（诸虚惫证）
短气候 平人无寒热，短气不足以息者体实，实则气盛，盛则气逆不通，故短气。又肺虚则气少不足，
亦令短气，则其人气微，常如少气不足以呼吸。诊其脉尺寸俱微，血气不足，其人短气。寸口脉沉，胸中短气。
脉前小后大，则为胸满短气。脉洪大者，亦短气也。（《病源论》）
少气候 此由脏气不足故也。肺主于气而通呼吸，脏气不足，则呼吸微弱而少气。胸痛少气者，水在
脏腑，水者阴气，阴气在内故少气。诊右手寸口脉阴实者，肺实也，苦少气，胸内满膨膨，与 相引。脉来濡
者，虚少气也。左手关上脉阴阳俱虚者，足厥阴少阳俱虚也，病苦少气不能言。右手关上脉阴阳俱虚者，足大
阴阳明俱虚也，病苦胃中如空
状，少气不足以息，四逆寒。脉弱者，少气。皮肤寒，脉小者。少气也。（同上）（按∶诊右手以下，是《脉
经》文。皮肤寒云云，是《论疾诊尺篇》文。）
乏气候 夫虚极之人，荣卫减耗，腑脏虚弱，气行不足，所以呼吸气短也。（同上）
短气之证，亦有虚实之殊，虚者肺气之虚，实者由心腹胀满，或水停心下，或风湿相搏之所致也，当各究
其所因而施治。（《统旨》）（按∶原举喘、短气之辨，全取《明理论》，既录于《伤寒广要》中，仍不赘。
《医贯》亦据成氏，补呼吸虽急而无痰声句。）
外有短气不足以息者似喘，但有虚有实，不可作喘治。虚者六君子加五味、麦冬。实者痰气阻碍，导痰丸。肾
气不能摄精者，补肾丸。（《苍生司命》）
若肺气太虚，气不能布息，呼吸不相接续，出多入少，名曰短气，此虚之极也。（《明医指掌》）
中年人病后，气促痰嗽，腿足冷肿，腰骨大痛，面目浮肿，太阳作痛，悉属命门火衰阳虚之候，用八味丸
料佳，若作痰治立殆。（《六要》）
关格之证为喘者，如《六节藏象论》曰∶人迎四盛以上，为格阳。寸口四盛以上，为关阴。人迎与寸口俱盛
四倍以上，为关格。此关格之证，以脉言，不以病言也。今人之患此者颇多，而人多不知。且近时察脉者，不论
人迎，惟在寸口。但其两手之脉，浮弦至极，大至四倍以上者，便是此证。其病必虚里跳动，而气喘不已。此之
喘状，多无咳嗽，但觉胸膈舂舂，似胀非胀，似短非短，微劳则喘甚，多言亦喘甚，甚至通身振振，慌张不宁。
此必情欲伤阴，以致元气无根，孤阳离居之候也。多不可治，方论详《关格》门。（《景岳》）
虚炎阴阳不升降，下虚上盛，气促喘急，宜苏子降气汤去前胡，下黑锡丹或养正丹。气急甚而不能眠卧者，
沉附汤或正元饮，或四柱散，去木香，用沉香，并以盐煎，下黑锡丹或灵砂丹、三炒丹，不效则以前药下朱砂丹。
短乏者，下气不接上气，呼吸不来，语言无力，宜补虚四柱饮，木香减半，加黄 、山药各一钱。若不胜热药
及痰多之人，当易熟附子作生附，在人活法，余皆仿此，药轻病重，四柱饮不足取效，宜于本方去木香，加炒
川椒十五粒。更不效，则用椒附汤。上焦干燥，不胜热药者，宜于椒附汤加人参一钱。寻常病当用姜附而或上
盛燥热不可服者，惟此最良。气短乏力之人，于进药之外，选一盛壮男子，吸自已之气，嘘入病患口中，如此
数次，亦可为药力一助。此法不特可治虚乏，寻常气暴逆致呃者，用之良验。（《要诀》）
(Various Deficiency and Exhaustion Syndromes)
Shortness of Breath (Duan Qi): In a person who is normally healthy, if there are no exterior signs of aversion to cold or fever, yet there is shortness of breath with insufficient respiration, this is due to excess constitution. Because the constitution is excess, the Qi is abundant; because the Qi is abundant, it becomes rebellious and obstructed, thus causing shortness of breath. Furthermore, if Lung Qi is deficient, the amount of Qi is insufficient, which also causes shortness of breath. Such individuals have faint Qi and often feel as if they have "Shao Qi" (insufficient Qi), unable to breathe adequately. Upon pulse diagnosis, if the pulses at Cun, Guan, and Chi positions are all fine (Wei), it indicates insufficiency of Blood and Qi, leading to shortness of breath. A Chen (Deep) pulse at the Cun Kou position indicates shortness of breath in the chest. A pulse that is small anteriorly and large posteriorly indicates chest fullness and shortness of breath. A Hong Da (Surging and Large) pulse also presents with shortness of breath. (From *Zhu Bing Yuan Hou Lun*)
