咳嗽，肺之病也。起因不一，变化亦多端。其病虽成人小儿，皆有患之，然以小儿脾胃殊为薄弱，肺体
更属娇嫩，一经感染，最易流连，荏苒日久，则酿大患，故小儿之咳嗽，倍重于成人也。至于证状，小儿气
息本短，脉息本数，一患咳嗽，则气息之短促，脉息之急数，益现异常之象。甚则神气不定，发为惊惕
啼哭之状，此证状之倍重于成人也。论其治法，亦属较难，盖小儿问诊脉诊，未易十分准确，得病之源，
知之非易，更以小儿五内之未充，身体之未固，用药亦倍费斟酌。故咳嗽一证，成人与小儿，其病虽同而证
治实有不同也。至于起因，大别之有三∶一曰外感咳嗽，一曰内伤咳嗽，一曰杂证咳嗽是也。外感咳嗽，
咳之属于外因者，属于内伤者不与也；内伤咳嗽，咳之属于内因者，属于外感者不与也；杂证咳嗽，咳之
属于内外因相杂者。以此分系，则一般咳嗽皆包罗其中，而于繁杂无当之咳嗽专名（如
心咳、肝咳、大肠咳、小肠咳等），亦可弃而不取矣。
一、伤风咳嗽
甲∶概况
外感咳嗽，受病之因，全由外邪所致。不由内因，故与内伤之咳嗽不同，其间亦有因外感失治而转成内
伤者，然初起固为外感也。外感咳嗽之轻者，厥为感冒风寒，俗所称伤风咳嗽是也。
考肺为清轻之体，最忌风寒之邪，一有所感，气管在上，先受其
病，病则酿痰，痰则阻碍呼吸，肺体因呼吸之有阻也，亟欲祛邪以外出，故发为咳嗽以驱之。初起之时。
咳声常尖锐而痰色常清白，以寒邪初袭，犹未化热，痰涎始生，犹未化浊也。病之中期，咳声常重浊而痰色常
稠黄，以邪势方盛，进而化热，痰涎积聚，熏蒸变稠也。病之后期，咳声常清爽而痰色常清白，以邪势
已衰，气道已通，浊痰既豁，仅存稀痰也。病之甚者，亦有热势内侵，而呈喘急之象，亦有痰不易出而呈惊
搐之状，要皆非危笃之证，但须因势利导，清热豁痰，使咳声得畅，肺气得宣，稍稽时日，亦无不愈。至于
有因循失治，有内外因相杂，有一再感冒不已，致肺气大伤者，亦可转成不治之证，俗所谓伤风不醒便成
痨，正指此也。
乙、治法
伤风初起，大率微有恶寒，鼻中喷嚏，或恶寒发热，鼻塞不通，头昏目泪，饮食无味，喉头作痒，咳嗽
以起，此时风寒之邪方袭，治宜解表开肺，用药轻则宜苏叶、前胡、荆芥、薄荷、象贝之类，重则宜麻黄、
防风、杏仁、秦艽之类，风滞经络，身体作痛者，酌加羌活、桂枝、桑枝、天麻之类，通治宜宣肺祛邪
汤。继则热势渐张，咳嗽渐盛，痰色由清而渐稠，是寒邪化热之象，治宜解表开肺之中，寓以清热豁痰之意，
用宣肺涤痰汤加减进之。继则咳声重浊，痰出黄稠，外邪完全化热，治宜清肺顺气，用清肺化热汤加减进之。
余邪未清，犹有微咳者，亦宜此方。此证虽小儿体质不同，病态互异，然为期不久，七八日至十余天可以痊
愈。愈后应服药调理，体虚者宜补养肺气，体实者宜清理余邪，加以补益，庶使肺气强固，俾免动辄感冒也。
二、流行咳嗽
甲、概说
流行咳嗽，虽由外感所致，然与普通之伤风咳嗽不同。伤风
咳嗽，其病势轻，流行咳嗽，其病势重，伤风咳嗽，为期颇暂，
流行咳嗽，迁延日久；伤风咳嗽，其感邪浅，流行咳嗽，其感邪深。考流行咳嗽有似时疫之传染，故小儿口鼻
感其气息，即可因而致病。因之一经流行，则沿门阖境，无或得免，故不似伤风咳嗽之或感或不感也。其病一
曰百日咳，言其咳嗽不易愈，往往经百日之久也。一曰鸬 咳，形其咳嗽之艰难，连声而作有如此状
也。此证之发动，常由天时寒燠不匀，变生疫气，一人感之，辗转流传，因小儿肺气之怯弱，故小儿感染为
独多。病之初发，虽亦由身热而起，然一发即连声作咳，咳多痰少，轻者一咳十数声而休，重者一咳数十声
乃至百余声方止，间歇之时，不过十分钟左右而又作，困顿不堪，至于呛食咳血而不能止。此病初期，较
少危险之象，若至后期，咳益艰而声益不畅者，则肺脏受损，渐
见难治，正昔人所谓金破不鸣，已转成内伤之证也。
乙、治法
流行咳嗽之初起，或发热或发热形寒，视其咳嗽连声而作，即为病邪之已受，治法在昔殊少成方，大率
则宜于解表开肺之中变通治之。何则？盖普通之咳嗽，固可以解表开肺了事，而流行之咳嗽，则以既挟疫气，
感受又深，非参以祛疫之剂，及保肺之品不为功也。初步宜用保肺祛邪汤，继则病势激进，咳声益剧，
祛痰保肺之中，再参镇静宁咳之品，宜用保肺涤痰汤。发热脉反沉细，咳则从下逆上，腰背相引痛，必深入
以发出之，宜用麻黄附子细辛汤。如咳嗽日久，其势不衰者，则肺气将乏，邪势方张，不补其气，邪必更深，
宜用四君子汤、五味异功散、六君子汤中加入祛痰顺气之品，方能渐次告痊。徒攻其痰，肺必益虚，
邪必益深，转成虚痨，陷为不治之证矣。故此病后期，宜用保肺扶正汤最妥。兼有他因，则宜就其他因合治之。
附方
（一）宣肺祛邪汤（自制） 治感冒风寒，形寒身热，咳嗽初起。
苏叶 薄荷（各一钱） 秦艽 前胡 杏仁 象贝母 橘红 姜竹茹 赤苓（各二钱） 桔梗 甘草（各五分）
清水煎服。形寒身热，汗不易出，气息不顺者，去桔梗加麻黄三分；头痛者去桔梗加荆芥、防风各一钱；
身痛者加羌活三分、桑枝三钱；四肢酸楚者加桂枝三分；喉痛者加牛蒡子、黄射干各二钱。
