先寒后热。不饥不食。继浮肿喘呛。俯不能仰。仰卧不安。古人以先喘后胀
治肺。先胀后喘治脾。今由气分 郁。以致水道阻塞。大便溏泻。仍不爽利。其肺
气不降。二肠交阻。水谷蒸腐之湿横趋脉络。肿由渐加。岂乱医可效。粗述大略。
与高明论证。至肺位最高。主气。为手太阴脏。其脏体恶寒喜热。宣辛则通。微苦
则降。若药气味重浊。直入中下。非宣肺方法矣。故手经与足经大异。当世不分
手足经混治者。特表及之。
麻黄 苡仁 茯苓 杏仁 甘草
色痿腠疏阳虚体质。平昔喜进膏粱。上焦易壅。中宫少运。浓味凝聚蒸痰。
频年咳嗽。但内伤失和。薄味自可清肃。医用皂荚搜攒。肺伤气泄。喷嚏不已。而
沉锢胶浊。仍处胸背募俞之间。玉屏风散之固卫。六君子汤之健脾理痰。多是
守剂。不令宣通。独小青龙汤。彻饮以就太阳。初服喘缓。得宣通之意。夫太阳但
开。所欠通补阳明一段工夫。不得其阖。暂开复痹矣。且喘病之因。在肺为实。在
肾为虚。此病细诊色脉。是上实下虚。以致耳聋鸣响。治下之法。壮水源以熄内
风为主。而胸次清阳少旋。浊痰阻气妨食。于卧时继以清肃上中二焦。小剂守
常调理。百日图功。至于接应世务。自宜节省。勿在药理中也。
熟地 萸肉 龟甲心 阿胶 牛膝 茯苓 远志 五味 磁石 秋石
脉细尺垂。形瘦食少。身动即气促喘急。大凡气出不爽而喘为肺病。客感
居多。今动则阳化。由乎阴弱失纳。乃吸气入而为喘。肾病何辞。治法惟以收摄
固真。上病当实下焦。宗肾气方法意。
熟地 萸肉 五味 补骨脂 胡桃肉 牛膝 茯苓 山药 车前子 蜜丸
望八大年。因冬温内侵。遂至痰嗽暮甚。诊脉大而动搏。察色形枯汗泄。吸
音颇促。似属痰阻。此乃元海根微。不司藏纳。神衰呓语。阳从汗出。最有昏脱之
变。古人老年痰嗽喘症。都从脾肾主治。今温邪扰攘。上中二焦留热。虽无温之
理。然摄固下真以治根本。所谓阳根于阴。岂可不为讲究。
熟地炭 胡桃肉 牛膝炭 车前子 云茯苓 青铅
疮毒内攻。所进水谷不化。蒸变湿邪。渍于经隧之间。不能由肠而下。膀胱
不利。浊上壅遏。肺气不降。喘满不堪着枕。三焦闭塞。渐不可治。议用中满分消
之法。必得小便通利。可以援救。
葶苈 苦杏仁 桑皮 浓朴 猪苓 通草 大腹皮 茯苓皮 泽泻
老年冬季喘嗽。是元海不主收摄。卫阳升举。饮邪上泛。阻遏流行。喘嗽愈
甚。阅古都主八味肾气。温养坎中之阳。收纳散失之真。不主消痰清肺。意谓非
因六气所致。奈体质不受桂附。年前议进柔阳通摄。若以创建上中之阳。乃心
脾甘温之剂。与下焦不纳无关。
紫衣胡桃肉 茯苓 补骨脂 鹿茸 肉苁蓉 五味子 远志肉 青盐 柏子霜 蜜丸
先是恶寒，随后发热。没有饥饿感，无法进食。接着出现全身浮肿、气喘和呛咳。身体前倾时不能后仰，平躺时感到不安稳。古人认为先气喘后腹胀的病证治肺，先腹胀后气喘的病证治脾。如今此病是由于气分郁滞，导致水道阻塞，大便溏泻，仍然排便不爽利。肺气不降，大肠和小肠气机交阻，水谷蒸腐产生的湿气横溢进入脉络，浮肿逐渐加重。这哪里是胡乱医治可以奏效的？粗略陈述大意，与高明之士论证。至于肺的位置最高，主司气，属于手太阴脏。其脏器性质厌恶寒冷而喜欢温热，用辛味药宣散则气机通畅，用微苦味药则气机下降。如果药物的气味厚重浑浊，直接入中下焦，就不是宣肺的方法了。所以手经与足经的治疗大不相同。当世不分手足经而混治的人，特此指出并说明。
面色萎黄，腠理疏松，属阳虚体质。平时喜欢吃油腻厚味的食物，上焦容易壅塞，中焦脾胃运化无力。浓腻的味道凝聚蒸腾产生痰浊。多年咳嗽，但这是内伤导致的失和，清淡饮食自然可以清肃肺气。医生使用皂荚搜刮积聚的痰浊，损伤了肺脏，导致肺气外泄，喷嚏不止。而沉痼胶着的浊痰，仍然停留在胸背部的募穴和俞穴之间。玉屏风散用于固护卫气，六君子汤用于健脾理痰，大多属于守补之剂，不能起到宣通的作用。只有小青龙汤，能彻除饮邪以顺应太阳经气。初服时气喘缓解，体现了宣通的意旨。然而太阳经只开了，欠缺了通补阳明经的一段功夫，得不到它的阖敛，暂时开通后又闭塞了。而且喘病的成因，在肺为实证，在肾为虚证。此病仔细诊察色脉，是上实下虚，导致耳聋鸣响。治疗下焦的方法，以壮补水源来熄灭内风为主。而胸中清阳之气很少旋转，浊痰阻碍气机妨碍进食，在卧时用清肃上中二焦的药物。用小剂量常规调理，百日图谋功效。至于应付世俗事务，应当节省精力，不要耗费在药理研究之中。
熟地黄、山茱萸肉、龟甲心、阿胶、牛膝、茯苓、远志、五味子、磁石、秋石。
脉象细弱，尺部脉象下垂。形体消瘦，食量减少。身体一动就气促喘急。大凡呼气不畅而喘的是肺病，多由外感客邪引起。如今一动则阳气化散，是因为阴弱失去摄纳能力，乃吸气深入而引发喘症，这与肾病有什么关系呢？治疗方法唯有收摄固护真气。上部的病应当充实下焦，遵循肾气丸的方法意旨。
熟地黄、山茱萸肉、五味子、补骨脂、胡桃肉、牛膝、茯苓、山药、车前子，制成蜜丸。
患者八十余岁高龄。因冬季温邪内侵，导致痰嗽傍晚加重。诊脉象大而搏动有力，观察面色枯槁、汗出淋漓。吸气声音颇为急促，似乎属于痰阻。这其实是元气之海根基微弱，不能主持藏纳功能。神气衰败出现胡言乱语，阳气随汗液外出，最有昏厥脱绝的变化。古人对于老年痰嗽喘症，都从脾肾主治。如今温邪扰乱，上中二焦留有热邪，虽然不能用温法，但是摄固下焦真元以治疗根本。所谓阳根于阴，怎么可以不讲究呢？
疮毒内攻，所进水谷不能消化，蒸变成为湿邪，浸渍在经络隧道之间，不能通过肠道向下排泄。膀胱气化不利，浊气上壅遏止，肺气不降，喘满不堪忍受着枕入睡。三焦闭塞，渐渐不可治愈。议用中满分消的方法，必须使小便通利，才可以挽救。
葶苈子、苦杏仁、桑白皮、厚朴、猪苓、通草、大腹皮、茯苓皮、泽泻。
