羌活（一两） 防风（去芦） 苍术（酒浸，去皮） 黄 （以上各一钱） 升麻（七分） 炙甘草 独
活柴胡（以上各五分） 川芎（去头痛） 黄柏 橘皮 本（以上各三分） 泽泻（去须，一分） 猪
苓（去黑皮） 茯苓（以上各二分） 黄连（去须，一分）
上 咀。每服秤三钱或五钱，水二盏，煎至一盏，去渣，稍热服，量虚实施用。
如有不尽证候，根据加减法用之。
夫脉弦洪缓，而沉按之中之下得时一涩，其证∶四肢满闷，肢节烦疼，难以屈伸，身体
沉重，烦心不安，忽肥忽瘦，四肢懒倦，口失滋味，腹难舒伸，大小便清利而数，或上饮下
便，或大便涩滞不行，一二日一见，夏月飧泄，米谷不化，或便后见血，见白脓，胸满短气
，膈咽不通，或痰嗽稠粘，口中沃沫，食入反出，耳鸣耳聋，目中流火，视物昏花， 肉红
丝，热壅头目，不得安卧，嗜卧无力，不思饮食，调中益气汤主之。
黄 （一钱） 人参（去芦头，有嗽者去之） 甘草 苍术（以上各五分） 柴胡（一味为上气不
足，胃气与脾气下溜，乃补上气，从阴引阳也）
橘皮（如腹中气不得运转，更加一分） 升
麻（以上各二分） 木香（一分或二分）
上件锉麻豆大。都作一服，水二大盏，煎至一盏，去渣，带热，宿食消尽服之。宁
心绝思，药必神效，盖病在四肢血脉，空腹在旦是也。
如时头热躁，是下元阴火蒸蒸发也，加真生地黄二分、黄柏三分，无此证则去之。
如大
便虚坐不得，或大便了而不了，腹中常逼迫，血虚血涩也，加当归身三分；如身体沉重，虽
小便数多，亦加茯苓二分，苍术一钱，泽泻五分，黄柏三分，时暂从权而祛湿也，不可常用
，兼足太阴已病，其脉亦络于心中，故显湿热相合而烦乱；如胃气不和，加汤洗半夏五分，
生姜三片；有嗽，加生姜，生地黄二分，以制半夏之毒；如痰厥头痛，非半夏不能除，此足
太阴脾所作也；如兼躁热，加黄柏、生地黄以上各二分；如无以上证，只服前药；如夏月，
须加白芍药三分；如春月腹中痛，尤宜加。
如恶热而渴，或腹痛者，更加芍药五分，生黄芩
二分。
如恶寒腹中痛，加中桂三分，去黄芩，谓之桂枝芍药汤，亦于芍药汤中加之同煎；如冬
月腹痛，不可用芍药，盖大寒之药也。只加干姜二分，或加半夏五七分，以生姜少许制之。
如秋冬之月，胃脉四道为冲脉所逆，并胁下少阳脉二道而反上行，病名曰厥逆，《内经》曰
∶逆气上行，满脉去形，明七神昏绝，离去其形而死矣，其证∶气上冲咽不得息，而喘急有
音，不得卧，加吴茱萸五分或一钱五分，汤洗去苦，观厥气多少而用之。
如夏月有此证，为
大热也，盖此病随四时为寒热温凉也，宜以酒黄连、酒黄柏、酒知母各等分，为细末，热
汤为丸。梧桐子大，每服二百丸，白汤送下，空心服。仍多饮热汤，服毕少时，便以美饮食
压之，使不令胃中留停，直至下元，以泻冲脉之邪也。大抵治饮食劳倦所得之病，乃虚劳七
损证也，当用温平，甘多辛少之药治之，是其本法也。
如时上见寒热，病四时也，又或将理
不如法，或酒食过多，或辛热之食作病，或寒冷之食作病，或居大热大寒之处益其病，当临
时制宜，暂用大寒大热治法而取效，此从权也，不可以得效之故而久用之，必致难治矣。
《黄帝针经》云∶从下上者，引而去之。上气不足，推而扬之。盖上气者，心肺上焦之
气，阳病在阴，从阴引阳，宜以入肾肝下焦之药，引甘多辛少之药，使升发脾胃之气，又从
而去其邪气于腠理皮毛也。又云∶视前痛者，常先取之，是先以缪刺泻其经络之壅者，为血
凝而不流，故先去之，而后治他病。
羌活（一两） 防风（去除芦头） 苍术（酒浸，去皮） 黄芪、人参（以上各一钱） 升麻（七分） 炙甘草 独活、柴胡（以上各五分） 川芎（专治头痛） 黄柏、陈皮、藁本（以上各三分） 泽泻（去须，一分） 猪苓（去黑皮）、茯苓（以上各二分） 黄连（去须，一分）
将上述药材捣碎成粗颗粒。每次服用三钱或五钱，加水两盏，煎煮至一盏，滤去药渣，趁稍热时服用，根据患者体质的虚实调整用量。
如果症状不完全符合上述描述，可根据加减法进行药物增减使用。
脉象弦、洪、缓，沉取时中下部偶尔出现涩象，其症状表现为：四肢胀满闷痛，关节烦疼，难以屈伸，身体沉重，心烦不安，忽胖忽瘦，四肢倦怠乏力，口中味觉丧失，腹部难以舒展，大小便清利但次数频繁，或者上饮水下排泄，或者大便涩滞不通，一二日才排便一次，夏季出现完谷不化的泄泻，米谷不消化，或者便后见血，排出白色脓液，胸满短气，膈咽部不通畅，或者痰嗽稠粘，口中流涎沫，食物吃进去又反吐出来，耳鸣耳聋，眼中感觉如火烧，视物昏花，眼睑红肿有红丝，热气壅塞头目，无法安卧，嗜睡无力，不想饮食，用调中益气汤主治。
黄芪（一钱） 人参（去芦头，有咳嗽者去掉） 甘草、苍术（以上各五分） 柴胡（一味药用于上气不足，胃气与脾气下陷，这是补上气，从阴引阳的方法）
陈皮（如果腹中气机运转不畅，再加一分） 升麻（以上各二分） 木香（一分或二分）
将上述药材锉成麻豆大小。全部作为一服，加水两大盏，煎煮至一盏，滤去药渣，趁热服用，待宿食消尽后服用。保持心情宁静，断绝思虑，药效必定神妙，因为病在四肢血脉，空腹在早晨服用效果最佳。
如果时常头部发热烦躁，这是下元阴火蒸腾所致，加真生地黄二分、黄柏三分，没有此证则去掉。
