治伤寒汗出解之后。胃中不和。心下痞硬。干噫食臭。胁下有水气。腹中雷鸣
此汤主之。
生姜（四两） 甘草（三两） 人参（三两） 干姜（一两） 黄芩（三两） 半夏（半
升
上八味。以水一斗。煮取六升。去滓再煎。取三升。温服一升。日三服。
歌曰 汗余痞证四生姜。（太阳寒水之邪伤于肌肤之表者从汗而解。入于躯壳之里者不
从汗
次男元犀按。太阳为寒水之经。寒水之气伤于外者。可从汗而解之。寒水之气入于里者。
不
心法统共之证。陈平伯云。君生姜之辛温善散者宣泄水气。复以干姜、参、草之甘温守中者
培养中州。然后以芩、连之苦寒者涤热泄痞。名曰生姜泻心。赖以泻心下之痞。而兼擅补中
散水之长也。倘无水气。必不用半夏、生姜之辛散。不涉中虚。亦无取干姜、参、草之补中。
要知仲景泻心汤有五。然除大黄黄连泻心汤正治之外。皆随证加减之方也。
治伤寒中风医反下之。其人下利日数十行。谷不化。腹中雷鸣。心下痞硬而满
烦不得安。医见心下痞。谓病不尽。复下之。其痞益甚。此非结热。但以胃中虚。客气上逆。
故使硬也。此方主之。
甘草（四两） 黄芩（三两） 干姜（三两） 半夏（半升） 黄连（一两） 大枣（十
二
上六味。以水一斗。煮取六升。去滓再煎。取三升。温服一升。日三服。
歌曰 下余痞作腹雷鸣。甘四姜芩三两平。一两黄连半升夏。枣枚十二擘同烹。
陈平伯曰。心下痞。本非可下之实热。但以妄下胃虚。客热内陷。上逆心下耳。是以胃
气愈
甘草者。下利不止。完谷不化。此非禀九士之精者不能和胃而缓中。方名甘草泻心。见泄热
之品得补中之力而其用始神也。此伊芳尹汤液所制。治狐惑蚀于上部则声嗄者。方中有人参三
两。
治疗伤寒经过发汗后表证已解，但胃中不和，心下部位痞塞胀硬，干呕伴有食物腐败的气味，胁下有停饮的水气，肠鸣音亢进如雷声。
此方主治上述症状。
生姜（四两） 甘草（三两） 人参（三两） 干姜（一两） 黄芩（三两） 半夏（半升）
以上八味药，用水一斗，煎煮至剩余六升，滤去药渣，再次煎煮，取三升药液。每次温服一升，每日服用三次。
歌诀曰：汗后遗留的痞证用生姜泻心汤。（太阳经寒水之邪侵袭肌肤体表者，可通过发汗解除；侵入躯壳内部者，不通过发汗解除。）
其次男元犀按语：太阳经属于寒水之经。寒水之气从外部侵袭者，可以通过发汗来解除；寒水之气侵入内部者，不从汗解。
这是心法统括的证候。陈平伯说：重用生姜的辛温发散特性以宣散水气，再用干姜、人参、甘草的甘温守中之性来培补中焦脾胃。然后用黄芩、黄连的苦寒性质来清除热邪、消除痞满。名为生姜泻心汤，依靠它来消除心下的痞满，同时具备补益中焦和消散水气的长处。如果没有水气，必定不用半夏、生姜的辛散之品；如果不涉及中气虚弱，也不需要干姜、人参、甘草的补中之功。要知道张仲景的泻心汤共有五种，除了大黄黄连泻心汤是正治之法外，其余都是随证加减的方剂。
治疗伤寒或中风，医生误用攻下法，导致患者腹泻每天数十次，完谷不化，肠鸣音如雷，心下痞塞胀硬且满闷，心烦不安。医生见心下痞，认为病邪未尽，再次使用攻下法，结果痞满更加严重。这并非实热结聚，而是因为胃中虚损，客气上逆，所以导致痞硬。此方主治上述症状。
甘草（四两） 黄芩（三两） 干姜（三两） 半夏（半升） 黄连（一两） 大枣（十二枚）
以上六味药，用水一斗，煎煮至剩余六升，滤去药渣，再次煎煮，取三升药液。每次温服一升，每日服用三次。
歌诀曰：误下后形成的痞证伴腹中雷鸣，甘草四两、干姜黄芩各三两持平。黄连一两、半夏半升，大枣十二枚掰开同煮。
陈平伯说：心下痞本不是可攻下的实热证，只是因为误下导致胃气虚弱，客热内陷，上逆于心下所致。因此胃气更加虚弱。
甘草能够止住不止的下利，治疗完谷不化，这不是禀受九土精气者不能调和胃气而缓急和中。方名甘草泻心汤，说明清热泄热的药物得到补益中焦的力量，其疗效才神奇。这是伊芳尹《汤液》所制的方子，治疗狐惑病蚀于上部导致声音嘶哑的情况，方中有人参三两。
Treats the condition after Taiyang disease (Taiyang Disease) has been resolved by sweating, where there is disharmony in the Stomach (Stomach), epigastric fullness and hardness (Epigastric Fullness and Hardness), dry belching with a smell of food rotting, fluid retention under the hypochondrium (Fluid Retention under Hypochondrium), and borborygmus (Borborygmus).
