野台参各一两，煎汤两茶杯，分二次温服。自午至暮，连进二剂，共服药四次，翌日精神清爽，能进饮食，半
日进食五次，犹饥而索食。看护者不敢复与，则周身颤动，复发谵语，疑其病又反复，求再诊视。其脉象大致
和平，而浮分仍然微弱。恍悟其胸中大气，因服破气之药下陷，虽用参数次，至此犹未尽复，故亟亟求助于水
谷之气，且胃中之气，因大气下陷无所统摄，或至速于下行，而饮食亦因之速下也。遂用野台参两许，佐以麦
门冬（带心）三钱、柴胡二钱，煎汤饮下，自此遂愈。
或问∶子所治大气下陷证，有两日不食者，有饮食减少者。此证亦大气下陷，何以转能多食？答曰∶事有
常变，病亦有常变。王清任《医林改错》载有所治胸中瘀血二案∶一则胸不能着物，一则非以物重压其胸不安，
皆治以血腑逐瘀汤而愈。夫同一胸中瘀血，其病状竟若斯悬殊，故同一大气之下陷也，其脾胃若因大气下陷，
而运化之力减者，必然少食；若大气下陷，脾胃之气亦欲陷者，或转至多食。曾治一少妇，忽然饮食甚多，一
时觉饥不食，即心中怔忡。医者以为中消证，屡治不效。向愚询方，疑其胸中大气下陷，为开升陷汤方，加龙
骨、牡蛎（皆不用 ）各五钱，数剂而愈。盖病因虽同，而病之情状，恒因人之资禀不同，而有变易。斯在临
证者，细心体察耳。
按∶此证与前证，虽皆大气下陷，而实在寒温之余，故方中不用黄 ，而用人参。因寒温之热，最能铄耗
津液，人参能补气，兼能生津液，是以《伤寒论》方中，凡气虚者，皆用人参，而不用黄 也。
上所列者，皆大气下陷治验之案也。然此证为医者误治及失于不治者甚多，略登数则于下，以为炯戒。
庚戍秋，在沧州治病，有赵姓，忽过访，言有疑事，欲质诸先生。问何疑？曰∶予妹半月前来归宁，数日
间，无病而亡，未知何故？愚曰∶此必有病，子盖未知耳。×曰∶其前一日，觉咽喉发闷，诊其脉沉细，疑其
胸有郁气，俾用开气之药一剂，翌日不觉轻重，惟自言不再服药，斯夕即安坐床上而逝。其咽喉中发闷，并不
甚剧，故曰无病也。愚曰∶此胸中大气下陷耳。时行箧中有治大气下陷诸案，因出示之，且为剖析其理。×泫
然流涕曰，斯诚为药误矣。
一人，年三十余。呼吸短气，胸中满闷。医者投以理气之品，似觉稍轻，医者以为药病相投，第二剂，遂
放胆开破其气分。晚间服药，至夜如厕，便后遂不能起。看护者，扶持至床上，昏昏似睡，呼之不应，须臾张
口呼气外出，若呵欠之状，如斯者日余而亡。后其兄向愚述之，且问此果何病？因历举大气下陷之理告之。其
兄连连太息，既自悔择医不慎，又痛恨医者误人，以后不敢轻于延医服药。
一农家媪，年五十余。因麦秋农家忙甚，井臼之事皆自任之，渐觉呼吸不利，气息迫促。医者误认为气逆
作喘，屡投以纳气降气之药，气息遂大形迫促，其努力呼吸之声，直闻户外。延愚诊视，及至，诊其脉左右皆
无，勉为疏方，取药未至而亡，此
亦大气下陷也。其气息之迫促，乃肺之呼吸将停，努力呼吸以自救也，医者又复用药，降下其气，何其谬哉！
一诸生，年五十六，为学校教员，每讲说后，即觉短气，向愚询方。愚曰，此胸中大气，虚而欲陷，为至
紧要之证，当多服升补气分之药。彼欲用烧酒炖药，谓朝夕服之甚便。愚曰，如此亦可，然必须将药炖浓，多
饮且常饮耳。遂为疏方，用生黄 四两、野台参二两，柴胡、桔梗各八钱，先用黄酒斤许，煎药十余沸，再用
烧酒二斤，同贮瓶中，置甑中炖开，每饭前饮之，旬日而愈。后因病愈，置不复饮。隔年，一日步行二里许，
自校至家，似有气息迫促之状，不能言语，倏忽而亡。盖其身体素胖，艰于行步，胸中大气，素有欲陷之机，
因行动劳苦，而遂下陷，此诚《内经》所谓“大气入于脏腑，不病而猝死”者也。方书有气厥，中气诸名目，
大抵皆大气下陷之证，特未窥《内经》之旨，而妄为议论耳。
按∶《内经》原有气厥二字，乃谓气厥逆上行，
非后世所谓气厥也。
或问∶案中所载大气下陷证，病因及其病状，皆了如指掌矣。然其脉之现象，或见于左部，或见于右部，
或左右两部皆有现象可征，且其脉多迟，而又间有数者，同一大气之下陷也，何以其脉若是不同乎？答曰∶胸
中大气包举肺外，原与肺有密切之关系，肺之脉诊在右部，故大气下陷，右部之脉多微弱者其常也。然人之元
气自肾达肝，自肝达于胸中，为大气之根本。其人或肝肾素虚，或服破肝气之药太过，其左脉或即更形微弱，
若案中左部寸关尺皆不见，左脉沉细欲无，左关参伍不调者是也。至其脉多迟，而又间有数者，或因阴分虚损，
或兼外感之热，或为热药所伤，乃兼证之现脉，非大气下陷之本脉也。
或问∶李东垣补中益气汤所治之证，若身热恶寒、心烦懒言，或喘、或渴、或阳虚自汗，子所治大气下
陷案中，类皆有之。至其内伤外感之辨，谓内伤则短气不足以息，尤为大气下陷之明征。至其方中所用之药，
又与子之升陷汤相似。何以其方名为补中益气，但治中气之虚陷，而不言升补大气乎？答曰∶大气之名，虽见
于《内经》，然《素问》中所言之大气，乃指外感之邪气而言，非胸中之大气也。至《灵枢》所言，虽系胸中
大气，而从来读《内经》者，恒目《灵枢》为针经而不甚注意。即王氏注《内经》，亦但注《素问》而不注
《灵枢》。后人为其不易索解，则更废而不读。至仲景《伤寒》、《金匮》两书，惟《金匮》水气门，有“大
气一转，其气乃散”之语。他如《难经》、《千金》、《外台》诸书，并未言及大气。是以东垣于大气下陷证，
亦多误认为中气下陷，故方中用白术以健补脾胃，而后来之调补脾胃者，皆以东垣为法。夫中气诚有下陷之时，
然不若大气下陷之尤属危险也。间有因中气下陷，泄泻日久，或转致大气下陷者，可仿补中益气汤之意，于拙
拟升陷汤中，去知母加白术数钱。若但大气下陷，而中气不下陷者，白术亦可不用，恐其气分或有郁结，而
、术并用，易生胀满也。
按∶补中益气汤所治之喘证，即大气下陷者之努力呼吸也。若果系真喘，桔梗尚不宜用，况升麻乎？愚少
时观东垣书，至此心尝疑之，后明大气下陷之理，始觉豁然，而究嫌其立言欠妥。设医者，真以为补中益气汤
果能治喘，而于气机上逆之真喘亦用之，岂不足偾事乎？此有关性命之处，临证者当审辨之。
附录∶
直隶青县张××来函∶
湖朝鲜××妻，年六旬，素多肝郁，浸至胸中大气下陷。其气短不足以息，因而努力呼吸，有似乎喘；喉干
作渴；心中满闷怔忡；其脉甚沉微。知其胸中大气下陷过甚，肺中呼吸几有将停之
势，非投以升陷汤，以升补其大气不可。为录出原方，遵注大气；陷之甚者将升麻加倍服。一剂后，吐出粘涎
数碗，胸中顿觉舒畅。又于方中加半夏、陈皮，连服三剂，病遂霍然。盖此证因大气下陷，其胸肺胃脘无大气
以斡旋之，约皆积有痰涎，迨服药后，大气来复，故能运转痰涎外出，此《金匮》水气门所谓“大气一转，其
气（水气即痰涎）乃散”也。后大气下陷证数见不鲜，莫不用升陷汤加减治愈。
