原注：此冬温咳嗽也。麻杏开泄外罩之凉风，芜活、葛根佐之；石膏清内伏之温热，白薇、玉竹佐之。冬温必头痛便泄，青木香治便泄之药也。病比伤寒多一温字，方比麻黄去桂枝一味，加入石膏以治热，有因方成硅遇圆为壁之妙。
诒按：此病既见痰浓口渴．则已有邪郁化热之征。方中羌、防、葛根，似宜酌用。
葛根一味，怕其性升助咳，原注辨寒温二字，殊属界限清楚。
孙评：冬温已经化热，较化燥略减一层，何以用诸多燥品?古人于温病未能分清界限，治法均是如此。今则大不然矣。且便泄为热之去路，何得用木香止之；青木香与木香，二种用法不同。
寒必伤营，亦必化热，咳嗽不止，呕吐紫血，咽中干痛，苔白边青，脉紧而数，近更咳甚则呕，气息短促。肺胃两经皆失其清降也。郁咳成劳，最为可怕。
邓评：旋覆花汤加芦根、枇杷叶，名瘀热汤，系先生所著。此病当有瘀热内阻．今反舍而不用何哉?
孙评：舌青脉紧，病情甚恶。用药平淡，大不可法。
再诊：白苔已薄，舌边仍青，痰出虽稀，咳逆未止。观其喘急呕逆，多见于咳甚之时。正所谓肺咳之状，咳而喘；胃咳之状，咳而呕也。
桑皮 骨皮知母 川贝 淡芩 浮石桔梗 甘草紫菀 麦冬芦根莱菔汁
原注：风寒之邪，郁于肺胃，久而化火，遂至见血，先用金沸草散、泻自散，以搜剔其邪。第二案即加入芦根、知母，清营中之热。用法转换，层次碧清。
诒按：此证先曾吐瘀，加以舌边色青，似有瘀血郁阻。方案中何以并不理会及此!
邓评：舌边之青为寒伤血瘀起见，虽则经久化热，而其本气究属寒邪，故其苔色亦自。前方有疏邪之力，故自苔已薄，无导瘀之功，故舌边仍青。
孙评：舌苔青紫，都系寒证，从无热郁之说。此而瘀血内阻，而见青苔，另是一格，惟瘀阻者紫舌最多。
伤风不醒，咳嗽呕恶，所见之痰，或薄或浓，或带血色。左关脉独见浮弦且数，小有寒热，此损征之根也。千金法治之。
原注：此用柴前连梅煎意，千金法也。咳嗽由来十八般，只因邪气入于肝，即是此方之歌诀。此方效，转方加竹茹一味。
诒按：弦数独见于左关，故知其病专在肝。
孙评：邪未清者，不可用收敛之品。虽与疏散并用，病愈必有留邪为害生变矣。
咳嗽吐出青黄之痰，项强恶风音烁，寒热分争，是名劳风。服秦艽鳖甲而更甚者，当进一层治之。
柴前连梅煎柴胡，前胡、黄连、乌梅、薤白、猪胆汁、童便、猪脊髓。
附 秦艽鳖甲煎秦艽、鳖甲、地骨皮、柴胡、青蒿、归身．知母、乌梅。
邓评：进秦艽鳖甲而更甚，易是方而见效，同有柴、梅二味．其效验必在前胡能疏风痰，黄连能泄木火也。
再诊：进前方咳嗽大减，所出之痰，仍见青黄之色，身热虽轻，咽中苦痛，脉形弦细数。风邪未尽，中下两虚，制小前方之外，参入猪肤法，一治身热，一治咽痛。
原注：此方治伤风不醒成劳，比秦艽鳖甲又进一层。其见证每以咳吐黄绿青痰为据。
邓按：一治身热，指柴胡、连、梅说，足见治此方之要旨，不仅在咳吐青黄痰也。今身热虽轻，反加咽中苦痛，大都阴气内竭，恐归不治。
孙评：热虽轻而咽痛，邪因敛而入肺，变证起矣。先生用此方想曾有损症，近者曾效过，遂一概用之，误事不小。
诒按：童便易秋石甚妙。
再诊：进劳风法，咳嗽大减，红痰亦无。但痰色尚带青黄，左关脉息弦硬不和，肝胆留邪容易犯肺胃俞也。毋忽。
原注；此方极玲珑，先生用之每灵。大约风喜伤肝，风郁于肝，久而不出，必有青黄之痰，所谓劳风是也。
诒按：先生案中治劳风一证，必用柴前连梅煎，自云法本千金，用之神效。查《千金方》所载劳风治法，及所叙病原，与此不同，即所用之柴前连梅煎，仅见于吴鹤皋《医方考》，《千金方》中并无此方，先生偶误记耳。
邓评：前方敛阴疏邪，此方清金制木，自属两途，想必有肝阳不和之意，怕难任柴胡之升也。
右脉弦滑而数，滑为痰；弦为风，风郁为热，热郁为痰，阻之于肺，清肃不行，咳嗽自作。
金沸草 前胡 半夏 荆芥 甘草 赤苓 川芎 枳壳 紫菀 杏仁 桑白皮 萎皮 竹沥
原注：方中芎、枳二味，是升降法也。必有一团寒风化热，郁闭于肺，用芎之升，枳之降，以挑松其火；若火重者不可用，有阴火者更不可用，恐火升则血易动耳。
诒按：此金沸草散去麻、芍，加芎、枳，以扰动之，菀、杏以宣泄之，桑、萎以清降之。细玩其加减，可识其心思之细密，用意之周到矣。案语亦简炼老洁。
邓评：川芎辛窜升散，非有风寒者不宜，盖此病由于寒郁化热，敬用之耳。
孙评：风热痰三者，一线串成，见解独具。
川芎之宜用与慎用，明白晓畅矣。
晨起咳嗽，劳倦伤脾，积湿生痰所致。久而不已，气喘畏风，金水因此而虚，补中寓化，一定章程。现在身热口干苔白，脉息细弦而紧；紧则为寒，寒风新感。必须先治新邪，权以疏化法。
又接服方：
诒按：此即六君加麦冬、旋覆、牛膝也，恰台脾虚有湿痍，而伤及金水者之治。
孙评：先后层次，亦是一定章程。新邪清，然后补虚。
《内经》云：秋伤于湿，冬生咳嗽。喻氏改作秋伤于燥，冬生咳嗽。岂知初秋之湿，本从夏令而来，原为正气，若论其燥，则在中秋以后，其气亦为正令，二者相因，理所固然，势所必至。仲景早已立方，独被飞畴看破，今人之用功不如古人远矣。
原注：此麦门冬汤也。先生以肺燥胃湿四字提之，故此案以燥湿二字为言。
孙评：读书不用格致功夫者，必非善读书者也。
去冬咳嗽，今春寒热，至秋令而咳嗽或轻或重。惟喉痒则一。所谓火逆上气，咽喉不利，此等证是也。最易成劳，未可以脉未促，气未喘为足恃。
邓评：寒热喉痒，当有风邪郁于肺络，郁热伤阴，阴虚成劳，于方中尚可参疏邪之品。
再诊：内热已除，咳嗽亦减。气火之逆上者，渐有下降之意。静养为佳。
前方加枇杷叶
肺经咳嗽，咳则喘息有音，甚则吐血；血已止，咳未除，右寸脉息浮弦，弦者痰饮也。良以饮食入胃，游溢精气，上输于脾，脾气散精，上归于肺；而肺气虚者，不能通调水道，下输膀胱，聚液为痰，积湿为饮，一俟诵读烦劳，咳而且嗽，自然作矣。补肺健脾，以绝生痰之源，以清贮痰之器。
原注：此曲曲写出痰饮之所由来。用二陈以化痰，佐以薏米；用麦冬以养肺，佐以百合；用白术以健脾，住以党参。味味切当熨贴，看似寻常，实是功夫纯熟之候。
邓评：此病必有木火乘于肺络，故一经诵读劳顿，则火自升动，痰随火逆，宜乎其咳而且嗽也。方内尚须参桑皮、蛤、黛之类，并降痰火。
孙评：聚液为痰二句，见透之言。
附录：咳嗽证治括要
