肺主气，其变动为咳嗽者，肺证也。疮疹发热之初便有咳嗽者，肺为五脏之盖，疮疹之火挟君相二火之势上
熏乎肺，肺叶焦举，故气逆而咳也。疮疹既出，其咳更增者，此喉咙有疮，淫淫如痒，习习如梗，故咳
也。疮疹收后而咳者，此卫气虚弱，腠理疏开，风寒外袭，肺气逆而不收，故亦咳也。〔薛〕痘疹未出欲出之际，
乃热毒上熏清道，肺气不宁，宜用惺惺散。若已出之后，则属元气虚弱，不能固卫腠理，
风邪乘虚而袭，宜用五味异功散加桔梗、五味子以补脾肺。
《痘疹方》云∶痘疮未出之先咳嗽，升麻汤（初热）。头疼身热恶寒咳嗽，参苏饮（初热）。呕吐痰涎咳嗽，
白术汤。时气头痛身热咳嗽，惺惺散（初热）。〔万〕如初发热咳嗽甚者，先以参苏饮发之，次以甘桔汤（咽喉）合泻白
散（肺）加牛蒡子治之。
凡痘子出盛咳嗽者，此肺中有火，或咽喉有疮作痒也，只用甘桔汤加牛蒡子，多服良。如涎唾带血，此咽中疮或齿
缝中出也，不须妄治。疮不起发，闷乱喘嗽，手足寒，饮冷者，木香散（泻。）嗽甚，别无他证，五味子汤。如疮
光壮，收靥身热咳甚者，人参清膈散主之。如疮已靥咳嗽者，不问形寒饮冷所致，并宜人参清膈散主之。
若涕唾稠粘，鼻塞不利者，乃风邪伤肺也，亦惺惺散、参苏饮主之（俱初热）。
若痰盛烦躁，痘赤壮热饮冷者，乃脾肺实热也，人参清膈散主之，并饮芹菜汁。
若痰唾稠粘，大便黑色，乃胃经热毒也，用犀角汤（失血）并饮芹菜汁以解之。
病后余毒咳嗽者，升麻汤（初热）。感寒头痛，身热恶寒而嗽者，参苏饮。烦热而嗽者，生地黄散。风热咳嗽，咽膈
不利，甘桔防风汤（咽喉）。兼喘，五味子汤。病后咳嗽胁疼者，盖胁居一身之左右，阴阳二气之所行也，余毒在中，二
气不能升降，故胁痛，用赤茯苓汤、小柴胡汤（发热）加五味子、桔梗、枳壳等解去毒瓦斯，则真气行而所苦自平矣。
〔袁〕若痘交七八之期，而身发火热，恶嗽连声，鼻窍冲出鲜血，金虚则鸣，枭
毒激荡于太阴之络故耳，以杏仁五钱、冬花五钱、门冬五钱、栝蒌仁五钱、与梨汁共煎为膏时取起，再加白蜜人乳，
紧煎数沸，纳于瓷器内，每辰昏进两匙，其效神应。歌曰∶痘中恶嗽冲出血，要识金虚枭毒彻，冬花杏仁与麦门，梨
汁栝蒌仁最切，熬膏投和白蜜中，量数斟加人乳捷，去火紧封瓷器内，晨昏进服嗽声歇。痘中患嗽，极为凶险，但
有感冒风邪于肺络而嗽者，不在此犯论，易治易痊，若元虚气枭，甚宜调养，而男子时迈十七八岁，破阳损精，痘犯于
此，贵宜按方法服治，斯免夭亡矣。
白术汤 治咳嗽呕吐，痰涎气喘通用。
白术（一钱半） 陈皮 白茯苓 五味子 半夏 杏仁（各一钱） 甘草（半钱）
水一盏半，生姜三片，煎六分，分二服。
五味子汤 喘促咳嗽通用。
五味子（二钱） 人参 麦门冬 杏仁 陈皮（各一钱）
上锉散。水一盏，煎六分，空肚温服。儿小者分二服。
人参清膈散
人参 柴胡 当归 芍药 知母 桑白皮 白术 黄 紫菀 地骨皮 茯苓
甘草 桔梗（各一两） 黄芩（半两） 石膏 滑石（各一两半）
上为粗末。每服三钱，水一大盏，生姜三片，同煎至六分，去滓温服，不拘时，量儿大小加减服。
生地黄散 治小儿 疹，身热口干，咳嗽心烦等证。
生地黄（半两） 麦门冬（去心七钱） 杏仁 款冬花 陈皮（各三钱） 甘草（炙，二钱半）
上，每三五钱，水煎，徐徐服。儿大加之。若痰气痘热内作，宜用桔梗甘草防风汤，若痰上壅者，佐以抱龙丸。
赤茯苓汤
赤茯苓 甘草 大青 升麻 枳壳 栀子（各一钱）
上，用水一小盏，苦竹叶七片，豆豉三十粒，煎五分，分为三服。看儿大小加减。
桔梗汤 治久嗽肺气伤，而吐痰有血，痰或腥秽，或咳吐脓血、肺痈等证。
桔梗（炒） 贝母（去心） 知母 桑白皮 枳壳（各一钱） 地骨皮 栝蒌仁 薏苡仁 杏仁
（各五分） 当归 黄 （微炒） 防己（各一钱） 五味子 百合（炒。各一钱五分） 葶苈（炒，五分）
上，每服三五钱，水煎服。
The Lung governs Qi; its pathological manifestation is coughing, which constitutes a Lung syndrome. When coughing occurs at the initial stage of fever in variola (smallpox) or measles, it is because the Lung, situated as the canopy above the five Zang organs, is scorched upward by the fire toxin of the rash, carrying the momentum of the Ministerial Fire and Sovereign Fire. This causes the Lung lobes to become dry and elevated, leading to rebellious Qi and cough. If coughing intensifies after the rash has erupted, it is due to sores in the throat causing itching and a sensation of obstruction, thus triggering cough. If coughing persists after the rash has crusted over, it is because the Wei Qi (Defensive Qi) is weak, the Cou Li (interstices) are loose, allowing Wind-Cold to invade externally; this causes Lung Qi to rebel and fail to descend, resulting in cough. [Xue] At the stage when smallpox is about to erupt, heat toxins ascend to scorch the clear passages, disturbing Lung Qi; Xingxing San (Stimulating Powder) should be used. After eruption, it belongs to deficiency of Yuan Qi (Original Qi), failing to secure the Cou Li, allowing Wind pathogens to invade via deficiency; Wuyi Yigong San (Five-Ingredient Extraordinary Efficacy Decoction) with Jiegeng (Platycodon Root) and Wuweizi (Schisandra Fruit) should be used to tonify Spleen and Lung.
