〔评析〕腰以下冰冷，痛如折断，阳痿、滑精持续１５年，前医多以肾阳虚衰而治之。要知疾病之源，本于寒湿，寒邪凝滞，湿聚不化，经脉受阻，气血不畅，故腰以下寒冷，疼痛如折；久痛及肾，肾精亏损，命门火衰，则阴器弛软不用；肾气既虚，下元疲惫，精关不固，则频发滑精。若纯用补阳之剂，则阴无以继，以致浮阳躁动于上，使上身热炽口伤烂赤，上热下寒，寒热格柜。此时治法，宜标本兼顾，益阴和阳，阳中求阴，阴中求阳，平衡阴阳。故药用祛风胜湿、散寒止痛之剂以治其标；用补益精血、温肾强健之剂以治其本。标去本实，沉年痼疾，竟侥幸告愈。
三、肺癌术后胸痛咳嗽案李某，男，６８岁，武汉市蔡甸区农民。１９８８年２月１１日初诊。胸痛、咳嗽、咯血反复发作４年，又发加重１月。患者自２０岁起至今一直大量吸烟，日１包许，伤害肺系。１９８７年１０月病发胸痛，咳嗽痰中带血，当时到武汉军区总院诊治，胸片检查：周围型肺癌。胸部右侧斜位断层：右中叶新生物可能性大。纤维支气管镜报告：周围性肺癌。遂于１９８７年１２月２９日在该院外科住院，在全麻下行右中叶肺切除术。术中见一拳头大包块，有坏死组织液化，经病理切片断为“腺癌”。术后又在该院对症治疗数日，于１９８８年元月１２日出院。出院后月余，胸痛咳嗽又发，即到当地县医院诊治，胸片检查：考虑肺癌复发。用中西药治疗（药名不详）无明显效果。刻诊所见：胸痛、咳嗽、痰少，不易咯出，每天痰中带血１～２口，血色暗红，右颈项部有一鸡蛋大肿块，红肿疼痛，纳食欠佳，舌淡红苔薄黄，脉细数。李氏断曰：此乃大量吸烟，正气伤损，第三卷２２２邪从肺入，毒热壅肺，久衍成癌也。肺癌手术，正伤更甚，阴液亏耗，而热毒壅肺肺失肃降，治当清热解毒，宣通肺气，滋阴补虚。处方：沙参１５克、炒冬术１０克、奶参２０克、玄参１５克、白芍１２克、陈皮１０克、茯苓１５克、炒枳壳１０克、土贝母１０克、半枝莲２０克、白花蛇舌草２０克、炒二芽３０克、炙甘草６克。日１剂，水煎服，日服３次，禁烟酒辛辣之物。
１９８８年６月２７日二诊：服上方１０剂，胸痛咳嗽咯血均消失，颈项部肿块亦消除。后数月未再服药。近月来因嗜食辣椒，烟瘾又犯（日吸半包许），致胸痛又发，咳嗽，咯痰带血，每日３～４口，血色鲜红，口干欲饮，舌红淡薄黄，脉细弦，是毒热壅肺，痰浊内阻，肺气失宣，肺阴受损之证也。治宜清热解毒，宣肺化痰，养肺生津，凉血止血。方用：蛇舌草１８克、贝母１０克、半枝莲１５克、桑皮１０克、苡仁１５克、玄参１２克、橘皮络各２０克、黄芩１０克、冬瓜子１５克、乌贼骨１２克、炙杷叶１５克、海蛤粉１５克、芦根１５克、茅根１５克。水煎服。
１９９１年１２月３日三诊：连服上方３０余剂，胸痛咳嗽咯血等症均缓解，３年多时间未有复发，亦未服用其他药物。近日来因劳作太过，又因吸烟未禁，原病复发。证见胸痛，饭后尤为剧烈，咳嗽，每天晨起咯血３～５口，血色鲜红，口渴欲饮，纳食欠佳，舌质尖红，苔薄黄少津，脉象细数。到省某医院胸片检查：考虑肺癌复发，右下胸膜增厚，膈肌粘连。此热毒壅肺，宣肃失职，肺津耗损所致。治拟清热解毒，宣肺化痰，养阴润肺。处方：半枝莲１８克、川贝１０克、连翘１５克、苡仁３０克、蛇舌草１８克、黄芩１０克、芦根１５克、茅根１８克、冬瓜子１５克、桑皮１０克、炙杷叶１５克、炙紫菀１０克、血余炭１０克、瓜蒌皮１０克、橘皮络各１０克、藕节１０克。服用上方１０剂，咳嗽咯血胸痛消失，精神亦振，惟背部作胀，遂于上方加入宽胸理气、活血解毒之品，继进３０余剂，调治而愈。随访３年半未发。
〔评析〕肺癌胸痛咳嗽咯血反复发作４年，曾作切除术，术后又反复发作，舌质红苔薄黄，脉细数，是毒热壅肺，肺失宣肃，阴津耗伤使然，故李氏用药，始以清热解毒，宣肺化痰，养阴润肺之重剂为法，首见捷效。药后数月，因患者食无禁忌，吸烟不止，胸痛诸证又作，则以清热解毒、宣肺利气、化痰止咳、凉血止血为治，药后缓解。时越３年，劳作过度，痼疾又发，而用清热解毒、宣肺化痰、凉血上血、养阴生津之法奏效。细审此病，前后长达４年。４年之中，胸痛咯血大发４次，然病机总在毒热壅盛、正伤邪恋之间。是以临证用药，始终谨守病机，以清热解毒、宣利肺气、养阴生津为本，不以久病虚损而忌用寒凉，而又深合中医辨证论治之道。１９９４年底，其子来谢曰：服药至今，诸证未发，已存活６年有余，且精神爽健，尚能下田间劳作，而其原同病室之５名肺癌术后病友，因未服中药，早已谢世多年云云。
四、恶性神经鞘瘤术后胸痛咳嗽案张某，男，２９岁，黄岗某中学教师。１９９３年１２月２７日初诊。左侧胸痛２月。１９９３年９月６日因劳累而胸痛，未予重视。１５天后胸闷烦躁，疼痛加剧，自觉日渐消瘦，但无发热咳嗽咯血等症。１９９３年１０月６日到黄岗某医院住院诊治，胸片检查：左侧胸腔大量积液，纵隔心影均向右侧移位。ＣＴ报告：左上肺尖块影，考虑为转移性肺癌。后２次ＣＴ复查均维持上述诊断。用放疗（ＶＤＯＰ）及抗痨药链霉素等治疗月余，并行胸腔穿刺抽胸水，症状无明显改善，遂出院来诊。刻诊所见：胸闷胸痛，左侧尤甚，烦躁欲死，咳嗽痰少，身体消瘦，右腋下淋巴结肿大（如鸽蛋大），舌质红苔薄黄，脉细弦数。既往史：１９９２年６月因在上臂外侧神经恶性鞘瘤在第三卷２２３同济医院做过切除术；１９９２年１０月因右侧臂部恶性鞘瘤在黄岗医院做过切除术；１９９３年４月左上臂内侧又发恶性神经鞘瘤在该院手术。几次手术后行病理切片均证实为恶性神经鞘瘤。
且近月来手术疤痕处又长出硬节，有疼痛感。ＣＴ检查：左上肺块影，考虑转移性肺癌，左侧胸膜肥厚并包裹性积液。胸腔穿刺：胸水为血性物。李氏谓：病者曾患恶性神经鞘瘤，做过３次手术，而屡有复发，毒热内蕴，转移于肺，肺失清肃，痰瘀阻络，水道失于通调，而有胸痛咳嗽瘰疬痰核之证也。当以清热解毒，宣肺化痰，软坚散结为治。处方：桑皮１０克、冬瓜子２０克、苡仁３０克、川贝１０克、桃仁１０克、炒黄芩１０克、炙杷叶１５克、白花蛇舌草１８克、炒瓜蒌皮１５克、连翘１５克、橘皮络各１０克、茅根３０克。
１９９３年１２月２７日二诊：服上药１９余剂，胸闷胸痛减轻，咳嗽已平，腋下肿大淋巴结竟告消退，精神振奋，纳食正常，二便通利，舌脉同前。药中肯綮，守上法而适当增损为治。处方：冬瓜子２０克、夏枯草３０克、苡仁５０克、川贝１０克、橘络１０克、半枝莲１０克、炙杷叶１５克、炒瓜蒌皮１５克、桑皮１０克、蒲公英１５克、连翘１５克、炒黄芩１０克、白茅根１５克、芦根１５克、车前子１０克。前后加减服至３０余剂，诸证缓解，体重增加，继以宣肺化痰、清热解毒、软坚散结、健脾益气之剂调理善后。
