戴云∶有痰喘,有气急喘,有胃虚喘,有火炎上喘。痰喘者,凡喘便有痰声。气急喘者,呼吸急促而无
痰声。有胃虚喘者,抬肩、撷肚、喘而不休。火炎上喘者,乍进乍退,得食则减,食已则喘。大概胃中有实
火,膈上有稠痰,得食咽坠下稠痰,喘即止。稍久,食已入胃,反助其火,痰再升上,
喘反大作。俗不知此,作胃虚,治以燥热之药者,以火济火也。昔叶都督患此,诸医作胃虚治之,不愈。后以
导水丸利五六次而安矣。
凡久喘,未发以扶正气为要,已发以攻邪为主。
有气虚短气而喘,有痰亦短气而喘。
有阴虚,自小腹下火起而上者。
喘急有风痰者,妇人大全方千缗汤。
阴虚有痰喘急者,补阴降火。四物汤加枳壳、半夏。
气虚者,人参、蜜炙黄柏、麦门冬、地骨皮之类。
大概喘急之病,甚不可用苦药凉药,火气盛故也。可用导痰汤加千缗汤治之。
诸喘不止者,用劫药一二帖则止之。劫药之后,因痰治痰,因火治火。椒目碾极细末,用一二钱以生姜汤
调下,止之。
又法∶用萝卜子蒸熟为君,皂角烧灰,等分为末,以生姜汁炼蜜为丸,小桐子大。每服五七十丸,噙化下之。效。
(专主于痰,宜吐法。)
治哮必用薄滋味,不可纯用凉药,必带表散。
治哮方∶用鸡子略敲,壳损膜不损,浸于尿缸内,三四日,夜取出。煮熟食之,效。盖鸡子能去风痰。
戴元礼说:有痰喘,有气急喘,有胃虚喘,有火炎上喘。所谓痰喘,凡是喘息时伴有痰鸣声。所谓气急喘,呼吸急促但没有痰鸣声。所谓胃虚喘,表现为耸肩、收腹,喘息不停止。所谓火炎上喘,症状忽轻忽重,进食后减轻,吃完饭后反而气喘加重。大抵是因为胃中有实火,膈上有粘稠的痰,进食时咽下稠痰,喘息随即停止。过了一段时间,食物进入胃中,反而助长火势,痰再次升腾到上面,喘息反而更加严重。世俗之人不懂这个道理,误认为是胃虚,用燥热药物治疗,这是以火救火。从前叶都督患此病,众医生按胃虚治疗,没有痊愈。后来用导水丸(Doshui Wan)通利大便五六次才安定下来。
凡是久喘,未发作时以扶助正气为关键,已发作时以攻逐邪气为主。
喘息急促且伴有风痰的,使用《妇人大全良方》中的千缗汤(Qianmin Tang)。
阴虚且有痰导致喘息急促的,采用补阴降火法。使用四物汤(Siyu Decoction)加枳壳(Aurantium Fructus)、半夏(Pinelliae Rhizoma)。
气虚的,用人参(Ginseng Radix)、蜜炙黄柏(Phellodendri Cortex Preparata with Honey)、麦门冬(Ophiopogonis Radix)、地骨皮(Lycii Cortex)之类的药物。
大抵喘息急促的病,非常不可使用苦寒凉药,因为火气旺盛的缘故。可以使用导痰汤(Daotan Decoction)加千缗汤治疗。
各种喘息不止的,使用劫药(强效止喘药)一二帖即可停止。劫药之后,根据痰则治痰,根据火则治火。椒目(Zanthoxyli Semen)碾成极细末,用一两钱,用生姜汤调服,可止喘。
又一种方法:用萝卜子(Radish Seed)蒸熟作为君药,皂角(Gleditsiae Fructus)烧成灰,两者等分为末,用生姜汁和炼蜜做成丸药,大小如梧桐子。每次服用五七十丸,含化吞下。有效。
治疗哮证必须饮食清淡,不可单纯使用凉药,必须兼带解表发散。
治疗哮证的方子:用鸡蛋轻轻敲破,使蛋壳破损但内膜不损,浸泡在尿缸内,三四天后,夜间取出。煮熟后食用,有效。因为鸡蛋能去除风痰。
Dai Yun said: There is phlegm asthma (Tan Chuan), there is breathlessness asthma (Qi Ji Chuan), there is stomach deficiency asthma (Wei Xu Chuan), and there is flaming fire ascending asthma (Huo Yan Shang Chuan). Phlegm asthma refers to cases where wheezing is accompanied by the sound of phlegm. Breathlessness asthma refers to rapid breathing without the sound of phlegm. Stomach deficiency asthma manifests as lifting the shoulders, drawing in the abdomen, and continuous wheezing. Flaming fire ascending asthma presents with symptoms that fluctuate in severity; it improves after eating but worsens immediately after finishing a meal. Generally, this is due to excess fire in the stomach and thick phlegm above the diaphragm. When food is swallowed, the thick phlegm goes down, and the wheezing stops. However, after some time, once the food enters the stomach, it further aids the fire, causing the phlegm to rise again, leading to more severe wheezing. Laypeople do not understand this and mistakenly treat it as stomach deficiency using drying and heating medicines, which is like adding fuel to the fire. In the past, General Ye suffered from this condition. Various physicians treated it as stomach deficiency, but he did not recover. Later, he was stabilized after taking Doshui Wan (Doshui Pill) to promote bowel movements five or six times.
