息不得卧。背寒则嗽甚。小青龙汤、桂苓五味甘草汤。各随方下变证加减。客邪伤肺。久嗽不止。
宁嗽化痰汤。形寒饮冷咳嗽。兼腹痛脉弦者。小建中汤加桔梗以提肺气之陷。寒热自汗。加黄 。
冬月嗽而发寒热。谓之寒嗽。小青龙汤加杏仁。冷热嗽。因增减衣裳。寒热俱感。遇乍寒乍热亦
嗽。饮热饮冷亦嗽。脉浮。风重。金沸草散。脉数或涩。热重。葳蕤汤去川芎。加香豉三钱。入
房汗出中风。嗽而面赤。内经谓之内风。脉浮紧。小青龙。脉沉紧。真武汤。饮酒中风。多汗而
嗽。谓之漏风。桂枝汤加泽泻、术、麻黄根。水肿脉浮自汗。喘嗽便秘。小青龙加葶苈、木香。
喘嗽脉沉畏寒。生料济生肾气丸煎服。有先伤风。咳嗽未除。更伤于热而咳嗽声嘶者。为热包寒。
葳蕤汤加减。有素咳嗽人。更感于寒。而咳嗽声哑者。为寒包热。金沸草散去芍药加石膏。不应。
用越婢汤。热嗽失音。多服寒剂。声愈不出者。古今录验续命汤发之。轻则消风散去僵蚕、蝉蜕。
加桔梗、薄荷。以生姜汁调服。冷热嗽失音尤宜。夏月嗽而发热者。小柴胡加石膏、知母。但手
足心热而不发热者。泻白散加橘红、桔梗。不应。凉膈散去硝、黄。加葳蕤、蜂蜜。伤热而嗽者。
脉数烦渴引饮。咽喉干痛。鼻出热气。喉声不清。咳唾稠粘。其痰屡咳而难出。色黄且浓。或带
血缕。或出血腥臭。或坚如蚬肉。不若风寒之嗽。痰清而白也。葳蕤汤。风热相兼。加减葱白香
豉汤。凡咳嗽面赤。胸腹胁常热。惟手足乍有凉时。其脉洪者。热痰在膈上也。小陷胸汤。感湿
嗽者。脉细而缓。身体重着。
骨节烦疼。或自汗。或小便不利。麻黄加术汤。有一嗽痰即出者。胛湿胜而痰滑也。有连嗽十数
声。痰不即出者。肺燥胜而痰涩也。咳而无痰者。以甘寒润其肺。痰多致嗽者。以辛平燥其脾。
形盛自汗。脉缓体重嗜卧之人咳者。脾湿胜也。二陈加防己、黄 、白术之类。兼食积痰垢壅塞
不利者。千缗汤荡涤之。兼食积痰气蕴酿火邪者。二陈加枳、术、黄连消导之。秋深伤热咳嗽而
洒淅恶寒发热者。千金麦门冬汤。但嗽无寒热。痰不得出。极力咯之乃得一丝粘痰者。千金五味
子汤。咳而无声者。肺气伤而不清。乃痰郁火邪在中不能上出。此肺燥也。桔梗汤加贝母、葳蕤、
蜜炙枇杷叶。洁古云。咳而无痰者。以辛甘润其肺。蜜煎姜、橘。蜜烧连皮胡桃。虚人当用人参
同蜜烧胡桃。不时细嚼。或二味煎服最妙。即观音应梦散。久嗽声飒者。古法用酥蜜膏。今改用
生地黄煎。取辛以润之。咳嗽声哑。气促满闷。语声不出者。心包火盛而肺气受伤也。古法用通
声膏。今改用千金地黄煎。取润以泄之。盖声飒虽云金实不鸣。久嗽多缘肺气枯槁。是当清润为
主。实则二陈、桔、薄、葳蕤。蜜煎姜、橘之类。枯则生脉、二冬、款冬、竹茹。亦加蜜煎姜、
橘。又当详形气之肥瘠。时令之寒喧而为施治。声哑须分暴久。暴多寒郁热邪而肺络壅塞。久多
热伤肺痿而真气受伤。壅则麻杏甘石。苓、半、姜、橘等。随微甚以搜涤之。伤则异功、生脉、
保元。参脉证以培养之。若风热心烦。咳喘便秘。脾胃热壅。食不下者。千金地黄煎主之。不可
拘于成则而废活法也。若喘咳失血。声飒音哑。食少便泄之金破不鸣。岐彭不能图治也。其生姜
治咳嗽声哑。惟暴嗽寒郁。肺气不通者为宜。若久嗽热伤肺气而喑者。虽二冬、二母、二地、黄
芩、花粉等。寒凉敛肺。为之禁剂。而麻、杏、辛、桂辛散耗气。亦为戈戟。其诃子、五味酸涩
固气。尤须慎详。壅嗽声重痰稠。或咳有血。以薄荷、生胡麻各一撮细嚼。煎苏子降气汤送下。
七情饥饱嗽。动传脏腑正气。致邪上逆。结
成痰涎。肺道不利。四七汤加杏仁、五味、人参、阿胶、麦冬。劳心思虑。心血耗散。人每有思
虑。则心火上乘。必发干咳。此为神伤。虽服药亦难取效。以归脾汤加麦冬、五味。作膏蜜收。
其木香或减半。或换砂仁。另为细末。离火加入。不时滋养方妙。大抵干咳。乃燥气乘肺。属火
郁证。乃痰郁火邪在肺。先用逍遥散加苦桔以开之。后用六味丸加五味以补之。不已。则成劳。
此证不得志者有之。咳嗽痛引肩背。虽久不已。不可误认为虚。此属三焦郁火。加味逍遥散。浊
痰。加味导痰汤。如咳而胁痛。宜疏肝气。枳壳煮散。或去川芎加青皮、柴胡、香附、姜汁之属。
肥盛气实者。二陈汤加白芥子。火热咳嗽。喉哑痰浓。或大便秘结者。凉膈散加桔梗。凡内伤气
虚不能上输于肺。而时嗽时止。其人黄白少神。脉亦虚微少力。补中益气去升麻。加煨葛根、麦
冬、五味。或兼肾水不足。前汤送下都气丸。咳嗽痰中见血而脉细者。此火邪伤血分也。归脾汤。
若痰中微有少血。或血丝。此肝血伤也。补中益气去升麻。加白芍、丹皮。前后心胀。喉中有血
腥气。气口脉涩。此膈间有蓄血也。试法。呷热姜汤作呃者。瘀血也。犀角地黄汤加童便、桃仁、
大黄攻散之。或平胃合越鞠。加韭汁、童便消伐之。气竭肝伤而咳嗽血腥者。四乌 骨一芦茹丸。
内伤瘀积在胃。不时吐血者。其人面色槁而滞。脉多弦涩。当先与百劳丸去瘀。后用异功、六君
调补。有兼停饮食而咳。须用消化之方。不可用乌梅、粟壳酸涩药。其寒邪未除。宜用发散之剂。
不可便用补药。咳嗽而面白。悲。嚏。或咳白痰白沫。属肺胃虚寒。若胸胁逆满。牵引背痛。心
腹冷痛。饮食即吐者。温肺汤。口甘涎沫流。脉沉弦细迟。属中寒。口出清水。心下汪洋作嘈杂。
胸胁胀痛不食。属冷冻饮料停于胃中。攻肺则咳。半夏温肺汤。兼芦吸散亦妙。嗽而声喑气乏。寒从
背起。口中如含冰雪。甚则吐血。此肺气不足。胃气虚寒也。千金补肺汤。嗽而声哑脉细者属寒。
宜半夏、生姜、细辛以辛散之。
如饮冷热酒。伤肺致嗽。谓之凑肺。或兼煎爆伤胃。咳嗽咽痒。痰多唾血。喘急胁痛。不得安卧。
改定紫菀茸汤。咳嗽呕吐并作。为肺胃俱病。先安胃气。二陈加芦根、姜汁、姜制枇杷叶。虚者。
六君子加桔梗。有咳嗽吐痰与食俱出者。此饮食失节。脾气不利。清浊相干。二陈加枳、术、杏
仁、细辛。有食积痰嗽发热。其人面青白黄色不常。面上有黄白纹痕者。二陈加香附、枳壳、曲、
。食积发热。加姜汁炒川连。停寒食作嗽。加炮姜。嗽而得食即缓者。脾虚也。异功散。有痰。
六君子。外感咳嗽与阴虚咳嗽。尤宜辨晰。外感咳嗽则声盛而浊。先缓后急。日夜无度。痰涎稠
粘而喘急。阴虚劳嗽则声怯而槁。先急后缓。或早甚。或暮甚。清痰少气而喘乏也。阴虚脉弦而
数。或细数。或涩。证兼盗汗。下午作寒热。面色纯白。两颊赤。多清痰干咳者。劳也。属阴虚
火盛。夜服六味丸。晨服异功散。久嗽之人。发散清肺俱不应。胸膈不利。咳唾脓血。坐卧不宁。
