风、寒、火、劳、痰、肺胀、湿、五脏咳,看痰例分六气治为要。
发散 风∶消风散、金沸草散。寒∶麻黄汤、干姜五味子汤。
下 湿∶十枣汤、小胃丹、葶苈木香散。水∶葶苈丸。胃实痰郁者,下后调理。
宣 痰在膈上,或停郁胃中。重者,瓜蒂散。轻者,萝卜子末吐之。
泻火 实者,解毒汤。轻者,知母、地骨、桑白皮、麦门冬、桔梗、甘草,礞石滚痰
丸。上半日属胃中有火,贝母、地骨。五更咳者,此胃中有食积,至此时流入肺中。
滋阴 午后嗽多者,属阴虚,四物、知母、黄柏、或四物入竹沥,或六味丸,或八味
丸为要药。
收敛 火气浮于肺,不宜用凉药,以五味、五倍敛而降之,或粟壳、乌梅之类。肺胀
者,诃子、青黛、杏仁,久咳自汗宜用之。
泻白 肺气有余宜泻之,桑白为主,半夏、茯菟佐之,泻其有余,补其不足。
清金 肺燥当润之。属热者,桔梗、大力、知母、鸡清。声哑者属寒,细辛、半夏、
生姜,辛以散之。
补 肺虚者,人参膏补之,阿胶为主。阴不足者,六味丸为要药,知母茯苓汤炒。咳
而泻者、痢者、用粟壳不必疑。
熏 款花、雄黄、艾,烧烟熏入喉中,以散肺中邪气。丹溪治久嗽风入肺者,用鹅管
石、雄黄、郁金,款花碾末和艾中,以生姜一片留舌上灸之,以烟入喉中为度。
灸 天突、肺俞、肩井、少商、然谷、肝俞、期门、行间、廉泉、扶突。
针 曲泽,治咳喘出血立已。前谷穴兼胸满。面赤热咳,支沟。多唾,三里。
导痰 食痰,瑞竹堂方化痰丸。热∶滚痰丸。湿∶葶苈、桑白。风痰∶青州白丸子。
行气 二陈加南星、紫苏、桔梗、枳壳之类,桑白皮。燥者,杏仁、苏子。热者兼荆
、芩、连、知母。
凉血 热伤血分,宜生地、地骨、知母、麦门冬、阿胶、甘草、桑白皮、桔梗、紫菀
、五味、荆、芩。
劫药 五味(半两) 甘草(二钱半) 五倍(一钱) 风化硝(一钱) 上为末,干含化。
一方∶粟壳(四两,炒) 乌梅(一两) 人参(半两) 款花(半两) 苦梗(半两) 兜苓(
一两) 南星(姜制,一两)
上为末,蜜丸弹子大,含化。汗多者用之。
风、寒、火、劳损、痰饮、肺胀、湿邪、五脏咳,治疗的关键在于根据痰液的性状来辨别六淫(风、寒、暑、湿、燥、火)之邪并施治。
发散法:针对风邪,使用消风散、金沸草散;针对寒邪,使用麻黄汤、干姜五味子汤。
攻下法:针对湿邪,使用十枣汤、小胃丹、葶苈木香散;针对水饮,使用葶苈丸。若为胃实痰郁者,攻下后需进行调理。
宣吐法:痰在膈上,或停滞郁结于胃中。病情重者,用瓜蒂散催吐;病情轻者,用萝卜子末催吐。
泻火法:实证,用解毒汤;轻证,用知母、地骨皮、桑白皮、麦门冬、桔梗、甘草,或礞石滚痰丸。上午咳嗽多属胃中有火,用贝母、地骨皮;五更时分咳嗽,此乃胃中有食积,此时食积流入肺中所致。
滋阴法:午后咳嗽多者,属阴虚,用四物汤、知母、黄柏,或在四物汤中加入竹沥,或选用六味丸、八味丸作为要药。
收敛法:火气浮越于肺,不宜用凉药,应用五味子、五倍子收敛而降逆,或用粟壳、乌梅之类。肺胀者,用诃子、青黛、杏仁;久咳自汗者宜用这些药物。
泻白法:肺气有余应当泻之,以桑白皮为主药,半夏、茯苓、菟丝子为辅佐,泻其有余,补其不足。
清金法:肺燥当滋润。属热者,用桔梗、牛大力、知母、鸡子清。声音嘶哑属寒,用细辛、半夏、生姜,以辛味药发散之。
补益法:肺虚者,用人参膏补益,以阿胶为主药。阴不足者,六味丸为要药,知母茯苓汤炒制服用。咳嗽兼腹泻者、痢疾者,用粟壳不必迟疑。
熏蒸法:款冬花、雄黄、艾叶,烧烟熏入喉中,以疏散肺中邪气。朱丹溪治疗久嗽风邪入肺者,用鹅管石、雄黄、郁金,将款冬花碾成粉末与艾叶混合,用一片生姜含在舌上灸之,以烟雾进入喉中为度。
艾灸法:天突穴、肺俞穴、肩井穴、少商穴、然谷穴、肝俞穴、期门穴、行间穴、廉泉穴、扶突穴。
针刺法:曲泽穴,治疗咳嗽气喘出血可立即停止。前谷穴兼治胸满。面赤热咳,取支沟穴。多唾,取足三里穴。
导痰法:食痰,用瑞竹堂方化痰丸;热痰,用滚痰丸;湿痰,用葶苈、桑白皮;风痰,用青州白丸子。
行气法:二陈汤加南星、紫苏、桔梗、枳壳之类,以及桑白皮。燥者,加杏仁、苏子;热者,兼加荆芥、黄芩、黄连、知母。
凉血法:热伤血分,宜用地黄、地骨皮、知母、麦门冬、阿胶、甘草、桑白皮、桔梗、紫菀、五味子、荆芥、黄芩。
劫药(强力止嗽药):五味子(半两)、甘草(二钱半)、五倍子(一钱)、风化硝(一钱)。以上研为末,干含化咽。
另一方:粟壳(四两,炒制)、乌梅(一两)、人参(半两)、款冬花(半两)、苦桔梗(半两)、兜铃(一两)、南星(姜制,一两)。以上研为末,蜜丸如弹子大,含化。汗多者用之。
Wind, cold, fire, consumption (lao), phlegm, lung distension (Fei Zhang), dampness, and five-zang coughs: the key to treatment lies in differentiating the six climatic factors (wind, cold, summer-heat, dampness, dryness, fire) based on the characteristics of sputum.
