脉∶咳嗽所因,浮风、紧寒、数热、细湿、房劳涩难。右关微濡,饮食伤脾;左关弦短,肝极劳疲。肺脉浮短
,咳嗽与期。五脏之嗽,各视本部。浮紧虚寒,沉数实热,沉滑多痰,弦涩少血。形盛脉细不足以息,沉小伏匿,
皆是危脉。唯有浮大而嗽者生。
春是上升之气,夏是火炎上最重,秋是湿热伤肺,冬是风寒外束。四时感冒,一切咳嗽发热吐痰者,宜发散风
邪也。
参苏饮 治四时感冒,发热头疼、咳嗽声重、涕唾稠粘、中脘痞满、呕吐痰水。宽中快膈,不致伤脾。此
药大解肌热,将欲成劳,痰咳喘热最效。
紫苏(一钱) 前胡(二钱) 桔梗 枳壳(各一钱) 干葛(二钱) 陈皮 半夏 茯苓(各一钱)
甘草(七分) 人参(七分,热咳者去之) 木香(五分,气盛者去之)
上锉一剂,生姜、枣子煎,食后温服。若天寒感冒,恶寒无汗,咳嗽喘促,或伤风无汗、鼻塞声重咳嗽,并加
麻黄二钱、去皮杏仁二钱、金沸草一钱,以汗散之;若初感冒,肺多有热加杏仁、黄芩、桑白皮、乌梅;肺寒咳嗽加
五味子、干姜,心下痞闷,或胸中烦热,或停酒不散,或嘈杂恶心加黄连、枳实各一钱,干葛、陈皮倍用之,胸满
痰多加栝蒌仁一钱;气促喘嗽加知母、贝母;鼻衄加乌梅、麦门冬、白茅根;心盛发热加柴胡、黄芩;头痛加川芎、
细辛;咳嗽吐血加升麻、牡丹皮、生地黄;劳热咳嗽久不愈加知母、贝母、麦门冬;见血加阿胶、生地黄、乌梅、
赤芍药、牡丹皮;吐血痰嗽加四物汤,名茯苓补心汤,妊娠伤寒去半夏,加香附。
感冒风寒,嗽而声哑者,是寒包热也。(与久嗽声哑不同。)冷风嗽者,遇风冷即发,痰多喘嗽是也。(以上
二条俱宜后方。)
三拗汤 治感冒风邪寒冷,鼻塞声重、语音不出、咳嗽多痰、胸满短气喘急。
甘草(生) 麻黄(不去节) 杏仁(不去皮尖。各二钱) 加荆芥、桔梗,名五拗汤。
上锉剂,生姜煎服。
痰嗽者,嗽动便有痰声,痰出嗽止是也。(嗽而痰多者,是脾虚也。)肺胀嗽者,嗽则喘满气急也。(喘急不得
眠者难治。) 久嗽不止成劳,若久嗽声哑,或喉生疮者,是火伤肺金也。(俱难治
之。若血气衰败,声失音者,亦难治也,以上三条,俱宜后方。)
清肺汤 治一切咳嗽,上焦痰盛。
黄芩(去朽心,一钱半) 桔梗(去芦) 茯苓(去皮) 陈皮(去白) 贝母(去心) 桑白皮(各一钱)
当归 天门冬(去心) 山栀 杏仁(去皮尖) 麦门冬(去心。各七分) 五味子(七粒) 甘草(三分)
上锉生姜、枣子煎,食后服。痰咯不出加栝蒌、枳实、竹沥,去五味子,咳嗽喘急加苏子、竹沥,去桔梗,痰火
咳嗽、面赤身热、咯出红痰加芍药、生地黄、紫菀、阿胶、竹沥,去五味子、杏仁、贝母、桔梗,久嗽虚汗多者加
白术、芍药、生地黄,去桔梗、贝母、杏仁;久嗽喉痹、声不清者加薄荷、生地黄、紫菀、竹沥,去贝母、杏仁、五
味;嗽而痰多者加白术、金沸草,去桔梗、黄芩、杏仁;咳嗽身热加柴胡;咳嗽,午后至晚发热者加知母、黄柏、
生地、芍药、竹沥,去黄芩、杏仁;咳嗽痰结胁痛者加白芥子、栝蒌、枳实、砂仁、木香、小茴、竹沥、姜汁少许,
去贝母、杏仁、山栀,亦加柴胡引经。
食积嗽者,痰嗽如胶也。咳嗽胸膈结痛者,是痰结也。早晨嗽者,胃中有食积也。上半日嗽多者,胃中有伏火
也。(以上四条,俱宜后方。)栝蒌枳实汤加减。(方见痰饮。)
午后至夜嗽多者,属阴虚也。(黄昏嗽多者,火气浮,少加凉药。)火嗽者,有声痰少、面赤身热、脉数者是
也。干咳嗽无痰者,是痰郁火邪在肺,难治也。劳嗽者,盗汗痰多作寒热、脉数大无力是也。(以上四者,皆是劳力、
酒色内伤、忧怒、郁结、阴虚火动而嗽者,俱宜后方。)滋阴降火汤。(方见虚怯。)
一切久嗽不止者,(宜后方。)
吕洞宾仙传芦吸散 治新久咳嗽,百药无功,服此立效。
款冬花蕊(五钱) 鹅管石(二钱五分) 陈皮(二钱五分) 年老人及
虚者加人参(五分) 冬月加肉桂(一钱五分)
上忌铁器,为细末和匀,分作七帖,作七日服。每服一帖。夜仰卧将药一帖作三次入竹筒内,病者口噙竹筒,
近咽喉用力一吸,将白温水一口送下。不可多吃水,忌诸般油腻盐一七日。药服完之后,亦少用些油盐,至半
月后不忌。
吸药仙丹
鹅管石(二两) 寒水石(四钱半) 金星礞石(七钱,焰硝 后,用醋淬) 白附子(七钱) 白矾(七钱,
枯过四钱半) 孩儿茶(四钱) 款冬花(净蕊,七钱) 粉甘草(四钱)
上各为末。研令极细秤过,方用总箩过搀匀。如有气加沉香五分、木香七分、官桂七分∶如心下虚悸加朱砂三分。
热嗽用茶汤下;寒用姜汤下;咳如浮肿,用木瓜、牛膝汤下;咳而有红痰吐血,白芥子汤下。
歌曰∶
仙方二两鹅管石,青礞白附款冬花,
三味各秤七钱重,四钱甘草与儿茶,
枯矾寒水四钱半,八味精研制莫差,
日进六分三次吸,寒用姜汤热用茶,
