Library

Yige (dysphagia with chest obstruction) and Fanwei (regurgitation of food, either immediately after eating or morning/evening vomiting), are mostly caused by internal injury, such as depression and loss of will, as well as indulgence in alcohol and diet, and excessive labor, leading to the internal accumulation of Yang Qi and the internal depletion of Yin Blood. The Classics state: "Accumulation in the Three Yang meridians is called Ge syndrome." The so-called Three Yang refer to the Hand-Taiyang Small Intestine Meridian, the Hand-Yangming Large Intestine Meridian, and the Foot-Taiyang Bladder Meridian. Generally, if there is heat accumulation in the Small Intestine, urine becomes scanty, and Fire Qi cannot be vented; if there is heat accumulation in the Large Intestine, defecation is difficult, and stagnant heat is hard to eliminate; if there is heat accumulation in the Bladder, body fluids are insufficient, and pathways become obstructed and rough; when the Qi of the Three Yang meridians accumulates together, the Qi mechanism of the anterior and posterior orifices fails to circulate. Since the lower part does not flow smoothly, Fire Evil rebels upward. When Qi and Fire rebel upward, phlegm-saliva is further generated. Once phlegm-saliva is produced, the circulating Qi mechanism becomes more obstructed, thus giving rise to symptoms of vomiting, rebellious Qi, Yige, and Fanwei. Moreover, severe injury from the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright) combined with contraction of the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire). Or failure to abstain from roasted, fried, and fatty foods; or reckless administration of acrid, aromatic, dry, and hot agents, causing Fire Evil to become even more blazing, body fluids to wither, and phlegm-saliva to coagulate further, making the condition deeper and harder to treat. Treatment must differentiate between the Upper, Middle, and Lower Jiao (Triple Burner). If there is blockage in the throat and epiglottis, Qi does not move smoothly, water and drinks can pass, but food is difficult to enter, the lesion is at Xi Men (the glottis/epiglottis area), named Ge syndrome. If pain occurs in the epigastrium after swallowing food, accompanied by restlessness and discomfort, followed by vomiting after a moment, with relief after vomiting, the lesion is at Ben Men (the cardia/gastric inlet), named Ye syndrome. Ye syndrome belongs to the Upper Jiao. If food can be swallowed but regurgitates after a long time, the lesion is at You Men (the pylorus/gastric outlet), named Fanwei, also called Weifan, which belongs to the Middle Jiao. If food eaten in the morning is vomited in the evening, or food eaten in the evening is vomited in the morning, with undigested food expelled, red urine, difficult defecation, or stool resembling sheep droppings, the lesion is at Lan Men (the junction of the small and large intestines), also named Fanwei, belonging to the Lower Jiao. However, those with strong constitution may still be treatable, using formulas that penetrate the diaphragm, soothe Qi, resolve phlegm, clear fire, strengthen the stomach, and harmonize the spleen. The Classics further state: "Yige often arises from blood dryness, and Fanwei also arises from spleen weakness." Li Dongyuan said: "The Spleen is Yin, and Blood is also Yin. Yin governs stillness. If both internal and external states are still, how would Fire of the Zang-Fu organs arise? If the Metal (Lung) and Water (Kidney) organs are nourished, Yin Blood will naturally generate, and the transmission and transformation of gastrointestinal fluids will be appropriate, thus preventing Yige and Fanwei."