鼻
鼻流清涕不臭有虚有寒之辨。
阳邪入三阳
下消者饮一溲二属肾,尿先浊混,停久则底有膏液。(乃少阴阴水虚不能制火,阳火虚不能化水也。)
上中二消属热,惟下消兼有寒热房痨,其溺出不臭反甜,此肾土之气下泻及溺,面浮如脂者此肾败而精不禁不治。
牙床红肿属阳明症。
呃逆 气自腹中时逆上冲才发于咽喉,连续数声,其声短促不长。
或胃中实热乃失下而作,宜用凉膈而逐热。
或食积壅塞而作者宜消导之。
嗳
乃胃气弱而不和,三焦因之失职,故清无所归而不升,浊无所纳而不降,留恋嗳酸作饱胸膈不爽,宜陈皮竹茹汤主之。
恣饮冷水水寒相搏胃中寒也,
有热气郁于上塞不通。
噫气者胸间气不得下通,无声无物也。因寒气客胃厥逆上行复出于胃故为噫,有伤食噫气臭也。
干呕辨别
呕者表邪入里里气拒格上逆作呕,故为殃,属少阳宜小柴胡汤。
呕症辨列
表不解之呕属太阳,宜桂枝汤。
吐辨
中寒者吐不能食不可而厥吐是虚寒之吐也,宜吴萸连汤理中汤之辈。
经曰呕多阳明症不可攻之。为气逆未收敛为寔也。
呕吐辨
水气呕吐者先渴后呕膈间怔冲 脓血呕吐者喉中腥腥血逆上冲 呕清水不渴者乃胃虚寒
反胃食入即吐名反胃乃热也。出是胃素有热得食热两热相冲用半夏泻心汤主之。
有声无痰乃肺气伤不清;有痰无声嗽也乃脾湿动以为痰;有声有痰咳嗽成脾肺气伤动乎脾湿也。
分患六气病
散寒加味华盖痊。
火嗽面赤咽干燥气秽痰黄带稠粘便软用加味泻白散,便硬者加味凉膈散主之。
肺虚面容淡白痰涎清用二陈汤主之。补肺用阿胶汤。老年虚咳三子养亲汤,真武汤主之。
肝为血海卫任归肝所主其血热充肌肤皮毛,卧则内归于肝,今肝虚不合卫任之血,出于肤腠,肝气从心包络上冲,上冲则先血后咳。肝内伤而包络则虚。心包虚则火冲克肺金,故为咳。心包为血脉,血虚夜则发热,轻则日咳,重则日夜热咳,先伤血后伤气,阴阳并竭,此为虚劳咳嗽。
食积生痰热熏蒸气促痰壅咳嗽频便溏。用曲麦二陈治。便燥苏葶滚痰攻。
气出不能布息实邪也。
气乏不能续息者虚邪也。
若痰饮清冷者寒邪也。
一实寒必挟凝痰宿饮上干阻气。小青龙加朴杏。
一气脱则根浮吸伤元海危可立待。(人参 河车 五味 石英之属)
哮者呼吸气出急促更加喉中有声响者谓之哮。气粗胸满不能布息也。
痰辨
少而粘连咯不易出属肺燥痰也。
搐搦眩晕风痰属肝。
饮辨
四肢身体重痛此饮留四肢行于体曰溢饮。
(完)抄后记: 此本所得似有不尽之处。收集之时只此一本。观文内容当尚有续本。不能尽得诚为可惜。
鼻部病症:
风邪中于卫分,呼气容易而吸气困难(因为气受风邪影响浮散,故呼气流利而难吸入)。
热邪过于深入营分,吸气容易而呼气困难(因为血受热邪煎熬而壅滞,导致气机不得舒展)。
若鼻流清涕且无臭味,需辨别是虚证还是寒证。
口渴症:
阳邪侵入三阴经引起的口渴:太阴经病变则咽干;少阴经病变则口燥;厥阴经病变则出现消渴症状。
阳明病之口渴,使用白虎汤,是因为胃热炽盛,饮水连绵不断所致。
少阴病出现寒热往来等症状,必伴有心烦和口渴,用小柴胡汤去掉半夏,加入天花粉治疗。
三消症:
上消症表现为口渴不止,病位在肺,饮水多但大小便正常。(这是由于心火移热于肺所致)。
中消症表现为进食后即感饥饿,病位在胃,饮水多但小便短赤。(这是由于阳明燥火所致)。
下消症表现为喝一杯水排出两杯尿,病位在肾,尿液先浑浊混浊,放置久了底部有膏状液体沉淀。(这是由于少阴阴水亏虚不能制约火气,同时阳气虚弱不能气化水液所致)。
上消和中消属于热证,只有下消兼有寒热及房劳虚损,其尿液不仅不臭反而甜味,这是肾与脾土之气下泄随尿而出,面色浮肿如脂者,此为肾败精关不固,属于不治之症。
齿痛:
牙齿统属于肾,又分为上下两部分。上部牙齿归属于胃,下部牙齿归属于大肠。
牙床红肿属于阳明经病症。
呃逆:
呃逆是指气从腹中不时逆向上冲,到达咽喉时发出连续数声,声音短促而不长。
如果是食积壅塞所致,宜消食导滞。
以上情况均需用引气下行、降逆、推荡的方法治疗。
若胸膈不利,呃逆从胸部发起,属肺胃不和,可用杏仁、桂枝润肺和胃。
