于栀子豉汤方内，加生姜五两。余根据前法，得吐止后服。
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伤寒下后，心烦腹满，卧起不安者，栀子厚朴汤主之。
【注】
论中下后满而不烦者有二：一热气入胃之实满，以承气汤下之；一寒气上逆之虚满，
以厚朴生姜甘草半夏人参汤温之。其烦而不满者，亦有二：一热邪入胸之虚烦，以竹
叶石膏汤清之；一懊□欲吐之心烦，以栀子豉汤吐之。今既烦且满，满甚则不能坐，
烦甚则不能卧，故卧起不安也。然既无三阳之证实，又非三阴之虚证，惟热与气结，
壅于胸腹之间，故宜栀子枳朴，涌其热气，则胸腹和而烦自去，满自消矣。此亦吐中
寓和之意也。
【集注】
程应旄曰：凡邪客胸，便上下不交，此与结胸心下痞相等，虽吐、下和解，各不同法
，其为交通阴阳则一也。
沈明宗曰：下后微邪内陷，而无痰饮搏结，故无结胸下利，但邪陷胸膈，扰乱于上则
心烦，邪入腹中，在下则腹满，两邪逼凑胸腹，所以心烦腹满。用此一涌一泻，亦表
里两解法也。
栀子（擘）十四枚 厚朴（姜炙）两 枳实（去穣，炒）四两
已上三味，以水三升半，煮取一升半，去滓，分三服，温进一服，得吐，止后服。
@@@
伤寒医以丸药大下之，身热不去，微烦者，栀子干姜汤主之。
【按】
栀子干姜汤当是栀子豉汤；栀子豉汤当是栀子干姜汤，断无烦热用干姜，结痛用香豉
之理。
【注】
伤寒表邪未解，医以丸药大下之，不至结胸痞□，犹未成逆也。然身热不去，表仍未
罢也，微烦者，热陷于胸也。表热之在胸者，既轻且微，故不可下，亦不可清，惟宜
以栀子豉汤，微涌其热，则微烦可除，而吐中有发散之意，身热亦可解矣。
【集注】
汪琥曰∶丸药误下，邪热不除，所以身热不去，邪气乘虚客于胸中，故令微烦也。
在栀子豉汤的方剂组成中，加入甘草二两，其余按照前面的煎服方法操作，待患者出现呕吐反应后停止后续服药。
在栀子豉汤的方剂组成中，加入生姜五两，其余按照前面的煎服方法操作，待患者出现呕吐反应后停止后续服药。
@@@
伤寒病经过攻下法治疗后，出现心中烦乱、腹部胀满，坐卧不宁的症状，应当使用栀子厚朴汤主治。
【注释】
原文中提到的攻下后出现腹胀但不心烦的情况有两种：一种是热气入胃导致的实性腹胀，用承气汤攻下；另一种是寒气上逆导致的虚性腹胀，用厚朴生姜甘草半夏人参汤温中散寒。文中提到的心烦但不腹胀的情况也有两种：一种是热邪入胸导致的虚性烦闷，用竹叶石膏汤清热；另一种是心中懊恼欲吐导致的心烦，用栀子豉汤催吐。现在既有心烦又有腹胀，腹胀严重时无法端坐，心烦严重时无法躺卧，所以出现坐卧不安的症状。然而，既然没有三阳经的实证表现，也不是三阴经的虚证表现，仅仅是热邪与气机郁结，壅滞于胸腹之间，因此适宜使用栀子、枳实、厚朴，涌泄其中的热邪，这样胸腹气和顺，烦闷自然消除，腹胀自然消退。这也体现了在涌吐之中蕴含调和之意的治疗思路。
【集注】
程应旄说：凡是邪气客居胸中，就会导致上下气机不交，这与结胸证和心下痞证相当，虽然催吐、攻下和解表的方法各不相同，但其目的都是为了交通阴阳，这一点是相同的。
沈明宗说：攻下之后，微弱的邪气内陷，但没有痰饮搏结，所以不会出现结胸或下利，只是邪气陷入胸膈，扰乱上部则导致心烦，邪气进入腹部，在下部则导致腹胀，两种邪气逼迫凑集于胸腹之间，所以出现心烦和腹胀。使用这一方剂，通过涌吐和泻下的作用，也是一种表里双解的方法。
栀子（掰开）十四枚 厚朴（姜汁炙）一两 枳实（去掉瓤，炒）四两
以上三味药，用水三升半，煮取一升半，滤去药渣，分三次服用，温服一次，若出现呕吐，则停止后续服药。
@@@
伤寒病，医生误用丸药进行猛烈攻下，导致身体发热不退，仅有轻微心烦的症状，应当使用栀子干姜汤主治。
【按语】
这里的“栀子干姜汤”应当是“栀子豉汤”；而原文中的“栀子豉汤”应当是“栀子干姜汤”，绝不会有治疗烦热使用干姜，治疗结痛使用香豉的道理。
【注释】
伤寒病的表邪尚未解除，医生误用丸药进行猛烈攻下，虽然没有导致结胸或痞证，也还未形成严重的变证。但是身体发热不退，说明表邪仍未完全解除；轻微心烦，是因为热邪陷入胸中。位于胸中的表热程度较轻且微弱，所以不可攻下，也不宜单纯清热，只适宜使用栀子豉汤，微微涌泄其热邪，这样轻微的心烦即可消除，而且吐法中蕴含着发散之意，身体的发热也可以解除。
In the formula of Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), add Gancao (Licorice Root, Glycyrrhizae Radix et Rhizoma) two liang. Follow the previous methods for preparation and administration; stop subsequent doses after vomiting occurs.
