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In autumn, the weather descends. The Upper Jiao (Upper Burner) is first affected by dryness transformation. Consequently, cough symptoms are most numerous. If repeated treatments with lung-regulating herbs prove ineffective, according to the Classic: "If chronic cough persists without resolution, it affects the Three Jiao." This indicates that treatment should not be exclusively focused on regulating the lungs. At sixty-three years old, although his physical form is full, his True Qi (Zhen Qi) is gradually declining. Ancients treated elderly patients with chronic cough primarily from the perspective of the mother-son generating relationship between the Spleen and Kidney. Furthermore, prolonged coughing causes Qi to dissipate; therefore, it is necessary to tonify Qi with sweet-warm tonics and employ astringent methods. This is sound reasoning. Here, we propose taking medication in the morning to grasp and secure the Lower Jiao, and pure-sweet, clear-drying formulas in the evening to fill the deficiency below and clear/descend above. Bitter and acrid flavors are contraindicated to prevent damage to the Stomach and leakage of Qi.

Morning Formula: Water-processed Rehmanniae Radix Praeparata (Shu Di Huang), Bai Yun Ling (Poria steamed with milk), Schisandrae Fructus (Wu Wei Zi), Jian Lian (Lotus Seed), Huai Shan Yao (Dioscoreae Rhizoma), Che Qian Zi (Plantaginis Semen), Huai Niu Xi (Achyranthis Bidentatae Radix), Zi Yi Tao Ren Shuang (Walnut Meat Frost). These are ground into powder, mixed with steamed pig spinal cord (membrane removed) and pounded into pills, taken with warm water.

Evening Formula: Zhen Bei Sha Shen (Glehniae Radix), Raw Astragali Radix (Huang Qi), Bo Pi (Tangerine Peel), Ophiopogonis Tuber (Mai Dong), Raw Amomi Fructus Rotundus (Bai Bian Dou), Raw Glycyrrhizae Radix et Rhizoma (Gan Cao), Nan Zao Rou (Jujube Flesh). Decocted in fresh water, filtered, and reduced to an extract. Just before completion, add genuine Persimmon Frost (Shi Shuang), dissolve in warm water, and take.

Yesterday's discussion concerned Upper Jiao Lung disease. After one hundred days, there has been no recovery; muscle wasting occurs due to heat transformation. Prolonged heat inevitably damages Yin fluids. We propose using salty-nourishing agents like Eclitae Fermentatum (E Jiao) and Gallus Domesticus Ovum (Ji Zi Huang), combined with Scutellariae Radix (Huang Qin) and Coptidis Rhizoma (Huang Lian) which are bitter-cold. This clears Qi-level heat from above and nourishes below. Although this is a temporary formula, it is not a harsh purgative. Carefully considering diseases of the Hand-Taiyin Lung Meridian, they originally do not severely affect the Foot meridians. However, human Qi mechanism follows the laws of nature: Lung Qi descends from the right, Liver Qi ascends from the left. Lung disease delays descent, while Liver stagnation accelerates ascent. Persistent coughing and wheezing indicate Wood (Liver/Gallbladder) insulting Metal (Lung). Consider sleep and waking: 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 incessantly, causing coughing without respite. Even sudden heat rising to the left cheek confirms excessive left-side ascent. If ascent continues unchecked, when Liver Wood takes command in Spring, there is fear of hemorrhage. Thus, left and right are pathways of Yin and Yang. Since Yin and Yang have deviated causing disease, cold-clearing and Yin-nourishing methods alone cannot achieve rapid results.

Formula: Eclitae Fermentatum (E Jiao), Gallus Domesticus Ovum (Ji Zi Huang), Rehmanniae Radix (Sheng Di Huang), Asparagi Tuber (Tian Dong), Ligustri Lucidi Fructus (Nv Zhen Zi), Agri Graminis Rhizoma Cum Mycelio (Nuo Dao Gen Xu).

