岐伯曰∶夜行则喘出于肾，淫气病肺。有所堕恐，喘出于肝，淫气害脾。有所惊恐，喘
出于肺，淫气伤心。度水跌仆，喘出于肾与骨。当是之时，勇者气行则已，怯者则着而
为病也。原疾之由，皆本于肺与气。然感外邪，则有太阳证脉浮无汗而喘者，宜麻黄汤。
阳明病汗出不恶寒，腹满而喘，有潮热者，宜承气汤，若表邪未解，误服下利药，利遂不
止，脉促，喘而汗出者，宜葛根黄芩黄连汤。若微喘者，桂枝浓朴杏子汤。汗出而喘，若
无大热者，宜麻黄杏子甘草石膏汤。若表邪未解，心下停水，发热而喘，或呕者，小青
龙汤去麻黄加杏仁主之。若阴证喘促者，四肢逆冷，脉息沉细，或寸大尺小，或六脉促
疾，或心下胀满结硬，若冷汗自出，或大便频数，上气喘促，或咽喉不利者，此是本气
极虚，内外挟寒冷所致，使阴寒内消，阳气得复则愈，宜返阴丹主之。（以上诸方，并见伤寒
准绳。）大概诸脏相乘而喘者，以杏子散。（本条。）如感寒伏热而喘者，以华盖散、（杂病嗽。）九宝
汤。（杂病喘。）若暴寒向火，覆衣被过当，伤热肺实而喘促者，其状多有热证，宜洗心散，（杂
病发热。）冷水调服。若因气宇不调，痰盛喘促者，宜四七汤（杂病气）。兼官局桔梗汤，（杂病痰
饮。）姜煎服。若涎多而喘者，宜千缗汤、（杂病喘。）橘皮半夏汤。（本条。）若不得卧，卧即喘者，
此由水气逆行，上乘于肺，肺得水则浮而开，使气不得通流，其脉沉大，宜神秘汤。（杂病喘。）
肺之积名曰息贲，在右胁下，大如杯，令人洒淅寒热，喘咳，发痈疽，宜枣膏丸。（本条。）
若上气喘者，神授汤。（本条。）若上盛下弱而喘促者，宜苏子降气汤（杂病气。）吞黑锡丹。（杂病
头痛。）若尊年之人，素来禀赋太浓，不任热药
者，不可轻投丹剂及诸热药，但以秘传降气汤、分心气饮。（俱杂病气。）论之梗概，不出于
此矣。若素有香港脚而喘者，当作香港脚治之。又有骨蒸劳喘，自有专门，不敢滥及。
〔薛〕东垣云∶肺金受邪，由脾胃虚弱不能生肺，乃所生受病，故咳嗽气短气上，皮
毛不能御寒，精神少而渴，情惨不乐，皆阳气不足，阴气有余也。治法∶若肺气虚弱，用
四君子（杂病虚劳。）加枳壳、半夏。脾虚不能生肺，补中益气汤。（杂病劳倦。）七情气结，四七
汤。（杂病气。）脾经郁结，归脾汤。（杂病健忘。）脾气虚弱，人参补肺散。肺经火盛，人参平肺
散。肾水败浊，六味地黄丸。（杂病虚劳。）真阳虚损，八味丸。（虚劳。）或兼小便不利，为害尤
速，非二丸不能救。一妇人伤风寒作喘，或用表散，愈而复患，仍用前药，其证益甚，饮
食少思，胸腹不利，此因脾肺气虚也。予先用六君子汤加桔梗渐愈，又用补中益气汤而
痊。一妇人患前证，属命门火虚，不能生脾土，用补中益气汤、八味地黄丸而痊。后
复患，其喘益甚，用前药不应，遂用黑锡丹二服喘止，仍用前二药而诸证痊。凡属邪气
有余者，其证易识，治效亦速。其属元气不足者，变证不一，效非可以旦夕期也。
杏子散 治诸脏相乘喘急。
杏仁（去皮尖，双仁，麸炒黄，细研如膏） 麻黄根（为细末，等分）
上和匀，煎橘皮汤调下二钱，无时。
橘皮半夏汤 （《和剂》）治肺胃虚弱，好食酸冷，寒痰停积，呕逆恶心，涎唾稠粘，或积
吐，粥药不下，手足逆冷，目眩身重。又治伤寒时气，欲吐不吐，欲呕不呕，昏愦闷乱，
或饮酒过多，中寒停饮，喉中涎声，干哕不止。
陈皮（去白） 半夏（煮，各七两）
上锉为粗散，每服三钱，生姜三片，水二盏，煎至一中盏，去滓温服，不计时。留
两服滓并一服，再煎服。
枣膏丸 治息贲在右胁下，大如杯，令人洒淅寒热，喘咳。
甜葶苈（炒，研） 陈皮 苦梗（各等分）
上为末，煮枣肉丸桐子大，每服数丸，白汤下。许学士云∶余常停饮水积，食已必嚏，
渐喘，觉肺系急，服此良验。
神授汤 治上气喘急不得卧。
橘红 苦梗 紫苏 人参（各一钱） 五味子（杵炒，三分）
上姜水煎服。
治妇人喘促虚肿，快利小便即痒。
用生姜二两，取汁，白面三两，以姜汁搜作小剂，大半夏十个，打研入面中，作饼
炙熟作黄色，为末，温熟水调下一钱，以小便通利为度。
天门冬丸 （《杨氏家传》）治妇人喘，手足烦热，骨蒸寝汗，口干引饮，面目浮肿。
天门冬（十两，去心秤） 麦门冬（去心，八两） 生地黄（三斤，取汁熬膏）
上二味为末，入地黄膏和丸如梧桐子大，每服五十丸，逍遥散中去甘草加人参煎汤送
下。或服王氏《博济方》中人参荆芥散亦可。如面肿不已，经曰∶面肿曰风，故宜汗。麻
黄桂枝，可发其汗，后服柴胡饮子去大黄。故论曰∶治脏者治其俞，治腑者治其合，浮肿
治其经。治俞者治其土也，治合者亦治其土也，如兵家围魏救赵之法也。
人参补肺汤 治肺痈肾水不足，虚火上炎，咳唾脓血，发热作渴，小便不调。
人参 黄 （炒） 白术 茯苓 陈皮 当归（各一两） 山茱萸（去核）
山药（各二钱） 五味子（杵） 麦门冬（去心） 甘草（炙，各七分） 熟地黄（自制，一钱五分）
牡丹皮（一钱） 上姜水煎服。
人参平肺散 治心火克肺金，患肺痿，咳嗽喘呕，痰涎壅盛，胸膈痞满，咽膈不利。
人参 青皮 茯苓 天门冬 陈皮 地骨皮（各一钱） 甘草（炙，五分） 知母（七分）
五味子（十粒，杵） 桑白皮（炒，一钱）
上姜水煎服。
Qibo said: Excessive walking at night causes panting originating from the Kidney, with pathogenic qi overflowing to damage the Lung. Panting due to falling or fright originates from the Liver, with overflowing qi harming the Spleen. Panting due to shock and fear originates from the Lung, with overflowing qi damaging the Heart. Wading through water or falling and injuring oneself causes panting originating from the Kidney and bones. At such times, those with robust constitution recover as their Qi circulates freely; those with weak constitution suffer disease as pathogenic factors linger. Tracing the origin of these diseases, all stem from dysfunction of the Lung and Qi. However, when affected by external pathogens, if Taiyang syndrome (disease pattern of the Taiyang channel) presents with floating pulse, anhidrosis, and panting, Mahuang Tang (Ephedra Decoction) is indicated. In Yangming disease (disease pattern of the Yangming channel), if there is sweating, aversion to cold is absent, abdominal fullness with