短气者，气急短促，不能相续，似喘非喘，似呻吟而无声也。有实者，虚者，在表者，在里
者，水停心下者，或失于汗下，或汗下后虚极，皆能令人短气。补泻误用，甚于操刃，当详察脉
症而治之。又有素虚人，汗下后，失于调补，以致忽然似喘，出言微弱少气，脉仅二、三至，沉
细如发，甚至无脉，此虚极短气，非真喘也。急宜温补，缓则不救，作喘治必死。汗下后，过用
刻消之剂而见此者，治亦同。总之，短气者，表里、虚实、寒热皆有，但虚者较多，当合脉与兼
症而细参之。
瘟疫兼暑，最难分晰。盖暑病之在表者，有头痛烦躁，肌体大热，脉浮气喘，口干面垢自汗，
手足逆冷，名暑厥，搐摄名暑风，昏不知人为中暑。其症最易与瘟疫表症相混。暑病之在里者，有
呕逆泄泻，心腹痞闷，或兼胀痛，又最易与瘟疫之在里者相混。惟于少气、倦怠、大渴三症，辨
其为暑。第瘟疫亦发渴，但瘟症在表，虽渴亦不甚，必至传里方甚。至暑症，不论表里皆渴，而在
表时，其渴较瘟疫之表者更凶猛殊甚也。以此为辨，庶得其情。如果系瘟兼暑症，即当用解瘟却
暑之剂，亦不必拘于日期，见表治表，见里治里，又宜先治其瘟，瘟解而暑热亦从而退矣。马卯
麟以五瘟丹治瘟暑，但中无治暑之剂，不过凉散，方亦未尽可用。倘遇此症，仍当于达原饮中，将
祛暑之药加减出入之。至于五瘟丹，每岁冬间，预先修和备用亦可。至祛暑等方，载在暑门，兹不
赘。（瘟症发热无休时，暑症发热有作止，以此为辨。若瘟与暑兼，亦难以此作准，仍当详参脉症。）
短气，表现为呼吸急促短促，气息不能接续，样子像喘但不是喘，像呻吟却发不出声音。有实证、虚证，病位在表、在里，水饮停聚在心下的情况，或者是因为误用汗法、下法，或者是经过汗法、下法治疗后正气极度虚弱，这些都能导致人出现短气。补法和泻法如果误用，危害比用刀割还要大，应当详细诊察脉象和症状来治疗。又有平时体质虚弱的人，在汗法、下法之后，失于调养和补益，以致突然表现出类似喘的样子，说话声音微弱、气少，脉搏只有两三次跳动，沉细得像头发丝一样，甚至摸不到脉搏，这是极度虚弱导致的短气，并不是真正的喘证。此时急需温补，如果迟缓救治则无法挽救，如果当作喘证治疗必定致死。在汗法、下法之后，过度使用攻伐消导的药物而出现这种情况的，治疗方法也相同。总之，短气这一病症，表里、虚实、寒热都有，但虚证较多，应当结合脉象和伴随症状仔细参详。
瘟疫兼夹暑邪，最难分辨清楚。大概暑病在体表的，有头痛烦躁，身体大热，脉浮气喘，口干面部油腻自汗，手足逆冷，名为暑厥；抽搐拘挛名为暑风；昏迷不省人事名为中暑。这些症状最容易与瘟疫在表的症状相混淆。暑病在体内的，有呕吐呃逆泄泻，心腹部痞塞闷胀，或者兼有胀痛，又最容易与瘟疫在体内的症状相混淆。只有在少气、倦怠、大渴这三个症状上，辨别出它是暑病。只是瘟疫也会引起口渴，但瘟邪在体表时，虽然口渴也不严重，一定要传到体内才会变得严重。至于暑症，不论在表在里都会口渴，而且在体表时，其口渴程度比瘟疫在体表时更加猛烈严重。以此作为辨别依据，才能掌握病情真相。如果确实是瘟疫兼夹暑症，就应当使用解除瘟疫驱除暑邪的方剂，也不必拘泥于发病日期，见到表证治表证，见到里证治里证，并且适宜先治疗瘟疫，瘟疫解除了暑热自然也就随之消退了。马卯麟用五瘟丹治疗瘟暑，但方中没有治疗暑邪的药物，不过是清凉发散，这个方子也不是完全可用。倘若遇到这种病症，仍然应当在达原饮的基础上，将祛暑的药物进行加减变化。至于五瘟丹，每年冬天预先配制好备用也可以。至于祛暑等方剂，记载在暑病门类中，这里不再赘述。（瘟症发热没有休止的时候，暑症发热有发作和停止的时候，以此作为辨别依据。如果是瘟与暑兼夹，也难以完全以此为标准，仍然应当详细参详脉象和症状。）
Shortness of breath (Duan Qi) refers to rapid and short breathing, where the breath cannot continue smoothly. It resembles panting but is not true panting, and resembles groaning but produces no sound. There are excess patterns (Shi Zheng), deficiency patterns (Xu Zheng), patterns located in the exterior (Biao), patterns located in the interior (Li), and cases where fluid retention occurs beneath the heart. It can also result from improper use of sweating or purging methods, or from extreme deficiency after such treatments; all these can cause shortness of breath. Misusing tonification and draining methods is more dangerous than wielding a blade; one must carefully examine the pulse and symptoms before treating. Additionally, individuals with inherent deficiency who undergo sweating or purging and fail to receive proper regulation and tonification may suddenly exhibit symptoms resembling panting, speaking weakly with little energy. Their pulse may be only two or three beats per cycle, deep and thin like a hair, or even imperceptible. This is extreme deficiency causing shortness of breath, not true panting. Immediate warm tonification is required; delay renders it incurable, and treating it as panting will lead to death. If this presentation occurs due to the overuse of harsh resolving agents after sweating or purging, the treatment is the same. In summary, shortness of breath can involve exterior/interior, excess/deficiency, and cold/heat patterns, though deficiency patterns are more common. One must carefully analyze the pulse and accompanying symptoms.
