喘病无不本于肺。故经曰∶诸痿喘呕，皆属于上。盖肺主气，气逆则喘。肺位最高，故曰属上也。
巢氏、严氏、本《内经》诸逆冲上，皆属于火之说止言实热。独王海藏辨华陀肺气盛为喘，《活人书》气
有余则喘，二语云∶气盛则当气衰，有余当作不足。若肺气果盛，果有余，则清肃之令下行，岂复为
喘？皆以火入于肺，炎灼真气，真气衰与
不足而喘。所谓盛与有余者，乃肺中之火，而非肺之真气也。斯言诚超出前人。然余观昔贤之论，悉有
所本，不可偏废。审果实热有余所致者，则从巢之诸说治之。审果火烁肺金，真气不足所致者，则从海
藏治之。故因风寒者解其邪；因暑湿者，涤其烦；火实者，清之；气郁者，疏之；痰壅者，开之，食滞
者，消之。气虚而火入于肺者，补气为主；阴虚而火乘金者，壮水为急；肾虚气不归原，纳气归根；肾
虚水邪泛滥，逐水下流。如上诸款，皆其大纲。然致喘之因甚多，须一隅三反，方不愧为明通之医矣。
疏邪利金汤〔见伤风。〕
此治风寒致喘之剂。
竹叶石膏汤〔见伤寒。〕
此治伤暑致喘之剂。
泻白散〔见火。〕
加茅根。〔肺热喘急，一味煎饮如神。〕
此治肺热致喘之剂，实火加苦寒，虚火加甘寒。
沉香降气散
真沉香 砂仁 苏子 橘红 郁金 枇杷叶〔治喘蜜炙，治呕姜炙。〕白茯苓 麦冬〔皆
下气降逆之品。〕肺壅喘甚者加甜葶苈，〔以泻肺气之壅逆。〕挟热者加茅根，〔凉金定喘。三、五
两。〕煎汤煎药。
此治气郁致喘之剂。
顺气开痰饮〔见中风。〕
或加二冬、沙参之属。
此治痰壅致喘之剂。按士材云∶《内经》论喘，其因众多，究不越于火逆上而气不降。斯言
深得要领。所以仲淳云∶喘病属肺虚有热，因而痰壅，此方可宗而加减用之。若果属痰，因而致喘，方
可用二陈、六君子等汤治之。
保和丸〔见泄泻。〕
此治伤食致喘之剂，加减用之。
生脉散〔见暑。〕
本方加苏子 茅根 贝母。〔气虚则喘，人参补之。喘则气耗，五味敛之。肺喜润，故用麦冬，
肺欲利，故用苏子，肺恶热以茅根清火，肺恶塞，以贝母消痰。〕
此方喘因气虚、而火入于肺者宜之。
八仙长寿丸〔见虚劳。〕
原方加麦冬〔合麦冬以清肺。〕牛膝〔各六两。〕
紫河车〔峻补其肾，一、 二具。〕或再加青铅〔色黑导肾镇坠之剂，降痰如神，铁铫内溶化，
去渣脚，收用，二两。〕真沉香 砂仁〔如气从脐逆冲而上者，此肾虚不能纳气归原，非沉香、砂仁
引导不济。各五钱。〕〔茅根汤送下。〕
此方、喘因阴虚而火乘金者宜之。
六味肾气丸〔见肿胀。〕
此方喘因肾虚，水邪泛滥者宜之。若果有火衰症脉者，方可用济生肾气丸。
参附汤 治真阳不足，上气喘急，气短头晕，〔阳欲上
脱。〕汗出肢冷。〔阳欲外脱。〕
人参〔一、二、三两。〕制附子〔一、三、五钱。〕
此方果系真阳欲脱致喘者，急用以挽之，否则切勿妄投。
麻杏甘石汤 治哮喘。
麻黄〔炒。三、五、七钱。〕杏仁〔散风寒。〕甘草 石膏〔清肺热。〕合二陈加栝
蒌〔消痰。〕苏子 桑皮 枳壳〔下气。〕
此降气消痰清火而兼散邪之剂。此病禁用热剂，亦不可纯用寒凉，恐外邪难解。盖哮症良由痰火郁于
内，风寒束于外而致者居多。或因过食酸咸，或因积火熏蒸，病根深久，难以卒除，宜避风寒，节浓味可也。
喘病之脉，不宜急疾。
喘病汗出小便利者死，若下利不止者亦死，汗出如油、喘而不休者死。久病肉脱作喘，六脉如平者〔
灯尽火焰之兆。〕必死。
喘病没有不根源于肺的。所以《内经》说：各种痿证、喘证和呕吐，都归属于上焦。这是因为肺主气，气机上逆就会发生喘证。肺的位置最高，所以说属于上焦。
巢元方、严用和依据《内经》“各种气逆冲上，都归属于火”的说法，只论述了实热证。唯独王海藏辨析华佗所说的肺气盛导致喘证，《活人书》中说气有余则喘，这两句话的意思是：气盛应当理解为气衰，有余应当理解为不足。如果肺气真的旺盛，真的有余，那么肺的清肃功能就能下行，怎么会反而发生喘证呢？这都是因为火邪侵入肺部，灼烧真气，导致真气衰弱和不足而发生喘证。所谓“盛”与“有余”，指的是肺中的火邪，而不是肺的真气。这种说法确实超出了前人。然而我观察前代贤人的论述，都有依据，不可偏废。如果确认为实热有余所致，就按照巢元方的诸种说法治疗；如果确认为火邪灼伤肺金，导致真气不足所致，就按照王海藏的方法治疗。因此，因风寒引起的，解除其邪气；因暑湿引起的，清除其烦闷；火邪实盛的，清泻之；气机郁滞的，疏理之；痰浊壅塞的，开泄之；食积停滞的，消导之。气虚而火邪入肺的，以补气为主；阴虚而火邪乘袭肺金的，急当壮水制火；肾虚导致气不归原的，纳气归根；肾虚导致水邪泛滥的，逐水下流。以上这些条目，都是大纲要领。然而导致喘证的原因很多，必须举一反三，才不愧为明达通晓的医生。
