生姜 半夏 甘草 人参 黄芩 黄连 干姜 大枣
汗后胃中不和。心下痞硬。干噫食臭。心下有水气。腹中雷鸣不利。 胃为津液之主。
阳气之根。汗后外亡津液。胃中空虚。客气上逆。心下痞硬。中焦未和。不能消谷。故干噫食臭
。水气腹鸣。土弱不能胜水也。
甘草 黄芩 干姜 半夏 黄连 大枣
伤寒中风医反下之。下利日数十行。谷不化。腹中雷鸣。心下痞硬而满。干呕心烦。复
下之。其痞益甚。此非结热。但胃虚气逆故硬也。此汤主之。 邪气在表而反下之。虚其中而邪
内陷也。利下谷不化腹鸣者。里虚胃弱也。痞鞭呕烦者。胃虚气逆也。与泻心汤以攻痞。加
炙甘草以补虚。前以汗后胃虚。是外伤阳气。故加生姜。此以下后胃虚。
是内损阴气。故加甘草。 痞与结胸。有高下之分。邪结在胸中。故曰陷胸。邪留在心下。
故曰泻心。泻心者。必以苦为主。是以黄连为君。黄芩为臣。散痞者必以辛为主。是以半夏
干姜为佐。阴阳不交曰痞。上下不通曰满。欲通上下。交阴阳者。必和其中。中者脾也。脾
不足者。以甘补之。故以人参甘草大枣为使。以补中气。中气安和。则水升火降。痞满自消。
发汗之后，胃气不和。心下（胃脘部）痞塞坚硬。嗳气带有未消化食物的酸腐气味。心下有停饮之水气。肠中雷鸣作响并伴有腹泻。胃是津液的主要来源，也是阳气的根本。发汗后，体表的津液外泄，导致胃中空虚。外来邪气上逆，造成心下痞塞坚硬。中焦脾胃功能尚未调和，不能正常消化食物，所以出现嗳气且有食臭味。水气在腹中流动发出声响，是因为脾土虚弱，无法制约水湿。
伤寒或中风病，医生反而使用攻下法治疗。导致腹泻每天几十次，完谷不化（粪便中含有未消化的食物），肠中雷鸣作响，心下痞塞坚硬且胀满。干呕，心烦意乱。如果再次使用攻下法，其痞塞症状会更加严重。这不是热邪结聚，而是因为胃气虚弱、气机上逆导致的坚硬。此方主治。邪气在体表却反而被攻下，导致中焦空虚，邪气内陷。腹泻且完谷不化、肠鸣，是因为里虚、胃弱。痞塞、呕吐、心烦，是因为胃虚气逆。给予泻心汤以消除痞塞，加入炙甘草以补益虚损。前一个方剂（生姜泻心汤）是因发汗后胃虚，属于外伤阳气，所以加生姜。这个方剂是因攻下后胃虚，属于内损阴气，所以加甘草。痞证与结胸证，有部位高下的区别。邪气结聚在胸中，所以称为陷胸汤证；邪气留滞在心下，所以称为泻心汤证。治疗泻心汤证，必须以苦味药为主，所以用黄连作为君药，黄芩作为臣药。消除痞塞必须以辛味药为主，所以用半夏、干姜作为佐药。阴阳之气不相交通称为痞，上下气机不通畅称为满。想要疏通上下，使阴阳相交，必须调和其中焦。中焦指的是脾。脾气不足的，用甘味药来补益，所以用人参、甘草、大枣作为使药，以补益中气。中气安定调和，则肾水上升、心火下降，痞塞胀满自然消除。
心下痞塞，并且又出现恶寒、汗出的症状，此方主治。心下痞塞，是邪热所致。恶寒、汗出，是阳气虚弱所致。用三黄（大黄、黄连、黄芩）清泄邪热……（原文此处中断）
Shengjiang Xie Xin Tang (Ginger Decoction for Draining the Epigastrium): Sheng Jiang (Zingiberis Rhizoma Recens), Ban Xia (Pinelliae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Gan Jiang (Zingiberis Rhizoma), Da Zao (Jujubae Fructus).
