治伤寒汗出解后, 胃中不和, 心下痞硬, 干噫食
臭,胁下有水气, 腹中雷鸣下痢者.
甘草 ( 炙 ) 三两 人参三两 干姜一两 半夏 ( 洗 ) 半升 黄芩
三两 黄连一两 生姜 ( 切 ) 四两 大枣 ( 擘 ) 十二枚, 右八味
,以水一斗, 煮取六升, 去滓再煎, 取三升, 温服一升, 日三服.
【注】伤寒汗出之后, 余邪转属阳明, 心下痞满硬痛不大便者, 此其
人胃素燥热, 因而成实, 攻之可也. 今其人平素胃虚, 兼胁下有水气
,即不误下, 余热乘虚入里, 结成痞硬不痛, 胃虚不能消化水谷, 则
干噫食臭也. 胃中寒热不和, 则腹中雷鸣下利也. 名生姜泻心汤者,
其义重在散水气之痞也. 生姜, 半夏散胁下之水气. 人参, 大枣补中
州之土虚. 干姜, 甘草以温里寒. 黄芩, 黄连以泻痞热. 备乎虚水寒
热之治, 胃中不和下利之痞, 未有不愈者也.
治伤寒五, 六日, 呕而发热, 柴胡证具, 而以他
药下之, 但满不痛, 心下痞者.
半夏 ( 洗 ) 半升 黄芩三两 干姜三两 人参三两 黄连一两 甘
草( 炙 ) 三两 大枣 ( 擘 ) 十二枚, 右七味, 以水一斗, 煮取六
升,去滓再煎, 取三升, 温服一升, 日三服.
【集注】王又原曰: 伤寒五, 六日, 柴胡证具, 而以他药下之成痞.
即用小柴胡汤, 以干姜易生姜, 以黄连易柴胡. 彼以和表里, 此以彻
上下. 而必推半夏为君者, 痞从呕得来, 半夏之辛以破结而止呕也.
治疗伤寒经发汗后，表证已解，但胃气不和，出现心下痞塞且按之坚硬，干呕伴有食物腐臭味，胁下有停饮，肠鸣音亢进并伴有腹泻的症状。
炙甘草三两、人参三两、干姜一两、半夏（洗净）半升、黄芩三两、黄连一两、生姜（切片）四两、大枣（掰开）十二枚。以上八味药，用水一斗，煎煮至剩余六升，滤去药渣，再次煎煮浓缩至三升，每次温服一升，每日服用三次。
【注解】伤寒经过发汗治疗后，残余的病邪转入阳明经，若出现心下痞满、坚硬、疼痛且大便不通的情况，这是因为患者平素胃中燥热，导致邪气结实，可以采用攻下法治疗。如今这位患者平素胃气虚弱，兼有胁下停饮，即使没有误用攻下法，余热也会乘虚入里，结聚成痞硬但不疼痛；胃气虚弱无法消化水谷，所以会出现干呕和嗳出酸腐食物气味；胃中寒热之气不调和，就会导致肠鸣音如雷并伴有腹泻。命名为“生姜泻心汤”，其含义重在消散因水气停滞导致的痞证。生姜、半夏能疏散胁下的水气；人参、大枣补益中焦脾胃的虚弱；干姜、甘草用来温补里寒；黄芩、黄连用来清泻痞结之热。该方兼顾了虚证、水饮、寒证、热证的治疗，对于胃气不和引起的腹泻及痞证，没有不能治愈的。
治疗伤寒病程五到六天，出现呕吐且发热，具备少阳病柴胡证的特征，却误用其他药物进行攻下，导致仅有心下痞满而不疼痛的症状。
半夏（洗净）半升、黄芩三两、干姜三两、人参三两、黄连一两、炙甘草三两、大枣（掰开）十二枚。以上七味药，用水一斗，煎煮至剩余六升，滤去药渣，再次煎煮浓缩至三升，每次温服一升，每日服用三次。
【集注】王又原说：伤寒五到六天，具备柴胡证，却误用他药攻下而成痞证。此时若用小柴胡汤，将生姜改为干姜，将柴胡改为黄连。小柴胡汤用于调和表里，此方用于通彻上下。之所以必须推举半夏为君药，是因为痞证源于呕吐，利用半夏的辛散之性来破除结滞并止呕。
Treats the condition after Shaoyang disease (Taiyang disease in some contexts, but here referring to exterior syndrome treated by sweating) has been resolved through sweating, yet there is disharmony in the Stomach, manifested as fullness and hardness below the heart (epigastric region), dry belching with a foul odor of food, fluid retention under the flanks, borborygmus (rumbling in the intestines), and diarrhea.
