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Licorice Root (Honey-fried) [Gancao] 3 liang, Ginseng Root [Renshen] 3 liang, Dried Ginger [Ganjiang] 1 liang, Pinellia Tuber (Washed) [Banxia] half sheng, Scutellaria Root [Huangqin] 3 liang, Coptis Rhizome [Huanglian] 1 liang, Fresh Ginger [Shengjiang] (sliced) 4 liang, Jujube Fruit (Broken open) [Dazao] 12 pieces.

The above eight herbs are decocted with one dou of water until six sheng remain. The dregs are filtered out, and the liquid is further concentrated by boiling until three sheng remain. Take one sheng warm per dose, three times a day.

[Formula Analysis]
Named "Shengjiang Xiexin Tang" (Fresh Ginger Decoction to Drain the Epigastrium), its significance lies primarily in dissipating the epigastric fullness caused by fluid retention. Shengjiang (Fresh Ginger) and Banxia (Pinellia Tuber) disperse the fluid qi stagnating below; Renshen (Ginseng Root) and Dazao (Jujube Fruit) tonify the deficiency of the Middle Jiao Earth; Ganjiang (Dried Ginger) and Gancao (Licorice Root) warm the interior cold; Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome) drain the heat of the palpable fullness. This formula comprehensively addresses treatments for deficiency, fluid, cold, and heat. For epigastric disharmony leading to diarrhea and palpable fullness, how could it fail to heal?

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In Taiyang disease (Cold Damage syndrome), after five or six days, if there is vomiting accompanied by fever, the Chaihu Tang (Bupleurum Decoction) pattern is complete. If mistakenly treated with purgatives from other formulas, and the Chaihu pattern persists, administer Chaihu Tang again. Although purgation has been performed, this is not yet a reversal condition. The patient will inevitably experience a sensation of rising heat followed by chills, and subsequently resolve through sweating and fever. If there is epigastric fullness accompanied by pain, this is Jie Xiong (Chest Binding), treated with Da Xianxiong Tang (Major Intractable Chest Decoction). If there is fullness without pain, this is Pi (Palpable Fullness/Blockage); Chaihu Tang is not indicated, and Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is appropriate.

[Annotation]

Jie Xiong (Chest Binding) combined with Yangming Interior Excess is the Da Xianxiong Tang pattern; combined with Yangming but not forming excess is the Xiao Xianxiong Tang (Minor Intractable Chest Decoction) pattern. Pi (Palpable Fullness) combined with Shaoyang Interior Excess is the Da Chaihu Tang (Major Bupleurum Decoction) pattern; combined with Shaoyang but not forming excess is the Banxia Xiexin Tang pattern. Currently, in Taiyang disease after five or six days, vomiting with fever indicates pathogenic factors transmitting to the Shaoyang (Lesser Yang) channel. Since the Chaihu pattern is present, failing to harmonize with Chaihu and instead using purgatives is an error. If the Chaihu pattern remains, although purgation has occurred, it has not yet become a reversal condition; thus, Chaihu Tang should be administered again. The patient will inevitably experience rising heat and chills, followed by resolution through fever and sweating. This is because post-purgation middle deficiency and the manifestations of resolving illness are all like this. If post-purgation results in epigastric fullness and pain, this is Jie Xiong (Chest Binding), and Da Xianxiong Tang is indeed appropriate. If there is only fullness without pain, this is Pi (Palpable Fullness) due to deficient heat and rebellious qi. Even with Shaoyang symptoms such as vomiting and fever, Chaihu Tang is not suitable. The method should treat Pi (Palpable Fullness); Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is indicated.

[Collected Annotations]

Cheng Wuji stated: If after purgation, Yang pathogenic factors transmit inward, they bind in the chest to form Jie Xiong (Chest Binding), because the chest is the region where Yang Qi receives energy. If Yin pathogenic factors transmit inward, they remain at the epigastrium to form Pi (Palpable Fullness), because the epigastrium is the region where Yin Qi receives energy.

Cheng Yingmao stated: Although both are called Xiexin Tang (Decoctions to Drain the Epigastrium), since this pattern features vomiting, its function specializes in draining phlegm-fluids, hence named after Banxia (Pinellia Tuber). To call it "Draining the Epigastrium" means that the fullness is located at the epigastrium, the seat of clear Yang Qi. Heat pathogens carrying phlegm-fluids have not yet formed solid excess. Therefore, clearing heat and draining fluids allows the Qi at the epigastrium to flow freely, eliminating obstruction above and below, allowing Yin and Yang to interact naturally. However, the pivot mechanism relies entirely on the Stomach; thus, tonifying the deficiency of the Stomach family is necessary to facilitate rotation. This is vastly different from treating solid heat entering the Stomach by draining accumulated fullness. Pi (Palpable Fullness) is a deficient pathogen, resulting from exterior Qi entering the interior and transforming from cold to heat. Although cold transforms into heat, the heat is not solid. Therefore, bitter-cold herbs are used to drain the heat, assisted by pungent-sweet herbs to tonify deficiency. There is no need to attack the Pi (Palpable Fullness) directly; it will dissipate on its own. Thus, within one formula, cold and heat herbs are used together. If it is Yin Pi (Deficient Cold Palpable Fullness) unrelated to Yang depression, or if depression has not yet transformed into heat, the method of Xiexin Tang (Draining the Epigastrium) can generally be applied.

Wang Hu stated: When Shaoyang (Lesser Yang) disease is mistakenly purged, the pathogen remains between the exterior and interior, situated between Yin and Yang, thus presenting with Pi (Palpable Fullness) binding patterns. Below the diaphragm belongs to Yin, above the diaphragm belongs to Yang. Shaoyang resides in the clear pathways, interposed between the diaphragms, also belonging to the half-exterior half-interior. This demonstrates that when Shaoyang disease is mistakenly purged, pathogens enter the interior taking advantage of deficiency, explaining the differentiation between Jie Xiong (Chest Binding) and Pi (Palpable Fullness).