脉浮缓者生。沉涩者死。脉涩而小。血不足。脉大而弱。气不足。
夫翻胃之症。其来也未有不由膈噎而始者。膈噎者喜怒不常。忧思劳役。惊恐无时。七
情伤于脾胃
郁而生痰。痰与气搏。升而不降。饮食不下。血气留于咽嗌。五噎结于胸膈者为五膈。法
当顺气化痰。温脾养胃。如阳脉紧而涩者。为难治之症。夫翻胃即膈噎。膈噎即翻胃之渐
大法有四。血虚气虚。有痰有热。血虚者。脉必数而无力。气虚者。脉必缓而无力。气血
俱虚者。则口中多出沫。但见沫大出者必死。有热者。脉必数而有力。有痰者。脉必滑数。
二者可治。血虚者。则以四物汤为主。左手脉无力。气虚者。则以四君子为主。右手脉无力
粪如羊屎者。断不可治。大肠无血故也。痰以二陈汤为主。寸关脉沉。或伏或大。有气结
滞。通气之药皆可用。寸关脉沉而涩大。不可用香燥热剂。宜薄滋味。又曰。膈噎翻胃之疾
得之六淫七情。遂有火热炎上之作。多升少降。又有外为阴火上炎翻胃者。作阴火治之。
大便必结。用童便、竹沥、韭汁、姜汁、牛羊乳。分别而用。
一论膈有十般之病。其实同出一源。皆因动性不能发泄。则郁于肝。人之膈膜。属肝木
否
则木乘土位。木曰曲直作酸。然酸则能收塞。胃脘因之而收小窒碍。乃作膈症。宜用此汤。
当归活血润膈汤
当归（酒洗一钱半） 桃仁（去皮尖一钱） 广陈皮（青色者八分） 川浓朴（姜炒一钱） 黄
连（吴茱萸煎汤炒一钱） 大腹皮（甘草汤洗一钱） 片白术（盐水炒一钱） 红花（七分） 炙甘
草（三分） 善饮酒者。加葛根。
上锉一剂。水煎。温服。
按五噎名虽有五。原其要在于气弱血枯之人。思虑劳欲而成者也。气弱则运化不开。血
枯
则道路闭塞。盖心生血。肾生气。任脉乃阴之母。枯则精涸。任脉不润矣。任脉循咽嗌胸中
胃之三脘。一直而下。肾虚则丹田清气不升。故中焦失顺下之化。脾虽思味而爱食。因升
降
不利而成噎矣。宜绝欲以后精血。须节顺志以和心脾。用当归活血润膈汤。去白术。加人参
一钱。白豆蔻七个。黄柏酒炒七分。知母七分。栀子炒一钱。栝蒌仁炒一钱。远志（甘草汤
泡去心）八分。红枣三个。水煎服。
一论膈噎。胸中不利。大便结燥。痰嗽喘满。脾胃壅滞。此能推陈致新。治膈气之圣药
也。
人参利膈丸
人参（三钱） 当归（二钱） 藿香（一钱五分） 浓朴（姜汁炒一两） 枳实（麸炒一两） 大
黄（酒蒸一两） 木香（一钱五分） 槟榔（一钱五分） 甘草（炙三钱）
上为末。滴水为丸。如梧子大。每服五十丸。温水送下。
一论噎食转食。宜
加减不换金正气散
苍术（米泔浸一钱半） 陈皮（去白二钱） 浓朴（姜汁炒八分） 藿香（三钱） 半夏（姜汁
炒二
钱） 枳实（麸炒二钱） 白术（去芦一钱五分） 白茯苓（去皮三钱） 白豆蔻（去壳八分） 甘
草（八分） 黄连（土炒六分）
上锉。生姜三片煎服。
一论噎膈翻胃之症。皆由七情之气太过。郁则生火生痰而致病。病则耗气耗血以致虚。
气虚
不能运化而生痰。血虚不能滋润而生火。或朝食而暮吐。或暮食而朝吐。或食已即吐者。日
久不愈。误投香燥攻克之药过多。以致危殆。宜以补中益气汤。（方见内伤）根据本方去柴胡、
升麻。加半夏二钱。白茯苓三钱。白芍酒炒三钱。枳实麸炒一钱。神曲炒二钱。
黄连姜炒六分。
一翻胃不食。脾胃虚弱。不进饮食。宜
人仓丸
丁香（一两） 砂仁（一两） 白豆蔻（去壳一两） 陈仓米（六两黄土炒米熟去土不用）
上为细末。生姜自然汁为丸。如梧子大。每服百丸。食后。用淡姜汤送下。有怒气。加
香附子姜汁炒一两。
一论五噎者。气忧劳食思也。气噎者心悸。上下不通。噫哕不得。胸胁苦痛。忧噎者。
天际
苦厥逆。心下悸动。手足厥冷。劳噎者苦气。膈胁下支满。胸中填塞。令手足厥冷。不能自
温。食噎者。食无多少。胸中苦塞。常痛。不能喘息。思噎者。心悸动。善忘。目视KT KT 。
皆忧恚嗔怒。寒气上攻胸膈。
五噎丸 治胸中虚寒。日久咽喉气逆。饮食不下。结气不消用。
人参（五分） 白术（去芦四分） 白茯苓（四分） 陈皮（四分） 细辛（四分） 川椒（五分）
