证
夫哮吼专主于痰，宜用吐法。亦有虚而不可吐者，此疾寒包热也。
治
治法必用薄滋味，不可纯用寒凉，须常带表散。
方
定喘汤（诀云） 诸病原来有药方，惟愁 喘最难当。麻黄桑杏寻
苏子，白果冬花更又良，甘草黄芩同半夏，水煎百沸不须姜，病患遇此灵丹药，一服从教四体康。
麻黄（去节，八分） 桑白皮（一钱） 杏仁（十四粒，泡） 苏子（炒，一钱，研） 白
果（七个） 款冬花（一钱） 甘草（八分） 黄芩（微炒，一钱） 半夏（姜制，一钱）
上锉一剂，水煎，食后热服。
五虎二陈汤（云林制）〔批〕（按此方发表之剂）
治哮吼喘急痰盛。
麻黄（去节，一钱） 杏仁（十四粒，泡） 石膏（ 过，一钱） 橘皮（一钱） 半夏
（姜制，一钱） 茯苓（去皮，八分） 甘草（八分） 人参（八分） 木香（七分） 沉香（七分） 细茶（一钱）
上锉一剂，生姜三片，葱白三茎，蜜三匙，水煎服。
导痰小胃丹（方见痰门） 治哮吼，不问新久。
脉
右手寸口、气口以前，阴脉应手有力，必上气喘逆，咽塞欲呕，自汗，皆肺实之疾也。若气口以前，
阴脉应手无力，必咽干无津，少气，此肺虚之证也。脉滑而手足温者生，脉沉涩而手足
寒者死，数者亦死，为其形损故也。
证
夫喘者，上气急促，不能以息之谓也。有肺虚挟寒而喘者，有肺实挟热而喘者，有水气乘肺而喘者。有
惊忧气郁肺胀而喘者，有阴虚者，有气虚者，有痰者，有气急者，有胃虚者，有火炎上者，
原其受病之不同，是以治疗而有异。
治
治喘之法，当究其原。肺虚肺寒，必有气乏表怯，冷痰如冰之症者。法当温补，如官桂、阿胶之类是也。
肺实肺热，必有壅盛，胸满，外哄上炎之状。法当清利，如桑白皮、葶苈之类是也。水气者，漉漉有声，怔
忡浮肿，与之逐水利小便，如半夏、茯苓、五苓散辈。惊忧者，惕惕闷闷，引息鼻胀，与之宽中下气，如四
七汤、枳壳汤辈。阴虚者，气从脐下起，直冲清道而上，以降气滋阴。气虚者，气息不能接续，以参、
补之。有痰者，喘动便有痰声，降痰为主。有气急者，呼吸急促，而无痰声。降气为主。有胃虚者，
抬肩撷肚，喘而不休，以温胃消痰。有火炎者，乍进乍退，得食则减，食已则喘，以降火清金。至若伤寒
发喘，表汗里下，香港脚充满，疏导取效。此皆但疗本病，其喘自安。虽然，喘有利下而愈者，亦有因泻
而殂者，喘有数年沉痼而复瘳者，亦有忽因他疾大喘而不救者。汗而发润为肺绝，身汗如油喘者为命绝，直
视谵语喘满者，皆不治。然则喘之危恶，又安可以寻常目之。
喘有三∶热喘发于夏，不发于冬；冷喘则遇寒而发；水喘停饮，胸膈满闷，脚先肿也。
方
五虎汤〔批〕（按此方治感寒作喘之剂） 治伤寒喘急。
麻黄（五钱，去节） 杏仁（二钱，去皮） 石膏（五钱，煨） 甘草（一钱） 细茶（一
撮） 加桑皮（一钱）
上锉，生姜三片，葱白三茎，水煎热服。
四磨汤 治七情郁结，上气喘急。
枳壳（一个） 槟榔（一个） 沉香（一块） 乌药（一个）
上用酒磨浓，入白汤服。
苏子降气汤〔批〕（按此方治因气作喘之剂） 治虚阳上升，气不升降，
上实下虚，痰涎壅盛，喘促短气咳嗽，气逆不安等症。（方见气门）
千缗导痰汤〔批〕（按此方治因痰作喘之剂） 治痰喘不能卧，一服而安。
天南星（制，一钱） 半夏（七个，火炮破皮，每一个切作四片） 陈皮（一钱） 枳壳
（去穣，一钱） 赤茯苓（一钱） 皂荚（一寸，炙去皮弦） 甘草（炙，一钱）
上锉一剂，生姜三片，水煎服。
参桃汤 治肺虚发喘，少气难以布息。
人参（二钱） 胡桃肉（二枚，去壳，不去皮）
上锉，生姜五片，大枣二枚，食后临卧时，水煎服。
定喘汤（诀云）〔批〕（按此方治肺虚作喘之剂） 和剂须投定喘汤，阿胶半夏
及麻黄，人参半两同甘草，半两桑皮五片姜，罂粟二钱同蜜炙，再
加五味子为强，多年气喘从今愈，始信良医有妙方。
阿胶（五钱，蛤粉炒成沫） 半夏（姜制，五钱） 麻黄（去节，五钱） 人参（五钱
）甘草（三钱） 桑白皮（五钱） 罂粟壳（二钱，蜜炙） 五味子（三钱）
上锉，每服一两一钱，生姜五片，水煎，临卧细服。
[Symptoms]
Asthma and stridor (wheezing and choking sounds) are primarily related to phlegm, and the method of inducing vomiting (emesis) is suitable for treatment. However, there are cases where the constitution is deficient and emesis cannot be used; this disease belongs to cold enveloping heat (cold exterior with heat interior).
