答曰。咳嗽之说。古书有咳而无嗽。后人兼言之。大抵皆从肺出。其声响亮。不因痰涎而发
者。谓之咳。言其声音闻于人。痰涎上下随声而发者。谓之嗽。如水之嗽荡。能荡其真气也
。况肺主乎气。经云。营气之行。常与卫气相随。久嗽损气。则血亦不足。遂致经闭不行。
时发寒热。久久成劳者。气血俱损之故也。
六神散。治妇人热劳咳嗽。月水不通。
柴胡(去苗) 白术 青皮(去白) 当归 牛膝 牡丹皮(各一两)
上为粗末。每用六两。入蜜四两炒令焦。入酒并童便各一碗。煎八九沸。去滓。分作六服。
空心食前。
紫菀丸。治肺气咳嗽。
紫菀 防风 桑白皮(炙) 木香 贝母 人参 款冬花 葶苈(隔纸炒) 槟榔(各一两) 杏
仁(炒) 天门冬(去心一两) 甘草
上为细末。蜜丸桐子大。每服三十丸。清米饮送下。食后服。
答曰。经称五脏六腑皆令人咳。原其至理。虽因寒邪之为患。当分内外所伤。难经云。形寒
饮冷则伤肺。肺主皮毛。自皮毛而入中者。谓之形寒。胃脉络肺。食寒而为嗽者。谓之饮冷
。水饮停积于胸膈。所以为痰。痰中有血者。乃心肺之相克也。肺属金而主气。心属火而行
血。以五脏而言之。心肺皆居膈上。以五行论之。金火应乎相制。故痰中有血者。此火克乎
金。心胜乎肺。久而不已。亦变成劳。难经所谓七传者死。亦此之类也。褚氏遗书云。喉有
窍。则咳血杀人。肠有窍。则便血羸人。便血犹可止。咳血不易医。所以咳嗽有红痰者。多
成虚劳之疾也。
平肺汤。定喘治嗽。
五味子 紫菀(洗去土) 陈皮(去白) 甘草(炙) 杏仁(泡去皮尖) 半夏(汤浸七次) 紫苏
子桑白皮
上为末每服二钱。水一盏姜四片。煎至七分。去滓温服食后。
立验丸。治肺热而咳。上气喘急。不得坐卧。身面浮肿。不下饮食。消肿下气。止嗽。
葶苈(十分研炒为末) 贝母(三分) 杏仁(一两半炒去皮尖) 赤茯苓 紫菀 五味子(各三
分) 人参(一两) 桑白皮(一两炙)
上为细末。蜜丸梧桐子大。每服十丸。日二服。甚者夜一服。加至三十丸。枣汤下。肿盛者
食后服。
止红散。治心肺客热。咳嗽吐血。
柴胡(去苗一两) 胡黄连 宣连(各半两)
上为末。入朱砂少许研和。每服二钱。水一盏。煎半盏。通口服。
Answer: Regarding the terminology of cough, ancient texts mention "ke" (cough without phlegm) but not "sou" (cough with phlegm); later authors combined them. Generally, both originate from the Lung organ. When the sound is loud and occurs without the presence of phlegm-fluids, it is called "ke," referring to the audibility of the voice. When phlegm-fluids rise and fall accompanying the sound, it is called "sou," resembling water washing away debris, which can damage the body's True Qi. Furthermore, the Lung governs Qi. As stated in the *Classic of Internal Medicine*: The circulation of Ying-Qi (Nutritive Qi) always accompanies Wei-Qi (Defensive Qi). Chronic cough depletes Qi, leading to a deficiency of Blood, thereby causing amenorrhea (cessation of menstruation), intermittent chills and fever, and eventually transforming into consumptive disease (Lao). This is due to the depletion of both Qi and Blood.
Liushen San (Six-God Powder) treats women suffering from heat-Lao (consumption due to heat) with cough and amenorrhea.
Chai Hu (Bupleuri Radix, removed sprouts), Baizhu (Atractylodis Macrocephalae Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride, removed white pith), Danggui (Angelicae Sinensis Radix), Niuxi (Achyranthis Bidentatae Radix), Mudan Pi (Moutan Cortex, each 1 liang).
Grind the above ingredients into coarse powder. Use 6 liang of this powder per dose, stir-fry with 4 liang of honey until scorched, then add 1 bowl of wine and 1 bowl of child's urine. Boil for eight or nine boils, strain, and divide into six doses. Take on an empty stomach before meals.
Ziwan Wan (Asterae Root Pill) treats Lung-Qi cough.
