卫（三十）失音已久。胃纳颇佳。非其气之馁。当金匮金实无声议治。
麻黄（三分） 石膏（三钱） 杏仁（三钱） 生草（三分） 射干（五分） 苡仁（三钱）
钱（四一）肺象空悬。其位最高。据述曾经吐血之后。声音出不扬。饮食少纳。干咳频多。此属少阴水亏。不能济
火。致君相上腾。燔烁娇脏。不无受伤。顾本是滋阴补虚为要。然岁气当深秋之际。肃化犹为最先。莫若暂用固金法。
从金生水意。
阿胶（二钱） 北沙参（一钱五分） 生地（三钱） 生鸡子黄（一枚）
麦冬（二钱） 川斛（四钱） 茯神（二钱） 生甘草（三分）
戴 瘀咯将净。痰咳亦缓。肺胃络脉。乃肝阳潜伏。渐有宁静之象。今诊得左关弦形已退。右关脉已鼓指。而独右
寸软弱。左尺虚细。右尺微小。六脉虽未调和。审体质未始不为平脉。古人所谓未见病脉。即平脉也。仍拟养肾。佐以
健脾。
熟地（四钱） 北沙参（一钱五分） 淮山药（炒，二钱） 陈阿胶（二钱） 拣麦冬（一钱五分）
建莲（去心，二钱） 云茯神（二钱） 川贝（二钱） 蒲黄（炒黑，五分）
又 填纳下焦。肝肾肺胃络脉渐宁。痰咯虽未净尽。而脏阴离络之瘀已尽。然而颐养宁神。络脉完固。不致贻患。
仍拟肝肾定例。少佐清化。
熟地（四钱） 拣麦冬（一钱五分） 建莲（二钱） 陈阿胶（二钱） 川贝（一钱五分）
淮山药（炒，二钱） 左牡蛎（三钱） 沙蒺藜（二钱） 云茯神（二钱）
又 自瘀尽以来。络脉巩固。肝肾根蒂亦基。痰咯亦少。形神颇安。脉右寸软。尺小弱。余部中和。但此小雪节候。
值少阴用事之时。只宜静养。以待一阳来复。其调剂仍宗前议。聊以益气佐之。
熟地（四钱） 西党参（二钱） 酸枣仁（炒焦，二钱） 陈阿胶（二钱） 拣麦冬（一钱五分）
云茯神（二钱） 川贝（一钱五分） 建莲（二钱） 炙草（四分）
又 照前议参脾为生痰之源治。
熟地（四钱） 炒焦冬术（一钱五分） 枣仁（炒黑，二钱） 陈阿胶（二钱） 新会皮（一钱）
拣麦冬（一钱五分） 云茯神（二钱） 川贝（去心研，一钱五分） 人参（另煎冲，一钱）
又
熟地（四钱） 北沙参（三钱） 建莲（去心，三钱） 陈阿胶（蛤粉炒，二钱） 川贝（去心研，二钱）
淮牛膝炭（一钱五分） 拣麦冬（去心，一钱五分） 云茯神（二钱） 九孔石决明（ 研三钱）
卫某（三十岁），失音已久。胃纳颇佳。并非因气虚所致。应当依据《金匮要略》中“金实无声”的理论进行诊治。
麻黄（三分） 石膏（三钱） 杏仁（三钱） 生甘草（三分） 射干（五分） 薏苡仁（三钱）
钱某（四十一岁），肺象空悬。肺位最高。据述曾在吐血之后，声音出不响亮。饮食减少，干咳频繁。此属少阴肾水亏虚，不能上济心火，导致君火与相火上腾，灼烧娇脏（肺），难免受到损伤。但根本在于滋阴补虚为要务。然而岁气正值深秋之际，肃杀之气最为显著。不如暂时采用固护肺金的方法，遵循“从金生水”的思路。
阿胶（二钱） 北沙参（一钱五分） 生地（三钱） 生鸡子黄（一枚）
麦冬（二钱） 川石斛（四钱） 茯神（二钱） 生甘草（三分）
戴某，瘀血咯出将净。痰咳亦缓解。肺胃络脉，乃肝阳潜伏，渐有宁静之象。如今诊得左关脉弦形已退，右关脉已鼓指。而唯独右寸脉软弱，左尺脉虚细，右尺脉微小。六脉虽未调和，审视体质未始不为平脉。古人所谓未见病脉，即平脉也。仍拟养肾，佐以健脾。
熟地（四钱） 北沙参（一钱五分） 淮山药（炒，二钱） 陈阿胶（二钱） 拣麦冬（一钱五分）
建莲（去心，二钱） 云茯神（二钱） 川贝母（二钱） 蒲黄（炒黑，五分）
又，填纳下焦。肝肾肺胃络脉渐宁。痰咯虽未净尽，而脏阴离络之瘀已尽。然而颐养宁神，络脉完固，不致贻患。仍拟肝肾定例，少佐清化。
熟地（四钱） 拣麦冬（一钱五分） 建莲（二钱） 陈阿胶（二钱） 川贝母（一钱五分）
淮山药（炒，二钱） 左牡蛎（三钱） 沙蒺藜（二钱） 云茯神（二钱）
又，自瘀尽以来，络脉巩固，肝肾根蒂亦基。痰咯亦少，形神颇安。脉右寸软，尺小弱。余部中和。但此小雪节候，值少阴用事之时，只宜静养，以待一阳来复。其调剂仍宗前议，聊以益气佐之。
熟地（四钱） 西党参（二钱） 酸枣仁（炒焦，二钱） 陈阿胶（二钱） 拣麦冬（一钱五分）
云茯神（二钱） 川贝母（一钱五分） 建莲（二钱） 炙甘草（四分）
熟地（四钱） 炒焦冬术（一钱五分） 枣仁（炒黑，二钱） 陈阿胶（二钱） 新会皮（一钱）
拣麦冬（一钱五分） 云茯神（二钱） 川贝母（去心研，一钱五分） 人参（另煎冲，一钱）
又
熟地（四钱） 北沙参（三钱） 建莲（去心，三钱） 陈阿胶（蛤粉炒，二钱） 川贝母（去心研，二钱）
淮牛膝炭（一钱五分） 拣麦冬（去心，一钱五分） 云茯神（二钱） 九孔石决明（研三钱）
Wei (30 years old) has suffered from aphonia (loss of voice) for a long time. His gastric appetite is quite good. This is not due to Qi deficiency. Treatment should follow the principle of "Metal being full results in no sound" discussed in *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet).
