三十一证 方一十六首
问曰∶病有结胸，有脏结，其状何如？答曰∶按之痛，其脉寸口浮，关上自沉，为结胸
。何谓脏结？曰∶如结胸状，饮食如故，时下利，阳脉浮，关上细沉而紧，名为脏结。舌上
白胎滑者，为难治。脏结者，无阳证，不往来寒热，其人反静，舌上胎滑者，不可攻也。夫
病发于阳，而反下之，热入因作结胸，发于阴而反汗之，因作痞。结胸者，下之早，故令结
胸。结胸者，其项亦强，如柔 状，下之即和，宜大陷胸丸。
结胸证，其脉浮大，不可下之，下之即死。
结胸证悉具，烦躁者死。
太阳病，脉浮而动数，浮则为风，数则为热，动则为痛，数则为虚，头痛发热，微盗汗
出，而反恶寒，其表未解，医反下之，动数则迟，头痛即眩，胃中空虚，客气动膈，短气躁
烦，心中懊 ，阳气内陷，心下因坚，则为结胸，大陷胸汤主之。若不结胸，但头汗出，其
余无汗，齐颈而还，小便不利，身必发黄。
伤寒六七日，结胸热实，脉沉紧，心下痛，按之如石坚，大陷胸汤主之。但结胸，无大
热，此为水结在胸胁，头微汗出，大陷胸汤主之。
太阳病，重发汗而复下之，不大便五六日，舌上燥而渴，日晡如小有潮热，从心下至少
腹坚满而痛不可近，大陷胸汤主之。若心下满而坚痛者，此为结胸，大陷胸汤主之。
大陷胸丸方∶
大黄（八两） 葶苈子（熬） 杏仁（去皮尖两仁者） 芒硝（各半升）
上四味，和捣取如弹丸一枚，甘遂末一钱匕，白蜜一两，水二升，合煮取一升，温顿服
一宿乃下。
大陷胸汤方∶
大黄（六两） 甘遂（末，一钱匕） 芒硝（一升）
上三味，以水六升，先煮大黄取二升，去滓，纳芒硝，煎一两沸，纳甘遂末，分再服，
得快利，止后服。
小结胸者，正在心下，按之即痛，其脉浮滑，小陷胸汤主之。
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，去滓，纳诸药，煮取二升，去滓，分温三服。
太阳病二三日，不能卧，但欲起者，心下必结，其脉微弱者，此本寒也。而反下之，利
止者，必结胸；未止者，四五日复重下之，此为挟热利。
太阳少阳并病，而反下之，结胸，心下坚，下利不复止，水浆不肯下，其人必心烦。
病在阳，当以汗解，而反以水 之，若灌之，其热却不得去，益烦，皮粟起，意欲饮水，
反不渴，宜服文蛤散。方∶
文蛤（五两）
上一味，捣为散，以沸汤五合，和服一方寸匕，若不瘥，与五苓散。
五苓散方∶
猪苓（十八铢，去黑皮） 白术（十八铢） 泽泻（一两六铢） 茯苓（十八铢） 桂
枝（半两）
上五味，各为散，更于臼中治之，白饮和服方寸匕，日三服，多饮暖水，汗出愈。
寒实结胸无热证者，与三物小白散方∶
桔梗（十八铢） 巴豆（六铢，去皮心，熬赤黑，研如脂） 贝母（十八铢）
上三味，捣为散，纳巴豆，更于臼中治之，白饮和服，强人半钱匕，羸者减之。病在上
则吐，在下则利。不利，进热粥一杯。利不止，进冷粥一杯（一云冷水一杯）；身热皮粟不
解，
欲
与芍药三两如上法。
太阳与少阳并病，头痛，或眩冒，如结胸，心下痞而坚，当刺肺俞、肝俞、大椎第一间，
慎不可发汗，发汗即谵语，谵语则脉弦，五日谵语不止，当刺期门。
心下但满，而不痛者，此为痞，半夏泻心汤主之∶
半夏（半升，洗） 黄芩 干姜 人参 甘草（各三两，炙） 黄连（一两） 大枣（十
二枚，
擘）
上七味，以水一斗，煮取六升，去滓，温服一升，日三服。
脉浮紧，而下之，紧反入里，则作痞，按之自濡，但气痞耳。
太阳中风，吐下呕逆，表解，乃可攻之。其人 汗出，发作有时。头痛，心下痞坚满
，引胁下呕即短气，此为表解里未和，十枣汤主之。方∶
芫花（熬） 甘遂 大戟（各等分）
上三味，捣为散，以水一升五合，先煮大枣十枚，取八合，去枣，强人纳药，末一钱匕
，羸人半钱匕，温服平旦服，若下少不利者，明旦更服加半钱得快下糜粥自养。
太阳病，发其汗，遂发热恶寒，复下之，则心下痞。此表里俱虚，阴阳气并竭，无阳则
阴独，复加烧针，胸烦，面色青黄肤 ，此为难治，今色微黄，手足温者愈。
心下痞，按之自濡，关上脉浮者，大黄黄连泻心汤主之。方∶
大黄（二两） 黄连（一两）
上二味，以麻沸汤二升渍之，须臾去滓，分温再服。（此方必有黄芩。）
心下痞而复恶寒，汗出者，附子泻心汤主之。方∶
附子一枚，炮，别煮取汁 大黄（二两） 黄连 黄芩（各一两）
上四味，以麻沸汤二升渍之须臾，去滓，纳附子汁，分温再服。本以下之，故心下痞，
与之泻心，其痞不解，其人渴而口燥烦，小便不利者，五苓散主之。一方言，忍之一日乃愈
（用
伤寒汗出，解之后，胃中不和，心下痞坚，干噫食臭，胁下有水气，腹中雷鸣而利，生
