赵 衰年喘嗽痰红，舌焦咽燥，背寒，耳鸣颊赤，脉左弦疾，右浮洪而尺搏指。按脉症系冬阳不潜，
金为火烁，背觉寒者，非真寒也。以父子悬壶，忽而桂、附，忽而知、柏，忽而葶苈逐水，忽而款冬泄肺，
致嗽血益加，身动即喘，坐则张口抬肩，卧则体侧喘剧，因侧卧则肺系缓而痰益壅也。思桂、附既辛热助火，
知、柏亦苦寒化燥，非水焉用葶苈，泄热何借款冬，细察吸气颇促，治宜摄纳。但热蒸腻痰，气冲咽痛，急
则治标，理先清降。用川百合、贝母、杏仁、麦冬、沙参、牡蛎、阿胶（水化），燕窝汤煎。一啜嗽定而痰红止。
去杏仁、牡蛎、阿胶，加生地、竹茹、丹皮、元参、羚羊角午服，以清上中浮游之火，用熟地、五味、茯神、
秋石、龟板、牛膝、青铅晚服，以镇纳下焦散越之气，脉症渐平。
族某 七旬以来，冒寒奔驰，咳呕喘急，脉弦滑，时 冷气。
夫寒痰停脘必呕，宿痰阻气必咳。老人元海根微，不任劳动，劳则嗽，嗽则气升而喘，必静摄为宜，仿温
肺汤，用辛温止嗽以定喘。淡干姜、五味、（干姜、五味摄太阳而定喘，古人治嗽喘，必二味同用。）
桑皮（炙）、茯苓、潞参、甜杏仁、橘红、制半夏、款冬花、紫衣胡桃，数服喘呕俱定，十服全瘳。
李 喘由外感者治肺，由内伤者治肾，以肺主出气，肾主纳气也。出气阻而喘，为肺病，吸气促而喘，
为肾病。今上气喘急，遇烦劳则发，不得卧息，必起坐伏案乃定，近则行步亦喘，是元海不司收纳之权，致胶
痰易阻升降之隧，急急摄固真丸。熟地炭、牛膝炭、茯神、五味、萸肉、补骨脂、莲子（俱炒）。数服颇安。
贡 积年痰嗽，脉细形衰，动则疝气偏坠，病因肝肾久损，客冬心事操劳，身动即喘，痰嗽益剧，肉消
骨立，是五液悉化为痰，偏卧不舒，是阴阳亦乖于用，所谓因虚致病，积损成劳候也。右脉沉数无力，左脉浮
数无根，良由下元真气失纳，以致下引上急，吸入颇促而为短气，若不纳使归源，将下元根蒂都浮，喘嗽何由
镇静，况症本肾虚水泛为痰，必非理嗽涤饮可效。奈何胆星、竺黄、芥子、芩、柏等无理乱投，不知顾忌。
昨议服固摄之品，痰气较平，而脉象未改，是损极难复，维系不固，有暴脱之忧。今酌定晨服都气丸加参、
术、远志、故纸，晚服肾气汤去萸、泻、丹皮、桂、附，加茯神、五味、杞子、沙苑子、莲子、枣仁。冀其气
平而痰嗽自定。
岳 少年体质阴亏，兼伤烦劳，脉虚促，热渴颊红，痰血喘急，速进糜粥以扶胃，食顷喘定，症宜清调肺
卫，润补心营。甜杏仁、阿胶（水化）、沙参、川贝、茯神、枣仁、麦冬、石斛、蒌仁、黄 （蜜炒）。三服
脉匀症退。继进燕窝汤，嗽喘悉止。治以培土生金，潞参、山药、炙草、玉竹、五味、茯神、杏仁、莲子、
红枣，食进。丸用加减都气而安。
服侄 初春脉左弦长，直上直下，喘嗽吐红，梦泄。冬阳不潜，足少阴经与冲脉同络，阴虚火炎，气冲
为喘，络伤为血，乃元海根蒂失固。医者不知纳气归原，泛用归、 、术、草，症势加剧，寒热咳逆，血升气
促，冲脉动诸脉皆动，总由肺肾失交，
急急收纳，务令阳潜阴摄。阿胶（水化）、牡蛎（醋 ）、龟板（酥炙）、龙骨（ ）、五味、山药、高丽参、
茯神、枣仁、坎 （焙研）。数服嗽平血止，去坎 ，加青铅，冲气亦定。
倪 年近七旬，木火体质，秋嗽上气喘急，痰深而黄，甚则不得卧息，须防晕厥。治先平气定喘。蜜
桑皮、苏子、杏仁、川贝母、茯神、栝蒌、百合。二服后，加白芍、麦冬。述旧服两仪膏痰多食减，今订胶方，
减用熟地（砂仁末拌熬晒干，四两）、高丽参（一两）、茯苓（三两）、甜杏仁（炒研，五两）、莲子
（八两）、枣仁（一两）、枇杷膏（四两）、燕窝（两半）、橘红（八钱）、贝母（一两）、山药（三两）、
阿胶（一两），各味熬汁，阿胶收，开水化服。
某 肾不纳气则喘息上奔，脾不输精则痰气凝滞。今痰哮不利，呼吸颇促，病本在脾肾，而肺胃其标也。
由冬延春，脉候若断若续，忽神烦不寐，语谵舌灰，虚中夹温，治先清降。杏仁、栝蒌、象贝、茯神、潞参，
菖蒲汁冲服。一剂嗽定得寐，舌苔稍退，进粳米粥，喘息乃粗，脉见虚促，急用纳气归原，冀根蒂渐固。高丽
参、五味、牛膝炭。远志、茯神、杞子、莲子、牡蛎粉，六服。间用七味地黄丸而安。
Zhao, an elderly patient with declining vitality, presented with asthma, cough, and blood-streaked sputum. His tongue was scorched and dry, throat parched, back felt cold, accompanied by tinnitus and flushed cheeks. The pulse was wiry and rapid on the left, and floating, large, and surging on the right, with the chi (cun-kou) position beating firmly against the finger. Analyzing the pulse and symptoms, this is due to winter yang failing to submerge, and lung metal being scorched by fire. The sensation of cold in the back is not true cold. As father and son practiced medicine, they alternately used Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Aconite Root), then Zhimu (Anemarrhena Rhizome) and Huangbai (Phellodendron Bark), then Tinglizi (Descurainiae Semen) to purge water, and Kuandonghua (Fritillariae Thunbergii Flos) to drain the lungs. This led to worsened hemoptysis; movement triggered asthma, sitting required opening mouth and lifting shoulders, and lying on the side exacerbated asthma because lateral recumbency