喘急之症，有因暴惊触心者，有因寒邪壅盛者，有因风邪外客者，有因食咸酸而痰滞者，有
因膏粱积热，熏蒸清道者。然喘与气急有轻重之别，喘则欲言不能，隘于胸臆，气急但息短
心神迷闷耳。治法∶因惊者，用雄朱化痰定喘丸，佐以天麻定喘。饮寒伤肺气者，用小青龙
汤。风邪伤肺者，用三拗汤加减之。食咸酸伤肺者，啖以生豆腐。热伤肺气者，当凉肺定喘
。哮喘喉声如锯者，梅花饮兼用半夏丸。前症多因脾胃气虚，腠理不密，外邪所乘，真气虚
而邪气实者为多。若已发则散邪为主，未发则补脾为主。设概攻其邪，则损真气，径补其肺
，而益其邪。凡喘嗽之症，若小便不利，则必生胀，胀则必生喘。要分标本先后，先喘而后
胀者，主于肺。先胀而后喘者，主于脾。盖肺金司降，外主皮毛；肺朝百脉，通调水道，下
输膀胱。肺既受邪，则失降下之令，故小便渐短，致水溢皮肤，而生胀满，此则喘为本而胀
为标也，治当清金降火为主，而行水次之。脾土恶湿，而主肌肉，土能克水。若脾土受伤，
不能制水，则水湿妄行，浸溃肌肉，水既上溢，则邪反侵肺，气不能降而生喘矣，此则胀为
本，而喘为标也，治当实脾行水为主，而清金次之。苟肺症而用燥脾之药，则金燥而喘愈甚
。脾病而用清金之药，则脾寒而胀益增。观其症，若中气虚弱者，用六君子汤。中气虚寒者
，前方加炮姜。郁结气滞者，用归脾汤加柴胡、山栀。肝木克脾土者，用六君、柴胡、山栀
。肺气壅滞者，用紫苏饮加白术。食郁壅滞者，用养胃汤加木香。肺中伏热，水不能生而喘
者，用黄芩清肺饮及五淋散。脾胃虚弱，不能通调水道者，用补中益气汤及六味丸。膏粱浓
味，脾肺
亏
柴胡、升麻
凡亏损足三阴，而致喘胀，或二便不调，及牵引作痛者，俱用六味、八味、加减肾气等丸治之
。仍参伤风咳嗽症。
治验
一小儿呕吐发热，胸痞胁痛，作喘发搐，内乳恚怒，母服加味逍遥散，子服异功散加钩藤钩
、山栀并愈。
一小儿痰喘鼻塞，用惺惺散而愈。后因伤乳，服消导之剂，痰喘腹胀益甚。余谓∶脾虚不能
生肺而痰喘，脾气不能运化而腹胀。用异功散而痊。
一小儿患喘，服发汗之剂，汗不出而喘益甚，用异功散顿愈，又用六君子汤而痊愈。后复痰
喘，服下痰丸，前症愈甚，更腹胀作呕，此脾肺复伤也，再用异功散而渐愈。半载后患喘嗽
面赤，此心火克肺金，用人参平肺散及六味地黄丸而痊。
一小儿伤风，喘急不能卧，服参苏饮之类不痊，余用小青龙汤一剂而愈。后复感寒，嗽喘益
甚，服发表之药，手足并冷，腹胀少食，余谓脾肺俱虚也，用六君子加桔梗、杏仁而愈。
一小儿患喘，面赤，服牛黄清心丸，面色 白，手足不热。余谓脾胃复伤，用六君子汤，不
半杯而愈。又伤风寒而喘，面色仍白，用五味异功散加桔梗、生姜，治之顿安。
一小儿七岁，患前症久不愈，或用下痰等药，连泻数次，饮食不入，手足并冷，喘急不得卧
，先用六君、桂、姜，益甚；用人参五钱，附子一钱，二剂少缓，又二剂，十减三四，乃用
独参，将愈，却用四君子而瘥。
雄朱化痰定喘丸 治因惊发喘，逆触心肺，暴急张口，虚烦神困。
雄黄 朱砂（各一钱，研） 蝉蜕 全蝎（少许） 白僵蚕 天南星 白附子（炮。各二钱） 轻粉（五分）
上为末，糊丸，麻子大。每服数丸，茶清送下。
梅花饮 治五脏积热，喉中有痰，面色赤白，鼻流清涕，气逆喘急，目赤咳嗽，或因惊夜啼
。
硼砂 马牙硝 片脑 人参（各一两） 甘草（五钱） 芒硝 辰砂 麝香（各一方）
上各另为末，瓷器收贮，每服半匙，麦门冬汤调服；气急喘嗽，桑白皮汤下；常服，薄荷汤
下。
天麻定喘饮 治喘嗽惊风。
天麻 防风 羌活 甘草（炒） 人参 桔梗 白术 川芎 半夏曲（各等分）
上每服二钱，水煎服。
三拗汤 治感冒风邪，鼻塞声重，语音不出，或伤风寒，头痛目眩，四肢拘倦，咳嗽多痰，
胸满气短。
麻黄（不去节） 杏仁（不去皮尖） 甘草（生用。各等分）
上每服二三钱，姜水煎服。
半夏丸 治肺气不调，咳嗽喘满，痰涎壅塞，心下坚满，及风痰呕吐恶心，涕唾稠粘。
白矾（一两半，焙） 半夏（三两，汤泡七次姜汁制一宿）
上为末，生姜自然汁丸，赤豆大。每服十丸，姜汤下。
紫苏饮子 治肺受风寒，喘热痰嗽。
紫苏叶 桑白皮 青皮 五味子 杏仁 麻黄 甘草（炙） 陈皮（各二分） 人参 半夏（各三分）
上姜三片，水煎温服。
小青龙汤
惺惺散（二方见咳嗽）
异功散
清胃散
六君子汤
加味逍遥散
归脾丸（五方见内钓）
人参平胃散（方见夜啼）
平胃散（方见胃气虚冷）
八味丸（即六味丸加肉桂、五味子，方见肾脏）
牛黄清心丸（方见急惊）
养胃丸（方见疟症）
黄芩清肺散（方见百 内嗽）
五淋散（方见五淋）
滋肾丸（方见发热）
补中益气汤（方见虚羸）
六味丸（方见肾脏）
金匮加减肾气丸（方见腹胀）
The syndrome of sudden panting and urgency may be caused by sudden fright disturbing the Heart, by excessive accumulation of Cold pathogenic factors, by external invasion of Wind pathogenic factors, by phlegm stagnation due to consumption of salty and sour foods, or by heat accumulation from rich and greasy foods steaming the clear pathways. However, there is a distinction in severity between Panting (Chuan) and Shortness of Breath (Qi Ji). Panting manifests as an inability to speak despite the urge, with Qi obstruction in the chest; Shortness of Breath merely presents as short respiration and mental confusion or irritability. Treatment methods: For cases caused by fright, use Xionzhu Huatan Dingchuan Wan (Realgar and Cinnabar Phlegm-Resolving Panting-Calming Pill), assisted by Tianma Dingchuan Yin (Gastrodia Panting-Calming Decoction). For those whose Lung Qi is injured by cold drinks, use Xiao Qinglong Tang (Minor Blue Dragon Decoction). For Lung injury by Wind pathogenic factors, use San'ao Tang (Three Uninhibited Decoction) with modifications. For Lung injury by salty and sour foods, consume raw tofu. For Lung Qi injury by Heat, cool the Lungs to calm panting. For asthma with a sawing sound in the throat, use Meihua Yin (Plum Blossom Drink) combined with Banxia Wan (Pinellia Pill). The aforementioned conditions