嗽与咳，一证也。后人或以嗽为阳，咳为阴，亦无考据。且《内经·咳论》一篇
，纯说嗽也，其中无咳字。由是言之，咳即嗽也，嗽即咳也。《阴阳应象大论》云∶秋伤于湿，冬
生咳嗽，又《五脏生成篇》云∶咳嗽上气。又《诊要经终》云∶春刺秋分，环为咳嗽。又《示从
容篇》云∶咳嗽烦冤者，肾气之逆也。《素问》惟以四处连言咳嗽，其余篇中，止言咳，不言嗽。乃知咳
嗽一证也。或言嗽为别一证，如《伤寒》书中说咳逆，即咽中作梯磴之声者是也。此一说，非《
内经》止以嗽为咳。《生气通天论》云∶秋伤于湿，上逆而咳。《应象大论》文义同，而无嗽字，乃
知咳即是嗽明矣！余所以苦论此者。孔子曰∶必也正名乎？
嗽之为病，自古归之肺，此言固不易也。《
素问》言∶肺病，喘咳逆。又曰∶咳嗽上气，厥在胸中，过在手太阴阳明。《灵枢》十二经
，惟太阴肺经云∶肺胀满，膨膨而喘咳，他经则不言。《素问·咳论》，虽言五脏六腑皆有咳，要之
止以肺为主。《素问》言∶皮毛者，肺之合也。皮毛先受邪气。注云∶邪为寒气。《经》又曰∶邪
气以从其合也。其寒饮食入胃，从脾脉上至于肺则肺寒，肺寒则内外合邪，因而客之，则为肺咳。
后人见是言，断嗽为寒，更不参较他篇。岂知六气皆能嗽人？若谓咳止为寒邪，何以“岁火太过
，炎暑流行，金肺受邪，民病咳嗽”？岁木不及，心气晚治，上胜肺金，咳而鼽。从革之纪，
金不及也，其病嚏咳。坚成之纪，金太过也，上征与正商同，其病咳。少阳司天，火气下临，
肺金上从，咳、嚏、衄。少阳司天，火淫所胜，咳、唾血、烦心。少阳司天，主胜则胸满
咳。少阳司天之气，热郁于上，咳逆、呕吐。三之气，炎暑至，民病咳、呕。终之气，阳气不藏而咳
。少阳之复，枯燥烦热，惊 咳衄，甚则咳逆而血泄。少阴司天，热气生于上，清气生于下，寒
热凌犯而生于中，民病咳、喘。三之气，天政布，大火行，余火内格，肿于上咳喘，甚则血
溢。少阴司天，客胜则鼽嚏，甚则咳喘。少阴之复，燠热内作，气动于左，
上行于右，咳，皮肤痛，则入肺，咳而鼻渊。若此之类，皆生于火与热也。岂可专于寒乎？
谓咳止于热与火耶
？厥阴司天，客胜则耳鸣掉眩，甚则咳。若此之类，乃生于风。岂可专于热与火也？
谓咳专于
风耶？太阴司天，湿淫所胜，咳唾则有血，太阴之复，湿变乃举，饮发于中，咳喘有声。若
此之类，乃生于湿。岂可专于风也？
谓咳止于湿耶？金郁之发，民病咳逆，心胁痛，岁金太
过，燥气流行，肝木受邪，民病咳喘逆，逆甚而呕血。阳明司天，金火合德，民病咳嗌塞。
阳明司天，燥淫所胜，咳，腹中鸣。阳明司天，清复内余，则咳、衄、嗌塞，心膈中热。咳
不止而目血出者死。阳明之胜，清发于中，溢塞而咳。阳明之复，清气大举，咳哕烦心。若此之
类，皆生于燥，岂可专于湿也？
谓咳止于燥耶？太阳司天，客气胜则胸中不利，出清涕，感
寒则咳。若此之类，乃生于寒。岂可专于燥也？
又肺风之状，多汗恶风，色
然白，时咳短气，昼日则瘥，夜幕则甚，亦风咳也。劳风，咳出青黄涕，其状如脓，大如弹丸，亦风咳也
。有所亡失，所求不得，则发肺鸣，鸣则肺热叶焦，亦热咳也。阳明厥逆，喘咳身热，亦热
咳也。一阳发病，少气善咳，亦火咳也。喘咳者，水气并于阳明，亦湿咳也。风水不能正偃
则咳，亦湿咳也。肾气腹大胫肿，喘咳身重，亦湿咳也。脾痹者，四肢懈堕，发咳呕汁，上
为大寒，亦寒咳也。咳之六气，固然可以辨其六者之状。
风乘肺者，日夜无度，汗出头痛，涎痰不利，非风咳之云乎？
热乘肺者，急喘而嗽，面赤潮热，手足寒，乳子亦多有之，非暑咳之云乎？
火乘肺者，咳喘上壅，涕唾出血，甚者七窍血溢，非火咳之云乎？
