秦子曰∶哮与喘似同,而实异短息。喉中如水鸡声者,乃谓之哮;但张口气急,不能转
息者,谓之喘。《正传》云,哮以声响名,喘以气息言。哮病内伤痰饮,外感风寒,合而成
【哮病之症】短息倚肩,不能仰卧,伛偻伏坐,每发六七日,轻则三四日,或一月,或
半月,起居失慎,则旧病复发,此哮病之症也。
【哮病之因】痰饮留伏,结成窠臼,潜伏于内,偶有七情之犯,饮食之伤,或外有时令
之风寒,束其肌表,则哮喘之症作矣。
【哮病之脉】多见沉弦,沉数痰火,沉涩湿痰,沉迟寒饮,沉结顽痰。
【哮病之治】身发热者,外有感冒,先解表,前胡苏子饮、防风泻白散,佐以化痰之药
。身无热,无外邪者,消痰理气为主,二陈汤、三子养亲汤、小半夏汤。伏痰留饮,结成窠臼,控
涎丹、滚痰丸,量情选用,然必气壮人乃可。
前胡苏子饮
前胡 苏子 枳壳 半夏 橘红 桔梗 甘草
伤风加防风 伤热,加薄荷、石膏。伤寒,加麻黄。身痛,加羌活。口干燥,
加葛根。嗽不止,加桑白皮。
防风泻白散
防风 桑白皮 地骨皮 甘草
二陈汤 见湿痰门。
三子养亲汤 见食积痰门。
小半夏汤 见支饮门。
控涎丹
甘遂 大干 白芥子
滚痰丸 见悬饮门。
哮症乃肺胃二经,痰火盘结,以其发作,则喉中有声,故知其病在肺。发作则不能饮食
,故知其胃亦病。痰火伏结肺胃,外邪一束肌表,其病即发。发时如有表邪,用荆防泻白散,先
散外邪。若痰涎壅盛,加枳桔半夏。病去之后,宜节齐化痰丸,加枳壳,半夏,兼治肺胃。
夫化痰丸,化肺痰,今兼二陈,则化胃痰。若大便硬者,加玄明粉,合指迷丸,兼化大肠之
秦子说:哮病与喘病看似相同,但实际上不同。呼吸短促,喉咙中发出像水鸡(青蛙)一样的叫声的,叫做哮;只是张口呼吸、气急,不能顺畅换气的,叫做喘。《正传》中说,哮是以声音命名的,喘是以气息状态描述的。哮病的成因是内伤痰饮和外感风寒,两者结合而形成的。
【哮病的症状】呼吸短促,需要倚靠肩膀呼吸,不能仰卧,弯腰伏坐,每次发作持续六七天,轻则三四天,或者一个月,或者半个月。如果起居不慎,旧病就会复发,这就是哮病的症状。
【哮病的病因】痰饮留滞潜伏,结成巢穴,潜伏在体内。偶尔受到七情(喜、怒、忧、思、悲、恐、惊)的侵犯,饮食的伤害,或者外有时令之风寒束缚肌表,那么哮喘的症状就会发作。
【哮病的脉象】多见沉弦脉。沉数脉主痰火,沉涩脉主湿痰,沉迟脉主寒饮,沉结脉主顽痰。
【哮病的治疗】身体发热的,说明外有感冒,先解表,用前胡苏子饮、防风泻白散,佐以化痰的药物。身体无热、无外邪的,以消痰理气为主,用二陈汤、三子养亲汤、小半夏汤。对于潜伏的痰饮,结成巢穴的,用控涎丹、滚痰丸,根据情况选用,但必须是体质强壮的人才能使用。
前胡苏子饮
药材:前胡、苏子、枳壳、半夏、橘红、桔梗、甘草。
若伤风加防风;若伤热,加薄荷、石膏;若伤寒,加麻黄;若身体疼痛,加羌活;若口干燥,加葛根;若咳嗽不止,加桑白皮。
二陈汤 见湿痰门。
三子养亲汤 见食积痰门。
小半夏汤 见支饮门。
滚痰丸 见悬饮门。
哮症乃是肺经和胃经,痰火盘结所致。因为发作时喉中有声音,所以知道病位在肺。发作时不能饮食,所以知道胃也病了。痰火伏结于肺胃,外邪束缚肌表,疾病就会发作。发作时如果有表邪,用荆防泻白散,先疏散外邪。如果痰涎壅盛,加枳壳、桔梗、半夏。病去之后,宜服用节齐化痰丸,加枳壳、半夏,兼治肺胃。夫化痰丸,化肺痰,现在兼用二陈汤,则能化胃痰。如果大便干硬者,加玄明粉,合指迷丸,兼化大肠之痰。
Qin Zi said: Asthma (Xiao) and panting (Chuan) appear similar but are actually different in terms of shortness of breath. When there is a sound in the throat like that of a water chicken (frog), it is called asthma; when one merely opens the mouth to breathe with急促 (rapid) breathing and cannot smoothly exchange air, it is called panting. *Zheng Chuan* states that asthma is named for its sound, while panting is described by its breath condition. The etiology of asthma involves internal injury from phlegm-fluid retention and external contraction of wind-cold, which combine to form...
