侯（左） 先感风寒，既饮火酒，寒热互阻于肺，痰饮因而上升，致肺气不能下通于肾。气喘痰鸣，胸次窒
闷异常，卧着尤甚。脉象沉弦，左尺尚觉有神。尚非肾气不能仰吸肺气下行之劣症。时自汗出。拟开太
阳之表。弄斧班门，即请主裁。
川桂枝（八分） 淡干姜（五分） 煨石膏（三钱） 光杏仁（三钱） 甜葶苈（五分） 白茯苓（三钱）
制半夏（一钱五分） 生莱菔子（一钱五分） 生熟草（各一分） 枳壳（七分）
陈 向有痰饮，咳嗽痰多，习为常事。兹以感冒新风，肺气失肃，发热咳甚，兼以肝木郁结，风气通肝，肝
木从而勃动，腹痛泄泻。此初起之情形也。乃热减痛止泻定，转见神志摸糊，喉有痰声，而不得吐，气喘
不能着枕，四肢搐动，面色红亮，汗出溱溱。舌苔灰滞，而脉象濡滑。良由痰饮之邪，随外感所余之热，肝
经郁勃之气，蒸腾而上，迷蒙清窍，阻塞肺气。清窍被蒙，则神机不运，而神识模糊。肺气阻塞，则出纳失
常，而气喘不能着枕，肺气不能下通于肾，则肾气立见空虚，肾为封藏之本，肾虚则封固不密，而为汗
出。本虚标实，恐成必败之局。勉拟扶正化痰，降胃纳肾即请商裁。
吉林参（七分切小块开水吞） 旋复花（三钱包） 怀牛膝（盐水炒三钱） 陈胆星（一钱） 焦远志肉（五分）
炒苏子（三钱） 车前子（盐水炒二钱） 天竺黄（二钱） 磁石（四钱） 广蛤蚧尾（一对） 竹沥（姜汁五滴
冲） 白金丸（一钱包入煎）
又 补泻兼施，上下兼顾，如油如珠之汗已止，神志稍清，痰出较多，而稠腻如胶，牵丝不断，汗虽止而
不时懊烦。脉见歇止，舌苔浊腻灰滞。无形之气火，有形之浊痰，蕴聚胸中，肺出肾纳之道路，为之阻塞，
肾气虽欲仰吸肺气下行，而无路可通。此时欲降肺气，莫如治痰。标实本虚，元气能否胜任，实非人事
所能为也。勉再议方。
白前（三钱） 白茯苓（四钱） 炒苏子（三钱） 旋复花（三钱包） 蜜炙橘红（一钱） 陈胆星（一钱五分）
炒蒌皮（三钱） 竹沥半夏（三钱） 紫口蛤壳（一两） 白果肉（四粒打烂） 礞石滚痰丸（一钱开水先服） 雪羹
汤代水。
郭（左） 幼时即有痰喘之症，今年二十余，喘发复盛，痰聚胸膈，胸膈窒闷，欲吐不得，四肢少暖。投以小
青龙下控涎丹，不吐不泻。改投此方。
皂荚子（一分五厘） 明矾（三分） 黑丑（四分） 上湘军（三分） 四味研细，淡姜汤送下。
杨（右） 感邪失表，邪伏肺 ，以致稍一感触，辄作哮喘。除访择针灸好手按穴针灸外，进以梨膏，以开
通肺络，而润肺金。
蜜炙麻黄（五钱另煎去沫冲入） 川贝母（一两五钱去心） 冬瓜子（一两五钱） 云茯苓（四两） 光杏仁（三
两） 洋糖拌石膏（五两） 苏子（水浸打烂绞汁四两）
上药煎为浓汁，用秋梨四斤，去核切片绞汁，同以上诸药汁及苏子汁，炭火收膏，将成时加入白冰
糖三两，以滴水成珠为度，每服一调匙，晚间或临卧服。
侯（左） 起初感受风寒，随后又饮用了烈性酒，导致寒邪与热邪相互阻滞于肺脏，痰饮随之上升，致使肺气无法下行通达于肾脏。出现气喘、喉间痰鸣的症状，胸部极度憋闷不适，躺下时症状尤为严重。脉象沉而弦，但左侧尺部脉象尚且有神。这还不是肾气虚弱到无法上吸肺气下行的危重病症。患者伴有自汗出。拟采用宣发太阳经表邪的方法治疗。班门弄斧，恳请主治医生裁定。
川桂枝（八分） 淡干姜（五分） 煨石膏（三钱） 光杏仁（三钱） 甜葶苈（五分） 白茯苓（三钱） 制半夏（一钱五分） 生莱菔子（一钱五分） 生甘草与熟甘草（各一分） 枳壳（七分）
陈 向来患有痰饮病，咳嗽且痰多，已成为习惯性的常态。此次因感冒新风，导致肺气失去肃降功能，发热且咳嗽加剧，加之肝木郁结，风气通应于肝，导致肝气勃动，出现腹痛、泄泻。这是发病初期的情形。后来热势减退、疼痛停止、泄泻平息，转而出现神志模糊，喉间有痰声却无法咳出，气喘严重到不能平卧，四肢抽搐颤动，面色红亮，出汗淋漓不止。舌苔灰暗滞涩，脉象濡滑。这是因为痰饮之邪，随着外感残留的热邪以及肝经郁结勃发的之气，蒸腾向上，迷蒙清窍，阻塞肺气。清窍被蒙蔽，则神机不运，导致神识模糊。肺气被阻塞，则呼吸出入失常，导致气喘不能平卧；肺气不能下行通达于肾，则肾气立刻显得空虚。肾为封藏之本，肾虚则封固不严密，从而导致汗出。此属本虚标实之证，恐怕会发展成难以挽回的局面。勉强拟定扶正化痰、降胃气以纳肾气的方剂，敬请商榷裁定。