若腹部饱满胀闷,呃逆从腹部发起,属胃气上逆,加甘草、芍药以调和胃气。此段出自《辨证汇篇》卷三。
嗳气:
这是由于胃气虚弱而不和顺,三焦因此失职,导致清气无处归附而不能上升,浊气无处接纳而不能下降,留恋于中焦,产生嗳酸、饱胀感,胸膈不爽,宜用陈皮竹茹汤主治。
哕与干呕相似,但哕的声音浑浊而长,干呕的声音短小而轻,两者都是有声音而没有实物吐出。
或者恣意饮用冷水,水寒之气相搏结,导致胃中寒冷;
或者有热气郁结于上部,阻塞不通。
噫气是指胸间气机不得下行通畅,无声也无物吐出。因寒气客居胃中,厥逆之气上行复出至胃,故称为噫,若是伤食导致的噫气则有臭味。
呕吐:
呕是指既有声音又有实物吐出,且逐渐涌出。
吐是指没有声音但有实物吐出,且突然涌出。
干呕是指只有声音而没有实物吐出。
干呕的辨别:
少阴病见下利而干呕,用姜附汤主治(此处原文“夏利”疑为“下利”之误,结合语境修正)。
呕症,若表邪入里,里气抗拒格拒,气机上逆作呕,故称殃,属少阳病,宜用小柴胡汤。
呕症的鉴别列表:
表邪入里,气机上格:心下硬满且心烦,或不大便,宜用大柴胡汤。
进食谷物欲呕,属胃中寒,宜用吴茱萸汤;进食汤水更呕,属表热,宜用葛根半夏汤。
饮水即呕,或呕吐后又想喝水,饮水与呕吐互为因果,已是停水之证,宜用五苓散。
吐症的辨别:
中寒者呕吐不能进食,四肢厥冷,这是虚寒之吐,宜用吴茱萸连理汤或理中汤之类。
经典记载:呕吐多者为阳明病,不可攻下。因为气逆尚未收敛,并非实证。
呕吐的进一步辨别:
脓血呕吐者,喉中有腥臭味,血逆上冲。
呕酸(有时受风也有此症)与呕苦,均属胃热,治法以疏泄肝气、安和胃气为主。
胃反症表现为早晨吃的食物晚上吐出,晚上吃的食物早晨吐出,宿食不消化,名为胃反,这是由于寒气且无火所致。条辨如下:
三焦无火:若在阳明经则腹胀(用吴茱萸汤);若在太阴经则腹满(用理中汤)。
反胃症表现为食物入口即吐,名为反胃,这是由于热证。这是因为胃素来有热,得食后两热相冲,用半夏泻心汤主治。
咳嗽:
有声无痰,是肺气受伤不清爽;有痰无声,是嗽,由脾湿动而生痰;有声有痰,是咳嗽,成于脾肺气伤且动于脾湿。
大要在于胃浊脾湿,津液不能正常布散,清浊不分,精气四布失常,这是生痰之本,咳嗽之源。
分患六气病:
寒咳:咳嗽频繁,喷嚏,鼻涕鼻塞,唾吐痰涎,用疏风参苏饮主治。
风乘肺咳:汗出,头痛,痰涎不利,用金沸散主治。散寒可加味华盖散痊愈。
火嗽:面赤,咽干燥,口气秽浊,痰黄带稠粘,大便软,用加味泻白散;大便硬者,用加味凉膈散主治。
肺虚:面容淡白,痰涎清稀,用二陈汤主治。补肺用阿胶汤。老年虚咳用三子养亲汤,真武汤主治。
劳咳:
肝为血海,卫气任脉归于肝所主,其血热充养肌肤皮毛,卧则内归于肝。如今肝虚不合卫任之血,出于肤腠,肝气从心包络上冲,上冲则先见血而后咳嗽。肝内伤而心包络则虚。心包虚则火冲克肺金,故为咳。心包为血脉,血虚夜则发热,轻则白天咳,重则日夜热咳,先伤血后伤气,阴阳并竭,此为虚劳咳嗽。
食积生痰:热熏蒸,气促,痰壅,咳嗽频繁,大便溏,用曲麦二陈汤治疗。大便燥结者,用苏葶滚痰丸攻下。
喘症:
喘是指气逆上冲,呼吸急促,谓之喘。
气出而不能布息,是实邪所致。
气乏而不能续息,是虚邪所致。
若痰饮清冷,是寒邪所致。
五脏中,肺气有司权则清肃下行,岂会再为喘?皆因火烁真气,气衰则喘。
一为实热,不外湿伏之邪蒸痰化火,用麻杏甘膏汤或千金苇茎汤治疗。
一为精伤,添精镇摄肾气,根据从阳从阴的不同,选用苏子降气汤等。
一气脱则根浮吸伤元海,危险立待,用人参、紫河车、五味子、石英之类。
哮症:
哮是指呼吸气出急促,更加喉中有声响者,谓之哮。气粗胸满,不能布息。
痰饮:
痰的辨别:
少而粘连,咯不易出,属肺燥痰。
搐搦眩晕,风痰属肝。
饮的辨别:
四肢身体重痛,此饮留四肢行于体,曰溢饮。
肺萎者,干枯萎缩不荣,津液涸竭而肺焦,多因冷寒虚火久停而生。
(完)抄后记:此本所得似有不尽之处。收集之时只此一本。观文内容当尚有续本。不能尽得诚为可惜。
