陈（右） 久咳根蒂不除，去秋燥气犯肺，咳而失血，金水由此而亏，连绵内热，肉脱形瘦。脉细数而促。理
宜壮水救阴，清金保肺。然舌淡少华，中气薄弱，稠腻之药，不能多进。症入劳损之途，不能许治。勉拟金
匮麦门冬方备质高明。
人参须（另煎冲四分） 云茯苓（四钱） 桑白皮（二钱炙） 甜杏仁（三钱） 川贝母（二钱） 麦冬
（炒去心三钱） 生甘草（三分） 地骨皮（二钱炒） 白粳米（一把煎汤代水） 枇杷叶（去毛四片）
二诊 用金匮麦门冬汤，咳嗽稍减，然清晨依然咳甚。脉细弦数。盖寅卯属木，金病而遇木旺之时，病
势胜矣。药既应手，未便更章。
人参须（五分冲） 生甘草（五分） 茯苓（三钱） 淡芩（炒一钱五分） 地骨皮（二钱） 法半夏（一钱五分）
川贝（炒一钱五分） 桑白皮（二钱） 知母（炒一钱五分） 枇杷叶（去毛四片） 肺露（一两冲）
三诊 神情稍振，胃亦渐起。然咳嗽仍然未定，甚则哕恶欲呕，上午清晨为甚，辰巳之交，往来寒热。脉
细数，舌红苔黄。还是肝肾阴虚，气难摄纳，自下及上，阴阳不能和协。虽略转机，不足为恃。
人参须（一钱） 生扁豆衣（三钱） 桑白皮（二钱炙） 蛤黛散（三钱包） 大麦冬（去心三钱） 霍石斛
（三钱） 代赭石（三钱） 法半夏（一钱五分） 生甘草（四分） 地骨皮（二钱） 茯苓神（各三钱） 粳米
汤代水。
某 金匮云、心下悸者有水气。未病之先，心下先悸，水饮早已停阻，复因感邪，遂起咳嗽，邪虽渐解，三
焦气伤。以致形色淡白，咳恋不止，甚至形寒内热。盖肺为相传，有分布阴阳之职，肺气一虚，阴阳之分
布失其常度，是以寒热往来。金所以制木也，金病则木无所制，所以气撑不和，得矢气则松，肝藏之气，
不能扶苏条达，有可见者。脉象虚弦，舌白少华，苔腻。此伤风激动伏饮，邪去而饮复阻肺，肺气日虚，肝邪日
旺，将成虚损之症。冠翁先生不降肺而和胃平肝，隔一隔二之治，所以卓卓人上。无如病久根深，未克奏效。兹勉从
经旨久咳不已则三焦受之之意，用异功为主。管窥之见，深恐贻笑于方家耳。尚乞斧正是荷。
人参须（一钱） 上广皮（一钱） 炙黑草（五分） 整砂仁（四粒） 茯苓（四钱） 川贝（炒黄二钱）
白芍（土炒一钱五分） 海蛤粉（四钱） 生熟谷芽（各一钱五分）
胡（左） 肺感风邪，邪郁肺卫。以致咳嗽不已，身热连绵。肺合皮毛，肺邪未泄，所以凛凛畏风。因邪致咳，
因咳动络，络损血溢，日前咯血数口，血止而咳逆如前。脉细而数，右寸关微浮。此即伤风成劳是也。咳
因邪起，因咳成劳兹则去其邪而保其正，明知鞭长莫及，然人事不得不尽。备方就质高明。
前胡 象贝 鲜薄荷 桔梗 茯苓 生熟莱菔子
连翘 牛蒡子 杏仁泥 桑叶 梨皮 炒黑丹皮
陈（在） 失血之后，久嗽不止，每交节令，辄复见血，面色桃红，时易怒火，然每至天寒，即恶寒足厥。脉形
沉细而数，颇有促意，其为血去阴伤，龙雷之火不能藏蛰，阴火逆犯，肺降无权。清肺壮水益阴，固属一
定不易之法。然药进百数十剂，未见病退转觉病进。再四思维一身之中，孤阳虽不能生，而独阴断不
能长，坎中之一点，真阳不化，则阴柔之剂不能化水生津，阴无阳化，则得力甚微。意者惟有引导虚阳，
使之潜伏，为万一侥幸之计。拙见然否。
龟甲心（八钱） 粉丹皮（二钱） 大麦冬（去心三钱） 阿胶（蛤粉炒一钱五分） 泽泻（一钱五分） 大生地
（一钱） 萸肉炭（三钱） 西洋参（元米炒三钱） 生熟白芍（各一钱） 上徭桂（研末饭糊丸二分药汁先送下）
二诊 壮水益肾，兼辛温为向导，脉数稍缓，火升之际，足厥转温。但交节仍复见红，龙相之火尚未安静。前方出
入再望转机。
西洋参 川贝母 云茯苓 炙紫菀肉 北五味 牛膝炭
阿胶珠 肥知母 蒲黄炭 牡蛎 太阴元精石 金色莲须
某 痰饮多年，加以病损，损而未复，气弱不运，饮食水谷尽化为痰。以致气喘肿发，两月方定。今神情
痿顿，肢体疲软，吸气则少腹触痛。脉细濡而苔白无华。呼出之气，主心与肺，吸入之气，属肝与肾，一呼
一吸，肺肾相通之道，必有痰阻。诚恐损而不复。
川桂枝 炒苏子 制半夏 浓杜仲 旋复花 生香附
云茯苓 炒牛膝 杏仁泥 蛤壳 广橘红 菟丝子（盐水炒）
朱（左） 先自经络抽掣，继而吐血盈碗，血从脘下上升。今血虽渐定，而呛咳气逆。脉象虚弦。肝肾阴虚，
虚火载血上行，遂至阴不收摄。恐咳不止而致入损。
大生地（四钱） 怀牛膝（盐水炒三钱） 杭白芍（一钱五分） 川贝母（二钱） 磁石（三钱） 青蛤散
（三钱包） 丹皮炭（一钱五分） 淡秋石（一钱五分） 侧柏炭（三钱） 藕节炭（两枚）
二诊 吐血仍未得定，血散鲜赤，食入胀满，气冲作呛。脉象虚弦。阴虚木火上凌，激损肺胃之络，络损
血溢。再降胃凉营止血，参以降气，所谓气降即火降也。
侧柏炭（三钱） 代赭石（ 五钱） 杭白芍（酒炒二钱） 丹皮炭（二钱） 栝蒌仁（五钱研） 上广皮（盐
水炒一钱） 竹茹（水炒三钱） 藕汁（一两冲） 沉香（乳汁磨二分）
（原注） 胃血，血夹水而散。肝血，凝浓外紫内红。心血，细点如针。
郑（右） 由咳嗽而致见红，咳嗽由此更甚，内热连绵，春间复发肛痈，月事由此停阻，心中烦懊，咳甚咽
中微痛。脉细弦而数，舌红心剥。肺肾并损，不能许治。以金水双调法，聊作缓兵之计而已。
北沙参（三钱） 白芍（酒炒二钱） 蛤黛散（四钱包） 女贞子（酒蒸三钱） 炙生地（四钱） 茯神（三钱）
川贝母（去心二钱） 生山药（三钱） 枇杷叶（去毛炙三钱） 都气丸（四钱开水分二次服）
二诊 脉稍柔缓，内热略减，咽痛亦轻，胃气稍振。然咳嗽时轻时重。金水并损，何能遽复。姑踵效方以观其后。
大生地 生甘草 蛤黛散 川贝母 云茯苓 大天冬 生山药 杭白芍 扁豆 都气丸
三诊 内热咳嗽降序，胃气渐振，纳食之后，胸脘亦舒，足见冲气逆上，则胸中必致填塞。滋养之剂在所必进。
大生地（四钱） 天冬（三钱） 白芍（酒炒二钱） 海蛤壳（五钱打） 云茯苓（三钱） 阿胶珠（二钱）
生甘草（三分） 山药（三钱） 生扁豆（三钱） 川贝母（一钱五分） 怀牛膝（盐水炒三钱） 都气丸（五钱分二
次
服）
四诊 饮食渐增，适交节令，咳仍轻减，时带恶心。肺肾并虚，中气亦弱，盖中气下根于肾，自必此响而
彼应也。前法参以补气。
大生地（四钱） 阿胶珠（二钱） 川贝（二钱） 党参（二钱） 茯苓（三钱） 蛤壳（五钱）
