川桂枝 茯苓 淡干姜 五味子 生甘草 大枣
某（二一）咳逆欲呕。是胃咳也。当用甘药。（胃咳）
生扁豆（一两） 北沙参（一钱半） 麦冬（米拌炒一钱半） 茯神（三钱） 南枣（三钱）
糯稻根须（五钱）
某 伏邪久咳。胃虚呕食。殆内经所谓胃咳之状耶。
麻黄 杏仁 甘草 石膏 半夏 苡仁
王（二七）脉沉短气。咳甚。呕吐饮食。便溏泄。乃寒湿郁痹渍阳明胃。营卫不和。胸痹如 。无非阳不
旋运。夜阴用事。浊泛呕吐矣。庸医治痰顺气。治肺论咳。不思内经胃咳之状。咳逆而呕耶。小半夏汤加姜汁。
石 气左升。腹膨。呕吐涎沫黄水。吞酸。暴咳不已。是肝逆乘胃射肺。致坐不得卧。（肝犯胃肺）安胃丸三钱。
范（妪）久咳涎沫。欲呕。长夏反加寒热。不思食。病起嗔怒。气塞上冲。不能着枕。显然肝逆犯胃冲
肺。此皆疏泄失司。为郁劳之症。故滋腻甘药。下咽欲呕矣。小青龙去麻辛甘加石膏。
颜（氏）久有痛经。气血不甚流畅。骤加暴怒。肝阳逆行。乘肺则咳。病家云。少腹冲气上干。其咳乃
作。则知清润肺药。非中 之法。今寒热之余。咳不声扬。但胁中拘急。不饥不纳。乃左升右降
不司旋转。而胃中遂失下行为顺之旨。古人以肝病易于犯胃。然则肝用宜泄。胃腑宜通。为定例矣。
桑叶 丹皮 钩藤 茯苓 半夏 广皮 威喜丸（三钱）
某 脉弦右甚。嗽。午潮热。便溏畏风。以大肠嗽治之。（大肠嗽）
生于术（一钱半） 茯苓（三钱） 赤石脂（一钱） 禹粮石（二钱） 姜汁（四分） 大枣（三枚）
又 照前方加白芍炙甘草。
又 脉数。右长左弦。上咳下溏。
生于术（一钱半） 茯苓（三钱） 炙草（五分） 木瓜（一钱） 姜汁（四分） 大枣肉（四钱）
石（四三）咳嗽十月。医从肺治无效。而巅胀喉痹脘痞。显是厥阳肝风。议镇补和阳熄风。（肝风）
生牡蛎 阿胶 青黛 淡菜
某 昨议上焦肺病。百日未痊。形肌消烁。悉由热化。久热无有不伤阴液。拟咸补如阿胶鸡子
黄。复入芩连苦寒。自上清气热以补下。虽为暂服之方。原非峻克之剂。细思手经之病。原无
遽入足经之理。但人身气机。合乎天地自然。肺气从右而降。肝气由左而升。肺病主降日迟。
肝横司升日速。咳呛未已。乃肝胆木反刑金之兆。试言及久寐寤醒。左常似闪烁。嘈杂如饥。
及至进食。未觉胃中安适。此肝阳化风。旋扰不息。致呛无平期。即倏热之来。升至左颊。其左
升太过。足为明验。倘升之不已。入春肝木司权。防有失血之累。故左右为阴阳之道路。阴阳
既造其偏以致病。所以清寒滋阴。不能骤其速功。
阿胶 鸡子黄 生地 天冬 女贞实 糯稻根须
姚 胁痛久嗽（胁痛） 旋复花汤加桃仁柏子仁。
某 寒热。右胁痛。咳嗽。
芦根（一两） 杏仁（三钱） 冬瓜子（三钱） 苡仁（三钱） 枇杷叶（三钱） 白蔻仁（三分）
咳为气逆。嗽为有痰。内伤外感之因甚多。确不离乎肺脏为患也。若因于风者。辛平解之。
因于寒者。辛温散之。因于暑者。为熏蒸之气。清肃必伤。当与微辛微凉。苦降淡渗。俾上焦
蒙昧之邪。下移出腑而后已。若因于湿者。有兼风兼寒兼热之不同。大抵以理肺治胃为
主。若因秋燥。则嘉言喻氏之议最精。若因于火者。即温热之邪。亦以甘寒为主。但温热犹
有用苦辛之法。非比秋燥而绝不用之也。至于内因为病。不可不逐一分之。有刚亢之威。
木扣而金鸣者。当清金制木。佐以柔肝入络。若土虚而不生金。真气无所禀摄者。有甘凉
甘温二法。合乎阴土阳土以配刚柔为用也。又因水虚而痰泛。元海竭而诸气上冲
者。则有金水双收。阴阳并补之治。或大剂滋填镇摄。葆固先天一 元精。至于饮邪窃发。
亦能致嗽。另有专门。兼参可也。以上诸法。皆先生临证权衡之治。非具慧心手眼。能如是乎。（邵新甫）
徐评 凡述医案。必择大症及疑症人所不能治者数则。以立法度。以启心思。为后学之所法。
今载百余方。重复者八九。此非医案。乃逐日之总簿耳。
某患者，二十一岁，咳嗽气逆欲呕吐。这是胃咳（指咳嗽伴有呕吐症状，病位主要在胃）。应当使用甘缓的药物来治疗。（针对胃咳的治法）
生扁豆（一两）、北沙参（一钱半）、麦冬（用米拌炒一钱半）、茯神（三钱）、南枣（三钱）、糯稻根须（五钱）。
另一位患者，伏邪（潜伏体内的病邪）导致久咳不愈，胃气虚弱导致呕吐食物。这大概就是《内经》所说的胃咳的症状吧。
王某，二十七岁，脉象沉短，气息短促，咳嗽剧烈，呕吐饮食，大便溏泄。这是寒湿之邪郁结痹阻，浸渍阳明胃经，导致营卫不和，胸中痹阻如物堵塞。无非是阳气不能旋转运化，夜间阴气主事，浊阴上泛导致呕吐。庸医只知治痰顺气，从肺论治咳嗽，却不思考《内经》中关于胃咳的描述：咳嗽气逆且伴有呕吐。用小半夏汤加姜汁。
