《古今录验》宫泰说,李将军儿得病,喘息甚难,并数上气呼吸,疗之不瘥,遂亡。本
由食饼后乃饮水得之,服五味汤不瘥,此辈皆死。是后乃有婢得之,行极而渴饮水多,此为
所发起同,与五味汤亦不瘥,然后小瘥,泰因此与三物备急药半钱,吐下得瘥。由此思惟病
之所由,以冷水入肺及入肠,寒热不消化,结聚逼迫于胃口,故令其呼吸乏,气息不得下过
,谓喘而上气息数也,宜吐下之亦可,与三物瓜蒂散吐之。
三味备急散 本疗卒死,感忤,宫泰以疗人卒上气,呼吸气不得下,喘逆瘥后,已为常
用方。
巴豆 干姜 大黄
上药等分,巴豆小熬,去心、皮,合捣下筛。服半钱匕,得吐下则愈。忌野猪肉、芦笋
。(《范汪》同)
又三味吐散 宫泰以疗上气呼吸喘逆方。
瓜蒂(三分) 杜蘅(三分) 人参(一分)
上药捣筛为散。以温汤服一钱匕,老小半之。(《范汪》同,并出第十九卷中)
《肘后》疗大走、马奔走喘乏,便饮冷水、冷冻饮料,因得上气发热方。
竹叶(三斤) 橘皮(三两切)
上二味,以水一斗半,煮取三升,去滓,分为三服,三日服一剂,良。《集验》用竹叶
三两。(文仲、《备急》、《范汪》等同)
又方
葶苈子(一两熬,捣) 干枣(四十颗)
上二味,以水三升,先煮枣,取一升,纳葶苈子,煎取五合。大人分一二服,小儿分三
四服。(并出第一卷中)
《古今录验》中宫泰记载:李将军的儿子患病,喘息非常困难,并且频繁出现气逆上冲、呼吸急促的症状,经过治疗没有好转,最终死亡。这原本是因为吃了饼之后又喝水导致的,服用五味汤后病情未愈,这类患者大多死亡。后来有一个婢女也得了同样的病,因行走极度疲劳且口渴而大量饮水,发病原因与此相同,服用五味汤也未见效,之后病情稍有好转。宫泰因此给予三物备急药半钱匕的量,通过催吐和泻下的方法使病情痊愈。由此思考疾病的成因,认为是冷水进入肺部和肠道,寒热之气无法消化,凝结聚集并压迫胃脘部,从而导致呼吸短促,气息不能下行,这就是所谓的“喘”以及气逆呼吸急促。这种情况适宜采用催吐或泻下的疗法,可以使用三物瓜蒂散进行催吐。
三味备急散:原本用于治疗猝死、邪气冲撞(感忤),宫泰将其用于治疗人突然气逆上冲、呼吸气息不能下行的症状。在喘息气逆症状缓解后,已成为常用方剂。
药材:巴豆、干姜、大黄。
以上药物等分,将巴豆轻微炒制,去掉心部和皮,混合捣碎过筛。每次服用半钱匕的量,如果产生呕吐或腹泻则病愈。忌食野猪肉、芦笋。(《范汪》中的记载相同)
又一方:三味吐散。宫泰用此方治疗气逆上冲、呼吸喘息气逆。
药材:瓜蒂(三分)、杜蘅(三分)、人参(一分)。
以上药物捣碎过筛制成散剂。用温水送服一钱匕,老人和儿童减半服用。(《范汪》中记载相同,均出自第十九卷)
《肘后备急方》治疗剧烈奔跑、马匹奔驰导致喘息乏力,随即饮用冷水、冷冻饮料,因而引发气逆发热的方法。
药材:竹叶(三斤)、橘皮(三两,切)。
以上两味药,用水一斗五升,煮取三升药液,去除药渣,分三次服用,每三天服用一剂,效果良好。《集验方》中使用竹叶三两。(文仲、《备急方》、《范汪》中记载相同)
又一方:
药材:葶苈子(一两,炒制后捣碎)、干枣(四十颗)。
以上两味药,用水三升,先煮大枣,取出一升药液,加入葶苈子,煎取五合药液。成人分一到两次服用,小儿分三到四次服用。(均出自第一卷)
According to *Gujin Luyian* (Records of Antiquity and Modern Times), Gong Tai recorded: The son of General Li fell ill with severe dyspnea, accompanied by frequent upward rushing of Qi and rapid breathing. Despite treatment, the condition did not improve, and he eventually died. This illness originated from drinking water after eating flatbread. Administration of Wuwei Tang (Five-Flavor Decoction) was ineffective, and patients with this presentation generally succumbed. Later, a maid contracted the same illness; she walked until exhausted and thirsty, then drank large amounts of water. The etiology was identical, yet Wuwei Tang also failed to cure her. Her condition improved slightly afterward. Consequently, Gong Tai administered half a qianbi dose of Sanwu Beiji Yao (Three-Ingredient Emergency Medicine). Through inducing vomiting and purging, she recovered. Reflecting on the origin of the disease, it was deduced that cold water entering the lungs and intestines resulted in an inability to digest the conflicting cold and heat energies. These energies condensed and gathered, compressing the epigastrium, thereby causing shortness of breath and preventing Qi from descending. This is termed "wheezing" (Chuan) and rapid, rebellious breathing. Such cases are suitable for emetic or purgative therapies; specifically, Sanwu Goudi San (Three-Ingredient Melon Seed Powder) can be used to induce vomiting.
