阳结阴涸，上下格拒，而噎膈反胃之症成。人身上下七门，自飞门至魄门。咽为吸门，即会厌，气喉上
饮食者。胃上口为贲门，下口为幽门，幽门上冲吸门，其吸气不得下归肝肾，为阴火格拒，故噎膈不通，
甚则反胃。分言之，则噎者咽下梗塞，水饮不行，食物难入，由痰气之阻于上也。膈者胃脘窄隘，食下拒痛，
由血液之槁于中也。反胃者，食入反出，完谷不化，由胃阳之衰于下也。而昔人通谓之膈。《黄帝针经》云∶
胃病者，膈咽不通，饮食不下。丹溪云∶血耗胃槁，槁在贲门，脘痛吐食，上焦膈也∶食下良久复出，槁在
幽门，中焦膈也；朝食暮吐，暮食朝吐，槁在阑门，下焦膈也。经云∶三阳结，谓之膈，以手太阳小肠主液，
足太阳膀胱主津。三阳，士材指大小肠膀胱，《金鉴》指胃大小肠。此据《内经》王注、汪注。二腑热结，
则津液枯燥，前后秘涩，下关既扃，势必上涌，故食噎不下，即下而仍出，是火上行而不下降矣。王太仆亦云∶
食不得入，是有火也，食入反出，是无火也。噎膈初起，多因忧恚悲悒，以致阳结于上，阴涸于下。《医鉴》
云∶五噎，忧、劳、思、食、气也，饮食猝阻，不能下。五膈，忧、恚、寒、食、气也，心脾之间，上下不通，
或结咽喉，时觉
妨碍，吐不出，咽不下。治宜调心脾以舒结气，归脾汤去术，养心汤去桂再加归、芍、香附。填精血以滋枯燥，
猪脂丸。反胃初起，多因土弱火衰，以致朝食暮吐，暮食朝吐，治宜扶胃土以通阳，异功散加益智，丁香、
干姜、砂仁、粳米。益命火以蒸化。八味丸。其立法要使辛滑通痞，姜汁、竹沥、贝母、杏仁、栝蒌、枇杷叶、
韭白汁。而脘痹以开；甘酸化阴，人参、天冬、麦冬、蔗汁、枣仁、白芍、乌梅、木瓜。而液枯以润。或
健脾理痰，四君子、六君子汤，或二陈汤加竹茹。不偏任温燥以劫液；或滋阴养血，生地、阿胶、牛乳、梨汁、
芝麻、柿霜，或四物汤。不偏用清润以助痰。气滞成噎者，宣理气隧。九香虫、丁香皮、郁金、檀香、石见穿、
枳壳、广皮、广木香。血瘀成膈者，兼通血络。桃仁、红花、延胡、当归须、鸡血藤膏。士材治血膈，用人参、
五灵脂、归尾、桃仁、郁金。云岐人参散用冰麝，亦同此法也。因胃阳虚，而浊瘀反胃者，用通补胃腑，辛
热泄浊法。参、苓、吴萸、干姜、益智、陈皮、半夏、砂仁壳。因气郁痰阻，用苦降辛通法。黄连、杏仁、
橘红、姜汁、竹茹、苏子、半夏。因肝郁气逆，用两通厥阴阳明法。当归、白芍、香附、半夏、茯苓、杏仁、
橘红、竹沥、姜汁。因酒热郁伤肺胃，用轻剂清降，枇杷叶、杏仁、郁金、栝蒌、前胡、桑白皮。及苦辛开肺
法。桔梗、贝母、杏仁、蔻仁、生姜、橘红、山栀。其由忧思伤脾，气郁生涎，饮可下，食难入。香砂宽中丸
去青皮、槟榔。由七情郁结，胸脘拒痛，脉必沉涩。七气汤加郁金、栝蒌、砂仁、木香。由痰饮阻滞，呕吐翻
胃，脉必结涩。先以来复丹控其痰，再用大半夏汤加茯苓、枳壳、竹沥。由瘀血积滞，传化不变，反上行者，
脉必芤涩。滋血润肠丸加减。至脾气败，血液耗，胃脘枯槁，溺少便秘。补气健脾丸，参入滋血润肠丸，或
韭汁牛乳饮。若口吐白沫，粪如羊屎，不可治矣。勉用姜汁、杏酪、白蜜、牛乳、益智、韭子、半夏。《医
学心悟》云∶开关用启膈散最效。又如五汁饮以清燥，利膈丸以通壅，汞硫散以止吐，总忌香燥破气，辛热耗
