经云∶秋脉者，肺也。秋脉不及则喘，呼吸少气而咳，上气见血，下闻病音，其治法则
生脉散
之类是也。李明之云∶腹胀彭彭而喘，胸膈满，壅盛而上奔者，于症用药方中多加五味子，
人参次之，麦门冬又次之，黄连少许。如甚则交两手而瞀，其真气太虚也。若气短加黄 、
五味子、人参。气甚去五味子、人参，加黄芩、荆芥穗。冬月去荆芥穗，加草豆蔻仁。仲景
治火逆上气，咽喉
不利，止逆下气，以麦门冬汤主之。用麦门冬七升，半夏一升，人参四两，甘草
二两，粳米三合，大枣十二枚，水一斗二升，煮取六升，温服一升，日三夜一。经
云∶
岁火太过，炎暑流行，肺金受邪，民病火气咳喘。又∶热淫所胜，病寒热喘咳，宜以人参、
麦冬、五味子救肺，喘有虚实之分，须细辨之。生脉散乃热伤气虚而设。童便炒黄柏降火。
《本事方
》治咳嗽上喘急，以人参一味为末，鸡子清投新水调下一钱。昔有二人同走，一含人参，一
不含。俱走三五里许，其不含者大喘，含者气息自如，乃人参之力也。楼全善治一妇人五十
余岁，
素有痰嗽，忽一日大喘，痰如泉涌，身汗出如油，脉浮而洪，似命绝之状。速用麦门冬四
钱，人参二钱，五味子一钱五分，煎服一帖，喘定汗止，三帖后痰亦渐少。更栝蒌仁、白
术、当归、芍药、黄芩各一钱，服十帖而安。
喘而无汗烦躁，脉浮大者汗之。喘而有汗腹满，脉沉实者下之。喘有内外感伤之别
，外感烦躁无汗而喘者，宜汗。腹满有汗而喘，脉沉实者，宜下。仲景云∶上气喘而躁者，
属
肺胀。欲作风水，发汗则愈。又云∶咳而上气，此为肺胀。其人喘，目如脱状，脉浮大者，
越
婢加半夏汤主之。（麻黄六两，石膏半斤，生姜三两，大枣十五枚，甘草一两，半
夏八两，以水六升，先煮麻黄去上沫，入诸药，煮取三升，分三服)。又云∶肺胀咳而
上气
，烦躁而喘，脉浮者，心下有水，小青龙加石膏主之。(肺胀，咳而上气者，水寒之标邪也
。治以
小青龙汤平其冲气。况方中安内攘外，各尽其妙。余仿其法，以治寒嗽，莫不有桴应鼓之效
也。
麻黄、芍药、桂枝、细辛、甘草、干姜各三钱，五味子、半夏各半升，石膏二两，用
水一斗，先煮
麻黄去上沫，内诸药，煎服取三升。强人服一升，羸者减之，日三服，小儿服四合)。喘而
自汗，腹满便秘，气口脉大于人迎，下之无疑。外此则不宜轻下也，罗谦甫平气散可用。仲
景云∶膈间支饮，其人喘满，心下痞坚，面色黧黑，其脉沉紧，得之数十日，医吐之不愈，
木防己汤主之。木防己三两，石膏如鸡子大十二枚，桂枝二两，人参四两，以
水
六升，煮取二升，温分二服，虚者即愈，实者三日复发复与。不愈者宜木防己汤去石膏，加
茯苓芒硝汤主之，微利即愈。痰多者，亦气短而喘，须察其平昔，非因劳倦气脱之症而发，
脉浮
滑而大，咽喉不利，四七汤甚效。气郁痰凝，俗名梅核气是也。仲景治妇人胸中如有炙脔，
用
半夏浓朴汤，即此是也。如是风痰，可用千缗汤，半夏七个煨四片，破之。皂角去皮尖
二枚，甘草炙一寸，生姜如指大，水一碗煎，去半顿服。 又治因伤风而痰作喘
逆，
兀兀欲吐，恶心欲倒，如夏月有此症，为大热也。盖此症随四时为寒热温凉，宜以酒黄连、
酒
黄柏、酒知母各等分，为细末，熟汤丸桐子大，每服二百丸，白汤送下，空心服之，仍多饮
汤，服
毕少时，便以善膳压之，使不得停留胃中，直至下元，以泻冲脉之逆也。冲脉上干逆气
不
降之故。平居则气平和，动则气促而喘者，亦冲脉之火，宜用酒黄柏，酒知母之属。凡泻气
下
痰定喘之药，施之形实痰多者为妙。降气行痰之药，损人真元，正虚者宜审。若一切虚症，
