咳嗽（五）咳嗽中医咳嗽病名太笼统，本编所列之咳嗽，近似西医急性传染病之肺炎及气管支炎一类之病症。凡轻微之咳嗽，及慢性传染病之肺痨，小儿之百日咳，均不在此例。中医对病人初起之咳嗽，往往不甚注意，在感冒风寒或轻微之咳嗽，一经治疗，或即自愈。然若患者罹真正急性传染之肺炎，再遇毫无西医知识之中医，往往误于医药，致伤人命，此非余轻视中医，在西医诊断治疗此症，绝不致误，然中药更有奇效，惜中医书太冗杂耳。盖以中医书论咳嗽，谓五脏六腑三焦，皆能令人咳嗽，说太支离，向无急性传染病之名，故中医对此危险之大传染病竟以咳嗽二字概之，贻误病家，不知凡几，小儿患此症尤多，且更危险。故余特为说明，愿中医注意也。
徐玉泉者，余友也，伊充吾乡庆祥茂商号之经理。一日患病，余闻之，急趋视，玉泉正苦咳嗽、胸痛、不能卧下，诊断结果，认为格鲁布性肺炎，余即亲赴西药房，力其调剂送回，令其速眼。至晚间，又往视之。则见其正煎中药，且玉泉见余有惭色，再视案上，则西药仍在，并未开瓶，坐间且有中医某君亲为煎药，盖亦玉泉之至友也。余处此场合，颇觉为难，乃辞出。七、八日后，闻玉泉已病重，因往伊家作友谊之探视，至则五泉已病危（自始至终吐锈色痰，不能卧下）肾囊及腿均肿甚，然某君仍昼夜尽心调治，不离左右，其真挚友爱之情令人感愧。所可惜者，中医书初无肺炎二字之病名，不得不谓为一大缺点，而医者为人治疗疾病，有时格于情势，不得尽其所长，亦余医话中之重要经验也。
（原因）本病约分两种，1．所谓气管支肺炎，2．格鲁布性肺炎是也。中医往往将此等病症概括为咳嗽一门，且多认为小病不甚重视，以致冶不得法，酿成危险大症者，数见不鲜。实则中药治此症，确实奇验，不可泯没，只要中医参照西医病理，认识此症，谨慎治疗，绝不致误人性命。故余谨将此症，根据西医病理，说明于下，以补中医之缺点也，①气管支肺炎，此症系由气管支，传达于肺之急性或亚急性炎症，多局限于肺之一小部，并生无数病灶，该部之气泡内，则有渗出物（痰）充满其间，所谓加答儿性肺炎是也。本病直接原因，系由细菌先侵小气管支，而后波及于肺，故多续发于麻疹痉咳（百日咳），流行性感冒，窒扶斯，其次则因吸入刺激之瓦斯及蒸汽，或因异物侵入气管支，均可诱起本病，老人及小儿，均易侵犯，尤以小儿为最多而小儿于麻疹后，尤易传染，且多危险。②格鲁布性肺炎，其原菌为双球菌，感冒及外伤，为本病之诱因，嗜酒家，尤易感染。
（症候）1．气管支肺炎，于诊断上最为紧要者，即为热之状态，本病之热型，极为不整，有强度之驰张，不分利，而徐徐涣散，脉搏非常增加，数脉，咳嗽频发，呼吸亦增加‘微喘），咯痰为粘液样‘稀痰），若肺脏大部分被侵害，因分泌物（痰）阻于气管，则呼吸更觉困难，小儿不能吐出痰液愈危险，死亡数亦愈多。热度增高，神识不清，凡衰弱小儿，由于疹后传染者更危险。本症体温，恒持续二十四及四十八小时以上，又在三十九度以上，若单纯之气管支炎，则无高热。咳嗽时，有胸痛、注意并皮肤苍白，均与单纯之气管支炎不同。此症小儿患者，胸挺目吊，已至危险期。
2，格鲁布性稠痰极粘肺炎，本病与气管支肺炎相反，多数以忽然寒战，或呕吐而起，嗣即发热，达四十度以上，胸内刺痛，尤以咳嗽及呼吸时为甚，脉强实。初起干咳，第二日后则吐血痰，再经二、三日，则为锈色痰（微蓝色，，诸症持续，高热亦不通（稽留约七八日，。而胸痛为奉病最重要之症状，尤应注意，热多分利·下降痰之稠粘及锈色，亦为诊断上主要之点，其馀则有不眠、谵妄、头痛、小便赤短、舌苔黄厚、大便秘结等，亦可供参考。老年人及小儿患者，尤危险。此症分充血期、变肝期，（肺肿似肝样）融解期（尽成脓汁），皆属于解剖病理，兹从略。本病体温率稽留数日，则分利下降，然分利过早（假性分利），则温度恐仍然上升，后再经一、二日，乃呈真一分利而退热。以上二种咳嗽多不能卧。
（治法）西医对于以上肺炎之疗法。多用下热剂、水治法、温浴、冷浴祛痰剂、麻醉剂、强心剂等，均有确效。其预防注射，于本病大流行时，尤为必要，不可忽略。惟冷浴治法，不但不合于中国人之习惯，且实际上亦无多大之效力，反有增加病势之流弊，此余由经验所下之断语，不可以其治法来自西洋，即冒然认为金科玉律也。中医有治此症极效之药，惜中医多半谬于种种古说，用药滥杂，反致误病。盖此症初起，多有寒战，继则发热，乃一定病程，中医往往认为感冒。伤寒，而忽略其本症，于是发散辛温之品纷进，而病势愈加，迨至病重，又按其发现类似之病症，成方成药，遵古杂投，例如肺咳，心痛喉中介介如梗状，则用麻黄汤。肝咳胁痛，不可转，转则胁下满，用小柴胡汤。肾咳，则腰背痛，用麻黄附于细卒汤等之谬说，不一而足。设使肺炎既重，若觉心痛则疑为肺咳，用麻黄汤，若觉胁痛，则疑为肝咳，用小柴胡汤，若觉腰背痛，则疑为肾咳，用麻黄附子细辛汤等，试问此种药物，用之于正在进行之肺炎，是否杀人，真令人不寒而栗矣。然临症之中医，用此方仍振振有词曰，根据古书，脉症用药相符，而病者死矣，呜呼1孰杀之？创造无稽谬说之古书，与夫笃信古书之医者杀之也。余临诊此种危症，检查过去所用药方，十之八九，不出此范围，尤以此症治不得法；久咳不止，谬加收敛药品，更觉荒谬绝伦，此虽不必尽用成方，然剪裁成方，凑合而成，以至酿成大患者，不知凡几，病者哀求，家属环泣，病已至此，余亦只有怜悯耳。（犹记一十四岁之幼子，抱其一息仅存之病父微微呼曰：“罗先生来矣，这就好了。”其声幽咽令人闻之酸鼻，此景如在目前，此即死于肺炎之一例也。）心所谓危，故不觉言之过激，愿中医猛省也。而小病酿成大病，以致误人性命，良可慨矣。此症在西医预后，虽不无多少危险，然以奇效之中药治之，余敢断言百不失一。