浊气在阳，乱于胸中，则 满闭塞，大便不通。夏月宜少加酒洗黄柏大苦寒之味，
冬月宜加吴茱萸大辛苦热之药以从权，乃随时用药，以泄浊气之不降也。借用大寒之气于甘
味中，故曰甘寒泻热火也。亦须用发散寒气，辛温之剂多，黄柏少也。
清气在阴者，乃人之脾胃气衰，不能升发阳气，故用升麻、柴胡助辛甘之味，以引元气
之升，不令飧泄也。
堵塞咽喉，阳气不得出者曰塞；阴气不得下降者曰噎。夫噎塞、迎逆于咽喉胸膈之间，
令诸经不行，则口开、目瞪、气欲绝。当先用辛甘气味俱阳之药，引胃气以治其本，加堵塞
之药以泻其标也。寒月阴气大助阴邪于外，于正药内加吴茱萸，大热大辛苦之味，以泻阴
寒之气。暑月阳盛，则于正药中加青皮、陈皮、益智、黄柏，散寒气，泻阴火之上逆；或以
消痞丸合滋肾丸。滋肾丸者，黄柏、知母，微加肉桂，三味是也。或更以黄连别作丸，二药
七八十丸，空心约宿食消尽服之，待少时，以美食压之，不令胃中停留也。
如食少不饥，加炒曲；如食已心下痞，别服橘皮枳术丸；如脉弦，四肢满闭，便难而心
下痞，加甘草、黄连、柴胡；如腹中气上逆者，是冲脉逆也，加黄柏三分，黄连一分半以泄
之；如大便秘燥，心下痞，加黄连、桃仁，少加大黄、当归身；如心下痞，夯闷者，加白芍
药、黄连；如心下痞，腹胀，加五味子、白芍药、缩砂仁；如天寒，少加干姜或中桂；如心
下痞，中寒者，加附子、黄连；如心下痞，呕逆者，加黄连、生姜、橘皮；如冬月，不加黄
连，少入丁香、藿香叶；如口干嗌干，加五味子、葛根；如胁下急或痛甚，俱加柴胡、甘
草；如胸中满闷郁郁然，加橘红、青皮，木香少许；如头痛有痰，沉重懒倦者，乃太阴痰厥
头痛，加半夏五分，生姜二分或三分；如腹中或周身间有刺痛，皆血涩不足，加当归身；如
哕，加五味子多，益智少；如食不下，乃胸中胃上有寒，或气涩滞，加青皮、陈皮、木香，
此三味为定法；如冬天，加益智仁、草豆蔻仁；如夏月，少用，更加黄连；如秋月，气涩滞
，食不下，更加槟榔、草豆蔻仁、缩砂仁，或少加白豆蔻仁；如三春之月，食不下，亦用青
皮少，陈皮多，更加风药，以退其寒覆其上；如初春犹寒，更少加辛热，以补春气之不足，
以为风药之佐，益智、草豆蔻皆可也；如脉弦者，见风动之证，以风药通之；如脉涩，觉
气涩滞者，加当归身、天门冬、木香、青皮、陈皮。有寒者，加桂枝、黄 ；如胸中窒
塞，或气闭闷乱者，肺气涩滞而不行，宜破滞气，青皮、陈皮，少加木香、槟榔；如冬月，
加吴茱萸、人参，或胸中窒塞，闭闷不通者，为外寒所遏，使呼出之气不得伸故也，必
寸口脉弦，或微紧，乃胸中大寒也，若加之以舌上有白苔滑者，乃丹田有热，胸中有寒明矣
。丹田有热者，必尻臀冷，前阴间冷汗，两丸冷，是邪气乘其本，而正气走于经脉中也。遇
寒，则必作阴阴而痛，以此辨丹田中伏火也。加黄柏、生地黄，勿误作寒证治之。如秋冬天
气寒凉而腹痛者，加半夏，或益智，或草豆蔻之类；如发热，或扪之而肌表热者，此表证也
，只服补中益气汤一二服，亦能得微汗则凉矣；如脚膝痿软，行步乏力，或疼痛，乃肾肝中
伏湿热，少加黄柏，空心服之，不愈，更增黄柏，加汉防己五分，则脚膝中气力如故也；
如多唾，或唾白沫者，胃口上停寒也，加益智仁；如少气不足以息者，服正药二三服；气犹
短促者，为膈上及表间有寒所遏，当引阳气上伸，加羌活、独活， 本最少，升麻多，柴胡
次之，黄 加倍。
