邪气传里。必先自胸而胁。以次经心腹而入胃也。是以胸满多带表症。胁满多带半表半里。故胸中窒。
栀子豉汤。以吐虚烦。胸中痞硬。气上冲咽喉。不得息者。瓜蒂散。以吐实痰。作表症治。若胸满痛及胁。
为少阳症。小柴胡汤。（参准绳）按金鉴云。脉浮。惟胸满而不及胁者。仍属太阳表分也。宜麻黄汤。
因胸及胁而皆满者。属少阳经。宜小柴胡汤。若十余日不解。胸胁满而兼干呕潮热者。是少阳兼阳明也。宜大柴
胡加芒硝两解之。若表已解。心下及腹。引胁满硬而痛。干呕。小便不利者。是停饮内实也。宜十枣汤攻之。
邵评∶胸胁满痛。有表里病因之不同。当分经辨症施治。惟伏暑湿温胁痛。寒热
如疟。不可误作柴胡证。以香附、旋复花、苏子、广皮、半夏、茯苓、米仁。治腹满。加川
朴。痛甚。加降香。久不解。间用控涎丹。（甘遂、大戟、白芥子为末。神曲糊丸。）
邪在半表半里。多呕。故呕属少阳。然六经皆有呕症。各照本经治之。
邵评∶呕属少阳。以木火上升犯胃。胃逆不降而呕也。然六经皆有呕症。故分别治之。
按金鉴云。表邪入里。里气拒格。上逆作呕。属少阳。宜小柴胡汤主之。若表邪不解
而呕。属太阳。宜柴桂汤。若食谷欲呕。属阳明中寒。宜吴茱萸汤。呕吐涎沫。属厥阴。
亦宜吴茱萸汤。呕吐蛔。乌梅丸。呕而饮。饮而呕。相因不已。是停水也。宜五苓散。
邵评∶呕有多因。宜分经辨症为治。临症时切须细审。
邪气传入体内，必然先从胸部传至胁部，再依次经过心腹进入胃中。因此，胸满多伴有表证，胁满多伴有半表半里证。所以，对于胸中窒塞感，用栀子豉汤（Zhi Zi Chi Tang, Gardenia and Fermented Soybean Decoction）来涌吐虚烦；对于胸中痞塞坚硬、气上冲咽喉、呼吸不畅者，用瓜蒂散（Gua Di San, Melon Seed Powder）来涌吐实痰，按表证治疗。如果胸满痛波及胁部，则为少阳病（Shaoyang Disease），用小柴胡汤（Xiao Chai Hu Tang, Minor Bupleurum Decoction）。参考《医宗金鉴》：脉浮，仅见胸满而未涉及胁部的，仍属于太阳经（Taiyang Meridian）表分，宜用麻黄汤（Ma Huang Tang, Ephedra Decoction）。因胸部及胁部皆满的，属于少阳经，宜用小柴胡汤。若十余日病情未解，胸胁满且兼有干呕、潮热者，是少阳病兼阳明病（Yangming Disease），宜用大柴胡加芒硝汤（Da Chai Hu Jia Mang Xiao Tang, Major Bupleurum with Mirabilite Decoction）两解之。若表证已解，心下及腹部牵引胁部满硬而痛，伴有干呕、小便不利者，是水饮内停、里实之证，宜用十枣汤（Shi Zao Tang, Ten Dates Decoction）攻逐水饮。
邵评注：胸胁满痛，有表里病因的不同，应当分经辨证施治。只有伏暑湿温引起的胁痛，寒热往来如疟疾状，不可误作柴胡证治疗。可用香附、旋复花、苏子、广皮、半夏、茯苓、薏苡仁治疗腹满，加厚朴。疼痛剧烈者，加降香。久不缓解者，间歇使用控涎丹（Kong Xian Dan, Phlegm-Expelling Pill，由甘遂、大戟、白芥子研末，神曲糊丸制成）。
邪气在半表半里之间，多出现呕吐症状，故呕吐归属于少阳。然而六经皆有呕吐症状，应分别按照本经进行治疗。
邵评注：呕吐归属于少阳，是因为肝胆木火之气上升侵犯胃腑，导致胃气上逆不降而呕吐。然而六经皆有呕吐症状，故需分别治疗。参考《医宗金鉴》：表邪入里，里气抗拒格拒，气机上逆作呕，属于少阳，宜用小柴胡汤主治。若表邪未解而呕吐，属于太阳病，宜用柴桂汤（Chai Gui Tang, Bupleurum and Cinnamon Twig Decoction）。若进食后欲呕吐，属于阳明中寒，宜用吴茱萸汤（Wu Zhu Yu Tang, Evodia Decoction）。呕吐涎沫，属于厥阴病（Jueyin Disease），也宜用吴茱萸汤。呕吐蛔虫，用乌梅丸（Wu Mei Wan, Mume Pill）。呕吐伴饮水，饮水后复呕吐，相互因果不止，这是停水之证，宜用五苓散（Wu Ling San, Five-Ingredient Powder with Poria）。
Pathogenic factors transmitting into the interior must first move from the chest to the hypochondrium, then successively through the heart and abdomen to enter the stomach. Therefore, fullness in the chest (chest fullness) is often accompanied by exterior syndrome (exterior pattern), while fullness in the hypochondrium (hypochondriac fullness) is often accompanied by half-exterior half-interior syndrome (half-exterior half-interior pattern). Thus, for a sensation of obstruction in the chest, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is used to induce vomiting for empty irritability; for epigastric stuffiness and hardness with qi rushing up to the throat causing difficulty in breathing, Gua Di San (Melon Seed Powder) is used to induce vomiting for solid phlegm, treated as an exterior syndrome. If chest fullness and pain extend to the hypochondrium, it constitutes Shaoyang Disease (Lesser Yang disease), treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction). Referencing *Yi Zong Jin Jian*: A floating pulse with only chest fullness not extending to the hypochondrium still belongs to the exterior aspect of the Taiyang Meridian (Greater Yang channel), suitable for Ma Huang Tang (Ephedra Decoction). When both the chest and hypochondrium are full, it belongs to the Shaoyang Meridian (Lesser Yang channel), suitable for Xiao Chai Hu Tang. If after more than