治伤寒结胸欲绝心膈高起。手不得近。
茯苓 人参 白术 干姜（炮） 甘草（炙各二两） 枳实（十六片麸炒）
上捣罗为细末。炼蜜为丸。如鸡子黄大。每服一丸。热汤化下。连进二三服。胸中豁然。渴者。加栝蒌根二两下利
者。加牡蛎二两。 之。
琥按上方。乃仲景理中丸。加枳实茯苓也。太阴虚寒痞满者。上汤大宜用之。若伤寒结胸。心膈高起。手不得近。
恐系寒实证。参术又非所宜用。又云。渴者加栝蒌根。或者服药阳回。口中燥渴。可暂加之。至于下利。则肠胃寒极。
反用牡蛎之咸寒以凝涩之。殊悖于理。
治阴经伤冷。脾胃不和。及感寒邪。并食积所伤。
官桂（去皮） 人参 川芎（各二两） 浓朴（去皮净姜汁拌） 白茯苓 半夏（汤洗五七遍） 芍药（洗净） 当
归（洗） 麻黄（去节） 干姜（各三两） 甘草（二两半） 枳壳（五两麸炒黄色） 桔梗（十二两紧实白者洗净焙
干） 陈橘皮（八两洗净不去穣） 苍术（二十四两新米泔水浸去皮） 吴白芷（四两洗净焙干）
上件。除枳壳官桂橘皮外。其余并一处。生捣为粗末。分作六分。于大镬内。用文武火炒令黄熟不得焦。用纸摊于
板上。候冷。入前件枳壳官桂橘皮末。一处和匀。入瓷盒盛。每服二钱。水一盏。生姜三片。同煎至七分。去滓温服。
伤寒入葱白一茎。豆豉七粒。同煎连服出汗。或脾胃不和。内伤冷食浑身疼痛。头昏无力。胸膈不快。吃食不下。气脉
不和。四肢觉冷。至晚心躁困倦。即入盐少许。同煎。或者阴经伤寒。手足逆冷。或睡里虚惊。及虚汗不止。脉细疾。
面青呕逆。更宜入附子同煎。加减多少。并在临时。观看虚实轻重候之。
琥按上方。乃阳明太阳。及三阴经气血兼走之剂。止无关乎少阳。以寒中三阴。有自太阳经入者。有自阳明腑受者。
以故温中发表。两者兼施也。全在医者。临证细审。加减出入用之。
琥又按上方后云。伤寒加葱白豆豉者。此发阳明经汗。乃发表不远热也。又云。阴经伤寒。虚汗不止。宜入附子同
煎。则方中麻黄白芷等阳经发汗之药。又当减去。若不分经络。一概溷用。不惟无益。而反有害矣。此方与易老治伤寒
九味羌活汤相等。若非加减出入。不可用也。
Treats *Jie Xiong* (chest binding) caused by *Shang Han* (cold damage), where the condition is critical, with swelling and distension rising in the epigastrium, making it impossible for the hand to approach.
Fuling (Poria), Renshen (Ginseng), Baizhu (Atractylodes Macrocephala Rhizome), Ganjiang (Dried Ginger, prepared), Gancao (Licorice Root, honey-fried, each 2 liang), Zhishi (Immature Bitter Orange, 16 slices, bran-fried).
Crush and sieve the above herbs into fine powder. Form pills using refined honey, sized like a chicken egg yolk. Take one pill per dose, dissolve in hot water and ingest. After taking two or three doses continuously, the chest will feel clear and open. If there is thirst, add Gualougen (Trichosanthes Root, 2 liang); if there is diarrhea, add Muli (Oyster Shell, 2 liang).
