治脾胃虚, 怠惰嗜卧, 四肢不收. 时值秋燥令行,
湿热方退, 体重节痛, 口干舌燥, 饮食无味, 大便不调, 小便频数,
食不消, 兼见肺病, 洒淅恶寒, 惨惨不乐, 面色不和.
羌活 独活 防风 柴胡 人参 白术 茯苓 甘草 黄耆 白芍
半夏 黄连 泽泻 陈皮, 水煎服.
【集注】吴琨曰: 脾土虚弱不能制湿, 故体重节痛; 不能运化精微,
故口干无味; 中气既弱, 传化失宜, 故大便不调, 小便频数也. 洒淅
恶寒, 肺弱表虚也. 面色不乐, 阳气不伸也. 是方半夏, 白术能燥湿
,茯苓, 泽泻渗之, 二活, 防风, 柴胡能升举清阳之气, 黄连疗湿热
,陈皮平胃气, 参, 耆, 甘草以益胃, 白芍酸收用以和营, 而协羌活
,柴胡辛散之性, 盖古人用辛散必用酸收, 所以防其竣厉, 犹兵家之
节制也.
【按】人参属补, 不知君于枳, 朴中, 即为补中泻也. 羌, 防辈为散
,不知佐于参, 耆中, 即为补中升也. 近世之医, 一见羌, 防辈, 即
曰:发散不可轻用. 亦不审佐于何药之中, 皆因读书未明, 不知造化
别有妙理耳.
治脾阴血虚, 胃阳气弱, 春寒不去, 及过食冷物,
抑遏少阳清气, 郁于脾土之中, 四肢发困热, 肌热, 筋骨间热, 表热
如火燎于肌肤, 扪之烙手, 并宜服之.
升麻 葛根 独活 羌活 白芍 人参以上各五钱 甘草 ( 炙 ) 三
钱 柴胡三钱 防风二钱 甘草 ( 生 ) 二钱, 右?? 咀, 如麻豆大
,每服秤五钱, 水二盏, 煎一盏, 去滓, 大温服, 无时, 忌寒凉之物
.
【集注】吴琨曰: 经云: 少火生气. 天非此火不能生物, 人非此火不
能有生, 扬之则光, 遏之则灭. 今为春寒不去, 遏郁阳气, 饮食冷物
,填塞至阴, 以致升生之气几于息矣. 故用升麻 , 柴胡, 羌活, 独
活,葛根, 皆辛温风药, 以鼓动少阳生气. 清阳既出上窍, 则浊阴自
归下窍, 而食物传化, 自无抑遏之患. 芍药味酸, 能泻土中之木. 人
参味甘, 能补中州之气. 生甘草能泻郁火于脾, 从而炙之, 则健脾胃
而和中矣. 李杲圣于脾位者, 其治之也, 必主于升阳. 俗医知降而不
知升, 是扑其少火也, 安望其卫生耶! 若气不虚, 本方除人参, 独活
加葱白, 名火郁汤, 治同.
治疗脾胃虚弱，身体倦怠嗜睡，四肢无力下垂。正值秋季燥气当令，湿热之气刚刚消退，身体沉重，关节疼痛，口干舌燥，饮食无味，大便不调，小便频数，食物不消化，同时兼见肺病症状，如怕冷发抖，心情抑郁不乐，面色不和顺。
羌活、独活、防风、柴胡、人参、白术、茯苓、甘草、黄耆、白芍、半夏、黄连、泽泻、陈皮，用水煎服。
【集注】吴琨说：脾土虚弱不能制约湿气，所以身体沉重、关节疼痛；不能运化水谷精微，所以口干、味觉缺失；中气既然虚弱，传导消化功能失调，所以大便不调、小便频数。怕冷发抖是肺气弱、表虚的表现。面色不悦，是阳气不能舒展的表现。这个方子中，半夏和白术能燥湿，茯苓和泽泻能渗利湿气，羌活、独活、防风、柴胡能升举清阳之气，黄连治疗湿热，陈皮调和胃气，人参、黄耆、甘草来补益胃气，白芍味酸收敛用来调和营血，并且配合羌活、柴胡辛散的性质，大概古人使用辛散药物时必定配合酸收药物，这是为了防止药性过于峻猛严厉，就像兵家讲究节制一样。
【按语】人参属于补益药，如果不知道它作为君药配伍枳实、厚朴中，就成为了补中兼泻的方法。羌活、防风这类属于发散药，如果不知道它们作为佐药配伍人参、黄耆中，就成为了补中兼升的方法。近世的医生，一看到羌活、防风这类药，就说：发散药不可轻易使用。也不审察它是佐助什么药物的，都是因为读书没有明白，不知道造化（自然规律）另有妙理罢了。
治疗脾阴血虚，胃阳气弱，春季寒气未去，以及过食生冷食物，抑制遏阻了少阳清气，郁结在脾土之中，四肢感到困倦发热，肌肉发热，筋骨间发热，体表发热如火烧灼肌肤，摸上去烫手，这些情况都适宜服用此方。
升麻、葛根、独活、羌活、白芍、人参（以上各五钱）、甘草（炙）三钱、柴胡三钱、防风二钱、甘草（生）二钱，将药材切碎，像麻豆大小，每次称取五钱，用水两盏，煎煮至一盏，去掉药渣，大温服用，不拘时候，忌食寒凉之物。
【集注】吴琨说：医经云：少火生气。天如果没有这把火就不能化生万物，人如果没有这把火就不能维持生命，扬起它就有光芒，遏制它就会熄灭。现在因为春季寒气未去，遏制郁结了阳气，饮食生冷食物，填塞至阴之地，导致升发生发之气几乎要停止了。所以用升麻、柴胡、羌活、独活、葛根，这些都是辛温的风药，用来鼓动少阳的生发之气。清阳之气既已出于上窍，那么浊阴之气自然归于下窍，而食物的传导消化，自然就没有被抑遏的隐患了。芍药味酸，能泻脾土中过盛的木气。人参味甘，能补益中焦之气。生甘草能泻除脾中的郁火，进而将其炙烤，就能健脾胃而调和其中气。李杲精通于脾脏生理特性的，他治疗疾病，必定以升阳为主。世俗医生只知道降法而不知道升法，这是在扑灭少火，哪里还能指望他们养生呢！如果气不虚，本方除去人参、独活，加入葱白，名为火郁汤，治疗方法相同。
Treats Spleen and Stomach deficiency (Xu, 虚), manifesting as lassitude and a desire to lie down, heaviness and drooping of the four limbs. When the autumn dryness command is in effect, and damp-heat is just receding, symptoms include heavy body, joint pain, dry mouth and tongue, loss of taste, irregular bowel movements, frequent urination, indigestion, accompanied by Lung disease symptoms such as aversion to cold with shivering, depression and unhappiness, and an unhealthy complexion.
Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix), Baishao (Paeoniae Radix Alba), Banxia (Pinelliae Rhizoma), Huanglian (Coptidis Rhizoma), Zexie (Alismatis Rhizoma), Chenpi (Citri Reticulatae Pericarpium). Decoct in water and take orally.
[Collected Notes] Wu Kun stated: The Spleen Earth is weak and cannot control dampness, hence the heavy body and joint pain; it cannot transform and transport essence and nutrients, hence the dry mouth and loss of taste; since the Middle Qi is weak, transmission and transformation are disordered, hence irregular bowel movements and frequent urination. Aversion to cold with shivering indicates weak Lung Qi and exterior deficiency. An unhappy complexion indicates that Yang Qi is not extending. In this formula, Banxia and Baizhu can dry dampness; Fuling and Zexie can leach out dampness; Qianghuo, Duhuo, Fangfeng, and Chaihu can raise clear Yang Qi; Huanglian treats damp-heat; Chenpi regulates Stomach Qi; Renshen, Huangqi, and Gancto tonify the Stomach; Baishao, being sour and astringent, is used to harmonize Ying (Nutrient) Blood, and to coordinate with the acrid-dispersing nature of Qianghuo and Chaihu. Generally, ancients used acrid-dispersing herbs together with sour-astringent ones to prevent the harshness and severity of the former, similar to military discipline and restraint.
[Commentary] Renshen belongs to tonifying herbs. If one does not know that when it serves as the Sovereign herb paired with Zhishi (Immature Bitter Orange) and Houpo (Magnolia Bark), it constitutes "tonifying the center while purging," then... [Note: Text implies contrast]. Qianghuo and Fangfeng belong to dispersing herbs. If one does not know that when they serve as Assistant herbs paired with Renshen and Huangqi, they constitute "raising within tonification," then... Modern physicians, upon seeing Qianghuo and Fangfeng, immediately say: "Dispersing methods should not be used lightly." They fail to examine which herbs they are assisting. This is due to incomplete study of texts and ignorance of the subtle principles of creation/nature.
Treats Spleen Yin and Blood deficiency, and weak Stomach Yang Qi. It applies when spring cold persists, or after excessive consumption of cold foods, which suppress and obstruct the clear Qi of Shaoyang (Lesser Yang), causing stagnation within the Spleen Earth. Symptoms include fatigue and heat sensation in the four limbs, muscle heat, heat between bones and sinews, and exterior heat feeling like fire burning the skin and muscles, hot to the touch. These conditions are all suitable for taking this prescription.
Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Duhuo, Qianghuo, Baishao, Renshen (each 5 qian); Gancao (Zhi, Honey-fried) 3 qian; Chaihu 3 qian; Fangfeng 2 qian; Gancao (Sheng, Raw) 2 qian. Pound the above into pieces the size of hemp seeds. Take 5 qian per dose, decoct in two cups of water until one cup remains, strain, and take warm at any time. Avoid cold and cooling foods.
[Collected Notes] Wu Kun stated: The Classics say: "Minor Fire generates Qi." Heaven cannot produce things without this fire; humans cannot sustain life without it. When raised, it shines; when suppressed, it extinguishes. Now, because spring cold has not dissipated, it suppresses and depresses Yang Qi; dietary cold foods fill the realm of Extreme Yin, causing the ascending and generating Qi to nearly cease. Therefore, Shengma, Chaihu, Qianghuo, Duhuo, and Gegen are used. These are all acrid-wind herbs that stimulate the generating Qi of Shaoyang. Once Clear Yang emerges from the upper orifices, Turbid Yin naturally returns to the lower orifices, and food transmission and transformation will no longer suffer from suppression. Shaoyao (Baishao) is sour and can drain Wood excess within Earth. Renshen is sweet and can tonify Qi in the Central Region. Raw Gancao can drain depressed Fire from the Spleen; subsequently, when honey-fried, it strengthens the Spleen and Stomach and harmonizes the Middle. Li Gao, who mastered the physiology of the Spleen, always prioritized raising Yang in his treatments. Vulgar physicians know only descending methods and do not understand ascending methods; this is extinguishing the Minor Fire. How can one expect them to preserve health? If Qi is not deficient, remove Renshen and Duhuo from this formula and add Congbai (Allii Fistulosi Bulbus), naming it Huoyu Tang (Fire Depression Decoction). The treatment indication is the same.