咳者，和谐声也，其音开口而出，仿佛亥字之音，故有声无痰为咳。嗽则如水之灌漱，然有物在喉，漾漾欲出，故从口从敕，后人遂以有痰为嗽。然则咳嗽之病，胡从生也?日：病有万变，要不出内伤外感两端，请先明外感。外感者，风寒暑湿燥火六者尽之。论其常，则各主一时为病；论其变，则四时皆可以受六淫之邪。今则即风寒论。感风者，鼻塞身重，恶风清涕，此证也；左脉浮弦，此脉也。感寒者，恶寒体痛，发热脉紧，此寒之证与脉也。而风之中，又有辨。春则为温风，肝木用事；受风者，必伤肝，而又有中血中气之别；风伤卫，则参苏饮；风伤营，则芎苏饮。夏则为热风，伤心包，而亦有凉热之别；凉风香薷饮，热风鸡苏散。秋为凉风，伤肺，败毒散、金沸草散。冬为寒风，伤膀胱，桂枝厚朴杏仁汤、麻黄汤。傥冬时天热而感寒风，则当用葳蕤汤、阳旦汤，此冬温之邪也。惟秋分以后少暑湿，春夏无燥气。他如先伤风而后伤热，为热包寒，葳蕤汤；肺素热而感寒风，为寒包热，金沸草散。一嗽而痰出稠粘者，脾湿胜，二陈之类。连嗽无痰者，肺燥甚，清燥救肺汤。此皆外感咳也。言风一端，而六气可类推矣。若夫内伤，大法惟痰饮、津伤两种。痰饮多阳虚，津伤多阴虚。其阳虚痰饮尚浅者，六安、二陈之类；有火者，温胆汤；夹阴虚者，金水六君煎；阳虚甚，兼夹痰火不可攻者，玉竹饮子成降法；喘者，降气汤、贞元饮，此阳虚痰饮一端也。他如阴虚者，阴火易于上升，胃气不清者，麦门冬汤；曾见血者，四阴煎；痰多而浓，无胃气者，六君子汤；痰少而嗌干，胃气未绝者，六味丸、都气丸、八仙长寿丸。此粗举内伤之一端也。此外又有劳风一门，咳吐浊涕青黄之痰，由劳碌伤风，恋而不化，最为难治。浅者，秦艽鳖甲，表虚汗多者，黄芪鳖甲；深则柴前连梅煎，千金法也。此皆劳风之治也。至于芎枳二味，以治寒郁化火之咳；合二母以泻肺之母；泻白散，以清泄肺脏；四物桔梗汤，以引清血分，皆在所常用也。似此某证某方，条分缕析，须平日有格致功夫。试观先生临证之方，似乎夹杂，合之病人之证，则无一味可以增减。先生尝曰：吾门之病，如时文，割截隔章隔节之题，他人无处下手，左支右拙。余能以心思灵空，贯串合凑一方，令病安稳。此无他，外感多与内伤同，病内伤，每因外感而发，更遇杂药乱投之医，治丝而棼，愈难就绪。治此者，不能不兼采众方，就中另出一方，其立方之意，在案中宣露明白。噫!执此意以寻先生之门径，思过半矣。
邓评：若叶氏论风温由口鼻入而肺胃受邪者，则又宜银翘、桑菊之类矣。
寒都火邪，亦能令人干咳，便宜辛散带润，如甘、桔、蜜炙姜、橘之类。秦艽鳖甲与黄芪鳖甲，总须有骨蒸寒热者乃合。治寒郁化火之类而将成肺痿者，莫若葛氏保和汤为最妙。
孙评：治杂症根本透彻。
失 血 门
饮食入胃，游溢精气，上输于脾，脾气散精，上归于肺，通调水道，下输膀胱，水精四布，五经并行，合于四时五脏，阴阳揆度，以为常也。此乃饮归于肺，失其通调之用，饮食之饮，变而为痰饮之饮。痰饮之贮于肺也，已非一日。今当火令，又值天符相火加临，两火相烁，金病更甚于前。然则痰之或带血，或兼臭，鼻之或干无涕，口之或苦且燥，小水之不多，大便之血沫，何一非痰火为患乎。
旋覆花 桑皮 川贝 橘红 浮石 炙草 沙参 茯苓 麦冬 竹叶 丝瓜络
诒按：此证乃素有浊痰郁热，壅结熏蒸于内，再受时令火邪，熏灼肺胃所致。如此立论，似亦直捷了当。何必用饮食入胃，及天符相火，如许大议论耶。可参用苇茎汤。
再诊。接阅手书，知咳血、梦遗、畏火三者，更甚于前。因思天符之火行于夏时，可谓火之淫矣。即使肺金无病者，亦必暗受其伤，而况痰火久踞，肺金久伤，再受此外来之火，而欲其清肃下降也，难矣。肺不下降，则不能生肾水，肾水不生，则相火上炎，此咳逆梦遗之所由来也。至于畏火一条，《内经》载在阳明脉解篇中，是肝火乘胃之故。法宜泻肝清火，不但咳血、梦遗、畏火等证之急者，可以速平，而且所患二便不通，亦可从此而愈。悬而拟之，未识效否。
鲜生地 蛤壳 青黛 桑皮 龙胆草 川贝 地骨皮 黑栀 竹叶 大黄盐水炒
邓评：咳逆梦遗，由相火之上淫下迫，非连、柏、知母等不足以泻之，岂是生地之甘寒，大黄之攻导所宜。
三诊：阳明中土，万物所归，现在盯经湿热之邪，大半归于阳明，以著顺乘之意，而逆克于肺者，犹未尽平。所以睡醒之余，每吐青黄绿痰，或带血点，其色非紫即红，右胁隐隐作痛，脉形滑数，独见肺胃两部。宜从此立方。
小生地桑皮 羚羊角 阿胶 冬瓜子 薏米 蛤壳 川贝 杏仁 忍冬藤 青黛 功劳露 芦根 丝瓜络
诒按：前方实做，不若此方之空灵活泼也。
【原注】：这是冬温咳嗽。麻黄、杏仁宣发泄散，以解除外罩的凉风；羌活、防风辅助它；石膏清解体内潜伏的温热，白薇、玉竹辅助它。冬温病必然伴有头痛和大便泄泻，青木香是治疗大便泄泻的药物。这种病比伤寒多了一个“温”字，方剂比麻黄汤去掉了桂枝一味，加入石膏来治疗热邪，有因方制宜、灵活变通的妙处。
诒按（尤在泾按语）：此病既然出现痰浓口渴，说明已经有邪气郁结化热的征象。方中羌活、防风、葛根，似乎应当斟酌使用。
邓评（邓铁涛评）：咳嗽起于寒热之后，应当是余邪留恋，大概不必用如此厚重的方剂。
葛根一味药，恐怕其性升提会助长咳嗽，原注对“寒”和“温”二字的辨析，界限确实清楚。
孙评（孙光荣评）：冬温已经化热，比化燥稍微轻一层，为什么用那么多燥性的药物？古人在温病上未能分清界限，治法都是这样。现在则完全不是这样了。而且大便泄泻是热邪排出的途径，怎么能用木香来止泻呢？青木香与木香，两种药的用法不同。
寒邪必伤营血，也必然化热，咳嗽不止，呕吐紫血，咽喉干燥疼痛，舌苔白而边缘发青，脉象紧而数，近来更是咳嗽剧烈时引发呕吐，气息短促。肺经和胃经都失去了清肃下降的功能。郁久咳嗽成劳损，最为可怕。
邓评：旋覆花汤加芦根、枇杷叶，名叫瘀热汤，是先生所著。此病应当有瘀热内阻，如今反而舍弃不用，为什么呢？
孙评：舌边青，脉象紧，病情很严重。用药平淡，非常不可取。
再诊：白苔已经变薄，舌边仍然发青，痰虽然稀薄，但咳逆没有停止。看他的喘急呕逆，多见于咳嗽剧烈的时候。这正是肺咳的症状，咳嗽伴喘息；胃咳的症状，咳嗽伴呕吐。
桑白皮 地骨皮 知母 川贝母 淡黄芩 浮海石 桔梗 甘草 紫菀 麦冬 芦根 莱菔汁
【原注】：风寒之邪，郁结在肺胃，日久化火，导致见血，先用金沸草散、泻白散，来搜剔清除邪气。第二案即加入芦根、知母，清解营分之热。用法转换，层次清晰。
诒按：此证先前曾吐瘀血，加上舌边色青，似有瘀血郁阻。方案中为何并不理会这一点！
邓评：舌边之青是因为寒邪损伤血瘀所致，虽然经久化热，但其本气终究属于寒邪，所以其苔色也自……前方有疏邪之力，所以白苔已薄，无导瘀之功，所以舌边仍青。
孙评：舌苔青紫，都属于寒证，从无热郁的说法。如果这里有瘀血内阻，而出现青苔，另是一格，只有瘀阻者多见紫舌。
伤风不愈，咳嗽呕吐恶心，所见的痰，或稀或浓，或带血色。左关脉独见浮弦且数，小有寒热，这是虚损病症的根源。用千金方的方法治疗。
苏叶 党参 黄连 乌梅 橘红 川贝母 柴胡 杏仁 桑白皮 地骨皮
【原注】：此方用柴前连梅煎之意，是千金法。咳嗽由来十八般，只因邪气入于肝，即是此方的歌诀。此方有效后，转方加竹茹一味。
诒按：弦数脉独见于左关，所以知道病专在于肝。
孙评：邪气未清者，不可用收敛的药物。虽然与疏散并用，病愈后必有留邪为害生变的后果。
咳嗽吐出青黄色的痰，项强恶风音哑，寒热交争，这名叫劳风。服用秦艽鳖甲散后反而更严重的，应当进一层治疗。
柴前连梅煎：柴胡，前胡、黄连、乌梅、薤白、猪胆汁、童便、猪脊髓。
附：秦艽鳖甲煎：秦艽、鳖甲、地骨皮、柴胡、青蒿、当归身、知母、乌梅。
邓评：进服秦艽鳖甲散后反而加重，换此方而见效，同有柴胡、乌梅两味药，其效验必定在于前胡能疏风痰，黄连能泄木火。
再诊：进前方后咳嗽大减，所出的痰，仍见青黄色，身热虽轻，咽喉苦痛，脉象弦细数。风邪未尽，中下两虚，在制小前方之外，参入猪肤汤法，一治身热，一治咽痛。