虚加五分沉木桂,咳而惊悸用朱砂,
薄荷煎汤潮热使,化痰止嗽最为佳。
鸡鸣丸 治男妇不问老少,十八般咳嗽吐血、诸虚等症如神。
从来咳嗽十八般,只因邪气入于肝,
胸膈咳嗽多加喘,胃嗽膈上有痰涎,
大肠咳嗽三焦热,小肠咳嗽舌上干,
伤风咳嗽喉多痒,胆嗽夜间不得安,
肝风嗽时喉多痹,三因嗽时船上滩,
气喘夜间多沉重,肺嗽痰多喘嗽难,
热嗽多血连心痛,膀胱嗽时气多寒,
暴嗽日间多出汗,伤寒嗽时冷痰酸,
此是神仙真妙诀,用心求取鸡鸣丸。
知母(四两、炒) 杏仁(去皮尖,二钱) 桔梗(去芦,五钱) 阿胶(麸炒,四钱) 葶苈(火上焙,
三钱) 款冬花(四钱) 旋复花(一两) 半夏(姜汁炒,三钱) 甘草(炙,一两) 陈皮(去白,一两)
兜铃(一两) 五味子(四钱) 麻黄(一两) 人参(五钱)
上共为细末,炼蜜为丸,如弹子大。每服一丸,五更,乌梅、生姜、枣子汤下。
大抵久嗽者,多属肾气亏损,火炎水涸,或津液涌而为痰者,乃真脏为患也。须用六味地黄丸壮肾水滋化源
为主;以补中益气汤养脾土生肺肾为佐。久之自愈。(方见补益。)
补遗方
治咳嗽肺痿、吐血气喘等症,用猪肺一个,倒悬滴尽血水,又用大萝卜十个捣烂,用新砂锅一个,水五碗,
煮前萝卜,烂,滤去渣,添蜜四两、鸡子清十个,不用黄。与蜜搅匀,却装入肺内。又用款冬花、五味子、诃子去
核各一钱,白矾五分,俱为末,通搅蜜入鸡清内,入肺管煮熟,空心服之,其效如神。
又方 猪肺一个,洗净血水,若病患每岁用杏仁一个去皮尖,将肺以竹片签眼,每眼用杏仁一个,麻扎住,
安瓷器内重汤煮熟,去杏仁不用,只吃此肺。轻者只用一具而已;重者制二具吃,全安。
加味上清丸 治咳嗽烦热,清声润肺,宽膈化痰,生津止渴,爽气凝神。
南薄荷叶(四两) 柿霜(四两) 玄明粉(五钱) 硼砂(五钱) 冰片(五分)
寒水石(五钱) 乌梅肉(五钱) 白粉(八两)
上为细末,甘草水熬膏为丸,如芡实大。每服一丸,噙化茶汤送下。
杏仁煎 治老人久患喘嗽不已,睡卧不得者,服之立效。
杏仁(水泡去皮尖,炒) 胡桃仁(去皮。等分)
上二味共碾为膏,入炼蜜少许为丸,如弹子大。每服一丸,细嚼,姜汤送下。
治痰火咳嗽,兼治酒痔。
白矾(一两, 过) 矿锻石(一两半)
上研匀、每服一钱,或茶,或滚水,酒亦可。如作丸,用灰面一两和合冷水为丸,如梧桐子大。每服二十
五丸,前引送下。
清上噙化丸 清火化痰、止嗽定喘。
栝蒌霜 天门冬(去心) 橘红 枯芩(去朽,酒炒) 海石( ) 柿霜(各一两) 桔梗(去芦)
连翘 玄参 青黛(各五钱) 风化硝(三钱。)
上为细末,炼蜜为丸,如龙眼大,食远噙化。
周藩海阳王昆湖公,患痰嗽喘热,左足肿痛,日轻夜重。每年发一二次,已经三十年,遍治弗效。余诊左
脉微数、右脉弦数,此血虚有湿痰也。以四物汤加苍术、黄柏、木瓜、槟榔、木通、泽泻,空心服以治下元,以
茯苓补心汤临卧服以治上焦。各三服而愈。后以神仙飞步丸空心服,清气化痰丸临卧服,各一料,永不再发。
一儒者,每至春咳嗽,用参苏饮之类乃愈。后复发,仍用前药,反喉喑,左尺洪数而无力。余以为肾经阴火
刑克肺金,以六味丸料加麦门冬、五味子、炒山栀,以补中益气汤而愈。
脉象:咳嗽的成因,浮脉主风邪,紧脉主寒邪,数脉主热邪,细脉主湿邪,房事过度导致肾精亏损而见涩难之象。右关脉微濡,提示饮食损伤脾胃;左关脉弦短,提示肝气极度劳损疲惫。肺脉若见浮短,预示咳嗽发作有定期。五脏咳嗽,需分别观察其对应脏腑部位的脉象。脉浮紧且虚为寒证,脉沉数且实为热证,脉沉滑多伴有痰饮,脉弦涩提示血少。形体壮盛但脉象细弱、气息不足以接续,或脉象沉小伏匿,都是危重的脉象。唯有脉象浮大且伴有咳嗽者,预后良好,可生。
春季是阳气上升之气,夏季火炎上亢最为严重,秋季湿热伤肺,冬季风寒外束肌表。四季感受外邪感冒,凡是出现一切咳嗽、发热、吐痰症状的,适宜采用发散风邪的方法治疗。
参苏饮:治疗四季感冒,症见发热头痛、咳嗽声音重浊、鼻涕唾液稠粘、中脘部痞满胀闷、呕吐痰水。此方能宽中快膈,不致损伤脾胃。此药能大力解除肌表之热,对于将欲形成虚劳、痰咳喘热等症状最为有效。
方药组成:紫苏(一钱)、前胡(二钱)、桔梗、枳壳(各一钱)、干葛(二钱)、陈皮、半夏、茯苓(各一钱)、甘草(七分)、人参(七分,热咳者去掉)、木香(五分,气盛者去掉)。
