冷嗽者，身受寒气，口饮寒浆得之。盖肺主气，外合皮毛，而其经内循胃口，故外内得
寒，
皆能伤之。经云∶形寒饮冷，外内合邪，因而客之，则为肺咳是也。其症呼吸不利，呕吐冷
沫，胸中急痛，恶寒声嘶，得温则减，得寒益甚。
仲景小青龙汤 散外寒，蠲内饮。
麻黄 芍药 干姜 炙甘草 细辛 桂枝（各三两） 五味子 半夏（各升半）
上八味，以水一斗先煮麻黄减二升，去上沫，内诸药，煮取三升，去滓，温服一升。
此散寒蠲饮之神剂。东垣云∶肺寒气逆，则宜五味子同干姜治之。有痰者以半夏为佐。
按∶
《金匮》浓朴麻黄汤，加浓朴、石膏、杏仁、小麦，减桂枝、芍药。《圣济》干姜汤，加紫
菀、杏仁、减芍药、细辛、半夏。《外台》羊肺汤
，加款冬、紫菀、白前，食茱萸，减麻黄、芍药、半夏。《易简》杏仁汤，加人参、茯苓、
杏仁，去麻黄。其干姜、五味、甘草则四方如一辙也。盖本一青龙而各有裁制耳。
加减麻黄汤
麻黄（去节，一两） 桂枝 炙甘草（各半两） 陈皮 半夏（各七钱） 杏仁（五十个，去
皮尖，微妙另研）
上细锉，每三钱，紫苏七叶，生姜四片，煎服。
三拗汤
麻黄 杏仁 甘草（炙，各等分）
上 咀，每服三钱，生姜三片，煎服微汗愈。深师有细辛。《外台》加桂枝，名小投杯
汤。《和剂》加苏子、茯苓、桑皮，名华盖散。
《圣济》饴糖煎
饴糖 干姜（炒，一两半） 豉（炒，二两） 杏仁（五十个，去皮尖）
上分二剂，煎去滓，入饴糖，干姜末服。
按∶咳嗽经年不愈，余无他症，服药无效者，得三拗汤恒愈。多用清凉，屡发屡甚，别
无热
症者，得饴糖煎遂瘥。不可不知也。《局方》于麻黄、杏仁、甘草中，加阿胶、贝母、桑叶
、知母、款冬、半夏，盖杂清润于辛温之内，凡阴虚邪伏者，服之最宜，名款冬花散。
冷嗽，是由于身体感受寒气，又饮用寒凉浆液所致。肺主司气机，外合皮毛，其经脉向内循行经过胃脘部，因此外界寒邪和内伤冷饮，都能损伤肺脏。《内经》说：“形体受寒、饮食生冷，内外之邪相合，客居于体内，就会形成肺咳。”其症状表现为呼吸不畅，呕吐清冷泡沫，胸中拘急疼痛，怕冷且声音嘶哑，遇温暖则症状减轻，遇寒冷则病情加重。
张仲景的小青龙汤能发散外寒，蠲除内饮。
麻黄、芍药、干姜、炙甘草、细辛、桂枝（各三两），五味子、半夏（各半升）。
以上八味药，用水一斗，先煮麻黄，减少二升水量，撇去浮沫，加入其余药物，煎煮至三升，滤去药渣，温服一升。
这是散寒蠲饮的神妙方剂。李东垣说：肺气寒而上逆，适宜用五味子配合干姜治疗。有痰者以半夏为佐使。
按语：
《金匮要略》中的浓朴麻黄汤，是在小青龙汤基础上加浓朴、石膏、杏仁、小麦，减去桂枝、芍药。《圣济总录》中的干姜汤，加紫菀、杏仁，减去芍药、细辛、半夏。《外台秘要》中的羊肺汤，加款冬花、紫菀、白前、食茱萸，减去麻黄、芍药、半夏。《易简方》中的杏仁汤，加人参、茯苓、杏仁，去掉麻黄。其中干姜、五味子、甘草这三味药在四方中是一致的。大概都是基于小青龙汤而各有裁减变化罢了。
加减麻黄汤
麻黄（去节，一两）、桂枝、炙甘草（各半两）、陈皮、半夏（各七钱）、杏仁（五十个，去皮尖，微炒后另研）。
以上药材切碎，每次取三钱，加紫苏叶七片、生姜四片，煎服。
三拗汤
麻黄、杏仁、甘草（炙，各等分）。
以上药材捣碎，每次服三钱，加生姜三片，煎服，微微出汗即愈。深师方中有细辛。《外台秘要》加桂枝，名为小投杯汤。《太平惠民和剂局方》加苏子、茯苓、桑白皮，名为华盖散。
《圣济总录》饴糖煎
饴糖、干姜（炒，一两半）、豆豉（炒，二两）、杏仁（五十个，去皮尖）。
以上分为两剂，煎煮去渣，加入饴糖，再调入干姜末服用。
按语：咳嗽经年不愈，没有其他症状，服药无效者，服用三拗汤通常能治愈。若多用清凉药物，导致病情反复且加重，并无热症者，服用饴糖煎随即痊愈。这一点不可不知。《太平惠民和剂局方》在麻黄、杏仁、甘草中加入阿胶、贝母、桑叶、知母、款冬花、半夏，这是在辛温药中杂入清润之品，凡是阴虚邪伏者，服用最为适宜，名为款冬花散。
Cold cough (Leng Sou) arises from the body contracting external cold pathogens and consuming cold fluids. The Lung governs Qi, is externally connected to the skin and hair, and its meridian internally circulates through the stomach region; therefore, both external cold and internal consumption of cold drinks can injure the Lung. The Classics state: "When the form is chilled and food/drink is cold, external and internal evils combine, lodging within, resulting in Lung cough." Its symptoms include difficulty in breathing, vomiting of cold froth, urgency and pain in the chest, aversion to cold, hoarseness, relief with warmth, and aggravation with cold.
