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，经络营卫
气伤，内有干血，肌肤甲错，两目暗黑者，用此缓中补虚。
大黄（十分蒸） 黄芩（二两） 杏仁 桃仁（各一升） 地黄（十两） 干漆（一两）
虻虫（一升） 水蛭（百枚） 蛴螬（一升） 虫（半升） 芍药（四两） 甘草（三两）
蜜丸小豆大，酒服五丸，日三服。
虫丸（ 虫破坚通络行伤，大有功效，故方名表之。）治干血劳，（喻嘉言《医门法律》
曰∶“此干血劳之良治也。血结在内，手足脉相失者宜之。”）大黄（从胃络宣瘀润燥）地黄
（滋肾燥）芩（清肺卫）杏（润心营）桃，（补肝虚）芍药（扶脾补虚）甘草（缓中解毒）
与干漆，（破脾胃关节之瘀血）虻虫（性升入阳络破血）水蛭（性潜入阴络逐瘀）并蛴螬。（去
胁下之坚血）血既瘀干攻必润，润补兼投琼玉膏。（按∶五劳虚极痹而内成干血者，悉皆由
伤而血瘀，由瘀而为干血。假如食伤脾，忧伤肺，醉饮伤肝，房室伤肾，劳伤心，饥伤胃，
是诸伤者，总皆伤其经络营卫之气也。细绎本文云“腹满不能饮食，肌肤甲错，两目暗黑”，
明是不能纳谷以通流营卫，则营卫凝泣。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。仲景另出手眼而制此方，以缓
中补虚。缓者，舒也，绰也，指方中宽舒润血之品言也。故喻嘉言《医门法律》谓兼入琼玉
膏润补之药同用尤妙，勿以 、术补中，失却宽舒胃气之义。仲景妙法，得喻氏之言而益彰，
活人无算矣。）
Indicated for **Wu Lao** (Five Exertions) resulting in extreme deficiency and emaciation, abdominal fullness with inability to eat, caused by injuries from diet, sorrow, excessive drinking, sexual excess, hunger, and overwork, as well as injury to the meridians, Ying, and Wei Qi. With dry blood retained internally, skin rough like scales, and dark circles around the eyes, this formula is used to gently relieve central stagnation and tonify deficiency.
Da Huang (Shi Fen, steamed), Huang Qin (Liang Er), Xing Ren, Tao Ren (Ge Yi Sheng), Di Huang (Shi Liang), Gan Xi (Liang Yi), Meng Chong (Yi Sheng), Shui Zhi (Bai Mei), Qi Cao (Yi Sheng), E Chong (Ban Sheng), Shao Yao (Liang Si), Gan Cao (Liang San).
Pounded into honey pills, size of small beans, taken five pills at a time with wine, three times daily.
E Chong (breaks hardness, unblocks collaterals, treats injuries, has great efficacy, thus named in the formula.) Treats Gan Xue Lao (Dry Blood Consumption). (Yu Jiayan in *Yi Men Fa Lv* states: "This is an excellent treatment for Dry Blood Consumption. When blood is knotted internally and the pulses of the hands and feet are discordant, this is suitable.") Da Huang (from the Stomach collateral, promotes stasis resolution and moistens dryness), Di Huang (moistens Kidney dryness), Huang Qin (clears Lung Wei), Xing Ren (moistens Heart Ying), Tao Ren (tonifies Liver deficiency), Shao Yao (supports Spleen and tonifies deficiency), Gan Cao (relaxes the center and resolves toxicity).
Combined with Gan Xi (breaks blood stasis in the joints of the Spleen and Stomach), Meng Chong (nature ascends to enter Yang collaterals to break blood), Shui Zhi (nature descends to enter Yin collaterals to drive out stasis), along with Qi Cao (removes hard blood under the hypochondrium). Since blood is stagnant and dry, attack must be accompanied by moistening; moistening and tonifying are administered together, such as Qiong Yu Gao. (Note: Wu Lao extreme deficiency with bi obstruction leading to internal dry blood arises entirely from injury causing blood stasis, which becomes dry blood. For instance, dietary injury harms the Spleen, sorrow injures the Lung, drunkenness harms the Liver, sexual excess harms the Kidney, overwork harms the Heart, and hunger harms the Stomach. These various injuries all damage the Qi of the meridians, Ying, and Wei. Carefully analyzing the text: "abdominal fullness with inability to eat, skin rough like scales, dark circles around the eyes" clearly indicates that inability to ingest grain fails to circulate Ying and Wei, causing Ying and Wei to stagnate. The accumulated stasis is firm and unbreakable; even if new blood is generated, it cannot flourish and flow freely. Only gradual emaciation occurs, becoming internal injury Dry Blood Lao, with few surviving cases. Zhang Zhongjing employed unique insight to create this formula to gently relieve the center and tonify deficiency. "Gentle" means soothing, referring to the blood-moistening and relaxing ingredients in the formula. Thus, Yu Jiayan's *Yi Men Fa Lv* suggests that combining it with moistening and tonifying medicines like Qiong Yu Gao is particularly wonderful. Do not use Bai Zhu or Cang Zhu to tonify the center, lest one lose the meaning of relaxing and soothing Stomach Qi. Zhang Zhongjing's brilliant method is further highlighted by Yu's words, saving countless lives.)