喘有寒、有热、有水病。寒喘遇寒则发，热喘发于夏，而不发于冬水病者，小
便涩，胸膈满闷，脚微肿是也，更有肺热，有肺虚，有胃热，有肾虚，最宜分别。
夫呼吸急促者，谓之喘，喉中有声响者，谓之哮，然痰盛而喘，则治痰为本，而
利气为标，气实而喘，则气反为本，痰反为标，哮喘未发，以扶正为要，已发以攻邪为
主，若自少腹下火气冲于上而喘者，宜补阴以敛之。凡咳不得卧，其脉浮，按之虚而涩
者，为阴虚，去死不远，慎勿下之，下之必死，大宜补阴壮火，火归则为气为痰，俱不
泛上矣。
苦久病肺虚而发喘者，必少气而喘，右寸脉微，或虚大无力，宜阿胶、人参、五味
补之。新病气实而喘者，寸脉沉实，痰涎壅盛，呼吸不利，宜桑白皮、苦葶苈泻之。凡
喘正发时无痰，将愈时却吐痰者，乃痰于生发之时闭塞不通，故喘甚。当于其时，开其
痰路则喘易安也，宜桔梗汤及枳壳、栝蒌、杏仁之类，引出其痰，候痰出喘退，却调其
虚实。
喘者，张口抬肩者是也。短气者，呼吸虽数，而不能相续，似喘而不摇肩，似呻吟
而无痛者是也。戴复庵曰∶短乏者，下气不接，上呼不来，语言无力，宜补虚，四桂饮
木香减半，加山药、黄 各一钱。东垣曰∶胸满少气短气者，肺主气，气不足乃尔气
短，小便利者，四君子汤去茯苓加黄 。更曰，少气短气，治法各异。夫短气有虚有
实，治法有补有泻，故曰，短气有属饮，脉必弦滑，宜苓术甘桂之类渗之，或从小便中
去之，一属气虚，脉必不足，若少气则纯属不足也。治惟有补而已，中年人病后，气促
痰嗽，腿足冷肿，腰骨大痛，面目浮肿，太阳作痛，悉属命门火衰，阳虚之候，用八味
丸料佳。若作痰治立危。
妇人产后喘，乃急症极危多死，此名孤阳绝阴，因所下过多，荣血暴竭，卫气无
根据，独聚肺中，故令喘促，喉中气急也，宜浓煎独参汤，或大料芎归汤。若恶露不快散
血停凝，上熏于肺，亦今喘急者，但云恶露，而喘自定。
《经》曰∶诸逆冲上，皆属于火。华佗云∶肺气盛为喘。《活人书》云∶气有余则
喘。后代集症类方，不过遵此而已。独海藏云∶气盛当作气衰，有余当认作不足，肺气
果盛与有余，则清肃下行，岂复为喘？以其火烁俱阴，衰与不足而为喘焉，所言盛与有
余者，非肺之气也，肺中之火也。海藏之辨。发千古之精奥，惜乎启其端，未竟其火
之所由来，夫火之有余，水之不足也。阳之有余，阴之不足也。凡诸逆冲之火，皆下焦
冲任相火，出于肝肾者也。肾水虚衰，相火偏胜，壮火食气，销烁肺金，乌得而不喘
焉？丹溪云∶喘有阴虚，自小腹下引起而上，宜四物汤加青黛、竹沥、陈皮入童便煎
服。如挟痰喘者，四物加枳壳、半夏，补阴以化痰。夫谓阴虚发喘，丹溪亦发前人之未
发，但如此治法，实流弊于后人，盖阴虚者，肾中之真阴虚也，岂四物汤阴血之谓
乎？其火起者，下焦龙雷之火也，岂寒凉所能降乎？其间有有痰，有无痰者。有痰者，
水挟木火而上也，岂竹沥，枳半之能化乎？须用六味地黄，加麦冬五味大剂煎饮，以壮
水之主，则水升火降而喘自定矣。盖绿阴水虚，故有火，有火则有痰，有痰则咳嗽，咳
嗽之甚则喘耳。
夫呼随阳出，吸随阴入，一升一降，阴阳乃和，苟有乘戾，则气上不行，升而不
降，否塞膈中，气道奔迫，乃喘急而有声也。故《经》曰∶不得卧而息有音者，是阳
明之逆也。又曰∶起居如故，而息有音者。此肺之络脉逆也。然又有一等似火非火，似
喘非喘。《经》曰∶少阴所谓呕咳上气喘者，
阴气在下，阳气在上，诸阳气浮，无所根据归，故上气喘也。乃真元耗损，喘出于肾气