石姓患者，气机左侧升发太过，腹部膨隆，呕吐涎沫和黄水，吞酸，突发咳嗽不止。这是肝气逆乱侵犯胃腑并射入肺脏，导致患者坐卧不安。（肝气犯胃及肺）服用安胃丸三钱。
范姓老妇人，久咳吐涎沫，想要呕吐，长夏季节反而出现寒热往来，不想进食。病起于嗔怒，气机阻塞上冲，无法枕卧。显然是肝气逆乱侵犯胃腑并冲击肺脏，这都是疏泄功能失常，属于郁劳之症。所以滋腻甘润的药物，咽下后就会引起呕吐。用小青龙汤去掉麻黄、细辛、甘草，加入石膏。
颜姓氏妇，长期有痛经病史，气血不是很流畅，突然加上暴怒，肝阳逆行，侵犯肺脏则引发咳嗽。病人家属说，少腹有冲气上干，咳嗽才发作。由此可知，清润肺药不是其中的关键方法。如今在寒热之余，咳嗽声音不高扬，只是胁肋部拘急，没有饥饿感也不进食，这是左升右降的气机旋转功能失调，而胃中也失去了下行顺应的旨意。古人认为肝病容易侵犯胃腑，那么肝的功能宜疏泄，胃腑宜通降，这是固定的法则。
某患者，脉象弦而右侧更甚，咳嗽，午后潮热，大便溏泄怕风。按照大肠嗽（咳嗽伴有大肠症状）来治疗。（大肠嗽）
生于术（一钱半）、茯苓（三钱）、赤石脂（一钱）、禹粮石（二钱）、姜汁（四分）、大枣（三枚）。
又诊：脉数，右脉长左脉弦，上部咳嗽下部溏泄。
生于术（一钱半）、茯苓（三钱）、炙草（五分）、木瓜（一钱）、姜汁（四分）、大枣肉（四钱）。
石姓患者，四十三岁，咳嗽十个月，医生从肺脏治疗无效，而出现头顶胀满、喉痹、胃脘痞闷，显然是厥阳肝风上扰。建议镇潜补益、调和阳气、熄风止痉。（肝风内动）
某患者，昨日讨论为上焦肺病，百日未痊愈，形体肌肉消瘦消耗，全由热邪转化所致。久热必然损伤阴液，拟定咸味滋补之法如阿胶鸡子黄，再配合芩连苦寒药物，从上焦清气热以补下焦。虽然这是暂时服用的方剂，原本就不是峻猛攻克的药剂。仔细思考手经（肺经）的疾病，原本没有迅速传入足经（脾胃等）的道理。但是人身气机，合乎天地自然规律，肺气从右而降，肝气由左而升。肺病主降功能迟缓，肝横逆司升功能急速。咳嗽呛逆未停，是肝胆木气反侮肺金的征兆。试着谈及长时间睡眠醒来，左侧常似闪烁不定，嘈杂如饥，等到进食时，并未觉得胃中安适。这是肝阳化风，旋转扰乱不息，导致呛咳没有平息之日。即使是倏忽而来的热邪，升至左颊，其左升太过，足以作为明证。倘若升发不已，进入春季肝木当令之时，防备有失血的祸患。所以左右是阴阳的道路，阴阳既然偏颇以致生病，因此清寒滋阴的方法，不能迅速见效。
芦根（一两）、杏仁（三钱）、冬瓜子（三钱）、苡仁（三钱）、枇杷叶（三钱）、白蔻仁（三分）。
咳嗽是气机上逆，嗽是有痰。内伤外感的病因很多，确实离不开肺脏为患。如果是因为风邪，用辛平的方法解表；因为寒邪，用辛温的方法发散；因为暑邪，那是熏蒸之气，清肃必伤正气，应当给予微辛微凉、苦降淡渗的药物，使上焦蒙昧的邪气，向下移出腑脏而后停止。如果是因为湿邪，有兼风、兼寒、兼热的不同，大体上以理肺治胃为主。如果是因为秋燥，那么嘉言喻氏（喻昌）的议论最精辟。如果是因为火邪，即温热之邪，也以甘寒为主。但温热病还有使用苦辛方法的余地，不像秋燥那样绝对不用。至于内因为病，不可不逐一分辨。有刚亢之威，木叩而金鸣（肝旺乘肺）的，应当清金制木，佐以柔肝入络。如果土虚而不生金，真气无所禀摄的，有甘凉、甘温两种方法，合乎阴土阳土配合刚柔为用。又因为水虚而痰泛，元海竭而诸气上冲的，则有金水双收、阴阳并补的治疗。或者大剂量滋填镇摄，葆固先天一元精。至于饮邪窃发，也能导致咳嗽，另有专门论述，可以参考以上方法。以上各种方法，都是先生临证权衡的治疗方案，不是具有慧心手眼的人，能如此吗？（邵新甫评）
徐评：凡是叙述医案，必须选择大病及疑难病症、别人不能治疗的几则，来确立法度，启发心思，作为后学者的效法对象。现在记载一百多张方子，重复的占八九成。这不是医案，而是逐日的总账簿罢了。
Chuan Guizhi (Cinnamomi Ramulus), Fuling (Poria), Dan Ganjiang (Dried Ginger), Wuweizi (Schisandrae Fructus), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Dazao (Jujubae Fructus).