老年人在冬季发生喘嗽，是元气之海不能主司收摄，卫阳升举，饮邪上泛，阻遏气机流行，导致喘嗽更加严重。查阅古籍大都主张用八味肾气丸，温养坎宫中的阳气，收纳散失的真元，不主张消痰清肺。意思认为是非因六淫邪气所致。无奈患者体质不能耐受桂枝、附子。年前建议进用柔阳通摄之法。如果以建立上中二焦的阳气，那是心脾甘温的药剂，与下焦不纳无关。
First, aversion to cold followed by fever. No sense of hunger and inability to eat. Subsequently, generalized edema, asthma, and choking coughs developed. The patient could not lean backward when bending forward, and felt restless when lying supine. Ancient texts state that for conditions where asthma precedes distension, the Lung is treated; for those where distension precedes asthma, the Spleen is treated. In this case, the pathology arises from Qi stagnation in the Qi division, leading to obstruction of the water passages, loose stools, and incomplete defecation. The Lung Qi fails to descend, causing a blockage between the Large Intestine and Small Intestine. Dampness generated from the steaming and rotting of food and fluids invades the collaterals horizontally, causing the edema to gradually worsen. How could such a condition be cured by reckless medical practice? I briefly outline the general principles for discussion with experts. Regarding the Lung, its position is the highest, it governs Qi, and it belongs to the Hand-Taiyin organ system. Its nature dislikes cold and prefers heat. Acrid flavors promote circulation and unblock, while slightly bitter flavors promote descent. If medicinal flavors are heavy and turbid, entering directly into the Middle and Lower Jiao, they do not constitute a method for ventilating the Lung. Therefore, treatment of the Hand meridians differs significantly from that of the Foot meridians. It is necessary to point out that contemporary practitioners often mix treatments without distinguishing between Hand and Foot meridians.
Ephedrae Herba (Mahuang), Coicis Semen (Yiren), Poria (Fuling), Armeniacae Semen Amarum (Xingren), Glycyrrhizae Radix et Rhizoma (Gancao).
The complexion is sallow, the interstices are loose, indicating a Yang-deficient constitution. The patient habitually consumes rich and greasy foods, leading to easy congestion in the Upper Jiao and weak transportation in the Middle Palace (Spleen/Stomach). Rich flavors condense and steam into phlegm. Chronic cough has persisted for years due to internal injury and disharmony; a bland diet would naturally clear and purify the Lungs. However, physicians used Gleditsiae Sinensis Spina (Zaojia) to scrape accumulated