论曰∶古书有咳而无嗽，后人以咳嗽兼言之者，盖其声响亮。不因痰涎而发，谓之咳
痰涎上下随声而发，谓之嗽，如水之漱荡，能漱其气也。诸咳之原，其来虽各不同，其气
至于肺而后发。若非其时感邪而发咳者，固因脏气虚弱，抑或五行之气，内相克制。病作
治，无使传注，不即治之，传注他脏，遂至不起。然有因寒者，因风者，因热者。风寒从
至，热则从内起。风寒则诸经自受其邪，热则脏腑熏蒸，乘而为病，风则散之，寒则温之
热则调之、泻之。因风者恶风，出风中则咳甚；因寒者，遇寒则剧；因热者，得热则发。
因外感风寒，不即治之，邪气留淫日深，攻伤脏气，一脏受极，遂传其所不胜。如肺经受
久而不去，咳则右胁痛，不可转侧，遂传之肝。肝属木，肺属金，金克木，咳引左胁，
卧，卧则咳剧，遂传之脾。脾，土也，为木来克，则大便鸭溏，甚则螈 如痫状，
肾属水，为土所克则骨痿，不能起于床，手足浮肿，次传之心则死。若因脏气自
心乘于肺，急补肺而泻心，补肺宜辛甘，泻心宜苦。若脾热熏蒸，但泻其脾，治
肺以辛温，谓之间传，学宜知此。
若肺咳，恶风脉浮，小青龙汤主之。恶寒脉紧，杏子汤主之。微弱者，钟乳丸主之。恶
热喉燥，脉数甚则咯血，天门冬汤、杏子汤主之。孙氏《仁存活法秘方》∶肺咳之状，喘息
有音，甚则咯血。
小青龙汤（见前寒证门。）
杏子汤
杏仁（去皮尖） 干姜 细辛（去苗） 甘草（炙，各半两） 五味子 桂心（各一两）
上为散。每服五钱，水二盏，枣一个，同煎至一盏，去滓温服。痰多者，加半夏半两，
汤洗七遍。
钟乳丸
钟乳（银石器内煮一时，研一伏时，一两） 紫菀（去苗及枯燥者，半两） 桑白皮（一
分，锉，微炒） 款冬花 黄 （各半两）
上为细末，炼蜜和丸，如梧桐子大。饮下三十丸，食前服。
天门冬汤
天门冬（去心） 紫菀（去苗及枯燥者，焙） 知母（焙，各一两） 桑白皮 五味子 桔
梗
（各半两）
上为散。每服五钱，水二盏，煎至一盏，去滓温服。咳血者，阿胶半两，炒燥。大便涩
而喘，加葶苈半两。
若心咳，脉浮恶风，桂心汤主之。恶寒，时口噤，脉紧大，附子细辛汤主之。恶热脉疾
小便赤涩，茯苓汤主之。
桂心汤 孙氏《仁存活法秘方》云∶心咳之状，上引心痛，喉介介然如梗，甚则咽喉肿
痛，脉浮恶风，宜桂心汤。
人参 桂（取心） 白茯苓（各一两） 麻黄 贝母（炒，各半两） 远志（去心） 甘
草（炙
各一分）
上为散。每服五钱，水二盏，煎至一盏，去滓温服。
附子细辛汤
附子（炮，去皮脐） 细辛（去苗，各半两） 人参 菖蒲（各一两） 甘草（炙，
半两）
五味子（二两）
上为散。每服五钱，水二盏，煎至一盏，去滓温服。
茯苓汤
茯苓 麦门冬（去心） 黄芩（各一两） 秦艽（去土） 柴胡（去苗，各半两） 杏
仁（去皮
尖，一分）
上为散。每服五钱，水二盏，煎至一盏，去滓温服。
若肝咳，恶风脉浮弦，射干汤主之。 孙氏《仁存活法秘方》云∶肝咳之状，咳则两胁
痛，甚则不可转侧，转侧两胁下满。 恶寒脉浮紧，五味子煎主之。恶热脉疾，目赤头眩，
百部丸主之。
射干汤
射干 麻黄（去根节，各半两） 五味子 半夏（汤泡七遍，各一两） 款冬花（二两）
上为散。每服五钱，水二盏，姜五片，同煎至一盏，去滓温服。
五味子煎
五味子（五两） 桂（取心，一两） 川乌头（炮，去皮脐，一两）
上为末，水五升，煎至一升，绞取汁，用好蜜二两，再熬成膏。温酒化弹子大，食前服
百部丸
百部（八两，为细末） 生地黄（五斤，取汁，熬成膏）
上将地黄膏和百部为丸，如梧桐子大。饮下三十粒，食后服。
若脾咳恶风脉浮缓，麻黄浓朴汤主之。 孙氏《仁存活法秘方》云∶脾咳之状，咳则右
胁下痛引肩背，痛甚则不可以动，动则咳剧。 口中如含霜雪，中脘隐隐冷，恶寒脉紧弱，
温中丸主之。大便坚，从腹上至头发热，脉疾，茯苓丸主之。
麻黄浓朴汤
浓朴（去皮，姜汁涂，炙） 麻黄（去根节） 杏仁（去皮尖） 橘皮（洗，各一两） 甘
草（
炙） 半夏（汤洗七遍，各半两）
上为散。每服五钱，水二盏，姜五片，同煎至一盏，去滓温服。
温中丸
干姜 半夏（汤洗七遍，各一两） 白术（二两） 细辛（去苗） 胡椒（各半两）
上为细末，炼蜜和丸，如梧桐子大。米饮下三十粒，食前服。
茯苓丸
茯苓 黄芩（各一两） 五味子（半两） 半夏（汤洗七遍，切，姜汁浸，焙，半两） 橘
皮
（洗，一两） 桔梗（半两）
上为细末，炼蜜和丸，如梧桐子大。米饮下三十粒，食后服。
若肾咳恶风脉浮，白前汤主之。 孙氏《仁存活法秘方》云∶肾咳之状，咳则腰背相
引疼痛。恶寒，唾冷沫，小便数，脉紧，椒红丸主之。 恶热，骨间烦疼，地骨皮汤主之。
白前汤
白前 细辛（去苗） 川芎 五味子（各一两） 麻黄（去根节） 芍药 桂（取心，
各半两）
上为散。每服五钱，水二盏，煎至一盏，去滓温服。
椒红丸
椒（去目，炒出汗，半两） 款冬花 紫菀（去苗及枯燥者） 干姜（各一两） 矾石
（火
一伏时） 附子（炮，去皮脐） 细辛（去苗） 皂荚（去子，酥炙，各半两）
上为细末，炼蜜和丸，如梧桐子大。米饮下三十粒，食前服。
地骨皮汤
地骨皮 百部（各二两） 芍药 赤茯苓（各一两）
上为散。每服五钱，水二盏，竹叶十片，同煎至一盏，去滓，食后温服。
