上并为末,淡豆豉一百粒,汤浸去壳,研如膏,入前五味,丸如桐子大。每服一丸,临卧冷茶清下。
治远年近日喘嗽。
蝉蜕(一两,去头足) 五灵脂(生) 砒(生) 雄黄(生) 杏仁(去皮尖。各五钱) 轻粉(一两)
淡豆豉(四十九粒) 马兜铃(生一两)
上研,除出轻粉另研,余为末,用生姜、葶苈自然汁合轻粉诸药为丸,如小弹大。每服一丸,临卧细嚼,
生姜汤送下。
上用信劫痰例,盖为寒湿痰设也。
运气 咳有二∶
一曰火。经云∶少阳司天之政,初之气,候乃大温,其病气拂于上咳逆。二之气,火反郁,白埃四起,其
病热郁于上咳逆。三之气,炎暑至,民病咳。终之气,风乃至,其病阳气不藏而咳是也。
二曰燥热。经云∶少阴司天之政,水火寒热,持于气交,民病咳喘。三之气,大火行,寒气时至,民病咳
喘,此上热下燥为咳喘也。终之气,燥令行,余火内格咳喘,此外燥包热在内喘咳也。
〔《本》〕治诸嗽久不瘥,贝母汤。
贝母(一两,去心,姜制) 黄芩(半两) 干姜(生,一两) 五味子 陈皮(各一两) 桑白皮(半两)
半夏 柴胡 桂心(各一两) 木香 甘草(各一分)
上为粗末,每服五钱,水一盏半,加杏仁七个,去皮尖,生姜七片,煎去渣热服。有姓蒋者,其妻积年嗽,
制此方授之,一服瘥,以治诸般嗽悉愈。
上方有寒有热,有收有散,诸嗽通用也。
〔《素》〕黄帝问曰∶肺之令人咳何也?岐伯对曰∶五脏六腑,皆令人咳,非独肺也。帝曰∶愿闻其状?岐
伯曰∶皮毛者,肺之合也,皮毛先受邪气,邪气以从其合也。(此邪从外受之。王注云∶邪谓寒气。)其寒饮食入
胃,从肺脉上至于肺则肺寒。(寒邪从外受也。)肺寒则外内合邪因而客之,则为肺咳。(所谓肺先受邪也。)
五脏各以其时受病,(王注云∶时谓王月也。)非其时各传以与之。人与天地相参,故五脏各以治时(肝治春,心
治夏,脾治长夏,肺治秋,肾治冬也。)感于寒则受病,微则为咳,甚则为泄为痛,乘秋则肺先受邪,乘春则肝先
受之,乘夏则心先受之,乘至阴则脾先受之,乘冬则肾先受之。帝曰∶何以异之?岐伯曰∶肺咳之状,咳而喘息有
音,甚则吐血。(取太渊穴也。)心咳之状,咳则心痛,喉仲介介如梗状,甚则咽肿喉痹。(取大陵穴也。)肝咳之状,
咳则两胁下痛,甚则不可以转,转则两 下满。(取太冲穴也。)脾咳之状,咳则右胁下痛阴阴引肩背,甚则不可
以动,动则咳剧。(取太白穴也。)肾咳之状,咳则腰背相引而痛,甚则咳涎。(取太溪穴也。)帝曰∶六腑之咳
奈何?安所受病?岐伯曰∶五脏之久咳,乃移于六腑,脾咳不已,则胃受之。胃咳之状,咳而呕,呕甚则长虫出。
(取三里穴也。)肝咳不已,则胆受之。胆咳之状,咳呕胆汁。(取阳陵泉穴也。)肺咳不已,则大肠受之,大肠
咳状,咳而遗矢。(取巨虚上廉也。)心咳不已,则小肠受之,小肠咳状,咳而失气,气与咳俱失。(取巨虚下
廉穴也。)肾咳不已,则膀胱受之,膀胱咳状,咳而遗溺。(取委中穴也。)久咳不已,则三焦受之,三焦咳状,
咳而腹满,不欲食饮,此皆聚于胃,关于肺,使人多涕唾而面浮肿气逆也。(取支沟穴也。)帝曰∶治之奈何?
