治阴阳两虚，喘逆迫促，有将脱之势。亦治肾虚不摄，冲气上干，致胃气不降作满闷。
野台参（四钱） 生赭石（六钱，轧细） 生芡实（五钱） 生山药（五钱） 萸肉（六钱，去净核）
生龙骨（六钱，捣细） 生牡蛎（六钱，捣细） 生杭芍（四钱） 苏子（二钱，炒捣）
生赭石压力最胜，能镇胃气冲气上逆，开胸膈，坠痰涎，止呕吐，通燥结，用之得当，诚有捷效。虚者可
与人参同用。
仲景旋复代赭石汤，赭石、人参并用。治“伤寒发汗，若吐若下解后，心下痞硬，噫气不除者”。参、赭
镇气汤中人参，借赭石下行之力，挽回将脱之元气，以镇安奠定之，亦旋复代赭石汤之义也。
一妇人，年三十余，劳心之后兼以伤心，忽喘逆大作，迫促异常。其翁知医，以补敛元气之药治之，觉胸
中窒碍不能容受。更他医以为外感，投以小剂青龙汤喘益甚。延愚诊视，其脉浮而微数，按之即无，知为阴阳
两虚之证。盖阳虚则元气不能自摄，阴虚而肝肾又不能纳气，故作喘也。为制此汤，病患服药后，未
及复杯曰∶“吾有命矣。”询之曰∶“从前呼吸惟在喉间，几欲脱去，今则转落丹田矣。”果一剂病愈强半，
又服数剂全愈。
一妇人，年二十余，因与其夫反目，怒吞鸦片。已经救愈，忽发喘逆，迫促异常。须臾又呼吸顿停，气息
全无，约十余呼吸之顷，手足乱动，似有蓄极之势，而喘复如故。若是循环不已，势近垂危，延医数人，皆不
知为何病。后愚诊视其脉，左关弦硬，右寸无力，精思良久，恍然悟曰∶此必怒激肝胆之火，上冲胃气。夫胃
气本下行者也，因肝胆之火冲之，转而上逆，并迫肺气亦上逆，此喘逆迫促所由来也。逆气上干，填塞胸膈，
排挤胸中大气，使之下陷。夫肺悬胸中，须臾无大气包举之，即须臾不能呼吸，此呼吸顿停所由来也（此理参
观升陷汤后跋语方明）。迨大气蓄极而通，仍上达胸膈，鼓动肺脏，使得呼吸、逆气遂仍得施其击撞，此又病
势之所以循环也。《神农本草经》载，桂枝主上气咳逆、结气、喉痹、吐吸（吸不归根即吐出），其能降逆气
可知。其性温而条达，能降逆气，又能升大气可知。遂单用桂枝尖三钱，煎汤饮下，须臾气息调和如常。夫以
桂枝一物之微，而升陷降逆，两擅其功，以挽回人命于顷刻，诚天之生斯使独也。然非亲自经验者，又孰信其
神妙如是哉！继用参赭镇气汤，去山药、苏子，加桂枝尖三钱、知母四钱，连服数剂，病不再发。此喘证之特
异者，故附记于此。
附录∶
直隶青县张××来函∶
定县吴××妻病，服药罔效。弟诊其脉，浮而无力。胸次郁结，如有物杜塞，饮食至胃间，恒觉烧热不下。
仿参赭镇气汤之义，用野台参六钱，赭石细末二两。将二药煎服，胸次即觉开通。服至二剂，饮食下行无碍。
因其大便犹燥，再用当归、肉苁蓉各四钱，俾煎服。病若失。
安徽绩溪章××来函∶
洪××，年五十余，家素贫苦，曾吸鸦片，戒未多年，由咳而成喘疾，勉强操劳，每届冬令则加剧，然病发
时亦往往不服药而自愈。兹次发喘，初由外感，兼发热头痛。医者投以二活、防、葛，大剂表散，遂汗出二日
不止，喘逆上冲，不能平卧，胸痞腹胀，大便旬余未行，语不接气，时或螈 ，种种见证，已濒极险。诊其脉，
微细不起。形状颓败殊甚。详细勘视，诚将有阴阳脱离之虞。适日前阅赭石解，记其主治，揣之颇合。但恐其
性太重镇而正气将随以下陷也，再四踌躇，因配以真潞党参、生怀山药、野茯神、净萸肉、广桔红、京半夏、
龙骨、牡蛎、苏子、蒡子等，皆属按证而拟，竟与参赭镇气汤大致相同。一剂病愈大半，两剂即扶杖起行，三
剂则康复如恒矣。前月遇之，自言冬不知寒，至春亦未反复。
治疗阴阳两虚，气喘逆乱且急促，有元气即将脱失的趋势。也治疗肾虚不能固摄，冲脉之气上犯，导致胃气不降而产生胀闷感。
野台参（四钱） 生赭石（六钱，碾碎） 生芡实（五钱） 生山药（五钱） 山茱萸肉（六钱，去净果核）
生龙骨（六钱，捣碎成细粉） 生牡蛎（六钱，捣碎成细粉） 生杭白芍（四钱） 苏子（二钱，炒后捣碎）
生赭石的沉降压力最强，能够镇降胃气和冲脉之气上逆，开通胸膈，坠化痰涎，止住呕吐，通导燥结，使用得当，确实有迅速见效的功效。对于虚证患者，可以与人参同用。
张仲景的旋复代赭汤中，赭石与人参并用。用于治疗“伤寒发汗后，或用吐法、下法解表后，心下痞塞坚硬，嗳气不止者”。本方（参赭镇气汤）中的人参，借助赭石下行的力量，挽回即将脱失的元气，以镇安稳固它，这也是遵循旋复代赭汤的法度。
有一位三十多岁的妇人，在劳心之后又兼伤心神，忽然气喘逆乱大作，急促异常。她的公公懂医术，用补益收敛元气的药物治疗，患者觉得胸中窒塞碍事，无法承受药力。改请其他医生诊治，认为是外感病，投以小剂量的大青龙汤，结果喘息更加严重。请我诊治，其脉象浮而微数，重按则无，判断为阴阳两虚的证候。因为阳虚则元气不能自我固摄，阴虚则肝肾不能纳气，所以发生喘息。于是为她配制此汤，病患服药后，还没等喝完一杯药就说：“我有命了。”询问她说：“以前呼吸只在喉间，几乎要脱失，现在气息转落到丹田了。”果然服一剂病愈大半，又服几剂完全痊愈。