液。唯一种胃阳衰，不能运化者，暂用辛温开结，继仍以益阴养胃为宜。粳米、人参、山药、莲、枣、牛乳、
小麦。膈症生虫，用河间雄黄
散。有梅核膈，吐不出，咽不下，咽喉妨碍，由气郁痰结，涤痰丸。由死血，昆布、当归、桃仁、韭汁，
童便。有翻胃，食入即翻出，或痰或热，壅阻膈间，非如反胃之早食晚吐，晚食早吐也。清热二陈汤。
再论噎由气结，膈由痰与气逆，或瘀血。一种气噎，临食辍箸，嗌阻沫升，气平食入，病在上焦肺
胃间，治以轻扬利膈，苦降则过病所。一种痛膈，食下格拒，呕涎嘈痛，而饥焰中焚，病在中焦，治以辛香通
降，不效，必兼理血络。一种胃槁，脘系窄隘，即勺饮亦妨碍，由衰年血液渐枯，胃管扃闭，饮入则涎升泪
出，二便俱少，开合都废，治以辛滑润养，大忌香燥耗液，刚热劫阴，此脘血失荣，下咽易梗，一切碍滞闭
气食品，咸宜禁忌。尝见食山芋而成噎者，食鸡子而咽成膈者，若再忧思郁怒，结于中而莫解，情志之病，尤
难霍然。徐灵胎谓噎膈症，十死八九，反胃症十愈八九。再论反胃，由食久不化，腐浊上攻，彻底翻澜，二肠失
司传送，病在幽门以下，古法多谓胃中无阳，精微不能蒸化。然经云∶诸呕吐逆，皆属于热。且胃津先夺，
热燥难投，必细参脉症，或苦降辛通，宣行壅滞。曾记一壮年反胃吐食，服八味汤，暂止复吐，食羊血得愈。
又沈姓年高嗜饮，兼情悒不遂，吐沫拒食，半载未愈。一老医投药四剂，病势减半，再用十剂料，浸酒服而
全愈。方用大生地（五钱）、海浮石（一两）、乌药（钱半）、牛膝、灵磁石、云苓、归身（各三钱）。玩
此方兼温清镇泄，升降气血，性味不偏，传者目睹治验，因附记备考。
阳气郁结，阴液枯竭，上下气机格拒，从而形成噎膈和反胃的病证。人体上下的七个门户，从飞门到魄门。咽部称为吸门，即会厌，是呼吸之气进入、饮食之物下行的通道。胃的上口称为贲门，下口称为幽门。幽门上冲至吸门，导致吸气不能下行归于肝肾，被阴火格拒，所以出现噎膈不通，严重时则发展为反胃。
分别来说，噎症表现为吞咽时梗塞感，水饮难行，食物难入，这是由于痰气阻滞于上部所致。膈症表现为胃脘部狭窄隘小，进食后拒绝疼痛，这是由于血液枯槁于中部所致。反胃表现为食物吃进去后又吐出来，完谷不化，这是由于胃阳衰弱于下部所致。而古人通称这些症状为“膈”。《黄帝针经》说：“胃病的人，会出现胸膈咽喉不通，饮食无法下咽。”朱丹溪说：血耗伤导致胃体干枯，干枯在贲门，引起脘痛呕吐，属于上焦的膈症；食物吃下去很久之后又吐出来，干枯在幽门，属于中焦的膈症；早晨吃的晚上吐，晚上吃的早晨吐，干枯在阑门，属于下焦的膈症。
经典经文说：“三阳经气郁结，就称为膈”，因为手太阳小肠主司津液，足太阳膀胱主司津气。对于“三阳”的解释，士材（赵献可）指大小肠和膀胱，《医宗金鉴》指胃、大小肠。这是依据《内经》王冰注和汪昂注的观点。如果二腑热邪郁结，就会导致津液枯燥，前后二便秘涩不通。下关既然闭塞，势必导致气机上涌，所以食物噎塞不下，即使勉强吞下也会再次吐出，这就是火性上行而不能下降的表现。王太仆（王冰）也说：“食物不能入口，是因为有火；食物入口后又吐出来，是因为无火。”
