《韩氏医通》“三子养亲汤”药仅三味，为苏子、白芥子、莱菔子也。原方不著药量，“看何证多，则以所主者为君，余次之”。三者均有祛痰定喘之力，而苏子兼擅降气。莱菔子长于消食导滞，白芥子有温肺快膈之能。正因白芥子辛温利肺，而于痰热喘嗽不相适宜，故有医家以性寒而善泻肺利水之葶苈子代芥子，葶苈子亦有良好之止咳平喘功效。对于此说，余极赞成。但在本例方中未加运用，于其他病例中用之屡屡，效果确实可靠。三子养亲汤以降气消痰之力而捷于止咳定喘，本例以痰吐极多，不易消除而加入此方，一经使用，效即立见。
地龙、桃仁、杏仁三药以治咳喘乃现代有效验方。方中桃杏仁以利肺降气、止咳平喘。地龙重用颇善解除支气管平滑肌之痉挛，从而达到止咳定喘之目的。三味相合则相须为用，相辅相成而相得益彰。余每将此方加入热性喘咳方中，常收捷效。
以上述三方加减，为刘某组成之新方，消痰、降逆、定喘之力有余，清肺泄热之功不足，故重加鱼腥草以达其平衡。全方药物与患者之证情丝丝相扣，物物对应，故能缓解二十年痼疾于两月之间也。此外附带述及一首秘方，乃治寒性喘嗽者。余于十年前曾针治一中风病人，为甘姓男子，年近七旬，某日行针后留针之际，彼谓余曰：其年四十时曾患哮喘，咳吐寒痰，治疗两年未愈。后遇一熟人，告以用福橘皮新鲜者一枚，浸入白酒瓶中，待酒成橙黄色，即可取饮。每日随量饮服，久之自愈。彼回家即随手撕橘皮一块，约全橘之半，浸酒一斤，饮尽即愈，后未复发云。
小议“截喘”说治喘
姜春华老师生前对中医各家学说、基础理论及临床医学，均曾深入研究，并有重要贡献。其中对顽固性哮喘病发作时之治疗，姜老师采用古今民间及日本、朝鲜的单方，将其中治喘有效药合在一起，组成一方名“截喘方”，能有效控制哮喘发作。
除师授而外，余于书刊中曾两处见到此方，所用药昧不尽相同。一见于《长江医话》p．185姜老师自撰之文“支气管哮喘证治之我见”，主方九味，药物为：
“旋覆花9g、鼠曲草15g、全瓜蒌15g、防风9g、合欢皮15g、老鹳草15g、碧桃干15g、五味子9g、野荞麦根15g。”二见于《上海中医药报》1993年12月5日(总第178期)“治哮喘奇效方”。“处方组成：瘪桃干15g、佛耳草15g、老鹳草15g、旋覆花10g、全瓜萎15g、姜半夏15g、防风10g、五昧子6g。”对勘前后两方，后方较前方少合欢皮、野养麦根二味，多姜半夏一味，同时药物剂量亦略有差异。姜师于原方后有“随证加减”法：“气虚加黄芪30g、党参15g、阴虚加生熟地各15g；痰多加半夏9g、贝母9g；咳加元参9g、麦冬9g；热证加竹沥30g、石膏30g；寒证加附子9g，肉桂3g。”
野荞麦根沪郊亦有栽培及野生，俗名开金锁或金锁银开，具良好之利咽、清肺作用，民间每以30～60g单味煎服或加入辨证方中，以治咽炎、支气管炎及肺炎等症，疗效可期。业师吴竺天先生于临床中常喜用此味配入方中，以治上述病症，每获佳效。合欢皮性味甘平，通常作宁心安神之用。然合欢皮有明显祛痰和血作用，肺痈(肺脓疡)恢复期常以单味合欢皮煎汤眼，名黄昏汤，以作肺痈后期修补及康复之有效药物。可以推测，合欢皮之祛痰利肺作用，用于哮喘一症，亦有可靠之解痉平喘功效。盖痰浊一去，气道畅通，哮喘自易缓解。
自后文分析，作者对于本方深为赞许，并已取得运用经验实为难能可贵。文中曰：“一般中医治哮喘必须进行寒热虚实的辨证，而运用本方，则无须辨证，各型哮喘均可服用。一般服用7～10剂均能治愈，且十分安全可靠。”作者之这一经验为姜老师本人所未述，是作者对本方效用之实际验证及发挥，对本方之推广应用具有良好作用。
余曾以先师原方随证加减治疗两男孩，均患顽固哮喘久治不效，经用上方一例治愈，一例有效控制。
第一例为六岁男童，幼年患奶癣，经敷外用药膏治愈。以后偶见哮喘，但服西药即平。至三岁渐发渐重，一月数发，至四岁时已一星期数发矣。且服用西药已不能控制，改服中药，亦不见大效。至一儿科名老中医处诊治，服药一年病无进退。此孩发病春夏秋三季为重，夏暑尤甚，冬寒病发反轻。咳喘哮吼，痰多不爽，脉滑数有力，舌质偏红，苔薄白而干。余诊断为“痰热壅肺”，以定喘汤化裁，益入生石膏，鱼腥草等味，即能控制发作。然易于感冒，凡感冒数日不愈，即见汗出而痰喘复作。余即以姜老师原方加鱼腥革、竹沥治之，可获复杯即安之效。几次复发经用此方治愈后，竟不再发。
第二例系一少年，在读初中。四、五年前发哮喘，发作由稀而频，常因发病不得已中断学习。此儿家境极为清寒，严父驼背，慈母退休，不仅供其养育之费，还须治病之资，其母省吃俭用，百计为之调治，仍然效果沓然。后来余处就诊，余见其身材瘦损矮小，叫名十四岁，却如八、九岁人，骨瘦如柴，皮薄肉脆。与之对坐时，哮鸣之声两耳可闻，痰声漉漉，咳吐频频。但脉却滑大有力，舌质偏红，舌中及舌尖剥苔，舌上红点如刺。此例不仅肺有痰浊，且上焦心肺有热，肺中津液耗伤，加之先天不足，肾阴亏损，为本虚标实之证。余亦以上方加减，随证益入生熟地、川石斛、北沙参、鱼腥草、鲜竹沥、川贝母之属，即可有效控制发作。但仍时有反复，恃药可使缓解，能勉强跟班学习。余思其不能根治之故，主要由于体质过差，先天真元太弱，后天营养不继，调养失宜，以致病久难痊。余同事黄金妹医师及其女儿李耿蔚医师不禁悲悯救苦之心，为其觅得健康母体之新鲜脐带数枚，教以每日一根煮熟后于睡前服食。以后则继以胎盘粉每日内服。精心调治两年余，哮喘已极少发作，偶有所发亦极轻微。且已长高10cm，面色红润，肌肤渐丰。乍见之下，岸然一英俊少年也。
哮喘缓解时服用脐带及胎盘粉，以增强体质、预防复发，古书已有记载，姜老师于文中亦极推崇，此二物既能补益气血、增强体质，又能平喘，一举两得。
脐带，中医古籍称为“坎炁”，放瓦上以炭火焙至干黄松脆，研末吞服。余往昔有一领导，其爱子幼年得喘，遍访名医，百治无功。后得亲戚为觅一方，即上方也。当时中药店尚有干燥坎炁可供购买，即逐渐购服，竟得痊愈，现已三十开外矣，形体结实，健康无病。
至于胎盘，为血肉有情之品，具补益气血之特殊功用。哮喘患者恢复期作培本之计时，如不服胎盘粉而服用河车大造丸，亦极有效。余曾治一大专生，哮喘屡发，余诊时正在缓解期中，患者形瘦，脉细，舌淡，嘱购河车大造丸，按常规剂量服用，每日2～3次，经服数月后，哮喘竟得有效控制。
另有一种肺肾阴虚之气喘症，症状以上气喘促、呼吸气短、呼吸急迫难以相续为主。兼见短气乏力、口干舌燥、腰酸足软，或见头晕耳鸣，喘甚则汗出等证。余每以六味地黄丸合生脉饮，应手取效。其中一例，病起于七十年代在农村劳动时，二十余年间几乎发无虚夕，投以上法一服见效。以后凡服药之日病必不发，连续服用半年后竟得根治。
小儿肺炎奇验案
