脉，应手无力，必咽干无津少气，此肺虚证。（右分虚实例。从前皆泻实例。今述补虚例于后。）
东垣云∶肺胀膨膨而喘咳，胸膈满，壅盛而上奔者，于随证用药方中，多加五味子，人
参次之，麦门冬又次之，黄连少许。如甚则交两手而瞀者，真气大虚也。若气短加
黄、五味子、人参。气盛去五味子、人参，加黄芩、荆芥穗。冬月去荆芥穗，加
草豆蔻仁。丹溪云∶气虚者，用人参、蜜炙黄柏、麦冬、地骨皮之类。本草治咳嗽
上气喘急，以人参一味为末，鸡子清投新水调下一钱。昔有二人同走，一含人参，
一不含，俱走三五里许，其不含者大喘，含者气息自如，此乃人参之力也。娄全善
治一妇人，五十余岁，素有痰嗽，忽一日大喘，痰出如泉，身汗如油，脉浮而洪，
似命绝之状，速用麦门冬四钱，人参二钱，五味子一钱五分，煎服一帖，喘定汗止，
三帖后，痰亦渐少，再与前方内加栝蒌仁一钱五分，白术、当归、芍药、黄芩各一
钱，服二十余帖而安。此实麦门冬、五味子、人参之功也。如自汗兼腹满，脉沉实
而喘者，里实也。宜下之。（以上治气虚例。）丹溪云∶喘有阴虚，自小腹下火起而上者，
宜四物汤加青黛、竹沥、陈皮，入童便煎服。有阴虚挟痰喘者，四物汤加枳壳、半
夏，补阴降火。愚谓归、地泥膈生痰，枳、半燥泄伤阴，不如用天门冬、桑皮、贝
母、马兜铃、地骨皮、麦门冬、枇杷叶之属。（以上治阴虚例。）东垣曰∶病机云，诸
痿喘呕，皆属于上。辩云，伤寒家论喘呕以为火热者，是明有余之邪中于外，寒变而为热，
心火太旺攻肺，故属于上。又云，膏粱之人，奉养太过，及过爱小儿，亦能积热于
上而为喘咳，宜以甘寒之剂治之。《脉经》又云，肺盛有余，则咳嗽上气喘渴，烦心
胸满短气，皆冲脉之火行于胸中而作也。系在下焦，非属上也。故杂病不足之邪，
起于有余病机之邪，自是标本病传多说。饮食劳役，喜怒不节，水谷之寒热，感则
害人六腑，皆由中气不足。其 胀腹满，咳喘，呕食不下，皆以大甘辛热之剂治之，
则立已。今立热喘、寒喘二方于后。人参平肺散，治心火刑肺，传为肺痿，咳嗽喘
呕，痰涎壅盛，胸膈痞闷，咽嗌不利。参苏温肺汤，治形寒饮冷则伤肺，喘，烦心
胸满，短气不能宣畅。调中益气汤加减法，如秋冬月胃脉四道，为冲脉所逆，并胁
下少阳脉二道而反上行，病名曰厥逆。其证气上冲咽不得息，而喘息有音不得卧，
加茱萸五分或一钱，汤洗去苦，观厥气多少而用之。如夏月有此证，为大热也。盖
此症随四时为寒热温凉，宜以酒黄连、酒黄柏、酒知母各等分，为细末，熟汤丸如
桐子大。每服二百丸，白汤送下，空心服，仍多饮热汤，服毕少时，便以美膳压之，
使不得胃中停留，直至下元，以泻冲脉之邪也。大抵治饮食劳倦所得之病，乃虚劳
七损症也，当用温平甘多辛少之药治之，是其本法也。如时止见寒热病，四时症也。
又或将理不如法，或酒食过多，或辛热之食作病，或寒冷之食作病，或居大寒大热
之处益其病，当临时制宜，暂用大寒大热治法而取效，此从权也。不可以得效之故，
而久用之，必致夭横矣。《黄帝针经》曰∶从下上者，引而去之。上气不足，推而扬
之。盖上气者，心肺上焦之气，阳病在阴，从阴引阳，宜以入肾肝下焦之药，引甘
多辛少之药，使升发脾胃之气，又从而去邪气于腠理皮毛也。又曰∶视前痛者，当
先取之。是先以缪刺，泻其经络之壅塞者，为血凝而不流，故先取之，而后治他病。
（以上分寒热例。）胃络不和，喘出于阳明之气逆。（阳明之气下行，今逆而上行，古人以通利为
戒，如分气紫苏饮，指迷七气汤加半夏，二陈汤加缩砂，施之为当。）真元耗损，喘生于肾气
之上奔。（真阳虚惫，肾气不得归
元，固有以金石镇坠，助阳接真而愈者，然亦不可峻骤，且先与安肾丸、八味丸辈，否则人参煎汤，
下养正丹主之。）肺虚则少气而喘。经云∶秋脉者，肺也，秋脉不及则喘，呼吸少气而咳，上气见
血，下闻病音，其治法则门冬、五味、人参之属是也。肺痹、肺积则久喘而不已。经云∶
淫气喘息，痹聚在肺。又云∶肺痹者，烦满喘而呕。是肺痹而喘治法，或表之，或吐之，使气宣通而
愈也。《难经》又云∶肺之积名息贲，在右胁下，如杯，久不已，令人喘咳，发肺痈。治法则息贲丸，
以磨其积是也。（右治肺喘例。）胃喘则身热而烦。经云∶胃为气逆。又云∶犯贼风虚邪者，阳受之，
阳受之则入六腑，入六腑则身热，不时卧，上为喘呼。又云∶阳明厥则喘而 ， 则恶人，或喘而死
者，或喘而生者何也？厥逆连脏则死，连经则生是也。 ，王注谓∶热内郁而烦。凡此胃喘治法，
宜加减白虎汤之类是也。（右治胃喘例。）肾喘则呕咳。经云∶少阴所谓呕咳，上气喘者，
阴气在下，阳气在上，诸阳气浮，无所根据从，故呕咳、上气喘也。东垣治以泻白散
是也。（右治肾喘例。）
【喘不得卧】凡喘而不得卧，其脉浮，按之虚而涩者，为阴虚，去死不远，慎勿
下之，下之必死。宜四物加童便、竹沥、青黛、门冬、五味、枳壳、苏叶服之。《素
问》逆调论∶夫不得卧，卧则喘者，是水气之客也。夫水者，循津液而流也，
肾者水脏，主津液，主卧与喘也。东垣云∶病患不得眠，眠则喘者，水气逆行，上
乘于肺，肺得水而浮，使气不流通，其脉沉，大宜神秘汤主之。仲景云∶咳逆倚息
不得卧，小青龙汤主之。（支饮亦喘不得卧，加短气，其脉平也。）青龙汤下已，多唾口燥，
寸脉沉，尺脉微，手足厥逆，气从小腹上冲胸咽，手足痹，其面翕然如醉状，因复下流
阴股，小便难，时复冒者，与茯苓桂技五味子甘草汤，治其气冲。冲气即低，而反更咳胸
满者，用桂枝茯苓五味甘草汤去桂，加干姜、细辛各三两，以治其咳满。咳
满即止，而更复渴，冲气复发者，以细辛、干姜为热药也，服之当遂渴，而渴反止
者，为支饮也。支饮者，法当冒，冒者必呕，呕者复纳半夏以去其水。（于桂苓甘草五味
汤中去桂，加干姜、细辛、半夏是也。）水去呕止，其人形肿者，加杏仁半升主之。其证应纳麻
黄，以其人遂痹，故不纳之。若逆而纳之必厥。所以然者，以其人血虚，麻黄发其
阳故也。用茯苓四两，甘草、干姜、细辛各三两，五味子、半夏、杏仁去皮尖各半
升，上煎去渣，温、日三服。若面热如醉，此为胃热所冲，熏其面，加大黄三
两以利之。《素问·逆调论》不得卧而息有音，是阳道之逆也。足三阳者下行，今逆
而上行，故息有音也。阳明者，胃脉也。胃者六腑之海，其气亦下行，阳明逆，不得
从其道，故不得卧也。《下经》曰∶胃不和则卧不安，此之谓也。治法已见前。
【哮】与喘相类，但不似喘开口出气之多。如《圣济总录》有名呷嗽者是也。以胸中
多痰，结于喉间，与气相系，随其呼吸，呀呷于喉中作声。呷者口开，呀者口闭，
乃开口闭口尽有其声。盖喉咙者，呼吸之气出入之门也。会厌者，声音之户也。悬
雍者，声之关也。呼吸本无声，胸中之痰随气上升，沾结于喉咙及于会厌悬雍，故
气出入不得快利，与痰引逆相击而作声也。是痰得之食味咸酸太过，因积成热，由
来远矣，故胶如漆粘于肺系。特哮出喉间之痰去，则声稍息，若味不节，其胸中未
尽之痰，复与新味相结，哮必更作，此其候矣。丹溪云∶哮主于痰，宜吐法。治哮
必用薄滋味，不可纯作凉药，必带表散。治哮方，用鸡子略击破壳，不可损膜，浸
尿缸内三四日夜，煮吃效。盖鸡子能去风痰。又方，用猫屎烧灰，沙糖汤调下立效。
哮喘遇冷则发者有二证∶其一属中外皆寒，治法乃东垣参苏温肺汤，调中益气加茱
萸汤，及紫金丹劫寒痰者是也。其二属寒包热，治法乃仲景、丹溪用越婢加半夏汤
等发表诸剂，及预于八九月未寒之时，先用大承气汤下其热，至冬寒时无热可包，
自不发者是也。遇浓味即发者，清金丹主之。
【产后喘】产后喉中气急喘促者，因所下过多，荣血暴竭，卫气无主，独聚肺中，
