夫结胸者。为热毒瓦斯。结聚于心胸也。此由病发于阳。而下之早。热气乘虚而痞结不散
。按
阳脉
者。
治伤寒十余日。热气结于胸中。往来寒热不定。宜服柴胡汤方。
柴胡（去苗） 枳实（麸炒微黄） 赤芍药 半夏（汤洗七遍去滑） 黄芩（以上各三
分） 甘
草（半两炙微赤锉） 桔梗（一两去芦头）
上件药。捣粗罗为散。每服五钱。以水一中盏。入生姜半分。枣三（二）枚。煎至六分。
去滓。不计时候温服。
治伤寒三四日。不能卧。但欲起。胸中结热烦闷。脉洪大者。宜服半夏汤方。
半夏（三分汤洗七遍去滑） 黄芩（三分） 干姜（半两炮裂锉） 赤茯苓（三分） 人
参（三
分去芦头） 甘草（半两炙微赤锉） 黄连（一分去须）
上件药。捣粗罗为散。每服三钱。以水一中盏。入枣二枚。煎至六分。去滓。不计时候
温服。
治伤寒五日后。结胸。气不散。汤饮难下。连背闷痛。宜服前胡散方。
前胡（一两去芦头） 当归（半两锉碎微炒） 川大黄（一两锉碎微炒） 羌活（一两）
桔梗
（一两去芦头） 槟榔（三分） 郁李仁（一两汤浸去皮尖微炒）
上件药。捣粗罗为散。每服四钱。以水一中盏。煎至六分。去滓。不计时候温服。
治伤寒十余日。热气结于胸中。往来寒热。头痛。宜服大黄散方。
川大黄（一两锉碎微炒） 柴胡（一两去苗） 枳实（三分麸炒微黄） 川朴硝（一两）
赤芍
药（一两） 黄芩（一两） 虎掌（三分微炒）
上件药。捣筛为散。每服四钱。以水一中盏。入生姜半分。煎至六分。去滓。不计时
候温服。
治伤寒结胸。气噎塞。烦闷。宜服此方。
枳实（二两麸炒微黄） 桂心（一两）
上件药。捣细罗为散。每服。不计时候。以温水调二钱
治伤寒结胸。内有瘀血。大便不利。小腹满急。宜服此方。
桃仁（半两汤浸去皮尖双仁麸炒微黄） 水蛭（一分炒令微黄） 虻虫（一分炒令微黄）
川
大黄（一两锉碎微炒）
上件药。捣筛为散。每服一钱。以水一小盏。煎至五分。去滓。不计时候温服。
治伤寒结胸。不下饮食。四肢烦劳。宜服桔梗散方。
桔梗（一两去芦头） 人参（一两去芦头） 赤茯苓（一两） 槟榔（半两） 桑根白
皮（一两
锉） 木香（半两） 赤芍药（三分） 白术（三分） 鳖甲（一两涂酥炙令黄去裙 ）
上件药。捣筛为散。每服四钱。以水一中盏。入生姜半分。煎至六分。去滓。不计时候
温服。
治伤寒结胸。腹中 痛。心下硬如石。按之烦闷。宜服牛膝散方。
牛膝（三分去苗） 川大黄（三分锉碎微炒） 桂心（半两） 附子（半两炮裂去皮脐）
鳖甲
（三
皮尖微
炒）
上件药。捣筛为散。每服四钱。以水一中盏。入生姜半分。煎至六分。去滓。不计时候
温服。
治伤寒结胸。烦满。喘息稍急。汤饮不下。宜服恒山汤方。
恒山（一分） 甘草（一分生用） 蜀漆（半分） 犀角屑（半分）
上件药。都细锉。以水一中盏。煎至五分。去滓。不计时候顿服。须臾当吐为效。
治伤寒结热不散。胸中痞满。欲成结胸。宜服木香散方。
木香（一分） 旋复花（半两） 赤茯苓（三分） 陈橘皮（半两汤浸去白瓤焙） 槟
榔（半两）
紫苏茎叶（三分）
上件药。捣筛为散。每服四钱。以水一中盏。煎至六分。去滓。不计时候温服。
治伤寒结胸。心膈躁闷。宜服人参丸方。
人参（一两去芦头） 白术（一两） 甘草（一两炙微赤锉） 犀角屑（半两） 栝蒌
根（一两）
赤茯苓（一两） 牡蛎（一两烧为粉）
上件药。捣罗为末。炼蜜和丸。如梧桐子大。不计时候。以粥饮下三十丸。
治伤寒结胸。烦闷。热毒瓦斯结聚不散。宜服鳖甲丸方。
鳖甲（一两涂酥炙令黄去裙 ） 防葵（三分） 诃黎勒皮（三分） 甘草（半两炙微
赤锉）
人参
分汤浸
去皮
上件药。捣罗为末。炼蜜和丸。如梧桐子大。不计时候。以温生姜汤下三十丸。
治伤寒结胸。心下结硬。烦闷腹胀。宜服赤芍药散方。
赤芍药（三分） 诃黎勒皮（三分） 白术（半两） 鳖甲（三分涂醋炙令黄去裙 ） 桂
心（
半两
微炒）
木香（
上件药。捣筛为散。每服五钱。以水一中盏。入生姜半分。煎至六分。去滓。不计时候
温服。
治伤寒心中坚硬。两胁胀满。欲成结胸。宜服赤茯苓丸方。
赤茯苓（三分） 鳖甲（三分涂醋炙令黄去裙 ） 牛膝（三分去苗） 枳壳（三分麸
炒微黄
去瓤）
芍药（三分）
桂