如果大便里急后重排不出，或者大便完了却觉得没排干净，腹部常感逼迫，这是血虚血涩，加当归身三分；如果身体沉重，虽然小便次数多，也加茯苓二分、苍术一钱、泽泻五分、黄柏三分，暂时权宜以祛除湿邪，不可常用，兼有足太阴脾经已病，其脉也络于心中，所以显现湿热相合而烦乱；如果胃气不和，加汤洗半夏五分、生姜三片；有咳嗽，加生姜、生地黄二分，以制约半夏的毒性；如果是痰厥头痛，非半夏不能除去，这是足太阴脾经病变所致；如果兼有躁热，加黄柏、生地黄以上各二分；如果没有以上症状，只服用前面的药；如果是夏季，必须加白芍药三分；如果是春季腹中痛，尤其适宜加入。
如果恶热且口渴，或者腹痛，再加芍药五分、生黄芩二分。
如果恶寒且腹中痛，加肉桂三分，去掉黄芩，称为桂枝芍药汤，也在芍药汤中加入同煎；如果是冬季腹痛，不可用芍药，因为它是大寒的药。只加干姜二分，或者加半夏五七分，用少许生姜来制约它。
如果是秋冬月份，胃脉四道被冲脉所逆乱，并胁下少阳脉二道反而上行，病名叫做厥逆，《内经》说：逆气上行，满脉去形，神明昏绝，离开形体而死。其症状表现为：气上冲咽喉不得呼吸，喘息急促有声，无法平卧，加吴茱萸五分或一钱五分，汤洗去苦味，观察厥气的多少来决定用量。
如果是夏季出现此证，属于大热，因为此病随四季变化而有寒热温凉的区别，宜用酒黄连、酒黄柏、酒知母各等分，研为细末，用热汤做成丸剂。梧桐子大小，每次服用二百丸，白开水送下，空腹服用。仍要多喝热汤，服药完毕后稍过片刻，立即用美味饮食压住药力，使药力不留在胃中，一直下行到下元，以泻除冲脉的邪气。大抵治疗因饮食劳倦所得的疾病，乃是虚劳七损证，应当用温平、甘多辛少的药物治疗，这是根本方法。
如果时常上部出现寒热，是病应四时，或者是调理不如法，或者酒食过多，或者辛辣热性食物致病，或者寒冷食物致病，或者居住在极热极冷的地方加重病情，应当临时制宜，暂时用大寒大热的治法以求见效，这是权宜之计，不可以因为见效而长期使用，必然导致难治。
《黄帝针经》说：病气从下向上走的，引导使其离去。上气不足的，推举而扬升之。所谓上气，是心肺上焦之气，阳病在阴，从阴引阳，宜用入肾肝下焦的药物，引导甘多辛少的药物，使脾胃之气升发，又从腠理皮毛驱除邪气。又说：看以前疼痛的地方，常常先取穴治疗，是先以缪刺法泻除经络的壅滞，是因为血凝而不流动，所以先去除此症，而后治疗其他疾病。
Qianghuo (Notopterygii Rhizoma et Radix, 1 liang) Fangfeng (Saposhnikoviae Radix, de-lusted) Cangzhu (Atractylodis Rhizoma, wine-soaked, skin removed) Huangqi (Astragali Radix), Renshen (Ginseng Radix et Rhizoma) (each 1 qian) Shengma (Cimicifugae Rhizoma, 7 fen) Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix) (each 5 fen) Chuanxiong (Ligustici Chuanxiong Rhizoma, for headache) Huangbai (Phellodendri Cortex), Chenpi (Citri Reticulatae Pericarpium), Gaoben (Ligustici Jingweii Rhizoma) (each 3 fen) Zexie (Alismatis Rhizoma, de-needled, 1 fen) Zhuling (Polyporus, de-black skin), Fuling (Poria) (each 2 fen) Huanglian (Coptidis Rhizoma, de-needled, 1 fen)
Crush the above herbs into coarse particles. For each dose, weigh 3 qian or 5 qian, add two zhan of water, decoct until one zhan remains, remove the dregs, and take it slightly warm. Adjust usage according to the patient's deficiency or excess.
If the symptoms are not entirely consistent, apply modifications according to the addition and subtraction rules.