Sanwei Beiji San (Three-Ingredient Emergency Powder): Originally indicated for sudden death and shock due to pathogenic invasion. Gong Tai utilized it to treat sudden upward rushing of Qi with respiratory distress where Qi fails to descend. After the resolution of wheezing and rebellious Qi, it became a commonly used formula.
Ingredients: Crotonis Fructus (Badou, 巴豆), Zingiberis Rhizoma (Ganjiang, 干姜), Rhei Radix et Rhizoma (Dahuang, 大黄).
The above ingredients are taken in equal proportions. Crotonis Fructus is lightly roasted, the heart and skin removed, then mixed, pounded, and sieved. Administer half a qianbi dose. Recovery occurs upon induction of vomiting or purging. Avoid wild boar meat and reed shoots. (Consistent with records in *Fan Wang*)
Another Formula: Sanwei Tusan (Three-Ingredient Emetic Powder). Gong Tai used this prescription to treat upward rushing of Qi with wheezing and rebellious respiration.
Ingredients: Cucumeris Fructus (Gua Di, 瓜蒂) - 3 fen, Asarum heterotropoides (Duheng, 杜蘅) - 3 fen, Ginseng Radix (Renshen, 人参) - 1 fen.
Pound and sieve the above ingredients into a powder. Administer one qianbi dose with warm water; reduce the dose by half for the elderly and children. (Consistent with *Fan Wang*, both cited from Volume 19)
*Zhouhou Beiji Fang* (Handbook of Prescriptions for Emergencies) treats severe exertion from running or horse riding leading to asthenic wheezing, followed by the consumption of cold water or frozen beverages, resulting in upward rushing of Qi and fever.
Ingredients: Bambusae Folium (Zhuye, 竹叶) - 3 jin, Citri Reticulatae Pericarpium (Jupi, 橘皮) - 3 liang, sliced.
Boil the above two ingredients in 15 sheng of water until reduced to 3 sheng. Strain the dregs. Divide into three doses. Take one course of treatment every three days. This is effective. (*Jiyan Fang* uses 3 liang of Zhuye.) (Consistent with records by Wen Zhong, *Beiji Fang*, and *Fan Wang*)
Another Formula:
Ingredients: Lepidii Semen (Tinglizi, 葶苈子) - 1 liang, roasted and pounded; Jujubae Fructus (Ganzao, 干枣) - 40 pieces.
Boil the Jujubae Fructus in 3 sheng of water until reduced to 1 sheng. Add Lepidii Semen and decoct until 5 he remains. Adults divide this into one or two doses; children divide it into three or four doses. (Cited from Volume 1)