诸气上逆喘逆。皆属于肺。
咳嗽有二 风寒外感者。痰饮者。
如因感冒得之者。必洒洒恶寒。鼻流清涕。或鼻塞。宜发散。加减五拗汤主之。
麻黄（连根节） 杏仁（留皮尖） 紫苏叶 苦梗 甘草（各等分） 上锉。水煎。姜引。服
得微汗止。
如发散不退。渴欲饮水者。宜泻白散主之。
如不热不渴。甘桔汤主之。
桔梗 甘草（各等分） 紫苏叶（减半） 乌梅肉（少许） 上用水煎去渣。入阿胶化服。
因于痰者。或母乳多涌出。儿小吞咽不及。呛出而成痰嗽者。或因儿啼声未息。气未平
。强以乳哺。气逆而嗽者。此乳夹痰而嗽也。宜玉液丸主之。
有痰甚气弱不可下。宜润下丸主之。
陈皮（去白淡盐水浸泡括锉炒） 枳壳（炒） 桔梗 大半夏（姜汤泡七次） 甘草 苏子（
炒） 莱菔子（炒） 白茯苓（各一钱） 上为末。神曲糊丸，黍米大。白汤下。
发挥云。经曰。秋伤于湿。冬生咳嗽。乃太阴湿土之病也。凡咳嗽有痰有气。痰出于脾
出于肝。皆饮食之所化。脾总司之也。饮食入胃。脾为传化。水谷之精气为荣悍气为卫。周
流一身。昼夜不息。虚则不能运化精悍之气以成荣卫。其糟粕之清者为饮。浊者为痰。留于
胸中。滞于咽嗌。其气相搏。浮涩作痒。介作声。而发为咳嗽也。故治痰咳。先化其痰。欲
化其痰者。先理其气。陈皮枳壳以理肺中之气。半夏茯苓以理脾中之痰。此治咳之大略也。
若夫虚则补之阿胶散。实则泻之葶苈丸。祖传玉液丸。
小阿胶散
阿胶（粉炒钱半） 苏叶（一钱） 乌梅（少许） 每服四字。水煎服。
监生胡笃庵滋。元溪翁之子也。辛丑方四岁。二月间患咳嗽。因与吾不合。请医张鹏素
用者。以葶苈治之。随止随作。四月间咳甚。又请医甘大用。治以五拗汤。暂止复作。更迭
用药。咳不得止。秋益甚。咳百十声。痰血并来。至九月加重。事急矣。不得已。欲请予治
。乃筮之。得蹇之渐。其辞曰。大蹇朋来。遂请予往。予以活人为心。不记宿怨。视其外候
。两颊微赤。山根青。准头红。视其内证。果咳声连至百十。气促面赤。痰先出而血随之。
痰血既来。其咳方定。问其所起之时。曰自二月有之。问其所服之药。曰某用葶苈丸。某用
五拗汤。予细思之。此病起于春初。春多上升之气。木旺金衰。法当抑肝补脾。以资肺之化
源。以葶苈泻肺。此一逆也。夏多火热。火旺金败。法当清心养肺。治以寒凉。反用五拗汤
甘热之药。犯用热远热之戒。此再逆也。今秋气宜降矣。而上气急者。春升之令未退也。气
宜敛矣。而痰血并出者。夏火之气未退也。必与清金降火润肺凉血。非三五十剂不效也。乃
告之曰。令郎之病肺有虚火。幸过秋深。金旺可治。吾能愈之。假以一月成功。元溪曰。何
太迟也。曰。病经八月无效。公不曰迟。而以一月为迟何哉。又思予虽用心。彼终不安。乃
语元溪云。请置一簿。自初服药日起。某日服某药。某日加减某药。彼闻之喜。终有疑心。
因制一方。天麦门冬知贝母桔梗生甘草陈皮去白枳壳阿胶片芩苏叶水煎。（一本无枳壳苏叶
。有瓜霜花粉前胡）取茆根自然汁和饮之。五剂后。咳减十分之七。口鼻之血止矣。元溪终
不释疑。又请医万绍治之。或谓予曰。他不要尔。尔可去矣。予曰。彼只一子。非吾不能治
也。吾去彼再不复请也。误了此儿。非吾杀之。亦吾过也。虽然且看万绍用何方。用之有理
吾去之。如又误。必力阻之。阻之不得。去未迟也。乃语元溪云。令郎之病。吾今治之。将
好一半矣。如何又请他人。彼云。有病众人医。恐一人之见有限也。予曰。然。绍立一方。
以防风百部杏仁桑白皮之类。予谓绍曰。王好古汤液本草。风升生例。防风居先。此儿肺
不降。肺散不收。防风百部。岂可并用耶。绍云。防风百部。治咳嗽之神药也。元溪从旁和
之云。他是秘方。予曰。吾为此子忧。非相妒也。故抚其子之头曰。且少吃些。可怜疾之复
作奈何。嘱毕不辞而退。元溪略不介意。是日服绍药。才一小杯。咳复作气复促血复来如初
。其子泣曰。吾吃万先生药好些。爷请这人来。要毒杀我。其妻且怒且骂。元溪始悔。亲至
大用之家。予被酒困。坐待夜半方醒。元溪拜谢。祈请之心甚切。予叹曰。早听吾言。不有
此悔。要我调治。必去嫌疑之心。专付托之任。以一月为期。至家。邓夫人取白金五两。权
作利市。小儿好时。再补五两。不敢少。望先生用心。予曰。只要专信我用我。使我治好了
。不在谢之多少也。至此专心听信。依旧照日立方。血止后。去芩栀。加冬花五味。咳止后
