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咳嗽(1/3) · 张聿青医案 · 医典·华经

张聿青医案

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张聿青医案 · 咳嗽(1/3) · 清

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简（左）感风入肺，肺失清肃。咳嗽痰色黄浓，夜重日轻。脉象带数。宜肃肺化痰。
粉前胡（一钱）马兜铃（一钱五分）牛蒡子（三钱）茯苓（三钱）橘红（一钱）炒杏仁（三钱）
竹沥半夏（一钱五分）冬瓜子（三钱）象贝（二钱）肺露（一两）
二诊咳仍不止，痰黄而浓，咽痒头胀。风温外薄，肺胃内应，气热而肺失肃耳。肃肺以清气热。
山栀皮（三钱）川贝母（二钱）粉前胡（一钱）花粉（二钱）桔梗（一钱）冬瓜子（四钱）
马兜铃（一钱五分）炒杏仁（三钱）枇杷叶（去毛四片）
三诊咳渐减疏，口燥咽干轻退。再清金润肺，而化气热。
北沙参（四钱）川贝母（二钱）光杏仁（二钱）炒枳壳（一钱）桔梗（一钱）冬瓜子（四钱）
马兜铃（一钱五分）炒竹茹（一钱）枇杷膏（五钱）
宋（媪）冬藏不固，感召风邪，肺合皮毛，邪袭于外，肺应于内。咳嗽咽燥。宜清肃太阴。俟咳止再商调理。
川贝母（二钱）桔梗（一钱）杏仁泥（三钱）花粉（二钱）茯苓（三钱）桑叶（一钱）
冬瓜子（三钱）前胡（一钱）川石斛（四钱）菊花（一钱五分）枇杷叶（去毛四片）
二诊清肃太阴，咳仍不减，夜重日轻，舌干咽燥。肺肾阴虚，虚多实少。宜兼治本。
北沙参（三钱）川贝母（二钱）甜杏仁（三钱）川石斛（四钱）青蛤散（四钱）茯苓（三钱）
前胡（一钱）桔梗（八分）枇杷叶（去毛四片）琼玉膏（四钱二次冲服）
秦（童）风温袭于肺胃。咳嗽气逆，身热头胀。脉数右大。肺本清虚，今为风邪所阻，则降令无权。宜清肃
太阴，疏泄肌表。
牛蒡子（三钱）光杏仁（三钱）薄荷（一钱）炒枳实（一钱）广郁金（一钱五分）粉前胡（一钱）
广橘红（一钱）茯苓（三钱）象贝母（二钱）冬桑叶（一钱五分）
陈（右）肾本空虚，封藏不固，暴凉暴暖，感于肌表，肺辄内应，痰饮因而复发。气喘胸闷，痰不得出，痰从
偏左而来，以肝用主左，肝气挟痰上逆，所以其势尤甚。药饵之外，务须怡情以条达肝木，使气不上逆，
勿助痰势，其病自然少发也。
代赭石（四钱）杜苏子（三钱）制半夏（一钱五分）橘红（一钱）川桂枝（四分）旋复花（二钱）
杏仁泥（三钱）煨石膏（四钱）枳壳（一钱）郁金（一钱五分）
陆（左）肺有伏寒，至冬寒水行令，阳气不化，以致寒饮停于肺下，咳嗽右胁作痛。宜温疏太阴之表，以觇动静
如何。
不去节麻黄（三分另煎去沫冲）制半夏（二钱）茯苓（四钱）冬瓜子（四钱）
不去皮尖杏仁（三钱）生香附（一钱五分）橘红（一钱）旋复花（一钱包）不去节甘草（三分）
炒苏子（三钱）枳壳（一钱）磨郁金（五分冲）
二诊温疏太阴之表，咳略减轻。而脉象微数，营液不足之征。论病宜续进苦温，然肺虽恶寒，心则恶
热，脉沉带数，未便耗伤营分，再出之以和平。
粉前胡广橘红制半夏云茯苓旋复花杏仁泥炒苏子炒黄川贝母蜜炙紫菀
另附梨膏方
麻黄（四钱蜜炙去沫）茯苓（四两）煨石膏（二两）桔梗（八钱）枳壳（八钱）姜汁（二钱）大荸荠
（八两）甜杏仁（七两荸荠同打汁冲）杜苏子（绞汁冲四两）白莱菔（打汁冲一斤）竹沥（四两冲）荆沥（二
两冲）悉尼（一斤）
上药熬膏，每日服一调羹，开水送下。
鲍（左）久咳而痰滞肺络，痰为阴类，所以每至暮夜，则凝聚郁塞，窒碍肺气，气逆咳频，至日中阴得阳
化，咳即大减。若非祛尽宿痰，则根株不能杜截。但为病已久，不易祛逐耳。
制半夏炙紫菀茯苓炒黄川贝苦桔梗海蛤壳炒枳壳橘红苦杏仁桑叶络生甘草苏子霜
水泛为丸，每服三钱。
邵（左）肺感风温，复以熬夜受寒，寒束热郁。由咽痛而致呛咳，痰不爽出，头胀恶寒。脉象沉弦。邪郁太
阴，金失降令。拟辛温寒合方，以彻肺邪。
蜜炙麻黄（四分）生甘草（四分）蜜炙橘红（一钱）茯苓（三钱）前胡（一钱）煨石膏（二钱）
光杏仁（三钱）炒枳壳（一钱）老生姜（三片）
二诊辛温寒以彻肺邪，咳仍不减。脉弦微数。热郁于肺。再宜清金肃肺。
炙桑皮（二钱）生甘草（五分）淡芩（一钱五分）茯苓（三钱）冬瓜子（四钱）地骨皮（二钱）
肥知母（二钱）前胡（一钱）川贝母（二钱）枇杷叶膏（五钱）
周（左）航海感风而咳剧，虽经养肺而咳止住，然肺络之中，邪未尽泄，所以稍一感触，辄喉痒咳剧。疏
其新感，咳即渐减腠理日疏，邪仍内踞。金病则不能制木，木火自必刑金。然右脉浮滑，病仍在肺。前贤
谓邪在肺络，或邪未楚而适投补益，以致邪伏难泄者，三拗汤主之。然苦温疏散，恐伤肺体。兹拟肺露
而变其法，作日就月将之计，庶几疏不碍表，补不滞里耳，请备方家正之。
不落水猪肺（一只）不去节麻黄（六钱）不去皮尖杏仁（三两）不去节甘草（一两）
三味与猪肺一同蒸露，随意温服。
王（左）降化温疏，脉证相安。久病而投猛剂，行侥徼幸，固知者所不为，然邪与正不能并立，不去其邪，
何以保全其正气，则和平缓治，是犹畏疡溃之痛而养毒也，再作背水之计。
粉前胡光杏仁制半夏广橘红茯苓炙紫菀荆芥穗炒蒌皮苏梗子梨肉
二诊肺感风邪，不为疏解，反为补益，以致邪恋而不得泄，咳久不止。脉濡而气口独浮。既从外感而
来，虽经日久，不得不为疏泄也。
不去节麻黄不去节甘草不去皮尖杏仁炒蒌皮炒枳壳炒苏子广郁金茯苓蜜炙橘红桔梗
杨（左）咳嗽气逆痰多，遍身作痛。脉象弦滑。痰饮阻肺，肺失降令，络隧因而不宣。姑辛温寒以开饮邪。
川桂枝（五分）白茯苓（三钱）光杏仁（三钱）炒苏子（三钱）煨石膏（三钱）广橘红（一钱）
