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This syndrome requires only the unblocking of Yang, without the need to protect Yin.

Li: Accumulated fatigue has damaged Yang Qi. The abdomen is distended but remains soft upon palpation. The pulse is wiry (fine in miscellaneous diseases) and lacks Stomach Qi. The physique is emaciated, and food intake is impossible. It is necessary to regulate the rotational movement of Yang Qi in the Middle Jiao (Spleen and Stomach), hoping for the resumption of eating. If prolonged, it will be unable to expel the disease.
*Ren Shen* (Ginseng Radix et Rhizoma), *Dan Fu Zi* (Prepared Aconiti Lateralis Radix), *Gu Ya* (Hordei Fructus Germinatus), *Fu Ling* (Poria), *Yi Zhi Ren* (Alpiniae Oxyphyllae Fructus), *Guang Pi* (Citri Reticulatae Pericarpium).

If the abdomen is distended and hard upon palpation, it indicates not only damage to the Yang Qi of the Middle Jiao, but also the coagulation of turbid Yin in the Middle and Lower Jiao. Only when the distension remains soft can we know that although Yang is damaged, Yin has not yet coagulated. By regulating the Yang Qi of the Middle Jiao and allowing it to rotate freely, the condition will improve.
Yang Qi ascends and descends, rotating in the chest and abdomen without a moment's pause. Only then can Clear and Turbid Qi separate, and the Upper and Lower Jiao be governed properly.

Shen (North City Lower, 36 years old): Warm pathogenic factors (Wen Bing) arise from inhaling foul pathogens through the nose and mouth. These are chaotic and abnormal energies of Heaven and Earth, formless entities. They obstruct the upper orifices, causing choking and inability to swallow food. Physicians, unaware of the distinction between formless and formed pathogens, merely employ clearing heat and cold-descending methods. Consequently, the medicine enters directly into the intestines and stomach, having no effect on the throat. (Formless foul pathogens possess Qi but lack substance; although the Qi is turbid, its nature tends to float upward. Therefore, light and clear Qi-level herbs are used.)
*Lian Qiao Xin* (Juglandis Semen Cordis, 1 qian), *She Gan* (Belamcandae Rhizoma, 3 fen), *Xian Lu Gen* (Phragmitis Rhizoma, 1 liang), *Ma Pi Bo* (Euphorbiae Humifusae Herba, 7 fen), *Niu Bang Zi* (Arctii Fructus, 1.5 qian), *Yin Hua* (Lonicerae Japonicae Flos, 1 qian).

Treating the formless with the formless, hitting the mark precisely. This method was not fully elucidated by predecessors. Tian Weng (referring to natural efficacy or self-deprecation) possesses this clear and light approach, transforming formless influences into nothingness. How ingenious such thought is!

Xu (Suqian, 47 years old): Cold contracted from wading in water during winter penetrated deeply into the sinews and bones. After accumulating for several years, it manifested as cold bones in the shins and knees, with flaccid sinews. The disease is located below, belonging to Yin. Over time, Qi and Blood inevitably mix with pathogens, making herbal medicines ineffective for expulsion. Ancients utilized insect and ant drugs assisted by aromatic substances to attack the sinews and bones directly, adopting the method of Scholar Xu.
*Chao Wu Tou* (Processed Aconiti Kusnezoffii Radix), *Shan Dong Di Long* (Pheretima, Shandong origin), *Quan Xie* (Scorpio), *She Xiang* (Moschus).

Pathogens adhering to sinews and bones require medications that adhere to sinews and bones.

Qian (Tongli, 56 years old): Wine-heat entered the Blood level, causing profuse vomiting of blood clots. After six or seven years, this transformed into regurgitation (Fan Wei) and food intolerance, with vomiting of saliva and foam. Inquiry revealed that bowel movements remain unobstructed; the blockage lies within the epigastrium (Wan). Temporarily employ methods to unblock stasis and open obstruction. (Wine nature naturally moves in the Blood level; strong wine is more likely to cause boiling/concoction. Blood is detained by heat qi, leading to stasis.)
*Jiu Bai Zhi* (Allii Tuberosi Bulbus Juice), *Tao Ren* (Persicae Semen), *Yan Hu Suo* (Corydalis Rhizoma), *Jing Mo Zhi* (Ink Stick Juice), *Sheng Pu Huang* (Typhae Pollen), *Pian Zi Jiang Huang* (Curcumae Longae Rhizoma Slice).

The key lies in asking whether bowel movements are still patent; thus, knowing the blockage is in the epigastrium. Unblocking stasis and opening obstruction is sufficient to cure this disease. It does not fall under the category of treating Fan Wei, demonstrating skillful assessment of the pathological mechanism.

Han (Xinkai Lake, 45 years old): Foul odor entering the throat ("inhale" should not be interpreted as smelling fragrant or foul; this is a disease of Kidney failing to grasp Qi). Choking cough and hemoptysis occur because the Kidney meridian ascends along the throat and under the tongue. This is Kidney deficiency with rebellious Qi. Physicians lacking insight use wind herbs to treat the exterior, and cold-clearing herbs to descend Qi. The patient states that before the illness onset, there was always a sensation of cold. This indicates Yang deficiency within Yin, failing to receive and retain. (As Mencius said regarding the nose and smell.)
*Ren Shen* (Ginseng Radix et Rhizoma), *Gou Qi Zi* (Lycii Fructus), *Fu Ling* (Poria), *Chen Xiang Zhi* (Aquilaria Resin Juice), *Kan Qi* (Umbilical Cord), *Jian Lian Rou* (Nelumbinis Semen), *Ren Ru Fen* (Human Milk Powder).

Li (Wuxi, 33 years old): Choking and vomiting accompanied by coldness in the Lower Jiao (Treat the Lower Jiao first, then the Middle Jiao.)