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Cough is a disease of the Lung. Its causes are diverse, and its variations are numerous. Although both adults and children may suffer from it, children's Spleen and Stomach are particularly weak, and their Lung tissue is even more delicate. Once infected, the condition easily lingers; if prolonged, it can develop into a major affliction. Therefore, cough in children is more severe than in adults. Regarding symptoms, children's breathing is naturally short, and their pulse is naturally rapid. Once they contract a cough, the shortness of breath and rapidity of the pulse become abnormally pronounced. In severe cases, their spirit becomes unsettled, leading to states of fright, startle, and crying. This represents another aspect in which the symptoms are more severe than in adults. As for treatment methods, they are also relatively difficult because obtaining accurate history through inquiry and pulse diagnosis in children is challenging, making it hard to ascertain the root cause of the disease. Furthermore, since children's internal organs are not yet fully developed and their physical constitution is not yet solid, medication requires extra caution. Thus, although the pathology of cough is the same in adults and children, the syndrome differentiation and treatment actually differ. As for the causes, they can be broadly categorized into three types: one is Exogenous Cough (cough caused by external pathogens), one is Endogenous Cough (cough caused by internal factors), and one is Miscellaneous Cough (cough caused by a mix of internal and external factors). By classifying according to this system, general coughs are all encompassed, and complex or inappropriate specific cough names (such as Heart Cough, Liver Cough, Large Intestine Cough, Small Intestine Cough, etc.) can be discarded.

I. Wind-Cold Cough
A. Overview
Exogenous coughs are caused entirely by external pathogenic factors. They are not caused by internal factors, so they differ from endogenous coughs. Although some may transform into endogenous conditions due to improper treatment of the initial exogenous stage, the onset is indeed exogenous. Among exogenous coughs, the milder form is Cold-Dampness Common Cold (Ganmao Fenghan), commonly known as Wind-Cold Cough.
The Lung is a clear and light organ, most sensitive to Wind-Cold pathogens. Upon infection, the trachea, being located superiorly, is affected first. The pathology generates phlegm, which obstructs respiration. Due to this respiratory obstruction, the Lung urgently seeks to expel the pathogen outward, thereby triggering a cough to drive it out. At the initial stage, the cough sound is often sharp, and the sputum is often clear and white, because the Cold pathogen has just invaded and has not yet transformed into Heat, and the saliva/phlegm has just begun to form and has not yet become turbid. In the middle stage of the illness, the cough sound is often heavy and turbid, and the sputum is often thick and yellow, because the pathogenic force is strong and transforming into Heat, causing phlegm accumulation and steaming into thickness. In the late stage, the cough sound is often clear and refreshing, and the sputum is often clear and white, because the pathogenic force has declined, the airways are clear, turbid phlegm has been expelled, leaving only thin phlegm. In severe cases, there may be internal invasion of Heat presenting with panting and urgency, or difficulty expectorating phlegm presenting with convulsions and startles. These are not critical conditions; provided one follows the trend to guide the pathogen out, clears Heat, and resolves phlegm, allowing the cough to be smooth and Lung Qi to diffuse, recovery will occur after a short time. However, if treatment is delayed, or if internal and external factors mix, or if repeated colds occur causing significant damage to Lung Qi, it may turn into an incurable condition. The saying "a wind-cold that does not resolve becomes consumption" refers precisely to this.

