天津徐××，年三十四岁，得肺劳痰喘证。
病因 因弱冠时游戏竞走，努力过度伤肺，致有喘病，入冬以来又兼咳嗽。
证候 平素虽有喘证，然安养时则不犯，入冬以来，寒风陡至，出外为风所袭，忽发咳嗽。咳
嗽不已，喘病亦发，咳喘相助为虐，屡次延医，服药不愈，夜不能卧。其脉左部弦细而
硬，右部濡而兼沉，至数如常。
诊断 此乃气血两亏，并有停饮之证，是以其左脉弦细者，气虚也。弦细兼硬者，肝血虚津液
短也。其右脉濡者，湿痰留饮也。濡而兼沉者，中焦气化亦有所不足也。其所以喘而且嗽
者，亦痰饮上溢之所迫致也。拟用小青龙汤，再加滋补之药治之。
处方 生怀山药（一两） 当归身（四钱） 天冬（四钱） 寸麦冬（四钱）
生杭芍（三钱） 清半夏（三钱） 桂枝尖（二钱五分） 五味子（二钱捣碎）
杏仁（二钱去皮） 干姜（钱半） 细辛（一钱） 甘草（钱半） 生姜（三片）
共煎一大盅温饮下。
方解 凡用小青龙汤，喘者去麻黄加杏仁，此定例也。若有外感之热者，更宜加生石膏，此
证无外感之热，故但加二冬以解姜桂诸药之热。
复诊 将药煎服一剂，其喘即愈，又继服两剂，咳嗽亦愈强半，右脉已不沉，似稍有力，左脉
仍近弦硬，拟再以健胃养肺滋生血脉之品。
处方 生怀山药（一两） 生百合（五钱） 大枸杞子（五钱） 天冬（五钱） 当归
身（三钱） 苏子（钱半炒捣） 川贝母（三钱） 白术（三钱炒） 生薏米（三钱捣碎） 生远志
（二钱） 生鸡内金（钱半黄色的捣） 甘草（钱半）
共煎汤一大盅温服。
效果 将药连服四剂，咳嗽全愈，脉亦调和如常矣。
天津人徐××，三十四岁，患有肺劳痰喘证。
病因：在二十岁左右时，因嬉戏竞走，用力过度损伤了肺脏，从而导致了喘病。入冬以来，又兼有咳嗽症状。
证候：平时虽然有喘证，但在安静调养时并不发作。入冬以来，寒风突然来袭，外出时被风邪侵袭，忽然引发咳嗽。咳嗽不止，喘病也随之发作，咳与喘相互加重病情，多次请医生诊治，服药后未见痊愈，夜间无法平卧。其脉象左部弦细而硬，右部濡软且兼沉，至数（脉搏跳动频率）正常。
诊断：这是气血两虚，并伴有停饮（水液代谢障碍形成的病理产物）的证候。因此，左脉弦细，是因为气虚；弦细兼硬，是因为肝血虚、津液不足；右脉濡软，是因为湿痰和留饮；濡软且兼沉，是因为中焦气化功能也有所不足。之所以出现喘而且咳，也是由于痰饮上溢压迫所致。拟用小青龙汤，再加滋补药物进行治疗。
处方：生怀山药（一两）、当归身（四钱）、天冬（四钱）、寸麦冬（四钱）、生杭芍（三钱）、清半夏（三钱）、桂枝尖（二钱五分）、五味子（二钱，捣碎）、杏仁（二钱，去皮）、干姜（钱半）、细辛（一钱）、甘草（钱半）、生姜（三片）。共煎煮一大盅，温服。
方解：凡是使用小青龙汤治疗喘证，若见喘症则去掉麻黄加杏仁，这是既定法则。若有外感之热，更宜加入生石膏。此证没有外感之热，所以只加天冬和麦冬以解除干姜、桂枝等药物的燥热之性。
复诊：将药煎服一剂后，喘症即愈；继服两剂后，咳嗽也好了大半，右脉已不沉，似乎稍有力，但左脉仍接近弦硬。拟再使用健胃、养肺、滋生血脉的药物。
处方：生怀山药（一两）、生百合（五钱）、大枸杞子（五钱）、天冬（五钱）、当归身（三钱）、苏子（钱半，炒后捣碎）、川贝母（三钱）、白术（三钱，炒）、生薏米（三钱，捣碎）、生远志（二钱）、生鸡内金（钱半，黄色的，捣碎）、甘草（钱半）。共煎汤一大盅，温服。
效果：将药连续服用四剂后，咳嗽完全痊愈，脉象也调和如常。
Mr. Xu XX from Tianjin, aged 34, suffered from pulmonary tuberculosis with phlegm and wheezing (Feilao Tanchuan).