[Therapeutic Principles]
Treatment must involve a bland diet, avoiding the sole use of cold-natured drugs, and should frequently incorporate methods to release the exterior and disperse pathogens.
[Formulas]
Dingchuan Tang (Cough-Stopping Decoction) (from *Yi Jue*): Various diseases originally have corresponding prescriptions, but one worries most that asthma is the hardest to manage. Use Ephedrae Herba (Mahuang), Dendrobii Caulis (Sangbaipi - note: text says Sangbai, usually refers to Mulberry Root Bark), Semen Armeniacae Amarum (Xingren), Fructus Perillae (Suzi), along with Ginkgo Seed (Baiguo) and Flos Farfarae (Kuandonghua) for better effect. Licorice Radix et Rhizoma (Gancao), Scutellariae Radix (Huangqin) together with Pinelliae Rhizoma (Banxia); decoct in water until boiling repeatedly, ginger is not required. When patients encounter this miraculous pill/medicine, after one dose, the four limbs will recover health.
Ingredients: Ephedrae Herba (Mahuang) (remove joints, 8 fen), Dendrobii Caulis (Sangbaipi) (1 qian), Semen Armeniacae Amarum (Xingren) (14 grains, soaked), Fructus Perillae (Suzi) (stir-fried, 1 qian, crushed), Ginkgo Seed (Baiguo) (7 pieces), Flos Farfarae (Kuandonghua) (1 qian), Radix Glycyrrhizae (Gancao) (8 fen), Radix Scutellariae (Huangqin) (lightly stir-fried, 1 qian), Rhizoma Pinelliae (Banxia) (processed with ginger, 1 qian).
The above ingredients are cut into coarse powder for one dose, decocted in water, and taken hot after meals.
Wuhu Erchen Tang (Five Tigers and Two Aged-Phlegm Decoction) (prepared by Yunlin) [Commentary] (Note: This is an exterior-releasing formula)
Treats asthma, stridor, rapid breathing, and excessive phlegm.
Ingredients: Ephedrae Herba (Mahuang) (remove joints, 1 qian), Semen Armeniacae Amarum (Xingren) (14 grains, soaked), Gypsum Fibrosum (Shigao) (calcined, 1 qian), Exocarpium Citri Reticulatae (Chenpi), Rhizoma Pinelliae (Banxia) (processed with ginger, 1 qian), Poria (Fuling) (peeled, 8 fen), Radix Glycyrrhizae (Gancao) (8 fen), Ginseng Radix (Renshen) (8 fen), Lignum Aquilariae Resinatum (Chenxiang) (7 fen), Lignum Santali Rubrum (Zitan - note: text says Muxiang/Aucklandia, but context implies aromatic qi-regulating; sticking to text: Radix Aucklandiae (Muxiang) (7 fen)), Rhizoma Acori Tatarinowii (Shichangpu - note: text says Chenxiang/Sandalwood? No, text says Chenxiang/Sinking Wood. Wait, text lists Muxiang then Chenxiang. I will list both as per text: Radix Aucklandiae (Muxiang) (7 fen), Lignum Aquilariae Resinatum (Chenxiang) (7 fen)), Fine Tea (Xi Cha) (1 qian).
