气促原因肺未清。开口出纳喘候真。鼻扇痰鸣肺将绝。胸高必定归幽冥。
气促之症。多缘肺热不清所致。治法当分时候。若见于未出及正出之时。药宜疏托。以清热
透肌汤（见二十五条）去甘草主之。如见于正收及收后。药宜降火及泻肺气。以清咽滋肺汤（见五
十条）去玉竹、桔梗、甘草。加茯苓、陈皮以消痰。若开口而作出纳。胸胁高叠。起止不常不定。
是为喘症。乃属痰火之候。热邪壅遏肺窍。气道阻塞而然也。然喘症有虚实之分。实者易治。虚者
难为。欲察其虚实之确。在于大便之溏泄。小便之清利。大便之坚结。小便之赤涩上别之。（朱曰
虚实之分。当于见证求之。）若大便溏泄。小便清利。唇白而身无大热。皆为虚症。治以半夏、苏
子、芥子、葶苈、桔梗、甘草、莱菔子、陈皮、南星、茯苓之类。以清痰润肺。多难获效。实则大便
坚燥。小便赤涩。唇红而身发壮热。用甘草、桔梗、陈皮、枳壳、苏子、栝蒌仁、杏仁、桑白皮、黄
芩、黄连、天冬、麦冬等味。多易于取效。果系实者。以竹叶石膏汤（见二十六条）去人参、半夏、炙
甘草、粳米。加栝蒌仁、贝母、白芥子治之。冬月更加蜜酒炒麻黄少许。可以随手而应。大抵未
出时喘者易治。收后而喘者难治。如发热时多喘。邪热壅于肺故也。慎勿用定喘之剂。惟宜以大
剂石膏知母竹叶汤。或柽叶葛根汤。去甘草主之。初发热而喘者。以麻黄汤去甘草。加连翘、牛
蒡子、枳壳。或以清金散火汤去桔梗、甘草。加酒炒黄芩、杏仁、连翘、枳壳治之。初发热未出之
时而喘者。以三拗汤去甘草。加荆芥、石膏、芽茶治之。如肺炎喘嗽。以加味泻白散去人参、甘草
主之。发喘而鼻黑干燥者。以白虎解毒汤（见二十六条）主之。如痰实壮热。胸中壅闷。卧则喘
急。以前胡枳壳散去甘草。加贝母、黄连、黄芩、栝蒌霜治之。如麻已出而喘者。用加味清肺降
火汤主之。如麻出三日后而作喘者。急以静远主人清肺饮（见五十条）去知母、桔梗、甘草。加
古仁、栝蒌霜、芥子治之。或以生地黄散（见五十条）治之。如麻后发喘。以清咽滋肺汤（见五十
条）去玉竹、桔梗、甘草。合白虎汤（见二十六条）去甘草、粳米。以滋润肺胃。若麻后而喘。日久
胃虚。不可用白虎汤（见二十六条）。只宜以静远主人清肺饮（见五十条）主之。麻后如有日久
发喘不歇者。以小柴胡汤（见二十二条）。以贝母易半夏、沙参易人参。加五味子从权治之。若喘
而无涕。兼之鼻扇者。则难治矣。盖鼻扇症。肺气将绝。若鼻扇而喘满痰鸣者。此必不治。如鼻
扇而咽喉清利。无喘满而精神如故不减者。十救二三。宜滋培肺气药。以润肺清痰为主。以补肺
阿胶散治之。收后而鼻扇者不治。若麻喘而胸高者。乃肺经热甚而胀起者也。其症多见于正收及
收后。凡麻见胸高之症。为肺坏。乃不治之候。有用葶苈桑白皮散治之者。亦仅十全一二而已。若
冀其施无不应。未之有也。
石膏知母竹叶汤
石膏（五钱至一两） 肥知母（一钱至二三钱） 淡竹叶（三十片至一百片） 麦冬（三钱至
五钱） 薄荷叶（三钱） 西河柳（两许） 水煎服。
柽叶葛根汤
西河柳 前胡 葛根 荆芥穗 贝母 元参 知母 麦冬 甘草 水煎服。
麻黄汤
麻黄（泡去绿汁） 杏仁（去皮尖油） 甘草（各五分） 石膏 腊茶叶（各一钱） 一方
去石膏。加桑白皮。水煎服。
清金散火汤
麻黄（泡去绿汁） 苏叶 牛蒡子 桔梗 甘草 水煎服。
三拗汤
麻黄（去节三钱） 杏仁（去油皮尖二十粒） 生甘草 水煎服。加桔梗、荆芥。名加味三拗汤。
加味泻白散
桑白皮 地骨皮 白茯苓 知母 黄芩 人参 甘草 糯米一百粒引。水煎。食后服。
前胡枳壳散
前胡 枳壳 赤茯苓 炙甘草（各五钱） 大黄（量儿加减） 每服三钱。水一盏。煎六分。旋服。
加味清肺降火汤治麻出喘急。
陈皮 枯黄芩 麦冬 桑白皮 生地黄 贝母 栀仁 栝蒌仁 天花粉 石膏 葶苈子
地骨皮 苏子（炒） 灯心二十根引。水煎服。
补肺阿胶散 治肺虚有火。嗽无津液而气梗鼻扇。
阿井胶（蛤粉炒一两五钱。能补血液。清肺滋肾。益血补阴。气顺则不梗。液补则津生。火退而
嗽宁。） 马兜铃（一两。象肺。故入肺清热降火。） 牛蒡子（炒香。一两。利膈滑痰。而润肺解毒。
能治火嗽。） 杏仁（去皮尖七钱。润燥散风。降气止嗽。） 粳米（一两。即HT 米。益脾胃。） 炙甘草
（一两。益脾胃。） 水煎服。
李时珍曰。补肺阿胶散用马兜铃。非取补肺。取其清热降气。而肺自安也。中间之阿胶HT 米。
乃补肺之正药。要知清热降气。泻之即所以补之也。若专于用补。反能助肺火而增咳嗽。
葶苈桑白皮散 治胸高气喘。
葶苈子（隔纸炒香研） 汉防己 杏仁 贝母 萝卜子（姜汁炒研） 家苏子（姜汁炒研） 桑
白皮（蜜炒） 枳壳 黄芩 白芥子（姜汁炒研） 水煎服。胸高而喘者。加蜜炒麻黄。
The cause of shortness of breath lies in the uncleared Lung heat. Observing the inhalation and exhalation through the mouth and nose reveals the true state of asthma (asthma). If nasal flaring (nasal flaring) and phlegm rales are present, it indicates that Lung Qi is about to fail; if the chest is elevated, the prognosis is definitely poor and difficult to reverse.
This symptom of shortness of breath is mostly caused by uncleared Lung heat. Treatment should be differentiated according to the stage of the disease. If it appears during the pre-eruption or eruption phase of measles, medication should adopt the method of dispersing and supporting eruption, primarily using Qing Re Tou Ji Tang (Clear Heat and Permeate Muscle Decoction) with Licorice Root removed (see Article 25). If it appears during the resolution phase or after resolution, medication should focus on descending fire and purging Lung Qi, primarily using Qing Yan Zi Fei Tang (Clear Throat and Nourish Lung Decoction) with Bletilla Rhizome and Platycodon Root removed, adding Poria and Tangerine Peel to