2.短气气短不能续, 少气气少不足言, 气痛走注内外痛, 气郁失志
怫情间, 上气气逆苏子降, 下气气陷补中宣, 臭甚伤食肠胃郁, 减食
消导自然安.
【注】短气者, 气短而不能续息也; 少气者, 气少而不能称形也, 皆
为不足之证. 气痛者, 气为邪阻, 气道不通, 或在经络, 或在脏腑,
攻冲走注疼痛也. 上气, 乃浊气上逆; 下气, 为清气下陷. 气郁者,
或得于名利失志, 或得于公私怫情, 二者之间也. 浊气上逆, 苏子降
气汤. 清气下陷, 补中益气汤, 甚者加诃子, 五味子. 然清气下陷,
下气不甚臭秽, 惟伤食下气, 甚臭甚秽, 乃肠胃郁结, 谷气内发, 而
不宣通于肠胃之外. 郁在胃者, 上噫气也. 郁在肠者, 下矢气也. 补
中益气汤, 方见内伤门.
3.寒热热寒结者散, 上抑下举惊者平, 喜以恐胜悲以喜, 劳温短少
补皆同.
【注】寒者热之, 麻黄理中是也. 热者寒之, 白虎生脉是也. 结者散
之,越鞠解郁是也. 上者抑之, 苏子降气是也. 下者举之, 补中益气
是也. 惊者平之, 镇心, 妙香是也. 喜以恐胜, 悲以喜胜, 以情治情
是也. 劳者温之, 短气, 少气者补之, 保元四君是也.
2. 短气是指呼吸短促、气息不能接续;少气是指气息微弱、不足以言语。气痛表现为疼痛部位游走不定,内外皆痛;气郁则导致意志消沉、心情抑郁不畅。对于上逆之气(气机上逆),可用苏子降气汤来降逆;对于下陷之气(中气下陷),可用补中益气汤来升提宣通。若排气气味恶臭,多因饮食停滞导致肠胃郁结,采用消食导滞的方法治疗,身体自然安宁。
【注】所谓短气,就是呼吸短促而不能连续喘息;所谓少气,就是气息虚弱不足以支撑形体活动,这两种情况都属于虚证。所谓气痛,是因为气被邪气阻滞,气道不通畅,疼痛可能在经络,也可能在脏腑,呈现攻冲走窜的疼痛特点。上气,是指浊气上逆;下气,是指清气下陷。气郁,有的是因为追求名利失败而意志消沉,有的是因为公私事务导致心情抑郁,这两种情况属于此类。针对浊气上逆,使用苏子降气汤。针对清气下陷,使用补中益气汤,病情严重的加诃子、五味子。然而,清气下陷导致的排气气味不很臭秽,只有伤食导致的排气,气味非常臭秽,这是肠胃郁结,谷气内发,但不能在肠胃之外宣通所致。郁结在胃的,表现为打嗝(噫气);郁结在肠的,表现为放屁(矢气)。补中益气汤,方剂内容见内伤门。
3. 寒热错杂且凝结的,用散结法;气机上逆的加以抑制,气机下陷的加以举托;受惊的使其平静;用喜胜悲、用恐胜喜的情志相胜疗法;劳损者用温补法,短气、少气者用补益法,原则都是相同的。
【注】寒证用热药治疗,如麻黄汤、理中汤即是;热证用寒药治疗,如白虎汤、生脉散即是;结滞的予以消散,如越鞠丸解郁即是;气机上逆的予以抑制,如苏子降气汤即是;气机下陷的予以举托,如补中益气汤即是;受惊的予以平复,如镇心丹、妙香散即是。用喜悦克服悲伤,用恐惧克服喜悦,这是以情治情的方法。劳损者用温养之法,短气、少气的用补益之法,如保元汤、四君子汤即是。
2. *Duanqi* (Shortness of breath) refers to short, rapid breathing where the breath cannot be sustained; *Shaoqi* (Deficiency of qi) refers to weak qi that is insufficient for speech. Pain caused by qi stagnation manifests as wandering pain affecting both interior and exterior; qi depression leads to low spirits and depressed mood. For rebellious qi (rebellious qi mechanism), *Suzi Jiangqi Tang* (Perilla Fruit Decoction to Direct the Qi Downward) is used to direct it downward; for sinking qi (sinking middle qi), *Buzhong Yiqi Tang* (Decoction to Supplement the Middle and Augment the Qi) is used to raise and diffuse it. If flatulence has a foul odor, it is often due to food retention causing stagnation in the stomach and intestines; treating with digestive methods brings natural relief.
[Note] *Duanqi* means shortness of breath where respiration cannot continue smoothly; *Shaoqi* means deficient qi that cannot support the physical form; both are signs of deficiency syndromes. Qi pain occurs when qi is obstructed by pathogenic factors, blocking the qi channels, causing attacking and wandering pain either in the meridians or in the zang-fu organs. "Shangqi" (Upper qi/rebellious qi) refers to turbid qi rebelling upward; "Xiaqi" (Lower qi/sinking qi) refers to clear qi sinking downward. Qi depression arises either from frustration over failed pursuit of fame and wealth, or from suppressed emotions regarding public and private matters. For turbid qi rebelling upward, *Suzi Jiangqi Tang* (Perilla Fruit Decoction to Direct the Qi Downward) is used. For clear qi sinking downward, *Buzhong Yiqi Tang* (Decoction to Supplement the Middle and Augment the Qi) is used; in severe cases, add *Hezi* (Chebulae Fructus) and *Wuweizi* (Schisandrae Chinensis Fructus). However, flatulence resulting from sinking clear qi is not very foul-smelling. Only flatulence resulting from food retention is extremely foul; this is due to stagnation in the stomach and intestines, where grain qi erupts internally but fails to diffuse externally through the gastrointestinal tract. Stagnation in the stomach manifests as belching (*Yiqi*); stagnation in the intestines manifests as passing flatus (*Shiqi*). *Buzhong Yiqi Tang* (Decoction to Supplement the Middle and Augment the Qi) is detailed in the Internal Injury section.
3. For cold-heat complex with knotting, use dispersing methods; for ascending qi, suppress it; for descending qi, elevate it; for fright, calm it; use joy to overcome sorrow, and fear to overcome joy (emotional counter-treatment); for exhaustion, use warming tonification; for shortness of breath and deficient qi, use tonification; these principles are consistent.
[Note] Cold syndromes are treated with heat therapies, such as *Mahuang Tang* (Ephedra Decoction) and *Lizhong Tang* (Regulate the Middle Decoction). Heat syndromes are treated with cold therapies, such as *Baihu Tang* (White Tiger Decoction) and *Shengmai San* (Generate the Pulse Powder). Knotting is dispersed, as in *Yueju Wan* (Pill to Resolve Depression). Ascending qi is suppressed, as in *Suzi Jiangqi Tang* (Perilla Fruit Decoction to Direct the Qi Downward). Descending qi is elevated, as in *Buzhong Yiqi Tang* (Decoction to Supplement the Middle and Augment the Qi). Fright is calmed, as in *Zhenxin Dan* (Heart-Calming Pill) and *Miaoxiang San* (Wonderful Fragrance Powder). Using joy to overcome sorrow, and fear to overcome joy, constitutes treatment via emotional regulation. Exhaustion is warmed, while shortness of breath and deficient qi are tonified, using formulas such as *Baoyuan Tang* (Preserve the Origin Decoction) and *Sijunzi Tang* (Four Gentlemen Decoction).