relaxed the lung system and allowed phlegm to accumulate further. Considering Guizhi and Fuzi are acrid-hot and aid fire, Zhimu and Huangbai are bitter-cold and induce dryness, why use Tinglizi if there is no water retention? Why use Kuandonghua for heat draining? Careful examination revealed rapid inhalation; treatment should focus on grasping and retaining kidney qi. However, heat steaming produces sticky phlegm, and qi rushing to the throat causes pain. In acute cases, treat the branch first; logically, clear and descend heat is prioritized. Use Chuan Baihe (Lilii Bulbus), Beimu (Fritillariae Cirrhosae Bulbus), Xingren (Armeniacae Semen Amarum), Maidong (Ophiopogonis Radix), Shashen (Glehniae Radix), Muli (Conchae Ostreae), Ejiao (Asini Corii Colla, dissolved in water), decocted in Yanwo Soup (Swallow's Nest Decoction). After one dose, cough stopped and blood-streaked sputum ceased. Remove Xingren, Muli, and Ejiao; add Shengdi (Rehmanniae Radix), Zhuru (Bambusae Caulis in Taenia), Danpi (Moutan Cortex), Yuanshen (Scrophulariae Radix), and Lingyangjiao (Saigae Tataricae Cornu) for noon administration to clear floating fire in the upper and middle jiao. Administer Shudi (Prepared Rehmanniae Radix), Wuweizi (Schisandrae Fructus), Fushen (Poria with Hostwood), Qiushi (Urinal Calculus), Guiban (Testudinis Carapax et Plastrum), Niuxi (Achyranthis Bidentatae Radix), and Qingqian (Galena) for evening administration to anchor and retain scattered qi in the lower jiao. Pulse and symptoms gradually normalized.
A clansman, over seventy years old, after exposing himself to cold while galloping, presented with cough, vomiting, and urgent asthma. The pulse was wiry and slippery, with occasional sensations of cold qi rising. Cold-phlegm stagnating in the epigastrium must cause vomiting; old phlegm obstructing qi must cause cough. The elder’s primordial sea root is weak and cannot withstand labor; labor induces cough, cough causes qi to rise leading to asthma. Quiet recuperation is suitable. Following the principle of Wenfei Tang (Warming Lung Decoction), use acrid-warm herbs to stop cough and calm asthma. Dan Jiangjiang (Light Dried Ginger), Wuweizi (Schisandrae Fructus) [Dried Ginger and Schisandra grasp Taiyang and calm asthma; ancients always used these two together for cough and asthma], Zhi Sangpiao (Honey-fried Mulberry Bark), Fuling (Poria), Lushen (Codonopsis Radix), Tian Xingren (Sweet Apricot Kernel), Juhong (Citri Reticulatae Pericarpium), Zhi Banxia (Prepared Pinellia Rhizome), Kuandonghua (Fritillariae Thunbergii Flos), and Ziyi Hetao (Walnut Kernel with Purple Skin). After several doses, asthma and vomiting settled; after ten doses, complete recovery occurred.
