短气者,气短而急,似喘非喘也。(详见诊条。)
〔仲〕平人无寒热,短气不足以息者,实也。(丹溪治白云许先生脾疼胯疼短气,用大吐大下者二十余日,
凡吐胶痰二大桶,如烂鱼肠,或如地沥青条者数碗而安,详见腹痛。)
〔孙〕正元散 治气不接续,气短,兼治滑泄,及小便数。王丞相服之有效。
蓬莪术(一两) 金铃子(去核一分)
上件为末,入硼砂一钱,炼过研细和匀,每服二钱,盐汤或温酒调下,空心服。
〔垣〕胸满少气短气者,肺主诸气,五脏之气皆不足,而阳道不行也。气短小便利者,四君子汤中去茯苓,
加黄 以补之。如腹中气不转者,更加甘草一半。肺气短促或不足者,加人参、白芍药,中焦用白芍药,则脾
中阳升,使肝胆之邪不敢犯之。如衣薄而短气,则添衣于无风处居止,气尚短,则以沸汤一碗熏其口鼻,即不
短也。(法见调摄,下同。)如浓衣于不通风处居止而气短,则宜减衣,摩汗孔令合,于漫风处居止。如久居
高屋,或天寒阴湿所遏,令气短者,亦如前法熏之。如居周密小室,或大热而处寒凉,气短,则就风日。凡
气短皆宜食滋味汤饮,令胃气调和。
〔仲〕胸痹,胸中气塞短气,茯苓杏仁甘草汤主之,橘枳姜汤亦主之。(方见胸痹痛门。)胸痹喘
息咳唾,胸背痛,短气,栝蒌薤白半夏汤主之。(方见胸痹痛门。)夫短气有微饮,当从小便去之,苓
桂术甘汤主之,肾气丸亦主之。(肾气丸见香港脚中。)款花补肺汤,治咳嗽短气。(方见咳嗽门气虚条。)
苓桂术甘汤
茯苓(四两) 桂枝 白术(各三两) 甘草(二两)
上四味,以水六升,煮取三升,分温三服,小便则利。
仲景论短气皆属饮,此方苓桂术甘汤,是其一法也。《金匮》云∶咳逆倚息,短气不得卧,其形如肿,谓之
支饮。又云∶支饮亦喘而不得卧,加短气,其脉平也。又云∶膈上有留饮,其人气短而渴,四肢历节痛,脉沉
者有留饮。又云∶肺饮不弦,但苦喘短气,其治法∶危急者,小青龙汤;胀满者,浓朴大黄汤;冒眩者,此方
苓桂术甘汤及泽泻汤;不得息,葶苈大枣汤;吐下不愈者,木防己汤之类是也。
〔《灵》〕短气息短不属,动作气索,补足少阴,去血络也。(癫狂篇)
〔东〕短气房劳∶天井 大椎 肺 肝 尺泽(灸)
〔《甲》〕短气心痹,悲怒逆气狂易,鱼际主之。
〔成〕短气者,短气而不能相续者是已,似喘而非喘,若有气上冲,而实非气上冲也。喘者张口抬肩,摇
身滚肚,谓之喘也。气上冲者,腹里气时时上冲也。所谓短气者,呼吸虽数而不能相续,似喘而不摇肩,似呻
吟而无痛者,短气也。经所言短气者众,实为难辨之证。愚师莫识之,为治有误者多矣。要识其短气之真者,
气急而短促,谓之气短者是也。
〔《脉》〕寸口脉沉,胸中短气。
〔仲〕阳脉微而紧,紧则为寒,微则为虚,微紧相搏,则为短气。
Shortness of breath (Duan Qi) refers to rapid and shallow breathing, resembling panting but not constituting true panting. (For details, see the diagnostic entries.)
[Zhang Zhongjing] In a healthy person without exterior cold or heat symptoms, shortness of breath with insufficient respiratory capacity indicates an excess condition. (Zhu Danxi treated Mr. Xu from Baiyun, who suffered from spleen pain, hip pain, and shortness of breath, using drastic emetic and purgative methods for over twenty days. He expelled two large buckets of gelatinous phlegm, some resembling rotten fish intestines and others like asphalt strips, after which the patient recovered. See the section on Abdominal Pain for details.)
[Sun Simiao] Zhengyuan San: Treats discontinuous qi, shortness of breath, and also addresses slippery discharge (incontinence or seminal emission) and frequent urination. Chancellor Wang found it effective.
Ezhu Rhizoma (1 liang) Chuanxiong Rhizoma (Jinlingzi, pitted, 1 fen)
Grind the above ingredients into powder, add 1 qian of Borax, refine and grind finely, then mix uniformly. Take 2 qian per dose, mixed with salt water or warm wine, taken on an empty stomach.
