内伤一门。东垣先生辨之详矣。或劳役无节。或饥饱失时。或思虑过度。皆
足伤其中气而发热焉。此与伤寒亦绝不相干。而治之者辄借口而妄治。
真大可叹矣。诊其脉。不辨其气口弦大无力也。察其症。头疼。不辨其时作
时止也。恶寒不辨其得就温暖即解也。发热。不辨其四肢乏力无气以动
也。不食。不辨其口淡无味也。恶风。不辨其惟恶些小贼风也。喘急。不辨其
气耗而乏也。不寐。不辨其心血不足也。神昏。不辨其神气浮越也。及用药。
又乌信东垣补中益气汤。可止头疼。可除寒热。可进饮食。可定喘促。乌信
济生归脾汤。可益心神。可调荣血。身虽大热。而投之辄应。其神妙有如是
乎。彼犹且扬扬骄人曰。此太阳症也。此阳明少阳症也。汗之不愈。表未解
也。下之不愈。里未清也。直至败坏。而医者病者。终不觉悟。尚忍言哉。尚忍
言哉。但东垣补中益气汤。其加减法最详。独兼外感者。则慎用黄 兼停
滞者。则渐进参术。惟在用之得宜耳。
按内伤症。必自汗。必体倦。必唇口淡白。必饮食无味。必脉大无力。纵使
发热。即与补中。倘兼风食。则先与解散。而后补之。若骤补。则邪反炽而
难为疗矣。此又不可不慎也。
补中益气汤
人参 黄 （蜜炙） 白术（土炒各一钱五分） 甘草（炙五分） 当归（一钱）
陈皮（五分） 柴胡 升麻（各三分）
加姜枣水煎。空心午前服。
归脾汤
人参 白术（土炒） 白茯神 黄 （蜜炙） 枣仁（炒研各二钱）
远志肉（甘草汤泡净焙） 当归（各一钱） 木香 甘草（炙各五分） 龙眼肉（二钱）
加姜枣水煎服
内伤这一类疾病，李东垣先生已经辨析得很详细了。有的是因为劳役没有节制，有的是因为饥饱不按时，有的是因为思虑过度，这些都足以损伤中气而导致发热。这种情况与伤寒也完全无关，但治疗的人却往往借口是外感而胡乱治疗，这真是非常令人叹息啊。
诊察他们的脉象，不能辨别出气口脉弦大而无力的特点；观察他们的症状，头痛时，不能辨别出它是时作时止的特点；恶寒时，不能辨别出它遇到温暖就能缓解的特点；发热时，不能辨别出它伴有四肢乏力、没有力气活动的特点；不想吃东西时，不能辨别出它口淡无味的特点；怕风时，不能辨别出它只是害怕轻微的风邪的特点；气喘急促时，不能辨别出它是因气耗损而乏力的特点；失眠时，不能辨别出它是心血不足的特点；神志昏沉时，不能辨别出它是神气浮越的特点。
等到用药时，又怎么相信李东垣的补中益气汤可以止住头痛、去除寒热、增进饮食、平定喘促呢？又怎么相信济生归脾汤可以补益心神、调和营血呢？身体虽然高热，但投用这些方剂却立刻见效，它们的神妙竟然到了这种地步吗？
那些人还扬扬得意地夸耀于人，说：“这是太阳病（太阳经受邪所致的病证）”，“这是阳明少阳病”。发汗后不好，就说表证未解；攻下后不好，就说里证未清。直到病情败坏，医生和病人始终不觉悟，这怎么忍心说出口呢？怎么忍心说出口呢？
不过，李东垣的补中益气汤，其加减用法最为详尽。如果兼有外感，就要慎用黄芪；如果有停滞积滞，就要逐渐进服人参和白术。关键在于使用得当罢了。
按语：内伤的症状，必然有自汗，必然身体疲倦，必然嘴唇口色淡白，必然饮食无味，必然脉象大而无力。即使发热，也要给予补益中气的方法。如果兼有风邪或食积，则先给予疏散解表的方法，然后再进行补益。如果骤然进补，那么邪气反而炽盛而难以治疗了。这一点又不可不谨慎啊。
补中益气汤
人参、黄芪（蜜炙）、白术（土炒，各一钱五分）、甘草（炙，五分）、当归（一钱）、陈皮（五分）、柴胡、升麻（各三分）。
加生姜、大枣，水煎服。空腹，午前服用。
归脾汤
人参、白术（土炒）、白茯神、黄芪（蜜炙）、枣仁（炒研，各二钱）、远志肉（甘草汤泡净焙干）、当归（各一钱）、木香、甘草（炙，各五分）、龙眼肉（二钱）。
加生姜、大枣，水煎服。
The category of internal injury has been thoroughly analyzed by Mr. Li Dongyuan. Some cases arise from unregulated labor and exertion, some from irregular meals (eating at improper times or amounts), and some from excessive mental worry. All of these are sufficient to damage the Middle Qi (the vital energy of the Spleen and Stomach) and cause fever. This condition is completely unrelated to Shanghan (Cold Damage diseases). Yet, practitioners often make excuses based on exterior patterns and treat them recklessly, which is truly lamentable.