A certain patient, aged 21, experienced cough with qi rebellion and a desire to vomit. This is Weike (Stomach Cough, characterized by cough accompanied by vomiting, with the pathology primarily in the Stomach). One should use sweet and mild medications to treat it. (Treatment principle for Stomach Cough)
Sheng Biandou (Lablab Album Seed, 1 liang), Beishashen (Glehniae Radix, 1.5 qian), Maidong (Ophiopogonis Tuber, stir-fried with rice, 1.5 qian), Fushen (Poria with Hostwood, 3 qian), Nanzao (Jujubae Fructus, 3 qian), Nuodaogenxu (Rhizoma Imperatae Rootlet, 5 qian).
Another patient suffered from prolonged cough due to latent pathogenic factors (Fu Xie), with weak Stomach Qi leading to vomiting of food. This is likely the manifestation of Weike described in the *Neijing* (Inner Canon).
Mahuang (Ephedrae Herba), Xingren (Armeniacae Semen Amarum), Gancao (Glycyrrhizae Radix et Rhizoma), Shigao (Gypsum Fibrosum), Banxia (Pinelliae Rhizoma), Yiren (Coicis Semen).
Patient Wang, aged 27, presented with a deep and short pulse, shortness of breath, severe cough, vomiting of food and drink, and loose stools. This indicates that Cold-Dampness was constrained and bi-obstructed, infiltrating the Yangming Stomach channel, leading to disharmony of Ying and Wei (Nutritive and Defensive levels), and chest bi-obstruction feeling like an obstruction. It is nothing other than Yang failing to rotate and transform. During the night, when Yin dominates, turbid Yin rises causing vomiting. Quack doctors only treat phlegm and regulate qi, discussing cough from the perspective of the Lung, without considering the description of Weike in the *Neijing*: cough with qi rebellion and vomiting. Prescribed Xiao Banxia Tang (Minor Pinellia Decoction) plus Jiangzhi (Ginger Juice).
