因虚 气虚火入肺;阴虚火起冲上;肺虚必咽干无津,少气不足以息也;肾
虚,先觉呼吸短气,两胁胀满,左尺大而虚者是,治宜补肾。
因实 有痰、有水气乘肺;气实肺盛,呼吸不利,肺气壅滞,右寸沉实者
是,其肺必胀,上气喘逆,咽中如塞、如呕状,自汗,治宜泻肺。
因邪 由肺感寒邪,伏于肺经,关窍不通,呼吸不利,右寸沉而紧,亦有六
部俱伏者,发散则身热退而喘定。
方∶
气虚 人参 黄柏(蜜炙) 麦门冬 地骨皮。
阴虚 四物加黄连。有痰加枳壳、半夏(阴则血也)。
痰 二陈汤加南星、枳壳、皂角。
神秘方 治水气逆,上乘肺,肺浮而气不通,其脉沉大,不卧者是,卧则喘也。
紫苏子 陈皮 桑白皮 生姜 茯苓 人参(五钱) 木香(二钱)
上 咀煎服。
泻白散 治阴气在下,阳气在上,咳呕喘逆。
桑白皮 地骨皮 青皮 五味 甘草 人参 茯苓 杏仁
痰加半夏、桔梗。
劫喘 治喘甚不可用苦寒药者,以温劫之。
椒目 为末姜汤下。
又 萝卜子(炒) 皂角(烧存性) 姜汁丸噙化。
又 大黄 牵牛(炒) 蜜水下二钱。
猪 丸 治喘,年深或作或止。
雄猪 一个,如食法,入杏仁五两,线缝其口,醋三碗煮干,先食 ,次以
杏仁新瓦上焙干,捻去皮,旋食,永不作。
分论咳嗽喘息
咳者 无痰有声,喉中如痒,习习如梗,甚者续续不止连连不已,冲击
膈间,外有心咳一切血证肺咳上逆者是。
嗽者 有痰。外有劳瘵喘促嗽血者是肺痿。
喘者 促促而气急,喝喝而息数,张口抬肩,摇身滚肚,外有香港脚。
气逆者 但气上而奔急。外有肺中风、肺中寒、肺中暑、肺水、肺热、肝热、胆寒、
心热、肠痹、痰水。
短气者 呼吸虽数而不能相续,似喘而不摇肩,似呻吟而无痛。外有脾中
风、肺热、肾热虚、历节风、忧气、胸痞、痰饮、短气。
脉寸口沉,胸中短气,辟大而滑中有短气;浮而绝者气微弱者,少气。
Due to Deficiency: Qi deficiency leads to fire invading the Lung; Yin deficiency causes deficient fire to rush upward. Lung deficiency inevitably results in dry throat without fluids, and shortness of breath insufficient for respiration; Kidney deficiency first manifests as shortness of breathing and distension/fullness in both hypochondria. If the left Chi pulse is large and empty, it belongs to this category, and treatment should focus on tonifying the Kidney.
Due to Excess: There may be phlegm or water qi attacking the Lung; Qi excess with Lung hyperactivity causes difficult breathing and Lung Qi stagnation. If the right Cun pulse is deep and solid, it belongs to this category. The Lung will necessarily be distended, with upper body asthma and counterflow, a sensation of blockage in the throat resembling vomiting, accompanied by spontaneous sweating. Treatment should focus on purging the Lung.
Due to Pathogenic Factors: Cold pathogenic factors are contracted by the Lung and lie latent in the Lung meridian, blocking the orifices and causing difficult breathing. The right Cun pulse is deep and tight, or all six positions of the pulse may be hidden. Dispersing (releasing the exterior) will cause the body heat to subside and the asthma to settle.
Formulas:
For Qi Deficiency: Ren Shen (Ginseng Radix), Huang Bo (Phellodendri Cortex, honey-fried), Mai Men Dong (Ophiopogonis Tuber), Di Gu Pi (Lycii Cortex).
For Yin Deficiency: Si Wu Tang (Four Substances Decoction) added with Huang Lian (Coptidis Rhizoma). If there is phlegm, add Zhi Ke (Aurantii Fructus) and Ban Xia (Pinelliae Tuber) (Yin deficiency implies blood dryness).
