升麻（五分） 柴胡（五分） 当归（二钱） 陈皮（一钱） 人参（一
钱） 白术（钱半） 炙草（一钱） 黄 （二钱半炙） 山栀（一钱） 川乌（一钱） 煨姜（一钱） 大
枣（三枚）
按∶上原方主治凡六经内伤外感。
内伤外感者，言由内伤以致外感也。盖以邪之所凑，其气必虚，东垣故立此方以补伤寒书之所未及，
非补虚方也。今感症家多不敢用，而以为调理补虚服食之药则谬矣。调理补虚及通其意而转用者耳。
及暑月劳倦发热，暑则气耗，劳则气伤。发热而在于暑月，且因劳倦，自非甘温不能。彼肆用藿香、
滑石等，为暑月发热必需之剂，只在不明此义耳。
或汗出不止，卫外之阳虚，则腠理不固矣。
俱用本方加白芍一钱（须再加五味，乃合肺主皮毛之义）。
痢疾腹痛已除，泻犹未已，是胃气下陷也。必尚兼后重，第圊后随减耳，加酒炒白芍三钱。
疟疾发久，形体 羸，无论六经，皆当加半夏一钱（合六君也）。
即有外感，不过加黄芩一钱（则合小柴胡矣）。
凡妇女胎前气虚，以致胎动不安，小产崩漏，皆因气虚不能升举故也。
或产后血虚发热。凡血虚发热者，其舌必干；气虚发热者，其舌必滑。然既在产后，则不但血虚，即其
气未有不虚者。盖当其临盆之际，为产妇者，若非全副精神、浑身力气，努力责以推送之，则胞胎如何下地？
迨至胞胎下地，则所去之血固多，之后能不伤其气乎？况血虚则气无所附，宁不与之俱虚乎？兹以产后发热，
专责血虚，殊有漏义。而症乃列于本方之下 是知有形之血不能速生，无形之气所当急固。阳旺阴生，其意固
自包举也。第不明言其意，则产后之血虚，人习闻之；而产后之气虚，人皆忽之，故特表而出之。
俱加酒炒白芍二钱（气味酸寒，恐伐生气，故用酒炒）。
此方凡属中宫虚损，病后调摄，无不相宜。倪氏曰∶“七情内伤，脾胃先病，治先补土，此方主之”。
然内伤脾胃，须有分别。如饥饱劳役，饮食生冷，内伤脾胃而病者，自当主以此方。若由思虑郁怒，七
情内伤，而脾胃先病者，则于本方尚隔一膜，不若归脾为的当也。
凡舌见赤色而滑润，属心脏阳虚气弱者，济生归脾汤加丹皮、肉桂主之。
升麻（五分） 柴胡（五分） 当归（二钱） 陈皮（一钱） 人参（一钱） 白术（钱半） 炙甘草（一钱） 黄芪（二钱半，蜜炙） 山栀（一钱） 川乌（一钱） 煨姜（一钱） 大枣（三枚）
按语：上述原方主治涵盖六经内伤与外感病证。所谓“内伤外感”，是指因内部正气受损而导致外部邪气侵袭。大概因为邪气聚集之处，人体正气必然虚弱，李东垣因此创立此方以补充《伤寒论》中未涉及的内容，这并非单纯的补虚方剂。如今治疗外感病的医生大多不敢使用此方，若将其视为调理补虚的服用药物，则是错误的。它仅用于调理补虚，或通晓其意后灵活变通使用罢了。
至于暑月因劳倦导致的发热，暑热耗气，劳倦伤气。发热发生在暑月，且由劳倦引起，自然非甘温性质的药物不能治愈。那些肆意使用藿香、滑石等药，认为它们是暑月发热的必需药剂，只是因为没有明白这个道理罢了。
如果出汗不止，这是卫外阳气虚弱，导致腠理不固。均使用本方加白芍一钱（必须再加五味子，才符合肺主皮毛的理论）。
痢疾腹痛已经消除，但腹泻仍未停止，这是胃气下陷的表现。必定还伴有里急后重，只是在排便后症状稍减而已，加酒炒白芍三钱。
疟疾发作日久，身体消瘦羸弱，无论属于哪一经，都应当加半夏一钱（合用六君子汤之意）。
凡是妇女怀孕前气虚，导致胎动不安、小产或崩漏，都是因为气虚不能升举的缘故。
或者产后血虚发热。凡是血虚发热的人，舌苔必定干燥；气虚发热的人，舌苔必定滑润。然而既然在产后，不仅血虚，其气也没有不虚的。大概在分娩之际，产妇若非用尽全部精神、浑身力气，努力负责推送胎儿，那么胞胎如何能降生？等到胞胎降生后，流失的血固然很多，之后能不损伤气吗？况且血虚则气无所依附，难道不与血一同虚弱吗？现在针对产后发热，专门归咎于血虚，确实遗漏了关键义理。而病症列在本方之下，可知有形之血不能快速生成，无形之气应当紧急固护。阳气旺盛则阴血滋生，其中的道理自然包含其中。只是没有明确说出这个意思，人们习以为常地知道产后血虚，却都忽视产后气虚，所以特意揭示并阐明这一点。
此方凡属中焦脾胃虚损，病后调养摄生，无不适宜。倪氏说：“七情内伤，脾胃先发病，治疗应先补脾土，此方为主治”。
然而内伤脾胃，需要加以区分。如饥饱失调、劳役过度、饮食生冷，导致内伤脾胃而生病的，自然应当以此方为主治。如果是由于思虑郁怒，七情内伤，导致脾胃先发病的，那么与本方尚隔一层膜，不如归脾汤更为恰当。
Shengma (Aucklandiae Radix, 5 fen) Chaihu (Bupleuri Radix, 5 fen) Danggui (Angelicae Sinensis Radix, 2 qian) Chenpi (Citri Reticulatae Pericarpium, 1 qian) Renshen (Ginseng Radix, 1 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Preparatum cum Melle, 1 qian) Huangqi (Astragali Radix, 2.5 qian, honey-fried) Shanzhi (Gardeniae Fructus, 1 qian) Chuanwu (Aconiti Radix, 1 qian) Weijiang (Zingiberis Rhizoma Preparatum, 1 qian) Dazao (Jujubae Fructus, 3 pieces)
Note: The aforementioned original prescription treats conditions involving internal injury and external contraction across the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin). "Internal injury leading to external contraction" refers to external pathogenic invasion resulting from prior internal deficiency of healthy Qi. Generally, where pathogenic factors gather, healthy Qi must be deficient; therefore, Li Dongyuan established this prescription to supplement what was omitted in the *Treatise on Cold Damage* (*Shanghan Lun*). It is not merely a tonifying formula for deficiency. Currently, physicians treating exogenous syndromes often dare not use it; regarding it as a medication for conditioning and tonifying deficiency is erroneous. It is used only for conditioning and tonifying, or applied flexibly by those who understand its principle.
Regarding fever caused by fatigue during the summer months: summer heat consumes Qi, and fatigue injures Qi. Fever occurring in summer due to fatigue naturally requires sweet-warm natured herbs to cure. Those who recklessly employ Huoxiang (Agastachis Herba), Huashi (Talcum), etc., considering them essential for summer fever, simply fail to comprehend this principle.
