（论二首 法十六条 律六条）
喻昌曰∶咳嗽一证，求之《内经》，博而寡要；求之《金匮》，惟附五方于痰饮之后，亦无颛论。不得已问津于后代
诸贤所述， 璧琳琅，非不棼然案头，究竟各鸣己得而鲜会归。昌不以漫然渺然之说，传信后人，将何以为言哉？盖尝
反复《内经》之文，黄帝问于岐伯曰∶肺之令人咳者，何也？岐伯对曰∶五脏六腑，皆足令人咳，非独肺也。此一语推
开肺咳，似涉太骤。设当日先陈肺咳，以渐推详，则了无疑义，后世有成法可遵矣。非然也，圣神立言，不过随文演义，
微启其端，苟必一一致详，即非片言居要之体。所以读《内经》，贵在自得其要。得其要，则一言而终；不得其要，则流
散无穷，岂特论咳嗽一证为然哉？黄帝训雷公之辞有曰∶不知比类，足以自乱，不足以自明。固知比类之法，不但足以
蔽《内经》之义，并足以蔽穷无穷极无极之义，管可窥天，蠡可测海。《内经》千万年脱略之文，一知比类，直可合符一
堂。至于苛病当前，游刃恢恢，不待言矣。请申之，岐伯虽言五脏六腑，皆足令人咳，其所重全在于肺。观其下文云∶
皮毛者，肺之合也。皮毛先受邪气，邪气以从其合也。其寒饮食入胃，从胃脉上至于肺，则肺寒，肺寒则内外合邪，因
而客之，则为肺咳，此举形寒饮冷伤肺之一端，以明咳始之因耳。内外合邪四字扼要，比类之法，重在于此。人身有外
邪，有内邪，有外内合邪，有外邪已去，而内邪不解，有内邪已除，而外邪未尽，才一比类，了然明白，奈何不辨之于
蚤，听其酿患日深耶。夫形寒者，外感风寒也。饮冷者，内伤饮食也。风寒无形之邪入内，与饮食有形之邪相合，必留
恋不舍。治之外邪须从外出，内邪须从下出，然未可表里并施也，《金匮》五方总不出小青龙汤一方为加减，是《内经》
有其论，《金匮》有其方矣。而《内经》、《金匮》之所无者，欲从比类得之，果何从哉？进而求之暑湿，暑湿之邪，皆足
令人咳也。盖暑湿之外邪内入，必与素酝之热邪相合，增其烦咳，宜从辛凉解散，又当变小青龙汤之例为白虎，而兼用
天水五苓之属矣。进而求之于火，则有君相之合，无内外之合，而其足以令人致咳者，十常八九。以心与肺同居膈上，
心火本易于克制肺金，然君火无为而治，恒不自动，有时劳其心而致咳，息其心咳亦自止，尚不为剥肤之灾也。惟相火
从下而上，挟君火之威而刑其肺，上下合邪，为患最烈，治之亦可从外内合邪之例比拟，其或引或折以下其火，俾不至
于燎原耳。于中咳嗽烦冤，肾气之逆，亦为上下合邪，但浊阴之气，上乾清阳，为膈肓遮蔽，任其烦冤，不能透出。亦
惟下驱其浊阴，而咳自止矣。进而求之于燥，内外上下，初无定属，或因汗吐太过而津越于外；或因泻利太久而阴亡于
下；或荣血衰少，不养于筋；或精髓耗竭，不充于骨；乃致肺金日就干燥，火入莫御，咳无止息。此时亟生其津，亟养
其血，亟补其精水，犹可为也。失此不治，转盼瓮干杯罄，毛瘁色弊，筋急爪枯，咳引胸背，吊胁疼痛，肺气 郁，诸
痿喘呕，嗌塞血泄，种种危象，相因而见，更有何法可以沃其焦枯也耶？《经》谓咳不止而出白血者死，岂非肺受燥火
煎熬而腐败，其血亦从金化而色白耶。至于五脏六腑之咳；《内经》言之不尽者，要亦可比类而会通之耳。昌一人知见
有限，由形寒饮冷伤肺一端，比类以及暑湿火燥，不过粗枝大叶，启发聪明之一助，至从根本入理深谭，是必待于后人
矣。
（论述两篇 法则十六条 律令六条）
喻昌说：咳嗽这一病症，查阅《黄帝内经》，内容广博却缺乏要领；查阅《金匮要略》，仅在痰饮病后附带了五个方剂，也没有专门的论述。不得已向后代各位贤医的著作中探寻，虽然琳琅满目，并非不杂乱地堆放在案头，但终究是各抒己见，很少能融会贯通。我如果不以荒诞渺茫的说法流传给后人，还能说什么呢？我曾反复研读《黄帝内经》的文字，黄帝问岐伯说：“肺让人咳嗽，是什么原因？”岐伯回答说：“五脏六腑都足以使人咳嗽，不仅仅是肺。”这句话推开了仅局限于肺咳的观点，似乎涉及得太急促。假如当时先陈述肺咳，再逐渐详细推演，那就没有任何疑义，后世就有成法可以遵循了。不是这样的，圣哲立言，不过是随着文意发挥大义，微微开启其端绪，如果一定要一一详细阐述，就不符合用简练言语抓住关键的原则。所以阅读《黄帝内经》，贵在自行领悟其要领。领悟了要领，则一句话就能终结全意；没领悟要领，就会流散无穷无尽，难道只有咳嗽这一病症是这样吗？黄帝教导雷公的话中有说：“不懂得类比推理，足以使自己混乱，不足以使自己明白。”本来就知道类比的方法，不但足以概括《黄帝内经》的含义，并足以概括穷尽无穷无极的道理，就像管中窥天，蠡测海一样。《黄帝内经》千万年来被忽略的文字，一旦懂得类比，简直可以在一堂之中合符验证。至于面对复杂的疾病，游刃有余，是不言而喻的了。请让我进一步申述，岐伯虽然说是五脏六腑都足以使人咳嗽，但他所重视的全在于肺。看他下文说：“皮毛是肺的外合。皮毛先受到邪气侵袭，邪气就顺着它的外合关系传入体内。寒冷的饮食进入胃中，沿着胃脉上行至肺，则肺受寒，肺寒则内外邪气相合，因而客居于肺，就成为肺咳”，这是举出形寒饮冷损伤肺脏的一个方面，来说明咳嗽起始的原因罢了。“内外合邪”这四个字扼住要害，类比的方法，重点就在这里。人体有外邪，有内邪，有内外合邪，有外邪已去而内邪未解，有内邪已除而外邪未尽，只要稍加类比，就了然明白，为什么不早点辨别，听任其酿成深重祸患呢？所谓形寒，是外感风寒。饮冷，是内伤饮食。风寒这种无形之邪入内，与饮食这种有形之邪相结合，必定留恋不舍。治疗时外邪须从体表排出，内邪须从下部排出，然而不可以表里同治。《金匮要略》中的五个方剂总不出小青龙汤一方作为加减变化，这是《黄帝内经》有相关论述，《金匮要略》有相应方剂了。而对于《黄帝内经》、《金匮要略》中所没有的内容，想要通过类比来求得，究竟从何入手呢？进而探究暑湿，暑湿之邪，都足以使人咳嗽。大概暑湿之外邪内入，必定与素有的热邪相结合，增加其烦闷咳嗽，应当采用辛凉解散的方法，又应当将小青龙汤的法度变为白虎汤，并兼用天水散、五苓散之类的方剂了。进而探究火邪，则有君火与相火的结合，没有内外邪气的结合，而其足以导致人咳嗽的情况，十常八九。因为心与肺同居膈上，心火本就容易克制肺金，然而君火无为而治，恒常不自动妄动，有时因劳心而导致咳嗽，使心休息咳嗽自然停止，尚且不算剥肤之灾。只有相火从下而上，挟持君火的威势来刑克肺金，上下邪气相合，为害最为猛烈，治疗也可以参照内外合邪的例子进行类比，或者引导下行，或者折降下行以抑制火势，使其不至于像燎原大火一样蔓延。其中咳嗽烦冤，肾气上逆，也属于上下合邪，但浊阴之气，上犯清阳，被膈肓遮蔽，任凭其烦闷冤屈，不能透出。也只有向下驱除浊阴，咳嗽自然停止。进而探究燥邪，内外上下，起初没有固定的归属，或许因为汗法吐法太过而津液越出于外；或许因为泻利太久而阴液亡失于下；或许营血衰少，不能滋养筋脉；或许精髓耗竭，不能充盈骨骼；以致肺金日渐干燥，火邪侵入无法抵御，咳嗽无止息。此时亟需生津，亟需养血，亟需补益精水，还可以挽救。错过此时不治疗，转眼之间瓮干杯空，毛发憔悴面色败坏，筋脉拘急指甲枯槁，咳嗽牵引胸背，吊胁疼痛，肺气郁滞，各种痿证喘证呕吐，咽喉阻塞便血，种种危象，相继出现，还有什么方法可以滋润其焦枯呢？《内经》说咳嗽不止而出白血的死亡，难道不是肺受到燥火煎熬而腐败，其血也随金气转化而色白吗？至于五脏六腑的咳嗽，《内经》说得详尽不尽的，大体也可以通过类比而融会贯通。我喻昌一人的见识有限，由形寒饮冷伤肺这一个方面，类比到暑湿火燥，不过是大致粗浅地启发聪明才智的一点帮助，至于从根本深入探讨道理，那必须等待后人了。