The *Douzhen Fang* states: For cough before the eruption of smallpox, use Shengma Tang (Cinnamon Twig Decoction) for the initial heat stage. For headache, fever, aversion to cold, and cough, use Shen Su Yin (Ginseng and Perilla Infusion) for the initial heat stage. For vomiting of phlegm-saliva with cough, use Baizhu Tang (Atractylodes Macrocephala Decoction). For epidemic headaches, fever, and cough, use Xingxing San for the initial heat stage. [Wan] If initial fever is accompanied by severe cough, first disperse with Shen Su Yin, then treat with Ganjie Tang (Licorice and Platycodon Decoction) combined with Xiebai San (Drain White Powder) plus Niubangzi (Arctii Fructus).
For cases where smallpox eruptions are abundant but cough is severe, this indicates fire in the Lung or sores in the throat causing itching; only Ganjie Tang plus Niubangzi should be used, taken frequently for good effect. If saliva contains blood, this is due to throat sores or bleeding from gum crevices; no arbitrary treatment is needed. If pustules fail to rise, accompanied by restlessness, panting cough, cold hands and feet, and desire for cold drinks, use Muxiang San (Aucklandia Powder) which has purgative effects. For severe cough without other symptoms, use Wuweizi Tang (Schisandra Decoction). If pustules are bright and full, and body heat/cough persist after crusting, Ren Shen Qingge San (Ginseng Clear Diaphragm Powder) is indicated. For cough after crusting, regardless of whether caused by cold exposure or cold drinks, Ren Shen 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 and Shen Su Yin are indicated (both for initial heat).
If there is profuse phlegm, irritability, red/pustular eruptions, high fever, and desire for cold drinks, this is Excess Heat in Spleen and Lung; Ren Shen Qingge San is indicated, along with drinking celery juice.
If phlegm-saliva is thick/sticky and stool is black, this is Heat Toxin in the Stomach channel; Xijiao Tang (Rhinoceros Horn Decoction) for hemorrhage is used, along with celery juice to resolve toxicity.
For residual toxin cough after illness, use Shengma Tang (initial heat). For cough due to Cold invasion with headache, fever, and aversion to cold, use Shen Su Yin. For irritability/heat with cough, use Shengdihuang San (Rehmannia Powder). For Wind-Heat cough with throat/chest discomfort, use Ganjie Fangfeng Tang (Licorice and Saposhnikovia Decoction) for throat issues. With accompanying wheezing, use Wuweizi Tang. For post-illness cough with hypochondriac pain: since the hypochondrium is on both sides of the body, the pathway of Yin and Yang Qi, residual toxin stagnation prevents the ascending/descending of these Qi, causing pain. Use Chifuling Tang (Red Poria Decoction) and Xiaochaihu Tang (Minor Bupleurum Decoction) for fever, adding Wuweizi, Jiegeng, and Zhike (Aurantii Fructus) to resolve toxin vapors, allowing True Qi to circulate and suffering to cease.
