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The *Jingui Yaolue* states: Sweating causes Yang to become weak, Qi in the Diaphragm (Diaphragm area) to become deficient, and the pulse to become rapid (Shu). A rapid pulse indicates exogenous heat (Ke Re), which cannot digest grain. The Stomach is cold and deficient, its Qi is exhausted; food eaten in the morning is vomited in the evening, evolving into Fan Wei (Gastric Regurgitation). It also states: The Fuyang pulse (pulse at the dorsum of the foot) is floating and choppy. Floating indicates deficiency; choppy indicates Spleen injury. When the Spleen is injured, it cannot grind and transform; food eaten in the morning is vomited in the evening, and food eaten in the evening is vomited in the morning, with undigested food remaining, known as Fan Wei. In Taiyang disease (Disease of the Taiyang Channel) from the *Shanghan Lun*, after vomiting and sweating, there is no aversion to cold or fever, the Guan pulse (radial artery at the wrist) is fine and rapid, the patient desires cold food, and food eaten in the morning is vomited in the evening. The commentary notes: Food enters the Stomach in the morning, but due to Stomach deficiency, it cannot be decomposed and transformed. By evening, when Stomach Qi moves inward, it clashes with pathogenic factors, causing the food to be regurgitated. The *Chao Shi Bing Yuan* also states: Ying and Wei are both deficient, Blood and Qi are insufficient, water retention and fluid accumulation occur in the Epigastrium, leading to Cold in the Zang organs. When the Zang organs are cold, the Spleen cannot grind, and undigested food remains. Qi rebels upward, forming Fan Wei, manifesting as morning eating and evening vomiting; in severe cases, immediate vomiting occurs after eating. Wang Taipu (Wang Bing) annotated the *Neijing*: "Food cannot enter, this is Fire; food enters and comes back out, this is lack of Fire." Thus, later generations all considered it Stomach deficiency-Cold, using only pungent, aromatic, and strongly hot agents to restore Yang. Even when the pulse is rapid due to pathogenic heat failing to digest grain, these agents were still used. They failed to realize that strong fire dissipates Qi; can such strongly hot medicines truly restore Qi? Zhu Danxi stated: Diseases of Ge Ye (Throat Obstruction) and Fan Wei arise from the Seven Emotions and Six Exogenous Pathogens, leading to transformations of Fire-Heat flaming upward. There is more ascending than descending, Body Fluids are not distributed, accumulating into Phlegm and Fluid Retention. Although temporarily relieved by being "robbed" (perhaps referring to purging or harsh treatment), irregular emotions and diet cause the symptoms to recur. Using previous medications again accumulates Heat, depletes Blood, and causes the Stomach lining to become dry and atrophic. If the atrophy is upper, near the throat, fluids can pass, but food is difficult to swallow and intake is small; this is called Ye (Dysphagia). If the atrophy is lower, near the Stomach, food can enter but cannot fully reach the Stomach, and re-emerges after a long time; this is called Ge (Obstruction) or Fan Wei. Stool is dry and scant, resembling sheep droppings. However, one must avoid the Six Exogenous Pathogens externally, regulate the Seven Emotions internally, nourish oneself through diet, nourish Blood and generate Body Fluids to moisten the Intestines and Stomach. Then, Metal (Lung) will not fear the inflammation of Fire, Kidney will have the gradual generation of Water (Yin), Qi will be clear and Blood harmonious, the Spleen will transport and transform vigorously, and food will be digested and transmitted. This discusses chronic cases of Ge Ye. However, there are also cases where the disease is not chronic, yet food enters and repeatedly comes out, with shapes similar to Ge Ye. Why is this? The *Neijing* states: Revolt of Jueyin causes vomiting, food and drink do not enter, if they enter they