燥乘肺者，气壅不利，百节内痛，头面汗出，寒热往来，皮肤干枯，细疮燥痒，大便秘涩，
涕唾稠粘，非燥咳之云乎？
寒乘肺者，或因形寒饮冷，冬月坐卧湿地，或冒冷风寒，秋冬水中感之，嗽急而喘，非寒咳之云乎？
其法治也，风之嗽，治以通圣散加半夏、大人参半夏丸，甚者汗之；暑之嗽，治以白虎汤、
洗心散、凉膈散，加蜜一匙为呷之；火之嗽，治以黄连解毒汤、洗心散、三黄丸，甚者加以咸
寒大下之；湿之嗽，治以五苓散、桂苓甘露散及白术丸，甚者以三花神佑丸下之；燥之嗽，治以
木香葶苈散、大黄黄连阿胶丸，甚者以咸寒大下之；寒之嗽，治以宁神散、宁肺散，有寒痰在
上者，以瓜蒂散越之。此法虽已几于万全，然老幼强弱，虚实肥瘦不同，临时审定权衡可也。
病有变态，而吾之方，亦与之俱变，然则枯矾、干姜、乌梅、罂粟壳，其误人也，不为少矣
！呜呼！有人自幼咳嗽，至老不愈而亦不死者，余平生见此等无限。或小年咳嗽，不计男女，不数
月而殒者，亦无限矣！夫宁神、宁肺散，此等之人，岂有不曾服者哉？其不愈而死者，以其
非寒嗽故也。彼执款冬花、佛耳草，至死不移者，虽与之割席而坐可也。曹魏时，军吏李成，苦
咳嗽，昼夜不寐，时吐脓血，华佗以谓“咳之所吐，非从肺来”，以苦剂二钱匕，吐脓血二升余
而瘥。若此之嗽，人不可不知也。
咳嗽与咳，属于同一证候。后人有的将嗽归为阳，咳归为阴，但这都没有考证依据。而且《内经·咳论》一篇，纯粹论述的是嗽，其中并没有“咳”字。由此而言，咳就是嗽，嗽就是咳。《阴阳应象大论》说：“秋季感受湿邪，冬季产生咳嗽”，又《五脏生成篇》说：“咳嗽气逆”。又《诊要经终》说：“春季针刺秋分时节对应的穴位，会导致环跳部位疼痛并引发咳嗽”。又《示从容篇》说：“咳嗽烦闷不安的，是肾气上逆所致”。《素问》只在四处连用“咳嗽”一词，其余篇章中，只说“咳”，不说“嗽”。由此可知，咳嗽是一个证候。有人说嗽是另一个独立的证候，如《伤寒》书中说的“咳逆”，即咽喉中发出阶梯般声音的那种情况。这种说法，并非《内经》仅以嗽作为咳。《生气通天论》说：“秋季感受湿邪，气机上逆而咳”。《应象大论》文义相同，但没有“嗽”字，由此可知咳即是嗽是很明确的！我之所以苦苦论证这一点，是因为孔子说：“一定要纠正名分吗？”
嗽这一病症，自古以来都归属于肺，这种说法固然不可改变。《素问》说：“肺病，表现为喘、咳、气逆”。又说：“咳嗽气逆，厥气在胸中，病变涉及手太阴肺经和手阳明大肠经”。《灵枢》十二经脉中，只有太阴肺经说：“肺胀满，膨膨胀满而喘咳”，其他经脉则没有提及。《素问·咳论》，虽然说到五脏六腑都有咳，但总之还是以肺为主。《素问》说：“皮毛是肺的外合。皮毛先受邪气。”注解说：“邪气指寒气”。《内经》又说：“邪气顺着其相合的部位侵入”。如果寒凉饮食进入胃中，通过脾脉上行至肺，则肺受寒，肺寒则内外邪气相合，因而客居于肺，就成为肺咳。后人见到这些言论，便断定嗽都是寒邪所致，不再参考其他篇章。哪里知道六气都能使人咳嗽？如果说咳仅仅是寒邪所致，为什么会有“岁火太过，炎暑流行，金肺受邪，百姓患病咳嗽”的情况？岁木不及，心气治疗滞后，上胜肺金，导致咳嗽和鼻渊。从革之纪，金气不足，其病症为打喷嚏和咳嗽。坚成之纪，金气太过，上与征（火）气和正商（金）气相同，其病症为咳嗽。少阳司天，火气下行，肺金顺从，出现咳嗽、打喷嚏、鼻衄。少阳司天，火气淫盛，出现咳嗽、唾血、心烦。少阳司天，主气胜则胸满咳嗽。少阳司天的气候，热气郁结于上，出现咳嗽气逆、呕吐。三之气，炎暑到来，百姓患病咳嗽、呕吐。终之气，阳气不收藏而咳嗽。少阳之复，枯燥烦热，惊悸咳嗽鼻衄，严重时咳嗽气逆且出血。