肺为华盖，职司整肃，自气逆而为咳，痰动而为嗽，其症之寒热虚实，外因内因，宜审辨也。肺寒嗽必
痰稀面白，畏风多涕，当温肺固卫。款冬、紫菀之属，加入玉屏风散。肺热嗽必痰稠面红，身热喘满，当降火清
痰。黄芩、花粉、海石、栝蒌、玉竹之属，加入清肺饮。肺虚嗽必气逆汗出，颜白飧泄，当补脾敛肺。六君子
汤加山药、五味子之属，肺实嗽必顿咳抱首，面赤反食，当利膈化痰。泻白散加杏、蒌、姜、橘之属。外因者，
六淫之邪，自表侵肺，治用辛散，则肺清而嗽止；内因者，五损之病，自下
及上，治在甘润，则肺清而嗽安。治外因嗽，感风者辛平解之，桂枝、防风之属。感寒者辛温散之，紫苏、
姜、杏之属。感暑者辛凉除之，香薷、薄荷、竹叶之属。感湿者苦降淡渗之，浓朴、通草、薏仁之属。感燥者
甘凉清润之，玉竹、花粉、百合之属。感火者甘寒苦辛涤之。麦冬、石膏、桔梗、山栀、象贝之属。湿热痰
火阻气，清降辛泄之。茯苓、沙参、杏仁、前胡、桑皮之属。治内因嗽，肝胆气升犯肺者，泄木降逆。钩藤、
栀子、枳壳、丹皮、陈皮之属。土虚不生金者，胃用甘凉，参、麦、山药、扁豆之属。脾用甘温。四君、姜、
枣之属。肾阴虚火炎金燥者，熟地、五味、人乳、燕窝、阿胶、胡桃之属。滋液填精。肾阳虚水泛为痰者，
益智、沉香、沙苑子、肾气丸之属。纳气归肾。劳心动火者，归脾汤去木香，加麦冬、五味，熬膏蜜收服。
润养心血。久嗽不已，人参蛤蚧散、噙化丸、劫嗽丸。
经云∶五脏六腑皆令人咳，非独肺也。肺咳则喘息有音。千金五味子汤去续断、地黄、赤小豆，加麦
冬、玉竹、细辛。心咳则心痛喉中如梗。凉膈散去硝黄，加黄连、竹叶。肝咳则胁痛。枳壳煮散去芎、防，
加肉桂、橘红、苏子。脾咳则右 下腋下胁痛引肩背。六君子汤加枳壳、桔梗。肾咳则腰背引痛。都气丸加
参、麦。胃咳则呕甚，长虫出。异功散加川椒、乌梅。胆咳则呕胆汁。小柴胡汤。大肠咳则遗矢。赤石脂禹余
粮汤。小肠咳则失气。芍药甘草汤，膀胱咳则遗溺。茯苓甘草汤。三焦咳腹满不欲食饮。七气汤加黄连、
枳实。夫五脏久咳，乃移六腑，脾咳不已则胃受，肝咳不已则胆受，心咳不已则小肠受，肺咳不已则大肠
受，肾咳不已则膀胱受，六腑久咳不已则三焦受。然终不离乎肺脾肾也。盖肺为贮痰之器，脾为生痰之源。
而肾与肺实母子之脏，因痰致咳者，痰为重，主治在脾。因咳动痰者，咳为重，主治在肺。无痰干咳者，
阴虚为重，主治在肾。景岳谓虚劳干咳，乃肺肾不交，气不生精，精不化气，当分有火无火治之。如脏平无
火，止因肺虚，补气自能生精。宜五福饮之类。如脏气微寒，非辛不润，补阳自可生阴。宜理阴煎，或六
君汤。如内热有火，须保真阴，壮水自能制火。宜一阴煎或贝母丸。切忌消痰开郁，使气愈
耗，水愈涸也。其脾肺亏损，致咳嗽喘促，畏寒呕泻，及脉见细弱，症见虚寒，咳久不已者，均勿清嗽，但
补元气，嗽自止。六味回阳饮，或理中汤、劫劳散、八味地黄丸。
以四时论之，春季咳木气升也，治宜兼降。前胡、杏仁、海浮石、栝蒌仁之属。夏季咳火气炎也，治宜
兼凉。沙参、花粉、麦冬、知母、元参之属。秋季咳燥气乘金也，治宜清润。玉竹、贝母、杏仁、阿胶、百合、
枇杷膏之属。冬季咳风寒侵肺也，治宜温散。苏叶、川芎、桂枝、麻黄之属。以一日计之，清晨嗽为气动宿痰，
二陈汤加贝母、枳壳、桑白皮、枇杷叶、橘红。上午嗽属胃火，石膏、川斛之属。午后嗽属阴虚，四物、
六味等汤。黄昏嗽属火浮于肺，当敛而降之，五味子、五倍子之属。夜半嗽为阳火升动，宜滋阴潜阳。六味
丸加牡蛎、淡菜之属。肺本娇脏，畏热畏寒，火刑金烁，故咳，无痰有声。水冷金寒，故嗽，无声有痰。当
分新久虚实治之。感风暴嗽，鼻流清涕；桂枝汤加葱豉。感寒暴嗽，肩背怯冷；华盖散。兼感风寒暴嗽，鼻
塞声重；芎苏饮。咳逆倚息不得卧。小青龙汤。风温化燥呛咳，金匮麦门冬汤去半夏，加玉竹、沙参、杏仁、
贝母。火热嗽，喉哑痰稠，加减凉膈散。感湿致嗽，面目浮肿，豆豉、杏仁、通草、滑石、半夏、茯苓、大
贝之属。一咳痰即出，脾湿胜也。二陈汤加术、薏、防己。连咳痰不出，肺燥甚也。桔梗汤去桑皮、防己，
加玉竹。客邪伤肺，久嗽不止，安嗽化痰汤。久嗽中气虚，营卫兼损，归 建中汤。肉伤嗽，脉虚气乏，补
中益气汤去升柴，加麦、味。脾虚食减久嗽，归 异功散加白芍、南枣。胃虚呕逆作咳，大半夏汤加砂仁、茯
苓、橘红、煨姜。肺胃虚寒，咳沫吐食，温肺汤。寒饮停胃，攻肺致咳，半夏温肺汤。上气呛咳胁痛，肝木
乘肺也，七气汤加白芍、金橘。思虑劳神干嗽，心火刑金也，生脉散加茯神、贝母、熟地、枣仁、龙眼肉。