Insufficient Qi (Shao Qi): This arises from insufficiency of Zang-Fu Qi. The Lung governs Qi and connects with respiration. When Zang-Fu Qi is insufficient, respiration becomes weak, manifesting as Shao Qi. Chest pain accompanied by Shao Qi indicates water retention within the Zang-Fu. Water is Yin pathogen; when Yin pathogen resides internally, it causes Shao Qi. Diagnosis of an Yin-Shi (Excess in Yin aspect) pulse at the right hand Cun Kou indicates Lung Excess syndrome. The patient suffers from Shao Qi and internal chest fullness/bloating, with pain radiating/tracting elsewhere. A Ru (Soggy) pulse indicates deficiency-type Shao Qi. Yin-Yang both deficient pulses at the left hand Guan position indicate simultaneous deficiency of Foot Jueyin Liver Channel and Foot Shaoyang Gallbladder Channel; the disease manifests as suffering from Shao Qi and inability to speak. Yin-Yang both deficient pulses at the right hand Guan position indicate simultaneous deficiency of Foot Taiyin Spleen Channel and Foot Yangming Stomach Channel; the disease manifests as a sensation of emptiness in the stomach, Shao Qi with insufficient respiration, and cold extremities (Si Ni). A Ruo (Weak) pulse indicates Shao Qi. Cold skin and Xiao (Small) pulse also indicate Shao Qi. (Ibid.) [Note: The diagnosis below the right hand is from *Mai Jing*. The description regarding cold skin is from *Ling Shu: Lun Ji Zhen Chi Pian*.]
Fatigue Qi (Fa Qi): In individuals who are extremely deficient, Ying-Wei (Nutritive and Defensive) Qi is diminished and exhausted, and Fu-Zang organs are weak, resulting in insufficient Qi movement, hence shortness of breath in respiration. (Ibid.)
Syndromes of Shortness of Breath differ between Excess and Deficiency. Deficiency involves deficiency of Lung Qi; Excess results from abdominal distension and fullness, or water retention under the heart, or binding of Wind-Dampness. One must investigate the specific cause for each case to apply treatment. (From *Yi Xue Tong Zhi*) [Note: The original text distinguishes between Asthma (Chuan) and Shortness of Breath, fully adopting content from *Ming Li Lun*. Since this has been recorded in *Shang Han Guang Yao*, it is not repeated here. *Yi Guan* also follows Cheng Shi, adding the phrase "respiration is rapid but without phlegm sounds."]