兹谨将余经验治法，说明于下：1．凡咳嗽初起，甚重，（第一日）热度甚高，恶寒时间太长，又兼头痛、身痛、脉紧，又在冬季注意此二字，当然按照表证，于治咳嗽药中，杏仁、贝母，苏子、桑皮、橘红，药量适宜。加入表散之品，苏叶，防风，甚则加麻黄，药量宜轻，微微取汗，姜三片、梨一枚为引经过一、二日，若无效，恶寒必去咳嗽发热更甚，即有肺炎嫌疑，注意不可发散。万不可再用表药发汗，此际必以大剂相当之品，例如霜桑叶、绿豆皮、竹叶、杏仁、粉丹皮、金银花、川贝母、鲜生地、鲜芦根每味四、五钱或五、六钱至一两，痰多可稍加橘红。等，以冀消炎。若系疹后，自初即不可用表药，更宜重加连翘，药量加至七、八钱可也，更须注意患者之大便，此是要诀不论如何，均宜酌加瓜蒌一、二钱。若有高热，而大便又三、四日不通，或泻极臭之便即宜于原方酌加熟大黄。若小儿胸挺气促神昏，不可骤用大黄，（若大便闭亦可用）宜于前药加犀角、羚羊角三、五分，但前药之量宜减。此症初起，虽以恶寒战栗而起，但其恶寒时间若甚小，且非冬月寒凉，而脉又洪数者，右手更显明总以不用表药防风、苏叶、麻黄等为是，而表药中之桂枝一味，尤为大忌，临症时应格外注意也。高热有时参用西药之撤曹及安其比林等，不可忽视。此症唯一奇效之中药，已如上述，此外中药治嗽之品，不可滥用，此实余经验之谈，愿医者相信也。此症本非必死之病，而吾乡则死于此者，木知凡几，均余所亲见，十之八九，皆药误人，惜哉。
（医验）严宅幼科，一岁，住东四牌楼汪家胡同十五号，于二十五年九月二十六日来诊，咳嗽、喘促、神昏、身有高热、目闭、胸挺，询知以前曾眼药发汗，现在病已数日，不能食乳，小便短少，兼有白粉样沉淀，断为肺炎波及脑膜及肾脏，均发炎，症属危殆，因以经验之方清肺之剂与之，并介绍西医，嘱其速行血清注射疗法，其方列下。余曾主张中医不可滥用炎字，本编说明病症用此字，系希望医理易于明显，并非医案也。
第一方，丹皮一钱绿豆皮二钱竹叶一钱桑叶一钱杏仁一钱贝母一钱瓜蒌五分鲜茅根——钱梨一枚引，煎服。嘱其煎妥分六次，一日夜灌下，乃第二日来诊，竟诸症皆减，大有转机，亦未请西医注射，惟大便未通，痰多，而精神则略清醒，乃照前方大意加减与之，其方列下。
第二方，丹皮一钱绿豆皮二钱竹叶一钱桑叶一钱橘红三分杏仁一钱贝母一钱天花粉一钱熟军五分通草一钱鲜茅根一钱梨一枚引，煎服。嘱其仍照前法服之，第三日来诊，已退热，咳嗽亦渐止，小便沉淀渐少，大便泻一次，极臭，诸症均减，精神清醒，乃与第三方，仍本第一方大意，其方列下。
第二方，丹皮五分绿豆皮二钱竹叶一钱桑叶一钱杏仁五分贝母五分金银花二钱瓜蒌仁三分寸冬五分鲜生地五分橘红三分鲜茅根一钱梨一枚引，煎服。嘱其仍照前法服下，此方连服三剂，完全告愈，始终未用西药。本书正在付印时，此孩又患此症喘热甚重，仍以此方加重药量治愈，兼用撒曹六次，并识之。
此等方，治愈肺炎重症，不知凡几，药虽平常，效实奇人，其药量，计成年人可用至七、八钱亦无妨，惟药量太轻则无效，杂以他药亦无效，此方几成标准方矣。以上医验，系一岁量，余可类推，前于疹疾门，列有女孙惟静并发肺炎极重一方，可与此参看，中医治病最活，其长处即在此，宜细参之。咳嗽症关于肺脏之西医病名极多，凡有热性之新得咳嗽，除肺痨外，此方统治，故不列举。
肺痨（六）肺痨此症包括于中医书所称痨瘵、虚劳、咳嗽、肺痿、肺瘅、失音、吐血等病名之中，殊嫌含混，兹揭肺痨病名，似较扼要。
此症已于前病理学中，阴虚发热条下，略说明之，可参看此症虽多以咳嗽及吐血为病征，然其根本来源，即在虚弱二字，所以此症自始至终，亦有不咳嗽、吐血而死亡者，若将虚弱根本治愈，使之强壮，则咳嗽、吐血，发热、自汗等现象，亦随之而去，可见咳嗽等症状，犹本症之标病也。近世震于西医肺结核为慢性传染病，并无特效根本治法之说，遂以为既得此症，必无生理，新识愈高，惶恐愈甚，其实此种心理，皆一偏之见，倒果为因，不能不有多少之错误。盖皮毛医者论此症，根本对中西医学，并不能作精密之研究，其言固不足以信，即或学理研究，已有相当程度，而又缺乏长时间临床之实验，骤下断语，亦必不能中肯。西医说非不可信，但彼只根据西医之学理与解剖而立论，学术虽至精当，然只囿于一方。中医古书，散漫庞杂，不合逻辑，而又参以各种荒唐不经之玄谈，操以不学无术之庸医，致使灵验奇效，远胜舶来品之中药，埋没弗彰，此辈罪不容诛矣。
余凡百学问事业，皆不如人，然对于中西医理，尤其对于肺痨病一症，实已消耗四十馀年之心血，乃至现在学理方面，实验方面，根据本明了此症之所以然，而能有极和平，极有效之治疗法，确能超过西医之拘板治法，更能洗清中医之杂滥流弊，而得其真谛。兹谨说细陈述，句句是断语，字字是经验，愿信余者，信余言也。立论不合中医古书，则人谓为非圣无法，不合西医书，则人谓为反科学。余不敏，对此症理论及药物，均不能与中西医吻合，余只知治病有效，不敢从同。故此章反驳中西医处，赤裸露骨，不留馀地，愿识者谅之。
亡原因）肺痨病之病源，为结核杆菌，渐次发生，因炎性产出物而起之化脓性分解，为长久持续之肺组织崩溃，同时其他脏器，亦呈同一之病症。本症于结核菌外，更有他种细菌，所谓混合传染也。该菌侵入人体之径路，大约不外吸气、血管、淋巴管。细分之为，①与空气同吸入，②由口腔传染，例如对痰、唾液，③食物传染，例如含杆菌之牛乳，④器物传染，例如病人用具，⑤损伤传染，例如皮肤破损，杆菌由破处侵入淋巴管而深入。⑥生殖器传染，有结核之男子精液及妇人生殖器，因交媾而互相传染，或传染初生儿。凡有以上传染机会，均易感受。然该菌发育极缓，且该菌侵入体内，并不常久固着体内排除体外，故亦有传染之后，幸有不罹本病者。例如兄弟姊妹，均有血族上之传染，因而死亡，其中一、二人，终身竟不感染者有之。亦有一种特异质之人，对结核菌感染后，最易发育，且以极迅速之病程而致命。俗名百日痨关于此症之诱因，亦有数种：①体格体质虚弱，及长身孱赢，胸狭颈细者，（痨瘵质）最易发生此症。⑧年龄尤以十八岁至三十岁为最多。③环境空气污浊，日光缺乏。④生活滋养不足，运动欠缺，忧愁、妊娠、产后、及过劳、恶嗜、暨大病之后等。