若颧骨赤，大如钱，日晡发热者死。若潮热有时，五心烦热，搏于营卫，不咳者易治，
脉促涩者难治，青蒿煎、柴胡芍药汤主之。
青蒿煎
青蒿（汁，一升） 人参 麦门冬（去心，各一两）
上将二味为末，用青蒿汁同熬成膏，丸如梧桐子大。饮下二十粒，食后服。
柴胡芍药汤
柴胡（去苗） 芍药（各一两） 地骨皮 石膏（各半两）
上为散。每服五钱，水二盏，小麦五十粒，同煎至一盏，去滓，食后温服。
若但嗜卧，饮食不荣肌肤，或不能食，心腹虚胀滑泄，背膂牵急，劳倦不能动止，或因
大病后，或因下利后不复常，得之于脾。脉弦大者不治，四肢煎厥，亦谓之肉极，炙肝散、
白术丸主之。
炙肝散（见前气证门）。
白术丸
白术 橘皮（洗，各一两） 浓朴（去皮，姜汁涂，炙焦） 人参（各半两）
上为细末，炼蜜和丸，如梧桐子大。米饮下三十丸。
若咳嗽如脓涕，或微喘急，短气，胁下痛，皮肤干燥，动则咳极，由形寒饮冷伤于肺经
久嗽不已则肺枯燥，令人先寒后热，脉弱者可治，或紧或弦者不可治。
It is stated: Ancient texts mention "ke" (cough with sound) but not "sou" (cough with phlegm). Later generations combined them into "kesou" because of the loudness of the sound. What does not arise from phlegm and saliva, but is characterized by a clear sound, is called "ke". What involves phlegm and saliva moving up and down with the sound, like water washing and agitating, capable of scouring the qi, is called "sou". The origins of various coughs differ, yet the pathogenic qi ultimately affects the Lung before symptoms manifest. If a cough occurs due to pathogenic factors contracted out of season, it is certainly due to the weakness of zang-fu qi, or internal mutual restriction among the Five Elements. When the disease arises, it must be treated promptly to prevent transmission; if not treated immediately, it will transmit to other zang-fu organs, leading to death. However, some are caused by Cold, some by Wind, and some by Heat. Wind and Cold enter from the exterior, while Heat arises from within. Wind and Cold cause the meridians to directly receive the pathogen, whereas Heat causes steaming and steaming of the zang-fu organs, leading to disease. For Wind, dispersing methods should be used; for Cold, warming methods; for Heat, harmonizing and purging methods. Those caused by Wind fear wind, and cough worsens when exposed to wind; those caused by Cold worsen upon exposure to cold; those caused by Heat flare up upon exposure to heat. If external Wind-Cold is not treated promptly, the pathogen lingers and penetrates deeper day by day, damaging zang-fu qi. Once one organ suffers extreme damage, it transmits to the organ it cannot overcome (the "unconquerable"). For example, if Lung meridian