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A floating, moderate, and slippery pulse, or a deep, moderate, and long pulse (both indicate treatable conditions); a wiry, choppy, short, and small pulse (indicates difficult-to-treat conditions).

Banxia Banbai Tang (Bamboo Shoot and Halbertia Decoction) (Formula seen in *Jingui Yaolue*)
Qige Yin (Qi-Opening Drink) (Formula seen in *Shizai Yi*)
Sanyi Chengqi Tang (Three-One Purging Qi Decoction) (Formula seen in *Shifang*)

Note: For patients with chronic illness and emaciated, debilitated constitutions, the aforementioned formulas are somewhat too harsh. I commonly use Mahuang Wan (Hemp Seed Pill) and Gao Gugeng's new formula to replace them. Gao Gugeng comprehended the subtlety of Wang Sun'an using Rhubarb (*Dahuang*) to treat dysphagia, integrating it into a single formula that is quite stable and appropriate. The formula uses Prepared Rehmannia Root (*Shudi*) 5 qian, Angelica Sinensis Root (*Danggui*), White Peony Root (*Baishao*), Peach Kernel (*Taoren*), and Hemp Seed (*Maren*) each 3 qian, to slightly moisten. If the patient's physical appearance is normal, add Rhubarb (*Dahuang*) 1-2 qian to the above formula to assist the blood-invigorating herbs.

Modified Zuogui Yin (Left Restoring Drink)
(The Classic states: The Kidney is the gate of the Stomach. If the gate is not functioning properly, the ascending and descending movements cease. This "gate" is the pivot within the qi intersection of Heaven. Therefore, when Kidney qi is robust, Stomach yin is sufficient; when Stomach yin is sufficient, one can eat.)
*Jiren Pian* states: Dysphagia ultimately belongs to the Yangming channel. I treated Pan Xiuxiu from Jingxi for dysphagia using Zuogui Yin without Poria (*Fuling*), adding Raw Rehmannia Root (*Shengdihuang*) and Angelica Sinensis Root (*Danggui*). After two large doses, bowel movements became moist and appetite improved; after ten more doses, bowel and bladder functions returned to normal, and diet resumed its former state. This is because Zuogui Yin contains Licorice Root (*Gancao*), which travels directly to the Yangming channel to harmonize the middle jiao. Furthermore, the combination of Angelica Sinensis Root (*Danggui*) and Raw Rehmannia Root (*Shengdihuang*) clears Stomach fire to generate yin. When Stomach yin nourishes upwards, the cardia relaxes, allowing food intake; when Stomach yin descends downwards, the pylorus and ileocecal valve are moistened, ensuring normal excretion. Poria (*Fuling*) is removed to prevent its draining action from flowing into the Kan water of the lower jiao, as focusing solely on the Yangming channel yields faster results.

Hezhong Changwei Tang (Harmonizing Middle and Unblocking Defense Decoction)
Perilla Stem (*Zisugeng*) 5 fen; Cyperus Rhizome (*Xiangfu*) stir-fried with vinegar; Medicated Leaven (*Shenqu*) stir-fried; Glehnia Root (*Shashen*) each 1 qian; Platycodon Root (*Jiegeng*); Forsythia Fruit (*Lianqiao*) with seeds and tips removed, each 6 fen; Aucklandia Root (*Muxiang*) 4 fen; Atractylodes Rhizome (*Cangzhu*); Ligusticum Chuanxiong Rhizome (*Fuxiong*); Fritillaria Bulb (*Beimu*) each 8 fen; Amomum Fruit (*Sharen*) 3 fen; Fresh Ginger (*Shengjiang*) 3 slices.
Decoct in water and take orally.

Yi Silan's self-note states: Cyperus Rhizome (*Xiangfu*) and Perilla Stem (*Zisugeng*) open orifices and move qi; Atractylodes Rhizome (*Cangzhu*) strengthens the middle; Fritillaria Bulb (*Beimu*) resolves stagnant phlegm; Forsythia Fruit (*Lianqiao*) disperses fire in the six channels; Ligusticum Chuanxiong Rhizome (*Fuxiong*) relieves Liver wood stagnation; Medicated Leaven (*Shenqu*) moves Spleen stagnation; Aucklandia Root (*Muxiang*) promotes qi circulation; Platycodon Root (*Jiegeng*) lifts Lung qi; Glehnia Root (*Shashen*) supports righteous qi without aiding fire. This formula aims to lift and disperse fire pathogenic factors in the upper jiao, embodying the principle of "releasing fire stagnation." However, using this formula alone without accompanying tonifying herbs for the lower jiao may only temporarily resolve the fire. Without water to control it, the fire will inevitably regenerate, potentially worsening the痞满 (fullness) and dysphagia compared to before.

