治伤寒大下后复发汗。心下痞。按之濡。其脉关上浮紧者。此方主之。若
未解也。宜先解表。然后攻痞。
大黄（二两） 黄连（一两）
上二味。以麻沸汤二升渍之。须臾绞去滓。分温再服。
歌曰 痞证分歧辨向趋。关浮心痞按之濡。大黄二两黄连一。麻沸汤调病缓驱。
蔚按。心下痞按之濡而不硬。是内陷之邪与无形之气搏聚而不散也。脉浮在关以上。其
势甚高。是君火亢于上不能下交于阴也。此感上焦君火之化而为热痞也。方用大黄、黄连大
苦大寒以降之。火降而水自升。亦所以转否为泰法也。最妙在不用煮而用渍。仅得其无形之
气。不重其有形之味。使气味俱薄。能降而即能升。所谓圣而不可知之谓神也。
治心下痞而复恶寒汗出者。此汤主之。
大黄（二两） 黄芩（一两） 黄连（一两） 附子（一枚 炮去皮。破。别煮取汁。）
上四味。切三味。以麻沸汤二升渍之。须臾绞去滓。内附子汁。分温再服。（愚按。麻沸汤
渍者。微取气不取其味也。）
歌曰 一枚附子泻心汤。一两连芩二大黄。汗出恶寒心下痞。专煎轻渍要参详。
蔚按。心下痞。是感少阴君火之本热也。复恶寒者。复呈太阳寒水之本寒也。汗出者。
太阳本寒甚而标阳大虚而欲外撒也。治伤寒以阳气为主。此际岂敢轻用苦寒。然其痞不解。
不得不取大黄、黄连、黄芩之大苦大寒。以解少阴之本热。又恐亡阳在即。急取附子之大温。
以温太阳之标阳。并行不悖。分建奇功如此。最妙在附子专煮扶阳。欲其熟而性重。三黄荡
积开痞。欲其生而性轻也。
治疗伤寒经过剧烈泻下后，又再次发汗。出现心下部痞塞胀满的症状，按压时感觉柔软不硬。脉象在关部呈现浮紧之象的，此方主治。如果表证尚未解除，应当先解表证，然后再攻逐痞证。
以上两味药，用滚开的沸水二升浸泡它们。片刻之后，绞去药渣。分两次温服。
歌诀曰：痞证的辨析需分清趋向，关脉浮、心下痞且按之柔软。大黄二两、黄连一两，用麻沸汤调服，病邪缓缓驱除。
蔚按（陈念祖自注）：心下痞，按压时柔软而不坚硬，这是内陷的病邪与无形之气搏结聚集而不能消散。脉象浮在关部以上，其势很高，这是君火（心火）亢盛于上，不能下行交于阴分。这是感受了上焦君火的化气而形成的热痞证。方中用大黄、黄连，大苦大寒以降泄之。火气下降，水气自然上升，这也是转“否”为“泰”的方法。最妙之处在于不用煎煮而用浸泡，只取其无形之气，不取重浊的有形之味，使药气味都轻薄，既能降又能升。这就是所谓“圣妙不可知谓之神”的境界。
大黄（二两） 黄芩（一两） 黄连（一两） 附子（一枚，炮制去皮，破开，另煮取汁液。）
以上四味药，将大黄、黄芩、黄连三味切碎，用麻沸汤二升浸泡它们。片刻之后，绞去药渣，加入附子的汁液。分两次温服。（我按：用麻沸汤浸泡，是微取其气而不取其味。）
歌诀曰：一枚附子组成的泻心汤，黄连黄芩各一两，大黄二两。若有汗出、恶寒、心下痞的症状，专门煎煮与轻渍的方法需要仔细参详。
蔚按（陈念祖自注）：心下痞，是感受了少阴君火的本热。又出现恶寒，是同时呈现了太阳寒水的本寒。出汗，是因为太阳本寒严重而标阳（卫阳）大虚，想要外脱散失。治疗伤寒以阳气为主，此时岂敢轻易使用苦寒药物。然而痞证不解，不得不取大黄、黄连、黄芩的大苦大寒，来解除少阴的本热。又担心亡阳就在眼前，急忙取附子的大温，来温补太阳的标阳。两者并行不悖，分别建立奇功。最妙之处在于附子专门煎煮以扶助阳气，希望它煮熟而药性厚重；三黄（大黄、黄连、黄芩）荡涤积滞、开通痞塞，希望它生泡而药性轻清。
Treats Taiyang disease (Taiyang disease) after severe purgation followed by repeated sweating. There is a sensation of fullness and obstruction in the epigastrium (heart below), which feels soft upon palpation. The pulse is floating and tight at the Guan position (middle position on the radial artery). This formula is indicated. If the exterior syndrome has not resolved, one should first resolve the exterior, then attack the fullness.