河北省沦县张××来函∶
族婶母，年四十余岁，身体素弱。因境遇不顺，又多抑郁。癸亥十月下旬，忽患头疼甚剧，已三日矣，
族叔来舍，俾生往诊。及至，闻呻吟不已，卧床不起，言已针过百会及太阳两处，均未见效。其左脉微细如丝，
按之即无，右脉亦无力，自言气息不接，胸闷不畅，不思饮食，自觉精神恍惚，似难支持，知其胸中之大气下
陷也。其头疼者，因大气陷后，有他经之逆气乘虚上干也。遵用升陷汤原方，升提其下陷之大气，连服数剂全愈。
四川泾南周××来函∶
程姓男孩，年五岁，乳哺不足，脱肛近四载，医不能治。其面白神疲，身体孱弱；大肠坠出二寸许，用
手塞入，旋又坠出；其脉濡弱无力；呼吸促短，状若不能接续。知其胸中大气下陷，下焦之气化因之不能固摄
也。仿用升陷汤方，用生箭 四钱，知母二钱，桔梗、柴胡、升麻各一钱，潞参、净萸肉各三钱煎汤一盅，分
两次温饮下。连服二剂，肛即收缩。乃减去升麻，再服三剂，全愈。
直隶唐山张××来函∶
××之内，以其夫病势沉重，深恐难起，忧虑成疾。心内动悸，痞塞短气。医者以为痰郁，用二陈汤加
减清之，病益加剧。因鉴其父为药所误（其父因下痢十余日，医用大黄四钱降之复杯而卒），遂停药不敢服。
此际愚正在城中为其夫调治余病。俟愚来家求诊，见其满面油光，两手尺寸之脉皆极沉，惟关脉坚而有力。愚
曰∶“此乃胸中大气下陷，何医者不明如是，而用清痰之二陈也。今两关脉之坚弦，乃彼用药推荡之力。”诊
际，大气一陷，遂全身一战，冷汗满额，心即连次跳动十余次。遂用升陷汤，再仿逍遥散、炙甘草汤之意，提
其下陷之气，散其中宫之滞，并以交其心肾。一剂而三部平，大气固。嗣因尺中太微，而理气药及升柴等药皆
不敢用，遂按治大气下陷方之意及治虚劳之法，精心消息，调治而愈。
安徽绩溪章××来函∶
有冯××，务农而家小康。其母章氏，年正八秩，体丰善饭。一日忽觉左手麻痹，渐至不能持碗。越朝方食
面饼，倏然僵厥，坐向下堕，肢冷额汗，气息仅属。人皆以为猝中也，聚商救治，自午至晡，逐见危殆，来请
吾为筹挽救简方，以老人素不服药，且口噤鼻塞，恐药汁亦难下咽耳。吾意谓年老久厥，讵能回阳？姑嘱以红
灵丹少许吹鼻中，倘嚏气能宣通，再议用药。乃药甫入而嚏作，似渐苏醒。然呼吸甚微，如一线游丝，恐风吹
断。先按口鼻，温度甚低，音在喉中，犹言誓不服药。诊其脉，则沉微，察其瞳，亦涣散。遂确定为大气下陷。
但值耄年，势难遽投重峻之剂，爰照升陷汤方而小其剂，用生箭 一钱五分，知母八分，净萸肉一钱，柴胡四
分，升麻三分。煎服须臾，即渐有转机。续进两剂，逐次平复。继俾服潞党参，每日二钱，加五味子五粒，广
陈皮少许，频饮代茶。今春见之，较未病前更倍康强矣。
山东德州卢××来函∶
五家嫂及内子两人，系因家务心力煎劳，自觉无日不病者。五家嫂怔忡异常，每犯此病，必数日不能起床，
须人重按其心，终日面目虚浮，无病不有。而内子则不但怔忡，寒热往来，少腹重坠，自汗、盗汗，亦无定时，
面目手足及右腿无日不肿。而两人丸药
日不离口，不但无效，更渐加剧。后侄查大气下陷一切方案，确知两人皆系大气下陷无疑。服升陷汤数剂，并
加滋补之味，而各病若失，现今均健壮如常矣。
直隶盐山孙××来函∶
一九二六年冬，河东友人翟××之母乳部生疮，疼痛难忍，同事王××约往诊视。翟××言，昨日请医诊
治，服药一剂，亦不觉如何，惟言誓不再服彼医方药。生诊视时，其脉左关弦硬，右寸独微弱，口不能言，气
息甚微，病势已危险万分。生断为年高因病疮大气下陷，为开升陷汤，以升举其气，又加连翘、丹参诸药，以
理其疮。一剂能言，病患喜甚，非按原方再服一剂不可。后生又诊数次，即方略为加减，数服全愈。后遇此证
数次，亦皆用升陷汤加减治愈。
奉天桓仁县阎××来函∶
客岁家慈得大气下陷证，吾以向未行医，未敢率尔用药，遂聘本县名流再三延医，终无效验。迟至今岁正
月初二日，气息奄奄，迫不及待，遂急用升陷汤，遵方后所注更番增减，按证投药，数月沉 ，数日全愈。
江苏平台王××来函∶
一妇人，产后乳上生痈，肿疼殊甚。延西医治不效，继延吾延医。其脓已成，用针刺之，出脓甚多，第二
日已眠食俱安矣。至第三日，忽神昏不食，并头疼。其母曰∶“此昨日受风寒以致如此。”诊其脉，微细若无，
身无寒热，心跳，少腹微疼，知非外感，当系胸中大气下陷。投以升陷汤，两剂全愈。
野台参各一两，煎煮成两茶杯的药汤，分两次温服。从中午到傍晚，连续服用两剂，总共服药四次。第二天精神清爽，能够进食饮食，半天吃了五次，仍然饥饿索要食物。看护者不敢再给喂食，于是全身颤动，又出现胡言乱语，怀疑病情反复，请求再次诊治。其脉象大致平和，但浮取时仍然微弱。恍然大悟是胸中大气，因服用破气药物而下陷，虽然多次使用人参，至此尚未完全恢复，所以急切求助于水谷之气；而且胃中之气，因大气下陷而失去统摄，可能加速下行，饮食也因此迅速下行。于是用野台参一两许，佐以带心的麦门冬三钱、柴胡二钱，煎汤饮下，从此痊愈。
有人问：您治疗的大气下陷证，有两天不吃饭的，有饮食减少的。这个病例也是大气下陷，为什么反而能多吃？回答说：事情有常规和变化，疾病也有常规和变化。王清任《医林改错》记载了他治疗的两个胸中瘀血案：一个是不能让物体接触胸部，另一个是非要用重物压迫胸部才感到安宁，都用血腑逐瘀汤治愈。同样是胸中瘀血，病状竟然如此悬殊，所以同样是大气下陷，如果脾胃因为大气下陷而导致运化力量减弱，必然吃得少；如果大气下陷，脾胃之气也想要下陷，反而可能会变得多吃。曾治疗一位少妇，突然饮食非常多，一时觉得饿但不吃东西，就会心中惊慌悸动。医生认为是中消证（糖尿病的一种表现），多次治疗无效。向我咨询药方，我怀疑是胸中大气下陷，为她开了升陷汤方，加龙骨、牡蛎（都不煅）各五钱，几剂后痊愈。大概病因虽然相同，但病情的状况，常常因为人的体质禀赋不同而有变化。这在于临证医生细心体察罢了。
按语：这个病例和前一个病例，虽然都是大气下陷，但实在是在寒温病（外感热病）之后的余症，所以方中不用黄芪，而用人参。因为寒温病的余热，最能销铄耗损津液，人参能补气，兼能生津液，所以在《伤寒论》方中，凡是气虚的，都用人参，而不用黄芪。
上面所列的，都是大气下陷治疗有效的案例。然而这个病症被医生误治以及疏于治疗的很多，略登载几则在下面，作为警戒。
庚戌年秋天，在沧州治病，有个姓赵的人，忽然来访，说有疑惑的事，想向先生请教。问有什么疑心？他说：我妹妹半个月前来娘家省亲，几天间，没病就死了，不知道什么原因？我说：这一定有病，你大概不知道罢了。×先生说：她前一天，觉得咽喉发闷，诊她的脉沉细，怀疑她胸中有郁结之气，让她用开气的药一剂，第二天不觉轻重，只说自己不再服药，那天晚上就安坐在床上去世了。她的咽喉中发闷，并不很剧烈，所以说没病。我说：这是胸中大气下陷啊。当时箱子里有治疗大气下陷的各种案例，于是出示给她看，并且剖析其中的道理。×先生流泪哭泣说，这确实是药物误治了。
