东垣曰∶华佗云盛而为喘,减而为枯;故《活人》亦云∶发喘者气有余也。凡看文本,
须要会得本意,盛而为喘者,非肺气盛也,喘为肺气有余者,亦非气有余也;气盛当认作气
衰,有余当认作不足。肺气果盛,又为有余,则当清肃下行而不喘,以其火入于肺,衰与不
足而为喘焉。故言盛者,非言肺气盛也,言肺中之火盛也;言有余者,非言肺气有余也,言
肺中之火有余也。故泻肺以苦寒之剂,非泻肺也,泻肺中之火,实补肺气也,用者不可不知
。
丹溪曰∶喘急者,气为火所郁而为,痰在肺胃间也。有痰者,有火炎者,有阴虚自小腹
下起而上逆者,有气虚而致气短者,有水气乘肺者,有肺虚挟寒而喘者,有肺实挟热而喘者
,有惊忧气郁肺胀而喘者,有胃络不和而喘者,有肾气虚损而喘者。虽然,未有不由痰火内
郁,风寒外束而致之者也。
璇玑、气海、膻中、期门。
背中骨节第七椎下穴,灸三壮,喘气立已,神效。
贞元饮(新补十九) 六安煎(新和二) 大补元煎(新补一) 大营煎(新补十四) 小营煎
(新补十五) 六君子汤(补五) 右归饮(新补三) 右归丸(新补五) 大青龙汤(散七) 独参
汤(补三五) 神秘汤(和一三八) 小青龙汤(散八) 圣术煎(新热二五) 生脉散(补五六)
玉女煎(新寒十二) 萝卜子汤(和一三九) 二陈汤(和一) 千缗汤(和九五) 桑白皮汤(寒
五二) 六味地黄汤(补百二十) 抱龙丸(小八五) 导痰汤(和九一) 廓清饮(新和十三)
金水六君煎(新和一) 四七汤(和九七) 四磨饮(和五二) 《金匮》肾气丸(补一二四) 五
虎汤(和一三六) 三拗汤(散七八) 人参白虎汤(寒三) 华盖散(散七九) 滚痰丸(攻七七)
苏子降气汤(和四一) 黄芩半夏汤(散五十) 越婢加半夏汤(散九十)
李东垣说:华佗曾说,气盛则表现为喘促,气减则表现为枯槁;所以《活人书》也说:出现喘促症状是因为气有余。凡是阅读医书文本,必须领会其本意。所谓“盛而为喘”,并不是指肺气盛,所谓“喘为肺气有余”,也不是指气真的有余;这里的“气盛”应当理解为气衰,“有余”应当理解为不足。如果肺气真的旺盛且有余,就应当清肃下行而不会发生喘促,之所以发生喘促,是因为火邪侵入肺中,导致肺气衰弱和不足。所以说“盛”,并非指肺气盛,而是指肺中的火邪盛;说“有余”,并非指肺气有余,而是指肺中的火邪有余。因此,使用苦寒药物泻肺,并不是在泻肺气,而是在泻肺中的火邪,这实际上是在补益肺气,使用者不可不知道这一点。
朱丹溪说:喘急的症状,是由于气被火邪郁结所致,痰停留在肺和胃之间。有的因为有痰,有的因为火炎上,有的因为阴虚从小腹下方向上逆冲,有的因为气虚导致气短,有的因为水气侵犯肺脏,有的因为肺虚兼有寒邪而喘,有的因为肺实兼有热邪而喘,有的因为惊恐忧思导致气机郁滞、肺胀而喘,有的因为胃络不和而喘,有的因为肾气虚损而喘。虽然情况各异,但没有不是由于痰火内郁、风寒外束所导致的。
璇玑穴、气海穴、膻中穴、期门穴。
背部脊柱第七椎节下方的穴位(注:通常指至阳穴或相关督脉穴位),艾灸三壮,喘促气息立刻停止,效果神妙。
贞元饮(新编第十九方) 六安煎(新编第二方) 大补元煎(新编第一方) 大营煎(新编第十四方) 小营煎(新编第十五方) 六君子汤(补益类第五方) 右归饮(新编第三方) 右归丸(新编第五方) 大青龙汤(发散类第七方) 独参汤(补益类第三十五方) 神秘汤(调和类第一百三十八方) 小青龙汤(发散类第八方) 圣术煎(新编热证类第二十五方) 生脉散(补益类第五十六方) 玉女煎(新编寒证类第十二方) 萝卜子汤(调和类第一百三十九方) 二陈汤(调和类第一方) 千缗汤(调和类第九十五方) 桑白皮汤(寒证类第五十二方) 六味地黄汤(补益类第一百二十方) 抱龙丸(小型方剂第八十五方) 导痰汤(调和类第九十一方) 廓清饮(新编调和类第十三方) 金水六君煎(新编调和类第一方) 四七汤(调和类第九十七方) 四磨饮(调和类第五十二方) 《金匮要略》肾气丸(补益类第一百二十四方) 五虎汤(调和类第一百三十六方) 三拗汤(发散类第七十八方) 人参白虎汤(寒证类第三方) 华盖散(发散类第七十九方) 滚痰丸(攻下类第七十七方) 苏子降气汤(调和类第四十一方) 黄芩半夏汤(发散类第五十方) 越婢加半夏汤(发散类第九十方)
Li Dongyuan stated: Hua Tuo said, "Excess manifests as panting, while deficiency manifests as withering." Therefore, the *Ren Shu* (Book of Life) also states, "Panting indicates an excess of Qi." When reading medical texts, one must grasp the original intent. The statement "excess manifests as panting" does not mean that Lung Qi is in a state of physiological excess; nor does "panting indicates Qi excess" imply that Qi is truly abundant. Here, "Qi excess" should be interpreted as Qi deficiency, and "abundance" should be understood as insufficiency. If Lung Qi were genuinely robust and abundant, it would descend clearly and turbidly without causing panting. Panting occurs because Fire pathogenic factors have entered the Lung, leading to a