治伤寒痞气，胸满欲死。
桔梗 枳壳（炙去穣各一两）
上锉如米豆大，用水一升半，煎减半。去滓，分二服。伤寒下早，则气上膨胸。世俗即
谓之结胸，多更用巴豆粉、霜腻粉下之。下之十有八七死，此盖泻其下焦。下焦虚，则气愈
上攻胸膈，多致不救。凡胸胀病，只可泻膈。若按之坚硬而痛，此是结胸。胸有水，须用大
黄甘遂辈下之， 胸丸之类是也。若按之不甚硬，亦不痛，此名痞气。上虚气热鼓胀，只可
用黄芩黄连大黄之类化之。尝有人患胸胀已危困，作结胸痞气皆不瘥。文大夫以此汤饮之，
下黄水一升许，遂瘥。予得此法，用之如神。若是痞气，莫不应手而瘥。凡伤寒胸胀，勿问
结胸痞气，但先投此药。若不瘥，然后别下药。缘此汤但行气下膈耳，无他损。又《西晋崔
行功方》，伤寒或下或不下，心中结满，胸胁痞塞，气急厥逆欲绝，心胸高起，手足不得近，
二三日辄死。用泻心大小 胸汤皆不瘥，此当是下后虚逆气已不理。而毒复上攻，气毒相搏，
结于胸
人参 白术 甘草（炙各二两） 干姜（炮一两半） 枳实（十六片麸炒或炙） 茯苓
（二两）
上为末，蜜丸，如弹大。一丸不效再服。予时用此，神速。下喉气即接续，复与之。不
过五六弹丸，胸中豁然矣。用药之速，未尝见此。渴者更加栝蒌二两，下痢者加牡蛎二两。
予以告领军韩康伯，右卫毛仲祖，光禄王道预，台郎顾君苗，著作殷仲堪。并悉用之，咸叹
其应速。于时枳实乃为贵，缘此病由毒攻于内，多类少阴。泄利之后，理应痞结，虽已泄利，
毒尚未除。毒与气争，凝结于胸。时或不利，而毒已入胃。胃中不通，毒必上冲。或气先不
理，或上焦痰实，共相冲结，复成此患。大抵毒之与气，相干不宣，关津壅遏，途径不通，
故泻心疗满而不疗气，虽复服之，其瘥莫由，疗毒理结，莫过理中丸，解毒通气，痞自消释
，然干姜性热，故减其分。茯苓通津，栝蒌除渴。牡蛎止痢，谨审其宜，无不得矣。家人黄
珍者，得病如上。其弟扶就叔尚书乞药。余曰，可与理中丸，坐中数客皆疑不可，予自决与，
于箱中取一弹丸与之，竺法大调余曰，此人不活，君微有缘矣。与时合暝许比至，三筹扶又
来，便叩头自搏，四座愕然，谓其更剧，叔问何如，扶答∶向药一服便觉大佳，更复乞耳，
予谓竺，向答曰上人不忧作缘，但恐夜更来乞，失人眠耳，果尔如何。余复与数弹丸，明日
便愈，遂至今用之。护军司法刘元宝外家病，亦如此。叔复与之一服，如鸡子一丸便瘥。叔知
故文武，遂多蒙救济，伤寒难疗，故详记焉。此行功自叙也。余以此丸，与枳壳汤兼服，理
无不验，理中丸所用枳实。只是枳壳，古人只谓之枳实，后人方别出枳壳一条。
治疗伤寒导致的痞气证，表现为胸部胀满，感觉快要死去。
桔梗、枳壳（经炙法处理并去除瓤，各一两）
将上述药材切碎成米豆大小，用水一升半，煎煮至药液减半。滤去药渣，分两次服用。伤寒病如果过早使用泻下法，会导致气机上逆，膨胀于胸部。世俗之人便称之为“结胸”，并且常常再用巴豆粉、轻粉等峻下药来攻下。这样用药，十有八九会导致死亡，这是因为泻下损伤了下焦。下焦虚弱，气机就会更加向上冲逆攻向胸膈，大多导致无法救治。凡是胸部胀满的病，只能清泻膈部的气滞。如果按压胸部感觉坚硬且疼痛，这才是“结胸”。胸中有水饮，必须用大黄、甘遂之类的药物攻下，如大陷胸丸之类就是这种用法。如果按压时并不很硬，也不疼痛，这叫做“痞气”。这是上焦虚损、热气鼓动引起的胀满，只能用黄芩、黄连、大黄这类药物来化解。曾经有人患胸胀病，病情危重，无论是按结胸治还是按痞气治都没有好转。