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Why should Qi disorders be distinguished into upper and lower sections? For instance, if a person experiences rebellious Qi rushing upward, causing fullness in both hypochondriac regions, without panting or coughing, and the phlegm is knotted like a nut, difficult to expectorate and difficult to evacuate, is this not a disorder of Qi in the upper section? The treatment method must not focus solely on the upper section. Such disorders arise either from melancholy or from anger. Xiaoyao San (Free and Easy Wanderer Powder) is the best prescription; there is no need to establish an extraordinary formula.

Conversely, if a person suffers from Qi collapsing and pressing downward, causing distension in both abdomen, with an urge to defecate that cannot be fulfilled, or an urgent desire to defecate despite no urge, accompanied by dry and hard stools, scanty urine, unbearable pain below the umbilicus, or pain circling the umbilicus, or swelling of both legs, is this not a disorder of Qi in the lower section? The treatment method must not focus solely on the lower section. Although such disorders also stem from melancholy and anger, why does the Qi descend rather than ascend? This is because there is no Fire in the Upper Jiao, leaving no gap for the Qi to exploit. Seeing an opportunity for descent in the lower part, the Qi follows and rushes downward. Regulating the middle and resolving the stagnation makes it not a difficult condition to treat; thus, although its momentum is heavier than upward rebellion, it is actually easier to treat. Xiaoyao San (Free and Easy Wanderer Powder) is also used to harmonize, resulting in immediate recovery.

Then why did I take the trouble to distinguish them in detail? It is because while prescriptions can be combined, symptoms must not be confused. By clearly distinguishing upper and lower symptoms, one can add herbs that direct Qi downward, such as Perilla Seed (Su Zi), to Xiaoyao San for upper disorders, and increase heat-clearing herbs, such as Gardenia (Zhi Zi), for lower disorders. How else could one avoid overlooking aspects when treating patients?

What is the reason for distinguishing Phlegm disorders into upper and lower? Phlegm in the Stomach belongs to the upper; Phlegm in the Spleen belongs to the lower; Phlegm in the Kidney belongs to the lower of the lower. People mistakenly say there is Phlegm in the Lung. The Lung is a delicate organ that tolerates no foreign matter. If "Lung Phlegm" is mentioned, it is named due to pathology in the Lung. In reality, it is all Phlegm from the Stomach. Even if there is Phlegm in the Heart or Liver, these are named according to their respective pathologies, but ultimately they cannot be considered independent of the Stomach's governance over Phlegm. Therefore, speaking of the Stomach encompasses all upper Phlegm.

How to treat upper Phlegm? Strengthen the Stomach and clear Phlegm, tonify Qi and promote dampness drainage. Treating Phlegm in the Upper Jiao in this manner should suffice. However, how to identify upper Phlegm? It is invariably caused by Wind-Cold invasion. The sputum may be yellow or white, or sticky and knotted, or vomited continuously throughout the day, or accompanied by chest tightness and distension, nasal congestion and coarse breathing, cough with expectoration, difficulty in spitting out saliva, resembling rotten cotton, or resembling yellow pus. All these are upper Phlegm. I have a formula that can treat them all universally with miraculous efficacy, named Gongtan San (Phlegm-Attacking Powder). This formula strengthens the Stomach, tonifies Qi, promotes dampness drainage, resolves Phlegm, and expels Wind.

For Phlegm in the lower section, although there are distinctions between the Spleen and Kidney, the symptoms are essentially the same. Deficiency of Spleen Qi leads to flooding of Kidney Water; deficiency of Kidney Qi leads to depletion of Spleen Earth; they naturally influence each other. Symptoms may include vomiting only clear water. This is because without Mingmen Fire, Water is cold; without Mingmen Fire, Earth is also cold. Once Water and Earth are cold, where is the barrier of the dike? Consequently, water will surge wildly, rise uncontrollably, and flood without restraint. Use Fanliu Tang (Reverse Flow Decoction): one dose calms the Phlegm, two doses eliminate the Phlegm, four doses remove the Phlegm entirely. The brilliance of this formula lies in using Atractylodis Macrocephalae Rhizoma (Baizhu) as the sovereign herb to strengthen the Spleen, assisted by herbs that tonify the Kidney and resolve Phlegm, guiding Water back to its source and first solidifying the Earth. When Qi carrying Water cannot wash away the Earth, the Earth naturally controls the Water.

Gongtan San (Phlegm-Attacking Powder)
Atractylodis Macrocephalae Rhizoma (Baizhu, 3 qian)
Poria (Fuling, 5 qian)
Bupleuri Radix (Chaihu, 1 qian)
Paeoniae Radix Alba (Baishao, 5 qian)
Pinelliae Tuber (Banxia, 3 qian)
Medicated Leaven (Shenqu, 1 qian)
Scutellariae Radix (Huangqin, 1 qian)
Licorice Root (Gancao, 1 qian)
Trichosanthis Radix (Tianhuafen, 2 qian)
Decoct with water and take orally.

Fanliu Tang (Reverse Flow Decoction)
Atractylodis Macrocephalae Rhizoma (Baizhu, 1 qian)
Dioscoreae Rhizoma (Shanyao, 5 qian)
Coicis Semen (Yiren, 5 qian)
Euryales Semen (Qianshi, 5 qian)
Corni Fruit (Shanzhuyu, 5 qian)
Schisandrae Fructus (Bei Wuwei, 2 qian)
Cinnamon Twig (Rougui, 2 qian)
Ginseng Radix et Rhizoma (Renshen, 3 qian)
Brassicae Semenis Albus (Baijiezi, 5 qian)
Decoct with water and take orally.