My Note: *Neijing* states: "Obstruction and closure of the diaphragm, with no passage between upper and lower, is a disease caused by sudden severe worry." This indicates that this disease often arises from emotional stagnation and discomfort, leading to an inability of Stomach qi to distribute and spread, which Zhang Jifeng refers to as a "mental disorder." Although the formula contains standard anti-stagnation herbs, the precise dosage and flavor combinations seem to possess unique efficacy. Taking it alternately with Bawei Wan (Eight-Ingredient Pill) yields frequent success. Yu Jiayan's Ziye Jiufen Tang (Fluid-Nourishing Fire-Rescuing Decoction), taken alternately with Bawei Wan, follows the same logic. However, Ziyue Jiufen Tang is extremely cooling and purgative, bordering on radical and dangerous, whereas this decoction is mild and accessible.

Wuye Wan (Five-Suffocation Pill) (From *Qianjin Fang*)
Treats chronic cold in the chest, vomiting and regurgitation obstructing food intake, and unresolved qi knots.
Dried Ginger (*Ganjiang*); Sichuan Pepper (*Shujiao*); Evodia Fruit (*Wuzhuyu*); Cinnamon Twig (*Guixin*); Asarum (*Beixixin*) each 1 liang; Ginseng Root (*Renshen*; Atractylodes Macrocephala Rhizome (*Baizhu*) each 2 liang; Tangerine Peel (*Juapi*); Poria (*Fuling*) each 1.5 liang; Prepared Aconite Root (*Fuzi*) 1 piece (prepared).
Grind into fine powder, mix with refined honey to make pills the size of mulberry seeds. Take 15 pills with wine, three times daily, gradually increasing to 30 pills.

Wuge Wan (Five-Dysphagia Pill) (From *Qianjin Fang*)
Treats inability to swallow food, cold hands and feet, and upward rushing qi with panting.
Ophiopogon Tuber (*Mendong*) 3 liang; Licorice Root (*Gancao*) 2 liang; Sichuan Pepper (*Shujiao*) stir-fried, sweat removed; Polygala Root (*Yuanzhi Rou*); Cinnamon Twig (*Guixin*); Asarum (*Xixin*); Dried Ginger (*Ganjiang*) prepared, each 1 liang; Prepared Aconite Root (*Fuzi*) 1 piece (prepared); Ginseng Root (*Renshen*) 2 liang.
Grind into powder, mix with refined white honey to make pills the size of quail eggs. Before meals, hold one pill in the mouth and swallow slowly. If heat remains in the throat and chest, continue until the pill is nearly finished. Hold another pill, take three times daily and twice at night, cured in seven days.

Zhang Shiwang states: These two pills both use Ginseng (*Renshen*), Aconite (*Fuzi*), Sichuan Pepper (*Shujiao*), Asarum (*Xixin*), Dried Ginger (*Ganjiang*), and Cinnamon (*Guixin*). One addresses Liver qi rebelling upward and Stomach qi failing to descend, causing vomiting and dysphagia; thus Evodia (*Wuzhuyu*) and Tangerine Peel (*Juapi*) are used to soothe the Liver and direct rebellious qi downward, while Poria (*Fuling*) and Atractylodes (*Baizhu*) strengthen the Spleen and promote fluid distribution. The other addresses Kidney qi failing to steam, causing dryness and withering of the Lungs and Stomach preventing ingestion; thus Ophiopogon (*Mendong*) and Licorice (*Gancao*) nourish the Lungs and harmonize the Stomach, while Polygala (*Yuanzhi*) tonifies fire to generate earth. For vomiting and dysphagia where medicine and food can still enter, frequently administer small pills for regulation; for severe obstruction where food cannot be taken, occasionally use large pills held in the mouth. Their legislative detail is such that it should not be ignored without careful distinction.

