（附内伤）
凡伤寒。恶寒。猛火不除。内伤。恶寒。稍就温暖即止。伤风。恶风。不耐一切风寒。
内伤。恶风。偏恶梦小贼风。外伤。恶热。无有休歇。日晡转剧。直待汗下方退。内
伤
内伤头痛时止时作外伤头疼非发散直待入里方罢。内伤元气不足。神思昏怠。语言倦懒。外伤
邪气有余。神思猛壮语言强健。内伤则手心热而手背不热。外伤则手背热而手心不热。内伤邪
在血脉中而不渴。外伤邪气传里则大渴。又以手按心口不痛为劳役伤。痛为饮食伤。劳役伤
发热兼恶寒。头骨节俱痛。饮食伤不恶寒但发热。头不甚痛。骨节不痛。但中脘饱闷。见食
即恶。宜细辨之。
凡内伤气口脉洪盛外伤人迎脉浮紧。然内伤劳役。气口脉急大而数。时一代而涩。涩者
脉之
有宿食也。
补中益气汤 治内伤劳倦。加减于后。
人参 黄 甘草 当归 白术（各一钱二分） 升麻（五分） 柴胡 陈皮（各八分）
如咳嗽去人参加五味子麦门冬。秋冬加不去节麻黄。春加款冬花。心下痞闷加芍药。黄
连能
。加枳实浓朴。木香砂仁。天寒加干姜。腹痛加白芍。寒痛加桂。夏加黄芩。冬加益智。脐
下痛加熟地。不已是寒也。加桂。脚软痛。加黄柏。不已加防己。身刺痛。倍当归。加枳壳
。身体重痛。乃风湿相搏。去人参黄 。加羌活苍术防风。宿食加山楂麦芽。食不知味。加
神曲。饥饿日久。去柴胡。加干山药。食不下。胃中有寒。或气滞。加青皮木香。精神短
少。倍参。加五味。犯房者。阳虚去升柴。加桂附。阴虚者。去升柴。加熟地山药茱萸。伤饮
食。视其所伤何物。各以主药治之。如伤于鱼肉。用山楂陈皮。蓬术三棱。甚至有加阿魏砂
仁巴豆霜。如伤于米食。用麦芽神曲。枳实槟榔草果。如伤于面食。用莱菔子为君。而佐以
苍术浓朴陈皮。如伤于生冷。用官桂木香。干姜砂仁。
(Attached: Internal Injury)
In cases of Cold Damage (Shanghan), there is aversion to cold that cannot be relieved even by approaching fierce fire. In cases of internal injury, there is aversion to cold that ceases upon seeking slight warmth. In cases of wind strike, there is aversion to wind, intolerance to all wind and cold.
In internal injury, there is aversion to wind, specifically fearing the "thief wind" (drafts) from dreams; in external injury, there is aversion to heat with no respite, worsening at dusk, and only subsiding after sweating.
Headache due to internal injury comes and goes intermittently; headache due to external injury does not cease until the pathogenic factor enters the interior unless dispersing methods are used. Internal injury involves deficiency of Yuan Qi (Primordial Qi), leading to mental dullness and fatigue, and languid speech. External injury involves excess of pathogenic factors, leading to vigorous spirit and strong speech. In internal injury, the palms are hot while the backs of the hands are not; in external injury, the backs of the hands are hot while the palms are not. In internal injury, the pathogen resides in the blood vessels without thirst; in external injury, when the pathogen transmits to the interior, there is intense thirst. Furthermore, if pressing the epigastrium causes no pain, it is an injury from overexertion; if it causes pain, it is an injury from diet. Fever from overexertion is accompanied by aversion to cold, with pain in the head, bones, and joints. Fever from dietary injury has no aversion to cold, only fever, mild headache, no joint pain, but rather fullness and oppression in the Zhongwan region, and nausea upon seeing food. These must be carefully distinguished.
