生姜（四两切） 甘草（三两炙） 人参（三两） 干姜（一两） 黄芩（一两）
半夏（半升洗） 黄连（一两） 大枣（十二枚）
上八味。以水一斗。煮取六升。去滓、再煎。取三升。温服一升。日三服。
伤寒中风。医反下之。其人下利。日数十行。谷不化。腹中雷鸣。心下痞硬而满。
干呕。心烦不得安。医见心下痞。谓病不尽。复下之。其痞益甚。此非结热。但以胃中
虚。客气上逆。故使硬也。甘草泻心汤主之。
伤寒中风。是伤寒或中风也。邪气在表。医反下之。虚其肠胃而气内陷也。下利日
数十行。谷不化。腹中雷鸣者。下后里虚胃弱也。心下痞硬。干呕心烦。不得安者。胃
中空虚。客气上逆也。与泻心汤以攻表。加甘草以补虚。前以汗后胃虚。是外伤阳气。
故加生姜。此以下后胃虚。是内损阴气。故加甘草。
甘草（四两） 黄芩（三两） 干姜（三两） 半夏（半升洗） 黄连（一两）
大枣（十二枚擘）
上六味。以水一斗。煮取六升。去滓、再煎。取三升。温服一升。日三服。
成氏云。气结而不散。壅而不通。为结胸。陷胸汤为直达之剂。塞而不通。否而不
泰。为痞。泻心汤为分解之剂。痞与结胸。有高下焉。邪结在胸中。故曰陷胸。留邪在
心下。故曰泻心。
沈亮宸云。半夏泻心。甘草泻心。皆下后伤真气之过也。生姜泻心。因于食。大黄
泻心。因于热。附子泻心。因于寒。
伤寒。服汤药。下利不止。心下痞硬。服泻心汤已。复以他药下之。利不止。医以
理中与之。利益甚。理中者。理中焦。此利在下焦。赤石脂禹余粮汤主之。复利不止者。
当利其小便。
伤寒服汤药下后。利不止而心下痞硬者。气虚而客气上逆也。与泻心汤攻之。则痞
已。医复以他药下之。又虚其里。致利不止也。理中丸。脾胃虚寒下利者服之愈。此以
下焦虚。故与之。其利益甚。圣济经曰。滑则气脱。欲其收也。如开肠洞
泄。便溺遗失涩剂所以收之。此利由下焦不约。与赤石脂禹余粮汤。以涩洞泄。下焦主
厘清浊。下利者。水谷不分也。若服涩剂而利不止。当利小便以分其气。
【生姜泻心汤方第六十】
生姜（四两，切片） 甘草（三两，炙烤） 人参（三两） 干姜（一两） 黄芩（一两）
半夏（半升，洗净） 黄连（一两） 大枣（十二枚）
以上八味药。用水一斗。煮取六升药液。滤去药渣，再次煎煮。取三升药液。每次温服一升。每日服用三次。
伤寒或中风病证。医生反而使用攻下法治疗。患者出现腹泻。每天数十次。食物不消化。肠中鸣响如雷。胃脘部痞塞硬满。
干呕。心烦不安。医生见胃脘部痞塞。认为病邪未尽。再次使用攻下法。其痞塞症状更加严重。这并非实热结聚。只是因为胃气虚弱。客气上逆。所以导致痞硬。用甘草泻心汤主治。
伤寒或中风。是指伤寒或中风病证。邪气在表。医生反而使用攻下法。使肠胃虚弱而气机内陷。腹泻每天数十次。食物不消化。肠中鸣响如雷。这是攻下后里虚胃弱所致。胃脘痞塞硬满。干呕心烦。不得安宁。这是胃中空虚。客气上逆所致。给予泻心汤以解除表邪（注：此处原文“攻表”疑为衍文或特定语境下的误植，结合上下文及成无己注解，通常指调和脾胃、消痞散结，但依原文直译），加甘草以补虚。此前是发汗后胃虚。属于外伤阳气。所以加生姜。此次是攻下后胃虚。属于内损阴气。所以加甘草。
【甘草泻心汤方第六十一】
甘草（四两） 黄芩（三两） 干姜（三两） 半夏（半升，洗净） 黄连（一两）
大枣（十二枚，掰开）
以上六味药。用水一斗。煮取六升药液。滤去药渣，再次煎煮。取三升药液。每次温服一升。每日服用三次。
成无己说。气机结聚而不散。壅滞而不通。称为结胸。陷胸汤是直接攻逐的方剂。堵塞而不通。闭塞而不泰。称为痞。泻心汤是分解消散的方剂。痞与结胸。有部位高下之分。邪气结聚在胸中。所以叫陷胸。留邪在心下。所以叫泻心。
沈亮宸说。半夏泻心汤和甘草泻心汤。都是攻下后损伤真气的过错所致。生姜泻心汤。是因为饮食停滞。大黄泻心汤。是因为实热。附子泻心汤。是因为寒邪。
伤寒病。服用汤药后。腹泻不止。胃脘痞塞硬满。服用泻心汤后。又用其他药物攻下。腹泻不止。医生用理中丸治疗。腹泻更严重。理中丸。是调理中焦的。此处的腹泻在下焦。用赤石脂禹余粮汤主治。如果腹泻仍不止。应当通过利小便来治疗。
伤寒服用汤药攻下后。腹泻不止且胃脘痞塞硬满。这是气虚而客气上逆。给予泻心汤攻治。则痞塞可除。医生又用其他药物攻下。再次损伤里气。导致腹泻不止。理中丸。适用于脾胃虚寒所致的腹泻。此处是因为下焦虚。所以服用它。腹泻反而更严重。《圣济经》说。滑脱则是气机外脱。需要收敛固涩。像肠道洞泄。大小便失禁。涩剂用来收敛固涩。这种腹泻由于下焦约束无力。给予赤石脂禹余粮汤。以涩止洞泄。下焦主管分清泌浊。下利是水谷不分。如果服用涩剂后腹泻仍不止。应当利小便以分清气水。
[Shengjiang Xiexin Decoction Formula, No. 60]
Shengjiang (Cinnamonis Cortex / Fresh Ginger Rhizome, 4 liang, sliced) Gancao (Glycyrrhizae Radix et Rhizoma, 3 liang, honey-fried) Renshen (Panacis Ginseng Radix, 3 liang) Ganjiang (Zingiberis Rhizoma, 1 liang) Huangqin (Scutellariae Radix, 1 liang)
Banxia (Pinelliae Rhizoma, half sheng, washed) Huanglian (Coptidis Rhizoma, 1 liang) Dazao (Jujubae Fructus, 12 pieces)
The above eight herbs. Boil in one dou of water. Reduce to six sheng of liquid. Remove the dregs, and decoct again. Obtain three sheng of liquid. Take one sheng warm each time. Three times a day.
