遗精数年，屡治不愈。且近年来，每次遗精之后，即患感冒。轻者每周1次，重者每周3次。医先用西药治之不效，继又用中药益气养阴，固肾止遗之剂亦不效。细审其证见头晕乏力，全身酸痛，喷嚏频作，发热，舌苔薄白，脉弦而细。综合脉证，思之：《灵枢·营卫生会篇》云：“营出于中焦，卫出于下焦。”下焦者，肝肾也，今病发于遗精之后，必肝肾俱虚，卫气不行，故而表气不固，而易得外感也。治以滋补肝肾，调理肝木。处方：柴胡10克，白芍10克，当归10克，生地18克，山药12克，山茱萸10克，白术6克，茯苓10克，泽泻10克，丹皮10克，栀子10克，薄荷6克。
服药30剂，愈。
急性气管炎和支气管炎
1．痰热阻于上焦，不佐温阳，阴霾难散
苏××，女，35岁。咳嗽两个多月。先用西药治之不效，后又以中成药治之仍不效。察其除阵阵咳嗽外，并时时感到咽喉有阻塞感，粘痰甚难咯出，口苦口干，舌苔黄白而腻，脉滑而数。综合脉证，思之：滑数之脉者，痰火阻肺也。治宜化痰泻火。清气化痰丸加减。处方：制南星10克，半夏10克，橘红10克，杏仁10克，川贝母10克，瓜萎15克，黄芩10克，枳壳1O克。
服药3剂，寸效未见。因思：《内经》所云之寒者热之，热者寒之，乃千古不破之真理，然此证何故不效也。又思：清气化痰丸一方均取姜汁为丸，姜汁者，辛温行散之药也，入肺之药也。痰也者，乃阴霾之物，非阳不能化，故痰火之证常于大队化痰药中酌加温化之品以化痰。干姜者，入肺而温，善化肺中之阴寒，宜用干姜替生姜汁治之。乃于原方中加入干姜1克。服药2剂，愈。
某医问：仅用干姜1克是否太少?答曰：痰热之证仅可以辛温相佐，不可为主也，过用则热必炽，而病不除也。
2．心下有水，但从肺治，以寒作热，其病难除
郜××，女，29岁。感冒后频频咳嗽3个多月。医诊急性支气管炎。先用西药控制感染、止咳化痰，住院40天，效果不显而出院。出院后，又以多种中成药与汤剂治疗一个多月，仍然效果不著。细询其咳嗽尤甚于夜间临睡之时，有时因刚躺时剧烈咳嗽而不得不采用半卧位才能逐渐入睡，且剑突之下微有痞满感。舌苔薄白，脉弦紧。再察原用诸方，有养阴止咳者，有清化痰热者，有宣肺者，有降肺者。综合脉证思之：仲景《伤寒论》云：“伤寒表不解，心下有水气，于呕，发热而咳……或喘者……小青龙汤主之。近人多用小青龙汤治喘，而曹颖甫《经方实验录》则用此治咳嗽。常常一剂得愈。又思小青龙者重在温肺兼化中焦偏上之饮，此证既有肺寒又有中焦偏上之饮，故宜之。且此证或用润药不化寒痰，或用清热不去治寒，或但用肺药而未顾及中焦，此方正合中、上二焦之证。乃拟小青龙汤加减。处方：麻黄4克，干姜4克，桂枝4克，白芍4克，细辛3克，半夏4克，甘草4克，五味子4克。
服药1剂，咳减近半，继服2剂而愈。
某医问：何不用大剂之品治之?答云：久用药铒，正气已虚，再以猛剂以除邪，正气必受其害，故治以小剂。
3．枢机不利，当以和解，但从肺治，延误病期
何××，男，24岁。感冒后4个多月来，经常咳嗽。医诊急性支气管炎。先用西药抗感染，镇咳3个多月无明显效果，后又以中药丸、胶囊、口服液、膏剂等治疗近2个月亦无功。余以止嗽散、金沸草散加减一周亦无功。询之。患者云：近曾服中药20剂矣，其药大都与朱老所处之方相仿。再询其咳嗽尤甚于夜间与中午刚刚平卧之时。因思痰饮者下沉而阻肺。属阴，平卧时为阴位，故此时加重，治宜温阳化饮，小青龙汤可也。刚刚处方完毕。患者曰：请你看病之前，刚刚服用某医所开的小青龙汤2剂，服药后不但咳嗽不减，反而出现烦乱心悸。余审思再三，不得其解，不得不再求之于脉。察其脉沉弦而涩。再问患者曰：有胸满口苦否?答曰：不但有胸满口苦，而且有头晕心烦。顿悟：此少阳枢机不利，痰饮内阻耳。因忆仲景《伤寒论》云：“伤寒五六日中风……胸胁苦满……心烦喜呕，或胸中烦而不呕……或咳者，小柴胡汤主之……若咳者，去人参大枣生姜，加五味子半升、干姜二两。”因拟小柴胡加减为方：柴胡10克，半夏10克，黄芩10克，干姜4克，五味子10克，紫菀10克，丝瓜络10克。
服药1剂，咳嗽大减，继服3剂，愈。
4．寒饮阻肺，反用寒凉，以寒治寒，必加病势
许××，男，3岁。
10天前，突然发热，咳嗽微喘。急至某院住院治疗。诊为急性支气管炎。予抗生素、化痰止咳剂中药、西药治疗10天不见好转。审其喘咳不断，口鼻微青，发热，体温37．6℃，舌苔薄白，脉弦以左为明显。因云：此外寒内饮，肺气不得肃降之证耳。可予旋覆花等药治之。处方：旋覆花6克(布包煎)，前胡6克，细辛1克，半夏6克，荆芥6克，茯苓3克，甘草3克，紫菀4克。
服药1剂，咳嗽、喘、发热均大减，继服2剂，诸证消失，愈。
某医问：《方剂学》云：外寒内饮者，用小青龙汤，何先生不用小青龙而用金沸草散?答曰：仲景《伤寒论》云：“伤寒表不解，心下有水气，干呕，发热而咳，小青龙汤主之。”小青龙汤者兼治心下之水饮，此证乃微饮在肺，只可从肺论治，此即所谓药要适其至所也。金沸草散诸药均肺药也，故以金沸草散加减为方以治之。
5．肝肺气郁，痰湿内阻，不去理气，但化痰浊，其病不解
郝××，女，62岁。
三个多月来，咳嗽吐痰，时轻时重，平卧时突然加重，而不得不经常坐起几次以减轻咳嗽，为此曾住院两次，共约一个半月，然咳嗽始终不见减轻。不得已，改请中医以化痰止咳之中药治之，或但予中成药，或汤、丸、散并投，然始终效果甚微，且日渐发现头晕头痛，胸满胸痛，脘腹不适，心悸烦乱。乃再求中医专家治之。审其咳声重浊，痰吐较稠粘，胸满胸痛，心悸烦乱，口于而粘，舌苔白，脉弦紧而滑。再询其发病原因，云：感冒之后，复因受骗而发。云：此肝肺气郁，痰浊阻滞所致也。治宜疏肝理气，化痰止咳。处方：柴胡10克，半夏10克，黄芩10克，瓜萎15克，桔梗10克，杏仁10克，青皮10克，陈皮10克，苏叶10克，甘草6克。
