治伤寒服汤药。下利不止。心下痞硬。服泻心汤已。复以他药下之。利不
与之。利益甚。理中者理中焦。此利在下焦。此方主之。复利不止者。当利其小便。
赤石脂（一斤） 太一禹余粮（一斤）
以上二味。以水六升。煮取二升。去滓。分三服。
歌曰 赤石余粮各一斤。下焦下利此汤欣。理中不应宜斯法。炉底填来得所闻。
张令韶曰。石性坠下。故以治下焦之利。非仅固涩也。下焦济泌别汁而渗入膀胱。故利
不止
成即下焦不和而亦能成痞也。
柯韵伯曰。甘、姜、参、术。可以补中宫元气之虚。而不足以固下焦脂膏之脱。此利在
下焦
皆土之精气所结。实胃而涩肠。急以治下焦之标者。实以培中宫之本也。要知此证土虚而火
不虚。故不宜于姜、附。若湿甚而虚不甚复利不止者。故又当利小便也。又曰。凡草木之药。
皆禀
治汗吐下解后。心下痞硬。噫气不除者。此方主之。
旋复花（三两） 代赭石（一两） 人参（二两） 甘草（三两 炙。） 半夏（半升）
生
上七味。以水一斗。煮取六升。去滓再煎。取三升。温服一升。日三服。（按。内台方
代赭石五两。半夏止用二两。）
歌曰 五两生姜夏半升。草旋三两噫堪凭。人参二两赭石一。枣十二枚力始胜。
俞麟州曰。此即生姜泻心汤之变法也。夫二条皆有心下痞硬句。而生姜泻心汤重在水气
下趋而作利。旋复代赭汤重在胃虚挟饮水气上逆而作噫。取治水气下趋而利者。必用生姜以
散水。胃虚挟饮而噫者。必用赭石以镇逆。二条对勘。益见仲景制方之妙。
罗东逸云。此方治正虚气不归元。而承领上下之圣方也。盖发汗吐下后。邪虽去而胃气
之亏损亦多。胃气既亏。三焦亦因之而失职。阳无所归而不升。阴无所纳而不降。是以浊邪
留滞。伏饮为逆。故心下痞硬噫气不除。方中以人参、甘草养正补虚。姜、枣和脾养胃。所
以定安中州者至矣。更以赭石得土气之甘而沉者。使之敛浮镇逆。领人参以归气于下。旋复
之辛而润者。用之开肺涤饮。佐半夏以蠲痰饮于上。苟非二物承领上下。则何能除噫气而消
心下之痞硬乎。观仲景治下焦水气上凌振振欲擗地者。用真武汤镇之。利在下焦大肠滑脱者。
用
元固下之法。各极其妙如此。
治疗伤寒服用汤药后，出现腹泻不止、胃脘部痞塞坚硬的症状。在服用泻心汤之后，又用其他药物攻下，导致腹泻不仅没有停止，反而更加严重。理中汤是调理中焦的方剂，而此处的腹泻病位在下焦，因此使用本方主治。如果服用本方后腹泻仍不止，应当采用利小便的方法治疗。
以上两味药，用水六升，煎煮至二升，滤去药渣，分三次服用。
歌诀曰：赤石脂与禹余粮各用一斤，此方专治下焦引起的腹泻令人欣喜。若理中汤无效则适宜使用此法，如同填补炉底般稳固根本，这是从前人那里听闻到的经验。
张令韶说：石头性质的药物具有沉降向下的特性，所以用来治疗下焦的腹泻，不仅仅是为了固涩止泻。下焦负责将清浊分离，使液体渗入膀胱，所以下焦功能不和也会导致痞塞症状。
柯韵伯说：甘草、干姜、人参、白术，可以补益中宫元气的虚弱，但不足以固摄下焦脂膏的滑脱。这种腹泻位于下焦，都是土的精气凝结而成，能够充实胃部并涩肠止泻，紧急治疗下焦的标症，实际上是在培补中宫的根基。要知道这个证候是脾土虚弱而心火不虚，所以不适合使用干姜、附子。如果湿气很重而虚损不严重，腹泻仍不止的，那么又应当通过利小便来治疗。又说：凡是草木类的药物，都禀受……
治疗发汗、催吐、泻下之后，出现胃脘部痞塞坚硬、嗳气持续不除的症状，使用本方主治。
旋复花（三两） 代赭石（一两） 人参（二两） 甘草（三两，炙） 半夏（半升，生用） 生姜（五两） 大枣（十二枚）
以上七味药，用水一斗，煎煮至六升，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。（按语：《内台方》中代赭石用五两，半夏仅用二两。）
歌诀曰：生姜五两、半夏半升，甘草和旋复花各三两，嗳气症状可凭此方消除。人参二两、代赭石一两，加上十二枚大枣，药效才能显著。
俞麟州说：这就是生姜泻心汤的变法。这两条条文都有“心下痞硬”的描述，但生姜泻心汤重点在于水气向下趋行而导致腹泻，旋复代赭汤重点在于胃气虚弱挟带饮邪上逆而导致嗳气。针对水气下趋引起腹泻的情况，必须用生姜来发散水气；针对胃虚挟饮导致嗳气的情况，必须用代赭石来镇降逆气。对比这两条条文，更能看出张仲景制方的精妙之处。
