赤石脂（一斤） 禹余粮（一斤碎）
上二味以水六升煮取二升去滓三服
本以下之故心下痞与泻心汤痞不解其人渴而口烦躁小便不利者五苓散主之（方在太阳四十二）
本以攻下之故得心下痞证是宜服泻心乃与泻心汤而痞不解其人土湿水停口渴心烦小便不利者宜五苓散泄水燥土以利
小便土燥则中气转运浊降清升痞硬自消也 痞证必兼下利上章复利不止者当利其小便利小便之法五苓散是也五苓证痞与
下利兼医此但言痞而不言下利者省文也
伤寒发汗若吐若下解后心下痞硬噫气不除者旋复花代赭石汤主之
伤寒汗吐下解后心下痞硬噫气不除以外证虽解而汗下伤中土败胃逆碍胆经降路胃口痞塞肺气郁蒸而化痰饮胃土壅遏
而生哕噫旋复花代赭石汤参甘大枣补其中脘半夏姜赭降其逆气旋复花行痰饮而开郁浊也浊气上填痞闷噫气以旋复花代赭
石补虚降逆噫气立除若除后再用则病下陷不可常服也
旋复花（三两） 代赭石（一两） 生姜（五两） 半夏（半斤洗） 甘草（三两炙） 人参（二两） 大枣（十
二枚）
上七味以水一斗煮取六升去滓再煎取三升温服一升日三服
病如桂枝证头不痛项不强寸脉微浮胸中痞硬气上冲咽喉不得息此为胸有寒也当吐之宜瓜蒂散诸亡血家不可与
病如桂枝汤证但头不痛项不强寸脉微浮其内则心中痞硬气上冲于咽喉不得喘息此为心有寒痰阻塞窍隧故令肺气壅塞
不得布散也法当吐之宜瓜蒂散香豉行其滞小豆泄其湿瓜蒂涌其寒痰若诸亡血之家血惯上逆不可与也
赤石脂（一斤） 禹余粮（一斤，捣碎）
以上两味药，用水六升，煎煮至取药液二升，滤去药渣，分三次服用。
原本因为误用攻下法，导致心下部痞塞胀满，服用泻心汤后痞证仍未解除，病人出现口渴、口内烦躁、小便不利的症状，应当用五苓散主治（方剂见太阳病篇第四十二节）。
原本因为误用攻下法而得到心下痞的证候，本应服用泻心汤，但给予泻心汤后痞证并未解除。此时病人因脾土湿气重、水饮停聚，出现口渴、心烦、小便不利等症状，适宜用五苓散来渗泄水湿、燥化脾土，以通利小便。脾土干燥则中气运转正常，浊气下降、清气上升，心下的痞硬自然消除。
痞证必然兼有下利。上一章提到如果下利不止，应当通利小便。通利小便的方法，五苓散是合适的。五苓散证中痞证与下利并见，这里只说痞证而不提下利，是省略了文字。
伤寒病经过发汗、催吐或攻下治疗后，表证已解，但心下部痞塞坚硬，嗳气持续不除的，应当用旋复花代赭石汤主治。
伤寒经过汗、吐、下法治疗后，虽然外部证候已解，但汗下损伤了中焦脾胃之气，导致胃气虚弱、胃气上逆，阻碍了胆经的气机降路，使胃口痞塞，肺气郁结蒸腾而生痰饮，胃土壅滞而产生呃逆和嗳气。旋复花代赭石汤中的人参、甘草、大枣补益中脘脾胃；半夏、生姜、代赭石降逆气；旋复花行化痰饮并开通郁结的浊气。如果浊气上填导致痞闷嗳气，用旋复花、代赭石补虚降逆，嗳气立刻就能消除。但如果嗳气停止后再继续服用，会导致病邪下陷，不可长期服用。
旋复花（三两） 代赭石（一两） 生姜（五两） 半夏（半斤，洗净） 甘草（三两，炙） 人参（二两） 大枣（十二枚）
以上七味药，用水一斗，煎煮至取药液六升，滤去药渣，再次煎煮浓缩至三升，每次温服一升，每日服用三次。
病情类似桂枝汤证，但头不痛、项不强，寸脉微浮，胸中痞塞坚硬，气向上冲撞咽喉，呼吸不畅，这是胸中有寒饮（痰饮），应当用涌吐法治疗，适宜用瓜蒂散。凡是失血的患者，不可使用此方。
病情类似桂枝汤证，但头不痛、项不强，寸脉微浮。内部则是心中痞塞坚硬，气向上冲撞咽喉，不能喘息，这是因为心下有寒痰阻塞窍道，导致肺气壅塞，不能布散。治法应当用涌吐法，适宜用瓜蒂散。香豉行其滞气，小豆排泄其湿气，瓜蒂涌吐其寒痰。如果是各种失血的患者，血液习惯上逆，不可使用此方。
Chishi Zhi (Lithong, Red Stone Lip) (one jin) Yuyuliang (Hematitum, Hematite) (one jin, crushed)
The above two ingredients are boiled in six sheng of water to obtain two sheng of decoction. The dregs are removed, and the liquid is divided into three doses for administration.
