答曰。喘急之病。皆繇营卫之气。流行失度。气经于脏而脏不能受。诸气上并于肺。肺管隘
而气争。故令喘急。其始得之。或因坠堕恐惧。则精神HT HT 。上焦闭而气不行。气不行则
流于肝。肝气乘肺。此喘出于肝。或因惊恐。惊则心无所倚。神无所归。气乱于中。心乘于
肺。此喘出于心。或因渡水跌仆。肾气暴伤而不通行。气流于肾。肾气上乘于脾。此喘出于
脾
。或因饮食过伤。动作用力。谷气不行。脾气逆而凝肺。此喘出于肺。凡诸脏相乘而喘。其
证各不同也。
神秘汤。治夜不得卧。卧则喘。此繇水气逆行。上乘于肺。肺得水则浮而开。使气不得通流
。其脉沉大。
陈橘皮(汤洗焙) 生姜 紫苏叶 人参 桑白皮(各半两)
上为 咀。每服三钱。水盏半。煎八分。去滓温服。
平肺汤。治喘急。
天门冬(去心一两) 马兜铃 百部(各半两)
上为粗末。每服五钱。水盏半。煎八分。去滓温服。
答曰。痰因饮生也。气道壅滞。津液不通。水饮气滞。停在胸腑。结而成痰。人皆有之。少
则不能为害。多则成病。乃至呕吐。妊娠呕吐甚者。多伤胎也。
细辛五味子汤。治痰饮壅滞。
细辛(一两) 五味子(三两) 白茯苓 人参 白术 甘草(炙各一两) 干姜(一两炮)
上为饮子。每服三钱。水盏半。煎八分。去滓温服。食后。
赤茯苓汤。治妊娠呕哕。心下满。胸膈间宿有停水。停水心悸。
赤茯苓 人参 陈皮(各一两) 芎 白术 半夏(各半两)
上为饮子。每服四钱。水盏半。姜五片。煎七分。去滓温服。不拘时。
答:喘急的病证,都是由于营卫之气流行失去常态。气进入脏腑而脏腑不能承受,各种气向上并聚于肺,肺管狭窄且气机争逆,所以导致喘急。其初起之时,可能是因为坠跌或恐惧,致使精神恍惚不定,上焦闭塞而气不能运行,气不能运行则流注于肝,肝气乘袭肺脏,这种喘是由肝引起的;可能是因为惊恐,惊则心无所依托,神无所归依,气在体内紊乱,心气乘袭肺脏,这种喘是由心引起的;可能是因为涉水或跌仆,肾气突然受伤而不能通行,气流注于肾,肾气上乘于脾脏,这种喘是由脾引起的;可能是因为饮食过度损伤,或者劳作用力,谷气不能运行,脾气上逆而凝滞于肺,这种喘是由肺引起的。凡是各脏腑相互乘袭导致的喘,其症状表现各不相同。
神秘汤,治疗夜间不能平卧,一躺下就喘促的病证。这是由于水气逆行,上乘于肺。肺得到水气则浮张而开泄,使得气机不能通畅流动。其脉象沉大。
处方组成:陈皮(用汤洗过焙干)、生姜、紫苏叶、人参、桑白皮(各半两)。
以上药物捣成粗颗粒。每次服用三钱,用水一盏半,煎至八分满,去渣后温服。
平肺汤,治疗喘急。
处方组成:天门冬(去心一两)、马兜铃、百部(各半两)。
以上药物捣成粗末。每次服用五钱,用水一盏半,煎至八分满,去渣后温服。
答:痰是因为饮邪产生的。气道壅塞阻滞,津液不通畅,水饮之气停滞,停留在胸腑,凝结而成痰。人人身上都有,量少则不能为害,量多则成为疾病,甚至引起呕吐。妊娠期间呕吐严重的,大多会损伤胎元。
细辛五味子汤,治疗痰饮壅滞。
处方组成:细辛(一两)、五味子(三两)、白茯苓、人参、白术、甘草(炙,各一两)、干姜(一两,炮制)。
以上药物制成饮子剂。每次服用三钱,用水一盏半,煎至八分满,去渣后温服,饭后服用。
赤茯苓汤,治疗妊娠呕吐呃逆,心下部胀满,胸膈间素有停水,停水导致心悸。
处方组成:赤茯苓、人参、陈皮(各一两)、川芎、白术、半夏(各半两)。
以上药物制成饮子剂。每次服用四钱,用水一盏半,加生姜五片,煎至七分满,去渣后温服,不拘泥于固定时间。
Answer: The disease of panting and urgency arises from the disordered circulation of Ying (Nutrient) and Wei (Defensive) Qi. When Qi enters the Zang organs but the organs cannot accommodate it, various Qi ascend and converge upon the Lung. Due to the narrowing of the airways and the contention of Qi, panting and urgency occur. Initially, this may result from falling or fear, causing the spirit to be unsettled, leading to blockage in the Upper Jiao (Upper Burner) and stagnation of Qi. When Qi fails to circulate, it flows into the Liver; Liver Qi then overacts on the Lung, resulting in panting originating from the Liver. It may also result from fright, where fright causes the Heart to have no support and the Spirit to have no refuge, leading to chaotic Qi in the middle; Heart Qi then overacts on the Lung, resulting in panting originating from the Heart. It may result from wading through water or falling, causing sudden injury to Kidney Qi and obstructing its flow; Qi flows into the Kidney, and Kidney Qi ascends to overact on the Spleen, resulting in panting originating from the Spleen. It may result from excessive dietary intake or strenuous physical effort, causing Gu Qi (Grain Qi) to fail to circulate; Spleen Qi rebels and congeals in the Lung, resulting in panting originating from the Lung. In cases of panting caused by mutual overaction among the Zang organs, the clinical manifestations vary.