pathogen persists for a long time, coughing is accompanied by pain in the right hypochondrium, inability to turn the body, transmitting to the Liver. Liver belongs to Wood, Lung to Metal; Metal overcomes Wood. Cough pulls on the left hypochondrium, worsening when lying down, transmitting to the Spleen. Spleen belongs to Earth, overcome by Wood, resulting in loose stools like duck feces, and in severe cases, convulsions resembling epilepsy. Kidney belongs to Water, overcome by Earth, resulting in bone萎 (bone atrophy/weakness), inability to rise from bed, and edema of hands and feet. Subsequent transmission to the Heart leads to death. If the disorder originates from internal zang-fu imbalance, such as Heart Fire invading Lung Metal, one should urgently tonify the Lung and purge the Heart. Tonifying the Lung suits acrid-sweet herbs, while purging the Heart suits bitter herbs. If Spleen Heat steams upward, only purge the Spleen, and treat the Lung with acrid-warm herbs; this is called "intermediate transmission," which students should understand.
For Lung Ke (Lung Cough), presenting with aversion to wind and floating pulse, Xiao Qing Long Tang (Minor Blue Dragon Decoction) is the primary formula. With aversion to cold and tight pulse, Xing Zi Tang (Apricot Seed Decoction) is used. For weak pulses, Zhong Ru Wan (Stalactite Pill) is indicated. With aversion to heat, dry throat, rapid pulse, and even hemoptysis, Tian Men Dong Tang (Asparagus Root Decoction) and Xing Zi Tang are used. Sun Simiao's *Ren Huo Cun Fa Mi Fang* records: Symptoms of Lung Ke include wheezing with sounds, and severe cases involve hemoptysis.
Xiao Qing Long Tang (See Cold Syndrome Section above.)
Xing Zi Tang
Xing Ren (Apricot Seed, peeled and tip removed) Gao Jiang (Dried Ginger) Xi Xin (Asarum, roots removed) Gan Cao (Licorice, honey-fried, each 0.5 liang) Wu Wei Zi (Schisandra) Gui Xin (Cinnamon Twig Heart, each 1 liang)
Grind all into powder. Take 5 qian per dose, add 2 zhan of water and 1 jujube, decoct until 1 zhan remains, strain, and take warm. For excessive phlegm, add Ban Xia (Pinellia) 0.5 liang, washed seven times with hot water.