炙甘草（三分） 怀牛膝（盐水炒三钱） 生扁豆（三钱研） 白芍（酒蒸一钱五分）
五诊 肺肾并调，兼养肝阴，呛咳降序，呕恶未止。药既应手，宜再扩充。
奎党参（三钱） 生熟甘草（各三分） 杭白芍（一钱五分） 怀牛膝（盐水炒三钱） 白茯苓（三钱） 蛤黛散
（三钱包） 大麦冬（去心三钱） 大生地（四钱） 川贝母（二钱） 款冬花（二钱） 车前子（三钱） 生山药（三
钱）
六诊 脾肺肾三脏并亏，脾不能运则生痰，肺不能降则呛咳，肾不能收则气逆，虚损不复，痛泄咽疼
诸恙，时轻时重。脉数细急。聊望缓兵耳。
麦冬（三钱） 生甘草（六分） 扁豆衣（三钱炒） 生山药（三钱） 阿胶珠（三钱） 桔梗（三分）
白芍（二钱） 川贝母（二钱） 木瓜皮（炒一钱五分） 八仙长寿丸（四钱）
周（左） 温胆以致开合，形寒已退。而气阴并亏，咳嗽痰多，左胁肋气觉上逆。脉细，关弦。一派虚损情形，
不敢许治也。
奎党参（二钱） 制半夏（一钱五分） 怀牛膝（三钱炒） 竹茹（水炒一钱） 广橘红（一钱） 白茯苓（三钱）
海蛤粉（三钱包） 川贝母（二钱） 金水六君丸（三钱开水先送下）
二诊 痰渐减少，咳亦退轻。然稍一举动，仍然气逆。下虚不摄，难许稳妥。
大生地（砂仁炙四钱） 紫蛤壳（五钱） 补骨脂（盐水炒二钱） 云茯苓（三钱） 牛膝炭（三钱） 菟丝子（盐
水炒三钱） 山药（三钱炒） 川贝母（一钱五分） 杞子（三钱） 紫衣胡桃肉（研细过药）
李（左） 肝肾阴虚于下，嗜饮肺损于上，虚火上凌，曾吐紫黑浓血。今于秋燥行令，更起呛咳。金水两伤，恐入
损途。
阿胶珠（三钱） 白芍（酒炒一钱五分） 蛤黛散（三钱包） 金石斛（三钱） 丹皮炭（一钱五分） 大生地（四
钱） 川贝母（三钱） 生山药（三钱） 女贞子（酒蒸一钱五分） 枇杷叶（去毛炙四片）
二诊 呛咳稍减，脉亦稍缓。药既应手，再为扩充。
北沙参（四钱） 大生地（四钱） 川贝母（二钱） 女贞子（三钱） 生山药（三钱） 阿胶珠（二钱）
大天冬（三钱） 蛤黛散（三钱包） 白薇（炒一钱五分） 白芍（酒炒一钱五分） 枇杷叶（去净毛蜜炙四片）
三诊 呛咳已止。再金水并调。
党参（二钱） 川贝（二钱） 生山药（三钱） 海蛤粉（三钱包） 橘红（盐水炒一钱） 于术（炒一钱五分）
白茯苓（三钱） 生熟甘草（各二分） 金水六君丸（四钱开水二次分服）
又膏方 阴分素亏，嗜饮激动阳气，肝肾之血，随火上逆，曾吐紫黑浓血，由此顿然消瘦。兹于秋燥行
令，忽起呛咳，数月不止。投金水双调，呛咳竟得渐定，其为虚火凌上烁金显然。脉细而数，舌苔黄糙。真
阴安能遽复。培养下元，更须保养，或可徐徐复元耳。
大生地（三两） 奎党参（三两） 真川贝（去心一两） 生牡蛎（四两） 麦冬（二两） 大熟地（五两）
西洋参（二两制） 金石斛（劈开一两） 杭白芍（酒炒一两五钱） 生熟甘草（合一两） 甘杞子（三两炒） 茯苓
神（各一两） 紫蛤壳（六两） 女贞子（酒炒三两） 肥玉竹（二两） 浓杜仲（二两） 天冬（一两） 生山药（二
两） 当归炭（一两五钱） 冬虫夏草（八钱） 炒萸肉（一两五钱） 潼沙苑（盐水炒三钱） 建泽泻（盐水炒二两）
五味子（蜜炙七钱） 粉丹皮（一两五钱炒） 牛膝炭（三两） 甜杏仁（二两打）
上药如法宽水煎三次，再煎极浓，用真阿胶三两，龟板胶二两，鱼鳔胶二两，溶化冲入收膏。每晨服
大半调羹，下午服小半调羹，俱以开水冲挑。
胡（左） 伤风夹湿，而致损肺。咳嗽不已，痰色稠黄，不时见红。兹则痰血日甚，脉数内热，肛门漏管。此阴
虚挟湿，湿热熏蒸，肺胃之络，为之所损，痿损情形，聊作缓兵之计而已。
赤白苓 海浮石 冬瓜子 青蛤散 栝蒌霜 建泽泻
生米仁 光杏仁 盐水炒竹茹 藕节 青芦管
二诊 带病经营，阳气内动，肝火凌金。咳甚带红，深入重地。急宜安营以循阳动阴静之道。
北沙参 丹皮炭 川石斛 炙桑皮 琼王膏（冲） 炒麦冬 青蛤散 冬瓜子 川贝母
三诊 痰红虽减于前，而咽中隐隐作痛。咽喉虽属肺胃，而少阴之脉系舌本循喉咙，则是咽痛一层，
其标在肺，其本在肾也。肾为先天之本，恐非草木之功，所能挽狂澜于既倒也。
阿胶珠（二钱） 青蛤散（五钱） 北沙参（五钱） 猪肤（煎去沫冲一钱五分） 鸡子黄（一枚） 炙
生地（四钱） 白蜜（一匙） 白粳米（炒黄一钱五分）
四诊 虚火上炎，咽中碎痛，卧不能寐。而时令之湿，侵侮脾土，以致似痢不止。急者先治之。
砂仁（盐水炒） 生熟米仁 煨木香 生冬术 连皮苓 建泽泻 炒扁豆衣 炒莲子
吴（左） 经云、面肿曰风，足胫肿曰水。先是足肿，其为湿热可知。乃久久方退。足肿甫退于下，咳嗽即起
于上，痰色带黄，稠多稀少，未几即见吐血。此时湿热未清，风邪外乘，所以风邪易入难出，为其湿之相
持也。邪湿久滞，咳而损络，络血外溢。迨血去之后，阴分大伤，遂令金水不能相生咳不得止。兹则声音
雌喑，咽痛内热，所吐之痰，黄稠居多。脉细数有急促之意，而右关尚觉弦滑。所有风邪，悉化为火，肾水
日亏，肺金日损，胃中之湿热，参杂于中，熏蒸于上。深恐咽痛日甚，才疏者不能胜任也。
光杏仁 冬瓜子 青蛤散 生薏仁 枇杷叶 黑元参 炙桑皮 蝉衣 茯苓 青芦管 水炒竹茹
二诊 风湿热相合，熏蒸损肺。前方引导湿热下行，缓其熏蒸之炎，即所以救其阴液之耗损。脉症尚
属相安姑踵前意，以尽人力。
北沙参 赤白苓 生米仁 青蛤散 鲜竹茹 光杏仁 黑元参 金石斛 冬瓜子 青芦管 生鸡子黄（冲） 枇杷
叶
三诊（悬拟） 湿热化燥伤阴，而致虚火上炎。症属难治，务即就正高明。
【患者陈（右）】久咳病根未除，去年秋季燥气侵犯肺脏，导致咳嗽并咯血，致使肺金与肾水由此亏损，出现连绵不断的内热，肌肉消瘦、形体枯瘦。脉象细数且急促。治疗应当壮水滋阴，清润肺金以保肺。然而舌色淡白缺乏光泽，中焦脾胃之气薄弱，过于滋腻的药物不能多服。病症已陷入虚劳损耗的范畴，难以承诺治愈。勉强拟定《金匮要略》中的麦门冬汤方，供高明人士审阅。
人参须（另煎后冲服四分） 云茯苓（四钱） 桑白皮（二钱，炙） 甜杏仁（三钱） 川贝母（二钱） 麦冬（炒去心三钱） 生甘草（三分） 地骨皮（二钱，炒） 白粳米（一把，煎汤代水） 枇杷叶（去毛四片）
