金陵一铺治哮喘，名白果定喘汤，服之无不效者。其人以此起家，方用白果二十一个炒黄，麻黄三钱，
苏子二钱，款冬花、法制半夏、桑白皮蜜炙各二钱，杏仁去皮尖、黄芩微炒各一钱半，甘草一钱，水三钟，煎
二钟，随时分作二服，不用姜。（《摄生方》、《本草纲目》。文田按∶风寒则白果、桑皮为大禁，南省伤
寒证少，风热什杂之气多耳。）
按∶此方惟风寒外感者宜用。若上盛下虚，气不归元者，服之立毙。如不问虚实，概行与之，虽起家
而杀人多矣。然今之时师执方治病，谬为知服，其人亦未必不起家，而其罪则加等矣。
泸东治一人，九月间病发热恶寒喘急，脉洪大而似实，众作伤寒治不效。此虚甚之脉，非真实也。止视其
短气不足以息，即当作虚治，以补中益气汤加麦冬、五味子、熟附子三分，六剂愈。症亦有痰食阻滞而声微
喘促者，与虚症相似，不可不审也。
陈三农治一人，每劳或怒，即喘急吐痰不卧。众以降火化痰、理气清肺之剂不效，脉浮数而虚涩，此阴虚
火动其痰也。用补阴平肺饮，下咽喘即定而愈。（同上。）
薛立斋治一妇人，伤风寒作喘。或用表散，愈而复患。仍用前药，其症益甚，饮食少思，胸腹不利。此因
脾肺气虚也，先用六君子汤加桔梗渐愈，又用补中益气汤全愈。
侍御谭希曾喘咳吐痰，或手足时冷。此中气虚寒，用补中益气、炮姜而愈。
一妇人患前症，属命门火虚，不能生脾土，用补中益气汤、八味丸而痊。后复患，其喘益甚，下前药不应。
遂用黑锡丹，二服喘止，仍用前二药而诸症痊。凡属邪气有余者，其症易识，治效亦速。其属元气不足者，变
症不一，效非可以旦夕期也。
定西侯蒋公患上气喘急，其脉寸口洪滑，此痰滞胸膈也。令先服稀涎散二钱，更以热水频频饮之，（用代探法
殊妙。）则溢而吐，其痰如胶，内有一长条，裹韭叶一根遂愈。《局方》稀涎散∶江子仁六粒，牙皂三钱，明
矾一两。为末，每用三分，吹入喉中。
一路姓者，年近五十，身体肥大，饮食倍常，病月余，每行动即喘。诊之，六脉微涩，曰∶此死症也。众
为妄，后逾月果卒。
孙文垣治程菊泉，暑月患喘嗽，咳咳连声，浓痰滚滚，行动则喘促不宁，夜分口渴，胸膈胀闷，脉两寸滑
而数，两关弦。此肺有宿痰，胆有郁火。经云∶火郁发之。又风寒外束者，可发散。苏子、半夏、采曲、杏仁
各一钱，石膏二钱，款冬花、桑皮各八分，桔梗、枳壳各五分，麻黄三分，病不减。改以杏仁、陈皮、人参、
贝母、款冬花、麦冬各七分，苡仁一钱五分，桔梗、知母各五分，五味子十粒，桑皮一钱，陈皮六分，痰减半。
胸膈未舒，口干脚热，前方减去款冬、五味，加枳壳、葶苈，两帖全愈。
陆祖愚治唐鸣和，平时有火症，因试事成痰火咳嗽，日夜吐黄痰二三碗，气逆喘急，饮食不进，服枳、梗、
二陈尤甚，改服参、术几危。脉之，两手俱洪滑而数，乃用茯苓、桑皮、贝母、芩、连、花粉、元参、枳壳，
加牛黄、竹沥，二三剂胸宽气缓，七八剂痰乃白色。去牛黄，三十余剂而安。
黄履素曰∶予家有庖丁王姓，生平多欲，年四十患脚痛。往针，予谓此足三阴虚，针无益也。数年后患
痰喘，胸中痛，昼夜不眠。予谓此肾虚，气不归元，峻补其下，则气自降。适名医陈药坡来诊，其持论与
予略同。奈病者服陈药嫌其作闷，别寻粗工治之，大服降气宽中之剂，服后觉宽，宽后复发。病者尚以渐
宽为效，信服之以至于死，良可叹也。大凡此等病服药，初觉闷，久当渐宽渐愈。愚者嫌闷，而别求宽药，
死者比比而是。（医者，病家，两宜熟悉。）如脾虚者亦然，初服必作闷，久则自宽。破气消导之药服之觉
宽，久乃愈闷，以至不救，病者不可不知。
李士材治一人，发热干咳，呼吸喘急。始用苏子降气不应，乃服八味丸，喘益急。诊之，见其两颧俱赤，
六脉数大，此肺肝蕴热也。以逍遥散用牡丹皮一两，苡仁五钱，兰叶三钱，连进两剂，喘吸顿止。以地黄丸料，
用麦冬、五味煎膏及龟胶为丸，至十日而康。（《局方》逍遥散∶甘草、当归、茯苓、白芍、白术、柴胡。
肝脾蕴热与逍遥散不合，因大用丹皮、苡米而获愈，善后之法亦稳，第用五味殊未妥。王说是则是矣，然《内经》
有肝咳之论，逍遥全治肝耳。既治肝得效，则何虑五味之酸收？况曾经误散伤其肺气耶。）
朱太学喘急多痰，可以坐不可以卧，可以俯不可以仰，惶急求治。李曰∶两尺独大而软，为上盛下虚。遂
以地黄丸一两，用桔梗三钱，枳壳二钱，甘草一钱，半夏一钱，煎汤送下，不数剂而安。
黄给谏中气大虚，发热自汗喘急。诊之，脉大而数，按之如无。此内有真寒，外见假热，当以理中汤冷冻饮料。
举家无主，不能信从，惟用清热化痰之剂，遂至不起。《金匮》理中汤∶人参、白术、甘草、干姜。
叶方伯夫人喘急痞闷，肌肤如灼，汗出如洗，目不得瞑。诊之，六脉皆空，所谓汗出如油，喘而不休，绝
症见矣。辞不治，三日而殁。（王氏按∶汗出至三日而后死，此何必不可救？此治脱不必治喘也。
真脏未见，何畏于六脉之空乎？）
宋氏女中气素虚，食少神倦，春初忽然喘急，闷绝不知人，手足俱冷，咸谓毙矣。李曰∶气虚极而不清肃，