甜葶苈（五分）制半夏（一钱五分）
二诊辛温寒合方，咳嗽气逆，十退五六。的是肝气挟饮上逆。再以退为进。
姜半夏（二钱）炒苏子（三钱）白茯苓（三钱）猩绛（五分）炙黑草（三分）广橘红（一钱）
川桂枝（四分）旋复花（二钱）上川朴（七分）青葱管（三分）
三诊痰喘大退，咳嗽未定，两胁作痛亦止。再为温化。
白芥子（四分炒研）广橘红（一钱）茯苓（三钱）旋复花（二钱包）光杏仁（三钱）制半夏（一钱五分）
炒苏子（三钱）枳壳（一钱）广郁金（一钱五分）猩绛（五分）
马（左）肺有伏寒，感风咳逆。且疏新感，俟咳减再商。
制半夏光杏仁白茯苓枳壳砂仁炒苏子
薄橘红前胡桑叶
又咳嗽稍减。的是肺有伏寒，而肺气暗虚。前法出入再进。
光杏仁橘红制半夏款冬花生薏仁炒苏子茯苓炒黄川贝炙紫菀肉
另方
川贝母（一两去心）炒莱菔子（四两）豆腐锅巴（八两）白果肉（一两）白冰糖（四两）
五味研为细末，每服四钱，开水调糊送下。或稍加糖霜。
张（左）音塞不扬，两年之久，遂起呛咳，却不见红。脉象气口不调。寒热互阻于肺，然肺为水之上源，恐
肺金日损，而变假为真。
不去节麻黄（三分）杏仁（三钱不去皮尖）煨石膏（三钱）炒苏子（三钱）不去节甘草（三分）
制半夏（一钱五分）枳壳（一钱）橘红（一钱）茯苓（三钱）
二诊用麻杏甘膏并不汗出，咳嗽音塞，尚复如前。肺邪伏匿既深，恐变假为真。拟重药轻服法。
麻杏甘膏加细辛前胡橘红茯苓枳壳（其人竟服七剂未见过节）
三诊用辛温寒合方，音塞较开，咳嗽大减。然天气温燥，呛咳复甚。脉象左大。伏匿之邪，虽得渐解，而
肺气阴液，早为并损。再清金养肺。
南沙参（四钱）光杏仁（三钱）炒天冬（三钱）白茯苓（三钱）生甘草（三分）川贝母（二钱）
生扁豆衣（三钱）水炒竹茹（一钱）生鸡子白（一枚冲服）
魏（左）肺有伏寒，稍一感冒，咳嗽即甚。兹当天气渐寒，更涉重洋，咳嗽因而尤甚，动辄气逆。脉沉弦重
按少力，舌红苔薄白并不浓腻。此风寒痰饮有余于上，而肾本空虚于下。用雷氏上下分治法。
炒苏子（三钱）制半夏（一钱五分）川朴（八分）橘红（一钱）白茯苓（三钱）熟地炭（四钱）
嫩前胡（一钱五分）当归（炒透一钱五分）老生姜（三片）
二诊上下兼治，喘嗽稍减。的是上实下虚，前法扩充。
制半夏（一钱五分）菟丝子（盐水炒三钱）巴戟肉（三钱）白茯苓（三钱）广橘红（一钱）怀牛膝
（盐水炒三钱）紫蛤壳（四钱）炒于术（二钱）炒苏子（三钱）附子都气丸（三钱晨服）
吴（左）咳逆得食即定，中虚显然。咳甚于晨。痰在肺下，因卧而不旋运，所以至阳气初展之时，而为之
咳也。下虚上实。拟补气立方。
奎党参炒苏子炙甘草制半夏粉前胡薄橘红川桂枝福泽泻
徐（左）汗出略减，而咳嗽仍然不定，甚则呕涎。脉细濡软，舌黄苔白。时有凛寒之象。经谓久咳不已，则
三焦受之。三焦者气之海也。进黄建中法。
川桂枝炙绵炙甘草白芍茯苓郁金煨姜
张（左）肺邪未彻，复感新风，与浊相合。头胀咳嗽身热，痰气带秽。宜以疏化。
池菊（一钱五分）橘红（一钱）牛蒡子（三钱生打）光杏仁（三钱）桑叶（一钱五分）冬瓜子（三钱）
荆芥穗（一钱）枳壳（一钱五分）前胡（一钱五分）生薏仁（三钱）广郁金（一钱）
二诊疏泄肺邪，咳仍不减，痰气带秽。脉大。风邪与浊交蒸，肺胃热郁。厥阴之病，在藏为肝，在色为苍，
而风气通肝，所以痰带青绿也。
冬瓜子（三钱）生薏仁（四钱）云茯苓（三钱）桔梗（六分）桑叶（一钱）光杏仁（三钱打）
甜葶苈（四分）粉前胡（一钱）水炒竹茹（一钱）
三诊咳嗽不减，痰不爽利，色带青绿。下虚上实。再清金润肺。
川贝母（二钱）光杏仁（三钱）蜜炙桑叶（一钱）炒蒌皮（三钱）冬瓜子（三钱）生薏仁（三钱）
黑栀皮（一钱五分）白茯苓（三钱）青芦管（八钱）枇杷叶膏（五钱分二次服）
四诊痰色仍带青绿，心中空豁。脉象虚细，舌红苔心霉黑。痰热上盛，真水下虚。再上下分治。
玉泉散（三钱）川贝母（二钱）光杏仁（三钱）炒蒌皮（三钱）桑叶（一钱五分）冬瓜子（三钱）
阿胶珠（二钱）水炒竹茹（一钱）枇杷叶（四片炙去毛）
五诊心中空豁较退，苔霉痰绿呛咳俱减。的是风热痰郁于肺胃，遂有火烁金伤之势。再用喻氏清
燥救肺法。
阿胶珠（三钱）生甘草（三分）光杏仁（三钱打）浮石（四钱）桑叶（一钱五分）煨石膏（三钱）
冬瓜子（三钱）川贝母（一钱五分）枇杷叶（去毛四片）芦根（一两）
六诊用喻氏法，病退十六，效方再望应手。
阿胶珠（三钱）桑叶（一钱五分）生甘草（三分）地骨皮（二钱）煨石膏（三钱）川贝母（二钱）
冬瓜子（三钱）干枇杷叶（三片）肺露（一两冲）
七诊咳嗽较定，而痰阻肺之支络，欲咳稍舒。舌心灰润。再开痰降肺。
光杏仁（三钱）冬瓜子（三钱）海浮石（二钱）炒蒌皮（三钱）郁金（一钱五分）枳壳（一钱）
桔梗（一钱）茯苓（三钱）池菊（一钱五分）桑叶（一钱）枇杷叶（四片）
朱（右）每至经来，辄先腹胀，兹则感风咳嗽痰多。先治新感，再调本病。
牛蒡子（三钱）前胡（一钱五分）橘红（一钱）茯苓（三钱）桔梗（八分）桑叶（一钱）
光杏仁（三钱）白蒺藜（三钱）象贝（二钱）丹参（二钱）池菊花（一钱五分）
二诊咳嗽稍减，音仍带涩。还是肺邪未清。经来腹胀，再商。
前胡（一钱）橘红（一钱）茯苓（三钱）大力子（三钱）丹参（二钱）苏梗（三钱）
杏仁（三钱）川贝（二钱）蝉衣（一钱）制香附（二钱）
三诊音涩渐开，咳未全止。再拟清金润肺。
川贝母（二钱）白茯苓（三钱）炒蒌皮（三钱）桔梗（一钱）前胡（一钱）光杏仁（三钱）
冬瓜子（三钱）生甘草（四分）生梨肉（一两）
孙（孩）咳嗽甚则呕吐。脉濡滑，舌白。童质泄泻之后，脾运不及，生痰聚湿。复感暑风，邪与痰合，肺胃因
而失降。宜降宜下。
制半夏（一钱五分）广橘红（一钱）白茯苓（三钱）枳实（三分）光杏仁（三钱打）大力子（二钱）