come back out; in severe cases, it transmits to the Spleen, causing Shi Bi (Food Impediment) and vomiting. Wang's annotation explains Shi Bi: After eating, pain occurs below the heart, dull and unbearable until vomiting stops; this is Stomach Qi rebelling upward and not descending. Additionally, if the Stomach pulse is Kou (hollow) and scattered, one should suffer from Shi Bi. If Lung disease transmits to the Liver, it is called Gan Bi (Liver Impediment), with hypochondriac pain and vomiting of food. As for the *Jingui Yaolue* mentioning Gan Zhong Han (Cold in the Liver), Xin Zhong Feng (Wind Strike to the Heart), and Bing of Jueyin, all three involve vomiting after food entry; thus, treatment must follow the pathogenic factor. Generally, treating Fan Wei is like treating vomiting in the previous section, dividing into methods for Qi, Accumulation, and Cold. Unfortunately, later generations uniformly used Qi-regulating formulas, creating one formula named Shige San (Ten Obstructions Powder) to treat ten types of Obstruction Qi. Modern people guard it as a good prescription, ignoring ancient sages without discussion. The way of treating disease is: unless the pathogen is addressed, how can the disease heal? I will illustrate with past cases where seeking the pathogen proved effective. A young man always vomited a few mouthfuls after meals, but not all; sounds were often made above the diaphragm, his complexion was normal. Knowing the disease was not in the Spleen/Stomach but in the Diaphragm, I asked the cause. He replied that after a great anger subsided, he ate noodles, and immediately developed this symptom. I deduced that extreme anger causes Blood to stagnate upward, accumulating in the Diaphragm, hindering the ascent and descent of Qi. Body Fluids gathered into Phlegm and Fluid Retention, clashing with Qi and moving, hence the sound. I prescribed Erchen Tang (Two-Aged Decoction) with Xiangfu (Cyperus Rhizome), Jiuzhi (Chinese Chive Juice), and Laifuzi (Radish Seed) for two days, then induced vomiting with Gouti San (Melon Seed Powder) and Suanjiang (Sour Plum Liquid). On the second day, he vomited again, with blood mixed in the Phlegm (one cup); the next day, he vomited again, seeing blood (one bell measure), and the disease was cured. A middle-aged man had pain in the Zhongwan point (CV12), vomiting after eating, with a purple-frost complexion and choppy pulses at both Guan positions, indicating a Blood disease. He reported pain in Zhongwan after a fall. I administered a formula to generate new Blood and eliminate old stasis; he vomited about a bowl of stagnant blood, after which the pain ceased and food was no longer vomited. Throat closure and chest/diaphragm distension seem to belong to Qi stagnation; temporarily use Xiangsha Kuanzhong Wan (Fragrant Sand Broad-Middle Pill) to open and disperse knots. However, if caused by excessive consumption of Qi-consuming drugs leading to failure of Middle Qi to move, one should tonify Qi to allow natural movement, using Buzhi Yunchi Tang (Tonify Qi and Transport Spleen Decoction). Li Jiang treated Fan Wei with unpredictable vomiting, where porridge and drinks were vomited immediately upon entry, leaving the patient exhausted and near death, by using three taels of Shangdang Ginseng, split, boiled in one sheng of water to yield four he, taken hot in one dose. Dry stool resembling sheep droppings, blocked for a long time, seems to belong to Blood Heat; only clear Heat and moisten/nourish, using small decoctions/pills, gradually increasing dosage, so the gates naturally open. (Zixue Runchang Tang, Ginger-processed Dahuang, Renshen Lige Wan, Xuanningfen with a little Gancao.) However, if excessive use of purgatives leads to exhaustion of Blood and increased constipation, one should nourish and moisten Blood to allow natural passage. If due to Fire rebelling upward, preventing food entry, with a surging, forceful, and rapid pulse, use Ziyin Qingge San (Nourish Yin Clear