人有病关格者，食至胃而吐，欲大小便而不能出，眼睛红赤，目珠暴露，两胁胀满，气逆
拂抑，求一通气而不可得，世以为胃气之太盛，而不知乃肝气之过郁耳。夫关格之症，宜分上下，
一上格而不得下，一下关而不得出也。今上既不得入，而下又不得出，是真正关格，死生危急之
症也。治之原有吐法，上吐则下气可通。今不必用吐药而先已自吐，是用吐药无益矣。若用下导
之法，则上既无饮食下胃，而大肠空虚，即用导药，止可出大肠之糟粕硬屎，而不能通小肠膀胱
之气，是导之亦无益也。必须仍用煎药和解为宜，但不可遽然多服，须渐渐饮之，初不受而后自
受矣。方用开门散∶
白芍（五钱） 白术（五钱） 茯苓（三钱） 陈皮（一钱） 当归（五钱） 柴胡（三钱） 苏叶（一钱）
牛膝（三钱） 车前子（三钱） 炒栀子（三钱） 天花粉（三钱） 水煎一碗，缓缓呷之，一剂而受矣。一
受而上关开，再剂而下格亦通。
此方直走肝经以解郁，郁解而关格自痊，所谓扼要争奇也。倘用香燥之药，以
耗胃气，适足以坚其关门而动其格据矣。
此症用通关散亦效。
白芍（五钱） 茯苓（三钱） 甘草 枳壳 神曲（各三分） 白豆蔻（一枚） 川芎（二钱） 生
姜汁（半合） 柴胡（一钱） 水煎服。一剂即开，二剂愈。愈后须用补肾之剂。
人有无故而忽然上不能食、下不能出者，胸中胀急，烦闷不安，大小便窘迫之
极，人以为关格之症也，谁知是少阳之气不通乎。夫少阳胆也，胆属木，木气最喜
舒泄，因寒气所袭，则木不能条达，而气乃闭矣。于是上克胃而下克脾，脾胃畏木
之刑，不敢去生肺气，而并生大肠之气矣。肺金因脾胃之气不生，失其清肃之令，
而膀胱、小肠无所凛遵，故一齐气闭矣。此症原可用吐法，一吐而少阳之气升腾可
愈。其次则用和解之法，和其半表半里之间，而胆木之郁结自通。二法相较，和胜
于吐，吐必伤五脏之气，而和则无损五脏之气也。方用和解汤∶
柴胡（一钱） 白芍（三钱） 甘草（一钱） 枳壳（五分） 薄荷（一钱） 茯神（三钱） 丹皮（二钱）
当归（三钱）
水煎服。缓缓服之，三剂则可以开关矣。上关一开，而下格自愈。
此方乃逍遥散之变方也。逍遥散有白术、陈皮，未尝不可开关。余改用薄荷、
枳壳、丹皮者，直入肝经之药，取其尤易于开郁也。此方全不开关，而关自开者，
正以其善于解郁也。
此症用宽缓汤亦妙。
柴胡 茯苓（各二钱） 当归（三钱） 白芍（五钱） 甘草 苏叶 黄芩（各一钱） 竹叶（三十片）
水煎服。二剂愈。
人有吐逆不得饮食，又不得大小便，此五志厥阳之火太盛，不能营于阴，遏抑
于心胞之内，头上有汗，乃心之液外亡，自焚于中也。存亡之机，间不容发，此关
格最危之症，人以为气之不通也，欲用麝香、片脑之类，以劫开其门，必至耗散真
气，反致归阴矣。法宜调其营卫，不偏阴偏阳，一味冲和，毋犯胃气，使其脏腑自
为敷布，不必问其关从何开，格从何启，一惟求之中焦握枢而运，以渐透于上下
之间，自能营气前通，卫气不闭，因其势而利导之，庶无 格耳。方用和中启关散∶
麦冬（五钱） 人参（五分） 甘草（五分） 柏子仁（三钱） 滑石（敲碎，一钱） 黄连（一钱）
白芍（五钱） 桂
枝（三分） 天花粉（一钱五分） 水煎服。一剂而上吐止，再剂而下闭通矣。
此方解散中焦之火，更能舒肝以平木，木气既平，而火热自减。内中最妙者，
用黄连与桂枝也。一安心以交于肾，一和肾而交于心，心肾两交，则营卫阴阳之气，
无不各相和好，阴阳既和，而上下二焦安能坚闭乎，此和解之善于开关也。
此症用黄连启心汤亦效。
人参（一钱） 白术 丹皮（各三钱） 黄连 玄参（各二钱） 甘草（一钱） 桂枝（三分）
半夏（五分） 柴胡（三分） 水煎服。二剂愈。
人有上吐下结，气逆不顺，饮食不得入，溲溺不得出，腹中作疼，手按之少可，
人以为此寒极而阴阳易位，其脉必涩而伏也。法当吐，不吐则死。然而不必吐也，
夫上部无脉下部有脉，吐之宜也，以食填塞于太阴耳。今脉涩而伏，非无脉之比，
况所食之物，已经吐出，是非食填太阴也。吐之不重伤脾胃之气，以坚其闭塞乎。
夫胃气之所以不开，与大小肠、膀胱之所以闭结者，由于肾气之衰也。胃为肾之关
门，肾之气不上，则胃之关必不开。肾主大小便、膀胱之气化，亦肾气化之也。肾
气不通于三经，则便溲何从而出然则上下开阖之权衡全在乎肾也。治法必须大补
其肾中之水火。肾中之水火足，而关格不治而自愈矣。方用水火两补汤∶
熟地（一两） 山茱（四钱） 茯神（五钱） 车前子（三钱） 人参（二钱） 麦冬（一两） 五味子（五分）
肉桂（一钱） 白术（五钱） 牛膝（三钱） 水煎服。连服二剂，上吐止而下结亦开矣，再服四剂全愈。
此方补肾中之水火，而又能通肾中之气。气足而上自达于胃，下自达于膀胱、大小肠矣。倘用
香燥之药以救胃，则胃气愈伤；倘用攻利之药以救膀胱、大小肠，则膀胱、大小肠愈损，何日是
开关解格之日哉。
此症用化肾汤亦神效。
熟地（二两） 肉桂（二钱） 水煎服。一剂即通，二剂全愈。
人有一时关格，大小便闭结不通，渴饮凉水，少顷即吐，又饮之又吐，面赤唇
