粉前胡(一钱) 炒竹茹(一钱) 六一散(荷叶包三钱) 鲜佛手(一钱)
二诊 大便畅行所下秽浊甚多,凝痰乳食从此而达,发热因而大退。然肺胃邪恋未清,咳嗽呕吐未
止。再从疏肺之中,参以甘辛法。
前胡(一钱) 制半夏(一钱五分) 茯苓(三钱) 杏仁(二钱) 橘红(一钱) 薄荷(七分后入)
炒竹茹(一钱) 薏仁(三钱) 姜汁(三滴) 枇杷叶(二片去毛) 活水芦根(六钱)
三诊 发热已退,咳亦降序,大便数日方行。再疏肺化痰,气降则大府自通也。
前胡(一钱) 橘红(一钱) 制半夏(一钱五分) 牛蒡子(一钱五分) 炒竹茹(一钱) 杏仁(三钱)
茯苓(三钱) 桑叶(一钱) 枇杷叶(去毛二片) 芦根(五钱) 姜汁(二滴)
董(左) 邪恋肺损,咳久不止,大便艰涩。损而难复。
蜜炙麻黄(二钱另煎去沫冲入) 白莱菔汁(一汤碗) 荸荠汁(半茶杯) 杜苏子(八两水浸打绞汁) 光杏
仁(八两去尖浸水绞汁) 竹沥(一茶杯) 悉尼汁(二中碗) 姜汁(一调羹)
上药同熬,将桔梗一两五钱桑叶一两煎汁加入,白蜜二两冰糖一两五钱收膏,每服半调羹。
邵(左) 夜卧受寒,咳嗽发热,即服酸收之品,肺邪因而不泄,咳经三月,仍然不止,痰出觉冷。伏寒不泄,
恐致损肺。
不去节麻黄(三分) 不去皮尖杏仁(三钱) 白茯苓(三钱) 不去节甘草(三分)
炒杜苏子(三钱研) 制半夏(一钱五分) 枳壳(七分) 橘红(一钱) 老姜(二片)
二诊 用三拗汤以搜太阴深伏之寒,咳嗽大退。然脉形仍然沉细。不入虎穴,焉得虎子。
不去节麻黄(三分) 炒苏子(三钱) 新会红(一钱) 不去皮尖杏仁(三钱)
制半夏(一钱五分) 白茯苓(三钱) 不去节甘草(五分) 砂仁末(三分研冲) 蜜生姜(八分)
三诊 咳嗽降序,十退七八,而仍痰多稀白。前法改进化痰。
制半夏(二钱) 炒苏子(三钱) 白茯苓(三钱) 光杏仁(三钱) 生薏仁(三钱) 广橘红(一钱)
旋复花(一钱五分) 台白术(一钱五分) 糖生姜(一钱)
四诊 搜散太阴伏寒,咳嗽渐定。然三日来不寒而热,汗不畅达。脉数,右寸关独大。此外感新邪,与本
病两途。拟用疏泄,不致引动伏气为上。
淡豆豉(三钱) 橘红(一钱) 荆芥穗(一钱) 炒苏子(三钱) 生薏仁(三钱) 光杏仁(三钱)
桑叶(一钱) 制半夏(一钱五分) 白茯苓(三钱) 鲜佛手(一钱)
马(左) 寒束于外,热伏于中,咳嗽痰黄。脉形滑大,拟辛温寒合方。
生麻黄(五分后入) 光杏仁(三钱打) 橘红(一钱) 前胡(一钱五分) 煨石膏(四钱) 制半夏(一钱五
分) 茯苓(三钱) 生甘草(三分) 马兜铃(一钱五分) 冬瓜子(三钱)
又 感邪已解,而晨昏之咳,仍然未止。再降气化痰。
光杏仁 川贝母 冬瓜 海蛤粉 白茯苓 炒苏子 蜜炙橘红 蜜炙款冬花 肺露
孙(左) 咳嗽已退,然肺气一时难复,有无之间,尚带微呛,时或耳鸣头痛,咽中火冲。脉细虚软。良以金
令不行,木邪易动。补其不足,此时正属机缘也,仿介宾金水六君法
炙生地(四钱) 制半夏(一钱五分) 川贝母(二钱) 炙款冬(二钱) 茯苓(四钱) 白归身(二钱炒)
新会红(一钱) 杏仁泥(三钱) 粉丹皮(二钱) 桑叶(一钱)
左 咳逆痰色稠黄,其状如脓。邪袭于外,湿蒸于内。
杏仁泥(三钱) 炒蒌皮(三钱) 马兜铃(一钱五分) 赤白苓(各二钱) 橘红(一钱) 炒枳壳(一钱)
淡黄芩(一钱五分酒炒) 炒苏子(三钱打) 生薏仁(四钱) 葶苈子(五分)
陈 久咳不已,肺金无权,不足以制服强肝,腹中作痛。姑拟平肝疏木法。
金铃子(切一钱五分) 青陈皮(各一钱) 砂仁(七分研后入) 桑叶(一钱) 制香附(三钱研) 广木香(
五分) 郁金(一钱五分) 楂炭(三钱) 镑沉香(三分后入) 茯苓(三钱)
支(左) 嗜饮过度,肺胃湿热蒸腾,至暮咳嗽痰多,痰浓色带青绿。精水下枯,痰热上扰,不易言治。
炒香玉竹(三钱) 炙紫菀(一钱) 冬瓜子(四钱) 生薏仁(四钱) 炒黄川贝(二钱) 白茯苓(四钱)
光杏仁(三钱打) 炙桑叶(二钱) 水炒竹茹(一钱) 青芦管(七钱) 枇杷叶(去毛四片)
贾(左) 大失血后,瘀血散入肺络,咳嗽凛寒发热,腹满作痛。脉象细弦。病实本虚,恐传入损途。
磨郁金(五分冲) 当归炭(二钱) 猩绛(五分) 川贝(一钱五分) 旋复花(一钱五分) 光杏仁(三钱)
白芍(一钱五分) 楂炭(二钱) 枳壳(一钱) 南枣(二枚)
陆(右) 咽痒呛咳,日久不止,屡次见红,甚至盈口。今血虽暂定,左卧咽痒气冲,暮热少寐。脉细弦微数。
肝火内烁,阴分日亏,阳气偏亢。金水并调,参以滋肝。
北沙参(三钱) 天麦冬(各一钱五分) 生白芍(二钱) 黑豆衣(三钱) 阿胶珠(三钱) 女贞子(
三钱酒蒸) 川贝母(二钱) 生山药(三钱) 大生地(四钱) 蛤黛散(三钱包)
萧(左) 久咳曾经见红,两月前吐血盈碗。今血虽止住,而咳嗽暮甚,必致呕吐而咳方减,音塞不扬。脉
形细数。经云、胃咳之状,咳而呕。良由肺肾并伤,中气亦损,损而难复,不可不防。
台参须(另煎冲六分) 盐半夏(一钱) 生扁豆(三钱) 生山药(三钱) 大麦冬(三钱) 生甘草(三分)
蛤黛散(三钱包) 北沙参(三钱) 川贝母(二钱) 白粳米(一撮煎汤代水)
二诊 甘以益胃,咳嗽大减,呕吐亦减。然大便泄泻,临圊腹痛。偶然饮冷。损伤脾土,一波未平,一波又
起。再参培土生金法,复入分消,以理水湿。
奎党参(三钱) 泽泻(一钱五分) 生熟草(各二钱) 砂仁(五分) 白茯苓(三钱) 炒扁豆(三钱)
炒山药(三钱) 生熟薏仁(各二钱) 木香(四分) 木猪苓(二钱)
三诊 水泻渐轻,便仍溏泄,胸脘痞满不舒。脾清不升,则胃浊不降。久病之体,未便遽投重剂。
陈皮(一钱) 生熟薏仁(各二钱) 木猪苓(二钱) 泽泻(一钱五分) 鲜佛手(一钱) 砂仁(五分)
白茯苓(三钱) 煨木香(四分) 楂炭(一钱五分)
卫(右) 上则咳嗽气逆,喉有痰声,不时眩晕,下则大便不实,甚则带泄。脾为生痰之源,主健运而司磨
化。古人治痰八法,理脾原属首务,特王道无近功耳。
奎党参(三钱) 白茯苓(三钱) 白蒺藜(去刺炒三钱) 制半夏(一钱五分) 炒于术(二钱) 炙黑草(二
分) 缩砂仁(四分研后入) 生熟谷芽(各一钱) 广橘红(一钱五分) 老生姜(八分以后二味用白蜜一钱化
水同煎至干存性)
二诊
玉竹(三钱炒香) 川贝(一钱五分) 光杏仁(三钱打) 炙紫菀(一钱) 白茯苓(三钱) 桔梗(四分)
枳壳(四分) 橘红(一钱二分) 老姜(八分后三味蜜炙)
