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The *I Ching* (Book of Changes) states: "Gu" (Insect/Decay Disease) refers to a situation where things have deteriorated to the extreme, leading to complications. When humans suffer from Gu disease, it signifies the failure of Spleen Earth (the digestive system's transformative function). The body does not die immediately but experiences subsequent pathological events. Here, "event" implies "disease." Symptoms include abdominal distension that is hard and rigid, with purple veins floating on the surface, the umbilicus flattening like a drumhead, appearing firm externally but empty internally. Regardless of whether the patient can eat or not, there is essentially no chance of survival; however, if the abdomen is merely swollen and soft upon palpation, the condition is in the stage of forming or not yet fully formed, termed "distension and fullness," which is still treatable.

Diseases of the Heart and Lungs lead to rapid death; diseases of Spleen Earth lead to slower death. Observing this slowness, people recklessly administer decoctions for treatment. Although the condition may slightly improve, it is not true recovery, but merely a prolongation of life. A skilled practitioner treats the root cause at the earliest萌芽 (germination/initial stage), preventing deterioration into Gu disease; this is the merit of the physician. If one attempts to treat after Gu has already formed, it is ultimately futile. Although Gu syndromes exist in the world, I have no treatment method for them. I list their categories here, awaiting capable practitioners.

"Ge" (Intestinal Obstruction/Regurgitation) means obstruction. It refers to blockage preventing the intake of food, a disease caused by the dysfunction of the Sanjiao (Triple Burner). The Upper Jiao emerges from the upper opening of the stomach and governs reception; the Middle Jiao resides within the stomach and governs rotting and ripening (digestion); the Lower Jiao separates the ileum and governs the separation of clear and turbid fluids. In healthy individuals, ingested food passes directly from the Upper Wan (Upper Stomach) to the Middle Wan (Middle Stomach). The Upper Wan and Middle Wan correspond to the Upper Jiao and Middle Jiao. Once entering the Middle Wan, digestion begins. The Classics state: The Upper Jiao is like mist (diffusing and irrigating); the Middle Jiao is like a fermenting vat (rotting and ripening); the Lower Jiao is like a ditch (draining and excreting). This is due to the function of the "outer furnace bottom" (Spleen and Stomach transformation). If the Fire Qi of the Middle and Upper Jiao declines, the Upper Jiao cannot irrigate like mist, and the Middle Jiao cannot digest like a fermenting vat. Consequently, grains cannot be digested, and food is regurgitated after ingestion. Patients suffering from this disease have virtually no chance of survival, though distinctions exist between Upper-Middle and Lower-Middle types, and between rapid and slow death. The Upper-Middle type involves disharmony between the Upper and Middle Jiao; the Lower-Middle type involves disharmony between the Lower and Middle Jiao. Death is slower in Lower-Middle disharmony and faster in Upper-Middle disharmony. However, if treatment is appropriate, rapid death can be delayed; if treatment is inappropriate, slow death can accelerate.

Initially, when suffering from this disease, physicians often use acrid-aromatic qi-moving herbs, believing they can broaden the chest to open the appetite. Little do they know that the inability to eat stems from deficiency of True Qi (Vital Energy). Since True Qi is deficient, how can one further deplete it with acrid-dispersing herbs? Once Qi is depleted, those with relatively robust Yuan Ben (Root Essence) may barely survive; those with deficient Yuan Ben will lose their lives within months. Furthermore, initially, some physicians use blood-nourishing and Yin-moistening herbs, claiming they open the Lanmen (Gate of the Ileum) to direct flow downward, thus stopping vomiting. If the pathology lies in the non-communication between the Middle and Lower Jiao, food enters the Middle Wan, but the Lower Jiao fails to connect smoothly, causing digestive errors and upward reversal from the Middle Wan, resulting in vomiting. In such cases, moistening and descending herbs may be effective. However, if the disease recurs after cure and these herbs are administered again, they become ineffective. Initially, because the Lower Jiao failed to connect smoothly, moistening and descending methods worked; over time, Yin becomes excessive and Yang deficient, so the generating Yang Qi of the Lower Jiao cannot circulate back upward. With flow only downward and not upward, the treatment fails, inevitably leading to death. For cases involving declining Fire Qi in the Upper and Middle Jiao, using Ginseng, [White] Atractylodes, Ginger, Cinnamon, and Aconite early on may seem effective. Although symptoms improve, the disease remains unrooted. Later, physicians doubt the efficacy of warming and tonifying methods and switch to other drugs, leading to untreatable conditions. How can there be anyone in the world who does not eat grains? The Classics say: "Those who obtain grain thrive; those who lose grain perish." How profound!