《内经》有喘正哮，至汉方哮喘并论。喘之源不一，哮之源止有冷痰入肺窍而已。夫肺为娇脏，清虚之
质，不容些毫芥蒂悬于胸间，其窍仰上，一有所入，则不能出。人而
饮冰食果，积成冷痰，浸淫于内，是为痰母，物交物则引之而已矣。一为潮上，肺窍为之闭塞，呼吸乱矣，呼
吸乱而二十七脉之迭见而杂出者，无所不至。其遇寒而发者，寒与寒感，痰因感而潮上也；其遇热而发者，寒
为热蒸，痰因蒸而潮上也。必待郁闷之极，咳出一点如鱼脑髓之形而症斯愈,脉亦随之而平。本草所训，性味
猛烈，惟麻黄、砒石，可以开其关而劫其痰。麻黄能发汗，一到哮症，虽盛夏之月不发汗；砒石能伤人，一到
哮症，虽羸弱之躯不伤人。有是症有是药而卒不能除其根者，麻黄能通痰塞之路，而不能拔痰踞之窠；砒石能
剿痰招之党，而不能歼痰伏之魁。药到即愈，愈而复发者，此也。余尝见老人患痨伤咳嗽吐血，体瘦脉数，败
症备矣，询其素有哮症，痨无可治者，以二药治其哮得愈者数人。又尝见老人患上气咳嗽，喘闷脉急不寐，困
顿极矣，问其素有哮症，气无可治者，以二药治其哮，得愈者亦数人。瑶池古冰雪，为肺拟冷痰，斯言近之
矣。
制砒石法∶以淡豆豉晒干研末一两，砒石一钱，饭和为丸。
（刺史家节庵，历宦四十年，解组归里，年已七十矣，患哮喘不寐，服麻黄而愈，重一本之亲，招诸玉，
砌结三生之愿，待聆金音，雅意殷殷，命着是篇。）
《黄帝内经》中有“喘”与“哮”的区分，到了汉代，方书开始将哮喘合并论述。喘证的成因不一，而哮证的成因仅有冷痰进入肺窍这一种罢了。肺是娇嫩的脏器，具有清虚的本质，不容许丝毫芥蒂悬留在胸间，其气窍向上，一旦有邪气进入，就无法排出。人如果饮用冰水、食用生冷瓜果，积结成冷痰，在体内浸淫蔓延，这就成为了生痰的根本（痰母），外物引动内邪，就会引发疾病。一旦冷痰如潮水般上涌，肺窍因此闭塞，呼吸就会紊乱；呼吸一乱，全身二十七部脉象就会交错杂出，表现无所不至。那些遇寒而发作的，是因为寒气与体内的寒邪相感，痰因受寒感应而潮水上泛；那些遇热而发作的，是因为体内的寒被热气蒸腾，痰因受热蒸腾而潮水上泛。必须等到郁闷之气达到极点，咳出一团像鱼脑髓形状的物质，病症才能痊愈，脉象也随之平复。本草书籍所教导的，药性猛烈能够治疗此病的，只有麻黄和砒石，可以打开闭塞的关窍并强力祛除痰浊。麻黄能发汗，但一到哮证，即使在盛夏月份也不使用其发汗之功；砒石能伤害人体，但一到哮证，即使是身体羸弱的人服用也不会造成伤害。如果有这样的病症和对应的药物，却终究不能根除病根的，是因为麻黄只能疏通痰塞的道路，而不能拔除痰浊盘踞的老巢；砒石只能剿灭痰浊招引的同党，而不能歼灭潜伏的痰浊魁首。服药后即刻痊愈，但愈后又复发的，原因就在这里。我曾经见过老人患有劳损咳嗽吐血，身体消瘦脉象急促，败症具备，询问得知他素来患有哮证，劳损已无可救治，用这两种药物治疗他的哮证得以痊愈的有好几个人。又曾经见过老人患上气咳嗽，气喘胸闷脉象急促无法入睡，困顿到了极点，询问得知他素来患有哮证，气机逆乱已无可救治，用这两种药物治疗他的哮证，得以痊愈的也有好几个人。“瑶池古冰雪”这句话，是为肺拟制治疗冷痰的方法，这种说法是很接近真理的。
制作砒石丸的方法：用淡豆豉晒干研成末一两，砒石一钱，用米饭调和制成丸剂。
（刺史家的节庵先生，做官四十年，辞官回到家乡，年龄已经七十岁了，患有哮喘不寐，服用麻黄后痊愈。为了报答一位亲戚的情谊，邀请各位玉友，结下三生之缘，等待聆听金玉良言，雅意殷切，命我撰写这篇文字。）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) distinguishes between "Chuan" (Wheezing/Dyspnea) and "Xiao" (Asthma/Wheezing with sound). By the Han Dynasty, medical texts began to discuss asthma and wheezing together. The origins of dyspnea are diverse, whereas the origin of asthma is solely due to cold phlegm entering the orifices of the lung. The lung is a delicate organ, possessing a clear and empty nature, allowing no slightest obstruction to remain suspended in the chest. Its orifices face upward; once an pathogen enters, it cannot exit. If a person drinks ice water or eats raw fruits, cold phlegm accumulates and permeates internally, becoming the mother of phlegm (Tan Mu). External factors interacting with internal pathogens trigger the disease. Once the phlegm surges upward like a tide, the lung orifices become blocked, and respiration becomes chaotic. When respiration is chaotic, the twenty-seven pulse positions exhibit mixed and alternating manifestations without limit. In cases triggered by cold, external cold interacts with internal