上件药。捣罗为末。炼蜜和丸。如梧桐子大。每服。不计时候。以温生姜汤下三十丸。
治伤寒。心中硬痛不可忍。或腹胀满。欲成结胸。宜服朱砂丸方。
朱砂（一两细研水飞过） 桃仁（一两汤浸去皮尖双仁麸炒微黄别研如膏） 麝香（一
分细
研）
上件药。同研令匀。炼蜜和丸。如梧桐子大。每服不计时候。以温生姜汤下二十丸。
Jie Xiong (Chest Binding Syndrome) is caused by the accumulation of heat-toxic qi in the chest and heart region. This condition typically arises when a disease initially presents in the Yang aspect (exterior syndrome), but purgative methods are applied prematurely. Consequently, heat qi enters through the deficiency, causing stagnation and binding that fails to dissipate.
For patients who have suffered from Shang Han (Cold Damage) for more than ten days, with heat qi binding in the chest, presenting with alternating chills and fever (Wang Lai Han Re -往来寒热), and a Yang pulse, the Chai Hu Tang (Bupleurum Decoction) is indicated.
**Ingredients:**
Chai Hu (Radix Bupleuri) 3 fen, Zhi Shi (Fructus Aurantii Immaturus) 3 fen (bran-fried until slightly yellow), Chi Shao Yao (Radix Paeoniae Rubra) 3 fen, Ban Xia (Rhizoma Pinelliae) 3 fen (boiled and washed seven times to remove slipperiness), Huang Qin (Radix Scutellariae) 3 fen, Gan Cao (Radix Glycyrrhizae) 0.5 liang (roasted until slightly red and chopped), Jie Geng (Radix Platycodi) 1 liang (rhizome removed).
**Preparation and Administration:**
Crush the above ingredients and sieve them coarsely to make a powder. Take 5 qian per dose. Add 1 zhong of water, 0.5 fen of fresh ginger, and 3 dates. Decoct until 6 fen of liquid remains. Strain and take warm at any time.
For patients suffering from Shang Han for three or four days, who cannot lie down and wish only to sit up, experiencing binding heat in the chest with irritability, and a洪 Da (Surging-Large) pulse, the Ban Xia Tang (Pinellia Decoction) is indicated.
