栀子（十四枚擘） 香豉（四合绵裹）
上二味。以水四升。先煮栀子。得二升半。内豉。煮取一升半。去滓。分为二服。温进一服。得吐者。止后服。
成氏明理论云。伤寒邪气自表而传里。留于胸中。为邪在高分。则可吐之。是越之之法也。所吐之证。亦自不同。
如不经汗下。邪气蕴郁于膈。则谓之膈实。应以瓜蒂散吐之。瓜蒂散。吐胸中实邪者也。若发汗吐下后。邪气乘虚。留
于胸中。则谓之虚烦。应以栀子豉汤吐之。栀子豉汤。吐胸中虚烦者也。栀子味苦寒。内经曰。酸苦涌泄为阴。涌者。
吐之也。涌吐虚烦。必以苦为主。是以栀子为君。烦为热胜也。涌热者。必以苦。胜热者必以寒。香豉味苦寒。助栀子
以吐虚烦。是以香豉为臣也。
琥按方中栀子十四枚。当是四十枚。否则香豉四合。分两多寡。不相称矣。
琥按栀子豉汤。仲景虽用以吐虚烦之药。余曾调此汤。与病患服之。未必能吐。何也。盖栀子之性苦寒。能清胃火。
润燥。豉性苦寒微甘。能泻热。而兼下气调中。所以其苦未必能使人吐也。医工必欲升散火郁。当于病患喉中。探之使
吐可耳。又用豉法。须陈腐极臭者能使人吐。方中云香豉。恐医工用豉。反取新制而气不臭者。无怪乎其不能使人吐也。
若少气者。栀子甘草豉汤主之。若呕者。栀子生姜豉汤主之。（此承上文而言。发汗吐下后。已见虚烦不眠证矣。若
其人兼少气者。成注云。热伤气也。故加甘草以益之。若兼呕者。热烦而气逆也。故加生姜以散之。）
Zhi Zi (Gardeniae Fructus, fourteen pieces, broken) Xiang Chi (Fermented Soybean, four he, wrapped in silk cloth)
Take the above two ingredients. Add four sheng of water. First decoct Zhi Zi until half a sheng remains (two and a half sheng). Then add Xiang Chi. Continue to decoct until one and a half sheng of liquid remains. Strain the dregs. Divide the liquid into two doses. Take one dose warm. If vomiting occurs after taking the medicine, stop taking the remaining dose.
Cheng Wuji stated in *Ming Lilun* (Theory of Clarification): In Shanghan (Cold Damage), pathogenic factors transmit from the exterior to the interior and remain in the chest. This indicates that the pathogen is located at a high position, and thus emesis (vomiting therapy) can be employed. This is the method of "Yue" (lifting and dispersing). The syndromes treated also vary.
If no sweating or purging has been performed, and pathogenic factors are constrained and stagnant in the diaphragm, it is called "Ge Shi" (Diaphragmatic Excess). One should use Gua Di San (Melon Seed Powder) to induce vomiting. Gua Di San is used to expel excess pathogens from the chest. However, if after sweating, vomiting, or purging, pathogenic factors take advantage of the deficiency and remain in the chest, it is called "Xu Fan" (Deficiency Irritability). One should use Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) to induce vomiting. Zhi Zi Chi Tang is used to expel deficiency irritability from the chest. Zhi Zi has a bitter and cold nature. The *Neijing* states: "Sour and bitter flavors have the effect of涌泄 (upward discharge and downward evacuation), belonging to Yin." "Yong" refers to inducing vomiting. To induce vomiting for deficiency irritability, bitter herbs must be primary. Therefore, Zhi Zi is used as the Jun (Monarch) herb. Irritability is caused by excessive heat. To discharge heat via vomiting, bitter herbs are necessary. To overcome heat, cold herbs are necessary. Xiang Chi has a bitter and cold nature with slight sweetness. It assists Zhi Zi in expelling deficiency irritability. Therefore, Xiang Chi is used as the Chen (Minister) herb.
Hu notes: The fourteen pieces of Zhi Zi in the formula should likely be forty pieces; otherwise, the weight ratio between four he of Xiang Chi and the Zhi Zi would be disproportionate.
Hu notes: Although Zhang Zhongjing used Zhi Zi Chi Tang as an emetic for deficiency irritability, I have prepared this decoction for patients, and it did not necessarily induce vomiting. Why? Because Zhi Zi's nature is bitter and cold, capable of clearing Stomach fire and moistening dryness. Chi's nature is bitter, cold, and slightly sweet, capable of draining heat and directing Qi downward while harmonizing the middle. Thus, its bitterness may not necessarily induce vomiting. If physicians wish to disperse Fire stagnation through ascending and dispersing methods, they can simply stimulate the patient's throat to induce vomiting. Furthermore, regarding the use of Chi, only aged, rotten, and extremely foul-smelling Chi can induce vomiting. The formula specifies "Xiang Chi" (Fragrant Chi). It is feared that physicians might use newly processed Chi which lacks the foul odor, explaining why it fails to induce vomiting.
If accompanied by shortness of breath (Shao Qi), Zhi Zi Gan Cao Chi Tang (Gardenia, Licorice, and Fermented Soybean Decoction) is indicated. If accompanied by vomiting, Zhi Zi Sheng Jiang Chi Tang (Gardenia, Ginger, and Fermented Soybean Decoction) is indicated. (This follows the preceding text. After sweating, vomiting, or purging, symptoms of deficiency irritability and insomnia have already appeared. If the patient additionally presents with shortness of breath, Cheng's commentary states that heat damages Qi, so Gan Cao (Licorice Root) is added to tonify Qi. If accompanied by vomiting, it indicates heat irritability causing rebellious Qi, so Sheng Jiang (Fresh Ginger Rhizome) is added to disperse the rebellion.)