ten days the condition remains unresolved, with chest and hypochondriac fullness accompanied by dry retching and tidal fever, this is Shaoyang disease combined with Yangming Disease (Yangming disease), suitable for Da Chai Hu Jia Mang Xiao Tang (Major Bupleurum with Mirabilite Decoction) to resolve both aspects. If the exterior syndrome has resolved, but there is pulling fullness, hardness, and pain in the epigastrium and abdomen extending to the hypochondrium, accompanied by dry retching and dysuria, this is internal retention of fluid with excess, suitable for Shi Zao Tang (Ten Dates Decoction) to attack and purge the water retention.
Commentary by Shao: Chest and hypochondriac fullness and pain have different etiologies of exterior and interior; one must differentiate by channel and syndrome for treatment. Only in cases of latent summerheat-dampness causing hypochondriac pain, with alternating chills and fever resembling malaria, should it not be mistaken for a Chai Hu syndrome. One may use Xiang Fu (Cyperi Rhizoma), Xuan Fu Hua (Inulae Flos), Su Zi (Perillae Fructus), Guang Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Yi Yi Ren (Coicis Semen) to treat abdominal fullness, adding Hou Po (Magnoliae Officinalis Cortex). For severe pain, add Jiang Xiang (Dalbergiae Odoriferae Lignum). For prolonged unresolved conditions, intermittently use Kong Xian Dan (Phlegm-Expelling Pill, made from Gan Sui (Kansui Radix), Da Ji (Euphorbiae Pekinensis Radix), Bai Jie Zi (Sinapis Semen) powdered and pillified with Shen Qu (Medicated Leaven)).
Pathogenic factors in the half-exterior half-interior stage often present with vomiting; thus, vomiting is attributed to Shaoyang. However, all six meridians can present with vomiting symptoms, each to be treated according to its respective meridian.
Commentary by Shao: Vomiting is attributed to Shaoyang because Liver-Gallbladder Wood-Fire ascending invades the Stomach, causing Stomach Qi to rebel and fail to descend, resulting in vomiting. However, since all six meridians can present with vomiting, they must be treated separately. Referencing *Yi Zong Jin Jian*: Exterior pathogenic factors entering the interior cause interior Qi to resist and reject, leading to upward rebellion and vomiting, which belongs to Shaoyang, suitably treated primarily with Xiao Chai Hu Tang. If vomiting occurs while exterior pathogenic factors remain unresolved, it belongs to Taiyang disease, suitably treated with Chai Gui Tang (Bupleurum and Cinnamon Twig Decoction). If vomiting follows eating, it belongs to Middle Cold of Yangming, suitably treated with Wu Zhu Yu Tang (Evodia Decoction). Vomiting of saliva and foam belongs to Jueyin Disease (Taiyin disease), also suitably treated with Wu Zhu Yu Tang. Vomiting of roundworms is treated with Wu Mei Wan (Mume Pill). Vomiting accompanied by drinking, where drinking leads to further vomiting in a continuous cycle, indicates retained water, suitably treated with Wu Ling San (Five-Ingredient Powder with Poria).
Commentary by Shao: Vomiting has multiple causes; one should differentiate by channel and syndrome for treatment. In clinical practice, careful examination is essential.