故令喘也。此名孤阳绝阴，为难治。陈无择云∶宜大料芎归汤，或用独参汤尤妙。
若恶露不快散，血停凝，上熏于肺，亦令喘急，宜夺命丹、参苏饮、血竭散。若因
风寒所伤，宜旋复花汤。若因忧怒郁结，用小调经散，以桑白皮、杏仁煎汤调服。
娄全善治浦江吴辉妻，孕时足肿，七月初旬产，后二月洗浴即气喘，但坐不得卧者
五个月，恶风得暖稍宽，两关脉动，尺寸皆虚，百药不效，用牡丹皮、桃仁、桂枝、
茯苓、干姜、枳实、浓朴、桑白皮、紫苏、五味子、栝蒌仁煎汤服之即宽，二三服
得卧，其痰如失盖作污血感寒治之也。若伤咸冷冻饮料食而喘者，宜见HT 丸。
【诊】喘者，肺主气，形寒饮冷则伤肺，故其气逆而上行，冲急喝喝而息数，
张口抬肩，摇身滚肚，是为喘也。喘逆上气，脉数有热，不得卧者，难治。上气面
浮肿，肩息，脉浮大者危。上气喘息低昂，脉滑、手足温者生。脉涩、四肢寒者死。
右寸沉实而紧，为肺感寒邪，亦有六部俱伏者，宜发散，则热退而喘定。右寸沉实
为肺实，左尺大为肾虚。
脉象按之无力，必然伴有咽喉干燥、津液匮乏、气短等症状，这是肺虚证。（右侧区分了虚证和实证。前面讲述的都是泻实的方法。现在在后面叙述补虚的方法。）
李东垣说：肺部胀满，膨隆而喘咳，胸膈部胀满，气机壅盛向上冲逆的，在随证用药的方剂中，多加五味子，其次用人参，再次用麦门冬，少量黄连。如果病情严重到双手交叉护心、视物昏花模糊的，是真气大虚的表现。如果气短，加黄柏、五味子、人参。如果气盛（邪热盛），去掉五味子、人参，加黄芩、荆芥穗。冬季去掉荆芥穗，加草豆蔻仁。朱丹溪说：气虚的人，用人参、蜜炙黄柏、麦冬、地骨皮之类的药物。《本草》记载治疗咳嗽上气喘急，只用一味人参研成末，用鸡蛋清投入新水中调服一钱。过去有两个人一起跑步，一个人含服人参，另一个人不含，都跑了三五里左右，那个不含人参的人大口喘气，含人参的人气息自如，这就是人参的功效。娄全善治疗一位五十多岁的妇人，素来有痰嗽病，忽然有一天出现大喘，痰涌如泉，身体出汗如油，脉象浮大而洪数，好像生命垂危的样子，迅速使用麦门冬四钱，人参二钱，五味子一钱五分，煎服一帖，喘定汗止，三帖后，痰也渐渐减少，再用前方加入栝蒌仁一钱五分，白术、当归、芍药、黄芩各一钱，服用二十多帖后痊愈。这确实是麦门冬、五味子、人参的功效。如果是自汗兼腹部胀满，脉象沉实而喘的，是里实证。应当用下法攻逐。（以上是治疗气虚的例子。）朱丹溪说：喘证有阴虚的，从小腹下有火气向上冲逆的，适宜用四物汤加青黛、竹沥、陈皮，加入童便煎服。有阴虚挟带痰浊导致喘证的，用四物汤加枳壳、半夏，以补阴降火。我认为当归、地黄滋腻碍膈而生痰，枳壳、半夏燥湿泄利损伤阴液，不如使用天门冬、桑白皮、贝母、马兜铃、地骨皮、麦门冬、枇杷叶这一类药物。（以上是治疗阴虚的例子。）李东垣说：《黄帝内经·病机十九条》中说，各种痿证、喘证、呕吐，都归属于上焦。辨析说，伤寒家论述喘呕认为是火热邪气，这是明显的有余之邪侵袭体表，寒邪转化为热，心火太旺攻伐肺金，所以归属于上焦。又说，吃膏粱厚味的人，供养太过，以及过分溺爱小儿，也能使积热停留在上焦而导致喘咳，适宜用甘寒性质的药剂治疗。《脉经》又说，肺气盛有余，就会咳嗽、上气喘促、口渴、心烦、胸满、气短，这都是冲脉的火气行于胸中所致。病根系在下焦，并不属于上焦。所以杂病中的不足之邪，起于有余的病机之邪，从标本传变的角度来说，多有此类说法。饮食劳役，喜怒不节制，水谷的寒热之气，感受后侵害六腑，都是由中气不足引起的。其腹部胀满，咳嗽气喘，呕吐食物不下，都用大甘辛热的药剂治疗，就能立即痊愈。现在在后面列出热喘、寒喘两个方剂。人参平肺散，治疗心火刑克肺金，传变为肺痿，咳嗽喘呕，痰涎壅盛，胸膈痞闷，咽喉不利。参苏温肺汤，治疗形体受寒、饮水过冷损伤肺脏，喘证，心烦胸满，气短不能宣畅。调中益气汤加减法，如果在秋冬季节胃脉四道（足阳明胃经等脉络），被冲脉所逆乱，并胁下少阳脉两道反而上行，病名叫做厥逆。其症状是气上冲咽喉导致呼吸不畅，喘息有声不能平卧，加吴茱萸五分或一钱，用水洗去苦味，根据厥气的多少来使用。如果是夏季出现这种症状，就是大热证。大概此症随着四季变化而有寒热温凉的不同，适宜用酒黄连、酒黄柏、酒知母各等分，研成细末，用热水泛丸如梧桐子大。每次服用二百丸，白开水送下，空腹服用，服药后多喝热汤，服完后稍待片刻，随即用美味膳食压住药力，使药物不在胃中停留，直达下元，以泻除冲脉的邪气。大抵治疗因饮食劳倦所得的疾病，属于虚劳七损症，应当用温平、味甘多味辛少的药物来治疗，这是根本法则。如果时常出现寒热病症，属于四时外感症。又或者是调理不得法，或者酒食过多，或者辛辣热性食物致病，或者寒冷食物致病，或者居住在极寒极热之处加重病情，应当临时制宜，暂时使用大寒大热的治法以求见效，这是权宜之计。不能因为见效的缘故，就长期服用，必定会导致夭折横死。《黄帝针经》说：病气从下向上的，引导它发散出去。上焦气不足的，推扬它使其上升。所谓上气，是指心肺上焦之气，阳病在阴分，从阴引阳，适宜用入肾肝下焦的药物，引导味甘多辛少的药物，使脾胃之气升发，进而祛除腠理皮毛的邪气。又说：看以前疼痛的地方，应当先取穴治疗。这是先用缪刺法，泻除经络中壅塞的部分，因为血凝滞而不流动，所以先取穴治疗，然后再治疗其他疾病。（以上区分寒热的例子。）胃络不和，喘证出于阳明之气上逆。（阳明之气本应下行，现在逆而上行，古人以通利为戒，比如分气紫苏饮，指迷七气汤加半夏，二陈汤加缩砂，施用的方法是恰当的。）真元耗损，喘证生于肾气之上奔。（真阳虚惫，肾气不能归元，固然有用金石类重镇坠降药物，助阳接真而痊愈的情况，但也不可峻猛急骤，且先用安肾丸、八味丸之类，否则用人参煎汤，送服养正丹主治。）肺虚则气少而喘。《内经》说：秋脉对应肺，秋脉不及则喘，呼吸气少而咳，上气见血，下闻病音，其治疗法则是用门冬、五味、人参这一类药物。肺痹、肺积则久喘不止。《内经》说：淫气喘息，痹聚在肺。又说：肺痹的症状，烦闷喘促而呕吐。所以肺痹而喘的治疗法则，或用汗法解表，或用吐法涌吐，使气机宣通而痊愈。《难经》又说：肺的积病名叫息贲，在右胁下，像杯子一样，久治不愈，使人喘咳，发为肺痈。治疗法则是息贲丸，以磨消其积块。（右侧治疗肺喘的例子。）胃喘则身体发热而烦躁。《内经》说：胃气上逆。又说：遭受贼风虚邪侵袭的，阳经受之，阳经受之则传入六腑，传入六腑则身体发热，不时卧床不起，向上表现为喘呼。又说：阳明厥逆则喘促，[注：原文此处似有脱字或异文，通常指“瘛”或类似痉挛症状]则恶人，有的喘促而死，有的喘促而生，为什么呢？厥逆连及脏腑则死，连及经络则生。王冰注解说：热郁结在内而烦躁。凡是这种胃喘的治疗法则，适宜用加减白虎汤之类。（右侧治疗胃喘的例子。）肾喘则呕吐咳嗽。《内经》说：少阴经所说的呕吐咳嗽、上气喘促，是因为阴气在下，阳气在上，诸阳气浮越，无所依附跟随，所以呕吐咳嗽、上气喘促。李东垣用泻白散治疗。（右侧治疗肾喘的例子。）
