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At the initial stage of Lao Sou (cough caused by consumptive disease), there is often an accompanying exterior pathogenic factor. Since the Lung is already deficient, Wind pathogen enters through the deficiency; when Cold-Wind enters the Lung, it transforms into Fire pathogen. The external Fire pathogen and internal Fire scorch each other, further damaging Lung Metal, resulting in incessant coughing. Quack doctors only know that Lao Sou is a disease of the five Zang organs, and they hastily use Baizhu (Atractylodis Macrocephalae Rhizoma) and Cangzhu (Atractylodis Rhizoma) to tonify Qi, Danggui (Angelicae Sinensis Radix) and Shudihuang (Rehmanniae Radix Preparata) to tonify Blood, and even use Baishao (Paeoniae Radix Alba), Wuweizi (Schisandrae Chinensis Fructus), and Zaoren (Ziziphi Spinosae Semen) to astringe and retain the pathogen. This causes the pathogen to become deeply stagnant in the Couli (interstices of skin and muscles), firmly adhered and difficult to eradicate. Whenever I encounter such cases, I first use Chaihu (Bupleuri Radix) and Qianhu (Peucedani Radix) to clear the exterior pathogen, along with Jiegeng (Platycodonis Radix), Beimu (Fritillariae Cirrhosae Bulbus), and Doulou (Aristolochiae Manshuriensis Fructus)—herbs that are clearing and moistening without being cloying or stagnating—to purify Lung Metal. After about six or seven doses, I then administer cooling and Yin-nourishing preparations to consolidate the treatment. However, Chaihu can be used for several more doses, while Qianhu should only be used for one or two doses. Once the exterior pathogen is cleared, Chaihu must be discontinued immediately.

Dry cough presents with sound but no sputum. Its etiology lies in the insufficiency of Essence and Blood, where Water fails to control Fire, causing Fire Qi to flare upward. True Yin is scorched and burning, leading to dryness and astringency in the Lung organ, resulting in coughing. Danshen (Salviae Miltiorrhizae Radix et Rhizoma) acts swiftly. Coughing in the afternoon indicates Yin deficiency; coughing at dusk indicates Fire Qi affecting the Lung from above.

This condition generally arises from constrained Fire injuring the Lung, where Lung Metal is affected and cannot generate Water. When Water and Fire fail to interact harmoniously, Yin Fire becomes hyperactive and Yang becomes excessive, leading to the coagulation of Phlegm and Blood, eventually forming consumptive disease. If not treated early, severe injury to Lung Metal occurs; excessive Fire and rebellious Blood form clumps and patches, expelled with sputum, or sometimes without sputum. Mild cases appear in the early morning, while severe cases occur frequently at any time. Emotional frustration or anger can trigger bleeding immediately upon occurrence, which is known as Jian Jue (fainting due to scorching). If not treated urgently, it develops into Bo Jue (fainting due to sudden qi rebellion), and the condition becomes critical.

The distinction between life and death in blood disorders depends on whether the "Da Rou" (large muscles/masseter muscles) remains intact: if Da Rou does not diminish, the disease is mild; if Da Rou gradually wastes away, the disease is severe; if Da Rou is completely depleted, there is absolutely no hope of survival. If appetite increases and weight gradually recovers, the case is still treatable; however, if the patient continues to fail to gain weight despite normal diet, the case is incurable, and even with robust appetite, it merely prolongs life. It is common to see patients with consumptive disease who have normal daily routines but leave the table during meals, putting down their chopsticks—this is a sign of this specific condition. For those suffering from this disease, if their temperament is open and cheerful, they practice self-care well, and live in favorable circumstances, they are treatable. Conversely, if their temperament is depressed and obstructed, prone to anger and worry, enduring unbearable injustice in adverse situations, or indulging in wine and lust in favorable situations, and failing to strictly adhere to medical advice, death is inevitable.