〔镇逆〕旋复代赭汤 见本卷呕吐。
〔降气〕苏子降气汤 见二卷失音。
〔虚滞〕十味保和汤 参 术 苓 夏 陈 藿 草 香附 砂仁 木香
〔寒滞〕和胃煎 朴 陈 姜 草 或加苓、夏、丁香、木香、砂仁、藿香亦可。
〔驱痰〕和胃二陈汤 见本卷饮食。
〔虚饱〕养中煎 见本卷饮食。
〔温中〕理中丸 见一卷中风。
〔火衰〕理阴煎 见二卷咳嗽。
〔痰火〕星夏栀子汤 半夏 南星 香附 石膏 栀子
〔和中〕健脾散 人参 白术 丁香 藿香 砂仁 肉果 神曲 炙草 姜 枣
侄 左胁痞闷，上撑胸臆，频嗳不舒。按丹溪云∶凡上升之气，自肝而出。左胁肝部也，痞而上逆，必
犯胃。仿仲景旋复代赭汤，成氏所谓咸以软坚，重以镇逆也。代赭汤去甘草、姜、枣，加广皮、栝蒌皮、枳壳
（俱麸炒）。三服而愈。
心下满而硬痛，为结胸；满而不痛，为痞。痞则闭而不开，
满则闷而不舒。病在胸膈气分，而外不胀急，但不知饥，不欲食，脉缓弱，或虚弦。不宜过用消耗，重损元气。
经云∶太阴所至为痞满。《保命集》曰∶脾不能行气于肺胃，结而不散，则为痞。伤寒之痞，从外之内，故
宜苦泄。杂病之痞，从内之外，故宜辛散。治伤寒热痞，用苦寒药，大黄黄连泻心汤。治伤寒阴阳不和而痞，
兼用寒热药，三黄加附子汤。治伤寒阴盛阳虚而痞，则辛甘药多，而苦寒药少。半夏、甘草、生姜诸泻心汤。
二黄泻心汤治伤寒心下痞，关上脉浮。附子泻心汤治伤寒心下痞，复恶寒汗出。去附子名三黄泻心汤，治伤寒
热痞。半夏泻心汤治胸满而呕。甘草泻心汤治胃虚气逆。生姜泻心汤治胁有水气。痞虽虚邪，然表气入里，
热郁于心胸之分，必用苦寒为泻，辛甘为散，诸泻心汤所以寒热互用也。杂病痞满，亦有寒热虚实之不同，
如胃口寒滞停痰痞闷者，辛温泄浊。橘皮半夏汤，或二陈汤加丁香。饮食寒凉，伤胃致痞者，温中化滞。
和胃煎加楂肉、麦芽、砂仁、或浓朴温中汤，脾胃阳微，胸不清旷者，辛甘理阳。苓桂术甘汤。中气久虚，
精微不化者，升清降浊。补中益气汤加猪苓、泽泻。《医通》曰∶升、柴从九地之下而升其清，苓、泻从九天
之上而降其浊，所以交否而为泰也。脾虚失运，食少虚痞者，温补脾元。四君子汤，异功散。胃虚气滞而
痞者，行气散满。保和汤，或三因七气汤，食滞未除作痞者，专消导。大和中饮，或枳术丸、资生丸。食滞既
消，脾气受伤者，宜调补。异功散、养中煎。心脾郁结而成痞者，调其气。归脾汤、治中汤。暴怒伤肝，气
逆而痞者，舒其郁。解肝煎。肺失肃降。痰热阻痞者，清理上焦。清肺饮去五味、甘草，加豆豉、栝蒌、山栀、
竹茹、枇杷叶、枳壳。气闭化热，不食便秘者，辛润开降。蔻仁、杏仁、麻仁、栝蒌仁、贝母、竹茹、石斛、
郁金，或小陷胸汤。热邪里结，恶心中痞者，苦酸泄降。半夏泻心汤去参、甘、枣，加枳、芍、乌梅。暑邪阻
气，热渴满闷者，暑邪面垢脉虚，胸闷脘痞。辛凉清上。三物香薷饮、消暑丸加桔梗、竹茹、杏仁、茯苓、
滑石、郁金汁。湿邪阻气，呕恶胸痞者，湿邪头胀，舌白不饥，脘痞恶心，脉缓。甘淡渗湿。六一散加芦根、
茯苓、杏仁、薏仁、通草、藿梗、半夏、
蔻仁、或平胃散。寒热往来，胸胁痞满者，和解半表半里。小柴胡汤加枳、桔、栝蒌皮。噎膈痞塞，乃痰与气
搏，不得宣通。痰为气激而升，气为痰腻而滞，故痞塞而成噎膈也。连理汤、生姜泻心汤。痰挟瘀血，成窠囊，
作痞，脉沉涩，日久不愈，惟悲哀郁抑之人有之，宜从血郁治。桃仁、红花、丹皮、香附、降香、苏木、韭汁、
童便。
[Method of Subduing Rebellious Qi] Xuanfu Daizhe Tang (Inula and Hematite Decoction), see Vomiting in this volume.
