黄连（一两，去毛） 半夏（泡七次，半升） 栝蒌实（一枚，去皮）
伤寒，下之早，热结胸中，按之则痛者，小结胸也，此方主之。
三阳经表证未去而早下之，则表邪乘虚而入，故结胸。结胸者，阳邪固结于胸中，不能
解散，为硬为痛也；按之则痛者，不按犹未痛也，故用小陷胸汤。黄连能泻胸中之热，半夏
能散胸中之结，栝蒌能下胸中之气。然必下后方有是证，若未经下后，则不曰结胸。
大黄（六两，酒浸） 芒硝（一升） 甘遂（一钱）
伤寒，下之早，从心下至少腹硬满而痛不可近者，大结胸也，此方主之。
三阳经表证未解，而用承气汤以攻里者，此下之早也；下之早则里虚，里虚则表邪乘之
而入，三焦皆实，故心下至少腹硬满而痛不可近也。此其为证危急，寻常药饵不能平矣，故
用大黄以荡实，硝石以软坚，甘遂以直达。噫！人称三物之峻矣，抑孰称其有起死之功乎？
用人之勇去其怒，惟善将将者能之。
半夏（半升，制） 黄芩（炒） 干姜 人参（去芦） 甘草（各三两） 黄连（一两，
去毛）
伤寒下之早，胸满而不痛者为痞，此方主之。
伤寒自表入里，传至三阴，三阴亦有在经表证。如太阴有桂枝加芍药汤，少阴有麻黄附
子细辛汤，厥阴有当归四逆汤之类。若不治其表，而用承气汤下之，则伤中气，而阴经之邪
乘之矣！以既伤之中气而邪乘之，则不能升清降浊，痞塞于中，如天地不交而成痞，故曰痞，
泻心者，泻心下之邪也。姜、夏之辛，所以散痞气；芩、连之苦，所以泻痞热；以下之后，
脾气必虚，人参、甘草、大枣，所以补脾之虚。
黄连（一两，去净毛须） 半夏（经过七次水泡处理，半升） 栝蒌实（一枚，去皮）
伤寒病，如果过早使用泻下法，导致热邪结聚于胸中，按压时才会感到疼痛的，称为小结胸证，此方主治。
三阳经的表证尚未解除而过早使用泻下法，表邪便会乘虚而入，从而形成结胸。所谓结胸，是指阳热邪气坚固结聚于胸中，无法解散，表现为胸部硬满且疼痛；只有按压时才疼痛，不按压则不痛的，因此使用小陷胸汤。黄连能够清泻胸中的热邪，半夏能够消散胸中的痰结，栝蒌能够降泄胸中的气机。但是，必须是在误用泻下法之后才会出现这种证候，如果没有经过泻下治疗，就不称为结胸。
大黄（六两，用酒浸泡） 芒硝（一升） 甘遂（一钱）
伤寒病，如果过早使用泻下法，从心窝部直到小腹都硬满且疼痛剧烈、甚至不能靠近触碰的，称为大结胸证，此方主治。
三阳经的表证尚未解除，却使用承气汤类方剂攻逐里实，这就是过早泻下；过早泻下会导致里气虚弱，里气虚弱则表邪乘虚而入，导致三焦皆呈实证状态，所以出现从心下至少腹硬满且疼痛剧烈、不可近触的症状。这种证候危急，寻常的药物难以平复，因此使用大黄来荡涤实邪，芒硝来软化坚积，甘遂来直达病所。唉！人们只称赞这三味药的峻猛，又有谁称赞它们有起死回生的功效呢？任用人的勇气去克服愤怒，只有善于统帅将领的人才能做到。
半夏（半升，炮制过） 黄芩（炒制） 干姜 人参（去芦头） 甘草（各三两） 黄连（一两，去净毛须）
伤寒病过早使用泻下法，导致胸部胀满但不疼痛的，称为痞证，此方主治。
伤寒病邪由表入里，传变至三阴经，三阴经也有在表的证候。例如太阴病有桂枝加芍药汤，少阴病有麻黄附子细辛汤，厥阴病有当归四逆汤等。如果不先治疗表证，而直接使用承气汤泻下，就会损伤中焦脾胃之气，使得阴经的病邪乘虚侵袭！由于中气已经受损，邪气乘虚而入，导致清气不能上升、浊气不能下降，气机痞塞于中焦，就像天地之气不交泰而形成痞塞一样，所以称为“痞”。“泻心”，指的是泻除心下部位的邪气。生姜、半夏的辛味，用来散除痞结的气机；黄芩、黄连的苦味，用来清泻痞结的热邪；因为经过泻下治疗后，脾气必然虚弱，人参、甘草、大枣，用来补益脾气的虚弱。
Coptidis Rhizoma (30 g, remove fibrous roots) Pinelliae Tuber (soaked seven times, 150 mL) Trichosanthis Fructus (one fruit, remove peel)
In Cold Damage (Shanghan), if purgation is applied prematurely, heat binds in the chest. If pain occurs only upon palpation, it is termed Xiao Xianxiong Tang Syndrome (Minor Phlegm-Heat Binding in the Chest); this formula governs it.