Li: Asthma caused by external contraction is treated in the lungs; that caused by internal injury is treated in the kidneys, because the lungs govern exhalation and the kidneys govern inhalation. Obstruction of exhalation causing asthma indicates lung disease; urgency of inhalation causing asthma indicates kidney disease. Now, upper body asthma is urgent, triggered by mental exertion, inability to lie down and rest, requiring sitting up and leaning forward to settle. Recently, walking also induces asthma. This shows the primordial sea fails to exercise its grasping authority, causing tough phlegm to easily obstruct the pathways of ascending and descending. Urgently administer Shegu Zhen Wan (Grasping and Consolidating True Pill). Shudi Tan (Charred Prepared Rehmanniae Radix), Niuxi Tan (Charred Achyranthis Bidentatae Radix), Fushen (Poria with Hostwood), Wuweizi (Schisandrae Fructus), Yurou (Corni Fructus), Buguzhi (Psoraleae Fructus), Lianzi (Nelumbinis Semen, all stir-fried). After several doses, considerable relief was achieved.
Gong: Chronic phlegm-cough, fine pulse, emaciated form, hernia drooping upon movement. Etiology involves long-term damage to liver and kidney. Last winter, mental toil induced asthma upon movement, worsening phlegm-cough, muscle wasting and bone prominence. This signifies all five fluids transformed into phlegm; discomfort in lateral recumbency indicates dysfunction of yin and yang. This is "disease arising from deficiency, accumulation of damage becoming exhaustion." Right pulse is deep, rapid, and powerless; left pulse is floating, rapid, and rootless. Indeed, loss of grasping by primordial qi in the lower yuan leads to lower pulling upper urgently, rapid inhalation, and shortness of breath. If not grasped and returned to the source, the lower yuan root will float away, how can asthma and cough be calmed? Moreover, the pathology is kidney deficiency with water overflowing as phlegm; simply regulating cough and purging fluid will not work. Regrettably, Danxing (Arisaema Cum Bile), Zhuhuang (Bambusae Calamus in Taenia), Jiezi (Brassicae Semenis Albi), Qin (Scutellariae Radix), and Bo (Phellodendri Cortex) were recklessly administered without regard for contraindications. Yesterday, solidifying agents were discussed; phlegm and qi slightly stabilized, but pulse unchanged. This indicates extreme depletion difficult to restore, unstable maintenance, with risk of sudden collapse. Now, morning administration: Duqi Wan (Eight-Ingredient Pill with Rehmannia) plus Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Yuanzhi (Polygalae Radix), Gubuzhi (Psoraleae Fructus). Evening administration: Shenqi Tang (Kidney Qi Decoction) minus Yurou (Corni Fructus), Xiexie (Alismatis Rhizoma), Danpi (Moutan Cortex), Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata), plus Fushen (Poria with Hostwood), Wuweizi (Schisandrae Fructus), Gouqi (Lycii Fructus), Shayuanzi (Astragali Complanati Semen), Lianzi (Nelumbinis Semen), Zaoren (Ziziphi Spinosae Semen). Hope for qi stabilization and natural cessation of phlegm-cough.
Yue: Youth with yin deficiency constitution, complicated by mental fatigue. Pulse is deficient and hurried, fever, thirst, flushed cheeks, blood-streaked sputum, urgent asthma. Quickly advance millet gruel to support stomach qi. After a brief meal, asthma settles. Symptoms require clearing and regulating lung defense, moistening and tonifying heart nourishment. Tian Xingren (Sweet Apricot Kernel), Ejiao (Asini Corii Colla, dissolved in water), Shashen (Glehniae Radix), Chuan Bei (Fritillariae Cirrhosae Bulbus), Fushen (Poria with Hostwood), Zaoren (Ziziphi Spinosae Semen), Maidong (Ophiopogonis Radix), Shihu (Dendrobii Caulis), Louren (Trichosanthis Semen), Huanglian (Coptidis Rhizoma, honey-fried). After three doses, pulse became even and symptoms receded. Continue with Yanwo Soup (Swallow's Nest Decoction); cough and asthma completely stopped. Treatment focuses on cultivating earth to generate metal: Lushen (Codonopsis Radix), Shanyao (Dioscoreae Rhizoma), Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata), Yuzhu (Polygonati Odorati Rhizoma), Wuweizi (Schisandrae Fructus), Fushen (Poria with Hostwood), Xingren (Armeniacae Semen Amarum), Lianzi (Nelumbinis Semen), Hongzao (Jujubae Fructus). Food intake increased. Pill formulation: Modified Duqi Wan brought peace.