白话

【左案一】感受风邪侵入肺脏，导致肺脏失去清肃下降的功能。咳嗽且痰色黄稠，夜间加重白天减轻。脉象带有数象。适宜采用肃降肺气、化痰的方法治疗。
粉前胡（一钱）马兜铃（一钱五分）牛蒡子（三钱）茯苓（三钱）橘红（一钱）炒杏仁（三钱）
竹沥半夏（一钱五分）冬瓜子（三钱）象贝母（二钱）肺露（一两）

二诊：咳嗽仍然不止，痰黄而稠，咽喉发痒头部胀痛。风温之邪外迫，肺胃内部相应受累，气分有热导致肺失肃降。采用肃降肺气以清除气分热邪的方法。
山栀皮（三钱）川贝母（二钱）粉前胡（一钱）花粉（二钱）桔梗（一钱）冬瓜子（四钱）
马兜铃（一钱五分）炒杏仁（三钱）枇杷叶（去毛四片）

三诊：咳嗽逐渐减少且间隔变长，口燥咽干症状轻微消退。继续清金润肺，以化解气分之热。
北沙参（四钱）川贝母（二钱）光杏仁（二钱）炒枳壳（一钱）桔梗（一钱）冬瓜子（四钱）
马兜铃（一钱五分）炒竹茹（一钱）枇杷膏（五钱）

【宋姓老妇案】冬季肾气封藏不固，感召风邪。肺与皮毛相合，邪气侵袭体表，肺脏在体内相应反应。出现咳嗽、咽干症状。适宜清肃太阴肺经。待咳嗽停止后再商议调理方案。
川贝母（二钱）桔梗（一钱）杏仁泥（三钱）花粉（二钱）茯苓（三钱）桑叶（一钱）
冬瓜子（三钱）前胡（一钱）川石斛（四钱）菊花（一钱五分）枇杷叶（去毛四片）

二诊：清肃太阴后，咳嗽仍未减少，夜间重白天轻，舌干咽燥。属肺肾阴虚，虚证多于实证。适宜标本兼治。
北沙参（三钱）川贝母（二钱）甜杏仁（三钱）川石斛（四钱）青蛤散（四钱）茯苓（三钱）
前胡（一钱）桔梗（八分）枇杷叶（去毛四片）琼玉膏（四钱，分两次冲服）

【秦姓儿童案】风温之邪侵袭肺胃。咳嗽气逆，身体发热头部胀痛。脉数，右脉大。肺本清虚，如今被风邪阻滞，则肃降功能无权。适宜清肃太阴，疏泄肌表。
牛蒡子（三钱）光杏仁（三钱）薄荷（一钱）炒枳实（一钱）广郁金（一钱五分）粉前胡（一钱）
广橘红（一钱）茯苓（三钱）象贝母（二钱）冬桑叶（一钱五分）

【陈姓右侧案】肾脏本空虚，封藏不固，遭遇暴冷暴热，邪气感于肌表，肺脏随即在体内相应。痰饮因此复发。气喘胸闷，痰液无法咳出，痰从左侧而来，因为肝气主左，肝气挟带痰浊上逆，所以病情尤为严重。除了药物治疗外，务必保持心情愉悦以条达肝木之气，使气不上逆，不要助长痰势，疾病自然会减少发作。
代赭石（四钱）杜苏子（三钱）制半夏（一钱五分）橘红（一钱）川桂枝（四分）旋复花（二钱）
杏仁泥（三钱）煨石膏（四钱）枳壳（一钱）郁金（一钱五分）

【陆姓左侧案】肺中有潜伏的寒邪，到了冬季寒水当令之时，阳气不能化气，导致寒饮停聚在肺下，咳嗽伴右胁疼痛。适宜温通疏解太阴之表，以观察病情动静如何。
不去节麻黄（三分，另煎去沫冲服）制半夏（二钱）茯苓（四钱）冬瓜子（四钱）
不去皮尖杏仁（三钱）生香附（一钱五分）橘红（一钱）旋复花（一钱包）不去节甘草（三分）
炒苏子（三钱）枳壳（一钱）磨郁金（五分冲服）

二诊：温疏太阴之表后，咳嗽略微减轻。但脉象微数，这是营阴津液不足的征象。论病应当继续进用苦温之法，然而肺虽恶寒，心则恶热，脉沉带数，不便耗伤营分，再改用平和之法。
粉前胡广橘红制半夏云茯苓旋复花杏仁泥炒苏子炒黄川贝母蜜炙紫菀
另附梨膏方
麻黄（四钱，蜜炙去沫）茯苓（四两）煨石膏（二两）桔梗（八钱）枳壳（八钱）姜汁（二钱）大荸荠（八两）甜杏仁（七两，与荸荠同打汁冲服）杜苏子（绞汁冲服四两）白莱菔（打汁冲服一斤）竹沥（四两冲服）荆沥（二两冲服）悉尼（一斤，注：疑为雪梨或类似食材，此处保留原名）
以上药物熬制成膏，每日服用一调羹，开水送下。

【鲍姓左侧案】久咳导致痰滞留在肺络。痰属于阴类，所以每到夜晚，痰凝聚郁塞，阻碍肺气，气逆咳嗽频繁。到了中午，阴得阳气化解，咳嗽就大大减少。如果不祛除尽宿存的痰，就不能杜绝病根。但因为患病已久，不容易祛除。
制半夏炙紫菀茯苓炒黄川贝苦桔梗海蛤壳炒枳壳橘红苦杏仁桑叶络生甘草苏子霜
用水泛丸，每次服用三钱。

【邵姓左侧案】肺感受风温，又因熬夜受寒，寒束热郁。由咽痛导致呛咳，痰液不爽利，头部胀痛恶寒。脉象沉弦。邪气郁结在太阴，肺金失去肃降功能。拟定辛温与寒凉合用的方剂，以彻除肺中邪气。
蜜炙麻黄（四分）生甘草（四分）蜜炙橘红（一钱）茯苓（三钱）前胡（一钱）煨石膏（二钱）
光杏仁（三钱）炒枳壳（一钱）老生姜（三片）

二诊：辛温寒合方彻除肺邪后，咳嗽仍不减。脉弦微数。热邪郁结在肺。再次适宜清金肃肺。
炙桑皮（二钱）生甘草（五分）淡芩（一钱五分）茯苓（三钱）冬瓜子（四钱）地骨皮（二钱）
肥知母（二钱）前胡（一钱）川贝母（二钱）枇杷叶膏（五钱）

【周姓左侧案】航海时感受风邪导致剧烈咳嗽，虽然经过养肺治疗后咳嗽停止，但肺络中的邪气未尽泄，所以稍微感触就会喉痒剧咳。疏解新感，咳嗽即逐渐减轻，腠理日渐疏松，但邪气仍内踞。肺病则不能制约肝木，木火必然刑克肺金。然而右脉浮滑，病仍在肺。前贤说邪在肺络，或者邪未清除而恰好投予补益，导致邪气伏留难以泄出者，用三拗汤主治。然而苦温疏散，恐怕损伤肺体。现在拟定使用肺露并改变方法，做日积月累的计划，或许能疏而不碍表，补而不滞里，请备方家指正。
不落水猪肺（一只）不去节麻黄（六钱）不去皮尖杏仁（三两）不去节甘草（一两）
这三味药与猪肺一同蒸露，随意温服。

【王姓左侧案】降气化湿温疏，脉证相安。久病而投猛剂，行侥幸之事，本是明理者所不为。然而邪气与正气不能并存，不去除邪气，如何保全正气？那么和平缓治，就像是害怕疮疡溃破的痛苦而滋养毒邪一样。再做背水一战之计。
粉前胡光杏仁制半夏广橘红茯苓炙紫菀荆芥穗炒蒌皮苏梗子梨肉

二诊：肺感受风邪，不被疏解，反而被补益，导致邪气留恋不得泄出，咳嗽长久不止。脉濡而气口独浮。既然来自外感，虽然日久，不得不进行疏泄。
不去节麻黄不去节甘草不去皮尖杏仁炒蒌皮炒枳壳炒苏子广郁金茯苓蜜炙橘红桔梗

【杨姓左侧案】咳嗽气逆痰多，遍身作痛。脉象弦滑。痰饮阻肺，肺失肃降功能，络脉隧道因此不通畅。暂用辛温寒合方以开泄饮邪。
川桂枝（五分）白茯苓（三钱）光杏仁（三钱）炒苏子（三钱）煨石膏（三钱）广橘红（一钱）
甜葶苈（五分）制半夏（一钱五分）

二诊：辛温寒合方后，咳嗽气逆，十退五六。确实是肝气挟带饮邪上逆。再以退为进。
姜半夏（二钱）炒苏子（三钱）白茯苓（三钱）猩绛（五分，注：可能指某种染料或特定药材，此处保留原名）炙黑草（三分）广橘红（一钱）
川桂枝（四分）旋复花（二钱）上川朴（七分）青葱管（三分）

