Gou Teng is judged by a combination of its distinctive hooks and overall appearance. The best quality shows solid, anchor-shaped twin hooks, which are the defining feature that confirms the material is Gou Teng rather than a similar plant. These hooks should be sturdy and intact, not broken or fragile, signaling proper harvesting and processing. In good quality Gou Teng, there are a small number of thin stems, rather than a dense bundle of stems with many hooks. This reflects proper selection and reduces adulteration risk, while keeping the material recognizable by its hooked ends. The surface color should be purplish-brown or reddish-brown and glossy, indicating appropriate drying and storage. A dull surface or other color typically points to aging, improper processing, or inferior material. So, the combination of solid, anchor-shaped twin hooks, a limited number of thin stems without hooks on most of the stems, and a purplish-brown to reddish-brown glossy surface best describes Gou Teng of good quality.

The herb being tested is one that primarily moves and uplifts qi, especially in the middle burner, to restore the SP’s function and promote overall qi flow. Zhi Shi has a strong qi-moving action that breaks up stagnation and guides qi upward, which helps the spleen’s qi rise and function more effectively. When SP qi is constrained by stagnation, lifting and directing qi upward can improve the body's energetic tone and, in patterns where deficient qi affects circulation, can manifest as a rise in energy and blood pressure. This upward-qi effect is why Zhi Shi is noted for promoting qi and supporting SP yang. Mai Ya mainly aids digestion and reduces food stagnation but doesn’t have the same pronounced qi-moving and upward-raising action as Zhi Shi. Mang Xiao is a purgative that softens hard stools and drains dampness, not about elevating SP qi. Tong Cao tonifies and harmonizes, SAMPLEincluding aiding SP qi, but its primary role is milder tonification and harmonization rather than the strong qi-upward movement seen with Zhi Shi.

acute cough with yellow phlegm points to phlegm-heat in the lungs, while nausea signals heat in the stomach. An herb that can clear heat in the stomach and simultaneously transform phlegm to relieve cough addresses both symptoms at once. Zhu Ru, bamboo shavings, is traditionally used to clear stomach heat and stop vomiting, and it also helps transform phlegm to ease coughing. That dual action makes it the most fitting choice when both yellow phlegm and nausea are present. Jie Geng primarily helps with coughing and phlegm by guiding Lung qi and opening the throat, but it doesn’t address nausea. Xing Ren is mainly for cough and wheeze due to LU cold or dryness, not the heat/phlegm pattern here. Bai Jie Zi transforms phlegm and helps with coughing, but similarly it doesn’t tackle the nausea component.

Ge Gen is the principal ingredient here—the herb that does the main work in the formula. In this combination, Ge Gen is used in the largest dose, 15-24 units, which signals its leading role in releasing the exterior and guiding the other herbs to work on the body’s surface. The other two heat-clearing herbs are added in smaller amounts to clear interior heat and support the exterior release, while the licorice would typically harmonize, though that one isn’t among the listed options. So the herb present at 15-24 units is Ge Gen.