are mostly due to Spleen and Stomach Qi deficiency, loose interstices (cou li), allowing external pathogens to invade, where True Qi is deficient and Pathogenic factors are excess. If already manifested, the primary treatment is to disperse pathogens; if not yet manifested, the primary treatment is to tonify the Spleen. If one generally attacks the pathogens, it damages True Qi; if one directly tonifies the Lungs, it benefits the pathogens. In all cases of panting and cough, if urination is difficult, edema will necessarily arise; if edema arises, panting will necessarily follow. One must distinguish the root and branch, and the sequence. If panting precedes edema, the root lies in the Lungs. If edema precedes panting, the root lies in the Spleen. This is because the Metal of the Lungs governs descending, and externally controls the skin and hair; the Lungs receive all vessels, regulate water passages, and transmit downwards to the Bladder. Once the Lungs are affected by pathogens, they lose their descending function, causing urine to gradually become scanty, leading to water overflowing into the skin and causing distension. Here, panting is the root and edema is the branch; treatment should focus on clearing Metal and descending Fire, with promoting urination as secondary. Earth of the Spleen dislikes dampness and governs muscles; Earth can control Water. If Spleen Earth is injured and cannot control Water, water-dampness runs wild, infiltrating muscles. Since water overflows upwards, pathogens invade the Lungs, Qi fails to descend, and panting arises. Here, edema is the root and panting is the branch; treatment should focus on solidifying the Spleen and promoting urination, with clearing Metal as secondary. If lung symptoms are treated with drying Spleen herbs, Lung Metal becomes dry and panting worsens. If spleen disease is treated with clearing Metal herbs, Spleen Cold increases and distension worsens. Observing the symptoms: for Middle Qi deficiency, use Liu Junzi Tang (Six Gentlemen Decoction). For Middle Qi deficiency with Cold, add Pao Jiang (Prepared Ginger) to the previous formula. For stagnation due to constraint, use Guipi Tang (Restore the Spleen Decoction) added with Chai Hu (Bupleurum) and Shan Zhi (Gardenia). For Liver Wood overcoming Spleen Earth, use Liu Junzi Tang, Chai Hu, and Shan Zhi. For Lung Qi stagnation, use Zisu Yin (Perilla Drink) added with Bai Zhu (Atractylodes Macrocephala). For food stagnation, use Yangwei Tang (Nourish Stomach Decoction) added with Mu Xiang (Aucklandia). For latent heat in the Lungs where Water cannot generate Metal causing panting, use Huangqin Qingfei Yin (Scutellaria Lung-Clearing Drink) and Wulin San (Five Dampness Powder). For Spleen and Stomach weakness failing to regulate water passages, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Wan (Six-Ingredient Pill with Rehmannia). Rich and greasy foods cause Spleen and Lung deficiency... [text missing] ... Chai Hu, Sheng Ma. For deficiencies of the Foot Three Yin meridians causing panting and distension, or irregular bowel/bladder movements, and牵引 pain, treat with Liuwei Wan, Bawei Wan, or Jiajian Shenqi Wan. Also refer to the treatment of Wind-Cold cough.
Clinical Cases:
