（附论）
夫时气结胸者。谓热毒瓦斯结聚于心胸也。此由病发于阳。而下之太早。热毒之气乘虚而
痞结。按之乃痛。其寸口脉浮。关上脉沉细是也。脉大不可下。下之即死。脉浮而大下之为
逆。若阳脉浮。关上沉紧者。名为脏结病。舌上白胎滑者。为难治。不往来寒热。其人反静
舌滑者。不可攻之也。
方
桂心散（出圣惠方）治时气结胸。心下坚实满痛。
桂心（一两） 甘遂（半两煨令微黄） 人参（一两去芦头） 栝蒌（一枚取子用） 上
为散。
每服三钱。以水一中盏。入枣三枚。煎至五分。去滓。不计时候。温服。
猪苓散（出圣惠方）治时气结胸。心下满实烦闷。
猪苓（一两去黑皮） 泽泻（一两） 桂心（五钱） 赤茯苓（三分） 川朴硝（三两）
上为
散。不计时候。以粥饮汤调下二钱。
陷胸汤（出圣惠方）治时气结胸。心下坚实。按之即痛。其脉沉滑。
栝蒌（一枚大者取子） 黄连（一两去须） 半夏（汤浸七次去滑一两） 上为散。每
服五
钱。以水一大盏。入生姜半分。煎至六分。去滓。不计时候。温服。
槟榔丸（出圣惠方）治时气结胸。烦闷喘急。
槟榔（半两） 马兰花（一分微炒） 甜葶苈（半两隔纸炒令赤色） 猪牙皂角（半两
去皮炙
令黄焦） 上为末。炼蜜和丸如梧桐子大。每服不计时候。以竹叶汤下二十丸。
苦参丸（出圣惠方）治时气结胸。热毒在内。
苦参（五钱锉） 黄连（一两去须） 黄芩（一两） 川大黄（一两锉碎微炒） 栀子
仁（五钱）
上为末。炼蜜为丸如梧桐子大。每服不计时候。以竹叶汤下二十丸。
陷胸丸（出圣惠方）治时气结胸。热实在内。其脉沉坚。心下痛满。按之如
石。
川大黄（三两锉碎微炒） 甜葶苈（二两锉碎微炒） 川芒硝（二两） 杏仁（二两汤
浸去皮
尖麸炒微黄） 上为末。炼蜜和丸如弹子大。每服一丸。用甘遂末半钱。蜜一小匙。水一中
盏。同煎至七分。温温化丸药。不计时候服之。以利为度。
治时气热毒在胸膈。六七日垂死者。破棺。（一名千金煮汤出圣惠方）
用苦参一两锉。捣碎。以酒二大盏。去滓。看冷暖得所。不计时候。都为一服。服后当
闻苦参气。即吐毒如羊胆汁便愈。一方以醋二升。煮取一升二合。尽饮之。当吐即愈。天行
毒病。非苦参醋药不解。及温覆取汗愈。
一方救急疗天行呕逆不下食。入则出。下又方同。
凝雪汤（出仁存方）治时气行毒病。七八日。热结在胸中。烦乱欲死。
用芫花一升。以水三升。煮一升半。渍布薄胸上。不过三薄。热则除。当温暖四肢不厥
也。
万金丸（出王氏博济方）治时气及疏理脏腑。通利胸膈。调顺荣卫。
木香（一两） 干姜（一两炮） 大黄（一两生） 陈橘皮（汤浸去瓤一两） 巴豆（去
皮膜一
两冷水浸一宿焙干研细或与前药一处捣罗） 上药五味。同细捣罗为末。用沙糖为丸如梧桐
子大。患者三日外。酌其毒瓦斯传入未曾疏利。不计时早晚。以粥饮下五丸。如药未行。热茶
投之。上有疾即吐。下有疾即泻。汗出或吐泻不止。即以黄连汤止之。老幼虚实加减丸散。
怀身人不得与吃。此药有返魂之功。如四季觉热。但有此药疏转。自然不染时气。若患常恶
转于五更时。亦用粥饮下。
治时气热毒在胸膈。六七日垂死者。破棺。
以鸡卵一枚。煮三五沸。出以水浸之。外熟内热则吞之。良。
（附论）
所谓时气结胸，是指热毒之气结聚在心胸部位。这通常是因为病发于阳经，却过早使用了下法，导致热毒之气乘虚而入而痞塞结聚，按压时才会感到疼痛。其脉象表现为寸口脉浮，关部脉沉细。如果脉象盛大则不可使用下法，误用下法会导致死亡；若脉象浮大而下之，属于逆治。如果阳脉浮，关部脉沉紧，则称为脏结病。舌苔白且滑润的，属于难治之症。如果不出现寒热往来，患者反而安静，且舌苔滑润的，不可使用攻下法。
方剂
桂心散（出自《圣惠方》），治疗时气结胸，心下部坚实、胀满疼痛。
药材：桂心（一两）、甘遂（半两，煨至微黄色）、人参（一两，去芦头）、栝蒌（一枚，取子使用）。
制法与用法：将上述药物研为散剂。每次服用三钱，用水一中盏，加入大枣三枚，煎煮至剩余五分水量，滤去药渣。不限服药时间，温服。
猪苓散（出自《圣惠方》），治疗时气结胸，心下部胀满结实、烦闷。
药材：猪苓（一两，去黑皮）、泽泻（一两）、桂心（五钱）、赤茯苓（三分）、川朴硝（三两）。
制法与用法：将上述药物研为散剂。不限服药时间，用米汤调服二钱。
陷胸汤（出自《圣惠方》），治疗时气结胸，心下部坚实，按压即痛，脉象沉滑。
药材：栝蒌（一枚大的，取子）、黄连（一两，去须）、半夏（汤浸七次以去除滑腻感，一两）。
制法与用法：将上述药物研为散剂。每次服用五钱，用水一大盏，加入生姜半分，煎煮至剩余六分水量，滤去药渣。不限服药时间，温服。
槟榔丸（出自《圣惠方》），治疗时气结胸，烦闷喘急。
药材：槟榔（半两）、马兰花（一分，微炒）、甜葶苈（半两，隔纸炒至红色）、猪牙皂角（半两，去皮炙至黄焦色）。
制法与用法：将上述药物研为细末，用炼蜜调和制成如梧桐子大小的丸剂。每次不限服药时间，用竹叶汤送服二十丸。
苦参丸（出自《圣惠方》），治疗时气结胸，热毒在内。
药材：苦参（五钱，锉碎）、黄连（一两，去须）、黄芩（一两）、川大黄（一两，锉碎微炒）、栀子仁（五钱）。