⑤外伤，⑥肺及肋膜之疾患肺炎，肋膜炎等。以上各项，均易辗转诱起肺痨病，年龄一项，不得为诱因，但在此时期，最易罹此症也。尤以身体衰弱一时的过劳亦包括在内之时为甚。
咳嗽（五）中医所说的“咳嗽”这一病名过于笼统，本编所列举的咳嗽，近似于西医急性传染病中的肺炎及支气管炎一类病症。凡是轻微的咳嗽，以及慢性传染病肺痨（肺结核），还有小儿的百日咳，均不在此列。中医对于病人初起时的咳嗽，往往不太重视，在感冒风寒或轻微咳嗽的情况下，一经治疗，或者就能自愈。然而，如果患者罹患的是真正的急性传染性肺炎，再遇到毫无西医知识的中医，往往会因误诊误治而致人死亡，这并不是我轻视中医，而是说在西医的诊断和治疗下，绝不会发生这种错误。当然，中药对此症也有奇效，可惜中医书籍太过冗杂混乱。因为中医书籍论述咳嗽时，称五脏六腑和三焦都能导致咳嗽，说法太支离破碎，古代又没有急性传染病的名称，所以中医对这种危险性极大的传染病竟然只用“咳嗽”二字概括，贻误了不知多少病患，尤其是小儿患此症更多，且更加危险。所以我特意加以说明，希望中医能注意这一点。
徐玉泉是我的朋友，他担任我们家乡庆祥茂商号的经理。有一天他生病了，我听说后，急忙赶去探望。玉泉正痛苦于咳嗽、胸痛，无法躺下。诊断结果认为是格鲁布性肺炎（大叶性肺炎）。我随即亲自去西药房，催促药剂师配好药送回去，让他尽快服用。到了晚上，我又去探望他。只见他正在煎中药，而且玉泉看到我时面露惭色。再看案子上，西药还在原处，并未开封。坐间还有一位姓某的中医朋友亲自为他煎药，这也是玉泉的至交好友。我处于这种场合，颇感为难，于是告辞离开。七八天后，听说玉泉病情加重，便去他家进行友谊性的探视。到达时，玉泉已经病危（从开始到结束一直吐锈色痰，无法躺下），阴囊和双腿都严重肿胀。然而那位某君仍然昼夜尽心调治，不离左右，其真挚的友爱之情令人感动又惭愧。所遗憾的是，中医书中起初根本没有“肺炎”这个病名，不得不说是个一大缺点。而医者为人治疗疾病，有时受限于情势，不能充分发挥所长，这也是我在医话中的重要经验之一。
（原因）本病大约分为两种：1. 所谓支气管肺炎；2. 格鲁布性肺炎。中医往往将这些病症概括为“咳嗽”一门，且多认为是小病而不甚重视，以致治疗不得法，酿成危险大病的情况，屡见不鲜。实际上，中药治疗此症确实有奇效，不可埋没。只要中医参照西医病理，认识此症，谨慎治疗，绝不会误人性命。所以我谨将此症根据西医病理说明如下，以弥补中医的缺点：①支气管肺炎，此症是由支气管传导至肺部的急性或亚急性炎症，多局限于肺部的一小部分，并产生无数病灶，该部分的气泡内充满渗出物（痰），这就是所谓的卡他性肺炎。本病的直接原因是细菌先侵入小支气管，而后波及肺部，故多继发于麻疹、痉咳（百日咳）、流行性感冒、伤寒之后，其次则是因为吸入刺激性瓦斯及蒸汽，或因异物侵入支气管，均可诱发本病。老人和小儿都容易患病，尤以小儿最多，而小儿在麻疹后尤其容易感染，且多危险。②格鲁布性肺炎，其病原菌为双球菌，感冒和外伤是本病的诱因，嗜酒者尤其容易感染。
（症候）1. 支气管肺炎，在诊断上最为紧要的是热的状态。本病的热型极为不规则，有强度的弛张热，不分利（指热势起伏不定），而是徐徐涣散。脉搏非常增加，呈数脉，咳嗽频发，呼吸也增加（微喘），咯痰为粘液样（稀痰）。若肺脏大部分被侵害，因分泌物（痰）阻塞气管，则呼吸更觉困难。小儿不能吐出痰液愈危险，死亡数也愈多。热度增高，神识不清，凡是衰弱的小儿，由于疹后传染者更危险。本症体温恒持续二十四及四十八小时以上，且在三十九度以上。若是单纯的支气管炎，则无高热。咳嗽时有胸痛，面色苍白，均与单纯之支气管炎不同。此症小儿患者，胸挺目吊，已至危险期。
2. 格鲁布性肺炎，本病与支气管肺炎相反，多数以突然寒战或呕吐而起，随后发热，达四十度以上，胸内刺痛，尤以咳嗽及呼吸时为甚，脉象强实。初起干咳，第二日后则吐血痰，再经二、三日，则为锈色痰（微蓝色）。诸症持续，高热也不退（稽留约七八日）。而胸痛为本病最重要的症状，尤应注意。热多分利（指热势下降），痰之稠粘及锈色，也是诊断上的主要点。其余还有不眠、谵妄、头痛、小便赤短、舌苔黄厚、大便秘结等，也可供参考。老年人及小儿患者尤其危险。此症分为充血期、变肝期（肺肿似肝样）、融解期（尽成脓汁），皆属于解剖病理，此处从略。本病体温率稽留数日，则分利下降，然分利过早（假性分利），则温度恐仍然上升，后再经一、二日，乃呈真一分利而退热。以上两种咳嗽多不能卧。