吴茱萸（五分） 大附子（煨去皮脐四分） 桂心（五分） 干姜（炒五分）
上为末。炼蜜为丸。如梧子大。每服三丸。酒送下。日服三次。
保和丸 治实热翻胃。
陈皮 半夏（姜汁炒） 白茯苓（去皮） 连翘 神曲 山楂肉 萝卜子（炒各三钱） 黄连
（姜炒二钱）
上为末。稀米糊为丸。胭脂为衣。粟米大。每服六七十丸。人参煎汤。入竹沥同下。
一论胃反不受食。食已即呕吐出。
人参（二两） 白术（去芦一两） 半夏（汤泡三两） 生姜（三两） 白蜜（一两）
上五味 咀。以水五升。和蜜搅之二三百下。煮取一升半。分三次服之。
一论反胃。呕吐无常。粥饮入口即吐。困弱无力。垂死者。人参二两。咀片。水煎顿服
立效。再用人参汁稀粥与服。
一治翻胃。用六君子汤加炮姜、白豆蔻、黄连。（用吴茱萸酒拌过宿炒去茱萸）
一治转食方。反翅鸡一只。煮熟去骨。入人参、当归、盐各五钱为末。再煮取与食之。
勿令人共食。
一人年过五十。得噎症。胃脘作痛。食不下。或食下良久复出。大便结燥。人黑瘦甚。
诊其
脉。右关弦滑而洪。关后略沉小。二部俱沉弦带芤。此中气不足。木来侮土。上焦湿热。郁
结成痰。下焦血少。故大便结燥。阴火上冲吸门。故食不下。用四物汤以生血。四君子汤以
补气。二陈汤以祛痰。三合成剂。加姜炒黄连。麸炒枳实。栝蒌仁。少加砂仁。又间服润肠
丸百余剂全安。（润肠丸方见大便秘方）
一治翻胃。用大附子一个最大者。坐于砖上。四面着火渐逼。淬入生姜自然汁。又根据前
火
逼干。复淬之。约生姜汁可尽半碗许。捣为末。每服一钱。用粟米汤下。不过三服立效。
一治噎膈大便燥结。
橘杏麻仁丸
陈皮（为末） 杏仁（去皮尖） 火麻仁（去壳各三两） 郁李仁（去壳五钱）
上三仁俱捣为膏。用枣肉和入石臼杵为丸。每服五十丸。枳实煎汤送下。
脉象浮而缓的，预后良好；脉象沉而涩的，预后不良。脉象涩且小，说明血不足；脉象大而弱，说明气不足。
翻胃这一病症，其起因没有不是从膈噎开始的。所谓膈噎，是由于喜怒无常、忧思过度、劳累役使以及惊恐无时，导致七情损伤脾胃，气机郁结而生痰。痰与气相互搏结，气机升而不降，导致饮食无法下行，气血滞留于咽喉。五噎结聚于胸膈部位便成为五膈。治疗法则应当顺气化痰，温补脾脏，滋养胃腑。如果阳脉紧而涩，属于难治之症。翻胃即是膈噎，膈噎则是翻胃的初期阶段。大致的辨证方法有四种：血虚、气虚、有痰、有热。血虚者，脉象必然数而无力；气虚者，脉象必然缓而无力。若气血俱虚，则口中多吐泡沫，只见泡沫大量涌出的，必定死亡。有热者，脉象必然数而有力；有痰者，脉象必然滑数。这两种情况是可以治疗的。对于血虚者，以四物汤为主方；左手脉无力者，属气虚，以四君子汤为主方；右手脉无力者……（注：原文此处逻辑稍显跳跃，通常右手候气/肺脾，左手候血/心肝肾，但依原文直译）……大便像羊屎一样干结的，断不可治，这是因为大肠无血滋润的缘故。对于有痰者，以二陈汤为主方。寸口和关部脉象沉，或者伏匿或者大，说明有气结滞，可以使用通气类药物。如果寸关脉沉而涩大，则不可使用香燥热性的药物，宜清淡饮食。又说，膈噎翻胃的疾病，得之于六淫（风、寒、暑、湿、燥、火外邪）和七情内伤，于是产生火热炎上的病机，多升少降。又有因外在阴火上炎导致的翻胃，应按阴火治疗。这类患者大便必然干结，可使用童便、竹沥、韭菜汁、姜汁、牛乳或羊奶，分别选用服用。
有一种理论认为膈部有十种疾病，其实同出一源，都是因为情绪波动不能发泄，导致郁结于肝脏。人的膈膜归属于肝木系统，如果肝木失调，就会乘克脾土（木克土）。肝主曲直，其味为酸，然而酸味具有收敛闭塞的作用，导致胃脘因此收缩变小、窒碍不通，从而形成膈症。适宜使用此方：当归活血润膈汤。
药材：当归（酒洗一钱半）、桃仁（去皮尖一钱）、广陈皮（青色者八分）、川厚朴（姜炒一钱）、黄连（用吴茱萸煎汤炒一钱）、大腹皮（甘草汤洗一钱）、片白术（盐水炒一钱）、红花（七分）、炙甘草（三分）。善于饮酒的人，加葛根。
以上药材锉碎为一剂，水煎煮，温服。
