咳嗽之病形何如。曰。咳嗽之病。尽属肺经。然有本经之咳嗽。有各脏腑迁移之咳嗽。本经
之嗽。皮毛受之。
玄府闭矣。此外感也。玄府既闭。则肺气不舒。其在中之二十四窍。所以列行分布诸脏之气者。
亦不能行于是肺满而逆。戛戛然咳嗽矣。此肺实也。肺虚者。由脾土不能生化。津液不得上布。
则肺失所养而阴虚。阴虚则肺热。肺热则上焰。火煽其窍。时为 张。亦多嗽矣。此肺虚也。独
有心火刑金。与水中之火。直奔西极。而消铄煎熬。则肺便危矣。缘肺为华盖。以覆诸脏。其二
十四空窍。虚如蜂窠。下垂无透窍。吸之则满。呼之则虚。最喜清凉。不耐烦热。今心肝脾肾四
脏之火热上炎。则随所吸之气而入于窍中。肺不受热。则戛戛然而嗽。甚至肺叶干枯。形如经霜
荷叶。委顿零落。而不能振举。水精亦不能四布。五经亦不能并行。而成肺败之症。总缘肺之空
窍中。只受得脏腑中固有元气以运乎一身。受不得一分邪气耳。（咳嗽一症。虽有各脏迁移。其
实不离肺金主治。其大旨亦不逾实则清之虚则补之二法。但清之补之之中。又有不同。因引长洲
诸法于后法之下。惟用者参之。）初起者。金沸草散以散之。年壮力盛。即久亦可用。如每月一
二发。弱症之渐也。六君子汤以补土生金。六味丸以滋水生木。此攻补二法也。（长洲云。嗽而
鼻塞声重。风邪伤肺也。用参苏饮。面赤咳嗽。火克肺也。人参平肺散。寒热交作。肝气不和也。
四君子汤加知母柴胡桔梗。咳喘短气。肺虚也。人参补肺汤。体倦少食。脾虚也。参术补脾汤。口干
咽燥。虚火上炎也。六味饮。凡发热喘嗽。或咳唾脓血。饮食不入。急补脾肺滋肾水。多有得生者。
又云。午前嗽属胃火盛。竹叶石膏汤。胃气虚。补中益气汤加炒山栀。午后嗽属阴血虚。四物汤
加酒拌炒黑黄柏知母。肾水虚用六味丸。黄昏嗽用四物汤加麦冬五味并六味丸。五更嗽用六君子汤。
不得眠及两胁下痛用六味饮补中益气汤。）如咸哮醋哮。胜金丸主之。（醋哮甘胆丸亦妙）如年
高筋骨作痛。气喘有痰。腰痛。用熟地山药当归白芍杜仲枸杞黄 枣仁麦冬五味甘草。喘盛去黄
。（有一
种气短似喘。呼吸促急。提不能升。咽不能降。气道噎塞。势剧垂危者。人但知为气急。其病在上
。而不知元海无根。亏因肝肾。此子午不交。气脱症也。凡妇人血海常亏者。最多此症。宜急用熟
地二两当归一两甘草五钱。以济之缓之。堪云神剂。如兼呕恶加生姜。气虚加人参。肝肾阴虚加
肉桂。凡诊此症。脉必微细无神。若微而兼紧。尤为可畏。倘庸技不知。妄云痰逆气滞。用牛黄
苏合及青皮枳壳破气等剂。则速其危矣。）如年高痰喘。气不归原者。生脉散加熟地山药当归枸杞牛
膝菟丝等治之。（凡因痰而嗽者。痰为重。主治在脾。因咳而动痰者。咳为重。主治在肺。一切
食积痰积上升而致咳者。只治其痰消其食。其咳自止。不必用凉药肺药。洁古云。治咳嗽以化
痰为先。化痰以导气为主。四明云。导气不如先治火。实者泻白加芩桔。虚者六味合生脉。胃虚
者竟以四君加归芍合生脉。无不应手。）
金沸草散
金沸草 前胡 麻黄 荆芥穗 黄芩 甘草 姜枣引
胜金丸
三棱 莪术 良姜 陈皮 人参 黄连
上神曲和丸。梧子大。每服七十丸。空心白滚汤下。
咳嗽这种病症的表现是怎样的？回答说：咳嗽这一病症，全都归属于肺经。然而，有本经（肺经）自身的咳嗽，也有由其他各脏腑传变而来的咳嗽。属于肺经本气的咳嗽，是因为皮毛受邪，玄府（汗孔）闭塞所致，这属于外感病证。玄府既然闭塞，肺气就不能舒展，其中分布运行于各脏腑的二十四窍之气，也不能正常在肺中流通，导致肺气壅满而上逆，发出戛戛的声音而咳嗽，这是肺实证。
肺虚证，是由于脾土不能生化气血，津液无法上输布散，致使肺脏失去滋养而出现阴虚。阴虚则生肺热，肺热则火气上炎，火热煽动肺窍，使气道时而张开，也容易引起咳嗽，这是肺虚证。唯独心火克制肺金，以及命门之火（肾中相火）直冲西方（肺），消铄煎熬肺阴，那么肺脏就危险了。因为肺为华盖（覆盖诸脏的脏器），覆盖在所有脏腑之上，其内部的二十四空窍，空虚如同蜂巢，下垂且没有透达的窍道，吸气时充满，呼气时虚空，最喜欢清凉，不耐受烦热。如今心、肝、脾、肾四脏的火热之气上炎，就会随着吸入的空气进入肺窍。肺不能耐受这种热邪，就会发出戛戛的声音而咳嗽，甚至导致肺叶干枯，形状像经霜的荷叶一样，萎靡零落，不能振作举扬。水精（津液）也不能向四周布散，五脏经脉也不能并行通畅，从而形成肺败的症候。总的原因在于肺的空窍中，只能容纳脏腑中固有的元气来运化全身，容不得一分邪气。（咳嗽一症，虽然涉及各脏腑的传变，其实离不开肺金的主治作用，其大旨也不超出“实则清之，虚则补之”两种方法。但在清法和补法之中，又有不同之处，因此引用长洲医家的各种方法列在后面，供使用者参考。）
