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(Attached: Baisan Formula)
After the Daxiexiong Tang (Major Scrofula-Resolving Decoction), the Shanghan Lun (Treatise on Cold Damage Disorders) further records the Xiaoxiexiong Tang (Minor Scrofula-Resolving Decoction) to treat mild cases of Jie Xiong (Chest Binding Syndrome). Presumably, because the condition is mild, the treatment formula should also be gentle and light.

The original text of the Shanghan Lun states: "In minor chest binding syndrome, the pathology is located precisely at the Xin Xia (epigastrium/substernal region); it causes pain only upon palpation, and the pulse is floating and slippery; this is primarily treated with Xiaoxiexiong Tang." Regarding the specific location of "Xin Xia," various commentators have argued whether it lies above or below the diaphragm. Reasoning from medical principles, it is actually more accurate to consider it above the diaphragm. This is because the area above the diaphragm belongs to the Taiyang (Greater Yang) channel territory, whereas the area below does not. Furthermore, preceding the discussion on minor chest binding (Article 139), it is stated: "In a Taiyang disease, after severe sweating and subsequent mistaken purgation, if there has been no bowel movement for five or six days, accompanied by a dry tongue and thirst, slight afternoon tidal fever, hardness and fullness extending from the Xin Xia down to the lower abdomen, with severe pain that cannot be tolerated by pressure, Daxiexiong Tang should be used." Observing this description of the disease treated by Daxiexiong Tang, which involves symptoms extending downward, it confirms without doubt that "Xin Xia" still belongs to the chest region.

[Xiaoxiexiong Tang Formula] Huanglian (Coptidis Rhizoma) 1 liang, Banxia (Pinelliae Tuber) half sheng (washed with water), Gualou Shi (Trichosanthis Fructus) one large fruit.
Take the above three ingredients, add six sheng of water, first decoct the Gualou until three sheng remain, remove the dregs, add the remaining herbs, decoct again until two sheng remain, remove the dregs, and divide into three warm doses.

This syndrome arises from excessive fire in the Heart (Heart Fire) scorching and consuming the fluid retention in the Xin Xia, condensing into hot phlegm (the pulse presents as slippery, indicating hot phlegm; if there were phlegm without heat, the pulse would present as soggy/Ru). Simultaneously, the exterior Yang sinks inward following wind pathogens, intermingling with the hot phlegm like lacquer and glue. It stagnates in the Xin Xia, forming a feeling of fullness and obstruction (Pi Man), blocking the meridians in this region and preventing free flow, thus causing pain upon palpation. Since the etiology stems from blazing Heart Fire, Huanglian is used to pacify and extinguish the Heart Fire and resolve the accumulation of heat-fire. Banxia is added to open phlegm obstructions and direct Qi downward. Gualou clears phlegm and clears heat. Although the medicinal power of these herbs is far inferior to that of Daxiexiong Tang, they are fully capable of resolving the obstruction and fullness in the Xin Xia through dispersion and elimination.
However, when using this formula, the Gualou must be finely sliced, including its seeds, to ensure the medicinal efficacy is extracted during decoction.

If this syndrome involves only phlegm-fluid obstruction in the Xin Xia without the slippery-heat pulse indication, it can be treated with my proposed Dangxiong Tang (Draining Chest Decoction), provided the dosage is carefully reduced.

Beyond minor chest binding, there is also cold-solid chest binding (Han Shi Jie Xiong), which is completely different from the heat-induced minor chest binding; thus, its treatment method must be discussed separately. The Shanghan Lun states: "It is suitable to treat with Sanwu Xiaoxiexiong Tang." It also states: "Baisan may also be taken." Sanwu Xiaoxiexiong Tang is not recorded in the Shanghan Lun. Commentators suspect it might be the Xiaoxiexiong Tang, considering it a contrary treatment method. However, they misunderstand the concept of "Cong Zhi" (following/treating according to the nature of the disease, often implying counter-agency or guiding). If pure heat is used to treat cold, fear of rejection (Ge Ju) might arise, so a small amount of cooling herb is added as a guide within the pure heat formula. But if pure cooling is used to treat cold, it is like piling ice upon ice, making the coagulation even harder. From this, we know that for treating cold-solid chest binding, Xiaoxiexiong Tang absolutely cannot be used, but Baisan can be used. Therefore, I record its formula below.

[Baisan Formula] Jiegeng (Platycodonis Radix) 3 fen, Badou (Crotonis Fructus) 1 fen (peeled, heart removed, stir-fried black, ground into paste), Beimu (Fritillariae Bulbus) 3 fen.
Grind the above three ingredients into powder, mix in the Badou, and pound further in a mortar. Mix with rice water (Bai Yin) and administer. For strong individuals, take half a Qianbi (coin-shaped measure); for frail individuals, reduce by half. If the pathology is above the diaphragm, vomiting will occur; if below, diarrhea will occur. If there is no diarrhea, drink one cup of hot porridge to promote evacuation; if diarrhea persists excessively, drink one cup of cold porridge to stop it.

