伤寒下之早，从心下至少腹硬满而痛，手不可近者，结胸也，此方主之。
甘遂（一钱，为末） 芒硝（一升） 大黄（二两） 水六升，先煮大黄，取二升，去滓，
纳硝，煮一沸，纳甘遂末，温服一升，得快利，止后服。
三阳经表症未解，用承气以攻里者，下之早也。下早则里虚，表邪乘之而入，三焦
皆实，故心下至少腹痛不可近也。成氏曰∶诸阳受气于胸中，邪气与阳气相结，不可分
解，高者陷之，故曰∶陷胸。陷胸破结，非苦寒直达者不能，是以甘遂为君，《经》曰∶
咸味涌泄为阴；又曰∶咸以软之，是以芒硝为臣，荡涤邪寇，将军之职也。是以大黄为
使，伤寒诸恶，结胸为甚，非此 剂不能通利。
下早热结胸中，按之则痛，小结胸也。
半夏（汤洗，半升） 黄连（一两） 栝蒌实（大者，一枚） 水六升，先煮栝蒌，取三
升，去滓，纳诸药，煮取二升，分二温服。
止在胸中不及于腹，按之则痛，不按犹未痛也，故曰∶小结胸。《经》曰∶苦以泄
之，辛以散之。黄连泄胸中之热，括蒌泄胸中之气，半夏散胸中之痰，一服未能即和，
再服微解下黄涎便安也。
治伤寒燥热，怫结心烦，懊 不眠，脏腑积热烦渴，头昏唇焦，咽燥喉痹，目赤烦
燥，口舌生疮，咳唾稠粘，谵语狂妄，肠胃燥涩，便溺闭结，风热壅滞，疮疹发斑，黑
陷将死。
连翘（一两） 山栀 大黄 薄荷 黄芩（各五钱） 甘草（一两五钱） 朴硝（二钱五分） 为
粗末，每服五钱，水煎温服。一方有黄连。
伤寒病若过早使用泻下法，导致从心窝部直至小腹坚硬胀满且疼痛，手不能触碰的，属于结胸证，此方主治。
甘遂（一钱，研为粉末） 芒硝（一升） 大黄（二两） 用水六升，先煮大黄，取药液二升，滤去药渣，
加入芒硝，煮沸一次，再加入甘遂粉末，温服一升，若得快速通利，则停止后续服用。
三阳经的表证尚未解除，就使用承气汤类攻逐里实的，属于下法过早。下法过早则导致里气虚弱，表邪趁机内陷，致使三焦皆呈实证，所以心窝部直至小腹疼痛剧烈，手不可近。成无己说：诸阳之气汇聚于胸中，邪气与阳气相互搏结，无法分解，病位较高者陷入胸中，所以称为“陷胸”。要破除结胸之邪，非苦寒直折之品不能胜任，因此以甘遂为君药，《内经》说：咸味具有涌吐和泄下的作用，属阴；又说：咸味能软坚散结，因此以芒硝为臣药，荡涤邪气寇乱，发挥将军般的职能。因此以大黄为使药，伤寒各种恶候中，结胸最为严重，非此方剂不能通利。
若下法过早，热邪结聚于胸中，按压时才感到疼痛的，属于小结胸证。
半夏（用热水洗，半升） 黄连（一两） 瓜蒌实（大的，一枚） 用水六升，先煮瓜蒌，取药液三升，滤去药渣，加入其他药物，煎煮取药液二升，分两次温服。
病邪仅停留在胸中，未波及腹部，按压才痛，不按就不痛，所以称为“小结胸”。《内经》说：苦味能泄降，辛味能发散。黄连泄除胸中的热邪，瓜蒌泄除胸中的气滞，半夏消散胸中的痰饮，若服一次未能立即调和，再服一次微解，排出黄涎后即可安宁。
治疗伤寒燥热，郁结心烦，心中烦闷懊恼不得安眠，脏腑积热导致烦躁口渴，头晕嘴唇焦裂，咽喉干燥喉痹，眼睛红赤烦躁，口舌生疮，咳嗽吐出的痰液稠厚粘腻，胡言乱语狂妄，肠胃干燥涩滞，大小便闭塞不通，风热壅滞，疮疹发出斑点，颜色黑陷濒临死亡。
连翘（一两） 山栀 大黄 薄荷 黄芩（各五钱） 甘草（一两五钱） 朴硝（二钱五分） 制成粗末，每次服用五钱，用水煎煮后温服。另一版本方中含有黄连。
If Shaoyang disease is treated with purgation too early, resulting in hardness, fullness, and pain from the epigastrium down to the lower abdomen, such that the area cannot be touched by hand, this is Jie Xiong (Chest Binding Syndrome), which this formula treats.
