夫伤寒喘。其证不一。有邪气在表。表未解。无汗而喘者。有邪气在里。汗出不恶寒。
腹满而喘者。有心下有水而喘者。古人治之。亦各求其本。故在表者。当汗之。在里者。宜
下之。至于心下有水而喘。则又当利其小便也。若乃阴证发喘。是为无阳。非灸之不可。伤
寒太阳病。下之后喘者。外未解故也。夫发汗后。饮水者必喘。以水停心下。肾气乘心。故
喘也。或饮水过多。入肾亦喘也。伤寒喘者。肺主气。形寒饮冷则伤肺。故其气逆而上行。
冲冲而气急。喝喝而息数。张口抬肩。摇身滚肚。是为喘也。伤寒喘者。为邪气在表。气不
利而喘者。有水气之气。射肺而喘者。各不同也。喘家作桂枝汤加浓朴杏仁佳。太阳病。骨
节疼痛。头疼腰疼。恶风无汗而喘者。发汗后。饮水多必喘。以水灌之亦喘。伤寒心下有水
气。干呕发热而咳。或喘者。小青龙汤。去麻黄。加杏子主之。是欲发散水寒也。经曰。喘
而汗出者。与葛根黄芩黄连汤。以利之。汗出而喘者。与麻黄杏子甘草石膏汤。以发之。二
者。如何而然也。盖邪气内攻。气逆不利而喘者。因喘而汗出。见其邪气在里也。虽表未解。
未
亦可发之。此亦古人之奥义。伤寒止于邪气在表而喘者。心腹必满而不坚。设或腹满而喘。
则又为可下之证。经曰。短气腹满而喘。有潮热者。此外欲解。可攻里也。为因腹满而喘矣。
又
喘不休者。此为肺绝。身汗如油。喘而不休。此为命绝。皆为不治之喘也。省疾问病。更宜
消息。
活人歌云。喘不 解表家。汗多潮热里攻邪。满胸合病尤须汗。水嗽青龙杏去麻。
经云。肺气实则喘。上气。所以气逆者。邪气为实耳。伤寒发喘。邪气在表者。心腹濡
而不坚。外证无汗。法当汗之。邪气在里者。心腹胀而为满。外证有汗。法当下之。又有水
气作喘。心下怔忪。即水为邪。是以有小青龙之证。若经汗下。逐水不获。至于喘促上攻。
壅塞而不得息。可以瓜蒂散从权吐之。吁喘时病之常也。其或直视谵语而喘。汗出发润而喘。
身
喘家汤剂。多用麻黄。太阳证无汗而喘。麻黄汤。或误下之。利不止。脉促。有汗而喘。葛
根黄芩黄连汤。下之微喘者。桂枝加浓朴杏子汤。发汗后。不可更行桂枝汤。若汗出而喘。
无大热者。麻黄杏仁甘草石膏汤。阳明证汗出不恶寒。气短腹满。潮热而喘。小承气汤。若
脉浮无汗而喘。即汗之。用麻黄汤。太阳、阳明合病。喘而胸满。勿下。可麻黄汤。水气嗽
喘。乃太阳汗后。饮水多而水停心下。小青龙去麻黄。加杏仁主之。小腹满者。小青龙去麻
黄。加茯苓。阴证喘。则必脉促伏而厥。返阴丹。五味子汤。鼻息鸣喘。气逆上冲。孙用和
用麻黄汤。加橘皮、杏子。久喘咳嗽。感冒鼻涕。易简九宝汤。
方
麻黄散 治伤寒烦热喘促。
麻黄(去根节) 木通(锉) 紫苏茎叶 赤茯苓 生干地黄 枳实(麸炒令微黄) 天
门冬
〔去心焙以上各一(半)两〕 甘草(一分炙微赤锉) 上捣粗罗为散。每服四钱。水一中
盏。
入生姜半分。煎至六分。去滓。不计时候。温服。
紫苏散(出圣惠方)治伤寒烦喘。胸膈满闷。不思饮食。
紫苏茎叶 赤茯苓 桔梗(去芦头) 枳壳(麸炒微黄去瓤) 川大黄(锉碎微炒) 陈
橘皮
(汤浸去白瓤焙) 柴胡(去苗) 前胡(去芦头) 大腹皮(锉) 麦门冬(去心) 郁
李仁(汤浸
去皮尖微炒) 诃黎勒皮(以上各半两) 甘草(一分炙微赤锉) 上捣筛为散。每服四钱。
水
一中盏。生姜半分。煎至六分。去滓。不计时候。温服。
生干地黄散(出圣惠方)治伤寒心烦。喘急咳逆。多涎唾。有血者。
生干地黄(一两) 赤茯苓(一两) 紫苏子(微炒) 桔梗(去芦头) 杏仁(汤浸
去皮尖双
仁麸炒微黄) 陈橘皮(汤浸去白瓤焙) 人参(去芦头各半两) 甘草(一分炙微赤锉) 上
捣
筛为散。每服四钱。水一中盏。入生姜半分。煎至六分。去滓。不计时候。温服。
治伤寒头痛壮热。涕唾稠粘。鼻塞气喘。心烦。宜服此方。效。(出圣惠方)
麻黄(一两半去根节) 前胡(一两半去芦头) 白前(一两半) 桑根白皮(一两半
锉) 石
膏(二两) 甘草(一两炙微赤锉) 陈橘皮(一两汤浸去白瓤焙) 杏仁(一两半汤浸去
皮尖双
仁麸炒微黄) 上捣粗罗为散。每服四钱。水一中盏。入生姜半分。葱白二茎。煎至六分。
去滓。不计时候。温服。
贝母散(出圣惠方)治伤寒汗出而喘促。烦热头痛者。
贝母(三分煨令微黄) 百合(三分) 杏仁(一两汤浸去皮尖双仁麸炒微黄) 赤茯
苓(三
分) 麻黄(一两去根节) 石膏(二两) 甘草(一两炙微赤锉) 人参(一两去芦头) 柴
胡(一
两去苗) 上捣粗罗为末。每服四钱。水一中盏。入生姜半分。煎至六分。去滓。不计时候。
温服。
治伤寒汗出不解。曾经吐下后。心胸痞满。烦喘不除。宜服此方。
桑根白皮〔一(二)两锉〕 旋复花(半两) 甘草(半两炙微赤锉) 人参(一两去
芦头) 木
香(一两) 枳壳(一两麸炒微黄去瓤) 半夏(半两汤浸七遍去滑) 槟榔(一两) 上
捣筛为
散。
治伤寒七八日。肺脏壅热。大肠不通。小便黄赤。心神烦喘。宜服此方。(出圣
惠
方)
紫苏茎叶 木通(锉) 桑根白皮(锉) 紫菀(洗去苗土) 黄芩(以上各一两) 川
大黄
(一两半碎微炒) 赤茯苓(一两) 甘草(半两炙微赤) 上捣筛为散。每服五钱。水一
大盏。
煎
槟榔散(出圣惠方)治伤寒气壅烦喘。腹胁妨闷。不欲饮食。
槟榔(半两) 诃黎勒皮(一两) 桑根白皮(半两锉) 木香(一分) 桂心(一分)
甘草
(一分炙微赤锉) 川大黄(三分锉碎微炒) 人参(半两去芦头) 赤茯苓(三分) 枳
壳(三分
麸炒微黄去瓤) 上捣细罗为散。每服二钱。水一中盏。入生姜半分。枣二枚。煎至五分。
即去姜枣。不计时候。和滓温服。
治伤寒头痛。百节酸疼。气壅烦喘。宜服此方。(出圣惠方)
麻黄(一两去根节) 甘草(三分炙微赤锉) 赤芍药(三分) 桂心(半两) 杏仁
(半两汤
浸去皮尖双仁麸炒微黄) 石膏(一两半杵碎) 上捣细锉。拌令匀。分为三服。每服水一
大
盏半。煎至一盏。去滓。不计时候。分温二服。如人行五七里。再服。以汗出为度。
小青龙去麻黄加杏仁汤(出活人书)治伤寒心下有水气。咳而发喘。
芍药 桂(去粗皮) 甘草(炙) 细辛(去苗叶) 五味子(炒) 干姜(炮裂) 杏
仁(汤浸
去皮尖双仁炒各三两) 半夏(汤浸七遍切焙二两半) 上锉如麻豆大。每服五钱。水一盏
半。
煎
麻黄杏仁甘草石膏汤(出千金方)治伤寒下后。不可更行桂枝汤。汗出而喘。
无大热者。
麻黄(去根节沸汤掠去沫焙四两) 杏仁(去皮双仁炒五十枚) 甘草(炙二两) 石
膏(半
斤碎) 上锉如麻豆大。每服五钱匕。水一盏半。煎取八分。去滓。温服。
茯苓汤(出圣济总录)治伤寒心下有水气。肺气虚胀。喘急咽燥。
赤茯苓(去黑皮) 石膏(各一两半) 芍药(三分) 半夏(一两汤浸七遍炒令干) 细
辛
(去苗叶) 桂(去粗皮) 五味子(各半两) 麻黄(去根节沸汤掠去沫焙) 桑根白皮
(锉各一
两) 上锉如麻豆大。每服五钱匕。水一盏半。入生姜一分。拍碎。同煎至八分。去滓。温
服。
猪苓汤(出圣济总录)治伤寒表不解。心下喘满。及大小便秘难。