〔评析〕此例李氏断为热毒内蕴，痰瘀阻络，肺失清肃，以清热解毒，宣肺化痰，软坚散结为治。药用蛇舌草、半枝莲、黄芩、连翘等清热解毒，消肿散结；夏枯草、川贝、冬瓜仁、苡仁、桑皮等宣肺化痰、软坚散结；桃仁行血化瘀，畅通血脉；瓜蒌皮、枇杷叶、橘皮络等宽胸理气、健脾化痰；芦根、茅根清热生津，利尿排痰。合而用之，则清热解毒，宣肺化痰，软坚散结，通利水湿之功昭然。１０剂后胸闷胸痛缓解，咳嗽即平，腋下之肿大淋巴结消失，其他证候亦有好转。中医药力量之神奇如斯，令人莫不信服也。而其中奥妙，贵在辨证论治矣。虽曰其预后难以逆料，然其近期疗效如此，亦可供来者研究参考。
医论医话
一、漫谈一药之师昔人评议文章，有增移一字而词句清顺，气势陡振，琅然可诵，即所谓“一字之师”。吾谓中医治病，若辨证既明，立法、遣方亦不误，惟用药不能丝丝入扣，设有贤达为之指点一二，加入对证之药，则疗效卓著，其作用当不亚于一字之功，此即吾所谓“一药之师”也。
忆余幼年学医时，此类事实而不能忘怀者有二。其一，某年端午后，同湾刘培义之弟患湿温，延龚某诊治，服药至十余剂，而无效，刘来县请吾父一决，并度父老病不能远行，先请龚医将病情，脉象，舌苔经过一一笔录，请为斟酌。父审视毕，谓余曰：“照龚方（内有芩、连、半夏等药）加干姜一味可也。盖湿温痞、呕、泻利，有同于伤寒胃不和。湿郁热蒸，中焦不和，则湿热二者，愈益纠缠不解，故前人有抽茧剥蕉之喻。仲景半夏泻心汤，用芩、连清热，姜夏燥湿，借用于湿温，可谓面面俱到。若今人只敢用寒凉药而不用辛热药，未免遗却一面，遂至不效矣。”刘持方归，服此方数剂，竟愈。以后愚临证时，对于湿温，有时施用此法亦有效验。然而患者舌苔黄第三卷２２４燥，或中心带剥，或舌质红绛，应谨防胃阴受损，干姜辛热，仍不可用。清·张聿清《医案》治湿温，有此类型一案，可作殷鉴。至于人参、甘草、大枣等药，助湿酿热，如遇湿热蕴隆，亦宜酌。
其二，是岁秋，余由县回乡，探视三叔之疾，其人素嗜酒，其证有腹满时痛，不食而吐，大便溏泻，日行三、五次，小便清白，脉缓弱，苔白厚，是太阴脏寒脾不健运寒湿凝滞致病，当与温中之法，进理中汤二剂，无效。又加熟附子，服二剂，亦无显效。急归持方示父，父审视毕，谓余曰：“方尚与证相合，惟宜加理气药一两味，必有大效矣。”“前人如朱丹溪用参芪补药，必佐以橘皮。张石顽于理中汤内加青陈二皮，方名治中汤，甚有巧思。盖气行则水行，气为血之帅，故治疗水血痰食诸病，苟能于对证方中，加入行气散结之品，殊有加强疗效作用，不仅气郁病患可用理气药而已。”余遵其说，遂于前方加砂仁、煨木香、川朴、炒建曲等药，又服二剂，果愈。
自抗战爆发后，余避难回乡，悬壶于官桥李家集，适福兴杂货店店东李某某老丈，体素弱，素有咳喘之疾，某年冬天大发，延愚诊治。审视前方，均为疏肺化痰之剂。其证面部浮肿，恶冷腰痛，呼吸迫促而不能平卧，少腹部拘急不舒，大便尚可，小溲短少，舌质淡苔白，脉沉细而弱。
断为久病咳喘，势必及肾。肾为真阳真阴之本，肾虚而不能温煦摄纳，故出现上列种种症状。
《内经》谓“肾者水脏，主津液，主卧与喘”（《素问·逆调论》），是其明证。故从前治肺、治脾无效，此时当用温肾益阳固本补虚之法为宜。遂用八味肾气丸方作汤与服。数剂后，诸证少减，惟喘证仍存。又仿都气丸之意，将前方去肉桂，加五味子，服五剂，药有小效。又参都气丸合观音应梦散复方之意，用六味地黄汤加五味子、盐水炒补骨脂、胡桃肉、炒杜仲、煅滋石、怀牛膝、车前子与服。十剂后，患者精神渐振，诸证减轻，惟稍一动作仍感喘息不支。适老中医李某某在集上开位育堂药店，余持方请教。彼谓：此方温镇固摄，与证甚合。惟建议加沉香一味，以加强理气平喘作用。余从其说，将前方煎汤后每次用沉香粉数分，随药汤吞下。又五剂，喘息渐平，时至新春，已能起床，随即告愈。盖沉香一物，李时珍谓“治上热下寒，气逆喘急，大肠虚闭，小便气淋，男子精冷”。用于此证，自有良效。
【评析】腰部以下冰冷，疼痛剧烈如同折断，阳痿、滑精持续了15年，之前的医生大多按照肾阳虚衰来治疗。要知道疾病的根源，本在于寒湿，寒邪凝滞，湿气积聚不化，经脉受阻，气血运行不畅，所以腰部以下寒冷，疼痛如折；久病及肾，肾精亏损，命门火衰，导致生殖器弛软无力；肾气既已虚弱，下元疲惫，精关不固，所以频繁发生滑精。如果单纯使用补阳的药物，则阴液无法接续，导致浮阳躁动于上，使上身热盛、口舌糜烂红肿，形成上热下寒、寒热格拒的局面。此时的治法，应当标本兼顾，益阴和阳，在补阳中求阴，在补阴中求阳，以平衡阴阳。所以用药用祛风胜湿、散寒止痛的方剂来治其标；用补益精血、温肾强健的方剂来治其本。标症去除，本元充实，多年的沉疴痼疾，竟然侥幸治愈。
三、肺癌术后胸痛咳嗽案
李某，男，68岁，武汉市蔡甸区农民。1988年2月11日初诊。胸痛、咳嗽、咯血反复发作4年，近1个月加重。患者从20岁起至今一直大量吸烟，每天约1包，损伤肺系。1987年10月发病，出现胸痛，咳嗽痰中带血，当时到武汉军区总医院诊治，胸片检查：周围型肺癌。胸部右侧斜位断层扫描：右中叶新生物可能性大。纤维支气管镜检查报告：周围性肺癌。遂于1987年12月29日在该院外科住院，在全麻下行右中叶肺切除术。术中见一拳头大小的肿块，有坏死组织液化，经病理切片诊断为“腺癌”。术后又在该院对症治疗数日，于1988年1月12日出院。出院后一个多月，胸痛咳嗽再次发作，即到当地县医院诊治，胸片检查：考虑肺癌复发。用中西药治疗（药名不详）无明显效果。目前诊察所见：胸痛、咳嗽、痰少，不易咯出，每天痰中带血1～2口，血色暗红，右颈项部有一个鸡蛋大小的肿块，红肿疼痛，食欲不佳，舌淡红苔薄黄，脉细数。李氏判断说：这是由于大量吸烟，正气受损，邪气从肺而入，毒热壅塞于肺，日久演变成癌症。肺癌手术后，正气损伤更甚，阴液亏耗，而热毒壅塞于肺，肺失肃降，治疗应当清热解毒，宣通肺气，滋阴补虚。处方：沙参15克、炒白术10克、南沙参20克、玄参15克、白芍12克、陈皮10克、茯苓15克、炒枳壳10克、土贝母10克、半枝莲20克、白花蛇舌草20克、炒麦芽神曲30克、炙甘草6克。每日1剂，水煎服，每日服3次，禁烟酒辛辣之物。