Taiyang disease or Wind-stroke. The physician incorrectly used purgation. The patient experiences diarrhea. Dozens of times per day. Undigested food. Borborygmus in the abdomen. Epigastric fullness and hardness.
Dry retching. Vexation and inability to rest. The physician sees epigastric stuffiness and assumes the pathogen is not exhausted. Purges again. The stuffiness becomes more severe. This is not excess heat accumulation. It is merely stomach Qi deficiency with rebellious hostile Qi ascending. Hence the hardness. Ganchao Xiexin Tang is indicated.
Taiyang disease or Wind-stroke refers to Taiyang disease or Wind-stroke. The pathogen is at the exterior. The physician incorrectly uses purgation. This weakens the intestines and stomach, causing Qi to sink inward. Diarrhea dozens of times daily, undigested food, borborygmus: this results from interior deficiency and weak stomach after purgation. Epigastric stuffiness and hardness, dry retching, vexation, inability to rest: this results from an empty stomach and rebellious hostile Qi. Administer Xiexin Tang to resolve the exterior (note: text says "attack exterior", context implies harmonizing), add Gancao to tonify deficiency. Previously, sweating caused stomach deficiency, damaging Yang Qi externally; thus Shengjiang was added. Here, purgation caused stomach deficiency, damaging Yin Qi internally; thus Gancao is added.
[Ganchao Xiexin Tang Formula, No. 61]
Gancao (Glycyrrhizae Radix et Rhizoma, 4 liang) Huangqin (Scutellariae Radix, 3 liang) Ganjiang (Zingiberis Rhizoma, 3 liang) Banxia (Pinelliae Rhizoma, half sheng, washed) Huanglian (Coptidis Rhizoma, 1 liang)
Dazao (Jujubae Fructus, 12 pieces, split)
The above six herbs. Boil in one dou of water. Reduce to six sheng of liquid. Remove the dregs, and decoct again. Obtain three sheng of liquid. Take one sheng warm each time. Three times a day.
Cheng Wuji stated: Qi knotting without dispersing, stagnating without flowing, constitutes Jie Xiong (Pleural Binding). Xiaoxiong Tang is a direct attacking agent. Obstruction without passage, blockage without smoothness, constitutes Pi (Epigastric Stuffiness). Xiexin Tang is a resolving agent. Pi and Jie Xiong differ in location. Pathogen knotting in the chest is called Xiaoxiong. Pathogen remaining below the heart is called Xiexin.
Shen Liangchen stated: Banxia Xiexin Tang and Ganchao Xiexin Tang are both due to damage of True Qi after purgation. Shengjiang Xiexin Tang is due to food retention. Dahuang Xiexin Tang is due to heat. Fuzi Xiexin Tang is due to cold.
In Taiyang disease, after taking herbal medicine, diarrhea persists. Epigastric fullness and hardness. After taking Xiexin Tang, other purgatives were used. Diarrhea persists. The physician administered Lizhong Wan. Diarrhea worsened. Lizhong Wan regulates the Middle Jiao. This diarrhea is in the Lower Jiao. Chishizhi Yuyuliang Tang is indicated. If diarrhea still persists, promote urination to separate fluids.
After Taiyang disease treatment with purgatives, diarrhea persists with epigastric fullness and hardness. This is Qi deficiency with rebellious hostile Qi. Xiexin Tang is given to attack the pathology, relieving stuffiness. The physician then used other purgatives, further damaging the interior, causing persistent diarrhea. Lizhong Wan cures diarrhea due to Spleen-Stomach deficiency-cold. Here, the Lower Jiao is deficient, so administering it worsens the diarrhea. *Shengji Jing* states: Slippage indicates Qi escape; astringents are needed for consolidation. Like intestinal洞泄 (profuse watery diarrhea) and incontinence, astringents consolidate. This diarrhea is due to Lower Jiao failure to constrain. Chishizhi Yuyuliang Tang is given to astringe profuse diarrhea. The Lower Jiao governs separating clear from turbid. Diarrhea is failure to distinguish water and grain. If diarrhea persists after astringents, promote urination to separate Qi/fluids.