猪苓(去黑皮) 赤茯苓(去黑皮) 白术(炒) 麻黄(去根节) 桂(去粗皮) 葶
苈(微炒)
泽泻(各等分) 上粗捣筛。每服三钱匕。水一盏。生姜三片。同煎至七分。去滓。温服。
马兜铃汤(出圣济总录)治伤寒后。肺气喘促。
马兜铃(一分) 木通(锉一两) 陈橘皮(汤浸去白焙半两) 紫苏茎叶(三分) 上
粗捣
筛。每服五钱匕。水一盏半。入灯心十五茎。枣三枚。擘破。同煎至七分。去滓。食后温服。
日二。
木香丸(出圣济总录)治伤寒后。肺气上喘。咽喉噎塞。头面虚浮。
木香(一两磨) 昆布(汤洗去咸味焙令干) 海藻(汤洗去咸味焙令干) 干姜(炮
裂各三
分) 海蛤(别研如粉) 细辛(去苗叶) 蜀椒(去目及闭口微炒令汗出各半两) 上将
六味捣
罗为末。入海蛤。同研令匀。炼蜜和。更捣三五百杵。丸如梧桐子大。每服空心。米饮下十
五丸。
大腹皮汤(出圣济总录)治伤寒汗后发喘。壮热不除。
大腹皮(锉) 柴胡(去苗各一两) 赤茯苓(去黑皮三分) 桑根白皮(微炙锉半两)
上粗
捣筛。每服三钱匕。水一盏。入生姜三片。同煎至六分。去滓。不计时候。温服。
芸苔子丸(出圣济总录)治伤寒后。喘咳不得卧。卧则气壅。心胸满闷。
芸苔子(一两微炒) 葶苈(微炒一两半) 马兜铃(半两) 紫菀(去土半两) 杏
仁(汤浸
去皮尖双仁麸炒令黄细研重一两半) 白前 防己 人参(各三分) 皂荚(酥炙令黄去皮
子)
甘草(各半两炙令微赤) 上捣罗九味为末。入杏仁。同研令匀。炼蜜和捣三五百杵。丸如
梧
桐子大。每服食前。童子小便煎乌梅汤。下二十丸。日二。
木香丸(出圣济总录)治伤寒后。脾胃虚冷。上攻气喘。
木香 肉豆蔻(去壳各半两) 白茯苓(去黑皮三分) 人参(三分) 桂(去粗皮) 槟
榔
(锉各一两) 丁香(一分) 阿魏(用酒研如泥入面少许拌和作饼子炙令黄熟一分) 上
捣罗为
末。
桂枝加浓朴杏子汤(出圣济总录)治伤寒太阳病。下之微喘者。表未解故也。
桂(去粗皮) 芍药(各三两) 甘草 浓朴(去粗皮生姜汁炙各二两) 杏仁(五十
枚去皮
尖) 上锉如麻豆大。每服五钱匕。水一盏。入生姜一枣大。切。大枣二枚。擘。煎取八分。
去滓。温服。戊申正月。有一武臣为寇所执。置舟中横板下。数日得脱。乘饥恣食。良久解
衣扪虱。次日遂作伤寒。自汗而膈不利。一医作伤寒而下之。一医作解衣中邪而汗之。杂治
数日。渐觉昏困。上喘息高。医者怆惶失措。予诊之曰。太阳病。下之。表微喘者。桂枝加
浓朴杏子汤。此仲景之法也。命令医者急治药。一啜喘定。再啜 微汗。至晚身凉。而脉
已和矣。医曰。某平生不曾用仲景方。不知其神捷如是。予曰。仲景之法。岂诳后人也。或
人自寡学以废明耳。
枳实汤 治病患气上冲心。胸痞喘急。以有寒饮也。
枳实(一两炙) 橘皮 半夏(一两) 生姜 浓朴(各三两) 上五味。以水六升。
煮取三
升。去滓。温服一升。咽痛。加桔梗一两。
五味子汤(出活人书)治伤寒喘促。脉伏而厥。
人参 麦门冬(去心) 杏仁(去皮尖) 橘皮(去白各一两) 五味子(半两) 上
锉如麻豆
大。生姜十片。枣子三枚。水三大白盏煎至一盏半。去滓。分二服。
伤寒引起的喘息,其证候表现并不单一。有的是邪气在体表,表证未解,无汗且喘息;有的是邪气在体内,出汗且不恶寒,腹部胀满且喘息;有的是心下(胃脘部)有水饮停留而喘息。古人治疗这些情况,都是各自探求病本。因此,邪气在体表的,应当用发汗法;邪气在体内的,应当用攻下法。至于心下有水饮而导致的喘息,则又应当通利小便。如果是阴证发作喘息,这是阳气衰微的表现,非用灸法不可。
伤寒太阳病,经过攻下治疗后出现喘息的,是因为表邪仍未解除。发汗之后,如果饮水过多必然导致喘息,这是因为水饮停聚在心下,肾气上乘于心,所以引起喘息。或者饮水过多,水气入肾也会导致喘息。
伤寒引起的喘息,肺主一身之气,形体受寒或饮用冷物就会损伤肺脏,因此肺气上逆上行,气息冲撞急促,呼吸声粗重,张口抬肩,身体摇晃肚腹起伏,这就是喘息。伤寒喘息的原因不同:有的是因为邪气在体表,气机不利而喘息;有的是因为有水气射肺而喘息,各不相同。
素有喘息的人,服用桂枝汤加浓朴、杏仁效果较好。太阳病,骨节疼痛,头痛腰痛,怕风无汗而喘息,发汗后若饮水多必致喘息,用水浇洗身体也会致喘息。
伤寒心下有 water qi(水气),干呕发热而咳嗽,或者喘息,用小青龙汤,去掉麻黄,加入杏子来主治,这是为了发散水寒之邪。经典记载:喘息且出汗的,给予葛根黄芩黄连汤,以清利之;出汗且喘息的,给予麻黄杏子甘草石膏汤,以发汗宣肺。这两者为何如此呢?大概是因为邪气内攻,气逆不利而喘息,因喘息而导致出汗,这说明邪气在里。虽然表证未解,也可以发汗,这也是古人的深奥义理。
伤寒仅因邪气在表而喘息,心腹部必定胀满但不坚硬。假如腹部胀满且喘息,这又是可以攻下的证候。经典说:短气、腹部胀满且喘息,伴有潮热的,这是表证将要解除,可以攻里,是因为腹部胀满而喘息。
另外,喘息不止的,这是肺气衰竭;身体出汗如油,喘息不止,这是生命垂危。这些都是不治的喘息。诊察疾病询问病情时,更应仔细斟酌。
《活人歌》说:“喘不解表家,汗多潮热里攻邪。满胸合病尤须汗,水嗽青龙杏去麻。”
经典说:肺气实盛则喘息、上气,所以气逆是因为邪气实盛。伤寒发喘,邪气在体表的,心腹部柔软而不坚硬,外证无汗,治法当发汗;邪气在体内的,心腹胀满,外证有汗,治法当攻下。又有水气作喘,心下悸动怔忪,这就是水为邪气,所以有小青龙汤的证候。如果经过发汗、攻下,逐水无效,以至于喘息急促上攻,壅塞无法呼吸,可以权宜使用瓜蒂散催吐。唉!喘息是时病的常见症状。如果出现两眼直视、胡言乱语且喘息,或者出汗、头发湿润且喘息,身……(原文此处似有脱漏,结合上下文推测为身冷或身痛等危象)。
治疗喘息的方剂,多用麻黄。太阳证无汗而喘息,用麻黄汤;或者误用攻下,导致腹泻不止,脉促,有汗而喘息,用葛根黄芩黄连汤;攻下后轻微喘息的,用桂枝加浓朴杏子汤;发汗后,不可再用桂枝汤。如果出汗且喘息,没有大热的,用麻黄杏仁甘草石膏汤。阳明证出汗不恶寒,气短腹部胀满,潮热而喘息,用小承气汤。如果脉浮无汗而喘息,就发汗,用麻黄汤。太阳、阳明合病,喘息且胸部胀满,不可攻下,可用麻黄汤。水气咳嗽喘息,是太阳病发汗后,饮水多导致水停心下,用小青龙汤去麻黄加杏仁主治。小腹满的,小青龙汤去麻黄加茯苓。阴证喘息,则必然脉促伏且四肢厥冷,用返阴丹、五味子汤。鼻息有声喘息,气逆上冲,孙用和用麻黄汤加橘皮、杏子。久喘咳嗽,感冒流鼻涕,用易简九宝汤。
【方剂】
麻黄散:治疗伤寒烦热喘息急促。
组成:麻黄(去根节)、木通(锉碎)、紫苏茎叶、赤茯苓、生干地黄、枳实(麸炒至微黄)、天门冬(去心焙干,以上各一两半);甘草(一分,炙微赤锉碎)。
制法:捣成粗散。每次服四钱,加水一中盏,放入生姜半分,煎至六分,去渣。不限时候,温服。
紫苏散(出自《圣惠方》):治疗伤寒烦喘,胸膈满闷,不思饮食。