Tanbo Yuanyin notes: The above formula is Zhang Zhongjing's Lizhong Wan (Regulate the Middle Pill), with added Zhishi and Fuling. For *Pi Man* (stuffiness and fullness) due to *Taiyin* deficiency-cold, this decoction is highly suitable. However, if it is *Shang Han Jie Xiong* (chest binding from cold damage) with epigastric swelling and tenderness preventing touch, it likely belongs to a cold-excess pattern, in which case Renshen and Baizhu are not appropriate. It also states that those with thirst add Gualougen; perhaps after taking the medicine, yang qi recovers causing dry mouth and thirst, so it can be temporarily added. As for diarrhea, it indicates extreme cold in the intestines and stomach; conversely using the salty-cold nature of Muli to astringe would be contrary to medical principles.
Treats cold injury to the *Yin* meridians, disharmony of the spleen and stomach, contraction of cold pathogens, and injuries caused by food stagnation.
Guangui (Cinnamon Twig, peeled), Renshen (Ginseng), Chuanxiong (Szechwan Lovage Rhizome, each 2 liang), Houpo (Magnolia Bark, peeled, cleaned and mixed with ginger juice), Baifuling (Poria), Banxia (Pinellia Tuber, washed five to seven times in boiling water), Shaoyao (Peony Root, washed), Danggui (Angelica Sinensis Root, washed), Mahuang (Ephedra Stem, nodes removed), Ganjiang (Dried Ginger, each 3 liang), Gancao (Licorice Root, 2.5 liang), Zhiqiao (Bitter Orange, 5 liang, bran-fried until yellow), Jiegeng (Platycodon Root, 12 liang, select firm white ones, wash and bake dry), Chenpi (Aged Tangerine Peel, 8 liang, wash without removing the pith), Cangzhu (Atractylodes Lancea Rhizome, 24 liang, soak in new rice washing water and peel), Baizhi (Angelica Dahurica Root, 4 liang, wash and bake dry).
For the above ingredients, except for Zhiqiao, Guangui, and Chenpi, place the rest together and crush into coarse powder. Divide into six portions. In a large wok, stir-fry over alternating mild and strong heat until yellow and cooked, but not burnt. Spread on paper on a board, wait for cooling, then add the powders of Zhiqiao, Guangui, and Chenpi, mix evenly. Store in a porcelain jar. Take 2 qian per dose, with one cup of water and three slices of fresh ginger, decoct until reduced to 0.7 cups, remove dregs, and take warm. For *Shang Han* entering the interior, add one stalk of Congbai (Scallion White) and seven grains of Douchi (Fermented Soybeans), decoct together and take continuously to induce sweating. Or for spleen-stomach disharmony, internal injury from cold food causing whole-body pain, dizziness, weakness, chest discomfort, anorexia, qi-pulse disharmony, cold sensation in limbs, irritability and fatigue at night, add a small amount of salt and decoct together. Or for *Yin* meridian *Shang Han*, with reversed cold in hands and feet, nocturnal fright, incessant spontaneous sweating, fine and rapid pulse, cyanotic face, vomiting and regurgitation, it is more suitable to add Fuzi (Prepared Aconite Root) and decoct together. The degree of addition or subtraction depends on temporary observation of deficiency/excess and severity.
Tanbo Yuanyin notes: The above formula is a preparation that moves qi and blood in the *Yangming*, *Taiyang*, and all three *Yin* meridians, excluding the *Shaoyang*. This is because cold invading the three *Yin* meridians may enter from the *Taiyang* meridian or be received from the *Yangming* fu organs. Therefore, warming the middle and releasing the exterior are applied simultaneously. It relies entirely on the physician's careful examination during clinical practice to adjust and use it.
Tanbo Yuanyin further notes: The latter part of the above formula states that adding Congbai and Douchi for *Shang Han* releases sweat from the *Yangming* meridian, meaning releasing the exterior does not avoid heat. It also states that for *Yin* meridian *Shang Han* with incessant spontaneous sweating, Fuzi should be added to decoct; thus, herbs for releasing the exterior in *Yang* meridians such as Mahuang and Baizhi should be reduced. If meridians are not distinguished and everything is mixed indiscriminately, it will not only be ineffective but harmful. This formula is comparable to Yi Lao's (Wang Haogu's) Jiwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) for treating *Shang Han*; unless adjusted according to circumstances, it should not be used arbitrarily.