岐伯曰∶治脏者治其俞,治腑者治其合,浮肿者治其经。(见咳论)
〔丹〕治嗽。灸天突、肺俞二穴,泄火热,泻肺气。
〔《千》〕嗽。灸两乳下黑白际各百壮即瘥。又以蒲当乳头周匝围身,令前后正平,当脊骨下解中灸十壮,又
以绳横量口中,折绳,从脊灸绳两头边,各八十壮,三报三日毕两边者是合度。
〔《玉》〕治咳嗽∶身柱(三分,泻三吸。)至阳(三分,补三呼。)不已,再取后穴∶肺 (寸一分,
沿皮向外一寸半,泻六吸。寒痰红痰,俱是虚 补实泻。)又法∶风门(一分,沿皮向外一寸半。)
〔《心》〕咳嗽喘满,气急不食,容颜黧黑,鼻流清涕∶风门(沿皮向外二寸半,补之。)巨阙(三寸三分,泻之。)
太渊(五分,泻之。)期门(平之。)下脘(五分,泻之。) 中(灸,七壮。)中脘(三寸,泻之)绝
骨(三寸半,退热妙穴也。)支沟(透间使,两胁胀满妙穴也。)
妇人咳嗽,寒热往来,风寒呕逆,劳疸中满喘急∶风门(沿皮一寸半,治感冒风寒。)太渊(五分,治咳
嗽。)中脘(三寸,治呕逆,使气往来为效。)绝骨 曲池(各一寸半,治寒嗽血膈劳疸。)间使(透支沟,
治中喘满上气。)
〔《甲》〕咳逆上气,舌干胁痛,心烦肩寒,少气不足以息,腹胀喘,尺泽主之。咳干呕烦满,侠白主之。
咳上气,喘不得息,暴痹内逆,肝肺相搏,鼻口出血,身胀,逆息不得卧,天府主之。咳逆上气,喘不得息,
呕吐,胸满不得饮食,输府主之。咳逆上气,涎出多吐,呼吸喘悸不得安, 中主之。胸满咳喘不得息,呕吐
烦满,不得饮食,神藏主之。咳逆上气,魄户及气舍主之。咳逆上气,噫嘻主之。胸胁 满,不得俯仰,饮食
不下,咳唾沫脓,周荣主之。咳而泄不欲食者,商丘主之。凄凄寒咳吐血,逆气,入心痛,手阴 主之。咳而
胸满,前谷主之。咳逆上气,吐沫,天容及行间主之。咳逆不止,三焦有水气,不能食,维道主之。咳,面赤
热,支沟主之。咳逆上气,咽喉痈肿,呼吸短气,喘息不通,水突主之。(一作天突。)咳上气喘,暴喑不能言,
及舌下挟缝青脉,颈有大气,喉痹,咽中干急不得息,喉中鸣,翕翕寒热,项痛肩痛胸痛,腹皮热,衄,气短鲠,
心痛隐疹,头痛,面皮赤热,身肉尽不仁,天突主之。咳逆上气,喘不能言,华盖主之。
成无己云∶咳者謦咳之咳,俗谓之嗽者是也。肺主气,形寒饮冷则伤之,使气上而不下,逆而不收,冲击
膈咽,令喉中淫淫如痒,习习如梗,是令嗽。甚者续续不已,连连不息,坐卧不安,言语不竟,动引百脉,咳
声闻四近矣。(謦,枯鼎切,咳声也。)
〔《脉》〕肺痿,咳唾咽燥,欲饮水者自愈,自张口者短气也。
〔丹〕咳嗽肺胀壅遏,不得眠者,难治。
〔仲〕人嗽十年,其脉弱者可治,实大数者死。其脉虚者必苦冒,其人本有支饮在胸中故也,治属饮家。
上气面浮肿,肩息,其脉浮大不治。又加利尤甚。脉浮短者,其人肺伤,诸气微少,不过一年死,法当嗽也。
咳嗽羸瘦,脉形坚大者死。
咳而脱形,身热,脉小坚急以疾,是逆也,不过十五日死。(全文见诊。)
〔《脉》〕上气脉数者死,谓其形损故也。咳嗽脉沉紧者死,浮直者生,浮软者生,小沉伏匿者死。
〔丹〕咳嗽口燥咽干有痰,不用半夏,用栝蒌、贝母;饮水者,不用栝蒌,恐泥膈不快。
The above medicines are ground into fine powder. Take one hundred grains of fermented soybean (Douchi, 淡豆豉), soak them in hot water, remove the shells, and grind them into a paste. Add the five previously mentioned powdered medicines to form pills the size of paulownia seeds. Each dose is one pill, taken with cold tea before bedtime.