语言不出者。将成肺痿之候也。紫菀散。肺热顿嗽。肌肤灼热。面赤如醉者。紫菀膏微利之。治
嗽须分新久虚实。如久嗽脉弱。或虽洪大按之不鼓。属肺虚。宜门冬、五味子、款冬、紫菀之类
敛而补之。酒色过度。虚劳少血。津液内耗。心火自炎。致令燥热乘肺。咯唾脓血。上气涎潮。
其嗽连续不已。加以邪客皮毛。入伤于肺。而自背得之尤速。当与炙甘草汤。或黄 建中加丹皮。
盖丹皮辛香。调和营气。治无汗骨蒸。故阴虚人解表。以丹皮为向导。好色之人元气素弱。咳嗽
不愈。喉中血腥。肠中隐痛。琼玉膏。不应。加减八味丸。久服乃效。有暴嗽。诸药不效。服生
料鹿茸丸。即愈。此乃肾虚所致。不可以暴嗽而疑遽补之非。有便溺如常。饮食不妨而咳嗽不安。
或兼血腥。年久不愈者。此肺胃虚热也。异功散加丹皮、山药。有肺胃虚弱。咳嗽喘促。或时吐
血衄血。自汗盗汗者。门冬清肺饮。劳嗽。即火郁嗽。因火伤迫。遂成郁遏胀满。一边不得眠者
难治。咳嗽吐粉红痰。谓之吐白血。仅
可绵延岁月。若血色正赤如朱。浓浓如漆。为守藏血。不治。有经年累月久嗽。服药不瘥。余无
他证。此是风寒客邪。久伏肺胃也。与劳嗽不同。三拗汤。佐以千缗汤。瘦人多火禁用。若饥时
胸中大痛。唇面上有白点如粞。咽喉或痒或痛。而咳不可忍。脉极数。或忽大忽小。此必肺中有
寸白虫。饥则虫上求食。痛嗽不宁也。一味百部熬膏。略加槟榔、乌梅。上半日嗽多。属胃中有
火。竹叶石膏汤降泄之。胃气虚者。补中益气或五味异功。并加山栀。午后嗽多。属阴虚。六味
丸加麦冬、五味以敛之。黄昏嗽者。火浮于肺。不宜用凉药。都气丸敛而降之。五更嗽甚者。胃
中有食积也。二陈汤加枳实、川连以消导之。虚者。六君子加姜汁炒川连。增补素问五脏六腑咳
治例。肺咳。千金五味子汤去续断、地黄、赤小豆。加麦门冬、葳蕤、细辛。心咳。凉膈散去硝、
黄。加黄连、竹叶。肝咳。枳壳煮散去芎、防。加肉桂、橘红、苏子。脾咳。六君子汤加枳壳、
桔梗。肾咳。都气丸加麦门冬、人参。胃咳。异功散加蜀椒、黄连、乌梅。胆咳。小柴胡汤加芦
根汁。大肠咳。补中益气汤去升麻加桔硬。小肠咳。桔梗汤加人参、茯苓、橘红、五味。膀胱咳。
五苓散加人参。三焦咳。局方七气汤加黄连、枳实。久嗽服药不应。可用熏法。款冬花将蜜拌润。
焙干。入有嘴壶中烧。吸烟咽之。若胸中闷。举起头。以指掩定烟。稍间再吸。杏仁散肺中风热。
然肺实有火。因风寒者为宜。桑皮泻肺气。然性不纯良。虚寒者当戒。补肺多用生姜。以其辛能
发散也。栝蒌仁甘能润肺。寒能降火。治热嗽之要药。阴虚血虚者勿用。以其能作呕作泻也。咳
而吐痰。膺乳痛。当看痰色如何。若浓浊如脓。或带血丝而臭。当从肺痈例治之。
〔诊〕咳嗽之脉。浮为风。紧为寒。洪数为热。濡细为湿。寸关涩难而尺内弦紧。为房劳阴虚。
右关濡大。为饮食伤脾。左关弦数。为疲极肝伤。右寸浮短为伤肺。迟涩肺寒。咳嗽洪滑为多痰。
弦涩为少血。肺脉微急。咳而唾血。脉或沉或
浮。声不损者。易治。脉来洪数。形瘦面赤。肾脏气衰。不能上循于喉而声哑者难疗。亦有肺络
支塞而声哑者。不在此例。暴病咳嗽。睡卧不下。为肺胀。可治。久病喘嗽。左侧不能卧者。为
肝伤。若精力未衰者可治。右边不能卧者。为肺损。无问新久。皆不可治。久嗽脉弱者生。实大
数者死。咳而脱形身热。脉小坚急以疾为逆。不出十五日死。咳脱形。身热脉疾。不过五日死。
咳溲血。形肉脱。脉搏者死。咳呕腹胀。且飧泄。其脉绝。不及一时而死。咳嗽形羸。脉形坚大
者死。沉紧及伏匿者死。浮直者可治。浮软者易治。咳而呕。腹满泄泻。脉弦急欲绝者死。久嗽
数岁。其脉弱者可治。实大数者死。其脉虚者必苦冒。其人本有支饮在胸中故也。治属饮家。
石顽疗吴江邑侯华野郭公。仲秋喘嗽气逆。诊之两尺左关弦数。两寸右关涩数。弦者肾之虚。
涩者肺之燥。夏暑内伏肺络。遇秋燥收之令。而发为咳嗽也。诊后公详述病情。言每岁交秋则咳。
连发四载。屡咳痰不得出则喘。至夜坐不得卧。咳剧则大便枯燥有血。先曾服令高徒施元倩越婢
汤。嗽即稍可。数日间堂事劳心。复咳如前。时元倩归苕。松陵诸医。治之罔效。因求洞垣之鉴。
起我沉 。答曰。公本东鲁。肾气素强。因水亏火旺。阴火上烁肺金。金燥不能生水。所以至秋
则咳。咳剧则便燥有血。肺移热于大肠之明验也。合用千金麦门冬汤。除去半夏、生姜之辛燥。
易以葳蕤、白蜜之甘润。藉麻黄以鼓舞麦冬、生地之力。与越婢汤中麻黄、石膏分解互结之燥热
同一义也。郭公曰。松陵诸医。咸诋麻黄为发汗之重剂。不可轻试。仅用杏仁、苏子、甘、桔、
前胡等药。服之其咳转甚何也。答言。麻黄虽云主表。今在麦门冬汤中。不过借以开发肺气。原
非发汗之谓。麻黄在大青龙汤、麻黄汤、麻杏甘石汤方。其力便峻。以其中皆有杏仁也。杏仁虽
举世视为治嗽之通药不。问虚实浑用。然辛温走肺。最不纯良。耗气动血
莫此为甚。熬黑入大陷胸丸。佐甘遂等搜逐结垢。性味可知。公首肯以为然。连进二剂。是夜便
得安寝。次早复诊。其脉之弦虽未退。而按之稍 。气口则虚濡乏力。因与六味、生脉。加葳蕤、
白蜜作汤四服。其嗽顿减。郭公复云。向闻元倩有言。六味、八味丸中。不可杂用参、术。而先
生居之不疑。用之辄应。其义云何。答曰。六味为填补真阴药。与人参同用。原非正理。此兼麦
冬、五味。缘合肺肾金水相生。当无留中恋膈之虑。善后之策。即以此方制丸。三时恒服不彻。
至秋庶无复嗽之虞。先是公子柔痉。予用桂枝汤。及六味作汤。咸加蝎尾。服之而瘥。其后夫人
素有败痰失道。左右两胁俱有结块。大如覆杯。发则咳嗽喘逆。腹胁掣痛。六脉止促而按之少力。
呼吸急促，无法平卧。背部发冷则咳嗽加重。用小青龙汤、桂苓五味甘草汤。根据方证变化进行加减。外邪侵袭肺部。久咳不止。
用宁嗽化痰汤。因受寒饮冷导致的咳嗽，兼有腹痛、脉弦的，用小建中汤加桔梗以提举下陷的肺气。若见寒热往来、自汗，加黄芩。
冬季咳嗽并伴有寒热的，称为寒嗽。用小青龙汤加杏仁。冷热夹杂的咳嗽，因增减衣物不当，同时感受寒热之邪，遇到突然变冷或变热也咳嗽，喝热饮或冷饮也咳嗽。脉浮，风邪偏重，用金沸草散。脉数或涩，热邪偏重，用葳蕤汤去掉川芎，加香豉三钱。
进入房事后出汗又中风，咳嗽且面色发红，《内经》称之为内风。脉浮紧，用小青龙汤。脉沉紧，用真武汤。饮酒后中风，多汗且咳嗽，称为漏风。用桂枝汤加泽泻、白术、麻黄根。水肿且脉浮、自汗，喘咳便秘，用小青龙汤加葶苈子、木香。
