肺如华盖，司呼吸以覆脏腑。凡五脏六腑外受之邪气，必上干于肺而为咳嗽，此咳嗽之
实证也；凡五脏六腑损伤之病气，亦上熏于肺，而为咳嗽，此咳嗽之虚证也。病源娄氏《纲目》
，繁而难从。今照《景岳全书》，只以虚实分之，甚见简括。
何谓实证？外受之邪，非寒邪即热邪也。表寒则脉浮，带弦带紧，头痛身痛，或鼻塞时
流清涕。轻者六安煎，重者金沸草散，及小青龙汤主之。里寒者脉沉细，真武汤去生姜，加干
姜、五味、细辛主之。热轻则脉洪而长，或浮数而有力，口渴面红，溺赤而短者，泻白散加减
主之，重者竹叶石膏汤主之。寒热往来而咳者，小柴胡汤去人参、大枣、生姜，加五味、干
姜主之。
六安煎（方见《三字经》）
金沸草散
旋复花（二钱） 荆芥 前胡 麻黄 白芍 半夏（各一钱五分） 甘草（一钱）
加生姜五片，水煎服。（《活人方》有茯苓、细辛，无麻黄、白芍）
何谓虚证？咳嗽为痨伤之渐，非气虚即精虚也。气虚者，羸瘦怠倦，少食痰多，言微，脉
微细，六君子汤、补中益气汤、归脾汤主之。如干姜、五味、细辛、阿胶、半夏、二冬、二
母、紫菀之类，随宜加入。精虚者，面色黯，口燥舌干，干咳痰稀气喘，腰膝酸痛，或
面色浮红，昼轻夜重，脉浮数而虚。右尺脉弱者，八味丸；左尺脉弱者，六味丸。二方俱宜
加入麦冬、五味、阿胶、胡桃之类，为标本同治之法。大抵气虚证是得之劳役饥饱过度，及
思虑伤脾所致。气不化精，阳病必及于阴，精虚证是得之色欲过度，或先天不足。少年阳痿
之人，精不化气，阴病必及于阳。
感春温之气而咳嗽，宜加玉竹；感夏令暑气而咳嗽，宜加石膏、麦冬、五味之类；感秋
令燥金之气而咳嗽，用喻嘉言清燥汤，神效；感冬寒之气而咳嗽，无汗宜金沸草散，有汗宜桂
枝汤，加浓朴一钱五分、杏仁二钱、半夏一钱五分。又三焦虚嗽，宜温肺汤；中焦虚嗽，宜六
君子汤，加干姜、细辛、五味子；下焦虚嗽，宜七味丸加五味；三焦俱虚，宜三才汤。
喻嘉言清燥救肺汤
治愤郁喘呕，郁痰加川贝母。
三才汤
天冬（二钱） 熟地（三钱） 人参（一钱）
水煎服。
补中益气汤 归脾汤 六君子汤 六味丸 八味丸（各见《时方》）
温肺汤
陈皮 半夏 酒芍 干姜 炙草（各一钱） 杏仁（去皮尖） 肉桂（或用桂枝） 五味 细
辛（各五分）
水煎服。（《仁斋方》有阿胶，无芍药）
The Lung is like a canopy (a cover resembling an umbrella that covers the five zang and six fu organs), governing respiration and covering/protecting the viscera. Any pathogenic factors affecting the five zang and six fu organs from the exterior must ascend to invade the Lung, resulting in cough; this constitutes the Excess syndrome of cough. Any pathological qi arising from damage within the five zang and six fu organs will also ascend to smolder in the Lung, causing cough; this constitutes the Deficiency syndrome of cough. Regarding the etiology of cough, Lou's *Gangmu* is too complex and difficult to follow. Currently, following the *Jingyue Quanshu*, distinguishing solely by Excess and Deficiency is very concise.
What is the Excess syndrome? External pathogens are either Cold or Heat. If it is Exterior Cold, the pulse is Floating, accompanied by Wiry or Tight qualities, with headache and body pain, or nasal congestion with frequent clear discharge. For mild cases, Liu'an Decoction is used; for severe cases, Jinfengcao Powder and Xiao Qinglong Tang are indicated. If it is Interior Cold, the pulse is Deep and Fine; Zhenwu Tang, removing Shengjiang (Fresh Ginger), adding Ganjiang (Dried Ginger), Wuweizi (Schisandra Fruit), and Xixin (Asarum) is indicated. When Heat is mild, the pulse is Surging and Long, or Floating, Rapid, and Forceful, accompanied by thirst, red face, and dark, scanty urine; Xiebai San, modified, is indicated. For severe cases, Zhuye Shigao Tang is indicated. For cough with alternating chills and fever, Xiaochaihu Tang, removing Renshen (Ginseng), Dazao (Jujube), and Shengjiang (Fresh Ginger), adding Wuweizi (Schisandra Fruit) and Ganjiang (Dried Ginger) is indicated.