（二）宣肺涤痰汤（自制） 治伤风咳嗽，身热痰多，气息不平。
前胡 苏子 杏仁 象贝母 竹茹 陈皮 薄荷 赤苓 连翘（各二钱）
清水煎服。身热息粗者加麻黄三分；身热气喘，胃热口气者加麻黄五分，石膏三钱；便难者加枳壳一
钱；呕吐者加半夏钱半；小便少者加通草一钱。
（三）清肺化热汤（自制） 治伤风咳嗽，熏蒸化热，痰浊胶结，肺胃并热者。
前胡 知母 栝蒌 淡芩 苏子 竹茹 象贝母 赤苓 当归（各二钱）
清水煎服。泄泻者去知母、栝蒌、当归，加陈皮、木香各一钱；脾胃气虚，湿重化痰者去栝蒌、知母，
加半夏、陈皮各钱半，或苍术五分；热势壮盛，痰升气急者，加猴枣一分，或葶苈子一钱。
（四）咳后调理方（自制） 治普通伤风咳嗽，病虽愈而余波未平，痰多作嗽。
沙参 白术 旋复花 陈皮 黄 半夏 茯苓 川贝母（各二钱） 甘草 青皮（各一钱）
清水煎服。气虚者去青皮，以沙参易党参；肠胃余热不清酿化成痰者，加栝蒌、知母各二钱。
（五）保肺祛邪汤（自制） 治流行感冒，恶寒发热，咳嗽阵作。
炙百部 炙紫菀（各五分） 旋复花 前胡 杏仁 苏子（各二钱） 象贝母 竹茹 天冬（各三钱）
清水煎服。身热无汗，咳不爽快者，先去百部、紫菀、旋复花、天冬，加麻黄五分，荆芥、桔梗、秦艽
各一钱，服一剂以透之，再用前方。其他莱菔子、白芥子、竹沥、制半夏等，俱可量证酌加。
（六）保肺涤痰汤（自制） 治咳嗽阵作不休，面红身热，有汗不解，痛引胸背。
炙百部 炙紫菀（各五分） 旋复花 代赭石 竹沥制半夏 前胡 当归（各二钱） 川贝母 天冬（各三钱）
清水煎服。肾虚而气易上逆者，加生地 磁石各三钱；咳血者去半夏；痰声漉漉，由于水泛者，加桂
枝五分，葶苈一钱，茯苓三钱。
（七）麻黄附子细辛汤 治少阴病始得之，反发热脉沉，及肾脏发咳，咳则腰背相引痛，甚则咳涎，
及寒邪犯齿，致脑齿俱痛。
麻黄 附子 细辛
（八）四君子汤 见第三章第五节。
（九）五味异功散 见第三章第六节。
（十）六君子汤 见第五章第三节。
（十一）保肺扶正汤（自制） 治顿咳日久，气虚而咳不止者。
北沙参 人参 白术 黄 麦冬 川贝母 法半夏 旋复花 化橘红 怀山药（各二钱）
清水煎服。咳久肺气耗散，不能收摄，加干姜、五味子各五分；脾虚泄泻加于术；肾虚泄泻加
补骨脂；咳血去半夏。
咳嗽，是肺部的疾病。起因多种多样，变化也极为复杂。虽然成人和儿童都会患病，但小儿的脾胃特别薄弱，肺体更加娇嫩，一旦受到感染，病情最容易迁延不愈，日久则酿成大患，所以小儿的咳嗽比成人更为严重。至于症状表现，小儿的呼吸本来短促，脉搏本来较快，一旦患上咳嗽，呼吸的短促和脉搏的急数会更加显现出异常的现象。严重时会出现神志不安，出现惊恐、啼哭的状态，这也是症状比成人严重的表现。论及治疗方法，也比较困难，因为对小儿进行问诊和脉诊，很难做到十分准确，了解疾病的根源并非易事，再加上小儿五脏六腑尚未充盈，身体体质尚未坚固，用药也需要加倍斟酌。因此，咳嗽这一病症，虽然成人与小儿的病机相同，但证候与治疗实际上是有区别的。至于起因，大致可以分为三类：一是外感咳嗽，二是内伤咳嗽，三是杂证咳嗽。外感咳嗽，是指咳嗽属于外因引起的，不属于内伤；内伤咳嗽，是指咳嗽属于内因引起的，不属于外感；杂证咳嗽，是指咳嗽属于内外因混杂引起的。按照这种分类方法，一般的咳嗽都包含在其中，而那些繁杂且不当的咳嗽专名（如心咳、肝咳、大肠咳、小肠咳等），也可以舍弃不用了。
一、伤风咳嗽
甲：概况
外感咳嗽，致病的原因完全由外邪引起。不是由内因引起，所以与内伤咳嗽不同，其中也有因外感治疗不当而转化为内伤的，但初起时确实是外感。外感咳嗽中较轻的，就是感冒风寒，也就是俗称的伤风咳嗽。
考察肺为清轻之体，最忌讳风寒之邪，一旦有所感受，气管位于上部，首先受病，生病后就会酿生痰液，痰液阻碍呼吸，肺体因为呼吸受阻，急于驱除邪气向外排出，所以引发咳嗽以驱逐它。初起之时，咳嗽声音通常尖锐且痰色通常清白，因为寒邪刚刚侵袭，尚未化热，痰涎刚开始生成，尚未变浊。病的中期，咳嗽声音通常重浊且痰色通常稠黄，因为邪气势力正盛，进而化热，痰液积聚，熏蒸变得稠厚。病的后期，咳嗽声音通常清爽且痰色通常清白，因为邪气势力已经衰退，气道已经通畅，浊痰已经清除，仅存稀痰。病情严重的，也有热势向内侵入，呈现喘息急促的现象，也有痰不易咳出而呈现惊厥抽搐状，这些都不是危重的证候，只要顺应病势加以引导，清热化痰，使咳嗽声得以畅快，肺气得以宣发，稍待时日，没有不痊愈的。至于有因循延误治疗，有内外因混杂，有一再感冒不止，导致肺气大伤的，也可以转为不治之症，俗话所说的“伤风不醒便成痨”，正是指这种情况。
乙：治法