1984年豫儿年方十二岁，9月中旬忽然壮热(体温39．7℃)，旋即咳嗽频作，声若从瓮中出。腹中隐痛，二便自调；有汗热不解，脉浮数，右手脉按之不衰，苔薄白。予桑菊饮无进退，改投银翘散，每服药后，体温辄从39．7℃降至37．4℃。数小时后，复升如初，两日皆然。西医胸透示：肺纹理增深，右肺小片状阴影，诊断为“肺炎”。给予抗生素注射。每次注射后二小时内体温可略降，二小时后又复回升，如此将近一周，病不能解。余寻思再三，一筹莫展。至9月24日叩求于张寿杰老师，师即详询前因后果及服药机变，沉思片时，继而谓曰：“吾得之矣。咳声‘空空’然若出瓮中，是肺气之壅而不清，法当开肺为先，清肺为辅。银翘、桑菊偏清偏透，与症虽近而未合；腹中隐痛，发热蒸蒸，是积热在肠，熏蒸肺脏。病发于里而见象于外，根本在下而标显于上也。治当泄热清肠。综观全体应以开肺达邪，清肠泄热为法。”
余聆听师训，顿有所悟。师尊清肠泄热之说，诚为高论，然余性钝识浅，谛思良久仍不得其药，因复赧然请益。师诲余曰：“余积数十年之经验，知母与枳实同用最为得体。夫知母一物，人皆知其清肺，不知最清肠热，与枳实相须为用，投剂得当，立竿见影。”语竟，师援笔直书一方：
南沙参9g枳实6g大力子9g知母6g蝉蜕6g银花9g桔梗4g藿香9g橘红9g黄芩6g
药煎就，时已中午，测得体温39．4℃，随即进药，过二小时许，复测体温38．2℃，四小时后体温降至37．4℃。再进二煎，晚间热即退清。为廓清余邪计，翌日又进一帖，从此恢复正常。
孰料愈后第四日晚间，豫儿又觉腹痛，移时便下糜粪半痰盂，色褐如酱，酸臭难闻。三十分钟后复便多许，色略淡。再半小时后又如厕，虽仍糜状，然色已纯黄，次晨登圊，却一切如常。始知隔宿所泄糜粪，为先前久稽之物，是肠中积热之根。药后肺开气降，肠疏积动，渐渐元气来复，则积滞自去也。
按：沪上名医张寿杰先生，早岁就学于丁甘仁先生创办之“中国医学院”，虽无等身著述，而经验宏富，观其治豫儿肺炎案，即可知之也。此案病因复杂，与常见肺炎截然不同，而张师治病如与可作画，胸有成竹，挥洒自如，余分析其关键有二：
一曰辨证精确，二曰用药精当。本症之辨证，其标在肺，其本在肠。师以咳声“空空”然若出瓮中辨为肺中浊气壅塞清道，与外邪袭肺、化热作咳者迥异，足气壅而非热郁。两者于治法上亦自不同：气壅须开，热郁宜清。可见原用宣肺泄热，是隔靴搔痒，其不效也宜矣。师以藿香、橘红、桔梗辛香引气之品重开肺气，佐蝉蜕、牛蒡、银花轻清宣泄以解气热。此为肺中标病之治。
此病之根在于肠中积滞化热，师以证见腹中隐痛绵绵，而即慧眼识真情，投知母、枳实以泄热清肠。师曾告余曰：知母、枳实同用最清肠热是乃师丁甘仁先生所授之法，用之得当，病去如扫。
张师于整个诊治过程中，未见病人，仅听余转述病情，不切脉，不观舌，竟如此识病真，用药准，除先生精研医理，学验丰富外，可见精于问诊，善于把握主症、主因及证情演变规律，亦是医家之基本功大。余昔年读书，见近代名医恽铁樵先生治病，不用脉诊，必待于问，深为不解，今见张师治此症，始自解悟。
心房纤颤
心房纤维性颤动为成人常见之心律失常病症，以惊悸、胸闷为患者主要自觉症状，房颤时心房发生每分钟350～600次不规则之冲动，引起不协调之心房颤动。本病无论急性与持久性，轻者易愈，重者难疗。虽临床见证多端，然余所见病例，多呈虚性脉症，于气、血、阴、阳四者之中，以气虚为其主体。而常兼阴血亏损，时或兼挟心火、痰涎或虚阳扰动、或血行阻滞、或心阳不振，如何立法主治，又当临证权衡，当机立断。当房颤影响及肺时，亦可导致喘息危象。今随文报告治愈房颤及房颤喘息各一例。
例一房颤例。三年前，有科技人员曹某前来就医，年龄约五十七岁，自诉无慢性病史，近年来常觉心悸怔忡，胸背间有跳突感，心动过速及早搏时作时止。经西医检查，拟诊心肌炎后遗症。余切其脉小而带数，指下按之不足，舌质淡红，苔薄净而干。证属气阴两虚。心失所养致心神不宁，治以两调气阴兼以宁心安神为法，用生脉散加昧。药如党参、麦门冬、五味子、生地、当归、白芍、朱茯神、炒枣仁、龙齿骨、炙远志、甘草、夜交藤、丹参之属，服第一帖后，即觉心胸间舒适异常，诸症尽失。于是连服十四剂，前十三剂，剂剂均觉有非常之效，自谓药后病已痊愈。不意服至第十四剂时，虽在春夏之交而天气燠热异常，突觉心跳不止，一分钟可达百跳以上，于是疑为用药不当所引起，因而自动停服前方，不再服余之药。心速一症持续半月后始渐平复。所幸以后．二、三年间，心律失常竟未复发。去岁冬杪，一日夜间子时，勃然心悸异常，胸闷窒塞，有惊慌恐惧之感。于是仰卧不敢稍动，静以待之，自觉心胸间如气轮机之发动。“突!突!突!突!”震跃不已。经二、三小时，渐渐缓解，次日白天，除胸膺不宁之外，深感疲劳乏力，动辄汗出。如此夜夜举发，三日后去长寿医院作检查，诊断为“心房纤维性颤动。”建议住院治疗，曹婉谢之，转来我处服中药。余诊其脉两寸小而有力，左关及右关尺均小而按之软。舌质淡红，苔薄净。据此脉症，仍属气虚阴血不足，而心火偏旺。治拟益气养血，清心宁神。方为：
黄芪24g党参15g炒白术9g茯苓9g甘草3g当归9g麦冬15g生地20g炒白芍9g苦参4．5g丹参9g生龙牡各30g炒枣仁15g五味子1．5g
《韩氏医通》中的“三子养亲汤”仅由三味药组成，分别是苏子、白芥子和莱菔子。原方没有注明具体药量，“根据哪种症状较多，就将针对该症状的药物作为君药（主药），其余药物依次递减”。这三味药都有祛痰平喘的功效，但苏子兼擅长降气。莱菔子长于消食导滞，白芥子具有温肺宽胸的作用。正因为白芥子性辛温且利肺，所以不适用于痰热引起的喘咳，因此有医生用性寒且善于泻肺利水的葶苈子代替白芥子，葶苈子也有良好的止咳平喘功效。对于这种说法，我非常赞同。但在本病例的处方中未加用此法，而在其他病例中多次使用，效果确实可靠。三子养亲汤凭借降气消痰之力，在止咳定喘方面见效迅速，本例患者因痰液极多，难以消除，故加入此方，一经使用，疗效立竿见影。
地龙、桃仁、杏仁三味药治疗咳喘是现代的有效验方。方中桃仁和杏仁用于利肺降气、止咳平喘。重用大剂量地龙非常善于解除支气管平滑肌的痉挛，从而达到止咳定喘的目的。这三味药配合使用，相互辅助，相得益彰。我每次将此方加入治疗热性喘咳的方剂中，常能收到迅速见效的效果。
以上述三个方剂为基础进行加减，为刘某组成了新方，其消痰、降逆、定喘的力量有余，但清肺泄热的功效不足，因此重加鱼腥草以达到平衡。全方药物与患者的证候丝丝相扣，一一对应，因此能在两个月内缓解二十年的顽疾。此外附带提及一首秘方，是治疗寒性喘咳的。我在十年前曾针灸治疗一位中风病人，是一位姓甘的男子，年近七十。某天行针留针期间，他对我说：他在四十岁时曾患哮喘，咳吐寒痰，治疗两年未愈。后来遇到一位熟人，告诉他用新鲜福橘皮一枚，浸入白酒瓶中，待酒变成橙黄色时，即可取饮。每日适量饮用，久而久之自愈。他回家后随手撕下一块橘皮，约半个橘子大小，浸泡在一斤酒中，喝完即愈，此后未再复发。
小议“截喘”说治喘
