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(Li Dongyuan) Treats the condition where the pylorus (lower opening of the stomach) is obstructed, causing qi to rush upward to the epiglottis (xi men), resulting in a sensation of choking and blockage that cannot be relieved. The qi fails to descend, and defecation is difficult. This condition is called "obstruction of the lower wan" (xia wan). The treatment focuses on unblocking the pylorus. (Note: The lower wan is synonymous with the pylorus, which is the lower outlet of the stomach. There are seven gates in the human body from top to bottom, through which qi tends to rush upward. When the pylorus rushes upward to the epiglottis—the epiglottis being the structure that covers the airway and esophagus during swallowing—if the inhaled qi cannot descend to return to the liver and kidneys due to rejection by yin-fire, it leads to obstruction in the chest and throat. Turbid yin fails to descend, resulting in dry and constipated stools. The dampness in the stomach combined with yin-fire causes abdominal distension. The treatment lies in unblocking the pylorus, making it patent, draining the yin-fire, moistening dry blood, and generating new blood. Once the pylorus is patent, the epiglottis is also protected from pathogenic factors, the chest and throat obstruction is resolved, and the distension disappears. This allows the turbid yin to descend back to the earth.)

Prescription: Danggui Shen (Radix Angelicae Sinensis Root End), Shengma (Rhizoma Cimicifugae), Taoren (Semen Persicae, pounded), Honghua (Flos Carthami), Gancao (Radix Glycyrrhizae Preparata), Yuanshengdi (Radix Rehmanniae Preparata), Yuanshudi (Radix Rehmanniae Preparata), or add Binglang (Areca Seed).

Analysis: Danggui, Shengdi, and Shudi nourish yin to generate blood; Taoren and Honghua moisten dryness and invigorate blood circulation; Binglang has a descending property and breaks qi stagnation. The reason for adding Shengma follows the way of heaven and earth... (Text gap/interpolation here, followed by "Yuan said") Li Dongyuan stated: For constipation caused by overeating or fatigue, use Taoren processed with wine and Dahuang (Radix et Rhizoma Rhei) to unblock bowels. For constipation due to wind-dryness, use Huomaren (Semen Cannabis) plus Dahuang to promote bowel movement. For constipation due to qi blockage, use Yuliren (Semen Pruni), Xingren (Semen Armeniacae Amarum), and Zaojiaoren (Fructus Gleditsiae Sinensis Seed) to moisten and unblock. One must not indiscriminately use harsh purgatives like Qianniuzi (Semel Phytolaccae Acinosae) or Badou (Semen Crotonis) to purge, as this damages body fluids. Although temporary relief may be achieved, the dryness and accumulation will worsen, eventually becoming incurable. (If Dahuang and Huomaren are added, it is named Danggui Runchang Tang [Danggui Intestine-Moistening Decoction], with the same indications.)

For any disease involving deficiency and damage, accompanied by closed and obstructed bowels, formulas containing Xiaoshi (Natrii Sulfas) and Dahuang (Radix et Rhizoma Rhei) that attack and purge must absolutely not be used. If the situation is urgent and evacuation is necessary, [Jichuan Jian] is the primary formula. This is a formula that achieves unblocking through tonification.

Prescription: Danggui (10-15 g), Niuxi (Radix Achyranthis Bidentatae) (6 g), Rongzhucong (Herba Cynomorii) (washed with wine to remove saltiness, 6-9 g), Zexie (Rhizoma Alismatis) (4.5 g), Shengma (Rhizoma Cimicifugae) (2-3.5 g), add Huangqin (Radix Scutellariae).