大黄（二两味苦寒） 黄连（一两味苦寒）
上二味。以麻沸汤二升。渍之。须臾。绞去滓。分温。再服。
内经曰。火热受邪。心病生焉。苦入心。寒除热大黄黄连之苦寒。以导泻心下之虚
热。但以麻沸汤渍服者。取其气薄而泄虚热。
心下痞。而复恶寒汗出者。附子泻心汤主之。
心下痞者。虚热内伏也。恶寒汗出者。阳气外虚也。与泻心汤攻痞。加附子以固阳。
大黄（二两） 黄连 黄芩（各一两） 附子（一枚炮去皮破别煮取汁）
上四味。切三味。以麻沸汤二升渍之。须臾。绞去滓。内附子汁。分温再服。
本以下之。故心下痞。与泻心汤。痞不解。其人渴而口燥烦。小便不利者。五苓散
主之。
本因下后成痞。当与泻心汤除之。若服之。痞不解。其人渴而口燥烦。小便不利者。
为水饮内蓄。津液不行。非热痞也。与五苓散。发汗散水则愈。一方。忍之一日。乃愈
者。不饮水者。外水不入。所停之水得行。而痞亦愈也。
伤寒汗出解之后。胃中不和。心下痞硬。干噫食臭。胁下有水气。腹中雷鸣。下利
者。生姜泻心汤主之。
胃为津液之主。阳气之根。大汗出后。外亡津液。胃中空虚。客气上逆。心下痞硬。
金匮要略曰。中焦气未和。不能消谷。故令噫。干噫食臭者。胃虚而不杀谷也。胁
下有水气。腹中雷鸣。土弱不能胜水也。与泻心汤以攻痞。加生姜以益胃。
Rhubarb (Radix et Rhizoma Rhei, 2 liang, bitter and cold in nature) Coptis Rhizome (Rhizoma Coptidis, 1 liang, bitter and cold in nature)
These two ingredients. Soak them in two sheng of boiling water (Ma Fei Tang). After a short while, strain off the dregs. Divide into two doses and take warm.
The *Neijing* states: When pathogenic fire-heat is received, heart disease arises. Bitter flavor enters the Heart. Cold nature eliminates heat. The bitter-cold properties of Rhubarb and Coptis Rhizome are used to guide and purge deficient heat from the epigastrium. Only soaking them in boiling water for ingestion is chosen to utilize their light aroma to drain deficient heat.
Epigastric fullness and obstruction (Xin Xia Pi), accompanied by aversion to cold and sweating, is primarily treated with Fuzi Xie Xin Decoction (Aconite Decoction to Drain the Epigastrium).
Epigastric fullness indicates deficient heat lurking internally. Aversion to cold and sweating indicate deficiency of Yang Qi on the exterior. Administer Xie Xin Decoction (Decoction to Drain the Epigastrium) to attack the fullness; add Prepared Aconite Root (Radix Aconiti Lateralis Preparata) to secure the Yang Qi.
Rhubarb (Radix et Rhizoma Rhei, 2 liang) Coptis Rhizome (Rhizoma Coptidis) Scutellaria Root (Radix Scutellariae, each 1 liang) Prepared Aconite Root (Radix Aconiti Lateralis Preparata, one piece, processed, skin removed, broken apart, decocted separately to extract juice)
These four ingredients. Slice the first three. Soak them in two sheng of boiling water. After a short while, strain off the dregs. Add the juice of the Prepared Aconite Root. Divide into two doses and take warm.
Originally, due to improper use of purgative methods, epigastric fullness resulted. Xie Xin Decoction was given, but the fullness did not resolve. If the patient experiences thirst, dry mouth with irritability, and dysuria, Wu Ling San (Five-Ingredient Powder with Poria) is indicated.
Originally, the pi syndrome formed after purgation should be eliminated with Xie Xin Decoction. If, after administration, the fullness does not resolve, and the patient exhibits thirst, dry mouth with irritability, and dysuria, this indicates internal accumulation of fluid retention and failure of Jin Ye (Body Fluids) to circulate, rather than Heat Pi Syndrome. Administer Wu Ling San; inducing sweat to dissipate water will lead to recovery. Another view: enduring without drinking water for one day leads to recovery. This is because no new water enters from outside, allowing the retained water to move, and the fullness resolves.
After Taiyang Disease (Shang Han) has been resolved by sweating, if there is disharmony in the Stomach, epigastric fullness with hardness, dry belching with food odor, fluid qi under the flanks, borborygmus in the abdomen, and diarrhea, Sheng Jiang Xie Xin Decoction (Fresh Ginger Decoction to Drain the Epigastrium) is indicated.
The Stomach is the master of Jin Ye and the root of Yang Qi. After profuse sweating, exterior Jin Ye is lost, leaving the Stomach empty. Hostile Qi rebels upward, causing epigastric fullness and hardness. The *Jingui Yaolue* states: When Qi in the Middle Jiao is unharmonized, it cannot digest grains, thus causing belching. Dry belching with food odor indicates Stomach deficiency failing to rot and ripen grains. Fluid qi under the flanks and borborygmus indicate weak Earth failing to overcome Water. Administer Xie Xin Decoction to attack the fullness; add Fresh Ginger (Rhizoma Zingiberis Recens) to benefit the Stomach.