Dahuang (Rhei Radix et Rhizoma) (2 liang) Huanglian (Coptidis Rhizoma) (1 liang)
Take the above two herbs. Soak them in 2 sheng of boiling water (Ma Fei Tang). After a short while, strain out the dregs. Divide into two doses and take warm.
Song verse: Differentiate the directions of Pi syndrome (fullness and obstruction). Floating pulse at Guan, epigastric fullness, soft upon pressure. Two liang of Dahuang, one liang of Huanglian. Mix with Ma Fei Tang to slowly drive away the disease.
Wei An (Chen Nianzu's commentary): Epigastric fullness that is soft and not hard upon pressure indicates that the pathogen that has sunk inward is clashing with formless Qi and gathering without dispersing. The pulse floating above the Guan position, with its force rising high, indicates that Minister Fire (Heart Fire) is hyperactive in the upper jiao and cannot descend to interact with Yin. This is Heat Pi syndrome caused by sensing the transformational Qi of the Minister Fire in the Upper Jiao. The formula uses Dahuang and Huanglian, which are greatly bitter and cold, to descend it. When Fire descends, Water naturally ascends; this is also the method of turning "Pi" (stagnation/blocked) into "Tai" (peace/prosperity). The most wonderful aspect is using soaking instead of decoction, extracting only the formless Qi, not the heavy tangible flavor, making both aroma and flavor light, enabling descent and immediate ascent. This is what is meant by "The sage-like and unknowable is called divine."
Treats epigastric fullness accompanied by aversion to cold and sweating. This decoction is indicated.
Dahuang (Rhei Radix et Rhizoma) (2 liang) Huangqin (Scutellariae Radix) (1 liang) Huanglian (Coptidis Rhizoma) (1 liang) Fuzi (Aconiti Lateralis Radix Praeparata) (1 piece, processed, skin removed, broken, boiled separately to extract juice.)
Cut the three herbs (Dahuang, Huangqin, Huanglian). Soak them in 2 sheng of Ma Fei Tang. After a short while, strain out the dregs. Add the Fuzi juice. Divide into two doses and take warm. (I note: Soaking with Ma Fei Tang extracts slight Qi but not flavor.)
Song verse: One piece of Fuzi in Xie Xin Tang (Drain the Epigastrium Decoction). One liang each of Lian (Huanglian) and Qin (Huangqin), two Dahuang. For sweating, aversion to cold, and epigastric fullness, carefully consider the distinction between separate decoction and light soaking.
Wei An (Chen Nianzu's commentary): Epigastric fullness is due to sensing the intrinsic heat of Shaoyin Minister Fire. The accompanying aversion to cold presents the intrinsic cold of Taiyang Water. Sweating occurs because the intrinsic cold of Taiyang is severe, while the marked Yang (Wei Yang/Defensive Yang) is greatly deficient and attempting to escape outward. In treating Taiyang disease, Yang Qi is primary; how can one lightly use bitter-cold substances at this time? However, since the fullness does not resolve, one must use the greatly bitter-cold Dahuang, Huanglian, and Huangqin to resolve the intrinsic heat of Shaoyin. Fearing imminent collapse of Yang, one urgently uses the greatly warming Fuzi to warm the marked Yang of Taiyang. They proceed together without conflict, achieving remarkable results separately. The most wonderful aspect is that Fuzi is specifically decocted to support Yang, desiring it to be cooked and heavy in nature; the Three Yellows (San Huang) clear accumulation and open fullness, desiring them to be raw-soaked and light in nature.