（附加减诸汤）
治阳明病脉浮而紧，咽燥，口苦，腹满而喘，发热，汗出，不恶寒，反恶热，身重烦躁，
心
栀子（十四枚） 香豉（四合，绵裹）
上二味，以水四升，先煮栀子得二升半，纳豉，煮取一升半，去渣，分二服温进。一服
得吐
安者
干姜
柯韵伯曰∶太阳以心腹为里，阳明以心腹为表。盖阳明之里是胃实，不特发热、恶寒、
目疼
卧、
制
明
暮
吐
表
色
这
心
之
加生姜以散邪。若下后而心腹满，起卧不安，是热已入胃，便不当吐，故去香豉。屎未燥硬
，不宜复下，故只用栀子以除烦，佐枳、朴以泄满，此两解心腹之妙，又小承气之轻剂也。
若以丸药下之，心微烦而不懊恼，是知寒气留中，而上焦留热，故任栀子以除烦，倍干姜以
逐内寒，而表热自解，此又寒热并用，为和中解表之剂矣。内外热炽，肌肉发黄，必须苦甘
之剂以调之，柏皮、甘草色黄而润，助栀子以除内烦而解外热，形色之病，仍假形色以通之
，此皆用栀豉于加减，以御阳明表证之变幻也。夫栀子之性，能屈曲下行，不是上涌之剂，
惟豉之腐气，上蒸心肺，能令人吐耳！观瓜蒂散必用豉汁和服，是吐在豉而不在栀也。（此
义
豉
陈
（栀子豉汤的加减应用方）
治疗阳明病，脉象浮而紧，咽喉干燥，口苦，腹部胀满且气喘，发热，出汗，不恶寒，反而怕热，身体沉重，心中烦乱躁扰。
以上两味药，用水四升，先煮栀子，取汁二升半，加入香豉，继续煮取一升半，滤去药渣，分两次温服。服用一次后，若出现呕吐现象，则停止服药；若症状缓解安和，则继续按法服用。
柯韵伯说：太阳经以心腹为里，阳明经以心腹为表。所谓阳明之里是指胃中实热，不仅表现为发热、恶寒、眼睛疼痛、睡眠不安等症状。
如果在攻下之后出现心腹部胀满，坐卧不安，这是热邪已经入胃，此时不应当使用催吐法，所以去掉香豉。如果大便尚未燥结坚硬，也不宜再次攻下，所以只用栀子来清除烦热，佐以枳实、厚朴来泄除胀满，这是同时解决心与腹部问题的妙法，也是小承气汤的轻剂版本。
如果是用丸药攻下导致的，心中轻微烦闷而没有懊恼感，这说明寒气留滞于中焦，而上焦留有热邪，所以任用栀子来清除烦热，加倍干姜用量以驱逐内部寒邪，而体表的熱邪自然解除，这又是寒热并用的方法，属于调和中焦、解除表邪的方剂。
如果内外热势炽盛，肌肉发黄，必须使用苦甘性质的方剂来调理，黄柏、甘草颜色黄且滋润，辅助栀子来清除内部烦热并解除外部热邪，针对颜色和形态的疾病，仍然借助具有相应颜色和形态的药物来疏通它，这些都是通过加减栀子豉汤，来应对阳明经表证变化的方法。
栀子的药性，能够曲折下行，并不是向上涌吐的药剂，只有豆豉的腐熟之气，向上蒸腾心肺，才能使人呕吐！观察瓜蒂散必须用豆豉汁调和服用，可知引起呕吐的是豆豉而不是栀子。（这一层含义……豆豉……陈……）
(Decoction for Modification of Zhizi Chi Tang)
Treats Yangming disease characterized by a floating and tight pulse, dryness of the throat, bitter taste in the mouth, abdominal fullness with panting, fever, sweating, aversion to cold absent but aversion to heat present, heaviness of the body, and irritability/restlessness.
Zhizi (Gardeniae Fructus, 14 pieces) Xiangchi (Fermented Soybean, 4 he, wrapped in silk gauze)
Take the above two ingredients, add four sheng of water, first decoct Zhizi until half remains (2.5 sheng), then add Xiangchi, and continue decocting until one and a half sheng remains. Strain off the dregs, divide into two doses, and take warm. After taking one dose, if vomiting occurs, stop; if the patient feels at ease, proceed as directed.
Ke Yunbo stated: In Taiyang disease, the heart and abdomen are considered the interior; in Yangming disease, the heart and abdomen are considered the exterior. The "interior" of Yangming refers to gastric excess, manifesting not only with fever, aversion to cold, eye pain, and restlessness during sleep.
If after purgation there is abdominal fullness and restlessness in sitting or lying down, it indicates that heat has entered the stomach; in this case, emesis is inappropriate, so Xiangchi is removed. If the stool is not yet dry and hard, further purgation is not suitable, so only Zhizi is used to relieve vexation, assisted by Zhishi (Immature Bitter Orange) and Houpo (Magnolia Bark) to drain fullness. This is a subtle method to resolve both cardiac and abdominal issues, serving as a mild formula of Xiaochengqi Tang.
If purgation was performed using pill preparations, resulting in slight mental vexation without profound regret/irritability (ao nao), it indicates that cold pathogen remains in the middle jiao while heat lingers in the upper jiao. Therefore, Zhizi is employed to clear vexation, and Ganjiang (Dried Ginger) is doubled to expel internal cold, allowing the exterior heat to resolve spontaneously. This represents the concurrent use of cold and hot properties, forming a formula that harmonizes the middle and releases the exterior.
When internal and external heat are blazing, causing yellowing of the muscles/skin, a bitter-sweet formula must be used to regulate. Baipi (Phellodendri Cortex) and Gancao (Licorice Root) are yellow and moistening; they assist Zhizi in clearing internal vexation and resolving external heat. For diseases manifesting in color and form, one still utilizes agents with corresponding colors and forms to facilitate communication/resolution. These are all modifications of Zhizi Chi Tang to manage the variations of Yangming exterior syndromes.
The nature of Zhizi allows it to descend curvingly; it is not an emetic agent. It is only the fermented odor of Xiangchi that steams upward to the heart and lungs, capable of inducing vomiting! Observing that Gouti San (Melon Seed Powder) must be taken mixed with Xiangchi juice, it is evident that the emetic effect lies in Xiangchi, not Zhizi. (This meaning... Xiangchi... Chen...)