及
脉浮大，按之而涩者，下之必死，须谨之。阴虚而喘，脉弱而涩，四肢寒者，去死不远，慎
勿下之。宜用人参、麦门冬、五味、当归、生地、童便、竹沥之属。《素问·逆调论》云∶
夫不得卧则喘
者，是水气之客也。夫水者，循津液而流也。肾者，水藏。主津液，主卧与喘也。汉防己、
茯苓之
属主之。又云∶不得卧而息有音者，是阳明之逆也。足三阳者下行，今逆而上行，故息有音
也。阳明者，胃脉也。胃者，六腑之海。其气亦下行，阳明逆不得从其道，故不得卧也。(
阳明径
道壅塞，则其气不能从道，故不卧矣)《下经》曰∶胃不和则卧不安。此之谓也。熟半夏、
橘红之属主之。
《黄帝内经》说：秋季的脉象对应肺脏。如果秋季脉象不及（肺气虚弱），就会出现喘息、呼吸短促且伴有咳嗽，气逆向上并见咳血，下部能听到病变的声音，治疗法则应当使用生脉散之类的方剂。
李东垣说：如果腹部胀满如鼓且伴有喘息，胸膈部痞闷胀满，气机壅盛上冲，应当在辨证用药的基础上多加五味子，人参次之，麦门冬再次之，再加少许黄连。如果病情严重到双手交叉按在心胸部且视物模糊昏花，这是真气极度虚弱的表现。如果气短，加黄芩、五味子、人参。如果气逆严重，去掉五味子和人参，加黄芩、荆芥穗。冬季去掉荆芥穗，加草豆蔻仁。张仲景治疗火邪逆乱导致的气逆上冲、咽喉不利，以止逆下气为主，用麦门冬汤主治。方中用麦门冬七升，半夏一升，人参四两，甘草二两，粳米三合，大枣十二枚，水一斗二升，煮取六升，每次温服一升，每日三次，夜间一次。
《黄帝内经》又说：岁运火气太过，炎暑流行，肺金受邪，百姓会患火气引起的咳嗽喘息。又说：热邪过胜，会导致寒热交替、喘息咳嗽，宜用人参、麦冬、五味子来救肺。喘息有虚证和实证的区分，必须仔细辨别。生脉散是针对热伤气虚而设立的。童便炒制的黄柏可以降火。
《本事方》治疗咳嗽气喘急迫，用人参一味研为末，用鸡蛋清加入新调制的清水，送服一钱。过去有两个人一起跑步，一个人含服人参，另一个人不含。都跑了三五里左右，不含人参的人剧烈喘息，含人参的人气息自如，这就是人参的功效。楼全善治疗一位五十多岁的妇人，平时就有痰嗽，忽然有一天出现大喘，痰液像泉水一样涌出，身上出汗如油，脉象浮大而洪数，似乎生命垂危的样子。迅速使用麦门冬四钱，人参二钱，五味子一钱五分，煎服一帖，喘息停止，汗止，服用三帖后痰也渐渐减少。后来改用栝蒌仁、白术、当归、芍药、黄芩各一钱，服用十帖后痊愈。
喘息而无汗、烦躁，脉象浮大的，应当用发汗法。喘息而有汗、腹部胀满，脉象沉实的，应当用泻下法。喘息有外感内伤的分别，外感引起的烦躁无汗而喘，适宜用发汗法；腹部胀满有汗而喘，脉象沉实的，适宜用泻下法。
张仲景说：上气喘促且躁动的，属于肺胀。想要发展为风水病，发汗则痊愈。又说：咳嗽且气逆上冲，这是肺胀。病人喘息，眼睛突出像要脱出一样，脉象浮大的，用越婢加半夏汤主治。（麻黄六两，石膏半斤，生姜三两，大枣十五枚，甘草一两，半夏八两，用水六升，先煮麻黄去掉上面的泡沫，再加入其他药物，煮取三升，分三次服用）。又说：肺胀咳嗽且气逆上冲，烦躁而喘，脉象浮的，心下有停饮，用小青龙加石膏汤主治。（肺胀，咳嗽气逆，是水寒之标邪所致。治疗用小青龙汤平抑冲气。况且此方安内攘外，各尽其妙。我仿照此法，治疗寒性咳嗽，没有不效如桴鼓相应的。）（麻黄、芍药、桂枝、细辛、甘草、干姜各三钱，五味子、半夏各半升，石膏二两，用水一斗，先煮麻黄去掉上面的泡沫，加入其他药物，煎服取三升。体质强壮的人服一升，瘦弱的人减量，每日三次，小儿服四合）。喘息且自汗，腹部胀满便秘，气口脉大于人迎脉，泻下无疑。除此之外则不宜轻易泻下，罗谦甫的平气散可以使用。