伤风初起，大体上轻微恶寒，鼻中打喷嚏，或者恶寒发热，鼻塞不通，头昏目泪，饮食无味，喉头发痒，引发咳嗽，此时风寒之邪刚侵袭，治疗宜解表开肺，用药轻的宜用苏叶、前胡、荆芥、薄荷、象贝母之类，重的宜用麻黄、防风、杏仁、秦艽之类，如果风邪阻滞经络，身体疼痛的，酌情加入羌活、桂枝、桑枝、天麻之类，通用方剂宜用宣肺祛邪汤。随后热势逐渐扩张，咳嗽逐渐加重，痰色由清渐稠，这是寒邪化热的现象，治疗宜在解表开肺之中，蕴含清热化痰之意，用宣肺涤痰汤加减服用。随后咳嗽声音重浊，痰出黄稠，外邪完全化热，治疗宜清肺顺气，用清肺化热汤加减服用。余邪未清，仍有轻微咳嗽的，也适宜用此方。此证虽然小儿体质不同，病态各异，但病程不久，七八天至十余天可以痊愈。痊愈后应服药调理，体质虚弱的宜补养肺气，体质强壮的宜清理余邪，加上补益，从而使肺气强固，避免动不动就感冒。
二、流行咳嗽
甲：概说
流行咳嗽，虽然由外感引起，但与普通的伤风咳嗽不同。伤风咳嗽，病势轻，流行咳嗽，病势重；伤风咳嗽，病程短暂，流行咳嗽，迁延日久；伤风咳嗽，感邪浅，流行咳嗽，感邪深。考察流行咳嗽有点像时疫的传染，所以小儿口鼻感受到其气息，就可以因而致病。因此一旦流行，则沿街满境，没有能免除的，所以不像伤风咳嗽那样有的感染有的不感染。其病一种叫百日咳，是说其咳嗽不容易好，往往经过一百天的时间。一种叫鸬鹚咳，形容其咳嗽艰难，连续发声有如此状态。此病的发动，常由天时冷热不均，变生疫气，一人感染，辗转流传，因为小儿肺气怯弱，所以小儿感染最为多见。病之初发，虽然也由身热而起，但是一发作就连声咳嗽，咳多痰少，轻的一次咳十几声才停，重的一次咳几十声乃至上百声才停止，间歇的时候，不过十分钟左右又发作，困顿不堪，以至于呛食咳血而不能止。此病初期，较少危险的现象，若到了后期，咳嗽越艰难且声音越不畅的，则肺脏受损，渐渐见难治，正是古人所说的“金破不鸣”，已转为内伤的证候了。
乙：治法
流行咳嗽之初起，或发热或形寒发热，看其咳嗽连声发作，即为病邪已受，治疗方法在过去很少有成方，大体则在解表开肺之中变通治疗。为什么呢？因为普通的咳嗽，固然可以用解表开肺了事，而流行咳嗽，因为既挟带疫气，感受又深，不参入祛疫的药剂，以及保肺的药物不能成功。初步宜用保肺祛邪汤，随后病势激进，咳嗽更剧烈，在祛痰保肺之中，再参入镇静宁咳的药物，宜用保肺涤痰汤。发热脉象反而沉细，咳嗽从下逆上，腰背相互牵引疼痛，必须深入以发散出来，宜用麻黄附子细辛汤。如咳嗽日久，其势不衰的，则肺气将乏，邪气势力正张，不补气，邪必更深，宜用四君子汤、五味异功散、六君子汤中加入祛痰顺气的药物，才能渐渐告痊。只攻伐其痰，肺必更虚，邪必更深，转为虚劳，陷入不治之证了。所以此病后期，宜用保肺扶正汤最妥当。兼有其他原因，则宜就其他原因合治之。
附方
（一）宣肺祛邪汤（自制） 治感冒风寒，形寒身热，咳嗽初起。
紫苏叶 薄荷（各一钱） 秦艽 前胡 杏仁 象贝母 橘红 姜竹茹 赤茯苓（各二钱） 桔梗 甘草（各五分）
清水煎服。形寒身热，汗不易出，气息不顺的，去掉桔梗加麻黄三分；头痛的去桔梗加荆芥、防风各一钱；身体痛的加羌活三分、桑枝三钱；四肢酸楚的加桂枝三分；喉咙痛的加牛蒡子、射干各二钱。
（二）宣肺涤痰汤（自制） 治伤风咳嗽，身热痰多，气息不平。
前胡 苏子 杏仁 象贝母 竹茹 陈皮 薄荷 赤茯苓 连翘（各二钱）
清水煎服。身热呼吸粗的加麻黄三分；身热气喘，胃热口气重的加麻黄五分，石膏三钱；大便难的加枳壳一钱；呕吐的加半夏钱半；小便少的加通草一钱。
（三）清肺化热汤（自制） 治伤风咳嗽，熏蒸化热，痰浊胶结，肺胃并热的。
前胡 知母 瓜蒌 淡黄芩 苏子 竹茹 象贝母 赤茯苓 当归（各二钱）
清水煎服。泄泻的去知母、瓜蒌、当归，加陈皮、木香各一钱；脾胃气虚，湿重化痰的去瓜蒌、知母，加半夏、陈皮各钱半，或苍术五分；热势壮盛，痰升气急的，加猴枣一分，或葶苈子一钱。
（四）咳后调理方（自制） 治普通伤风咳嗽，病虽愈而余波未平，痰多作嗽。
沙参 白术 旋复花 陈皮 黄芪 半夏 茯苓 川贝母（各二钱） 甘草 青皮（各一钱）
清水煎服。气虚的去青皮，以沙参换党参；肠胃余热不清酿化成痰的，加瓜蒌、知母各二钱。
（五）保肺祛邪汤（自制） 治流行感冒，恶寒发热，咳嗽阵作。
炙百部 炙紫菀（各五分） 旋复花 前胡 杏仁 苏子（各二钱） 象贝母 竹茹 天冬（各三钱）
清水煎服。身热无汗，咳不爽快的，先去百部、紫菀、旋复花、天冬，加麻黄五分，荆芥、桔梗、秦艽各一钱，服一剂以透发，再用前方。其他莱菔子、白芥子、竹沥、制半夏等，都可量证酌情加入。
（六）保肺涤痰汤（自制） 治咳嗽阵作不休，面红身热，有汗不解，痛引胸背。
炙百部 炙紫菀（各五分） 旋复花 代赭石 竹沥制半夏 前胡 当归（各二钱） 川贝母 天冬（各三钱）
清水煎服。肾虚而气易上逆的，加生地、磁石各三钱；咳血的去半夏；痰声漉漉，由于水泛的，加桂枝五分，葶苈一钱，茯苓三钱。
（七）麻黄附子细辛汤 治少阴病始得之，反发热脉沉，及肾脏发咳，咳则腰背相引痛，甚则咳涎，及寒邪犯齿，致脑齿俱痛。
麻黄 附子 细辛
（八）四君子汤 见第三章第五节。
（九）五味异功散 见第三章第六节。
（十）六君子汤 见第五章第三节。