二诊：服用《金匮》麦门冬汤后，咳嗽稍减，但清晨依然咳嗽剧烈。脉象细弦而数。盖因寅时、卯时属木，肺金有病而遇到木旺之时，病势加重。既然药已见效，不便更改处方。
人参须（五分冲服） 生甘草（五分） 茯苓（三钱） 黄芩（炒一钱五分） 地骨皮（二钱） 法半夏（一钱五分） 川贝母（炒一钱五分） 桑白皮（二钱） 知母（炒一钱五分） 枇杷叶（去毛四片） 肺露（一两冲服）
三诊：神情稍见振奋，胃气也逐渐恢复。然而咳嗽仍未稳定，严重时呃逆恶心欲呕，上午清晨尤为严重，辰时与巳时之间，出现往来寒热。脉象细数，舌红苔黄。仍是肝肾阴虚，气难摄纳，自下而上，阴阳不能和谐。虽然略有转机，不足以依赖。
人参须（一钱） 生扁豆衣（三钱） 桑白皮（二钱，炙） 蛤黛散（三钱包煎） 大麦冬（去心三钱） 霍山石斛（三钱） 代赭石（三钱） 法半夏（一钱五分） 生甘草（四分） 地骨皮（二钱） 茯神（各三钱） 粳米汤代水。
【某患者】《金匮要略》说：心下悸动是有水气。在发病之前，心下先感到悸动，说明水饮早已停聚阻滞，又因感受外邪，于是引发咳嗽。邪气虽逐渐解除，但三焦之气受损。导致面色和形体淡白，咳嗽缠绵不止，甚至出现怕冷而内部发热。肺作为传化之官，有分布阴阳的职责，肺气一旦虚弱，阴阳的分布就失去常度，因此出现寒热往来。金本应克制木，金病则木无所制，所以气机撑胀不和，排气后则舒缓，这是肝藏之气不能舒展条达的表现。脉象虚弦，舌白少光泽，苔腻。这是伤风激动了伏留的水饮，邪气去除而水饮再次阻滞于肺，肺气日益虚弱，肝邪日益旺盛，将形成虚损病症。冠翁先生不直接降肺，而是通过调和胃气和平抑肝气来治疗，这种隔一隔二的治法，所以卓绝过人。无奈病程长久，病根深固，未能奏效。现在勉强遵循经旨“久咳不已则三焦受之”的意思，以异功散为主方。管窥之见，深恐被行家嘲笑。恳请斧正为荷。
人参须（一钱） 上广陈皮（一钱） 炙黑甘草（五分） 整砂仁（四粒） 茯苓（四钱） 川贝母（炒黄二钱） 白芍（土炒一钱五分） 海蛤粉（四钱） 生熟谷芽（各一钱五分）
【胡（左）】肺感风邪，邪气郁闭于肺卫。导致咳嗽不止，身体发热连绵不断。肺合皮毛，肺邪未泄，所以凛凛畏风。因邪气导致咳嗽，因咳嗽损伤络脉，络损血溢，日前咯出数口血，血止后咳嗽如前。脉象细而数，右寸关微浮。这就是伤风成劳的病证。咳嗽因邪而起，因咳而成劳，此时则去除邪气以保护正气，明知鞭长莫及，但人事不得不尽力。备方就请高明人士指正。
前胡 象贝母 鲜薄荷 桔梗 茯苓 生熟莱菔子
连翘 牛蒡子 杏仁泥 桑叶 梨皮 炒黑丹皮
【陈（在）】失血之后，久嗽不止，每逢节气交替，辄复发咯血，面色桃红，时常易怒发火，然而每到天寒，即恶寒且足部厥冷。脉形沉细而数，颇有急促之意，此为失血导致阴伤，龙雷之火不能潜藏蛰伏，阴火逆犯，肺下降功能无权。清肺壮水益阴，固然是确定不移的方法。然而服药百数十剂，未见病退反而觉病进。再四思考，一身之中，孤阳虽不能独生，但独阴也绝不能独长，坎宫中的一点点真阳若不化气，则阴柔之剂不能化水生津，阴无阳气转化，则效力甚微。意者唯有引导虚阳，使其潜伏，作为万一侥幸成功的计划。拙见是否如此？
龟甲心（八钱） 粉丹皮（二钱） 大麦冬（去心三钱） 阿胶（蛤粉炒一钱五分） 泽泻（一钱五分） 大生地（一钱） 萸肉炭（三钱） 西洋参（元米炒三钱） 生熟白芍（各一钱） 上徭桂（研末饭糊丸二分，药汁先送下）
二诊：壮水益肾，兼用辛温作为向导，脉数稍缓，火升之际，足部厥冷转为温暖。但交节令时仍复见咯血，龙相之火尚未安静。前方出入变化，再望转机。
西洋参 川贝母 云茯苓 炙紫菀肉 北五味子 牛膝炭
阿胶珠 肥知母 蒲黄炭 牡蛎 太阴元精石 金色莲须
【某患者】痰饮多年，加上病损，损而未复，气弱不运，饮食水谷尽化为痰。导致气喘浮肿发作，两个月才安定。如今神情萎靡困顿，肢体疲软，吸气则少腹触痛。脉细濡而苔白无光泽。呼出的气，由心与肺主司；吸入的气，属肝与肾。一呼一吸，是肺肾相通的道路，必有痰阻。诚恐损伤而不能恢复。
川桂枝 炒苏子 制半夏 浓杜仲 旋复花 生香附
云茯苓 炒牛膝 杏仁泥 蛤壳 广橘红 菟丝子（盐水炒）
【朱（左）】先前从经络出现抽掣，继而吐血盈碗，血从脘下上升。如今血虽渐定，但呛咳气逆。脉象虚弦。肝肾阴虚，虚火载血上行，遂至阴液不收摄。恐咳嗽不止而导致进入虚损阶段。
大生地（四钱） 怀牛膝（盐水炒三钱） 杭白芍（一钱五分） 川贝母（二钱） 磁石（三钱） 青蛤散（三钱包煎） 丹皮炭（一钱五分） 淡秋石（一钱五分） 侧柏炭（三钱） 藕节炭（两枚）
二诊：吐血仍未得定，血液散开呈鲜红色，食入胀满，气冲作呛。脉象虚弦。阴虚木火上凌，激损肺胃之络，络损血溢。再降胃凉营止血，参以降气，所谓气降即火降也。
侧柏炭（三钱） 代赭石（五钱） 杭白芍（酒炒二钱） 丹皮炭（二钱） 栝蒌仁（五钱研碎） 上广陈皮（盐水炒一钱） 竹茹（水炒三钱） 藕汁（一两冲服） 沉香（乳汁磨二分）
（原注）：胃血，血夹水而散。肝血，凝浓外紫内红。心血，细点如针。
【郑（右）】由咳嗽而导致见红，咳嗽由此更甚，内热连绵，春季间复发肛痈，月事由此停阻，心中烦闷懊恼，咳甚咽中微痛。脉细弦而数，舌红心剥（地图舌）。肺肾并损，难以承诺治愈。以金水双调法，聊作缓兵之计而已。
北沙参（三钱） 白芍（酒炒二钱） 蛤黛散（四钱包煎） 女贞子（酒蒸三钱） 炙生地（四钱） 茯神（三钱） 川贝母（去心二钱） 生山药（三钱） 枇杷叶（去毛炙三钱） 都气丸（四钱开水分二次服）
二诊：脉稍柔缓，内热略减，咽痛亦轻，胃气稍振。然咳嗽时轻时重。金水并损，何能遽复。姑循有效方以观其后。
大生地 生甘草 蛤黛散 川贝母 云茯苓 大天冬 生山药 杭白芍 扁豆 都气丸
三诊：内热咳嗽降序，胃气渐振，纳食之后，胸脘亦舒，足见冲气逆上，则胸中必致填塞。滋养之剂在所必进。
大生地（四钱） 天冬（三钱） 白芍（酒炒二钱） 海蛤壳（五钱打碎） 云茯苓（三钱） 阿胶珠（二钱） 生甘草（三分） 山药（三钱） 生扁豆（三钱） 川贝母（一钱五分） 怀牛膝（盐水炒三钱） 都气丸（五钱分二次服）
四诊：饮食渐增，适交节令，咳仍轻减，时带恶心。肺肾并虚，中气亦弱，盖中气下根于肾，自必此响而彼应也。前法参以补气。
