大意
诸病喘满。皆属于热。（内经）故病寒则气衰而息微。病热则气盛而息粗。（河间）盛则为喘。减则为枯。（华佗）盛
者肺中之火邪盛也。减者肺中之元气衰也。（汇补）
内因
肺居五脏之上。升降往来。无过不及。或六淫七情之所伤。或食饱碍气之为病。由是呼吸之气。不得宣畅
而生喘。（汇补）
外候
气喘者。呼吸急促。无痰而有声。痰喘者。喘动有痰而有声。火喘者。乍进乍退。得食则减。食已大发。水喘者。
辘辘有声。怔忡浮肿。此有余之喘也。气虚喘者。呼吸急促。不能接续。胃虚喘者。抬肩撷肚。饮食不进。阴虚
喘者。气从脐下直冲清道。此不足之喘也。（汇补）
喘分虚实
虚者。气乏身凉。冷痰如冰。实者。气壮胸满。身热便硬。（入门）
短气分辨
若夫少气不足以息。呼吸不相接续。出多入少。名曰气短。气短者。气微力弱。非若喘症之气粗奔迫也。（汇补）
死候
发汗如油。汗出如珠。抬肩撷肚。直视谵语。鼻煽口开。及胸前高起。脉络散张。手足厥冷。脉散及数者死。
（入门）
脉法
脉滑手足温者生。脉涩四肢寒者死。脉宜浮迟。不宜急数。（脉经）上气脉数。身热不得卧者死。上气面浮。脉
浮大者死。右寸脉实而紧。为肺感寒邪。亦有六脉沉伏者。并宜发散。则热退喘止。（汇补）
治法
外邪则散之。气郁则开之。痰则豁之。火则清之。停饮者吐之。脾虚者温之。气虚而火入于肺者。补气为先。
阴虚而火来乘金者。壮水为亟。水寒火不归经者。导龙入海。肾虚水邪泛溢者。逐水下流。（汇补）
用药
主以二陈汤。加桔梗、枳壳、苏子等。寒郁。加麻黄、杏仁。风痰。加南星。火痰。加黄连、山栀。水气。加猪苓、
泽泻。胃虚。四君子汤。肾经阴虚。六味地黄汤。阳虚。安肾丸。妇人产后。及跌扑损伤。瘀血入肺喘者。二味参苏饮。
脾肾两虚。观音应梦散。或参胡汤、八味丸。凡喘盛。不可用苦寒。以火盛故也。
喘病选方
二陈汤 统治喘病。为其能顺气和中化痰也。（方见痰症）
安肾丸 治肾虚水涸。气孤阳浮致喘者。
肉桂（五两） 破故纸 山药 石斛 白术 茯苓
肉苁蓉 萆 巴戟 蒺藜 桃仁（各十五两） 川乌（炮去皮脐五两）
蜜丸。空心。温酒或盐汤服。
二味参苏饮 治产后瘀血入肺。咳嗽喘急。
人参（一两） 苏木（二两）
若口鼻气急黑色者。加附子救之。如愈后。即服六君子汤为妙。
三拗汤 治风寒郁闭。喘促不得息。
麻黄（一钱） 杏仁（七粒） 甘草（五分）
水煎。热服取汗。
应梦散 治肾气烦冤。喘促不得卧。
人参（一两） 胡桃肉（二枚连衣） 生姜（五片） 大枣（二枚）
水煎。临卧服。
千缗汤 治风痰上喘。
半夏（七枚） 皂荚（一寸） 甘草（一寸）
合导痰汤同煎更效。
苏子降喘汤
苏子（炒捣碎） 杏仁 桑皮 前胡 橘皮 半夏 桔梗（各一钱） 甘草（四分）
水煎。
五味子汤 治胃虚喘促。脉伏而数者。
五味子（二钱） 人参 麦冬 杏仁 陈皮（各二钱半） 生姜（三片） 大枣（三枚）
水煎服。
四君子汤 治胃虚气弱。水气上乘作喘。（方见中风）
参胡汤 治喘急随绝者。余屡用之有效。功不可尽述。
人参（二钱） 胡桃肉（二枚不去衣膈）
水煎服。
八味丸（方见中风） 越婢加半夏汤（方见咳嗽）
华盖散 治风寒致哮。
麻黄 紫苏 杏仁 桑皮 赤茯苓 橘红 甘草
加姜煎。
参苏温肺汤
人参 肉桂 甘草 木香 五味 陈皮 半夏 桑皮 白术 紫苏（各五钱） 茯苓（三分）
冬月加麻黄。
劫法
椒目研极细末。姜汤调下二钱。未效再服。俟喘止后。分痰分火治之。
【大意】
各种疾病出现喘息胀满的症状，大多属于热证。（出自《内经》）所以患病为寒时，正气衰弱而呼吸微弱；患病为热时，正气亢盛而呼吸粗重。（出自刘河间）正气亢盛则表现为喘，正气衰减则表现为枯槁。（出自华佗）所谓“盛”，是指肺中的火邪亢盛；所谓“减”，是指肺中的元气衰败。（出自《证治汇补》）
【内因】
肺位于五脏之上，负责气的升降往来，既不能太过也不能不及。如果受到六淫（风、寒、暑、湿、燥、火）或七情（喜、怒、忧、思、悲、恐、惊）的损伤，或者因为饮食过饱阻碍了气机的运行从而致病，导致呼吸之气不能宣通畅达，进而产生喘息。（出自《证治汇补》）
【外候】
气喘病，表现为呼吸急促，没有痰液但有声音；痰喘病，喘息时伴有痰液且有声音；火喘病，症状忽轻忽重，进食后减轻，吃完饭后大发作；水喘病，喉咙间辘辘有声，伴有心悸怔忡和浮肿。这些属于有余（实证）的喘息。气虚喘息，表现为呼吸急促，气息不能接续；胃虚喘息，表现为抬肩撷肚（耸肩缩腹），饮食不进；阴虚喘息，表现为气从脐下直冲咽喉清道。这些属于不足（虚证）的喘息。（出自《证治汇补》）
【喘分虚实】
虚证：气力匮乏，身体发凉，冷痰如冰一样寒冷。实证：气壮胸满，身体发热，大便干硬。（出自《医宗入门》）
【短气分辨】
至于少气不足以息，呼吸不能接续，呼多吸少，这叫做气短。气短的人，气息微弱力量弱，不像喘症那样气息粗重奔迫。（出自《证治汇补》）
【死候】
出汗像油一样粘腻，汗出如珠粒状，抬肩撷肚，直视不瞬且胡言乱语，鼻翼煽动口张不开，以及胸前高起，脉络散乱张开，手足厥冷，脉象散乱及数者，均为死证。（出自《医宗入门》）
【脉法】
脉滑且手足温暖者生；脉涩且四肢寒冷者死。脉象宜浮迟，不宜急数。（出自《脉经》）上气病脉数，身体发热不能卧倒者死；上气病面色浮肿，脉象浮大者死。右寸脉实而紧，是肺感受寒邪，也有六脉沉伏的情况，都适宜用发散法治疗，则热退喘止。（出自《证治汇补》）
【治法】
外邪所致则用发散法；气郁所致则用开郁法；痰阻所致则用豁痰法；火盛所致则用清热法；停饮所致则用吐法；脾虚所致则用温补法。气虚而火入于肺者，以补气为先；阴虚而火来乘金（克伐肺金）者，以壮水（滋阴）为急务；水寒火不归经者，需导龙入海（引火归元）；肾虚水邪泛溢者，需逐水下流。（出自《证治汇补》）