以上药材锉碎为一剂,加生姜、大枣煎煮,饭后温服。若遇天寒感冒,恶寒无汗,咳嗽气喘急促,或伤风无汗、鼻塞声重咳嗽,并加麻黄二钱、去皮杏仁二钱、金沸草一钱,以发汗散邪;若初起感冒,肺部多有热邪,加杏仁、黄芩、桑白皮、乌梅;肺寒咳嗽加五味子、干姜;心下痞闷,或胸中烦热,或饮酒后酒气不散,或嘈杂恶心,加黄连、枳实各一钱,干葛、陈皮加倍使用;胸满痰多加栝蒌仁一钱;气促喘嗽加知母、贝母;鼻衄(鼻出血)加乌梅、麦门冬、白茅根;心经盛热发热加柴胡、黄芩;头痛加川芎、细辛;咳嗽吐血加升麻、牡丹皮、生地黄;劳热咳嗽久不愈加知母、贝母、麦门冬;见血加阿胶、生地黄、乌梅、赤芍药、牡丹皮;吐血痰嗽加四物汤,名为茯苓补心汤;妊娠期间伤寒去半夏,加香附。
感冒风寒,咳嗽声音嘶哑的,是寒包热证。(这与久咳声音嘶哑不同。)冷风咳嗽者,遇到风冷即发作,痰多喘嗽即是。(以上两条都适宜用后方治疗。)
三拗汤:治疗感冒风邪寒冷,症见鼻塞声重、语音不出、咳嗽多痰、胸满短气喘急。
方药组成:甘草(生用)、麻黄(不去节)、杏仁(不去皮尖,各二钱)。加荆芥、桔梗,名为五拗汤。
以上药材锉碎为一剂,加生姜煎服。
痰嗽者,咳嗽一动就有痰声,痰出则咳嗽停止。(咳嗽而痰多者,是脾虚所致。)肺胀咳嗽者,咳嗽则喘满气急。(喘急不能安睡者难治。)久咳不止成劳损,若久咳声音嘶哑,或咽喉生疮者,是火邪损伤肺金所致。(都难治。若血气衰败,声音失音者,也难治,以上三条,都适宜用后方治疗。)
方药组成:黄芩(去朽心,一钱半)、桔梗(去芦)、茯苓(去皮)、陈皮(去白)、贝母(去心)、桑白皮(各一钱)、当归、天门冬(去心)、山栀、杏仁(去皮尖)、麦门冬(去心,各七分)、五味子(七粒)、甘草(三分)。
以上药材锉碎,加生姜、大枣煎煮,饭后服用。痰咯不出加栝蒌、枳实、竹沥,去掉五味子;咳嗽喘急加苏子、竹沥,去掉桔梗;痰火咳嗽、面赤身热、咯出红痰加芍药、生地黄、紫菀、阿胶、竹沥,去掉五味子、杏仁、贝母、桔梗;久咳虚汗多者加白术、芍药、生地黄,去掉桔梗、贝母、杏仁;久咳喉痹、声音不清者加薄荷、生地黄、紫菀、竹沥,去掉贝母、杏仁、五味子;咳嗽而痰多者加白术、金沸草,去掉桔梗、黄芩、杏仁;咳嗽身热加柴胡;咳嗽,午后至晚间发热者加知母、黄柏、生地、芍药、竹沥,去掉黄芩、杏仁;咳嗽痰结胁痛者加白芥子、栝蒌、枳实、砂仁、木香、小茴、竹沥、姜汁少许,去掉贝母、杏仁、山栀,也加柴胡作为引经药。
食积咳嗽者,痰嗽如胶状。咳嗽胸膈结痛者,是痰结所致。早晨咳嗽者,胃中有食积。上半日咳嗽多者,胃中有伏火。(以上四条,都适宜用后方治疗。栝蒌枳实汤加减。(方剂见痰饮篇。)
午后至夜间咳嗽多者,属于阴虚。(黄昏咳嗽多者,是火气浮越,少加凉药。)火嗽者,有声痰少、面赤身热、脉数是其特征。干咳无痰者,是痰郁火邪在肺,难治。劳嗽者,盗汗痰多、忽冷忽热、脉数大无力是其表现。(以上四种情况,都是因为劳力、酒色内伤、忧怒、郁结、阴虚火动而咳嗽的,都适宜用后方治疗。滋阴降火汤。(方剂见虚怯篇。)
一切久咳不止者,(适宜用后方治疗。)
吕洞宾仙传芦吸散:治疗新久咳嗽,百药无效,服用此方立即见效。
方药组成:款冬花蕊(五钱)、鹅管石(二钱五分)、陈皮(二钱五分)。年老人及体虚者加人参(五分),冬季加肉桂(一钱五分)。
以上药材忌用铁器,研为细末和匀,分作七帖,分七日服用。每服一帖。夜晚仰卧,将一帖药分三次装入竹筒内,病人口含竹筒,靠近咽喉用力一吸,用一口白温水送下。不可多喝水,忌食各种油腻盐分七天。药服完后,也少量使用油盐,到半个月后不再禁忌。
方药组成:鹅管石(二两)、寒水石(四钱半)、金星礞石(七钱,用焰硝处理后,用醋淬炼)、白附子(七钱)、白矾(七钱,枯制后剩四钱半)、孩儿茶(四钱)、款冬花(净蕊,七钱)、粉甘草(四钱)。
以上各药研为细末。研磨至极细并过秤,然后用总箩过滤搀匀。如有气滞加沉香五分、木香七分、官桂七分;如心下虚悸加朱砂三分。热嗽用茶汤送下;寒嗽用姜汤送下;咳嗽如浮肿,用木瓜、牛膝汤送下;咳嗽而有红痰吐血,用白芥子汤送下。
歌诀曰:
仙方二两鹅管石,青礞白附款冬花,
三味各秤七钱重,四钱甘草与儿茶,
枯矾寒水四钱半,八味精研制莫差,
日进六分三次吸,寒用姜汤热用茶,
虚加五分沉木桂,咳而惊悸用朱砂,
薄荷煎汤潮热使,化痰止嗽最为佳。
鸡鸣丸:治疗男女不问老少,十八种咳嗽吐血、诸虚等症,效果如神。
从来咳嗽十八般,只因邪气入于肝,
胸膈咳嗽多加喘,胃嗽膈上有痰涎,
大肠咳嗽三焦热,小肠咳嗽舌上干,
伤风咳嗽喉多痒,胆嗽夜间不得安,
肝风嗽时喉多痹,三因嗽时船上滩,
气喘夜间多沉重,肺嗽痰多喘嗽难,
热嗽多血连心痛,膀胱嗽时气多寒,
暴嗽日间多出汗,伤寒嗽时冷痰酸,
此是神仙真妙诀,用心求取鸡鸣丸。
方药组成:知母(四两,炒)、杏仁(去皮尖,二钱)、桔梗(去芦,五钱)、阿胶(麸炒,四钱)、葶苈(火上焙,三钱)、款冬花(四钱)、旋复花(一两)、半夏(姜汁炒,三钱)、甘草(炙,一两)、陈皮(去白,一两)、兜铃(一两)、五味子(四钱)、麻黄(一两)、人参(五钱)。