Zhong Ru Wan
Zhong Ru (Stalactite, boiled for 1 shi in silver/copper vessel, ground for 1 fu, 1 liang) Zi Wan (Perilla Leaf, remove roots and dried parts, 0.5 liang) Sang Bai Pi (Mulberry Root Bark, 1 fen, crushed, slightly fried) Kuan Dong Hua (Coltsfoot Flower) Huang Qi (Astragalus, each 0.5 liang)
Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 30 pills with water before meals.
Tian Men Dong Tang
Tian Men Dong (Asparagus Root, remove heart) Zi Wan (Perilla Leaf, remove roots and dried parts, baked) Zhi Mu (Anemarrhena, baked, each 1 liang) Sang Bai Pi (Mulberry Root Bark) Wu Wei Zi (Schisandra) Jie Geng (Platycodon, each 0.5 liang)
Grind into powder. Take 5 qian per dose, add 2 zhan of water, decoct until 1 zhan remains, strain, and take warm. For hemoptysis, add E Jiao (Donkey-hide Gelatin) 0.5 liang, stir-fried until dry. For constipation and wheezing, add Ting Li Zi (Lepidium Seed) 0.5 liang.
For Xin Ke (Heart Cough), presenting with floating pulse and aversion to wind, Gui Xin Tang (Cinnamon Twig Heart Decoction) is used. With aversion to cold, occasional lockjaw, and large tight pulse, Fu Zi Xi Xin Tang (Aconite and Asarum Decoction) is used. With aversion to heat, rapid pulse, and dark scanty urine, Fu Ling Tang (Poria Decoction) is used.
Gui Xin Tang Sun Simiao's *Ren Huo Cun Fa Mi Fang* states: Symptoms of Heart Ke include upward pulling heart pain, a sensation of obstruction in the throat like a lump, severe cases with sore throat and swelling, floating pulse, and aversion to wind; Gui Xin Tang is suitable.
Ren Shen (Ginseng) Gui Xin (Cinnamon Twig Heart) Bai Fu Ling (White Poria, each 1 liang) Ma Huang (Ephedra) Bei Mu (Fritillaria, stir-fried, each 0.5 liang) Yuan Zhi (Polygala, remove heart) Gan Cao (Licorice, honey-fried, each 1 fen)
Grind into powder. Take 5 qian per dose, add 2 zhan of water, decoct until 1 zhan remains, strain, and take warm.
Fu Zi Xi Xin Tang
Fu Zi (Prepared Aconite, peel and navel removed) Xi Xin (Asarum, roots removed, each 0.5 liang) Ren Shen (Ginseng) Chang Pu (Acorus, each 1 liang) Gan Cao (Licorice, honey-fried, 0.5 liang) Wu Wei Zi (Schisandra, 2 liang)
Grind into powder. Take 5 qian per dose, add 2 zhan of water, decoct until 1 zhan remains, strain, and take warm.
Fu Ling Tang
Fu Ling (Poria) Mai Men Dong (Ophiopogon, remove heart) Huang Qin (Scutellaria, each 1 liang) Qin Jiao (Gentiana Macrophylla, clean soil) Chai Hu (Bupleurum, remove roots, each 0.5 liang) Xing Ren (Apricot Seed, peel and tip removed, 1 fen)
Grind into powder. Take 5 qian per dose, add 2 zhan of water, decoct until 1 zhan remains, strain, and take warm.
For Gan Ke (Liver Cough), presenting with aversion to wind and floating-wiry pulse, She Gan Tang (Belamcanda Decoction) is used. Sun Simiao's *Ren Huo Cun Fa Mi Fang* states: Symptoms of Liver Ke include pain in both hypochondria during coughing, severe cases with inability to turn the body, and fullness under the hypochondria when turning. With aversion to cold and floating-tight pulse, Wu Wei Zi Jian (Schisandra Decoction) is used. With aversion to heat, rapid pulse, red eyes, and dizziness, Bai Bu Wan (Stemona Pill) is used.
