天津陈××，年十八岁。自幼得肺劳喘嗽证。
病因 因其母素有肺劳病，再上推之，其外祖母亦有斯病。是以自幼时，因有遗传性亦患此病。
证候 其证，初时犹轻，至热时即可如常人，惟略有感冒即作喘嗽。治之即愈，不治则两
三日亦可自愈。至过十岁则渐加重，热时亦作喘嗽，冷时则甚于热时，服药亦可见轻，旋即
反复。至十六七岁时，病又加剧，屡次服药亦无效，然犹可支持也。迨愚为诊视，在一九三○年仲冬，
其时病剧已难支持，昼夜伏几，喘而且嗽，咳吐痰涎，连连不竭，无论服何中药，皆分毫无
效。惟日延西医注射药针一次，虽不能止咳喘而可保当日无虞。诊其脉左右皆弦细，关前微浮，两尺重
按无根。
诊断 此等证原因，肺脏气化不能通畅，其中诸细管即易为痰涎滞塞，热时肺胞松缓，故病犹
轻，至冷时肺胞紧缩，是以其病加剧。治之者当培养其肺中气化，使之 辟有力，更疏瀹其肺
中诸细管，使之宣通无滞，原为治此病之正则也。而此证两尺之脉无根，不但其肺中有病，其肝
肾实亦有病，且病因又为遗传性，原非一蹴所能治愈，当分作数步治之。
处方 生怀山药（一两） 大甘枸杞（一两） 天花粉（三钱） 天冬（三钱） 生杭芍（三钱）
细辛（一钱） 射干（三钱） 杏仁（二钱去皮） 五味子（二钱捣碎） 葶苈子（二钱微炒） 广三七（二钱捣细）
药共十一味，前十味煎汤一大盅，送服三七末一钱，至煎渣再服时仍送服余一钱。
方解 方中用三七者，恐肺中之气窒塞，肺中之血亦随之凝滞，三七为止血妄行之圣药，更为流
通瘀血之圣药，故于初步药中加之。
复诊 将药连服四剂，咳喘皆愈三分之二，能卧睡两三点钟。其脉关前不浮，至数少减，而两
尺似无根，拟再治以纳气归肾之方。
处方 生怀山药（一两） 大甘枸杞（一两） 野党参（三钱） 生赭石（六钱轧细） 生怀地黄（
六钱） 生鸡内金（钱半黄色的捣） 净萸肉（四钱） 天花粉（四钱） 天冬（三钱） 牛蒡子（三钱
捣碎） 射干（二钱）
共煎汤一大盅温服。
方解 参之性补而微升，惟与赭石并用，其补益之力直达涌泉。况咳喘之剧者，其冲胃之气恒
因之上逆，赭石实又为降胃镇冲之要药也。至方中用鸡内金者，因其含有稀盐酸，原善化肺管
中之瘀滞以开其闭塞，又兼能运化人参之补力不使作满闷也。
三诊 将药连服五剂，咳喘皆愈，惟其脉仍逾五至，行动时犹觉气息微喘，此乃下焦阴分犹
未充足，不能与阳分相维系也。此当峻补其真阴，俾阴分充足自能维系其阳分，气息自不上奔矣。
处方 生怀山药（一两） 大甘枸杞（一两） 熟怀地黄（一两） 净萸肉（四钱）
玄参（四钱） 生远志（钱半） 北沙参（四钱） 怀牛膝（三钱）
大云苓片（二钱） 苏子（二钱炒捣） 牛蒡子（二钱捣碎） 生鸡内金（钱半）
共煎汤一大盅温服。
效果 将药连服八剂，行走动作皆不作喘，其脉至数已复常。从此停服汤药，俾日用生怀山
药细末，水调煮作茶汤，少调以生梨自然汁，当点心用之以善其后。
Chen XX from Tianjin, aged eighteen. Since childhood, he suffered from Feilao Chuansou syndrome (pulmonary tuberculosis with chronic cough and asthma).
Etiology: His mother had always suffered from Feilao disease. Tracing back further, his maternal grandmother also had this disease. Therefore, since childhood, due to hereditary factors, he contracted this illness.
Symptoms: Initially, the condition was mild; during hot weather, he appeared normal, only experiencing coughing and wheezing upon slight exposure to cold. Treatment led to quick recovery, and without treatment, it could resolve spontaneously within two or three days. After age ten, the condition gradually worsened. Even in hot weather, coughing and wheezing occurred, worsening significantly in cold weather. Medication provided temporary relief, but symptoms recurred promptly. By age sixteen or seventeen, the condition aggravated further; repeated medication proved ineffective, though he could still barely sustain himself. When I examined him in mid-winter of 1930, the illness was severe and difficult to endure. He lay hunched over desks day and night, suffering from wheezing and coughing, expectorating copious phlegm continuously. Regardless of the Chinese herbal medicines taken, they yielded no effect. Only daily injections by Western doctors ensured safety for the day, although they did not stop the cough or wheezing. His pulse was wiry and fine on both left and right sides, slightly floating at the Guan position, and rootless when pressed heavily at both Chi positions.
