情志抑郁，原属肝病，辛散酸收甘缓，俱厥阴正治之方。屡投未应，窃思肝木不平，金
失其
刚，肺脏不能无患。肺欲收，观其胸痞，喘咳不得卧，岂非肺张不收。卧则叶粘背俞，阻塞
气道之故乎。经言诸气 郁，皆属于肺。喻氏发明秋伤于燥，冬生咳嗽之义，是知郁病可不
专责于肝，而燥证则全关于肺也。盖肺主气，居相傅之官，苟治节有权，则清肃下行，克称
其职。病缘木郁生火，兼挟燥邪，金受火刑，令失清肃。肺燥叶张，阻塞气机，而为患矣。
倘果专属肝病，而不涉肺，何至喘咳不能着枕耶?且肝病治肺，辅金制木，道犹不悖。设令
肺病不救，则烦冤逆满，内闭外脱，更何如耶。拟《千金》苇茎汤大意。
安波按∶然气闭欲死时，先总以开豁为主，或降气，或豁痰，善后之法，不出《己任
编》等方意义也。
又按∶木叩金鸣，以《千金》苇茎汤治，大有深意。
质亏烦劳证，经多日诊脉，虚弦带急，精神欠充，夜寐少逸。询其病初，并无寒热，知
非外
因。惟头痛乍轻乍重，推求其故，东坦云∶内伤头痛，时痛时止，究缘烦劳抑郁，水不涵木
，肝风上扰，清空鼓动不定。夫头痛神烦，倏然而至，迅速莫如风火。但身中阳化内风，非
发散可解，寒凉可平，必须阳和，庶乎风熄。经旨以下虚则上实，阴伤阳浮，冒上病疗下，
滋苗灌根，语可味也。
安波按∶胃阳不潜，宜和阳以就阴，拟虎潜法。
情志抑郁，原本属于肝脏病变，使用辛散、酸收、甘缓的药物，都是治疗厥阴病（足厥阴肝经病变）的正治法。多次投药却未见效，我私下思考：肝木之气不平，导致肺金失去其刚健之性，肺脏不可能没有隐患。肺脏喜好收敛，观察患者胸中痞闷、喘咳不能平卧的症状，难道不是肺气张弛不收吗？躺下时，肺叶粘连于背部俞穴，阻塞了气道，这就是原因吧。《内经》说：“各种气机郁滞的病证，都归属于肺。”喻嘉言阐发了“秋伤于燥，冬生咳嗽”的道理，由此可知，郁证不一定专责于肝，而燥证则完全与肺有关。大概因为肺主气，位居相傅之官（辅助君主之官的重要职位），如果治理调节有权柄，就能使清气肃降下行，胜任其职。此病源于肝木郁结而生火，兼夹燥邪，肺金受火邪刑克，导致清肃功能失常。肺燥导致肺叶张开，阻塞气机，从而产生病患。如果确实只属于肝病，而不涉及肺，怎么会到喘咳不能枕卧的地步呢？况且治疗肝病时兼顾治肺，通过补益肺金来制约肝木，道理也是不违背的。假如肺病得不到救治，就会出现烦闷冤屈、气逆胀满，甚至内闭外脱的危象，那又该怎么办呢？现拟定《千金方》苇茎汤的大致思路。
安波按语：然而在气机闭塞欲死之时，首先总应以开豁痰气为主，或是降气，或是豁痰，善后调理的方法，不出《己任编》等方的意义范围。
又按语：木叩金鸣（肝气犯肺），用《千金方》苇茎汤治疗，大有深意。
体质亏虚且因烦劳致病，经过多日诊脉，脉象虚弦带急，精神不足，夜间睡眠少得安宁。询问其发病初期，并没有恶寒发热的症状，知道不是外感病因。只是头痛有时轻有时重，推究其原因，东垣先生曾说：内伤头痛，时痛时止，终究是因为烦劳抑郁，肾水不能涵养肝木，肝风上扰，使头部清空之气鼓动不定。头痛伴神志烦躁，突然而至，迅速莫过于风火。但是人体内部的阳化内风，不能用发散法解除，也不能用寒凉药平抑，必须用温和之法，才能使风熄。《内经》旨意指出：下虚则上实，阴伤则阳浮，上部患病应从下部治疗，滋养苗头以灌溉树根，这些话值得细细品味。
安波按语：胃阳不能潜藏，应当调和阳气以就合阴液，拟定虎潜丸的法度。
Emotional depression originally belongs to liver pathology. Formulas employing acrid dispersing, sour astringing, and sweet moderating methods are the correct treatments for Jueyin disease (diseases of the Foot-Jueyin Liver meridian). After repeated administration with no effect, I privately pondered: If Liver Wood qi is unbalanced, Metal loses its firmness, and the Lung cannot be without隐患 (hidden dangers). The Lung desires astringency; observing the patient's chest fullness, wheezing, coughing, and inability to lie flat, is this not due to Lung Qi failing to contract? When lying down, the lung lobes adhere to the back Shu points, obstructing the airway, which is the cause. The Classics state: "All disorders of Qi stagnation belong to the Lung." Yu Jiayan elucidated the principle that "autumn injury by dryness leads to winter coughs." From this, we know that stagnation syndromes are not exclusively blamed on the Liver, whereas dryness syndromes are entirely related to the Lung. Generally, the Lung governs Qi and holds the position of the Prime Minister (an official assisting the sovereign); if it exercises control and regulation effectively, clear and pure Qi descends, fulfilling its