The pulse is wiry, surging, and slow; upon deep pressure at the middle and lower levels, a occasional choppy quality is felt. The manifestations include: fullness and stuffiness in the four limbs, vexing pain in the joints, difficulty in flexion and extension, heaviness of the body, mental restlessness, fluctuating weight (sudden fatness or thinness), lassitude of the four limbs, loss of taste in the mouth, abdominal discomfort and inability to stretch, clear urination and defecation but frequent, or drinking water above and excreting below, or constipation with difficult passage occurring once every one or two days, diarrhea with undigested food in summer, blood or white pus after defecation, chest fullness and shortness of breath, obstruction in the diaphragm and throat, thick and sticky phlegm-cough, excessive salivation in the mouth, regurgitation of food after eating, tinnitus and deafness, sensation of fire flowing in the eyes, blurred vision, red filaments in the eyelids, heat congestion in the head and eyes, inability to lie down peacefully, lethargy and weakness, lack of appetite. Tiaozhong Yiqi Tang (Regulate the Middle and Boost Qi Decoction) is the primary formula.
Huangqi (Astragali Radix, 1 qian) Renshen (Ginseng Radix et Rhizoma, de-lusted, omit if coughing) Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Cangzhu (Atractylodis Rhizoma) (each 5 fen) Chaihu (Bupleuri Radix) (This single herb addresses insufficiency of upper qi; sinking of stomach and spleen qi is treated by tonifying upper qi, drawing from yin to guide yang.)
Chenpi (Citri Reticulatae Pericarpium) (If qi movement in the abdomen is obstructed, add 1 fen more) Shengma (Cimicifugae Rhizoma) (each 2 fen) Muxiang (Aucklandiae Radix) (1 fen or 2 fen)
Cut the above herbs to the size of hemp seeds. Combine as one dose, add two large zhan of water, decoct until one zhan remains, remove the dregs, and take it while hot. Administer after residual food in the stomach has digested. Maintain calmness and cease overthinking; the medicinal effect will be miraculous, as the disease resides in the vessels of the four limbs, and taking it on an empty stomach in the morning is optimal.
If there is frequent heat and irritability in the head, this is steaming from yin-fire in the lower origin. Add Shengdihuang (Rehmanniae Radix, 2 fen) and Huangbai (Phellodendri Cortex, 3 fen); omit if these symptoms are absent.