服药2剂，诸证俱减，继服15剂，诸证俱失，愈。
因思《素问‘咳论》云：“五脏六腑皆令人咳，非独肺也……肝咳之状，咳则两胁下痛，甚则不可以转，转则两胠下满。”此证乃肝肺同病，故治肺而不治肝则不可也。
6．肝肺同病，不审虚实，但去化痰，虚以实治，岂能得愈
赵××，女，40岁。
4个多月以来，经常不断的咳嗽。医诊急性支气管炎。始予抗生素、西药化痰止咳药不效，继又以中药止咳化痰、清热化痰、养阴润肺等剂亦无效。审其两脉弦紧，右脉明显大于左脉，因思右大于左者内伤也，气阴俱虚也；弦脉者肝脉也，紧脉者寒痰凝结也。乃再询其他诸证。患者云：病发于人工流产后不久。咳嗽之状，每咳则遗尿，且见胸胁苦满，心悸心烦，气短头晕，口咽干燥，生气或劳累必甚。乃云：此证乃气阴两虚为本，肝肺气郁，痰湿内郁为标，治宜补气养阴以培本，疏肝理气，化痰止咳以治标。处方：柴胡10克，当归10克，白芍10克，麦冬10克，党参10克，五味子10克，半夏10克，陈皮10克，青皮10克，黄芩10克，紫菀10克。
服药4剂，诸证若失大半，继服六剂，愈。
患者云：愚用止咳化痰、消炎解毒数月何见效不著也?答曰：虚实不分，脏腑不明耳。
7．肾气不足，反从肺治，病位不同，治之不效
汤××，男，58岁。
咳嗽3个多月，每咳一声即遗尿点滴，有时因咳嗽数声而致裤子湿的难于再穿，为此不得不每日换裤子1～2次。为此曾先后请中、西医十余人进行治疗，然都以无效而作罢。乃改邀余治。余始以治遗尿咳方治之。处方：川芎10克，当归10克，白芍10克，半夏10克，陈皮10克，青皮10克，黄芩10克，人参10克，麦冬10克，五昧子10克。
6剂后，诸证不减。再询其证。云：病发于前列腺手术之后，且时见腰痛。审其脉沉细弦尺稍大。乃云：前方治肝肺，此病乃肾虚之故，正如《素问》所云之肾咳也。因拟补肾为法。处方：熟地20克，山药12克，山萸肉10克，茯苓10克，泽泻10克，丹皮10克，附子10克，肉桂10克，五昧子10克，车前子10克(布包煎)。服药3剂，诸证消失，愈。
8．痰饮阻于胸膈，不治中焦，但治上焦，久延时日张××，男，50岁。今年感冒之后8个多月以来，一直反复不断的咳嗽，痰难咯出，严重影响工作。为此不得不住院两次检查治疗。除西药外，仅只中药化痰止咳汤剂即服80多剂，然始终效果不明显。余检其方视之，大多为宣肺化痰止嗽之品，有泻白者，有止嗽者，有金沸草者种种不一。细询其证，除咳嗽痰多难于咯出之外，并感心下痞坚不适，脉沉弦紧数。因思仲景《金匮要略》云：“膈间支饮，其人喘满，心下痞坚，面色黧黑，其脉沉紧，得之数十日，木防己汤主之。”尤在泾《金匮要略心典》云：“支饮上为喘满，而下为痞坚，则不特碍其肺，抑且滞其胃矣。面色黧黑者，胃中成聚，营卫不行也。脉浮紧者为外寒，沉紧者为里实。里实可下，而饮气之实，非常法可下；痰饮可吐，而饮之在心下者，非吐可去，宜其得之数十日，医吐下之而不愈也。木防己、桂枝一苦一辛，并能行水气而散结气，而痞坚之处必有伏阳，吐下之余，定无完气，书不尽言，而意可会也。故又以石膏治热，人参益虚，于法可谓密矣。”又思中焦者，上中下三焦之轮轴，中焦阻滞，斡旋不能，则肺气不降，。肾气不升耳。因拟木防己汤加减：防己10克，桂枝10克，生石膏15克，人参10克，半夏10克，陈皮10克，紫菀10克，茯苓6克。
服药3剂，咳嗽次数及幅度均大减，继服4剂，诸证俱解而愈。
9．燥痰在肺，不予凉润，反以清肺化痰，肺阴因损，咳嗽难愈
耿××，男，38岁。
4个多月来，咳嗽少痰，有时连续数十声方得暂时停止，停止半小时后又连续咳嗽数分钟，夜间经常因咳嗽难于睡眠片刻。为此曾数次住院检查治疗，虽经x线拍片，B超，cT检查数次迄未阳性发现，但药效始终未见。审其除阵发性剧烈咳嗽之外，并见咽喉不利，口咽干而喜饮，舌苔薄白质嫩红，脉弱而缓。因思病久者尤当审脉，脉弱而缓者，肺虚也；虚火相兼而成火逆上气之势，故阵阵剧咳也。仲景《金匮要略》云：“火逆上气，咽喉不利，止逆下气者，麦门冬汤主之”。《金匮编注》云：“此阴火上逆也。真阴之虚，阴火上逆刑金，为火逆上气，咽喉不利，惟当壮水之主，以镇阳火。”再检视所用药铒。云：除博利康尼喷雾吸人有几秒钟的症状缓解而后加剧外，西药遍试均无效果。中药清热化痰、温肺化饮不但不效反见加重，即使养阴泻火亦功效不显。又思阴虚火旺者当养阴而效，而其不效者何也?脉数者热也，而本证脉不见数，反见弱而缓，弱而缓乃气阴不足而无火也，且燥痰阻肺，故但用养阴泻火不效也。治拟加减麦门冬汤：麦冬10克，沙参10克，半夏10克，紫菀10克，桑皮10克，甘草10克，百部15克，竹叶10克，炙杷叶10克。
服药4剂，咳嗽骤减，继服4剂，愈。
10．但治肺咳，不知五脏，久治不效
郑××，男，成。
咳嗽3个多月。医诊急性支气管炎。先以西药治疗1个多月不效，后又配合中药止咳化痰等亦不效。细审其证，咳嗽尤甚于早晨，且咳痰不多，口苦口干，烦躁易怒，大便干燥，舌质红，苔黄，脉弦数。综合脉证，早晨者，肝胆之时也，且脉见弦数，亦属肝火；大便秘结者，胃与大肠实火也。肝胃实火，上烁肺金，肺失肃降，则咳嗽也。治以清泻肝火。处方：当归10克，川芎10克，大黄4克，栀子10克，羌活6克，防风6克，青黛4克。
服药2剂，咳减六七，继服2剂，愈。
某医云：咳本在肺，为何以泻青丸法治之?答曰：《素问·咳论》曰：“黄帝问曰：肺之令人咳，何也?岐伯对曰：五脏六腑皆令人咳，非独肺也……肝咳之状，咳则两胁下痛，甚则不可以转，转则两肱下满。”今证见脉弦数，且烦躁易怒，故为肝咳也。肝咳者，当调肝为主，今肝火为主，故当以泻肝火之法治之。
慢性支气管炎
1．肺肾俱虚，水泛为痰，但从治肺，不予补肾，久咳不除
