陈左（递浦，五十二岁） 久嗽伤阴已成肺痿，咳嗽曾失血，但吐白沫，咽痛喉痹，妨纳
饮食，五内烦热，便燥，溺水眩晕，体疲，形内羸瘦，积劳成之候。脉虚数近弦，姑拟滋清一
则，兼其转机，附方请正。
台参须（五分入煎） 陈清阿胶（一钱五分，藕粉炒成珠） 北杏仁（三钱，去皮尖） 悉尼膏（一两，
分冲） 冰糖水炒石膏（三钱） 连心麦冬（一钱五分） 炙冬花（一钱五分） 川贝（去心，二钱） 酒炒丹
皮（一钱五分） 生蛤壳（五钱，青黛五分拌打） 霜桑叶（二钱五分） 冬虫夏草（一钱五分，蜜炙） 枇杷叶
（三张） 炒马兜铃（二钱） 玫瑰花（八分，后入）。
老夫自服风哮有年，遇寒劳秋而发，咳逆痰稠，甚且不能平卧，脉弦滑浮，治宜降气豁痰。
方见肝气痰饮，同王姓之方。
肺风痰喘宜从《指掌》。肺伤痰喘之法加羚角犀黄竹沥，或用小青龙汤，麻杏甘石汤，射干麻黄汤。
严左（七十二岁，八月） 喘逆未平，咯痰欠顺，丹溪谓∶上升之气，自肝而出。操劳动
肝，肝气横逆扰动痰饮为患，年高病者是非宜也，脉濡滑近弦，舌苔黄腻。治拟平肝降逆理
气豁痰，附方是否，以候高明酌政。
姜制西洋参（一钱五分） 真川贝（二钱） 复（一钱五分） 真紫沉水香（三分） 蛤蚧尾（一对
，酒洗去鳞，焙研极细分冲） 化陈皮（一钱五分，盐水炒软） 紫石英（三钱，生打） 丝瓜络（三钱） 白杏
仁（三钱） 戈制半夏（一钱五分） 炒白蒺（三钱） 竹沥（一两，淡姜汁一滴和匀分冲）。
陈左（来自递浦，五十二岁）：长期咳嗽损伤阴液，已发展为肺痿证。曾经咳嗽导致咯血，目前仅吐出白色泡沫，咽喉疼痛且喉部闭塞感，妨碍进食饮水，体内烦热，大便干燥，因溺水后出现眩晕，身体疲倦，形体内部消瘦，这是由积劳成疾所致。脉象虚数而近弦。暂拟定一个滋阴清热的方子，兼顾调理气机转折，附上药方请指正。
台参须（五分入煎剂） 陈年清阿胶（一钱五分，用藕粉炒至成珠状） 北杏仁（三钱，去皮尖） 悉尼膏（一两，分次冲服） 冰糖水炒石膏（三钱） 连心麦冬（一钱五分） 炙款冬花（一钱五分） 川贝母（去心，二钱） 酒炒牡丹皮（一钱五分） 生蛤壳（五钱，拌青黛五分共同捣碎） 霜桑叶（二钱五分） 冬虫夏草（一钱五分，蜜炙） 枇杷叶（三张） 炒马兜铃（二钱） 玫瑰花（八分，后下）。
老夫自己患有风哮多年，遇到寒冷、劳累或秋季时发作，咳嗽气逆，痰液稠厚，严重时甚至不能平卧，脉象弦滑浮。治疗应当降气豁痰。此方涉及肝气与痰饮问题，同王姓患者的方子类似。
对于肺风痰喘，适宜参考《指掌》中的方法。若是肺伤导致的痰喘，治疗方法需加入羚羊角、犀黄、竹沥，或者使用小青龙汤、麻杏甘石汤、射干麻黄汤。
严左（七十二岁，八月就诊）：喘逆症状尚未平息，咯痰不够顺畅。丹溪曾说：“上升之气，发自肝脏。”操劳和运动伤肝，导致肝气横逆，扰动痰饮引发疾病，这对于年老患者来说是不适宜的。脉象濡滑近弦，舌苔黄腻。治疗拟定平肝降逆、理气豁痰的方法，附上药方是否合适，等候高明人士斟酌指正。
姜制西洋参（一钱五分） 真川贝母（二钱） 复盆子（一钱五分） 真紫沉水香（三分） 蛤蚧尾（一对，酒洗去鳞，焙干研成极细粉末冲服） 化橘红（一钱五分，盐水炒软） 紫石英（三钱，生打） 丝瓜络（三钱） 白杏仁（三钱） 戈制半夏（一钱五分） 炒白蒺藜（三钱） 竹沥（一两，加淡姜汁一滴调和均匀后分次冲服）。
Patient Chen, Left (from Dipu, aged 52): Chronic cough has damaged Yin fluids, progressing to Lung Wei syndrome (Lung Atrophy). There was a history of hemoptysis due to coughing; currently, only white froth is expectorated. Symptoms include sore throat and throat obstruction (Hou Bi), difficulty swallowing food and drink, internal irritability and heat, dry stools, dizziness following drowning, physical fatigue, and emaciation within the body. These are signs resulting from accumulated exhaustion. The pulse is deficient, rapid, and nearly wiry. A prescription for nourishing Yin and clearing heat is tentatively proposed to facilitate the transition of Qi mechanism. The attached formula is submitted for correction.