焦，粒米不能下胃，饮一杯吐出杯半，脉亦沉伏，人以为脉绝也，谁知是格阳不宣，
肾经寒邪太盛之故乎。夫肾属少阴，喜温而不喜寒也。寒邪入肾则阳无所附，阳欲
杜阴而不能，阴且格阳而愈胜，于是阳不敢居于下焦，而尽逆冲于上焦咽喉之间，
难于容物而作吐矣。夫阳宜阴折，热宜寒折，似乎阳热在上，宜用阴寒之药以治之。
然而阳热在上，而下正阴寒也，用阴寒以折阴寒，正投其所恶也，不特无功，而反
有大害。盖上假热而下真寒，非用真热假寒之法从治之，断不能顺其性而开其关也。
方用白通汤治之。
方中原是大热之味，得人尿、猪胆以乱之，则下咽觉寒，而入腹正热，阳可重
回，而阴可立散，自然脉通而关启矣。然后以大剂八味汤投之，永不至关再闭而吐再发也。
此症用加味术桂汤亦神效。
白术（一两） 肉桂（一钱） 甘草（一分） 人参（二钱） 丁香（一钱） 水煎，加人尿半碗，
探冷服之，一剂即安。
有一位患关格病的患者，食物进入胃部即发生呕吐，想大小便却排不出来，眼睛红赤，眼球突出，两胁部胀满，气机逆乱且压抑不畅，想要通畅却做不到。世人认为这是胃气太盛，却不知道其实是肝气过度郁结所致。关格的病症，应当区分上下：一是上部的“格”，导致食物无法下行；二是下部的“关”，导致二便无法排出。现在上部既不能进食，下部又不能排泄，这是真正的关格症，是关乎生死的危急重症。治疗原本可以用吐法，上部吐出后，下部的气机就可以通畅。现在不需要用催吐药而患者已经自行呕吐，那么使用催吐药就没有益处了。如果使用通下的方法，因为上部已经没有饮食进入胃中，大肠处于空虚状态，即使使用导泻药，也只能排出大肠中的干硬粪便，而不能疏通小肠和膀胱的气机，所以导泻也没有益处。必须仍然使用煎煮的汤药进行和解调理比较适宜，但不可突然大量服用，必须慢慢饮用，开始可能不受纳，后来自然就能接受了。方用开门散：白芍（五钱）、白术（五钱）、茯苓（三钱）、陈皮（一钱）、当归（五钱）、柴胡（三钱）、苏叶（一钱）、牛膝（三钱）、车前子（三钱）、炒栀子（三钱）、天花粉（三钱）。水煎一碗，缓缓呷服，一剂后即可受纳。一次受纳后，上部的闭塞就打开了；再服一剂，下部的格拒也就通了。
此方直接作用于肝经以解除郁结，郁结解除后关格自然痊愈，这就是所谓的抓住关键、出奇制胜。如果误用香燥的药物，会耗伤胃气，反而足以加固关门并加重格拒。
此症使用通关散也有效。
白芍（五钱）、茯苓（三钱）、甘草、枳壳、神曲（各三分）、白豆蔻（一枚）、川芎（二钱）、生姜汁（半合）、柴胡（一钱）。水煎服。一剂即可开通，二剂可愈。痊愈后必须使用补肾的方剂。
有人无缘无故忽然出现上部不能进食、下部不能排泄的情况，胸中胀急，烦闷不安，大小便窘迫到了极点，人们以为这是关格症，谁知道这是少阳之气不通畅呢。少阳属于胆，胆属木，木气最喜欢舒展宣泄，因为受到寒气侵袭，导致木气不能条达舒畅，气机因此闭塞。于是向上克制胃，向下克制脾，脾胃畏惧木气的刑克，不敢去滋生肺气，进而也停止了生成大肠之气。肺金因为脾胃之气不生，失去了清肃下降的职能，导致膀胱和小肠无人遵循其令，所以一齐气闭了。此症原本可以使用吐法，一吐出来，少阳之气升腾就可以痊愈。其次则使用和解的方法，调和半表半里之间，胆木的郁结自然通畅。这两种方法相比，和解优于吐法，吐法必定损伤五脏之气，而和解则不会损伤五脏之气。方用和解汤：柴胡（一钱）、白芍（三钱）、甘草（一钱）、枳壳（五分）、薄荷（一钱）、茯神（三钱）、丹皮（二钱）、当归（三钱）。水煎服。缓缓服用，三剂就可以开关了。上部闭塞一开，下部格拒自然痊愈。
此方是逍遥散的变方。逍遥散中有白术、陈皮，未尝不可以开关。我改用薄荷、枳壳、丹皮，是因为这些是直接入肝经的药物，取其更容易开郁的作用。此方全不刻意去开关，而关自开的道理，正是因为它善于解郁。
此症使用宽缓汤也很奇妙。
柴胡、茯苓（各二钱）、当归（三钱）、白芍（五钱）、甘草、苏叶、黄芩（各一钱）、竹叶（三十片）。水煎服。二剂可愈。
有人呕吐逆乱不能饮食，又大小便不得出，这是因为五志厥阳之火太盛，不能在阴分得到滋养，遏制在心包之内，头上有汗，这是心之液外泄，心脏在内部自焚。存亡的关键，间不容发，这是关格最危险的病症，人们以为是气机不通，想用麝香、冰片之类的药物来强行打开门户，必定会耗散真气，反而导致死亡。治法应当调和营卫，不偏阴也不偏阳，一味追求冲和平和，不要触犯胃气，使脏腑自己能够敷布运行，不必问关从哪里开，格从哪里启，只要在中焦把握枢纽而运转，逐渐透达于上下之间，自然能使营气前通，卫气不闭，顺着病势加以引导，这样才没有格拒之害。方用和中启关散：麦冬（五钱）、人参（五分）、甘草（五分）、柏子仁（三钱）、滑石（敲碎，一钱）、黄连（一钱）、白芍（五钱）、桂枝（三分）、天花粉（一钱五分）。水煎服。一剂后上部呕吐停止，再剂后下部闭塞通畅。
此方解散中焦的火邪，更能舒缓肝气以平抑木气，木气既然平和，火热自然减退。其中最为巧妙的是使用黄连与桂枝。黄连安心以交于肾，桂枝和肾以交于心，心肾两相交通，那么营卫阴阳之气，无不各自和好，阴阳既然调和，上下二焦怎么能坚闭呢？这就是和解法善于开关的道理。
