咳嗽之原。而但以清肺清痰疏风利气为治。适害己也。外有伤风咳嗽初起。便服清散药。
不能取效者。此
为虚伤风也。最忌寒凉发散。投剂得宜。可以渐愈。又有冬时肾气不足。水不生木。致
肝气内虚。洞涕不收。鼻窍不利。亦为虚伤风。亦忌发散。投剂得宜。至春天和冻解。
洞涕始收。鼻窍始利。咳嗽大略。其义如是。得其意而引伸之。其庶几乎。 又云、咳嗽
俗名曰呛。连嗽不已。谓之顿呛。顿呛者、一气连呛二三十声。少则十数声。呛则头倾
胸曲。甚则手足拘挛。痰从口出。涕泣相随。从膺胸而下。应于少腹。大人患此。如同
哮喘。小儿患此。谓之时行顿呛。不服药至一个月亦愈。所以然者。周身八万四千毛窍。
太阳膀胱之气应之。以合于肺。毛窍之内。即有络脉之血。胞中血海之血应之。以合
于肝。若毛窍受寒。致胞血凝涩。其血不能澹渗于皮毛络脉之间。气不煦而血不濡。则
患顿呛。至一月。则胞中之血一周环复。故一月可愈。若一月不愈。必至两月。不与之
药。亦不丧身。若人过爱其子。频频服药。医者但治其气。不治其血。但理其肺。不理
其肝。顿呛未已。又增他痛。或寒凉过多。而呕吐不食。或攻下过多。而腹满泻泄。或表
散过多。而浮肿喘急。不应死而死者。不可胜计矣。
苓甘五味加姜辛夏杏大黄汤方
茯苓（四两） 甘草（二两） 干姜 细辛（各三两） 五味 半夏 杏仁（各半升） 大黄（三
两）
上八味。以水一斗。煮取三升。去滓。温服一升。日三服。
（水停心下。当知其先后之分。何以为）先渴（水能格火。火独行而上烁喉舌。则为
渴。可于未呕之前。追溯其为水停心下。何以为）后呕。（渴必多饮。饮多上逆则必呕。
可于既渴之后。实指其）为水停心下。此属
饮家。（医者不管其已过之渴。只据其现下之呕而治之。以）小半夏加茯苓汤主之。
此于咳嗽后。忽又言及水饮。以水饮为咳嗽之根。故言之不厌其复也。
小半夏加茯苓汤方（见上）
咳嗽的病因，如果仅仅用清肺、清痰、疏风、利气的方法治疗，反而有害。外感伤风引起的咳嗽在初起阶段，就服用清热发散的药物，不能见效的，这是因为虚证感受风邪。最忌讳使用寒凉发散的药物，只要用药得当，可以逐渐痊愈。又有冬季肾气不足，水不能生木，导致肝气内虚，鼻涕淋漓不止，鼻窍不通畅，这也属于虚证伤风，同样忌讳发散治疗，用药得当，等到春季气温调和、冻土解冻时，鼻涕才会停止，鼻窍才会通畅。咳嗽的大致道理，就是如此，领会其意旨并加以推演，大概就差不多了。
又说：咳嗽俗称为“呛”，连续咳嗽不停，称为“顿呛”。所谓顿呛，是一次吸气后连续呛咳二三十声，少则十几声。呛咳时头部低垂、胸部弯曲，严重时手足拘挛，痰液从口中涌出，鼻涕眼泪随之流出，感觉从胸膺向下延伸，应及少腹。大人患此病，如同哮喘；小儿患此病，称为“时行顿呛”。不服药经过一个月也能自愈。之所以这样，是因为周身八万四千个毛窍，由太阳膀胱经之气所主，与肺相合。毛窍之内，有络脉之血，与胞中血海之血相应，与肝相合。如果毛窍受寒，导致胞中血液凝涩，血液不能渗透于皮毛络脉之间，气不温煦而血不濡润，就会患顿呛。到一个月时，胞中之血完成一个循环，所以一个月可以痊愈。如果一个月不好，必定延续到两个月，即使不给药，也不会丧命。如果人们过分疼爱孩子，频繁服药，医生只治气而不治血，只调理肺而不调理肝，顿呛未愈，又增加其他病痛。或者寒凉药过多，导致呕吐不食；或者攻下药过多，导致腹部胀满泄泻；或者解表发散药过多，导致浮肿喘急。本不该死却死亡的，不可胜数。
苓甘五味加姜辛夏杏大黄汤方
茯苓（四两） 甘草（二两） 干姜 细辛（各三两） 五味子 半夏 杏仁（各半升） 大黄（三两）
以上八味药，用水一斗，煮取三升，去渣，温服一升，每日三次。
（水饮停聚在心下，应当知道其先后顺序的区别。为什么先出现口渴？因为水能格拒阳气，阳气独行而上灼喉舌，则为口渴。可以在未呕吐之前，追溯其为水停心下。为什么后出现呕吐？因为口渴必然多饮水，饮水过多上逆则必然呕吐。可以在既口渴之后，明确指出这是水停心下。这属于饮家病证。）（医生不管患者已经过去的口渴症状，只根据现下的呕吐症状进行治疗，用小半夏加茯苓汤主治。）这是在咳嗽之后，忽然又谈及水饮，因为水饮是咳嗽的根本，所以说得不厌其烦。
小半夏加茯苓汤方（见上文）
The etiology of cough: if treatment is limited solely to clearing the lungs, resolving phlegm, dispersing wind, and regulating qi, it will inevitably cause harm. In cases of initial cough due to external wind invasion, administering heat-clearing and dispersing agents prematurely often proves ineffective; this is termed "deficiency-type wind invasion." Such cases strictly contraindicate cold-natured dispersing methods. With appropriate prescription, gradual recovery can be achieved. Additionally, during winter, insufficient kidney qi fails to nourish wood (liver), leading to internal deficiency of liver qi. This results in profuse rhinorrhea and nasal obstruction, also classified as deficiency-type wind invasion, which similarly contraindicates dispersing therapies. With proper medication, symptoms such as rhinorrhea and nasal patency typically resolve only when spring arrives, temperatures moderate, and ice thaws. The general principles of cough are as described above; grasping the underlying intent and extending it logically allows for accurate application.
