Cheng Wuji's Commentary: Qi rushing upward refers to the qi in the abdomen rushing upward intermittently. This is a disease occurring after sweating, vomiting, or purging; although purging has been performed, the pathogenic factor remains in the exterior, hence this occurs. In the Pi syndrome (fullness obstruction), qi rushing up to the throat also arises from erroneous use of sweating, vomiting, or purging. There are cases where the condition resembles the Guizhi Tang (Cinnamon Twig Decoction) pattern, but with chest fullness and obstruction, and qi rushing up to the throat causing difficulty in breathing; the Gualou San (Thistle Powder) should be used. This is because it is a case of diaphragmatic excess formed without prior sweating, vomiting, or purging, so the emetic method is appropriate. For Jueyin channel qi rushing against the heart, and pathological qi rushing upward, one must carefully deliberate and treat according to the specific clauses.

If there is qi rushing causing heart pain accompanied by vomiting of roundworms, this is the primary disease of the Jueyin channel. If qi rushes upward but does not involve vomiting roundworms, it belongs to a Yang pattern. If the rush reaches the throat and causes respiratory distress, Gualou San should be used for emesis. Cases presenting with alternating chills and fever are Ben Tun (Rushing Pig) disease; those with contraction and cramping of the yin organs are Yin-Yang Yi (Yin-Yang Exchange) disease; sudden lockjaw and inability to speak indicate Gang Jing (Stiff Spasm). Each of these has specific diagnostic and treatment methods following sweating, vomiting, or purging; students should study them in detail. The formulas and discussions for the primary diseases of the Jueyin channel have already appeared in previous clauses.

When the condition resembles the Guizhi Tang pattern, but there is no headache or stiffness of the neck, the cun pulse is slightly floating, the chest is full and hard, and qi rushes up to the throat causing respiratory distress, this indicates cold-fluid retention in the chest. Emesis should be induced using Gualou San.

Gualou (Thistle Fruit, processed until yellow) and Chi Xiaodou (Red Adzuki Bean, each 1 fen) are ground into a fine powder. Take 1 qian of the powder, mix with 1 he of Xiangchi (Fermented Soybean Paste) and 7 he of water. Soak briefly, then boil into a thin porridge. Strain and take the decoction, mixing it with the powder. Take warm in one dose. If vomiting does not occur, slightly increase the dose. Stop when vigorous vomiting occurs. Patients with blood loss or deficiency constitution must not take this.

Linggui Zhongjing's Commentary: For Gualou San, take 1 qian bi per dose. After taking the medicine, lie down. If you feel the urge to vomit, endure it for a long time. If vomiting does not occur, take 3 qian bi of the powder mixed with 2 he of soup, and induce vomiting by stimulating the throat with a finger. If still no vomiting, slightly increase the dose. Stop when vomiting occurs. If vomiting is insufficient and the disease persists, repeat the method the next day. Do not cause excessive weakness. If the medicinal power passes without inducing vomiting, drink 1 sheng of hot water to assist the medicinal effect. After vomiting, food can be taken; no further doses are needed. If too much medicine is taken, drink water to detoxify.

Ben Tun disease presents with qi rushing up to the chest and abdomen, pain, and alternating chills and fever; Bentun Tang is the main formula (see Miscellaneous Diseases Accumulation section).

Yin-Yang Yi disease presents with urgency and tightness in the lower abdomen,牵引 (pulling) and cramping of the yin organs, heat rushing up to the chest, heaviness of the head making lifting difficult, and visual disturbances (seeing flowers); Shao Kun San (Burned Underwear Powder) is appropriate (see Yin-Yang Yi discussion).

Qi rushing up to the chest and throat, lockjaw, and inability to speak, indicating impending Gang Jing (Stiff Spasm), should be treated with Gegen Tang (Kudzu Root Decoction) (see Miscellaneous Diseases Spasm section).

Using burning needles to induce sweating, if the needle site is exposed to cold and develops nodules that turn red, Ben Tun disease will inevitably develop, with qi rushing from the lower abdomen to the heart. Moxibustion should be applied to each nodule (one moxa cone per nodule), followed by Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Added Cinnamon Twig).

Guizhi (Cinnamon Twig, 2 liang 5 qian), Shaoyao (Peony Root), Shengjiang (Fresh Ginger, each 1 liang 5 qian), Gancao (Licorice Root, 1 liang), Dazao (Jujube, 6 pieces). Cut the herbs. Take 5 qian per dose, decoct in water, and take warm. (Guizhi Jia Gui Tang can drain the qi of Ben Tun.)

Dongqi (Moving Qi) syndrome: If sweating is induced, qi rushes upward, stopping exactly at the heart end (see Dongqi discussion). After purging in Taiyang disease, if qi rushes upward, use Guizhi Tang with the previous method. If qi does not rush upward, do not use it. After vomiting and purging in Cold Damage, if there is rebellious fullness below the heart, qi rushing up to the chest, dizziness, and a deep, tight pulse, inducing sweating again will disturb the channels, causing body tremors; Fuling Baizhu Gancao Tang (Poria, Atractylodes, and Licorice Decoction) is indicated (see Tremors section). After vomiting, purging, and sweating in Cold Damage, if there is deficiency irritability, a very faint pulse, and after eight or nine days, fullness and hardness below the heart, pain under the ribs, qi rushing up to the throat, dizziness, and palpitations/tremors of the meridians, this may eventually lead to Wei syndrome (Flaccidity Syndrome).

Supplementary Formula:

Linggui Zhongjing: Li Gen Tang (Li Root Decoction), treats qi rushing upward stopping exactly at the heart end.

Banxia (Pinellia Tuber), Danggui (Angelica Sinensis), Shaoyao (Peony Root), Shengjiang (Fresh Ginger), Fuling (Poria), Guizhi (Cinnamon Twig), Huangqin (Scutellaria Root), Gancao (Licorice Root), Ganli Gen Bapi (White Bark of Prunus Serrulata Root, equal parts). Cut the herbs. Take 5 qian per dose, decoct in water, and take warm.