A child presented with vomiting, fever, chest oppression, hypochondriac pain, panting, convulsions, and irritability during feeding. The mother took Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), and the child took Yigong San (Extraordinary Efficacy Powder) added with Gouteng (Uncaria) and Shan Zhi (Gardenia); both recovered.
A child with phlegm-panting and nasal congestion was cured using Xingxing San (Shining Star Powder). Later, due to milk injury, he took digestive agents, worsening phlegm-panting and abdominal distension. I stated: Spleen deficiency fails to generate Lung Qi causing phlegm-panting; Spleen Qi fails to transform causing abdominal distension. He recovered using Yigong San.
A child with panting took sweating agents but sweated not, worsening panting. He was instantly cured by Yigong San, then fully recovered with Liu Junzi Tang. Later, recurrent phlegm-panting was worsened by taking phlegm-draining pills, accompanied by abdominal distension and vomiting, indicating re-injury to Spleen and Lung. He gradually improved with Yigong San. Half a year later, panting-cough with red face occurred, indicating Heart Fire overcoming Lung Metal; he recovered with Renping Fei San (Ginseng Lung-Pacifying Powder) and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill).
A child with Wind-Cold had urgent panting unable to lie down. Shen Su Yin (Ginseng and Perilla Decoction) failed. One dose of Xiao Qinglong Tang cured him. Later, re-exposure to Cold worsened cough and panting. Taking releasing exterior drugs caused cold hands and feet, abdominal distension, and poor appetite. I diagnosed Spleen and Lung dual deficiency and cured him with Liu Junzi Tang added with Jie Geng (Platycodon) and Xing Ren (Apricot Seed).
A child with panting had a red face. After taking Niuhuang Qingxin Wan (Calveskin Calculus Heart-Clearing Pill), his face turned pale and hands/feet were not warm. I diagnosed re-injury to Spleen and Stomach and used Liu Junzi Tang; he recovered before finishing half a cup. Later, Wind-Cold induced panting with pale face; Wuwei Yigong San (Five-Flavor Extraordinary Efficacy Powder) added with Jie Geng and Sheng Jiang (Fresh Ginger) brought instant relief.
A seven-year-old child suffered from the above condition for a long time without cure. Using phlegm-draining drugs caused multiple diarrheas, inability to eat, cold limbs, and urgent panting unable to lie down. Initially, Liu Junzi Tang added with Gui Zhi (Cinnamon Twig) and Jiang (Ginger) worsened it. Using 5 qian of Renshen (Ginseng) and 1 qian of Fuzi (Prepared Aconite Root) for two doses slightly alleviated it; after two more doses, symptoms reduced by 30-40%. Then, Dushen Tang (Single Ginseng Decoction) was used until near recovery, followed by Sijunzi Tang (Four Gentlemen Decoction) for complete cure.
Xionzhu Huatan Dingchuan Wan: Treats panting triggered by fright, rebellious Qi touching Heart and Lung, sudden open-mouth breathing, empty irritability, and mental fatigue.
Xionghuang (Realgar), Zhusha (Cinnabar) (each 1 qian, ground), Chantui (Cicada Slough), Quanxie (Whole Scorpion) (small amount), Baijiangcan (White Silkworm), Tiannanxing (Arisaema Cum Bile), Baifuzi (Prepared Typhonii Rhizoma) (each 2 qian), Qingfen (Calomelas) (0.5 qian).