三诊：痰喘大幅减退，咳嗽未定，两胁作痛也停止。继续温化。
白芥子（四分，炒研）广橘红（一钱）茯苓（三钱）旋复花（二钱包）光杏仁（三钱）制半夏（一钱五分）
炒苏子（三钱）枳壳（一钱）广郁金（一钱五分）猩绛（五分）

【马姓左侧案】肺有潜伏寒邪，感受风邪导致咳嗽气逆。先疏解新感，待咳嗽减轻后再商议。
制半夏光杏仁白茯苓枳壳砂仁炒苏子
薄橘红前胡桑叶

又案：咳嗽稍减。确实是肺有伏寒，而肺气暗虚。前方出入调整后再进。
光杏仁橘红制半夏款冬花生薏仁炒苏子茯苓炒黄川贝炙紫菀肉
另方
川贝母（一两去心）炒莱菔子（四两）豆腐锅巴（八两）白果肉（一两）白冰糖（四两）
五味研为细末，每次服用四钱，开水调糊送下。或稍加糖霜。

【张姓左侧案】声音嘶哑不畅两年之久，于是引发呛咳，却不见咯血。脉象气口不调。寒热互阻于肺，然而肺为水之上源，恐怕肺金日益受损，而由假症变为真症。
不去节麻黄（三分）杏仁（三钱，不去皮尖）煨石膏（三钱）炒苏子（三钱）不去节甘草（三分）
制半夏（一钱五分）枳壳（一钱）橘红（一钱）茯苓（三钱）

二诊：用麻杏甘膏并不汗出，咳嗽声音嘶哑，尚且如前。肺中邪气伏匿既深，恐怕由假变真。拟定重药轻服法。
麻杏甘膏加细辛、前胡、橘红、茯苓、枳壳（此人竟服七剂未见去节麻黄等原方全貌，此处依原文记录）

三诊：用辛温寒合方，声音嘶哑较开通，咳嗽大减。然而天气温燥，呛咳又甚。脉象左大。伏匿之邪，虽然得以渐解，但肺气和阴液，早已被共同损伤。再次清金养肺。
南沙参（四钱）光杏仁（三钱）炒天冬（三钱）白茯苓（三钱）生甘草（三分）川贝母（二钱）
生扁豆衣（三钱）水炒竹茹（一钱）生鸡子白（一枚冲服）

【魏姓左侧案】肺有伏寒，稍微感冒，咳嗽就很严重。此时正当天气渐寒，更涉重洋（长途旅行），咳嗽因而尤其严重，动辄气逆。脉沉弦重按少力，舌红苔薄白并不浓腻。此乃风寒痰饮有余于上，而肾本空虚于下。用雷氏上下分治法。
炒苏子（三钱）制半夏（一钱五分）川朴（八分）橘红（一钱）白茯苓（三钱）熟地炭（四钱）
嫩前胡（一钱五分）当归（炒透一钱五分）老生姜（三片）

二诊：上下兼治，喘嗽稍减。确实是上实下虚，前方法扩充。
制半夏（一钱五分）菟丝子（盐水炒三钱）巴戟肉（三钱）白茯苓（三钱）广橘红（一钱）怀牛膝（盐水炒三钱）紫蛤壳（四钱）炒于术（二钱）炒苏子（三钱）附子都气丸（三钱，晨服）

【吴姓左侧案】咳逆得食即定，中焦虚显然。咳嗽甚于早晨。痰在肺下，因卧位而不旋转运化，所以到阳气初展之时，为之咳嗽。下虚上实。拟补气立方。
奎党参炒苏子炙甘草制半夏粉前胡薄橘红川桂枝福泽泻

【徐姓左侧案】汗出略减，而咳嗽仍然不定，甚至呕吐涎沫。脉细濡软，舌黄苔白。时有凛寒之象。经书说久咳不已，则三焦受之。三焦是气之海。进用黄芪建中法。
川桂枝炙绵（注：疑为炙黄芪或炙绵芪，此处保留简称）炙甘草白芍茯苓郁金煨姜

【张姓左侧案】肺邪未彻，复感新风，与浊气相合。头胀咳嗽身热，痰气带秽浊。适宜疏化。
池菊（一钱五分）橘红（一钱）牛蒡子（三钱，生打）光杏仁（三钱）桑叶（一钱五分）冬瓜子（三钱）
荆芥穗（一钱）枳壳（一钱五分）前胡（一钱五分）生薏仁（三钱）广郁金（一钱）

二诊：疏泄肺邪，咳嗽仍不减，痰气带秽浊。脉大。风邪与浊气交蒸，肺胃热郁。厥阴之病，在脏为肝，在色为苍，而风气通肝，所以痰带青绿色。
冬瓜子（三钱）生薏仁（四钱）云茯苓（三钱）桔梗（六分）桑叶（一钱）光杏仁（三钱，打）
甜葶苈（四分）粉前胡（一钱）水炒竹茹（一钱）

三诊：咳嗽不减，痰不爽利，色带青绿。下虚上实。再次清金润肺。
川贝母（二钱）光杏仁（三钱）蜜炙桑叶（一钱）炒蒌皮（三钱）冬瓜子（三钱）生薏仁（三钱）
黑栀皮（一钱五分）白茯苓（三钱）青芦管（八钱）枇杷叶膏（五钱，分二次服）

四诊：痰色仍带青绿，心中空豁。脉象虚细，舌红苔心霉黑。痰热上盛，真水下虚。再次上下分治。
玉泉散（三钱）川贝母（二钱）光杏仁（三钱）炒蒌皮（三钱）桑叶（一钱五分）冬瓜子（三钱）
阿胶珠（二钱）水炒竹茹（一钱）枇杷叶（四片，炙去毛）

五诊：心中空豁较退，苔霉痰绿呛咳俱减。确实是风热痰郁于肺胃，遂有火烁金伤之势。再用喻氏清燥救肺法。
阿胶珠（三钱）生甘草（三分）光杏仁（三钱，打）浮石（四钱）桑叶（一钱五分）煨石膏（三钱）
冬瓜子（三钱）川贝母（一钱五分）枇杷叶（去毛四片）芦根（一两）

六诊：用喻氏法，病退十六，效方再望应手。
阿胶珠（三钱）桑叶（一钱五分）生甘草（三分）地骨皮（二钱）煨石膏（三钱）川贝母（二钱）
冬瓜子（三钱）干枇杷叶（三片）肺露（一两冲服）

七诊：咳嗽较定，而痰阻肺之支络，欲咳稍舒。舌心灰润。再次开痰降肺。
光杏仁（三钱）冬瓜子（三钱）海浮石（二钱）炒蒌皮（三钱）郁金（一钱五分）枳壳（一钱）
桔梗（一钱）茯苓（三钱）池菊（一钱五分）桑叶（一钱）枇杷叶（四片）

【朱姓右侧案】每逢月经来潮，辄先腹胀，此次则感受风邪咳嗽痰多。先治新感，再调本病。
牛蒡子（三钱）前胡（一钱五分）橘红（一钱）茯苓（三钱）桔梗（八分）桑叶（一钱）
光杏仁（三钱）白蒺藜（三钱）象贝母（二钱）丹参（二钱）池菊花（一钱五分）

二诊：咳嗽稍减，声音仍带涩。还是肺邪未清。月经来潮腹胀，再商议。
前胡（一钱）橘红（一钱）茯苓（三钱）大力子（三钱）丹参（二钱）苏梗（三钱）
杏仁（三钱）川贝（二钱）蝉衣（一钱）制香附（二钱）

三诊：声音涩滞渐开，咳嗽未全止。再次拟定清金润肺。
川贝母（二钱）白茯苓（三钱）炒蒌皮（三钱）桔梗（一钱）前胡（一钱）光杏仁（三钱）
冬瓜子（三钱）生甘草（四分）生梨肉（一两）

【孙姓孩童案】咳嗽甚则呕吐。脉濡滑，舌白。童质泄泻之后，脾运不及，生痰聚湿。复感暑风，邪与痰合，肺胃因而失降。宜降宜下。
制半夏（一钱五分）广橘红（一钱）白茯苓（三钱）枳实（三分）光杏仁（三钱，打）大力子（二钱）

英文

[Left Case 1] Wind pathogen invaded the Lung, causing the Lung to lose its clear and descending function. Cough with thick yellow phlegm, worse at night and lighter during the day. The pulse is rapid. Treatment should focus on descending Lung Qi and resolving phlegm.
Fen Qian Hu (Radix Peucedani) 1 qian; Madou Ling (Fructus Aristolochiae) 1.5 qian; Niubang Zi (Fructus Arctii) 3 qian; Fuling (Poria) 3 qian; Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Chao Xingren (Semen Armeniacae Amarum, stir-fried) 3 qian; Zhuli Banxia (Rhizoma Pinelliae Preparatum with Bamboo Juice) 1.5 qian; Dongguazi (Semen Benincasae) 3 qian; Xiang Bei (Bulbus Fritillariae Thunbergii) 2 qian; Feilu (Lung Dew) 1 liang.

