炒，二两） 栀子（炒，二两） 连翘（一两） 天南星（制，二两） 半夏（制，二两） 白
术（炒，二两） 枳实（炒，二两） 贝母（去心，一两五钱） 天花粉（一两） 陈皮（一两）
白茯苓（一两） 神曲（炒，一两） 青黛（五钱） 玄明粉（七钱） 甘草（五钱） 白芥子（炒，二两）
上末，姜汁竹沥，丸梧子大，每服姜汤下四十丸。
脉
咳嗽所因，浮风、寒紧、数热、细湿、房劳涩难。右关濡者，饮食伤脾；左关弦短，疲极肝衰。浮短肺
伤，法当咳嗽。五脏之嗽，各视其部，沉紧虚寒，沉数实热，洪滑多痰，弦涩少血。形盛
脉细，不足以息；沉小伏匿，皆是死脉。惟有浮大而嗽者生。
证
伤风咳者，脉浮，憎寒壮热，自汗恶风，口干烦躁，鼻流清涕，欲语未竟而咳也。
伤寒咳者，脉紧，憎寒发热，无汗恶寒，烦躁不渴，遇寒而咳。
伤暑咳者，脉数，烦热引饮，口燥，或吐涎沫，声嘶咯血。
伤湿咳者，脉细，骨节烦疼，四肢重着，或自汗，小便涩。
治
咳者，无痰而有声，肺气伤而不清也。治以防风、桔梗、升
麻，杏仁、五味子、生姜、甘草、桑白皮、苏子、枳壳。
嗽者，无声而有痰，脾湿动而为痰也。治以半夏、白术、五味
子、枳壳、防风、甘草、枳实、山楂、苍术、橘皮。
咳嗽者，有痰有声，因伤肺气而动脾湿也。治以半夏、白术、五味子、桔梗、枳壳、桑白皮、麦门冬、
甘草之类。
风寒嗽者，鼻塞声重，恶风恶寒，或自汗，或无汗者是也。治当以发散行痰，用二陈汤加麻黄、桔梗、杏仁。
风寒郁热于肺夜嗽者，治以三拗汤加知母。脉大而浮，有热，加黄芩、生姜。
痰嗽者，嗽动便有痰声，痰出嗽止者是也。主豁痰，用二陈
汤，或以半夏、栝蒌仁各五两，桔梗、贝母各一两，枳壳一两半，知母一两，姜汁蒸饼为丸服。
火郁者，有声痰少，面赤者是也。主降火清金化痰。
干咳嗽者，系火郁之甚，难治。乃痰郁火，邪在肺中，用桔梗开之，再用补阴降火之药。不已则成劳，须
行倒仓法。此症多是不得志者有之。有痰因火逆上者，必先治其火。然亦看痰火孰急，若
痰急，则先治痰而后治火，在乎医者之随机变可也。
劳嗽者，痰多盗汗是也。或作寒热，宜补阴清金，四物汤加竹沥姜汁。阴虚火动而嗽者，四物、二陈，
顺而下之。加黄柏，知母尤妙。阴虚喘嗽，或吐血者，四物汤加黄柏、知母、五味子、麦门冬、桑白皮、地
骨皮、牡丹皮、山栀子。咳嗽声嘶者，乃血虚受热也。用青黛、蛤粉，蜜调服。一方用芩连四物汤。好
色之人元气虚，咳嗽不已者琼玉膏。
肺胀而嗽者，动则喘满，气急息重者是也。宜收敛肺气，用诃子、杏仁，青黛、海粉、半夏、香附、栝蒌
仁之类。肺胀郁遏不得眠者难治。
凡治咳嗽，最要分肺虚肺实。若肺虚久嗽，宜五味子、款冬花、紫菀、马兜铃之类敛而补之；若肺实
有邪，宜黄芩、天花粉、桑白皮、杏仁之类散而泻之。
凡治嗽，有用五味子者，以收肺气，乃火热必用之剂。若有外邪而骤用之，恐闭住邪气，必先发散，然
后可用。诃子味酸苦，有
收敛降火之功。杏仁散肺中风寒，然形实有热，因于寒者为宜。桑白皮泻肺气，然性不纯良，用之者当戒。马
兜铃去肺热而补肺也。生姜辛能发散也。罂粟壳不可骤用，乃后收功药也。人参以其气虚，或新咳挟虚者可
用。若风寒邪盛，或久嗽肺有郁火者，不可用也。栝蒌仁甘能补肺，润能降气，胸中有痰者自降。
凡咳嗽口燥咽干有痰者，不可用南星、半夏，宜用栝蒌仁、贝母。若饮水者，又不宜栝蒌，恐泥膈不松快耳。
方
参苏饮 治四时感冒，发热头疼，咳嗽声重，涕唾稠粘，中脘
痞满，呕吐痰水。宽中快膈，不致伤脾。此药大解肌热潮热，将欲成劳瘵之证，神效。
紫苏（一钱） 前胡（一钱） 桔梗（一钱） 枳壳（一钱） 干葛（一钱） 陈皮（一钱）
半夏（一钱） 白茯苓（一钱） 甘草（七分） 人参（七分，实热者去之） 木香（五分，气盛去之）
上锉作一剂，生姜三片，黑枣二枚，水煎食后温服。若天寒感冒，恶寒无汗，咳嗽喘促；或伤风自汗，
鼻塞声重，咳嗽，并加麻黄二钱，去皮杏仁一钱，金沸草一钱，以汗散之。若初感冒，肺实有热，加杏仁、桑
白皮、黄芩各一钱，乌梅七个。胸满痰多，加栝蒌仁一钱。气促喘嗽，加知母、贝母各一钱。肺寒咳
嗽，加五味子、干姜各七分。心下痞满，或胸中烦热，或停酒不散，或嘈杂恶心，加黄连、枳实各一钱，干
葛、陈皮倍用之。鼻衄，加乌梅五个，麦门冬、茅根各一钱。心盛发热，加柴胡、黄芩