【喘不得卧】凡是喘促而不能平卧的，脉象浮，按之虚而涩的，是阴虚，离死不远，千万不要用下法，用下法必死。适宜用四物汤加童便、竹沥、青黛、门冬、五味、枳壳、苏叶服用。《素问·逆调论》说：不能平卧，一躺下就喘的，是水气客犯所致。水，是顺着津液流动的，肾是水脏，主管津液，主司卧与喘。李东垣说：病人不能入睡，一睡就喘的，是水气逆行，上乘于肺，肺得水而浮，使气机不流通，其脉沉，非常适宜用神秘汤主治。张仲景说：咳逆倚息不能平卧，用小青龙汤主治。（支饮也会喘促不得卧，加上短气，脉象平和。）小青龙汤服用后，多唾口燥，寸脉沉，尺脉微，手足厥冷，气从小腹上冲胸咽，手足麻木，面色红赤如醉状，随后气又向下流注阴股，小便困难，时常头晕目眩的，给予茯苓桂枝五味子甘草汤，治疗其气冲。气冲即降低，反而更咳嗽胸满的，用桂枝茯苓五味甘草汤去掉桂枝，加干姜、细辛各三两，以治疗其咳满。咳满即止，而又复现口渴，气冲复发的，是因为细辛、干姜是热药，服用后应当随即口渴，而渴反止的，是有支饮。支饮者，法当头晕，头晕者必呕吐，呕吐者再纳入半夏以去除水饮。（即在桂苓甘草五味汤中去掉桂枝，加干姜、细辛、半夏。）水去呕止，其人形体浮肿的，加杏仁半升主治。此证应当纳入麻黄，因为此人已有麻木痹症，所以不纳入。如果逆势纳入麻黄必定导致厥逆。之所以这样，是因为此人血虚，麻黄发散其阳气所致。用茯苓四两，甘草、干姜、细辛各三两，五味子、半夏、杏仁去皮尖各半升，上药煎煮去渣，温服，每日三次。如果面部发热如醉，这是胃热所冲，熏蒸面部，加大黄三两以利之。《素问·逆调论》说：不能平卧而呼吸有声，是阳道逆乱。足三阳经本应下行，现在逆而上行，所以呼吸有声。阳明经，是胃脉。胃是六腑之海，其气也下行，阳明逆乱，不能从其正道，所以不能平卧。《下经》说：胃不和则卧不安，说的就是这个道理。治法已见前文。
【哮】与喘相似，但不像喘那样张口出气多。如《圣济总录》中有名呷嗽的就是这类。因为胸中多痰，结于喉间，与气相系，随着呼吸，在喉中发出呀呷的声音。呷是口开，呀是口闭，开口闭口都有声音。大概喉咙是呼吸之气出入的门户。会厌是声音的门户。悬雍垂是声音的关隘。呼吸本来无声，胸中的痰随气上升，沾结于喉咙及于会厌悬雍，所以气出入不得快利，与痰相互撞击而发出声音。这是因为痰得之于食味咸酸太过，因而积结成热，由来已久，所以胶着如漆粘于肺系。只有喉间的痰排出，声音才稍微平息，如果口味不节制，胸中未尽的痰，又会与新摄入的味道相结合，哮证必定再次发作，这就是它的征候。朱丹溪说：哮证主因于痰，适宜用吐法。治疗哮证必须用清淡滋味，不可纯用凉药，必须带有表散作用。治疗哮证的方子，用鸡蛋略击破壳，不要损坏内膜，浸泡在尿缸内三四天，煮熟吃有效。大概鸡蛋能去风痰。又一个方子，用猫屎烧成灰，沙糖汤调服立效。哮喘遇到寒冷就发作的有两种证型：其一属于中外皆寒，治法是李东垣的参苏温肺汤，调中益气汤加茱萸汤，以及紫金丹劫除寒痰。其二属于寒包热，治法是张仲景、朱丹溪用的越婢加半夏汤等发表诸剂，以及在八九月份未寒冷之时，先用大承气汤攻下其热，到了冬天寒冷时没有热可包，自然就不发作了。遇到浓味食物就发作的，用清金丹主治。
【产后喘】产后喉中气急喘促的，因为分娩时失血过多，营血突然枯竭，卫气失去主宰，独聚于肺中，所以导致喘证。这名叫孤阳绝阴，难以治疗。陈无择说：适宜用大剂量芎归汤，或者用独参汤尤其妙。如果恶露排泄不快，血液停凝，上熏于肺，也会导致喘急，适宜用夺命丹、参苏饮、血竭散。如果因风寒所伤，适宜用旋复花汤。如果因忧怒郁结，用小调经散，用桑白皮、杏仁煎汤调服。娄全善治疗浦江吴辉的妻子，怀孕时脚肿，七月初旬生产，产后两个月洗澡后就气喘，只能坐着不能平卧长达五个月，怕风得暖稍宽舒，两手关脉动，尺寸脉皆虚，百药无效，用牡丹皮、桃仁、桂枝、茯苓、干姜、枳实、浓朴、桑白皮、紫苏、五味子、栝蒌仁煎汤服用即觉宽舒，二三服后能平卧，其痰仿佛消失，大概是作为污血感寒来治疗的。如果因食用咸冷冻饮料食物而喘的，适宜用见HT丸（注：原文疑为特定丸剂名，此处保留）。
【诊】喘证，肺主气，形体受寒、饮水过冷则损伤肺脏，所以气逆而上行，冲急喝喝而呼吸频数，张口抬肩，摇身滚肚，这就是喘证。喘逆上气，脉数有热，不能平卧的，难治。上气面部浮肿，肩息（耸肩呼吸），脉浮大的，危重。上气喘息高低起伏，脉滑、手足温的，可生。脉涩、四肢寒的，死。右寸脉沉实而紧，是肺感寒邪，也有六部脉俱伏的，适宜发散，则热退而喘定。右寸脉沉实为肺实，左尺脉大为肾虚。
Pulse is weak upon palpation, inevitably accompanied by dry throat with scanty fluids and shortness of breath; this is a Lung Deficiency syndrome. (The right side distinguishes between deficiency and excess patterns. The preceding text discussed only draining excess methods. Now, tonifying deficiency methods are described below.)
Li Dongyuan stated: When the lungs are distended and swollen with wheezing and cough, chest and diaphragm fullness, and qi stagnating and rushing upward, add Schisandrae Fructus (Wuweizi) in large amounts to the formula prescribed according to the pattern, followed by Ginseng Radix et Rhizoma (Renshen), then Ophiopogonis Radix (Maidong), and a small amount of Coptidis Rhizoma (Huanglian). If the condition is severe, manifesting as crossing hands over the heart and visual confusion, it indicates a great deficiency of true qi. If there is shortness of breath, add Phellodendri Cortex (Huangbai), Schisandrae Fructus (Wuweizi), and Ginseng Radix et Rhizoma (Renshen). If qi is excessive (excess heat), remove Schisandrae Fructus (Wuweizi) and Ginseng Radix et Rhizoma (Renshen), and add Scutellariae Radix (Huangqin) and Schizonepetae Spica (Jingjie Sui). In winter, remove Schizonepetae Spica (Jingjie Sui) and add Alpiniae Katsumadai Semen (Caodoukou Ren). Zhu Danxi stated: For those with qi deficiency, use Ginseng Radix et Rhizoma (Renshen), honey-fried Phellodendri Cortex (Huangbai), Ophiopogonis Radix (Maidong), and Lycii Cortex (Digupi). Materia Medica records that for treating cough with upper qi rebellion and rapid breathing, using only Ginseng Radix et Rhizoma (Renshen) ground into powder, mixed with egg white and new water, taken as one qian, is effective. Once, two people ran together; one held Ginseng Radix et Rhizoma (Renshen) in the mouth, the other did not. After running about three to five li, the one without ginseng panted heavily, while the one with ginseng breathed normally. This demonstrates the power of Ginseng Radix et Rhizoma (Renshen). Lou Quanshan treated a woman in her fifties who had chronic phlegm-cough. Suddenly, she experienced severe panting, expectorating sputum like a spring, sweating profusely like oil, with a floating and surging pulse, appearing as if near death. Quickly, Mai Men Dong Si Qian Tang was used: Ophiopogonis Radix (Maidong) 4 qian, Ginseng Radix et Rhizoma (Renshen) 2 qian, Schisandrae Fructus (Wuweizi) 1.5 qian. After one decoction, panting stopped and sweating ceased. After three doses, sputum gradually decreased. Then, the previous formula was modified by adding Trichosanthis Semen (Gualou Ren) 1.5 qian, Atractylodis Macrocephalae Rhizoma (Baizhu), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Shaoyao), and Scutellariae Radix (Huangqin) each 1 qian. After more than twenty doses, she recovered. This was indeed the merit of Ophiopogonis Radix (Maidong), Schisandrae Fructus (Wuweizi), and Ginseng Radix et Rhizoma (Renshen). If spontaneous sweating accompanies abdominal fullness, with a deep, solid pulse and panting, it is an interior excess pattern. Purging should be employed. (Above are examples of treating qi deficiency.) Zhu Danxi stated: There is yin-deficiency panting, where fire rises from below the lower abdomen. Si Wu Tang (Four Substances Decoction) added with Qingdai (Indigo Naturalis), Zhuli (Bamboo Sap), and Chenpi (Citri Reticulatae Pericarpium), decocted with Tongbian (Child's Urine), is suitable. For yin-deficiency complicated with phlegm-panting, Si Wu Tang (Four Substances Decoction) added with Zhiqiao (Aurantii Fructus) and Banxia (Pinelliae Rhizoma) is used to nourish yin and descend fire. I believe that Danggui (Angelicae Sinensis Radix) and Dihuang (Rehmanniae Radix) are cloying and obstruct the diaphragm, generating phlegm; Zhiqiao (Aurantii Fructus) and Banxia (Pinelliae Rhizoma) are drying and purgative, damaging yin. It is better to use Asparagi Radix (Tianmendong), Bombycis Batryticatus (Sangpi), Fritillariae Thunbergii Bulbus (Beimu), Aristolochiae Fructus (Madouling), Lycii Cortex (Digupi), Ophiopogonis Radix (Maidong), and Loquat Leaf (Pipaye). (Above are examples of treating yin deficiency.) Li Dongyuan said: The *Neijing* states that various atrophy syndromes, panting, and vomiting belong to the Upper Jiao. Analysis clarifies that when Taiyang physicians attribute panting and vomiting to fire-heat, it is because obvious excess pathogenic factors invade the exterior, cold transforms into heat, Heart Fire becomes too vigorous and attacks Lung Metal, thus belonging to the Upper Jiao. It also