B. Treatment Methods
At the onset of Wind-Cold Cough, there is generally mild aversion to cold, sneezing, or aversion to cold with fever, nasal congestion, dizziness, tearing, loss of taste, throat itching, and the onset of cough. At this time, when the Wind-Cold pathogen is just invading, the treatment should be to Release the Exterior and Open the Lungs. For mild cases, herbs such as Perilla Leaf (Ziye), Peucedanum Root (Qianhu), Schizonepeta Spike (Jingjie), Mint (Bohe), and Fatsia Rhizome (Xiangbei) are suitable. For severe cases, Ephedra Stem (Mahuang), Saposhnikovia Root (Fangfeng), Apricot Seed (Xingren), and Gentian Macrophylla Root (Qinjiao) are suitable. If Wind stagnates in the meridians causing body pain, consider adding Notopterygium Root (Qianghuo), Cinnamon Twig (Guizhi), Mulberry Twig (Sangzhi), or Gastrodia Tuber (Tianma). The general formula is Xuanfei Quxie Tang (Lung-Opening and Pathogen-Expelling Decoction). Subsequently, as Heat expands and cough intensifies, and sputum changes from clear to thick, indicating Cold transforming into Heat, the treatment should incorporate clearing Heat and resolving phlegm within the strategy of releasing the exterior and opening the lungs, using Xuanfei Ditang Tang (Lung-Opening and Phlegm-Scouring Decoction) with modifications. Later, when the cough sound is heavy and turbid, and sputum is yellow and thick, indicating complete transformation of exogenous pathogens into Heat, the treatment should clear the Lung and regulate Qi, using Qingfei Huare Tang (Lung-Clearing and Heat-Transforming Decoction) with modifications. If residual pathogens remain and slight cough persists, this formula is also appropriate. Although children's constitutions vary and symptoms differ, the course is short, usually resolving within seven to ten days. After recovery, medicinal regulation is needed: those with deficiency should tonify Lung Qi, while those with excess should clear residual pathogens and add tonification, thereby strengthening Lung Qi and preventing frequent colds.

II. Epidemic Cough
A. Overview
Epidemic Cough, although caused by exogenous factors, differs from ordinary Wind-Cold Cough. Wind-Cold Cough has a mild progression, whereas Epidemic Cough is severe; Wind-Cold Cough is short-lived, whereas Epidemic Cough lingers for a long time; Wind-Cold Cough involves shallow pathogenic invasion, whereas Epidemic Cough involves deep invasion. Epidemic Cough resembles the transmission of seasonal epidemics; thus, when children inhale the infected air, they contract the disease. Consequently, once it spreads, it affects entire neighborhoods, unlike Wind-Cold Cough where infection is sporadic. Two main types exist: one is Pertussis (Bairike), named because the cough is difficult to cure and often lasts for a hundred days. The other is Cormorant Cough (Lu'e Ke), describing the difficulty of the cough, characterized by continuous bouts. The onset is often due to irregular weather changes generating epidemic Qi. Once one person is infected, it spreads sequentially. Because children's Lung Qi is weak, they are most susceptible. Initially, the disease starts with fever, but immediately progresses to continuous coughing with much phlegm and little sputum. Mild cases involve ten-plus coughs per bout before resting; severe cases involve dozens to over a hundred coughs per bout. Rest intervals are only about ten minutes before recurrence, leading to exhaustion, choking on food, and hemoptysis. The early stage poses little danger, but in the late stage, if coughing becomes increasingly difficult and voice hoarse, Lung damage occurs, becoming difficult to treat. This aligns with the ancient saying "broken metal makes no sound," indicating a transformation into an endogenous condition.

B. Treatment Methods
At the onset of Epidemic Cough, whether feverish or chills-and-fever, the continuous cough indicates pathogen reception. Historically, few established formulas existed; generally, treatment involved modifying strategies of releasing the exterior and opening the lungs. Why? Ordinary coughs can be resolved by releasing the exterior and opening the lungs, but Epidemic Cough involves epidemic Qi and deep invasion, requiring anti-epidemic agents and Lung-nourishing herbs to be effective. The initial step uses Baofei Quxie Tang (Lung-Nourishing and Pathogen-Expelling Decoction). As the condition advances and cough worsens, calming and stopping cough herbs should be added to phlegm-resolving and Lung-nourishing strategies, using Baofei Ditang Tang (Lung-Nourishing and Phlegm-Scouring Decoction). If fever is present with a deep and fine pulse, and cough radiates upward from below causing lower back and back pain, deep-seated pathogens must be released, using Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite Root, and Asarum Decoction). If cough persists for a long time without subsiding, Lung Qi is depleted while pathogenic force is strong; failing to tonify Qi allows deeper pathogen invasion. In such cases, Si Junzi Tang (Four Gentlemen Decoction), Wuwei Yigong San (Five-Ingredient Powder with Extra Efficacy), or Liujunzi Tang (Six-Gentlemen Decoction) should be used with phlegm-resolving and Qi-regulating herbs for gradual recovery. Merely attacking phlegm will further weaken the Lung and deepen the pathogen, turning into consumptive disease and becoming incurable. Therefore, in the late stage, Baofei Fuzheng Tang (Lung-Nourishing and Righteousness-Supporting Decoction) is most appropriate. If other factors are involved, they should be treated concurrently.