（十一）保肺扶正汤（自制） 治顿咳日久，气虚而咳不止者。
北沙参 人参 白术 黄芪 麦冬 川贝母 法半夏 旋复花 化橘红 怀山药（各二钱）
清水煎服。咳久肺气耗散，不能收摄的，加干姜、五味子各五分；脾虚泄泻加于术；肾虚泄泻加补骨脂；咳血的去半夏。
Cough is a disease of the Lung. Its causes are diverse, and its variations are numerous. Although both adults and children may suffer from it, children's Spleen and Stomach are particularly weak, and their Lung tissue is even more delicate. Once infected, the condition easily lingers; if prolonged, it can develop into a major affliction. Therefore, cough in children is more severe than in adults. Regarding symptoms, children's breathing is naturally short, and their pulse is naturally rapid. Once they contract a cough, the shortness of breath and rapidity of the pulse become abnormally pronounced. In severe cases, their spirit becomes unsettled, leading to states of fright, startle, and crying. This represents another aspect in which the symptoms are more severe than in adults. As for treatment methods, they are also relatively difficult because obtaining accurate history through inquiry and pulse diagnosis in children is challenging, making it hard to ascertain the root cause of the disease. Furthermore, since children's internal organs are not yet fully developed and their physical constitution is not yet solid, medication requires extra caution. Thus, although the pathology of cough is the same in adults and children, the syndrome differentiation and treatment actually differ. As for the causes, they can be broadly categorized into three types: one is Exogenous Cough (cough caused by external pathogens), one is Endogenous Cough (cough caused by internal factors), and one is Miscellaneous Cough (cough caused by a mix of internal and external factors). By classifying according to this system, general coughs are all encompassed, and complex or inappropriate specific cough names (such as Heart Cough, Liver Cough, Large Intestine Cough, Small Intestine Cough, etc.) can be discarded.
I. Wind-Cold Cough
A. Overview
