经曰∶三阳结，谓之膈。又曰∶少阳所致，为呕涌溢，食不下。食不得入，是有火也。是证
因七情过极，房室劳役，致五脏火炽，血液枯涸，煎熬成痰，渐致胃脘干槁。近咽嗌间则水饮可
行，食物难入，名之曰噎。槁在胃脘，食虽可下，不能营运，良久复出，不出则胀满难当，名之
曰膈。既无谷味生养气血，自然衰惫。或因病起微渐之时，惟欲速效，过用香燥辛热之药，损伤
阴血而致者，然去死不远也。脉寸紧而尺微涩，浮弱气虚，涩小血弱。治宜补气养血，顺气消痰
清热。五噎者，忧、思、气、劳、食也。五膈者，思、忧、喜、怒、悲也。此神思间病，惟内观
自养，神静阴生，阴生则血生。火降而肠胃滋润，能断浓味，庶不助火。若吐白沫，粪如羊屎者
不治。
主方 人参（五分） 白术 茯苓 当归 陈皮 半夏（姜制） 黄连（各八分） 甘草（
三分）上加姜、枣煎，磨入沉香汁（三匙）服。
气虚加黄 ；呕加霍香、砂仁；助胃加山药、莲肉；消食，山楂、麦芽；开郁，香附、神曲、
抚芎、山栀；气胀不舒加木香、萝卜子；大便秘加酒煮大黄；肥人多痰加二陈，制半夏、贝母、蒌
仁，药中入竹沥、姜汁少许，韭汁、童便、驴尿服。瘦人四物养血，少加桃仁、红花，常宜人乳、牛羊乳。
少入姜汁、蜂蜜、砂糖、甘蔗汁、梨汁作饮。枇杷叶、青橘叶、兰叶煎汤饮。御米、粟米煎粥，
入竹沥食。此证有干食糯米饭，绝不饮茶汤而安者。
五噎五膈散 治膈噎等证。
人参 半夏 桔梗 白术 白豆蔻 木香 沉香 干姜 HT 头糠 荜HT 茄 甘草（各三分）
枇杷叶（五片，刷去毛，蜜炙）
上加生姜七片，水一盏煎服。
生姜汁煎，治噎食不下，咽喉壅塞，胸膈烦闷等证。
生姜汁 白蜜 牛酥（各五两） 人参 百合 （各二两）
上药入铜铫中，以慢火熬膏，不拘时。每用三匙，用人参百合汤调下。
枇杷叶煎 治五噎立效。
枇杷叶（刷去毛，炙） 陈皮（去白。各三钱） 生姜（五钱）
水盏半，煎七分，作二次温服。
嘉禾散 治脾胃不利，胸膈痞闷，气逆生痰，不进饮食，五噎五膈。
砂仁 白茯苓 薏苡仁（炒） 枇杷叶（刷去毛，姜汁炙） 桑白皮（炒） 沉香（磨汁）
五味子 甘草（炙。各五分） 木香（磨汁） 青皮 芽（炒） 藿香 随风子 石斛（酒
炒） 大腹皮（洗） 陈皮 半夏曲（炒） 神曲（炒） 槟榔 杜仲（姜汁炒断丝。各三分）
白豆蔻 丁香 人参 白术（各五分）
上水二盏，姜三片，枣二枚，煎八分，食远服。五噎入柿干一枚；膈气吐逆，入韭白三寸、
枣五枚同煎。
人参利膈丸 治胸中不利，痰逆喘满，利脾胃壅滞，膈噎圣药。
人参 当归 藿香（各一两） 木香 槟榔（各七钱） 枳实（炒） 甘草（各八钱） 浓
朴（姜炒） 大黄（酒浸各二两）
上为末，滴水丸桐子大，温水下三十丸。
According to the *Huangdi Neijing* (Yellow Emperor's Inner Canon): "When the Qi of the Three Yang meridians is knotted, it is called 'Ge' (Regurgitation/Obstruction)." It also states: "Pathogenic factors affecting the Shaoyang (Lesser Yang) meridian cause vomiting and overflow, with food unable to go down." The inability of food to enter indicates the presence of Fire. This syndrome arises from excessive emotional fluctuations (Seven Emotions), sexual exhaustion, or overwork, leading to blazing Fire in the Five Zang organs, drying up and depleting the Blood, which then condenses fluids into Phlegm. Gradually, this causes the stomach cavity to become dry and withered. If the lesion is near the throat, water and drinks may pass through, but solid food cannot enter; this is named "Ye" (Choking). If the withering is in the stomach cavity, although food can be swallowed, it cannot be transported and transformed, and after a while, it is vomited back up; if not vomited, it causes unbearable distension and fullness; this is named "Ge" (Regurgitation/Obstruction). Since there is no grain essence to nourish the Qi and Blood, the body naturally becomes weak and exhausted. Alternatively, when the disease begins subtly, patients desire quick results and overuse aromatic, dry, acrid, and hot medicines, damaging Yin and Blood, leading to this condition, which is close to death. The pulse is tight at the Cun (inch) position and faint and choppy at the Chi (cubit) position; floating and weak indicates Qi deficiency, while choppy and small indicates Blood deficiency. Treatment should focus on tonifying Qi and nourishing Blood, smoothing Qi, resolving