喘气之病。哮吼如水鸡之声。牵引胸背。气不得息。坐卧不安
此谓嗽而气喘。或宿有此根。如遇寒暄则发。一时暴感。并于前嗽药中。加桑白皮。则续
加仍吞养正丹。间进青金丹。风寒喘嗽。宜九宝汤。若干喘不嗽。不分久远近发。宜苏子
降气汤。或神秘汤。吞养正丹。重则四磨饮。或六磨饮。吞灵砂丹。或应梦观音散。吞养正
丹。尤宜。
喘而服药不效者。利导之。宜神保丸。大便已溏者。不可用。
不嗽而气自急。有二证。须用分别。有外邪迫肺。而气急者。病初得。气不急。必兼外
证。
此谓之喘。若用耗气除邪之药。则元气愈脱。而气愈上奔矣。宜于虚损门气急痰证求之。气
急。而膈间更有刺痛处。宜分气饮。治嗽与喘。用五味为多。但五味有南有北。生津止渴。
润肺益肾。治劳嗽者。宜用北五味若风邪在肺。宜用南五味。不若二者兼用。
（附恶心）
呕与吐之辨。已于伤寒论之。然证亦不一。有寒呕。有热呕。气呕。痰呕、吐食呕、吐
血、
吐蛔、恶心、干呕。除热呕吐血外。近世呕吐二字。皆通用。然却无甚利害。理亦自不妨。
并小半夏茯苓汤。或二陈汤。或理中汤。多加生姜煎。生姜呕中之圣药。大痛色如青菜叶者
死。
寒呕。中脘停寒。饮食喜辛热。物入口。即吐出。宜二陈汤。加丁香十粒。或理中汤加
枳实
半钱。不效。则温中汤。甚则附子理中汤。或丁附汤。并须冷服。盖冷遇冷则相入。庶不吐
出。有痰饮。粥药到口即吐。人皆谓其翻胃。非也。此乃痰气结在咽膈之间。宜先以姜苏汤
下灵砂丹。俟药可进。则以顺气之药继之。
外有吐泻及痢疾。或腹冷痛。进热剂太骤。以致呕逆。宜二陈汤。加砂仁白豆蔻各半钱
甚
则入沉香少许。寒、热、气、食、痰、血六呕。外有漏气走哺。漏气者。上焦热。食必先吐
而后下。汗出身。胃热走哺者。下焦热。气逆不续。大小便不通。呕吐不禁。
热呕。见诸伤门。伤寒呕吐证。凡进热药愈增者。当于寒呕中求。热呕宜二陈汤。加黄
连一
钱气呕胸满膈胀。关格不通。不食常饱。食则常气逆而吐。此因盛怒。中饮食而然。宜二陈
汤。加枳实木香各半钱。或吴茱萸汤。不效。则丁沉透膈汤。及五膈宽中汤。
食呕。多因七情而得。有外感邪气。并饮食不节而生。大概治以理中为先。二陈汤。加
枳实一钱。或加南星七分。沉香木香各四分。亦好。或只服枳南汤或导痰汤。
又有中脘伏痰。遇冷即发。俗谓之冷痫。或服新法半夏汤。或抓脾汤。外有热痰而呕
者。
宜小半夏茯苓汤。加竹茹如钱大。若呕痰而或致厥者。乃寒痰逆闷。谓之痰厥。宜姜附汤。
以生附代熟附。
吐蛔。乃胃寒所生。经云蛔者长虫也。胃中冷则吐蛔。成蛔厥。宜理中汤。加炒川椒五
粒。
槟榔半钱。吞乌梅丸。恶心干呕。欲吐不吐。心下映漾。人如畏舡。宜大半夏汤。或小半夏
茯苓汤。或理中汤。治中汤。皆可用。呕吐。诸药不效当借镇重之药。以坠其逆气。宜姜苏
汤下灵砂丹。须百粒作一服。俟药得效。却以养正丹。半硫丸导之。呕吐。津液既去。其口
必渴。不可因渴而遽以为热。
又有呕吐。诸药不效。又别无前项痰气等证。乃蛔在胸膈作呕。见药则动。动则不纳药
药
出而蛔不出。虽非吐蛔之比。亦宜用吐蛔药。或于治呕药中。入炒川椒十粒。蛔见椒。则头
伏故也。
曾有患人用附子理中汤四逆汤。加丁香。到口即吐。后去干姜。只参附。加丁木二香煎
更磨入沉香。药立吐定。盖虚痰气凝结。丁附既温。佐以沉木香则通。干姜白术则泥耳。
哮喘发作时，呼吸急促有声，哮鸣音如同水鸡（田鸡）的叫声。气息牵引胸背部位，呼吸不畅，坐立不安。
这被称为咳嗽伴气喘。有些人原本就有此病根，遇到寒冷或温暖变化时就会发作，或者是突然感受外邪所致。对于之前的止咳药物中，加入桑白皮，然后继续服用养正丹，间歇性进服青金丹。若是风寒引起的喘咳，适宜使用九宝汤。如果是干喘而不咳嗽，无论病程长短、新旧，都适宜使用苏子降气汤，或者神秘汤，并吞服养正丹。病情严重的，使用四磨饮，或者六磨饮，吞服灵砂丹，或者应梦观音散，吞服养正丹，尤其适宜。