以上共研为细末,炼蜜为丸,如弹子大。每服一丸,五更天时,用乌梅、生姜、大枣汤送下。
大抵久咳者,多属肾气亏损,火炎水涸,或津液涌而为痰者,乃真脏为患。须用六味地黄丸壮肾水滋化源为主;以补中益气汤养脾土生肺肾为佐。久而久之自愈。(方剂见补益篇。)
补遗方
治疗咳嗽肺痿、吐血气喘等症,用猪肺一个,倒悬滴尽血水,又用大萝卜十个捣烂,用新砂锅一个,水五碗,煮前萝卜至烂,滤去渣,添蜜四两、鸡蛋清十个,不用蛋黄。与蜜搅匀,却装入肺内。又用款冬花、五味子、诃子去核各一钱,白矾五分,俱为末,通搅蜜入鸡清内,入肺管煮熟,空腹服用,其效如神。
又一方:猪肺一个,洗净血水,若病患每岁用杏仁一个去皮尖,将肺以竹片签眼,每眼用杏仁一个,麻扎住,安瓷器内重汤煮熟,去杏仁不用,只吃此肺。轻者只用一具而已;重者制二具吃,全安。
加味上清丸:治疗咳嗽烦热,清声润肺,宽膈化痰,生津止渴,爽气凝神。
方药组成:南薄荷叶(四两)、柿霜(四两)、玄明粉(五钱)、硼砂(五钱)、冰片(五分)、寒水石(五钱)、乌梅肉(五钱)、白粉(八两)。
以上为细末,甘草水熬膏为丸,如芡实大。每服一丸,噙化,茶汤送下。
杏仁煎:治疗老人久患喘嗽不已,睡卧不得者,服用立效。
以上二味共碾为膏,入炼蜜少许为丸,如弹子大。每服一丸,细嚼,姜汤送下。
以上研匀,每服一钱,或用茶,或用滚水,酒亦可。如作丸,用灰面一两和合冷水为丸,如梧桐子大。每服二十五丸,前引送下。
方药组成:栝蒌霜、天门冬(去心)、橘红、枯芩(去朽,酒炒)、海石、柿霜(各一两)、桔梗(去芦)、连翘、玄参、青黛(各五钱)、风化硝(三钱)。
以上为细末,炼蜜为丸,如龙眼大,食远噙化。
周藩海阳王昆湖公,患痰嗽喘热,左足肿痛,日轻夜重。每年发一二次,已经三十年,遍治弗效。余诊左脉微数、右脉弦数,此血虚有湿痰也。以四物汤加苍术、黄柏、木瓜、槟榔、木通、泽泻,空心服以治下元,以茯苓补心汤临卧服以治上焦。各三服而愈。后以神仙飞步丸空心服,清气化痰丸临卧服,各一料,永不再发。
一儒者,每至春咳嗽,用参苏饮之类乃愈。后复发,仍用前药,反喉喑,左尺洪数而无力。余以为肾经阴火刑克肺金,以六味丸料加麦门冬、五味子、炒山栀,以补中益气汤而愈。
Pulse: The causes of cough include floating pulse indicating wind pathogen, tight pulse indicating cold pathogen, rapid pulse indicating heat pathogen, fine pulse indicating dampness pathogen, and rough/difficult pulse indicating sexual exhaustion. A slightly soggy pulse at the right Guan position indicates spleen injury from diet; a wiry and short pulse at the left Guan position indicates extreme liver fatigue. A floating and short lung pulse predicts periodic onset of cough. Coughs of the five zang organs should be viewed according to their respective organ positions. Floating and tight with deficiency indicates cold; deep and rapid with excess indicates heat; deep and slippery indicates much phlegm; wiry and choppy indicates blood deficiency. A robust body form with a fine pulse and insufficient breath, or a deep, small, and hidden pulse, are all critical pulses. Only those with a floating and large pulse accompanied by cough have a good prognosis (survival).