1988年6月27日二诊：服用上方10剂，胸痛、咳嗽、咯血均消失，颈项部肿块也消除。之后数月未再服药。近一个月来因嗜食辣椒，烟瘾又犯（每天吸半包左右），导致胸痛再次发作，咳嗽，咯痰带血，每天3～4口，血色鲜红，口干想喝水，舌红苔薄黄，脉细弦，这是毒热壅塞于肺，痰浊内阻，肺气失于宣发，肺阴受损的证候。治疗宜清热解毒，宣肺化痰，养肺生津，凉血止血。方用：白花蛇舌草18克、贝母10克、半枝莲15克、桑白皮10克、薏苡仁15克、玄参12克、橘皮络各20克、黄芩10克、冬瓜子15克、乌贼骨12克、炙枇杷叶15克、海蛤粉15克、芦根15克、白茅根15克。水煎服。
1991年12月3日三诊：连续服用上方30余剂，胸痛、咳嗽、咯血等症状均缓解，3年多时间未有复发，也未服用其他药物。近日因劳作过度，又因未禁吸烟，原病复发。证见胸痛，饭后尤为剧烈，咳嗽，每天晨起咯血3～5口，血色鲜红，口渴想喝水，食欲不佳，舌尖红，苔薄黄少津，脉象细数。到省某医院胸片检查：考虑肺癌复发，右下胸膜增厚，膈肌粘连。这是热毒壅塞于肺，宣发肃降功能失职，肺津耗损所致。治疗拟定清热解毒，宣肺化痰，养阴润肺。处方：半枝莲18克、川贝母10克、连翘15克、薏苡仁30克、白花蛇舌草18克、黄芩10克、芦根15克、白茅根18克、冬瓜子15克、桑白皮10克、炙枇杷叶15克、炙紫菀10克、血余炭10克、瓜蒌皮10克、橘皮络各10克、藕节10克。服用上方10剂，咳嗽、咯血、胸痛消失，精神也振作，只是背部感到胀满，于是于上方加入宽胸理气、活血解毒的药物，继续进服30余剂，调治而愈。随访3年半未复发。
【评析】肺癌引起的胸痛、咳嗽、咯血反复发作4年，曾做过切除术，术后又反复发作，舌质红苔薄黄，脉细数，这是毒热壅塞于肺，肺失宣发肃降，阴津耗伤所致，所以李氏用药，开始以清热解毒，宣肺化痰，养阴润肺的重剂为法，首见显著疗效。药后数月，因患者饮食无禁忌，吸烟不止，胸痛诸证又发作，则以清热解毒、宣肺利气、化痰止咳、凉血止血为治，药后缓解。时隔3年，劳作过度，痼疾又发，而用清热解毒、宣肺化痰、凉血止血、养阴生津之法奏效。仔细审视此病，前后长达4年。4年之中，胸痛咯血大发4次，然而病机总在毒热壅盛、正气受损邪气留恋之间。因此临证用药，始终谨守病机，以清热解毒、宣利肺气、养阴生津为本，不因久病虚损而忌用寒凉，而又深合中医辨证论治之道。1994年底，其子来致谢意说：服药至今，诸证未发，已存活6年多，且精神爽健，尚能下田间劳作，而其原同病室的5名肺癌术后病友，因未服中药，早已去世多年云云。
四、恶性神经鞘瘤术后胸痛咳嗽案
张某，男，29岁，黄冈某中学教师。1993年12月27日初诊。左侧胸痛2个月。1993年9月6日因劳累而胸痛，未予重视。15天后胸闷烦躁，疼痛加剧，自觉日渐消瘦，但无发热咳嗽咯血等症。1993年10月6日到黄冈某医院住院诊治，胸片检查：左侧胸腔大量积液，纵隔心影均向右侧移位。CT报告：左上肺尖块影，考虑为转移性肺癌。后2次CT复查均维持上述诊断。用放疗（VDP方案）及抗结核药链霉素等治疗月余，并行胸腔穿刺抽胸水，症状无明显改善，遂出院来诊。目前诊察所见：胸闷胸痛，左侧尤甚，烦躁欲死，咳嗽痰少，身体消瘦，右腋下淋巴结肿大（如鸽蛋大小），舌质红苔薄黄，脉细弦数。既往史：1992年6月因在上臂外侧神经恶性鞘瘤在同济医院做过切除术；1992年10月因右侧臂部恶性鞘瘤在黄冈医院做过切除术；1993年4月左上臂内侧又发恶性神经鞘瘤在该院手术。几次手术后行病理切片均证实为恶性神经鞘瘤。
且近月来手术疤痕处又长出硬结，有疼痛感。CT检查：左上肺块影，考虑转移性肺癌，左侧胸膜肥厚并包裹性积液。胸腔穿刺：胸水为血性物。李氏谓：病患者曾患恶性神经鞘瘤，做过3次手术，而屡有复发，毒热内蕴，转移于肺，肺失清肃，痰瘀阻络，水道失于通调，而有胸痛咳嗽瘰疬痰核之证也。当以清热解毒，宣肺化痰，软坚散结为治。处方：桑白皮10克、冬瓜子20克、薏苡仁30克、川贝母10克、桃仁10克、炒黄芩10克、炙枇杷叶15克、白花蛇舌草18克、炒瓜蒌皮15克、连翘15克、橘皮络各10克、白茅根30克。
1993年12月27日二诊：服用上药19余剂，胸闷胸痛减轻，咳嗽已平，腋下肿大淋巴结竟告消退，精神振奋，纳食正常，二便通利，舌脉同前。药中肯綮，守上法而适当增损为治。处方：冬瓜子20克、夏枯草30克、薏苡仁50克、川贝母10克、橘络10克、半枝莲10克、炙枇杷叶15克、炒瓜蒌皮15克、桑白皮10克、蒲公英15克、连翘15克、炒黄芩10克、白茅根15克、芦根15克、车前子10克。前后加减服至30余剂，诸证缓解，体重增加，继以宣肺化痰、清热解毒、软坚散结、健脾益气之剂调理善后。
【评析】此例李氏断为热毒内蕴，痰瘀阻络，肺失清肃，以清热解毒，宣肺化痰，软坚散结为治。药用白花蛇舌草、半枝莲、黄芩、连翘等清热解毒，消肿散结；夏枯草、川贝母、冬瓜仁、薏苡仁、桑白皮等宣肺化痰、软坚散结；桃仁行血化瘀，畅通血脉；瓜蒌皮、枇杷叶、橘皮络等宽胸理气、健脾化痰；芦根、白茅根清热生津，利尿排痰。合而用之，则清热解毒，宣肺化痰，软坚散结，通利水湿之功昭然。10剂后胸闷胸痛缓解，咳嗽即平，腋下之肿大淋巴结消失，其他证候亦有好转。中医药力量之神奇如斯，令人莫不信服也。而其中奥妙，贵在辨证论治矣。虽曰其预后难以逆料，然其近期疗效如此，亦可供来者研究参考。
医论医话
一、漫谈一药之师
昔人评议文章，有增移一字而词句清顺，气势陡振，琅然可诵，即所谓“一字之师”。吾谓中医治病，若辨证既明，立法、遣方亦不误，惟用药不能丝丝入扣，设有贤达为之指点一二，加入对证之药，则疗效卓著，其作用当不亚于一字之功，此即吾所谓“一药之师”也。
忆余幼年学医时，此类事实而不能忘怀者有二。其一，某年端午后，同湾刘培义之弟患湿温，延龚某诊治，服药至十余剂，而无效，刘来县请吾父一决，并度父老病不能远行，先请龚医将病情，脉象，舌苔经过一一笔录，请为斟酌。父审视毕，谓余曰：“照龚方（内有芩、连、半夏等药）加干姜一味可也。盖湿温痞、呕、泻利，有同于伤寒胃不和。湿郁热蒸，中焦不和，则湿热二者，愈益纠缠不解，故前人有抽茧剥蕉之喻。仲景半夏泻心汤，用芩、连清热，姜夏燥湿，借用于湿温，可谓面面俱到。若今人只敢用寒凉药而不用辛热药，未免遗却一面，遂至不效矣。”刘持方归，服此方数剂，竟愈。以后愚临证时，对于湿温，有时施用此法亦有效验。然而患者舌苔黄燥，或中心带剥，或舌质红绛，应谨防胃阴受损，干姜辛热，仍不可用。清·张聿清《医案》治湿温，有此类型一案，可作殷鉴。至于人参、甘草、大枣等药，助湿酿热，如遇湿热蕴隆，亦宜斟酌。