姜春华老师生前对中医各家学说、基础理论及临床医学均有过深入研究，并做出了重要贡献。其中对于顽固性哮喘发作时的治疗，姜老师采用古今民间及日本、朝鲜的单方，将其中治疗哮喘有效的药物合在一起，组成一方名为“截喘方”，能有效控制哮喘发作。
除了师授之外，我在书刊中还曾两处见到此方，所用药物不尽相同。一处见于《长江医话》第185页姜老师自撰的文章《支气管哮喘证治之我见》，主方九味，药物为：
“旋覆花9克、鼠曲草15克、全瓜蒌15克、防风9克、合欢皮15克、老鹳草15克、碧桃干15克、五味子9克、野荞麦根15克。”另一处见于《上海中医药报》1993年12月5日（总第178期）的《治哮喘奇效方》。“处方组成：瘪桃干15克、佛耳草15克、老鹳草15克、旋覆花10克、全瓜蒌15克、姜半夏15克、防风10克、五味子6克。”对比前后两方，后方较前方少了合欢皮、野荞麦根两味，多了姜半夏一味，同时药物剂量也略有差异。姜老师在原方后有“随证加减”的方法：“气虚加黄芪30克、党参15克；阴虚加生地黄、熟地黄各15克；痰多加半夏9克、贝母9克；咳嗽加玄参9克、麦冬9克；热证加竹沥30克、石膏30克；寒证加附子9克、肉桂3克。”
野荞麦根在上海郊区也有栽培和野生，俗名开金锁或金锁银开，具有良好的利咽、清肺作用，民间常用30～60克单味煎服或加入辨证方中，以治疗咽炎、支气管炎及肺炎等症，疗效可期。我的恩师吴竺天先生在临床中常喜欢将此药配入方中，治疗上述病症，每每获得佳效。合欢皮性味甘平，通常用作宁心安神。然而合欢皮有明显的祛痰和血作用，肺痈（肺脓疡）恢复期常以单味合欢皮煎汤服用，名为黄昏汤，作为肺痈后期修补及康复的有效药物。可以推测，合欢皮的祛痰利肺作用，用于治疗哮喘一症，也有可靠的解痉平喘功效。因为痰浊一去，气道畅通，哮喘自然容易缓解。
从后文分析，作者对本方深为赞许，并已取得运用经验，实为难能可贵。文中说：“一般中医治疗哮喘必须进行寒热虚实的辨证，而运用本方，则无须辨证，各型哮喘均可服用。一般服用7～10剂均能治愈，且十分安全可靠。”作者的这一经验是姜老师本人所未述及的，是作者对本方效用的实际验证及发挥，对本方的推广应用具有良好作用。
我曾以先师的原方随证加减治疗两个男孩，均患有顽固性哮喘，久治不效。经用上方的一个治愈，一个有效控制。
第一例是一个六岁男童，幼年患奶癣，经敷外用药膏治愈。以后偶尔出现哮喘，但服用西药即可平息。到三岁逐渐发作频繁且加重，一月数次发作，到四岁时已是一星期数次发作。且服用西药已不能控制，改服中药，也不见大效。去一位儿科名老中医处诊治，服药一年病情无进退。这个孩子发病在春夏秋三季较重，夏季暑热时尤其严重，冬季寒冷时发病反而较轻。咳喘哮吼，痰多不爽，脉滑数有力，舌质偏红，苔薄白而干。我诊断为“痰热壅肺”，以定喘汤化裁，加入生石膏、鱼腥草等药，即能控制发作。然而易于感冒，凡感冒数日不愈，即见汗出而痰喘复发。我便用姜老师的原方加鱼腥草、竹沥治疗，可获复杯即安（喝下药很快见效）的效果。几次复发经用此方治愈后，竟不再发。
第二例是一名少年，在读初中。四五年前发生哮喘，发作由稀变频，常因发病不得已中断学习。这孩子家境极为清寒，父亲驼背，母亲退休，不仅供养其养育费用，还需治病资金，其母省吃俭用，百计调治，仍然效果不佳。后来到我处就诊，我看他身材瘦损矮小，叫名字说是十四岁，却像八九岁的人，骨瘦如柴，皮薄肉脆。与他相对而坐时，哮鸣之声两耳可闻，痰声漉漉，咳嗽频频。但脉象却滑大有力，舌质偏红，舌中及舌尖剥苔，舌上红点如刺。此例不仅肺有痰浊，且上焦心肺有热，肺中津液耗伤，加之先天不足，肾阴亏损，属于本虚标实之证。我也以上方加减，随证加入生地黄、熟地黄、川石斛、北沙参、鱼腥草、鲜竹沥、川贝母等药，即可有效控制发作。但仍时有反复，依靠药物可使缓解，能勉强跟班学习。我思考其不能根治的原因，主要由于体质过差，先天真元太弱，后天营养不继，调养失宜，以致病久难痊。我的同事黄金妹医师及其女儿李耿蔚医师不禁悲悯救苦之心，为其觅得健康母体之新鲜脐带数枚，教以每日一根煮熟后于睡前服食。以后则继以胎盘粉每日内服。精心调治两年余，哮喘已极少发作，偶有所发亦极轻微。且已长高10厘米，面色红润，肌肤渐丰。乍见之下，俨然一英俊少年也。
哮喘缓解时服用脐带及胎盘粉，以增强体质、预防复发，古书已有记载，姜老师在文中亦极推崇，此二物既能补益气血、增强体质，又能平喘，一举两得。
脐带，中医古籍称为“坎炁”，放在瓦上用炭火焙至干黄松脆，研末吞服。我往昔有一位领导，其爱子幼年患哮喘，遍访名医，百治无功。后得亲戚觅得一方的建议，即上方也。当时中药店尚有干燥坎炁可供购买，便逐渐购服，竟得痊愈，现已三十多岁，形体结实，健康无病。
至于胎盘，为血肉有情之品，具补益气血的特殊功用。哮喘患者恢复期作培本之时，如不服胎盘粉而服用河车大造丸，亦极有效。我曾治疗一名大专生，哮喘屡发，我诊视时正处于缓解期中，患者形瘦，脉细，舌淡，嘱其购买河车大造丸，按常规剂量服用，每日2～3次，经服数月后，哮喘竟得有效控制。
另有一种肺肾阴虚之气喘症，症状以上气喘促、呼吸气短、呼吸急迫难以相续为主。兼见短气乏力、口干舌燥、腰酸足软，或见头晕耳鸣，喘甚则汗出等证。我每以六味地黄丸合生脉饮，应手取效。其中一例，病起于七十年代在农村劳动时，二十余年间几乎每晚都发作，投以上法一服见效。以后凡服药之日病必不发，连续服用半年后竟得根治。
小儿肺炎奇验案
1984年豫儿年仅十二岁，9月中旬忽然壮热（体温39.7℃），旋即咳嗽频作，声音若从瓮中发出。腹中隐痛，二便正常；有汗但热不解，脉浮数，右手脉按之不衰，苔薄白。予桑菊饮无效，改投银翘散，每服药后，体温辄从39.7℃降至37.4℃。数小时后，又回升如初，两日皆然。西医胸透示：肺纹理增深，右肺小片状阴影，诊断为“肺炎”。给予抗生素注射。每次注射后二小时内体温可略降，二小时后又复回升，如此将近一周，病不能解。我寻思再三，一筹莫展。至9月24日向张寿杰老师请教，老师即详询前因后果及服药机变，沉思片刻，继而说道：“我明白了。咳声‘空空’然若出瓮中，是肺气之壅而不清，法当开肺为先，清肺为辅。银翘、桑菊偏清偏透，与症虽近而未合；腹中隐痛，发热蒸蒸，是积热在肠，熏蒸肺脏。病发于里而见象于外，根本在下而标显于上也。治当泄热清肠。综观全体应以开肺达邪，清肠泄热为法。”
我聆听师训，顿有所悟。师尊清肠泄热之说，诚为高论，但我天性迟钝见识浅陋，仔细思考良久仍不得其药，因而羞愧地再次请教。老师教诲我说：“我积累数十年之经验，知母与枳实同用最为得体。夫知母一物，人皆知其清肺，不知最清肠热，与枳实相须为用，投剂得当，立竿见影。”说完，老师援笔直书一方：
南沙参9克 枳实6克 大力子9克 知母6克 蝉蜕6克 银花9克 桔梗4克 藿香9克 橘红9克 黄芩6克
