咳谓无痰而有声，肺气伤而不清也。嗽谓无声而有痰，脾湿动而为痰也。咳嗽
是有痰而有声，盖因伤于肺气而咳，动于脾湿，因咳而为嗽也。经言脏腑皆有咳嗽，
咳嗽属肺，何为脏腑皆有之？盖咳嗽为病，有自外而入者，有自内而发者，风寒暑
湿外也，七情饥饱内也。风寒暑湿先自皮毛而入，皮毛者，肺之合，故虽外邪欲传
脏腑，亦必先从其合而为嗽，此自外而入者也。七情饥饱内有所伤，则邪气上逆，
肺为气出入之道，故五脏之邪上蒸于肺而为嗽，此自内而发者也。然风寒暑湿有不
为嗽者，盖所感者重，径伤脏腑，不留于皮毛。七情亦有不为嗽者，盖病尚浅，止
在本脏，未即上攻。所以伤寒以有嗽为轻，而七情饥饱之嗽，久而后见，治法当审
脉证三因。若外因邪气，止当发散，又须原其虚实冷热。若内因七情，则随其部经，
在与气口脉相应，当以顺气为先，下痰次之。有停饮而咳，又须消化之方，不可用
乌梅、罂粟酸涩之药。其寒邪未除，亦不可便用补药。尤忌忧思过度，房室劳伤，
遂成瘵疾，宜养脾生肺也。《仁斋直指》云∶感风者鼻塞声重，伤冷者凄清怯寒，挟
热为焦烦，受湿为缠滞，瘀血则膈间腥闷，停水则心下怔忪，或实或虚，痰之黄白，
唾之稀稠，从可知也。治嗽大法，肺脉浮为风邪所客，以发散取之。肺脉实为气壅
内热，以清利行之。脉濡散为肺虚，以补肺安之。其间久嗽之人，曾经解利，以致
肺胃俱寒，饮食不进，则用温中助胃，加和平治嗽之药。至若酒色过度，虚劳少血，
津液内耗，心火自炎，遂使燥热乘肺，咯唾脓血，上气涎潮，其嗽连续而不已。唯
夫血不荣肌，故邪在皮毛，皆能入肺，而自背得之尤速，此则人参、芎、归，所不
可无。一种传注，病涉邪恶，五脏反克，毒害尤深，近世率用蛤蚧、天灵盖、桃、
柳枝，丹砂、雄黄、安息香、苏合香丸通神之剂。然则咳嗽证治，于此可以问津索
途矣。抑犹有说焉，肺出气也，肾纳气也，肺为气之主，肾为气之本。凡咳嗽暴重，
动引百骸，自觉气从脐下逆奔而上者，此肾虚不能收气归元也。当以破故纸、安肾
丸主之。毋徒从事于宁肺。感风而嗽者，恶风自汗，或身体发热，或鼻流清涕，其
脉浮，宜桂枝汤加防风、杏仁、前胡、细辛。感寒而嗽者，恶寒发热无汗，鼻流清
涕，其脉紧，宜杏子汤去干姜、五味，加紫苏、干葛，或二陈加紫苏、葛根、杏仁、
桔梗。暴感风寒，不恶寒发热，止是咳嗽鼻塞声重者，宁嗽化痰汤。薛新甫云∶春
月风寒所伤，咳嗽声重，头疼，用金沸草散。咳嗽声重，身热头痛，用《局方》消
风散。盖肺主皮毛，肺气虚则腠理不密，风邪易入，治法当解表兼实肺气。肺有火
则腠理不闭，风邪外乘，治宜解表兼清肺火，邪退即止。若数行解散，则重亡津液，
邪蕴而为肺疽、肺痿矣。故凡肺受邪不能输化，而小便短少，皮肤渐肿，咳嗽日增
者，宜用六君子汤以补脾肺，六味丸以滋肾水。夏月喘急而嗽，面赤潮热，其脉洪
大者，黄连解毒汤。热躁而咳，栀子汤。咳唾有血，麦门冬汤。俱吞六味丸，
壮水之主以制阳光，而保肺金。秋月咳而身热自汗，口干便赤，脉虚而洪者，白虎
汤。身热而烦，气高而短，心下痞满，四肢困倦，精神短少者，香薷饮。若病邪既
去，宜用补中益气汤，加干山药、五味子以养元气，柴胡、升麻各二分以升生气。
冬月风寒外感，形气病气俱实者，宜华盖散、加减麻黄汤。所谓从表而入，自表而
出。若形气病气俱虚者，宜补其元气，而佐以解表之药，若专于解表，则肺气益虚，
腠理益疏，外邪乘虚易入，而其病愈难治矣。《活法机要》云∶夏月嗽而发热者，谓
之热痰嗽，小柴胡汤四两，加石膏一两，知母半两用之。冬月嗽而发寒热，谓之寒
嗽，小青龙加杏仁服之。感湿而嗽者，身体痛重，或有汗，或小便不利，此多乘热
入水，或冒雨露，或浴后不解湿衣，致有此患，宜白术酒。热嗽，咽喉干痛，鼻出
热气，其痰嗽而难出，色黄且浓，或带血缕，或出血腥臭，或坚如蛎肉，不若风寒
之嗽痰清而白，宜金沸草散，去麻黄、半夏，加薄荷、枇杷叶、五味、杏仁、桑根
白皮、贝母、茯苓、桔梗，入枣子一个同煎，仍以辰砂化痰丸，或薄荷煎、八风散
含化。有热嗽诸药不效，竹叶石膏汤，去竹叶，入粳米，少加知母，多服五味、杏
仁、枇杷叶，此必审是伏热在上焦心肺间可用。冷热嗽，因增减衣裳，寒热俱感，
遇乍寒亦嗽，乍热亦嗽，饮热亦嗽，饮冷亦嗽，宜金沸草散、消风散各一帖和煎，
或应梦人参散，或款冬花散，以薄荷代麻黄，或二母散，仍以辰砂化痰丸、八风丹
吞化。七情饥饱嗽，无非伤动脏腑正气，致邪上逆，结成痰涎，肺道不理。宜顺气
为先，四七汤一帖，加杏仁、五味子、桑白皮、人参、阿胶、麦门冬、枇杷叶各一
钱。有饮冷热酒，或饮冷水，伤肺致嗽，俗谓之凑肺，宜紫菀饮。有嗽吐痰与食俱
出者，此盖饮食失节，致肝气不利，而肺又有客邪，肝浊道，肺清道，清浊相干，
宜二陈汤加木香、杏仁、细辛、枳壳各半钱。食积痰嗽发热，二陈汤加栝蒌、莱菔
子、山楂、枳实、曲 。《机要》云∶痰而能食者，大承气微下之。痰而不能食者，
浓朴汤主之。嗽而失声，润肺散，或清音丸。戴云∶有热嗽失声咽疼，多进冷剂，
而声愈不出者，宜以生姜汁调消风散，少少进之，或只一味姜汁亦得，冷热嗽后失
声者尤宜。嗽而失声者，非独热嗽有之，宜审其证用药，佐以橄榄丸含化，仍浓煎
独味枇杷叶散热服。声哑者，寒包其热也，宜细辛、半夏、生姜辛以散之。亦有痰
热壅于肺者，金空则鸣，必清金中邪滞，用清咽宁嗽汤。劳嗽，有因久嗽成劳者，
有因病劳乃嗽者，其证寒热往来，或独热无寒，咽干嗌痛，精神疲极，所嗽之痰，
或浓或淡，或时有血，腥臭异常，语声不出者，薏苡仁五钱，桑根白皮、麦门冬各
三钱，白石英二钱，人参、五味子、款冬花、紫菀、杏仁、贝母、阿胶、百合、桔
梗、秦艽、枇杷叶各一钱，姜、枣、粳米同煎，去渣调钟乳粉。亦宜蛤蚧散，或保
和汤、知母茯苓汤、紫菀散、宁嗽汤。经年累月，久嗽不已，服药不瘥，余无他证，
却与劳嗽不同。戴用三拗汤、青金丸。予谓其不妥，独宜保肺而已，一味百部膏可
也。《衍义》云∶有妇人患肺热久嗽，身如炙，肌瘦，将成肺劳。以枇杷叶、木通、
款冬花、紫菀、杏仁、桑白皮各等分，大黄减半，各如常制治讫，同为末，蜜丸如
樱桃大。食后、夜卧各含化一丸，未终剂而愈。有风寒者，可用熏法。有热者，可
用枳壳汤。有实积者，可用款气丸、利膈丸、马兜铃丸。脾胃如常，饮食不妨者，
加味人参清肺汤、参粟汤。《素问》云∶咳嗽烦冤者，是肾气之逆也，八味丸、安肾
丸主之。有暴嗽，服诸药不效，或教之进生料鹿茸丸、大菟丝子丸方愈。有本有标，
却不可以其暴嗽而疑遽补之非，所以易愈者，亦觉之早故也。时行嗽，发热恶寒，
头痛鼻塞，气急，状如伤冷热，连咳不已。初得病即伏枕一两日即轻，俗呼为虾蟆
瘟，用参苏饮加细辛半钱。洁古云∶咳而无痰者，以辛甘润其肺，蜜煎生姜汤、蜜
煎橘皮汤、烧生姜、胡桃，皆治无痰而嗽者。《本事方》补肺法，生地黄二斤，净
洗，杏仁二两，生姜、蜜各四两，捣如泥，入瓦盆中，置饭上蒸五七度，每五更挑
三匙咽下。《金匮》方，咳而上气，喉中水鸡声，射干麻黄汤主之。咳嗽喉中作声，
一味白前妙。《千金》有白前汤。一男子五十余岁，病伤寒咳嗽，喉中声如 ，与独
参汤一服而 声徐，至二三帖咳嗽亦渐退，凡服二三斤，病始全愈。丹溪云∶上半
日嗽多，属胃中有火。午后嗽多，属阴虚。黄昏嗽多，此火气浮于肺，不宜用凉药，
宜敛而降之。有一咳即出痰者，脾湿胜而痰滑也。有连咳十数不能出痰者，肺燥胜
痰涩也。滑者宜南星、半夏、皂角灰之属燥其脾，若利气之剂所当忌也。涩者
宜枳壳、紫苏、杏仁之属利其肺，若燥肺之剂所当忌也。形肥，或有汗，或脉缓，
体重嗜卧之人咳者，脾湿胜也。宜白术、苍术、茯苓之属燥之。形瘦，或夏月无汗，
或脉涩之人咳者，肺燥胜也。宜杏仁、栝蒌之属润之。凡咳嗽面赤，胸腹胁常热，
唯于足乍有凉时，其脉洪者，热痰在胸膈也。宜小陷胸汤、礞石丸之类清膈降痰。
甚而不已者，宜吐下其痰热也。面白悲嚏，或胁急胀痛，或脉沉弦细迟而咳者，寒
饮在胸腹也。宜辛甘热去之，半夏温肺汤。丹溪治饮酒伤肺痰嗽，以竹沥煎入韭汁，
就吞栝蒌、杏仁、青黛、黄连丸。按此恐太寒，闭遏热气，不得发舒，不若先以辛
散之，而后以酸收之，甚者吐之。后与五苓甘露，胜湿去痰之剂。吃醋抢喉，咳嗽
不止，用甘草二两，去赤皮，作二寸 ，中半劈开，用猪胆汁五枚浸三日，取出火
上炙干为细末，炼蜜丸。每服四十丸，茶清吞下，临卧服。咸物所伤，哮嗽不止，
用白面二钱，砂糖二钱，通搜和，用糖饼灰汁捻作饼子，放在炉内炸熟，划出，加
轻粉四钱，另炒略熟，将饼切作四亚，掺轻粉在内，令患人吃尽，吐出病根即愈。
肺咳之状，咳而喘息有音，甚则唾血，麻黄汤。心咳之状，咳则心痛，喉仲介
介如梗状，甚则咽肿喉痹，桔梗汤。肝咳之状，咳而两胁下痛，甚则不可以转，转
则两 下满，小柴胡汤。（仲景云∶咳引胁痛为悬饮，宜十枣汤。丹溪云∶咳引胁痛，
宜疏肝气，用青皮、枳壳、香附子等，实者白芥子之属。）脾咳之状，咳则右胁下痛，阴阴引肩
背，甚则不可以动，动则咳剧，升麻汤。肾咳之状，咳则腰背相引而痛，甚则咳涎，麻黄附子细辛
汤。五脏之久嗽，乃移于六腑，脾咳不已，则胃受之，胃咳之状，咳而呕，呕甚则长虫出，乌梅
丸。肝咳不已，则胆受之，胆咳之状，咳呕胆汁，黄芩加半夏生姜汤。肺咳不已、则大肠
受之，大肠咳状，咳而遗失，赤石脂禹余粮汤、桃花汤。不止用猪苓分水散。心
咳不已、则小肠受之，小肠咳状，咳而失气，气与咳俱失，芍药甘草汤。肾咳不已，
则膀胱受之，膀胱咳状，咳而遗溺，茯苓甘草汤。久咳不已，则三焦受之，三焦咳
状，咳而腹满不欲食饮，此皆聚于胃，关于肺，使人多涕唾，而面浮肿气逆也，钱
氏异功散。
【肺痿】仲景云∶热在上焦者，因咳为肺痿，肺痿之病，从何得之？师曰∶或从汗出，
或从呕吐，或从消渴小便利数，或从便难，又被快药下利，重亡津液故得之。肺痿，
咳吐涎沫不止，咽燥而渴，生姜甘草汤主之。生姜五两，人参二两，甘草四两，大
枣十五枚，水七升，煮取三升，分温三服。炙甘草汤，治肺痿涎唾多，心中温温液
液者。用甘草一味，水三升，煮半升，分温三服。桂枝去芍药加皂荚汤，治肺痿吐
涎沫。桂技、生姜各三两，甘草一两，大枣十枚，皂荚十枚，去皮弦、炙焦，水七
升，微火煮取三升，分三温服。肺痿吐涎沫而不咳者，其人不渴必遗尿，小便数。
