徽宗宠妃苦痰嗽，终夕不寐，面浮如盘。诏内医李防御用药，令供状，三日不效当诛。李忧挠技穷，与妻
对泣。忽闻外间叫云∶咳嗽药一文一帖，吃了今夜睡得。李使人市药十帖，其色浅碧，用淡 水滴麻油数点调
服。李疑草药性犷，或使脏腑滑泄，并三为一，自试之，既而无他。于是取三帖合为一，携入禁庭授妃，请分
两服。是夕嗽止，比晓面肿亦消，上喜赐金帛值万缗。李念病即安，倘索方无以为对，令仆俟前卖药人过邀饮，
以百金赂其方，乃蚌粉一物，新瓦炒令通红，拌青黛少许耳。叩其从来？曰∶壮而从军，老而停汰，顷见主帅
有此方，故剽得之。以其易辨，姑借以度余生，无他长也。李给之终身。（《槎庵小乘》。文田按∶咳嗽
症辛升太过，肾气逆上，故蚌粉以养其肾阴，所以能愈。）
潘埙曰∶予夏秋之交，火嗽月余，昼夜不辍声，不能伏枕几殆。群医皆主故常，曰∶西方金司令，肺气盛
耳，当泻。或曰∶久嗽肺虚，当补。或曰∶敛之愈。予曰∶金初司令，稚金也。火尚未伏，壮火也。壮火能烁
稚金，泻之金愈弱，火愈炽，此嗽所以不能止也。经曰无违时，无伐化。又曰无伐生生之气。今气初生而伐
泻之，伐化也，殆于不可。况五火相煽，肺失清化之令，补之恐反助火，敛之恐不能散火，请更思之。医不听，
各主所见，溃药不敢尝。日饮解毒凉膈散，去硝、黄加白术，以助胃气，晨服童便，不时服梨汁、瓜浆，各十
数杯。医乃暗投人参、五味，煎以予饮，而予不知也。饮之则愈嗽加喘，乃专主己见，饮前药，数日火退嗽止，
而病瘳矣。（楮记室。）解毒凉膈散∶大黄、芒硝、甘草、连翘、黄芩、薄荷、栀子。为末，加竹叶、生蜜。
汉阳库兵王六，病痰嗽并喘，百药不效。于岳阳遇一道人，教用五味子、白矾等分为末，每服三钱，以生
猪肺炙熟，蘸末细嚼，白汤下，两服病遂不发。久病乃可服此。（《本草纲目》。）
张子和治东门高三郎，病嗽一年半，耳鸣三月矣。嗽吐脓血，面多黑点，身表俱热，喉中不能发声。曰∶
嗽之源，心火之胜也。秋伤于湿，冬生咳嗽，冬水既旺，水湿相接，隔绝于心火，火不下降，反而炎上，肺金
被烁，发而为嗽。金 既久，声反不发，医补肺肾皆非也。令先备西瓜、冰雪等凉物，次用涌泄之法，又服去
湿之药，病日已矣。
刘氏一男子，年二十余，病劳嗽咯血，吐唾粘臭不可闻。秋冬少缓，春夏则甚，寒热往来，日晡发作，状如 疟，
寝汗如水。累服麻黄根、败蒲扇止汗，汗自若也。又服宁神散、宁肺散止嗽，嗽自若也。张先以独圣散吐其痰，状如鸡
黄，汗随涌出，昏愦三日不省，时时饮以凉水，精神稍开，饮食加进。又与人参半夏丸、桂苓甘露散，服之不数日乃愈。
赵君玉妻病嗽，时已十月矣。张处方用陈皮、归身、甘草、白术、枳壳、桔梗。赵以其不类嗽药。张笑曰∶
君怪无乌梅、莺粟囊乎？夫冬嗽，乃秋之湿也，湿上逆而为嗽。此方皆散气除湿，解结和经，三服而愈。
窦材治一人，病咳嗽盗汗，发热困倦减食，四肢逆冷，六脉弦紧，乃肾气虚也。先灸关元五百壮，予保命
延寿丹二十丸，钟乳粉二钱，间日服金液丹百丸，一月全安。
一人病咳嗽，脉症与上条同，但病患怕灸，止服延寿丹五十粒、金液丹百粒、钟乳粉二两，五日减可，十
日脉沉缓，乃真气复也。仍服前药，一月全安。盖此病早不灸亦可，迟必加灸，否则难治。
凌汉章治里人病嗽，绝食五日，众投以补剂益盛。凌曰∶此寒湿积也。穴在顶，针之必晕绝，超时始苏。
命四人分牵其发使勿倾侧，乃针果晕绝。家人皆哭，凌言笑自若。顷之气渐苏，复加补始出针，呕积痰斗许，
病即除。（《明史》。）
一中年妇人干咳，寸脉滑动似豆状，余皆散大不浮，左大于右，每五更心躁热，有汗，但怒气则甚，与桔
梗、贝母诸药不效。遂以石膏、香附为君，芩、连、青黛、门冬、栝蒌仁、陈皮、炒柏、归、梗为臣，五味、
砂仁、川芎、紫菀为佐，凡二十余帖而安。（《医学纲目》。）
崔某疗久嗽熏法，每旦取款冬花如鸡子大，少许蜜拌花使润，约一升，铁器铛中。又用一瓦碗钻一孔，内
安小竹筒，或笔管亦得，其筒少长，置碗铛相合及插筒处，皆面糊涂之，勿令泄气。铛下着炭火，少时款冬烟
自管出，以口含筒吸取咽之。如胸中稍闷，须举头，即将指头捻竹筒头，勿令漏烟出气，及烟尽止，凡如是五
日一为之，至六日，则饱食羊肉馄饨一顿，永瘥。（一法不用铛碗，用有嘴瓦瓶烧药，盖住瓶口，却以口
于瓶嘴吸烟咽之尤捷也。）
侍御谭希曾咳嗽吐痰，手足时冷，以为脾肺虚寒，用补中益气加炮姜而愈。（窦材以肢冷为肾气虚。）
一妇人患咳嗽，胁痛发热，日晡益甚，用加味逍遥散、熟地，治之而愈。年余因怒气劳役，前症仍作，又
太阳痛，或寒热往来，或咳嗽遗尿，此肺气虚、肝火盛，而尿脬失制也，用前散及地黄丸，月余而瘥。
表弟妇咳嗽发热，呕吐痰涎，日夜约五六碗，喘咳不宁，胸痞燥渴，饮食不进，崩血如涌。此命门火衰，
脾土虚寒，用八味丸及附子理中汤加减，治之而愈。
一妇人久咳嗽，面色萎黄，或时 白，肢体倦怠，饮食少思，稍多则泻。此脾土虚而不能生肺金，朝用补
中益气汤，夕用六君子汤为主，间佐以八珍汤，三月余渐愈。后感寒邪喘嗽，胸腹作胀，饮食不入，四肢逆冷，
此中气尚虚，不能充皮毛，实腠理，司开阖之所致也。遂用六君加生姜及桔梗而愈。
一妇人患劳嗽，晡热内热，寒热往来，作渴盗汗，小便频数，其经两三月一行。此肝脾气血虚损，用八珍
汤、六味丸，六十余剂，诸症渐愈。其经两月一行，仍用前二药，间以加味逍遥散，各三十余剂。后恚怒，适
经行去血过多，诸症悉至，饮食少思，腹胀气促，用十全大补汤，数剂渐愈，仍用前药调补。复因丧子，胸腹
不利，食少内热，盗汗便血，无寐，用加味归脾汤，仍兼前药而愈。
锦衣李大用，素不慎起居，吐痰自汗，咳嗽发热，服二陈、芩、连、枳壳、山栀之类，前症不减，饮食少
思。用四物、二陈、芩、连、元参、知、柏之类，前症愈甚，更加胸腹不利，饮食亦少，内热晡热。加桑皮、
紫苏、杏仁、紫菀、桔梗之类，胸腹膨胀，小便短少。用猪苓、泽泻、白术、茯苓、枳壳、青皮、半夏、黄连、
苏子，胸膈痞满，胁肋膨胀，小便不通。加茵陈、葶苈，喘促不卧，饮食不进。诊之，六脉洪数，肺肾二部
尤甚，曰∶脾土既不能生肺金，而心火又乘之，此肺痈之候也，当滋化源，缓则不救。不信，后唾脓痰，复
求治。胸膈痞满，脾土败也。喘促不卧，肺金败也。小便不通，肾水败也。胁肋膨胀，肝木败也。饮食不化，
心火败也。此化源既绝，五脏已败，药岂能生？已而果然。
丝客姚荃者，素郁怒。年近六十，脾胃不健。服香燥行气，饮食少思，两胁胀闷。服行气破血，饮食不入，
右胁胀痛，喜用手按。彼疑为膈气痰饮内伤。曰∶肝木克脾土，而脾土不能生肺金也。若内有瘀血，虽单衣亦
不敢着肉。用滋化源之药四剂，诸症顿退。彼以为愈。曰∶火令在迩，当保脾土以补肺金。彼不信，后复作，
另用痰火之剂益甚。求治，左关右寸滑数，此肺内溃矣。仍不信，服前药，果吐秽脓而殁。
嘉兴周上舍，每至夏患咳嗽，服降火化痰之剂，咳嗽益甚。脾肺肾脉皆浮而洪，按之微细。此脾土虚不能
生肺金，肺金不能生肾水，而虚火上炎也。朝用补中益气汤，夕用六味地黄丸而痊，后至夏遂不再发。
一妇人不得于姑，患咳嗽，胸膈不利，饮食无味。此脾肺俱伤，痰郁于中，先用归脾汤加山栀、川芎、贝
母、桔梗，诸症渐愈。后以六君加川芎、桔梗，间服全愈。