不能下行，非大剂温补决无生理。遂以人参一两，干姜三钱，熟附子三钱，白术五钱，药服而苏。后服人参七
斤余，姜、附各二斤，遂全愈。（王氏拟删此案。岂以术、附壅滞，无治喘理乎？然此证不少，王氏亦一偏之见耳。）
孙氏女久嗽而喘，凡顺气化痰、清金降火之剂，几于遍尝，绝不见效。一日喘甚烦躁，李视其目则胀出，
鼻则鼓肩，脉则浮而且大，肺胀无疑矣。遂以越婢加半夏汤投之，一剂而减，再剂而愈。曰∶今虽愈，未可恃
也，当以参、术补之，助养金气，使清肃下行。竟因循月余终不补，再发遂不可救药矣。（急则治其标，
用越婢善矣。缓则治其本，用参、术以善后，犹未为当也。）
冯楚瞻治司文选，素患痰喘，发则饮食不进，旦夕不寐，调治数月不效。脉之，两寸少洪，余皆沉弱，其
右关尺微细更甚。乃命门之火衰极无根，虚阳上浮，且服克削，脾元亏损，致痰涎益甚，虚气愈逆。以炒黄白
术八钱，固中气为君。炒燥麦冬三钱，清肺引气降下为臣。炮姜二钱，温中导火；牛膝二钱，下趋接引；五味
子一钱，敛纳收藏，并以为佐。制附子一钱五分，承上药力，直达丹田为使。如是数剂，痰退喘止，食进神强，
久服八味丸不再发。（冯氏治病，大半皆是此种药，真景岳、立斋嫡派，而其用药更狠。尝见一酒客病喘，
医以此法施之，大喘而死。误补与误攻，厥罪固维均也。）
吴孚先治赵太学，患水气咳嗽而喘，误作伤风，概投风药，面目尽肿，喘逆愈甚。曰∶风起则水涌，药之
误也。以真武汤温中镇水，诸症悉平。
李成槐之室，蓦地气喘，呼吸促急，提不能升，咽不能降，气道噎塞，势甚危。或作痰逆气滞，欲用牛黄、
苏合二丸，不敢遽服。脉之，两尺微细无神，此肝肾亏损，子午不交，气脱症也。用人参一两，熟地二两，当
归五钱，甘草二钱，一帖稍定，二帖喘平。凡气短似喘，人谓其病在上，不知元海无根，病实在下也，误治立
危。（予遇此等症重投熟地，无力之家不能备参者，以枣仁一两，枸杞子一两代之，亦应如桴鼓。）
张飞畴治韩顺溪内子，患喘症月余，服破气宽胸豁痰清火等药不效，发表利水亦不应，其痰转急，稍动则
喘，难以休息。诊之，六脉细数，而面赤戴阳，用大剂六味地黄丸作汤，加青铅两许，一服而缓，三服而安。
柴屿青治程别驾尊人，高年忽患痰喘，不进饮食。诊其脉有根，决无意外事。用四磨汤内加人参一两，一
服而愈。《济生方》四磨饮∶人参、槟榔、沉香、乌药。
王观察在太史时，方酷暑，令媳面红唇燥发喘不止，足冷至胯，危甚，两脉鼓指，按之微细。必过服苦寒所
至，询之果然。曰∶此戴阳症也。内真寒而外假热。急以人参三钱，熟附子一钱五分，投之喘定。又加肉桂一
钱五分，半夜尚发烦躁足冷未愈。遂以六味汤内加桂、附各一钱五分，六剂并煎，冰冷，频频饮之而愈。
少宗伯邹小山，春月患喘咳，吐痰甚剧。延诊视，按其诸脉和平，惟肺部沉洪，明有伏邪，此小疾也。缘
医谓风寒凝结，用桂枝温散，彻夜不寐，惫甚不支，遂用清理药而愈。
张三锡云∶《纲目》载一男子五十余，病伤寒咳嗽，喉中声如 。与独柴汤一服，而 声除，至二三帖咳嗽
亦渐退，服二三斤病始痊。不病亦屡用有验，但可与知者道耳。今若但以寸脉大，不知分别有力无力，遽认为
实，枳、桔、桑、杏、芩、栀妄投，死亦不悔者多矣。（此案但盛称柴胡之功而已，流弊无穷。今日市医，何
患不用柴胡？王氏删之有见。）
薛立斋治妇儒者，体肥，仲夏患痰喘，用二陈、芩、连、桔梗，痰喘益甚。加桑皮、杏仁、栝蒌，盗汗气
促。加贝母、枳壳，不时发热，饮食渐减，脉大而无力。以为脾肺虚寒，用八味地黄丸，以补土母，用补中益
气汤，以接中气而愈。（王氏删，非是。）
一妇人早间吐痰甚多，夜间喘息不寝。夫早间多痰，乃脾虚饮食所化；夜间喘急，乃肺虚阴火上冲。用
补中益气加麦冬、五味而愈。（王氏删，非是。）
王叔权治一贵人久患喘，夜卧不得而起行，夏月亦衣夹背心，知是膏肓病也，令灸膏肓而愈。亦有暴喘者，
知是痰为梗，令细锉浓朴七八钱、重以姜七片，水二碗，煎七分服，滓再煎服，不过数服愈。若不因痰而喘者，
当灸肺 。凡有喘与哮者，为按肺 无不酸疼，皆为缪刺肺 ，又令灸而愈。亦有只缪刺不灸而愈者，
此病有浅深也。
舍弟登山为雨所抟，一夕气闷几不救。见昆季必泣，有欲别之意。疑其心悲，为刺百会不效。按其肺 ，
云疼如锥刺，以火针微刺之即愈。因此与人治哮喘，只缪刺肺 ，不刺他穴。惟按肺 酸疼者，然后点灸，其
他穴非是。（并《资生经》。）
滁阳高司法，名申之，每苦寒喘痰发甚时，非此药不能治，方名五味子汤。用橘皮三两去白，甘草一两半
炙，麻黄四两去根、节，五味子二两，杏仁二两面炒，去皮、尖。上为粗末，水一盏半，药末两大钱，煎至七
分去渣，通口服，不拘时候。如喘甚加药末，入马兜铃、桑白皮同煎，夏服减麻黄一两。（《医方集成》医说篇。）
陈三农治一人，极言痰气作楚，喘急而不能食，遍体作痛。服清气化痰药，无异服水，何也？曰∶岂止无