浊气滞留于阳分，扰乱胸中，就会导致胸脘痞满闭塞，大便不通。夏季月份适宜在方剂中少量加入经酒洗过的黄柏，因其味大苦性大寒；冬季月份适宜加入吴茱萸，因其味大辛、性大热，这是权宜之计，属于随季节变化用药，目的是泄降不降的浊气。借用大寒之气的黄柏配合甘味药，所以称为“甘寒泻火”法。同时也必须使用发散寒气、性质辛温的药物为主，黄柏用量较少。
清气本应上升却滞留于阴分，这是由于人的脾胃之气衰弱，不能升发阳气，因此使用升麻、柴胡辅助辛甘味的药物，以引导元气上升，防止出现完谷不化的泄泻。
咽喉堵塞感，阳气不得外达称为“塞”；阴气不得下降称为“噎”。所谓噎塞，是气机逆乱于咽喉胸膈之间，导致各条经脉气血运行受阻，从而出现口张、眼瞪、气息将绝的症状。应当先使用气味俱属阳的辛甘药物，引导胃气以治其根本，再添加疏通堵塞的药物以治其标。寒冷月份，外界阴气助长体内的阴邪，应在主药中加入吴茱萸，利用其大热、大辛、大苦的味道，来泻除阴寒之气。暑热月份，阳气旺盛，则在主药中加入青皮、陈皮、益智仁、黄柏，以散寒气、泻上逆的阴火；或者使用消痞丸合滋肾丸。滋肾丸由黄柏、知母组成，微量加入肉桂，共三味药。或者另外用黄连单独制成丸药，每次服用七八十丸，空腹待宿食消化完后服用，过一会儿，用美味的食物压住药力，不让药力在胃中停留过久。
如果饮食减少且不感到饥饿，加入炒神曲；如果进食后心下痞满，另服橘皮枳术丸；如果脉象弦，四肢胀满闭塞，大便困难且心下痞满，加入甘草、黄连、柴胡；如果腹中有气向上冲逆，这是冲脉之气上逆，加入三分黄柏、一分半黄连以泄降之；如果大便秘结干燥，心下痞满，加入黄连、桃仁，少量加入大黄、当归身；如果心下痞满，伴有沉重闷胀感，加入白芍药、黄连；如果心下痞满，伴有腹胀，加入五味子、白芍药、缩砂仁；如果天气寒冷，少量加入干姜或肉桂；如果心下痞满，属于中焦有寒，加入附子、黄连；如果心下痞满，伴有呕吐逆气，加入黄连、生姜、橘皮；如果是冬季月份，不加黄连，少量加入丁香、藿香叶；如果口干、咽干，加入五味子、葛根；如果胁下拘急或疼痛严重，均加入柴胡、甘草；如果胸中痞满郁闷，加入橘红、青皮，少许木香；如果头痛且有痰湿，感觉头重懒倦，这是太阴痰厥头痛，加入半夏五分，生姜二分或三分；如果腹中或周身有刺痛，都是血行涩滞不足所致，加入当归身；如果出现呃逆（哕），加入多量五味子，少量益智仁；如果食物难以下咽，这是胸中胃上有寒，或者气机涩滞，加入青皮、陈皮、木香，这三味药是固定用法；如果是冬天，加入益智仁、草豆蔻仁；如果是夏天，用量要少，再加黄连；如果是秋天，气机涩滞，食物难以下咽，再加槟榔、草豆蔻仁、缩砂仁，或少量加入白豆蔻仁；如果是春季三个月，食物难以下咽，也使用少量青皮，多量陈皮，再加风药，以退去覆盖在上方的寒气；如果初春仍然寒冷，更少加辛热药物，以补充春气的不足，作为风药的佐使，益智仁、草豆蔻都可以；如果脉象弦，出现风动的证候，用风药通利；如果脉象涩，感觉气机涩滞，加入当归身、天门冬、木香、青皮、陈皮。如果有寒，加入桂枝、黄芩；如果胸中窒塞，或者气闭闷乱，这是肺气涩滞而不运行，应当破滞气，使用青皮、陈皮，少量加入木香、槟榔；如果是冬季月份，加入吴茱萸、人参；或者胸中窒塞，闭闷不通，这是因为被外寒遏制，使得呼出的气息无法伸展的缘故，此时寸口脉一定呈现弦象，或者微紧，这是胸中大寒的表现。如果再加上舌上有白苔且滑润，那么丹田有热、胸中有寒的情况就明确了。