寒实结胸，无热证者，与三白小陷胸汤，为散亦可服。
太阳表热未除，而反下之，热邪与寒水相结，成热实结胸。太阴腹满时痛，而反下之，寒邪与寒药相结，成
寒实结胸。无热证者，不四肢烦疼者也。名曰三白者，三物皆白，别于黄连小陷胸也。旧本误作三物，以黄连、
栝蒌投之，阴盛则亡矣。又误作白散，是二方矣。黄连、巴豆，寒热天渊，云亦可服，岂不误人？且妄编于太阳
篇中水 证后，而方后又以身热皮粟一段杂之，使人难解。今移太阴胸下结硬之后，其证其方，若合符节。
按∶三白小陷胸，非是两汤，系三白可陷下胸中之结耳。不可作
两句看，盖既称寒实，小陷胸是大寒之药，乃下井投石耳。
三物白散∶
桔梗 贝母（各二钱） 巴豆（一分，去皮熬黑研如脂）
上二味为散，内巴豆，更于臼中杵之，以白饮和服。强人半钱匕，羸者减之。
贝母主疗心胸郁结，桔梗能开提血气利膈宽胸。然非巴豆之辛热斩关而入，何以胜硝、黄之苦寒，使阴气
流行而成阳也？白饮和服者，甘以缓之，取其留恋于胸，不使速下耳。散者散其结塞，比“汤以荡之”更精。
病在膈上者，必吐；在膈下者，必利。
本证原是吐利，因胸下结硬，故不能通。因其势而利导之，则结硬自除矣。
不利，进热粥一杯，利过不止，进冷粥一杯。
东垣云∶“淡粥为阴中之阳，所以利小便。”今人服大黄后，用粥止利，即此遗意耳。
寒实结胸证，没有热象表现的，给予三白小陷胸汤，制成散剂服用也可以。
太阳表热尚未解除，反而使用攻下法，热邪与寒水相互搏结，形成热实结胸。
太阴病出现腹部胀满且时而疼痛，反而使用攻下法，寒邪与寒性药物相互搏结，形成寒实结胸。
所谓“无热证”，是指没有四肢烦扰疼痛的症状。
命名为“三白”的原因，是因为方中三味药颜色皆白，以此区别于黄连小陷胸汤。
旧版书籍误写为“三物”，若用黄连、栝蒌投治，会导致阴寒过盛而危及生命。
又有人误写为“白散”，这就变成了两个不同的方剂。
黄连与巴豆，一寒一热，犹如天壤之别，如果说“也可以服用（指黄连等寒药）”，岂不是误导人？
况且有人妄自将其编排在太阳篇中水饮证的后面，而在方剂之后又混杂了关于身热、皮肤粟起的一段文字，使人难以理解。
现在将其移置到太阴篇胸下结硬症状之后，其症状与方剂，如同符节相合，非常契合。
按语：所谓的“三白小陷胸”，并不是指两个汤剂，而是指三白散能够消除胸中的结滞。
不能将其断句为两句话来看待，既然称为寒实结胸，小陷胸汤是大寒之药，若是用于此证，无异于落井下石。
三物白散方：
桔梗、贝母（各二钱），巴豆（一分，去皮，炒至黑色，研成脂状）
以上两味药研为散剂，加入巴豆，再在臼中捣匀，用白米汤调和服用。
体质强壮的人服用半钱匕的量，体弱的人减少用量。
贝母主要治疗心胸部位的郁结，桔梗能够升提气血，利膈宽胸。
然而，若非巴豆的辛热之性斩关夺隘而入，怎能胜过硝石、大黄之苦寒，使阴气流通而转化为阳气呢？
用白米汤调和服用的原因，是利用甘味来缓和药性，使其留恋于胸中，不使药力迅速下行。
散剂的作用是消散结塞，比“汤剂以荡涤”更为精当。
病位在膈膜以上的，必然引起呕吐；病位在膈膜以下的，必然引起腹泻。
本证原本就有吐利的表现，但因为胸下结硬阻塞，所以导致气机不通。
顺应病势进行引导，则结硬自然消除。
如果服药后没有腹泻，喝一杯热粥以助药力；如果腹泻过度不止，喝一杯冷粥以抑制药力。
李东垣说：“淡薄的粥属于阴中之阳，所以能通利小便。”
现在人们服用大黄后，用喝粥的方法来止泻，就是沿袭了这一遗意。
Cold-solid Jie Xiong (Chest Binding Syndrome) without heat manifestations should be treated with Sanbai Xiaoxianxiong Tang (Three-White Minor Phlegm-Thrashing Decoction); it may also be administered as a powder.