之上奔，其人平日若无病，但觉气喘，非气喘也，乃气不归元也。视其外症，四肢厥
逆，而赤烦燥，恶热似火，非火也。乃命门真元之火离其宫而不归也，察其脉两寸虽浮
大而数，两尺微而无力，或似有而无为辨耳，不知者，以其有火也，少用凉药以清
之，以其喘急难禁也，佐以四磨之类以宽之。下咽之后，似觉稍快，少顷依然，岂知
宽一分更耗一分，甚有见其稍快，误认药力欠到，倍进寒凉快气之剂，立见其毙矣。盖
阴虚至喘，去死不远，幸几希一线，牵带命门，尚尔留连，善治者、能求其绪而接助真
元、裨其返本归原、或可回生，然亦不可峻骤也。且先以八味丸、安肾丸、养正丹之
类，煎人参生脉散送下，觉气若稍定，然后以大剂参 补剂，加破故纸、阿胶、朱膝之
类，以镇于下，又以八味丸加河车为丸，日夜遇饥吞服方可。然尤须远房帏，绝色欲，
经年积月，方可保全。不守此禁，终亦必亡而已。聪明男子，当自治未病，毋蹈此危
机。
又有一等火郁之症，六脉俱涩，甚至沉伏，四肢悉寒，甚至厥逆，怫怫促而喘，却
似有余，而脉不紧数，欲作阴虚而按尺鼓指，此为蓄郁已久，阳气怫遏不能营运于
表，以致身冷脉微，闷乱喘急，当此之时，不可以寒药下之，又不可以热药投之，惟逍
遥散加茱连之类，宣散蓄热，得汗而愈，后仍以六味地黄，养阴和阳方佳。此谓火郁则
发之，木郁则达之，即《金匮》所云∶六脉沉伏，宜发散，则热退而喘定也。然喘多不
能卧，何也？肾者，水脏，主津液，主卧与喘也。卧则喘者，水气逆行乘于肺，肺得水
而浮，气不得流通也。
病后产后，一切疮症，溃后发喘，即是短气，悉属气虚。虽素有痰火，若在年高病
久，正气耗散，若误作有余，削伐寒凉，立见倾危，须大剂生脉散，扶接元气为急，或
温补之，以导气导火归原，则为喘为痰，不治而自愈。然喘病因虚而死者，十之九，因
实而死者，十之一，盖实者，攻之即愈无所难也。虚者，补之，未即见效，转折进退，
良非易也。凡服温补药后，纵喜凉饮，而冷水切不可与，盖咽干口燥者，因虚火未下，
津液未生故耳。若一饮冷水则温热药力全消，毫无所济，况寒气一人丹田，龙雷愈为浮越矣。
喘证有寒喘、热喘和水饮致喘三种。寒喘在遇冷时发作，热喘在夏季发作而不在冬季发作；水饮致喘表现为小便涩滞不畅，胸膈部满闷不适，双脚轻微浮肿，这些情况都应当仔细辨别。此外还有肺热、肺虚、胃热、肾虚导致的喘证，更需加以区分。
呼吸急促的称为喘，喉咙中有声响的称为哮。如果痰多导致气喘，治疗应以治痰为本，理气为标；如果是气实导致气喘，则气逆为本，痰多为标。哮喘未发作时，以扶正固本为主；已发作时，以攻邪为主。如果是从少腹下有火气冲向上方而导致气喘的，适宜用滋阴的方法使其收敛。凡是咳嗽严重到不能平卧，脉象浮取可见，重按则虚弱且涩滞的，属于阴虚，离死亡不远，千万不要使用泻下法，误用泻下法必然致死，最适宜采用补阴壮火的方法，使火归元，则气和痰都不会上泛了。
如果是久病导致肺虚而引发气喘的，必定伴有气短而喘，右寸脉微弱，或虚大无力，适宜用阿胶、人参、五味子来补益。新近患病、气实而气喘的，寸脉沉实，痰涎壅盛，呼吸不利，适宜用桑白皮、苦葶苈来泻实。凡是气喘正在发作时没有痰，快要痊愈时却吐出痰的，这是因为痰在生发之时闭塞气道不通畅，所以气喘严重。应当在当时开通痰路，这样气喘容易平息，适宜用桔梗汤以及枳壳、瓜蒌、杏仁等药物，引出其痰，等到痰出气喘退去后，再调理虚实。