cold, causing phlegm to surge upward due to this interaction; in cases triggered by heat, internal cold is steamed by heat, causing phlegm to surge upward due to this steaming. Recovery occurs only when pent-up qi reaches its extreme, and a substance resembling fish brain mucus is coughed out, at which point the symptoms subside and the pulse returns to normal. According to materia medica teachings, among herbs with potent properties, only Ephedrae Herba (Mahuang, 麻黄) and Realgar (Pishi, 砒石) can open the blocked orifices and forcibly expel the phlegm. Mahuang induces sweating, but in cases of asthma, its diaphoretic function is not utilized even in midsummer. Pishi is toxic and harmful, but in cases of asthma, it does not harm the patient even if their constitution is frail. If there is a corresponding symptom and herb, yet the root cause cannot be eradicated, it is because Mahuang can clear the pathways blocked by phlegm but cannot uproot the nest where phlegm resides; Pishi can eliminate the associates of phlegm but cannot annihilate the chief leaders of latent phlegm. This explains why symptoms resolve immediately after medication but recur later. I have observed elderly patients suffering from consumptive cough with hemoptysis, emaciation, and rapid pulses, exhibiting signs of terminal decline. Upon inquiry, they were found to have a history of asthma. Since the consumption was incurable, treating the asthma with these two herbs led to recovery in several cases. I have also observed elderly patients with rebellious qi, cough, asthmatic oppression, rapid pulses, and insomnia, in extreme exhaustion. Upon inquiry, they had a history of asthma. Since the rebellious qi was deemed incurable, treating the asthma with these two herbs resulted in recovery in several cases. The saying "Ancient ice and snow of Yaochi" refers to a method for treating cold phlegm in the lungs, which is quite accurate.
Method for preparing Pishi pills: Take one liang of dried and powdered Fermented Soybean (Danshidou, 淡豆豉), one qian of Realgar (Pishi, 砒石), mix with rice paste, and form into pills.
(Mr. Jie'an of the Cishi family served as an official for forty years. After resigning and returning home, he was seventy years old. He suffered from asthma and insomnia and recovered after taking Mahuang. To repay the kindness of a close relative, he invited various friends, established a bond of three lifetimes, and eagerly awaited insightful advice, requesting that I write this article.)