姜泻心汤主之。方∶
生姜（四两，切） 半夏（半升，洗） 干姜（一两） 黄连（一两） 人参 黄芩 甘
草（各
三两，炙） 大枣（十二枚，擘）
上八味，以水一斗，煮取六升，去滓，温服一升，日三服。
伤寒中风，医反下之，其人下利日数十行，谷不化，腹中雷鸣，心下痞坚而满，干呕而
烦，不能得安，医见心下痞，为病不尽，复重下之，其痞益甚，此非结热，但胃中虚，客气
上逆，故使之坚，甘草泻心汤主之。方∶
甘草（四两，炙） 黄芩 干姜（各三两） 黄连（一两） 半夏（半升，洗） 大枣
（十二枚
，擘） 一方有人参（三两。）
上六味，以水一斗，煮取六升，去滓，温服一升，日三服。
伤寒，服汤药，下利不止，心下痞坚。服泻心汤，复以他药下之，利不止。医以理中与
之，而利益甚。理中治中焦，此利在下焦，赤石脂禹余粮汤主之。方∶
赤石脂（一斤，碎） 太一禹余粮（一斤，碎）
上二味，以水六升，煮取二升，去滓分温三服，若不止，当利小便。
伤寒吐下发汗，虚烦，脉甚微，八九日心下痞坚，胁下痛，气上冲喉咽，眩冒，经脉动
惕者，久而成痿。
伤寒发汗吐下，解后，心下痞坚，噫气不除者，旋复代赭汤主之。方∶
旋复花（三两） 人参（二两） 生姜（五两，切） 代赭（一两，碎） 甘草（三两，
炙） 半
夏（半升，洗） 大枣（十二枚，擘）
上七味，以水一斗，煮取六升，去滓，温服一升，日三服。
太阳病，外证未除，而数下之，遂挟热而利不止，心下痞坚，表里不解，桂枝人参汤主
之方∶
桂枝（四两，别切） 甘草（四两，炙） 白术 人参 干姜（各二两）
上五味，以水九升，先煮四味，取五升，去滓，纳桂更煮取三升，去滓，温服一升，日
再
伤寒大下后，复发其汗，心下痞，恶寒者，表未解也，不可攻其痞，当先解表，表解乃
攻其痞，宜大黄黄连泻心汤（用上方。）
病如桂枝证，头项不强痛，脉微浮，胸中痞坚，气上冲喉咽不得息，此为胸有寒，当吐
之，宜瓜蒂散。方∶
瓜蒂（熬） 赤小豆（各一分）
上二味，捣为散，取半钱匕，豉一合，汤七合渍之，须臾去滓，纳散汤中和，顿服之，
若不吐，稍加之，得快吐止，诸亡血虚家，不可与瓜蒂散。
第三十一节 方剂十六首
问：疾病中有结胸证和脏结证，它们的症状表现是怎样的？答：按压时疼痛，脉象寸口部浮，关部自沉，这是结胸证。什么是脏结证？说：症状像结胸证，但饮食如常，时常腹泻，阳脉（寸脉）浮，关脉细、沉且紧，这叫做脏结证。舌苔白而滑润的，难以治疗。脏结证没有阳证表现，没有往来寒热，病人反而安静，舌苔滑润的，不可用攻下法。病发于阳证，却误用攻下法，热邪内陷因而形成结胸；病发于阴证，却误用发汗法，因而形成痞证。结胸证是因为攻下过早，所以导致结胸。结胸证，其颈部也强直，像柔痉（一种以项背强急、口噤不开为特征的病证）的样子，攻下后病情即可缓解，适宜用大陷胸丸。
太阳病，脉象浮而动数，浮脉主风邪，数脉主热，动脉主痛，数脉也主虚。头痛发热，微微盗汗，反而恶寒，说明表证未解，医生反而使用攻下法，导致动数之脉转为迟脉，头痛随即变为眩晕，胃中空虚，外邪乘虚扰动膈间，出现短气、烦躁、心中烦闷不舒，阳气内陷，心下部因此坚硬，这就形成了结胸证，由大陷胸汤主治。如果不形成结胸，只是头部出汗，身体其他部位无汗，汗止于颈部，小便不利，身体必然发黄。
伤寒病六七天，出现结胸热实证，脉象沉紧，心下部疼痛，按压时像石头一样坚硬，由大陷胸汤主治。如果是单纯的结胸，没有大热，这是水饮结聚在胸胁，头部微有汗出，由大陷胸汤主治。
太阳病，重发汗后又攻下，导致五六天不大便，舌上干燥且口渴，傍晚时分有轻微潮热，从心下部直到小腹部坚硬胀满且疼痛拒按，由大陷胸汤主治。如果心下部胀满且坚硬疼痛，这是结胸证，由大陷胸汤主治。
大陷胸丸方：
大黄（八两） 葶苈子（炒） 杏仁（去皮尖，选用双仁者） 芒硝（各半升）
以上四味药，混合捣碎取如弹丸大小的一枚，甘遂末一钱匕，白蜜一两，水二升，合在一起煮取一升，温服，一次顿服，过一夜大便通下。
大陷胸汤方：
大黄（六两） 甘遂（末，一钱匕） 芒硝（一升）
以上三味药，用水六升，先煮大黄取二升，去渣，加入芒硝，煎煮一两沸，再加入甘遂末，分两次服用，得到快速通便效果后，停止后续服用。
小结胸证，病位正在心下部，按压即痛，脉象浮滑，由小陷胸汤主治。
黄连（一两） 半夏（半升，洗净） 栝蒌实（大者一枚）
以上三味药，用水六升，先煮栝蒌，取三升，去渣，加入其他药物，煮取二升，去渣，分三次温服。
太阳病二三天，不能卧倒，只想坐起，心下部必然结滞，脉象微弱的，这本是寒证。却误用攻下法，腹泻停止的，必形成结胸；腹泻不止的，四五天后又再次攻下，这属于挟热利。