一个人，三十多岁。呼吸短气，胸中满闷。医生投以理气的药物，似乎觉得稍轻，医生认为药病相投，第二剂，就大胆地开破其气分。晚间服药，到了夜里上厕所，便后就不能起来了。看护者，扶持他到床上，昏昏沉沉像睡着，叫他不答应，一会儿张口呼气向外，像打哈欠的样子，这样持续一天多就死了。后来他的哥哥向我叙述这件事，并且问我这到底是什么病？于是我历举大气下陷的道理告诉他。他的哥哥连连叹息，既后悔自己选择医生不慎，又痛恨医生误人，以后不敢轻易延请医生服药。
一个农家老妇人，五十多岁。因为麦收季节农家很忙，汲水舂米的事情都自己承担，渐渐觉得呼吸不利，气息迫促。医生误认为是气逆作喘，屡次投以纳气降气的药物，气息于是更加迫促，她努力呼吸的声音，一直传到户外。请我去诊治，等到我到了，诊她的脉左右都没有，勉强为她开方，取药还没回来就死了，这也是大气下陷。她气息的迫促，是肺的呼吸即将停止，努力呼吸以自救，医生又用药，降下其气，多么荒谬啊！
一个书生，五十六岁，是学校教员，每次讲课后，就觉得短气，向我咨询药方。我说，这是胸中大气，虚而欲陷，是非常紧要的证候，应当多服升补气分的药物。他想用烧酒炖药，说早晚服用很方便。我说，这样也可以，但是必须将药炖浓，多喝且常喝才行。于是为他开方，用生黄芪四两、野台参二两，柴胡、桔梗各八钱，先用黄酒一斤左右，煎药十余沸，再用烧酒二斤，同贮瓶中，放在蒸笼中炖开，每顿饭前饮用，十天就好了。后来因为病愈，放置不再喝。隔了一年，有一天步行二里左右，从学校到家，似乎有气息迫促的样子，不能说话，忽然就死了。大概他身体素来肥胖，行走困难，胸中大气，素来有欲陷的趋势，因为行动劳苦，于是就下陷，这确实是《内经》所说的“大气入于脏腑，不病而猝死”的情况。方书有气厥，中气等名目，大抵都是大气下陷的证候，只是没有窥探《内经》的宗旨，而妄加议论罢了。
按语：《内经》原有气厥二字，是说气厥逆上行，不是后世所谓的气厥。
有人问：案例中所载的大气下陷证，病因及其病状，都已经了如指掌了。然而它的脉象现象，有的见于左部，有的见于右部，有的左右两部都有现象可征，而且脉多迟，却又间或有数的，同样是大气下陷，为什么脉象如此不同呢？回答说：胸中大气包举肺外，原本与肺有密切的关系，肺的脉诊在右部，所以大气下陷，右部的脉多微弱的，这是常态。然而人的元气自肾达肝，自肝达于胸中，是大气的根本。那个人如果肝肾素虚，或者服用破肝气的药物太过，他的左脉或者就更加形微弱，就像案例中左部寸关尺皆不见，左脉沉细欲无，左关参伍不调的情况。至于脉多迟，而又间或有数的，可能是因为阴分虚损，或者兼有外感的发热，或者被热药所伤，这是兼证的现脉，不是大气下陷的本脉。
有人问：李东垣补中益气汤所治疗的证候，像身热恶寒、心烦懒言，或者喘、或者渴、或者阳虚自汗，我所治的大气下陷案例中，类皆有之。至于内伤外感的辨别，说内伤则短气不足以息，更是大气下陷的明显征兆。至于方中所用的药，又与我的升陷汤相似。为什么那个方子名为补中益气，只治中气的虚陷，而不说升补大气呢？回答说：大气之名，虽然见于《内经》，但是《素问》中所说的大气，是指外感的邪气而言，不是胸中的大气。至于《灵枢》所说，虽然是胸中大气，但是从来读《内经》的人，往往把《灵枢》看作针经而不甚注意。即使是王氏注《内经》，也只注《素问》而不注《灵枢》。后人因为其中不易索解，就更废弃不读了。至于张仲景《伤寒》、《金匮》两书，只有《金匮》水气门，有“大气一转，其气乃散”的话。其他如《难经》、《千金》、《外台》诸书，并未提及大气。所以李东垣对于大气下陷证，也多误认为中气下陷，所以方中用白术以健补脾胃，而后来的调补脾胃者，都以李东垣为法。中气确实有下陷的时候，然而不如大气下陷那样危险。间或有因为中气下陷，泄泻日久，或者转而导致大气下陷的，可以仿照补中益气汤的意思，在我的升陷汤中，去掉知母加白术数钱。如果只是大气下陷，而中气不下陷的，白术也可以不用，恐怕气分或有郁结，而芪、术并用，容易产生胀满。
按语：补中益气汤所治疗的喘证，就是大气下陷者的努力呼吸。如果真的属于真喘，桔梗尚且不宜用，何况升麻呢？我年轻时看李东垣的书，到这里心里曾经怀疑过，后来明白了大气下陷的道理，才觉得豁然开朗，然而终究嫌弃他立言不妥当。假设医生，真的以为补中益气汤果真能治喘，而对于气机上逆的真喘也用它，岂不是足以败事吗？这有关性命的关键之处，临证医生应当审慎辨别。
附录：
直隶青县张××来函：
湖鲜××的妻子，六十岁，素来多有肝郁，逐渐发展到胸中大气下陷。她气短不足以息，因而努力呼吸，有点像喘；喉咙干作渴；心中满闷怔忡；脉象非常沉微。知道她胸中大气下陷过甚，肺中呼吸几乎有停止的趋势，非投以升陷汤，以升补其大气不可。抄录出原方，遵照注释：大气下陷严重的将升麻加倍服用。一剂后，吐出粘涎几碗，胸中顿时觉得舒畅。又在方中加入半夏、陈皮，连服三剂，病于是霍然痊愈。大概这个病例因为大气下陷，其胸肺胃脘没有大气来斡旋，大约都积有痰涎，等到服药后，大气来复，所以能运转痰涎外出，这就是《金匮》水气门所说的“大气一转，其气（水气即痰涎）乃散”啊。后来大气下陷证屡见不鲜，没有不用升陷汤加减治愈的。
河北省沦县张××来函：
族婶母，四十多岁，身体素弱。因为境遇不顺，又多抑郁。癸亥十月下旬，忽然患头疼非常剧烈，已经三天了，族叔来我家，让我去诊治。等到去了，听到呻吟不止，卧床不起，说已经针刺过百会及太阳两处，均未见效。她的左脉微细如丝，按之即无，右脉也无力度，自己说气息不接，胸闷不畅，不思饮食，自觉精神恍惚，似难支持，知道她胸中的大气下陷。她的头疼，是因为大气陷后，有其他经络的逆气乘虚上干所致。遵照使用升陷汤原方，升提其下陷的大气，连服数剂全愈。
四川泾南周××来函：
程姓男孩，五岁，乳哺不足，脱肛近四年，医生不能治。他面白神疲，身体孱弱；大肠坠出二寸左右，用手塞入，随即又坠出；脉濡弱无力；呼吸促短，状若不能接续。知道他胸中大气下陷，下焦的气化因此不能固摄。仿照使用升陷汤方，用生黄芪四钱，知母二钱，桔梗、柴胡、升麻各一钱，潞党参、净山茱萸各三钱，煎汤一盅，分两次温饮下。连服二剂，肛门即收缩。于是减去升麻，再服三剂，全愈。
直隶唐山张××来函：