Treats chronic or recent asthma and cough.
Cicada slough (one tael, remove head and feet) Wulingzhi (Raw) Arsenic (Raw) Realgar (Raw) Apricot Kernel (remove skin and tip, each five qian) Calomel (one tael)
Fermented soybean (forty-nine grains) Aristolochia Manshuriensis (Raw, one tael)
Grind the above medicines together, except for Calomel which is ground separately. Mix the remaining powders with fresh ginger juice and natural juice of Lepidium Seed (Tingli, 葶苈子) combined with Calomel to form pills the size of small pellets. Each dose is one pill, chewed thoroughly before bedtime,
and swallowed with ginger decoction.
The above formula uses the method of using realgar to expel phlegm, specifically designed for cold-dampness phlegm patterns.
Regarding the influence of Six Qi (Yunqi, 运气): There are two types of cough:
One is caused by Fire. The classics state: When Shaoyang governs the heaven, during the first phase, the climate becomes significantly warm, and the disease manifests as qi rebellion upwards causing cough. During the second phase, fire is suppressed, white dust rises everywhere, and the disease manifests as heat stagnation upwards causing cough. During the third phase, intense summer heat arrives, and people suffer from cough. During the final phase, wind arrives, and the disease manifests as yang qi failing to store, leading to cough.
The second is caused by Dryness-Heat. The classics state: When Shaoyin governs the heaven, water, fire, cold, and heat interact at the qi junction, and people suffer from cough and asthma. During the third phase, great fire prevails, and cold qi occasionally arrives, causing people to suffer from cough and asthma; this is cough and asthma due to upper heat and lower dryness. During the final phase, dryness command prevails, residual fire is blocked internally, causing cough and asthma; this is wheezing and cough due to external dryness enclosing internal heat.
[Bencao] Beimu Decoction for treating various long-standing coughs that do not heal.
Fritillaria Bulb (Beimu, 贝母) (one tael, remove heart, processed with ginger) Scutellaria Root (Huangqin, 黄芩) (half tael) Dried Ginger (Ganjiang, 干姜) (raw, one tael) Schisandra Berry (Wuweizi, 五味子) Tangerine Peel (Chenpi, 陈皮) (each one tael) Mulberry Root Bark (Sangbaipi, 桑白皮) (half tael)
Pinellia Tuber (Banxia, 半夏) Bupleurum Root (Chaihu, 柴hu) Cinnamon Twig (Guixin, 桂心) (each one tael) Aucklandia Root (Muxiang, 木香) Licorice Root (Gancao, 甘草) (each one fen)
Grind the above into coarse powder. Each dose is five qian, boiled with one and a half cups of water, adding seven apricot kernels (removed skin and tip) and seven slices of fresh ginger. Decoct, remove dregs, and take hot. A man surnamed Jiang was given this formula for his wife's year-long cough; one dose cured her, and it cures all kinds of coughs.
The above formula contains both cold and hot herbs, astringent and dispersing herbs, making it a general formula for all coughs.
[Suwen] The Yellow Emperor asked: Why does the Lung cause cough? Qibo replied: All five zang organs and six fu organs can cause cough, not just the Lung. The Emperor said: I wish to hear its manifestations. Qibo said: The skin and hair are the exterior correspondence of the Lung. If the skin and hair are first attacked by pathogenic factors, the pathogens will follow their correspondence into the Lung. (This refers to pathogens entering from the exterior. Wang Bing's commentary states: Pathogen refers to cold qi.) If cold food and drink enter the stomach, they travel up along the Lung meridian to the Lung, causing Lung cold. (Cold pathogen enters from the exterior.) Lung cold causes external and internal pathogens to combine and lodge there, resulting in Lung cough. (This is what is meant by the Lung being the first to receive the pathogen.)