少阴司天，热气生于上，清气生于下，寒热交争而生于中，百姓患病咳嗽、气喘。三之气，天政布散，大火运行，余火内格，肿于上导致咳嗽气喘，严重时出血。少阴司天，客气胜则鼻渊打喷嚏，严重时咳嗽气喘。少阴之复，燠热内生，气动于左侧，上行于右侧，咳嗽，皮肤痛，则入肺，咳嗽且鼻渊。像这类情况，都生于火与热。怎么能专门归于寒呢？如果说咳仅仅在于热与火呢？厥阴司天，客气胜则耳鸣眩晕，严重时咳嗽。像这类情况，乃生于风。怎么能专门归于热与火呢？如果说咳仅仅在于风呢？太阴司天，湿气淫盛，咳嗽唾血，太阴之复，湿变兴起，饮邪发于中，咳嗽气喘有声。像这类情况，乃生于湿。怎么能专门归于风呢？如果说咳仅仅在于湿呢？金郁之发，百姓患病咳嗽气逆，心胁痛，岁金太过，燥气流行，肝木受邪，百姓患病咳嗽气喘气逆，气逆严重则呕血。阳明司天，金火合德，百姓患病咳嗽咽喉阻塞。阳明司天，燥气淫盛，咳嗽，腹中鸣响。阳明司天，清气复返内留，则咳嗽、鼻衄、咽喉阻塞，心膈中热。咳嗽不止且目血出者死。阳明之胜，清气发于中，溢塞而咳嗽。阳明之复，清气大举，咳嗽呃逆心烦。像这类情况，皆生于燥，怎么能专门归于湿呢？如果说咳仅仅在于燥呢？太阳司天，客气胜则胸中不利，流出清涕，感受寒邪则咳嗽。像这类情况，乃生于寒。怎么能专门归于燥呢？
另外肺风的症状，多汗恶风，面色苍白，时常咳嗽短气，白天减轻，夜晚加重，这也是风咳。劳风，咳出青黄色的鼻涕，状如脓液，大如弹丸，也是风咳。有所丧失，所求不得，则导致肺鸣，鸣则肺热叶焦，也是热咳。阳明厥逆，喘咳身热，也是热咳。一阳发病，少气善咳，也是火咳。喘咳者，水气并于阳明，也是湿咳。风水不能仰卧则咳嗽，也是湿咳。肾气病腹部肿大小腿肿胀，喘咳身重，也是湿咳。脾痹者，四肢懈怠堕废，发作咳嗽呕汁，上部为大寒，也是寒咳。咳之六气，固然可以通过辨别这六种状况来区分。
风邪乘袭肺脏，日夜无度，出汗头痛，涎痰不利，这不是风咳是什么？热邪乘袭肺脏，急促喘息而嗽，面赤潮热，手足寒冷，乳母也多有此病，这不是暑咳是什么？火邪乘袭肺脏，咳嗽气喘上壅，涕唾出血，严重者七窍出血，这不是火咳是什么？燥邪乘袭肺脏，气机壅滞不利，全身关节内部疼痛，头面出汗，寒热往来，皮肤干枯，细小疮疡干燥瘙痒，大便秘涩，涕唾稠粘，这不是燥咳是什么？寒邪乘袭肺脏，或因形体受寒饮水冷，冬天坐卧湿地，或冒犯冷风寒，秋冬水中感受，咳嗽急迫而喘，这不是寒咳是什么？
其治疗方法如下：风之嗽，用通圣散加半夏、大人参半夏丸治疗，严重的发汗；暑之嗽，用白虎汤、洗心散、凉膈散，加蜜一匙慢慢服用；火之嗽，用黄连解毒汤、洗心散、三黄丸治疗，严重的加以咸寒药物大力攻下；湿之嗽，用五苓散、桂苓甘露散及白术丸治疗，严重的用三花神佑丸攻下；燥之嗽，用木香葶苈散、大黄黄连阿胶丸治疗，严重的用咸寒药物大力攻下；寒之嗽，用宁神散、宁肺散治疗，有寒痰在上部的，用瓜蒂散涌吐。这种方法虽然已经近乎万全，然而老幼强弱、虚实肥瘦不同，需临时审定权衡即可。病情有变化，我们的方剂也随之变化，然而枯矾、干姜、乌梅、罂粟壳，这些误人的药方，造成的危害不少了！唉！有人自幼咳嗽，到老不愈也不死的，我平生见此等无数。也有少年咳嗽，不论男女，几个月就死亡的，也是无数啊！那宁神散、宁肺散，这类人，难道不曾服用过吗？那些不愈而死的，是因为他们不是寒嗽的缘故。那些执着于款冬花、佛耳草，至死不改变观点的人，即使与他们割席而坐都可以。曹魏时期，军吏李成，苦于咳嗽，昼夜不眠，时常吐出脓血，华佗认为“咳吐出的东西，不是从肺来的”，用苦剂二钱匕，吐出脓血二升多而痊愈。像这样的咳嗽，人们不可不知道。