Taishen Xu (Ginseng Radicula, 5 fen, added to decoction)
Chen Qing Ejiao (Donkey-hide Gelatin, 1 qian 5 fen, stir-fried with lotus root powder until bead-like)
Beixingren (Bitter Apricot Seed, 3 qian, skin and tip removed)
Xini Gao (Sydney Paste, 1 liang, taken in divided doses by mixing)
Bingtang Shui Chao Shigao (Gypsum Fibrosum Stir-fried with Rock Sugar Water, 3 qian)
Lianxin Maidong (Ophiopogonis Radix with Heart, 1 qian 5 fen)
Zhi Donghua (Flos Kolkwitziae Preparatus / Sonchus Flower? Note: Usually refers to Adenophorae Radix or similar, here likely *Adenophorae Radix* or *Sonchus*, but standard TCM herb is *Dong Hua Ren* - Flos Sonchi. Translating as Prepared Sonchus Flower), 1 qian 5 fen)
Chuanbei (Fritillariae Bulbus, heart removed, 2 qian)
Jiu Chao Danpi (Moutan Cortex Stir-fried with Wine, 1 qian 5 fen)
Sheng Geqiao (Tridacnidae Concha, 5 qian, mixed with 5 fen Qingdai and pounded)
Shuang Sangye (Folium Mori Frosted, 2 qian 5 fen)
Dongchongxiacao (Cordyceps Sinensis, 1 qian 5 fen, honey-fried)
Pipaye (Eriobotryae Folium, 3 leaves)
Chao Madouling (Aristolochiae Fructus Stir-fried, 2 qian)
Meiguahua (Rosae Rugosae Flos, 8 fen, added later).
The old man has suffered from Wind Asthma (Feng Xiao) for years, triggered by cold, labor, or autumn weather. Cough with qi reversal and thick phlegm occurs, severe cases preventing lying flat. The pulse is wiry, slippery, and floating. Treatment should focus on descending Qi and resolving phlegm. This formula addresses Liver Qi and Phlegm-Fluids, similar to the formula for Patient Wang.
For Lung Wind Phlegm Asthma, reference should be made to *Zhi Zhang*. For phlegm asthma due to Lung injury, methods should add Lingyang Jiao (Saiga Antelope Horn), Xihuang (Calculus Bovis), and Zhuli (Bambusae Caulis in Taenia); alternatively, use Xiao Qing Long Tang (Minor Blue Dragon Decoction), Ma Xing Gan Shi Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction), or Shegan Mahuang Tang (Belamcanda and Ephedra Decoction).
Patient Yan, Left (aged 72, August): Asthma and qi reversal have not subsided; expectoration of phlegm is not smooth. Danxi stated: "Ascending Qi originates from the Liver." Labor and movement injure the Liver, causing Liver Qi to invade horizontally and disturb Phlegm-Fluids, leading to pathology. This is unsuitable for elderly patients. The pulse is soggy, slippery, and nearly wiry; the tongue coating is yellow and greasy. Treatment proposes calming the Liver, descending rebellion, regulating Qi, and resolving phlegm. The attached formula is submitted for your esteemed judgment.
Jiang Zhi Yangshen (Prepared American Ginseng, 1 qian 5 fen)
Zhen Chuanbei (Authentic Fritillariae Bulbus, 2 qian)
Fupenzi (Rubia Fruit / Rubus Chingii? Note: Text says 'Fu', likely short for Fupenzi or similar. Given context of lung/kidney, Fupenzi is common. Translating as Rubi Fructus), 1 qian 5 fen)
Zhen Zichen Shuixiang (Authentic Aquilaria Lignum Resinatum, 3 fen)
Gejie Wei (Tail of Gecko, one pair, washed with wine to remove scales, baked and ground into fine powder for mixing),
Hu Chenpi (Processed Citrus Reticulatae Pericarpium, 1 qian 5 fen, stir-fried with salt water until soft)
Zhi Yanshi (Fluorite, 3 qian, raw pounded)
Sigualuo (Luffae Fructus Retinervia, 3 qian)
Baixingren (White Apricot Seed, 3 qian)
Ge Zhi Banxia (Pinelliae Rhizoma Prepared with Alum/Gelatin?, 1 qian 5 fen)
Chao Baiji (Tribuli Fructus Stir-fried, 3 qian)
Zhuli (Bambusae Caulis in Taenia, 1 liang, mixed with one drop of light Ginger Juice and taken in divided doses).