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(Commentary on the manuscript by disciple Wu Yuchun)

Regarding the two syndromes of *Jie Xiong* (Chest Binding) and *Pi* (Stagnation), former sages regarded *Jie Xiong* as an Excess syndrome and *Pi* as a Deficiency syndrome, with annotations that are clear and beyond doubt. However, there is still incomplete meaning in this interpretation. Since the formulas for treating *Jie Xiong* are more峻烈 (pungent and severe) than those of Chengqi Tang (Gut-Purging Decoction), yet the formula names include "Xie Xin" (Draining the Heart), there must be another profound intention here, which requires deep reflection and detailed discrimination. Examining the symptoms of *Jie Xiong*: some present with hardness and pain below the heart; others present with hardness, fullness, and extreme pain from below the heart down to the lower abdomen, so severe that one cannot bear to be touched. The minor *Jie Xiong* syndrome presents with pain upon pressure exactly below the heart. The *Pi* syndrome presents with a sensation of blockage below the heart, or hardness and blockage below the heart. Thus, investigating its location, it truly lies within the diaphragm membrane; observing its etiology, it is indeed caused by Phlegm-Fluids and Heat binding together and refusing to resolve. Phlegm-Fluids belong to the Water category, while Heat belongs to the Fire image. When Water and Fire bind together within the diaphragm membrane, the pathogenic Qi is deep, the disease pathway is distant, and the root of the disease is firmly established. Moreover, the nature of Phlegm-Fluids is exceptionally sticky and greasy. Any decoction with mild medicinal power not only fails to scour and cleanse but also adheres to the substance of the Phlegm-Fluids, causing further harm. Therefore, Da Xianxiong Tang (Major Chest-Expelling Decoction) uses Rhubarb (Rhei Radix et Rhizoma) and Mirabilite (Natrii Sulfas) from Chengqi Tang, replaces Zhi Shi (Aurantii Fructus Immaturus) and Hou Po (Magnoliae Officinalis Cortex) with Kansui (Kansui Radix). Its pungency and severity are fierce, allowing it to directly strike the nest of the Phlegm-Fluids without resistance. As for the minor *Jie Xiong* syndrome, the retention and binding of Phlegm-Fluids are lighter, yet the Phlegm-Fluids steamed by Heat transform into Phlegm. Hence, Huanglian (Coptidis Rhizoma) is used as the Sovereign herb to treat the source of Heat steaming Dampness; Banxia (Pinelliae Rhizoma) eliminates Phlegm as the Minister herb; Gualou (Trichosanthis Fructus) guides Phlegm-Heat downward as the Assistant and Envoy herbs. Regarding the *Pi* syndrome, although it belongs to the obstruction of formless Qi, it must inevitably involve either Dampness or Heat, or both Dampness and Heat obstructing each other in the diaphragm. Therefore, Xiexin Tang (Heart-Draining Decoction) relies primarily on Huangqin (Scutellariae Radix) and Huanglian. The Heart belongs to the Fire of the Li Trigram; "Draining the Heart" means draining Fire. The Li Trigram is hollow in the middle, Yang on the outside and Yin on the inside, containing Water within Fire. Heat steams Dampness, and since the disease is located in the diaphragm, it is indeed insufficient to reach the disease site unless one utilizes the bitter-cold and drying properties of Huangqin and Huanglian. If Phlegm-Dampness is abundant, Shengjiang (Zingiberis Rhizoma Recens) and Banxia must be assisted; if Yang Qi is deficient, Fuzi (Aconiti Lateralis Radix Praeparata) is the main agent; if Middle Qi is weak, Renshen (Ginseng Radix) and Gancao (Glycyrrhizae Radix) assist. The methods can be said to be comprehensive. Then why do both Xianxiong Tang and Xiexin Tang treat diseases of the diaphragm, yet Zhang Zhongjing (the Grand Administrator of Changsha) does not name them by treating the diaphragm? The answer is: "Rejection pain within the diaphragm, hostile Qi agitating the diaphragm," Zhang Zhongjing has already stated this. It is merely because the concept of the "diaphragm membrane" was rarely elucidated in the *Neijing* (Inner Canon) and *Nanjing* (Classic of Difficult Issues). Furthermore, the diaphragm serves to shield the Heart and Lungs, preventing turbid Qi from ascending and fuming upwards. Now that the diaphragm membrane is diseased, the empty and vast region of the Upper Jiao is entirely occupied by Phlegm-Fluids, Phlegm, and Heat. If one does not urgently sweep and clear them away, the Palace City of the Sovereign Organ (the Heart) faces the danger of being shaken and endangered. This is like the way of suppressing bandits: one must first eliminate the violent rebels before one can pacify the good people. Extending this logic, the use of Sanwu Baisan (Three-Material White Powder) for Cold-Excess *Jie Xiong*, the untreatability of Zangjie (Visceral Binding), the fact that softness upon pressure indicates Qi *Pi* which is not within the scope of Xiexin Tang, can all be clarified item by item. As for external Chest Bi (Obstruction) and Pi Qi (Stagnation Qi), Gualou Xiebai Tang (Trichosanthes and Macrostemon Decoction) is suitable; for Chest Pi caused by Damp-Warmth, Xingren (Armeniacae Semen Amarum), Houpo, Jupe (Citri Reticulatae Pericarpium), and Banxia are suitable. Differentiation during clinical practice depends entirely on the reader's ability to integrate and understand comprehensively.