The above ingredients are cut into coarse powder for one dose, add 3 slices of Zingiberis Rhizoma Recens (Shengjiang), 3 stalks of Allii Fistulosi Album (Congbai), 3 spoons of honey, decoct in water and take.
Daotan Xiaowei Dan (Phlegm-Guiding Small Stomach Pill) (Formula seen in "Phlegm" section)
Treats asthma and stridor, regardless of whether it is new or chronic.
[Pulse Diagnosis]
At the Cun Kou and Qi Kou positions on the right hand, if the Yin pulse feels forceful upon palpation, there will inevitably be upward rushing of Qi causing wheezing, throat obstruction with desire to vomit, and spontaneous sweating; these are all diseases of Lung Excess (Fei Shi). If at the Qi Kou position, the Yin pulse feels weak upon palpation, there will inevitably be dryness of the throat without saliva and shortness of breath; this is a syndrome of Lung Deficiency (Fei Xu). If the pulse is slippery and the hands and feet are warm, survival is indicated; if the pulse is deep and choppy and the hands and feet are cold, death is indicated; if the pulse is rapid, death is also indicated, because the physical form has been damaged.
[Symptoms]
What is called "Chuan" (panting/wheezing) refers to rapid upper Qi movement and the inability to breathe smoothly. There are cases of panting due to Lung Deficiency combined with Cold, cases due to Lung Excess combined with Heat, cases due to Water-Qi invading the Lung, cases due to fright and worry causing Qi stagnation and Lung distension, cases of Yin Deficiency, cases of Qi Deficiency, cases of Phlegm, cases of urgent Qi, cases of Stomach Deficiency, and cases of Fire flaring upwards. Because the causes of disease differ, the treatments vary accordingly.
[Therapeutic Principles]
The method for treating panting should investigate the root cause. For Lung Deficiency and Lung Cold, there must be symptoms of lack of Qi, weakness of the defensive exterior, and cold phlegm like ice. The method should be warming and tonifying, such as using Cinnamomi Cortex (Guirui) and Asini Corii Colla (Ejiao). For Lung Excess and Lung Heat, there must be signs of congestion, chest fullness, and external pathogenic flare-up. The method should be clearing and draining, such as using Dendrobii Caulis (Sangbaipi) and Lepidii Fructus (Tinglizi). For Water-Qi, there is gurgling sound, palpitations, and edema; administer drugs to drain water and promote urination, such as Pinelliae Rhizoma (Banxia), Poria (Fuling), and Wuling San (Five-Ingredient Powder with Poria). For fright and worry, there is fearfulness and depression, with nasal flaring during inhalation; administer drugs to broaden the middle and direct Qi downward, such as Siqi Tang (Four-Seven Decoction) and Zhike Tang (Immature Bitter Orange Decoction). For Yin Deficiency, Qi rises from below the navel straight up the clear pathways; use methods to direct Qi downward and nourish Yin. For Qi Deficiency, the breath cannot connect continuously; use Ginseng Radix (Renshen) to tonify. For Phlegm, panting is accompanied by phlegm sounds; focus on resolving phlegm. For urgent Qi, breathing is rapid without phlegm sounds; focus on directing Qi downward. For Stomach Deficiency, shoulders are raised and abdomen sucked in, panting does not cease; use warming of the stomach and resolving phlegm. For Fire Flaring, symptoms come and go, decrease after eating, and worsen after digestion; use methods to descend fire and clear the Metal (Lung). As for panting caused by Cold Damage (Shanghan), use sweating to release the exterior and purging to clear the interior; for swelling caused by Jiangying (Beriberi/Water-Dampness), use dredging methods to achieve efficacy. These cases simply treat the primary disease, and the panting naturally settles. Although so, some panting cases are cured by promoting urination/purging, while others die due to purging; some chronic panting cases lasting years recur, while others suddenly suffer severe panting due to other diseases and cannot be saved. Sweating followed by moist skin indicates Lung Qi exhaustion; sweating like oil with panting indicates exhaustion of life; staring straight ahead, delirious speech, and chest fullness with panting are all untreatable. Thus, how can the critical and malignant nature of panting be regarded as ordinary?
There are three types of panting: Heat Panting occurs in summer and not in winter; Cold Panting is triggered by cold; Water Panting is caused by retained fluids, with chest and diaphragm fullness and swelling starting in the legs.