唐(左) 咳嗽半载不愈,咳则火升轰热,曾经见红。脉形虚细。不能收摄,其标在上,其本在下。拟金水双调法。
大生地 冬瓜子 川贝母 云茯苓 蛤黛散 甜杏仁 广郁金 都气丸
二诊 火升轰然已定,咳嗽略减。然每晨必咳尽稠痰,方得舒畅。脉象虚细。肾虚液炼成痰,上阻肺降。
再作缓兵之计。
川贝母 蛤黛散 薄橘红 女贞子 炒竹茹 冬瓜子 茯苓块 炒苏子 粉前胡 都气丸
三诊 身热已退,咳嗽大减。然肺胃运化不及,水谷生痰,每晨必咳吐痰尽,方得舒畅。摄下之中,兼调脾胃。
奎党参 茯苓 制半夏 蛤壳 炒枳壳 野于术 橘皮 炒苏子 炒玉竹 都气丸
四诊 咳虽降序,而每至清晨,其咳必甚,寐则口干咽燥。脉形濡细苔黄中心浊腻。阴虚于下,痰甚于
上。拟和阴清金,兼化痰热。
细生地(四钱) 川贝母(二钱) 云茯苓(三钱) 冬瓜子(三钱) 北沙参(三钱) 海蛤粉(三钱包)
水炒竹茹(一钱) 甜杏仁(三钱) 炙枇杷叶(三钱) 肺露(一两冲)
顾(右) 燥气化寒生热,蒸痰酿饮,上阻肺降。咳嗽气逆痰多,恐传入损途。
葶苈(三分) 广橘红(一钱) 制半夏(一钱五分) 炒苏子(三钱) 缩砂仁(四分) 杏仁(三钱)
白茯苓(三钱) 旋复花(一钱五分) 生熟薏仁(各二钱)
倪(右) 向有肝气,腹胀内热。兹感风燥,肺金失肃,致肝火逆犯于肺,咽中热冲,即作呛咳。舌红苔糙霉
底。木叩金鸣,恐致入损。
栀皮 冬瓜子 蒌皮 竹茹 茯苓 蛤黛散 川贝母 川石斛 冬桑叶 地骨皮 枇杷叶
二诊 清气热而肃肺金,咽中热冲稍平,咳嗽大减。舌红苔糙霉底如昨。阴分耗残,再兼清养。
川石斛 南花粉 川贝母 细生地 丹皮 大天冬 北沙参 蛤黛散 枇杷叶
三诊 清肺气而化燥风,天时寒暄,封固不密,咳嗽转甚。脉形虚细,舌红苔糙。阴分亏损,不问可知。宜
舍其标而治其本。
细生地(四钱) 蛤黛散(三钱) 甜杏仁(三钱) 白茯苓(三钱) 生白芍(一钱五分) 冬瓜子(三钱)
生甘草(三分) 都气丸(三钱先服) 川贝母(二钱) 炙枇杷叶(三片去毛)
张(左) 哮喘多年,肺伤吐血,渐至咳嗽痰多,痰色黄稠,兼带青绿,有时腹满,运化迟钝。脉形濡细,左部
带涩。肺胃并亏,而湿滞中州。且作缓兵之计。
海蛤粉(三钱) 川贝母(二钱) 冬瓜子(三钱) 炙款冬(二钱) 淡秋石(一钱) 炙紫菀(一钱五分)
牛膝炭(三钱) 云茯苓(三钱) 煨磁石(三钱) 金水六君丸(六钱二次服)
二诊 痰饮凭凌于上,肾阴亏损于下,饮聚则成痰,阴虚则生热,热痰交蒸,所以咳血频来,痰黄青绿,
热蒸痰郁,痰带臭秽。脉细濡数。腹中不和。将成肺痿重症,再作缓兵之计。
南沙参(三钱) 川贝母(二钱) 橘红(盐水炒八分) 冬瓜子(三钱) 海蛤粉(三钱) 炒枳壳(一钱)
沉香曲(一钱五分) 炙款冬(二钱) 清阿胶(二钱) 炒天冬(二钱) 生谷芽(一钱五分)
沈(左) 咳嗽不时带血,缠绵数载,肺肾久虚。兹以感受风温,咳遂增剧。今身热已退,而每至寅卯之交,
辄咽痒咳甚,口渴咽干,舌燥痰稠浓,纳少胃呆。脉形虚细,舌红苔糙。风邪虽解,而肺肾更虚,遂致冲阳
挟痰上逆,证属本原,与痰饮攸殊也。拟金水双调法。
阿胶 川贝 炙生地 甜杏仁 枇杷叶 杭白芍 茯苓 青蛤散 橘红 都气丸
二诊 寅卯之交,咽痒呛咳已止,然胃气呆钝。脉象濡弦。口燥咽干,犹未全定。肾阴不复,中气下根于
肾,所以肾愈虚则胃愈弱也。
阿胶珠(二钱) 橘白(盐水炒一钱) 川贝(二钱) 甜杏仁(三钱炒香) 金石斛(三钱) 海蛤粉(三钱)
茯苓(三钱) 杭白芍(一钱五分酒炒) 肥玉竹(三钱) 生熟谷芽(各一钱) 七味都气丸(三钱分二次另服)
丁(左) 咳嗽时轻时重,肺气久伤,以致窃盗母气,脾土因而不振,大便不时溏泄。脉细,苔白少华。拟培
土生金法。
奎党参(三钱) 云茯苓(三钱) 炒扁豆(三钱) 生熟薏仁(各二钱) 炒于术(二钱) 炒山药(三钱)
炙黑草(三分) 炙款冬花(二钱)
夏(左) 痰饮阻于肺胃,胸次闷窒,痰多咳逆,甚则四肢不温。阳气为阴所阻。宜为温化。
制半夏(一钱五分) 广皮(一钱) 茯苓(三钱) 栝蒌霜(四钱) 桔梗(七分) 薤白头(三钱)
桂枝(四分) 枳壳(一钱) 炒莱菔(二钱研)
二诊 胸次窒闷稍舒,四肢亦稍温和。然仍痰多咳逆。还是痰饮内阻,肺胃之气不宣。再化痰而开展气化。
制半夏(一钱五分) 栝蒌霜(四钱) 桔梗(七分) 白蒺藜(三钱) 薤白头(三钱) 广郁金(一钱五分)
枳壳(一钱) 光杏仁(三钱) 枇杷叶(去毛炙四片) 白金丸(四分开水送下)
三诊 四肢渐觉温和,痰亦稍利。然胸次时仍窒闷。还是痰饮伏而不化。恐难杜绝根株。
制半夏 枳实 霞天曲 茯苓 陈南星 上广皮 郁金 薤白头 杏仁 白金丸(五分)
四诊 肢厥转温,咳嗽虽属和平,而胸次尚觉窒闷。无非痰气之阻。前法扩充用千缗汤出入。
陈皮 竹茹 光杏仁 制半夏 茯苓 枳壳 郁金 薤白头 皂荚子
五诊 胸次窒闷稍舒,然仍不时呵欠的是胸有伏痰,以致阴阳相引。再化痰以通阴阳。
制半夏 橘红 广郁金 茯苓 龙骨 陈胆星 炒枳壳 竹茹 姜汁
六诊 胸中之伏痰渐开,阴阳交通,呵欠大退,咳嗽痰多较盛。此痰饮之本态也。宜化痰和中降肺。
制半夏(一钱五分) 炒苏子(三钱) 光杏仁(三钱) 前胡(一钱) 郁金(一钱五分) 广
粉前胡(一钱) 炒竹茹(一钱) 六一散(荷叶包三钱) 鲜佛手(一钱)
二诊:大便通畅,排出大量秽浊之物,凝滞的痰液和乳食由此得以排出,发热因此大幅减退。然而肺胃间的邪气留恋未清,咳嗽呕吐仍未停止。再从疏理肺气的方法中,参合甘辛法进行治疗。
处方:前胡(一钱) 制半夏(一钱五分) 茯苓(三钱) 杏仁(二钱) 橘红(一钱) 薄荷(七分,后下) 炒竹茹(一钱) 薏仁(三钱) 姜汁(三滴) 枇杷叶(二片,去毛) 活水芦根(六钱)
三诊:发热已退,咳嗽也按顺序减轻,但大便数日才行一次。继续疏理肺气、化痰,气机下降则大肠自然通畅。
处方:前胡(一钱) 橘红(一钱) 制半夏(一钱五分) 牛蒡子(一钱五分) 炒竹茹(一钱) 杏仁(三钱) 茯苓(三钱) 桑叶(一钱) 枇杷叶(去毛二片) 芦根(五钱) 姜汁(二滴)
董(左):邪气留恋,肺脏受损,咳嗽日久不止,大便艰涩难解。亏损之体难以恢复。
处方:蜜炙麻黄(二钱,另煎去沫冲入) 白莱菔汁(一汤碗) 荸荠汁(半茶杯) 杜苏子(八两,水浸打绞汁) 光杏仁(八两,去尖浸水绞汁) 竹沥(一茶杯) 悉尼汁(二中碗) 姜汁(一调羹)
