（仲景） 治伤寒误下。小结胸，正在心下，按之则痛，脉浮滑者，及痰热塞胸。（前
证上下俱硬，此则正在心下，前证痛不可近，此则按之则痛。结胸脉沉紧，或寸浮关沉。
脉浮滑，知热未深，与此汤以除膈上结热。）
黄连（一两） 半夏（半升） 栝蒌（大者一枚）
黄连之苦寒以泄热，栝蒌之寒润以涤垢，半夏之辛温以散结。结胸多由痰热结聚，故用
三物
实旋
（仲景） 治伤寒结胸，项强如柔痉状。（有汗为柔痉，胸膈实满，故项强而不能俯
项属太阳部位。）
大黄（八两） 杏仁（去皮尖） 葶苈（炒） 芒硝（各半升） 合研，取如弹丸一枚。
别捣甘遂末
降气，葶苈
（仲景） 治太阳中风，下利呕逆，表解者乃可攻之。其人 汗出，头痛，心下痞硬
，引胁下痛，干呕短气，汗出不恶寒，表解而里未和。邪热内蓄，有伏饮者。（下利呕逆，
里受邪也。汗出不恶寒，表已解也。头痛痞硬，引胁下痛，干呕短气，邪热内蓄，而有伏
也，此为水气上逆。呕逆头痛，与表证头痛稍别。周扬俊曰∶此证与结胸颇同，故汤亦与
胸相仿，表解后攻，与结胸之戒不殊也。）
芫花（炒黑） 甘遂 大戟（等分） 大枣（十枚） 先煮枣去滓，内前药末。强人服
一钱，虚人
芫花大戟之辛苦，以遂水饮，甘遂苦寒，能直达水气所结之处，以攻决为用。三药过峻，
故
桂
表
咳
痛
枣
术
恣
逐
是
除大枣，加大黄黑丑轻粉，水丸，名三花神佑丸。（河间）治壮实人风痰郁热，肢体麻
痹，走
涎塞，
以去痰
小胃丹。（
[Small Xianxiong Decoction]
(Zhang Zhongjing) Treats the minor Jie-Xiong (chest binding) syndrome resulting from the erroneous use of purgatives in Shanghan (Cold Damage). The pathology is located precisely at the epigastrium; pain occurs only upon palpation, and the pulse is floating and slippery. It also treats phlegm-heat obstructing the chest. (In previous syndromes, hardness and fullness extend above and below the chest; here it is localized to the epigastrium. In previous syndromes, pain is severe and patients avoid touch; here, pain occurs only upon pressure. The pulse in Jie-Xiong is typically deep and tight, or floating at the Cun position and deep at the Guan position. A floating and slippery pulse indicates that the heat has not penetrated deeply. This decoction is administered to clear the constrained heat in the diaphragm.)
Coptidis Rhizoma (Huanglian, 黄连) - 1 liang
Pinelliae Tuber (Banxia, 半夏) - half sheng
Trichosanthis Fructus (Gualou, 栝蒌) - one large fruit
The bitter and cold nature of Huanglian clears heat; the cold and moistening nature of Gualou washes away turbidity; the acrid and warm nature of Banxia dissipates constraints. Jie-Xiong syndromes are mostly caused by the accumulation of phlegm-heat; therefore, these three herbs are used.
[Large Xianxiong Pill]
(Zhang Zhongjing) Treats Shanghan Jie-Xiong syndrome, characterized by stiffness of the neck resembling Rou-Ji (soft spasm). (Rou-Ji is defined by the presence of sweating; due to excess fullness in the chest and diaphragm, the neck is stiff and cannot bend forward. The neck belongs to the Taiyang meridian region.)
Rhei Radix et Rhizoma (Dahuang, 大黄) - 8 liang
Prunus Armeniaca Seed (Xingren, 杏仁) - skin and tips removed
Lepidii Semen (Tinglizi, 葶苈子) - stir-fried
Miris Natrii Sulfas (Mangxiao, 芒硝) - half sheng each
Grind together and form into a pill the size of a bullet.
Separately grind Kansui Radix (Gansui, 甘遂) into powder.
(Aimed at) descending Qi; Tinglizi...
[Shizao Decoction]
(Zhang Zhongjing) Treats Taiyang Wind-Strike syndrome accompanied by diarrhea and vomiting/reversal of Qi. Purging may be employed only after the exterior syndrome has resolved. The patient exhibits sweating, headache, epigastric stuffiness and hardness, pain radiating to the hypochondriac region, dry retching, shortness of breath, sweating without aversion to cold. This indicates the exterior is resolved but the interior is not harmonized. Pathogenic heat accumulates internally, with latent fluid retention. (Diarrhea and vomiting indicate pathogenic invasion of the interior; sweating without aversion to cold indicates the exterior is resolved; headache, epigastric stuffiness/hardness, pain radiating to the hypochondrium, dry retching, and shortness of breath indicate internal accumulation of pathogenic heat and latent fluid, constituting rebellious upward movement of water qi. Vomiting/reversal and headache differ slightly from those in exterior syndromes. Zhou Yangjun stated: This syndrome is quite similar to Jie-Xiong; thus, the decoction resembles the Xianxiong formulas. Purging after resolving the exterior aligns with the precautions for Jie-Xiong.)
Genkwa Flos (Yuanhua, 芫花) - stir-fried until black
Kansui Radix (Gansui, 甘遂)
Euphorbiae Pekinensis Radix (Daji, 大戟) - equal parts
Jujubae Fructus (Dazao, 大枣) - 10 pieces
Boil the Dazao first, remove the dregs, and add the powders of the aforementioned herbs. Robust individuals take 1 qian; frail individuals...
The acrid and bitter nature of Yuanhua and Daji expels water retention; the bitter and cold nature of Gansui reaches directly to the site where water qi is constrained, employing attacking and resolving actions. These three herbs are excessively harsh; therefore...
Guizhi (Cinnamon Twig) Exterior syndrome Cough Pain Dazao Baizhu (Atractylodes Macrocephala Rhizome) Indulge/Excessively Pursue Water Is Remove Dazao, add Dahuang, Black Chou (Semen Sinapis), Qingfen (Calomel), form into water pills, named Sanhua Shenyu Wan. (He Jian) Treats robust individuals with wind-phlegm and stagnant heat, causing numbness and bi-syndrome of the limbs, migrating... Phlegm-fluid obstruction, used to eliminate phlegm...
Xiaowei Dan (Small Stomach Pill).