治五劳虚极羸瘦。腹满不能饮食。食伤。忧伤。饮伤。房室伤。饥伤。劳伤。
气伤。内有干血。肌肤甲错。两目黯黑。缓中补虚者。此丸主之。
大黄（十分。蒸。） 黄芩（二两。） 甘草（三两。） 桃仁（一升。） 杏仁（一升。）
芍
螬（百枚
上十二味。末之。炼蜜和丸小豆大。酒服五丸。日三服。
歌曰 干血致劳穷源委。缓中补虚治大旨。螬蛭百个 半升。桃杏虻虫一升止。一两干
漆
生大可恃。
尤在泾曰。风气不去。则足以贼正气而生长不荣。故薯蓣丸为要方。干血不去。则足以
留新
芦茹丸
而为痹
补虚和
血也。
忧患
于肝
则饥
故
液
皆伤其经络营卫之气也。细绎本文云。腹满不能食。肌肤甲错。面目黯黑。明是不能内谷以
通流营卫。则营卫凝注。瘀积之血。牢不可破。即有新生之血。亦不得畅茂条达。惟有日渐
羸瘦。而成内伤干血劳。其有不死者几希矣。仲景乃出佛心仙手。治以大黄 虫丸。君以大
黄。从胃络中宣瘀润燥。佐以黄芩清肺卫。杏仁润心营。桃仁补肝虚。生地滋肾燥。干漆性
急飞窜。破脾胃关节之瘀血。虻虫性升。入阳分破血。水蛭性下。入阴分逐瘀。螬蛴去两胁
下之坚血。 虫破坚通络行阳。却有神功。故方名标而出之。芍药、甘草扶脾胃。解药毒。
缓中补虚者。缓舒也。绰也。指方中宽舒润血之品而言也。故喻嘉言曰。可用琼玉膏补之。
勿以 、术补中。失却宽舒胃气之义。
治疗五劳（久病导致的五种虚损）导致极度虚弱消瘦。腹部胀满，不能进食。由饮食所伤、忧思所伤、饮酒所伤、房事所伤、饥饿所伤、劳累所伤，以及气机受损。体内有干血（陈旧性瘀血），皮肤粗糙如鳞甲，两眼颜色暗黑。需要缓中补虚的，此丸主治。
大黄（十分，蒸制）、黄芩（二两）、甘草（三两）、桃仁（一升）、杏仁（一升）、芍药、䗪虫（百枚）、水蛭（百枚，熬）、虻虫（百枚，去翅足，熬）、干漆（炒至烟尽）、地黄（十两）、干地黄（此处原文似有脱漏或异文，依《金匮要略》原方应为干地黄十两，歌括中作“生大可恃”指生地）、蘘荷根（即芦茹，一两）。
以上十二味药，研成细末，用炼蜜调和制成如小豆大小的丸剂。每次服用五丸，酒送服，每日三次。
歌诀说：干血导致劳损，需穷究其源委；缓中补虚是治疗的总旨。䗪虫一百个，半升；桃仁、杏仁、虻虫各一升止。干漆一两，生地黄大量可依靠。
尤在泾说：风气不去除，就足以伤害正气，使生长功能不荣盛。所以薯蓣丸是重要方剂。干血不去除，就足以留住新血生成的障碍，导致营卫之气皆损伤经络。细细推敲本文所说，腹部胀满不能进食，皮肤粗糙如鳞甲，面目暗黑，明显是不能摄入谷气以通流营卫之气。那么营卫之气凝滞注着，瘀积之血牢固不可破除。即使有新生的血液，也不能畅茂条达。只有日渐消瘦，而成内伤干血劳。能够不死的很少了。张仲景于是出于佛心仙手，用大黄䗪虫丸来治疗。以大黄为君药，从胃络中宣散瘀血、润燥；佐以黄芩清肺卫，杏仁润心营，桃仁补肝虚，生地滋肾燥。干漆性急飞窜，破除脾胃关节的瘀血；虻虫性升，入阳分破血；水蛭性下，入阴分逐瘀；䗪虫去除两胁下的坚血；䗪虫（此处歌括可能有误，通常指䗪虫或土鳖虫等，结合上下文及尤氏注解，应指䗪虫或类似虫类药，但原文歌括写的是“螬蛴”，尤氏注解提到“螬蛴去两胁下之坚血”，故保留螬蛴/䗪虫概念）破坚通络行阳，确有神功。所以方名标出。芍药、甘草扶持脾胃，解药毒。“缓中补虚”的意思是缓舒。绰约也。指方中宽舒润血的药物而言。所以喻嘉言说：可用琼玉膏补之，不要用白术、苍术补中，以免失去宽舒胃气的本义。
Treats the condition of *Wulao* (Five Labors, referring to five types of chronic deficiency syndromes) leading to extreme emaciation and weakness. Abdominal fullness and inability to eat. Caused by injury from diet, sorrow/worry, drinking/alcohol, sexual activity, hunger, labor/exhaustion, and Qi injury. There is dry blood (old stasis) inside the body, the skin is rough like scales (*jicuo*), and both eyes are dark. For those requiring the method of "soothing the middle and tonifying deficiency," this pill is the primary treatment.
