喘急息肩，浮滑者顺。沉涩肢寒，散脉逆证。
呼吸疾速曰喘，气息短促曰急。息肩者，肩随息动。吸则提气，呼则舒气。出
入不利，故肩亦为之耸动耳。脉浮滑者，浮为阳、为表、为风。（宜汗解。仲景麻黄汤或香苏
散，及枳桔桑杏之类。）滑为阳、为痰、为食。（痰宜枳桔二陈汤、蒌仁、苏子，及三子养亲汤之
类。食宜丹溪保和丸、平胃散、和剂小七香丸或瓜蒂散吐之。）盖因外邪闭遏，或为内物阻挠，致令
机关壅滞，胸膈痞塞，而为喘急息肩者有矣。苟能散其邪，则机关可利；推其物，则痞塞可通，
故曰顺。脉沉涩者，沉为阴、为里、为下部。涩为阴、为虚。乃元气不能接续，不
能舒徐以达上焦。不能达上，又岂能充四肢乎？是以喘急息肩而四肢又寒也。若更见散脉，则
元真将随喘而散，死亡必矣。故曰逆。（脉涩肢寒，阳退陷而不达。喘息脉散，阳散越而脱根。）
仲景麻黄汤（见第十六）
香苏散（宝鉴）治水气虚肿，小便赤涩。
陈皮（去白，一两） 防己 木通 紫苏叶（各半两）
上为末，每服二钱。水二盏，生姜三片，煎至一盏。去滓，食前温服。
枳桔二陈汤（即二陈加枳壳桔梗）
三子养亲汤 治年高痰盛气实，并气壅哮喘等证。
紫苏子（沉水者） 白芥子 萝卜子（各三钱）
上水二钟，姜二片，煎七分，食后服。
丹溪保和丸（见第十七）
平胃散（见第四十四）
和剂小七香丸（见第十七）
仲景瓜蒂散
瓜蒂（二十个）
上锉。以水一升，煮取五合。去滓顿服。
喘促气急且耸肩呼吸，脉象浮滑的属于顺证。脉象沉涩且四肢发冷的，若见散脉则为逆证（预后不良）。
呼吸急促称为“喘”，气息短促称为“急”。“息肩”是指肩膀随着呼吸而上下耸动。吸气时提气，呼气时舒气。如果出入呼吸不利，所以肩膀也会随之耸动。脉象浮滑，浮脉主阳、主表、主风邪。（适宜用发汗法解表。可用张仲景的麻黄汤或香苏散，以及枳壳桔梗、桑叶杏仁之类的方药。）滑脉主阳、主痰、主食积。（痰证适宜用枳桔二陈汤、瓜蒌仁、紫苏子，以及三子养亲汤之类的方药。食积适宜用朱丹溪的保和丸、平胃散、《太平惠民和剂局方》的小七香丸，或者用瓜蒂散催吐。）这是因为外邪闭阻，或者体内食物阻滞，导致气机壅滞，胸膈痞塞，从而出现喘促气急耸肩的症状。如果能够发散邪气，那么气机就可以通畅；推荡积滞之物，那么痞塞就可以疏通，所以称为顺证。脉象沉涩，沉脉主阴、主里、主下部病变。涩脉主阴、主虚。这是元气不能接续，不能舒缓地到达上焦。既然不能到达上焦，又怎么能充养四肢呢？因此出现喘促气急耸肩且四肢寒冷的症状。如果再见到散脉，那么元真之气将随着喘息而耗散，必然死亡。所以称为逆证。（脉涩肢寒，是阳气退陷而不能通达。喘息脉散，是阳气散越而脱根。）
张仲景麻黄汤（见第十六章）
香苏散（出自《卫生宝鉴》）治疗水气虚肿，小便赤涩。
陈皮（去白，一两） 防己 木通 紫苏叶（各半两）
以上药物研为细末，每次服用二钱。加水两盏，生姜三片，煎煮至一盏。去除药渣，饭前温服。
枳桔二陈汤（即二陈汤加入枳壳、桔梗）
三子养亲汤 治疗年老痰盛气实，以及气壅哮喘等证候。
紫苏子（以沉水者为佳） 白芥子 萝卜子（各三钱）
以上用水两钟，生姜两片，煎煮至七分，饭后服用。
朱丹溪保和丸（见第十七章）
平胃散（见第四十四章）
《太平惠民和剂局方》小七香丸（见第十七章）
张仲景瓜蒂散
瓜蒂（二十个）
以上切碎。用水一升，煮取五合。去除药渣，一次性顿服。
Panting with urgency and shoulder shrugging, accompanied by a floating and slippery pulse, indicates a favorable prognosis (Shun). A deep and choppy pulse with cold limbs, or a scattered pulse, indicates an unfavorable prognosis (Ni).
