〔钱〕有喘而咯脓血者，乃肺热。食后服甘桔汤。久嗽者肺亡津液，阿胶散主之。咳而痰实，不甚
喘而面赤饮水者，可褊银丸下之。（阿胶散即补肺散，方见治虚实法。褊银丸方见前。）
甘桔散
桔梗（米泔浸一宿，焙干） 甘草（炒。各二两）
上为细末，每服一大钱，水一大盏，入阿胶半两，炮过，煎至五分，食后温服。
〔海〕甘桔汤，仲景少阴咽痛药也。孙真人治肺痈吐脓血，用生甘草加减二十余条。
〔丹〕小儿咯血。黑豆、甘草、陈皮煎服。
〔钱〕段斋郎子四岁，病嗽身热，吐痰数日而咯血，前医以桔梗汤及防己丸，治之不愈，涎上攻，吐喘不
止，请钱氏，下褊银丸一大服，复以补肺汤、补肺散治之。或问段氏子咯血肺虚，何以下之？钱曰∶
肺虽咯血，有热故也，久则虚痿。今涎上潮而吐，当下其涎。若不吐涎，则不甚便。盖吐涎能虚，又生惊也。
痰实上攻，亦能发搐。故根据法只宜先下痰，而后补脾肺，必涎止而吐愈，为顺治也。若先补其肺，为逆耳。
此所谓识病之轻重先后为治也。
〔洁〕肺虚则喘而少气，先益黄散，后补肺散。（二方并见治虚实法。）
〔钱〕京东转运使李公孙八岁，病嗽而喘满短气。医者言肺经有热，用竹叶汤、牛黄膏治之，三日加喘。
钱氏云∶此肺气不足，复有寒邪，即便喘满，当补肺脾，勿服凉药。李曰∶医已用竹叶汤、牛黄膏。钱
曰∶何治也？前医曰∶退热退涎。钱曰∶何热之所作？曰∶肺经热而生嗽，嗽久不除生涎。钱曰∶本虚
而风寒所作，
何热也？若作肺热，何不治其肺而反调心？盖竹叶汤、牛黄膏治心药也。李师有惭色。钱治愈。
〔洁〕肺实则喘而气盛，泻白散。（方见治虚实法。）
〔钱〕东都张氏孙九岁，病肺热咳嗽，他医以朱、犀、龙、麝、牛黄药治之，一月不愈。其证咳
嗽喘急闷乱，饮水不止，全不能食，钱氏用使君子丸，益黄散。张曰∶本有热，何以又行温药？他医
用凉药攻之，一月尚无效。钱曰∶凉药久则胃寒不能食，小儿虚不能食，当与补脾，候饮食如故，即
泻肺经，病必愈矣。服补脾药二日，其子欲饮食，钱以泻白散泻肺遂愈。张曰∶何以不虚？钱曰∶先实
其脾，然后泻肺，故不虚也。
〔云〕小儿结热上气喘者，四顺散，一名清凉饮子。
〔《本》〕治小儿哮啼。
黄丹 砒霜
上各姜制为末，用枣肉为丸如麻子大。每服三丸，临卧，冷茶下。
〔丹〕痰嗽痰喘，并用涌法吐之。重剂，用瓜蒂散。轻剂，用苦参、赤小豆末，须虾齑汁调服之。
〔世〕万金丹治哮，痰涎喘急。（方见疟，大人通用。）
〔汤〕治肺中风，多因嗽而始，但服嗽药，不能散其风邪，入于肺脏之络，其候喘急，面色青黄，目
能认人，口不能言。医不能明其证，坐以待尽，不亦陋乎！绍兴王尚书女伴、老妪，得此病半月相继而死。
庸医俱不能识。又张南轩亦得此疾而逝，医师满目环视而立待尽。余悔不得一见，岂非天命也哉。后有亲
楼八哥之子病此症，是时乃一气之行，诸医皆言无术而退。子父来告急，但欲得别是何疾，亦不望其
活矣。余往视之，尚留残喘，以橘皮、桑白皮、罂粟壳三件煎汤，化百部丸二服，急灸肺 ，其喘立定，
而忽能言，继时索粥，自此生矣。鸣呼！是病有法不遇余者多矣，可深惜哉！
〔《素》〕帝曰∶乳子中风热，喘鸣肩息者，脉何如？岐伯曰∶喘鸣肩息者，脉实大也，缓则生，急则死。
（通评虚实论）
【钱乙】有喘息且咯出脓血症状的，这是肺热。应在饭后服用甘桔汤。久咳导致肺中津液耗损的，用阿胶散主治。咳嗽且痰涎壅盛结实，但喘息不严重，同时面部发红、想喝水的，可以用褊银丸攻下。（阿胶散即补肺散，方剂见治虚实法章节。褊银丸方剂见前文。）
甘桔散
桔梗（用米泔水浸泡一夜，焙干） 甘草（炒制。各二两）
以上药物研为细末，每次服用一大钱，加水一大盏，放入半两炮制过的阿胶，煎至五分量的时候，饭后温服。
【海藏】甘桔汤，是张仲景治疗少阴经咽痛的药方。孙思邈治疗肺痈吐脓血，使用生甘草加减二十余条。
【钱乙】段斋郎的儿子四岁，患咳嗽身体发热，吐痰数日后咯血，前医使用桔梗汤及防己丸治疗，未能痊愈，导致涎沫上逆攻冲，呕吐喘息不止，请钱乙诊治。钱乙先用褊银丸一大服攻下，随后用补肺汤、补肺散治疗。有人问段氏之子咯血属肺虚，为何还要用攻下法？钱乙说：肺虽然咯血，是因为有热邪的缘故，时间久了会导致虚痿。现在涎沫上潮而呕吐，应当先攻下其涎沫。如果不吐出涎沫，病情就不会好转。因为呕吐涎沫能导致正气虚弱，又容易引发惊风。痰涎实邪上攻，也能引发抽搐。所以根据法则只宜先攻下痰涎，然后补益脾肺，必须等到涎止呕吐停止，才是顺治之法。如果先补肺，就是逆治了。这就是所说的识别病情的轻重缓急来制定治疗先后顺序。
