人参 白术 黄 甘草 当归 柴胡 橘皮 升麻（酒炒）
中气者，脾胃之气也。人身众体皆禀受于兹而后治。故《易》曰∶坤浓载物，德合无疆。一为饥困劳倦所伤，
则众体无以滋其生。是以李东垣谆谆以脾胃为言也。上方人参、黄 、甘草皆甘温之品，甘者味之中，温者气之
中，故曰补中。橘、术辛苦而燥，当归辛温而润，燥可刚中，润能泽土。复用升麻降浊阴于沟渎，柴胡行清阳于
腠理，则宇宙太和之气，长居脾胃，自然充发春荣，故又曰益气。凡劳苦伤神，复感风寒，寒热交作，目发赤肿，
头痛如破，服外感散剂病愈甚，用此方获效者，盖脾胃中火，以甘温养之自退。书曰劳者温之，损者温之，甘温
能除大热，此之谓也。
升麻、柴胡均属凉散之剂，而升麻味苦气腐，锐于柴胡远甚，血气虚衰人，非所宜服。东垣专主内伤，奈何
列入补益。盖以脾味之症，始得则热中，继而气高身烦，头痛而渴，其脉空大，其皮肤不任风寒而生寒热，与外
感风寒颇同。法当甘寒以泻火，辛温以升阳，立愈。所谓补中求行，而行不碍真元，行中求补，而补无虑积滞，
诚本气自病之良方也。后人不明其理，徒以是汤妙在升麻升地气于右，柴胡
升天气以左，乃大力如人参、 、术辈，绝不提起。凡阳虚下陷及中州虚损，似疟疾而类感冒，偏出参、 ，倍
入此二物，害不旋踵。前注未妥，再为发明，且以警惯用升柴杀人之不悟者。
中气，指的是脾胃之气。人体的各种形体组织都依赖于此气才能维持正常的生理功能。所以《易经》说：“大地厚德载物，其德行广大无边。”一旦因为饥饿、困顿、劳累或倦怠而损伤了中气，那么全身各部分就失去了滋养生命的源泉。因此，李东垣反复强调脾胃的重要性。上方中的人参、黄芪、甘草都是味甘性温的药物，甘味属于“中”的范畴，温性也属于“中”的范畴，所以称为“补中”。陈皮和白术味辛苦且性燥，当归味辛性温且性润，燥性能使中焦刚健，润性能滋润脾土。再配合升麻将浊阴之气降入沟渎（比喻下焦），柴胡将清阳之气运行于腠理（皮肤肌肉的纹理间隙），那么宇宙间太和之气就能长久驻留于脾胃，自然像春天草木荣发一样充盛，所以又称为“益气”。凡是因劳苦损伤精神，又感受风寒，导致寒热交替发作，眼睛发红肿胀，头痛剧烈如要破裂，服用治疗外感的发散药物后病情反而加重，而使用此方获得疗效的情况，是因为脾胃中的虚火，通过甘温的方法调养自然会消退。医书说：“劳损之证用温法治疗，亏损之证用温法治疗”，甘温能够消除大热，说的就是这个道理。
升麻和柴胡都属于清凉发散的药物，但升麻味苦、气腐（指气味特殊或略带腐败感），其药性比柴胡锐利得多，气血虚弱衰退的人，不适合服用。李东垣专门主张针对内伤进行治疗，为什么却将其列入补益剂中呢？大概是因为脾虚引起的病症，刚开始出现时会有热在中焦的表现，随后出现气逆身烦、头痛口渴，脉象空大，皮肤不能耐受风寒侵袭而产生寒热症状，这与外感风寒非常相似。治疗方法应当用甘寒药物来泻火，用辛温药物来升举阳气，病即可痊愈。这就是所谓的在补益中寻求宣通，宣通而不伤害真元；在宣通中寻求补益，补益而不担心产生积滞，这确实是治疗本气自病的良方。后人不明白其中的原理，仅仅认为这个汤剂的妙处在于升麻从右边提升地气，柴胡从左边提升天气，而对于人参、黄芪、白术这样力量强大的补气药，却完全不加以重视提起。凡是遇到阳气虚弱下陷以及中焦虚损，症状类似疟疾又像感冒，如果去掉人参、黄芪，加倍使用升麻和柴胡，危害很快就会到来。之前的注解不够妥当，现在再次阐明其理，以此来警示那些惯用升麻、柴胡而不知变通、害人性命却不醒悟的人。
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma), Huang Qi (Astragali Radix), Gan Cao (Licorice Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chai Hu (Bupleuri Radix), Ju Pi (Citri Reticulatae Pericarpium), Sheng Ma (Cimicifugae Rhizoma) [processed with wine].