如果喘息服药无效，应当采用通利导下的方法，适宜使用神保丸。如果大便已经稀溏，则不可使用。
不咳嗽而气息自然急促，有两种证候，必须加以区分。一种是外邪迫肺导致的气急，这种病初起时，气息并不急促，必定兼有外在表证。这被称为喘。如果使用耗损正气、祛除邪气的药物，那么元气会更加虚脱，气息会更加上逆奔涌。应当在虚损门的气急痰证中寻找治法。气息急促，且膈间还有刺痛之处，适宜使用分气饮。治疗咳嗽与气喘，多用五味子。但五味子有南五味子和北五味子之分。生津止渴、润肺益肾、治疗劳嗽的，适宜用北五味子；若风邪在肺，适宜用南五味子。不如两者兼用。
（附恶心）
呕吐的区别，已经在《伤寒论》中论述过。然而证候也不单一，有寒呕、热呕、气呕、痰呕、吐食呕、吐血、吐蛔虫、恶心、干呕。除了热呕和吐血外，近代“呕吐”二字通用，但这并无太大利害，道理上也不妨碍。可以使用小半夏茯苓汤，或者二陈汤，或者理中汤，多加生姜煎煮。生姜是治疗呕吐的圣药。如果疼痛剧烈，面色像青菜叶一样惨绿，则是死证。
寒呕：中脘部停聚寒气，饮食喜欢辛辣温热之物，食物入口即吐出。适宜使用二陈汤，加丁香十粒；或者理中汤加枳实半钱。如果无效，则使用温中汤。极重的，使用附子理中汤，或者丁附汤，都必须冷服。因为冷遇冷则相互渗透，这样才不至于吐出。如果有痰饮，粥药到口即吐，人们都称之为翻胃，其实不是。这是痰气结聚在咽喉膈膜之间。适宜先用姜苏汤送服灵砂丹，等到药物可以进服后，再用顺气药物接续治疗。
另外还有吐泻及痢疾，或者腹部冷痛，因进服热剂过于迅猛，以致引起呕逆。适宜使用二陈汤，加砂仁、白豆蔻各半钱。极重的，加入少许沉香。寒、热、气、食、痰、血六种呕吐之外，还有漏气走哺。所谓漏气，是指上焦有热，进食必先呕吐而后下行。汗出身体发热，胃热导致的走哺，是指下焦有热，气逆不能接续，大小便不通，呕吐不止。
热呕：见诸于伤门。伤寒呕吐证，凡是进服热药后症状增加的，应当在寒呕中寻求治法。热呕适宜使用二陈汤，加黄连一钱。
气呕：胸满膈胀，关格不通，不吃东西也常觉得饱，吃东西则常气逆而吐。这是因为盛怒之后进食所致。适宜使用二陈汤，加枳实、木香各半钱；或者吴茱萸汤。如果无效，则使用丁沉透膈汤，以及五膈宽中汤。
食呕：多因七情内伤所致，也有因外感邪气，加上饮食不节而产生的。大概治疗以理中汤为先，或者二陈汤，加枳实一钱；或者加南星七分，沉香、木香各四分，也很好。或者只服用枳南汤或导痰汤。
又有中脘伏留痰湿，遇到寒冷就发作，俗称冷痫。或者服用新法半夏汤，或者抓脾汤。另外有热痰导致呕吐的，适宜使用小半夏茯苓汤，加如铜钱大小的竹茹。如果呕吐痰液而导致昏厥的，乃是寒痰逆闷，称为痰厥。适宜使用姜附汤，以生附子代替熟附子。
吐蛔虫：乃胃寒所生。经书说蛔虫是长虫。胃中寒冷则吐蛔虫，形成蛔厥。适宜使用理中汤，加炒川椒五粒，槟榔半钱，吞服乌梅丸。
恶心干呕：想吐又吐不出来，心下悸动晃漾，人好像害怕坐船一样。适宜使用大半夏汤，或小半夏茯苓汤，或者理中汤、治中汤，都可以使用。
对于呕吐，各种药物无效时，应当借助镇重药物，来镇压上逆之气。适宜用姜苏汤送服灵砂丹，每次一百粒作为一服。等到药物见效后，再用养正丹、半硫丸引导排泄。呕吐导致津液流失，口中必然口渴，不要因为口渴就立刻认为是热证。
又有呕吐，各种药物无效，又没有前述痰气等证候，乃是蛔虫在胸膈作祟引起呕吐，见到药物就躁动，躁动则不接受药物，药出而蛔不出。虽然不像直接吐蛔虫那样，但也适宜使用治蛔虫的药物，或者在治呕药中加入炒川椒十粒。因为蛔虫见到花椒，头部就会伏下不动的缘故。
