〔钱〕嗽者，肺感微寒。八九月间肺气大旺，病嗽者其病必实，非久病也。其症面赤痰盛身热，法
当以葶苈丸下之。若久者，不可下也。
葶苈丸 治乳食冲脾，伤风咳嗽，面赤痰盛，身热喘促。
甜葶苈（去土，隔纸略炒） 黑牵牛（微炒） 汉防己 杏仁（去皮尖，炒，另研如膏。各一两）
上为末，研入杏膏拌匀，蒸陈枣肉和，再捣为剂，丸如麻子大，每服五丸至七丸，淡生姜汤下，
乳食后或临夜服，量儿加减。
〔洁〕人参荆芥散 治身热痰嗽，胸膈不利，宜下痰去热。
人参（半两） 荆芥穗（一两） 大黄（二钱）
上为细末，水煎，调槟榔、木香细末五分，轻粉一字，乳后服。如身热潮热，宜服清凉饮子去大黄，
三服之后，一二日却入大黄服之，令疏利则愈，不可便动脏腑。
〔钱〕十一月十二月嗽者，乃伤风寒嗽也。风寒从背第三椎肺 穴入，当以麻黄汤汗之。有热证面
赤，饮水，痰热，咽喉不利者，宜以甘桔汤兼治之。若五七日，其证身热，痰盛唾粘，加减三拗汤下之。
麻黄（去根节，三钱，水煮去沫，焙干） 桂枝（二钱） 杏仁（七个，去皮尖，炒黄，另研如膏）
甘草（炙，一钱）
上为粗末，入杏膏拌匀，每服一钱，水六分，煎至四分，去渣，温服无时，以汗出为度，量大小
加减。若
自汗者，不宜服之。
百部丸 治小儿肺寒壅嗽，微喘有痰。
百部（炒） 麻黄（去节。各三两） 杏仁（四十个，去皮尖，微炒，研入）
上为末，熟枣子丸如皂子大。温水下二三丸，无时，日三四服。此本方也，仲景加松子仁五十个，
蜜丸，更加胡桃肉含化大妙。一方加甘草二钱。
紫苏子散 治小儿咳逆上气，因乳哺无度，内挟风冷，伤于肺气，或小儿啼气未定，与乳饮之，
与气相逆，气不得下。
紫苏子 诃子（去核） 杏仁（去皮尖，炒） 萝卜子 木香 人参（去芦。各三两） 青皮
甘草（炒。各一两半）
上为细末，每服二钱，水一盏，生姜三片，煎至五分，去渣，不拘时服，量儿加减。
有肺盛者，咳而后喘，面肿欲饮水。有不饮水者，其身即热。以泻白散泻之。若伤寒咳嗽，五七日无
热证，而但嗽者，亦葶苈丸主之，后用化痰药。（泻白散方见虚实法。）
有肺虚者，咳而哽气，长出气，喉中有声，此久病也，以阿胶散补之。痰盛者先入脾，后以褊银丸
微下之，涎退速即补肺，如上法。（补肺法方见治虚实法。）
〔洁〕黄 汤 治小儿咳嗽喘逆，身热，鼻干燥者，是热入肺经，为客热，呷呀有声。
黄 （二两） 人参（二钱半） 地骨皮（五钱） 桑白皮（三钱） 甘草（二钱半）
上 咀，水煎，放温，频频服之。
〔海〕涎嗽，四君子加杏仁、桑白皮等分，半夏曲减半，同煎。咳嗽，四君子末煎紫苏汤调下。
〔洁〕咳嗽 肺之生病而成嗽，大抵秋冬则实，春夏则虚，更详五脏兼见之证，以辨虚实。若实则
面赤饮水，身热，痰涎盛，涕唾稠粘，咽干不利，喘嗽，面肿，吐食，皆当先补脾，益黄散，后泻肝，
泻青丸。若咯脓血，是肺痿也，用清肺散治之，若虚则面白脱色，气少不语，喉中有声，唾痰清利，
法当阿胶散补之。若亡
津液，用白术散主之。
〔钱〕治嗽大法，盛即下之，久即补之，更量虚实，以意加减。
褊银丸 治风涎膈实上热及乳食不消，腹胀喘粗。
巴豆（去油膜皮心，研细，半两） 水银（五钱） 黑铅（二钱半，同水银炒结砂） 麝香（另研，五分）
好墨（火烧醋淬，研，八钱）
上将巴豆末并墨再研匀，和入砂子麝香，陈米粥和丸如绿豆大，捻褊。一岁儿一丸，三二岁二三丸，
五岁以上五六丸，煎薄荷汤放冷送下。不得化破，更量虚实加减，并食后服。（虚人先以益黄散实脾，
后以此方下之，下后补肺。）
嗽而吐水或青绿水者，百祥丸下之。（方见痘门。）嗽而吐痰涎乳食者，白饼子下之。（方见积门。）
〔丹〕小儿痰嗽，必用吐法，（详见喘条。）
〔世〕白附丸治咳嗽有痰。（方见脾主湿门。）
胜金方 治小儿咳嗽。蜂房二两，净洗，去蜂粪及泥土，以火烧为灰，每服一字，饭饮下。
〔罗〕涂唇膏 治襁褓小儿咳嗽吐乳，久不愈。石燕一味，为末，每用一捻，蜜少许，调涂儿唇上，
日三五次，无时。
〔钱〕杜氏子五岁，自十一月病嗽，至三月未止。始得嗽而吐痰，乃外风寒蓄入肺经，令肺病嗽而吐痰，
风在肺中故也。宜以麻黄散辈发散，后用凉药压之即愈。时医与朱粉丸、半夏丸、褊银丸诸法下之，
其肺即虚而嗽甚，至春三月间尚未愈。召钱视之，其候面青而光，嗽而喘促，哽气，又时时长出气。钱曰∶
病困十已八九，然所以面青而光者，肝气旺也。春三月者。肝之位，肺衰之时也。嗽者肺之病，肺自十一
月至三月，肺即虚痿，又再下之，脾肺子母俱虚，复为肝所胜，此为逆也，故嗽而喘促，哽气，长出气