××的妻子，因为丈夫病势沉重，深恐难以起色，忧虑成疾。心里动悸，痞塞短气。医生认为是痰郁，用二陈汤加减清理，病更加剧。因为借鉴父亲被药所误（父亲因为下痢十余日，医生用大黄四钱降之，片刻后就死了），于是停药不敢服。此时我正在城中为他丈夫调理余病。等我回家求诊，见她满面油光，两手尺寸之脉皆极沉，只有关脉坚而有力。我说：“这是胸中大气下陷，为什么医生不明白如此，而用清痰的二陈汤呢。现在两关脉的坚弦，是他们用药推荡的力量。”诊脉时，大气一陷，于是全身一战，冷汗满额，心脏就连次跳动十余次。于是用升陷汤，再仿逍遥散、炙甘草汤的意思，提其下陷之气，散其中宫之滞，并且以交通心肾。一剂而三部平，大气固。后来因为尺中太微，而理气药及升柴等药都不敢用，于是按照治大气下陷方的意思及治虚劳的方法，精心斟酌，调治而愈。
安徽绩溪章××来函：
有冯××，务农而家小康。他的母亲章氏，正好八十岁，体丰善饭。一天忽然觉得左手麻痹，逐渐至不能持碗。第二天刚吃面饼，突然僵厥，坐向下堕，肢冷额汗，气息仅属。人们都以为是猝中了，聚集商量救治，从中午到傍晚，逐渐见危殆，来请我为筹谋挽救简方，因为老人素不服药，而且口噤鼻塞，恐怕药汁也难以下咽。我认为年老久厥，怎么能回阳？暂且嘱咐以红灵丹少许吹鼻中，如果喷嚏气能宣通，再议用药。于是药刚入而喷嚏作，似乎渐苏醒。然而呼吸甚微，如一线游丝，恐怕风吹断。先按压口鼻，温度很低，声音在喉中，还说誓不服药。诊她的脉，则沉微，观察瞳孔，也涣散。于是确定为大气下陷。正值耄年，势难遽投重峻之剂，于是照升陷汤方而缩小剂量，用生黄芪一钱五分，知母八分，净山茱萸一钱，柴胡四分，升麻三分。煎服不久，就渐有转机。续进两剂，逐渐平复。接着让她服潞党参，每日二钱，加五味子五粒，广陈皮少许，频饮代茶。今年春天见到她，比未病前更倍康强了。
山东德州卢××来函：
五家嫂及内子两人，系因家务心力煎劳，自觉无日不病者。五家嫂怔忡异常，每次犯此病，必数日不能起床，须人重按其心，终日面目虚浮，无病不有。而内子则不但怔忡，寒热往来，少腹重坠，自汗、盗汗，也无定时，面目手足及右腿无日不肿。而两人丸药日不离口，不但无效，更渐加剧。后来侄子查大气下陷一切方案，确知两人皆系大气下陷无疑。服升陷汤数剂，并加滋补之味，而各病若失，现今均健壮如常矣。
直隶盐山孙××来函：
一九二六年冬，河东友人翟××的母亲乳房生疮，疼痛难忍，同事王××约往诊视。翟××说，昨天请医生诊治，服药一剂，也不觉得如何，只说誓不再服那个医生的方药。我诊视时，她的脉左关弦硬，右寸独微弱，口不能言，气息甚微，病势已危险万分。我断定为年高因病疮大气下陷，为她开升陷汤，以升举其气，又加连翘、丹参诸药，以理其疮。一剂能言，病患很高兴，非要按原方再服一剂不可。后来我又诊数次，就方略为加减，数服全愈。后来遇到这个证几次，也都用升陷汤加减治愈。
奉天桓仁县阎××来函：
去年家慈得大气下陷证，我以向来未行医，不敢率尔用药，于是聘请本县名流再三延医，终无效验。延迟到今年正月初二日，气息奄奄，迫不及待，于是急用升陷汤，遵照方后所注更番增减，按证投药，数月沉疴，数日全愈。
江苏平台王××来函：
一个妇人，产后乳上生痈，肿疼殊甚。请西医治不效，继请我延医。脓已成，用针刺之，出脓甚多，第二天已眠食俱安了。到第三天，忽然神昏不食，并头疼。她的母亲说：“这是昨天受风寒以致如此。”诊她的脉，微细若无，身无寒热，心跳，少腹微疼，知道不是外感，应当是胸中大气下陷。投以升陷汤，两剂全愈。
Each of the Ye Tai Shen (Wild Taiwan Ginseng, *Panax ginseng* var. *minor*) is one tael (approx. 37.5g). Decoct in water to yield two teacups of liquid, divided into two doses taken warm. From noon until dusk, two doses were administered consecutively, totaling four administrations. The next day, the patient's spirit was refreshed and clear, able to eat and drink. In half a day, five meals were consumed, yet the patient still felt hungry and demanded more food. The nurse dared not feed her further, whereupon the whole body began to tremble, and delirious speech recurred. Suspecting a relapse, they requested another consultation. The pulse was generally harmonious, but weak upon superficial palpation. It suddenly became clear that the Great Qi in the chest had sunk due to the administration of Qi-breaking medicines. Although Ren Shen (*Panax ginseng*) had been used multiple times, it had not yet fully restored the condition. Thus, there was an urgent reliance on the Qi derived from water and grain (dietary essence). Furthermore, the Qi in the stomach, lacking the control of the Great Qi which had sunk, likely accelerated its downward movement, causing food and drink to pass through quickly as well. Consequently, approximately one tael of Ye Tai Shen was used, assisted by San Qian (three qian, approx. 11.25g) of Mai Men Dong (*Ophiopogonis Radix*, retaining the heart/core) and Er Qian (two qian, approx. 7.5g) of Chai Hu (*Bupleuri Radix*). Decocted and drunk as a soup, the patient recovered thereafter.