曾经有病人服用附子理中汤、四逆汤，加丁香，药到口即吐。后来去掉干姜，只用人参、附子，加丁香、木香两种香料煎煮，再磨入沉香，药立即停止呕吐。这是因为虚痰气凝结，丁香、附子既已温补，佐以沉香、木香则能通行，而干姜、白术则会凝滞阻碍。
Asthma is characterized by rapid breathing with a wheezing sound like that of a bullfrog (Shuiji). The sensation pulls at the chest and back, breathing is obstructed, and there is restlessness in sitting or lying down.
This is referred to as cough accompanied by asthma. Some individuals have this underlying condition; it may be triggered by exposure to cold or warmth, or by sudden contraction of external pathogens. In previous prescriptions for cough, add Bai Pi (Cortex Mori Radicis) [Sangbaipi], then continue taking Yangzheng Dan (Nourishing the Right Pill), and intermittently administer Qingjin Dan (Green Gold Pill). For asthma and cough caused by wind-cold, Jiubao Tang (Nine Treasures Decoction) is suitable. For dry asthma without cough, regardless of duration or chronicity, Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction) or Shenmi Tang (Mysterious Secret Decoction) are suitable, taken with Yangzheng Dan. For severe cases, Simo Yin (Four Moans Drink) or Limo Yin (Six Moans Drink) is used, taken with Lingsha Dan (Cinnabar Pill), or Yingmeng Guanyin San (Dream-Encountering Guanyin Powder) taken with Yangzheng Dan, which is particularly suitable.
If asthma does not respond to medication, purgative methods should be employed; Shenbao Wan (Divine Protection Pill) is suitable. If the stool is already loose, it must not be used.