**Lung Disease:** A metallic or pungent taste in the mouth (caused by Lung Qi overflowing upwards).
**Kidney Disease:** A salty taste in the mouth (caused by Kidney fluids rising upwards).
**Stomach Disease:** A bland taste with bad breath in the mouth (caused by Fire-Heat rushing upwards).
**Gallbladder Disease:** Bitter taste in the mouth and dry throat.
**Oral Ulcers and Gingival Rot:** All caused by excessive Fire-Heat in the Heart, Lungs, and Stomach.
**Teeth Grinding:** Belongs to Stomach Heat.
**Chapped Lips:** Mostly belongs to Stomach and Spleen Heat.
**Nasal Disorders:**
When Wind pathogen attacks the Wei (Defensive) level, exhalation is easy but inhalation is difficult (Qi becomes floating due to Wind, making exhalation smooth but inhalation difficult).
When Heat pathogen excessively invades the Ying (Nutritive) level, inhalation is easy but exhalation is difficult (Blood becomes stagnant due to Heat, preventing Qi from extending).
If the Lungs are injured, Wei Qi fails to circulate smoothly, and pathogenic factors obstruct the orifices, leading to breathing difficulties.
If the Spleen and Stomach are damaged, Ying Qi fails to ascend, and pathogenic factors block the apertures, leading to obstruction.
**Bi Yuan (Nasal Polyps/Sinusitis):** Thick, foul-smelling nasal discharge, caused by Damp-Heat in the Lung system.
For yellow nasal discharge, **Fangfeng Tongsheng San** (Saposhnikovia Decoction for Unblocking the Intestines and Releasing the Exterior) is effective.
For clear, odorless nasal discharge, differentiate between Deficiency and Cold patterns.
For turbid nasal discharge that is not dry, the primary formula is **Cang'er San** (Xanthium Powder).