各一钱。头痛，加川芎一钱，细辛八分。咳嗽吐血，加升麻、牡丹皮各一钱，生地黄一钱五分。劳热咳嗽，
久不愈，加知母、贝母、麦门冬各一钱。吐血，加阿胶、牡丹皮、赤芍药各一钱，生
地黄一钱五分，乌梅七个。咳嗽痰中见血，以本方加四物汤，名茯苓补心汤。妊娠伤寒，去半夏，加香附。
清金降火汤 泻肺胃中之火，火降则痰消嗽止。
陈皮（一钱五分） 半夏（泡，一钱） 茯苓（一钱） 桔梗（一钱） 枳壳（麸炒，一钱）
贝母（去心，一钱） 前胡（一钱） 杏仁（去皮尖，一钱半） 黄芩（炒，一钱） 石膏（一钱）
栝蒌仁（一钱） 甘草（炙，三分）
上锉一剂，生姜三片，水煎，食远临卧服。
二母宁嗽汤〔批〕（按此方治四时一切痰嗽，无问新久，肺气有余者宜之） 治因
伤酒食，胃火上炎，冲逼肺金，以致咳嗽吐痰，经旬不愈，一服即瘥。
知母（去毛，钱半） 贝母（去心，钱半） 黄芩（一钱二分） 山栀仁（一钱二分）
石膏（二钱） 桑白皮（一钱） 茯苓（一钱） 栝蒌仁（一钱） 陈皮（一钱） 枳实（七分）
五味子（十粒） 生甘草（三分）
上锉一剂，生姜三片，水煎。临卧时，细细逐口服。
润肺豁痰宁嗽汤（云林制）〔批〕（按此方治痰嗽兼阴虚者宜之）
陈皮（五分） 半夏（姜制 五分） 白茯苓（四分） 甘草（炙，三分） 黄柏（酒炒，
五分） 黄芩（酒洗，三分） 知母（酒炒，五分） 贝母（去心，五分） 天冬（去心，三分）
麦冬（去心，三分） 紫菀（酒洗，三分） 款冬花（酒洗，三分） 桔梗（三分） 熟地黄
（五分） 当归（三分）
上锉一剂，生姜三片，水煎温服。
吸药如神散（陈太医传）〔批〕（按此方治久年痰嗽专攻之剂） 治风入肺中，久嗽不愈。
雄黄 佛耳草 鹅管石 款冬花 甘草 寒水石 青礞石（ 过） 白附子 枯矾 孩儿茶（各等分）
上为细末，纸燃烧烟，令病患吸之。
灸法 治久患咳嗽，百药无效，可用此法。
将病者乳下，大约离一指头，看其低陷之处，与乳直对不偏者，此名直骨穴。其妇人即按其乳头所
到之处，即是直骨穴也。艾灸三壮，其艾圆如小豆大。男左女右不可差，其咳即愈。如不愈，其病再不可治矣。
(Previous text omitted, continuing with prescription composition) Stir-fried (2 liang), Gardenia (stir-fried, 2 liang), Forsythia (1 liang), Pinelliae Rhizoma Preparatum (Arisaema Cum Bile, processed, 2 liang), Pinelliae Rhizoma Preparatum (Pinellia Ternata, processed, 2 liang), Atractylodis Macrocephalae Rhizoma (stir-fried, 2 liang), Immature Tangerine Peel (stir-fried, 2 liang), Fritillariae Bulbus (heart removed, 1.5 liang 5 qian), Trichosanthis Radix (1 liang), Citri Reticulatae Pericarpium (1 liang), Poria (1 liang), Massao Fermentatus (stir-fried, 1 liang), Indigo Naturalis (5 qian), Natrii Sulfas Exsiccatus (7 qian), Glycyrrhizae Radix et Rhizoma (5 qian), Brassicae Semen Album (stir-fried, 2 liang). Grind the above herbs into fine powder, use Ginger Juice and Bamboo Sap to form pills the size of a Chinese quince seed. Take 40 pills each time, washed down with Ginger Decoction.