遗精数年，多次治疗未愈。且近年来，每次遗精后，随即患上感冒。轻者每周1次，重者每周3次。医生先用西药治疗无效，继而又用中药益气养阴、固肾止遗的方剂也无效。仔细审查其症状：头晕乏力，全身酸痛，频繁打喷嚏，发热，舌苔薄白，脉象弦而细。综合脉象和症状，思考道：《灵枢·营卫生会篇》说：“营气出于中焦，卫气出于下焦。”下焦指的是肝肾，现在病发于遗精之后，必定是肝肾俱虚，卫气运行不畅，从而导致表气不固，容易感受外邪。治疗方法以滋补肝肾，调理肝木为主。处方：柴胡10克，白芍10克，当归10克，生地18克，山药12克，山茱萸10克，白术6克，茯苓10克，泽泻10克，丹皮10克，栀子10克，薄荷6克。
服药30剂，痊愈。
急性气管炎和支气管炎
1．痰热阻滞于上焦，不配合温阳药物，阴霾难以消散
苏××，女，35岁。咳嗽两个多月。先用西药治疗无效，后又服用中成药治疗仍无效。观察其除了阵阵咳嗽外，还时时感到咽喉有阻塞感，粘痰很难咳出，口苦口干，舌苔黄白而腻，脉象滑而数。综合脉象和症状，思考道：滑数之脉，是痰火阻滞肺脏的表现。治疗宜化痰泻火。使用清气化痰丸加减。处方：制南星10克，半夏10克，橘红10克，杏仁10克，川贝母10克，瓜蒌15克，黄芩10克，枳壳10克。
服药3剂，毫无效果。于是思考：《内经》所说的寒者热之，热者寒之，是千古不变的真理，但这证为何无效呢？又思考：清气化痰丸一方均取姜汁为丸，姜汁是辛温行散的药物，入肺经。痰，是阴霾之物，非阳气不能化解，所以痰火之证常在大队化痰药中酌情加入温化之品以化痰。干姜，入肺经而性温，善于化解肺中的阴寒，宜用干姜代替生姜汁来治疗。于是在原方中加入干姜1克。服药2剂，痊愈。
某医生问：仅用干姜1克是否太少？回答说：痰热之证只能以辛温药物相佐助，不可作为主药，过用则火热必炽盛，而病不能去除。
2．心下有停水，只从肺论治，将寒证误作热证，病难消除
郜××，女，29岁。感冒后频频咳嗽3个多月。医生诊断为急性支气管炎。先用西药控制感染、止咳化痰，住院40天，效果不明显而出院。出院后，又以多种中成药与汤剂治疗一个多月，仍然效果不显著。详细询问得知其咳嗽在夜间临睡时尤为严重，有时因刚躺下时剧烈咳嗽而不得不采用半卧位才能逐渐入睡，且剑突之下微有痞满感。舌苔薄白，脉象弦紧。再查看原来使用的各方，有养阴止咳的，有清化痰热的，有宣肺的，有降肺的。综合脉象和症状思考：仲景《伤寒论》说：“伤寒表不解，心下有水气，干呕，发热而咳……或喘者……小青龙汤主之。”近人多用小青龙汤治疗喘证，而曹颖甫《经方实验录》则用此方治疗咳嗽。常常一剂即愈。又思考：小青龙汤重在温肺兼化中焦偏上之饮邪，此证既有肺寒又有中焦偏上之饮邪，故适宜使用。而且此证或用润药不能化解寒痰，或用清热不能去除寒邪，或只用肺药而未顾及中焦，此方正合中、上二焦之证。于是拟定小青龙汤加减。处方：麻黄4克，干姜4克，桂枝4克，白芍4克，细辛3克，半夏4克，甘草4克，五味子4克。
服药1剂，咳嗽减轻近一半，继服2剂而痊愈。
某医生问：为何不用大剂量药物治疗？回答说：久用药饵，正气已虚，再用猛剂以祛除邪气，正气必受损害，所以用小剂量治疗。
3．枢机不利，应当和解，只从肺论治，延误病情
何××，男，24岁。感冒后4个多月来，经常咳嗽。医生诊断为急性支气管炎。先用西药抗感染，镇咳3个多月无明显效果，后又以中药丸、胶囊、口服液、膏剂等治疗近2个月亦无功效。我用止嗽散、金沸草散加减治疗一周也无功效。询问患者。患者说：最近曾服用中药20剂，其药大都与朱老所开之方相似。再询问其咳嗽在夜间与中午刚刚平卧时尤为严重。于是思考：痰饮下沉而阻滞肺脏。属阴，平卧时为阴位，故此时加重，治疗宜温阳化饮，可用小青龙汤。刚刚处方完毕。患者说：请你看病之前，刚刚服用某医所开的小青龙汤2剂，服药后不但咳嗽不减，反而出现烦乱心悸。我审思再三，不得其解，不得不再求之于脉象。察其脉沉弦而涩。再问患者说：有胸满口苦吗？回答说：不但有胸满口苦，而且有头晕心烦。顿时领悟：这是少阳枢机不利，痰饮内阻所致。于是回忆仲景《伤寒论》说：“伤寒五六日中风……胸胁苦满……心烦喜呕，或胸中烦而不呕……或咳者，小柴胡汤主之……若咳者，去人参大枣生姜，加五味子半升、干姜二两。”于是拟定小柴胡汤加减为方：柴胡10克，半夏10克，黄芩10克，干姜4克，五味子10克，紫菀10克，丝瓜络10克。
服药1剂，咳嗽大减，继服3剂，痊愈。
4．寒饮阻滞肺脏，反用寒凉药物，以寒治寒，必然加重病情
许××，男，3岁。
10天前，突然发热，咳嗽微喘。急至某院住院治疗。诊断为急性支气管炎。给予抗生素、化痰止咳剂中药、西药治疗10天不见好转。审查其喘咳不断，口鼻微青，发热，体温37.6℃，舌苔薄白，脉象弦以左侧为明显。于是说：这是外寒内饮，肺气不得肃降的证候。可予旋覆花等药治疗。处方：旋覆花6克（布包煎），前胡6克，细辛1克，半夏6克，荆芥6克，茯苓3克，甘草3克，紫菀4克。
服药1剂，咳嗽、喘、发热均大减，继服2剂，诸证消失，痊愈。
某医生问：《方剂学》说：外寒内饮者，用小青龙汤，何先生不用小青龙而用金沸草散？回答说：仲景《伤寒论》说：“伤寒表不解，心下有水气，干呕，发热而咳，小青龙汤主之。”小青龙汤兼治心下之水饮，此证乃是微饮在肺，只可从肺论治，这就是所谓药要适其至所（药物作用部位要准确）的意思。金沸草散诸药均为肺经药，故以金沸草散加减为方以治疗它。
5．肝肺气郁，痰湿内阻，不去理气，只化痰浊，病难解除
郝××，女，62岁。
三个多月来，咳嗽吐痰，时轻时重，平卧时突然加重，而不得不经常坐起几次以减轻咳嗽，为此曾住院两次，共约一个半月，然咳嗽始终不见减轻。不得已，改请中医以化痰止咳之中药治疗，或只予中成药，或汤、丸、散并投，然始终效果甚微，且日渐发现头晕头痛，胸满胸痛，脘腹不适，心悸烦乱。于是再求中医专家治疗。审查其咳声重浊，痰吐较稠粘，胸满胸痛，心悸烦乱，口干燥而粘，舌苔白，脉象弦紧而滑。再询问其发病原因，说：感冒之后，复因受骗而发。说：这是肝肺气郁，痰浊阻滞所致。治疗宜疏肝理气，化痰止咳。处方：柴胡10克，半夏10克，黄芩10克，瓜蒌15克，桔梗10克，杏仁10克，青皮10克，陈皮10克，苏叶10克，甘草6克。
