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If Shaoyang disease is treated with purgation too early, resulting in hardness, fullness, and pain from the epigastrium down to the lower abdomen, such that the area cannot be touched by hand, this is Jie Xiong (Chest Binding Syndrome), which this formula treats.

Gansui (1 qian, powdered) Mangxiao (1 sheng) Dahuang (2 liang) Add six sheng of water, first decoct Dahuang until two sheng remain, strain off the dregs,
add Mangxiao, boil once, then add Gansui powder, take one sheng warm. If rapid evacuation occurs, stop taking the remainder.

When the exterior syndromes of the Three Yang channels are not yet resolved, using Chengqi Tang to attack the interior constitutes premature purgation. Premature purgation leads to deficiency in the interior, allowing exterior pathogenic factors to penetrate inward, causing excess in the Sanjiao (Triple Burner). Thus, there is severe pain from the epigastrium to the lower abdomen that cannot be touched. Cheng Wuji stated: All Yang qi gathers in the chest. When pathogenic factors bind with Yang qi and cannot be separated, if the condition is high, it sinks into the chest; hence it is called "Xian Xiong" (Sunken Chest). To break the binding of Xian Xiong, only bitter-cold herbs that reach directly can suffice; therefore, Gansui is used as the Sovereign herb. The Classic states: Salty flavors induce vomiting and purgation and belong to Yin; also: Salty flavors soften hardness. Therefore, Mangxiao is used as the Minister herb to sweep away pathogenic invaders, fulfilling the role of a General. Thus, Dahuang is used as the Envoy herb. Among all severe conditions of Shaoyang disease, Jie Xiong is the most serious, and only this formula can ensure unobstructed flow.

If purgation is performed too early, heat binds in the chest, causing pain only upon pressure, this is Xiao Jie Xiong (Minor Chest Binding Syndrome).

Banxia (washed with hot water, half sheng) Huanglian (1 liang) Gualou Shi (one large fruit) Add six sheng of water, first decoct Gualou until three sheng remain, strain off the dregs, add the other herbs, decoct to obtain two sheng, divide into two doses and take warm.

The pathology is confined to the chest and does not extend to the abdomen; pain occurs only upon pressing, but not when unpressed; hence it is called "Xiao Jie Xiong" (Minor Chest Binding). The Classic states: Bitter flavors drain downward, and pungent flavors disperse. Huanglian drains heat from the chest, Gualou drains Qi stagnation from the chest, and Banxia disperses Phlegm from the chest. If one dose fails to harmonize immediately, a second dose will provide slight relief, and after evacuating yellow turbid fluid, peace will be restored.

Treats Shaoyang dry-heat, constrained mental restlessness, vexation and regretfulness with insomnia, accumulation of heat in the Zang-Fu organs causing irritability and thirst, dizziness and cracked lips, dry throat and Bi syndrome, red and irritable eyes, sores on the mouth and tongue, thick and sticky sputum, delirium and madness, dryness and constipation of the intestines and stomach, closure of urination and defecation, stagnation of Wind-Heat, eruption of sores and rashes, blackening and sinking of rashes indicating imminent death.

Lianqiao (1 liang) Shanzhi Dahuang Bohe Huangqin (each 5 qian) Gancao (1 liang 5 qian) Puxiao (2 qian 5 fen) Process into coarse powder. Take 5 qian per dose, decoct in water and take warm. Another version includes Huanglian.