When exterior syndromes of the Three Yang meridians remain unresolved and purgation is used prematurely, exterior pathogens enter due to deficiency, resulting in Jie Xiong (Binding Chest). "Jie Xiong" refers to Yang pathogens firmly binding in the chest, unable to disperse, causing hardness and pain. If pain occurs only upon palpation but not otherwise, Xiao Xianxiong Tang is used. Coptidis Rhizoma clears heat from the chest; Pinelliae Tuber disperses phlegm-bindings in the chest; Trichosanthis Fructus directs Qi downward from the chest. However, this syndrome must follow improper purgation; without prior purgation, it is not termed Jie Xiong.
Rhei Radix et Rhizoma (180 g, soaked in wine) Natrii Sulfas (250 mL) Kansui Radix (3 g)
In Cold Damage, if purgation is applied prematurely, leading to hardness, fullness, and severe pain from the epigastrium down to the lower abdomen that cannot be tolerated by touch, it is termed Da Jie Xiong (Major Binding Chest); this formula governs it.
When exterior syndromes of the Three Yang meridians are unresolved, using Chengqi Tang formulas to attack interior excess constitutes premature purgation. Premature purgation causes interior deficiency; interior deficiency allows exterior pathogens to invade, resulting in excess in the Triple Burner. Thus, hardness, fullness, and severe pain from the epigastrium to the lower abdomen occur. This condition is critical and cannot be resolved by ordinary medicines. Therefore, Rhei Radix et Rhizoma is used to purge excess, Natrii Sulfas to soften hardness, and Kansui Radix to reach the disease site directly. Alas! People praise the harshness of these three herbs, but who praises their power to revive the dying? Utilizing human courage to overcome anger can only be done by one skilled at commanding generals.
Pinelliae Tuber (150 mL, processed) Scutellariae Radix (stir-fried) Zingiberis Rhizoma Recens Ginseng Radix et Rhizoma (remove rhizomes) Glycyrrhizae Radix et Rhizoma (each 90 g) Coptidis Rhizoma (30 g, remove fibrous roots)
In Cold Damage, if purgation is applied prematurely, resulting in chest fullness without pain, it is termed Pi Syndrome (Stagnant Epigastrium); this formula governs it.
Cold Damage pathogens move from the exterior to the interior, transmitting to the Three Yin meridians. The Three Yin meridians also have exterior syndromes. For example, Taiyin has Guizhi Ji Shaoyao Tang, Shaoyin has Mahuang Fuzi Xixin Tang, and Jueyin has Danggui Sini Tang. If the exterior is not treated and Chengqi Tang is used for purgation, the Middle Qi (Spleen/Stomach Qi) is damaged, allowing pathogens from the Yin meridians to invade. Since the Middle Qi is already damaged and pathogens invade, Clear Qi fails to ascend and Turbid Qi fails to descend, causing stagnation in the middle, similar to Heaven and Earth failing to interact, forming Pi (Stagnation). Hence, it is called "Pi." "Xie Xin" (Draining the Heart) refers to draining pathogens from the epigastric region. The pungency of Zingiberis Rhizoma and Pinelliae Tuber disperses Qi stagnation; the bitterness of Scutellariae Radix and Coptidis Rhizoma drains heat from the stagnation; since Spleen Qi is deficient after purgation, Ginseng Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, and Jujubae Fructus tonify Spleen deficiency.