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In addition to the Xiongxiang Decoctions (Chest-Trap Formulas), Pills, and Baisan (White Powder), there are several Xiexin Decoctions (Heart-Purging Formulas). Although named "Heart-Purging," they actually treat diseases of the chest. Generally speaking, the Xiongxiang formulas treat diseases caused by tangible phlegm-fluids in the chest, whereas the Xiexin formulas treat diseases caused by intangible Qi transformation disorders in the chest.

The original text of *Shanghan Lun* (Treatise on Cold Pathogenic Diseases) states: "Epigastric fullness and stuffiness, soft upon palpation, with a floating pulse at the Guan position, is primarily treated with Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Heart-Purging Decoction)."

[Dahuang Huanglian Xiexin Tang Formula] Rhubarb (Radix et Rhizoma Rhei) two liang, Coptis (Rhizoma Coptidis) one liang.
Take the above two ingredients, soak them in two sheng of boiling water (Mafei Tang), wait for a short while, strain off the dregs, and divide into two doses to be taken warm.

The upper Jiao (Triple Burner) of humans is like mist. The upper Jiao is located above the diaphragm. What is meant by "like mist" is that Heart Yang can vaporize the dampness of the upper Jiao, transforming it into clouds and mist, which then becomes fluids, descending through the fatty membranes of the Triple Jiao to reach the Bladder. However, now due to external pathogenic factors sinking deeply into the chest, they knot together with the Qi steamed by Heart Fire at the epigastrium, causing fullness and stuffiness (Pi syndrome). Therefore, Coptis is used to purge Heart Fire, and Rhubarb is used to eliminate the internally sunk external pathogens. Thus, the epigastric fullness will dissipate, naturally restoring the normal state of the upper Jiao being like mist. As for why Rhubarb and Coptis are not decocted but soaked in Mafei Tang (boiling water), it is solely to extract their clear and light aromatic properties to treat the upper body, without desiring their heavy and turbid juices to attack downward.

(Attached: Self-devised Modified Formula)
For treating epigastric fullness and stuffiness, some cases require combining cooling and warming herbs in one formula to achieve a cure; this is the condition primarily treated by Fuzi Xiexin Tang (Aconite Heart-Purging Decoction) in *Shanghan Lun*. Let us discuss it in further detail.

The original text of *Shanghan Lun* states: "Epigastric fullness and stuffiness, accompanied by aversion to cold and sweating, is primarily treated with Fuzi Xiexin Tang."

[Fuzi Xiexin Tang Formula] Rhubarb two liang, Coptis and Scutellaria (Radix Scutellariae) one liang each, Aconite Root (Radix Aconiti Lateralis Preparata) one piece (processed, skin removed, broken, decocted separately to obtain juice).
Cut the first three ingredients. Soak them in two sheng of boiling water for a short while, strain off the dregs, add the Aconite juice, and divide into two doses to be taken warm.

The condition primarily treated by Fuzi Xiexin Tang involves epigastric fullness identical to that treated by Dahuang Huanglian Xiexin Tang. However, because there is also aversion to cold and sweating, it indicates that the defensive Yang on the exterior cannot consolidate, and the Yang aspect is weak, unable to resist external cold. The root foundation of the Taiyang (Greater Yang) channel lies in the lower Jiao Water Mansion (Kidneys and Bladder). Therefore, Aconite is added to the previous formula to supplement the Primordial Yang of the Water Mansion. Meanwhile, Rhubarb and Coptis treat the upper part, soaked only in Mafei Tang to take advantage of their clear and light Qi ascending easily. Aconite treats the lower part, decocted into a strong soup, intending for its heavy and turbid juice to descend easily. Thus, drugs with such different cold and hot natures are mixed into one preparation. Upon ingestion, the hot nature does not hinder the cold nature, nor does the cold hinder the hot. They act along separate paths but achieve efficacy simultaneously. This demonstrates not only the ingenuity of medication but also the almost inconceivable brilliance of formula formulation.

Although the Fuzi Xiexin Tang formula is brilliant, because it combines major cold and major heat herbs, physicians often dare not try it lightly. I originally had a modified method for this formula, which seems more accessible and easy to use. The formula has no other secret; it simply uses Astragalus (Radix Astragali) to replace Aconite. The Taiyang Fu organs originally include two: one in the Bladder and one in the Chest. The Great Qi accumulated in the chest has an intimate relationship with the Defensive Qi on the exterior of Taiyang. Qi belongs to Yang. When the Great Qi in the chest is deficient, not only is the exterior Defensive Qi deficient and unable to consolidate, but the exterior Defensive Yang also becomes weak and unable to ward off cold, resulting in sweating and aversion to cold. Using Astragalus to supplement the Great Qi in the chest will solidify the exterior Defensive Qi, stopping sweating, and strengthen the exterior Defensive Yang, eliminating aversion to cold. Using Aconite supplements the Taiyang lower Jiao Fu organ; using Astragalus supplements the Taiyang upper Jiao Fu organ. The Qi transformations of these two Fu organs originally circulate mutually. Therefore, I have finalized the following formula for reference.

Rhubarb 3 qian, Coptis 2 qian, Raw Astragalus 3 qian.
Soak the first two ingredients in Mafei Tang to obtain most of a cup of clear decoction. Decoct the third ingredient to obtain a small amount of concentrated decoction. Mix them together and take once warm.

One might ask: Whenever there is blood stasis in the Zang-Fu organs, tonifying medicines are generally contraindicated because tonification may further obstruct the stasis. In this case, since there is stasis in the epigastrium causing fullness, why use Astragalus to replace Aconite? The answer is: When using medicine to resolve stasis, after administration, the Qi transformation of the Zang-Fu organs must be able to transport and utilize the breaking power of the medicine for it to be effective. If one merely relies on heavily using breaking medicines to break stasis, it often happens that the Qi aspect is damaged, and the stasis remains unresolved. Therefore, those with stasis should indeed avoid taking Qi-tonifying medicines alone. However, if Qi-tonifying medicines are used together with breaking/opening medicines, the Qi-tonifying medicines can assist the breaking medicines, enabling the stasis to dissipate rapidly.