劳嗽初起之时,多兼表邪而发。盖肺部既亏,风邪乘虚而入,风寒入肺,化为火邪,邪
火与内火交灼,则肺金愈伤,而咳嗽因之不止。庸医但知劳嗽为五内本病,而骤以 、术益其气
,归、地补其血,甚以白芍、五味、枣仁敛其邪,则邪气深滞腠理,胶固而难拔矣。余凡遇
此症,先以柴胡、前胡清理表邪,及桔梗、贝母、兜铃之类,清润而不泥滞者,以清理肺金
,或六七剂后,方用清凉滋阴之品,以要其终。但柴胡可多用几剂,前胡止可用一二剂,若
表邪一清,柴胡亦须急去也。
干咳者,有声无痰,病因精血不足,水不济火,火气炎上,真阴燔灼,肺脏KT 涩而咳也
。丹
捷。午后咳,阴虚也;黄昏咳,火气上感于肺也。
此症大约皆从郁火伤肺,肺金受邪,不能生水,水火不相济,则阴火亢阳,而为痰血凝
结,
而成。若不早治,肺金受伤之至,火盛血逆,成块成片,夹痰而出,有时无痰而出,轻则见
于清晨,甚则时时频见,或拂郁愤怒,则随触随见,即煎厥也。不急治,则为薄厥,而病笃
矣。
血症生死之辨,以大肉不消者,其病轻;大肉渐消者,其病重;若大肉脱尽者,万无生
理。
长起,则犹可治;设使仍前不长者,断然不可治,即使饮食自健,亦不过迁延时日而已。每
见患怯之人,起居如常,正当进膳之时,执匕箸而去者,即此症也。凡患此症者,如心性开
爽,善自调养,又当境遇顺适,则为可治;若心性系滞,或善怒多郁,处逆境而冤抑难堪,
处顺境而酒色眷恋,又不恪信医药,死何疑焉?
劳嗽(因虚劳引起的咳嗽)初起的时候,多兼有表邪而发作。因为肺部已经亏虚,风邪乘虚而入,风寒进入肺中,化为火邪,邪火与体内的内火相互灼烧,导致肺金更加受损,从而引起咳嗽不止。庸医只知道劳嗽是五脏内部的疾病,就急于用白术、苍术来补气,当归、熟地黄来补血,甚至用白芍、五味子、酸枣仁来收敛邪气,这样会导致邪气深伏在腠理之间,胶结牢固而难以拔除。我凡是遇到这种病症,先用柴胡、前胡清理表邪,以及桔梗、贝母、马兜铃之类清润而不滋腻滞气的药物,来清理肺金,或者服用六七剂后,才使用清凉滋阴的药物,以巩固疗效。但是柴胡可以多服几剂,前胡只可用一两次,如果表邪已经清除,柴胡也必须立即停用。
干咳的,只有声音没有痰,病因是精血不足,水不能制约火,火气炎上,真阴被焚烧灼热,肺脏干燥涩滞而咳嗽。丹参可捷效。午后咳嗽,属于阴虚;黄昏时咳嗽,是火气上感于肺所致。
这种病症大约都是从郁火伤肺,肺金受邪,不能生水,水火不能相济,导致阴火亢盛、阳气偏亢,进而形成痰血凝结,最终成为劳损之证。如果不尽早治疗,肺金受伤严重,火盛血逆,结成块状片状,夹杂痰液而出,有时也没有痰而直接出血,轻则见于清晨,重则时时频繁出现,如果遇到拂逆愤怒的情绪,就会随情绪触发而见血,这就是煎厥。如果不紧急治疗,就会发展为薄厥,病情就会危重了。
血症生死的关键辨别,在于大肉(肌肉)是否消退:大肉不消退的,病轻;大肉逐渐消退的,病重;如果大肉完全脱失的,绝对没有生机。如果饮食能够增加,体重逐渐恢复,那么还可以治疗;假如仍然像以前一样不长肉,断然不可治,即使饮食正常强健,也不过是拖延时日罢了。经常见到患虚劳的人,起居如常,正当进餐的时候,放下碗筷离开,就是这种症状。凡是患此症的人,如果心性开朗爽利,善于自我调养,又处于顺遂的环境,那么就可以治疗;如果心性抑郁阻滞,或者容易发怒多忧,处在逆境中感到冤屈难以忍受,处在顺境中又眷恋酒色,又不严格信奉医药,死亡有什么可疑的呢?