组成:紫苏茎叶、赤茯苓、桔梗(去芦头)、枳壳(麸炒微黄去瓤)、川大黄(锉碎微炒)、陈橘皮(汤浸去白瓤焙干)、柴胡(去苗)、前胡(去芦头)、大腹皮(锉碎)、麦门冬(去心)、郁李仁(汤浸去皮尖微炒)、诃黎勒皮(以上各半两);甘草(一分,炙微赤锉碎)。
制法:捣筛为散。每次服四钱,加水一中盏,生姜半分,煎至六分,去渣。不限时候,温服。
生干地黄散(出自《圣惠方》):治疗伤寒心烦,喘息急促咳嗽逆气,多涎唾,有血者。
组成:生干地黄(一两)、赤茯苓(一两)、紫苏子(微炒)、桔梗(去芦头)、杏仁(汤浸去皮尖双仁麸炒微黄)、陈橘皮(汤浸去白瓤焙干)、人参(去芦头,各半两);甘草(一分,炙微赤锉碎)。
制法:捣筛为散。每次服四钱,加水一中盏,放入生姜半分,煎至六分,去渣。不限时候,温服。
(此方治)伤寒头痛壮热,涕唾稠粘,鼻塞气喘,心烦。宜服此方,有效。(出自《圣惠方》)
组成:麻黄(一两半去根节)、前胡(一两半去芦头)、白前(一两半)、桑根白皮(一两半锉碎)、石膏(二两)、甘草(一两炙微赤锉碎)、陈橘皮(一两汤浸去白瓤焙干)、杏仁(一两半汤浸去皮尖双仁麸炒微黄)。
制法:捣成粗散。每次服四钱,加水一中盏,放入生姜半分,葱白二茎,煎至六分,去渣。不限时候,温服。
贝母散(出自《圣惠方》):治疗伤寒出汗而喘息急促,烦热头痛者。
组成:贝母(三分煨令微黄)、百合(三分)、杏仁(一两汤浸去皮尖双仁麸炒微黄)、赤茯苓(三分)、麻黄(一两去根节)、石膏(二两)、甘草(一两炙微赤锉碎)、人参(一两去芦头)、柴胡(一两去苗)。
制法:捣成粗末。每次服四钱,加水一中盏,放入生姜半分,煎至六分,去渣。不限时候,温服。
(此方治)伤寒出汗不解,曾经吐下后,心胸痞满,烦喘不除。宜服此方。
组成:桑根白皮〔一两或二两锉碎〕、旋复花(半两)、甘草(半两炙微赤锉碎)、人参(一两去芦头)、木香(一两)、枳壳(一两麸炒微黄去瓤)、半夏(半两汤浸七遍去滑)、槟榔(一两)。
制法:捣筛为散。
(此方治)伤寒七八日,肺脏壅热,大肠不通,小便黄赤,心神烦喘。宜服此方。(出自《圣惠方》)
组成:紫苏茎叶、木通(锉碎)、桑根白皮(锉碎)、紫菀(洗去苗土)、黄芩(以上各一两)、川大黄(一两半碎微炒)、赤茯苓(一两)、甘草(半两炙微赤)。
制法:捣筛为散。每次服五钱,加大盏水,煎……(原文此处中断,依惯例应为煎至一定比例)。
槟榔散(出自《圣惠方》):治疗伤寒气壅烦喘,腹胁妨闷,不欲饮食。
组成:槟榔(半两)、诃黎勒皮(一两)、桑根白皮(半两锉碎)、木香(一分)、桂心(一分)、甘草(一分炙微赤锉碎)、川大黄(三分锉碎微炒)、人参(半两去芦头)、赤茯苓(三分)、枳壳(三分麸炒微黄去瓤)。
制法:捣细罗为散。每次服二钱,加水一中盏,放入生姜半分,枣二枚,煎至五分,即去掉姜枣,不限时候,连同药渣一起温服。
(此方治)伤寒头痛,百节酸疼,气壅烦喘。宜服此方。(出自《圣惠方》)
组成:麻黄(一两去根节)、甘草(三分炙微赤锉碎)、赤芍药(三分)、桂心(半两)、杏仁(半两汤浸去皮尖双仁麸炒微黄)、石膏(一两半杵碎)。
制法:捣细锉,拌匀,分为三服。每服加大盏半水,煎至一盏,去渣。不限时候,分两次温服。如人行走五七里路程的时间,再服一次,以出汗为度。
小青龙去麻黄加杏仁汤(出自《活人书》):治疗伤寒心下有 water qi(水气),咳嗽并引发喘息。
组成:芍药、桂(去粗皮)、甘草(炙)、细辛(去苗叶)、五味子(炒)、干姜(炮裂)、杏仁(汤浸去皮尖双仁炒,各三两)、半夏(汤浸七遍切焙,二两半)。
制法:锉如麻豆大小。每次服五钱,加水一盏半,煎……(原文此处中断)。
麻黄杏仁甘草石膏汤(出自《千金方》):治疗伤寒攻下后,不可再用桂枝汤。出汗且喘息,没有大热的。
组成:麻黄(去根节,沸汤掠去沫焙干,四两)、杏仁(去皮双仁炒,五十枚)、甘草(炙,二两)、石膏(半斤碎)。
制法:锉如麻豆大小。每次服五钱匕,加水一盏半,煎取八分,去渣,温服。
茯苓汤(出自《圣济总录》):治疗伤寒心下有 water qi(水气),肺气虚胀,喘息急促咽燥。
组成:赤茯苓(去黑皮)、石膏(各一两半)、芍药(三分)、半夏(一两汤浸七遍炒令干)、细辛(去苗叶)、桂(去粗皮)、五味子(各半两)、麻黄(去根节,沸汤掠去沫焙干)、桑根白皮(锉,各一两)。
制法:锉如麻豆大小。每次服五钱匕,加水一盏半,放入生姜一分拍碎,同煎至八分,去渣,温服。
猪苓汤(出自《圣济总录》):治疗伤寒表证未解,心下喘息胀满,以及大小便秘难。
组成:猪苓(去黑皮)、赤茯苓(去黑皮)、白术(炒)、麻黄(去根节)、桂(去粗皮)、葶苈(微炒)、泽泻(各等分)。
制法:粗捣筛。每次服三钱匕,加水一盏,生姜三片,同煎至七分,去渣,温服。
马兜铃汤(出自《圣济总录》):治疗伤寒后,肺气喘促。
组成:马兜铃(一分)、木通(锉,一两)、陈橘皮(汤浸去白焙,半两)、紫苏茎叶(三分)。
制法:粗捣筛。每次服五钱匕,加水一盏半,放入灯心十五茎,枣三枚掰破,同煎至七分,去渣,食后温服。每日二次。
木香丸(出自《圣济总录》):治疗伤寒后,肺气上喘,咽喉噎塞,头面虚浮。
组成:木香(一两磨粉)、昆布(汤洗去咸味焙干)、海藻(汤洗去咸味焙干)、干姜(炮裂,各三分)、海蛤(别研如粉)、细辛(去苗叶)、蜀椒(去目及闭口微炒令出油汗,各半两)。
制法:先将前六味捣罗为末,加入海蛤,同研均匀,炼蜜和药,再捣三五百杵,制成梧桐子大小的丸药。每次空腹,米饮送下十五丸。
大腹皮汤(出自《圣济总录》):治疗伤寒发汗后发喘,壮热不退。
组成:大腹皮(锉碎)、柴胡(去苗,各一两)、赤茯苓(去黑皮,三分)、桑根白皮(微炙锉,半两)。
制法:粗捣筛。每次服三钱匕,加水一盏,放入生姜三片,同煎至六分,去渣。不限时候,温服。
芸苔子丸(出自《圣济总录》):治疗伤寒后,喘咳不能平卧,卧则气壅,心胸满闷。
组成:芸苔子(一两微炒)、葶苈(微炒,一两半)、马兜铃(半两)、紫菀(去土,半两)、杏仁(汤浸去皮尖双仁麸炒令黄细研,重一两半)、白前、防己、人参(各三分)、皂荚(酥炙令黄去皮子)、甘草(各半两炙令微赤)。
制法:将上述九味捣罗为末,加入杏仁,同研均匀,炼蜜和捣三五百杵,制成梧桐子大小的丸药。每次饭前,用童子小便煎乌梅汤,送下二十丸。每日二次。
木香丸(出自《圣济总录》):治疗伤寒后,脾胃虚冷,寒气上攻气喘。
组成:木香、肉豆蔻(去壳,各半两)、白茯苓(去黑皮,三分)、人参(三分)、桂(去粗皮)、槟榔(锉,各一两)、丁香(一分)、阿魏(用酒研如泥,入少许面粉拌和作饼子炙令黄熟,一分)。
制法:捣罗为末。
桂枝加浓朴杏子汤(出自《圣济总录》):治疗伤寒太阳病,攻下后轻微喘息的,是因为表证未解除。
组成:桂(去粗皮)、芍药(各三两)、甘草、浓朴(去粗皮,生姜汁炙,各二两)、杏仁(五十枚去皮尖)。
制法:锉如麻豆大小。每次服五钱匕,加水一盏,放入生姜一块枣大切片,大枣二枚掰开,煎取八分,去渣,温服。