其二，是岁秋，余由县回乡，探视三叔之疾，其人素嗜酒，其证有腹满时痛，不食而吐，大便溏泻，日行三、五次，小便清白，脉缓弱，苔白厚，是太阴脏寒脾不健运寒湿凝滞致病，当与温中之法，进理中汤二剂，无效。又加熟附子，服二剂，亦无显效。急归持方示父，父审视毕，谓余曰：“方尚与证相合，惟宜加理气药一两味，必有大效矣。”“前人如朱丹溪用参芪补药，必佐以橘皮。张石顽于理中汤内加青陈二皮，方名治中汤，甚有巧思。盖气行则水行，气为血之帅，故治疗水血痰食诸病，苟能于对证方中，加入行气散结之品，殊有加强疗效作用，不仅气郁病患可用理气药而已。”余遵其说，遂于前方加砂仁、煨木香、川朴、炒建曲等药，又服二剂，果愈。
自抗战爆发后，余避难回乡，悬壶于官桥李家集，适福兴杂货店店东李某某老丈，体素弱，素有咳喘之疾，某年冬天大发，延愚诊治。审视前方，均为疏肺化痰之剂。其证面部浮肿，恶冷腰痛，呼吸迫促而不能平卧，少腹部拘急不舒，大便尚可，小溲短少，舌质淡苔白，脉沉细而弱。
断为久病咳喘，势必及肾。肾为真阳真阴之本，肾虚而不能温煦摄纳，故出现上列种种症状。
《内经》谓“肾者水脏，主津液，主卧与喘”（《素问·逆调论》），是其明证。故从前治肺、治脾无效，此时当用温肾益阳固本补虚之法为宜。遂用八味肾气丸方作汤与服。数剂后，诸证少减，惟喘证仍存。又仿都气丸之意，将前方去肉桂，加五味子，服五剂，药有小效。又参都气丸合观音应梦散复方之意，用六味地黄汤加五味子、盐水炒补骨脂、胡桃肉、炒杜仲、煅磁石、怀牛膝、车前子与服。十剂后，患者精神渐振，诸证减轻，惟稍一动作仍感喘息不支。适老中医李某某在集上开位育堂药店，余持方请教。彼谓：此方温镇固摄，与证甚合。惟建议加沉香一味，以加强理气平喘作用。余从其说，将前方煎汤后每次用沉香粉数分，随药汤吞下。又五剂，喘息渐平，时至新春，已能起床，随即告愈。盖沉香一物，李时珍谓“治上热下寒，气逆喘急，大肠虚闭，小便气淋，男子精冷”。用于此证，自有良效。
[Analysis] Coldness below the waist, pain severe as if broken, impotence, and seminal emission persisting for 15 years. Previous physicians mostly treated this as Kidney Yang Deficiency (Kidney Yang Xu). It must be known that the source of the disease lies in Cold-Dampness. Cold pathogen stagnates, dampness accumulates and fails to transform, meridians are obstructed, and Qi and Blood flow is unsmooth; thus, coldness below the waist and pain as if broken occur. Long-standing pain affects the Kidneys, leading to depletion of Kidney Essence and decline of Mingmen Fire, causing flaccidity and dysfunction of the genitalia. Since Kidney Qi is deficient and the Lower Yuan is exhausted, with insecure essence gate, frequent seminal emission occurs. If purely using Yang-tonifying agents, Yin will have no foundation to sustain, leading to floating Yang agitating above, causing intense heat in the upper body, mouth sores, and redness/swelling, resulting in Upper Heat and Lower Cold with Cold-Heat rejection. At this time, the treatment method should address both root and branch simultaneously, nourish Yin and harmonize Yang, seek Yin within Yang tonification, and seek Yang within Yin tonification, to balance Yin and Yang. Therefore, use wind-dispelling and dampness-resolving, cold-scattering and pain-relieving formulas to treat the branch; use formulas that tonify Essence and Blood, warm the Kidneys, and strengthen the body to treat the root. Once the branch symptoms are removed and the root is solidified, this chronic stubborn disease was fortunately cured.
Case 3: Post-operative Lung Cancer with Chest Pain and Cough