按语：五噎的名称虽然有五种，但其关键原因在于气弱血枯之人，因思虑、劳累、房欲而成病。气弱则运化功能不开通，血枯则经络道路闭塞。盖心生血，肾生气，任脉是阴血的母源，任脉枯竭则精血涸竭，任脉失去滋润。任脉循行经过咽喉、胸中及胃的三个脘部，一直向下。肾虚则丹田清气不升，导致中焦失于顺畅，下部的转化功能受阻。虽然脾喜欢味道而爱吃食物，但因升降不利而形成噎症。应当在节制欲望后保养精血，须调节情志以调和心脾。使用当归活血润膈汤，去掉白术，加入人参一钱、白豆蔻七个、黄柏（酒炒）七分、知母七分、栀子（炒）一钱、栝蒌仁（炒）一钱、远志（甘草汤泡去心）八分、红枣三个，水煎服。
有一种理论认为膈噎表现为胸中不利，大便干结，痰嗽喘满，脾胃壅滞。此方能推陈致新，是治疗膈气的圣药。
方名：人参利膈丸。
药材：人参（三钱）、当归（二钱）、藿香（一钱五分）、厚朴（姜汁炒一两）、枳实（麸炒一两）、大黄（酒蒸一两）、木香（一钱五分）、槟榔（一钱五分）、甘草（炙三钱）。
以上研为细末，滴水泛丸，如梧桐子大小。每次服用五十丸，温水送下。
有一种理论认为噎食转食（指吞咽困难或呕吐未消化食物），适宜使用加减不换金正气散。
药材：苍术（米泔水浸一钱半）、陈皮（去白二钱）、厚朴（姜汁炒八分）、藿香（三钱）、半夏（姜汁炒二钱）、枳实（麸炒二钱）、白术（去芦一钱五分）、白茯苓（去皮三钱）、白豆蔻（去壳八分）、甘草（八分）、黄连（土炒六分）。
以上锉碎，加生姜三片煎服。
有一种理论认为，噎膈翻胃的病症，皆由七情之气太过，郁结则生火生痰而致病。患病则耗气耗血以致虚弱。气虚不能运化而生痰，血虚不能滋润而生火。症状表现为早晨吃晚上吐，或晚上吃早上吐，或刚吃完就吐。日久不愈，若误投香燥攻伐的药物过多，会导致病情危重。适宜使用补中益气汤。（该方见内伤章节）根据本方去掉柴胡、升麻，加入半夏二钱、白茯苓三钱、白芍（酒炒）三钱、枳实（麸炒）一钱、神曲（炒）二钱、黄连（姜炒）六分。
一种情况是翻胃不进食，脾胃虚弱，不进饮食，适宜用人仓丸。
药材：丁香（一两）、砂仁（一两）、白豆蔻（去壳一两）、陈仓米（六两，黄土炒米熟后去土不用）。
以上研为细末，用生姜自然汁泛丸，如梧桐子大小。每次服用一百丸，饭后用淡姜汤送下。如果有怒气，加香附子（姜汁炒）一两。
一种理论认为五噎是指气噎、忧噎、劳噎、食噎、思噎。
气噎者，心悸，上下气机不通，嗳气和呃逆不得出，胸胁苦痛。
忧噎者，苦于厥逆，心下悸动，手足厥冷。
劳噎者，苦于气短，膈胁下支撑胀满，胸中填塞感，令手足厥冷，不能自温。
食噎者，无论食量多少，胸中苦于堵塞，常疼痛，不能喘息。
思噎者，心悸动，健忘，视物模糊不清。
这些病症皆因忧恚嗔怒，寒气上攻胸膈所致。
方名：五噎丸。主治胸中虚寒，日久咽喉气逆，饮食不下，结气不消。
药材：人参（五分）、白术（去芦四分）、白茯苓（四分）、陈皮（四分）、细辛（四分）、川椒（五分）、吴茱萸（五分）、大附子（煨去皮脐四分）、桂心（五分）、干姜（炒五分）。
以上研为细末，炼蜜为丸，如梧桐子大小。每次服用三丸，酒送下，每日三次。
方名：保和丸。主治实热翻胃。
药材：陈皮、半夏（姜汁炒）、白茯苓（去皮）、连翘、神曲、山楂肉、萝卜子（炒，各三钱）、黄连（姜炒二钱）。
以上研为细末，稀米糊为丸，胭脂为衣，粟米大小。每次服用六七十丸，人参煎汤，加入竹沥一同送下。
一种理论认为胃反不受食，食已即呕吐出。
药材：人参（二两）、白术（去芦一两）、半夏（汤泡三两）、生姜（三两）、白蜜（一两）。
以上五味药切碎，用水五升，加入蜂蜜搅拌二三百下，煮取一升半，分三次服用。
一种理论认为反胃，呕吐无常，粥饮入口即吐，困弱无力，濒临死亡者，用人参二两，切片，水煎顿服，立见效验。再用人参汁调稀粥服用。
一种治疗翻胃的方法，用六君子汤加炮姜、白豆蔻、黄连。（其中黄连用吴茱萸酒拌过，隔夜炒后去掉吴茱萸）。
一种治疗转食（呕吐未消化食物）的方子。取反翅鸡一只，煮熟去骨，加入人参、当归、盐各五钱研为细末，再煮鸡肉与药末混合食用。不要让人一起食用。
