麻子（二升） 芍药（半斤） 杏仁（一升熬别作脂） 大黄（一斤去皮） 浓朴（一斤） 枳实（半斤炙）
上六味为末炼蜜丸桐子大饮服十丸日三服渐加以和为度
得病二三日脉弱无太阳柴胡证烦躁心下硬至四五日虽能食与小承气汤少少与微和之令小安至六日与承气汤一升若不
大便六七日小便少者虽不能食但初头硬后必溏未定成硬攻之必溏须小便利屎定硬乃可攻之宜大承气汤
得病二三日脉弱而无太阳少阳表证乃烦躁而心下硬满是非少阳之证而实阳明之证也盖胆胃之经自头走足悉由胃口下
行少阳病则以甲木而迫戊土阳明病则以戊土而遏甲木经气不降痞结胃口皆有心下硬满之证而此则无少阳表证而见烦躁故
定属阳明而不关少阳也至四五日虽犹能食然腑邪已成可以小承气汤少少与和之令其烦躁少安至六日邪实之时与承气汤一
升以利之则腑热泄矣若不大便六七日计期可下而小便少者则大便必不硬便硬肠结胃热不得下泄浊气薰冲必不能食此证虽
不能食然胃非干燥其大便初头结硬阻浊气下泄之路故不能食其后必是稀溏未至结硬而遽攻之必成溏泄须小便利后津亡土
燥屎定全硬乃可攻之宜大承气汤也
阳明病潮热大便微硬者可与大承气汤不硬者不可与之若不大便六七日恐有燥屎欲知之法少与小承气汤汤入腹中转失
气者此有燥屎乃可攻之若不转失气此但初头硬后必溏攻之必胀满不能食也欲饮水者与水则哕其后发热者必大便复硬而少
也以小承气和之不转失气者慎不可攻也
燥屎阻碍滞气之郁遏者多小承气泄其壅滞隧道略通故转失秽气此当以大承气攻之若不转失气则胃无燥屎攻之败其中
气必胀满不能食也与水则哕亦不能饮虽其后阳回发热大便坚矣而粪必少也以其不能食故亦止可以小承气汤和之不可攻也
麻子（二升） 芍药（半斤） 杏仁（一升，另熬制成脂状） 大黄（一斤，去皮） 浓朴（一斤） 枳实（半斤，炙烤）
以上六味药研成细末，用炼蜜制作成梧桐子大小的丸剂，每次服用十丸，每日三次，逐渐增加剂量，以大便调和为度。
患病两三天，脉象虚弱，没有太阳病（太阳经受邪所致的病证）和少阳病（少阳经受邪所致的病证）的柴胡证，出现烦躁、胃脘部硬满的症状。到了第四五天，虽然还能进食，可给予小承气汤（小承气方），少量多次服用，微微调和肠胃，使患者稍感安宁。到了第六天，邪气实盛时，给予承气汤一升以通利大便，则腑热得以泄出。如果六七天不大便，但小便量少，即使不能进食，也只是大便开头硬，后面必定稀溏。此时若贸然攻下，必然导致腹泻。必须等到小便通畅，津液耗伤，大便完全变硬后，才可以攻下，适宜使用大承气汤（大承气方）。
患病两三天，脉象虚弱，且没有太阳病和少阳病的表证，却出现烦躁和胃脘部硬满，这不是少阳病的证候，而是阳明病（阳明经受邪所致的病证）。因为胆经和胃经的经脉从头走足，都经过胃口下行。少阳病是甲木（胆）逼迫戊土（胃），阳明病则是戊土（胃）遏制甲木（胆）。经气不降，痞结于胃口，都有心下硬满的症状，但此证没有少阳病的表证而见烦躁，所以确定属于阳明病，与少阳病无关。到了第四五天，虽然还能进食，但腑邪已成，可以少量给予小承气汤调和，使烦躁稍安。到了第六天邪气实盛之时，给予承气汤一升以通利，则腑热泄出。如果六七天不大便，按病程应当攻下，但若小便少，则大便一定不硬。大便硬、肠道结滞、胃热不得下泄、浊气上冲，必然不能进食。此证虽然不能进食，但胃中并非干燥，只是大便开头结硬，阻碍了浊气下泄的路径，所以不能进食，其后必定是稀溏。未至结硬而遽然攻下，必然造成溏泄。必须等到小便通畅后，津液耗伤，土燥屎定全硬，才可以攻下，适宜使用大承气汤。
阳明病，有潮热（定时发热）、大便微硬的，可以给予大承气汤；如果不硬，不可给予。如果六七天不大便，担心有燥屎（干结的粪便），想要验证的方法，是少量给予小承气汤。汤药入腹后，如果转矢气（放屁），这是有燥屎，才可以攻下；如果不转矢气，这只是开头硬后面稀溏，攻下必然导致胀满、不能进食。想喝水的人，给水喝则会发生呃逆（打嗝）。其后如果出现发热，大便又会变硬但量少。用小承气汤调和即可；对于不转矢气的，千万不要攻下。
燥屎阻碍，导致滞气郁遏的情况很多。小承气汤能泄其壅滞，肠道略通，所以会转矢秽气。这种情况应当用大承气汤攻下。如果不转矢气，说明胃中没有燥屎，攻下会败坏中气，必然导致胀满、不能进食。给水喝则呃逆，也不能再饮。即使其后阳气回复发热，大便坚硬，但粪量必少。因为不能进食，所以也只可以用小承气汤调和，不可攻下。
Hemp Seed (Er Sheng) / Paeonia Root (Ban Jin) / Apricot Seed (Yi Sheng, processed separately into paste) / Rhubarb (Yi Jin, peeled) / Magnolia Bark (Yi Jin) / Immature Bitter Orange (Ban Jin, stir-fried)
The above six herbs are ground into powder, mixed with refined honey to form pills the size of a tung tree seed. Take ten pills per dose, three times daily. Gradually increase the dosage until bowel movements become harmonious.