(Luo Er Shou, Fa Shi Liu Tiao, Lü Liu Tiao)
Yu Chang said: Regarding the syndrome of coughing (Ke), if one consults the *Huangdi Neijing* (Yellow Emperor's Inner Canon), the content is extensive yet lacks the essential key points; if one consults the *Jinkui Yaolue* (Essential Prescriptions of the Golden Cabinet), it only attaches five formulas after Phlegm-Fluids (Tan Yin), without any dedicated discussion. Reluctantly seeking guidance in the works described by later sages, although they are as dazzling as jade and non-stop scattered on the desk, ultimately each expresses their own insights with little convergence. If I do not transmit absurd and vague theories to future generations, what else can I say? I have repeatedly reviewed the text of the *Huangdi Neijing*. The Yellow Emperor asked Qibo: "What causes the lung to make a person cough?" Qibo replied: "All five zang organs and six fu organs are sufficient to cause coughing, not just the lung." This statement pushes open the view of lung-specific coughing, seemingly involving too abrupt a generalization. If at that time, lung cough had been stated first and then gradually detailed, there would be no doubt, and later generations would have established methods to follow. It is not so. The establishment of words by sages merely expands upon the text to reveal profound meanings, slightly opening the beginning. If one insists on detailing everything, it does not conform to the style of capturing the essence in few words. Therefore, reading the *Huangdi Neijing* values self-discovery of its essentials. Grasping the essence allows one to conclude with a single word; failing to grasp it leads to infinite dispersion. Is this not true only for the syndrome of coughing? In the words where the Yellow Emperor instructed Leigong, it says: "Not knowing analogy (Bilei) is sufficient to confuse oneself, insufficient to clarify oneself." It is indeed known that the method of analogy is sufficient not only to cover the meaning of the *Huangdi Neijing* but also to cover the meaning of the infinite and boundless. Just as looking at the sky through a tube or measuring the sea with a ladle, the texts overlooked by the *Huangdi Neijing* over thousands of years, once analogy is understood, can be verified as consistent in one hall. When facing complex diseases, handling