Dispersing Method: For wind pathogen, use Xiaofeng San (Eliminate Wind Powder) or Jinfeicao San (Ferulae Seed Decoction); for cold pathogen, use Mahuang Tang (Ephedra Decoction) or Ganjiang Wuweizi Tang (Dried Ginger and Schisandra Decoction).
Purgative Method: For dampness, use Shizao Tang (Ten Jujube Decoction), Xiaowei Dan (Minor Stomach Pill), or Tingli Muxiang San (Descurainia and Costus Powder); for water retention, use Tingli Wan (Descurainia Pill). If there is stomach excess with phlegm stagnation, post-purgation regulation is required.
Expeorating/Vomiting Method: When phlegm is above the diaphragm or stagnant in the stomach. For severe cases, use Gouti San (Melon Twig Powder) to induce vomiting; for mild cases, use Radish seed powder to induce vomiting.
Draining Fire Method: For excess patterns, use Jiedu Tang (Detoxification Decoction); for mild cases, use Motherwort Root Bark (Zhimu), Ground Tree Bark (Digupi), Mulberry Root Bark (Sangbaipi), Ophiopogon Tuber (Maimendong), Platycodon Root (Jiegeng), Licorice Root (Gancao), or Mengshi Guntan Wan (Calamine Rolling Phlegm Pill). Coughing in the morning often indicates fire in the stomach, treated with Fritillaria Bulb (Beimu) and Ground Tree Bark (Digupi). Coughing at dawn (wugeng) indicates food stagnation in the stomach that flows into the lungs at this time.
Nourishing Yin Method: Coughing mostly in the afternoon indicates yin deficiency. Use Siwu Tang (Four Substances Decoction), Zhimu, Huangbai, or Siwu Tang with Bamboo Sap (Zhuli). Alternatively, Liuwei Wan (Six-Ingredient Pill) or Bawei Wan (Eight-Ingredient Pill) are essential medicines.
Astringent Method: When fire qi floats in the lungs, cooling herbs should not be used. Instead, use Wuweizi (Schisandra Fruit) and Wubeizi (Chinese Gall) to astringe and descend, or use Qieke (Poppy Shell) and Wumei (Dark Plum). For lung distension, use Hezi (Chebula Fruit), Qingdai (Indigo Naturalis), and Xingren (Apricot Seed); these are suitable for chronic cough with spontaneous sweating.