初起咳嗽者，用金沸草散来发散邪气。如果年壮力盛，即使病程较长也可以使用。如果每月发作一两次，则是虚弱病症的渐象。用六君子汤来补益脾胃（土）以生肺金；用六味丸来滋补肾水以涵养肝木。这是攻邪与补虚两种方法。（长洲医家说：咳嗽伴有鼻塞声重，是风邪伤肺，用人参苏饮；面赤咳嗽，是火克肺，用人参平肺散；寒热交替发作，是肝气不和，用四君子汤加知母、柴胡、桔梗；咳喘短气，是肺虚，用人参补肺汤；体倦少食，是脾虚，用参术补脾汤；口干咽燥，是虚火上炎，用六味饮。凡是发热喘嗽，或咳吐脓血，饮食不入，急当补脾肺、滋肾水，多能得生。又说：午前咳嗽属胃火盛，用竹叶石膏汤；胃气虚，用补中益气汤加炒山栀；午后咳嗽属阴血虚，用四物汤加酒拌炒黑黄柏、知母；肾水虚用六味丸；黄昏咳嗽用四物汤加麦冬、五味子及六味丸；五更咳嗽用六君子汤；失眠及两胁下痛用六味饮合补中益气汤。）
如果是咸哮或醋哮，用胜金丸主治。（醋哮也可用甘胆丸，效果也很好。）如果是年老筋骨疼痛，气喘有痰，腰痛，用熟地黄、山药、当归、白芍、杜仲、枸杞、枣仁、麦冬、五味子、甘草治疗。如果气喘严重，去掉黄芩。（有一种气短似喘，呼吸急促，提气不能升，咽气不能降，气道噎塞，病情危急垂死者，人们只知道是气急，病位在上，却不知道这是因为元海无根，亏损源于肝肾，这是子午不交、气脱的症候。凡是妇女血海常亏的，最多出现这种症候，宜急用熟地黄二两、当归一两、甘草五钱来济助缓和它，可称为神剂。如果兼有呕吐恶心，加生姜；气虚加人参；肝肾阴虚加肉桂。凡诊断此症，脉象必定微细无神，如果微而兼紧，尤为可怕。倘若庸医不知，妄说是痰逆气滞，使用牛黄苏合香丸及青皮、枳壳等破气药剂，则会加速其死亡。）
如果是年老痰喘，气不归原者，用生脉散加熟地黄、山药、当归、枸杞、牛膝、菟丝子等治疗。（凡是因痰而咳嗽的，痰为重，主治在脾；因咳嗽而动痰的，咳为重，主治在肺。一切因食积、痰积上升而导致咳嗽的，只需治疗其痰、消除其食，咳嗽自然停止，不必使用凉药和肺药。洁古说：治咳嗽以化痰为先，化痰以导气为主。四明说：导气不如先治火，实证泻白散加黄芩、桔梗，虚证六味丸合生脉散，胃虚者直接用四君子汤加当归、白芍合生脉散，无不奏效。）
The manifestation of the disease of coughing and wheezing (Késou) is as follows: It is said that all cases of coughing belong to the Lung Meridian. However, there are coughs originating from the meridian itself (Lung), and those transferred from various other Zang-Fu organs. Coughs belonging to the Lung's own qi arise when the skin and hair are affected by pathogens, causing the Xuanfu (pores/sweat apertures) to close; this constitutes an external contraction. Once the Xuanfu is closed, Lung Qi cannot diffuse smoothly. The twenty-four orifices within, which distribute Qi to various organs, cannot circulate properly in the Lung, leading to Lung fullness and rebellion, resulting in a harsh coughing sound; this is a Lung Excess pattern.