服药2剂，诸证俱减，继服15剂，诸证俱失，痊愈。
于是思考《素问·咳论》说：“五脏六腑皆令人咳，非独肺也……肝咳之状，咳则两胁下痛，甚则不可以转，转则两胠下满。”此证乃肝肺同病，故治肺而不治肝则不可。
6．肝肺同病，不审虚实，只去化痰，虚以实治，岂能得愈
赵××，女，40岁。
4个多月以来，经常不断的咳嗽。医生诊断为急性支气管炎。始予抗生素、西药化痰止咳药无效，继又以中药止咳化痰、清热化痰、养阴润肺等剂也无效。审查其两脉弦紧，右脉明显大于左脉，于是思考右大于左者为内伤，气阴俱虚；弦脉为肝脉，紧脉为寒痰凝结。于是再询问其他诸证。患者说：病发于人工流产后不久。咳嗽之状，每咳则遗尿，且见胸胁苦满，心悸心烦，气短头晕，口咽干燥，生气或劳累必甚。于是说：此证乃气阴两虚为本，肝肺气郁，痰湿内郁为标，治疗宜补气养阴以培本，疏肝理气，化痰止咳以治标。处方：柴胡10克，当归10克，白芍10克，麦冬10克，党参10克，五味子10克，半夏10克，陈皮10克，青皮10克，黄芩10克，紫菀10克。
服药4剂，诸证若失大半，继服六剂，痊愈。
患者说：我使用止咳化痰、消炎解毒数月为何见效不显著？回答说：虚实不分，脏腑不明罢了。
7．肾气不足，反从肺论治，病位不同，治疗无效
汤××，男，58岁。
咳嗽3个多月，每咳一声即遗尿点滴，有时因咳嗽数声而致裤子湿得难于再穿，为此不得不每日换裤子1～2次。为此曾先后请中、西医十余人进行治疗，然都以无效而作罢。于是改邀我治疗。我起初以治遗尿咳方治疗。处方：川芎10克，当归10克，白芍10克，半夏10克，陈皮10克，青皮10克，黄芩10克，人参10克，麦冬10克，五味子10克。
6剂后，诸证不减。再询问其证。说：病发于前列腺手术之后，且时见腰痛。审查其脉沉细弦尺稍大。于是说：前方治肝肺，此病乃肾虚之故，正如《素问》所说的肾咳。于是拟定补肾为法。处方：熟地20克，山药12克，山萸肉10克，茯苓10克，泽泻10克，丹皮10克，附子10克，肉桂10克，五味子10克，车前子10克（布包煎）。服药3剂，诸证消失，痊愈。
8．痰饮阻滞于胸膈，不治中焦，只治上焦，久延时日
张××，男，50岁。今年感冒之后8个多月以来，一直反复不断的咳嗽，痰难咯出，严重影响工作。为此不得不住院两次检查治疗。除西药外，仅只中药化痰止咳汤剂即服80多剂，然始终效果不明显。我检查其方视之，大多为宣肺化痰止嗽之品，有泻白散的，有止嗽散的，有金沸草散的种种不一。详细询问其证，除咳嗽痰多难于咯出之外，并感心下痞坚不适，脉象沉弦紧数。于是思考仲景《金匮要略》说：“膈间支饮，其人喘满，心下痞坚，面色黧黑，其脉沉紧，得之数十日，木防己汤主之。”尤在泾《金匮要略心典》说：“支饮上为喘满，而下为痞坚，则不特碍其肺，抑且滞其胃矣。面色黧黑者，胃中成聚，营卫不行也。脉浮紧者为外寒，沉紧者为里实。里实可下，而饮气之实，非常法可下；痰饮可吐，而饮之在心下者，非吐可去，宜其得之数十日，医吐下之而不愈也。木防己、桂枝一苦一辛，并能行水气而散结气，而痞坚之处必有伏阳，吐下之余，定无完气，书不尽言，而意可会也。故又以石膏治热，人参益虚，于法可谓密矣。”又思考中焦者，是上中下三焦之轮轴，中焦阻滞，斡旋不能，则肺气不降，肾气不升耳。于是拟定木防己汤加减：防己10克，桂枝10克，生石膏15克，人参10克，半夏10克，陈皮10克，紫菀10克，茯苓6克。
服药3剂，咳嗽次数及幅度均大减，继服4剂，诸证俱解而痊愈。
9．燥痰在肺，不予凉润，反以清肺化痰，肺阴因损，咳嗽难愈
耿××，男，38岁。
4个多月来，咳嗽少痰，有时连续数十声方得暂时停止，停止半小时后又连续咳嗽数分钟，夜间经常因咳嗽难于睡眠片刻。为此曾数次住院检查治疗，虽经X线拍片，B超，CT检查数次迄未阳性发现，但药效始终未见。审查其除阵发性剧烈咳嗽之外，并见咽喉不利，口咽干而喜饮，舌苔薄白质嫩红，脉弱而缓。于是思考病久者尤当审脉，脉弱而缓者为肺虚；虚火相兼而成火逆上气之势，故阵阵剧咳也。仲景《金匮要略》说：“火逆上气，咽喉不利，止逆下气者，麦门冬汤主之”。《金匮编注》说：“此阴火上逆也。真阴之虚，阴火上逆刑金，为火逆上气，咽喉不利，惟当壮水之主，以镇阳火。”再检视所用药物。说：除博利康尼喷雾吸入有几秒钟的症状缓解而后加剧外，西药遍试均无效果。中药清热化痰、温肺化饮不但不效反见加重，即使养阴泻火亦功效不显。又思考阴虚火旺者当养阴而效，而其不效者何也？脉数者为热，而本证脉不见数，反见弱而缓，弱而缓乃气阴不足而无火也，且燥痰阻肺，故但用养阴泻火不效也。治疗拟定加减麦门冬汤：麦冬10克，沙参10克，半夏10克，紫菀10克，桑皮10克，甘草10克，百部15克，竹叶10克，炙杷叶10克。
服药4剂，咳嗽骤减，继服4剂，痊愈。
10．只治肺咳，不知五脏，久治不效
郑××，男，成人。
咳嗽3个多月。医生诊断为急性支气管炎。先以西药治疗1个多月无效，后又配合中药止咳化痰等也无效。仔细审查其证，咳嗽在早晨尤为严重，且咳痰不多，口苦口干，烦躁易怒，大便干燥，舌质红，苔黄，脉弦数。综合脉象和症状，早晨者，肝胆之时也，且脉见弦数，亦属肝火；大便秘结者，胃与大肠实火也。肝胃实火，上烁肺金，肺失肃降，则咳嗽也。治疗以清泻肝火。处方：当归10克，川芎10克，大黄4克，栀子10克，羌活6克，防风6克，青黛4克。
服药2剂，咳减六七，继服2剂，痊愈。