Draining White (Lung) Method: When lung qi is in excess, it should be drained. Sangbaipi (Mulberry Root Bark) is the main herb, assisted by Banxia (Pinellia Rhizome), Fuling (Poria), and Tusizi (Cuscuta Seed), draining the excess and tonifying the deficiency.
Clearing Metal (Lung) Method: Dryness of the lung requires moistening. For heat patterns, use Jiegeng (Platycodon Root), Nidali (Niu Dalili/Zanthoxylum Root), Zhimu (Anemarrhena Rhizome), and Ji Qing (Chicken Egg White). Hoarseness indicates cold, treated with Xixin (Asarum), Banxia (Pinellia Rhizome), and Shengjiang (Fresh Ginger), dispersing with acrid flavors.
Tonifying Method: For lung deficiency, Ren Shen Gao (Ginseng Paste) is used for tonification, with Ejiao (Donkey-Hide Gelatin) as the main herb. For yin insufficiency, Liuwei Wan (Six-Ingredient Pill) is essential, taken with fried Zhimu Fuling Tang (Anemarrhena and Poria Decoction). For cough accompanied by diarrhea or dysentery, Qieke (Poppy Shell) can be used without hesitation.
Fumigation Method: Kuandonghua (Coltsfoot Flower), Xionghuang (Realgar), and Aiye (Mugwort Leaf) are burned to produce smoke inhaled into the throat to disperse evil qi in the lungs. Zhu Danxi treated chronic cough with wind entering the lungs using Eguanshi (Goose Quill Stone), Xionghuang (Realgar), and Yujin (Curcuma Tuber). The Kuotonghua was powdered and mixed with mugwort, applied with a slice of fresh ginger on the tongue for moxibustion, until smoke entered the throat.
Moxibustion Points: Tiantu (CV22), Feishu (BL13), Jianjing (GB21), Shaoshang (LU11), Ran Gu (KI2), Ganshu (BL18), Qimen (LR14), Xingjian (LR2), Lianquan (CV23), Futu (LI18).
Acupuncture Points: Quze (PC3) treats cough, asthma, and bleeding, stopping them immediately. Qiangu (SI4) treats chest fullness. Facial redness with hot cough is treated with Zhigou (SJ6). Excessive saliva is treated with Zusanli (ST36).
Guiding Phlegm Method: For food-phlegm, use Huatan Wan (Phlegm-Resolving Pill) from Ruizhutang Formula; for heat-phlegm, use Guntan Wan (Rolling Phlegm Pill); for damp-phlegm, use Tingli (Descurainia Seed) and Sangbaipi (Mulberry Root Bark); for wind-phlegm, use Qingzhou Baiwanzi (Qingzhou White Pills).
Moving Qi Method: Erchen Tang (Two-Cured Decoction) added with Nanxing (Arisaema Rhizome), Zisu (Perilla Leaf), Jiegeng (Platycodon Root), Zhike (Bitter Orange), and Sangbaipi (Mulberry Root Bark). For dryness, add Xingren (Apricot Seed) and Su Zi (Perilla Seed); for heat, add Jingjie (Schizonepeta), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Zhimu (Anemarrhena Rhizome).
Cooling Blood Method: Heat injuring the blood level is treated with Shengdi (Rehmannia Root), Digupi (Ground Tree Bark), Zhimu (Anemarrhena Rhizome), Maimendong (Ophiopogon Tuber), Ejiao (Donkey-Hide Gelatin), Gancao (Licorice Root), Sangbaipi (Mulberry Root Bark), Jiegeng (Platycodon Root), Ziwan (Aster Root), Wuweizi (Schisandra Fruit), Jingjie (Schizonepeta), and Huangqin (Scutellaria Root).
Jie Medicine (Potent Antitussive): Wuweizi (50g), Gancao (12.5g), Wubeizi (3g), Fenghua Xiao (Weathered Nitre, 3g). Grind into powder and suck dry.
Another Formula: Qieke (400g, stir-fried), Wumei (30g), Renshen (15g), Kuandonghua (15g), Kujie (15g), Doulou (30g), Nanxing (30g, ginger-processed). Grind into powder, make pills with honey the size of a bullet, and suck. Use for patients with excessive sweating.