咳嗽初起多是阳邪之感咳嗽日久多是阴气之虚然亦不可拘于此论也有初起而即是阴虚者
有日
久而仍是阳虚者又不可不辨也何以见初起之即犯阴经也如日间不嗽而夜间嗽者或朝咳之轻而
夜咳之重者虽有风邪袭之终是阴虚使然开手即宜用补阴之味而佐之散风之品则邪易去而正气
不耗也何以见日久之犹是阳经也如嗽必抬肩咳必声振吐痰而结成黄块塞鼻而长流清涎或昼重
而夜反安然或坐躁而卧转宁贴此阳气之未虚而邪气凭之而不散也必须仍用祛风荡痰之品而少
兼之滋阴之味则邪自散而阴气不伤也吾今留二方一治阴经之咳嗽一治阳经之咳嗽阴经方名护
阴止嗽丹此方有调济之宜看甚平常而奏功实神也阳经方名散邪止嗽丹此方虽是散邪而仍然补
阴而不补阳者何故盖阳既旺而邪自难去补益其阴则阳气自平阳平而邪亦难留矣倘不知阴阳之
异即一味偏补之则阴不能生而阳不能化不特咳嗽难愈而且变症百端矣可不慎哉
护阴止嗽丹
麦冬(五钱) 紫菀(五钱) 百部(五钱) 天门冬(三钱) 熟地(五钱) 桔梗(二钱) 甘草(一
钱) 白芥子(二钱) 玄参(三钱) 沙参(五钱) 陈皮(五分) 款冬花(五分)水煎服
散邪止嗽丹
柴胡(一钱) 白芍(五钱) 黄芩(一钱) 石膏(一钱) 桔梗(一钱) 甘草(一钱) 生地(五钱)
麦冬(二钱) 茯苓(三钱) 半夏(一钱) 陈皮(五分)水煎服
咳嗽初起多是由于感受阳邪所致,咳嗽日久则多因阴气虚弱引起。然而也不可拘泥于这一论断,也有初起即为阴虚的,有日久仍属阳虚的,这些情况又不可不加以辨别。
如何判断初起即侵犯阴经呢?例如白天不咳嗽而夜间咳嗽,或者早晨咳嗽轻而晚上咳嗽重,虽然看似有风邪侵袭,但终究是阴虚所致。治疗时一开始就应当使用补阴的药物,并辅以疏散风邪的药物,这样邪气容易去除而正气不会耗损。
如何判断日久仍属于阳经病变呢?例如咳嗽时必须抬肩,咳声震动身体,吐出的痰凝结成黄色块状,鼻塞且长期流出清稀涎液,或者白天症状重而夜晚反而安宁,坐立烦躁而躺卧却转安适。这是阳气尚未虚弱,但邪气依附其中而不散。治疗必须仍然使用祛风涤痰的药物,并少量兼用滋阴的药物,这样邪气自然消散而阴气不受损伤。
我现在留下两个方子:一个治疗阴经咳嗽,一个治疗阳经咳嗽。阴经方名为“护阴止嗽丹”,此方看起来平常,实则具有调节平衡之妙,疗效神奇。阳经方名为“散邪止嗽丹”,此方虽是发散邪气,但仍然补阴而不补阳,这是什么缘故呢?因为阳气既已旺盛,邪气自然难以去除;补益其阴分,则阳气自能平复;阳气平和,邪气也难以留存。倘若不知阴阳的差异,一味偏于补阳,则阴不能生发而阳不能化生,不仅咳嗽难以痊愈,而且会变化出各种病症,这能不谨慎吗?
护阴止嗽丹
麦冬(五钱) 紫菀(五钱) 百部(五钱) 天门冬(三钱) 熟地黄(五钱) 桔梗(二钱) 甘草(一钱) 白芥子(二钱) 玄参(三钱) 沙参(五钱) 陈皮(五分) 款冬花(五分),水煎服。
散邪止嗽丹
柴胡(一钱) 白芍(五钱) 黄芩(一钱) 石膏(一钱) 桔梗(一钱) 甘草(一钱) 生地黄(五钱) 麦冬(二钱) 茯苓(三钱) 半夏(一钱) 陈皮(五分),水煎服。
Cough at the initial stage is mostly caused by the invasion of Yang pathogens (Yang pathogenic factors), while chronic cough is often due to deficiency of Yin Qi (Vital energy associated with cooling, moistening, and calming functions). However, one must not rigidly adhere to this theory. There are cases where Yin deficiency exists from the onset, and others where Yang deficiency persists despite the duration; these situations require careful differentiation.