A questioner asked: "In your treated cases of Sinking of the Great Qi, some patients did not eat for two days, while others had reduced appetite. This case also involves Sinking of the Great Qi, why did the patient end up eating more?" I replied: "Events have both constancy and variation; diseases likewise have constancy and variation." Wang Qingren's *Yi Lin Gai Cuo* (Correction of Errors in Medical Forest) records two cases of Blood Stasis in the Chest he treated: in one, the patient could not tolerate objects touching the chest; in the other, the patient only felt comfortable when heavy objects pressed upon the chest. Both were cured with Xue Fu Zhu Yu Tang (Blood Mansion Stasis-Expelling Decoction). Since the same pathology of Blood Stasis in the Chest presented with such drastically different symptoms, it follows that in cases of Sinking of the Great Qi, if the Spleen and Stomach suffer reduced transformative power due to the sinking, the patient will inevitably eat less. However, if the Sinking of the Great Qi causes the Qi of the Spleen and Stomach to also desire to sink, the patient may paradoxically eat more. I once treated a young woman who suddenly developed excessive hunger and intake. If she did not eat immediately upon feeling hungry, she experienced palpitations. Physicians diagnosed this as Xiao Ke (Wasting-Thirst Syndrome, often associated with diabetes) and treatment failed repeatedly. Consulting me, I suspected Sinking of the Great Qi in the chest and prescribed Sheng Xian Tang (Decoction to Raise the Sinking), adding Long Gu (*Fossilia Ossis Mastodi* or *Os Draconis*, uncalcined) and Mu Li (*Concha Ostreae*, uncalcined), each five qian (approx. 18.75g). After several doses, she recovered. Generally, although the etiology may be the same, the clinical presentation often varies according to the individual's constitutional endowment. This requires careful observation by the clinician.
Note: Although both this case and the previous one involve Sinking of the Great Qi, this case occurred during the residual phase of Cold-Warm diseases (exogenous febrile diseases). Therefore, Huang Qi (*Astragali Radix*) was not used in the formula, but Ren Shen (*Panax ginseng*) was employed. The lingering heat of Cold-Warm diseases can most effectively consume and damage body fluids. Ren Shen tonifies Qi and simultaneously generates body fluids. Hence, in the formulas of Zhang Zhongjing's *Shang Han Lun* (Treatise on Cold Damage), whenever Qi deficiency is present, Ren Shen is used instead of Huang Qi.
