1.喘则呼吸气急促, 哮则喉中有响声, 实热气粗胸满硬, 虚寒气乏
饮痰清.
【注】呼吸气出急促者, 谓之喘急. 若更喉中有声响者, 谓之哮吼.
气粗胸满不能布息而喘者, 实邪也, 而更痰稠便鞭者, 热邪也. 气乏
息微不能续息而喘, 虚邪也, 若更痰饮清冷, 寒邪也.
2.喘汗润发为肺绝, 脉涩肢寒命不昌, 喘咳吐血不得卧, 形衰脉大
气多亡.
【注】气多, 谓出气多, 入气少也.
华盖汤 千金定喘汤 葶苈大枣汤
3.外寒喘吼华盖汤, 麻杏苏草橘苓桑, 减苓加芩款半果, 饮喘难卧
枣葶方.
【注】外寒伤肺喘急, 用华盖散. 即麻黄, 杏仁, 苏子, 甘草, 橘红
,赤茯苓, 桑皮也. 根据本方减茯苓, 加黄芩, 款冬花, 半夏, 白果,
名千金定喘汤, 治哮吼表寒之喘. 葶苈大枣汤, 治停饮不得卧之喘也
.
萝皂丸 苏子降气汤
4.火郁喘急泻白散, 痰盛作喘萝皂丸, 蒌仁海石星萝皂, 气喘苏子
降气痊.
【注】面赤浮肿, 谓之火郁之喘, 宜泻白散. 痰盛声急, 谓之痰喘,
宜萝皂丸. 无痰声急, 谓之气喘, 宜苏子降气汤. 方在诸气门.
五味子汤 黑锡丹 肾气汤 人参理肺汤
5.气虚味麦参陈杏, 虚寒黑锡肾气汤, 日久敛喘参桔味, 麻杏罂粟
归木香.
【注】五味子汤, 即五味子, 麦冬, 人参, 陈皮, 杏仁也. 人参理肺
汤, 即人参, 桔梗, 五味子, 麻黄, 杏仁, 罂粟壳, 当归, 木香也.
黑锡丹, 方在浊带门. 肾气汤, 方在虚劳门.
1. 喘证表现为呼吸气促,哮证表现为喉间有响声。实证多为热气盛、呼吸粗重、胸部胀满坚硬;虚证多为寒气盛、气息乏力、痰饮清稀。
【注】呼吸急促者,称为喘急。如果喉间还有声响的,称为哮吼。呼吸粗重、胸部胀满、气息不能顺畅布散而喘的,属于实邪;若同时伴有痰液粘稠、大便干结的,属于热邪。气息微弱、呼吸短促难以接续而喘的,属于虚邪;若同时伴有痰饮清冷的,属于寒邪。
2. 喘促伴汗出如油、头发湿润是肺气将绝的表现;脉象涩滞、四肢寒冷预示生命不昌。喘咳吐血、无法平卧,形体衰败且脉象大,说明元气即将耗亡。
【注】“气多”,指出气多而入气少。
华盖汤、千金定喘汤、葶苈大枣汤
3. 外感寒邪引起的喘吼用华盖汤治疗,方由麻黄、杏仁、苏子、甘草、橘红、茯苓、桑白皮组成。减去茯苓,加入黄芩、款冬花、半夏、白果,名为千金定喘汤,用于治疗表寒引起的哮吼喘证。葶苈大枣汤用于治疗水饮停聚导致不得平卧的喘证。
萝皂丸、苏子降气汤
4. 火郁引起的喘急用泻白散治疗;痰盛引起的喘证用萝皂丸治疗,方由瓜蒌仁、海浮石、天南星、皂角组成;气喘用苏子降气汤治疗可痊愈。
【注】面赤浮肿,称为火郁之喘,适宜用泻白散。痰多声急,称为痰喘,适宜用萝皂丸。无痰声急,称为气喘,适宜用苏子降气汤。方剂见诸气门章节。
五味子汤、黑锡丹、肾气汤、人参理肺汤
5. 气虚引起的喘证用五味子汤治疗,方由五味子、麦冬、人参、陈皮、杏仁组成;虚寒引起的喘证用黑锡丹或肾气汤治疗;日久收敛止喘用人参桔梗五味子汤,方由人参、桔梗、五味子、麻黄、杏仁、罂粟壳、当归、木香组成。
【注】五味子汤,即五味子、麦冬、人参、陈皮、杏仁。人参理肺汤,即人参、桔梗、五味子、麻黄、杏仁、罂粟壳、当归、木香。黑锡丹,方剂见浊带门章节。肾气汤,方剂见虚劳门章节。
1. Chuan (Wheezing) is characterized by rapid and labored breathing, while Xiao (Asthmatic Wheeze) is characterized by sounds in the throat. Excess patterns involve abundant heat, coarse breathing, chest fullness, and hardness; deficiency patterns involve cold qi, lack of energy, and clear, thin phlegm-fluids.