**Ingredients:**
Ban Xia (Rhizoma Pinelliae) 3 fen (boiled and washed seven times), Huang Qin (Radix Scutellariae) 3 fen, Gan Jiang (Rhizoma Zingiberis Secatum) 0.5 liang (pao-cracked and chopped), Chi Fu Ling (Poria Cocos with Red Wood) 3 fen, Ren Shen (Radix Ginseng) 3 fen (rhizome removed), Gan Cao (Radix Glycyrrhizae) 0.5 liang (roasted until slightly red and chopped), Huang Lian (Rhizoma Coptidis) 1 fen (fibers removed).
**Preparation and Administration:**
Crush and sieve coarsely to make a powder. Take 3 qian per dose. Add 1 zhong of water and 2 dates. Decoct until 6 fen remains. Strain and take warm at any time.
For patients suffering from Shang Han for five days or more, presenting with Jie Xiong (Chest Binding), stagnant qi, difficulty swallowing liquids or food, and dull pain extending to the back, the Qian Hu San (Peucedanum Powder) is indicated.
**Ingredients:**
Qian Hu (Radix Peucedani) 1 liang (rhizome removed), Dang Gui (Radix Angelicae Sinensis) 0.5 liang (chopped and lightly fried), Chuan Da Huang (Radix et Rhizoma Rhei) 1 liang (chopped and lightly fried), Qiang Huo (Rhizoma Notopterygii) 1 liang, Jie Geng (Radix Platycodi) 1 liang (rhizome removed), Bing Lang (Semen Arecae) 3 fen, Yu Li Ren (Semen Pruni) 1 liang (soaked in water, skin and tip removed, lightly fried).
**Preparation and Administration:**
Crush and sieve coarsely to make a powder. Take 4 qian per dose. Add 1 zhong of water. Decoct until 6 fen remains. Strain and take warm at any time.
For patients suffering from Shang Han for more than ten days, with heat qi binding in the chest, alternating chills and fever, and headache, the Da Huang San (Rhubarb Powder) is indicated.
**Ingredients:**
Chuan Da Huang (Radix et Rhizoma Rhei) 1 liang (chopped and lightly fried), Chai Hu (Radix Bupleuri) 1 liang (shoots removed), Zhi Shi (Fructus Aurantii Immaturus) 3 fen (bran-fried until slightly yellow), Chuan Pu Xiao (Natrii Sulfas) 1 liang, Chi Shao Yao (Radix Paeoniae Rubra) 1 liang, Huang Qin (Radix Scutellariae) 1 liang, Hu Zhang (Rhizoma Arisaematis) 3 fen (lightly fried).
**Preparation and Administration:**
Crush and sieve finely to make a powder. Take 4 qian per dose. Add 1 zhong of water and 0.5 fen of fresh ginger. Decoct until 6 fen remains. Strain and take warm at any time.
For Shang Han Jie Xiong (Chest Binding) accompanied by Qi Ye Sai (Qi obstruction/blockage) and irritability, this formula is indicated.
**Ingredients:**
Zhi Shi (Fructus Aurantii Immaturus) 2 liang (bran-fried until slightly yellow), Gui Xin (Cortex Cinnamomi) 1 liang.
**Preparation and Administration:**
Crush and sieve finely to make a powder. Take 2 qian mixed with warm water at any time.
For Shang Han Jie Xiong (Chest Binding) with intra-abdominal blood stasis (Yu Xue), difficult defecation, and fullness/urgency in the lower abdomen, this formula is indicated.
**Ingredients:**
Tao Ren (Semen Persicae) 0.5 liang (soaked in water, skin and tip removed, double-kernel removed, bran-fried until slightly yellow), Shui Zhi (Hirudo) 1 fen (fried until slightly yellow), Meng Chong (Tabanus) 1 fen (fried until slightly yellow), Chuan Da Huang (Radix et Rhizoma Rhei) 1 liang (chopped and lightly fried).
**Preparation and Administration:**
Crush and sieve finely to make a powder. Take 1 qian per dose. Add 1 small zhong of water. Decoct until 5 fen remains. Strain and take warm at any time.