Originally, due to the erroneous use of purgative methods, epigastric fullness and obstruction (Xin Xia Pi) occurred. After administering Xiexin Tang (Heart-Draining Decoction), the fullness did not resolve. If the patient presents with thirst, irritability in the mouth, and difficulty in urination, Wuling San (Five-Ingredient Powder with Poria) should be used as the primary treatment (formula found in Taiyang Chapter 42).
Originally, epigastric fullness was induced by the erroneous use of purgatives. Although Xiexin Tang was indicated, the fullness persisted after administration. In this case, due to dampness of the Spleen-Earth and retention of water, accompanied by thirst, vexation, and oliguria, Wuling San is appropriate to drain water and dry the Earth to facilitate urination. When the Earth becomes dry, the Middle Qi rotates normally, turbid Yin descends and clear Yang ascends, and the epigastric fullness and hardness naturally dissipate.
Fullness syndromes (Pi Zheng) must be accompanied by diarrhea. The previous chapter stated that if diarrhea persists, one should promote urination. The method for promoting urination is Wuling San. In the Wuling San syndrome, both fullness and diarrhea are present; here, only fullness is mentioned while diarrhea is omitted for brevity.
After Taiyang disease has been treated with sweating, vomiting, or purging, and the exterior symptoms have resolved, if epigastric fullness and hardness persist with incessant belching (Yi Qi), Xuanshuhua Daizheshi Tang (Inula and Hematite Decoction) should be administered.
After Taiyang disease is treated with sweating, vomiting, or purging, although the exterior symptoms have resolved, the sweating and purging have damaged the Middle Jiao Earth, leading to deficiency of Stomach Qi and rebellious Stomach Qi. This obstructs the descending pathway of the Gallbladder Meridian, causing blockage at the stomach opening. Lung Qi becomes stagnant and steams to generate phlegm-fluids, and Stomach Earth stagnation generates hiccups and belching. In Xuanshuhua Daizheshi Tang, Renshen (Ginseng Radix), Gancao (Licorice Root), and Dazao (Jujube Fruit) tonify the Middle Jiao; Banxia (Pinellia Tuber), Shengjiang (Fresh Ginger Rhizome), and Daizheshi (Hematitum) descend rebellious Qi; and Xuanshuhua (Flower of Inula) moves phlegm-fluids and opens stagnant turbidity. If turbid Qi fills upward causing fullness and belching, Xuanshuhua and Daizheshi tonify deficiency and descend rebellion, immediately relieving belching. However, if taken again after relief, it may cause the pathogen to sink downward; thus, it should not be taken continuously.
Xuanshuhua (Flos Inulae) (three liang) Daizheshi (Hematitum) (one liang) Shengjiang (Rhizoma Zingiberis Recens) (five liang) Banxia (Tuber Pinelliae) (half a jin, washed) Gancao (Radix Glycyrrhizae) (three liang, honey-fried) Renshen (Radix Ginseng) (two liang) Dazao (Fructus Jujubae) (twelve pieces)
The above seven ingredients are boiled in ten dou of water to obtain six sheng of decoction. The dregs are removed, and the decoction is further concentrated to three sheng. Each dose is one sheng, taken warm, three times daily.
The condition resembles Guizhi Tang syndrome, but without headache or stiffness of the neck, with a slightly floating pulse at the Cun position, epigastric fullness and hardness, Qi rushing upward to the throat causing dyspnea. This indicates cold-phlegm (Han) in the Chest. It should be treated with emesis, and Goudi San (Thladiantha Seed Powder) is suitable. Patients who have suffered blood loss should not receive this formula.
The condition resembles Guizhi Tang syndrome, but without headache or neck stiffness, with a slightly floating pulse at the Cun position. Internally, there is epigastric fullness and hardness, with Qi rushing upward to the throat causing inability to breathe. This is due to cold-phlegm blocking the orifices, causing Lung Qi stagnation and failure to disperse. The treatment method requires emesis, and Goudi San is appropriate. Xiangchi (Fermented Soybean) moves stagnation, Chixiaodou (Adzuki Bean) drains dampness, and Goudi (Fructus Thladianthae) induces vomiting of cold-phlegm. For patients with a history of blood loss, whose blood tends to rebel upward, this formula is contraindicated.