予侄妇何氏在室时，四月间因多食青梅，得痰饮病，日间胸膈中大痛如刀锥，至晚胸中痛止而膝KT 大痛，盖痰饮
随气升降故也。一医作胃寒治，用干姜、良姜、官桂、乌、附、丁、沉辈，及煮胡椒粥间与。病日刷，加之口渴，小水
淋涩。求予治，诊其六脉洪数而滑，予作清痰处治，令其急烹竹沥服。三日口不渴，小水亦不淋涩，但胸中与膝互痛如
旧。用萝卜子研汁，与半碗，吐痰半升许，至夜痛尤甚于前，正丹溪所谓引动其猖狂之势耳。次日用人参芦一两，逆流
水煎服，不吐。又次日与苦参煎汤服，又不吐；又与附子尖、桔梗芦，皆不吐。一日清晨，藜芦末一钱，入麝香少许，
酸浆水调与，始得大吐，至次日天明，吐方定，前后得顽痰及稠饮一小桶许，其痛如脱，后以软粥将理而安。
论
《内经》曰∶五脏六腑皆令人咳，非独肺也。皮毛者肺之合也，皮毛先受邪气，邪气以从其合也。五脏之咳延久，
乃移于六腑。河间曰∶咳谓无痰而有声，肺气伤而不清也。嗽谓无声而有痰，脾湿动而生痰也。咳嗽谓有痰而有声，盖
因伤于肺气，动于脾湿，咳而为嗽也。脾湿者，秋伤于湿，积于脾也。故《内经》又曰∶秋伤于湿，冬必咳嗽。大抵素
秋之气宜清肃，反动之，气必上冲而为咳，甚则动于脾湿，发而为痰焉。又曰∶寒、暑、燥、湿、风、火，六气皆令人
咳，惟湿病痰饮入胃，留之而不行，上入于肺，则为咳嗽。假令湿在心经，谓之热痰；湿在肝经，谓之风痰；湿在肺经，
谓之气痰；湿在肾经，谓之寒痰，为患不同，宜随证而治之。是故咳而无痰者，以辛甘润其肺。夫欲治咳嗽者，当以治
痰为先；治痰者，必以顺气为主。是以南星、半夏胜其痰，而咳嗽自愈；枳壳、橘红利其气，而痰饮自降。痰盛而能食
者，小承气汤微下之；痰盛而不能食者，浓朴汤疏导之。夏月嗽而发热者，谓之热嗽，小柴胡加石膏、知母；冬月嗽而
发寒热，谓之寒嗽，小青龙汤加杏仁。此治法之大要也，学人不可不知。
脉法
关上脉微为咳。肺脉微急为咳而唾血。脉弦涩而咳为少血。脉紧者为肺寒。双弦者寒。脉浮而紧者为虚寒。脉浮而
缓者伤风。脉细者湿。脉数为热。脉沉数为实热。脉弦为水。偏弦为饮。脉沉为留饮。洪滑多痰。
咳，脉浮直者生。脉浮濡者生。脉紧者死。沉小伏匿者死。咳而羸瘦，脉坚大者死。咳而脱形发热，脉小坚急者
死。凡肌瘦脱形，热不去，咳呕，腹胀且泄，脉弦急者，皆死证也。
方法
丹溪曰∶咳嗽有风寒，有火，有劳，有痰，有肺胀。
风寒者，主发散行痰，二陈汤加麻黄、杏仁、桔梗之类。（戴氏曰∶风寒者，鼻塞声重恶寒是也。）
风寒郁热于肺，夜嗽者，三拗汤加知母。脉大而浮，有热，加黄芩、生姜。
寒嗽，古方有以生姜切作薄片，焙干为末，糯米糊为丸，如芥子大，空心清米饮下三十丸。
声哑属寒（寒包热也，此言感寒而嗽者），宜细辛、半夏、生姜，辛以散之。
风入肺久嗽者，用鹅管石、雄黄、蔚金、款冬花为末，以生姜一片置舌上，以药末拌艾，于姜上灸之，取烟入喉中
愈。一方有南星、佛耳草，无蔚金（此即烟筒法，小异。）
治嗽烟筒方，用鹅管石、雄黄、款冬花、佛耳草为末，以鸡子清剧纸上，卷药末作筒，烧烟，以口衔，吸烟入喉，
姜汤送下。
喘嗽遇冬则发，此寒包热也，解表热自除。枳壳、桔梗（各一钱）、麻黄、防风、甘草、陈皮、紫苏、木通、黄芩（各
等分）。如严寒，去黄芩，加杏仁五分。
感冷则嗽，膈上有痰，二陈汤加炒枳壳、黄芩、桔梗、苍术、麻黄、木通、生姜。
火者，主降火清金化痰，黄芩、海石、栝蒌、青黛、桔梗、半夏、香附、诃子、青皮之类（戴氏曰∶有声痰少面赤
是也），蜜丸噙化。
干咳嗽者，系火郁之甚，难治，乃痰郁火，邪在肺中，用苦梗以开之，下用补阴降火，不已则成劳，须行倒仓法，
此证不得志者有之。
有痰因火逆上者，必先治火，然亦看痰火孰急，若痰急，先治痰而后降火也。
劳者，主补阴清金，四物汤加竹沥、姜汁。（戴氏曰∶盗汗出，兼痰多作寒热是也。）
阴虚火动而嗽，四物合二陈，顺而下之。（加炒黄柏、知母尤佳。）
阴虚喘嗽或吐红者，四物汤加知母、黄柏、五味子、人参、麦门冬、桑白皮、地骨皮。
好色之人，元气虚弱，咳嗽不愈，琼玉膏最捷。
肺虚甚者，人参膏以生姜、陈皮佐之，有痰加痰药，此好色肾虚者有之。
久嗽、劳嗽，用贝母、知母各一两，以巴豆同炒黄色，去巴豆，再用白矾、白芨各一两为末，以生姜一片蘸药，睡