In general, for internal injury, the Qi Kou pulse is surging and excessive; for external injury, the Ren Ying pulse is floating and tight. However, for internal injury due to overexertion, the Qi Kou pulse is urgent, large, and rapid, occasionally presenting as a Dai pulse (intermittent pulse) and choppy. A choppy pulse indicates retained food stagnation.
Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction) treats internal injury from labor and fatigue. Modifications are as follows:
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Gan Cao (Licorice Root), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Rhizoma) (each 1.2 qian); Sheng Ma (Cimicifugae Rhizoma) (0.5 qian); Chai Hu (Bupleuri Radix), Chen Pi (Citri Reticulatae Pericarpium) (each 0.8 qian).
If cough occurs, remove Ren Shen, add Wu Wei Zi (Schisandrae Fructus) and Mai Men Dong (Ophiopogonis Tuber). In autumn and winter, add Ma Huang (Ephedrae Herba) without removing joints. In spring, add Kuan Dong Hua (Fritillariae Thunbergii Flos). For subcostal fullness and oppression, add Bai Shao (Paeoniae Radix Alba) and Huang Lian (Coptidis Rhizoma). Add Zhi Shi (Aurantii Fructus Immaturus), Hou Po (Magnoliae Officinalis Cortex), Mu Xiang (Aucklandiae Radix), and Sha Ren (Amomi Fructus). In cold weather, add Gan Jiang (Zingiberis Rhizoma). For abdominal pain, add Bai Shao. For cold-type abdominal pain, add Gui Zhi (Cinnamomi Ramulus). In summer, add Huang Qin (Scutellariae Radix). In winter, add Yi Zhi Ren (Alpiniae Oxyphyllae Fructus). For pain below the umbilicus, add Shu Di Huang (Rehmanniae Radix Praeparata). If pain persists, it indicates cold; add Gui Zhi. For soft and painful legs, add Huang Bo (Phellodendri Cortex). If pain persists, add Fang Ji (Stephaniae Tetrandrae Radix). For stabbing body pain, double Dang Gui and add Zhi Ke (Aurantii Fructus). For heavy and painful body, this is rheumatism-wind-dampness binding; remove Ren Shen and Huang Qi, add Qiang Huo (Notopterygii Rhizoma et Radix), Cang Zhu (Atractylodis Rhizoma), and Fang Feng (Saposhnikoviae Radix). For retained food, add Shan Zha (Crataegi Fructus) and Mai Ya (Hordei Fructus Germinatus). For loss of taste, add Shen Qu (Mashihuangji Fermentatum). For prolonged hunger, remove Chai Hu, add Gan Shan Yao (Dioscoreae Rhizoma). For inability to swallow food, due to cold in the stomach or qi stagnation, add Qing Pi (Citri Reticulatae Pericarpium Viride) and Mu Xiang. For shortness of spirit, double Ren Shen and add Wu Wei Zi. For those injured by sexual activity: if Yang deficient, remove Sheng Ma and Chai Hu, add Rou Gui (Cinnamomi Cortex) and Fu Zi (Aconiti Lateralis Radix Praeparata); if Yin deficient, remove Sheng Ma and Chai Hu, add Shu Di Huang, Shan Yao, and Shan Zhu Yu (Corni Fructus). For dietary injury, treat according to the specific ingested item using its primary remedy. For injury from meat and fish, use Shan Zha, Chen Pi, Peng Zhu (Curcumae Longae Rhizoma), and San Leng (Sparganii Rhizoma); sometimes adding E Wei (Ferulae Resina), Sha Ren, and Ba Dou Frost (Crotonis Fructus). For injury from rice, use Mai Ya, Shen Qu, Zhi Shi, Bing Lang (Arecae Semen), and Cao Guo (Tsaoko Fructus). For injury from wheat products, use Lai Fu Zi (Radish Seed) as the chief herb, assisted by Cang Zhu, Hou Po, and Chen Pi. For injury from raw and cold foods, use Guan Gui (Cinnamomi Cortex), Mu Xiang, Gan Jiang, and Sha Ren.