某医生说：咳本在肺，为何以泻青丸法治之？回答说：《素问·咳论》说：“黄帝问曰：肺之令人咳，何也？岐伯对曰：五脏六腑皆令人咳，非独肺也……肝咳之状，咳则两胁下痛，甚则不可以转，转则两肱下满。”今证见脉弦数，且烦躁易怒，故为肝咳也。肝咳者，当调肝为主，今肝火为主，故当以泻肝火之法治之。
Nocturnal emission for several years, repeatedly treated without cure. Moreover, in recent years, after each nocturnal emission, a cold immediately develops. In mild cases, it occurs once a week; in severe cases, three times a week. The physician first used Western medicine with no effect, then used Chinese medicine formulas to tonify Qi and nourish Yin, and secure the Kidney to stop emission, also without effect. Carefully examining the symptoms: dizziness and fatigue, soreness and pain throughout the body, frequent sneezing, fever, thin white tongue coating, wiry and fine pulse. Synthesizing the pulse and symptoms, one reflects: The *Lingshu · Yingwei Shenghui Pian* states: "Ying (Nutrient) Qi originates from the Middle Jiao, Wei (Defensive) Qi originates from the Lower Jiao." The Lower Jiao refers to the Liver and Kidneys. Since the illness arises after nocturnal emission, it must be that both the Liver and Kidneys are deficient, causing the movement of Wei Qi to stagnate, thereby failing to secure the Exterior Qi, making one susceptible to external pathogens. The treatment should focus on tonifying and nourishing the Liver and Kidneys, and regulating Liver Wood. Prescription: Chai Hu 10g, Bai Shao 10g, Dang Gui 10g, Sheng Di 18g, Shan Yao 12g, Shan Zhu Yu 10g, Bai Zhu 6g, Fu Ling 10g, Ze Xie 10g, Dan Pi 10g, Zhi Zi 10g, Bo He 6g.
After taking 30 doses, the patient recovered.
Acute Tracheitis and Bronchitis
1. Phlegm-Heat obstructing the Upper Jiao; without assisting Yang, the Yin pathogen is hard to dissipate
Su XX, Female, 35 years old. Coughing for over two months. First treated with Western medicine without effect, then with proprietary Chinese medicines still without effect. Observation revealed that besides paroxysmal coughing, she frequently felt a sensation of obstruction in the throat, with sticky phlegm difficult to expectorate, bitter and dry mouth, yellow-white greasy tongue coating, and slippery rapid pulse. Synthesizing the pulse and symptoms, one reflects: A slippery rapid pulse indicates Phlegm-Fire obstructing the Lung. Treatment should prioritize resolving phlegm and purging fire. Use Qingqi Huatan Wan modified. Prescription: Zhi Nan Xing 10g, Ban Xia 10g, Ju Hong 10g, Xing Ren 10g, Chuan Bei Mu 10g, Gua Lou 15g, Huang Qin 10g, Zhi Ke 10g.