肾虚肺燥喘咳，都气丸加麦冬。喘嗽痰多，怯冷，生料肾气丸煎服。肺虚喘嗽吐血，门冬清肺饮。咳痰见血，
脉虚数，六味丸料煎加阿胶、秋石。
〔嗽〕伤风嗽，恶风自汗脉浮。加味桂枝汤。伤寒嗽，恶寒无汗，脉紧。加味麻黄汤。风寒嗽，痰多
气逆。六安煎。寒包热，
热郁肺俞，遇秋冬寒凉辄发咳，寸脉坚，声音窒，但解其寒而热自散。麻杏石甘汤，或金沸草散。热包寒，
先伤风寒，痰嗽未止，更伤炎热，呛咳声嘶，宜两解其邪。葳蕤汤加减。风热咳，风郁化热，宜辛凉散解。薄
荷、桔梗、杏仁、苏梗、桑皮之属。风温嗽，风温上侵，头胀咽痛，呛咳失音，宜清轻凉解。桑叶、象贝、
连翘、薄荷、杏仁、沙参、桔、甘之属。温邪嗽，春冬温邪犯肺，呛咳气窒喉痛。治同风温。如热郁者，加
山栀、豆豉、郁金、甘蔗、蒌霜、川贝母。暑嗽，暑热蒸嗽，及暑风袭入肺卫，寸脉大，喉痒口渴，俱宜微辛
微凉。竹叶、蒌皮、杏仁、石膏、薄荷、香薷。暑兼湿，咳而痰稠，气阻溺涩，宜苦降淡渗。浓朴、黄芩、
苏子、苡仁、滑石、通草、花粉、西瓜翠衣，或益元散。燥嗽，秋燥嗽渴，气促，宜甘润。玉竹、沙参、
麦冬、梨、蜜、杏仁、蔗汁之属，或复脉汤去姜、桂。火嗽，火逆上气，咽喉不利。金匮麦门冬去半夏，
加沙参、栝蒌、桔梗。火热乘肺，咳唾有血。千金麦门冬汤去麻黄、姜。
〔喘嗽〕咳而上气，苏子膏。喘咳发热自汗，安肺汤。咳逆上气，喉中有水鸡声响，射干麻黄汤。肺
胀喘咳，鼻扇肩抬，越婢加半下汤。咳而喘急，咽燥如有塞，唾血者，杏仁膏。肺虚久嗽作喘，补肺阿胶散。喘促
脉沉数，五味子汤。
〔劳嗽〕虚劳干咳，琼玉膏，或金水六君煎。脾肺伤损，劳嗽，憎寒壮热，团参饮子。心肾虚，发热盗
汗，劳嗽无痰，劫劳散。咳而无痰者，人参同蜜煎桃肉细嚼，或二味煎服，名观音应妙散。脾肺虚寒，怯冷
痰嗽，加味理中汤。肾阴虚，脉细数，下午寒热，干咳颊红，晨服异功散，夜服六味丸。肾阳虚，脉微弱，
水泛为痰，七味地黄丸。肺劳久嗽，饥则胸中大痛，视上唇有白点如粞者，此虫啮其肺，百部膏加乌梅、槟
榔。下其虫自愈。经年嗽，药不瘥，余无他症者，与劳嗽异。一味百部膏。有暴嗽，诸药不效，服生料鹿茸
丸即愈。乃肾虚也，不可以暴嗽而疑遽补之非。
〔哑嗽〕气促满闷失音，通声煎。肺实痰壅，宜杏、桔、蒌、橘、贝、枳、竹叶之属。肺虚喉燥，宜生
脉散加玉竹、款冬花、
蜜。外感包热者，细辛、半夏、蜜、姜辛散之。内伤火刑金者，六味汤合生脉散。顿咳至声不出者，痰郁火邪，
桔梗汤加贝母、枇杷叶。久嗽失音，杏仁膏。
〔肺胀〕上气喘胀，脉浮大，越婢加半夏汤。肺胀咳喘，脉浮，心下有水气，小青龙加石膏汤。肺胀咳
左右一偏不得卧，动则喘急息重，此痰挟血瘀。宜当归、丹皮、赤芍，桃仁、枳壳、桔梗、半夏、甘草、竹沥、姜
汁。如外邪去后，宜半夏、海石、香附、栝蒌仁、甘草为末，姜汁蜜调噙之。
〔嗽吐〕咳呕并作，为肺胃俱病，先安胃气，二陈汤加芦根、姜汁、枇杷叶，虚者六君子汤加桔梗
咳吐，痰食俱出，二陈汤加枳、术、杏仁、细辛。食积痰嗽，二陈汤加栝蒌、山楂、莱菔子、枳实、曲 。
肺被称为“华盖”，其职能是维持气机的清肃下降。若气机上逆则引发咳嗽，痰液涌动则表现为嗽。对于病症的寒热虚实属性，以及外感或内伤病因，应当仔细辨别。
肺寒引起的咳嗽，必然伴有痰液稀薄、面色苍白、怕风且鼻涕多等症状，治疗应当温补肺气、巩固卫表。可使用款冬花、紫菀等药物，加入玉屏风散中。
肺热引起的咳嗽，必然伴有痰液黏稠、面色发红、身体发热、气喘胸闷等症状，治疗应当降火清热、清除痰浊。可使用黄芩、天花粉、海浮石、瓜蒌、玉竹等药物，加入清肺饮中。
肺虚引起的咳嗽，必然伴有气逆、出汗、面色苍白、完谷不化的泄泻等症状，治疗应当补益脾土、收敛肺气。可使用六君子汤，加入山药、五味子等药物。
肺实引起的咳嗽，必然伴有阵发性剧烈咳嗽（顿咳）、双手抱头、面红目赤、反而不能进食等症状，治疗应当通利膈膜、化解痰浊。可使用泻白散，加入杏仁、瓜蒌、生姜、陈皮等药物。
外因导致的咳嗽，是由六淫邪气从体表侵袭肺部所致，治疗宜用辛散之法，使肺气清肃而咳嗽停止；内因导致的咳嗽，是由五脏亏损的病证由下向上影响所致，治疗宜用甘润之法，使肺气清宁而咳嗽安宁。
治疗外因咳嗽：感受风邪者，用辛平之法解表，选用桂枝、防风等药物；感受寒邪者，用辛温之法发散，选用紫苏、生姜、杏仁等药物；感受暑邪者，用辛凉之法祛除，选用香薷、薄荷、竹叶等药物；感受湿邪者，用苦降淡渗之法，选用厚朴、通草、薏苡仁等药物；感受燥邪者，用甘凉清润之法，选用玉竹、天花粉、百合等药物；感受火邪者，用甘寒苦辛之法涤除火热，选用麦冬、石膏、桔梗、山栀、浙贝母等药物。若是湿热痰火阻滞气机，则用清降辛泄之法，选用茯苓、沙参、杏仁、前胡、桑白皮等药物。