另一位二十多岁的妇人，因与丈夫吵架生气，吞服鸦片。虽然被救活，但忽然发作气喘逆乱，急促异常。一会儿呼吸突然停止，气息全无，大约经过十余次呼吸的时间，手足乱动，似乎积蓄了极大的势能，然后喘息又如先前一样发作。如此循环不已，形势接近垂危，请了几位医生，都不知道是什么病。后来我诊察其脉象，左关脉弦硬，右寸脉无力，深思良久，恍然大悟说：“这一定是愤怒激发了肝胆之火，向上冲犯胃气。胃气本是下行的，因为肝胆之火的冲激，反而上逆，并迫使肺气也上逆，这就是气喘逆乱急促的原因。逆气上干，填塞胸膈，排挤胸中的大气，使其下陷。肺悬挂在胸中，片刻没有大气的包举支撑，就片刻不能呼吸，这就是呼吸突然停止的原因（这个道理参考《升陷汤》后的跋语才明白）。等到大气积蓄到极点而通达，仍然上达胸膈，鼓动肺脏，使得能够呼吸，逆气于是又能继续冲击，这又是病情之所以循环往复的原因。《神农本草经》记载，桂枝主治上气咳逆、结气、喉痹、吐吸（吸气不能归根即吐出），可知它能降逆气。桂枝性温而条达，能降逆气，又能升举大气，由此可知。于是单用桂枝尖三钱，煎汤饮下，片刻后气息调和如常。凭借桂枝这一味药的微小之力，却能同时具备升陷和降逆的功效，在顷刻间挽回人命，真是上天独厚地生出这种药物啊。然而如果不是亲自经验过的人，又有谁会相信它的神妙如此呢！随后使用参赭镇气汤，去掉山药、苏子，加入桂枝尖三钱、知母四钱，连续服用几剂，病不再复发。这是喘证中特异的一种情况，所以记录在此。
附录：
直隶青县张××来信：
定县吴××的妻子患病，服药无效。我诊察其脉象，浮而无力。胸中郁结，好像有东西堵塞，饮食到胃里，常常觉得烧热不下行。仿照参赭镇气汤的意义，使用野台参六钱，赭石细末二两。将这两味药煎服，胸中即刻感觉开通。服用至两剂，饮食下行无障碍。因为大便仍然干燥，再用当归、肉苁蓉各四钱，一起煎服。病就好了。
安徽绩溪章××来信：
洪××，五十多岁，家里一向贫苦，曾吸食鸦片，戒断未多年，由咳嗽发展成喘疾，勉强操劳，每到冬天就加重，但发病时往往不服药也能自愈。这次发作喘息，起初由外感引起，兼有发热头痛。医生投以羌活、独活、防风、葛根等大剂量发散表邪的药物，导致出汗两天不止，喘息逆乱上冲，不能平卧，胸痞腹胀，大便十几天未行，说话接不上气，时而抽搐，种种见证，已经濒临极度危险。诊察其脉象，微细不起。形体颓败非常严重。详细查看，确实有阴阳离决的担忧。恰好前几天阅读关于赭石的解说，记得它的主治功效，揣测颇合病情。但担心其性质太重镇，正气会随之陷入，再三犹豫，于是配伍真潞党参、生怀山药、野茯神、净山茱萸肉、广桔红、京半夏、龙骨、牡蛎、苏子、牛蒡子等，都是根据证候拟定的，竟然与参赭镇气汤大致相同。一剂病愈大半，两剂就能扶着拐杖行走，三剂则康复如常。上个月遇到他，自己说冬天不怕冷，到了春天也没有反复。
Treats deficiency of both Yin and Yang, with panting and counterflow that is urgent and hurried, showing signs of impending collapse. It also treats Kidney deficiency failing to secure, where Qi from the Chong vessel attacks upward, causing Stomach Qi to fail to descend and resulting in fullness and oppression.
Ye Tai Shen (Wild Rhizoma Panacis Japonici, 4 qian) Sheng Zhe Shi (Raw Haematitum, 6 qian, finely crushed) Sheng Qian Shi (Raw Semen Euryales, 5 qian) Sheng Shan Yao (Raw Rhizoma Dioscoreae Oppositae, 5 qian) Yu Rou (Flesh of Fructus Corni, 6 qian, pits completely removed)
Sheng Long Gu (Raw Os Draconis, 6 qian, pounded into fine powder) Sheng Mu Li (Raw Concha Ostreae, 6 qian, pounded into fine powder) Sheng Hang Shao (Raw Radix Paeoniae Albae, 4 qian) Su Zi (Fructus Perillae, 2 qian, stir-fried and pounded)