For chronic asthma, when not acute, the priority is to support healthy qi (Zheng Qi); when acute, the priority is to attack pathogenic factors (Xie Qi).
There are cases of shortness of breath with wheezing due to qi deficiency, and cases of shortness of breath with wheezing due to phlegm.
There are cases of yin deficiency, where heat rises upward from the lower abdomen.
For wheezing that is urgent and accompanied by wind-phlegm, use Qianmin Tang (Thousand-Mill Cash Decoction) from *The Great Complete Formulas for Women*.
For yin deficiency with phlegm causing urgent wheezing, employ nourishing yin and descending fire methods. Use Siyu Decoction (Four Substances Decoction) with added Aurantium Fructus (Zhi Ke) and Pinelliae Rhizoma (Ban Xia).
For qi deficiency, use herbs such as Ginseng Radix (Ren Shen), Phellodendri Cortex Preparata with Honey (Mi Zhi Huang Bo), Ophiopogonis Radix (Mai Dong), and Lycii Cortex (Di Gu Pi).
Generally, for diseases of urgent wheezing, bitter and cooling medicines should strictly be avoided because the fire energy is abundant. Daotan Decoction (Expectorating Phlegm Decoction) combined with Qianmin Tang can be used.
For various types of unremitting wheezing, use "robber medicines" (Jie Yao - strong agents to arrest symptoms) for one or two doses to stop it. After using robber medicines, treat according to the cause: if due to phlegm, treat the phlegm; if due to fire, treat the fire. Grind Zanthoxyli Semen (Jiao Mu) into an extremely fine powder, take one or two qian, and mix with ginger decoction to swallow; this stops wheezing.
Another method: Steam Radish Seeds (Luo Bo Zi) to serve as the chief ingredient, burn Gleditsiae Fructus (Zao Jiao) to ash, mix them in equal proportions into powder, and form pills with ginger juice and refined honey, sized like paulownia seeds. Take fifty to seventy pills each time, holding them in the mouth to dissolve slowly. This is effective.
(Focuses primarily on phlegm; expectoration therapy is suitable.)
Treating asthma (Xiao) requires bland diet; cold medicines should not be used exclusively, but must be combined with exterior-releasing dispersants.
Formula for treating asthma: Lightly crack an egg so the shell is damaged but the inner membrane remains intact. Soak it in a urine jar for three to four days. Take it out at night, cook it thoroughly, and eat it. This is effective because eggs can eliminate wind-phlegm.