。以参芩白术散调之。凡十七日而安如旧。谢归。因名其方曰。润肺降火茆根汤。今吾子等
用之皆效。
黄州府省祭许成仁。有子病咳血。医用吾茆根汤治之。不效。吾见之。与其医云。病不
。彼乃肺中有火。气逆而嗽。此则肺虚嗽血矣。乃立方与之。用阿胶珠天门冬麦门冬桑白皮
蜜炒桔梗甘草苏叶乌梅柿霜煎服。五日效。
麻城曾芸塘喻长州之妹婿也。病咳。半夜甚。其子年九岁。乃胎禀之不足。肾虚嗽也。
用人参固本丸加阿胶桑白皮蜜丸服。尽剂而安。
本县汪元津。一子病肾虚嗽。与上证同。请予治。用人参固本丸加白茯苓知母贝母山药
各等分为末蜜丸。服之。安。
凡小儿百日内嗽不止者。名百 嗽难治。宜甘桔汤加阿胶主之。
小儿素有哮喘。遇天雨则发者。苏陈九宝汤主之。如吐痰多者。六味地黄丸主之。
发挥云。肾者水脏也。受五脏六腑之津液而藏之。入心为汗。入肺为涕。入脾为涎。入
肾为
盐水炒。肉苁蓉酒洗去甲。小茴香炒。破故纸炒。研末蜜丸。煎麦门冬汤下。
本县胡三溪长女。素有喘痰。发则多吐痰涎。用上补肾地黄丸。人初不知。有笑之者。
后喘止痰止乃信之。
凡小儿久嗽不止。面目浮肿者。此肺气逆也。宜五皮汤加苏叶最妙。
一富室小儿泻泄后病喘急。予思此脾虚也。寒湿之气上升也。用陈氏芎蝎散。一服而止
一儿三岁病嗽血。医用茆根汤主治。予阻之。彼有后言。予笑曰。此吾家方也。不信。
子之道。反议夫子乎。因制一方。用阿胶珠桑白皮蜜炒杏仁桔梗甘草紫苏叶各等分为末。蜜
丸芡实大。每一丸陈皮汤下。五日而安。
Any upward reversal of Qi causing panting and Qi rebellion belongs to the Lung.
There are two types of cough: one caused by external contraction of Wind-Cold, and the other caused by Phlegm-Fluid retention.
If caused by a cold, there must be aversion to cold with shivering, clear nasal discharge, or nasal congestion. It is appropriate to use dispersing methods, with Modified Wu Ao Decoction (Ji Jian Wu Ao Tang) as the main formula.
Ephedrae Herba (Mahuang, 麻黄) [keep roots and nodes], Armeniacae Semen Amarum (Xingren, 杏仁) [keep skin and tips], Perillae Folium (Zisuye, 紫苏叶), Platycodonis Radix (Jiegeng, 桔梗), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [equal parts]. The above herbs are chopped, decocted in water, with Zingiberis Rhizoma Recens (Shengjiang, 生姜) as an adjuvant. Stop taking after slight sweating is achieved.
If symptoms do not recede after dispersing, and thirst with desire to drink water occurs, Xie Bai San (Pulmonary Draining Powder) should be used as the main formula.
If there is no fever and no thirst, Gan Jie Tang (Licorice and Platycodon Decoction) should be used as the main formula.