When there is no cough but spontaneous rapid breathing, two patterns must be distinguished. One is rapid breathing caused by external pathogens forcing the lungs; in the early stage of illness, breathing is not yet rapid, and there are necessarily accompanying exterior symptoms. This is called asthma. If one uses drugs that deplete healthy qi to eliminate pathogens, healthy qi will become more depleted, and the breath will rush upward even more. One should seek treatment in the section on deficiency injuries regarding rapid breathing and phlegm patterns. If rapid breathing is accompanied by stabbing pain in the diaphragm area, Fenqi Yin (Separating Qi Drink) is suitable. When treating cough and asthma, Wuweizi (Schisandra Berry) is used frequently. However, Wuweizi comes from southern and northern sources. To generate fluids, quench thirst, moisten the lungs, benefit the kidneys, and treat consumptive cough, Northern Wuweizi is suitable. If wind-pathogens are in the lungs, Southern Wuweizi is suitable. It is better to use both together.
(Attached: Nausea)
The distinction between Ou (vomiting) and Tu (spitting up) has been discussed in Shanghan Lun (Treatise on Cold Damage). However, the patterns are not uniform: there are cold ou, hot ou, qi (stagnant qi) ou, tan (phlegm) ou, food ou, blood tu, roundworm tu, enxin (nausea), and ganou (dry heaving). Except for hot ou and blood tu, the terms "ou" and "tu" are generally used interchangeably in modern times, which causes little harm and is theoretically acceptable. Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction), Erchen Tang (Two Aged Substances Decoction), or Lizhong Tang (Regulate the Middle Decoction) can be used, with extra Shengjiang (Fresh Ginger Rhizome) added for decoction. Shengjiang is the supreme herb for treating vomiting. Severe pain with a complexion resembling green vegetable leaves indicates a fatal prognosis.
Cold Ou: Cold stagnates in the Zhongwan (CV12) region. The patient prefers spicy and hot foods, but vomits immediately after swallowing. Erchen Tang (Two Aged Substances Decoction) with ten Dingxiang (Clove) grains, or Lizhong Tang (Regulate the Middle Decoction) with Banqian (half qian) of Zhishi (Immature Bitter Orange) is suitable. If ineffective, Wenzhong Tang (Warm the Middle Decoction) is used. For severe cases, Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) or Dingfu Tang (Clove and Aconite Decoction) are used, and they must be taken cold. Because cold meets cold, they penetrate each other, preventing vomiting. If there is fluid retention, and porridge or medicine is vomited immediately upon reaching the mouth, people often mistake this for Fanwei (reversal stomach/cancer), but this is incorrect. This is actually phlegm-qi knotting in the throat and diaphragm area. First, administer Lingsha Dan (Cinnabar Pill) with Jiangsu Tang (Ginger and Perilla Decoction). Once medicines can be retained, follow up with qi-regulating herbs.
Additionally, there are cases of vomiting/diarrhea and dysentery, or cold abdominal pain, where vomiting and reversal occur because hot agents were administered too rapidly. Erchen Tang (Two Aged Substances Decoction) with Banqian (half qian) each of Sharen (Amomum Fruit) and Baiddoukou (White Cardamom) is suitable. For severe cases, add a small amount of Chenxiang (Agarwood). Beyond the six types of vomiting (cold, heat, qi, food, phlegm, blood), there is also Louqi Zoubu (Leaking Qi and Food Reflux). "Louqi" refers to upper jiao heat, where food must be vomited before descending. Sweating with body heat indicates stomach heat causing Zoubu. Lower jiao heat causes qi reversal and discontinuation, obstruction of urination and defecation, and uncontrollable vomiting.
Hot Ou: See the section on injuries. For cold damage vomiting, if symptoms worsen with hot medicines, seek treatment within cold ou patterns. Hot ou is suitable for Erchen Tang (Two Aged Substances Decoction) with Qian (one qian) of Huanglian (Rhizoma Coptidis).
Qi Ou: Chest fullness and diaphragmatic distension, obstruction of Guan Ge (gate and lock), feeling full even without eating, and vomiting with qi reversal after eating. This results from eating while in a state of extreme anger. Erchen Tang (Two Aged Substances Decoction) with Banqian (half qian) each of Zhishi (Immature Bitter Orange) and Muxiang (Aucklandia Root) is suitable, or Wuzhuyu Tang (Evodia Decoction). If ineffective, Dingchen Touge Tang (Clove and Agarwood Penetrating Obstruction Decoction) and Wuge Kuanzhong Tang (Five Obstructions Widening Middle Decoction) are used.
