治心肺阳虚，大气又下陷者。其人心冷、背紧、恶寒，常觉短气。
生黄 （八钱） 干姜（六钱） 当归身（四钱） 桂枝尖（三钱） 甘草（一钱）
周身之热力，借心肺之阳，为之宣通，心肺之阳，尤赖胸中大气，为之保护。大气一陷，则心肺阳分素虚
者，至此而益虚，欲助心肺之阳，不知升下陷之大气，虽日服热药无功也。
或问∶心脏属火，西人亦谓周身热力皆发于心，其能宣通周身之热宜矣。今论周身热力不足，何以谓心肺
之阳皆虚？答曰∶肺与心同居膈上，左心房之血脉管，右心房之回血管，皆与肺循环相通，二脏之宣通热力，
原有相助为理之妙。然必有大气以斡旋之，其功用始彰耳。
按∶喻嘉言《医门法律》最推重心肺之阳，谓心肺阳旺，则阴分之火自然潜伏。至陈修园推展其说，谓心
肺之阳下济，大能温暖脾胃消化痰饮。皆确论也。
一童子，年十三四，心身俱觉寒凉，饮食不化，常常短气，无论服何热药，皆分毫不觉热。其脉微弱而迟，
右部兼沉。知其心肺阳分虚损，大气又下陷也。为制此汤，服五剂，短气已愈，身心亦不若从前之寒凉。遂减
桂枝之半，又服数剂全愈。俾停药，日服生硫黄分许，以善其后。
一人，年五十余。大怒之后，下痢月余始愈。自此胸中常觉满闷，饮食不能消化。数次延医服药，不外通
利气分之品，即间有温补脾胃者，亦必杂以破气之药，愈服病愈增重。后愚诊视，其脉沉细微弱，至数甚迟。
询其心中，常有觉凉之时。知其胸中大气下陷，兼上焦阳分虚损也。遂投以此汤，十剂全愈。后因怒，病又反
复，医者即愚方，加浓朴二钱，服后少腹下坠作疼，彻夜不能寐，复求为延医，仍投以原方而愈。
赵姓媪，年近五旬，忽然昏倒不语，呼吸之气大有滞碍，几不能息，其脉微弱而迟。询其生平，身体羸弱，
甚畏寒凉，恒觉胸
中满闷，且时常短气。即其素日资禀及现时病状以互戡病情，其为大气下陷兼寒饮结胸无疑。然此时情势将成
痰厥，住在乡村取药无及，遂急用胡椒二钱捣碎煎两三沸，澄取清汤灌下。须臾胸中作响，呼吸顿形顺利。继用
干姜八钱煎汤一盅，此时已自能饮下。须臾气息益顺，精神亦略清爽，而仍不能言，且时作呵欠，十余呼吸之顷
必发太息，知其寒饮虽开，大气之陷者犹未复也。遂投以拙拟回阳升陷汤。服数剂，呵欠与太息皆愈，渐能言语。
按∶此证初次单用干姜开其寒饮，而不敢佐以赭朴诸药以降下之者，以其寒饮结胸又兼大气下陷也。设
若辨证不清而误用之，必至凶危立见，此审证之当细心也。
治疗心肺阳气虚弱，且胸中大气下陷的病证。患者感到心口发冷、背部紧绷、怕冷，经常觉得气短。
生黄芪（八钱） 干姜（六钱） 当归身（四钱） 桂枝尖（三钱） 甘草（一钱）
周身的热力，依靠心肺的阳气来宣通；心肺的阳气，尤其依赖胸中的大气来保护。一旦大气下陷，那么心肺阳气本就虚弱的人，到了这个时候会更加虚弱。想要补助心肺的阳气，如果不知道提升下陷的大气，即使每天服用热性药物也是没有效果的。
有人问：心脏属火，西医也认为周身的热力都发自心脏，心脏宣通周身热力的功能是很适宜的。现在论述说周身热力不足，为什么说心肺的阳气都虚弱呢？回答说：肺和心同处膈肌之上，左心房的血脉管与右心房的回血管，都与肺循环相通，这两个脏器在宣通热力方面，原本就有互相协助的妙用。但是必须有大气来斡旋其中，其功用才能彰显出来。
按语：喻嘉言在《医门法律》中最推崇重视心肺的阳气，认为心肺阳气旺盛，阴分之火自然潜伏。到了陈修园进一步发挥这一观点，认为心肺的阳气向下济助，能极大地温暖脾胃以消化痰饮。这都是确切的论述。
有一个童子，十三四岁，感觉心和身体都寒冷，饮食不消化，经常气短，无论服用什么热性药物，都丝毫感觉不到热。他的脉象微弱而迟缓，右部兼有沉象。判断他是心肺阳气虚损，大气又下陷。于是配制了这方汤药，服用五剂后，气短已经痊愈，身心也不再像从前那样寒冷。于是将桂枝减半，又服用几剂后完全康复。让他停药，每天服用少许生硫黄粉，以巩固疗效。
一个人，五十多岁。在大怒之后，腹泻痢疾持续一个多月才痊愈。从此以后胸中经常觉得胀满闷塞，饮食不能消化。几次请医生服药，不外乎是疏通气分的药物，即使偶尔有用温补脾胃的，也必然混杂破气的药物，越服药病情越重。后来我诊治，他的脉象沉细微弱，至数非常迟缓。询问他心中，经常有觉得凉的时候。判断他是胸中大气下陷，兼有上焦阳气虚损。于是投以此汤药，十剂后完全康复。后来因为生气，病情又反复，医生沿用我的方子，加入浓朴二钱，服用后小腹部下坠疼痛，整夜不能入睡，再次请求我诊治，仍然投以原方而痊愈。
赵姓老妇人，年近五十，突然昏倒不语，呼吸之气大有滞碍，几乎不能呼吸。她的脉象微弱而迟缓。询问她生平，身体瘦弱，非常怕冷，经常觉得胸中满闷，且时常气短。根据她平素的体质禀赋和现在的病症相互参验病情，这是大气下陷兼寒饮结胸无疑。然而此时情势将要形成痰厥，住在乡村取药来不及，于是急忙用胡椒二钱捣碎煎煮两三沸，澄清取清汤灌服。片刻后胸中作响，呼吸顿时变得顺利。接着用干姜八钱煎汤一盅，此时她已经能自己喝下。片刻后气息更加顺畅，精神也略清爽，但仍然不能说话，且时常打呵欠，十余次呼吸之间必定要长叹一口气，判断是寒饮虽然开通，但下陷的大气还没有恢复。于是投以我自己拟定的回阳升陷汤。服用几剂后，呵欠和长叹都好了，渐渐能说话。