药煎好时，已是中午，测得体温39.4℃，随即进药，过二小时左右，复测体温38.2℃，四小时后体温降至37.4℃。再进二煎，晚间热即退清。为廓清余邪计，翌日又进一帖，从此恢复正常。
孰料愈后第四日晚间，豫儿又觉腹痛，过了一会儿大便排出半痰盂糜粪，色褐如酱，酸臭难闻。三十分钟后又排多许，色略淡。再半小时后又如厕，虽仍呈糜状，但色已纯黄，次日清晨排便，却一切如常。始知隔宿所泄糜粪，为先前久稽之物，是肠中积热之根。药后肺开气降，肠疏积动，渐渐元气来复，则积滞自去也。
按语：沪上名医张寿杰先生，早岁就学于丁甘仁先生创办的“中国医学院”，虽无等身著述，而经验宏富，观其治豫儿肺炎案，即可知之也。此案病因复杂，与常见肺炎截然不同，而张师治病如作画，胸有成竹，挥洒自如，我分析其关键有二：
一曰辨证精确，二曰用药精当。本症之辨证，其标在肺，其本在肠。师以咳声“空空”然若出瓮中辨为肺中浊气壅塞清道，与外邪袭肺、化热作咳者迥异，属气壅而非热郁。两者于治法上亦自不同：气壅须开，热郁宜清。可见原用宣肺泄热，是隔靴搔痒，其不效也宜矣。师以藿香、橘红、桔梗辛香引气之品重开肺气，佐蝉蜕、牛蒡、银花轻清宣泄以解气热。此为肺中标病之治。
此病之根在于肠中积滞化热，师以证见腹中隐痛绵绵，而即慧眼识真情，投知母、枳实以泄热清肠。师曾告诉我：知母、枳实同用最清肠热是乃师丁甘仁先生所授之法，用之得当，病去如扫。
张师在整个诊治过程中，未见病人，仅听我转述病情，不切脉，不观舌，竟如此识病真，用药准，除先生精研医理，学验丰富外，可见精于问诊，善于把握主症、主因及证情演变规律，亦是医家之基本功大。我昔年读书，见近代名医恽铁樵先生治病，不用脉诊，必待于问，深为不解，今见张师治此症，始自解悟。
心房纤颤
心房纤维性颤动为成人常见之心律失常病症，以惊悸、胸闷为患者主要自觉症状，房颤时心房发生每分钟350～600次不规则之冲动，引起不协调之心房颤动。本病无论急性与持久性，轻者易愈，重者难疗。虽临床见证多端，然我所见病例，多呈虚性脉症，于气、血、阴、阳四者之中，以气虚为其主体。而常兼阴血亏损，时或兼挟心火、痰涎或虚阳扰动、或血行阻滞、或心阳不振，如何立法主治，又当临证权衡，当机立断。当房颤影响及肺时，亦可导致喘息危象。今随文报告治愈房颤及房颤喘息各一例。
例一房颤例。三年前，有科技人员曹某前来就医，年龄约五十七岁，自诉无慢性病史，近年来常觉心悸怔忡，胸背间有跳突感，心动过速及早搏时作时止。经西医检查，拟诊心肌炎后遗症。我切其脉小而带数，指下按之不足，舌质淡红，苔薄净而干。证属气阴两虚。心失所养致心神不宁，治以两调气阴兼以宁心安神为法，用生脉散加味。药如党参、麦门冬、五味子、生地、当归、白芍、朱茯神、炒枣仁、龙齿骨、炙远志、甘草、夜交藤、丹参之属，服第一帖后，即觉心胸间舒适异常，诸症尽失。于是连服十四剂，前十三剂，剂剂均觉有非常之效，自谓药后病已痊愈。不意服至第十四剂时，虽在春夏之交而天气燠热异常，突觉心跳不止，一分钟可达百跳以上，于是疑为用药不当所引起，因而自动停服前方，不再服余之药。心速一症持续半月后始渐平复。所幸以后二、三年间，心律失常竟未复发。去年冬末，一日夜间子时，勃然心悸异常，胸闷窒塞，有惊慌恐惧之感。于是仰卧不敢稍动，静以待之，自觉心胸间如气轮机之发动。“突!突!突!突!”震跃不已。经二、三小时，渐渐缓解，次日白天，除胸膺不宁之外，深感疲劳乏力，动辄汗出。如此夜夜举发，三日后去长寿医院作检查，诊断为“心房纤维性颤动。”建议住院治疗，曹婉谢之，转来我处服中药。我诊其脉两寸小而有力，左关及右关尺均小而按之软。舌质淡红，苔薄净。据此脉症，仍属气虚阴血不足，而心火偏旺。治拟益气养血，清心宁神。方为：
黄芪24克 党参15克 炒白术9克 茯苓9克 甘草3克 当归9克 麦冬15克 生地20克 炒白芍9克 苦参4.5克 丹参9克 生龙牡各30克 炒枣仁15克 五味子1.5克
The "Sanzi Yangqin Decoction" (Three-Seed Decoction for Nourishing the Elderly) from *Han Shi Yi Tong* consists of only three herbs: Perillae Fructus (Suzi, 紫苏子), White Mustard Seed (Baijiezi, 白芥子), and Radish Seed (Laifuzi, 莱菔子). The original formula does not specify dosages; it states, "Based on which symptom is more prominent, make the herb targeting that symptom the Jun herb (Chief herb), and arrange the others in descending order." All three herbs have the power to resolve phlegm and calm wheezing, but Perillae Fructus excels at directing Qi downward. Radish Seed is good at resolving food stagnation and promoting digestion, while White Mustard Seed has the ability to warm the Lung and relieve chest oppression. Because White Mustard Seed is acrid and warm and benefits the Lung, it is not suitable for wheezing and cough caused by Phlegm-Heat. Therefore, some physicians substitute it with Lepidium Seed (Tinglizi, 葶苈子), which is cold in nature and good at draining the Lung and promoting urination; Lepidium Seed also has good effects on stopping cough and calming wheezing. I strongly approve of this view. However, in the prescription for this case, it was not used. It has been used frequently in other cases with reliable results. Sanzi Yangqin Decoction acts swiftly in stopping cough and calming wheezing due to its power of directing Qi downward and resolving phlegm. In this case, the patient expectorated an excessive amount of phlegm that was difficult to eliminate, so this formula was added. Once used, the effect was immediate.