以上药物同熬,将桔梗一两五钱、桑叶一两煎汁加入,加白蜜二两、冰糖一两五钱收膏,每次服用半调羹。
邵(左):夜间卧睡受寒,出现咳嗽发热,随即服用了酸收敛涩的药物,导致肺中邪气无法宣泄,咳嗽经过三个月仍然不止,咳出的痰感觉寒冷。伏藏的寒邪未能宣泄,恐怕会导致肺损。
处方:不去节麻黄(三分) 不去皮尖杏仁(三钱) 白茯苓(三钱) 不去节甘草(三分) 炒杜苏子(三钱,研) 制半夏(一钱五分) 枳壳(七分) 橘红(一钱) 老姜(二片)
二诊:使用三拗汤以搜剔太阴经深伏的寒邪,咳嗽大幅减退。然而脉象仍然沉细。“不入虎穴,焉得虎子”,需深入病所治疗。
处方:不去节麻黄(三分) 炒苏子(三钱) 新会红(一钱) 不去皮尖杏仁(三钱) 制半夏(一钱五分) 白茯苓(三钱) 不去节甘草(五分) 砂仁末(三分,研冲) 蜜生姜(八分)
三诊:咳嗽按顺序减轻,十去七八,但仍然痰多且稀白。在前法基础上改进,侧重化痰。
处方:制半夏(二钱) 炒苏子(三钱) 白茯苓(三钱) 光杏仁(三钱) 生薏仁(三钱) 广橘红(一钱) 旋复花(一钱五分) 台白术(一钱五分) 糖生姜(一钱)
四诊:搜散太阴经伏藏的寒邪,咳嗽逐渐平息。然而三天来无恶寒却发热,汗出不畅。脉数,右寸关脉独大。这是外感新邪,与本病属于两种情况。打算用疏泄之法,以免引动伏邪为上策。
处方:淡豆豉(三钱) 橘红(一钱) 荆芥穗(一钱) 炒苏子(三钱) 生薏仁(三钱) 光杏仁(三钱) 桑叶(一钱) 制半夏(一钱五分) 白茯苓(三钱) 鲜佛手(一钱)
马(左):寒邪束于体表,热邪伏于体内,咳嗽痰黄。脉象滑大,拟定辛温与寒凉并用的方剂。
处方:生麻黄(五分,后下) 光杏仁(三钱,捣) 橘红(一钱) 前胡(一钱五分) 煨石膏(四钱) 制半夏(一钱五分) 茯苓(三钱) 生甘草(三分) 马兜铃(一钱五分) 冬瓜子(三钱)
又:外感邪气已解,但早晚的咳嗽仍然未止。再降气化痰。
处方:光杏仁 川贝母 冬瓜 海蛤粉 白茯苓 炒苏子 蜜炙橘红 蜜炙款冬花 肺露
孙(左):咳嗽已退,但肺气一时难以恢复,处于似有似无之间,尚带轻微呛咳,时而耳鸣头痛,咽喉中有火冲之感。脉象细虚软。这是因为金令(肺气肃降功能)不行,木邪(肝气)容易妄动。补其不足,此时正是好时机,仿照介宾的金水六君法。
处方:炙生地(四钱) 制半夏(一钱五分) 川贝母(二钱) 炙款冬(二钱) 茯苓(四钱) 白归身(二钱,炒) 新会红(一钱) 杏仁泥(三钱) 粉丹皮(二钱) 桑叶(一钱)
左:咳逆,痰色稠黄,状如脓液。邪气侵袭于外,湿邪蒸腾于内。
处方:杏仁泥(三钱) 炒蒌皮(三钱) 马兜铃(一钱五分) 赤白苓(各二钱) 橘红(一钱) 炒枳壳(一钱) 淡黄芩(一钱五分,酒炒) 炒苏子(三钱,捣) 生薏仁(四钱) 葶苈子(五分)
陈:久咳不愈,肺金无力,不足以制服强盛的肝木,腹中作痛。暂拟平肝疏木法。
处方:金铃子(切一钱五分) 青陈皮(各一钱) 砂仁(七分,研后下) 桑叶(一钱) 制香附(三钱,研) 广木香(五分) 郁金(一钱五分) 楂炭(三钱) 镑沉香(三分,后下) 茯苓(三钱)
支(左):嗜酒过度,肺胃湿热蒸腾,至傍晚咳嗽痰多,痰浓色带青绿。精水下枯,痰热上扰,不易言治。
处方:炒香玉竹(三钱) 炙紫菀(一钱) 冬瓜子(四钱) 生薏仁(四钱) 炒黄川贝(二钱) 白茯苓(四钱) 光杏仁(三钱,捣) 炙桑叶(二钱) 水炒竹茹(一钱) 青芦管(七钱) 枇杷叶(去毛四片)
贾(左):大失血后,瘀血散入肺络,咳嗽凛寒发热,腹部胀满作痛。脉象细弦。病属实证而根本虚弱,恐怕传入虚损途径。
处方:磨郁金(五分,冲) 当归炭(二钱) 猩绛(五分) 川贝(一钱五分) 旋复花(一钱五分) 光杏仁(三钱) 白芍(一钱五分) 楂炭(二钱) 枳壳(一钱) 南枣(二枚)
陆(右):咽痒呛咳,日久不止,屡次见血,甚至满口都是。现在血虽暂时停止,但左侧卧时咽痒气冲,傍晚发热少寐。脉象细弦微数。肝火内灼,阴分日渐亏损,阳气偏亢。金水并调,参以滋肝。
处方:北沙参(三钱) 天麦冬(各一钱五分) 生白芍(二钱) 黑豆衣(三钱) 阿胶珠(三钱) 女贞子(三钱,酒蒸) 川贝母(二钱) 生山药(三钱) 大生地(四钱) 蛤黛散(三钱,包)
萧(左):久咳曾经见血,两个月前吐血盈碗。现在血虽止住,但咳嗽傍晚加重,必须呕吐然后咳嗽才能减轻,声音嘶哑不扬。脉象细数。《内经》说:胃咳的症状,是咳嗽伴随呕吐。良由肺肾俱伤,中气亦受损,亏损难以恢复,不可不防。
处方:台参须(另煎冲六分) 盐半夏(一钱) 生扁豆(三钱) 生山药(三钱) 大麦冬(三钱) 生甘草(三分) 蛤黛散(三钱,包) 北沙参(三钱) 川贝母(二钱) 白粳米(一撮,煎汤代水)
二诊:甘味药益胃,咳嗽大减,呕吐也减少。但大便泄泻,临厕腹痛。偶然饮冷,损伤脾土,一波未平一波又起。再参培土生金法,复入分消,以调理水湿。
处方:奎党参(三钱) 泽泻(一钱五分) 生熟草(各二钱) 砂仁(五分) 白茯苓(三钱) 炒扁豆(三钱) 炒山药(三钱) 生熟薏仁(各二钱) 木香(四分) 木猪苓(二钱)
三诊:水泻渐轻,但仍便溏,胸脘痞满不适。脾清阳不升,则胃浊阴不降。久病之体,不便遽投重剂。
处方:陈皮(一钱) 生熟薏仁(各二钱) 木猪苓(二钱) 泽泻(一钱五分) 鲜佛手(一钱) 砂仁(五分) 白茯苓(三钱) 煨木香(四分) 楂炭(一钱五分)
卫(右):上则咳嗽气逆,喉有痰声,不时眩晕;下则大便不实,甚则带泄。脾为生痰之源,主健运而司磨化。古人治痰八法,理脾原属首要任务,只是王道之法没有近效罢了。
处方:奎党参(三钱) 白茯苓(三钱) 白蒺藜(去刺炒三钱) 制半夏(一钱五分) 炒于术(二钱) 炙黑草(二分) 缩砂仁(四分,研后下) 生熟谷芽(各一钱) 广橘红(一钱五分) 老生姜(八分,后两味用白蜜一钱化水同煎至干存性)
二诊:
处方:玉竹(三钱,炒香) 川贝(一钱五分) 光杏仁(三钱,捣) 炙紫菀(一钱) 白茯苓(三钱) 桔梗(四分) 枳壳(四分) 橘红(一钱二分) 老姜(八分,后三味蜜炙)
唐(左):咳嗽半年不愈,咳则火升轰热,曾经见血。脉象虚细。不能收摄,其标在上,其本在下。拟金水双调法。
处方:大生地 冬瓜子 川贝母 云茯苓 蛤黛散 甜杏仁 广郁金 都气丸
二诊:火升轰然之势已定,咳嗽略减。然而每天早晨必咳尽稠痰,方才舒畅。脉象虚细。肾虚液炼成痰,上阻肺降。
再作缓兵之计。