How can one identify that the initial stage involves the Yin meridians? For instance, if a patient does not cough during the day but coughs at night, or if the cough is mild in the morning but severe at night, although it may appear to be caused by wind pathogens invading the body, it is ultimately due to Yin deficiency. Treatment should begin immediately with herbs that nourish Yin, supplemented by those that disperse wind. This approach facilitates the expulsion of pathogens without depleting the healthy Qi (Vital energy).
How can one determine that a long-standing cough still belongs to the Yang meridians? For example, if coughing requires raising the shoulders, the sound of coughing vibrates the body, sputum is expectorated in yellow clumps, nasal congestion occurs with prolonged flow of clear saliva, symptoms are heavier during the day but peaceful at night, or restlessness occurs when sitting but relief is found when lying down. These indicate that Yang Qi is not yet deficient, but pathogens are attached and lingering. Treatment must still employ methods to dispel wind and resolve phlegm, combined with a small amount of Yin-nourishing agents. In this way, pathogens will naturally dissipate without injuring Yin Qi.
I now present two formulas: one for treating cough related to Yin meridians, and one for cough related to Yang meridians. The formula for Yin meridian cough is named "Huyin Zhisou Dan" (Protect Yin Cough-Stopping Pill). Although this formula appears ordinary, it possesses subtle regulatory properties and yields miraculous results. The formula for Yang meridian cough is named "Sanxie Zhisou Dan" (Dispel Pathogens Cough-Stopping Pill). Although this formula is designed to disperse pathogens, it nourishes Yin rather than tonifying Yang. Why is this? Because when Yang is already excessive, pathogens are difficult to expel; by nourishing Yin, Yang becomes balanced. Once Yang is harmonious, pathogens cannot remain. If one fails to distinguish between Yin and Yang and blindly applies Yang-tonifying methods, Yin cannot generate, and Yang cannot transform. Not only will the cough fail to heal, but various complications may arise. One must be extremely cautious.
Huyin Zhisou Dan (Protect Yin Cough-Stopping Pill)
Ophiopogonis Radix (Ouyangdong, 5 qian) *Note: Text says Maidong* -> Ophiopogonis Radix (Maidong, 5 qian); Asteris Tuber (Ziwan, 5 qian); Stemona Rhizome (Bubai, 5 qian); Asparagi Radix (Tianmendong, 3 qian); Prepared Rehmanniae Radix (Shudi, 5 qian); Platycodonis Radix (Jiegeng, 2 qian); Glycyrrhizae Radix et Rhizoma (Gancao, 1 qian); Sinapis Semen (Baijiezi, 2 qian); Scrophulariae Radix (Xuanshen, 3 qian); Glehniae Radix (Shashen, 5 qian); Citri Reticulatae Pericarpium (Chenpi, 0.5 qian); Farflos Flos (Kuandonghua, 0.5 qian). Decoct in water and take orally.
Sanxie Zhisou Dan (Dispel Pathogens Cough-Stopping Pill)
Bupleuri Radix (Chaihu, 1 qian); Paeoniae Radix Alba (Baishao, 5 qian); Scutellariae Radix (Huangqin, 1 qian); Gypsum Fibrosum (Shigao, 1 qian); Platycodonis Radix (Jiegeng, 1 qian); Glycyrrhizae Radix et Rhizoma (Gancao, 1 qian); Rehmanniae Radix Recens (Shengdi, 5 qian); Ophiopogonis Radix (Maidong, 2 qian); Poria (Fuling, 3 qian); Pinelliae Rhizoma Preparatum (Banxia, 1 qian); Citri Reticulatae Pericarpium (Chenpi, 0.5 qian). Decoct in water and take orally.