钱乙曰。夫嗽者。肺感微寒。八九月肺气大旺。病嗽者必实。非久病也。其症面赤痰盛。或身热。宜葶苈丸下之。
久者不可下也。十一二月嗽者。乃伤风嗽也。风从背脊第三椎肺俞穴入也。宜麻黄汤汗之。有热症面赤饮水涎热。咽喉
不
利者。宜兼甘桔汤。若五七日间身热痰盛唾粘者。褊银丸下之。有肺盛者。咳而后喘。面肿欲饮水。有不饮水者。其身
即热。泻白散。若伤风嗽。五七日无热症而但嗽者。亦可用葶苈丸。后用下痰药。有肺虚者。咳而哽气。时时常出气。
喉中有声。此久病也。阿胶散补之。痰盛者。先实脾。后以褊银丸微下之。痰退。即补肺如上法。盖久嗽者。肺亡津液。
故必用阿胶散。治嗽大法。盛则下之。久即补之。更量虚实。以意为增损。
圣惠方曰。小儿嗽而呀呷作声者。由胸膈痰多嗽动。其痰上搏于咽喉之间。痰与气相击。随嗽动息。呀呷有声。其
咳嗽本体虽同。而于治疗则加消痰破饮之药。以此为异耳。宜圣惠射干散。
罗谦甫曰。小儿 症。本由暑热所侵。未经发散。邪传心肺。变而为热。热生风。风生痰。痰实不化。因循日久。
结为顽块。圆如豆粒。遂成痰母。推本其原。或啼哭未休。遽与乳食。或饲以酸咸。气郁不利。致令生痰。或风寒暑湿
侵袭。或堕水中。水入口鼻。传之于肺。故痰母发动而风随之。风痰潮紧。气促而喘。乃成痼痰。急宜去风化痰。先以
五苓散同宽气饮、宽热饮。稍用姜汁和匀。沸汤调服。次进知母汤、半夏丸治之。
张元素曰。嗽而两胁痛者。属肝经。小柴胡汤。嗽而呕苦者。属胆经。黄芩半夏生姜汤。嗽而喉中如梗者。属心经。
甘桔汤。嗽而失气者。属小肠。芍药甘草汤。嗽而右胁痛者。属脾经。升麻汤。咳而呕长虫者。属胃经。乌梅丸。嗽而
喘息吐血者。属肺经。麻黄汤。咳而遗尿者。属大肠。赤石脂汤。咳而腰背痛。甚则咳涎者。属肾经。麻黄附子细辛汤。
咳而遗溺者。属膀胱。茯苓甘草汤。咳而腹满。不欲食。面肿。气虚者。属三焦。异功散。
曾氏曰。脾虚亦能作嗽。当投补剂。醒脾散、茯苓浓朴汤。令脾气实。然后间与清肺饮。疏解肺经风寒。及藿香饮
助脾养胃。亦救子益母之法也。有一症。咳嗽至极时。顿呕吐。乳食与痰俱出尽。方少定。此名
风痰壅盛。肝木克脾土。用白附饮治之。
薛己曰。咳嗽流涕。外邪伤肺也。参苏饮。咳嗽面赤。心火刑肺也。人参平肺散。嗽而吐青绿水。肝木乘脾也。异
功散加柴胡。嗽而吐痰乳。脾肺气伤也。六君加桔梗。嗽而吐脓痰。热蕴于肺而成肺痈也。桔梗汤。凡风邪外伤。法当
表散而实腠理。其用下药。非邪传于内。及胃有实热者。不宜轻用。面色白。脉短涩者。肺之本症也。易治。面色赤。
脉洪数者。火刑金也。难治。
钱乙说：咳嗽，是肺受到轻微寒邪侵袭所致。在农历八、九月，肺气旺盛，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，或者身体发热，适宜用葶苈丸（Tingli Wan）攻下治疗。
如果是久咳，则不可使用攻下法。在农历十一、十二月出现的咳嗽，属于伤风咳嗽。风邪从背部第三椎骨处的肺俞穴（Feishu, BL13）侵入体内。适宜用麻黄汤（Mahuang Tang）发汗解表。如果伴有热症，如面色发红、口渴饮水、唾液发热、咽喉不利者，适宜兼用甘桔汤（Ganjie Tang）。若在发病五到七天内，身体发热、痰多且唾沫粘稠者，宜用褊银丸（Pianyin Wan）攻下。若肺气盛实，表现为先咳嗽后气喘，面部浮肿想喝水，或者不想喝水但身体即感发热者，宜用泻白散（Xiebai San）。若是伤风咳嗽，在五到七天内没有热症而仅仅咳嗽的，也可以用葶苈丸，之后再用化痰药。若有肺气虚者，表现为咳嗽时气逆哽塞，时常长出气，喉中有声音，这是久病，宜用阿胶散（Ejiao San）补益。若痰多者，先健脾实脾，后用褊银丸轻微攻下。待痰退后，再按上述方法补肺。大概久咳的人，肺中津液耗亡，所以必须用阿胶散。治疗咳嗽的大法则是：实证则攻下，久病则补益，更要衡量虚实情况，酌情增减。
《圣惠方》说：小儿咳嗽发出呀呷声，是由于胸膈间痰多，咳嗽触动痰液，痰上冲搏结于咽喉之间，痰与气相互撞击，随着咳嗽动作起伏，发出呀呷的声音。虽然咳嗽的本体相同，但在治疗上需增加消痰破饮的药物，以此作为区别。适宜用《圣惠方》中的射干散（Shegan San）。