After taking 3 doses, there was no effect at all. One then reflects: The principle from *Neijing* that "cold conditions are treated with heat, and heat conditions with cold" is an eternal truth. Why did this case fail? Further reflection: Qingqi Huatan Wan uses ginger juice to form pills. Ginger juice is acrid-warm and dispersing, entering the Lung meridian. Phlegm is a Yin pathogen; it cannot be transformed without Yang. Therefore, in cases of Phlegm-Fire, warming agents are often added to the large group of phlegm-resolving herbs to transform phlegm. Gan Jiang (Dried Ginger) enters the Lung and is warm, good at transforming Yin-Cold in the Lung. It is appropriate to use Gan Jiang instead of fresh ginger juice. Thus, 1g of Gan Jiang was added to the original prescription. After taking 2 doses, the patient recovered.
A colleague asked: Is only 1g of Gan Jiang too little? Answered: In Phlegm-Heat conditions, acrid-warm herbs can only be used as assistants, not as main ingredients. Overuse will cause Fire to blaze, and the disease will not be cured.
2. Water retention below the heart; treating only from the Lung perspective, mistaking Cold for Heat makes the disease hard to eliminate
Gao XX, Female, 29 years old. Frequent coughing for over 3 months after a cold. Diagnosed with acute bronchitis by physicians. First controlled infection and resolved phlegm/cough with Western medicine; hospitalized for 40 days with insignificant results before discharge. After discharge, treated for over a month with various proprietary Chinese medicines and decoctions, still with poor results. Detailed inquiry revealed coughing was worse at night just before sleep; sometimes severe coughing upon lying down forced her to adopt a semi-recumbent position to gradually fall asleep. There was slight fullness and hardness below the xiphoid process. Tongue coating was thin white, pulse was wiry-tight. Reviewing previous prescriptions, some nourished Yin to stop cough, some cleared Heat and resolved phlegm, some diffused Lung Qi, some descended Lung Qi. Synthesizing pulse and symptoms, one reflects: Zhang Zhongjing's *Shanghan Lun* states: "In Taiyang disease, if the exterior is not resolved, and there is water qi below the heart, leading to dry retching, fever, and cough... or wheezing... Xiao Qing Long Tang is the primary formula." Recently, many use Xiao Qing Long Tang for wheezing, but Cao Yingfu's *Jingfang Shiyan Lu* uses it for coughing, often curing in one dose. Further reflection: Xiao Qing Long Tang focuses on warming the Lung and transforming fluid retention in the upper part of the Middle Jiao. This case has both Lung Cold and fluid retention in the upper Middle Jiao, so it is suitable. Moreover, previous treatments either used moistening agents which failed to transform Cold-Phlegm, or clearing agents which failed to remove Cold, or focused only on Lung herbs neglecting the Middle Jiao. This formula fits the Middle and Upper Jiao pathology perfectly. Thus, Xiao Qing Long Tang modified was prescribed. Prescription: Ma Huang 4g, Gan Jiang 4g, Gui Zhi 4g, Bai Shao 4g, Xi Xin 3g, Ban Xia 4g, Gan Cao 4g, Wu Wei Zi 4g.
After 1 dose, cough reduced by nearly half; after continuing for 2 doses, recovery was achieved.
A colleague asked: Why not use a large dose? Answered: After long-term medication, Zheng Qi (Upright Qi) is already deficient. Using strong agents to expel pathogens would further damage Zheng Qi, hence small doses were used.
3. Pivot mechanism unfavorable; should harmonize, but treating only from the Lung delayed the course
He XX, Male, 24 years old. Frequent coughing for over 4 months after a cold. Diagnosed with acute bronchitis. Treated with Western antibiotics and antitussives for over 3 months with no obvious effect. Then treated with Chinese medicine pills, capsules, oral liquids, and pastes for nearly 2 months with no merit. I used Zhisou San and Jinfeicao San modified for a week with no effect. Inquiry revealed the patient had taken 20 doses of Chinese medicine recently, mostly similar to formulas prescribed by Dr. Zhu. Further inquiry showed coughing was worse at night and just after lying flat at noon. Reflection: Phlegm-fluids sink and obstruct the Lung. They belong to Yin; lying flat is a Yin position, hence worsening at this time. Treatment should warm Yang and transform fluids; Xiao Qing Long Tang could work. Just as the prescription was finished, the patient said: Before seeing you, I took 2 doses of Xiao Qing Long Tang prescribed by another doctor. Instead of reducing the cough, it caused irritability and palpitations. I pondered deeply but found no explanation, so I sought further insight from the pulse. The pulse was deep, wiry, and choppy. I asked again: Do you have chest fullness and bitter taste? Answered: Not only chest fullness and bitter taste, but also dizziness and mental restlessness. Suddenly enlightened: This is due to unfavorable Shaoyang pivot mechanism and internal obstruction by phlegm-fluids. Recalling Zhang Zhongjing's *Shanghan Lun*: "After five or six days of Taiyang disease or Wind-stroke... chest and hypochondriac fullness... mental restlessness and desire to vomit, or mental restlessness without vomiting... or coughing, Xiao Chai Hu Tang is the primary formula... If coughing, remove Ren Shen, Da Zao, Sheng Jiang, add Wu Wei Zi half sheng, Gan Jiang two liang." Thus, Xiao Chai Hu Tang modified was prescribed: Chai Hu 10g, Ban Xia 10g, Huang Qin 10g, Gan Jiang 4g, Wu Wei Zi 10g, Zi Wan 10g, Si Gua Luo 10g.
After 1 dose, cough greatly reduced; after continuing for 3 doses, recovery was achieved.
4. Cold-fluid obstructing the Lung; using Cold/Cooling herbs reversely, treating Cold with Cold inevitably aggravates the condition
Xu XX, Male, 3 years old.
Sudden fever, coughing with slight wheezing 10 days ago. Urgently hospitalized. Diagnosed with acute bronchitis. Treated with antibiotics, Chinese medicine expectorants/antitussives, and Western medicine for 10 days without improvement. Examination revealed continuous wheezing and coughing, slightly bluish lips and nose, fever, temperature 37.6°C, thin white tongue coating, wiry pulse more prominent on the left. Statement: This is External Cold with Internal Fluids, where Lung Qi fails to descend. Treatment should use Inula Flower and other herbs. Prescription: Xuan Fu Hua 6g (wrapped in cloth, decocted), Qian Hu 6g, Xi Xin 1g, Ban Xia 6g, Jing Jie 6g, Fu Ling 3g, Gan Cao 3g, Zi Wan 4g.
