川桂枝 茯苓 淡干姜 五味子 生甘草 大枣
某（二一）咳逆欲呕。是胃咳也。当用甘药。（胃咳）
生扁豆（一两） 北沙参（一钱半） 麦冬（米拌炒一钱半） 茯神（三钱） 南枣（三钱）
糯稻根须（五钱）
某 伏邪久咳。胃虚呕食。殆内经所谓胃咳之状耶。
麻黄 杏仁 甘草 石膏 半夏 苡仁
王（二七）脉沉短气。咳甚。呕吐饮食。便溏泄。乃寒湿郁痹渍阳明胃。营卫不和。胸痹如 。无非阳不
旋运。夜阴用事。浊泛呕吐矣。庸医治痰顺气。治肺论咳。不思内经胃咳之状。咳逆而呕耶。小半夏汤加姜汁。
石 气左升。腹膨。呕吐涎沫黄水。吞酸。暴咳不已。是肝逆乘胃射肺。致坐不得卧。（肝犯胃肺）安胃丸三钱。
范（妪）久咳涎沫。欲呕。长夏反加寒热。不思食。病起嗔怒。气塞上冲。不能着枕。显然肝逆犯胃冲
肺。此皆疏泄失司。为郁劳之症。故滋腻甘药。下咽欲呕矣。小青龙去麻辛甘加石膏。
颜（氏）久有痛经。气血不甚流畅。骤加暴怒。肝阳逆行。乘肺则咳。病家云。少腹冲气上干。其咳乃
作。则知清润肺药。非中 之法。今寒热之余。咳不声扬。但胁中拘急。不饥不纳。乃左升右降
不司旋转。而胃中遂失下行为顺之旨。古人以肝病易于犯胃。然则肝用宜泄。胃腑宜通。为定例矣。
桑叶 丹皮 钩藤 茯苓 半夏 广皮 威喜丸（三钱）
某 脉弦右甚。嗽。午潮热。便溏畏风。以大肠嗽治之。（大肠嗽）
生于术（一钱半） 茯苓（三钱） 赤石脂（一钱） 禹粮石（二钱） 姜汁（四分） 大枣（三枚）
又 照前方加白芍炙甘草。
又 脉数。右长左弦。上咳下溏。
生于术（一钱半） 茯苓（三钱） 炙草（五分） 木瓜（一钱） 姜汁（四分） 大枣肉（四钱）
石（四三）咳嗽十月。医从肺治无效。而巅胀喉痹脘痞。显是厥阳肝风。议镇补和阳熄风。（肝风）
生牡蛎 阿胶 青黛 淡菜
某 昨议上焦肺病。百日未痊。形肌消烁。悉由热化。久热无有不伤阴液。拟咸补如阿胶鸡子
黄。复入芩连苦寒。自上清气热以补下。虽为暂服之方。原非峻克之剂。细思手经之病。原无
遽入足经之理。但人身气机。合乎天地自然。肺气从右而降。肝气由左而升。肺病主降日迟。
肝横司升日速。咳呛未已。乃肝胆木反刑金之兆。试言及久寐寤醒。左常似闪烁。嘈杂如饥。
及至进食。未觉胃中安适。此肝阳化风。旋扰不息。致呛无平期。即倏热之来。升至左颊。其左
升太过。足为明验。倘升之不已。入春肝木司权。防有失血之累。故左右为阴阳之道路。阴阳
既造其偏以致病。所以清寒滋阴。不能骤其速功。
阿胶 鸡子黄 生地 天冬 女贞实 糯稻根须
姚 胁痛久嗽（胁痛） 旋复花汤加桃仁柏子仁。
某 寒热。右胁痛。咳嗽。
芦根（一两） 杏仁（三钱） 冬瓜子（三钱） 苡仁（三钱） 枇杷叶（三钱） 白蔻仁（三分）
咳为气逆。嗽为有痰。内伤外感之因甚多。确不离乎肺脏为患也。若因于风者。辛平解之。
因于寒者。辛温散之。因于暑者。为熏蒸之气。清肃必伤。当与微辛微凉。苦降淡渗。俾上焦
蒙昧之邪。下移出腑而后已。若因于湿者。有兼风兼寒兼热之不同。大抵以理肺治胃为
主。若因秋燥。则嘉言喻氏之议最精。若因于火者。即温热之邪。亦以甘寒为主。但温热犹
有用苦辛之法。非比秋燥而绝不用之也。至于内因为病。不可不逐一分之。有刚亢之威。
木扣而金鸣者。当清金制木。佐以柔肝入络。若土虚而不生金。真气无所禀摄者。有甘凉
甘温二法。合乎阴土阳土以配刚柔为用也。又因水虚而痰泛。元海竭而诸气上冲
者。则有金水双收。阴阳并补之治。或大剂滋填镇摄。葆固先天一 元精。至于饮邪窃发。
亦能致嗽。另有专门。兼参可也。以上诸法。皆先生临证权衡之治。非具慧心手眼。能如是乎。（邵新甫）
徐评 凡述医案。必择大症及疑症人所不能治者数则。以立法度。以启心思。为后学之所法。
今载百余方。重复者八九。此非医案。乃逐日之总簿耳。
Chuan Guizhi (Cinnamomi Ramulus), Fuling (Poria), Dan Ganjiang (Dried Ginger), Wuweizi (Schisandrae Fructus), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Dazao (Jujubae Fructus).
A certain patient, aged 21, experienced cough with qi rebellion and a desire to vomit. This is Weike (Stomach Cough, characterized by cough accompanied by vomiting, with the pathology primarily in the Stomach). One should use sweet and mild medications to treat it. (Treatment principle for Stomach Cough)
