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Pathogenic factors transmitting into the interior must first move from the chest to the hypochondrium, then successively through the heart and abdomen to enter the stomach. Therefore, fullness in the chest (chest fullness) is often accompanied by exterior syndrome (exterior pattern), while fullness in the hypochondrium (hypochondriac fullness) is often accompanied by half-exterior half-interior syndrome (half-exterior half-interior pattern). Thus, for a sensation of obstruction in the chest, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is used to induce vomiting for empty irritability; for epigastric stuffiness and hardness with qi rushing up to the throat causing difficulty in breathing, Gua Di San (Melon Seed Powder) is used to induce vomiting for solid phlegm, treated as an exterior syndrome. If chest fullness and pain extend to the hypochondrium, it constitutes Shaoyang Disease (Lesser Yang disease), treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction). Referencing *Yi Zong Jin Jian*: A floating pulse with only chest fullness not extending to the hypochondrium still belongs to the exterior aspect of the Taiyang Meridian (Greater Yang channel), suitable for Ma Huang Tang (Ephedra Decoction). When both the chest and hypochondrium are full, it belongs to the Shaoyang Meridian (Lesser Yang channel), suitable for Xiao Chai Hu Tang. If after more than ten days the condition remains unresolved, with chest and hypochondriac fullness accompanied by dry retching and tidal fever, this is Shaoyang disease combined with Yangming Disease (Yangming disease), suitable for Da Chai Hu Jia Mang Xiao Tang (Major Bupleurum with Mirabilite Decoction) to resolve both aspects. If the exterior syndrome has resolved, but there is pulling fullness, hardness, and pain in the epigastrium and abdomen extending to the hypochondrium, accompanied by dry retching and dysuria, this is internal retention of fluid with excess, suitable for Shi Zao Tang (Ten Dates Decoction) to attack and purge the water retention.

Commentary by Shao: Chest and hypochondriac fullness and pain have different etiologies of exterior and interior; one must differentiate by channel and syndrome for treatment. Only in cases of latent summerheat-dampness causing hypochondriac pain, with alternating chills and fever resembling malaria, should it not be mistaken for a Chai Hu syndrome. One may use Xiang Fu (Cyperi Rhizoma), Xuan Fu Hua (Inulae Flos), Su Zi (Perillae Fructus), Guang Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Yi Yi Ren (Coicis Semen) to treat abdominal fullness, adding Hou Po (Magnoliae Officinalis Cortex). For severe pain, add Jiang Xiang (Dalbergiae Odoriferae Lignum). For prolonged unresolved conditions, intermittently use Kong Xian Dan (Phlegm-Expelling Pill, made from Gan Sui (Kansui Radix), Da Ji (Euphorbiae Pekinensis Radix), Bai Jie Zi (Sinapis Semen) powdered and pillified with Shen Qu (Medicated Leaven)).

Pathogenic factors in the half-exterior half-interior stage often present with vomiting; thus, vomiting is attributed to Shaoyang. However, all six meridians can present with vomiting symptoms, each to be treated according to its respective meridian.

Commentary by Shao: Vomiting is attributed to Shaoyang because Liver-Gallbladder Wood-Fire ascending invades the Stomach, causing Stomach Qi to rebel and fail to descend, resulting in vomiting. However, since all six meridians can present with vomiting, they must be treated separately. Referencing *Yi Zong Jin Jian*: Exterior pathogenic factors entering the interior cause interior Qi to resist and reject, leading to upward rebellion and vomiting, which belongs to Shaoyang, suitably treated primarily with Xiao Chai Hu Tang. If vomiting occurs while exterior pathogenic factors remain unresolved, it belongs to Taiyang disease, suitably treated with Chai Gui Tang (Bupleurum and Cinnamon Twig Decoction). If vomiting follows eating, it belongs to Middle Cold of Yangming, suitably treated with Wu Zhu Yu Tang (Evodia Decoction). Vomiting of saliva and foam belongs to Jueyin Disease (Taiyin disease), also suitably treated with Wu Zhu Yu Tang. Vomiting of roundworms is treated with Wu Mei Wan (Mume Pill). Vomiting accompanied by drinking, where drinking leads to further vomiting in a continuous cycle, indicates retained water, suitably treated with Wu Ling San (Five-Ingredient Powder with Poria).

Commentary by Shao: Vomiting has multiple causes; one should differentiate by channel and syndrome for treatment. In clinical practice, careful examination is essential.