秦子曰∶短气者,气短不能相续,呼吸慢而不流利,较之喘症而无促喝,若促促喝喝,
喘息抬肩,呼吸便利,则谓之喘而非短气矣。
【外感短气之症】身发寒热,呼吸不利,短息出入,似喘而不急促,此外邪壅滞之症也
【外感短气之因】感冒六淫之邪,初入肌表,传入于里,郁结不散,阻绝阴阳之道路,
则呼吸壅塞,而成短气,息不得接续矣。
【外感短气之脉】脉见浮紧,太阳寒邪。脉见洪数,乃是风热。脉若躁疾,燥邪所伤。
寸口脉大,邪壅于肺。右关弦长,邪在阳明;左关弦急,肝胆邪逆。
【外感短气之治】冒寒者,三拗汤。冒风者,防风泻白散。伤燥热,石膏泻白散、清肺
饮。脉促结,应宣通。脉沉伏,当升散。
三拗汤 见风痰门。
防风泻白散 即泻白散加防风。
石膏泻白散 即泻白散加石膏。
清肺饮
黄芩 山栀 薄荷 桔梗 甘草 连翘 杏仁 桑白皮 枳壳
大便结,加大黄。脉数口渴,加石膏、知母。
【实邪短气之症】身无寒热,短气不足以息,呼吸不利,喘息倚肩,胁肋作痛,不得仰
卧,其形似肿,此实邪短气之症也。
【实邪短气之因】或膏粱积热,或水饮停留,干碍清道,则实邪短气之症作矣。
【实邪短气之脉】或见沉伏,或见沉滑,或见沉弦,或见促结,脉不弦紧,乃为支饮。
【实邪短气之治】《金匮》云∶短气有微饮,当从小便去之,桂苓术甘汤主之,肾气丸
亦主之
饮也。又云∶咳逆倚肩,不得卧,小青龙汤,此治带表症者。以上《金匮》治痰饮停积诸经
之治也。若膏粱积热者,浓朴大黄汤。肝火上冲者,龙胆泻肝汤。肺热喘逆者,泻白散加知
母、石膏。胃火上升者,栀连二陈汤。水饮胁痛短气,名悬饮,十枣汤主之。
桂苓术甘汤
肾气丸 俱见痰饮门。
葶苈大枣汤 见支饮门。
小青龙汤 见悬饮门。
浓朴大黄汤 见支饮门。
龙胆泻肝汤 见内火喘门。
泻白散 见哮症。
栀连二陈汤 见湿痰门。
十枣汤 见悬饮门。
秦子说:短气,是指气息短促、不能连续接续,呼吸缓慢且不流利。与喘症相比,短气没有急促呼喝的表现;如果呼吸急促、喘息时耸肩抬臂、呼吸通畅但急促,则称为喘,而不是短气。
【外感短气的症状】身体出现恶寒发热,呼吸不畅,气息短浅出入,似有喘息但并不急促,这是外邪壅滞导致的病症。
【外感短气的病因】感受风、寒、暑、湿、燥、火六淫之邪,初起侵犯肌表,进而传入体内,郁结不散,阻绝了阴阳之气运行的道路,导致呼吸壅塞,形成短气,气息无法接续。
【外感短气的脉象】脉象浮紧,为太阳经受寒邪所致;脉象洪数,是风热之邪所致;脉象躁动疾速,是燥邪所伤;寸口脉大,说明邪气壅滞在肺;右关脉弦长,说明邪气在阳明经;左关脉弦急,说明肝胆邪气上逆。
【外感短气的治疗】受寒者,用三拗汤(San'ao Tang, Three-Emergence Decoction)。受风者,用防风泻白散(Fangfeng Xiebai San, Sap-Bark Decoction with Fangfeng)。伤于燥热者,用石膏泻白散(Shigao Xiebai San, Sap-Bark Decoction with Gypsum)或清肺饮(Qingfei Yin, Lung-Clearing Drink)。脉象促结者,应当宣通肺气;脉象沉伏者,应当升散发散。
三拗汤 见风痰门(Wind-Phlegm Section)。
防风泻白散 即泻白散加防风(Fangfeng, Saposhnikiae Radix)。
石膏泻白散 即泻白散加石膏(Gypsum Fibrosum)。
清肺饮
黄芩(Scutellariae Radix)、山栀(Gardeniae Fructus)、薄荷(Menthae Haplocalycis Herba)、桔梗(Platycodonis Radix)、甘草(Glycyrrhizae Radix et Rhizoma)、连翘(Forsythiae Fructus)、杏仁(Armeniacae Semen Amarum)、桑白皮(Mori Cortex)、枳壳(Aurantii Fructus Immaturus)。
大便干结者,加大黄(Rhei Radix et Rhizoma)。脉数口渴者,加石膏、知母(Anemarrhenae Rhizoma)。
【实邪短气的症状】身体无恶寒发热,短气不足以息,呼吸不畅,喘息时需倚靠肩膀,胁肋部疼痛,不能仰卧,形体看似浮肿,这是实邪导致的短气症状。
【实邪短气的病因】或是由于膏粱厚味积热,或是水饮停留体内,干扰阻碍了清阳之道,从而引发实邪短气。
【实邪短气的脉象】脉象可见沉伏、沉滑、沉弦或促结,若脉不弦紧,则为支饮(Branchy Fluid Retention)。