一妇人咳嗽胁痛，或用清气化痰降火等剂，久不愈。更加内热晡热。若两胁或小腹内热，其嗽益甚，小便
自遗。此属肝经血虚火动，用六味丸加五味子，滋肾水以生肝血，用补中益气生脾土，以滋肺金而寻愈。
上舍陈道复长子，亏损肾经，久患咳嗽，午后益甚。薛曰∶当补脾土滋化源，使金水自能相生。时孟春。
不信，乃服黄柏、知母之类。至夏吐痰引饮，小便频数，面目如绯。薛以白术、当归、茯苓、陈皮、麦冬、五
味、丹皮、泽泻四剂，乃以参、 、熟地、山茱为丸，俾服之，诸症顿退。复请视以为信，遂以前药如常与之。
仍泥不服，卒致不起。
陆养愚治吴氏外家，寡居夜热，以烦劳感冒，干咳无痰，医与疏风药，反增呕恶。更以二陈，症不减，而夜
不能寐，若失神志，烦乱不安。脉之，沉弦而数，曰∶干咳乃火郁之甚，最为难治。况寡居多年，其郁可知。
虽有风寒，但于养气养血舒郁清热中，微加疏散。若竟发其表，升动阴火则病反甚。重以二陈之燥，宜其烦乱
不寐，神志如失也。用清气养荣汤加黄芩、前胡、薄荷、杏仁、苏叶，二剂咳嗽烦闷俱减。第睡未安，脉微浮
而数，去苏叶、前胡、杏仁，加贝母、知母、山栀、枣仁、竹茹、大枣，二剂诸症俱愈，但四肢倦怠，气乏不
足以息，脉浮数而弱。此虚火已平，真气衰乏之候。仍用前汤加贝母、枣仁，更入人参一钱五分，数剂而愈。
陈曙仓室咳嗽，或时纯血，或时纯痰，或时痰血相半，夜热头眩，胸膈不舒，脚膝无力，服滋阴降火药，
已半年矣，饮食渐少，精神渐羸。脉之，两寸关沉数而有力，两尺涩弱而微浮，此上盛下虚之症也。上盛者，
心肺间有留饮瘀血；下虚者，肝肾之气不足。用人参固本丸，令空腹服之。日中用贝母、苏子、山楂、丹皮、
桃仁、红花、小蓟，以茅根煎汁，入药同煎，十剂痰清血止。后以清气养荣汤与固本丸间服，三月后病痊而孕。
陆肖愚治吴逊斋，患咳嗽身热胁痛，日轻夜重，寝食俱废，咸以年高病重为虑。脉之，左手浮弦，右手弦
滑，曰∶此病极轻，何以忧疑？乃内有食积痰饮，外感风邪所致也，少为消导疏散即愈矣。用苏叶、柴胡以解
其表，青皮、白芥以治其胁，桑皮、前胡、杏仁以治其嗽，陈皮、半夏以清其痰，山楂、枳实以消其食。二剂
而减，四剂脱然。
陆祖愚治费表母，生平饮酒多而谷食少，酿成痰火。每至五更则疾作，喘嗽频并，气逆息粗，不能伏枕，
由来久矣。年近七旬，其痰大发，日夜昏晕数次，四肢厥冷，自汗如洗，形容瘦削，六脉如丝。或与清火清痰，
毫不应。乃用附子理中料，千杵蜜丸，淡盐汤服，以助下元；另以知母、贝母，桑皮辈，煎汤徐徐含咽，清其
上膈。数剂嗽稀喘止，肢温汗敛。再用十全大补汤料丸服，数十年痼疾，从此遂瘳。
陈三农之室，遇夜嗽甚多痰，作阴虚火动，以四物换生地、贝母、知母、蒌仁、杏仁、麦冬、五味，二剂而愈。
孙文垣侄妇，喉中 痒，咳嗽红痰，两寸关洪大，内热生疮。山栀、小蓟、生地、丹皮、滑石、青皮、麦
冬、甘草、黄连、蒌仁，水煎服，血止嗽除。后遇劳即咳嗽，嗽喉中血腥，总由上焦热甚而然。以枇杷叶、山
栀、生地、白芍、甘草、丹皮、地骨皮、天花粉、滑石、紫菀，常服三五剂，两月而安。
温天衢冬月病目，医与发散太过，至春间吐血碗余，及夏下午潮热咳嗽，胸膈胀疼，早晨冷汗淋漓，大便
溏，一日两行，饮食少，肌肉消十之七，脉数。孙曰∶据症脉法在不治。众恳不能辞，乃用泻白散加五味、白
芍、贝母、马兜铃，服下其夜帖然而卧，不嗽。惟大便溏，前药加扁豆、山药、茯苓、汗亦渐止。复与泻白散
加石斛、马兜铃、贝母、陈皮、苡仁、白芍、山药、五味、桔梗，调理三月而痊。
按∶此与孙治吴肖峰内人注夏，误服参苏饮成咳嗽，同为发散所伤，世俗谓伤风不醒变成劳者是也，
过表之害洵然。然亦有风寒痼闭不出而成劳者，魏君犹知其一，未知其二也。不知此等皆为市医不分虚
实，恣用疏散散病变之重，而重者至死，犹曰伤风不醒。哀哉！（吴案见痿门。）
李士材治一人，咳而上气。凡清火润肺、化痰理气之剂，几无遗用，而病不少衰。诊其肾脉大而软，此气
虚火不归元。用人参三钱煎汤，送八味丸五钱，一服而减。后用补中益气汤加桂一钱，附子八分，凡五十剂，
及八味丸二斤而痊。
一人经年咳嗽，更医数十人，药不绝口，而病反增剧，自谓必成劳嗽。李曰∶不然，脉不数不虚，惟右寸
浮大而滑，是风未解。必多服酸收，故久而弥甚。用麻黄、杏仁、半夏、前胡、桔梗、甘草、橘红、苏子，五
剂减，十剂已。
冯楚瞻治李孝廉，患咳嗽甚频。视其身长肥白，颊色常红，知为表有余而里不足，上假热而下真寒，病必
当剧，劝以重服药饵。时有通谱新贵，甚精医药，乃托其治，所用乃山栀、黄芩、花粉、橘红、贝母、苏子、
杏仁之类。止之勿听，数剂后嗽转甚，烦躁喜冷倍常。益信寒凉为对症，倍用之转剧，再进，烦躁更甚，粒不
宋徽宗的一位宠妃深受痰嗽之苦，整夜无法入睡，面部浮肿如盘。皇帝下诏命令内医李防御用药，并要求他写下供状，如果三天内无效就要被处死。李防御忧虑无措、技艺穷尽，与妻子相对哭泣。忽然听到外面有人叫喊：“咳嗽药一文钱一帖，吃了今晚就能睡着。”李防御派人买了十帖药，药色浅碧，用淡盐水滴入几滴麻油调匀后服用。李防御怀疑草药性猛烈，可能会使脏腑滑泄，于是将三帖合为一帖自己先试服，之后没有其他不良反应。于是他取三帖合为一帖，带入皇宫交给妃子，请求分两次服用。当晚咳嗽停止，到天亮时面部肿胀也消退了，皇上很高兴，赏赐金帛价值万缗。李防御心想病虽然好了，但如果皇上索要药方就无法回答，于是让仆人在那个卖药人经过时邀请他饮酒，用一百两金子买下了他的药方，原来只是蚌粉一味药，在新瓦上炒至通红，拌入少许青黛罢了。询问其来源？回答说：“年轻时从军，年老时被裁撤，刚才看见主帅有这个方子，所以偷学来的。因为这个方子容易辨认，姑且借此度过余生，没有别的特长。”李防御给予他终身供养。（《槎庵小乘》。文田按：咳嗽症若辛散太过，会导致肾气逆上，所以用蚌粉来滋养肾阴，因此能治愈。）
潘埙说：我在夏秋之交，火嗽持续一个多月，昼夜不停声，不能伏枕休息，几乎危殆。众医生都主张常规治法，说：“西方金当令，肺气盛，应当泻。”有人说：“久嗽肺虚，应当补。”有人说：“收敛就会好。”我说：“金初当令，是稚金。火尚未潜伏，是壮火。壮火能灼烧稚金，泻之则金更弱，火更炽，这就是咳嗽不能止的原因。经书说不要违背时令，不要破坏化机。又说不要破坏生生之气。现在气初生而伐泻它，就是破坏化机，恐怕不可以。况且五火相煽，肺失去清化的功能，补之恐怕反而助火，敛之恐怕不能散火，请再想想。”医生不听，各自坚持己见，我不敢喝他们开的药。每天只喝解毒凉膈散，去掉硝、黄加入白术，以辅助胃气，早晨服用童便，不时服用梨汁、瓜浆，各十几杯。医生暗中投入人参、五味子，煎煮后给我喝，而我却不知道。喝了之后咳嗽加重并出现气喘，于是医生专主己见，让我喝之前的药，几天后火退咳止，病就好了。（楮记室。）解毒凉膈散：大黄、芒硝、甘草、连翘、黄芩、薄荷、栀子。研为末，加竹叶、生蜜。
汉阳库兵王六，患痰嗽兼喘，百药无效。在岳阳遇到一位道人，教他用五味子、白矾等分为末，每次服用三钱，用生猪肺烤熟，蘸药末细嚼，白开水送下，服两次病就不再发作。久病才可以服用此方。（《本草纲目》。）
