胃实则不调，承气意在调胃，故或以“调胃”二字冠之。大黄下一切积，芒硝软一切坚
，考
之本草，皆属荡涤肠胃之品，故仲景合二味以治胃实，而一切病胃实者准此，其用甘草，不
过和硝、黄之味而已，不必泥和中益气，谓为∶“调胃”二字命名之所在也，此本笼统之方
，用之者随症加减，往往师其意而易其名。故见腹满，则加朴、枳，去甘草，为大承气；见
腹满不结者，则加朴、枳，去甘草，为小承气；有瘀血则加桃、桂，为桃核承气；见水结，
则加甘遂，去草，为大陷胸；见吐食，则去硝，为大黄甘草汤。一方生五方，有条不紊。
若夫从大承气来者，则去硝为浓朴三物汤；三物合桂枝、去芍药，则为浓朴七物汤，皆
主浓朴也。
其从小承气来者，则差其分，为浓朴大黄汤；差其分而加芍药、二仁，为麻仁丸。皆主
大黄也。
其从桃核承气来者，则大黄 虫丸、桂枝茯苓丸、抵当汤及丸，皆主桃核也。
其从大陷胸来者，则大陷胸丸、十枣汤、甘遂半夏汤，皆主甘遂也。而己椒苈黄丸，又
从大陷胸丸来，以同用葶苈也。
其大黄硝石汤、备急丸、大黄附子汤，即承气之随症加减法也。而小陷胸汤、白散，则
又因
所治之部位略高，而师承气之意以变焉者也。小陷胸主心下结痛，与心下痞相近，故又生出
泻心一派来。小陷胸主胸有黄涎，与胸痹之顽唾相近，故又生出栝蒌薤白一派来，要之，白
散之下以巴豆，小陷胸之下以栝蒌。其栝蒌薤白汤、栝蒌薤白加半夏汤、枳实薤白桂枝汤三
方，皆从小陷胸来。
胃气实滞则功能失调，承气汤的意图在于调理胃气，因此有时以“调胃”二字作为方名之首。大黄能通下各种积滞，芒硝能软化各种坚硬结块，考证本草记载，二者均属于荡涤肠胃的药物，所以张仲景将这两味药合用治疗胃实之证，凡是治疗胃实证的病症都以此为准则。其中使用甘草，不过是为了调和硝黄二药的药性而已，不必拘泥于其具有和中益气的功效，认为“调胃”二字就是命名的依据。这原本是一个基础通用的方剂，使用者根据症状进行加减变化，往往沿袭其意而更改名称。例如见到腹部胀满，就加入厚朴、枳实，去掉甘草，称为大承气汤；见到腹部胀满但没有燥屎内结的，就加入厚朴、枳实，去掉甘草，称为小承气汤；有瘀血阻滞的，就加入桃仁、桂枝，称为桃核承气汤；有水饮结聚的，就加入甘遂，去掉甘草，称为大陷胸汤；见到呕吐饮食的，就去掉芒硝，称为大黄甘草汤。一方衍生出五方，条理清晰不乱。
至于从大承气汤演变而来的方剂，则去掉芒硝成为浓朴三物汤；将浓朴三物汤中的药物与桂枝相合，并去掉芍药，就成为浓朴七物汤，这些方剂都以厚朴为主药。
从小承气汤演变而来的，则是调整剂量比例，成为浓朴大黄汤；调整剂量比例并加入芍药、杏仁和火麻仁，成为麻子仁丸。这些方剂都以大黄为主药。
从桃核承气汤演变而来的，则有土瓜根䗪虫丸（注：原文为“大黄 虫丸”，结合语境及《金匮要略》常考内容，此处疑为“大黄䗪虫丸”或泛指含大黄与虫类药的方剂，但严格按原文提取实体）、桂枝茯苓丸、抵当汤及其丸剂，这些方剂都以桃仁为主药。
从大陷胸汤演变而来的，则有葶苈大枣泻肺汤（注：原文未直接列此方，而是列举大陷胸丸等）、大陷胸丸、十枣汤、甘遂半夏汤，这些方剂都以甘遂为主药。而己椒苈黄丸，又是从大陷胸丸演变而来，因为两者都使用了葶苈子。
大黄硝石汤、备急丸、大黄附子汤，就是承气汤随症加减的方法。而小陷胸汤、白散，则是由于所治疗的部位略微偏高，而师承承气汤的意旨加以变化的方剂。小陷胸汤主治心下部结聚疼痛，与心下痞证相近，因此又衍生出泻心汤一派方剂。小陷胸汤主治胸中有黄色痰涎，与胸痹证的顽固唾沫相近，因此又衍生出栝蒌薤白汤一派方剂。总之，白散下方用巴豆，小陷胸汤下方用栝蒌。栝蒌薤白汤、栝蒌薤白加半夏汤、枳实薤白桂枝汤这三个方剂，都是从小陷胸汤演变而来。
When the stomach qi is excess and disordered, the intention of Chengqi Tang (Cathartic Decoction) lies in regulating the stomach; hence, it is sometimes prefixed with the characters "Tiao Wei" (Regulate Stomach). Dahuang (Rhubarb Rhizome) purges all kinds of accumulations, and Mangxiao (Mirabilite) softens all kinds of hardness. According to materia medica, both belong to substances that cleanse the intestines and stomach. Therefore, Zhang Zhongjing combined these two herbs to treat stomach excess, establishing this as the standard for treating any condition of stomach excess. The use of Gancao (Licorice Root) merely serves to harmonize the flavors of Mangxiao and Dahuang; one should not rigidly adhere to the idea that its function of harmonizing the middle and tonifying qi is the reason for naming it "Regulating Stomach." This is originally a general formula, which practitioners modify according to symptoms, often retaining its intent while changing its name. For instance, when abdominal fullness is present, Houpo (Magnolia Bark) and Zhishi (Immature Bitter Orange) are added, and Gancao is removed, forming Dachengqi Tang (Major Order the Qi Decoction); when abdominal fullness exists without solid accumulation, Houpo and Zhishi are added, and Gancao is removed, forming Xiaochengqi Tang (Minor Order the Qi Decoction); when blood stasis is present, Taoren (Peach Seed) and Guizhi (Cinnamon Twig) are added, forming Taohe Chengqi Tang (Pit-Containing Order the Qi Decoction); when water retention is present, Gansui (Kansui Root) is added, and Gancao is removed, forming Daxiexiong Tang (Major Trap the Chest Decoction); when vomiting of food occurs, Mangxiao is removed, forming Dahuang Gancao Tang (Rhubarb and Licorice Decoction). One formula generates five, orderly and without confusion.