The combination of Earthworm (Dilong, 地龙), Peach Kernel (Taoren, 桃仁), and Apricot Seed (Xingren, 杏仁) is a modern effective empirical formula for treating cough and wheezing. In this formula, Peach Kernel and Apricot Seed are used to benefit the Lung, direct Qi downward, stop cough, and calm wheezing. A heavy dose of Earthworm is particularly good at relieving spasm of the bronchial smooth muscle, thereby achieving the purpose of stopping cough and calming wheezing. These three herbs work synergistically, complementing each other to enhance efficacy. Whenever I add this combination to formulas treating heat-type cough and wheezing, I often achieve rapid results.
Based on modifications of the above three formulas, a new formula was composed for Patient Liu. Its power to resolve phlegm, direct rebellious Qi downward, and calm wheezing was sufficient, but its merit in clearing Lung Heat and purging fire was insufficient. Therefore, Houttuynia Herb (Yuxingcao, 鱼腥草) was heavily added to achieve balance. The herbs in the entire formula corresponded precisely to the patient's syndrome pattern, allowing the relief of a twenty-year chronic disease within two months. Additionally, I mention a secret recipe for treating cold-type wheezing and cough. Ten years ago, I treated a stroke patient via acupuncture, a Mr. Gan who was nearly seventy years old. During needle retention one day, he told me: "When I was forty, I suffered from asthma, coughing up cold phlegm, and treatment failed for two years. Later, an acquaintance advised me to soak one piece of fresh Fortune Tangerine Peel (Fuju Pi, 福橘皮) in a bottle of white liquor. When the liquor turns orange-yellow, drink it. Drink according to capacity daily, and it will heal itself over time." He went home, tore off a piece of tangerine peel (about half an orange), soaked it in one jin (500g) of liquor, drank it all, and was cured, never relapsing.
A Brief Discussion on the Theory of "Jie Chuan" (Intercepting Wheezing)
Teacher Jiang Chunhua conducted in-depth research on various schools of Traditional Chinese Medicine (TCM), basic theories, and clinical medicine during his lifetime, making significant contributions. Regarding the treatment of stubborn asthma attacks, Teacher Jiang combined single herbs effective for asthma from ancient and folk sources, as well as from Japan and Korea, into a formula named "Jie Chuan Fang" (Wheezing-Intercepting Formula), which can effectively control asthma attacks.
