若虚喘脉微，色青黑，四肢厥，小便多，以《活人书》五味子汤或四磨汤。（《丹溪》）
东阳一羽士，年五十余，素有喘病，九月间得发热恶寒证，喘甚，脉洪盛而似实。一医作伤寒治而用小柴胡
汤加枳壳、陈皮等药，六日后欲行大承气。一医曰不可，当作伤食治，宜用枳实导滞丸。争不决，召予视之。二
医皆曰∶脉实气盛，当泻。予为诊后晓之曰∶此火盛之脉，非真实也。观其短气不足以息，当作虚治而用补中益
气汤，加麦门冬、五味子，入附子三分煎服。二帖脉收敛而病轻减，六帖病痊安。（《正传》）
盘溪周训导舜卿，年五十时，患痰火之证，外貌虽 ，禀气则浓，性不喜饮。请朱医视脉，孟浪指为虚火，
用补中益气汤加参、术各五钱。病者服药超时，反致气喘上升，喘息几不能活。复延钱中立视之，曰∶此实火也，
宜泻不宜补。痰气得补，火邪愈炽，岂不危殆。先用二陈汤探吐，出痰碗许，其后安寝。平明仍用二陈去半夏，
加朴消、大黄，下结粪无数，其热始退。更用调理药，旬日始安。吁！不识病机，妄施补泻，鲜不败事者矣。
（《续医说》）
遇冷则发证 有内热而外逢寒则发，脉沉数者，谓之寒
包热。治法以仲景越婢加半夏汤发表诸方之类，及预于八九月间未寒之时，用大承气汤先下其热，至冬寒时，
无热可作，喘自不发者是也。（《医统》）
哮喘遇冷则发，其法有二∶一属中外皆寒，温肺汤、钟乳丸、冷哮丸选用，并以三建膏护肺俞穴最妙。一属
寒包热，越婢加半夏汤、麻黄定喘汤表散其邪，平时用芦吸散亦妙。古人治寒包热邪，预于八、九月未寒之时，
用滚痰丸下其热痰，后至冬无热可包，则不发矣。（《医通》）（按∶咳嗽预用滚痰丸，出《汪石山医案》，
载在波门泻肺方中。）
水喘（水肿为喘）水喘，有人先因咳发喘，胸膈痞闷，难于倒头，气上凑者，宜早利水道，化痰下气，
若不早治必成水，宜服紫金丹。（《医说》引《医余》）（按∶紫金丹当是《水气》禹余粮丸。）
水病为喘者，以肾邪干肺也。然水不能化而子病及母，使非精气之败，何以至此。此其虚者十九，而间乎虚
中挟实，则或有之耳。故凡治水喘者，不宜妄用攻击之药，当求肿胀门诸法治之，肿退而喘自定矣。古法治心下
有水气，上乘于肺，喘而不得卧者，以《直指》神秘汤主之。但此汤性用多主气分，若水因气滞者，用之则可；
若水因气虚者，必当以加减《金匮》肾气汤之类主之。（《景岳》）（按∶神秘汤用陈皮、北梗、紫苏、人参、
五味子、槟榔、桑白皮、半夏、甘草、姜煎服）
食喘 食喘者，凡病初起即喘急，多是停食也，或放屁，甚者或咬人，消食自愈。小儿行走气急作喘，
多是食。食喘兼外感，散邪消食。经有胃喘一证，谓胃络不和，气逆作喘（胃气本下行，二肠脉亦从头走足。
若不下行，而反干平上，则气喘逆）。然所以致逆者，非火则食与痰耳，审治
之。（《医碥》）
喉中如水鸡鸣 肺病令人上气，兼胸膈痰满，气行壅滞，喘息不调，致咽喉有声，如水鸡之鸣也。
（《病源论》）
呕吐 肺主于气，肺为邪所乘则上气，此为膈内有热，胃间有寒，寒从胃上乘于肺，与膈内热相搏，故
乍寒乍热而上气，上气动于胃，胃气逆故呕吐也。（《病源论》）
身肿 肺主于气，候身之皮毛，而气之行，循环脏腑，流通经络。若外为邪所乘，则肤腠闭密，使气内
壅，与津液相并，不得泄越，故上气而身肿也。（《病源论》）
死证 《葛氏方》云∶上气喘嗽，肩息不得卧，手足逆冷，及面浮肿者死。（《医心方》）
病气人，一身悉肿，四肢不收，喘无时，厥逆不食，脉候沉小者死，浮大者生。（《中藏》）
汗出发润者为肺绝，身汗如油喘者为命绝，直视 语喘满者不治。诸有笃病，正气欲绝之时，邪气盛行，多
壅逆而为喘，然则喘之危恶，又安可寻常目之。（《直指》）
喘甚胸前高起，此脉络散张，不治。（《原病集》）
（《医通》曰∶凡哮证见胸凸背驼者，此肺络散，为痼疾，不治。）
凡喘病，上喘下泄者死，上喘而小便利者死。喘病危笃，鼻出冷气者，此肺绝也。（《苍生司命》）
人有大病不得瘥，一朝加喘者，不治。（《保命歌括》）
治例 大抵哮喘，未发以扶正为主，已发以攻邪为主（按∶此语出丹溪）。亦有痰气壅盛壮实者，可用
吐法。大便秘结，服定喘药不效，而用利导之药而安者。治须使薄滋味，不可纯用凉药，亦不可多服砒毒劫药，
倘若受伤，追悔何及。（《统旨》）
扶正气者，须辨阴阳，阴虚者补其阴，阳虚者补其阳。攻邪气者，须分微甚，或散其风，或温其寒，或清其
痰火。然发久者，气无不虚，故于消散中，宜酌加温补，或于温补中，宜量加消散。此等证候，当 以元气
为念，必使元气渐充，庶可望其渐愈。若攻之太过，未有不至日甚而危者。（《景岳》）
膈有胶固之痰，外有非时之感，内有壅塞之气，然后令人哮喘。能温之汗之吐之，皆是良法。若逡巡调理，
则虚喘宜之。人而羸瘦气弱，则宜灸其背 。今考古方七首，而哮喘之大目可知矣。（《医方考》）（按∶古方
七首系麻黄汤、瓜蒂散、定喘汤、五味子汤、附子理中汤、六君子汤、青皮江子方。）
治当安五脏养肺金 人身难治之病有百证，喘病其最也。喘病无不本之于肺，然随所伤而互关，渐以造
于其极，惟兼三阴之证者为最剧。三阴者，少阴肾、太阴脾、厥阴肝也。而三阴又以少阴肾为最剧云云。究而言
之，岂但窠囊之中痰不易除，即肺叶之外，膜原之间，顽痰胶结多年，如树之有萝，如屋之有游，如石之有苔，
附托相安，仓卒有难于划去者。肺金以脾土为母，而肺中之浊痰，亦以脾中之湿为母。脾性本喜燥恶湿，迨夫湿
热久锢，遂至化刚为柔，居间用事。饮食入胃，既以精华输我周身，又以败浊填彼窍隧。始尚交相为养，最后挹