【用药】
主方使用二陈汤（Danchen Tang, Two-Cured Decoction），加桔梗、枳壳、苏子等。寒郁者，加麻黄、杏仁；风痰者，加天南星；火痰者，加黄连、山栀；水气者，加猪苓、泽泻；胃虚者，用四君子汤（Sijunzi Tang, Four Gentlemen Decoction）；肾经阴虚者，用六味地黄汤（Liuwei Dihuang Tang, Six-Ingredient Rehmannia Decoction）；阳虚者，用安肾丸（Anshen Wan, Kidney-Anchoring Pill）；妇人产后及跌扑损伤，瘀血入肺致喘者，用二味参苏饮（Erwei Rensu Yin, Two-Ingredient Ginseng and Sappanwood Decoction）；脾肾两虚者，用观音应梦散（Guanyin Yingmeng San, Guanyin’s Dream-Fulfilling Powder）或参胡汤（Shenhutang, Ginseng and Bupleurum Decoction）、八味丸（Bawei Wan, Eight-Ingredient Pill）。凡是喘盛者，不可用苦寒药，因为火盛故也。
【喘病选方】
二陈汤 统治各类喘病，因为它能顺气和中化痰。（方剂见痰症章节）
安肾丸 治疗肾虚水涸，气孤阳浮导致喘息者。
肉桂（Cinnamon Twig, Rougui）五两，破故纸（Psoraleae Fructus, Pogostemonis Herba? Note: Traditionally Psoralea corylifolia, here referred to as Poguozhi/Badabizi contextually often Psoralea or Cistanche in some texts, but standard is Psoraleae Fructus. I will use Latin for accuracy if possible, but prompt asks for Latin herb names. Poguozhi is usually Psoraleae Fructus. Let's stick to standard WHO/Latin mapping where clear. Actually, "Po Gu Zi" is Psoraleae Fructus. "Ba Ji Tian" is Morindae Officinalis Radix. "Tao Ren" is Pruni Semen. "Chuan Wu" is Aconiti Radix lateralis preparata.
Ingredients: Rougui (Cortex Cinnamomi), Pogostemonis Herba? No, Po Gu Zi is Psoraleae Fructus. Shanyao (Dioscoreae Rhizoma), Shihu (Dendrobii Caulis), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Rongrong (Cistanches Herba), Bibi (Dioscoreae Hypoglaucae Rhizoma? Or Biji? Text says "Bi". Likely Bi Xie or similar. Given context of kidney, likely Bi Xie Fen Qing Yi Zhu Tang ingredients? But here it lists Ba Ji, Ji Li. "Bi" might be a typo for Bi Xie or just a short form. I will list the Chinese name as extracted). Bajitian (Morindae Officinalis Radix), Jili (Tribuli Fructus), Taoren (Pruni Semen) each fifteen liang; Chuanwu (Aconiti Radix Lateralis Preparata) five liang (processed, skin and core removed).
Made into honey pills, taken on an empty stomach with warm wine or salt water.
二味参苏饮 治疗产后瘀血入肺，咳嗽喘急。
人参（Ginseng Radix, Renshen）一两，苏木（Sappanwood, Sumu）二两。
如果口鼻气急且色黑者，加附子（Aconiti Lateralis Radix Preparata, Fuzi）急救。如果痊愈后，服用六君子汤（Liujunzi Tang, Six-Gentleman Decoction）为佳。
三拗汤 治疗风寒郁闭，喘促不得息。
麻黄（Ephedrae Herba, Mahuang）一钱，杏仁（Armeniacae Semen Amarum, Xingren）七粒，甘草（Glycyrrhizae Radix et Rhizoma, Gancao）五分。
水煎，热服取汗。
应梦散 治疗肾气烦冤，喘促不得卧。
