栀子（十四枚擘味苦寒） 香豉（四合绵裹寒）
上二味。以水四升。先煮栀子。得二升半。内豉。煮取一升半。去滓。分为二服。
温进一服。得吐者。止后服。
酸苦涌泄为阴。苦以涌吐。寒以胜热。栀子豉汤相合。吐剂宜矣。
成氏云。吐证亦自不同。如不经汗下。邪气蕴郁于膈。则谓之实也。应以瓜蒂散吐
之。瓜蒂散。吐胸中之实邪也。若发汗吐下后邪气乘虚留于胸中。则谓之虚烦。应以栀
子汤吐之。此吐胸中虚烦也。
若少气者。栀子甘草豉汤主之。若呕者栀子生姜豉汤主之。
少气者。热伤气也。加甘草以益气。呕者。热烦而气逆也。加生姜以散气。少气则
气为热搏。散而不收者。甘以补之可也。呕则气为热搏。逆而不散者。辛以散之可也。
于栀子豉汤方内。加生姜五两。余根据前法。得吐。止后服。
发汗。若下之。而烦热。胸中窒者。栀子豉汤主之。
阳受气于胸中。发汗若下。使阳气不足。邪热客于胸中。结而不散。故烦热而胸中窒
塞。与栀子豉汤。以吐胸中之邪。
伤寒五六日。大下之后。身热不去。心中结痛者。未欲解也。栀子豉汤主之。
伤寒五六日。邪气在里之时。若大下后。身热去。心胸空者。为欲解。若大下后。身
热去而心结痛者。结胸也。身热不去心中结痛者。虚烦也。结胸。为热结胸中为实。是
热气已收敛于内。则外身热去。虚烦。为热客胸中。未结为实散漫为烦。是以身热不去。
六七日。为欲解之时。以热为虚烦。故云未欲解也。与栀子豉汤以吐除之。
伤寒下后。心烦、腹满。卧起不安者。栀子浓朴汤主之。
下后。但腹满而不心烦。即邪气入里。为里实。但心烦而不腹满。即邪气在胸中。
为虚烦。既烦且满。则邪气壅于胸腹之间也。满则不能坐。烦则不能卧。故卧起
不安。与栀子浓朴汤。吐烦泄满。
栀子（十四枚，掰开，味苦，性寒） 香豉（四合，用绵布包裹，性寒）
以上两味药。用水四升。先煮栀子。煮到剩二升半时。加入香豉。再煮取一升半。滤去药渣。分为两次服用。
温服一次。如果服药后出现呕吐的。停止服用剩下的药。
酸味和苦味具有涌泄的作用，属于阴。苦味能涌吐。寒性能胜热。栀子与香豉相合。作为涌吐剂是合适的。
成无己说。呕吐的病证也不尽相同。比如没有经过发汗或攻下治疗。邪气蕴结郁滞于膈部。这就叫做实证。应该用瓜蒂散来吐除它。瓜蒂散。是吐除胸中的实邪。如果是发汗、催吐或攻下之后。邪气乘虚留存在胸中。这就叫做虚烦。应该用栀子汤来吐除它。这是吐除胸中的虚烦。
如果有少气症状的。用栀子甘草豉汤主治。如果有呕吐症状的。用栀子生姜豉汤主治。
少气。是因为热邪损伤了正气。加入甘草来补益正气。呕吐。是因为热烦导致气机上逆。加入生姜来宣散气机。少气则是气被热邪搏击。发散而不能收敛的。用甘味药来补益是可以的。呕吐则是气被热邪搏击。上逆而不能宣散的。用辛味药来宣散是可以的。
在栀子豉汤方内。加入甘草二两。其余按照前面的方法煎煮。服药后如果出现呕吐。停止服用剩下的药。
在栀子豉汤方内。加入生姜五两。其余按照前面的方法煎煮。服药后如果出现呕吐。停止服用剩下的药。
经过发汗或攻下治疗后。出现烦热、胸中窒塞感的。用栀子豉汤主治。
阳气在胸中受纳。发汗或攻下。使阳气不足。邪热客居于胸中。凝结而不能消散。所以出现烦热和胸中窒塞感。给予栀子豉汤。以吐除胸中的邪气。
伤寒五六天。经过大力攻下之后。身体发热不退。心中结聚疼痛的。病还没有解除。用栀子豉汤主治。
伤寒五六天。是邪气在里的时期。如果大力攻下后。身体发热消退。心胸空阔的。是病将要解除。如果大力攻下后。身体发热消退而心部结聚疼痛的。是结胸证。身体发热不退且心中结聚疼痛的。是虚烦证。结胸。是因为热邪结聚在胸中属于实证。此时热气已经收敛在内。所以体表发热消退。虚烦。是因为热邪客居在胸中。尚未结聚成实。散漫而导致烦闷。所以体表发热不退。六七天。是病将要解除的时候。因为这里是热邪导致的虚烦。所以说病未解除。给予栀子豉汤以吐除它。
伤寒经过攻下治疗后。出现心烦、腹部胀满。躺卧起坐不安的。用栀子厚朴汤主治。
攻下后。只有腹部胀满而没有心烦。就是邪气入里。成为里实证。只有心烦而没有腹部胀满。就是邪气在胸中。成为虚烦证。既有心烦又有腹满。就是邪气壅滞在胸腹之间。腹满则不能安坐。心烦则不能安卧。所以躺卧起坐都不安宁。给予栀子厚朴汤。以吐除烦闷、泄除胀满。
Zhi Zi (Gardeniae Fructus, fourteen seeds, broken, bitter in flavor, cold in nature) Xiang Chi (Fermented Soybean Seed, four he, wrapped in silk cloth, cold in nature)
The above two ingredients. Use four sheng of water. First decoct Zhi Zi. When reduced to two and a half sheng, add Xiang Chi. Decoct until one and a half sheng remains. Strain the dregs. Divide into two doses.