Second visit: Cough persists, phlegm is yellow and thick, throat itches, head feels distended. Wind-warmth attacks externally, Lung and Stomach respond internally; Qi heat causes Lung to lose its descending function. Descend Lung Qi to clear Qi-level heat.
Shanzhi Pi (Pericarpium Gardeniae Jasminoidis) 3 qian; Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Fen Qian Hu (Radix Peucedani) 1 qian; Huafen (Radix Platycodonis) 2 qian; Jiegeng (Radix Platycodonis) 1 qian; Dongguazi (Semen Benincasae) 4 qian; Madou Ling (Fructus Aristolochiae) 1.5 qian; Chao Xingren (Semen Armeniacae Amarum, stir-fried) 3 qian; Pipaye (Folium Eriobotryae) 4 pieces, hairs removed.

Third visit: Cough gradually decreases and becomes less frequent, dry mouth and throat slightly improve. Continue to clear Metal and moisten Lung, transforming Qi heat.
Beishashen (Radix Glehniae) 4 qian; Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Guang Xingren (Semen Armeniacae Amarum) 2 qian; Chao Zhiqiao (Fructus Aurantii Immaturus, stir-fried) 1 qian; Jiegeng (Radix Platycodonis) 1 qian; Dongguazi (Semen Benincasae) 4 qian; Madou Ling (Fructus Aristolochiae) 1.5 qian; Chao Zhuru (Caulis Bambusae in Taeniam, stir-fried) 1 qian; Pipa Gao (Loquat Paste) 5 qian.

[Old Woman Song] Winter storage is not secure, inducing wind pathogen. Lung connects with skin and hair; pathogen attacks exterior, Lung responds internally. Cough and dry throat. Clear and descend Taiyin (Lung). After cough stops, discuss conditioning.
Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Jiegeng (Radix Platycodonis) 1 qian; Xingren Ni (Paste of Semen Armeniacae Amarum) 3 qian; Huafen (Radix Platycodonis) 2 qian; Fuling (Poria) 3 qian; Sangye (Folium Mori) 1 qian; Dongguazi (Semen Benincasae) 3 qian; Qianhu (Radix Peucedani) 1 qian; Chuan Shihu (Caulis Dendrobii) 4 qian; Juhua (Flos Chrysanthemi) 1.5 qian; Pipaye (Folium Eriobotryae) 4 pieces, hairs removed.

Second visit: After clearing/descending Taiyin, cough remains unchanged, worse at night/lighter by day, dry tongue/throat. Lung-Kidney Yin deficiency, deficiency exceeds excess. Treat both root and branch.
Beishashen (Radix Glehniae) 3 qian; Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Tian Xingren (Semen Armeniacae Amarum, sweet) 3 qian; Chuan Shihu (Caulis Dendrobii) 4 qian; Qingge San (Green Clam Powder) 4 qian; Fuling (Poria) 3 qian; Qianhu (Radix Peucedani) 1 qian; Jiegeng (Radix Platycodonis) 8 fen; Pipaye (Folium Eriobotryae) 4 pieces, hairs removed; Qiongyu Gao (Qiongyu Paste) 4 qian, taken twice dissolved in liquid.

[Child Qin] Wind-warmth attacks Lung and Stomach. Cough with rebellious Qi, fever, head distension. Pulse rapid, Right side large. Lung is originally clear and empty, now blocked by wind pathogen, losing its descending authority. Clear/descend Taiyin, ventilate muscle layer.
Niubang Zi (Fructus Arctii) 3 qian; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Bohe (Herba Menthae) 1 qian; Chao Zhishi (Fructus Aurantii Immaturus, stir-fried) 1 qian; Guang Yujin (Radix Curcumae) 1.5 qian; Fen Qian Hu (Radix Peucedani) 1 qian; Guang Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Fuling (Poria) 3 qian; Xiang Beimu (Bulbus Fritillariae Thunbergii) 2 qian; Dong Sangye (Folium Mori) 1.5 qian.

[Right Case Chen] Kidney is originally empty, sealing/storage insecure. Sudden cold/heat affects skin/hair, Lung responds internally. Phlegm-fluids recur. Asthma, chest tightness, phlegm cannot be expectorated. Phlegm comes from the left; Liver governs the left, Liver Qi carries phlegm upward rebelliously, making it severe. Besides medication, must keep mood happy to soothe Liver Wood, prevent Qi rebellion, do not aid phlegm, disease will naturally decrease.
Daizheshi (Malleum et Radix Magnetitatis) 4 qian; Du Suzi (Fructus Brassicae Chinensis) 3 qian; Zhi Banxia (Rhizoma Pinelliae Preparatum) 1.5 qian; Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Chuan Guizhi (Ramulus Cinnamomi) 4 fen; Xuanfuhua (Capitium Inulae) 2 qian; Xingren Ni (Paste of Semen Armeniacae Amarum) 3 qian; Wei Shigao (Gypsum Fibrosum, calcined) 4 qian; Zhiqiao (Fructus Aurantii Immaturus) 1 qian; Yujin (Radix Curcumae) 1.5 qian.

[Left Case Lu] Latent cold in Lung. In winter when Water dominates, Yang Qi fails to transform, leading to cold-phlegm accumulation below Lung. Cough with right hypochondriac pain. Warm and disperse Taiyin exterior, observe dynamics.
Mahuang (Herba Ephedrae), nodes unremoved (3 fen, decocted separately, foam removed, taken with liquid); Zhi Banxia (Rhizoma Pinelliae Preparatum) 2 qian; Fuling (Poria) 4 qian; Dongguazi (Semen Benincasae) 4 qian; Xingren (Semen Armeniacae Amarum), skin and tip unremoved (3 qian); Sheng Xiangfu (Rhizoma Cyperi) 1.5 qian; Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Xuanfuhua (Capitium Inulae) 1 bag; Gancao (Radix Glycyrrhizae), nodes unremoved (3 fen); Chao Suzi (Fructus Brassicae Chinensis, stir-fried) 3 qian; Zhiqiao (Fructus Aurantii Immaturus) 1 qian; Mo Yujin (Radix Curcumae, ground, taken with liquid) 5 fen.

Second visit: Warming/dispersing Taiyin exterior, cough slightly reduced. Pulse slightly rapid, sign of insufficient Ying fluids. Disease theory suggests continuing bitter-warm, but Lung dislikes cold while Heart dislikes heat. Pulse deep-rapid, avoid damaging Ying. Switch to mild method.
Fen Qian Hu (Radix Peucedani); Guang Juhong (Pericarpium Citri Reticulatae Rubrum); Zhi Banxia (Rhizoma Pinelliae Preparatum); Yun Fuling (Poria); Xuanfuhua (Capitium Inulae); Xingren Ni (Paste of Semen Armeniacae Amarum); Chao Suzi (Fructus Brassicae Chinensis, stir-fried); Chao Huang Chuan Beimu (Bulbus Fritillariae Cirrhosae, stir-fried yellow); Mi Zhi Ziwan (Herba Asteris Tatarici, honey-fried).
Attached Pear Paste Formula: Mahuang (Herba Ephedrae, 4 qian, honey-fried, foam removed); Fuling (Poria, 4 liang); Wei Shigao (Gypsum Fibrosum, calcined, 2 liang); Jiegeng (Radix Platycodonis, 8 qian); Zhiqiao (Fructus Aurantii Immaturus, 8 qian); Jiangzhi (Jucius Zingiberis Recens, 2 qian); Da Biqi (Tuber Dioscoreae Bulbiferae, 8 liang); Tian Xingren (Semen Armeniacae Amarum, sweet, 7 liang, pounded with Biqi for juice); Du Suzi (Fructus Brassicae Chinensis, pressed juice, 4 liang); Bai Laifu (Radix Raphani Sativi, pressed juice, 1 jin); Zhuli (Succus Bambusae, 4 liang); Jingli (Succus Schizonepetae, 2 liang); Xini (Pear Dew/Juice, 1 jin).
Decoct into paste, take one spoon daily with hot water.