[Formulas]
Wuhu Tang (Five Tigers Decoction) [Commentary] (Note: This is a formula for treating panting caused by cold invasion)
Treats panting urgency caused by Shanghan (Cold Damage).
Ingredients: Ephedrae Herba (Mahuang) (5 qian, remove joints), Semen Armeniacae Amarum (Xingren) (2 qian, peel), Gypsum Fibrosum (Shigao) (5 qian, baked), Radix Glycyrrhizae (Gancao) (1 qian), Fine Tea (Xi Cha) (a pinch), add Dendrobii Caulis (Sangpi) (1 qian).
The above ingredients are cut, add 3 slices of Zingiberis Rhizoma Recens (Shengjiang), 3 stalks of Allii Fistulosi Album (Congbai), decoct in water and take hot.
Simotang (Four-Beat Decoction)
Treats panting urgency due to Qi stagnation from seven emotions (psychological factors).
Ingredients: Fructus Aurantii Immaturus (Zhike) (one piece), Semen Arecae (Binglang) (one piece), Lignum Aquilariae Resinatum (Chenxiang) (one piece), Radix Linderae (Wuyao) (one piece).
The above ingredients are ground thickly with wine, mixed with plain boiled water, and taken.
Suzi Jiangqi Tang (Perilla Fruit Directing-Downward Qi Decoction) [Commentary] (Note: This is a formula for treating panting caused by Qi dysfunction)
Treats rising of deficient Yang, failure of Qi to ascend and descend, excess above and deficiency below, excessive phlegm-saliva, panting with shortness of breath and cough, restless Qi reversal, etc. (Formula seen in "Qi" section).
Qianmin Daotan Tang (Thousand-Moneta Guiding-Phlegm Decoction) [Commentary] (Note: This is a formula for treating panting caused by phlegm)
Treats phlegm-panting where the patient cannot lie down; peace is achieved after one dose.
Ingredients: Rhizoma Arisaematis (Tiannanxing) (processed, 1 qian), Rhizoma Pinelliae (Banxia) (seven pieces, fire-roasted, skin broken, each cut into four pieces), Exocarpium Citri Reticulatae (Chenpi) (1 qian), Fructus Aurantii Immaturus (Zhike) (remove pith, 1 qian), Poria (Chifuling) (1 qian), Fructus Gleditsiae (Zaojiao) (one inch, roasted, skin and fibers removed), Radix Glycyrrhizae (Gancao) (roasted, 1 qian).
The above ingredients are cut into coarse powder for one dose, add 3 slices of Zingiberis Rhizoma Recens (Shengjiang), decoct in water and take.
Shentao Tang (Ginseng and Walnut Decoction)
Treats panting caused by Lung Deficiency, with shortness of breath and difficulty in distributing Qi.
Ingredients: Ginseng Radix (Renshen) (2 qian), Semen Juglandis (Hutaorou) (two pieces, shelled, skin not removed).
The above ingredients are cut, add 5 slices of Zingiberis Rhizoma Recens (Shengjiang), two dates (Dazao), decoct in water and take after meals before bedtime.
Dingchuan Tang (Cough-Stopping Decoction) (from *Yi Jue*) [Commentary] (Note: This is a formula for treating panting caused by Lung Deficiency)
To harmonize the agent, one must administer Dingchuan Tang. Ejiao, Banxia, and Mahuang; Renshen half liang together with Gancao, half liang Sangpi with five slices of Jiang, Yingusu (Poppy Shell) two qian honey-roasted, adding Wuweizi strengthens it further. Years of chronic asthma will be cured from now on; one begins to believe that good doctors have miraculous formulas.
Ingredients: Asini Corii Colla (Ejiao) (5 qian, stir-fried with蛤粉 Ge Fen/Collae Corii Asini processed with aragonite powder into foam), Rhizoma Pinelliae (Banxia) (ginger-processed, 5 qian), Ephedrae Herba (Mahuang) (remove joints, 5 qian), Ginseng Radix (Renshen) (5 qian), Radix Glycyrrhizae (Gancao) (3 qian), Dendrobii Caulis (Sangbaipi) (5 qian), Fructus Papaveris (Yingsuke/Poppy Shell) (2 qian, honey-roasted), Fructus Schisandrae (Wuweizi) (3 qian).
The above ingredients are cut. Each dose uses 1 liang 1 qian, add 5 slices of Zingiberis Rhizoma Recens (Shengjiang), decoct in water, and take slowly before bedtime.