也。钱急与泻青丸泻之，后与阿胶散实肺。次日面青而不光，钱又用补肺，而嗽如前。又与泻肝，未已
而又加肺虚，唇白如练。钱曰∶此病必死，不可治也。何者？肝大旺而肺虚绝，肺病不得时而肝胜之，今
三泻肝而肝病症不退，三补肺而肺病尤虚，此不久生，故言死也。此证病于秋者十救三四，春夏者十难
救一，果大喘而死。
【钱乙】咳嗽，是肺受到轻微寒邪侵袭所致。在八九月间，肺气最为旺盛，此时患咳嗽的病证多属实证，并非久病。其症状表现为面色发红、痰多、身体发热，治疗法则应当使用葶苈丸（Tingli Wan）攻下。如果是久咳，则不可使用攻下法。
葶苈丸：治疗因乳食冲犯脾脏、伤风引起的咳嗽，症见面色红赤、痰多、身热、气喘急促。
配方：甜葶苈（去除泥土，隔纸略炒）、黑牵牛（微炒）、汉防己、杏仁（去皮尖，炒制，另研成膏状，各一两）。
制法与用法：将上述药物研为细末，加入杏膏拌匀，用蒸过的陈枣肉调和，再次捣匀制成丸剂，大小如麻子。每次服用五至七丸，用淡生姜汤送服，于吃奶进食后或临睡前服用，根据患儿年龄体质酌情增减剂量。
【李杲】人参荆芥散：治疗身热、痰嗽、胸膈不畅，适宜通过祛痰清热来治疗。
配方：人参（半两）、荆芥穗（一两）、大黄（二钱）。
制法与用法：研为细末，用水煎煮，调入槟榔、木香的细末五分及轻粉一字，于乳饭后服用。若出现身热、潮热症状，宜服用清凉饮子并去掉大黄，服用三剂后，隔一两天再重新加入大黄服用，使大便通畅疏利即可痊愈，不可轻易扰动脏腑。
【钱乙】十一月、十二月发生的咳嗽，属于伤风寒咳嗽。风寒之邪从背部第三椎体处的肺俞穴侵入，应当使用麻黄汤（Mahuang Tang）发汗解表。若有热证表现，如面色红赤、想喝水、痰热、咽喉不利者，宜配合甘桔汤（Ganjie Tang）共同治疗。若病程经过五到七天，症状表现为身热、痰多且唾液粘稠，使用加减三拗汤（Jiajian San'ao Tang）攻下。
配方：麻黄（去根节，三钱，水煮去沫，焙干）、桂枝（二钱）、杏仁（七个，去皮尖，炒黄，另研成膏）、甘草（炙，一钱）。
制法与用法：研为粗末，加入杏膏拌匀，每次服用一钱，加水六分，煎至四分，去渣，随时温服，以出汗为度，根据患者大小酌情增减。若患者自汗出，不宜服用此方。
百部丸：治疗小儿肺寒壅滞引起的咳嗽，伴有轻微气喘且有痰。
配方：百部（炒制）、麻黄（去节，各三两）、杏仁（四十个，去皮尖，微炒，研入药中）。
制法与用法：研为细末，用熟枣子制成如皂荚子大小的丸剂。温水送服二三丸，随时可服，每日三四次。这是原方，张仲景曾加松子仁五十个，蜜丸，再加胡桃肉含化效果极佳。另一版本加甘草二钱。
紫苏子散：治疗小儿咳逆上气，因哺乳无节制，内挟风冷，损伤肺气；或因小儿啼哭气息未定，立即给予乳饮，导致气机相逆，气不得下行。
配方：紫苏子、诃子（去核）、杏仁（去皮尖，炒制）、萝卜子、木香、人参（去芦，各三两）、青皮、甘草（炒制，各一两半）。
制法与用法：研为细末，每次服用二钱，加水一盏，生姜三片，煎至五分，去渣，不拘时服用，根据患儿情况酌情增减。
若肺气盛者，先咳后喘，面部浮肿想喝水。若不喝水，身体即发热。应用泻白散（Xiebai San）清泻肺热。若是伤寒咳嗽，五到七天无热证，仅表现为咳嗽的，也用葶苈丸主治，之后再用化痰药。（泻白散方见虚实法章节。）
若肺气虚者，咳嗽伴哽气（呼吸短促有声），长出气，喉中有声音，此为久病，应用阿胶散（Ejiao San）补益。痰多者，病邪先涉及脾，后用褊银丸（Pianyin Wan）轻微攻下，待涎液消退后立即补肺，方法同上。（补肺法方见治虚实法章节。）
【李杲】黄芪汤（Huangqi Tang）：治疗小儿咳嗽喘逆、身热、鼻干燥者，此为热邪入肺经，属客热，伴有呷呀声（呼吸有声）。
配方：黄芪（二两）、人参（二钱半）、地骨皮（五钱）、桑白皮（三钱）、甘草（二钱半）。
制法与用法：切碎，用水煎煮，放温后频频服用。
【滑寿】涎嗽（痰湿咳嗽）：四君子汤加杏仁、桑白皮等量，半夏曲减半，同煎。普通咳嗽：用四君子汤末，以紫苏汤调服。
【李杲】咳嗽是肺生病而形成的咳嗽，大体而言秋冬季节多实证，春夏季节多虚证，需详细查看五脏兼见的症状，以辨别虚实。若属实证，见面色红赤、想喝水、身热、痰涎多、鼻涕唾液稠粘、咽干不利、喘嗽、面肿、吐食，都应当先补脾，用益黄散（Yihuang San），后泻肝，用泻青丸（Xieqing Wan）。若咯出脓血，是肺痿（Feiwei, Lung Abscess/Atrophy），用清肺散（Qingfei San）治疗。若属虚证，见面色苍白脱色、气少不语、喉中有声、唾痰清稀，治疗法则当用阿胶散补益。若亡失津液，用白术散（Baizhu San）主治。
