桂枝（三两去皮） 芍药（六两） 甘草（二两炙） 生姜（三两切） 胶饴（一升） 大枣（十
一枚擘）
上六味。以水七升。煮取三升。去滓。纳胶饴。更上微火消解。温服一升。日三服。
此桂枝汤倍芍药而加胶饴也。本太阳表药。一转移而即变为安太阴之制。神化极矣。伤
寒二
三日。心中悸而烦者。中土虚馁。都城震恐。桂枝汤本主和营复阳。而但倍芍药加胶饴。奠
安中土。故曰建中。甘能满中。仍与桂枝汤同。故重申其禁曰。呕家不可用建中汤。以甜
故也。
伤寒阳脉涩。阴脉弦。腹中急痛者。先与小建中汤。盖阳脉涩。则中土已虚。阴脉弦
。则
木来贼土之象。腹中急痛。是脾阳下陷。此时若用小柴胡制木。其如中土先已虚馁何。夫中
土虚馁。非甘不补。土受木克。非酸不安。必先以小建中汤。扶植中土。土气既实。若不瘥
。再以小柴胡。疏土中之木。用药自有先后。非先以小建中姑为尝试也。
栀子（十二枚擘） 香豉（四两绵裹）
上二味。以水四升。先煮栀子。得二升半。纳豉煮取一升半。去滓。分为二服。温进一
服。得吐者止后服。
此非吐法之主方也。因误汗吐下后。正气已伤。邪留上焦。扰动阳气。因生烦热。无论
虚烦
实烦。皆宜此方取吐。虚烦者。若经中所指虚烦不得眠。反复颠倒。心中懊 。胃中空虚。
客气动膈。按之心下濡。舌上胎饥不能食。不结胸。但头汗出。皆虚烦之候也。实烦者。若
经中所指胸中窒。心中结痛。皆实烦之候也。此方主宣膈上之热。使得涌吐而解。若本有寒
分者不宜。故经有病患旧微溏不可与之戒。
今人用栀子俱炒黑。不能作吐。本方生用。故入口即吐也。香豉蒸 而成。性主上升。
故能载之以作吐。乃吐法中之轻剂也。
凡用吐法。当先审邪之高下。心下满而硬痛者。结胸证也。宜陷胸法。心下痞硬者。虚
痞也。宜泻心法。此则心中懊 。心中结痛。心下濡。故宜涌吐。毫厘千里。须当辨之。
Cinnamon Twig (Guizhi, 3 liang, bark removed) White Peony Root (Baishao, 6 liang) Licorice Root (Gancao, 2 liang, honey-fried) Fresh Ginger (Shengjiang, 3 liang, sliced) Maltose (Jiaoyi, 1 sheng) Jujube (Dazao, 10 pieces, torn open)
Take the above six ingredients. Add seven sheng of water. Decoct to obtain three sheng. Remove the dregs. Add the maltose. Heat gently over a low fire until dissolved. Take one sheng warm. Administer three times daily.
This is Guizhi Tang (Cinnamon Twig Decoction) with doubled Baishao and added Jiaoyi. Originally a formula for treating Taiyang exterior syndromes, it transforms immediately into a regimen that stabilizes the Taiyin. Its transformation is extremely subtle. In Shaoyang disease, after two or three days, if there is palpitation and irritability in the heart, it indicates deficiency and weakness of the Middle Jiao (Spleen and Stomach), akin to a capital city shaken by fear. Guizhi Tang originally harmonizes Ying (Nutrient) Qi and restores Yang Qi; here, by merely doubling Baishao and adding Jiaoyi, it secures and anchors the Middle Jiao. Hence it is called "Jian Zhong" (Establishing the Middle). Sweet flavor can fill and tonify the Middle. The principle remains similar to Guizhi Tang, hence the contraindication is reiterated: patients prone to vomiting should not use Jianzhong Tang, due to the sweet nature.
In Shaoyang disease, if the Yang pulse is choppy (Se) and the Yin pulse is taut (Xian), accompanied by acute abdominal pain, first administer Xiao Jianzhong Tang. A choppy Yang pulse indicates existing deficiency of the Middle Jiao; a taut Yin pulse is a sign of Wood attacking Earth. Acute abdominal pain signifies sinking of Spleen Yang. At this time, if Xiaochaihu Tang were used to subdue Wood, what would be done about the already deficient Middle Jiao? Deficiency of the Middle Jiao cannot be tonified without sweet flavors; when Earth is overcome by Wood, it cannot be pacified without sour flavors. One must first use Xiao Jianzhong Tang to support and establish the Middle Jiao. Once the Qi of Earth is solid, if the condition does not resolve, then use Xiaochaihu Tang to vent the Wood stagnated within the Earth. There is a proper sequence in medication; it is not merely a trial with Xiao Jianzhong Tang first.
Gardenia Fruit (Zhizi, 12 pieces, torn open) Fermented Soybean (Xiangchi, 4 liang, wrapped in silk)
Take the above two ingredients. Add four sheng of water. First decoct Zhizi until two and a half sheng remain. Add Xiangchi and decoct to obtain one and a half sheng. Remove the dregs. Divide into two doses. Take one dose warm. If vomiting occurs, stop taking the remaining dose.
This is not the primary formula for emesis methods. It is used because after erroneous application of sweating, vomiting, or purging methods, the Righteous Qi (Zheng Qi) is damaged, pathogenic factors remain in the Upper Jiao (Chest/Diaphragm), disturbing Yang Qi and generating irritability and heat. Whether it is Empty Irritability (Xu Fan) or Full Irritability (Shi Fan), this formula is suitable to induce vomiting for resolution. Empty Irritability refers to symptoms such as inability to sleep due to irritability, tossing and turning, profound mental discomfort (Ao Nu), emptiness in the stomach, disturbance of hostile Qi in the diaphragm, softness upon pressing the epigastrium, dry tongue coating, inability to eat, absence of Chest Binding (Jie Xiong), and sweating only on the head. These are signs of Empty Irritability. Full Irritability refers to chest oppression and tying pain in the heart, which are signs of Full Irritability. This formula primarily vents heat from the diaphragm, allowing resolution through vomiting. It is unsuitable for those with pre-existing cold-damp patterns; hence, the classic warns against using it in patients with chronic loose stools.
Modern practitioners often stir-fry Zhizi until blackened, rendering it unable to induce vomiting. This original formula requires raw usage, which causes immediate vomiting upon ingestion. Xiangchi is steamed and possesses an ascending nature, thus carrying Zhizi to induce vomiting. It is a mild agent among emetic methods.
Whenever employing emetic methods, one must first assess the location of the pathogen. If there is fullness, hardness, and pain in the epigastrium, it is a Chest Binding syndrome, suitable for the Chest Binding resolving method. If there is epigastric stuffiness and hardness, it is Empty Stuffiness, suitable for the Heart-venting method. Here, since there is mental discomfort, tying pain in the heart, and softness in the epigastrium, emesis is indicated. A slight error can lead to significant deviation; careful differentiation is required.