太阳少阳并病，却误用攻下法，形成结胸，心下部坚硬，腹泻不再停止，水浆难以下咽，病人必定心烦。
病在阳分，应当用发汗法解除，却误用水洗或灌洗等方法，若进行灌洗，热邪反而无法去除，更加烦躁，皮肤起粟粒状鸡皮疙瘩，想要喝水，反而不觉口渴，适宜服用文蛤散。方剂：
文蛤（五两）
以上一味药，捣成散剂，用沸水五合调和，服用一方寸匕，如果不好转，给予五苓散。
五苓散方：
猪苓（十八铢，去黑皮） 白术（十八铢） 泽泻（一两六铢） 茯苓（十八铢） 桂枝（半两）
以上五味药，分别制成散剂，再在臼中研磨均匀，用米汤调和服用一方寸匕，每日三次，多喝暖水，出汗即愈。
寒实结胸证，没有热象表现的，给予三物小白散方：
桔梗（十八铢） 巴豆（六铢，去皮心，炒至赤黑色，研如脂状） 贝母（十八铢）
以上三味药，捣成散剂，加入巴豆，再在臼中研磨均匀，用米汤调和服用，体质强者半钱匕，体弱者减量。病位在上则引起呕吐，病位在下则引起腹泻。如果不下利，喝一杯热粥。如果腹泻不止，喝一杯冷粥（一说冷水一杯）；如果身热、皮肤粟起不解，
欲
加芍药三两，按上述方法处理。
太阳与少阳并病，头痛，或者眩晕昏冒，症状像结胸，心下部痞塞且坚硬，应当针刺肺俞、肝俞、大椎第一间隙，千万不可发汗，发汗就会谵语，谵语则脉弦，如果五天谵语不止，应当针刺期门穴。
心下部只是胀满，而不疼痛的，这是痞证，由半夏泻心汤主治：
半夏（半升，洗净） 黄芩 干姜 人参 甘草（各三两，炙） 黄连（一两） 大枣（十二枚，掰开）
以上七味药，用水一斗，煮取六升，去渣，温服一升，每日三次。
脉象浮紧，却误用攻下法，紧脉反入里，则形成痞证，按压自己感觉柔软，这只是气机痞塞而已。
太阳中风证，伴有呕吐逆气，表证已解，才可以攻里。病人经常汗出，发作有定时。头痛，心下部痞塞坚硬胀满，牵引胁下呕吐且短气，这是表证已解而里气未和，由十枣汤主治。方剂：
芫花（炒） 甘遂 大戟（各等分）
以上三味药，捣成散剂，用水一升五合，先煮大枣十枚，取八合，去枣，体质强者纳入药末一钱匕，体弱者半钱匕，清晨温服，如果下得少或不利的，第二天早晨再服，增加半钱匕，得到快速通便后，吃稀粥自我调养。
太阳病，发汗后，于是发热恶寒，又攻下，导致心下部痞塞。这是表里俱虚，阴阳之气都衰竭，无阳则阴独存，如果再加用烧针，出现胸闷烦乱，面色青黄，皮肤干枯，这是难治之证，现在如果面色微黄，手足温暖，则会痊愈。
心下部痞塞，按压自己感觉柔软，关脉浮的，由大黄黄连泻心汤主治。方剂：
大黄（二两） 黄连（一两）
以上两味药，用麻沸汤二升浸泡片刻，去渣，分两次温服。（此方中必有黄芩。）
心下部痞塞而又恶寒、汗出的，由附子泻心汤主治。方剂：
附子一枚，炮制，另煮取汁 大黄（二两） 黄连 黄芩（各一两）
以上四味药，用麻沸汤二升浸泡片刻，去渣，加入附子汁，分两次温服。本因误用攻下法，所以心下部痞塞，给予泻心汤，其痞塞不解，病人口渴且口燥烦，小便不利的，由五苓散主治。另一说法，忍耐一天自愈（用
伤寒汗出，表解之后，胃中不和，心下部痞塞坚硬，干呕食臭，胁下有 water qi（水气），腹中雷鸣且腹泻，由生姜泻心汤主治。方剂：
生姜（四两，切片） 半夏（半升，洗净） 干姜（一两） 黄连（一两） 人参 黄芩 甘草（各三两，炙） 大枣（十二枚，掰开）
以上八味药，用水一斗，煮取六升，去渣，温服一升，每日三次。
伤寒中风，医生误用攻下法，病人腹泻每天几十次，完谷不化，腹中雷鸣，心下部痞塞坚硬且胀满，干呕且心烦，不能安卧，医生见心下部痞塞，认为病邪未尽，再次攻下，痞塞更加严重，这不是结热，只是胃中虚弱，客气上逆，所以导致坚硬，由甘草泻心汤主治。方剂：
甘草（四两，炙） 黄芩 干姜（各三两） 黄连（一两） 半夏（半升，洗净） 大枣（十二枚，掰开） 另一方有人参（三两。）
以上六味药，用水一斗，煮取六升，去渣，温服一升，每日三次。
伤寒，服用汤药后，腹泻不止，心下部痞塞坚硬。服用泻心汤后，又以其他药攻下，腹泻仍不止。医生给予理中汤治疗，腹泻反而更严重。理中汤治疗中焦，此腹泻在下焦，由赤石脂禹余粮汤主治。方剂：
赤石脂（一斤，捣碎） 太一禹余粮（一斤，捣碎）
以上两味药，用水六升，煮取二升，去渣，分三次温服，如果不止，应当利小便。
伤寒吐下发汗后，虚烦，脉象非常微弱，八九天后心下部痞塞坚硬，胁下痛，气上冲喉咽，眩晕昏冒，经脉跳动惕惧的，久则成为痿证。
伤寒发汗吐下后，表解，心下部痞塞坚硬，嗳气不除的，由旋复代赭汤主治。方剂：
