一切留饮不散，五苓散（二十四）、桂苓甘露饮（三十四）、黄连解毒汤（二十一）、凉膈散（
二十三）、白虎汤（二十二）、小陷胸汤（十八）、三一承气汤（十三）选用。伤寒表未罢，心下有水
气，干呕、发热而咳，或呕，或利，或噎，或小便不利，小腹满，或喘者，小青龙汤（七）。
伤寒表里俱热，下证未全，法当和解。误下之早，则成痞。心下痞满而不痛，按之虚软者痞。
脉浮而尚恶寒者，表未解也，当先桂枝（二）解表已，而后用大黄黄连泻心汤（三十三）攻痞也；或
只用五苓散（二十四）使除表里甚良。或痞恶寒而汗出者；或痞而烦小便不利者；或痞留饮湿热下
利者；或已成痞，因其痞满
误更下之，其痞转甚，呕哕下利，心烦躁者，无问脉浮、沉，并宜生姜煎汤调下五苓散（二十四）频服之。
或痞不已，则后亦湿热烦满，或谵妄，脉沉无他证者，宜大黄黄连泻心汤（三十三）；或小陷胸汤（十八）
亦可。下早成痞槟榔散（四十一）。
结胸之证有三∶不按而痛者名大结胸；按之而痛者名小结胸；心下怔忡，头汗出者名水结胸也。
汗下之后，不大便五、六日，舌干而渴，日脯少有潮热，从心下至小腹硬满而痛不可近，而脉沉紧滑数，或
但关脉沉紧者，宜大陷胸汤（十六），或陷胸丸（十七）下之。或脉浮者，表未罢也，不可下，下之则死，
宜小陷胸汤（十八）及小柴胡汤（九）之类和解之；表罢者方可下之。或结胸虽脉浮而里热势恶，须可下者，
宜三一承气汤（十三），分作三次，约三时许服讫，得利甚良，虽未稍减，脉必沉；病微者，只用三一承
气半服，按法而下之；里热甚者，以大陷胸汤（十六）大半服而下之；或但结胸，别无大段热证，但头微汗
出，脉沉潜者，水结胸也，通宜大陷胸丸（十七）。小结胸，心下按之而痛，脉浮而滑，别无大段
热证；及水结胸者，小陷胸汤（十八）。伤寒下之太早，结胸，黄连解毒汤（二十
一）加枳壳。伤寒结胸，虚痞，凉膈散（二十三）加枳壳、桔梗。或但自热结胸者，其胸高起，腹虽不满而
但喘急、闷结、谵妄、昏冒，关脉沉数而紧者，用大承气汤（七）加甘遂一钱匕下之。表证罢，热入里，结于
胸中，烦满而饥不能食，微厥而脉乍紧者，瓜蒂散吐之（二十六）。太阳中风，下利、呕逆、表证罢、干呕短
气、不恶寒、 汗出发作有时、头痛、心下痞硬满、引胁下痛者，十枣汤（三十一）。结胸而发黄者，茵陈
汤（三十二）、陷胸汤（十六）各半服下之。协热下利不止，更结胸发黄，茵陈汤五分、陷胸汤三分、大
承气汤二分下之为佳。脉浮不可下者，小陷胸汤合小柴胡汤（九）。
所有留饮（水液停聚不散）无法消散的情况，可选用五苓散、桂苓甘露饮、黄连解毒汤、凉膈散、白虎汤、小陷胸汤、三一承气汤。若伤寒表证未解，心下有水气，出现干呕、发热且咳嗽，或呕吐，或腹泻，或噎塞感，或小便不利、小腹胀满，或气喘者，选用小青龙汤。
伤寒表里俱热，但下法适应证尚未完全具备，治法应当和解。如果过早使用下法，就会形成痞证（指心下痞塞胀满的病证）。心下痞塞胀满但不疼痛，按压时感觉虚软的称为痞。脉象浮且仍然恶寒的，说明表证未解，应当先用桂枝汤解表，待表证解除后，再用大黄黄连泻心汤攻逐痞结；或者仅用五苓散来消除表里之邪，效果也很好。如果是痞证伴有恶寒且汗出的；或者是痞证伴有心烦、小便不利的；或者是痞证兼有留饮、湿热导致的腹泻的；或者是已经形成痞证，因为痞满误用下法，导致痞证加重，出现呕吐呃逆、腹泻、心中烦躁的，无论脉象是浮还是沉，都适宜用生姜煎汤调服五苓散，频繁服用。如果痞证不止，随后出现湿热烦闷，或者谵语妄言，脉沉且无其他症状的，适宜用大黄黄连泻心汤；或者小陷胸汤也可以。因下法过早而成痞证的，可用槟榔散。
结胸证有三种：不按就痛的叫大结胸；按压才痛的叫小结胸；心下悸动不安，头部出汗的叫水结胸。经过发汗和攻下治疗后，五六天不大便，舌干口渴，下午略有潮热，从心下直到小腹硬满且疼痛拒按，脉象沉紧滑数，或者只是关脉沉紧的，适宜用大陷胸汤，或者陷胸丸攻下。如果脉浮的，说明表证未解，不可攻下，攻下会导致死亡，适宜用小陷胸汤及小柴胡汤之类和解；待表证解除后才可攻下。如果结胸虽然脉浮但里热势态严重，必须攻下的，适宜用三一承气汤，分三次服用，大约三个时辰内服完，得利则效果很好，即使症状没有稍减，脉象必然变沉；病情轻微的，只用三一承气汤的一半剂量，按法攻下；里热严重的，用大陷胸汤的大半剂量攻下；或者只是结胸，没有特别严重的热证，只是头部微汗出，脉象沉潜的，是水结胸，普遍适宜用大陷胸丸。小结胸，心下按压才痛，脉象浮而滑，没有特别严重的热证；以及水结胸的，用小陷胸汤。伤寒攻下太早导致结胸的，用黄连解毒汤加枳壳。伤寒结胸兼有虚痞的，用凉膈散加枳壳、桔梗。或者只是自热导致的结胸，胸部高起，腹部虽不满但气喘急促、闷结、谵语妄言、昏蒙冒昧，关脉沉数而紧的，用大承气汤加甘遂一钱匕攻下。表证解除，热邪入里，结于胸中，烦闷且饥饿但不能进食，四肢微冷且脉象乍紧的，用瓜蒂散催吐。太阳中风证，出现腹泻、呕吐逆气，表证解除，干呕短气，不恶寒，汗出发作有时，头痛，心下痞塞硬满，牵引胁下疼痛的，用十枣汤。结胸兼发黄病的，茵陈汤和大陷胸汤各半剂量合用攻下。协热下利不止，再次结胸并发黄，用茵陈汤五分、陷胸汤三分、大承气汤二分合用攻下为佳。脉浮不可攻下的，用小陷胸汤合小柴胡汤。