[Method of Descending Qi] Suzi Jiangqi Tang (Perilla Seed Decoction for Descending Qi), see Aphonia in Volume II.
[Deficiency with Stagnation] Shiwei Baohe Tang (Ten-Ingredient Harmonizing the Middle Decoction): Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Banxia (Pinelliae Tuber), Chenpi (Citri Reticulatae Pericarpium), Huoxiang (Agastaches Herba), Gancao (Glycyrrhizae Radix et Rhizoma), Xiangfu (Cyperi Rhizoma), Sharen (Amomi Fructus), Muxiang (Aucklandiae Radix).
[Cold with Stagnation] Hewei Jian (Stomach-Harmonizing Decoction): Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Shengjiang (Zingiberis Rhizoma Recens), Gancao (Glycyrrhizae Radix et Rhizoma); alternatively, add Fuling (Poria), Banxia (Pinelliae Tuber), Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), Huoxiang (Agastaches Herba).
[Method of Expelling Phlegm] Hewei Erchen Tang (Stomach-Harmonizing Two-Aged Decoction), see Diet in this volume.
[Fullness due to Deficiency] Yangzhong Jian (Nourishing the Middle Decoction), see Diet in this volume.
[Method of Warming the Middle] Lizhong Wan (Regulate the Middle Pill), see Stroke in Volume I.
[Decline of Fire] Liyin Jian (Nourishing Yin Decoction), see Cough in Volume II.
[Phlegm-Fire] Xingxia Zhizi Tang (Arisaema, Pinellia, and Gardenia Decoction): Banxia (Pinelliae Tuber), Nanxing (Arisaematis Rhizoma), Xiangfu (Cyperi Rhizoma), Shigao (Gypsum Fibrosum), Zhizi (Gardeniae Fructus).
[Method of Harmonizing the Middle] Jianpi San (Spleen-Strengthening Powder): Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Dingxiang (Caryophylli Flos), Huoxiang (Agastaches Herba), Sharen (Amomi Fructus), Rougu (Myristicae Semen), Shenqu (Massa Medicata Fermentata), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), Dazao (Jujubae Fructus).
The nephew suffered from stuffiness and oppression in the left hypochondrium, distending upward to the chest and epigastrium, accompanied by frequent belching and discomfort. According to Danxi: "All ascending qi originates from the Liver." The left hypochondrium is the region of the Liver; stuffiness with rebellious qi must invade the Stomach. Following Zhongjing's Xuanfu Daizhe Tang, which Chengshi describes as "salty to soften hardness, heavy to subdue rebellion," we used Daizhe Tang removing Gancao (Glycyrrhizae Radix et Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus), adding Guangpi (Citri Reticulatae Pericarpium), Gualoupi (Trichosanthis Pericarpium), and Zhike (Aurantii Fructus Immaturus) (all stir-fried with bran). After three doses, he recovered.
