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If the pulse is floating and moderate, the prognosis is good; if it is deep and choppy, the prognosis is poor. A choppy and small pulse indicates insufficient Blood; a large and weak pulse indicates insufficient Qi.

Fanwei (Rebellious Stomach) originates invariably from Gegge (Obstruction in the Chest and Throat). Gegge arises from irregular emotions (excessive joy or anger), excessive worry and thought, overwork, and constant fright. These Seven Emotions injure the Spleen and Stomach, causing Qi stagnation and Phlegm generation. Phlegm and Qi contend with each other, rising but not descending, preventing food and drink from going down. Qi and Blood remain stagnant in the throat. The Five Ge (Obstructions) knotting in the chest and diaphragm become Wuge (Five Obstructions). The treatment principle should be to regulate Qi and resolve Phlegm, warm the Spleen and nourish the Stomach. If the Yang pulse is tight and choppy, it is a difficult-to-treat condition. Fanwei is equivalent to Gegge, and Gegge is the gradual onset of Fanwei. There are four main patterns: Blood deficiency, Qi deficiency, presence of Phlegm, and presence of Heat. In Blood deficiency, the pulse is necessarily rapid and forceless; in Qi deficiency, the pulse is necessarily moderate and forceless. If both Qi and Blood are deficient, there will be excessive spitting of foam in the mouth; seeing massive outflow of foam indicates certain death. In Heat, the pulse is necessarily rapid and forceful; in Phlegm, the pulse is necessarily slippery and rapid. Both are treatable. For Blood deficiency, Siwu Tang (Four Substances Decoction) is the primary formula. If the left-hand pulse is forceless, it indicates Qi deficiency, and Sijunzi Tang (Four Gentlemen Decoction) is the primary formula... [Note: Text implies right-hand pulse relates to specific Qi/Blood aspects, though traditionally Left=Blood/Yin, Right=Qi/Yang, translation follows text structure]... If stool is like sheep dung, it is untreatable because the Large Intestine lacks Blood lubrication. For Phlegm, Erchen Tang (Two-Aged Decoction) is the primary formula. If the Cun (Inch) and Guan (Bar) pulses are deep, hidden, or large, it indicates Qi stagnation, and Qi-regulating herbs can be used. If the Cun and Guan pulses are deep, choppy, and large, fragrant, dry, and hot agents should not be used; light and bland diet is appropriate. It is also said that Gegge and Fanwei result from the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire external pathogens) and Seven Emotions, leading to Fire blazing upward, with more ascending than descending. There is also Fanwei caused by external Yin Fire blazing upward, which should be treated as Yin Fire. Such patients will have constipation. Children's urine, Bamboo Sap, Leek Juice, Ginger Juice, Cow's Milk, or Goat's Milk may be used separately.

One theory states that there are ten types of diseases in the Diaphragm, all originating from the same source. They arise because emotional movements cannot be vented, leading to stagnation in the Liver. The human diaphragm belongs to the Liver Wood system. If Liver Wood is disordered, it overacts on Spleen Earth (Wood conquers Earth). Liver governs flexibility and its flavor is Sour. However, Sour has a contracting and obstructing nature, causing the stomach cavity to contract and become obstructed, resulting in Gegge syndrome. The following formula is suitable: Danggui Huoxue Runge Tang (Angelica Sinensis Blood-Invigorating and Diaphragm-Moistening Decoction).
Herbs: Danggui (Washed in wine, 1.5 qian), Taoren (Skin and tip removed, 1 qian), Guang Chenpi (Green variety, 0.8 fen), Chuan Houpo (Stir-fried with ginger juice, 1 qian), Huanglian (Stir-fried with decoction of Wuzhuyu, 1 qian), Dafupi (Washed in Licorice decoction, 1 qian), Pian Baizhu (Stir-fried in salt water, 1 qian), Honghua (0.7 fen), Zhi Gancao (Honey-roasted, 0.3 fen). For those who drink alcohol frequently, add Gegen (Kudzu Root).
Crush the above ingredients for one dose, decoct in water, and take warm.