Previously, insufficient Yang responded well to warming tonics. Recently, due to mental fatigue, Yang has become lax, allowing Wind-Warmth pathogens to bypass the Lung and Wei defenses to disturb the Ying level of the Heart. Itching precedes coughing; sputum occasionally contains blood spots. Do not overuse descending/clearing dispersants. Use pungent-sweet-cool agents to regulate upper dryness and clear collateral heat. Maintain a light diet and rest; peace can be restored in ten days.

Formula: Mori Folium (Dong Sang Ye), Polygonati Odorati Rhizoma (Yu Zhu), Glehniae Radix (Da Sha Shen), Armeniacae Semen Amarum (Tian Xing Ren), Raw Glycyrrhizae Radix et Rhizoma (Sheng Gan Cao), Coicis Semen (Yi Yi Ren). Decocted in Rice Decoction.

Externally constrained by Wind-Warmth, internally driven by uncontrolled Liver-Gallbladder Yang ascent, the Lung loses its clearing and descending function. For over a month, Qi feels congested and fails to descend. Appetite is poor, bowel movements are unsatisfactory. Body fluids are depleted and fail to supply the Lung. Fu-organ Qi is also not smooth. We propose nourishing Stomach Yin to harmonize Yang, rather than treating cough generically.

Formula: Ophiopogonis Tuber (Mai Dong), Glehniae Radix (Sha Shen), Polygonati Odorati Rhizoma (Yu Zhu), Raw Paeoniae Radix Alba (Sheng Bai Shao), Amomi Fructus Rotundus (Bian Dou), Poria (Fu Ling).

Winter Warm-Evil cough stems from Water deficiency and internal Heat invasion. Cough subsides after Jingzhe (Awakening of Insects) solar term. Using Liuwei Dihuang Wan plus Eclitae Fermentatum (E Jiao), Ophiopogonis Tuber (Mai Dong), and Urini Hominis Praeparatus (Qiu Shi) treats Metal and Water simultaneously. This is a method of draining Yang and benefiting Yin, suitable for constitution regulation and disease treatment. Ten days ago, cough recurred with poor appetite. Inquiry revealed night sitting caused physical strain. In late spring, Earth Qi ascends; sitting until dawn causes body Yang to ascend without descending, raising concerns of hemorrhage. Moreover, a plump, soft physique implies Qi easily leaks. Reading should be paused; recovery in a few days is expected.

Formula: Mori Folium (Sang Ye), Armeniacae Semen Amarum (Tian Xing Ren), Glehniae Radix (Da Sha Shen), Raw Glycyrrhizae Radix et Rhizoma (Sheng Gan Cao), Polygonati Odorati Rhizoma (Yu Zhu), Saccharum Sinense Liquidum (Qing Zhe Jiang).

Right pulse is forceful. Frequent hot baths for scabies weakened the Defensive Qi (Wei Qi), making one susceptible to cold/heat. Skin/hair corresponds internally to the Lung. Cough, Qi obstruction, and profuse sputum occur. Long-term, food tastes bland, stool becomes dry and hard. Stomach fluids deplete daily, failing to supply the Lung. With autumn/winter weather descending and Dryness adding to it, signs of Phlegm-Fire in old age emerge. Clearing Heat and moistening dryness is appropriate. If one fears deficiency and uses cloying tonics daily, dryness will worsen.

Formula: Frost-treated Mori Folium (Shuang Sang Ye), Armeniacae Semen Amarum (Tian Xing Ren), Ophiopogonis Tuber (Mai Dong), Polygonati Odorati Rhizoma (Yu Zhu), Glehniae Radix (Bai Sha Shen), Trichosanthis Radix (Tian Hua Fen), Saccharum Sinense Liquidum (Gan Zhe Jiang), Pyri Fructus Juice (Tian Li Zhi).

Thin physique, dark complexion, constitutive heat, yet Five Fluids are insufficient. Winter warmth prevents proper storage of True Qi. The Shaoyin Kidney channel experiences wind generation, a sign of Yang movement. Without nourishing Yin to drive out heat, using generic acrid-dispersants treats acute Wind-Cold. Excessive acridity leaks Lung Qi, prolonging cough. Bitter-descending agents damage the Stomach and Kidney gate, reducing appetite and courage, causing panting after short walks. The function of storing and securing is lost; internal damage is evident. This is not treating the symptom directly. Rest for one hundred days may bring peace.

