伤寒喘急最宜详。专论阳明及太阳。太阳无汗麻黄症。阳明潮热小承汤。水停心下
喘而咳。加减青龙必可当。阴症喘时肢逆冷。理中四逆用为良。
夫喘者。肺病也。经曰。肺主气。肺气逆而上行。冲冲而上。喝喝而息。数张口、抬肩
、摇
身、滚肚、是为喘也。凡伤寒发喘。有因太阳无汗而喘者。此为邪气在表。心腹必濡而不坚
。当用麻黄汤主之。有因水停心下而喘者。此为即水为邪。宜小青龙汤散之。有因阳明潮湿而
喘者。此为邪气在里。心腹必胀而为满。法当用小承气汤下之。若阴症喘则必促。脉浮而厥
。宜理中四逆汤温之。大抵诸喘为恶症。以邪气因盛。正气将脱也。他如直视谵语。及汗
出如油。喘不休。俱不治也。
太阳咳嗽用青龙。里水还须十枣攻。寒热柴胡加减治。阴邪真武总收功。
有声无痰曰咳。有痰无声曰嗽。经曰。肺主气。形寒饮冷则伤之。使气逆而不散。冲击
咽膈
。今喉中淫淫如痒。习习如梗。而咳嗽也。凡伤寒咳嗽。有因太阳水气在表而咳者。宜小青
龙汤主之。有因太阳水气在里而咳者。宜十枣汤主之。有因少阳寒热往来而咳者。宜小柴胡
汤加减治之。有因少阴水气在里而咳者。宜真武汤主之。大抵伤寒以嗽为轻。不与杂症同。须斟
酌治之。
伤寒引起的喘息急促，需要仔细辨证。主要涉及阳明经和太阳经的病证。太阳病无汗的喘症，适用麻黄汤；阳明病出现潮热症状的，适用小承气汤。若水饮停聚在心下部位，导致喘息兼咳嗽，使用加减后的青龙汤必然有效。阴寒证出现的喘息，伴有四肢逆冷，使用理中汤或四逆汤疗效良好。
所谓喘症，是肺部的疾病。医经记载：肺主司气机，肺气上逆而向上冲行，气息冲冲而上，呼吸时发出喝喝的声音，频繁张口、耸肩、摇动身体、腹部滚动，这就是喘症的表现。大凡伤寒引发的喘症，有因太阳表证无汗而致喘的，这是邪气在体表，心腹部必然柔软而不坚硬，应当用麻黄汤主治。有因水饮停聚在心下而致喘的，这是以水为邪气，宜用小青龙汤发散水气。有因阳明里实潮湿（燥屎内结）而致喘的，这是邪气在体内，心腹部必然胀满，治法应当用小承气汤攻下。如果是阴寒证导致的喘，必然气息短促，脉象浮而四肢厥冷，宜用理中汤或四逆汤温补。大致来说，各种喘症都属于恶候，因为邪气亢盛，正气即将脱失。其他如两眼直视、胡言乱语，以及出汗如油、喘息不止的，都属于不治之症。
太阳经咳嗽适用青龙汤；里有水饮还需用十枣汤攻逐。寒热往来的少阳证，用柴胡汤加减治疗；阴寒水气的少阴证，总归由真武汤收功。
有声音但无痰的叫咳，有痰但没声音的叫嗽。医经记载：肺主气，形体受寒或饮食生冷就会损伤肺气，使气机上逆而不能疏散，冲击咽喉膈膜。现在喉咙中感觉痒痒的，像有东西梗塞一样，从而引发咳嗽。大凡伤寒引发的咳嗽，有因太阳经水气停留在体表而咳的，宜用小青龙汤主治。有因太阳经水气停留在体内而咳的，宜用十枣汤主治。有因少阳经寒热往来而咳的，宜用小柴胡汤加减治疗。有因少阴经水气停留在体内而咳的，宜用真武汤主治。大致来说，伤寒中的咳嗽相对较轻，不能与杂病混同，必须斟酌病情进行治疗。
In cases of *Shanghan* (Cold Damage) presenting with urgent panting (*Chuan*), detailed differentiation is essential. These conditions primarily involve the Yangming and Taiyang channels. For Taiyang syndrome characterized by anhidrosis (absence of sweating) and panting, Mahuang Tang (Ephedra Decoction) is indicated; for Yangming syndrome manifesting as tidal fever (*Chao Re*), Xiaochengqi Tang (Minor Order the Qi Decoction) is appropriate. If fluid retention occurs in the epigastrium ("heart below"), causing panting accompanied by cough, a modified Qinglong Tang (Azure Dragon Decoction) will certainly be effective. In Yin syndromes where panting is accompanied by cold extremities (*Ni Leng*), Lizhong Tang (Regulate the Middle Decoction) or Sini Tang (Frigid Extremities Decoction) are beneficial.
Panting (*Chuan*) is a disease of the Lung. The Classics state: "The Lung governs Qi." When Lung Qi rebels and moves upward, it rushes up violently, and respiration produces a harsh sound. Frequent opening of the mouth, raising of the shoulders, shaking of the body, and rolling of the abdomen constitute panting. Generally, panting induced by *Shanghan* may arise from Taiyang anhidrosis; this indicates pathogenic factors at the exterior, and the epigastrium and abdomen will be soft rather than firm. Mahuang Tang should be administered. Alternatively, panting may result from fluid retention in the epigastrium; here, water acts as the pathogen, and Xiao Qinglong Tang (Minor Azure Dragon Decoction) should be used to disperse the fluid. Panting may also stem from interior dryness-heat accumulation in the Yangming channel; this indicates pathogens in the interior, with abdominal distension and fullness. The method requires purgation using Xiaochengqi Tang. If panting results from a Yin syndrome, the breathing will likely be short and rapid, the pulse floating, and the limbs cold; Lizhong Tang or Sini Tang should be used to warm the interior. Broadly speaking, various forms of panting are ominous signs, indicating that pathogenic factors are exuberant while healthy Qi is on the verge of collapse. Other manifestations such as fixed staring, delirious speech, sweating like oil, and ceaseless panting are considered untreatable.
For Taiyang channel cough, Qinglong Tang is used; if there is interior fluid retention, Shizao Gong (Ten Jujube Attack) is required. Cough associated with alternating chills and fever in the Shaoyang channel is treated with modified Chaihu Tang (Bupleurum Decoction); Shaoyin channel cough due to Yin pathogenic water is ultimately managed by Zhenwu Tang (True Warrior Decoction).
Coughing with sound but no phlegm is termed "Ke" (Cough); coughing with phlegm but no sound is termed "Sou". The Classics state: "The Lung governs Qi." External cold or cold drinks injure the Lung, causing Qi to rebel and fail to disperse, impacting the throat and diaphragm. Currently, the throat feels itchy and obstructed, leading to cough. Generally, cough induced by *Shanghan* may arise from Taiyang fluid retention at the exterior, treated with Xiao Qinglong Tang. If Taiyang fluid retention is in the interior, Shizao Tang (Ten Jujube Decoction) is indicated. If cough arises from Shaoyang alternating chills and fever, modified Chaihu Tang is used. If cough stems from Shaoyin fluid retention in the interior, Zhenwu Tang is appropriate. Broadly speaking, cough in *Shanghan* is relatively mild and differs from miscellaneous diseases; treatment must be carefully斟酌 (considered/deliberated).