案例:戊申年正月,有一位武官被贼寇俘虏,藏在船中的横板下,几天后逃脱。乘饥荒大肆进食,许久后脱衣捉虱子。第二天便患伤寒,自汗且膈气不利。一位医生当作伤寒攻下,另一位医生当作脱衣感受邪气而发汗。混杂治疗数日,逐渐感到昏困,上喘息高。医者惊慌失措。我诊断说:“这是太阳病,攻下后,表证轻微喘息,应用桂枝加浓朴杏子汤,这是张仲景的方法。”命令医者急煎药,喝一付喘息停止,再喝一付微微出汗,到了晚上身体凉爽,脉搏已调和。医生说:“我平生没用过仲景方,不知其神效快捷如此。”我说:“仲景之法,岂能欺骗后人?只是有人自己学识浅薄而废弃了明理罢了。”
枳实汤:治疗病患气上冲心,胸痞喘息急促,因为有寒饮。
组成:枳实(一两炙)、橘皮、半夏(一两)、生姜、浓朴(各三两)。
制法:以上五味药,用水六升,煮取三升,去渣,温服一升。若咽痛,加桔梗一两。
五味子汤(出自《活人书》):治疗伤寒喘息急促,脉伏且四肢厥冷。
组成:人参、麦门冬(去心)、杏仁(去皮尖)、橘皮(去白,各一两)、五味子(半两)。
制法:锉如麻豆大小。放入生姜十片,枣子三枚,用水三大白盏煎至一盏半,去渣,分两次服。
Wheezing caused by Shanghan (Cold Damage) presents various syndromes. Some cases involve pathogenic factors in the exterior, where the exterior syndrome is unresolved, characterized by anhidrosis (absence of sweating) and wheezing. Other cases involve pathogenic factors in the interior, characterized by sweating, aversion to cold being absent, abdominal fullness, and wheezing. Still other cases involve fluid retention in the epigastrium (heart below), leading to wheezing. Ancient practitioners treated these conditions by addressing their root causes. Therefore, for pathogenic factors in the exterior, diaphoresis (sweating method) should be used; for pathogenic factors in the interior, purgation (downward draining method) is appropriate. For wheezing due to fluid retention in the epigastrium, promoting urination to drain fluids is indicated. If wheezing occurs in a Yin syndrome, it indicates a deficiency of Yang, and moxibustion is indispensable.
If wheezing occurs after purgation in Taiyang disease (Disease of the Bladder/Large Intestine channel system), it is because the exterior pathogen has not been resolved. After diaphoresis, if the patient drinks excessive water, wheezing will inevitably result because water stagnates in the epigastrium, and Kidney Qi attacks the Heart, causing wheezing. Alternatively, excessive water intake affecting the Kidneys can also cause wheezing.
In Shanghan-induced wheezing, the Lung governs Qi. Cold damaging the body or consuming cold drinks injures the Lung, causing Lung Qi to rebel and ascend. This results in turbulent, rapid breathing, loud respiratory sounds, opening the mouth and raising the shoulders, and rocking the body with abdominal movement. These constitute wheezing. The causes of wheezing in Shanghan vary: some are due to pathogenic factors in the exterior obstructing Qi flow; others are due to fluid Qi attacking the Lung. Each differs.
For patients with a chronic history of wheezing (Chronic Asthmatic), Guizhi Tang (Cinnamon Twig Decoction) added with Houpo (Magnolia Bark) and Xingren (Apricot Seed) is beneficial. In Taiyang disease, if there is pain in bone joints, headache, lower back pain, aversion to wind, anhidrosis, and wheezing, drinking large amounts of water after diaphoresis will cause wheezing; similarly, washing the body with cold water can induce wheezing.