喘证的表现是张口抬肩。短气的表现是呼吸虽然频繁，但不能连续，好像喘但不摇动肩膀，好像呻吟但没有痛苦的样子。戴复庵说：短乏（气短），是下气不接续，上呼不来，语言无力，适宜补虚，用四桂饮（此处原文似有误，通常指四君子类或特定方，依原文保留）木香减半，加山药、黄芪各一钱。李东垣说：胸满、少气、短气的，肺主气，气不足就会气短，如果小便通利的，用四君子汤去掉茯苓加上黄芪。又说，少气和短气的治疗方法各不相同。短气有虚有实，治疗方法有补有泻，所以说，短气属于饮邪的，脉象一定弦滑，适宜用茯苓、白术、甘草、桂枝之类渗湿利水，或者从小便中排出；另一种属于气虚，脉象一定不足，如果是少气则纯属正气不足。治疗方法只有补益而已。中年人在病后出现气促、痰嗽、腿足冷肿、腰骨剧痛、面目浮肿、太阳穴作痛，都属于命门火衰、阳虚的症状，用八味丸（金匮肾气丸）药料煎服效果佳。如果当作痰证治疗，立刻会有危险。
妇人产后气喘，是急症，极危重，多导致死亡，这名叫“孤阳绝阴”，因为产后失血过多，营血突然枯竭，卫气没有依附，独自聚积在肺中，所以导致气喘急促，喉中气急。适宜浓煎独参汤，或者大剂量芎归汤。如果恶露排出不畅，瘀血停滞凝结，上熏于肺，也会导致气喘急促，只要处理好恶露，气喘自然平息。
《黄帝内经》说：各种逆气冲上的病症，都属于火。华佗说：肺气盛会导致喘。《活人书》说：气有余就会喘。后代收集症状分类成方的书籍，不过遵循这些说法罢了。唯独海藏（张元素弟子张璧，号海藏）说：气盛应当理解为气衰，有余应当认为是不足，如果肺气真的盛和有余，那么清肃之气应该下行，怎么会反而喘呢？是因为火灼伤了阴液，导致气衰和不足才发生喘证。所说的盛与有余，不是指肺的气，而是指肺中的火。海藏的辨析，阐发了千古的精微奥妙，可惜他只开了个头，没有探究火从哪里来。火的有余，是因为水的不足；阳的有余，是因为阴的不足。凡是各种逆冲之火，都是下焦冲任二脉的相火，出于肝肾。肾水虚衰，相火偏胜，壮火食气，销烁肺金，怎么能不喘呢？朱丹溪说：喘有阴虚型，从小腹下引起而上冲，适宜用四物汤加青黛、竹沥、陈皮，加入童便煎服。如果夹杂痰喘的，四物汤加枳壳、半夏，通过补阴来化痰。所谓阴虚发喘，丹溪也阐发了前人未发的观点，但这样的治疗方法，实际上给后人带来了流弊。因为阴虚指的是肾中的真阴虚，难道是四物汤所指的阴血吗？那起火的，是下焦龙雷之火，难道是寒凉药所能降伏的吗？其中有痰和无痰两种情况。有痰的，是水挟带木火上冲，难道是竹沥、枳壳、半夏能化解的吗？必须用六味地黄丸，加麦冬、五味子大剂煎饮，以壮水之主（补肾阴），则水升火降而喘自定。因为肾阴水虚，所以有火；有火则有痰；有痰则咳嗽；咳嗽严重时则喘。
呼气随阳气外出，吸气随阴气入内，一升一降，阴阳才能调和。如果有乖戾之气，则气上行而不行，升而不降，痞塞于膈中，气道奔迫，于是气喘急促而有声音。所以《内经》说：不能平卧且呼吸有声音的，是阳明经气逆乱所致。又说：起居如常，但呼吸有声音的，这是肺的络脉逆乱所致。然而还有一类似火非火、似喘非喘的情况。《内经》说：少阴病所谓的呕吐、咳嗽、上气喘，是因为阴气在下，阳气在上，诸阳气浮越，无所依附回归，所以上气喘。这是真元耗损，喘是由于肾气上奔所致。这个人平时好像没病，只是觉得气喘，其实不是气喘，是气不归元。看他的外在症状，四肢厥冷逆冷，面色赤红烦躁，怕热似火，其实不是火。这是命门真元之火离开其宫位而不回归。诊察他的脉象，两寸脉虽浮大而数，两尺脉微而无力，或者似有若无，以此辨别。