有一人年过五十，患噎症，胃脘作痛，食不下，或食下良久复出，大便干结，身体黑瘦严重。诊其脉，右关脉弦滑而洪，关后略沉小，两部脉俱沉弦带芤。这是中气不足，肝木来侮脾土，上焦湿热，郁结成痰，下焦血少，故大便干结，阴火上冲吸门，故食不下。使用四物汤以生血，四君子汤以补气，二陈汤以祛痰，三合成剂，加姜炒黄连、麸炒枳实、栝蒌仁，少加砂仁。又间服润肠丸百余剂，完全康复。（润肠丸方见大便秘章节）。
一种治疗翻胃的方法，用最大的一个附子，放在砖上，四面点火逐渐逼近，淬入生姜自然汁。又按照前面的方法用火逼干，再次淬入。大约生姜汁可耗尽半碗左右，捣为细末。每次服用一钱，用粟米汤送下，不超过三服立见效验。
一种治疗噎膈大便燥结的方法。
方名：橘杏麻仁丸。
药材：陈皮（为末）、杏仁（去皮尖）、火麻仁（去壳，各三两）、郁李仁（去壳五钱）。
以上三种仁类全部捣为膏状，用枣肉和入石臼杵为丸。每次服用五十丸，枳实煎汤送下。
If the pulse is floating and moderate, the prognosis is good; if it is deep and choppy, the prognosis is poor. A choppy and small pulse indicates insufficient Blood; a large and weak pulse indicates insufficient Qi.
Fanwei (Rebellious Stomach) originates invariably from Gegge (Obstruction in the Chest and Throat). Gegge arises from irregular emotions (excessive joy or anger), excessive worry and thought, overwork, and constant fright. These Seven Emotions injure the Spleen and Stomach, causing Qi stagnation and Phlegm generation. Phlegm and Qi contend with each other, rising but not descending, preventing food and drink from going down. Qi and Blood remain stagnant in the throat. The Five Ge (Obstructions) knotting in the chest and diaphragm become Wuge (Five Obstructions). The treatment principle should be to regulate Qi and resolve Phlegm, warm the Spleen and nourish the Stomach. If the Yang pulse is tight and choppy, it is a difficult-to-treat condition. Fanwei is equivalent to Gegge, and Gegge is the gradual onset of Fanwei. There are four main patterns: Blood deficiency, Qi deficiency, presence of Phlegm, and presence of Heat. In Blood deficiency, the pulse is necessarily rapid and