Platycodonis Radix (Jiegeng, 桔梗), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [equal parts], Perillae Folium (Zisuye, 紫苏叶) [half dose], Prunus mume Seed (Wumei Rou, 乌梅肉) [a small amount]. The above are decocted in water, strained, and Ejiao (Donkey-hide Gelatin) is added and dissolved for administration.
If caused by Phlegm, some cases arise because breast milk flows excessively, and the infant is too young to swallow it all, leading to choking and forming Phlegm-cough; others occur because the infant's crying has not subsided and Qi has not settled, yet feeding is forced, causing Qi rebellion and cough. This is cough caused by milk mixed with Phlegm. Yuye Wan (Jade Liquid Pill) should be used as the main formula.
If there is excessive Phlegm but weak Qi, purgative methods are contraindicated. Runxia Wan (Moistening Downward Pill) should be used as the main formula.
Citri Reticulatae Pericarpium (Chenpi, 陈皮) [remove white pith, soak in light salt water, scrape off veins, stir-fry], Aurantii Fructus Immaturus (Zhike, 枳壳) [stir-fried], Platycodonis Radix (Jiegeng, 桔梗), Pinelliae Rhizoma Banxia (Dabansha, 大半夏) [soak in Ginger juice seven times], Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Perillae Fructus (Suzi, 苏子) [stir-fried], Raphani Semen (Laifuzi, 莱菔子) [stir-fried], Poria (Baifuling, 白茯苓) [each 1 qian]. The above are ground into powder, bound with dough made from Medicated Leaven (Shenqu), formed into pills the size of millet seeds, and taken with warm water.
Wan Quan elaborates: The Classic states, "Injury by Dampness in Autumn leads to Cough in Winter." This is a disease of the Taiyin Spleen-Earth. Generally, coughs involve Phlegm and Qi. Phlegm originates from the Spleen and also from the Liver, all transformed from food and drink, managed by the Spleen. When food enters the Stomach, the Spleen transforms and transports it. The essence of food and drink becomes Ying (Nutritive) Qi and Wei (Defensive) Qi, circulating throughout the body day and night without rest. If deficiency prevents the transformation of Jing-Han (Essential and Vigorous) Qi into Ying and Wei, the clear residue of waste becomes Yin (Fluids), and the turbid residue becomes Tan (Phlegm). These remain in the chest and stagnate in the throat. Qi and Phlegm contend, manifesting as floating and choppy pulses, itching, and sounds, thereby triggering cough. Therefore, to treat Phlegm-cough, one must first resolve the Phlegm. To resolve Phlegm, one must first regulate Qi. Citri Reticulatae Pericarpium (Chenpi, 陈皮) and Aurantii Fructus Immaturus (Zhike, 枳壳) regulate Qi in the Lung; Pinelliae Rhizoma (Banxia, 半夏) and Poria (Fuling, 茯苓) regulate Phlegm in the Spleen. This is the general principle for treating cough.
For deficiency, tonify with Ejiao San (Donkey-hide Gelatin Powder); for excess, drain with Tingli Wan (Descurainia Seed Pill). There is also the family-prescribed Yuye Wan (Jade Liquid Pill).
Small Ejiao San
Ejiao (Donkey-hide Gelatin) [powder-cooked, 1.5 qian], Perillae Folium (Zisuye, 紫苏叶) [1 qian], Prunus mume Seed (Wumei, 乌梅) [a small amount]. Take 4 zi per dose, decocted in water.