Zhong Qi (Middle Qi, the Qi of the Spleen and Stomach) refers to the Qi of the Spleen and Stomach. All physical structures in the human body rely on this Qi to maintain normal physiological functions. Therefore, the *I Ching* (Book of Changes) states: "The Earth's virtue is great and carries all things; its virtue matches the boundless." Once Zhong Qi is damaged by hunger, fatigue, overwork, or lassitude, the various parts of the body lose their source of nourishment for life. Hence, Li Dongyuan repeatedly emphasized the importance of the Spleen and Stomach. In the above formula, Ren Shen, Huang Qi, and Gan Cao are all sweet and warm substances. Sweetness belongs to the category of "middle," and warmth also belongs to the category of "middle"; thus, it is called "Bu Zhong" (Tonifying the Middle). Ju Pi and Bai Zhu are pungent, bitter, and drying, while Dang Gui is pungent, warm, and moistening. Drying properties can strengthen the middle Jiao, and moistening properties can nourish the Spleen Earth. Furthermore, by using Sheng Ma to descend turbid Yin into the ditches (a metaphor for the lower Jiao) and Chai Hu to circulate clear Yang into the cou-li (the interstices of skin and muscle), the Taihe Qi (Harmonious Qi of the universe) can reside long-term in the Spleen and Stomach, naturally flourishing like spring vegetation. Thus, it is also called "Yi Qi" (Augmenting Qi).
For cases where labor and hardship damage the spirit, followed by contraction of wind-cold, resulting in alternating chills and fever, redness and swelling of the eyes, severe headache as if splitting, where taking external-contraction dispersing agents worsens the condition, but this formula yields results: this is because the deficient fire in the Spleen and Stomach will recede when nourished by sweet-warm methods. The medical texts state: "Treat exhaustion with warmth, treat deficiency with warmth." Sweet-warm herbs can eliminate great heat; this is what is meant.
Sheng Ma and Chai Hu both belong to cool-dispersing agents. However, Sheng Ma is bitter in taste and has a peculiar odor, being far more acute than Chai Hu. It is not suitable for individuals with deficient and declining Blood and Qi. Li Dongyuan specifically focused on internal injury; why did he include these in tonifying formulas? Presumably because symptoms arising from Spleen deficiency initially present with heat in the middle, followed by qi rebellion, restlessness, headache, thirst, an empty and large pulse, and skin that cannot withstand wind-cold, generating chills and fever. This closely resembles external wind-cold contraction. The method should be to use sweet-cold herbs to drain fire and pungent-warm herbs to raise Yang, leading to immediate recovery. This is所谓 "seeking circulation within tonification, so circulation does not harm true Yuan Qi; seeking tonification within circulation, so tonification does not worry about stagnation." It is indeed an excellent formula for diseases caused by the failure of original Qi itself. Later generations did not understand this principle, merely believing that the efficacy of this decoction lies in Sheng Ma raising earth Qi from the right and Chai Hu raising heaven Qi from the left, while completely neglecting powerful tonics like Ren Shen, Huang Qi, and Bai Zhu. In cases of Yang deficiency with sinking, or deficiency of the central region, presenting similarly to malaria or resembling a cold, if one removes Ren Shen and Huang Qi and doubles the dosage of Sheng Ma and Chai Hu, harm will follow swiftly. The previous annotations were inadequate; I hereby clarify the principles again to warn those who habitually use Sheng Ma and Chai Hu without understanding, causing death without realizing it.