治下焦结热，而成血淋。（心主血，小肠其腑也。热甚搏血，流入胞中，与便俱出，痛
者为血淋，不痛者为溺血。盖心热者，小肠必热，经所谓胞移热于膀胱。则癃，溺血是也，
然热必兼湿。戴氏曰∶血鲜者，心小肠实热，血瘀者，肾膀胱虚冷。准绳曰∶多有热极而血
凝黑者，未可便以为冷也。）
小蓟 薄黄（炒黑） 藕节 滑石 木通 生地 栀子（炒） 淡竹叶 当归 甘草梢
各五分
小蓟藕节，退热散瘀。生地凉血，蒲黄止血，木通降心肺之火，下达小肠。栀子散三焦
郁火，由小便出。淡竹叶草，清心而利小便。（心与小肠相为表里。）滑石泻热而滑窍，当归
能引血归经，草梢能径达茎中也。
（汤名羌活，而方内无之，疑缺误。）治从高坠下，恶血留于肋下，疼痛不可忍者。（不
问伤在何经，恶血心留于胁下，以肝主血故也。）
柴胡（五钱） 当归 栝蒌根 穿山甲（炮） 甘草 红花（二钱） 桃仁（五十去皮
尖研） 大黄
原文曰∶肝胆之经行于胁下，属厥阴少阳，故以柴胡引用为君；以当归活血脉，以甘草
缓其急为臣；以穿山甲花粉桃仁红花，破血润血为佐；以大黄荡涤败血为使，恶血去而痛自
除矣。
（景岳） 治劳倦伤阴，精不化气，或阴精内乏，以致外感不解，寒热 疟，阴虚
不通等证。
人参（一钱） 熟地（三五钱。或一二两。） 当归（二三钱） 山药（酒炒二钱） 甘
草（炙） 陈皮（一钱） 柴胡（一二钱。如无外邪不用。） 升麻（三五分。火浮于上不
用。） 姜枣煎。
此补中益气汤之变方也。凡气虚感邪者，宜补中益气汤。精虚感邪者，宜此。（张景岳
曰∶补中益气汤乃东垣独得之心法，盖以脾胃属土，为水谷之海，凡五脏生成，唯此是赖者。
在
凡春夏之土，能生能长者，以得阳气而上升，升则向生也。秋冬之土，不生不长者，以得阴
气而下降，降则向死也。今本方以升柴助升气，以参 归术助阳气，此东垣立方之意，诚尽
善矣。第肺本象天，脾本象地，地天既交，所以成泰。然不知泰之前犹有临，临之前独有复
，此实三阳之元始，故予再制补阴益气煎，正所以助临复之气。庶乎得根本之道，而足补东
垣之未备也。）
治疗下焦郁结之热，从而形成血淋。（心主司血液运行，小肠是其相表里的腑。热邪炽盛迫血妄行，血液流入膀胱，随小便一同排出，伴有疼痛的称为血淋，不伴有疼痛的称为溺血。大概心经有热，小肠必然受热，医经所谓“胞移热于膀胱”，则出现小便不通、尿血的症状，然而热邪往往兼夹湿邪。戴氏说：血色鲜红的，是心和小肠实热；血色瘀滞暗黑的，是肾和膀胱虚冷。《准绳》说：多有热极导致血液凝黑的情况，不能立刻就认为是寒证。）
小蓟、炒黑蒲黄、藕节、滑石、木通、生地黄、炒栀子、淡竹叶、当归、甘草梢，各五分。
小蓟和藕节，能退热散瘀。生地黄凉血，蒲黄止血，木通降泄心肺之火，引火下行至小肠。栀子疏散三焦郁结之火，通过小便排出。淡竹叶清心火并利小便。（心与小肠互为表里。）滑石泻热并滑利窍道，当归能引导血液回归经脉，甘草梢能直达尿道茎中。
（汤剂名为羌活汤，但方剂中没有羌活这味药，怀疑是遗漏或错误。）治疗从高处坠落，恶血停滞在胁下，疼痛难以忍受。（不论损伤哪条经络，恶血留滞于胁下，是因为肝主司血液的缘故。）
柴胡（五钱）、当归、栝蒌根、炮穿山甲、甘草、红花（二钱）、桃仁（五十粒，去皮尖后研碎）、大黄。
原文说：肝胆的经络行走于胁下，归属于厥阴经和少阳经，所以用柴胡作为引经药且为君药；用当归活血脉，用甘草缓解急迫疼痛作为臣药；用穿山甲、天花粉、桃仁、红花，破血润血作为佐药；用大黄荡涤败血作为使药，恶血去除而疼痛自然消除。
（张景岳）治疗因劳倦损伤阴精，精气不能化生为气，或者阴精内部匮乏，导致外感病邪不解，出现寒热往来如疟疾、阴虚气机不通等证候。
人参（一钱）、熟地黄（三到五钱，或一到二两）、当归（二到三钱）、山药（酒炒二钱）、炙甘草、陈皮（一钱）、柴胡（一到二钱，如果没有外邪则不用）、升麻（三到五分，如果火气浮越于上部则不用）。用生姜、大枣煎服。
这是补中益气汤的变方。凡是气虚感受外邪者，适宜使用补中益气汤。精虚感受外邪者，适宜使用此方。（张景岳说：补中益气汤是李东垣独得的心法，大概因为脾胃属土，是水谷之海，五脏的生成，唯独依赖于此。春夏季的土，能够生长万物，是因为得到阳气而上升，上升则趋向生机。秋冬季的土，不生不长，是因为得到阴气而下降，下降则趋向衰亡。现在本方用升麻、柴胡辅助升发之气，用人参、当归、白术辅助阳气，这是李东垣立方的用意，确实尽善尽美。只是肺本来象天，脾本来象地，天地交泰，所以形成泰卦。然而不知道泰卦之前还有临卦，临卦之前唯有复卦，这实际上是三阳之气的元始，所以我再制定补阴益气煎，正是为了辅助临卦和复卦的气机。这样才符合根本之道，足以弥补李东垣学说的未备之处。）
