Drain the Middle addresses a syndrome of simultaneous repletion and vacuity in the Middle Burner due to the improper purging of an external pathogenic factor. When a pathogenic influence has not been properly purged it will sink deeper into the body causing epigastric distention. A patient with this condition usually has an underlying Stomach Qi vacuity which allows the pathogen to take hold and create Heat which in turn causes greater vacuity and Cold. As a result, the Stomach and Spleen are no longer able to perform their functions of raising and transforming the Qi, thus the turbid Yin stagnates causing symptoms such as dry heaves, vomiting, borborygmus, diarrhea and a reduced appetite. This syndrome can arise in any patient with a Spleen and Stomach vacuity where there is a concurrent Cold-Heat complex due to the invasion of an external pathogenic influence. It is also typical that a patient with this condition will have a belly that is soft to the touch.