I can remember it took me some years until I got everything more or less working.
First, did you run the setup for the graphics board? It sets some important environment variables, e.g. the amount of memory of the board and how much is used as RAM.
Second, if you have a gfx board with more than 128 MB memory, you may need to set with a jumper a different memory configuration.
Third, is it really a 5V card? Or does your mediator support 3.3V cards?
Four, I still have some issues that are most likely related to old caps or a bad power supply. My machine must run some minutes before I can boot the gfx card without a Guru. It seems that something in my machine must get warm before it works correctly and it seems to be related to the power supply as this behavior changes when using a different power supply. However, I was never able to fix this issue.
Five, my gfx board was also defective. It was a board by Elbox modified for 5V but this modification was broken after some month. Elbox fixed that for a small fee.
Six, it was hard to plug in the bus board such that all contacts with the mainboard fit. The slot is a bit longer than the card.
Seven, there are jumper on the mediator (not the bus board). Try different configs here.