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Yang qi becomes constrained, yin fluids are depleted, and the upper and lower parts repel each other, resulting in the syndromes of dysphagia (Yege) and regurgitation (Fanwei). The human body has seven gates from top to bottom, ranging from Feimen (Flying Gate) to Pomen (Corpse Gate). The pharynx is called Ximen (Suction Gate), which is the epiglottis, the passage for respiratory air to enter and food/drink to descend. The upper opening of the stomach is called Benmen (Receiving Gate), and the lower opening is Youmen (Secluded Gate). Youmen ascends to connect with Ximen; when inhalation cannot descend to return to the Kidney and Liver, it is repelled by Yin fire, leading to obstruction in dysphagia, and in severe cases, progressing to regurgitation.

Speaking separately, "Ye" (dysphagia/choking sensation) presents as a blockage during swallowing, where water and drinks do not pass, and food is difficult to enter, caused by phlegm and qi obstruction in the upper jiao. "Ge" (diaphragmatic obstruction) presents as a narrow and constricted epigastrium, with rejection and pain after eating, caused by blood depletion and dryness in the middle jiao. "Fanwei" (regurgitation) presents as food being vomited out after ingestion, with undigested food remaining, caused by the decline of Stomach Yang in the lower jiao. Historically, these were collectively referred to as "Ge". *Huangdi Zhenjing* states: "In stomach diseases, there is obstruction in the chest, diaphragm, and throat, and food cannot be swallowed." Zhu Danxi stated: When blood is consumed and the stomach dries up, if the dryness is at Benmen, causing epigastric pain and vomiting, it is Upper Jiao Ge; if food is eaten and vomited out after a long time, with dryness at Youmen, it is Middle Jiao Ge; if morning food is vomited in the evening and evening food in the morning, with dryness at Lanmen, it is Lower Jiao Ge.

The classics state: "Constriction of the Three Yang meridians is called Ge," because the Hand-Taiyang Small Intestine governs fluids, and the Foot-Taiyang Bladder governs jin-ye. Regarding "Three Yang," Shicai (Zhao Xianke) refers to the small intestine, large intestine, and bladder, while *Yizong Jinjian* refers to the stomach, small intestine, and large intestine. This interpretation follows the annotations of Wang Bing and Wang Ang on the *Neijing*. If heat constrains the two fu organs, fluids become dry, and both anterior and posterior orifices become constipated. Since the lower gate is closed, qi must surge upward, causing food to choke and not go down, or if forced down, to come back up. This indicates fire ascending without descending. Wang Taipu also said: "Food cannot enter due to fire; food enters and comes back up due to lack of fire."

At the onset of Yege, it is often due to sorrow, anger, grief, and depression, causing yang constraint above and yin depletion below. *Yijian* states: The Five Yies are caused by sorrow, labor, thought, food, and qi, causing sudden obstruction of food and drink. The Five Ges are caused by sorrow, resentment, cold, food, and qi, causing blockage between the Heart and Spleen, or stagnation in the throat, feeling obstructed, unable to spit out or swallow. Treatment should regulate the Heart and Spleen to relieve qi constraint, using Guipi Tang minus Atractylodes macrocephala, Yangxin Tang minus Cinnamon twig, plus Angelica sinensis, White Peony Root, and Cyperus rotundus. To fill essence and blood to moisten dryness, use Zhizhi Wan (Pig Fat Pill).