Obstruction Powder), adding Pipaye (Loquat Leaf) 2 qian and Lugeng (Reed Rhizome) 1 liang. Or if obstructed by Phlegm-Fluid with a knotted/choppy pulse, use Erchen Tang with Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice). If there is much Phlegm, and food/drink is immediately wrapped by Phlegm-saliva preventing descent, use Laifu Dan to control Phlegm-saliva, and self-made Tidan Wan (Eliminate Phlegm Pill): Banxiaqu (Pinellia Fermented Paste), Kubai (Calcined Alum), Zaorao (Gleditsia Sinensis, fire-roasted, skin/strings/seeds removed), Xuanningfen (Mirabilite), Baifuling (Poria), Zhike (Aurantium Fructus) in equal parts, mixed with Xiatiangao (Gelatin) into pills. If due to decline of Spleen/Stomach Yang-Fire internally, with a deep, minute, and slow pulse, use pungent-aromatic drugs to warm Qi; Dingchen Touge Tang (Cloves and Amber Penetrating Obstruction Decoction), Wuge Kuanzhong San (Five Obstructions Broad-Middle Powder), Jiahe San (Harvest Abundance Powder) etc. are suitable, assisted by Yin-nourishing drugs. Most cases of Fan Wei are formed by Blood Stasis in the Diaphragm blocking the Qi pathway. Use Daididang Wan (Substitute Resisting Dang Decoction) made mustard-seed sized, take 3 qian, lie supine without pillow, swallow slowly to search and expel accumulated stasis. By dawn, foul matter is discharged, and recovery follows with proper care. Wulingzhi (Trogopterus Dung), purified and powdered, mixed with Yellow Dog Gallbladder juice into pills the size of a longan. Take one pill per dose, warm with half a cup of good wine; effective within three doses; this is also a Blood-moving agent. For parasitic cases, use Qinchuan Jianhong Wan to expel them; this pill also targets Blood Stasis. Yanhua Wan (Genkwa Flower Pill) from *Ben Shi Fang* treats accumulation, retained fluid, Phlegm-fluid generating worms; over time becoming Fan Wei or transforming into Wei Yong (Stomach Abscess). This theory is found in *Lingshu* and *Chao Shi Bing Yuan*. For solid accumulation without internal Heat, ancient formulas Nongpo Wan (Magnolia Bark Pill) and Wanbing Ziwan Wan (Myriad Disease Aster Pill) should be taken as directed to expel parasites. To treat Fan Wei, take one large bowl of fresh well-water, reserve half a bowl. Slowly pour sesame oil into the remaining half bowl, covering the surface. Place one packet of Yi Yuan San (Benefit Origin Powder) gently on the oil surface; soon it sinks to the bottom. This illustrates the Dao of Yin-Yang ascending and descending. Stir evenly with a spoon and take. Rinse the medicine bowl with the reserved half bowl of water and swallow. Once vomiting stops, administer Mazi Liangge San (Hemp Seed Cool Obstruction Powder) to unblock bowel and bladder movements. If ineffective, administer another packet of Yi Yuan and Liangge San, which will be effective. This prescription is extremely reliable. Tongbian (Child Urine) [clears Fire], Zhuli (Bamboo Sap) [moves Phlegm], Jiuzhi (Chinese Chive Juice) [moves Blood], Renru (Human Milk), Niuru (Cow Milk) [tonifies deficiency and moistens dryness], Lugengzhi (Reed Rhizome Juice) [stops vomiting], Maogenzhi (Imperata Rhizome Juice) [cools Blood], Jiangzhi (Ginger Juice) [assists Zhuli in moving Phlegm], Zhuganzhi (Sugar Cane Juice) [harmonizes Stomach), Lvniao (Donkey Urine] [kills parasites]. Mix with small amounts of Shaojiu (Burning Wine), Micu (Rice Vinegar), and Mi (Honey), warm over water and take in one dose. Self-made Tongchang Wan: Dahuang (wine-soaked), Huashi (flying powder) each 2 liang; Chenpi (peeled), Houpo (ginger-processed) each 1.5 liang; Renshen, Danggui, Guanzhong (de-haired), Ganqi (stir-fried until smoke ceases) each 1 liang; Muxiang, Binglang each 7.5 qian; Sanleng (roasted), Pengzi (roasted), Chuanxiong, Bohe, Xuanningfen, Xionghuang, Taoren paste, Gancao each 5 qian. All separately finely powdered. Mix with 2 cups each of Zhuli, Tongbian, Jiuzhi, Renru, Lvniao, Lugengzhi, Maogenzhi, Zhuganzhi, Shaojiu, Micu, Mi, and 