时噙化，药尽嚼姜咽之。麦门冬、陈皮、阿胶珠各等分，蜜丸噙化。又方有人参、五味子。
咳嗽声嘶哑，乃血虚受热，用青黛、蛤粉蜜调服之。
《医说》内一方治痰嗽，用蚌粉新瓦上炒通红，拌入青黛少许，以淡 水滴入麻油数点调服。
痰者，主豁痰。（戴氏曰∶嗽动便有痰声，痰出嗽止是也。）
痰嗽，用半夏、栝蒌子各五两，贝母、桔梗各二两，知母一两，枳壳一两半，为细末，生姜汁浸，蒸饼为丸服。
一方∶黄芩一两半酒洗，白芥子去壳、滑石各五钱，贝母、南星各一两，风化硝二钱半，姜汁浸，蒸饼为丸，青黛
为衣。
痰多喘嗽，白术、半夏、苍术、香附、杏仁各一两，黄芩五钱，为末，姜汗调面糊为丸服。
痰嗽因酒伤肺，栝蒌仁、杏仁俱杵如泥，黄连为末，以竹沥入紫苏叶煎，再入韭汁调丸服。一方用青黛、栝蒌，蜜
丸噙化以救肺。
久嗽，有积痰留肺脘中如胶，气不能升降，或挟温与酒而作，茜根（俗名过山龙，童便浸）、僵蚕、炒海粉、栝蒌仁、
蜂房、杏仁、神曲为末，姜汁、竹沥调，噙化。
痰嗽气急，苍术三两，香附一两半，萝卜子蒸、杏仁、栝蒌仁、半夏各一两，黄芩、茯苓各五钱，川芎三钱，丸服。
嗽而有痰，宜灸天突穴、肺 穴，以泄火热，泻肺气。
食积痰嗽发热，半夏、南星为君，栝蒌、萝卜子为臣，青黛、海石、石 为使，姜汁浸，蒸饼丸服。
食积痰嗽，三补加二母炒为末，丸如椒核大，以竹沥、藕汁吞之。（三补，芩、连、柏也。二母，知、贝母也。）
肺胀者，主收敛。（戴氏曰∶动则喘满、气急声重者是也。）
肺因火伤极，遂成郁遏胀满，用诃子为君，佐以海粉、香附、青黛、杏仁之类。
肺胀，郁遏不得眠者，难治。
凡嗽，春是春升之气，夏是火炎于上，秋是湿热伤肺，冬是风寒外束，用药发散之后，必以半夏等药，逐去其痰，
庶不再作。
早晨嗽多者，此胃中有食积，至此时火气流入肺中，以知母、地骨皮降肺火。上半日嗽多者，胃中有火，知母、石
膏降之。午后嗽多者，属阴虚，四物汤加知母、黄柏先降其火。黄昏嗽多者，火气浮乘肺，不宜用凉剂，以五味子、五
倍敛而降之。
嗽而胁痛，宜以青皮疏肝气，后以二陈汤加南星、香附、青黛、姜汁。一云∶实者，白芥子之类。
嗽而心烦不安，六一散加辰砂服。
嗽而失声，润肺散。
诃子肉 五倍子 五味子 黄芩 甘草（各等分）
上为细末，蜜丸噙化。
（以上丹溪方法凡三十八条）
嗽而无声有痰方（河间）
半夏 白术 五味子 防风 枳壳 甘草（各等分）
嗽而有声无痰方（河间）
生姜 杏仁（泡去皮尖） 五味子（九枚） 升麻 防风 桔梗（各等分） 甘草（炙，二分）
嗽而有声有痰方
白术 半夏 五味子 防风
久不愈，加枳壳、阿胶珠各等分。
寒热交作而痰嗽者，小柴胡加知母之类。一方加白芍药、五味子、桑白皮。
阴气在下，阳气在上，咳嗽呕吐喘促，泻白散加青皮、五味子、人参、茯苓、粳米。
热嗽胸满，小陷胸汤（方见伤寒门。）
治嗽劫药，五味子汤
五味子（五钱） 甘草（一钱半） 五倍子 风化硝（各一钱）
上为末，蜜丸噙化。或用诃子、百药煎、荆芥穗、蜜丸噙化。
治嗽最要分肺虚肺实。若肺虚久嗽，宜五味子、款冬花、紫菀、马兜铃之类以补之；若肺实有火邪，宜黄芩、天花
粉、桑白皮、杏仁之类以泻之。
东垣曰∶治嗽必用五味子为君，然有外邪者骤用之，恐闭住其邪气，必先发散之，而后用之可也。
治嗽用呵子，味酸苦有收敛降火之功。五味子收肺气，乃火热必用之剂。杏仁散肺气风热，然肺实有热因于寒者为
宜。桑白皮泻肺气，然性不纯良，用之多者当戒。或用马兜铃，以其去肺热补肺也。多用生姜，以其辛能发散也。栝蒌
子甘，能补肺润肺降气，胸中有痰者，以肺受火逼，失降下之令，今得甘缓润下之助，则痰自降，宜其为治嗽之要药也。
琼玉膏（丹溪） 治虚劳、干咳嗽。
人参（十二两） 沉香 琥珀（各五钱） 白砂蜜（五斤，煎沸去沫） 白茯苓（去皮净者，二十五两） 生地黄
（去
芦净者，十斤，洗净银石器内，杵细，取自然汁，大忌铁器）
仙曰∶今予所制此方，加沉香、琥珀二味，其功效异于世传之方。
上以人参、茯苓、沉香、琥珀俱为细末，先将地黄汁与白砂蜜搅匀，用密绢滤去细渣，入药末搅匀，入好瓷瓶或银
瓶内，用绵纸十数层，外加箭箬包封，扎瓶口，入砂锅内或铜锅内，以长流水浸没瓶颈，用桑柴文武火煮三昼夜取出，
