治眉棱骨痛不可忍者,此痰厥也。
半夏(不拘多少,汤洗七次,切作片子)
上每服三钱,水一盏半,生姜十片,煎八分,去滓,食后温服。
诸喘为热。夫火热为阳,主乎急数,而火动于上,喘急乃作。若夏热甚,则息数气粗,
喘之属热无疑矣。经云,诸逆冲上,皆属相火者此也。盖肺主气为阳,阳气流行,通荣脏腑
,故肺为五脏之华盖,喜清虚不欲窒涩,若阴气在下,阳气在上,与气之有余者,则发咳呕
而喘急也。《圣济方》云∶呼随阳出气,于是升,吸随阴入气,于是降。一升一降,阴阳乃
和,苟有乖和,则气上不行,升而不降,痞塞膈中,气道奔迫,喘息有声也。又风寒暑湿,
邪气相干,肺张满而喘者,或喜怒之气,伤于五气,郁而生痰作喘者,或肺肾俱虚,由体弱
不能摄养一身之痰而喘者,或脾湿肿满,水气乘呻而喘者,或本脏虚风邪所干,于肺叶气壅
遏而上冲者,岂可一概而论之?《内经·灵枢》诸篇,所论诸喘,而名不同,所感各异。若
言喘喝,与言喘息,言喘迫,言喘致,言喘呕,言上气者,虽名不同,而病之皆出于肺。《
内经》又云∶卧则喘者,水气之客。《经脉篇》云∶夜行则喘出于肾;淫气病肺,有所堕恐
,喘出于肝;淫气害脾,有所惊恐,喘出于肺;淫气伤心,度水跌仆,喘出于肾与骨。《痹
论篇》云∶腰痹者,中气喘争。《大奇篇》云∶肺之喘而两怯满。《至真大要篇》论太阴司
天为客胜,则首面 肿,呼吸喘气。《阳明篇》云∶谓邪入六腑,身热喘呼,不得卧也,此
各藏所感之异乎?仲景云∶发汗如油,汗出如珠不流,喘而不休者,此为不治。其脉滑而手
足温者生,脉涩四肢厥者死。又有妇人喘急,为病尤亟。因产后所下过多,荣气暴竭,卫气
无根据,独聚于肺,故发喘也,此名孤阳绝阴,为难治。治法∶外感者以祛散之,气之内郁者
以调顺为先,肾虚者宜以温补,痰盛者当以疏导,有阴血虚少而上喘者,宜以滋阴养荣之剂
。所论前证,临期用药,在乎消息,治之无不愈矣。
治疗眉棱骨疼痛难以忍受的症状,这是痰厥病。
半夏(数量不限,用开水清洗七次,切成片)
每次服用三钱,加水一盏半,生姜十片,煎煮至剩余八分药液,滤去药渣,饭后温服。
各种喘证多属热证。火热之邪属于阳,其特性是急迫且脉数,火气上炎扰动,导致喘息急促发作。如果夏季炎热严重,则呼吸次数增多、气息粗重,这显然是属于热证的喘。医经说,所有向上冲逆的症状,都属于相火的范畴。肺主司气,属性为阳,阳气运行通畅,能通达滋养脏腑,所以肺被称为五脏的华盖,喜欢清虚而厌恶窒塞不通。如果阴气在下,阳气在上,加上气机有余,就会引发咳嗽、呕吐和喘息急促。《圣济方》说:呼气随着阳气而出,气于是上升;吸气随着阴气而入,气于是下降。一升一降,阴阳才能调和。如果有乖违不和,气就不能上行,只升不降,痞塞在膈中,气道奔迫,从而产生有声音的喘息。另外,风寒暑湿等邪气相互干扰,导致肺胀满而喘的;或者因喜怒等情志之气,损伤五脏之气,郁结而生痰导致喘的;或者肺肾两虚,因体质虚弱不能摄养全身之痰而致喘的;或者脾虚湿盛肿胀,水气乘袭而致喘的;或者本脏虚弱受风邪干扰,肺气壅遏而上冲的,怎么能一概而论呢?《内经·灵枢》各篇所论述的各种喘证,名称不同,感受的病因也各异。如果说喘喝、喘息、喘迫、喘致、喘呕、上气等,虽然名称不同,但病源都出于肺。《内经》又说:躺下就喘的,是水气客犯所致。《经脉篇》说:夜间行走后喘的,病出于肾;淫气伤肺,若有堕坠惊恐,喘出于肝;淫气害脾,若有惊恐,喘出于肺;淫气伤心,若渡水跌仆,喘出于肾与骨。《痹论篇》说:腰痹患者,胸中气喘争鸣。《大奇篇》说:肺病喘促且两胁满闷。《至真要大论篇》论述太阴司天作为客气胜复时,则头面浮肿,呼吸喘气。《阳明篇》说:邪气传入六腑,身体发热喘息呼叫,不能平卧,这是各脏腑感受病因不同的表现吗?张仲景说:出汗如油,汗珠如珠不流,喘息不止的,这是不治之症。如果脉象滑利且手足温暖的是可生,脉象涩滞且四肢厥冷的是死证。又有妇人喘息急促,病情尤为紧急。因为产后失血过多,营气突然枯竭,卫气无所依附,独聚于肺,所以发生喘证,这名叫孤阳绝阴,属于难治之症。治疗方法:外感引起的以祛散为主,气机内郁的以调顺为先,肾虚的宜用温补,痰盛的当用疏导,有阴血虚少而上喘的,宜用滋阴养荣的药剂。上述论述的前述证候,临证用药,在于仔细斟酌,治疗没有不痊愈的。
For the treatment of unbearable pain in the supraorbital ridge, this is Phlegm Jue (Phlegm Obstruction Syndrome).