罗谦甫说：小儿惊风证，原本由暑热邪气侵袭所致，未经发散，邪气传入心肺，转化为热，热生风，风生痰，痰实无法化解，拖延日久，结成顽固块状，圆如豆粒，遂成为“痰母”。追溯其根源，或是啼哭未停就立即给予乳食，或是喂食酸咸食物，导致气机郁滞不畅，致使生痰；或是风寒暑湿侵袭，或坠入水中，水进入口鼻，传之于肺，因此痰母发动而风邪随之而来。风痰潮急，气促喘息，便成了顽固之痰。急需祛风化痰，先用五苓散（Wuling San）配合宽气饮、宽热饮，稍加姜汁调和均匀，用沸水调服。随后进服知母汤、半夏丸进行治疗。
张元素说：咳嗽且两胁疼痛的，属于肝经病变，用小柴胡汤（Xiaochaihu Tang）。咳嗽且呕吐苦水的，属于胆经病变，用黄芩半夏生姜汤（Huangqin Banxia Shengjiang Tang）。咳嗽且喉咙中有异物梗阻感的，属于心经病变，用甘桔汤。咳嗽且放屁的，属于小肠病变，用芍药甘草汤（Shaoyao Gancao Tang）。咳嗽且右胁疼痛的，属于脾经病变，用升麻汤（Shengma Tang）。咳嗽且吐出长虫的，属于胃经病变，用乌梅丸（Wumei Wan）。咳嗽且喘息吐血者，属于肺经病变，用麻黄汤。咳嗽且遗尿者，属于大肠病变，用赤石脂汤（Chishizhi Tang）。咳嗽且腰背疼痛，严重时咳出涎沫者，属于肾经病变，用麻黄附子细辛汤（Mahuang Fuzi Xixin Tang）。咳嗽且遗溺者，属于膀胱病变，用茯苓甘草汤（Fuling Gancao Tang）。咳嗽且腹部胀满，不想进食，面部浮肿，气虚者，属于三焦病变，用异功散（Yigong San）。
曾氏说：脾虚也能引起咳嗽，应当投用补剂，如醒脾散、茯苓浓朴汤，使脾气充实，然后间歇性地给予清肺饮，疏解肺经的风寒，以及藿香饮帮助脾胃养胃，这也是“救子益母”的方法。有一种症状，咳嗽至极时，突然呕吐，乳食与痰全部吐出，方才稍微平静，这名叫风痰壅盛，肝木克伐脾土，用白附饮（Baifu Yin）治疗。
薛己说：咳嗽流涕，是外邪伤肺，用参苏饮（Rensu Yin）。咳嗽且面色发红，是心火刑克肺金，用人参平肺散（Renshen Pingfei San）。咳嗽且吐出青绿水，是肝木乘袭脾土，用异功散加柴胡。咳嗽且吐出痰乳，是脾肺气受伤，用六君子汤加桔梗。咳嗽且吐出脓痰，是热蕴积于肺而成肺痈，用桔梗汤（Jiegeng Tang）。凡是风邪外伤，治法应当解表散邪并充实腠理，如果不是邪气传入内部及胃有实热的情况，不宜轻易使用下药。面色苍白，脉短涩的，是肺的本证，容易治疗。面色发红，脉洪数的，是火刑克金，难以治疗。
Qian Yi stated: Cough is caused by the lung being affected by slight cold. In the eighth and ninth lunar months, Lung Qi is flourishing; coughs occurring at this time are necessarily excess patterns and not chronic diseases. The symptoms include a red face and abundant phlegm, or fever. It is appropriate to use Tingli Wan (Thladianthae Fructus Pill) to purge downward.
If it is a chronic cough, purging should not be used. Coughs occurring in the eleventh and twelfth lunar months are wind-cold coughs. The wind pathogen enters through the Feishu (BL13) acupoint located at the third thoracic vertebra on the back. It is appropriate to use Mahuang Tang (Ephedra Decoction) to induce sweating. If there are heat