换蜡纸数重包扎瓶口，浸没井中半日，以出火毒，提起，仍入前锅内煮半日，以出水气，然后收藏。每日清晨及午前、
后，取一、二匙，用温酒一盏调服。不饮酒人，白汤亦可。……。
九仙散（局方） 治一切咳嗽、久嗽，乃击其惰归之药也。
人参 款冬花 桑白皮 桔梗 阿胶（炒成珠） 五味子（各一钱） 乌梅（一个） 贝母（五分） 罂粟壳（去
穣蒂盖，蜜炙，二钱）
上细切，作一服，加生姜三片，水二盏，煎至一盏，温服。
三拗汤（局方） 治风寒咳嗽喘急。
麻黄（不去根节） 甘草（生用） 杏仁（不去皮尖，另研细，各一钱五分）
上细切，作一服，加生姜五片，枣二枚，水一盏半，煎至一盏，温服，痰清乃止。
温肺汤（局方） 治肺感寒邪，咳嗽吐痰。
半夏（泡） 陈皮（去白） 五味子 干姜（泡） 桂心（各五分） 杏仁（去皮，炒研，五分） 北细辛 阿胶
（炒成珠） 甘草（炙，各二分半）
上细切，作一服，加生姜三片，大枣二枚，水一盏半，煎至一盏，去渣温服。
愚按∶此方乃冬月寒冷之时，触冒寒邪而未郁热者，极效。如久嗽郁热者，切不可用。
杏苏饮（局方） 治上气喘嗽，面目浮肿。
紫苏叶（七分） 五味子 大腹皮（酒洗净） 乌梅肉 杏仁泥（各五分） 陈皮（去白） 桔梗 麻黄（去根节）
柔白皮（蜜炙） 阿胶珠（各二分半） 紫菀茸（三分半） 甘草（炙，一分）
上细切，加生姜五片，水一盏半，煎至一盏，温服。
（丹溪活套）云∶二陈汤治咳嗽，去痰代病根之药也，除阴虚血虚火盛干咳嗽者勿用。如血虚有痰者，本方合四物
汤，加五味子、麦门冬、栝蒌仁之类。如伤风邪咳嗽，本方加南星、枳壳、防风、荆芥、前胡、细辛、旋复花之类。如
伤寒邪咳嗽，本方加麻黄、杏仁、桔梗、干姜、桂枝之类。如伤热邪咳嗽，本方加黄芩、薄荷、知母、石膏、桔梗之类。
如先伤风寒郁热，久嗽不已，欲成劳者，本方加知母、贝母、款冬花、紫菀、五味子、天麦二门冬、马兜铃、当归、生
地黄之类。如伤风寒，喘嗽并作，本方加麻黄、杏仁、防风、荆芥、枳壳、桑白皮、桔梗、地骨皮、紫苏之类。如咳嗽
声嘶，引两胁痛不可忍者，本方加芎、归、芍药、青皮、柴胡、草龙胆、黄芩、竹茹之类。如年久喘嗽，遇风寒则发作
者，本方加紫菀、款冬花、桑白皮、杏仁、五味子、知母、石膏之类。不问风寒郁热，劳嗽久嗽，曾先服麻黄、杏仁、
防风等药，病虽退减而病根未除者，本方加粟壳、乌梅、阿胶、五味子、栝蒌仁之类，可一服而愈。凡诸嗽，须分气虚、
气实、新、久用药。如新咳嗽挟虚者，可用人参；风寒邪甚者，则不可用；如久嗽已郁热者，切不可用人参，反增喘满
嗽剧。如肺虚久嗽，加五味子、款冬花、紫菀茸、马兜铃之类以补之。若肺实而有火邪者，宜桑白皮、片黄芩、天花粉、
杏仁、枳壳、桔梗之类以泻之。
（祖传方）
润肺除嗽饮 治远年咳嗽如神。
人参 杏仁 生甘草 薄荷（各三分） 五味子（九粒） 款冬花 紫菀茸 麻黄 陈皮（去白） 石膏（ ） 桔
梗半夏 桑白皮（蜜炙） 枳壳（麸炒） 乌梅 粟壳（去穣，蜜炙，各等分）
上细切，加生姜三片，细茶一撮，水一盏半，煎至一盏服。
三圣丹 治久嗽极效。
天南星（泡制，一两） 半夏（汤泡七次，二两） 甘草（生用，五钱）
先以星、夏二味研为细末，用生姜自然汁拌匀， 作曲，春秋七日，冬十日，夏五日取出，再同甘草共研为细末，
My niece-in-law, surnamed He, while still unmarried, contracted Phlegm-Fluid Retention (Tan Yin) in April due to excessive consumption of green plums. During the day, she experienced severe pain in the chest and diaphragm, as if pierced by knives and awls; by evening, the chest pain ceased, but severe pain shifted to her knees. This occurred because Phlegm-Fluid moves with the ascending and descending of Qi. A physician