咳嗽症。方书最繁。反启人多疑之惑。其实不若虚实二症。实者。外感风寒而发。虚者。
内伤精气而生也。总不离乎水饮。金匮以小青龙汤。加减五方。大有意义。小柴胡汤自注云
。咳嗽。去人参。加干姜五味子。人多顺口读过。余于此悟透全书之旨。而得治咳嗽之秘钥
。因集溢未详。大为恨事。向着有金匮浅注等十种。言之不厌于复。业斯道者。请鉴予之苦
心焉。
一外感风寒。内挟水饮。必咳嗽不已。兼见头痛发热恶寒等症。若外感重者宜香苏饮加
杏仁防风各二钱。半夏干姜各一钱五分。五味子捣扁。细辛各八分。水煎服。温覆取微汗。
外感轻者。宜二陈汤。加细辛干姜五味子杏仁前胡。○若二症面目浮肿。俱加桑白皮三钱。
葶苈子八分微炒。研末调服。
香苏饮。（三十五） 二陈汤。（八十二）
一外感风寒。咳嗽颇久。每呛。两胁牵痛发热者。或寒热往来者。宜
逍遥散。倍柴胡。加半夏干姜各一钱半。五味子一钱。（四十八）
一夏月伤暑。咳嗽自汗。口渴小便赤短。宜
六一散。滑石六钱。甘草一钱。加干姜细辛五味子各一钱。水煎服。
一秋间伤秋金燥气。皮毛洒淅恶寒。寒已发热。渐生咳嗽。咳嗽不已。渐至泻利。宜
泻白散二剂。合为一剂。去粳米。加黄芩阿胶各一钱五分。干姜一钱。五味子细辛各五
分。水煎服。此方加减。庸医必骇其杂。能读孙真人书者。方知从五味子汤麦门冬汤二方得
来也。（八十六）
以上咳嗽。治之失法。多至吐血痨伤。
咳嗽这一病症，医书中的记载最为繁杂，反而引发了人们更多的疑惑。其实，不如将其归纳为虚、实两类病症。实证，是由外感风寒而引发；虚证，则是由内伤精气而产生。总的来说，都不离乎水饮（体内停聚的水液）的影响。《金匮要略》中用小青龙汤，并由此加减出五个方子，其中大有深意。小柴胡汤的自注中提到：“若有咳嗽症状，去掉人参，加入干姜和五味子。”许多人只是顺口读过，而我于此透彻领悟了全书的宗旨，从而掌握了治疗咳嗽的关键钥匙。因为觉得前人论述尚有不详尽之处，深感遗憾。此前我著有《金匮浅注》等十种著作，对此不厌其烦地反复阐述。从事医学的人，请体谅我的苦心。
一、外感风寒，体内兼有水饮，必然导致咳嗽不止，同时伴有头痛、发热、恶寒等症状。如果外感症状较重，适宜使用香苏饮，加杏仁、防风各二钱，半夏、干姜各一钱五分，五味子捣扁，细辛各八分，用水煎服，服药后覆盖衣被以取得微汗。如果外感症状较轻，适宜使用二陈汤，加细辛、干姜、五味子、杏仁、前胡。○如果上述两种情况出现面目浮肿，均加桑白皮三钱，葶苈子八分（微炒后研成粉末调服）。
香苏饮。（第三十五方） 二陈汤。（第八十二方）
一、外感风寒，咳嗽时间较长，每次呛咳时两胁牵引疼痛、发热，或者出现寒热往来（忽冷忽热）症状的，适宜使用逍遥散，加倍柴胡用量，加半夏、干姜各一钱半，五味子一钱。（第四十八方）
一、夏季感受暑邪，出现咳嗽、自汗、口渴、小便赤短症状的，适宜使用六一散，滑石六钱，甘草一钱，加干姜、细辛、五味子各一钱，用水煎服。
一、秋季感受秋金燥气，皮肤洒淅恶寒，寒冷过后发热，逐渐产生咳嗽，咳嗽不止，逐渐发展到腹泻痢疾，适宜使用泻白散两剂合并为一剂，去掉粳米，加黄芩、阿胶各一钱五分，干姜一钱，五味子、细辛各五分，用水煎服。这个方子的加减变化，庸医一定会惊骇其杂乱，只有能读懂孙思邈（孙真人）书籍的人，才知道此方是从五味子汤、麦门冬汤两个方子演变而来的。（第八十六方）
Coughing is a syndrome with the most complicated records in medical books, which instead arouses much doubt and confusion among people. In fact, it is better to categorize it into two types: excess (Shi) and deficiency (Xu). Excess type arises from external contraction of wind-cold; deficiency type originates from internal injury to essence and qi. Generally speaking, neither deviates from the influence of fluid retention (accumulation of pathological fluids in the body). *Jin Gui Yao Lue* utilizes Xiao Qing Long Tang (Minor Blue Dragon Decoction) as a base, adding and subtracting five formulas, which holds profound significance. The self-annotation of Xiao Chai Hu Tang (Minor Bupleurum Decoction) states: "For coughing, remove Ren Shen (Ginseng Root), add Gan Jiang (Dried Ginger) and Wu Wei Zi (Schisandra Fruit)." Many people merely read this through casually, but I thoroughly comprehended the gist of the entire book here, thereby obtaining the secret key to treating coughing. I felt it was a great pity that previous discussions were not detailed enough. Previously, I authored ten works such as *Jin Gui Qian Zhu* (Light Commentary on the Golden Cabinet), expounding on this without tiring of repetition. Practitioners of this profession, please appreciate my earnest intentions.