If there is tenesmus (feeling the need to defecate without success) or incomplete evacuation with constant abdominal pressure, this indicates blood deficiency and stagnation. Add Dangguishen (Angelicae Sinensis Radix, 3 fen). If the body feels heavy, even with frequent urination, also add Fuling (Poria, 2 fen), Cangzhu (Atractylodis Rhizoma, 1 qian), Zexie (Alismatis Rhizoma, 5 fen), and Huangbai (Phellodendri Cortex, 3 fen) to temporarily dispel dampness. Do not use long-term. Since the Foot-Taiyin Spleen channel is already diseased and its pulse connects to the heart, damp-heat combines causing vexation. If stomach qi is disharmonious, add Banxia (Pinelliae Rhizoma, washed with water, 5 fen) and Shengjiang (Zingiberis Rhizoma Recens, 3 slices). If coughing, add Shengjiang (Zingiberis Rhizoma Recens) and Shengdihuang (Rehmanniae Radix, 2 fen) to moderate the toxicity of Banxia. If there is phlegm-jue headache, only Banxia can resolve it; this is caused by the Foot-Taiyin Spleen. If accompanied by irritability and heat, add Huangbai (Phellodendri Cortex) and Shengdihuang (Rehmanniae Radix, 2 fen each). If none of the above symptoms exist, take only the previous prescription. In summer, add Baishao (Paeoniae Radix Alba, 3 fen). In spring, if there is abdominal pain, addition is especially suitable.
If there is aversion to heat and thirst, or abdominal pain, add Baishao (Paeoniae Radix Alba, 5 fen) and Sheng Huangqin (Scutellariae Radix, 2 fen).
If there is aversion to cold and abdominal pain, add Rougui (Cinnamomi Cortex, 3 fen) and remove Huangqin (Scutellariae Radix); this is called Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction), added to the Shaoyao Tang for simultaneous decoction. In winter, do not use Baishao (Paeoniae Radix Alba) as it is a great cold medicine. Use Ganjiang (Zingiberis Rhizoma, 2 fen) instead, or add Banxia (Pinelliae Rhizoma, 5-7 fen) moderated by a little Shengjiang (Zingiberis Rhizoma Recens).
In autumn and winter months, if the four pathways of the stomach pulse are reversed by the Chong Mai (Penetrating Vessel), and the two pathways of the Shaoyang pulse under the hypochondrium reverse upward, the disease is named Jue Ni (Jue-Ni). The *Neijing* states: "Upward reversal of qi fills the pulses and separates from the form; when the seven spirits become confused and severed, death occurs as the spirit leaves the form." Symptoms include: qi rushing up to the throat preventing breathing, rapid panting with sound, inability to lie flat. Add Wuzhuyu (Evodiae Fructus, 5 fen or 1.5 qian), washed with water to remove bitterness, using the amount based on the degree of jue qi.
If this occurs in summer, it is due to great heat. This disease varies with the seasons' cold, heat, warmth, and coolness. Use Jiuhuanglian (Coptidis Rhizoma processed with wine), Jiuhuangbai (Phellodendri Cortex processed with wine), and Jiuzhimu (Anemarrhenae Rhizoma processed with wine) in equal parts, ground into fine powder, and made into pills with hot water. Size of Sophora japonica seeds. Take 200 pills per dose with plain warm water, on an empty stomach. Drink plenty of hot soup afterwards. Shortly after taking the medicine, consume delicious food to suppress the gastric retention, guiding the medicine down to the lower origin to drain the pathogenic factors of the Chong Mai (Penetrating Vessel). Generally, diseases obtained from diet and overwork are deficiency-fatigue and Seven Damages syndromes; they should be treated with warm, neutral medicines that are sweet and pungent, which is the fundamental method.
If there are alternating chills and fever at the upper level, it corresponds to the four seasons, or improper management, excessive alcohol and food, illness caused by spicy-hot foods, illness caused by cold foods, or staying in extreme heat/cold environments aggravating the condition. One must adapt to the time and temporarily use great cold or great heat treatments to achieve effect; this is a provisional measure. Do not use them long-term just because they work, or it will lead to difficult-to-treat conditions.
The *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) states: "For conditions rising from below, guide them away." "For insufficiency of upper qi, push and elevate it." Upper qi refers to the qi of the Heart and Lungs in the Upper Jiao. Yang disease in Yin requires drawing from Yin to guide Yang. Use medicines entering the Kidney and Liver Lower Jiao to guide sweet-and-pungent medicines to raise and develop Spleen and Stomach qi, and expel pathogenic factors from the couli (interstices) and skin/hair. It also states: "Where there was previous pain, often select points first." This means using Mi Ci (Mistaken Puncture) to drain stagnation in the collaterals, because blood coagulates and does not flow; thus, remove this first, then treat other diseases.