Commentary: Although the Five Ge have five names, their essence lies in individuals with weak Qi and dry Blood, caused by excessive thinking, labor, and sexual indulgence. Weak Qi fails to promote transformation and transportation; dry Blood blocks the pathways. Heart generates Blood, Kidney generates Qi, and the Ren Mai (Conception Vessel) is the mother of Yin. When dry, Essence and Blood are exhausted, and the Ren Mai loses moisture. The Ren Mai runs through the throat, chest, and three parts of the Stomach, descending directly. Kidney deficiency causes clear Qi from the Dantian to fail to ascend, leading to disorder in the Middle Jiao and impaired downward transformation. Although the Spleen enjoys flavors and appetite, obstruction of ascending and descending leads to Ge syndrome. One must conserve Jing and Blood after restraining desires and regulate emotions to harmonize the Heart and Spleen. Use Danggui Huoxue Runge Tang, removing Baizhu, and adding Renshen (1 qian), Baidoukou (7 pods), Huangbai (Stir-fried with wine, 0.7 fen), Zhimu (0.7 fen), Zhizi (Roasted, 1 qian), Gualouren (Roasted, 1 qian), Yuanzhi (Soaked in Licorice decoction, heart removed, 0.8 fen), and Hongzao (3 dates). Decoct in water and take.

Another theory states that Gegge presents with discomfort in the chest, dry and hard stool, cough with Phlegm, wheezing and fullness, and stagnation in the Spleen and Stomach. This formula eliminates stale matter and promotes new growth, serving as a sacred medicine for treating Qi obstruction in the diaphragm.
Formula: Renshen Lige Wan (Ginseng Diaphragm-Regulating Pill).
Herbs: Renshen (3 qian), Danggui (2 qian), Huoxiang (1.5 qian), Houpo (Stir-fried with ginger juice, 1 liang), Zhishi (Bran-roasted, 1 liang), Dahuang (Steamed with wine, 1 liang), Muxiang (1.5 qian), Binglang (1.5 qian), Gancao (Roasted, 3 qian).
Grind into fine powder, form pills with drops of water, size of Sophora seeds. Take 50 pills per dose with warm water.

Another theory suggests that for Yishi Zhuan Shi (Choking food regurgitating undigested food), Jiajian Bu Huan Jin Zhengqi San (Modified Unchanging Golden Upright Qi Powder) is suitable.
Herbs: Cangzhu (Soaked in rice wash water, 1.5 qian), Chenpi (White pith removed, 2 qian), Houpo (Stir-fried with ginger juice, 0.8 fen), Huoxiang (3 qian), Banxia (Stir-fried with ginger juice, 2 qian), Zhishi (Bran-roasted, 2 qian), Baizhu (Aerial part removed, 1.5 qian), Bai Fuling (Peel removed, 3 qian), Baidoukou (Shell removed, 0.8 fen), Gancao (0.8 fen), Huanglian (Earth-stir-fried, 0.6 fen).
Crush the ingredients, decoct with 3 slices of fresh ginger, and take.

Another theory holds that Yige Fanwei syndromes are caused by excessive influence of the Seven Emotions. Stagnation generates Fire and Phlegm, causing disease. Illness consumes Qi and Blood, leading to deficiency. Deficient Qi fails to transform, generating Phlegm; deficient Blood fails to moisten, generating Fire. Symptoms include morning eating and evening vomiting, evening eating and morning vomiting, or immediate vomiting after eating. If prolonged and untreated, misusing fragrant, dry, and attacking drugs leads to critical danger. It is suitable to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (see Internal Injury chapter). Remove Chaihu and Shengma from this formula, add Banxia (2 qian), Bai Fuling (3 qian), Baishao (Wine-stir-fried, 3 qian), Zhishi (Bran-roasted, 1 qian), Shenqu (Roasted, 2 qian), Huanglian (Ginger-stir-fried, 0.6 fen).

For Fanwei with no desire to eat due to Spleen and Stomach weakness, Ren Cang Wan (Human Granary Pill) is suitable.
Herbs: Dingxiang (1 liang), Sharen (1 liang), Baidoukou (Shell removed, 1 liang), Chen Cangmi (6 liangs, stir-fried with yellow earth until cooked, then discard earth).
Grind into fine powder, form pills with natural Ginger Juice, size of Sophora seeds. Take 100 pills per dose after meals with light Ginger Soup. If there is anger, add Xiangfu (Stir-fried with ginger juice, 1 liang).