[Symptoms of Asthma] Shortness of breath requiring leaning on shoulders to breathe, inability to lie supine, stooping and sitting forward. Each attack lasts six or seven days; mild cases last three or four days, or perhaps a month or half a month. If daily life is not managed carefully, the old disease will recur. These are the symptoms of asthma.
[Etiology of Asthma] Phlegm-fluid retention lingers and hides, forming nests, latent within the body. Occasionally, provoked by emotional disturbances (Seven Emotions), dietary injury, or external seasonal wind-cold binding the muscle-surface, the symptoms of asthma and panting arise.
[Pulse of Asthma] Mostly deep-wiry (Chen-Xian). Deep-rapid pulse indicates phlegm-fire; deep-choppy pulse indicates damp-phlegm; deep-slow pulse indicates cold-fluid; deep-knotted pulse indicates stubborn phlegm.
[Treatment of Asthma] For those with fever, indicating external cold-attack, first release the exterior using Qianhu Suzi Yin (Peucedani Root and Perilla Seed Decoction) or Fangfeng Xiebai San (Saposhnikovia Root and White Peony Powder), assisted by herbs that resolve phlegm. For those without fever and no external pathogen, focus on resolving phlegm and regulating qi, using Erchen Tang (Two-Cured Decoction), Sanzi Yangqin Tang (Three-Seed Decoction for Nourishing Parents), or Xiao Banxia Tang (Minor Pinellia Decoction). For latent phlegm-fluid retention forming nests, use Kongxian Dan (Phlegm-Fluid Expelling Pill) or Guntan Wan (Rolling Phlegm Pill), selected according to circumstances; however, these must only be used on patients with strong constitution.
Qianhu Suzi Yin
Herbs: Peucedani Radix (Qianhu), Perillae Fructus (Suzi), Aurantii Fructus Immaturus (Zhiqiao), Pinelliae Rhizoma Preparatum (Banxia), Citri Reticulatae Pericarpium (Juhong), Platycodonis Radix (Jiegeng), Glycyrrhizae Radix et Rhizoma (Gancao).
If affected by wind-addition, add Saposhnikoviae Radix (Fangfeng); if affected by heat, add Menthae Haplocalycis Herba (Bohe) and Gypsum Fibrosum (Shigao); if affected by cold-stagnation, add Ephedrae Herba (Mahuang); if body pain, add Notopterygii Radix et Rhizoma (Qianghuo); if dry mouth/thirst, add Puerariae Radix (Gegen); if cough persists, add Mori Cortex (Sangbaipi).
Fangfeng Xiebai San
Herbs: Saposhnikoviae Radix (Fangfeng), Mori Cortex (Sangbaipi), Lycii Cortex (Digupi), Glycyrrhizae Radix et Rhizoma (Gancao).
Erchen Tang See Damp-Phlegm Section.
Sanzi Yangqin Tang See Food-Stagnation-Phlegm Section.
Xiao Banxia Tang See Branch-Fluid Retention Section.
Kongxian Dan
Herbs: Kansui Radix (Gansui), Euphorbiae Pekinensis Radix (Daji), Sinapis Albae Semen (Baijiezi).
Guntan Wan See Suspended-Fluid Retention Section.
Asthma syndrome arises from phlegm-fire coiling and knotting in the Lung and Stomach meridians. Because sounds occur in the throat during attacks, we know the pathology lies in the Lung. Because eating and drinking are impossible during attacks, we know the Stomach is also diseased. When phlegm-fire is latent and knotted in the Lung and Stomach, and external pathogens bind the muscle-surface, the disease manifests. If exterior pathogens are present during an attack, use Jingfang Xiebai San (Schizonepeta and Saposhnikovia Powder) to first disperse the exterior pathogens. If phlegm-saliva is abundant and obstructing, add Aurantii Fructus Immaturus (Zhiqiao), Platycodonis Radix (Jiegeng), and Pinelliae Rhizoma Preparatum (Banxia). After the illness subsides, one should take Jieqi Huatan Wan (Regulate Qi Resolve Phlegm Pill), adding Aurantii Fructus Immaturus (Zhiqiao) and Pinelliae Rhizoma Preparatum (Banxia) to treat both Lung and Stomach. Huatan Wan resolves Lung phlegm; now combined with Erchen Tang, it also resolves Stomach phlegm. If stool is hard, add Mirabilite (Xuanmingfen) and combine with Zhimi Wan (Point-to-Mistake Pill) to simultaneously resolve Large Intestine phlegm.