the other focuses on expelling Phlegm from the Stomach via emesis. Regarding hardness and fullness extending from the epigastrium (Xin Xia) to the abdomen, it states: "If the pulse is floating and large, and the epigastrium feels hard contrary to expectation, indicating Heat belonging to the Zang organs, purgation should be applied." It also says: "From the epigastrium down to the lower abdomen, if there is hardness, fullness, and pain, Da Xianxiong Tang (Major Chest-Infiltrating Decoction) is indicated." These two clauses discuss hardness and fullness of the heart and abdomen: one uses Chengqi Tang formulas to purge dry feces in the intestines and stomach; the other uses Xianxiong Tang formulas to purge Phlegm-Fluids in the chest and abdomen. Regarding post-illness recovery, if grains are forced upon the patient after they have just recovered, causing slight vexation, stopping grain intake will lead to recovery. This refers to symptoms of recurrence due to dietary indiscretion after illness. Apart from this, there is no record of using digestive methods for food stagnation in the middle Jiao causing chest and diaphragmatic fullness.

It is unknown that nowadays, patients suffering from Shanghan febrile diseases or Sha Yi Du (Sha epidemic toxins), due to food stagnation in the middle Jiao, cause the Wei Yang (Stomach Yang) to congeal and fail to distribute and generate sweat. The interior and exterior become knotted, steaming and fermenting each other, leading to prolonged unresolved fever, with deaths occurring frequently. This is indeed because the term "Jia Shi Shanghan" (Cold Damage complicated by Food Stagnation) exists in the world, but earlier sages did not provide treatments for food stagnation. I have now pondered and established methods for treatment.

Food stagnation in the middle Jiao combined with external exposure to pathogenic factors presents various etiologies. Some cases begin with a cold invasion, leading to undigested food; here, the external contraction is the root (Ben), and food stagnation is the branch (Biao). Other cases begin with food stagnation, followed by exposure to wind-cold; here, food stagnation is the root, and external contraction is the branch. Although there is a distinction between root and branch, the urgent condition should be treated first. If both are urgent, both should be treated simultaneously. The ancients said, "In emergencies, treat the branch," but many people misunderstood this. The emphasis is on the word "urgent"; it means that generally, one should treat the root first. However, if the branch condition is urgent, one should set aside the root and treat the branch first; if not urgent, the root should still be treated first. Furthermore, detailed analysis reveals more nuances. For example, in cases of exterior Heat combined with food stagnation, the exterior pathogens must be released through sweating, and the exterior Heat resolved externally before the food stagnation can be eliminated. One must realize that to release exterior pathogens, Wei Yang distribution is required to generate sweat. Therefore, treatment involves half medication to digest food and half to release the exterior. If the Stomach Qi is harmonious, sweat can be generated for external resolution. However, if Phlegm-fluids and heavy food accumulation are firmly stuck in the Stomach, treating with mild exterior-interior harmonizing methods will be ineffective. Thus, a family secret formula, Baohe San (Harmony-Preserving Powder), was created, ground into fine powder, to dissipate congealment in the chest. It is taken with decoctions of Shengyang Jiubiao Tang (Yang-Raising Exterior-Resolving Decoction) to steam and assist Stomach fluids, thereby generating sweat for external resolution. If exterior pathogens remain unresolved, exterior Heat is intense, food stagnation persists, and interior Heat has formed, accompanied by cracked lips and dry mouth, the Kuai Ge Mo (Fast-Clearing Powder) cannot be used. Instead, the previous formula (Shengyang Jiubiao Tang) is decocted together to moisten dryness with the liquid.

If food stagnation in the chest is firmly stuck and unopened, without using digestive methods, prolonged Heat will lead to mental confusion and death. Digestive medicines that are too drying will intensify the Heat due to dryness, also leading to death. Insufficient use of moistening agents results in bias toward dryness, failing to reduce Heat. Excessive use of moistening agents results in bias toward moisture, making the congealment even more solid. Zhang Zhongjing used Zhizi Chi Tang to treat interior vexing Heat where sweat cannot be generated for external resolution. Liu Hejian further developed the use of Dou Chi (Fermented Soybean), Shi Gao (Gypsum), Hua Shi (Talcum), combined with Cong Bai (Scallion White) to resolve interior Heat without sweat, which contains profound truth. The family secret uses Baohe San to eliminate chest and diaphragm Phlegm and food, often mixed with Zhu Li (Bamboo Sap) and Luo Bo Zhi (Radish Juice), because they are moistening rather than drying, and cold rather than coagulating. They not only eliminate Phlegm and food but also clear closed-up Dry Fire; without them, Dry Heat without sweat cannot be moistened. Their mild nature precisely targets the disease, often achieving miraculous recoveries. However, in cases where rich meat/fish foods heavily suppress exterior pathogens, these methods often fail. In cases of Sha Yi Du caused by consuming such foods, survival rates are extremely low, because epidemic toxins encountering rich flavors become trapped and unable to emerge, leading to intestinal corruption and subsequent bloody diarrhea, which is more severe than other diseases. Therefore, treating Jia Shi requires cross-referencing toxin signs and symptoms like cracked lips and chest fullness to succeed.

Family Secret Formula: Baohe San
Banxia (Pinelliae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Zhike (Aurantii Fructus Immaturus), Xiangfu (Cyperi Rhizoma), Zharon (Crataegi Fructus), Laifuzi (Raphani Semen), Maiya (Hordei Fructus Germinatus), Chuanlian (Coptidis Rhizoma), Doukou (Amomi Fructus Rotundus), Shichangpu (Acori Tatarinowii Rhizoma).
Grind the above into fine powder and take with hot water. If there is Dry Heat, mix with Zhu Li or Luo Bo Zhi, or decoct and take as soup.

This formula eliminates Phlegm and transforms stagnation. The family secret treats chest fullness with alternating chills and fever, complicated by food and Phlegm, by administering this formula first, followed by Shengyang Jiubiao Tang.
If both exterior and interior conditions are urgent, the two formulas are used together, known in ancient times as Baohe Wan (Harmony-Preserving Pill). However, congealment in the chest must be dissipated by powder and washed away by decoction. Using pills would act too slowly, causing further filling of the chest.

Shengyang Jiubiao Tang
Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Zhike, Houpo, Guangpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Banxia.
This formula raises Stomach Qi, distributes Wei Yang, generates sweat to scatter exterior pathogens. The family secret treats fever with chest fullness and unresolved exterior pathogens. If exterior symptoms are heavy, administer this formula first to scatter the exterior. If both exterior and interior are heavy, administer both formulas together. Five ingredients scatter the exterior; five ingredients promote dispersion. Wei Yang distributes to generate sweat. The ancients used one exterior-dispersing herb and one cooling herb to harmonize the exterior and interior. Or used half the dosage to scatter the exterior and half to clear internally, doubly resolving the exterior and interior. Now, the family secret has transformed and established this formula to harmonize exterior contraction complicated by food stagnation, utilizing the subtle method of proportional opening and transforming formulas.