治疗内因咳嗽：肝胆气机上逆侵犯肺脏者，治宜疏泄肝木、降逆气，选用钩藤、栀子、枳壳、丹皮、陈皮等药物；脾气虚弱不能生养肺金者，胃阴不足需用甘凉滋润，选用人参、麦冬、山药、扁豆等药物；脾阳不足需用甘温补益，选用四君子汤加生姜、大枣等药物；肾阴虚导致虚火上炎、肺金干燥者，选用熟地黄、五味子、人乳、燕窝、阿胶、胡桃等药物以滋液填精；肾阳虚导致水湿泛滥化为痰饮者，选用益智仁、沉香、沙苑子、肾气丸等药物以纳气归肾。劳伤心神导致心火亢盛者，使用归脾汤去掉木香，加入麦冬、五味子，熬制成膏剂用蜂蜜收服以润养心血。久咳不止者，用人参蛤蚧散、噙化丸、劫嗽丸。
《内经》说：“五脏六腑都能让人咳嗽，不仅仅局限于肺。”肺咳表现为喘息有声音。千金方中的五味子汤，去掉续断、地黄、赤小豆，加入麦冬、玉竹、细辛。心咳表现为心痛、喉咙中有异物梗阻感。凉膈散去掉芒硝、大黄，加入黄连、竹叶。肝咳表现为胁肋疼痛。枳壳煮散去川芎、防风，加入肉桂、橘红、苏子。脾咳表现为右侧腋下及胁部疼痛牵引至肩背。六君子汤加入枳壳、桔梗。肾咳表现为腰背部牵引疼痛。都气丸加入人参、麦冬。胃咳表现为严重呕吐，甚至吐出蛔虫。异功散加入川椒、乌梅。胆咳表现为呕吐胆汁。用小柴胡汤。大肠咳表现为大便失禁。用赤石脂禹余粮汤。小肠咳表现为放屁。用芍药甘草汤。膀胱咳表现为遗尿。用茯苓甘草汤。三焦咳表现为腹部胀满、不想饮食。七气汤加入黄连、枳实。
大凡五脏久咳不愈，病邪会传移至六腑。脾咳不愈则胃受病，肝咳不愈则胆受病，心咳不愈则小肠受病，肺咳不愈则大肠受病，肾咳不愈则膀胱受病。六腑久咳不愈则三焦受病。然而终究离不开肺、脾、肾三脏。因为肺是储存痰液的容器，脾是生成痰液的源头。而肾与肺实际上是母子关系的脏腑。因痰致咳的，以痰为重，主治在脾；因咳嗽触动痰液的，以咳为重，主治在肺；无痰干咳的，以阴虚为重，主治在肾。张景岳认为虚劳干咳，是由于肺肾不交，气不能生精，精不能化气，应当区分有火和无火来治疗。如果脏腑平和无火，仅因肺虚，补气自然能生精。适宜用五福饮之类。如果脏腑之气微寒，非辛温不能滋润，补阳自然可以生阴。适宜用理阴煎，或六君子汤。如果体内有热有火，必须保护真阴，壮水制火自然能制约火势。适宜用一阴煎或贝母丸。切忌使用消痰开郁的药物，以免使气更加耗损，水更加枯竭。如果是脾肺亏损，导致咳嗽气喘、畏寒呕吐腹泻，以及脉象细弱、症状呈现虚寒，久咳不愈的，均不要使用清肺止咳药，只需补益元气，咳嗽自然停止。可用六味回阳饮，或理中汤、劫劳散、八味地黄丸。
从四季角度论述：春季咳嗽是木气升发所致，治疗宜兼用降气法。选用前胡、杏仁、海浮石、瓜蒌仁等药物。夏季咳嗽是火气炎上所致，治疗宜兼用清凉法。选用沙参、天花粉、麦冬、知母、玄参等药物。秋季咳嗽是燥气乘袭肺金所致，治疗宜用清润法。选用玉竹、贝母、杏仁、阿胶、百合、枇杷膏等药物。冬季咳嗽是风寒侵袭肺脏所致，治疗宜用温散法。选用苏叶、川芎、桂枝、麻黄等药物。
从一日时辰角度论述：清晨咳嗽是因气动宿痰，用二陈汤加入贝母、枳壳、桑白皮、枇杷叶、橘红。上午咳嗽属胃火，选用石膏、石斛等药物。下午咳嗽属阴虚，用四物汤、六味丸等方剂。黄昏咳嗽属虚火浮于肺，应当收敛并降逆，选用五味子、五倍子等药物。夜半咳嗽为阳火升动，宜滋阴潜阳，用六味丸加入牡蛎、淡菜等药物。
肺本是娇嫩之脏，怕热怕冷。火克金灼烧肺金，故引起咳嗽，特点是干咳无痰而有声。水冷金寒，故引起嗽，特点是有声无痰或有痰无声。应当区分新病久病、虚实来治疗。感受风暴引发的急性咳嗽，伴有鼻流清涕，用桂枝汤加入葱白、豆豉。感受寒邪引发的急性咳嗽，伴有肩背怯冷，用华盖散。兼感风寒引发的急性咳嗽，伴有鼻塞声重，用芎苏饮。咳嗽气逆倚靠呼吸不得平卧，用小青龙汤。风温化燥引发的呛咳，用金匮要略中的麦门冬汤去掉半夏，加入玉竹、沙参、杏仁、贝母。火热咳嗽，喉哑痰稠，用加减凉膈散。感受湿邪导致咳嗽，面目浮肿，选用豆豉、杏仁、通草、滑石、半夏、茯苓、大贝母等药物。一咳嗽痰即出，是脾湿胜的表现，用二陈汤加入白术、薏苡仁、防己。连续咳嗽痰不出，是肺燥严重的表现，用桔梗汤去掉桑白皮、防己，加入玉竹。客邪伤肺，久咳不止，用安嗽化痰汤。久咳导致中气虚弱，营卫俱损，用黄芪建中汤。外伤导致咳嗽，脉虚气乏，用补中益气汤去掉升麻、柴胡，加入麦冬、五味子。脾虚食少久咳，用黄芪异功散加入白芍、南枣。胃虚呕逆作咳，用大半夏汤加入砂仁、茯苓、橘红、煨姜。肺胃虚寒，咳吐泡沫、呕吐食物，用温肺汤。寒饮停聚胃部，攻冲肺部导致咳嗽，用半夏温肺汤。上气呛咳胁痛，是肝木乘侮肺金，用七气汤加入白芍、金橘。思虑劳神导致干咳，是心火刑克肺金，用生脉散加入茯神、贝母、熟地、枣仁、龙眼肉。肾虚肺燥喘咳，用都气丸加入麦冬。喘嗽痰多、怯冷，用生料肾气丸煎服。肺虚喘嗽吐血，用门冬清肺饮。咳痰带血，脉虚数，用六味丸药料煎煮加入阿胶、秋石。