eliminate phlegm. If there is open-mouth breathing with difficulty in air intake and output, and the chest and hypochondrium are significantly elevated with irregular movements, this is asthma, belonging to the Phlegm-Fire syndrome. This is caused by heat pathogen obstructing the Lung orifices and blocking the airways. However, asthma has deficiency and excess patterns; excess patterns are easy to treat, while deficiency patterns are difficult. To accurately distinguish between deficiency and excess, one can differentiate based on whether the stool is loose or formed, whether urination is clear and profuse or scanty and painful, whether the stool is dry and hard, and whether urination is red and astringent. (Zhu stated: The distinction between deficiency and excess should be sought in the manifestations.) If the stool is loose, urination is clear and smooth, lips are pale, and there is no high fever, these are all deficiency patterns. Treatment may use Pinellia, Perilla Seed, Mustard Seed, Lepidium Seed, Platycodon, Licorice, Radish Seed, Tangerine Peel, Arisaema, and Poria to clear phlegm and moisten the Lung, but efficacy is often poor. If it is an excess pattern, then the stool is dry and hard, urination is red and painful, lips are red, and there is high fever. Medications such as Licorice, Platycodon, Tangerine Peel, Aurantium, Perilla Seed, Trichosanthes Seed, Apricot Kernel, Mulberry Root Bark, Scutellaria, Coptis, Ophiopogon, and Asparagus Fern may be used, which usually yield effective results quickly. If it is indeed an excess pattern, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) with Ginseng, Pinellia, Honey-fried Licorice, and Rice removed, adding Trichosanthes Seed, Fritillaria, and White Mustard Seed can be used for treatment. In winter, a small amount of Ephedra stir-fried with honey and wine may be added for immediate effect. Generally speaking, asthma occurring before the eruption of measles is easy to treat, whereas asthma occurring after resolution is difficult to treat. If asthma occurs frequently during fever, it is because the pathogenic heat is congested in the Lung. One must strictly avoid using anti-asthma agents; instead, large doses of Shi Gao Zhi Mu Zhu Ye Tang (Gypsum, Anemarrhena, and Bamboo Leaf Decoction) or Cheng Ye Ge Gen Tang (Torenia Leaf and Pueraria Decoction) with Licorice removed should be used. For asthma appearing at the initial fever stage, Ma Huang Tang (Ephedra Decoction) with Licorice removed, adding Forsythia, Burdock Fruit, and Aurantium can be used. Alternatively, Qing Jin San Huo Tang (Clear Metal and Disperse Fire Decoction) with Platycodon and Licorice removed, adding Wine-fried Scutellaria, Apricot Kernel, Forsythia, and Aurantium can be used. For asthma appearing at the initial fever stage before eruption, San Ao Tang (Three Unyielding Decoction) with Licorice removed, adding Schizonepeta, Gypsum, and Young Tea Leaves can be used. For pneumonia-induced cough and asthma, Jia Wei Xie