益？反受害矣。肥人气居于表，中气必虚，脾弱不能胜湿，气虚不能健运，是以多痰而喘。以四君子加南星、
半夏，佐以姜汁，数剂而愈。
刘点生治汪去尘，脾虚水逆伤肺，喘嗽不食，小水不通。脉虚不胜补泻，用茯苓五钱，泽泻、橘红各一钱
五分，防风、肉桂、熟附各五分，二服水去，后加人参，调理而安。（《张氏医通》。）
薛立斋治职方王用之，喘嗽作渴，面赤鼻干。为脾胃有痰，用二陈加芩、连、山栀、桔梗、麦冬而愈。
一武职体魁梧，素不围炉，不喜热食，行则喘促。自谓气实老痰，服碑记丸攻伐之。（又名黑丸子。）诊其
脉洪数，重按全无，谓命门火衰，脾肺虚寒，与八味丸一服痰喘稍止，数服全止，遂能亲火，喜热饮食。盖碑记丸
出自西域方外人所制者。经云∶西域水土刚强，其民不衣而褐荐，其民华色而脂肥，故邪不能伤其形体。其病
生于内，其治宜毒药。由此观之，恐不可概用也。
太守钱东圩先患肩疽，属足三阴虚，火不归元，用壮水之主，以制阳光而愈。曰∶疮疾虽愈，当摒去侍女，
恐相火一动，其精暗流，金水复竭，必致变症。后果咳嗽，痰出如涌，面目赤色，小便淋涩。又误认为外感风
寒，用麻黄汤表散，汗出不止。迎视其脉已脱，惟太冲未绝，曰∶此脾虚不能摄涎，肾虚不能生水，肺虚不能
摄气，水泛为痰，虚极之症也。辞为难治，勉以益火之源，以消阴翳而愈。继又劳伤神思，外邪乘之，仍汗出
亡阳，以致不愈。
朱丹溪治七三婶喘，遇冬则发。此寒包热也，解表则热自除。枳壳三钱炒，麻黄、防风、黄芩、桔梗各二
钱，木通一钱半，（通利九窍，治肺壅甚当。）紫苏叶五分，四帖，煎取小半盏饮之。
薛立斋治一男子咳嗽，脉紧数，以小青龙汤一剂，表症已解。更以葶苈大枣汤，喘止，乃以桔梗汤愈。
马元仪治朱千秋患喘嗽，自夏及秋，群治不愈，自谓已成阴虚。曰∶阴虚者宜补阴以制火，阳虚者宜补气
以散邪。今两脉浮濡，浮为虚气，濡为气弱，病在阳而补阴，故邪留而不愈也。不信。又一月，食减喘增，寒
热自汗，身重不能转侧，复求治。其脉空大急疾，此中气大亏，阳不外固，治法先固卫外之阳，次补内守之阴，
A physician in Jinling treated asthma with a formula named Baiguo Dingchuan Tang (White Fruit Asthma-Calming Decoction), which proved effective in every case. This physician amassed great wealth through this method. The prescription consists of twenty-one roasted White Fruit (Ginkgo Seed, *Bai Guo*), three qian of Ephedra Herb (*Ma Huang*), two qian of Perilla Seed (*Su Zi*), two qian of Winter Flower (*Kuan Dong Hua*), two qian of Processed Pinellia Tuber (*Fa Zhi Ban Xia*), two qian of Honey-fried Mulberry Root Bark (*Sang Bai Pi*), one and a half qian of Apricot Kernel (*Xing Ren*) peeled and cored, one and a half qian of Scutellaria Root (*Huang Qin*) lightly stir-fried, and one qian of Licorice Root (*Gan Cao*). Boil in three zhong of water until reduced to two zhong, divide into two doses taken at any time, without using Ginger. (From *Sheng Fang* and *Ben Cao Gang Mu*. Wentian notes: If the cause is Wind-Cold, White Fruit and Mulberry Root Bark are strictly contraindicated; this is because in the Jiangnan region, Cold Damage syndromes are rare, and there are more cases of mixed Wind-Heat pathogens.)