所以然者，以上虚不能制下故也。此为肺中冷，必眩，多涎唾，甘草干姜汤以温之。
甘草炙四两，干姜炮二两，水三升，煮取一升五合，分温再服。若服汤口渴，属消
渴。肺痿，咳唾咽燥，欲饮水者自愈。自张口者，短气也。咳而口中自有津液，舌
上胎滑，此为浮寒，非肺痿也。肺痿，或咳沫，或咳血，今编咳沫者于此，咳血者
入血证门。
【肺胀】仲景云∶咳而上气，此为肺胀，脉浮大者，越婢加半夏汤主之。又云∶肺胀，
咳而上气，烦躁而喘，脉浮者，心下有水，小青龙汤加石膏主之。丹溪治主收敛，
用诃子为主，佐以海石、香附（童便浸三日）、栝蒌仁、青黛、半夏曲、杏仁、姜汁、蜜调
噙之。肺胀而嗽，或左或右，不得眠，此痰夹瘀血碍气而病，宜养血以流动乎气，
降火疏肝以清痰，四物汤加桃仁、诃子、青皮、竹沥、韭汁之属，壅遏不得眠者，难治。
【诊】浮为风。紧为寒。数为热。细为湿。浮紧则虚寒。沉数则实热。弦涩则
少血。洪滑则多痰。涩为房劳。右关濡伤脾。左关弦短伤肝。浮短伤肺。脉出鱼际，
为逆气喘息。弦为饮，咳而浮，四十日已。咳而眩，实者吐之愈。咳而脉虚，必苦
冒。脉沉不可发汗。脾脉微为咳。肺脉微急为咳唾血。浮直而濡者，易治。喘而逆
上气，脉数有热，不得卧，难治。上气喘，面浮肿，肩，脉浮大者死。久嗽脉弱
者可治，实大数者死。上气喘息低昂，脉滑手足温者生，脉涩四肢寒者死。咳而脱
形，身热脉小，坚急以疾，是逆也，不过十五日死。咳嗽羸瘦，脉形坚大者死。咳
嗽脉沉紧者死，浮直者生，浮软者生，小沉伏匿者死。咳而呕，腹满泄，弦急欲绝
者死。
咳嗽是指没有痰但有声，这是肺气受损而不清肃的表现。嗽是指无声但有痰，这是脾湿扰动而生痰所致。咳嗽则是既有痰又有声，大概是因为伤及肺气而咳，又因脾湿而动，因咳而引发嗽。经典著作中说脏腑都会发生咳嗽，既然咳嗽归属于肺，为什么说所有脏腑都有咳嗽呢？原来咳嗽这种病，有从外部侵入的，也有从内部引发的。风寒暑湿属于外邪，七情和饥饱失调属于内因。风寒暑湿首先从皮毛侵入，皮毛是肺的外合部位，所以即使外邪想要传变到脏腑，也必定先从其相合的部位（皮毛）导致嗽，这就是从外部侵入的情况。七情和饥饱在内部造成损伤，则邪气上逆，肺是气体出入的通道，所以五脏的邪气向上熏蒸于肺而导致嗽，这就是从内部引发的情况。然而，感受风寒暑湿并不一定都导致咳嗽，这是因为感受的病邪较重，直接伤害了脏腑，没有停留在皮毛。七情致病也不一定都导致咳嗽，这是因为病情尚浅，只局限于本脏，没有立即向上攻冲。所以伤寒病中，伴有咳嗽的属于轻症；而由七情、饥饱引起的咳嗽，往往要过很久才显现出来。治疗方法应当仔细审察脉象、证候以及三因（内因、外因、不内外因）。如果是外因邪气，只应当使用发散的方法，并且必须推究其虚实冷热。如果是内因七情，则要根据所属经络，与气口脉相应，应当以顺气为先，化痰次之。如果有停饮导致的咳嗽，又必须用消导化饮的方法，不可使用乌梅、罂粟壳等酸涩收敛的药物。如果寒邪尚未去除，也不可立即使用补药。尤其忌讳过度忧思和房劳损伤，否则容易演变成痨瘵（肺结核类疾病），应当注重养脾生肺。《仁斋直指方》说：感受风邪的鼻塞声音重浊，受冷的凄清怕冷，挟热的焦躁烦闷，受湿的缠绵滞重，瘀血则胸膈间腥闷，停水则心下悸动怔忪，无论是实证还是虚证，通过观察痰的黄白、唾液的稀稠，就可以知道了。治疗咳嗽的大法：肺脉浮，为风邪客居，用发散法取效；肺脉实，为气壅内热，用清利法疏导；脉濡散，为肺虚，用补肺法安定。其中久嗽之人，曾经经过解表利窍的治疗，导致肺胃俱寒，饮食不进，则用温中助胃的药，加上平和治嗽的药。至于酒色过度，虚劳少血，津液内耗，心火自炎，致使燥热乘袭肺脏，咯吐脓血，气逆涎潮，咳嗽连续不断。只有血不能荣养肌肉，所以邪气在皮毛，都能入肺，而从背部受邪的尤其迅速，这种情况下人参、川芎、当归是不可缺少的。有一种传染性疾病，病涉邪恶，五脏反克，毒害尤深，近代通常使用蛤蚧、天灵盖、桃枝、柳枝、丹砂、雄黄、安息香、苏合香丸等通神之剂。那么咳嗽的证治，从这里可以探寻门径了。还有进一步的说法：肺主呼气，肾主纳气，肺为气之主，肾为气之本。凡是咳嗽突然加重，牵动全身骨骼，自觉气从脐下逆奔而上者，这是肾虚不能收摄气归元。应当用破故纸、安肾丸主治。不要仅仅从事于宁肺。感受风邪而咳嗽的，恶风自汗，或身体发热，或鼻流清涕，其脉浮，宜用桂枝汤加防风、杏仁、前胡、细辛。感受寒邪而咳嗽的，恶寒发热无汗，鼻流清涕，其脉紧，宜用杏子汤去掉干姜、五味子，加紫苏、干葛，或者二陈汤加紫苏、葛根、杏仁、桔梗。暴感风寒，不恶寒发热，只是咳嗽鼻塞声音重浊的，用宁嗽化痰汤。薛新甫说：春季风寒所伤，咳嗽声音重浊，头疼，用金沸草散。咳嗽声音重浊，身热头痛，用《局方》消风散。因为肺主皮毛，肺气虚则腠理不密，风邪易入，治法当解表兼实肺气。肺有火则腠理不闭，风邪外乘，治宜解表兼清肺火，邪退即止。如果多次使用解散药物，则会严重耗伤津液，邪气蕴结而成肺疽、肺痿。所以凡是肺受邪不能输布化气，而小便短少，皮肤渐肿，咳嗽日益增多的，宜用六君子汤以补脾肺，六味丸以滋肾水。夏季喘急而咳，面赤潮热，脉洪大的，用黄连解毒汤。热躁而咳，用栀子汤。咳唾带血，用麦门冬汤。都吞服六味丸，壮水之主以制阳光，从而保肺金。秋季咳嗽而身热自汗，口干便赤，脉虚而洪大的，用白虎汤。身热而烦，气高而短，心下痞满，四肢困倦，精神短少的，用香薷饮。如果病邪已去，宜用补中益气汤，加干山药、五味子以养元气，柴胡、升麻各二分以升发生气。冬季风寒外感，形气和病气都实的，宜用华盖散、加减麻黄汤。所谓从表而入，自表而出。如果形气和病气都虚的，宜补其元气，而佐以解表的药，如果专于解表，则肺气更虚，腠理更疏，外邪乘虚易入，而其病更难治了。《活法机要》说：夏季咳嗽而发热的，叫做热痰嗽，用小柴胡汤四两，加石膏一两，知母半两用之。冬季咳嗽而发寒热的，叫做寒嗽，用小青龙汤加杏仁服之。感受湿邪而咳嗽的，身体痛重，或有汗，或小便不利，这多是因为乘热入水，或冒雨露，或浴后不解湿衣，导致有此患，宜用白术酒。热嗽，咽喉干痛，鼻出热气，其痰嗽而难出，色黄且浓，或带血缕，或出血腥臭，或坚如蛎肉，不像风寒之嗽痰清而白，宜用金沸草散，去掉麻黄、半夏，加薄荷、枇杷叶、五味子、杏仁、桑根白皮、贝母、茯苓、桔梗，入枣子一个同煎，仍以辰砂化痰丸，或薄荷煎、八风散含化。有热嗽诸药不效的，用竹叶石膏汤，去掉竹叶，入粳米，少加知母，多服五味子、杏仁、枇杷叶，这必须审察是伏热在上焦心肺间才可用。冷热嗽，因增减衣裳，寒热俱感，遇乍寒亦嗽，乍热亦嗽，饮热亦嗽，饮冷亦嗽，宜用金沸草散、消风散各一帖和煎，或者应梦人参散，或者款冬花散，以薄荷代麻黄，或者二母散，仍以辰砂化痰丸、八风丹吞化。七情饥饱引起的咳嗽，无非是伤动脏腑正气，致邪气上逆，结成痰涎，肺道不理。宜顺气为先，四七汤一帖，加杏仁、五味子、桑白皮、人参、阿胶、麦门冬、枇杷叶各一钱。有喝冷热酒，或饮冷水，伤肺致嗽，俗谓之凑肺，宜用紫菀饮。有咳嗽吐痰与食物一起出来的，这大概是饮食失节，致肝气不利，而肺又有客邪，肝为浊道，肺为清道，清浊相干，宜用二陈汤加木香、杏仁、细辛、枳壳各半钱。食积痰嗽发热，用二陈汤加栝蒌、莱菔子、山楂、枳实、神曲。《机要》说：痰多而能食的，用大承气汤微下之。痰多而不能食的，用浓朴汤主治。咳嗽而失声，用润肺散，或者清音丸。戴云说：有热嗽失声咽疼，多进冷剂，而声愈不出者，宜用生姜汁调消风散，少量服用，或者只用一味姜汁也可以，冷热嗽后失声的尤其适宜。咳嗽而失声的，不只是热嗽有这种情况，宜审察其证用药，佐以橄榄丸含化，仍浓煎独味枇杷叶散热服。声哑的，是寒包其热，宜用细辛、半夏、生姜辛以散之。也有痰热壅于肺的，金空则鸣，必须清金中邪滞，用清咽宁嗽汤。劳嗽，有因久嗽成劳的，有病劳乃嗽的，其证寒热往来，或独热无寒，咽干嗌痛，精神疲极，所嗽之痰，或浓或淡，或时有血，腥臭异常，语声不出者，用薏苡仁五钱，桑根白皮、麦门冬各三钱，白石英二钱，人参、五味子、款冬花、紫菀、杏仁、贝母、阿胶、百合、桔梗、秦艽、枇杷叶各一钱，姜、枣、粳米同煎，去渣调钟乳粉。也宜用蛤蚧散，或者保和汤、知母茯苓汤、紫菀散、宁嗽汤。经年累月，久嗽不已，服药不愈，其余没有其他证候，却与劳嗽不同。戴人用三拗汤、青金丸。我认为不妥，独宜保肺而已，一味百部膏就可以了。《衍义》说：有妇人患肺热久嗽，身如炙烤，肌瘦，将成肺劳。用枇杷叶、木通、款冬花、紫菀、杏仁、桑白皮各等分，大黄减半，各按常规炮制处理后，同为末，蜜丸如樱桃大。食后、夜卧各含化一丸，未服完一剂而愈。有风寒的，可用熏法。有热的，可用枳壳汤。有实积的，可用款气丸、利膈丸、马兜铃丸。脾胃如常，饮食不妨的，加味人参清肺汤、参粟汤。《素问》说：咳嗽烦冤的，是肾气之逆，用八味丸、安肾丸主治。有暴嗽，服诸药不效，或者教其进服生料鹿茸丸、大菟丝子丸方愈。有本有标，却不可以因其暴嗽而怀疑遽然进补不对，所以容易痊愈的，也是发觉得早的缘故。时行嗽，发热恶寒，头痛鼻塞，气急，状如伤冷热，连咳不已。初得病即伏枕一两日即轻，俗呼为虾蟆瘟，用参苏饮加细辛半钱。洁古说：咳而无痰的，用辛甘润其肺，蜜煎生姜汤、蜜煎橘皮汤、烧生姜、胡桃，都治无痰而嗽。《本事方》补肺法，生地黄二斤，净洗，杏仁二两，生姜、蜜各四两，捣如泥，入瓦盆中，置饭上蒸五七次，每五更挑三匙咽下。《金匮》方，咳而上气，喉中水鸡声，射干麻黄汤主治。咳嗽喉中作声，一味白前妙。《千金》有白前汤。一男子五十余岁，病伤寒咳嗽，喉中声如鸱枭，与独参汤一服而鸱枭声缓，至二三帖咳嗽亦渐退，凡服二三斤，病始全愈。丹溪说：上半日嗽多，属胃中有火。午后嗽多，属阴虚。黄昏嗽多，此火气浮于肺，不宜用凉药，宜敛而降之。有一咳即出痰的，脾湿胜而痰滑也。有连咳十数不能出痰的，肺燥胜痰涩也。滑的宜南星、半夏、皂角灰之类燥其脾，若利气之剂所当忌也。涩的宜枳壳、紫苏、杏仁之类利其肺，若燥肺之剂所当忌也。形体肥胖，或有汗，或脉缓，体重嗜卧之人咳的，脾湿胜也。宜白术、苍术、茯苓之类燥之。形体消瘦，或夏月无汗，或脉涩之人咳的，肺燥胜也。宜杏仁、栝蒌之类润之。凡是咳嗽面赤，胸腹胁常热，唯于足乍有凉时，其脉洪的，热痰在胸膈也。宜小陷胸汤、礞石丸之类清膈降痰。