Li Mou, Male, 68 years old, farmer from Caidian District, Wuhan City. First consultation on February 11, 1988. Recurrent chest pain, cough, and hemoptysis for 4 years, aggravated for 1 month. The patient has been a heavy smoker since age 20, smoking about 1 pack per day, damaging the Lung system. In October 1987, he developed chest pain and cough with blood-streaked sputum. He visited Wuhan Military Region General Hospital, where chest X-ray showed peripheral lung cancer. Right lateral oblique tomography suggested a high probability of a neoplasm in the right middle lobe. Fiberoptic bronchoscopy report confirmed peripheral lung cancer. On December 29, 1987, he was hospitalized in the surgery department of that hospital and underwent a right middle lobectomy under general anesthesia. Intraoperatively, a fist-sized mass was seen with liquefied necrotic tissue; pathological biopsy diagnosed "adenocarcinoma." After several days of symptomatic treatment at the same hospital, he was discharged on January 12, 1988. Over a month after discharge, chest pain and cough recurred, and he sought treatment at a local county hospital. Chest X-ray suggested lung cancer recurrence. Treatment with Chinese and Western medicines (names unknown) had no obvious effect. Current examination findings: chest pain, cough, scanty sputum difficult to expectorate, blood-streaked sputum 1-2 mouthfuls daily, dark red blood color, an egg-sized mass in the right neck/neck region, red and swollen and painful, poor appetite, pale red tongue with thin yellow coating, fine and rapid pulse. Dr. Li diagnosed: This is due to heavy smoking damaging Zheng Qi (Upright Qi), pathogenic factors entering via the Lungs, toxic heat congesting the Lungs, evolving into cancer over time. Post-lung cancer surgery further damaged Zheng Qi, depleting Yin fluids, while toxic heat congests the Lungs, causing loss of Lung descending function. Treatment should clear heat and detoxify, ventilate and unblock Lung Qi, nourish Yin and tonify deficiency. Prescription: Sha Shen (Glehniae Radix) 15g, Chao Bai Zhu (Atractylodis Rhizoma Preparatum) 10g, Nan Sha Shen (Glehniae Radix) 20g, Xuan Shen (Scrophulariae Radix) 15g, Bai Shao (Paeoniae Radix Alba) 12g, Chen Pi (Citri Reticulatae Pericarpium) 10g, Fu Ling (Poria) 15g, Chao Zhi Ke (Aurantii Fructus Preparatum) 10g, Tu Bei Mu (Fritillariae Thunbergii Bulbus) 10g, Ban Zhi Lian (Scutellariae Barbatae Herba) 20g, Bai Hua She She Cao (Hedyotis Diffusae Herba) 20g, Chao Er Ya (Prepared Malt and Shenqu) 30g, Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparatum) 6g. One dose daily, decocted in water, taken three times daily. Avoid tobacco, alcohol, and spicy foods.