张仲景说：膈间有支饮，病人喘满，心下痞塞坚硬，面色黧黑，脉象沉紧，得病几十天，医生用吐法治疗未愈，用木防己汤主治。木防己三两，石膏如鸡蛋大小十二枚，桂枝二两，人参四两，用水六升，煮取二升，分两次温服，虚证者即愈，实证者三天后复发再给予。如果不愈，宜用木防己汤去掉石膏，加茯苓芒硝汤主治，轻微腹泻即愈。
痰多的人，也会气短而喘，必须考察其平素情况，如果不是因为劳倦气脱的症状而发作，脉象浮滑而大，咽喉不利，四七汤非常有效。这是气郁痰凝，俗名梅核气。张仲景治疗妇人胸中如有炙脔（感觉喉咙或胸中有异物感），用半夏厚朴汤，就是这个方子。如果是风痰，可以用千缗汤，半夏七个煨熟切片，破开。皂角去皮尖二枚，甘草炙一寸，生姜如手指大，用水一碗煎，去渣剩半碗顿服。又治疗因伤风导致痰作喘逆，恶心欲吐，头晕想倒，如果是夏季有此症状，属于大热证。因为这个症状随四季变化而有寒热温凉的不同，宜用酒黄连、酒黄柏、酒知母各等分，研为细末，用热水泛丸如梧桐子大，每次服二百丸，白开水送下，空腹服用，服药后仍要多喝汤水，服完后稍顷，立即用好的饮食压住药力，使药不得停留在胃中，一直下行到下元，以泻除冲脉的逆气。这是因为冲脉上干导致逆气不降的缘故。平时气机平和，一动就气促而喘的，也是冲脉之火，宜用酒黄柏、酒知母之类。凡是泻气、下痰、定喘的药物，施用于形体壮实、痰多的人是巧妙的。降气行痰的药物，会损伤人的真元，正气虚弱者应当审慎。如果一切虚证，以及脉象浮大，按之而涩的，用泻下法必死，必须谨慎。阴虚而喘，脉弱而涩，四肢寒冷的，离死不远，千万不要用泻下法。宜用人参、麦门冬、五味子、当归、生地、童便、竹沥之类。
《素问·逆调论》说：不能卧倒而喘息的，是水气侵犯所致。水，是顺着津液流动的。肾是水脏，主管津液，主司卧与喘。汉防己、茯苓之类主治。又说：不能卧倒且呼吸有声的，是阳明经气逆乱所致。足三阳经气本应下行，现在逆而上行，所以呼吸有声。阳明经，是胃脉。胃是六腑之海，其气也下行，阳明逆乱不能顺从其道，所以不能卧倒。（阳明经脉通道壅塞，则其气不能从道而行，所以不能卧倒）。《下经》说：胃不和则卧不安。说的就是这种情况。熟半夏、橘红之类主治。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The autumn pulse corresponds to the Lung organ. If the autumn pulse is deficient (indicating Lung Qi deficiency), wheezing, shortness of breath with cough, upward rushing of Qi accompanied by hemoptysis, and pathological sounds audible from the lower body will occur. The treatment principle should involve formulas such as Shengmai San (Generate Pulse Powder).