1 cup Jiangzhi. Boil thick over water, mix into pills the size of mustard seeds. Take 3 qian per dose, lie supine without pillow, swallow with saliva. Stop taking after bowels/unblocking cease. After taking this pill and the aforementioned juices, if the medicine does not cause regurgitation, do not immediately give porridge or other foods. Daily, take 5 qian Renshen and 2 qian Chenpi as a decoction, sip slowly to support Stomach Qi. When feeling slightly better, gradually increase Renshen. Only after 10 days to half a month can one cautiously try aged rice water and soft porridge. If the granary is not secure, one should not store grain; commonly, those who eat porridge/rice immediately lead to untreatable conditions. Another type of Fan Wei results from shouting with great effort, damaging the Qi throat. Leakage of the Qi throat causes Qi to block the Stomach tube; the Stomach receiving Qi also leads to Fan Wei. This is considered untreatable by law, or one may use roasted ox trachea. Zhang Zihe's "Ten Ge Five Ye" branches are arbitrary. The division of disease categories began with Chao Yuanfang; the loss of the disease's root also began with him. Why? Laozi said: "Less is gain, more is confusion." The common term "Ye Shi" (Dysphagia) has little mention in the *Neijing*, only stating "Three Yang knotting is called Ge." Three Yang refers to Large Intestine, Small Intestine, and Bladder. Knotting means knotting Heat. Small Intestine knotting Heat dries Blood vessels; Large Intestine knotting Heat prevents defecation; Bladder knotting Heat dries Body Fluids. If all Three Yang knot, front and back become blocked. Since the lower does not unblock, it must rebel upward; this is why food cannot go down, and even if it goes down, it comes back out. The Stomach is the Sea of Water and Grain, receiving new daily to replace the old, with one bowel movement daily as the norm. Now, patients with Ye do not have a bowel movement for 3, 5, or 7 days, deviating from the norm. Is it not because the Three Yang are knotted below, the Large Intestine is withered, the ingested food is rejected by the pharynx, and even if entering the Tai Cang (Stomach), it returns out the throat? This is Yang Fire not pushing downward but rising upward. The Classics state: "Where Shaoyang arrives, there is vomiting, gushing overflow, and food cannot descend." The *Qijue Lun* says: "Liver transfers Cold to Heart, causing Mania and Ge in the middle." Commentary: Yang and Cold clash, causing Ge-food and middle obstruction; this Ge-Heat and Cold cause it, not solely Cold. The *Liujie Zangxiang* states: "Renying four-fold excess and above is Ge Yang." Wang Taipu said: "Extreme Yang excess causes Ge rejection and food not entering." The *Zhengli Lun* states: "Ge implies vomiting and rebellion, so Ge should also be Ge." Later generations forcibly divided it into Five Ye, then Ten Ge and Five Ye. With many branches, confusion increases. Human food overflow does not happen suddenly. Initially, it may be due to alcohol/food injury, Stomach Heat wanting to vomit, or Stomach Wind wanting to vomit. Physicians fail to examine the origin, roasting ginger in fire, boiling cinnamon in soup, continuing with Dingxiang (Clove), Doukou (Cardamom), Bibo (Long Pepper), Hujiao (Pepper). Although claiming to harmonize the Stomach, the Stomach is originally not Cold. Although claiming to tonify the Stomach, the Stomach is originally not Deficient. If injured by fluids, one should only expel fluids. If injured by food, one should only expel food. How can one speak of deficiency and use hot tonification? Those prone to Heat will surely have Three Yang knotting. Once knotted, food must surge upward. Physicians still say Stomach Cold fails to receive, burning needles and moxa, causing further Three Yang knotting. A clear statement becomes hard to follow. Extracting firewood to remove heat is most crucial. Stirring boiling water to stop boiling makes it worse. Years deepen, misled