Exogenous coughs are caused entirely by external pathogenic factors. They are not caused by internal factors, so they differ from endogenous coughs. Although some may transform into endogenous conditions due to improper treatment of the initial exogenous stage, the onset is indeed exogenous. Among exogenous coughs, the milder form is Cold-Dampness Common Cold (Ganmao Fenghan), commonly known as Wind-Cold Cough.
The Lung is a clear and light organ, most sensitive to Wind-Cold pathogens. Upon infection, the trachea, being located superiorly, is affected first. The pathology generates phlegm, which obstructs respiration. Due to this respiratory obstruction, the Lung urgently seeks to expel the pathogen outward, thereby triggering a cough to drive it out. At the initial stage, the cough sound is often sharp, and the sputum is often clear and white, because the Cold pathogen has just invaded and has not yet transformed into Heat, and the saliva/phlegm has just begun to form and has not yet become turbid. In the middle stage of the illness, the cough sound is often heavy and turbid, and the sputum is often thick and yellow, because the pathogenic force is strong and transforming into Heat, causing phlegm accumulation and steaming into thickness. In the late stage, the cough sound is often clear and refreshing, and the sputum is often clear and white, because the pathogenic force has declined, the airways are clear, turbid phlegm has been expelled, leaving only thin phlegm. In severe cases, there may be internal invasion of Heat presenting with panting and urgency, or difficulty expectorating phlegm presenting with convulsions and startles. These are not critical conditions; provided one follows the trend to guide the pathogen out, clears Heat, and resolves phlegm, allowing the cough to be smooth and Lung Qi to diffuse, recovery will occur after a short time. However, if treatment is delayed, or if internal and external factors mix, or if repeated colds occur causing significant damage to Lung Qi, it may turn into an incurable condition. The saying "a wind-cold that does not resolve becomes consumption" refers precisely to this.