处方:川贝母 蛤黛散 薄橘红 女贞子 炒竹茹 冬瓜子 茯苓块 炒苏子 粉前胡 都气丸
三诊:身热已退,咳嗽大减。然而肺胃运化不及,水谷生痰,每天早晨必咳吐痰尽,方才舒畅。摄下之中,兼调脾胃。
处方:奎党参 茯苓 制半夏 蛤壳 炒枳壳 野于术 橘皮 炒苏子 炒玉竹 都气丸
四诊:咳虽按顺序减轻,但每到清晨,咳嗽必然严重,睡觉时口干咽燥。脉象濡细苔黄中心浊腻。阴虚于下,痰甚于上。拟和阴清金,兼化痰热。
处方:细生地(四钱) 川贝母(二钱) 云茯苓(三钱) 冬瓜子(三钱) 北沙参(三钱) 海蛤粉(三钱,包) 水炒竹茹(一钱) 甜杏仁(三钱) 炙枇杷叶(三钱) 肺露(一两,冲)
顾(右):燥气化寒生热,蒸痰酿饮,上阻肺降。咳嗽气逆痰多,恐怕传入虚损途径。
处方:葶苈(三分) 广橘红(一钱) 制半夏(一钱五分) 炒苏子(三钱) 缩砂仁(四分) 杏仁(三钱) 白茯苓(三钱) 旋复花(一钱五分) 生熟薏仁(各二钱)
倪(右):向来有肝气问题,腹胀内热。此次感受风燥,肺金失肃,致肝火逆犯于肺,咽中热冲,即作呛咳。舌红苔糙霉底。木叩金鸣,恐怕导致入损。
处方:栀皮 冬瓜子 蒌皮 竹茹 茯苓 蛤黛散 川贝母 川石斛 冬桑叶 地骨皮 枇杷叶
二诊:清气热而肃肺金,咽中热冲稍平,咳嗽大减。舌红苔糙霉底如昨日。阴分耗残,再兼清养。
处方:川石斛 南花粉 川贝母 细生地 丹皮 大天冬 北沙参 蛤黛散 枇杷叶
三诊:清肺气而化燥风,天时寒暄交替,封固不密,咳嗽转甚。脉象虚细,舌红苔糙。阴分亏损,不问可知。宜舍其标而治其本。
处方:细生地(四钱) 蛤黛散(三钱) 甜杏仁(三钱) 白茯苓(三钱) 生白芍(一钱五分) 冬瓜子(三钱) 生甘草(三分) 都气丸(三钱,先服) 川贝母(二钱) 炙枇杷叶(三片,去毛)
张(左):哮喘多年,肺伤吐血,渐至咳嗽痰多,痰色黄稠,兼带青绿,有时腹满,运化迟钝。脉象濡细,左部带涩。肺胃并亏,而湿滞中州。且作缓兵之计。
处方:海蛤粉(三钱) 川贝母(二钱) 冬瓜子(三钱) 炙款冬(二钱) 淡秋石(一钱) 炙紫菀(一钱五分) 牛膝炭(三钱) 云茯苓(三钱) 煨磁石(三钱) 金水六君丸(六钱,二次服)
二诊:痰饮凭凌于上,肾阴亏损于下,饮聚则成痰,阴虚则生热,热痰交蒸,所以咳血频来,痰黄青绿,热蒸痰郁,痰带臭秽。脉细濡数。腹中不和。将成肺痿重症,再作缓兵之计。
处方:南沙参(三钱) 川贝母(二钱) 橘红(盐水炒八分) 冬瓜子(三钱) 海蛤粉(三钱) 炒枳壳(一钱) 沉香曲(一钱五分) 炙款冬(二钱) 清阿胶(二钱) 炒天冬(二钱) 生谷芽(一钱五分)
沈(左):咳嗽不时带血,缠绵数载,肺肾久虚。此次因感受风温,咳嗽遂增剧。现在身热已退,但每到寅卯之交,辄咽痒咳甚,口渴咽干,舌燥痰稠浓,纳少胃呆。脉象虚细,舌红苔糙。风邪虽解,而肺肾更虚,遂致冲阳挟痰上逆,证属本原,与痰饮攸殊也。拟金水双调法。
处方:阿胶 川贝 炙生地 甜杏仁 枇杷叶 杭白芍 茯苓 青蛤散 橘红 都气丸
二诊:寅卯之交,咽痒呛咳已止,但胃气呆钝。脉象濡弦。口燥咽干,犹未全定。肾阴不复,中气下根于肾,所以肾愈虚则胃愈弱也。
处方:阿胶珠(二钱) 橘白(盐水炒一钱) 川贝(二钱) 甜杏仁(三钱,炒香) 金石斛(三钱) 海蛤粉(三钱) 茯苓(三钱) 杭白芍(一钱五分,酒炒) 肥玉竹(三钱) 生熟谷芽(各一钱) 七味都气丸(三钱,分二次另服)
丁(左):咳嗽时轻时重,肺气久伤,以致窃盗母气,脾土因而不振,大便不时溏泄。脉细,苔白少华。拟培土生金法。
处方:奎党参(三钱) 云茯苓(三钱) 炒扁豆(三钱) 生熟薏仁(各二钱) 炒于术(二钱) 炒山药(三钱) 炙黑草(三分) 炙款冬花(二钱)
夏(左):痰饮阻于肺胃,胸次闷窒,痰多咳逆,甚则四肢不温。阳气为阴所阻。宜为温化。
处方:制半夏(一钱五分) 广皮(一钱) 茯苓(三钱) 栝蒌霜(四钱) 桔梗(七分) 薤白头(三钱) 桂枝(四分) 枳壳(一钱) 炒莱菔(二钱,研)
二诊:胸次窒闷稍舒,四肢亦稍温和。然而仍痰多咳逆。还是痰饮内阻,肺胃之气不宣。再化痰而开展气化。
处方:制半夏(一钱五分) 栝蒌霜(四钱) 桔梗(七分) 白蒺藜(三钱) 薤白头(三钱) 广郁金(一钱五分) 枳壳(一钱) 光杏仁(三钱) 枇杷叶(去毛炙四片) 白金丸(四分开水送下)
三诊:四肢渐觉温和,痰亦稍利。然而胸次时仍窒闷。还是痰饮伏而不化。恐难杜绝根株。
处方:制半夏 枳实 霞天曲 茯苓 陈南星 上广皮 郁金 薤白头 杏仁 白金丸(五分)
四诊:肢厥转温,咳嗽虽属和平,而胸次尚觉窒闷。无非痰气之阻。前法扩充用千缗汤出入。
处方:陈皮 竹茹 光杏仁 制半夏 茯苓 枳壳 郁金 薤白头 皂荚子
五诊:胸次窒闷稍舒,然而仍不时呵欠的是胸有伏痰,以致阴阳相引。再化痰以通阴阳。
处方:制半夏 橘红 广郁金 茯苓 龙骨 陈胆星 炒枳壳 竹茹 姜汁
六诊:胸中之伏痰渐开,阴阳交通,呵欠大退,咳嗽痰多较盛。此痰饮之本态也。宜化痰和中降肺。
处方:制半夏(一钱五分) 炒苏子(三钱) 光杏仁(三钱) 前胡(一钱) 郁金(一钱五分) 广
Radix Peucedani (Qianhu, 1 qian) Stir-fried Bamboo Shavings (Zhuru, 1 qian) Liu Yi San (Six-One Powder, wrapped in lotus leaf, 3 qian) Fresh Fruit of Bergamot (Foshou, 1 qian)
Second Visit: Stool passed smoothly with a large amount of turbid discharge; congealed phlegm and undigested food were thus expelled, and fever subsided significantly. However, pathogenic factors lingered in the Lung and Stomach without being cleared, and coughing and vomiting continued. Treatment should combine methods for dispersing Lung Qi with the Sweet-Pungent method.
