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Jie Xiong (Chest Binding Syndrome) arises from pathogenic factors lingering in the chest. The chest is located at a high position in the body, and when pathogens accumulate there, it might seem appropriate to use diaphoresis (sweating method). However, what is meant by "binding" is like a tightly knotted rope that cannot be untied on its own. The Qi of all Yang meridians converges in the chest; when pathogenic factors bind with Yang Qi, they cannot separate, leading to obstruction of Qi flow. This stagnation accumulates in the epigastrium, causing hardness and pain. This indicates that the pathogen is indeed bound in the chest, which differs from deficiency-heat vexation or fullness in the diaphragm. Therefore, purgatives must be used to resolve it. According to the principle "raise what is low, depress what is high," the goal is to restore balance. Jie Xiong involves high-level pathogens, so a depressing method is needed to level it. Hence, the formula for treating Jie Xiong is called Xian Xiong Tang (Major Inward-Draining Chest Decoction).

Gansui (Kansui Root) has a bitter and cold nature. Bitterness drains downward, and cold overcomes heat. Although it clears heat, Gansui acts like penetrating through gaps, reaching the Qi directly to break the chest binding. Only such direct-penetrating herbs can reach the pathology, so Gansui serves as the Sovereign herb. Mangxiao (Natrii Sulfas) has a salty and cold nature. The *Neijing* states: "Salty flavor descends and drains, belonging to Yin." It also says: "Salty softens hardness." For conditions of solidified Qi, salty flavors are used to soften them; for excessive heat, cold properties are used to eliminate it. Thus, Mangxiao serves as the Minister herb. Dahuang (Rhei Radix et Rhizoma), with a bitter and cold nature, is known as the "General." It sweeps away pathogenic invaders and removes imbalance, fulfilling the role of a general. To drain heat in Xian Xiong Tang, Dahuang serves as the Envoy herb. Among purgative drugs, this is a harsh/decocting formula. Typhoid disorders are complex and severe, with Jie Xiong being the most serious. Without this decoction, unblocking is impossible. The dosage is large but the number of ingredients is small, aiming for speed to decompose the bound pathogens. This is the formulation of an extraordinary prescription. The *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) states: "Even if the binding is large, it can still be resolved." In typhoid bindings, one cannot wait long; apart from Xian Xiong Tang, what else could resolve it?

Gansui (Sovereign, 1 qian 7 fen) Mangxiao (Minister, 1 sheng) Dahuang (Envoy, 6 liang, peeled)

Take the above three ingredients. Add 6 sheng of water. First boil Dahuang until reduced to 2 sheng. Remove dregs. Add Mangxiao. Boil for one or two boils. Add Gansui powder. Take 1 sheng warm. If rapid purgation occurs, stop taking the remaining medicine.

Xian Xiong Tang attacks binding, while Xi Xin Tang (Minor Inward-Draining Heart Decoction) attacks Pi (fullness/stuffiness). When Qi binds and does not disperse, accumulating and obstructing, it forms Jie Xiong; Xian Xiong Tang is a direct-penetrating agent. When blockage prevents passage, and Yin-Yang fail to interact, forming Pi; Xi Xin Tang is a decomposing agent. It is called "Xi Xin" because it drains pathogens from the heart region. There is a distinction in location between Pi and Jie Xiong. Jie Xiong involves pathogens bound in the chest, hence treated with Xian Xiong Tang. Pi involves pathogens lingering in the epigastrium (heart region), hence treated with Xi Xin Tang.

Huanglian (Coptidis Rhizoma) is bitter and cold. Huangqin (Scutellariae Radix) is bitter and cold. The *Neijing* states: "Bitter flavor enters the Heart first; use bitter to drain." Treating Pi requires bitterness as the main component. Thus, Huanglian serves as the Sovereign herb, and Huangqin as the Minister, to descend Yang and ascend Yin. Banxia (Pinelliae Rhizoma) is acrid and warm. Ganjiang (Zingiberis Rhizoma) is acrid and hot. The *Neijing* states: "Acrid flavor moves Qi; use acrid to disperse." Dispersing Pi requires acrid assistance. Thus, Banxia and Ganjiang serve as Assistant herbs, to differentiate Yin and move Yang. Gancao (Glycyrrhizae Radix et Rhizoma) is sweet and neutral. Dazao (Jujubae Fructus) is sweet and warm. Renshen (Ginseng Radix) is sweet and warm. When Yin and Yang do not intersect, it is called Pi; when upper and lower do not communicate, it is called Man (fullness). To connect upper and lower, and allow Yin-Yang interaction, the Middle Jiao must be harmonized. The Middle Jiao refers to the Spleen and Stomach. When Spleen Qi is deficient, it is tonified with sweet flavors. Thus, Renshen, Gancao, and Dazao serve as Envoy herbs to tonify the Spleen and harmonize the Middle. When Middle Qi is harmonized, upper and lower flow freely, Yin and Yang return to their proper positions, Water ascends and Fire descends. Then Pi resolves, heat subsides, and the disease is solved through profuse sweating.

Huanglian (Sovereign, 4 liang) Huangqin (Minister, 3 liang) Banxia (Assistant, 0.5 sheng, washed) Ganjiang (Assistant, 3 liang) Renshen (Envoy, 3 liang) Gancao (Envoy, 3 liang, honey-fried) Dazao (Envoy, 12 pieces, split)

Take the above seven ingredients. Add 1 dou of water. Boil to obtain 6 sheng. Remove dregs. Decoct again to obtain 3 sheng. Take 1 sheng warm, three times daily.