噎膈初起，多因忧愁愤怒悲伤抑郁，导致阳气郁结于上，阴液枯竭于下。《医鉴》说：五噎，由忧、劳、思、食、气引起，饮食突然阻塞，不能下行。五膈，由忧、恚、寒、食、气引起，心脾之间，上下不通，或者结滞于咽喉，时常觉得妨碍，吐不出来，咽不下去。治疗应当调理心脾以舒展郁结之气，用归脾汤去掉白术，养心汤去掉肉桂，再加当归、白芍、香附。填补精血以滋润枯燥，用猪脂丸。
反胃初起，多因脾胃虚弱、命门火衰，导致朝食暮吐，暮食朝吐。治疗应当扶助胃土以通达阳气，用异功散加益智仁、丁香、干姜、砂仁、粳米。补益命门之火以助蒸化，用八味丸。其立法要点在于使用辛滑之品以通痞塞，如姜汁、竹沥、贝母、杏仁、瓜蒌、枇杷叶、韭白汁来开通脘痹；使用甘酸化阴之法，如人参、天冬、麦冬、蔗汁、枣仁、白芍、乌梅、木瓜来滋润液枯。或者健脾理痰，用四君子汤、六君子汤，或二陈汤加竹茹，不偏执于温燥以免劫夺阴液；或者滋阴养血，用地黄、阿胶、牛乳、梨汁、芝麻、柿霜，或四物汤，不偏用清润以免助长痰湿。
气滞导致噎症的，宣通气机通道，用九香虫、丁香皮、郁金、檀香、石见穿、枳壳、广陈皮、广木香。血瘀导致膈症的，兼以疏通血络，用桃仁、红花、延胡索、当归须、鸡血藤膏。赵士材治疗血膈，用人参、五灵脂、归尾、桃仁、郁金。云岐人参散用冰片、麝香，也是同样的方法。
因胃阳虚，浊瘀导致反胃的，用通补胃腑、辛热泄浊的方法，用人参、茯苓、吴茱萸、干姜、益智仁、陈皮、半夏、砂仁壳。因气郁痰阻的，用苦降辛通的方法，用黄连、杏仁、橘红、姜汁、竹茹、苏子、半夏。因肝郁气逆的，用两通厥阴、阳明的方法，用当归、白芍、香附、半夏、茯苓、杏仁、橘红、竹沥、姜汁。因酒热郁伤肺胃的，用轻剂清降，用枇杷叶、杏仁、郁金、瓜蒌、前胡、桑白皮。以及苦辛开肺法，用桔梗、贝母、杏仁、蔻仁、生姜、橘红、山栀。
因忧思伤脾，气郁生涎，饮水可下，进食难入的，用香砂宽中丸去青皮、槟榔。因七情郁结，胸脘拒痛，脉必沉涩的，用七气汤加郁金、瓜蒌、砂仁、木香。因痰饮阻滞，呕吐翻胃，脉必结涩的，先以来复丹控制痰饮，再用大半夏汤加茯苓、枳壳、竹沥。因瘀血积滞，传化不变，反向上行的，脉必芤涩，用滋血润肠丸加减。
到了脾气败坏，血液耗竭，胃脘枯槁，小便少大便秘结的地步，用补气健脾丸，参入滋血润肠丸，或韭汁牛乳饮。如果口吐白沫，大便像羊屎一样，就无法治愈了。勉强试用姜汁、杏酪、白蜜、牛乳、益智仁、韭子、半夏。《医学心悟》说：开关用启膈散最见效。又如五汁饮以清燥，利膈丸以通壅，汞硫散以止吐，总忌用香燥破气、辛热耗液的药物。唯有一种情况是胃阳衰微，不能运化的，暂时用辛温开结，随后仍以益阴养胃为宜，用药如粳米、人参、山药、莲子、大枣、牛乳、小麦。
膈症生虫的，用河间雄黄散。有梅核膈，吐不出，咽不下，咽喉妨碍，由气郁痰结引起，用涤痰丸。由死血（瘀血）引起的，用昆布、当归、桃仁、韭汁、童便。有翻胃，食入即翻出，或痰或热，壅阻膈间，不像反胃那样早食晚吐、晚食早吐，用清热二陈汤。