The above listed are all verified cases of treating Sinking of the Great Qi. However, this syndrome is frequently misdiagnosed or neglected by physicians. I record a few instances below as a warning.
In the autumn of the Gengxu year, while practicing medicine in Cangzhou, a Mr. Zhao visited unexpectedly, stating he had doubts he wished to consult. When asked what his doubt was, he said: "My sister came to my home for a visit half a month ago. Within a few days, she died without apparent illness. I do not know the cause." I said: "There must have been an illness; you were simply unaware of it." Mr. Zhao said: "The day before her death, she complained of stuffiness in the throat. Her pulse was deep and fine. Suspecting stagnant Qi in the chest, I gave her one dose of a Qi-opening prescription. The next day, her condition seemed unchanged. She stated she would no longer take medicine. That evening, she sat peacefully on her bed and passed away. Her throat stuffiness was not severe, so I considered her healthy." I said: "This was Sinking of the Great Qi in the chest." At that time, I had records of various cases of Sinking of the Great Qi in my traveling kit. I showed them to him and analyzed the pathogenesis. Mr. Zhao wept and said, "This was indeed a medical error caused by medication."
A man, over thirty years old, suffered from shortness of breath and fullness/stuffiness in the chest. A physician administered Qi-regulating herbs, and the patient felt slightly relieved. The physician believed the medicine matched the disease, so in the second dose, boldly prescribed strong Qi-breaking herbs. The patient took the medicine in the evening. During the night, after defecating, he could not rise. The nurse supported him to bed. He appeared comatose, unresponsive to calls. Soon, he opened his mouth and exhaled air outward, resembling a yawn. This state persisted for over a day before he died. Later, his brother recounted this to me and asked what the disease was. I explained the principles of Sinking of the Great Qi at length. His brother sighed repeatedly, regretting his careless choice of physician and resenting the doctor for harming people, vowing never to easily seek medical help or take medicine again.
An elderly peasant woman, over fifty years old. Due to the busy wheat harvest season, she performed all labor-intensive tasks like drawing water and pounding grain. Gradually, she felt difficulty breathing and rapid, shallow respiration. A physician mistakenly diagnosed this as rebellious Qi causing asthma/wheezing and repeatedly administered herbs to guide Qi downward and calm wheezing. Her breathing became increasingly labored; the sound of her effortful breathing could be heard outside the house. I was summoned to examine her. Upon arrival, her pulse was imperceptible on both left and right sides. I reluctantly drafted a prescription, but she died before the medicine could be obtained. This was also Sinking of the Great Qi. Her labored breathing was due to the lungs' respiratory function nearing cessation; she was making effortful attempts to breathe to save herself. The physician, however, administered drugs to further descend the Qi. How erroneous!
A scholar, fifty-six years old, worked as a school teacher. After every lecture, he felt shortness of breath. He consulted me. I said: "This is Deficiency of the Great Qi in the chest with a tendency to sink. It is a critical condition. You should take multiple doses of herbs that raise and tonify the Qi of the chest." He suggested stewing the medicine in liquor (baijiu/spirit), believing it convenient for morning and evening use. I said: "That is acceptable, but the medicine must be stewed concentrated, and you must drink it frequently and in quantity." I prescribed: Raw Huang Qi (*Astragali Radix*) 4 liang (approx. 150g), Ye Tai Shen 2 liang (approx. 75g), Chai Hu (*Bupleuri Radix*) 8 qian (approx. 30g), and Jie Geng (*Platycodonis Radix*) 8 qian (approx. 30g). First, decoct with about one jin (approx. 500ml) of yellow wine for ten boils. Then, add two jin (approx. 1000ml) of liquor, store in a bottle, and steam in a steamer until hot. Drink before each meal. He recovered in ten days. After recovery, he stopped drinking it. A year later, after walking about two li (approx. 1km) from school to home, he exhibited signs of labored breathing, lost the ability to speak, and suddenly died. His body was naturally obese, making walking difficult. His Great Qi in the chest had long had a tendency to sink. The physical exertion triggered this sinking. This truly exemplifies the *Nei Jing* statement: "When the Great Qi enters the zang-fu organs, death occurs suddenly without prior obvious disease." Medical texts mention terms like Qi Jue (Qi Syncope) and Zhong Qi (Middle Qi); these are largely manifestations of Sinking of the Great Qi. Authors merely speculated without grasping the essence of the *Nei Jing*.
Note: The term "Qi Jue" originally appears in the *Nei Jing*, referring to Qi reversing and moving upward, not the Qi Jue described by later generations.
A questioner asked: "The cases recorded regarding Sinking of the Great Qi clearly describe the etiology and symptoms. However, the pulse manifestations vary: appearing in the left cun/guan/chii positions, the right positions, or both. The pulse is mostly slow (Chi), yet occasionally rapid (Shu). Why do pulses differ so much in the same syndrome of Sinking of the Great Qi?" I answered: "The Great Qi in the chest envelops the exterior of the lungs and has a close relationship with them. Lung pulse diagnosis is located in the right position. Therefore, in Sinking of the Great Qi, a weak pulse in the right position is the norm. However, human Yuan Qi (Original Qi) originates in the Kidney, reaches the Liver, and then ascends to the chest to become the root of the Great Qi. If a person has inherent Kidney/Liver deficiency, or has taken too many herbs that break Liver Qi, their left pulse may become even weaker. This corresponds to cases where the left cun, guan, and chi positions are imperceptible, the left pulse is deep and fine nearly absent, or the left guan position is irregular. Regarding the pulse being mostly slow but occasionally rapid: this may be due to Yin deficiency, concurrent external heat, or injury from hot herbs. These are pulses of accompanying syndromes, not the fundamental pulse of Sinking of the Great Qi."