Cough (sou) and coughing (ke) constitute a single syndrome. Later generations sometimes classified sou as Yang and ke as Yin, but this lacks evidentiary basis. Moreover, the chapter "Ke Lun" (Treatise on Cough) in the *Neijing* exclusively discusses sou, without using the character ke. Therefore, ke is sou, and sou is ke. The *Yin Yang Ying Xiang Da Lun* states: "Injury by dampness in autumn leads to cough in winter." The *Wu Zang Sheng Cheng Pian* states: "Cough with rebellious Qi." The *Zhen Yao Jing Zhong Pian* states: "Acupuncture at the Autumn Equinox point in spring may cause pain around the Huan Tiao acupoint and induce cough." The *Shi Cong Rong Pian* states: "Cough accompanied by vexation and resentment is due to rebellious Kidney Qi." In the *Suwen*, the term "cough" (kesou) appears together only four times; in other chapters, only "ke" is mentioned, not "sou". Thus, it is known that cough constitutes a single syndrome. Some argue that sou is a distinct syndrome, such as the "rebellious cough" described in the *Shanghan* texts, characterized by a ladder-like sound in the throat. This view contradicts the *Neijing*, which does not distinguish sou from ke. The *Sheng Qi Tong Tian Lun* states: "Autumn injury by dampness causes rebellious Qi leading to cough." The *Ying Xiang Da Lun* has similar meaning but omits the character sou, confirming clearly that ke is indeed sou. I have labored to discuss this because Confucius said: "Must rectification of names be undertaken first?"