Two or three days after onset of disease, if the pulse is weak and there are no Shaoyang Hu Tang (Bupleurum Decoction) signs characteristic of Taiyang disease (diseases caused by pathogenic invasion of the Taiyang channel), but rather irritability and hardness in the epigastrium: By the fourth or fifth day, even if the patient can still eat, administer Xiao Chengqi Tang (Minor Order the Yang Decoction) in small amounts frequently to mildly harmonize the interior and provide slight relief. By the sixth day, when pathogenic factors are substantial, administer one sheng of Chengqi Tang (Order the Yang Decoction) to promote bowel movement, thereby draining fu-organ heat. If there is no bowel movement for six or seven days, yet urine output is scanty, even if the patient cannot eat, it indicates that only the beginning of the stool is hard while the rest will be loose. Premature purgation will inevitably cause diarrhea. One must wait until urination becomes smooth, indicating fluid depletion and dryness of the spleen-earth, resulting in completely hardened feces, before proceeding with purgation; Da Chengqi Tang (Major Order the Yang Decoction) is indicated.
Two or three days after onset of disease, if the pulse is weak and there are no exterior signs of Taiyang disease or Shaoyang disease (diseases caused by pathogenic invasion of the Shaoyang channel), yet irritability and fullness/hardness in the epigastrium appear, this is not a Shaoyang syndrome but a Yangming disease (diseases caused by pathogenic invasion of the Yangming channel). The meridians of the Gallbladder and Stomach run from the head to the feet, passing through the stomach opening. In Shaoyang disease, Jia Wood (Gallbladder) forces Wu Earth (Stomach); in Yangming disease, Wu Earth (Stomach) obstructs Jia Wood (Gallbladder). When meridian qi fails to descend and stagnates at the stomach opening, both present with hardness/fullness in the epigastrium. However, since this case lacks Shaoyang exterior signs and presents with irritability, it is definitively a Yangming condition, unrelated to Shaoyang. By the fourth or fifth day, although the patient can still eat, the fu-organ pathogen has formed; administering small amounts of Xiao Chengqi Tang (Minor Order the Yang Decoction) can harmonize the interior and alleviate irritability slightly. By the sixth day, when pathogens are substantial, administering one sheng of Chengqi Tang (Order the Yang Decoction) promotes drainage, clearing fu-organ heat. If there is no bowel movement for six or seven days, suggesting the timing is suitable for purgation, but urine is scanty, the stool will certainly not be hard. Hard stool with intestinal binding and stomach heat failing to drain downward causes turbid qi to rush upward, leading to an inability to eat. Although the patient cannot eat due to this obstruction, the stomach is not dry; rather, the initial hardening of the stool blocks the path of turbid qi descent. Subsequent stools will be loose. Purging prematurely before complete hardening will result in diarrhea. Only after urination is smooth, fluids are depleted, earth is dry, and feces are fully hardened should purgation be employed, using Da Chengqi Tang (Major Order the Yang Decoction).
In Yangming disease, if there is tidal fever (periodic fever) and slightly hard stool, Da Chengqi Tang (Major Order the Yang Decoction) may be given; if the stool is not hard, it must not be given. If there is no bowel movement for six or seven days and one suspects dry feces (desiccated feces), the method to verify is to administer a small amount of Xiao Chengqi Tang (Minor Order the Yang Decoction). If, after the decoction enters the abdomen, flatus (passing gas) occurs, this indicates the presence of dry feces, and purgation may proceed. If there is no flatus, it merely indicates hard stool at the beginning and loose stool at the end; purgation will inevitably cause abdominal distension and an inability to eat. A patient desiring water who drinks water may experience hiccups. If fever develops subsequently, the stool will become hard again but scanty. Harmonize with Xiao Chengqi Tang (Minor Order the Yang Decoction); do not purge cases without flatus.
Dry feces often obstruct and cause stagnation of qi. Xiao Chengqi Tang (Minor Order the Yang Decoction) drains congestion, allowing the intestinal tunnel to open slightly, thus causing the passage of foul-smelling flatus. This situation requires purgation with Da Chengqi Tang (Major Order the Yang Decoction). If there is no flatus, it indicates no dry feces in the stomach; purgation will damage middle qi, inevitably causing distension and an inability to eat. Drinking water causes hiccups and further refusal to drink. Even if yang returns and fever develops later, with hard stool, the fecal volume will be small because the patient cannot eat. Therefore, only Xiao Chengqi Tang (Minor Order the Yang Decoction) should be used to harmonize, not to purge.