states that individuals consuming rich foods have excessive nourishment, or those who overly dote on children, can accumulate heat in the Upper Jiao leading to panting and coughing, which should be treated with sweet-cool agents. *Mai Jing* further states that when Lung Qi is excessive, it causes cough, upper qi rebellion, panting, thirst, vexation, chest fullness, and shortness of breath. This is caused by Chong Mai (Penetrating Vessel) fire acting in the chest. The root lies in the Lower Jiao, not the Upper Jiao. Therefore, deficiencies in miscellaneous diseases arising from excess pathogenesis involve many discussions on root-branch transmission. Dietary labor, unregulated emotions, and cold/heat from food and drink, when contracted, harm the Six Fu Organs, all due to insufficiency of Middle Qi. Abdominal distension, coughing, panting, vomiting, and inability to eat are treated immediately with large doses of sweet-acrid-hot agents. Below are two formulas for Heat Panting and Cold Panting. Renshen Pingfei San (Ginseng Calms the Lungs Powder) treats Heart Fire punishing Lung Metal, transmitting to Fei Wei (Lung Atrophy), causing cough, panting, vomiting, abundant saliva/phlegm, chest oppression, and throat obstruction. Shensu Wenfei Tang (Ginseng and Schizonepeta Warming the Lungs Decoction) treats lung injury from cold exposure and cold drinks, causing panting, vexation, chest fullness, and shortness of breath without free flow. Tiaozhong Yiqi Tang (Regulate Middle Boost Qi Decoction) modification: In autumn/winter, if the Stomach Meridian pathways are reversed by the Chong Mai (Penetrating Vessel), and the Shaoyang pathways under the ribs reverse upward, the disease is named Jue Ni (Reversal Cold/Counterflow). Symptoms include qi rushing to the throat preventing respiration, audible panting, and inability to lie down. Add Evodiae Fructus (Zhuyu) 0.5 or 1 qian, washed to remove bitterness, dosed according to the degree of counterflow qi. If this occurs in summer, it is a Great Heat pattern. Generally, this pattern varies with the seasons' cold/heat/warmth/coolness. Use equal parts of Wine-processed Coptidis Rhizoma (Huanglian), Wine-processed Phellodendri Cortex (Huangbai), and Wine-processed Anemarrhenae Rhizoma (Zhimu), ground to fine powder, made into pills the size of paulownia seeds with hot water. Take 200 pills per dose with warm water, on an empty stomach. Drink plenty of hot water after taking. Shortly after, consume a good meal to prevent the medicine from staying in the stomach, guiding it to the Lower Yuan to drain Chong Mai pathogens. Generally, diseases from diet and fatigue belong to Xu Lao Seven Damages (Deficiency Consumption Seven Losses), treated fundamentally with warm-neutral medicines that are sweet-dominant and acrid-minimal. If intermittent chills and fever occur, it is a Four Seasons pattern. If improper care, excessive alcohol/food, spicy-hot foods, cold foods, or extreme environments exacerbate the illness, temporary drastic cold/heat treatments may be used for effect, which is a flexible approach. Do not use them