此症使用黄连启心汤也有效。
人参（一钱）、白术、丹皮（各三钱）、黄连、玄参（各二钱）、甘草（一钱）、桂枝（三分）、半夏（五分）、柴胡（三分）。水煎服。二剂可愈。
有人上部呕吐下部结滞，气逆不顺，饮食不能入口，小便不能排出，腹中疼痛，用手按压稍觉缓解，人们以为这是寒极导致阴阳易位，脉象必然涩而伏。治法应当用吐法，不用吐法就会死。然而其实不必用吐法。如果是上部无脉下部有脉，用吐法是适宜的，因为食物填塞在太阴经。现在脉象涩而伏，并不是无脉的情况，况且所吃的食物，已经吐出来了，这不是食物填塞太阴。吐法如果不重伤脾胃之气，从而加固其闭塞吗？
胃气之所以不开，以及大小肠、膀胱之所以闭结，是由于肾气衰弱。胃是肾的关门，肾的气不上行，那么胃的关门一定打不开。肾主管大小便，膀胱的气化功能，也是由肾气化实现的。肾气不通达这三条经脉，大小便从哪里排出呢？那么上下开阖的权衡完全在于肾。治法必须大补肾中的水火。肾中的水火充足，关格不治而自愈了。方用水火两补汤：熟地（一两）、山茱萸（四钱）、茯神（五钱）、车前子（三钱）、人参（二钱）、麦冬（一两）、五味子（五分）、肉桂（一钱）、白术（五钱）、牛膝（三钱）。水煎服。连服二剂，上部呕吐停止，下部结滞也开了，再服四剂完全痊愈。
此方补益肾中的水火，又能通达肾中的气。气充足后，上能直达胃，下能直达膀胱、大小肠。如果误用香燥的药物来救胃，胃气会更受伤；如果误用攻利（泻下逐水）的药物来救膀胱、大小肠，膀胱、大小肠会更受损，哪一天才能开关解格呢？
此症使用化肾汤也有神奇疗效。
熟地（二两）、肉桂（二钱）。水煎服。一剂即通，二剂全愈。
有人一时出现关格，大小便闭结不通，口渴想喝凉水，喝一会儿就吐，再喝又吐，面色红赤，嘴唇焦裂，米粒不能下胃，喝一杯水吐出一杯半，脉象也沉伏，人们以为是脉绝，谁知道这是格阳不宣，肾经寒邪太盛的缘故呢。肾属于少阴，喜欢温暖而不喜欢寒冷。寒邪进入肾脏，阳气就无所依附，阳气想要杜绝阴寒却做不到，阴气反而格拒阳气而更加旺盛，于是阳气不敢居于下焦，而全部逆冲于上焦咽喉之间，难以容纳食物而发生呕吐。按理说，阳气应该用阴来折服，热应该用寒来折服，似乎阳热在上，应该用阴寒的药物来治疗。然而阳热在上，下部却是阴寒，用阴寒药去折服阴寒，正是投其所恶，不仅无功，反而有大害。因为是上假热而下真寒，不用真热假寒的从治法，绝对不能顺从其本性而打开关卡。方用白通汤治疗。
方中原是大热的药物，加入人尿、猪胆来扰乱它，那么咽下时感觉寒冷，进入腹部后正是热性，阳气可以重回，阴寒可以立即消散，自然脉通而关启了。然后用大剂量的八味汤投服，永远不会再次关闭而呕吐发作。
此症使用加味术桂汤也有神奇疗效。
白术（一两）、肉桂（一钱）、甘草（一分）、人参（二钱）、丁香（一钱）。水煎，加入人尿半碗，放冷后探喉服用，一剂即安。
A patient suffering from Guan Ge (Obstruction and Rejection) syndrome vomits immediately after food enters the stomach, and is unable to pass urine or stool. The eyes are red and bloodshot, eyeballs protrude, the hypochondriac regions are distended and full, Qi rebels and feels suppressed, and there is no way to achieve free flow. The world considers this to be excessive Stomach Qi, but fails to realize it is actually due to excessive Liver Qi stagnation. The syndrome of Guan Ge should be distinguished into upper and lower parts: one is the upper "Ge" (Rejection), preventing downward movement; the other is the lower "Guan" (Closure), preventing exit. Now, since the upper part cannot accept intake and the lower part cannot discharge, this is true Guan Ge, a critical condition involving life and death. Originally, treatment could employ the vomiting