论阳虚下陷 阴虚下陷
天师曰∶升治者，乃气虚下陷，不能升而升之者也。凡人因饥饱劳役，内伤正气，以致气乃下行，脾
胃不能克化，饮食不能运动，往往变成痨瘵。若疑饮食不进，为是脾胃之火；或疑肉黍所伤，谓是水谷
之积。轻则砂仁、枳壳、山楂、麦芽之类，重则大黄、芒硝，牵牛、巴豆之品，纷然杂进，必致臌闷不
已。倘先以升提之药治之，何成此等病症哉。方用人参一钱，黄 三钱，柴胡一钱，升麻三分，当归三钱，
陈皮一钱，甘草一钱，白术三钱治之。此方即补中益汤，余为之增定其轻重，以为万世不删之定则。东垣
一生学问，全在此方。凡人右手寸脉，大于左手寸口之脉，无论其左右关脉，与左右肾脉之大与小、沉与
浮，即以此方投之，无不神效。盖右寸之脉大于左寸口，即内伤之症也，此方实为对病。妙在用柴胡、升
麻二味，杂于参、 、归、术之中。以升提其至阳之气，不使其下陷于阴分之间∶尤妙加甘草。陈皮于补
中解纷。则补者不至呆补，而升者不至偏堕，所以下口安然，奏功如响耳。或疑参、 太多。不妨略减则
可。倘以为补药不可骤，竟去参、 ，则柴，麻无力。譬如绳索细小，欲升千斤重物于百丈之上，难矣。或
用参而不用 ，或用 而不用参，则功必减半，然犹胜于尽去之也。倘以升，柴提气，或疑清气不升，反
又浊阴之腾上者，此必左手寸口之脉，大于右手寸口，始可借言。苟或不然，杀人无算，
必是此人创说也。余最恶此等似是而非，为吾道之乡愿，吾子尽辟之也。
张公曰∶讲补中益气汤，从无有如此痛快者，东垣何幸得如此之褒扬哉。余何言乎。惟是阳虚
而下陷者，宜如是升提∶阴虚而下陷者，又当何法以升提之乎？天师不言，予当增入。譬如人阴虚脾泄，
岁久不止，或食而不能化，或化而溏泄是也。方用熟地五钱，山茱萸五钱，北五味一钱，白术一两，山药
三钱，车前子一钱，肉桂一钱，茯苓三钱，升麻三分，水煎服。（〔批〕升阴汤。此方之妙，不意张
公见及。雷公曰∶张公之方妙甚，真补天手也。）此方之妙，纯是补阴之药，惟加升麻三分，以提阴中之
气，阴气升而泻自止；乃又有温热之味，以暖命门而健脾土，又何至再行溏泄哉，天师乃升阳气之论，而余
乃补升阴气之汤也。有此二方，可与乾坤不老。
华君曰∶亦未传。
陈士铎说：所谓“升治法”，是针对气虚下陷、无法自行上升而采用的提升治疗方法。一般人因为饥饿与饱食不规律，或者过度劳累，导致内伤正气，致使气机下行，脾胃无法正常运化，饮食不能正常消化吸收，往往演变成痨瘵（慢性消耗性疾病）。如果误以为食欲不振是脾胃之火过旺，或者误以为肉类黍米等食物损伤是由于水谷积滞所致，轻则使用砂仁、枳壳、山楂、麦芽之类的药物，重则使用大黄、芒硝、牵牛子、巴豆等峻猛之品，杂乱进服，必然导致腹部胀满闷痛不止。倘若先用提升气机的药物治疗，怎么会造成这样的病症呢？方剂用人参一钱，黄芪三钱，柴胡一钱，升麻三分，当归三钱，陈皮一钱，甘草一钱，白术三钱来治疗。这个方子就是补中益气汤，我对其剂量轻重进行了增定，作为万世不可删改的准则。李东垣一生的学问，全在于此方。凡是患者右手寸脉大于左手寸口之脉的，无论其左右关脉以及左右尺脉的大小、沉浮如何，都以此方投药，无不神效。因为右寸脉大于左寸脉，即是内伤的症候，此方确实是对症的。妙处在于用柴胡、升麻两味药，混杂在人参、黄芪、当归、白术之中，用以提升至阳之气，不让它下陷于阴分之间；尤其妙在加入甘草、陈皮以调和补益中的纷杂。这样补益就不会呆滞，提升就不会偏坠，所以下药后安然无恙，见效迅速如回响。有人怀疑人参、黄芪太多，不妨稍微减少即可。如果认为补药不可骤用，竟然去掉人参、黄芪，那么柴胡、升麻就会无力。譬如绳索细小，想要将千斤重物提升到百丈之高，很难做到。或者只用参而不用芪，或者只用芪而不用参，功效必然减半，然而这仍然比完全去掉要好。如果认为柴胡、升麻提气，有人怀疑清气不升反而浊阴上腾，这种情况必须是左手寸口之脉大于右手寸口之脉，才可以借言此理。假如不是这样，却乱用此法，会杀死无数人，这必定是此人凭空捏造的说法。我最厌恶这种似是而非、看似正统实则误导的人，他们是中医道统中的“乡愿”（伪君子），你们要彻底驳斥他们。
张公说：讲解补中益气汤，从来没有如此痛快淋漓的，李东垣何幸能得到如此高的褒扬呢？我还有什么可说的呢。只是对于阳虚而下陷的情况，应该像这样提升；对于阴虚而下陷的情况，又该用什么方法提升呢？陈天师没有提及，我应当补充进去。比如有人阴虚导致脾泄，多年不止，或者吃了东西不能消化，或者消化了却大便溏稀。方剂用熟地黄五钱，山茱萸五钱，北五味子一钱，白术一两，山药三钱，车前子一钱，肉桂一钱，茯苓三钱，升麻三分，水煎服。（批注：升阴汤。这个方子的妙处，没想到张公能想到。雷公说：张公的方子非常精妙，真是补天的能手啊。）这个方子的妙处，纯粹是补阴的药物，只加上三分升麻，用来提升阴中之气，阴气上升而泄泻自然停止；又有温热的药味，用来温暖命门并健脾土，又怎么会再次发生溏泄呢？陈天师论述的是提升阳气的方法，而我提出的是补益并提升阴气的汤剂。有了这两个方子，就可以与天地同寿而不老。
华君说：这也算是未传之秘。
Chen Shiduo stated: The so-called "Sheng Zhi Fa" (Lifting Therapy) is a treatment method employed to lift Qi that has sunk due to deficiency and cannot rise on its own. Generally, people suffer from irregular eating habits or overexertion, which internally injures the Zheng Qi (Upright Qi), causing Qi mechanism to descend. Consequently, the Spleen and Stomach fail to transform and