大生地（四钱） 阿胶珠（二钱） 川贝（二钱） 党参（二钱） 茯苓（三钱） 蛤壳（五钱） 炙甘草（三分） 怀牛膝（盐水炒三钱） 生扁豆（三钱研碎） 白芍（酒蒸一钱五分）
五诊：肺肾并调，兼养肝阴，呛咳降序，呕恶未止。药既应手，宜再扩充。
奎党参（三钱） 生熟甘草（各三分） 杭白芍（一钱五分） 怀牛膝（盐水炒三钱） 白茯苓（三钱） 蛤黛散（三钱包煎） 大麦冬（去心三钱） 大生地（四钱） 川贝母（二钱） 款冬花（二钱） 车前子（三钱） 生山药（三钱）
六诊：脾肺肾三脏并亏，脾不能运则生痰，肺不能降则呛咳，肾不能收则气逆，虚损不复，痛泄咽疼诸恙，时轻时重。脉数细急。聊望缓兵耳。
麦冬（三钱） 生甘草（六分） 扁豆衣（三钱炒） 生山药（三钱） 阿胶珠（三钱） 桔梗（三分） 白芍（二钱） 川贝母（二钱） 木瓜皮（炒一钱五分） 八仙长寿丸（四钱）
【周（左）】温胆以致开合，形寒已退。而气阴并亏，咳嗽痰多，左胁肋气觉上逆。脉细，关弦。一派虚损情形，不敢许治也。
奎党参（二钱） 制半夏（一钱五分） 怀牛膝（三钱炒） 竹茹（水炒一钱） 广橘红（一钱） 白茯苓（三钱） 海蛤粉（三钱包煎） 川贝母（二钱） 金水六君丸（三钱开水先送下）
二诊：痰渐减少，咳亦退轻。然稍一举动，仍然气逆。下虚不摄，难许稳妥。
大生地（砂仁炙四钱） 紫蛤壳（五钱） 补骨脂（盐水炒二钱） 云茯苓（三钱） 牛膝炭（三钱） 菟丝子（盐水炒三钱） 山药（三钱炒） 川贝母（一钱五分） 杞子（三钱） 紫衣胡桃肉（研细过药）
【李（左）】肝肾阴虚于下，嗜饮肺损于上，虚火上凌，曾吐紫黑浓血。今于秋燥行令，更起呛咳。金水两伤，恐入损途。
阿胶珠（三钱） 白芍（酒炒一钱五分） 蛤黛散（三钱包煎） 金石斛（三钱） 丹皮炭（一钱五分） 大生地（四钱） 川贝母（三钱） 生山药（三钱） 女贞子（酒蒸一钱五分） 枇杷叶（去毛炙四片）
二诊：呛咳稍减，脉亦稍缓。药既应手，再为扩充。
北沙参（四钱） 大生地（四钱） 川贝母（二钱） 女贞子（三钱） 生山药（三钱） 阿胶珠（二钱） 大天冬（三钱） 蛤黛散（三钱包煎） 白薇（炒一钱五分） 白芍（酒炒一钱五分） 枇杷叶（去净毛蜜炙四片）
三诊：呛咳已止。再金水并调。
党参（二钱） 川贝（二钱） 生山药（三钱） 海蛤粉（三钱包煎） 橘红（盐水炒一钱） 于术（炒一钱五分） 白茯苓（三钱） 生熟甘草（各二分） 金水六君丸（四钱开水二次分服）
又膏方：阴分素亏，嗜饮激动阳气，肝肾之血，随火上逆，曾吐紫黑浓血，由此顿然消瘦。兹于秋燥行令，忽起呛咳，数月不止。投金水双调，呛咳竟得渐定，其为虚火凌上烁金显然。脉细而数，舌苔黄糙。真阴安能遽复。培养下元，更须保养，或可徐徐复元耳。
大生地（三两） 奎党参（三两） 真川贝（去心一两） 生牡蛎（四两） 麦冬（二两） 大熟地（五两） 西洋参（二两制） 金石斛（劈开一两） 杭白芍（酒炒一两五钱） 生熟甘草（合一两） 甘杞子（三两炒） 茯苓神（各一两） 紫蛤壳（六两） 女贞子（酒炒三两） 肥玉竹（二两） 浓杜仲（二两） 天冬（一两） 生山药（二两） 当归炭（一两五钱） 冬虫夏草（八钱） 炒萸肉（一两五钱） 潼沙苑（盐水炒三钱） 建泽泻（盐水炒二两） 五味子（蜜炙七钱） 粉丹皮（一两五钱炒） 牛膝炭（三两） 甜杏仁（二两打）
上药如法宽水煎三次，再煎极浓，用真阿胶三两，龟板胶二两，鱼鳔胶二两，溶化冲入收膏。每晨服大半调羹，下午服小半调羹，俱以开水冲挑。
【胡（左）】伤风夹湿，而致损肺。咳嗽不已，痰色稠黄，不时见红。兹则痰血日甚，脉数内热，肛门漏管。此阴虚挟湿，湿热熏蒸，肺胃之络，为之所损，痿损情形，聊作缓兵之计而已。
赤白苓 海浮石 冬瓜子 青蛤散 栝蒌霜 建泽泻
生米仁 光杏仁 盐水炒竹茹 藕节 青芦管
二诊：带病经营，阳气内动，肝火凌金。咳甚带红，深入重地。急宜安营以循阳动阴静之道。
北沙参 丹皮炭 川石斛 炙桑皮 琼王膏（冲服） 炒麦冬 青蛤散 冬瓜子 川贝母
三诊：痰红虽减于前，而咽中隐隐作痛。咽喉虽属肺胃，而少阴之脉系舌本循喉咙，则是咽痛一层，其标在肺，其本在肾也。肾为先天之本，恐非草木之功，所能挽狂澜于既倒也。
阿胶珠（二钱） 青蛤散（五钱） 北沙参（五钱） 猪肤（煎去沫冲服一钱五分） 鸡子黄（一枚） 炙生地（四钱） 白蜜（一匙） 白粳米（炒黄一钱五分）
四诊：虚火上炎，咽中碎痛，卧不能寐。而时令之湿，侵侮脾土，以致似痢不止。急者先治之。
砂仁（盐水炒） 生熟米仁 煨木香 生冬术 连皮苓 建泽泻 炒扁豆衣 炒莲子
【吴（左）】经云：面肿曰风，足胫肿曰水。先是足肿，其为湿热可知。乃久久方退。足肿甫退于下，咳嗽即起于上，痰色带黄，稠多稀少，未几即见吐血。此时湿热未清，风邪外乘，所以风邪易入难出，为其湿之相持也。邪湿久滞，咳而损络，络血外溢。迨血去之后，阴分大伤，遂令金水不能相生咳不得止。兹则声音雌喑，咽痛内热，所吐之痰，黄稠居多。脉细数有急促之意，而右关尚觉弦滑。所有风邪，悉化为火，肾水日亏，肺金日损，胃中之湿热，参杂于中，熏蒸于上。深恐咽痛日甚，才疏者不能胜任也。
光杏仁 冬瓜子 青蛤散 生薏仁 枇杷叶 黑元参 炙桑皮 蝉衣 茯苓 青芦管 水炒竹茹
二诊：风湿热相合，熏蒸损肺。前方引导湿热下行，缓其熏蒸之炎，即所以救其阴液之耗损。脉症尚属相安姑踵前意，以尽人力。
北沙参 赤白苓 生米仁 青蛤散 鲜竹茹 光杏仁 黑元参 金石斛 冬瓜子 青芦管 生鸡子黄（冲服） 枇杷叶