After sweating, the Stomach Qi is disharmonious. There is epigastric fullness and hardness (Xin Xia Pi Ying). Belching with a smell of undigested food occurs. There is fluid retention in the epigastrium. Borborygmus (rumbling sounds in the abdomen) accompanies diarrhea. The Stomach is the master of body fluids and the root of Yang Qi. After sweating, body fluids are lost externally, leaving the Stomach empty. Pathogenic factors ascend counterflow, causing epigastric fullness and hardness. The Middle Jiao has not yet harmonized and cannot digest grain; thus, belching with a food odor occurs. Water qi causes rumbling in the abdomen because the Earth element (Spleen/Stomach) is weak and cannot control Water.
Gancao Xie Xin Tang (Licorice Decoction for Draining the Epigastrium): Gan Cao (Glycyrrhizae Radix et Rhizoma), Huang Qin (Scutellariae Radix), Gan Jiang (Zingiberis Rhizoma), Ban Xia (Pinelliae Rhizoma), Huang Lian (Coptidis Rhizoma), Da Zao (Jujubae Fructus).
In Taiyang disease or Wind-stroke, if the physician erroneously applies purgation, it results in diarrhea dozens of times a day, with undigested food in the stool (Gu Bu Hua), borborygmus, and epigastric fullness, hardness, and distension. There is dry retching and irritability. If purgation is applied again, the epigastric fullness becomes even more severe. This is not due to accumulated heat, but rather to Stomach deficiency and rebellious Qi causing hardness. This decoction is indicated. When pathogenic factors are at the exterior and purgation is erroneously used, the interior becomes deficient, and pathogens sink inward. Diarrhea with undigested food and borborygmus indicates interior deficiency and weak Stomach function. Epigastric fullness, vomiting, and irritability indicate Stomach deficiency and rebellious Qi. A Xie Xin Tang (Decoction for Draining the Epigastrium) is given to resolve the fullness, and roasted Gan Cao (Zhi Gan Cao) is added to tonify deficiency. In the previous formula (Shengjiang Xie Xin Tang), Stomach deficiency after sweating implies external damage to Yang Qi, hence Sheng Jiang is added. In this case, Stomach deficiency after purgation implies internal damage to Yin Qi, hence Gan Cao is added. There is a distinction in location between Pi Syndrome (Epigastric Fullness) and Jie Xiong (Chest Binding). When pathogens bind in the chest, it is called Xian Xiong (Sunken Chest); when pathogens remain in the epigastrium, it is called Xie Xin (Draining the Heart/Epigastrium). To treat Xie Xin, bitter herbs must be primary; thus, Huang Lian is the Sovereign herb, and Huang Qin is the Minister herb. To dissipate fullness, acrid herbs must be primary; thus, Ban Xia and Gan Jiang are Assistant herbs. When Yin and Yang do not intersect, it is called Pi (fullness); when upper and lower do not communicate, it is called Man (distension). To unblock the upper and lower and facilitate the intersection of Yin and Yang, the Middle Jiao must be harmonized. The Middle Jiao refers to the Spleen. For Spleen insufficiency, sweet herbs are used to tonify; thus, Ren Shen, Gan Cao, and Da Zao are used as Envoy herbs to tonify Middle Qi. When Middle Qi is stable and harmonious, Kidney Water ascends and Heart Fire descends, and epigastric fullness naturally resolves.
Fuzi Xie Xin Tang (Aconite Decoction for Draining the Epigastrium): Da Huang (Rhei Radix et Rhizoma), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Fu Zi (Aconiti Lateralis Radix Praeparata).
When there is epigastric fullness accompanied by aversion to cold and sweating, this decoction is indicated. Epigastric fullness is caused by pathogenic heat. Aversion to cold and sweating are signs of Yang deficiency. The three yellows (Da Huang, Huang Lian, Huang Qin) are used to clear pathogenic heat... [Text ends abruptly]