Formula: Ophiopogonis Tuber (Mai Dong), Sweet Glehniae Radix (Tian Sha Shen), Raw Glycyrrhizae Radix et Rhizoma (Sheng Gan Cao), Jujube Flesh (Nan Zao Rou), Saccharum Sinense Liquidum (Qing Zhe Jiang).

Chronic cough for three years, profuse sputum, poor appetite. Movement triggers wheezing sounds. Left pulse is rapid and bounding; right pulse is fine and slow. Internal fire feels blazing. This is consumption of Five Fluids, with insufficient Yang control, not Excess Fire. Usually use Qiongyu Gao to nourish Water and tonify Qi. Temporary decoctions must prioritize protecting the Stomach. Cough medicines likely benefit the body condition little.

Formula: Bei Sha Shen (Glehniae Radix), White Amomi Fructus Rotundus (Bai Bian Dou), Stir-fried Ophiopogonis Tuber (Chao Mai Dong), Poria Cum Radix (Fu Shen), Dendrobii Caulis (Chuan Shi Hu), Trichosanthis Radix (Hua Fen).

Living alone with mental labor, right pulse bounds while left is choppy. Dry Qi is above, Blood is secretly deficient. Thought and depression cause vexation of the Five Zang Fires. Morning cough with saliva expectoration suggests treating from the Stomach, as the Sea of Blood belongs to the Yangming channel.

Formula: Raw Amomi Fructus Rotundus (Sheng Bai Bian Dou), Polygonati Odorati Rhizoma (Yu Zhu), Glehniae Radix (Da Sha Shen), Poria Cum Radix (Fu Shen), Frost-treated Mori Folium (Jing Shuang Rou Ye), Coicis Semen (Yi Yi Ren). Decocted with clear rice water.

Another case: Deficiency originates below. Depressed emotions cause Yang of the Five Zang Fires to ascend and irritate, causing cough. This is not Excess Fire. However, long stagnation leads to Qi knotting and Blood drying, progressing to Dry Blood Consumption Disease. Menstruation is scanty, irregular, and delayed—clear evidence. Tonify Liver-Kidney Yin to treat the root; clear/nourish Lung-Stomach Qi Heat to treat the branch. Hot-acrid tonics are feared for injuring Yin, so they are improper.

Formula: Raw Amomi Fructus Rotundus (Sheng Bian Dou), Bei Sha Shen (Glehniae Radix), Poria Cum Radix (Fu Shen), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhi Cao), Jujube Flesh (Nan Zao Rou).

Pill Formula: Rehmanniae Radix Praeparata (Shu Di Huang) stir-fried with Amomi Fructus (Sha Ren), Cornu Cervi Pantotrichum (Lu Jiao Shuang), Angelicae Sinensis Radix (Dang Gui) stir-fried with Foeniculum Fructus (Xiao Hui Xiang), Achyranthis Bidentatae Radix (Huai Niu Xi) charred with salt water, Cloud Poria (Yun Fu Ling), Psilum (Zi Shi Qing) prepared with vinegar, Green Salt (Qing Yan), and Bovine Osseum Colla (Sheng Yang Rou Jiao) melted together for pills.

This spring epidemic brought cough and throat issues to most. Pathogens attack from above, injuring Lung Qi first. Recently, movement causes panting, voice weakens. Sleeping on the left causes pulling sensation in the left hypochondrium. This is Liver-Kidney Yin deficiency with Chong Qi ascending. Winter storage failed. Hoarseness upon lateral sleeping is imminent. This is damage from overwork, not a disease treatable by clearing pathogens and stopping cough.

Formula: Liuwei Dihuang Wan plus Dan Qiu Shi, Eclitae Fermentatum (E Jiao), Ophiopogonis Tuber (Mai Dong), honey pills.

Left pulse is weak, right is bounding. Chronic deficiency persists into Spring. Night lying causes Qi rushing and severe cough. Walking causes shortness of breath. Root of Lower Yuan is thin; Winter storage is insecure; Spring ascending Qi is shallow. Urgently secure and grasp the lower. Secular doctors often use acrid-cool cough remedies, leading to failure.