[Li Dongyuan] For chest fullness, scanty qi, and shortness of breath: The Lung governs all qi in the body. When the qi of the five zang organs is deficient and the yang pathway fails to circulate, these symptoms arise. If there is shortness of breath with free urination, use Sijunzi Tang (Four Gentlemen Decoction) removing Poria (Fuling), and add Astragali Radix (Huangqi) to tonify. If abdominal qi does not circulate, add half the amount of Licorice Root (Gancao). If lung qi is short and hurried or deficient, add Ginseng Radix (Renshen) and White Peony Root (Baishao); using Baishao at the middle jiao raises the spleen's yang, preventing pathogenic factors from the liver and gallbladder from invading. If shortness of breath is caused by wearing thin clothes, add clothing and reside in a windless place; if shortness of breath persists, fumigate the mouth and nose with a bowl of boiling water, and the shortness will cease. (Method seen in Regulation, same below.) If residing in a thick-clothed, unventilated space causes shortness of breath, reduce clothing, massage the sweat pores to close them, and reside in a place with gentle breeze. If residing in high buildings for long periods, or being obstructed by cold heaven and damp earth causing shortness of breath, fumigate as described above. If residing in a tightly enclosed small room, or experiencing shortness of breath due to extreme heat while in a cold environment, move to a place with wind and sunlight. Generally, for shortness of breath, one should consume flavorful soups and drinks to harmonize stomach qi.
[Zhang Zhongjing] In Chest Bi (Xiong Bi), with chest oppression, qi obstruction, and shortness of breath, Linggui Fuling Gancao Tang (Poria, Cinnamon Twig, and Licorice Decoction) is the primary formula; Ju Zhi Jiang Tang (Citrus Peel, Immature Bitter Orange, and Ginger Decoction) is also indicated. (Formula seen in Chest Bi Pain section.) In Chest Bi with panting, labored breathing, coughing, and expectoration, chest and back pain, and shortness of breath, Gualou Xiebai Banxia Tang (Trichosanthes Fruit, Macrostemon Rhizome, and Pinellia Tuber Decoction) is the primary formula. (Formula seen in Chest Bi Pain section.) When shortness of breath is caused by slight fluid retention, it should be eliminated via urination; Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction) is the primary formula, and Shenqi Wan (Kidney Qi Pill) is also indicated. (Shenqi Wan seen in Hongjiao section.) Kuanhua Bufei Tang treats cough and shortness of breath. (Formula seen in Cough section, Deficiency of Qi entry.)
Linggui Zhugan Tang
Poria (4 liang) Cinnamon Twig Guizhi Atractylodes Macrocephala Rhizoma Baizhu (3 liang each) Licorice Root Gancao (2 liang)
Take the four ingredients, add six sheng of water, decoct to obtain three sheng, divide into three warm doses. Urination will become profuse after administration.
Zhongjing's discussion on shortness of breath generally attributes it to fluid retention; this Linggui Zhugan Tang is one method. The *Jingui Yaolue* states: "Cough with air rushing upward, requiring leaning to breathe, shortness of breath preventing lying down, and swelling-like appearance, is called Zhi Yin (Fluid Retention in the Diaphragm)." It further states: "Zhi Yin also involves panting and inability to lie flat, accompanied by shortness of breath, with a normal pulse." It also states: "Fluid retention above the diaphragm causes shortness of breath and thirst, pain in the four limbs and joints, and a deep pulse indicates retained fluid." It also states: "Lung fluid retention does not present with a wiry pulse, but rather suffering from panting and shortness of breath. Treatment methods: for critical cases, Xiao Qinglong Tang; for distension and fullness, Houpo Dahuang Tang; for dizziness and vertigo, this Linggui Zhugan Tang and Zexie Tang; for dyspnea, Tingli Dazao Tang; for cases unresponsive to vomiting and purging, Mufangji Tang, etc."
[*Lingshu*] Shortness of breath and disconnected respiration, with qi exhaustion upon movement, require tonifying the Shaoyin channel and bleeding the collateral vessels. (From the Chapter on Epilepsy and Mania)
[Zhang Yuansu] Shortness of breath due to sexual exhaustion: Tianjing LI-10, Dazhui GV-14, Feishu BL-13, Ganshu BL-18, Chize LU-5 (Moxibustion applicable).
[*Jiayi Jing*] For shortness of breath with Heart Bi, sorrow and anger leading to rebellious qi, mania, and irritability, Yuji LU-10 is the primary point.
[Cheng Wuji] Shortness of breath refers to rapid, shallow breathing that cannot continue, resembling panting but not being panting. It feels like qi rushing upward, but it is not truly qi rushing upward. Panting involves opening the mouth, raising the shoulders, shaking the body, and rolling the abdomen. Qi rushing upward refers to qi in the abdomen constantly surging upward. True shortness of breath features frequent breathing that cannot connect, resembling panting but without shoulder shaking, and resembling groaning but without pain. There are many descriptions of shortness of breath in classics, making it a difficult syndrome to differentiate. My teacher failed to recognize it clearly, leading to many mis-treatments. To identify true shortness of breath, it is characterized by urgent and short breathing, termed Qi Duan.
[*Mai Jing*] Deep pulse at Cun Kou indicates shortness of breath in the chest.
[Zhang Zhongjing] A faint and tight pulse in the Yang position: Tight indicates cold, faint indicates deficiency. The binding of faint and tight pulses results in shortness of breath.