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Pulse: The pulse in cases of Qi Stagnation (Yu Zheng) is mostly deep and wiry. It may present as knotted and hidden, or deep and choppy, indicating Blood Stagnation; deep and hidden indicates Qi Stagnation; deep and fine indicates Dampness Stagnation; deep and rapid indicates Heat Stagnation; deep and slippery indicates Phlegm Stagnation; a tight and full pulse at the Qi Kou (radial artery point) indicates Food Stagnation. Additionally, melancholy leads to a choppy pulse, anger leads to a wiry pulse, and overthinking leads to a slow pulse that occasionally stops. This type of pulse is called a Knotted Pulse (Jie Mai).

Symptoms: Zhu Danxi stated: "When Qi and Blood are harmonious, hundred diseases do not arise; once there is frustration and stagnation, various diseases are born." He also said: "All diseases arise from stagnation, and they can be treated by opening them up." When pathological changes occur, it is generally observed that most diseases involve concurrent stagnation. Either long-standing stagnation gives rise to disease, or long-standing disease generates stagnation. In treating diseases related to Qi, Blood, Phlegm, and Fire, one must always address the stagnation concurrently, thus avoiding complications.

Treatment Principles: The *Classic of Internal Medicine* states: "For Wood stagnation, facilitate its spread," meaning induce vomiting to allow for free and smooth flow. "For Fire stagnation, disperse it," meaning induce sweating to allow for dissipation. "For Earth stagnation, seize/drain it," meaning use purgatives to eliminate obstruction. "For Metal stagnation, drain it," meaning use diaphoresis, release the exterior, and promote urination. "For Water stagnation, restrain it," meaning suppress it and control its ascending and spreading nature. These are the general principles for treating stagnation. However, Fire stagnation varies by meridian, so treatment should follow the specific meridian involved. Thus, it is said "Fire stagnation is dispersed," but one must determine which meridian is affected and treat accordingly. Zhu Danxi stated that there are six types of stagnation: Qi, Blood, Phlegm, Dampness, Heat, and Food.
- For Qi Stagnation, use methods to open stagnation. Symptoms include pain in the chest and hypochondrium, with a deep and choppy pulse.
- For Blood Stagnation, use methods to invigorate or resolve blood. Symptoms include good appetite but hematochezia (blood in stool), weakness in the four limbs, and a deep, choppy pulse.
- For Phlegm Stagnation, use methods to resolve and guide out phlegm. Symptoms include panting upon exertion, and a deep, slippery pulse at the Cun Kou (radial pulse position).
- For Dampness Stagnation, use drying and draining methods. Symptoms include wandering pain throughout the body or joint pain, worsening in cold/yin conditions, and a deep, fine, and soggy pulse.
- For Heat Stagnation, use clearing methods. Symptoms include blurred vision, red and烦 (restless/irritated) urine, cough, and a deep, fine, and rapid pulse.
- For Food Stagnation, use digestion-promoting methods. Symptoms include belching with sour taste, abdominal fullness and inability to eat, a normal pulse at the left Cun position, and a tight, full pulse at the right Cun position. If food is stagnant in the upper Qi level, raising the Qi will cause the food to descend naturally; other cases follow this analogy. For chronic aversion to cold, resolving stagnation is also necessary; once stagnation is resolved, the disease heals along with it.