After 1 dose, cough, wheezing, and fever greatly reduced; after continuing for 2 doses, all symptoms disappeared, and recovery was achieved.
A colleague asked: *Fangjixue* states: For External Cold and Internal Fluids, use Xiao Qing Long Tang. Why did Mr. X not use Xiao Qing Long Tang but use Jinfei Cao San? Answered: Zhang Zhongjing's *Shanghan Lun* states: "In Taiyang disease, if the exterior is not resolved, and there is water qi below the heart, leading to dry retching, fever, and cough, Xiao Qing Long Tang is the primary formula." Xiao Qing Long Tang treats water-fluids below the heart. This case involves slight fluids in the Lung, so treatment should focus solely on the Lung. This is what is meant by "medicine must reach its target site." All herbs in Jinfei Cao San act on the Lung, so Jinfei Cao San modified was used.
5. Liver-Lung Qi Stagnation, Internal Obstruction by Phlegm-Dampness; failing to regulate Qi and only resolving Phlegm-Turbidity prevents cure
Hao XX, Female, 62 years old.
For over three months, coughing with sputum, fluctuating in severity. Sudden worsening when lying flat, forcing frequent sitting up to relieve coughing. Hospitalized twice for about a month and a half, yet cough never subsided. Forced to seek Chinese medicine for phlegm-resolving and cough-stopping herbs, or proprietary medicines, or decoctions/pills/powders combined, yet effects were minimal. Gradually developed dizziness, headache, chest fullness/pain, epigastric/abdominal discomfort, palpitations, and mental restlessness. Sought expert Chinese medicine treatment. Examination revealed heavy cough sound, thick/sticky sputum, chest fullness/pain, palpitations, dry/sticky mouth, white tongue coating, wiry-tight-slippery pulse. Inquiry into etiology revealed onset after a cold, followed by emotional distress from being deceived. Statement: This is caused by Liver-Lung Qi stagnation and turbid phlegm obstruction. Treatment should soothe the Liver, regulate Qi, resolve phlegm, and stop cough. Prescription: Chai Hu 10g, Ban Xia 10g, Huang Qin 10g, Gua Lou 15g, Jie Geng 10g, Xing Ren 10g, Qing Pi 10g, Chen Pi 10g, Su Ye 10g, Gan Cao 6g.
After 2 doses, all symptoms reduced; after continuing for 15 doses, all symptoms vanished, and recovery was achieved.
Reflection: *Suwen · Ke Lun* states: "All Zang and Fu organs can cause cough, not just the Lung... Signs of Liver Cough include pain under the costal arches upon coughing, severe cases unable to turn, turning causes fullness under the flanks." This case involves simultaneous Liver and Lung pathology; thus, treating the Lung without treating the Liver is unacceptable.
6. Simultaneous Liver-Lung Disease; failing to assess Deficiency/Excess, only removing Phlegm, treating Deficiency as Excess cannot lead to cure
Zhao XX, Female, 40 years old.
Continuous frequent coughing for over 4 months. Diagnosed with acute bronchitis. Initially treated with antibiotics and Western expectorants/antitussives without effect. Then treated with Chinese medicine for cough/phlegm resolution, Heat-clearing/phlegm-resolution, and Yin-nourishing/Lung-moistening without effect. Examination revealed wiry-tight pulses in both wrists, right pulse significantly larger than left. Reflection: Right larger than left indicates internal injury, Qi and Yin deficiency; wiry pulse is Liver pulse, tight pulse is Cold-Phlegm coagulation. Further inquiry revealed onset shortly after induced abortion. Cough characteristics: urinary incontinence with each cough, chest/hypochondriac fullness, palpitations, mental restlessness, shortness of breath, dizziness, dry mouth/throat, worsening with anger or fatigue. Statement: This case has Qi and Yin deficiency as the root, and Liver-Lung Qi stagnation with internal Phlegm-Dampness as the branch. Treatment should tonify Qi and nourish Yin to support the root, and soothe the Liver, regulate Qi, resolve phlegm, and stop cough to treat the branch. Prescription: Chai Hu 10g, Dang Gui 10g, Bai Shao 10g, Mai Dong 10g, Dang Shen 10g, Wu Wei Zi 10g, Ban Xia 10g, Chen Pi 10g, Qing Pi 10g, Huang Qin 10g, Zi Wan 10g.
After 4 doses, most symptoms largely disappeared; after continuing for 6 doses, recovery was achieved.
Patient asked: Why did months of cough-phlegm resolution and anti-inflammatory/detoxification show little effect? Answered: Failure to distinguish Deficiency from Excess, and ignorance of Zang-Fu pathology.
7. Kidney Qi Insufficiency; treating from the Lung perspective, different disease location leads to ineffective treatment
Tang XX, Male, 58 years old.
Coughing for over 3 months, with urinary dribbling with every cough; sometimes wetting pants after several coughs, requiring changing underwear 1-2 times daily. Consulted over ten Chinese and Western physicians, all ineffective. Invited me for treatment. Initially used a formula for cough-induced enuresis. Prescription: Chuan Xiong 10g, Dang Gui 10g, Bai Shao 10g, Ban Xia 10g, Chen Pi 10g, Qing Pi 10g, Huang Qin 10g, Ren Shen 10g, Mai Dong 10g, Wu Wei Zi 10g.
After 6 doses, no reduction in symptoms. Re-inquired about symptoms. Revealed onset after prostate surgery, accompanied by occasional lower back pain. Pulse examination revealed deep, fine, wiry pulse with slightly enlarged Chi position. Statement: Previous formula treated Liver and Lung; this disease is due to Kidney deficiency, exactly as described in *Suwen* as Kidney Cough. Thus, Kidney-tonifying method was adopted. Prescription: Shu Di 20g, Shan Yao 12g, Shan Yu Rou 10g, Fu Ling 10g, Ze Xie 10g, Dan Pi 10g, Fu Zi 10g, Rou Gui 10g, Wu Wei Zi 10g, Che Qian Zi 10g (wrapped in cloth, decocted). After 3 doses, all symptoms disappeared, and recovery was achieved.