【李东垣】肺虚则喘息且气短，先用益黄散，后用补肺散。（两个方剂并见治虚实法章节。）
【钱乙】京东转运使李公孙八岁，患咳嗽且喘满气短。医生说肺经有热，使用竹叶汤、牛黄膏治疗，三天后喘息加重。钱乙说：这是肺气不足，又有寒邪侵袭，所以立即出现喘满，应当补益肺脾，不要服用凉药。李姓家属说：医生已经用了竹叶汤、牛黄膏。钱乙问：这是什么治疗方法？前医说：退热退涎。钱乙问：热邪是从哪里产生的？回答说：肺经热而生咳嗽，咳嗽久了不除产生涎沫。钱乙说：本是虚证受风寒所致，怎么说是热呢？如果认为是肺热，为什么不治肺反而调心？因为竹叶汤、牛黄膏是治疗心的药方。李姓家属面露惭愧之色。钱乙治愈了该病。
【李东垣】肺实则喘息且气盛，用泻白散。（方剂见治虚实法章节。）
【钱乙】东都张氏孙子九岁，患肺热咳嗽，其他医生用朱砂、犀角、龙骨、麝香、牛黄等药物治疗，一个月未愈。其症状为咳嗽喘息急促、胸闷烦乱，不停饮水，完全不能进食，钱乙使用使君子丸、益黄散。张某说：本来就有热，为什么又用温药？其他医生用凉药攻伐，一个月尚无效。钱乙说：凉药久用则胃寒不能进食，小儿体虚不能进食，应当给予补脾药，等到饮食恢复正常，再泻肺经之热，病必痊愈。服用补脾药两天后，其子想要饮食，钱乙用泻白散泻肺遂痊愈。张某问：为什么不会导致虚损？钱乙说：先充实其脾，然后泻肺，所以不会虚损。
【《本草》】治疗小儿哮鸣啼哭。
黄丹 砒霜
以上各用姜汁处理后研为细末，用枣肉做成如麻子大小的丸剂。每次服用三丸，临睡前，冷茶送下。
【丹溪】痰嗽痰喘，均用涌吐法使其吐出。重剂，用瓜蒂散。轻剂，用苦参、赤小豆末，需用虾酱汁调服。
【世医】万金丹治疗哮喘，痰涎喘急。（方剂见疟疾章节，大人通用。）
【汤氏】治疗肺中风，多因咳嗽开始，但只服止咳药，不能疏散风邪，风邪进入肺脏之络脉，其表现为喘息急促，面色青黄，眼睛能认人，口不能说话。医生不能明白此证候，坐以待毙，不也很浅陋吗！绍兴王尚书的女伴、老妪，得此病半月相继死亡。庸医都不能识别。还有张南轩也得了此疾去世，医师们满眼环视站立等待其死。我后悔没能一见，这难道不是天命吗？后来有亲戚楼八哥的儿子患此症，当时正值一气流行，众医都说无术而退去。孩子父亲来告急，只求知道是什么病，也不指望他能活了。我去诊视，尚留残喘，用橘皮、桑白皮、罂粟壳三味药煎汤，化开百部丸两服，紧急灸肺俞穴，其喘息立刻安定，忽然能说话，接着索要粥喝，从此活了下来。唉！这种病有法治却遇不到我的情况太多了，实在令人痛惜啊！
【《素问》】黄帝问：婴儿感受风热，喘息有声、耸肩呼吸的，脉象如何？岐伯说：喘息有声耸肩呼吸的，脉象实大，脉缓则生，脉急则死。（出自《通评虚实论》）
[Qian Yi] For those presenting with panting and expectorating pus and blood, this is due to Lung Heat. Ganjie Tang (Glycyrrhiza and Platycodon Decoction) should be taken after meals. For chronic coughs that have depleted the fluids of the Lung, Ejiao San (Donkey-hide Gelatin Powder) is the primary treatment. For coughing with phlegm-dampness accumulation and solidity, but without severe panting, accompanied by a red face and thirst, Bianyin Wan (Bismuth Pill) can be used to purge downwards. (Note: Ejiao San is identical to Bufei San; see the section on treating deficiency and excess for the formula. Bianyin Wan is found in the preceding text.)