【原注】：此方治疗伤风不愈成劳损，比秦艽鳖甲散又进一层。其见证多以咳吐黄绿青痰为依据。
邓按：一治身热，指柴胡、黄连、乌梅说，足见治此方之要旨，不仅在咳吐青黄痰也。如今身热虽轻，反加咽中苦痛，大都阴气内竭，恐怕难治。
孙评：热虽轻而咽痛，邪气因敛而入肺，变证起了。先生用此方想必曾有损症，近者曾效过，遂一概用之，误事不小。
诒按：童便代替秋石甚妙。
再诊：进劳风法治疗后，咳嗽大减，红痰也没有了。但痰色尚带青黄，左关脉息弦硬不和，肝胆留邪容易犯肺胃俞穴。不可忽视。
【原注】：此方极玲珑，先生用之每灵。大约风喜伤肝，风郁于肝，久而不出，必有青黄之痰，所谓劳风是也。
诒按：先生案中治劳风一证，必用柴前连梅煎，自云法本千金，用之神效。查《千金方》所载劳风治法，及所叙病原，与此不同，即所用之柴前连梅煎，仅见于吴鹤皋《医方考》，《千金方》中并无此方，先生偶误记耳。
邓评：前方敛阴疏邪，此方清金制木，自属两途，想必有肝阳不和之意，怕难任柴胡之升也。
右脉弦滑而数，滑为痰；弦为风，风郁为热，热郁为痰，阻之于肺，清肃不行，咳嗽自作。
金沸草 前胡 半夏 荆芥 甘草 赤茯苓 川芎 枳壳 紫菀 杏仁 桑白皮 瓜蒌皮 竹沥
【原注】：方中芎、枳二味，是升降法也。必有一团寒风化热，郁闭于肺，用芎之升，枳之降，以挑松其火；若火重者不可用，有阴火者更不可用，恐火升则血易动耳。
诒按：此金沸草散去麻黄、芍药，加芎、枳，以扰动之，菀、杏以宣泄之，桑、萎以清降之。细玩其加减，可识其心思之细密，用意之周到矣。案语亦简炼老洁。
邓评：川芎辛窜升散，非有风寒者不宜，盖此病由于寒郁化热，敬用之耳。
孙评：风热痰三者，一线串成，见解独具。
川芎之宜用与慎用，明白晓畅矣。
晨起咳嗽，劳倦伤脾，积湿生痰所致。久而不已，气喘畏风，金水因此而虚，补中寓化，一定章程。现在身热口干苔白，脉息细弦而紧；紧则为寒，寒风新感。必须先治新邪，权以疏化法。
又接服方：
诒按：此即六君子汤加麦冬、旋覆花、牛膝也，恰合脾虚有湿而伤及金水者之治。
孙评：先后层次，也是一定章程。新邪清，然后补虚。
《内经》说：秋伤于湿，冬生咳嗽。喻嘉言改作秋伤于燥，冬生咳嗽。岂知初秋之湿，本从夏令而来，原为正气，若论其燥，则在中秋以后，其气亦为正令，二者相因，理所固然，势所必至。仲景早已立方，独被飞畴看破，今人之用功不如古人远矣。
【原注】：此麦门冬汤也。先生以肺燥胃湿四字提之，故此案以燥湿二字为言。
孙评：读书不用格致功夫者，必非善读书者也。
去年冬天咳嗽，今年春天寒热，到秋天时令而咳嗽或轻或重。只有喉痒一样。所谓火逆上气，咽喉不利，此类证候是也。最容易成劳损，不可以脉未促，气未喘为足恃。
邓评：寒热喉痒，当有风邪郁于肺络，郁热伤阴，阴虚成劳，于方中尚可参疏邪之品。
再诊：内热已除，咳嗽亦减。气火之逆上者，渐有下降之意。静养为佳。
前方加枇杷叶
肺经咳嗽，咳则喘息有音，甚则吐血；血已止，咳未除，右寸脉息浮弦，弦者痰饮也。良以饮食入胃，游溢精气，上输于脾，脾气散精，上归于肺；而肺气虚者，不能通调水道，下输膀胱，聚液为痰，积湿为饮，一俟诵读烦劳，咳而且嗽，自然作矣。补肺健脾，以绝生痰之源，以清贮痰之器。
【原注】：此曲曲写出痰饮之所由来。用二陈汤以化痰，佐以薏米；用麦冬以养肺，佐以百合；用白术以健脾，佐以党参。味味切当熨贴，看似寻常，实是功夫纯熟之候。
邓评：此病必有木火乘于肺络，故一经诵读劳顿，则火自升动，痰随火逆，宜乎其咳而且嗽也。方内尚须参桑皮、蛤蚧、青黛之类，并降痰火。
孙评：聚液为痰二句，见透之言。
附录：咳嗽证治括要
咳者，和谐声也，其音开口而出，仿佛亥字之音，故有声无痰为咳。嗽则如水之灌漱，然有物在喉，漾漾欲出，故从口从敕，后人遂以有痰为嗽。然则咳嗽之病，胡从生也?曰：病有万变，要不出内伤外感两端，请先明外感。外感者，风寒暑湿燥火六者尽之。论其常，则各主一时为病；论其变，则四时皆可以受六淫之邪。今则即风寒论。感风者，鼻塞身重，恶风清涕，此证也；左脉浮弦，此脉也。感寒者，恶寒体痛，发热脉紧，此寒之证与脉也。而风之中，又有辨。春则为温风，肝木用事；受风者，必伤肝，而又有中血中气之别；风伤卫，则参苏饮；风伤营，则芎苏饮。夏则为热风，伤心包，而亦有凉热之别；凉风香薷饮，热风鸡苏散。秋为凉风，伤肺，败毒散、金沸草散。冬为寒风，伤膀胱，桂枝厚朴杏仁汤、麻黄汤。傥冬时天热而感寒风，则当用葳蕤汤、阳旦汤，此冬温之邪也。惟秋分以后少暑湿，春夏无燥气。他如先伤风而后伤热，为热包寒，葳蕤汤；肺素热而感寒风，为寒包热，金沸草散。一嗽而痰出稠粘者，脾湿胜，二陈之类。连嗽无痰者，肺燥甚，清燥救肺汤。此皆外感咳也。言风一端，而六气可类推矣。若夫内伤，大法惟痰饮、津伤两种。痰饮多阳虚，津伤多阴虚。其阳虚痰饮尚浅者，六安、二陈之类；有火者，温胆汤；夹阴虚者，金水六君煎；阳虚甚，兼夹痰火不可攻者，玉竹饮子成降法；喘者，降气汤、贞元饮，此阳虚痰饮一端也。他如阴虚者，阴火易于上升，胃气不清者，麦门冬汤；曾见血者，四阴煎；痰多而浓，无胃气者，六君子汤；痰少而嗌干，胃气未绝者，六味丸、都气丸、八仙长寿丸。此粗举内伤之一端也。此外又有劳风一门，咳吐浊涕青黄之痰，由劳碌伤风，恋而不化，最为难治。浅者，秦艽鳖甲，表虚汗多者，黄芪鳖甲；深则柴前连梅煎，千金法也。此皆劳风之治也。至于芎枳二味，以治寒郁化火之咳；合二母以泻肺之母；泻白散，以清泄肺脏；四物桔梗汤，以引清血分，皆在所常用也。似此某证某方，条分缕析，须平日有格致功夫。试观先生临证之方，似乎夹杂，合之病人之证，则无一味可以增减。先生尝曰：吾门之病，如时文，割截隔章隔节之题，他人无处下手，左支右拙。余能以心思灵空，贯串合凑一方，令病安稳。此无他，外感多与内伤同，病内伤，每因外感而发，更遇杂药乱投之医，治丝而棼，愈难就绪。治此者，不能不兼采众方，就中另出一方，其立方之意，在案中宣露明白。噫!执此意以寻先生之门径，思过半矣。
邓评：若叶氏论风温由口鼻入而肺胃受邪者，则又宜银翘、桑菊之类矣。
寒郁火邪，亦能令人干咳，便宜辛散带润，如甘、桔、蜜炙姜、橘之类。秦艽鳖甲与黄芪鳖甲，总须有骨蒸寒热者乃合。治寒郁化火之类而将成肺痿者，莫若葛氏保和汤为最妙。
孙评：治杂症根本透彻。
失 血 门
饮食入胃，游溢精气，上输于脾，脾气散精，上归于肺，通调水道，下输膀胱，水精四布，五经并行，合于四时五脏，阴阳揆度，以为常也。此乃饮归于肺，失其通调之用，饮食之饮，变而为痰饮之饮。痰饮之贮于肺也，已非一日。今当火令，又值天符相火加临，两火相烁，金病更甚于前。然则痰之或带血，或兼臭，鼻之或干无涕，口之或苦且燥，小水之不多，大便之血沫，何一非痰火为患乎。
旋覆花 桑白皮 川贝母 橘红 浮海石 炙甘草 沙参 茯苓 麦冬 竹叶 丝瓜络
诒按：此证乃素有浊痰郁热，壅结熏蒸于内，再受时令火邪，熏灼肺胃所致。如此立论，似亦直捷了当。何必用饮食入胃，及天符相火，如许大议论耶。可参用苇茎汤。