泻白散（见火证章节）。
加白茅根。（肺热喘急，单味煎服如神效。）
这是治疗因肺热导致喘证的方剂，实火加苦寒药，虚火加甘寒药。
沉香降气散
真沉香、砂仁、苏子、橘红、郁金、枇杷叶（治喘用蜜炙，治呕用姜炙）、白茯苓、麦冬（都是下气降逆的药物）。肺壅喘严重的加甜葶苈（以泻除肺气的壅逆）。兼有热象的加白茅根（凉金定喘，用量三至五两），煎汤代水煎药。
这是治疗因气郁导致喘证的方剂。
顺气开痰饮（见中风章节）。
或者加入天冬、麦冬、沙参之类的药物。
这是治疗因痰壅导致喘证的方剂。按士材（李中梓）说：《内经》论述喘证，原因众多，究其根本离不开火气上逆而气不下降。这话深得要领。所以仲淳（张介宾）说：喘病属于肺虚有热，因而痰壅，此方可作为宗法进行加减使用。如果确实属于痰证因而致喘，方才可用二陈汤、六君子汤等治疗。
保和丸（见泄泻章节）。
这是治疗因伤食导致喘证的方剂，加减使用。
生脉散（见暑证章节）。
本方加苏子、白茅根、贝母。（气虚则喘，用人参补益。喘则耗气，用五味子收敛。肺喜润，故用麦冬；肺欲通利，故用苏子；肺恶热，用白茅根清火；肺恶塞，用贝母消痰。）
此方适用于因气虚而火邪入肺导致的喘证。
八仙长寿丸（见虚劳章节）。
原方加麦冬（合麦冬以清肺）、牛膝（各六两）、紫河车（峻补肾精，一至二个）、或再加青铅（色黑，能引导肾气、镇坠降逆的药物，降痰效果极佳，在铁锅中溶化，去渣留汁，收存备用，二两）、真沉香、砂仁（如果气从脐部逆冲而上，这是肾虚不能纳气归原，非沉香、砂仁引导不能奏效，各五钱）。（用白茅根汤送服。）
此方适用于因阴虚而火邪乘袭肺金导致的喘证。
六味肾气丸（见肿胀章节）。
此方适用于因肾虚，水邪泛滥导致的喘证。如果确实有火衰的症状和脉象，才可使用济生肾气丸。
参附汤 治疗真阳不足，上气喘急，气短头晕（阳气欲向上脱失），汗出肢冷（阳气欲向外脱失）。
人参（一至三两）、制附子（一至五钱）。
此方如果是真阳欲脱导致的喘证，急用此方挽回，否则切勿妄用。
麻杏甘石汤 治疗哮喘。
麻黄（炒制，三至七钱）、杏仁（疏散风寒）、甘草、石膏（清肺热）。合二陈汤加瓜蒌（消痰）、苏子、桑白皮、枳壳（下气）。
这是降气、消痰、清火并兼散邪的方剂。此病禁用热性药剂，也不可纯用寒凉药，恐怕外邪难以解除。大概哮症多由痰火郁结于内，风寒束缚于外所致。或因过食酸咸之物，或因积火熏蒸，病根深久，难以立刻消除，适宜避风寒、节制浓味饮食。
喘病的脉象，不宜急疾。
喘病若汗出且小便通利的，预后不良（死）；如果腹泻不止的，也预后不良（死）；汗出如油、喘促不止的，预后不良（死）。久病肌肉消瘦而发喘，六脉看似平和的（灯尽火灭之兆），必死无疑。
Asthma (Chuan Bing) invariably originates from the Lung. Therefore, the *Classic of Internal Medicine* states: "All flaccidity syndromes, asthma, and vomiting belong to the Upper Jiao." This is because the Lung governs Qi; when Qi rebels upward, asthma occurs. The Lung is located at the highest position, hence it is said to belong to the Upper Jiao.