Besides what was taught by my master, I encountered this formula in two places in books and journals, with slightly different ingredients. One appeared in *Changjiang Yi Hua* (Medical Talks of the Yangtze River), page 185, in an article self-written by Teacher Jiang titled "My Views on the Syndrome Differentiation and Treatment of Bronchial Asthma." The main formula consisted of nine herbs:
"Inula Flower (Xuanfuhua, 旋覆花) 9g, Gnaphalium Herb (Qucaicao, 鼠曲草) 15g, Whole Trichosanthes Fruit (Quangualong, 全瓜蒌) 15g, Saposhnikovia Root (Fangfeng, 防风) 9g, Albizia Bark (Hehuanpi, 合欢皮) 15g, Old Stork Grass (Lao'gucao, 老鹳草) 15g, Persimmon Calyx (Bitaogan, 碧桃干) 15g, Schisandra Berry (Wuweizi, 五味子) 9g, Buckwheat Root (Yeqiaomagen, 野荞麦根) 15g." Another appeared in *Shanghai Journal of Traditional Chinese Medicine* on December 5, 1993 (Issue No. 178), titled "An Extraordinary Effective Formula for Treating Asthma." "Prescription Composition: Dried Persimmon Calyx (Beitaogan, 瘪桃干) 15g, Golden Ear Herb (Fo'ercao, 佛耳草) 15g, Old Stork Grass (Lao'gucao, 老鹳草) 15g, Inula Flower (Xuanfuhua, 旋覆花) 10g, Whole Trichosanthes Fruit (Quangualong, 全瓜蒌) 15g, Pinellia Rhizome Processed with Ginger (Jiang Banxia, 姜半夏) 15g, Saposhnikovia Root (Fangfeng, 防风) 10g, Schisandra Berry (Wuweizi, 五味子) 6g." Comparing the two formulas, the later one lacked Albizia Bark and Buckwheat Root compared to the earlier one, but included Pinellia Rhizome Processed with Ginger. Dosages also varied slightly. After the original formula, Teacher Jiang provided methods for "modifications based on syndrome differentiation": "For Qi deficiency, add Astragalus Root (Huangqi, 黄芪) 30g and Codonopsis Root (Dangshen, 党参) 15g; for Yin deficiency, add Raw Rehmannia Root (Sheng Dihuang, 生地黄) and Prepared Rehmannia Root (Shu Dihuang, 熟地黄) 15g each; for excessive phlegm, add Pinellia Rhizome (Banxia, 半夏) 9g and Fritillaria Bulb (Beimu, 贝母) 9g; for cough, add Scrophularia Root (Yuanshen, 玄参) 9g and Ophiopogon Tuber (Maidong, 麦冬) 9g; for heat syndromes, add Bamboo Juice (Zhuli, 竹沥) 30g and Gypsum (Shigao, 石膏) 30g; for cold syndromes, add Aconite Lateral Root (Fuzi, 附子) 9g and Cinnamon Bark (Rougui, 肉桂) 3g."
Buckwheat Root is cultivated or wild in the suburbs of Shanghai, commonly known as Kaijin Suo (Opening the Gold Lock) or Jin Suo Yin Kai. It has excellent effects on benefiting the throat and clearing the Lung. Folk medicine often uses 30–60g as a single herb decocted in water or added to syndrome-differentiated formulas to treat pharyngitis, bronchitis, and pneumonia, with expected efficacy. My master, Mr. Wu Zhutian, often liked to include this herb in prescriptions during clinical practice to treat the aforementioned conditions, always achieving good results. Albizia Bark is sweet and neutral in nature and is usually used for calming the mind and spirit. However, Albizia Bark has obvious effects on resolving phlegm and invigorating blood. In the recovery phase of Lung Abscess (Fei Yong, 肺痈 - Lung Empyema), a decoction of single Albizia Bark is often taken, named Huanghun Tang (Twilight Decoction), as an effective drug for repair and rehabilitation in the late stage of Lung Abscess. It can be inferred that Albizia Bark's phlegm-resolving and Lung-benefiting action also has reliable antispasmodic and anti-wheezing effects when used for asthma. Once turbid phlegm is eliminated, the airway becomes unobstructed, and asthma naturally alleviates.
From the subsequent analysis, the author deeply approves of this formula and has gained practical experience in its use, which is rare. The text states: "Generally, TCM treatment of asthma requires syndrome differentiation of cold, heat, deficiency, and excess. However, using this formula requires no such differentiation; it can be taken for all types of asthma. Generally, taking 7–10 doses can cure it, and it is very safe and reliable." This experience of the author was not mentioned by Teacher Jiang himself; it represents the author's actual verification and expansion of the formula's efficacy, playing a good role in its promotion and application.
I once treated two boys with stubborn asthma, unresponsive to long-term treatment, using modifications of my late master's original formula. One was cured, and the other was effectively controlled.
The first case was a six-year-old boy who suffered from infantile eczema (Nai Xuan, 奶癣) in childhood, cured by topical ointment. Later, he occasionally had asthma, but Western medicine平息ed it. By age three, attacks became more frequent and severe, occurring several times a month. By age four, they occurred several times a week. Western medicine could no longer control them, and switching to TCM showed little effect. After consulting a famous pediatric TCM physician for a year, there was no improvement. His attacks were heavier in spring, summer, and autumn, especially in summer heat, and lighter in winter cold. He had wheezing cough with loud rattling, excessive sticky phlegm, slippery and rapid forceful pulse, red tongue body, and thin white dry coating. I diagnosed "Phlegm-Heat Obstructing the Lung" and modified Dingchuan Tang (Calming Wheezing Decoction), adding Raw Gypsum (Sheng Shigao, 生石膏) and Houttuynia Herb (Yuxingcao, 鱼腥草), which controlled the attacks. However, he was prone to colds; if a cold lasted several days without healing, sweating would occur followed by recurrence of phlegm and wheezing. I then used Teacher Jiang's original formula plus Houttuynia Herb and Bamboo Juice, achieving immediate relief after one dose. After several recurrences cured by this formula, he did not relapse again.
The second case was a middle school student. Four or five years prior, he developed asthma, with attacks becoming increasingly frequent, often forcing him to interrupt his studies. His family was extremely poor; his father was hunchbacked, and his mother was retired. They struggled to afford both living expenses and medical bills. His mother saved every penny and tried every method to treat him, but with little effect. When he visited me, he was emaciated and short. Although fourteen years old, he looked like an eight- or nine-year-old, skeletal with thin skin and fragile flesh. Sitting opposite him, wheezing sounds were audible in both ears, with rattling phlegm and frequent coughing. Yet his pulse was slippery, large, and forceful. His tongue body was red, with peeled coating in the center and tip, and prickles on the surface. This case involved not only Phlegm-Turbidity in the Lung but also Heat in the Upper Jiao Heart and Lung, consumption of Lung fluids, congenital insufficiency, and Kidney Yin deficiency, constituting a syndrome of root deficiency and branch excess. I also used modifications of the above formula, adding Raw and Prepared Rehmannia Roots, Dendrobium Stem (Chuan Shihu, 川石斛), Glehnia Root (Bei Shashen, 北沙参), Houttuynia Herb, Fresh Bamboo Juice, and Fritillaria Bulb (Chuan Beimu, 川贝母), which effectively controlled attacks. However, relapses still occurred occasionally. Medication provided relief, allowing him to勉强 attend classes. I reasoned that the inability to cure him completely was mainly due to poor constitution, weak congenital Yuan Qi, inadequate postnatal nutrition, and improper care, leading to a chronic illness hard to heal. My colleague, Dr. Huang Jinmei, and her daughter, Dr. Li Gengwei, feeling compassion, obtained several fresh umbilical cords from healthy mothers and taught him to cook and eat one daily before sleep. Subsequently, he took Placenta Powder (Tai Pan Fen, 胎盘粉) daily. After careful regulation for over two years, asthma attacks became very rare, and any occasional ones were mild. He grew 10 cm taller, his complexion became ruddy, and his flesh filled out. At first glance, he appeared as a handsome young man.