Sheng Biandou (Lablab Album Seed, 1 liang), Beishashen (Glehniae Radix, 1.5 qian), Maidong (Ophiopogonis Tuber, stir-fried with rice, 1.5 qian), Fushen (Poria with Hostwood, 3 qian), Nanzao (Jujubae Fructus, 3 qian), Nuodaogenxu (Rhizoma Imperatae Rootlet, 5 qian).
Another patient suffered from prolonged cough due to latent pathogenic factors (Fu Xie), with weak Stomach Qi leading to vomiting of food. This is likely the manifestation of Weike described in the *Neijing* (Inner Canon).
Mahuang (Ephedrae Herba), Xingren (Armeniacae Semen Amarum), Gancao (Glycyrrhizae Radix et Rhizoma), Shigao (Gypsum Fibrosum), Banxia (Pinelliae Rhizoma), Yiren (Coicis Semen).
Patient Wang, aged 27, presented with a deep and short pulse, shortness of breath, severe cough, vomiting of food and drink, and loose stools. This indicates that Cold-Dampness was constrained and bi-obstructed, infiltrating the Yangming Stomach channel, leading to disharmony of Ying and Wei (Nutritive and Defensive levels), and chest bi-obstruction feeling like an obstruction. It is nothing other than Yang failing to rotate and transform. During the night, when Yin dominates, turbid Yin rises causing vomiting. Quack doctors only treat phlegm and regulate qi, discussing cough from the perspective of the Lung, without considering the description of Weike in the *Neijing*: cough with qi rebellion and vomiting. Prescribed Xiao Banxia Tang (Minor Pinellia Decoction) plus Jiangzhi (Ginger Juice).
Patient Shi, exhibited excessive rising of Qi on the left side, abdominal distension, vomiting of saliva and yellow water, acid regurgitation, and sudden persistent cough. This is Liver Qi rebelling, invading the Stomach and shooting into the Lung, causing the patient to be unable to sit or lie down. (Liver invading Stomach and Lung). Administered Anwei Wan (Stomach-Calming Pill), 3 qian.