duties. This illness originates from Liver Wood stagnation generating fire, combined with dryness pathogen. Metal suffers fire punishment, losing its clear and descending function. Lung dryness causes lung lobes to expand, blocking Qi mechanism, thus causing harm. If it were solely a Liver disease and did not involve the Lung, how could it reach the point of wheezing and coughing preventing one from resting their head on a pillow? Moreover, treating the Lung while addressing the Liver, supplementing Metal to restrain Wood, follows sound principles. If Lung disease is not rescued, it will lead to vexation, oppression, rebellious Qi, and distension, resulting in internal closure and external collapse; what then would happen? I propose the general idea of *Qianjin* Weijing Tang (Reed Rhizome Decoction from the Essential Prescriptions Worth a Thousand Gold).
An Bo's commentary: However, when Qi blockage is severe enough to feel like death, the primary approach should always be to open and resolve phlegm/Qi obstruction, either by directing Qi downward or resolving phlegm. Methods for convalescence do not exceed the principles found in formulas such as those in *Jiren Bian*.
Another note: "Wood striking Metal" (Liver Qi invading the Lung) treated with *Qianjin* Weijing Tang carries profound significance.
Deficient constitution complicated by fatigue: After pulse diagnosis over several days, the pulse was deficient, wiry, and rapid. Spirit was lacking, and night sleep was restless. Inquiring about the onset, there were initially no aversion to cold or fever, indicating it was not an exogenous cause. The headache varied in intensity, now light, now heavy. Investigating the cause, Li Dongyuan stated: Internal injury headaches, which come and go, ultimately stem from fatigue and depression, where Kidney Water fails to nourish Liver Wood, causing Liver Wind to disturb upwards and agitate the clear orifices. Headache accompanied by mental restlessness arrives suddenly; nothing is more rapid than Wind-Fire. However, internal wind generated by Yang transformation within the body cannot be resolved by diaphoresis nor pacified by cold/cool herbs; only gentle warming can extinguish the wind. The Classic teachings indicate: "Lower deficiency leads to upper excess; Yin injury leads to Yang floating." Treating upper diseases from the lower part, nourishing the shoots to irrigate the roots—these words deserve deep reflection.
An Bo's commentary: Stomach Yang fails to submerge; one should harmonize Yang to align with Yin. I propose the method of *Hujian Wan* (Tiger Crouching Pill).