再诊。接阅手书，知咳血、梦遗、畏火三者，更甚于前。因思天符之火行于夏时，可谓火之淫矣。即使肺金无病者，亦必暗受其伤，而况痰火久踞，肺金久伤，再受此外来之火，而欲其清肃下降也，难矣。肺不下降，则不能生肾水，肾水不生，则相火上炎，此咳逆梦遗之所由来也。至于畏火一条，《内经》载在阳明脉解篇中，是肝火乘胃之故。法宜泻肝清火，不但咳血、梦遗、畏火等证之急者，可以速平，而且所患二便不通，亦可从此而愈。悬而拟之，未识效否。
鲜生地 蛤壳 青黛 桑白皮 龙胆草 川贝母 地骨皮 黑栀子 竹叶 大黄盐水炒
邓评：咳逆梦遗，由相火之上淫下迫，非连、柏、知母等不足以泻之，岂是生地之甘寒，大黄之攻导所宜。
三诊：阳明中土，万物所归，现在盯经湿热之邪，大半归于阳明，以著顺乘之意，而逆克于肺者，犹未尽平。所以睡醒之余，每吐青黄绿痰，或带血点，其色非紫即红，右胁隐隐作痛，脉形滑数，独见肺胃两部。宜从此立方。
小生地 桑白皮 羚羊角 阿胶 冬瓜子 薏苡仁 蛤壳 川贝母 杏仁 忍冬藤 青黛 功劳露 芦根 丝瓜络
诒按：前方实做，不若此方之空灵活泼也。
[Original Note]: This is winter-warmth cough (Dongwen Ke Sou). Ephedrae Herba and Armeniacae Semen Amarum disperse and vent to release the external cool wind; Notopterygii Rhizoma and Saposhnikoviae Radix assist it; Gypsum Fibrosum clears the latent warmth-heat within; Anemarrhenae Rhizoma and Polygonati Odorati Rhizoma assist it. Winter-warmth disease inevitably presents with headache and diarrhea, and Qemu Xiang (Aquilariae Lignum) is a herb for treating diarrhea. This illness has one more character "warmth" compared to Cold Damage (Shanghan); the formula removes Cinnamon Twig from Ma Huang Tang and adds Gypsum Fibrosum to treat heat, possessing the subtlety of adapting the prescription to the specific situation.
You Zai's Commentary: Since this illness presents with thick sputum and thirst, there are already signs of pathogenic stagnation transforming into heat. The use of Notopterygii Rhizoma, Saposhnikoviae Radix, and Puerariae Radix in the formula should perhaps be used with discretion.
Deng's Commentary: The cough arose after cold and fever, likely due to lingering residual pathogens; it probably does not require such heavy formulas.
Puerariae Radix alone, its ascending nature might aggravate the cough. The Original Note's distinction between "cold" and "warmth" is indeed clear.
Sun's Commentary: Winter-warmth has already transformed into heat, which is slightly less severe than transformation into dryness. Why use so many drying herbs? Ancients failed to clearly distinguish boundaries in warm diseases, and their treatment methods were all like this. Today, it is completely different. Moreover, diarrhea is the pathway for heat to exit; how can one use Aucklandiae Radix to stop it? Qing Mu Xiang (Aquilariae Lignum) and Mu Xiang (Aucklandiae Radix) have different uses.
Cold must damage the Ying level (nutritive level) and inevitably transform into heat. Cough persists, vomiting purple blood, throat dry and painful, tongue coating white with green edges, pulse tight and rapid. Recently, severe cough induces vomiting, and breath is short. Both the Lung and Stomach meridians have lost their clear descending function. Stagnant cough becoming consumption (Lao) is most terrifying.
Schizonepetae Herba, Armeniacae Semen Amarum, Asteris Radix, Mori Cortex, Lycii Cortex, Perillae Fructus, Ophiopogonis Radix, Tussilaginis Flos, Polygonati Odorati Rhizoma.