旋复花（三两） 人参（二两） 生姜（五两，切片） 代赭（一两，捣碎） 甘草（三两，炙） 半夏（半升，洗净） 大枣（十二枚，掰开）
以上七味药，用水一斗，煮取六升，去渣，温服一升，每日三次。
太阳病，外证未除，却多次攻下，于是挟热腹泻不止，心下部痞塞坚硬，表里不解，由桂枝人参汤主治。方剂：
桂枝（四两，另切） 甘草（四两，炙） 白术 人参 干姜（各二两）
以上五味药，用水九升，先煮前四味，取五升，去渣，加入桂枝再煮取三升，去渣，温服一升，每日两次。
伤寒大攻下后，又发汗，心下部痞塞，恶寒的，是表证未解，不可攻痞，应当先解表，表解后再攻痞，适宜用大黄黄连泻心汤（用上方的方剂）。
病症类似桂枝汤证，但头项不强痛，脉微浮，胸中痞塞坚硬，气上冲喉咽不得呼吸，这是胸中有寒饮，应当用吐法，适宜用瓜蒂散。方剂：
瓜蒂（炒） 赤小豆（各一分）
以上两味药，捣成散剂，取半钱匕，香豉一合，汤七合浸泡，片刻去渣，将散剂纳入汤液中，一次顿服，如果不吐，稍加剂量，得到快速呕吐即止，所有失血及虚家，不可给予瓜蒂散。
Section 31: Sixteen Prescriptions
Q: In diseases, there are "Jie Xiong" (Chest Binding Syndrome) and "Zang Jie" (Organ Binding Syndrome). What are their manifestations? A: Pain upon palpation, with the pulse floating at the Cun position (inch) and sinking naturally at the Guan position (cubit), indicates Jie Xiong. What is Zang Jie? It is said: The symptoms resemble Jie Xiong, but eating and drinking remain normal; there is occasional diarrhea. The Yang pulse (Cun) is floating, while the Guan pulse is fine, sinking, and tight; this is named Zang Jie. If the tongue has a white, slippery coating, it is difficult to treat. Zang Jie presents without Yang syndrome signs, no alternating chills and fever, and the patient appears quiet. If the tongue coating is slippery, attack methods (purging) should not be used. When a disease originates from Yang and is mistakenly purged, heat enters and forms Jie Xiong; when it originates from Yin and is mistakenly sweated, Pi (Stagnation/Fullness) forms. Jie Xiong occurs because purging was done too early. In Jie Xiong, the neck may also be stiff, resembling Rou Ji (Soft Spasm). Purging will harmonize the condition; Da Xian Xiong Wan (Major Sinking Chest Pill) is indicated.
In Jie Xiong syndrome, if the pulse is floating and large, do not purge; purging leads to death.
If all symptoms of Jie Xiong are present and the patient is restless/fidgety (Fan Zao), it is a death sign.