At the onset of Fanwei, it is often due to weak Earth (Spleen/Stomach) and declining Fire (Mingmen), causing morning food to be vomited in the evening and evening food in the morning. Treatment should support Stomach Earth to unblock Yang, using Yigong San plus Alpinia oxyphylla, Syzygium aromaticum, Zingiberis Rhizoma, Amomum villosum, and Oryza sativa. To benefit Mingming Fire for steaming and transformation, use Bawei Wan (Eight-Ingredient Pill). The legislative principle involves using pungent and slippery agents to unblock痞 (pi), such as Ginger juice, Phragmitis Rhizoma juice, Fritillaria cirrhosa, Prunus armeniaca seed, Trichosanthes kirilowii root, Eriobotrya japonica leaf, and Allium tuberosum juice to open epigastric bi; using sweet-to-acid method to generate yin, such as Codonopsis pilosula, Asparagus cochinchinensis, Ophiopogon japonicus, Sugarcane juice, Ziziphus jujuba seed, White Peony Root, Mume fruit, and Chaenomelis fructus to moisten fluid depletion. Alternatively, strengthen Spleen and resolve phlegm using Sijunzi Tang, Liujunzi Tang, or Erchen Tang plus Bamboo shavings, avoiding excessive warming and drying that might劫 (rob) fluids; or nourish yin and blood using Rehmannia glutinosa, Donkey-hide gelatin, Cow's milk, Pear juice, Sesamum indicum, Diospyros kaki frost, or Siwu Tang, avoiding excessive cooling and moistening that might aid phlegm.

For Ye caused by qi stagnation, promote qi flow in the channels using Chorus fuscus, Syzygium aromaticum pericarp, Curcuma aromatica, Santalum album, Pericarpium Passiflorae, Aurantii Fructus Immaturus, Citrus reticulata peel, and Aucklandiae Radix. For Ge caused by blood stasis, simultaneously unblock blood collaterals using Persicae Semen, Carthamus tinctorius flower, Corydalis yanhusuo, Angelica sinensis radix tip, and Spatholobus suberectus paste. Zhao Shicai treated blood Ge with Codonopsis, Trogopterus dung, Angelica sinensis tail, Persicae Semen, and Curcuma aromatica. Yunqi Renshen San using Borneol and Moschus follows this same method.

For Fanwei due to Stomach Yang deficiency and turbid stasis, use the method of tonifying and unblocking the Stomach fu with pungent-hot herbs to drain turbidity, using Codonopsis, Poria cocos, Cnidium monnieri, Zingiberis Rhizoma Recens, Alpinia oxyphylla, Citrus reticulata, Pinellia ternata, and Amomum villosum shell. For obstruction due to qi constraint and phlegm, use bitter-descending and pungent-unblocking methods, using Coptis chinensis, Prunus armeniaca seed, Citrus reticulata white pith, Ginger juice, Bamboo shavings, Perilla frutescens seed, and Pinellia ternata. For liver qi constraint and rebellion, use the method of unblocking both Jueyin and Yangming, using Angelica sinensis, White Peony Root, Cyperus rotundus, Pinellia ternata, Poria cocos, Prunus armeniaca seed, Citrus reticulata white pith, Bamboo juice, and Ginger juice. For lung and stomach injury due to wine-heat constraint, use mild clearing and descending agents, including Eriobotrya japonica leaf, Prunus armeniaca seed, Curcuma aromatica, Trichosanthes kirilowii root, Peucedanum praeruptorum root, and Datisca cannabina root bark. Also use bitter-pungent lung-opening methods, including Platycodon grandiflorus, Fritillaria cirrhosa, Prunus armeniaca seed, Amomum kravanh, Zingiber officinale, Citrus reticulata white pith, and Gardenia jasminoides.

For spleen injury due to sorrow/thought, qi constraint generating saliva, where drinking is possible but eating is difficult, use Xiangsha Kuanzhong Wan minus Qingpi and Areca seed. For chest/epigastric rejection and pain due to seven emotions constraint, with deep-choppy pulse, use Qi Qi Tang plus Curcuma aromatica, Trichosanthes kirilowii root, Amomum villosum, and Aquilaria sinensis wood. For phlegm-fluid obstruction causing vomiting/regurgitation, with knotted-choppy pulse, first control phlegm with Laifu Dan, then use Banxia Houpo Tang plus Poria cocos, Aurantii Fructus Immaturus, and Bamboo juice. For blood stasis accumulation causing failure of transmission and reverse ascent, with floating-choppy pulse, use Zixue Runchang Wan modified.