制法与用法：将上述药物研为细末，用炼蜜制成如梧桐子大小的丸剂。每次不限服药时间，用竹叶汤送服二十丸。
陷胸丸（出自《圣惠方》），治疗时气结胸，热邪实积于内，脉象沉坚，心下部疼痛胀满，按压如石头般坚硬。
药材：川大黄（三两，锉碎微炒）、甜葶苈（二两，锉碎微炒）、川芒硝（二两）、杏仁（二两，汤浸去皮尖，麸炒至微黄色）。
制法与用法：将上述药物研为细末，用炼蜜调和制成如弹子大小的丸剂。每次服用一丸，用甘遂末半钱、蜂蜜一小匙、水一中盏，共同煎煮至剩余七分水量，温热化开丸药服用。不限服药时间，以通利大便为度。
治疗时气热毒在胸膈，病程六七日濒临死亡的危重病例。（又名千金煮汤，出自《圣惠方》）
用法：取苦参一两，锉碎捣烂，用酒两大盏煎煮，滤去药渣。根据冷热适宜的程度，不限时间，一次性服完。服药后应当能闻到苦参的气味，随即吐出如羊胆汁样的毒物即可痊愈。另一方法是用醋二升，煮取一升二合，全部饮下，当呕吐后即可痊愈。天行毒病，非苦参醋药不能解除，以及温覆取汗也可治愈。
另一方用于急救治疗天行呕逆无法进食，吃进去就吐出来，或者下利不止的情况。
凝雪汤（出自《仁存方》），治疗时气行毒病，病程七八日，热邪结聚在胸中，烦乱欲死。
用法：取芫花一升，用水三升，煮取一升半。用布浸透药液薄敷于胸部，不超过三次热敷，热邪即可消除，四肢应当温暖而不厥冷。
万金丸（出自《王氏博济方》），治疗时气及疏理脏腑，通利胸膈，调和营卫。
药材：木香（一两）、干姜（一两，炮制）、大黄（一两，生用）、陈橘皮（汤浸去瓤，一两）、巴豆（去皮膜，一两，冷水浸泡一夜后焙干研细，或与前药一起捣罗）。
制法与用法：以上五味药，共同细捣罗为细末，用砂糖制成如梧桐子大小的丸剂。患者在发病三日外，酌情判断毒瓦斯传入尚未疏利的情况，不限早晚，用米汤送服五丸。如果药力未行，可饮热茶催动。病在上部则呕吐，病在下部则腹泻。如果出汗或吐泻不止，即用黄连汤止住。老人、儿童及虚实不同者需加减丸散剂量。孕妇不得服用。此药有返魂之功，如在四季感觉发热，只要有此药疏转，自然不感染时气。如果患常恶风转筋在五更时分发作，也用米汤送服。
治疗时气热毒在胸膈，病程六七日濒临死亡的危重病例，破棺急救。
用法：取鸡蛋一枚，煮三五沸，取出后用冷水浸泡，待外皮熟而内部仍热时吞食，效果良好。
(Attached Discussion)
What is referred to as "Shi Qi Jie Xiong" (Seasonal Qi Chest Knotting) implies the accumulation and knotting of heat-toxic qi in the chest and heart region. This condition arises when a disease originates in the Yang channels, but purgative methods are applied too early. Consequently, heat-toxic qi takes advantage of the deficiency to become obstructed and knotted; pain occurs only upon palpation. The pulse presentation features a floating pulse at the Cun position (distal radial artery point) and a deep, fine pulse at the Guan position (middle radial artery point). If the pulse is large, purgatives must not be used; misuse leads to death. If the pulse is floating and large, applying purgatives is contraindicated (adverse treatment). If the Yang pulse is floating and the Guan pulse is deep and tight, it is named "Zang Jie Bing" (Zang Knotting Disease). If the tongue coating is white and slippery, it is difficult to treat. If there is no alternating chills and fever, and the patient appears unusually quiet with a slippery tongue coating, attacking methods (such as purgation) should not be employed.