She Gan Tang
She Gan (Belamcanda) Ma Huang (Ephedra, remove root joints, each 0.5 liang) Wu Wei Zi (Schisandra) Ban Xia (Pinellia, soaked in hot water seven times, each 1 liang) Kuan Dong Hua (Coltsfoot Flower, 2 liang)
Grind into powder. Take 5 qian per dose, add 2 zhan of water and 5 slices of ginger, decoct until 1 zhan remains, strain, and take warm.
Wu Wei Zi Jian
Wu Wei Zi (Schisandra, 5 liang) Gui Xin (Cinnamon Twig Heart, 1 liang) Chuan Wu Tou (Chuanwu Aconite, prepared, peel and navel removed, 1 liang)
Grind into powder, add 5 sheng of water, decoct until 1 sheng remains, squeeze out juice, add 2 liang of good honey, and boil again into a paste. Dissolve a pill the size of a bullet in warm wine, take before meals.
Bai Bu Wan
Bai Bu (Stemona, 8 liang, grind to fine powder) Sheng Di Huang (Fresh Rehmannia, 5 jin, extract juice, boil into paste)
Mix the Rehmannia paste with Stemona powder to form pills the size of paulownia seeds. Take 30 pills with water after meals.
For Pi Ke (Spleen Cough), presenting with aversion to wind and floating-slow pulse, Ma Huang Nong Po Tang (Ephedra and Magnolia Bark Decoction) is used. Sun Simiao's *Ren Huo Cun Fa Mi Fang* states: Symptoms of Spleen Ke include pain in the right hypochondrium radiating to the shoulder and back during coughing, severe cases with immobility, and worsening cough upon movement. Sensation of frost/snow in the mouth, coldness in the Zhongwan area, aversion to cold, and weak-tight pulse indicate Wen Zhong Wan (Warm the Middle Pill). Hard stool, heat from abdomen to scalp, and rapid pulse indicate Fu Ling Wan (Poria Pill).
Ma Huang Nong Po Tang
Nong Po (Magnolia Bark, peel, coat with ginger juice, fry) Ma Huang (Ephedra, remove root joints) Xing Ren (Apricot Seed, peel and tip removed) Ju Pi (Tangerine Peel, wash, each 1 liang) Gan Cao (Licorice, fry) Ban Xia (Pinellia, wash in hot water seven times, each 0.5 liang)
Grind into powder. Take 5 qian per dose, add 2 zhan of water and 5 slices of ginger, decoct until 1 zhan remains, strain, and take warm.
Wen Zhong Wan
Gan Jiang (Dried Ginger) Ban Xia (Pinellia, wash in hot water seven times, each 1 liang) Bai Zhu (Atractylodes, 2 liang) Xi Xin (Asarum, remove roots) Hu Jiao (Pepper, each 0.5 liang)
Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 30 pills with rice drink before meals.
Fu Ling Wan
Fu Ling (Poria) Huang Qin (Scutellaria, each 1 liang) Wu Wei Zi (Schisandra, 0.5 liang) Ban Xia (Pinellia, wash in hot water seven times, slice, soak in ginger juice, bake, 0.5 liang) Ju Pi (Tangerine Peel, wash, 1 liang) Jie Geng (Platycodon, 0.5 liang)
Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 30 pills with rice drink after meals.
For Shen Ke (Kidney Cough), presenting with aversion to wind and floating pulse, Bai Qian Tang (Cynanchum Stalk Decoction) is used. Sun Simiao's *Ren Huo Cun Fa Mi Fang* states: Symptoms of Kidney Ke include pain linking waist and back during coughing. With aversion to cold, cold saliva, frequent urination, and tight pulse, Jiao Hong Wan (Pepper Red Pill) is used. With aversion to heat and painful bones, Di Gu Pi Tang (Lycium Bark Decoction) is used.