【钱乙】治疗咳嗽的大法：实证即用攻下法，久病（虚证）即用补益法，更要衡量虚实程度，凭经验加减。
褊银丸：治疗风涎、膈实上热及乳食不消、腹胀喘粗。
配方：巴豆（去油膜皮心，研细，半两）、水银（五钱）、黑铅（二钱半，与水银同炒结成砂状）、麝香（另研，五分）、好墨（火烧醋淬，研，八钱）。
制法与用法：先将巴豆末和墨再研均匀，混入砂子和麝香，用陈米粥调和制成如绿豆大小的丸剂，压扁。一岁婴儿服一丸，两三岁服二至三丸，五岁以上服五至六丸，用薄荷汤冷却后送服。丸药不得化破，还要根据虚实加减，并在食后服用。（体虚之人先用益黄散实脾，再用此方攻下，攻下后再补肺。）
咳嗽并吐出清水或青绿水的，用百祥丸（Baixiang Wan）攻下。（方见痘门章节。）咳嗽并吐出痰涎乳食的，用白饼子（Baibing Zi）攻下。（方见积门章节。）
【世医】白附丸（BaiFu Wan）：治疗咳嗽有痰。（方见脾主湿门章节。）
胜金方：治疗小儿咳嗽。蜂房二两，洗净，去除蜂粪及泥土，用火烧成灰，每次服用一字，用饭饮送下。
【罗天益】涂唇膏：治疗襁褓中婴儿咳嗽吐乳，久治不愈。单味石燕，研为细末，每次取一捻，加少许蜂蜜，调和涂抹于婴儿嘴唇上，每日三至五次，随时可用。
【钱乙】杜氏之子五岁，从十一月患病咳嗽，直到三月仍未停止。起初咳嗽并吐痰，这是外感风寒蓄积入肺经，导致肺病咳嗽吐痰，风邪在肺中的缘故。应当用麻黄散之类发散，之后用凉药压制即可痊愈。当时的医生用朱粉丸、半夏丸、褊银丸等方法攻下，导致肺气更虚而咳嗽加剧，到了春季三个月间仍未痊愈。请钱乙诊治，其征象为面色青而光亮，咳嗽且气喘急促，哽气，又时常长出气。钱乙说：病情已危重十之八九，之所以面色青而光亮，是因为肝气旺盛。春季三个月是肝的主位，也是肺衰弱的时期。咳嗽是肺的病，肺从十一月到三月本就虚弱萎顿，又被多次攻下，脾肺母子俱虚，再被肝所克制，此为逆证，所以咳嗽气喘急促、哽气、长出气。钱乙急用泻青丸泻肝，后用阿胶散实肺。次日面色青而不光亮，钱乙又用补肺法，但咳嗽依旧。后又用泻肝法，未止而又加重肺虚，唇白如绢。钱乙说：此病必死，不可治了。为什么呢？肝大旺而肺虚绝，肺病不得其时而肝胜之，如今三次泻肝而肝病证不退，三次补肺而肺病尤虚，这不久将死亡，所以说死。此证若在秋季发病，十分可救三四；若在春夏发病，十分难救一，果然大喘而死。
[Qian Yi] Cough is caused by the lung being affected by slight cold. In the eighth and ninth months, lung qi is at its peak; coughs occurring during this time are typically excess patterns (Shi Zheng) rather than chronic conditions. Symptoms include a red face, profuse phlegm, and fever. The treatment principle should be to purge using Tingli Wan (Thladianthae Fructus Pill). If it is a chronic cough, purging methods must not be used.
Tingli Wan: Treats cough due to food stagnation attacking the spleen or wind-cold injury, presenting with a red face, profuse phlegm, fever, and panting.