When Spleen qi fails, blood is exhausted, and the stomach is withered, with scant urine and constipation, use Buqi Jianpi Wan combined with Zixue Runchang Wan, or Leek Juice and Cow Milk Drink. If white foam is vomited and stool resembles sheep droppings, it is incurable. Desperately try Ginger juice, Apricot kernel paste, White honey, Cow milk, Alpinia oxyphylla, Allium tuberosum seed, and Pinellia ternata. *Yixue Xinwu* states: Kaiguan (opening the gate) with Qige San is most effective. Also, Wuzhi Yin clears dryness, Lige Tongyong pill unblocks congestion, Gongsu San stops vomiting. Generally, avoid pungent-drying qi-breaking and hot-fluid-consuming drugs. Only in cases of extreme Stomach Yang decline failing to transform, temporarily use pungent-warm opening agents, followed by yin-nourishing and stomach-tonifying measures, such as Oryza sativa, Codonopsis, Dioscorea opposita, Nelumbo nucifera, Ziziphus jujuba, Cow milk, and Triticum aestivum.

For parasites in Ge syndrome, use Hejian Xionghuang San. For Meihe Ge (plum-pit throat), unable to spit out or swallow, feeling obstructed in the throat due to qi-phlegm constraint, use Ditang Wan. Due to dead blood (stasis), use Ecklonia stolonifera, Angelica sinensis, Persicae Semen, Leek juice, and Child's urine. For Fanwei where food is immediately turned out, or phlegm/heat obstructs the diaphragm, distinct from Fanwei's morning-evening vomiting pattern, use Qingre Erchen Tang.

Further discussing Ye caused by qi constraint, and Ge caused by phlegm, qi rebellion, or blood stasis. One type is Qi Ye: putting down chopsticks before eating, throat obstruction with saliva rising, food entering after qi settles; disease is in Upper Jiao Lung/Stomach, treat with light-floating agents to benefit the diaphragm; bitter-descending agents may reach the disease site too forcefully. One type is Tong Ge (painful Ge): food rejection, vomiting saliva, burning pain, hunger-fire burning in the middle; disease is in Middle Jiao, treat with pungent-aromatic descending agents; if ineffective, must address blood collaterals. One type is Wei Gao (withered stomach): narrow esophagus/stomach tube, even spoonfuls cause obstruction; due to aging blood depletion closing the stomach tube, drinking causes saliva/tears to rise, scant urination/defecation, loss of opening/closing function; treat with pungent-slippery nourishment, strictly avoiding pungent-drying fluid-consuming and hot-yin-robbing agents. This is stomach blood losing nourishment, easy choking upon swallowing. All foods that obstruct qi should be forbidden. I have seen cases of Ye from eating sweet potatoes, and Ge from eating eggs. If accompanied by sorrow/thought/depression unresolved in the middle, emotional diseases are especially hard to cure quickly. Xu Lingtai stated that 80-90% of Ge/Ye cases die, while 80-90% of Fanwei cases recover.

Regarding Fanwei, it is caused by food not digesting for a long time, rotting turbidity attacking upward, overturning completely, and the intestines losing transmission function; the disease is below Youmen. Ancient methods often attribute this to lack of Yang in the Stomach, preventing steaming/transformation of essences. However, the classics state: "All vomiting and rebellious qi belong to Heat." Since Stomach fluids are first depleted, hot-drying drugs are difficult to administer. One must carefully analyze pulse and symptoms, using bitter-descending/pungent-unblocking methods to circulate congestion. I recall a young man with Fanwei vomiting food who took Bawei Tang, stopped temporarily, then vomited again, but was cured by eating sheep blood. Another case: an elderly man named Shen, addicted to alcohol, with depressed mood, vomiting foam and refusing food, uncured for half a year. An old doctor prescribed four doses, halving the illness, then ten doses soaked in wine, resulting in full recovery. The formula used: Sheng Dihuang (5 qian), Haifushi (1 liang), Wuyao (1.5 qian), Achyranthes bidentata, Magnetitum, Poria cocos, Danggui shen (3 qian each). Observing this formula, it combines warming, clearing, sedating, and draining, regulating ascending/descending qi and blood, with balanced properties. The transmitter witnessed its efficacy, so I record it for reference.