Spring is the qi rising upward; summer fire flares up most severely; autumn damp-heat injures the lungs; winter wind-cold binds the exterior. For colds in the four seasons, for all cases of cough, fever, and expectoration, it is appropriate to disperse wind pathogens.
Shen Su Yin (Ginseng and Perilla Decoction): Treats colds in the four seasons, with symptoms of fever, headache, heavy coughing voice, thick and sticky nasal discharge and saliva, epigastric fullness and distension, and vomiting of phlegm-water. It opens the middle and pleases the diaphragm without injuring the spleen. This medicine greatly resolves muscle-layer heat and is most effective for conditions about to become consumptive, as well as for phlegm-cough, wheezing, and heat.
Ingredients: Zi Su Ye (Perillae Folium, 1 qian), Qian Hu (Peucedani Radix, 2 qian), Jie Geng (Platycodonis Radix), Zhi Ke (Aurantii Fructus, each 1 qian), Gan Ge (Puerariae Radix, 2 qian), Chen Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria, each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 7 fen), Ren Shen (Ginseng Radix et Rhizoma, 7 fen, remove if heat-cough), Mu Xiang (Aucklandiae Radix, 5 fen, remove if qi is excessive).
Crush one dose, decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Zao (Jujubae Fructus), take warm after meals. If cold weather colds present with aversion to cold, no sweat, coughing with panting urgency, or wind-strike with no sweat, nasal congestion, heavy voice, and cough, add Ma Huang (Ephedrae Herba, 2 qian), Qu Pi Xing Ren (Armeniacae Semen Amarum, peeled, 2 qian), and Fei Cao (Boraginis Herba, 1 qian) to induce sweating via perspiration. If initial colds involve much heat in the lungs, add Xing Ren (Armeniacae Semen Amarum), Huang Qin (Scutellariae Radix), Sang Bai Pi (Mori Cortex), and Wu Mei (Mume Fructus); for lung-cold cough, add Wu Wei Zi (Schisandrae Fructus) and Gan Jiang (Zingiberis Rhizoma); for subcardiac stuffiness, chest vexation-heat, retained alcohol, or acid regurgitation with nausea, add Huang Lian (Coptidis Rhizoma) and Zhi Shi (Aurantii Fructus Immaturus, each 1 qian), double Gan Ge (Puerariae Radix) and Chen Pi (Citri Reticulatae Pericarpium); for chest fullness with much phlegm, add Gua Lou Ren (Trichosanthis Semen, 1 qian); for panting urgency and cough, add Zhi Mu (Anemarrhenae Rhizoma) and Bei Mu (Fritillariae Bulbus); for epistaxis, add Wu Mei (Mume Fructus), Mai Men Dong (Ophiopogonis Radix), and Bai Mao Gen (Imperatae Rhizoma); for heart-excess fever, add Chai Hu (Bupleuri Radix) and Huang Qin (Scutellariae Radix); for headache, add Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Xi Xin (Asari Radix et Rhizoma); for cough with hemoptysis, add Sheng Ma (Cimicifugae Rhizoma), Mu Dan Pi (Moutan Cortex), and Sheng Di Huang (Rehmanniae Radix); for consumptive heat cough persisting long, add Zhi Mu (Anemarrhenae Rhizoma), Bei Mu (Fritillariae Bulbus), and Mai Men Dong (Ophiopogonis Radix); for bleeding, add E Jiao (Colla Corii Asini), Sheng Di Huang (Rehmanniae Radix), Wu Mei (Mume Fructus), Chi Shao Yao (Paeoniae Radix Rubra), and Mu Dan Pi (Moutan Cortex); for hemoptysis with phlegm-cough, add Si Wu Tang (Four Substances Decoction), named Fu Ling Bu Xin Tang (Poria Decoction to Nourish the Heart); for pregnant women with cold damage, remove Ban Xia (Pinelliae Rhizoma) and add Xiang Fu (Cyperi Rhizoma).
For cold-damage wind-cold with hoarse cough, this is cold enveloping heat (different from chronic cough with hoarseness). Cold-wind cough occurs upon exposure to cold wind, characterized by much phlegm and panting cough (both above suit the following formulas).