Pulse Diagnosis
The causes of cough include: floating pulse indicates Wind pathogen, tight pulse indicates Cold pathogen, rapid pulse indicates Heat pathogen, fine pulse indicates Dampness pathogen, and choppy/difficult pulse indicates damage from sexual exhaustion. A soft pulse at the right Guan position indicates spleen/stomach injury from diet; a wiry and short pulse at the left Guan position indicates liver qi deficiency due to extreme fatigue. A floating and short pulse indicates lung qi injury, which according to standard principles should present with cough. For coughs of the five zang organs, observe their corresponding positions: deep, tight, and deficient pulses indicate Cold patterns; deep, rapid, and excess pulses indicate Heat patterns; surging and slippery pulses often involve Phlegm; wiry and choppy pulses indicate blood deficiency. If the body is robust but the pulse is fine, indicating insufficient breath; or if the pulse is deep, small, and hidden, these are all signs of death. Only those with a floating and large pulse accompanied by cough have a chance of survival.
Syndrome Differentiation
Cough caused by Wind-Strike: The pulse is floating, accompanied by aversion to cold and high fever, spontaneous sweating, aversion to wind, dry mouth, irritability, runny clear nasal discharge, and coughing interrupting speech.
Cough caused by Cold Damage: The pulse is tight, accompanied by aversion to cold and fever, absence of sweating, aversion to cold, irritability without thirst, and worsening cough upon exposure to cold.
Cough caused by Summerheat: The pulse is rapid, accompanied by irritability, heat, desire for water, dry mouth, vomiting of saliva/froth, hoarseness, or hemoptysis.
Cough caused by Dampness: The pulse is fine, accompanied by painful joints, heaviness in the limbs, spontaneous sweating, or difficult urination.
Treatment Principles
"Cou" (cough sound only): Refers to coughing without phlegm, caused by injured lung qi failing to clear. Treatment uses Fangfeng, Platycodon, Cimicifuga, Apricot Seed, Schisandra, Fresh Ginger, Licorice, Mulberry Root Bark, Perilla Seed, and Bitter Orange.
"Sou" (phlegm sound only): Refers to producing phlegm without a distinct cough sound, caused by spleen dampness generating phlegm. Treatment uses Pinellia, Atractylodes, Schisandra, Bitter Orange, Fangfeng, Licorice, Immature Tangerine Peel, Hawthorn, Atractylodes Lancea, and Tangerine Peel.
"Ke Sou" (cough with phlegm and sound): Caused by lung qi injury combined with spleen dampness. Treatment uses Pinellia, Atractylodes, Schisandra, Platycodon, Bitter Orange, Mulberry Root Bark, Ophiopogon, and Licorice.
Cold-Phlegm Cough: Presents with nasal congestion, heavy voice, aversion to wind and cold, either with or without sweating. Treatment requires dispersing cold and resolving phlegm, using Er Chen Tang added with Ephedra, Platycodon, and Apricot Seed.
Cold-Phlegm Stagnating into Heat causing Night Cough: Treated with San Ao Tang added with Anemarrhena. If the pulse is large and floating with heat signs, add Scutellaria and Fresh Ginger.
Phlegm Cough: Characterized by phlegm sounds upon coughing, stopping when phlegm is expectorated. Main treatment involves resolving phlegm, using Er Chen Tang, or a pill made from Pinellia and Trichosanthis Seed (each 5 liang), Platycodon and Fritillaria (each 1 liang), Bitter Orange (1.5 liang), and Anemarrhena (1 liang), steamed with ginger juice and formed into pills with steamed biscuit dough.