喘咳且脉沉、畏寒，用生料济生肾气丸煎服。有人先伤风，咳嗽未愈，又受热邪侵袭而咳嗽声嘶哑的，为热邪包裹寒邪（热包寒）。用葳蕤汤加减。有人素来咳嗽，又感寒邪而咳嗽声哑的，为寒邪包裹热邪（寒包热）。用金沸草散去芍药加石膏。若无效，用越婢汤。
热嗽导致失音，多服寒凉药物后声音仍不出者，用古今录验续命汤发散。轻症用消风散去僵蚕、蝉蜕，加桔梗、薄荷，用生姜汁调服。冷热嗽导致失音尤其适宜。夏季咳嗽且发热，用小柴胡汤加石膏、知母。仅手足心热而不全身发热的，用泻白散加橘红、桔梗。若无效，用凉膈散去芒硝、大黄，加葳蕤、蜂蜜。
伤热邪而咳嗽的，脉数、心烦口渴想喝水，咽喉干痛，鼻孔出热气，喉间声音不清，咳吐稠粘痰液，痰多次咳嗽难以排出，颜色黄且浓稠，或带血丝，或出血腥臭，或坚硬如蚬肉，不像风寒咳嗽那样痰清色白。用葳蕤汤。风热相兼，用加减葱白香豉汤。
凡是咳嗽面赤，胸腹胁部常觉发热，只有手足偶尔发凉的，其脉洪大，是热痰在膈上。用小陷胸汤。
感受湿邪而咳嗽的，脉细而缓，身体沉重，骨节烦疼，或自汗，或小便不利，用麻黄加术汤。
有一种咳嗽痰随即而出的，是脾湿胜而痰滑。有一种连续咳嗽十数声，痰不立即出来的，是肺燥胜而痰涩。
咳嗽而无痰的，用甘寒药物滋润肺脏。痰多导致咳嗽的，用辛平药物燥湿健脾。
形体丰盛、自汗、脉缓、身体沉重嗜睡的人咳嗽，是脾湿胜。用二陈汤加防己、黄芩、白术之类。兼有食积、痰垢壅塞不利的，用千缗汤荡涤。兼有食积、痰气蕴酿火邪的，用二陈汤加枳实、白术、黄连消导。
深秋伤热邪咳嗽并伴有洒淅恶寒发热的，用千金麦门冬汤。仅咳嗽无寒热，痰出不来，极力咯出才有一丝粘痰的，用千金五味子汤。
咳嗽无声的，是肺气受伤而不清晰，乃痰郁火邪在中不能上出，这是肺燥。用桔梗汤加贝母、葳蕤、蜜炙枇杷叶。
洁古说：咳嗽而无痰的，用辛甘药物滋润肺脏。可用蜜煎姜、橘，蜜烧连皮胡桃。体虚之人当用人参同蜜烧胡桃，不时细嚼，或者将两味药煎服最好，即观音应梦散。
久咳声音飒飒的，古法用酥蜜膏，今改用生地黄煎，取辛味以润之。咳嗽声哑，气促满闷，说话不出声的，是心包火盛而肺气受伤。古法用通声膏，今改用千金地黄煎，取润降以泄之。大概声音飒飒虽说是“金实不鸣”，但久咳多因肺气枯槁，应当以清润为主。实证用二陈汤、桔梗、薄荷、葳蕤，蜜煎姜、橘之类；虚证用生脉散、天冬、麦冬、款冬花、竹茹，也加蜜煎姜、橘。又应当详细辨别形气的肥瘦，时令的寒暖来施治。
声音嘶哑须分暴病和久病。暴病多是寒郁热邪而肺络壅塞，久病多是热伤肺痿而真气受伤。壅塞的用麻杏甘石汤、茯苓、半夏、生姜、橘皮等，随病情轻重搜涤。损伤的用异功散、生脉散、保元汤，参合脉证培养正气。
若风热心烦，咳喘便秘，脾胃热壅，饮食不下，用千金地黄煎主治。不可拘泥于成规而废弃活法。
若喘咳失血，声音飒飒音哑，食少便泄的金破不鸣（肺气衰竭），岐伯、彭祖也不能图谋治疗。生姜治咳嗽声哑，只适用于暴嗽寒郁、肺气不通的情况。若久咳热伤肺气而失音的，虽然二冬、二母、二地、黄芩、花粉等寒凉敛肺药，也是禁忌之剂；而麻黄、杏仁、细辛、桂枝等辛散耗气药，也成为戈戟（有害之物）。诃子、五味子的酸涩固气，尤其需要慎重详辨。
壅塞性咳嗽声音重浊痰稠，或咳血，用薄荷、生胡麻各一撮细嚼，煎苏子降气汤送下。
七情失调、饥饱失常导致的咳嗽，动传脏腑正气，致使邪气上逆，结成痰涎，肺道不利，用四七汤加杏仁、五味子、人参、阿胶、麦冬。
劳神思虑，心血耗散，人每当思虑时，心火上乘，必发干咳，此为神伤，虽然服药也难取效，用归脾汤加麦冬、五味子，制成膏蜜收存。其中的木香可减半，或换砂仁，另研为细末，离火后加入，不时滋养才好。
大抵干咳，是燥气乘肺，属火郁证，乃痰郁火邪在肺。先用逍遥散加苦桔梗以开之，后用六味丸加五味子以补之。若不愈，则成劳损。此证多有不得志者。
咳嗽疼痛牵引肩背，虽久不愈，不可误认为虚证，此属三焦郁火，用加味逍遥散。浊痰，用加味导痰汤。如咳而胁痛，宜疏肝气，用枳壳煮散，或去川芎加青皮、柴胡、香附、姜汁之类。
形体肥胖、气实的人，用二陈汤加白芥子。火热咳嗽，喉哑痰浓，或大便秘结的，用凉膈散加桔梗。
凡内伤气虚不能上输于肺，而时咳时止，其人面色黄白少神，脉亦虚微少力，用补中益气汤去升麻，加煨葛根、麦冬、五味子。或兼肾水不足，用前汤送下都气丸。
咳嗽痰中带血而脉细的，此火邪伤血分，用归脾汤。若痰中微有少量血，或血丝，此肝血伤，用补中益气汤去升麻，加白芍、丹皮。
前后心胀，喉中有血腥气，气口脉涩，此膈间有蓄血。试法：喝热姜汤打呃的是瘀血。用犀角地黄汤加童便、桃仁、大黄攻散。或用平胃散合越鞠丸，加韭汁、童便消伐。
气竭肝伤而咳嗽带血腥的，用四乌鲗骨一芦茹丸。
内伤瘀积在胃，不时吐血的，其人面色枯槁而滞，脉多弦涩，当先用百劳丸去瘀，后用异功散、六君子汤调补。
有兼停食饮食而咳的，须用消化之方，不可用乌梅、粟壳等酸涩药。其寒邪未除，宜用发散之剂，不可便用补药。
咳嗽而面白，悲伤，喷嚏，或咳白痰白沫，属肺胃虚寒。若胸胁逆满，牵引背痛，心腹冷痛，饮食即吐的，用温肺汤。
口甘、涎沫流，脉沉弦细迟，属中寒。口出清水，心下汪洋作嘈杂，胸胁胀痛不食的，属冷冻饮料停于胃中，攻肺则咳，用半夏温肺汤。兼用芦吸散亦妙。
嗽而声喑气乏，寒从背起，口中如含冰雪，甚则吐血，此肺气不足，胃气虚寒，用千金补肺汤。
嗽而声哑脉细的属寒，宜半夏、生姜、细辛以辛散之。
如饮冷热酒，伤肺致咳，称为凑肺。或兼煎爆伤胃，咳嗽咽痒，痰多唾血，喘急胁痛，不得安卧，用改定紫菀茸汤。
咳嗽呕吐并作，为肺胃俱病，先安胃气，用二陈汤加芦根、姜汁、姜制枇杷叶。虚者，用六君子汤加桔梗。
有咳嗽吐痰与食物一起出来的，此饮食失节，脾气不利，清浊相干，用二陈汤加枳实、白术、杏仁、细辛。
有食积痰嗽发热，其人面青白黄色不常，面上有黄白纹痕的，用二陈汤加香附、枳壳、神曲、厚朴。食积发热，加姜汁炒川连。停寒食作嗽，加炮姜。
嗽而得食即缓的，脾虚也，用异功散。有痰，用六君子汤。
外感咳嗽与阴虚咳嗽，尤宜辨析清楚。外感咳嗽则声音盛大而浑浊，先缓后急，日夜无度，痰涎稠粘而喘急。阴虚劳嗽则声音怯弱而干枯，先急后缓，或早晨重，或傍晚重，清痰少气而喘乏。
阴虚脉弦而数，或细数，或涩，证兼盗汗，下午作寒热，面色纯白，两颊赤，多清痰干咳的，是劳损，属阴虚火盛。夜服六味丸，晨服异功散。
久咳之人，发散清肺均不应，胸膈不利，咳唾脓血，坐卧不宁，语言不出者，将成肺痿之候，用紫菀散。