甚而不已的，宜吐下其痰热也。面白悲嚏，或胁急胀痛，或脉沉弦细迟而咳的，寒饮在胸腹也。宜辛甘热去之，半夏温肺汤。丹溪治饮酒伤肺痰嗽，以竹沥煎入韭汁，就吞栝蒌、杏仁、青黛、黄连丸。按此恐太寒，闭遏热气，不得发舒，不若先以辛散之，而后以酸收之，甚者的吐之。后与五苓甘露，胜湿去痰之剂。吃醋抢喉，咳嗽不止，用甘草二两，去赤皮，作二寸段，中半劈开，用猪胆汁五枚浸三日，取出火上炙干为细末，炼蜜丸。每服四十丸，茶清吞下，临卧服。咸物所伤，哮嗽不止，用白面二钱，砂糖二钱，通搜和，用糖饼灰汁捻作饼子，放在炉内炸熟，划出，加轻粉四钱，另炒略熟，将饼切作四块，掺轻粉在内，令患人吃尽，吐出病根即愈。肺咳的状貌，咳而喘息有音，甚则唾血，用麻黄汤。心咳的状貌，咳则心痛，喉中介介如梗状，甚则咽肿喉痹，用桔梗汤。肝咳的状貌，咳而两胁下痛，甚则不可以转，转则两胁下满，用小柴胡汤。（仲景说：咳引胁痛为悬饮，宜十枣汤。丹溪说：咳引胁痛，宜疏肝气，用青皮、枳壳、香附子等，实者白芥子之类。）脾咳的状貌，咳则右胁下痛，隐隐引肩背，甚则不可以动，动则咳剧，用升麻汤。肾咳的状貌，咳则腰背相引而痛，甚则咳涎，用麻黄附子细辛汤。五脏之久嗽，乃移于六腑，脾咳不已，则胃受之，胃咳的状貌，咳而呕，呕甚则长虫出，用乌梅丸。肝咳不已，则胆受之，胆咳的状貌，咳呕胆汁，用黄芩加半夏生姜汤。肺咳不已，则大肠受之，大肠咳的状貌，咳而遗失，用赤石脂禹余粮汤、桃花汤。不止用猪苓分水散。心咳不已，则小肠受之，小肠咳的状貌，咳而失气，气与咳俱失，用芍药甘草汤。肾咳不已，则膀胱受之，膀胱咳的状貌，咳而遗溺，用茯苓甘草汤。久咳不已，则三焦受之，三焦咳的状貌，咳而腹满不欲食饮，此皆聚于胃，关于肺，使人多涕唾，而面浮肿气逆也，用钱氏异功散。
【肺痿】仲景说：热在上焦的，因咳为肺痿，肺痿的病，从何得来？老师说：或者从汗出，或者从呕吐，或者从消渴小便利数，或者从便难，又被快药下利，重亡津液故得之。肺痿，咳吐涎沫不止，咽燥而渴，生姜甘草汤主治。生姜五两，人参二两，甘草四两，大枣十五枚，水七升，煮取三升，分温三服。炙甘草汤，治肺痿涎唾多，心中温温液液者。用甘草一味，水三升，煮半升，分温三服。桂枝去芍药加皂荚汤，治肺痿吐涎沫。桂枝、生姜各三两，甘草一两，大枣十枚，皂荚十枚，去皮弦、炙焦，水七升，微火煮取三升，分三温服。肺痿吐涎沫而不咳的，其人必不渴，必遗尿，小便数。之所以这样，是因为上虚不能制下故也。此为肺中冷，必眩，多涎唾，甘草干姜汤以温之。甘草炙四两，干姜炮二两，水三升，煮取一升五合，分温再服。如果服汤口渴，属消渴。肺痿，咳唾咽燥，欲饮水的自愈。自张口的，短气也。咳而口中自有津液，舌上胎滑，此为浮寒，非肺痿也。肺痿，或咳沫，或咳血，今编咳沫者于此，咳血者入血证门。
【肺胀】仲景说：咳而上气，此为肺胀，脉浮大的，越婢加半夏汤主治。又说：肺胀，咳而上气，烦躁而喘，脉浮的，心下有水，小青龙汤加石膏主治。丹溪治主收敛，用诃子为主，佐以海浮石、香附（童便浸三日）、栝蒌仁、青黛、半夏曲、杏仁、姜汁、蜜调噙之。肺胀而嗽，或左或右，不得眠，此痰夹瘀血碍气而病，宜养血以流动乎气，降火疏肝以清痰，四物汤加桃仁、诃子、青皮、竹沥、韭汁之类，壅遏不得眠的，难治。
【诊】浮为风。紧为寒。数为热。细为湿。浮紧则虚寒。沉数则实热。弦涩则少血。洪滑则多痰。涩为房劳。右关濡伤脾。左关弦短伤肝。浮短伤肺。脉出鱼际，为逆气喘息。弦为饮，咳而浮，四十日已。咳而眩，实者吐之愈。咳而脉虚，必苦冒。脉沉不可发汗。脾脉微为咳。肺脉微急为咳唾血。浮直而濡的，易治。喘而逆上气，脉数有热，不得卧，难治。上气喘，面浮肿，肩息，脉浮大的死。久嗽脉弱的可治，实大数的死。上气喘息低昂，脉滑手足温的生，脉涩四肢寒的死。咳而脱形，身热脉小，坚急以疾，是逆也，不过十五日死。咳嗽羸瘦，脉形坚大的死。咳嗽脉沉紧的死，浮直的生，浮软的生，小沉伏匿的死。咳而呕，腹满泄，弦急欲绝的死。
Cough (Ke) is defined as having sound but no phlegm, indicating damage to Lung Qi and failure of its clear descending function. Salivation (Sou) is defined as having phlegm but no sound, caused by Spleen dampness stirring up phlegm. Cough with salivation (Kesu) involves both phlegm and sound; it arises because Lung Qi is injured leading to cough, and Spleen dampness is activated, causing salivation due to the cough. The Classics state that all Zang-Fu organs can have cough. Since cough belongs to the Lung, why do all organs exhibit it? This is because coughing illness can enter from outside or originate from inside. Wind, cold, summer-heat, and dampness are external pathogens; seven emotions and irregular diet are internal factors. Wind, cold, summer-heat, and dampness first enter through the skin and hair. Skin and hair are the exterior correspondence of the Lung, so even if external pathogens intend to transmit to the Zang-Fu organs, they must first affect their correspondence (skin/hair) to cause cough; this is entering from outside. Damage from seven emotions and diet internally causes pathogenic qi to rebel upward. The Lung is the pathway for Qi entry and exit, so pathogenic qi from the Five Zang organs steams upward into the Lung causing cough; this originates from inside. However, contracting wind, cold, summer-heat, or dampness does not always result in cough because the contracted pathogen is heavy, directly injuring the Zang-Fu organs without lingering on the skin. Seven emotions may also not cause cough because the disease is still shallow, confined to the original organ, without immediately attacking upward. Therefore, in Cold Damage (Shanghan), cough indicates a mild condition; whereas cough from seven emotions or diet appears after a long time. Treatment methods must carefully examine pulse, symptoms, and the Three Causes. If external pathogenic qi, only dispersing methods should be used, and one must investigate deficiency/excess and cold/heat. If internal seven emotions, follow the respective meridians corresponding to the Qi Kou pulse; prioritize regulating Qi, followed by resolving phlegm. For cough due to retained fluid, digestion/dissipation methods are required; sour/astringent drugs like Wu Mei (Fructus Mume) and Ying Su Ke (Pericarpium Papaveris) must not be used. If cold pathogen is not eliminated, tonifying drugs must not be used immediately. One must especially avoid excessive worry/thought and sexual fatigue/injury, lest it become Phthisis (Zhai Ji); nourishing Spleen and generating