In Shanghan, if there is fluid retention in the epigastrium, accompanied by dry heaving, fever, and cough, or wheezing, Xiao Qinglong Tang (Minor Blue Dragon Decoction) with Mahuang (Ephedra) removed and Xingren (Apricot Seed) added is the primary treatment, aiming to disperse cold-fluid. The Classics state: for wheezing with sweating, Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction) is given to clear and drain; for sweating with wheezing, Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) is given to release the exterior. Why is this so? Generally, when pathogenic factors attack internally, causing Qi rebellion and obstruction leading to wheezing, the sweating is a result of the wheezing, indicating the pathogen is in the interior. Even if the exterior is not fully resolved, releasing the exterior may still be appropriate; this reflects the profound wisdom of the ancients.
In Shanghan, if wheezing is solely due to pathogenic factors in the exterior, the heart and abdomen will be full but not hard. However, if abdominal fullness accompanies wheezing, it becomes a indication for purgation. The Classics say: shortness of breath, abdominal fullness, and wheezing, especially with tidal fever, indicate that the exterior is resolving and the interior can be attacked, due to abdominal fullness causing wheezing.
Furthermore, incessant wheezing indicates Lung exhaustion; sweating like oil with incessant wheezing indicates death. These are untreatable forms of wheezing. When examining patients, careful deliberation is required.
The *Huoren Ge* (Song of the Living Person) states: "Wheezing unresolved by exterior-releasing methods; profuse sweating and tidal fever indicate interior-attacking pathogens. Full chest combined syndrome requires sweating; for fluid-phlegm cough and wheezing, use Xiao Qinglong Tang removing Mahuang."
The Classics state: Excess in Lung Qi leads to wheezing and rebellious Qi; thus, Qi rebellion is due to excess pathogenic factors. In Shanghan wheezing, if pathogenic factors are in the exterior, the heart and abdomen are soft and not hard, with no sweating externally; the treatment is diaphoresis. If pathogenic factors are in the interior, the heart and abdomen are distended and full, with sweating externally; the treatment is purgation. Additionally, wheezing due to fluid Qi presents with palpitations in the epigastrium, indicating water as the pathogen, hence the Xiao Qinglong Tang pattern. If diaphoresis and purgation fail to remove water, leading to急促 wheezing, upper rushing, obstruction, and inability to breathe, Didi San (Thladiantha Fruit Powder) may be used temporarily to induce vomiting. Alas, wheezing is common in epidemic diseases. If accompanied by fixed gaze, delirium, and wheezing, or sweating with wet hair and wheezing, and [body symptoms missing in text], these are critical signs.