treated it as Stomach Cold, using dried ginger (Gan Jiang), high ginger (Liang Jiang), cassia twig (Guan Gui), aconite root (Wu Tou), processed aconite root (Fu Zi), clove (Ding Xiang), and agarwood (Chen Xiang), along with intermittent consumption of pepper porridge. Consequently, the condition worsened daily, accompanied by thirst and dysuria (scanty, painful urination). Seeking my treatment, I palpated her six pulses, finding them surging (Hong), rapid (Shuo), and slippery (Hua). Diagnosing it as Phlegm-Heat, I instructed her to urgently decoct bamboo sap (Zhu Li) for oral administration. After three days, her thirst subsided, and urination normalized, yet the alternating pain in the chest and knees persisted. I then administered juice extracted from radish seeds (Luo Bo Zi); after consuming half a bowl, she vomited approximately half a sheng of phlegm. By night, the pain intensified further than before, which aligns with Zhu Danxi’s description of "provoking the rampant momentum of the pathogen." The following day, one liang of ginseng rhizome tip (Ren Shen Lu) was decocted using the "reverse current" method, but vomiting did not occur. On the second subsequent day, a decoction of sophora root (Ku Shen) failed to induce vomiting; similarly, aconite tips (Fu Zi Jian) and polyporus stem (Jie Geng Lu) were ineffective. One morning, one qian of veratrum powder (Li Lu) mixed with a small amount of musk (She Xiang) and adjusted with sour water (Suan Jiang Shui) finally induced profuse vomiting. Vomiting continued until dawn the next day, expelling stubborn phlegm and thick fluids totaling about one small bucket. The pain vanished immediately thereafter, and recovery was achieved through dietary management with soft congee.