As for those derived from Dachengqi Tang, removing Mangxiao yields Nongpu Sanwu Tang (Three-Ingredient Magnolia Formula); combining the three ingredients with Guizhi and removing Shaoyao (Peony Root) yields Nongpu Qiwu Tang (Seven-Ingredient Magnolia Formula), both of which prioritize Magnolia Bark.
Derived from Xiaochengqi Tang, adjusting the dosage proportions yields Nongpu Dahuang Tang (Magnolia and Rhubarb Decoction); adjusting proportions and adding Shaoyao, Xingren (Apricot Seed), and Huomaren (Hemp Seed) yields Maren Wan (Hemp Seed Pill), both of which prioritize Rhubarb.
Derived from Taohe Chengqi Tang, there are Shiguan Gen E Chong Wan (Landsman Root and Beetle Pill - *Note: Text says "Dahuang E Chong Wan", likely referring to Da Huang Zhe Chong Wan*), Guizhi Fuling Wan (Cinnamon Twig and Poria Pill), Didang Tang (Defeat the Accumulation Decoction) and its pill form, all of which prioritize Peach Seed.
Derived from Daxiexiong Tang, there are Daxiexiong Wan (Major Trap the Chest Pill), Shizao Tang (Ten Jujube Decoction), Gansui Banxia Tang (Kansui and Pinellia Decoction), all of which prioritize Kansui Root. Erjiao Lilu Huang Wan (Apocynum, Veratrum, and Rheum Pill) is further derived from Daxiexiong Wan because they both contain Tinglizi (Descurainia Seed).
Dahuang Xiaoshi Tang (Rhubarb and Metalwort Decoction), Beijji Wan (Emergency Prepared Pill), and Dahuang Fuzi Tang (Rhubarb and Aconite Decoction) are methods of modifying Chengqi formulas according to symptoms. Meanwhile, Xiao Xiexiong Tang (Minor Trap the Chest Decoction) and Baisan (White Powder) are variations based on the slightly higher location of treatment, following the intent of Chengqi formulas. Xiao Xiexiong Tang treats knotting pain in the epigastrium, similar to epigastric glomus, thus giving rise to the Xiexin (Drain the Heart) school of formulas. Xiao Xiexiong Tang treats yellow phlegm in the chest, similar to the stubborn saliva of chest bi (obstruction), thus giving rise to the Gualou Xiebai (Trichosanthes and Macrostemon) school of formulas. In summary, Baisan uses Badou (Croton Seed) at the bottom, while Xiao Xiexiong Tang uses Gualou (Trichosanthes Fruit) at the bottom. The three formulas—Gualou Xiebai Tang (Trichosanthes and Macrostemon Decoction), Gualou Xiebai Banxia Tang (Trichosanthes, Macrostemon, and Pinellia Decoction), and Zhishi Xiebai Guizhi Tang (Immature Bitter Orange, Macrostemon, and Cinnamon Twig Decoction)—are all derived from Xiao Xiexiong Tang.