Fullness, hardness, and pain in the epigastrium constitute Jie Xiong (Chest Binding); fullness without pain constitutes Pi (Stagnant Fullness). Pi is characterized by blockage and lack of openness, while Man (Fullness) is characterized by oppression and discomfort. The pathology lies in the Qi level of the chest and diaphragm, with no external tension or swelling, but rather a lack of hunger and anorexia. The pulse may be slow and weak, or deficient and wiry. One should not overuse draining drugs that severely damage Yuan Qi (Original Qi). The Classics state: "What arrives from Taiyin manifests as Pi Man (Stagnant Fullness)." *Baoming Ji* states: "When the Spleen cannot transport Qi to the Lung and Stomach, and it knots without dispersing, Pi results." Pi caused by Shanghan (Cold Damage) arises from the exterior moving inward, thus requiring bitter-draining methods. Pi caused by miscellaneous diseases arises from the interior reaching outward, thus requiring acrid-dispersing methods. For Shanghan Heat Pi, use bitter-cold herbs, such as Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Heart-Draining Decoction). For Pi due to Yin-Yang disharmony in Shanghan, combine cold and hot herbs, such as Sanhuang Jia Fuzi Tang (Three Yellows plus Aconite Decoction). For Pi due to excess Yin and deficiency of Yang in Shanghan, use more acrid-sweet herbs and fewer bitter-cold ones, such as Banxia, Gancao, and Shengjiang Xiexin Tangs. Erhuang Xiexin Tang treats Shanghan Epigastric Pi with a floating Guan pulse. Fuzi Xiexin Tang treats Shanghan Epigastric Pi accompanied by aversion to cold and sweating. Sanhuang Xiexin Tang (without Fuzi) treats Shanghan Heat Pi. Banxia Xiexin Tang treats chest fullness with vomiting. Gancao Xiexin Tang treats Stomach deficiency with rebellious Qi. Shengjiang Xiexin Tang treats water-Qi in the hypochondrium. Although Pi is a deficiency-pathogen, when exterior Qi enters the interior and heat stagnates in the heart-chest region, bitter-cold herbs are necessary to drain, and acrid-sweet herbs to disperse; hence, the various Xiexin Tangs use cold and hot herbs mutually. Miscellaneous disease Pi Man also varies by cold, heat, deficiency, and excess. For stomach cold-stagnation with retained phlegm causing stuffiness, use acrid-warm turbidity-draining methods, such as JuPi Banxia Tang (Tangerine Peel and Pinellia Decoction) or Erchen Tang (Two-Aged Decoction) added with Dingxiang (Caryophylli Flos). For Pi caused by dietary cold damaging the Stomach, use warming-middle and stagnation-resolving methods, such as Hewei Jian (Stomach-Harmonizing Decoction) added with Zhari Rou (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), and Sharen (Amomi Fructus), or Nongpu Wenzhong Tang (Magnolia Bark Decoction for Warming the Middle). For slight Spleen-Stomach Yang deficiency with unclear chest cavity, use acrid-sweet Yang-regulating methods, such as Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction). For long-term Middle Qi deficiency with failure to transform essence, use ascending-clear and descending-turbid methods, such as Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting Qi) added with Zhuling (Polyporus) and Zexie (Alismatis Rhizoma). *Yitong* states: "Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) ascend clear Qi from below, while Fuling (Poria) and Zexie (Alismatis Rhizoma) descend turbid Qi from above, transforming obstruction into harmony." For Spleen deficiency with failed transportation, leading to food intake reduction and deficient Pi, use warming-tonifying Spleen-origin methods, such as Sijunzi Tang (Four Gentlemen Decoction) or Yigong San (Extraordinary Skill Powder). For Stomach deficiency with Qi stagnation causing Pi, use Qi-moving and distension-resolving methods, such as Baohe Tang (Harmonizing the Middle Decoction) or Sanyin Qi Qi Tang (Three Causes Seven Qi Decoction). For Pi caused by unremoved food stagnation, focus