Bai San (Modified Draining White Powder) with Ginseng and Licorice removed can be used. For asthma accompanied by black and dry nose, Bai Hu Jie Du Tang (White Tiger Detoxification Decoction) can be used (see Article 26). For phlegm-excess with high fever, chest oppression, and urgent asthma when lying down, Qian Hu Zhi Ke San (Peucedanum and Aurantium Powder) with Licorice removed, adding Fritillaria, Coptis, Scutellaria, and Trichosanthes Peel can be used. If asthma occurs after measles have erupted, Jia Wei Qing Fei Jiang Huo Tang (Modified Clear Lung and Descend Fire Decoction) can be used. If asthma occurs three days after measles eruption, Jing Yuan Zhu Ren Qing Fei Yin (Jing Yuan Master's Lung-Clearing Infusion) with Anemarrhena, Platycodon, and Licorice removed, adding Ku Ren (likely Apricot Kernel), Trichosanthes Peel, and Mustard Seed should be urgently administered. Alternatively, Sheng Di Huang San (Rehmannia Powder) can be used (see Article 50). If asthma occurs after measles resolution, Qing Yan Zi Fei Tang with Bletilla Rhizome, Platycodon, and Licorice removed, combined with Bai Hu Tang (White Tiger Decoction) with Licorice and Rice removed, can be used to moisten the Lung and Stomach. If asthma persists long-term after measles resolution due to Stomach Qi deficiency, Bai Hu Tang should not be used; only Jing Yuan Zhu Ren Qing Fei Yin should be used (see Article 50). For persistent asthma after measles, Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Fritillaria replacing Pinellia, Sha Shen replacing Ginseng, and Schisandra Berry added can be used as a provisional measure. If asthma occurs without nasal discharge and with nasal flaring, it is difficult to treat. Nasal flaring indicates impending failure of Lung Qi. If nasal flaring is accompanied by asthma, fullness, and phlegm rales, it is invariably incurable. If nasal flaring occurs but the throat is clear, without asthma/fullness, and spirit remains unchanged, two out of ten cases may be saved; medications nourishing and tonifying Lung Qi, focusing on moistening the Lung and clearing phlegm, such as Bu Fei E Jiao San (Tonify Lung and Donkey-Hide Gelatin Powder), should be used. Nasal flaring after measles resolution is incurable. If measles-related asthma is accompanied by chest elevation, it is due to severe heat in the Lung meridian causing distension. This symptom is mostly seen during the resolution phase or after resolution. Any case of measles presenting with chest elevation indicates Lung destruction and is an incurable sign. Although some use Ting Li Sang Bai Pi San (Lepidium and Mulberry Root Bark Powder), success rates are only one or two in ten. It is impossible to achieve universal success.
Shi Gao Zhi Mu Zhu Ye Tang (Gypsum, Anemarrhena, and Bamboo Leaf Decoction)
Gypsum (1.5g–30g), Fat Anemarrhena Rhizome (3g–9g), Light Bamboo Leaves (30–100 leaves), Ophiopogon Tuber (9g–15g), Mint Leaf (9g), Torenia Herb (appropriate amount). Decoct in water and take orally.
