未发,以扶正气为主。已发,以攻邪为主。有外感邪盛。
补 气虚短气,用人参、蜜炙黄柏、麦门冬、地骨、阿胶、桑白皮。
降痰 有痰亦短气而喘。导痰汤方∶
半夏、南星、陈皮、枳实、茯苓、甘草。
滋阴 阴虚,自小腹下火起而上者,地黄丸。年高痰喘不定者,必用此,仍茯菟与地
黄等分。
疏利风痰 《妇人大全良方》千缗汤方∶
半夏、皂角、炙草、生姜。
降火 有热甚而喘。
泄水 有水乘肺而喘,葶苈、牵牛之类。
降气 导气汤、苏子降气汤,气实导气下行。
润燥 款花膏。
下 有胃实壅遏,以承气汤下之,气实者下之。
劫 椒目为细末一二钱,用姜汁调下止之。又萝卜蒸熟为君、皂角烧灰等分、姜汁,
炼蜜丸,梧桐子大,服五六十丸。劫后,看证用药。
温 外感心下有水气,干呕而喘,小青龙去麻黄加杏仁主之。
专主于痰,必用薄滋味。
宣 宜春初吐之。
导痰顺气 清肺养正之药。
内有所积,外有所感。
宣 就微吐之,以提其气,或用樟木汤吐亦可。
解散 干霍乱不用凉剂,二陈加川芎、仙术、防风、白芷。
分利
有热,有痰、寒、停食。
清热 胃口有热,膈上有痰,二陈加姜、黄连。
滋阴 还少丹、肾气丸。
温 理中丸、不二丸。
导滞 有积滞毒瓦斯上攻而呕者。
下 有食用内消丸。
清镇 烧针丸必用之。
渗泄 水逆者,五苓散主之。
补 久病者,胃虚不纳谷也,人参、黄 、白术、陈皮之类。
在疾病未发作时,以扶助正气为主要原则;在疾病已发作时,以攻逐邪气为主要原则。若外感邪气盛实,则需针对具体情况处理。
补气:对于气虚导致呼吸短促者,使用人参、蜜炙黄柏、麦门冬、地骨皮、阿胶、桑白皮。
降痰:若有痰浊亦会导致呼吸短促且喘息。导痰汤方组成:半夏、天南星、陈皮、枳实、茯苓、甘草。
滋阴:对于阴虚,表现为热气从小腹升起并向上冲逆者,使用地黄丸。对于年高体弱、痰喘症状不稳定的患者,必须使用此方,且仍需用菟丝子与地黄等量配伍。
疏利风痰:参考《妇人大全良方》中的千缗汤方:半夏、皂角、炙甘草、生姜。
泄水:对于水饮凌犯肺脏而致喘息者,使用葶苈子、牵牛子之类药物。
下法(泻下):对于胃中实邪壅塞阻滞者,用承气汤泻下之;对于气实者,采用泻下法。
劫法(急治/强力止喘):将椒目研为细末,每次一至二钱,用姜汁调服以制止喘息。或者将萝卜蒸熟作为主药,配合烧成灰的皂角等量,加入姜汁,炼蜜制成梧桐子大小的丸剂,每次服用五六十丸。急救之后,再根据具体证候用药。
温法:对于外感风寒且心下有停饮水气,出现干呕兼喘息者,以小青龙汤去掉麻黄,加入杏仁为主治方。
治疗应专主于化痰,饮食必须清淡。
宣吐法:适宜在春季初起时使用。
病因在于内有积滞,外有感受。
宣吐法:通过轻微催吐来提举气机,或者使用樟木汤催吐亦可。
解散:对于干霍乱不使用凉性药剂,使用二陈汤加川芎、苍术、防风、白芷。
分利(分消渗利):
When the disease has not yet manifested, the primary principle is to support healthy qi (vital energy); when the disease has manifested, the primary principle is to attack pathogenic factors. If external pathogenic factors are abundant, specific treatments are applied accordingly.
Tonifying Qi: For shortness of breath due to Qi deficiency, use Ren Shen (Ginseng Root), Mi Zhi Huang Bo (Honey-fried Phellodendron Bark), Mai Men Dong (Ophiopogon Tuber), Di Gu Pi (Lycium Bark), E Jiao (Donkey-hide Gelatin), and Sang Bai Pi (Mulberry Root Bark).