Formulas for treating wheezing often contain Mahuang (Ephedra). For Taiyang syndrome with anhidrosis and wheezing, use Mahuang Tang (Ephedra Decoction). If mistakenly purged, leading to diarrhea, rapid pulse, sweating, and wheezing, use Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction). For mild wheezing after purgation, use Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction Added with Magnolia Bark and Apricot Seed). After diaphoresis, do not use Guizhi Tang again. If there is sweating and wheezing without high fever, use Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction). For Yangming syndrome with sweating, no aversion to cold, shortness of breath, abdominal fullness, tidal fever, and wheezing, use Xiaochengqi Tang (Minor Order the Qi Decoction). If the pulse is floating, there is no sweating, and there is wheezing, induce sweating with Mahuang Tang (Ephedra Decoction). For combined Taiyang and Yangming disease with wheezing and chest fullness, do not purge; use Mahuang Tang (Ephedra Decoction). For fluid-phlegm cough and wheezing resulting from excessive water intake after Taiyang diaphoresis, use Xiao Qinglong Tang (Minor Blue Dragon Decoction) with Mahuang removed and Xingren added. For fullness in the lower abdomen, use Xiao Qinglong Tang (Minor Blue Dragon Decoction) with Mahuang removed and Fuling (Poria) added. For Yin syndrome wheezing, the pulse is likely suppressed and deep with cold limbs; use Fanyin Dan (Return to Yin Pill) and Wuweizi Tang (Schisandra Decoction). For noisy respiration and wheezing with Qi rushing upward, Sun Yonghe used Mahuang Tang (Ephedra Decoction) added with Chenpi (Tangerine Peel) and Xingren (Apricot Seed). For chronic wheezing and cough with cold and nasal discharge, use Yijian Jiubao Tang (Simple Nine Treasures Decoction).
[Formulas]
Mahuang San (Ephedra Powder): Treats Shanghan with vexatious heat, wheezing, and急促 breathing.
Ingredients: Mahuang (Ephedra, roots and nodes removed), Mutong (Akebia Stem), Zisu Jingye (Perilla Stem and Leaf), Chifuling (Red Poria), Sheng Gan Dihuang (Fresh Rehmannia Root), Zhishi (Immature Bitter Orange, bran-fried to light yellow), Tianmendong (Asparagus Tuber, heart removed and dried) [each 1.5 taels]; Gancao (Licorice Root, 1 fen, honey-fried to light red and crushed).
Preparation: Coarsely ground into powder. Take 4 qian per dose, add 1 zhuan of water and 0.5 fen of fresh ginger, decoct to 0.6 zhuan, strain. Warm drink at any time.
Zisu San (Perilla Powder) (from *Shenghui Fang*): Treats Shanghan with vexatious wheezing, chest and diaphragm fullness, and loss of appetite.
Ingredients: Zisu Jingye (Perilla Stem and Leaf), Chifuling (Red Poria), Jiegeng (Platycodon Root, radicle removed), Zhike (Bitter Orange, bran-fried to light yellow, pith removed), Chuandahuang (Sichuan Rhubarb, crushed and lightly fried), Chenjupi (Aged Tangerine Peel, soaked in water, white pith removed and dried), Chaihu (Bupleurum Root, radix removed), Qianhu (Peucedanum Root, radicle removed), Dafupi (Areca Pericarp, crushed), Maimendong (Ophiopogon Tuber, heart removed), Yuliren (Buried Plum Kernel, soaked in water, skin and tip removed, lightly fried), Helile Pi (Persimmon Peel) [each 0.5 tael]; Gancao (Licorice Root, 1 fen, honey-fried to light red and crushed).
Preparation: Ground and sifted into powder. Take 4 qian per dose, add 1 zhuan of water and 0.5 fen of fresh ginger, decoct to 0.6 zhuan, strain. Warm drink at any time.
Sheng Gan Dihuang San (Dried Rehmannia Powder) (from *Shenghui Fang*): Treats Shanghan with vexation,急促 wheezing, rebellious cough, excessive saliva, and hemoptysis.
Ingredients: Sheng Gan Dihuang (Dried Rehmannia Root, 1 tael), Chifuling (Red Poria, 1 tael), Zisu Zi (Perilla Seed, lightly fried), Jiegeng (Platycodon Root, radicle removed), Xingren (Apricot Seed, soaked in water, skin and tip removed, double-kernel, bran-fried to light yellow), Chenjupi (Aged Tangerine Peel, soaked in water, white pith removed and dried), Renshen (Ginseng Root, radicle removed, each 0.5 tael); Gancao (Licorice Root, 1 fen, honey-fried to light red and crushed).
Preparation: Ground and sifted into powder. Take 4 qian per dose, add 1 zhuan of water and 0.5 fen of fresh ginger, decoct to 0.6 zhuan, strain. Warm drink at any time.
(For) Shanghan with headache, high fever, thick sticky sputum, nasal congestion,气喘, and vexation. This formula is effective. (From *Shenghui Fang*)
Ingredients: Mahuang (Ephedra, 1.5 taels, roots and nodes removed), Qianhu (Peucedanum Root, 1.5 taels, radicle removed), Baiqian (Cynanchum Root, 1.5 taels), Sangbaipí (Mulberry Root Bark, 1.5 taels, crushed), Shigao (Gypsum, 2 taels), Gancao (Licorice Root, 1 tael, honey-fried to light red and crushed), Chenjupi (Aged Tangerine Peel, 1 tael, soaked in water, white pith removed and dried), Xingren (Apricot Seed, 1.5 taels, soaked in water, skin and tip removed, double-kernel, bran-fried to light yellow).
Preparation: Coarsely ground into powder. Take 4 qian per dose, add 1 zhuan of water, 0.5 fen of fresh ginger, and 2 stalks of scallion white, decoct to 0.6 zhuan, strain. Warm drink at any time.
Beimu San (Fritillaria Powder) (from *Shenghui Fang*): Treats Shanghan with sweating,急促 wheezing, vexatious heat, and headache.
Ingredients: Beimu (Fritillaria Bulb, 3 qian, baked to light yellow), Baihe (Lily Bulb, 3 qian), Xingren (Apricot Seed, 1 tael, soaked in water, skin and tip removed, double-kernel, bran-fried to light yellow), Chifuling (Red Poria, 3 qian), Mahuang (Ephedra, 1 tael, roots and nodes removed), Shigao (Gypsum, 2 taels), Gancao (Licorice Root, 1 tael, honey-fried to light red and crushed), Renshen (Ginseng Root, 1 tael, radicle removed), Chaihu (Bupleurum Root, 1 tael, radix removed).
Preparation: Coarsely ground into powder. Take 4 qian per dose, add 1 zhuan of water and 0.5 fen of fresh ginger, decoct to 0.6 zhuan, strain. Warm drink at any time.
(This formula treats) Shanghan with sweating that does not resolve, following previous emesis or purgation, presenting with chest and epigastric stuffiness, persistent vexatious wheezing.
