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The syndrome of Guan Ge (Obstruction and Repletion) originally has distinctions between the upper and lower parts: the upper part manifests as "Ge" (Rejection), where food cannot enter; the lower part manifests as "Guan" (Closure), where urination and defecation cannot exit. Since the conditions of the upper and lower parts differ, the treatment methods should also vary. Generally speaking, for the upper part where "Ge" prevents entry, treatment should focus on the Liver; for the lower part where "Guan" prevents exit, treatment should focus on the Spleen. However, methods to resolve stagnation and promote Qi movement are the same for both upper and lower parts.

In the upper "Ge" syndrome, neither water nor food can be swallowed; upon intake, vomiting occurs, accompanied by fullness in the hypochondriac regions, rebellious Qi, a feeling of oppression and stifling, and a sensation that Qi cannot flow freely. At the initial stage, Xiaoyao San (Free and Easy Wanderer Powder) should be used to harmonize the Liver. How could it develop into an incurable condition? It is only because this decoction was not taken, causing the Wood of the Liver to remain unresolved indefinitely. Furthermore, taking other medications additionally would only exacerbate the distension and stifling. I have now formulated a prescription to be sipped slowly; naturally, layers of obstruction will gradually open, and the transport mechanism will regain its pathway.

In the lower "Guan" syndrome, both urination and defecation are blocked. After eating or drinking, there is a sensation of severe distension and stifling, rapid and coarse breathing. At the initial stage, Xiaoyao San (Free and Easy Wanderer Powder) is also used to harmonize, yielding immediate results. Unfortunately, people fail to recognize this, leading to dryness of the Spleen Qi and encroachment by Liver Wood. The Fire in the Large and Small Intestines is obstructed and cannot descend, creating an urgent situation. However, compared to the upper "Ge" syndrome, it is actually less severe. This is because pathogenic factors in the upper part are difficult to vent, whereas those in the lower part are easier to push out and eliminate. Using Siwu Tang (Four Substances Decoction) augmented with Dahuang (Rhubarb Rhizome) and Chaihu (Bupleurum Root), combining tonification with purgation and dispersal, allows the stagnant Fire to be resolved, opening the gates like unlocking a door. Who says the syndrome of Guan Ge can be treated without distinguishing between upper and lower?

Supplemented Xiaoyao Decoction
Baishao (White Peony Root, 3 qian) Baizhu (Atractylodes Macrocephala Rhizome, 1 qian) Zhike (Immature Bitter Orange, 1 qian) Danggui (Angelica Sinensis Radix, 3 qian) Chaihu (Bupleurum Root, 1 qian) Xiangfu (Cyperus Rotundus Rhizome, 1 qian) Gancao (Licorice Root, 5 fen)
Chuanxiong (Sichuan Lovage Rhizome, 1 qian) Chao Zhizi (Fried Gardenia Fruit, 1 qian) Fuling (Poria, 3 qian) Chenpi (Tangerine Peel, 5 fen) Tianhuafen (Trichosanthes Root, 1 qian) Zhuli (Bamboo Sap, 5 spoons) Decoct in water and take orally.

Yong Ju (Carbuncles and Ulcers) must be distinguished as true or false; if not clearly differentiated, many lives are lost. The toxicity of Yong Ju accumulates within the Zang-Fu organs and erupts on the skin, often presenting false images to deceive people: heat syndromes masquerading as cold, and Yin syndromes masquerading as Yang. The method of differentiation requires urgent attention. For example, when a carbuncle first appears, the body is necessarily heavy and the mouth thirsty; this presents the true image. When observing the sore, if it protrudes high and hurts, showing only one yellow head, this is the true image; if the sore itches, showing numerous small heads without protrusion, presenting only a circular red shadow, this is the false image. When the head breaks and pus discharges, if the pus is red-yellow and painful, this is the true image; if the pus discharge is scanty, or purple-black, with a dull sore surface, painless and itchless, this is the false image. When approaching healing, if the tissue rises like mist and clouds, with flesh bulging and skin wrinkling, containing yellow-red pus but no pus on the sides, this is the true image; if there is depression with stagnant color, scanty pus and abundant blood, lacking luster on the surrounding skin, or if the outer flesh grows fully while the center remains painful, or if the center is incomplete and itchy while the sides hurt, these are all false images.

Generally, true syndromes are caused by Fire-Toxin and should be treated by dissipating Fire and cooling; false syndromes are caused by Deficiency-Cold and should be treated with tonifying agents to warm, supplemented slightly with detoxifying herbs. I have now formulated two prescriptions: one for true syndromes and one for false syndromes, both highly effective. The one for true syndromes is named Sanzhen Tang (Disperse True Toxin Decoction). This formula dissipates toxin and clears Fire; it can resolve unbroken sores and consolidate broken ones. It can be taken from the initial onset of toxin until after pus discharge, suitable regardless of the stage. The one for false syndromes is named Jiujia Tang (Save Falsehood Decoction). This formula greatly tonifies Qi and Blood while dissipating toxin. Whenever a Yin syndrome is encountered, whether at the initial stage, broken, ulcerated, or necrotic, administering this formula can bring the dying back to life and turn disaster into fortune, eliminating the fear of premature death. If treating poor families who lack Ginseng, it can still be taken by adding Huangqi (Astragalus Root) and Danggui (Angelica Sinensis Radix).

Sanzhen Tang
Jinyinhua (Honeysuckle Flower, 1 liang) Gongying (Dandelion Herb, 5 qian) Sheng Gancao (Raw Licorice Root, 5 qian) Jingjie (Schizonepeta Spike, 2 qian) Danggui (Angelica Sinensis Radix, 1 liang) Decoct in water and take orally.

Jiujia Tang
Jinyinhua (Honeysuckle Flower, 3 liang) Renshen (Ginseng Root, 3 liang) Sheng Huangqi (Raw Astragalus Root, 5 liang) Rougui (Cinnamon Bark, 2 qian) Danggui (Angelica Sinensis Radix, 3 liang) Decoct in water and take orally.