Descending Phlegm: Shortness of breath and wheezing may also result from phlegm. The Dao Tan Tang (Phlegm-Resolving Decoction) formula consists of: Ban Xia (Pinellia Rhizome), Nan Xing (Arisaema Rhizoma), Chen Pi (Citrus Reticulatae Pericarpium), Zhi Shi (Immature Bitter Orange), Fu Ling (Poria), and Gan Cao (Licorice Root).
Nourishing Yin: For Yin deficiency characterized by heat rising from the lower abdomen upwards, use Di Huang Wan (Rehmannia Pill). For elderly patients with unstable wheezing due to phlegm, this formula must be used, specifically combining Tu Si Zi (Cuscuta Seed) and Di Huang (Rehmannia Root) in equal proportions.
Dispersing Wind-Phlegm: Refer to the Qian Min Tang (Thousand String Decoction) formula from *Fu Ren Da Quan Liang Fang* (Great Comprehensive Good Prescriptions for Women): Ban Xia (Pinellia Rhizome), Zao Jiao (Tamarix Fruit), Zhi Gan Cao (Honey-fried Licorice Root), and Sheng Jiang (Fresh Ginger).
Descending Fire: For wheezing caused by extreme heat.
Draining Water: For wheezing caused by water invading the lungs, use Ting Li Zi (Descurainiae Semen) and Qian Niu Zi (Pharbitidis Semen).
Descending Qi: Use Dao Qi Tang (Qi-Guiding Decoction) or Su Zi Jiang Qi Tang (Perilla Seed Descending-Qi Decoction) to guide excess Qi downward.
Moistening Dryness: Use Kuan Hua Gao (Kuanhua Paste).
Purgation (Downward Discharge): For stomach fullness and obstruction due to excess, use Cheng Qi Tang (Order the Qi Decoction) to purge; for cases of Qi excess, employ purgative methods.
Coup/Forceful Intervention: Grind Jiao Mu (Sesame Eye/Pepper Seed) into a fine powder, take 1–2 qian, and swallow with Ginger Juice to stop wheezing. Alternatively, steam Radish as the chief ingredient, mix with equal parts of Sooted Zao Jiao (Tamarix Fruit Ash) and Ginger Juice, refine with honey to make pills the size of paulownia seeds, and take 50–60 pills per dose. After this forceful intervention, prescribe medication based on the remaining syndrome.
Warming: For external contraction with fluid retention in the heart region, presenting as dry retching and wheezing, treat primarily with Xiao Qing Long Tang (Minor Blue Dragon Decoction) minus Ma Huang (Ephedra Herb), adding Xing Ren (Apricot Seed).
Treatment should focus primarily on resolving phlegm; diet must be bland.
Ventilation/Emerging Phase: Suitable for early spring onset.
Guiding Phlegm and Smooth Qi: Use herbs that clear the lungs and nourish healthy qi.
The etiology involves internal accumulation and external contraction.
Ventilation/Catharsis: Induce mild vomiting to lift the Qi, or using Zhang Mu Tang (Camphor Wood Decoction) for vomiting is also acceptable.
Dissolution: For Gan Huo Luan (Dry Cholera), do not use cold-natured formulas; use Er Chen Tang (Two-Cured Decoction) plus Chuan Xiong (Ligusticum Rhizome), Cang Zhu (Atractylodes Rhizome), Fang Feng (Saposhnikovia Root), and Bai Zhi (Angelica Dahurica Root).
Separating and Draining:
Syndromes include heat, phlegm, cold, and retained food.
Clearing Heat: For heat in the stomach and phlegm above the diaphragm, use Er Chen Tang (Two-Cured Decoction) plus Sheng Jiang (Fresh Ginger) and Huang Lian (Coptis Rhizome).
Nourishing Yin: Use Huan Shao Dan (Restore Youth Pill) and Shen Qi Wan (Kidney Qi Pill).
Warming: Use Li Zhong Wan (Regulate the Middle Pill) and Bu Er Wan (Unparalleled Pill).
Guiding Stagnation: For vomiting caused by toxic stagnation attacking upward.
Purgation (Downward Discharge): Use Nei Xiao Wan (Internal Dissolving Pill).
Clearing and Calming: Shao Zhen Wan (Burned Needle Pill) is essential.
Percolating and Leaching: For water counterflow, treat primarily with Wu Ling San (Five-Ingredient Powder with Poria).
Tonifying: For chronic illness where the stomach is deficient and cannot accept grain, use Ren Shen (Ginseng Root), Huang Qi (Astragalus Root), Bai Zhu (Atractylodes Macrocephala Rhizome), and Chen Pi (Citrus Reticulatae Pericarpium).