此注彼， 为外邪示岂弟，致使凭城凭社辈，得以人遂其奸。如附近流寇之地，益以巨家大族暗为输导，其滋蔓
难图也，有由然矣。治法必静以驭气，使三阴之火不上升，以嘿杜外援；又必严以驭脾，使太阴之权有独伸，而不
假敌饩。我实彼虚，我坚彼瑕，批瑕捣虚，迅不掩耳，不崇朝而扫清秽浊。乃广服大药，以安和五脏，培养肺金。
肺金之气一清，则周身之气翕然从之下降，前此上升浊邪，允绝其源，百年之间，常保清明在躬矣。（《寓意草》）
（按∶喻氏论窠囊之痰，既从《医通》删正。录之《痰涎》中，今更取意与彼异者，拈出于兹，读者宜互参耳。）
冷水入肺宜吐下之《古今录验》宫泰说∶李将军儿得病，喘息甚难，并数上气呼吸，疗之不瘥遂亡。本
由食饼后乃饮水得之，服五味汤不瘥，此辈皆死。是后乃有婢，得之行极而渴，饮水多，此为所发起同，与五味汤
亦不瘥，然后小瘥，泰因此与三物备急药半钱，吐下得瘥。由此思惟，病之所由，以冷水入肺及入肠，寒热不消
化，结聚逼迫于胃口，故令其呼吸之气息不得下过，为喘而上气息数也。宜吐下之，亦可与三物瓜蒂散吐之。
（《外台》）（按∶三物瓜蒂散用瓜蒂、杜蘅、人参。）
疏肺诸方 麻黄汤，肺部原有风痰，背 复感寒邪而成哮喘者，此方主之。（《医方考》）
治上气胸满者，麻黄石膏汤方。
麻黄（四两） 石膏（一枚如鸡子大） 小麦（一升） 杏仁（半升） 浓朴（五两）
上五味 咀，以水一斗，先煮小麦熟丢之，下药煮取三升，去滓分三服。（深师方用治久逆上气，喉中如水
鸡鸣，名小投杯汤。咳者，加五味子、半夏各半升，干姜三累。）（《千金》）（按∶均气八仙汤及《幼幼集成》
一方，俱自麻杏甘石汤变来，然其意一在清肺，一在驱痰，仍类列于后。）
《近效》疗久上气，气急，卧不得方。
紫苏叶（二两） 生姜 麻黄（去节） 杏仁（各三两） 赤茯苓 桑根白皮 葶苈子（各二两熬）
橘皮（一两半）
上八味切，以水八升，先煮麻黄去沫，下诸药和，煮取二升七合，绞去滓，分三服，每服如人行七、八里
久，温服之。（《外台》）（按∶《和剂》华盖散，从此方增损，既录《咳嗽》中。）
治积年肺气，九宝散。
大腹（并皮） 肉桂 甘草（炙） 甘紫苏 杏仁（去皮尖） 桑根白皮（各一两） 麻黄（去根） 陈
橘皮（炒） 干薄荷（各三两馆本各二两）
上捣为粗末，每服十钱匕，用水一大盏，童子小便半盏，乌梅二个，姜钱五片，同煎至一中盏，滤去滓，食
后临卧服。两浙张大夫病喘二十年，每至秋冬辄剧，不可坐卧，百方不瘥，后得临平僧法本方服之，遂瘥。法本
凡病喘三十年，服此药半年，乃绝根本，永不复发。凡服此药，须久乃效。（《苏沈》）
定喘汤。
白果（二十一枚去壳扎碎炒黄色） 黄芩（一钱五分微炒） 杏仁（一钱五分去皮尖） 桑白皮（三钱蜜炙）
苏子（二钱） 甘草（一钱） 麻黄（三钱） 法制半夏（三钱如无用甘草汤泡七次去脐用） 款冬花（三钱）
上用水三钟，煎二钟，作二服，每服一钟，不用姜，徐徐服。金陵有一铺舍，用此方专治喘，无不取效，此
其真方也。（《众妙方》）肺虚感寒，气逆膈热，作哮喘者，此方主之。（《医方考》）
凡喘气实，服参、 药过多，用三拗汤泻之。（《识病捷法）（按∶此系麻黄汤去桂。）
定肺汤，治上气喘嗽。
紫菀茸 北五味子 橘红 杏仁（去皮尖略炒） 甘草（炙）
真苏子（炒） 桑白皮（炒） 半夏（制） 枳壳（制等分）
上细锉，每服三钱，姜三片，紫苏五叶，煎，食后服。（《直指》）
喘嗽面浮，并四肢浮者，蛤蚧一雌一雄头尾全者，清酒和蜜涂之炙熟，紫团人参似人形者半两为末，化蜡
四两，和作六饼，每煮糯米薄粥一盏，投一饼搅化，细细热呷之。（《本草纲目》引《普济》）
润肺诸方 五味子汤。
五味子（半两炒） 人参（去芦） 麦门冬（去心） 杏仁（去皮尖） 陈皮（去白） 生姜（各二钱）
肺虚作喘，脉大者，此方主之。（《医方考》）（按∶此方本出《活人书》。）
治卒上气喘息便欲绝方，末人参服方寸匕，日五、六。（肘后）
治咳嗽上气喘急，以人参一味为末，鸡子清投新水，调下一钱。昔有二人同走，一含人参，一不含，俱走三、
五里许，其不含者大喘，含者气息自如，此人参之力也。（《纲目》）（按∶此方《本草》引《灵苑方》，今录
之血证中。）
独参汤，治气虚喘急，服之喘定者生，不定者死。（《入门》）（按∶程星海治虚喘，用人参五钱，生姜十
大片，水一钟，煎五分，频频缓服。）
予治一妇人，五十余岁，素有痰嗽，忽一日大喘，痰出如泉，身汗如油，脉浮而洪，似命绝之状。予适在彼，
速用麦门冬四钱，人参二钱，五味子一钱五分，煎服。一帖喘定汗止，三帖后痰亦渐少。再于前方内，加栝蒌仁
一钱五分，白术、当归、芍药、黄芩各一钱，服二十余帖而安，此实麦门冬、五味、人参之助也。如自汗兼腹满
脉沉实而喘者，里实也，
宜下之。（同上）
上用门冬、五味、人参三味为主，治肺实，或自汗，或少气而喘，盖圣药也。（同上）（按∶《要诀》曰∶
五味有南有北，生津止渴，润肺益肾。治劳嗽者，宜用北五味。若风邪在肺，宜用南五味。不若二者兼用。）
生脉散，治久病气虚作喘。（《识病捷法》）
人参胡桃汤，治痰喘。《夷坚己志》第三卷。
新罗人参（一寸许） 胡桃肉（一个去壳不剥皮）
上煎汤服。盖人参定喘，带皮胡桃敛肺故也。（《是斋》）
杏仁煎，治久患肺喘，咳嗽不止，睡卧不得者，服之即定。
杏仁（去皮尖微炒半两） 胡桃肉（去皮半两）
上件入生蜜少许，同研令极细，每一两作一十丸，每服一丸，生姜汤嚼下，食后临卧。（《杨氏》）《神效
方》名三生丸，于本方加生姜（去皮细切，各一两），同研为泥，可得十三、四丸，临卧烂嚼一丸。