transport properly, food and drink cannot be moved and digested, often evolving into Lao Zhai (chronic consumptive diseases). If one mistakenly suspects that loss of appetite is due to Fire in the Spleen and Stomach, or suspects that damage from meat and millet is due to accumulation of water and grain, they may administer mild drugs such as Sha Ren (Amomi Fructus), Zhi Ke (Aurantii Fructus), Shan Zha (Crataegi Fructus), and Mai Ya (Hordei Fructus Germinatus) for mild cases, or heavy drugs like Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas), Qian Niu (Pharbitidis Semen), and Ba Dou (Crotonis Fructus) for severe cases. Administering these indiscriminately will inevitably lead to persistent abdominal distension and fullness. Had lifting herbs been used first, how could such conditions have arisen? The prescription consists of Ren Shen (Ginseng Radix et Rhizoma) 1 qian, Huang Qi (Astragali Radix) 3 qian, Chai Hu (Bupleuri Radix) 1 qian, Sheng Ma (Cimicifugae Rhizoma) 3 fen, Dang Gui (Angelicae Sinensis Radix) 3 qian, Chen Pi (Citri Reticulatae Pericarpium) 1 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian, and Bai Zhu (Atractylodis Macrocephalae Rhizoma) 3 qian. This formula is Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction); I have adjusted its dosages to establish an unchangeable standard for generations. Li Dongyuan's lifelong scholarship is entirely centered on this formula. Whenever the Cun pulse (Inch position) on the right hand is larger than the Cun pulse on the left hand, regardless of the size or depth/superficiality of the Guan (Bar position) or Chi (Cubit position) pulses on either side, this formula should be administered with miraculous efficacy. This is because a right Cun pulse larger than the left indicates internal injury, making this formula precisely targeted. The brilliance lies in mixing Chai Hu and Sheng Ma among Ren Shen, Huang Qi, Dang Gui, and Bai Zhu to lift the Supreme Yang Qi, preventing it from sinking into the Yin compartments; even more brilliant is the addition of Gan Cao and Chen Pi to harmonize the tonification, ensuring that tonification is not stagnant and lifting is not lopsided, thus allowing safe administration and rapid effect. Some may suspect that Ren Shen and Huang Qi are too abundant; it is acceptable to reduce them slightly. However, if one believes that tonic herbs should not be used abruptly and removes Ren Shen and Huang Qi entirely, Chai Hu and Sheng Ma