人参一两，胡桃肉（Juglandis Semen, Hetaoren）二枚（连衣），生姜（Zingiberis Rhizoma Recens, Shengjiang）五片，大枣（Jujubae Fructus, Dazao）二枚。
水煎，临睡前服用。
千缗汤 治疗风痰上喘。
半夏（Pinelliae Rhizoma, Banxia）七枚，皂荚（Gleditsiae Fructus, Zaojiao）一寸，甘草一寸。
合导痰汤（Daotan Tang, Phlegm-Resolving Decoction）同煎效果更佳。
苏子降喘汤
苏子（Perillae Fructus, Suzi）炒捣碎，杏仁，桑皮（Mori Cortex, Sangbai Pi），前胡（Peucedani Radix, Qianhu），橘皮（Citri Reticulatae Pericarpium, Chenpi），半夏，桔梗（Platycodonis Radix, Jiegeng）各一钱，甘草四分。
水煎。
五味子汤 治疗胃虚喘促，脉伏而数者。
五味子（Schisandrae Fructus, Wuweizi）二钱，人参，麦冬（Ophiopogonis Radix, Maidong），杏仁，陈皮（Citri Reticulatae Pericarpium, Chenpi）各二钱半，生姜三片，大枣三枚。
水煎服。
参胡汤 治疗喘急随绝者。我屡用之有效，功效不可尽述。
人参二钱，胡桃肉二枚（不去衣膈）。
水煎服。
华盖散 治疗风寒致哮。
麻黄，紫苏（Perillae Folium, Zisu），杏仁，桑皮，赤茯苓（Poria cum Rubro, Chifuling），橘红（Citri Reticulatae Pericarpium Rubrum, Juhong），甘草。
加姜煎。
参苏温肺汤
人参，肉桂，甘草，木香（Aucklandiae Radix, Muxiang），五味（Wuweizi），陈皮，半夏，桑皮，白术，紫苏各五钱，茯苓三分。
冬季加麻黄。
【劫法】
椒目（Zanthoxyli Semen, Jiaomu）研成极细末，姜汤调下二钱。未效再服。待喘止后，再分痰、分火进行治疗。
[General Principle]
Various diseases presenting with panting and fullness generally belong to Heat syndromes. (From *Neijing*) Therefore, when the disease is Cold, vital Qi declines and respiration becomes faint; when the disease is Heat, vital Qi flourishes and respiration becomes coarse. (From Liu Hejian) Flourishing manifests as panting, while decline manifests as withering. (From Hua Tuo) "Flourishing" refers to the flourishing of Fire pathogenic factors in the Lung; "decline" refers to the decline of Original Qi in the Lung. (From *Zhengzhi Huibu*)
[Internal Causes]
The Lung resides above the other five Zang organs, governing the ascending and descending movement of Qi, neither excessive nor deficient. If injured by the Six Exogenous Pathogens (Wind, Cold, Summerheat, Dampness, Dryness, Fire) or the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright), or if obstructed by overeating which hinders Qi mechanism, causing the respiratory Qi to fail to circulate freely, panting arises. (From *Zhengzhi Huibu*)
[External Manifestations]
Panting (Chuan): characterized by rapid breathing, without phlegm but with sound. Phlegm-panting (Tan Chuan): panting accompanied by phlegm and sound. Fire-panting (Huo Chuan): symptoms fluctuate, improving after eating but exacerbating immediately after meals. Water-panting (Shui Chuan): rattling sounds in the throat, accompanied by palpitations and edema. These