肺热顿咳，肌肤灼热，面赤如醉的，用紫菀膏微利之。
治嗽须分新久虚实。如久咳脉弱，或虽洪大按之不鼓，属肺虚，宜门冬、五味子、款冬、紫菀之类敛而补之。
酒色过度，虚劳少血，津液内耗，心火自炎，致令燥热乘肺，咯唾脓血，上气涎潮，其嗽连续不已，加以邪客皮毛，入伤于肺，而自背得之尤速，当与炙甘草汤，或黄芪建中汤加丹皮。盖丹皮辛香，调和营气，治无汗骨蒸，故阴虚人解表，以丹皮为向导。
好色之人元气素弱，咳嗽不愈，喉中血腥，肠中隐痛，用琼玉膏。若无效，用加减八味丸，久服乃效。
有暴嗽，诸药不效，服生料鹿茸丸，即愈。此乃肾虚所致，不可以暴嗽而疑遽补之非。
有便溺如常，饮食不妨而咳嗽不安，或兼血腥，年久不愈的，此肺胃虚热也，用异功散加丹皮、山药。
有肺胃虚弱，咳嗽喘促，或时吐血衄血，自汗盗汗的，用门冬清肺饮。
劳嗽，即火郁嗽，因火伤迫，遂成郁遏胀满，一边不得眠者难治。
咳嗽吐粉红痰，谓之吐白血，仅可绵延岁月。若血色正赤如朱，浓浓如漆，为守藏血（真血），不治。
有经年累月久嗽，服药不瘥，余无他证，此是风寒客邪，久伏肺胃也，与劳嗽不同，用三拗汤，佐以千缗汤。瘦人多火禁用。
若饥时胸中大痛，唇面上有白点如粞，咽喉或痒或痛，而咳不可忍，脉极数，或忽大忽小，此必肺中有寸白虫，饥则虫上求食，痛嗽不宁也。用一味百部熬膏，略加槟榔、乌梅。
上半日嗽多，属胃中有火，用竹叶石膏汤降泄之。胃气虚者，用补中益气或五味异功散，并加山栀。
午后嗽多，属阴虚，用六味丸加麦冬、五味以敛之。
黄昏嗽者，火浮于肺，不宜用凉药，用都气丸敛而降之。
五更嗽甚者，胃中有食积也，用二陈汤加枳实、川连以消导之。虚者，用六君子汤加姜汁炒川连。
增补《素问》五脏六腑咳治例：
肺咳，用千金五味子汤去续断、地黄、赤小豆，加麦门冬、葳蕤、细辛。
心咳，用凉膈散去硝、黄，加黄连、竹叶。
肝咳，用枳壳煮散去川芎、防己，加肉桂、橘红、苏子。
脾咳，用六君子汤加枳壳、桔梗。
肾咳，用都气丸加麦门冬、人参。
胃咳，用异功散加蜀椒、黄连、乌梅。
胆咳，用小柴胡汤加芦根汁。
大肠咳，用补中益气汤去升麻加桔梗。
小肠咳，用桔梗汤加人参、茯苓、橘红、五味子。
膀胱咳，用五苓散加人参。
三焦咳，用局方七气汤加黄连、枳实。
久嗽服药不应，可用熏法。款冬花将蜜拌润，焙干，入有嘴壶中烧，吸烟咽之。若胸中闷，举起头，以指掩定烟，稍间再吸。
杏仁散治肺中风热，然肺实有火，因风寒者为宜。桑皮泻肺气，然性不纯良，虚寒者当戒。补肺多用生姜，以其辛能发散也。栝蒌仁甘能润肺，寒能降火，治热嗽之要药，阴虚血虚者勿用，以其能作呕作泻也。
咳而吐痰，膺乳痛，当看痰色如何。若浓浊如脓，或带血丝而臭，当从肺痈例治之。
〔诊〕咳嗽之脉，浮为风，紧为寒，洪数为热，濡细为湿。寸关涩难而尺内弦紧，为房劳阴虚。右关濡大，为饮食伤脾。左关弦数，为疲极肝伤。右寸浮短为伤肺，迟涩肺寒。咳嗽洪滑为多痰，弦涩为少血。
肺脉微急，咳而唾血。脉或沉或浮，声不损者，易治。脉来洪数，形瘦面赤，肾脏气衰，不能上循于喉而声哑者难疗。亦有肺络支塞而声哑者，不在此例。
暴病咳嗽，睡卧不下，为肺胀，可治。久病喘嗽，左侧不能卧者，为肝伤，若精力未衰者可治。右边不能卧者，为肺损，无问新久，皆不可治。
久嗽脉弱者生，实大数者死。咳而脱形身热，脉小坚急以疾为逆，不出十五日死。咳脱形，身热脉疾，不过五日死。咳溲血，形肉脱，脉搏者死。咳呕腹胀，且飧泄，其脉绝，不及一时而死。
咳嗽形羸，脉形坚大者死。沉紧及伏匿者死。浮直者可治。浮软者易治。咳而呕，腹满泄泻，脉弦急欲绝者死。
久嗽数岁，其脉弱者可治。实大数者死。其脉虚者必苦冒，其人本有支饮在胸中故也，治属饮家。
石顽治疗吴江邑侯华野郭公，仲秋喘嗽气逆，诊之两尺左关弦数，两寸右关涩数。弦者肾之虚，涩者肺之燥。夏暑内伏肺络，遇秋燥收之令，而发为咳嗽也。诊后公详述病情，言每岁交秋则咳，连发四载，屡咳痰不得出则喘，至夜坐不得卧，咳剧则大便枯燥有血。先曾服令高徒施元倩越婢汤，嗽即稍可。数日间堂事劳心，复咳如前。时元倩归苕，松陵诸医，治之罔效，因求洞垣之鉴，起我沉疴。答曰：公本东鲁，肾气素强，因水亏火旺，阴火上烁肺金，金燥不能生水，所以至秋则咳，咳剧则便燥有血，肺移热于大肠之明验也。合用千金麦门冬汤，除去半夏、生姜之辛燥，易以葳蕤、白蜜之甘润，藉麻黄以鼓舞麦冬、生地之力，与越婢汤中麻黄、石膏分解互结之燥热同一义也。
郭公曰：松陵诸医，咸诋麻黄为发汗之重剂，不可轻试，仅用杏仁、苏子、甘、桔、前胡等药，服之其咳转甚何也？答言：麻黄虽云主表，今在麦门冬汤中，不过借以开发肺气，原非发汗之谓。麻黄在大青龙汤、麻黄汤、麻杏甘石汤方，其力便峻，以其中皆有杏仁也。杏仁虽举世视为治嗽之通药，不问虚实浑用，然辛温走肺，最不纯良，耗气动血莫此为甚。熬黑入大陷胸丸，佐甘遂等搜逐结垢，性味可知。公首肯以为然。连进二剂，是夜便得安寝。次早复诊，其脉之弦虽未退，而按之稍缓。气口则虚濡乏力，因与六味、生脉，加葳蕤、白蜜作汤四服，其嗽顿减。
郭公复云：向闻元倩有言，六味、八味丸中，不可杂用参、术，而先生居之不疑，用之辄应，其义云何？答曰：六味为填补真阴药，与人参同用，原非正理。此兼麦冬、五味，缘合肺肾金水相生，当无留中恋膈之虑。善后之策，即以此方制丸，三时恒服不彻，至秋庶无复嗽之虞。
先是公子柔痉，予用桂枝汤，及六味作汤，咸加蝎尾，服之而瘥。其后夫人素有败痰失道，左右两胁俱有结块，大如覆杯，发则咳嗽喘逆，腹胁掣痛，六脉止促而按之少力。
Shortness of breath and inability to lie flat. Cough worsens with cold in the back. Use Xiao Qing Long Tang (Minor Blue Dragon Decoction) or Guiling Wuli Gancao Tang (Cassia Twig, Poria, Fructus Schisandrae, and Licorice Decoction). Modify according to the variations of the syndrome. External pathogens injuring the Lung. Chronic cough that does not cease.