Cheng Ye Ge Gen Tang (Torenia Leaf and Pueraria Decoction)
Torenia Herb, Peucedanum Root, Pueraria Root, Schizonepeta Spike, Fritillaria Bulb, Scrophularia Root, Anemarrhena Rhizome, Ophiopogon Tuber, Licorice Root. Decoct in water and take orally.
Ma Huang Tang (Ephedra Decoction)
Ephedra Stem (soaked to remove green juice), Apricot Seed (skin and tip removed, oil drained), Licorice Root (each 1.5g), Gypsum, Winter Tea Leaves (each 3g). One formula removes Gypsum and adds Mulberry Root Bark. Decoct in water and take orally.
Qing Jin San Huo Tang (Clear Metal and Disperse Fire Decoction)
Ephedra Stem (soaked to remove green juice), Perilla Leaf, Burdock Fruit, Platycodon Root, Licorice Root. Decoct in water and take orally.
San Ao Tang (Three Unyielding Decoction)
Ephedra Stem (de-jointed, 9g), Apricot Seed (oil, skin, and tip removed, 20 seeds), Raw Licorice Root. Decoct in water and take orally. Adding Platycodon Root and Schizonepeta Spike creates Jia Wei San Ao Tang (Modified Three Unyielding Decoction).
Jia Wei Xie Bai San (Modified Draining White Powder)
Mulberry Root Bark, Ground Tree Bark, White Poria, Anemarrhena Rhizome, Scutellaria Root, Ginseng, Licorice Root. Use 100 grains of Rice as a guide. Decoct in water and take after meals.
Qian Hu Zhi Ke San (Peucedanum and Aurantium Powder)
Peucedanum Root, Aurantium, Red Poria, Honey-fried Licorice Root (each 15g), Rhubarb (dose adjusted for child). Take 9g per dose, decoct in one cup of water until reduced to 0.6 cups, and take frequently.
Jia Wei Qing Fei Jiang Huo Tang (Modified Clear Lung and Descend Fire Decoction) treats urgent asthma after measles eruption.
Tangerine Peel, Withered Scutellaria Root, Ophiopogon Tuber, Mulberry Root Bark, Rehmannia Root, Fritillaria Bulb, Gardenia Seed, Trichosanthes Seed, Trichosanthes Root, Gypsum, Lepidium Seed, Ground Tree Bark, Perilla Seed (stir-fried). Use 20 stems of Juncus Effusus as a guide. Decoct in water and take orally.
Bu Fei E Jiao San (Tonify Lung and Donkey-Hide Gelatin Powder) treats Lung deficiency with fire, cough without fluids, qi rebellion, and nasal flaring.
Donkey-Hide Gelatin from A-Jing (stir-fried with Clam Shell Powder, 45g): Tonifies blood, clears Lung, nourishes Kidney, benefits blood and Yin. When Qi flows smoothly, obstruction ceases; when fluids are replenished, saliva generates, fire retreats, and cough calms. Aristolochia Root (30g): Resembles Lung shape, thus enters Lung to clear heat and descend fire. Burdock Fruit (stir-fried until fragrant, 30g): Benefits diaphragm, slides phlegm, moistens Lung, detoxifies, and treats fire-induced cough. Apricot Kernel (skin and tip removed, 21g): Moistens dryness, disperses wind, descends Qi, and stops cough. Glutinous Rice (30g): Benefits Spleen and Stomach. Honey-fried Licorice Root (30g): Benefits Spleen and Stomach. Decoct in water and take orally.
Li Shizhen said: Using Aristolochia Root in Bu Fei E Jiao San does not aim to tonify the Lung, but to clear heat and descend Qi, thereby stabilizing the Lung. The Gelatin and Glutinous Rice within are the true Lung-tonifying herbs. One must understand that clearing heat and descending Qi, by purging, is actually a form of tonification. If one specializes solely in using tonics, it will反而 (instead) assist Lung fire and increase coughing.
Ting Li Sang Bai Pi San (Lepidium and Mulberry Root Bark Powder) treats chest elevation and asthma.
Lepidium Seed (stir-fried until fragrant between papers and ground), Han Fang Ji (Stephania Tetrandra), Apricot Seed, Fritillaria Bulb, Radish Seed (stir-fried with Ginger Juice and ground), Domestic Perilla Seed (stir-fried with Ginger Juice and ground), Mulberry Root Bark (honey-fried), Aurantium, Scutellaria Root, White Mustard Seed (stir-fried with Ginger Juice and ground). Decoct in water and take orally. Add Honey-fried Ephedra Stem for cases with chest elevation and asthma.