Li Dongyuan stated: If there is abdominal distension like a drum accompanied by wheezing, chest and diaphragm fullness, and excessive Qi rushing upward, one should add significantly more Schisandrae Fructus (Wuweizi) in the formula based on syndrome differentiation, followed by Ginseng Radix et Rhizoma (Renshen), then Ophiopogonis Radix (Maidong), and a small amount of Coptidis Rhizoma (Huanglian). If the condition is severe, manifesting as crossing hands over the heart region and visual blurring or dizziness, this indicates extreme deficiency of True Qi. For shortness of breath, add Scutellariae Radix (Huangqin), Schisandrae Fructus (Wuweizi), and Ginseng Radix et Rhizoma (Renshen). For severe Qi rebellion, remove Schisandrae Fructus (Wuweizi) and Ginseng Radix et Rhizoma (Renshen), and add Scutellariae Radix (Huangqin) and Schizonepetae Spica (Jingjie Sui). In winter, remove Schizonepetae Spica (Jingjie Sui) and add Amomi Fructus Rotundus (Caodoukouren). Zhang Zhongjing treated Qi rebellion due to Fire pathogen causing throat discomfort and inability to swallow smoothly, using Mai Men Dong Tang (Ophiopogon Decoction) to stop rebellion and direct Qi downward. The prescription uses seven sheng of Ophiopogonis Radix (Maidong), one sheng of Pinelliae Rhizoma (Banxia), four liang of Ginseng Radix et Rhizoma (Renshen), two liang of Glycyrrhizae Radix et Rhizoma (Gancao), three he of Oryzae Fructus (Jingmi), and twelve Jujubae Fructus (Dazao). Boil in twelve dou of water until six dou remain; take one dou warm each time, three times daily and once at night.
The *Huangdi Neijing* further states: When the annual fire qi is excessive, hot summer heat prevails, and the Metal of the Lung is affected, the people suffer from cough and wheezing caused by fire qi. It also states: When heat pathogen is excessive, it causes alternating chills and fever, wheezing, and cough. One should use Ginseng Radix et Rhizoma (Renshen), Ophiopogonis Radix (Maidong), and Schisandrae Fructus (Wuweizi) to rescue the Lung. Wheezing has deficiency and excess patterns that must be carefully distinguished. Shengmai San (Generate Pulse Powder) was established for Qi deficiency caused by heat injury. Semen Tauri (Tongbian) stir-fried with Cortex Phellodendri (Huangbai) can descend fire.
*Benshi Fang* (Formulas of Ability) treats urgent cough and wheezing by grinding one ingredient, Ginseng Radix et Rhizoma (Renshen), into powder, mixing with egg white (Albumen Ovi) and fresh water, and administering one qian per dose. Once, two men ran together; one held Ginseng Radix et Rhizoma (Renshen) in his mouth, while the other did not. After running about three to five li, the one without Ginseng Radix et Rhizoma (Renshen) panted severely, while the one with it breathed normally. This demonstrates the power of Ginseng Radix et Rhizoma (Renshen). Lou Quanshan treated a woman in her fifties who had chronic phlegm-cough. Suddenly, she experienced severe wheezing with phlegm gushing like a spring, sweating profusely like oil, and a floating, surging, and large pulse, appearing near death. He quickly prescribed four qian of Ophiopogonis Radix (Maidong), two qian of Ginseng Radix et Rhizoma (Renshen), and 1.5 qian of Schisandrae Fructus (Wuweizi). After one dose, wheezing stopped and sweating ceased. After three doses, phlegm gradually decreased. Subsequently, he used Akebiae Caulis (Gualou Ren - note: text says Gualou Ren which is Trichosanthis Semen, but context implies fruit/pulp often used for phlegm, here translated as Trichosanthis Semen/fruit part), Atractylodis Macrocephalae Rhizoma (Baizhu), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Shaoyao), and Scutellariae Radix (Huangqin), each one qian. After ten doses, she recovered.