them with ease is taken for granted. Let me elaborate further. Although Qibo stated that all five zang and six fu organs can cause coughing, his emphasis lies entirely on the lung. Observing the following text: "The skin and hair are the exterior correspondence of the lung. When pathogenic factors first invade the skin and hair, they enter the interior through this correspondence. Cold food entering the stomach travels up along the stomach meridian to the lung, causing lung cold. Lung cold results in the combination of internal and external pathogenic factors, which then lodge in the lung, resulting in lung cough." This cites one aspect of damage to the lung due to external cold exposure and cold beverages to explain the initial cause of coughing. The four characters "combination of internal and external pathogenic factors" (Neiwai Hexie) capture the essence; the method of analogy emphasizes this point. The human body has external pathogens, internal pathogens, combined internal and external pathogens, cases where external pathogens are gone but internal ones remain unresolved, and cases where internal pathogens are cleared but external ones are not fully eliminated. With simple analogy, these become clear. Why not distinguish them early and allow them to brew deep troubles? "Formal cold" refers to external contraction of wind-cold. "Drinking cold" refers to internal injury from diet. Formless pathogenic factors like wind-cold entering the interior combine with tangible pathogenic factors from diet, inevitably lingering. Treatment requires expelling external pathogens outward and internal pathogens downward, but one cannot treat both exterior and interior simultaneously. The five formulas in the *Jinkui Yaolue* generally do not go beyond modifications of Xiao Qinglong Tang (Minor Blue Dragon Decoction). Thus, the *Huangdi Neijing* has its discussion, and the *Jinkui Yaolue* has its formulas. For what is absent in both, seeking it through analogy, where should one start? Proceeding to explore damp-heat (Shushi), damp-heat pathogenic factors are also sufficient to cause coughing. Generally, when external damp-heat enters the interior, it must combine with pre-existing heat pathogens, increasing vexatious coughing. One should use acrid-cool dispersing methods, changing the example of Xiao Qinglong Tang to Baihu Tang (White Tiger Decoction), and additionally using formulas such as Tianshui San (Heavenly Water Powder) and Wuling San (Five苓 Powder). Proceeding to explore fire pathogens, there is a combination of Ministerial Fire (Xiang Huo) and Sovereign Fire (Jun Huo), but no combination of internal and external pathogens, yet ten out of eight or nine cases of causing coughing