在腑不寒专发热。咽干作呕心烦渴。发狂谵语大肠坚。大小三承汤可啜。
按不恶寒者，邪不在表也。咽干烦渴，并作呕者。皆胃热甚也。胃火上冲。故心神失守
。谵语狂言。大便坚燥。皆里症也。急宜下之。陶节 曰。伤寒邪热传里。须看气势浅深用
药。若三焦俱伤。则痞满燥实坚全见。宜大承气汤。邪在中焦。只有燥实坚三症。宜调胃承气
汤加甘草和中。去枳实者。恐伤上焦氤氲之气也。邪在上焦。则痞而满。宜小承气汤去芒硝
者。恐伤下焦真阴也。若表症未除。里症又急。不得不下者。则用大柴胡汤通表里而缓治之
。大承气最紧。小承气次之。调胃又次之。大柴胡又次之。盖恐硝性急燥。不可轻用也。
大承气汤用朴硝。大黄等分不须饶。浓朴倍加并枳实。通肠利便有功劳。小承气汤
三件药。枳实大黄并浓朴。结胸谵语大肠坚。每服五钱功易觉。
大黄 浓朴 枳实 名浓朴三物汤 又浓朴大黄两味治太阳病腹痛而闭。
调胃承气有硝黄。甘草同加用最良。腹满便坚兼口渴。心烦谵语总相当。大柴胡汤用大
半夏枳实共为良。更有黄芩与芍药。姜枣同煎利大肠。瓜蒂散中赤小豆。二味匀平有传授。
豆豉一合水同煎。膈上停痰须此吐。栀子豉汤栀子先。更加豆豉水同煎。病后虚烦眠不得
。心中懊恼吐之痊。
邪气传入阳明腑证，表现为不恶寒而专门发热。出现咽喉干燥、作呕、心烦、口渴的症状。若出现发狂、说胡话（谵语）以及大肠燥结坚硬的情况，可以使用大小三承气汤来治疗。
按语：如果不恶寒，说明邪气不在体表。咽喉干燥、心烦口渴，同时伴有呕吐的，都是胃热严重的表现。胃火向上冲逆，导致心神失守。说胡话、狂言乱语、大便干结坚硬，都属于里证。应当紧急使用攻下法。陶节庵说：伤寒邪热传入体内，必须根据病势的深浅来用药。如果上、中、下三焦都受到损伤，那么痞塞、胀满、燥结、实邪、坚硬等症状全部出现，适宜用大承气汤。邪气在中焦，只有燥、实、坚三个症状，适宜用调胃承气汤加甘草以调和脾胃；去掉枳实的原因，是恐怕损伤上焦氤氲之气。邪气在上焦，则表现为痞塞而胀满，适宜用小承气汤；去掉芒硝的原因，是恐怕损伤下焦的真阴。如果表证尚未解除，里证又很急迫，不得不攻下的，则使用大柴胡汤来通达表里并缓和地治疗。大承气汤药力最猛，小承气汤次之，调胃承气汤再次之，大柴胡汤又次之。这是恐怕芒硝的药性急燥，不可轻易使用。
大承气汤用朴硝和大黄等量，不需要过多。厚朴加倍加入并配合枳实，通利肠道排便有功劳。小承气汤由三味药组成：枳实、大黄和厚朴。治疗结胸、谵语、大肠燥结，每服五钱，功效容易察觉。
大黄、厚朴、枳实，这三味药合起来名为浓朴三物汤。另外，厚朴和大黄两味药可以治疗太阳病引起的腹痛且便秘。
调胃承气汤含有芒硝和大黄，加上甘草同用效果最好。治疗腹满、大便干结兼有口渴、心烦谵语，都非常对症。大柴胡汤使用大黄、半夏、枳实共同发挥良效。还有黄芩和芍药，加上生姜和大枣同煎，能利大肠。瓜蒂散中有赤小豆，这两味药比例均匀且有传承。豆豉一合与水同煎，膈上停聚的痰饮需要此方催吐。栀子豉汤先煮栀子，再加入豆豉与水同煎。病后虚烦失眠不得安卧，心中懊恼，用此方催吐可痊愈。
When the pathogen enters the Fu organs, it manifests as fever without aversion to cold. Symptoms include dryness of the throat, vomiting, mental restlessness, and thirst. If there is mania, delirium (delusional speech), and hardness of the large intestine, one of the three Chengqi Decoctions (Chengqi Formulas) may be used.
