[总诀]上焦心肺属胸中，空阔无尘比太空。寒热血痰相阻滞，开提升降具全功。
胸前胀满，兼见口渴胁痛者，少阳气不畅也。宜加减柴胡汤。
柴胡（一钱） 半夏（二钱） 人参（二钱） 黄芩（二钱） 杏仁（二钱） 栝蒌（二钱） 枳壳（一
钱） 旋复（二钱） 甘草（一钱） 大枣（二枚） 生姜（三片） 荷梗（三钱）
歌曰∶胀痛胸前引胁旁，柴胡栝蒌夏芩姜。
枳甘参枣旋花杏，荷梗兼能达少阳。
（伯未按∶蜀刻本无旋复、荷梗。）
胸前痹痛，兼见痛而彻背者，心肺之阳郁也。宜栝蒌薤白汤。
桂枝（三钱） 生姜（三钱） 枳壳（一钱） 栝蒌（三钱） 薤白（三钱） 清酒（一盏）
歌曰∶胸前痹痛势连绵，彻背疼时更不堪。
蒌桂枳姜添薤白，宣阳还要酒来煎。
胸前胀满，饭后更觉痞满者，胃虚而生痰也。宜香砂六君汤。
木香（一钱） 砂仁（二钱） 白术（三钱） 云苓（三钱） 党参（三钱） 陈皮（三钱） 半夏（二
钱） 生姜（三片） 大枣（二枚）
歌曰∶饭后胸前胀满增，香砂陈术解痰凝。
参苓姜夏甘和枣，补胃调中效可凭。
胸前结痛，不可触近按摩者，水火相搏结也。宜消息陷胸汤。
葶苈（一钱） 甘草（五分） 枳壳（一钱） 杏仁（三钱） 黄连（一钱） 大黄（炒，一钱）
栝蒌（整枚捣）
歌曰∶陷胸葶苈枳黄攻，甘杏黄连力倍充。
全仗栝蒌除积痛，膈中水火两消融。
（伯未按∶蜀刻本此方作甘遂、大黄、芒硝三味，与消息之义不合。）
胸前胀满，游走有声而呕者，膈上有水饮也。宜加味二陈汤。
陈皮（二钱） 云苓（三钱） 法夏（三钱） 贝母（二钱） 桔梗（二钱） 甘草（一钱） 枳壳（一
钱） 白芥子（一钱） 苡仁（三钱） 苏子（二钱） 白术（三钱） 生姜（三钱）
歌曰∶水满胸前走有声，二陈加味最详明。
芥苏桔贝苓甘夏，苡枳姜陈术用生。
胸前疼痛，彻背彻心不止者，寒气相攻冲也。宜乌头赤丸方。
干姜（三钱） 附子（三钱） 乌头（三钱） 赤石脂（三钱） 蜀椒（二钱）
歌曰∶彻心彻背痛无休，附子姜椒一剂投。
赤石朱砂蜂蜜裹，散寒专取炮乌头。
胸前烦痛，口酸口苦闷郁者，火气之结滞也。宜整肃
舒气汤。
柴胡（二钱） 黄芩（二钱） 桔梗（二钱） 枳壳（一钱） 丹参（二钱） 菖蒲（一钱） 当归（二
钱） 旋复（二钱） 尖贝（二钱） 云苓（二钱） 车前子（二钱） 甘草（一钱） 炒栀（二钱） 生姜
（三片）
歌曰∶口苦兼酸病在胸，柴芩桔枳有奇功。
参归旋贝菖栀炒，前草姜苓一样同。
（伯未按∶蜀刻木无柴胡、黄芩、旋复、多吴萸、川连、栀子。）
[General Principle] The Heart and Lungs of the Upper Jiao (Upper Burner) are located in the chest, their space being vast and pure, akin to the empty sky. When Cold, Heat, Blood Stasis, and Phlegm obstruct each other, full efficacy is achieved by employing methods of opening and ascending, as well as descending.