B. Treatment Methods
At the onset of Wind-Cold Cough, there is generally mild aversion to cold, sneezing, or aversion to cold with fever, nasal congestion, dizziness, tearing, loss of taste, throat itching, and the onset of cough. At this time, when the Wind-Cold pathogen is just invading, the treatment should be to Release the Exterior and Open the Lungs. For mild cases, herbs such as Perilla Leaf (Ziye), Peucedanum Root (Qianhu), Schizonepeta Spike (Jingjie), Mint (Bohe), and Fatsia Rhizome (Xiangbei) are suitable. For severe cases, Ephedra Stem (Mahuang), Saposhnikovia Root (Fangfeng), Apricot Seed (Xingren), and Gentian Macrophylla Root (Qinjiao) are suitable. If Wind stagnates in the meridians causing body pain, consider adding Notopterygium Root (Qianghuo), Cinnamon Twig (Guizhi), Mulberry Twig (Sangzhi), or Gastrodia Tuber (Tianma). The general formula is Xuanfei Quxie Tang (Lung-Opening and Pathogen-Expelling Decoction). Subsequently, as Heat expands and cough intensifies, and sputum changes from clear to thick, indicating Cold transforming into Heat, the treatment should incorporate clearing Heat and resolving phlegm within the strategy of releasing the exterior and opening the lungs, using Xuanfei Ditang Tang (Lung-Opening and Phlegm-Scouring Decoction) with modifications. Later, when the cough sound is heavy and turbid, and sputum is yellow and thick, indicating complete transformation of exogenous pathogens into Heat, the treatment should clear the Lung and regulate Qi, using Qingfei Huare Tang (Lung-Clearing and Heat-Transforming Decoction) with modifications. If residual pathogens remain and slight cough persists, this formula is also appropriate. Although children's constitutions vary and symptoms differ, the course is short, usually resolving within seven to ten days. After recovery, medicinal regulation is needed: those with deficiency should tonify Lung Qi, while those with excess should clear residual pathogens and add tonification, thereby strengthening Lung Qi and preventing frequent colds.
II. Epidemic Cough
A. Overview
Epidemic Cough, although caused by exogenous factors, differs from ordinary Wind-Cold Cough. Wind-Cold Cough has a mild progression, whereas Epidemic Cough is severe; Wind-Cold Cough is short-lived, whereas Epidemic Cough lingers for a long time; Wind-Cold Cough involves shallow pathogenic invasion, whereas Epidemic Cough involves deep invasion. Epidemic Cough resembles the transmission of seasonal epidemics; thus, when children inhale the infected air, they contract the disease. Consequently, once it spreads, it affects entire neighborhoods, unlike Wind-Cold Cough where infection is sporadic. Two main types exist: one is Pertussis (Bairike), named because the cough is difficult to cure and often lasts for a hundred days. The other is Cormorant Cough (Lu'e Ke), describing the difficulty of the cough, characterized by continuous bouts. The onset is often due to irregular weather changes generating epidemic Qi. Once one person is infected, it spreads sequentially. Because children's Lung Qi is weak, they are most susceptible. Initially, the disease starts with fever, but immediately progresses to continuous coughing with much phlegm and little sputum. Mild cases involve ten-plus coughs per bout before resting; severe cases involve dozens to over a hundred coughs per bout. Rest intervals are only about ten minutes before recurrence, leading to exhaustion, choking on food, and hemoptysis. The early stage poses little danger, but in the late stage, if coughing becomes increasingly difficult and voice hoarse, Lung damage occurs, becoming difficult to treat. This aligns with the ancient saying "broken metal makes no sound," indicating a transformation into an endogenous condition.