Treats heat accumulation in the Lower Jiao (Lower Burner), resulting in blood strangury (hematuria with pain). The Heart governs blood, and the Small Intestine is its paired organ. When heat is severe and forces blood to move recklessly, it flows into the bladder and exits with urine. If painful, it is called blood strangury; if painless, it is called hematuria without pain. Generally, if there is heat in the Heart, the Small Intestine must also be hot. As stated in the classics: "When heat from the bladder moves to the urinary bladder, it causes difficulty in urination and hematuria." However, heat often accompanies dampness. Dai Shi said: Fresh red blood indicates excess-heat in the Heart and Small Intestine; dark, stagnant blood indicates deficiency-cold in the Kidney and Bladder. *Zhunsheng* states: There are many cases where extreme heat causes blood to coagulate and turn black; one should not hastily diagnose this as cold.
Xiaoji (Cephalanoplos Herba), Chao Huang (Stir-fried Black Polygoni Multiflori Radix Praeparata - *Note: Text says 'Bo Huang' but context implies Polygonum or similar hemostatic, likely typo for Pu Huang or specific processing of Huang Qin/Huang Lian, but strictly translating text 'Bo Huang' as Stir-fried Yellow Herb, though clinically likely refers to a hemostatic agent like Polygonum or processed Huang Bai. Given 'Chao Hei', likely referring to a hemostatic herb. Let's stick to literal 'Stir-fried Yellow Herb' or assume typo for Pu Huang based on later text mentioning Pu Huang. Later text says 'Pu Huang Zhi Xue'. So 'Bo Huang' is likely a typo for 'Pu Huang'. I will translate as Pu Huang (Polygoni Catenuati Spica) based on internal consistency*), Ou Jie (Nelumbinis Node), Huashi (Talcum), Mutong (Akebiae Caulis), Shengdi Huang (Rehmanniae Radix), Zhizi (Gardeniae Fructus, stir-fried), Dan Zhuye (Lophatheri Herba), Dang Gui (Angelicae Sinensis Radix), Gancao Shao (Glycyrrhizae Radix et Rhizoma tip). Each at 5 fen.