按语：这个病证初次单用干姜来开通寒饮，而不敢佐以赭石、厚朴等降下药物的原因，是因为寒饮结胸又兼大气下陷。如果辨证不清而误用这些药，必定导致凶险危急立刻出现，这是审察证候应当细心的地方。
Treatment for conditions where the Yang Qi of the Heart and Lungs is deficient, and the Vast Qi (Zong Qi) in the chest has sunk. The patient feels coldness in the heart region, tightness in the back, aversion to cold, and frequently experiences shortness of breath.
Sheng Huangqi (Raw Radix Astragali, 8 qian) Gan Jiang (Dried Rhizoma Zingiberis, 6 qian) Danggui Shen (Radix Angelicae Sinensis Root Body, 4 qian) Guizhi Jian (Cortex Cinnamomi Ramulus Tip, 3 qian) Gancao (Radix Glycyrrhizae, 1 qian)
The thermal energy throughout the body relies on the Yang Qi of the Heart and Lungs to be disseminated and unblocked; the Yang Qi of the Heart and Lungs, in turn, relies particularly on the Vast Qi (Zong Qi) in the chest for protection. Once the Vast Qi sinks, those whose Yang division of the Heart and Lungs was already deficient will become even more deficient at this point. To assist the Yang Qi of the Heart and Lungs, if one does not know how to lift the sunken Vast Qi, even taking heat-inducing medicines daily will be ineffective.
One might ask: The Heart belongs to Fire, and Western medicine also posits that all thermal energy in the body originates from the Heart, so its ability to disseminate heat throughout the body should be appropriate. Now, discussing insufficient thermal energy in the body, why is it said that the Yang Qi of both the Heart and Lungs is deficient? The answer is: The Lung and Heart reside together above the diaphragm. The blood vessels of the left atrium and the venous return vessels of the right atrium are both connected to pulmonary circulation. There is originally a subtle mutual assistance between these two organs in disseminating thermal energy. However, there must be Vast Qi (Zong Qi) to facilitate and rotate this process for its function to manifest.