Note: The "fen" in the formula refers to proportion rather than weight. For example, Jiegeng and Beimu are each 3 parts, while Badou is 1 part, meaning Jiegeng and Beimu are twice the quantity of Badou, and Badou constitutes one-third of the quantity of either Jiegeng or Beimu. Badou is pungent and hot in nature, acting primarily as a purgative, and excels at breaking up cold accumulations. Therefore, it serves as the principal herb for cold-solid chest binding. Jiegeng and Beimu are added as assistants because Jiegeng not only carries the medicinal power upward but also opens the airways in the Lung, facilitating respiration. Beimu is an essential herb for treating coughs and effectively resolves phlegm-Qi stagnation in the chest and epigastrium. Badou must be stir-fried black before use because its nature is extremely fierce; charring reduces its ferocity. Nevertheless, it is still not used in large amounts. The term "half a Qianbi" refers to the total combined weight of the three herbs, which converts to approximately 1.5 liang in modern units (note: historical unit conversion varies, here interpreted as small fraction). Within this, the amount of Badou is only slightly over 2 li. For those with weak constitutions, it should be used sparingly, demonstrating extreme caution.

In the Baisan formula, the proportions of Jiegeng and Beimu are not critical. However, since Badou is the principal herb, using only slightly over 2 li (of the total mixture) makes it difficult to achieve efficacy despite its potency. This suggests a transcription error in the dosages. I once encountered a case of cold-solid chest binding cured solely by using Badou, which I record in detail here to verify this point.

A man nearing thirty years of age had chronic phlegm-fluid retention in his chest, often producing rattling sounds in his throat during breathing. In early spring, he went out exposed to cold, suffered excessive chilling, and hurried home to lie in bed. After resting for some time, he did not respond when called for dinner. He appeared to be in a deep sleep, with loud rattling sounds during respiration. He woke only when shaken, opened his eyes but could not speak, rubbing his chest with his hand, experiencing significant respiratory obstruction. Physicians diagnosed him with Tan Jue (Phlegm Syncope) and prescribed various formulas for this condition, all of which failed. Upon my examination, his limbs were ice-cold, and his pulse was deep, fine, and nearly imperceptible. I informed his family: "This is cold-solid chest binding; only the Baisan from the Shanghan Lun will suffice." I urgently purchased Badou, peeled it, removed the heart, stir-fried it black, and ground it. Wrapped in several layers of paper, I pressed out the oil (known as Badou Shuang/Croton Seed Frost in pharmacies; fearing improper preparation, I prepared it myself), weighed exactly 1.5 fen, and administered it with boiling water. After a while, a sensation of opening occurred in the chest, respiration became smooth, he could hum, and drank half a bowl of rice soup. The next morning, another dose was taken, resulting in bowel movement, significant symptom relief, recovery of the pulse, warming of the limbs, and ability to speak. He reported that previously he felt mentally confused and numb, but now felt chest fullness. I then prescribed a formula containing Ganjiang (Zingiberis Rhizoma), Guizhi Jian (Cinnamomi Ramulus), Renshen (Ginseng Radix et Rhizoma), and Houpo (Magnoliae Officinalis Cortex) to be taken for several doses to conclude treatment.

For those who fear the ferocity of Badou and dare not use it lightly, I have an alternative method. I cite another case to illustrate this.

A woman nearing forty years of age suffered from chronic cold-fluid retention and usually preferred taking Ganjiang and Guizhi. During severe winter, after spending a long time in a cold room counting furniture, she suddenly fainted and fell to the ground. Carried to bed, she could still speak, stating that she felt cold Qi rushing upward causing faintness, and now found breathing extremely laborious, requiring great effort to inhale. She urged immediate medication. Suddenly, she became confused again, and her breath nearly ceased. I happened to be treating another patient in her village and was urgently summoned. Her pulse was minute and fine, almost imperceptible, with fewer than four beats per cycle. After inquiring about her constitution and the cause of illness, I confirmed it was undoubtedly cold-solid chest binding. Medication was unavailable in time. Urgently, I used HuJiao (Piperis Longi Fructus) (pungent and hot, capable of opening cold obstructions), 3 qian, crushed and decocted for two or three boils, and slowly administered it. She immediately felt smoother respiration and no further fainting. I then prescribed: Ganjiang and Sheng Huaishanyao (Dioscoreae Hypoglaucae Rhizoma) each 6 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) and Danggui (Angelicae Sinensis Radix) each 4 qian, Guizhi Jian, Banxia, and Gancao (Glycyrrhizae Radix et Rhizoma) each 3 qian, and Houpo and Chenpi (Citri Reticulatae Pericarpium) each 2 qian. After two doses, the illness improved by eighty to ninety percent. Subsequent prescriptions were slight modifications of this formula, taken for several doses to conclude treatment.