forceless; in Qi deficiency, the pulse is necessarily moderate and forceless. If both Qi and Blood are deficient, there will be excessive spitting of foam in the mouth; seeing massive outflow of foam indicates certain death. In Heat, the pulse is necessarily rapid and forceful; in Phlegm, the pulse is necessarily slippery and rapid. Both are treatable. For Blood deficiency, Siwu Tang (Four Substances Decoction) is the primary formula. If the left-hand pulse is forceless, it indicates Qi deficiency, and Sijunzi Tang (Four Gentlemen Decoction) is the primary formula... [Note: Text implies right-hand pulse relates to specific Qi/Blood aspects, though traditionally Left=Blood/Yin, Right=Qi/Yang, translation follows text structure]... If stool is like sheep dung, it is untreatable because the Large Intestine lacks Blood lubrication. For Phlegm, Erchen Tang (Two-Aged Decoction) is the primary formula. If the Cun (Inch) and Guan (Bar) pulses are deep, hidden, or large, it indicates Qi stagnation, and Qi-regulating herbs can be used. If the Cun and Guan pulses are deep, choppy, and large, fragrant, dry, and hot agents should not be used; light and bland diet is appropriate. It is also said that Gegge and Fanwei result from the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire external pathogens) and Seven Emotions, leading to Fire blazing upward, with more ascending than descending. There is also Fanwei caused by external Yin Fire blazing upward, which should be treated as Yin Fire. Such patients will have constipation. Children's urine, Bamboo Sap, Leek Juice, Ginger Juice, Cow's Milk, or Goat's Milk may be used separately.
