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Intestinal obstruction (Chang Jie) is a critical condition that often threatens life. It can be caused by frequent vomiting, excessive consumption of raw and cold or hard foods, or overeating after anger. The obstruction usually occurs between the duodenum and the small intestine, or sometimes at the pylorus. Symptoms may include abdominal pain or vomiting; cases with vomiting are particularly difficult to treat because the medication intended to resolve the obstruction is vomited out before it can take effect. In some cases where vomiting was not originally present, the ingested medicine reaches the site of obstruction, cannot pass through, and is forced back up, causing vomiting. Therefore, the primary goal in treating this condition is to ensure that the patient does not vomit after taking the medicine.

For patients with severe vomiting due to this condition, who had been unable to retain even a spoonful of liquid for eight or nine days, I once used five taels of fine Ochre powder (Heshi). From this, I sifted out one tael of the finest particles. The remaining four taels were decocted into a soup, which was then used to administer the one tael of finest Ochre powder. This stopped the vomiting and resolved the obstruction. In extremely critical cases of intestinal obstruction, this formula should be used boldly. Even for pregnant women suffering from hyperemesis gravidarum (Ezu), this can be applied (see the case studies following the description of Zhenqi Tang with Ochre for reference). Some claim that vomiting during pregnancy, regardless of severity, is irrelevant to life; this is a statement born of insufficient experience.

In cases where rapid purgation is urgently needed, I once used three taels of fine Ochre powder and five qian of Mangxiao (Mirabilite), decocted in water, to administer one and a half qian of fine Kansui powder (Gansui). Half an hour and a half after ingestion, the obstruction was relieved. Later, another physician used this formula to treat a case of intestinal obstruction lasting over a month and achieved a cure with a single dose. Subsequently, I learned that this same physician suffered from intestinal obstruction himself and used this formula: he first took half the decoction and administered half the Gansui powder. Although the medicinal force moved downward, the obstruction did not resolve, and he vomited again. He then took the remaining half, but vomited immediately afterward, leading to his death. This illustrates that while being too bold in prescribing can lead to errors, being overly cautious can also cause missed opportunities. Furthermore, regarding the nature of Gansui, whether taken in large or small amounts, it typically does not induce vomiting upon the first administration. However, if taken repeatedly, even when combined with Ochre, it will inevitably cause vomiting.

Therefore, my formulated "Dangxiong Decoction with Added Gansui" uses a large dose of Dachengqi Tang (Major Order the Qi Decoction) with two taels of Ochre decocted together, to administer two qian of fine Gansui powder. A note below the formula states: "If one dose is ineffective, wait three days before administering again." This is intended not only to allow time for the body's healthy qi to recover by spacing out doses, but also to prevent vomiting caused by continuous administration. Ochre can be used in such large quantities because its original composition is iron oxide, which has a very mild nature, nourishes blood, does not damage qi, and is harmless even in large doses. However, Ochre sold in pharmacies is often calcined with vinegar and crushed; this processing method compromises its chemical integrity. It is better to use raw Ochre directly. Although it is a mineral similar to rust (which is also iron oxide), using raw fine Ochre powder causes no harm to the gastrointestinal tract. If one finds the potency of Gansui in the above formula too harsh, the book records another formula, Xiaofu Tongjie Tang (Radish and Mirabilite Obstruction-Resolving Decoction), which has a stable and gentle nature, though its preparation is slightly more laborious. Two successful case reports follow this formula, and I have successfully treated multiple subsequent cases of this condition using it.