一、实喘之证，以邪实在肺也，肺之实邪，非风寒则火邪耳。盖风寒之邪，必受自皮
毛，所以入肺而为喘，火之炽盛，金必受伤，故亦以病肺而为喘。治风寒之实喘，宜以温散
；治火热之实喘，治以寒凉。又有痰喘之说，前人皆曰治痰，不知痰岂能喘，而必有所以生
痰者，此当求其本而治之。
一、凡风寒外感，邪实于肺而咳喘并行者，宜六安煎加细辛或苏叶主之。若冬月风寒感
甚者，于本方加麻黄亦可，或用小青龙汤、华盖散、三拗汤之类主之。
一、外有风寒，内兼微火而喘者，宜黄芩半夏汤主之。若兼阳明火盛而以寒包热者，宜
凉而兼散，以大青龙汤，或五虎汤、越婢加半夏汤之类主之。
一、外无风寒而惟火盛作喘，或虽有微寒而所重在火者，宜桑白皮汤，或抽薪饮之类主
之。
一、痰盛作喘者，虽宜治痰，如二陈汤、六安煎、导痰汤、千缗汤、滚痰丸、抱龙丸之
类，皆可治实痰之喘也；六君子汤、金水六君煎之类，皆可治虚痰之喘也。然痰之为病，亦
惟为病之标耳，犹必有生痰之本，故凡痰因火动者，必须先治其火；痰因寒生者，必须先治
其寒。至于或因气逆，或因风邪，或因湿滞，或因脾肾虚弱，有一于此，皆能生痰，使欲治
痰而不治其所以痰，则痰终不能治，而喘何以愈哉。
一、气分受邪，上焦气实作喘，或怒气郁结伤肝，而人壮力强，胀满脉实者，但破其气
而喘自愈，宜廓清饮、四磨饮、四七汤、萝卜子汤、苏子降气汤之类主之；或阳明气秘不通
而胀满者，可微利之。
一、喘有夙根，遇寒即发，或遇劳即发者，亦名哮喘，未发时以扶正气为主，既发时以
攻邪气为主。扶正气者，须辨阴阳，阴虚者补其阴，阳虚者补其阳。攻邪气者，须分微甚，
或散其风，或温其寒，或清其痰火。然发久者气无不虚，故于消散中宜酌加温补，或于温补
中宜量加消散。此等证候，当KT KT 以元气为念，必使元气渐充，庶可望其渐愈，若
攻之太过，未有不致日甚而危者。
一、实喘这一病证，是由于邪气壅实在肺所致。肺中的实邪，无非是风寒或火邪罢了。风寒之邪，必定是从皮毛侵入，进而入肺导致气喘；火邪炽盛时，金（肺）必然受到损伤，因此也会因肺病而引发气喘。治疗风寒引起的实喘，适宜采用温散的方法；治疗火热引起的实喘，则应采用寒凉的方法。又有痰喘的说法，前人常说治疗痰，却不知道痰本身并不能直接导致气喘，必定有产生痰的原因，这里应当探究其根本原因并加以治疗。
二、凡是风寒外感，邪气壅实在肺且咳嗽与气喘并发的，适宜用六安煎加入细辛或紫苏叶来主治。如果是冬季感受风寒特别严重的，可以在本方中加入麻黄也可以，或者使用小青龙汤、华盖散、三拗汤之类的方剂来主治。
三、外部有风寒，内部兼有轻微火邪而导致气喘的，适宜用黄芩半夏汤来主治。如果兼有阳明经火气旺盛，并且属于寒包热（外寒内热）的情况，适宜采用既清凉又发散的方法，以大青龙汤，或者五虎汤、越婢加半夏汤之类的方剂来主治。
四、外部没有风寒，仅仅是火气旺盛导致气喘，或者虽然伴有轻微寒气但重点在于火邪的，适宜用桑白皮汤，或者抽薪饮之类的方剂来主治。
五、痰盛导致气喘的，虽然适宜治疗痰，如二陈汤、六安煎、导痰汤、千缗汤、滚痰丸、抱龙丸之类的方剂，都可以用来治疗由实痰引起的气喘；六君子汤、金水六君煎之类的方剂，都可以用来治疗由虚痰引起的气喘。然而痰作为一种病症，也只是疾病的表象而已，必定还有生痰的根本原因，所以凡是痰因火动引起的，必须先治疗火邪；痰因寒生成的，必须先治疗寒气。至于有的因为气机逆乱，有的因为风邪，有的因为湿气停滞，有的因为脾肾虚弱，只要具备其中一种情况，都能生痰。如果想要治痰却不治疗产生痰的原因，那么痰终究无法治愈，气喘又怎么能痊愈呢？
六、气分受邪，上焦气机壅实导致气喘，或者因愤怒郁结损伤肝脏，且患者身体强壮有力，伴有胀满、脉象实的症状，只需破气下行，气喘自然自愈，适宜用廓清饮、四磨饮、四七汤、萝卜子汤、苏子降气汤之类的方剂来主治；或者因阳明经气机闭塞不通导致胀满的，可以稍微通利一下。
七、气喘有宿根，遇到寒冷就发作，或者遇到劳累就发作的，也叫做哮喘。未发作时以扶助正气为主，发作时以攻逐邪气为主。扶助正气时，必须辨别阴阳，阴虚的补益其阴，阳虚的补益其阳。攻逐邪气时，必须区分轻重程度，或者疏散风邪，或者温散寒气，或者清化痰火。然而病程长久的，气无不虚弱，所以在消散邪气中适宜酌情加入温补药物，或在温补药物中适量加入消散邪气的药物。这类证候，应当时刻顾念元气，务必使元气逐渐充盛，这样才有望逐渐痊愈，如果攻伐太过，没有不导致病情日益加重而陷入危境的。
1. The syndrome of excess-type panting (Shi Chuan) is caused by pathogenic factors stagnating in the Lung. The excess pathogens in the Lung are none other than Wind-Cold or Fire-Heat. Wind-Cold pathogens must enter from the skin and hair, thereby entering the Lung to cause panting; when Fire-Heat is blazing, Metal (the Lung) inevitably suffers injury, thus also causing panting due to Lung pathology. For treating excess panting caused by Wind-Cold, warm dispersing methods should be used; for treating excess panting caused by Fire-Heat, cold-cooling methods should be employed. There is also the concept of phlegm-induced panting. Predecessors often stated that one treats the phlegm, not realizing that phlegm itself does not directly cause panting, but rather there must be a root cause for the generation of phlegm. In such cases, one must seek the root cause and treat it accordingly.