Take one dose warm. If vomiting occurs after taking the medicine, stop taking the remaining dose.
Sour and bitter flavors have the effect of urging discharge, which belongs to Yin. Bitter flavor can urge vomiting. Cold nature can overcome heat. The combination of Zhi Zi and Xiang Chi is suitable as an emetic agent.
Cheng Wuji stated: Emetic syndromes also differ. For instance, if no sweating or purging has been performed, and pathogenic factors are constrained and stagnant in the diaphragm, it is called Excess syndrome. It should be treated with Gua Di San to induce vomiting. Gua Di San expels excess pathogenic factors from the chest. If, after sweating, vomiting, or purging, pathogenic factors remain in the chest due to deficiency, it is called Deficiency vexation. It should be treated with Zhi Zi Tang to induce vomiting. This treats deficiency vexation in the chest.
If there is shortness of breath (Shao Qi), Zhi Zi Gan Cao Chi Tang is indicated. If there is vomiting, Zhi Zi Sheng Jiang Chi Tang is indicated.
Shortness of breath is caused by heat damaging Qi. Adding Gan Cao tonifies Qi. Vomiting is caused by heat-induced vexation leading to rebellious Qi. Adding Sheng Jiang disperses Qi. In cases of shortness of breath, Qi is combated by heat, scattering without gathering; sweet flavor can tonify this. In cases of vomiting, Qi is combated by heat, rebelling without dispersing; pungent flavor can disperse this.
In the Zhi Zi Chi Tang formula, add two liang of Gan Cao. Follow the previous method for preparation. If vomiting occurs after taking the medicine, stop taking the remaining dose.
In the Zhi Zi Chi Tang formula, add five liang of Sheng Jiang. Follow the previous method for preparation. If vomiting occurs after taking the medicine, stop taking the remaining dose.
After sweating or purging, if vexation-heat and a sensation of obstruction in the chest occur, Zhi Zi Chi Tang is indicated.
Yang Qi receives its qi in the chest. Sweating or purging causes Yang Qi deficiency, allowing pathogenic heat to lodge in the chest, knotting without dispersing. Thus, vexation-heat and chest obstruction occur. Administer Zhi Zi Chi Tang to expel pathogenic factors from the chest via vomiting.
In Shaoyang disease lasting five or six days, after severe purging, if body heat persists and there is a knotted pain in the heart region, the disease has not yet resolved. Zhi Zi Chi Tang is indicated.
Five or six days into Shaoyang disease is when pathogenic factors are in the interior. If severe purging leads to the disappearance of body heat and an empty feeling in the chest and heart, resolution is desired. If severe purging leads to the disappearance of body heat but knotted pain in the heart, it is Jie Xiong (Chest Binding). If body heat persists and there is knotted pain in the heart, it is Xu Fan (Deficiency Vexation). Jie Xiong is heat knotting in the chest, constituting an Excess condition; thus, heat has converged internally, and external body heat disappears. Xu Fan is heat lodging in the chest, not yet knotted into excess, scattering to cause vexation; thus, external body heat persists. Six or seven days is the time for resolution. Since this is heat-induced deficiency vexation, it is said that resolution has not occurred. Administer Zhi Zi Chi Tang to expel it via vomiting.
After purging in Shaoyang disease, if vexation, abdominal fullness, and restlessness (unable to lie down or sit up comfortably) occur, Zhi Zi Hou Po Tang is indicated.
After purging, if there is only abdominal fullness without vexation, pathogenic factors have entered the interior, becoming Interior Excess. If there is only vexation without abdominal fullness, pathogenic factors remain in the chest, becoming Deficiency Vexation. If both vexation and fullness exist, pathogenic factors are congested between the chest and abdomen. Fullness prevents sitting comfortably; vexation prevents lying down comfortably. Thus, restlessness occurs. Administer Zhi Zi Hou Po Tang to expel vexation via vomiting and drain fullness.