Formula: Yueju Wan is the principal formula for treating stagnation. It resolves various stagnations, clears heat, eliminates phlegm, and regulates Qi.
Ingredients: Cangzhu (Atractylodis Rhizoma, broadens the middle, dries dampness, remove rhizome 1.5 qian), Shenqu (Medicated Leaven, promotes digestion and moves Qi, stir-fried 1 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, harmonizes Blood and regulates Qi, remove rhizome 1 qian), Xiangfu (Cyperi Rhizoma, opens stagnation and dissipates nodules, soaked in child's urine and stir-fried with vinegar 1.5 qian), Zhizi (Gardeniae Fructus, clears heat, benefits phlegm, descends fire, stir-fried 1.2 qian).
Usage: Combine these as one dose, decoct in water. Alternatively, grind into powder and form pills with water, size of mung beans. Take 80 pills per dose, washed down with warm water. Generally, Qi, Blood, and Phlegm disorders often involve stagnation. Since there are six types of stagnation, modify according to symptoms. For all stagnations: add Fangfeng (Saposhnikoviae Radix) in Spring; Kushen (Sophorae Flavescentis Radix) in Summer; Wuzhuyu (Evodiae Fructus) in Autumn; Wuzhuyu and Ganjiang Tan (Zingiberis Rhizoma Carbonized) in Winter.
- Qi Stagnation: Add Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 0.8 qian); Muxiang (Vladimiriae Radix), Binglang (Arecae Semen) (each 0.7 qian); Wuyao (Linderae Radix) (1 qian). For deficiency, combine with Sijunzi Tang (Four Gentlemen Decoction).
- Blood Stagnation: Add Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba) (each 1 qian); Taoren (Persicae Semen), Honghua (Carthami Flos), Qingdai (Indigo Naturalis), Yujin (Curcumae Radix) (each 0.8 qian). For deficiency, combine with Sijunzi Tang.
- Phlegm Stagnation: Add Nanting (Arisaematis Cum Bile), Haishi (Calcitrum), Gualouren (Trichosanthis Semen), Beimu (Fritillariae Bulbus) (1.5 qian); Jiegeng (Platycodonis Radix) (0.7 qian); Baijiezi (Brassicae Semenis White) (0.8 qian). For severe phlegm, combine with Erchen Tang (Two Aged Decoction).
- Dampness Stagnation: Add Fangfeng, Baizhi (Angelicae Dahuricae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Baifuling (Poria) (each 0.8 qian). Double the amount of Cangzhu.
- Heat Stagnation: Add Huanglian (Coptidis Rhizoma, stir-fried with Wuzhuyu 0.8 qian), Qingdai (0.8 qian). For severe cases, add Jiuzheng Dahuang (Rhei Radix et Rhizoma steamed with wine) (2.5 qian).
- Food Stagnation: Add Shanzha (Crataegi Fructus), Shenqu (each 1.5 qian); Sharen (Amomi Fructus Rotundus), Chenpi, Zhishi (Immature Bitter Orange Fruit) (each 0.8 qian); Zhencha (Iron Filings, stir-fried with vinegar 1 qian).
- Wood Stagnation: Use Li Lu (Pear Leaf and Reed Rhizome) or Goutisan (Melon Stalk Powder) to induce vomiting. After vomiting, use the base formula plus Baizhu, Chenpi, Shaoyao (each 1 qian), Qingpi (Citri Reticulatae Pericarpium Viride) (0.5 qian).
- Fire Stagnation: Base formula plus Fangfeng, Qianghuo, Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix) (each 0.8 qian); Shengma (Cimicifugae Rhizoma) (0.5 qian) to disperse. In winter months, add Mahuanggen (Ephedrae Radix et Rhizoma).
- Earth Stagnation: Use Guizhi (Cinnamomi Ramulus), Shaoyao, Houpo (Magnoliae Officinalis Cortex), Chenpi, Zhike (Aurantii Fructus Immaturus) (equal parts); Dahuang (3 qian) to purge. After purging, regulate with Sijunzi Tang plus Shaoyao, Xiangfu, Chenpi.
- Metal Stagnation: Add Fuling (Poria), Zexie (Alismatis Rhizoma) (each 1 qian) to drain.
- Water Stagnation: Add Baizhu (1.5 qian), Chenpi, Dafupi (Arecae Pericarpium) (each 1 qian); Qingpi (0.5 qian); Zisugeng (Perillae Caulis) (0.6 qian).
- Anger-induced Stagnation: Left Guan pulse is wiry. Add Muxiang, Binglang, Qingpi, Shaoyao (equal parts).
- Overthinking-induced Stagnation: Right Guan pulse is knotted. Add Baizhu, Chenpi, Shichangpu (Acori Tatarinowii Rhizoma) (each 1 qian); Muxiang, Chenxiang (Aquilariae Lignum Resinatum) (each 0.5 qian).
- Melancholy-induced Stagnation: Right Cun pulse is short and choppy. Add Beimu (1.5 qian), Chenpi, Zhishi, Wuyao, Suzi (Perillae Fructus) (each 0.8 qian); Muxiang, Binglang.
- Cold-induced Stagnation: Add Wuzhuyu, Ganjiang (Zingiberis Rhizoma) (each 0.8 qian); Muxiang, Chenxiang (each 0.5 qian); Congbai (Scallion White) (three sections).
- Excessive Grief-induced Stagnation: Add Beimu (1.5 qian), Fushen (Poria cum Radice), Yuanzhi (Polygalae Radix), Shichangpu, Muxiang, Sharen (each 0.7 qian).
The above describes the modification methods for Yueju Wan. One must assess deficiency/excess and the duration of the condition to decide usage, thereby avoiding errors.