文大夫用这个汤剂给他服用，排出约一升黄水后，病就好了。我得到这个方法，用起来像神一样灵验。如果是痞气，没有不立刻痊愈的。凡是伤寒引起的胸胀，不要管它是结胸还是痞气，先投用此药。如果不好转，然后再选用其他药物。因为这个汤剂只是行气、降膈，没有其他损害。另外，《西晋崔行功方》记载：伤寒病或者用了泻下法，或者没用，心中结塞满闷，胸胁痞塞不通，气急厥逆几乎要断气，心胸高高隆起，手脚不能触碰，两三天内就会死亡。用泻心汤类或大陷胸汤都无效，这应当是泻下后正气虚逆，气机已经紊乱。而毒邪再次上攻，气与毒相互搏结，郁结在胸部。
人参、白术、甘草（经炙法处理，各二两）、干姜（炮制，一两半）、枳实（十六片，麸炒或炙）、茯苓（二两）
将上述药材研为细末，用蜂蜜制成丸子，大小如弹丸。服一丸无效再服。我当时使用这个方法，效果神速。药一下喉，气机就接续恢复，再给予服用。不过五六颗弹丸，胸中豁然开朗了。用药见效之快，从未见过。口渴的人加栝蒌二两，腹泻的人加牡蛎二两。我把这个方法告诉了领军韩康伯、右卫毛仲祖、光禄王道预、台郎顾君苗、著作殷仲堪。他们都使用了，都感叹反应迅速。当时枳实因此变得珍贵，因为这种病是由于毒邪攻入体内，多类似于少阴病。泄利之后，理应出现痞结，虽然已经泄利，但毒邪尚未清除。毒邪与正气相争，凝结在胸部。有时虽然不再腹泻，但毒邪已进入胃中。胃中气机不通，毒邪必然向上冲逆。或者是气机先已紊乱，或者是上焦有痰实，共同冲撞凝结，又形成这种病患。大体来说，毒邪与气机相互干扰，宣通不畅，关津壅塞遏止，途径不通，所以单用泻心汤治疗满闷而不能调理气机，即使服用，也无法痊愈。治疗毒邪、理顺结滞，没有比理中丸更好的了，它能解毒通气，痞气自然消散。然而干姜性热，所以减少其用量。茯苓能通利津液，栝蒌能消除口渴，牡蛎能止住痢疾，谨慎审察适宜的情况，就没有不得到疗效的了。我的家人黄珍，得了上面描述的病。他的弟弟扶着去找叔尚书求药。我说，可以给他理中丸，座中的几位客人都怀疑不行，我自己决定给他，从箱子里取了一颗弹丸大小的药给他。竺法大嘲笑我说，这个人活不了了，你稍微有点缘分罢了。时间快到傍晚时，黄珍的弟弟又来了，就叩头自打耳光，四座的人都愕然，以为他病情更重了。叔尚书问怎么样，弟弟回答说：刚才那药吃下去就觉得好多了，再来求药。我对竺法大说，刚才的回答说上人不用担心结缘，只怕晚上再来求药，耽误别人睡觉罢了，果真如此怎么办？我又给了几颗弹丸大小的药，第二天就好了，于是到现在还在使用。护军司法刘元宝的外家亲属生病，也是这样。叔尚书又给了一服，像鸡蛋大的一颗药丸就好了。叔尚书知道以前的文武官员，因此多蒙受救济，伤寒难治，所以详细记录下来。这是崔行功自己的叙述。我用这个丸药，配合枳壳汤一起服用，道理上没有不验证的。理中丸中所用的枳实，其实就是枳壳，古人只叫它枳实，后人方才把枳壳单独列出一条。
Treats *Shanghan* (Cold Damage) leading to *Pi Qi* (Stagnant Qi Syndrome), characterized by chest fullness and a sensation of impending death.
Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus, roasted and pith removed, each 1 liang).