Zhi Gancao (Prepared Licorice Root) 3 liang, Renshen (Ginseng Root) 3 liang, Ganjiang (Dried Ginger) 1 liang, Banxia (Pinellia Tuber, washed) 0.5 sheng, Huangqin (Scutellaria Root) 3 liang, Huanglian (Coptis Rhizome) 1 liang, Shengjiang (Fresh Ginger, sliced) 4 liang, Dazao (Jujube Fruit, broken open) 12 pieces. The above eight herbs are decocted in 10 dou of water until 6 sheng remain. Strain the dregs, then decoct again until 3 sheng remain. Take 1 sheng warm, three times a day.
[Annotation] After sweating for Taiyang disease (Exterior Syndrome), residual pathogens may transfer to the Yangming channel. If epigastric fullness, hardness, pain, and constipation occur, it indicates that the person's stomach was originally dry and hot, leading to excess accumulation; purgation is appropriate. However, this patient has a constitutionally weak stomach and fluid retention under the flanks. Even without erroneous purgation, residual heat enters the interior due to deficiency, forming fullness and hardness without pain. The weak stomach cannot digest food and fluids, causing dry belching with a foul odor. Disharmony of cold and heat in the stomach leads to borborygmus and diarrhea. The formula is named Shengjiang Xiexin Tang (Ginger Decoction to Drain the Epigastrium) because its primary function is to dissipate fullness caused by fluid retention. Shengjiang and Banxia dissipate fluid retention under the flanks. Renshen and Dazao tonify the deficiency of the Middle Jiao (Spleen and Stomach). Ganjiang and Zhi Gancao warm the interior cold. Huangqin and Huanglian drain the heat of the fullness. This formula comprehensively addresses deficiency, fluid, cold, and heat. There is no case of epigastric fullness and diarrhea due to stomach disharmony that will not be cured.
Treats Taiyang disease occurring on the fifth or sixth day, characterized by vomiting and fever, presenting with all signs of Chaihu Zheng (Bupleurum Pattern), which was erroneously treated with purgatives by other physicians, resulting in epigastric fullness without pain.
Banxia (Pinellia Tuber, washed) 0.5 sheng, Huangqin (Scutellaria Root) 3 liang, Ganjiang (Dried Ginger) 3 liang, Renshen (Ginseng Root) 3 liang, Huanglian (Coptis Rhizome) 1 liang, Zhi Gancao (Prepared Licorice Root) 3 liang, Dazao (Jujube Fruit, broken open) 12 pieces. The above seven herbs are decocted in 10 dou of water until 6 sheng remain. Strain the dregs, then decoct again until 3 sheng remain. Take 1 sheng warm, three times a day.
[Collected Annotations] Wang Youyuan stated: When Taiyang disease occurs on the fifth or sixth day with Chaihu Zheng present, if purgatives are erroneously used, it results in fullness. One could use Xiao Chaihu Tang (Minor Bupleurum Decoction), replacing Shengjiang with Ganjiang and Chaihu with Huanglian. The former harmonizes the exterior and interior; this formula clears the upper and lower jiao. Banxia must be regarded as the sovereign herb because the fullness arises from vomiting; Banxia’s acrid nature breaks up stagnation and stops vomiting.