〔嗽〕伤风咳嗽，恶风自汗脉浮，用加味桂枝汤。伤寒咳嗽，恶寒无汗，脉紧，用加味麻黄汤。风寒咳嗽，痰多气逆，用六安煎。寒包热证，热郁于肺俞穴，遇秋冬寒凉辄发咳嗽，寸脉坚硬，声音窒塞，只需解除寒邪而热自散，用麻杏石甘汤，或金沸草散。热包寒证，先伤风寒，痰嗽未止，又伤炎热，呛咳声嘶，宜两解其邪，用葳蕤汤加减。风热咳嗽，风郁化热，宜辛凉散解，选用薄荷、桔梗、杏仁、苏梗、桑白皮等药物。风温咳嗽，风温上侵，头胀咽痛，呛咳失音，宜清轻凉解，选用桑叶、浙贝母、连翘、薄荷、杏仁、沙参、桔梗、甘草等药物。温邪咳嗽，春冬温邪犯肺，呛咳气窒喉痛，治法同风温。如热郁者，加山栀、豆豉、郁金、甘蔗、瓜蒌霜、川贝母。暑咳，暑热蒸腾致咳，及暑风袭入肺卫，寸脉大，喉痒口渴，俱宜微辛微凉，选用竹叶、瓜蒌皮、杏仁、石膏、薄荷、香薷。暑兼湿，咳而痰稠，气阻溺涩，宜苦降淡渗，选用厚朴、黄芩、苏子、薏苡仁、滑石、通草、天花粉、西瓜翠衣，或益元散。燥咳，秋燥咳嗽口渴，气促，宜甘润，选用玉竹、沙参、麦冬、梨、蜜、杏仁、蔗汁等药物，或复脉汤去掉生姜、桂枝。火咳，火逆上气，咽喉不利，用金匮麦门冬汤去掉半夏，加入沙参、瓜蒌、桔梗。火热乘肺，咳唾有血，用千金麦门冬汤去掉麻黄、生姜。
〔喘嗽〕咳嗽而上气，用苏子膏。喘咳发热自汗，用安肺汤。咳逆上气，喉中有如水鸡声响，用射干麻黄汤。肺胀喘咳，鼻翼扇动、抬肩呼吸，用越婢加半夏汤。咳而喘急，咽燥如有堵塞感，唾血者，用杏仁膏。肺虚久嗽作喘，用补肺阿胶散。喘促脉沉数，用五味子汤。
〔劳嗽〕虚劳干咳，用琼玉膏，或金水六君煎。脾肺伤损，劳嗽，憎寒壮热，用团参饮子。心肾虚，发热盗汗，劳嗽无痰，用劫劳散。咳嗽而无痰者，用人参同蜂蜜煎煮桃肉细嚼，或二味煎服，名为观音应妙散。脾肺虚寒，怯冷痰嗽，用加味理中汤。肾阴虚，脉细数，下午寒热，干咳颊红，晨服异功散，夜服六味丸。肾阳虚，脉微弱，水泛为痰，用七味地黄丸。肺劳久嗽，饥饿时胸中大痛，观察上唇有白点如米屑者，这是虫蛀蚀肺部，用百部膏加入乌梅、槟榔以驱下虫子自愈。经年咳嗽，药物无效，其余无其他症状的，与劳嗽不同，用一味百部膏。有暴发性咳嗽，诸药无效，服用生料鹿茸丸即愈，这是肾虚所致，不可以因为是暴嗽就怀疑急于进补是错误的。
〔哑嗽〕气促满闷失音，用通声煎。肺实痰壅，宜用杏仁、桔梗、瓜蒌、橘红、贝母、枳壳、竹叶等药物。肺虚喉燥，宜用生脉散加入玉竹、款冬花、蜂蜜。外感包热者，用细辛、半夏、蜂蜜、生姜辛散之。内伤火刑金者，用六味汤合生脉散。顿咳至声不出者，是痰郁火邪，用桔梗汤加入贝母、枇杷叶。久嗽失音，用杏仁膏。
〔肺胀〕上气喘胀，脉浮大，用越婢加半夏汤。肺胀咳喘，脉浮，心下有水气，用小青龙加石膏汤。肺胀咳嗽，左右偏侧不得平卧，动则喘急息重，这是痰挟血瘀。宜用当归、丹皮、赤芍、桃仁、枳壳、桔梗、半夏、甘草、竹沥、姜汁。如外邪去后，宜用半夏、海浮石、香附、瓜蒌仁、甘草研为末，姜汁蜂蜜调匀含服。
〔嗽吐〕咳呕并作，为肺胃俱病，先安胃气，用二陈汤加入芦根、姜汁、枇杷叶，体虚者用六君子汤加入桔梗。咳吐，痰食俱出，用二陈汤加入枳壳、白术、杏仁、细辛。食积痰嗽，用二陈汤加入瓜蒌、山楂、莱菔子、枳实、神曲。
The Lung is referred to as the "Canopy" (Huagai), and its function is to maintain the clear descent of Qi. If Qi rebels upward, it causes cough; if Phlegm stirs, it manifests as sputtering. The cold-heat deficiency-excess nature of the symptoms, as well as whether the etiology is external or internal, must be carefully differentiated.
