治病发于阳，而反下之，热入，因作结胸，以下之太早故也，其病项强如柔
状，下之则和。
大黄（二两） 葶苈(炒) 杏仁(去皮尖炒) 芒硝（各三分）
上前二味为末，将杏仁、芒硝合研为脂，和药，取如弹子大一枚，别杵甘遂末一钱匕、
白蜜一大匕，水二盏，煎至七分，顿服之，一宿乃下；如不下更服，取下为效。甘遂性猛，
宜斟酌虚实入之。
胸痞证者，胃中不和，心下坚硬，干呕，恶寒汗出，噫气不除；亦有因伤寒身冷，医反
下之，遂成胸痞。
治伤寒及诸吐利后，胸痞欲绝，膈高起急痛，手不得近。
枳实(去瓤面炒) 茯苓 人参 白术 干姜(炮) 甘草(炙，各等分)
上为末，蜜和，一两作四丸。热汤化下。渴，加栝蒌根；下利，加牡蛎粉各等分。
治中寒气痞，胸满欲死。
桔梗 枳壳(麸炒去瓤，各一分)
上为锉散。每服五钱匕，水一盏半，煎七分，去滓，食前服。
治伤寒阴证，下之太早，致心下痞，按之软，其脉关上浮者主之；若表未解，
未可攻，宜先随风寒二证投桂枝麻黄汤，表解已，即服此方。
大黄(蒸) 黄连 黄芩
上为锉散。每服五钱，沸汤二盏，热渍之一时久，去滓分二服暖服。或汗出恶寒，加附
子，别煎汁入一协议服。
治心下痞满而不痛者。
半夏(汤洗七次，一两一钱） 黄芩 人参 甘草(炙) 干姜(炮，各两半) 黄连（半两）
上锉散。每服五钱，水盏半，姜五片，枣一个，煎七分，去滓温服。或伤寒中风，医反
下之，下利日数十行，谷不化，腹中鸣，心下痞硬，干呕心烦者，加甘草半两、人参一两，
名甘草泻心汤。或汗出解后，胃中不和，心下痞硬，干噎食臭，胁下水鸣，下利者，加生
姜一两，减干姜一两，余如正方，名生姜泻心汤。
When a disease originates from Yang (referring to exterior heat syndrome) and is incorrectly treated with purgation, heat enters the interior, resulting in Jie Xiong (Chest Binding), due to premature purgation. The condition presents with neck stiffness, resembling Rou Ji (a type of spasm characterized by rigidity of the neck and back with sweating); administration of this formula will harmonize the condition.
Dahuang (Rhubarb Radix et Rhizoma, 2 liang) Tingli (Descurainiae Semen, stir-fried) Xingren (Apricot Seed, skin and tip removed, stir-fried) Mangxiao (Natrii Sulfas, each 3 fen)
Grind the first two herbs (Dahuang and Tingli) into powder. Grind Xingren and Mangxiao together until they form a paste-like consistency, then mix with the powder. Take one pill-sized piece (size of a bullet). Separately, prepare Gansui (Kansui Root) powder (1 qianbi) and Baimi (White Honey, 1 large spoon). Add 2 zhan of water, decoct until reduced to 7/10 volume, and take in one dose. If stool is not passed after one night, administer another dose; passage of stool indicates efficacy. Gansui has a potent nature; its inclusion should be carefully weighed according to the patient's deficiency or excess condition.
Xiong Pi (Chest Stagnation) syndrome arises from disharmony of the Stomach, hardness below the heart, dry retching, aversion to cold, sweating, and persistent belching. It may also result from Cold Damage where the body becomes cold, and the physician erroneously applies purgation, thereby causing Chest Stagnation.
For treating post-Cold Damage and various vomiting and diarrhea conditions, where chest stagnation feels extreme, the diaphragm rises and is acutely painful, and cannot be touched by hand.
Zhishi (Immature Bitter Orange Fruit, pith removed, stir-fried with bran) Fuling (Poria) Renshen (Ginseng Radix et Rhizoma) Baizhu (Atractylodis Macrocephalae Rhizoma) Ganjiang (Dried Ginger, processed) Gancao (Licorice Root, honey-fried, equal parts)
Grind all ingredients into fine powder. Mix with honey to form four pills, each weighing 1 liang. Dissolve in hot water before ingestion. If thirsty, add Gualougen (Trichosanthis Radix); if diarrhea occurs, add Muli Fen (Oyster Shell Powder), both in equal parts.
To treat Qi stagnation caused by internal Cold, presenting with chest fullness so severe it feels like death.
Jiegeng (Platycodon Root) Zhike (Bitter Orange Fruit, stir-fried with bran, pith removed, each 1 fen)
Grind the above into a coarse powder. Each dose consists of 5 qianbi, decocted in 1.5 zhan of water until reduced to 7/10 volume. Strain and take before meals.
For Yin syndrome of Cold Damage, where premature purgation leads to epigastric stagnation that is soft upon palpation, and the pulse is floating at the Guan position. This formula governs such cases. If the exterior syndrome is unresolved, do not attack the interior; instead, initially administer Guizhi Tang (Cinnamon Twig Decoction) or Mahuang Tang (Ephedra Decoction) according to Wind-Cold patterns. Once the exterior is resolved, administer this formula.
Dahuang (Rhubarb Radix et Rhizoma, steamed) Huanglian (Coptidis Rhizoma) Huangqin (Scutellariae Radix)
Grind the above into a coarse powder. Each dose is 5 qian, soaked in 2 zhan of boiling water for one shichen (approx. 2 hours). Strain and divide into two warm doses. If sweating and aversion to cold occur, add Fuzi (Prepared Aconite Root), decoct separately, and mix the juice with the main decoction for combined administration.
For treating epigastric fullness and stagnation without pain.
Banxia (Pinellia Tuber, washed seven times with hot water, 1 liang 1 qian) Huangqin (Scutellariae Radix) Renshen (Ginseng Radix et Rhizoma) Gancao (Licorice Root, honey-fried) Ganjiang (Dried Ginger, processed, each 2.5 liang) Huanglian (Coptidis Rhizoma, 0.5 liang)
Grind the above into a coarse powder. Each dose is 5 qian, decocted with 1.5 zhan of water, 5 slices of fresh ginger, and one jujube, until reduced to 7/10 volume. Strain and take warm. If, following Cold Damage or Wind Strike, erroneous purgation leads to frequent diarrhea (dozens of times daily), undigested food, abdominal borborygmus, epigastric hardness, dry retching, and irritability, add Gancao (Licorice Root) 0.5 liang and Renshen (Ginseng Radix et Rhizoma) 1 liang; this is named Gancao Xiexin Tang (Licorice Decoction for Draining the Epigastrium). If, after sweating resolves the exterior, stomach disharmony persists with epigastric hardness, dry heaving with foul breath, fluid rumbling in the hypochondrium, and diarrhea, add Shengjiang (Fresh Ginger) 1 liang and reduce Ganjiang (Dried Ginger) by 1 liang; the rest remains as in the standard formula; this is named Shengjiang Xiexin Tang (Fresh Ginger Decoction for Draining the Epigastrium).