Rapid breathing is termed "Chuan" (panting), while shortness of breath is termed "Ji" (urgency). "Xi Jian" (shoulder shrugging) refers to the shoulders moving up and down with respiration. During inhalation, Qi is drawn up; during exhalation, Qi is released. When the movement of Qi in and out is obstructed, the shoulders consequently rise and fall. A floating and slippery pulse: Floating indicates Yang, exterior syndrome, and wind pathogen. (Sweating therapy is suitable. Zhongjing's Mahuang Tang or Xiangsu San, as well as formulas containing Zhiqiao, Jiegeng, Sangye, and Xingren, may be used.) Slippery indicates Yang, phlegm, and food retention. (For phlegm, Zhijie Erchen Tang, Louren, and Suzi, or Sanszi Yangqin Tang are suitable. For food retention, Danxi's Baohe Wan, Pingwei San, Xiaoqixiang Wan from Heji, or Guiti San for emesis are suitable.) This occurs because external pathogens close off the orifices, or internal obstructions hinder the flow, causing stagnation of the mechanisms and fullness in the chest and diaphragm, leading to panting, urgency, and shoulder shrugging. If the pathogen can be dispersed, the mechanisms will become unobstructed; if the obstructing matter can be pushed away, the fullness will be cleared. Therefore, this is called favorable. A deep and choppy pulse: Deep indicates Yin, interior syndrome, and lower body involvement. Choppy indicates Yin and deficiency. This signifies that Yuan Qi (Original Qi) cannot connect continuously and cannot reach the Upper Jiao smoothly. Since it cannot reach the Upper Jiao, how can it nourish the four limbs? Thus, panting, urgency, shoulder shrugging, and cold limbs occur. If a scattered pulse is also seen, the Yuan Zhen (True Qi) will dissipate along with the panting, leading to certain death. Therefore, this is called unfavorable. (A choppy pulse and cold limbs indicate Yang retreating and failing to penetrate. Panting with a scattered pulse indicates Yang dissipating and losing its root.)
Zhongjing's Mahuang Tang (See Chapter 16)
Xiangsu San (from *Weisheng Baojian*) treats edema due to water qi deficiency and red, scanty urination.
Chenpi (peel removed, 1 liang) Fangji Mutong Zisuye (each 0.5 liang)
Grind the above into powder. Take 2 qian per dose. Add 2 zhan of water and 3 slices of fresh ginger, decoct until 1 zhan remains. Remove the dregs and take warm before meals.
Zhijie Erchen Tang (Erchen Tang plus Zhiqiao and Jiegeng)
Sanszi Yangqin Tang treats excessive phlegm and excess Qi in the elderly, as well as Qi stagnation and asthma.
Zisuzi (those that sink in water are preferred) Baijieziluoboziz (each 3 qian)
Add 2 zhong of water and 2 slices of ginger, decoct until 7 fen remains. Take after meals.
Danxi's Baohe Wan (See Chapter 17)
Pingwei San (See Chapter 44)
Xiaoqixiang Wan from *Heji* (See Chapter 17)
Zhongjing's Guiti San
Guiti (20 pieces)
Cut into small pieces. Add 1 sheng of water, boil to obtain 5 he. Remove the dregs and take in one dose.