Lung Qi is appropriate. *Ren Zhi Zhi Zhi Fang* states: Contracting wind causes nasal congestion and heavy voice; injury from cold causes shivering and fear of cold; carrying heat causes irritability; receiving dampness causes lingering stagnation; blood stasis causes stifling sensation in the chest/diaphragm; retained water causes palpitations in the epigastrium. Whether excess or deficiency, yellow/white phlegm and thin/thick saliva allow one to know the nature. General treatment principles for cough: Floating pulse at Lung indicates Wind Pathogen lodging, treat with dispersing method. Excess pulse at Lung indicates Qi obstruction and internal heat, treat with clearing/draining method. Soft/scattered pulse indicates Lung deficiency, treat with tonifying Lung method. Among those with chronic cough who have undergone dispersing/clearing treatments, resulting in dual Cold of Lung and Stomach and loss of appetite, use warming middle/assisting Stomach drugs plus mild cough-resolving drugs. Regarding excessive alcohol/sex, consumptive deficiency with little blood, internal consumption of fluids, spontaneous flaming of Heart Fire, causing dry-heat to attack Lung, spitting pus/blood, rebellious Qi with salivary tide, continuous unceasing cough: since Blood fails to nourish muscles, pathogens in skin/hair easily enter Lung, especially quickly from the back; here Ren Shen (Radix Ginseng), Xiong (Radix Chuanxiong), Gui (Radix Angelicae Sinensis) are indispensable. A type of infectious disease involving evil pathogens, reverse conquest of Five Zang, deep toxicity, modern times generally use Ge Jie (Pleuroceras), Tian Ling Gai (Skull of Human), Tao/Zhi (Peach/Willow branches), Dan Sha (Cinnabar), Xiong Huang (Realgar), An Xi Xiang (Benzoin), Su He Xiang Wan (Styrax Pill) and other spirit-unblocking agents. Thus, the syndrome differentiation and treatment of cough can be explored from here. Furthermore: Lung exhales Qi, Kidney grasps Qi; Lung is Master of Qi, Kidney is Root of Qi. When cough suddenly worsens, moving the whole body, with sensation of Qi rushing upward from below the navel, this is Kidney deficiency failing to gather Qi to its origin. Use Po Gu Zi (Fructus Psoraleae), An Shen Wan (Kidney-Calming Pill). Do not merely engage in calming Lung. Contracting wind causing cough: aversion to wind, spontaneous sweating, or body fever, or runny clear nose, floating pulse; use Gui Zhi Tang (Cinnamon Twig Decoction) plus Fang Feng (Radix Saposhnikoviae), Xing Ren (Semen Armeniacae Amarum), Qian Hu (Radix Peucedani), Xi Xin (Herba Asari). Contracting cold causing cough: aversion to cold, fever, no sweat, runny clear nose, tight pulse; use Xing Zi Tang (Apricot Kernel Decoction) removing Gan Jiang (Rhizoma Zingiberis Recens), Wu Wei Zi (Fructus Schisandrae), adding Zi Su (Folium Perillae), Gan Ge (Radix Puerariae Lobatae), or Er Chen Tang (Two-Cured Decoction) plus Zi Su, Ge Gen (Radix Puerariae Lobatae), Xing Ren, Jie Geng (Radix Platycodi). Sudden contraction of wind-cold, no aversion to cold/fever, only cough, nasal congestion, heavy voice; use Ning Sou Hua Tan Tang (Cough-Calming Phlegm-Resolving Decoction). Xue Xin Fu says: Spring wind-cold injury, cough heavy voice, headache; use Jin Fei Cao San (Boilweed Powder). Cough heavy voice, body fever, headache; use Ju Fang Xiao Feng San (Formulary Wind-Expelling Powder). Because Lung governs skin/hair, Lung Qi deficiency means pores are not dense, wind pathogen enters easily; treatment should release exterior and strengthen Lung Qi. Lung fire means pores are not closed, wind pathogen attacks externally; treatment should release exterior and clear Lung fire, stop when pathogen retreats. If multiple dispersing treatments are used, fluids are severely lost, pathogen accumulates becoming Lung Abscess (Fei Ju) or Lung Flaccidity (Fei Wei). So whenever Lung receives pathogen unable to distribute/transform, with short urine, gradual skin swelling, increasing daily cough; use Liu Jun Zi Tang (Six-Gentlemen Decoction) to tonify Spleen/Lung, Liu Wei Wan (Six-Ingredient Pill) to nourish Kidney Water. Summer wheezing急促 and cough, red face, tidal fever, large