[Note] Rapid exhalation is called Chuan Ji (Urgent Wheezing). If accompanied by sounds in the throat, it is called Xiao Hou (Asthmatic Roar). Coarse breathing, chest fullness, inability to distribute breath smoothly, and wheezing indicate Excess pathogenic factors. If accompanied by thick phlegm and hard stools, it indicates Heat pathogenic factors. Weak breath, faint respiration, inability to continue breathing, and wheezing indicate Deficiency pathogenic factors. If accompanied by clear and cold phlegm-fluids, it indicates Cold pathogenic factors.
Hua Gai Tang (Covering Canopy Decoction), Qian Jin Ding Chuan Tang (Thousand-Gold Asthma-Calming Decoction), Ting Li Da Zao Tang (Descurainia Seed and Jujube Decoction)
2. Wheezing with sweating that moistens the hair indicates Lung Qi exhaustion; a choppy pulse and cold limbs indicate impending death. Wheezing, coughing, hemoptysis, and inability to lie flat, combined with physical emaciation and a large pulse, indicate the loss of vital Qi.
[Note] "Excessive Qi" refers to excessive exhalation and insufficient inhalation.
3. For wheezing and roaring caused by external Cold attacking the Lungs, use Hua Gai Tang. It consists of Ephedrae Herba (Mahuang, 麻黄), Armeniacae Semen Amarum (Xingren, 杏仁), Perillae Fructus (Suzi, 苏子), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Citri Reticulatae Pericarpium (Juhong, 橘红), Poria (Fuling, 茯苓), and Mori Cortex (Sangbai, 桑白皮). By reducing Poria and adding Scutellariae Radix (Huangqin, 黄芩), Dendrobii Flos (Kuandonghua, 款冬花), Pinelliae Rhizoma (Banxia, 半夏), and Ginkgo Semen (Baiguo, 白果), it becomes Qian Jin Ding Chuan Tang, used for asthmatic wheezing due to exterior Cold. Ting Li Da Zao Tang is used for wheezing caused by retained fluids preventing lying flat.
Luo Zao Wan (Melon Seed and Soap Pod Pill), Su Zi Jiang Qi Tang (Perilla Fruit Descending-Qi Decoction)
4. For urgent wheezing due to Fire depression, use Xie Bai San (Drain White Powder). For wheezing due to abundant phlegm, use Luo Zao Wan, composed of Trichosanthis Fructus (Louren, 瓜蒌仁), Pumex (Haishi, 海浮石), Arisaematis Rhizoma (Tianxing, 天南星), and Gleditsiae Sinensis Fructus (Zaocao, 皂角). For Qi wheezing, Su Zi Jiang Qi Tang leads to recovery.
[Note] Red face and edema are called wheezing due to Fire depression, suitable for Xie Bai San. Abundant phlegm and urgent sounds are called Phlegm-wheezing, suitable for Luo Zao Wan. Absence of phlegm with urgent sounds is called Qi-wheezing, suitable for Su Zi Jiang Qi Tang. See the Chapter on Various Qi Disorders for formulas.
Wu Wei Zi Tang (Schisandra Decoction), Hei Xi Dan (Black Tin Pill), Shen Qi Tang (Kidney Qi Decoction), Ren Shen Li Fei Tang (Ginseng Regulating-Lung Decoction)
5. For Qi-deficiency wheezing, use Wu Wei Zi Tang, composed of Schisandrae Fructus (Wuweizi, 五味子), Ophiopogonis Tuber (Maidong, 麦冬), Ginseng Radix (Renshen, 人参), Citri Reticulatae Pericarpium (Chenpi, 陈皮), and Armeniacae Semen Amarum (Xingren, 杏仁). For deficiency-cold wheezing, use Hei Xi Dan or Shen Qi Tang. For long-term wheezing requiring astringency, use Ren Shen Ju Wei Zi Tang, composed of Ginseng Radix (Renshen, 人参), Platycodonis Radix (Jiegeng, 桔梗), Schisandrae Fructus (Wuweizi, 五味子), Ephedrae Herba (Mahuang, 麻黄), Armeniacae Semen Amarum (Xingren, 杏仁), Papaveris Capsula (Yingsuke, 罂粟壳), Angelicae Sinensis Radix (Danggui, 当归), and Aucklandiae Radix (Muxiang, 木香).
[Note] Wu Wei Zi Tang consists of Schisandrae Fructus, Ophiopogonis Tuber, Ginseng Radix, Citri Reticulatae Pericarpium, and Armeniacae Semen Amarum. Ren Shen Li Fei Tang consists of Ginseng Radix, Platycodonis Radix, Schisandrae Fructus, Ephedrae Herba, Armeniacae Semen Amarum, Papaveris Capsula, Angelicae Sinensis Radix, and Aucklandiae Radix. Hei Xi Dan is found in the Chapter on Turbid Discharges and Leukorrhea. Shen Qi Tang is found in the Chapter on Consumption and Emaciation.