If sweating continues without stopping, it indicates deficiency of Wei Yang (Defensive Yang) externally, leading to insecure Couli (pores/skin texture). In such cases, use the base formula plus Baishao (Paeoniae Radix Alba) 1 qian (must add Wuweizi (Schisandrae Chinensis Fructus) to align with the theory that the Lung governs skin and hair).
If abdominal pain from dysentery has subsided but diarrhea persists, this indicates sinking of Stomach Qi. There will likely still be tenesmus (feeling of incomplete defecation), which alleviates slightly after defecation. Add Jiuchao Baishao (wine-fried Paeoniae Radix Alba) 3 qian.
For malaria persisting for a long time with emaciation, regardless of the channel involved, add Banxia (Pinelliae Rhizoma) 1 qian (aligning with the intent of Liu Junzi Tang).
Even if there is an external contraction, simply add Huangqin (Scutellariae Radix) 1 qian (aligning with the intent of Xiao Chaihu Tang).
For women with pre-pregnancy Qi deficiency leading to restless fetus, spontaneous abortion, or metrorrhagia, these are all due to Qi deficiency failing to lift and hold.
Or postpartum blood deficiency causing fever. For those with blood deficiency fever, the tongue must be dry; for those with Qi deficiency fever, the tongue must be slippery. However, since this occurs postpartum, not only is blood deficient, but Qi is invariably deficient as well. During delivery, if the parturient does not exert her full spirit and physical strength to push, how can the fetus descend? Once the fetus descends, although much blood is lost, can Qi not be injured thereafter? Moreover, when blood is deficient, Qi has no foundation to attach to; surely they both become deficient. To attribute postpartum fever solely to blood deficiency is indeed an omission of key principles. Since the syndrome is listed under this formula, it is known that tangible blood cannot be generated quickly, while intangible Qi must be urgently secured. When Yang flourishes, Yin generates; this meaning is inherently contained. However, because this meaning is not explicitly stated, people are accustomed to hearing about postpartum blood deficiency but neglect postpartum Qi deficiency. Therefore, it is specifically highlighted and elucidated here.
Add Jiuchao Baishao (wine-fried Paeoniae Radix Alba) 2 qian (its flavor is sour and cold, fearing it may damage the generating Qi, hence wine-fried).
This formula is suitable for any deficiency damage of the Middle Jiao (Spleen and Stomach) and for convalescence after illness. Ni Shi said: "Internal injury from the Seven Emotions first affects the Spleen and Stomach; treatment should prioritize tonifying Earth (Spleen), and this formula is primary."
However, internal injury to the Spleen and Stomach requires differentiation. For injuries caused by irregular eating/drinking, overwork, or consumption of raw/cold foods, this formula is appropriate. But for injuries caused by excessive thinking, depression, or anger (Seven Emotions) affecting the Spleen and Stomach first, this formula is less precise than Guipi Tang (Restore the Spleen Decoction).
When the tongue appears red and slippery, indicating Heart Yang deficiency and weak Qi, treat with Jisheng Guipi Tang (Guipi Decoction from the Generation Hall) added with Danpi (Moutan Cortex) and Rougui (Cinnamomi Cortex).