张子和治疗东门高三郎，患咳嗽一年半，耳鸣三个月了。咳嗽吐脓血，脸上有很多黑点，全身表热，喉咙里发不出声音。他说：“咳嗽的根源，是心火过胜。秋天受伤于湿，冬天产生咳嗽，冬天的水气既旺，水湿相接，隔绝于心火，火不下降，反而炎上，肺金被灼烧，发为咳嗽。金气受损久了，声音反而发不出来，医生补肺肾都不对。让他先准备西瓜、冰雪等凉物，接着用涌泄之法，又服用去湿的药，病一天天好了。
刘氏的一个男子，二十多岁，患劳嗽咯血，吐出的唾沫粘臭不可闻。秋冬季节稍缓，春夏季节加重，寒热往来，傍晚发作，症状像疟疾，睡觉出汗如水。多次服用麻黄根、败蒲扇止汗，汗依然如故。又服用宁神散、宁肺散止咳，咳嗽依然如故。张子和先用独圣散催吐其痰，痰状如鸡黄，汗随着涌出，昏迷三天不省人事，时时饮用凉水，精神稍微清醒，饮食增加。又给人参半夏丸、桂苓甘露散，服用了没几天就好了。
赵君玉的妻子患咳嗽，当时已经是十月了。张子和开处方用陈皮、当归身、甘草、白术、枳壳、桔梗。赵君玉认为这不像是治咳嗽的药。张子和笑着说：“您奇怪为什么没有乌梅、罂粟壳吗？冬季咳嗽，是秋季的湿气所致，湿气上逆而为咳嗽。这个方子都是行气除湿，解结和经，服三帖就好了。
窦材治疗一个人，患咳嗽盗汗，发热困倦食欲减退，四肢逆冷，六脉弦紧，这是肾气虚。先灸关元穴五百壮，给予保命延寿丹二十丸，钟乳粉二钱，隔天服用金液丹一百丸，一个月完全康复。
另一个人患咳嗽，脉症与上一条相同，但病人害怕艾灸，只服用延寿丹五十粒、金液丹一百粒、钟乳粉二两，五天减轻可愈，十天脉象沉缓，是真气恢复的表现。仍然服用前面的药，一个月完全康复。这种病早不灸也可以，迟了必须加灸，否则难治。
凌汉章治疗同乡人患咳嗽，绝食五天，众人投以补剂病情反而加重。凌汉章说：“这是寒湿积滞。穴位在头顶，针刺必会晕厥，过一段时间才苏醒。命令四个人分别牵拉他的头发使其不倾斜，于是针刺果然晕厥。家人们都哭，凌汉章言笑自若。一会儿气息渐渐复苏，再加补针后才出针，呕出积痰约一斗，病随即消除。（《明史》。）
一位中年妇女干咳，寸脉滑动似豆状，其余脉象散大不浮，左脉大于右脉，每在五更时分心中烦躁发热，有汗，只有生气时症状加重，服用桔梗、贝母等药无效。于是以石膏、香附为君药，黄芩、黄连、青黛、麦冬、瓜蒌仁、陈皮、炒黄柏、当归、桔梗为臣药，五味子、砂仁、川芎、紫菀为佐药，共二十余帖而安。
崔某治疗久嗽的熏法，每天早晨取款冬花如鸡蛋大小，少许蜜拌花使其湿润，约一升，放入铁器铛中。又用一个瓦碗钻一个孔，里面安装小竹筒，或者笔管也可以，筒的长短适中，将碗和铛合拢以及插筒的地方，都用面糊涂严，不让漏气。铛下放置炭火，一会儿款冬花的烟就从管中出来，用口含住筒吸取咽下。如果胸中稍闷，须抬起头，立即用手指捏住竹筒头，不让漏烟出气，等到烟尽停止，凡是这样五天做一次，到第六天，就饱吃一顿羊肉馄饨，永远痊愈。（另一种方法不用铛碗，用有嘴的瓦瓶烧药，盖住瓶口，却把口对着瓶嘴吸烟咽下尤其快捷。）
侍御谭希曾咳嗽吐痰，手足有时发冷，认为是脾肺虚寒，用补中益气汤加炮姜而痊愈。（窦材认为肢冷是肾气虚。）
一位妇人患咳嗽，胁痛发热，傍晚加重，用加味逍遥散、熟地黄，治疗而痊愈。一年多后因怒气劳累，前症复发，又有太阳头痛，或寒热往来，或咳嗽遗尿，这是肺气虚、肝火盛，而膀胱失于制约，用前面的方子及地黄丸，一个多月后好转。
表弟妇咳嗽发热，呕吐痰涎，日夜约五六碗，喘咳不宁，胸痞燥渴，饮食不进，崩血如涌。这是命门火衰，脾土虚寒，用八味丸及附子理中汤加减，治疗而痊愈。
一位妇人久咳嗽，面色萎黄，有时发白，肢体倦怠，饮食少思，稍多则腹泻。这是脾土虚而不能生肺金，早晨服用补中益气汤，晚上服用六君子汤为主，间杂佐以八珍汤，三个多月逐渐痊愈。后感冒寒邪喘嗽，胸腹作胀，饮食不入，四肢逆冷，这是中气尚虚，不能充实皮毛，固密腠理，司掌开阖所致。于是用六君子汤加生姜及桔梗而痊愈。
一位妇人患劳嗽，傍晚内热，寒热往来，口渴盗汗，小便频数，月经两三月一行。这是肝脾气血虚损，用八珍汤、六味丸，六十多剂，诸症逐渐痊愈。月经两个月一行，仍用前面两种药，间杂服用加味逍遥散，各三十多剂。后来因愤怒，适逢经期去血过多，诸症悉至，饮食少思，腹胀气促，用十全大补汤，几剂后逐渐痊愈，仍用前面的药调理补益。后又因丧子，胸腹不利，食少内热，盗汗便血，失眠，用加味归脾汤，仍兼用前面的药而痊愈。
锦衣卫李大用，平时不注意起居，吐痰自汗，咳嗽发热，服用二陈汤、黄芩、黄连、枳壳、山栀之类，前症不减，饮食少思。用四物汤、二陈汤、黄芩、黄连、玄参、知母、黄柏之类，前症更甚，更加胸腹不利，饮食也少，内热傍晚发热。加桑白皮、紫苏、杏仁、紫菀、桔梗之类，胸腹膨胀，小便短少。用猪苓、泽泻、白术、茯苓、枳壳、青皮、半夏、黄连、苏子，胸膈痞满，胁肋膨胀，小便不通。加茵陈、葶苈，喘促不能卧，饮食不进。诊察，六脉洪数，肺肾两部尤其严重，说：“脾土既然不能生肺金，而心火又乘势侵犯，这是肺痈的征候，应当滋生化源，迟缓则救不了。”不信，后来吐脓痰，再次求治。胸膈痞满，脾土败坏。喘促不能卧，肺金败坏。小便不通，肾水败坏。胁肋膨胀，肝木败坏。饮食不化，心火败坏。这生化之源已绝，五脏已败，药怎么能救活？后来果然如此。
丝商姚荃，平时郁怒。年近六十，脾胃不健。服用香燥行气药，饮食少思，两胁胀闷。服用行气破血药，饮食不入，右胁胀痛，喜欢用手按。他怀疑是膈气痰饮内伤。我说：“肝木克脾土，而脾土不能生肺金。如果内有瘀血，即使穿单衣也不敢贴着肉。用滋生化源的药四剂，诸症顿退。他认为好了。我说：“火令将至，应当保护脾土以补肺金。”他不信，后来复发，另外用治痰火的药病情更重。求治，左关右寸滑数，这是肺内溃烂了。仍不信，服用前面的药，果然吐出秽脓而死。
嘉兴周上舍，每到夏天患咳嗽，服用降火化痰的药剂，咳嗽更甚。脾肺肾脉皆浮而洪，按之微细。这是脾土虚不能生肺金，肺金不能生肾水，而虚火上炎。早晨服用补中益气汤，晚上服用六味地黄丸而痊愈，以后到夏天就不再发作。
一位妇人不得婆婆欢心，患咳嗽，胸膈不利，饮食无味。这是脾肺俱伤，痰郁于中，先用归脾汤加山栀、川芎、贝母、桔梗，诸症逐渐痊愈。后用六君子汤加川芎、桔梗，间服全愈。
一位妇人咳嗽胁痛，或用清气化痰降火等药剂，久不愈。更加内热傍晚发热。如果两胁或小腹内热，咳嗽更甚，小便自遗。这属于肝经血虚火动，用六味丸加五味子，滋肾水以生肝血，用补中益气汤生脾土，以滋肺金而寻愈。
上舍陈道复长子，亏损肾经，久患咳嗽，午后加重。薛己说：“应当补脾土滋生化源，使金水自然相生。当时是孟春。”不信，乃服用黄柏、知母之类。到了夏天吐痰引饮，小便频数，面目如绯红。薛己用白术、当归、茯苓、陈皮、麦冬、五味子、丹皮、泽泻四剂，然后以人参、黄芪、熟地黄、山茱萸为丸，让他服用，诸症顿退。再次请视以为信，遂以前药照常给他。仍固执不服，最终导致死亡。
陆养愚治疗吴氏外家，寡居夜热，因烦劳感冒，干咳无痰，医生给疏风药，反而增加呕恶。改用二陈汤，症不减，而夜里不能寐，若失神志，烦乱不安。诊脉，沉弦而数，说：“干咳乃是火郁之甚，最为难治。何况寡居多年，其郁可知。虽有风寒，只在养气养血舒郁清热中，微加疏散。如果竟发其表，升动阴火则病反甚。重以二陈之燥，宜其烦乱不寐，神志如失也。用清气养荣汤加黄芩、前胡、薄荷、杏仁、苏叶，二剂咳嗽烦闷俱减。只是睡未安，脉微浮而数，去苏叶、前胡、杏仁，加贝母、知母、山栀、枣仁、竹茹、大枣，二剂诸症俱愈，但四肢倦怠，气乏不足以息，脉浮数而弱。这是虚火已平，真气衰乏之候。仍用前汤加贝母、枣仁，更入人参一钱五分，数剂而愈。
