风寒伤肺气喘急,表热无汗华盖方,肺虚被邪紫苏饮,无邪气逆降气汤。
【注】肺主皮毛,一受风寒,内闭肺气,则气逆不降,呼吸气急,故作喘也。发热无
汗,宜以华盖散汗而散之。若肺气本虚,外复被风寒所伤者,宜以紫苏饮子补而散之;若
肺虚外无风寒所伤,内无痰涎壅塞,惟气逆喘急者,以加减苏子降气汤降其逆气,其喘
自愈。治者宜详察之。
华盖散(方见风寒咳嗽)
紫苏饮子
苏叶 杏仁(炒去皮尖) 桑皮(炒) 陈皮 青皮(醋炒) 半夏(姜制) 人参 五味子 甘
草(生) 麻黄
引用生姜,水煎服。
【方歌】气虚又被风寒伤,紫苏饮子最相当,苏叶杏桑陈青半,人参五味草麻黄。
苏子降气汤
苏子(炒) 当归 陈皮 前胡 半夏(姜制) 甘草(生) 浓朴(姜制) 桂心 沉香
引用姜、枣,水煎服。
【方歌】气逆喘用降气汤,肺虚无邪服最良,苏子当归陈半草,前胡浓朴桂沉香。
痰饮壅逆因作喘,痰饮苏葶滚痰从,停饮喘急不得卧,泻饮降逆用苏葶。
【注】小儿痰饮作喘者,因痰壅气逆也。其音如潮响,声如拽锯者,须急攻痰壅,苏
葶滚痰丸主之。若停饮喘急不得卧者,又当泻饮降逆苏葶丸主之。医者须分别施治,庶
几曲中病情矣。
苏葶滚痰丸(方见食积咳嗽)
苏葶丸
南苏子(炒) 苦葶苈子(微炒,各等分)
为细末,蒸枣肉为丸,如麻子大,每服五丸至七丸,淡姜汤下。
风寒之邪侵袭肺脏,导致气喘急促,若伴有表热且无汗,宜用华盖方;肺气虚弱又受邪气侵袭,宜用紫苏饮;若无外邪且气逆喘急,则用降气汤。
【注】肺主司皮毛,一旦受到风寒侵袭,会导致肺气内闭,气机逆乱不降,呼吸急促,从而形成喘证。若出现发热、无汗的症状,适宜使用华盖散通过发汗来疏散邪气。如果肺气原本虚弱,外部又遭受风寒伤害的,适宜使用紫苏饮子通过补益兼发散的方法治疗;如果肺气虚弱但外部没有风寒侵袭,内部也没有痰涎壅塞,仅仅是气逆导致喘急的,使用加减苏子降气汤来降逆气,喘症自然痊愈。治疗者应当详细察辨。
紫苏饮子
苏叶 杏仁(炒制,去皮尖) 桑白皮(炒制) 陈皮 青皮(醋炒制) 半夏(姜汁制) 人参 五味子 甘草(生用) 麻黄
引用生姜为引,加水煎服。
【方歌】气虚又被风寒伤,紫苏饮子最相当,苏叶杏桑陈青半,人参五味草麻黄。
苏子降气汤
苏子(炒制) 当归 陈皮 前胡 半夏(姜汁制) 甘草(生用) 厚朴(姜汁制) 桂心 沉香
引用生姜、大枣为引,加水煎服。
【方歌】气逆喘用降气汤,肺虚无邪服最良,苏子当归陈半草,前胡浓朴桂沉香。
痰饮壅盛逆乱因而作喘,治疗痰饮所致喘急可用苏葶滚痰丸;若停饮导致喘急不能平卧,应用泻饮降逆的苏葶丸。
【注】小儿因痰饮引发喘证的,是因为痰浊壅盛、气机逆乱所致。其声音如潮水般响亮,声如拉锯般的,必须紧急攻逐痰壅,以苏葶滚痰丸为主治方。若是停饮导致喘急、不能平卧的,又应当采用泻饮降逆的方法,以苏葶丸为主治方。医者必须分别施治,才能准确契合病情。
苏葶滚痰丸(方剂见“食积咳嗽”章节)
苏葶丸
南苏子(炒制) 苦葶苈子(微炒制,各等分)
研为细末,用蒸枣肉制成丸药,大小如麻子,每次服用五丸至七丸,用淡姜汤送服。
Wind-cold invading the Lung causes rapid panting; if accompanied by exterior heat and absence of sweating, Huagai San (Crown Covering Powder) is indicated. If Lung Qi is deficient and invaded by pathogenic factors, Zisu Yin (Perilla Decoction) is indicated. If there is no external pathogen but Qi rebellion with panting, Jiangqi Tang (Descending Qi Decoction) is indicated.