Deng's Commentary: Xuan Fu Dai Zhe Wan Decoction plus Phragmitis Rhizoma and Loquat Leaf, named Yu Re Tang (Stasis-Heat Decoction), was authored by the Master. This illness should have stasis-heat obstructing internally; why discard it now?
Sun's Commentary: Green tongue edge and tight pulse indicate severe condition. The medication is too plain; this is highly inadvisable.
Second Visit: White coating has thinned, but the tongue edge remains green. Sputum is thin, but cough and rebellious Qi persist. Observing his wheezing and vomiting, they occur mostly during severe coughing. This is exactly the state of Lung Cough: cough with wheezing; and Stomach Cough: cough with vomiting.
Mori Cortex, Lycii Cortex, Anemarrhenae Rhizoma, Fritillariae Bulbus, Scutellariae Radix (light fry), Pteridis Spora, Platycodonis Radix, Glycyrrhizae Radix et Rhizoma (roasted), Asteris Radix, Ophiopogonis Radix, Phragmitis Rhizoma, Raphani Fructus Juice.
[Original Note]: Wind-cold pathogens, stagnant in the Lung and Stomach, transform into fire over time, leading to bleeding. First, use Jin Fei Cao San (Tussilaginis Flos Decoction) and Xie Bai San (Pulmonariae Root Decoction) to search out and eliminate pathogens. In the second case, Phragmitis Rhizoma and Anemarrhenae Rhizoma were added to clear heat in the Ying level. The change in usage is clear in layers.
You Zai's Commentary: This syndrome previously involved vomiting stasis, combined with a green tongue edge, suggesting blood stasis obstruction. Why did the plan ignore this!
Deng's Commentary: The green on the tongue edge arises from cold damaging blood stasis. Although it has transformed into heat over time, its root nature is still cold pathogen, hence the coating color... The previous formula had the power to disperse pathogens, so the white coating thinned; lacking the function to guide out stasis, the tongue edge remains green.
Sun's Commentary: Green-purple tongue coating belongs to cold syndromes; there is no theory of heat stagnation. If there is internal blood stasis presenting with green coating, it is a separate category; only stasis obstruction often shows purple tongue.
Wind-stroke unresolved, cough, vomiting, nausea. The sputum seen may be thin or thick, or contain blood. The Left Guan pulse alone shows floating, wiry, and rapid qualities, with slight cold and fever; this is the root of deficiency syndromes. Treat according to the method of Qian Jin Fang.
Perillae Folium, Codonopsis Radix, Coptidis Rhizoma, Mume Fructus, Citri Reticulatae Pericarpium, Fritillariae Bulbus, Bupleuri Radix, Armeniacae Semen Amarum, Mori Cortex, Lycii Cortex.
[Original Note]: This uses the intent of Chai Qian Lian Mei Jian (Bupleurum, Peucedanum, Coptis, and Mume Decoction), the method of Qian Jin. There are eighteen types of coughs, all because pathogens enter the Liver; this is the rhyme for this formula. After this formula is effective, switch to adding Houttuyniae Herba.