pulse; use Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity). Heat/agitation with cough; use Zhi Zi Tang (Gardenia Decoction). Cough/spitting blood; use Mai Men Dong Tang (Ophiopogon Decoction). All swallow Liu Wei Wan, strengthening the master of Water to control Yang light, thereby protecting Lung Metal. Autumn cough with body fever, spontaneous sweating, dry mouth, red urine, deficient and large pulse; use Bai Hu Tang (White Tiger Decoction). Body fever with vexation, high breath, shortness of breath, epigastric fullness/stuffiness, limbs fatigue, scanty spirit; use Xiang Ru Yin (Elsholtzia Drink). If pathogen is gone, use Bu Zhong Yi Qi Tang (Tonify Middle Augment Qi Decoction) plus Gan Shan Yao (Rhizoma Dioscoreae Hypoglaucae), Wu Wei Zi to nourish Yuan Qi, Chai Hu (Radix Bupleuri), Sheng Ma (Rhizoma Cimicifugae) 2 fen each to raise Sheng Qi. Winter wind-cold external contraction, form/Qi and disease/Qi both excess; use Hua Gai San (Flower Canopy Powder), Jia Jian Ma Huang Tang (Modified Ephedra Decoction). Meaning entering from exterior, exiting from exterior. If form/Qi and disease/Qi both deficient; tonify Yuan Qi, assist with exterior-releasing drugs. If solely releasing exterior, Lung Qi becomes more deficient, pores more sparse, external pathogen enters easily via deficiency, disease harder to treat. *Huo Fa Ji Yao* says: Summer cough with fever called Re Tan Sou (Heat-Phlegm Cough); use Xiao Chai Hu Tang (Minor Bupleurum Decoction) 4 liang, add Shi Gao (Gypsum Fibrosum) 1 liang, Zhi Mu (Rhizoma Anemarrhenae) half liang. Winter cough with chills/fever called Han Sou (Cold Cough); use Xiao Qing Long Tang (Minor Blue Dragon Decoction) plus Xing Ren. Contracting dampness causing cough: body pain/heaviness, maybe sweat, or difficult urination; this often results from entering water while hot, exposure to rain/dew, or bathing without changing wet clothes; use Bai Zhu Jiu (Atractylodes Wine). Heat cough: throat dry/painful, nose emits hot air, phlegm hard to expectorate, yellow/thick color, maybe blood threads, bloody/foul odor, or hard like oyster meat; unlike wind-cold cough where phlegm is clear/white; use Jin Fei Cao San, remove Ma Huang (Herba Ephedrae), Ban Xia (Rhizoma Pinelliae), add Bo He (Herba Menthae), Pi Ye (Folium Eriobotryae), Wu Wei Zi, Xing Ren, Sang Bai Pi (Cortex Mori Radicis), Bei Mu (Bulbus Fritillariae Cirrhosae), Fu Ling (Poria), Jie Geng, decoct together with one Jujube. Still use Chen Sha Hua Tan Wan (Cinnabar Phlegm-Resolving Pill), or Bo He Jian, Ba Feng San lozenges. If various heat-cough drugs fail, use Zhu Ye Shi Gao Tang (Bamboo Leaf Gypsum Decoction), remove Zhu Ye (Folium Bambusae), add Jing Mi (Semen Oryzae Sativae), add small amount Zhi Mu, take much Wu Wei Zi, Xing Ren, Pi Ye; this must be examined as latent heat in Upper Jiao between Heart/Lung. Cold/Heat cough: due to clothing changes, contracting both cold/heat, coughs upon sudden cold, sudden heat, drinking hot, drinking cold; use Jin Fei Cao San, Xiao Feng San one dose each mixed/decocted, or Ying Meng Ren Shen San, or Kuan Dong Hua San replacing Ma Huang with Bo He, or Er Mu San, still swallowing Chen Sha Hua Tan Wan, Ba Feng Dan. Seven emotions/diet cough: all injure Zang-Fu Zheng Qi, causing pathogenic rebellion, forming phlegm/saliva, Lung pathways disordered. Prioritize regulating Qi; Si Qi Tang one dose, add Xing Ren, Wu Wei Zi, Sang Bai Pi, Ren Shen, E Jiao (Colla Corii Asini), Mai Men Dong, Pi Ye each 1 qian. Drinking cold/hot wine or cold water injuring Lung causing cough, vulgarly called Cou Fei; use Zi Wan Yin (Aster Drink). Cough vomiting phlegm with food: due to dietary irregularity injuring Liver Qi non-flow, Lung has guest pathogen; Liver is turbid pathway, Lung is clear pathway, clear/turbid interfere; use Er Chen Tang plus Mu Xiang (Radix Aucklandoniae), Xing Ren, Xi Xin, Zhi Ke (Pericarpium Citri Reticulatae) half qian each. Food accumulation phlegm-cough fever: Er Chen Tang plus Gua Lou (Fructus Trichosanthis), Lai Fu Zi (Semen Raphani), Shan Zha (Fructus Crataegi), Zhi Shi (Fructus Aurantii Immaturus), Qu (Medicated Leaven). *Ji Yao* says: Phlegm with ability to eat, Da Cheng Qi Tang slightly purge. Phlegm inability to