再论噎症由气结引起，膈症由痰与气逆，或瘀血引起。一种气噎，临吃饭时放下筷子，咽喉阻塞唾液上泛，气平后食物能入，病在上焦肺胃之间，治疗以轻扬利膈为主，苦降药力过猛则会直达病所。一种痛膈，食下格拒，呕涎嘈痛，心中如火焚烧，病在中焦，治疗以辛香通降为主，如果不效，必须兼理血络。一种胃槁，胃系狭窄隘小，即使是勺饮也感到妨碍，由年老血液逐渐枯竭，胃管闭塞，饮水则唾液上泛眼泪流出，二便都少，开合功能废弛，治疗以辛滑润养为主，大忌香燥耗液、刚热劫阴，这是胃血失于荣养，下咽容易梗塞，一切碍滞闭气的食品，都应禁忌。曾见过吃山芋而成噎症的，吃鸡子而咽成膈症的，如果再忧思郁怒，结于中焦而无法解开，这种情志之病，尤其难以迅速痊愈。徐灵胎说噎膈症十人死八九，反胃症十人愈八九。
再论反胃，由食物久不消化，腐浊之气上攻，彻底翻澜，大小肠失去传送功能，病在幽门以下，古法多认为是胃中无阳，精微物质不能蒸化。然而经文说：“各种呕吐逆气，都属于热。”且胃津先被剥夺，热燥之药难投，必须仔细参详脉症，或用苦降辛通，宣行壅滞。曾记得一个壮年反胃吐食的患者，服用八味汤，暂时停止后又吐，吃羊血后痊愈。又有一个姓沈的年高者嗜酒，兼有情志抑郁不顺，吐沫拒食，半年未愈。一位老医生投药四剂，病势减半，再用十剂药料浸酒服用而全愈。方用大生地（五钱）、海浮石（一两）、乌药（一钱半）、牛膝、灵磁石、云苓、归身（各三钱）。玩味此方，兼具温清镇泄，升降气血，性味不偏，传授者目睹治验，因此附录记录以备考证。
Yang qi becomes constrained, yin fluids are depleted, and the upper and lower parts repel each other, resulting in the syndromes of dysphagia (Yege) and regurgitation (Fanwei). The human body has seven gates from top to bottom, ranging from Feimen (Flying Gate) to Pomen (Corpse Gate). The pharynx is called Ximen (Suction Gate), which is the epiglottis, the passage for respiratory air to enter and food/drink to descend. The upper opening of the stomach is called Benmen (Receiving Gate), and the lower opening is Youmen (Secluded Gate). Youmen ascends to connect with Ximen; when inhalation cannot descend to return to the Kidney and Liver, it is repelled by Yin fire, leading to obstruction in dysphagia, and in severe cases, progressing to regurgitation.
