大黄（四两清酒浸） 甘草（二两炙） 芒硝（半升）
上三味 咀。以水三升煮取一升。去滓。纳芒硝更上火微煮令沸。少少温服之。
承气者。用以制亢极之气使之承顺而下也。伤寒秘要曰。王海藏论云。仲景承气汤有大小调胃之殊。今人以三一承
气不分上下缓急用之。岂不失仲景本意。大热大实。用大承气。小热小实。用小承气。实热尚在胃中，用调胃承气以甘
草缓其下行而祛胃热也若病大用小。则邪气不伏。病小用大则过伤正气。病在上而用急下之剂。则上热不除岂可一概混
治哉节庵论小承气曰。上焦受伤。去芒硝恐伤下焦血分之真阴。论调胃承气曰邪在中焦不用枳实浓朴以伤上焦虚无氤氲
之元气然此汤独可用芒硝以伤下焦乎。吾未闻承气汤有主上焦者。未闻调胃承气之证。至于坚而燥也。仲景调胃承气汤
证。八方中并无干燥。不过曰胃气不和。曰胃实。曰腹满。则知此汤专主表邪悉罢初入腑而欲结之证也。故仲景以调胃
承气收入太阳阳明。而大黄注曰酒浸。是太阳阳明去表未远其病在上。不当攻下。故宜缓剂以调和之。及至正阳阳明。
则皆曰急下之。而大承气汤大黄注曰。酒洗是洗轻于浸微升其走下之性以和其中。至于少阳阳明。则去正阳而逼太阴。
其分在下。故用小承气大黄不用酒制也。
大黄（四两，用清酒浸泡） 甘草（二两，炙烤） 芒硝（半升）
以上三味药，切碎。用水三升，煎煮至取汁一升。滤去药渣。加入芒硝，再次放在火上微煮至沸腾。少量多次温服。
所谓“承气”，是指用来制约亢盛至极的气机，使其顺承而下。《伤寒秘要》记载：王海藏在论述中提到，张仲景的承气汤有大承气、小承气、调胃承气之分。现在的人将三一承气汤不加区分地用于上、下、缓、急各种情况，这难道不是违背了张仲景的本意吗？大热大实之证，使用大承气汤；小热小实之证，使用小承气汤；实热邪气尚在胃中，使用调胃承气汤，利用甘草的甘缓之性减缓其下行速度，从而清除胃热。如果病重而用药轻，则邪气不能伏除；病轻而用药重，则会过度损伤正气。病位在上却使用峻下的方剂，则上部的热邪无法消除，怎么可以一概混治呢？节庵在论述小承气汤时说：上焦受损，去掉芒硝是担心损伤下焦血分的真阴。在论述调胃承气汤时说：邪气在中焦，不用枳实、厚朴是为了不损伤上焦虚无氤氲的元气。然而此方独独使用芒硝，难道不会伤害下焦吗？我没听说过承气汤主治上焦病症，也没听说过调胃承气汤的适应症是燥屎坚硬的情况。张仲景关于调胃承气汤的证候描述中，八方条文里并没有提到干燥，不过是说“胃气不和”、“胃实”、“腹满”，由此可知此汤专门主治表邪完全解除，初入腑道且将要结聚的证候。因此，张仲景将调胃承气汤归入太阳阳明病篇，并且注明大黄要用酒浸，这是因为太阳阳明病离表未远，病位偏上，不应当直接攻下，所以适宜用缓和的方剂来调和它。到了正阳阳明病，都说应当急下，而大承气汤中的大黄注明是用酒洗，洗比浸程度轻，略微提升其走下的药性，以调和其中焦。至于少阳阳明病，则是远离正阳而逼近太阴，病位在下，所以使用小承气汤，其中的大黄不用酒制。
Rhei Radix et Rhizoma (Four liang, soaked in clear wine) Glycyrrhizae Radix et Rhizoma Preparata (Two liang, honey-fried) Natrii Sulfas (Half sheng)
The above three ingredients are coarsely crushed. Boil with three sheng of water to obtain one sheng of decoction. Remove the dregs. Add Natrii Sulfus and boil gently over fire until it boils. Take warm medicine in small amounts frequently.
"Chengqi" refers to using agents to restrain excessive Qi and make it descend smoothly. *Shanghan Miyao* states: Wang Haicang discussed that Zhang Zhongjing's Chengqi Decoctions differ into Da Chengqi Tang, Xiao Chengqi Tang, and Tiaowei Chengqi Tang. Nowadays, people use San-Yi Chengqi Tang indiscriminately for upper/lower or slow/urgent conditions, which surely deviates from Zhang Zhongjing's original intent. For severe heat and excess, use Da Chengqi Tang; for mild heat and excess, use Xiao Chengqi Tang; when excess-heat remains in the Stomach, use Tiaowei Chengqi Tang. The sweetness of Glycyrrhizae Radix slows its downward action to dispel Stomach heat. If a severe disease is treated with a mild formula, the pathogenic factor will not be subdued; if a mild disease is treated with a strong formula, healthy Qi will be excessively damaged. If an urgent purgative is used for a disease located in the upper jiao, the upper heat will not be eliminated. How can all cases be treated uniformly? Jie'an discussed Xiao Chengqi Tang, stating that removing Natrii Sulfus prevents damage to the true Yin of the blood in the lower jiao when the upper jiao is injured. He discussed Tiaowei Chengqi Tang, stating that avoiding Zhi Shi and Hou Po protects the ethereal Yuan Qi of the upper jiao from injury by the middle-jiao pathogen. However, does this formula alone, containing Natrii Sulfus, not harm the lower jiao? I have never heard of Chengqi Tang treating the upper jiao, nor have I heard of indications for Tiaowei Chengqi Tang involving hard, dry stool. In Zhang Zhongjing's descriptions of Tiaowei Chengqi Tang indications across eight clauses, there is no mention of dryness, only "Stomach Qi disharmony," "Stomach excess," and "abdominal fullness." Thus, we know this decoction specifically treats conditions where exterior pathogens have completely resolved, just entering the fu-organs and beginning to bind. Therefore, Zhang Zhongjing included Tiaowei Chengqi Tang in the Taiyang-Yangming chapter and noted that Rhei Radix should be wine-soaked. This is because Taiyang-Yangming pathology is still close to the exterior, with the disease location higher up, so direct purgation is inappropriate; thus, a mild harmonizing formula is suitable. When reaching Zhengyang Yangming, urgent purgation is indicated, and the Rhei Radix in Da Chengqi Tang is noted as wine-washed. Washing is milder than soaking, slightly enhancing its descending property to harmonize the middle jiao. As for Shaoyang-Yangming, it moves away from Zhengyang and approaches Taiyin, with the pathology located lower down; therefore, Xiao Chengqi Tang is used, and the Rhei Radix therein is not processed with wine.