This decoction is the primary treatment.
Shengjiang (Raw Ginger, four liang) Gancao (Licorice Root, three liang) Renshen (Ginseng Root, three liang) Ganjiang (Dried Ginger, one liang) Huangqin (Scutellaria Root, three liang) Banxia (Pinellia Tuber, half sheng)
The above eight ingredients are boiled in ten dou of water until six sheng remain. The dregs are removed, and the liquid is boiled again until three sheng remain. Take one sheng warm, three times daily.
Song says: For post-sweat epigastric fullness, use Shengjiang Xie Xin Tang (Ginger Decoction to Drain the Epigastrium). (Pathogenic Cold-Water from the Taiyang Channel affecting the exterior skin and muscles can be resolved through sweating; if it enters the interior of the body shell, it is not resolved through sweating.)
Commentary by Yuanxi, the second son: The Taiyang Channel belongs to Cold-Water. When Cold-Water Qi invades from the outside, it can be resolved through sweating; when it enters the interior, it is not resolved through sweating.
This is a comprehensive syndrome covered by the core methods. Chen Pingbo stated: Using the pungent-warm nature of Raw Ginger to disperse fluid retention, combined with the sweet-warm nature of Dried Ginger, Ginseng, and Licorice to nourish the Middle Jiao (Middle Burner). Then, using the bitter-cold nature of Scutellaria and Coptis to clear heat and drain epigastric fullness. Named Shengjiang Xie Xin Tang, it relies on draining the epigastric fullness while possessing the strength to tonify the middle and disperse water. If there were no fluid retention, the pungent-dispersing herbs like Pinellia and Raw Ginger would not be used. If there were no deficiency of the Middle Qi (Middle Qi Deficiency), the middle-tonifying herbs like Dried Ginger, Ginseng, and Licorice would not be needed. It must be known that Zhang Zhongjing's Xie Xin Decoctions total five types. Apart from Da Huang Huang Lian Xie Xin Tang (Rhubarb and Coptis Decoction to Drain the Epigastrium) which treats the standard pattern, all others are modified formulas based on specific syndromes.
Treats Taiyang disease or Wind Strike where the physician incorrectly applied purgation, resulting in diarrhea dozens of times a day, undigested food in stool, borborygmus, severe epigastric fullness and hardness with distension, irritability, and inability to rest. Seeing the epigastric fullness, the physician assumed the pathogen was not fully eliminated and applied purgation again, causing the fullness to worsen. This is not due to accumulated heat, but rather stomach deficiency with rebellious pathogenic Qi ascending, causing the hardness. This decoction is the primary treatment.
Gancao (Licorice Root, four liang) Huangqin (Scutellaria Root, three liang) Ganjiang (Dried Ginger, three liang) Banxia (Pinellia Tuber, half sheng) Huanglian (Coptis Rhizome, one liang) Dazao (Jujube Fruit, twelve pieces)
The above six ingredients are boiled in ten dou of water until six sheng remain. The dregs are removed, and the liquid is boiled again until three sheng remain. Take one sheng warm, three times daily.
Song says: Post-purgation fullness with abdominal borborygmus, Gancao four liang, Ganjiang and Huangqin three liang each balanced. Huanglian one liang, Banxia half sheng, twelve Dazao pieces torn open and cooked together.
Chen Pingbo said: Epigastric fullness is originally not a solid-heat pattern suitable for purgation. It arises because incorrect purgation caused stomach deficiency, allowing pathogenic heat to sink inward and rebel upward to the epigastrium. Thus, the Stomach Qi becomes even more deficient.
Gancao stops persistent diarrhea and treats undigested food in stool. Only those endowed with the essence of the Nine Earths can harmonize the Stomach and moderate the Middle. The formula is named Gancao Xie Xin Tang, indicating that heat-draining agents achieve their miraculous effect when empowered by middle-tonifying strength. This is derived from Yi Fangyin's *Tangye* (Decoctions), treating Hu Huo Disease (Fox-Biting Disease) where erosion occurs in the upper part causing hoarseness. In that variation, Renshen (Ginseng Root) is three liang.