Second consultation on June 27, 1988: After taking 10 doses of the above prescription, chest pain, cough, and hemoptysis disappeared, and the neck mass also resolved. No medication was taken for several months thereafter. Recently, due to craving chili peppers and resuming smoking (about half a pack daily), chest pain recurred, along with cough and blood-streaked sputum, 3-4 mouthfuls daily, bright red blood color, dry mouth with desire to drink, red tongue with thin yellow coating, fine and wiry pulse. This indicates toxic heat congesting the Lungs, turbid phlegm obstructing internally, Lung Qi failing to disperse, and Lung Yin being damaged. Treatment should clear heat and detoxify, ventilate the Lungs and resolve phlegm, nourish the Lungs and generate fluids, cool blood and stop bleeding. Formula: Bai Hua She She Cao (Hedyotis Diffusae Herba) 18g, Bei Mu (Fritillariae Bulbus) 10g, Ban Zhi Lian (Scutellariae Barbatae Herba) 15g, Sang Pi (Mori Cortex) 10g, Yi Yi Ren (Coicis Semen) 15g, Xuan Shen (Scrophulariae Radix) 12g, Ju Pi Luo (Citri Reticulatae Pericarpium and Albedo) 20g each, Huang Qin (Scutellariae Radix) 10g, Dong Gua Zi (Benincasae Semen) 15g, Ou Hai Gu (Sepiae Endoconcha) 12g, Zhi Pa Ye (Eriobotryae Folium Preparatum) 15g, Hai Ge Fen (Concha Meretricis et Cyclinae Pulvis) 15g, Lu Gen (Phragmitis Rhizoma) 15g, Mao Gen (Imperatae Rhizoma) 15g. Decoct in water and take.
Third consultation on December 3, 1991: After continuously taking over 30 doses of the above prescription, symptoms such as chest pain, cough, and hemoptysis were relieved, with no recurrence for over 3 years, and no other medications were taken. Recently, due to excessive labor and failure to abstain from smoking, the original disease recurred. Symptoms include chest pain, especially severe after meals, cough, hemoptysis of 3-5 mouthfuls every morning upon waking, bright red blood color, thirst with desire to drink, poor appetite, red tongue tip, thin yellow coating with little fluid, fine and rapid pulse. Chest X-ray at a provincial hospital suggested lung cancer recurrence, thickening of the right lower pleura, and diaphragmatic adhesion. This is caused by toxic heat congesting the Lungs, failure of dispersing and descending functions, and consumption of Lung fluids. Treatment plans to clear heat and detoxify, ventilate the Lungs and resolve phlegm, nourish Yin and moisten the Lungs. Prescription: Ban Zhi Lian (Scutellariae Barbatae Herba) 18g, Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) 10g, Lian Qiao (Forsythiae Fructus) 15g, Yi Yi Ren (Coicis Semen) 30g, Bai Hua She She Cao (Hedyotis Diffusae Herba) 18g, Huang Qin (Scutellariae Radix) 10g, Lu Gen (Phragmitis Rhizoma) 15g, Mao Gen (Imperatae Rhizoma) 18g, Dong Gua Zi (Benincasae Semen) 15g, Sang Pi (Mori Cortex) 10g, Zhi Pa Ye (Eriobotryae Folium Preparatum) 15g, Zhi Zi Wan (Adenostematis Folium Preparatum) 10g, Xue Yu Tan (Capillis Carbonisatus) 10g, Gua Lou Pi (Trichosanthis Pericarpium) 10g, Ju Pi Luo (Citri Reticulatae Pericarpium and Albedo) 10g each, Ou Jie (Nelumbinis Nodus) 10g. After taking 10 doses of the above prescription, cough, hemoptysis, and chest pain disappeared, and spirit improved, except for a feeling of distension in the back. Therefore, herbs for opening the chest, regulating Qi, invigorating blood, and detoxifying were added to the previous formula, and continued for over 30 doses, leading to recovery through regulation. Follow-up for 3.5 years showed no recurrence.
[Analysis] Lung cancer-induced chest pain, cough, and hemoptysis recurred repeatedly for 4 years, with surgical resection performed, followed by repeated post-operative recurrences. Red tongue body, thin yellow coating, fine and rapid pulse indicate toxic heat congesting the Lungs, loss of Lung dispersing and descending functions, and consumption of Yin fluids. Thus, Dr. Li's initial treatment used heavy doses of formulas to clear heat and detoxify, ventilate the Lungs and resolve phlegm, and nourish Yin and moisten the Lungs, achieving prompt efficacy. Months later, due to lack of dietary restrictions and continued smoking, chest pain and other symptoms recurred. Treatment then focused on clearing heat and detoxifying, ventilating the Lungs and promoting Qi movement, resolving phlegm and stopping cough, and cooling blood and stopping bleeding, leading to relief. Three years later, due to excessive labor, the chronic disease recurred, and treatment with clearing heat and detoxifying, ventilating the Lungs and resolving phlegm, cooling blood and stopping bleeding, and nourishing Yin and generating fluids proved effective. Careful review of this case spans 4 years. Within these 4 years, severe chest pain and hemoptysis occurred 4 times, but the pathogenesis always centered on excess toxic heat and damage to Zheng Qi with lingering pathogens. Therefore, clinical medication consistently adhered to the pathogenesis, focusing on clearing heat and detoxifying, ventilating and benefiting Lung Qi, and nourishing Yin and generating fluids as the root, without avoiding cold-natured herbs due to chronic deficiency, deeply aligning with the principles of TCM syndrome differentiation and treatment. At the end of 1994, his son came to express gratitude, stating that since taking the medication, all symptoms have not recurred, he has survived for over 6 years, is mentally vigorous, and can still work in the fields. His 5 fellow lung cancer post-operative patients in the same ward, who did not take Chinese medicine, had passed away many years ago.