Furthermore, cough is colloquially called "choking" (Qiang). Continuous coughing without pause is termed "sudden choking" (Dun Qiang). Sudden choking involves a single breath followed by twenty to thirty consecutive choking coughs, or at least ten to twenty. During these episodes, the head droops and the chest bends; severely, limbs may become spasmodic, with sputum gushing from the mouth, accompanied by tears and mucus flowing down from the chest and epigastrium to the lower abdomen. In adults, this resembles asthma; in children, it is known as "epidemic sudden choking." It often resolves spontaneously within one month without medication. This occurs because the eighty-four thousand pores of the body are governed by the Qi of the Taiyang Bladder channel, which connects with the Lung. Within the pores lie collateral vessels whose blood corresponds to the blood in the "Bao" (uterus/blood sea), connecting with the Liver. If cold invades the pores, causing stagnation of blood in the Bao, the blood cannot permeate the skin and collateral vessels. Consequently, Qi fails to warm and Blood fails to moisten, resulting in sudden choking. By one month, the blood in the Bao completes a full circulation, allowing for spontaneous resolution. If unresolved after one month, it may persist for two months; even without medication, it is rarely fatal. However, excessive parental anxiety leading to frequent medication, where physicians treat only Qi but not Blood, or only the Lung but not the Liver, may prolong the condition or induce new pathologies. Excessive use of cold-natured herbs causes vomiting and anorexia; excessive purgatives cause abdominal distension and diarrhea; excessive diaphoretic agents cause edema and wheezing. Many deaths that should not have occurred result from such errors.
Ling Gan Wu Wei Jiang Xin Xia Xing Da Huang Tang (Poria, Licorice, Schisandra, Dried Ginger, Asarum, Pinellia, Apricot Seed, and Rhubarb Decoction)
Formula Composition:
Fuling (Poria) 4 liang
Gancao (Licorice Root) 2 liang
Ganjiang (Dried Ginger) 3 liang
Xixin (Asarum) 3 liang
Wuweizi (Schisandra Berry) 0.5 sheng
Banxia (Pinellia Tuber) 0.5 sheng
Xingren (Apricot Seed) 0.5 sheng
Dahuang (Rhubarb Root) 3 liang
Preparation: Decoct the eight ingredients in 10 dou of water until reduced to 3 sheng. Strain. Take 1 sheng warm, three times daily.
(When fluid retention occurs below the heart, one must distinguish the sequence of symptoms. Why does thirst precede vomiting? Fluid retention obstructs Yang Qi, forcing it upward to scorch the throat and tongue, causing thirst. Before vomiting occurs, one can trace this back to fluid retention below the heart. Why does vomiting follow thirst? Thirst leads to excessive drinking; excess fluid regurgitates upward, causing vomiting. After thirst appears, one can confirm fluid retention below the heart. This pattern belongs to patients with fluid retention syndromes.) Physicians should not focus on the resolved symptom of thirst but treat the current symptom of vomiting using Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia and Poria Decoction). This discussion follows the section on cough because fluid retention is the root cause of cough; thus, it is reiterated extensively.
Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia and Poria Decoction) (See above)