Library

Lung governs Qi, and its pathological change manifests as coughing, which is a syndrome of the Lung. When coughing occurs at the beginning of fever in variola/rubella (chuang zhen), it is because the Lung acts as the canopy over the five Zang organs; the fire of the rash carries the momentum of the Sovereign Fire (Jun Huo) and Ministerial Fire (Xiang Huo) to scorch the Lung upwards, causing the lung lobes to become dry and elevated, thus leading to rebellious Qi and coughing. If the cough increases after the rash has erupted, this is due to sores in the throat that cause itching and a sensation of obstruction, resulting in coughing. If coughing persists after the rash has crusted and healed, this is because the Defensive Qi (Wei Qi) is weak, the interstices (Cou Li) are loose, allowing Wind-Cold to invade from outside, causing Lung Qi to rebel and fail to descend, hence also causing coughing. [Xue] states: At the stage when smallpox is about to erupt, heat-toxin ascends to cloud the clear passages (respiratory tract), disturbing the peace of Lung Qi; Xingxing San should be used. After eruption, it belongs to deficiency of Original Qi, failing to secure the interstices, allowing Wind pathogen to invade through the deficiency; Wuyi Yigong San with Jiegeng and Wuweizi should be used to tonify Spleen and Lung.

The *Douzhen Fang* (Smallpox Formulas) records: Coughing before the eruption of smallpox lesions calls for Shengma Tang (for initial heat stage). Headache, fever, aversion to cold, and coughing call for Shen Su Yin (for initial heat stage). Vomiting of phlegm-saliva with coughing calls for Baizhu Tang. Epidemic headache, fever, and coughing call for Xingxing San (for initial heat stage). [Wan] points out: If coughing is severe during the initial fever, first use Shen Su Yin to disperse, then treat with Ganjie Tang (targeting throat) combined with Xiebai San (targeting Lung) plus Niubangzi.

For cases where coughing is severe while smallpox lesions are abundant, this indicates fire in the Lung or itching caused by sores in the throat; only Ganjie Tang with Niubangzi should be used, taken frequently for good effect. If saliva contains blood, this is due to sores in the throat or bleeding from gum crevices; no arbitrary treatment is needed. If lesions fail to rise, accompanied by restlessness, panting, coughing, cold hands and feet, and desire for cold drinks, Muxiang San (for purging) is indicated. Severe coughing without other symptoms calls for Wuweizi Tang. If lesions are bright and robust, but body heat and severe cough persist after crusting, Renshen Qingge San is the primary formula. If coughing continues after lesions have crusted, regardless of whether caused by exposure to cold or drinking cold fluids, Renshen Qingge San is appropriate.

If nasal discharge and saliva are thick and sticky, with nasal congestion, this is Wind pathogen injuring the Lung; Xingxing San or Shen Su Yin may be used (both for initial heat stage).

If there is profuse phlegm, irritability, red and hot lesions, high fever, and desire for cold drinks, this is Excess-Heat in Spleen and Lung; Renshen Qingge San is indicated, along with drinking celery juice.

If saliva is thick and sticky, and stool is black, this is Heat-Toxin in the Stomach channel; Xijiao Tang (for hemorrhage) should be used, along with celery juice to resolve toxicity.

Coughing due to residual toxins after illness calls for Shengma Tang (initial heat stage). Coughing with headache, fever, and aversion to cold due to Cold invasion calls for Shen Su Yin. Coughing with irritability and heat calls for Shengdihuang San. Wind-Heat coughing with discomfort in the throat and chest calls for Ganjie Fangfeng Tang (targeting throat). Coughing with wheezing calls for Wuweizi Tang. Coughing with hypochondriac pain after illness occurs because the hypochondrium lies on both sides of the body, serving as the pathway for Yin and Yang Qi; residual toxins trapped within prevent the proper ascending and descending of these two Qi types, causing pain; Chifuling Tang and Xiaochaihu Tang (for fever) with Wuweizi, Jiegeng, and Zhike should be used to resolve toxic qi, allowing True Qi to circulate and suffering to cease.