Ingredients: Sangbaipí (Mulberry Root Bark, 1 or 2 taels, crushed), Xuanfuhua (Inula Flower, 0.5 tael), Gancao (Licorice Root, 0.5 tael, honey-fried to light red and crushed), Renshen (Ginseng Root, 1 tael, radicle removed), Muxiang (Costus Root, 1 tael), Zhike (Bitter Orange, 1 tael, bran-fried to light yellow, pith removed), Banxia (Pinellia Tuber, 0.5 tael, soaked in water seven times to remove slipperiness), Binglang (Areca Nut, 1 tael).
Preparation: Ground and sifted into powder.
(This formula treats) Shanghan after 7-8 days, with Lung heat congestion, large intestine blockage, yellow-red urine, and mental vexation with wheezing. (From *Shenghui Fang*)
Ingredients: Zisu Jingye (Perilla Stem and Leaf), Mutong (Akebia Stem, crushed), Sangbaipí (Mulberry Root Bark, crushed), Ziwan (Aster Root, washed free of soil and radix), Huangqin (Scutellaria Root) [each 1 tael], Chuandahuang (Sichuan Rhubarb, 1.5 taels, crushed and lightly fried), Chifuling (Red Poria, 1 tael), Gancao (Licorice Root, 0.5 tael, honey-fried to light red).
Preparation: Ground and sifted into powder. Take 5 qian per dose, add 1 large zhuan of water, decoct... [text cuts off].
Binglang San (Areca Nut Powder) (from *Shenghui Fang*): Treats Shanghan with Qi congestion, vexatious wheezing, abdominal and hypochondriac oppression, and loss of appetite.
Ingredients: Binglang (Areca Nut, 0.5 tael), Helile Pi (Persimmon Peel, 1 tael), Sangbaipí (Mulberry Root Bark, 0.5 tael, crushed), Muxiang (Costus Root, 1 fen), Guixin (Cinnamon Bark, 1 fen), Gancao (Licorice Root, 1 fen, honey-fried to light red and crushed), Chuandahuang (Sichuan Rhubarb, 3 qian, crushed and lightly fried), Renshen (Ginseng Root, 0.5 tael, radicle removed), Chifuling (Red Poria, 3 qian), Zhike (Bitter Orange, 3 qian, bran-fried to light yellow, pith removed).
Preparation: Finely ground and sifted. Take 2 qian per dose, add 1 zhuan of water, 0.5 fen of fresh ginger, and 2 jujubes, decoct to 0.5 zhuan, discard ginger and jujubes. Drink warm with dregs at any time.
(This formula treats) Shanghan with headache, soreness and pain in all joints, Qi congestion, and vexatious wheezing. (From *Shenghui Fang*)
Ingredients: Mahuang (Ephedra, 1 tael, roots and nodes removed), Gancao (Licorice Root, 3 qian, honey-fried to light red and crushed), Chi Shaoyao (Red Peony Root, 3 qian), Guixin (Cinnamon Bark, 0.5 tael), Xingren (Apricot Seed, 0.5 tael, soaked in water, skin and tip removed, double-kernel, bran-fried to light yellow), Shigao (Gypsum, 1.5 taels, pounded).
Preparation: Finely ground and mixed evenly. Divide into three doses. Each dose adds 1.5 large zhuan of water, decocts to 1 zhuan, strains. Warm drink at any time, divided into two servings. Re-administer after walking five to seven li, stopping when sweating occurs.
Xiao Qinglong Qu Mahuang Jia Xingren Tang (Minor Blue Dragon Decoction Removing Ephedra and Adding Apricot Seed) (from *Huoren Shu*): Treats Shanghan with fluid retention in the epigastrium, cough, and induced wheezing.
Ingredients: Shaoyao (Peony Root), Gui (Cinnamon, bark removed), Gancao (Licorice Root, honey-fried), Xixin (Asarum, radix and leaves removed), Wuweizi (Schisandra Berry, stir-fried), Ganjiang (Dried Ginger, roasted), Xingren (Apricot Seed, soaked in water, skin and tip removed, double-kernel, stir-fried, each 3 taels), Banxia (Pinellia Tuber, soaked in water seven times, sliced and dried, 2.5 taels).
Preparation: Crushed to the size of hemp seeds. Take 5 qian per dose, add 1.5 zhuan of water, decoct... [text cuts off].
Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) (from *Qianjin Fang*): Treats Shanghan after purgation, where Guizhi Tang is contraindicated. Presents with sweating, wheezing, and no high fever.
Ingredients: Mahuang (Ephedra, 4 taels, roots and nodes removed, foam removed with boiling water and dried), Xingren (Apricot Seed, 50 kernels, skin removed, double-kernel, stir-fried), Gancao (Licorice Root, 2 taels, honey-fried), Shigao (Gypsum, 0.5 jin, crushed).
Preparation: Crushed to the size of hemp seeds. Take 5 qian bi per dose, add 1.5 zhuan of water, decoct to 0.8 zhuan, strain, warm drink.
Fuling Tang (Poria Decoction) (from *Shengji Zonglu*): Treats Shanghan with fluid retention in the epigastrium, Lung Qi deficiency with distension,急促 wheezing, and dry throat.
Ingredients: Chifuling (Red Poria, black skin removed), Shigao (Gypsum) [each 1.5 taels], Shaoyao (Peony Root, 3 qian), Banxia (Pinellia Tuber, 1 tael, soaked in water seven times and stir-fried until dry), Xixin (Asarum, radix and leaves removed), Gui (Cinnamon, bark removed), Wuweizi (Schisandra Berry) [each 0.5 tael], Mahuang (Ephedra, 1 tael, roots and nodes removed, foam removed with boiling water and dried), Sangbaipí (Mulberry Root Bark, 1 tael, crushed).
Preparation: Crushed to the size of hemp seeds. Take 5 qian bi per dose, add 1.5 zhuan of water and 1 fen of smashed fresh ginger, decoct together to 0.8 zhuan, strain, warm drink.
Zhuling Tang (Polyporus Decoction) (from *Shengji Zonglu*): Treats Shanghan with unresolved exterior syndrome, epigastric wheezing and fullness, and difficult urination and defecation.
Ingredients: Zhuling (Polyporus, black skin removed), Chifuling (Red Poria, black skin removed), Baizhu (Atractylodes Macrocephala, stir-fried), Mahuang (Ephedra, roots and nodes removed), Gui (Cinnamon, bark removed), Tingli (Descurainia Seed, lightly stir-fried), Zexie (Alisma Rhizome) [equal parts].
Preparation: Coarsely ground and sifted. Take 3 qian bi per dose, add 1 zhuan of water and 3 slices of fresh ginger, decoct together to 0.7 zhuan, strain, warm drink.
Madouling Tang (Aristolochia Decoction) (from *Shengji Zonglu*): Treats post-Shanghan lung Qi rebellious wheezing.