Ephedrae Herba (Mahuang, 麻黄) - 3 fen
Gypsum Fibrosum (Shigao, 石膏) - 3 qian
Prunus Armeniaca Seed (Xingren, 杏仁) - 3 qian
Raw Glycyrrhizae Radix et Rhizoma (Sheng Cao, 生草) - 3 fen
Belamcandae Rhizoma (Shegan, 射干) - 5 fen
Coicis Semen (Yiren, 薏苡仁) - 3 qian
Qian (41 years old) presents with a hollow sensation in the Lung. The Lung resides at the highest position. It is reported that after hemoptysis (spitting blood), his voice became indistinct and weak. He has reduced dietary intake and frequent dry cough. This belongs to Kidney Water deficiency in Shaoyin (Lesser Yin), failing to ascend and nourish Heart Fire, causing Ministerial Fire to surge upward, scorching the delicate organ (Lung), inevitably causing injury. However, the root lies in nourishing Yin and tonifying deficiency as the primary objective. Nevertheless, the seasonal qi is in late autumn, where the desiccating transformation is most prominent. It is advisable to temporarily employ methods to consolidate Metal (Lung), following the intention of "generating Water from Metal".
Donkey-hide Gelatin (Ejiao, 阿胶) - 2 qian
Glehniae Radix (Beishashen, 北沙参) - 1.5 qian
Rehmanniae Radix (Shengdi, 生地) - 3 qian
Raw Chicken Egg Yolk (Sheng Jizi Huang, 生鸡子黄) - 1 piece
Ophiopogonis Radix (Maidong, 麦冬) - 2 qian
Dendrobii Caulis (Chuanhu, 川斛) - 4 qian
Poria (Fushen, 茯神) - 2 qian
Raw Glycyrrhizae Radix et Rhizoma (Sheng Gancao, 生甘草) - 3 fen
Dai: Hemoptysis of blood stasis is nearly cleared. Phlegm-cough is also alleviated. The collaterals of the Lung and Stomach are affected by latent Liver Yang, gradually showing signs of tranquility. Current pulse diagnosis reveals that the wiry quality at the left Guan position has receded, and the right Guan pulse beats forcefully against the finger. However, the right Cun position alone is soft and weak; the left Chi position is deficient and fine; the right Chi position is minute and small. Although the six pulses are not yet harmonized, examining the constitution suggests they may still be considered normal pulses. As the ancients said, if pathological pulses are not seen, it is a normal pulse. The prescription continues to nourish the Kidney, assisted by strengthening the Spleen.