温肺诸方（温中）深师疗气上迫满，或气不通，烦闷喘呕，苏子汤方。
苏子（一升） 干姜（三两） 半夏（四两洗） 桂心 人参（各一两） 橘皮 茯苓（各三两） 甘草（一两炙）
上八味切，以水八升，煮取二升半，分为三服。若虚热，去干姜，用生姜六两，加黄芩二两。（《外台》）
小青龙汤本方，去麻黄，加杏仁去皮三两，治水气喘嗽。若小腹满，更加茯苓。（《直指》）（按∶此即《易
简》杏子汤，既录《伤寒广要》中。）
附子理中汤，脾肺虚寒，痰涎壅塞，少有动作，喘嗽频
促，脉来迟细者，此方主之。（《医方考》）（沉附汤方，载在重坠方中，宜参。）
六君子汤，气虚痰喘者，此方主之。（同上）
四君子汤，治气喘气短而喘者，呼吸短促而无痰声也。
If deficiency wheezing presents with a faint pulse, cyanotic or dark complexion, cold limbs, and polyuria, use *Wuweizi Tang* (Schisandra Decoction) from the *Ren Shu* or *Simotu Tang* (Four-Obstruction Decoction). (From *Danxi Xinfa*)
A Daoist priest in Dongyang County, over fifty years old, had a chronic history of wheezing. In September, he contracted a syndrome of fever and aversion to cold, with exacerbated wheezing. His pulse was surging and full, appearing as an excess pattern. One physician treated it as Taiyang disease (*Shanghan*) using *Xiaochaihu Tang* (Minor Bupleurum Decoction) augmented with Zhike (Bitter Orange Fruit) and Chenpi (Tangerine Peel). After six days, he intended to administer *Dachengqi Tang* (Major Order the Qi Decoction). Another physician objected, suggesting it should be treated as food retention, appropriate for *Zhishi Daoshi Wan* (Immature Bitter Orange Pill to Guide Out Stagnation). Unable to resolve the dispute, they summoned me. Both physicians stated: "The pulse is excess and qi is abundant; purgation is indicated." After examining the patient, I explained: "This is a pulse of excessive fire, not a true excess pattern. Observing his shortness of breath and inability to take deep breaths, this should be treated as deficiency using *Buzhong Yiqi Tang* (Tonify the Middle and Augment the Qi Decoction), augmented with Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Berry), and decocted with 3 fen of Fuzi (Prepared Aconite Root). After two doses, the pulse became restrained and symptoms alleviated; after six doses, the illness resolved." (From *Danxi Xinfa*)