A Lung Deficiency pattern arises because Spleen Earth fails to transform and produce, preventing body fluids from ascending and distributing, thereby depriving the Lung of nourishment and leading to Yin deficiency. Yin deficiency generates Lung Heat, which flares upward. Fire stirs the orifices, causing them to open intermittently, also frequently inducing coughing; this is a Lung Deficiency pattern. Only when Heart Fire insults Metal (Lung) or Fire from Water (Kidney Mingmen fire) rushes directly to the West (Lung), consuming and simmering the Lung Yin, does the Lung enter a critical state. This is because the Lung serves as the Canopy (Huagai), covering all other organs. Its twenty-four hollow orifices are empty like honeycombs, hanging downward without penetrating passages; they fill upon inhalation and empty upon exhalation. The Lung prefers coolness and dislikes heat. Now, if the pathogenic heat of the Heart, Liver, Spleen, and Kidney flares upward, it enters the orifices along with inhaled air. If the Lung cannot tolerate this heat, it coughs harshly. In severe cases, the lung lobes become dry and shriveled, resembling lotus leaves after frost, limp and fallen, unable to recover. Body fluids (Jingshui) fail to distribute to the four directions, and the five meridians cannot function in parallel, resulting in a syndrome of Lung failure. The root cause is that the Lung's hollow orifices can only accommodate the inherent Yuan Qi of the Zang-Fu organs to govern the whole body, but cannot tolerate even a trace of pathogenic Qi. (Although coughing involves transmission from various organs, it essentially remains under the governance of Lung Metal. The general principle does not exceed the two methods of "clearing excess" and "tonifying deficiency." However, within these methods, there are variations. Therefore, the methods of the Changzhou physicians are cited below for reference.)
For early-stage coughing, use Jinfei Cao San (Golden Fern Herb Powder) to disperse the pathogen. For those who are young and vigorous, it can be used even if the condition has persisted for some time. If attacks occur once or twice a month, it indicates the gradual onset of a weak constitution. Use Liu Junzi Tang (Six Gentlemen Decoction) to tonify Earth to generate Metal; use Liuwei Wan (Six-Ingredient Pill with Rehmannia) to nourish Water to nurture Wood. These represent the methods of attacking excess and tonifying deficiency. (Physicians from Changzhou state: Coughing with nasal congestion and heavy voice indicates Wind-Evil injuring the Lung; use Renshen Su Yin (Ginseng and Perilla Drink). Red face and coughing indicate Fire insulting the Lung; use Renshen Pingfei San (Ginseng Lung-Pacifying Powder). Alternating chills and fever indicate Disharmony of Liver Qi; use Sijunzi Tang (Four Gentlemen Decoction) plus Zhimu (Anemarrhena Rhizome), Chaihu (Bupleurum Root), and Jiegeng (Platycodon Root). Coughing, wheezing, and shortness of breath indicate Lung Deficiency; use Renshen Bufei Tang (Ginseng Lung-Tonifying Decoction). Fatigue and poor appetite indicate Spleen Deficiency; use Shenbai Toubi Tang (Ginseng and Atractylodes Spleen-Tonifying Decoction). Dry mouth and throat indicate Flaring of Deficient Fire; use Liuwei Yin (Six-Ingredient Decoction). For any case of fever, wheezing, coughing, or expectoration of pus and blood, with inability to eat, urgently tonify the Spleen and Lung and nourish Kidney Water; many patients survive. Furthermore: Morning cough belongs to excessive Stomach Fire; use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Stomach Qi Deficiency: use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus fried Gardenia. Afternoon cough belongs to Yin-Blood Deficiency; use Siwu Tang (Four Substance Decoction) plus wine-processed, charred Huangbai (Phellodendron Bark) and Zhimu. Kidney Water Deficiency: use Liuwei Wan. Dusk cough: use Siwu Tang plus Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Berry), and Liuwei Wan. 5 AM cough: use Liu Junzi Tang. Insomnia and pain under both hypochondria: use Liuwei Yin combined with Buzhong Yiqi Tang.)