8. Phlegm-Fluid obstructing Thoracic Diaphragm; failing to treat Middle Jiao, treating only Upper Jiao prolongs duration
Zhang XX, Male, 50 years old. For over 8 months since a cold, persistent recurrent coughing with difficult sputum expectoration, severely affecting work. Hospitalized twice for examination/treatment. Besides Western medicine, consumed over 80 doses of Chinese medicine decoctions for phlegm resolution/cough stopping, yet results remained insignificant. Reviewing previous prescriptions, they were mostly Lung-diffusing/phlegm-resolving/cough-stopping herbs, including Xie Bai San, Zhisou San, Jinfei Cao San, etc. Detailed inquiry revealed coughing with copious difficult sputum, plus sensation of fullness/hardness below the heart. Pulse was deep, wiry, tight, and rapid. Reflection: Zhang Zhongjing's *Jingui Yaolue* states: "Subfluids in the diaphragm, patient suffers wheezing/fullness, fullness/hardness below the heart, dark complexion, deep-tight pulse, lasting dozens of days, Mufangji Tang is the primary formula." You Zaijing's *Jingui Yaolue Xindian* states: "Subfluids cause wheezing/fullness above and fullness/hardness below, hindering not only the Lung but also stagnating the Stomach. Dark complexion indicates accumulation in Stomach, blocking Ying and Wei circulation. Floating-tight pulse is External Cold, Deep-tight pulse is Interior Excess. Interior Excess can be purged, but Excess of Fluid-Qi cannot be purged by standard methods; Phlegm-Fluid can be vomited, but Fluids below the Heart cannot be removed by vomiting. Hence, after dozens of days, vomiting and purging by physicians failed to cure. Mufangji and Gui Zhi, one bitter one acrid-warm, both move Water-Qi and dissipate Knot-Qi. Where there is fullness/hardness, there must be hidden Yang. After vomiting and purging, Qi is certainly damaged. Books cannot fully express words, but meaning can be grasped. Thus, Shi Gao treats Heat, Ren Shen benefits Deficiency; the method is indeed meticulous." Further reflection: The Middle Jiao is the hub of the Upper, Middle, and Lower Jiao. If Middle Jiao is obstructed, rotation fails, Lung Qi fails to descend, and Kidney Qi fails to ascend. Thus, Mufangji Tang modified was prescribed: Fang Ji 10g, Gui Zhi 10g, Sheng Shi Gao 15g, Ren Shen 10g, Ban Xia 10g, Chen Pi 10g, Zi Wan 10g, Fu Ling 6g.
After 3 doses, frequency and amplitude of coughing greatly reduced; after continuing for 4 doses, all symptoms resolved, and recovery was achieved.
9. Dry-Phlegm in Lung; failing to provide Cooling/Moistening, instead using Lung-Clearing/Phlegm-Resolving damages Lung Yin, making cough hard to cure
Geng XX, Male, 38 years old.
For over 4 months, coughing with scant sputum; sometimes continuous dozens of coughs before temporary cessation, followed by minutes of coughing after half an hour. Frequently unable to sleep due to coughing at night. Hospitalized several times for examination/treatment. X-ray, Ultrasound, CT scans showed no positive findings, yet efficacy was never seen. Examination revealed paroxysmal severe coughing, throat discomfort, dry mouth/throat with desire to drink, thin white tongue coating with tender red substance, weak and slow pulse. Reflection: In chronic diseases, pulse examination is crucial. Weak and slow pulse indicates Lung Deficiency; deficiency Fire combines to create upward reversal of Qi, causing paroxysmal severe coughing. Zhang Zhongjing's *Jingui Yaolue* states: "Upward reversal of Qi due to Fire, throat discomfort, those who reverse downward Qi, Maidong Tang is the primary formula." *Jingui Bianzhu* states: "This is Yin-Fire reversing upward. True Yin deficiency, Yin-Fire reverses upward attacking Metal, causing upward reversal of Qi and throat discomfort. Only by strengthening the Master of Water can Yang-Fire be suppressed." Re-examining medications used: Besides Bricanyl spray providing seconds of relief before worsening, Western medicines were all ineffective. Chinese medicine clearing Heat/resolving phlegm, warming Lung/transforming fluids not only failed but worsened symptoms; even Yin-nourishing/Fire-purging showed little effect. Further reflection: Yin-deficiency with Fire-hyperactivity should respond to Yin-nourishing, why no effect? Rapid pulse indicates Heat, but this case's pulse is not rapid, but weak and slow. Weak and slow indicates Qi and Yin insufficiency without Fire, plus Dry-Phlegm obstructing Lung. Hence, only using Yin-nourishing/Fire-purging is ineffective. Treatment planned Modified Maidong Tang: Mai Dong 10g, Sha Shen 10g, Ban Xia 10g, Zi Wan 10g, Sang Bai Pi 10g, Gan Cao 10g, Bai Bu 15g, Zhu Ye 10g, Zhi Pa Ye 10g.
After 4 doses, cough suddenly reduced; after continuing for 4 doses, recovery was achieved.
10. Treating only Lung Cough, ignoring Five Zang Organs, long-term treatment ineffective
Zheng XX, Male, Adult.
Coughing for over 3 months. Diagnosed with acute bronchitis. Treated with Western medicine for over a month without effect, then combined with Chinese medicine for cough/phlegm resolution without effect. Careful examination revealed coughing worse in the morning, scant sputum, bitter/dry mouth, irritability, dry stool, red tongue substance, yellow coating, wiry-rapid pulse. Synthesizing pulse and symptoms: Morning corresponds to Liver/Gallbladder time; wiry-rapid pulse also belongs to Liver Fire; dry constipation indicates Excess Fire in Stomach and Large Intestine. Liver-Stomach Excess Fire scorches Lung Metal, Lung loses descending function, resulting in cough. Treatment: Clear and purge Liver Fire. Prescription: Dang Gui 10g, Chuan Xiong 10g, Da Huang 4g, Zhi Zi 10g, Qiang Huo 6g, Fang Feng 6g, Qing Dai 4g.
After 2 doses, cough reduced by 60-70%; after continuing for 2 doses, recovery was achieved.
A colleague stated: Cough originates in the Lung, why use Xieqing Wan method? Answered: *Suwen · Ke Lun* states: "Yellow Emperor asked: Why does the Lung cause cough? Qibo answered: All Zang and Fu organs can cause cough, not just the Lung... Signs of Liver Cough include pain under the costal arches upon coughing, severe cases unable to turn, turning causes fullness under the flanks." Current case shows wiry-rapid pulse and irritability, thus it is Liver Cough. Liver Cough should primarily regulate the Liver. Since Liver Fire is dominant, treatment should purge Liver Fire.
Chronic Bronchitis
1. Lung and Kidney both deficient, Water overflowing to become Phlegm; treating only from the Lung, failing to tonify Kidney, chronic cough persists