Zhou Shunqing, a tutor in Panxi, at age fifty, suffered from phlegm-fire syndrome. Although outwardly obese, his constitution was robust, and he disliked drinking alcohol. Physician Zhu examined his pulse and rashly diagnosed it as deficient fire, prescribing *Buzhong Yiqi Tang* augmented with 5 qian each of Renshen (Ginseng Root) and Baizhu (Atractylodes Rhizome). The patient took the medicine for too long, resulting in ascending wheezing and near-asphyxiation. Physician Qian Zhongli was then consulted, stating: "This is excess fire; purgation is indicated, not tonification. Tonifying phlegm and qi will intensify the fire pathogen, which is dangerous." He first used *Erchen Tang* (Two-Cured Decoction) to induce vomiting, expelling about one bowl of phlegm, allowing the patient to sleep peacefully. At dawn, he continued with *Erchen Tang* minus Banxia (Pinellia Tuber), adding Poxiao (Mirabilite) and Dahuang (Rhubarb Root and Rhizome), evacuating numerous hardened stools, after which the heat subsided. Following with regulating herbs, he recovered within ten days. Alas! Those who fail to understand the pathogenesis and recklessly apply tonification or purgation rarely avoid failure. (From *Xu Yishuo*)
Recurring upon exposure to cold: When internal heat is triggered by external cold, presenting with a deep and rapid pulse, it is termed "Cold Enveloping Heat" (Han Bao Re). Treatment involves releasing the exterior using formulas such as *Yuespi Jia Banxia Tang* (Mahuang Decoction plus Pinellia) from Zhang Zhongjing, or preemptively using *Dachengqi Tang* to purge heat before the onset of cold in August or September. By winter, when there is no heat to be enveloped, wheezing naturally does not occur. (From *Yitong*)
Asthma recurring upon exposure to cold has two methods: One belongs to cold inside and outside; select *Wenfei Tang* (Warm the Lung Decoction), *Zhongru Wan* (Zeolite Pill), or *Lengxiao Wan* (Cold Asthma Pill), and applying *Sanjian Gao* (Three Jian Paste) to Feishu (BL13) is excellent. The other belongs to Cold Enveloping Heat; use *Yuespi Jia Banxia Tang* or *Mahuang Dingchuan Tang* (Ephedra Anti-Wheezing Decoction) to disperse the pathogen externally, while using *Luxi San* (Reed Siphon Powder) daily is also effective. Ancients treating Cold Enveloping Heat pathogen would preemptively use *Guntan Wan* (Rolling Phlegm Pill) in August/September to purge hot phlegm; by winter, with no heat to envelop, attacks do not occur. (From *Yitong*) (Note: Preemptive use of *Guntan Wan* for cough appears in *Wang Shishan Yian*, recorded in Bo Men Xiefei Fang.)