In Tai Yang disease, the pulse is floating, moving, and rapid. Floating indicates Wind, Rapid indicates Heat, Moving indicates Pain, and Rapid also indicates Deficiency. Symptoms include headache, fever, slight night sweating, and aversion to cold, indicating the exterior is not resolved. If the physician mistakenly purges, the moving/rapid pulse becomes slow, headache turns into dizziness, the stomach becomes empty and deficient, pathogenic Qi disturbs the Diaphragm, causing shortness of breath, restlessness, and mental depression (Ao Nan). Yang Qi sinks inward, making the epigastrium hard, forming Jie Xiong. Da Xian Xiong Tang (Major Sinking Chest Decoction) is the primary treatment. If Jie Xiong does not form, but there is only sweating on the head, with no sweat elsewhere stopping at the neck, and urination is difficult, jaundice will likely develop.
After six or seven days of Shang Han (Cold Damage), if there is Jie Xiong with Heat and Excess, the pulse is sinking and tight, pain in the epigastrium, and hardness like stone upon palpation, Da Xian Xiong Tang is indicated. If it is pure Jie Xiong without significant heat, this is Water binding in the chest and hypochondrium, with slight sweating on the head; Da Xian Xiong Tang is indicated.
In Tai Yang disease, after heavy sweating followed by purging, leading to constipation for five or six days, dry tongue with thirst, and slight tidal fever in the late afternoon, with hardness, fullness, and pain from the epigastrium down to the lower abdomen that cannot be touched, Da Xian Xiong Tang is indicated. If the epigastrium is full, hard, and painful, this is Jie Xiong, treated with Da Xian Xiong Tang.
Da Xian Xiong Wan Prescription:
Da Huang (Rhubarb Root and Rhizome) 8 liang, Ting Li Zi (Descurainiae Semen/Lepidii Semen) roasted, Xing Ren (Prunus Armeniaca Seed) peeled and tipped, Mang Xiao (Natrii Sulfas) half sheng each.
