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Banxia (washed) half sheng, Huangqin three liang, Ganjiang three liang, Renshen three liang, Huanglian one liang, Gancao (roasted with honey) three liang, Dazao (broken open) twelve pieces.

The above seven herbs, with ten dou of water, decoct to obtain six sheng, remove the dregs and decoct again to obtain three sheng, take one sheng warm each time, three times a day.

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Originally due to premature purgation, epigastric fullness (epigastric stuffiness) resulted, and Xixin Tang (Heart-Draining Decoction) was administered. If the fullness does not resolve, and the patient presents with thirst, dry mouth, vexation, and dysuria, Wuling San (Five-Ingredient Powder with Poria) is indicated.
[Annotation]
It originally became epigastric fullness due to premature purgation. If it is fullness caused by heat accumulation and solidification, Dahuang Huanglian Xixin Tang (Rhubarb and Coptis Heart-Draining Decoction) is suitable; this is a cold purging method. If it is fullness caused by exterior cold and interior heat, Fuzi Xixin Tang (Aconite Heart-Draining Decoction) is suitable; this is a warm purging method. If it is fullness caused by deficiency-heat and water qi, Shengjiang Xixin Tang (Fresh Ginger Heart-Draining Decoction) is suitable; this is a method to dissipate fluid retention. If it is fullness accompanied by vomiting due to deficiency-heat, Banxia Xixin Tang (Pinellia Heart-Draining Decoction) is suitable; this is a method to subvert rebellion (stop vomiting). If it is fullness where deficiency-heat is even more severe, Gancao Xixin Tang (Licorice Heart-Draining Decoction) is suitable; this is a method to moderate urgency. Now, if various Xixin Tangs are used, and after careful syndrome differentiation and administration, the fullness still does not resolve, one must examine the patient. If there is thirst, dry mouth, vexation, and dysuria, it is not due to unclear syndrome differentiation or insufficient medicinal power. It is because internal accumulation of water-fluid impedes the movement of body fluids, so the fullness disease does not resolve. It is appropriate to use Wuling San to induce sweating externally and promote urination internally; when sweat appears and urination becomes smooth, the disease will heal. This can be analogized to other cases.
[Collected Annotations]
Fang Youzhi said: When Xixin Tang treats fullness but the fullness does not resolve, it is evident that this is not fullness caused merely by qi aggregation. Thirst, dry mouth, vexation, and dysuria indicate that body fluids are stagnant and not flowing, with latent fluid retention condensing. Wuling San promotes urination and generates fluids; when fluids are generated, thirst and vexation cease, and when water is promoted, fullness naturally removes. Thus, this is another method for eliminating fullness.
Cheng Yingmao said: Various Xixin formulas, in opening knots, clearing heat, and benefiting deficiency, are quite comprehensive. However, their treatment methods focus on the Upper and Middle Jiao. There are cases where fullness is in the upper part but treated in the Lower Jiao, which differs from these methods. Although the origin of the fullness may be the same, if the patient presents with thirst, dryness, vexation, and dysuria, it indicates that post-purgation stomach deficiency led to internal accumulation of water-fluid and impaired fluid movement, leaving no exit for the fullness, rather than accumulated heat. Using Wuling San as the main treatment causes turbid yin to exit through the lower orifices, allowing clear yang in the Upper Jiao to flow without obstruction. Moreover, Wuling San is suitable for promoting qi transformation and expelling pathogenic factors from both the exterior and interior, causing heart-pathogens to drain via the Bladder rather than the Heart channel. This is yet another method.

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In typhoid fever, after taking herbal decoctions, diarrhea persists incessantly, with epigastric fullness. After taking Xixin Tang, the physician again used other drugs to purge, resulting in persistent diarrhea. The physician then administered Lizhong Tang (Middle-Warming Decoction), but the diarrhea worsened. Lizhong Tang regulates the Middle Jiao, whereas this diarrhea is in the Lower Jiao; Chishizhi Yuyuliang Tang (Red Stone Lip and Hematite Decoction) should be used. If diarrhea persists despite this, diuresis should be promoted.
[Annotation]
In typhoid fever, after taking herbal decoctions, persistent diarrhea and epigastric fullness are caused by erroneous purgation. Diarrhea with fullness remains a deficient fullness. Taking Xixin Tang was already the correct method. However, since the fullness did not heal, and the physician again used other drugs to purge, although the fullness resolved, the diarrhea persisted. The physician gave Lizhong Tang to warm, but the diarrhea worsened. One must understand that Lizhong Tang regulates the Middle Jiao; this diarrhea is in the Lower Jiao and belongs to slipping and loss of control. Therefore, Chishizhi Yuyuliang Tang is used to astringe intestines and secure leakage, stopping the diarrhea. If it stops and then recurs, one must examine whether urination is smooth or difficult. If urination is smooth, warming and tonifying medicines should be assisted to complete the cure. If urination is difficult, it means water has no exit; prolonged astringency causes recurrent persistent diarrhea. In this case, diuresis should be promoted to unblock the water passages, after which the diarrhea will stop spontaneously.
[Collected Annotations]
Zheng Zhongguang said: "Tang" (decoction) implies sweeping away, referring here to purgative drugs. Erroneous purgation caused persistent diarrhea and epigastric fullness; taking Xixin Tang was the legal treatment. Yet, using other drugs to purge again was an error upon error. Using Lizhong Tang to open fullness and stop diarrhea was not originally wrong, but the worsening diarrhea occurred because repeated purgation injured Kidney Qi, leading to Lower Jiao instability. Therefore, Chishizhi and Yuyuliang are used to consolidate intestinal deficiency and arrest slipping. If diarrhea still does not stop, diuresis should be promoted. Since the Bladder is the mansion of the Kidney, and the Kidney governs both excreta, opening apertures at the two yins, promoting urination allows the zang-fu organs to perform their respective duties, thereby separating water and grain, and stopping diarrhea spontaneously.