You Zai's Commentary: The wiry-rapid pulse appears only at the Left Guan, indicating the disease is specifically in the Liver.
Deng's Commentary: Without cold/fever manifestations, Bupleuri Radix is difficult to use lightly, fearing excessive Liver Yang.
Sun's Commentary: When pathogens are not cleared, astringent substances cannot be used. Even if combined with dispersing agents, after recovery, lingering pathogens will cause harm and changes.
Coughing up green-yellow sputum, stiff neck, aversion to wind, hoarse voice, alternating chills and fever; this is called Lao Feng (Consumption-Wind). Taking Qin Jiao Bie Jia Tang (Gentian and Turtle Shell Decoction) makes it worse; advance to a deeper treatment.
Chai Qian Lian Mei Jian: Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Huang Lian (Coptidis Rhizoma), Wu Mei (Mume Fructus), Xie Bai (Allii Macrostemonis Bulbus), Pig Bile, Tong Bian (Child's Urine), Pig Spinal Cord.
Appendix: Qin Jiao Bie Jia Tang: Qin Jiao (Gentianae Radix), Bie Jia (Testudinis Carapax et Plastrum), Di Gu Pi (Lycii Cortex), Chai Hu (Bupleuri Radix), Qing Hao (Artemisiae Annuae Herba), Dang Gui Shen (Angelicae Sinensis Radix), Zhi Mu (Anemarrhenae Rhizoma), Wu Mei (Mume Fructus).
Deng's Commentary: Advancing to Qin Jiao Bie Jia Tang made it worse; switching to this formula brought effect. Both contain Chai Hu and Wu Mei. Its efficacy must lie in Qian Hu's ability to disperse wind-phlegm and Huang Lian's ability to drain Wood-fire.
Second Visit: After taking the previous formula, cough decreased significantly. The expelled sputum is still green-yellow. Body heat is mild, but throat is bitter and painful. Pulse is wiry, fine, and rapid. Wind pathogen is not exhausted; Middle and Lower deficiencies exist. Besides the small previous formula, incorporate Zhu Fu Tang (Pig Skin Decoction): one treats body heat, one treats throat pain.
Chai Qian Lian Mei Jian combined with Zhu Fu Tang, add Dang Shen (Codonopsis Radix) and Shi Hu (Dendrobii Caulis).
[Original Note]: This formula treats wind-stroke unresolved becoming consumption, advancing one step further than Qin Jiao Bie Jia Tang. Its manifestations are mainly based on coughing up yellow-green-blue sputum.
Deng's Note: "One treats body heat" refers to Chai Hu, Lian (Huang Lian), and Mei (Wu Mei). This shows the key point of this formula is not just about coughing green-yellow sputum. Now that body heat is mild, but throat bitterness/pain is added, it largely indicates internal exhaustion of Yin Qi; it is feared to be untreatable.
Sun's Commentary: Heat is mild but throat hurts; pathogens entered the Lung due to astringency, and complications arose. The Master used this formula likely having treated deficiency syndromes before, and seeing recent efficacy, applied it universally, causing significant error.
Cough, waxing and waning, pink sputum turning green-yellow; this is the root of Lao Feng.
Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Wu Mei (Mume Fructus), Huang Lian (Coptidis Rhizoma), Xie Bai (Allii Macrostemonis Bulbus), Tong Bian (Child's Urine), Pig Bile, Pig Spinal Cord.
You Zai's Commentary: Replacing Tong Bian with Qiu Shi (Mineral Salt) is excellent.
Second Visit: After advancing Lao Feng treatment, cough decreased greatly, red sputum disappeared. But sputum color still carries green-yellow. Left Guan pulse is wiry, hard, and discordant. Lingering pathogens in Liver and Gallbladder easily invade Lung and Stomach Shu points. Do not neglect.
Ophiopogonis Radix, Glehniae Radix, Scutellariae Radix (light fry), Glycyrrhizae Radix et Rhizoma (roasted), Paeoniae Radix Alba, Fritillariae Bulbus, Qing Dai (Mineral Blue), Guang Pi (Citri Reticulatae Pericarpium).
[Original Note]: This formula is extremely delicate; the Master uses it with frequent efficacy. Generally, wind likes to damage the Liver; wind stagnant in the Liver, lingering without exiting, inevitably produces green-yellow sputum, known as Lao Feng.
You Zai's Commentary: In the Master's cases treating Lao Feng, he always uses Chai Qian Lian Mei Jian, claiming the method originates from Qian Jin and is miraculous. Checking the Lao Feng treatment methods and etiology described in *Qian Jin Fang*, they differ from this. Even the Chai Qian Lian Mei Jian used here only appears in Wu Hegao's *Yi Fang Kao*; it is not in *Qian Jin Fang*. The Master misremembered occasionally.
Deng's Commentary: The previous formula astringes Yin and disperses pathogens; this formula clears Metal and controls Wood. They belong to two different paths. It must imply Liver Yang disharmony, fearing difficulty tolerating the ascending nature of Chai Hu.
Right pulse is wiry, slippery, and rapid. Slippery indicates phlegm; wiry indicates wind. Wind stagnates into heat; heat stagnates into phlegm. Obstructed in the Lung, clear descending fails, cough arises spontaneously.
Tussilaginis Flos, Peucedani Radix, Pinelliae Rhizoma, Schizonepetae Herba, Glycyrrhizae Radix et Rhizoma, Poria, Chuan Xiong (Ligustici Chuanxiong Rhizoma), Aurantii Fructus Immaturus, Asteris Radix, Armeniacae Semen Amarum, Mori Cortex, Trichosanthis Pericarpium, Bamboo Sap.
[Original Note]: In the formula, Chuan Xiong and Zhi Ke represent the ascending-descending method. There must be a mass of cold wind transforming into heat, stagnant and closed in the Lung. Use the ascending of Chuan Xiong and descending of Zhi Ke to loosen the fire; if fire is heavy, do not use; if there is yin-fire, even more do not use, fearing fire ascending will move blood easily.
You Zai's Commentary: This Jin Fei Cao San removes Ma Huang and Shao Yao, adds Chuan Xiong and Zhi Ke to stir/move it; Zi Wan and Xing Ren to vent/disperse; Sang Bai Pi and Gua Lou Pi to clear/descend. Carefully studying its modifications reveals meticulous thinking and thorough intention. The case notes are also concise and old-fresh.
Deng's Commentary: Chuan Xiong is pungent, penetrating, ascending, and dispersing; unsuitable for those without wind-cold. This illness arises from cold stagnation transforming into heat, respectfully using it.
Sun's Commentary: Wind, heat, and phlegm are linked in a line; unique insight.
The appropriate and cautious use of Chuan Xiong is now clear and fluent.
