脉∶喘急脉沉，肺胀停水；气逆填胸，脉必伏取；沉而实滑，身温易愈；身冷脉浮，尺涩难补。又云∶脉滑
而手足温者生，脉沉涩而四肢寒者死。
喘者为恶候，因火所郁而痰在脾胃也。痰喘者，喘动便有痰声也。（宜后方。）栝蒌枳实汤治痰喘。（方见
痰饮。）
火喘者，乍进乍退，得食则减，止食则喘也。（宜后方。）
清肺汤 治火喘。
片黄芩（一钱） 山栀子 枳实 桑白皮 陈皮 白茯苓（去皮） 杏仁（去皮尖） 苏子 麦门冬（去心）
贝母（去心。各八分） 沉香（磨水） 辰砂（研末，一味临服调入。各五分）
上锉一剂，姜一片，水煎，入竹沥同服。
气短而喘者，呼吸短促而无痰声也。
四君子汤 治短气。
人参（去芦） 白术（去芦，一钱三分） 茯苓（去皮） 陈皮 浓朴（姜汁炒） 砂仁 苏子 桑白皮
（各六分） 当归（八分） 沉香 木香（各五分，另磨水） 甘草（炙，一钱）
上锉一剂，姜一片，枣二枚，水煎，磨沉香调服。
阴虚火动而喘者，心脉数也。滋阴降火汤。（方见虚症。）根据本方加苏子、沉香、杏仁、桑白皮、竹沥。
寒喘者，四肢逆冷，脉沉细也。
理中汤 治寒喘。
砂仁 干姜（炒） 苏子 浓朴（姜汁炒） 官桂 陈皮 甘草（炙，各一钱） 沉香 木香（各五分，水
磨入）
上锉一剂，生姜三片，水煎，磨沉、木香同服。若脉细手足冷加附子。
伤寒喘急者，宜发表也。
五虎汤 治伤寒喘急。
麻黄（三钱） 杏仁（去皮尖，炒，三钱） 石膏（五钱） 甘草（一钱） 细茶（一撮），加桑皮（一钱），
有痰加和二陈汤。
上锉一剂，生姜三片、葱白三根，煎热服。后用小青龙汤加杏仁。
虚阳上攻喘急者，宜降痰气也。
苏子降气汤 治阳虚上攻，气不升降，上盛下虚，痰涎壅盛、喘促气满咳嗽。
苏子（五钱） 陈皮 浓朴（姜汁炒） 前胡 肉桂（各二钱） 半夏（姜汁浸，炒） 当归 甘草 一方
去桂加南星
上锉一剂，生姜三片，枣一枚，水煎服。若加川芎、细辛、茯苓、桔梗，名大降气汤。
定西侯蒋公，患上气喘急，其脉寸口洪滑，此痰滞胸膈也。余令先服稀涎散二钱，更以熟水频频饮之，则
嗌而吐其痰如胶，内有一长条裹韭叶一根，痊愈。
一路姓者，年近五十，身体肥大，饮食倍常，患月余。每行动即喘，求予诊。六脉微涩，予曰∶此死症也。
众皆以予为妄，后逾月果中痰而卒。
脉象：喘急而脉象沉，是肺胀停水；气逆填塞胸中，脉象必然伏匿难取；若脉象沉而实滑，身体温暖则容易痊愈；若身体寒冷且脉浮，尺部脉涩则难以救治。又说：脉象滑利且手足温暖的能生，脉象沉涩且四肢寒冷的会死亡。
喘证属于恶候，多因火邪郁结导致痰浊停滞在脾胃。痰喘，表现为喘息时伴有痰声。（适宜使用后方。）栝蒌枳实汤治疗痰喘。（方剂见痰饮篇。）
火喘，症状忽轻忽重，进食后减轻，停止进食则气喘加重。（适宜使用后方。）
清肺汤 治疗火喘。
黄芩（一钱） 山栀子 枳实 桑白皮 陈皮 白茯苓（去皮） 杏仁（去皮尖） 苏子 麦门冬（去心）
贝母（去心。各八分） 沉香（磨水） 辰砂（研末，单独临服调入。各五分）
以上锉为一剂，加生姜一片，水煎，加入竹沥一同服用。
气短而喘，表现为呼吸短促但没有痰声。
四君子汤 治疗短气。
人参（去芦头） 白术（去芦头，一钱三分） 茯苓（去皮） 陈皮 厚朴（姜汁炒） 砂仁 苏子 桑白皮
（各六分） 当归（八分） 沉香 木香（各五分，另磨水） 甘草（炙，一钱）
以上锉为一剂，加生姜一片，大枣二枚，水煎，磨沉香调服。
阴虚火动而喘，表现为心脉数疾。滋阴降火汤。（方剂见虚症篇。）根据本方加苏子、沉香、杏仁、桑白皮、竹沥。
寒喘，表现为四肢逆冷，脉象沉细。
理中汤 治疗寒喘。
砂仁 干姜（炒） 苏子 厚朴（姜汁炒） 官桂 陈皮 甘草（炙，各一钱） 沉香 木香（各五分，水磨入）
以上锉为一剂，加生姜三片，水煎，磨沉香、木香同服。如果脉细手足冷，加附子。
伤寒引起的喘急，适宜用发表法治疗。
五虎汤 治疗伤寒喘急。
麻黄（三钱） 杏仁（去皮尖，炒，三钱） 石膏（五钱） 甘草（一钱） 细茶（一撮），加桑白皮（一钱），
有痰加和二陈汤。
以上锉为一剂，加生姜三片、葱白三根，煎热服用。之后用小青龙汤加杏仁。
虚阳上攻引起的喘急，适宜降痰气。
苏子降气汤 治疗阳虚上攻，气机不升降，上盛下虚，痰涎壅盛、喘促气满咳嗽。
苏子（五钱） 陈皮 厚朴（姜汁炒） 前胡 肉桂（各二钱） 半夏（姜汁浸，炒） 当归 甘草 一方
去桂枝加天南星
以上锉为一剂，加生姜三片，大枣一枚，水煎服。如果加川芎、细辛、茯苓、桔梗，名为大降气汤。
定西侯蒋公，患上气喘急，其脉寸口洪滑，这是痰滞于胸膈。我让他先服用稀涎散二钱，再用熟水频频饮用，于是嗌出胶状痰液，其中包裹着一根韭菜叶大小的长条物，痊愈。
一路姓的人，年近五十，身体肥大，饮食加倍，患病月余。每次行动就气喘，求我诊脉。六脉微涩，我说：这是死症。众人都认为我胡说，后来过月果然因中痰而死。