For salty asthma or vinegar-induced asthma, Shengjin Wan (Victory Over Gold Pill) is the primary treatment. (Gan Dan Wan is also excellent for vinegar asthma.) For the elderly suffering from bone and joint pain, wheezing with phlegm, and lower back pain, use Shudi (Prepared Rehmannia Root), Shanyao (Chinese Yam), Danggui (Angelica Sinensis), Baishao (White Peony Root), Duzhong (Eucommia Bark), Gouqi (Goji Berry), Zaoren (Ziziphus Seed), Maidong, Wuweizi, and Gancao (Licorice Root). If wheezing is severe, remove Huangqin (Scutellaria Root). (There is a type of shortness of breath resembling wheezing, with urgent respiration, where Qi cannot ascend nor descend, and the airway feels blocked, presenting a critical and life-threatening situation. People often mistake this for simple Qi urgency located in the upper jiao, not realizing that the Yuanhai (Sea of Origin) lacks roots due to Kidney and Liver deficiency. This is a syndrome of Zi-Wu non-intersection and Qi collapse. Women with chronic Blood Sea deficiency are most prone to this. Urgently use Shudi (2 liang), Danggui (1 liang), and Gancao (5 qian) to rescue and缓 (soothe) the condition; this can be called a miraculous formula. If accompanied by vomiting and nausea, add Shengjiang (Fresh Ginger); for Qi Deficiency, add Renshen (Ginseng); for Kidney and Liver Yin Deficiency, add Rougui (Cinnamon Bark). Upon diagnosing this syndrome, the pulse must be faint, thin, and spiritless. If faint and tight, it is particularly alarming. If incompetent physicians do not recognize this and wrongly diagnose it as Phlegm-Rebellion and Qi-Stagnation, using agents like Niuhuang Suhexiang Wan (Calculus Bovis and Liquidambar Pill) or Qi-breaking herbs like Qingpi (Tangerine Peel) and Zhike (Aurantii Fructus), they will hasten the patient's demise.)
For the elderly with phlegm-wheezing and Qi failing to return to its source, use Shengmai San (Generate the Pulse Powder) plus Shudi, Shanyao, Danggui, Gouqi, Nixi (Achyranthes Root), Tusizi (Cuscuta Seed), etc. (When coughing is caused by phlegm, phlegm is the primary issue, and treatment focuses on the Spleen. When coughing moves phlegm, coughing is primary, and treatment focuses on the Lung. For all coughs caused by rising Food Accumulation or Phlegm Accumulation, simply treat the phlegm and digest the food; the cough will stop naturally. There is no need to use cooling or Lung-specific medicines. Jiegu stated: Treating coughing prioritizes resolving phlegm, and resolving phlegm prioritizes guiding Qi. Siming stated: Guiding Qi is inferior to first treating Fire. For Excess patterns, use Xiebai San (Drain White Powder) plus Huangqin and Jiegeng; for Deficiency patterns, use Liuwei Wan combined with Shengmai San; for Stomach Deficiency, use Sijunzi Tang plus Danggui and Baishao combined with Shengmai San; all yield prompt results.)
Jinfei Cao San (Golden Fern Herb Powder)
Jinfei Cao (Spreading Goldenfern Herb), Qianhu (Peucedani Radix), Mahuang (Ephedrae Herba), Jingjie Sui (Schizonepeta Spike), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), with Shengjiang (Fresh Ginger) and Dazao (Jujubae Fructus) as guides.
Shengjin Wan (Victory Over Gold Pill)
Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Liangjiang (Alpiniae Officinarum Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Renshen (Ginseng Radix et Rhizoma), Huanglian (Coptidis Rhizoma).
Grind the above into powder and mix with Shenqu (Medicated Leaven) to make pills the size of wutong seeds. Take 70 pills per dose, fasting, with plain warm water.