罗东逸说：此方是治疗正气虚弱、气不归元，从而统领上下气机的圣方。大概是因为发汗、催吐、泻下之后，虽然邪气已去，但胃气的亏损也很多。胃气既然亏虚，三焦也因此失职，阳气无所归依而不能上升，阴气无所容纳而不能下降，因此浊邪留滞，伏饮上逆，所以出现胃脘痞塞坚硬、嗳气持续不除。方中使用人参、甘草养护正气、补益虚弱，生姜、大枣调和脾胃、养胃气，以此来安定中焦的作用达到了极致。再加上代赭石得土气之甘且性质沉重，使其收敛浮阳、镇降逆气，引领人参之气归于下部；旋复花辛润，用于开宣肺气、涤除饮邪，佐助半夏在上部清除痰饮。如果不是这两味药承领上下气机，怎么能消除嗳气并消散胃脘部的痞塞坚硬呢？观察张仲景治疗下焦水气上凌、身体震颤欲倒地的情况，使用真武汤来镇压它；治疗腹泻位于下焦、大肠滑脱不禁的情况，使用赤石脂禹余粮汤固护下焦的根本，各种方法都极其精妙。
Treats cases where, after taking decoctions for Shanghan (Cold Damage), diarrhea persists unceasingly, accompanied by a sensation of fullness and hardness in the epigastrium. After having taken Xiexin Tang (Drain the Epigastrium Decoction), if other purgative medicines are administered again, the diarrhea does not cease but becomes more severe. Lizhong Tang (Regulate the Middle Decoction) regulates the Middle Jiao (Middle Burner); this diarrhea is located in the Lower Jiao (Lower Burner). This formula is indicated for it. If the diarrhea still does not stop after taking this formula, one should promote urination to treat it.
Chishizhi (Halloysitum Rubrum, Red Halloysite) [1 jin]
Taiyi Yuyuliang (Yuyuliang, Hematite) [1 jin]
Take the above two herbs, add six sheng of water, boil to obtain two sheng, remove the dregs, and divide into three doses.
Song says: Chishizhi and Yuyuliang each use one jin; this formula delights in treating Lower Jiao diarrhea. When Lizhong is ineffective, this method is suitable; filling the bottom of the stove, as heard from the ancients.
Zhanglingshao states: Stone minerals have a sinking nature, thus they are used to treat Lower Jiao diarrhea, not merely for astringency. The Lower Jiao separates clear from turbid fluids, allowing them to seep into the Bladder; therefore, disharmony in the Lower Jiao can also lead to a sensation of fullness.