Attached Formulas
(1) Xuanfei Quxie Tang (Self-made): Treats Cold-Dampness Common Cold with chills, fever, and initial cough.
Perilla Leaf (Ziye), Mint (Bohe) (each 1 qian); Gentian Macrophylla Root (Qinjiao), Peucedanum Root (Qianhu), Apricot Seed (Xingren), Fatsia Rhizome (Xiangbei), Tangerine Peel (Juhong), Ginger-processed Bamboo Shavings (Zhuju), Red Poria (Chiling) (each 2 qian); Platycodon Root (Jiegeng), Licorice Root (Gancao) (each 5 fen).
Decoct in clear water. For chills, fever, difficulty sweating, and irregular breathing, remove Jiegeng and add Ephedra Stem (Mahuang) 3 fen; for headache, remove Jiegeng and add Schizonepeta Spike (Jingjie) and Saposhnikovia Root (Fangfeng) each 1 qian; for body pain, add Notopterygium Root (Qianghuo) 3 fen and Mulberry Twig (Sangzhi) 3 qian; for sore throat, add Arnebia Root/Lithospermum Root (Niubangzi) and Belamcanda Rhizome (Shegan) each 2 qian.

(2) Xuanfei Ditang Tang (Self-made): Treats Wind-Cold Cough with fever, abundant phlegm, and irregular breathing.
Peucedanum Root (Qianhu), Perilla Fruit (Suzi), Apricot Seed (Xingren), Fatsia Rhizome (Xiangbei), Bamboo Shavings (Zhuru), Tangerine Peel (Chenpi), Mint (Bohe), Red Poria (Chiling), Forsythia Fruit (Lianqiao) (each 2 qian).
Decoct in clear water. For fever and coarse breathing, add Ephedra Stem (Mahuang) 3 fen; for fever, panting, and foul breath (Stomach Heat), add Ephedra Stem (Mahuang) 5 fen and Gypsum (Shigao) 3 qian; for constipation, add Aurantium Fruit (Zhike) 1 qian; for vomiting, add Pinellia Tuber (Banxia) 1.5 qian; for scanty urination, add Tongcao 1 qian.

(3) Qingfei Huare Tang (Self-made): Treats Wind-Cold Cough steaming into Heat, with sticky turbid phlegm and simultaneous Lung-Stomach Heat.
Peucedanum Root (Qianhu), Anemarrhena Rhizome (Zhimu), Trichosanthes Fruit (Gualou), Light Scutellaria Root (Danqin), Perilla Fruit (Suzi), Bamboo Shavings (Zhuru), Fatsia Rhizome (Xiangbei), Red Poria (Chiling), Angelica Sinensis Root (Danggui) (each 2 qian).
Decoct in clear water. For diarrhea, remove Zhimu, Gualou, and Danggui; add Tangerine Peel (Chenpi) and Costus Root (Muxiang) each 1 qian. For Spleen-Stomach Qi deficiency with dampness generating phlegm, remove Gualou and Zhimu; add Pinellia Tuber (Banxia) and Tangerine Peel (Chenpi) each 1.5 qian, or Atractylodes Macrocephala Rhizome (Cangzhu) 5 fen. For intense heat with rising phlegm and急促 breathing, add Monkey Date (Houzao) 1 fen or Lepidium Seed (Tinglizi) 1 qian.

(4) Post-Cough Regulation Formula (Self-made): Treats ordinary Wind-Cold Cough where the illness has resolved but residual waves remain, with abundant phlegm and cough.
Glehnia Root (Shashen), Atractylodes Macrocephala Rhizome (Baizhu), Inula Flower (Xuanfuhua), Tangerine Peel (Chenpi), Astragalus Root (Huangqi), Pinellia Tuber (Banxia), Poria (Fuling), Fritillaria Cirrhosa Bulb (Chuanbeimu) (each 2 qian); Licorice Root (Gancao), Bitter Orange (Qingpi) (each 1 qian).
Decoct in clear water. For Qi deficiency, remove Qingpi and replace Shashen with Codonopsis Root (Dangshen). For lingering intestinal/stomach heat generating phlegm, add Trichosanthes Fruit (Gualou) and Anemarrhena Rhizome (Zhimu) each 2 qian.