Hu Zi, son of Yuanxi Weng, was the son of Supervisor Hu Du'an. In the Xin-Chou year, he was four years old. In February, he suffered from cough. Due to a prior disagreement with me, Doctor Zhang Pengsu was consulted and treated him with Tingli Wan (Descurainia Seed Pill). The cough stopped temporarily but returned. In April, the cough worsened. Doctor Gan Dayong was consulted and treated him with Wu Ao Decoction (Wu Ao Tang). It stopped temporarily but returned again. Medications were alternated, but the cough did not cease. By autumn, it became more severe, with coughing bouts of over a hundred sounds, and blood mixed with sputum. By September, the condition became critical. Reluctantly, they sought my treatment. A divination yielded the hexagram Jian changing to Jian, with the text "Great obstruction, friends come." Thus, I was invited. I hold saving lives as my heart and do not harbor grudges. Observing his external signs, his cheeks were slightly red, the mountain root (root of the nose) was blue-green, and the tip of the nose was red. Observing internal signs, indeed, the cough sounded continuous for over a hundred sounds, with shortness of breath and flushed face, sputum coming out first followed by blood. After the blood and sputum appeared, the cough ceased. Asking when it started, he said February. Asking what medicines were taken, he mentioned Tingli Wan and Wu Ao Decoction. I pondered carefully: this illness began in early spring. Spring has ascending Qi, Wood is prosperous and Metal is weak. The method should suppress Liver and tonify Spleen to nourish the source of Lung transformation. Using Tingli to drain the Lung is the first deviation. Summer has abundant Fire, Fire is strong and Metal is defeated. The method should clear Heart and nourish Lung with cold/cool drugs. Instead, using Wu Ao Decoction, a sweet-warm drug, violates the taboo of "avoiding heat in heat seasons," which is the second deviation. Now in autumn, Qi should descend, but the urgent upper Qi indicates the spring ascending command has not retreated. Qi should consolidate, but the simultaneous expulsion of phlegm and blood indicates summer Fire Qi has not retreated. One must combine clearing Metal, descending Fire, moistening Lung, and cooling Blood. It will take thirty to fifty doses to see effect. I told them: "Your son's illness is deficient Fire in the Lung. Fortunately, it passed late autumn when Metal is prosperous, so it is treatable. I can cure him within one month." Yuanxi asked, "Why so late?" I replied, "The illness has been ineffective for eight months. You do not consider that late, why do you consider one month late?" I thought that although I tried hard, he would still be uneasy. So I said to Yuanxi, "Please keep a record book. From the first day of medication, record what medicine was taken on which day, and any additions or subtractions." He was pleased but remained suspicious. So I prescribed a formula: Tianshen (Asparagi Radix), Maishen (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma), Beimu (Fritillariae Bulbus), Jiegeng (Platycodonis Radix), Sheng Gancao (Raw Licorice), Chenpi (Citri Reticulatae Pericarpium, white removed), Zhike (Aurantii Fructus Immaturus), Ejiao (Donkey-hide Gelatin), Huangqin (Scutellariae Radix), Zisuye (Perillae Folium), decocted in water. (Another version lacks Zhike and Zisuye, but includes Guashuang, Huafen, and Qianhu). Mix with natural juice from Mao Gen (Imperatae Rhizoma) and drink. After five doses, cough decreased by seventy percent, and bleeding from mouth and nose stopped. Yuanxi remained doubtful and consulted Doctor Wan Shao. Someone told me, "He does not want you; you may leave." I said, "He has only one son. Only I can treat him. If I leave, he will never invite me again. Delaying this child is not killing him, but it is my fault. Nevertheless, let us see Wan Shao's prescription. If it is reasonable, I will leave; if it causes error again, I will strongly oppose it. If I cannot stop it, leaving later is not too late." I then told Yuanxi, "I am now treating your son's illness, and it is already half better. Why consult another?" He said, "Many doctors treat illnesses, fearing one person's view is limited." I said, "True." Wan Shao prescribed a formula containing Fangfeng (Saposhnikoviae Radix), Baibu (Stemonae Radix), Xingren (Armeniacae Semen Amarum), Sangbaipi (Mori Cortex), etc. I said to Wan Shao, "In Wang Haogu's *Tangye Bencao*, under the category of Wind Rising and Generating, Fangfeng comes first. This child's Lung Qi does not descend, and Lung disperses without consolidating. How can Fangfeng and Baibu be used together?" Wan Shao said, "Fangfeng and Baibu are divine drugs for treating cough." Yuanxi supported him from the side, saying, "It is a secret recipe." I said, "I worry for this child, not out of jealousy." So I stroked the child's head and said, "Eat less for now. Pity that the illness recurs." After instructing, I left without saying goodbye. Yuanxi paid no attention. That day, after drinking just a small cup of Wan Shao's medicine, the cough returned, breathing became urgent again, and blood came out as before. The child cried, "I felt better taking Mr. Wan's medicine. Father invited this person to poison me." His wife was angry and scolded. Yuanxi finally regretted it and went personally to Gan Dayong's house. I was intoxicated and woke up at midnight. Yuanxi bowed and thanked me, his request being very earnest. I sighed, "If you had listened to me earlier, there would be no regret. For me to regulate and treat, you must remove suspicion and entrust everything to me, setting a one-month period." Back home, Madam Deng took out five taels of silver as a gift, promising another five taels when the child recovered, urging me to pay close attention. I said, "Just trust and employ me wholeheartedly. As long as I cure him, the amount of gratitude gift does not matter." From then on, they trusted me completely. I continued prescribing daily. After bleeding stopped, I removed Huangqin (Scutellariae Radix) and Zhizi (Gardeniae Fructus), adding Jiedonghua (Kalanchoes Flos) and Wuweizi (Schisandrae Fructus). After cough stopped, I regulated with Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder). In seventeen days, he recovered fully. He thanked me and returned home. I named this formula: Runfei Jianghuo Mao Gen Tang (Lung-Moistening and Fire-Descending Imperata Decoction). My descendants use it with good effect.