Morning cough, fatigue injuring Spleen, accumulated dampness generating phlegm. Unresolved for a long time, asthma and aversion to wind, Metal and Water become deficient due to this. Tonify containing transformation, a fixed principle. Currently body heat, dry mouth, white coating, pulse fine, wiry, and tight; tight indicates cold, new sensation of cold wind. Must first treat new pathogens, temporarily using dispersing-transforming method.
Xiang Su Yin combined with Er Chen Tang, add Zhi Ke, Jie Geng, Xing Ren, Tong Cao.
Next continued prescription:
Mai Men Dong Tang combined with Er Chen Tang, add Xuan Fu Hua, Zhu Ling (Atractylodis Macrocephalae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix).
You Zai's Commentary: This is Liu Jun Zi Tang plus Mai Dong, Xuan Fu Hua, Niu Xi, fitting the treatment for Spleen deficiency with dampness injuring Metal and Water.
Deng's Commentary: Long-term cough and asthma, Metal and Water naturally deficient. Using Xiang Su Yin and Jie Geng, fear it is too ascending and dispersing.
Sun's Commentary: Sequence and hierarchy are also a fixed principle. Clear new pathogens, then tonify deficiency.
*Nei Jing* says: Autumn injury by dampness, Winter generates cough. Yu Jia Yan changed it to Autumn injury by dryness, Winter generates cough. Who knows early autumn dampness comes from summer, originally righteous Qi; if discussing dryness, it is after mid-autumn, its qi is also regular command. The two follow each other, logically natural, inevitably so. Zhong Jing had already established formulas, only Bei Fei Chou saw through it. Modern people's effort is far inferior to ancients.
Ophiopogonis Radix, Pinelliae Rhizoma, Glycyrrhizae Radix et Rhizoma, Polygonati Odorati Rhizoma, Asteris Radix, Xie Bai San (Pulmonariae Root Decoction).
[Original Note]: This is Mai Men Dong Tang. The Master highlights "Lung Dryness, Stomach Dampness," so this case speaks of dryness and dampness.
Deng's Commentary: This formula treats autumn-dryness cough, milder/better than Yu's Qing Zao Jiu Fei Tang.
Sun's Commentary: Those who read without Ge Zhi (investigating things) effort are certainly not good readers.
Last winter cough, this spring cold/fever, arriving at autumn season cough light or heavy. Only throat itch remains. So-called fire rebellion upward Qi, throat unfavorable, such syndromes are these. Most easily becomes consumption; cannot rely on pulse not rapid, Qi not asthmatic.
Mai Men Dong Tang combined with Xie Bai San, add Ju Hong, Fu Ling, Gan Cao, Yu Zhu.
Deng's Commentary: Cold/fever and throat itch, likely wind pathogen stagnant in Lung collaterals, stagnant heat injuring Yin, Yin deficiency becoming consumption. In the formula, one can still refer to dispersing pathogen items.
Second Visit: Internal heat removed, cough reduced. Rebellious Qi and Fire gradually showing descending intent. Quiet rest is best.
Previous formula add Pi Pa Ye (Loquat Leaf).
[Original Note]: This illness must have tongue coating, but no night cough, thus differing from Si Yin Jian syndrome.
Deng's Commentary: Adding Pi Pa Ye, is it also for clearing Lung pathogens?
Lung Meridian Cough, cough with wheezing and sound, severely hemoptysis; blood stopped, cough not removed, Right Cun pulse floating and wiry, wiry indicates phlegm-fluid. Indeed, food enters Stomach, wandering essence ascends to Spleen, Spleen Qi scatters essence, ascends returns to Lung; but Lung Qi deficiency cannot regulate water passages, descend to Bladder, gather fluid into phlegm, accumulate dampness into fluid. Once reading or labor occurs, cough and sputum arise naturally. Tonify Lung and strengthen Spleen, to cut off source of phlegm generation, to clear vessel storing phlegm.
Mai Men Dong Tang combined with Yi Gong San, add Yi Yi Ren (Coicis Semen) and Bai He (Lilii Bulbus).
[Original Note]: This writes out the origin of phlegm-fluid curve by curve. Use Er Chen Tang to resolve phlegm, assisted by Yi Mi; use Mai Dong to nourish Lung, assisted by Bai He; use Bai Zhu to strengthen Spleen, assisted by Dang Shen. Every taste fits appropriately, seemingly ordinary, actually skill mature stage.
You Zai's Commentary: Above several cases are all Mai Men Dong Tang syndromes, method of dryness-dampness mutual use.
Deng's Commentary: This illness must have Wood-Fire invading Lung collaterals, so once reading/labor, fire rises spontaneously, phlegm follows fire rebellion, suitable for cough and sputum. Formula still needs to refer to Sang Pi, Ha Ge (Margaritifer Concha), Qing Dai, etc., to descend phlegm-fire.
Sun's Commentary: "Gather fluid into phlegm" two sentences, penetrating words.
Appendix: Summary of Cough Syndrome and Treatment
Ke (Cough) harmonizes sound, its sound opens mouth out, resembling 'Hai' character sound, thus sound without phlegm is Ke. Sou (Sputtering) like water pouring/rinsing, yet object in throat, swishing wanting out, thus from mouth from Chi, later people take having phlegm as Sou. Then cough-sputum disease, where from born? Say: Disease has ten thousand changes, essentially not exceeding internal injury and external contraction two ends, please first clarify external contraction. External contraction, wind-cold-summerheat-dryness-fire six complete. Discussing normal, each governs one time for disease; discussing variation, four seasons all can receive six excess pathogens. Now discuss wind-cold. Feeling wind, nasal congestion body heavy, aversion to wind clear runny nose, this syndrome; Left pulse floating wiry, this pulse. Feeling cold, aversion to cold body pain, fever pulse tight, this cold syndrome and pulse. And within wind, again differentiation. Spring is warm wind, Liver Wood governing; feeling wind, must damage Liver, and again有中血中气 difference; wind damages Wei, then Shen Su Yin; wind damages Ying, then Xiong Su Yin. Summer is hot wind, damages Heart Bao, and again cool-hot difference; cool wind Xiang Ru Yin, hot wind Ji Su San. Autumn is cool wind, damages Lung, Bai Du San, Jin Fei Cao San. Winter is cold wind, damages Bladder, Gui Zhi Hou Po Xing Ren Tang, Ma Huang Tang. If winter weather hot and feels cold wind, then should use Wei Rui Tang, Yang Dan Tang, this winter-warmth pathogen. Only after Autumn Equinox little summer-dampness, Spring-Summer no dryness. Others like first wind-stroke then heat-stroke, heat wraps cold, Wei Rui Tang; Lung originally hot and feels cold wind, cold wraps heat, Jin Fei Cao San. One cough and sputum out thick-sticky, Spleen dampness wins, Er Chen type. Continuous cough no phlegm, Lung dryness severe, Qing Zao Jiu Fei Tang. These all external contraction cough. Speaking wind one end, six Qi can infer. As for internal injury, general