Prepared Rehmanniae Radix (Shudi, 熟地) - 4 qian
Glehniae Radix (Beishashen, 北沙参) - 1.5 qian
Dioscoreae Rhizoma (Huai Shanyao, 淮山药) - stir-fried, 2 qian
Aged Donkey-hide Gelatin (Chen Ejiao, 陈阿胶) - 2 qian
Selected Ophiopogonis Radix (Jian Maidong, 拣麦冬) - 1.5 qian
Nelumbinis Plumula (Jianlian, 建莲) - heart removed, 2 qian
Cloud Poria (Yun Fushen, 云茯神) - 2 qian
Fritillariae Bulbus (Chuanbei, 川贝) - 2 qian
Polygoni Multiflori Caulis (Puhuang, 蒲黄) - stir-fried black, 5 fen
Again: Tonifying and filling the Lower Jiao. The collaterals of the Liver, Kidney, Lung, and Stomach are gradually tranquil. Although phlegm expectoration is not completely cleared, the blood stasis separating from the collaterals due to Zang Yin deficiency has been exhausted. However, to nurture and calm the spirit, ensuring the collaterals are complete and solid, preventing future complications. The treatment follows the established pattern for Liver and Kidney, with slight addition of clearing and resolving transformations.
Prepared Rehmanniae Radix (Shudi, 熟地) - 4 qian
Selected Ophiopogonis Radix (Jian Maidong, 拣麦冬) - 1.5 qian
Nelumbinis Plumula (Jianlian, 建莲) - 2 qian
Aged Donkey-hide Gelatin (Chen Ejiao, 陈阿胶) - 2 qian
Fritillariae Bulbus (Chuanbei, 川贝) - 1.5 qian
Dioscoreae Rhizoma (Huai Shanyao, 淮山药) - stir-fried, 2 qian
Left Oyster Shell (Zuo Muli, 左牡蛎) - 3 qian
Tribuli Fructus (Shajili, 沙蒺藜) - 2 qian
Cloud Poria (Yun Fushen, 云茯神) - 2 qian
Again: Since the exhaustion of blood stasis, the collaterals have consolidated, and the roots of the Liver and Kidney are established. Phlegm expectoration is also reduced; physical form and spirit are quite peaceful. The pulse at the right Cun is soft, and the Chi is small and weak. The remaining positions are moderate and harmonious. However, during this period of Minor Snow solar term, when Shaoyin (Kidney) governs, only quiet rest is suitable, awaiting the return of Yang Qi. The adjustment still adheres to the previous discussion, with a slight addition of Qi-tonifying herbs.
Prepared Rehmanniae Radix (Shudi, 熟地) - 4 qian
Western Codonopsis Radix (Xi Dangshen, 西党参) - 2 qian
Ziziphi Spinosae Semen (Suanzaoren, 酸枣仁) - stir-fried scorched, 2 qian
Aged Donkey-hide Gelatin (Chen Ejiao, 陈阿胶) - 2 qian
Selected Ophiopogonis Radix (Jian Maidong, 拣麦冬) - 1.5 qian
Cloud Poria (Yun Fushen, 云茯神) - 2 qian
Fritillariae Bulbus (Chuanbei, 川贝) - 1.5 qian
Nelumbinis Plumula (Jianlian, 建莲) - 2 qian
Honey-fried Glycyrrhizae Radix et Rhizoma (Zhi Cao, 炙草) - 4 fen
Again: Following the previous discussion, treating the Spleen as the source of phlegm generation.
Prepared Rehmanniae Radix (Shudi, 熟地) - 4 qian
Stir-fried Scorched Atractylodis Macrocephalae Rhizoma (Chao Jiao Dongzhu, 炒焦冬术) - 1.5 qian
Ziziphi Spinosae Semen (Zaoren, 枣仁) - stir-fried black, 2 qian
Aged Donkey-hide Gelatin (Chen Ejiao, 陈阿胶) - 2 qian
Xinhui Tangerine Peel (Xinhui Pi, 新会皮) - 1 qian
Selected Ophiopogonis Radix (Jian Maidong, 拣麦冬) - 1.5 qian
Cloud Poria (Yun Fushen, 云茯神) - 2 qian
Fritillariae Bulbus (Chuanbei, 川贝) - heart removed, ground, 1.5 qian
Ginseng Radix (Renshen, 人参) - separately decocted and mixed in, 1 qian
Again
Prepared Rehmanniae Radix (Shudi, 熟地) - 4 qian
Glehniae Radix (Beishashen, 北沙参) - 3 qian
Nelumbinis Plumula (Jianlian, 建莲) - heart removed, 3 qian
Aged Donkey-hide Gelatin (Chen Ejiao, 陈阿胶) - stir-fried with clam powder, 2 qian
Fritillariae Bulbus (Chuanbei, 川贝) - heart removed, ground, 2 qian
Charred Achyranthes Bidentatae Radix (Huainiuxi Tan, 淮牛膝炭) - 1.5 qian
Selected Ophiopogonis Radix (Jian Maidong, 拣麦冬) - heart removed, 1.5 qian
Cloud Poria (Yun Fushen, 云茯神) - 2 qian
Nine-hole Halitostea Concha (Jiu Kong Shi Jueming, 九孔石决明) - ground, 3 qian