Pulse: In cases of panting and urgency, if the pulse is deep (Shen), it indicates lung distension with retained water; when rebellious Qi fills the chest, the pulse must be sought at a sunken level (Fu). If the pulse is deep, solid, and slippery, and the body temperature is warm, recovery is easy; if the body is cold and the pulse is floating, but the Chi position is choppy (Se), treatment is difficult. It is also said: If the pulse is slippery and the hands and feet are warm, there is hope for life; if the pulse is deep and choppy and the four limbs are cold, death ensues.
Panting is an ominous sign, caused by fire pathogen constraint leading to phlegm stagnation in the Spleen and Stomach. Phlegm panting is characterized by audible phlegm sounds during breathing. (The following formula is appropriate.) Gualou Zhishi Tang (Trichosanthes Fruit and Immature Bitter Orange Decoction) treats phlegm panting. (Formula see Phlegm-Fluids chapter.)
Fire panting is characterized by symptoms that fluctuate in intensity, alleviated by eating and worsening when fasting. (The following formula is appropriate.)
Qingfei Tang (Lung-Clearing Decoction) treats fire panting.
Huangqin (Scutellariae Radix, 1 qian) Shanzhizi (Gardeniae Fructus) Zhishi (Aurantii Fructus Immaturus) Sangbaipi (Mori Cortex) Chenpi (Citri Reticulatae Pericarpium) Baifuling (Poria, peeled) Xingren (Armeniacae Semen Amarum, peeled and cleft) Su Zi (Perillae Fructus) Maimendong (Ophiopogonis Radix, heart removed)
Beimu (Fritillariae Bulbus, heart removed. Each 8 fen) Chenxiang (Aquilariae Lignum Resinatum, ground into water) Chensha (Cinnabaris, powdered, added alone before taking. Each 5 fen)
Grind these into one dose, add one slice of fresh ginger, decoct in water, and take mixed with Zhuli (Bambusae Sap).
Shortness of breath with panting is characterized by short, rapid breathing without phlegm sounds.
Sijunzi Tang (Four Gentlemen Decoction) treats shortness of breath.