At the initial stage of Lao Sou (cough caused by consumptive disease), there is often an accompanying exterior pathogenic factor. Since the Lung is already deficient, Wind pathogen enters through the deficiency; when Cold-Wind enters the Lung, it transforms into Fire pathogen. The external Fire pathogen and internal Fire scorch each other, further damaging Lung Metal, resulting in incessant coughing. Quack doctors only know that Lao Sou is a disease of the five Zang organs, and they hastily use Baizhu (Atractylodis Macrocephalae Rhizoma) and Cangzhu (Atractylodis Rhizoma) to tonify Qi, Danggui (Angelicae Sinensis Radix) and Shudihuang (Rehmanniae Radix Preparata) to tonify Blood, and even use Baishao (Paeoniae Radix Alba), Wuweizi (Schisandrae Chinensis Fructus), and Zaoren (Ziziphi Spinosae Semen) to astringe and retain the pathogen. This causes the pathogen to become deeply stagnant in the Couli (interstices of skin and muscles), firmly adhered and difficult to eradicate. Whenever I encounter such cases, I first use Chaihu (Bupleuri Radix) and Qianhu (Peucedani Radix) to clear the exterior pathogen, along with Jiegeng (Platycodonis Radix), Beimu (Fritillariae Cirrhosae Bulbus), and Doulou (Aristolochiae Manshuriensis Fructus)—herbs that are clearing and moistening without being cloying or stagnating—to purify Lung Metal. After about six or seven doses, I then administer cooling and Yin-nourishing preparations to consolidate the treatment. However, Chaihu can be used for several more doses, while Qianhu should only be used for one or two doses. Once the exterior pathogen is cleared, Chaihu must be discontinued immediately.
Dry cough presents with sound but no sputum. Its etiology lies in the insufficiency of Essence and Blood, where Water fails to control Fire, causing Fire Qi to flare upward. True Yin is scorched and burning, leading to dryness and astringency in the Lung organ, resulting in coughing. Danshen (Salviae Miltiorrhizae Radix et Rhizoma) acts swiftly. Coughing in the afternoon indicates Yin deficiency; coughing at dusk indicates Fire Qi affecting the Lung from above.
This condition generally arises from constrained Fire injuring the Lung, where Lung Metal is affected and cannot generate Water. When Water and Fire fail to interact harmoniously, Yin Fire becomes hyperactive and Yang becomes excessive, leading to the coagulation of Phlegm and Blood, eventually forming consumptive disease. If not treated early, severe injury to Lung Metal occurs; excessive Fire and rebellious Blood form clumps and patches, expelled with sputum, or sometimes without sputum. Mild cases appear in the early morning, while severe cases occur frequently at any time. Emotional frustration or anger can trigger bleeding immediately upon occurrence, which is known as Jian Jue (fainting due to scorching). If not treated urgently, it develops into Bo Jue (fainting due to sudden qi rebellion), and the condition becomes critical.
The distinction between life and death in blood disorders depends on whether the "Da Rou" (large muscles/masseter muscles) remains intact: if Da Rou does not diminish, the disease is mild; if Da Rou gradually wastes away, the disease is severe; if Da Rou is completely depleted, there is absolutely no hope of survival. If appetite increases and weight gradually recovers, the case is still treatable; however, if the patient continues to fail to gain weight despite normal diet, the case is incurable, and even with robust appetite, it merely prolongs life. It is common to see patients with consumptive disease who have normal daily routines but leave the table during meals, putting down their chopsticks—this is a sign of this specific condition. For those suffering from this disease, if their temperament is open and cheerful, they practice self-care well, and live in favorable circumstances, they are treatable. Conversely, if their temperament is depressed and obstructed, prone to anger and worry, enduring unbearable injustice in adverse situations, or indulging in wine and lust in favorable situations, and failing to strictly adhere to medical advice, death is inevitable.