**Thirst:**
Thirst syndromes are mostly caused by damage to body fluids due to excessive sweating, vomiting, or purging, leading to Stomach dryness.
Thirst caused by Yang pathogens invading the Three Yin meridians: Taiyin syndrome causes dry throat; Shaoyin syndrome causes dry mouth; Jueyin syndrome causes Xiao Ke (Wasting-Thirst).
Yang pathogens are Heat, which damages body fluids, thus causing thirst.
**Thirst caused by Yang pathogens invading the Three Yang meridians:**
For thirst in Taiyang syndrome, use **Wuling San** (Five-Ingredient Powder with Poria), because water stagnates in the Lower Jiao causing difficult urination.
For thirst in Yangming syndrome, use **Baihu Tang** (White Tiger Decoction), because Stomach Heat causes continuous drinking.
For Shaoyin syndrome with alternating cold and heat, accompanied by vexation and thirst, use **Xiaochaihu Tang** (Minor Bupleurum Decoction) removing Banxia (Pinellia Rhizome) and adding Huafen (Trichosanthes Root).
**Three Xiao (Wasting-Thirst) Syndromes:**
**Shang Xiao (Upper Wasting-Thirst):** Unrelenting thirst, located in the Lungs, with increased drinking but normal bowel movements. (Caused by Heart Heat transferring to the Lungs).
**Zhong Xiao (Middle Wasting-Thirst):** Hunger immediately after eating, located in the Stomach, with increased drinking but scanty, dark urine. (Caused by Yangming Dryness-Fire).
**Xia Xiao (Lower Wasting-Thirst):** Drinking one part results in urinating two parts, located in the Kidneys. Urine is initially turbid; after standing, a paste-like sediment forms at the bottom. (Caused by Shaoyin Yin Water deficiency failing to control Fire, and Yang Fire deficiency failing to transform Water).
Upper and Middle Xiao belong to Heat patterns. Only Lower Xiao involves both Cold and Heat, along with sexual exhaustion consumptive disease. The urine is not only odorless but sweet-tasting. This indicates the Qi of the Kidney and Earth descending and leaking through the urine. If the face appears puffy like fat, this signifies Kidney failure and uncontrolled essence, which is incurable.
**Toothache:**
Teeth generally belong to the Kidneys but are divided into upper and lower. The upper teeth belong to the Stomach, and the lower teeth belong to the Large Intestine.
Swollen and red gums belong to Yangming syndrome.
Rotting teeth with a tight jaw belong to the Heart and Gallbladder.
Bleeding from the gum roots without swelling indicates Rising Deficient Fire from the Kidney meridian.
**Hiccups:**
Hiccups refer to Qi reversing upward from the abdomen, reaching the throat, producing several consecutive short, abrupt sounds.
If caused by Excess Heat in the Stomach due to failure to purge earlier, use **Liange San** (Cooling the Diaphragm Powder) to eliminate Heat.
If caused by excessive intake of cold medicines leading to Cold deficiency in the Stomach, use warming methods to dispel Cold.
If caused by Phlegm-Fire in the Stomach reversing upward, use methods to open and resolve phlegm.
If caused by fluid retention, use diuretic methods to separate and drain.
If caused by food stagnation blocking the interior, use digestion-promoting methods.
In all cases, use methods to guide Qi downward, descend rebellion, and push out the pathogen.
If there is discomfort in the chest and diaphragm, and hiccups originate from the chest, it indicates Disharmony between the Lungs and Stomach; use Apricot Kernel and Cinnamon Twig to moisten the Lungs.
If there is abdominal fullness and distension, and hiccups originate from the abdomen, it indicates Stomach Qi rebelling upward; add Licorice and White Peony Root to harmonize the Stomach. (From *Bianzheng Huibian*, Volume 3).
**Belching:**
Belching occurs when eating too quickly causes food Qi to reverse upward.
It is due to weak and disharmonious Stomach Qi, causing the Triple Burner to fail in its duties. Thus, Clear Qi has no place to return and cannot ascend, while Turbid Qi has no place to accept and cannot descend. It lingers, causing belching of sour taste, fullness, and chest discomfort. The primary formula is **Chenpi Zhuru Tang** (Tangerine Peel and Bamboo Shavings Decoction).