In the formula of Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), add Shengjiang (Fresh Ginger, Zingiberis Rhizoma Recens) five liang. Follow the previous methods for preparation and administration; stop subsequent doses after vomiting occurs.
@@@
After Shaoyang disease (Cold Damage) was treated with purgation, if the patient presents with vexation in the heart, abdominal fullness, and restlessness in lying down or sitting up, Zhizi Houpo Tang (Gardenia and Magnolia Bark Decoction) is the primary treatment.
[Annotation]
There are two types of abdominal fullness without vexation mentioned in the text following purgation: one is excess fullness caused by heat qi entering the stomach, treated with Chengqi Tang (Eucalyptus Pill Decoction) to purge; the other is deficiency fullness caused by cold qi counterflow, treated with Houpo Shengjiang Gancao Banxia Renshen Tang (Magnolia Bark, Fresh Ginger, Licorice, Pinellia, and Ginseng Decoction) to warm. There are also two types of vexation without abdominal fullness: one is deficiency vexation caused by pathogenic heat entering the chest, cleared with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction); the other is vexation with a sensation of stifling oppression and desire to vomit, treated with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) to induce vomiting. Now, since there is both vexation and fullness, severe fullness prevents sitting, and severe vexation prevents lying down, resulting in restlessness. However, since there are no excess syndromes of the Three Yang meridians, nor deficiency syndromes of the Three Yin meridians, it is merely heat and qi stagnation obstructing between the chest and abdomen. Therefore, it is appropriate to use Zhizi (Gardeniae Fructus), Zhishi (Immature Bitter Orange Fruit), and Houpo (Magnolia Bark) to surge out the heat qi. When the chest and abdomen harmonize, the vexation will naturally disappear, and the fullness will subside. This also embodies the meaning of harmonization within the method of inducing vomiting.
[Collected Annotations]
Cheng Yingmao stated: Whenever pathogens lodge in the chest, communication between the upper and lower parts is disrupted. This is comparable to Jie Xiong syndrome (Chest Binding) and Xin Xia Pi syndrome (Epigastric Glomus). Although the methods of inducing vomiting, purging, and harmonizing differ, their goal of facilitating communication between Yin and Yang is the same.
Shen Mingzong stated: After purgation, slight pathogens sink inward without phlegm-fluids binding together, so there is no Jie Xiong or diarrhea. The pathogens sink into the chest-diaphragm, disturbing the upper part causing heart vexation, and enter the abdomen, affecting the lower part causing abdominal fullness. The two pathogens press upon the chest and abdomen, hence the heart vexation and abdominal fullness. Using this formula involves both surging (vomiting) and purging, which is also a method of resolving both exterior and interior simultaneously.
Zhizi (broken open) fourteen pieces, Houpo (stir-fried with ginger juice) one liang, Zhishi (pulp removed, stir-fried) four liang.
The above three herbs are boiled in three and a half sheng of water to obtain one and a half sheng. Strain the dregs, divide into three doses, take one dose warm. If vomiting occurs, stop subsequent doses.
@@@
In Shaoyang disease (Cold Damage), if the physician mistakenly used pill medicines for vigorous purgation, resulting in persistent body heat and slight vexation, Zhizi Ganjiang Tang (Gardenia and Dried Ginger Decoction) is the primary treatment.
[Commentary]
"Zhizi Ganjiang Tang" should be "Zhizi Chi Tang"; and "Zhizi Chi Tang" should be "Zhizi Ganjiang Tang". It is inconceivable that Ganjiang (Dried Ginger, Zingiberis Rhizoma) would be used for treating vexation-heat, or Chiyi (Prepared Fermented Soybean, Perillae Fructus Preparatory) for treating knotted pain.
[Annotation]
When the exterior pathogens of Shaoyang disease have not yet resolved, and the physician mistakenly uses pill medicines for vigorous purgation, although it does not lead to Jie Xiong or Pi syndromes, it has not yet become a critical deviation. However, persistent body heat indicates the exterior pathogen has not completely dissipated. Slight vexation indicates heat sinking into the chest. The exterior heat located in the chest is mild and slight, so it cannot be purged, nor can it be simply cleared. It is only appropriate to use Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) to slightly surge out the heat. Thus, the slight vexation can be eliminated, and since the method of vomiting contains the intent of dispersing, the body heat can also be resolved.
[Collected Annotations]
Wang Hu stated: Mistaken purgation with pills fails to eliminate pathogenic heat, hence body heat persists. Pathogens take advantage of the deficiency to lodge in the chest, causing slight vexation.