method; if the upper part is vomited, the Qi in the lower part can become unobstructed. However, since the patient is already vomiting spontaneously without the need for emetic drugs, using emetics is of no benefit. If purgative methods are used, since there is no food entering the stomach from above, the Large Intestine is empty. Even with purgatives, only dry feces in the Large Intestine can be expelled, but the Qi of the Small Intestine and Bladder cannot be unobstructed; thus, purgation is also of no benefit. It is necessary to still use decocted herbal medicine for harmonization, but it should not be taken in large amounts suddenly. It must be sipped slowly. Initially, it may not be accepted, but later it will naturally be tolerated. The formula used is Kai Men San (Opening the Door Powder): Bai Shao (Radix Paeoniae Alba, 5 qian), Bai Zhu (Rhizoma Atractylodis Macrocephalae, 5 qian), Fu Ling (Poria, 3 qian), Chen Pi (Pericarpium Citri Reticulatae, 1 qian), Dang Gui (Radix Angelicae Sinensis, 5 qian), Chai Hu (Radix Bupleuri, 3 qian), Su Ye (Folium Perillae, 1 qian), Niu Xi (Radix Achyranthis Bidentatae, 3 qian), Che Qian Zi (Semen Plantaginis, 3 qian), Chao Zhi Zi (Fructus Gardeniae Praeparated, 3 qian), Tian Hua Fen (Radix Trichosanthis, 3 qian). Decoct with water to yield one bowl, sip slowly. After one dose, tolerance is achieved. Once tolerance is established, the upper obstruction opens; after another dose, the lower rejection also clears.
This formula acts directly on the Liver Meridian to resolve stagnation. Once the stagnation is resolved, Guan Ge heals itself, which is what is meant by seizing the key point to achieve remarkable results. If aromatic-drying herbs are used, they will consume Stomach Qi, merely serving to solidify the closure and exacerbate the rejection.