陈曙仓的妻子咳嗽，有时纯血，有时纯痰，有时痰血相半，夜热头眩，胸膈不舒，脚膝无力，服用滋阴降火药，已经半年了，饮食渐少，精神渐羸。诊脉，两寸关沉数而有力，两尺涩弱而微浮，这是上盛下虚之症。上盛者，心肺间有留饮瘀血；下虚者，肝肾之气不足。用人参固本丸，令空腹服之。日中用贝母、苏子、山楂、丹皮、桃仁、红花、小蓟，以茅根煎汁，入药同煎，十剂痰清血止。后用清气养荣汤与固本丸间服，三月后病痊而孕。
陆肖愚治疗吴逊斋，患咳嗽身热胁痛，日轻夜重，寝食俱废，大家都因为年高病重而担忧。诊脉，左手浮弦，右手弦滑，说：“这病极轻，为何忧疑？”乃是内有食积痰饮，外感风邪所致，稍加消导疏散即愈。用苏叶、柴胡以解其表，青皮、白芥子以治其胁，桑白皮、前胡、杏仁以治其嗽，陈皮、半夏以清其痰，山楂、枳实以消其食。二剂而减，四剂脱然痊愈。
陆祖愚治疗费表母的咳嗽，生平饮酒多而谷食少，酿成痰火。每到五更则疾病发作，喘嗽频并，气逆息粗，不能伏枕由来已久。年近七旬，其痰大发，日夜昏晕数次，四肢厥冷，自汗如洗，形容瘦削，六脉如丝。或与清火清痰药，毫不应。乃用附子理中料，千杵蜜丸，淡盐汤服，以助下元；另以知母、贝母，桑白皮辈，煎汤徐徐含咽，清其上膈。数剂嗽稀喘止，肢温汗敛。再用十全大补汤料丸服，数十年痼疾，从此遂瘳。
陈三农的妻子，遇夜嗽多痰，作阴虚火动，以四物汤换生地、贝母、知母、瓜蒌仁、杏仁、麦冬、五味子，二剂而愈。
孙文垣侄妇，喉中痒，咳嗽红痰，两寸关洪大，内热生疮。山栀、小蓟、生地、丹皮、滑石、青皮、麦冬、甘草、黄连、瓜蒌仁，水煎服，血止嗽除。后遇劳即咳嗽，嗽喉中血腥，总由上焦热甚而然。以枇杷叶、山栀、生地、白芍、甘草、丹皮、地骨皮、天花粉、滑石、紫菀，常服三五剂，两月而安。
温天衢冬天病目，医生发散太过，到春天吐血碗余，及夏天下午潮热咳嗽，胸膈胀疼，早晨冷汗淋漓，大便溏，一日两行，饮食少，肌肉消十之七，脉数。孙一奎说：“据症脉法在不治。”众人恳求不能推辞，乃用泻白散加五味子、白芍、贝母、马兜铃，服下其夜帖然而卧，不嗽。惟大便溏，前药加扁豆、山药、茯苓、汗亦渐止。复与泻白散加石斛、马兜铃、贝母、陈皮、苡仁、白芍、山药、五味子、桔梗，调理三月而痊。
按：这与孙一奎治疗吴肖峰内人注夏，误服参苏饮成咳嗽，同为发散所伤，世俗谓伤风不醒变成劳者是也，过表之害确实如此。然而也有风寒痼闭不出而成劳者，魏君犹知其一，未知其二也。不知此等皆为市医不分虚实，恣用疏散散病变之重，而重者至死，犹曰伤风不醒。哀哉！（吴案见痿门。）
李士材治疗一人，咳而上气。凡清火润肺、化痰理气之剂，几乎无遗漏使用，而病不少衰减。诊其肾脉大而软，这是气虚火不归元。用人参三钱煎汤，送八味丸五钱，一服而减。后用补中益气汤加桂枝一钱，附子八分，凡五十剂，及八味丸二斤而痊愈。
另一人经年咳嗽，更换医生几十人，药不绝口，而病反增剧，自认为必成劳嗽。李士材说：“不然，脉不数不虚，惟右寸浮大而滑，是风未解。必多服酸收，故久而弥甚。用麻黄、杏仁、半夏、前胡、桔梗、甘草、橘红、苏子，五剂减，十剂已。
冯楚瞻治疗李孝廉，患咳嗽甚频。看其身长肥白，颊色常红，知道为表有余而里不足，上假热而下真寒，病必当剧烈，劝以重服药饵。时有通谱新贵，甚精医药，乃托其治，所用乃山栀、黄芩、花粉、橘红、贝母、苏子、杏仁之类。止之勿听，数剂后嗽转甚，烦躁喜冷倍常。益信寒凉为对症，倍用之转剧，再进，烦躁更甚，粒米不进
The Emperor Huizong's favored concubine suffered from severe phlegm-cough, unable to sleep all night, with her face swollen like a plate. An imperial edict ordered the internal physician Li Fangyu to prescribe medicine and submit a written statement; if there was no effect within three days, he would be executed. Li Fangyu was anxious and at his wit's end, weeping with his wife. Suddenly, he heard someone shouting outside: "Cough medicine, one wen per packet; take it and you will sleep soundly tonight." Li sent someone to buy ten packets of medicine. The medicine was light green in color; he mixed it with a few drops of sesame oil diluted in water and took it himself. Suspecting that the herbal medicine might be too harsh and cause gastrointestinal looseness, he combined three packets into one and tested it on himself first. Afterward, there were no adverse reactions. He then took three packets, combined them into one, brought them into the palace to give to the concubine, and requested they be divided into two doses. That night, her cough stopped, and by dawn, her facial swelling had subsided. The Emperor was delighted and bestowed gold and silk worth ten thousand strings of cash. Li thought to himself that although the illness was cured, if the Emperor asked for the prescription, he would have no answer. So, he instructed his servant to invite the medicine seller to drink when he passed by, bribing him with one hundred