San Ao Tang (Three Unyielding Decoction): Treats cold damage from wind-cold, with nasal congestion, heavy voice, inability to speak, cough with much phlegm, chest fullness, shortness of breath, and panting urgency.
Ingredients: Gan Cao (Glycyrrhizae Radix et Rhizoma, raw), Ma Huang (Ephedrae Herba, joints unremoved), Xing Ren (Armeniacae Semen Amarum, skin and tips unremoved, each 2 qian). Add Jing Jie (Schizonepetae Herba) and Jie Geng (Platycodonis Radix), named Wu Ao Tang (Five Unyielding Decoction).
Crush one dose, decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and take.
Phlegm-cough: Coughing produces phlegm sounds immediately, stopping when phlegm is expelled (cough with much phlegm indicates spleen deficiency). Lung-distension cough: coughing leads to panting, fullness, and urgency (panting preventing sleep is difficult to treat). Chronic cough leading to consumption: if chronic cough has hoarseness or throat ulcers, it is fire injuring lung metal (all difficult to treat. If blood and qi decline and voice is lost, also difficult to treat; the above three suit the following formulas).
Qing Fei Tang (Clear the Lung Decoction): Treats all coughs with abundant phlegm in the upper jiao.
Ingredients: Huang Qin (Scutellariae Radix, remove rotten center, 1.5 qian), Jie Geng (Platycodonis Radix, remove rhizome), Fu Ling (Poria, remove skin), Chen Pi (Citri Reticulatae Pericarpium, remove white pith), Bei Mu (Fritillariae Bulbus, remove core), Sang Bai Pi (Mori Cortex, each 1 qian), Dang Gui (Angelicae Sinensis Radix), Tian Men Dong (Asparagi Radix, remove core), Shan Zhi (Gardeniae Fructus), Xing Ren (Armeniacae Semen Amarum, remove skin and tips), Mai Men Dong (Ophiopogonis Radix, remove core, each 7 fen), Wu Wei Zi (Schisandrae Fructus, 7 grains), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen).
Crush, decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Zao (Jujubae Fructus), take after meals. If phlegm cannot be expectorated, add Gua Lou (Trichosanthis Fructus), Zhi Shi (Aurantii Fructus Immaturus), Zhu Li (Bambusae Succus), remove Wu Wei Zi (Schisandrae Fructus); for cough with panting urgency, add Su Zi (Perillae Fructus), Zhu Li (Bambusae Succus), remove Jie Geng (Platycodonis Radix); for phlegm-fire cough, red face, body heat, expectoration of red phlegm, add Shao Yao (Paeoniae Radix), Sheng Di Huang (Rehmanniae Radix), Zi Wan (Asteris Radix), E Jiao (Colla Corii Asini), Zhu Li (Bambusae Succus), remove Wu Wei Zi (Schisandrae Fructus), Xing Ren (Armeniacae Semen Amarum), Bei Mu (Fritillariae Bulbus), Jie Geng (Platycodonis Radix); for chronic cough with deficient sweating, add Bai Zhu (Atractylodis Macrocephalae Rhizoma), Shao Yao (Paeoniae Radix), Sheng Di Huang (Rehmanniae Radix), remove Jie Geng (Platycodonis Radix), Bei Mu (Fritillariae Bulbus), Xing Ren (Armeniacae Semen Amarum); for chronic cough with throat obstruction and unclear voice, add Bo He (Menthae Haplocalycis Herba), Sheng Di Huang (Rehmanniae Radix), Zi Wan (Asteris Radix), Zhu Li (Bambusae Succus), remove Bei Mu (Fritillariae Bulbus), Xing Ren (Armeniacae Semen Amarum), Wu Wei Zi (Schisandrae Fructus); for cough with much phlegm, add Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fei Cao (Boraginis Herba), remove Jie Geng (Platycodonis Radix), Huang Qin (Scutellariae Radix), Xing Ren (Armeniacae Semen Amarum); for cough with body heat, add Chai Hu (Bupleuri Radix); for cough with fever from afternoon to evening, add Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Sheng Di Huang (Rehmanniae Radix), Shao Yao (Paeoniae Radix), Zhu Li (Bambusae Succus), remove Huang Qin (Scutellariae Radix), Xing Ren (Armeniacae Semen Amarum); for cough with phlegm nodules and hypochondriac pain, add Bai Jie Zi (Sinapis Semen), Gua Lou (Trichosanthis Fructus), Zhi Shi (Aurantii Fructus Immaturus), Sha Ren (Amomi Fructus), Mu Xiang (Aucklandiae Radix), Xiao Hui Xiang (Foeniculi Fructus), Zhu Li (Bambusae Succus), Jiang Zhi (Zingiberis Rhizoma Recens Juice, small amount), remove Bei Mu (Fritillariae Bulbus), Xing Ren (Armeniacae Semen Amarum), Shan Zhi (Gardeniae Fructus), also add Chai Hu (Bupleuri Radix) as a guiding herb.
Food-stagnation cough: phlegm-cough like glue. Cough with chest/diaphragm knotting pain indicates phlegm nodulation. Morning cough indicates food stagnation in the stomach. Cough more in the first half of the day indicates latent fire in the stomach (the above four suit the following formulas. Gua Lou Zhi Shi Tang (Trichosanthes and Aurantium Decoction modified. See Phlegm-Fluids chapter).