by physicians. People say purging is possible, retreating Yang to nourish Yin, opening eyes and sticking out tongue, fearing damage to Yuan Qi, stopping at harmony. Blockage and non-unblocking, Intestines should be patent, hence borborygmus. Since Intestines are not unblocked, Ye disease forms. Someone asks: Can忧恚 (worry/anger) Qi knotting be purged? I say: Worry/anger stagnation is like Fire Depression. Tai Cang Gong saw this and purged all. Since laws were abandoned, a thousand years have passed without restoration. In modern times, Liu Hejian treats Ge Qi and Ye Shi using Chengqi San Yi Tang (Major Order Three Yi Decoction), surpassing modern practitioners. I do not mind, briefly showing this to posterity. When using drugs, detail severity. If constipated for a long time, do not attack abruptly. Although needing to open, consider after-effects. First moisten and nourish, use small decoctions/pills, gradually increase, gates will open. If throat obstruction, upper blockage by Phlegm-saliva, lightly use bitter/sour to induce slight vomiting. Then treat below, drug power moves easily. If it doesn't work, honey/salt guides downward, connecting start and end, two drugs communicate, knots scatter, Yang dissipates, food/drink descends naturally. Do not use Badou (Croton Seed), consuming true nature, drying fluids and withering Jin, leaving toxins. People say this disease, once purged, became deficient and bloated from purging. This is Badou's fault, not Dahuang or Qianniue's. An official in Jicheng suffered vomiting for over a year, treated as Stomach Cold with Dingxiang, Banxia, Qingpi, Chenpi, Jiang, Fuzi, various drying-hot drugs, burning cones and moxa, countless times. Sometimes slightly better, sometimes worse. For ten years, stool was astringent and dry, urine red-yellow. I examined him and said: "All Wei, panting, and vomiting belong to Upper." Wang Taipu said: "Upper refers to Upper Jiao." Fire-Heat Qi flaming upward causes all to vomit due to extreme Heat. Use Sisheng Wan (Four Generations Pill) to purge thirty times; dry feces and intestinal filth exceeded a bushel. The person was confused and tired for one or two days, frequently sipping ice water, gradually administering cool yogurt and sesame drink, swallowing occasionally. After several days, ate and drank largely, spirit and Qi/Blood returned to normal, subsequently had three children, lived to fifty.

[Diagnosis] Cun Kou pulse is minute and rapid. Minute means no Qi; no Qi means Ying deficiency; Ying deficiency means Blood insufficiency; Blood insufficiency means Cold in the Chest. Fuyang pulse is floating and choppy. Floating indicates deficiency; choppy indicates Spleen injury. Spleen injury means it cannot grind; morning eating/evening vomiting, evening eating/morning vomiting, undigested grain, known as Fan Wei. Tight and choppy pulse, the disease is difficult to treat. String-taut pulse indicates deficiency; Stomach Qi is exhausted; morning eating/evening vomiting, transforming into Fan Wei. Cold is above, but physicians wrongly purged, making the pulse string-taut, hence named Deficiency. Kou and scattered Stomach pulse indicates Shi Bi. (*Zhiyao Lun* states: Shi Bi and vomiting.) Minute and slow Kidney pulse indicates Dong (Cave/Hole); Dong means food not digested, going down the throat and coming back out. Deep, slow, and forceless, or large and weak, indicates Qi deficiency. Rapid and forceless, or choppy and small, indicates Blood deficiency. Rapid and forceful indicates Heat. Deep at Cun/Guan, or hidden, or large and slippery-rapid, indicates Phlegm. Deep and choppy at Cun/Guan indicates Qi. Fan Wei pulse: deep, fine, scattered, lacking direction; present at floating/sinking, absent at moderate pressure; fatal and untreatable. Further check complexion: not yellow-white, nor pure white; all are bad omens. Elderly with long-term disease, Yuan Qi ruined, cold hands/feet, stool like sheep droppings, profuse frothy discharge; all untreatable.