Patient Shi, exhibited excessive rising of Qi on the left side, abdominal distension, vomiting of saliva and yellow water, acid regurgitation, and sudden persistent cough. This is Liver Qi rebelling, invading the Stomach and shooting into the Lung, causing the patient to be unable to sit or lie down. (Liver invading Stomach and Lung). Administered Anwei Wan (Stomach-Calming Pill), 3 qian.
Elderly Patient Fan, suffered from prolonged cough with salivation and a desire to vomit. In late summer, she paradoxically experienced alternating chills and fever, loss of appetite. The illness began with anger, causing Qi blockage and upward rushing, making it impossible to rest her head on a pillow. Clearly, this is Liver Qi rebelling, invading the Stomach and impacting the Lung. All these are due to dysfunction of dispersion and descent, constituting a syndrome of depression and exhaustion. Therefore, cloying and sweet-nourishing medicines caused vomiting upon swallowing. Prescribed Xiao Qinglong Tang (Minor Blue Dragon Decoction) removing Mahuang, Xixin, and Gancao, adding Shigao.
Patient Yan, had a history of dysmenorrhea, with Qi and Blood not flowing smoothly. Sudden rage caused Liver Yang to rebel, invading the Lung resulting in cough. The family reported that rebellious Qi from the lower abdomen rushed upward, triggering the cough. Thus, it is known that clearing and moistening Lung medicines are not the core method. Now, after the residual chills and fever, the cough is not loud, but there is tension in the hypochondrium, no hunger, and inability to eat. This indicates that the rotation of Left-Rising and Right-Descending Qi is dysfunctional, and the Stomach has lost its principle of downward flow being smooth. Ancients stated that Liver diseases easily invade the Stomach; thus, regulating Liver function requires dispersing, and regulating the Stomach腑 (Fu organ) requires unblocking, which is a fixed rule.
Sangye (Mori Folium), Danpi (Moutan Cortex), Gouteng (Uncariae Ramulus cum Uncis), Fuling (Poria), Banxia (Pinelliae Rhizoma), Guangpi (Citri Reticulatae Pericarpium), Weixi Wan (Weixi Pill), 3 qian.
A certain patient, pulse was wiry and more pronounced on the right, cough, afternoon tidal fever, loose stools, and aversion to wind. Treated as Dachang Sou (Large Intestine Cough). (Large Intestine Cough)
Sheng Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian), Fuling (Poria, 3 qian), Chishizhi (Halloysit Rubrum, 1 qian), Yuliangshi (Kaolinite, 2 qian), Jiangzhi (Ginger Juice, 4 fen), Dazao (Jujubae Fructus, 3 pieces).
Re-examination: Add Baishao (Paeoniae Radix Alba) and Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) to the previous prescription.
Re-examination: Pulse is rapid, Right pulse is long, Left pulse is wiry. Upper body cough, lower body loose stools.
Sheng Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian), Fuling (Poria, 3 qian), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 5 fen), Mugua (Chaenomelis Fructus, 1 qian), Jiangzhi (Ginger Juice, 4 fen), Dazao Rou (Jujubae Fructus Pulp, 4 qian).
Patient Shi, aged 43, coughed for ten months. Doctors treated from the Lung perspective with no effect, presenting with distension at the vertex, throat obstruction, and epigastric fullness. Clearly, this is Jueyang Liver Wind disturbing upwards. Proposed treatment: sedate and tonify, harmonize Yang, extinguish Wind. (Internal Stirring of Liver Wind)
Sheng Muli (Ostreae Concha), Ejiao (Colla Corii Asini), Qingdai (Indici Folium), Danshen (Mytili Edulis).