[Bao Left Case] Long-term cough with phlegm stagnating in Lung collaterals. Phlegm is Yin type, so it condenses/stagnates at night, obstructing Lung Qi, causing rebellious Qi and frequent cough. At noon, Yin transforms by Yang, cough greatly reduces. If old phlegm is not expelled, root cannot be cut. But long illness makes expulsion difficult.
Zhi Banxia (Rhizoma Pinelliae Preparatum); Zhi Ziwan (Herba Asteris Tatarici, honey-fried); Fuling (Poria); Chao Huang Chuan Bei (Bulbus Fritillariae Cirrhosae, stir-fried yellow); Ku Jiegeng (Radix Platycodonis, bitter); Hai Geke (Concha Meretricis et Cyclinae); Chao Zhiqiao (Fructus Aurantii Immaturus, stir-fried); Juhong (Pericarpium Citri Reticulatae Rubrum); Ku Xingren (Semen Armeniacae Amarum, bitter); Sangye Luo (Venula Folii Mori); Sheng Gancao (Radix Glycyrrhizae); Suzi Shuang (Fructus Brassicae Chinensis Frost/Powder).
Water-pill, take 3 qian each time.

[Shao Left Case] Lung affected by wind-warmth, compounded by staying up late and catching cold. Cold binds, heat郁 (stagnates). From sore throat to spasmodic cough, phlegm not smooth, head distension, aversion to cold. Pulse deep-stringy. Pathogen stagnant in Taiyin, Metal loses descending command. Prescribe pungent-warm/cold combined formula to penetrate Lung pathogen.
Mi Zhi Mahuang (Herba Ephedrae, honey-fried, 4 fen); Sheng Gancao (Radix Glycyrrhizae, raw, 4 fen); Mi Zhi Juhong (Pericarpium Citri Reticulatae Rubrum, honey-fried, 1 qian); Fuling (Poria) 3 qian; Qianhu (Radix Peucedani) 1 qian; Wei Shigao (Gypsum Fibrosum, calcined, 2 qian); Guang Xingren (Semen Armeniacae Amarum) 3 qian; Chao Zhiqiao (Fructus Aurantii Immaturus, stir-fried) 1 qian; Lao Shengjiang (Rhizoma Zingiberis Recens, old, 3 slices).

Second visit: Pungent-warm/cold penetrated Lung pathogen, cough unchanged. Pulse stringy-slightly rapid. Heat stagnant in Lung. Again clear Metal/descend Lung.
Zhi Sangpi (Cortex Moriraadicis, fried) 2 qian; Sheng Gancao (Radix Glycyrrhizae, raw) 5 fen; Dan Qin (Radix Scutellariae, light) 1.5 qian; Fuling (Poria) 3 qian; Dongguazi (Semen Benincasae) 4 qian; Digupi (Cortex Lycii) 2 qian; Fei Zhimu (Rhizoma Anemarrhenae, fat) 2 qian; Qianhu (Radix Peucedani) 1 qian; Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Pipa Ye Gao (Loquat Leaf Paste) 5 qian.

[Zhou Left Case] Caught wind while sailing, severe cough. Although Lung-nourishing stopped cough, pathogen not fully cleared in Lung collaterals. Any touch causes throat itch/severe cough. Ventilate new pathogen, cough reduces, pores loosen, but pathogen remains internal. Lung disease fails to control Liver Wood; Wood-Fire punishes Metal. Right pulse floating-slippery, disease still in Lung. Ancients say pathogen in Lung collaterals or pathogen not cleared but given tonics leads to latent pathogen; use San Ao Tang. But bitter-warm dispersal may damage Lung body. Now use Feilu changing method, planning for gradual progress, so dispersing doesn't hinder exterior, tonifying doesn't stagnate interior. Please correct experts.
Bu Luo Shui Zhu Fei (Pig Lung, not falling into water) 1 piece; Mahuang (Herba Ephedrae), nodes unremoved (6 qian); Xingren (Semen Armeniacae Amarum), skin/tip unremoved (3 liang); Gancao (Radix Glycyrrhizae), nodes unremoved (1 liang).
Steam these three with Pig Lung, take warm as desired.

[Wang Left Case] Descending/transformation/warming/dispersing, pulse/symptoms peaceful. Long illness using strong medicine is luck, wise men don't do this. But pathogen and Zheng Qi cannot coexist; remove pathogen to preserve Zheng Qi. Peaceful slow treatment is like fearing ulcer pain and nurturing toxin. Make a last stand plan.
Fen Qian Hu (Radix Peucedani); Guang Xingren (Semen Armeniacae Amarum); Zhi Banxia (Rhizoma Pinelliae Preparatum); Guang Juhong (Pericarpium Citri Reticulatae Rubrum); Fuling (Poria); Zhi Ziwan (Herba Asteris Tatarici, honey-fried); Jingjie Sui (Herba Schizonepetae, awn); Chao Lou Pi (Pericarpium Trichosanthis, stir-fried); Su Geng Zi (Stem/Fructus Perillae); Li Rou (Pear Flesh).

Second visit: Lung affected by wind, not dispersed but tonified, pathogen lingers, cough long-standing. Pulse soggy, Qi Kou floats alone. Since external origin, though long, must disperse.
Mahuang (Herba Ephedrae), nodes unremoved; Gancao (Radix Glycyrrhizae), nodes unremoved; Xingren (Semen Armeniacae Amarum), skin/tip unremoved; Chao Lou Pi (Pericarpium Trichosanthis, stir-fried); Chao Zhiqiao (Fructus Aurantii Immaturus, stir-fried); Chao Suzi (Fructus Brassicae Chinensis, stir-fried); Guang Yujin (Radix Curcumae); Fuling (Poria); Mi Zhi Juhong (Pericarpium Citri Reticulatae Rubrum, honey-fried); Jiegeng (Radix Platycodonis).

[Yang Left Case] Cough, rebellious Qi, much phlegm, whole body pain. Pulse stringy-slippery. Phlegm-fluids block Lung, Lung loses descending command, collaterals blocked. Temporarily use pungent-warm/cold combined to open fluid pathogen.
Chuan Guizhi (Ramulus Cinnamomi) 5 fen; Bai Fuling (Poria) 3 qian; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Chao Suzi (Fructus Brassicae Chinensis, stir-fried) 3 qian; Wei Shigao (Gypsum Fibrosum, calcined) 3 qian; Guang Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Tian Tingli (Semen Lepidii et Descurainiae, sweet) 5 fen; Zhi Banxia (Rhizoma Pinelliae Preparatum) 1.5 qian.

Second visit: Pungent-warm/cold combined, cough/rebellious Qi reduced 50-60%. Indeed Liver Qi carries fluid upward. Retreat to advance.
Jiang Banxia (Rhizoma Pinelliae Preparatum with Ginger) 2 qian; Chao Suzi (Fructus Brassicae Chinensis, stir-fried) 3 qian; Bai Fuling (Poria) 3 qian; Xing Jiang (Cinnabaris, red cinnabar) 5 fen; Zhi Hei Cao (Radix Glycyrrhizae, honey-charred) 3 fen; Guang Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Chuan Guizhi (Ramulus Cinnamomi) 4 fen; Xuanfuhua (Capitium Inulae) 2 qian; Shang Chun Pi (Cortex Magnoliae Officinalis) 7 fen; Qing Cong Guan (Caulis Allii Fistulosi) 3 fen.