Taking umbilical cord and placenta powder during asthma remission to strengthen the physique and prevent relapse is recorded in ancient books. Teacher Jiang highly praised these two substances in his text, noting they can tonify Qi and Blood, strengthen the physique, and calm wheezing, achieving two goals with one effort.
Umbilical Cord is called "Kan Qi" (坎炁) in TCM classics. It is dried on a tile over charcoal fire until yellow and brittle, then ground into powder for swallowing. I once had a leader whose son suffered from asthma in childhood. Visiting many famous doctors yielded no success. A relative later suggested a formula, which was the one above. At that time, dry Kan Qi was available in pharmacies. He gradually purchased and took it, eventually being cured. Now in his thirties, he is physically robust and healthy.
As for Placenta, it is a substance of flesh and blood with special functions of tonifying Qi and Blood. During the recovery phase of asthma, when tonifying the root, if Placenta Powder is not taken, Heche Dazao Wan (Placenta Great Creation Pill) is also very effective. I once treated a college student with recurrent asthma. During my consultation, he was in the remission phase, emaciated, with a fine pulse and pale tongue. I instructed him to buy Heche Dazao Wan and take it at regular dosage, 2–3 times daily. After several months of intake, his asthma was effectively controlled.
Another type is Asthma due to Lung and Kidney Yin Deficiency. Main symptoms include upper body panting, shortness of breath, and urgent breathing difficult to continue. Accompanied by shortness of breath and fatigue, dry mouth and tongue, soreness and weakness of lower back and feet, dizziness and tinnitus, and sweating when wheezing is severe. I often use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) combined with Shengmai Yin (Generate the Pulse Drink), achieving prompt results. One case began during rural labor in the 1970s. For over twenty years, it almost occurred every night. Taking the above method brought immediate effect. On days he took medicine, the disease did not occur. After continuous intake for half a year, he was completely cured.
An Extraordinary Case of Pediatric Pneumonia
In 1984, Yu Er, aged twelve, suddenly developed high fever (39.7°C) in mid-September, followed by frequent coughing with a sound as if coming from a pot. He had dull abdominal pain, normal bowel and bladder movements, sweating but unresolved fever, floating and rapid pulse, non-depressible right-hand pulse, and thin white coating. Sangju Yin (Mulberry Leaf and Chrysanthemum Decoction) had no effect. Silver and Forsythia Decoction (Yinqiao San, 银翘散) was administered. After each dose, temperature dropped from 39.7°C to 37.4°C. Hours later, it rose back to original levels, persisting for two days. Western medicine chest fluoroscopy showed deepened lung markings and small patchy shadows in the right lung, diagnosing "Pneumonia." Antibiotic injections were given. Temperature dropped slightly within two hours of each injection but rose again afterward. This continued for nearly a week without resolution. I pondered deeply but was at a loss. On September 24th, I sought advice from Teacher Zhang Shoujie. He carefully inquired about the cause, course, and medication changes, contemplated for a moment, and said: "I understand. The 'empty' cough sound suggests Lung Qi obstruction and lack of clarity. The method should prioritize opening the Lung, with clearing the Lung as secondary. Yinqiao and Sangju lean towards clearing and dispersing; although close to the symptoms, they do not fully match. Dull abdominal pain and steaming fever indicate accumulated heat in the Intestines steaming the Lung. The disease originates internally but manifests externally; the root is below, but the branch shows above. Treatment should purge heat and clear the Intestines. Overall, the method should be opening the Lung to expel pathogens and clearing the Intestines to purge heat."
Listening to my teacher's instruction, I suddenly understood. Teacher Zhang's theory of clearing the Intestines and purging heat was indeed profound. However, due to my dull nature and shallow knowledge, after careful thought for a long time, I still could not determine the herbs, so I shamefully asked for further guidance. The teacher taught me: "Based on decades of experience, I know that Anemarrhena Rhizome (Zhimu, 知母) combined with Immature Bitter Orange (Zhishi, 枳实) is most appropriate. Everyone knows Anemarrhena clears the Lung, but few know it best clears Intestinal Heat. Used synergistically with Immature Bitter Orange, with proper dosage, the effect is immediate." Saying this, the teacher wrote a prescription directly:
Glehnia Root (Nanshashen, 南沙参) 9g, Immature Bitter Orange (Zhishi, 枳实) 6g, Arctium Fruit (Dali Zi, 大力子) 9g, Anemarrhena Rhizome (Zhimu, 知母) 6g, Cicada Slough (Chantui, 蝉蜕) 6g, Honeysuckle Flower (Yinhua, 银花) 9g, Platycodon Root (Jiegeng, 桔梗) 4g, Patchouli Herb (Huoxiang, 藿香) 9g, Tangerine Peel (Juhong, 橘红) 9g, Scutellaria Root (Huangqin, 黄芩) 6g.
When the medicine was decocted, it was noon. The measured temperature was 39.4°C. He took the medicine immediately. About two hours later, the temperature was re-measured at 38.2°C. Four hours later, it dropped to 37.4°C. After taking the second decoction, the fever cleared by evening. To clear residual pathogens, another dose was given the next day, after which he returned to normal.
Unexpectedly, on the fourth evening after recovery, Yu Er felt abdominal pain again. After a while, he passed half a chamber pot of mushy stool, brown like sauce, sour and foul-smelling. Thirty minutes later, he passed more, slightly lighter in color. Half an hour later, he went to the toilet again; although still mushy, the color was pure yellow. The next morning, bowel movements were completely normal. Only then did I realize that the mushy stool passed the previous night was material retained for a long time, the root of accumulated heat in the Intestines. After the medicine opened the Lung and directed Qi downward, and cleared the Intestines to move stagnation, Yuan Qi gradually recovered, and the stagnation naturally left.