One theory states that there are ten types of diseases in the Diaphragm, all originating from the same source. They arise because emotional movements cannot be vented, leading to stagnation in the Liver. The human diaphragm belongs to the Liver Wood system. If Liver Wood is disordered, it overacts on Spleen Earth (Wood conquers Earth). Liver governs flexibility and its flavor is Sour. However, Sour has a contracting and obstructing nature, causing the stomach cavity to contract and become obstructed, resulting in Gegge syndrome. The following formula is suitable: Danggui Huoxue Runge Tang (Angelica Sinensis Blood-Invigorating and Diaphragm-Moistening Decoction).
Herbs: Danggui (Washed in wine, 1.5 qian), Taoren (Skin and tip removed, 1 qian), Guang Chenpi (Green variety, 0.8 fen), Chuan Houpo (Stir-fried with ginger juice, 1 qian), Huanglian (Stir-fried with decoction of Wuzhuyu, 1 qian), Dafupi (Washed in Licorice decoction, 1 qian), Pian Baizhu (Stir-fried in salt water, 1 qian), Honghua (0.7 fen), Zhi Gancao (Honey-roasted, 0.3 fen). For those who drink alcohol frequently, add Gegen (Kudzu Root).
Crush the above ingredients for one dose, decoct in water, and take warm.
Commentary: Although the Five Ge have five names, their essence lies in individuals with weak Qi and dry Blood, caused by excessive thinking, labor, and sexual indulgence. Weak Qi fails to promote transformation and transportation; dry Blood blocks the pathways. Heart generates Blood, Kidney generates Qi, and the Ren Mai (Conception Vessel) is the mother of Yin. When dry, Essence and Blood are exhausted, and the Ren Mai loses moisture. The Ren Mai runs through the throat, chest, and three parts of the Stomach, descending directly. Kidney deficiency causes clear Qi from the Dantian to fail to ascend, leading to disorder in the Middle Jiao and impaired downward transformation. Although the Spleen enjoys flavors and appetite, obstruction of ascending and descending leads to Ge syndrome. One must conserve Jing and Blood after restraining desires and regulate emotions to harmonize the Heart and Spleen. Use Danggui Huoxue Runge Tang, removing Baizhu, and adding Renshen (1 qian), Baidoukou (7 pods), Huangbai (Stir-fried with wine, 0.7 fen), Zhimu (0.7 fen), Zhizi (Roasted, 1 qian), Gualouren (Roasted, 1 qian), Yuanzhi (Soaked in Licorice decoction, heart removed, 0.8 fen), and Hongzao (3 dates). Decoct in water and take.
Another theory states that Gegge presents with discomfort in the chest, dry and hard stool, cough with Phlegm, wheezing and fullness, and stagnation in the Spleen and Stomach. This formula eliminates stale matter and promotes new growth, serving as a sacred medicine for treating Qi obstruction in the diaphragm.
Formula: Renshen Lige Wan (Ginseng Diaphragm-Regulating Pill).
Herbs: Renshen (3 qian), Danggui (2 qian), Huoxiang (1.5 qian), Houpo (Stir-fried with ginger juice, 1 liang), Zhishi (Bran-roasted, 1 liang), Dahuang (Steamed with wine, 1 liang), Muxiang (1.5 qian), Binglang (1.5 qian), Gancao (Roasted, 3 qian).