Speaking separately, "Ye" (dysphagia/choking sensation) presents as a blockage during swallowing, where water and drinks do not pass, and food is difficult to enter, caused by phlegm and qi obstruction in the upper jiao. "Ge" (diaphragmatic obstruction) presents as a narrow and constricted epigastrium, with rejection and pain after eating, caused by blood depletion and dryness in the middle jiao. "Fanwei" (regurgitation) presents as food being vomited out after ingestion, with undigested food remaining, caused by the decline of Stomach Yang in the lower jiao. Historically, these were collectively referred to as "Ge". *Huangdi Zhenjing* states: "In stomach diseases, there is obstruction in the chest, diaphragm, and throat, and food cannot be swallowed." Zhu Danxi stated: When blood is consumed and the stomach dries up, if the dryness is at Benmen, causing epigastric pain and vomiting, it is Upper Jiao Ge; if food is eaten and vomited out after a long time, with dryness at Youmen, it is Middle Jiao Ge; if morning food is vomited in the evening and evening food in the morning, with dryness at Lanmen, it is Lower Jiao Ge.
The classics state: "Constriction of the Three Yang meridians is called Ge," because the Hand-Taiyang Small Intestine governs fluids, and the Foot-Taiyang Bladder governs jin-ye. Regarding "Three Yang," Shicai (Zhao Xianke) refers to the small intestine, large intestine, and bladder, while *Yizong Jinjian* refers to the stomach, small intestine, and large intestine. This interpretation follows the annotations of Wang Bing and Wang Ang on the *Neijing*. If heat constrains the two fu organs, fluids become dry, and both anterior and posterior orifices become constipated. Since the lower gate is closed, qi must surge upward, causing food to choke and not go down, or if forced down, to come back up. This indicates fire ascending without descending. Wang Taipu also said: "Food cannot enter due to fire; food enters and comes back up due to lack of fire."
At the onset of Yege, it is often due to sorrow, anger, grief, and depression, causing yang constraint above and yin depletion below. *Yijian* states: The Five Yies are caused by sorrow, labor, thought, food, and qi, causing sudden obstruction of food and drink. The Five Ges are caused by sorrow, resentment, cold, food, and qi, causing blockage between the Heart and Spleen, or stagnation in the throat, feeling obstructed, unable to spit out or swallow. Treatment should regulate the Heart and Spleen to relieve qi constraint, using Guipi Tang minus Atractylodes macrocephala, Yangxin Tang minus Cinnamon twig, plus Angelica sinensis, White Peony Root, and Cyperus rotundus. To fill essence and blood to moisten dryness, use Zhizhi Wan (Pig Fat Pill).
At the onset of Fanwei, it is often due to weak Earth (Spleen/Stomach) and declining Fire (Mingmen), causing morning food to be vomited in the evening and evening food in the morning. Treatment should support Stomach Earth to unblock Yang, using Yigong San plus Alpinia oxyphylla, Syzygium aromaticum, Zingiberis Rhizoma, Amomum villosum, and Oryza sativa. To benefit Mingming Fire for steaming and transformation, use Bawei Wan (Eight-Ingredient Pill). The legislative principle involves using pungent and slippery agents to unblock痞 (pi), such as Ginger juice, Phragmitis Rhizoma juice, Fritillaria cirrhosa, Prunus armeniaca seed, Trichosanthes kirilowii root, Eriobotrya japonica leaf, and Allium tuberosum juice to open epigastric bi; using sweet-to-acid method to generate yin, such as Codonopsis pilosula, Asparagus cochinchinensis, Ophiopogon japonicus, Sugarcane juice, Ziziphus jujuba seed, White Peony Root, Mume fruit, and Chaenomelis fructus to moisten fluid depletion. Alternatively, strengthen Spleen and resolve phlegm using Sijunzi Tang, Liujunzi Tang, or Erchen Tang plus Bamboo shavings, avoiding excessive warming and drying that might劫 (rob) fluids; or nourish yin and blood using Rehmannia glutinosa, Donkey-hide gelatin, Cow's milk, Pear juice, Sesamum indicum, Diospyros kaki frost, or Siwu Tang, avoiding excessive cooling and moistening that might aid phlegm.
