风寒、火(主降火)、劳、肺胀、火郁、痰(主降痰)。
戴云∶风寒者,鼻塞、声重、恶寒者是也;火者,有声、痰少、面赤者是也;劳者,盗汗出,兼痰者,多
作寒热;肺胀者,动则喘满,气急息重;痰者,嗽动便有痰声,痰出嗽止。五者大概耳,亦当明其是否也。
风寒,行痰开腠理。二陈汤加麻黄、杏仁、桔梗。
火,降火、清金、化痰。
劳,四物汤中加竹沥、姜汁。必以补阴为主。
肺胀而嗽者,用诃子、青黛、杏仁。诃子能治肺气,因火伤极,遂成郁遏胀满,取其味酸苦,有收敛降火
之功。佐以海蛤粉、香附、栝蒌、青黛、半夏曲。
食积痰作嗽发热者,半夏、南星为君,栝蒌、萝卜子为臣,青黛、石碱为使。
火郁嗽者,诃子、海石、栝蒌、青黛、半夏、香附。
咳嗽声嘶者,此血虚受热也。用青黛、蛤粉,蜜调服。
久嗽风入肺,用鹅管石、雄黄、郁金、款冬花碾末和艾中,以生姜一片留舌上灸之,以烟入喉中为度。
干咳嗽者,难治。此系火郁之证,乃痰郁火邪在中。用苦梗以开之,下用补阴降火。不已,则成劳,倒仓
好。此证不得志者有之。
嗽而胁痛,宜疏肝气,用青皮等方。在后,二陈汤内加南星、香附、青黛、姜汁。
治嗽药,大概多用生姜者,以其辛散也。
上半日嗽多者,属胃中有火。贝母、石膏能降胃火。
午后嗽多者,此属阴虚。必用四物汤加知母、黄柏,先降其火。
五更嗽多者,此胃中有食积,至此时候,流入肺金。知母、地骨皮降肺火。
火气浮于肺者,不宜用凉药,用五味、五倍敛而降之。有痰因火逆上者,先治火,后治其痰也。
肺虚甚者用参膏,此好色肾虚有之。以生姜、陈皮佐之。大概有痰者,可加痰药治之。
治嗽多用粟壳,不必疑,但要先云病根,此乃收后之药也。师云∶阴分嗽者,多属阴虚治之也。
有嗽而肺胀壅遏不得眠者,难治。
治嗽烟筒∶
佛耳草 款冬花 鹅管石
上为末,用纸卷烧其烟熏之;或白汤调亦得。
治嗽有痰,天突、肺 二穴灸。治嗽泄火热,大泻肺气,三椎骨下横过各一寸半是穴。
嗽∶春是春升之气,用清药,二陈加薄、荆之类;夏是火炎上,最重芩、连;秋是湿热伤肺;冬是风寒外
来,用药发散之后,以半夏必逐去痰,庶不再来。
又方∶治嗽劫药。
五味子(半两) 五倍子(一钱) 甘草(二钱半) 风化硝(一钱) 为末以蜜为丸,噙化之。
戴元礼说:风寒咳嗽,表现为鼻塞、声音沉重、怕冷;火邪咳嗽,表现为有声、痰少、面红;劳损咳嗽,表现为盗汗,兼有痰者,多伴有寒热往来;肺胀咳嗽,表现为活动后气喘胸闷、气急呼吸沉重;痰咳,表现为咳嗽一动就有痰声,痰出则咳嗽停止。这五种情况是大致的分类,但也应当辨明其是否准确。
对于风寒咳嗽,治法为行痰、开通腠理。方用二陈汤加麻黄、杏仁、桔梗。
对于肺胀引起的咳嗽,使用诃子、青黛、杏仁。诃子能调理肺气,因为火邪损伤至极,导致气机郁遏而胀满,取其味酸苦,具有收敛和降火的功效。辅以海蛤粉、香附、栝蒌、青黛、半夏曲。
对于食积生痰引起的咳嗽发热,以半夏、天南星为君药,栝蒌、萝卜子为臣药,青黛、石碱为使药。
对于火郁引起的咳嗽,使用诃子、海浮石、栝蒌、青黛、半夏、香附。
对于咳嗽声音嘶哑者,这是血虚受热所致。使用青黛、蛤粉,用蜂蜜调服。
对于久咳风邪入肺者,将鹅管石、雄黄、郁金、款冬花研成细末,与艾绒混合,取生姜一片置于舌上,进行艾灸,以烟雾进入喉中为度。
干咳者,难以治疗。此属火郁证,是痰郁火邪在中焦。用桔梗来开提肺气,下部用补阴降火之法。若不止,则会发展为劳损,倒仓法较好。此证多见于心情不畅之人。
咳嗽伴胁痛者,宜疏肝气,使用青皮等方剂。后续可在二陈汤内加入南星、香附、青黛、姜汁。
午后咳嗽多者,此属阴虚。必须用四物汤加知母、黄柏,先降其火。
五更时分咳嗽多者,这是胃中有食积,到了这个时候,食积流入肺金。用知母、地骨皮降肺火。
火气浮于肺者,不宜用凉药,应用五味子、五倍子收敛而降火。若有痰因火逆上者,先治火,后治其痰。
肺虚严重者用人参膏,这种情况多见于好色导致的肾虚。以生姜、陈皮佐助。大概有痰者,可加化痰药治疗。
治疗咳嗽多用罂粟壳,不必怀疑,但必须先清除病根,这是收涩之后的用药。老师说:阴分咳嗽者,多属阴虚,按阴虚治疗。
治疗咳嗽的烟筒方:
佛耳草、款冬花、鹅管石。
以上研为细末,用纸卷起来燃烧其烟熏之;或用白开水调服也可以。
治疗咳嗽有痰者,灸天突穴、肺俞穴。治疗咳嗽泄火热,大泻肺气,第三椎骨下横过各一寸半处是穴位。
咳嗽:春季是春升之气,用清热药,二陈汤加薄荷、荆芥之类;夏季是火炎上,最重用黄芩、黄连;秋季是湿热伤肺;冬季是风寒外来,用药发散之后,必用半夏逐去痰,这样痰才不再来。
又一方:治疗咳嗽的劫痰药。
五味子(半两)、五倍子(一钱)、甘草(二钱半)、风化硝(一钱)。研为细末,用蜜做成丸药,含化服用。
Wind-cold, Fire (primarily to descend Fire), Consumption (Lao), Lung Distension, Fire Stagnation, Phlegm (primarily to resolve Phlegm).
