即大补汤去川芎加陈皮远志五味子治脾肺俱虚发热恶寒肢体瘦倦食少作泻又治
口干食少咳而下痢心惊悸热而自汗等证
治手足厥寒脉细欲绝者
当归（三两辛温） 桂枝（三两去皮辛热） 芍药（三两酸寒） 细辛（三两辛热） 通
草（二两甘
上七味以水八升煮取三升去滓温服一升日三服
成无己云内经曰脉者血之腑也诸血者皆属心通脉者必先补心益血苦先入于心当归之苦以
助心血心苦缓急食酸以收之芍药之酸以收心气肝苦急急食甘以缓之大枣甘草通草之甘以缓阴
血
即本方加吴茱萸（二升）生姜（半斤）水酒（各六升）煮服治手足厥逆
以散久
寒生姜辛温以行阳气
用吴茱萸（一升）洗人参（三两）生姜（六两）大枣（十二枚）治食谷欲呕者属阳明也
成
内经曰寒淫于内治以甘热佐以苦辛吴茱萸生姜之辛以温胃人参大枣之甘以缓脉
用五味子炒三两吴茱萸炒五钱上二味为末每服二钱白汤调下治肾泄在清晨五更
进或大便不实不时去后为丸尤妙
治中气不足饮食劳倦清气下陷以致脾胃虚弱发热头痛四肢倦怠心烦肌瘦日渐羸
升元气退虚热补脾胃生血气
黄 （病甚劳役热甚者一钱） 甘草（炙以上各五分） 人参（去芦三分有嗽去之以上
三味
除湿
以导
气又
术（三
姜枣煎
上八味 咀作一服水二盏煎至一盏量气弱气盛临病斟酌水盏大小去滓食远稍稍热服
加减法
如腹中痛者加白芍药（五分）炙甘草（三分）○如恶寒冷痛者加去皮中桂（一分或三分）
即桂
心是
腹痛
而不
腹痛去
蔓荆子
（二分
细辛（
二分）
下痛者加
腹
痛皆寒证
汤并丸主
痛
者湿若身
分
升麻苍术
之药损人
玄
明粉（五
之
冬月或
分）
○如夏
寒勿
用之○
能
食而心下痞加黄连（一分或三分）○如不能食心下痞勿加黄连○如胁下痛或胁下急缩俱加柴
胡
（三分）甚则（五分）上方加减是饮食劳倦喜怒不节始病热中则可用之若末传为寒中则不可
用也
盖甘酸适足益其病尔如黄 人参甘草芍药五味子之类也出东垣脾胃论
这就是大补汤去掉川芎，加入陈皮、远志、五味子，用来治疗脾肺两虚引起的发热、恶寒、肢体消瘦疲倦、食欲不振、腹泻，以及口干、食欲减退、咳嗽伴下痢、心惊悸动、发热伴自汗等症状。
这就是四物汤去掉地黄、芍药，用桂枝酒煎煮，用来治疗产后腹痛的复方。
这就是四物汤合参苏饮，用来治疗心气虚耗导致不能藏血，出现面色萎黄、五心烦热等症状。
治疗手足厥冷、脉象细微几乎摸不到的病症：
当归（三两，味辛性温）、桂枝（三两，去皮，味辛性热）、芍药（三两，味酸性寒）、细辛（三两，味辛性热）、通草（二两，味甘）。
以上七味药，用水八升，煮取三升，去渣滓，每次温服一升，每日三次。
成无己说，《内经》记载：“脉是血的府库，所有的血都属于心。”要通畅血脉，必须先补益心脏、滋养血液。“苦味先入于心”，当归的苦味可以助益心血；“心气苦缓，急食酸以收之”，芍药的酸味可以收敛心气；“肝气苦急，急食甘以缓之”，大枣、甘草、通草的甘味可以缓和阴血的急迫。
这就是本方加入吴茱萸（二升）、生姜（半斤），用水和酒各六升煮服，用来治疗手足厥逆，以驱散久留的寒邪。生姜味辛性温，可以运行阳气。
使用吴茱萸（一升，洗净）、人参（三两）、生姜（六两）、大枣（十二枚），用来治疗进食后想呕吐，这属于阳明病。
《内经》说：“寒邪侵袭体内，用甘热药治疗，辅以苦辛药。”吴茱萸、生姜的辛味可以温胃，人参、大枣的甘味可以缓和脉象。
使用炒制的五味子（三两）、炒制的吴茱萸（五钱），将这两味药研成末，每次服用二钱，用白开水调下，用来治疗肾泄（清晨五更时分腹泻），或者大便不实、随时想去厕所的情况，制成丸药服用尤其好。
治疗因中气不足、饮食劳倦导致清气下陷，进而引起脾胃虚弱，出现发热、头痛、四肢倦怠、心烦、肌肉日渐消瘦等症状。此法能升发元气、退除虚热、补益脾胃、生养血气。
黄芪（病情严重、劳累发热甚者用一钱）、炙甘草（以上各五分）、人参（去芦头三分，有咳嗽者去掉）、白术（三分）、茯苓（三分）、陈皮（三分）、升麻（二分）、柴胡（二分）。
以上八味药，切碎作为一剂，用水两盏，煎至一盏，根据气弱或气盛的情况，斟酌水量的多少，去渣滓，饭后稍热服用。
加减法：
如果腹中疼痛，加白芍药（五分）、炙甘草（三分）；如果怕冷且寒冷疼痛，加去皮肉桂（一分或三分）；如果不腹痛，去掉蔓荆子（二分）、细辛（二分）；如果下部疼痛，加...（原文此处残缺）；腹部疼痛都是寒证，汤剂和丸剂都主治疼痛。如果是湿邪导致的身体沉重，加升麻、苍术等药会损伤人体...（原文此处残缺）玄明粉（五分）...冬季或者...（原文此处残缺）○如果夏季...寒勿用之○能够进食但心下痞满，加黄连（一分或三分）；如果不能进食且心下痞满，不要加黄连；如果胁下疼痛或胁下拘急收缩，都加柴胡（三分），严重者加五分。上述方剂的加减，是因为饮食劳倦、喜怒不节，起初发病为热中，则可以使用；如果后来传变为寒中，则不可使用。因为甘味和酸味足以加重病情，如黄芪、人参、甘草、芍药、五味子之类。出自李东垣的《脾胃论》。