Commentary: This formula is suitable only for those with external Wind-Cold contraction. For patients with excess above and deficiency below, where Qi fails to return to its source, administration will lead to immediate death. If administered indiscriminately regardless of deficiency or excess, although it may enrich the physician, the sin of causing death is even greater. However, contemporary physicians who rigidly adhere to fixed formulas to treat diseases, claiming expertise in their use, may indeed become wealthy, but their culpability is compounded.
In Ludong, a patient fell ill in September with fever, aversion to cold, and urgent panting. The pulse was surging and large yet appeared solid when it was not. Physicians treated it as Cold Damage without success. This was a pulse of extreme deficiency, not true excess. Observing his shortness of breath and inability to take sufficient breath, it should have been treated as a deficiency syndrome. Using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Ophiopogon Tuber (*Mai Dong*), Schisandra Berry (*Wu Wei Zi*), and Prepared Aconite Root (*Shu Fu Zi*) three fen, he recovered after six doses. Symptoms can also mimic deficiency due to phlegm-food obstruction causing weak voice and panting; careful differentiation is essential.
Chen Sansan treated a patient who experienced urgent panting, expectoration of phlegm, and inability to lie flat whenever fatigued or angered. Treatments aimed at descending fire, resolving phlegm, regulating Qi, and clearing the Lung were ineffective. The pulse was floating, rapid, deficient, and choppy, indicating Yin deficiency with stirring of Fire generating phlegm. Using Buyin Pingfei Yin (Nourish Yin and Calm the Lung Decoction), the panting ceased immediately upon ingestion, and he recovered. (Ibid.)
Xue Lizhai treated a woman whose panting was caused by contracting Wind-Cold. She was treated with diaphoretic herbs; the condition resolved but recurred. Re-administering the previous herbs worsened the symptoms, leading to poor appetite and chest/abdominal discomfort. This was due to Spleen and Lung Qi deficiency. Initially treated with Liujunzi Tang (Six Gentlemen Decoction) added with Platycodon Root (*Jie Geng*) for gradual improvement, then fully cured with Buzhong Yiqi Tang.
Tan Xizeng, a Censor, suffered from panting, coughing, and expectoration, sometimes with cold hands and feet. This was deficiency-cold of the Middle Jiao. He recovered using Buzhong Yiqi Tang added with Roasted Ginger (*Pao Jiang*).
A woman suffered from the aforementioned condition, attributed to deficiency of Mingmen Fire failing to generate Spleen Earth. She recovered using Buzhong Yiqi Tang and Bawei Wan (Eight-Ingredient Pill). Upon recurrence, her panting worsened, and the previous medicines failed. She was then given Heixi Dan (Black Tin Pill); after two doses, the panting stopped, and she recovered completely with the previous two medicines. Conditions with excess pathogenic factors are easy to identify and respond quickly. Conditions with insufficient Yuan Qi present varied symptoms and require time to resolve.
Jiang, Marquis of Dingxi, suffered from urgent panting. His Cun (Cun position) pulse was surging and slippery, indicating Phlegm stagnation in the chest and diaphragm. He was ordered to first take Xixian San (Saliva-Dispersing Powder) two qian, followed by frequent sipping of hot water (using a simulated emetic method was ingenious). He vomited copiously; the phlegm was gelatinous, containing a long strip wrapping a leek leaf, after which he recovered. *Ju Fang* Xixian San: Six seeds of Croton Seed (*Jiang Zi*), three qian of Glycyrrhiza Uralensis Root (*Ya Zao*), one liang of Alum (*Ming Fan*). Grind to powder, use three fen each time, blown into the throat.
A man surnamed Lu, nearly fifty years old, was obese and ate double the usual amount. After over a month of illness, he panted with every movement. His six pulses were faint and choppy. It was declared a fatal condition. Others dismissed this as absurd; he died exactly one month later.