are excess-type pantings. Qi-deficiency panting: rapid breathing with inability to sustain inhalation. Stomach-deficiency panting: raising shoulders and drawing in the abdomen, with loss of appetite. Yin-deficiency panting: Qi rushing directly from below the umbilicus up the clear passages. These are deficiency-type pantings. (From *Zhengzhi Huibu*)
[Differentiation of Deficiency and Excess in Panting]
Deficiency: lack of Qi, cool body, cold phlegm like ice. Excess: robust Qi, chest fullness, hot body, hard stool. (From *Yizong Rumeng*)
[Differentiation of Shortness of Breath]
When there is insufficient Qi to breathe, respiration cannot continue smoothly, with exhalation exceeding inhalation, this is called Shortness of Breath (Duan Qi). Those with Shortness of Breath have faint Qi and weak strength, unlike the coarse and urgent breath of Panting syndrome. (From *Zhengzhi Huibu*)
[Signs of Death]
Sweat like oil, sweat like pearls, raising shoulders and drawing in the abdomen, fixed gaze and delirious speech, nasal flaring with open mouth, chest protrusion, scattered and distended collaterals, cold extremities, and scattered or rapid pulse indicate death. (From *Yizong Rumeng*)
[Pulse Diagnosis]
Slippery pulse with warm hands and feet indicates survival; choppy pulse with cold limbs indicates death. The pulse should be floating and slow, not rapid and frequent. (From *Maijing*) For Shangqi (Rebellious Qi), rapid pulse with fever and inability to lie down indicates death. Floating face with floating and large pulse indicates death. Solid and tight pulse at the Right Cun position indicates Lung invasion by Cold pathogen; even if all six pulses are deep and hidden, dispersing methods are suitable, leading to resolution of heat and cessation of panting. (From *Zhengzhi Huibu*)
[Therapeutic Methods]
For external pathogens, use dispersing methods; for Qi stagnation, use opening methods; for phlegm, use resolving methods; for Fire, use clearing methods; for retained fluids, use emetic methods; for Spleen deficiency, use warming and tonifying methods. For Qi deficiency with Fire entering the Lung, tonifying Qi is primary; for Yin deficiency with Fire attacking Metal (Lung), nourishing Water (Kidney Yin) is urgent; for Cold Water with Fire not returning to its source, guide the Dragon to the Sea (lead fire back to origin); for Kidney deficiency with overflowing Water pathogen, drain water downwards. (From *Zhengzhi Huibu*)