arise from this. Since the heart and lung reside together above the diaphragm, heart fire easily controls lung metal. However, sovereign fire governs without action and rarely moves spontaneously. Sometimes laboring the heart causes coughing, and resting the heart stops the cough naturally, which is not yet a disaster of peeling skin. Only ministerial fire rises from below, carrying the majesty of sovereign fire to punish the lung. Upper and lower pathogenic combinations cause the most severe harm. Treatment can also be analogized to the example of combined internal and external pathogens, either guiding down or reducing down to suppress the fire, preventing it from spreading like a prairie fire. Among these, coughing with vexation and resentment, with rebellious kidney qi, also belongs to upper-lower combination. However, turbid yin qi invades clear yang upwards, blocked by the diaphragm and huang, allowing the vexation to persist without emergence. Only by driving down the turbid yin will the cough stop. Proceeding to explore dryness (Zao), internal and external, upper and lower, initially have no fixed attribution. It may be due to excessive sweating or vomiting causing fluids to escape outward; or prolonged diarrhea causing yin loss downward; or deficient nutritive blood failing to nourish sinews; or exhausted essence and marrow failing to fill bones. This leads to daily drying of lung metal, inability to resist invading fire, and ceaseless coughing. At this time, urgently generating fluids, nourishing blood, and supplementing essence and water can still save the situation. Missing this opportunity to treat, in a blink, jars become empty and cups dry, hair becomes brittle and complexion deteriorates, sinews contract and nails wither, cough pulls chest and back, hypochondriac pain hangs, lung qi stagnates, various wasting-thirst syndromes, wheezing, and vomiting occur, throat obstruction and bloody stool appear, and various critical signs follow sequentially. What method remains to moisten this scorched dryness? The Classic states that if coughing persists and white blood is expectorated, death ensues. Is this not because the lung is fried by dryness-fire and rots, and its blood transforms according to metal properties becoming white? As for coughing from all five zang and six fu organs, which the *Neijing* does not exhaustively describe, they can essentially be understood through analogy and integration. My limited knowledge, starting from the aspect of formal cold and cold beverages damaging the lung, analogizing to damp-heat, fire, and dryness, is merely a rough aid to inspire intelligence. Deep theoretical discussions from the root must await future generations.