Sun Wenyuan treated Cheng Juquan, who suffered from panting and coughing in summer. He coughed continuously with thick, rolling phlegm, became restless and panting with movement, felt thirsty at night, had chest/diaphragm distension, and his Cun pulses were slippery and rapid while Guan pulses were wiry. This indicated old Phlegm in the Lung and Stagnant Fire in the Gallbladder. The Classics state: "Stagnant Fire should be dispersed." Also, if bound by external Wind-Cold, it can be released. Initial prescription: Perilla Seed, Pinellia Tuber, Qu (Medicated Leaven), Apricot Kernel each one qian; Gypsum two qian; Winter Flower and Mulberry Root Bark each eight fen; Platycodon Root and Aurantium Fruit each five fen; Ephedra Herb three fen. No improvement. Changed to: Apricot Kernel, Tangerine Peel, Ginseng Root, Fritillaria Bulb, Winter Flower, Ophiopogon Tuber each seven fen; Coix Seed one and a half qian; Platycodon Root and Anemarrhena Rhizome each five fen; Schisandra Berry ten grains; Mulberry Root Bark one qian; Tangerine Peel six fen. Phlegm reduced by half. Chest remained uncomfortable, mouth dry, feet hot. Removed Winter Flower and Schisandra from the previous formula, added Aurantium Fruit and Lepidium Seed. Recovered after two doses.
Lu Zuyu treated Tang Minghe, who usually had Fire syndromes. Due to stress from an examination, he developed Phlegm-Fire coughing, expectorating two to three bowls of yellow phlegm daily, with rebellious Qi, urgent panting, and loss of appetite. Treatment with Aurantium Fruit, Platycodon Root, and Erchen Tang worsened his condition; switching to Ginseng and Atractylodes Rhizome nearly killed him. Pulses were surging, slippery, and rapid in both hands. Prescribed Poria (*Fu Ling*), Mulberry Root Bark, Fritillaria Bulb, Scutellaria Root, Scutellaria Barbata (*Lian*), Trichosanthes Root (*Hua Fen*), Scrophularia Root (*Yuan Shen*), Aurantium Fruit, added Buffalo Horn (*Niu Huang*) and Bamboo Juice (*Zhu Li*). After two to three doses, chest comfort and breathing eased; after seven to eight doses, phlegm turned white. Remove Buffalo Horn; recover after thirty-plus doses.
Huang Lvsu said: My household had a cook surnamed Wang who indulged in desires. At forty, he suffered foot pain. I advised acupuncture, stating this was deficiency of the Three Foot Yin meridians, so acupuncture would be useless. Years later, he suffered Phlegm-panting and chest pain, unable to sleep day or night. I stated this was Kidney deficiency with Qi failing to return to its source; tonifying the lower body strongly would allow Qi to descend naturally. Famous physician Chen Yaopo arrived and agreed. However, the patient disliked the chest fullness caused by Chen's medicine and sought a quack who prescribed Qi-descending and middle-expanding agents. He felt relief initially, but the condition relapsed. Believing the temporary relief was efficacy, he continued until death, which is lamentable. Generally, such conditions cause initial chest fullness with medication, gradually easing and healing over time. Fools dislike the fullness and seek expanding drugs, leading to many deaths. (Both physicians and families must understand this.) Similarly for Spleen deficiency: initial fullness occurs, eventually easing. Qi-breaking and digestion-promoting drugs feel relieving initially but cause increasing fullness later, leading to untreatable states. Patients must know this.
Li Shicai treated a patient with fever, dry cough, and urgent breathing. Initial treatment with Perilla Seed to descend Qi failed; taking Bawei Wan worsened the panting. Inspection showed red malar flush and rapid, large pulses, indicating Heat stored in Lung and Liver. Used Xiaoyao San (Free and Easy Wanderer Powder) with one liang of Moutan Cortex (*Mu Dan Pi*), five qian of Coix Seed, and three qian of Orchid Leaf (*Lan Ye*). After two doses, panting stopped instantly. Followed up with Dihuang Wan ingredients, made into pills with Ophiopogon Tuber, Schisandra Berry paste, and Tortoise Shell Glue (*Gui Jiao*). Recovered in ten days. (*Ju Fang* Xiaoyao San: Licorice Root, Angelica Sinensis Root, Poria, White Peony Root, Atractylodes Macrocephala Rhizome, Bupleurum Root. Liver-Spleen Heat does not fit Xiaoyao San perfectly, but recovery occurred due to heavy use of Moutan Cortex and Coix Seed. The follow-up method was stable, though using Schisandra Berry was questionable. Wang's comment is valid; however, the *Neijing* discusses Liver Cough, and Xiaoyao San treats the Liver. Since treating the Liver worked, why worry about the astringent nature of Schisandra? Especially since Lung Qi was previously damaged by incorrect dispersal.)
Zhu Taixue suffered urgent panting with much phlegm; could sit but not lie down, bend forward but not backward. Seeking treatment anxiously. Li stated: The Chi positions alone were large and soft, indicating excess above and deficiency below. Administered Dihuang Wan (Rehmannia Pill) one liang, decocted with Platycodon Root three qian, Aurantium Fruit two qian, Licorice Root one qian, Pinellia Tuber one qian, taken as a soup. Recovered after a few doses.
Hui Gejian suffered severe Middle Qi deficiency, fever, spontaneous sweating, and urgent panting. Pulse was large and rapid but empty on pressure. This indicated true Cold inside with false Heat outside. Should have used Lizhong Tang (Regulate the Middle Decoction) served cold. With no head of the family to decide, they did not believe it, using only Heat-clearing and Phlegm-resolving agents, leading to death. *Jin Gui* Lizhong Tang: Ginseng Root, Atractylodes Macrocephala Rhizome, Licorice Root, Dried Ginger.
