曾氏曰。百日内婴儿。咳嗽痰壅。睡中不宁。亦因产后感风而得。不可过用表散。宜惺惺散、贝母汤。
王肯堂曰。此名乳嗽。实难调理。亦恶症也。当审虚实。实者散之。虚者补之。其症气粗痰盛。口疮眼热。发散后。
可微利之。比金丸等主之。散其实也。其症呕吐惊悸。困倦自汗者。宜补肺散、益黄散、天麻散。补其虚也。大抵治惊
嗽。琥珀散、天麻丸。乃要药也。用天麻、蝉蜕、僵蚕、人参、川芎、甘草、硼砂、胆星、天竺黄、白附子、雄黄、金
箔末之。蜜丸芡子大。金箔为衣。薄荷汤下。此治百日内嗽不止。远胜诸药。
张兼善曰。哮喘遇冬则发者。有二症。一由内外皆寒。须用东垣参苏温肺汤。一由寒包热。用越婢汤加半夏。
虞抟曰。喘促喉中如水鸡声者。曰哮。气促而连续不能以息者。谓之喘。
李 曰。哮以声响言。喘以气息言。
鳌按。哮症。古人专主痰。后人谓寒包热。治须表散。窃思之。大都幼稚多吃咸酸。渗透气脘。一遇风寒。
便窒塞道路。气息喘促。故多发于冬初。必须淡饮食。行气化痰为主。禁凉剂。恐风邪难解也。禁热剂。恐痰火易
升也。苏子、枳壳、青皮、桑皮、桔梗、半夏、前胡、杏仁、山栀。皆治哮必用之药。李士材谓先于八九月未寒时。用
大承气下其热。至冬寒无热可包。此法颇好。曾试之。亦效。而又有食哮。宜清金丹。有水哮。宜水哮方。有风痰哮。
宜千 导痰汤。有年久哮。宜皂角丸。或青皮散。
钱乙曰。喘症有由肺盛。复有风冷者。胸满短气。气急喘嗽。上气。当先散肺。后发散风冷。散肺泻白散。风冷大
青膏。有由肺脏怯弱者。其唇白色。当补肺。阿胶散。若闷乱气粗。喘促哽气者。难治。肺虚损故也。脾肺病久。则虚
而唇白。脾者肺之母也。母子皆虚。不能相营。故曰怯。肺主唇。唇白而泽者吉。白如枯骨者死。
阎孝忠曰。小儿喘病。甚于咳嗽。然有虚实冷热之分。实热者。清肺饮加五和汤加姜、葱。及泻肺汤。经云。喘息
皆因气有余。盖肺主气也。虚冷者。补肺散。坎离汤。此肺虚感风。气不升降。致有是症。及用定喘饮常验。不拘冷热
皆可服。痰涎失音。二圣散。
娄全善曰。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。有因多食咸酸痰滞者。有因膏粱积热。
熏灼清道者。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。化痰
定喘丸。寒伤肺气者。小青龙汤。风邪伤肺者。三拗汤加减。咸酸伤肺者。食生豆腐。热伤肺者。清肺饮。喉声如锯者。
半夏丸。前症多因脾肺气虚。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。迳补其肺。则益其邪。
Zeng stated: Infants within one hundred days presenting with cough, phlegm obstruction, and restlessness during sleep, are also caused by contracting wind after birth. One must not overuse dispersing and releasing exterior methods. It is appropriate to use Xingxing San (Stupifying Powder) or Beimu Tang (Fritillaria Decoction).
Wang Kentang stated: This is named Ru Sou (Breast Cough), which is indeed difficult to regulate and is also a severe condition. One must examine the deficiency and excess. For excess conditions, disperse them; for deficiency conditions, tonify them. If symptoms include coarse breathing and profuse phlegm, accompanied by mouth sores and heat in the eyes, after dispersing treatment, mild purgation can be applied. Bi Jin Wan (Bijinn Pill) and similar formulas should be used to treat this, dissipating the excess. If symptoms include vomiting, palpitations, fatigue, and spontaneous sweating, Bufeisan (Lung-Tonifying Powder), Yihuang San (Yellow-Protecting Powder), and Tianma San (Gastrodia Powder) should be used to tonify the deficiency. Generally, for treating Jing Sou (Startle Cough), Hupo San (Amber Powder) and Tianma Wan (Gastrodia Pill) are essential medicines. The formula consists of Tianma (Gastrodiae Rhizoma), Chantui (Cicadae Periostracum), Jiangcan (Bombyx Batryticatus), Renshen (Ginseng Radix et Rhizoma), Chuanxiong (Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Pengsha (Borax), Danning (Arisaematis Cum Bile), Tianzhuhuang (Calami Tuber), Baifuzi (Typhonii Rhizoma), Xionghuang (Realgar), added with powdered Jinpiao (Gold Leaf). These are made into honey pills the size of an Euryale seed, coated with gold leaf, and taken down with Bohe Tang (Mint Decoction). This is superior to other medicines for treating persistent cough in infants within one hundred days.
Zhang Jianshan stated: Asthma that flares up in winter has two syndromes. One is caused by cold inside and out, requiring Dongyuan's Renshen Su Wenfei Tang (Ginseng and Perilla Lung-Warming Decoction). The other is caused by cold wrapping heat, using Yeshibian Tang (Ma Huang Decoction) plus Banxia (Pinelliae Rhizoma).