When examining their pulse, one fails to distinguish the characteristic of the Qi Kou (radial artery at the wrist) being wiry, large, and powerless. When observing symptoms, regarding headache, one fails to recognize that it comes and goes intermittently; regarding aversion to cold, one fails to recognize that it resolves upon seeking warmth; regarding fever, one fails to recognize that it is accompanied by weakness in the four limbs and a lack of energy to move; regarding anorexia, one fails to recognize the bland taste in the mouth with no flavor; regarding aversion to wind, one fails to recognize that it is only sensitivity to slight drafts; regarding panting and urgency, one fails to recognize that it stems from depleted Qi and fatigue; regarding insomnia, one fails to recognize it as insufficient Heart Blood; regarding mental confusion, one fails to recognize it as floating and dispersing Shen Spirit (Spirit/Mind).
When prescribing medication, how can one believe that Buzhong Yiqi Tang (Supplement the Middle and Boost Qi Decoction) can stop headaches, eliminate chills and fever, promote appetite, and calm panting? How can one believe that Jisheng Guipi Tang (Guipi Decoction from the Generation of Life Hall) can nourish the Heart Spirit and regulate Ying and Wei (Nutritive and Defensive energies)? Even if the body is highly febrile, administering these formulas yields immediate results. Are their miraculous effects really so profound?
Yet, such practitioners proudly boast to others, saying, "This is Taiyang disease (disease pattern of the Taiyang channel)," "This is Yangming and Shaoyang disease." If sweating therapy fails, they claim the exterior pattern is unresolved; if purgative therapy fails, they claim the interior pattern is not cleared. Until the condition becomes critical and irreparable, both the physician and the patient remain unaware. How can one bear to speak of this? How can one bear to speak of this?
However, for Buzhong Yiqi Tang, the methods for modification are most detailed. If there is a concurrent exterior contraction, Huangqi (Astragali Radix) should be used with caution. If there is stagnation, Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) should be administered gradually. The key lies in appropriate application.
Commentary: Symptoms of internal injury must include spontaneous sweating, physical fatigue, pale lips and mouth, loss of taste in food, and a large but powerless pulse. Even if fever is present, tonification of the Middle should be employed. If Wind or Food stagnation is concurrent, dispersing and resolving methods should be used first, followed by tonification. If tonification is applied abruptly, the pathogenic factors will instead flare up, making treatment difficult. This point must not be neglected.
Buzhong Yiqi Tang (Supplement the Middle and Boost Qi Decoction)
Renshen (Ginseng Radix), Huangqi (Astragali Radix, honey-fried), Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried, each 1.5 qian), Gancao (Licorice Radix, fried, 0.5 qian), Danggui (Angelicae Sinensis Radix, 1 qian), Chenpi (Citri Reticulatae Pericarpium, 0.5 qian), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma, each 0.3 qian).
Add Jiang (Zingiberis Rhizoma Recens, fresh ginger) and Zao (Jujubae Fructus, jujube), decoct in water. Take on an empty stomach before noon.
Guipi Tang (Guipi Decoction)
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Baifushen (Poria with Hostwood, specifically the part surrounding the pine roots), Huangqi (Astragali Radix, honey-fried), Zaoren (Ziziphi Spinosomi Semen, stir-fried and crushed, each 2 qian), Yuanzhi (Polygalae Radix, soaked in Licorice decoction, cleaned and dried), Danggui (Angelicae Sinensis Radix, each 1 qian), Muxiang (Aucklandiae Radix), Gancao (Licorice Radix, fried, each 0.5 qian), Longyanrou (Longan Aril, 2 qian).
Add Jiang (Zingiberis Rhizoma Recens, fresh ginger) and Zao (Jujubae Fructus, jujube), decoct in water and take.