[Medication]
The main formula is Erchen Tang (Two-Cured Decoction), added with Jiegeng (Platycodon Root), Zhike (Aurantii Fructus Immaturus), and Suzi (Perilla Fruit). For Cold stagnation, add Mahuang (Ephedra Stem) and Xingren (Apricot Seed); for Wind-phlegm, add Nanting (Arisaema Cum Bile); for Fire-phlegm, add Huanglian (Coptis Rhizome) and Shanzhi (Gardenia Fruit); for Water-Qi, add Zhuling (Polyporus) and Zexie (Alisma Rhizome); for Stomach deficiency, use Sijunzi Tang (Four Gentlemen Decoction); for Kidney Meridian Yin deficiency, use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill); for Yang deficiency, use Anshen Wan (Kidney-Anchoring Pill); for postpartum women or trauma patients with Blood stasis entering the Lung causing panting, use Erwei Rensu Yin (Two-Ingredient Ginseng and Sappanwood Decoction); for simultaneous Spleen and Kidney deficiency, use Guanyin Yingmeng San (Guanyin’s Dream-Fulfilling Powder) or Shenhutang (Ginseng and Bupleurum Decoction), Bawei Wan (Eight-Ingredient Pill). In cases of severe panting, bitter-cold herbs should not be used due to existing Fire excess.
[Selected Formulas for Panting]
Erchen Tang (Two-Cured Decoction): Governs various panting syndromes as it harmonizes Qi, moderates the Middle, and resolves phlegm. (See Phlegm Syndrome chapter for formula details)
Anshen Wan (Kidney-Anchoring Pill): Treats panting caused by Kidney deficiency, dryness of Water, isolated Qi, and floating Yang.
Rougui (Cinnamon Bark, Rougui) 5 liang, Poguaizi (Psoralea Fruit, Poguaizi), Shanyao (Chinese Yam Rhizome, Shanyao), Shihu (Dendrobium Stem, Shihu), Baizhu (Atractylodes Macrocephala Rhizome, Baizhu), Fuling (Poria, Fuling), Rongrong (Cistanche Herb, Rongrong), Biji (likely Dioscorea Hypoglauca Rhizome or similar, listed as Biji in text), Bajitian (Morinda Officinalis Root, Bajitian), Jili (Tribulus Fruit, Jili), Taoren (Persica Seed, Taoren) each 15 liang; Chuanwu (Prepared Aconite Lateral Root, Chuanwu) 5 liang (processed, skin and core removed).
Made into honey pills, taken on an empty stomach with warm wine or salt water.
Erwei Rensu Yin (Two-Ingredient Ginseng and Sappanwood Decoction): Treats cough and urgent panting caused by blood stasis entering the Lung postpartum.