For all cases of retained fluid (accumulation and stagnation of body fluids) that do not dissipate, Wuling San (Five-Ingredient Poria Decoction), Guiling Ganlu Yin (Cassia Twig and Poria Sweet Dew Drink), Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity), Liangge San (Cooling the Diaphragm Powder), Baihu Tang (White Tiger Decoction), Xiao Xianxiong Tang (Minor Inverted Chest Powder), or Sanyi Chengqi Tang (Three-One Receiving Qi Decoction) may be selected. If the exterior syndrome of Shanghan (Cold Damage) has not yet resolved, and there is water qi in the epigastrium, presenting with dry retching, fever, and cough, or vomiting, or diarrhea, or a sensation of choking, or difficulty in urination with fullness in the lower abdomen, or wheezing, Xiaolongtan Tang (Minor Dragon Decoction) should be used.
When both the exterior and interior syndromes of Shanghan present with heat, but the indications for purgation are not fully established, the treatment method should be harmonization. If purgation is applied too early, Pi syndrome (a syndrome characterized by epigastric stuffiness and fullness) will result. Epigastric stuffiness and fullness without pain, feeling soft upon palpation, is defined as Pi. If the pulse is floating and aversion to cold persists, the exterior has not resolved; one should first use Guizhi Tang (Cinnamon Twig Decoction) to resolve the exterior, and subsequently use Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Heart-Draining Decoction) to attack the Pi; alternatively, using only Wuling San to eliminate both exterior and interior pathogenic factors is also excellent. For cases where Pi is accompanied by aversion to cold and sweating; or Pi accompanied by vexation and difficulty in urination; or Pi complicated by retained fluid, damp-heat, and diarrhea; or when Pi has already formed, and due to mistaken purgation for fullness, the Pi worsens, presenting with vomiting, hiccups, diarrhea, and mental restlessness, regardless of whether the pulse is floating or deep, it is appropriate to administer Wuling San frequently, mixed with ginger decoction. If the Pi does not subside, subsequently presenting with damp-heat vexation and fullness, or delirium, with a deep pulse and no other symptoms, Dahuang Huanglian Xiexin Tang is suitable; or Xiao Xianxiong Tang may also be used. For Pi caused by premature purgation, Banglang San (Areca Seed Powder) is indicated.