Madam of Ye Fangbo suffered urgent panting, chest stuffiness, burning skin, profuse sweating like washing, and insomnia. All six pulses were empty. This is known as sweating like oil, continuous panting, a terminal sign. Declined treatment; died three days later. (Wang's note: Sweating for three days before death—why is it incurable? Treating collapse does not require treating panting. True Zang pulses were not seen, why fear empty six pulses?)
Song's daughter had chronic Middle Qi deficiency, poor appetite, and mental fatigue. In early spring, she suddenly suffered urgent panting, fainted, and became unconscious with cold limbs. Everyone thought she would die. Li stated: Extreme Qi deficiency prevents clear and pure descent; only massive warm-tonification offers hope. Used Ginseng Root one liang, Dried Ginger three qian, Prepared Aconite Root three qian, Atractylodes Macrocephala Rhizome five qian. Consciousness returned after medication. Later consumed over seven jin of Ginseng Root and two jin each of Ginger and Aconite, achieving full recovery. (Wang intended to delete this case. Does he think Atractylodes and Aconite are cloying and lack efficacy for panting? Such cases are common; Wang's view is biased.)
Sun's daughter suffered chronic cough and panting. Tried all Qi-regulating, Phlegm-resolving, Lung-cooling, and Fire-descending agents without effect. One day, severe panting and irritability occurred. Li observed bulging eyes, flaring nostrils, and floating, large pulses, confirming Lung distension. Prescribed Yebipi Jia Banxia Tang (Yebipi plus Pinellia Decoction). Reduced after one dose, recovered after two. He said: Although recovered now, do not rely on it. Must tonify with Ginseng and Atractylodes to support Metal Qi, allowing clear descent. Neglected tonification for over a month; recurrence was incurable. (Treating the branch in acute phase with Yebipi was good. Treating the root in chronic phase with Ginseng and Atractylodes for follow-up was still not ideal.)
Feng Chuzhan treated Si Wenxuan, who chronically suffered Phlegm-panting. Attacks prevented eating and sleeping. Months of treatment failed. Pulses: Cun positions slightly surging, others sinking and weak, especially fine at Right Guan and Chi. This indicated extreme decline of Mingmen Fire without root, floating deficient Yang, and damage from harsh draining herbs causing Spleen Yuan depletion, worsening Phlegm and rebellious Qi. Used Stir-fried Yellow Atractylodes Rhizome (*Chao Huang Bai Zhu*) eight qian as Sovereign to stabilize Middle Qi. Stir-fried Dry Ophiopogon Tuber (*Chao Zao Mai Dong*) three qian as Minister to clear Lung and guide Qi downward. Roasted Ginger (*Pao Jiang*) two qian to warm Middle and guide Fire; Achyranthes Root (*Niu Xi*) two qian to direct downward; Schisandra Berry (*Wu Wei Zi*) one qian to gather and store, serving as Assistant. Prepared Aconite Root (*Zhi Fu Zi*) one and a half qian to carry the power of other herbs to the Dantian as Envoy. After several doses, Phlegm receded, panting stopped, appetite improved, spirit strengthened. Long-term use of Bawei Wan prevented recurrence. (Feng's treatments mostly use such drugs, truly the orthodox lineage of Jingyue and Lizhai, but his dosing is bolder. I once saw a wine drinker with panting treated this way, resulting in severe panting and death. Incorrect tonification and incorrect attack bear equal guilt.)
Wu Fuxian treated Zhao Taixue, who suffered Water-Qi coughing and panting. Mistaken for Wind-Cold, treated generally with Wind-dispelling herbs, leading to facial swelling and worsened panting. He said: Wind rises, Water surges; this is a medicinal error. Used Zhenwu Tang (True Warrior Decoction) to warm Middle and calm Water; all symptoms subsided.
The wife of Li Chenghuai suddenly suffered panting,急促 breathing, inability to inhale deeply or swallow, airway blockage, critical condition. Some suspected Phlegm-rebellion and Qi-stagnation, wanting to use Niuhuang Wan (Calculus Bovis Pill) or Suhexiang Wan (Styrax Pill), but dared not administer immediately. Pulses: Chi positions faint, fine, and spiritless. This was Liver-Kidney depletion, failure of Zi-Wu intersection, Qi-collapse syndrome. Used Ginseng Root one liang, Prepared Rehmannia Root (*Shu Di*) two liang, Angelica Sinensis Root five qian, Licorice Root two qian. Slightly stabilized after one dose, panting ceased after two. Generally, shortness of breath resembling panting is considered upper pathology, but the truth is Yuan Sea has no root, and the disease is actually lower. Incorrect treatment leads to immediate danger. (When encountering such severe cases, I heavily use Prepared Rehmannia Root. For poor families unable to afford Ginseng, I substitute with one liang of Ziziphus Seed (*Zao Ren*) and one liang of Goji Berry (*Gou Qi Zi*), which works as effectively as a drumstick striking a drum.)