Prescription: Radix Peucedani (Qianhu, 1 qian) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Poria (Fuling, 3 qian) Semen Armeniacae Amarum (Xingren, 2 qian) Pericarpium Citri Reticulatae (Juhong, 1 qian) Folium Menthae Haplocalycis (Bohe, 0.7 qian, added later) Stir-fried Bamboo Shavings (Zhuru, 1 qian) Semen Coicis (Yiren, 3 qian) Juice of Zingiberis Rhizoma Recens (Jiangzhi, 3 drops) Folium Eriobotryae (Pipaye, 2 slices, hairs removed) Fresh Rhizoma Phragmitis (Lugen, 6 qian)
Third Visit: Fever has subsided, and coughing has decreased in sequence, but defecation occurs only after several days. Continue to disperse Lung Qi and resolve phlegm; as Qi descends, the Large Intestine will naturally become unobstructed.
Prescription: Radix Peucedani (Qianhu, 1 qian) Pericarpium Citri Reticulatae (Juhong, 1 qian) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Fructus Armeniacae (Niuzi, 1.5 qian) Stir-fried Bamboo Shavings (Zhuru, 1 qian) Semen Armeniacae Amarum (Xingren, 3 qian) Poria (Fuling, 3 qian) Folium Mori (Sangye, 1 qian) Folium Eriobotryae (Pipaye, 2 slices, hairs removed) Rhizoma Phragmitis (Lugen, 5 qian) Juice of Zingiberis Rhizoma Recens (Jiangzhi, 2 drops)
Dong (Left): Pathogenic factors linger, damaging the Lung; chronic cough persists, and stool is difficult to pass. The deficiency is severe and hard to recover.
Prescription: Honey-fried Caulis Ephedrae (Mahuang, 2 qian, decocted separately, foam removed, liquid mixed in) Juice of Radish (Laifu, one bowl) Juice of Water Chestnut (Biqie, half cup) Juice of Fructus Armeniacae (Suzi, 8 liang, soaked in water, pressed) Juice of Semen Armeniacae Amarum (Xingren, 8 liang, tips removed, soaked in water, pressed) Bamboo Sap (Zhuli, one cup) Juice of Sydney Plum (Xini, two medium bowls) Juice of Zingiberis Rhizoma Recens (Jiangzhi, one spoon)
Decoct all ingredients together, add juice from decocting Radix Platycodi (Jiegeng, 1.5 liang) and Folium Mori (Sangye, 1 liang), then reduce with White Honey (2 liang) and Rock Sugar (1.5 liang) to form an electuary. Take half a spoon per dose.
Shao (Left): Caught cold while sleeping at night, resulting in cough and fever. Immediately took sour astringents, causing Lung pathogens to remain unexcreted. Cough has persisted for three months without stopping; sputum feels cold. Latent cold remains unexcreted, fearing it may lead to Lung damage.
Prescription: Untrimmed Caulis Ephedrae (Mahuang, 3 fen) Untrimmed Semen Armeniacae Amarum (Xingren, 3 qian) White Poria (Fuling, 3 qian) Untrimmed Radix Glycyrrhizae (Gancao, 3 fen) Stir-fried Fructus Armeniacae (Suzi, 3 qian, ground) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Fructus Aurantii (Zhiqiao, 0.7 qian) Pericarpium Citri Reticulatae (Juhong, 1 qian) Old Ginger (Laojiang, 2 slices)
Second Visit: Used San Ao Tang (Three Untrimmed Decoction) to search out deep-seated cold in the Taiyin channel; coughing decreased significantly. However, the pulse remains deep and fine. "How can one catch tiger cubs without entering the tiger's den?"
Prescription: Untrimmed Caulis Ephedrae (Mahuang, 3 fen) Stir-fried Fructus Armeniacae (Suzi, 3 qian) Xinhui Red Peel (Xinhuihong, 1 qian) Untrimmed Semen Armeniacae Amarum (Xingren, 3 qian) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) White Poria (Fuling, 3 qian) Untrimmed Radix Glycyrrhizae (Gancao, 5 fen) Seed Amomi Rotundus powder (Sharen, 3 fen, ground and mixed) Honey-fried Ginger (Mi Shengjiang, 8 fen)
Third Visit: Coughing decreased in sequence, improving by 70-80%, but still abundant thin white sputum. Improve previous method to focus on resolving phlegm.
Prescription: Processed Rhizoma Pinelliae (Banxia, 2 qian) Stir-fried Fructus Armeniacae (Suzi, 3 qian) White Poria (Fuling, 3 qian) Light Semen Armeniacae Amarum (Xingren, 3 qian) Raw Semen Coicis (Yiren, 3 qian) Guang Pericarpium Citri Reticulatae (Juhong, 1 qian) Flos Inulae (Xuanfuhua, 1.5 qian) Taizhou Atractylodis Macrocephalae Rhizome (Baizhu, 1.5 qian) Sugar Ginger (Tang Shengjiang, 1 qian)
Fourth Visit: Dispersed latent cold in the Taiyin channel; coughing gradually settled. However, for the past three days, there was fever without chills, and sweating was incomplete. Pulse is rapid, with the Right Cun and Guan positions particularly prominent. This indicates new external pathogens distinct from the underlying condition. Plan to use dispersing and draining methods to avoid stirring up latent qi.
Prescription: Fermented Soybean (Douchi, 3 qian) Pericarpium Citri Reticulatae (Juhong, 1 qian) Flower Head of Schizonepeta (Jingjie Sui, 1 qian) Stir-fried Fructus Armeniacae (Suzi, 3 qian) Raw Semen Coicis (Yiren, 3 qian) Light Semen Armeniacae Amarum (Xingren, 3 qian) Folium Mori (Sangye, 1 qian) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) White Poria (Fuling, 3 qian) Fresh Fruit of Bergamot (Foshou, 1 qian)
Ma (Left): Cold constrained externally, heat trapped internally; cough with yellow sputum. Pulse is slippery and large. Prescribe a formula combining Acrid-Warm and Cold properties.