Formula: Water-processed Rehmanniae Radix Praeparata (Shu Di), Schisandrae Fructus (Wu Wei), Lake Lotus Seeds (Hu Lian), Euryales Semen (Qian Shi), Poria Cum Radix (Fu Shen), Green Salt (Qing Yan), Lamb Kidney.

Chronic dysmenorrhea implies stagnant Qi and Blood. Sudden anger causes Liver Yang to reverse and attack the Lung, causing cough. Patient reports abdominal Qi rushing upward triggers cough. Clear/moisten Lung herbs are not the key method. Post-chills/fever, cough is hoarse, hypochondrium is tight, no appetite. Left ascent and Right descent fail to rotate; Stomach loses its downward flow. Liver disease easily invades Stomach; thus, soothing Liver and unblocking Stomach is the rule.

Formula: Mori Folium (Sang Ye), Moutan Cortex (Dan Pi), Uncariae Ramulus cum Uncis (Gou Teng), Poria (Fu Ling), Pinelliae Tuber (Ban Xia), Citri Reticulatae Pericarpium (Guang Pi), Weixi Wan.

Qi stagnation distension, hollow inside, lying down causes Qi blockage, turbid fluids rush up, preventing rest. Onset due to anger injuring Liver Wood and damaging Spleen Earth. Spleen fails to transport, Qi blocks causing distension. After 100 days, Zheng Qi is weaker, turbidity solidifies, attacks Lung, causing cough, panting, epigastric heat, purulent bloody sputum. Root in Liver/Spleen, now spread to Lung. Danxi said: "Nourish Metal to control Wood, Spleen free from thief evil; Nourish Water to control Fire, Lung gains clearing power." Priority is smoothing Qi. If chest opens and sleep/eating resume, treatment can proceed calmly. Otherwise, near Chunfen, it will be hard to regulate. First use method to ventilate Upper Jiao.

Formula: Astigmatos Radix (Zi Wan), Armeniacae Semen Amarum (Xing Ren), Benincasae Pericarpium (Lou Pi), Curcumae Radix (Yu Jin), Magnoliae Officinalis Cortex (Nong Po), Arecae Pericarpium (Da Fu Pi), Morus Cortex (Sang Pi), Poria Cocostele (Fu Ling Pi), Gardeniae Fructus (Hei Shan Zhi).

Kidney Essence damaged below, Yin Qi rises, Floating Yang scorches above. Throat pain/bi, throat swelling, cough/panting. Lower Yuan Sea fails to grasp; Chong Mai Qi rushes up. Daily moistening agents hope to reduce cough—this is a mediocre doctor's good method, but actually creates disaster. Currently weak Stomach and loose stools mean cough treatment is futile. Recovery from consumptive weakness requires securing True Qi, grasping Qi, supporting Stomach appetite. Hope for increased food intake brings luck.

Formula: Ginseng Radix et Rhizoma (Ren Shen), Poria (Fu Ling), Euryales Semen (Qian Shi), Canalis Ureteris (Kan Qi), Hunan Lotus Seeds (Xiang Lian Zi), Urini Hominis Praeparatus (Qiu Shi), Schisandrae Fructus (Wu Wei Zi), Walnut (Hu Tao).

Internal injury from worry/thought first damages Upper Heart/Lung. Heart governs Ying, Lung governs Wei. Both Qi deficient, intolerant of labor, susceptible to pathogens. Only by nourishing Righteousness is Evil removed. No need for Ma Huang/Gui Zhi drastic dispersants. Internal injuries follow Dong Yuan's methods. Now bleeding stopped, pulse faint, fatigue, no appetite, persistent cough, sticky sputum—all signs of Earth failure and Metal withering. Urgently use sweet-mild tonification.

Formula: Raw Astragali Radix (Sheng Huang), Stir-fried Paeoniae Radix Alba (Chao Bai Shao), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhi Cao), Malt Sugar (Yi Tang), Jujube Flesh (Nan Zao).