Each of the five zang organs receives disease in its corresponding season. (Wang Bing's commentary states: Season refers to the month when the organ is prosperous.) If it is not its governing season, the disease transmits to other organs. Humans correspond with heaven and earth, so each zang organ receives disease in its governing season (Liver governs Spring, Heart governs Summer, Spleen governs Late Summer, Lung governs Autumn, Kidney governs Winter). Receiving cold qi leads to illness; mild cases result in cough, severe cases result in diarrhea or pain. In Autumn, the Lung receives the pathogen first; in Spring, the Liver; in Summer, the Heart; in Late Summer, the Spleen; in Winter, the Kidney. The Emperor asked: How to distinguish them? Qibo said: The manifestation of Lung cough is cough with wheezing and sound, and in severe cases, hemoptysis. (Taiyuan acupoint may be used.) The manifestation of Heart cough is cough accompanied by heart pain, a sensation of obstruction in the throat like a foreign body, and in severe cases, sore throat and bi-syndrome. (Daling acupoint may be used.) The manifestation of Liver cough is cough with pain under both hypochondria, inability to turn over in severe cases, and fullness under both hypochondria when turning. (Taichong acupoint may be used.) The manifestation of Spleen cough is cough with pain under the right hypochondrium radiating to the shoulder and back, inability to move in severe cases, and worsening cough upon movement. (Taibai acupoint may be used.) The manifestation of Kidney cough is cough with pulling pain between the waist and back, and coughing up saliva in severe cases. (Taixi acupoint may be used.) The Emperor asked: What about cough of the six fu organs? Where does the disease come from? Qibo said: Long-standing cough of the five zang organs transfers to the six fu organs. If Spleen cough persists, the Stomach receives it. The manifestation of Stomach cough is cough with vomiting, and in severe cases, expulsion of roundworms. (Zusanli acupoint may be used.) If Liver cough persists, the Gallbladder receives it. The manifestation of Gallbladder cough is cough with vomiting of bile. (Yanglingquan acupoint may be used.) If Lung cough persists, the Large Intestine receives it. The manifestation of Large Intestine cough is cough with fecal incontinence. (Shangliao of Yangming may be used.) If Heart cough persists, the Small Intestine receives it. The manifestation of Small Intestine cough is cough with flatus, gas escaping with the cough. (Xialiao of Yangming may be used.) If Kidney cough persists, the Bladder receives it. The manifestation of Bladder cough is cough with urinary incontinence. (Weizhong acupoint may be used.) If long-standing cough persists, the Sanjiao receives it. The manifestation of Sanjiao cough is cough with abdominal fullness and loss of appetite. These are all gathered in the Stomach and related to the Lung, causing excessive phlegm and drool, facial edema, and rebellious qi. (Zhigou acupoint may be used.) The Emperor asked: How to treat? Qibo said: Treat zang organs by selecting their Shu-stream points, treat fu organs by selecting their He-sea points, and treat edema by selecting their Jing-river points. (See "Ke Lun" chapter)
[Zhu Danxi] For treating cough. Moxibustion on Tiantu and Feishu acupoints to drain fire-heat and disperse Lung qi.
[Qianjin Fang] For cough. Moxibustion on the boundary of black and white skin below both nipples, one hundred moxa cones each side, will cure. Also, use papyrus wrapped around the nipple circumference to measure the body, ensuring front and back alignment. Moxibustion ten cones on the Jie point below the spine. Also, measure horizontally across the mouth with a string, fold the string, and from the spine, moxibustion eighty cones at each end of the string on both sides. Completed in three days; symmetry indicates correct measurement.
[Yuji Wei Yi] For treating cough: Shen Zhu (depth 3 fen, reducing method with three inhalations.) Zhi Yang (depth 3 fen, tonifying method with three exhalations.) If ineffective, select posterior points again: Feishu (depth 1.1 cun, oblique insertion outward 1.5 cun, reducing method with six inhalations. Cold phlegm and red phlegm are deficiency patterns to be tonified, excess patterns to be reduced.) Another method: Fengmen (depth 1 fen, oblique insertion outward 1.5 cun.)
[Yixin] Cough, asthma, chest fullness, shortness of breath, anorexia, dark complexion, runny nose: Fengmen (oblique insertion outward 2.5 cun, tonify.) Juque (depth 3.3 cun, reduce.)
Taiyuan (depth 5 fen, reduce.) Qimen (neutral.) Xiawan (depth 5 fen, reduce.) Shanzhong (moxibustion, seven cones.) Zhongwan (depth 3 cun, reduce.) Jiegu (depth 3.5 cun, excellent point for clearing heat.) Zhigou (penetrating to Jianshi, excellent point for hypochondriac distension.)
Women with cough, alternating chills and fever, wind-cold retching, labor jaundice with abdominal fullness and asthma: Fengmen (oblique insertion 1.5 cun, for wind-cold invasion.) Taiyuan (depth 5 fen, for cough.) Zhongwan (depth 3 cun, for retching, effective for regulating qi flow.) Jiegu Quchi (each depth 1.5 cun, for cold cough, blood stasis, labor jaundice.) Jianshi (penetrating to Zhigou, for middle jiao fullness, asthma, and rebellious qi.)