B. Treatment Methods
At the onset of Epidemic Cough, whether feverish or chills-and-fever, the continuous cough indicates pathogen reception. Historically, few established formulas existed; generally, treatment involved modifying strategies of releasing the exterior and opening the lungs. Why? Ordinary coughs can be resolved by releasing the exterior and opening the lungs, but Epidemic Cough involves epidemic Qi and deep invasion, requiring anti-epidemic agents and Lung-nourishing herbs to be effective. The initial step uses Baofei Quxie Tang (Lung-Nourishing and Pathogen-Expelling Decoction). As the condition advances and cough worsens, calming and stopping cough herbs should be added to phlegm-resolving and Lung-nourishing strategies, using Baofei Ditang Tang (Lung-Nourishing and Phlegm-Scouring Decoction). If fever is present with a deep and fine pulse, and cough radiates upward from below causing lower back and back pain, deep-seated pathogens must be released, using Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite Root, and Asarum Decoction). If cough persists for a long time without subsiding, Lung Qi is depleted while pathogenic force is strong; failing to tonify Qi allows deeper pathogen invasion. In such cases, Si Junzi Tang (Four Gentlemen Decoction), Wuwei Yigong San (Five-Ingredient Powder with Extra Efficacy), or Liujunzi Tang (Six-Gentlemen Decoction) should be used with phlegm-resolving and Qi-regulating herbs for gradual recovery. Merely attacking phlegm will further weaken the Lung and deepen the pathogen, turning into consumptive disease and becoming incurable. Therefore, in the late stage, Baofei Fuzheng Tang (Lung-Nourishing and Righteousness-Supporting Decoction) is most appropriate. If other factors are involved, they should be treated concurrently.
Attached Formulas
(1) Xuanfei Quxie Tang (Self-made): Treats Cold-Dampness Common Cold with chills, fever, and initial cough.
Perilla Leaf (Ziye), Mint (Bohe) (each 1 qian); Gentian Macrophylla Root (Qinjiao), Peucedanum Root (Qianhu), Apricot Seed (Xingren), Fatsia Rhizome (Xiangbei), Tangerine Peel (Juhong), Ginger-processed Bamboo Shavings (Zhuju), Red Poria (Chiling) (each 2 qian); Platycodon Root (Jiegeng), Licorice Root (Gancao) (each 5 fen).
Decoct in clear water. For chills, fever, difficulty sweating, and irregular breathing, remove Jiegeng and add Ephedra Stem (Mahuang) 3 fen; for headache, remove Jiegeng and add Schizonepeta Spike (Jingjie) and Saposhnikovia Root (Fangfeng) each 1 qian; for body pain, add Notopterygium Root (Qianghuo) 3 fen and Mulberry Twig (Sangzhi) 3 qian; for sore throat, add Arnebia Root/Lithospermum Root (Niubangzi) and Belamcanda Rhizome (Shegan) each 2 qian.
(2) Xuanfei Ditang Tang (Self-made): Treats Wind-Cold Cough with fever, abundant phlegm, and irregular breathing.
Peucedanum Root (Qianhu), Perilla Fruit (Suzi), Apricot Seed (Xingren), Fatsia Rhizome (Xiangbei), Bamboo Shavings (Zhuru), Tangerine Peel (Chenpi), Mint (Bohe), Red Poria (Chiling), Forsythia Fruit (Lianqiao) (each 2 qian).
Decoct in clear water. For fever and coarse breathing, add Ephedra Stem (Mahuang) 3 fen; for fever, panting, and foul breath (Stomach Heat), add Ephedra Stem (Mahuang) 5 fen and Gypsum (Shigao) 3 qian; for constipation, add Aurantium Fruit (Zhike) 1 qian; for vomiting, add Pinellia Tuber (Banxia) 1.5 qian; for scanty urination, add Tongcao 1 qian.
(3) Qingfei Huare Tang (Self-made): Treats Wind-Cold Cough steaming into Heat, with sticky turbid phlegm and simultaneous Lung-Stomach Heat.
Peucedanum Root (Qianhu), Anemarrhena Rhizome (Zhimu), Trichosanthes Fruit (Gualou), Light Scutellaria Root (Danqin), Perilla Fruit (Suzi), Bamboo Shavings (Zhuru), Fatsia Rhizome (Xiangbei), Red Poria (Chiling), Angelica Sinensis Root (Danggui) (each 2 qian).
Decoct in clear water. For diarrhea, remove Zhimu, Gualou, and Danggui; add Tangerine Peel (Chenpi) and Costus Root (Muxiang) each 1 qian. For Spleen-Stomach Qi deficiency with dampness generating phlegm, remove Gualou and Zhimu; add Pinellia Tuber (Banxia) and Tangerine Peel (Chenpi) each 1.5 qian, or Atractylodes Macrocephala Rhizome (Cangzhu) 5 fen. For intense heat with rising phlegm and急促 breathing, add Monkey Date (Houzao) 1 fen or Lepidium Seed (Tinglizi) 1 qian.
(4) Post-Cough Regulation Formula (Self-made): Treats ordinary Wind-Cold Cough where the illness has resolved but residual waves remain, with abundant phlegm and cough.
