黄连（一两） 半夏（半升洗） 栝蒌实（大者一枚）
上三味。以水六升。先煮栝蒌取三升。去滓。纳诸药。煮取二升。去滓。分温三服。
小结胸病。正在心下。按之则痛。脉又浮滑。视大结胸证从心上至少腹痛不可近者有间
矣。邪入未深。故本方黄连清热。蒌半散结。但开中焦之热结。勿犯下焦。故曰小。
大陷胸证。痛不可近。小陷胸证。按之则痛。大陷胸证。痛连心上。小陷胸证。正在心
下。同一陷胸。证隔天渊。不能通用。
桔梗 贝母（各三分） 巴豆（一分去皮心熬黑研如脂）
上三味为末。纳巴豆。更于臼中杵。以白饮和服。强人服半钱匕。羸者减之。病在膈上
必吐。
在膈下必利不利进热粥一杯。利过不止。进冷粥一杯。身热皮粟不解。欲引衣自覆者。若以
水之洗之。益令热却不得出。当汗而不汗。则烦。假令汗出已。腹中痛与芍药三两。如上
法。此为寒实结胸立法。以其胸之结也。用桔梗贝母以开结。以其寒之实也。用巴豆以攻寒
。与大小结胸不同法。必审无大热者方可用。
寒实结胸。恰从何辨其为寒实。而可任此方之猛峻耶。盖本衣冠文物言病发于阳。以冷水灌
之
之。其热被却不得去。太阳寒水之气。复与外寒相格。因成寒实之证。故可主以此汤无疑也
。
经言寒实结胸无大热者。与三物小陷胸汤。白散亦可服。夫小陷胸之黄连。与此方之巴
豆。
寒热天渊。何堪通用。想三物小陷胸汤。即属白散之药味。但有为汤为散之不同。此说亦是
。
Coptidis Rhizoma (1 liang) Pinelliae Tuber (0.5 sheng, washed) Trichosanthis Fructus (one large fruit)
Take the above three herbs. Add six sheng of water. First decoct the Trichosanthis Fructus until three sheng remain. Strain to remove the dregs. Add the remaining herbs. Decoct until two sheng remain. Strain to remove the dregs. Divide into three doses and take warm.
Xiao Xin Xiong Bing (Minor Chest Binding Disease). The location is exactly at the heart below (epigastrium). It hurts only when pressed. The pulse is floating and slippery. Compared with the Da Xin Xiong Zheng (Major Chest Binding Syndrome), where pain extends from the heart below to the lower abdomen and is intolerable to touch, there is a clear distinction. The pathogenic factor has not penetrated deeply; therefore, this formula uses Huang Lian (Coptidis Rhizoma) to clear heat, and Gua Lou (Trichosanthis Fructus) combined with Ban Xia (Pinelliae Tuber) to dissipate nodulation. It only opens the heat binding in the Middle Jiao without affecting the Lower Jiao, hence it is called "Minor".
Da Xian Xiong Zheng (Major Inward Binding Syndrome). Pain is severe and cannot be touched. Xiao Xian Xiong Zheng (Minor Inward Binding Syndrome). Hurts only when pressed. Da Xian Xiong Zheng. Pain involves the heart below. Xiao Xian Xiong Zheng. Location is strictly at the heart below. Both are "Inward Binding," yet the syndromes are as different as heaven and earth, and they cannot be used interchangeably.
Jie Geng (Platycodonis Radix) Bei Mu (Fritillariae Bulbus, each 3 fen) Ba Dou (Crotonis Fructus, 1 fen, skin and core removed, stir-fried black, ground into paste)
Grind the above three herbs into fine powder. Mix in the Ba Dou. Further pound in a mortar. Harmonize with Bai Yin (rice water) for administration. For robust individuals, administer half a Qian Bi dose. For frail individuals, reduce the dose. If the pathology is above the diaphragm, vomiting will necessarily occur.
If the pathology is below the diaphragm, diarrhea will necessarily occur. If there is no diarrhea, drink one cup of hot porridge to promote efficacy. If diarrhea persists uncontrollably, drink one cup of cold porridge to stop it. If body heat and cutaneous gooseflesh persist unresolved, and the patient desires to cover themselves with clothes: if bathed with cold water, it will further cause heat to retreat and become trapped, unable to exit. If sweating should occur but does not, restlessness will ensue. If, after sweating, abdominal pain occurs, add Shaoyao (Paeoniae Radix Alba) 3 liang, following the aforementioned method. This establishes the treatment principle for Han Shi Jie Xiong (Cold-Excess Chest Binding). Because there is binding in the chest, Jie Geng and Bei Mu are used to open the binding; because it is a Cold-Excess condition, Ba Dou is used to attack the cold. This differs from the methods for Major and Minor Chest Binding. It can only be used after confirming the absence of significant heat.
Han Shi Jie Xiong (Cold-Excess Chest Binding). How precisely can one distinguish it as a Cold-Excess syndrome, thereby daring to use such a fierce and峻烈 (potent/rough) formula? Generally, it is said that for patients from civilized regions, when a disease originates from Yang, pouring cold water over them causes the heat to be suppressed and unable to disperse. The Taiyang Cold-Water Qi then conflicts with external cold, resulting in a Cold-Excess syndrome. Thus, using this decoction is undoubtedly appropriate.
The Classic states: "For Cold-Excess Chest Binding without significant heat, San Wu Xiao Xin Xiong Tang (Three-Ingredient Minor Chest Binding Decoction) may be given; Bai San (White Powder) may also be taken." The Huang Lian in Xiao Xin Xiong Tang and the Ba Dou in this formula differ vastly in cold and heat properties, like heaven and earth. How can they be used interchangeably? I surmise that "San Wu Xiao Xin Xiong Tang" refers to the same herbal ingredients as Bai San, differing only in preparation form (decoction vs. powder). This explanation is also plausible.