A questioner asked: "Li Dongyuan's Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) treats conditions such as fever with aversion to cold, vexation, reluctance to speak, asthma, thirst, and spontaneous sweating due to Yang deficiency. My cases of Sinking of the Great Qi share many of these features. Regarding the differentiation between internal injury and external contraction, Li states that internal injury manifests as shortness of breath insufficient for inhalation, which is a clear sign of Sinking of the Great Qi. The herbs in his formula are similar to my Sheng Xian Tang. Why is his formula named 'Tonify the Middle and Augment the Qi,' focusing only on Sinking of Middle Qi, without mentioning raising the Great Qi?" I answered: "Although the name 'Great Qi' appears in the *Nei Jing*, the 'Great Qi' mentioned in the *Su Wen* refers to exogenous pathogenic factors, not the Great Qi in the chest. While the *Ling Shu* discusses the Great Qi in the chest, readers of the *Nei Jing* traditionally viewed the *Ling Shu* primarily as a acupuncture classic and paid little attention to it. Even Wang Bing's commentary on the *Nei Jing* only covered the *Su Wen*, ignoring the *Ling Shu*. Later scholars, finding it difficult to understand, abandoned it entirely. In Zhang Zhongjing's *Shang Han Lun* and *Jin Gui Yao Lue*, only the latter's section on Water Qi mentions: 'When the Great Qi rotates, the pathological Qi disperses.' Other texts like *Nan Jing*, *Qian Jin Fang*, and *Wai Tai Mi Yao* do not mention the Great Qi. Therefore, Li Dongyuan often mistook Sinking of the Great Qi for Sinking of Middle Qi. Consequently, his formula uses Bai Zhu (*Atractylodis Macrocephalae Rhizoma*) to strengthen and tonify the Spleen and Stomach, setting a precedent for later practitioners tonifying the Spleen and Stomach. While Middle Qi can indeed sink, it is not as dangerous as Sinking of the Great Qi. Occasionally, prolonged diarrhea due to Sinking of Middle Qi may lead to Sinking of the Great Qi. In such cases, one may imitate the intent of Bu Zhong Yi Qi Tang by removing Zhi Mu (*Anemarrhenae Rhizoma*) and adding a few qian of Bai Zhu to my Sheng Xian Tang. If only the Great Qi sinks while the Middle Qi does not, Bai Zhu need not be used, lest it cause distension if combined with Huang Qi in the presence of Qi stagnation."
Note: The asthma treated by Bu Zhong Yi Qi Tang is actually the effortful breathing of patients with Sinking of the Great Qi. If it were true asthma, Jie Geng (*Platycodonis Radix*) would be inappropriate, let alone Sheng Ma (*Cimicifugae Rhizoma*). When I was young and read Li Dongyuan's works, I harbored doubts here. Only after understanding the principle of Sinking of the Great Qi did I feel enlightened, though I still found his formulation of theory inadequate. If a physician truly believes Bu Zhong Yi Qi Tang can treat asthma and uses it for true asthma caused by rebellious Qi ascending, it would surely lead to disaster. This concerns life and death; clinicians must distinguish carefully.
Appendix:
Letter from Zhang XX of Qing County, Zhili:
The wife of XX from Xianhu Lake, aged sixty, had a history of Liver Qi Stagnation, which gradually progressed to Sinking of the Great Qi in the chest. She suffered from shortness of breath insufficient for inhalation, leading to effortful breathing resembling asthma; dry throat with thirst; chest fullness and palpitations; and a very deep, weak pulse. Recognizing severe Sinking of the Great Qi with lung respiration near cessation, I determined that Sheng Xian Tang (Decoction to Raise the Sinking) was necessary to raise and tonify the Great Qi. I copied the original formula, following the note: for severe Sinking of the Great Qi, double the dose of Sheng Ma (*Cimicifugae Rhizoma*). After one dose, she vomited several bowls of sticky phlegm, and her chest instantly felt comfortable. I added Ban Xia (*Pinelliae Rhizoma*) and Chen Pi (*Citri Reticulatae Pericarpium*) to the formula. After three consecutive doses, she recovered completely. Because the Great Qi had sunk, there was no Qi to govern the chest, lungs, and stomach, leading to accumulation of phlegm-fluids. Once the medicine restored the Great Qi, it was able to transform and expel the phlegm. This illustrates the *Jin Gui* statement: "When the Great Qi rotates, the Qi (water-phlegm) disperses." Subsequently, numerous cases of Sinking of the Great Qi were cured using modified Sheng Xian Tang.
Letter from Zhang XX of Lun County, Hebei Province:
My clan aunt, over forty years old, had always been physically weak. Due to unfavorable circumstances and frequent depression, in late October of the Guihai year, she suddenly suffered severe headache for three days. My clan uncle came to my residence and asked me to diagnose her. Upon arrival, I heard constant groaning; she was bedridden. She stated she had already received acupuncture at Baihui (*GV20*) and Taiyang (*EX-HN5*), with no effect. Her left pulse was micro-fine like a thread, disappearing upon pressure; her right pulse was also forceless. She reported disconnected breath, chest stuffiness, poor appetite, mental confusion, and a sense of impending collapse. I diagnosed Sinking of the Great Qi in the chest. Her headache resulted from rebellious Qi from other meridians attacking upwards due to the void created by the sinking Great Qi. I prescribed the original Sheng Xian Tang to raise the sinking Great Qi. After several doses, she fully recovered.
Letter from Zhou XX of Jingnan, Sichuan:
A boy surnamed Cheng, five years old, suffered from rectal prolapse for nearly four years due to insufficient breastfeeding, unresponsive to previous treatments. He had a pale face, listless spirit, and frail body. The large intestine protruded about two cun (approx. 6-7 cm); manual reduction led to immediate re-prolapse. His pulse was soggy, weak, and forceless. Breathing was rapid and short, seeming unable to continue. I diagnosed Sinking of the Great Qi in the chest, causing failure of the Lower Jiao's Qi transformation to secure and hold. I imitated the Sheng Xian Tang formula: Raw Huang Qi (*Astragali Radix*) 4 qian (approx. 15g), Zhi Mu (*Anemarrhenae Rhizoma*) 2 qian (approx. 7.5g), Jie Geng (*Platycodonis Radix*), Chai Hu (*Bupleuri Radix*), and Sheng Ma (*Cimicifugae Rhizoma*) 1 qian (approx. 3.75g) each, Lu Shen (*Codonopsis Radix*) and purified Shan Zhu Yu (*Corni Fructus*) 3 qian (approx. 11.25g) each. Decoct in one zhong (approx. 200ml) of water, divide into two warm doses. After two doses, the anus contracted. Sheng Ma was removed, and three more doses were given, resulting in complete recovery.