[Yuan] states: During the seventh or eighth day of smallpox progression, if the body burns with heat, coughing is incessant and distressing, and fresh blood spurts from the nostrils, this is because Metal (Lung) deficiency causes ringing, and Xiao Du (ferocious toxin) agitates the collaterals of Taiyin (Lung). Use Xingren (5 qian), Donghua (5 qian), Menmendong (5 qian), and Gualou Ren (5 qian), decocted with pear juice into a paste. Remove from heat, add white honey and human milk, boil briefly, and store in porcelain. Take two spoons at dawn and dusk; the effect is miraculous. The song says: "Malignant cough in smallpox spurts blood, recognize Metal deficiency and pervasive toxin; Donghua, Xingren, and Maidong, Pear juice and Gualou Ren are most fitting; Boil paste with white honey, adjust dosage with human milk for speed; Seal tightly in porcelain away from fire, take at dawn and dusk to stop cough." Coughing in smallpox is extremely dangerous. However, coughing due to Wind pathogen invading Lung collaterals is not included in this discussion; it is easy to treat and cure. For those with Original Qi deficiency and rebellious Qi, careful nursing is essential. For males aged seventeen or eighteen who have depleted Yang and essence, if smallpox strikes here, strict adherence to treatment methods is crucial to avoid premature death.

Baizhu Tang: General formula for cough, vomiting, phlegm-saliva, and asthma.
Baizhu (1.5 qian), Chenpi, Baifuling, Wuweizi, Banxia, Xingren (each 1 qian), Gancao (0.5 qian).
Add 1.5 cups of water, 3 slices of Shengjiang, decoct to 0.6 cup, divide into two doses.

Wuweizi Tang: General formula for panting and coughing.
Wuweizi (2 qian), Renshen, Maidong, Xingren, Chenpi (each 1 qian).
Crush into coarse powder. Add 1 cup of water, decoct to 0.6 cup, take warm on an empty stomach. Infants divide into two doses.

Renshen Qingge San
Renshen, Chaihu, Danggui, Shaoyao, Zhimu, Sangbaipi, Baizhu, Huangqi, Ziwan, Digupi, Fuling, Gancao, Jiegeng (each 1 liang), Huangqin (0.5 liang), Shigao, Huashi (each 1.5 liang).
Grind into coarse powder. Take 3 qian per dose, add 1 large cup of water, 3 slices of Shengjiang, decoct to 0.6 cup, strain and take warm. No fixed time, adjust dosage according to child's age/size.

Shengdihuang San: Treats pediatric rubella/variolae with fever, dry mouth, cough, and irritability.
Shengdihuang (0.5 liang), Maidong (decored heart, 7 qian), Xingren, Kuandonghua, Chenpi (each 3 qian), Gancao (roasted, 2.5 qian).
Take 3-5 qian per dose, decoct in water, take slowly. Increase dose for older children. If phlegm-Qi and varicella heat arise internally, use Jiegeng Gancao Fangfeng Tang; if phlegm obstructs upward, assist with Baolong Wan.

Chifuling Tang
Chifuling, Gancao, Daqing, Shengma, Zhike, Zhizi (each 1 qian).
Use 1 small cup of water, 7 leaves of Kuzhuye, 30 grains of Douchi, decoct to 0.5 cup, divide into three doses. Adjust according to child's size.

Jiegeng Tang: Treats chronic cough injuring Lung Qi, expectoration of bloody sputum, foul-smelling sputum, hemoptysis, lung abscess, etc.
Jiegeng (fried), Beimu (decored heart), Zhimu, Sangbaipi, Zhike (each 1 qian), Digupi, Gualou Ren, Yiyiren, Xingren (each 0.5 qian), Danggui, Huangqi (lightly fried), Fangji (each 1 qian), Wuweizi, Baihe (fried, each 1.5 qian), Tingli (fried, 0.5 qian).
Take 3-5 qian per dose, decoct in water and take.