long-term just because they work, or premature death will result. *Huangdi Zhenjing* states: For conditions rising from below, guide them outward. For insufficiency of Upper Qi, push and uplift it. Upper Qi refers to the Qi of Heart/Lung Upper Jiao. Yang disease in Yin aspects requires drawing Yang from Yin. Use herbs entering Kidney/Liver Lower Jiao to guide sweet-dominant/acrid-minimal herbs to raise Spleen/Stomach Qi, and subsequently expel pathogens from Cou Li (interstices) and skin/hair. It also states: Where pain occurred previously, treat it first. This uses Miu Ci (Needling opposite sides) to drain meridian blockage caused by blood stasis. Treat this first, then other diseases. (Above are examples distinguishing cold and heat.) Stomach Collateral disharmony causes panting from Mingyang Qi rebellion. (Mingyang Qi should descend; now it rebels upward. Ancients advised against obstruction. Formulas like Fenqi Zisu Yin, Zhimi Qi Qi Tang plus Banxia, Er Chen Tang plus Suisha are appropriate.) True Yuan depletion causes panting from Kidney Qi rushing upward. (True Yang deficiency leads to Kidney Qi failing to return to its source. While heavy minerals can settle and assist Yang, do not act too harshly. First use An Shen Wan or Ba Wei Wan. Otherwise, use Ginseng decoction to administer Yang Zheng Dan.) Lung deficiency causes shortness of breath and panting. Classic says: Autumn pulse corresponds to Lung. If Autumn pulse is insufficient, panting occurs, with short breath and cough, upper qi bleeding, and abnormal sounds heard below. Treatment uses Maidong, Wuweizi, Renshen. Fei Bi (Lung Obstruction) and Fei Ji (Lung Accumulation) cause chronic panting. Classic says: Pathogenic qi causing panting accumulates in the Lung. Also: Fei Bi symptoms include vexation, fullness, panting, and vomiting. Treatment for Fei Bi panting involves releasing the exterior or inducing vomiting to open the Qi. *Nan Jing* states: Lung accumulation is named Xi Ben, located under the right hypochondrium, cup-shaped. Long-standing, it causes panting/cough and Fei Yong (Lung Abscess). Treatment is Xi Ben Wan to grind away the accumulation. (Right side: Treating Lung Panting.) Stomach panting causes body heat and vexation. Classic says: Stomach Qi rebels. Also: Invading wind/pathogens affect Yang meridians, entering Six Fu Organs, causing body heat, insomnia, and upper panting. Also: Yangming Jue Ni (Counterflow) causes panting and [spasms], aversion to people. Some die from panting, some live. Why? Jue Ni connecting to Zang organs leads to death; connecting to Jing meridians leads to survival. Wang Bing notes: Internal heat depression causes vexation. Treatment for Stomach panting uses Jiajian Baihu Tang (Modified White Tiger Decoction). (Right side: Treating Stomach Panting.) Kidney panting causes vomiting and cough. Classic says: Shaoyin vomiting/cough and upper qi panting occur because Yin Qi is below, Yang Qi is above, all Yang Qi floats without foundation. Treatment by Li Dongyuan uses Xie Bai San. (Right side: Treating Kidney Panting.)
