获效。若频愈频发,此根于中而深者矣,岂标药所能治乎?宜早服六味丸以滋肾,午服
六君子以补脾,则标本俱顾,不治嗽而嗽自愈也。咳而膺乳痛,即看痰色如何?若浓浊
则脓,或黄,或赤,即从肺痿肺痈治。以脉数而虚者,为肺痿,脉数而实者,为肺痈。
久嗽必用熏法,用款花以鸡子清和蜜拌润款花,入有嘴壶中烧,以有口壶嘴,吸烟
咽之。若中塞须举起头,以指捻住烟,少顷再吸。五日一次,至六日饱食羊肉馄饨,
妙。肺与大肠为表里。若火郁于腑,肺气不得下降,因而咳多,大便闭涩,而脉沉实滑
数者,大柴胡汤下之,或用竹沥姜汤下,王隐君滚痰丸。
令醋呛喉,哮嗽不止,诸药不效者,甘胆丸妙。用甘草(去皮)二两,作三段劈
开,用猪胆五个浸三日取出,火上炙干,为末,蜜丸,每服四五十丸,临卧茶清送下。
肺主皮毛,平人荣卫周流,内气自皮肤腠理宣达于外,卫护一身,一为风寒外束,
内气不畅,变从中起,所以气升痰上而为咳嗽,必从辛散,内郁自宽,邪退正安,而嗽
自止,且肺为华盖,性最清肃,倘饥饱劳役,七情内伤,则浊阴上升,或酒肉膏粱,
炙爆浓味,则湿热上蒸,肺不得宁静,皆令为咳。夫肺主气,营运血液,周润一身,今
肺受邪迫,气从火化,液变为痰,有升无降,气血日衰,成为痨瘵,治者寻源,用药
对症无瘥,方可望其功成勿毁也,若以古载五脏六腑之咳,分门求治,则反有歧路亡羊之叹!
咳嗽之脉,浮风紧寒,数热细湿,房劳涩难,右关濡者,饮食伤脾,左关弦短,疲
极肝伤,浮短伤肺,法当咳嗽,洪滑多痰,弦涩少血,脉出上鱼,逆气喘急,浮直而濡
者,易治。上气喘急而浮肿,身抬胸扇,脉浮大者,死。久嗽脉弱者,可治,实大数
者,死。咳而脱形,身热脉小,坚急而疾,是逆也,不过十日死,咳嗽羸瘦,脉形坚大
者,死。咳嗽脉沉紧者,死。浮软者,生。沉小伏匿者死,咳而呕,腹满泄,弦急欲绝
者,死。《经》曰∶荣气之行常与卫气相随,久嗽损气,则血亦不足,液化为痰,真阴日
亏,所以久嗽必成痨。
获得疗效。如果频繁痊愈又频繁复发,这是病根在中焦且深重的表现,难道仅靠治标的药物能够治愈吗?应当早晨服用六味丸以滋补肾阴,中午服用六君子汤以补益脾气,这样就能兼顾标本,不直接治疗咳嗽而咳嗽自然痊愈。
咳嗽伴有胸膺部及乳房疼痛,此时需观察痰液的颜色性状。如果痰液浓浊,则是脓痰;或者呈黄色,或者呈红色,就按照肺痿、肺痈来治疗。脉象数而虚的,属于肺痿;脉象数而实的,属于肺痈。
久咳必须使用熏蒸疗法。用款冬花与鸡蛋清和蜂蜜拌匀润湿款冬花,放入有嘴的壶中燃烧,通过有口的壶嘴吸入烟雾咽下。如果感觉咽喉堵塞,须抬起头,用手指捏住烟流,片刻后再吸。每五日进行一次,到第六天饱食羊肉馄饨,效果奇妙。肺与大肠互为表里。如果火邪郁结于腑,肺气不能下降,因而咳嗽增多,大便闭结涩滞,且脉象沉实滑数的,用大柴胡汤攻下,或者用竹沥姜汤攻下,也可用王隐君的滚痰丸。
因醋呛入喉咙,导致哮嗽不止,各种药物无效的情况,甘胆丸效果奇妙。取甘草(去皮)二两,切成三段劈开,用五个猪胆浸泡三天后取出,在火上烤干,研为细末,用蜂蜜制成丸药,每次服用四五十丸,临睡前用茶汁送服。
肺主皮毛,普通人营卫之气周流全身,内气自然从皮肤腠理宣发达于体表,护卫一身。一旦遭受风寒外束,内气运行不畅,病变从中而起,所以气机上逆、痰涎上涌而导致咳嗽,必须采用辛散的方法,使内郁之气得以宽舒,邪气退去正气安宁,咳嗽自然停止。况且肺为华盖,性质最喜清肃,如果饥饱失常、劳役过度,或七情内伤,则浊阴之气上升;或者饮酒吃肉、膏粱厚味、炙烤爆炒及浓烈味道,则湿热上蒸,肺不得宁静,都会导致咳嗽。肺主气,营运血液,周润全身,如今肺受邪气逼迫,气随火化,津液变为痰,只有升没有降,气血日渐衰败,形成痨瘵。治疗者寻找病源,用药对症无误,才可以期望功成而不毁败。如果按照古籍记载的五脏六腑之咳,分门别类求治,反而会有歧路亡羊的叹息!
