If the pulse appears slow and gentle, it indicates that the earth energy is not yet depleted.

The stomach is small and cannot hold substances, stools are dry like sheep's feces, and bowel movements occur every three to four days, indicating a decline in the functions of the spleen and stomach, often associated with chronic atrophic gastritis. Moreover, chronic atrophic gastritis presents various symptoms and is mostly more difficult to treat than ulcers.

As You Zaijing says: "The symptom is Yin deficiency, fluid depletion, and blockage."

What does it mean?

This sentence refers to the deficiency of fluids in the stomach, which cannot moisten the grains, and the ingested food is not digested but instead vomited.

This inevitably brings up a statement made by Mr. Li Dongheng in his medical book: "A rapid pulse indicates diaphragmatic Qi deficiency, a string-like pulse indicates liver Qi abundance; the combination of rapid and string-like pulses indicates liver Qi attacking the diaphragm while the stomach remains deficient and cold."

Hence, the heat caused by diaphragmatic Qi is not real heat and should not be treated with cold; the cold in the stomach is not real cold and should not be treated with heat.

This sounds full of contradictions and makes it difficult to diagnose and treat. One reason is that it is not real heat and should not be treated with cold.

Another reason is that it is not real cold and should not be treated with heat; what method should be used to treat it thoroughly?

In diagnosing and treating, one must explore and search; one should mainly nurture the true Qi, the liver's harmonious Qi in the stomach will naturally digest and expel the ingested grains smoothly, this is the liver's harmonious Qi.

If it floats, it generates heat; if it sinks, it generates cold; if it is warm, the floating heat naturally dissipates; if it is nurtured, the deficiency-cold naturally transforms. If one uses both strong heat and cold to attack, the true Qi will become even more deficient, bodily fluids will deplete, the sea of grains will gradually decline, and symptoms in the digestive tract and throughout the body will become more severe.

Ji Xiuwen frowned and thought for a moment before asking: "Then in this situation, how should it be treated?"

What prescription should be used for treatment?

Lu Xuan smiled and said: "It is treated with Astragalus Decoction for Strengthening the Middle, applied with modifications as needed, which is composed by adding one and a half liang of raw Astragalus to Minor Strengthening the Middle Decoction. Zhang Zhongjing used this formula to treat deficiency taxation, acute abdominal pain, and various deficiency symptoms.

This formula is used to treat symptoms of both yin and yang deficiencies, but with a bias towards yang Qi deficiency. When yang Qi is deficient, its warming effect is lost, hence the abdominal tension and pain; 'various deficiencies' refer to deficiencies in yin, yang, Qi, and blood, treated with Astragalus Decoction for Strengthening the Middle to supplement Qi and establish the central region; Astragalus in the formula is for tonifying deficiency and boosting Qi.

Thus it is said in medicinal properties assignment: "Astragalus is sweet in flavor, supporting the interior and stabilizing the exterior, eliminating all deficiencies," like in the 'Direct Pointing Formulas', it is used to treat body pain from pierced blood, adding Chuanxiong in the formula; as stated in the 'Jiyin Outline': "A string-like pulse, weak Qi, withered hair, and hair loss." Zhang's Medical Guide states: "Harmed by overwork, inappropriate cold and dampness, body heat, headache, spontaneous sweating, aversion to cold, with a fine and weak pulse."

At this point, Lu Xuan paused, then said: "In modern context, Astragalus Decoction for Strengthening the Middle is widely used for digestive system diseases such as gastritis, gastroparesis, aplastic anemia, prolonged low fever, hand and foot peeling, chronic pharyngitis, and gynecological diseases, etc.

The so-called various deficiencies refer to deficiencies in yin, yang, Qi, blood, and fluids; concerning the viscera, the five organs should be solid and not deficient, the six bowels should be deficient and not solid, but neither deficiency nor excess should be too extreme, as extremes lead to physiological and pathological changes."

Having said this, Lu Xuan said no more.

There are too many disorders of the digestive system, and the knowledge involved is not a mere fraction; discussing for merely a meal's duration would hardly cover one-tenth of it.

"By the way, after eating, don't go back just yet." Lu Xuan drank a sip of plain water and looked at him.

"Why?"

Ji Xiuwen turned off the recorder on his phone and looked up to ask.

"If you have something to do, then it's okay, but I was thinking if you are free tonight, accompany me to the Ninth Hospital. There are still several stroke patients who need acupuncture today."

Ji Xiuwen's eyes lit up instantly: "Brother, I'm free, very free."

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