taels of silver to obtain the formula. It turned out to be only one ingredient: clam powder (Concha Margaritifera), stir-fried in a new tile until red-hot, mixed with a small amount of Qingdai (Indigo Naturalis). When asked about its origin, the seller replied: "I joined the army in my youth and was discharged in old age. I recently saw this prescription used by my commander, so I stole it. Because it is easy to identify, I use it merely to survive; I have no other skills." Li provided for him for life. (*Cha'an Xiaocheng*. Wen Tian notes: In cough syndromes, excessive use of acrid-aromatic ascending herbs can cause Kidney Qi to rebel upward; therefore, using clam powder to nourish Kidney Yin allows for cure.)
Pan Xun said: During the transition between summer and autumn, I suffered from fire-cough for over a month, coughing day and night without pause, unable to rest my head on the pillow, nearly dying. All physicians advocated conventional treatments, saying: "Metal governs in the West, Lung Qi is abundant, so purging is indicated." Others said: "Prolonged cough indicates Lung deficiency, so tonification is indicated." Still others said: "Astringents will bring improvement." I said: "Metal has just begun to govern; it is immature Metal. Fire has not yet hidden; it is vigorous Fire. Vigorous Fire can scorch immature Metal; purging will make Metal weaker and Fire more blazing, which is why the cough cannot stop. The Classics state: 'Do not violate the seasons, do not destroy the transformative processes.' It also states: 'Do not destroy the vitalizing energy.' Now, the Qi is just beginning to generate, yet we purge and attack it; this destroys the transformative process and is likely inadvisable. Moreover, with five Fires fanning each other, the Lung loses its clear and descending function; tonifying may inadvertently aid Fire, while astringing may fail to dissipate Fire. Please reconsider." The physicians did not listen, each sticking to their own views, so I dared not taste their decoctions. I drank Jiedu Liangge San (Detoxifying and Cool the Chest Powder) daily, removing Mangxiao (Mirabilite) and Dahuang (Rhubarb), adding Baizhu (Atractylodes Macrocephala) to support Stomach Qi. I drank Tongbian (Child's Urine) in the morning and pear juice or melon syrup frequently, consuming over ten cups each time. Secretly, the physicians added Renshen (Ginseng) and Wuweizi (Schisandra) to the decoction and gave it to me without my knowledge. After drinking it, my cough worsened and became accompanied by wheezing. They persisted with their own approach, having me drink their previous prescriptions. After several days, the Fire subsided, the cough stopped, and I recovered. (*Chu Ji Shi*). Jiedu Liangge San consists of Dahuang (Rhubarb), Mangxiao (Mirabilite), Gancao (Licorice), Lianqiao (Forsythia), Huangqin (Scutellaria), Bohe (Mint), Zhizi (Gardenia). These are ground into powder, with Zhuye (Bamboo Leaf) and raw honey added.
