天津罗××，年三十四岁，得肺劳喘嗽病。
病因 数年之前，曾受肺风发咳嗽，治失其宜，病虽暂愈，风邪锢闭肺中未去，致成肺劳喘嗽证。
证候 其病在暖燠之时甚轻，偶发喘嗽一半日即愈，至冬令则喘嗽连连，必至天气暖和时
始渐愈。其脉左部弦硬，右部濡滑，两尺皆重按无根。
诊断 此风邪锢闭肺中，久而伤肺，致肺中气管滞塞，暖时肌肉松缓，气管亦随之松缓，其呼
吸犹可自如；冷时肌肉紧缩，气管亦随之紧缩，遂至吸难呼易而喘作，更因痰涎壅滞而嗽作
矣。其脉左部弦硬者，肝肾之阴液不足也。右部濡滑者，肺胃中痰涎充溢也。两尺不任重按
者，下焦气化虚损，不能固摄，则上焦之喘嗽益甚也。欲治此证，当先宣通其肺，俾气管之
郁者皆开后，再投以滋阴培气，肺肾双补之剂以祓除其病根。
处方 麻黄（钱半） 天冬（三钱） 天花粉（三钱） 牛蒡子（三钱捣碎） 杏仁（二钱去皮
捣碎） 甘草（钱半） 苏子（二钱炒捣） 生远志（二钱去心）
生麦芽（二钱） 生杭芍（二钱） 细辛（一钱）
共煎汤一大盅，温服。
复诊 将药煎服两剂，喘嗽皆愈，而劳动时仍微喘。其脉左部仍似弦硬，右部仍濡，不若
从前之滑，两尺犹虚，此病已去而正未复也。宜再为谋根本之治法，而投以培养之剂。
处方 野台参（三钱） 生赭石（八钱轧细） 生怀山药（一两） 熟怀地黄（一两）
生怀地黄（一两） 大云苓片（二钱） 大甘枸杞（六钱） 天冬（六钱） 净萸肉（五钱）
苏子（三钱炒捣） 牛蒡子（三钱捣碎）
共煎一大盅温服。
方解 人参为补气主药，实兼具上升之力。喻嘉言谓。“气虚欲上脱者专用之转气高不返。”
是以凡喘逆之证，皆不可轻用人参，惟重用赭石以引之下行，转能纳气归肾，而下焦之气
化，遂因之壮旺而固摄。此方中人参、赭石并用，不但欲导引肺气归肾，实又因其两
尺脉虚，即借以培补下焦之气化也。
效果 将药连服十余剂，虽劳动亦不作喘。再诊其脉，左右皆调和无病，两尺重按
不虚，遂将赭石减去二钱，俾多服以善其后。
Luo XX from Tianjin, aged 34, suffered from Pulmonary Consumption with Asthma and Cough (Fei Lao Chuan Sou).
Etiology: Several years ago, he contracted Lung Wind (Pulmonary Wind) causing cough. The treatment was inappropriate. Although the illness temporarily subsided, the Wind pathogen remained entrenched and obstructed within the Lungs, leading to the syndrome of Pulmonary Consumption with Asthma and Cough.
Symptoms: The condition was mild during warm weather; occasional episodes of asthma and cough would resolve after half a day. However, during winter, asthma and cough occurred continuously, only gradually improving when the weather became warm. The pulse was wiry and hard on the left side, soft and slippery on the right side, and rootless upon heavy pressure at both Chi positions.
Diagnosis: This is caused by Wind pathogen entrenched and obstructing the Lungs, damaging Lung Qi over time, resulting in stagnation and obstruction of the bronchial tubes. During warmth, muscles relax, and the bronchial tubes also relax, allowing relatively free respiration. During cold, muscles contract, and the bronchial tubes constrict accordingly, leading to difficult inhalation and easy exhalation, manifesting as asthma. Additionally, phlegm-fluid retention causes cough. The wiry and hard pulse on the left indicates insufficiency of Yin fluids in the Liver and Kidney. The soft and slippery pulse on the right indicates overflow of phlegm-fluid in the Lung and Stomach. The inability of the Chi pulses to withstand heavy pressure indicates deficiency and damage of Qi transformation in the Lower Jiao, failing to secure and hold, thereby exacerbating asthma and cough in the Upper Jiao. To treat this syndrome, one must first ventilate and unblock the Lung Qi, ensuring the obstructed bronchial tubes are opened. Subsequently, administer formulas that nourish Yin, tonify Qi, and simultaneously benefit the Lung and Kidney to eradicate the root cause.
Prescription: Ephedrae Herba (Mahuang, 1.5 qian), Asparagi Radix (Tian Dong, 3 qian), Trichosanthis Radix (Tian Hua Fen, 3 qian), Arctii Fructus (Niu Bang Zi, 3 qian, crushed), Armeniacae Semen Amarum (Xing Ren, 2 qian, peeled and crushed), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1.5 qian), Perillae Fructus (Su Zi, 2 qian, stir-fried and crushed), Polygalae Radix (Yuan Zhi, 2 qian, heart removed), Malto (Mai Ya, 2 qian), Paeoniae Radix Alba (Bai Shao, 2 qian), Asari Radix et Rhizoma (Xi Xin, 1 qian).
Decoct together in a large bowl of water, take warm.
Follow-up Visit: After taking two doses, asthma and cough resolved, but slight asthma persisted during physical exertion. The pulse remained wiry and hard on the left, soft on the right (no longer slippery as before), and empty at both Chi positions. This indicates that the pathogenic factor has been eliminated but the healthy Qi has not yet recovered. It is appropriate to plan for fundamental treatment and administer tonic formulas.
Prescription: Codonopsis Radix (Tai Shen, 3 qian), Hematitum (Zhe Shi, 8 qian, finely ground), Dioscoreae Rhizoma (Shan Yao, 1 liang), Rehmanniae Radix Praeparata (Shu Di Huang, 1 liang), Rehmanniae Radix Recens (Sheng Di Huang, 1 liang), Poria Cocos (Fu Ling, 2 qian), Lycii Fructus (Gou Qi Zi, 6 qian), Asparagi Radix (Tian Dong, 6 qian), Corni Fructus (Yu Rou, 5 qian), Perillae Fructus (Su Zi, 3 qian, stir-fried and crushed), Arctii Fructus (Niu Bang Zi, 3 qian, crushed).
Decoct together in a large bowl of water, take warm.
Formula Analysis: Ginseng Radix et Rhizoma (Ren Shen) is the primary herb for tonifying Qi and possesses ascending properties. Yu Jiayan stated, "For Qi deficiency with tendency to float upward, exclusive use of it may cause Qi to rise uncontrollably." Therefore, in cases of asthma and counterflow, Ginseng should not be used lightly. Instead, using a heavy dose of Hematitum (Zhe Shi) guides Qi downward, facilitating the grasping of Qi by the Kidneys. Consequently, Qi transformation in the Lower Jiao becomes robust and securing. In this formula, the combination of Ginseng and Hematitum aims not only to guide Lung Qi to the Kidneys but also, given the emptiness of the Chi pulses, to tonify Qi transformation in the Lower Jiao.
Outcome: After continuous administration for more than ten doses, asthma did not occur even during physical exertion. Upon re-examination, the pulse was harmonious and disease-free on both sides, and the Chi pulses were no longer empty upon heavy pressure. Two qian of Hematitum were then removed to allow continued consumption of the remaining herbs for convalescence.