symptoms such as a red face, thirst with drinking, hot saliva, and throat discomfort, it is appropriate to combine with Ganjie Tang (Licorice and Platycodon Decoction). If within five to seven days there is fever, abundant phlegm, and sticky sputum, Pianyin Wan (Bitter Silver Pill) should be used to purge downward. If Lung Qi is excessive, manifesting as cough followed by wheezing, facial edema, and desire to drink water (or no desire to drink but immediate body heat), Xiebai San (Drain White Powder) is indicated. For wind-cold cough without heat symptoms after five to seven days, only coughing present, Tingli Wan may also be used, followed by phlegm-resolving medicines. If Lung Qi is deficient, manifesting as cough with qi obstruction, frequent sighing, and sounds in the throat, this is a chronic disease treated with Ejiao San (Donkey-hide Gelatin Decoction) for tonification. If phlegm is abundant, first strengthen the Spleen, then mildly purge with Pianyin Wan. After phlegm recedes, tonify the Lung using the aforementioned method. Generally, in chronic cough, Lung fluids are depleted, so Ejiao San must be used. The general principle for treating cough is: excess patterns are purged, chronic conditions are tonified, and adjustments are made based on deficiency and excess.
The *Shenghui Fang* states: When children cough with a rattling sound ("ya xia"), it is due to excessive phlegm in the chest and diaphragm moving during coughing. The phlegm rises and strikes the throat, where phlegm and qi collide, producing rattling sounds synchronized with the cough. Although the nature of the cough is the same, treatment differs by adding herbs that resolve phlegm and break fluid retention. The *Shenghui Fang* Shegan San (Belamcanda Decoction) is indicated.