Grind into powder, make pills with paste, size of hemp seeds. Take several pills each time, washed down with tea liquor.
Meihua Yin: Treats accumulated heat in Five Viscera, phlegm in throat, alternating red and white complexion, runny nose, rebellious Qi with urgent panting, red eyes and cough, or night crying due to fright.
Pengsha (Borax), Mayaxiao (Sodium Nitrate), Pian Nao (Borneolum Syntheticum), Renshen (Ginseng Radix et Rhizoma) (each 1 liang), Gancao (Licorice Radix et Rhizoma) (5 qian), Mangxiao (Natrii Sulfas), Chen Sha (Cinnabar), Shexiang (Moschus) (each appropriate amount).
Grind each separately into powder, store in porcelain. Take half a spoon each time, mixed with Maidong Tang (Ophiopogon Decoction); for urgent panting and cough, take with Sangbaipi Tang (Morus Bark Decoction); for daily use, take with Bohe Tang (Mentha Decoction).
Tianma Dingchuan Yin: Treats panting, cough, and wind-stroke.
Tianma (Gastrodiae Rhizoma), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Gancao (Processed Licorice Radix et Rhizoma), Renshen (Ginseng Radix et Rhizoma), Jiegeng (Platycodonis Radix), Baizhu (Atractodis Macrocephalae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Banxiaqu (Fermented Pinellia) (equal parts).
Take 2 qian each time, decoct in water and drink.
San'ao Tang: Treats Wind-Cold invasion, nasal congestion and heavy voice, loss of voice, or Wind-Cold injury with headache, dizziness, limb stiffness and fatigue, cough with much phlegm, chest fullness and shortness of breath.
Mahuang (Ephedrae Herba, stems not removed), Xingren (Armeniacae Semen Amarum, skin and tip not removed), Gancao (Raw Licorice Radix et Rhizoma) (equal parts).
Take 2-3 qian each time, decoct in ginger water and drink.
Banxia Wan: Treats Lung Qi dysfunction, cough and panting with fullness, phlegm-saliva obstruction, epigastric hardness, and wind-phlegm vomiting/nausea, thick sputum.
Baifan (Alumen, roasted), Banxia (Pinelliae Rhizoma, soaked in water seven times, processed with ginger juice overnight).
Grind into powder, make pills with fresh ginger juice, size of red beans. Take 10 pills each time, washed down with ginger soup.
Zisu Yinzi: Treats Lung affected by Wind-Cold, panting-heat, and phlegm-cough.
Zisuye (Perillae Folium), Sangbaipi (Mori Cortex), Qingpi (Citri Reticulatae Pericarpium Viride), Wuweizi (Schisandrae Chinensis Fructus), Xingren (Armeniacae Semen Amarum), Mahuang (Ephedrae Herba), Gancao (Processed Licorice Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 2 fen), Renshen (Ginseng Radix et Rhizoma), Banxia (Pinelliae Rhizoma) (each 3 fen).
Add three slices of ginger, decoct in water and take warm.
Xiao Qinglong Tang (Minor Blue Dragon Decoction)
Xingxing San (Shining Star Powder) (See "Cough" chapter)
Yigong San (Extraordinary Efficacy Powder)
Qingwei San (Stomach-Clearing Powder)
Liu Junzi Tang (Six Gentlemen Decoction)
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)
Guipi Wan (Restore the Spleen Pill) (See "Internal Hook" chapter)
Renping Weisan (Ginseng Pacifying Stomach Powder) (See "Night Crying" chapter)
Pingwei San (Pacifying Stomach Powder) (See "Stomach Qi Deficiency Cold" chapter)
Bawei Wan (Eight-Ingredient Pill) (i.e., Liuwei Wan added with Rougui (Cinnamon Bark) and Wuweizi (Schisandra), See "Kidney" chapter)
Niuhuang Qingxin Wan (Calveskin Calculus Heart-Clearing Pill) (See "Acute Convulsion" chapter)
Yangwei Wan (Nourish Stomach Pill) (See "Malaria" chapter)
Huangqin Qingfei San (Scutellaria Lung-Clearing Powder) (See "Whooping Cough/Internal Cough" chapter)
Wulin San (Five Dampness Powder) (See "Five Dampness" chapter)
Zishen Wan (Kidney-Nourishing Pill) (See "Fever" chapter)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See "Emaciation" chapter)
Liuwei Wan (Six-Ingredient Pill with Rehmannia) (See "Kidney" chapter)
Jingui Jiashen Shenqi Wan (Golden Cabinet Modified Kidney Qi Pill) (See "Abdominal Distension" chapter)