Chao Yuanfang and Yan Yonghe, based on the *Classic of Internal Medicine*'s statement that "all rebellious Qi rushing upward belongs to Fire," only discussed excess-heat patterns. Only Wang Haizang analyzed Hua Tuo's assertion that "excess Lung Qi causes asthma," and the *Jiu Liu Bie Lu* states "excess Qi leads to asthma." These two statements imply: "Qi excess" should be understood as Qi deficiency, and "having surplus" should be interpreted as insufficiency. If Lung Qi were truly excessive or in surplus, its clearing and descending function would proceed downward, and how could it result in asthma? In these cases, Fire pathogen enters the Lung, scorching the True Qi, causing the True Qi to become deficient and insufficient, thereby leading to asthma. What is referred to as "excess" and "surplus" is actually the Fire within the Lung, not the Lung's True Qi. This insight indeed surpasses previous scholars. However, observing the discussions of past sages, all have their basis and cannot be disregarded partially. If confirmed to be caused by excess-heat and surplus, treat according to Chao Yuanfang's various methods. If confirmed to be caused by Fire scorching Lung Metal, resulting in True Qi deficiency, treat according to Wang Haizhang's methods. Thus, for those caused by Wind-Cold, resolve the pathogen; for those caused by Summer-Heat and Dampness, clear the vexation; for excess Fire, clear it; for Qi stagnation, soothe it; for Phlegm obstruction, open it; for Food Stagnation, digest it. For Qi deficiency with Fire entering the Lung, tonify Qi as the primary method; for Yin deficiency with Fire attacking Lung Metal, urgently nourish Water to control Fire; for Kidney deficiency where Qi does not return to its root, grasp Qi and return it to the root; for Kidney deficiency with flooding of Water pathogen, drain water downward. The above items constitute the general outline. However, there are many causes for asthma; one must infer other instances from one example to be considered a wise and competent physician.
Shu Xie Li Jin Tang (See Shang Feng chapter).
This is a formula for treating asthma caused by Wind-Cold.
Zhu Ye Shi Gao Tang (See Shang Han chapter).
This is a formula for treating asthma caused by Summer-Heat injury.
Xie Bai San (See Huo chapter).
Add Bai Mao Gen (White Imperata Rhizome). (For Lung Heat causing urgent asthma, decocting this single herb alone is miraculous.)
This is a formula for treating asthma caused by Lung Heat. For Excess Fire, add bitter-cold herbs; for Deficient Fire, add sweet-cold herbs.
Chen Xiang Jiang Qi San
Zhen Chen Xiang (True Agarwood), Sha Ren (Amomum Fruit), Su Zi (Perilla Seed), Ju Hong (Tangerine Peel), Yu Jin (Curcuma Root), Pi Pa Ye (Loquat Leaf - honey-fried for asthma, ginger-fried for vomiting), Bai Fu Ling (Poria), Mai Dong (Ophiopogon Tuber) [These are all herbs that descend Qi and counteract rebellion]. For severe Lung obstruction and asthma, add Tian Ting Li (Sweet Descurainia Seed) [to drain obstructed and rebellious Lung Qi]. If accompanied by heat, add Bai Mao Gen [to cool Metal and calm asthma, dosage 3-5 liang], decoct in water instead of regular water.
This is a formula for treating asthma caused by Qi stagnation.
Shun Qi Kai Tan Yin (See Zhong Feng chapter).
Or add Dong Chong Xia Cao (Cordyceps), Tian Dong (Asparagus Tuber), Mai Dong (Ophiopogon Tuber), or Sha Shen (Glehnia Root).