Formulas
Guixin San (Cinnamon Heart Powder) [Source: *Shenghui Fang*]: Treats Shi Qi Jie Xiong, characterized by firmness, fullness, and pain in the epigastrium.
Ingredients: Guixin (Cortex Cinnamomi, 1 liang), Gansui (Radix Euphorbiae Kansui, 0.5 liang, baked until slightly yellow), Renshen (Radix Ginseng, 1 liang, radix tip removed), Gualou (Fructus Trichosanthis, 1 piece, seeds used).
Preparation and Administration: Grind the above ingredients into powder. Take 3 qian per dose. Add 3 jujubes to 1 zhongzhan (approx. 200-250ml) of water, decoct until 0.5 zhongzhan remains. Strain the dregs. Take warm, regardless of meal times.
Zhuling San (Polyporus Powder) [Source: *Shenghui Fang*]: Treats Shi Qi Jie Xiong, characterized by fullness, solidity, and stifling sensation in the epigastrium.
Ingredients: Zhuling (Polyporus, 1 liang, black skin removed), Zexie (Rhizoma Alismatis, 1 liang), Guixin (Cortex Cinnamomi, 5 qian), Chifuling (Red Polyporus, 3 fen), Chuan Puxiao (Natrii Sulfas, 3 liang).
Preparation and Administration: Grind the above ingredients into powder. Take 2 qian per dose, mixed with rice soup, regardless of meal times.
Xianxiong Tang (Chest-Sinking Decoction) [Source: *Shenghui Fang*]: Treats Shi Qi Jie Xiong, characterized by firmness in the epigastrium, pain upon pressure, and a deep-slippery pulse.
Ingredients: Gualou (Fructus Trichosanthis, 1 large piece, seeds used), Huanglian (Rhizoma Coptidis, 1 liang, whiskers removed), Banxia (Rhizoma Pinelliae, soaked in hot water seven times to remove slipperiness, 1 liang).
Preparation and Administration: Grind the above ingredients into powder. Take 5 qian per dose. Add 0.5 banfen (approx. 15g) of Shengjiang (Rhizoma Zingiberis Recens) to 1 dazhan (approx. 300ml) of water, decoct until 0.6 dazhan remains. Strain the dregs. Take warm, regardless of meal times.
Binglang Wan (Areca Pill) [Source: *Shenghui Fang*]: Treats Shi Qi Jie Xiong, characterized by stifling sensation and rapid breathing.
Ingredients: Binglang (Semen Arecae, 0.5 liang), Malanhua (Flos Iris Tectorii, 1 fen, lightly stir-fried), Tiantingli (Semen Lepidii et Descurainiae, 0.5 liang, fried between paper until red), Zhuya Zaojiao (Fructus Gleditsiae Sinensis, 0.5 liang, skin removed, roasted until yellow-brown).
Preparation and Administration: Grind the above ingredients into fine powder. Mix with refined honey to form pills the size of Sophora japonica seeds. Take 20 pills per dose, washed down with Zhuye (Bamboo Leaf) decoction, regardless of meal times.
Kushen Wan (Sophora Pill) [Source: *Shenghui Fang*]: Treats Shi Qi Jie Xiong with heat-toxin internal retention.