Ingredients: Tian Ting Li (Fructus Thladianthae, cleaned of soil, lightly fried between papers), Hei Qian Niu (Semen Impatientae, slightly fried), Han Fang Ji (Radix Stephaniae Tetrandrae), Xing Ren (Semen Armeniacae Amarum, skin and tip removed, fried, ground separately into paste; each 1 liang).
Preparation and Administration: Grind the above into powder, mix with almond paste, blend with steamed flesh of aged jujube, pound again into pills the size of hemp seeds. Take 5–7 pills per dose, administered with light ginger soup after feeding or before bed, adjusting dosage according to the child's condition.
[Li Gao] Renshen Jingjie San (Ginseng and Schizonepeta Powder): Treats fever, phlegm-cough, and chest/diaphragm discomfort. It is suitable for resolving phlegm and clearing heat.
Ingredients: Renshen (Radix Ginseng, half liang), Jingjie Sui (Cacumen Schizonepetae, 1 liang), Dahuang (Radix et Rhizoma Rhei, 2 qian).
Preparation and Administration: Grind into fine powder, decoct in water, and mix with 5 fen of fine powder from Binglang (Arecae Semen) and Muxiang (Radix Aucklandiae), plus 1 zi of Qingfen (Calomelas). Administer after milk feeds. If there is fever or tidal fever, use Qingliang Yinzi (Cooling Drink) without Dahuang. After three doses, reintroduce Dahuang every one to two days to promote bowel movement and resolve the condition; do not disturb the zang-fu organs prematurely.
[Qian Yi] Coughs occurring in the eleventh and twelfth months are due to wind-cold injury. Wind-cold enters through the Feishu (BL13) acupoint on the third thoracic vertebra of the back. Treatment should involve sweating via Mahuang Tang (Ephedra Decoction). If there are heat signs such as a red face, thirst, phlegm-heat, and throat obstruction, Ganjie Tang (Licorice and Platycodon Decoction) should be combined. If five to seven days have passed and symptoms include fever, profuse sticky sputum, treat with Jiajian San'ao Tang (Modified San'ao Decoction) to purge.