Cough due to Lung Cold must present with thin sputum, pale complexion, aversion to wind, and excessive nasal discharge. Treatment should warm the Lung and consolidate the Defensive Qi (Wei Qi). Herbs such as Jundonghua (Flower of Winter Tansy) and Ziwan (Radix Asteris Tatarici) are added to Yupingfeng San (Jade Windscreen Powder).
Cough due to Lung Heat must present with thick sputum, red face, fever, wheezing, and chest fullness. Treatment should descend Fire, clear heat, and resolve Phlegm. Herbs such as Huangqin (Radix Scutellariae), Huafen (Radix Platycodi), Haishi (Lapis Lapidis), Gualou (Fructus Trichosanthis), and Yuzhu (Rhizoma Polygonati Odorati) are added to Qingfei Yin (Lung-Clearing Decoction).
Cough due to Lung Deficiency must present with rebellious Qi, sweating, pale face, and undigested stool in diarrhea. Treatment should tonify the Spleen and astringe the Lung. Liujunzi Tang (Six Gentlemen Decoction) is used, adding Shanyao (Rhizoma Dioscoreae) and Wuweizi (Fructus Schisandrae).
Excess Cough in the Lung must present with paroxysmal severe coughing (Dunken), holding the head with both hands, red face, and inability to eat. Treatment should benefit the diaphragm and transform Phlegm. Xiebai San (White-Draining Powder) is used, adding Xingren (Semen Armeniacae Amarum), Gualou (Fructus Trichosanthis), Shengjiang (Rhizoma Zingiberis Recens), and Chenpi (Pericarpium Citri Reticulatae).
External causes involve the pathogenic factors of the Six Excesses invading the Lung from the exterior. Treatment uses acrid dispersal methods so that Lung Qi becomes clear and cough stops. Internal causes involve diseases of the Five Wasting-and-Tingling conditions affecting upwards from below. Treatment uses sweet moistening methods so that Lung Qi becomes peaceful and cough subsides.
For treating external cause coughs: Those affected by Wind are resolved with acrid-neutral methods, using Guizhi (Ramulus Cinnamomi) and Fangfeng (Radix Saposhnikoviae). Those affected by Cold are dispersed with acrid-warm methods, using Zisu (Folium Perillae), Shengjiang (Rhizoma Zingiberis Recens), and Xingren (Semen Armeniacae Amarum). Those affected by Summerheat are eliminated with acrid-cool methods, using Xiangru (Herba Elsholtziae), Bohe (Folium Menthae), and Zhuye (Folium Bambusae). Those affected by Dampness are treated with bitter-draining and bland-leaching methods, using Houpo (Cortex Magnoliae Officinalis), Tongcao (Medulla Tetrapanacis), and Yiren (Semen Coicis). Those affected by Dryness are cleared and moistened with sweet-cool methods, using Yuzhu (Rhizoma Polygonati Odorati), Huafen (Radix Platycodi), and Baihe (Bulbus Lilii). Those affected by Fire are cleansed with sweet-cold, bitter-acrid methods, using Maidong (Radix Ophiopogonis), Shigao (Gypsum Fibrosum), Jiegeng (Radix Platycodonis), Shanzhi (Fructus Gardeniae), and Zhebeimu (Bulbus Fritillariae Thunbergii). If Damp-Heat, Phlegm, and Fire obstruct Qi, use clearing-descending and acrid-dispersing methods, using Fuling (Poria), Shashen (Radix Glehniae), Xingren (Semen Armeniacae Amarum), Qianhu (Radix Peucedani), and Sangbai (Cortex Mori Radicis).
For treating internal cause coughs: When Liver and Gallbladder Qi rises and invades the Lung, drain Wood and descend rebellion, using Gouteng (Ramulus Uncariae cum Uncis), Zhizi (Fructus Gardeniae), Zhike (Fructus Aurantii), Danpi (Cortex Moutan), and Chenpi (Pericarpium Citri Reticulatae). When Earth (Spleen) is deficient and fails to generate Metal (Lung), nourish Stomach Yin with sweet-cool methods, using Renshen (Radix Ginseng), Maidong (Radix Ophiopogonis), Shanyao (Rhizoma Dioscoreae), and Bian Dou (Semen Dolichoris). Warm the Spleen with sweet-warm methods, using Sijunzi Tang (Four Gentlemen Decoction) plus Shengjiang (Rhizoma Zingiberis Recens) and Dazao (Fructus Jujubae). When Kidney Yin is deficient causing Deficient Fire to flare and Lung Metal to dry, use Shudi (Radix Rehmanniae Preparata), Wuweizi (Fructus Schisandrae), Renru (Human Milk), Yanwo (Swallow's Nest), Ejiao (Colla Corii Asini), and Hetao (Semen Juglandis) to nourish fluids and fill essence. When Kidney Yang is deficient causing Water to overflow and transform into Phlegm, use Yizhi (Fructus Alpiniae Oxyphyllae), Chenxiang (Lignum Aquilariae Resinatum), Shayuanzi (Semen Astragali Complanati), and Shenqi Wan (Kidney-Qi Pill) to grasp Qi and return it to the Kidneys. When Labor damages the Heart causing Fire to rise, use Guipi Tang (Restore the Spleen Decoction) removing Muxiang (Radix Aucklandiae), adding Maidong (Radix Ophiopogonis) and Wuweizi (Fructus Schisandrae), decocted into a paste preserved with honey to nourish Heart Blood. For chronic persistent cough, use Ren Shen Ge Jie San (Ginseng and Gecko Powder), Qinhua Wan (Holding-Melt Pill), or Jiesou Wan (Seizing-Cough Pill).