This is Da Bu Tang (Great Tonifying Decoction) with Chuanxiong Rhizome (Chuanxiong, 川芎) removed, and Chenpi (Aged Tangerine Peel, 陈皮), Yuanzhi (Polygala Root, 远志), and Wuweizi (Schisandra Fruit, 五味子) added. It treats deficiency of both the Spleen and Lung manifesting as fever, aversion to cold, emaciation and fatigue of the limbs, poor appetite, diarrhea, dry mouth, reduced food intake, cough accompanied by dysentery, palpitations, fever with spontaneous sweating, and other syndromes.
This is Si Wu Tang (Four Substances Decoction) with Shu Dihuang (Prepared Rehmannia Root, 熟地黄) and Shaoyao (Peony Root, 芍药) removed, decocted with Guizhi (Cinnamon Twig, 桂枝) and wine. It is a compound formula used to treat abdominal pain after childbirth.
This is the combination of Si Wu Tang (Four Substances Decoction) and Shen Su Yin (Ginseng and Perilla Drink, 参苏饮). It treats exhaustion of Heart Qi leading to the inability to store blood, presenting with sallow complexion and five-palm heat (heat sensation in the palms, soles, and chest).
This is the combination of Si Wu Tang (Four Substances Decoction) and Li Zhong Tang (Regulate the Middle Decoction, 理中汤). It treats Jiao Chang (Intestinal Intercourse/Inversion, 交肠), a condition involving abnormal passage of stool through the urinary tract or vice versa.
Treats cases of cold extremities and a fine pulse nearly imperceptible:
Danggui (Radix Angelicae Sinensis, 当归) – 3 liang, acrid, warm;
Guizhi (Ramulus Cinnamomi, 桂枝) – 3 liang, peeled, acrid, hot;
Shaoyao (Radix Paeoniae Alba/Lactiflorae, 芍药) – 3 liang, sour, cold;
Xixin (Herba Asari, 细辛) – 3 liang, acrid, hot;
Tongcao (Medulla Tetrapanacis, 通草) – 2 liang, sweet.
Take these seven ingredients, add eight sheng of water, boil to obtain three sheng, remove the dregs, and take one sheng warm, three times daily.
Cheng Wuji stated: The *Neijing* says, "The vessels are the mansion of Blood; all Blood belongs to the Heart." To unblock the vessels, one must first tonify the Heart and nourish the Blood. "Bitter flavors enter the Heart first"; the bitterness of Danggui assists Heart Blood. "The Heart suffers from flaccidity; urgently eat sour to astringe it"; the sourness of Shaoyao astringes Heart Qi. "The Liver suffers from urgency; urgently eat sweet to relieve tension"; the sweetness of Dazao (Jujube Fruit, 大枣), Gancao (Licorice Root, 甘草), and Tongcao relieves the urgency of Yin Blood.