For Phlegm: Er Chen Tang (Two Aged Substances Decoction) added with Nan Xing (Arisaematis Rhizoma), Zhi Ke (Aurantii Fructus), and Zao Jiao (Gleditsiae Spina).
Mysterious Formula: Treats counterflow of water qi ascending to the Lung, where the Lung floats and Qi mechanism is blocked. The pulse is deep and large, and the patient cannot lie down; lying down exacerbates the asthma. Zi Su Zi (Perillae Fructus), Chen Pi (Citri Reticulatae Pericarpium), Sang Bai Pi (Mori Cortex), Sheng Jiang (Zingiberis Rhizoma Recens), Fu Ling (Poria), Ren Shen (Ginseng Radix, 5 qian), Mu Xiang (Aucklandiae Radix, 2 qian). The above herbs are chopped and decocted for oral administration.
Xie Bai San (Drain White Powder): Treats Yin qi below and Yang qi above, resulting in cough, vomiting, asthma, and counterflow. Sang Bai Pi (Mori Cortex), Di Gu Pi (Lycii Cortex), Qing Pi (Citri Reticulatae Pericarpium Viride), Wu Wei Zi (Schisandrae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix), Fu Ling (Poria), Xing Ren (Armeniacae Semen Amarum). If there is phlegm, add Ban Xia (Pinelliae Tuber) and Jie Geng (Platycodonis Radix).
Jie Chuan Formula (Seizing Asthma Formula): For severe asthma where bitter-cold medicines cannot be used, use warm medicines to seize and eliminate the pathogen. Jiao Mu (Zanthoxyli Semen) ground into powder, taken with Ginger Decoction.
Another Formula: Luo Bo Zi (Brassicae Semperfoliorum Semen, stir-fried), Zao Jiao (Gleditsiae Spina, burnt to retain character), made into pills with Ginger Juice for holding in the mouth to dissolve.
Another Formula: Da Huang (Rhei Radix et Rhizoma), Qian Niu (Pharbitidis Semen, stir-fried), taken with Honey Water, 2 qian per dose.
Zhu Wan (Pig Pill): Treats asthma that has persisted for years, occurring intermittently. One male pig, prepared for consumption, with 5 liang of Xing Ren (Armeniacae Semen Amarum) inserted inside, the mouth sewn shut with thread, boiled dry in three bowls of vinegar. First eat the pork, then eat the Xing Ren, which has been dried on a new tile, rubbed to remove the skin, and consumed immediately. This prevents recurrence forever.
Discussion on Cough and Asthma separately
Cough (Ke): No phlegm but with sound, itching in the throat, feeling like an obstruction. In severe cases, it continues incessantly, impacting the diaphragm. Externally, there are conditions such as Heart Cough and all blood syndromes associated with Lung Cough counterflow.
Sputtering (Sou): With phlegm. Externally, there are conditions such as consumptive disease (Lao Zhai) causing rapid breathing and hemoptysis, which belong to Lung Flaccidity (Fei Fei).
Asthma (Chuan): Rapid and urgent breathing, frequent sighing, opening the mouth and raising the shoulders, shaking the body, and rolling the abdomen. Externally, there is Hong Kong Foot (Jiao Qi / Beriberi).
Qi Counterflow (Qi Ni): Only manifests as Qi rushing upward urgently. Externally, there are conditions such as Wind-stroke of the Lung, Cold in the Lung, Summerheat in the Lung, Lung Water, Lung Heat, Liver Heat, Gallbladder Cold, Heart Heat, Intestinal Bi, and Phlegm-Water.
Shortness of Breath (Duan Qi): Breathing is frequent but cannot continue smoothly. It resembles asthma but without shoulder movement; it resembles groaning but without pain. Externally, there are conditions such as Wind-stroke of the Spleen, Lung Heat, Kidney Heat Deficiency, Li Jie Feng (Gout-like joint pain), Worry Qi, Chest Stagnation, Phlegm-Fluid, and Shortness of Breath.
Pulse: Cun Kou pulse is deep, with shortness of breath in the chest; the pulse is wide and slippery with a sense of shortness of breath within; if the pulse is floating and interrupted, Qi is weak, belonging to Little Qi (Shao Qi).