喘者，积痰在肺，遇冷即发，喘鸣迫塞，但坐不得卧，外寒与内饮相搏，宜小青龙汤
主之。若肺有积热，热为寒束者，宜越婢汤主之。
小青龙汤（方见前。）
越婢加半夏汤
麻黄（六两） 石膏（半斤） 生姜（三两） 甘草（一两） 半夏（半升） 大枣（五十枚）
上六味以水六升，先煮麻黄去上沫，内诸药，煮取三升，分温三服。
定喘汤
白果（二十一枚，去壳、切碎，炒黄色） 麻黄 半夏 杏仁 苏子 桑皮 款冬花（各
二钱） 黄芩（炒，一钱半） 甘草（一钱）
水三盅，煎二盅，分二服，徐徐服无时。一方无黄芩。
按∶仲景云，咳而上气，此为肺胀，其人喘，目如脱状，越婢加半夏汤治之。又肺胀，
咳而上气，烦躁而喘，脉浮者，心下有水，小青龙汤加石膏汤主之。丹溪云∶肺胀而咳者，用诃
子、青黛、杏仁，佐以海石、香附、栝蒌、半曲，蜜丸噙化。仲景之治，乃伤寒法也。邪从
皮毛入肺，则肺胀，故治宜散邪之剂。丹溪之治，乃阴虚火动迫肺，及浊痰瘀血凝结于内，
故治以收敛消瘀之剂。然亦有引动肾间虚气，喘不得卧，足冷如冰者，非《济生》肾气不效
。丹溪治 喘之症，未发以扶正气为主，八味肾气，温肾行水之谓也。已发用攻邪气为主，
越婢、青龙，泄肺蠲饮之谓也。
定喘丸 治虚人痰多咳嗽，胸满气逆，行坐无时，连年不已。
人参（二钱半） 南星 半夏（各二钱） 苦葶苈（五钱）
上为末，生姜自然汁糊丸黍粒大，每三五十丸，生姜汤下，亦可渐加。
Asthma (Chuan) is caused by the accumulation of phlegm-fluid in the Lung. It is triggered by cold, manifesting as wheezing with a roaring sound and a sensation of obstruction. The patient can only sit upright and cannot lie flat. This condition results from the struggle between external cold and internal fluid retention, and should be primarily treated with Xiao Qing Long Tang (Minor Green Dragon Decoction). If there is accumulated heat in the Lung constrained by cold, Yue Bi Tang (Yuebi Decoction) should be used.
Xiao Qing Long Tang (Formula see previous section).
Yue Bi Jia Ban Xia Tang (Yuebi Decoction plus Pinellia)
Ephedrae Herba (Mahuang, 麻黄) - 6 liang
Gypsum Fibrosum (Shigao, 石膏) - 0.5 jin
Zingiberis Rhizoma Recens (Shengjiang, 生姜) - 3 liang
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - 1 liang
Pinelliae Rhizoma Preparatum (Banxia, 半夏) - 0.5 sheng
Jujubae Fructus (Dazao, 大枣) - 50 pieces
Take the above six ingredients, add 6 sheng of water. First decoct Ephedrae Herba, remove the foam on the surface, then add the remaining herbs. Decoct to obtain 3 sheng of liquid. Divide into three warm doses.
Ding Chuan Tang (Stabilize Asthma Decoction)
Ginkgonis Semen (Baiguo, 白果) - 21 pieces, shell removed, chopped, stir-fried until yellow
Ephedrae Herba (Mahuang, 麻黄)
Pinelliae Rhizoma Preparatum (Banxia, 半夏)
Pruni Semen (Xingren, 杏仁)
Perillae Fructus (Suzi, 苏子)
Morus Cortex (Sangbai Pi, 桑白皮)
Farfarae Flos (Kuandonghua, 款冬花)
(each 2 qian)
Scutellariae Radix (Huangqin, 黄芩), stir-fried - 1.5 qian
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - 1 qian
Add 3 zhong of water, decoct to 2 zhong. Divide into two doses. Take slowly at any time. Another version does not contain Scutellariae Radix.
Commentary: Zhang Zhongjing stated, "Cough with qi rebellion upward, this is Lung Distension (Fei Zhang). The person wheezes, eyes protruding as if about to fall out." This is treated with Yue Bi Jia Ban Xia Tang. Also, for Lung Distension with cough, qi rebellion, irritability, wheezing, and a floating pulse, indicating fluid retention under the heart, Xiao Qing Long Jia Shi Gao Tang (Minor Green Dragon Decoction plus Gypsum) is indicated. Zhu Danxi stated: For Lung Distension with cough, use Hezi (Chebulae Fructus), Qingdai (Indigo Naturalis), Xingren (Pruni Semen), assisted by Haishi (Fossilia Silicium), Xiangfu (Cyperi Rhizoma), Gualou (Trichosanthis Fructus), and Shenqu (Massa Medicata Fermentata), made into honey pills to be held in the mouth and dissolved. Zhang Zhongjing's treatment follows the method for Cold Damage (Shang Han). Pathogenic factors enter the Lung from the skin and hair, causing Lung Distension; thus, treatment requires formulas that disperse pathogenic factors. Zhu Danxi's treatment addresses Yin deficiency with hyperactive fire forcing the Lung, and congealed turbid phlegm and blood stasis internally; thus, treatment uses astringent and blood-stasis-resolving formulas. However, there are cases where virtual Qi from the Kidney is stirred up, causing wheezing preventing lying down, and feet cold as ice; this is not due to the ineffectiveness of Shenqi Wan (Kidney Qi Pill) from *Jisheng Fang*. Zhu Danxi's treatment of asthma: when unmanifested, focus on supporting healthy Qi, referring to Bawei Shenqi Wan (Eight-Ingredient Rehmannia Root Pill), which warms the Kidney and promotes water metabolism; when manifested, focus on attacking pathogenic factors, referring to Yue Bi Tang and Qinglong Tang, which drain the Lung and eliminate fluid retention.
Ding Chuan Wan (Stabilize Asthma Pill) treats patients with weak constitution having excessive phlegm and cough, chest fullness with rebellious Qi, restlessness during walking or sitting, persisting for years without cessation.
Ren Shen (Ginseng Radix et Rhizoma) - 2.5 qian
Arisaematis Rhizoma (Nanxing, 天南星)
Pinelliae Rhizoma Preparatum (Banxia, 半夏)
(each 2 qian)
Descurainiae Semen seu Lepidii Semen Tingli Zi (Kutingli, 苦葶苈) - 5 qian
Grind all into powder. Use fresh juice of Zingiberis Rhizoma Recens (Shengjiang, 生姜) mixed with paste to form pills the size of millet seeds. Take 30-50 pills per dose, washed down with ginger soup. Dosage may be gradually increased.