Plague (Wen Yi) complicated by summerheat (Shu) is difficult to distinguish clearly. Summerheat pathogenic factors in the exterior present with headache, irritability, high fever, floating pulse with panting, dry mouth, greasy complexion, spontaneous sweating, and cold extremities reversed upwards. This is named Summerheat Jue (Shu Jue); convulsions are named Summerwind (Shu Feng); unconsciousness is named Severe Summerheat (Zhong Shu). These symptoms easily confuse with the exterior signs of plague. Summerheat in the interior presents with vomiting, belching, diarrhea, epigastric and abdominal fullness and stuffiness, or distending pain, which easily confuses with the interior signs of plague. Differentiation relies on the triad of shortness of breath, fatigue, and intense thirst. Although plague also causes thirst, when the plague pathogen is in the exterior, thirst is mild and becomes severe only upon transmission to the interior. In contrast, summerheat causes thirst regardless of whether it is in the exterior or interior; moreover, when in the exterior, the thirst is much more intense than that of plague in the exterior. Using this criterion helps ascertain the true nature of the condition. If it is indeed plague complicated by summerheat, one should use formulas that resolve plague and dispel summerheat. One need not rigidly adhere to the days of illness; treat the exterior if exterior signs appear, and treat the interior if interior signs appear. It is advisable to treat the plague first; once the plague is resolved, the summerheat will recede accordingly. Ma Maolin used Wu Wen Dan (Five Plagues Pill) to treat plague-summerheat, but the formula lacks herbs for treating summerheat, serving merely as a cooling and dispersing agent, so it is not entirely suitable. In such cases, one should modify Da Yuan Yin (Origin-Reaching Powder) by adding or subtracting herbs to dispel summerheat. Wu Wen Dan can be prepared in advance during winter each year for future use. Formulas for dispelling summerheat are recorded under the category of Summerheat diseases and are not repeated here. (Plague fever has no cessation, while summerheat fever comes and goes; this serves as a differentiating factor. However, if plague and summerheat are combined, this criterion alone is insufficient, and careful examination of pulse and symptoms remains necessary.)