Phlegm, and clearing Heat. The so-called "Five Ye" refers to Choking caused by Worry, Pensive thought, Qi stagnation, Fatigue, and Food retention. The "Five Ge" refers to Regurgitation caused by Pensive thought, Worry, Joy, Anger, and Sorrow. These are disorders of the Shen (Spirit/Mind); only through introspection and self-nurturing, keeping the Spirit calm, can Yin generate. When Yin generates, Blood is produced, Fire descends, and the intestines and stomach become moistened. If one abstains from rich and heavy flavors, one will not assist the Fire. If white foam is vomited and stool resembles sheep droppings, it is incurable.
Main Formula: Renshen (Ginseng Radix et Rhizoma, 5 fen), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma, prepared with ginger), Huanglian (Coptidis Rhizoma, each 8 fen), Gancao (Licorice Root, 3 fen). Decoct the above with Shengjiang (Fresh Ginger) and Dazao (Jujube), add Chenxiang juice (Sanxianmu, 3 spoons), and take orally.
If Qi is deficient, add Huangqi (Astragali Radix); if vomiting occurs, add Huoxiang (Agastaches Herba) and Sharen (Amomi Fructus); to strengthen the Stomach, add Shanyao (Dioscoreae Rhizoma) and Lianrou (Nelumbinis Semen); for digestion, add Shanzha (Crataegi Fructus) and Maiya (Hordei Fructus Germinatus); to relieve depression, add Xiangfu (Cyperi Rhizoma), Shenqu (Massa Medicata Fermentata), Fuxiong (Ligustici Chuanxiong Rhizoma), and Shanzhi (Gardeniae Fructus); for Qi distension and discomfort, add Muxiang (Aucklandiae Radix) and Luobozizi (Brassicae Semius); for constipation, add Jiudahuang (Rhei Radix et Rhizoma, wine-processed); for obese individuals with much Phlegm, add Erchen Tang components: Zhibanxia (Pinelliae Rhizoma, prepared), Beimu (Fritillariae Thunbergii Bulbus), Gualouren (Trichosanthis Semen), with a little Zhuli (Bambusa Textilis Caulis Sap), Jiangzhi (Fresh Ginger Juice), Jiuji (Allium Tuberosum Juice), Tongbian (Human Urine), and Lvniao (Donkey Urine) added to the medicine. For thin individuals, use Siwu Tang (Four Substances Decoction) to nourish Blood, adding slightly Taoren (Persicae Semen) and Honghua (Carthami Flos), and frequently consuming Niurui (Bovis Lac) or Yangrui (Ovis Lac). Add small amounts of Jiangzhi (Fresh Ginger Juice), Fengmi (Honey), Shatang (Sugar), Ganshezhī (Saccharum Officinarum Juice), and Lizhī (Pyrí Fructus Juice) as beverages. Boiled decoctions of Pipaye (Loquat Leaf), Qingjuye (Citrus Aurantium Leaf), and Lan ye (Orchid Leaf) can be drunk. Porridge made from Yumi (Corn Zea mays) and Sumi (Setaria italica) can be eaten with Zhuli (Bambusa Textilis Caulis Sap). There are cases where eating dry glutinous rice without drinking tea or soup leads to recovery.
Wuye Wuge San (Five Ye and Five Ge Powder): Treats Ge and Ye syndromes.
