风寒客肺杏苏先,痰热凉膈白虎煎,泄泻声微参术剂,倒靥作喘归茸痊。
【注】五脏之气皆统于肺,若为邪干,则肺气窒塞,气道不利,故发为喘也。实者,声
粗有力而长;虚者,声微无力而短。痘初发热,以至既出之后,或喷嚏频频,或鼻流清
水,此风寒客肺而喘也,杏苏饮主之。有食热痰积,上冲作喘者,此火炎肺金也,宜凉
膈白虎汤治之。泄泻后元气下陷,此脾气不足而喘也,人参白术散主之。有痘浆灌至半
足,忽倒靥而喘者,此中气大亏也,参归鹿茸汤主之。
杏苏饮
苏叶 枳壳(麸炒) 桔梗 葛根 前胡 陈皮 甘草(生) 半夏(姜炒)
杏仁(炒,去皮、尖) 茯苓
引用生姜,水煎服。
【方歌】杏苏饮治肺伤风,苏叶枳桔葛根从,前胡陈皮生甘草,半夏杏仁白茯苓。
凉膈白虎汤
薄荷 连翘(去心) 石膏(生) 知母(生) 黄芩 甘草(生) 栀子 大黄 朴硝
引用粳米,水煎服。
【方歌】凉膈白虎治火喘,薄荷连翘共石膏,知母黄芩生甘草,栀子大黄配朴硝。
人参白术散
藿香 白术(土炒) 葛根 木香(煨) 甘草(炙) 白茯苓 人参
引用生姜,水煎服。
【方歌】脾虚白术散如神,藿香白术共葛根,木香甘草茯苓配,人参加入扶元真。
参归鹿茸汤(方见灌浆证治)
风寒之邪侵袭肺脏导致的喘证,应首选杏苏饮;痰热内蕴引起的喘证,宜用凉膈白虎汤;因泄泻导致声音微弱、元气下陷的喘证,用人参白术散治疗;痘疹出现倒靥(痘疮塌陷不起)并伴有喘证的,用参归鹿茸汤治愈。
【注】五脏之气都由肺所统摄,如果受到邪气干扰,就会导致肺气窒塞,气道不畅,从而引发喘证。实证表现为呼吸声粗重有力且长;虚证表现为呼吸声微弱无力且短。痘疹刚开始发热,直到出疹之后,如果出现频繁打喷嚏或鼻流清涕,这是风寒客于肺脏引起的喘证,主方为杏苏饮。如果有食积化热、痰浊积聚,向上冲逆引起喘证的,这是火邪刑克肺金的表现,适宜用凉膈白虎汤治疗。泄泻之后元气下陷,这是脾气不足引起的喘证,主方为人参白术散。有的痘疹浆液灌满至足部一半时,突然发生倒靥并伴随喘证,这是中气严重亏损的表现,主方为参归鹿茸汤。
杏苏饮
组成:紫苏叶、枳壳(麸炒)、桔梗、葛根、前胡、陈皮、甘草(生用)、半夏(姜炒)、杏仁(炒,去皮尖)、茯苓。
用法:引用生姜,水煎服。
【方歌】杏苏饮治肺伤风,苏叶枳桔葛根从,前胡陈皮生甘草,半夏杏仁白茯苓。
凉膈白虎汤
组成:薄荷、连翘(去心)、石膏(生用)、知母(生用)、黄芩、甘草(生用)、栀子、大黄、朴硝。
用法:引用粳米,水煎服。
【方歌】凉膈白虎治火喘,薄荷连翘共石膏,知母黄芩生甘草,栀子大黄配朴硝。
人参白术散
组成:藿香、白术(土炒)、葛根、木香(煨)、甘草(炙)、白茯苓、人参。
用法:引用生姜,水煎服。
【方歌】脾虚白术散如神,藿香白术共葛根,木香甘草茯苓配,人参加入扶元真。
参归鹿茸汤(方剂见“灌浆证治”章节)
For asthma caused by wind-cold invading the Lung, Xing Su Yin (Apricot and Perilla Decoction) should be used first; for asthma caused by phlegm-heat accumulation, Liang Ge Bai Hu Tang (Cool the Diaphragm and White Tiger Decoction) is suitable; for asthma with a faint voice due to diarrhea and sinking of Yuan Qi (Original Qi), Ren Shen Bai Zhu San (Ginseng and Atractylodes Macrocephala Powder) is prescribed; for asthma accompanied by dae zhen dao ye (inversion of pustules where they collapse instead of rising), Can Gui Lu Rong Tang (Ginseng, Angelica, and Deer Antler Decoction) cures it.
