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-> -> 喘

《喘》[View] [Edit] [History]

1 喘者,气短而促,吸不归根,呼吸之气不应皮毛之开合也。有实喘,有虚喘,有半虚半实喘。
2 实者,风寒之邪,伤其毛腠,致肌表不和。毛,皮毛也,主表:腠,腠理也,主肌。经云:三焦、膀胱者,腠理毫毛其应。是三焦应肝血之腠理以主肌,膀胱应肺气之皮毛以主表。若寒邪凝敛于皮毛,皮毛之气不通于腠理,则喘;风邪中伤于腠理,腠理之气不通于皮毛,亦喘。然此喘也,必病之初起,微微气急,或无汗恶寒,或有汗恶风,斯时和其肌表,散其风寒,喘自平矣。
3 半虚半实者,手足太阴之气,不相交合也。手太阴肺金,天也;足太阴脾土,地也。地气上升,则天气下降,或寒逆于肺而肺金寒,或湿滞于脾而脾土湿,则脾气不升,肺气不降,痰涎在中,上下不交而为喘。然此喘也,必兼咳也。夫脾肺不交,则为虚;寒湿内凝,则为实。虚实相半,则补泻并施;虚多实少,则补多泻少;
4 实多虚少,则泻多补少。寒凉之药,在所禁也。《伤寒论》中,有麻黄杏子石膏汤、葛根黄连黄芩汤以治喘,乃病太阳之标阳,而毛腠不通,阳热过盛,病在气化,不在经脉也。又有冷风哮喘,乃胃积寒痰,三焦火热之气然之不力,火虚土弱,土弱金虚,致中有痰而上咳喘。此缓病也,亦痼疾也,久久不愈,致脾肾并伤,胃无谷神,则死矣。
5 至虚喘者,水天之气不相交接也。肺,天也;肾,水也。天体不连地而连水。经云其本在肾,其末在肺,以明水天一气。若天水违行,则肺肾不交而喘,治不得宜,将离脱矣。当用参、苓、 、术以补肺,辛、味、桂、附以补肾,肺肾相交,则喘平而能卧;若上下不交,昼夜不卧,喘无宁刻,则太阳标本之气,亦几乎息矣。盖太阳以寒为本,以热为标。寒本,膀胱之水也,气根于肾;
6 热标,皮毛之阳也,气合于肺。此肺肾不交,而太阳标本之气,将以孤危,前药所以必需也。若外道之药,消削于前,其后亦无济矣。余曾以前方治半月之虚喘,一剂而安,举家欣喜,即以告馀,问前方可再服否?余曰:姑俟明日。病家曰:何也?余曰:安卧者,肺气下交,子时一阳初生,肾气上行,方为交合,恐惫极而肾气之不升也。至寅时,果死矣。经云:升降息,则气立孤危;出入废,则神机化灭。其即肺肾不交,太阳气绝之喘病为然乎!
URN: ctp:ws74099

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