For wheezing without sweat and irritability, with a floating and large pulse, induce sweating. For wheezing with sweat and abdominal fullness, with a deep and solid pulse, purge downwards. Wheezing differs between external contraction and internal injury. For external contraction causing irritability, no sweat, and wheezing, sweating is appropriate. For abdominal fullness, sweat, and wheezing with a deep solid pulse, purgation is appropriate.
Zhang Zhongjing said: Upper body wheezing with agitation belongs to Lung Distension (Fei Zhang). If developing into Wind Water (Fengshui), inducing sweating leads to cure. He also said: Cough with Qi rebellion is Lung Distension. The patient wheezes, eyes bulge as if protruding, with a floating and large pulse; treat with Yebing Jia Banxia Tang (Yibo Decoction plus Pinellia). (Ephedrae Herba (Mahuang) six liang, Gypsum Fibrosum (Shigao) half jin, Zingiberis Recens Rhizoma (Shengjiang) three liang, Ziziphi Jujubae Fructus (Dazao) fifteen pieces, Glycyrrhizae Radix et Rhizoma (Gancao) one liang, Pinelliae Rhizoma (Banxia) eight liang. Boil in six sheng of water, first boil Mahuang to remove foam, then add other herbs, boil to three sheng, divide into three doses). He also said: Lung Distension with cough, Qi rebellion, irritability, wheezing, and a floating pulse, where there is fluid retention in the epigastrium, treat with Xiao Qinglong Jia Shigao Tang (Minor Blue Green Dragon Decoction plus Gypsum). (Lung Distension with cough and Qi rebellion is a superficial pathogen of cold-water. Treat with Xiao Qinglong Tang to calm Chong Qi. This formula stabilizes the interior and expels the exterior. I imitated this method to treat cold coughs, achieving immediate efficacy like a drumstick hitting a drum.) (Ephedrae Herba (Mahuang), Paeoniae Radix Alba (Shaoyao), Cinnamomi Ramulus (Guizhi), Asari Radix et Rhizoma (Xixin), Glycyrrhizae Radix et Rhizoma (Gancao), Zingiberis Rhizoma (Ganjiang) each three qian; Schisandrae Fructus (Wuweizi), Pinelliae Rhizoma (Banxia) each half sheng; Gypsum Fibrosum (Shigao) two liang. Boil in one dou of water, first boil Mahuang to remove foam, add other herbs, boil to three sheng. Strong persons take one sheng, weak persons reduce dose, three times daily; children take four he). For wheezing with spontaneous sweating, abdominal fullness, constipation, and a Qi Kou pulse larger than Ren Ying pulse, purgation is undoubtedly indicated. Otherwise, do not lightly purge; Luo Qianfu's Pingqi San (Calm Qi Powder) may be used.
Zhang Zhongjing said: When there is fluid retention in the intercostal space (Zhi Yin), the patient experiences wheezing and fullness, epigastric hardness and obstruction, dark facial complexion, and a deep tight pulse. After dozens of days, if vomiting fails to cure, use Mufangji Tang (Stephania Decoction). Mufangji three liang, Gypsum Fibrosum (Shigao) size of chicken eggs twelve pieces, Cinnamomi Ramulus (Guizhi) two liang, Ginseng Radix et Rhizoma (Renshen) four liang. Boil in six sheng of water until two sheng remain; divide into two warm doses. Deficient cases heal immediately; excess cases relapse after three days and require re-administration. If ineffective, use Mufangji Tang removing Shigao and adding Poria (Fuling) and Mirabilite (Mangxiao). Mild diarrhea indicates cure.