(5) Baofei Quxie Tang (Self-made): Treats epidemic influenza with chills, fever, and paroxysmal cough.
Processed Stemona Root (Zhibaiibu), Processed Aster Tataricus Root (Zhi Ziwan) (each 5 fen); Inula Flower (Xuanfuhua), Peucedanum Root (Qianhu), Apricot Seed (Xingren), Perilla Fruit (Suzi) (each 2 qian); Fatsia Rhizome (Xiangbei), Bamboo Shavings (Zhuru), Asparagus Tuber (Tiantong) (each 3 qian).
Decoct in clear water. For fever without sweat and ineffective cough, initially remove Baiibu, Ziwan, Xuanfuhua, and Tiantong; add Ephedra Stem (Mahuang) 5 fen, Schizonepeta Spike (Jingjie), Platycodon Root (Jiegeng), and Gentian Macrophylla Root (Qinjiao) each 1 qian. Take one dose to release the pathogen, then resume the original formula. Radish Seed (Laifuzi), White Mustard Seed (Baijiezhi), Bamboo Sap (Zhuli), and Processed Pinellia (Zhi Banxia) can be added as appropriate.

(6) Baofei Ditang Tang (Self-made): Treats incessant paroxysmal cough, red face, fever, sweating without relief, and pain radiating to chest and back.
Processed Stemona Root (Zhibaiibu), Processed Aster Tataricus Root (Zhi Ziwan) (each 5 fen); Inula Flower (Xuanfuhua), Hematitum (Daizheshi), Pinellia Tuber processed with Bamboo Sap (Zhuli Zhi Banxia), Peucedanum Root (Qianhu), Angelica Sinensis Root (Danggui) (each 2 qian); Fritillaria Cirrhosa Bulb (Chuanbeimu), Asparagus Tuber (Tiantong) (each 3 qian).
Decoct in clear water. For Kidney deficiency with easy Qi rebellion, add Rehmannia Root (Shengdi) and Magnetite (Cishi) each 3 qian. For hemoptysis, remove Banxia. For rattling phlegm sounds due to Water flooding, add Cinnamon Twig (Guizhi) 5 fen, Lepidium Seed (Tinglizi) 1 qian, and Poria (Fuling) 3 qian.

(7) Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite Root, and Asarum Decoction): Treats Shaoyin disease at onset with contrary fever and deep pulse; Kidney-originating cough with lower back and back pain radiating upon coughing, severe salivation upon coughing, and brain/tooth pain caused by Cold pathogen invading teeth.
Ephedra Stem (Mahuang), Prepared Aconite Root (Fuzi), Asarum (Xixin)

(8) Si Junzi Tang (Four Gentlemen Decoction): See Chapter 3, Section 5.

(9) Wuwei Yigong San (Five-Ingredient Powder with Extra Efficacy): See Chapter 3, Section 6.

(10) Liujunzi Tang (Six-Gentlemen Decoction): See Chapter 5, Section 3.

(11) Baofei Fuzheng Tang (Lung-Nourishing and Righteousness-Supporting Decoction) (Self-made): Treats prolonged pertussis with Qi deficiency and unceasing cough.
Northern Glehnia Root (Beishashen), Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Astragalus Root (Huangqi), Ophiopogon Tuber (Maidong), Fritillaria Cirrhosa Bulb (Chuanbeimu), Processed Pinellia Tuber (Fa Banxia), Inula Flower (Xuanfuhua), Processed Citrus Reticulata Peel (Huajuhong), Chinese Yam (Huaishanyao) (each 2 qian).
Decoct in clear water. For prolonged cough with dissipating Lung Qi unable to consolidate, add Dried Ginger (Ganjiang) and Schisandra Berry (Wuweizi) each 5 fen. For Spleen deficiency with diarrhea, add Prepared Atractylodes Rhizome (Yuzhu). For Kidney deficiency with diarrhea, add Psoralea Fruit (Buguzhi). For hemoptysis, remove Banxia.