不知道的人，认为他有火，就少量用凉药来清解，因为他气喘急促难以忍受，辅以四磨汤之类来宽胸顺气。药咽下去后，似乎觉得稍快，一会儿又恢复原状。哪里知道宽一分就耗散一分，甚至有看到他稍微舒服一点，错误地认为药力不够，加倍进用寒凉快气之剂，立刻就会导致死亡。因为阴虚至极导致气喘，离死不远，幸好还有一丝生机，牵连着命门，尚且留连人间。善于治疗的医生，能探寻其根源并接助真元，帮助其返本归原，或许可以挽回生命，但也不可峻猛急躁。并且先用八味丸、安肾丸、养正丹之类，煎人参生脉散送服，感觉气稍微安定后，然后用大剂量人参、黄芪补剂，加破故纸（补骨脂）、阿胶、牛膝之类，以镇摄于下，又以八味丸加紫河车制成丸药，日夜饥饿时吞服才可以。然而尤其需要远离房事，断绝色欲，经过长年累月，才可以保全性命。如果不遵守这些禁忌，最终必然死亡。聪明的男子，应当自治未病，不要陷入这种危机。
又有一类火郁的病症，六脉都涩，甚至沉伏，四肢全部寒冷，甚至厥逆，怫怫然促急而喘，看起来似乎有余，但脉不紧数，想要诊断为阴虚但按尺脉鼓指有力，这是因为蓄郁已久，阳气被遏阻不能营运于体表，以致身冷脉微，闷乱喘急。在这个时候，不可以用寒药泻下，也不可以用热药投喂，只能用逍遥散加吴茱萸、黄连之类，宣散蓄热，得汗而愈，之后仍以六味地黄丸，养阴和阳为佳。这叫“火郁则发之，木郁则达之”，即《金匮要略》所说：六脉沉伏，宜发散，则热退而喘定。然而喘大多不能平卧，为什么呢？肾是水脏，主津液，主卧与喘。卧则喘的，是水气逆行乘袭于肺，肺得水而浮，气不得流通。
病后、产后，一切疮疡症状，溃烂后发喘，即是短气，都属于气虚。即使素有痰火，如果在年高病久，正气耗散，如果错误地当作有余实证，用削伐寒凉之法，立刻会导致倾覆危险，必须用大剂量生脉散，扶接元气为急务，或者温补之，以导气导火归原，则为喘为痰，不治而自愈。然而喘病因虚而死的，十之九；因实而死的，十之一。因为实证，攻之即愈，没有什么难的。虚证，补之，未必立即见效，转折进退，确实不容易。凡是服用温补药后，纵然喜欢凉饮，但冷水切不可给，因为咽干口燥，是因为虚火未下潜，津液未生成所致。如果一喝冷水，则温热药力全消，毫无益处，况且寒气进入丹田，龙雷之火更加浮越了。
Asthma (Chuan) can be caused by Cold, Heat, or Water retention. Cold asthma manifests upon exposure to cold; heat asthma occurs in summer but not in winter. Water retention asthma is characterized by scanty and difficult urination, fullness and oppression in the chest and diaphragm, and slight swelling of the feet. These conditions must be carefully distinguished. Furthermore, asthma caused by Lung Heat, Lung Deficiency, Stomach Heat, and Kidney Deficiency should also be differentiated.