Banxia (Pinelliae Rhizoma) (quantity as needed, washed seven times with boiling water, sliced)
Take three qian per dose, add one and a half sheng of water and ten slices of Shengjiang (Zingiberis Rhizoma Recens), decoct until eight parts remain, strain, and take warm after meals.
Various forms of asthma (Chuan) are attributed to Heat. Fire-Heat belongs to Yang, characterized by urgency and rapid pulse; when Fire moves upward, urgent asthma arises. If summer heat is severe, breathing becomes frequent and coarse, undoubtedly indicating asthma due to Heat. The Classics state that all symptoms rushing upward belong to Ministerial Fire (Xiang Huo). The Lung governs Qi and belongs to Yang; when Yang Qi circulates freely, it nourishes the Zang-Fu organs. Thus, the Lung is called the "Canopy of the Five Zang Organs," preferring clarity and emptiness while disliking obstruction. If Yin Qi resides below and Yang Qi above, combined with excess Qi, it triggers cough, vomiting, and urgent asthma. The *Shengji Fang* states: Exhalation follows Yang Qi out, causing Qi to ascend; inhalation follows Yin Qi in, causing Qi to descend. Through ascending and descending, Yin and Yang harmonize. If disharmony occurs, Qi fails to move upward, rising but not descending, causing stagnation in the diaphragm, forcing the airways, resulting in asthmatic breathing with sound. Furthermore, Wind-Cold, Summer-Heat, and Dampness interfering with each other cause lung distension and asthma; or emotional disturbances like anger and joy injure the Five Qi, leading to phlegm accumulation and asthma; or dual deficiency of Lung and Kidney, where weak constitution fails to regulate phlegm throughout the body, causing asthma; or Spleen dampness with swelling, where Water Qi attacks causing asthma; or intrinsic organ deficiency with Wind invasion, causing Lung Qi congestion and upward rush—how can these be generalized? Various chapters in the *Ling Shu* section of the *Nei Jing* discuss different types of asthma with distinct names and etiologies. Terms such as asthmatic gasping (*chuan he*), panting (*chuan xi*), oppressive asthma (*chuan po*), induced asthma (*chuan zhi*), vomiting with asthma (*chuan ou*), and rebellious Qi (*shang qi*) differ in name but originate from the Lung. The *Nei Jing* further states: Asthma upon lying down is caused by Water Qi invasion. The *Jing Mai* chapter says: Asthma after walking at night originates from the Kidney; Yin Qi harming the Lung with falling/fright originates from the Liver; Yin Qi harming the Spleen with fright originates from the Lung; Yin Qi harming the Heart with drowning/falling originates from the Kidney and bones. The *Bi Lun* chapter states: In lumbar Bi syndrome, there is asthmatic contention in the chest. The *Da Qi* chapter states: Lung asthma presents with bilateral hypochondriac fullness. The *Zhi Zhen Yao Da Lun* chapter discusses Taiyin ruling the year as an invading pathogen winning over; then head and face swell, and breathing is asthmatic. The *Yangming* chapter states: When pathogens enter the Six Fu organs, the body is hot, with asthmatic calling and inability to lie flat—are these not differences in organ-specific pathogenesis? Zhang Zhongjing stated: Sweating like oil, sweat beads forming but not flowing, with unceasing asthma indicates an incurable condition. If the pulse is slippery and hands/feet are warm, life is preserved; if the pulse is choppy and limbs are cold, death ensues. Women suffering from urgent asthma present a particularly critical condition. Due to excessive blood loss postpartum, Ying Qi suddenly exhausts, Wei Qi loses its foundation, gathering solely in the Lung, causing asthma. This is named "Solitary Yang and Absolute Yin," a difficult-to-treat condition. Treatment methods: For external pathogens, use dispersing methods; for internal Qi stagnation, prioritize regulating and smoothing; for Kidney deficiency, use warming and tonifying; for abundant phlegm, use guiding and draining; for Yin-Blood deficiency causing upper asthma, use agents that nourish Yin and enrich Ying Qi. Regarding the aforementioned syndromes, medication selection depends on careful deliberation at the time of treatment, ensuring no case remains uncured.