Grind into fine powder, form pills with drops of water, size of Sophora seeds. Take 50 pills per dose with warm water.
Another theory suggests that for Yishi Zhuan Shi (Choking food regurgitating undigested food), Jiajian Bu Huan Jin Zhengqi San (Modified Unchanging Golden Upright Qi Powder) is suitable.
Herbs: Cangzhu (Soaked in rice wash water, 1.5 qian), Chenpi (White pith removed, 2 qian), Houpo (Stir-fried with ginger juice, 0.8 fen), Huoxiang (3 qian), Banxia (Stir-fried with ginger juice, 2 qian), Zhishi (Bran-roasted, 2 qian), Baizhu (Aerial part removed, 1.5 qian), Bai Fuling (Peel removed, 3 qian), Baidoukou (Shell removed, 0.8 fen), Gancao (0.8 fen), Huanglian (Earth-stir-fried, 0.6 fen).
Crush the ingredients, decoct with 3 slices of fresh ginger, and take.
Another theory holds that Yige Fanwei syndromes are caused by excessive influence of the Seven Emotions. Stagnation generates Fire and Phlegm, causing disease. Illness consumes Qi and Blood, leading to deficiency. Deficient Qi fails to transform, generating Phlegm; deficient Blood fails to moisten, generating Fire. Symptoms include morning eating and evening vomiting, evening eating and morning vomiting, or immediate vomiting after eating. If prolonged and untreated, misusing fragrant, dry, and attacking drugs leads to critical danger. It is suitable to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (see Internal Injury chapter). Remove Chaihu and Shengma from this formula, add Banxia (2 qian), Bai Fuling (3 qian), Baishao (Wine-stir-fried, 3 qian), Zhishi (Bran-roasted, 1 qian), Shenqu (Roasted, 2 qian), Huanglian (Ginger-stir-fried, 0.6 fen).
For Fanwei with no desire to eat due to Spleen and Stomach weakness, Ren Cang Wan (Human Granary Pill) is suitable.
Herbs: Dingxiang (1 liang), Sharen (1 liang), Baidoukou (Shell removed, 1 liang), Chen Cangmi (6 liangs, stir-fried with yellow earth until cooked, then discard earth).
Grind into fine powder, form pills with natural Ginger Juice, size of Sophora seeds. Take 100 pills per dose after meals with light Ginger Soup. If there is anger, add Xiangfu (Stir-fried with ginger juice, 1 liang).
One theory defines the Five Ge as Qi Ge, You Ge, Lao Ge, Shi Ge, and Si Ge.
Qi Ge involves palpitations, blockage of upper and lower Qi, inability to belch or hiccup, and painful hypochondrium.
You Ge involves suffering from cold limbs, palpitations in the epigastrium, and cold hands and feet.
Lao Ge involves suffering from shortness of breath, distension under the diaphragm and hypochondrium, chest fullness, cold hands and feet unable to self-warm.
Shi Ge involves chest blockage regardless of food amount, constant pain, and inability to breathe easily.
Si Ge involves palpitations, forgetfulness, and blurred vision.
These conditions are all caused by sorrow, resentment, and anger, with Cold Qi attacking the chest and diaphragm.
Formula: Wuye Wan (Five Ge Pill). Treats deficiency-cold in the chest, chronic rebellious Qi in the throat, inability to swallow food, and unresolved Qi knots.
Herbs: Renshen (0.5 fen), Baizhu (Aerial part removed, 0.4 fen), Bai Fuling (0.4 fen), Chenpi (0.4 fen), Xixin (0.4 fen), Chuanjiao (0.5 fen), Wuzhuyu (0.5 fen), Da Fuzi (Roasted, peel and navel removed, 0.4 fen), Guixin (Cinnamon Twig Heart, 0.5 fen), Ganjiang (Stir-fried, 0.5 fen).
