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Brother Huang Jingxiu had previously been trading in Jinhua, suffering from hemoptysis (coughing up blood). Despite treatment, it was ineffective; his appetite decreased, and he emaciated, raising concerns that he might develop consumptive disease (Xu Lao). I frequently visited Lanxi, and a friend recommended me for consultation. Reviewing previous prescriptions, they leaned towards warming and tonifying. I told him: "Although ancients used this method for treating blood disorders, one must examine whether the syndrome belongs to deficiency-cold to be appropriate." Based on the pulse and symptoms here, the issue lies in the yin deficiency of the Lung and Kidney, with hyperactive Liver Yang ascending. Severe coughing causes fire to flare up, leading to blood溢ing out. The principle should be to nourish Kidney Water to support Liver Wood, moisten the Lung to protect Lung Metal, so that coughing decreases and bleeding stops naturally. After taking medicine that matched the syndrome, I wished to leave, but Brother Huang insisted I stay. He treated him for over a month, after which hemoptysis completely ceased, appetite increased, spirit became vigorous, and muscle mass returned.

An Bo's Commentary: Using warm-hot medicines to treat consumptive disease is no different from disregarding human life. Thus, former sages said that men often have excess Yang and deficient Yin. Generally, men often have excess Qi, while many suffer from Blood deficiency. Using warm-hot medicines to treat consumptive disease refers to Zhang Zhongjing's methods of establishing the Middle Jiao, such as those involving the sweet flavor of grain (Jia Se), urgently strengthening the Middle Qi. This allows the Central Palace to become strong, increasing food intake and flourishing fluids, thereby generating blood and essence to restore the insufficiency of True Yin. I believe this is suitable for treating Xu Lao caused by Spleen deficiency. However, if Kidney Yin is exhausted and Ministerial Fire scorches Lung Metal, presenting with coughing up blood, emaciation, seminal emission, tidal fever, etc., administering such medicine is like carrying firewood to put out a fire.

In Brother Huang Jingxiu's shop, there was a colleague named Bao Zonghai. Due to contracting Wind-Cold, he suffered from wheezing and coughing for many days. He consulted an old doctor of a certain surname in that area, who believed his syndrome belonged to internal deficiency and prescribed Rehmanniae Radix (Dihuang), Angelicae Sinensis Radix (Danggui), Ginseng Radix et Rhizoma (Renshen), and Atractylodis Macrocephalae Rhizoma (Baizhu). Seeing the prescription, I advised him not to take it. Zonghai believed his constitution was inherently weak and the old doctor's judgment was correct, so he secretly took the medicine. That night, his wheezing and coughing worsened significantly. The next day, he went back for adjustment. The doctor said the previous dosage was too light and added Astragali Radix (Huangqi) and Schisandrae Fructus (Wuweizi). After taking it, his chest felt distended with Qi rebelling upwards, making it impossible to lie down. He made gasping sounds incessantly, feeling suffocated and near death. Brother Huang inquired about the cause and instructed me to save him. I said: "I originally advised against taking the previous medicine. He did not believe me, and moreover, acid-astringent herbs were added, causing the pathogen to become even more entrenched. How can it be resolved?" Brother Huang said: "He has worked with me for years; I cannot bear to see him die without rescue. After repeated deliberation, I formulated a prescription using Ephedrae Herba (Mahuang), Cinnamomi Ramulus (Guizhi), Asari Radix et Rhizoma (Xixin), Pinelliae Rhizoma Preparatum (Banxia), Glycyrrhizae Radix et Rhizoma (Gancao), Zingiberis Rhizoma Recens (Shengjiang), Armeniacae Semen Amarum (Xingren), and Lepidii Fructus (Tinglizi). I told him: 'This is Wind-Cold lodging in the Lung, causing Qi obstruction and Phlegm condensation, leading to wheezing and coughing. The doctor failed to use dispersing methods but instead administered astringent and tonifying herbs, causing the obstructed to become more obstructed and the congested to become more congested, brewing into a critical syndrome of Lung Distension (Fei Zhang).' The *Jin Gui Yao Lue* states: 'For coughing and rebellion of Qi with inability to lie flat, Xiao Qing Long Tang governs.' In my formula, I removed the acid-astringent effects of Schisandrae Fructus (Wuweizi) and Paeoniae Radix Alba (Baishao), adding the bitter-draining effects of Lepidii Fructus (Tinglizi) and Armeniacae Semen Amarum (Xingren). This is because the Lung dislikes Qi rebelling upwards, and bitter substances are urgently needed to drain it. It is as urgent as putting out a fire at one's eyebrows; delay is not an option." Brother Huang agreed happily and immediately ordered the medicine to be purchased and decocted. Shortly after, he coughed up two basins of thick phlegm, and his chest and diaphragm instantly relaxed. Taking the remaining dregs again, he vomited about a cup of phlegm-saliva, his wheezing stopped, and he could lie down. Zonghai finally realized the error of the previous medicine and cried, begging for rescue. I smiled and said: "No harm done; you just suffered needlessly for a few days." For the second dose, the dosages of Ephedrae Herba (Mahuang) and Cinnamomi Ramulus (Guizhi) were reduced, and Platycodonis Radix (Jiegeng), Citri Reticulatae Pericarpium (Juhong), Poria (Fuling), and Perillae Fructus (Suzi) were added to better harmonize the Lung and Stomach, leading to recovery.

An Bo's Commentary: Wind-Cold coughing is also a major syndrome and should not be dismissed as minor or superficial. Dr. Xu Lingtai struggled for thirty years before mastering the treatment of coughing. By modifying *Xiao Qing Long Tang*, removing Schisandrae Fructus (Wuweizi) and Paeoniae Radix Alba (Baishao) and adding Lepidii Fructus (Tinglizi) and Armeniacae Semen Amarum (Xingren), Mr. An truly exemplifies skillfully following the ancients without being bound by them.