治心下痞，按之则痛，脉浮滑者。
黄连（一两） 半夏（半升） 栝蒌实（大者一个）
上三味，以水六升，先煮栝蒌实，取三升，去滓，纳诸药，煮取二升，分温三服。
程扶生曰∶此热结未深者在心下，不若大结胸之高在心上；按之痛，比手不可近为轻；
脉之
黄连
上
程郊倩曰∶黄连涤热，半夏导饮，栝蒌润燥，合之以开结气。亦名曰陷胸者，攻虽不峻，
而
主治伤寒发热，不发汗而反下之，表热乘虚入于胸中，与不得为汗之水气结而不散，令
心下
肠
大黄（六两） 芒硝 葶苈子 杏仁（去皮，各半升） 甘遂（一钱，为末）
上五味，以水先煮大黄、杏、苈，去滓，纳芒硝，煮一二沸，纳甘遂末。温服，得快利，
止
柯韵伯曰∶胸中者，宗气之所出，故名气海。气为阳，故属太阳之部。气为水母，气清
则水
下输
淫于
任
行
胸
解
痢疾之初起者甚捷。然必视其人壮实，可以一战成功。如平素虚弱者，病久而任攻伐者，当
念虚虚之戒矣。
伤寒五六日，呕而发热，柴胡证具，而以他药下之，但满而不痛，此为痞，宜半夏泻心
汤。
半夏（半斤） 黄芩 干姜 人参（各三两） 黄连（一两） 大枣（十二枚） 甘草
（三两）
上七味，以水一斗，煮取六升，分温三服。
（此小柴胡去柴胡，而加干姜、黄连。）
Treats the syndrome of epigastric stuffiness (Xin Xia Pi), where pressing causes pain, and the pulse is floating and slippery.
Coptidis Rhizoma (Huanglian, 黄连) (1 liang) Pinelliae Tuberum Preparatum (Banxia, 半夏) (0.5 sheng) Trichosanthis Fructus (Gualou Shi, 栝蒌实) (one large fruit)
Take the above three herbs, add six sheng of water, first decoct Trichosanthis Fructus until reduced to three sheng, remove the dregs, add the other herbs, and decoct until two sheng remain. Divide into three doses and take warm.
Cheng Fusheng said: This is heat binding not yet deep, located at the epigastrium, unlike the Great Jie Xiong (Major Chest Binding) which is higher up on the chest; pain upon pressing is milder than being unable to bear touch;
the pulse is [floating and slippery].
Coptidis Rhizoma (Huanglian, 黄连)
Up
Cheng Jiaoqian said: Coptidis Rhizoma clears heat, Pinelliae Tuberum Preparatum guides out fluid retention, and Trichosanthis Fructus moistens dryness; combined, they open up bound qi. It is also named "Xian Xiong" (Sinking Chest) because although the attacking force is not severe,
It treats exterior heat entering the chest due to failure to sweat after cold damage fever, and instead using purgatives wrongly. The exterior heat enters the chest through deficiency and binds with fluid that cannot transform into sweat, causing
epigastric hardness
intestine
Rhei Radix et Rhizoma (Dahuang, 大黄) (6 liang) Natrii Sulfas (Mangxiao, 芒硝) Lepidii Semen (Tinglizi, 葶苈子) Prunus Armeniaca Semen (Xingren, 杏仁) (decoicated, each 0.5 sheng) Kansui Radix (Gansui, 甘遂) (1 qian, ground into powder)
Take the above five herbs, first decoct Rhei Radix et Rhizoma, Prunus Armeniaca Semen, and Lepidii Semen in water, remove the dregs, add Natrii Sulfas, boil for one or two boils, then add the Kansui Radix powder. Take warm. If rapid diarrhea occurs,
stop taking it.
Ke Yunbo said: The chest is where Zong Qi (Pectoral Qi) originates, hence called the Sea of Qi. Qi belongs to Yang, thus belonging to the Taiyang (Greater Yang) sector. Qi is the mother of water; when qi is clear,
then water
transports downward
excessively into
Ren Mai (Conception Vessel)
moves
chest
resolves
It is very effective for dysentery in its initial stage. However, one must assess if the patient's constitution is robust enough for a single decisive attack. For those who are usually weak, have been ill for a long time, and cannot tolerate attacking methods, one should heed the warning against "making deficiency more deficient."
After five or six days of cold damage, vomiting and fever occur, and the Chai Hu Tang (Bupleurum Decoction) pattern is complete, but purgatives were wrongly used. There is only fullness without pain; this is called Pi (Stuffiness). Banxia Xiexin Tang (Pinellia Heart-Draining Decoction) is appropriate.
Pinelliae Tuberum Preparatum (Banxia, 半夏) (0.5 jin) Scutellariae Radix (Huangqin, 黄芩) Zingiberis Rhizoma Recens (Ganjiang, 干姜) Ginseng Radix (Renshen, 人参) (each 3 liang) Coptidis Rhizoma (Huanglian, 黄连) (1 liang) Jujubae Fructus (Dazao, 大枣) (12 pieces) Glycyrrhizae Radix et Rhizoma (Gancao, 甘草)
(3 liang)
Take the above seven herbs, add one dou of water, decoct until six sheng remain. Divide into three doses and take warm.
(This is Xiao Chai Hu Tang (Minor Bupleurum Decoction) minus Chai Hu (Bupleuri Radix), plus Ganjiang (Zingiberis Rhizoma Recens) and Huanglian (Coptidis Rhizoma).)