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The classification of disease categories originated with Chao Yuanfang. The misunderstanding of the root causes of diseases also originated with Chao Yuanfang. Why? Laozi said, "To have little is to gain; to have much is to be confused." Moreover, the so-called "Yi Shi" (dysphagia with food retention) syndrome in popular belief has very few mentions in the *Huangdi Neijing* (Yellow Emperor's Inner Canon), which only states: "When the Three Yang channels are knotted, it is called Ge (obstruction)." By "Three Yang," we refer to the Large Intestine, Small Intestine, and Bladder. "Knotting" refers to the stagnation of heat. When heat knots in the Small Intestine, the blood vessels become dry; when heat knots in the Large Intestine, defecation is obstructed; when heat knots in the Bladder, body fluids are depleted. Once the Three Yang channels are knotted, both the anterior and posterior orifices become blocked. Since the lower part is not unblocked, the Qi must reverse and move upward. This is why dysphagia occurs where food cannot go down, and even if forced down, it comes back up.

The Stomach is regarded as the Sea of Water and Grain, receiving new intake daily to replace the old. Defecating once a day is the normal standard. Now, patients suffering from Yi disease may go three, five, or even five to seven days without defecation. This clearly deviates from the normal standard. Is it not because the Three Yang channels are all knotted at the lower level, causing the Changchang (rectum) to become dry and withered, so that ingested food is rejected by the throat? Even if it enters the Taicang (Stomach), it returns out through the pharynx. This is because Yang Fire does not descend but is pushed upward. Thus, the classics state: "Where Shaoyang reaches, there is vomiting and surging, overflow, and inability to ingest food." Is this principle not obvious? Furthermore, the *Qi Jue Lun* (Treatise on Qi Reversal) says: "When Liver transfers cold to the Heart, it results in Kuang (mania) and Ge (obstruction). The Yang Qi in the middle jiao contends with the cold, causing obstruction of food and blockage in the middle. This is caused by the contention between Ge Yang and cold, not solely by cold." The *Liu Jie Zang Xiang* (Six Sections of Viscera Manifestations) also states: "When the Renying pulse is four times fuller than normal, it is called Ge Yang." Wang Bing (Wang Taipu) commented: "Extreme excess of Yang leads to rejection, preventing food from entering." The *Zheng Li Lun* (Theory of Regular Principles) states: "Ge manifests as vomiting and reversal." Therefore, "Ge" should also be written as "Ge" (rejection).

Later generations arbitrarily divided it into Five Types of Yi: Qi Yi (Qi-type), You Yi (Sorrow-type), Shi Yi (Food-type), Si Yi (Thought-type), and Lao Yi (Exhaustion-type). Later, it was further subdivided into Ten Types of Ge and Five Types of Yi. With so many branches, the confusion became even more profound. The phenomenon of regurgitation in people did not necessarily occur suddenly at first. Initially, it might be due to injury from alcohol or food, or stomach heat wanting to vomit, or stomach wind wanting to vomit. Physicians, failing to investigate the root cause, would roast ginger in fire and boil Cinnamon Twig (Guizhi) in decoctions. After Dingxiang (Clove) came Doukou (Cardamom); after Bibai (Long Pepper) came Hujiao (Pepper). Although they claimed to harmonize the Stomach, the Stomach was originally not cold; although they claimed to tonify the Stomach, the Stomach was originally not deficient. If injured by fluid retention, one should only dispel the fluid; if injured by food stagnation, one should only resolve the food. How can one speak of deficiency and immediately use hot tonics? Methods not found in the *Suwen* are contrary to medical principles. In individuals with inherent heat, the Three Yang channels must knot; once knotted, food will inevitably reflux. Yet physicians still claim: "Cold Stomach fails to receive." They use burning needles piercing flesh and moxa burning muscle, inflicting countless sufferings. The phrase "Three Yang Heat Knotting" is clear, yet difficult to follow. The most crucial method is removing the firewood (addressing the root); stirring boiling water to stop boiling only makes it worse. As years passed, errors accumulated due to medical mismanagement. Some argue for purgation to withdraw Yang and nourish Yin, fearing damage to Yuan Qi. However, maintaining harmony is key. If blocked, meridians have no path, intestines should be patent, hence borborygmus. If intestines are blocked, Yi disease forms.

The widely circulated Wuzhe Kuanzhong San contains Ginger and Cinnamon Twig; Shige San contains Aconite and Aconitum. Since I have criticized these formulas, let future sages judge their validity. Someone asks: "Can purgation be used for Qi knotting due to sorrow?" I reply: "Sorrowful Qi stagnation is similar to Fire Depression. Tai Cang Gong treated such cases with purgation. Since this method was abandoned, it has not been restored for a millennium. Today, Liu Hejian treats Ge Qi and Yi Shi using Chengqi Decoction variants, surpassing modern practitioners. Current prescribers do not understand the primary agents. Like a madman laughing, they fail to observe efficacy and remain ignorant of the root. Lazy to consult, they rashly criticize. I disregard this and show this to posterity. When prescribing, carefully consider severity. If obstruction is long-standing, do not attack abruptly. Even if opened, worry about sequelae. First, moisten and nourish. Use small doses of decoctions or pills repeatedly until the gates open naturally. If there is throat blockage with saliva and phlegm above, mildly use bitter and sour substances to induce slight vomiting, then treat the lower part, allowing medicinal force to flow easily. If still ineffective, use honey and salt as guides, connecting upper and lower. The knot disperses, Yang dissipates, and food descends naturally. Do not use Croton Seed (Badou) to deplete True Essence, leading to dry fluids and retained toxins. People say this disease resulted from previous purgative depletion, causing weakness and fullness. This is Badou's fault, not Dahuang or Niuxi's. An official in Jicheng suffered vomiting for over a year, treated as Cold Stomach with Clove, Pinellia, Tangerine Peel, Ginger, and Aconite—various drying and heating herbs, plus burning cones and moxa. Condition fluctuated for ten years, with dry stool and dark yellow urine. I examined him. I said: 'All Wei, Chuan, and Ou syndromes belong to the Upper Jiao.' Wang Bing noted: 'Upper refers to the Upper Jiao.' Flaming fire Qi rises, indicating excessive heat causing vomiting. I administered Sisheng Wan, inducing thirty purgations, expelling dry feces and intestinal filth, several sheng in volume. The patient was dazed for one or two days, frequently sipping ice water, gradually consuming cool yogurt and sesame drink. Days later, he ate heartily, recovering his spirit and Qi/Blood. He later had three sons and died at fifty."