【内火喘逆之症】五心烦热，口燥唇焦，喘逆自汗，得食稍减，少顷复发，时作时止，
面赤便秘，此内火发喘症也。
【内火喘逆之因】内而欲心妄动，外而起居如惊，五志厥阳之火，时动于中，煎熬真阴
，精竭血燥，内火刑金，肺气焦满，而喘逆作矣。
【内火喘逆之脉】脉多洪数，心火上炎。左关脉数，肝胆之热。两尺洪数，肾火上逆。
右寸脉数，肺中有火。右关洪数，胃家有热。
【内火喘逆之治】肾虚火旺，宜养阴制火，壮水之主，以镇阳光，门冬饮子、家秘肝肾
丸。肝火上冲，宜柴胡清肝散。心火上炎，导赤各半汤。脾胃之火上冲，宜清胃汤。肺火煎熬，石
门冬饮子 见伤燥嗽门。
家秘肝肾丸 治肾水不足，虚火上炎。
黄柏 知母 白芍药 当归
四味为末，又以天冬、地黄二味同煎，收膏为丸。
柴胡清肝散
柴胡 黄芩 人参 山栀 连翘 桔梗 甘草
导赤各半汤 见前心咳。
石膏泻白散
桑白皮 地骨皮 桔梗 甘草 石膏
【痰饮喘逆之症】面色虚白，胸中漉漉有声，时咳时呕，卧下喘逆，此痰饮逆之症也
【痰饮喘逆之因】饮水过多，脾弱不能四布，水积肠间，成痰成饮，上干肺家，则喘息
【痰饮喘逆之脉】多见弦滑，或见弦紧，或见弦数。弦紧寒饮，弦数痰热。
【痰饮喘逆之治】苓桂术甘汤、小半夏汤、甘遂半夏汤、二陈汤。带表症者，小青龙汤
；大便闭者，导痰汤加大黄，甚者滚痰丸、十枣汤。
苓桂术甘汤 见痰饮门。
小半夏汤 见支饮门。
甘遂半夏汤 见留饮门。
二陈汤 见湿痰门。
小青龙 见溢饮门。
滚痰丸 见悬饮门。
十枣汤 见悬饮门。
导痰汤 见食积痰门。
[Symptoms of Panting and Reversal due to Internal Fire] Five-center heat distress (heat sensation in the palms, soles, and chest), dry mouth and parched lips, panting and reversal with spontaneous sweating. Symptoms decrease slightly after eating but recur shortly thereafter; they come and go intermittently. The face is red, and there is constipation. This is a case of panting caused by internal fire.
[Causes of Panting and Reversal due to Internal Fire] Internally, excessive desire moves recklessly; externally, daily life is disrupted by fright. The Jue-Yang fire generated from the five emotional zang organs stirs within at times, simmering and consuming the true yin. Essence becomes exhausted, and blood dries up. Internal fire attacks Metal (the Lung), causing the Lung Qi to become scorched and distended, leading to panting and reversal.
[Pulse of Panting and Reversal due to Internal Fire] The pulse is mostly surging (Hong) and rapid (Shu), indicating Heart Fire flaring upward. A rapid pulse at the left Guan position indicates Heat in the Liver and Gallbladder. Surging and rapid pulses at both Chi positions indicate Kidney Fire reversing upward. A rapid pulse at the right Cun position indicates Fire in the Lung. A surging and rapid pulse at the right Guan position indicates Heat in the Stomach.
[Treatment of Panting and Reversal due to Internal Fire] If it is Kidney Deficiency with vigorous Fire, one should nourish Yin to control Fire, strengthen the source of Water (nourish Kidney Yin) to suppress the Yang (deficient fire). Use Men Dong Yin Zi (Asparagus Decoction) or Jia Mi Gan Shen Wan (Secret Formula for Nourishing Liver and Kidney Pills). If Liver Fire rushes upward, use Chai Hu Qing Gan San (Bupleurum Powder to Clear the Liver). If Heart Fire flares upward, use Dao Chi Ge Ban Tang (Half-Portion Decoction to Guide Out Redness). If Spleen and Stomach Fire rushes upward, use Qing Wei Tang (Stomach-Clearing Decoction). If Lung Fire causes simmering, use Shi Men Dong Yin Zi (see the section on Cough due to Dryness).
Jia Mi Gan Shen Wan: Treats insufficiency of Kidney Water with deficient Fire flaring upward.
Herbs: Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), Bai Shao Yao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix).
Grind these four herbs into powder, then decoct Tian Dong (Asparagi Radix) and Di Huang (Rehmanniae Radix) together, reduce to an extract, and form pills.
Chai Hu Qing Gan San:
Herbs: Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Ren Shen (Ginseng Radix), Shan Zhi (Gardeniae Fructus), Lian Qiao (Forsythiae Fructus), Jie Geng (Platycodonis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Dao Chi Ge Ban Tang: See the previous section on Heart Cough.
Shi Gao Xie Bai San:
Herbs: Sang Bai Pi (Mori Cortex), Di Gu Pi (Lycii Cortex), Jie Geng (Platycodonis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Shi Gao (Gypsum Fibrosum).
[Symptoms of Panting and Reversal due to Phlegm-Fluid Retention] The complexion is pale and empty. There is a gurgling sound in the chest. There is intermittent coughing and vomiting. Panting and reversal worsen when lying down. This is a case of panting caused by Phlegm-Fluid retention.
[Causes of Panting and Reversal due to Phlegm-Fluid Retention] Excessive drinking of water, combined with weak Spleen function unable to distribute fluids properly, leads to water accumulation in the intestines, forming Phlegm and Fluid. These rise to interfere with the Lung, resulting in panting.
[Pulse of Panting and Reversal due to Phlegm-Fluid Retention] The pulse is mostly wiry (Xuan) and slippery (Hua), or wiry and tight (Xuan Jin), or wiry and rapid (Xuan Shu). Wiry-tight indicates Cold-Fluid; wiry-rapid indicates Phlegm-Heat.
[Treatment of Panting and Reversal due to Phlegm-Fluid Retention] Use Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction), Xiao Ban Xia Tang (Minor Pinellia Decoction), Gan Sui Ban Xia Tang (Kansui and Pinellia Decoction), or Er Chen Tang (Two-Aged Decoction). If accompanied by exterior symptoms, use Xiao Qing Long Tang (Minor Green Dragon Decoction); if there is fecal impaction, use Dao Tan Tang (Phlegm-Guiding Decoction) with added Da Huang (Rhei Radix et Rhizoma); in severe cases, use Gun Tan Wan (Rolling Phlegm Pill) or Shi Zao Tang (Ten Dates Decoction).
Ling Gui Zhu Gan Tang: See the Phlegm-Fluid section.
Xiao Ban Xia Tang: See the Branch-Fluid section.
Gan Sui Ban Xia Tang: See the Retained-Fluid section.
Er Chen Tang: See the Damp-Phlegm section.
Xiao Qing Long Tang: See the Overflowing-Fluid section.
Gun Tan Wan: See the Suspended-Fluid section.
Shi Zao Tang: See the Suspended-Fluid section.
Dao Tan Tang: See the Food-Stagnation-Phlegm section.