Water Wheezing (Edema-induced Wheezing): Some patients first develop wheezing due to cough, with chest and diaphragm oppression, difficulty lying flat, and qi rushing upward. Early intervention to promote urination, resolve phlegm, and direct qi downward is required; otherwise, edema will develop. *Zijin Dan* (Purple Gold Pill) is indicated. (From *Yishuo* citing *Yiyu*) (Note: *Zijin Dan* is likely *Yuyuliang Wan* [Hematite Pill] from the *Shuiqi* chapter.)
Wheezing caused by water disease results from kidney pathogenic factors interfering with the lung. Since water metabolism fails, the "child disease affects the mother," indicating severe essence and qi depletion. Ninety percent of these cases are deficiency, occasionally mixed with excess. Therefore, treating water wheezing requires avoiding reckless purgation; instead, follow methods from the Edema chapter. Once edema resolves, wheezing stabilizes. Ancient texts treat heart-diaphragm fluid retention ascending to the lung, causing wheezing and inability to lie down, using *Shenmi Tang* (Divine Mystery Decoction) from *Zhizhi Fang*. However, this formula primarily regulates qi; if edema stems from qi stagnation, it is suitable. If edema stems from qi deficiency, modified *Jinkui Shenqi Tang* (Golden Cabinet Kidney Qi Decoction) is necessary. (From *Jingyue Quanshu*) (Note: *Shenmi Tang* contains Chenpi, Jiegeng, Zisu, Renshen, Wuweizi, Binglang, Sangbaipi, Banxia, Gancao, and ginger.)
Food Wheezing: Acute wheezing at onset often indicates food retention, accompanied by flatulence or even biting behavior; resolving food stagnation leads to self-healing. Children walking with急促 breathing and wheezing often suffer from food retention. If combined with external pathogens, disperse pathogens and resolve food. Classics mention "Stomach Wheezing," where stomach meridians are disharmonious, causing rebellious qi and wheezing (Stomach qi normally descends; if it rebels upward, wheezing occurs). The causes of rebellion are fire, food, or phlegm; examine carefully. (From *Yique*)
Roaring in the Throat like a Water Frog: Lung disease causes upper qi rebellion, combined with phlegm-fullness in the chest/diaphragm, qi obstruction, irregular breathing, leading to throat sounds resembling a water frog. (From *Bingyuan Lun*)
Vomiting: The Lung governs qi. When attacked by pathogens, upper qi rebels. This indicates heat in the diaphragm and cold in the stomach. Cold rises from the stomach to the lung, clashing with diaphragmatic heat, causing alternating chills and fever, upper qi rebellion, and stomach qi rebellion leading to vomiting. (From *Bingyuan Lun*)
Body Swelling: The Lung governs qi and controls skin/hair. Qi circulates through organs and collaterals. External pathogens close the pores, trapping qi internally, combining with body fluids, preventing excretion, leading to upper qi rebellion and body swelling. (From *Bingyuan Lun*)
Death Signs: *Ge Shi Fang* states: Upper wheezing and cough, shoulder breathing, inability to lie down, cold extremities, and facial edema indicate death. (From *Yixin Fang*)
Disease affecting qi, general edema, flaccid limbs, constant wheezing, cold limbs, anorexia, with deep/small pulse indicates death; floating/large pulse indicates survival. (From *Zhongzang Jing*)
Sweating with sticky hair indicates Lung exhaustion; sweating like oil with wheezing indicates Life exhaustion; staring fixedly, delirium, wheezing, and fullness indicate untreatable conditions. In critical illnesses, when righteous qi is exhausted and pathogenic qi flourishes, obstruction and rebellion cause wheezing. Thus, the severity of wheezing cannot be underestimated. (From *Zhizhi Fang*)
Severe wheezing with chest protrusion indicates dispersed collaterals; untreatable. (From *Yuanbing Ji*)
(*Yitong* states: Asthma with convex chest and hunched back indicates dispersed lung collaterals, a chronic incurable disease.)
