胸满者，胸膈间气塞闭也，非心下满。胁满者，胁肋下气填胀满也，非腹中
满。盖邪自表传里，必先自胸胁以至心腹而入胃，是以胸满多带表证，宜发汗。胁满者，多在半表
半里之间，宜和解。至于邪结胸中而为实者，又须涌吐之也。
太阳病，下后脉促，胸满，桂枝去芍药汤。病在于胃气，芍药入荣，故去之。
阳明病，喘而胸满，犹带表证，不可下，与麻黄汤、麻黄杏仁甘草石膏汤。
胸胁俱满，或胁下硬痛，或呕吐，舌上白苔，或不大便，并属小柴胡汤。
伤寒五七日，往来寒热，胸胁若满，默默不饮食，心烦喜呕，或胁下痞硬，柴胡加牡蛎汤。
伤寒七八日，下之，胸满烦惊，小便不利，谵语，一身尽痛，不可转侧，柴胡加龙骨牡蛎汤；
胸中痰实，瓜蒂散吐之。胸膈不快，填满闭塞，唇青手冷，脉细沉，少情绪，或腹痛，此名太阴。
经曰∶病发于阳而反下之，热入因作结胸。注曰∶发热恶寒者，发于阳也。外
证项强，心下满硬而痛是也。此为实邪在里，法当下之。若脉浮大，若表证，若水气填，不可下。亦
有不因下而心下硬满者。经曰∶病患手足厥，脉乍紧，邪结胸中，心满而烦，饥不欲食；当吐之。
是则病在胸中也。经曰∶阳明病，心下硬满，不可下，下之，利不止而死。是则邪气自表传里，留
于心下，未全为实，法当吐之，故有此戒。其或结胸证具而烦躁者，不治。
结胸，寸脉浮，关尺皆沉紧，宜下。若脉浮大，或有表证，先用小柴胡汤，表已解，下之。大
结胸，不按而痛连脐腹，痛硬不可近，大陷胸汤；或太峻，用丸。
小结胸，按之而痛，心下硬，小陷胸汤。热实结胸，懊 烦渴，心下痛，少与大陷胸汤。寒实
结胸，无热证，三物白散、枳实理中丸。
大热且大渴，使用黑奴丸。中暑导致口渴，使用白虎加人参汤（Gypsum and Ginseng Decoction）。
胸满，是指胸膈间气机阻塞闭塞，并非心下（胃脘部）胀满。胁满，是指胁肋下部气机填塞胀满，并非腹中胀满。因为邪气从体表传入体内，必定先从胸胁部位进入，进而到达心腹并侵入胃腑，所以胸满多伴有表证，适宜采用发汗法治疗。胁满，多处于半表半里之间，适宜采用和解法治疗。至于邪气结聚于胸中形成实证的情况，又必须采用涌吐法治疗。
太阳病（Taiyang Disease），经过攻下治疗后出现脉促、胸满，使用桂枝去芍药汤（Cinnamon Twig Decoction without Paeonia）。病位在于胃气受扰，芍药（Paeonia Root）入营分，因此去掉它。
阳明病（Yangming Disease），出现气喘且胸满，仍带有表证，不可使用攻下法，给予麻黄汤（Ephedra Decoction）或麻黄杏仁甘草石膏汤（Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction）。
胸胁均感胀满，或者胁下硬痛，或者呕吐，舌苔白，或者不大便，这些情况都归属于小柴胡汤（Minor Bupleurum Decoction）的主治范围。
伤寒病五到七天，出现往来寒热（alternating chills and fever）、胸胁胀满、神情沉默不欲饮食、心烦喜呕，或者胁下痞硬，使用柴胡加牡蛎汤（Bupleurum with Oyster Shell Decoction）。
伤寒病七八天，经过攻下治疗后，出现胸满、烦躁惊悸、小便不利、谵语、全身疼痛、身体转动困难，使用柴胡加龙骨牡蛎汤（Bupleurum with Dragon Bone and Oyster Shell Decoction）；若是胸中有痰实之邪，使用瓜蒂散（Melon Stalk Powder）进行涌吐。若胸膈不适，填满闭塞，嘴唇青紫、手脚冰冷、脉象细沉、情绪低落，或者腹痛，这名为太阴病（Taiyin Disease）。
经典记载：疾病发于阳经却反而被误用攻下法，热邪内陷因而形成结胸（Jie Xiong / Knotting Chest Syndrome）。注释说：发热恶寒的，是发于阳经。外在表现为项背强直，心下胀满坚硬且疼痛。这是实邪在里，依法应当使用攻下法。但是如果脉象浮大，或者仍有表证，或者有停水之气，则不可攻下。也有不是因误下而导致心下硬满的情况。经典记载：病人手足厥冷，脉象突然紧束，邪气结聚于胸中，心中烦闷胀满，感到饥饿但不想吃东西；应当使用涌吐法。这说明病位在胸中。经典记载：阳明病，心下硬满，不可攻下，如果攻下，会导致腹泻不止而死亡。这说明邪气从体表传入体内，停留于心下，尚未完全成为实证，依法应当涌吐，所以有此告诫。那些结胸证候齐全但出现烦躁不安的，属于不治之症。
结胸证，寸脉浮，关脉和尺脉皆沉紧，适宜使用攻下法。如果脉象浮大，或者还有表证，先使用小柴胡汤，待表证解除后，再行攻下。大结胸（Major Jie Xiong），不按也疼痛且牵连至脐腹部，疼痛剧烈、坚硬拒按，使用大陷胸汤（Major Downward Draining Decoction for the Chest）；如果觉得药力太峻猛，可以使用丸剂。
小结胸（Minor Jie Xiong），按压才疼痛，心下硬满，使用小陷胸汤（Minor Downward Draining Decoction for the Chest）。热实结胸，心中懊憹烦渴，心下疼痛，少量给予大陷胸汤。寒实结胸，没有热象，使用三物白散（Three-Ingredient White Powder）或枳实理中丸（Aurantium and Immature Bitter Orange Pill to Regulate the Middle）。
For severe heat and extreme thirst, use Heinu Wan (Black Slave Pill). For heatstroke causing thirst, use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng).