The Classic states: "The five Zang organs and six Fu organs can all cause cough, not just the Lung." Lung cough presents with wheezing and sounds. In the Qianjin Formula Wuweizi Tang (Schisandra Decoction), remove Xuduan (Radix Dipsaci), Dihuang (Radix Rehmanniae), and Chixiaodou (Semen Phaseoli Angularis), and add Maidong (Radix Ophiopogonis), Yuzhu (Rhizoma Polygonati Odorati), and Xixin (Herba Asari). Heart cough presents with heart pain and a sensation of obstruction in the throat. In Liange San (Cooling the Diaphragm Powder), remove Xiaoshi (Natrii Sulfas) and Dahuang (Radix Rhei Palmati), and add Huanglian (Rhizoma Coptidis) and Zhuye (Folium Bambusae). Liver cough presents with hypochondriac pain. In Zhike Zhu San (Citrus Peel Decoction), remove Xiong (Radix Chuanxiong) and Fangfeng (Radix Saposhnikoviae), and add Rougui (Cortex Cinnamomi), Juhong (Exocarpium Citri Grandis), and Suzi (Fructus Perillae). Spleen cough presents with pain in the right axilla and hypochondrium radiating to the shoulder and back. Add Zhike (Fructus Aurantii) and Jiegeng (Radix Platycodonis) to Liujunzi Tang (Six Gentlemen Decoction). Kidney cough presents with pain radiating to the waist and back. Add Renshen (Radix Ginseng) and Maidong (Radix Ophiopogonis) to Duqi Wan (Duqi Pill). Stomach cough presents with severe vomiting and expulsion of roundworms. Add Chuanjiao (Pericarpium Zanthoxyli) and Wumei (Fructus Mume) to Yigong San (Extraordinary Power Powder). Gallbladder cough presents with vomiting of bile. Use Xiaochaihu Tang (Minor Bupleurum Decoction). Large Intestine cough presents with fecal incontinence. Use Chishizhi Yuyuliang Tang (Red Stone and Hematite Decoction). Small Intestine cough presents with flatus. Use Shaoyao Gancao Tang (Peony and Licorice Decoction). Bladder cough presents with urinary incontinence. Use Fuling Gancao Tang (Poria and Licorice Decoction). Sanjiao cough presents with abdominal fullness and loss of appetite. Add Huanglian (Rhizoma Coptidis) and Zhishi (Fructus Aurantii Immaturus) to Qiqi Tang (Seven Qi Decoction).
Generally, when cough from the five Zang organs persists for a long time, it transfers to the six Fu organs. Persistent Spleen cough affects the Stomach; persistent Liver cough affects the Gallbladder; persistent Heart cough affects the Small Intestine; persistent Lung cough affects the Large Intestine; persistent Kidney cough affects the Bladder. Persistent cough from the six Fu organs eventually affects the Sanjiao. However, it ultimately does not depart from the Lung, Spleen, and Kidney. The Lung is the vessel storing Phlegm, and the Spleen is the source generating Phlegm. The Kidney and Lung have a mother-child relationship. When Phlegm causes cough, Phlegm is the primary issue, and treatment focuses on the Spleen. When Cough agitates Phlegm, Cough is the primary issue, and treatment focuses on the Lung. For dry cough without Phlegm, Yin Deficiency is primary, and treatment focuses on the Kidney. Zhang Jingyue stated that dry cough in Consumption arises from the failure of communication between Lung and Kidney, where Qi fails to generate Essence, and Essence fails to transform Qi. Treatment should distinguish between presence or absence of Fire. If the viscera are balanced without Fire, and it is merely Lung Deficiency, tonifying Qi will naturally generate Essence. Use Wufu Yin (Five Blessings Decoction). If the organ Qi is slightly cold and requires acridity for moistening, tonifying Yang can generate Yin. Use Liyin Jian (Yin-Nourishing Decoction) or Liujunzi Tang (Six Gentlemen Decoction). If there is internal heat and Fire, preserve True Yin; strengthening Water will control Fire. Use Yiyin Jian (One Yin Decoction) or Beimu Wan (Fritillaria Pill). Avoid using phlegm-resolving and Qi-unblocking drugs, which would further deplete Qi and dry up fluids. For Spleen-Lung deficiency leading to cough, wheezing, aversion to cold, vomiting, diarrhea, fine-weak pulse, and deficiency-cold signs with chronic cough, do not use lung-clearing cough remedies; instead, simply tonify Yuan Qi (Original Qi), and the cough will stop. Use Liuwei Huiyang Yin (Six-Ingredient Return-Yang Decoction), Lizhong Tang (Regulate the Middle Decoction), Jiaolao San (Consumption-Seizing Powder), or Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill).
From the perspective of seasons: Spring cough is due to rising Wood Qi; treatment should include descending methods. Use Qianhu (Radix Peucedani), Xingren (Semen Armeniacae Amarum), Haifushi (Lapis Lapidis), and Gualouren (Semen Trichosanthis). Summer cough is due to flaming Fire Qi; treatment should include cooling methods. Use Shashen (Radix Glehniae), Huafen (Radix Platycodi), Maidong (Radix Ophiopogonis), Zhimu (Rhizoma Anemarrhenae), and Xuanshen (Radix Scrophulariae). Autumn cough is due to Dryness attacking Metal; treatment should use clearing and moistening methods. Use Yuzhu (Rhizoma Polygonati Odorati), Beimu (Bulbus Fritillariae), Xingren (Semen Armeniacae Amarum), Ejiao (Colla Corii Asini), Baihe (Bulbus Lilii), and Pipa Gao (Loquat Paste). Winter cough is due to Wind-Cold invading the Lung; treatment should use warming and dispersing methods. Use Sueye (Folium Perillae), Chuanxiong (Radix Chuanxiong), Guizhi (Ramulus Cinnamomi), and Mahuang (Herba Ephedrae).