Commentary: Mr. Zhang Shoujie, a famous physician in Shanghai, studied at the "China Medical College" founded by Mr. Ding Ganren in his youth. Although he left no massive written works, his experience was rich, as seen in this case of treating Yu Er's pneumonia. The etiology of this case was complex, completely different from common pneumonia. Teacher Zhang treated the disease like painting, confident and free-flowing. I analyze the key points as two:
First, precise syndrome differentiation; second, precise medication selection. For this syndrome, the branch is in the Lung, and the root is in the Intestines. The teacher identified Lung turbid Qi obstructing the clear pathways based on the "empty" cough sound, distinct from external pathogens invading the Lung and transforming into heat causing cough. It was Qi obstruction rather than Heat stagnation. The treatment methods differ: Qi obstruction requires opening, Heat stagnation requires clearing. Thus, the original use of diffusing the Lung and purging heat was ineffective, like scratching an itch through boots. The teacher used Patchouli, Tangerine Peel, and Platycodon, aromatic herbs guiding Qi, to heavily open Lung Qi, assisted by Cicada Slough, Arctium, and Honeysuckle, light and clear herbs to vent Qi-Heat. This treats the branch manifestation in the Lung.
The root of this disease lies in stagnation in the Intestines transforming into heat. Seeing the continuous dull abdominal pain, the teacher discerned the truth and prescribed Anemarrhena and Immature Bitter Orange to purge heat and clear the Intestines. The teacher once told me: Using Anemarrhena and Immature Bitter Orange together to clear Intestinal Heat was a method taught by his master, Mr. Ding Ganren. Used appropriately, the disease disappears like sweeping.
During the entire diagnosis and treatment process, Teacher Zhang did not see the patient, relying only on my verbal description, without palpating the pulse or observing the tongue, yet identified the disease truthfully and prescribed accurately. Besides his profound study of medical principles and rich experience, it shows his skill in inquiry, ability to grasp main symptoms, causes, and syndrome evolution patterns, which are fundamental skills for physicians. In my youth, reading about the modern famous physician Mr. Yun Tieqiao, who treated diseases without pulse diagnosis, relying solely on inquiry, I was deeply puzzled. Seeing Teacher Zhang treat this case, I finally understood.
Atrial Fibrillation
Atrial fibrillation is a common arrhythmia in adults, with palpitations and chest tightness as the main subjective symptoms. During atrial fibrillation, the atria generate irregular impulses of 350–600 times per minute, causing uncoordinated atrial flutter. Whether acute or persistent, mild cases are easy to cure, while severe cases are difficult to treat. Although clinical manifestations are diverse, the cases I have seen mostly present with deficiency-type pulse and symptoms. Among Qi, Blood, Yin, and Yang, Qi deficiency is the main body. It is often accompanied by Yin and Blood deficiency, sometimes with Heart Fire, Phlegm-Saliva, disturbance of deficient Yang, blood stasis, or failure of Heart Yang. How to establish treatment principles depends on clinical judgment and decisive action. When atrial fibrillation affects the Lung, it can also lead to critical wheezing. Here, I report one cured case of atrial fibrillation and one case of atrial fibrillation with wheezing.
Case 1: Atrial Fibrillation. Three years ago, a technical worker named Cao came for treatment, aged about fifty-seven. He reported no history of chronic disease but often felt palpitations and anxiety in recent years, with a jumping sensation between the chest and back. Tachycardia and premature beats occurred intermittently. Western medical examination suspected sequelae of myocarditis. I palpated his pulse as small and rapid, insufficient under pressure. The tongue body was pale red, with thin, clean, and dry coating. The syndrome belonged to Dual Deficiency of Qi and Yin. The Heart lost nourishment, causing restless Spirit. The treatment principle was to regulate Qi and Yin simultaneously and calm the Mind and Spirit. I used Shengmai San (Generate the Pulse Powder) with modifications. Herbs included Codonopsis Root (Dangshen, 党参), Ophiopogon Tuber (Maidong, 麦门冬), Schisandra Berry (Wuweizi, 五味子), Raw Rehmannia Root (Shengdi, 生地), Angelica Sinensis Root (Danggui, 当归), White Peony Root (Baishao, 白芍), Poria with Hostwood (Zhufushen, 朱茯神), Stir-fried Ziziphus Seed (Chao Zaoren, 炒枣仁), Dragon Teeth and Oyster Shell (Longgu Gu, 龙齿骨), Prepared Polygala Root (Zhi Yuanzhi, 炙远志), Licorice Root (Gancao, 甘草), Night-jasmine Vine (Ye Jiaoteng, 夜交藤), and Salvia Root (Danshen, 丹参). After the first dose, he felt unusual comfort in the chest and heart, and all symptoms disappeared. He then took fourteen doses continuously. For the first thirteen doses, each showed extraordinary effect, and he claimed to be cured. Unexpectedly, upon taking the fourteenth dose, despite the hot weather in early spring and summer, he suddenly felt incessant heartbeat, exceeding one hundred beats per minute. Suspecting improper medication, he voluntarily stopped taking the formula and refused further treatment. The tachycardia persisted for half a month before gradually subsiding. Fortunately, in the following two or three years, arrhythmia did not recur. Late last winter, one night at midnight, he suddenly experienced abnormal palpitations, chest tightness and suffocation, with feelings of panic and fear. He lay supine, afraid to move, waiting quietly, feeling his chest and heart moving like an air turbine. "Thump! Thump! Thump! Thump!" Vibrating incessantly. After two or three hours, it gradually eased. The next day, besides chest restlessness, he felt deeply fatigued and weak, sweating easily with slight movement. This happened every night for three days. He went to Changshou Hospital for examination, diagnosed with "Atrial Fibrillation." Hospitalization was recommended, but Cao politely declined and transferred to my clinic for TCM. I palpated his pulse: both Cun positions were small but forceful; Left Guan and Right Guan-Chi positions were small and soft under pressure. The tongue body was pale red, with thin, clean coating. Based on pulse and symptoms, it still belonged to Qi deficiency and Yin-Blood insufficiency, with hyperactive Heart Fire. The treatment plan was to tonify Qi and nourish Blood, clear Heart Fire, and calm the Spirit. The formula was:
Astragalus Root (Huangqi, 黄芪) 24g, Codonopsis Root (Dangshen, 党参) 15g, Stir-fried Atractylodes Macrocephala Rhizome (Chao Baizhu, 炒白术) 9g, Poria (Fuling, 茯苓) 9g, Licorice Root (Gancao, 甘草) 3g, Angelica Sinensis Root (Danggui, 当归) 9g, Ophiopogon Tuber (Maidong, 麦冬) 15g, Raw Rehmannia Root (Shengdi, 生地) 20g, Stir-fried White Peony Root (Chao Baishao, 炒白芍) 9g, Sophora Flavescens Root (Kushen, 苦参) 4.5g, Salvia Root (Danshen, 丹参) 9g, Raw Dragon Teeth and Oyster Shell (Sheng Longmu, 生龙牡) 30g each, Stir-fried Ziziphus Seed (Chao Zaoren, 炒枣仁) 15g, Schisandra Berry (Wuweizi, 五味子) 1.5g.