Gansui (1 qian, powdered) Mangxiao (1 sheng) Dahuang (2 liang) Add six sheng of water, first decoct Dahuang until two sheng remain, strain off the dregs,
add Mangxiao, boil once, then add Gansui powder, take one sheng warm. If rapid evacuation occurs, stop taking the remainder.
When the exterior syndromes of the Three Yang channels are not yet resolved, using Chengqi Tang to attack the interior constitutes premature purgation. Premature purgation leads to deficiency in the interior, allowing exterior pathogenic factors to penetrate inward, causing excess in the Sanjiao (Triple Burner). Thus, there is severe pain from the epigastrium to the lower abdomen that cannot be touched. Cheng Wuji stated: All Yang qi gathers in the chest. When pathogenic factors bind with Yang qi and cannot be separated, if the condition is high, it sinks into the chest; hence it is called "Xian Xiong" (Sunken Chest). To break the binding of Xian Xiong, only bitter-cold herbs that reach directly can suffice; therefore, Gansui is used as the Sovereign herb. The Classic states: Salty flavors induce vomiting and purgation and belong to Yin; also: Salty flavors soften hardness. Therefore, Mangxiao is used as the Minister herb to sweep away pathogenic invaders, fulfilling the role of a General. Thus, Dahuang is used as the Envoy herb. Among all severe conditions of Shaoyang disease, Jie Xiong is the most serious, and only this formula can ensure unobstructed flow.
If purgation is performed too early, heat binds in the chest, causing pain only upon pressure, this is Xiao Jie Xiong (Minor Chest Binding Syndrome).
Banxia (washed with hot water, half sheng) Huanglian (1 liang) Gualou Shi (one large fruit) Add six sheng of water, first decoct Gualou until three sheng remain, strain off the dregs, add the other herbs, decoct to obtain two sheng, divide into two doses and take warm.
The pathology is confined to the chest and does not extend to the abdomen; pain occurs only upon pressing, but not when unpressed; hence it is called "Xiao Jie Xiong" (Minor Chest Binding). The Classic states: Bitter flavors drain downward, and pungent flavors disperse. Huanglian drains heat from the chest, Gualou drains Qi stagnation from the chest, and Banxia disperses Phlegm from the chest. If one dose fails to harmonize immediately, a second dose will provide slight relief, and after evacuating yellow turbid fluid, peace will be restored.
Treats Shaoyang dry-heat, constrained mental restlessness, vexation and regretfulness with insomnia, accumulation of heat in the Zang-Fu organs causing irritability and thirst, dizziness and cracked lips, dry throat and Bi syndrome, red and irritable eyes, sores on the mouth and tongue, thick and sticky sputum, delirium and madness, dryness and constipation of the intestines and stomach, closure of urination and defecation, stagnation of Wind-Heat, eruption of sores and rashes, blackening and sinking of rashes indicating imminent death.
Lianqiao (1 liang) Shanzhi Dahuang Bohe Huangqin (each 5 qian) Gancao (1 liang 5 qian) Puxiao (2 qian 5 fen) Process into coarse powder. Take 5 qian per dose, decoct in water and take warm. Another version includes Huanglian.