己未岁初秋越三日。奉召至六盘山。至八月中。霖雨不止。时承上命治不邻吉歹元帅夫人。年逾
五旬。身体肥盛。因饮酒吃 乳过度。遂病腹胀喘满。声闻舍外。不得安卧。大小便涩滞。气口脉
大两倍于人迎。关脉沉缓而有力。予思霖雨之湿。饮食之热。湿热大盛。上攻于肺。神气躁乱。故
为喘满。邪气盛则实。实者宜下之。故制平气散以下之。
【平气散】
青皮（去白） 鸡心槟榔（各三钱） 大黄（七钱） 陈皮（去白。五钱）
白牵牛（二两。半生半炒。取头末一半）
上为末。每服三钱。煎生姜汤一盏调下。无时一服减半。再服喘愈。止有胸膈不利。烦热口干
。时时咳嗽。以加减泻白散治之。
内经曰。肺苦气上逆。急食苦以泻之。故白牵牛苦寒。泻气分湿
热。上攻喘满。故以为君。陈皮苦温。体轻浮。理肺气。青皮苦辛平。散肺中滞气。故以为臣。槟
榔辛温。性沉重、下痰降气。大黄苦寒。荡涤满实。故以为使也。
【加减泻白散】
知母 陈皮（去白。各五钱） 桑白皮（一两） 桔梗
地骨皮（各五钱） 青皮（去白）。 甘草 黄芩（各三钱）
上 咀。每服五钱。水二盏。煎至一盏。去渣。温服。食后。数服良愈。
华佗云。盛则为喘。减则为枯。活人书云。发喘者气有余也。凡看文本。须要晓会得本意。且
盛而为喘者。非肺气盛也。喘为气有余者。亦非肺气有余也。气盛当认作气衰。有余当认作不足。
肺气果盛又为有余。当清肃下行而不喘。以火入于肺。衰与不足而为喘焉。故言盛者非言肺气盛也。
言肺中之火盛。言有余者。非言肺气有余也。言肺中之火有余也。故泻肺用苦寒之剂者。非泻肺也
。泻肺中之火。实补肺气也。用者不可不知。
In the early autumn of the Jiwei year (1259), three days later, I was summoned to Liupan Mountain. By mid-August, continuous heavy rain persisted. At that time, I received orders from superiors to treat the wife of Marshal Bulin Jidai. She was over fifty years old and had a robust, obese physique. Due to excessive consumption of alcohol and dairy products, she developed abdominal distension and wheezing with fullness; her breathing sounds could be heard outside the house, and she was unable to lie down comfortably. Her urination and defecation were obstructed and difficult. The Qi Kou pulse was twice as large as the Ying Shou pulse, and the Guan pulse was deep, slow, and forceful. I reasoned that the dampness from the continuous rain combined with the heat from improper diet resulted in an excess of damp-heat attacking the Lungs upwards, causing agitation and disorder of the Shen (Spirit). Thus, wheezing and fullness occurred. When pathogenic factors are excessive, it constitutes a Excess syndrome (Shi Zheng); Excess syndromes should be treated with purgation. Therefore, I formulated Pingqi San (Balancing Qi Powder) for purgation.
[Pingqi San]
Qingpi (Green Tangerine Peel, removed albedo) 3 qian, Jixin Binglang (Chicken-heart Areca Seed) 3 qian, Dahuang (Rhubarb Root) 7 qian, Chenpi (Aged Tangerine Peel, removed albedo) 5 qian, Bai Qianniu (White Morning Glory Seed) 2 liang (half raw, half stir-fried, taking only half of the finest powder).
Grind all ingredients into fine powder. Take 3 qian per dose, mixed with one cup of decoction made from fresh ginger. If taken at irregular intervals, reduce the dose by half. After a second dose, the wheezing subsided, leaving only discomfort in the chest and diaphragm, irritability, fever, dry mouth, and occasional coughing. These symptoms were then treated with Jiajian Xiebai San (Modified Bupleurum Decoction for Clearing the Lung).
The *Neijing* states: "The Lung dislikes rebellious Qi rising; urgently consume bitter substances to drain it." Therefore, Bai Qianniu is bitter and cold; it drains damp-heat from the Qi level and eliminates wheezing and fullness caused by upward attack, serving as the Sovereign herb (Jun Yao). Chenpi is bitter and warm, with a light and floating nature, regulating Lung Qi; Qingpi is bitter, acrid, and neutral, dispersing stagnant Qi in the Lung; thus, they serve as Minister herbs (Chen Yao). Binglang is acrid and warm, with a heavy and sinking nature, descending phlegm and Qi; Dahuang is bitter and cold, sweeping away fullness and excess accumulation; thus, they serve as Envoy herbs (Shi Yao).
[Jiajian Xiebai San]
Zhimu (Anemarrhena Rhizome), Chenpi (Aged Tangerine Peel, removed albedo, each 5 qian), Sangbaipi (Mulberry Bark) 1 liang, Jiegeng (Platycodon Root), Digupi (Groundcherry Root Bark, each 5 qian), Qingpi (Green Tangerine Peel, removed albedo), Gancao (Licorice Root), Huangqin (Scutellaria Root, each 3 qian).
Cut all ingredients into small pieces. Take 5 qian per dose, add two cups of water, boil down to one cup, strain, and take warm after meals. Multiple doses lead to good recovery.
Hua Tuo said: "Excess manifests as wheezing; deficiency manifests as withering." The *Huoren Shu* (Book of Living People) states: "Wheezing indicates an excess of Qi." When reading medical texts, one must understand the original intent. The phrase "excess leads to wheezing" does not mean Lung Qi is excessive; nor does "wheezing indicates Qi excess" mean Lung Qi itself is abundant. "Qi excess" here should be interpreted as Qi deficiency, and "abundance" as insufficiency. If Lung Qi were truly abundant and excessive, it would descend clearly and turbidly without wheezing. Wheezing occurs because Fire enters the Lung, causing Lung Qi to become deficient and insufficient. Therefore, "excess" refers not to Lung Qi being excessive, but to Fire in the Lung being excessive; "abundance" refers not to Lung Qi being abundant, but to Fire in the Lung being abundant. Thus, using bitter-cold formulas to "drain the Lung" is not draining Lung Qi, but draining the Fire in the Lung, which actually tonifies Lung Qi. Practitioners must be aware of this.