Generally, wheezing with simultaneous diarrhea or clear urine indicates death. Critical wheezing with cold air from the nose indicates Lung exhaustion. (From *Cangsheng Siming*)
Patients with severe illness who suddenly develop wheezing are untreatable. (From *Baoming Gekuo*)
Treatment Principles: Generally, asthma in remission focuses on supporting righteousness; during attacks, focus on attacking pathogens (attributed to Danxi). For robust patients with excessive phlegm-qi, emesis may be used. For constipation unresponsive to anti-wheezing drugs, laxatives may bring relief. Diet should be bland; avoid pure cooling herbs or excessive arsenic-containing drugs, which can cause irreversible damage. (From *Tongzhi*)
Supporting righteousness requires distinguishing yin/yang: tonify yin for yin deficiency, yang for yang deficiency. Attacking pathogens requires assessing severity: dispel wind, warm cold, or clear phlegm-fire. Long-standing attacks inevitably involve qi deficiency; thus, add warming/tonifying herbs to dispersing formulas, or dispersing herbs to tonifying ones. Prioritize yuan qi; gradual replenishment offers hope for recovery. Over-aggressive treatment leads to worsening and danger. (From *Jingyue Quanshu*)
Phlegm congealed in the diaphragm, external non-seasonal pathogens, and internal qi obstruction cause asthma. Warming, sweating, and emesis are good methods. For lingering regulation, deficiency wheezing is suitable. Emaciated and weak patients benefit from moxibustion on the back. Seven ancient formulas outline major asthma treatments. (From *Yifang Kao*) (Note: The seven formulas are Mahuang Tang, Gouti San, Dingchuan Tang, Wuweizi Tang, Fuzi Lizhong Tang, Liujunzi Tang, and Qingpi Jiangzi Fang.)
Treatment should harmonize the five zang and nourish Lung Metal: Among difficult diseases, wheezing is paramount. All wheezing originates in the Lung but interacts with other organs, progressing to extremes. Cases involving the Three Yin (Shaoyin Kidney, Taiyin Spleen, Jueyin Liver) are most severe, especially Shaoyin Kidney. Beyond phlegm in "cocoons," stubborn phlegm adheres to lung membranes like vines on trees or moss on stones, hard to remove. Lung Metal relies on Spleen Earth; turbid phlegm in the Lung arises from dampness in the Spleen. Spleen prefers dryness and dislikes dampness. Prolonged damp-heat transforms rigidity into flexibility, intervening in processes. Food nutrients nourish the body, while waste fills orifices. Initially mutual nourishment, eventually, one draws from the other, aiding external pathogens like bandits receiving support from local elites, making control difficult. Treatment must calm qi to prevent Three Yin fire from rising, suppressing external aid; strictly regulate the Spleen to assert Taiyin authority without enemy supplies. Strengthen oneself, exploit weakness, swiftly clearing turbidity. Then administer potent medicines to harmonize the five zang and cultivate Lung Metal. Once Lung qi clears, whole-body qi descends, cutting off the source of rising turbidity, ensuring clarity for decades. (From *Yuyi Cao*) (Note: Yu's discussion on cocoon phlegm corrects *Yitong*. Recorded in *Tanxian*, now extracted for different insights.)
Cold Water Entering the Lung Requires Emesis/Purgation: *Gujin Luyan* records Gong Tai's case: General Li's son suffered severe wheezing and frequent upper qi rebellion, dying despite treatment. Caused by drinking water after eating cake. *Wuwu Tang* failed. Later, a maid drank excessively after extreme exertion, developing similar symptoms; *Wuwu Tang* failed initially, then improved slightly. Gong Tai administered half a qian of *Sanwu Beiji Yao* (Three Substances Emergency Medicine), inducing emesis/purgation for recovery. Reason: Cold water entering lung/intestines fails to transform due to cold/heat conflict, accumulating at the stomach gate, blocking respiration, causing wheezing and rapid breathing. Emesis/purgation is indicated; *Sanwu Gouti San* (Three Substances Melon Spore Powder) may be used. (From *Waitai Miyao*) (Note: *Sanwu Gouti San* contains Gouti, Duheng, and Renshen.)
Formulas to Disperse the Lung: *Mahuang Tang* (Ephedra Decoction) treats asthma caused by original wind-phlegm in the lung compounded by cold invasion on the back. (From *Yifang Kao*)
For upper qi and chest fullness, *Mahuang Shigao Tang* (Ephedra and Gypsum Decoction):
Mahuang (4 liang), Shigao (1 piece, egg-sized), Xiaomai (1 sheng), Xingren (0.5 sheng), Houpo (5 liang).
