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Treats conditions where the Great Qi (Da Qi) in the chest sinks, accompanied by stagnation of Qi in the Qi division and stasis in the collaterals.

Sheng Huangqi (Raw Radix Astragali, 6 qian) Zhi Mu (Rhizoma Anemarrhenae, 3 qian) Danggui Shen (Radix Angelicae Sinensis, Root Body, 3 qian) Guizhi Jian (Ramulus Cinnamomi, Tip, 1.5 qian) Chai Hu (Radix Bupleuri, 1.5 qian) Ruxiang (Resina Olibani, 3 qian, not removing oil) Moyao (Resina Myrrhae, 3 qian, not removing oil)

If accompanied by distending fullness under the hypochondrium, or pain, add Longgu (Fossilia Ossis Mastodi, calcined) and Muli (Concha Ostreae, calcined), each 5 qian; if accompanied by a sensation of sinking in the lower abdomen, add Shengma (Rhizoma Cimicifugae, 1 qian).

A woman, approximately thirty years old, experienced fullness and oppression in the chest, occasional pain, feverish sensation in nasal respiration, and frequent thirst. She stated that the condition began several days after childbirth due to excessive physical labor. Her pulse was slow and deficient. After careful consideration, I could not discern the origin of the disease. Initially, I prescribed Sheng Shanyao (Rhizoma Dioscoreae, 1 liang) to nourish body fluids, Jineijin (Endothelium Corneum Gigeriae Galli, 2 qian), and Chenpi (Pericarpium Citri Reticulatae, 1 qian) to regulate pain and fullness. After taking the medicine, she suddenly developed alternating chills and fever. Upon re-examination, her pulse was even more deficient. I determined that there was stagnation of Qi in the Qi division combined with sinking of the Great Qi. Consequently, I prepared this decoction. After one dose, all symptoms alleviated; after four additional doses, she was completely cured.

A fifteen-year-old girl had a mass (Jia) forming on the left side below the umbilicus, causing a heavy, sinking pain radiating to the waist, also presenting with a sinking painful sensation, accompanied by occasional groaning. During severe episodes, she often felt urinary retention, although urination was not actually obstructed. Her pulse was fine, small, and deep. Inquiry revealed that the condition originated from difficulty in urination, where excessive straining occurred during voiding. Initially, there was only a sinking pain in the waist, which later consolidated into this mass. When it first formed, it was soft upon palpation; however, five months later, the affected area became hard and firm. The pain intensified daily at 4:00 PM and gradually lightened by 4:00 AM. Based on the history and pulse diagnosis, I concluded that excessive straining during urination caused Qi from the Upper Jiao to sink into the Lower Jiao and become stagnant. I treated her with Li Yu Sheng Xian Tang (Regulate Stagnation and Raise Sinking Decoction). In the formula, Ruxiang and Moyao were increased to 4 qian each, and Danshen (Radix Salviae Miltiorrhizae, 3 qian) and Shengma (1.5 qian) were added. After two doses, the sinking sensation and pain resolved. Shengma was then removed, and she took Zhuxuejie (Sanguis Draconis processed with Cinnabar, approx. 1 qian) powder delivered with the decoction juice for several consecutive doses, resulting in the dissipation of the mass.

Someone asked: "Longgu and Muli are astringent agents. Why are they added for cases with hypochondriac distension and pain?" I replied: "The hypochondrium is the territory of the Liver. Hypochondriac distension and pain indicate rampant Liver Qi. Originally, purgative herbs for the Liver should be used, but these are unsuitable for patients with sinking Great Qi. Using Longgu and Muli to restrain Liver Fire prevents Liver Qi from rampaging. This method of using astringency to achieve purgation is a subtle technique of ancient physicians in treating the Liver. Furthermore, Huangqi has an expanding effect, which is generally contraindicated for distension and pain. However, the astringent properties of Longgu and Muli can counteract this expanding force, allowing its safe use. This understanding comes from clinical experience."

I once treated a young woman who had amenorrhea for two months, alternating chills and fever, hypochondriac pain, and a very weak yet rapid pulse (six beats per breath). She reported frequent shortness of breath. I administered Li Yu Sheng Xian Tang with Longgu and Muli (5 qian each). Due to the rapid pulse, I added Xuanshen (Radix Scrophulariae, several qian), Shengdi (Radix Rehmanniae Preparata, several qian), and Baishao (Radix Paeoniae Alba, several qian). After four doses, she felt relief in the hypochondrium, and dark purple blood clots passed. Her menstruation subsequently normalized, and all symptoms resolved. Although Longgu and Muli are astringent, they possess opening properties. The *Shennong Bencao Jing* states that Longgu eliminates masses, and when assisted by Muli, whose salty nature softens hardness, such rapid efficacy is achieved.