Zhang Feichou treated the wife of Han Shunxi, who suffered panting for over a month. Qi-breaking, chest-expanding, Phlegm-resolving, and Fire-clearing agents failed. Diaphoresis and diuresis were also ineffective. Phlegm became urgent, panting with slight movement, unable to rest. Pulses: six pulses fine and rapid, face red with Dai Yang (floating Yang). Used massive dose of Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) as decoction, adding approximately two qian of Lead Ore (*Qing Qian*). Relieved after one dose, safe after three.
Chai Yuqing treated the father of Cheng Biejia, an elderly man who suddenly suffered Phlegm-panting and refused food. Pulses had root; predicted no unexpected events. Used Simo Tang (Four-Marrow Decoction) added with Ginseng Root one liang. Recovered after one dose. *Jisheng Fang* Simo Yin: Ginseng Root, Areca Seed (*Bing Lang*), Agarwood (*Chen Xiang*), Lindera Root (*Wu Yao*).
Wang Guancha, while serving as Grand Secretary, during intense heat, his daughter-in-law had red face, dry lips, unceasing panting, and cold feet extending to the groin, critically ill. Pulses beat against fingers but were faint and fine on pressure. Caused by excessive bitter-cold herbs. Confirmed. He said: This is Dai Yang syndrome. True Cold inside, false Heat outside. Urgently administered Ginseng Root three qian, Prepared Aconite Root one and a half qian; panting settled. Added Cinnamon Bark (*Rou Gui*) one and a half qian; still irritable and cold feet at midnight. Then used Liuyi Tang (Six-Ingredient Decoction) added with Cinnamon Bark and Aconite Root one and a half qian each. Six doses decocted together, served cold, sipped frequently; recovered.
Zou Xiaoshan, Vice Director of Ceremonies, suffered panting and coughing in spring with severe expectoration. Examination showed peaceful pulses except for sinking and surging in Lung position, indicating hidden pathogen, a minor illness. Previously treated by a physician who diagnosed Wind-Cold condensation and used Guizhi Tang (Cinnamon Twig Decoction) for warming dispersion. Resulted in insomnia and exhaustion. Finally recovered with clearing and regulating herbs.
Zhang Sanxi said: *Gangmu* records a man over fifty with Cold Damage coughing, sound in throat like sawing wood. Given Duchai Tang (Single Bupleurum Decoction); sawing sound removed after one dose, cough gradually retreated after two to three doses, recovered after consuming two to three jin. Effective even for non-diseased individuals, but only discussable with those who understand. Today, if one merely sees large Cun pulse, fails to distinguish forceful or feeble, and hastily diagnoses excess, blindly administering Aurantium Fruit, Platycodon Root, Mulberry Root Bark, Apricot Kernel, Scutellaria Root, Gardenia Fruit leads to many deaths without regret. (This case only praises the merit of Bupleurum Root (*Chai Hu*), leading to endless abuses. Why worry about market physicians not using Chai Hu today? Wang's deletion shows insight.)
Xue Lizhai treated a scholarly woman, obese, suffering Phlegm-panting in mid-summer. Used Erchen Tang, Scutellaria Root, Scutellaria Barbata, Platycodon Root; Phlegm-panting worsened. Added Mulberry Root Bark, Apricot Kernel, Trichosanthes Fruit; night sweats and shortness of breath. Added Fritillaria Bulb, Aurantium Fruit; intermittent fever, decreasing appetite, large but forceless pulse. Diagnosed Spleen-Lung deficiency-cold. Used Bawei Dihuang Wan to tonify Earth to nourish Mother, and Buzhong Yiqi Tang to connect Middle Qi; recovered. (Wang deleted this, which is incorrect.)
A woman expected much phlegm in the morning and panted at night preventing sleep. Morning phlegm is transformed from food due to Spleen deficiency; night panting is Yin Fire rushing up due to Lung deficiency. Used Buzhong Yiqi Tang added with Ophiopogon Tuber and Schisandra Berry; recovered. (Wang deleted this, which is incorrect.)
Wang Shuquan treated a nobleman with chronic panting, unable to lie down at night, walking instead, wearing a padded vest even in summer. Knew this was Gaohuang disease, ordered moxibustion on Gaohuang points; recovered. There are also sudden panting cases caused by Phlegm obstruction. Ordered finely chopped Thick Bark (*Hou Po*) seven to eight qian with seven slices of Ginger, boiled in two bowls of water to七分, taken twice. Not more than a few doses needed. If panting is not due to Phlegm, moxa Lung Shu point. For all panting and wheezing, pressing Lung Shu causes soreness/pain; perform Miacupuncture (lateral needling) on Lung Shu and moxa to cure. Some heal with only lateral needling without moxa; this depends on depth of disease.
My younger brother was caught in rain while climbing a mountain, suffocated almost to death overnight. Wept seeing brothers, showing intent to part. Suspected heart sorrow, needled Baihui point without effect. Pressed Lung Shu point, described pain like needle piercing. Mildly pricked with fire needle; healed immediately. Therefore, treating asthma, I only laterally needle Lung Shu, not other points. Only moxa if Lung Shu is sore/painful; other points are not indicated. (All from *Zisheng Jing*.)