Xiaoji and Ou Jie clear heat and dissipate stasis. Shengdi Huang cools blood, Pu Huang stops bleeding, Mutong descends fire from the Heart and Lung, directing it downward to the Small Intestine. Zhizi disperses stagnant fire in the Three Jiao, expelling it via urination. Dan Zhuye clears Heart heat and promotes urination. (The Heart and Small Intestine are exterior-interior partners.) Huashi drains heat and lubricates orifices, Dang Gui guides blood back to its vessels, and Gancao Shao reaches directly to the urethra.
(The decoction is named Qianghuo Tang, but Qianghuo is absent from the formula; suspected omission or error.) Treats trauma from falling from heights, where evil blood remains under the ribs, causing unbearable pain. (Regardless of which meridian is injured, evil blood stagnating under the ribs occurs because the Liver governs blood.)
Chai Hu (Bupleuri Radix, 5 qian), Dang Gui (Angelicae Sinensis Radix), Gua Lou Gen (Trichosanthis Radix), Chuan Shan Jia (Pangolin Scales, prepared), Gan Cao (Glycyrrhizae Radix et Rhizoma), Hong Hua (Carthami Flos, 2 qian), Tao Ren (Persicae Semen, 50 grains, skin and tips removed, ground), Da Huang (Rhei Radix et Rhizoma).
The original text states: The meridians of the Liver and Gallbladder traverse the hypochondrium, belonging to the Jueyin and Shaoyang channels. Therefore, Chai Hu is used as the guiding drug and sovereign agent; Dang Gui is used to invigorate blood vessels, and Gan Cao is used to relieve urgency as ministerial agents; Chuan Shan Jia, Gua Lou Gen (Tian Hua Fen), Tao Ren, and Hong Hua are used to break blood stasis and moisten blood as adjunctive agents; Da Huang is used to purge foul blood as envoy agent. Once the evil blood is eliminated, the pain naturally ceases.
(Zhang Jingyue) Treats Yin injury due to overwork and fatigue, where essence fails to transform into Qi, or internal deficiency of Yin essence leading to unresolved external pathogens, presenting with alternating chills and fever resembling malaria, or Yin deficiency with blocked Qi mechanism.
Ren Shen (Ginseng Radix, 1 qian), Shu Di Huang (Rehmanniae Radix Praeparata, 3-5 qian, or 1-2 liang), Dang Gui (Angelicae Sinensis Radix, 2-3 qian), Shan Yao (Dioscoreae Rhizoma, wine-fried, 2 qian), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Chen Pi (Citri Reticulatae Pericarpium, 1 qian), Chai Hu (Bupleuri Radix, 1-2 qian; omit if no external pathogen), Sheng Ma (Cimicifugae Rhizoma, 3-5 fen; omit if fire floats upward). Decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus).
This is a modification of Buzhong Yiqi Tang. For those with Qi deficiency contracting external pathogens, Buzhong Yiqi Tang is appropriate. For those with Essence deficiency contracting external pathogens, this formula is appropriate. (Zhang Jingyue said: Buzhong Yiqi Tang is Li Dongyuan's unique method. Since the Spleen and Stomach belong to Earth and are the sea of water and grain, the generation of all five Zang organs relies solely on this. In spring and summer, Earth can generate and grow because it obtains Yang Qi and rises; rising leads to life. In autumn and winter, Earth does not generate or grow because it obtains Yin Qi and descends; descending leads to death. This formula uses Sheng Ma and Chai Hu to assist the ascending Qi, and Ren Shen, Dang Gui, and Bai Zhu to assist Yang Qi. This reflects Li Dongyuan's intention in creating the formula, which is indeed perfect. However, the Lung corresponds to Heaven, and the Spleen corresponds to Earth. When Heaven and Earth interact, Tai Hexagram is formed. Yet, before Tai comes Lin Hexagram, and before Lin comes Fu Hexagram. This is the origin of the Three Yang Qi. Therefore, I created Buyin Yiqi Jian to assist the Qi of Lin and Fu. Thus, one can attain the Way of the Root and supplement what Li Dongyuan left incomplete.)