（治法）西医对于以上肺炎的疗法，多用退热剂、水疗法、温浴、冷浴、祛痰剂、麻醉剂、强心剂等，均有确切疗效。其预防注射，在本病大流行时，尤为必要，不可忽略。惟冷浴治法，不仅不合中国人的习惯，且实际上也无多大效力，反而有增加病势的流弊，这是我由经验得出的断语，不可以因为其治法来自西洋，就冒然认为金科玉律。中医有治疗此症极有效的药物，可惜中医多半谬于种种古说，用药滥杂，反致误病。盖此症初起，多有寒战，继则发热，乃一定病程，中医往往认为是感冒、伤寒，而忽略其本症，于是发散辛温之品纷进，而病势愈加。迨至病重，又按其发现类似之病症，成方成药，遵古杂投。例如肺咳，心痛喉中介介如梗状，则用麻黄汤；肝咳胁痛，不可转，转则胁下满，用小柴胡汤；肾咳，则腰背痛，用麻黄附子细辛汤等谬说，不一而足。假设肺炎既重，若觉心痛则疑为肺咳，用麻黄汤；若觉胁痛，则疑为肝咳，用小柴胡汤；若觉腰背痛，则疑为肾咳，用麻黄附子细辛汤等，试问此种药物，用之于正在进行之肺炎，是否杀人？真令人不寒而栗矣。然而临症之中医，用此方仍振振有词曰：“根据古书，脉症用药相符”，而病者死矣，呜呼！谁杀之？创造无稽谬说之古书，与夫笃信古书之医者杀之也。我临诊此种危症，检查过去所用药方，十之八九，不出此范围。尤以此症治不得法，久咳不止，谬加收敛药品，更觉荒谬绝伦。此虽不必尽用成方，然剪裁成方，凑合而成，以至酿成大患者，不知凡几。病者哀求，家属环泣，病已至此，余亦只有怜悯耳。（犹记一十四岁之幼子，抱其一息仅存之病父微微呼曰：“罗先生来矣，这就好了。”其声幽咽令人闻之酸鼻，此景如在目前，此即死于肺炎之一例也。）心所谓危，故不觉言之过激，愿中医猛省也。而小病酿成大病，以致误人性命，良可慨矣。此症在西医预后，虽不无多少危险，然以奇效之中药治之，余敢断言百不失一。兹谨将余经验治法，说明于下：1. 凡咳嗽初起，甚重，（第一日）热度甚高，恶寒时间太长，又兼头痛、身痛、脉紧，又在冬季，注意此二字，当然按照表证，于治咳嗽药中，杏仁、贝母、苏子、桑皮、橘红，药量适宜。加入表散之品，苏叶、防风，甚则加麻黄，药量宜轻，微微取汗，姜三片、梨一枚为引。经过一、二日，若无效，恶寒必去，咳嗽发热更甚，即有肺炎嫌疑，注意不可发散。万不可再用表药发汗，此际必以大剂相当之品，例如霜桑叶、绿豆皮、竹叶、杏仁、粉丹皮、金银花、川贝母、鲜生地、鲜芦根，每味四、五钱或五、六钱至一两，痰多可稍加橘红等，以冀消炎。若系疹后，自初即不可用表药，更宜重加连翘，药量加至七、八钱可也。更须注意患者之大便，此是要诀。不论如何，均宜酌加瓜蒌一、二钱。若有高热，而大便又三、四日不通，或泻极臭之便，即宜于原方酌加熟大黄。若小儿胸挺气促神昏，不可骤用大黄，（若大便闭亦可用）宜于前药加犀角、羚羊角三、五分，但前药之量宜减。此症初起，虽以恶寒战栗而起，但其恶寒时间若甚小，且非冬月寒凉，而脉又洪数者，右手更显明，总以不用表药防风、苏叶、麻黄等为是，而表药中之桂枝一味，尤为大忌，临症时应格外注意也。高热有时参用西药之撒曹及安其比林等，不可忽视。此症唯一奇效之中药，已如上述，此外中药治嗽之品，不可滥用，此实余经验之谈，愿医者相信也。此症本非必死之病，而吾乡则死于此者，不知凡几，均余所亲见，十之八九，皆药误人，惜哉。
（医验）严宅幼科，一岁，住东四牌楼汪家胡同十五号，于二十五年九月二十六日来诊，咳嗽、喘促、神昏、身有高热、目闭、胸挺，询知以前曾服药发汗，现在病已数日，不能食乳，小便短少，兼有白粉样沉淀，断为肺炎波及脑膜及肾脏，均发炎，症属危殆。因以经验之方清肺之剂与之，并介绍西医，嘱其速行血清注射疗法。其方列下。余曾主张中医不可滥用“炎”字，本编说明病症用此字，系希望医理易于明显，并非医案也。
第一方，丹皮一钱，绿豆皮二钱，竹叶一钱，桑叶一钱，杏仁一钱，贝母一钱，瓜蒌五分，鲜茅根一钱，梨一枚为引，煎服。嘱其煎妥分六次，一日夜灌下。乃第二日来诊，竟诸症皆减，大有转机，亦未请西医注射，惟大便未通，痰多，而精神则略清醒，乃照前方大意加减与之，其方列下。
第二方，丹皮一钱，绿豆皮二钱，竹叶一钱，桑叶一钱，橘红三分，杏仁一钱，贝母一钱，天花粉一钱，熟军五分，通草一钱，鲜茅根一钱，梨一枚为引，煎服。嘱其仍照前法服之。第三日来诊，已退热，咳嗽亦渐止，小便沉淀渐少，大便泻一次，极臭，诸症均减，精神清醒，乃与第三方，仍本第一方大意，其方列下。
第三方，丹皮五分，绿豆皮二钱，竹叶一钱，桑叶一钱，杏仁五分，贝母五分，金银花二钱，瓜蒌仁三分，寸冬五分，鲜生地五分，橘红三分，鲜茅根一钱，梨一枚为引，煎服。嘱其仍照前法服下。此方连服三剂，完全告愈，始终未用西药。本书正在付印时，此孩又患此症，喘热甚重，仍以此方加重药量治愈，兼用撒曹六次，并识之。
此等方，治愈肺炎重症，不知凡几，药虽平常，效实奇人，其药量，计成年人可用至七、八钱亦无妨，惟药量太轻则无效，杂以他药亦无效，此方几成标准方矣。以上医验，系一岁量，余可类推。前于疹疾门，列有女孙惟静并发肺炎极重一方，可与此参看。中医治病最活，其长处即在此，宜细参之。咳嗽症关于肺脏之西医病名极多，凡有热性之新得咳嗽，除肺痨外，此方统治，故不列举。
肺痨（六）肺痨此症包括于中医书所称痨瘵、虚劳、咳嗽、肺痿、肺瘅、失音、吐血等病名之中，殊嫌含混，兹揭肺痨病名，似较扼要。
此症已于前病理学中，阴虚发热条下，略说明之，可参看。此症虽多以咳嗽及吐血为病征，然其根本来源，即在虚弱二字，所以此症自始至终，亦有不咳嗽、吐血而死亡者。若将虚弱根本治愈，使之强壮，则咳嗽、吐血、发热、自汗等现象，亦随之而去，可见咳嗽等症状，犹本症之标病也。近世震于西医肺结核为慢性传染病，并无特效根本治法之说，遂以为既得此症，必无生理，新识愈高，惶恐愈甚，其实此种心理，皆一偏之见，倒果为因，不能不有多少之错误。盖皮毛医者论此症，根本对中西医学，并不能作精密之研究，其言固不足以信，即或学理研究，已有相当程度，而又缺乏长时间临床之实验，骤下断语，亦必不能中肯。西医说非不可信，但彼只根据西医之学理与解剖而立论，学术虽至精当，然只囿于一方。中医古书，散漫庞杂，不合逻辑，而又参以各种荒唐不经之玄谈，操以不学无术之庸医，致使灵验奇效，远胜舶来品之中药，埋没弗彰，此辈罪不容诛矣。