Etiology: In his early twenties, excessive exertion during playful running injured the lungs, leading to a history of wheezing. Since winter began, he also developed coughing.
Symptoms: Although he usually had wheezing, it did not manifest when at rest. However, since winter arrived, a sudden cold wind attacked him while he was outdoors, triggering an acute cough. The persistent cough exacerbated the wheezing, with both symptoms mutually aggravating each other. Despite multiple medical consultations and medication, there was no improvement, and he could not lie down flat at night. His pulse was wiry, fine, and hard on the left side; soggy and deep on the right side; with a normal rate.
Diagnosis: This is a syndrome of deficiency in both Qi and Blood, accompanied by retained fluid retention (Tingyin). Therefore, the wiry and fine left pulse indicates Qi deficiency. The wiry, fine, and hard quality indicates Liver Blood deficiency and shortness of body fluids. The soggy right pulse indicates damp-phlegm and retained fluid. The soggy and deep quality indicates insufficiency in the Qi transformation of the Middle Jiao. The reason for wheezing and coughing is also due to the pressure caused by phlegm-fluid overflowing upwards. It is proposed to use Xiao Qing Long Tang (Minor Blue Dragon Decoction) combined with tonifying herbs for treatment.
Prescription: Raw Huai Yam (Sheng Huai Shanyao, 1 liang), Dang Gui Body (Danggui Shen, 4 qian), Asparagus Root (Tiantong, 4 qian), Ophiopogon Tuber (Cun Maidong, 4 qian), Raw Hang Peony Root (Sheng Hangshao, 3 qian), Processed Pinellia Rhizome (Qing Banxia, 3 qian), Cinnamon Twig Tip (Guizhi Jian, 2.5 qian), Schisandra Berry (Wuweizi, 2 qian, crushed), Apricot Seed (Xingren, 2 qian, peeled), Dried Ginger (Ganjiang, 1.5 qian), Fineleaf Asarum Root (Xixin, 1 qian), Licorice Root (Gancao, 1.5 qian), Fresh Ginger (Shengjiang, 3 slices). Decoct together in one large bowl and take warm.
Formula Analysis: Whenever Xiao Qing Long Tang is used for wheezing, Ephedra Herb (Mahuang) is removed and replaced with Apricot Seed (Xingren); this is a fixed rule. If there is heat from external contraction, Raw Gypsum (Sheng Shigao) should be added. Since this case lacks heat from external contraction, only Tiantong and Maidong are added to resolve the dry-heat nature of Ganjiang and Guizhi.
Follow-up Visit: After taking one dose, the wheezing subsided completely. After two more doses, the cough improved significantly. The right pulse was no longer deep and seemed slightly stronger, but the left pulse remained close to wiry and hard. It is proposed to further use herbs that strengthen the stomach, nourish the lungs, and generate blood vessels.
Prescription: Raw Huai Yam (Sheng Huai Shanyao, 1 liang), Raw Lily Bulb (Sheng Baihe, 5 qian), Large Goji Berry (Da Gouqizi, 5 qian), Asparagus Root (Tiantong, 5 qian), Dang Gui Body (Danggui Shen, 3 qian), Perilla Fruit (Suzi, 1.5 qian, stir-fried and crushed), Sichuan Fritillary Bulb (Chuan Beimu, 3 qian), Atractylodes Macrocephala Rhizome (Baizhu, 3 qian, stir-fried), Raw Coix Seed (Sheng Yimi, 3 qian, crushed), Raw Polygala Root (Sheng Yuanzhi, 2 qian), Raw Chicken Gizzard Lining (Sheng Jineijin, 1.5 qian, yellow variety, crushed), Licorice Root (Gancao, 1.5 qian). Decoct in water in one large bowl and take warm.
Outcome: After continuously taking four doses, the cough was completely cured, and the pulse became harmonious and normal.