Chop the five ingredients. Decoct in 1 dou of water, boil Xiaomai until cooked, add remaining herbs, boil to 3 sheng, strain, divide into three doses. (*Shenshi Fang* uses this for chronic rebellious qi and frog-like throat sounds, named *Xiaotoubei Tang*; for cough, add Wuweizi and Banxia 0.5 sheng each, Ganjiang 3 lei.) (From *Qianjin Fang*) (Note: Both *Qibaxian Tang* and a formula in *Youyou Jicheng* derive from *MaXingGanShi Tang*, one focusing on clearing lung heat, the other on expelling phlegm.)
*Jinxiao* Formula for Chronic Upper Qi,急促 Breathing, and Inability to Lie Down:
Zisu Ye (2 liang), Shengjiang, Mahuang (de-segmented), Xingren (3 liang each), Chifuling, Sangbaipi, Tinglizi (roasted, 2 liang each), Juapi (1.5 liang).
Cut eight ingredients. Decoct in 8 sheng of water, boil Mahuang first to remove foam, add others, boil to 2.7 sheng, strain, divide into three doses. Take warm after walking 7-8 li. (From *Waitai Miyao*) (Note: *Huagai San* in *Heji Jufang* is derived from this.)
Nine Treasures Powder for Chronic Lung Qi:
Dafu (with peel), Rougui, Gancao (roasted), Zisu, Xingren (de-skinned/de-seeded), Sangbaipi (1 liang each), Mahuang (de-rooted), Chenpi (stir-fried), Ganbohe (3 liang each, or 2 liang in some editions).
Pulverize coarsely. Take 10 qian with 1 large cup of water, 0.5 cup of child's urine, 2 wumei, 5 slices of ginger. Decoct to 1 medium cup, strain, take after meals and before bed. Dr. Zhang of Zhejiang suffered 20-year asthma, worsening in autumn/winter, unable to sit/lie down. Recovered after taking Monk Faben's formula. Faben, suffering 30-year asthma, took this for half a year, eliminating the root cause permanently. Efficacy requires long-term use. (From *SuShen Liangfang*)
*Dingchuan Tang* (Anti-Wheezing Decoction):
Baiguo (21, shelled, crushed, stir-fried yellow), Huangqin (1.5 qian, lightly roasted), Xingren (1.5 qian, de-skinned/de-seeded), Sangbaipi (3 qian, honey-roasted), Suzi (2 qian), Gancao (1 qian), Mahuang (3 qian), Fazhi Banxia (3 qian, or soaked 7 times in Gancao decoction if unavailable), Kuandonghua (3 qian).
Decoct in 3 zhong of water to 2 zhong, divide into two doses. Take 1 zhong per dose without ginger, sip slowly. A pharmacy in Jinling used this exclusively for asthma with success. (From *Zhongmiao Fang*) Treats asthma due to Lung deficiency with cold invasion, rebellious qi, and diaphragmatic heat. (From *Yifang Kao*)
For excess wheezing caused by excessive intake of Renshen/Qi tonics, use *Sansao Tang* (Three Un-twisted Decoction) to purge. (From * Shibing Jiefang*) (Note: This is Mahuang Tang minus Guizhi.)
*Dingfei Tang* (Lung-Stabilizing Decoction) for Upper Qi Wheezing/Cough:
Ziwanrong, Bei Wuweizi, Juhong, Xingren (lightly roasted), Gancao (roasted), Zhen Suzi (roasted), Sangbaipi (roasted), Banxia (processed), Zhike (processed, equal parts).
Finely cut. Take 3 qian with 3 slices of ginger and 5 leaves of Zisu. Decoct, take after meals. (From *Zhizhi Fang*)
For wheezing/cough with facial and limb edema: Roast one pair of Gejie (Gecko) with rice wine and honey. Mix 0.5 liang of Ren-shaped Zituan Renshen powder with 4 liang of melted wax to make six cakes. Boil thin rice porridge, dissolve one cake, sip slowly while hot. (From *Bencao Gangmu* citing *Puji Fang*)
Moistening Lung Formulas: *Wuweizi Tang* (Schisandra Decoction):
Wuweizi (roasted, 0.5 liang), Renshen (de-rhizome), Maidong (de-heart), Xingren (de-skinned/de-seeded), Chenpi (de-white), Shengjiang (2 qian each).
Treats Lung deficiency wheezing with large pulse. (From *Yifang Kao*) (Note: Originally from *Ren Shu*.)