Excessive phlegm also causes shortness of breath and wheezing. Examine the patient's usual state; if not caused by fatigue and Qi collapse, but with a floating, slippery, and large pulse and throat discomfort, Siqi Tang (Four Seven Decoction) is very effective. This is Qi stagnation with Phlegm condensation, commonly known as Plum Pit Qi (Meiheqi). Zhang Zhongjing treated women feeling as if there were a roasted meat slice in the chest using Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction), which is this formula. For wind-phlegm, Qianmin Tang (Thousand Thread Decoction) can be used: seven Pinelliae Rhizoma (Banxia) pieces, stir-baked and sliced open; two Sophorae Tonkinensis Fructus (Zaojiao) pieces, skin and tips removed; one cun of stir-fried Glycyrrhizae Radix et Rhizoma (Gancao); ginger the size of a finger. Boil in one bowl of water, reduce to half a bowl, take in one dose.
It also treats wheezing and rebellion due to wind-cold with phlegm, nausea, dizziness, and desire to vomit. If this occurs in summer, it is a great heat pattern. Since symptoms vary with seasons (cold, heat, warmth, coolness), use equal parts of Wine-processed Coptidis Rhizoma (Huanglian), Wine-processed Cortex Phellodendri (Huangbai), and Wine-processed Anemarrhenae Rhizoma (Zhimu). Grind into fine powder, make pills the size of tung seeds. Take 200 pills per dose with warm water, on an empty stomach. Drink plenty of water afterwards. Shortly after taking, eat good food to prevent the medicine from staying in the stomach, allowing it to reach the lower origin to drain rebellious Chong Mai Qi. This is because Chong Mai rebellion prevents Qi descent. Normally Qi is peaceful, but movement causes shortness of breath and wheezing due to Chong Mai fire; use Wine-processed Cortex Phellodendri (Huangbai) and Anemarrhenae Rhizoma (Zhimu). Medicines that drain Qi, descend phlegm, and stop wheezing are excellent for those with strong constitution and excessive phlegm. However, medicines that direct Qi downward and move phlegm damage True Yuan; those with deficiency must be cautious. For all deficiency patterns, and pulses that are floating and large but thready upon pressure, purgation leads to death; be extremely careful. For Yin deficiency wheezing with weak and thready pulses and cold limbs, death is near; absolutely do not purge. Use Ginseng Radix et Rhizoma (Renshen), Ophiopogonis Radix (Maidong), Schisandrae Fructus (Wuweizi), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix Preparata (Shengdi), Semen Tauri (Tongbian), and Bamboo Sap (Zhuli).
The *Suwen: Ni Diao Lun* states: Those who cannot lie down and wheeze are affected by Water Qi. Water flows along Jin Ye (Body Fluids). The Kidney is the Water Organ, governing Jin Ye, and controlling lying down and wheezing. Stephaniae Tetrandrae Radix (Hanfangji) and Poria (Fuling) are indicated. It also states: Those who cannot lie down and have noisy breathing have reversal of Yangming Qi. Foot Triple Burner Yang meridians descend; now they reverse and ascend, causing noisy breathing. Yangming is the Stomach Meridian. The Stomach is the Sea of Six Fu Organs, and its Qi also descends. Yangming reversal prevents it from following its pathway, hence inability to lie down. (When Yangming pathways are blocked, Qi cannot flow through them, hence inability to lie down). The *Xia Jing* states: "If the Stomach is not harmonious, sleep is uneasy." This refers to the above. Prepared Pinelliae Rhizoma (Banxia) and Citri Reticulatae Pericarpium (Juhong) are indicated.