Third visit: Phlegm-asthma greatly reduced, cough unsettled, bilateral hypochondriac pain stopped. Continue warming/transformation.
Bai Jie Zi (Semen Sinapis Albae, 4 fen, stir-fried ground); Guang Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Fuling (Poria) 3 qian; Xuanfuhua (Capitium Inulae) 2 bags; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Zhi Banxia (Rhizoma Pinelliae Preparatum) 1.5 qian; Chao Suzi (Fructus Brassicae Chinensis, stir-fried) 3 qian; Zhiqiao (Fructus Aurantii Immaturus) 1 qian; Guang Yujin (Radix Curcumae) 1.5 qian; Xing Jiang (Cinnabaris) 5 fen.

[Ma Left Case] Latent cold in Lung, caught wind causing cough/rebellious Qi. First ventilate new pathogen, wait for cough reduction to discuss.
Zhi Banxia (Rhizoma Pinelliae Preparatum); Guang Xingren (Semen Armeniacae Amarum); Bai Fuling (Poria); Zhiqiao (Fructus Aurantii Immaturus); Sharen (Fructus Amomi Rotundus); Chao Suzi (Fructus Brassicae Chinensis, stir-fried); Bo Juhong (Thin Pericarpium Citri Reticulatae Rubrum); Qianhu (Radix Peucedani); Sangye (Folium Mori).

Again: Cough slightly reduced. Indeed latent cold in Lung, Lung Qi secretly deficient. Adjust previous method and continue.
Guang Xingren (Semen Armeniacae Amarum); Juhong (Pericarpium Citri Reticulatae Rubrum); Zhi Banxia (Rhizoma Pinelliae Preparatum); Kuandonghua (Flos Farfarae); Sheng Yiren (Semen Coicis, raw); Chao Suzi (Fructus Brassicae Chinensis, stir-fried); Fuling (Poria); Chao Huang Chuan Bei (Bulbus Fritillariae Cirrhosae, stir-fried yellow); Zhi Ziwan Rou (Herba Asteris Tatarici, honey-fried flesh).
Another Formula: Chuan Beimu (Bulbus Fritillariae Cirrhosae, 1 liang, heart removed); Chao Laifu Zi (Semen Raphani Sativi, stir-fried, 4 liang); Doufu Guoba (Rice Crust from Tofu Pot, 8 liang); Bai Guo Rou (Semen Ginkgo, flesh, 1 liang); Bai Bingtang (White Rock Sugar, 4 liang).
Five ingredients ground to fine powder, take 4 qian daily, mix with hot water as paste. Or add sugar frost.

[Zhang Left Case] Hoarseness for two years, then spasmodic cough, no hemoptysis. Qi Kou pulse irregular. Cold/heat mutually blocking Lung. Lung is upper source of water, fear Lung Metal daily damaged, false becoming true.
Mahuang (Herba Ephedrae), nodes unremoved (3 fen); Xingren (Semen Armeniacae Amarum, 3 qian, skin/tip unremoved); Wei Shigao (Gypsum Fibrosum, calcined, 3 qian); Chao Suzi (Fructus Brassicae Chinensis, stir-fried, 3 qian); Gancao (Radix Glycyrrhizae), nodes unremoved (3 fen); Zhi Banxia (Rhizoma Pinelliae Preparatum, 1.5 qian); Zhiqiao (Fructus Aurantii Immaturus, 1 qian); Juhong (Pericarpium Citri Reticulatae Rubrum, 1 qian); Fuling (Poria, 3 qian).

Second visit: Using Ma Xing Gan Shi Tang, no sweating, cough/hoarseness same as before. Lung pathogen deeply latent, fear false becoming true. Prescribe heavy medicine light dosage method.
Ma Xing Gan Shi Tang plus Xixin (Radix Asari), Qianhu (Radix Peucedani), Juhong (Pericarpium Citri Reticulatae Rubrum), Fuling (Poria), Zhiqiao (Fructus Aurantii Immaturus). (Patient took 7 doses without seeing original nodes/unremoved parts mentioned).

Third visit: Pungent-warm/cold combined, hoarseness opened somewhat, cough greatly reduced. Weather warm-dry, spasmodic cough worsened. Left pulse large. Latent pathogen gradually resolved, but Lung Qi/Yin fluids already damaged. Clear Metal/nourish Lung again.
Nanshashen (Radix Glehniae) 4 qian; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Chao Tiandong (Radix Asparagi, stir-fried) 3 qian; Bai Fuling (Poria) 3 qian; Sheng Gancao (Radix Glycyrrhizae, raw) 3 fen; Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Sheng Bian Dou Yi (Testa Phaseoli Radiati, raw) 3 qian; Shui Chao Zhuru (Caulis Bambusae in Taeniam, water-stir-fried) 1 qian; Sheng Jizi Bai (Albumen Ovi Galli, raw) 1 egg white, taken with liquid.

[Wei Left Case] Latent cold in Lung, slight cold causes severe cough. Weather getting colder, crossing ocean, cough especially severe, often rebellious Qi. Pulse deep-stringy, heavy press weak force. Tongue red, thin white coating, not greasy. Wind-cold/phlegm-fluids excess above, Kidney empty below. Use Lei's Upper-Lower Separate Treatment Method.
Chao Suzi (Fructus Brassicae Chinensis, stir-fried) 3 qian; Zhi Banxia (Rhizoma Pinelliae Preparatum) 1.5 qian; Chuan Pu (Cortex Magnoliae Officinalis) 8 fen; Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Bai Fuling (Poria) 3 qian; Shudi Tan (Radix Rehmanniae Preparatum, charred) 4 qian; Nen Qianhu (Radix Peucedani, tender) 1.5 qian; Danggui (Radix Angelicae Sinensis, stir-fried through) 1.5 qian; Lao Shengjiang (Rhizoma Zingiberis Recens, old) 3 slices.

Second visit: Upper-lower treated together, asthma/cough slightly reduced. Indeed excess above/deficiency below, expand previous method.
Zhi Banxia (Rhizoma Pinelliae Preparatum) 1.5 qian; Tusizi (Semen Cuscutae, salt-water stir-fried) 3 qian; Bajirou (Cortex Morinda Officinalis) 3 qian; Bai Fuling (Poria) 3 qian; Guang Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Huai Niuxi (Radix Achyranthis Bidentatae, salt-water stir-fried) 3 qian; Zi Geke (Concha Meretricis et Cyclinae, purple) 4 qian; Chao Baizhu (Rhizoma Atractylodis Macrocephalae, stir-fried) 2 qian; Chao Suzi (Fructus Brassicae Chinensis, stir-fried) 3 qian; Fuzi Duqi Wan (Aconite Duqi Pills) 3 qian, morning dose.

[Wu Left Case] Cough/rebellious Qi settles after eating, Middle Deficiency obvious. Cough severe in morning. Phlegm below Lung, lying down prevents rotation/movement, so when Yang Qi first expands, cough occurs. Lower deficiency/Upper excess. Prescribe Qi-tonifying formula.
Kui Dangshen (Radix Codonopsis, Kweichow); Chao Suzi (Fructus Brassicae Chinensis, stir-fried); Zhi Gancao (Radix Glycyrrhizae, honey-fried); Zhi Banxia (Rhizoma Pinelliae Preparatum); Fen Qianhu (Radix Peucedani); Bo Juhong (Thin Pericarpium Citri Reticulatae Rubrum); Chuan Guizhi (Ramulus Cinnamomi); Fu Zexie (Rhizoma Alismatis).

[Xu Left Case] Sweating slightly reduced, cough unsettled, even vomiting saliva. Pulse fine-soggy-soft, tongue yellow coating white. Occasional chills. Classics say long cough affects Sanjiao. Sanjiao is Sea of Qi. Advance Huangqi Jianzhong method.
Chuan Guizhi (Ramulus Cinnamomi); Zhi Mian (Honey-fried Mian [likely Astragalus]); Zhi Gancao (Radix Glycyrrhizae, honey-fried); Bai Shao (Radix Paeoniae Albae); Fuling (Poria); Yujin (Radix Curcumae); Wei Jiang (Rhizoma Zingiberis Recens, calcined).

