赤石脂（碎）一筋 太乙禹余粮（碎）一筋
右二味，以水六升，煮取二升，去滓，分温三服。
【方解】
柯琴曰：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，未可以理中之剂收功也。然大肠之不固，仍责在胃，关门之不紧，仍责在脾，此
二味皆土之精气所结，能实胃而涩肠，盖急以治下焦之标者，实以培中宫之本也。要
之此证是土虚而非火虚，故不宜于姜、附。若水不利而湿甚，复利不止者，则又当利
其小便矣。
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伤寒发汗，若吐若下，解后，心下痞□，噫气不除者，旋覆代赭石汤主之。
【注】
伤寒发汗，若吐若下，解后，设表里俱清，自然胃和思食而愈。今邪虽解，而心下痞
□，胃虚结也；噫气不除，胃气逆也。然治痞之法，无出诸泻心汤。故于生姜泻心汤
方中，去芩、连、干姜，以病解无寒热之邪也。佐旋覆代赭石者，所以补虚宣气，涤
饮镇逆也。
【集注】
方有执曰：解，谓大邪已散也。心下痞□，噫气不除者，正气未复，胃气尚弱，而伏
饮为逆也。故用旋覆代赭石汤，以养正而散余邪也。
喻昌曰：大意重在噫气不除上。既心下痞□，更加噫气不除，则胃气上逆，全不下行
，有升无降。所谓弦绝者，其声嘶；土败者，其声哕也。故用代赭石领人参下行，以
镇安其逆气也。
汪琥曰：此噫气较前生姜泻心汤之干噫不同，是虽噫而不至食臭，故知其为中气虚也
。
沈明宗曰：误下成痞，观此之发汗解后，亦可成痞。盖发汗、吐、下，皆伤内气。然
最虚之处，便是容邪之处，所以微邪从虚内陷，浊阴上逆冲心，则心下痞□，而噫气
不除也。
赤石脂（捣碎）一两，太乙禹余粮（捣碎）一两。
以上两味药，用水六升，煎煮至剩余二升，滤去药渣，分三次温服。
【方解】
柯琴说：甘遂、干姜、人参、白术，可以补益中焦元气的虚弱，但不足以固摄下焦脂膏的滑脱。这种泄泻病位在下焦，不能单用理中汤这类方剂来收功。然而大肠的不固摄，责任仍在于胃；关门不紧密，责任仍在于脾。这两味药都是土的精气凝结而成，能够充实胃气并涩肠止泻，这看似是急于治疗下焦的症状，实际上是在培补中焦的根本。总之，这个证候是土虚而不是火虚，所以不适合使用干姜、附子。如果水液代谢不利且湿气很重，再次出现泄泻不止的情况，则应当通利小便了。
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伤寒经过发汗，或者使用催吐，或者使用泻下法后，表证已解，但心下痞塞胀满，嗳气持续不缓解的，用旋覆代赭石汤主治。
【注】
伤寒经过发汗，或者使用催吐，或者使用泻下法后，如果表里都清净了，自然胃气和顺就会想吃东西而痊愈。现在邪气虽然已解，但心下痞塞胀满，这是胃气虚弱导致的气机结滞；嗳气持续不缓解，这是胃气上逆的表现。然而治疗痞证的方法，没有超出各类泻心汤的范围。所以在生姜泻心汤的方子中，去掉黄芩、黄连、干姜，因为病邪已解，没有寒热之邪了。加入旋覆花、代赭石作为佐使，是为了补虚宣通气机，涤除痰饮并镇降逆气。
【集注】
方有执说：“解”，是指大邪已经消散。心下痞塞胀满，嗳气持续不缓解，是因为正气尚未恢复，胃气仍然虚弱，而有潜伏的痰饮上逆。所以使用旋覆代赭石汤，以扶助正气并疏散残余邪气。
喻昌说：大意重点在于“嗳气不除”。既然心下痞塞胀满，再加上嗳气持续不缓解，那么就是胃气上逆，完全不能下行，只有上升没有下降。所谓琴弦断绝，声音就嘶哑；土气败坏，声音就呃逆。所以使用代赭石引领人参下行，以镇安上逆之气。
汪琥说：这里的嗳气与之前生姜泻心汤证的干噫不同，这里是虽然嗳气但没有食物的酸腐臭味，所以知道这是中气虚弱所致。
沈明宗说：误用泻下法导致成痞，看这里发汗解表后，也可以形成痞证。大概发汗、催吐、泻下，都会损伤内在正气。然而身体最虚弱的地方，就是邪气容易停留的地方，所以微弱的邪气从虚弱处内陷，浊阴之气上逆冲犯心胸，就会导致心下痞塞胀满，以及嗳气持续不缓解。
Shizhi Shi (Crushed) [Chinosideritis Folium] 1 jin, Taiyi Yuyuliang (Crushed) [Haematitum] 1 jin.