For Shang Han Jie Xiong (Chest Binding) where food and fluids cannot be taken, and the limbs feel restless and fatigued, the Jie Geng San (Platycodon Powder) is indicated.
**Ingredients:**
Jie Geng (Radix Platycodi) 1 liang (rhizome removed), Ren Shen (Radix Ginseng) 1 liang (rhizome removed), Chi Fu Ling (Poria Cocos with Red Wood) 1 liang, Bing Lang (Semen Arecae) 0.5 liang, Sang Gen Bai Pi (Cortex Morus Radicis) 1 liang (chopped), Mu Xiang (Radix Aucklandiae) 0.5 liang, Chi Shao Yao (Radix Paeoniae Rubra) 3 fen, Bai Zhu (Rhizoma Atractylodis Macrocephalae) 3 fen, Bie Jia (Carapax et Plastrum Testudinis) 1 liang (coated with lard, roasted until yellow, skirt removed).
**Preparation and Administration:**
Crush and sieve finely to make a powder. Take 4 qian per dose. Add 1 zhong of water and 0.5 fen of fresh ginger. Decoct until 6 fen remains. Strain and take warm at any time.
For Shang Han Jie Xiong (Chest Binding) with abdominal pain, hardness in the epigastrium like stone, and irritability upon pressure, the Niu Xi San (Achyranthes Powder) is indicated.
**Ingredients:**
Niu Xi (Radix Achyranthis Bidentatae) 3 fen (shoots removed), Chuan Da Huang (Radix et Rhizoma Rhei) 3 fen (chopped and lightly fried), Gui Xin (Cortex Cinnamomi) 0.5 liang, Fu Zi (Radix Aconiti Lateralis Preparata) 0.5 liang (pao-cracked, skin and umbilicus removed), Bie Jia (Carapax et Plastrum Testudinis) [Text fragmentary].
**Preparation and Administration:**
Crush and sieve finely to make a powder. Take 4 qian per dose. Add 1 zhong of water and 0.5 fen of fresh ginger. Decoct until 6 fen remains. Strain and take warm at any time.
For Shang Han Jie Xiong (Chest Binding) with irritability, fullness, slightly rapid breathing, and inability to swallow liquids, the Heng Shan Tang (Dichroa Decoction) is indicated.
**Ingredients:**
Heng Shan (Radix Dichroae) 1 fen, Gan Cao (Radix Glycyrrhizae) 1 fen (raw use), Shu Qi (Ramulus Dichroae) 0.5 fen, Xi Jiao Xie (Cornu Rhinocerotis Tritum) 0.5 fen.
**Preparation and Administration:**
Finely chop all ingredients. Add 1 zhong of water. Decoct until 5 fen remains. Strain and take in one dose at any time. Vomiting should occur shortly after, which indicates efficacy.
For Shang Han where heat binds and does not dissipate, causing chest痞 Man (Stagnant-Fullness), approaching Jie Xiong (Chest Binding), the Mu Xiang San (Aucklandia Powder) is indicated.
**Ingredients:**
Mu Xiang (Radix Aucklandiae) 1 fen, Xuan Fu Hua (Flos Inulae) 0.5 liang, Chi Fu Ling (Poria Cocos with Red Wood) 3 fen, Chen Ju Pi (Pericarpium Citri Reticulatae) 0.5 liang (soaked in water, white pith removed, baked), Bing Lang (Semen Arecae) 0.5 liang, Zi Su Jing Ye (Folium et Caulis Perillae) 3 fen.
**Preparation and Administration:**
Crush and sieve finely to make a powder. Take 4 qian per dose. Add 1 zhong of water. Decoct until 6 fen remains. Strain and take warm at any time.
For Shang Han Jie Xiong (Chest Binding) with restlessness and irritability in the heart and diaphragm, the Ren Shen Wan (Ginseng Pill) is indicated.