【实邪短气的治疗】《金匮要略》说:短气伴有轻微水饮,应当通过小便排出,主方用桂苓术甘汤(Guiling Zhugan Tang, Cinnamon-Poria-Atractylodes-Glycyrrhiza Decoction),肾气丸(Shenqi Wan, Kidney Qi Pill)也可主治此类水饮。又说:咳嗽气逆、倚肩呼吸、不能平卧者,用小青龙汤(Xiaoqinglong Tang, Minor Blue Dragon Decoction),这是治疗兼有表证的情况。以上均为《金匮要略》中治疗痰饮停积各经的方法。若是膏粱积热者,用浓朴大黄汤(Nongpo Dahuang Tang, Magnolia Bark and Rhubarb Decoction)。肝火上冲者,用龙胆泻肝汤(Longdan Xiegan Tang, Gentian Liver-Draining Decoction)。肺热喘逆者,用泻白散加知母、石膏。胃火上升者,用栀连二陈汤(Zhilian Erchen Tang, Gardenia and Coptis Two-Chen Decoction)。水饮导致胁痛短气,名为悬饮(Hanging Fluid Retention),主方用十枣汤(Shizao Tang, Ten Dates Decoction)。
桂苓术甘汤 见痰饮门(Phlegm-Fluid Section)。
肾气丸 俱见痰饮门。
葶苈大枣汤(Tingli Dazao Tang, Lepidium Seed and Jujube Decoction) 见支饮门。
小青龙汤 见悬饮门。
浓朴大黄汤 见支饮门。
龙胆泻肝汤 见内火喘门(Internal-Fire Panting Section)。
泻白散 见哮症(Wheezing Syndrome)。
栀连二陈汤 见湿痰门(Damp-Phlegm Section)。
十枣汤 见悬饮门。
Qin Zi said: Shortness of breath (Duǎnqì) refers to short, non-continuous breathing, where respiration is slow and unsmooth. Compared to panting (Chuǎn), shortness of breath lacks rapid, gasping exhalations; if one breathes rapidly, lifts the shoulders while panting, and has smooth but hurried respiration, it is called panting, not shortness of breath.
[Symptoms of Exogenous Shortness of Breath] The body presents with aversion to cold and fever, respiratory difficulty, shallow and irregular breathing, resembling panting but without urgency. This is a condition caused by the stagnation of external pathogens.
[Etiology of Exogenous Shortness of Breath] Contracting the six excesses (Liùyín, Six External Pathogens: Wind, Cold, Summerheat, Dampness, Dryness, Fire), which initially invade the muscle and skin layer, then transmit inward, becoming stagnant and unresolved. This obstructs the pathways of Yin and Yang, leading to respiratory congestion, resulting in shortness of breath where breath cannot be continuous.
[Pulse of Exogenous Shortness of Breath] A floating and tight pulse indicates Cold pathogen affecting the Taiyang channel. A surging and rapid pulse indicates Wind-Heat. A restless and rapid pulse indicates injury by Dryness pathogen. A large pulse at the Cun Kou position indicates pathogen stagnating in the Lung. A string-like and long pulse at the Right Guan position indicates pathogen in the Yangming channel. A string-like and urgent pulse at the Left Guan position indicates rebellious pathogen in the Liver and Gallbladder.
