安昌娄 阴火上升，咳嗽气喘，着枕不耐，脉滑数，舌黄燥底赤。宜防变幻，候正。（二月七号壬寅十九日。）
鲜生地（六钱） 栝蒌子（三钱） 白石英（三钱） 赖橘红（八分） 陈萸肉（钱半） 川贝（
二钱） 天冬（二钱） 海石（三钱） 粉丹皮（二钱） 杜兜铃（钱半） 光杏仁（三钱） （引）青铅（一
三帖。
又 据述痰气稍平，胃钝，浮肿溺少，恐痰壅致险，仍遵前法加减，候正。（四月十二号癸卯念五日。）
栝蒌子（三钱） 苏子（二钱） 炒谷芽（四钱） 海金沙（四钱） 川贝（三钱） 橘红（一钱）
白石英（三钱） 杜赤豆（四钱） 光杏仁（三钱） 通草（钱半） 紫菀（二钱）
清煎二帖。
介按∶喘病之因，在肺为实，在肾为虚，此则虚实兼夹，肺肾同病，虚则虚于肾之不固
，实
喘不能着枕。初方镇摄固纳，清宣肃降，得以痰气稍平。然湿浊尚未净退。而浮肿溺少，继
进清肺渗湿以化痰，治法标本兼顾。
安昌叶 脘痹气冲，得嗳稍舒，脉弦细，腹中有瘕，咳逆。姑宜栝蒌薤白汤主治。（三
栝蒌皮（三钱） 川贝（钱半） 炒谷芽（四钱） 绿萼梅（钱半） 薤白（钱半） 生香附（钱
半） 广郁金（三钱） 远志肉（八分） 仙半夏（钱半） 佩兰（三钱） 苦丁茶（钱半）
清煎二帖。
介按∶阴虚肝旺，腹中聚瘕，挟痰而上冲于肺。肺失清降之司，而阻痹气机，则嗳咳兼
作。治法宗仲景辛滑微通其阳。
安昌杨 肺气不宣，胸脘仍属窒痹，右脉涩，左沉弦，舌浓腻，仍遵前法加减（三月二十一号癸卯初五日。）
栝蒌皮（三钱） 乌药（二钱） 生牡蛎（四钱） 炒青皮（八分） 薤白（钱半） 浓朴（一钱）
木蝴蝶（四分） 玫瑰花（五朵） 仙半夏（钱半） 炒麦芽（三钱） 鸡内金（三钱）
清煎三帖。
介按∶此方平肝运气，消食健脾，借以清宣肺气。
长巷宋 呛咳痰阻，脉濡细数，胸冷窒痹，舌微黄。宜清气化痰。
栝蒌皮（五钱） 白前（钱半） 炒枳壳（钱半） 霜桑叶（三钱） 薤白（钱半） 广郁金（三
钱） 冬瓜子（三钱） 绿萼梅（钱半） 广橘络（钱半） 京川贝（钱半） 通草（钱半）
清煎四帖。
介按∶痰饮疑冱，清阳失旷，以致咳呛而胸冷窒痹，苦辛开郁，治法极是。
西庄易 血后咳痰不爽，脉弦，肝逆上冲，脘闷，肺气窒痹。仍遵前法加减为妥（八月
念七日。）
冬桑叶（三钱） 栝蒌皮（三钱） 橘络（钱半） 川贝（钱半） 石决明（八钱） 薤白（钱半）
广郁金（三钱） 杜兜铃（一钱） 光杏仁（三钱） 白前（钱半） 焦山栀（三钱）
清煎四帖。
介按∶血后肝逆未平，络伤气窒，尚有郁热未清，故治以降气通络，藉涤肝肺之热。
某 肺痹气逆，呛咳稠痰，脉浮滑，耳木。姑宜清降消痰为治（八月念一日。）
栝蒌皮（三钱） 仙半夏（钱半） 金沸花（三钱，包煎） 桑叶（三钱） 薤白（一钱） 川贝
（钱半） 海石（四钱） 池菊（钱半） 紫菀（钱半） 白前（钱半） 青蛤壳（二钱）
清煎三帖。
介按∶肝性上升，胆脉贯耳，兹以厥阳与少阳挟稠痰而上腾，阻遏清阳，方以苦降辛通
，柔肝肃肺，治法极好。
An Chang Lou: Yin fire rises, causing cough and asthma. The patient cannot tolerate lying flat on the pillow (orthopnea). The pulse is slippery and rapid; the tongue coating is yellow and dry with a red base. Prevention of pathological changes is advised; await the recovery of righteous qi. (February 7th, Renyin 19th day.)
Fresh Rehmanniae Radix (6 qian) Trichosanthis Semen (3 qian) Alumen Rubrum (White Quartz) (3 qian) Lai Ju Hong (8 fen) Chen Yu Rou (1.5 qian) Chuan Bei Mu (2 qian) Asparagi Tuber (2 qian) Hai Shi (3 qian) Fen Dan Pi (2 qian) Du Dou Ling (1.5 qian) Guang Xing Ren (3 qian) [Guiding herb] Qing Qian (1 qian) Decoct in water, three doses.
Second visit: It is reported that phlegm and qi have slightly subsided, but stomach qi is dull. Edema and oliguria are present. Fear of danger due to phlegm obstruction persists. Continue with modifications of the previous method; await the recovery of righteous qi. (April 12th, Guimao 25th day.)
Trichosanthis Semen (3 qian) Perillae Fructus (2 qian) Fried Coix Seed (4 qian) Hijinsha (4 qian) Chuan Bei Mu (3 qian) Ju Hong (1 qian) Alumen Rubrum (White Quartz) (3 qian) Du Chi Dou (4 qian) Guang Xing Ren (3 qian) Tong Cao (1.5 qian) Zi Wan (2 qian) Decoct in water, two doses.
