Rhei Radix et Rhizoma (Dahuang), Natrii Sulfas (Mangxiao), Kansui Radix (Gansui)

Jie Xiong (Chest Binding Syndrome) of the heat-excess type. The pulse is deep and tight. There is pain in the epigastrium, and palpation reveals hardness like a stone. This is typical Jie Xiong, with no significant fever on the exterior, indicating water retention binding in the chest. When pathogenic factors are located in the upper jiao (Upper Burner), one might initially consider emesis; however, since it is termed "binding," the pathogens are firmly bound in the chest, differing from deficiency-heat vexation or fullness in the diaphragm. The upper jiao is high; thus, pathogens there must be descended to be pacified. Hence, the formula is named Xia Xiong Tang (Inferior Chest Decoction), aiming to sweep away pathogens, akin to the duty of a general. Therefore, Rhei Radix et Rhizoma (Dahuang) serves as the sovereign herb. Natrii Sulfas (Mangxiao), being salty, softens hardness, serving as the minister herb. Kansui Radix (Gansui) penetrates from top to bottom, breaking bindings and driving out water, serving as the assistant herb. This combined formula is suitable only for cases of great excess. If there is accompanying deficiency, shortness of breath, or a floating pulse, this formula should not be administered lightly.

Pinelliae Rhizoma Preparatum (Banxia), Coptidis Rhizoma (Huanglian), Trichosanthis Fructus (Gualou Shi)

Minor Jie Xiong (Minor Chest Binding) presents with pain only upon palpation, and the pulse is floating and slippery. This decoction treats it. Major Jie Xiong (Major Chest Binding) presents with pain even without palpation. Minor Jie Xiong requires manual pressure to elicit pain. The pathogenic factor is milder than in major Jie Xiong, hence it is called Xiao Xiong Tang (Minor Inferior Chest Decoction). Bitter substances drain downward, and acrid substances disperse. Coptidis Rhizoma (Huanglian) and Trichosanthis Fructus (Gualou Shi), being bitter and cold, drain heat. Pinelliae Rhizoma Preparatum (Banxia), being acrid and warm, disperses bindings. The pathogen is thereby resolved.

Veneris Testium Glans (Wenli)

When the disease is in the yang level, it should be resolved through sweating. However, if cold water is erroneously splashed or poured over the body, the heat is suppressed and cannot escape, leading to increased irritability. Gooseflesh appears on the skin. The patient feels thirsty but does not actually desire water. In such cases, Wenli San (Clam Shell Powder) should be administered. If symptoms do not resolve, Wuling San (Five-Ingredient Powder with Poria) should be given. This occurs because heat is closed by cold, and fire is depressed in the lung, unable to vent. Thus, there is increased irritability. Cool herbs are inappropriate here; instead, the sour and neutral properties of Veneris Testium Glans (Wenli) should be used to astringe and descend qi.

Platycodonis Radix (Jiegeng), Fritillariae Bulbus (Beimu), Crotonis Fructus (Badou)

Cold-excess Jie Xiong (Cold Chest Binding) without heat symptoms can be treated with Baisan (White Powder). This formula is designed for cold binding in the chest and is used only when necessary for severe cases. For mild cases, *Ren Shu* (The Book that Saves the World) suggests using Zhishi Lizhong Wan (Atractylodes Macrocephala and Magnolia Bark Pill to Regulate the Middle), which yields prompt results.

Pinelliae Rhizoma Preparatum (Banxia), Scutellariae Radix (Huangqin), Zingiberis Rhizoma (Ganjiang), Ginseng Radix et Rhizoma (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), Coptidis Rhizoma (Huanglian), Jujubae Fructus (Dazao)

Vomiting accompanied by fever, presenting with Shaoyang Chai Hu (Bupleurum) syndrome characteristics, but erroneously treated with purgatives, results in epigastric fullness without pain. Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is indicated. If Gancao (Licorice) is added and Renshen (Ginseng) removed, it becomes Gancao Xiexin Tang (Licorice Decoction to Drain the Epigastrium), treating fullness and hardness with vomiting and diarrhea. If Shengjiang (Fresh Ginger) is added, it becomes Shengjiang Xiexin Tang (Fresh Ginger Decoction to Drain the Epigastrium), treating fullness and hardness with belching carrying the odor of food. Acrid flavors enter the lung and disperse qi; the acrid nature of Pinelliae Rhizoma Preparatum (Banxia) and Zingiberis Rhizoma (Ganjiang) disperses stagnant qi. Bitter flavors enter the heart and drain heat; the bitter nature of Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian) drains epigastric heat. The spleen desires relaxation; urgent relief is provided by sweet flavors. The sweet nature of Ginseng Radix et Rhizoma (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), and Jujubae Fructus (Dazao) soothes the spleen.