Rapid breathing is termed Asthma (Chuan), while wheezing with sound in the throat is termed Wheezing (Xiao). If asthma is caused by abundant phlegm, treatment should focus on resolving phlegm as the root, and regulating Qi as the branch. If asthma is caused by Excess Qi, then rebellious Qi is the root, and phlegm is the branch. When asthma/wheezing is not active, the priority is to support healthy Qi (Zheng Qi); when it is active, the priority is to attack pathogenic factors. If asthma arises from fire Qi rushing upward from the lower abdomen, Yin-nourishing methods should be used to consolidate and restrain it. For cases where coughing prevents lying flat, and the pulse is floating on superficial pressure but weak and choppy on deep pressure, this indicates Yin Deficiency. Death is imminent; purgatives must never be used, as their use will certainly lead to death. The most appropriate treatment is to nourish Yin and strengthen Fire (to guide it back to its source), so that Qi and Phlegm do not float upward.
In cases of asthma triggered by Lung Deficiency due to chronic illness, there is invariably shortness of breath accompanied by asthma, with a faint or empty and large, forceless pulse at the Right Cun position. Treatment should involve tonifying with Ejiao (Donkey-hide Gelatin), Renshen (Ginseng), and Wuweizi (Schisandra Berry). In new-onset asthma due to Qi Excess, the Cun pulse is deep and solid, with abundant salivary phlegm and difficulty in breathing. Treatment should involve draining with Sangbaipi (Morus Bark) and Kutingli (Periploca Seed). If asthma presents without phlegm during the acute phase but expectorates phlegm as it resolves, it is because phlegm blocked the airways during the onset, causing severe asthma. At that time, opening the phlegm pathways will easily alleviate the asthma. Suitable formulas include Jiegeng Tang (Platycodon Decoction) along with Zhike (Aurantium Fructus), Gualou (Trichosanthes Fruit), and Xingren (Apricot Seed) to draw out the phlegm. Once the phlegm is expelled and asthma subsides, then regulate the Deficiency and Excess.
Asthma is characterized by gaping mouth and lifting shoulders. Shortness of breath (Duan Qi) is characterized by frequent respiration that cannot continue, resembling asthma but without shoulder movement, and resembling groaning but without pain. Dai Fu'an stated: Shortness of breath involves lower Qi failing to connect and upper Qi failing to arrive, with weak voice. It requires tonifying deficiency using Sigui Yin (Four Cinnamon Drink) with reduced Muxiang (Aucklandia Root), plus Shanyao (Dioscorea Rhizome) and Huangqi (Astragalus Root), each 1 qian. Li Dongyuan stated: Chest fullness, little Qi, and shortness of breath occur because the Lung governs Qi, and insufficiency of Qi leads to shortness of breath. If urination is clear and abundant, use Sijunzi Tang (Four Gentlemen Decoction) minus Fuling (Poria), plus Huangqi (Astragalus Root). He further stated that the treatment for "little Qi" and "shortness of breath" differs. Shortness of breath can be Deficient or Excessive, requiring tonification or purgation respectively. Thus, if shortness of breath is due to fluid retention, the pulse will be wiry and slippery; treat with Shenling Baizhu San variations (Fuling, Baizhu, Gancao, Guizhi) to leach out dampness, or eliminate via urination. If it is due to Qi Deficiency, the pulse will be insufficient. "Little Qi" is purely a state of insufficiency, treated only by tonification. In middle-aged patients after illness, symptoms such as rapid breathing, phlegmy cough, cold and swollen legs/feet, severe lumbar pain, facial edema, and Taiyang headache all belong to Declining Fire of the Mingmen (Gate of Life) and Yang Deficiency. Bawei Wan (Eight-Ingredient Pill) is excellent. Treating this as phlegm will lead to immediate danger.