吉林参（七分切小块开水吞服） 旋复花（三钱包煎） 怀牛膝（盐水炒三钱） 陈胆星（一钱） 焦远志肉（五分） 炒苏子（三钱） 车前子（盐水炒二钱） 天竺黄（二钱） 磁石（四钱） 广蛤蚧尾（一对） 竹沥（加姜汁五滴冲服） 白金丸（一钱包入同煎）
又诊 补益与攻泻兼施，上下兼顾，如油如珠般的冷汗已经止住，神志稍见清醒，痰液排出较多，但质地稠腻如胶，牵丝不断。汗虽止但心中不时懊恼烦躁。脉象出现歇止，舌苔浊腻灰暗滞涩。无形的气火与有形的浊痰，蕴聚于胸中，使得肺出肾纳的道路被阻塞，肾气虽然想要上吸肺气下行，却无路可通。此时想要降肺气，不如先治痰。标实本虚，元气能否胜任治疗，实在不是人力所能强求的。勉强再议定方剂。
白前（三钱） 白茯苓（四钱） 炒苏子（三钱） 旋复花（三钱包煎） 蜜炙橘红（一钱） 陈胆星（一钱五分） 炒瓜蒌皮（三钱） 竹沥半夏（三钱） 紫口蛤壳（一两） 白果肉（四粒捣烂） 礞石滚痰丸（一钱开水先服） 用雪羹汤代水煎药。
郭（左） 幼年时就有痰喘的病症，今年二十多岁，喘息发作再次加重，痰液聚集在胸膈部位，胸膈憋闷，想吐却吐不出来，四肢稍微发凉。投用小青龙汤合控涎丹，未能引起呕吐或腹泻。改为投用此方。
皂荚子（一分五厘） 明矾（三分） 黑丑（四分） 上湘军（三分） 将四味药研成细粉，用淡姜汤送服。
杨（右） 感受邪气时失于解表，邪气潜伏于肺络，以致稍一感触外邪，就引发哮喘。除了寻访擅长针灸的好手按穴进行针灸治疗外，给予梨膏服用，以开通肺络，滋润肺金。
蜜炙麻黄（五钱另煎去沫后冲入） 川贝母（一两五钱去心） 冬瓜子（一两五钱） 云茯苓（四两） 光杏仁（三两） 洋糖拌石膏（五两） 苏子（用水浸泡捣烂绞取汁液四两）
以上药物煎煮为浓汁，用秋梨四斤，去核切片绞取汁液，与上述诸药汁及苏子汁混合，用炭火收膏，即将完成时加入白糖三两，以滴水成珠为度。每次服用一调匙，晚间或临睡前服用。
Hou (Left) Initially contracted wind-cold, and subsequently consumed strong liquor. Cold and heat mutually obstructed the Lungs, causing phlegm-fluids to rise upward, preventing Lung Qi from descending to connect with the Kidneys. Symptoms include asthma with rhonchi in the throat, extreme oppression and stuffiness in the chest, which is particularly severe when lying down. The pulse is deep and wiry; however, the left Chi position still shows spirit (Shen), indicating this is not yet a critical condition where Kidney Qi is too deficient to inhale Lung Qi downward. Spontaneous sweating occurs. The proposed treatment is to release the exterior of the Taiyang channel. Presumptuously offering this suggestion for the attending physician's review.
Guizhi Tang (Cinnamon Twig Decoction) - Cinnamon Twig (8 fen), Pale Dried Ginger (5 fen), Calcined Gypsum (3 qian), Apricot Kernel (3 qian), Thladiantra Fruit (5 fen), Poria (3 qian), Processed Pinellia Tuber (1.5 qian), Raw Radish Seed (1.5 qian), Raw and Prepared Licorice Root (1 fen each), Bitter Orange (7 fen).