Renshen (Ginseng Radix, rhizome removed) Baizhu (Atractylodis Macrocephalae Rhizoma, rhizome removed, 1.3 qian) Fuling (Poria, peeled) Chenpi (Citri Reticulatae Pericarpium) Houpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice) Sharen (Amomi Fructus) Su Zi (Perillae Fructus) Sangbaipi (Mori Cortex)
(Each 6 fen) Danggui (Angelicae Sinensis Radix, 8 fen) Chenxiang (Aquilariae Lignum Resinatum) Muxiang (Aucklandiae Radix, each 5 fen, ground into water separately) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 qian)
Grind these into one dose, add one slice of fresh ginger and two jujubes, decoct in water, and take mixed with ground Chenxiang.
Panting due to Yin deficiency and hyperactive fire is indicated by a rapid Heart pulse. Ziyin Jianghuo Tang (Yin-Nourishing and Fire-Subduing Decoction). (Formula see Deficiency Syndromes chapter.) Add Su Zi, Chenxiang, Xingren, Sangbaipi, and Zhuli to this formula.
Cold panting is characterized by cold extremities and a deep, fine pulse.
Lizhong Tang (Regulate the Middle Decoction) treats cold panting.
Sharen (Amomi Fructus) Ganjiang (Zingiberis Rhizoma, stir-fried) Su Zi (Perillae Fructus) Houpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice) Guigui (Cinnamomi Cortex) Chenpi (Citri Reticulatae Pericarpium) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 1 qian) Chenxiang (Aquilariae Lignum Resinatum) Muxiang (Aucklandiae Radix, each 5 fen, ground in water)
Grind these into one dose, add three slices of fresh ginger, decoct in water, and take mixed with ground Chenxiang and Muxiang. If the pulse is fine and hands and feet are cold, add Fuzi (Aconiti Lateralis Radix Praeparata).
Panting and urgency due to Cold Damage (Shanghan) should be treated with exterior-releasing methods.
Wuhu Tang (Five Tigers Decoction) treats panting and urgency due to Cold Damage.
Mahuang (Ephedrae Herba, 3 qian) Xingren (Armeniacae Semen Amarum, peeled and cleft, stir-fried, 3 qian) Shigao (Gypsum Fibrosum, 5 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian) Xiacha (Fine Tea, a pinch), add Sangbaipi (Mori Cortex, 1 qian).
If there is phlegm, combine with Erchen Tang (Two Aged Decoction).
Grind these into one dose, add three slices of fresh ginger and three stalks of scallion white, decoct until hot and take. Afterwards, use Xiaoqinglong Tang (Minor Blue Dragon Decoction) with added Xingren.
Panting and urgency due to deficient Yang attacking upwards should be treated by descending phlegm and Qi.
Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction) treats upward attack of Yang deficiency, failure of Qi to ascend and descend, excess above and deficiency below, abundance of phlegm and saliva, panting, suffocation, fullness, and cough.
Suzi (Perillae Fructus, 5 qian) Chenpi (Citri Reticulatae Pericarpium) Houpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice) Qianhu (Peucedani Radix) Rougui (Cinnamomi Cortex, each 2 qian) Banxia (Pinelliae Rhizoma, soaked in ginger juice, stir-fried) Danggui (Angelicae Sinensis Radix) Gancao (Glycyrrhizae Radix et Rhizoma) One variation removes Guigui and adds Nanting (Arisaematis Rhizoma Preparatum).
Grind these into one dose, add three slices of fresh ginger and one jujube, decoct in water and take. If Chuanxiong (Ligustici Chuanxiong Rhizoma), Xixin (Asari Radix et Rhizoma), Fuling (Poria), and Jiegeng (Platycodonis Radix) are added, it is named Da Jiangqi Tang (Great Descending Qi Decoction).
Duke Jiang of Dingxi suffered from severe panting and urgency. His Cun Kou pulse was surging and slippery, indicating phlegm stagnation in the chest and diaphragm. I instructed him to first take 2 qian of Xixian San (Saliva-Thinning Powder), then frequently drink boiled water. He subsequently vomited up phlegm like glue, containing a long strip wrapped around a leek-leaf-sized object, and recovered completely.
A man surnamed Yi, nearing fifty years old, was obese and ate double the usual amount. He had been ill for over a month. Every time he moved, he panted. He asked me to diagnose him. All six pulses were faint and choppy. I said: This is a fatal condition. Everyone thought I was absurd. Later, after more than a month, he indeed died from phlegm obstruction.