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Pathogenesis of Qi Disorders. Although the root lies in Qi, the pathological manifestations of Qi vary according to the syndrome; the discussion in *San Yin Fang* (Formulas of Three Causes) is the most detailed. Joy, anger, worry, thought, grief, fear, and fright are referred to as the Seven Emotions (Qi). If Qi stagnation causes injury, resulting in a sensation of a foreign body like cotton wadding in the throat, which cannot be coughed out or swallowed, Siqi Tang (Seven-Emotion Decoction) is suitable; if ineffective, Dingchen Touge Tang (Clove and Amber Cardamom Diaphragm-Penetrating Decoction) should be advanced.

If it is confirmed that the disease arises from excessive rumination, Siqi Tang is suitable. Remove Fuling (Poria), add Banxia (Pinelliae Rhizoma) in an amount equal to the original dosage, and additionally add Shichangpu (Acori Tatarinowii Rhizoma) and Renshen (Ginseng Radix), each half qian. If it is confirmed that the disease arises from extreme anger, presenting with a bluish-yellow complexion or distension and fullness in both hypochondria, Tiaoqi San (Regulating Qi Powder) or Siqi Tang is suitable, with Zhike (Aurantii Fructus) and Muxiang (Aucklandiae Radix) added, each half qian. For diseases caused by fright and alarm, leading to palpitations under the heart, refer to the "Palpitations" section; for those accompanied by dizziness, select herbs from the "Various Wind-Stroke" and "Middle Qi Syndrome" sections.

(Attached: Yige [Dysphagia])
Various types of Pi-syndrome (obstruction/fullness) and Yige (dysphagia) occur when Phlegm is agitated upward by Qi, while Qi is obstructed and stagnant by Phlegm. Phlegm and Qi contend with each other, preventing free circulation. Erchen Tang (Two-Aged Decoction) is suitable for all such cases, with Zhishi (Aurantii Fructus Immaturus) and Suosharen (Amomi Fructus) added, each half qian, and Muxiang (Aucklandiae Radix) one qian. Alternatively, Wuge Kuanchong San (Five Obstructions Mid-Jiao Widening Powder) may be used. It applies to various obstructions, distensions, chest and diaphragmatic discomfort, Qi rebelling upward, or abdominal pain. Muxiang Liuqi Yin (Aucklandia Flowing Qi Decoction) is suitable for all these conditions. For various cold evils in the upper diaphragm, regardless of obstruction or pain, give 1-2 cups of Ginger Juice, which is particularly suitable for Phlegm-Fluids.

For Pi-syndrome caused by pathogenic evils, dispersing agents are suitable. If Qi fails to flow smoothly and rebels upward causing Pi-syndrome, this is Deficient Pi-syndrome; further dispersing will exacerbate the obstruction. One should employ astringent and tonifying methods, incorporating mild dispersing intent within them, and must not excessively use aromatic Qi-regulating agents. Ancient formulas record the use of Lizhong Tang (Mid-Jiao Regulating Decoction) for post-purging diaphragmatic obstruction, illustrating this principle. For Pi-syndrome and fullness caused by Seven Emotions damaging the body and forming stagnation, Siqi Tang or Daotan Tang (Phlegm-Guiding Decoction) with half qian of Muxiang is suitable, or Xialaifu Dan (Descending Revival Pill). For cold Qi stagnating in the Zhongwan point causing obstruction, Zhuapi Tang (Splee-Scratching Decoction) with Dingxiang (Caryophylli Flos) or Dingchen Touge Tang is applicable. For food-stagnation-induced obstruction, see the "Food Injury" section. For Qi deficiency leading to rebellious Qi, resulting in obstructive pain, Liumo Yin (Six-Mortar Infusion) taken with Heixin Dan (Black Tin Pill) is indicated.

If Pi-syndrome proves unresponsive to various medications and bowel movements are not significantly blocked, Ganying Wan (Responsive Pill) with Baiduo (Crotonis Semen), Banshou Wan (Half-Sulfur Pill), Beiji Wan (Emergency Aid Pill), or Muxiang Binglang Wan (Aucklandia and Areca Nut Pill) should be used to promote purgation.

For anger-induced Pi-syndrome, refer to the "Seven Emotions Syndrome" section of this chapter. For all forms of Five Chokes and Five Obstructions, Wuge Kuanchong San is suitable; if ineffective, Gujia Jiahe San may be used. The aforementioned medications for Pi-syndrome can be selected as appropriate. In severe Yige where fluids cannot enter, and food/medicine are rejected, vomiting immediately upon ingestion, sedative and downward-draining methods are required. Lingsha Dan (Spirit Sand Pill) administered with salt water is suitable, followed by dry administration of Jiahe San powder.