method only phlegm-fluid, Jin-Yin injury two kinds. Phlegm-fluid mostly Yang deficiency, Jin-Yin injury mostly Yin deficiency. Its Yang deficiency phlegm-fluid shallow, Liu An, Er Chen type; having fire, Wen Dan Tang; mixed Yin deficiency, Jin Shui Liu Jun Jian; Yang deficiency severe, mixed phlegm-fire cannot attack, Yu Zhu Yin Zi become descending method; asthma, Jiang Qi Tang, Zhen Yuan Yin, this Yang deficiency phlegm-fluid one end. Others like Yin deficiency, Yin fire easy rise, Stomach Qi unclear, Mai Men Dong Tang; once seeing blood, Si Yin Jian; phlegm much and thick, no Stomach Qi, Liu Jun Zi Tang; phlegm little and throat dry, Stomach Qi not extinct, Liu Wei Wan, Du Qi Wan, Ba Xian Chang Shou Wan. This roughly raises internal injury one end. Additionally there is Lao Feng category, coughing turbid鼻涕 green-yellow sputum, from labor wind-stroke, lingering not transforming, most difficult to treat. Shallow, Qin Jiao Bie Jia, surface deficiency sweat much, Huang Qi Bie Jia; deep then Chai Qian Lian Mei Jian, Qian Jin method. These all Lao Feng treatment. Regarding Chuan Xiong Zhi Ke two flavors, to treat cold stagnation transforming fire cough; combine Er Mu to drain Lung mother; Xie Bai San, to clear-drain Lung organ; Si Wu Jie Geng Tang, to lead clear Blood level, all in commonly used. Like this certain syndrome certain formula, strip branch analyze node, must daily have Ge Zhi effort. Try observe Master clinical formula, seems mixed, combined with patient syndrome, then no single flavor can increase-decrease. Master once said: My gate's disease, like time essay, cut intercept separate chapter separate section topic, others nowhere start hand, left support right awkward. I can use mind spirit empty, connect match together one formula, let disease stable. This no other, external contraction mostly with internal injury same, disease internal injury, often due to external contraction erupt, more meet miscellaneous medicine random throw doctor, manage silk and confuse, more difficult arrange. Manage this person, cannot not jointly adopt many formulas, among separately produce one formula, its formula meaning, in case reveal clear. Alas! Hold this meaning to seek Master's gate path, think half over.
Deng's Commentary: If Ye's discussion on wind-warmth entering via mouth/nose and Lung/Stomach receiving pathogen, then again suitable Yin Qiao, Sang Ju type.
Cold stagnant fire pathogen, also can make person dry cough, cheap pungent-dispersing carrying moistening, like Gan, Jie, Honey-roasted Ginger, Orange type. Qin Jiao Bie Jia and Huang Qi Bie Jia, always must have bone-steaming cold-fever person then fit. Treating cold stagnation transforming fire type and about to become Lung Atrophy, none if Ge Shi Bao He Tang most wonderful.
Sun's Commentary: Treating miscellaneous syndromes root thoroughly penetrated.
Loss of Blood Gate
Food enters Stomach, wandering essence ascends to Spleen, Spleen Qi scatters essence, ascends returns to Lung, regulates water passages, descends to Bladder, water essence four distributes, five meridians parallel run, combines with four seasons five zang, Yin-Yang measure, as constant. This is drink returns to Lung, loses its regulation function, food drink, transforms into phlegm-fluid drink. Phlegm-fluid stored in Lung, already not one day. Now when fire command, again value Tian Fu Xiang Huo addition, two fires mutually burning, Metal disease more severe than before. Then phlegm either carry blood, or accompany smell, nose either dry no mucus, mouth either bitter and dry, small water not much, large stool blood foam, which one not phlegm-fire disaster?
Xuan Fu Hua, Mori Cortex, Fritillariae Bulbus, Ju Hong, Pteridis Spora, Roasted Gan Cao, Sha Shen, Fu Ling, Mai Dong, Zhu Ye, Si Gua Luo.
You Zai's Commentary: This syndrome is originally turbid phlegm stagnant heat, congested steaming inside, again receives seasonal fire pathogen, roasting Lung-Stomach caused. Such establishing argument, seems also direct simple. Why must use food enters stomach, and Tian Fu Xiang Huo, such big argument? Can refer use Wei Jing Tang.
Deng's Commentary: This disease looks topic still clear, but medication not yet grasp, thus cannot like splitting bamboo down.
Second Visit. Receive reading handwritten letter, know hemoptysis, nocturnal emission, fear fire three, more severe than before. Because think Tian Fu fire runs in Summer time, can say fire excess. Even if Lung Metal no disease person, also must secretly receive its injury,何况 phlegm-fire long occupy, Lung Metal long injured, again receive this external fire, and want its clear-descent, difficult. Lung not descending, then cannot generate Kidney Water, Kidney Water not generate, then Xiang Huo upward flare, this cough-rebellion nocturnal-emission source come from. Regarding fear fire one item, *Nei Jing* recorded in Yang Ming Mai Jie Pian, is Liver fire multiplying Stomach cause. Method suitable drain Liver clear fire, not only hemoptysis, nocturnal emission, fear fire etc syndrome urgent ones, can quickly calm, moreover afflicted two passages unblocking, also can from this heal. Hang and propose it, not know effect whether.
Fresh Sheng Di, Ge Qiao, Qing Dai, Mori Cortex, Long Dan Cao, Fritillariae Bulbus, Di Gu Pi, Black Zhi Zi, Zhu Ye, Da Huang salt-water fried.
Deng's Commentary: Cough-rebellion nocturnal-emission, by Xiang Huo upper-excess lower-pressure, not Lian, Bo, Zhi Mu etc insufficient to drain them, how is Sheng Di sweet-cold, Da Huang attacking-guiding suitable.
Third Visit: Yang Ming Middle Earth, ten thousand things return, currently Jing meridian damp-heat pathogen, half return to Yang Ming, to mark smooth multiplication intent, and reverse conquer Lung者, not yet fully calm. So sleep wake remainder, every spit green-yellow-green sputum, or carry blood spot, its color not purple then red, Right hypochondrium hidden pain, pulse shape slippery-rapid, alone see Lung-Stomach two parts. Suitable from this establish formula.
Small Sheng Di, Mori Cortex, Ling Yang Jiao (Antelope Horn), E Jiao (Colla Corii Asini), Dong Gua Zi (Benincasae Semen), Yi Yi Ren, Ge Qiao, Fritillariae Bulbus, Xing Ren, Ren Dong Teng (Lonicerae Japonicae Caulis), Qing Dai, Gong Lao Lu (Ardisiae Fructus Dew), Lu Gen, Si Gua Luo.
[Original Note]: Liver meridian long disease, conquering Earth is smooth multiplication, offending Lung is reverse conquest.
You Zai's Commentary: Previous formula solid doing, not like this formula empty-lively-active.
Deng's Commentary: Disease by Xiang Huo internal-high, more phlegm-damp mixed, use Sheng Di to assist phlegm, then fire contrary suppressed,窜 (窜) into collateral thus hypochondriac pain.