即大建中汤加白术 白茯苓 熟地 川芎 麦冬 肉苁蓉（各等分）。
白术 附子（炮） 陈皮 苍术（制） 浓朴（制） 半夏（汤泡） 茯苓（去皮） 泽泻（各一两） 猪苓
（去皮，半两） 肉桂（四钱） 每服五钱，水一盏，生姜三片，煎半盏，食前温服，量虚实
加减。
黄 （一钱） 人参 甘草（炙） 当归 白术（各半钱） 白芍药 柴胡 升麻（各三分） 橘皮（二分） 五
味子（十五粒） 水二钟，煎一钟，去滓温服，食前。
柴胡（八钱） 防风（二钱五分） 葛根 升麻 羌活 独活 人参 白芍（各五钱） 生甘草（二钱）
炙甘草（三钱） 每服五钱，加姜、枣煎。
肉桂 甘草 芍药 黄 当归 川芎 人参 白术 茯苓 熟地黄（各等分） 为
粗末，每服二大钱，水一盏、生姜三片，枣二枚，煎七分，不拘时温服。
白芍药（一钱五分） 人参 陈皮 黄 （蜜炙） 桂心 白术 当归 甘草（炙，各一钱） 熟
地黄 五味子（炒，杵） 茯苓（各七分半） 远志（五分，去心） 姜、枣，水煎服。
（即下方加附子、肉桂。）
桂、附能补一切火，得六味引之，则专补命门之火。何则？附子通行诸经，走
而不守，肉桂性亦窜发，（逢阳药则为汗散，逢血药则为温行。）二者皆难控制，必得六味为之
浚导，乃能下行而无上僭之虞。今人不明此理，动称桂、附引火归元，离六味而用
之，以致酷烈中上，烁涸三阴，为祸大矣。（火欲少，不欲壮，故桂、附各止一两。火少则生气，故
《金匮》名此为肾气丸。）裁八味为六味，始自钱仲阳之治小儿，以小儿稚阳纯气，故去桂、
附也。 立斋因之悟，大人阴虚火动，用丹溪补阴法不验者，用此立应。（丹溪用四物汤
补阴，乃补后天有形之血，此则补先天无形之水，故水虚者非此不可。）自是以来，群推为滋阴之神方。
《医贯》又推展其义，触处旁通，以应无穷之变。而要之皆为根本亏败而设，若病不
涉肾，固可不用也。今人未达《医贯》之旨，不论何病，辄令服此，延缓误事。
故张介石谓《医贯》以六味治伤寒，其言如 ，而医者病家反谓平稳，亦可哂也。
就是大建中汤加入白术、白茯苓、熟地黄、川芎、麦冬、肉苁蓉（各取等量）。
白术、附子（炮制）、陈皮、苍术（炮制）、厚朴（炮制）、半夏（汤泡过）、茯苓（去皮）、泽泻（各一两）、猪苓（去皮，半两）、肉桂（四钱）。每次服用五钱，加水一盏，生姜三片，煎至半盏，饭前温服，根据患者虚实情况加减药量。
黄芪（一钱）、人参、甘草（炙）、当归、白术（各半钱）、白芍药、柴胡、升麻（各三分）、橘皮（二分）、五味子（十五粒）。加水二钟，煎至一钟，去渣温服，饭前服用。
柴胡（八钱）、防风（二钱五分）、葛根、升麻、羌活、独活、人参、白芍（各五钱）、生甘草（二钱）、炙甘草（三钱）。每次服用五钱，加生姜、大枣煎煮。
肉桂、甘草、芍药、黄芪、当归、川芎、人参、白术、茯苓、熟地黄（各取等量）。制成粗末，每次服用两大钱，加水一盏、生姜三片、大枣二枚，煎至七分，不拘时候温服。
白芍药（一钱五分）、人参、陈皮、黄芪（蜜炙）、桂心、白术、当归、甘草（炙，各一钱）、熟地黄、五味子（炒，捣碎）、茯苓（各七分半）、远志（五分，去心）。加生姜、大枣，水煎服。
（这就是下方方剂加入附子、肉桂。）
肉桂、附子能补益全身的阳气（命门之火），得到六味地黄丸的引导，就能专门补益命门之火。为什么呢？因为附子通行十二经脉，走而不守；肉桂的药性也窜发，（遇到阳药则发散为汗，遇到血药则温通运行。）这两者都难以控制，必须得到六味地黄丸的疏导，才能下行而没有上僭（火热上冲）的忧虑。现在的人不明白这个道理，动不动就说肉桂、附子引火归元，离开六味地黄丸而单独使用它们，导致药性酷烈伤害中焦和上焦，灼烧枯竭三阴经，造成的祸害太大了。（命门之火宜少不宜壮，所以肉桂、附子各只用到一两。火少则能生气，所以《金匮要略》将此方命名为肾气丸。）将八味药裁减为六味，始于钱乙治疗小儿，因为小儿是稚阳纯气，所以去掉肉桂、附子。薛己因此领悟到，大人阴虚火动，使用朱丹溪的补阴法无效时，使用此方立刻见效。（朱丹溪用四物汤补阴，那是补后天有形之血，此方则是补先天无形之水，所以水虚者非此方不可。）从此以后，大家推崇它为滋阴的神方。《医贯》又进一步发挥其义理，触类旁通，以应对无穷的变化。但归根结底，这些都是为根本亏败而设立的，如果病证不涉及肾脏，本来就可以不用。现在的人没有通达《医贯》的宗旨，不论什么病，就让病人服用此方，延误病情，耽误事情。所以张介石说《医贯》用六味地黄丸治疗伤寒，这种言论如同梦呓，而医生和病人反而认为它平稳，也可笑啊。
This is Da Jian Zhong Tang (Greatly Building the Middle Decoction) added with Baizhu (Atractylodis Rhizoma), Baifuling (Poria Cum Ramo et Substrato), Shudi (Rehmanniae Radix Praeparata), Chuanxiong (Ligustici Chuanxiong Rhizoma), Maidong (Ophiopogonis Radix), and Roucongrong (Cynomorii Herba) (in equal parts).