Use Ningsou Huatan Tang (Calming Cough and Resolving Phlegm Decoction). For cough caused by exposure to cold and drinking cold beverages, accompanied by abdominal pain and a wiry pulse, use Jianzhong Tang (Construct the Middle Decoction) plus Jiegeng (Platycodon Root) to lift the sinking Qi of the Lung. If there are alternating chills and fever with spontaneous sweating, add Huangqin (Scutellaria Root).
Cough in winter accompanied by chills and fever is called "Cold Cough." Use Xiao Qing Long Tang (Minor Blue Dragon Decoction) plus Xingren (Apricot Seed). Cold-heat mixed cough, caused by improper adjustment of clothing, contracting both cold and heat pathogens; coughs upon sudden changes from cold to hot or vice versa, and upon drinking hot or cold beverages. If the pulse is floating, wind is predominant; use Feicao San (Boiling Herb Powder). If the pulse is rapid or choppy, heat is predominant; use Weirui Tang (Polygonatum Decoction) minus Chuanxiong (Sichuan Lovage Rhizome), plus Fangshi (Fermented Soybean) 3 qian.
Contracting wind after sweating in bed, with cough and flushed face; the *Neijing* calls this "Internal Wind." If the pulse is floating and tight, use Xiao Qing Long Tang (Minor Blue Dragon Decoction). If the pulse is deep and tight, use Zhen Wu Tang (True Warrior Decoction). Contracting wind after drinking alcohol, with profuse sweating and cough, is called "Leakage Wind." Use Guizhi Tang (Cinnamon Twig Decoction) plus Zexie (Alisma Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), and Mahuanggen (Ephedra Root). For edema with a floating pulse and spontaneous sweating, wheezing cough and constipation, use Xiao Qing Long Tang (Minor Blue Dragon Decoction) plus Tinglizi (Lepidium Seed) and Muxiang (Aucklandia Root).
Wheezing cough with a deep pulse and aversion to cold: use Shengliao Jisheng Shenqi Wan (Raw Material Enhancing Life Kidney Qi Pill) decocted and taken orally. Some first contracted wind, and while the cough persisted, were further injured by heat, resulting in hoarseness; this is "Heat Enveloping Cold." Use Weirui Tang (Polygonatum Decoction) modified. Those who chronically cough and then contract cold, resulting in hoarseness, have "Cold Enveloping Heat." Use Feicao San (Boiling Herb Powder) minus Shaoyao (Peony Root), plus Shigao (Gypsum Fibrosum). If ineffective, use Yebibo Tang (Jade Screen Decoction).
For heat cough causing aphonia, if repeated use of cold agents fails to restore voice, use Gujin Luyan Xuming Tang (Ancient and Modern Recorded Verification Reviving Life Decoction) to disperse it. For mild cases, use Xiaofeng San (Wind-Dispersing Powder) minus Jiangcan (Silkworm) and Chantui (Cicada Slough), plus Jiegeng (Platycodon Root) and Bohe (Mint), taken with fresh ginger juice. This is especially suitable for cold-heat cough with aphonia. Summer cough with fever: use Xiaochaihu Tang (Minor Bupleurum Decoction) plus Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhena Rhizome). If only the palms and soles are hot without systemic fever, use Xiebaid San (Drain White Powder) plus Juhong (Tangerine Peel) and Jiegeng (Platycodon Root). If ineffective, use Liangge San (Cool the Diaphragm Powder) minus Xiaoshi (Mirabilite) and Dahuang (Rhubarb Root), plus Weirui (Polygonatum) and Fengmi (Honey).
Injury by heat pathogen causing cough: rapid pulse, vexation, thirst with desire to drink, dry and painful throat, hot air from nostrils, unclear throat sounds, coughing up thick and sticky sputum difficult to expectorate, yellow and dense, possibly with blood threads, foul-smelling bleeding, or hard like clam meat, unlike the clear white phlegm of wind-cold cough. Use Weirui Tang (Polygonatum Decoction). Wind-heat combined: use Jiandan Congbai Xiangchi Tang (Modified Scallion and Fermented Soybean Decoction).
Whenever cough presents with a flushed face, constant heat in the chest, abdomen, and hypochondrium, but occasional coolness in the hands and feet, and a surging pulse, this indicates hot phlegm above the diaphragm. Use Xiaoxiantang Tang (Small Trap Decoction).
Cough due to dampness: fine and slow pulse, heavy body, painful joints, spontaneous sweating, or difficulty urinating. Use Mahuang Jia Zhu Tang (Ephedra Plus Atractylodes Decoction).
Some produce phlegm immediately upon coughing; this is spleen dampness prevailing with slippery phlegm. Some cough continuously for ten or more times without immediate phlegm production; this is lung dryness prevailing with obstructed phlegm.
Cough without phlegm: moisten the Lung with sweet and cold herbs. Cough due to excessive phlegm: dry the Spleen with acrid and neutral herbs.
Those with robust physique, spontaneous sweating, slow pulse, heavy body, and drowsiness who cough: spleen dampness prevails. Use Erchen Tang (Two-Aged Decoction) plus Fangji (Stephania Root), Huangqin (Scutellaria Root), Baizhu (Atractylodes Macrocephala Rhizome), etc. If accompanied by food stagnation and phlegm turbidity causing obstruction, use Qianmin Tang (Thousand Strings Decoction) to purge. If accompanied by food stagnation and phlegm qi fermenting into fire evil, use Erchen Tang (Two-Aged Decoction) plus Zhishi (Immature Bitter Orange), Baizhu (Atractylodes Macrocephala Rhizome), and Huanglian (Coptis Rhizome) to digest and guide out.
Late autumn injury by heat causing cough with aversion to cold and fever: use Qianjin Maidong Tang (Thousand Years Ophiopogon Decoction). Only cough without chills/fever, phlegm cannot be expelled, requiring great effort to cough out a thread of sticky phlegm: use Qianjin Wuzi Tang (Thousand Years Schisandra Decoction).