余凡百学问事业，皆不如人，然对于中西医理，尤其对于肺痨病一症，实已消耗四十馀年之心血，乃至现在学理方面，实验方面，根据本明了此症之所以然，而能有极和平，极有效之治疗法，确能超过西医之拘板治法，更能洗清中医之杂滥流弊，而得其真谛。兹谨说细陈述，句句是断语，字字是经验，愿信余者，信余言也。立论不合中医古书，则人谓为非圣无法，不合西医书，则人谓为反科学。余不敏，对此症理论及药物，均不能与中西医吻合，余只知治病有效，不敢从同。故此章反驳中西医处，赤裸露骨，不留馀地，愿识者谅之。
（亡原因）肺痨病之病源，为结核杆菌，渐次发生，因炎性产出物而起之化脓性分解，为长久持续之肺组织崩溃，同时其他脏器，亦呈同一之病症。本症于结核菌外，更有他种细菌，所谓混合传染也。该菌侵入人体之径路，大约不外吸气、血管、淋巴管。细分之为，①与空气同吸入，②由口腔传染，例如对痰、唾液，③食物传染，例如含杆菌之牛乳，④器物传染，例如病人用具，⑤损伤传染，例如皮肤破损，杆菌由破处侵入淋巴管而深入。⑥生殖器传染，有结核之男子精液及妇人生殖器，因交媾而互相传染，或传染初生儿。凡有以上传染机会，均易感受。然该菌发育极缓，且该菌侵入体内，并不常久固着体内排除体外，故亦有传染之后，幸有不罹本病者。例如兄弟姊妹，均有血族上之传染，因而死亡，其中一、二人，终身竟不感染者有之。亦有一种特异质之人，对结核菌感染后，最易发育，且以极迅速之病程而致命。俗名百日痨。关于此症之诱因，亦有数种：①体格体质虚弱，及长身孱赢，胸狭颈细者，（痨瘵质）最易发生此症。②年龄，尤以十八岁至三十岁为最多。③环境空气污浊，日光缺乏。④生活滋养不足，运动欠缺，忧愁、妊娠、产后、及过劳、恶嗜、暨大病之后等。⑤外伤，⑥肺及肋膜之疾患（肺炎，肋膜炎等）。以上各项，均易辗转诱起肺痨病，年龄一项，不得为诱因，但在此时期，最易罹此症也。尤以身体衰弱一时的过劳亦包括在内之时为甚。
Cough (5) The term "cough" in Traditional Chinese Medicine (TCM) is too broad. The coughs listed in this compilation are similar to pneumonia and bronchitis, which are types of acute infectious diseases in Western medicine. Mild coughs, chronic infectious disease tuberculosis (pulmonary tuberculosis), and whooping cough in children are not included in this category. TCM practitioners often pay little attention to the initial cough of a patient. In cases of cold wind or mild cough, treatment may lead to spontaneous recovery. However, if a patient suffers from true acute infectious pneumonia and encounters a TCM practitioner with no knowledge of Western medicine, misdiagnosis and mistreatment can often result in death. This is not my disrespect for TCM; rather, under Western medical diagnosis and treatment, such errors would absolutely not occur. Of course, Chinese herbal medicine also has miraculous effects on this condition, but unfortunately, TCM books are too verbose and chaotic. When discussing cough in TCM texts, it is stated that the five zang organs, six fu organs, and San Jiao (Triple Burner) can all cause cough, which is a fragmented view. Since there was no name for acute infectious diseases in ancient times, TCM generalized this highly dangerous infectious disease simply as "cough," misleading countless patients, especially children who are more susceptible and face greater danger. Therefore, I specifically explain this to urge TCM practitioners to take note.