Bai Qian Tang
Bai Qian (Cynanchum Stalk) Xi Xin (Asarum, remove roots) Chuan Xiong (Ligusticum) Wu Wei Zi (Schisandra, each 1 liang) Ma Huang (Ephedra, remove root joints) Shao Yao (Peony) Gui Xin (Cinnamon Twig Heart, each 0.5 liang)
Grind into powder. Take 5 qian per dose, add 2 zhan of water, decoct until 1 zhan remains, strain, and take warm.
Jiao Hong Wan
Jiao (Sichuan Pepper, remove eyes, stir-fry until sweat appears, 0.5 liang) Kuan Dong Hua (Coltsfoot Flower) Zi Wan (Perilla Leaf, remove roots and dried parts) Gan Jiang (Dried Ginger, each 1 liang) Fan Shi (Alum, fire-burned for 1 fu) Fu Zi (Prepared Aconite, peel and navel removed) Xi Xin (Asarum, remove roots) Zao Jia (Gleditsia Fruit, remove seeds, fry in butter, each 0.5 liang)
Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 30 pills with rice drink before meals.
Di Gu Pi Tang
Di Gu Pi (Lycium Bark) Bai Bu (Stemona, each 2 liang) Shao Yao (Peony) Chi Fu Ling (Red Poria, each 1 liang)
Grind into powder. Take 5 qian per dose, add 2 zhan of water and 10 bamboo leaves, decoct until 1 zhan remains, strain, and take warm after meals.
If the cheekbones are red, the size of a coin, with evening fever, the prognosis is fatal. If there is tidal fever at specific times, five-palm heat, and pathogenic struggle between Ying and Wei without coughing, the condition is easy to treat. If the pulse is choppy and hesitant, it is difficult to treat; Qing Hao Jian (Artemisia Decoction) and Chai Hu Shao Yao Tang (Bupleurum and Peony Decoction) are used.
Qing Hao Jian
Qing Hao (Artemisia, juice, 1 sheng) Ren Shen (Ginseng) Mai Men Dong (Ophiopogon, remove heart, each 1 liang)
Grind the two ingredients into powder, use Artemisia juice to boil into a paste, form pills the size of paulownia seeds. Take 20 pills with water after meals.
Chai Hu Shao Yao Tang
Chai Hu (Bupleurum, remove roots) Shao Yao (Peony, each 1 liang) Di Gu Pi (Lycium Bark) Shi Gao (Gypsum, each 0.5 liang)
Grind into powder. Take 5 qian per dose, add 2 zhan of water and 50 wheat grains, decoct until 1 zhan remains, strain, and take warm after meals.
If there is only lethargy, diet failing to nourish the muscles and skin, or inability to eat, empty distension in the heart and abdomen with slippery diarrhea, tension in the back and spine, fatigue preventing movement, or recovery failure after major illness or diarrhea, this originates from the Spleen. If the pulse is wiry and large, it is untreatable. Limb jue-ni (cold reversal) is also called Rou Ji (Extreme Flesh); Zhi Gan San (Roasted Liver Powder) and Bai Zhu Wan (Atractylodes Pill) are used.
Zhi Gan San (See Qi Syndrome Section above.)
Bai Zhu Wan
Bai Zhu (Atractylodes) Ju Pi (Tangerine Peel, wash, each 1 liang) Nong Po (Magnolia Bark, peel, coat with ginger juice, fry until scorched) Ren Shen (Ginseng, each 0.5 liang)
Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 30 pills with rice drink.
If cough resembles pus and nasal discharge, or slight wheezing and urgency, shortness of breath, hypochondriac pain, dry skin, and extreme cough upon movement, this is due to cold injury to the body and cold drinks injuring the Lung Meridian. Persistent cough leads to Lung dryness, causing initial chills followed by fever. If the pulse is weak, it is treatable; if tight or wiry, it is untreatable.