Chest distension accompanied by thirst and hypochondriac pain indicates sluggish Qi flow in the Shaoyang (Lesser Yang) channel. Jiajian Chaihu Tang (Modified Bupleurum Decoction) is indicated.
Chai Hu (Bupleuri Radix, 1 qian), Ban Xia (Pinelliae Rhizoma Preparatum, 2 qian), Ren Shen (Ginseng Radix et Rhizoma, 2 qian), Huang Qin (Scutellariae Radix, 2 qian), Xing Ren (Armeniacae Semen Amarum, 2 qian), Gua Lou (Trichosanthis Fructus, 2 qian), Zhi Ke (Aurantii Fructus Immaturus, 1 qian), Xuan Fu Hua (Inulae Flos, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Da Zao (Ziziphi Jujubae Fructus, 2 pieces), Sheng Jiang (Zingiberis Rhizoma Recens, 3 slices), He Geng (Nelumbinis Petiolus, 3 qian).
The verse states: Distension and pain in the chest radiating to the sides of the ribs; use Chai Hu, Gua Lou, Ban Xia, Huang Qin, and Sheng Jiang together.
Zhi Ke, Gan Cao, Ren Shen, Da Zao, Xuan Fu Hua, and Xing Ren; He Geng additionally helps to unblock the Shaoyang channel.
(Note by Bo'an: The Shu edition lacks Xuan Fu Hua and He Geng.)
Chest bi-syndrome (obstruction and pain) accompanied by pain radiating through to the back indicates depression of the Yang Qi of the Heart and Lung. Gualou Xiebai Tang (Trichosanthes and Macrostemon Decoction) is indicated.
Gui Zhi (Cinnamomi Ramulus, 3 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 qian), Zhi Ke (Aurantii Fructus Immaturus, 1 qian), Gua Lou (Trichosanthis Fructus, 3 qian), Xie Bai (Allii Macrostemonis Bulbus, 3 qian), Qing Jiu (Clear Wine, 1 zhan).
The verse states: The sensation of chest bi-syndrome is continuous; when pain radiates to the back, it becomes unbearable.
Add Xie Bai to Gua Lou, Gui Zhi, Zhi Ke, and Sheng Jiang; to disseminate Yang Qi, decoct with wine.
Chest distension that feels more stifling after meals indicates Phlegm generated due to Spleen-Stomach deficiency. Xiangsha Liujun Tang (Costus and Amomum Six-Gentlemen Decoction) is indicated.
Mu Xiang (Aucklandiae Radix, 1 qian), Sha Ren (Amomi Fructus Rotundus, 2 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Yun Ling (Poria, 3 qian), Dang Shen (Codonopsis Radix, 3 qian), Chen Pi (Citri Reticulatae Pericarpium, 3 qian), Ban Xia (Pinelliae Rhizoma Preparatum, 2 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 slices), Da Zao (Ziziphi Jujubae Fructus, 2 pieces).
The verse states: Chest distension increases after meals; Mu Xiang, Sha Ren, Chen Pi, and Bai Zhu resolve Phlegm stagnation.
Ren Shen, Fu Ling, Sheng Jiang, Ban Xia, Gan Cao harmonize the middle; Da Zao assists; tonifying the Stomach and regulating the Middle Jiao yields reliable results.
Knotted pain in the chest that cannot be touched or massaged indicates a struggle between Water (Fluids) and Fire. Xiaoxi Xiantong Tang (Message-Seeking Chest-Depressing Decoction) is indicated for careful adjustment.
Ting Li (Descurainiae Semen seu Lepidii et Descurainiae Semen, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 5 fen), Zhi Ke (Aurantii Fructus Immaturus, 1 qian), Xing Ren (Armeniacae Semen Amarum, 3 qian), Huang Lian (Coptidis Rhizoma, 1 qian), Da Huang (Rhei Radix et Rhizoma, stir-fried, 1 qian), Gua Lou (Trichosanthis Fructus, whole, crushed).