panting, and tidal fever, Chengqi Tang (Gut-Draining Decoction) is indicated. If exterior pathogens remain unresolved and purgatives are mistakenly administered, leading to persistent diarrhea, rapid pulse, panting, and sweating, Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction) is indicated. For mild panting, Guizhi Houpo Xingzi Tang (Cinnamon Twig, Magnolia Bark, and Apricot Kernel Decoction) is used. If there is sweating and panting without significant heat, Mahuang Xingzi Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) is indicated. If exterior pathogens are unresolved, fluid retention exists in the epigastrium, accompanied by fever, panting, or vomiting, Qinglong Tang (Azure Dragon Decoction) with Ephedra removed and Apricot Kernel added is the primary treatment. For panting caused by Yin syndromes, characterized by cold extremities, deep and fine pulse, or large cun pulse and small chi pulse, or rapid six-pulse presentation, epigastric distension and hardness, spontaneous cold sweat, frequent bowel movements, upper body panting, or throat obstruction, this indicates extreme deficiency of original Qi and internal/external cold accumulation. Recovery occurs when internal Yin-cold dissipates and Yang Qi returns; Fanyin Dan (Return to Yin Pill) is indicated. (All aforementioned formulas are found in Shanghan Zhunsheng.) Generally, for panting caused by mutual overacting of various Zang organs, Xingzi San (Apricot Kernel Powder) is used. For panting due to cold invasion with latent heat, Huagai San (Canopy Powder) and Jiubao Tang (Nine Treasures Decoction) are used. If sudden cold exposure followed by excessive warming leads to lung excess due to heat injury, presenting with heat signs, Xixin San (Heart-Washing Powder) taken with cold water is indicated. For panting due to dysfunctional Qi mechanism and profuse phlegm, Siqi Tang (Four Seven Decoction) is indicated, combined with Guanju Jiegeng Tang (Imperial Bureau Platycodon Decoction) decocted with ginger juice. For panting with excessive saliva, Qianmin Tang (Thousand Strings Decoction) and JuPi Banxia Tang (Tangerine Peel and Pinellia Decoction) are indicated. For inability to lie flat, with panting upon lying down, this is due to counterflow of Water Qi ascending to the Lung; the Lung becomes flaccid and open upon contact with water, obstructing Qi flow, presenting with deep and large pulse; Shenmi Tang (Divine Mystery Decoction) is indicated. The accumulation in the Lung named Xiben (Breath-Turbulence) is located under the right hypochondrium, cup-sized, causing chills, panting, cough, and potentially carbuncles; Zaogao Wan (Date Paste Pill) is indicated. For upper body panting, Shenshou Tang (Heavenly Bestowal Decoction) is used. For panting due to excess above and deficiency below, Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction) taken with Heixi Dan (Black Tin Pill) is indicated. For elderly patients with strong constitutions intolerant to hot medicines, Dan preparations and other hot herbs should not be lightly administered; instead, Michuan Jiangqi Tang (Secret Transmission Descending Qi Decoction) and Fenxin Qi Yin (Separate Heart Qi Drink) are used. This summary covers the main points. For patients with Hongxiangjiao (Beriberi/Foot Qi) who also pant, treat the Foot Qi. Bone-steaming劳喘 (consumptive panting) has its own specialized treatments and is not discussed here.
