病发于阳，而反下之，热入因作结胸。病发于阴，而反下之，因作痞。所以成结胸者，以下之太早故也。
按卫气为阳，风伤卫者，病发于阳也。卫伤则遏逼营血，而生里热，血化于脏，脏阴衰者，多传于阳
明之腑。营血为阴，寒伤营者，病发于阴也。营伤则束闭卫气，而生表寒，气化于腑，腑阳弱者，多传于太
阴之脏。病发于阳者，俟其热邪传里，已入胃腑，非不可下，方其在经，法应汗解，而反下之，表阳内陷，
而成结胸。病发于阴者，内寒郁动，易入脾脏，始终忌下。方其在经，亦应汗解，而反下之，里阴上逆，
则成痞证。太阳之病不解于太阳之经，而内传脏腑，生死攸关，是皆太阳之坏病也。然入腑则用承气，入脏
则用四逆，犹有救坏之法。至于未入胃腑，下早而为结胸，未入脾脏，误下而成痞证，则坏而又坏矣。
仲景变承气而为陷胸，变四逆而为泻心，所以救坏中之坏也。
按结胸证重者，以大陷胸汤，大陷胸丸主之。轻者以小陷胸汤主之。痞证表未解而里虚，以桂枝
人参汤主之。表已解而里实，上有热，以大黄黄连泻心汤主之。表已解而里实，下有寒，以附子泻心汤
主之。表解而里有水，以十枣汤主之。表解而里有寒、有热，以生姜泻心汤，甘草泻心汤主之。里湿而便滑
，以赤石脂禹余粮汤主之。里湿而水停，以五苓散主之。表解而里郁，以旋复花代赭石汤主之。里寒而可
吐，以瓜蒂散主之。
The disease originates in the Yang pattern, but if purgation is incorrectly applied, heat enters and results in Jie Xiong (Chest Binding). The disease originates in the Yin pattern, but if purgation is incorrectly applied, Pi Syndrome (Stagnant Lump) ensues. The reason for the formation of Jie Xiong is that purgation was administered too early.
Note: Wei Qi (Defensive Qi) belongs to Yang; Wind pathogen injuring Wei Qi constitutes a disease originating in Yang. When Wei Qi is injured, it obstructs and forces Ying Blood (Nutritive Blood), generating interior heat. As blood transforms within the Zang organs, if Zang Yin is deficient, the condition often transmits to the Fu organs of the Yangming channel. Ying Blood belongs to Yin; Cold pathogen injuring Ying Blood constitutes a disease originating in Yin. When Ying Blood is injured, it binds and closes off Wei Qi, generating exterior cold. As Qi transforms within the Fu organs, if Fu Yang is weak, the condition often transmits to the Zang organs of the Taiyin channel.
For diseases originating in Yang, once the heat pathogen has transmitted to the interior and entered the Stomach Fu organ, purgation may not be contraindicated. However, while the pathogen is still in the meridians, the appropriate method should be diaphoresis (sweating); incorrectly applying purgation causes Exterior Yang to sink inward, resulting in Jie Xiong. For diseases originating in Yin, interior cold stagnates and moves, easily transmitting to the Spleen Zang organ; purgation should always be avoided. While the pathogen is still in the meridians, diaphoresis should also be employed; incorrectly applying purgation causes Interior Yin to rebel upward, resulting in Pi Syndrome.
Taiyang disease that fails to resolve at the Taiyang meridian level and instead transmits internally to the Zang and Fu organs involves life-and-death stakes; these are all considered Huai Bing (Ruined Diseases due to mistreatment) of Taiyang. Nevertheless, if the pathogen enters the Fu organs, Chengqi Decoctions are used; if it enters the Zang organs, Sini Decoctions are used, providing methods to rescue ruined diseases. However, if purgation is applied too early before the pathogen enters the Stomach Fu organ, resulting in Jie Xiong; or if purgation is mistakenly applied before the pathogen enters the Spleen Zang organ, resulting in Pi Syndrome, this constitutes a "ruin within ruin." Zhang Zhongjing transformed Chengqi Decoction into Xianxiong Decoction, and transformed Sini Decoction into Xiexin Decoction, precisely to rescue such conditions.
Note: For severe cases of Jie Xiong syndrome, Da Xianxiong Tang (Major Chest-Binding Decoction) and Da Xianxiong Wan (Major Chest-Binding Pill) are indicated. For mild cases, Xiao Xianxiong Tang (Minor Chest-Binding Decoction) is indicated. For Pi Syndrome where the exterior pattern remains unresolved and the interior is deficient, Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) is indicated. If the exterior pattern has resolved and the interior is excess with heat above, Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Heart-Draining Decoction) is indicated. If the exterior pattern has resolved and the interior is excess with cold below, Fuzi Xiexin Tang (Aconite Heart-Draining Decoction) is indicated. If the exterior pattern has resolved but water retention exists in the interior, Shizao Tang (Ten Jujube Decoction) is indicated. If the exterior pattern has resolved but there is a mixture of cold and heat in the interior, Shengjiang Xiexin Tang (Fresh Ginger Heart-Draining Decoction) and Gancao Xiexin Tang (Licorice Heart-Draining Decoction) are indicated. If there is dampness in the interior accompanied by loose stools, Chishizhi Yuyuliang Tang (Red Halloysite and Hematite Decoction) is indicated. If there is dampness in the interior with fluid retention, Wuling San (Five-Ingredient Powder with Poria) is indicated. If the exterior pattern has resolved but there is interior Qi depression, Xuanfuhua Dahezeshi Tang (Inula Flower and Magnetite Decoction) is indicated. If there is interior cold suitable for emesis, Gouti San (Melon Sprout Powder) is indicated.