Shenmi Tang (Mysterious Decoction) treats inability to lie flat at night and panting upon lying down. This is due to Water Qi rebelling upward and overacting on the Lung. When the Lung receives Water Qi, it becomes flaccid and open, preventing the smooth flow of Qi. The pulse is deep and large.
Ingredients: Chenpi (Cortex Citri Reticulatae, washed with decoction and baked), Shengjiang (Rhizoma Zingiberis Recens), Zisu Ye (Folium Perillae), Renshen (Radix Ginseng), Sangbaipi (Cortex Mori Radicis) (each 0.5 liang).
Process the above ingredients into coarse granules. Take 3 qian per dose, add 1.5 zhan of water, decoct until 0.8 portion remains, remove dregs, and take warm.
Pingfei Tang (Lung-Pacifying Decoction) treats panting and urgency.
Ingredients: Tianmendong (Radix Asparagi, heart removed, 1 liang), Madouling (Fructus Aristolochiae), Baibu (Rhizoma Stemonae) (each 0.5 liang).
Process the above ingredients into a coarse powder. Take 5 qian per dose, add 1.5 zhan of water, decoct until 0.8 portion remains, remove dregs, and take warm.
Answer: Tan (Phlegm) is generated from Yin (Fluids). When the Qi pathway is congested and stagnant, and Jin-Ye (Body Fluids) fail to circulate smoothly, Water-Yin Qi stagnates and accumulates in the chest and fu organs, condensing to form Tan. Everyone possesses some amount; if small, it causes no harm; if excessive, it becomes pathological, potentially leading to vomiting. Severe vomiting during pregnancy often damages the Tai Yuan (Fetus).
Xixin Wuweizi Tang (Asarum and Schisandra Decoction) treats congestion and stagnation of Tan-Yin.
Ingredients: Xixin (Herba Asari), Wuweizi (Fructus Schisandrae Chinensis) (3 liang), Baifuling (Poria Cocos with Red Cortex), Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae), Gancao (Radix Glycyrrhizae Preparata, each 1 liang), Ganjiang (Rhizoma Zingiberis Preparatum, 1 liang, processed).
Process the above ingredients into a decoction mixture. Take 3 qian per dose, add 1.5 zhan of water, decoct until 0.8 portion remains, remove dregs, and take warm after meals.
Chifuling Tang (Red Poria Decoction) treats vomiting and hiccups during pregnancy, fullness below the heart, and palpitations caused by pre-existing retained fluids in the chest and diaphragm.
Ingredients: Chifuling (Poria Cocos with Red Cortex), Renshen (Radix Ginseng), Chenpi (Cortex Citri Reticulatae) (each 1 liang), Xiong (Rhizoma Chuanxiong), Baizhu (Rhizoma Atractylodis Macrocephalae), Banxia (Rhizoma Pinelliae Preparatae) (each 0.5 liang).
Process the above ingredients into a decoction mixture. Take 4 qian per dose, add 1.5 zhan of water and 5 slices of fresh ginger, decoct until 0.7 portion remains, remove dregs, and take warm at any time.