Gao Shenzhi, Judicial Officer of Chuyang, suffered severely from Cold-panting and Phlegm. Could only be treated with this formula named Wuweizi Tang (Schisandra Berry Decoction). Tangerine Peel three liang peeled, Licorice Root one and a half liang roasted, Ephedra Herb four liang rooted and jointed removed, Schisandra Berry two liang, Apricot Kernel two liang flour-roasted, peeled and cored. Coarsely ground. Boil one and a half zhong water with two large qian of powder to七分, strain, drink whole, anytime. If panting severe, add powder, boil with Aristolochia Root (*Madou Ling*) and Mulberry Root Bark. Summer dosage reduces Ephedra by one liang. (*Yi Fang Ji Cheng*, Yi Shuo section.)
Chen Sansan treated a man complaining bitterly of Phlegm-Qi distress, urgent panting, inability to eat, body-wide pain. Taking Clear-Qi and Resolve-Phlegm medicines was like drinking water, useless? He said: Not just useless; harmful! Fat people have Qi at the exterior, Middle Qi must be deficient. Weak Spleen cannot overcome Dampness, deficient Qi cannot transport effectively, thus producing much Phlegm and panting. Used Sijunzi Tang added with Star Fennel (*Nan Xing*) and Pinellia Tuber, assisted with Ginger Juice; recovered after several doses.
Liu Dianheng treated Wang Quchen, Spleen deficiency with Water rebellion injuring Lung, panting, coughing, refusal to eat, urination blocked. Pulse too deficient to withstand tonification or purgation. Used Poria five qian, Alisma Rhizome (*Ze Xie*) and Tangerine Peel (*Ju Hong*) each one and a half qian, Saposhnikovia Root (*Fang Feng*), Cinnamon Bark, Prepared Aconite Root each five fen. After two doses, water passed; later added Ginseng Root, regulated and recovered. (*Zhang Shi Yi Tong*.)
Xue Lizhai treated Wang Yongzhi, Official of Works, suffering panting, coughing, thirst, red face, dry nose. Phlegm in Spleen-Stomach. Used Erchen Tang added with Scutellaria Root, Scutellaria Barbata, Gardenia Fruit, Platycodon Root, Ophiopogon Tuber; recovered.
A muscular military officer, never used heating pads, disliked hot food, panted when walking. Claimed strong Qi and old Phlegm, took Beijii Wan (Monument Record Pill) for attacking/clearing. (Also called Black Pill.) Pulse surging and rapid, empty on deep pressure. Stated Mingmen Fire decline, Spleen-Lung deficiency-cold. Gave Bawei Wan; Phlegm-panting stopped slightly after one dose, completely after several doses. Could then approach fire, liked hot food. Beijii Wan was made by outsiders from Western Regions. Classics say: Western regions have hard water and soil; people wear coarse mats, have fair skin and fat bodies, so pathogens cannot injure form. Diseases arise internally, treated with toxic drugs. Thus, it is feared this cannot be universally applied.
Prefect Qian Dongxu first suffered shoulder abscess, attributed to deficiency of Three Foot Yin meridians, Fire not returning to source. Used "Strengthen the Master of Water to control Solar Flare" method; recovered. Said: Though wound healed, dismiss female attendants, lest Ministerial Fire stir, essence secretly flows, Metal and Water exhaust again, causing transformation. Indeed, later coughing, gushing phlegm, red face, painful urination. Mistakenly diagnosed as external Wind-Cold, used Ma Huang Tang (Ephedra Decoction) for dispersal. Sweating did not stop. Examined pulse, already collapsed, only Taichong remained. Said: Spleen deficiency cannot hold saliva, Kidney deficiency cannot generate Water, Lung deficiency cannot hold Qi, Water floods becoming Phlegm, extreme deficiency syndrome. Declared difficult to treat, tentatively used "Benefit the Source of Fire to eliminate Yin Shadows"; recovered. Later, mental labor injury, external pathogens attacked, sweating led to Yang collapse, thus not recovering.
Zhu Danxi treated Seventh Aunt San's panting, occurring in winter. This is Cold enveloping Heat; resolving exterior removes Heat. Fried Aurantium Fruit three qian, Ephedra Herb, Saposhnikovia Root, Scutellaria Root, Platycodon Root each two qian, Akebia Stem (*Mu Tong*) one and a half qian (Unblocks nine orifices, appropriate for severe Lung congestion), Perilla Leaf five fen. Four doses, decoct to small half cup, drink.
Xue Lizhai treated a man coughing, pulse tight and rapid. One dose of Xiao Qinglong Tang (Minor Blue Dragon Decoction) resolved exterior signs. Then Tingli Dazao Tang (Descurainia Seed and Jujube Decoction) stopped panting, finally cured with Jiegeng Tang (Platycodon Decoction).
Ma Yuanyi treated Zhu Qianqiu's panting and coughing, from summer to autumn, various treatments failed, self-diagnosed as Yin deficiency. Said: Yin deficiency should be treated by tonifying Yin to control Fire; Yang deficiency should be treated by tonifying Qi to disperse Pathogens. Now pulses are floating and soggy; floating indicates deficient Qi, soggy indicates weak Qi. Disease is in Yang, but tonifying Yin was done, so Pathogen remains unresolved. Patient did not believe. One month later, decreased appetite, increased panting, alternating chills and fever, spontaneous sweating, heavy body unable to turn. Sought treatment again. Pulse empty, large, rapid. This is severe Middle Qi deficit, Yang not securing exterior. Treatment method: First secure exterior-protecting Yang, then tonify interior-preserving Yin.