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Carefully studying the case in your letter, it is known that this syndrome is a severe type of Cold-Fluid Accumulation in the Chest (Han Yin Jie Xiong). The Linyin Decoction (Regulate Fluids Decoction) I originally proposed was intended for treating such syndromes; only the herbal ingredients and dosages require slight modification.

Hereby, a prescription is proposed below for reference and selection. The prescription uses Raw Astragali Radix (Sheng Huangqi) 1 liang, Dried Ginger (Gan Jiang) 8 qian, Atractodis Rhizoma (Baizhu) 4 qian, Cinnamomi Ramulus Acumen (Guizhi Jian), Poria (Fuling Pian), and Prepared Licorice Root (Zhi Gancao) each 3 qian, Magnoliae Officinalis Cortex (Houpo) and Citri Reticulatae Pericarpium (Chenpi) each 2 qian. Decoct in water and take orally. The rationale of the prescription: Using Astragali Radix to tonify the Great Qi (Da Qi, referring to Zong Qi accumulating in the chest). When the Great Qi is robust and vigorous, it naturally transforms and transports fluids. As Zhongjing stated, "When the Great Qi rotates, the Qi (referring to the Qi of fluid accumulation) disperses." Furthermore, Astragali Radix, in synergy with Dried Ginger and Cinnamomi Ramulus, can assist and supplement the Yang of the Heart and Lung. When the Yang of the Heart and Lung is sufficient, like the sun shining at its zenith, the yin-cold mist dissipates naturally. Additionally, using Atractodis Rhizoma and Poria to regulate dampness in the Spleen, and Magnoliae Officinalis Cortex and Citri Reticulatae Pericarpium to unblock the Qi of the Stomach; when Qi flows smoothly and dampness disappears, Phlegm-Fluid is naturally eliminated. Using Prepared Licorice Root is to utilize its extremely sweet flavor, which can harmonize the pungency and heat of Dried Ginger. Moreover, when Dried Ginger is combined with Licorice Root, its heat energy is retained longer, becoming sustained, and its intensity is moderated so as not to be too fierce.

Note: This prescription is essentially Linggui Zhugan Decoction (Poria, Cinnamon Twig, Atractodes, and Licorice Decoction) from *Jingui Yaolue*, added with Astragali Radix, Dried Ginger, Magnoliae Officinalis Cortex, and Citri Reticulatae Pericarpium. It is also equivalent to my proposed Linyin Decoction minus Paeoniae Radix Alba (Baishao). The reason for using Paeoniae Radix Alba in the original formula is that in cases of Cold-Fluid, there may be forcing of True Yang to escape outward, causing burning sensations throughout the body, or stimulating True Yang to rush upward, causing dizziness and deafness. The sour-astringent and bitter-descending nature of Paeoniae Radix Alba can gather the rushing and escaping Yuan Yang and return it to its root (however, this effect is achieved only when used together with warming and tonifying herbs). Since this patient's disease originally lacked these symptoms, Baishao is not used. Regarding Astragali Radix in the original formula, it was originally added when fluid accumulation had cleared and the patient felt a deficiency of Qi. In this case, heavy use of Astragali Radix from the beginning is indeed because Cold-Fluid has been solidified for over twenty years; without the powerful action of Astragali Radix, it would be difficult to maneuver the other herbs to achieve success.

Further Note: This prescription greatly supplements the Yang aspect of the Upper Jiao. However, the root of human Yuan Yang actually lies in the Lower Jiao. If one additionally takes Raw Sulfur (Sheng Liuhuang) to cultivate the Yang of the Lower Jiao, the therapeutic effect will be faster. The Japanese Sulfur mentioned can also be used, but one must select pure yellow sulfur free of impurities. Its heat energy is reduced compared to domestic sulfur. For dosage, initially, one can take 1 qian of fine powder. If no feeling of heat is perceived, gradually increase the amount. The maximum daily dose can reach half a liang, but it must be divided into four or five doses. It does not need to be taken simultaneously with the decoction; taking it before or after is acceptable.

[Attached Original Inquiry] My friend suffers from wheezing and coughing due to Cold-Fluid. Treatment according to previous prescriptions has been ineffective. According to his self-description of the etiology, in June of his twentieth year, he encountered war turmoil and was trapped in the mountains and marshes, deprived of food and drink for five days and nights. Upon returning home, he hastily drank a small bucket of well water. By June of his twenty-first year, he suddenly developed severe asthma. After one day and night, taking Erchen Decoction (Two-Cured Decoction) added with Dried Ginger, Ephedrae Herba (Xixin - *Note: Text says Xixin/Schisandra contextually often implies San Wei, but text lists Xixin/Wuweizi separately or together. Here translated as Schisandra based on Wuweizi*), and Schisandrae Fructus (Wuweizi) gradually stabilized. Since then, phlegm-fluid wheezing and coughing have become a stubborn disease. Medications taken can be strongly drying and hot; cold-natured medicines cannot be swallowed even in drops. If mistakenly taken, chest Qi becomes urgent and wheezing occurs, stopping only after coughing up a large amount of fluid. Urination occurs five to six times per hour, resembling clear water. Without wheezing, urination is normal. Diet, whether meat or vegetables, must be of drying and hot nature. Porridge soup and vegetable soup are generally avoided. His condition prefers dryness and heat while abhorring cold and dampness as follows. His symptoms are slightly relieved in summer, but every morning after Frost Descent (Shuangjiang), he develops wheezing. He must wait until the Si hour (9-11 AM) to cough up a certain amount of phlegm-fluid before feeling somewhat settled. Or, drinking extremely boiling soup can also help him cough out several mouthfuls of phlegm-fluid, slightly relaxing the chest and diaphragm. This has persisted for twenty-six or twenty-seven years. Recently, using Veratrum Nigrum Powder (Lilu San) for vomiting methods and Shizao Decoction (Ten Dates Decoction) for purging methods, several sheng of phlegm-fluid were expelled, yet the condition remained unchanged. Formulas related to the Phlegm-Fluid chapter of *Jingui Yaolue* and those dealing with Cold Water were taken dozens of times, yet the condition remained unchanged. Considering this disease has persisted for so many years, there must be a treatment method. I beg you, Sir, to bestow a good prescription. If the root cause of the disease can be eradicated, my gratitude will be boundless. Also, *Yixue Zhongzhong Canxi Lu* records the method of taking Raw Sulfur; I wonder if Japanese Sulfur is suitable for consumption?

[Letter of Thanks After Recovery from Medication] Receiving your letter and instruction, I am indebted to you for imparting the wonderful prescription. Treating my friend's strange chronic illness, after continuously taking four or five doses, breathing immediately felt smooth and comfortable. Later, following the prescription for another seven or eight doses, Cold-Fluid was eliminated, and the asthma was completely cured.