Chen Has long suffered from phlegm-fluids, with excessive coughing and sputum becoming a habitual occurrence. Recently, due to contracting new wind pathogens, Lung Qi lost its descending function, resulting in fever and aggravated cough. Additionally, Liver Wood was constrained; as wind corresponds to the Liver, Liver Qi became hyperactive, leading to abdominal pain and diarrhea. This describes the initial presentation. Subsequently, the heat subsided, pain ceased, and diarrhea stopped, but symptoms shifted to mental confusion, gurgling phlegm in the throat that could not be expectorated, severe asthma preventing supine positioning, twitching of the four limbs, a bright red complexion, and profuse sweating. The tongue coating is gray and stagnant, and the pulse is soggy and slippery. This is likely due to phlegm-fluid pathogens, combined with residual heat from the external contraction and the constrained, hyperactive Qi of the Liver Channel, steaming upward to confuse the clear orifices and obstruct Lung Qi. When clear orifices are confused, the Spirit mechanism fails to operate, causing mental confusion. When Lung Qi is obstructed, inhalation and excretion become abnormal, causing asthma preventing supine positioning. If Lung Qi cannot descend to the Kidneys, Kidney Qi becomes immediately deficient. Since the Kidney is the root of sealing and storing, deficiency leads to insecure containment, resulting in sweating. This is a case of root deficiency with branch excess, fearing it may develop into an incurable situation. Tentatively prescribing a formula to support the healthy Qi, resolve phlegm, descend Stomach Qi, and assist the Kidneys in grasping Qi, for your consideration.
Jilin Ginseng (7 fen, cut into small pieces, swallowed with boiling water), Inula Flower wrapped in cloth (3 qian), Achyranthes Root stir-fried with salt water (3 qian), Arisaema with Bile (1 qian), Scorched Polygala Root (5 fen), Stir-fried Perilla Fruit (3 qen), Plantago Seed stir-fried with salt water (2 qian), Hyacinth Bean Meal (2 qian), Magnetite (4 qian), Gecko Tail (1 pair), Bamboo Sap mixed with 5 drops of Ginger Juice, Platinum Pill wrapped in cloth (1 qian, decocted together).
Second Visit: Simultaneously tonifying and purging, addressing both upper and lower aspects. The cold sweat resembling oil and pearls has stopped, mental clarity has slightly improved, and more phlegm has been expectorated, though it remains thick, sticky like glue, and stringy. Although sweating has ceased, there is occasional restlessness and irritability. The pulse shows intermittent pauses, and the tongue coating is turbid, greasy, gray, and stagnant. Formless Qi-fire and tangible turbid phlegm accumulate in the chest, blocking the pathway of Lung exhalation and Kidney inhalation. Although Kidney Qi desires to ascend and draw Lung Qi downward, there is no path available. At this juncture, to descend Lung Qi, one should treat the phlegm first. With branch excess and root deficiency, whether the Yuan Qi can withstand the treatment depends on factors beyond human control. Tentatively proposing another prescription.
Cynanchum Root (3 qian), Poria (4 qian), Stir-fried Perilla Fruit (3 qian), Inula Flower wrapped in cloth (3 qian), Honey-fried Tangerine Peel (1 qian), Arisaema with Bile (1.5 qian), Stir-fried Trichosanthes Peel (3 qian), Bamboo Sap Processed Pinellia (3 qian), Purple Clam Shell (1 liang), White Walnut Meat (4 kernels, crushed), Mengshi Rolling Phlegm Pill (1 qian, taken first with boiling water), Xue Geng Tang used as water for decoction.
Guo (Left) Suffered from phlegm-asthma since childhood. Now over twenty years old, the asthma has recurred severely, with phlegm accumulating in the chest and diaphragm, causing oppression, inability to vomit, and slightly warm extremities. Administered Xiao Qing Long Tang combined with Kong Xian Dan, but neither vomiting nor diarrhea occurred. Changed to this prescription.
Gleditsia Sinensis Seed (1.5 li), Alum (3 fen), Morning Glory Seed (4 fen), Rhubarb (3 fen). Grind the four ingredients into fine powder, take with light Ginger Decoction.
Yang (Right) Failed to release the exterior upon contracting pathogens, causing evil to lie latent in the Lung collaterals. Thus, any slight exposure triggers asthma. Besides seeking skilled acupuncture practitioners for point-specific treatment, administered Pear Paste to open Lung collaterals and moisten Metal (Lung).
Honey-fried Ephedra Stem (5 qian, decocted separately, foam removed, added to mixture), Fritillaria Bulb (1.5 liang, heart removed), Winter Melon Seed (1.5 liang), Cloud Poria (4 liang), Apricot Kernel (3 liang), Rock Sugar mixed with Gypsum (5 liang), Perilla Fruit (soaked in water, crushed, juice extracted 4 liang).
Decoct the above medicines into a concentrated liquid. Use four jin of Autumn Pears, remove pits, slice, and extract juice. Mix with the aforementioned medicinal juices and Perilla juice. Reduce over charcoal fire to form a paste. Near completion, add three liang of white rock sugar. Stop when a drop forms a bead upon contact with water. Take one teaspoon per dose, in the evening or before bed.