Commentary by Jie: The etiology of asthma lies in excess in the Lung and deficiency in the Kidney. This case involves both excess and deficiency, affecting both the Lung and Kidney. Deficiency in the Kidney leads to failure of grasping qi, while excess in the Lung causes inability to lie flat during panting. The initial prescription used methods to anchor and consolidate, clear and diffuse, and descend lung qi, resulting in slight relief of phlegm and qi. However, damp-turbidity has not yet completely cleared, and edema and oliguria persist. Subsequent treatment employed clearing the Lung and promoting diuresis to resolve phlegm, addressing both root and branch.
An Chang Ye: Epigastric bi-syndrome with qi rushing upward, slightly relieved by belching. The pulse is wiry and thin. There is a mass (jia) in the abdomen and rebellious cough. Temporarily treat with Gualou Xiebai Tang. (Date missing.)
Gualou Pi (3 qian) Chuan Bei Mu (1.5 qian) Fried Coix Seed (4 qian) Lv E Mei (1.5 qian) Xie Bai (1.5 qian) Sheng Xiang Fu (1.5 qian) Guang Yu Jin (3 qian) Yuan Zhi Rou (0.8 fen) Xian Ban Xia (1.5 qian) Pei Lan (3 qian) Ku Ding Cha (1.5 qian) Decoct in water, two doses.
Commentary by Jie: Yin deficiency with hyperactive Liver, accumulation of masses (jia) in the abdomen, carrying phlegm upward to rush into the Lung. The Lung loses its function of clearing and descending, obstructing qi mechanism, leading to simultaneous belching and coughing. The treatment follows Zhang Zhongjing’s principle of using pungent and slippery herbs to slightly unblock Yang.
An Chang Yang: Lung qi is not diffusing; chest and epigastrium remain obstructed and blocked. Right pulse is choppy, left pulse is deep and wiry. Tongue coating is thick and greasy. Continue with modifications of the previous method. (March 21st, Guimao 5th day.)
Gualou Pi (3 qian) Wu Yao (2 qian) Raw Oyster Shell (4 qian) Fried Qing Pi (0.8 fen) Xie Bai (1.5 qian) Hou Po (1 qian) Mu Hu Die (0.4 fen) Rose Flower (5 pieces) Xian Ban Xia (1.5 qian) Fried Mai Ya (3 qian) Ji Nei Jin (3 qian) Decoct in water, three doses.
Commentary by Jie: This formula calms the Liver and regulates qi, promotes digestion and strengthens the Spleen, thereby assisting in clearing and diffusing Lung qi.
Chang Xiang Song: Irritating cough with phlegm obstruction. Pulse is soft, fine, and rapid. Chest feels cold and obstructed/blocked. Tongue coating is slightly yellow. Clear heat and transform phlegm is indicated.
Gualou Pi (5 qian) Bai Qian (1.5 qian) Fried Zhi Ke (1.5 qian) Frost Mulberry Leaf (3 qian) Xie Bai (1.5 qian) Guang Yu Jin (3 qian) Dong Gua Zi (3 qian) Lv E Mei (1.5 qian) Guang Ju Luo (1.5 qian) Jing Chuan Bei Mu (1.5 qian) Tong Cao (1.5 qian) Decoct in water, four doses.
Commentary by Jie: Phlegm-fluids are suspected to be frozen/stagnant, causing loss of expansion of Clear Yang, resulting in irritating cough and cold, obstructed chest. Using bitter and pungent methods to open depression is very appropriate.
Xi Zhuang Yi: After bleeding, coughing up sputum is unsatisfactory. Pulse is wiry. Liver qi rebels and rushes upward. Epigastric fullness. Lung qi is obstructed and blocked. Modifications of the previous method are appropriate. (August 27th.)
Dong Sang Ye (3 qian) Gualou Pi (3 qian) Ju Luo (1.5 qian) Chuan Bei Mu (1.5 qian) Shi Jue Ming (8 qian) Xie Bai (1.5 qian) Guang Yu Jin (3 qian) Du Dou Ling (1 qian) Guang Xing Ren (3 qian) Bai Qian (1.5 qian) Jiao Shan Zhi (3 qian) Decoct in water, four doses.
Commentary by Jie: After bleeding, Liver rebellion has not settled. Collaterals are damaged and qi is obstructed. Depressed heat remains uncleared. Therefore, treatment focuses on descending qi and unblocking collaterals to cleanse heat from the Liver and Lung.
Certain Patient: Lung bi-syndrome with rebellious qi, irritating cough with thick sputum. Pulse is floating and slippery. Ear numbness. Temporarily treat with clearing and descending to eliminate phlegm. (August 21st.)
Gualou Pi (3 qian) Xian Ban Xia (1.5 qian) Jin Fei Hua (3 qian, wrapped and decocted) Sang Ye (3 qian) Xie Bai (1 qian) Chuan Bei Mu (1.5 qian) Hai Shi (4 qian) Chi Ju (1.5 qian) Zi Wan (1.5 qian) Bai Qian (1.5 qian) Qing Ge Ke (2 qian) Decoct in water, three doses.
Commentary by Jie: The nature of the Liver is ascending. The Gallbladder meridian passes through the ear. Here, Jue-Yang and Shaoyang carry thick phlegm upward, obstructing Clear Yang. The formula uses bitter descent and pungent unblocking, softening the Liver and purifying the Lung. The treatment method is excellent.