火喘燥渴面唇红,肺胃凉膈白虎清,泻心宜用导赤散,阴虚知柏地黄灵。
【注】火邪刑金作喘者,多口干舌燥作渴,面赤唇红也。因于肺热者,以凉膈散主之;胃
热者,凉膈白虎汤主之;心火刑金者,导赤散主之;肾虚火来烁金者,宜知柏地黄汤主
之。医者果能审察精详,按证调治,庶几用药如响,而不致有虚实之误矣!
凉膈散(方见急惊风)
凉膈白虎汤
大黄(生) 朴硝 甘草(生) 栀子 黄芩(生) 连翘(去心) 薄荷叶 石膏(生) 知母
(生)
引用粳米水煎,温服。
【方歌】凉膈白虎肺胃热,栀子连翘薄荷叶,黄芩大黄朴硝草,知母石膏粳米列。
导赤散(方见不小便)
知柏地黄汤
干地黄 山茱萸肉 山药(炒) 茯苓 知母(炒) 黄柏(盐炒) 牡丹皮 泽泻
水煎服。
【方歌】知柏地黄阴虚热,知母黄柏牡丹皮,干生地黄并泽泻,茯苓山药共茱萸。
虚喘气乏声短涩,洁古黄 汤效捷,百合固金化虚痰,本事黄 清虚热。
【注】虚喘之证,气乏声音短涩,以洁古黄 汤主之。若喘促夹痰者,以百合固金汤
主之;夹热者,以《本事》黄 汤主之。
洁古黄 汤
人参 黄 (炙) 甘草(炙) 地骨皮 桑白皮(炒)
水煎温服。
【方歌】洁古黄 汤,虚喘最为良,人参黄 共,甘草地骨桑。
百合固金汤
百合 天门冬 麦门冬(去心) 生地黄 熟地黄 当归 白芍药(炒) 甘草(生) 贝母(去
心) 元参 桔梗
水煎服。
【方歌】百合固金虚痰喘,百合二冬二地黄,当归白芍生甘草,贝母元参桔梗良。
本事黄 汤
五味子 白芍药 天门冬 人参 麦门冬(去心) 黄 (炙) 熟地黄 茯苓 甘草(炙)
引用乌梅、姜、枣,水煎服。
【方歌】本事黄 虚热喘,五味芍药二门冬,参 熟地炙甘草,乌梅姜枣白茯苓。
火邪所致之喘,伴有燥热口渴、面色及口唇发红。肺胃有热者,宜用凉膈散或白虎汤清泄;心火亢盛者,宜用导赤散泻心火;阴虚火旺者,宜用知柏地黄丸滋阴降火。
【注】火邪克制肺金导致气喘的病症,多表现为口干舌燥、烦渴、面红唇赤。若因肺热引起,以凉膈散为主治方;若因胃热引起,以凉膈白虎汤为主治方;若因心火刑克肺金引起,以导赤散为主治方;若因肾中虚火上炎灼伤肺金引起,宜用知柏地黄汤为主治方。医生若能仔细审察病情,依据证候进行调治,用药便能如回声般应验,从而避免虚实辨证的错误。
凉膈白虎汤
组成:生大黄、朴硝、生甘草、栀子、生黄芩、去心连翘、薄荷叶、生石膏、生知母。
用法:引用粳米煎煮,温服。
【方歌】凉膈白虎治肺胃热,栀子、连翘、薄荷叶,黄芩、大黄、朴硝、甘草,知母、石膏、粳米列其中。
知柏地黄汤
组成:干地黄、山茱萸肉、炒山药、茯苓、炒知母、盐炒黄柏、牡丹皮、泽泻。
用法:水煎服。
【方歌】知柏地黄治阴虚热,知母、黄柏、牡丹皮,干生地黄并泽泻,茯苓、山药共配茱萸。
虚喘表现为气息乏力、声音短促涩滞。李东垣(洁古)的黄耆汤疗效迅速;百合固金汤可化解虚痰;《本事方》中的黄耆汤可清虚热。
【注】虚喘这一证候,表现为气乏、声音短促涩滞,以洁古黄耆汤为主治方。若气喘兼夹痰浊者,以百合固金汤为主治方;若兼夹热象者,以《本事方》中的黄耆汤为主治方。
洁古黄耆汤
组成:人参、炙黄耆、炙甘草、地骨皮、炒桑白皮。
用法:水煎温服。
【方歌】洁古黄耆汤,治疗虚喘最为良效,人参、黄耆共同使用,配以甘草、地骨皮、桑白皮。
百合固金汤
组成:百合、天门冬、去心麦门冬、生地黄、熟地黄、当归、炒白芍药、生甘草、去心贝母、元参、桔梗。
用法:水煎服。
【方歌】百合固金汤治虚痰喘,百合、二冬(天门冬、麦门冬)、二地黄(生地黄、熟地黄),当归、白芍、生甘草,贝母、元参、桔梗药效良。
本事黄耆汤
组成:五味子、白芍药、天门冬、人参、去心麦门冬、炙黄耆、熟地黄、茯苓、炙甘草。
用法:引用乌梅、生姜、大枣,水煎服。
【方歌】本事黄耆汤治虚热喘,五味子、芍药、二门冬,人参、黄耆、熟地黄、炙甘草,乌梅、姜、枣、白茯苓同用。
Asthma caused by fire pathogen is accompanied by dryness, thirst, and redness of the face and lips. For heat in the Lung and Stomach, Liangge San (Cooling the Diaphragm Decoction) or Baihu Tang (White Tiger Decoction) should be used to clear heat; for hyperactive Heart Fire, Daochi San (Draining the Urine Decoction) should be used to purge Heart Fire; for Yin deficiency with fire hyperactivity, Zhibai Dihuang Wan (Anemarrhena, Phellodendron and Rehmannia Pill) should be used to nourish Yin and descend fire.