Discussion
The *Nei Jing* states: "All five zang and six fu organs can cause cough, not merely the lung." The skin and hair are the exterior correspondence of the lung; when pathogens invade the skin and hair first, they transmit inward to the lung via this correspondence. Chronic cough originating in the five zang organs may eventually transfer to the six fu organs. Liu Hejian stated: "Cough refers to sound without phlegm, indicating lung Qi injury and lack of clarity. Su refers to phlegm without sound, caused by spleen dampness stirring up phlegm. Cough-Su involves both phlegm and sound, resulting from lung Qi injury combined with spleen dampness activation." Spleen dampness arises from autumn dampness accumulation in the spleen. Thus, the *Nei Jing* adds: "Autumn dampness invasion leads to winter cough." Generally, early autumn Qi should be clear and肃 (descending); if disturbed, Qi rushes upward causing cough, potentially triggering spleen dampness and phlegm formation. Furthermore, cold, heat, dryness, dampness, wind, and fire—the Six Qi—can all cause cough. Specifically, dampness-induced Phlegm-Fluid entering the stomach, stagnating, and ascending to the lung causes cough. If dampness affects the Heart channel, it is termed Heat-Phlegm; Liver channel, Wind-Phlegm; Lung channel, Qi-Phlegm; Kidney channel, Cold-Phlegm. Treatments must vary according to the syndrome. Therefore, for cough without phlegm, use acrid-sweet herbs to moisten the lung. To treat cough, resolving phlegm is primary; to resolve phlegm, regulating Qi is essential. Thus, arisaema (Nan Xing) and pinellia (Ban Xia) eliminate phlegm, curing cough; bupleurum fruit (Zhi Ke) and tangerine peel (Ju Hong) regulate Qi, reducing Phlegm-Fluid. For abundant phlegm with normal appetite, minor Chengqi Decoction (Xiao Chengqi Tang) gently purges; for abundant phlegm with anorexia, magnolia bark decoction (Nong Po Tang) guides flow. Summer cough with fever is Heat-Cough, treated with Xiao Chaihu Tang plus gypsum (Shi Gao) and anemarrhena (Zhi Mu); winter cough with chills and fever is Cold-Cough, treated with Xiao Qinglong Tang plus apricot kernel (Xing Ren). These are the general principles of treatment, which students must know.
Pulse Diagnosis
A faint pulse at the Guan position indicates cough. A slightly urgent Lung pulse indicates cough with spitting blood. A wiry and choppy pulse with cough indicates blood deficiency. A tight pulse indicates Lung cold. Double wiry pulses indicate cold. Floating and tight pulses indicate deficient cold. Floating and slow pulses indicate wind injury. Fine pulses indicate dampness. Rapid pulses indicate heat. Deep and rapid pulses indicate excess heat. Wiry pulses indicate water retention. Unilateral wiry pulses indicate fluid retention. Deep pulses indicate retained fluid. Surging and slippery pulses indicate abundant phlegm.
In cough, floating and straight pulses suggest survival. Floating and soft pulses suggest survival. Tight pulses indicate death. Deep, small, and hidden pulses indicate death. Cough with emaciation and firm, large pulses indicate death. Cough with wasting, fever, and small, firm, urgent pulses indicate death. Any case with emaciation, persistent fever, cough, vomiting, abdominal distension, diarrhea, and wiry-urgent pulses constitutes a fatal prognosis.
Methods
Zhu Danxi stated: Cough includes types of Wind-Cold, Fire, Consumption (Lao), Phlegm, and Lung Distension.
For Wind-Cold cough, primarily use dispersing and phlegm-resolving methods: Er Chen Tang added with ephedra (Ma Huang), apricot kernel (Xing Ren), and platycodon (Jie Geng). (Dai Yuanli noted: Wind-Cold cough presents with nasal congestion, heavy voice, and aversion to cold.)
For Wind-Cold stagnating and transforming into heat in the lung, causing night cough, use San Ao Tang added with anemarrhena (Zhi Mu). If the pulse is large and floating with heat signs, add scutellaria (Huang Qin) and fresh ginger (Sheng Jiang).
For Cold Cough, ancient formulas used sliced dried ginger, baked and powdered, formed into pills the size of mustard seeds with rice paste, taken thirty pills on an empty stomach with rice drink.
Hoarseness belongs to Cold (Cold enveloping Heat, specifically cold-induced cough): use asarum (Xi Xin), pinellia (Ban Xia), and fresh ginger (Sheng Jiang) to disperse with acrid properties.
For chronic cough due to wind invading the lung, use tube stone (E Guan Shi), realgar (Xiong Huang), weijin (Wei Jin), and coltsfoot (Kuan Dong Hua) powdered. Place a slice of ginger on the tongue, mix herb powder with mugwort, moxa-burn on the ginger, inhaling the smoke into the throat to cure. Another formula includes arisaema (Nan Xing) and auricularia (Fo Er Cao), excluding weijin (this is the smoke-tube method, slightly different).
Smoke-tube formula for cough: tube stone, realgar, coltsfoot, and auricularia powdered. Coat paper with egg white, roll herb powder into a tube, burn and inhale smoke into the throat, followed by ginger soup.
Wheezing cough recurring in winter is Cold enveloping Heat; releasing the exterior heat resolves it. Zhi Ke, Jie Geng (1 qian each), Ma Huang, fangfeng, gancao, chenpi, zi su, mu tong, huang qin (equal parts). In severe cold, remove huang qin, add xing ren (5 fen).
Cough triggered by cold with phlegm above the diaphragm: Er Chen Tang added with fried zhi ke, huang qin, jie geng, cang zhu, ma huan, mu tong, sheng jiang.