Ziwan (Asterae Radix), Fangfeng (Saposhnikoviae Radix), Sangbaipi (Mori Cortex, processed), Muxiang (Aucklandiae Radix), Beimu (Fritillariae Bulbus), Renshen (Ginseng Radix), Kuandonghua (Farfarae Flos), Tingli (Descurainiae Semen seu Lepidii Semen, stir-fried between papers), Binglang (Arecae Semen, each 1 liang), Xingren (Armeniacae Semen Amarum, stir-fried), Tiantaomen (Asparagi Radix, removed heart, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma).
Grind the above into fine powder, mix with honey, and form pills the size of paulownia seeds. Take 30 pills per dose, washed down with clear rice water. Take after meals.
Answer: The *Classic of Internal Medicine* states that all five Zang organs and six Fu organs can cause cough. Investigating the underlying principle, although caused by cold pathogenic factors, one must distinguish between external injury and internal injury. The *Classic of Difficult Issues* states: "Exposure to cold and ingestion of cold drinks injure the Lung." The Lung governs the skin and hair; invasion from the exterior through the skin and hair is termed "Xinghan" (formal cold). The Stomach meridians connect to the Lung; cough induced by eating cold food is termed "Yinleng" (drinking cold). Water and fluids stagnate in the chest and diaphragm, thus forming Phlegm. Blood in the phlegm results from the mutual restriction between the Heart and Lung. The Lung belongs to Metal and governs Qi; the Heart belongs to Fire and governs Blood. In terms of Zang organ positions, both Heart and Lung reside above the diaphragm. In terms of Five Elements theory, Metal and Fire constrain each other. Therefore, blood in phlegm indicates Fire overcoming Metal, i.e., the Heart overcoming the Lung. If prolonged and untreated, it transforms into consumptive disease. This aligns with the statement in the *Classic of Difficult Issues* that "sequential transmission to the seventh organ leads to death," which is of the same category. The *Chu Shi Yi Shu* (Remnant Book of Master Chu) states: "If the throat has openings, hemoptysis kills; if the intestines have openings, hematochezia emaciates." Hematochezia can still be stopped, but hemoptysis is difficult to treat. Thus, cough with red sputum often develops into consumptive disease.
Pingfei Tang (Lung-Calming Decoction) calms wheezing and stops cough.
Wuweizi (Schisandrae Fructus), Ziwan (Asterae Radix, washed to remove soil), Chenpi (Citri Reticulatae Pericarpium, removed white pith), Gancao (Glycyrrhizae Radix et Rhizoma, processed), Xingren (Armeniacae Semen Amarum, soaked, skin and tips removed), Banxia (Pinelliae Rhizoma, soaked in boiling water seven times), Zisuzi (Perillae Fructus), Sangbaipi (Mori Cortex).
Grind the above into powder. Take 2 qian per dose with 1 bowl of water and 4 slices of ginger. Boil until reduced to 7/10 volume, strain, and take warm. Take after meals.
Liyan Wan (Instantly Effective Pill) treats Lung-heat cough, upper asthma with rapid breathing, inability to sit or lie down, edema of the body and face, loss of appetite, and has effects of reducing edema, directing Qi downward, and stopping cough.
Tingli (Descurainiae Semen seu Lepidii Semen, ground into powder after stir-frying, 10 fen), Beimu (Fritillariae Bulbus, 3 fen), Xingren (Armeniacae Semen Amarum, stir-fried, skin and tips removed, 1.5 liang), Chifuling (Poria with Red Host, 3 fen), Ziwan (Asterae Radix, 3 fen), Wuweizi (Schisandrae Fructus, 3 fen), Renshen (Ginseng Radix, 1 liang), Sangbaipi (Mori Cortex, processed, 1 liang).
Grind the above into fine powder, mix with honey, and form pills the size of paulownia seeds. Take 10 pills per dose, twice daily. For severe cases, take once at night as well, increasing up to 30 pills. Wash down with jujube decoction. For severe edema, take after meals.
Zhihong San (Stop-Red Powder) treats exogenous heat in the Heart and Lung, cough with hematemesis/hemoptysis.
Chai Hu (Bupleuri Radix, removed sprouts, 1 liang), Huhuanglian (Coptidis Rhizoma var. chinense or similar, often referring to specific Coptis sources in historical contexts, here likely Coptidis Rhizoma), Xuanlian (Coptidis Rhizoma, 0.5 liang each).
Grind the above into powder, add a small amount of Zhusha (Cinnabar), grind and mix evenly. Take 2 qian per dose with 1 bowl of water, boil until half remains, and take orally in one go.