宁人郑姓子。甫七岁。患哮吼症。脉形俱实。结喉两旁。青筋突起如笔管。喉中作牛马声。此系果饵杂进。痰浊壅
塞。
始用苏子降气汤加减。服六七剂。不效。余思病重药轻。遂以苏梗八钱。易本方之苏子。余药分量加重。连服三剂。
青筋隐而不露。脉亦和软。鸣声不作矣。凡治病。虽用药不误。而分量不足。药不及病。往往不效。
定海陈姓妇。年四十许。患气喘倚息不得卧。延余诊之。面色光亮。两颧发赤。舌上无胎。其脉浮部空大。沉部细
如
蛛丝。寻之若失。余出谓其女曰。此症甚危。决不能治。因再三求方。遂勉写医案曰。阴虚于下。格阳于上。面色戴阳。
脉象无根。真元将绝。若大汗一出。顷刻阴阳脱离矣。姑拟二加龙骨汤。婉辞而去。他医辄谓不妨。进旋复代赭汤。
下咽即毙。
广东盐大使汪公。回杭途次。偶感微邪。又加忿怒。遂致喘逆倚息不卧。余因治桑观察之症。乘便召诊。其息甚促。
音不接续。面色黧黑。中有油光。脉浮部豁大。中部空芤。沉部细弱。不相联贯。余曰。此症邪少虚多。勿误用表散。
进二加龙牡汤二剂而安。
宁波蓬莱宫羽士陈信良。患虚喘。咳逆无痰。动喘乏力。脉虚自汗。症属肺脾两虚。与西洋参、冬虫夏草、川贝、
青盐陈皮、阿胶、当归、杞子、枇杷叶、蒺藜、牡蛎等。土金相生。服二十余剂而愈。
姓郑的人家有个儿子，刚满七岁。患上了哮吼症（以呼吸急促、喉间痰鸣为特征的疾病）。脉象表现为充实有力。喉结两侧的青筋突起，形状像笔管一样。喉咙里发出类似牛马叫的声音。这是由于水果零食混杂进食，导致痰浊壅塞所致。
起初使用苏子降气汤进行加减治疗，服用了六七剂，没有效果。我思考病情重而药力轻，于是用苏梗八钱替换原方中的苏子，其余药物的分量加重。连续服用三剂后，青筋隐没不再显露，脉象也变得和缓柔软，鸣叫声也停止了。大凡治病，虽然用药没有错误，但如果剂量不足，药力达不到病所，往往不会见效。
定海姓陈的妇人，四十岁左右。患气喘，只能倚靠物体呼吸，无法平卧。请我去诊治。面色光亮，两颧发红。舌上没有苔。脉象在浮取时空大，沉取时细如蛛丝，仔细寻找似乎要消失。我出来对她的女儿说：这个病症非常危险，断定不能治愈。因为她再三请求开方，我便勉强写了医案说：下焦阴虚，格拒阳气于上，面色呈现戴阳（虚阳上浮的面色），脉象无根，真元即将断绝。如果出一身大汗，顷刻间阴阳就会分离脱失。暂且拟定二加龙骨汤，婉言推辞离开。其他医生却说不要紧，进服旋复代赭汤，药一下咽就死亡了。
广东盐大使汪公，回杭州途中，偶然感受轻微邪气，又加上愤怒，导致喘逆，倚靠物体呼吸无法平卧。因为我正在治疗桑观察的病，顺便召我去诊治。他的呼吸非常急促，声音不接续。面色黧黑，中间有油光。脉象浮取豁大，中部空芤，沉取细弱，不相连贯。我说：这个病症邪气少而正气虚多，不要误用解表发散的方法。进服二加龙牡汤两剂而安定。
宁波蓬莱宫道士陈信良，患虚喘，咳嗽气逆无痰，活动后气喘乏力，脉虚自汗。病症属于肺脾两虚。给予西洋参、冬虫夏草、川贝、青盐陈皮、阿胶、当归、杞子、枇杷叶、蒺藜、牡蛎等药物。通过培土生金（健脾益肺）的方法，服用二十多剂而痊愈。
Mr. Zheng's son, just seven years old, suffered from *xiaohou* (asthma with stridor). His pulse was full and solid. The blue veins on both sides of the larynx protruded like pen tubes, and his throat made sounds resembling those of oxen or horses. This was caused by the mixed consumption of fruits and snacks, leading to an accumulation of turbid phlegm.