The disease of cough has traditionally been attributed to the Lung, an assertion that remains unchangeable. The *Suwen* states: "Lung disease manifests as wheezing, cough, and rebellious Qi." It also says: "Cough with rebellious Qi involves rebellion in the chest, affecting the Hand Taiyin and Hand Yangming meridians." Among the twelve meridians in the *Lingshu*, only the Taiyin Lung Meridian mentions: "Lung distension, fullness, and wheezing cough"; other meridians do not mention this. Although the *Suwen · Ke Lun* states that all five Zang and six Fu organs can suffer from cough, the Lung remains primary. The *Suwen* states: "The skin and hair are the exterior correspondence of the Lung. Pathogenic factors first invade the skin and hair." The commentary notes: "Pathogen refers to cold qi." The classics further state: "Pathogens enter via their corresponding exterior." If cold food and drink enter the Stomach, they travel up the Spleen meridian to the Lung, causing Lung cold. When internal and external pathogens combine and lodge in the Lung, it results in Lung cough. Later practitioners, seeing these statements, concluded that cough is solely caused by cold, ignoring other chapters. They failed to realize that all six climatic factors can cause cough. If cough were only due to cold pathogen, how could we explain cases where "excessive Fire year, prevalent heat and summer heat, injure Metal and Lung, causing people to suffer from cough"? Or when Wood deficiency allows Heart Qi to lag, allowing Upper Jiao to overcome Lung Metal, resulting in cough and nasal obstruction? In the Cong Ge cycle, Metal deficiency leads to sneezing and cough. In the Jian Cheng cycle, Metal excess leads to cough. When Shaoyang governs the year, Fire descends, Lung Metal follows, causing cough, sneezing, and epistaxis. With Shaoyang governance and excessive Fire, symptoms include cough, hemoptysis, and heart vexation. With Shaoyang governance and dominant win, chest fullness and cough occur. Shaoyang climate causes heat stagnation above, leading to cough, rebellious Qi, and vomiting. During the third period, intense heat arrives, causing cough and vomiting. At the final period, failure of Yang Qi to store leads to cough. In Shaoyang recurrence, dryness and vexatious heat cause palpitations, cough, and epistaxis; severe cases involve rebellious cough with hemorrhage. When Shaoyin governs, heat arises above, cold air below, and cold-heat conflict in the middle, causing cough and wheezing. During the third period, heavy fire spreads, residual fire blocks internally, swelling above leads to cough and wheezing, potentially hemorrhage. With Shaoyin governance and victorious guest pathogen, nasal obstruction and sneezing occur, progressing to cough and wheezing. In Shaoyin recurrence, internal heat moves Qi from the left to the right, causing cough, skin pain, lung involvement, and rhinitis. Such cases arise from Fire and Heat. How can one attribute them solely to Cold? If cough were only due to Heat and Fire, consider Jueyin governance: victorious guest pathogen causes tinnitus, dizziness, and severe cough. These arise from Wind. How can one attribute them solely to Heat and Fire? If cough were only due to Wind, consider Taiyin governance: excessive Dampness causes cough with bloody sputum. In Taiyin recurrence, Dampness transforms, fluid retention occurs internally, causing cough and wheezing with sounds. These arise from Dampness. How can one attribute them solely to Wind? If cough were only due to Dampness, consider Metal depression onset: people suffer cough, rebellious Qi, and costal pain. Excessive Metal year brings Dryness, injuring Liver Wood, causing cough, wheezing, rebellious Qi, and severe vomiting of blood. When Yangming governs, Metal and Fire combine, causing cough and throat obstruction. With Yangming governance and excessive Dryness, cough and borborygmus occur. With Yangming governance and returning clear Qi remaining internally, cough, epistaxis, throat obstruction, and chest heat occur. Persistent cough with eye bleeding indicates death. Yangming victory causes clear Qi to emerge internally, leading to blockage and cough. Yangming recurrence sees abundant clear Qi, causing cough, hiccups, and heart vexation. These arise from Dryness. How can one attribute them solely to Dampness? If cough were only due to Dryness, consider Taiyang governance: victorious guest pathogen causes chest discomfort, clear nasal discharge, and cough upon cold exposure. These arise from Cold. How can one attribute them solely to Dryness?
