虚寒嗽者，其寒不从外入，乃上中二焦阳气不足而寒动于中也。或初虽起于火热，因过
服寒
凉消克，以致脾士受伤而肺益失养，脉微气少，饮食不入者，急宜温养脾肺为主也。
加味理中汤
人参 白术 干姜（生） 甘草（炙） 橘红 茯苓 半夏 细辛 五味（等分）
上 咀，每服三钱，姜枣煎，食前服。戴元礼云∶饮水一二口而暂止者，热嗽也。呷热
汤而
得停者，寒嗽也。治热嗽以小柴胡加五味，冷嗽以理中汤加五味，皆已试之验。《直指方》
理中丸加阿胶、五味。
《济生》紫菀汤 治肺虚实嗽喘急，无热症者。
紫菀茸（洗） 干姜（炮） 黄 人参 五味子 钟乳石 杏仁（面炒，去皮尖） 甘草（
炙，各五钱）
上 咀，每服四钱，水一盏，姜五片，枣一枚，煎服。
肾虚气逆者，肾之脉从肾上贯肝膈，入肺中，循喉咙。肾中阴火上炎入肺则咳。肾中阴
水随
经入肺亦咳。《内经》云∶咳嗽烦冤者，是肾气之逆也。又少阴所谓咳呕上气喘者，阴气在
下，阳气在上，诸阳气浮，无所根据从，故咳呕上气喘也。水则《济生》肾气补而逐之，火则
六味、都气之属引而下之。又有一种少阴肾症，水饮与里寒，合而作嗽，腹痛下利者，宜真
武汤加减治之。
真武汤
白茯苓 白术 白芍（各一两） 熟附子（半两）
上锉散，每二钱半，加生干姜、细辛、五味子各半钱，姜三片，食前煎服。
虚寒咳嗽，其寒气并非从体外侵入，而是由于上焦和中焦阳气不足，导致寒气在体内产生。有的起初虽然是由火热引起，但因为过度服用寒凉、消导攻伐的药物，致使脾土受损而肺脏更加失去滋养，出现脉象微弱、气短、饮食无法进服的状况，此时应当紧急以温补脾肺为主进行治疗。
加味理中汤：人参、白术、干姜（生用）、甘草（炙用）、橘红、茯苓、半夏、细辛、五味子（以上各等分）。
将药材切碎，每次服用三钱，加入生姜、大枣煎煮，饭前服用。戴元礼说：喝一两口水后暂时停止咳嗽的，是热咳；喝热汤后得以缓解的，是寒咳。治疗热咳用小柴胡汤加五味子，治疗冷咳用理中汤加五味子，都是已经验证有效的方子。《直指方》中的理中丸加上阿胶、五味子。
《济生方》紫菀汤：治疗肺脏虚实夹杂引起的咳嗽气喘急促，且没有热症的患者。
紫菀茸（洗净）、干姜（炮制）、黄芪、人参、五味子、钟乳石、杏仁（面粉炒，去皮尖）、甘草（炙用，各五钱）。
将药材切碎，每次服用四钱，用水一盏，生姜五片，大枣一枚，煎煮后服用。
肾虚导致气机上逆的情况，肾的经脉从肾脏向上穿过肝脏和膈肌，进入肺中，沿着喉咙走行。肾中的阴火上炎进入肺脏就会引起咳嗽。肾中的阴水顺着经脉进入肺脏也会引起咳嗽。《内经》说：咳嗽烦闷不安的，这是肾气上逆所致。另外少阴经所说的咳嗽、呕吐、上气喘急，是因为阴气在下，阳气在上，各种阳气浮越，没有依托和归依，所以出现咳嗽、呕吐、上气喘急的症状。对于水饮证，用《济生方》的肾气丸进行补益并逐水；对于火证，用六味地黄丸、都气丸之类引导火势下行。还有一种少阴肾症，是水饮与里寒结合导致咳嗽，伴有腹痛、下利的情况，适宜用真武汤加减来治疗。
真武汤：白茯苓、白术、白芍（各一两）、熟附子（半两）。
将药材锉成散剂，每次服用二钱半，加入生干姜、细辛、五味子各半钱，生姜三片，饭前煎煮服用。
Deficiency-cold cough arises not from external invasion of cold, but from insufficient Yang Qi in the Upper and Middle Jiao (Upper and Middle Burners), causing cold to stir within. In some cases, although it initially stems from heat/fire, excessive use of cold-cooling and purgative/digestive drugs damages the Spleen Earth, thereby depriving the Lung of nourishment further. When presenting with a faint pulse, shortness of breath, and inability to take food, urgent treatment should focus on warming and nourishing the Spleen and Lung.