[Treatment of Exogenous Shortness of Breath] For those affected by Cold, use San'ao Tang (Three-Emergence Decoction). For those affected by Wind, use Fangfeng Xiebai San (Sap-Bark Decoction with Fangfeng). For injury by Dryness-Heat, use Shigao Xiebai San (Sap-Bark Decoction with Gypsum) or Qingfei Yin (Lung-Clearing Drink). If the pulse is choppy and intermitted, one should promote circulation and unblock. If the pulse is deep and hidden, one should raise and disperse.
San'ao Tang See Wind-Phlegm Section.
Fangfeng Xiebai San Is Xiebai San added with Fangfeng (Saposhnikiae Radix).
Shigao Xiebai San Is Xiebai San added with Gypsum (Gypsum Fibrosum).
Qingfei Yin (Lung-Clearing Drink)
Scutellariae Radix (Huangqin), Gardeniae Fructus (Shanzhi), Menthae Haplocalycis Herba (Bohe), Platycodonis Radix (Jiegeng), Glycyrrhizae Radix et Rhizoma (Gancao), Forsythiae Fructus (Lianqiao), Armeniacae Semen Amarum (Xingren), Mori Cortex (Sangbaipi), Aurantii Fructus Immaturus (Zhiqiao).
If stool is constipated, add Rhei Radix et Rhizoma (Dahuang). If the pulse is rapid and there is thirst, add Gypsum (Shigao) and Anemarrhenae Rhizoma (Zhimu).
[Symptoms of Excess Shortness of Breath] The body has no aversion to cold or fever, shortness of breath makes breathing insufficient, respiration is difficult, panting requires leaning on the shoulders, hypochondriac pain occurs, and lying supine is impossible. The form appears swollen. This is the symptom of shortness of breath due to excess pathogens.
[Etiology of Excess Shortness of Breath] It may be due to accumulated heat from rich and greasy food, or retention of fluid-dampness interfering with the clear pathways, thereby triggering shortness of breath due to excess pathogens.
[Pulse of Excess Shortness of Breath] The pulse may appear deep and hidden, deep and slippery, deep and string-like, or choppy and intermitted. If the pulse is not string-like and tight, it is Branchy Fluid Retention (Zhiyin).
[Treatment of Excess Shortness of Breath] The *Jinkui Yaolue* states: "Shortness of breath with slight fluid retention should be eliminated via urination; Guiling Zhugan Tang (Cinnamon-Poria-Atractylodes-Glycyrrhiza Decoction) is the primary formula, and Shenqi Wan (Kidney Qi Pill) also treats this type of fluid retention." It further states: "Coughing, rebellion of qi, leaning on shoulders, inability to lie flat, treated with Xiaoqinglong Tang (Minor Blue Dragon Decoction); this treats cases with exterior symptoms." The above are treatments for phlegm-fluid retention in various meridians from the *Jinkui Yaolue*. For accumulated heat from rich food, use Nongpo Dahuang Tang (Magnolia Bark and Rhubarb Decoction). For Liver Fire rushing upward, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction). For Lung Heat causing panting and rebellion, use Xiebai San added with Anemarrhenae Rhizoma and Gypsum. For Stomach Fire rising, use Zhilian Erchen Tang (Gardenia and Coptis Two-Chen Decoction). For water-retention causing hypochondriac pain and shortness of breath, named Hanging Fluid Retention (Xuanyin), the primary formula is Shizao Tang (Ten Dates Decoction).
Guiling Zhugan Tang See Phlegm-Fluid Section.
Shenqi Wan Both see Phlegm-Fluid Section.
Tingli Dazao Tang (Lepidium Seed and Jujube Decoction) See Branchy Fluid Retention Section.
Xiaoqinglong Tang See Hanging Fluid Retention Section.
Nongpo Dahuang Tang See Branchy Fluid Retention Section.
Longdan Xiegan Tang See Internal-Fire Panting Section.
Xiebai San See Wheezing Syndrome.
Zhilian Erchen Tang See Damp-Phlegm Section.
Shizao Tang See Hanging Fluid Retention Section.