Cough more from afternoon to night belongs to yin deficiency (evening cough more indicates floating fire, add slight cooling herbs). Fire-cough: sound but little phlegm, red face, body heat, rapid pulse. Dry cough without phlegm: phlegm-stagnation and fire-pathogen in the lung, difficult to treat. Consumptive cough: night sweats, much phlegm, alternating chills and fever, large and forceless rapid pulse (the above four are due to labor, internal injury from wine/sex, worry/anger, depression/stagnation, yin-deficiency fire-flaring causing cough, all suit the following formulas. Zi Yin Jiang Huo Tang (Nourish Yin and Descend Fire Decoction. See Deficiency and Emaciation chapter).
All chronic coughs not stopping (suit the following formula).
Lu Xi San (Reed Suction Powder) passed down from Lu Dongbin: Treats new and chronic coughs where hundred medicines fail, taking effect immediately.
Ingredients: Kuan Dong Hua (Farfarae Flos, stamens, 5 qian), E Guan Shi (Monimiæ Lignum, 2.5 qian), Chen Pi (Citri Reticulatae Pericarpium, 2.5 qian). For elderly and deficient, add Ren Shen (Ginseng Radix et Rhizoma, 5 fen); in winter add Rou Gui (Cinnamomi Cortex, 1.5 qian).
Avoid iron vessels, grind to fine powder, mix evenly, divide into seven doses, take over seven days. Each dose: lie supine at night, put one dose into a bamboo tube in three parts, hold tube near throat, inhale forcefully, swallow with one mouthful of warm water. Do not drink much water. Avoid oily foods and salt for seven days. After finishing medicine, use small amounts of oil/salt, no restrictions after half a month.
Xi Yao Xian Dan (Immortal Pill for Inhaling Medicine)
Ingredients: E Guan Shi (Monimiæ Lignum, 2 liang), Han Shui Shi (Stibis Mineral, 4.5 qian), Jin Xing Meng Shi (Calamina with Pyrite, 7 qian, treated with saltpeter and quenched in vinegar), Bai Fu Zi (Typhonii Rhizoma, 7 qian), Bai Fan (Alumen, 7 qian, calcined to 4.5 qian), Hai Er Cha (Child's Tea, 4 qian), Kuan Dong Hua (Farfarae Flos, clean stamens, 7 qian), Fen Gan Cao (Glycyrrhizae Radix et Rhizoma, 4 qian).
Grind each to powder, mill extremely fine, weigh, sieve through total strainer, mix evenly. If qi stagnation, add Chen Xiang (Aquilariae Lignum Resinatum, 5 fen), Mu Xiang (Aucklandiae Radix, 7 fen), Guan Gui (Cinnamomi Cortex, 7 fen); if subcardiac deficiency palpitations, add Zhu Sha (Cinnabar, 3 fen). Heat-cough taken with tea soup; cold-cough with ginger soup; cough resembling edema with Mugua (Chaenomelis Fructus) and Niu Xi (Achyranthis Bidentatae Radix) soup; cough with red phlegm/hemoptysis with Bai Jie Zi (Sinapis Semen) soup.
Song:
Two taels of Goose Tube Stone in immortal pill,
Green Mengshi, White Attusa, Farfara flower fill.
Seven qian each of the three, four qian licorice and child's tea,
Calcined alum and cold water stone, four and a half qia,
Eight ingredients refined precisely, do not err,
Six fen daily taken thrice by inhalation,
Cold with ginger soup, heat with tea,
Deficiency adds five fen agarwood, wood cinnamon,
Cough with fright/palpitations uses cinnabar,
Mint decoction for tidal heat,
Best for resolving phlegm and stopping cough.
Ji Ming Wan (Rooster-Crowing Pill): Treats men and women of any age for eighteen types of cough/hemoptysis and various deficiencies, efficacious as a spirit.
Eighteen types of cough since ancient times,
Due to evil qi entering the liver.
Chest/diaphragm cough often with panting,
Stomach cough has phlegm-fluids above diaphragm.
Large intestine cough involves triple burner heat,
Small intestine cough has dry tongue.
Wind-strike cough has itchy throat,
Gallbladder cough prevents night rest.
Liver-wind cough has throat obstruction,
Three Causes cough feels like climbing rapids.
Nighttime panting is heavy,
Lung cough has much phlegm, hard to pant/cough.
Heat cough has much blood connecting to heart pain,
Bladder cough has cold qi.
Sudden cough during day has much sweat,
Cold damage cough has cold phlegm/sourness.
These are true divine secrets,
Seek diligently the Rooster-Crowing Pill.
Ingredients: Zhi Mu (Anemarrhenae Rhizoma, 4 liang, stir-fried), Xing Ren (Armeniacae Semen Amarum, peeled/tipped, 2 qian), Jie Geng (Platycodonis Radix, removed rhizome, 5 qian), E Jiao (Colla Corii Asini, bran-fried, 4 qian), Ting Li (Lepidii Semen, baked on fire, 3 qian), Kuan Dong Hua (Farfarae Flos, 4 qian), Xuan Fu Hua (Inulae Flos, 1 liang), Ban Xia (Pinelliae Rhizoma, ginger-juice fried, 3 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 liang), Chen Pi (Citri Reticulatae Pericarpium, white pith removed, 1 liang), Dou Ling (Campanulae Fructus, 1 liang), Wu Wei Zi (Schisandrae Fructus, 4 qian), Ma Huang (Ephedrae Herba, 1 liang), Ren Shen (Ginseng Radix et Rhizoma, 5 qian).
Grind to fine powder, refine honey into pills like bullet size. Take one pill at fifth watch (3-5 AM), taken down with Wu Mei (Mume Fructus), Sheng Jiang (Zingiberis Rhizoma Recens), Zao (Jujubae Fructus) soup.
