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Coptidis Rhizoma (30 g, remove fibrous roots) Pinelliae Tuber (soaked seven times, 150 mL) Trichosanthis Fructus (one fruit, remove peel)
In Cold Damage (Shanghan), if purgation is applied prematurely, heat binds in the chest. If pain occurs only upon palpation, it is termed Xiao Xianxiong Tang Syndrome (Minor Phlegm-Heat Binding in the Chest); this formula governs it.
When exterior syndromes of the Three Yang meridians remain unresolved and purgation is used prematurely, exterior pathogens enter due to deficiency, resulting in Jie Xiong (Binding Chest). "Jie Xiong" refers to Yang pathogens firmly binding in the chest, unable to disperse, causing hardness and pain. If pain occurs only upon palpation but not otherwise, Xiao Xianxiong Tang is used. Coptidis Rhizoma clears heat from the chest; Pinelliae Tuber disperses phlegm-bindings in the chest; Trichosanthis Fructus directs Qi downward from the chest. However, this syndrome must follow improper purgation; without prior purgation, it is not termed Jie Xiong.

Rhei Radix et Rhizoma (180 g, soaked in wine) Natrii Sulfas (250 mL) Kansui Radix (3 g)
In Cold Damage, if purgation is applied prematurely, leading to hardness, fullness, and severe pain from the epigastrium down to the lower abdomen that cannot be tolerated by touch, it is termed Da Jie Xiong (Major Binding Chest); this formula governs it.
When exterior syndromes of the Three Yang meridians are unresolved, using Chengqi Tang formulas to attack interior excess constitutes premature purgation. Premature purgation causes interior deficiency; interior deficiency allows exterior pathogens to invade, resulting in excess in the Triple Burner. Thus, hardness, fullness, and severe pain from the epigastrium to the lower abdomen occur. This condition is critical and cannot be resolved by ordinary medicines. Therefore, Rhei Radix et Rhizoma is used to purge excess, Natrii Sulfas to soften hardness, and Kansui Radix to reach the disease site directly. Alas! People praise the harshness of these three herbs, but who praises their power to revive the dying? Utilizing human courage to overcome anger can only be done by one skilled at commanding generals.

Pinelliae Tuber (150 mL, processed) Scutellariae Radix (stir-fried) Zingiberis Rhizoma Recens Ginseng Radix et Rhizoma (remove rhizomes) Glycyrrhizae Radix et Rhizoma (each 90 g) Coptidis Rhizoma (30 g, remove fibrous roots)
In Cold Damage, if purgation is applied prematurely, resulting in chest fullness without pain, it is termed Pi Syndrome (Stagnant Epigastrium); this formula governs it.
Cold Damage pathogens move from the exterior to the interior, transmitting to the Three Yin meridians. The Three Yin meridians also have exterior syndromes. For example, Taiyin has Guizhi Ji Shaoyao Tang, Shaoyin has Mahuang Fuzi Xixin Tang, and Jueyin has Danggui Sini Tang. If the exterior is not treated and Chengqi Tang is used for purgation, the Middle Qi (Spleen/Stomach Qi) is damaged, allowing pathogens from the Yin meridians to invade. Since the Middle Qi is already damaged and pathogens invade, Clear Qi fails to ascend and Turbid Qi fails to descend, causing stagnation in the middle, similar to Heaven and Earth failing to interact, forming Pi (Stagnation). Hence, it is called "Pi." "Xie Xin" (Draining the Heart) refers to draining pathogens from the epigastric region. The pungency of Zingiberis Rhizoma and Pinelliae Tuber disperses Qi stagnation; the bitterness of Scutellariae Radix and Coptidis Rhizoma drains heat from the stagnation; since Spleen Qi is deficient after purgation, Ginseng Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, and Jujubae Fructus tonify Spleen deficiency.