This syndrome can also be treated effectively with Tong Guan San (Unblocking the Pass Powder): Bai Shao (5 qian), Fu Ling (3 qian), Gan Cao (Radix Glycyrrhizae, unspecified amount), Zhi Ke (Fructus Aurantii, unspecified amount), Shen Qu (Massa Medicata Fermentata, 3 fen each), Bai Dou Kou (Semen Amomi Rotundus, 1 piece), Chuan Xiong (Rhizoma Chuanxiong, 2 qian), Sheng Jiang Zhi (Jucius Zingiberis Recens, half he). Decoct and take orally. One dose opens the passage; two doses cure. After recovery, kidney-tonifying formulas must be used.
There are cases where, without apparent cause, a person suddenly cannot eat from above and cannot excrete from below, with chest distension and urgency, restlessness, and extreme distress in urination and defecation. People consider this Guan Ge syndrome, but who would know it is actually due to the obstruction of Shaoyang Qi? Shaoyang belongs to the Gallbladder, and the Gallbladder belongs to Wood. Wood Qi most desires to spread and vent. When attacked by Cold Evil, the Wood Qi cannot flourish freely, and Qi becomes closed. Thus, it attacks the Stomach upwards and the Spleen downwards. The Spleen and Stomach, fearing the punishment of Wood, dare not generate Lung Qi, and consequently cease generating Large Intestine Qi. The Metal of the Lung, lacking Qi generation from the Spleen and Stomach, loses its clear-descending function, so the Bladder and Small Intestine have no one to follow its orders, leading to simultaneous Qi closure. This syndrome originally could be treated with vomiting; once vomited, the Shaoyang Qi rises and the condition improves. Alternatively, harmonization can be used to regulate the area between the exterior and interior, allowing the stagnation of Gallbladder Wood to clear naturally. Comparing these two methods, harmonization is superior to vomiting; vomiting inevitably damages the Qi of the Five Zang Organs, whereas harmonization does not. The formula used is He Jie Tang (Harmonizing Decoction): Chai Hu (1 qian), Bai Shao (3 qian), Gan Cao (1 qian), Zhi Ke (5 fen), Bo He (Herba Menthae, 1 qian), Fu Shen (Poria with Hostwood, 3 qian), Dan Pi (Cortex Moutan, 2 qian), Dang Gui (3 qian). Decoct and take orally. Sip slowly. After three doses, the gates can open. Once the upper obstruction opens, the lower rejection heals itself.
