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Tian Shi (Heavenly Master) said: The method of "treating obstruction by tonification" refers to addressing the pathology of blockage by employing tonifying strategies. An example is middle-fullness caused by Qi deficiency. Generally, when a person suffers from Qi deficiency, they often lack appetite; upon eating, they easily experience postprandial fullness and discomfort. People mistakenly attribute this to overeating and therefore use pills such as Xiangsha Wan (Amomum and Sand Ginger Pill) or Zhishi Wan (Immature Bitter Orange Pill), which have actions of promoting digestion and guiding out stagnation, for treatment. Initially, symptoms may provide slight relief, but over time, abdominal fullness persists, leading to repeated use of digestive aids. If this continues indefinitely, it will inevitably evolve into severe middle-fullness syndrome. At this stage, the abdomen becomes distended and enlarged, accompanied by rapid and coarse breathing. People then misdiagnose this as鼓胀 (Gu Zhang / Drum Distension) and employ harsh water-draining herbs like Qianniu Zi (Pharbitis Seed) or Gansui (Kansui Root) to promote diuresis and drain fluid. However, the fluid may not be eliminated, and the distension worsens. Believing that the medication was insufficient to overcome the disease, practitioners then resort to purgatives such as Dahuang (Rhubarb Rhizome) or Badou (Croton Seed). If these also fail, they might attribute the condition to wind-pathogen invasion and add acrid-dispersing herbs like Longdan Cao (Gentiana Root) or Ychen (Artemisia Capillaris). Various medications are administered in a chaotic mixture until death ensues. Such practices, whether involving opening the ghost gate (sweating) or cleansing the pure residence (urination), represent those who wield knives to strike down the already fallen. Who realizes that at the onset of the disease, if one immediately employs herbs to tonify the Stomach and strengthen the Spleen for prompt treatment, how could it reach such a dire state? The initial prescription is: Renshen (Ginseng Radix et Rhizoma) 1 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 2 qian, Fuling (Poria) 3 qian, Chenpi (Citri Reticulatae Pericarpium) 3 fen, Gancao (Licorice Radix et Rhizoma) 1 fen, Luobozhi (Brassicae Seminum) 1 qian, Yiren (Coicis Semen) 5 qian, Qianshi (Euryales Semen) 5 qian, Shanyao (Dioscoreae Rhizoma) 3 qian, decocted in water. (Commentary: This formula is named Xiaozhang Zhishen Tang [Miraculous Soup for Eliminating Fullness].) This formula entirely avoids digestive agents and focuses exclusively on tonification. Physicians of the world invariably mock it as pedantic, believing that such medicines will inevitably increase fullness. Upon swallowing, patients indeed feel slightly bloated, allowing worldly physicians to boast, "My words have proven accurate." Patients, their families, and relatives all praise these worldly physicians while blaming this formula for being pedantic and harmful. Little do they know that although slight fullness is felt upon ingestion, after entering the abdomen, a sense of openness and comfort gradually emerges. After taking several doses, not only is there comfort, but the disease of fullness completely disappears. This is because middle-fullness originates from Qi deficiency; without tonifying the deficiency, how can the fullness resolve? Within the tonifying herbs, Luobozhi is added to distribute and dissipate the qi of fullness, ensuring that Renshen does not aid the pathogen but rather supports the righteous Qi. Moreover, with purely damp-resolving herbs like Fuling, Yiren, and Qianshi, the water pathways flow naturally, preventing upper congestion. Particularly ingenious is the use of just 1 fen of Gancao to guide the group of herbs into the area of fullness. Although middle-fullness typically contraindicates the use of Gancao, I deliberately use it, achieving success within the realm of contraindications.

Zhang Gong said: Profound discussions emerge endlessly; the words of the sages are truly great. Middle-fullness is indeed an obstruction syndrome, and chest/epigastric fullness due to excessive eating is also an obstruction syndrome. People generally use Xiangfu (Cyperus Rhizome), Sharen (Amomi Fructus), and Houpo (Magnolia Bark) to promote digestion, but I differ. My prescription uses Renshen 3 qian, Baizhu 3 qian, Chenpi 1 qian, Gancao 1 fen, Rougui (Cinnamon Twig) 1 qian, Shenqu (Massa Medicata Fermentata) 3 qian, decocted in water. The brilliance of this formula lies in its complete avoidance of food-digestion promotion, seemingly aggravating the sensation of satiety and oppression. Yet, the reason food remains undigested is insufficient Stomach Qi. By tonifying Stomach Qi, the Stomach becomes strong enough to transform and transport food to the Spleen naturally, rendering the need for digestive herbs like Houpo or Zhike (Aurantii Fructus) unnecessary. This is also a method of treating obstruction by tonification, worthy of being preserved alongside Tian Shi's formula for eternity.

Hua Jun said: The method aligns with mine, but the discussion is more comprehensive.

Lei Gong said: I also have a prescription. Middle-fullness is indeed due to deficient Stomach Qi, yet merely tonifying Stomach Qi is difficult to cure. One should tonify Heart Fire to generate Stomach Earth. The prescription consists of: Renshen 3 qian, Baizhu 5 qian, Chao Zaoren (Fried Ziziphus Seed) 5 qian, Yuanzhi (Polygalae Radix) 8 fen, Shanyao 3 qian, Fuling 3 qian, Miren (Coicis Semen) 5 qian, Chenpi 3 fen, Shenqu 3 fen, Maiya (Hordei Fructus Germinatus) 5 fen, decocted in water. In this formula, fullness is not directly treated, yet it resolves spontaneously, precisely because the Heart Fire is being addressed.