Luo Qianfu stated: The pediatric convulsion syndrome originates from invasion by summer-heat, which was not dispersed, allowing pathogens to transmit to the Heart and Lung, transforming into heat. Heat generates wind, wind generates phlegm. The phlegm becomes solid and fails to transform. Over time, it knots into stubborn masses, round like bean grains, becoming "phlegm mothers." Tracing the origin, crying without rest followed immediately by feeding, or feeding sour and salty foods, causes qi stagnation and difficulty in flow, leading to phlegm production. Alternatively, invasion by wind, cold, summer-heat, and dampness, or falling into water where water enters the mouth and nose and transmits to the Lung, causes the "phlegm mother" to activate with accompanying wind. Wind-phlegm surges urgently, causing rapid breathing and wheezing, forming stubborn phlegm. Urgent treatment requires dispelling wind and resolving phlegm. First, administer Wuling San (Five-Ingredient Poria Decoction) combined with Kuanqi Yin (Qi-Widening Drink) and Kuanye Yin (Heat-Widening Drink), mixed with a little ginger juice, and taken with boiling water. Subsequently, administer Zhimu Tang (Anemarrhena Decoction) and Banxia Wan (Pinellia Pill) for treatment.
Zhang Yuansu stated: Cough with pain in both hypochondria belongs to the Liver channel; treat with Xiaochaihu Tang (Minor Bupleurum Decoction). Cough with bitter vomiting belongs to the Gallbladder channel; treat with Huangqin Banxia Shengjiang Tang (Scutellaria, Pinellia, and Fresh Ginger Decoction). Cough with a sensation of obstruction in the throat belongs to the Heart channel; treat with Ganjie Tang. Cough with flatus belongs to the Small Intestine channel; treat with Shaoyao Gancao Tang (Peony and Licorice Decoction). Cough with right hypochondriac pain belongs to the Spleen channel; treat with Shengma Tang (Cimicifuga Decoction). Cough with expulsion of long worms belongs to the Stomach channel; treat with Wumei Wan (Mume Pill). Cough with wheezing and hemoptysis belongs to the Lung channel; treat with Mahuang Tang. Cough with enuresis belongs to the Large Intestine channel; treat with Chishizhi Tang (Red Halloysite Decoction). Cough with lower back and waist pain, or severe coughing up of saliva, belongs to the Kidney channel; treat with Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction). Cough with urinary incontinence belongs to the Bladder channel; treat with Fuling Gancao Tang (Poria and Licorice Decoction). Cough with abdominal fullness, anorexia, facial edema, and qi deficiency belongs to the Triple Burner; treat with Yigong San (Extraordinary Skill Powder).
Zeng Shi stated: Spleen deficiency can also cause cough. Tonifying agents such as Xingpi San (Spleen-Awakening Powder) and Fuling Niu Bang Tang (Poria and Magnolia Bark Decoction) should be administered to solidify Spleen qi. Then, intermittently administer Qingfei Yin (Lung-Clearing Drink) to disperse wind-cold in the Lung channel, and Huoxiang Yin (Agastache Drink) to assist the Spleen and nourish the Stomach. This is also the method of "saving the child by benefiting the mother." One symptom involves extreme coughing leading to sudden vomiting, expelling milk, food, and phlegm completely, after which the patient calms slightly. This is named excessive wind-phlegm turbidity, where Liver wood overacts on Spleen earth. Treat with Baifu Yin (White Attitude Drink).
Xue Ji stated: Cough with runny nose indicates external pathogens injuring the Lung; treat with Rensu Yin (Ginseng and Perilla Leaf Decoction). Cough with a red face indicates Heart fire punishing Lung metal; treat with Renshen Pingfei San (Ginseng Lung-Pacifying Powder). Cough with vomiting of green or clear water indicates Liver wood invading Spleen earth; treat with Yigong San added with Chaihu (Bupleurum). Cough with vomiting of phlegm-milk mixture indicates injury to Spleen and Lung qi; treat with Liujun Zi Tang (Six-Gentlemen Decoction) added with Jiegeng (Platycodon). Cough with purulent sputum indicates heat accumulating in the Lung forming Lung abscess; treat with Jiegeng Tang. For external wind pathogens, the method should be to release the exterior and consolidate the interstices. Purging medicines should not be used lightly unless pathogens have transmitted internally or there is excess heat in the Stomach. A pale face with short and choppy pulse indicates the primary pattern of the Lung; it is easy to treat. A red face with flooding and rapid pulse indicates fire punishing metal; it is difficult to treat.