Xu Yuquan was my friend, serving as the manager of Qingxiang Mao Commercial Firm in our hometown. One day he fell ill, and upon hearing this, I rushed to visit him. Yuquan was suffering severely from cough, chest pain, and an inability to lie down. The diagnosis indicated lobar pneumonia (lobar pneumonia). I immediately went to the Western pharmacy myself, urged the pharmacist to prepare the medication, and sent it back for him to take promptly. That evening, I visited again. I saw him brewing Chinese herbal medicine, and Yuquan looked ashamed when he saw me. Looking at the desk, the Western medicine remained unopened. A certain TCM doctor, a close friend of Yuquan, was personally brewing the herbs for him. I felt awkward in this situation and took my leave. Seven or eight days later, hearing that Yuquan's condition had worsened, I visited him out of friendship. Upon arrival, Yuquan was critically ill (he had been expectorating rust-colored sputum throughout and could not lie down); his scrotum and legs were severely swollen. Yet, that doctor continued to care for him diligently day and night, never leaving his side. His sincere friendship moved and humbled me. Regrettably, TCM books initially lacked the disease name "pneumonia," which is a significant shortcoming. Physicians treating patients are sometimes constrained by circumstances and unable to fully utilize their expertise, which is an important experience recorded in my medical anecdotes.
(Causes) This illness is roughly divided into two types: 1. Bronchopneumonia; 2. Lobar pneumonia. TCM often categorizes these conditions under "cough" and frequently considers them minor illnesses, neglecting them. Consequently, improper treatment often leads to dangerous complications, a phenomenon seen frequently. In reality, Chinese herbal medicine is indeed effective for this condition and should not be overlooked. As long as TCM practitioners refer to Western pathological principles, recognize this condition, and treat it cautiously, it will absolutely not prove fatal. Therefore, I hereby explain this condition based on Western pathology to supplement TCM shortcomings: ① Bronchopneumonia is an acute or subacute inflammation transmitted from the bronchi to the lungs, mostly localized to a small part of the lung, producing numerous lesions. The alveoli in that area are filled with exudate (sputum), known as catarrhal pneumonia. The direct cause is bacteria first invading the small bronchi and then spreading to the lungs; thus, it often occurs secondary to measles, whooping cough (pertussis), influenza, or typhoid fever. Secondly, inhaling irritating gas and steam, or foreign bodies entering the bronchi, can induce this disease. The elderly and children are susceptible, especially children, who are particularly prone to infection after measles and face higher risks. ② Lobar pneumonia is caused by diplococci, with colds and trauma as inducing factors; alcoholics are especially prone to infection.
(Symptoms) 1. For bronchopneumonia, the most critical aspect in diagnosis is the nature of the fever. The fever pattern is extremely irregular, showing intense remittent characteristics, fluctuating without clear resolution, gradually dissipating. The pulse increases significantly, presenting as a rapid pulse. Coughing is frequent, and respiration increases (slight wheezing). Sputum is mucous-like (thin). If most of the lung is affected, secretion (sputum) obstructs the trachea, making breathing more difficult. The inability of children to expel sputum is more dangerous, leading to higher mortality. Increased body temperature and confusion are common; weak children infected after rashes are particularly at risk. Body temperature consistently remains above 39°C for over 24 to 48 hours. Simple bronchitis does not present with high fever. Chest pain during coughing and pale skin distinguish it from simple bronchitis. Children with this condition exhibit rigid chests and staring eyes, indicating a critical stage.
2. Lobar pneumonia contrasts with bronchopneumonia. It often begins with sudden chills or vomiting, followed by fever reaching over 40°C. There is stabbing chest pain, worse during coughing and breathing, with a strong and full pulse. Initially dry cough, turning to bloody sputum on the second day, and then rust-colored sputum (slightly blue) after two to three days. Symptoms persist, and high fever remains unremitting (continued fever for about seven to eight days). Chest pain is the most important symptom and requires special attention. Fever reduction (defervescence), along with the thickness and rust color of sputum, are key diagnostic points. Other symptoms include insomnia, delirium, headache, dark and scanty urine, thick yellow tongue coating, and constipation, which are also reference points. Elderly and pediatric patients are particularly at risk. This condition is divided anatomically into congestion, hepatization (lung swelling resembling liver tissue), and resolution (turning entirely to pus), details of which are omitted here. Body temperature typically remains continued for several days before defervescence. Premature defervescence (false defervescence) may lead to a subsequent rise in temperature, followed by true defervescence and fever reduction after one or two days. Both types of cough often prevent lying down.
