Library

The etiology of diarrhea (Xie Xie) is excessive dampness. Treatment should be based on the traditional method of Weiling Tang (Stomach-Calm Decoction, composed of Pingwei San and Wuling San) with flexible adaptation. Sishen Wan (Four Spirits Pill, a formula for warming the kidney and spleen to secure the intestines and stop diarrhea) is used to consolidate the Kidney; if accompanied by external pathogens, it must be combined with other treatments. The combination of bitter and sour-sweet flavors is highly recommended for its efficacy (This statement cannot be understood by anyone who has not studied for ten years and treated thousands of cases).

Regarding constipation (Mi Jie), *Jingui Zhenyan Lun* states: "The North corresponds to black, connects internally to the Kidney, and opens through the two yin orifices." *Qi Jue Lun* states: "Heat from the Bladder transfers to the Small Intestine, causing obstruction in the intestines and difficulty in defecation." *Zangqi Fashi Lun* states: "The Kidney dislikes dryness; urgently consume pungent foods to moisten it, open the interstices, generate fluids, and promote Qi circulation." *Zabing Pian* states: "When rebellious Qi rushes to the throat causing inability to speak, cold hands and feet, and difficulty in defecation, treat the Foot Shaoyin channel." From this, we know that except for cases of Yangming internal heat accumulation, where mild cases use Piyue Wan and severe cases use one of the Three Chengqi Decoctions, all constipation originates from the Kidney. The Kidney governs the two yin orifices and controls opening and closing. Those with incontinence are blamed for opening without closing; those with obstruction are blamed for closing without opening. Therefore, for Kidney heat, cool and moisten; for Kidney cold, warm and moisten; for Kidney deficiency, tonify and moisten; for Kidney dryness, lubricate and moisten. Furthermore, nourishing the Kidney also treats the Bladder, and the disease of transferred heat obstructing the intestines will resolve itself. Since constipation mostly stems from the Kidney, it is classified under interior syndromes.

Use the Three Chengqi Decoctions cautiously for constipation. Maren Wan (Hemp Seed Pill, also known as Piyue Wan) provides moisture without causing fragmentation or depletion. One must understand that the Kidney is the master of Yin; whether using tonification, purgation, cold, or warmth methods, the principle is always moistening.

In dysphagia (Ge Shi), water drinks can go down, but food is difficult to ingest. Gao Gufeng specifically advocates treating via the Yangming Stomach, using Zuogui Yin removing Fu Ling, adding Shu Di Huang and Dang Gui to nourish Stomach Yin. This method derives from Xue's *Medical Cases*, which treated chest fullness and anorexia by adding these two herbs to Liuwei Dihuang Wan. Fu Ling is removed to prevent its action from drifting into the Kan (Kidney/Water) region; instead, focusing solely on Yangming yields faster results. Using this formula allows Stomach Yin to ascend, widening the贲门 (cardia) for food intake; descending Stomach Yin moistens the pylorus and lanmen, facilitating bowel movements and urination. Effect is seen after more than ten doses. If ineffective, *Renjing Jing* strictly follows the *Neijing* saying "Obstruction of the Three Yang constitutes Ge," using Sanyi Chengqi Decoction in stages to purge, clearing old accumulations so new matter can enter. This is a harsh remedy. However, this syndrome often leads to death; even if treated vigorously, it is merely doing one's utmost human duty. Another condition is vomiting what was eaten in the morning at night, called Fan Wei (Reverse Regurgitation), caused by middle-jiao deficiency-cold and lower-jiao lack of fire. Suitable formulas include Wuzhuyu Tang, Fuzi Lizhong Tang, added with Fu Ling, Ban Xia, Chuan Jiao, etc., or alternating Zhenwu Tang and Bawei Wan. However, *Jingui Yaolue* contains Dabanxia Tang, which directs rebellious Chong Mai Qi downward, serving as a divine prescription for early-stage Ge Shi and Fan Wei.

(Interpretation of Classics) *Yinyang Bie Lun* states: "Disease of One Yang transmits to Ge." Note: One Yang refers to Shaoyang. Hand Shaoyang Sanjiao and Foot Shaoyang Gallbladder are governed by the ministerial fire seen in the initial qi. Xiao Chaihu Tang and various Xiexin Decoctions are used according to symptoms with miraculous effect. It also states: "Obstruction of the Three Yang constitutes Ge." Note: Three Yang refers to Taiyang. Hand Taiyang Small Intestine and Foot Taiyang Bladder, fundamentally cold but superficially hot. Obstruction can result from both cold and hot Qi, representing a deeper level of discussion. Zhang Jingyue stated: "Small Intestine belongs to Fire, Bladder to Water. If Fire fails to transform, Yang Qi does not circulate and transportation fails; if Water fails to transform, Yin Qi does not circulate and clear/turbid separation fails, both leading to obstruction." This is a shallower level of discussion. *Shanghan Lun* contains many miraculous prescriptions. *Xieqi Zangfu Bingxing Pian* states: "Slight urgency in the Spleen pulse indicates Ge Zhong, where food and drink are vomited back up, and copious saliva is discharged." Note: A slight pulse indicates Spleen deficiency and failing Middle Qi; copious saliva indicates Spleen deficiency and failure to control fluids. Lizhong Wan is the best strategy. If ineffective, identify the root cause of the pulse urgency and treat it. *Daqi Lun* states: "If the Stomach pulse is deep and beats涩ly, or if the Stomach pulse beats large superficially and the Heart pulse is small, firm, and urgent, these indicate Ge and hemiplegia." Note: This aligns with Gao Gufeng's previous argument. *Tongping Xuushi Lun* states: "Ge implies closure and isolation, upper and lower blockage, caused by sudden worry and anger." *Benshen Pian* states: "Those who worry have blocked Qi that does not circulate." Note: These two sections reflect Zhang Jifeng's view that "Yegge is a disorder of the spirit/mind." *Jingui Yaolue*'s Fuling Nongpu Tang and Danxi's Yueju Wan can treat this, but one must seek the root cause to achieve cure. *Xueqi Xingzhi Pian* states: "Physical hardship and mental suffering cause diseases arising in the throat and esophagus; treat with bitter medicines." I believe this also falls within the category of Xiexin Decoctions. For Fan Wei, *Neijing* lacks specific discussions; one should primarily rely on *Jingui Yaolue*.