Fire cough requires clearing fire, purifying metal, and resolving phlegm: huang qin, hai shi, gua lou, qing dai, jie geng, ban xia, xiang fu, he zi, qing pi. (Dai Yuanli: audible cough with little phlegm and red face.) Form pills with honey for sucking.
Dry cough results from severe fire stagnation, difficult to treat; it is phlegm-stagnant fire with pathogen in the lung. Use jie geng to open the lung; below, use yin-nourishing and fire-clearing herbs. If unresolved, it becomes consumption; Cang Dao (stomach purge) method is required. This often occurs in those with emotional frustration.
For phlegm rising due to counterflowing fire, treat fire first, but assess urgency. If phlegm is urgent, treat phlegm before clearing fire.
Consumption (Lao) cough requires nourishing yin and purifying metal: Si Wu Tang added with zhu li and jiang zhi. (Dai Yuanli: night sweats, abundant phlegm, alternating chills and fever.)
Yin-deficiency with fire stirring causing cough: Si Wu Tang combined with Er Chen Tang, guiding downward. (Added fried huang bo and zhi mu is better.)
Yin-deficiency wheezing cough or hemoptysis: Si Wu Tang added with zhi mu, huang bo, wu wei zi, ren shen, mai men dong, sang bai pi, di gu pi.
Those indulging in sexual activity have deficient yuan qi and chronic cough; Qiong Yu Gao is most effective.
For severe Lung deficiency, Ren Shen Gao aided by sheng jiang and chen pi; add phlegm-resolving herbs if present. Common in those with kidney deficiency from sexual excess.
For chronic/consumptive cough: bei mu and zhi mu (1 liang each) stir-fried with ba dou until yellow, remove ba dou, add bai fan and bai ji (1 liang each) powdered. Dip ginger slice in powder, suck before sleep, chew ginger after finishing. Alternatively, mai men dong, chen pi, e jiao zhu (equal parts), honey pills for sucking. Another formula includes ren shen and wu wei zi.
Hoarse cough due to blood deficiency and heat: qing dai and ge fen mixed with honey.
Formula from *Yi Shuo* for phlegm-cough: clam powder stir-fried on new tile until red, mixed with slight qing dai, diluted water, and sesame oil drops.
Phlegm cough primarily requires expelling phlegm. (Dai Yuanli: cough produces sound only when phlegm moves; cough stops when phlegm exits.)
Phlegm cough: ban xia and gua lou zi (5 liang each), bei mu, jie geng (2 liang each), zhi mu (1 liang), zhi ke (1.5 liang). Powder, soak in sheng jiang zhi, steam cake pills.
Another formula: huang qin (1.5 liang, wine-washed), bai jie zi (dehusked), hua shi (5 qian each), bei mu, nan xing (1 liang each), feng hua xiao (2.5 qian). Soak in ginger juice, steam cake pills, coated with qing dai.
Abundant phlegm wheezing cough: bai zhu, ban xia, cang zhu, xiang fu, xing ren (1 liang each), huang qin (5 qian). Powder, adjust with ginger juice and flour paste for pills.
Alcohol-induced phlegm cough: gua lou ren, xing ren pounded to paste, huang lian powdered. Decoct zhu li with zi ye, add jiu zhi, form pills. Alternative: qing dai, gua lou, honey pills for sucking to save the lung.
Chronic cough with sticky phlegm like glue in the lung, obstructing Qi ascent/descent, or mixed with warm pathogen/alcohol: qian gen (soaked in child's urine), jiang can, chao hai fen, gua lou ren, feng fang, xing ren, shen qu powdered. Adjust with jiang zhi and zhu li, suck.
Phlegm cough with急促 qi: cang zhu (3 liang), xiang fu (1.5 liang), steamed luo bo zi, xing ren, gua lou ren, ban xia (1 liang each), huang qin, fu ling (5 qian each), chuan xiong (3 qian). Pills.
Cough with phlegm: moxibustion on Tiantu (CV22) and Feishu (BL13) to drain heat/fire and泻 Lung Qi.
Food-stagnation phlegm cough with fever: ban xia, nan xing as sovereign; gua lou, luo bo zi as minister; qing dai, hai shi, shi chang pu as assistant. Ginger juice soaked, steam cake pills.
Food-stagnation phlegm cough: San Bu (huang qin, huang lian, huang bo) plus Er Mu (zhi mu, bei mu) stir-fried, powdered. Pill size of pepper seed, swallowed with zhu li and ou zhi.
Lung Distension (Fei Zhang) primarily requires astringency. (Dai Yuanli: exertion causes wheezing/fullness,急促 qi, heavy voice.)
Lung damaged severely by fire, leading to stagnation and distension: he zi as sovereign, assisted by hai fen, xiang fu, qing dai, xing ren.
Lung distension with stagnation preventing sleep is difficult to treat.