One theory defines the Five Ge as Qi Ge, You Ge, Lao Ge, Shi Ge, and Si Ge.
Qi Ge involves palpitations, blockage of upper and lower Qi, inability to belch or hiccup, and painful hypochondrium.
You Ge involves suffering from cold limbs, palpitations in the epigastrium, and cold hands and feet.
Lao Ge involves suffering from shortness of breath, distension under the diaphragm and hypochondrium, chest fullness, cold hands and feet unable to self-warm.
Shi Ge involves chest blockage regardless of food amount, constant pain, and inability to breathe easily.
Si Ge involves palpitations, forgetfulness, and blurred vision.
These conditions are all caused by sorrow, resentment, and anger, with Cold Qi attacking the chest and diaphragm.
Formula: Wuye Wan (Five Ge Pill). Treats deficiency-cold in the chest, chronic rebellious Qi in the throat, inability to swallow food, and unresolved Qi knots.
Herbs: Renshen (0.5 fen), Baizhu (Aerial part removed, 0.4 fen), Bai Fuling (0.4 fen), Chenpi (0.4 fen), Xixin (0.4 fen), Chuanjiao (0.5 fen), Wuzhuyu (0.5 fen), Da Fuzi (Roasted, peel and navel removed, 0.4 fen), Guixin (Cinnamon Twig Heart, 0.5 fen), Ganjiang (Stir-fried, 0.5 fen).
Grind into powder, form pills with refined honey, size of Sophora seeds. Take 3 pills per dose with wine, three times daily.

Formula: Baohe Wan (Preserve Harmony Pill). Treats excess-Heat Fanwei.
Herbs: Chenpi, Banxia (Stir-fried with ginger juice), Bai Fuling (Peel removed), Lianqiao, Shenqu, Shanzha Rou (Mesocarp of Hawthorn), Luobozi (Roasted Radish Seed, each 3 qian), Huanglian (Ginger-stir-fried, 2 qian).
Grind into powder, form pills with thin rice paste, coat with carmine, size of millet seeds. Take 60-70 pills per dose with Ginseng decoction mixed with Bamboo Sap.

One theory describes Weifan (Stomantic Reversal) where food is rejected and vomited immediately after ingestion.
Herbs: Renshen (2 liangs), Baizhu (Aerial part removed, 1 liang), Banxia (Soaked in boiling water, 3 liangs), Shengjiang (Fresh Ginger, 3 liangs), Baimi (White Honey, 1 liang).
Chop the five ingredients, add 5 sheng of water and honey, stir 200-300 times, boil to obtain 1.5 sheng. Divide into three doses.

One theory states that for Fanwei with unpredictable vomiting, immediate vomiting of porridge and drinks upon entry, extreme weakness, and impending death, use Renshen (2 liangs), sliced, decocted in water and taken in one dose for immediate effect. Follow up with thin porridge made with Ginseng juice.

One method to treat Fanwei uses Liujunzi Tang (Six Gentlemen Decoction) plus Paojiang (Charred Ginger), Baidoukou, and Huanglian. (The Huanglian is soaked in Wuzhuyu wine, stir-fried overnight, and the Wuzhuyu discarded).

One prescription for Zhuan Shi (Regurgitation of undigested food): Take one "fanchi" chicken (a specific type of chicken), cook thoroughly, remove bones, add Renshen, Danggui, and Salt (each 5 qian), grind into powder, re-boil the chicken meat with the powder, and consume. Do not let others share the meal.

A case: A man over fifty suffered from Ge syndrome, epigastric pain, inability to eat, or vomiting food long after eating, dry stool, and severe emaciation with dark complexion. His pulse was wiry, slippery, and surging at the right Guan position, slightly deep and small behind it; both positions were deep, wiry, and thready (Kou). This indicates insufficient Middle Qi, Liver Wood insulting Spleen Earth, Damp-Heat in the Upper Jiao condensing into Phlegm, and scant Blood in the Lower Jiao causing dry stool. Yin Fire rushing up to the Xi Men (Admission Gate) prevents swallowing. Use Siwu Tang to generate Blood, Sijunzi Tang to tonify Qi, and Erchen Tang to dispel Phlegm. Combine these three formulas, add Ginger-stir-fried Huanglian, Bran-roasted Zhishi, Gualouren, and a little Sharen. Also intermittently take Run Chang Wan (Moisten Intestines Pill) for over a hundred doses for complete recovery. (Run Chang Wan formula see Constipation chapter).

One method to treat Fanwei: Take the largest Fuzi (Prepared Aconite Root), place it on a brick, apply fire around it gradually, and quench it in natural Ginger Juice. Repeat the heating and quenching process until about half a bowl of Ginger Juice is consumed. Grind into powder. Take 1 qian per dose with Millet Soup. Effect is seen within three doses.

One method to treat Yige with dry and hard stool.
Formula: Ju Xing Ma Ren Wan (Tangerine Peel, Apricot Kernel, and Hemp Seed Pill).
Herbs: Chenpi (Ground to powder), Xingren (Skin and tip removed), Huomaren (Shell removed, each 3 liangs), Yuliren (Shell removed, 5 qian).
Grind the three kernels into a paste, mix with Jujube flesh, pound in a mortar to form pills. Take 50 pills per dose with Zhishi decoction.