Furthermore, Lung Wind presents with profuse sweating, aversion to wind, pale complexion, intermittent cough and shortness of breath, improving during the day and worsening at night; this is Wind cough. Lao Feng (Labor-induced Wind) presents with coughing up green-yellow sputum resembling pus, size of a pill; this is also Wind cough. Loss or unfulfilled desires cause Lung resonance, leading to Lung heat and scorched lung leaves; this is Heat cough. Yangming reversal causes wheezing, cough, and fever; this is Heat cough. Onset of One Yang causes shortness of breath and frequent coughing; this is Fire cough. Wheezing and cough due to Water Qi combining with Yangming is Damp cough. Feng Shui (Wind-Water) inability to lie flat causes cough; this is Damp cough. Kidney Qi disease with abdominal distension, leg edema, wheezing, cough, and heaviness is Damp cough. Pi Bi (Spleen Obstruction) with flaccid limbs, coughing with vomit, and upper body cold is Cold cough. The six types of cough can indeed be distinguished by their respective presentations.
When Wind attacks the Lung, there is relentless coughing day and night, sweating, headache, and difficult expectoration of phlegm; is this not Wind cough? When Heat attacks the Lung, there is rapid wheezing and coughing, red face, tidal fever, and cold hands and feet, common in nursing mothers; is this not Summer-Heat cough? When Fire attacks the Lung, there is coughing, wheezing, upward congestion, bloody sputum, and in severe cases, bleeding from the seven orifices; is this not Fire cough? When Dryness attacks the Lung, there is Qi stagnation, internal joint pain, sweating on head and face, alternating chills and fever, dry skin, small itchy sores, constipation, thick sticky sputum; is this not Dryness cough? When Cold attacks the Lung, due to physical cold exposure, cold drinks, sitting/lying on wet ground in winter, or exposure to cold wind/water in autumn/winter, there is urgent coughing and wheezing; is this not Cold cough?
Treatment methods are as follows: For Wind cough, use Tongsheng San added with Banxia and Daren Shen Banxia Wan; for severe cases, induce sweating. For Summer-Heat cough, use Baihu Tang, Xi Xin San, Liangge San, taken with honey. For Fire cough, use Huanglian Jiedu Tang, Xi Xin San, Sanhuang Wan; for severe cases, use salty-cold purgatives strongly. For Damp cough, use Wuling San, Guiling Ganlu San, and Baizhu Wan; for severe cases, use Sanhua Shenyao Wan to purge. For Dryness cough, use Muxing Tingli San, Dahuang Huanglian Ejiao Wan; for severe cases, use salty-cold purgatives strongly. For Cold cough, use Ningshen San and Ningfei San; if cold phlegm is in the upper jiao, use Guiti San to induce vomiting. Although this method is nearly comprehensive, patients vary in age, strength, deficiency/excess, and constitution, requiring flexible adjustment. Diseases change, and formulas must change accordingly. However, the misuse of drugs like Kufan, Ganjiang, Wumei, and Yingsuke has caused significant harm. Alas! I have seen countless cases of lifelong chronic cough that did not lead to death, and countless cases of acute cough in youth leading to death within months. Have these patients not taken Ningshen San or Ningfei San? Those who died did not recover because their condition was not Cold cough. Those who stubbornly persist with Kuandonghua and Erercao until death deserve to be shunned. During the Cao Wei period, military officer Li Cheng suffered from severe cough, insomnia, and expectoration of pus and blood. Hua Tuo stated, "The material coughed up does not originate from the Lung," and prescribed a bitter emetic (2 qian bi), resulting in the expulsion of over 2 sheng of pus and blood, leading to recovery. Such cases of cough must be understood.