Note: The absence of aversion to cold indicates that the pathogen is not in the exterior. Dryness of the throat, mental restlessness, thirst, and vomiting together indicate severe Stomach heat. The upward rushing of Stomach fire causes the loss of control over the Spirit (Shen). Delirium, manic speech, and hard, dry stools are all interior syndromes. Immediate purgation is required. Tao Jie'an stated: When the pathogenic heat of Shanghan (Cold Damage) transmits inward, medication must be chosen based on the depth of the pathogen's influence. If the Upper, Middle, and Lower Jiao are all injured, presenting with fullness, distension, dryness, excess, and hardness simultaneously, Da Chengqi Tang (Major Order the Qi Decoction) is appropriate. If the pathogen is in the Middle Jiao, presenting only with dryness, excess, and hardness, Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) with added Gancao (Licorice Root) to harmonize the Middle Jiao should be used; Zhi Shi (Immature Bitter Orange) is omitted to avoid damaging the ethereal Qi of the Upper Jiao. If the pathogen is in the Upper Jiao, presenting with fullness and distension, Xiao Chengqi Tang (Minor Order the Qi Decoction) is appropriate; Mangxiao (Mirabilite) is omitted to avoid damaging the True Yin of the Lower Jiao. If the exterior syndrome has not yet been resolved but the interior syndrome is urgent, requiring purgation, Dachaihu Tang (Major Bupleurum Decoction) should be used to unblock both the exterior and interior for a milder treatment. Da Chengqi Tang is the most potent, followed by Xiao Chengqi Tang, then Tiaowei Chengqi Tang, and finally Dachaihu Tang. This caution exists because Mangxiao has an urgent and drying nature and should not be used lightly.
Da Chengqi Tang uses Puxiao (Mirabilite) and Dahuang (Rhubarb Rhizome) in equal proportions, without excess. Houpo (Magnolia Bark) is doubled and combined with Zhishi (Immature Bitter Orange); this combination excels at unblocking the intestines and promoting bowel movements. Xiao Chengqi Tang consists of three herbs: Zhishi (Immature Bitter Orange), Dahuang (Rhubarb Rhizome), and Houpo (Magnolia Bark). For treating Jie Xiong (Chest Binding), delirium, and hardness of the large intestine, each dose of five qian demonstrates its efficacy readily.
Dahuang (Rhubarb Rhizome), Houpo (Magnolia Bark), and Zhishi (Immature Bitter Orange) constitute Nongpu Sanwu Tang (Three-Ingredient Magnolia Bark Decoction). Additionally, the two-herb combination of Houpo (Magnolia Bark) and Dahuang (Rhubarb Rhizome) treats abdominal pain and constipation associated with Taiyang disease (Taiyang Syndrome).
Tiaowei Chengqi Tang contains Mangxiao (Mirabilite) and Dahuang (Rhubarb Rhizome); adding Gancao (Licorice Root) yields the best results. It is suitable for abdominal fullness, hard stools accompanied by thirst, mental restlessness, and delirium. Dachaihu Tang (Major Bupleurum Decoction) utilizes Dahuang (Rhubarb Rhizome), Banxia (Pinellia Tuber), and Zhishi (Immature Bitter Orange) for excellent effect. Huangqin (Scutellaria Root) and Shaoyao (Peony Root) are also included; decocting with Shengjiang (Fresh Ginger) and Dazao (Jujube Fruit) benefits the large intestine. Gouti San (Gourd Tip Powder) contains Chixiaodou (Adzuki Bean); these two ingredients are used in equal proportions, a method passed down through tradition. Douchi (Prepared Soybean) combined with water is decocted; this formula induces vomiting to expel phlegm retained above the diaphragm. Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) involves decocting Zhizi (Gardenia Fruit) first, then adding Douchi (Prepared Soybean) and water. For post-illness deficiency heat causing restlessness and insomnia, with a feeling of stifling discomfort in the chest, inducing vomiting with this formula leads to recovery.