Sheng Zhe Shi has the strongest descending pressure; it can suppress the counterflow of Stomach Qi and Chong Qi, open the chest and diaphragm, sink phlegm and saliva, stop vomiting, and unblock dry constipation. When used appropriately, it indeed yields rapid effects. For deficiency patterns, it can be used together with Ren Shen.
In Zhang Zhongjing's Xuan Fu Dai Zhe Shi Tang, Zhe Shi and Ren Shen are used together. It treats "after Han syndrome treated by sweating, or after treatment by emesis or purgation, epigastric stuffiness and hardness, with persistent belching." In this formula (Shen Zhen Zhen Qi Tang), Ren Shen borrows the descending power of Zhe Shi to rescue Yuan Qi on the verge of collapse, thereby stabilizing and anchoring it, which also aligns with the principle of Xuan Fu Dai Zhe Shi Tang.
A woman in her thirties, after mental exertion compounded by emotional injury to the Heart, suddenly suffered severe panting and counterflow, extremely urgent. Her father-in-law, who knew medicine, treated her with herbs to tonify and astringe Yuan Qi, but she felt chest obstruction and could not tolerate the medication. Another doctor diagnosed an external contraction and administered a small dose of Da Qing Long Tang, which worsened the panting. Upon my consultation, her pulse was floating and slightly rapid, vanishing upon heavy pressure, indicating a pattern of deficiency of both Yin and Yang. Since Yang deficiency fails to self-secure Yuan Qi, and Yin deficiency causes the Liver and Kidney to fail to grasp Qi, panting ensues. I prepared this decoction for her. After taking one dose, before finishing the cup, she said, "I have life now." Upon inquiry, she stated, "Previously, breathing was only in the throat, nearly collapsing; now the Qi has descended to the Dantian." Indeed, one dose cured more than half the illness, and after several more doses, she fully recovered.