**Ingredients:**
Ren Shen (Radix Ginseng) 1 liang (rhizome removed), Bai Zhu (Rhizoma Atractylodis Macrocephalae) 1 liang, Gan Cao (Radix Glycyrrhizae) 1 liang (roasted until slightly red and chopped), Xi Jiao Xie (Cornu Rhinocerotis Tritum) 0.5 liang, Gua Lou Gen (Radix Trichosanthis) 1 liang, Chi Fu Ling (Poria Cocos with Red Wood) 1 liang, Mu Li (Concha Ostreae) 1 liang (calcined to powder).
**Preparation and Administration:**
Grind into fine powder. Mix with refined honey to form pills the size of Sophora seeds. Take 30 pills with rice broth at any time.
For Shang Han Jie Xiong (Chest Binding) with irritability and heat-toxic qi binding without dissipation, the Bie Jia Wan (Turtle Shell Pill) is indicated.
**Ingredients:**
Bie Jia (Carapax et Plastrum Testudinis) 1 liang (coated with lard, roasted until yellow, skirt removed), Fang Kui (Radix Dictamni) 3 fen, He Li Le Pi (Pericarpium Terminaliae Chebulae) 3 fen, Gan Cao (Radix Glycyrrhizae) 0.5 liang (roasted until slightly red and chopped), Ren Shen (Radix Ginseng) [Text fragmentary].
**Preparation and Administration:**
Grind into fine powder. Mix with refined honey to form pills the size of Sophora seeds. Take 30 pills with warm ginger decoction at any time.
For Shang Han Jie Xiong (Chest Binding) with hardness and binding in the epigastrium, irritability, and abdominal distension, the Chi Shao Yao San (Red Peony Powder) is indicated.
**Ingredients:**
Chi Shao Yao (Radix Paeoniae Rubra) 3 fen, He Li Le Pi (Pericarpium Terminaliae Chebulae) 3 fen, Bai Zhu (Rhizoma Atractylodis Macrocephalae) 0.5 liang, Bie Jia (Carapax et Plastrum Testudinis) 3 fen (coated with vinegar, roasted until yellow, skirt removed), Gui Xin (Cortex Cinnamomi) 0.5 liang (lightly fried), Mu Xiang (Radix Aucklandiae) [Text fragmentary].
**Preparation and Administration:**
Crush and sieve finely to make a powder. Take 5 qian per dose. Add 1 zhong of water and 0.5 fen of fresh ginger. Decoct until 6 fen remains. Strain and take warm at any time.
For Shang Han with hardness and pain in the heart, fullness in both hypochondria, approaching Jie Xiong (Chest Binding), the Chi Fu Ling Wan (Red Poria Pill) is indicated.
**Ingredients:**
Chi Fu Ling (Poria Cocos with Red Wood) 3 fen, Bie Jia (Carapax et Plastrum Testudinis) 3 fen (coated with vinegar, roasted until yellow, skirt removed), Niu Xi (Radix Achyranthis Bidentatae) 3 fen (shoots removed), Zhi Ke (Fructus Aurantii) 3 fen (bran-fried until slightly yellow, pith removed), Shao Yao (Radix Paeoniae Alba/Rubra) 3 fen, Gui Xin (Cortex Cinnamomi) [Text fragmentary].
**Preparation and Administration:**
Grind into fine powder. Mix with refined honey to form pills the size of Sophora seeds. Take 30 pills with warm ginger decoction at any time.
For Shang Han with unbearable hardness and pain in the heart, or abdominal fullness, approaching Jie Xiong (Chest Binding), the Zhu Sha Wan (Cinnabar Pill) is indicated.
**Ingredients:**
Zhu Sha (Cinnabaris) 1 liang (finely ground and purified by water flotation), Tao Ren (Semen Persicae) 1 liang (soaked in water, skin and tip removed, double-kernel removed, bran-fried until slightly yellow, separately ground into paste), She Xiang (Moschus) 1 fen (finely ground).
**Preparation and Administration:**
Grind together uniformly. Mix with refined honey to form pills the size of Sophora seeds. Take 20 pills with warm ginger decoction at any time.