[Zhang Left Case] Lung pathogen not cleared, caught new wind, combined with turbidity. Head distension, cough, fever, phlegm-Qi turbid. Disperse/transform.
Chi Ju (Chrysanthemum from Pond) 1.5 qian; Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Niubang Zi (Fructus Arctii, raw pounded) 3 qian; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Sangye (Folium Mori) 1.5 qian; Dongguazi (Semen Benincasae) 3 qian; Jingjie Sui (Herba Schizonepetae, awn) 1 qian; Zhiqiao (Fructus Aurantii Immaturus) 1.5 qian; Qianhu (Radix Peucedani) 1.5 qian; Sheng Yiren (Semen Coicis, raw) 3 qian; Guang Yujin (Radix Curcumae) 1 qian.

Second visit: Dispersing Lung pathogen, cough unchanged, phlegm-Qi turbid. Pulse large. Wind pathogen and turbidity steaming, Lung-Stomach heat stagnant. Jueyin disease, organ is Liver, color is Green, wind connects to Liver, so phlegm is green.
Dongguazi (Semen Benincasae) 3 qian; Sheng Yiren (Semen Coicis, raw) 4 qian; Yun Fuling (Poria) 3 qian; Jiegeng (Radix Platycodonis) 6 fen; Sangye (Folium Mori) 1 qian; Guang Xingren (Semen Armeniacae Amarum, pounded) 3 qian; Tian Tingli (Semen Lepidii et Descurainiae, sweet) 4 fen; Fen Qianhu (Radix Peucedani) 1 qian; Shui Chao Zhuru (Caulis Bambusae in Taeniam, water-stir-fried) 1 qian.

Third visit: Cough unchanged, phlegm not smooth, green color. Lower deficiency/Upper excess. Clear Metal/moisten Lung again.
Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Mi Zhi Sangye (Folium Mori, honey-fried) 1 qian; Chao Lou Pi (Pericarpium Trichosanthis, stir-fried) 3 qian; Dongguazi (Semen Benincasae) 3 qian; Sheng Yiren (Semen Coicis, raw) 3 qian; Hei Zhi Pi (Pericarpium Gardeniae Jasminoidis, black) 1.5 qian; Bai Fuling (Poria) 3 qian; Qing Lu Guan (Caulis Phyllostachys Nigrae, green bamboo tube) 8 qian; Pipa Ye Gao (Loquat Leaf Paste) 5 qian, taken twice.

Fourth visit: Phlegm still green, heart feels empty. Pulse deficiency-fine, tongue red center moldy-black. Phlegm-heat excess above, True Water deficiency below. Separate Upper/Lower treatment again.
Yuquan San (Yuquan Powder) 3 qian; Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Chao Lou Pi (Pericarpium Trichosanthis, stir-fried) 3 qian; Sangye (Folium Mori) 1.5 qian; Dongguazi (Semen Benincasae) 3 qian; Ejiao Zhu (Colla Corii Asini, bead form) 2 qian; Shui Chao Zhuru (Caulis Bambusae in Taeniam, water-stir-fried) 1 qian; Pipa Ye (Folium Eriobotryae) 4 pieces, honey-fried hairs removed.

Fifth visit: Heart emptiness reduced, moldy coating/green phlegm/spasmodic cough all reduced. Indeed wind-heat/phlegm stagnant in Lung/Stomach, fire scorching Metal injuring. Use Yu's Qingzao Jiufei method.
Ejiao Zhu (Colla Corii Asini, bead form) 3 qian; Sheng Gancao (Radix Glycyrrhizae, raw) 3 fen; Guang Xingren (Semen Armeniacae Amarum, pounded) 3 qian; Fusshi (Lapis Calcitae) 4 qian; Sangye (Folium Mori) 1.5 qian; Wei Shigao (Gypsum Fibrosum, calcined) 3 qian; Dongguazi (Semen Benincasae) 3 qian; Chuan Beimu (Bulbus Fritillariae Cirrhosae) 1.5 qian; Pipa Ye (Folium Eriobotryae) 4 pieces, hairs removed; Lugeng (Rhizoma Phragmitis) 1 liang.

Sixth visit: Using Yu's method, disease retreated 16%, hope for immediate effect.
Ejiao Zhu (Colla Corii Asini, bead form) 3 qian; Sangye (Folium Mori) 1.5 qian; Sheng Gancao (Radix Glycyrrhizae, raw) 3 fen; Digupi (Cortex Lycii) 2 qian; Wei Shigao (Gypsum Fibrosum, calcined) 3 qian; Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Dongguazi (Semen Benincasae) 3 qian; Gan Pipa Ye (Dry Folium Eriobotryae) 3 pieces; Feilu (Lung Dew) 1 liang, taken with liquid.

Seventh visit: Cough settled, but phlegm blocks Lung branch collaterals, wanting to cough brings slight relief. Tongue center gray-moist. Open phlegm/descend Lung again.
Guang Xingren (Semen Armeniacae Amarum) 3 qian; Dongguazi (Semen Benincasae) 3 qian; Haifushi (Lapis Calcitae) 2 qian; Chao Lou Pi (Pericarpium Trichosanthis, stir-fried) 3 qian; Yujin (Radix Curcumae) 1.5 qian; Zhiqiao (Fructus Aurantii Immaturus) 1 qian; Jiegeng (Radix Platycodonis) 1 qian; Fuling (Poria) 3 qian; Chi Ju (Chrysanthemum from Pond) 1.5 qian; Sangye (Folium Mori) 1 qian; Pipa Ye (Folium Eriobotryae) 4 pieces.

[Zhu Right Case] Every menstruation, abdominal distension first. This time caught wind, cough, much phlegm. Treat new pathogen first, then regulate root disease.
Niubang Zi (Fructus Arctii) 3 qian; Qianhu (Radix Peucedani) 1.5 qian; Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Fuling (Poria) 3 qian; Jiegeng (Radix Platycodonis) 8 fen; Sangye (Folium Mori) 1 qian; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Bai Jili (Semen Tribuli) 3 qian; Xiang Bei (Bulbus Fritillariae Thunbergii) 2 qian; Danshen (Radix Salviae Miltiorrhizae) 2 qian; Chi Juhua (Chrysanthemum from Pond) 1.5 qian.

Second visit: Cough slightly reduced, voice still husky. Lung pathogen not cleared. Menstrual abdominal distension, discuss later.
Qianhu (Radix Peucedani) 1 qian; Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Fuling (Poria) 3 qian; Dali Zi (Fructus Arctii, large) 3 qian; Danshen (Radix Salviae Miltiorrhizae) 2 qian; Su Geng (Stem Perillae) 3 qian; Xingren (Semen Armeniacae Amarum) 3 qian; Chuan Bei (Bulbus Fritillariae Cirrhosae) 2 qian; Chan Yi (Periostracum Cicadae) 1 qian; Zhi Xiangfu (Rhizoma Cyperi, processed) 2 qian.

Third visit: Voice huskiness opening, cough not fully stopped. Clear Metal/moisten Lung again.
Chuan Beimu (Bulbus Fritillariae Cirrhosae) 2 qian; Bai Fuling (Poria) 3 qian; Chao Lou Pi (Pericarpium Trichosanthis, stir-fried) 3 qian; Jiegeng (Radix Platycodonis) 1 qian; Qianhu (Radix Peucedani) 1 qian; Guang Xingren (Semen Armeniacae Amarum) 3 qian; Dongguazi (Semen Benincasae) 3 qian; Sheng Gancao (Radix Glycyrrhizae, raw) 4 fen; Sheng Li Rou (Raw Pear Flesh) 1 liang.

[Child Sun] Cough severe leads to vomiting. Pulse soggy-slippery, tongue white. Child constitution after diarrhea, Spleen transport inadequate, generates phlegm/gathers dampness. Caught summer-wind, pathogen combines with phlegm, Lung/Stomach lose descending. Descend/Purge.
Zhi Banxia (Rhizoma Pinelliae Preparatum) 1.5 qian; Guang Juhong (Pericarpium Citri Reticulatae Rubrum) 1 qian; Bai Fuling (Poria) 3 qian; Zhishi (Fructus Aurantii Immaturus) 3 fen; Guang Xingren (Semen Armeniacae Amarum, pounded) 3 qian; Dali Zi (Fructus Arctii, large) 2 qian.