The above two ingredients are boiled in six sheng of water until reduced to two sheng. The dregs are removed, and the decoction is divided into three warm doses.
[Fangjie - Analysis of the Formula]
Ke Qin stated: Ganjiang, Renshen, and Baizhu can tonify the deficiency of Yuanqi (Original Qi) in the Middle Jiao, but they are insufficient to secure the slippage of Zhigao (adipose tissue/fluids) in the Lower Jiao. Since this diarrhea is located in the Lower Jiao, it cannot be cured solely by formulas like Lizhong Tang (Cinnamon Twig and Poria Decoction). However, the failure of the Large Intestine to consolidate is still attributed to the Stomach; the looseness of the gate is still attributed to the Spleen. These two herbs are formed from the essence of Earth, capable of solidifying the Stomach and astringing the Intestines. Although this appears to be an urgent treatment for the branch symptoms of the Lower Jiao, it actually serves to cultivate the root of the Middle Jiao. In summary, this syndrome is due to Earth deficiency rather than Fire deficiency, so Jiangtang (Dried Ginger) and Fuzi (Prepared Aconite Root) are not suitable. If there is difficulty in water metabolism with severe dampness, and diarrhea persists, then promoting urination should be adopted.
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After Taiyang Cold Damage disease has been treated with sweating, vomiting, or purging methods, and the exterior syndrome has resolved, if epigastric fullness and obstruction persist along with incessant belching, Xuanfu Daizhe Shi Tang (Inula and Hematite Decoction) is the primary prescription.
[Zhushi - Annotation]
After Taiyang Cold Damage disease has been treated with sweating, vomiting, or purging, if both the exterior and interior are cleared, the Stomach Qi naturally harmonizes, appetite returns, and recovery ensues. Now that the pathogenic factor has resolved but epigastric fullness and obstruction remain, this indicates Stomach Qi deficiency leading to Qi stagnation; incessant belching indicates rebellious Stomach Qi. However, the methods for treating Pi (fullness-obstruction) syndromes do not go beyond the various Xiexin Tangs (Drain the Epigastrium Decoctions). Therefore, in the formula for Shengjiang Xiexin Tang (Fresh Ginger Drain the Epigastrium Decoction), Huangqin (Scutellaria Root), Lianzi (Lotus Plumule), and Ganjiang (Dried Ginger) are removed because the pathogen has resolved and there are no cold-heat pathogens remaining. Xuanfuhua (Inula Flower) and Daizhe Shi (Hematite) are added as assistants to tonify deficiency, disseminate Qi, eliminate phlegm-fluids, and suppress rebellion.
[Jizhu - Collected Annotations]
Fang Youzhi stated: "Jie" (resolve) means the major pathogenic factors have dispersed. Epigastric fullness and obstruction with incessant belching occur because Zhengqi (Upright Qi) has not yet recovered, Stomach Qi is still weak, and latent phlegm-fluids are rebelling. Thus, Xuanfu Daizhe Shi Tang is used to nourish upright Qi and disperse residual pathogens.
Yu Chang stated: The main emphasis lies on "incessant belching." Given epigastric fullness and obstruction accompanied by incessant belching, it indicates that Stomach Qi is rebelling upward and failing to descend, rising without descending. As the saying goes, when a string breaks, its sound becomes hoarse; when Earth fails, the sound becomes hiccups. Therefore, Daizhe Shi is used to guide Renshen downward to pacify the rebellious Qi.
Wang Hu stated: This belching differs from the "gan yi" (dry belching) in the previous Shengjiang Xiexin Tang syndrome. Here, although there is belching, there is no sour or rotten odor of food, indicating that it is caused by deficiency of Middle Qi.
Shen Mingzong stated: Misuse of purgatives leading to Pi (fullness-obstruction) shows that even after resolving the exterior through sweating, Pi can form. Sweating, vomiting, and purging all damage internal Qi. The place where Qi is most deficient is where pathogens easily lodge. Thus, slight pathogens sink inward from the deficiency, turbid Yin rebels upward attacking the Heart region, resulting in epigastric fullness and obstruction and incessant belching.