**Hiccup/Regurgitation (Note: Yi)**
"Hui" (a type of hiccup/regurgitation) resembles dry heaving. "Hui" has a turbid, long sound, while dry heaving has a short, small sound. Both produce sound but no substance.
If Stomach Qi is originally deficient and damaged by excessive sweating or purging, leading to Cold deficiency in the Stomach;
Or if excessive consumption of cold water causes Water-Cold to clash, resulting in Cold in the Stomach;
Or if Heat Qi is constrained in the upper part, causing blockage.
"Yi" (belching/burping) refers to Qi in the chest unable to descend smoothly, with no sound or substance. It occurs because Cold pathogen lodges in the Stomach, causing Jue reversal Qi to rise and exit through the Stomach. If caused by food injury, the belch will have an offensive odor.
**Vomiting:**
"Ou" (vomiting) involves both sound and substance, emerging gradually.
"Tu" (spitting up/vomiting) involves substance without sound, emerging suddenly.
"Gan Ou" (dry heaving) involves sound without substance.
**Differentiation of Dry Heaving:**
Caused by pathogenic factors in the epigastrium, where Heat Qi combines with Grain Qi, reversing upward to the chest.
For Taiyang syndrome with sweating and dry heaving, use **Guizhi Tang** (Cinnamon Twig Decoction).
For Shaoyin syndrome with diarrhea and dry heaving, use **Jiangfu Tang** (Ginger and Aconite Decoction).
For Jueyin syndrome with spitting of saliva/froth and dry heaving, use **Wuzhuyu Tang** (Evodia Decoction); once the pathogen is eliminated, vomiting stops naturally.
"Ou" (vomiting) occurs when exterior pathogen enters the interior, and interior Qi rejects it, causing upward rebellion. This is considered a Shaoyang syndrome, treated with **Xiaochaihu Tang** (Minor Bupleurum Decoction).
**List of Vomiting Differentiations:**
Exterior pathogen entering the interior with Qi rebellion: Hardness below the heart with vexation, or constipation, treated with **Dachaihu Tang** (Major Bupleurum Decoction).
Vomiting due to unresolved exterior syndrome belongs to Taiyang, treated with **Guizhi Tang** (Cinnamon Twig Decoction).
Desire to vomit after eating grains belongs to Stomach Cold, treated with **Wuzhuyu Tang**. Vomiting after drinking soup belongs to Exterior Heat, treated with **Gegen Banxia Tang** (Kudzu and Pinellia Decoction).
Vomiting without diarrhea indicates Qi stagnation belonging to Shaoyin, treated with **Zhenwu Tang** (True Warrior Decoction).
Drinking leads to vomiting, or vomiting leads to desire to drink; these mutually reinforcing symptoms indicate Water Retention, treated with **Wuling San** (Five-Ingredient Powder with Poria).
**Differentiation of Spitting Up:**
Cold invasion causing vomiting, inability to eat, and cold extremities indicates Deficiency-Cold vomiting, treated with **Wuyou Lianli Tang** (Evodia and Coptis Combined Decoction) or **Lizhong Tang** (Regulate the Middle Decoction).
Thirst with ability to eat, followed by vomiting, indicates Fire vomiting.
For Excess Heat, use **Huanglian Jiedu Yin** (Coptis Decoction for Resolving Toxins).
For Deficient Heat, use **Ganjiang Huangqin Huanglian Renshen Tang** (Ginger, Scutellaria, Coptis, and Ginseng Decoction) or **Zhuye Shigao Tang** (Bamboo Leaf and Gypsum Decoction).
Thirst, drinking, then thirst again, indicates Water Rebellion, treated with **Wuling San** (Five-Ingredient Powder with Poria).
The Classics state: Frequent vomiting indicates Yangming syndrome, do not purge. Because Qi is rebellious and not yet gathered, it is not an Excess pattern.
**Further Differentiation of Vomiting:**
Stomach Heat vomiting: Pulse is wiry and rapid, with dry mouth and thirst.
Stomach Cold vomiting: Pulse is wiry and slow, with cold extremities.
Water-Qi vomiting: Thirst precedes vomiting, with palpitations in the diaphragm.
Pus and blood vomiting: Foul smell in the throat, blood reversing upward.
Vomiting clear water without thirst indicates Stomach Deficiency-Cold.