[Note] Asthma resulting from the fire pathogen restraining Metal (Lung) often presents with a dry mouth, dry tongue, thirst, flushed face, and red lips. If caused by Lung Heat, Liangge San (Cooling the Diaphragm Decoction) is the primary formula; if caused by Stomach Heat, Liangge Baihu Tang (Cooling the Diaphragm and White Tiger Decoction) is the primary formula; if caused by Heart Fire attacking the Lung (Metal), Daochi San (Draining the Urine Decoction) is the primary formula; if caused by deficient fire rising from the Kidney and scorching the Lung (Metal), Zhibai Dihuang Tang (Anemarrhena, Phellodendron and Rehmannia Decoction) should be used as the primary formula. If physicians can carefully examine the condition and treat according to the syndrome differentiation, their medication will be as effective as an echo, thereby avoiding errors in distinguishing between excess and deficiency.
Liangge San (See formula under "Acute Convulsive Wind")
Liangge Baihu Tang (Cooling the Diaphragm and White Tiger Decoction)
Ingredients: Da Huang Sheng (Raw Rhizoma et Radix Rhei), Po Xiao (Natrii Sulfas), Gan Cao Sheng (Raw Radix Glycyrrhizae), Zhi Zi (Fructus Gardeniae), Huang Qin Sheng (Raw Radix Scutellariae), Lian Qiao Qu Xin (Forsythiae Fructus, heart removed), Bo He Ye (Menthae Haplocalycis Folium), Shi Gao Sheng (Raw Gypsum Fibrosum), Zhi Mu Sheng (Raw Rhizoma Anemarrhenae).
Usage: Decoct with Jing Mi (Oryza Sativa Glutinosa), take warm.
[Fang Ge]: Liangge Baihu treats Lung and Stomach heat, Zhi Zi, Lian Qiao, Bo He Ye; Huang Qin, Da Huang, Po Xiao, Gan Cao; Zhi Mu, Shi Gao, Jing Mi are listed.
Daochi San (See formula under "Scanty Urination")
Zhibai Dihuang Tang (Anemarrhena, Phellodendron and Rehmannia Decoction)
Ingredients: Gan Di Huang (Dry Rehmanniae Radix), Shan Zhu Yu Rou (Corni Fructus pericarpium), Chao Shan Yao (Stir-fried Dioscoreae Rhizoma), Fu Ling (Poria), Chao Zhi Mu (Stir-fried Anemarrhenae Rhizoma), Yan Chao Huang Bo (Salt-stir-fried Phellodendri Cortex), Mu Dan Pi (Moutan Cortex), Ze Xie (Alismatis Rhizoma).
