人参 黄 白术 白芍药 熟地黄 茯苓 当归 川芎 甘草（各等分） 桂心（少
许）
肉极者，肌肉消瘦，皮肤枯槁，此方主之。
肉极由于阴火久灼者难治，宜别主六味地黄丸。若由饮食劳倦伤脾而致肉极者，宜大补
气血以充之。经曰∶气主煦之，血主濡之。故用人参、白术、黄 、茯苓、甘草甘温之品以
补气，气盛则能充实于肌肉矣。用当归、川芎、芍药、地黄、肉桂味浓之品以补血，血生则
能润泽其枯矣。
人参 麦门冬（去心） 五味子（炒，等分）
气极者，正气少，邪气多，多喘少言，此方主之。
肺主气，正气少，故少言。邪气多，故多喘。此小人道长，君子道消之象也。人参补肺
气，麦冬清肺气，五味敛肺气，一补一清一敛，养气之道毕矣。名曰生脉者，以脉得气则充，
失气则弱，故名之，东垣云∶夏月服生脉散，加黄 、甘草，令人气力涌出。若东垣者，可
以医气极矣。
虎骨（一具，通炙，取黄焦，汁尽，碎如雀脑） 糯米（三石，入虎骨，倍用曲，如酿
酒
法酿之，酒熟封头，五十日开饮之）
骨极者，腰脊酸削，齿痛，手足烦疼，不欲行动，此方主之。
肾主骨，骨极者，骨内空虚之极也，故令腰脊酸削。齿者，骨之余，故齿亦痛。手足烦
疼，不欲行动，皆骨内空虚之征也。以骨治骨，求其类也。以虎骨治骨，取其壮也。酿之以
酒者，取酒性善渍，直澈于骨也。褚澄云∶男子天癸未至而御女，则四肢有未满之处，异日
必有难状之疾。其骨极之类乎。
人参、黄芪、白术、白芍药、熟地黄、茯苓、当归、川芎、甘草（各取等量），桂心（少量）。
肌肉极度消瘦的病症，表现为肌肉消减、皮肤干枯，此方主治。
若肉极是由于阴火长期灼烧所致，则难以治疗，适宜另外选用六味地黄丸主治。如果是由于饮食不节和过度劳累损伤脾胃而导致的肉极，应当大补气血以充盈身体。《内经》说：气主要起温煦作用，血主要起濡润作用。因此用人参、白术、黄芪、茯苓、甘草这些甘温性质的药物来补气，气充足了就能充实肌肉。用当归、川芎、芍药、地黄、肉桂这些气味浓厚的药物来补血，血生成了就能润泽干枯的身体。
人参、麦门冬（去掉心）、五味子（炒制，等量）。
气极的病症，表现为正气不足、邪气亢盛，多喘息少言语，此方主治。
肺主司气，正气不足所以少言。邪气亢盛所以多喘。这是小人得势、君子失势的征象。人参补益肺气，麦冬清肃肺气，五味子收敛肺气，一补、一清、一敛，养气的道理就完备了。命名为“生脉”，是因为脉搏得到气的充养则充盈，失去气的充养则虚弱，所以这样命名。李东垣说：夏季服用生脉散，加入黄芪、甘草，能让人气力涌现。像李东垣这样的人，可以治疗气极的病症了。
虎骨（一副，整体炙烤，直到表面焦黄、汁液流尽，捣碎如雀脑大小）、糯米（三石，放入虎骨，加倍使用酒曲，按照酿酒的方法酿造，酒酿成后封口，五十天后开坛饮用）。
骨极的病症，表现为腰脊酸软削瘦、牙齿疼痛、手足烦热疼痛、不想活动，此方主治。
肾主司骨骼，骨极是骨骼内部空虚到了极点，所以导致腰脊酸软削瘦。牙齿是骨骼的余气所生，所以牙齿也会痛。手足烦热疼痛、不想活动，都是骨骼内部空虚的征象。用骨头来治疗骨头，是取其同类相求的道理。用虎骨来治疗骨病，是取其强壮筋骨的作用。用酒来酿造，是取酒性善于渗透，能直达骨骼深处。褚澄说：男子在先天之精（天癸）尚未成熟时就进行房事，那么四肢就会有发育不全的地方，日后必定会有难以名状的疾病。这大概就是骨极之类的情况吧。
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Rhizoma), Bai Shao Yao (Paeoniae Radix Alba), Shu Di Huang (Rehmanniae Radix Praeparata), Fu Ling (Poria), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma) [each in equal parts], Gui Xin (Cinnamomi Cortex) [a small amount].
