大黄（半斤） 葶苈子（熬） 芒硝 杏仁（去皮尖熬黑，各半升） 上四味，捣筛二味，纳杏仁、芒硝，合研
如脂，和散，取如弹丸一枚，别捣甘遂末一钱匕，白蜜二合，水二升，煮取一升，温顿服之，一宿乃下，如不
下，更服，取下为效。
病发于阳，而反下之，热入因作结胸，病发于阴，而反下之，热入因作痞。此明所以致结胸与痞之故。
发热恶寒之症，则热入于阳位而作结胸，无热恶寒之症，则热入于阴位而作痞，故治结胸用寒剂，治痞用
温剂也。所以成结胸者，以下之太早故也。二病未尝不可下，但各有其时，不可过早耳。结胸者，项亦强，
如柔痉状，此陷胸之外症。下之则和，宜大陷胸丸。
黄连（一两） 半夏（半升洗） 栝蒌实（大者一枚） 上三味，以水六升，先煮栝蒌，取三升，去渣，纳诸药，
煮取二升，去渣，分温三服，一服未和，再服微解，下黄涎，便安也。按∶大承气所下者，燥屎；大陷胸
所下者，蓄水；此所下者，为黄涎。涎者，轻于蓄水，而未成水者也。审病之精，用药之切如此。
小结胸病，正在心下，按之则痛，上不至心，下不及少腹，必按之方痛，非不可近乎，与大陷胸症迥
别。脉浮滑者，不若大陷胸症之沉紧，其邪未入深也。小陷胸汤主之。
大黄（半斤） 葶苈子（炒制） 芒硝 杏仁（去皮尖，炒至焦黑，各半升） 以上四味药，将其中两味捣碎过筛，加入杏仁和芒硝，共同研磨混合如脂状，调和成散剂。每次取如弹丸大小的一枚，另取甘遂末一钱匕，白蜜二合，水二升，煎煮至一升，温服一次顿下。若一夜后仍未排便，可再服用，以排出病邪为见效标准。
疾病初起于阳分，误用攻下法，热邪内陷因而形成结胸；疾病初起于阴分，误用攻下法，热邪内陷因而形成痞证。这是阐明导致结胸与痞证的原因。发热恶寒的症状，说明热邪陷入阳位而结成结胸；无热恶寒的症状，说明热邪陷入阴位而形成痞证。因此治疗结胸使用寒凉药剂，治疗痞证使用温热药剂。之所以形成结胸，是因为攻下过早的缘故。这两种病并非不可用攻下法，只是各有其适宜时机，不可过早而已。结胸证，颈部也僵硬，像柔痉病的样子，这是陷胸汤证的外在表现。攻下之后则和解，宜用大陷胸丸。
黄连（一两） 半夏（半升，洗净） 栝蒌实（大的一个） 以上三味药，用水六升，先煮栝蒌，取汁三升，去渣，加入其他药物，煎煮至二升，去渣，分三次温服。如果服后未缓解，再服一次，微微缓解，排出黄涎，身体便安适了。按：大承气汤所下的，是燥屎；大陷胸汤所下的，是蓄水；此方所下的，是黄涎。涎，比蓄水轻浅，是水液尚未完全积聚的状态。审察病情精微，用药确切，达到如此程度。
小结胸病，部位正在心下（胃脘部），按压才疼痛，上不连及心胸，下不及少腹，必须按压才痛，并非不可接近，与大陷胸证截然不同。脉象浮滑者，不像大陷胸证的沉紧，说明邪气未深入体内。用小陷胸汤主治。
Rhizoma et Radix Rhei (Dahuang, 大黄) [0.5 jin], Semen Lepidii seu Descureniae (Tinglizi, 葶苈子) [roasted], Natrii Sulfas (Mangxiao, 芒硝), Semen Armeniacae Amarum (Xingren, 杏仁) [dehulled and deseeded, roasted until dark brown] [each 0.5 sheng]. The above four herbs: crush and sieve two of them, add Xingren and Mangxiao, grind together until paste-like, mix with powder. Take one pill-sized amount (like a bullet). Independently grind Gan Sui end (Gansui, 甘遂) to powder, one qianbi. Add Bai Mi (White Honey, 白蜜) [2 he] and water [2 sheng]. Boil to obtain 1 sheng. Take warm in one dose overnight. If stool is not passed, administer again. Passing stool indicates efficacy.
When the disease originates in Yang, and purgation is wrongly applied, heat enters and forms Jie Xiong (Chest Binding, 结胸); when the disease originates in Yin, and purgation is wrongly applied, heat enters and forms Pi (Stagnation, 痞). This clarifies the causes of Jie Xiong and Pi. Symptoms of fever and aversion to cold indicate heat entering Yang positions to form Jie Xiong; symptoms of no fever but aversion to cold indicate heat entering Yin positions to form Pi. Therefore, treat Jie Xiong with cold-natured agents, and treat Pi with warm-natured agents. The reason for forming Jie Xiong is that purgation was applied too early. Both diseases can be treated with purgation, but each has its appropriate timing; it must not be applied too early. In Jie Xiong syndrome, the neck is also stiff, resembling Rou Jing (Soft Spasm, 柔痉). This is an external manifestation of the Xian Xiong (Depress the Chest, 陷胸) syndrome. Purging leads to harmony; Da Xian Xiong Wan (Major Depress the Chest Pill, 大陷胸丸) is indicated.
Radix Coptidis (Huanglian, 黄连) [1 liang], Rhizoma Pinelliae Preparatum (Banxia, 半夏) [0.5 sheng, washed], Fructus Trichosanthis (Gualou Shi, 栝蒌实) [one large fruit]. The above three herbs: use 6 sheng of water. First boil Gualou, obtain 3 sheng, remove dregs. Add other herbs, boil to obtain 2 sheng, remove dregs. Divide into three warm doses. If not relieved after one dose, take another; slight relief occurs, yellow phlegm-fluid is discharged, and comfort is restored. Note: Da Cheng Qi Tang (Major Order the Qi Decoction, 大承气汤) discharges dry feces; Da Xian Xiong Tang discharges accumulated water; this formula discharges yellow phlegm-fluid. Phlegm-fluid is lighter than accumulated water, being fluid that has not yet fully accumulated. Such precision in diagnosing illness and appropriateness in medication is remarkable.
Xiao Jie Xiong Bing (Minor Chest Binding Disease, 小结胸病) is located exactly at Xin Xia (Epigastrium, 心下). Pain occurs only upon pressure. It does not extend upward to the heart or downward to the Shao Fu (Lower Abdomen, 少腹). Pain requires pressure; it is not untouchable, distinctly different from Da Xian Xiong syndrome. A floating and slippery pulse differs from the deep and tight pulse of Da Xian Xiong syndrome, indicating the pathogen has not penetrated deeply. Xiao Xian Xiong Tang (Minor Depress the Chest Decoction, 小陷胸汤) is the primary treatment.