疫邪留于心胸，令人痞满，下之痞应去，今反痞者，虚也。以其人或因他病先亏
，或因新产后气血两虚，或禀赋娇怯，因下益虚，失其健运，邪气留止，故令痞满。今愈下
而痞愈甚，若更用行气破气之剂，转成坏证，宜参附养营汤。
参附养营汤
当归（一钱） 白芍（一钱） 生地（三钱） 人参（一钱） 附子（炮,七分） 干姜（炒，一钱）
照常煎服。果如前证，一服痞如失，倘有下证，下后脉实，痞未除者，再下之。此有虚实
之分，一者有下证，下后痞即减者为实；一者表虽微热，脉不甚数，口不渴，下后痞反甚者
为虚。若潮热口渴，脉数而痞者，投之祸不旋踵。
疫邪留于心胸，胃口热甚，皆令呕不止，下之呕当去，今反呕者，此属胃气虚寒
，少进粥饮，便欲吞酸者，宜半夏藿香汤，一服呕立止，谷食渐加。
半夏藿香汤
半夏（一钱五分） 真藿香（一钱） 干姜（炒，一钱） 白茯苓（一钱） 广陈皮（一钱） 白术（炒，一钱） 甘
草（五分）
水姜煎服。有前后一证首尾两变者，有患时疫，心下胀满，口渴发热而呕，此应下之证也。
下之诸证减去六七，呕亦减半，再下之胀除热退渴止，向则数日不眠，今则少寐，呕独转甚
，此疫毒去而诸证除，胃续寒而呕甚，与半夏藿香汤一剂，而呕即止。
疫邪滞留于心胸部位，导致患者出现痞满症状。使用下法后，痞满应当消除，如今反而痞满依旧，这是因为正气虚弱。因为患者或许因其他疾病先前已亏损，或因新产之后气血两虚，或先天禀赋娇弱怯懦，经过攻下治疗后更加虚弱，失去了脾胃的健运功能，致使邪气停留阻滞，所以导致痞满。此时如果继续攻下，痞满会更加严重；若再使用行气、破气的药物，反而会转变为坏证（病情恶化），适宜使用参附养营汤。
参附养营汤
当归（一钱） 白芍（一钱） 生地（三钱） 人参（一钱） 附子（炮制，七分） 干姜（炒，一钱）
按照常规方法煎煮服用。果然如前述证候，服用一次后痞满消失；倘若仍有可下的证候，下法之后脉象实大，但痞满未除者，可再次使用下法。这里存在虚实之分：一种是有可下之证，下法之后痞满即减轻的，属于实证；一种是虽然体表有轻微发热，脉象不特别急促，口不渴，下法之后痞满反而加重的，属于虚证。如果出现潮热、口渴，脉数且伴有痞满的情况，投用此方灾祸立至（后果严重）。
疫邪滞留于心胸，胃中热势极盛，都会导致呕吐不止。使用下法后，呕吐应当停止，如今反而呕吐，这是属于胃气虚寒的表现，稍微喝一点粥水饮料，就想吞酸水的，适宜使用半夏藿香汤，服用一次后呕吐立即停止，饮食逐渐增加。
半夏藿香汤
半夏（一钱五分） 真藿香（一钱） 干姜（炒，一钱） 白茯苓（一钱） 广陈皮（一钱） 白术（炒，一钱） 甘草（五分）
用水和生姜一起煎煮服用。有一种情况是前后证候相同，但治疗首尾发生两次变化：有人患时疫，心下部胀满，口渴发热且呕吐，这应该是使用下法的证候。使用下法后，各种证候减去六七成，呕吐也减半，再次使用下法后，胀满消除、热退、口渴停止，之前连续几天不眠，现在则睡眠减少，唯独呕吐反而加重，这是疫毒已去而各种证候消除，但胃中续发寒邪导致呕吐加重，给予半夏藿香汤一剂，呕吐随即停止。
The epidemic pathogen remains in the heart and chest, causing a sensation of fullness and obstruction (Pi Man). After purgation, this fullness should resolve; if it persists, it indicates deficiency. This may be because the patient was previously depleted by other illnesses, or suffers from both Qi and Blood deficiency following recent childbirth, or has a delicate constitution. Purgation further depletes them, impairing the Spleen and Stomach's transportive function, allowing pathogenic factors to stagnate, thus causing fullness. If one continues to purge, the fullness will worsen; using Qi-moving or Qi-breaking formulas would lead to a deteriorated condition (Huai Zheng). The appropriate treatment is Shen Fu Yang Ying Tang.
Shen Fu Yang Ying Tang (Ginseng and Aconite Nourishing Camp Decoction)
Dang Gui (Angelicae Sinensis Radix, 1 qian), Bai Shao (Paeoniae Radix Alba, 1 qian), Sheng Di Huang (Rehmanniae Radix, 3 qian), Ren Shen (Ginseng Radix, 1 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, processed, 7 fen), Gan Jiang (Zingiberis Rhizoma, stir-fried, 1 qian).
Decoct and take as usual. If the symptoms match those described above, one dose will eliminate the fullness. However, if there are still indications for purgation, and after purgation the pulse is excess/full but the fullness remains, another purgative measure may be taken. There is a distinction between excess and deficiency here: one type involves indications for purgation where fullness decreases after purgation, indicating an Excess pattern; the other type presents with slight surface heat, a pulse that is not rapid, no thirst, and worsening fullness after purgation, indicating a Deficiency pattern. If tidal fever, thirst, rapid pulse, and fullness are present, administering this formula will bring immediate disaster.
When epidemic pathogens remain in the heart and chest, or when there is excessive heat in the Stomach, continuous vomiting occurs. After purgation, vomiting should cease; if it persists, it belongs to Stomach Qi deficiency and cold. If the patient desires to swallow acid even after consuming a small amount of porridge or drink, Ban Xia Huo Xiang Tang is indicated. One dose will stop the vomiting immediately, and food intake will gradually increase.
Ban Xia Huo Xiang Tang (Pinellia and Agastache Decoction)
Ban Xia (Pinelliae Rhizoma, 1.5 qian), Zhen Huo Xiang (Agastaches Herba, genuine, 1 qian), Gan Jiang (Zingiberis Rhizoma, stir-fried, 1 qian), Bai Fu Ling (Poria, 1 qian), Guang Chen Pi (Citri Reticulatae Pericarpium, 1 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 qian).
Decoct with water and fresh ginger.
There are cases where the initial and final presentations differ despite similar underlying conditions. For instance, a patient suffering from seasonal epidemics presents with epigastric distension, thirst, fever, and vomiting. This is an indication for purgation. After the first purgation, most symptoms decrease by six or seven tenths, and vomiting halves. After a second purgation, distension resolves, fever subsides, and thirst stops. Previously, the patient had insomnia for several days; now sleep is reduced, but vomiting intensifies. This indicates that the epidemic toxin has been expelled and other symptoms resolved, but Cold has arisen in the Stomach, causing severe vomiting. Administering one dose of Ban Xia Huo Xiang Tang will stop the vomiting immediately.