Initially, *Suzi Jiangqi Tang* (Perilla Fruit Decoction for Descending Qi) was used with modifications. After taking six or seven doses, there was no effect. I reasoned that the disease was severe while the medication was light. Therefore, I replaced the Perilla Fruit (*Fructus Perillae*) in the original formula with eight qian of Perilla Stem (*Caulis Perillae*), and increased the dosage of the other herbs. After taking it continuously for three doses, the protruding veins receded and were no longer visible, the pulse became harmonious and soft, and the wheezing ceased. Generally, in treating diseases, even if the prescription is correct, if the dosage is insufficient and the medicinal power does not reach the pathology, it often fails.
A Mrs. Chen from Dinghai, around forty years old, suffered from asthma where she could only breathe while leaning on something and could not lie flat. I examined her and found her complexion bright and shiny, with redness on both malar eminences. Her tongue had no coating. Her pulse was empty and large at the superficial level, and fine as a spider's thread at the deep level, seeming to disappear upon careful search. I came out and told her daughter: "This condition is very critical and is incurable." Because she pleaded repeatedly for a prescription, I reluctantly wrote a medical record stating: "Yin deficiency in the lower jiao, with Yang repelled to the upper jiao; facial flushing due to floating deficient Yang (Daiyang); rootless pulse; true Yuan Qi is about to perish. If profuse sweating occurs, Yin and Yang will separate instantly." I tentatively prescribed *Erjia Longgu Tang* (Double-Added Dragon Bone Decoction) and politely declined further engagement. Other physicians said it was not a problem and administered *Xuanfu Daizhe Tang* (Inula and Hematite Decoction). She died immediately after swallowing the medicine.
Public Official Wang, Salt Commissioner of Guangdong, contracted a slight pathogenic factor while returning to Hangzhou, compounded by anger. This led to panting and inability to lie flat. Since I was treating another patient, Observer Sang, I happened to be summoned to examine him. His breathing was very rapid, and his voice was discontinuous. His complexion was dark black with an oily sheen in the center. His pulse was hollow and large at the superficial level, empty and spongy at the middle level, and weak and disconnected at the deep level. I said: "This condition involves little pathogen but significant deficiency. Do not mistakenly use diaphoretic methods." He took two doses of *Erjia Longmu Tang* (Double-Added Dragon Bone and Oyster Shell Decoction) and stabilized.
Chen Xinliang, a Daoist priest at Penglai Palace in Ningbo, suffered from deficient asthma, coughing with qi rebellion and no phlegm. He experienced shortness of breath and fatigue upon movement, a deficient pulse, and spontaneous sweating. The condition belonged to deficiency of both Lung and Spleen. I prescribed American Ginseng (*Radix Panacis Quinquefolii*), Cordyceps (*Cordyceps Sinensis*), Fritillaria (*Bulbus Fritillariae Cirrhosae*), Qingyan Chenpi (Salted Tangerine Peel), Donkey-hide Gelatin (*Corium Asini Colla*), Angelica Sinensis (*Radix Angelicae Sinensis*), Goji Berry (*Fructus Lycii*), Loquat Leaf (*Folium Eriobotryae*), Tribulus (*Fructus Tribuli*), and Oyster Shell (*Concha Ostreae*). Through the method of generating Metal from Earth (strengthening Spleen to benefit Lung), he recovered after taking more than twenty doses.