Vomiting sour or bitter tastes (sometimes caused by Wind) belongs to Stomach Heat. Treatment focuses on draining Liver Heat and calming the Stomach.
**Fan Wei (Reverse Stomach / Regurgitation):**
Fan Wei presents as morning food vomited in the evening, or evening food vomited in the morning, undigested. This is called Fan Wei, caused by Cold and lack of Fire. Analysis:
Triple Burner lacks Fire: If in Yangming, there is fullness (treat with **Wuzhuyu Tang**); if in Taiyin, there is abdominal fullness (treat with **Lizhong Tang**).
Fan Wei presenting as immediate vomiting upon ingestion is due to Heat. This is because the Stomach already has Heat, and upon eating, the two heats clash. Treat with **Banxia Xiexin Tang** (Pinellia Decoction for Draining the Epigastrium).
Alternatively, treat with **Huangqin Huanglian Ganjiang Renshen Tang** (Scutellaria, Coptis, Ginger, and Ginseng Decoction).
**Cough:**
Sound without phlegm indicates Lung Qi injury and lack of clarity.
Phlegm without sound ("Sou") is caused by Spleen Dampness generating phlegm.
Sound with phlegm ("Ke Sou") results from Spleen and Lung Qi injury driven by Spleen Dampness.
Essentially, Stomach turbidity and Spleen dampness prevent proper distribution of body fluids. When Clear and Turbid do not distribute properly, essence does not spread, forming the root of phlegm and the origin of cough.
**Differentiating Six Pathogens:**
Cold Cough: Frequent coughing, sneezing, nasal congestion, spitting saliva/phlegm. Treat with **Shufeng Shen Su Yin** (Wind-Dispersing Ginseng and Perilla Drink).
Wind attacking the Lungs: Cough with sweating, headache, and difficult phlegm. Treat with **Jinfei San** (Boiling Down Powder). For dispersing Cold, modify **Huagai San** (Canopy Powder).
Fire attacking the Lungs: Cough with panting, oppression, reversed Qi, bloody sputum, and itchy throat.
Fire Cough: Red face, dry throat, foul breath, thick yellow sticky phlegm, soft stool. Treat with **Jiawei Xiebai San** (Modified Draining White Powder). If stool is hard, treat with **Jiawei Liange San** (Modified Cooling Diaphragm Powder).
Lung Deficiency: Pale complexion, clear thin phlegm. Treat with **Erchen Tang** (Two-Aged Decoction). To tonify Lung, use **Ejiao Tang** (Donkey-Hide Gelatin Decoction). For elderly deficiency cough, use **Sanzi Yangqin Tang** (Three-Seed Nourishing Parent Decoction) or **Zhenwu Tang** (True Warrior Decoction).
**Consumptive Cough:**
The Liver is the Sea of Blood, governing the Ren and Wei vessels. Its blood nourishes skin and hair. During sleep, blood returns to the Liver. Now, due to Liver deficiency, it cannot integrate with the blood of Ren and Wei, which leaks out through the pores. Liver Qi rises from the Pericardium Meridian, causing bleeding before coughing. Internal Liver injury leads to Pericardium deficiency. Pericardium deficiency allows Fire to attack Metal (Lungs), causing cough. Since the Pericardium governs blood vessels, Blood deficiency causes night fever. Mild cases cough during the day; severe cases cough day and night with fever. First Blood is injured, then Qi, leading to exhaustion of Yin and Yang. This is Consumptive Cough.
**Wind Invasion:** Aversion to wind, spontaneous sweating, clear nasal discharge, floating pulse.
**Food Stagnation Generating Phlegm:** Heat steams, Qi is urgent, phlegm is congested, frequent cough, loose stool. Treat with **Qu Mai Erchen Tang** (Malt and Two-Aged Decoction). If stool is dry, use **Su Ting Guntan Wan** (Perilla and Sedum Rolling Phlegm Pill) to purge.
**Cold Invasion:** Aversion to cold, no sweating, clear nasal discharge, tight pulse.
**Panting Syndrome:**
Panting refers to Qi reversing upward, with急促 (rapid/urgent) breathing.
Inability to distribute breath upon exhalation indicates Excess Pathogen.
Inability to continue breath due to Qi deficiency indicates Deficient Pathogen.