Usage: Decoct in water and take.
[Fang Ge]: Zhibai Dihuang treats Yin deficiency heat, Zhi Mu, Huang Bo, Mu Dan Pi; Gan Di Huang and Ze Xie; Fu Ling, Shan Yao, and Zhu Yu are combined.
Deficient asthma manifests as fatigue in breathing and short, obstructed voice. Jiegu's Huang Qi Tang (Codonopsis Astragali Decoction) yields rapid results; Baihe Gujin Tang (Lily Bulb to Secure the Metal Decoction) resolves deficient phlegm; Ben Shi Huang Qi Tang (Astragali Decoction from *Bencao Fang*) clears deficient heat.
[Note] The syndrome of deficient asthma is characterized by breathlessness, shortness of voice, and obstruction, treated primarily with Jiegu Huang Qi Tang (Codonopsis Astragali Decoction). If asthma is complicated by phlegm, Baihe Gujin Tang (Lily Bulb to Secure the Metal Decoction) is the primary formula; if complicated by heat, Huang Qi Tang (Astragali Decoction) from *Bencao Fang* is the primary formula.
Jiegu Huang Qi Tang (Codonopsis Astragali Decoction)
Ingredients: Ren Shen (Ginseng Radix), Zhi Huang Qi (Honey-fried Astragali Radix), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix), Di Gu Pi (Lycii Cortex), Chao Sang Bai Pi (Stir-fried Mori Cortex).
Usage: Decoct in water and take warm.
[Fang Ge]: Jiegu Huang Qi Tang is most effective for deficient asthma, Ren Shen and Huang Qi together, with Gan Cao, Di Gu Pi, and Sang Bai Pi.
Baihe Gujin Tang (Lily Bulb to Secure the Metal Decoction)
Ingredients: Bai He (Lilii Bulbus), Tian Men Dong (Asparagi Radix), Mai Men Dong Qu Xin (Ophiopogonis Radix, heart removed), Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Prepared Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Chao Bai Shao Yao (Stir-fried Paeoniae Radix Alba), Sheng Gan Cao (Raw Glycyrrhizae Radix), Bei Mu Qu Xin (Fritillariae Cirrhosae Bulbus, heart removed), Yuan Shen (Scrophulariae Radix), Jie Geng (Platycodonis Radix).
Usage: Decoct in water and take.
[Fang Ge]: Baihe Gujin Tang treats deficient phlegm asthma, Bai He, Er Dong (Tian Men Dong and Mai Men Dong), Er Di Huang (Sheng Di Huang and Shu Di Huang); Dang Gui, Bai Shao, Sheng Gan Cao; Bei Mu, Yuan Shen, Jie Geng are excellent.
Ben Shi Huang Qi Tang (Astragali Decoction from *Bencao Fang*)
Ingredients: Wu Wei Zi (Schisandrae Chinensis Fructus), Bai Shao Yao (Paeoniae Radix Alba), Tian Men Dong (Asparagi Radix), Ren Shen (Ginseng Radix), Mai Men Dong Qu Xin (Ophiopogonis Radix, heart removed), Zhi Huang Qi (Honey-fried Astragali Radix), Shu Di Huang (Prepared Rehmanniae Radix), Fu Ling (Poria), Zhi Gan Cao (Honey-fried Glycyrrhizae Radix).
Usage: Decoct with Wu Mei (Mume Fructus), Sheng Jiang (Zingiberis Rhizoma Recens), and Da Zao (Jujubae Fructus) in water, and take.
[Fang Ge]: Ben Shi Huang Qi Tang treats deficient heat asthma, Wu Wei Zi, Shao Yao, Er Men Dong; Ren Shen, Huang Qi, Shu Di, Zhi Gan Cao; Wu Mei, Jiang, Zao, and Bai Fu Ling are used together.