Postpartum asthma in women is an acute, critical condition often leading to death, named "Lone Yang and Absolute Yin." Due to excessive blood loss, Ying Blood (Nutritive Blood) is suddenly exhausted, leaving Wei Qi (Defensive Qi) without foundation, gathering solely in the Lungs, causing rapid asthma and urgent throat breathing. Strongly decocted Dushen Tang (Single Ginseng Decoction) or a large dose of Xionggui Tang (Szechwan Lovage and Angelica Decoction) are suitable. If lochia (postpartum discharge) is not smooth, causing stagnant blood to condense and harass the Lungs upward, also causing urgent asthma, resolving the lochia will naturally settle the asthma.
The Classic states: All rebellious Qi rushing upward belongs to Fire. Hua Tuo said: Excess Lung Qi causes asthma. Huoren Shu (Book of Vitality) said: Excess Qi leads to asthma. Later compilations of symptoms and formulas merely followed these principles. Only Haicang (Zhang Bi) argued: "Qi Excess" should be understood as Qi Deficiency, and "Excess" as Insufficiency. If Lung Qi were truly excessive, its clearing and descending function would operate normally, why would asthma occur? It is because Fire scorches Yin, leading to Qi Deficiency and insufficiency, causing asthma. The "excess" mentioned refers not to Lung Qi, but to Fire in the Lungs. Haicang's differentiation elucidated profound ancient wisdom, though he did not fully explore the origin of this Fire. Excess Fire stems from Insufficient Water; Excess Yang stems from Insufficient Yin. All rebellious Fire originates from the Ministerial Fire of the Chong and Ren vessels in the Lower Jiao, arising from the Liver and Kidneys. When Kidney Water declines, Ministerial Fire prevails. Vigorous Fire consumes Qi and scorces Lung Metal, inevitably causing asthma. Danxi (Zhu Zhenheng) said: There is Yin-Deficiency asthma originating from the lower abdomen rising upward. Treat with Siwu Tang (Four Substances Decoction) plus Qingdai (Indigo Naturalis), Zhuli (Bamboo Juice), Chenpi (Tangerine Peel), decocted with Tongbian (Child's Urine). If complicated by phlegm, add Zhike (Aurantium Fructus) and Banxia (Pinellia Tuber) to Siwu Tang to resolve phlegm by nourishing Yin. Although Danxi revealed this aspect of Yin-deficiency asthma, his treatment method has led to errors in later generations. "Yin Deficiency" refers to the True Yin of the Kidney, not merely the Yin Blood addressed by Siwu Tang. The fire arising is the Dragon-Lei Fire of the Lower Jiao, which cannot be subdued by cold herbs. Cases may have phlegm or no phlegm. With phlegm, it is Water carrying Wood-Fire upward, which Zhuli and Zhike/Banxia cannot resolve. One must use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) plus Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Berry) in large doses to strengthen the Master of Water (Kidney Yin). Then Water rises, Fire descends, and asthma settles. Because Kidney Yin/Water is deficient, Fire arises; with Fire, Phlegm forms; with Phlegm, Cough occurs; severe Cough leads to Asthma.