From the perspective of daily hours: Morning cough is due to Qi moving old Phlegm; use Erchen Tang (Two Aged Ingredients Decoction) adding Beimu (Bulbus Fritillariae), Zhike (Fructus Aurantii), Sangbaipi (Cortex Mori Radicis), Pipaye (Folium Eriobotryae), and Juhong (Exocarpium Citri Grandis). Forenoon cough belongs to Stomach Fire; use Shigao (Gypsum Fibrosum) and Chuhu (Dendrobii Caulis). Afternoon cough belongs to Yin Deficiency; use Siwu Tang (Four Substances Decoction) or Liuwei Wan (Six-Ingredient Pill). Dusk cough belongs to floating Fire in the Lung; it should be astringed and descended, using Wuweizi (Fructus Schisandrae) and Wubeizi (Galla Chinensis). Midnight cough is due to rising Yang Fire; nourish Yin and subdue Yang, using Liuwei Wan (Six-Ingredient Pill) adding Muli (Concha Ostreae) and Dancai (Mytilus edulis).
The Lung is a delicate organ, fearing heat and cold. Fire punishing Metal scorches the Lung, causing cough with sound but no Phlegm. Cold water freezing Metal causes sputtering with no sound but with Phlegm. Differentiate new vs. old and deficiency vs. excess for treatment. Acute cough from Wind-Storm with clear nasal discharge: Guizhi Tang (Cinnamon Twig Decoction) adding Congbai (Scallion White) and Chidouchi (Prepared Soybean). Acute cough from Cold with aversion to cold, no sweat, and tight pulse: Jiawei Mahuang Tang (Modified Ephedra Decoction). Wind-Cold cough with abundant Phlegm and rebellious Qi: Liu'an Jian (Six-Safe Decoction). Cold wrapping Heat, with Heat stagnating at Feishu (BL13), triggering cough in autumn/winter, hard Cun pulse, and muffled voice: Resolve the Cold, and Heat will dissipate naturally. Use Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) or Jinfeicao San (Golden Fern Grass Powder). Heat wrapping Cold, where Wind-Cold was first injured, Phlegm-cough persists, then Heat is additionally injured causing harsh cough and hoarseness: Resolve both pathogens. Use Weiyu Tang (Weiyu Decoction) modified. Wind-Heat cough, where Wind stagnates transforming into Heat: Disperse with acrid-cool methods. Use Bohe (Folium Menthae), Jiegeng (Radix Platycodonis), Xingren (Semen Armeniacae Amarum), Sugeng (Caulium Perillae), and Sangbai (Cortex Mori Radicis). Wind-Warm cough, where Wind-Warm invades upwards causing head distension, sore throat, harsh cough, and aphonia: Clear with light-cool methods. Use Sangye (Folium Mori), Xiangbei (Bulbus Fritillariae Cirrhosae), Lianqiao (Fructus Forsythiae), Bohe (Folium Menthae), Xingren (Semen Armeniacae Amarum), Shashen (Radix Glehniae), Jiegeng (Radix Platycodonis), and Gancao (Radix Glycyrrhizae). Warm-Evil cough, where Spring/Winter Warm-Evil attacks the Lung causing harsh cough, Qi obstruction, and sore throat: Treat same as Wind-Warm. If Heat stagnates, add Shanzhi (Fructus Gardeniae), Douchi (Prepared Soybean), Yujin (Radix Curcumae), Sugan (Saccharum Sinense), Lou Shuang (Powdered Fructus Trichosanthis), and Chuanbeimu (Bulbus Fritillariae Thunbergii). Summerheat cough, where Summerheat steams causing cough, or Summerwind attacks Lung-Wei, large Cun pulse, itchy throat, thirst: Use mild acrid-mild cool methods. Use Zhuye (Folium Bambusae), Loupi (Pericarpium Trichosanthis), Xingren (Semen Armeniacae Amarum), Shigao (Gypsum Fibrosum), Bohe (Folium Menthae), Xiangru (Herba Elsholtziae). Summerheat combined with Dampness, cough with thick Phlegm, Qi obstruction, and difficult urination: Use bitter-draining and bland-leaching methods. Use Houpo (Cortex Magnoliae Officinalis), Huangqin (Radix Scutellariae), Suzi (Fructus Perillae), Yiren (Semen Coicis), Huashi (Talcum), Tongcao (Medulla Tetrapanacis), Huafen (Radix Platycodi), Xigua Cuiyi (Rind of Watermelon), or Yi Yuan San (Benefit Origin Powder). Dryness cough, Autumn Dryness cough with thirst and shortness of breath: Use sweet-moistening methods. Use Yuzhu (Rhizoma Polygonati Odorati), Shashen (Radix Glehniae), Maidong (Radix Ophiopogonis), Pear, Honey, Xingren (Semen Armeniacae Amarum), Sugan juice, or Maixue Tang (Decoction to Restore Pulse) removing Jiang (Zingiber) and Gui (Cinnamomum). Fire cough, where Fire rebels upwards causing throat discomfort: Use Jin Gui Mai Men Dong Tang (Ophiopogon Decoction from the Golden Cabinet) removing Banxia (Rhizoma Pinelliae), adding Shashen (Radix Glehniae), Gualou (Fructus Trichosanthis), and Jiegeng (Radix Platycodonis). Fire-Heat attacking the Lung causing coughing and spitting blood: Use Qianjin Mai Men Dong Tang (Ophiopogon Decoction from Thousand Gold) removing Mahuang (Herba Ephedrae) and Jiang (Zingiber).