(Treatment Methods) Western medical therapies for pneumonia above include antipyretics, hydrotherapy, warm baths, cold baths, expectorants, anesthetics, and cardiotonics, all of which have definite effects. Preventive vaccination is especially necessary during epidemics and should not be ignored. However, cold bath therapy not only conflicts with Chinese habits but also lacks practical efficacy, potentially exacerbating the condition, as concluded from my experience. One should not blindly accept Western treatments as absolute truths just because they originate from the West. TCM possesses highly effective medicines for this condition, yet many TCM practitioners err due to adherence to ancient theories, using indiscriminate medications that worsen the illness. Initially, this condition often presents with chills followed by fever, a fixed progression. TCM often mistakes it for a cold or Shanghan (Cold Damage), ignoring the primary symptoms, and thus administers acrid-warm diaphoretic agents, worsening the condition. When the illness becomes severe, practitioners apply ancient formulas based on superficial similarities. For example, for lung cough with heart pain and a sensation of obstruction in the throat, Maxing Shigan Tang (Ephedra, Apricot Seed, Gypsum, and Licorice Decoction) is used; for liver cough with hypochondriac pain preventing turning, Xiao Chaihu Tang (Minor Bupleurum Decoction) is used; for kidney cough with lower back and leg pain, Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite, and Asarum Decoction) is used. Such erroneous practices are endless. If pneumonia is severe and the patient feels heart pain, suspecting lung cough and using Maxing Shigan Tang; if hypochondriac pain suggests liver cough and using Xiao Chaihu Tang; if lower back pain suggests kidney cough and using Mahuang Fuzi Xixin Tang—ask yourself, do these drugs kill patients with active pneumonia? It is chilling. Yet, practicing TCM physicians still justify these prescriptions citing ancient texts and matching pulses and symptoms, while patients die. Alas! Who kills them? The ancient books creating baseless fallacies and the physicians blindly believing them kill them. In my clinical practice with such critical cases, examining past prescriptions, nine out of ten fall within this scope. Especially when treated improperly, prolonged coughing leads to the absurd addition of astringent herbs. While not all ancient formulas must be used, modifying and combining them often causes disasters. Countless patients suffer, families weep, and I can only feel pity. (I recall a fourteen-year-old boy holding his dying father, whispering, "Mr. Luo is here, it will be better now." His sobbing voice was heartbreaking, a scene vivid in my memory, an example of death from pneumonia.) My concern for danger makes my words seem harsh, but I hope TCM practitioners awaken. Small illnesses酿成 major ones, leading to fatal errors, is truly lamentable. Although Western prognosis acknowledges some danger, I dare assert that treating with effective Chinese herbal medicine ensures success in nearly all cases. Herein, I explain my experienced treatment methods: 1. For severe initial cough (Day 1) with high fever, prolonged aversion to cold, headache, body ache, and tight pulse, especially in winter, treat according to exterior syndrome. In cough remedies, use appropriate doses of Xingren (Apricot Seed), Beimu (Fritillaria Bulb), Suzi (Perilla Fruit), Sangbai Pi (Mulberry Root Bark), and Juhong (Tangerine Peel). Add exterior-releasing herbs like Ziyeh (Perilla Leaf) and Fangfeng (Saposhnikovia Root), or even Mahuang (Ephedra) in light doses to induce slight sweating. Use three slices of ginger and one pear as guides. After one or two days, if ineffective and aversion to cold disappears while cough and fever intensify, suspect pneumonia. Note: Do not use diaphoretics. Absolutely avoid further exterior-releasing sweat-inducing drugs. At this stage, use large doses of appropriate herbs such as Shuang Sangye (Frost-treated Mulberry Leaf), Ludoupi (Mung Bean Skin), Zhuye (Bamboo Leaf), Xingren (Apricot Seed), Fen Danpi (Moutan Cortex), Jinyinhua (Honeysuckle Flower), Chuan Beimu (Chuan Fritillaria Bulb), Xian Shengdi (Fresh Rehmannia Root), and Xian Lugen (Fresh Reed Rhizome), each 4-5 qian, 5-6 qian, up to 1 liang. Add Juhong (Tangerine Peel) slightly if sputum is abundant, aiming to reduce inflammation. If post-rash, avoid exterior herbs from the start; heavily add Qiaoliao (Forsythia Fruit), dosage 7-8 qian. Pay close attention to bowel movements, a key point. Regardless, add Gualou (Trichosanthes Fruit) 1-2 qian. If high fever persists with constipation for 3-4 days or foul diarrhea, add Shu Dahuang (Prepared Rhubarb) to the original formula. If children show rigid chest, shortness of breath, and coma, do not abruptly use Dahuang (Rhubarb) (can be used if constipated); instead, add Xijiao (Rhinoceros Horn - substitute available) and Lingyangjiao (Antelope Horn) 3-5 fen, reducing previous dosages. Although starting with chills, if the aversion to cold is brief, not in winter cold, and pulse is surging and rapid (more evident on the right hand), avoid exterior herbs like Fangfeng, Ziyeh, and Mahuang. Guizhi (Cinnamon Twig) among exterior herbs is particularly taboo and requires extra caution. High fever may occasionally require Western antipyretics like Salol and Antipyrine; do not ignore them. The unique effective Chinese herb for this condition has been described above. Other cough medicines should not be abused. This is my experiential advice; I urge physicians to believe it. This condition is not necessarily fatal, yet many in my hometown died from it, witnessed by me, nine out of ten due to medicinal error. What a pity.
(Medical Cases) Yan family pediatric case, age one, residing at No. 15 Wangjia Hutong, East Four Gates Pagoda, diagnosed on September 26th of the 25th year. Symptoms: cough, panting, coma, high fever, closed eyes, rigid chest. History: previously took medicine to induce sweating. Illness duration: several days. Unable to suck milk, scanty urine with white powdery sediment. Diagnosis: Pneumonia involving meninges and kidneys, both inflamed. Critical condition. Prescribed my experienced Lung-Clearing Formula and recommended Western serum injection therapy urgently.
Formula 1: Danpi (Moutan Cortex) 1 qian, Ludoupi (Mung Bean Skin) 2 qian, Zhuye (Bamboo Leaf) 1 qian, Sangye (Mulberry Leaf) 1 qian, Xingren (Apricot Seed) 1 qian, Beimu (Fritillaria Bulb) 1 qian, Gualou (Trichosanthes Fruit) 5 fen, Xian Maogen (Fresh Imperata Rhizome) 1 qian, Pear 1 piece as guide. Decoct and take. Instructions: Divide into six doses, administer over one day and night. Second day visit: All symptoms reduced, significant improvement. Did not seek Western injection. Constipation and abundant sputum persisted, but spirit slightly cleared. Modified Formula 1 accordingly.