[Xue Yi] Dongyuan stated: Pathogens affecting Metal of the Lung result from Spleen-Stomach weakness failing to generate Lung Metal, causing the generated organ to become diseased. Symptoms include cough, shortness of breath, Qi rebellion, inability of skin/hair to resist cold, low spirit, thirst, and melancholy, all indicating insufficient Yang Qi and excess Yin Qi. Treatment methods: For weak Lung Qi, use Sijunzi Tang (Four Gentlemen Decoction) with Zhike (Aurantii Fructus) and Banxia (Pinelliae Rhizoma). For Spleen deficiency failing to generate Lung, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For emotional Qi stagnation, use Siqi Tang. For Spleen meridian depression/stagnation, use Guipi Tang (Restore the Spleen Decoction). For weak Spleen Qi, use Renshen Bufei San (Ginseng Tonifying Lung Powder). For excess Fire in the Lung meridian, use Renshen Pingfei San (Ginseng Calming Lung Powder). For turbid failure of Kidney Water, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). For deficiency of True Yang, use Bawei Wan (Eight-Ingredient Pill). If accompanied by difficult urination, the harm is rapid, requiring these two pills for rescue. A woman suffered panting from wind-cold; after dispersing methods cured her temporarily, recurrence occurred with worsening symptoms despite previous medication, reduced appetite, and chest/abdominal discomfort, indicating Spleen-Lung Qi deficiency. I first treated with Liujunzi Tang (Six Gentlemen Decoction) plus Jiegeng (Platycodonis Radix), achieving gradual recovery, then completed cure with Buzhong Yiqi Tang. Another woman with similar symptoms attributed to Mingmen (Gate of Life) fire deficiency failing to generate Spleen Earth was cured with Buzhong Yiqi Tang and Liuwei Dihuang Wan. Upon recurrence with severe panting unresponsive to previous meds, two doses of Heixi Dan stopped the panting, followed by the previous two medicines for full recovery. Syndromes with excess pathogenic factors are easy to identify and respond quickly. Syndromes with deficient Yuan Qi present varied changes and require time for efficacy.
Xingzi San treats panting urgency from mutual overacting of Zang organs.
Xingren (Apricot Kernel, peeled, tip removed, double-kernel, bran-fried yellow, ground fine like paste) Mahuanggen (Ephedrae Radix et Rhizoma Caulis, powdered, equal parts)
Mix well, decoct Jupi Tang (Tangerine Peel Decoction) to take 2 qian, anytime.
JuPi Banxia Tang (from Heji Jufang) treats weak Lung/Stomach, preference for sour/cold foods, cold-phlegm retention, retching, nausea, thick saliva, vomiting, inability to keep food/medicine down, cold extremities, dizziness, heavy body. Also treats Shanghan seasonal pathogens, desire to vomit but unable, confusion, excessive alcohol consumption causing cold-fluid retention, rattling saliva in throat, dry hiccups.