[Panting with Inability to Lie Down] Any panting with inability to lie down, with a floating pulse that is deficient and choppy upon pressure, indicates Yin Deficiency, nearing death. Do not purge; purging will cause death. Use Si Wu Tang (Four Substances Decoction) added with Tongbian (Child's Urine), Zhuli (Bamboo Sap), Qingdai (Indigo Naturalis), Mendong (Ophiopogon), Wuweizi (Schisandra), Zhike (Aurantium), and Ziye (Perilla Leaf). *Suwen · Nidiao Lun* states: Inability to lie down, panting when lying down, is due to Water Qi invasion. Water flows with Jin Ye (Body Fluids). Kidney is the Water Organ, governing Jin Ye, and controlling sleep and panting. Li Dongyuan said: Patients unable to sleep, panting when sleeping, have Water Qi reversing upward, attacking the Lung. Lung becomes buoyant with water, Qi circulation stops, pulse is deep. Shenmi Tang (Divine Mystery Decoction) is highly suitable. Zhang Zhongjing said: Cough/rebellion leaning on support, unable to lie down, treated with Xiao Qinglong Tang (Minor Blue Dragon Decoction). (Zhi Yin (Branch Fluid Retention) also causes panting/inability to lie down, with shortness of breath, but pulse is normal.) After Xiao Qinglong Tang, if there is much saliva, dry mouth, deep Cun pulse, shallow Chi pulse, cold limbs, Qi rushing from lower abdomen to chest/throat, limb numbness, flushed face like drunkenness, Qi flowing down to inner thighs, difficult urination, and occasional vertigo, give Fuling Guizhi Wuweizi Gancao Tang (Poria, Cinnamon Twig, Schisandra, Licorice Decoction) to treat Qi rushing. When Qi rushing subsides but cough/chest fullness worsen, use Guizhi Fuling Wuweizi Gancao Tang removing Guizhi, adding Ganjiang (Dried Ginger) and Xixin (Asarum) 3 liang each, to treat cough/fullness. When cough/fullness stop but thirst recurs and Qi rushing returns, it is because Xixin/Ganjiang are hot. They should cause thirst; if thirst stops, it indicates Zhi Yin (Branch Fluid). Zhi Yin causes vertigo; vertigo causes vomiting. Add Banxia (Pinellia) to remove water. (Remove Guizhi from Guiling Gancao Wuwei Tang, add Ganjiang, Xixin, Banxia.) When water goes and vomiting stops, but body swelling remains, add Xingren (Apricot Seed) 0.5 sheng. Normally Mahuang (Ephedra) would be added, but due to existing numbness, it is omitted. Adding it reversely would cause Jue Ni (Cold Extremities). Reason: Blood deficiency; Mahuang disperses Yang. Use Fuling 4 liang, Gancao, Ganjiang, Xixin 3 liang each, Wuweizi, Banxia, Xingren (de-husked) 0.5 sheng each. Decoct, strain, take warm, three times daily. If face is hot like drunkenness, this is Stomach Heat rushing up, steaming the face. Add Dahuang (Rhubarb) 3 liang to drain it. *Suwen · Nidiao Lun*: Inability to lie down with noisy breathing is reversal of Yang Dao. Foot Three Yang meridians descend; now they reverse upward, causing noisy breathing. Yangming is Stomach Meridian. Stomach is Sea of Six Fu Organs, Qi descends. Yangming reversal prevents following its path, causing inability to lie down. *Xia Jing* says: Stomach disharmony leads to restless sleep. Treatment seen previously.