Zhang Zhongjing's Xiao Qing Long Tang (Minor Blue Dragon Decoction) disperses external cold and eliminates internal fluid retention.
Ephedrae Herba (Mahuang), Paeoniae Radix Alba (Shaoyao), Zingiberis Rhizoma Recens (Ganjiang), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao), Asari Radix (Xixin), Cinnamomi Ramulus (Guizhi) (each 3 liang); Schisandrae Fructus (Wuweizi), Pinelliae Tuber (Banxia) (each 0.5 sheng).
Take these eight herbs, add one dou of water, first boil Ephedrae Herba until reduced by two sheng, skim off the foam on top, then add the remaining herbs. Boil until three sheng remain, strain, and take one sheng warm.
This is a miraculous formula for dispersing cold and eliminating fluid retention. Li Dongyuan stated: For Lung cold with rebellious Qi, it is appropriate to treat with Schisandrae Fructus combined with Zingiberis Rhizoma Recens. If there is phlegm, use Pinelliae Tuber as an assistant herb.
Note:
Nongpu Mahuang Tang in *Jin Gui Yao Lue* adds Magnoliae Officinalis Cortex (Nongpu), Gypsum Fibrosum (Shigao), Armeniacae Semen Amarum (Xingren), and Triticum Aestivum (Xiaomai) to Xiao Qing Long Tang, while removing Cinnamomi Ramulus and Paeoniae Radix Alba. Ganjiang Tang in *Sheng Ji Zong Lu* adds Asteris Radix (Ziwan) and Armeniacae Semen Amarum, while removing Paeoniae Radix Alba, Asari Radix, and Pinelliae Tuber. Yangfei Tang in *Waitai Mi Yao* adds Dendrobii Flos (Kuandonghua), Asteris Radix, Cynanchi Atrati Radix (Baiqian), and Corni Fructus (Shizhuyu), while removing Ephedrae Herba, Paeoniae Radix Alba, and Pinelliae Tuber. Xingren Tang in *Yijian Fang* adds Ginseng Radix (Renshen), Poria (Fuling), and Armeniacae Semen Amarum, while removing Ephedrae Herba. The combination of Zingiberis Rhizoma Recens, Schisandrae Fructus, and Glycyrrhizae Radix et Rhizoma Preparata remains consistent across all four formulas. Essentially, they are all variations derived from Xiao Qing Long Tang with specific modifications.
Jiajian Mahuang Tang (Modified Ephedra Decoction)
Ephedrae Herba (devoid of joints, 1 liang), Cinnamomi Ramulus, Glycyrrhizae Radix et Rhizoma Preparata (each 0.5 liang), Tangerine Peel (Chenpi), Pinelliae Tuber (each 7 qian), Armeniacae Semen Amarum (50 seeds, devoid of skin and tips, slightly fried and separately ground).
Finely chop the herbs. For each dose of 3 qian, decoct with 7 leaves of Perilla Folium (Zisu) and 4 slices of Zingiberis Rhizoma Recens (Shengjiang).
San'ao Tang (Three Unyielding Decoction)
Ephedrae Herba, Armeniacae Semen Amarum, Glycyrrhizae Radix et Rhizoma Preparata (equal parts).
Crush the herbs. Take 3 qian per dose, decoct with 3 slices of Zingiberis Rhizoma Recens. Cure is achieved when slight sweating occurs. Shen Shi Fang includes Asari Radix. *Waitai Mi Yao* adds Cinnamomi Ramulus, naming it Xiaotoubei Tang. *Tai Ping Hui Min He Ji Ju Fang* adds Perillae Fructus (Suzi), Poria, and Morus Alba Cortex (Sangpiao), naming it Huagai San.
Yitang Jian (Maltose Decoction) from *Sheng Ji Zong Lu*
Maltose (Yitang), Zingiberis Rhizoma (stir-fried, 1.5 liang), Sojae Semen Preparatum (Chao Chi, stir-fried soybeans, 2 liang), Armeniacae Semen Amarum (50 seeds, devoid of skin and tips).
Divide into two doses. Decoct, strain, add Maltose, and administer with powdered Zingiberis Rhizoma.
Note: For chronic cough persisting for years without other symptoms and unresponsive to medication, San'ao Tang often brings a cure. If frequent use of cooling/clearing herbs leads to recurrence and worsening without heat signs, Yitang Jian will resolve it. This must be known. In *Ju Fang*, Euphorbiae Humifusae Herba (Ejiao), Fritillariae Bulbus (Beimu), Mori Folium (Sangye), Anemarrhenae Rhizoma (Zhimu), Dendrobii Flos, and Pinelliae Tuber are added to Ephedrae Herba, Armeniacae Semen Amarum, and Glycyrrhizae Radix et Rhizoma Preparata. This mixes clearing and moistening herbs with acrid-warm ones. It is most suitable for patients with Yin deficiency and latent pathogens, and is named Kuandonghua San.