Formula 2: Danpi (Moutan Cortex) 1 qian, Ludoupi (Mung Bean Skin) 2 qian, Zhuye (Bamboo Leaf) 1 qian, Sangye (Mulberry Leaf) 1 qian, Juhong (Tangerine Peel) 3 fen, Xingren (Apricot Seed) 1 qian, Beimu (Fritillaria Bulb) 1 qian, Tianhuafen (Trichosanthes Root) 1 qian, Shu Jun (Prepared Rhubarb) 5 fen, Tongcao (Tetrapanax Pith) 1 qian, Xian Maogen (Fresh Imperata Rhizome) 1 qian, Pear 1 piece as guide. Decoct and take. Instructions: Continue previous method. Third day visit: Fever subsided, cough gradually stopped, urinary sediment decreased, one foul stool passed, all symptoms reduced, spirit clear. Prescribed Formula 3, following the general idea of Formula 1.
Formula 3: Danpi (Moutan Cortex) 5 fen, Ludoupi (Mung Bean Skin) 2 qian, Zhuye (Bamboo Leaf) 1 qian, Sangye (Mulberry Leaf) 1 qian, Xingren (Apricot Seed) 5 fen, Beimu (Fritillaria Bulb) 5 fen, Jinyinhua (Honeysuckle Flower) 2 qian, Gualou Ren (Trichosanthes Seed) 3 fen, Cundong (Ophiopogon Tuber) 5 fen, Xian Shengdi (Fresh Rehmannia Root) 5 fen, Juhong (Tangerine Peel) 3 fen, Xian Maogen (Fresh Imperata Rhizome) 1 qian, Pear 1 piece as guide. Decoct and take. Instructions: Continue previous method. Three doses completely cured the condition, without any Western medicine. When this book was going to press, this child contracted the same severe condition again. Cured by increasing the dosage of this formula, combined with six doses of Salol. Recorded here.
Such formulas have cured countless severe pneumonia cases. Though the herbs are ordinary, the effect is miraculous. Adult dosage can reach 7-8 qian without harm; too light a dose is ineffective, and mixing other herbs renders it ineffective. This formula has become almost a standard. The above case is for a one-year-old; others can be inferred. Previously, in the Rashes section, a formula for my granddaughter Weijing with severe concurrent pneumonia was listed; consult it together. TCM's strength lies in its flexibility; study it carefully. There are many Western names for lung-related coughs. This formula governs all new-onset febrile coughs except tuberculosis, so they are not listed individually.
Tuberculosis (6) Tuberculosis is included in TCM terms like Laozha (Consumption), Xulao (Deficiency Labor), Keso (Cough), Feiwei (Lung Withering), Feidan (Lung Heat), Shiyin (Loss of Voice), and Toutie (Hemoptysis), which is confusing. Using the term "Tuberculosis" seems more concise.
This condition was briefly explained under "Yin Deficiency with Fever" in the pathology section earlier; please refer to it. Although this condition often manifests as cough and hemoptysis, its root lies in "weakness." Thus, some patients die without cough or hemoptysis throughout the illness. If the fundamental weakness is cured and strength restored, symptoms like cough, hemoptysis, fever, and spontaneous sweating disappear. Thus, cough and other symptoms are merely the branch manifestations of this condition. Recently, shocked by the Western claim that pulmonary tuberculosis is a chronic infectious disease with no specific curative method, people believe that once infected, survival is impossible. The higher the new knowledge, the greater the panic. Actually, this psychology is one-sided and causal inversion, inevitably containing errors. Superficial doctors cannot conduct precise research on both TCM and Western medicine, so their words are unreliable. Even those with adequate theoretical understanding but lacking long-term clinical experimentation make hasty judgments that miss the mark. Western theories are not untrustworthy, but they are based solely on Western theory and anatomy. Although academically precise, they are limited to one perspective. TCM ancient books are scattered, complex, illogical, mixed with absurd metaphysical discussions, and handled by incompetent quacks, causing effective Chinese herbs, far superior to imported goods, to remain obscure. These people deserve condemnation.
In all my studies and endeavors, I am inferior to others, but regarding TCM and Western medical principles, especially pulmonary tuberculosis, I have devoted over forty years of effort. Now, theoretically and experimentally, having understood the essence of this condition, I have developed a very gentle and highly effective treatment method, certainly surpassing the rigid Western approach and clearing TCM's chaotic abuses to find the true essence. Herein, I state carefully; every sentence is a conclusion, every word is experience. Those who trust me, please trust my words. If my arguments contradict TCM ancient books, people call me anti-sage and lawless; if they contradict Western books, people call me anti-science. I am not talented; my theories and drugs for this condition do not align perfectly with either TCM or Western medicine. I only know what cures effectively and dare not follow the crowd. Thus, my refutation of both sides in this chapter is blunt and leaves no room for compromise. I hope scholars understand.
(Death Causes) The pathogen of tuberculosis is the tubercle bacillus, developing gradually, causing purulent decomposition due to inflammatory products, leading to prolonged destruction of lung tissue, while other organs show similar symptoms. Besides tubercle bacilli, other bacteria cause mixed infections. The routes of bacterial entry into the human body are roughly inhalation, blood vessels, and lymphatic vessels. Specifically: ① Inhalation with air; ② Oral transmission, e.g., via sputum or saliva; ③ Food transmission, e.g., milk containing bacilli; ④ Object transmission, e.g., patient utensils; ⑤ Injury transmission, e.g., skin breaks allowing bacilli to enter lymphatics; ⑥ Genital transmission, e.g., between partners with tuberculosis or to newborns. Any of these opportunities facilitate infection. However, the bacillus develops slowly and does not always stay in the body long enough to cause disease; thus, some exposed individuals escape infection. For example, siblings may inherit susceptibility and die, while one or two remain uninfected lifelong. Some individuals with special constitutions develop the disease rapidly after infection, leading to quick death. Commonly known as "hundred-day consumption." Inducing factors include: ① Weak physique, emaciation, narrow chest, thin neck (consumptive constitution) are most prone. ② Age, especially 18-30 years old. ③ Polluted environment, lack of sunlight. ④ Insufficient nutrition, lack of exercise, worry, pregnancy, postpartum, overwork, bad habits, and aftermath of severe illnesses. ⑤ Trauma. ⑥ Lung and pleura diseases (pneumonia, pleurisy, etc.). All these can trigger tuberculosis. Age itself is not an inducing factor, but susceptibility is highest in this period. Especially when physical weakness and temporary overwork coincide.