Ganjie San
Jiegeng (Platycodonis Radix, soaked in rice wash overnight, then dried by baking)
Gancao (Licorice Root, stir-fried). Each two liang.
Grind the above into a fine powder. Take one da qian (approx. 3-5g) per dose, add one da zhan (approx. 200ml) of water, half liang of processed Ejiao (Colla Corii Asini), and decoct until only five fen remains. Take warm after meals.
[Hai Zang] Ganjie Tang is a formula from Zhang Zhongjing for treating sore throat due to Shaoyin channel involvement. Sun Simiao treated lung abscesses with expectoration of pus and blood using raw Gancao (Licorice Root) with modifications across more than twenty prescriptions.
[Danyu] For hemoptysis in children, decoct Heidou (Sojae Semen Nigrum), Gancao (Licorice Root), and Chenpi (Citri Reticulatae Pericarpium) and take orally.
[Qian Yi] The son of Duan Zhaolang, aged four, suffered from cough and fever. After several days of expectorating phlegm, he began to hemoptysis. Previous physicians treated him with Jiegeng Tang (Platycodon Decoction) and Fangji Wan (Stephania Pill) without success. This led to an upward attack of saliva/phlegm, resulting in continuous vomiting and panting. Qian Yi was consulted. He first administered a large dose of Bianyin Wan (Bismuth Pill) to purge, followed by Bufei Tang (Tonify Lung Decoction) and Bufei San (Tonify Lung Powder). Someone asked why purging was necessary when the child's hemoptysis indicated Lung deficiency. Qian Yi replied: Although the Lung exhibits hemoptysis, it is caused by heat. If prolonged, it leads to deficiency and atrophy. Currently, the upward flooding of saliva causing vomiting requires purging the saliva first. If the saliva is not expelled, the condition will not improve. Vomiting saliva depletes healthy qi and can also induce fright convulsions. Phlegm-dampness accumulation attacking upwards can also trigger convulsions. Therefore, according to the principle, one must first purge the phlegm, then tonify the Spleen and Lung. Only when the saliva stops and vomiting ceases is this considered a favorable course of treatment. Tonifying the Lung first would be contrary to the proper order. This illustrates the importance of recognizing the severity and sequence of pathology to determine treatment priority.
[Li Dongyuan] When the Lung is deficient, there is panting and shortness of breath. First use Yihuang San (Yellow Protector Powder), then Bufei San (Tonify Lung Powder). (Both formulas are found in the section on treating deficiency and excess.)
[Qian Yi] The grandson of Li, Transport Commissioner of Jingdong, aged eight, suffered from cough, panting, chest fullness, and shortness of breath. Physicians stated there was heat in the Lung channel and prescribed Zhuye Tang (Bamboo Leaf Decoction) and Niuhuang Gao (Calculus Bovis Ointment). After three days, the panting worsened. Qian Yi said: This is insufficient Lung qi combined with cold pathogenic factors, leading immediately to panting and fullness. One should tonify the Lung and Spleen and avoid cooling medicines. The father replied that the previous doctors had already used Zhuye Tang and Niuhuang Gao. Qian Yi asked what their rationale was. The previous doctors said they were clearing heat and resolving phlegm. Qian Yi asked: What caused the heat? They answered: Heat in the Lung channel generates cough; prolonged cough generates phlegm. Qian Yi said: This is fundamentally a deficiency pattern caused by wind-cold, not heat. If it were Lung heat, why treat the Heart instead of the Lung? Zhuye Tang and Niuhuang Gao are formulas for treating the Heart. The father showed signs of shame. Qian Yi cured the illness.