Exhalation follows Yang exiting, inhalation follows Yin entering. Ascending and descending harmonize Yin and Yang. If rebellious Qi disrupts this, Qi fails to descend, becoming obstructed in the Diaphragm, forcing the Airway, resulting in urgent, noisy asthma. Thus, the Classic states: Inability to lie flat with noisy respiration indicates reversal of Yangming Qi. Also: Normal daily activities but noisy respiration indicates reversal of Lung collateral Qi. However, there is a type resembling Fire but not Fire, resembling Asthma but not Asthma. The Classic states: Shaoyin disease involving vomiting, cough, and upper asthma occurs because Yin is below, Yang is above, and all Yang Qi floats without foundation, causing upper asthma. This is due to depletion of True Yuan, with asthma arising from Kidney Qi rushing upward. The patient appears healthy normally but feels asthmatic; this is not true asthma but Qi failing to return to its source. External signs include cold extremities, red face, irritability, and aversion to heat resembling Fire, but it is not Fire. It is the True Yuan Fire of the Mingmen leaving its palace and not returning. Pulse examination shows floating, large, and rapid pulses at both Cun positions, but faint and forceless pulses at both Chi positions, or seemingly present yet absent. Unaware practitioners, seeing "Fire," use small amounts of cooling herbs to clear it, or use Simo Tang (Four-Mortar Decoction) to relieve urgency. After ingestion, there may be temporary relief, but soon returns. Relieving slightly consumes more Qi. Some mistakenly increase cold/clearing herbs upon slight relief, leading to immediate death. Severe Yin Deficiency asthma is near fatal. A sliver of life remains connected to the Mingmen. Skilled physicians trace the root, assist True Yuan, and help it return to its origin, potentially saving life, but must avoid harsh or rapid treatments. Initially use Bawei Wan, Anshen Wan, or Yangzheng Dan, delivered with Renshen Shengmai San (Ginseng and Pulse-Nourishing Decoction). Once Qi stabilizes, use large doses of Renshen and Huangqi tonics, plus Poguozhi (Psoralea Fruit), Ejiao, and Nixi (Achyranthes Root) to anchor downward. Then use Bawei Wan added with Heche (Placenta) as pills, taken during hunger day and night. Crucially, one must abstain from sexual activity. Only through long-term adherence can life be preserved. Violation of these prohibitions leads to death. Wise men should prevent disease before it arises.
Another type is Fire Depression syndrome. All six pulses are choppy, even deep and hidden. Extremities are cold, even cold to the point of inversion. Restless, rapid breathing and asthma appear Excess-like, but the pulse is not tight or rapid. Pressing the Chi pulse reveals drumming strength, indicating long-standing depression where Yang Qi is constrained and cannot circulate to the exterior, causing cold body, faint pulse, confusion, and urgent asthma. At this stage, do not use cold purgatives or hot tonics. Use Xiaoyao San (Free and Easy Wanderer Powder) plus Zhuyu (Evodia) and Huanglian (Coptis) to vent and disperse accumulated heat. Recovery comes with sweating. Afterwards, use Liuwei Dihuang Wan to nourish Yin and harmonize Yang. This illustrates "Vent Fire Depression, Reach Wood Depression," as stated in Jin Gui: Deep/hidden pulses require dispersion, leading to heat resolution and asthma settling. Why does asthma often prevent lying down? The Kidney is the Water Organ, governing fluids, sleep, and asthma. Asthma when lying down results from Water Qi counterflow harassing the Lungs. The Lung becomes buoyant with water, and Qi cannot circulate freely.
After illness or postpartum, and in all ulcerative sores, asthma appearing after ulceration is essentially shortness of breath, belonging to Qi Deficiency. Even if there is pre-existing Phlegm-Fire, in elderly or chronically ill patients with depleted Zheng Qi, treating it as Excess and using draining/cold methods leads to immediate collapse. Urgently use large doses of Shengmai San to support Yuan Qi, or use warm tonification to guide Qi and Fire back to their source. Asthma and phlegm will resolve spontaneously. Nine-tenths of asthma deaths are due to Deficiency; one-tenth due to Excess. Excess is easily cured by attacking. Deficiency is hard to treat with tonification, as effects are not immediate, requiring careful navigation. After taking warm tonics, even if the patient desires cool drinks, cold water must absolutely be avoided. Dry throat and mouth result from un-submerged Deficient Fire and lack of generated fluids. Drinking cold water extinguishes the warm tonic's power entirely. Moreover, Cold Qi entering the Dantian causes Dragon-Lei Fire to float even more.