The above four ingredients are mixed and pounded to obtain one pill size like a bullet. Add Gan Sui (Euphorbiae Lathyris Radix) powder, one qian bi, and Bai Mi (White Honey) 1 liang. Boil with 2 sheng of water to obtain 1 sheng. Take warm in one dose. Bowel movement usually occurs overnight.
Da Xian Xiong Tang Prescription:
Da Huang (Rhubarb Root and Rhizome) 6 liang, Gan Sui (Euphorbiae Lathyris Radix) powder, one qian bi, Mang Xiao (Natrii Sulfas) 1 sheng.
The above three ingredients are boiled in 6 sheng of water. First, boil Da Huang to obtain 2 sheng, remove dregs, add Mang Xiao, boil for one or two boils, then add Gan Sui powder. Divide into two doses. Stop subsequent doses once rapid bowel movement is achieved.
Xiao Jie Xiong (Minor Chest Binding) is located exactly at the epigastrium, painful upon pressure, with a floating and slippery pulse. Xiao Xian Xiong Tang (Minor Sinking Chest Decoction) is indicated.
Huang Lian (Coptidis Rhizoma) 1 liang, Ban Xia (Pinelliae Rhizoma) half sheng, washed, Gua Lou Shi (Trichosanthis Fructus) one large fruit.
The above three ingredients are boiled in 6 sheng of water. First, boil Gua Lou to obtain 3 sheng, remove dregs, add other medicines, boil to obtain 2 sheng, remove dregs, divide into three warm doses.
In Tai Yang disease, two or three days in, inability to lie down, only wanting to sit up, indicates binding in the epigastrium. If the pulse is weak, this is originally Cold. Mistaken purging leads to Jie Xiong if diarrhea stops; if diarrhea continues, and purging is repeated after four or five days, this is considered Li with夹 (mixed) Heat.
In simultaneous Tai Yang and Shao Yang disease, mistaken purging leads to Jie Xiong, hardness in the epigastrium, unceasing diarrhea, inability to swallow fluids, and severe irritability.
When the disease is in the Yang level, it should be resolved by sweating. Mistakenly using water washing or pouring causes heat to remain, increasing irritability, skin gooseflesh, desire to drink but no actual thirst. Wen Ge San (Clam Shell Powder) is indicated. Prescription:
Wen Ge (Arcae Shell) 5 liang.
Pound into powder. Mix with 5 he of boiling water. Take one fang cun bi. If not cured, use Wu Ling San (Five-Ingredient Powder with Poria).
Wu Ling San Prescription:
Zhu Ling (Polyporus) 18 zhu, peeled, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 18 zhu, Ze Xie (Alismatis Rhizoma) 1 liang 6 zhu, Fu Ling (Poria) 18 zhu, Gui Zhi (Cinnamomi Ramulus) half liang.
The above five ingredients are made into powders separately, then ground together in a mortar. Mix with rice water and take one fang cun bi, three times daily. Drink plenty of warm water until sweating occurs for cure.
Han Shi Jie Xiong (Cold-Excess Chest Binding) without heat signs is treated with San Wu Xiao Bai San (Three-Ingredient Small White Powder).
Jie Geng (Platycodonis Radix) 18 zhu, Ba Dou (Crotonis Fructus) 6 zhu, peeled and heart removed, roasted until dark red/black, ground to fat-like consistency, Bei Mu (Fritillariae Bulbus) 18 zhu.
The above three ingredients are pounded into powder, mixed with Ba Dou, and ground again. Mix with rice water. Strong adults take half qian bi; weak patients reduce the dose. Disease in the upper part induces vomiting; disease in the lower part induces diarrhea. If no diarrhea, give one cup of hot porridge. If diarrhea persists, give one cup of cold porridge (or cold water). If body heat and skin gooseflesh persist,
add Shao Yao (Paeoniae Radix Alba) 3 liang, following the above method.
Simultaneous Tai Yang and Shao Yang disease with headache, or dizziness/dizziness, resembling Jie Xiong, with epigastric stagnation and hardness, should be treated with acupuncture at Fei Shu (BL13), Gan Shu (BL18), and the first interspace of Da Zhui (GV14). Do not sweat. Sweating leads to delirium (Chan Yu). Delirium makes the pulse string-taut. If delirium persists for five days, puncture Qi Men (LR14).
Epigastric fullness without pain is Pi (Stagnation). Ban Xia Xie Xin Tang (Pinellia Decoction for Draining the Epigastrium) is indicated.