For Ye caused by qi stagnation, promote qi flow in the channels using Chorus fuscus, Syzygium aromaticum pericarp, Curcuma aromatica, Santalum album, Pericarpium Passiflorae, Aurantii Fructus Immaturus, Citrus reticulata peel, and Aucklandiae Radix. For Ge caused by blood stasis, simultaneously unblock blood collaterals using Persicae Semen, Carthamus tinctorius flower, Corydalis yanhusuo, Angelica sinensis radix tip, and Spatholobus suberectus paste. Zhao Shicai treated blood Ge with Codonopsis, Trogopterus dung, Angelica sinensis tail, Persicae Semen, and Curcuma aromatica. Yunqi Renshen San using Borneol and Moschus follows this same method.
For Fanwei due to Stomach Yang deficiency and turbid stasis, use the method of tonifying and unblocking the Stomach fu with pungent-hot herbs to drain turbidity, using Codonopsis, Poria cocos, Cnidium monnieri, Zingiberis Rhizoma Recens, Alpinia oxyphylla, Citrus reticulata, Pinellia ternata, and Amomum villosum shell. For obstruction due to qi constraint and phlegm, use bitter-descending and pungent-unblocking methods, using Coptis chinensis, Prunus armeniaca seed, Citrus reticulata white pith, Ginger juice, Bamboo shavings, Perilla frutescens seed, and Pinellia ternata. For liver qi constraint and rebellion, use the method of unblocking both Jueyin and Yangming, using Angelica sinensis, White Peony Root, Cyperus rotundus, Pinellia ternata, Poria cocos, Prunus armeniaca seed, Citrus reticulata white pith, Bamboo juice, and Ginger juice. For lung and stomach injury due to wine-heat constraint, use mild clearing and descending agents, including Eriobotrya japonica leaf, Prunus armeniaca seed, Curcuma aromatica, Trichosanthes kirilowii root, Peucedanum praeruptorum root, and Datisca cannabina root bark. Also use bitter-pungent lung-opening methods, including Platycodon grandiflorus, Fritillaria cirrhosa, Prunus armeniaca seed, Amomum kravanh, Zingiber officinale, Citrus reticulata white pith, and Gardenia jasminoides.
For spleen injury due to sorrow/thought, qi constraint generating saliva, where drinking is possible but eating is difficult, use Xiangsha Kuanzhong Wan minus Qingpi and Areca seed. For chest/epigastric rejection and pain due to seven emotions constraint, with deep-choppy pulse, use Qi Qi Tang plus Curcuma aromatica, Trichosanthes kirilowii root, Amomum villosum, and Aquilaria sinensis wood. For phlegm-fluid obstruction causing vomiting/regurgitation, with knotted-choppy pulse, first control phlegm with Laifu Dan, then use Banxia Houpo Tang plus Poria cocos, Aurantii Fructus Immaturus, and Bamboo juice. For blood stasis accumulation causing failure of transmission and reverse ascent, with floating-choppy pulse, use Zixue Runchang Wan modified.