Grind into powder, form pills with refined honey, size of Sophora seeds. Take 3 pills per dose with wine, three times daily.
Formula: Baohe Wan (Preserve Harmony Pill). Treats excess-Heat Fanwei.
Herbs: Chenpi, Banxia (Stir-fried with ginger juice), Bai Fuling (Peel removed), Lianqiao, Shenqu, Shanzha Rou (Mesocarp of Hawthorn), Luobozi (Roasted Radish Seed, each 3 qian), Huanglian (Ginger-stir-fried, 2 qian).
Grind into powder, form pills with thin rice paste, coat with carmine, size of millet seeds. Take 60-70 pills per dose with Ginseng decoction mixed with Bamboo Sap.
One theory describes Weifan (Stomantic Reversal) where food is rejected and vomited immediately after ingestion.
Herbs: Renshen (2 liangs), Baizhu (Aerial part removed, 1 liang), Banxia (Soaked in boiling water, 3 liangs), Shengjiang (Fresh Ginger, 3 liangs), Baimi (White Honey, 1 liang).
Chop the five ingredients, add 5 sheng of water and honey, stir 200-300 times, boil to obtain 1.5 sheng. Divide into three doses.
One theory states that for Fanwei with unpredictable vomiting, immediate vomiting of porridge and drinks upon entry, extreme weakness, and impending death, use Renshen (2 liangs), sliced, decocted in water and taken in one dose for immediate effect. Follow up with thin porridge made with Ginseng juice.
One method to treat Fanwei uses Liujunzi Tang (Six Gentlemen Decoction) plus Paojiang (Charred Ginger), Baidoukou, and Huanglian. (The Huanglian is soaked in Wuzhuyu wine, stir-fried overnight, and the Wuzhuyu discarded).
One prescription for Zhuan Shi (Regurgitation of undigested food): Take one "fanchi" chicken (a specific type of chicken), cook thoroughly, remove bones, add Renshen, Danggui, and Salt (each 5 qian), grind into powder, re-boil the chicken meat with the powder, and consume. Do not let others share the meal.
A case: A man over fifty suffered from Ge syndrome, epigastric pain, inability to eat, or vomiting food long after eating, dry stool, and severe emaciation with dark complexion. His pulse was wiry, slippery, and surging at the right Guan position, slightly deep and small behind it; both positions were deep, wiry, and thready (Kou). This indicates insufficient Middle Qi, Liver Wood insulting Spleen Earth, Damp-Heat in the Upper Jiao condensing into Phlegm, and scant Blood in the Lower Jiao causing dry stool. Yin Fire rushing up to the Xi Men (Admission Gate) prevents swallowing. Use Siwu Tang to generate Blood, Sijunzi Tang to tonify Qi, and Erchen Tang to dispel Phlegm. Combine these three formulas, add Ginger-stir-fried Huanglian, Bran-roasted Zhishi, Gualouren, and a little Sharen. Also intermittently take Run Chang Wan (Moisten Intestines Pill) for over a hundred doses for complete recovery. (Run Chang Wan formula see Constipation chapter).
One method to treat Fanwei: Take the largest Fuzi (Prepared Aconite Root), place it on a brick, apply fire around it gradually, and quench it in natural Ginger Juice. Repeat the heating and quenching process until about half a bowl of Ginger Juice is consumed. Grind into powder. Take 1 qian per dose with Millet Soup. Effect is seen within three doses.
One method to treat Yige with dry and hard stool.
Formula: Ju Xing Ma Ren Wan (Tangerine Peel, Apricot Kernel, and Hemp Seed Pill).
Herbs: Chenpi (Ground to powder), Xingren (Skin and tip removed), Huomaren (Shell removed, each 3 liangs), Yuliren (Shell removed, 5 qian).
Grind the three kernels into a paste, mix with Jujube flesh, pound in a mortar to form pills. Take 50 pills per dose with Zhishi decoction.