phlegm, damaging the Lung and causing Qi leakage, resulting in incessant sneezing. Yet, the entrenched, sticky, and turbid phlegm remains between the Front-Mu and Back-Shu points of the chest and back. Yupingfeng San (Jade Windscreen Powder) consolidates the Wei Qi, and Liujunzi Tang (Six Gentlemen Decoction) strengthens the Spleen and regulates phlegm; these are mostly tonifying agents that do not promote unblocking. Only Xiao Qinglong Tang (Minor Blue Dragon Decoction) thoroughly eliminates fluid retention to align with the Taiyang channel. Initial administration relieved the asthma, reflecting the intent of unblocking. However, the Taiyang was only opened, lacking the effort to unblock and tonify the Yangming channel. Without its closing function, temporary opening leads to re-obstruction. Furthermore, the cause of asthma is excess in the Lung and deficiency in the Kidney. Careful examination of color and pulse reveals upper excess and lower deficiency, leading to deafness and tinnitus. The treatment for the lower part focuses on strengthening the Water source to extinguish internal Wind. Meanwhile, the Clear Yang in the chest rarely rotates, and turbid phlegm obstructs Qi and hinders eating. At bedtime, decoctions that clear and purify the Upper and Middle Jiao should be continued. Use small doses for routine regulation, aiming for results over one hundred days. As for handling worldly affairs, energy should be conserved, not wasted on pharmacological research.
Rehmanniae Radix Preparata (Shudi), Corni Fructus (Yurou), Testudinis Carapax et Plastrum (Guijia), Ecliptae Herba (Ejiao), Achyranthis Bidentatae Radix (Niuxi), Poria (Fuling), Polygalae Radix (Yuanzhi), Schisandrae Fructus (Wuweizi), Magnetitum (Cishi), Urinis Deposition (Qiushi).
The pulse is fine and the Chi position sinks. The body is emaciated with poor appetite. Movement immediately causes shortness of breath and rapid asthma. Generally, difficulty exhaling with asthma indicates Lung disease, mostly caused by external pathogens. Here, movement transforms Yang due to Yin weakness failing to grasp, causing inhalation to trigger asthma. How can this be denied as a Kidney disease? The treatment method must focus on grasping and securing True Qi. For diseases manifesting above, the Lower Jiao should be solidified, following the principle of Shenqi Wan (Kidney Qi Pill).