Wuzhuyu Tang (Evodia Decoction) (Formula seen in *Shanghan Lun*)
Lizhong Tang/Wan (Regulate the Middle Decoction/Pill) (Formula seen in *Shanghan Lun*)
Lianli Wan (Coagulating Harmony Pill: Lizhong Pill plus Coptis Rhizome (*Huanglian*))
Bawei Wan (Eight-Ingredient Pill)
(Formula seen in *Shifang*)

Furthermore, regarding dysphagia with regurgitation, and symptoms of vomiting where even a grain of rice cannot be retained, these are mostly caused by unresolved emotions agitating qi. Chaotic qi carries blood upward, causing stasis accumulation in the middle, blocking Stomach qi. Drinking fresh goose blood while hot is recommended. Its vitality has not yet departed; using blood to attack blood penetrates the gates directly, forcing old accumulated stasis out in a rush, thereby clearing the chest and hypochondrium. This method is detailed in *Su Dongpo Suolu*. Predecessors Jin Chunhuan (also known as Han Mulu Dongtan) have verified its efficacy. Extending this, fresh duck blood and fresh yellow ox blood can also be used.

Western Medicine Wine Recipe (From *Jinnang Mishou*)
Treats dysphagia, regurgitation, all types of dysentery, watery diarrhea, etc., with immediate effect.
Cardamom Seed (*Hongdoukou*) peeled; Nutmeg (*Roudoukou*) baked in flour coating, pressed in coarse paper to remove oil; White Cardamom (*Baidoukou*) peeled; Galangal Root (*Gaoliangjiang*) sliced and stir-fried; Sweet Cinnamon (*Tianrougui*) peeled; Clove Bud (*Gongdingxiang*) each ground into fine powder, weighed accurately at 5 fen.
First, dissolve 4 liang of premium white rock sugar in one bowl of water in a copper pot. Add two egg whites and boil for about ten boils. Add 1 jin of good liquor, remove from fire, and place in a stable location. Add the powdered herbs to the copper pot and mix well. Ignite the liquor briefly, then cover the pot to extinguish the fire. Filter through gauze to remove dregs, pour into a porcelain bottle, cool with cold water to remove heat, and drink in small amounts as needed.

Miao Zhongchun's Secret Dysphagia Paste
Ginseng Concentrated Juice; Human Milk; Cow Milk; Pear Juice; Sugarcane Juice; Reed Rhizome Juice; Longan Concentrated Juice.
Take equal parts of the above seven ingredients, add a little ginger juice, and simmer over boiling water until it becomes a paste. Mix in refined honey and take frequently in small amounts; its efficacy is like an immortal elixir.

Fritillaria Sugar-Wine Recipe
Good aged wine (1 jin); Rock sugar (10 liang); Fritillaria Bulb (*Beimu*) decentered; Amomum Fruit (*Sharen*); Aucklandia Root (*Muxiang*); Tangerine Peel (*Chenpi*) each 2 qian.
Cut into pieces, place in a porcelain bottle. Seal tightly with bamboo leaf sheaths. Place a pinch of rice on top. Boil until the rice is cooked. Take one large cup every morning.

Sugar-Ginger Cake
Use 1 jin of high-quality molasses residue from a sugar workshop and 4 liang of fresh ginger. First, mash the molasses residue thoroughly, mix with ginger, and pound again into small cakes. Dry them in the sun, store in a porcelain bottle, and place on the stove smoke cabinet. Every morning, soak one cake in boiling water, let it sit for a moment, and drink the soup.

Eight-Juice Decoction
Treats dysphagia.
Raw Lotus Root Juice; Fresh Ginger Juice; Sydney Juice (likely a typo for a specific local ingredient or plant, kept as transliteration); Radish Juice; Sugarcane Juice; White Fruit Juice (likely Quince or similar); Honey; Bamboo Sap (*Zhuli*).
Mix one cup of each evenly, steam over rice until cooked, and eat as desired.

Cow, Sheep, and Human Milk
Treats regurgitation and diaphragmatic qi stagnation. This condition must originate from intestinal dryness and blood dryness, with bowel movements occurring once every three to four days. Stool resembling horse chestnuts; if resembling sheep dung, it is untreatable; if constantly spitting white foam, it is untreatable.
Cow milk, sheep milk, and human milk, regardless of weight, should be taken regularly as a miraculous remedy for generating blood and moistening the intestines.