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Treats fullness and oppression in the chest and diaphragm, with a pulse that is large and wiry; upon deep pressure it seems forceful, but this is not true forcefulness. This is a syndrome of leakage of the true qi of the Spleen and Stomach outward, and rebellious Qi of the Chong vessel (Penetrating Vessel) invading upward. Do not treat it as an Excess syndrome. If opening and draining herbs are used, danger and critical conditions will appear immediately. After taking several doses of this decoction, if the pulse becomes soft and harmonious, it indicates a turning point in the illness; continuing to take it will lead to self-healing.

Yetaishen (Codonopsis Radix, Wild Type, 5 qian) Shengzheshi (Hematitum, Raw, finely crushed, 5 qian) Shengqianshi (Euryales Semen, Raw, 5 qian) Shengshanyao (Dioscoreae Rhizoma, Raw, 5 qian) Yurou (Corni Fructus, pips removed completely, 5 qian) Qingbanxia (Pinelliae Rhizoma Preparatum, Cleaned, 2 qian) Fuling (Poria, 2 qian)

After taking several doses, if the fullness and oppression lighten, remove Qianshi and add Baizhu (Atractylodis Macrocephalae Rhizoma) 2 qian.

Truly forceful pulses all exhibit the characteristics of Hong (Surging) and Hua (Slippery). "Hong" resembles waves surging one after another, with momentum rising and falling; "Hua" feels slippery under the fingers, continuous like pearls strung together. This pulse is wiry and straight, lacking both the rising and falling momentum and the shape of strung pearls. Although it appears large and forceful, it is actually not a truly forceful pulse.

The soft and harmonious pulse is the normal pulse of the Spleen and Stomach; the wiry and long pulse is the normal pulse of the Liver and Gallbladder. However, since the Spleen belongs to Earth, its pulse should originally encompass the characteristics of the Metal, Wood, Water, and Fire organs. Therefore, having a soft and harmonious quality in all six positions is the correct manifestation. Now, the pulse is wiry and forceful, which is a sign of Liver Wood acting recklessly and encroaching upon/insulting Spleen Earth; thus, we know the Spleen and Stomach are deficient.

The Chong vessel (Penetrating Vessel) is subordinate to the Yangming (Stomach) channel, so the Qi of the Chong vessel and the Stomach Qi are originally connected. Now, because Stomach Qi is deficient and fails to descend, the Qi of the Chong vessel easily invades upward. At this time, the transformation and transportation of the Spleen and Stomach are unstable, showing a tendency to escape outward; the rebellious Qi of the Chong vessel further invades upward and pushes against it, making the outward escaping tendency even more severe, hence the pulse also exhibits largeness.

An elderly woman, over sixty years old, suffered from fullness and oppression in the chest and abdomen, often feeling Qi rushing upward from below, preventing food and drink from descending. Her son was a bookseller and knew medicine. He once came to my study while selling books to have books proofread, described his mother's symptoms, and stated her pulse was large, wiry, and hard. I prescribed this decoction for her. After one dose, the fullness and oppression decreased; after several more doses, she was completely cured.

A man, nearly fifty years old, often felt fullness and oppression in the heart region, vomiting phlegm and water. He often felt Qi rising from the Lower Jiao (Lower Burner) and rushing upward to the stomach entrance. His pulse was wiry, hard, and long, especially prominent on the right side. This indicates rebellious Qi of the Chong vessel ascending and forcing Stomach Qi to rebel upward. Asking about his bowel movements, he said they were very dry. Thus, I changed the Zheshi in the formula to 1 liang, added Zhimu (Anemarrhenae Rhizoma) and Shengmuli (Ostreae Concha, Raw), each 5 qian, Houpo (Magnoliae Officinalis Cortex), and Suzi (Perillae Fructus), each 1.5 qian. After continuously taking six doses, he was completely cured.

Appendix:
Letter from Li XX of Yanshan, Zhili:
Old Madam Wang in Tianjin had been ill for over a month, extremely exhausted and debilitated, seeking treatment from me. Palpating her pulse, all six positions were wiry, hard, and forceful, and exceptionally coarse and large. Inquiring about her illness, she reported fullness and oppression in the chest and diaphragm, vomiting immediately after eating. For over a month, no meal went down without being vomited up. She also had bowel movements two or three times daily, with scanty excrement resembling chicken droppings. She claimed the discomfort in her heart was indescribable, and she would rather die early to escape this suffering. Upon careful consideration, the chest and diaphragm fullness resembled an Excess syndrome; however, the pulse was wiry, hard, coarse, and large, lacking any hint of softness. I then recalled the note under ZhenShe Tang (Sedation and Suppression Decoction): "Treats fullness and oppression in the chest and diaphragm, with a pulse that is large and wiry, forceful upon pressure. This is a syndrome of leakage of the true qi of the Spleen and Stomach outward, and rebellious Qi of the Chong vessel invading upward. Do not treat it as an Excess syndrome." I copied the original prescription of ZhenShe Tang and gave it to her. After one dose, vomiting decreased significantly, bowel movement frequency also decreased, and the pulse began to show softness. After four or five doses, all illnesses were completely cured. Since then, whenever encountering such pulse patterns, I treat them by modifying this decoction, achieving efficacy as immediate as a drumstick striking a drum.