[Patient Chen (Right)] The root of chronic cough has not been eliminated. Last autumn, dryness qi invaded the Lung, causing cough and hemoptysis, thereby depleting Metal (Lung) and Water (Kidney). This led to continuous internal heat, emaciation, and thinness. The pulse is fine, rapid, and hurried. Treatment should strengthen Water to save Yin, clear Metal to protect the Lung. However, the tongue is pale and lacks luster, indicating weak Middle Qi; heavy and greasy medicines cannot be taken in large amounts. The condition has entered the realm of consumptive disease (Lao Sun), and a cure cannot be promised. I tentatively prescribe the Maidong Decoction from *Jin Gui Yao Lue* for the review of experts.
Ginseng Radicula (decocted separately, taken with infusion: 4 fen) Cloud Poria (4 qian) Mulberry Root Bark (2 qian, stir-baked) Sweet Almond (3 qian) Sichuan Fritillaria Bulb (2 qian) Ophiopogon Tuber (stir-baked, heart removed, 3 qian) Raw Licorice Root (3 fen) Groundcherry Root Bark (2 qian, stir-baked) White Rice (a handful, decocted to replace water) Loquat Leaf (hairs removed, 4 leaves)
Second visit: After taking the Maidong Decoction from *Jin Gui*, the cough decreased slightly, but it remains severe in the early morning. The pulse is fine, wiry, and rapid. Yin and Mao hours correspond to Wood. When Metal is diseased and encounters the time of flourishing Wood, the pathogenic force prevails. Since the medicine has responded well, there is no need to change the prescription.
Ginseng Radicula (taken with infusion: 5 fen) Raw Licorice Root (5 fen) Poria (3 qian) Scutellaria Root (stir-baked, 1.5 qian) Groundcherry Root Bark (2 qian) Processed Pinellia Tuber (1.5 qian) Sichuan Fritillaria Bulb (stir-baked, 1.5 qian) Mulberry Root Bark (2 qian) Anemarrhena Rhizome (stir-baked, 1.5 qian) Loquat Leaf (hairs removed, 4 leaves) Pulmonary Dew (taken with infusion: 1 liang)
Third visit: Mental spirit has slightly revived, and Stomach Qi is gradually recovering. However, the cough is still unstable; when severe, there is hiccups, nausea, and desire to vomit, especially in the early morning. Between Chen and Si hours, there are alternating chills and fever. The pulse is fine and rapid; the tongue is red with yellow coating. This is still Liver-Kidney Yin deficiency, with Qi failing to grasp and receive, moving from below upwards, preventing Harmony between Yin and Yang. Although there is a slight turning point, it is not reliable.
Ginseng Radicula (1 qian) Raw Coix Seed Husk (3 qian) Mulberry Root Bark (2 qian, stir-baked) Clam-Calcium Powder (3 qian, wrapped for decoction) Large Ophiopogon Tuber (heart removed, 3 qian) Huoshan Dendrobium Stem (3 qian) Hematite (3 qian) Processed Pinellia Tuber (1.5 qian) Raw Licorice Root (4 fen) Groundcherry Root Bark (2 qian) Poria and Spirit of Poria (each 3 qian) Rice soup to replace water.