Generally, chronic coughs belong to kidney qi deficiency, fire flaring and water drying up, or fluids surging to become phlegm, caused by the true zang organs. Must use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) to strengthen kidney water and nourish the source as main treatment; Yi Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to nourish spleen earth and generate lung/kidney as assistant. Long-term use heals itself naturally. (See Tonification chapter).
Supplementary Prescriptions
Treat cough, lung萎 (withering), hemoptysis, panting urgency: Use one pig lung, hang upside down to drain blood/water. Use ten large radishes, mash. Use a new clay pot, five bowls of water, boil radishes until soft, filter dregs. Add four liang honey, ten egg whites (no yolks). Mix with honey, fill into lung. Add Kuan Dong Hua (Farfarae Flos), Wu Wei Zi (Schisandrae Fructus), He Zi (Chebulae Fructus, pitted, each 1 qian), Bai Fan (Alumen, 5 fen), all powdered. Mix powder into honey/egg white mixture, insert into lung trachea, cook thoroughly. Take on empty stomach, efficacy like a spirit.
Another prescription: One pig lung, wash clean. For each year of patient's age, use one almond (peeled/tipped). Pierce lung with bamboo skewer holes, place one almond in each hole, tie tightly with hemp. Place in porcelain vessel, steam-cook thoroughly. Remove almonds, eat only the lung. Mild cases use one lung; severe cases use two lungs for complete recovery.
Jia Wei Shang Qing Wan (Modified Upper-Clearing Pill): Treats cough with vexation-heat, clears voice/nourishes lung, opens diaphragm/resolves phlegm, generates fluids/stops thirst, refreshes qi/calms spirit.
Ingredients: Nan Bo He Ye (Menthae Haplocalycis Herba, 4 liang), Shi Shuang (Diospyros Frost, 4 liang), Xuan Ming Fen (Mirabilite, 5 qian), Peng Sha (Borax, 5 qian), Bing Pian (Borneolum Syntheticum, 5 fen), Han Shui Shi (Stibis Mineral, 5 qian), Wu Mei Rou (Mume Fructus Pulp, 5 qian), Bai Fen (Rice Flour, 8 liang).
Grind to fine powder, Gan Cao (Glycyrrhizae Radix et Rhizoma) water boiled into paste to form pills like Euryale Seed size. Take one pill, hold in mouth to dissolve, taken down with tea soup.
Xing Ren Jian (Almond Decoction/Syrup): Treats elderly with chronic panting/cough unable to sleep, takes effect immediately.
Ingredients: Xing Ren (Armeniacae Semen Amarum, water-soaked peeled/tipped, stir-fried), Hu Tao Ren (Juglandis Semen, peeled, equal parts).
Grind two ingredients into paste, add small amount of refined honey to form pills like bullet size. Take one pill, chew finely, taken down with ginger soup.
Treats phlegm-fire cough, also treats hemorrhoids from wine.
Ingredients: Bai Fan (Alumen, 1 liang, calcined), Kuang Duan Shi (Ferrum Oxidatum Rubrum, 1.5 liang).
Grind evenly, take 1 qian each time, with tea, boiling water, or wine. If making pills, mix with ash-flour (1 liang) and cold water into pills like Sophora Seed size. Take 25 pills each time, taken down with previous guides.
Qing Shang Qin Hua Wan (Upper-Clearing Holding Pill): Clears fire/resolves phlegm, stops cough/calms panting.
Ingredients: Gua Lou Shuang (Trichosanthis Fructus Frost), Tian Men Dong (Asparagi Radix, remove core), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Ku Qin (Scutellariae Radix, remove rotten, wine-fried), Hai Shi (Fossilia Skeletum Depolymerizatum), Shi Shuang (Diospyros Frost, each 1 liang), Jie Geng (Platycodonis Radix, remove rhizome), Lian Qiao (Forsythiae Fructus), Xuan Shen (Scrophulariae Radix), Qing Dai (Indigo Naturalis, each 5 qian), Feng Hua Xiao (Natrii Sulfas Efflorescens, 3 qian).
Grind to fine powder, refine honey into pills like Longan size, hold in mouth to dissolve long after meals.
Lord Kunhu of Haiyang, Prince of Zhou Branch, suffered from phlegm-cough, panting, and heat, with left foot swelling/pain, lighter by day, heavier by night. Occurred once or twice yearly for thirty years, all treatments failed. I diagnosed left pulse slightly rapid, right pulse wiry-rapid, indicating blood deficiency with damp-phlegm. Used Si Wu Tang (Four Substances Decoction) plus Cang Zhu (Atractylodis Rhizoma), Huang Bo (Phellodendri Cortex), Mu Gua (Chaenomelis Fructus), Bing Lang (Arecae Semen), Mu Tong (Akebiae Caulis), Ze Xie (Alismatis Rhizoma), taken on empty stomach to treat lower origin; used Fu Ling Bu Xin Tang (Poria Decoction to Nourish the Heart) before bed to treat upper jiao. Three doses cured. Later used Shen Xian Fei Bu Wan (Immortal Flying Step Pill) on empty stomach, Qing Qi Hua Tan Wan (Clear Qi Resolve Phlegm Pill) before bed, one supply each, never recurred.
A scholar suffered spring cough, healed using Shen Su Yin (Ginseng and Perilla Decoction) type. Relapsed later, used same medicine, resulted in hoarseness, left Chi pulse flooding-rapid but forceless. I considered kidney meridian yin-fire attacking lung metal. Used Liu Wei Wan (Six-Ingredient Pill) material plus Mai Men Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Fructus), stir-fried Shan Zhi (Gardeniae Fructus), healed with Yi Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).