The condition of *Rou Ji* (Muscle Extremity/Severe Muscle Wasting), characterized by emaciated muscles and withered skin, is primarily treated by this formula.
If *Rou Ji* results from prolonged burning by Yin Fire (Yin-deficiency heat), it is difficult to treat; instead, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) should be used. If *Rou Ji* is caused by damage to the Spleen due to improper diet and overexertion, one should greatly tonify Qi and Blood to replenish the body. The Classics state: "Qi provides warmth, Blood provides nourishment." Therefore, Ren Shen, Bai Zhu, Huang Qi, Fu Ling, and Gan Cao—sweet and warm substances—are used to tonify Qi; when Qi is abundant, it can fill the muscles. Dang Gui, Chuan Xiong, Shao Yao, Di Huang, and Rou Gui—substances with rich flavors—are used to nourish Blood; when Blood is generated, it can moisten the withered tissues.
Ren Shen (Ginseng Radix), Mai Men Dong (Ophiopogonis Tuber) [heart removed], Wu Wei Zi (Schisandrae Fructus) [stir-fried, equal parts].
The condition of *Qi Ji* (Qi Extremity/Severe Qi Deficiency), characterized by deficiency of Righteous Qi (Zheng Qi) and excess of Pathogenic Qi, with frequent panting and few words, is primarily treated by this formula.
The Lung governs Qi; deficiency of Righteous Qi leads to few words. Excess of Pathogenic Qi leads to frequent panting. This is a manifestation akin to "the rise of petty men and the decline of gentlemen." Ren Shen tonifies Lung Qi, Mai Men Dong clears Lung Qi, and Wu Wei Zi astringes Lung Qi. One tonifies, one clears, and one astringes; thus, the method of nourishing Qi is complete. It is named "Sheng Mai San" (Generate Pulse Powder) because the pulse becomes full when supported by Qi, and weak when Qi is lost. Li Dongyuan stated: "In summer, taking Sheng Mai San with added Huang Qi and Gan Cao causes Qi and strength to surge forth." Someone like Li Dongyuan could treat the condition of *Qi Ji*.
Hu Gu (Tiger Bone) [one whole piece, thoroughly roasted until surface is scorched yellow and juices are exhausted, crushed like sparrow brain], Nuomi (Glutinous Rice) [three shi, mixed with tiger bone, using double the amount of Qu (ferment), brewed according to wine-making methods; after brewing, seal the head, and drink after fifty days].
The condition of *Gu Ji* (Bone Extremity/Severe Bone Depletion), characterized by soreness and wasting of the waist and spine, toothache, vexatious pain in the hands and feet, and reluctance to move, is primarily treated by this formula.
The Kidney governs bones; *Gu Ji* represents extreme emptiness within the bones, hence causing soreness and wasting of the waist and spine. Teeth are considered the surplus of bones, hence they also ache. Vexatious pain in the hands and feet and reluctance to move are all signs of extreme emptiness within the bones. Using bone to treat bone follows the principle of seeking similarity. Using Tiger Bone to treat bone diseases takes advantage of its strengthening properties. Brewing it in wine utilizes the wine's nature to permeate deeply, reaching straight into the bones. Chu Cheng said: "If a man engages in sexual activity before his Tian Gui (Heavenly Water/Primordial Essence) has arrived, there will be areas of incomplete development in the four limbs, and later he will surely suffer from inexplicable illnesses." This likely belongs to the category of *Gu Ji*.