"Fullness in the chest" refers to the obstruction and closure of Qi in the chest and diaphragm region, not fullness below the heart (epigastrium). "Fullness in the hypochondrium" refers to the filling and distension of Qi under the ribs, not fullness in the abdomen. This is because pathogenic factors transmitting from the exterior to the interior must first pass through the chest and hypochondrium before entering the epigastrium and stomach. Therefore, chest fullness is often accompanied by exterior syndromes and should be treated with sweating methods. Hypochondriac fullness usually occurs between the exterior and interior and should be treated with harmonizing methods. As for cases where pathogenic factors knot in the chest forming excess syndromes, emetic methods must be used.
In Taiyang Disease (Taiyang Disease), if pulse acceleration and chest fullness occur after purgation, use Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction without Paeonia). The pathology lies in the disturbance of Stomach Qi; since Shaoyao (Paeonia Root) enters the Ying (Nutritive) level, it is removed.
In Yangming Disease (Yangming Disease), if panting and chest fullness occur while still carrying an exterior syndrome, purgation is contraindicated. Administer Mahuang Tang (Ephedra Decoction) or Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction).
If both the chest and hypochondrium are full, or there is hardness and pain under the hypochondrium, vomiting, a white coating on the tongue, or constipation, these all fall under the indication for Xiaochaihu Tang (Minor Bupleurum Decoction).
In Cold Damage disease lasting five to seven days, if there are alternating chills and fever, chest and hypochondriac fullness, silent demeanor with loss of appetite, irritability and frequent vomiting, or hardness beneath the hypochondrium, use Chaihu Jia Muli Tang (Bupleurum with Oyster Shell Decoction).
In Cold Damage disease lasting seven to eight days, if purgation was performed leading to chest fullness, irritability and fright, difficulty in urination, delirious speech, generalized body pain, and inability to turn the body, use Chaihu Jia Longgu Muli Tang (Bupleurum with Dragon Bone and Oyster Shell Decoction); if there is phlegm-excess in the chest, use Goudi San (Melon Stalk Powder) to induce vomiting. If the chest and diaphragm feel uncomfortable, filled and blocked, with blue lips, cold hands, fine and deep pulse, low mood, or abdominal pain, this is named Taiyin Disease (Taiyin Disease).
The Classics state: When a disease originating in the Yang stage is mistakenly treated with purgation, heat enters and causes Jie Xiong (Knotting Chest Syndrome). The commentary notes: Fever and aversion to cold indicate origin in the Yang stage. External signs include stiffness of the neck and fullness, hardness, and pain below the heart. This represents excess pathogens in the interior, and according to the method, purgation should be used. However, if the pulse is floating and large, if there are still exterior signs, or if there is fluid retention, purgation is contraindicated. There are also cases of hardness and fullness below the heart not caused by mistaken purgation. The Classics state: When patients have cold extremities, sudden tightness of the pulse, pathogens knotted in the chest, mental fullness and vexation, hunger but no desire to eat, emesis should be induced. This indicates the pathology is in the chest. The Classics state: In Yangming Disease, hardness and fullness below the heart are contraindications for purgation; if purged, diarrhea will persist until death. This indicates that pathogens transmitted from the exterior remain below the heart and have not fully formed excess; thus, emesis is indicated, hence this warning. Cases where Jie Xiong symptoms are complete but accompanied by restlessness are considered incurable.
For Jie Xiong, the cun pulse is floating, while guan and chi pulses are sunken and tight; purgation is appropriate. If the pulse is floating and large, or if there are exterior signs, first use Xiaochaihu Tang (Minor Bupleurum Decoction); once the exterior is resolved, proceed with purgation. For Major Jie Xiong (Major Knotting Chest Syndrome), pain radiates to the umbilicus and abdomen even without pressure, and the area is painful, hard, and intolerant to touch; use Daxiexiong Tang (Major Downward Draining Decoction for the Chest). If this is too harsh, use pills.
For Minor Jie Xiong (Minor Knotting Chest Syndrome), pain occurs only upon pressure, with hardness below the heart; use Xiaoxiexiong Tang (Minor Downward Draining Decoction for the Chest). For Heat-Excess Jie Xiong, characterized by profound stifling sensation, vexation, thirst, and pain below the heart, administer small doses of Daxiexiong Tang (Major Downward Draining Decoction for the Chest). For Cold-Excess Jie Xiong, with no heat signs, use Sanwu Baisan (Three-Ingredient White Powder) or Zhishi Lizhong Wan (Aurantium and Immature Bitter Orange Pill to Regulate the Middle).