Da Huang (Polygoni Multiflori Radix Prepared / Rhizoma Polygoni Cuspidati), Huang Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Tao Ren (Persicae Semen), Xing Ren (Armeniacae Semen Amarum), Shao Yao (Paeoniae Radix Alba), E Chong (Asiatic Ground Beetle), Shui Zhi (Hirudo), Meng Chong (Tabanidae), Gan Qi (Resina Taxilli), Di Huang (Rehmanniae Radix), Lu Ru (Rhizoma Alpinii Offinarum).
The above twelve ingredients are powdered, mixed with refined honey, and formed into pills the size of small beans. Take five pills per dose, administered with wine, three times daily.
The song states: Dry blood causes labor; trace the source and details. Soothing the middle and tonifying deficiency is the main principle. One hundred E Chong, half a sheng; Tao Ren, Xing Ren, and Meng Chong each one sheng. One liang of Gan Qi, a large amount of raw Di Huang can be relied upon.
You Zaijing said: If wind-qi is not expelled, it will sufficiently damage righteous Qi, causing growth and flourishing to be unprosperous. Therefore, Shuyu Wan is an essential formula. If dry blood is not expelled, it will suffice to hinder the generation of new blood, injuring the Qi of Ying and Wei in their collaterals. Carefully analyzing the original text: abdominal fullness and inability to eat, skin rough like scales, dark face and eyes, clearly indicate the inability to process grain to circulate Ying and Wei Qi. Thus, Ying and Wei Qi stagnate and accumulate, and the stasis becomes firm and unbreakable. Even if new blood is generated, it cannot flourish and flow freely. Only gradually becoming emaciated, resulting in internal injury dry blood labor. Few would survive. Zhang Zhongjing then, with Buddha's heart and immortal hands, treats it with Dahuang Zhechong Wan. Da Huang serves as the sovereign herb, dispersing stasis and moistening dryness from the stomach collaterals. Huang Qin assists by clearing Lung Wei, Xing Ren moistens Heart Ying, Tao Ren tonifies Liver deficiency, Di Huang nourishes Kidney dryness. Gan Qi has an urgent and penetrating nature, breaking stasis in the spleen, stomach, and joints. Meng Chong has an ascending nature, entering the Yang aspect to break blood. Shui Zhi has a descending nature, entering the Yin aspect to expel stasis. E Chong removes hard stasis under the two flanks. [Note: The text mentions 'Cao Si' or similar insect in the song, but You's commentary refers to properties of specific insects]. It breaks hardness, unblocks collaterals, and promotes Yang movement, possessing divine efficacy. Hence the formula name is highlighted. Shao Yao and Gan Cao support the Spleen and Stomach and resolve drug toxicity. "Soothing the middle and tonifying deficiency" means soothing and relaxing. Graceful and soft. It refers to the herbs in the formula that broaden and moisten the blood. Therefore, Yu Jiayan said: Qiongyu Gao can be used for tonification. Do not use Bai Zhu and Cang Zhu to tonify the middle, lest you lose the meaning of broadening and soothing the Stomach Qi.