Ingredients: Madouling (Aristolochia Fructus, 1 fen), Mutong (Akebia Stem, 1 tael, crushed), Chenjupi (Aged Tangerine Peel, 0.5 tael, soaked in water, white pith removed and dried), Zisu Jingye (Perilla Stem and Leaf, 3 qian).
Preparation: Coarsely ground and sifted. Take 5 qian bi per dose, add 1.5 zhuan of water, 15 stems of Centella asiatica (Dengxin Cao), and 3 jujubes split open, decoct together to 0.7 zhuan, strain. Warm drink after meals. Twice daily.
Muxiang Wan (Costus Pill) (from *Shengji Zonglu*): Treats post-Shanghan Lung Qi rebellious wheezing, throat obstruction, and facial edema.
Ingredients: Muxiang (Costus Root, 1 tael, ground), Kunbu (Kelp, washed in water to remove salt and dried), Haizao (Sargassum, washed in water to remove salt and dried), Ganjiang (Dried Ginger, roasted) [each 3 qian], Haiha (Clam Shell, separately ground to powder), Xixin (Asarum, radix and leaves removed), Shujiao (Sichuan Pepper, eyes and closed-mouth removed, lightly stir-fried until sweat appears) [each 0.5 tael].
Preparation: First six ingredients ground into powder, mixed with Haiha powder, blended uniformly. Bind with refined honey, pound 300-500 times. Form pills the size of Sophora seeds. Take 15 pills on an empty stomach with rice water.
Dafupi Tang (Areca Pericarp Decoction) (from *Shengji Zonglu*): Treats post-Shanghan wheezing after sweating, with persistent high fever.
Ingredients: Dafupi (Areca Pericarp, crushed), Chaihu (Bupleurum Root, radix removed) [each 1 tael], Chifuling (Red Poria, black skin removed, 3 qian), Sangbaipí (Mulberry Root Bark, lightly roasted and crushed, 0.5 tael).
Preparation: Coarsely ground and sifted. Take 3 qian bi per dose, add 1 zhuan of water and 3 slices of fresh ginger, decoct together to 0.6 zhuan, strain. Warm drink at any time.
Yuntaizi Wan (Rapeseed Pill) (from *Shengji Zonglu*): Treats post-Shanghan wheezing and cough preventing lying down, with Qi congestion when supine and chest fullness.
Ingredients: Yuntaizi (Rapeseed, 1 tael, lightly stir-fried), Tingli (Descurainia Seed, 1.5 taels, lightly stir-fried), Madouling (Aristolochia Fructus, 0.5 tael), Ziwan (Aster Root, 0.5 tael, dirt removed), Xingren (Apricot Seed, 1.5 taels weight, soaked in water, skin and tip removed, double-kernel, bran-fried until yellow and finely ground), Baiqian (Cynanchum Root), Fangji (Stephania Root), Renshen (Ginseng Root) [each 3 qian], Zhaojiao (Soap Pod, fried in lard until yellow, skin and seeds removed), Gancao (Licorice Root) [each 0.5 tael, honey-fried to light red].
Preparation: Nine ingredients ground into powder, mixed with ground Xingren, blended uniformly. Bind with refined honey, pound 300-500 times. Form pills the size of Sophora seeds. Take 20 pills before meals with plum decoction made with child's urine. Twice daily.
Muxiang Wan (Costus Pill) (from *Shengji Zonglu*): Treats post-Shanghan Spleen and Stomach deficiency-cold with Qi rushing upward causing wheezing.
Ingredients: Muxiang (Costus Root), Rou Doukou (Nutmeg, shell removed) [each 0.5 tael], Baifuling (White Poria, black skin removed, 3 qian), Renshen (Ginseng Root, 3 qian), Gui (Cinnamon, bark removed), Binglang (Areca Nut, crushed) [each 1 tael], Dingxiang (Clove, 1 fen),awei (Asafoetida, 1 fen, dissolved in wine to paste, mixed with small amount of flour, formed into cake, roasted until yellow and cooked).
Preparation: Ground into powder.
Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction Added with Magnolia Bark and Apricot Seed) (from *Shengji Zonglu*): Treats Taiyang disease in Shanghan, mild wheezing after purgation, due to unresolved exterior.
Ingredients: Gui (Cinnamon, bark removed), Shaoyao (Peony Root) [each 3 taels], Gancao (Licorice Root), Houpo (Magnolia Bark, ginger juice-fried) [each 2 taels], Xingren (Apricot Seed, 50 kernels, skin and tip removed).
Preparation: Crushed to the size of hemp seeds. Take 5 qian bi per dose, add 1 zhuan of water, 1 date-sized piece of sliced fresh ginger, and 2 jujubes split open, decoct to 0.8 zhuan, strain, warm drink.
Case Study: In the first month of Wushen year, a military officer was captured by bandits and hidden under a plank in a boat. He escaped after several days. Starving, he ate excessively, then undressed to catch lice. The next day, he developed Shanghan with spontaneous sweating and diaphragmatic obstruction. One physician treated it as Shanghan and purged him; another treated it as pathogenic invasion from undressing and induced sweating. Mixed treatments for several days led to confusion and lethargy, with loud, high-pitched wheezing. Physicians were panicked. I diagnosed: "Taiyang disease, purged, resulting in mild exterior wheezing. Use Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction Added with Magnolia Bark and Apricot Seed), the method of Zhang Zhongjing." Ordered urgent preparation. One dose stopped wheezing; second dose produced slight sweating. By evening, body temperature normalized, pulse harmonized. Physician said: "I have never used Zhongjing's formulas in my life; I did not know they were so miraculous." I replied: "Zhongjing's methods do not deceive posterity; it is merely that some neglect learning and abandon clarity."
Zhishi Tang (Immature Bitter Orange Decoction): Treats Qi rushing to the heart, chest stuffiness, and急促 wheezing due to cold-fluid retention.
Ingredients: Zhishi (Immature Bitter Orange, 1 tael, honey-fried), Jupi (Tangerine Peel), Banxia (Pinellia Tuber, 1 tael), Shengjiang (Fresh Ginger), Houpo (Magnolia Bark) [each 3 taels].
Preparation: Five ingredients with 6 sheng of water, boil to 3 sheng, strain, warm drink 1 sheng. If sore throat, add Jiegeng (Platycodon Root) 1 tael.
Wuweizi Tang (Schisandra Decoction) (from *Huoren Shu*): Treats Shanghan with急促 wheezing, suppressed pulse, and cold limbs.
Ingredients: Renshen (Ginseng Root), Maimendong (Ophiopogon Tuber, heart removed), Xingren (Apricot Seed, skin and tip removed), Jupi (Tangerine Peel, white pith removed) [each 1 tael], Wuweizi (Schisandra Berry, 0.5 tael).
Preparation: Crushed to the size of hemp seeds. Add 10 slices of fresh ginger and 3 jujubes, decoct 3 large bai zhans of water to 1.5 zhan, strain, divide into two doses.