Elderly Patient Fan, suffered from prolonged cough with salivation and a desire to vomit. In late summer, she paradoxically experienced alternating chills and fever, loss of appetite. The illness began with anger, causing Qi blockage and upward rushing, making it impossible to rest her head on a pillow. Clearly, this is Liver Qi rebelling, invading the Stomach and impacting the Lung. All these are due to dysfunction of dispersion and descent, constituting a syndrome of depression and exhaustion. Therefore, cloying and sweet-nourishing medicines caused vomiting upon swallowing. Prescribed Xiao Qinglong Tang (Minor Blue Dragon Decoction) removing Mahuang, Xixin, and Gancao, adding Shigao.
Patient Yan, had a history of dysmenorrhea, with Qi and Blood not flowing smoothly. Sudden rage caused Liver Yang to rebel, invading the Lung resulting in cough. The family reported that rebellious Qi from the lower abdomen rushed upward, triggering the cough. Thus, it is known that clearing and moistening Lung medicines are not the core method. Now, after the residual chills and fever, the cough is not loud, but there is tension in the hypochondrium, no hunger, and inability to eat. This indicates that the rotation of Left-Rising and Right-Descending Qi is dysfunctional, and the Stomach has lost its principle of downward flow being smooth. Ancients stated that Liver diseases easily invade the Stomach; thus, regulating Liver function requires dispersing, and regulating the Stomach腑 (Fu organ) requires unblocking, which is a fixed rule.
Sangye (Mori Folium), Danpi (Moutan Cortex), Gouteng (Uncariae Ramulus cum Uncis), Fuling (Poria), Banxia (Pinelliae Rhizoma), Guangpi (Citri Reticulatae Pericarpium), Weixi Wan (Weixi Pill), 3 qian.
A certain patient, pulse was wiry and more pronounced on the right, cough, afternoon tidal fever, loose stools, and aversion to wind. Treated as Dachang Sou (Large Intestine Cough). (Large Intestine Cough)
Sheng Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian), Fuling (Poria, 3 qian), Chishizhi (Halloysit Rubrum, 1 qian), Yuliangshi (Kaolinite, 2 qian), Jiangzhi (Ginger Juice, 4 fen), Dazao (Jujubae Fructus, 3 pieces).
Re-examination: Add Baishao (Paeoniae Radix Alba) and Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) to the previous prescription.
Re-examination: Pulse is rapid, Right pulse is long, Left pulse is wiry. Upper body cough, lower body loose stools.
Sheng Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian), Fuling (Poria, 3 qian), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 5 fen), Mugua (Chaenomelis Fructus, 1 qian), Jiangzhi (Ginger Juice, 4 fen), Dazao Rou (Jujubae Fructus Pulp, 4 qian).
Patient Shi, aged 43, coughed for ten months. Doctors treated from the Lung perspective with no effect, presenting with distension at the vertex, throat obstruction, and epigastric fullness. Clearly, this is Jueyang Liver Wind disturbing upwards. Proposed treatment: sedate and tonify, harmonize Yang, extinguish Wind. (Internal Stirring of Liver Wind)
Sheng Muli (Ostreae Concha), Ejiao (Colla Corii Asini), Qingdai (Indici Folium), Danshen (Mytili Edulis).
A certain patient, yesterday discussed as Upper Jiao Lung disease, unresolved for 100 days, with emaciation and wasting of flesh and muscle, all due to transformation into Heat. Prolonged heat inevitably damages Yin fluids. Proposed salty nourishment such as Ejiao and Ji Zihuang (Chicken Egg Yolk), combined with Huangqin and Huanglian (Scutellariae Radix and Scutellariae Barbatae Radix) bitter-cold herbs, to clear upper Jiao Qi-heat and supplement the lower. Although this is a temporary formula, it is originally not a harsh purgative agent. Carefully considering diseases of the Hand meridians (Lung), there is originally no logic for them to rapidly enter the Foot meridians (Spleen/Stomach etc.). However, human Qi mechanism conforms to Heaven and Earth's natural laws: Lung Qi descends from the right, Liver Qi ascends from the left. Lung disease causes slow descent, while Liver rebellion causes rapid ascent. Persistent coughing and choking indicate Wood (Liver/Gallbladder) counter-rebelling against Metal (Lung). Consider waking from long sleep; the left side often feels flickering, with epigastric discomfort resembling hunger. Upon eating, the Stomach does not feel comfortable. This is Liver Yang transforming into Wind, rotating and disturbing ceaselessly, causing coughing without a peaceful period. Even if sudden heat comes, rising to the left cheek, the excessive leftward ascent serves as clear evidence. If ascending continues, entering Spring when Liver Wood governs, one must guard against the burden of bleeding. Thus, left and right are the pathways of Yin and Yang. Since Yin and Yang have deviated causing disease, clearing cold and nourishing Yin cannot achieve rapid results.