[Note] The Qi of the five Zang organs is all governed by the Lung. If disturbed by pathogenic factors, Lung Qi becomes obstructed, and the airway is not smooth, thus causing asthma. Excess patterns manifest as coarse, forceful, and long breath sounds; deficiency patterns manifest as faint, weak, and short breath sounds. When dae zhen (smallpox/variolae) first begins to fever, or after the rash has erupted, if there are frequent sneezes or clear nasal discharge, this is asthma caused by wind-cold in the Lung, primarily treated with Xing Su Yin. If food heat and phlegm accumulation rush upward causing asthma, this is Fire insulting Metal (the Lung), and Liang Ge Bai Hu Tang is appropriate. After diarrhea, when Yuan Qi sinks, this is asthma caused by Spleen Qi deficiency, primarily treated with Ren Shen Bai Zhu San. In cases where the pustules fill halfway to the feet but suddenly invert (collapse) and cause asthma, this is a severe depletion of Middle Qi, primarily treated with Can Gui Lu Rong Tang.
Xing Su Yin (Apricot and Perilla Decoction)
Ingredients: Perillae Folium (Suye), Aurantii Fructus (Zhike, stir-bran fried), Platycodonis Radix (Jiegeng), Puerariae Radix (Gegen), Peucedani Radix (Qianhu), Citri Reticulatae Pericarpium (Chenpi), Glycyrrhizae Radix et Rhizoma (Sheng Gancao, raw), Pinelliae Rhizoma (Banxia, ginger-fried), Armeniacae Semen Amarum (Xingren, stir-fried, skin and tip removed), Poria (Fuling).
Usage: Use fresh Ginger as an adjuvant, decoct in water and take orally.
[Formula Song] Xing Su Yin treats Lung injury by wind, Suye, Zhike, Jiegeng, and Gegen follow, Qianhu, Chenpi, and raw Gancao, Banxia, Xingren, and white Fuling combine.
Liang Ge Bai Hu Tang (Cool the Diaphragm and White Tiger Decoction)
Ingredients: Menthae Haplocalycis Herba (Bohe), Forsythiae Fructum (Lianqiao, heart removed), Gypsum Fibrosum (Sheng Shigao, raw), Anemarrhenae Rhizoma (Sheng Zhimu, raw), Scutellariae Radix (Huangqin), Glycyrrhizae Radix et Rhizoma (Sheng Gancao, raw), Gardeniae Fructum (Zhizi), Rheomi Radix et Rhizoma (Dahuang), Natrii Sulfas (Puxiao).
Usage: Use Oryzae Semen (Jingmi) as an adjuvant, decoct in water and take orally.
[Formula Song] Liang Ge Bai Hu treats Fire-induced asthma, Bohe and Lianqiao share Shigao, Zhimu and Huangqin with raw Gancao, Zhizi and Dahuang paired with Puxiao.
Ren Shen Bai Zhu San (Ginseng and Atractylodes Macrocephala Powder)
Ingredients: Agastachis Herba (Huoxiang), Atractylodis Macrocephalae Rhizoma (Baizhu, earth-stir-fried), Puerariae Radix (Gegen), Aucklandiae Radix (Muxiang, baked), Glycyrrhizae Radix et Rhizoma (Zhi Gancao, honey-fried), Poria (Baifuling), Ginseng (Renshen).
Usage: Use fresh Ginger as an adjuvant, decoct in water and take orally.
[Formula Song] For Spleen deficiency, Baizhu San is miraculous, Huoxiang and Baizhu share Gegen, Muxiang, Gancao, and Fuling pair, Ginseng added to support true Yuan Qi.
Can Gui Lu Rong Tang (Ginseng, Angelica, and Deer Antler Decoction) (See formula in "Gu Jiang Zheng Zhi" chapter)