气逆者,气自腹中时时上冲也。盖因太阳病,下之,表邪乘虚传里,里不受邪,则气逆上行,
仍在表也,当复汗之。厥阴客热,气上冲心,此热在里而气上也。若病如虚羸少气,气逆欲吐者,
又动气发汗而气上冲者,此正气虚而气逆也,当根据法调治之。脉沉紧者,不可汗。
太阳病,下之后其气上冲者,可与桂枝汤;不上冲者,不可与之。病如桂枝证,头不痛,项不
强,寸脉浮微,胸中痞硬,气上冲咽喉不得息,此为胸中寒,瓜蒂散吐之;脉微者,不可吐。吐则
心口逆满,气上冲胸,起则头眩,脉沉紧,发汗则动经,身为振摇,茯苓白术桂枝甘草汤。
动气,发汗,气上冲者,李根汤。病后虚羸少气,气逆,吐者,竹叶石膏汤。
短气者,呼吸短促而不能相续也。《千金方》云少气不足以息也。《金匮要略》
曰∶短气不足以息者,实。大抵心腹胀满而短气者,邪在里而为实。心腹濡满而气短者,邪在表而
为虚。又有停水心下,亦令短气,随证攻治,无不愈矣。
短气潮热,腹满而喘,此为外欲解而里欲实,大柴胡汤,小承气汤。
风湿相搏,汗出短气,小便不利,恶风不欲去衣,其邪在表,甘草附子汤。
食少饮多,水停心下,短气,小半夏汤。
身凉干呕,短气汗出,不恶寒,此表解里有水,十枣汤。
误下太阳,短气烦躁,心中懊 ,便为结胸,大陷胸汤及丸。
Qi Rebellion refers to the sensation of Qi rushing upward from the abdomen from time to time. This is generally caused by a Taiyang disease (disease pattern resulting from pathogenic invasion of the Taiyang channel), where inappropriate purgation allows exterior pathogens to transmit inward due to deficiency. If the interior cannot accept the pathogen, Qi rebels and moves upward. If the pathogen remains in the exterior, sweating therapy should be reapplied. When Jueyin channel receives external heat, Qi rushes up to the heart; this indicates heat residing in the interior with rebellious Qi movement. If the patient presents with emaciation resembling consumptive weakness, shortness of breath, and rebellious Qi with nausea/vomiting, it results from disturbing Qi and improper sweating leading to upward rebellion; this is due to deficiency of righteous Qi and rebellious Qi, and treatment should follow standard protocols for regulation. If the pulse is deep and tight, sweating is contraindicated.
In Taiyang disease, after purgation, if Qi rebels upward, Guizhi Tang (Cinnamon Twig Decoction) may be administered; if Qi does not rebel upward, it should not be given. If the condition resembles a Guizhi Tang syndrome but without headache or neck stiffness, and the cun pulse is floating and slightly weak, with chest oppression and hardness, and Qi rebelling up to the throat causing difficulty in breathing, this is cold-phlegm obstructing the chest, treated with Gualian San (Melon Seed Powder) to induce vomiting. If the pulse is faint, vomiting induction is contraindicated. If vomiting induces fullness and rebellion at the epigastrium, Qi rushing to the chest, dizziness upon standing, and a deep-tight pulse, subsequent sweating would disturb the collaterals, causing body tremors; Puling Baizhu Guizhi Gancao Tang (Poria, Atractodes, Cinnamon Twig, and Licorice Decoction) is indicated. For cases where "Dongqi" (pulsating qi masses) leads to Qi rebellion after improper sweating, Ligen Tang (Li Root Decoction) is used. For post-illness emaciation, shortness of breath, Qi rebellion, and vomiting, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is prescribed.
Shortness of Breath (Duan Qi) refers to rapid, shallow respiration that cannot be sustained continuously. The *Qianjin Fang* states this as "insufficient Qi failing to sustain respiration." The *Jin Gui Yao Lue* states: "Shortness of breath with inability to sustain respiration indicates Excess." Generally, abdominal distension/fullness accompanied by shortness of breath indicates an Excess pattern with pathogens in the interior. Soft abdominal fullness with shortness of breath indicates a Deficiency pattern with pathogens in the exterior. Additionally, fluid retention in the epigastrium can also cause shortness of breath; treating according to the specific presentation ensures recovery.
Shortness of breath with tidal fever, abdominal fullness, and wheezing indicates that exterior pathogens are resolving while interior pathogens are becoming excess; Da Chai Hu Tang (Major Bupleurum Decoction) or Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is used. When Wind-Dampness combats each other, presenting with sweating, shortness of breath, dysuria, aversion to wind, and reluctance to remove clothing, the pathogen is in the exterior; Gancao Fuzi Tang (Licorice and Prepared Aconite Decoction) is indicated. With poor appetite, excessive drinking, fluid retention in the epigastrium, and shortness of breath, Xiao Banxia Tang (Minor Pinellia Decoction) is used. With cool body, dry retching, shortness of breath, sweating, and no aversion to cold, the exterior is resolved but water resides in the interior; Shizao Tang (Ten Jujube Decoction) is prescribed. Inappropriate purgation of Taiyang disease leading to shortness of breath, irritability, and mental restlessness results in Jie Xiong (Chest Binding); Da Xian Xiong Tang or Wan (Major Draining the Chest Decoction/Pills) is used.