A certain patient, yesterday discussed as Upper Jiao Lung disease, unresolved for 100 days, with emaciation and wasting of flesh and muscle, all due to transformation into Heat. Prolonged heat inevitably damages Yin fluids. Proposed salty nourishment such as Ejiao and Ji Zihuang (Chicken Egg Yolk), combined with Huangqin and Huanglian (Scutellariae Radix and Scutellariae Barbatae Radix) bitter-cold herbs, to clear upper Jiao Qi-heat and supplement the lower. Although this is a temporary formula, it is originally not a harsh purgative agent. Carefully considering diseases of the Hand meridians (Lung), there is originally no logic for them to rapidly enter the Foot meridians (Spleen/Stomach etc.). However, human Qi mechanism conforms to Heaven and Earth's natural laws: Lung Qi descends from the right, Liver Qi ascends from the left. Lung disease causes slow descent, while Liver rebellion causes rapid ascent. Persistent coughing and choking indicate Wood (Liver/Gallbladder) counter-rebelling against Metal (Lung). Consider waking from long sleep; the left side often feels flickering, with epigastric discomfort resembling hunger. Upon eating, the Stomach does not feel comfortable. This is Liver Yang transforming into Wind, rotating and disturbing ceaselessly, causing coughing without a peaceful period. Even if sudden heat comes, rising to the left cheek, the excessive leftward ascent serves as clear evidence. If ascending continues, entering Spring when Liver Wood governs, one must guard against the burden of bleeding. Thus, left and right are the pathways of Yin and Yang. Since Yin and Yang have deviated causing disease, clearing cold and nourishing Yin cannot achieve rapid results.
Ejiao (Colla Corii Asini), Ji Zihuang (Chicken Egg Yolk), Shengdi (Rehmanniae Radix), Tiandong (Asparagi Tuber), Nvzhenzi (Ligustri Lucidi Fructus), Nuodaogenxu (Rhizoma Imperatae Rootlet).
Patient Yao, chronic hypochondriac pain and prolonged cough (Hypochondriac Pain). Prescribed Xuansu Hua Tang (Inula Flower Decoction) adding Taoren (Prunus Persica Seed) and Baiziren (Biota Orientalis Seed).
A certain patient, chills and fever, right hypochondriac pain, cough.
Lugen (Phragmitis Rhizoma, 1 liang), Xingren (Armeniacae Semen Amarum, 3 qian), Dongguazi (Benincasae Semen, 3 qian), Yiren (Coicis Semen, 3 qian), Pipaye (Loquat Leaf, 3 qian), Baokouren (Amomi Fructus Rotundus, 3 fen).
Cough is Qi rebellion; Sou is having phlegm. The causes of internal injury and external contraction are numerous, but essentially always involve pathology of the Lung. If due to Wind, resolve with pungent-neutral methods. If due to Cold, disperse with pungent-warm methods. If due to Summer-Heat, which is steaming and vaporizing, clearing and肃ifying will injure [the body]; provide slightly pungent and slightly cool, bitter-descending and light-leaching methods, allowing the obscure pathogens of the Upper Jiao to move downward out of the Fu organs before stopping. If due to Dampness, there are differences in accompanying Wind, Cold, or Heat. Generally, regulating the Lung and treating the Stomach is primary. If due to Autumn Dryness, the discussion by Yu Jieyan (Yu Chang) is the most exquisite. If due to Fire, i.e., Warm-Thermal pathogens, also prioritize sweet-cold methods. However, warm-heat diseases still have room for using pungent-bitter methods, unlike autumn dryness where they are absolutely not used. As for internal causes of disease, one must distinguish them one by one. There is the majesty of rigidity and exuberance, where Wood strikes and Metal rings (Liver overacting on Lung); one should clear Metal to control Wood, assisted by softening the Liver and entering the collaterals. If Earth is deficient and fails to generate Metal, with True Qi having no source to rely on, there are two methods: sweet-cool and sweet-warm, conforming to Yin-Earth and Yang-Earth matching rigid and soft for use. Also, due to Water deficiency causing phlegm flooding, and Yuanhai (Sea of Origin) depletion causing various Qi rushing upward, there is treatment of dual collection of Metal and Water, simultaneous supplementation of Yin and Yang. Or large doses of nourishing filling and sedation, preserving the primordial Essence of the First Origin. As for fluid retention secretly emerging, it can also cause cough, with separate specialized discussions; reference can be made here. The above various methods are all treatments weighed by Mr. Ye during clinical practice. Without wisdom and insight, could one be so? (Commentary by Shao Xinpu)
Xu's Commentary: Whenever narrating medical cases, one must select several major and difficult cases that others cannot treat, to establish legal standards and inspire thinking, serving as models for later learners. Now, recording over a hundred prescriptions, with eight or nine out of ten being repetitive. This is not a medical case record, but merely a daily general ledger.