The verse states: Xiantong Tang uses Ting Li, Zhi Ke, and Da Huang to attack; Gan Cao, Xing Ren, and Huang Lian double the strength.
Reliance is entirely on Gua Lou to remove accumulated pain, dissolving both Water and Fire in the Diaphragm.
(Note by Bo'an: The Shu edition lists this formula as containing Gan Sui, Da Huang, and Mang Xiao, which contradicts the meaning of "Xiaoxi" [careful adjustment/moderation].)
Chest distension with moving sounds and vomiting indicates Fluid retention above the Diaphragm. Jiawei Erchen Tang (Modified Two-Aged Decoction) is indicated.
Chen Pi (Citri Reticulatae Pericarpium, 2 qian), Yun Ling (Poria, 3 qian), Fa Ban Xia (Pinelliae Rhizoma Preparatum, 3 qian), Bei Mu (Fritillariae Bulbus, 2 qian), Jie Geng (Platycodonis Radix, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Zhi Ke (Aurantii Fructus Immaturus, 1 qian), Bai Jie Zi (Sinapis Semen, 1 qian), Yi Yi Ren (Coicis Semen, 3 qian), Su Zi (Perillae Fructus, 2 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 qian).
The verse states: Fluid fills the chest, moving with sound; the modified Erchen Tang is most detailed and clear.
Bai Jie Zi, Su Zi, Jie Geng, Bei Mu, Fu Ling, Gan Cao, Ban Xia; Yi Yi Ren, Zhi Ke, Sheng Jiang, Chen Pi, and Bai Zhu are used raw.
Chest pain radiating continuously to the back and heart indicates attacking and clashing of Cold Qi. Wutou Chiwan Fang (Aconite Red Pill Formula) is indicated.
Gan Jiang (Zingiberis Rhizoma, 3 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, 3 qian), Wu Tou (Aconiti Radix, 3 qian), Chi Shi Zhi (Halloysit Rubrum, 3 qian), Shu Jiao (Zanthoxyli Pericarpium, 2 qian).
The verse states: Pain piercing the heart and back without cease; one dose of Fu Zi, Gan Jiang, and Shu Jiao is administered.
Chi Shi Zhi and Zhu Sha (Cinnabar) wrapped in honey form pills; to dispel Cold, specially processed Wu Tou is taken.
Restlessness and pain in the chest, accompanied by sour/bitter taste and depression, indicates stagnation of Fire Qi. Zhengsu Shuqi Tang (Ordering and Soothing Qi Decoction) is indicated.
Chai Hu (Bupleuri Radix, 2 qian), Huang Qin (Scutellariae Radix, 2 qian), Jie Geng (Platycodonis Radix, 2 qian), Zhi Ke (Aurantii Fructus Immaturus, 1 qian), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 2 qian), Chang Pu (Acori Tatarinowii Rhizoma, 1 qian), Dang Gui (Angelicae Sinensis Radix, 2 qian), Xuan Fu Hua (Inulae Flos, 2 qian), Jian Bei (Fritillariae Thunbergii Bulbus, 2 qian), Yun Ling (Poria, 2 qian), Che Qian Zi (Plantaginis Semen, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Chao Zhi Zi (Gardeniae Fructus, stir-fried, 2 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 slices).
The verse states: Sourness and bitterness accompany chest disease; Chai Hu, Huang Qin, Jie Geng, and Zhi Ke have miraculous effects.
Dan Shen, Dang Gui, Xuan Fu Hua, Bei Mu, Chang Pu, and Chao Zhi Zi; Che Qian Zi, Gan Cao, Sheng Jiang, and Fu Ling are used similarly.
(Note by Bo'an: The Shu edition lacks Chai Hu, Huang Qin, and Xuan Fu Hua, but includes Wu Zhu Yu, Chuan Lian, and Zhi Zi.)