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Zhi Shi (Fructus Aurantii Immaturus) 4 pieces, Hou Po (Cortex Magnoliae Officinalis) 4 liang, Xie Bai (Bulbus Allii Macrostemonis) half jin, Gui Zhi (Ramulus Cinnamomi) 1 liang, Gua Lou Shi (Fructus Trichosanthis) 1 piece (crushed).
The above five herbs are boiled with 5 sheng of water. First, decoct Zhi Shi and Hou Po to obtain 3 sheng of liquid, remove the dregs, add the remaining herbs, boil for a few more boils, and divide into three warm doses.

Ren Shen (Radix Ginseng), Gan Cao (Radix Glycyrrhizae Preparata), Gan Jiang (Rhizoma Zingiberis Secundi), and Bai Zhu (Rhizoma Atractylodis Macrocephalae) are each 3 liang.
The above four herbs are boiled with 8 sheng of water to obtain 3 sheng of liquid. Take 1 sheng warm per dose, three times daily.
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For "Xin Zhong Pi" (chest oppression/stagnation) and various rebellious Qi causing "Xuan Tong" (suspended heart pain), Gui Zhi Sheng Jiang Zhi Shi Tang (Cinnamon Twig, Ginger, and Immature Bitter Orange Decoction) is the primary treatment.
[Annotation]
"Xin Zhong Pi" refers to the chest stagnation Qi described in the previous clause. "Zhu Ni" refers to various rebellious Qi movements. The rebellion in the previous clause merely struck the heart without pain; the rebellion in this clause causes the heart to feel suspended and hollow-painful, as if a suspended object were shaking and causing pain. Using Gui Zhi Sheng Jiang Zhi Shi Tang unblocks Yang Qi and breaks rebellious Qi, stopping the pain and resolving the stagnation.
[Collected Notes]
Cheng Lin stated: Various rebellious Qi, such as Qi rushing up from the lower abdomen to the heart, when pathogenic factors remain exclusively in the upper part, lead to suspended heart pain.
You Yi stated: "Zhu Ni" encompasses phlegm-fluids and hostile Qi. "Xuan Tong" means pain like that caused by a suspended object shaking, which is due to rebellious Qi.

Gui Zhi (Ramulus Cinnamomi) 3 liang, Sheng Jiang (Rhizoma Zingiberis Recens) 3 liang, Zhi Shi (Fructus Aurantii Immaturus) 5 pieces.
The above three herbs are boiled with 6 sheng of water to obtain 3 sheng of liquid. Divide into three warm doses.
[Collected Explanations]
Zhao Liang said: Zhi Shi and Sheng Jiang are originally used to treat Qi blockage, let alone Pi syndrome. Therefore, the dosage is slightly reduced compared to the previous clause, allowing patients with Pi syndrome to descend Qi to open the obstruction. Suspended pain caused by fluid retention is dispersed by Sheng Jiang, which is sufficient to achieve efficacy. The reason for removing Ju Pi (Pericarpium Citri Reticulatae) and using Gui Zhi is that the rebellious Qi is not of a single type; whether unblocking Yang Qi, breaking condensed Qi, or dispersing Cold Qi, all can remove Bi obstruction.

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If the Fu Yang pulse is slightly wiry (Xian), according to standard principles, abdominal fullness should occur. If there is no abdominal fullness, there will certainly be difficult defecation and pain in both hypochondriac regions. This is deficiency-Cold ascending from below, and it should be treated with warming medicines.
[Annotation]
Fu Yang is the Stomach pulse, which should be slow and harmonious. Now seeing a wiry pulse indicates Liver involvement. When the Liver pulse appears in the Spleen/Stomach region, it indicates Wood excess and Earth deficiency, so abdominal fullness should theoretically occur. The reason for the absence of fullness now is that the Liver pulse is only slightly wiry and not excessive, and the Spleen is not deficient, so the Spleen has not been diseased. When Liver Qi stagnates internally, it loses its free-flowing nature, inevitably affecting its own meridian, thus causing difficult defecation and hypochondriac pain. However, this is not a Liver Fire excess condition, but rather deficiency-Cold ascending from below, so it should be treated with warming medicines.
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Abdominal fullness that decreases intermittently and then returns to normal indicates Cold; warming medicines should be administered.
[Commentary]
This section lacks a formula for treating deficiency-Cold abdominal fullness. Below the phrase "should be given warming medicines," the fourteen characters "Yi Hou Po Sheng Jiang Gan Cao Ban Xia Ren Shen Tang Zhu Zhi" (Hou Po, Ginger, Licorice, Pinellia, and Ginseng Decoction should be used as the main treatment) should likely exist, indicating a missing text (tuo jian). This can be verified by reading the *Tai Yin* chapter of the *Shang Han Lun*.
[Annotation]
This clause follows the previous one, detailing the symptoms to clarify the treatment. Abdominal fullness accompanied by difficult defecation is a Spleen Excess condition; current abdominal fullness without difficult defecation is a Spleen Deficiency condition. Moreover, since abdominal fullness sometimes decreases and sometimes returns as if nothing were wrong, it is a deficiency-Cold condition, and warming medicines should be used as the main treatment. Hou Po Sheng Jiang Gan Cao Ban Xia Ren Shen Tang (Magnolia Bark, Fresh Ginger, Licorice, Pinellia, and Ginseng Decoction) eliminates fullness, scatters Cold, moderates the middle, directs rebellious Qi downward, and tonifies deficiency, representing the method for treating deficiency-type fullness.
[Collected Notes]
Wei Litong said: If abdominal fullness decreases after taking purgatives or tonics, but soon returns to fullness, it cannot be treated as an Excess or Heat condition.
Zhong Jing clearly identifies this as Cold. Interior Cold never uses purgation methods; only warming medicines should be taken. For deficiency, warming the middle and tonifying Qi is used; for excess, warming the middle and moving Qi is the principle. This is the best method for treating Qi-cold abdominal fullness.