Keyunbo states: Gancao (Licorice Root), Ganjiang (Dried Ginger), Renshen (Ginseng Root), and Baizhu (Atractylodes Rhizome) can tonify the deficiency of Yuanqi (Original Qi) in the Middle Palace (Spleen/Stomach), but they are insufficient to secure the slippage of the Lower Jiao's essence. This diarrhea is in the Lower Jiao, formed by the condensation of Earth's essence. It solidifies the Stomach and astringes the intestines. Urgently treating the branch symptom in the Lower Jiao is actually cultivating the root in the Middle Palace. One must know that in this syndrome, Earth is deficient while Fire is not excessive; thus, Ganjiang and Fuzi (Prepared Aconite Root) are unsuitable. If dampness is severe and deficiency is not significant, yet diarrhea persists, then promoting urination is indicated. He further states: All herbal medicines inherit...
Treats cases after sweating, vomiting, or purging, where there is a sensation of fullness and hardness in the epigastrium and belching that does not cease. This formula is indicated.
Xuanfuhua (Inulae Flos, Inula Flower) [3 liang]
Daizheshi (Hematitum, Hematite) [1 liang]
Renshen (Ginseng Root) [2 liang]
Gancao (Licorice Root) [3 liang, honey-fried]
Banxia (Pinelliae Rhizoma, Pinellia Tuber) [0.5 sheng, raw]
Shengjiang (Zingiberis Rhizoma Recens, Fresh Ginger) [5 liang]
Dazao (Jujubae Fructus, Jujube Fruit) [12 pieces]
Take the above seven herbs, add ten dou of water, boil to obtain six sheng, remove the dregs, and decoct again to obtain three sheng. Take one sheng warm, three times daily. (Note: In Neitai Fang, Daizheshi is used in 5 liang, and Banxia is used only in 2 liang.)
Song says: Five liang of Shengjiang and half a sheng of Banxia; with three liang each of Gancao and Xuanfuhua, belching can be relied upon to cease. Two liang of Renshen and one liang of Daizheshi; twelve pieces of Dazao make the efficacy complete.
Yulinzhou states: This is a variation of Shengjiang Xiexin Tang (Fresh Ginger Drain the Epigastrium Decoction). Both clauses mention "fullness and hardness in the epigastrium," but Shengjiang Xiexin Tang focuses on Water-Qi flowing downward causing diarrhea, whereas Xuafu Daizhe Tang focuses on Stomach Deficiency carrying Phlegm-Fluid upward causing belching. To treat Water-Qi flowing downward causing diarrhea, one must use Shengjiang to disperse Water. For Stomach Deficiency carrying Phlegm-Fluid causing belching, one must use Daizheshi to suppress rebellion. Comparing these two clauses reveals the subtlety of Zhang Zhongjing's formula construction.
Luodongyi says: This formula is a sacred prescription for treating Zhengxu (Righteous Qi Deficiency) where Qi does not return to its origin, thereby governing the ascending and descending of Qi. Generally, after sweating, vomiting, or purging, although the pathogenic factor is gone, the Stomach Qi is significantly damaged. Since Stomach Qi is deficient, the Sanjiao (Triple Burner) also fails in its duties. Yang has no place to reside and cannot ascend; Yin has no place to receive and cannot descend. Thus, turbid pathogens remain stagnant, and latent Phlegm-Fluid rebels upward, resulting in epigastric fullness/hardness and persistent belching. In the formula, Renshen and Gancao nourish righteousness and tonify deficiency; Shengjiang and Dazao harmonize the Spleen and nourish the Stomach, thereby stabilizing the Middle Jiao to the utmost degree. Furthermore, Daizheshi, inheriting the sweetness of Earth and being heavy in nature, gathers floating Yang and suppresses rebellion, leading Renshen's Qi to descend. Xuanfuhua, being pungent and moistening, opens the Lungs and clears Phlegm-Fluid, assisting Banxia in eliminating Phlegm-Fluid above. Without these two herbs to coordinate the upper and lower, how could belching be eliminated and epigastric fullness resolved? Observing Zhang Zhongjing's treatment of Lower Jiao Water-Qi flooding upward causing tremors and a desire to fall, he uses Zhenwu Tang (True Warrior Decoction) to suppress it; for diarrhea in the Lower Jiao due to Large Intestine slippage, he uses Chishizhi Yuyuliang Tang to secure the Lower Jiao. Each method is exquisitely effective.