General cough principles: Spring involves ascending Qi; Summer involves flaming fire upward; Autumn involves damp-heat injuring Lung; Winter involves external wind-cold binding. After dispersing medication, use ban xia etc. to expel phlegm to prevent recurrence.
Morning cough abundance: food stagnation in Stomach, fire flows to Lung. Use zhi mu, di gu pi to descend Lung fire.
First-half-day cough abundance: fire in Stomach. Use zhi mu, shi gao to descend.
Afternoon cough abundance: Yin deficiency. Si Wu Tang + zhi mu, huang bo to descend fire first.
Dusk cough abundance: floating fire attacking Lung. Avoid cold herbs; use wu wei zi, wu bei zi to astringe and descend.
Cough with hypochondriac pain: qing pi to soothe Liver Qi, followed by Er Chen Tang + nan xing, xiang fu, qing dai, jiang zhi. Alternative: shi syndrome uses bai jie zi.
Cough with restlessness: Liu Yi San + chen sha.
Cough with loss of voice: Run Fei San.
He Zi Rou, Wu Bei Zi, Wu Wei Zi, Huang Qin, Gan Cao (equal parts). Powder, honey pills for sucking.
(Above are 38 methods from Danxi)
Cough silent with phlegm formula (Hejian): Ban Xia, Bai Zhu, Wu Wei Zi, Fang Feng, Zhi Ke, Gan Cao (equal parts).
Cough audible without phlegm formula (Hejian): Sheng Jiang, Xing Ren (soaked, peeled, core removed), Wu Wei Zi (9 pieces), Sheng Ma, Fang Feng, Jie Geng (equal parts), Gan Cao (roasted, 2 fen).
Cough audible with phlegm formula: Bai Zhu, Ban Xia, Wu Wei Zi, Fang Feng.
If chronic, add Zhi Ke, E Jiao Zhu (equal parts).
Alternating chills/fever with phlegm cough: Xiao Chaihu Tang + zhi mu. Alternative: add bai shao, wu wei zi, sang bai pi.
Yin below, Yang above, cough/vomiting/wheezing: Xie Bai San + qing pi, wu wei zi, ren shen, fu ling, jing mi.
Heat cough with chest fullness: Xiao Xian Xiong Tang (see Shang Han section).
Cough-purgative medicine: Wu Wei Zi Tang. Wu Wei Zi (5 qian), Gan Cao (1.5 qian), Wu Bei Zi, Feng Hua Xiao (1 qian each). Powder, honey pills for sucking. Or he zi, bai yao jian, jing jie sui, honey pills.
Crucial to distinguish Lung Deficiency vs Excess in cough. Lung deficiency chronic cough: wu wei zi, kuan dong hua, zi wan, dou mu ling to tonify. Lung excess with fire: huang qin, tian hua fen, sang bai pi, xing ren to drain.
Li Dongyuan said: Wu Wei Zi must be sovereign for cough, but if exterior pathogen exists, sudden use may trap pathogen; disperse first, then use.
He Zi is acrid-bitter, astringent, descends fire. Wu Wei Zi collects Lung Qi, essential for heat-fire. Xing Ren disperses Lung wind-heat, suitable for Lung excess heat due to cold. Sang Bai Pi drains Lung Qi, but nature is not purely good; caution with long-term use. Dou Mu Ling removes Lung heat and tonifies Lung. Sheng Jiang is acrid-dispersing. Gua Lou Zi is sweet, tonifies/moistens Lung, descends Qi. For chest phlegm due to fire forcing Qi upward, sweet-moistening help allows phlegm to descend, making it a key cough herb.
Qiong Yu Gao (Danxi): Treats consumptive dry cough. Ren Shen (12 liang), Chen Xiang, Hu Po (5 qian each), Bai Sha Mi (5 jin, boiled skimmed), Bai Fu Ling (peeled, 25 liang), Sheng Di Huang (unrooted, 10 jin, washed silver/copper mortar, crushed for juice, avoid iron).
Immortal said: My version adds Chen Xiang and Hu Po, differing from common formulas.
Powder ren shen, fu ling, chen xiang, hu po. Mix Di Huang juice with Bai Sha Mi, filter fine residue through silk, add powders, mix well. Store in porcelain/silver jar, seal with multi-layer cotton paper and arrow bamboo leaves, tie mouth. Simmer in sand/copper pot submerged in running water with mulberry wood fire for 3 days/nights. Remove, reseal with wax paper, immerse in well water for half day to remove fire toxicity. Return to pot for half day to remove water vapor. Store. Take 1-2 spoons morning/noon/evening with warm wine or plain water.
Jiu Xian San (Ju Fang): Treats all coughs/chronic cough, striking when pathogen is weak. Ren Shen, Kuan Dong Hua, Sang Bai Pi, Jie Geng, E Jiao (fried pearl), Wu Wei Zi (1 qian each), Wu Mei (1 piece), Bei Mu (5 fen), Ying Su Ke (removed core/stem, honey-roasted, 2 qian).