Dai Yun said: Wind-cold is characterized by nasal congestion, heavy voice, and aversion to cold; Fire is characterized by a hoarse sound, scanty phlegm, and red face; Consumption is characterized by night sweats, and when accompanied by phlegm, it often presents with alternating chills and fever; Lung Distension is characterized by panting and chest fullness upon exertion,急促 breathing, and heavy respiration; Phlegm cough is characterized by the sound of phlegm as soon as coughing starts, and the cough stops when the phlegm is expectorated. These five are general categories, but one must also clarify whether they apply accurately.
For wind-cold, the method is to move phlegm and open the interstices (Cou Li). Use Er Chen Tang (Two-Aged Decoction) added with Mahuang (Ephedrae Herba), Xingren (Prunus Semen), and Jiegeng (Platycodonis Radix).
For Fire, the method is to descend Fire, clear Metal (clear Lung heat), and resolve phlegm.
For Consumption, add Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice) to Siwu Tang (Four Substances Decoction). The primary treatment must be to tonify Yin.
For cough due to Lung Distension, use Hezi (Terminalia Chebula Fruit), Qingdai (Indigo Naturalis), and Xingren (Prunus Semen). Hezi can regulate Lung Qi because extreme injury by Fire leads to stagnation and distension; its sour and bitter taste has the effect of astringing and descending Fire. Assist with Haige Fen (Arca Shell Powder), Xiangfu (Cyperus Rhizome), Gualou (Trichosanthes Fruit), Qingdai (Indigo Naturalis), and Banxia Qu (Pinelliae Fermented Powder).
For cough and fever caused by food retention generating phlegm, Banxia (Pinelliae Rhizoma) and Nanxing (Arisaematis Rhizoma) are the Sovereign herbs, Gualou (Trichosanthes Fruit) and Luobozhi (Raphani Semen) are the Minister herbs, and Qingdai (Indigo Naturalis) and Shijian (Calcined Sodium Bicarbonate) are the Envoy herbs.
For cough due to Fire Stagnation, use Hezi (Terminalia Chebula Fruit), Haishi (Fossilized Wood or Arca Shell), Gualou (Trichosanthes Fruit), Qingdai (Indigo Naturalis), Banxia (Pinelliae Rhizoma), and Xiangfu (Cyperus Rhizome).