[Note] The Lung governs the skin and hair. Once invaded by wind-cold, it causes internal closure of Lung Qi, leading to rebellious Qi that fails to descend and rapid breathing, thus forming asthma (chuan). If fever and absence of sweating are present, it is appropriate to use Huagai San to disperse the pathogen through sweating. If Lung Qi is originally deficient and additionally injured by external wind-cold, it is appropriate to use Zisu Yin Zi to tonify while dispersing. If Lung Qi is deficient but not injured by external wind-cold, nor obstructed internally by phlegm-fluids, but solely suffering from rebellious Qi causing rapid panting, Jiachian Suzi Jiangqi Tang (Modified Perilla Seed Descending Qi Decoction) should be used to descend the rebellious Qi, after which the panting will heal spontaneously. Practitioners must examine carefully.
Huagai San (Formula see "Wind-Cold Cough")
Zisu Yin Zi (Perilla Decoction)
Perillae Folium (Suye), Apricot Seed (Xingren, stir-fried, peel and tip removed), Mulberry Root Bark (Sangpi, stir-fried), Tangerine Peel (Chenpi), Green Tangerine Peel (Qingpi, vinegar-stir-fried), Pinellia Rhizome (Banxia, ginger-processed), Ginseng Radix et Rhizoma (Renshen), Schisandra Fruit (Wuweizi), Licorice Root (Gancao, raw), Ephedra Stem (Mahuang).
Add fresh ginger as a guide, decoct in water and take orally.
[Prescription Song] When Qi deficiency is injured by wind-cold, Zisu Yin Zi is most appropriate; Suye, Xingren, Sang, Chen, Qing, Ban, Renshen, Wuwei, Gancao, Mahuang.
Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction)
Perilla Seed (Suzi, stir-fried), Angelica Sinensis Radix (Danggui), Tangerine Peel (Chenpi), Peucedani Radix (Qianhu), Pinellia Rhizome (Banxia, ginger-processed), Licorice Root (Gancao, raw), Magnolia Bark (Houpo, ginger-processed), Cinnamon Twig (Guixin), Agarwood (Chenxiang).
Add fresh ginger and jujube as guides, decoct in water and take orally.
[Prescription Song] For rebellious Qi causing panting, use Jiangqi Tang; for Lung deficiency without pathogens, taking it is best; Suzi, Danggui, Chen, Ban, Gancao, Qianhou, Houpo, Guixin, Chenxiang.
Phlegm-fluids obstructing and rebelling cause panting; treat phlegm-fluid-induced panting with Suzhi Guntan Wan (Perilla and Lepidium Draining Phlegm Pill); if retained fluid causes rapid panting preventing lying flat, use Su Ting Wan (Perilla and Lepidium Pill) to drain fluid and descend rebellion.
[Note] In children, panting caused by phlegm-fluids results from phlegm obstruction and Qi rebellion. If the sound is loud like tidal waves or sawing wood, urgent attack on phlegm obstruction is required, with Suzhi Guntan Wan as the primary formula. If retained fluid causes rapid panting preventing lying flat, one must drain fluid and descend rebellion using Su Ting Wan as the primary formula. Physicians must differentiate and treat accordingly to accurately address the condition.
Suzhi Guntan Wan (Formula see "Food Stagnation Cough")
Su Ting Wan (Perilla and Lepidium Pill)
Southern Perilla Seed (Nansuzi, stir-fried), Bitter Lepidium Seed (Kutingli, slightly stir-fried, equal parts).
Grind into fine powder, mix with steamed jujube pulp to form pills the size of sesame seeds. Take 5 to 7 pills per dose, administered with light ginger soup.