天津乔××，年三十余，得咳吐痰血病。
病因 前因偶受肺风，服药失宜，遂息咳嗽，咳嗽日久，继患咳血。
证候 咳嗽已近一年，服药转浸加剧，继则痰中带血，又继则间有呕血之时，然犹不至于倾吐。
其心中时常发热，大便时常燥结，幸食欲犹佳，身形不至羸弱，其脉左部近和平，右部
寸关俱有滑实之象。
诊断 证脉合参，知系从前外感之热久留肺胃，金畏火刑，因热久而肺金受伤，是以咳嗽；至于
胃腑久为热铄，致胃壁之膜腐烂连及血管，是以呕血；至其大便恒燥结者，因其热下输肠中，且因胃
气因热上逆失其传送之职也。治此证者，当以清肺胃之热为主，而以养肺降胃之药辅之。
处方 生石膏（二两细末） 粉甘草（六钱细末） 镜面朱砂（二钱细末）
共和匀每服一钱五分。
又方 生怀山药（一两） 生赭石（八钱轧细） 天冬（六钱） 玄参（五钱） 沙参（
五钱） 天花粉（五钱） 生杭芍（四钱） 川贝母（三钱） 射干（二钱） 儿茶（二钱） 甘草（
钱半） 广三七（二钱轧细）
共药十二味，将前十一味煎汤送服三七一钱，至煎渣再服时
再送服一钱。每日午前十点钟服散药一次，临睡时再服一次，汤药则晚服头煎，翌晨服次煎。
效果 服药三日，咳血吐血皆愈。仍然咳嗽，遂即原方去沙参加生百合五钱、米壳钱半，又服四
剂，咳嗽亦愈，已不发热，大便已不燥结。俾将散药惟头午服一次，又将汤药中赭石减
半，再服数剂以善后。
Tianjin resident Qiao XX, in his thirties, suffered from a disease characterized by coughing up sputum mixed with blood.
Etiology Previously, due to an accidental invasion of lung wind (pathogenic factors affecting the lungs), improper medication led to persistent coughing; after a long duration, hemoptysis (coughing up blood) developed.
Symptoms The cough had persisted for nearly a year. Medication caused the condition to gradually worsen, followed by blood streaks in the sputum, and subsequently occasional hematemesis (vomiting blood), though not profuse vomiting. He experienced frequent internal heat sensation, and his stool was often dry and constipated. Fortunately, his appetite remained good, and his physique did not become emaciated. His pulse on the left side was relatively balanced, while both the cun (inch) and guan (bar) positions on the right side exhibited slippery and excess characteristics.
Diagnosis Combining symptoms and pulse diagnosis, it is known that the heat from previous exterior contraction has lingered in the lung and stomach for a long time. Metal (Lung) fears fire punishment (heat damaging metal organs). Due to prolonged heat injuring Lung Metal, coughing occurs. As the Stomach organ has been long scorched by heat, causing the mucous membrane of the stomach wall to rot and involve blood vessels, hematemesis results. Regarding the frequent dryness and constipation of the stool, it is because heat transmits downward to the intestines, and because Stomach Qi rebels upward due to heat, losing its function of transportation and transformation. To treat this syndrome, one should primarily clear the heat of the Lung and Stomach, assisted by herbs that nourish the Lung and direct Stomach Qi downward.
Prescription Raw Gypsum (2 liang, fine powder) Powdered Licorice Root (6 qian, fine powder) Mirror-faced Cinnabar (2 qian, fine powder)
Mix uniformly; take 1.5 qian per dose.
Alternative Prescription Raw Huai Yam (1 liang) Raw Hematite (8 qian, finely crushed) Asparagus Tuber (6 qian) Scrophularia Root (5 qian) Glehnia Root (5 qian) Trichosanthes Root (5 qian) Raw Hang Peony Root (4 qian) Sichuan Fritillaria Bulb (3 qian) Belamcanda Rhizome (2 qian) Child’s Tea (2 qian) Licorice Root (0.5 qian) Guang Sanqi / Notoginseng Root (2 qian, finely crushed)
Twelve herbs in total. Decoct the first eleven herbs and use the decoction to wash down 1 qian of Sanqi. When taking the second decoction of the dregs, wash down another 1 qian of Sanqi. Take the powdered medicine once at 10:00 AM and again before sleep. Take the first decoction of the herbal medicine in the evening and the second decoction the next morning.
Effect After three days of medication, both hemoptysis and hematemesis were cured. Coughing persisted, so Glehnia Root was removed from the original prescription, and Raw Lily Bulb (5 qian) and Poppy Shell (0.5 qian) were added. After four more doses, the cough also ceased, fever subsided, and stool was no longer dry and constipated. It was advised to take the powdered medicine only once in the morning, reduce the amount of Hematite in the herbal decoction by half, and take a few more doses to consolidate the recovery.