丹田有热的人，必然尻臀冷，前阴间出冷汗，睾丸冷，这是邪气乘虚侵袭根本，而正气走窜于经脉中。遇到寒冷，一定会产生隐隐作痛，以此辨别丹田中潜伏的火邪。加入黄柏、生地黄，不要误当作寒证治疗。如果秋冬天气寒凉而腹痛，加入半夏，或者益智仁，或者草豆蔻之类；如果发热，或者触摸肌肤表面发热，这是表证，只服用补中益气汤一两服，也能得到微汗从而凉爽；如果脚膝痿软无力，行走乏力，或者疼痛，这是肝肾中潜伏湿热，少量加入黄柏，空腹服用，如果不愈，增加黄柏用量，加入汉防己五分，那么脚膝中的气力就会恢复如常；如果多唾，或者吐白沫，这是胃口上方停聚寒邪，加入益智仁；如果气短不足以呼吸，服用主药两三服；气息仍然短促，是因为膈上及体表之间有寒邪遏制，应当引导阳气向上伸展，加入羌活、独活，藁本最少，升麻最多，柴胡次之，黄芩加倍。
When turbid qi stagnates in the Yang aspect and disturbs the chest, it leads to fullness and obstruction in the chest and epigastrium, along with constipation. In summer months, it is appropriate to add a small amount of Huangbai (Phellodendri Cortex) washed with wine, which has a bitter taste and cold nature; in winter months, it is appropriate to add Wuzhuyu (Evodiae Fructus), which has a pungent and hot nature. This is a flexible approach, adjusting medication according to the season, to drain the descending turbid qi. Borrowing the great cold property of Huangbai within sweet-flavored medicines is called "Sweet-Cold Draining Fire." However, one must also use predominantly pungent-warm agents to disperse cold qi, with a smaller dose of Huangbai.
When clear qi remains in the Yin aspect, it is due to the decline of Spleen-Stomach qi, which fails to ascend and generate Yang qi. Therefore, Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) are used to assist pungent-sweet flavors to guide Yuanqi (Original Qi) upward, preventing undigested diarrhea (Sunxie).