There are three types of Jie Xiong (Knotting in the Chest) syndrome: pain without palpation is called Da Jie Xiong (Major Knotting in the Chest); pain upon palpation is called Xiao Jie Xiong (Minor Knotting in the Chest); palpitations in the epigastrium with sweating on the head is called Shui Jie Xiong (Water Knotting in the Chest). After sweating and purging, if there is no bowel movement for five or six days, with a dry tongue and thirst, slight tidal fever in the late afternoon, hardness and fullness from the epigastrium down to the lower abdomen with pain that cannot tolerate pressure, and a pulse that is deep, tight, slippery, and rapid, or only the Guan position pulse is deep and tight, Da Xianxiong Tang (Major Inverted Chest Decoction) or Xianxiong Wan (Inverted Chest Pill) should be used to purge. If the pulse is floating, the exterior has not resolved, and purgation is contraindicated; purging will lead to death. Instead, Xiao Xianxiong Tang and Xiao Chaihu Tang (Minor Bupleurum Decoction) or similar formulas should be used for harmonization; purgation can only be performed after the exterior resolves. If Jie Xiong presents with a floating pulse but severe interior heat requiring purgation, Sanyi Chengqi Tang should be used, divided into three doses, taken within approximately three shi (two-hour periods); obtaining stool yields good results. Even if symptoms do not slightly decrease, the pulse must become deep. For mild conditions, half the dose of Sanyi Chengqi Tang is used for purgation according to the method; for severe interior heat, Da Xianxiong Tang is used at a large half-dose for purgation. If there is merely Jie Xiong without significant heat signs, but only slight sweating on the head and a deep, hidden pulse, it is Water Jie Xiong, and Da Xianxiong Wan is generally suitable. For Xiao Jie Xiong, pain upon palpation of the epigastrium, with a floating and slippery pulse, and no significant heat signs; as well as for Water Jie Xiong, Xiao Xianxiong Tang is used. For Jie Xiong resulting from overly early purgation in Shanghan, Huanglian Jiedu Tang added with Zhike (Aurantii Fructus) is indicated. For Shanghan Jie Xiong complicated by deficiency Pi, Liangge San added with Zhike and Jiegeng (Platycodon Root) is used. For self-heating Jie Xiong, where the chest protrudes, the abdomen is not full but there is rapid breathing, stifling oppression, delirium, and confusion, with a deep, rapid, and tight Guan pulse, Dachengqi Tang (Major Receiving Qi Decoction) added with Gansui (Kansui Root) at a dose of one qian bi (approx. 3-5 grams) is used for purgation. When the exterior syndrome resolves and heat enters the interior, knotting in the chest, causing vexation, fullness, hunger but inability to eat, slight cold extremities, and an intermittent tight pulse, Gouti San (Melon Truss Powder) is used to induce vomiting. For Taiyang Wind Strike syndrome, presenting with diarrhea, vomiting and reverse qi, resolved exterior syndrome, dry retching, shortness of breath, absence of aversion to cold, paroxysmal sweating, headache, epigastric stuffiness and hardness with fullness, and pain radiating to the hypochondrium, Shizao Tang (Ten Jujube Decoction) is used. For Jie Xiong complicated by jaundice, Yincheng Tang (Artemisia Capillaris Decoction) and Xianxiong Tang are each used at half doses for purgation. For協热下利 (diarrhea with accompanying heat) that does not stop, recurring Jie Xiong and jaundice, a combination of Yincheng Tang (five parts), Xianxiong Tang (three parts), and Dachengqi Tang (two parts) for purgation is optimal. For cases with a floating pulse where purgation is contraindicated, Xiao Xianxiong Tang combined with Xiao Chaihu Tang is used.