Letter from Zhang XX of Tangshan, Zhili:
The wife of XX feared her husband's severe illness would not improve, becoming ill from worry. She experienced palpitations, chest obstruction, and shortness of breath. A physician diagnosed Phlegm Stagnation and prescribed modified Er Chen Tang (Two-Cured Decoction) to clear it, worsening the condition. Remembering her father's death due to medical error (her father died shortly after taking 4 qian of Da Huang (*Rhei Radix et Rhizoma*) for dysentery lasting over ten days), she refused further medication. I was in the city treating her husband's residual illness. Upon returning home to examine her, I saw her face was oily/shiny, and her cun and chi pulses on both hands were extremely deep. Only the guan pulse was firm and forceful. I said: "This is Sinking of the Great Qi in the chest. Why did the physician fail to recognize this and use phlegm-clearing Er Chen Tang? The firmness and wiriness of the bilateral guan pulses are the result of the pushing/draining force of the previous medications." During the examination, the Great Qi sank further, causing a whole-body shudder, cold sweat covering the forehead, and the heart beating rapidly over ten times. I prescribed Sheng Xian Tang, imitating the intents of Xiao Yao San (Free and Easy Wanderer Powder) and Zhi Gan Cao Tang (Honey-Fried Licorice Decoction) to raise the sinking Qi, dissipate stagnation in the Middle Jiao, and communicate Heart and Kidney. After one dose, the three positions on both wrists became balanced, and the Great Qi was secured. Later, because the chi pulse was too weak, I avoided Qi-regulating herbs and lifting herbs like Sheng Ma and Chai Hu. Instead, I carefully adjusted the treatment based on protocols for Sinking of the Great Qi and Consumption Disease (Xu Lao), eventually curing her.
Letter from Zhang XX of Jixi, Anhui:
Feng XX, a farmer with moderate wealth, had a mother, Mrs. Zhang, aged exactly eighty, who was robust and had a good appetite. One day, she suddenly felt numbness in her left hand, progressing to inability to hold a bowl. The next morning, while eating pancake, she suddenly collapsed, fell backward, with cold limbs and sweaty forehead, and breath barely perceptible. People assumed sudden stroke and gathered to discuss rescue. From noon until dusk, her condition worsened. They asked me to provide a simple rescue formula. Since the elderly lady rarely took medicine, and now had locked jaw and nasal congestion, swallowing liquid medicine seemed difficult. I reasoned that in an elderly person with prolonged syncope, restoring Yang might be impossible. I temporarily advised blowing a small amount of Hong Ling Dan (Red Spirit Pill) into the nose. If sneezing could open the orifices, we would reconsider medication. As soon as the medicine entered, she sneezed and seemed to revive. However, her breathing was very faint, like a wandering silk thread, fearing it might break. Checking mouth and nose temperature, it was very low; voice was hoarse; she still vowed not to take medicine. Her pulse was deep and weak; pupils were dilated. I confirmed Sinking of the Great Qi. Given her advanced age, harsh/decocting-strong herbs were contraindicated. I used a small dose of Sheng Xian Tang: Raw Huang Qi (*Astragali Radix*) 1.5 qian (approx. 5.6g), Zhi Mu (*Anemarrhenae Rhizoma*) 0.8 qian (approx. 3g), purified Shan Zhu Yu (*Corni Fructus*) 1 qian (approx. 3.75g), Chai Hu (*Bupleuri Radix*) 0.4 qian (approx. 1.5g), Sheng Ma (*Cimicifugae Rhizoma*) 0.3 qian (approx. 1.1g). Shortly after decoction and ingestion, improvement began. Two more doses led to gradual recovery. Subsequently, she took Lu Dang Shen (*Codonopsis Radix*) 2 qian daily, plus five Wu Wei Zi (*Schisandrae Chinensis Fructus*) and a little Guang Chen Pi (*Citri Reticulatae Pericarpium*), frequently drunk as tea. Seeing her this spring, she was healthier than before the illness.
Letter from Lu XX of Dezhou, Shandong:
My fifth brother's wife and my own wife both suffered from mental and physical exhaustion due to household duties, feeling ill every day. My fifth brother's wife had extreme palpitations; episodes lasted several days, requiring someone to press heavily on her heart. Her face and eyes were puffy daily, and she suffered from various ailments. My wife not only had palpitations but also alternating chills and fever, heavy bearing sensation in the lower abdomen, spontaneous and night sweats at irregular times, and daily swelling of the face, hands, feet, and right leg. Both constantly took pill medicines with no effect, only worsening. Later, my nephew reviewed all schemes for Sinking of the Great Qi and confirmed both suffered from this syndrome. After several doses of Sheng Xian Tang, supplemented with tonifying flavors, all symptoms disappeared. They are now robust and normal.
Letter from Sun XX of Yanshan, Zhili:
Winter of 1926. Friend Zhai XX's mother from Hedong had a sore on her breast, unbearable pain. Colleague Wang XX invited me to consult. Zhai XX said: "Yesterday, a doctor treated her. One dose of medicine brought no relief. She vowed never to take that doctor's prescriptions again." Upon examination, her left guan pulse was wiry and hard; right cun pulse was uniquely weak. She could not speak, breath was very faint, and the condition was critically dangerous. I diagnosed Sinking of the Great Qi due to the sore in an elderly patient. I prescribed Sheng Xian Tang to raise the Qi, adding Lian Qiao (*Forsythiae Fructus*) and Dan Shen (*Salviae Miltiorrhizae Radix et Rhizoma*) to treat the sore. After one dose, she could speak. The patient was delighted and insisted on continuing the original formula. I examined her several more times, making slight modifications. After several doses, she fully recovered. I encountered this syndrome a few times afterward, always curing it with modified Sheng Xian Tang.
Letter from Yan XX of Huanren County, Fengtian:
Last year, my mother suffered from Sinking of the Great Qi. As I had never practiced medicine, I dared not prescribe rashly. I hired famous local physicians repeatedly, but to no avail. By the second day of the first lunar month this year, her breath was faint, and the situation was urgent. I urgently used Sheng Xian Tang, following the notes for sequential adjustments, prescribing according to the syndrome. Months of chronic illness were cured in a few days.
Letter from Wang XX of Pingtai, Jiangsu:
A woman developed a carbuncle/abscess on her breast after childbirth, with severe swelling and pain. Western medicine failed. I was then consulted. The pus had formed; it was lanced with a needle, draining much pus. On the second day, sleep and appetite were normal. On the third day, she suddenly became unconscious, refused food, and had a headache. Her mother said: "This is due to catching wind-cold yesterday." Her pulse was micro-fine, almost imperceptible. No fever or chills. Palpitations. Mild lower abdominal pain. I determined this was not external contraction but Sinking of the Great Qi in the chest. I prescribed Sheng Xian Tang. After two doses, she fully recovered.