阳明病不吐不下心烦者
大黄（四两去皮清酒浸苦寒） 甘草（二两炙甘平） 芒硝（半升咸苦大寒）
上三味 咀以水三升煮取一升去滓内芒硝更上火微煮令沸少少温服之
成无己曰热淫于内治以咸寒佐以苦甘芒硝咸寒以除热大黄苦寒以荡实甘草甘平助二物推
陈而
阳明病脉迟汗出不恶寒身重短气腹满潮热大便硬者
大黄（四两酒洗苦寒） 浓朴（半斤炙去皮苦温） 枳实（五枚炙苦寒） 芒硝（三合
咸寒）
上四味以水一斗先煮二物取五升去滓内大黄更煮取二升去滓内芒硝更上微火一两沸分温
再服
成无己曰内经曰燥淫所胜以苦下之大黄枳实之苦以润燥除热又曰燥淫于内治以苦温浓朴
之苦
即大承气汤去芒硝减浓朴（六两）枳实（二枚）大热结实者与大承气汤小热微结者与
承气
汤以热不大甚故去芒硝又以结不至坚故减浓朴枳实也一名顺气汤一名三物浓朴汤成无己曰承
顺也伤寒入胃胃气郁滞糟粕秘结壅而为实是正气不得舒顺也汤以荡涤实邪使正气
以承气名之又曰承气汤下药也用之尤宜审焉审知大实大满坚有燥屎乃可投之也如
寒热而病不除况无满实者而或妄投之则结胸痞气之病生矣故曰伤寒有承气之戒也
按海藏云调胃承气汤治实而不满即正阳阳明是也大承气汤治大满大实即太阳阳明是也小
承气
也惟
药则
损成
承气
Yangming disease, where there is mental restlessness (Xin Fan) without prior emesis or purgation:
Rhubarb Radix et Rhizoma (Da Huang, 4 liang, peeled, soaked in clear wine, bitter and cold) Licorice Root (Gan Cao, 2 liang, honey-fried, sweet and neutral) Mirabilite (Mang Xiao, half sheng, salty and very cold)
Take the above three herbs, cut into pieces, decoct with three sheng of water to obtain one sheng, strain off the dregs, add Mang Xiao, heat again over a mild fire until boiling, and take warm in small amounts frequently.
Cheng Wuji stated: When heat pervades internally, treat with salty-cold substances, assisted by bitter-sweet ones. Mang Xiao is salty and cold to eliminate heat; Da Huang is bitter and cold to purge accumulation; Gan Cao is sweet and neutral, assisting these two substances to push out the old and bring forth the new.
Yangming disease characterized by a slow pulse, sweating, aversion to cold absent, heavy body, shortness of breath, abdominal fullness, tidal fever, and hard stool:
Rhubarb Radix et Rhizoma (Da Huang, 4 liang, washed with wine, bitter and cold) Magnolia Bark (Hou Po, half jin, fried, peeled, bitter and warm) Immature Bitter Orange (Zhi Shi, five pieces, fried, bitter and cold) Mirabilite (Mang Xiao, three he, salty and cold)
Take the above four herbs, decoct with one dou of water. First decoct Hou Po and Zhi Shi to obtain five sheng, strain off the dregs, add Da Huang, decoct further to obtain two sheng, strain off the dregs, add Mang Xiao, heat briefly over a mild fire for one or two boils, and divide into two doses to be taken warm.
Cheng Wuji stated: The *Neijing* says: When dryness prevails, use bitter purgatives. The bitterness of Da Huang and Zhi Shi moistens dryness and eliminates heat. It also states: When dryness invades internally, treat with bitter-warm methods. The bitterness of Hou Po...
This refers to Da Cheng Qi Tang minus Mang Xiao, with reduced Hou Po (6 liang) and Zhi Shi (two pieces). For cases of severe heat and solid accumulation, administer Da Cheng Qi Tang; for cases of slight heat and minor accumulation, administer Cheng Qi Tang. Because the heat is not extreme, Mang Xiao is omitted; because the accumulation is not hard, Hou Po and Zhi Shi are reduced. Also known as Shun Qi Tang or San Wu Hou Po Tang. Cheng Wuji stated: "Cheng" means to follow or accommodate. When Shaoyang pathogen enters the stomach, stomach qi becomes stagnant, waste products become constipated, obstructing and forming excess syndrome, preventing the healthy qi from flowing smoothly. This decoction purges excess pathogens, allowing the healthy qi to flow smoothly, hence named Cheng Qi Tang. He further stated: Cheng Qi Tang belongs to purgative formulas; their use requires particular caution. Only when there is confirmed great excess, great fullness, hardness, and dry feces should they be administered. If one administers them recklessly in cases where chills and fever persist but there is no fullness or excess, conditions such as Jie Xiong (Chest Binding) and Pi Qi (Pi Syndrome) may arise. Thus, it is said that there are warnings regarding the use of Cheng Qi Tang in Shaoyang diseases.
According to Haicang (Zhang Yuansu): Tiao Wei Cheng Qi Tang treats excess without fullness, corresponding to Zheng Yang Yangming syndrome; Da Cheng Qi Tang treats great fullness and great excess, corresponding to Tai Yang Yangming syndrome; Xiao Cheng Qi Tang... regarding the herbs... damage... Cheng Qi...