Fire Stagnation Cough: Has sound but little phlegm, with a red face. Main treatment involves descending fire, clearing metal (lung), and resolving phlegm.
Dry Cough: Indicates severe fire stagnation, difficult to treat. It is phlegm-stagnant fire with pathogens in the lung. First use Platycodon to open the lung qi, then use yin-nourishing and fire-descending herbs. If unresolved, it becomes consumption (lao), requiring the "Dao Cang" method. This syndrome is common in frustrated individuals. If phlegm rises due to rebellious fire, treat the fire first. However, assess whether phlegm or fire is more urgent; if phlegm is urgent, treat phlegm first, then fire. This depends on the physician's adaptability.
Consumption Cough: Characterized by excessive phlegm and night sweats. May present with alternating chills and fever; treat by nourishing yin and clearing lung heat, using Si Wu Tang added with Bamboo Sap and Ginger Juice. For cough due to yin deficiency with hyperactive fire, use Si Wu Tang combined with Er Chen Tang to smooth and descend qi. Adding Phellodendron and Anemarrhena is excellent. For yin-deficiency wheezing/cough or hemoptysis, use Si Wu Tang added with Phellodendron, Anemarrhena, Schisandra, Ophiopogon, Mulberry Root Bark, Cortex Lycii, Moutan, and Gardenia. Hoarse cough due to blood deficiency and heat: use Indigo Naturalis and Clam Shell Powder mixed with honey. Another formula uses Qin Lian Si Wu Tang. Individuals with excessive sexual activity have deficient yuan qi; for persistent cough, use Qiongyu Gao.
Lung Distension Cough: Wheezing and chest fullness upon movement, rapid breathing. Treat by astringing lung qi, using Chebula, Apricot Seed, Indigo Naturalis, Sea Powder, Pinellia, Cyperus, and Trichosanthis Seed. Lung distension with stagnation preventing sleep is difficult to treat.
In treating cough, distinguishing between lung deficiency and excess is crucial. For chronic cough due to lung deficiency, use Schisandra, Farfusa, Aster, and Aristolochia to astringe and tonify. For excess cough with pathogens, use Scutellaria, Trichosanthis Radix, Mulberry Root Bark, and Apricot Seed to disperse and purge.
Regarding the use of Schisandra in cough: It astringes lung qi and is essential for heat-fire patterns. However, if used abruptly with exterior pathogens, it may trap the pathogen; exterior dispersion must be done first. Chebulic Myrobalan is sour and bitter, possessing astringent and fire-descending properties. Apricot Seed disperses wind-cold in the lung, suitable for robust individuals with heat caused by cold. Mulberry Root Bark purges lung qi but its nature is not purely benign; use with caution. Aristolochia clears lung heat and tonifies the lung. Fresh Ginger is acrid and dispersing. Poppy Capsule should not be used abruptly; it is a final astringent agent. Ginseng is for qi deficiency or new coughs with deficiency. It is contraindicated in strong wind-cold or long-term cough with lung stagnation-fire. Trichosanthis Seed is sweet and tonifies the lung, moistening and descending qi; phlegm in the chest will naturally descend.
For cough with dry mouth/throat and phlegm, avoid Arisaema and Pinellia; use Trichosanthis Seed and Fritillaria instead. If the patient drinks water, avoid Trichosanthis as it may cause chest obstruction and discomfort.
Formulas
Shen Su Yin (Ginseng and Perilla Decoction): Treats seasonal colds, fever, headache, heavy cough, thick sputum/nasal discharge, epigastric fullness, and vomiting of phlegm/water. It benefits the middle jiao, prevents spleen damage, resolves muscle-layer heat and tidal fever, and is miraculous for preventing progression to consumption.
Perilla (1 qian), Peucedanum (1 qian), Platycodon (1 qian), Bitter Orange (1 qian), Kudzu Root (1 qian), Tangerine Peel (1 qian), Pinellia (1 qian), Poria (1 qian), Licorice (7 fen), Ginseng (7 fen, remove if excess heat), Costus Root (5 fen, remove if qi is abundant).