Wang Liu, a soldier in the Hanyang treasury, suffered from phlegm-cough with wheezing; hundreds of medicines failed. In Yueyang, he met a Daoist who taught him to mix Wuweizi (Schisandra) and Baifan (Alum) in equal parts into a powder. Each dose was three qian, taken by roasting a fresh pig lung, dipping it in the powder, chewing thoroughly, and swallowing with plain boiled water. After two doses, the disease did not recur. This is suitable for chronic conditions. (*Bencao Gangmu*).
Zhang Zihe treated Dongmen Gao Sanlang, who had suffered from cough for a year and a half and tinnitus for three months. He coughed up pus and blood, had many black spots on his face, felt heat throughout his body surface, and could not produce sound from his throat. Zhang said: "The source of the cough is the excess of Heart Fire. Injury from dampness in autumn leads to cough in winter. Since Winter Water is strong, water and dampness connect, isolating the Heart Fire; Fire fails to descend and instead flares upward, scorching Lung Metal, resulting in cough. With prolonged damage to Metal, voice production fails; treating by tonifying Lung and Kidney is incorrect. First, prepare cooling items such as watermelon and ice. Then apply the vomiting and purging methods, followed by damp-draining herbs. The illness improved day by day."
A man from the Liu family, in his twenties, suffered from consumption-cough with hemoptysis, and sticky, foul-smelling sputum. Symptoms eased in autumn and winter but worsened in spring and summer, with alternating chills and fever, occurring in the afternoon resembling malaria, and night sweats profuse as water. Repeated use of Mahuanggen (Ephedra Root) and Baipushan (Decayed Hemp Mat) failed to stop sweating. Use of Ningshen San (Spirit-Calming Powder) and Ningfei San (Lung-Calming Powder) failed to stop cough. Zhang first used Dusheng San (Single Miracle Powder) to induce vomiting of phlegm, which resembled chicken yolk. Sweating ensued profusely, leading to coma and unconsciousness for three days. Cold water was given intermittently, after which his spirit slightly recovered and appetite increased. He was then given Renshen Banxia Wan (Ginseng and Pinellia Pill) and Guiling Ganlu San (Cassia Twig and Lingzhi Sweet Dew Powder). Within a few days, he recovered.
Zhao Junyu's wife suffered from cough in the tenth month. Zhang prescribed Chenpi (Tangerine Peel), Danggui Shen (Angelica Sinensis Root Tip), Gancao (Licorice), Baizhu (Atractylodes Macrocephala), Zhike (Aurantium Fruit), and Jiegeng (Platycodon). Zhao found these unlike typical cough medicines. Zhang smiled and said: "Are you surprised there are no Wumei (Mume Fruit) or Ying Su Nang (Poppy Capsule)? Winter cough is caused by autumn dampness; dampness rebels upward causing cough. This formula moves Qi, drains dampness, resolves knots, and harmonizes meridians. Three doses resulted in recovery."
Dou Cai treated a patient with cough, night sweats, fever, fatigue, reduced appetite, cold limbs, and wiry-tight pulse in all six positions, indicating Kidney Qi deficiency. He first moxa-ed the Guan Yuan (CV4) point 500 moxa cones, administered Baoming Yanshou Dan (Life-Prolonging Pill) 20 pills, and Zhongru Fen (Hematite Powder) 2 qian. Every other day, he administered Jin Ye Dan (Golden Elixir) 100 pills. Full recovery occurred within one month.
Another patient presented with identical pulse and symptoms but feared moxibustion. He only took Yanshou Dan 50 pills, Jin Ye Dan 100 pills, and Zhongru Fen 2 liang. Improvement was seen in five days; by ten days, the pulse was deep and slow, indicating the return of True Qi. Continuing the previous medication led to full recovery in one month. Early moxibustion was optional for this condition, but delayed treatment required it; otherwise, cure would be difficult.
Ling Hanzhang treated a fellow townsman with cough who had fasted for five days. The crowd administered tonics, worsening the condition. Ling said: "This is accumulation of cold-dampness. The acupoint is at the vertex; needling will cause fainting, with recovery after some time." He ordered four people to hold his hair to prevent tilting. Upon needling, the patient indeed fainted. The family cried, but Ling remained calm. Soon, the patient revived. Additional supplementation was applied before withdrawing the needle. The patient vomited approximately one dou of accumulated phlegm, and the illness was immediately resolved. (*History of Ming*).
A middle-aged woman suffered from dry cough. The Cun (Inch) pulse was slippery and rolling like a bean; other pulses were scattered, large, and not floating. The left pulse was larger than the right. She experienced heart irritability and heat every fifth watch (around 3-5 AM), with sweating. Symptoms worsened with anger. Jiegeng (Platycodon) and Beimu (Fritillaria) were ineffective. Shi Gao (Gypsum) and Xiangfu (Cyperus) were used as sovereign herbs; Huangqin (Scutellaria), Huanglian (Coptis), Qingdai (Indigo Naturalis), Maidong (Ophiopogon), Gualou Ren (Trichosanthes Seed), Chenpi (Tangerine Peel), Chao Baihuo (Stir-fried Phellodendron), Danggui (Angelica), and Jiegeng (Platycodon) as minister herbs; Wuweizi (Schisandra), Sharen (Amomum), Chuanxiong (Ligusticum), and Ziwan (Asterae Radix) as assistant herbs. Over twenty doses brought relief. (*Yixue Gangmu*).
Cui's fumigation method for chronic cough: Each morning, take a quantity of Kuandonghua (Farfara Flower) the size of a chicken egg, mix with a little honey to moisten, totaling about one sheng, and place in an iron pan. Take a clay bowl, drill a hole, insert a small bamboo tube (or pen tube). Adjust the length of the tube. Seal the junction between the bowl, pan, and tube with flour paste to prevent gas leakage. Place charcoal fire under the pan. Soon, smoke from the Farfara flower will emerge from the tube. Inhale the smoke through the mouth and swallow it. If chest discomfort occurs, lift the head and pinch the tube tip with fingers to prevent leakage. Stop when smoke ends. Repeat this every five days. On the sixth day, eat a hearty meal of lamb wontons for a permanent cure. (Alternative method: Use a spouted clay pot to burn the herb, cover the mouth, and inhale smoke directly from the spout, which is even faster.)
Censor Tan Xizeng suffered from cough with expectoration and intermittent cold hands and feet. He was diagnosed with Spleen-Lung deficiency-cold and cured using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Paojiang (Prepared Ginger). (Dou Cai attributed cold limbs to Kidney Qi deficiency.)
A woman suffered from cough, hypochondriac pain, and fever, worsening in the late afternoon. She was cured with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Shudi (Rehmannia). Over a year later, due to anger and overwork, symptoms recurred, accompanied by Taiyang headache, alternating chills and fever, cough, and urinary incontinence. This indicated Lung Qi deficiency and Liver Fire excess, with loss of control over the bladder. Using the previous powder plus Dihuang Wan (Rehmannia Pill), she recovered after a month.
My cousin's wife suffered from cough, fever, vomiting of saliva and phlegm (about 5-6 bowls day and night), restless wheezing and cough, chest oppression, dry thirst, poor appetite, and uterine bleeding like a gush. This was due to Mingmen (Gate of Life) Fire decline and Spleen Earth deficiency-cold. Treatment with Bawei Wan (Eight-Ingredient Pill) and Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle) with modifications resulted in recovery.
