李 曰。五脏传变。皆痰为患。盖痰乃风苗。火静则伏于脾。风动则壅于肺。痰火交作。则为急惊。或成嗽痹。痰
火结滞。则为痫钓。或为咳嗽。痰火来去。则为泻青。皆由脾湿而成。所以惊风忌纯用风药。当以养血药为使。古方保
元汤加白芍。为慢惊美剂也。
脾肺母子也。二脏俱虚。则生 涎。 涎者。脾肺所出也。涎则流溢在于咽喉。如水鸡之声。喘嗽烦闷。宜抱龙丸、
夺命散。
咳嗽哮喘。肺脏所招。为虚为实。有本有标。析而治之。理无或淆。咳则无痰。其声必高。嗽则无声。其痰若胶。
声痰俱有。咳嗽名昭。大抵咳嗽。由伤肺杓。或风乘肺。头痛汗饶。或寒乘肺。肢冷酸 。或热乘肺。面赤热潮。或火
乘肺。涕唾血条。或燥乘肺。毛发如烧。惟嗽之痰。脾湿未消。更详时令。四序分 。秋冬多实。春夏虚劳。更分久暂。
莫任 。初时感冒。邪舍皮毛。淫淫习习。喉痒难搔。嗽久液耗。华盖难浇。声连气促。涎沫盈瓢。更参脏腑。仔细
推敲。呕苦属胆。胁痛肝挠。小肠失气。喉梗心苗。长虫胃呕。吐乳脾嘈。大肠遗粪。喘息肺摇。膀胱遗溺。肾痛背腰。
腹满面肿。此属三焦。须明种种。咳嗽堪标。哮喘相近。细核实遥。哮专主痰。与气相撩。或嗜咸醋。膈腕煎熬。口开
呷吸。口闭呀嗷。呀呷二音。乃合成哮。喘气促急。专主热燎。痰声喝喝。肚撷胸尧。抬肩张口。鼻扇气 。俱为恶候。
非可易调。故知肺病。不自一朝。金为火克。热被寒包。根因不一。辨析厘毫。整肃娇脏。永令坚牢。
Li Zhongzi stated: The transmission of diseases among the five Zang organs is all caused by Phlegm (Tan, 痰). Phlegm is the seedling of Wind (Feng, 风); when Fire (Huo, 火) is still, it lies latent in the Spleen (Pi, 脾); when Wind moves, it obstructs the Lung (Fei, 肺). When Phlegm and Fire interact violently, they manifest as Acute Convulsion (Ji Jing Feng, 急惊风); or they may form Cough Bi (Sou Bi, 嗽痹). When Phlegm and Fire stagnate and knot, they manifest as Epilepsy (Xian, 痫) or Tendon Crisis (Diao Feng, 钓风); or they cause Cough (Ke Sou, 咳嗽). When Phlegm and Fire come and go, they lead to Liver Wood overacting on Earth (Xie Qing, 泻青). All these conditions arise from Dampness (Shi, 湿) in the Spleen. Therefore, in treating Convulsions (Jing Feng, 惊风), one must avoid using purely Wind-expelling medicines; instead, Blood-nourishing herbs should be used as guides. The ancient formula Baoyuan Tang (Preserve Origin Decoction) added with Bai Shao (Radix Paeoniae Alba) is an excellent remedy for Slow Convulsion (Man Jing Feng, 慢惊风).
The Spleen and Lung are in a mother-son relationship. If both Zang organs are deficient, they produce Saliva (Xian, 涎). Saliva originates from the Spleen and Lung. When Saliva flows and overflows into the throat, it produces sounds like that of a water chicken, accompanied by panting, coughing, irritability, and oppression. One should use Baolong Wan (Embrace Dragon Pill) and Duoming San (Snatch Life Powder).
Cough (Ke Sou, 咳嗽) and Asthma (Xiao Chuan, 哮喘) are induced by pathogenic factors affecting the Lung. Conditions can be Excess (Shi, 实) or Deficiency (Xu, 虚), having Root (Ben, 本) and Branch (Biao, 标) aspects, which must be analyzed and treated separately without confusion. In Cough without phlegm, the voice is necessarily high. In Sou (a type of cough with phlegm but no distinct sound), there is no sound, but the phlegm is sticky like glue. When both sound and phlegm are present, it is clearly called Ke Sou. Generally, cough arises from damage to the Lung's descending function. It may be due to Wind invading the Lung, presenting with headache and profuse sweating; or Cold invading the Lung, presenting with cold limbs and soreness; or Heat invading the Lung, presenting with red face and feverish sensation; or Fire invading the Lung, presenting with bloody streaks in nasal discharge and saliva; or Dryness invading the Lung, presenting with dry, burnt-looking hair. The phlegm produced by Sou indicates that Spleen Dampness has not yet dissipated, requiring detailed differentiation according to seasonal timing. In the four seasons, Autumn and Winter tend toward Excess patterns, while Spring and Summer tend toward Deficiency-Wasting patterns. One must also distinguish between acute and chronic cases and not let them progress unchecked. Initially, it is a common cold where pathogens reside in the skin and hair, causing a creeping discomfort and unbearable throat itching. Chronic cough consumes fluids, making it difficult to moisten the Lung (Huagai, 华盖 - metaphor for Lung). The voice becomes continuous with shortness of breath, and saliva and foam fill the bowl. One must further consult the Zang-Fu organs for careful deduction. Vomiting bitter fluid belongs to the Gallbladder (Dan, 胆); hypochondriac pain belongs to the Liver (Gan, 肝); small intestine failing to move Qi causes throat obstruction, belonging to the Heart (Xin, 心); roundworms disturbing the Stomach (Wei, 胃) cause vomiting; vomiting milk belongs to Spleen Cacao (irritability); large intestine failing to retain feces leads to enuresis/incontinence; severe panting indicates Lung instability; bladder failing to control urine leads to incontinence; Kidney (Shen, 肾) pain radiating to the back and waist; abdominal distension and whole-body edema belong to the Triple Burner (San Jiao, 三焦). One must understand these various manifestations to correctly identify Cough. Asthma is similar to Cough but requires careful verification of differences. Xiao (Asthma with phlegm-rattle) is primarily caused by Phlegm interacting with Qi. Some who indulge in salty or sour foods suffer from stifling heat in the chest and diaphragm, opening their mouth to inhale and closing it to exhale, producing "ya" and "xia" sounds. The combination of these two sounds constitutes "Xiao". Chuan (Panting/Asthma without rattle) is characterized by rapid breathing and is primarily caused by scorching Heat. With rattling phlegm sounds, the abdomen retracts and the chest protrudes, shoulders lift, mouth opens, and nasal wings flare. These are all ominous signs and difficult to regulate. Thus, one knows that Lung disease does not develop overnight. Metal (Lung) is controlled by Fire, and Heat is wrapped by Cold. The root causes vary, requiring meticulous differentiation. One must rectify the delicate Lung organ to keep it firm and secure forever.