Glehnia Root (Shashen), Atractylodes Macrocephala Rhizome (Baizhu), Inula Flower (Xuanfuhua), Tangerine Peel (Chenpi), Astragalus Root (Huangqi), Pinellia Tuber (Banxia), Poria (Fuling), Fritillaria Cirrhosa Bulb (Chuanbeimu) (each 2 qian); Licorice Root (Gancao), Bitter Orange (Qingpi) (each 1 qian).
Decoct in clear water. For Qi deficiency, remove Qingpi and replace Shashen with Codonopsis Root (Dangshen). For lingering intestinal/stomach heat generating phlegm, add Trichosanthes Fruit (Gualou) and Anemarrhena Rhizome (Zhimu) each 2 qian.
(5) Baofei Quxie Tang (Self-made): Treats epidemic influenza with chills, fever, and paroxysmal cough.
Processed Stemona Root (Zhibaiibu), Processed Aster Tataricus Root (Zhi Ziwan) (each 5 fen); Inula Flower (Xuanfuhua), Peucedanum Root (Qianhu), Apricot Seed (Xingren), Perilla Fruit (Suzi) (each 2 qian); Fatsia Rhizome (Xiangbei), Bamboo Shavings (Zhuru), Asparagus Tuber (Tiantong) (each 3 qian).
Decoct in clear water. For fever without sweat and ineffective cough, initially remove Baiibu, Ziwan, Xuanfuhua, and Tiantong; add Ephedra Stem (Mahuang) 5 fen, Schizonepeta Spike (Jingjie), Platycodon Root (Jiegeng), and Gentian Macrophylla Root (Qinjiao) each 1 qian. Take one dose to release the pathogen, then resume the original formula. Radish Seed (Laifuzi), White Mustard Seed (Baijiezhi), Bamboo Sap (Zhuli), and Processed Pinellia (Zhi Banxia) can be added as appropriate.
(6) Baofei Ditang Tang (Self-made): Treats incessant paroxysmal cough, red face, fever, sweating without relief, and pain radiating to chest and back.
Processed Stemona Root (Zhibaiibu), Processed Aster Tataricus Root (Zhi Ziwan) (each 5 fen); Inula Flower (Xuanfuhua), Hematitum (Daizheshi), Pinellia Tuber processed with Bamboo Sap (Zhuli Zhi Banxia), Peucedanum Root (Qianhu), Angelica Sinensis Root (Danggui) (each 2 qian); Fritillaria Cirrhosa Bulb (Chuanbeimu), Asparagus Tuber (Tiantong) (each 3 qian).
Decoct in clear water. For Kidney deficiency with easy Qi rebellion, add Rehmannia Root (Shengdi) and Magnetite (Cishi) each 3 qian. For hemoptysis, remove Banxia. For rattling phlegm sounds due to Water flooding, add Cinnamon Twig (Guizhi) 5 fen, Lepidium Seed (Tinglizi) 1 qian, and Poria (Fuling) 3 qian.
(7) Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite Root, and Asarum Decoction): Treats Shaoyin disease at onset with contrary fever and deep pulse; Kidney-originating cough with lower back and back pain radiating upon coughing, severe salivation upon coughing, and brain/tooth pain caused by Cold pathogen invading teeth.
Ephedra Stem (Mahuang), Prepared Aconite Root (Fuzi), Asarum (Xixin)
(8) Si Junzi Tang (Four Gentlemen Decoction): See Chapter 3, Section 5.
(9) Wuwei Yigong San (Five-Ingredient Powder with Extra Efficacy): See Chapter 3, Section 6.
(10) Liujunzi Tang (Six-Gentlemen Decoction): See Chapter 5, Section 3.
(11) Baofei Fuzheng Tang (Lung-Nourishing and Righteousness-Supporting Decoction) (Self-made): Treats prolonged pertussis with Qi deficiency and unceasing cough.
Northern Glehnia Root (Beishashen), Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Astragalus Root (Huangqi), Ophiopogon Tuber (Maidong), Fritillaria Cirrhosa Bulb (Chuanbeimu), Processed Pinellia Tuber (Fa Banxia), Inula Flower (Xuanfuhua), Processed Citrus Reticulata Peel (Huajuhong), Chinese Yam (Huaishanyao) (each 2 qian).
Decoct in clear water. For prolonged cough with dissipating Lung Qi unable to consolidate, add Dried Ginger (Ganjiang) and Schisandra Berry (Wuweizi) each 5 fen. For Spleen deficiency with diarrhea, add Prepared Atractylodes Rhizome (Yuzhu). For Kidney deficiency with diarrhea, add Psoralea Fruit (Buguzhi). For hemoptysis, remove Banxia.