A woman with chronic cough had a sallow complexion, sometimes pale, limb fatigue, poor appetite, and diarrhea if eating too much. This indicated Spleen Earth deficiency failing to generate Lung Metal. Morning administration of Buzhong Yiqi Tang and evening administration of Liujunzi Tang (Six Gentlemen Decoction) as main formulas, occasionally supplemented with Bazhen Tang (Eight-Treasure Decoction), led to gradual recovery over three months. Later, catching a cold caused wheezing and cough, abdominal distension, inability to eat, and cold limbs. This was due to remaining Middle Qi deficiency, failing to fill the skin/hair, secure the interstices, and regulate opening/closing. Treatment with Liujunzi Tang plus Shengjiang (Fresh Ginger) and Jiegeng (Platycodon) resulted in recovery.
A woman with consumption-cough had afternoon internal heat, alternating chills and fever, thirst, night sweats, frequent urination, and menstruation every two to three months. This indicated Liver and Spleen Qi and Blood deficiency. Treatment with Bazhen Tang and Liuwei Wan (Six-Ingredient Pill) for over sixty doses gradually resolved symptoms. For menstruation every two months, continuing the previous two medicines with occasional Jiawei Xiaoyao San (each for over thirty doses) was used. Later, anger coincided with heavy menstrual bleeding, exacerbating all symptoms, including poor appetite, abdominal distension, and shortness of breath. Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) for several doses brought gradual recovery, followed by continued tonic adjustment. Subsequently, grief over losing a child caused chest/abdominal discomfort, poor appetite, internal heat, night sweats, bloody stools, and insomnia. Jiawei Guipi Tang (Modified Restore the Spleen Decoction), combined with previous medicines, resulted in recovery.
Jinyiwei (Imperial Guard) Li Dayong neglected his daily routine, suffering from expectoration, spontaneous sweating, cough, and fever. Taking Erchen Tang (Two-Aged Decoction), Huangqin (Scutellaria), Huanglian (Coptis), Zhike (Aurantium), Zhizi (Gardenia) did not reduce symptoms or improve appetite. Taking Siwu Tang (Four Substance Decoction), Erchen Tang, Huangqin, Huanglian, Xuanshen (Scrophularia), Zhimu (Anemarrhena), Huangbai (Phellodendron) worsened symptoms, adding chest/abdominal discomfort, poor appetite, and afternoon internal heat. Adding Sangpiao (Mulberry Bark), Zisu (Perilla), Xingren (Apricot Seed), Ziwan (Asterae), Jiegeng (Platycodon) caused abdominal distension and scanty urine. Using Zhuling (Polyporus), Zexie (Alisma), Baizhu (Atractylodes), Fuling (Poria), Zhike, Qingpi (Green Tangerine Peel), Banxia (Pinellia), Huanglian, Suzi (Perilla Seed) caused chest diaphragm fullness, hypochondriac distension, and urinary retention. Adding Yinchen (Artemisia) and Tingli (Descurainia) caused panting, inability to lie down, and anorexia. Pulse was flooding and rapid, especially in Lung and Kidney positions. Diagnosis: Spleen Earth failing to generate Lung Metal, with Heart Fire attacking; this is a sign of Lung Abscess. Must nourish the source of transformation; delay means death. Patient refused belief. Later expectorated pus-phlegm and sought treatment again. Chest fullness indicated Spleen failure; panting indicated Lung failure; urinary retention indicated Kidney failure; hypochondriac distension indicated Liver failure; indigestion indicated Heart failure. With the source of transformation exhausted and five Zang organs failing, how could medicine save him? This proved true.
Silk merchant Yao Quan, prone to depression and anger, near sixty years old, with weak Spleen-Stomach. Taking aromatic-dry Qi-moving herbs led to poor appetite and hypochondriac distension. Taking Qi-moving and blood-breaking herbs led to anorexia and right hypochondriac pain relieved by pressure. He suspected Diaphragmatic Qi, phlegm-fluid, or internal injury. Diagnosis: Liver Wood overacting on Spleen Earth, preventing Spleen from generating Lung Metal. If there were stagnant blood, he would dare not wear thin clothes against his skin. Four doses of herbs nourishing the source of transformation rapidly reduced symptoms. He considered himself cured. I warned: "Fire season approaches; protect Spleen Earth to supplement Lung Metal." He disbelieved. Relapse occurred; using phlegm-fire remedies worsened it. Seeking treatment again, Left Guan and Right Cun pulses were slippery and rapid, indicating internal Lung ulceration. Disbelieving again, he took previous medicines and died expectorating foul pus.
Shangshe Zhou from Jiaxing suffered from summer cough, worsening with fire-descending and phlegm-resolving agents. Spleen, Lung, and Kidney pulses were floating and flooding but fine upon pressure. This indicated Spleen Earth deficiency failing to generate Lung Metal, Lung Metal failing to generate Kidney Water, with deficient Fire flaming upward. Morning Buzhong Yiqi Tang and evening Liuwei Dihuang Wan resulted in recovery, with no recurrence in subsequent summers.
A woman, ill-treated by her mother-in-law, suffered from cough, chest diaphragm discomfort, and loss of taste. This indicated dual injury to Spleen and Lung with phlegm stagnation in the center. Initial treatment with Guipi Tang (Restore the Spleen Decoction) plus Zhizi (Gardenia), Chuanxiong (Ligusticum), Beimu (Fritillaria), Jiegeng (Platycodon) gradually resolved symptoms. Subsequent treatment with Liujunzi Tang (Six Gentlemen Decoction) plus Chuanxiong and Jiegeng, taken intermittently, led to complete recovery.
A woman with cough and hypochondriac pain failed to improve with clearing-heat, transforming-phlegm, and fire-descending agents. Internal heat and afternoon fever developed. Heat in hypochondrium or lower abdomen worsened cough, accompanied by urinary incontinence. This belonged to Liver Meridian Blood deficiency with Fire stirring. Liuwei Wan (Six-Ingredient Pill) plus Wuweizi (Schisandra) nourished Kidney Water to generate Liver Blood. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) generated Spleen Earth to nourish Lung Metal, leading to recovery.
Eldest son of Shangshe Chen Daofu damaged Kidney Meridian, suffering from chronic cough worsening in the afternoon. Xue Ji said: "Must tonify Spleen Earth to nourish the source of transformation, allowing Metal and Water to generate each other naturally." It was early spring. Patient disbelieved, taking Huangbai (Phellodendron) and Zhimu (Anemarrhena). By summer, expectorated phlegm, craved drinks, frequent urination, and flushed face. Xue Ji prescribed Baizhu (Atractylodes), Danggui (Angelica), Fuling (Poria), Chenpi (Tangerine Peel), Maidong (Ophiopogon), Wuweizi (Schisandra), Danpi (Moutan), Zexie (Alisma) for four doses. Then prepared pills with Renshen (Ginseng), Huangqi (Astragalus), Shudi (Rehmannia), Shanzhuyu (Cornus). Symptoms retreated instantly. Patient believed again, resuming previous meds. However, stubborn refusal to comply led to death.
Lu Yangyu treated a relative of the Wu family, widowed, with night fever. Due to mental fatigue and wind-cold invasion, she had dry cough without phlegm. Physicians gave wind-dispersing herbs, worsening nausea/vomiting. Switching to Erchen Tang did not help; she suffered insomnia, appearing delirious and restless. Pulse was deep, wiry, and rapid. Diagnosis: Dry cough due to severe Fire stagnation, very difficult to treat. Widowed for years implies deep stagnation. Although wind-cold exists, treatment should focus on nourishing Qi/Blood, resolving stagnation, clearing heat, with slight dispersal. Directly releasing the exterior would raise deficient Fire, worsening the disease. Combined with the dryness of Erchen Tang, this explains her delirium, insomnia, and loss of spirit. Qingqi Yangying Tang (Clear Qi and Nourish Ying Decoction) plus Huangqin (Scutellaria), Qianhu (Peucedanum), Bohe (Mint), Xingren (Apricot Seed), Zisu (Perilla) for two doses reduced cough and irritability. Sleep remained unsettled; pulse slightly floating and rapid. Removed Zisu, Qianhu, Xingren; added Beimu (Fritillaria), Zhimu (Anemarrhena), Zhizi (Gardenia), Zaoren (Ziziphus Seed), Zhuru (Bamboo Shavings), Dazao (Jujube). Two doses resolved all symptoms, leaving limb fatigue and shortness of breath. Pulse floating, rapid, and weak. This indicated deficient Fire had calmed, but True Qi was depleted. Continued previous decoction with Beimu, Zaoren, adding 1.5 qian Renshen (Ginseng). Several doses led to recovery.