Renshen (Ginseng Radix et Rhizoma), Banxia (Pinelliae Rhizoma), Jiegeng (Platycodonis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baidoukou (Amomi Fructus), Muxiang (Aucklandiae Radix), Chenxiang (Aquilariae Lignum Resinatum), Ganjiang (Zingiberis Rhizoma), Toutang (Head chaff - likely referring to a specific part of grain husk or typo for another herb, kept as literal translation), Bibo (Piperis Kadsurae Fructus), Qie (Eggplant), Gancao (Licorice Root, each 3 fen), Pipaye (Loquat Leaf, 5 pieces, brushed clean of hairs, honey-fried).
Decoct the above with seven slices of Shengjiang (Fresh Ginger) in one cup of water.
Shengjiang Zhi Jian (Fresh Ginger Juice Decoction): Treats inability to swallow food, throat obstruction, chest and diaphragm oppression, etc.
Shengjiang Zhi (Fresh Ginger Juice), Baimi (White Honey), Niusu (Butyrum Bovis), Renshen (Ginseng Radix et Rhizoma), Baihe (Lilii Bulbus, each 5 liang); Renshen and Baihe (each 2 liang).
Place the above herbs in a copper pot, simmer slowly into an ointment/paste. Take at any time. Each time, use three spoons, taken with Renshen and Baihe decoction.
Pipaye Jian (Loquat Leaf Decoction): Highly effective for the Five Ye.
Pipaye (Loquat Leaf, brushed clean of hairs, fried), Chenpi (Citri Reticulatae Pericarpium, pith removed, each 3 qian), Shengjiang (Fresh Ginger, 5 qian).
Decoct in one and a half cups of water until reduced to 0.7 cups, take warm in two doses.
Jiahe San (Harvest Harmony Powder): Treats Stomach and Spleen dysfunction, chest and diaphragm stuffiness, rebellious Qi generating Phlegm, loss of appetite, and the Five Ye and Five Ge.
Sharen (Amomi Fructus), Bai Fuling (Poria), Yiyiren (Coicis Semen, stir-fried), Pipaye (Loquat Leaf, brushed clean of hairs, fried with ginger juice), Sangbaipi (Mori Cortex, stir-fried), Chenxiang (Aquilariae Lignum Resinatum, ground into juice), Wuweizi (Schisandrae Chinensis Fructus), Gancao (Licorice Root, honey-fried, each 5 fen), Muxiang (Aucklandiae Radix, ground into juice), Qingpi (Citri Reticulatae Pericarpium Viride), Ya (Sprout/Malt, stir-fried), Huoxiang (Agastaches Herba), Suifengzi (Semen Cuscutae or similar, kept as Suifengzi), Shihu (Dendrobii Caulis, wine-fried), Dafupi (Arecae Pericarpium, washed), Chenpi (Citri Reticulatae Pericarpium), Banxiaqu (Pinelliae Rhizoma fermentatum, stir-fried), Shenqu (Massa Medicata Fermentata, stir-fried), Binglang (Arecae Semen), Duzhong (Eucommiae Cortex, fried with ginger juice until fibers break, each 3 fen), Baidoukou (Amomi Fructus), Dingxiang (Caryophylli Flos), Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma, each 5 fen).
Add two cups of water, three slices of ginger, and two jujubes. Decoct until reduced to 0.8 cups. Take well after meals. For Five Ye, add one dried persimmon; for Ge Qi with vomiting and reflux, add three cun of Jiubai (Allium tuberosum white part) and five jujubes, decoct together.
Renshen Lige Wan (Ginseng Unblocking Ge Pill): Treats chest discomfort, rebellious Phlegm causing wheezing and fullness, unblocks Stomach and Spleen stagnation; a sacred medicine for treating Ge and Ye.
Renshen (Ginseng Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), Huoxiang (Agastaches Herba, each 1 liang), Muxiang (Aucklandiae Radix), Binglang (Arecae Semen, each 7 qian), Zhishi (Aurantii Fructus Immaturus, stir-fried), Gancao (Licorice Root, each 8 qian), Houpo (Magnoliae Officinalis Cortex, ginger-fried), Dahuang (Rhei Radix et Rhizoma, wine-soaked, each 2 liang).
Grind into powder, mix with water to form pills the size of tung tree seeds. Take thirty pills with warm water.