This is the base formula plus Wuzhuyu (Evodia Fruit, 吴茱萸) – 2 sheng, and Shengjiang (Fresh Ginger, 生姜) – half jin, boiled with water and wine (six sheng each). It treats reversal cold of the extremities to disperse long-standing cold. Shengjiang is acrid and warm to circulate Yang Qi.
Use Wuzhuyu (Evodia Fruit, 吴茱萸) – 1 sheng (washed), Renshen (Ginseng Root, 人参) – 3 liang, Shengjiang (Fresh Ginger, 生姜) – 6 liang, and Dazao (Jujube Fruit, 大枣) – 12 pieces. It treats desire to vomit after eating, which belongs to the Yangming syndrome.
The *Neijing* states: "When cold invades the interior, treat with sweet-hot herbs, assisted by bitter-acrid ones." The acridity of Wuzhuyu and Shengjiang warms the Stomach; the sweetness of Renshen and Dazao moderates the pulse.
Use stir-fried Wuweizi (Schisandra Fruit, 五味子) – 3 liang, and stir-fried Wuzhuyu (Evodia Fruit, 吴茱萸) – 5 qian. Grind these two into powder. Take 2 qian per dose, mixed with plain water. It treats Kidney Diarrhea occurring at dawn (fifth watch). Alternatively, if stools are loose and frequent, making pills is especially excellent.
Treats weakness of the Middle Qi due to insufficient diet and overwork, causing clear Yang to sink, resulting in Spleen-Stomach weakness, fever, headache, limb fatigue, irritability, and progressive muscle emaciation. This method raises Yuan Qi, clears deficient heat, tonifies the Spleen and Stomach, and generates Blood and Qi.
Huangqi (Astragalus Root, 黄芪) – 1 qian for severe cases with labor-induced fever;
Zhi Gancao (Honey-fried Licorice Root, 炙甘草) – 5 fen each;
Renshen (Ginseng Root, 人参) – 3 qian (remove rhizome; omit if coughing);
Baizhu (Atractylodes Macrocephala Rhizome, 白术) – 3 qian;
Fuling (Poria, 茯苓) – 3 qian;
Chenpi (Aged Tangerine Peel, 陈皮) – 3 qian;
Shengma (Cimicifugae Rhizoma, 升麻) – 2 fen;
Chaihu (Bupleuri Radix, 柴胡) – 2 fen.
These eight ingredients, chopped as one dose, are boiled in two cups of water until one cup remains. Adjust the amount of water based on whether Qi is weak or strong. Remove dregs and take warm shortly after meals.
Modifications:
If there is abdominal pain, add Shaoyao (Peony Root, 芍药) – 5 fen and Zhi Gancao (Honey-fried Licorice Root, 炙甘草) – 3 fen.
If there is aversion to cold and cold pain, add Rougui (Cinnamon Bark, 肉桂) without skin – 1 fen or 3 fen.
If there is no abdominal pain, remove Manjingzi (Vitex Fruit, 蔓荆子) – 2 fen and Xixin (Herba Asari, 细辛) – 2 fen.
If there is lower abdominal pain, add... [text missing]; Abdominal pain is generally a Cold syndrome; both decoctions and pills treat pain. If dampness causes body heaviness, adding Shengma (Cimicifugae Rhizoma, 升麻) and Cangzhu (Atractylodes Lancea Rhizome, 苍术) damages the person... [text missing] Xuanmingfen (Natrii Sulfas, 玄明粉) – 5 fen... In winter or... [text missing] ○ In summer... avoid using for cold... ○ If able to eat but with epigastric fullness/stuffiness, add Huanglian (Coptis Rhizome, 黄连) – 1 fen or 3 fen. ○ If unable to eat with epigastric fullness, do not add Huanglian. ○ If there is hypochondriac pain or tightness/constriction, add Chaihu (Bupleuri Radix, 柴胡) – 3 fen, up to 5 fen for severe cases. The above modifications apply because initial onset from diet, labor, and emotional irregularity leads to Heat in the Middle, which can be treated this way. If it later transmits to Cold in the Middle, it cannot be used. Sweet and sour flavors alone would only exacerbate the disease, such as those found in Huangqi, Renshen, Gancao, Shaoyao, and Wuweizi. From Li Dongyuan's *Pi Wei Lun* (Treatise on the Spleen and Stomach).