When the exterior heat of Taiyang (Greater Yang) has not yet resolved, and purgation is mistakenly applied, heat pathogens bind with cold water, forming Re-shi Jie Xiong (Heat-Solid Chest Binding).
When Taiyin (Lesser Yin) presents with abdominal fullness and intermittent pain, and purgation is mistakenly applied, cold pathogens bind with cold-natured medicines, forming Han-shi Jie Xiong (Cold-Solid Chest Binding).
"No heat manifestations" refers to the absence of irritability and pain in the four limbs.
It is named "Sanbai" (Three Whites) because all three ingredients are white, distinguishing it from Huanglian Xiaoxianxiong Tang (Coptis Minor Phlegm-Thrashing Decoction).
Old editions erroneously wrote "Sanwu" (Three Things); administering Huanglian (Rhizoma Coptidis) and Gualou (Fructus Trichosanthis) would cause excessive Yin-cold and lead to death.
Others erroneously wrote "Baisan" (White Powder), implying two different formulas.
Huanglian (Rhizoma Coptidis) and Badou (Semen Crotonis) differ in temperature like heaven and earth; suggesting that cold herbs can also be used would surely mislead people.
Moreover, some recklessly placed it after the Water Syndromes in the Taiyang chapter, and mixed text regarding body heat and skin pruritus after the formula, causing confusion.
Now moved to follow the section on chest hardness below the sternum in the Taiyin chapter, the symptoms and formula match perfectly like a tally.
Note: "Sanbai Xiaoxianxiong" does not refer to two decoctions; rather, Sanbai Powder can resolve the binding in the chest.
It should not be read as two separate sentences. Since it is termed Cold-Solid Jie Xiong, Xiaoxianxiong Tang consists of great cold medicines; using it here would be like throwing stones into a well (adding insult to injury).
Sanwu Baisan Formula (Three-Ingredient White Powder):
Jiegeng (Radix Platycodi) and Beimu (Bulbus Fritillariae Cirrhosae) (each 2 qian), Badou (Semen Crotonis) (1 fen, peeled, stir-fried until black, ground into a paste).
Grind the first two ingredients into a powder, mix with Badou, and pound further in a mortar. Mix with Baiyin (white rice gruel) for administration.
Strong individuals take half a Qianbi (a measuring spoon size); frail individuals reduce the dose.
Beimu (Bulbus Fritillariae Cirrhosae) primarily treats depression and binding in the heart and chest; Jiegeng (Radix Platycodi) can lift Qi and Blood, benefit the diaphragm, and broaden the chest.
However, without the pungent-hot nature of Badou (Semen Crotonis) breaking through barriers, how could it overcome the bitter-cold nature of Xiaoshi (Natrii Sulfas) and Dahuang (Radix et Rhizoma Rhei), allowing Yin Qi to circulate and transform into Yang?
Mixing with white rice gruel utilizes sweetness to moderate the action, keeping the medicine lingering in the chest to prevent rapid downward purging.
Powders disperse blockages, which is more precise than "decoctions sweeping away" pathogens.
If the disease is located above the diaphragm, vomiting will necessarily occur; if below the diaphragm, diarrhea will necessarily occur.
This syndrome originally involves vomiting and diarrhea, but due to hardness and binding below the chest, free flow is obstructed.
Guiding according to the pathological trend will naturally eliminate the binding.
If there is no diarrhea, drink one cup of hot porridge to promote bowel movement; if diarrhea is excessive and unceasing, drink one cup of cold porridge to inhibit the effect.
Li Dongyuan stated: "Light porridge is Yang within Yin, thus it promotes urination."
The modern practice of drinking porridge to stop diarrhea after taking Dahuang (Radix et Rhizoma Rhei) follows this legacy.