[Another Patient] *Jin Gui Yao Lue* states: Palpitations under the heart indicate the presence of fluid retention. Before the illness began, palpitations under the heart occurred first, indicating that fluid retention had already stagnated. Subsequently, due to pathogenic invasion, cough arose. Although the pathogen has gradually resolved, the Qi of the Triple Burner is damaged. This leads to pale complexion and body, lingering cough, and even feeling cold externally while having internal heat. The Lung acts as a transmitting organ, responsible for distributing Yin and Yang. When Lung Qi is deficient, the distribution of Yin and Yang loses its normal measure, resulting in alternating chills and fever. Metal should control Wood; if Metal is diseased, Wood is uncontrolled, causing Qi distension and disharmony. Relief after passing gas indicates that the Qi stored in the Liver fails to flourish and flow freely. The pulse is deficient and wiry; the tongue is white, lacking luster, with a greasy coating. This is wind-cold stimulating latent fluid retention; after the pathogen leaves, fluid retention again obstructs the Lung. Lung Qi becomes increasingly deficient, while Liver pathogen becomes increasingly vigorous, likely leading to consumptive disease. Mr. Guan treated by harmonizing the Stomach and calming the Liver rather than directly descending Lung Qi. This "treating one step away" method is excellent. However, the disease is long-standing and rooted deeply, so efficacy was not achieved. Now, following the classic principle that "prolonged cough affects the Triple Burner," I use Yigong San as the main formula. My humble opinion may be laughed at by experts. I request your correction.
Ginseng Radicula (1 qian) Upper Guang Tangerine Peel (1 qian) Stir-baked Black Licorice Root (5 fen) Whole Amomum Fruit (4 grains) Poria (4 qian) Sichuan Fritillaria Bulb (stir-fried yellow, 2 qian) White Peony Root (soil-stir-fried, 1.5 qian) Sea Clam Powder (4 qian) Raw and Cooked Millet Sprout (each 1.5 qian)
[Hu (Left)] The Lung is affected by wind pathogen, which stagnates in the Lung-Wei. This causes persistent cough and continuous low-grade fever. The Lung governs the skin and hair; since Lung pathogen is not released, there is aversion to wind. Cough caused by pathogen damages collaterals, leading to blood leakage. A few days ago, several mouthfuls of blood were expectorated. After bleeding stopped, coughing against the Qi resumed. The pulse is fine and rapid; the Right Cun and Guan positions are slightly floating. This is wind-cold transforming into consumptive disease. Cough starts from pathogen, and through coughing, transforms into consumption. At this stage, we eliminate the pathogen to protect the healthy Qi. Knowing it is beyond our capacity, we must do our best. Here is the prescription for expert review.
Peucedanum Root (Qianhu) Xiangbei Mother Fresh Mint Perilla Stem Licorice Root Raw and Cooked Radish Seed
Forsythia Fruit Bullfruit Seed Almond Paste Mulberry Leaf Pear Skin Stir-baked Black Moutan Cortex
[Chen (Zai)] After hemoptysis, chronic cough persists. Every time solar terms change, bleeding recurs. The face is peach-red, and anger flares easily. However, when it gets cold, there is aversion to cold and cold feet. The pulse is deep, fine, and rapid, with a hurried quality. This indicates Yin injury from blood loss, with Dragon-Li Fire failing to hide and settle. Yin fire rebels upward, and Lung descent is powerless. Clearing Lung, strengthening Water, and benefiting Yin is indeed an immutable method. However, after taking over a hundred doses, the disease did not recede but worsened. Thinking carefully, solitary Yang cannot generate alone, nor can solitary Yin grow alone. If the true Yang in Kan does not transform, Yin-nourishing agents cannot transform water to generate fluids. Without Yang transformation, Yin benefits little. Perhaps only by guiding deficient Yang to submerge can we hope for a miracle. Is my view correct?
Tortoise Plastron Heart (8 qian) Powdered Moutan Cortex (2 qian) Large Ophiopogon Tuber (heart removed, 3 qian) Donkey-hide Gelatin (stir-fried with clam powder, 1.5 qian) Alisma Rhizome (1.5 qian) Large Rehmannia Root (1 qian) Cornus Fruit Charcoal (3 qian) American Ginseng (stir-fried with Yuanmi rice, 3 qian) Raw and Cooked White Peony Root (each 1 qian) Shangyao Cinnamon Bark (powdered, pill-shaped with rice paste, 2 fen, taken first with medicine juice)
Second visit: Strengthening Water and benefiting Kidney, combined with acrid-warm guidance, the rapid pulse slowed slightly. During the rise of fire, foot coldness turned warm. But upon changing solar terms, bleeding recurs, and Dragon-Xiang fire is not yet calm. Adjusting the previous prescription, hoping for a turning point.
American Ginseng Sichuan Fritillaria Bulb Cloud Poria Stir-baked Aster Root Northern Schisandra Berry Achyranthes Bidentata Charcoal
Donkey-hide Gelatin Pearl Fat Anemarrhena Rhizome Lychee Seed Charcoal Oyster Shell Taiyin Yuanjing Stone Golden Lotus Stamen
[Another Patient] Phlegm-fluid retention for many years, compounded by damage, incomplete recovery. Weak Qi fails to transport, causing food and drink to transform entirely into phlegm. This leads to asthma and edema, resolving only after two months. Now mental spirit is listless, limbs are weak, and inhalation causes lower abdominal pain. The pulse is fine and soggy; the tongue is white and lusterless. Exhaled air is governed by Heart and Lung; inhaled air belongs to Liver and Kidney. One exhalation and one inhalation constitute the pathway connecting Lung and Kidney; there must be phlegm obstruction. Fear that damage will not recover.
Sichuan Cinnamon Twig Stir-fried Perilla Seed Processed Pinellia Tuber Thick Eucommia Bark Inula Flower Raw Cyperus Rhizome
Cloud Poria Stir-fried Achyranthes Root Almond Paste Clam Shell Broad Orange Peel Dodder Seed (stir-fried with salt water)
[Zhu (Left)] Initially, spasms in the meridians, followed by vomiting a bowlful of blood rising from below the epigastrium. Now blood has stabilized, but there is choking cough and rebellious Qi. The pulse is deficient and wiry. Liver-Kidney Yin deficiency, with deficient fire carrying blood upward, failing to contain Yin. Fear that persistent cough will lead to consumption.
Large Rehmannia Root (4 qian) Huai Achyranthes Root (stir-fried with salt water, 3 qian) Hangzhou White Peony Root (1.5 qian) Sichuan Fritillaria Bulb (2 qian) Magnetite (3 qian) Green Clam Powder (3 qian, wrapped) Moutan Cortex Charcoal (1.5 qian) Light Autumn Stone (1.5 qian) Biota Tops Charcoal (3 qian) Lotus Node Charcoal (2 pieces)
Second visit: Hemoptysis still not stabilized; blood is scattered and bright red. Fullness after eating, Qi rushing causing choking. Pulse is deficient and wiry. Yin deficiency with Wood fire harassing metal, damaging Lung-Stomach collaterals, causing blood leakage. Descend Stomach, cool Ying, stop bleeding, combined with descending Qi. As said, descending Qi descends fire.
Biota Tops Charcoal (3 qian) Hematite (5 qian) Hangzhou White Peony Root (wine-stir-fried, 2 qian) Moutan Cortex Charcoal (2 qian) Trichosanthes Seed (5 qian, crushed) Upper Guang Tangerine Peel (salt-water stir-fried, 1 qian) Bamboo Shavings (water-stir-fried, 3 qian) Lotus Juice (taken with infusion: 1 liang) Agarwood (ground with milk, 2 fen)
(Original Note): Stomach blood is mixed with water and scattered. Liver blood is thick, purple outside and red inside. Heart blood is like fine needle points.