Ejiao (Colla Corii Asini), Ji Zihuang (Chicken Egg Yolk), Shengdi (Rehmanniae Radix), Tiandong (Asparagi Tuber), Nvzhenzi (Ligustri Lucidi Fructus), Nuodaogenxu (Rhizoma Imperatae Rootlet).
Patient Yao, chronic hypochondriac pain and prolonged cough (Hypochondriac Pain). Prescribed Xuansu Hua Tang (Inula Flower Decoction) adding Taoren (Prunus Persica Seed) and Baiziren (Biota Orientalis Seed).
A certain patient, chills and fever, right hypochondriac pain, cough.
Lugen (Phragmitis Rhizoma, 1 liang), Xingren (Armeniacae Semen Amarum, 3 qian), Dongguazi (Benincasae Semen, 3 qian), Yiren (Coicis Semen, 3 qian), Pipaye (Loquat Leaf, 3 qian), Baokouren (Amomi Fructus Rotundus, 3 fen).
Cough is Qi rebellion; Sou is having phlegm. The causes of internal injury and external contraction are numerous, but essentially always involve pathology of the Lung. If due to Wind, resolve with pungent-neutral methods. If due to Cold, disperse with pungent-warm methods. If due to Summer-Heat, which is steaming and vaporizing, clearing and肃ifying will injure [the body]; provide slightly pungent and slightly cool, bitter-descending and light-leaching methods, allowing the obscure pathogens of the Upper Jiao to move downward out of the Fu organs before stopping. If due to Dampness, there are differences in accompanying Wind, Cold, or Heat. Generally, regulating the Lung and treating the Stomach is primary. If due to Autumn Dryness, the discussion by Yu Jieyan (Yu Chang) is the most exquisite. If due to Fire, i.e., Warm-Thermal pathogens, also prioritize sweet-cold methods. However, warm-heat diseases still have room for using pungent-bitter methods, unlike autumn dryness where they are absolutely not used. As for internal causes of disease, one must distinguish them one by one. There is the majesty of rigidity and exuberance, where Wood strikes and Metal rings (Liver overacting on Lung); one should clear Metal to control Wood, assisted by softening the Liver and entering the collaterals. If Earth is deficient and fails to generate Metal, with True Qi having no source to rely on, there are two methods: sweet-cool and sweet-warm, conforming to Yin-Earth and Yang-Earth matching rigid and soft for use. Also, due to Water deficiency causing phlegm flooding, and Yuanhai (Sea of Origin) depletion causing various Qi rushing upward, there is treatment of dual collection of Metal and Water, simultaneous supplementation of Yin and Yang. Or large doses of nourishing filling and sedation, preserving the primordial Essence of the First Origin. As for fluid retention secretly emerging, it can also cause cough, with separate specialized discussions; reference can be made here. The above various methods are all treatments weighed by Mr. Ye during clinical practice. Without wisdom and insight, could one be so? (Commentary by Shao Xinpu)
Xu's Commentary: Whenever narrating medical cases, one must select several major and difficult cases that others cannot treat, to establish legal standards and inspire thinking, serving as models for later learners. Now, recording over a hundred prescriptions, with eight or nine out of ten being repetitive. This is not a medical case record, but merely a daily general ledger.