1. External contraction of wind-cold combined with internal fluid retention inevitably leads to incessant coughing, accompanied by symptoms such as headache, fever, and aversion to cold. If the external contraction is severe, Xiang Su Yin (Fragrant Perilla Drink) is appropriate, added with Xing Ren (Apricot Seed) and Fang Feng (Saposhnikovia Root) each at 2 qian, Ban Xia (Pinellia Tuber) and Gan Jiang (Dried Ginger) each at 1.5 qian, Wu Wei Zi (Schisandra Fruit) crushed flat, and Xi Xin (Asarum Root) each at 0.8 fen. Decoct in water and take orally. After taking the medicine, cover with blankets to induce slight sweating. If the external contraction is mild, Er Chen Tang (Two-Cured Decoction) is appropriate, added with Xi Xin (Asarum Root), Gan Jiang (Dried Ginger), Wu Wei Zi (Schisandra Fruit), Xing Ren (Apricot Seed), and Qian Hu (Peucedani Radix). ○ If either of these two conditions presents with edema of the face and eyes, add Sang Bai Pi (Morus Bark) at 3 qian, and Ting Li Zi (Lepidii Fructus) at 0.8 fen (lightly fried, ground into powder, and taken mixed with liquid).
Xiang Su Yin. (Formula 35) Er Chen Tang. (Formula 82)
1. External contraction of wind-cold with prolonged coughing, where each paroxysmal cough causes pulling pain in the hypochondrium and fever, or alternating chills and fever, is suitable for Xiao Yao San (Free and Easy Wanderer Powder). Double the dosage of Chai Hu (Bupleuri Radix), and add Ban Xia (Pinellia Tuber) and Gan Jiang (Dried Ginger) each at 1.5 qian, and Wu Wei Zi (Schisandra Fruit) at 1 qian. (Formula 48)
1. Summerheat injury in summer presenting with coughing, spontaneous sweating, thirst, and scanty dark urine is suitable for Liu Yi San (Six-to-One Powder): Hua Shi (Talcum) at 6 qian, Gan Cao (Licorice Root) at 1 qian, added with Gan Jiang (Dried Ginger), Xi Xin (Asarum Root), and Wu Wei Zi (Schisandra Fruit) each at 1 qian. Decoct in water and take orally.
1. Autumn dryness injury in autumn, presenting with shivering aversion to cold, followed by fever after the cold subsides, gradually developing into coughing. If coughing persists and gradually progresses to diarrhea and dysentery, Xie Bai San (Drain White Powder) is appropriate. Combine two doses into one, remove Jing Mi (Rice Grain), and add Huang Qin (Scutellaria Root) and E Jiao (Donkey-Hide Gelatin) each at 1.5 qian, Gan Jiang (Dried Ginger) at 1 qian, and Wu Wei Zi (Schisandra Fruit) and Xi Xin (Asarum Root) each at 0.5 fen. Decoct in water and take orally. This modification of the formula would likely astonish mediocre physicians with its complexity; only those who can read the works of Sun Simiao (Sun Zhenren) will know that it derives from the combination of Wu Wei Zi Tang (Schisandra Decoction) and Mai Men Dong Tang (Ophiopogon Decoction). (Formula 86)
If the above-mentioned coughs are treated incorrectly, they may frequently lead to hemoptysis (coughing up blood) and consumptive disease (deficiency-emaciation).