Prescription: Raw Caulis Ephedrae (Mahuang, 5 fen, added later) Light Semen Armeniacae Amarum (Xingren, 3 qian, crushed) Pericarpium Citri Reticulatae (Juhong, 1 qian) Radix Peucedani (Qianhu, 1.5 qian) Calcined Gypsum (Shigao, 4 qian) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Poria (Fuling, 3 qian) Raw Radix Glycyrrhizae (Gancao, 3 fen) Radix Aristolochiae (Madouling, 1.5 qian) Semen Benincasae (Dongguazi, 3 qian)
Again: External pathogens resolved, but morning and evening cough persists. Descend Qi and resolve phlegm again.
Prescription: Light Semen Armeniacae Amarum Chuan Bei Mu (Chuanbeimu) Semen Benincasae (Donggua) Pulx Tridacnatis et Cydoniae (Haige Fen) White Poria (Fuling) Stir-fried Fructus Armeniacae (Suzi) Honey-fried Pericarpium Citri Reticulatae (Juhong) Honey-fried Flos Distantherae (Kudonghua) Lung Dew (Feilu)
Sun (Left): Cough has subsided, but Lung Qi cannot recover immediately; symptoms are intermittent with slight choking coughs, occasional tinnitus, headache, and sensation of fire rushing in the throat. Pulse is fine, deficient, and soft. This is due to failure of Metal command (Lung Qi descent) allowing Wood evil (Liver Qi) to move easily. Tonify deficiency; this is the opportune time. Follow Jiebin’s Jin Shui Liu Jun method.
Prescription: Honey-fried Rehmanniae Radix (Shengdi, 4 qian) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Bulbus Fritillariae Cirrhosae (Chuanbeimu, 2 qian) Honey-fried Flos Distantherae (Kudong, 2 qian) Poria (Fuling, 4 qian) Radix Angelicae Sinensis (Guishen, 2 qian, stir-fried) Xinhui Red Peel (Xinhuihong, 1 qian) Almond Paste (Xingren Ni, 3 qian) Moutan Cortex (Danpi, 2 qian) Folium Mori (Sangye, 1 qian)
Left: Coughing with reverse flow, sputum thick and yellow, resembling pus. Pathogens attacked externally, dampness steamed internally.
Prescription: Almond Paste (Xingren Ni, 3 qian) Stir-fried Pericarpium Trichosanthis (Loupi, 3 qian) Radix Aristolochiae (Madouling, 1.5 qian) Red and White Poria (Chibailing, 2 qian each) Pericarpium Citri Reticulatae (Juhong, 1 qian) Stir-fried Fructus Aurantii (Zhiqiao, 1 qian) Light Scutellariae Radix (Huangqin, 1.5 qian, wine-fried) Stir-fried Fructus Armeniacae (Suzi, 3 qian, crushed) Raw Semen Coicis (Yiren, 4 qian) Semen Lepidii et Descurainiae (Tinglizi, 5 fen)
Chen: Chronic cough unresolved, Lung Metal lacks authority, insufficient to control strong Liver Wood, causing abdominal pain. Tentatively prescribe calming Liver and dispersing Wood method.
Prescription: Golden Bell Fruit (Jinlingzi, 1.5 qian sliced) Green and Orange Peel (Qing Chenpi, 1 qian each) Amomum Seed (Sharen, 7 fen, ground and added later) Folium Mori (Sangye, 1 qian) Processed Rhizoma Cyperi (Xiangfu, 3 qian, ground) Guang Costus Root (Muxiang, 5 fen) Curcuma Tuber (Yujin, 1.5 qian) Charred Hawthorn Fruit (Zhatan, 3 qian) Slashed Agarwood (Chenxiang, 3 fen, added later) Poria (Fuling, 3 qian)
Zhi (Left): Excessive drinking led to steaming damp-heat in Lung and Stomach; evening cough with abundant thick sputum greenish-yellow. Essence fluids depleted below, phlegm-heat disturbs above; difficult to treat.
Prescription: Fragrant Polygonati Rhizome (Yuzhu, 3 qian stir-fried) Honey-fried Asterae Radix (Ziwan, 1 qian) Semen Benincasae (Dongguazi, 4 qian) Raw Semen Coicis (Yiren, 4 qian) Stir-fried Yellow Chuanbei (Chuanbei, 2 qian) White Poria (Fuling, 4 qian) Light Semen Armeniacae Amarum (Xingren, 3 qian, crushed) Honey-fried Folium Mori (Sangye, 2 qian) Water-stir-fried Bamboo Shavings (Zhuru, 1 qian) Green Reed Tube (Qing Luguan, 7 qian) Folium Eriobotryae (Pipaye, 4 slices, hairs removed)
Jia (Left): After massive blood loss, blood stasis dispersed into Lung collaterals; cough with chills and fever, abdominal fullness and pain. Pulse fine and wiry. Disease is excess rooted in deficiency, fearing progression to consumptive disease.
Prescription: Ground Curcuma Tuber (Yujin, 5 fen, mixed) Charred Angelicae Radix (Danggui Tan, 2 qian) Scarlet Silk (Xingjiang, 5 fen) Chuanbei (Chuanbei, 1.5 qian) Flos Inulae (Xuanfuhua, 1.5 qian) Light Semen Armeniacae Amarum (Xingren, 3 qian) White Peony Root (Baishao, 1.5 qian) Charred Hawthorn Fruit (Zhatan, 2 qian) Fructus Aurantii (Zhiqiao, 1 qian) Southern Dates (Nanzao, 2 pieces)
Lu (Right): Throat itching with choking cough, persistent for years, recurrent hemoptysis, even filling the mouth. Blood temporarily stopped, but lying on left side causes throat itching and Qi rush, evening fever and poor sleep. Pulse fine, wiry, slightly rapid. Liver Fire scorches internally, Yin aspect depletes daily, Yang Qi becomes hyperactive. Harmonize Metal and Water, supplement with nourishing Liver.
Prescription: Glehniae Radix (Beishashen, 3 qian) Ophiopogonis Radix and Liriopes Tuber (Tian Maidong, 1.5 qian each) Raw White Peony Root (Baishao, 2 qian) Black Soybean Coat (Heidouyi, 3 qian) Asini Corii Colla Beads (Ejiaozhu, 3 qian) Ligustrum Lucidum Fruit (Nvzhenzi, 3 qian, wine-steamed) Bulbus Fritillariae Cirrhosae (Chuanbeimu, 2 qian) Raw Dioscoreae Rhizome (Shanyao, 3 qian) Large Rehmanniae Radix (Shengdi, 4 qian) Pulx Tridacnatis et Cydoniae (Geda San, 3 qian, wrapped)
Xiao (Left): Chronic cough once involved hemoptysis; massive hematemesis two months ago. Blood stopped now, but cough worsens at evening, requiring vomiting to relieve cough; voice hoarse and suppressed. Pulse fine and rapid. Classic says: Stomach cough presents as cough with vomiting. Caused by simultaneous injury to Lung and Kidney, damaging Middle Qi; deficiency is hard to recover, must prevent worsening.
Prescription: Taishen Mustache (Taishenxu, 6 fen decocted separately, mixed) Salt-processed Pinellia (Banxia, 1 qian) Raw Lablab Bean (Biandou, 3 qian) Raw Dioscoreae Rhizome (Shanyao, 3 qian) Large Ophiopogonis Tuber (Maidong, 3 qian) Raw Radix Glycyrrhizae (Gancao, 3 fen) Pulx Tridacnatis et Cydoniae (Geda San, 3 qian, wrapped) Glehniae Radix (Beishashen, 3 qian) Bulbus Fritillariae Cirrhosae (Chuanbeimu, 2 qian) White Rice Grains (Bengmi, one pinch, decocted for water substitute)
Second Visit: Sweet herbs tonified Stomach; cough greatly reduced, vomiting also decreased. But diarrhea occurred, abdominal pain during defecation. Accidental ingestion of cold drinks damaged Spleen Earth; one wave not yet flat, another rises. Combine with Tonifying Earth to Generate Metal method, plus separating and eliminating to regulate water-dampness.