eat, Nong Po Tang main treatment. Cough losing voice: Run Fei San or Qing Yin Wan. Dai Yun says: Heat cough losing voice/throat pain, taking many cold agents, voice further不出来; use Sheng Jiang Zhi (Ginger Juice) to mix Xiao Feng San, take little by little, or just Ginger Juice alone, especially suitable for post cold/heat cough voice loss. Cough losing voice is not only in heat cough; examine syndrome and medicate, assist with Gan Lan Wan lozenges, still decoct single Pi Ye strongly to dissipate heat. Hoarseness: Cold wrapping Heat; use Xi Xin, Ban Xia, Sheng Jiang acrid to disperse. Also phlegm-heat congesting Lung; "Gold empty then rings", must clear Lung of pathogenic stagnation, use Qing Yan Ning Sou Tang. Consumptive cough: some from chronic cough becoming consumptive, some from consumptive disease causing cough; syndrome alternating chills/fever, or only fever no chills, throat dry/painful, extreme spiritual fatigue, phlegm thick/thin, sometimes blood, extremely foul odor, voice不出来; use Yi Yi Ren 5 qian, Sang Bai Pi, Mai Men Dong each 3 qian, Bai Shi Ying (Quartz) 2 qian, Ren Shen, Wu Wei Zi, Kuan Dong Hua (Flos Farfarae), Zi Wan (Radix Asteris), Xing Ren, Bei Mu, E Jiao, Bai He (Bulbus Lilii), Jie Geng, Qin Jiao (Radix Gentianae Macrophyllae), Pi Ye each 1 qian, decoct with Jiang, Zao, Jing Mi, remove dregs, tune Zhong Ru Fen (Margarita). Also suitable Ge Jie San, or Bao He Tang, Zhi Mu Fu Ling Tang, Zi Wan San, Ning Sou Tang. Year after year, chronic cough unceasing, drugs ineffective, no other syndromes, different from consumptive cough. Dai uses San Ao Tang, Qing Jin Wan. I think inappropriate, only suitable to protect Lung, single Bu Bu Gao (Stemona Paste) is sufficient. *Yan Yi* says: Woman with Lung heat chronic cough, body like roasting, emaciated, about to become Lung consumptive. Use Pi Ye, Mu Tong (Caulis Akebiae), Kuan Dong Hua, Zi Wan, Xing Ren, Sang Bai Pi equal parts, Da Huang (Radix et Rhizoma Rhei) halved, process normally, powder together, honey pills like cherry size. After meals, before sleep, lozenge one pill, healed before finishing dose. With wind-cold, use fumigation method. With heat, use Zhi Ke Tang. With excess accumulation, use Kuan Qi Wan, Li Ge Wan, Ma Dou Ling Wan. Spleen/Stomach normal, diet unaffected; Jia Wei Ren Shen Qing Fei Tang, Shen Su Tang. *Su Wen* says: Cough with vexation is Kidney Qi rebellion; Ba Wei Wan, An Shen Wan main treatment. Sudden cough, various drugs ineffective, or taught to take Sheng Liao Lu Rong Wan, Da Tu Si Zi Wan to heal. Has root and branch, do not doubt sudden tonification is wrong because of sudden cough; easy healing is due to early detection. Epidemic cough: fever/aversion to cold, headache/nasal congestion, rapid breathing, like cold/heat injury, continuous cough. Onset lying down 1-2 days then light, vulgarly called Toad Plague; use Shen Su Yin plus Xi Xin half qian. Jie Gu says: Cough without phlegm, use acrid-sweet to moisten Lung; Honey-fried Ginger Tea, Honey-fried Tangerine Peel Tea, Roasted Ginger, Walnut, all treat cough without phlegm. *Ben Shi Fang* Lung-tonifying method: Sheng Di Huang (Radix Rehmanniae Preparata) 2 jin, washed clean, Xing Ren 2 liang, Sheng Jiang, Mi (Honey) each 4 liang, pound to paste, enter earthen pot, steam over rice 5-7 times, every fifth watch scoop 3 spoons swallow. *Jin Gui* formula: Cough with rebellious Qi, frog sounds in throat, She Gan Ma Huang Tang (Belamcanda and Ephedra Decoction) main treatment. Cough with throat sounds, single Bai Qian (Radix Cynanchi Stauntonii) is excellent. *Qian Jin* has Bai Qian Tang. Man over 50, Cold Damage cough, throat sound like owl, give Du Shen Tang (Single Ginseng Decoction) one dose, owl sound slows, after 2-3 doses cough gradually recedes, total 2-3 jin taken, disease fully healed. Dan Xi says: First half day cough mostly, belongs to Stomach Fire. Afternoon cough mostly, belongs to Yin Deficiency. Dusk cough mostly, Fire Qi floats in Lung, do not use cold drugs, should astringe/descend. One cough immediately produces phlegm, Spleen dampness excess and phlegm slippery. Continuous cough ten-plus times unable to produce phlegm, Lung dryness excess and phlegm astringent. Slippery