Ingredients: Kushen (Cortex Sophorae Flavescentis, 5 qian, chopped), Huanglian (Rhizoma Coptidis, 1 liang, whiskers removed), Huangqin (Radix Scutellariae, 1 liang), Chuan Dahuang (Radix et Rhizoma Rhei, 1 liang, chopped and lightly fried), Zhizi Ren (Semen Gardeniae, 5 qian).
Preparation and Administration: Grind the above ingredients into fine powder. Mix with refined honey to form pills the size of Sophora japonica seeds. Take 20 pills per dose, washed down with Zhuye (Bamboo Leaf) decoction, regardless of meal times.
Xianxiong Wan (Chest-Sinking Pill) [Source: *Shenghui Fang*]: Treats Shi Qi Jie Xiong with excess heat internally, deep-firm pulse, pain and fullness in the epigastrium, hardness like stone upon pressure.
Ingredients: Chuan Dahuang (Radix et Rhizoma Rhei, 3 liang, chopped and lightly fried), Tiantingli (Semen Lepidii et Descurainiae, 2 liang, chopped and lightly fried), Chuan Mangxiao (Natrii Sulfas, 2 liang), Xingren (Semen Pruni Armeniacae, 2 liang, soaked in water, skin and tips removed, bran-fried until slightly yellow).
Preparation and Administration: Grind the above ingredients into fine powder. Mix with refined honey to form pills the size of a bullet. Take 1 pill per dose. Mix with 0.5 qian of Gansui powder, 1 small spoon of honey, and 1 zhongzhan of water. Simmer together until 0.7 zhongzhan remains. Warmly dissolve the pill in this liquid. Take regardless of meal times. Stop when bowel movement occurs.
Treats critical cases of seasonal heat-toxin in the chest and diaphragm, near death after 6-7 days. (Also known as Qianjin Zhu Tang, Source: *Shenghui Fang*)
Usage: Take 1 liang of Kushen (Cortex Sophorae Flavescentis), chop and crush. Decoct in 2 large zhan of wine. Strain. Adjust temperature to suit. Take all at once, regardless of time. After ingestion, one should smell the Kushen odor, followed by vomiting bile-like fluid (resembling sheep bile), indicating recovery. Alternative method: Decoct 2 sheng of vinegar until 1.2 he remains. Drink entirely. Vomiting indicates recovery. For Tianxing Du Bing (Epidemic Toxic Disease), only Kushen and vinegar can resolve the toxin; covering warmly to induce sweating also cures.
Another formula for emergency treatment of epidemic vomiting and inability to eat, where food is immediately expelled or diarrhea persists.
Ningxue Tang (Snow-Coagulating Decoction) [Source: *Ren Cun Fang*]: Treats epidemic toxic disease after 7-8 days, with heat knotting in the chest, severe restlessness approaching death.
Usage: Take 1 sheng of Yuanhua (Flos Genkwa). Decoct in 3 sheng of water until 1.5 sheng remains. Soak cloth in the decoction and apply thinly to the chest. Do not exceed three applications. Heat will dissipate, and limbs should remain warm without cold reversal.
Wanjin Wan (Ten-Thousand-Gold Pill) [Source: *Wangshi Boji Fang*]: Treats seasonal diseases, regulates viscera, unblocks the chest and diaphragm, and harmonizes Ying and Wei.
Ingredients: Muxiang (Radix Aucklandiae, 1 liang), Jiangjiang (Rhizoma Zingiberis Preparatum, 1 liang, processed), Dahuang (Radix et Rhizoma Rhei, 1 liang, raw), Chenju Pi (Pericarpium Citri Reticulatae, soaked in water, pith removed, 1 liang), Badou (Semen Crotonis, 1 liang, skin and membrane removed, soaked in cold water overnight, dried, finely ground, or pounded with other herbs).
Preparation and Administration: Fine-grind the five herbs into powder. Form pills with brown sugar, size of Sophora japonica seeds. For patients beyond 3 days post-onset, assess if toxic qi has entered and requires regulation. Take 5 pills with rice soup, regardless of time. If the medicine does not act, drink hot tea to promote action. Pathogens above cause vomiting; pathogens below cause diarrhea. If sweating or persistent vomiting/diarrhea occurs, stop with Huanglian Tang. Dosage adjustments for elderly, children, and varying deficiency/excess conditions. Pregnant women must not take. This pill has life-restoring properties. In any season, if fever is felt, taking this pill to regulate prevents seasonal infection. For frequent spasms occurring at dawn (Wu Geng), also use rice soup for administration.
Treats critical cases of seasonal heat-toxin in the chest and diaphragm, near death after 6-7 days, for emergency rescue.
Usage: Take 1 chicken egg. Boil for 3-5 boils. Remove and soak in water. Swallow while the shell is cooked but the inside remains hot. Effective.