Rehmanniae Radix Preparata (Shudi), Corni Fructus (Yurou), Schisandrae Fructus (Wuweizi), Psoraleae Fructus (Buguzhi), Juglandis Semen (Hutaoren), Achyranthis Bidentatae Radix (Niuxi), Poria (Fuling), Dioscoreae Rhizoma (Shanyao), Plantaginis Semen (Cheqianzi), prepared as honey pills.
The patient is eighty-eight years old. Due to winter-warmth pathogen invading internally, phlegm-cough worsens in the evening. The pulse is large and bounding; the complexion is withered with sweating. The sound of inhalation is quite rapid, seemingly due to phlegm obstruction. This is actually due to the weakness of the Root of the Yuan Sea (Kidney), failing to govern storage and reception. Spirit is depleted, leading to delirium; Yang escapes with sweat, posing a risk of collapse and loss of consciousness. Ancient texts treat elderly phlegm-cough and asthma primarily through the Spleen and Kidney. Currently, warm pathogens disturb the Upper and Middle Jiao, leaving heat. Although warming therapy is not indicated, securing the Lower True Yuan to treat the root is essential. Since Yang is rooted in Yin, this must be carefully considered.
Rehmanniae Radix Preparata carbonized (Shuditann), Juglandis Semen (Hutaoren), Achyranthis Bidentatae Radix carbonized (Niuxitann), Plantaginis Semen (Cheqianzi), Poria (Yunfuling), Cinnabaris (Qingqian - *Note: Qingqian usually refers to Lead, but in some contexts implies specific mineral processing; here kept as literal translation or specific mineral*). *Correction based on standard TCM: Qingqian is Galena/Galena Ore (Litharge/Lead).* Let's use Galena (Qingqian).
Internal attack of toxin sores. Ingested food and fluids are not digested, steaming into damp-evil, soaking into the meridians and collaterals, unable to descend via the intestines. Bladder transformation is impaired, turbidity rises and blocks, Lung Qi fails to descend, causing severe asthma and fullness making it impossible to lie on a pillow. The Triple Burner is blocked, becoming increasingly untreatable. Propose using Zhongman Fenxiao (Middle Distension Resolving) method. Urination must become free-flowing to save the patient.
Descurainiae Semen seu Lepidii Semen (Tinglizi), Armeniacae Semen Amarum (Kuxingren), Morus Cortex Sangbai Pi (Sangpi), Magnoliae Officinalis Cortex (Noupo), Polyporus (Zhuling), Akebiae Caulis (Tongcao), Arecae Pericarpium (Dafupi), Poria Peel (Fulingpi), Alisma Rhizoma (Zexie).
In the elderly, winter asthma and cough indicate that the Yuan Sea fails to govern reception. Wei Yang rises, fluid evil floats upward, obstructing circulation, worsening asthma and cough. Ancient classics mainly advocate Bawei Shenqi Wan (Eight-Ingredient Replenishing Kidney Qi Pill) to warm and nourish the Yang of Kan (Water/Kidney) and gather scattered True Yuan, rather than eliminating phlegm and clearing the Lungs. The reasoning is that it is not caused by the Six Evils (External Pathogens). However, the patient's constitution cannot tolerate Cinnamon Twig (Guizhi) and Aconite (Fuzi). Last year, it was proposed to use gentle Yang-unblocking methods. Establishing Yang in the Upper and Middle Jiao involves sweet-warm formulas for the Heart and Spleen, which are unrelated to the failure of the Lower Jiao to receive.
Purple-skin Juglandis Semen (Ziyi Hutaoren), Poria (Fuling), Psoraleae Fructus (Buguzhi), Cervi Cornu Pantotrichum (Lurong), Cynomorii Herba (Roucongrong), Schisandrae Fructus (Wuweizi), Polygalae Seed (Yuanzirou), Halitum (Qingyan), Biota Seed (Baizishuang), prepared as honey pills.