Crush the above herbs to the size of rice or beans. Use 1.5 sheng of water, decoct until reduced by half. Strain the dregs, and divide into two doses for administration. If purgatives are used too early in *Shanghan*, qi rebels upward, causing distension in the chest. The common people call this *Jie Xiong* (Chest Binding), and often administer harsh purgatives like Badou powder (Crotonis Semen) or Qingfen (Calomel) to purge. This approach leads to death in eight or nine out of ten cases, as it damages the Lower Jiao (Lower Burner). When the Lower Jiao is deficient, qi attacks the chest and diaphragm even more fiercely, often resulting in untreatable conditions. For diseases of chest distension, only the diaphragm should be purged. If palpation reveals hardness and pain, this is indeed *Jie Xiong*. If there is fluid retention in the chest, one must use strong purgatives such as Dahuang (Rhei Radix et Rhizoma) and Gansui (Kansui Radix), as seen in formulas like Daxion Wan. If palpation reveals no significant hardness or pain, it is named *Pi Qi*. This condition arises from upper deficiency and heat steaming causing distension; it can only be resolved with herbs like Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Dahuang. Once, a patient suffered from severe chest distension, critically ill, and neither treatment for *Jie Xiong* nor *Pi Qi* was effective. Dr. Wen administered this decoction to him, after which he excreted about one sheng of yellow fluid, and the illness resolved. I adopted this method and found it miraculous. For *Pi Qi*, recovery is immediate upon administration. In all cases of *Shanghan*-induced chest distension, regardless of whether it is *Jie Xiong* or *Pi Qi*, administer this medicine first. If there is no improvement, then select other medications. This decoction merely moves qi and descends it through the diaphragm, causing no other harm. Furthermore, the *Xi Jin Cui Xinggong Fang* records: In *Shanghan*, whether purged or not, if there is central knotting and fullness, chest and hypochondriac obstruction,急促 breathing, syncope almost reaching extremity, high elevation of the heart and chest, and inability to touch the limbs, death occurs within two or three days. Treatments using Xiexin Tang (Gastrodia and Rhubarb Decoction variants) or Daxion Tang (Major Chest Binding Decoction) fail. This is likely due to post-purgative deficiency and rebellious qi, where the pathogenic toxin attacks upward again. Qi and toxin struggle and knot in the chest.
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Licorice Radix et Rhizoma, roasted, each 2 liang), Ganjiang (Zingiberis Rhizoma, processed, 1.5 liang), Zhishi (Aurantii Fructus Immaturus, sixteen slices, bran-fried or roasted), Fuling (Poria, 2 liang).
Grind the above into powder, mix with honey, and form pills the size of bird eggs. If one pill is ineffective, take another. When I used this method, the effect was swift. Upon swallowing, qi connection is restored; administer again. Within five or six pills, the chest becomes clear and open. I have never seen medication act so quickly. For those with thirst, add Gualou (Trichosanthis Radix) 2 liang; for those with dysentery, add Muli (Ostreae Concha) 2 liang. I shared this method with Han Kangbo (Commander-in-Chief), Mao Zhongzu (Right Guard), Wang Daoyu (Guanglu), Gu Junmiao (Palace Attendant), and Yin Zhengan (Historiographer). All used it and marveled at its rapid response. At that time, Zhishi became precious because this disease stems from internal toxin attack, resembling Shaoyin (Lesser Yin) syndrome. After diarrhea, *Pi Jie* (Stagnant Knotting) is expected; although diarrhea has occurred, the toxin remains. Toxin and healthy qi contend, knotting in the chest. Sometimes diarrhea ceases, but the toxin enters the stomach. Stomach qi fails to circulate, forcing toxin to rush upward. Or, qi is initially disordered, or phlegm-solid exists in the Upper Jiao, colliding and knotting together to cause this affliction. Generally, when toxin and qi interfere with each other, circulation is obstructed, and pathways blocked. Thus, Xiexin Tang treats fullness but does not regulate qi; even if taken, cure is unlikely. To treat toxin and resolve stagnation, Lizhong Wan (Regulate the Middle Pill) is unsurpassed; it detoxifies and unblocks qi, allowing *Pi* to dissipate naturally. However, Ganjiang is hot in nature, so its dosage is reduced. Fuling promotes fluid metabolism, Gualou relieves thirst, and Muli stops dysentery. Carefully assessing suitability ensures efficacy. My family member Huang Zhen suffered from the aforementioned illness. His brother sought medicine from Uncle Shangshu. I said, "Give him Lizhong Wan." Several guests doubted this. I decided to give it myself, taking an egg-sized pill from the box and giving it to him. Zhu Fada mocked me, saying, "This person will not survive; you have slight affinity with him." Near dusk, the brother returned, kowtowing and slapping himself. The four guests were startled, thinking his condition worsened. Uncle Shangshu asked how he was. The brother replied, "After taking the medicine once, I felt much better; I beg for more." I told Zhu Fada, "The reply suggests the Master need not worry about forming karma, but fears the patient will come back at night and disturb sleep. What if he comes?" I gave several more pills. He recovered the next day, and this method has been used ever since. Liu Yuanbao (Judicial Officer of the Protector General's Office) had relatives fall ill similarly. Uncle Shangshu gave one dose; an egg-sized pill cured him. Uncle Shangshu knew former civil and military officials, thereby saving many. *Shanghan* is difficult to treat, so I recorded this in detail. This is Cui Xinggong's own account. I use this pill in conjunction with Zhike Tang, and the rationale is invariably verified. The Zhishi used in Lizhong Wan is actually Zhike. Ancients called it Zhishi; later generations separated Zhike into a distinct entry.