[Zheng (Right)] Cough led to hemoptysis, making cough worse. Continuous internal heat. In spring, anal abscess recurred, causing menstrual obstruction. Restlessness and irritability in the chest. Severe cough causes slight throat pain. Pulse is fine, wiry, and rapid; tongue is red with peeling (geographic tongue). Lung and Kidney both damaged; cure cannot be promised. Using the method of dual regulation of Metal and Water as a temporary delaying tactic.
Northern Glehnia Root (3 qian) White Peony Root (wine-stir-fried, 2 qian) Clam-Calcium Powder (4 qian, wrapped) Glossy Privet Fruit (wine-steamed, 3 qian) Stir-baked Rehmannia Root (4 qian) Spirit of Poria (3 qian) Sichuan Fritillaria Bulb (heart removed, 2 qian) Raw Chinese Yam (3 qian) Loquat Leaf (hairs removed, stir-baked, 3 qian) Duqi Pill (4 qian, taken with water in two doses)
Second visit: Pulse slightly softer and slower; internal heat slightly reduced; throat pain lighter; Stomach Qi slightly revived. However, cough fluctuates. With both Metal and Water damaged, how can recovery be sudden? Temporarily follow the effective prescription to observe further.
Large Rehmannia Root Raw Licorice Root Clam-Calcium Powder Sichuan Fritillaria Bulb Cloud Poria Large Asparagus Tuber Raw Chinese Yam Hangzhou White Peony Root Coix Seed Duqi Pill
Third visit: Internal heat and cough have subsided; Stomach Qi gradually revived. After eating, chest and epigastrium feel comfortable, showing that rebellious Qi from Chong vessel causes chest fullness. Nourishing agents are necessary.
Large Rehmannia Root (4 qian) Asparagus Tuber (3 qian) White Peony Root (wine-stir-fried, 2 qian) Sea Clam Shell (5 qian, crushed) Cloud Poria (3 qian) Donkey-hide Gelatin Pearl (2 qian) Raw Licorice Root (3 fen) Chinese Yam (3 qian) Raw Coix Seed (3 qian) Sichuan Fritillaria Bulb (1.5 qian) Huai Achyranthes Root (stir-fried with salt water, 3 qian) Duqi Pill (5 qian, divided into two doses)
Fourth visit: Food intake gradually increases. Upon changing solar terms, cough lightens slightly, sometimes with nausea. Lung and Kidney both deficient, Middle Qi also weak. Middle Qi roots in Kidney, so they respond to each other. Previous method combined with tonifying Qi.
Large Rehmannia Root (4 qian) Donkey-hide Gelatin Pearl (2 qian) Sichuan Fritillaria Bulb (2 qian) Codonopsis Root (2 qian) Poria (3 qian) Clam Shell (5 qian) Stir-baked Licorice Root (3 fen) Huai Achyranthes Root (stir-fried with salt water, 3 qian) Raw Coix Seed (3 qian, crushed) White Peony Root (wine-steamed, 1.5 qian)
Fifth visit: Dual regulation of Lung and Kidney, nourishing Liver Yin. Choking cough subsides, but nausea persists. Medicine responds well; expand treatment.
Kui Dangshen (3 qian) Raw and Cooked Licorice Root (each 3 fen) Hangzhou White Peony Root (1.5 qian) Huai Achyranthes Root (stir-fried with salt water, 3 qian) White Poria (3 qian) Clam-Calcium Powder (3 qian, wrapped) Large Ophiopogon Tuber (heart removed, 3 qian) Large Rehmannia Root (4 qian) Sichuan Fritillaria Bulb (2 qian) Winterflower Bud (2 qian) Plantago Seed (3 qian) Raw Chinese Yam (3 qian)
Sixth visit: Spleen, Lung, and Kidney all deficient. Spleen fails to transport, generating phlegm; Lung fails to descend, causing choking cough; Kidney fails to grasp, causing rebellious Qi. Consumptive disease does not recover; pain, diarrhea, and sore throat fluctuate. Pulse is rapid, fine, and urgent. Hoping for a temporary delay.
Ophiopogon Tuber (3 qian) Raw Licorice Root (6 fen) Coix Seed Husk (3 qian, stir-fried) Raw Chinese Yam (3 qian) Donkey-hide Gelatin Pearl (3 qian) Platycodon Root (3 fen) White Peony Root (2 qian) Sichuan Fritillaria Bulb (2 qian) Papaya Peel (stir-fried, 1.5 qian) Baxian Changshou Pill (4 qian)
[Zhou (Left)] Wendan Tang facilitated opening and closing; aversion to cold has retreated. However, Qi and Yin are both deficient. Cough with profuse phlegm; Qi feels rebellious in left hypochondrium. Pulse is fine; Guan position is wiry. A picture of consumptive disease; dare not promise cure.
Kui Dangshen (2 qian) Processed Pinellia Tuber (1.5 qian) Huai Achyranthes Root (stir-fried, 3 qian) Bamboo Shavings (water-stir-fried, 1 qian) Broad Orange Peel (1 qian) White Poria (3 qian) Sea Clam Powder (3 qian, wrapped) Sichuan Fritillaria Bulb (2 qian) Jinshui Liujun Pill (3 qian, taken first with water)
Second visit: Phlegm gradually decreases, cough lightens. However, slight movement causes rebellious Qi. Lower deficiency fails to grasp; stability cannot be promised.
Large Rehmannia Root (stir-baked with Amomum, 4 qian) Purple Clam Shell (5 qian) Psoralea Fruit (stir-fried with salt water, 2 qian) Cloud Poria (3 qian) Achyranthes Bidentata Charcoal (3 qian) Dodder Seed (stir-fried with salt water, 3 qian) Chinese Yam (stir-fried, 3 qian) Sichuan Fritillaria Bulb (1.5 qian) Goji Berry (3 qian) Walnut Kernel with Purple Skin (finely ground, passed through medicine)
[Li (Left)] Liver-Kidney Yin deficiency below; lung damage above due to alcoholism; deficient fire harasses upward; previously vomited dark purple thick blood. Now, during autumn dryness, choking cough arises. Metal and Water both injured; fear entering consumption.
Donkey-hide Gelatin Pearl (3 qian) White Peony Root (wine-stir-fried, 1.5 qian) Clam-Calcium Powder (3 qian, wrapped) Jinshi Dendrobium Stem (3 qian) Moutan Cortex Charcoal (1.5 qian) Large Rehmannia Root (4 qian) Sichuan Fritillaria Bulb (3 qian) Raw Chinese Yam (3 qian) Glossy Privet Fruit (wine-steamed, 1.5 qian) Loquat Leaf (hairs removed, stir-baked, 4 leaves)
Second visit: Choking cough slightly reduced; pulse slightly slower. Medicine responds well; expand treatment.
Northern Glehnia Root (4 qian) Large Rehmannia Root (4 qian) Sichuan Fritillaria Bulb (2 qian) Glossy Privet Fruit (3 qian) Raw Chinese Yam (3 qian) Donkey-hide Gelatin Pearl (2 qian) Large Asparagus Tuber (3 qian) Clam-Calcium Powder (3 qian, wrapped) Baiwei Root (stir-fried, 1.5 qian) White Peony Root (wine-stir-fried, 1.5 qian) Loquat Leaf (hairs removed, honey-stir-baked, 4 leaves)
Third visit: Choking cough has stopped. Again, dual regulation of Metal and Water.