Finely cut, one dose, add 3 slices sheng jiang, 2 cups water, decoct to 1 cup, warm take.
San Ao Tang (Ju Fang): Treats wind-cold cough/wheezing urgency. Ma Huang (roots/nodes intact), Gan Cao (raw), Xing Ren (skin/core intact, separately ground fine, 1.5 qian each).
Finely cut, one dose, add 5 slices sheng jiang, 2 dates, 1.5 cups water, decoct to 1 cup, warm take. Stop when phlegm clears.
Wen Fei Tang (Ju Fang): Treats Lung cold invasion, cough with phlegm. Ban Xia (soaked), Chen Pi (white removed), Wu Wei Zi, Gan Jiang (soaked), Gui Xin (5 fen each), Xing Ren (peeled, fried ground, 5 fen), Bei Xi Xin, E Jiao (fried pearl), Gan Cao (roasted, 2.5 fen each).
Finely cut, one dose, add 3 slices sheng jiang, 2 dates, 1.5 cups water, decoct to 1 cup, strain warm take.
Commentary: This formula is highly effective for winter cold exposure without heat stagnation. Contraindicated for chronic cough with heat stagnation.
Xing Su Yin (Ju Fang): Treats upper jiao wheezing cough, facial/eye edema. Zi Su Ye (7 fen), Wu Wei Zi, Da Fu Pi (wine washed), Wu Mei Rou, Xing Ren Ni (5 fen each), Chen Pi (white removed), Jie Geng, Ma Huang (roots removed), Rou Bai Pi (honey roasted), E Jiao Zhu (2.5 fen each), Zi Wan Rong (3.5 fen), Gan Cao (roasted, 1 fen).
Finely cut, add 5 slices sheng jiang, 1.5 cups water, decoct to 1 cup, warm take.
(Danxi Flexible Application): Er Chen Tang treats cough by removing phlegm and addressing root, except for Yin/blood deficiency with fire-dry cough. Blood deficiency with phlegm: combine with Si Wu Tang + wu wei zi, mai men dong, gua lou ren. Wind-cold cough: add nan xing, zhi ke, fang feng, jing jie, qian hu, xi xin, xuan fu hua. Cold damage cough: add ma huan, xing ren, jie geng, gan jiang, gui zhi. Heat damage cough: add huang qin, bo he, zhi mu, shi gao, jie geng. Wind-cold with heat stagnation chronic cough approaching consumption: add zhi mu, bei mu, kuan dong hua, zi wan, wu wei zi, tian/mai men dong, dou mu ling, dang gui, sheng di huang. Wind-cold with wheezing: add ma huan, xing ren, fang feng, jing jie, zhi ke, sang bai pi, jie geng, di gu pi, zi su. Hoarse cough with hypochondriac pain: add xiong gui, dang gui, shao yao, qing pi, chai hu, cao long dan, huang qin, zhu ru. Chronic wheezing triggered by wind-cold: add zi wan, kuan dong hua, sang bai pi, xing ren, wu wei zi, zhi mu, shi gao. Regardless of wind-cold/heat or consumption/chronic cough, if prior ma huan/xing ren/fang feng reduced symptoms but root remains: add ying su ke, wu mei, e jiao, wu wei zi, gua lou ren for potential cure. Differentiate Qi deficiency/excess, new/chronic. New cough with deficiency: use ren shen (avoid if severe wind-cold). Chronic cough with heat: avoid ren shen (worsens wheezing/cough). Lung deficiency chronic: add wu wei zi, kuan dong hua, zi wan rong, dou mu ling to tonify. Lung excess fire: add sang bai pi, pian huang qin, tian hua fen, xing ren, zhi ke, jie geng to drain.
(Ancestral Formula)
Run Fei Chu Sou Yin: Miraculous for remote chronic cough. Ren Shen, Xing Ren, Sheng Gan Cao, Bo He (3 fen each), Wu Wei Zi (9 grains), Kuan Dong Hua, Zi Wan Rong, Ma Huang, Chen Pi (white removed), Shi Gao, Jie Geng, Ban Xia, Sang Bai Pi (honey roasted), Zhi Ke (bran fried), Wu Mei, Su Ke (core removed, honey roasted, equal parts).
Finely cut, add 3 slices sheng jiang, pinch strong tea, 1.5 cups water, decoct to 1 cup.
San Sheng Dan: Highly effective for chronic cough. Tian Nan Xing (processed, 1 liang), Ban Xia (water-soaked 7 times, 2 liang), Gan Cao (raw, 5 qian).
Grind nan xing and ban xia fine, mix with fresh sheng jiang juice, make into qu (fermented starter). Spring/Autumn 7 days, Winter 10 days, Summer 5 days. Remove, grind together with gan cao fine.