Yu Tun stated: When panting is rapid and there is a sound like a water frog in the throat, it is called Xiao (Wheezing). When breath is rapid and continuous, unable to breathe normally, it is called Chuan (Panting/Asthma).
Li Shicai stated: Xiao refers to the sound, while Chuan refers to the breath.
Shen Jin'ao commented: For Xiao syndrome, ancient physicians focused primarily on phlegm, while later physicians attributed it to cold wrapping heat, requiring exterior-dispersing treatments. Upon reflection, most young children consume too much salty and sour food, which penetrates the Qi passageways. Once exposed to wind-cold, the pathways become obstructed, leading to rapid breathing. Thus, it often occurs in early winter. Diet must be bland, focusing on moving Qi and resolving phlegm. Cold-natured agents are forbidden lest wind pathogen be difficult to resolve. Hot-natured agents are forbidden lest phlegm-fire easily ascend. Susu (Perillae Fructus), Zhike (Aurantii Fructus Immaturus), Qingpi (Citri Reticulatae Pericarpium Viride), Sangbai Pi (Mori Cortex), Jiegeng (Platycodonis Radix), Banxia (Pinelliae Rhizoma), Qianhu (Peucedani Radix), Xingren (Armeniacae Semen Amarum), and Shanzhi (Gardeniae Fructus) are all essential herbs for treating Xiao. Li Shicai suggested that before the cold sets in in August and September, Da Chengqi Tang (Major Order the Qi Decoction) should be used to purge heat. By winter, when it is cold but without heat to wrap, this method is quite good. I have tried it and found it effective. Additionally, there is Food-induced Xiao, treated with Qingjin Dan (Clear Metal Pill); Water-induced Xiao, treated with Shui Xiao Fang (Water Asthma Formula); Wind-phlegm Xiao, treated with Qian Dao Tan Tang (Thousand-Guiding Phlegm Decoction); and chronic Xiao, treated with Zaojiao Wan (Soap Pod Pill) or Qingpi San (Green Peel Powder).
Qian Yi stated: Chuan syndrome can be caused by Lung excess compounded by wind-cold, manifesting as chest fullness, shortness of breath, rapid panting and coughing, and rebellious Qi. One should first disperse the Lung, then disperse wind-cold. Dispersing the Lung uses Xiebai San (Draining White Powder); dispersing wind-cold uses Daqing Gao (Great Blue Ointment). It can also be caused by Lung deficiency, manifesting as white lips. One should tonify the Lung using Ejiao San (Donkey-Hide Gelatin Powder). If there is restlessness, coarse breathing, and choking gasps, it is difficult to treat due to Lung deficiency damage. Chronic Spleen-Lung disease leads to deficiency and white lips. The Spleen is the mother of the Lung; if both mother and child are deficient, they cannot nourish each other, hence termed "timidity" (Que). The Lung governs the lips. White lips with luster indicate a good prognosis; white lips like dry bone indicate death.
Yan Xiaozhong stated: Pediatric Chuan disease is more severe than cough, but it is divided into deficiency/excess and cold/heat. Excess-heat cases are treated with Qingfei Yin (Lung-Clearing Drink) plus Wuhe Tang (Five-Harmony Decoction) with Ginger and Scallion, as well as Xiefei Tang (Lung-Draining Decoction). The Classic states: All panting is due to excess Qi, because the Lung governs Qi. Deficiency-cold cases are treated with Bufei San (Lung-Tonifying Powder) and Kanli Tang (Kan-Li Decoction). This is Lung deficiency contracting wind, causing failure of Qi ascending and descending, resulting in these symptoms. Dingchuan Yin (Panting-Stopping Drink) is also frequently effective and can be used regardless of cold or heat. For phlegm-saliva and loss of voice, Ersheng San (Two-Sages Powder) is used.
Lou Quanshan stated: Urgent panting syndromes can be caused by sudden startle affecting the Heart, by abundant cold pathogen, by external wind pathogen, by excessive consumption of salty/sour foods leading to phlegm stagnation, or by accumulation of heat from rich foods scorching the clear passages. However, there is a difference in severity between Chuan and Qi Ji (Qi urgency). Chuan involves inability to speak and chest constriction; Qi Ji involves only short breath and mental confusion. Treatment methods: For startle-induced cases, use Huatan Dingchuan Wan (Phlegm-Resolving Panting-Stopping Pill); for cold damaging Lung Qi, use Xiao Qinglong Tang (Minor Green Dragon Decoction); for wind damaging the Lung, use San'ao Tang (Three-Unobstructed Decoction) with modifications; for salty/sour damaging the Lung, eat raw tofu; for heat damaging the Lung, use Qingfei Yin. For throat sounds like sawing, use Banxia Wan (Pinellia Pill). Most preceding conditions are due to Spleen-Lung Qi deficiency, loose interstices, and invasion by external pathogens, where true Qi is deficient and pathogenic Qi is excess. If already manifested, focus on dispelling pathogens; if not yet manifested, focus on tonifying the Spleen. If one generally attacks the pathogen, it damages true Qi; if one directly tonifies the Lung, it benefits the pathogen.