关者，不得小便，格者，吐逆，上下俱病者也。
〔《难》〕邪在六腑，则阳脉不和，阳脉不和，则气留之，气留之则阳脉盛矣。邪在五脏，则阴脉不和，
阴脉不和，则血留之，血留之则阴脉盛矣。阴气太盛，则阳气不得相营也，故曰格。（阴盛阳不得营，故寸口大三
四倍于人迎。）阳气太盛，则阴气不得相营也，故曰关。（阳盛阴不得营，故人迎大三四倍于寸口。）阴阳
俱盛，不得相营也，故曰关格。关格者，不得尽其命而死矣。（三十七难）
〔洁〕关则不得小便，格则吐逆。关者，甚热之气；格者，甚寒之气。是关无出之由，故曰关也；格无入
之理，故曰格也。寒在胸中，遏绝不入，热在下焦，填塞不便。
〔云〕阴阳易位，病名关格。胸膈上阳气常在，则热为主病。身半已下阴气常在，则寒为主。病寒反在胸
中，舌上白胎，而水浆不下，故曰格，格则吐逆。热在丹田，小便不通，故曰关，关则不得小便。胸中有寒，
以热药治之。丹田有热，以寒药治之。若胸中寒热兼有，以主客之法治之。治主当缓，治客当急。尺寸反者死，
阴阳交者死，关格者不得尽其命而死矣。
〔丹〕必用吐，提其气之横格，不必在出痰也。有痰，以二陈汤吐之，吐中便有降。有中虚气不运者，补
气药中升降之。
〔孙〕奉职赵令仪女，忽吐逆，大小便不通，烦乱，四肢渐冷，无脉。凡一日半，与大承气汤一剂。至夜
半渐得大便通，脉渐和，翌日乃安。此关格之病，极为难治，垂死而活者，惟此一人耳。
〔孙〕治大小便不通，关格不利。烧皂角细研，粥饮下三钱，立通。
〔《外》〕关格胀满，大小便不通。独头蒜烧热去皮，纸裹纳下部，气立通。
〔仲〕寸口脉浮而大，浮为虚，大为实，在尺为关，在寸为格，关则不得小便，格则吐逆。
〔《脉》〕下微本大者，则为关格不通，不得尿。头无汗者可治，有汗者死。（成注云∶下微谓脉沉
之而微也，本大谓关后脉大也。）
关，指小便不通；格，指呕吐逆反，这是上下二焦同时患病的状况。
〔《难经》〕邪气侵犯六腑，会导致阳脉不和；阳脉不和，则气机滞留；气机滞留，则阳脉亢盛。邪气侵犯五脏，会导致阴脉不和；阴脉不和，则血行瘀滞；血行瘀滞，则阴脉亢盛。阴气过盛，阳气就无法与之相互营卫调和，所以称为“格”。（阴盛而阳气无法营卫，表现为寸口脉搏动比人迎脉搏大三到四倍。）阳气过盛，阴气就无法与之相互营卫调和，所以称为“关”。（阳盛而阴气无法营卫，表现为人迎脉搏动比寸口脉搏大三到四倍。）阴阳两脉都亢盛，导致无法相互营卫调和，所以称为“关格”。患关格病的人，寿命将尽而死。（出自《难经·三十七难》）
〔李东垣〕关，就是小便不通；格，就是呕吐逆反。关，是由于极热之气所致；格，是由于极寒之气所致。因为关阻没有排出的途径，所以叫“关”；因为格拒没有进入的道理，所以叫“格”。寒气停留在胸中，遏制阻挡食物不能入内；热气积聚在下焦，填塞阻碍大小便排泄。
〔滑寿〕阴阳位置颠倒错乱，这种病叫做关格。如果胸膈以上阳气常存，则以热证为主要病机。如果身体半以下阴气常存，则以寒证为主要病机。如果寒邪反而在胸中，舌苔白腻，饮食水浆无法咽下，这就叫“格”，格则呕吐逆反。如果热邪在丹田（下焦），小便不通，这就叫“关”，关则小便不通。胸中有寒，用热性药物治疗；丹田有热，用寒性药物治疗。如果胸中寒热兼有，就用主客之法治疗。治疗主证应当缓图，治疗客证应当急治。如果出现尺寸脉相反的情况会死亡，阴阳脉交错混乱会死亡，患关格病的人，寿命将尽而死。
〔朱丹溪〕必须使用催吐法，以提起横格于上的气机，不一定非要吐出痰液。如果有痰，用二陈汤催吐，吐的过程中自然就有降逆的作用。如果是中气虚弱、气机不运转的，在补气药中加入升降气机的药物。
〔孙一奎〕奉职赵令仪的女儿，突然呕吐逆反，大小便都不通，心烦意乱，四肢逐渐变冷，摸不到脉搏。经过一天半后，给予大承气汤一剂。到了半夜，大便逐渐通畅，脉搏逐渐平和，第二天就安稳了。这是关格病，极其难以治疗，濒临死亡而救活的，只有这一例罢了。
〔孙一奎〕治疗大小便不通，关格不利。将皂角烧制后细研，用米粥汁送服三钱，立刻就能通畅。
〔《太平惠民和剂局方》〕关格伴有胀满，大小便不通。取独头蒜烧热去皮，用纸包裹后纳入下部（肛门），气机立刻通畅。
〔张仲景〕寸口脉浮而大，浮表示虚，大表示实。脉象在尺部出现为“关”，在寸部出现为“格”。关则小便不通，格则呕吐逆反。
〔《脉经》〕脉象沉取微弱而本位（关前或整体）大的，就是关格不通，无法排尿。头部无汗的可以治愈，有汗的会死亡。（成无己注解说：下微是指脉沉取时感觉微弱，本大是指关脉之后脉象盛大。）
Guan (Obstruction) refers to the inability to urinate, while Ge (Rejection) refers to vomiting and regurgitation; this condition involves simultaneous pathology in both the upper and lower jiao.