Diagnosis: The cause of such conditions is that the Qi transformation function of the Lung cannot flow smoothly, making its small bronchioles prone to blockage by phlegm. During hot weather, alveoli relax, so the illness remains mild; during cold weather, alveoli contract, causing the illness to aggravate. Treatment should cultivate the Qi transformation within the Lung to strengthen it, and simultaneously dredge the various small tubes in the Lung to ensure unobstructed ventilation. This is the standard method for treating this disease. However, the rootlessness of the Chi pulses indicates not only lung pathology but also Liver and Kidney disorders. Furthermore, given the hereditary etiology, a cure cannot be achieved overnight. Treatment must proceed in several stages.
Prescription: Raw Huai Yam (Sheng Huai Shan Yao) 1 liang, Large Sweet Goji Berry (Da Gan Gou Qi) 1 liang, Powder Flower of Melon Root (Tian Hua Fen) 3 qian, Asparagus Tuber (Tian Dong) 3 qian, Raw Hang Peony Root (Sheng Hang Shao) 3 qian, Fine Asarum (Xi Xin) 1 qian, Belamcanda Rhizome (She Gan) 3 qian, Apricot Seed (Xing Ren, peeled) 2 qian, Schisandra Fruit (Wu Wei Zi, crushed) 2 qian, Lepidium Seed (Ting Li Zi, lightly fried) 2 qian, Panax Notoginseng (Guang San Qi, finely pounded) 2 qian.
Total eleven ingredients. Decoct the first ten in one large cup of water. Take the decoction while swallowing 1 qian of San Qi powder. When re-decocting the dregs, swallow the remaining 1 qian of San Qi powder.
Formula Analysis: San Qi is included because Qi stagnation in the Lung may lead to blood stasis. San Qi is a supreme herb for stopping abnormal bleeding and for resolving blood stasis.
Second Visit: After taking four doses, cough and wheezing improved by two-thirds, allowing him to lie down and sleep for two to three hours. The pulse at the Guan position was no longer floating, and the rate decreased, but the Chi pulses still seemed rootless. I planned to treat with a formula to guide Qi back to the Kidney.
Prescription: Raw Huai Yam (Sheng Huai Shan Yao) 1 liang, Large Sweet Goji Berry (Da Gan Gou Qi) 1 liang, Wild Codonopsis Root (Ye Dang Shen) 3 qian, Raw Hematite (Sheng Zhe Shi, ground fine) 6 qian, Raw Huai Rehmannia Root (Sheng Huai Di Huang) 6 qian, Raw Chicken Gizzard Lining (Sheng Ji Nei Jin, yellow part, crushed) 1.5 qian, Clean Cornus Fruit (Jing Yu Rou) 4 qian, Powder Flower of Melon Root (Tian Hua Fen) 4 qian, Asparagus Tuber (Tian Dong) 3 qian, Arctium Seed (Niu Bang Zi, crushed) 3 qian, Belamcanda Rhizome (She Gan) 2 qian.
Decoct together in one large cup of water and take warm.
Formula Analysis: Ren Shen tonifies and has a slight ascending nature. Combined with Zhe Shi, its tonifying power reaches directly to Yongquan (KI-1). In severe cases of cough and wheezing, Qi from the Chong Mai and Stomach often rebels upward. Zhe Shi is indeed a key herb for descending Stomach Qi and calming the Chong Mai. Ji Nei Jin is used because it contains dilute hydrochloric acid, which effectively resolves stasis in pulmonary tubes to open blockages. It also aids in transforming the tonifying effects of Ren Shen to prevent fullness and stuffiness.
Third Visit: After taking five doses, cough and wheezing completely ceased. However, the pulse rate remained above five beats per breath cycle, and slight shortness of breath persisted during movement. This indicated insufficient Yin in the Lower Jiao, unable to anchor Yang. Severe tonification of True Yin was required. Once Yin was sufficient, it would naturally anchor Yang, and the rebellious Qi would subside.
Prescription: Raw Huai Yam (Sheng Huai Shan Yao) 1 liang, Large Sweet Goji Berry (Da Gan Gou Qi) 1 liang, Prepared Huai Rehmannia Root (Shu Huai Di Huang) 1 liang, Clean Cornus Fruit (Jing Yu Rou) 4 qian, Scrophularia Root (Xuan Shen) 4 qian, Raw Polygala Root (Sheng Yuan Zhi) 1.5 qian, Glehnia Root (Bei Sha Shen) 4 qian, Achyranthes Root (Huai Niu Xi) 3 qian, Poria Cocos (Da Yun Ling Pian) 2 qian, Perilla Seed (Su Zi, fried and crushed) 2 qian, Arctium Seed (Niu Bang Zi, crushed) 2 qian, Raw Chicken Gizzard Lining (Sheng Ji Nei Jin) 1.5 qian.
Decoct together in one large cup of water and take warm.
Outcome: After eight doses, walking and movement no longer caused wheezing, and the pulse rate returned to normal. From then on, herbal decoctions were stopped. Instead, he consumed fine powder of Raw Huai Yam mixed with water and boiled into a tea-like consistency, sweetened with fresh pear juice, taken as a snack for convalescence.