Chen Shucang's wife coughed, sometimes with pure blood, sometimes pure phlegm, sometimes mixed. Night fever, dizziness, chest discomfort, weak legs/knees. Took Yin-nourishing and Fire-descending herbs for half a year; diet decreased, spirit emaciated. Pulse: Cun/Guan deep, rapid, forceful; Chi slippery, weak, slightly floating. This is Upper Excess and Lower Deficiency. Upper Excess: retained fluid and blood stasis in Heart/Lung; Lower Deficiency: insufficient Liver/Kidney Qi. Ren Shen Gu Ben Wan (Ginseng Root-Firming Pill) taken on empty stomach. Midday: Beimu, Suzi, Shanzha, Danpi, Taoren, Honghua, Xiaoji, decocted with Genjian (Rhizoma Imperatae) juice. Ten doses cleared phlegm and stopped bleeding. Later, alternating Qingqi Yangying Tang and Gu Ben Wan led to recovery and pregnancy after three months.
Lu Xiaoyu treated Wu Xunzhai with cough, body heat, hypochondriac pain, worse at night, disrupting sleep and eating. Everyone worried due to age and severity. Pulse: Left hand floating/wiry; Right hand wiry/slippery. Diagnosis: Mild illness, why worry? Caused by internal food stagnation/phlegm-fluid and external wind pathogen. Slight guiding and dispersing will cure. Zisu (Perilla), Chaihu (Bupleurum) released exterior; Qingpi (Green Tangerine Peel), Baijiezi (White Mustard Seed) treated hypochondrium; Sangpiao (Mulberry Bark), Qianhu (Peucedanum), Xingren (Apricot Seed) treated cough; Chenpi (Tangerine Peel), Banxia (Pinellia) cleared phlegm; Shanzha (Hawthorn), Zhishi (Immature Bitter Orange) digested food. Reduced in two doses, fully recovered in four.
Lu Zuyu treated Mother Fei, who drank heavily and ate little grain, creating phlegm-fire. Illness struck at the fifth watch (3-5 AM): frequent wheezing/cough, rebellious Qi, coarse breathing, unable to rest head on pillow. Long-standing history. Near seventy, phlegm surged, causing multiple daily fainting episodes, cold limbs, profuse sweating, emaciation, thread-like pulse. Clearing-fire/phlegm herbs failed. Used Fuzi Lizhong material, pounded into honey pills, taken with light salt water to assist Lower Origin; separately, Zhimu, Beimu, Sangpiao decocted and slowly swallowed to clear Upper Diaphragm. Several doses reduced cough/panting, warmed limbs, stopped sweat. Then Shiquan Dabu Tang material made into pills. Decades of chronic disease healed from then on.
Chen Sannong's wife had night cough with much phlegm, diagnosed as Yin deficiency with Fire stirring. Siwu Tang modified with Shengdi (Rehmannia), Beimu, Zhimu, Gualou Ren, Xingren, Maidong, Wuweizi. Two doses cured.
Sun Wenyuan's niece had itchy throat, coughing red phlegm. Cun/Guan pulses flooding/large, internal heat with sores. Zhizi, Xiaoji, Shengdi, Danpi, Huashi (Talcum), Qingpi, Maidong, Gancao, Huanglian, Gualou Ren, decocted in water. Bleeding stopped, cough removed. Later, labor triggered cough with bloody taste in throat, due to severe Upper Jiao heat. Loquat leaf, Zhizi, Shengdi, Baishao (White Peony), Gancao, Danpi, Digupi (Dogwood Bark), Tianguafen (Trichosanthes Root), Huashi, Ziwan taken regularly for 3-5 doses. Recovered in two months.
Wen Tianqu had eye disease in winter; physicians dispersed too much. By spring, vomited cupfuls of blood. By summer, afternoon tidal fever, cough, chest/diaphragm distension/pain, morning cold sweats, loose stool twice daily, poor diet, muscle loss 70%, rapid pulse. Sun Yi Kui said: Based on symptoms/pulse, this is untreatable. Pressed by requests, used Xiebai San (Drain White Powder) plus Wuweizi, Baishao, Beimu, Madouling (Aristolochia). Slept peacefully that night, no cough. Loose stool remained; added Bian Dou (Lablab), Shanyao (Dioscorea), Fuling (Poria); sweating gradually stopped. Prescribed Xiebai San plus Shihu (Dendrobium), Madouling, Beimu, Chenpi, Yiyiren (Coix Seed), Baishao, Shanyao, Wuweizi, Jiegeng. Regulated for three months until recovery.
Note: This parallels Sun's treatment of Wu Xiaofeng's wife, who contracted cough in summer by mistakenly taking Renshen Su Yin Yin, both injured by excessive dispersal. The common saying "wind-cold unresolving becomes consumption" holds truth regarding the harm of over-releasing the exterior. However, some cases become consumption due to stubborn closure of wind-cold not exiting. Mr. Wei knows one aspect but not the second. Such cases arise from market physicians failing to distinguish deficiency/excess, recklessly using dispersing agents, turning mild disease into severe, even fatal, still blaming "wind-cold unresolving." Tragic! (See Wu case in Flaccidity Section.)
Li Shicai treated a person with cough and rebellious Qi. All fire-clearing, Lung-moistening, phlegm-transforming, Qi-regulating agents were used without omission, yet illness did not abate. Kidney pulse was large and soft, indicating Qi deficiency with Fire not returning to its source. Renshen (Ginseng) 3 qian decocted in water, delivering Bawei Wan (Eight-Ingredient Pill) 5 qian. One dose reduced symptoms. Later, Buzhong Yiqi Tang plus Guizhi (Cinnamon Twig) 1 qian, Fuzi (Aconite) 0.8 fen. Fifty doses total, plus 2 jin of Bawei Wan, resulted in recovery.
Another person coughed for a year, seeing dozens of doctors, taking endless medicine, yet illness worsened, believing it would become consumption-cough. Li said: "Incorrect. Pulse is neither rapid nor deficient. Only Right Cun is floating, large, and slippery, indicating Wind has not resolved. Must take many astringent herbs, hence worsening over time." Ma Huang (Ephedra), Xingren, Banxia, Qianhu, Jiegeng, Gancao, Juhong (Tangerine Peel), Suzi. Five doses reduced, ten doses cured.
Feng Chuzhan treated Li Xiaolian with frequent cough. Patient tall, fat, white complexion, red cheeks. Diagnosed as Exterior Excess with Interior Deficiency, False Heat above with True Cold below. Disease would be severe; advised heavy medication. A newly promoted official, expert in medicine, was consulted. Used Zhizi, Huangqin, Huafen (Angelica Dahurica), Juhong, Beimu, Suzi, Xingren. Feng advised against it; he ignored. After several doses, cough worsened, irritability increased, preference for cold doubled. Believing cold-natured herbs were correct, he doubled the dose, worsening condition. Further intake increased irritability, leading to anorexia...