病发于阳，而反下之，热入，因作结胸，病发于阴，而反下之，因作痞也;所以成结胸者，以下之太早故也。结胸者，项亦强，如柔痉状，下之则和，宜大陷胸丸。

大陷胸丸方

大黄   半斤

葶苈   半升，煞

芒硝   半升

杏仁   半升，去皮尖，熬黑

上四味，捣筛二味，内杏仁、芒硝，合研如脂，和散，取如弹丸一枚，别捣甘遂末一钱ヒ，白蜜二合，水二升，煮取一升，温顿服之，一宿乃下；如不下，更服，取下为效；禁如药法。

If a purgative is given to dispel the syndrome originating from Yang, pathogenic Heat will invade the Interior to form Blocked-up Chest. In case a purgative is given as a remedy for the syndrome originating from Yin, Vital-Energy Stagnancy (Pi) will take shape. The reason for the formation of the Blocked-up Chest is that a purgative was adopted too early. One of the symptoms of a Blocked-up Chest is stiffness in the neck, like Roujing. A dose of purgative, Greater Xianxiang Pill, will serve as a curative.

Greater Xianxiong Pill

(Da Xianxiong Wan):

Radix et Rhizoma Rhei                                  0.5 jin

Semen Lepidii seu Descurainiae                   0.5 sheng

Natrii Sulfas                                                   0.5 sheng

Semen Armeniacae Amarum                         0.5 sheng

Radix Euphorbiae Kansui (used separately)   1 qianbi

Pound the above drugs into powder and make pills as big as a bullet (approximately ten grams) each. Stew one pill together with one qianbi (equals 1.5 grams) Radix Euphorbiae Kansui and Honey (Mel) two ge in two sheng of water till one sheng is left. Take the decoction when lukewarm. The syndrome will be eliminated overnight. If it is not efficacious, take another dose till the syndrome is gone.

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