Ban Xia (Pinelliae Rhizoma) half sheng, washed, Huang Qin (Scutellariae Radix), Gan Jiang (Zingiberis Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma) roasted, each 3 liang, Huang Lian (Coptidis Rhizoma) 1 liang, Da Zao (Jujubae Fructus) 12 pieces, split.
The above seven ingredients are boiled in 1 dou of water to obtain 6 sheng. Remove dregs. Take 1 sheng warm, three times daily.
Floating and tight pulse, followed by purging, causes the tight pulse to enter the interior, forming Pi. Palpation feels soft; this is merely Qi Pi (Qi Stagnation).
Tai Yang Feng Zhong (Wind Strike) with vomiting and regurgitation. After the exterior is resolved, internal attack can proceed. Profuse sweating occurring at specific times, headache, epigastric stagnation and hardness, pulling pain to the hypochondrium with vomiting and shortness of breath. This indicates the exterior is resolved but the interior is not harmonized. Shi Zao Tang (Ten Jujube Decoction) is indicated. Prescription:
Yuan Hua (Genkwa Flos) roasted, Gan Sui (Euphorbiae Lathyris Radix), Da Ji (Euphorbiae Pekinensis Radix) equal parts.
The above three ingredients are pounded into powder. Boil 10 Da Zao in 1.5 sheng of water to obtain 8 he. Remove dates. Strong adults take one qian bi of powder; weak patients take half qian bi. Take warm at dawn. If bowel movement is insufficient or ineffective, take another half qian bi the next morning. Once rapid evacuation occurs, nourish oneself with millet porridge.
Tai Yang disease, after sweating, develops fever and aversion to cold. Subsequent purging leads to epigastric Pi. This indicates both exterior and interior deficiency, exhaustion of Yin and Yang Qi. Without Yang, Yin stands alone. Adding burning needle therapy causes chest irritability, greenish-yellow complexion, and dry skin; this is difficult to treat. If the complexion is slightly yellow and hands/feet are warm, recovery is expected.
Epigastric Pi, soft upon palpation, with floating pulse at the Guan position, is treated with Da Huang Huang Lian Xie Xin Tang (Rhubarb and Coptis Decoction for Draining the Epigastrium). Prescription:
Da Huang (Rhubarb Root and Rhizoma) 2 liang, Huang Lian (Coptidis Rhizoma) 1 liang.
Soak the above two ingredients in 2 sheng of Ma Fei Tang (boiling water) for a moment, remove dregs, divide into two warm doses. (This prescription must contain Huang Qin.)
Epigastric Pi accompanied by aversion to cold and sweating is treated with Fu Zi Xie Xin Tang (Aconite Decoction for Draining the Epigastrium). Prescription:
Fu Zi (Aconiti Lateralis Radix Praeparata) one piece, processed, decocted separately for juice. Da Huang (Rhubarb Root and Rhizoma) 2 liang, Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix) each 1 liang.
Soak the above four ingredients in 2 sheng of Ma Fei Tang for a moment, remove dregs, add Fu Zi juice, divide into two warm doses. Originally caused by purging, leading to epigastric Pi. Given Xie Xin Tang, but Pi did not resolve. Patient is thirsty, mouth dry, irritable, with difficult urination. Wu Ling San is indicated. Another view says enduring it for one day leads to cure.
After Shang Han sweating resolves, stomach disharmony remains, epigastric Pi and hardness, belching with food odor, water qi under the hypochondrium, borborygmus and diarrhea. Sheng Jiang Xie Xin Tang (Fresh Ginger Decoction for Draining the Epigastrium) is indicated. Prescription:
Sheng Jiang (Zingiberis Rhizoma Recens) 4 liang, sliced, Ban Xia (Pinelliae Rhizoma) half sheng, washed, Gan Jiang (Zingiberis Rhizoma) 1 liang, Huang Lian (Coptidis Rhizoma) 1 liang, Ren Shen (Ginseng Radix et Rhizoma), Huang Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) roasted, each 3 liang, Da Zao (Jujubae Fructus) 12 pieces, split.
The above eight ingredients are boiled in 1 dou of water to obtain 6 sheng. Remove dregs. Take 1 sheng warm, three times daily.
