典藏书目

Tympanites (Gu) and Dysphagia with obstruction (Ge) are both severe diseases; however, Tympanites is treatable, whereas Dysphagia with obstruction is generally considered untreatable. This is because Tympanites involves the accumulation of tangible pathogenic factors within the body, presenting as an Excess syndrome (Excess); Dysphagia with obstruction involves the inability to retain food, presenting as a Deficiency syndrome (Deficiency). Excess conditions are treatable, while Deficiency conditions are difficult to treat; this is the general rule.

The disease of Tympanites arises from the weakness of the stomach and intestines, leading to an inability to transform and transport nutrients. Consequently, phlegm, blood stasis, Qi stagnation, or undigested food may coagulate in the middle jiao, resulting in abdominal distension and fullness. Treatment should first focus on purging the accumulated excess, followed by nourishing the Middle Qi (Spleen and Stomach Qi), thereby allowing the stomach and intestines to gradually restore their digestive functions. The *Nei Jing* (Inner Canon of the Yellow Emperor) contains the prescription *Jishi Li* (Chicken Dropping Fermented Liquid), which exemplifies this therapeutic approach. Later prescriptions for treating Tympanites have also often proven effective. However, if the Zang organ Qi has already exhausted itself, manifesting in ominous signs such as emaciated arms, protruding umbilicus, flat and full palms and back, and green veins encircling the abdomen, it becomes incurable.

As for Dysphagia with obstruction, it is caused by Liver Fire invading the Stomach, where Wood overacts on Earth, termed "Zei Evil" (Robber Pathogen). The epigastrium becomes dry and atrophic, losing its function of receiving and decomposing food, leaving only a narrow passage that is further blocked by phlegm-drool and blood stasis, preventing food from descending. Even if food is forced down, it is immediately vomited up. Human life depends entirely on dietary intake. As stated in the classics: "Grain enters the Stomach, and its essence is transmitted to the Lungs, so that all five Zang and six Fu organs receive Qi." Now, since food cannot enter, the five Zang and six Fu organs will become depleted. Therefore, patients with this condition who can ingest a small amount of grain will die within one year; those who cannot ingest any grain will die within half a year. Those who contract the disease in Spring will die in Autumn, and those who contract it in Autumn will die in Spring, due to the time when Metal (Autumn) and Wood (Spring) mutually overcome each other.

There is also sudden vomiting, or vomiting that occurs intermittently, or vomiting in individuals who are young and robust; this is named Fan Wei (Rebellious Stomach/Regurgitation), not Ge (Dysphagia with obstruction), and this condition is also treatable. Regarding symptoms resembling Tympanites, such as edema and water swelling, some may be suitable for acupuncture, while others may require treatment through purgation/diuresis. The clinical manifestations vary greatly, and treatments are equally diverse. Physicians should seek a wide range of methods and apply them according to the specific situation.

The fundamental aspects of disease do not exceed Cold, Heat, Deficiency, and Excess. However, one must distinguish between true and false presentations before treating to avoid error. False Cold presents with cold on the exterior but heat on the interior; although the patient feels very cold, they dislike hot drinks. False Heat presents with heat on the exterior but cold on the interior; although the patient feels very hot, they dislike cold drinks. This is the general overview. False Excess presents with a seemingly robust physique but depleted spirit, with pulse qualities that are Floating (Fu), Surging (Hong), Empty (Kou), or Scattered (San). False Deficiency presents with a seemingly debilitated physique but intact spirit, with pulse qualities that are Quiet (Jing), Small (Xiao), Firm (Jian), and Solid (Shi). Within these categories, there is a distinction between the deficiency/excess of the person's constitution and the deficiency/excess of the current syndrome. For example, a timid and weak person contracting Wind-Cold or Food Stagnation represents a Deficient person with an Excess syndrome. A strong person suffering from Blood Loss or Fatigue represents an Excess person with a Deficient syndrome. Treatments may involve direct regulation (Zheng Zhi) or following the apparent symptoms (Cong Zhi); separate treatment or combined treatment; addressing the root (Ben) or the branch (Biao); using heat for cold conditions and cold for heat conditions (note: text says "Heat due to Cold use", implying treating cold with heat, though phrasing is classical); different formulas for upper and lower parts; decoctions and pills prepared differently; tonifying while attacking, and attacking while tonifying. One must think deeply and employ skillful techniques, adapting to changes to generate vitality. With thousands of disease manifestations and myriad legislative principles, true and false presentations cannot confuse my mind nor exhaust my skills. This lies in extensively studying ancient methods and achieving divine mastery. If one adheres rigidly to personal views or lacks sufficient scholarly attainment, few will remain unconfused by the disease!