[Chuan Sou] Cough with rebellious Qi: Suzi Gao (Perilla Seed Paste). Wheezing cough with fever and spontaneous sweating: Anf Tang (Lung-Calming Decoction). Cough with rebellious Qi and water-frog sounds in the throat: Shegan Mahuang Tang (Belamcanda and Ephedra Decoction). Lung distension with wheezing cough, flaring nostrils, and lifting shoulders: Yebing Jia Banxia Tang (Yebing Plus Pinellia Decoction). Cough with urgent wheezing, dry throat with sensation of blockage, and hemoptysis: Xingren Gao (Apricot Kernel Paste). Lung deficiency with chronic cough turning to wheezing: Bufei Ejiao San (Tonify Lung and Donkey-Hide Gelatin Powder). Urgent breathing with deep-rapid pulse: Wuweizi Tang (Schisandra Decoction).
[Lao Sou] Consumption dry cough: Qiongyu Gao (Jade Pearl Paste) or Jinshui Liujun Jian (Metal-Water Six-Gentlemen Decoction). Spleen-Lung damage with consumption cough, aversion to cold and high fever: Tuanshen Yin (Round Ginseng Drink). Heart-Kidney deficiency with fever and night sweats, consumption cough without Phlegm: Jiaolao San (Consumption-Seizing Powder). Cough without Phlegm: Decoct Ren Shen (Radix Ginseng) with Honey and chew Tao Rou (Kernel Peach Seed) finely, or decoct these two ingredients together, named Guanyin Yingmiao San (Guanyin Responsive Marvel Powder). Spleen-Lung deficiency-cold with chills and Phlegm cough: Jiawei Lizhong Tang (Modified Regulate-Middle Decoction). Kidney Yin deficiency with fine-rapid pulse, afternoon chills-fever, dry cough, and red cheeks: Take Yigong San (Extraordinary Power Powder) in the morning, Liuwei Wan (Six-Ingredient Pill) at night. Kidney Yang deficiency with weak pulse, Water overflowing as Phlegm: Qiwei Dihuang Wan (Seven-Ingredient Rehmannia Pill). Lung consumption with chronic cough, severe chest pain when hungry, and white spots like rice grains on the upper lip: This indicates worms biting the Lung. Use Baibu Gao (Stemona Paste) adding Wumei (Fructus Mume) and Binglang (Semen Arecae) to expel worms for self-healing. Chronic cough for years, unresponsive to medicine, with no other symptoms: Different from consumption cough. Use single-ingredient Baibu Gao (Stemona Paste). Acute cough unresponsive to various medicines: Cure immediately with Shengliao Lurong Wan (Raw Material Deer Antler Pill); this is Kidney deficiency. Do not doubt that sudden tonification is incorrect because it is an acute cough.
[Ya Sou] Shortness of breath, chest fullness, and aphonia: Tongsheng Jian (Voice-Recovery Decoction). Lung excess with Phlegm congestion: Use Xingren (Semen Armeniacae Amarum), Jiegeng (Radix Platycodonis), Gualou (Fructus Trichosanthis), Juhong (Exocarpium Citri Grandis), Beimu (Bulbus Fritillariae), Zhike (Fructus Aurantii), and Zhuye (Folium Bambusae). Lung deficiency with dry throat: Use Shengmai San (Generate Pulse Powder) adding Yuzhu (Rhizoma Polygonati Odorati), Kundonghua (Flos Dodecatemonis), and Honey. External contraction wrapping Heat: Disperse with acridity using Xixin (Herba Asari), Banxia (Rhizoma Pinelliae), Honey, and Shengjiang (Rhizoma Zingiberis Recens). Internal injury with Fire punishing Metal: Combine Liuwei Tang (Six-Ingredient Decoction) with Shengmai San (Generate Pulse Powder). Paroxysmal cough preventing voice production due to Phlegm-stagnation and Fire-Evil: Jiegeng Tang (Platycodon Decoction) adding Beimu (Bulbus Fritillariae) and Pipaye (Folium Eriobotryae). Chronic cough with aphonia: Xingren Gao (Apricot Kernel Paste).
[Fei Zhang] Upper body wheezing and distension, floating-large pulse: Yebing Jia Banxia Tang (Yebing Plus Pinellia Decoction). Lung distension with cough and wheezing, floating pulse, Fluid retention under the Heart: Xiao Qinglong Jia Shigao Tang (Minor Green Dragon Plus Gypsum Decoction). Lung distension with cough unable to lie on either side, urgent wheezing and heavy breathing upon movement: This is Phlegm combined with Blood Stasis. Use Danggui (Radix Angelicae Sinensis), Danpi (Cortex Moutan), Chishao (Radix Paeoniae Rubra), Taoren (Semen Persicae), Zhike (Fructus Aurantii), Jiegeng (Radix Platycodonis), Banxia (Rhizoma Pinelliae), Gancao (Radix Glycyrrhizae), Zhuli (Caulum Bambusae in Succo), and Jiangzhi (Zingiberis Juice). After external pathogens are removed: Use Banxia (Rhizoma Pinelliae), Haishi (Lapis Lapidis), Xiangfu (Rhizoma Cyperi), Gualouren (Semen Trichosanthis), and Gancao (Radix Glycyrrhizae) powdered, mixed with Ginger Juice and Honey for holding in the mouth.
[Sou Tu] Cough and vomiting occurring together indicate disease in both Lung and Stomach. First calm Stomach Qi: Erchen Tang (Two Aged Ingredients Decoction) adding Lugeng (Rhizoma Phragmitis), Jiangzhi (Zingiberis Juice), and Pipaye (Folium Eriobotryae). For deficiency: Liujunzi Tang (Six Gentlemen Decoction) adding Jiegeng (Radix Platycodonis). Coughing up vomitus with both Phlegm and Food: Erchen Tang (Two Aged Ingredients Decoction) adding Zhike (Fructus Aurantii), Baizhu (Rhizoma Atractylodis Macrocephalae), Xingren (Semen Armeniacae Amarum), and Xixin (Herba Asari). Food stagnation with Phlegm cough: Erchen Tang (Two Aged Ingredients Decoction) adding Gualou (Fructus Trichosanthis), Shanzha (Fructus Crataegi), Laifuzi (Semen Raphani), Zhishi (Fructus Aurantii Immaturus), and Qu (Medicated Leaven).