on digestion-promoting methods, such da Hezhong Yin (Great Harmonizing the Middle Infusion), or Zhizhu Wan (Aurantium and Atractylodes Pill), or Zisheng Wan (Nourishing Life Pill). After food stagnation is resolved but Spleen Qi is injured, use regulation and tonification, such as Yigong San (Extraordinary Skill Powder) or Yangzhong Jian (Nourishing the Middle Decoction). For Pi formed by Heart-Spleen depression, regulate Qi, such as Guipi Tang (Restore the Spleen Decoction) or Zhizhong Tang (Regulate the Middle Decoction). For Pi caused by sudden anger injuring the Liver and rebellious Qi, soothe depression, such as Jiegan Jian (Relieve Liver Decoction). For Lung failing in descending function with phlegm-heat obstructing Pi, clear the Upper Jiao, such as Qingfei Yin (Lung-Clearing Infusion) removing Wuweizi (Schisandrae Fructus) and Gancao (Glycyrrhizae Radix et Rhizoma), adding Douchi (Sojae Semen Preparatum), Gualou (Trichosanthis Fructus), Zhizi (Gardeniae Fructus), Zhuru (Bambusae Caulis in Taenia), Pipaye (Loquat Leaf), and Zhike (Aurantii Fructus Immaturus). For Qi closure transforming into heat, with anorexia and constipation, use acrid-moistening opening and descending methods, such as Keren (Amomi Semen), Xingren (Armeniacae Semen Amarum), Maren (Cannabis Semen), Gualou Ren (Trichosanthis Semen), Beimu (Fritillariae Bulbus), Zhuru (Bambusae Caulis in Taenia), Shihu (Dendrobii Caulis), and Yujin (Curcumae Radix), or Xiaoxianxiong Tang (Small Chest-Thrashing Decoction). For internal binding of heat pathogen with nausea and epigastric Pi, use bitter-acid draining and descending methods, such as Banxia Xiexin Tang (Pinellia Heart-Draining Decoction) removing Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), and Dazao (Jujubae Fructus), adding Zhishi (Aurantii Fructus Immaturus), Shaoyao (Paeoniae Radix Alba), and Wumei (Mume Fructus). For Summerheat pathogen obstructing Qi with heat-thirst and fullness, if presenting with summerheat facial greasiness, deficient pulse, chest fullness, and epigastric Pi, use acrid-cool clearing-upper methods, such as Sanwu Xiangru Yin (Three-Ingredient Elsholtzia Infusion) or Xiaoshu Wan (Summerheat-Dispelling Pill) added with Jiegeng (Platycodon Radix), Zhuru (Bambusae Caulis in Taenia), Xingren (Armeniacae Semen Amarum), Fuling (Poria), Huashi (Humphilitis), and Yujin juice. For Dampness pathogen obstructing Qi with vomiting, nausea, and chest Pi, if presenting with dampness-induced head heaviness, white tongue coating, anorexia, epigastric Pi, nausea, and slow pulse, use sweet-bland damp-draining methods, such as Liuyi San (Six-to-One Powder) added with Lugen (Reed Rhizome), Fuling (Poria), Xingren (Armeniacae Semen Amarum), Yiren (Coicis Semen), Tongcao (Tetrapanacis Medulla), Huogeng (Agastache Stem), Banxia (Pinelliae Tuber), and Keren (Amomi Semen), or Pingwei San (Level the Stomach Powder). For alternating chills and fever with chest-hypochondriac Pi Man, harmonize half-exterior half-interior, such as Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Zhishi (Aurantii Fructus Immaturus), Jiegeng (Platycodon Radix), and Gualoupi (Trichosanthis Pericarpium). Yige (Dysphagia) and Pi Se (Obstruction) result from the struggle between Phlegm and Qi, preventing free circulation. Phlegm rises due to Qi agitation, and Qi stagnates due to Phlegm viscosity, thus forming obstruction leading to Yige. Use Lianli Tang (Connected Decoction) or Shengjiang Xiexin Tang (Fresh Ginger Heart-Draining Decoction). When Phlegm carries Blood Stasis forming nests causing Pi, with deep-choppy pulse and chronic non-resolution, occurring only in those who are sorrowful and depressed, treat from Blood Depression, such as Tao Ren (Persicae Semen), Honghua (Carthami Flos), Danpi (Moutan Cortex), Xiangfu (Cyperi Rhizoma), Jiangxiang (Dalbergiae Odoriferae Lignum), Sumu (Pterocarpi Santalinus), Jiuzhi (Allii Tuberosi Juice), and Tongbian (Human Urine).