天津陈××，年三十八岁，得大气下陷兼疝气证。
病因 初因劳心过度，浸觉气分不舒，后又因出外办事劳碌过甚，遂觉呼吸短气，犹不
以为意也。继又患疝气下坠作疼，始来寓求为延医。
证候 呼吸之际，常觉气短似难上达，劳动时则益甚。夜间卧睡一点钟许，即觉气分不舒，
披衣起坐移时将气调匀，然后能再睡。至其疝气之坠疼，恒觉与气分有关，每当呼吸不利时，
则疝气之坠疼必益甚。其脉关前沉而无力，右部尤甚，至数稍迟。
诊断 即此证脉参之，其呼吸之短气，疝气之下坠，实皆因胸中大气下陷也。此气一陷则肺脏
之辟失其斡旋，是以呼吸短气，三焦之气化失其统摄，是以疝气下坠。斯当升补其下陷
之大气，俾仍还其本位，则呼吸之短气，疝气之坠疼自皆不难愈矣。
处方 生箭 （六钱） 天花粉（六钱） 当归（三钱） 荔枝核（三钱）
生明没药（三钱） 生五灵脂（三钱） 柴胡（钱半） 升麻（钱半） 小茴香（一钱炒捣）
共煎汤一大盅，温饮下。
复诊 将药连服三剂，短气之病已大见愈，惟与人谈话多时，仍觉短气。其疝气已上升，有
时下坠亦不作疼，脉象亦大有起色。此药已对证，而服药之功候未到也。爰即原方略为加
减，俾再服之。
处方 生箭 （六钱） 天花粉（六钱） 净萸肉（四钱） 当归（三钱） 荔枝核（三
钱） 生明没药（三钱） 生五灵脂（三钱） 柴胡（钱半） 升麻（钱半） 广砂仁（一钱捣碎）
共煎一大盅温服。
效果 将药连服四剂，呼吸已不短气，然仍自觉气分不足，疝气亦大轻减，犹未全消。遂即
原方去萸肉，将柴胡、升麻皆改用一钱，又加党参、天冬各三钱，俾多服数剂以善其后。
天津的陈某某，三十八岁，患有大气下陷兼疝气证。
病因：起初因为用脑过度，逐渐感觉气分不舒畅，后来又因为外出办事过于劳累，于是觉得呼吸短促，当时还不以为意。接着又患上疝气，出现下坠疼痛的症状，这才来到寓所请求我为他延请医生诊治。
证候：在呼吸时，常常觉得气短，似乎难以向上通达，劳动时症状更加严重。夜间睡觉大约一小时后，就感觉气分不舒畅，披衣起身坐一会儿，将气息调匀之后，才能再次入睡。至于疝气的下坠疼痛，常觉得与气分有关，每当呼吸不畅时，疝气的下坠疼痛必定更加严重。其脉象关前部位沉而无力，右部尤为明显，脉搏次数稍慢。
诊断：综合此证的脉象来看，其呼吸短气和疝气的下坠，实际上都是因为胸中大气下陷所致。这大气一旦下陷，肺脏的宣发肃降功能失去斡旋作用，所以导致呼吸短气；三焦的气化功能失去统摄作用，所以导致疝气下坠。此时应当升提补益下陷的大气，使其回归本位，那么呼吸短气和疝气的下坠疼痛自然就不难治愈了。
处方：生黄芪（六钱）、天花粉（六钱）、当归（三钱）、荔枝核（三钱）、生明没药（三钱）、生五灵脂（三钱）、柴胡（一钱半）、升麻（一钱半）、小茴香（一钱，炒后捣碎）。以上药物共煎成一大盅汤剂，温服。
复诊：连续服用三剂药后，短气的症状已大有好转，只是与人长时间交谈时，仍觉得气短。疝气已经上升，有时即使下坠也不再疼痛，脉象也有很大改善。这说明药已对症，但服药的时间还不够。因此就在原方基础上略微加减，让他继续服用。
处方：生黄芪（六钱）、天花粉（六钱）、净山茱萸肉（四钱）、当归（三钱）、荔枝核（三钱）、生明没药（三钱）、生五灵脂（三钱）、柴胡（一钱半）、升麻（一钱半）、广砂仁（一钱，捣碎）。以上药物共煎一大盅，温服。
效果：连续服用四剂药后，呼吸不再短促，但仍自觉气分不足，疝气也大大减轻，尚未完全消除。于是就在原方中去掉山茱萸肉，将柴胡、升麻均改为一钱，又加入党参、天冬各三钱，让他多服几剂以巩固疗效。
Chen XX from Tianjin, aged 38, suffered from a syndrome of sinking of the Great Qi (Qi of the chest) complicated with hernia.