Cough without sound: Lung Qi is injured and unclear; phlegm stagnates with fire evil in the middle, unable to ascend; this is Lung dryness. Use Jiegeng Tang (Platycodon Decoction) plus Beimu (Fritillaria Bulb), Weirui (Polygonatum), and Mi Zhi Pipaye (Honey-fried Loquat Leaf).
Jiegu said: For cough without phlegm, moisten the Lung with acrid and sweet herbs. Honey-fried ginger and tangerine peel; honey-roasted walnuts with skin. For deficient persons, roast walnuts with Ren Shen (Ginseng Root) and honey, chew slowly from time to time, or decoct these two items; this is best, known as Guanyin Yingmeng San (Guanyin Responding to Dream Powder).
For chronic cough with a rasping voice, ancient methods used Su Mi Gao (Butter and Honey Paste); now use Sheng Dihuang Jian (Fresh Rehmannia Decoction), taking the acrid nature to moisten. Cough with hoarseness, shortness of breath, chest fullness, and inability to speak: Heart Pericardium fire is excessive and Lung Qi is injured. Ancient methods used Tongsheng Gao (Voice-Unblocking Paste); now use Qianjin Dihuang Jian (Thousand Years Rehmannia Decoction), using moisture to drain. Generally, although a rasping voice is termed "Metal Solid Does Not Ring," chronic cough often stems from Lung Qi exhaustion; treatment should primarily focus on clearing and moistening. Excess patterns: Erchen Tang (Two-Aged Decoction), Jiegeng (Platycodon Root), Bohe (Mint), Weirui (Polygonatum), honey-fried ginger and tangerine peel. Deficiency patterns: Shengmai San (Generate Pulse Powder), Dongqu (Asparagus Tuber), Maidong (Ophiopogon Tuber), Kundonghua (Winter Flower Bud), Zhuru (Bamboo Shavings), also with honey-fried ginger and tangerine peel. One must also detail the fat/thin constitution and seasonal cold/warmth to apply treatment.
Hoarseness must be distinguished between acute and chronic. Acute cases are mostly cold trapping heat evil, obstructing Lung collaterals; chronic cases are mostly heat injuring Lung flaccidity and damaging true Qi. Obstruction: Maxing Shigan Shi Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction), Fuling (Poria), Banxia (Pinellia Tuber), Shengjiang (Fresh Ginger), Chenpi (Tangerine Peel), etc., to search and purge according to severity. Injury: Yigong San (Extraordinary Aid Powder), Shengmai San (Generate Pulse Powder), Baoyuan Tang (Preserve Origin Decoction), nourishing based on pulse and syndrome.
If wind-heat causes vexation, wheezing cough, constipation, Spleen/Stomach heat obstruction, and inability to eat, treat with Qianjin Dihuang Jian (Thousand Years Rehmannia Decoction). Do not stick to fixed rules and abandon flexible methods.
If wheezing cough involves hemoptysis, rasping voice, hoarseness, poor appetite, and loose stools, this is "Broken Metal Does Not Ring" (Lung Qi depletion); even Qibo and Pengzu could not treat it. Fresh ginger for cough hoarseness is only suitable for acute cough with cold trapping and Lung Qi blockage. For chronic cough where heat injures Lung Qi causing aphonia, cold/astringent Lung-consolidating herbs like Dongqu, Maidong, Mumian, Fumu, Dihuang, Huangqin, Huafen are contraindicated; acrid-dispersing Qi-consuming herbs like Mahuang, Xingren, Xixin, Guizhi are also harmful. Astringent Qi-consolidating herbs like Hezi (Chebula Fruit) and Wubeizi (Chinese Gall) require extreme caution.
For obstructive cough with heavy voice and thick phlegm, or hemoptysis, chew one handful each of Bohe (Mint) and Sheng Huma (Raw Sesame Seeds), decoct Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction), and take orally.
Cough due to emotional disturbances or irregular eating/diet moves the righteous Qi of the Zang-Fu, causing evil to rebel upward, forming phlegm-saliva, obstructing the Lung pathways. Use Siqi Tang (Four Emotions Decoction) plus Xingren (Apricot Seed), Wubeizi (Chinese Gall), Renshen (Ginseng Root), Ejiao (Donkey-hide Gelatin), Maidong (Ophiopogon Tuber).
Mental labor and overthinking dissipate Heart Blood. Whenever one thinks, Heart Fire ascends, inevitably causing dry cough; this is Spirit injury. Medication is difficult to effect. Use Guipi Tang (Restore the Spleen Decoction) plus Maidong (Ophiopogon Tuber) and Wubeizi (Chinese Gall), made into a honey paste. Reduce or replace Muxiang (Aucklandia Root) with Sharen (Amomum Fruit), grind separately, add off-heat, and nourish occasionally.
Generally, dry cough is dryness attacking the Lung, belonging to Fire Stagnation syndrome, where phlegm traps fire evil in the Lung. First use Xiaoyao San (Free and Easy Wanderer Powder) plus Jiegeng (Platycodon Root) to open; later use Liuwei Wan (Six-Ingredient Pill) plus Wubeizi (Chinese Gall) to tonify. If unceasing, it becomes consumption. This condition often occurs in those frustrated.
Cough pain radiating to shoulders and back, persistent despite long duration, should not be mistaken for deficiency; this belongs to Triple Burner Fire Stagnation. Use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Turbid phlegm: Jiawei Daotan Tang (Modified Phlegm-Resolving Decoction). If cough with hypochondriac pain, soothe Liver Qi: use Zhike Zhusan (Bitter Orange Decoction), or remove Chuanxiong (Sichuan Lovage Rhizome) and add Qingpi (Green Tangerine Peel), Chaihu (Bupleurum Root), Xiangfu (Cyperus Rhizome), Jiangzhi (Ginger Juice).
For obese individuals with excess Qi, use Erchen Tang (Two-Aged Decoction) plus Baijiezi (White Mustard Seed). Fire-heat cough with hoarse voice and thick phlegm, or constipation: use Liangge San (Cool the Diaphragm Powder) plus Jiegeng (Platycodon Root).
When internal injury Qi deficiency cannot transport upward to the Lung, causing intermittent cough, with sallow complexion, lack of spirit, and weak/pulseless pulse: use Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) minus Shengma (Cimicifuga Rhizome), plus Wei Gegen (Calcined Kudzu Root), Maidong (Ophiopogon Tuber), Wubeizi (Chinese Gall). If accompanied by Kidney Water insufficiency, take the previous decoction with Duqi Wan (Duqi Pill).
Cough with blood in sputum and fine pulse: fire evil injuring the Blood level. Use Guipi Tang (Restore the Spleen Decoction). If slight blood or threads in sputum: Liver Blood injury. Use Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) minus Shengma (Cimicifuga Rhizome), plus Baishao (White Peony Root), Danpi (Moutan Bark).
Distension in front and back of chest, bloody smell in throat, choppy pulse at the Qi Kou: blood stasis in the diaphragm. Test method: drinking hot ginger water causing hiccups indicates blood stasis. Use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) plus Tongbian (Child's Urine), Taoren (Peach Seed), Dahuang (Rhubarb Root) to attack and disperse. Or use Pingwei San (Calm the Stomach Powder) combined with Yueju Wan (Overcome Depression Pill), plus Jiu Zhi (Garlic Juice), Tongbian (Child's Urine) to eliminate.
Qi exhaustion and Liver injury with bloody cough: use Si Wu Eigu Yi Luzhu Wan (Four-part Cuttlebone and Rubia Pill).
Internal injury blood stasis in the Stomach causing intermittent hematemesis: sallow and dull complexion, wiry-choppy pulse. First use Bailao Wan (Hundred Labors Pill) to remove stasis, then use Yigong San (Extraordinary Aid Powder) and Liujun Zi Tang (Six Gentlemen Decoction) to regulate and tonify.
For cough with retained food/drink, use digestive formulas; do not use sour/astringent herbs like Wumei (Dark Plum) or Suske (Persimmon Calyx). If cold pathogen remains, use dispersing agents; do not use tonics prematurely.