Chenpi (Tangerine Peel, white pith removed) Banxia (Pinelliae Rhizoma, boiled, each 7 liang)
Coarsely crush, take 3 qian per dose, with 3 slices of fresh ginger, 2 zhan water, decoct to 1 zhan, strain, warm drink, anytime. Retain dregs of two doses plus one dose, decoct again.
Zaogao Wan treats Xiben under right hypochondrium, cup-sized, causing chills, panting, cough.
Tingli (Descurainiae Semen seu Lepidii Semen, fried, ground) Chenpi (Tangerine Peel) Kugeng (Platycodonis Radix, each equal parts)
Powder, mix with date paste to make pills size of paulownia seeds, take several pills with warm water. Scholar Xu noted: I often had fluid retention, sneezing after eating, gradual panting, tight lung sensation; this medicine proved effective.
Shenshou Tang treats upper body panting urgency preventing lying down.
Juhong (Citri Reticulatae Pericarpium Rubrum) Kugeng (Platycodonis Radix) Zisu (Perillae Folium) Renshen (Panacis Ginseng Radix, each 1 qian) Wuweizi (Schisandrae Fructus, pounded fried, 3 fen)
Decoct with ginger water.
Treats women's panting with deficiency edema; rapid diuresis relieves itching.
Use 2 liang fresh ginger, extract juice, mix with 3 liang wheat flour into small dough pieces, pound 10 Banxia (Pinelliae Rhizoma), mix into dough, form cakes, roast until yellow, powder, take 1 qian with warm cooked water, stop when urination flows freely.
Tianmendong Wan (from Yangshi Jiachuan) treats women's panting, restless heat in limbs, bone-steaming night sweats, dry mouth with thirst, facial/ocular edema.
Tianmendong (Asparagi Radix, 10 liang, heart removed, weighed) Maidong (Ophiopogonis Radix, 8 liang, heart removed) Shengdihuang (Rehmanniae Radix, 3 jin, juice extracted and boiled into paste)
Powder the first two, mix with Rehmannia paste, make pills paulownia seed size, take 50 pills per dose, delivered with decoction of Xiaoyao San (Free and Easy Wanderer Powder) minus Licorice plus Ginseng. Alternatively, Ren Shen Jingjie San (Ginseng and Schizonepeta Powder) from Wangshi Boji Fang may be used. If facial swelling persists, Classics state: "Facial swelling indicates Wind," thus sweating is appropriate. Mahuang and Guizhi can induce sweating, followed by Chaihu Yinzi (Bupleurum Decoction) minus Dahuang. Theory states: Treat Zang via Shu points, Fu via He points, edema via Jing points. Treating Shu treats Earth; treating He also treats Earth, akin to besieging Wei to rescue Zhao in military strategy.
Renshen Bufei Tang treats Lung abscess, insufficient Kidney Water, deflected deficiency Fire, coughing up pus/blood, fever/thirst, irregular urination.
Renshen (Panacis Ginseng Radix) Huangqi (Astragali Radix, fried) Baizhu (Atractylodis Macrocephalae Rhizoma) Fuling (Poria) Chenpi (Tangerine Peel) Danggui (Angelicae Sinensis Radix, each 1 liang) Shanzhuyu (Corni Fructus, core removed)
Shanyao (Dioscoreae Rhizoma, each 2 qian) Wuweizi (Schisandrae Fructus, pounded) Maidong (Ophiopogonis Radix, heart removed) Gancao (Licorice Root, honey-fried, each 7 fen) Shudihuang (Prepared Rehmanniae Radix, homemade, 1.5 qian) Mudanpi (Moutan Cortex, 1 qian)
Decoct with ginger water.
Renshen Pingfei San treats Heart Fire overcoming Lung Metal, Lung萎 (flaccidity), cough/panting/vomiting, profuse phlegm, chest/diaphragm fullness, throat obstruction.
Renshen (Panacis Ginseng Radix) Qingpi (Aurantii Fructus Immaturus) Fuling (Poria) Tianmendong (Asparagi Radix) Chenpi (Tangerine Peel) Digupi (Lycii Cortex, each 1 qian) Gancao (Licorice Root, honey-fried, 5 fen) Zhimu (Anemarrhenae Rhizoma, 7 fen)
Wuweizi (Schisandrae Fructus, 10 grains, pounded) Sangbaipi (Mori Cortex, fried, 1 qian)
Decoct with ginger water.