This formula is a variation of Xiao Yao San (Free and Easy Wanderer Powder). Xiao Yao San contains Bai Zhu and Chen Pi, which can indeed open the gates. I replaced them with Bo He, Zhi Ke, and Dan Pi because these are herbs that enter the Liver Meridian directly, taking advantage of their ease in resolving stagnation. This formula does not deliberately aim to open the gates, yet the gates open naturally, precisely because it excels at resolving stagnation.
This syndrome can also be treated wonderfully with Kuan Huan Tang (Relaxing Decoction): Chai Hu, Fu Ling (2 qian each), Dang Gui (3 qian), Bai Shao (5 qian), Gan Cao, Su Ye, Huang Qin (1 qian each), Zhu Ye (Bamboo Leaves, 30 pieces). Decoct and take orally. Two doses cure.
There are patients with rebellious vomiting, inability to eat, and inability to pass urine or stool. This is due to the excessive Fire of Jue Yang from the Five Emotions, which cannot nourish Yin and is suppressed within the Pericardium. Sweat appears on the head, indicating the loss of Heart Fluid externally and self-burning internally. The moment of survival or death is imminent. This is the most critical type of Guan Ge. People think it is simply Qi obstruction and wish to use Musk (She Xiang) or borneol (Bing Pian) to forcibly open the doors, which will inevitably dissipate True Qi and lead to death. The method should be to harmonize Ying (Nutritive) and Wei (Defensive) Qi, neither leaning towards Yin nor Yang, pursuing harmony and mildness, without offending Stomach Qi, allowing the Zang-Fu organs to distribute and operate themselves. There is no need to ask where the Guan opens or the Ge starts; one should only seek the pivot in the Middle Jiao to transport and gradually penetrate between the upper and lower parts. Naturally, Ying Qi will flow forward, and Wei Qi will not be closed. By following the trend and guiding it appropriately, there will be no rejection. The formula used is He Zhong Qi Guan San (Harmonizing the Middle and Opening the Gate Powder): Mai Dong (Radix Ophiopogonis, 5 qian), Ren Shen (Radix Ginseng, 5 fen), Gan Cao (5 fen), Bai Zi Ren (Semen Platycladi, 3 qian), Hua Shi (Talcum, crushed, 1 qian), Huang Lian (Rhizoma Coptidis, 1 qian), Bai Shao (5 qian), Gui Zhi (Ramulus Cinnamomi, 3 fen), Tian Hua Fen (1 qian 5 fen). Decoct and take orally. After one dose, upper vomiting stops; after two doses, lower closure clears.
This formula disperses Fire in the Middle Jiao and soothes the Liver to calm Wood. Once Wood is calm, Fire and Heat naturally decrease. The most exquisite aspect is the use of Huang Lian and Gui Zhi. Huang Lian calms the Heart to connect with the Kidney, and Gui Zhi harmonizes the Kidney to connect with the Heart. When Heart and Kidney communicate, Ying, Wei, Yin, and Yang Qi all harmonize well. Once Yin and Yang are harmonized, how can the upper and lower Jiao remain firmly closed? This demonstrates the superiority of harmonization in opening gates.
This syndrome can also be treated effectively with Huang Lian Qi Xin Tang (Coptis Awakening Heart Decoction): Ren Shen (1 qian), Bai Zhu, Dan Pi (3 qian each), Huang Lian, Xuan Shen (Radix Scrophulariae, 2 qian each), Gan Cao (1 qian), Gui Zhi (3 fen), Ban Xia (Rhizoma Pinelliae, 5 fen), Chai Hu (3 fen). Decoct and take orally. Two doses cure.
There are patients with upper vomiting and lower binding, rebellious Qi, inability to ingest food, inability to urinate, abdominal pain relieved slightly by pressure. People believe this is extreme Cold causing the reversal of Yin and Yang, and the pulse must be choppy and deep-hidden. The method should be vomiting; without vomiting, death ensues. However, vomiting is actually unnecessary. If the upper pulse is absent and the lower pulse is present, vomiting is appropriate because food is blocking the Taiyin. Now, the pulse is choppy and deep-hidden, which is not the same as absent pulse. Moreover, the ingested food has already been vomited, so it is not food blocking the Taiyin. Would vomiting not severely damage Spleen and Stomach Qi, thereby solidifying the blockage?