Ingredients: Mahuang (Herba Ephedrae, roots and joints removed, 3 qian, boiled to remove foam, dried), Guizhi (Ramulus Cinnamomi, 2 qian), Xing Ren (Semen Armeniacae Amarum, 7 pieces, skin and tip removed, fried yellow, ground into paste), Gancao (Radix Glycyrrhizae, honey-fried, 1 qian).
Preparation and Administration: Grind into coarse powder, mix with almond paste. Take 1 qian per dose, add 6 parts water, boil down to 4 parts, strain, and take warm at any time until sweat appears. Adjust dosage based on age/size. Do not use if the patient has spontaneous sweating.
Baibu Wan (Stemona Pill): Treats pediatric cough due to lung cold obstruction, with mild panting and phlegm.
Ingredients: Baibu (Rhizoma Stemanae, fried), Mahuang (Herba Ephedrae, joints removed; each 3 liang), Xing Ren (Semen Armeniacae Amarum, 40 pieces, skin and tip removed, slightly fried, ground into mixture).
Preparation and Administration: Grind into powder, form pills the size of soap pods using cooked jujubes. Take 2–3 pills with warm water at any time, 3–4 times daily. This is the original formula; Zhang Zhongjing added 50 Songziren (Pine nuts) and formed honey pills; adding Hutaorou (Walnut kernel) to be sucked is also excellent. Another variation adds Gancao (2 qian).
Zisuzi San (Perilla Seed Powder): Treats pediatric cough with rebellious qi, caused by unregulated nursing leading to internal wind-cold damaging lung qi, or by giving milk while the child is crying and breath is unsettled, causing qi rebellion and failure to descend.
Ingredients: Zisuzi (Semen Perillae), Hezi (Fructus Chebulae, pitted), Xing Ren (Semen Armeniacae Amarum, skin and tip removed, fried), Luoboz (Semen Raphani), Muxiang (Radix Aucklandiae), Renshen (Radix Ginseng, rhizome removed; each 3 liang), Qingpi (Exocarpium Citri Reticulatae Viride), Gancao (Radix Glycyrrhizae, fried; each 1.5 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, add 1 cup water and 3 slices of fresh ginger, boil down to 0.5 cup, strain, and take at any time, adjusting for the child.
If lung qi is excessive, cough precedes panting, face is swollen, and there is thirst. If there is no thirst, the body becomes hot. Use Xiebai San (Clear White Powder) to purge. If it is a cold-induced cough with no heat signs after 5–7 days, only coughing remains, Tingli Wan is primary, followed by phlegm-resolving medicines. (See Xiebai San in the Deficiency-Excess chapter.)
If lung qi is deficient, coughing is accompanied by gasping, long sighs, and sounds in the throat; this is a chronic condition. Use Ejiao San (Donkey-Hide Gelatin Powder) to tonify. If phlegm is profuse, the pathology first involves the spleen; use Pianyin Wan (Narrow Silver Pill) to mildly purge, then immediately tonify the lung once saliva subsides, following the method above. (See Lung Tonification in the Treating Deficiency-Excess chapter.)
[Li Gao] Huangqi Tang (Astragalus Decoction): Treats pediatric cough with panting, fever, and dry nose. This indicates heat entering the lung meridian, constituting "guest heat," accompanied by noisy breathing.
Ingredients: Huangqi (Radix Astragali, 2 liang), Renshen (Radix Ginseng, 2.5 qian), Digupi (Cortex Lycii Radicis, 5 qian), Sangbaipi (Cortex Mori Radicis, 3 qian), Gancao (Radix Glycyrrhizae, 2.5 qian).
Preparation and Administration: Cut into small pieces, decoct in water, let cool to warm temperature, and administer frequently.
[Hua Shou] Saliva-Cough: Si Junzi Tang (Four Gentlemen Decoction) plus equal parts Xing Ren and Sangbaipi, with Banxia Qu (Fermented Pinelliae Mass) halved, decocted together. General Cough: Si Junzi powder taken with Zijue Tang (Perilla Decoction).