Xu Chengren, a provincial examiner from Huangzhou Prefecture, had a son with hemoptysis. Doctors used my Mao Gen Tang, but it was ineffective. I examined him and told the doctor, "The pathology is not here. He has Fire in the Lung, causing Qi rebellion and cough. This case is Lung deficiency causing cough with blood." So I prescribed a formula: Ejiao Zhu (Caramelized Donkey-hide Gelatin), Tianmendong (Asparagi Radix), Maidong (Ophiopogonis Radix), Sangbaipi (Mori Cortex, honey-fried), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix), Zisuye (Perillae Folium), Wumei (Prunus mume), Shishuang (Diospyroi Fructus Frost), decocted and taken. Effective in five days.
Zeng Yuntang from Macheng was the brother-in-law of Yu Changzhou. He suffered from cough, worse at midnight. His son was nine years old, suffering from congenital insufficiency and Kidney deficiency cough. Ren Shen Gu Ben Wan (Ginseng Root-Firming Pill) plus Ejiao, made into honey pills, was taken. One course brought recovery.
Wang Yuanjin from the county had a son with Kidney deficiency cough, same as the above syndrome. I treated him with Ren Shen Gu Ben Wan plus Baifuling (Poria), Zhimu (Anemarrhenae Rhizoma), Beimu (Fritillariae Bulbus), and Shanyao (Dioscoreae Rhizoma) in equal parts, ground into powder and made into honey pills. Taken, he recovered.
For infants under one hundred days with incessant cough, named Hundred-Day Cough, it is difficult to treat. Gan Jie Tang (Licorice and Platycodon Decoction) plus Ejiao should be used as the main formula.
For children with chronic asthma that flares up during rainy weather, Su Chen Jiu Bao Tang (Perilla and Alisma Nine-Treasure Decoction) should be used as the main formula. If there is much expectoration, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) should be used as the main formula.
Wan Quan elaborates: The Kidney is the Water Organ, receiving fluids from the Five Zang and Six Fu organs and storing them. Entering the Heart, it becomes sweat; entering the Lung, it becomes nasal discharge; entering the Spleen, it becomes saliva; entering the Kidney... [text fragment] Salt-water fried, Congrong Rous (Cistanche Stem) washed with wine to remove scales, Xiao Huixiang (Fennel Fruit) stir-fried, Gubuzhi (Psoraleae Fructus) stir-fried, ground into powder, bound with honey pills, taken with Ophiopogon Decoction.
Eldest daughter of Hu Sanxi from the county had chronic wheezing and phlegm, often expelling phlegm and saliva upon attack. She used the aforementioned Bushen Dihuang Wan (Kidney-Nourishing Rehmannia Pill). Initially, people did not know and mocked her. Later, when wheezing and phlegm stopped, they believed in it.
For children with chronic cough that does not stop, accompanied by facial and ocular edema, this is Lung Qi rebellion. Wupi Tang (Five-Bark Decoction) plus Zisuye (Perillae Folium) is best.
A wealthy family's child developed acute wheezing after diarrhea. I reasoned this was Spleen deficiency with rising Cold-Damp Qi. Chenshi Xiongxie San (Chen's Ligusticum and Scorpion Powder) was used, effective after one dose.
A three-year-old child suffered from cough with blood. Doctors used Mao Gen Tang as the main treatment. I opposed it. He had complaints. I smiled and said, "This is my family formula. If you don't believe it, you question the master." So I formulated a prescription: Ejiao Zhu (Caramelized Donkey-hide Gelatin), Sangbaipi (Mori Cortex, honey-fried), Xingren (Armeniacae Semen Amarum), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix), Zisuye (Perillae Folium) in equal parts, ground into powder, bound with honey into pills the size of Euryale Seed. One pill taken with Tangerine Peel Decoction. Recovered in five days.