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Discourse states: In individuals who are extremely deficient, when invaded by cold pathogenic factors, qi rushes upward and presses, causing obstruction and lack of free flow, thus forming Chest Bi (Thoracic Obstruction). The manifestations include hardness and fullness in the chest, stuffiness and urgency, or a sensation of blockage in the chest, or pain throughout the chest and back, or chest fullness with shortness of breath, coughing and expectoration inducing pain, irritability and restlessness with cold sweat, or heart pain radiating to the back, or muscle Bi (obstruction) and skin pain. These are all signs of blockage and lack of free flow. When taking the pulse, one should look for excess and deficiency patterns; if the Yang position is faint (Yang Wei) and the Yin position is wiry (Yin Xian), Chest Bi with pain will occur. It is also stated that the disease of Chest Bi presents with wheezing, coughing and expectoration, back pain, and shortness of breath; the pulse at the Cun Kou position is deep and slow, while the Guan position is small, tight, and rapid.

Discourse states: The pulse of Chest Bi is characterized by a faint Yang position and a wiry Yin position. Deficiency of Yang indicates the pathology is in the Upper Jiao (Upper Burner); the wiry Yin causes Chest Bi and heart pain. Ancient formulas use Lizhong Tang (Regulate the Middle Decoction) to gently harmonize the Qi of the Middle Jiao. However, the back is the mansion of the chest; symptoms may include a pounding sensation, palpitations, thirst, abdominal pain, aversion to cold, or abdominal fullness. Since the presentations vary, treatment should be adjusted according to specific indications.

To treat Chest Bi, Lizhong Tang Formula:
Ren Shen (Ginseng Radix et Rhizoma), Zhi Gan Cao (Prepared Licorice Root), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Pao Gan Jiang (Prepared Dried Ginger) [each 1 liang 5 qian].
The above four ingredients are coarsely crushed and sieved. Each dose consists of 5 Qian Bi, decocted in 2 Zhan of water until reduced to 1 Zhan. Strain and take warm. Administer on an empty stomach, at noon, and before bed. If there is a pounding sensation, this indicates disturbance of Kidney Qi; remove Bai Zhu and add Gui Zhi (Cinnamon Twig) 2 liang. If there is a pounding sensation above the umbilicus with excessive vomiting, remove Bai Zhu and add Sheng Jiang (Fresh Ginger) 1 liang 5 qian. If there is excessive diarrhea, reuse Bai Zhu. For palpitations, add Fu Ling (Poria) 1 liang; for thirst, add Bai Zhu 2 liang 1 fen. For abdominal pain, add Ren Shen 2 liang 1 fen. For aversion to cold, add Gan Jiang (Dried Ginger) 2 liang 1 fen. For abdominal fullness, remove Bai Zhu and add Fu Zi (Aconite Lateralis Radix Praeparata) 1 piece. After taking the decoction, consume thin porridge after some time, and keep warm with clothing to induce slight sweating.

To treat Chest Bi, Gualou Tang Formula:
Gua Lou Shi (Trichosanthis Fructus, including pulp) [1 fruit], Zhi Shi (Immature Bitter Orange Fruit, pulp removed, bran-fried) [5 fruits], Ban Xia (Pinellia Tuber, washed in hot water to remove slipperiness) [4 liang].
The above three ingredients are cut into pieces the size of hemp seeds. Each dose consists of 5 Qian Bi, decocted in 2 Zhan of rice liquid (Mi Jiang), with 1 handful of Xie Bai (Allium Macrostemon Bulb) cut, and 1 Fen of Sheng Jiang (Fresh Ginger) crushed. Decoct together until reduced to 1 Zhan.

To treat Chest Bi, Zhishi Tang Formula:
Zhi Shi (Immature Bitter Orange Fruit, pulp removed, bran-fried) [0.5 liang], Gua Lou Shi (Trichosanthis Fructus, including pulp) [1 fruit], Hou Po (Magnolia Bark, coarse skin removed, ginger juice fried) [3 liang].
The above three ingredients are cut into pieces the size of hemp seeds. Each dose consists of 5 Qian Bi, decocted in 2 Zhan of water until reduced to 1 Zhan. Strain and take warm. Administer on an empty stomach and in the evening.

To treat Chest Bi, Zhishi Tang Formula:
Zhi Shi (Immature Bitter Orange Fruit, pulp removed, bran-fried) [4 fruits], Hou Po (Magnolia Bark, coarse skin removed, ginger juice fried) [3 liang].
The above two ingredients are coarsely crushed and sieved. Each dose consists of 5 Qian Bi, decocted in 2 Zhan of water with 1 handful of Xie Bai (Allium Macrostemon Bulb) cut. Decoct until reduced to 1 Zhan. Strain and take warm. Administer on an empty stomach and in the evening.

To treat Chest Bi, Shexiang San Formula:
She Xiang (Musk) [ground, 1 liang], Niu Huang (Calculus Bovis) [ground, 0.5 liang], Xi Jiao (Rhinoceros Horn) [sliced, 1 fen].
The above three ingredients are pounded and ground into a powder. Each dose consists of 2 Qian Bi, taken with warm wine. Administer on an empty stomach, at noon, and before bed.

To treat Chest Bi, with hardness and stuffiness below the heart, urgent pain radiating to the back, shortness of breath, irritability, and cold sweat, Banxia Tang Formula:
Ban Xia (Pinellia Tuber, washed seven times in hot water, cut and dried) [2.5 liang], Gua Lou Shi (Trichosanthis Fructus) [1 fruit], Xie Bai (Allium Macrostemon Bulb, cut) [2 He].
The above three ingredients are cut into pieces the size of hemp seeds. Each dose consists of 5 Qian Bi, decocted in 2 Zhan of water with 1 Fen of Sheng Jiang (Fresh Ginger) cut. Decoct until reduced to 1 Zhan. Strain and take warm. Take three times daily.

Another formula:
Zhi Ke (Aurantii Fructus Immaturus, pulp removed, bran-fried) [30 fruits].
The above single ingredient is pounded and sifted into a powder. Take 1 Fang Cun Bi with Mi Yin (rice drink) before meals. Take three times daily and once at night.

Another formula: Add Gui Zhi (Cinnamon Twig) in equal proportions.

To treat severe pain in Chest Bi, Zhizi Tang Formula:
Zhi Zi Ren (Gardeniae Fructus Seed) [2 liang], Fu Zi (Aconite Lateralis Radix Praeparata, cracked, skin and navel removed) [1 liang].
The above two ingredients are chewed/crushed. Each dose consists of 3 Qian Bi, decocted in 1 Zhan of water with 3 Cun of Xie Bai (Allium Macrostemon Bulb). Decoct until reduced to 0.5 parts. Strain and take warm.