Emergency Upper Qi/Asthma Near Collapse: Powdered Renshen, 1 fangcun bi dose, 5-6 times daily. (From *Zhouhou Beiji Fang*)
Cough with Upper Qi/Asthma: Powdered Renshen, mixed with egg white and fresh water, 1 qian dose. Two men walked 3-5 li; one held Renshen, the other did not. The one without Renshen wheezed severely; the one with Renshen breathed normally. Proof of Renshen's power. (From *Bencao Gangmu*) (Note: Cited from *Lingyuan Fang* in *Bencao*, recorded here in Blood Syndromes.)
*Dushen Tang* (Single Ginseng Decoction) for Qi Deficiency Wheezing: Survival if wheezing stops after administration; death if not. (From *Rumen*) (Note: Cheng Xinghai treated deficiency wheezing with 5 qian Renshen, 10 slices ginger, 1 zhong water, decocted to 0.5 zhong, taken frequently and slowly.)
I treated a woman, over fifty, with chronic phlegm-cough, who suddenly developed severe wheezing, profuse sputum, oily sweat, and floating/surging pulse, resembling impending death. I immediately prescribed Maidong (4 qian), Renshen (2 qian), Wuweizi (1.5 qian). After one dose, wheezing stopped and sweating ceased; after three doses, sputum decreased. Added Gualouren (1.5 qian), Baizhu, Danggui, Shaoyao, Huangqin (1 qian each) to the previous formula. After twenty-plus doses, she stabilized. This demonstrates the efficacy of Maidong, Wuweizi, and Renshen. If spontaneous sweating accompanies abdominal fullness, deep/excess pulse, and wheezing, it is interior excess; purgation is indicated. (Same source)
Using Maidong, Wuweizi, and Renshen as main ingredients treats Lung excess, spontaneous sweating, or shortness of breath with wheezing; considered a sacred medicine. (Same source) (Note: *Yaojue* states: Southern and Northern Wuweizi exist. Both generate fluids, quench thirst, moisten lungs, and benefit kidneys. Use Northern Wuweizi for labor coughs; Southern for wind-pathogens in the lung. Using both is preferable.)
*Shengmai San* (Generate Pulse Powder) for chronic Qi deficiency wheezing. (From *Shibing Jiefang*)
*Renshen Huta Tang* (Ginseng and Walnut Decoction) for Phlegm Wheezing. (*Yijian Zhi* Vol 3):
Xinluo Renshen (~1 cun), Hutao Rou (one walnut, shell removed, skin intact).
Decoct and drink. Renshen stabilizes wheezing; skin-on walnuts astringe the lung. (From *Shizhai Baixuan*)
*Xingren Jian* (Almond Decoction) for chronic lung wheezing, persistent cough, insomnia:
Xingren (de-skinned/de-seeded, lightly roasted, 0.5 liang), Hutao Rou (de-skinned, 0.5 liang).
Grind with raw honey into fine paste. Make ten pills per liang. Take one pill chewed with ginger decoction after meals/before bed. (*Yangshi Fang*) *Shenxiao Fang* calls this *Sansheng Wan*, adding Ginger (peeled, chopped, 1 liang), grinding into mud, making 13-14 pills. Chew one well before bed.
Warming Lung Formulas (Warming Middle): *Shenshi* Su Zi Tang for Qi Rushing Fullness, Obstruction, Restlessness, Wheezing/Vomiting:
Suzi (1 sheng), Ganjiang (3 liang), Banxia (washed, 4 liang), Guixin, Renshen (1 liang each), Juapi, Fuling (3 liang each), Gancao (roasted, 1 liang).
Cut eight ingredients. Decoct in 8 sheng of water to 2.5 sheng, divide into three doses. For deficient heat, replace Ganjiang with 6 liang Shengjiang and add Huangqin (2 liang). (From *Waitai Miyao*)
*Xiao Qinglong Tang* (Minor Blue Dragon Decoction) base, minus Mahuang, add Xingren (de-skinned, 3 liang), for water wheezing/cough. Add Fuling if lower abdomen is full. (From *Zhizhi Fang*) (Note: This is *Xingzi Tang* from *Yijian Fang*, recorded in *Shanghan Guangyao*.)
*Fuzi Lizhong Tang* (Aconite and Licorice Regulate the Middle Decoction) for Spleen/Lung deficiency-cold, phlegm-fluid obstruction, frequent wheezing/cough with slight movement, slow/fine pulse. (From *Yifang Kao*) (Refer to *Chenfu Tang* in Heavy Sedation formulas.)
*Liujunzi Tang* (Six Gentlemen Decoction) for Qi deficiency phlegm wheezing. (Same source)
*Sijunzi Tang* (Four Gentlemen Decoction) for wheezing and shortness of breath with急促 breathing but no phlegm sounds.