Case 4: Post-operative Malignant Schwannoma with Chest Pain and Cough
Zhang Mou, Male, 29 years old, teacher at a middle school in Huanggang. First consultation on December 27, 1993. Left-sided chest pain for 2 months. On September 6, 1993, chest pain occurred due to fatigue, which was ignored. Fifteen days later, chest tightness and irritability worsened, pain intensified, and he felt progressively thinner, but without fever, cough, or hemoptysis. On October 6, 1993, he was hospitalized at a hospital in Huanggang. Chest X-ray showed massive left pleural effusion, with mediastinal heart shadow shifted to the right. CT report: Apical mass in the left upper lung, considered metastatic lung cancer. Two subsequent CT reviews maintained the above diagnosis. Treatment included radiotherapy (VDP regimen) and anti-tuberculosis drugs like streptomycin for over a month, along with thoracentesis to drain pleural fluid, with no obvious improvement in symptoms, so he was discharged and sought consultation. Current examination findings: Chest tightness and pain, worse on the left, extreme irritability, cough with scanty sputum, emaciation, enlarged lymph nodes in the right axilla (pigeon-egg sized), red tongue body with thin yellow coating, fine, wiry, and rapid pulse. Past medical history: Surgery for malignant schwannoma on the outer aspect of the upper arm at Tongji Hospital in June 1992; surgery for malignant schwannoma on the right arm at Huanggang Hospital in October 1992; surgery for recurrent malignant schwannoma on the inner aspect of the left upper arm at the same hospital in April 1993. Pathological biopsies after several surgeries confirmed malignant schwannoma.
Moreover, hard nodules have grown at the surgical scar sites in recent months, with pain. CT examination: Mass shadow in the left upper lung, considered metastatic lung cancer; left pleural thickening with encapsulated effusion. Thoracentesis: Pleural fluid was bloody. Dr. Li stated: The patient previously suffered from malignant schwannoma, underwent 3 surgeries, yet recurred repeatedly. Toxic heat accumulates internally, metastasizes to the lungs, causing loss of Lung clarity and descending function, phlegm and blood stasis obstructing collaterals, and failure of water pathways to regulate, resulting in chest pain, cough, scrofula, and phlegm nodules. Treatment should clear heat and detoxify, ventilate the Lungs and resolve phlegm, and soften hardness and dissipate nodules. Prescription: Sang Pi (Mori Cortex) 10g, Dong Gua Zi (Benincasae Semen) 20g, Yi Yi Ren (Coicis Semen) 30g, Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) 10g, Tao Ren (Persicae Semen) 10g, Chao Huang Qin (Scutellariae Radix Preparatum) 10g, Zhi Pa Ye (Eriobotryae Folium Preparatum) 15g, Bai Hua She She Cao (Hedyotis Diffusae Herba) 18g, Chao Gua Lou Pi (Trichosanthis Pericarpium Preparatum) 15g, Lian Qiao (Forsythiae Fructus) 15g, Ju Pi Luo (Citri Reticulatae Pericarpium and Albedo) 10g each, Mao Gen (Imperatae Rhizoma) 30g.
Second consultation on December 27, 1993: After taking over 19 doses of the above medicine, chest tightness and pain decreased, cough subsided, and enlarged axillary lymph nodes unexpectedly resolved. Spirit improved, appetite normalized, urination and defecation were smooth, tongue and pulse remained the same. The medicine hit the mark; adhere to the previous method with appropriate modifications for treatment. Prescription: Dong Gua Zi (Benincasae Semen) 20g, Xia Ku Cao (Prunellae Spica) 30g, Yi Yi Ren (Coicis Semen) 50g, Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) 10g, Ju Luo (Citri Reticulatae Albedo) 10g, Ban Zhi Lian (Scutellariae Barbatae Herba) 10g, Zhi Pa Ye (Eriobotryae Folium Preparatum) 15g, Chao Gua Lou Pi (Trichosanthis Pericarpium Preparatum) 15g, Sang Pi (Mori Cortex) 10g, Pu Gong Ying (Taraxaci Herba) 15g, Lian Qiao (Forsythiae Fructus) 15g, Chao Huang Qin (Scutellariae Radix Preparatum) 10g, Bai Mao Gen (Imperatae Rhizoma) 15g, Lu Gen (Phragmitis Rhizoma) 15g, Che Qian Zi (Plantaginis Semen) 10g. Taken with modifications totaling over 30 doses, all symptoms relieved, weight increased. Subsequently regulated and concluded with formulas to ventilate the Lungs and resolve phlegm, clear heat and detoxify, soften hardness and dissipate nodules, and strengthen the Spleen and benefit Qi.
[Analysis] In this case, Dr. Li diagnosed internal accumulation of heat-toxin, phlegm and blood stasis obstructing collaterals, and loss of Lung clarity and descending function. Treatment focused on clearing heat and detoxifying, ventilating the Lungs and resolving phlegm, and softening hardness and dissipating nodules. Medications included Bai Hua She She Cao (Hedyotis Diffusae Herba), Ban Zhi Lian (Scutellariae Barbatae Herba), Huang Qin (Scutellariae Radix), and Lian Qiao (Forsythiae Fructus) to clear heat and detoxify, reduce swelling and dissipate nodules; Xia Ku Cao (Prunellae Spica), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus), Dong Gua Ren (Benincasae Semen), Yi Yi Ren (Coicis Semen), and Sang Pi (Mori Cortex) to ventilate the Lungs, resolve phlegm, soften hardness, and dissipate nodules; Tao Ren (Persicae Semen) to move blood and resolve stasis, unblocking blood vessels; Gua Lou Pi (Trichosanthis Pericarpium), Pa Ye (Eriobotryae Folium), and Ju Pi Luo (Citri Reticulatae Pericarpium and Albedo) to open the chest, regulate Qi, strengthen the Spleen, and resolve phlegm; Lu Gen (Phragmitis Rhizoma) and Mao Gen (Imperatae Rhizoma) to clear heat, generate fluids, promote urination, and expel phlegm. Used together, their effects in clearing heat and detoxifying, ventilating the Lungs and resolving phlegm, softening hardness and dissipating nodules, and promoting water metabolism are evident. After 10 doses, chest tightness and pain relieved, cough subsided immediately, enlarged axillary lymph nodes disappeared, and other symptoms improved. The miraculous power of Chinese medicine is thus undeniable. The secret lies in syndrome differentiation and treatment. Although prognosis is unpredictable, such short-term efficacy provides reference for future research.
Medical Discussions and Conversations
I. A Brief Talk on "One Herb as a Teacher"
Ancients commenting on literature mentioned that adding or moving one character could make sentences clear and fluent, suddenly boosting momentum, making it melodious and readable, known as "one character as a teacher." I believe that in treating diseases with TCM, if syndrome differentiation is clear, formulation principles and prescriptions are correct, but herb selection lacks precision, if an expert points out a detail and adds a对症 (symptom-matching) herb, the curative effect will be outstanding, its role comparable to the effect of changing one character. This is what I call "one herb as a teacher."