Jiawei Lizhong Tang (Modified Regulate the Middle Decoction): Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Ganjiang (Zingiberis Rhizoma, raw), Gancao (Licorice Radix et Rhizoma, honey-fried), Juhong (Citri Reticulatae Pericarpium Rubrum), Fuling (Poria), Banxia (Pinelliae Rhizoma), Xixin (Asari Radix et Rhizoma), Wuwei Zi (Schisandrae Chinensis Fructus) (all in equal parts).
Crush the herbs. Take 3 qian per dose, decoct with fresh ginger and jujube, and administer before meals. Dai Yuanli stated: "Drinking one or two mouthfuls of water and having the cough temporarily cease indicates heat cough." Conversely, finding relief by sipping hot soup indicates cold cough. For treating heat cough, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Wuwei Zi is used; for cold cough, Lizhong Tang (Regulate the Middle Decoction) added with Wuwei Zi is used; both are proven effective. The Lizhong Wan (Regulate the Middle Pill) from *Zhizhi Fang* adds Ejiao (Donkey-hide Gelatin) and Wuwei Zi.
Ziwan Tang (Asterniae Decoction) from *Jisheng Fang*: Treats deficiency-excess cough and wheezing with urgency due to Lung deficiency/excess, where no heat symptoms are present.
Ziwan Rong (Asterniae Flos, washed), Ganjiang (Zingiberis Rhizoma, processed), Huangqi (Astragali Membranacei Radix), Renshen (Ginseng Radix et Rhizoma), Wuweizi (Schisandrae Chinensis Fructus), Zhonglushi (Gypsum Fibrosum), Xingren (Prunus Armeniacae Semen, stir-fried with flour, skin and tips removed), Gancao (Licorice Radix et Rhizoma, honey-fried) (each 5 qian).
Crush the herbs. Take 4 qian per dose, decoct with one sheng of water, five slices of fresh ginger, and one jujube, then administer.
When Kidney deficiency leads to rebellious Qi ascent, the Kidney meridian ascends from the Kidney, pierces the Liver and diaphragm, enters the Lung, and follows the throat. If Yin Fire from the Kidney flares upward into the Lung, it causes cough. If Yin Water from the Kidney follows the meridian into the Lung, it also causes cough. *Neijing* states: "Cough accompanied by vexation and distress is due to the rebellion of Kidney Qi." Furthermore, regarding Shaoyin (Lesser Yin), the text mentions cough, vomiting, and upper body wheezing/asthma; this occurs because Yin Qi is below and Yang Qi is above, causing all Yang Qi to float without foundation or direction, thus resulting in cough, vomiting, and upper body wheezing/asthma. For water retention, Shengji Shenqi Wan (Kidney Qi Supplementing Pill from *Jisheng Fang*) is used to tonify and expel water; for fire patterns, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) and Duqi Wan (Duqi Pill) are used to guide the fire downward. There is another type of Shaoyin Kidney pattern where water-fluid retention combines with interior cold to cause cough, accompanied by abdominal pain and diarrhea; Zhenwu Tang (True Warrior Decoction) modified is suitable for treatment.
Zhenwu Tang (True Warrior Decoction): Bai Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Baishao (Paeoniae Radix Alba) (each 1 liang), Shu Fuzi (Aconiti Lateralis Radix Praeparata) (0.5 liang).
Cut into pieces to make a powder. Take 2.5 qian per dose, add Sheng Ganjiang (Raw Dried Ginger), Xixin (Asari Radix et Rhizoma), and Wuweizi (Schisandrae Chinensis Fructus) each 0.5 qian, and three slices of fresh ginger. Decoct and administer before meals.