[Xiao/Wheezing] Similar to Chuan (Panting), but does not involve opening the mouth for exhalation as much. E.g., *Shengji Zonglu* mentions "Xi Sou" (Sipping Cough). Chest has much phlegm, knotting in the throat, tied to Qi. With breathing, it makes "ya-xia" sounds in the throat. "Xia" is open mouth, "Ya" is closed mouth; both have sound. Throat is the gate for Qi entry/exit. Huiyan (Epiglottis) is the door of voice. Xianyong (Uvula) is the latch of voice. Breathing is naturally silent. Chest phlegm rises with Qi, sticking to throat/Huiyan/Xianyong. Qi cannot move freely, colliding with phlegm to make sound. This phlegm comes from excessive salty/sour flavors, accumulating heat over time, sticking to Lung channels like lacquer. Only when phlegm in throat is expelled does sound cease. If diet is not regulated, remaining phlegm binds with new flavors, and Xiao recurs. This is the pattern. Zhu Danxi said: Xiao is primarily due to phlegm; expectoration method is suitable. Treat Xiao with bland diet, not purely cooling herbs, must include releasing exterior herbs. Formula: Crack eggshell slightly without breaking membrane, soak in urine vat for 3-4 nights, boil and eat. Egg clears Wind-Phlegm. Another formula: Burn cat feces to ash, mix with brown sugar water for immediate effect. Xiao triggered by cold has two patterns: 1. Interior/Exterior Cold. Treat with Li Dongyuan's Shensu Wenfei Tang, Tiaozhong Yiqi Tang plus Zhuyu, or Zijin Dan to seize Cold-Phlegm. 2. Cold wrapping Heat. Treat with Zhang Zhongjing/Zhu Danxi's Yebing Jia Banxia Tang (Yebing Plus Pinellia Decoction) and other releasing formulas. Or in Aug/Sep before cold, use Dachengqi Tang (Major Order the Qi Decoction) to purge heat. In winter cold, no heat to wrap, so it doesn't flare. Triggered by rich flavors: Qingjin Dan.
[Postpartum Panting] Postpartum throat urgency and panting is due to excessive blood loss, sudden exhaustion of Ying Blood (Nutrient Blood), Wei Qi (Defensive Qi) losing master, gathering alone in Lung, causing panting. Named Gu Yang Jue Yin (Lone Yang Absolute Yin), difficult to treat. Chen Wuyue said: Use large dose Xiong Gui Tang (Ligusticum and Angelica Decoction), or Dushen Tang (Single Ginseng Decoction) is excellent. If Lochia is slow, blood stagnates, steams Lung, causing urgent panting. Use Dueming Dan, Shensu Yin, Xuejie San. If injured by Wind-Cold, use Xuanfuhua Tang. If due to sorrow/anger stagnation, use Xiaotiaojing San, administered with Sangbaipi (Mulberry Bark) and Xingren (Apricot Seed) decoction. Lou Quanshan treated wife of Wu Hui from Pujiang. Swollen feet during pregnancy. Delivered early July. Two months postpartum, bathing caused panting. Could only sit, not lie down, for five months. Averse to wind, relieved by warmth. Guan pulses active, Cun/Chi deficient. Hundreds of medicines failed. Used Mudanpi, Taoren, Guizhi, Fuling, Ganjiang, Zhishi, Houpo, Sangbaipi, Zisu, Wuweizi, Gualou Ren decoction. Immediately felt relief. After 2-3 doses, could lie down. Sputum seemed lost. Treated as Stagnant Blood with Cold injury. If panting from salty/frozen drinks/food, use Jian HT Wan.
[Diagnosis] Panting: Lung governs Qi. Cold body/cold drinks injure Lung. Qi rebels upward, rushing and noisy, rapid breathing, opening mouth, raising shoulders, shaking body, rolling belly. This is Panting. Panting with rebellious Qi, rapid pulse with heat, inability to lie down: Difficult to treat. Rebellious Qi, facial edema, shoulder breathing, floating-large pulse: Critical. Rebellious Qi, panting varying in intensity, slippery pulse, warm limbs: Survival. Choppy pulse, cold limbs: Death. Right Cun deep-solid-tight: Lung infected by Cold. All six positions submerged: Release exterior, heat retreats, panting settles. Right Cun deep-solid: Lung Excess. Left Chi large: Kidney Deficiency.