[Nan Jing] When pathogenic factors invade the fu organs, the yang pulses become discordant. Discordance of the yang pulses leads to qi stagnation, and qi stagnation results in an excess of the yang pulses. When pathogenic factors invade the zang organs, the yin pulses become discordant. Discordance of the yin pulses leads to blood stasis, and blood stasis results in an excess of the yin pulses. When yin qi is excessively strong, yang qi cannot circulate and nourish it mutually, hence it is called Ge (Rejection). (Excess of yin with yang unable to circulate manifests as the Cun Kou pulse being three to four times larger than the Ying Chang pulse.) When yang qi is excessively strong, yin qi cannot circulate and nourish it mutually, hence it is called Guan (Obstruction). (Excess of yang with yin unable to circulate manifests as the Ying Chang pulse being three to four times larger than the Cun Kou pulse.) When both yin and yang pulses are excessive and cannot circulate mutually, it is called Guan Ge (Obstruction and Rejection). Those suffering from Guan Ge will die before their natural lifespan is completed. (From Nan Jing, Chapter 37)
[Li Dongyuan] Guan means inability to urinate, and Ge means vomiting and regurgitation. Guan is caused by extreme heat qi; Ge is caused by extreme cold qi. Because Guan has no outlet, it is called Guan; because Ge has no entry, it is called Ge. Cold resides in the chest and middle jiao, obstructing and preventing food intake; heat fills the lower jiao, blocking bowel movements and urination.
[Hua Shou] When yin and yang shift positions, the disease is named Guan Ge. If yang qi constantly resides above the chest and diaphragm, heat is the primary pathogenesis. If yin qi constantly resides below the midpoint of the body, cold is the primary pathogenesis. If cold pathogen resides in the chest, accompanied by a white tongue coating and inability to swallow fluids or food, this is called Ge, which causes vomiting and regurgitation. If heat pathogen resides in the Dan Tian (lower jiao), causing urinary obstruction, this is called Guan, which causes inability to urinate. For cold in the chest, treat with hot-natured herbs. For heat in the Dan Tian, treat with cold-natured herbs. If both cold and heat exist in the chest, apply the method of treating the principal and secondary pathogens. Treating the principal should be gradual, while treating the secondary should be urgent. Death occurs if the Chi and Cun pulses are reversed, if yin and yang pulses intersect chaotically, and those with Guan Ge will die before their natural lifespan is completed.
[Zhu Danxi] Emetic therapy must be used to lift the qi that is horizontally obstructed; it is not necessary to expel phlegm. If phlegm is present, use Er Chen Tang (Two-Aged Decoction) for emesis; within the act of vomiting lies the mechanism of descending. For cases of deficiency of middle qi with failure of qi movement, add herbs that ascend and descend qi to tonifying qi formulas.
[Sun Yiqi] The daughter of Zhao Lingyi, a Fengzhi official, suddenly experienced vomiting and regurgitation, obstruction of both stool and urine, restlessness, gradual coldness of the four limbs, and absence of pulse. After one and a half days, one dose of Da Cheng Qi Tang (Major Order the Yang Decoction) was administered. By midnight, bowel movement gradually became unobstructed, the pulse gradually normalized, and she was stable the next day. This case of Guan Ge is extremely difficult to treat; among those near death who were revived, this was the only one.
[Sun Yiqi] To treat obstruction of stool and urine and unfavorable Guan Ge: burn Jie Jiao (Gleditsia Sinensis Fruit), grind finely, and administer three qian with congee water for immediate relief.
[Wai Tai Mi Yao] For Guan Ge with distension and fullness, and obstruction of stool and urine: take a single-head garlic clove, heat it until hot, peel it, wrap it in paper, and insert it into the lower orifice (anus); qi flow will immediately resume.
[Zhang Zhongjing] The Cun Kou pulse is floating and large. Floating indicates deficiency, and large indicates excess. When this pulse pattern appears at the Chi position, it is Guan; when it appears at the Cun position, it is Ge. Guan leads to inability to urinate, and Ge leads to vomiting and regurgitation.
[Mai Jing] When the pulse is faint upon deep pressure but large at the root (or Guan position), it indicates Guan Ge obstruction with inability to pass urine. If there is no sweat on the head, it is treatable; if there is sweat on the head, it is fatal. (Cheng Wuji notes: "Faint upon deep pressure" refers to the pulse feeling faint when pressed deeply; "Large at the root" refers to the pulse being large behind the Guan position.)