Liu'an Decoction (Formula seen in *San Zi Jing*)
Jinfengcao Powder
Xuanfuhua (Inula Flower, 2 qian) Jingjie (Schizonepeta) Qianhu (Peucedani Radix) Mahuang (Ephedrae Herba) Baishao (Paeoniae Radix Alba) Banxia (Pinelliae Rhizoma) (each 1.5 qian) Gancao (Licorice Root, 1 qian)
Add five slices of Shengjiang (Fresh Ginger), decoct in water and take orally. (Huoren Fang contains Fuling (Poria) and Xixin (Asarum), but lacks Mahuang (Ephedrae Herba) and Baishao (Paeoniae Radix Alba)).
What is the Deficiency syndrome? Cough is the beginning of consumptive disease (Lao Shang); it is either Qi Deficiency or Essence/Jing Deficiency. Those with Qi Deficiency are emaciated and fatigued, have poor appetite with much phlegm, speak softly, and have a Micro and Fine pulse; Liujunzi Tang, Buzhong Yiqi Tang, and Guipi Tang are indicated. Drugs such as Ganjiang (Dried Ginger), Wuweizi (Schisandra Fruit), Xixin (Asarum), Ejiao (Donkey-hide Gelatin), Banxia (Pinelliae Rhizoma), Erdong (Tian Dong and Mai Dong), Ermu (Zhi Mu and Bei Mu), and Ziwan (Aster Root) may be added as appropriate. Those with Essence Deficiency have a dark complexion, dry mouth and tongue, dry cough with thin sputum, asthma, soreness and weakness of the waist and knees, or a floating red complexion, with symptoms lighter during the day and heavier at night, and a Floating, Rapid, and Empty pulse. If the Right Chi pulse is Weak, Bawei Wan is used; if the Left Chi pulse is Weak, Liuwei Wan is used. Both formulas are suitable for adding Maidong (Ophiopogon Root), Wuweizi (Schisandra Fruit), Ejiao (Donkey-hide Gelatin), and Hutaorenr (Walnut Kernel) as a method of treating both root and branch simultaneously. Generally, Qi Deficiency syndrome results from overexertion, irregular diet, and excessive worry damaging the Spleen. Qi fails to transform into Essence; Yang pathology inevitably affects Yin. Essence Deficiency syndrome results from excessive sexual activity or congenital insufficiency. Young men with impotence fail to transform Essence into Qi; Yin pathology inevitably affects Yang.
For cough caused by contracting Spring Warmth Qi, Yuzhu (Polygonatum Odorati Rhizoma) should be added; for cough caused by Summer Heat Qi, Shigao (Gypsum Fibrosum), Maidong (Ophiopogon Root), and Wuweizi (Schisandra Fruit) should be added; for cough caused by Autumn Dry Metal Qi, Yu Jiayan's Qingzao Jiufei Tang is indicated, which is miraculous; for cough caused by Winter Cold Qi, if there is no sweating, Jinfengcao Powder is used; if there is sweating, Guizhi Tang is used, adding Houpo (Magnolia Bark, 1.5 qian), Xingren (Prunus Seed, 2 qian), and Banxia (Pinelliae Rhizoma, 1.5 qian). Additionally, for Three Burner Deficiency Cough, Wenfei Tang is indicated; for Middle Burner Deficiency Cough, Liujunzi Tang with Ganjiang (Dried Ginger), Xixin (Asarum), and Wuweizi (Schisandra Fruit) is indicated; for Lower Burner Deficiency Cough, Qiwei Wan with Wuweizi (Schisandra Fruit) is indicated; for deficiency of all Three Burners, Santang Tang is indicated.
Yu Jiayan's Qingzao Jiufei Tang
Treats wheezing and vomiting due to resentment and depression; add Chuanbeimu (Fritillaria Cirrhosa Bulb) if there is stagnant phlegm.
Santang Tang
Tian Dong (Asparagus Root, 2 qian) Shudi (Rehmanniae Radix Preparata, 3 qian) Renshen (Ginseng Root, 1 qian)
Decoct in water and take orally.
Buzhong Yiqi Tang Guipi Tang Liujunzi Tang Liuwei Wan Bawei Wan (See *Shifang* for each formula)
Wenfei Tang
Chenpi (Citrus Reticulatae Pericarpium) Banxia (Pinelliae Rhizoma) Jiushao (Prepared Paeoniae Radix Alba) Ganjiang (Dried Ginger) Zhigancao (Prepared Licorice Root) (each 1 qian) Xingren (Prunus Seed, peeled and tips removed) Rougui (Cinnamon Bark, or Guizhi/Cinnamon Twig) Wuweizi (Schisandra Fruit) Xixin (Asarum) (each 0.5 qian)
Decoct in water and take orally. (Renzhai Fang contains Ejiao (Donkey-hide Gelatin) but lacks Shaoyao (Paeonia Root)).