Prescription: Kudzu Root Codonopsis (Kuidangshen, 3 qian) Alisma Rhizome (Zexie, 1.5 qian) Raw and Fried Radix Glycyrrhizae (Caoshu, 2 qian each) Amomum Seed (Sharen, 5 fen) White Poria (Fuling, 3 qian) Stir-fried Lablab Bean (Biandou, 3 qian) Stir-fried Dioscoreae Rhizome (Shanyao, 3 qian) Raw and Fried Semen Coicis (Yiren, 2 qian each) Costus Root (Muxiang, 4 fen) Polyporus (Zhuling, 2 qian)
Third Visit: Watery diarrhea lightened, but stool remains loose; chest and epigastrium feel full and uncomfortable. Spleen Clear Yang fails to ascend, so Stomach Turbid Yin fails to descend. For chronic illness, heavy doses are inappropriate.
Prescription: Tangerine Peel (Chenpi, 1 qian) Raw and Fried Semen Coicis (Yiren, 2 qian each) Polyporus (Zhuling, 2 qian) Alisma Rhizome (Zexie, 1.5 qian) Fresh Fruit of Bergamot (Foshou, 1 qian) Amomum Seed (Sharen, 5 fen) White Poria (Fuling, 3 qian) Baked Costus Root (Muxiang, 4 fen) Charred Hawthorn Fruit (Zhatan, 1.5 qian)
Wei (Right): Upper: cough, reverse Qi, phlegm sound in throat, occasional dizziness. Lower: loose stools, sometimes diarrhea. Spleen is source of phlegm, governs transportation and transformation. Ancient Eight Methods for Phlegm prioritize regulating Spleen; however, Kingly Way yields no quick results.
Prescription: Kudzu Root Codonopsis (Kuidangshen, 3 qian) White Poria (Fuling, 3 qian) Tribulus Fruit (Jiliqi, 3 qian stir-fried, thorns removed) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Stir-fried Atractylodis Rhizome (Baizhu, 2 qian) Honey-fried Black Radix Glycyrrhizae (Caocao, 2 fen) Cardamom Seed (Sharen, 4 fen, ground and added later) Raw and Fried Hordegerm (Guyagen, 1 qian each) Guang Pericarpium Citri Reticulatae (Juhong, 1.5 qian) Old Ginger (Laojiang, 8 fen; last two items decocted with 1 qian honey until dry and preserved nature)
Second Visit:
Prescription: Polygonati Rhizome (Yuzhu, 3 qian fragrant stir-fried) Chuanbei (Chuanbei, 1.5 qian) Light Semen Armeniacae Amarum (Xingren, 3 qian crushed) Honey-fried Asterae Radix (Ziwan, 1 qian) White Poria (Fuling, 3 qian) Radix Platycodi (Jiegeng, 4 fen) Fructus Aurantii (Zhiqiao, 4 fen) Pericarpium Citri Reticulatae (Juhong, 1.2 qian) Old Ginger (Laojiang, 8 fen; last three items honey-fried)
Tang (Left): Cough half-year unresolved; coughing brings rising fire and heat, history of hemoptysis. Pulse deficient and fine. Cannot consolidate; branch is upper, root is lower. Prescribe Dual Regulation of Metal and Water.
Prescription: Large Rehmanniae Radix Dongguazi Chuanbeimu Yun Fuling Geda San Tian Xingren Guang Yujin Duqi Wan
Second Visit: Rising fire settled, cough slightly reduced. Yet every morning must cough out thick sputum to feel comfortable. Pulse deficient and fine. Kidney deficiency leads to fluid condensing into phlegm, obstructing Lung descent above.
Continue with delaying tactics.
Prescription: Bulbus Fritillariae Cirrhosae Geda San Thin Juhong Nvzhenzi Zhuru Dongguazi Fuling Kuai Suzi Qianhu Duqi Wan
Third Visit: Body heat subsided, cough greatly reduced. However, Lung-Stomach transportation inadequate, water-grain generates phlegm; every morning must cough out phlegm to feel comfortable. While consolidating lower, simultaneously regulate Spleen and Stomach.
Prescription: Kudzu Root Codonopsis Fuling Banxia Geke Zhi Zhiqiao Ye Baizhu Jupi Suzi Yuzhu Duqi Wan
Fourth Visit: Cough decreased in sequence, but severe every early morning; dry mouth and throat during sleep. Pulse soggy and fine, coating yellow with turbid greasy center. Yin deficient below, phlegm excessive above. Prescribe Harmonizing Yin and Clearing Metal, plus resolving phlegm-heat.
Prescription: Fine Rehmanniae Radix (Xishengdi, 4 qian) Bulbus Fritillariae Cirrhosae (Chuanbeimu, 2 qian) Yun Poria (Fuling, 3 qian) Semen Benincasae (Dongguazi, 3 qian) Glehniae Radix (Beishashen, 3 qian) Pulx Tridacnatis et Cydoniae (Haige Fen, 3 qian wrapped) Water-stir-fried Bamboo Shavings (Zhuru, 1 qian) Sweet Almond (Tian Xingren, 3 qian) Honey-fried Folium Eriobotryae (Pipaye, 3 qian) Lung Dew (Feilu, 1 liang mixed in)
Gu (Right): Dryness transforms to cold generating heat, steaming phlegm and brewing fluid, obstructing Lung descent above. Cough, reverse Qi, abundant sputum, fearing progression to consumptive disease.
Prescription: Semen Lepidii et Descurainiae (Tingli, 3 fen) Guang Pericarpium Citri Reticulatae (Juhong, 1 qian) Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Stir-fried Fructus Armeniacae (Suzi, 3 qian) Cardamom Seed (Sharen, 4 fen) Almond (Xingren, 3 qian) White Poria (Fuling, 3 qian) Flos Inulae (Xuanfuhua, 1.5 qian) Raw and Fried Semen Coicis (Yiren, 2 qian each)
Ni (Right): History of Liver Qi stagnation, abdominal distension and internal heat. Now affected by Wind-Dryness, Lung Metal loses肃 (descent/clearing), causing Liver Fire to rebel against Lung; heat rush in throat triggers choking cough. Tongue red, coating rough and moldy base. Wood striking Metal, fearing entry into consumption.
Prescription: Gardenia Bark (Zhipi) Semen Benincasae Loupi Zhuru Fuling Geda San Chuanbeimu Chuan Shihu Winter Mulberry Leaf (Dongsangye) Cortex Lycii (Digupi) Folium Eriobotryae
Second Visit: Cleared Qi-heat and肃 Lung Metal; throat heat rush slightly calm, cough greatly reduced. Tongue red, rough moldy coating as yesterday. Yin aspect depleted and damaged, further clear and nourish.
Prescription: Chuan Shihu Nan Huafen Chuanbeimu Xishengdi Danpi Da Tiantong Beishashen Geda San Pipaye
Third Visit: Cleared Lung Qi and transformed Dryness-Wind; weather changes, sealing not tight, cough worsened. Pulse deficient and fine, tongue red rough coating. Yin aspect damaged, evident without asking. Abandon branch to treat root.
Prescription: Fine Rehmanniae Radix (Xishengdi, 4 qian) Pulx Tridacnatis et Cydoniae (Geda San, 3 qian) Sweet Almond (Tian Xingren, 3 qian) White Poria (Fuling, 3 qian) Raw White Peony Root (Baishao, 1.5 qian) Semen Benincasae (Dongguazi, 3 qian) Raw Radix Glycyrrhizae (Gancao, 3 fen) Duqi Wan (Duqi Wan, 3 qian taken first) Bulbus Fritillariae Cirrhosae (Chuanbeimu, 2 qian) Honey-fried Folium Eriobotryae (Pipaye, 3 slices, hairs removed)
Zhang (Left): Asthma for years, Lung injured with hemoptysis, progressing to chronic cough with abundant thick yellow-green sputum, occasional abdominal fullness, slow digestion. Pulse soggy and fine, Left side choppy. Lung and Stomach both deficient, dampness stagnant in Middle Jiao. Adopt delaying tactics.
