伤寒喘急是其常。先论阳明及太阳。太阳无汗麻黄证。（仲景云。太阳病头痛发热。身疼。腰痛骨节疼痛。恶风。无
汗而喘者。麻黄汤主之。又一证。太阳病下之微喘者。表未解也。桂枝加浓朴杏子汤主之。又一证。下后不可便行桂枝
汤。若汗出而喘无大热者。可与麻黄杏子甘草石膏汤。）阳明潮热小承汤。（仲景云。潮热短气。腹满而有潮热者。小承
气汤主之。）水停心下喘而咳。加减青龙必可当。（仲景云。伤寒表不解。心下有水气。发热而咳。或渴或利。小腹满而
喘者。小青龙汤。）阴证喘时须喘急。反阴丹辈用为良。（阴证喘与阳证异。其喘必急。宜用反阴丹主之。）
脉浮而渴太阳病。有汗而渴阳明证。渴而自利属少阴。三者不同须审订。（仲景云发汗已。脉浮数烦渴者。五苓散主
之。又云阳明病。汗出多而渴者。不可与猪苓汤。以其汗多。胃中燥。猪苓复利其小便故也。又云。少阴病。其人欲吐。
复不得吐。而烦。但欲寐。五六日自利而渴者。属少阴。此三证。渴虽同其病则异也。）自非大渴莫与水。小渴唯宜滋润
尔。若令剧饮心下满。变成水结难调理。（仲景云。太阳病。胃中干。燥烦不得眠。其人欲饮水。当稍饮之。胃中和。则
愈。）渴太阳。无汗休供白虎汤。汗后脉洪方可与。此证思之要审量（太阳病，须汗后渴。方可行白虎。亦须白虎加人参
也。仲景云。伤寒脉浮发热无汗者。表未解。不可与白虎汤。渴者白虎加人参主之。）渴阳明。有汗且休供五苓。小便不
利汗仍少。脉浮而渴用为精。（仲景云。阳明病。汗出多而渴者。不可与猪苓汤。以汗多胃中燥。猪苓复利其小便故也。
又云。若脉浮发热。渴欲饮水。小便不利。猪苓汤主之。）阳毒躁盛黑奴用。中暑黄连丸酒蒸。（黑奴丸。千金方也。酒
蒸黄连丸。活人书方。二药虽非仲景之方。然治阳毒中暑。最为有效。）
Wheezing and urgency in breathing caused by Shanghan (Cold Damage) is a common manifestation. One must first differentiate between Yangming disease (Disease of the Yangming channel/organ) and Taiyang disease (Disease of the Taiyang channel/organ). In Taiyang disease, absence of sweating indicates the Mahuang Tang (Ephedra Decoction) syndrome. (Zhang Zhongjing stated: In Taiyang disease, if there is headache, fever, body pain, lower back pain, joint pain, aversion to wind, absence of sweating, and wheezing, Mahuang Tang should be administered. Another case: If mild wheezing occurs after purgation in Taiyang disease, the exterior pattern remains unresolved; Guizhi Jia Houpo Ziren Tang (Cinnamon Twig Decoction with Magnolia Bark and Apricot Seed) should be administered. Another case: After purgation, Guizhi Tang cannot be used immediately. If there is sweating, wheezing, and no significant heat, Mahuang Xingzi Gancao Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) may be given.) In Yangming disease, tidal fever indicates the Xiaochengqi Tang (Minor Order the Qi Decoction) syndrome. (Zhang Zhongjing stated: With tidal fever, shortness of breath, abdominal fullness, and tidal fever, Xiaochengqi Tang should be administered.) When fluid retention in the heart region causes wheezing and coughing, Jiajian Qinglong Tang (Modified Green Dragon Decoction) is certainly appropriate. (Zhang Zhongjing stated: In Shanghan, if the exterior pattern is unresolved and there is fluid qi in the heart region, accompanied by fever and cough, or thirst, or diarrhea, fullness in the lower abdomen, and wheezing, Xiao Qinglong Tang (Minor Green Dragon Decoction) should be administered.) In Yin-pattern wheezing, the breathing is often urgent; Fan Yin Dan (Reverse Yin Pill) and similar formulas are effective. (Yin-pattern wheezing differs from Yang-pattern wheezing; the wheezing is necessarily urgent, and Fan Yin Dan is suitable for administration.)
A floating pulse with thirst belongs to Taiyang disease. Thirst accompanied by sweating belongs to Yangming syndrome. Thirst accompanied by spontaneous diarrhea belongs to Shaoyin disease. These three conditions differ and must be carefully examined and differentiated. (Zhang Zhongjing stated: After sweating therapy, if the pulse is floating and rapid with irritability and thirst, Wuling San (Five-Ingredient Powder with Poria) should be administered. He also stated: In Yangming disease, if there is profuse sweating and thirst, Zhu Ling Tang (Polyporus Decoction) must not be given, because profuse sweating dries the stomach interior, and Zhu Ling Tang would further promote urination, depleting fluids. He also stated: In Shaoyin disease, if the patient desires to vomit but cannot, feels irritable, only desires to sleep, and after five or six days develops spontaneous diarrhea with thirst, it belongs to Shaoyin. In these three syndromes, although thirst is present, the underlying pathology differs.) Unless there is extreme thirst, do not give water freely; for slight thirst, moistening and nourishing measures are appropriate. If one allows the patient to drink excessively, it will lead to fullness in the epigastrium, transforming into fluid accumulation that is difficult to regulate. (Zhang Zhongjing stated: In Taiyang disease, if the stomach interior is dry, causing irritability and insomnia, and the patient desires water, they should be given small amounts of water occasionally. Once the stomach qi harmonizes, the disease will resolve.) For thirst in Taiyang disease, if there is no sweating, Baihu Tang (White Tiger Decoction) must not be provided. It can only be used after sweating when the pulse is surging; this syndrome requires careful consideration. (In Taiyang disease, Baihu Tang can only be used if thirst appears after sweating, and typically Baihu Jia Renshen Tang (White Tiger Decoction with Ginseng) is required. Zhang Zhongjing stated: In Shanghan, if the pulse is floating, there is fever, and no sweating, the exterior pattern is unresolved, and Baihu Tang must not be given. If there is thirst, Baihu Jia Renshen Tang should be administered.) For thirst in Yangming disease, if there is sweating, Wu Ling San must not be provided. If urination is obstructed, sweating remains scanty, and the pulse is floating with thirst, Zhu Ling Tang is the most precise choice. (Zhang Zhongjing stated: In Yangming disease, if there is profuse sweating and thirst, Zhu Ling Tang must not be given, because profuse sweating dries the stomach interior, and Zhu Ling Tang would further promote urition. He also stated: If the pulse is floating, there is fever, thirst with desire to drink water, and obstructed urination, Zhu Ling Tang should be administered.) For excessive agitation due to Yang Toxin, Hei Nu Wan (Black Slave Pill) should be used; for heatstroke, Huanglian Wan (Coptis Pill) steamed with wine is indicated. (Hei Nu Wan is from Qianjin Fang. Huanglian Wan steamed with wine is from Huoren Shu. Although these two formulas are not from Zhang Zhongjing, they are highly effective for treating Yang Toxin and heatstroke.)