Cough with pale face, sadness, sneezing, or coughing clear white phlegm/froth: Lung/Spleen-Stomach deficiency cold. If chest/hypochondrium fullness/reversal, radiating back pain, cold pain in heart/abdomen, vomiting after eating: use Wenfei Tang (Warm Lung Decoction). Sweet taste in mouth, flowing saliva, deep-wiry-fine-slow pulse: Middle Cold. Clear water from mouth, gastric sloshing with discomfort, chest/hypochondrium distension/pain, anorexia: frozen/cold drinks retained in Stomach, attacking Lung causing cough. Use Banxia Wenfei Tang (Pinellia Warm Lung Decoction). Lu Xi San (Reed Root Inhalation Powder) is also excellent.
Cough with hoarse voice and lack of Qi, cold rising from back, mouth feeling like holding ice/snow, severe hematemesis: Lung Qi insufficiency, Stomach Qi deficiency cold. Use Qianjin Bufei Tang (Thousand Years Tonify Lung Decoction).
Cough with hoarse voice and fine pulse belongs to cold; use Banxia (Pinellia Tuber), Shengjiang (Fresh Ginger), Xixin (Asarum) to disperse with acridity.
Drinking cold/hot wine injuring Lung causing cough is called "Coufei" (Approaching Lung). Or combined with frying/burning injuring Stomach, causing cough, itchy throat, copious phlegm, spitting blood, wheezing, hypochondriac pain, inability to lie flat: use Gaiding Ziwan Rong Tang (Revised Aster Velvet Decoction).
Cough and vomiting together: Lung and Stomach both diseased. First calm Stomach Qi: Erchen Tang (Two-Aged Decoction) plus Lugeng (Reed Rhizome), Jiangzhi (Ginger Juice), Jiang Zhi Pipaye (Ginger-processed Loquat Leaf). Deficient: Liujun Zi Tang (Six Gentlemen Decoction) plus Jiegeng (Platycodon Root).
Cough with phlegm and food coming out together: dietary irregularity, Spleen Qi dysfunction, mixing of clear and turbid. Use Erchen Tang (Two-Aged Decoction) plus Zhishi (Immature Bitter Orange), Baizhu (Atractylodes Macrocephala Rhizome), Xingren (Apricot Seed), Xixin (Asarum).
Food stagnation phlegm-cough with fever, variable green-white-yellow face, yellow-white streaks on face: Erchen Tang (Two-Aged Decoction) plus Xiangfu (Cyperus Rhizome), Zhike (Bitter Orange Qu), Shenqu (Medicated Leaven), Houpo (Magnolia Bark). Food stagnation fever: add Jiangzhi Chao Chuanlian (Ginger-fried Coptis Rhizome). Retained cold food cough: add Paojiang (Roasted Ginger).
Cough relieved by eating: Spleen deficiency. Use Yigong San (Extraordinary Aid Powder). With phlegm: Liujun Zi Tang (Six Gentlemen Decoction).
External contraction cough vs. Yin deficiency cough must be distinguished. External cough: loud and turbid voice, initially slow then rapid, day and night without limit, thick sticky phlegm with wheezing. Yin deficiency consumption cough: weak and dry voice, initially rapid then slow, worse morning/evening, scant clear phlegm, shortness of breath, fatigue.
Yin deficiency: wiry-rapid, fine-rapid, or choppy pulse; accompanied by night sweats, afternoon chills/fever, pure white face, red malar flush, frequent clear phlegm dry cough: this is consumption, Yin deficiency with hyperactive fire. Night: Liuwei Wan (Six-Ingredient Pill). Morning: Yigong San (Extraordinary Aid Powder).
Chronic cough unresponsive to dispersing/clearing Lung methods, chest/diaphragm discomfort, coughing pus/blood, restlessness, inability to speak: impending Lung Flaccidity. Use Ziwan San (Aster Powder).
Acute Lung heat cough, burning skin, flushed face like drunkenness: Ziwan Gao (Aster Paste) to mildly purgatively relieve.
Treating cough requires distinguishing new/old and excess/deficiency. Chronic cough with weak pulse, or surging but empty on pressure: Lung deficiency. Use Maidong (Ophiopogon Tuber), Wubeizi (Chinese Gall), Kundonghua (Winter Flower Bud), Ziwan (Aster) to astringe and tonify.
Excessive sex/life, deficiency consumption, scant blood, internal fluid depletion, self-flaring Heart Fire, leading to dry-heat attacking Lung, spitting pus/blood, upper rushing salivary tide, continuous cough, compounded by external pathogens entering skin/Lung, especially fast from the back: use Zhigancao Tang (Licorice Decoction) or Huangqi Jianzhong Tang (Astragalus Construct Middle Decoction) plus Danpi (Moutan Bark). Danpi is acrid-aromatic, harmonizes Ying Qi, treats bone-steaming without sweat; thus for Yin deficiency exterior resolution, Danpi acts as a guide.
Those fond of sex have inherently weak Yuan Qi; chronic cough, bloody smell in throat, dull intestinal pain: Qiongyu Gao (Jade Essence Paste). If ineffective: Jiawei Bawei Wan (Modified Eight-Ingredient Pill), long-term use yields results.
Acute cough unresponsive to other medicines: Shengliao Lurong Wan (Raw Material Deer Antler Pill) cures immediately. This is Kidney deficiency; do not doubt that tonifying acute cough is wrong.
Normal urination/defecation, normal diet, but uneasy cough or bloody smell, chronic: Lung/Stomach deficiency heat. Use Yigong San (Extraordinary Aid Powder) plus Danpi (Moutan Bark), Shanyao (Dioscorea Rhizome).
Lung/Stomach weakness, cough/wheezing, intermittent hematemesis/epistaxis, spontaneous/night sweats: Mendong Qingfei Yin (Ophiopogon Clear Lung Drink).
Consumption cough is Fire Stagnation cough; fire injury forces stagnation/fullness, inability to sleep on one side is difficult to treat.
Cough spitting pink phlegm is called "Spitting White Blood"; can only prolong life. If blood is bright red like vermilion, thick like lacquer, it is True Blood (Zang Blood); untreatable.
Chronic cough for years, medication ineffective, no other symptoms: wind-cold external pathogen lingering in Lung/Stomach for a long time, different from consumption cough. Use San'ao Tang (Three Unobstructed Decoction), assisted by Qianmin Tang (Thousand Strings Decoction). Contraindicated for thin people with much fire.
Severe chest pain when hungry, white spots on lips/face like rice grains, itchy/painful throat, unbearable cough, extremely rapid or fluctuating pulse: likely Ascaris lumbricoides (Inchworm) in Lung. Worms seek food when hungry, causing painful cough. Use single Stemona Root boiled into paste, plus Areca Nut, Dark Plum.
Morning cough predominance: Stomach fire. Use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) to descend and drain. Stomach Qi deficiency: Buzhong Yiqi Tang (Tonify Middle/Augment Qi) or Wuwei Yigong San (Five-Gentle Extraordinary Aid), plus Zhizi (Gardenia Fruit).
Afternoon cough predominance: Yin deficiency. Use Liuwei Wan (Six-Ingredient Pill) plus Maidong (Ophiopogon Tuber), Wubeizi (Chinese Gall) to astringe.
Twilight cough: Fire floating in Lung; avoid cold herbs. Use Duqi Wan (Duqi Pill) to astringe and descend.
Early morning severe cough: Food stagnation in Stomach. Use Erchen Tang (Two-Aged Decoction) plus Zhishi (Immature Bitter Orange), Chuanlian (Coptis Rhizome) to digest. Deficient: Liujun Zi Tang (Six Gentlemen Decoction) plus Jiangzhi Chao Chuanlian (Ginger-fried Coptis Rhizome).
Supplementing *Suwen* Five Zang/Six Fu Cough treatments:
Lung Cough: Qianjin Wuzi Tang (Thousand Years Schisandra Decoction) minus Xuduan (Drynaria Rhizome), Dihuang (Rehmannia Root), Chixiaodou (Red Bean), plus Maidong (Ophiopogon Tuber), Weirui (Polygonatum), Xixin (Asarum).
Heart Cough: Liangge San (Cool Diaphragm Powder) minus Xiaoshi (Mirabilite), Dahuang (Rhubarb Root), plus Huanglian (Coptis Rhizome), Zhuye (Bamboo Leaf).