Prescription: Pulx Tridacnatis et Cydoniae (Haige Fen, 3 qian) Bulbus Fritillariae Cirrhosae (Chuanbeimu, 2 qian) Semen Benincasae (Dongguazi, 3 qian) Honey-fried Flos Distantherae (Kudong, 2 qian) Light Autumn Stone (Qiushi, 1 qian) Honey-fried Asterae Radix (Ziwan, 1.5 qian) Charred Achyranthes Root (Niuxi Tan, 3 qian) Yun Poria (Fuling, 3 qian) Calcined Magnetite (Cishi, 3 qian baked) Jin Shui Liu Jun Wan (Jinshui Liu Jun Wan, 6 qian divided twice)
Second Visit: Phlegm-fluid overwhelms above, Kidney Yin deficient below; fluid accumulation forms phlegm, Yin deficiency generates heat; heat-phlegm steams together, hence frequent hemoptysis, yellow-green sputum, heat steaming phlegm stagnation, foul-smelling sputum. Pulse fine, soggy, rapid. Abdominal discomfort. Approaching severe Lung Flaccidity (Fei Wei), adopt delaying tactics.
Prescription: Southern Glehniae Radix (Nanshashen, 3 qian) Bulbus Fritillariae Cirrhosae (Chuanbeimu, 2 qian) Pericarpium Citri Reticulatae (Juhong, 8 fen salt-water fried) Semen Benincasae (Dongguazi, 3 qian) Pulx Tridacnatis et Cydoniae (Haige Fen, 3 qian) Stir-fried Fructus Aurantii (Zhiqiao, 1 qian) Agarwood Qu (Chenxiang Qu, 1.5 qian) Honey-fried Flos Distantherae (Kudong, 2 qian) Clear Donkey-hide Glue (Ejiao, 2 qian) Stir-fried Asparagi Tuber (Tiantong, 2 qian) Raw Hordegerm (Guyagen, 1.5 qian)
Shen (Left): Cough occasionally bloody, lingering for years, Lung-Kidney long deficient. Now affected by Wind-Warmth, cough worsened. Body heat subsided, but at Yin-Mao hours (3-5 AM), throat itches severely with cough, thirst, dry throat, dry tongue, thick dense sputum, poor appetite, dull stomach. Pulse deficient and fine, tongue red rough coating. Wind pathogen resolved, but Lung-Kidney more deficient, causing Chongyang Qi carrying phlegm to rebel upward; syndrome belongs to root origin, distinct from phlegm-fluid. Prescribe Dual Regulation of Metal and Water.
Prescription: Asini Corii Colla Chuanbei Zhi Shengdi Tian Xingren Pipaye Hang Baishao Fuling Qing Geda San Juhong Duqi Wan
Second Visit: At Yin-Mao hours, throat itching and choking cough stopped, but Stomach Qi dull. Pulse soggy and wiry. Dry mouth and throat not fully resolved. Kidney Yin not restored; Middle Qi roots in Kidney, so the more Kidney deficient, the weaker Stomach.
Prescription: Asini Corii Colla Beads (Ejiaozhu, 2 qian) Orange Peel (Jubai, 1 qian salt-water fried) Chuanbei (Chuanbei, 2 qian) Sweet Almond (Tian Xingren, 3 qian fragrant stir-fried) Jinshi Shihu (Shihu, 3 qian) Pulx Tridacnatis et Cydoniae (Haige Fen, 3 qian) Poria (Fuling, 3 qian) Hang White Peony Root (Baishao, 1.5 qian wine-fried) Plump Polygonati Rhizome (Yuzhu, 3 qian) Raw and Fried Hordegerm (Guyagen, 1 qian each) Seven-Ingredient Duqi Pill (Duqi Wan, 3 qian divided twice taken separately)
Ding (Left): Cough fluctuates severity, Lung Qi long injured, stealing Mother Qi, Spleen Earth consequently weak, occasional loose stools. Pulse fine, coating white lacking luster. Prescribe Tonifying Earth to Generate Metal method.
Prescription: Kudzu Root Codonopsis (Kuidangshen, 3 qian) Yun Poria (Fuling, 3 qian) Stir-fried Lablab Bean (Biandou, 3 qian) Raw and Fried Semen Coicis (Yiren, 2 qian each) Stir-fried Atractylodis Rhizome (Baizhu, 2 qian) Stir-fried Dioscoreae Rhizome (Shanyao, 3 qian) Honey-fried Black Radix Glycyrrhizae (Caocao, 3 fen) Honey-fried Flos Distantherae (Kudonghua, 2 qian)
Xia (Left): Phlegm-fluid obstructs Lung and Stomach, chest stuffiness, abundant sputum and reverse cough, even cold limbs. Yang Qi blocked by Yin. Should warm and transform.
Prescription: Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Guang Peel (Guapi, 1 qian) Poria (Fuling, 3 qian) Trichosanthis Frost (Gualou Shuang, 4 qian) Radix Platycodi (Jiegeng, 7 fen) Allii Macrostemonis Bulb (Xiebaitou, 3 qian) Cinnamon Twig (Guizhi, 4 fen) Fructus Aurantii (Zhiqiao, 1 qian) Stir-fried Radish (Laifu, 2 qian ground)
Second Visit: Chest stuffiness slightly relieved, limbs slightly warm. Still abundant sputum and reverse cough. Phlegm-fluid internally obstructs, Lung-Stomach Qi not diffusing. Resolve phlegm and promote Qi movement again.
Prescription: Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Trichosanthis Frost (Gualou Shuang, 4 qian) Radix Platycodi (Jiegeng, 7 fen) Tribulus Fruit (Jiliqi, 3 qian) Allii Macrostemonis Bulb (Xiebaitou, 3 qian) Guang Curcuma Tuber (Yujin, 1.5 qian) Fructus Aurantii (Zhiqiao, 1 qian) Light Semen Armeniacae Amarum (Xingren, 3 qian) Folium Eriobotryae (Pipaye, 4 slices honey-fried hairs removed) Baijin Wan (Baijin Wan, 4 fen taken with water)
Third Visit: Limbs gradually warm, phlegm slightly easier. Chest still occasionally stuffy. Phlegm-fluid latent and untransformed. Hard to eradicate root.
Prescription: Processed Rhizoma Pinelliae Zhishi Xiaticur Fuling Chen Nanxing Shang Guangpi Yujin Xiebaitou Xingren Baijin Wan (5 fen)
Fourth Visit: Cold extremities turned warm, cough peaceful, but chest still stuffy. Merely phlegm-Qi obstruction. Expand previous method using Qianmian Tang modifications.
Prescription: Chenpi Zhuru Xingren Banxia Fuling Zhiqiao Yujin Xiebaitou Zhaojiaozi
Fifth Visit: Chest stuffiness slightly relieved, but frequent yawning indicates latent phlegm in chest causing Yin-Yang attraction. Resolve phlegm to connect Yin-Yang.
Prescription: Processed Rhizoma Pinelliae Juhong Guang Yujin Fuling Longgu Chen Danning Zhi Zhiquiao Zhuru Jiangzhi
Sixth Visit: Latent phlegm in chest gradually opened, Yin-Yang communicating, yawning greatly reduced, cough and sputum relatively vigorous. This is the fundamental state of phlegm-fluid. Resolve phlegm, harmonize middle, descend Lung.
Prescription: Processed Rhizoma Pinelliae (Banxia, 1.5 qian) Stir-fried Fructus Armeniacae (Suzi, 3 qian) Light Semen Armeniacae Amarum (Xingren, 3 qian) Radix Peucedani (Qianhu, 1 qian) Curcuma Tuber (Yujin, 1.5 qian) Guang