Renshen (Ginseng Root, Renshen) 1 liang, Sumu (Sappanwood, Sumu) 2 liang.
If breath is urgent and nose/mouth turn black, add Fuzi (Prepared Aconite Lateral Root, Fuzi) for rescue. After recovery, taking Liujunzi Tang (Six-Gentleman Decoction) is advisable.
San'ao Tang (Three-Uninhibited Decoction): Treats panting and suffocation due to closure by Wind-Cold.
Mahuang (Ephedra Stem, Mahuang) 1 qian, Xingren (Apricot Seed, Xingren) 7 grains, Gancao (Licorice Root, Gancao) 0.5 qian.
Decoct in water, take hot to induce sweating.
Yingmeng San (Dream-Fulfilling Powder): Treats vexation of Kidney Qi and urgent panting preventing lying down.
Renshen 1 liang, Hetaoren (Walnut Kernel, Hetaoren) 2 pieces (with skin), Shengjiang (Fresh Ginger Rhizome, Shengjiang) 5 slices, Dazao (Jujube Fruit, Dazao) 2 pieces.
Decoct in water, take before bedtime.
Qianmin Tang (Thousand-Silk Decoction): Treats upper panting due to Wind-phlegm.
Banxia (Pinellia Tuber, Banxia) 7 pieces, Zaojiao (Gleditsia Fruit, Zaojiao) 1 cun, Gancao 1 cun.
Decoct together with Daotan Tang (Phlegm-Resolving Decoction) for better efficacy.
Suzi Jiangchuan Tang (Perilla Fruit Descending-Panting Decoction)
Suzi (Perilla Fruit, Suzi) stir-fried and crushed, Xingren, Sangbapi (Mulberry Bark, Sangbapi), Qianhu (Peucedanum Root, Qianhu), Chenpi (Tangerine Peel, Chenpi), Banxia, Jiegeng (Platycodon Root, Jiegeng) each 1 qian, Gancao 0.4 qian.
Decoct in water.
Wuweizi Tang (Schisandra Decoction): Treats Stomach deficiency panting with deep and rapid pulse.
Wuweizi (Schisandra Fruit, Wuweizi) 2 qian, Renshen, Maidong (Ophiopogon Root, Maidong), Xingren, Chenpi each 2.5 qian, Shengjiang 3 slices, Dazao 3 pieces.
Decoct in water and take.
Sijunzi Tang (Four Gentlemen Decoction): Treats panting caused by Water-Qi rising due to Stomach deficiency and weak Qi. (See Stroke chapter for formula details)
Shenhutang (Ginseng and Bupleurum Decoction): Treats critical panting nearing cessation. I have used it frequently with good effect; its merits cannot be fully described.
Renshen 2 qian, Hetaoren 2 pieces (skin and septum not removed).
Decoct in water and take.
Bawei Wan (Eight-Ingredient Pill) (See Stroke chapter) Yebishu Jia Banxia Tang (Yebishu plus Arisaema Decoction) (See Cough chapter)
Huagai San (Canopy Powder): Treats asthma induced by Wind-Cold.
Mahuang, Zisu (Perilla Leaf, Zisu), Xingren, Sangbapi, Chifuling (Poria with Red Mycelium, Chifuling), Juhong (Red Tangerine Peel, Juhong), Gancao.
Decoct with Ginger.
Rensu Wenfei Tang (Ginseng and Sappanwood Warming-Lung Decoction)
Renshen, Rougui, Gancao, Muxiang (Aucklandia Root, Muxiang), Wuwei (Wuweizi), Chenpi, Banxia, Sangbapi, Baizhu, Zisu each 5 qian, Fuling 0.3 qian.
Add Mahuang in winter months.
[Emergency Method]
Jiaomu (Zanthoxylum Seed, Jiaomu) ground into extremely fine powder, mixed with Ginger Decoction and taken orally (2 qian). Repeat if ineffective. After panting ceases, treat according to Phlegm or Fire differentiation.