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(Zhang Zhongjing) Treats Taiyang disease (Taiyang disease, a syndrome caused by pathogenic factors invading the Taiyang channel) where premature purgation causes exterior pathogens to sink inward. This results in resistance and pain in the diaphragm, hardness in the epigastrium, forming the Jie Xiong syndrome (Chest Binding syndrome). If heavy sweating is followed by further purgation, leading to constipation for five or six days, dryness and thirst on the tongue, and slight tidal fever in the late afternoon (Ri Bu), from the heart region down to the lower abdomen, there is hardness, fullness, and severe pain that makes the area intolerable to touch. (Pressing reveals hardness and pain: this is Jie Xiong; hardness without pain is Pi [Stagnation]. Premature purgation allows pathogenic heat to enter vacuity and bind between the heart and chest, causing hardness and pain. There are cases of hardness and pain without heat signs, known as Cold-Shi Jie Xiong [Cold-Excess Chest Binding], treated with Bai San [White Powder]. Although Jie Xiong generally requires purgation, if the pulse is floating and large, purgation must be avoided as it leads to death. This is because exterior pathogens remain; purging severely depletes healthy Qi, causing deeper binding of pathogens, hence fatal. Jiayan states: In Taiyang disease mismanaged by purgation, the pathology remains in Yang. Even if pulses are deep-tight or deep-slippery, they should not be classified as Interior Yin syndromes. The Six Books state: Fullness in the chest and diaphragm refers to qi obstruction and stuffiness in the chest, not fullness in the epigastrium. Fullness in the hypochondrium refers to distension in the rib area, not abdominal fullness. Generally, when exterior pathogens transmit inward, they first affect the chest, then move to the heart/abdomen and stomach. Thus, chest fullness often accompanies exterior syndromes and is suitable for mild sweating. Hypochondriac fullness often accompanies Half-Exterior/Half-Interior syndromes and is suitable for harmonizing. Phlegm-excess in the chest requires emesis. If there is excess accumulation, dryness, thirst, and constipation, this decoction is suitable for purgation.)

Appendix: Bai San formula. Ba Dou (Crotonis Fructus, 1 fen), peeled, heart removed, stir-fried until black, and ground; Bei Mu (Fritillariae Bulbus, 3 fen); Jie Geng (Platycodonis Radix, 3 fen). Used for Cold-Shi Jie Xiong. Ba Dou is acrid and hot, dispersing cold binding. Bei Mu is bitter and acrid, dispersing phlegm-heat. Since the binding is in the chest, Jie Geng's floating nature directs it upward, benefiting the diaphragm and clearing the exterior. Therefore, if the disease is above the diaphragm, vomiting occurs; if below, diarrhea occurs.

Da Huang (Rhei Radix et Rhizoma, 2 liang); Mang Xiao (Natrii Sulfas, 1 sheng); Gan Sui (Kansui Radix, 1 qian, ground). First, boil Da Huang, remove dregs, add Mang Xiao, boil for one or two boils, then add Gan Sui powder.

When exterior pathogens enter the interior and bind at a high position, resulting in excess conditions in the Triple Burner (San Jiao), with pain so severe the area cannot be touched, the condition is critical and cannot be resolved by ordinary medicines. Therefore, the bitter-cold property of Gan Sui... [Text fragment] ...causes agitation in the chest (Ao Nao), requiring Zhi Zi Chi Tang (Gardenia and Soybean Decoction) to induce vomiting and expel pathogens from the chest. Tao Jian'an states: Jie Xiong is formed by premature purgation. For those who have not yet been purged, treatment should be gradual based on depth, avoiding excessive harshness. The Upper Burner is the pathway of clear Qi and the highest region; excessive purgation damages Yuan Qi (Primal Qi). Cui Xinggong states: In Taiyang Jie Xiong... [Text fragment] ...natural resolution occurs, likely because Li Zhong Tang (Regulate the Middle Decoction) treats the Middle Burner. Although the Stomach is harmonized, if Taiyang pathogens persist, wait for sufficient time before using Cheng Qi Tang (Order the Qi Decoction) again, as previous purgation was inappropriate. For Water-Jie Xiong, use Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Formula with Added Poria) or Xiao Chai Hu Tang (Minor Bupleurum Decoction) minus Jujube, plus Mu Li (Oyster Shell). For Blood-Jie Xiong, where the area is untouchable, rinsing water but not swallowing, forgetfulness resembling mania, black stool, and free urination, Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) is indicated.)