[Yuan] If during the 7th-8th day of smallpox, the body burns with heat, coughing is incessant, and fresh blood spurts from the nostrils, this is because Metal (Lung) is deficient causing resonance, and Xiao Du (Fierce Toxin) agitates the Taiyin (Lung) collaterals. Use Xingren (Apricot Seed) 5 qian, Donghua (Kalanchoe Flower) 5 qian, Menmen Dong (Ophiopogon Tuber) 5 qian, and Gualou Ren (Trichosanthes Seed) 5 qian, decocted with Pear Juice into a paste. Remove from heat, add White Honey and Human Milk, boil briefly, store in porcelain. Take two spoons at dawn and dusk; efficacy is miraculous. The song says: "Malignant cough in smallpox spurts blood, know that Metal deficiency allows fierce toxin penetration; Donghua, Xingren, and Maidong, paired with Pear Juice and Trichosanthes seed are most pertinent; Boil paste with honey, adjust dosage with human milk swiftly; Seal tightly in porcelain away from fire, take morning and evening until cough ceases." Cough in smallpox is extremely dangerous. However, if cough is merely due to Wind pathogen invading Lung collaterals, it is not discussed here as it is easy to treat and cure. If Original Qi is deficient and Qi is rebellious, careful nourishment is essential. Especially for males aged 17-18 who have depleted Essence through sexual activity, if smallpox strikes, one must strictly follow treatment methods to avoid premature death.
Baizhu Tang: General formula for cough, vomiting, phlegm-saliva, and asthma.
Baizhu (1.5 qian), Chenpi (Tangerine Peel), Baifuling (White Poria), Wuweizi, Banxia (Pinellia Tuber), Xingren (each 1 qian), Gancao (0.5 qian).
Add 1.5 cups of water, 3 slices of Shengjiang (Fresh Ginger), decoct to 0.6 cup, divide into two doses.
Wuweizi Tang: General formula for panting and cough.
Wuweizi (2 qian), Renshen (Ginseng), Maimendong (Ophiopogon Tuber), 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. For infants, divide into two doses.
Ren Shen Qingge San
Renshen, Chaihu (Bupleuri Radix), Danggui (Angelica Sinensis Radix), Shaoyao (Paeoniae Radix), Zhimu (Anemarrhenae Rhizoma), Sangbaipi (Morus Cortex), Baizhu, Huangqi (Astragali Radix), Ziwan (Asternis Radix), Digupi (Lycii Cortex), Fuling (Poria), Gancao, Jiegeng (each 1 liang), Huangqin (Scutellariae Radix) (0.5 liang), Shigao (Gypsum Fibrosum), Huashi (Talcum) (each 1.5 liang).
Make into coarse powder. Take 3 qian per dose, add 1 large cup of water, 3 slices of Shengjiang, decoct to 0.6 cup, remove dregs, take warm. Time unspecified, adjust dosage based on child's age/size.
Shengdihuang San: Treats pediatric measles with fever, dry mouth, cough, and irritability.
Shengdihuang (Rehmanniae Radix) (0.5 liang), Maidong (Ophiopogon Tuber, heart removed) (7 qian), Xingren, Kuandonghua (Farfarae Flos), 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-heat and measles heat arise internally, use Jiegeng Gancao Fangfeng Tang; if phlegm obstructs upward, assist with Baolong Wan.
Chifuling Tang
Chifuling (Red Poria), Gancao, Daqing (Isatidis Folium), Shengma (Cimicifugae Rhizoma), Zhike, Zhizi (Gardeniae Fructus) (each 1 qian).
Use 1 small cup of water, 7 leaves of Kuzhuye (Bitter Bamboo Leaf), 30 grains of Douchi (Fermented Soybean), decoct to 0.5 cup, divide into three doses. Adjust based on child's size.
Jiegeng Tang: Treats chronic cough damaging Lung Qi, expectoration of bloody sputum, foul-smelling sputum, hemoptysis, lung abscess, etc.
Jiegeng (Stir-fried), Beimu (Fritillariae Bulbus, heart removed), Zhimu, Sangbaipi, Zhike (each 1 qian), Digupi, Gualou Ren, Yiyiren (Coix Semen), Xingren (each 0.5 qian), Danggui, Huangqi (Lightly stir-fried), Fangji (Stephaniae Tetrandrae Radix) (each 1 qian), Wuweizi, Baihe (Lilii Bulbus, stir-fried) (each 1.5 qian), Tingli (Descurainiae Semen, stir-fried) (0.5 qian).
Take 3-5 qian per dose, decoct in water and administer.