大黄（三两清酒浸去皮） 甘草（二两炙） 芒硝（半斤）
上三味。 咀。以水三升。煮取一升。去滓。纳芒硝。更上火微煮令沸。少少温服。
调胃承气汤。以甘草缓硝黄下行之性。使留恋中焦胃分。以清热而导滞。不用枳朴以伤
上焦
之气。盖热邪聚胃。宜分有形无形。有形者。当破其结而秽方解。无形者。但涤其热而气自
和。胃宜降则和。故曰调胃。
桃仁（五十个去皮尖） 桂枝（二两去皮） 大黄（四两） 芒硝（二两） 甘草（二两炙）
上五味。以水七升。煮取二升半。去滓。纳芒硝。更上火微沸。下火。先食温服五合。
日三服。当微利。
此治太阳瘀热入腑。膀胱蓄血。其人如狂。表已解而但少腹急结。血自下者。主用桃仁
以利瘀。承气以逐实。使血分之结热。亟从下夺。与三承气之攻阳明胃实者不同。
方主攻里。而仍用桂枝者。用以分解太阳随经之热。喻嘉言曰。正恐余邪稍有未尽。其
血得
以留恋不下。析义最精。此先圣处方丝丝入扣处。此与五苓散同为太阳府病立治法。膀胱为
太阳之府。热伤膀胱气分则蓄溺。当导其热从小便而解。热伤膀胱血分则蓄血。当导其热从
大便而解。
水蛭（三十个熬） 虻虫（三十个去翅足熬） 大黄（三两酒浸） 桃仁（三十个去皮尖）
上四味。为末。以水五升。煮取三升。去滓。温服一升。不下。再服。
抵当。攻血之峻剂也。视桃仁承气则加猛矣。盖病不止如狂而至于发狂。则逆血攻心。
瞬将
危殆。虽表证仍在。难任桂枝攻表。虽少腹硬满。不事芒硝软坚。非迅走血分之品。不能斩
关取胜。而桃仁大黄。犹以力缓而难膺重寄。故必资水蛭虻虫。方能直入血道。峻夺其邪。
转逆为顺。然抵当峻剂。从何谛实血证。可以用之无误。而仲景教人辨证之法。全以小便之
利与不利为断。小便不利。非蓄血证。小便自利。非蓄水证。故经特申言之曰。小便不利者
。为无血也。小便自利其人如狂者。血证谛也。谛者审也。又当也。言当审之至当也。
Dahuang (San liang, soaked in clear wine and peeled) Gancao (Liang liang, honey-fried) Mangxiao (Ban jin)
The above three ingredients. Cut into small pieces. Decoct with three sheng of water to obtain one sheng of liquid. Strain the dregs. Add Mangxiao. Heat again slightly until boiling. Take warm in small amounts frequently.
Tiaowei Chengqi Tang (Regulate the Stomach and Drain the Intestines Decoction), uses Gancao to moderate the downward-draining nature of Mangxiao and Dahuang, allowing them to linger in the middle jiao (middle burner) at the stomach level, to clear heat and guide stagnation. It does not use Zhishi (Immature Bitter Orange) or Houpo (Magnolia Bark) to avoid damaging the qi of the upper jiao (upper burner). Since heat pathogens gather in the stomach, it is necessary to distinguish between tangible (有形) and intangible (无形) pathogens. For tangible pathogens, their knots must be broken so that turbid matter can be resolved; for intangible pathogens, merely purging the heat will harmonize the qi naturally. The stomach qi should descend to achieve harmony, hence it is called "Regulating the Stomach."
Taoren (Fifty seeds, peeled and removed of kernels) Guizhi (Er liang, peeled) Dahuang (Si liang) Mangxiao (Er liang) Gancao (Er liang, honey-fried)
The above five ingredients. Decoct with seven sheng of water to obtain two and a half sheng of liquid. Strain the dregs. Add Mangxiao. Heat again slightly until boiling. Remove from fire. Take warm before meals, five ge per dose. Administer three times daily. A mild diarrhea is expected.
This treats Taiyang (Greater Yang) stasis-heat entering the fu organs, specifically Bladder Xue accumulation (Blood Retention Syndrome). The patient exhibits mental agitation resembling madness. The exterior syndrome has been resolved, leaving only urgency and binding in the lower abdomen. If blood can discharge spontaneously, Taoren is primarily used to promote blood circulation and remove stasis, while Chengqi-type formulas are used to purge excess, causing the heat bound in the blood level to be rapidly expelled downwards. This differs from the San Chengqi Tangs which attack Yangming Stomach excess.
Although this formula mainly attacks interior excess, Guizhi is still used to resolve residual heat from the Taiyang channel transmitted along the meridians. Yu Jiayan stated: One fears that if residual pathogens remain even slightly, the blood may linger and fail to descend; this analysis is most profound. This reflects the meticulous precision of the ancient sages' prescriptions. This formula, along with Wuling San (Five-Ling Powder), establishes treatment methods for Taiyang Fu organ diseases. The Bladder is the Fu organ of Taiyang. When heat damages the Qi level of the Bladder, it causes Water Retention (Urinary Retention), and heat should be guided out through urination. When heat damages the Blood level of the Bladder, it causes Blood Retention, and heat should be guided out through defecation.
Shuizhi (Thirty leeches, processed by heating) Mengchong (Thirty horseflies, wings and feet removed, processed by heating) Dahuang (San liang, wine-soaked) Taoren (Thirty seeds, peeled and removed of kernels)
The above four ingredients. Grind into powder. Decoct with five sheng of water to obtain three sheng of liquid. Strain the dregs. Take one sheng warm. If no effect, administer another dose.
Didang Tang (Resist the Core Decoction) is a harsh agent for attacking blood stasis. It is more potent than Taohe Chengqi Tang. Because the condition progresses from mental agitation resembling madness to actual mania, indicating rebellious blood attacking the heart, danger looms instantly. Although exterior symptoms persist, Guizhi Tang cannot be tolerated for releasing the exterior; although the lower abdomen is hard and full, Mangxiao is not used for softening hardness. Only drugs that swiftly traverse the blood level can break through barriers to achieve victory. Taoren and Dahuang are relatively mild and insufficient for such heavy responsibility. Therefore, Shuizhi and Mengchong are essential to enter the blood vessels directly, ruthlessly expel the pathogen, and turn rebellion into顺 (harmony). However, since Didang Tang is a harsh agent, how does one accurately diagnose blood stasis to use it without error? Zhang Zhongjing teaches that differentiation relies entirely on whether urination is unobstructed or obstructed. Obstructed urination indicates it is not a Blood Retention syndrome; free urination indicates it is not a Water Retention syndrome. Thus, the classic text explicitly states: "If urination is obstructed, there is no blood stasis. If urination is free and the person is manic, the blood stasis diagnosis is confirmed." "Di" means careful examination, implying one must judge with utmost precision.