Nephew: Early spring, left pulse wiry and long, straight up and down, asthma, cough, hemoptysis, nocturnal emission. Winter yang fails to submerge; Foot Shaoyin Meridian connects with Chong Mai (Penetrating Vessel). Yin deficiency with fire flaming, qi rushing causes asthma, collateral damage causes bleeding. This is loss of solidity in the primordial sea root. Physicians failed to grasp qi and return it to the source, widely using Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), exacerbating condition with chills, fever, cough, rebellious qi, rising blood, and hurried qi. When Chong Mai moves, all pulses move. Total failure of lung-kidney interaction requires urgent grasping, ensuring yang submerges and yin retains. Ejiao (Asini Corii Colla, dissolved in water), Muli (Conchae Ostreae, vinegar-quenched), Guiban (Testudinis Carapax et Plastrum,酥-roasted), Longgu (Fossilia Ossis Mastodi, calcined), Wuweizi (Schisandrae Fructus), Shanyao (Dioscoreae Rhizoma), Gaolishen (Korean Ginseng), Fushen (Poria with Hostwood), Zaoren (Ziziphi Spinosae Semen), Kanqi (Ureter, roasted and powdered). After several doses, cough calmed and bleeding stopped. Remove Kanqi, add Qingqian (Galena); rushing qi also settled.
Ni: Near seventy years old, wood-fire constitution. Autumn cough with upper asthma, deep yellow phlegm, severe cases unable to lie down. Prevent syncope. Treat first to calm qi and stabilize asthma. Honey-fried Sangpiao (Mulberry Bark), Suzi (Perillae Fructus), Xingren (Armeniacae Semen Amarum), Chuan Beimu (Fritillariae Cirrhosae Bulbus), Fushen (Poria with Hostwood), Gualou (Trichosanthis Fructus), Baihe (Lilii Bulbus). After two doses, add Baishao (Paeoniae Radix Alba) and Maidong (Ophiopogonis Radix). Previously took Liangyi Gao (Two-Powder Paste) resulting in excessive phlegm and reduced appetite. Now prescribe Jiao Fang (Collagen Formula): Reduce Shudi (Prepared Rehmanniae Radix, mixed with Amomi Fructus powder, boiled, dried, 4 liang), Gaolishen (Korean Ginseng, 1 liang), Fuling (Poria, 3 liang), Tian Xingren (Sweet Apricot Kernel, fried and ground, 5 liang), Lianzi (Nelumbinis Semen, 8 liang), Zaoren (Ziziphi Spinosae Semen, 1 liang), Pipa Gao (Loquat Leaf Paste, 4 liang), Yanwo (Swallow's Nest, half liang), Juhong (Citri Reticulatae Pericarpium, 8 qian), Beimu (Fritillariae Cirrhosae Bulbus, 1 liang), Shanyao (Dioscoreae Rhizoma, 3 liang), Ejiao (Asini Corii Colla, 1 liang). Decoct each ingredient, collect with Ejiao, take dissolved in boiling water.
Certain Patient: Kidney failing to grasp qi leads to rushing asthma; spleen failing to transport essence leads to stagnant phlegm-qi. Now, wheezing phlegm is obstructive, breathing is hurried. Pathology root lies in spleen and kidney, while lung and stomach are the branch. From winter extending to spring, pulse feels intermittent. Suddenly, mental agitation, insomnia, delirious speech, gray tongue coating. Deficiency complicated by warm pathogen. Treat first to clear and descend. Xingren (Armeniacae Semen Amarum), Gualou (Trichosanthis Fructus), Xiang Beimu (Fritillariae Thunbergii Bulbus), Fushen (Poria with Hostwood), Lushen (Codonopsis Radix), taken with Changpu Juice (Acori Tatarinowii Rhizoma juice). One dose stopped cough and enabled sleep; tongue coating slightly receded. Advance rice porridge; breathing coarse, pulse deficient and hurried. Urgently use grasping qi returning to source method, hoping roots gradually solidify. Gaolishen (Korean Ginseng), Wuweizi (Schisandrae Fructus), Niuxi Tan (Charred Achyranthis Bidentatae Radix), Yuanzhi (Polygalae Radix), Fushen (Poria with Hostwood), Qizi (Lycii Fructus), Lianzi (Nelumbinis Semen), Muli Fen (Conchae Ostreae Powder). Six doses. Intermittently use Qishi Dihuang Wan (Seven-Ingredient Rehmannia Pill) for stability.