Exterior conditions presenting with shortness of breath and insufficient respiration resemble Asthma (Chuan), but one must distinguish between Deficiency and Excess; it should not be treated as Asthma. For Deficiency, use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Wu Wei Zi (Schisandra Fruit) and Mai Dong (Ophiopogon Tuber). For Excess caused by obstruction of Phlegm-Qi, use Dao Tan Wan (Phlegm-Guiding Pill). If Kidney Qi fails to grasp Essence, use Bu Shen Wan (Kidney-Nourishing Pill). (From *Cang Sheng Si Ming*)
If Lung Qi is excessively deficient, Qi cannot distribute respiration, and inhalation/exhalation fail to connect continuously, with exhalation exceeding inhalation, this is called Shortness of Breath. This represents extreme Deficiency. (From *Ming Yi Zhi Zhang*)
In middle-aged individuals after illness, symptoms such as rapid breathing with coughing up phlegm, cold swelling of legs and feet, severe lower back bone pain, facial edema, and pain in the Taiyang region all belong to the pattern of Ming Men Fire Decline and Yang Deficiency. Using Ba Wei Wan (Eight-Ingredient Pill) decoction is excellent. If treated as a Phlegm syndrome, danger will ensue immediately. (From *Jing Yue Quan Shu: Liu Yao*)
When Guan Ge Syndrome presents with Asthma, as stated in *Su Wen: Liu Jie Zang Xiang Lun*: When the Ren Ying pulse is four times larger than normal, it is called Ge Yang (Rebellious Yang). When the Cun Kou pulse is four times larger than normal, it is called Guan Yin (Closed Yin). When both Ren Ying and Cun Kou pulses are more than four times larger, it is called Guan Ge. This Guan Ge syndrome is defined by pulse characteristics, not by a specific disease name. Many people suffer from this today, yet few know it. Moreover, contemporary pulse diagnosticians do not examine the Ren Ying pulse, focusing only on Cun Kou. However, if the pulses in both hands are floating, wiry to the extreme, and large to more than four times the normal size, this is the syndrome. The disease necessarily presents with throbbing at Xu Li (Vital Gate area) and continuous asthmatic breathing. This type of asthma usually lacks coughing; the patient feels palpitations/churning in the chest and diaphragm, feeling like fullness but not quite full, like shortness but not quite short. Mild exertion worsens the asthma, and excessive talking worsens it. It may even lead to whole-body trembling, panic, and restlessness. This is inevitably a sign of Yin injury due to sexual indulgence, leading to rootless Yuan Qi (Original Qi) and solitary Yang residing apart. It is mostly incurable. Formula discussions are detailed in the Guan Ge section. (From *Jing Yue Quan Shu*)
When Deficient Fire flares upward, Yin and Yang fail to ascend and descend, with deficiency below and excess above, causing rapid breathing and asthma, use Su Zi Jiang Qi Tang (Perilla Seed Descending Qi Decoction) removing Qian Hu (Peucedani Radix), administered with Hei Xi Dan (Black Tin Pill) or Yang Zheng Dan (Nourish Righteousness Pill). If asthma is severe enough to prevent lying down, use Chen Fu Tang (Aucklandia and Aconite Decoction) or Zheng Yuan Yin (Upright Original Drink), or Si Zhu San (Four Pillars Powder) replacing Mu Xiang (Aucklandiae Radix) with Chen Xiang (Aquilaria Wood), decocted with salt, administered with Hei Xi Dan or Ling Sha Dan (Spirit Sand Pill) or San Chao Dan (Three-Fried Pill). If ineffective, administer previous medicines with Zhu Sha Dan (Cinnabar Pill). For shortness and fatigue where lower Qi fails to connect with upper Qi, respiration fails, and speech is weak, use Bu Xu Si Zhu Yin (Tonify Deficiency Four Pillars Drink), reducing Mu Xiang by half, adding Huang Qi (Astragali Radix) and Shan Yao (Dioscoreae Rhizoma) each 1 qian. For those who cannot tolerate hot medicines or have much phlegm, replace cooked Fu Zi (Aconiti Lateralis Radix Praeparata) with raw Fu Zi; this depends on the physician's flexibility, following similar principles for others. If the medicine is too mild for the severity of the disease and Si Zhu Yin is ineffective, remove Mu Xiang from the base formula and add 15 fried Chuan Jiao (Sichuan Pepper). If still ineffective, use Jiao Fu Tang (Pepper and Aconite Decoction). For upper jiao dryness where hot medicines are not tolerated, add 1 qian of Ren Shen (Ginseng Radix) to Jiao Fu Tang. For ordinary diseases requiring Ginger and Aconite, but where the patient has upper excess and dry-heat making them unsuitable for these herbs, this method is best. For individuals with shortness of breath and fatigue, besides administering medicine, select a robust male, have him inhale his own breath and exhale ("xu") into the patient's mouth. Repeating this several times can assist the medicinal effect. This method is not only effective for deficiency and fatigue but also yields good results for ordinary sudden rebellious Qi causing hiccups. (From *Yi Xue Yao Jue*)