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Treats the syndrome of Major Chest Binding (Da Jie Xiong Zheng). The pulse is deep and tight. There is pain in the epigastrium, and palpation reveals hardness like a stone.

Rhubarb Root (Da Huang) - 6 liang
Mirabilite (Mang Xiao) - 1 sheng
Kansui Root (Gan Sui) - 1 qian bi

Take the above three herbs. Add six sheng of water. First decoct Rhubarb Root until two sheng remain. Strain to remove the dregs. Add Mirabilite. Boil for one or two boils. Add Kansui Root powder. Take one sheng warm.

Song says: One qian bi of Kansui Root, one sheng of Mirabilite, six liang of Rhubarb Root; the medicinal power is quite ample. For tidal fever occurring at dusk (ri bu), abdominal fullness and pain, this formula eliminates the accumulation in the chest.

Wei An (Chen Nianzu's commentary): Rhubarb Root and Mirabilite are bitter and salty substances. Relying on the toxicity of Kansui Root, they reach directly to the fluid retention (yin xie) in the chest. They do not specifically purge the filth in the stomach.

The action of the decoction covers both upper and lower regions. If the diaphragm can resist the pathogen, the pathogen remains only in the chest. If the diaphragm cannot resist the pathogen, the pathogen stays in the chest and spreads to the stomach. When both the chest and stomach are diseased, it becomes Chest Binding. If there is pathogen in the chest but the stomach is not affected, it presents as half-exterior half-interior syndrome with chest and hypochondriac fullness (Shaoyang disease). If the stomach is affected but the chest does not retain the pathogen, it presents as Yangming disease with excess in the stomach (Yangming Fu Syndrome). None of these are Chest Binding. Therefore, differentiation must be clear to avoid errors.

Treats Minor Chest Binding (Xiao Jie Xiong Bing). The location is precisely in the epigastrium. Pain occurs only upon palpation. A floating and slippery pulse indicates this formula is indicated. It also treats binding pain in the epigastrium accompanied by asthma and chest oppression.

Coptis Rhizome (Huang Lian) - 1 liang
Pinellia Tuber (Ban Xia) - half sheng (washed)
Trichosanthes Fruit (Gua Lou Shi) - one large fruit

Take the above three herbs. Add six sheng of water. First decoct Trichosanthes Fruit until three sheng remain. Strain to remove the dregs. Add the other herbs. Decoct until two sheng remain. Strain to remove the dregs. Divide into three warm doses.

Song says: Pain only upon palpation indicates the disease is lighter. (This is distinctly different from Major Chest Binding where touch is intolerable.) Pathogenic factors condense in the meridians and form a knot in the epigastrium. ("Precisely in the epigastrium" is stated.)

Zhang Ling Shao (Zhang Yinan) said: Formless pathogenic qi binds between the chest and diaphragm. Because it is formless, it transforms into something tangible, causing severe pain that cannot be touched, thus forming Major Chest Binding. When bound in the meridians, the accumulated heat descends. If Major Chest Binding were treated with this formula (Minor Chest Binding Formula), the medicinal strength would be insufficient for the disease, often leading to death. Furthermore: Qi is formless, while meridians are tangible. To resolve pathogenic qi bound formlessly within the chest and diaphragm, one uses Tangkuei Root (Da Huang) and Kansui Root (Gan Sui) to expel via the tangible intestines and stomach. To resolve binding in the meridians, one uses Coptis Rhizome (Huang Lian) and Pinellia Tuber (Ban Xia) to dissipate from the formless qi level. This illustrates the principle of mutual penetration between meridians and qi.

Xu Ling Tai said: Da Cheng Qi Tang purges dry feces. Da Xian Xiong Tang purges accumulated water. This formula purges yellow phlegm sputum (huang xian). Sputum is lighter than accumulated water and has not yet formed fluid retention. Such precision in syndrome differentiation and appropriateness in medication is remarkable.