For cough with hoarseness, this is due to Blood deficiency and Heat invasion. Use Qingdai (Indigo Naturalis) and Gefen (Clam Shell Powder), mixed with honey for administration.
For chronic cough with Wind invading the Lung, grind Eguanshi (Tube Bone Stone), Xionghuang (Realgar), Yujin (Curcuma Rhizome), and Kuaodonghua (Farfarae Flos) into powder, mix with Mugwort, place a slice of fresh Ginger on the tongue, and moxa-burn until the smoke enters the throat.
Dry cough is difficult to treat. This belongs to the syndrome of Fire Stagnation, where Phlegm and Fire pathogenic factors are stagnant in the middle. Use Jiegeng (Platycodonis Radix) to open and lift, and use methods to tonify Yin and descend Fire below. If it does not cease, it will develop into Consumption; Dao Cang Fa (Stomach Purging Method) is suitable. This condition often occurs in those who are frustrated or dissatisfied.
For cough with hypochondriac pain, one should soothe Liver Qi, using formulas such as those containing Qingpi (Citrus Reticulata Pericarpium Viride). Later, add Nanxing (Arisaematis Rhizoma), Xiangfu (Cyperus Rhizome), Qingdai (Indigo Naturalis), and Jiangzhi (Ginger Juice) to Er Chen Tang (Two-Aged Decoction).
Medicines for treating cough generally use much Shengjiang (Fresh Ginger) because of its acrid dispersing nature.
Cough occurring mostly in the first half of the day belongs to Fire in the Stomach. Beimu (Fritillariae Bulbus) and Shigao (Gypsum Fibrosum) can descend Stomach Fire.
Cough occurring mostly in the afternoon belongs to Yin deficiency. One must use Siwu Tang (Four Substances Decoction) added with Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex) to first descend the Fire.
Cough occurring mostly at dawn (Wu Geng) belongs to food retention in the Stomach, which flows into the Lung Metal at this time. Zhimu (Anemarrhenae Rhizoma) and Digupi (Dictamni Cortex) descend Lung Fire.
When Fire Qi floats in the Lung, cool medicines should not be used; instead, use Wuweizi (Schisandrae Fructus) and Wubeizi (Galla Chinensis) to astringe and descend it. When Phlegm rises due to rebellious Fire, treat the Fire first, then treat the Phlegm.
For severe Lung deficiency, use Shengshen Gao (Ginseng Paste); this is seen in cases of Kidney deficiency due to excessive sexual indulgence. Assist with Shengjiang (Fresh Ginger) and Chenpi (Citrus Reticulata Pericarpium). Generally, if there is Phlegm, add phlegm-resolving medicines.
Treating cough often uses Sangpiao Xiao (Poppy Capsule) without doubt, but one must first address the root cause, as this is an astringent medicine used after the pathogen is cleared. The Master said: Coughs in the Yin aspect mostly belong to Yin deficiency and should be treated accordingly.
Cough with Lung distension and obstruction preventing sleep is difficult to treat.
Smoke Tube for Treating Cough:
Ercao (Petasitae Herba), Kuaodonghua (Farfarae Flos), Eguanshi (Tube Bone Stone).
Grind these into powder, roll in paper, burn to inhale the smoke; or mix with warm water for oral administration.
To treat cough with Phlegm, moxa-burn Tiantu (CV 22) and Feishu (BL 13). To treat cough by draining Fire and Heat and greatly draining Lung Qi, the point is located one and a half cun lateral to the transverse process below the third thoracic vertebra.
Cough: In Spring, due to ascending Qi, use clearing medicines, such as Er Chen Tang (Two-Aged Decoction) added with Bohe (Menthae Haplocalycis Herba) and Jingjie (Schizonepetae Spica); in Summer, due to Fire flaming upward, prioritize Huangqin (Scutellariae Radix) and Lianqiao (forbidden context? No, Lian Qiao is Forsythiae, here likely Huanglian Coptidis Rhizoma based on "Qin, Lian"); in Autumn, Damp-Heat injures the Lung; in Winter, Wind-Cold comes from outside, so use dispersing medicines, and afterwards, Banxia (Pinelliae Rhizoma) must eliminate the Phlegm so that it does not return.
Another Formula: A potent medicine for treating cough.
Wuweizi (Schisandrae Fructus, 0.5 liang), Wubeizi (Galla Chinensis, 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 2.5 qian), Fenghuaxiao (Natrii Sulfas Efflorescens, 1 qian). Grind into powder, form pills with honey, and hold in the mouth to dissolve.