Obstruction in the throat where Yang qi cannot exit is called "Se" (Blockage); where Yin qi cannot descend is called "Ye" (Choking). Ye-Se refers to counterflow obstructing the throat and chest-diaphragm area, causing the meridians to cease functioning, resulting in an open mouth, staring eyes, and impending cessation of breath. One should first use pungent-sweet medicines with Yang properties to guide Stomach qi to treat the root, adding unblocking agents to treat the branch. In cold months, external Yin qi aids internal Yin pathogens; thus, Wuzhuyu (Evodiae Fructus), with its great heat, pungency, and bitterness, is added to the principal medicine to drain Yin-cold qi. In hot months, when Yang is abundant, Qingpi (Aurantii Fructus Pericarpium), Chenpi (Citri Reticulatae Pericarpium), Yizhi (Alpiniae Oxyphyllae Fructus), and Huangbai (Phellodendri Cortex) are added to the principal medicine to disperse cold qi and drain counterflow Yin-fire; alternatively, Xiaopi Wan (Dispel Fullness Pill) combined with Zishen Wan (Nourish Kidney Pill) may be used. Zishen Wan consists of Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), and a trace of Rougui (Cinnamomi Cortex), totaling three ingredients. Alternatively, Huanglian (Coptidis Rhizoma) can be made into pills separately; take 70-80 pills on an empty stomach after residual food has digested, wait a while, then consume delicious food to prevent the medicine from lingering in the Stomach.
If food intake is low and there is no hunger, add Chaoqu (Fried Medicated Leaven). If epigastric fullness occurs after eating, take Jupi Zhizhu Wan (Tangerine Peel and Atractylodes Macrocephala Pill) separately. If the pulse is wiry, limbs are full and closed, defecation is difficult, and there is epigastric fullness, add Gancao (Glycyrrhizae Radix et Rhizoma), Huanglian (Coptidis Rhizoma), and Chaihu (Bupleuri Radix). If qi rebels upward in the abdomen, this is rebellion of the Chong Mai (Penetrating Vessel); add 3 fen of Huangbai (Phellodendri Cortex) and 1.5 fen of Huanglian (Coptidis Rhizoma) to drain it. If feces are dry and hard with epigastric fullness, add Huanglian (Coptidis Rhizoma) and Taoren (Persicae Semen), with a small amount of Dahuang (Rhei Radix et Rhizoma) and Dangguishen (Angelicae Sinensis Radix). If there is epigastric fullness with heavy oppression, add Baishao (Paeoniae Radix Alba) and Huanglian (Coptidis Rhizoma). If there is epigastric fullness with abdominal distension, add Wuweizi (Schisandrae Fructus), Baishao (Paeoniae Radix Alba), and Suosharen (Amomi Fructus). If the weather is cold, add a small amount of Ganjiang (Zingiberis Rhizoma) or Zhonggui (Cinnamomi Ramulus). If there is epigastric fullness due to middle Jiao cold, add Fuzi (Aconiti Lateralis Radix Praeparata) and Huanglian (Coptidis Rhizoma). If there is epigastric fullness with vomiting and rebellion, add Huanglian (Coptidis Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), and Jupi (Citri Reticulatae Pericarpium). In winter months, do not add Huanglian; instead, add a small amount of Dingxiang (Eugenol) and Huoxiangye (Agastaches Herba). If there is dryness of the mouth and throat, add Wuweizi (Schisandrae Fructus) and Gegen (Puerariae Lobatae Radix). If the hypochondrium is tight or painful, add Chaihu (Bupleuri Radix) and Gancao (Glycyrrhizae Radix et Rhizoma). If there is chest fullness and depression, add Juhong (Citri Reticulatae Pericarpium Rubrum), Qingpi (Aurantii Fructus Pericarpium), and a little Muxiang (Aucklandiae Radix). If headache is accompanied by phlegm, heaviness, and lassitude, this is Taiyin Phlegm-Jue Headache; add Banxia (Pinelliae Rhizoma) 5 fen, and Shengjiang (Zingiberis Rhizoma Recens) 2-3 fen. If there are stabbing pains in the abdomen or throughout the body, this indicates blood stasis and insufficiency; add Dangguishen (Angelicae Sinensis Radix). If there is hiccups (Yue), add a large amount of Wuweizi (Schisandrae Fructus) and a small amount of Yizhi (Alpiniae Oxyphyllae Fructus). If food cannot go down, this is cold in the chest and Stomach, or qi stagnation; add Qingpi (Aurantii Fructus Pericarpium), Chenpi (Citri Reticulatae Pericarpium), and Muxiang (Aucklandiae Radix); these three are a fixed method. In winter, add Yizhiren (Alpiniae Oxyphyllae Fructus) and Caodoukou (Myristicae Semen). In summer, use less and add Huanglian (Coptidis Rhizoma). In autumn, if qi is stagnant and food cannot go down, add Binglang (Arecae Semen), Caodoukou (Myristicae Semen), and Suosharen (Amomi Fructus), or a little Baidoukou (Cardamomi Fructus). In the spring months, if food cannot go down, use a little Qingpi (Aurantii Fructus Pericarpium) and more Chenpi (Citri Reticulatae Pericarpium), plus wind-dispersing herbs to dispel cold covering the upper body. If early spring is still cold, add a little pungent-hot herb to supplement the deficiency of Spring qi, serving as an assistant to wind herbs; Yizhiren (Alpiniae Oxyphyllae Fructus) and Caodoukou (Myristicae Semen) are suitable. If the pulse is wiry, indicating wind-moving symptoms, use wind herbs to unblock. If the pulse is choppy and qi feels stagnant, add Dangguishen (Angelicae Sinensis Radix), Tianmendong (Asparagi Radix), Muxiang (Aucklandiae Radix), Qingpi (Aurantii Fructus Pericarpium), and Chenpi (Citri Reticulatae Pericarpium). If there is cold, add Guizhi (Cinnamomi Ramulus) and Huangqin (Scutellariae Radix). If there is chest obstruction or qi closure with confusion, this is Lung qi stagnation and non-flow; break the stagnant qi using Qingpi (Aurantii Fructus Pericarpium) and Chenpi (Citri Reticulatae Pericarpium), with a little Muxiang (Aucklandiae Radix) and Binglang (Arecae Semen). In winter months, add Wuzhuyu (Evodiae Fructus) and Renshen (Ginseng Radix et Rhizoma). Or, if chest obstruction and closure occur due to external cold suppressing exhaled qi, the Cun Kou (Radial Pulse at the wrist) will be wiry or slightly tight, indicating great cold in the chest. If accompanied by a white slippery coating on the tongue, it confirms Heat in the Dantian and Cold in the Chest. Those with Heat in the Dantian must have cold buttocks, cold sweat in the anterior yin, and cold testicles; this is pathogenic qi attacking the root while Zhengqi (Upright Qi) moves into the meridians. Upon exposure to cold, dull pain will occur; this distinguishes latent fire in the Dantian. Add Huangbai (Phellodendri Cortex) and Shengdihuang (Rehmanniae Radix); do not mistakenly treat it as a Cold syndrome. If abdominal pain occurs during the cold weather of autumn and winter, add Banxia (Pinelliae Rhizoma), or Yizhi (Alpiniae Oxyphyllae Fructus), or Caodoukou (Myristicae Semen). If there is fever, or skin surface heat upon palpation, this is a Exterior Syndrome; take Buchong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) one or two doses, and slight sweating will lead to cooling. If legs and knees are flaccid, walking is weak or painful, this is latent Damp-Heat in Liver and Kidney; add a small amount of Huangbai (Phellodendri Cortex) taken on an empty stomach. If not cured, increase Huangbai and add Hanfangji (Stephaniae Tetrandrae Radix) 5 fen, restoring strength to the legs and knees. If there is excessive salivation or spitting of white foam, this is cold stagnating above the Stomach opening; add Yizhiren (Alpiniae Oxyphyllae Fructus). If there is shortness of breath and insufficient respiration, take the principal medicine two or three doses. If breathing remains short, it is because Cold in the Diaphragm and Exterior suppresses the Qi; guide Yang qi upward by adding Qianghuo (Notopterygii Rhizoma et Radix) and Duhuo (Angelicae Pubescentis Radix), with GaoBen (Ligustici Rhizoma et Radix) in the smallest amount, Shengma (Cimicifugae Rhizoma) in the largest amount, Chaihu (Bupleuri Radix) next, and Huangqin (Scutellariae Radix) doubled.