ones use Nan Xing (Rhizoma Arisaematis Cum Bile), Ban Xia, Zao Jiao Hui (Ash of Gleditsia Sinensis) to dry Spleen, avoid Qi-regulating agents. Astringent ones use Zhi Ke, Zi Su, Xing Ren to benefit Lung, avoid drying Lung agents. Fat form, maybe sweat, or slow pulse, heavy body sleepy person coughing, Spleen dampness excess. Use Bai Zhu, Cang Zhu (Rhizoma Atractylodis), Fu Ling to dry. Thin form, or summer no sweat, or choppy pulse person coughing, Lung dryness excess. Use Xing Ren, Gua Lou to moisten. Any cough with red face, chest/abdomen/flanks usually hot, only feet suddenly cool, large pulse, Heat Phlegm in chest/diaphragm. Use Xiao Xian Xiong Tang (Minor Chest-Harmonizing Decoction), Meng Shi Wan (Calamine Pill) to clear diaphragm/descend phlegm. Severe unceasing, induce vomit/purge phlegm-heat. Pale face sad sneezing, or flank urgent distending pain, or deep/string-taut/thin/slow pulse coughing, Cold Fluid in chest/abdomen. Use acrid-sweet-hot to remove, Ban Xia Wen Fei Tang (Pinellia Warming Lung Decoction). Dan Xi treats alcohol-injured Lung phlegm-cough, with Zhu Li (Bamboo Sap) decocted with Jiu Zhi (Juice of Allium Tuberosum), swallow Gua Lou, Xing Ren, Qing Dai (Indigo Naturalis), Huang Lian Wan. Note this might be too cold, closing heat, not舒展, better first disperse acridly, then astringe sourly, severe cases vomit. Later use Wu Ling Gan Lu (Five-Ling Sweet Dew), dampness-vanquishing phlegm-resolving agents. Vinegar grabbing throat, cough unceasing; use Gan Cao (Radix Glycyrrhizae) 2 liang, remove red skin, cut 2 cun segments, split midline, soak in 5 Pig Gallbladders for 3 days, take out roast dry on fire to fine powder, refined honey pills. Take 40 pills each time, swallow with tea liquid, before bed. Salt injury, asthma-cough unceasing; use White Flour 2 qian, Sugar 2 qian, mix well, shape into cakes with sugar cake ash juice, fry in stove until cooked, remove, add Qing Fen (Calomel) 4 qian, stir-fry slightly cooked, cut cake into four pieces, sprinkle Qing Fen inside, let patient eat completely, spit out disease root then healed. Lung cough appearance: cough with panting sound, severe spitting blood; Ma Huang Tang. Heart cough appearance: cough then Heart pain, throat feeling stuck like obstruction, severe throat swelling/obstruction; Jie Geng Tang. Liver cough appearance: cough then bilateral hypochondriac pain, severe cannot turn, turning then hypochondriac fullness; Xiao Chai Hu Tang. (Zhong Jing says: Cough pulling flank pain is Suspended Fluid, use Shi Zao Tang. Dan Xi says: Cough pulling flank pain, soothe Liver Qi, use Qing Pi (Exocarpium Citri Reticulatae), Zhi Ke, Xiang Fu Zi (Rhizoma Cyperi), excess Bai Jie Zi (Semen Sinapis).) Spleen cough appearance: cough then right hypochondriac pain, dull pain radiating to shoulder/back, severe cannot move, moving then cough worsens; Sheng Ma Tang. Kidney cough appearance: cough then waist/back drawing pain, severe coughing saliva; Ma Huang Fu Zi Xi Xin Tang. Chronic cough of Five Zang transfers to Six Fu organs. Spleen cough unceasing, Stomach receives it; Stomach cough appearance: cough then vomiting, severe vomiting then roundworms come out; Wu Mei Wan. Liver cough unceasing, Gallbladder receives it; Gallbladder cough appearance: cough/vomiting bile; Huang Qin Jia Ban Xia Sheng Jiang Tang (Scutellaria Plus Pinellia and Ginger Decoction). Lung cough unceasing, Large Intestine receives it; Large Intestine cough appearance: cough then fecal incontinence; Chi Shi Zhi Yu Liang Tang (Red Stone and Hematite Decoction), Tao Hua Tang. Unceasing use Zhu Ling Fen Shui San. Heart cough unceasing, Small Intestine receives it; Small Intestine cough appearance: cough then passing gas, gas passes with cough; Shao Yao Gan Cao Tang (Peony and Licorice Decoction). Kidney cough unceasing, Bladder receives it; Bladder cough appearance: cough then urinary incontinence; Fu Ling Gan Cao Tang. Chronic cough unceasing, San Jiao receives it; San Jiao cough appearance: cough then abdominal fullness unwilling to eat/drink; these all gather in Stomach, concern Lung, causing much snot/saliva, facial edema, rebellious Qi; Qian Shi Yi Gong San.