Food Ou: Often caused by emotional disturbances, or by external pathogens combined with irregular diet. Generally, treatment begins with Lizhong Tang (Regulate the Middle Decoction), or Erchen Tang (Two Aged Substances Decoction) with Qian (one qian) of Zhishi (Immature Bitter Orange); or adding Qifen (seven fen) of Nanxing (Arisaema Cum Bile), and Sifen (four fen) each of Chenxiang (Agarwood) and Muxiang (Aucklandia Root) is also good. Alternatively, only Zhinan Tang (Immature Bitter Orange and Arisaema Decoction) or Daotan Tang (Great Phlegm Resolving Decoction) can be taken.
There is also latent phlegm in Zhongvan (CV12) that flares up upon exposure to cold, commonly known as Lengxian (Cold Epilepsy). Xinfa Banxia Tang (New Method Pinellia Decoction) or Zhuapi Tang (Grasp Spleen Decoction) can be taken. For vomiting caused by hot phlegm, Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction) with Zhu Ru (Bamboo Shavings) the size of a coin is suitable. If vomiting phlegm leads to syncope, it is Han Tan Ni Men (Cold Phlegm Reversal Stifling), called Tan Jue (Phlegm Syncope). Jiangfu Tang (Ginger and Aconite Decoction) is suitable, using Sheng Fu (Raw Aconite) instead of Shu Fu (Prepared Aconite).
Tu Hui (Vomiting Roundworms): Generated by stomach cold. The classics state that roundworms are long parasites. Cold in the stomach causes vomiting of roundworms, forming Hui Jue (Roundworm Syncope). Lizhong Tang (Regulate the Middle Decoction) with five fried Chuanjiao (Sichuan Pepper) grains and Banqian (half qian) of Binglang (Areca Seed), taken with Wumei Wan (Mume Pill), is suitable.
Enxin Ganou (Nausea and Dry Heaving): Desire to vomit but unable to do so, palpitations in the epigastrium, feeling as if afraid of riding a boat. Banxia Tang (Pinellia Decoction), Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction), Lizhong Tang (Regulate the Middle Decoction), or Zhizhong Tang (Regulate the Center Decoction) are all applicable.
For vomiting unresponsive to various medicines, heavy sedatives should be borrowed to suppress rebellious qi. Lingsha Dan (Cinnabar Pill) administered with Jiangsu Tang (Ginger and Perilla Decoction), 100 pills per dose, is suitable. Once effective, Yangzheng Dan (Nourishing the Right Pill) or Banshu Wan (Half Sulfur Pill) can guide the expulsion. Vomiting depletes body fluids, leading to thirst. Do not assume heat solely based on thirst.
In cases of vomiting unresponsive to medicines, without preceding phlegm-qi symptoms, it is due to roundworms disturbing the chest and diaphragm, causing vomiting. The worms move upon seeing medicine, rejecting intake, so medicine exits but worms do not. Although not identical to direct vomiting of worms, worm-treating herbs are suitable. Adding ten fried Chuanjiao (Sichuan Pepper) grains to anti-emetic formulas works because roundworms immobilize their heads upon encountering pepper.
A patient once took Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) and Sini Tang (Reverse the Extremities Decoction) with Dingxiang (Clove), but vomited immediately upon ingestion. Later, Ganjiang (Dried Ginger) was removed, leaving only Renshen (Ginseng) and Fuzi (Aconite), with Dingxiang (Clove) and Muxiang (Aucklandia Root) added to the decoction, and Chenxiang (Agarwood) ground in. The vomiting stopped immediately. This is because deficiency-phlegm and qi were knotted; Ding and Fu provided warmth, while Chen and Muxiang promoted circulation. Ganjiang and Baizhu (Atractylodes Macrocephala Rhizome) would have been cloying and obstructive.