Codonopsis Root (2 qian) Sichuan Fritillaria Bulb (2 qian) Raw Chinese Yam (3 qian) Sea Clam Powder (3 qian, wrapped) Tangerine Peel (stir-fried with salt water, 1 qian) Atractylodes Macrocephala Rhizome (stir-fried, 1.5 qian) White Poria (3 qian) Raw and Cooked Licorice Root (each 2 fen) Jinshui Liujun Pill (4 qian, taken with water in two doses)
Another Paste Prescription: Yin division inherently deficient; alcoholism agitates Yang Qi. Liver-Kidney blood follows fire upward, previously vomiting dark purple thick blood, leading to sudden emaciation. Now, during autumn dryness, sudden choking cough arose, lasting months. Administering dual regulation of Metal and Water, choking cough gradually settled, clearly indicating deficient fire harassing upward and scorching Metal. Pulse is fine and rapid; tongue coating is yellow and rough. How can True Yin recover suddenly? Cultivating the Lower Origin requires maintenance; perhaps gradual recovery is possible.
Large Rehmannia Root (3 liang) Kui Dangshen (3 liang) Real Sichuan Fritillaria Bulb (heart removed, 1 liang) Raw Oyster Shell (4 liang) Ophiopogon Tuber (2 liang) Large Prepared Rehmannia Root (5 liang) American Ginseng (processed, 2 liang) Jinshi Dendrobium Stem (split, 1 liang) Hangzhou White Peony Root (wine-stir-fried, 1.5 liang) Raw and Cooked Licorice Root (combined 1 liang) Sweet Goji Berry (stir-fried, 3 liang) Poria and Spirit of Poria (each 1 liang) Purple Clam Shell (6 liang) Glossy Privet Fruit (wine-stir-fried, 3 liang) Fat Polygonatum Rhizome (2 liang) Thick Eucommia Bark (2 liang) Asparagus Tuber (1 liang) Raw Chinese Yam (2 liang) Angelica Sinensis Root Charcoal (1.5 liang) Cordyceps (8 qian) Stir-faked Cornus Fruit (1.5 liang) Tongsuyuan (stir-fried with salt water, 3 qian) Jian Alisma Rhizome (stir-fried with salt water, 2 liang) Schisandra Berry (honey-stir-fried, 7 qian) Powdered Moutan Cortex (stir-fried, 1.5 liang) Achyranthes Bidentata Charcoal (3 liang) Sweet Almond (2 liang, crushed)
Decoct these medicines with ample water three times, then boil to extreme concentration. Add 3 liang of real Donkey-hide Gelatin, 2 liang of Tortoise Plastron Glue, and 2 liang of Fish Swim Bladder Glue, melt and mix to form paste. Take half a large spoonful in the morning, half a small spoonful in the afternoon, all diluted with boiling water.
[Hu (Left)] Wind-cold with dampness damages the Lung. Persistent cough, thick yellow phlegm, occasional hemoptysis. Now sputum-blood worsens daily; pulse rapid with internal heat; anal fistula. This is Yin deficiency with dampness, damp-heat steaming, damaging Lung-Stomach collaterals. Emaciated and consumptive state; treating as a delaying tactic.
Red and White Poria Sea Floating Stone Winter Melon Seed Green Clam Powder Trichosanthes Frost Jian Alisma Rhizome
Raw Coix Seed Guang Almond Salt-water Stir-fried Bamboo Shavings Lotus Node Green Reed Tube
Second visit: Managing illness while working, internal Yang moves, Liver fire harasses Metal. Severe cough with blood, entering deep territory. Urgently stabilize camp to follow the way of Yang moving and Yin resting.
Northern Glehnia Root Moutan Cortex Charcoal Sichuan Dendrobium Stem Stir-baked Mulberry Root Bark Qiongwang Paste (infused) Stir-fried Ophiopogon Tuber Green Clam Powder Winter Melon Seed Sichuan Fritillaria Bulb
Third visit: Sputum-blood reduced compared to before, but throat has dull pain. Throat belongs to Lung and Stomach, but Shaoyin meridian connects to tongue base and circulates along throat. Thus, throat pain's branch is in Lung, root is in Kidney. Kidney is the root of congenital constitution; fear that herbal medicine cannot turn the tide.
Donkey-hide Gelatin Pearl (2 qian) Green Clam Powder (5 qian) Northern Glehnia Root (5 qian) Pig Skin (boiled, foam removed, infused, 1.5 qian) Chicken Egg Yolk (one piece) Stir-baked Rehmannia Root (4 qian) White Honey (one spoon) White Rice (stir-fried yellow, 1.5 qian)
Fourth visit: Deficient fire flares upward, fragmented throat pain, unable to sleep. Seasonal dampness invades and insults Spleen Earth, causing dysentery-like symptoms. Treat the acute first.
Amomum Fruit (stir-fried with salt water) Raw and Cooked Coix Seed Calcined Atractylodes Rhizome Raw Atractylodes Macrocephala Rhizome Poria with Skin Jian Alisma Rhizome Stir-fried Coix Seed Husk Stir-fried Lotus Seed
[Wu (Left)] Classics say: Facial swelling is wind; leg swelling is water. Initially leg swelling, indicating damp-heat. It took a long time to recede. Just as leg swelling receded below, cough started above. Sputum is yellow, mostly thick, rarely thin. Soon hemoptysis appeared. At this time, damp-heat not cleared, wind pathogen attacks externally. Wind pathogen enters easily but exits hard, due to dampness holding it. Pathogenic dampness stagnates long, cough damages collaterals, collateral blood leaks out. After blood loss, Yin division greatly injured, causing Metal and Water unable to generate each other, cough stops not. Now voice is hoarse, throat painful with internal heat, sputum mostly yellow and thick. Pulse is fine and rapid with hurriedness, Right Guan feels wiry and slippery. All wind pathogen transformed into fire. Kidney Water declines daily, Lung Metal damages daily. Damp-heat in Stomix mixes in, steaming upward. Fear throat pain worsens daily; my limited talent cannot handle it.
Guang Almond Winter Melon Seed Green Clam Powder Raw Coix Seed Loquat Leaf Black Scrophularia Root Stir-baked Mulberry Root Bark Cicada Slough Poria Green Reed Tube Water-stir-fried Bamboo Shavings
Second visit: Wind-damp-heat combine, steaming and damaging Lung. Previous prescription guides damp-heat downward, slowing steaming heat, thus saving Yin fluid consumption. Pulse and symptoms relatively stable. Follow previous intent to do human effort.
Northern Glehnia Root Red and White Poria Raw Coix Seed Green Clam Powder Fresh Bamboo Shavings Guang Almond Black Scrophularia Root Jinshi Dendrobium Stem Winter Melon Seed Green Reed Tube Raw Chicken Egg Yolk (infused) Loquat Leaf
Third visit (Hypothetical): Damp-heat transforms to dryness, injuring Yin, causing deficient fire to flare upward. Condition is difficult to treat; seek advice from experts immediately.