Shang Han Zhong Feng, mistakenly purged by the physician, leads to diarrhea dozens of times daily, undigested food, borborygmus, epigastric Pi, hardness, and fullness, dry retching, irritability, and inability to rest. Seeing epigastric Pi, the physician thinks pathogens remain and purges again, worsening the Pi. This is not accumulated heat, but stomach deficiency with rebellious pathogenic Qi causing hardness. Gan Cao Xie Xin Tang (Licorice Decoction for Draining the Epigastrium) is indicated. Prescription:
Gan Cao (Glycyrrhizae Radix et Rhizoma) roasted 4 liang, Huang Qin (Scutellariae Radix), Gan Jiang (Zingiberis Rhizoma) each 3 liang, Huang Lian (Coptidis Rhizoma) 1 liang, Ban Xia (Pinelliae Rhizoma) half sheng, washed, Da Zao (Jujubae Fructus) 12 pieces, split. Another version includes Ren Shen (Ginseng Radix et Rhizoma) 3 liang.
The above six ingredients are boiled in 1 dou of water to obtain 6 sheng. Remove dregs. Take 1 sheng warm, three times daily.
Shang Han, taking herbal medicine leads to unceasing diarrhea and epigastric Pi/hardness. Taking Xie Xin Tang and purging with other drugs still results in unceasing diarrhea. Physician gives Li Zhong Tang, but diarrhea worsens. Li Zhong Tang treats the Middle Jiao; this diarrhea is in the Lower Jiao. Chi Shi Zhi Yu Yi Liang Tang (Red Halloysite and Pyrite Decoction) is indicated. Prescription:
Chi Shi Zhi (Halloysitum Rubrum) 1 jin, crushed, Tai Yi Yu Yi Liang (Pyrites) 1 jin, crushed.
The above two ingredients are boiled in 6 sheng of water to obtain 2 sheng. Remove dregs, divide into three warm doses. If unceasing, promote urination.
Shang Han after sweating, vomiting, and purging, with empty irritability and very faint pulse. After eight or nine days, epigastric Pi/hardness, hypochondriac pain, Qi rushing to throat and pharynx, dizziness, and twitching of meridians. Long-term, this becomes Wei syndrome (flaccidity syndrome).
Shang Han after sweating, vomiting, and purging, post-resolution, with epigastric Pi/hardness and persistent belching. Xuan Fu Dai Zhe Tang (Inula and Hematite Decoction) is indicated. Prescription:
Xuan Fu Hua (Inulae Flos) 3 liang, Ren Shen (Ginseng Radix et Rhizoma) 2 liang, Sheng Jiang (Zingiberis Rhizoma Recens) 5 liang, sliced, Dai Zhe (Haematitum) 1 liang, crushed, Gan Cao (Glycyrrhizae Radix et Rhizoma) roasted 3 liang, Ban Xia (Pinelliae Rhizoma) half sheng, washed, Da Zao (Jujubae Fructus) 12 pieces, split.
The above seven ingredients are boiled in 1 dou of water to obtain 6 sheng. Remove dregs. Take 1 sheng warm, three times daily.
Tai Yang disease, exterior signs unresolved, but repeatedly purged, leading to unceasing diarrhea with mixed heat, epigastric Pi/hardness, unresolved exterior and interior. Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction) is indicated. Prescription:
Gui Zhi (Cinnamomi Ramulus) 4 liang, sliced separately, Gan Cao (Glycyrrhizae Radix et Rhizoma) roasted 4 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma) each 2 liang.
The above five ingredients are boiled in 9 sheng of water. First boil the first four to obtain 5 sheng, remove dregs, add Gui Zhi, boil to obtain 3 sheng, remove dregs. Take 1 sheng warm, twice daily.
After severe purging and subsequent sweating in Shang Han, epigastric Pi with aversion to cold indicates unresolved exterior. Do not attack the Pi; first resolve the exterior. After exterior resolution, attack the Pi. Da Huang Huang Lian Xie Xin Tang (use the formula above) is indicated.
Symptoms resemble Gui Zhi syndrome, but without head/neck stiffness/pain, pulse slightly floating, epigastric Pi/hardness, Qi rushing to throat preventing breathing. This is Cold Phlegm in the chest. Induce vomiting. Gua Di San (Melon Seed Powder) is indicated. Prescription:
Gua Di (Momordicae Fructus) roasted, Chi Xiao Dou (Vigna umbellata Seed) equal parts.
The above two ingredients are pounded into powder. Take half qian bi. Mix with 1 he of Chi Xiao Dou and 7 he of water soaked Dou Chi (Prepared Soybean). After a moment, remove dregs, mix powder into liquid, take in one dose. If no vomiting, increase dose slightly. Stop once rapid vomiting occurs. Do not give to patients with blood loss or deficiency.