This is a formula for treating asthma caused by Phlegm obstruction. According to Shicai (Li Zhongzi): The *Classic of Internal Medicine* discusses numerous causes for asthma, but ultimately they do not exceed Fire rebelling upward while Qi fails to descend. This statement captures the essence. Therefore, Zhongchun (Zhang Jingyue) stated: Asthma belongs to Lung deficiency with Heat, leading to Phlegm obstruction; this formula can be taken as a model for modification and use. If it is indeed caused by Phlegm leading to asthma, then Er Chen Tang or Liu Jun Zi Tang can be used.
Bao He Wan (See Xie Xie chapter).
This is a formula for treating asthma caused by Food Injury, used with modifications.
Sheng Mai San (See Shu chapter).
Original formula plus Su Zi (Perilla Seed), Bai Mao Gen (White Imperata Rhizome), Bei Mu (Fritillaria Bulb). (Qi deficiency causes asthma, Ren Shen tonifies it. Asthma consumes Qi, Wu Wei Zi astringes it. The Lung prefers moisture, thus Mai Dong is used; the Lung desires unobstructed flow, thus Su Zi is used; the Lung dislikes Heat, so Bai Mao Gen clears Fire; the Lung dislikes obstruction, so Bei Mu eliminates Phlegm.)
This formula is suitable for asthma caused by Qi deficiency with Fire entering the Lung.
Ba Xian Chang Shou Wan (See Xu Lao chapter).
Original formula plus Mai Dong (Ophiopogon Tuber) [combined with Mai Dong to clear Lung], Niu Xi (Achyranthes Root) [6 liang each], Zi He Che (Human Placenta) [powerfully tonifies the Kidney, 1-2 units], or additionally add Qing Qian (Lead Oxide) [black in color, guides Kidney Qi and has heavy-sinking properties, miraculously reduces Phlegm, melt in an iron pot, remove dregs, collect residue, 2 liang], Zhen Chen Xiang (True Agarwood), Sha Ren (Amomum Fruit) [If Qi rebels upward from the navel, this indicates Kidney deficiency failing to grasp Qi and return it to the root; without Chen Xiang and Sha Ren to guide, it will not work, 5 qian each]. (Take with Bai Mao Gen decoction.)
This formula is suitable for asthma caused by Yin deficiency with Fire attacking Lung Metal.
Liu Wei Di Huang Wan (See Zhong Zhang chapter).
This formula is suitable for asthma caused by Kidney deficiency with flooding of Water pathogen. If there are indeed signs and pulses of Fire deficiency, Ji Sheng Shen Qi Wan may be used.
Shen Fu Tang Treats True Yang deficiency, upper body asthma and urgency, shortness of breath and dizziness [Yang about to escape upward], sweating and cold limbs [Yang about to escape outward].
Ren Shen (Ginseng Root) [1-3 liang], Zhi Fu Zi (Prepared Aconite Root) [1-5 qian].
If this formula is indeed for asthma caused by impending collapse of True Yang, use it urgently to rescue; otherwise, do not administer recklessly.
Ma Xing Gan Shi Tang Treats Xiao Chuan (Wheezing/Asthma).
Ma Huang (Ephedra Stem) [stir-fried, 3-7 qian], Xing Ren (Apricot Seed) [disperses Wind-Cold], Gan Cao (Licorice Root), Shi Gao (Gypsum Fibrosum) [clears Lung Heat]. Combine with Er Chen Tang plus Gua Lou (Trichosanthes Fruit) [eliminates Phlegm], Su Zi (Perilla Seed), Sang Bai Pi (Mulberry Root Bark), Zhi Ke (Aurantium Fruit) [descends Qi].
This is a formula that descends Qi, eliminates Phlegm, clears Fire, and simultaneously disperses pathogens. This disease contraindicates hot agents, and pure cold/cool agents should also be avoided, lest external pathogens fail to resolve. Generally, Xiao syndrome is mostly caused by Phlegm-Fire郁结 internally and Wind-Cold binding externally. It may also result from overconsumption of sour and salty foods, or steaming by accumulated Fire. The disease root is deep and long-standing, difficult to eliminate abruptly. One should avoid Wind-Cold and regulate rich flavors.
The pulse of asthma should not be rapid and hurried.
Death ensues if asthma is accompanied by sweating and free urination; death also ensues if diarrhea persists uncontrollably; death ensues if sweat is like oil and asthma does not cease. Death is certain if chronic muscle wasting is accompanied by asthma and the six pulses appear normal [a sign of lamp running out and flame extinguishing].