[Fei Wei] Zhong Jing says: Heat in Upper Jiao, due to cough becomes Fei Wei (Lung Flaccidity). How does Fei Wei disease arise? Teacher says: Or from sweating, or from vomiting, or from Xiao Ke (Wasting-Thirst) frequent urination, or from difficult stool, again purged by strong laxatives, heavy loss of fluids thus arising. Fei Wei, coughing/spitting saliva unceasing, throat dry/thirsty; Sheng Jiang Gan Cao Tang (Ginger and Licorice Decoction) main treatment. Sheng Jiang 5 liang, Ren Shen 2 liang, Gan Cao 4 liang, Da Zao 15 pieces, water 7 sheng, boil to 3 sheng, divide warm 3 doses. Zhi Gan Cao Tang (Honey-Fried Licorice Decoction) treats Fei Wei with much saliva/phlegm, warm liquid sensation in heart. Use Gan Cao alone, water 3 sheng, boil to half sheng, divide warm 3 doses. Gui Zhi Qu Shao Yao Jia Zao Jia Tang (Cinnamon Twig Decoction Removing Peony Adding Soapberry Pod) treats Fei Wei spitting saliva. Gui Zhi, Sheng Jiang each 3 liang, Gan Cao 1 liang, Da Zao 10 pieces, Zao Jia 10 pieces, remove skin/strings, roast charred, water 7 sheng, simmer boil to 3 sheng, divide warm 3 doses. Fei Wei spitting saliva without cough, person not thirsty, must have urinary incontinence, frequent urination. Why? Upper deficiency cannot control lower. This is Cold in Lung, must have dizziness, much saliva/phlegm; Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction) to warm. Gan Cao roasted 4 liang, Gan Jiang roasted 2 liang, water 3 sheng, boil to 1.5 sheng, divide warm 2 doses. If taking decoction causes thirst, belongs to Xiao Ke. Fei Wei, coughing/spitting throat dry, desiring water heals itself. Self-opening mouth is shortness of breath. Cough with own saliva in mouth, tongue coating slippery, this is floating cold, not Fei Wei. Fei Wei, maybe cough foam, maybe cough blood; now compiling cough foam here, cough blood enters Blood Syndrome section.
[Fei Zhang] Zhong Jing says: Cough with rebellious Qi, this is Fei Zhang (Lung Distension), pulse floating/large, Yue Bi Jia Ban Xia Tang (Yuebi Plus Pinellia Decoction) main treatment. Also says: Fei Zhang, cough/rebellious Qi, restlessness/panting, floating pulse, water under Heart, Xiao Qing Long Tang Jia Shi Gao (Minor Blue Dragon Plus Gypsum Decoction) main treatment. Dan Xi treats mainly astringing, use He Zi (Fructus Chebulae) as main, assist with Hai Shi (Lithostes), Xiang Fu (soaked in child's urine 3 days), Gua Lou Ren (Semen Trichosanthis), Qing Dai, Ban Xia Qu, Xing Ren, Jiang Zhi, Mi mixed to lozenge. Fei Zhang with cough, left or right, unable to sleep, this phlegm clashing with blood stasis obstructing Qi causing disease; nourish Blood to move Qi, descend Fire soothe Liver to clear Phlegm; Si Wu Tang (Four Substances Decoction) plus Tao Ren (Semen Persicae), He Zi, Qing Pi, Zhu Li (Bamboo Sap), Jiu Zhi (Juice of Allium Tuberosum) etc. Obstructed unable to sleep, difficult to treat.
[Diagnosis] Floating is Wind. Tight is Cold. Rapid is Heat. Fine is Damp. Floating-Tight is Deficient Cold. Deep-Rapid is Excess Heat. String-Taut-Choppy is Little Blood. Surging-Slippery is Much Phlegm. Choppy is Sexual Fatigue. Right Guan soft injures Spleen. Left Guan string-taut-short injures Liver. Floating-short injures Lung. Pulse emerging from Yu Ji point is Rebellious Qi Panting. String-taut is Fluid, cough floating, resolves in 40 days. Cough with dizziness, excess vomit to heal. Cough with deficient pulse, must suffer vertigo. Deep pulse cannot sweat. Spleen pulse faint is cough. Lung pulse faint-urgent is cough/spitting blood. Floating-straight-soft is easy to treat. Panting/rebellious Qi, rapid pulse with heat, unable to lie down, difficult to treat. Upper Qi panting, facial edema, shoulder lifting, floating-large pulse death. Chronic cough weak pulse treatable, excess-large-rapid pulse death. Upper Qi panting low/high, slippery pulse hands/feet warm live, choppy pulse limbs cold die. Cough wasting form, body fever small pulse, firm-urgent-fast, is adverse, not exceeding 15 days death. Cough emaciation, pulse form firm-large death. Cough pulse deep-tight death, floating-straight live, floating-soft live, small-deep-hidden death. Cough vomiting, abdominal fullness diarrhea, string-tight-desperate death.