Note: Yu Jiayan, in *Yi Men Fa Lv* (Legal Laws of Medicine), highly emphasized the importance of the Yang Qi of the Heart and Lungs, stating that when the Yang Qi of the Heart and Lungs is vigorous, the fire of the Yin division naturally lies dormant. Chen Xiuyuan later expanded on this view, stating that the downward assistance of the Yang Qi of the Heart and Lungs greatly warms the Spleen and Stomach to digest phlegm-fluids. These are indeed accurate discussions.
A boy, aged thirteen or fourteen, felt coldness in both his mind/heart and body. His food did not digest, and he frequently experienced shortness of breath. Regardless of what heat-inducing medicines he took, he felt no warmth whatsoever. His pulse was weak, thready, and slow, with the right side additionally being deep. It was determined that the Yang division of the Heart and Lungs was damaged and deficient, and the Vast Qi had sunk. This decoction was prepared. After taking five doses, the shortness of breath was cured, and the body and mind were no longer as cold as before. The dosage of Guizhi was then halved, and after taking several more doses, full recovery was achieved. He was instructed to stop the decoction and take small amounts of raw Shihuang (Sulfur) daily to consolidate the results.
A person, over fifty years old. After a fit of great anger, dysentery persisted for over a month before healing. Since then, the chest often felt full and stifled, and food could not be digested. Several times doctors were consulted and medicines prescribed, which were nothing but agents to unblock the Qi division. Even when warming and tonifying the Spleen and Stomach were occasionally used, they were invariably mixed with Qi-breaking drugs. The more medicine was taken, the heavier the illness became. Later, I examined him. His pulse was deep, fine, minute, and weak, with a very slow rate. Inquiring about his heart, he reported often feeling cold within. It was determined that the Vast Qi in the chest had sunk, accompanied by deficiency and damage of the Yang division in the Upper Jiao. This decoction was administered, and after ten doses, full recovery was achieved. Later, due to anger, the illness relapsed. A doctor used my prescription, adding Houpo (Cortex Magnoliae Officinalis, 2 qian). After taking it, the lower abdomen sank and hurt, and he could not sleep all night. He sought my help again. The original prescription was administered once more, and he recovered.
An elderly woman surnamed Zhao, nearly fifty years old, suddenly fainted and lost the ability to speak. Her breathing was significantly obstructed, almost to the point of cessation. Her pulse was weak, thready, and slow. Inquiring into her life history, she was physically frail, greatly feared cold, often felt chest fullness, and frequently experienced shortness of breath. By cross-referencing her innate constitution with her current symptoms, it was undoubtedly a case of Vast Qi sinking complicated by Cold-Fluid binding in the chest. However, the situation threatened to develop into Phlegm-Jue (Phlegm Obstruction Syndrome). Living in a rural area, obtaining medicine would take too long. Therefore, hastily using Hu Jiao (Fructus Piperis Nigris, 2 qian) crushed and decocted for two or three boils, the clear liquid was extracted and forced down her throat. Soon, sounds were heard in the chest, and breathing immediately became smooth. Subsequently, Gan Jiang (Dried Rhizoma Zingiberis, 8 qian) was decocted in a cup of water. At this time, she was able to drink it herself. Soon, her breathing became even smoother, and her spirit cleared slightly, but she still could not speak, frequently yawned, and sighed deeply every ten or twelve breaths. It was determined that although the Cold-Fluid had been opened, the sunken Vast Qi had not yet recovered. Thus, my formulated Huiyang Shengxian Tang (Decoction for Restoring Yang and Lifting Sunken Qi) was administered. After several doses, the yawning and sighing ceased, and she gradually regained the ability to speak.
Note: In this condition, initially using only Gan Jiang to open the Cold-Fluid without assisting it with descending drugs like Zheshi (Hematitum) and Houpo was because Cold-Fluid binding in the chest was complicated by Vast Qi sinking. If the syndrome differentiation were unclear and these drugs were mistakenly used, fatal danger would appear immediately. This highlights the necessity of careful syndrome examination.