[Li Gao] Cough resulting from lung disease generally presents as excess in autumn/winter and deficiency in spring/summer. One must examine concurrent symptoms of the five zang organs to distinguish deficiency and excess. If excess: red face, thirst, fever, profuse phlegm/saliva, thick nasal discharge, dry/uncomfortable throat, panting/cough, facial swelling, vomiting food. First tonify the spleen with Yihuang San (Benefit Yellow Powder), then purge the liver with Xieqing Wan (Drain Green Pill). If pus and blood are expectorated, it is Feiwei (Lung Atrophy/Abscess); treat with Qingfei San (Clear Lung Powder). If deficiency: pale/washed-out face, shortness of breath/silence, sounds in throat, clear/thin sputum. The method is to tonify with Ejiao San. If body fluids are depleted, use Baizhu San (Atractylodes Macrocephala Powder).
[Qian Yi] The general principle for treating cough: Purge excess, tonify chronic deficiency, and adjust based on an assessment of deficiency and excess.
Pianyin Wan: Treats wind-phlegm, diaphragmatic fullness with upper heat, indigestion, abdominal distension, and rough breathing.
Ingredients: Badou (Semen Crotonis, oil/film/core removed, finely ground, half liang), Shuiyin (Hydrargyrum, 5 qian), Heiqian (Plumbum, 2.5 qian, fried with mercury to form cinnabar-like grains), Shexiang (Moschus, ground separately, 5 fen), Haomo (Good Ink, fired in fire and quenched in vinegar, ground, 8 qian).
Preparation and Administration: Grind Badou powder and ink evenly, mix with the mercury grain and musk, bind with old rice porridge into pills the size of mung beans, flatten. For a one-year-old, one pill; 2–3 years old, 2–3 pills; over 5 years old, 5–6 pills. Send down with cooled Bohe Tang (Mint Decoction). Do not let the pill dissolve in the mouth. Adjust based on deficiency/excess, administer after meals. (For deficient patients, first solidify the spleen with Yihuang San, then purge with this formula, and tonify the lung afterward.)
Cough with vomiting clear water or green-blue water: Purge with Baixiang Wan (Hundred Auspicious Pills). (See Vaccine Disease Chapter.) Cough with vomiting phlegm/saliva/milk: Purge with Baibing Zi (White Cake Pill). (See Accumulation Chapter.)
[Zhu Danxi] Pediatric phlegm-cough requires emetic therapy. (See Panting section.)
[Worldly Physicians] Baifu Wan (Leadwort Pill): Treats cough with phlegm. (See Spleen Governing Dampness Chapter.)
Shengjin Fang (Winning Gold Formula): Treats pediatric cough. Fengfang (Vespa Nidus, 2 liang), washed clean, removing feces and dirt, burned to ash. Take 1 zi per dose, swallowed with rice drink.
[Luo Tianyi] Lip Paste: Treats infants coughing and vomiting milk, chronic and unresponsive. Shiyan (Fossilized Bird Bone), single herb, ground to powder. Take a pinch, mix with little honey, apply to infant's lips 3–5 times daily at any time.
[Qian Yi] Son of Du, age five, had cough from November to March. Initially coughing and spitting phlegm, this was external wind-cold accumulating in the lung meridian, causing lung disease and phlegm expulsion due to wind in the lungs. Should have been treated with dispersing agents like Mahuang San (Ephedra Powder), followed by cooling medicines to resolve. Contemporary physicians used Zhufen Wan, Banxia Wan, and Pianyin Wan to purge, causing lung deficiency and worsening cough. By spring, still not cured. Qian Yi examined him: face blue and shiny, coughing with panting, gasping, and frequent long sighs. Qian Yi said: The illness is critical (90% fatal). The blue-shiny face indicates flourishing liver qi. Spring is the domain of the liver and the time of lung decline. Cough is a lung disease; from Nov to Mar, the lung is already deficient and flaccid. Further purging damaged both spleen and lung (mother and child relationship), allowing the liver to overcome them further. This is a counter-indication, hence the panting and sighing. Qian Yi urgently prescribed Xieqing Wan to drain the liver, then Ejiao San to solidify the lung. Next day, face was blue but not shiny. Qian Yi used lung tonification, but cough persisted. Then used liver draining, which failed, and lung deficiency worsened, lips becoming white as silk. Qian Yi said: This case is fatal and untreatable. Why? Liver is hyperactive, lung is exhausted. Lung disease occurs out of season while liver overcomes it. Three drains of liver failed to reduce liver pathology; three tonifications of lung failed to strengthen lung pathology. Death is imminent. Cases starting in autumn have 30–40% survival; cases starting in spring/summer have less than 10% survival. The patient indeed died of severe panting.