state of weakness and insufficiency in Lung Qi. Thus, when speaking of "excess," it refers not to Lung Qi being excessive, but to Fire within the Lung being excessive; when speaking of "abundance," it refers not to Lung Qi being abundant, but to Fire within the Lung being abundant. Therefore, using bitter-cold herbs to purge the Lung is not purging Lung Qi, but purging the Fire within the Lung, which effectively tonifies Lung Qi. Practitioners must understand this principle.
Zhu Danxi stated: Urgent panting arises from Qi being constrained by Fire, with Phlegm lodged between the Lung and Stomach. Causes include: presence of Phlegm; blazing Fire; Yin deficiency causing reversal rising from below the lower abdomen; Qi deficiency leading to shortness of breath; Water-Qi invading the Lung; Lung deficiency combined with Cold causing panting; Lung excess combined with Heat causing panting; fright and worry causing Qi stagnation and Lung distension leading to panting; disharmony of the Stomach collaterals causing panting; and Kidney Qi deficiency causing panting. Although these presentations vary, none arise without internal constraint of Phlegm-Fire and external binding by Wind-Cold.
Xuanji (Circumference), Qihai (Sea of Qi), Tanzhong (Center of Chest), Qimen (Gate of Liver).
The acupoint located below the spinous process of the seventh thoracic vertebra on the back: moxibustion of three cones (zhuang) stops panting immediately, demonstrating miraculous efficacy.
Zhenyuan Yin (New Supplement 19) Liu'an Jian (New Harmonize 2) Dabu Yuanyuan Jian (New Supplement 1) Daying Jian (New Supplement 14) Xiaoying Jian (New Supplement 15) Liujunzi Tang (Tonify 5) Yougui Yin (New Supplement 3) Yougui Wan (New Supplement 5) Da Qinglong Tang (Disperse 7) Duchen Tang (Tonify 35) Shenmi Tang (Harmonize 138) Xiao Qinglong Tang (Disperse 8) Shengshu Jian (New Heat 25) Shengmai San (Tonify 56) Yunu Jian (New Cold 12) Luobozizi Tang (Harmonize 139) Erchen Tang (Harmonize 1) Qianmin Tang (Harmonize 95) Sangbaipi Tang (Cold 52) Liuwei Dihuang Tang (Tonify 120) Baolong Wan (Small 85) Daotan Tang (Harmonize 91) Kuqing Yin (New Harmonize 13) Jinshui Liujun Jian (New Harmonize 1) Sqi Tang (Harmonize 97) Simo Yin (Harmonize 52) Jinkui Shenqi Wan (from *Jin Gui Yao Lue*, Tonify 124) Wuhu Tang (Harmonize 136) San'ao Tang (Disperse 78) Renshen Baihu Tang (Cold 3) Huagai San (Disperse 79) Guntan Wan (Attack 77) Suzi Jiangqi Tang (Harmonize 41) Huangqin Banxia Tang (Disperse 50) Yebijia Banxia Tang (Disperse 90)