[Jiayi Jing] Cough with rebellious qi, dry tongue, hypochondriac pain, vexation, cold shoulders, shortness of breath, insufficient respiration, abdominal distension, and asthma are primarily treated by Chize. Cough with dry retching and vexation/fullness are primarily treated by Xiabai.
Cough with rebellious qi, asthma with inability to breathe, sudden bi-syndrome with internal rebellion, Liver and Lung conflict, bleeding from nose and mouth, body swelling, rebellious breathing with inability to lie down are primarily treated by Tianfu. Cough with rebellious qi, asthma with inability to breathe,
vomiting, chest fullness with inability to eat are primarily treated by Shufu. Cough with rebellious qi, excessive salivation and spitting, panting palpitations with inability to rest are primarily treated by Shenfeng. Chest fullness, cough, asthma with inability to breathe, vomiting,
vexation/fullness, inability to eat are primarily treated by Shencang. Cough with rebellious qi are primarily treated by Pohu and Qishe. Cough with rebellious qi are primarily treated by Yixi. Chest and hypochondriac
distension, inability to bend or extend, inability to eat, coughing up pus and saliva are primarily treated by Zhourong. Cough with diarrhea and anorexia are primarily treated by Shangqiu. Chilly cough with hemoptysis, rebellious qi, penetrating heart pain are primarily treated by Hand-Yangming points. Cough with
chest fullness are primarily treated by Qian Gu. Cough with rebellious qi and spitting saliva are primarily treated by Tianrong and Xingjian. Cough with rebellious qi unceasing, Sanjiao having water qi, inability to eat are primarily treated by Weidao. Cough with red hot face are primarily treated by Zhigou. Cough with rebellious qi, throat abscess, shortness of breath, inability to breathe through wheezing are primarily treated by Shuitu. (Alternatively Tiantu.) Cough with asthma, sudden aphonia with inability to speak,
and green veins under the tongue near the seam, large qi in the neck, throat bi, dry and urgent throat with inability to breathe, humming in throat, aversive chill and fever, neck pain, shoulder pain, chest pain, hot abdominal skin, epistaxis, shortness of breath with obstruction,
hidden heart pain, headache, red hot facial skin, insensitivity of body flesh are primarily treated by Tiantu. Cough with rebellious qi, asthma with inability to speak are primarily treated by Huagai.
Cheng Wuji stated: Cough refers to the sound of coughing, commonly called Sou refers to cough with phlegm. The Lung governs qi; cold exposure and cold drinks injure it, causing qi to rebel upwards instead of descending, becoming rebellious and uncollected, impacting the diaphragm and throat, causing itching and obstruction sensations in the throat. This is Sou. Severe cases continue incessantly, causing restlessness in sitting and lying, inability to finish speaking, affecting all meridians, with cough sounds audible to neighbors. (Qing, pronounced Qing, refers to cough sound.)
[Maijue] Lung萎 (Feiwei), coughing up saliva with dry throat, healing if desiring water, shortness of breath if gaping mouth.
[Zhu Danxi] Cough with Lung distension and obstruction, unable to sleep, is difficult to treat.
[Zhang Zhongjing] Ten-year cough with weak pulse is treatable; solid, large, rapid pulse indicates death. Deficient pulse implies suffering from dizziness, due to pre-existing Zhi Yin (branch fluid) in the chest; treatment belongs to fluid retention categories.
Upper qi with facial edema, shoulder breathing, floating and large pulse is untreatable. Worse with diarrhea. Floating and short pulse indicates Lung injury, scarcity of all qi, death within a year, likely involving cough.
Cough with emaciation and firm, large pulse indicates death.
Cough with physical depletion, fever, small, firm, rapid, and hurried pulse is adverse, death within fifteen days. (Full text see Diagnosis.)
[Maijue] Upper qi with rapid pulse indicates death, due to bodily depletion. Cough with deep, tight pulse indicates death; floating and straight pulse indicates survival; floating and soft pulse indicates survival; small, deep, hidden pulse indicates death.
[Zhu Danxi] Cough with dry mouth and throat and phlegm: Do not use Banxia; use Gualou and Beimu. If drinking water is desired, do not use Gualou, fearing it obstructs the diaphragm and causes discomfort.