2. Whenever external Wind-Cold invades, with pathogens exuberant in the Lung and coughing and panting occurring simultaneously, Liu An Decoction (Six-Safe Decoction) added with Asarum Root (Xi Xin) or Perilla Leaf (Su Ye) is appropriate as the main prescription. If the contraction of Wind-Cold during winter is particularly severe, Ephedra Stem (Ma Huang) may be added to this base formula, or alternatively, Xiao Qing Long Tang (Minor Blue Dragon Decoction), Hua Gai San (Flower Canopy Powder), or San Ao Tang (Three Unbinding Decoction) may be used as the main prescription.
3. When there is external Wind-Cold combined with internal mild Fire-Heat leading to panting, Huang Qin Ban Xia Tang (Scutellaria and Pinellia Decoction) is appropriate as the main prescription. If there is concurrent excessive Fire-Heat in the Yangming channel, presenting as "Cold Enveloping Heat" (external cold with internal heat), a method that is both cooling and dispersing should be used, primarily with Da Qing Long Tang (Major Blue Dragon Decoction), or Hu Wu Tang (Five Tiger Decoction), or Yue Bi Jia Ban Xia Tang (Yue Bi Decoction plus Pinellia).
4. When there is no external Wind-Cold, but panting is caused solely by excessive Fire-Heat, or although slight cold is present, the focus is on Fire-Heat, Sang Bai Pi Tang (Morus Bark Decoction) or Chou Xin Yin (Fire-Withdrawing Drink) are appropriate as the main prescriptions.
5. For panting caused by excessive phlegm, although treating phlegm is indicated, formulas such as Er Chen Tang (Two-Aged Decoction), Liu An Decoction, Dao Tan Tang (Phlegm-Guiding Decoction), Qian Min Tang (Thousand Strings Decoction), Gun Tan Wan (Rolling Phlegm Pill), and Bao Long Wan (Embracing Dragon Pill) can all be used to treat panting caused by excess phlegm; Liu Jun Zi Tang (Six Gentlemen Decoction) and Jin Shui Liu Jun Jian (Metal-Water Six Gentlemen Decoction) can be used to treat panting caused by deficiency-phlegm. However, phlegm as a pathological product is merely the branch manifestation of disease; there must necessarily be a root cause for its generation. Therefore, whenever phlegm is stirred by Fire, the Fire must first be treated; whenever phlegm is generated by Cold, the Cold must first be treated. Furthermore, whether due to Qi rebellion, Wind pathogens, Dampness stagnation, or Spleen-Kidney deficiency, any one of these conditions can generate phlegm. If one attempts to treat phlegm without addressing the cause of its generation, the phlegm will never be cured, and how can the panting heal?
6. When the Qi aspect is affected by pathogens, resulting in upper Jiao Qi excess and panting, or when anger and depression injure the Liver, and the patient is robust with fullness and an excess pulse, simply breaking the Qi stagnation will allow the panting to resolve spontaneously. Kuang Qing Yin (Clearing Drink), Si Mo Yin (Four Grindings Drink), Si Qi Tang (Four Seven Decoction), Luo Bo Zi Tang (Radish Seed Decoction), or Su Zi Jiang Qi Tang (Perilla Seed Descending Qi Decoction) are appropriate as main prescriptions. Alternatively, if Yangming Qi obstruction leads to fullness, mild purgation may be applied.
7. Panting with a chronic root, triggered by cold or exertion, is also called Asthma (Xiao Chuan). During remission, the primary approach is to support healthy Qi (Zheng Qi); during exacerbation, the primary approach is to attack pathogenic factors. When supporting healthy Qi, Yin and Yang must be differentiated: those with Yin deficiency benefit from nourishing Yin, and those with Yang deficiency benefit from tonifying Yang. When attacking pathogenic factors, severity must be distinguished: dispersing Wind, warming Cold, or clearing Phlegm-Fire. However, in long-standing cases, Qi is invariably deficient. Therefore, while dispersing pathogens, warm-tonifying herbs should be酌情 (discretionarily) added; conversely, while tonifying, dispersing herbs should be moderately included. For such syndromes, consideration must always be given to Yuan Qi (Original Qi). Only by ensuring the gradual replenishment of Original Qi can gradual recovery be hoped for. If attack methods are too aggressive, the condition will inevitably worsen daily, leading to danger.