Etiology: Initially, due to excessive mental exertion, he gradually felt discomfort in the Qi mechanism. Later, due to excessive physical fatigue from going out for business affairs, he began to experience shortness of breath, which he initially disregarded. Subsequently, he developed hernia with downward dragging and pain, at which point he came to his residence requesting medical treatment.
Symptoms: During respiration, he often felt shortness of breath, as if the Qi could not reach upward effectively; this worsened during physical labor. After sleeping for about an hour at night, he would feel discomfort in the Qi mechanism. He would get up, sit for a while, regulate his breathing until it became even, and then be able to sleep again. Regarding the hernia's downward dragging and pain, he constantly felt it was related to the Qi mechanism; whenever respiration was obstructed, the hernia's downward dragging and pain would inevitably intensify. His pulse was deep and forceless anterior to the Guan position (middle cun), more pronounced on the right side, with a slightly slow rate.
Diagnosis: Based on this syndrome and pulse, the shortness of breath and the downward dragging of the hernia are actually caused by the sinking of the Great Qi in the chest. When this Qi sinks, the dispersing and descending functions of the Lung lose their dynamic regulation, resulting in shortness of breath; the transformation and transportation functions of the Sanjiao (Triple Burner) lose their control, resulting in the downward dragging of the hernia. Therefore, it is necessary to raise and tonify the sinking Great Qi, allowing it to return to its original position, so that the shortness of breath and the hernia's dragging pain will naturally be easy to cure.
Prescription: Raw Radix Astragali Preparata (Sheng Huangqi, 6 qian), Radix Trichosanthis (Tianhuafen, 6 qian), Radix Angelicae Sinensis (Danggui, 3 qian), Fructus Litchi (Lizhihe, 3 qian), Raw Resina Myrrhae (Sheng Ming Moyao, 3 qian), Raw Feces Trogopterori (Sheng Wulingzhi, 3 qian), Radix Bupleuri (Chaihu, 1.5 qian), Rhizoma Cimicifugae (Shengma, 1.5 qian), Fructus Foeniculi (Xiaohuixiang, 1 qian, stir-fried and crushed). Decoct together in one large cup of water, take warm.
Second Visit: After taking three doses consecutively, the shortness of breath improved significantly, but he still felt short of breath after talking for a long time. The hernia had risen, and sometimes even when dragging, it did not hurt. The pulse showed great improvement. This indicates the prescription was correct, but the duration of medication was insufficient. Therefore, slight modifications were made to the original prescription for continued use.
Prescription: Raw Radix Astragali Preparata (Sheng Huangqi, 6 qian), Radix Trichosanthis (Tianhuafen, 6 qian), Prepared Flesh of Cornus Officinalis Fruit (Jing Yurou, 4 qian), Radix Angelicae Sinensis (Danggui, 3 qian), Fructus Litchi (Lizhihe, 3 qian), Raw Resina Myrrhae (Sheng Ming Moyao, 3 qian), Raw Feces Trogopterori (Sheng Wulingzhi, 3 qian), Radix Bupleuri (Chaihu, 1.5 qian), Rhizoma Cimicifugae (Shengma, 1.5 qian), Semen Amomi Rotundae (Guang Sharen, 1 qian, crushed). Decoct in one large cup, take warm.
Outcome: After taking four doses consecutively, respiration was no longer short, although he still felt a deficiency of Qi. The hernia was greatly alleviated but not completely resolved. Thus, Cornus Officinalis Fruit (Yurou) was removed from the original prescription, Chaihu and Shengma were both changed to 1 qian, and Radix Codonopsis (Dangshen) and Radix Asparagi (Tiandong), each 3 qian, were added, to be taken for several more doses to consolidate the therapeutic effect.