Another woman in her twenties, due to a quarrel with her husband, swallowed opium out of anger. Although saved, she suddenly developed severe panting and counterflow, extremely urgent. Moments later, breathing stopped abruptly, with no breath remaining. After approximately ten breaths' worth of time, her limbs moved chaotically, as if accumulating extreme force, after which the panting resumed as before. This cycle continued endlessly, approaching critical danger. Several doctors were consulted but did not know the disease. Later, I examined her pulse: the Left Guan position was wiry and hard, and the Right Cun position was powerless. After deep reflection, I suddenly realized: "This must be anger stimulating Fire of the Liver and Gallbladder, rushing upward to attack Stomach Qi. Stomach Qi naturally descends; because of the assault by Liver-Gallbladder Fire, it reverses and flows upward, forcing Lung Qi to also reverse upward. This is the origin of the urgent panting and counterflow. The counterflow Qi attacks upward, filling the chest and diaphragm, squeezing the Great Qi in the chest downward. The Lung hangs in the chest; without the enveloping support of Great Qi for even a moment, respiration cannot occur. This is the origin of the abrupt cessation of breathing (this principle becomes clear when referring to the postscript of Sheng Xian Tang). When Great Qi accumulates to its limit and then opens, it still reaches the chest and diaphragm, stirring the Lung, allowing respiration to resume. The counterflow Qi then continues its impact, which is why the disease condition cycles. *Shennong Bencao Jing* records that Gui Zhi treats upper Qi cough and counterflow, constrained Qi, sore throat, and spitting inhalation (inhaling without returning to the root, i.e., spitting out); thus, its ability to descend counterflow Qi is known. Its nature is warm and unobstructed; it can descend counterflow Qi and also raise Great Qi. Therefore, I used only Gui Zhi Jiao (tips of Cinnamomi Ramulus) 3 qian, decocted in water and drunk. Within moments, breath harmonized as usual. With just the slight power of Gui Zhi, it achieves both raising collapsed Qi and descending counterflow, rescuing human life in an instant. Truly, Heaven alone produces such a unique herb! However, unless one has personally experienced it, who would believe its efficacy so miraculous? Subsequently, Shen Zhen Zhen Qi Tang was used, removing Shan Yao and Su Zi, adding Gui Zhi Jiao 3 qian and Zhi Mu 4 qian. After several doses, the illness did not recur. This is a special type of panting syndrome, so it is recorded here.
Appendix:
Letter from Zhang XX of Qing County, Zhili:
The wife of Wu XX of Ding County was ill, and medications had no effect. I diagnosed her pulse as floating and powerless. There was郁结 (stagnation/constraint) in the chest, as if something were blocking it. When food reached the stomach, it often felt hot and failed to descend. Mimicking the principle of Shen Zhen Zhen Qi Tang, I used Ye Tai Shen 6 qian and Zhe Shi fine powder 2 liang. Decocting and administering these two herbs, the chest immediately felt open. After two doses, food descended without obstruction. Because the stool remained dry, I added Dang Gui and Rou Cong Rong, each 4 qian, to be decocted and taken together. The illness disappeared.
Letter from Zhang XX of Jixi County, Anhui:
Hong XX, over fifty years old, came from a poor family, had previously smoked opium, and had quit for only a few years. He developed panting from chronic cough. Forced to work hard, the condition worsened every winter, though attacks often resolved spontaneously without medication. This time, the panting started with an external contraction, accompanied by fever and headache. The physician prescribed large doses of Bie Huo (Qiang Huo and Du Huo), Fang Feng, and Ge Gen to disperse the exterior extensively. This resulted in continuous sweating for two days, urgent panting and counterflow preventing lying flat, chest stuffiness and abdominal distension, no bowel movement for over ten days, speech interrupted by lack of breath, and occasional convulsions. Various signs indicated a critically dangerous state. His pulse was faint and fine, barely rising. His physical appearance was severely decadent. Detailed examination confirmed the fear of separation of Yin and Yang. Fortunately, having recently read the explanation of Zhe Shi and remembering its indications, I suspected it fit well. However, fearing its heavy sedative nature might cause Zheng Qi to sink further, I hesitated repeatedly. Finally, I combined it with Zhen Lu Dang Shen, Sheng Huai Shan Yao, Ye Fu Shen, Jing Yu Rou, Guang Ju Hong, Jing Ban Xia, Long Gu, Mu Li, Su Zi, and Niu Bang Zi. All were prescribed according to the syndrome, and the formula was largely identical to Shen Zhen Zhen Qi Tang. One dose cured more than half the illness; two doses allowed him to walk with a cane; three doses restored him to health. Meeting him last month, he said he no longer feared cold in winter, nor did the illness recur in spring.