[Li Dongyuan] When the Lung is excessive, there is panting with abundant qi. Use Xiebai San (Drain White Powder). (Formula found in the section on treating deficiency and excess.)
[Qian Yi] The grandson of the Zhang family in the Eastern Capital, aged nine, suffered from Lung heat cough. Other physicians treated him with drugs containing Cinnabaris (Zhusha), Rhinoceros Horn (Xijiao), Dragon Bone (Longgu), Moschus (Shexiang), and Calculus Bovis (Niuhuang) for a month without improvement. His symptoms included coughing, rapid panting, chest oppression, confusion, incessant drinking, and complete inability to eat. Qian Yi prescribed Shijunzi Wan (Quisqualis Pill) and Yihuang San (Yellow Protector Powder). Mr. Zhang asked: There is originally heat; why use warming medicines? Other physicians had used cooling medicines to attack the pathogen for a month with no effect. Qian Yi said: Prolonged use of cooling medicines causes Stomach cold and inability to eat. Since the child is deficient and cannot eat, one must tonify the Spleen first. Once eating habits return to normal, then drain the Lung channel; the disease will surely heal. After two days of taking Spleen-tonifying medicine, the child desired food. Qian Yi then used Xiebai San (Drain White Powder) to drain the Lung, and the child recovered. Mr. Zhang asked: Why did this not cause further deficiency? Qian Yi said: By first solidifying the Spleen and then draining the Lung, deficiency is avoided.
[Yun Qizi] For children with accumulated heat causing upper body panting and wheezing, use Sishun San (Four Smooths Powder), also known as Qingliang Yinzi (Cooling Drink).
[Ben Cao] To treat pediatric asthma and crying.
Huangdan (Lead Monoxide)
Pishuang (Arsenic Trioxide)
Process each with ginger juice and grind into powder. Form pills the size of hemp seeds using jujube flesh. Take three pills before sleep, washed down with cold tea.
[Danyu] For cough and panting due to phlegm, use the method of inducing vomiting to expel the pathogen. For heavy cases, use Gouti San (Melon Sepal Powder). For mild cases, use powder of Kushen (Sophorae Flavescentis Radix) and Chixiaodou (Adzuki Bean), mixed with shrimp paste juice for administration.
[Worldly Physicians] Wanjindan (Ten Thousand Gold Pill) treats asthma and urgent panting with phlegm-saliva. (Formula found in the Malaria section, applicable to adults.)
[Tang Shi] Treating Wind-stroke of the Lung often begins with cough. However, merely taking antitussive medicines fails to disperse the wind pathogen, allowing it to enter the collaterals of the Lung organ. The manifestations include urgent panting, greenish-yellow complexion, ability to recognize people, but inability to speak. Physicians who do not understand this syndrome sit idle waiting for death, which is indeed shallow! In Shaoxing, the female companion and old maid of Minister Wang died successively within half a month of contracting this disease. Quack physicians failed to identify it. Zhang Nanxuan also died from this illness; physicians stood around looking helpless, waiting for death. I regret not having seen him; is this not destiny? Later, the son of my relative Lou Bagge contracted this disease. At that time, a specific qi was circulating, and all physicians claimed they had no remedy and withdrew. The child's father came in desperation, asking only what disease it was, not expecting survival. I went to examine him; he still had faint breathing. I decocted a soup of Chenpi (Citri Reticulatae Pericarpium), Sangbaipi (Morus Alba Bark), and Yingkesuqiao (Papaveris Pericarpium), administered two doses of Baibu Wan (Stemona Pill), and urgently moxa-ed Feishu (BL13). The panting stabilized immediately, he suddenly spoke, and subsequently asked for porridge. Thus, he survived. Alas! Many patients with this curable disease did not encounter me; it is deeply regrettable!
[Su Wen] The Yellow Emperor asked: When an infant contracts wind-heat and presents with panting, wheezing, and shoulder lifting during respiration, what is the pulse like? Qibo replied: In cases of panting, wheezing, and shoulder lifting, the pulse is excess and large. If the pulse is slow/harmonious, there is life; if rapid/tense, there is death. (From "Tong Ping Xu Shi Lun" - General Discussion on Deficiency and Excess)