Decoct one dose with 3 slices of fresh ginger and 2 black dates. Warmly administer after meals. For cold-induced cold with aversion to cold, no sweat, cough, and panting; or wind-strike with spontaneous sweating, nasal congestion, heavy voice, and cough, add Ephedra (2 qian), peeled Apricot Seed (1 qian), and Boilweed (1 qian) to induce sweating. For initial cold with lung excess and heat, add Apricot Seed, Mulberry Root Bark, and Scutellaria (each 1 qian), and 7 Smoked Plums. For chest fullness and much phlegm, add Trichosanthis Seed (1 qian). For panting and cough, add Anemarrhena and Fritillaria (each 1 qian). For cold-lung cough, add Schisandra and Dried Ginger (each 7 fen). For subcostal fullness, chest irritability, retained alcohol, or nausea, add Coptis and Immature Tangerine Peel (each 1 qian), doubling Kudzu Root and Tangerine Peel. For epistaxis, add 5 Smoked Plums, Ophiopogon, and Imperata Rhizome (each 1 qian). For heart-fire heat, add Bupleurum and Scutellaria (each 1 qian). For headache, add Ligusticum (1 qian) and Asarum (8 fen). For cough with hemoptysis, add Cimicifuga and Moutan (each 1 qian), and Rehmannia (1.5 qian). For consumption-fever cough, unresolved for long, add Anemarrhena, Fritillaria, and Ophiopogon (each 1 qian). For hemoptysis, add Donkey-hide Gelatin, Moutan, and Red Peony Root (each 1 qian), Rehmannia (1.5 qian), and 7 Smoked Plums. For cough with blood in sputum, add Si Wu Tang to this formula, named Fu Ling Bu Xin Tang. For pregnancy with cold damage, remove Pinellia, add Cyperus.
Qing Jin Jiang Huo Tang (Clear Metal and Descend Fire Decoction): Purges fire from lung and stomach; when fire descends, phlegm dissipates and cough stops.
Tangerine Peel (1.5 qian), Pinellia (soaked, 1 qian), Poria (1 qian), Platycodon (1 qian), Bitter Orange (bran-fried, 1 qian), Fritillaria (heart removed, 1 qian), Peucedanum (1 qian), Apricot Seed (peeled and cored, 1.5 qian), Scutellaria (fried, 1 qian), Gypsum (1 qian), Trichosanthis Seed (1 qian), Licorice (roasted, 3 fen).
Decoct one dose with 3 slices of fresh ginger. Administer warm, far from meals and before sleep.
Er Mu Ning Sou Tang [Commentary] (Note: Suitable for all phlegm-coughs in four seasons, new or old, with lung qi excess) Treats cough and sputum caused by wine/food stagnation leading to stomach fire flaming upward and attacking lung metal, persisting for days. One dose brings cure.
Anemarrhena (de-haired, 1.5 qian), Fritillaria (heart removed, 1.5 qian), Scutellaria (1.2 qian), Gardenia Kernel (1.2 qian), Gypsum (2 qian), Mulberry Root Bark (1 qian), Poria (1 qian), Trichosanthis Seed (1 qian), Tangerine Peel (1 qian), Immature Tangerine Peel (7 fen), Schisandra (10 berries), Raw Licorice (3 fen).
Decoct one dose with 3 slices of fresh ginger. Sip slowly before sleep.
Run Fei Huo Tan Ning Sou Tang (Yunlin Formula) [Commentary] (Note: Suitable for phlegm-cough with yin deficiency)
Tangerine Peel (5 fen), Pinellia (ginger-processed, 5 fen), Poria (4 fen), Licorice (roasted, 3 fen), Phellodendron (wine-fried, 5 fen), Scutellaria (wine-rinsed, 3 fen), Anemarrhena (wine-fried, 5 fen), Fritillaria (heart removed, 5 fen), Asparagus Root (heart removed, 3 fen), Ophiopogon (heart removed, 3 fen), Aster (wine-rinsed, 3 fen), Farfusa (wine-rinsed, 3 fen), Platycodon (3 fen), Prepared Rehmannia (5 fen), Angelica Sinensis (3 fen).
Decoct one dose with 3 slices of fresh ginger. Drink warm.
Xi Yao Ru Shen San (Immortal Absorption Powder, transmitted by Imperial Physician Chen) [Commentary] (Note: Specialized for chronic phlegm-cough) Treats wind entering the lung causing chronic unresolved cough.
Realgar, Petasites, Goose Tube Stone, Farfusa, Licorice, Calcite, Malachite (calcined), White Aconite, Alum, Child's Tea (equal parts).
Grind into fine powder. Burn paper to produce smoke and let the patient inhale it.
Moxibustion Method: Treats chronic cough unresponsive to all medicines.
Locate the point directly below the nipple, approximately one finger-width away. Find the depression that aligns vertically with the nipple without deviation. This is called Zhi Gu Xue (Straight Bone Acupoint). In women, press along the nipple line to find this point. Apply three moxa cones, sized like a small bean. For men, use the left side; for women, the right side. Do not err. The cough will heal. If it does not heal, the disease is incurable.