Thick phlegm and hard stool indicate Heat Pathogen.
Clear/cold phlegm and fluid retention indicate Cold Pathogen.
In the Five Zang, Lung Qi should be clear and descend. Why does panting occur? It is because Fire scorches True Qi, leading to Qi deficiency and panting.
Causes of panting: Excess in the Lungs, Deficiency in the Kidneys. As a guideline, there are four types:
1. Excess Cold: Must carry congealed phlegm and retained fluid interfering with Qi. Use **Xiao Qinglong Tang** (Minor Green Dragon Decoction) plus Houpo (Magnolia Bark) and Xingren (Apricot Kernel).
2. Excess Heat: Not outside the dampness-constrained pathogen steaming phlegm into Fire. Use **Ma Xing Gan Shi Tang** (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) or **Qianjin Weijing Tang** (Millennium Reed Shoot Decoction).
**Distinction between Essence Injury and Qi Collapse:**
1. Essence Injury: Tonify essence and calm/restrain Kidney Qi. Choose based on following Yang or Yin, e.g., **Suzi Jiangqi Tang** (Radish Seed Descending Qi Decoction).
2. Qi Collapse: Root floats, inspiration injures the Source Sea, danger is imminent. Use Ginseng, Placenta Humanis (Ziheche), Schisandra (Wuweizi), Quartz (Shiyin), etc.
**Asthma (Xiao):**
Asthma is characterized by急促 (rapid) breathing with audible sounds in the throat. Qi is coarse, chest is full, and breath cannot be distributed.
Often caused by Cold pathogen latent in the Lungs and Phlegm nests结 (knotted) in the lung membranes, responding internally and externally.
**Phlegm and Fluid Retention:**
External contraction by the Six Evils injures the Lungs, Lung Qi fails to circulate smoothly, generating phlegm.
Internal cause: Dampness injures the Middle Earth (Spleen), Spleen Qi condenses turbidity, generating phlegm.
Phlegm-Fluid syndrome is Water Qi flooding upward. When acted upon by Yang, it boils and thickens into Phlegm. When acted upon by Yin, it coagulates and thins into Fluid. This syndrome is caused by weak Mingmen Fire and不振 (lack of vigor) of Spleen Yang.
**Differentiation of Phlegm:**
Thick and turbid is Heat Phlegm, belonging to the Heart.
Clear foam is Cold Phlegm, belonging to the Kidney.
Scanty, sticky, and difficult to expectorate is Lung Dryness Phlegm.
Abundant and easy to expectorate is Dampness Phlegm, belonging to the Spleen.
Convulsions and dizziness are Wind-Phlegm, belonging to the Liver.
**Differentiation of Fluid:**
Fullness above the diaphragm, vomiting saliva/phlegm: This is retained fluid in the diaphragm, named **Fu Yin** (Hidden Fluid).
Panting, cough, facial swelling, inability to lie down: This is retained fluid in the Lungs, named **Zhi Yin** (Supporting Fluid).
Heavy pain in limbs and body: This is fluid retained in the limbs, moving through the body, named **Yi Yin** (Overflowing Fluid).
Cough drawing pain in ribs: This is fluid retained under the ribs, named **Xuan Yin** (Hanging Fluid).
Thin body with gurgling sounds, water moving in the diaphragm: This is fluid retained in the intestines and stomach, named **Tan Yin** (Phlegm-Fluid).
Generally, food/fluid retention in the chest and lungs causes panting and fullness. Qi retention in the diaphragm causes palpitations below the heart, or coldness in the back.
**Lung Distension, Lung Withering, Lung Abscess:**
**Lung Distension:** Flaring of nostrils, profuse sweating like flowing, urgent and rapid Lung pulse.
**Lung Withering:** Dry withering, lack of nourishment, depletion of fluids, scorching of the Lung. Often caused by prolonged Cold and Deficient Fire.
**Lung Abscess:** Obstruction and blockage, Heat accumulation leading to Lung ulceration. Abscesses are often caused by prolonged Wind-Heat knotting.
Severe Lung disease causes back pain when bowing the head.
(End) Postscript: This copy seems incomplete. Only one version was collected. Judging by the content, there should be a continuation. It is regrettable that it could not be fully obtained.