大黄（半斤） 葶苈子（熬） 芒硝 杏仁（去皮尖熬黑，各半升） 上四味，捣筛二味，纳杏仁、芒硝，合研
如脂，和散，取如弹丸一枚，别捣甘遂末一钱匕，白蜜二合，水二升，煮取一升，温顿服之，一宿乃下，如不
下，更服，取下为效。
病发于阳，而反下之，热入因作结胸，病发于阴，而反下之，热入因作痞。此明所以致结胸与痞之故。
发热恶寒之症，则热入于阳位而作结胸，无热恶寒之症，则热入于阴位而作痞，故治结胸用寒剂，治痞用
温剂也。所以成结胸者，以下之太早故也。二病未尝不可下，但各有其时，不可过早耳。结胸者，项亦强，
如柔痉状，此陷胸之外症。下之则和，宜大陷胸丸。
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，去渣，纳诸药，
煮取二升，去渣，分温三服，一服未和，再服微解，下黄涎，便安也。按∶大承气所下者，燥屎；大陷胸
所下者，蓄水；此所下者，为黄涎。涎者，轻于蓄水，而未成水者也。审病之精，用药之切如此。
小结胸病，正在心下，按之则痛，上不至心，下不及少腹，必按之方痛，非不可近乎，与大陷胸症迥
别。脉浮滑者，不若大陷胸症之沉紧，其邪未入深也。小陷胸汤主之。
Rhizoma et Radix Rhei (Dahuang, 大黄) [0.5 jin], Semen Lepidii seu Descureniae (Tinglizi, 葶苈子) [roasted], Natrii Sulfas (Mangxiao, 芒硝), Semen Armeniacae Amarum (Xingren, 杏仁) [dehulled and deseeded, roasted until dark brown] [each 0.5 sheng]. The above four herbs: crush and sieve two of them, add Xingren and Mangxiao, grind together until paste-like, mix with powder. Take one pill-sized amount (like a bullet). Independently grind Gan Sui end (Gansui, 甘遂) to powder, one qianbi. Add Bai Mi (White Honey, 白蜜) [2 he] and water [2 sheng]. Boil to obtain 1 sheng. Take warm in one dose overnight. If stool is not passed, administer again. Passing stool indicates efficacy.
When the disease originates in Yang, and purgation is wrongly applied, heat enters and forms Jie Xiong (Chest Binding, 结胸); when the disease originates in Yin, and purgation is wrongly applied, heat enters and forms Pi (Stagnation, 痞). This clarifies the causes of Jie Xiong and Pi. Symptoms of fever and aversion to cold indicate heat entering Yang positions to form Jie Xiong; symptoms of no fever but aversion to cold indicate heat entering Yin positions to form Pi. Therefore, treat Jie Xiong with cold-natured agents, and treat Pi with warm-natured agents. The reason for forming Jie Xiong is that purgation was applied too early. Both diseases can be treated with purgation, but each has its appropriate timing; it must not be applied too early. In Jie Xiong syndrome, the neck is also stiff, resembling Rou Jing (Soft Spasm, 柔痉). This is an external manifestation of the Xian Xiong (Depress the Chest, 陷胸) syndrome. Purging leads to harmony; Da Xian Xiong Wan (Major Depress the Chest Pill, 大陷胸丸) is indicated.
Radix Coptidis (Huanglian, 黄连) [1 liang], Rhizoma Pinelliae Preparatum (Banxia, 半夏) [0.5 sheng, washed], Fructus Trichosanthis (Gualou Shi, 栝蒌实) [one large fruit]. The above three herbs: use 6 sheng of water. First boil Gualou, obtain 3 sheng, remove dregs. Add other herbs, boil to obtain 2 sheng, remove dregs. Divide into three warm doses. If not relieved after one dose, take another; slight relief occurs, yellow phlegm-fluid is discharged, and comfort is restored. Note: Da Cheng Qi Tang (Major Order the Qi Decoction, 大承气汤) discharges dry feces; Da Xian Xiong Tang discharges accumulated water; this formula discharges yellow phlegm-fluid. Phlegm-fluid is lighter than accumulated water, being fluid that has not yet fully accumulated. Such precision in diagnosing illness and appropriateness in medication is remarkable.
Xiao Jie Xiong Bing (Minor Chest Binding Disease, 小结胸病) is located exactly at Xin Xia (Epigastrium, 心下). Pain occurs only upon pressure. It does not extend upward to the heart or downward to the Shao Fu (Lower Abdomen, 少腹). Pain requires pressure; it is not untouchable, distinctly different from Da Xian Xiong syndrome. A floating and slippery pulse differs from the deep and tight pulse of Da Xian Xiong syndrome, indicating the pathogen has not penetrated deeply. Xiao Xian Xiong Tang (Minor Depress the Chest Decoction, 小陷胸汤) is the primary treatment.