阳明病，脉迟，虽汗出不恶寒者，其身必重，短气，腹满而喘。有潮热者，此外欲解，可攻里也。手足澉然汗出者，此大便已也，大承气汤主之。若汗多，微发热恶寒者，外未解也，一法与桂枝汤其热不潮，未可与承气汤，若腹大满不通者，可与小承气汤，微和胃气，勿令至大泄下。

大承气汤方

大黄   四两，酒洗

厚朴   半斤，炙，去皮

枳实   五枚，炙

芒硝   三合

上四味，以水一斗，先煮二物，取五升，去滓，内大黄，更煮取二升，去滓，内芒硝，更上微火一两沸，分温再服，得下，余勿服。

小承气汤方

大黄   四两，酒洗

厚朴   二两，炙，去皮

枳实   三枚大者，炙

上三味，以水四升，煮取一升二合，去滓，分温二服；初服汤，当更衣，不尔者，尽饮之；若更衣者，勿服之。

Greater Yang syndrome, slow pulse: The following symptoms and signs will indicate that the Exterior syndrome is disappearing and a purgative can be adopted to eliminate the Interior syndrome: The patient has perspiration without chills, feels heavy in movement, is short of breath, and has dyspnea, abdominal distention and a tide-fever. When the patient sweats all over the bands and feet, it can be diagnosed that constipation is taking shape. Decoction of Greater Chengqi can be adopted. If there is much perspiration with a slight fever and a chill, it will indicate that the Exterior syndrome has not yet gone. (One edition says the therapy is the adoption of Decoction of Ramulus Cinnamomi). Before a tide-fever is observed, Decoction of Chengqi should not be given. Decoction of Lesser

Chengqi is a curative for the syndrome with a severe case of abdominal distention and no stool. This is to harmonize the Stomach Vital Energy, rather than an acute drastic, which would cause repeated diarrhea.

Decoction of Greater Chengqi

(Da Chengqi Tang):

Radix et Rhizoma Rhei            4 liang

Cortex Magnoliae Officinalis  0.5 jin

Fructus Aurantii Immaturus    5 pcs.

Natrii Sulfas                            3 ge

Stew Cortex Magnoliae Officinalis and Fructus Aurantii Immaturus in one dou of water till five sheng are left. Filter the decoction and put Radix et Rhizoma Rhei into it and stew till two sheng are left. Filter the decoction and put Natrii Sulfas into the decoction and stew for a while.Take the medicine when lukewarm in two doses. When defecation occurs, stop taking the rest of the decoction.

Decoction of Lesser Chengqi

(Xiao Chengqi Tang)

Radix et Rhizoma Rhei                           4 liang

Cortex Magnoliae Officinalis                  2 liang

Fructus Aurantii Immaturus (big ones)   3 pcs.

Stew the above drugs in four sheng of water till one sheng two ge are left. Filter the decoction and take it in two doses. After the first dose, the patent should defecate. If not, finish the rest of the dose. When defecation occurs, stop taking the decoction.

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