will lack strength. It is like using a thin rope to lift a thousand-jin weight to a height of a hundred zhang—difficult indeed. Using only Ren Shen without Huang Qi, or only Huang Qi without Ren Shen, will halve the efficacy, though this is still better than removing both entirely. If one argues that Chai Hu and Sheng Ma lift Qi, and suspects that clear Qi fails to rise while turbid Yin rises instead, this argument holds only if the left Cun pulse is larger than the right Cun pulse. Otherwise, misusing this approach would kill countless people; such claims must be baseless fabrications. I detest such ambiguous theories and those who appear orthodox but mislead—the "Xiang Yuan" (hypocrites) of our tradition—and urge you to thoroughly refute them.
Master Zhang said: No one has explained Bu Zhong Yi Qi Tang so clearly and effectively; how fortunate is Li Dongyuan to receive such praise! What more can I say? Regarding Yang Deficiency with sinking, lifting should be done as described above; but for Yin Deficiency with sinking, what method should be used for lifting? Master Chen did not mention this, so I shall add it. For instance, when a person suffers from Spleen diarrhea due to Yin Deficiency, persisting for years, where food is not digested or digestion results in loose stools, the prescription uses Shu Di Huang (Rehmanniae Radix Preparata) 5 qian, Shan Zhu Yu (Corni Fructus) 5 qian, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 1 qian, Bai Zhu 1 liang, Shan Yao (Dioscoreae Rhizoma) 3 qian, Che Qian Zi (Plantaginis Semen) 1 qian, Rou Gui (Cinnamomi Cortex) 1 qian, Fu Ling (Poria) 3 qian, and Sheng Ma 3 fen, decocted in water and taken orally. [Commentary: Sheng Yin Tang (Lifting Yin Decoction). The brilliance of this formula was unforeseen by others until Master Zhang proposed it. Lei Gong said: Master Zhang's formula is exquisite; he is truly a master capable of mending the heavens.] The brilliance of this formula lies purely in Yin-nourishing herbs, with only 3 fen of Sheng Ma added to lift the Qi within Yin. When Yin Qi rises, diarrhea stops naturally; furthermore, warm and hot herbs warm the Ming Men (Gate of Life) and strengthen the Spleen Earth, preventing recurrent loose stools. While Master Chen discussed lifting Yang Qi, I present a decoction for tonifying and lifting Yin Qi. With these two formulas, one can achieve longevity comparable to Heaven and Earth.
Master Hua said: This also remains an untransmitted secret.