Recalling my early years learning medicine, two such facts remain unforgettable. First, after Dragon Boat Festival one year, Liu Peiyi's younger brother from the same village suffered from Damp-Warmth. Mr. Gong was invited for treatment, but after more than ten doses, there was no effect. Liu came to the county to ask my father for a decision. Knowing my father was ill and could not travel far, he first asked Doctor Gong to write down the condition, pulse, and tongue coating details for consideration. After reviewing, my father told me: "Add Gan Jiang (Zingiberis Rhizoma) to Doctor Gong's formula (which contains Qin, Lian, Ban Xia, etc.). Damp-warmth presenting with fullness, vomiting, and diarrhea is similar to Taiyang disease with stomach disharmony. When dampness stagnates and heat steams, causing Middle Jiao disharmony, dampness and heat become increasingly entangled, hence the ancient metaphor of 'pulling silk from cocoons.' Zhang Zhongjing's Ban Xia Xie Xin Tang uses Qin and Lian to clear heat, and Jiang and Xia to dry dampness. Borrowing it for damp-warmth is comprehensive. If modern doctors only dare to use cold-natured herbs and avoid acrid-hot ones, they miss half the picture, leading to inefficacy." Liu took the formula home, took a few doses, and was cured. Later, when I practiced clinically, this method sometimes worked for damp-warmth. However, if the patient's tongue coating is yellow and dry, peeled in the center, or the tongue body is crimson, one must beware of damaging Stomach Yin; Gan Jiang, being acrid and hot, should still not be used. Qing Dynasty physician Zhang Yuqing's medical case book has a case of damp-warmness of this type, serving as a warning. As for herbs like Ren Shen (Ginseng Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Da Zao (Jujubae Fructus), which aid dampness and generate heat, they should also be used cautiously when damp-heat is abundant.
Second, in autumn of that year, I returned home from the county to visit my third uncle. He loved alcohol, and his symptoms included abdominal fullness with intermittent pain, inability to eat and vomiting, loose stools 3-5 times a day, clear urine, slow and weak pulse, and thick white tongue coating. This was Taiyin organ coldness with Spleen failing to transport, causing disease from cold-damp stagnation. Warm-middle method was indicated, and Li Zhong Tang (Regulate the Middle Decoction) was given for two doses, with no effect. Shu Fu Zi (Prepared Aconiti Lateralis Radix) was added, and two more doses were taken, still with no obvious effect. Urgently returning home, I showed the formula to my father. After reviewing, my father said: "The formula matches the syndrome, but adding one or two Qi-regulating herbs would yield great results." "Ancients like Zhu Danxi, when using tonics like Ren Shen and Huang Qi, always assisted with Ju Pi (Citri Reticulatae Pericarpium). Zhang Shiwen added Qing Pi (Citri Aurantii Fructus) and Chen Pi (Citri Reticulatae Pericarpium) to Li Zhong Tang, naming it Zhi Zhong Tang, showing great ingenuity. Since Qi movement promotes water movement, and Qi is the commander of Blood, treating diseases of water, blood, phlegm, and food stagnation, adding Qi-moving and nodule-dissipating herbs to the matching formula significantly enhances efficacy, not just for Qi stagnation patients." Following his advice, I added Sha Ren (Amomi Fructus Rotundus), Wei Mu Xiang (Aucklandiae Radix Preparatum), Chuan Po (Magnoliae Officinalis Cortex), and Chao Jian Qu (Prepared Medicated Leaven) to the previous formula. Taking two more doses resulted in a cure.
After the outbreak of the Anti-Japanese War, I sought refuge in my hometown and practiced medicine at Li Family Collection in Guanqiao. An elder, Mr. Li, owner of Fuxing Grocery Store, was constitutionally weak and had a chronic cough and asthma. One winter, it flared up severely, and he invited me for treatment. Reviewing previous prescriptions, they were all Lung-ventilating and phlegm-resolving agents. His symptoms included facial edema, aversion to cold and lower back pain,急促 breathing unable to lie flat, lower abdominal tension and discomfort, normal bowel movements, scanty urine, pale tongue with white coating, and deep, fine, and weak pulse.
Diagnosed as long-standing cough and asthma inevitably affecting the Kidneys. The Kidneys are the root of True Yang and True Yin. Kidney deficiency fails to warm and grasp, causing the aforementioned symptoms.
The *Nei Jing* states: "The Kidneys are the Water Organ, governing Jin-Ye (Body Fluids), and governing sleep and asthma" (*Su Wen: Ni Diao Lun*), which is clear evidence. Thus, previous treatments targeting Lungs and Spleens were ineffective; now, warming the Kidneys, benefiting Yang, consolidating the root, and tonifying deficiency is appropriate. Therefore, Ba Wei Shen Qi Wan (Eight-Ingredient Rehmannia Pill) was used as a decoction. After several doses, symptoms reduced slightly, but asthma persisted. Mimicking Du Qi Wan (Nine-Ingredient Pill), removing Rou Gui (Cinnamomi Cortex) from the previous formula and adding Wu Wei Zi (Schisandrae Fructus), five doses were taken, yielding slight effect. Further referencing the combined intent of Du Qi Wan and Guan Yin Ying Meng San, Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction) was used with added Wu Wei Zi (Schisandrae Fructus), salt-fried Bu Gu Zhi (Psoraleae Fructus), Hu Tao Rou (Juglandis Semen), Chao Du Zhong (Eucommiae Cortex Preparatum), Duan Ci Shi (Magnetitum), Huai Niu Xi (Achyranthis Bidentatae Radix), and Che Qian Zi (Plantaginis Semen). After ten doses, the patient's spirit gradually revived, symptoms lessened, but slight exertion still caused breathlessness. An elderly TCM physician, Mr. Li, opened Weiyutang Pharmacy in the market. I consulted him with the prescription. He said: "This formula warms, settles, consolidates, and grasps, matching the syndrome well. However, I suggest adding Chen Xiang (Aquilariae Lignum Resinatum) to enhance Qi-regulating and asthma-relieving effects." Following his advice, after decocting the previous formula, a small amount of Chen Xiang powder was swallowed with each dose of herbal soup. After five more doses, breathing gradually stabilized. By early spring, he could get out of bed and was soon cured. Chen Xiang, according to Li Shizhen, treats "upper heat and lower cold, rebellious Qi with急促 asthma, large intestine deficiency closure, urinary strangury, and male seminal coldness." Used for this syndrome, it naturally has good efficacy.