When Spleen qi fails, blood is exhausted, and the stomach is withered, with scant urine and constipation, use Buqi Jianpi Wan combined with Zixue Runchang Wan, or Leek Juice and Cow Milk Drink. If white foam is vomited and stool resembles sheep droppings, it is incurable. Desperately try Ginger juice, Apricot kernel paste, White honey, Cow milk, Alpinia oxyphylla, Allium tuberosum seed, and Pinellia ternata. *Yixue Xinwu* states: Kaiguan (opening the gate) with Qige San is most effective. Also, Wuzhi Yin clears dryness, Lige Tongyong pill unblocks congestion, Gongsu San stops vomiting. Generally, avoid pungent-drying qi-breaking and hot-fluid-consuming drugs. Only in cases of extreme Stomach Yang decline failing to transform, temporarily use pungent-warm opening agents, followed by yin-nourishing and stomach-tonifying measures, such as Oryza sativa, Codonopsis, Dioscorea opposita, Nelumbo nucifera, Ziziphus jujuba, Cow milk, and Triticum aestivum.
For parasites in Ge syndrome, use Hejian Xionghuang San. For Meihe Ge (plum-pit throat), unable to spit out or swallow, feeling obstructed in the throat due to qi-phlegm constraint, use Ditang Wan. Due to dead blood (stasis), use Ecklonia stolonifera, Angelica sinensis, Persicae Semen, Leek juice, and Child's urine. For Fanwei where food is immediately turned out, or phlegm/heat obstructs the diaphragm, distinct from Fanwei's morning-evening vomiting pattern, use Qingre Erchen Tang.
Further discussing Ye caused by qi constraint, and Ge caused by phlegm, qi rebellion, or blood stasis. One type is Qi Ye: putting down chopsticks before eating, throat obstruction with saliva rising, food entering after qi settles; disease is in Upper Jiao Lung/Stomach, treat with light-floating agents to benefit the diaphragm; bitter-descending agents may reach the disease site too forcefully. One type is Tong Ge (painful Ge): food rejection, vomiting saliva, burning pain, hunger-fire burning in the middle; disease is in Middle Jiao, treat with pungent-aromatic descending agents; if ineffective, must address blood collaterals. One type is Wei Gao (withered stomach): narrow esophagus/stomach tube, even spoonfuls cause obstruction; due to aging blood depletion closing the stomach tube, drinking causes saliva/tears to rise, scant urination/defecation, loss of opening/closing function; treat with pungent-slippery nourishment, strictly avoiding pungent-drying fluid-consuming and hot-yin-robbing agents. This is stomach blood losing nourishment, easy choking upon swallowing. All foods that obstruct qi should be forbidden. I have seen cases of Ye from eating sweet potatoes, and Ge from eating eggs. If accompanied by sorrow/thought/depression unresolved in the middle, emotional diseases are especially hard to cure quickly. Xu Lingtai stated that 80-90% of Ge/Ye cases die, while 80-90% of Fanwei cases recover.
Regarding Fanwei, it is caused by food not digesting for a long time, rotting turbidity attacking upward, overturning completely, and the intestines losing transmission function; the disease is below Youmen. Ancient methods often attribute this to lack of Yang in the Stomach, preventing steaming/transformation of essences. However, the classics state: "All vomiting and rebellious qi belong to Heat." Since Stomach fluids are first depleted, hot-drying drugs are difficult to administer. One must carefully analyze pulse and symptoms, using bitter-descending/pungent-unblocking methods to circulate congestion. I recall a young man with Fanwei vomiting food who took Bawei Tang, stopped temporarily, then vomited again, but was cured by eating sheep blood. Another case: an elderly man named Shen, addicted to alcohol, with depressed mood, vomiting foam and refusing food, uncured for half a year. An old doctor prescribed four doses, halving the illness, then ten doses soaked in wine, resulting in full recovery. The formula used: Sheng Dihuang (5 qian), Haifushi (1 liang), Wuyao (1.5 qian), Achyranthes bidentata, Magnetitum, Poria cocos, Danggui shen (3 qian each). Observing this formula, it combines warming, clearing, sedating, and draining, regulating ascending/descending qi and blood, with balanced properties. The transmitter witnessed its efficacy, so I record it for reference.