Liver Cough: Zhike Zhusan (Bitter Orange Decoction) minus Chuanxiong (Sichuan Lovage), Fangji (Stephania Root), plus Rougui (Cinnamon Bark), Juhong (Tangerine Peel), Suzi (Perilla Seed).
Spleen Cough: Liujun Zi Tang (Six Gentlemen Decoction) plus Zhike (Bitter Orange), Jiegeng (Platycodon Root).
Kidney Cough: Duqi Wan (Duqi Pill) plus Maidong (Ophiopogon Tuber), Renshen (Ginseng Root).
Stomach Cough: Yigong San (Extraordinary Aid Powder) plus Shuzhu (Sichuan Pepper), Huanglian (Coptis Rhizome), Wumei (Dark Plum).
Gallbladder Cough: Xiaochaihu Tang (Minor Bupleurum Decoction) plus Lugeng汁 (Reed Rhizome Juice).
Large Intestine Cough: Buzhong Yiqi Tang (Tonify Middle/Augment Qi) minus Shengma (Cimicifuga Rhizome), plus Jiegeng (Platycodon Root).
Small Intestine Cough: Jiegeng Tang (Platycodon Decoction) plus Renshen (Ginseng Root), Fuling (Poria), Juhong (Tangerine Peel), Wubeizi (Chinese Gall).
Bladder Cough: Wuling San (Five-Ling Powder) plus Renshen (Ginseng Root).
Triple Burner Cough: Jufang Qiqi Tang (Formulary Seven-Qi Decoction) plus Huanglian (Coptis Rhizome), Zhishi (Immature Bitter Orange).
Chronic cough unresponsive to medication: use fumigation. Mix Kundonghua (Winter Flower Bud) with honey, dry, burn in a spouted pot, inhale smoke. If chest feels stuffy, raise head, cover smoke hole with finger, pause, then inhale again.
Xingren San (Apricot Kernel Powder) treats Lung wind-heat; suitable for Lung excess with fire due to wind-cold. Sangbai (Mulberry Root Bark) drains Lung Qi but is not purely benign; contraindicated in deficiency-cold. Tonifying Lung uses much Shengjiang (Fresh Ginger) for its acrid dispersing nature. Gualou Ren (Trichosanthes Seed) is sweet to moisten Lung, cold to descend fire; essential for heat cough; contraindicated in Yin/Blood deficiency as it causes vomiting/diarrhea.
Cough with phlegm, chest/breast pain: examine phlegm color. If thick/turbid like pus, or with blood threads and foul odor: treat as Lung Abscess.
[Diagnosis] Cough pulses: Floating indicates Wind; Tight indicates Cold; Surging-Rapid indicates Heat; Soft-Fine indicates Dampness. Choppy-difficult at Cun/Guan with wiry-tight at Chi: consumptive Yin deficiency from sexual excess. Soft-large at Right Guan: dietary injury to Spleen. Wiry-rapid at Left Guan: liver injury from exhaustion. Floating-short at Right Cun: Lung injury; Slow-Choppy: Lung cold. Surging-slipping cough: much phlegm; Wiry-choppy: scant blood.
Lung pulse slightly urgent: cough with spitting blood. Pulse deep or floating, voice undamaged: easy to treat. Surging-rapid pulse, emaciated, flushed face, Kidney Qi decline, unable to ascend to throat causing hoarseness: difficult to treat. Hoarseness due to Lung collateral blockage is excluded here.
Acute cough, unable to lie down: Lung Distension, treatable. Chronic wheezing cough, unable to lie on left side: Liver injury, treatable if vitality remains. Unable to lie on right side: Lung damage, untreatable regardless of new/old.
Chronic cough, weak pulse: survival; Excess-large-rapid: death. Cough with emaciation, fever, small-tight-rapid pulse: adverse, death within 15 days. Cough with emaciation, fever, rapid pulse: death within 5 days. Cough with bloody urine, flesh wasting, thready pulse: death. Cough/vomit, abdominal distension, undigested stool evacuation, pulse absent: death within an hour.
Cough with emaciation, firm-large pulse: death. Deep-tight or hidden pulse: death. Floating-straight: treatable. Floating-soft: easily treated. Cough/vomit, abdominal fullness/diarrhea, wiry-rapid pulse about to vanish: death.
Chronic cough for years, weak pulse: treatable. Excess-large-rapid: death. Empty pulse:必定 suffers from dizziness; this is because Branch Fluid retention exists in the chest; treatment belongs to Fluid Disease families.
Shiwan treated Guo Gong, Prefect of Wujiang County, in mid-autumn with wheezing cough and rebellious Qi. Pulses: wiry-rapid at both Chi and Left Guan; choppy-rapid at both Cun and Right Guan. Wiry indicates Kidney deficiency; choppy indicates Lung dryness. Summer heat internally lodged in Lung collaterals, triggered by autumn dryness收敛 (contracting) command, causing cough. After diagnosis, Guo Gong detailed his history: cough every year at autumn onset, recurring for four years, wheezing when phlegm cannot be expelled, unable to lie down at night, severe cough causing dry bloody stools. Previously took Shi Yuanqian's Yebibo Tang (Jade Screen Decoction), cough slightly improved. But mental labor from official duties caused recurrence. Yuanqian had returned to Tiao, doctors in Songling failed. Seeking my advice to cure his chronic illness. I replied: You are from Donglu, originally strong Kidney Qi. Due to Water deficiency and Fire hyperactivity, Yin Fire scorches Lung Metal; Metal dryness cannot generate Water, hence cough in autumn. Severe cough causes dry bloody stools, clear evidence of Lung transferring heat to Large Intestine. Should use Qianjin Maidong Tang (Thousand Years Ophiopogon Decoction), removing Banxia (Pinellia Tuber) and Shengjiang (Fresh Ginger) acrid-dryness, replacing with Weirui (Polygonatum) and Baimit (White Honey) sweet-moisture, borrowing Mahuang (Ephedra) to encourage Maidong (Ophiopogon) and Shengdi (Rehmannia) power, same principle as Mahuang/Shigao resolving locked dry-heat in Yebibo Tang.
Guo Gong said: Songling doctors all denounce Mahuang as a heavy sweating agent, dare not try lightly, only used Xingren (Apricot Seed), Suzi (Perilla Seed), Gancao (Licorice), Jiegeng (Platycodon), Qianhu (Peucedanum), yet cough worsened. Why? I answered: Although Mahuang governs exterior, in Maidong Tang it merely borrows to open Lung Qi, not for sweating. In Da Qinglong Tang, Mahuang Tang, Maxing Shigan Shi Tang, its power is fierce because they all contain Xingren (Apricot Seed). Although Xingren is universally seen as a common cough medicine used indiscriminately for excess/deficiency, its acrid-warm nature travels to Lung, least benign, consuming Qi and moving Blood most severely. Charred into Daxiexiong Wan (Great Trap Chest Pill) assisting Kansui (Kansui Root) to search/purge stuck turbidity, its nature/flavor is known. Guo Gong agreed. Continued two doses, slept peacefully that night. Next morning re-examination: pulse wiry remained, but pressing slightly relaxed. Qi Kou was empty-soft weak. Prescribed Liuwei (Six-Ingredient), Shengmai (Generate Pulse), plus Weirui, Baimit decocted, four doses, cough instantly reduced.
Guo Gong added: Heard Yuanqian say Liuwei/Bawei Pills should not mix Renshen (Ginseng)/Baizhu (Atractylodes), yet you use them confidently with success. What is the meaning? I answered: Liuwei fills True Yin; mixing with Renshen is originally incorrect logic. Here combined with Maidong/Wubeizi, aligning Lung/Kidney Metal-Water mutual generation, no worry of lingering in middle/diaphragm. Post-care strategy: make pills from this formula, take constantly through three seasons until autumn, then no fear of recurrent cough.
Previously, his son had soft spasms; I used Guizhi Tang (Cinnamon Twig Decoction) and Liuwei as decoction, all adding Xiewei (Scorpion Tail), cured. Later, his wife had chronic bad phlegm losing its pathway, masses in both hypochondria size of inverted cups,发作 (attacks) with cough/wheezing/rebellious Qi, abdominal/hypochondriac pulling pain, six pulses only rapid and weak on pressure.