The reason Stomach Qi does not open, and the Small/Large Intestines and Bladder do not close, is due to the decline of Kidney Qi. The Stomach is the gate of the Kidney. If Kidney Qi does not ascend, the Stomach's gate certainly cannot open. The Kidney governs urination and defecation, and the Qi transformation of the Bladder is also driven by Kidney Qi transformation. If Kidney Qi does not reach the three meridians, how can urine and stool be discharged? Therefore, the balance of opening and closing above and below lies entirely with the Kidney. The treatment method must greatly tonify the Water and Fire in the Kidney. When the Water and Fire in the Kidney are sufficient, Guan Ge heals itself without specific treatment. The formula used is Shui Huo Liang Bu Tang (Tonifying Both Water and Fire Decoction): Shu Di Huang (Radix Rehmanniae Preparata, 1 liang), Shan Zhu Yu (Fructus Corni, 4 qian), Fu Shen (5 qian), Che Qian Zi (3 qian), Ren Shen (2 qian), Mai Dong (1 liang), Wu Wei Zi (Fructus Schisandrae, 5 fen), Rou Gui (Cortex Cinnamomi, 1 qian), Bai Zhu (5 qian), Niu Xi (3 qian). Decoct and take orally. Take continuously for two doses; upper vomiting stops and lower binding opens. Take four more doses for complete recovery.
This formula tonifies the Water and Fire in the Kidney and unblocks Qi in the Kidney. When Qi is sufficient, it reaches the Stomach upwards and the Bladder/Intestines downwards. If aromatic-drying herbs are used to save the Stomach, Stomach Qi will be further damaged; if purgative/diuretic herbs are used to save the Bladder/Intestines, the Bladder/Intestines will be further impaired. When will the gates open and rejection resolve?
This syndrome can also be treated miraculously with Hua Shen Tang (Transforming Kidney Decoction): Shu Di Huang (2 liang), Rou Gui (2 qian). Decoct and take orally. One dose brings clearance; two doses bring complete recovery.
There are cases of sudden Guan Ge with blocked urination and defecation, thirst for cold water, vomiting shortly after drinking, repeated drinking and vomiting, red face, cracked lips, inability to swallow even a grain of rice, vomiting half a cup after drinking one cup, and a deep-hidden pulse. People think this is pulse extinction, but who would know it is due to Yang being rejected and not disseminated, caused by excessive Cold Evil in the Kidney Meridian? The Kidney belongs to Shaoyin, preferring warmth and disliking cold. When Cold Evil enters the Kidney, Yang has nothing to attach to. Yang desires to suppress Yin but cannot; Yin rejects Yang and becomes stronger. Thus, Yang dares not reside in the Lower Jiao and reverses completely to the Upper Jiao throat area, making it difficult to accommodate food and causing vomiting. Logically, Yang should be checked by Yin, and Heat by Cold. It seems that with Heat/Yang above, Yin-Cold herbs should be used. However, while Heat/Yang is above, the lower part is truly Cold. Using Yin-Cold to check Yin-Cold is exactly catering to what it dislikes, achieving no merit and causing great harm. Since it is false Heat above and true Cold below, unless the method of treating according to nature (using true heat/false cold) is employed, it is impossible to follow its nature and open the gate. The formula used is Bai Tong Tang (White Connect Decoction).
The original formula consists of very hot substances. Adding Human Urine (Ren Niao) and Pig Bile (Zhu Dan) confuses it, so it feels cold when swallowed but is hot upon entering the abdomen. Yang can return heavily, and Yin can dissipate immediately. Naturally, the pulse flows and the gate opens. Then, administer a large dose of Ba Wei Tang (Eight-Ingredient Pill Decoction) to prevent recurrence of closure and vomiting.
This syndrome can also be treated miraculously with Jia Wei Shu Gui Tang (Modified Atractylodes and Cinnamon Decoction): Bai Zhu (1 liang), Rou Gui (1 qian), Gan Cao (1 fen), Ren Shen (2 qian), Ding Xiang (Flos Caryophylli, 1 qian). Decoct, add half a bowl of Human Urine, cool down, and administer by probing the throat. One dose brings relief.