Baizhu (Atractylodis Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata, processed), Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma, prepared), Houpo (Magnoliae Officinalis Cortex, prepared), Banxia (Pinelliae Tuber, soaked in decoction), Fuling (Poria Cum Ramo et Substrato, peeled), Zexie (Alismatis Rhizoma) (each 1 liang), Zhuling (Polyporus, peeled, 0.5 liang), Rougui (Cinnamomi Cortex, 4 qian). Each dose is 5 qian, boiled with one zhan of water and three slices of fresh ginger, until half a zhan remains. Take warm before meals, adjusting dosage according to the patient's deficiency or excess.
Huangqi (Astragali Membranacei Radix, 1 qian), Renshen (Ginseng Radix), Gancao (Licorice Root, honey-fried), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Rhizoma) (each 0.5 qian), Baishao (Paeoniae Radix Alba), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma) (each 3 fen), Jupi (Citri Reticulatae Pericarpium, 2 fen), Wuweizi (Schisandrae Chinensis Fructus) (15 berries). Boil with two zhong of water until one zhong remains, remove dregs, and take warm before meals.
Chaihu (Bupleuri Radix, 8 qian), Fangfeng (Saposhnikoviae Radix, 2.5 qian), Gegen (Puerariae Lobatae Radix), Shengma (Cimicifugae Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Renshen (Ginseng Radix), Baishao (Paeoniae Radix Alba) (each 5 qian), Shenggancao (Licorice Root, raw, 2 qian), Zhigancao (Licorice Root, honey-fried, 3 qian). Each dose is 5 qian, boiled with ginger and jujube.
Renshen (Ginseng Radix, 2 qian), Huangqi (Astragali Membranacei Radix, 3 qian), Zhigancao (Licorice Root, honey-fried, 1 qian). Boil with water and take.
(This is Siwu Tang (Four Substance Decoction) added with Danpi (Moutan Cortex) and Digupi (Lycii Cortex).)
Rougui (Cinnamomi Cortex), Gancao (Licorice Root), Shaoyao (Paeoniae Radix), Huangqi (Astragali Membranacei Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Renshen (Ginseng Radix), Baizhu (Atractylodis Rhizoma), Fuling (Poria Cum Ramo et Substrato), Shudihuang (Rehmanniae Radix Praeparata) (in equal parts). Make into coarse powder. Each dose is two large qian, boiled with one zhan of water, three slices of fresh ginger, and two jujubes, until seven-tenths remain. Take warm at any time.
Baishao (Paeoniae Radix Alba, 1.5 qian), Renshen (Ginseng Radix), Chenpi (Citri Reticulatae Pericarpium), Huangqi (Astragali Membranacei Radix, honey-fried), Guixin (Cinnamomi Cortex), Baizhu (Atractylodis Rhizoma), Danggui (Angelicae Sinensis Radix), Gancao (Licorice Root, honey-fried) (each 1 qian), Shudihuang (Rehmanniae Radix Praeparata), Wuweizi (Schisandrae Chinensis Fructus, stir-fried and pounded), Fuling (Poria Cum Ramo et Substrato) (each 0.75 qian), Yuanzhi (Polygalae Radix, 0.5 fen, heart removed). Add ginger and jujube, boil with water and take.
(This is the following formula added with Fuzi (Aconiti Lateralis Radix Praeparata) and Rougui (Cinnamomi Cortex).)
Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata) can tonify all fire (Mingmen Fire). Guided by Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), they specifically tonify Mingmen Fire. Why? Because Fuzi (Aconiti Lateralis Radix Praeparata) circulates through all meridians, moving without staying; Rougui (Cinnamomi Cortex) also has a penetrating and dispersing nature. (When combined with yang-tonifying herbs, it induces sweating; when combined with blood-invigorating herbs, it warms and moves.) Both are difficult to control and must be guided by Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to descend downward, avoiding the danger of hyperactivity rising upward. Nowadays, people do not understand this principle and often claim that Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata) guide fire back to its source, using them alone without Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). This results in harshness damaging the middle and upper jiao, scorching and drying up the three yin meridians, causing great harm. (Mingmen fire should be slight, not strong; therefore, Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata) are limited to one liang each. Slight fire generates qi, which is why the *Jinkui Yaolue* names this Shenqi Wan (Kidney Qi Pill).) Reducing the eight ingredients to six originated from Qian Yizhi’s treatment of children, because children have tender yang and pure qi, so Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata) were removed. Xue Ji realized from this that for adults with yin deficiency and hyperactive fire, if Zhu Danxi’s method of nourishing yin fails, this formula works immediately. (Zhu Danxi used Siwu Tang (Four Substance Decoction) to nourish yin, which tonifies the acquired, tangible blood; this formula tonifies the congenital, intangible water. Therefore, for those with water deficiency, this formula is indispensable.) Since then, it has been widely praised as a divine formula for nourishing yin. *Yi Guan* further expanded its principles, applying them broadly to handle infinite variations. However, fundamentally, these are designed for severe depletion of the root. If the disease does not involve the kidney, it should certainly not be used. Nowadays, people fail to grasp the essence of *Yi Guan*, prescribing this indiscriminately for any disease, thereby delaying treatment and causing errors. Thus, Zhang Jieshi stated that *Yi Guan*’s use of Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) for treating Shanghan (Cold Damage) is like talking in one’s sleep, yet doctors and patients still consider it safe and mild, which is indeed laughable.