咳嗽的脉象:浮脉主风,紧脉主寒,数脉主热,细脉主湿,房劳过度致脉涩难,右关脉濡弱的,是饮食损伤脾胃;左关脉弦短的,是疲劳至极损伤肝脏;浮短脉伤肺,法当咳嗽;洪滑脉多痰,弦涩脉少血;脉出鱼际,逆气喘急;浮直而濡的,容易治疗。上气喘急而浮肿,身体抬举胸部扇动,脉象浮大的,预后不良(死证)。久咳脉象虚弱的,可治;脉象实大数的,预后不良(死证)。咳嗽且形体脱失,身体发热脉小,脉象坚急而疾速的,这是逆证,不超过十天死亡;咳嗽羸瘦,脉形坚大的,预后不良(死证)。咳嗽脉象沉紧的,预后不良(死证)。脉象浮软的,可生。脉象沉小伏匿的,预后不良(死证);咳嗽且呕吐,腹部胀满泄泻,脉象弦急欲绝的,预后不良(死证)。《内经》说:营气的运行常与卫气相随,久咳损伤气,则血也不足,津液化为痰,真阴日渐亏损,所以久咳必然形成痨病。
Obtain efficacy. If recovery is frequent but relapses are also frequent, this indicates that the root cause lies in the middle jiao and is deep-seated; how can it be treated merely by symptomatic remedies? It is advisable to take Liuwei Wan (Six-Ingredient Pill with Rehmannia) in the morning to nourish Kidney Yin, and Liujunzi Tang (Six-Gentlemen Decoction) at noon to tonify Spleen Qi. In this way, both the root and branch are addressed, and cough will resolve spontaneously without direct treatment for it.
If cough is accompanied by pain in the chest and breasts, observe the color and consistency of the sputum. If the sputum is thick and turbid, it indicates pus; if yellow or red, treat according to Fei Wei (Lung Atrophy) or Fei Yong (Lung Abscess). A rapid and deficient pulse indicates Fei Wei (Lung Atrophy); a rapid and excess pulse indicates Fei Yong (Lung Abscess).
For chronic cough, fumigation therapy must be used. Mix Donghua (Flos Cum Bud of Kolkwitzia amabilis / Flos Sonchus arvensis - *Note: Kuandonghua usually refers to Flos Sonchus arvensis or Adenophora*, here translated as Flos Sonchus/Adenophora Flower) with egg white and honey to moisten it, place it in a pot with a spout, burn it, and inhale the smoke through the spout, swallowing it. If there is blockage in the throat, raise the head, pinch the smoke stream with fingers, wait a moment, then inhale again. Perform this once every five days; on the sixth day, eat mutton wontons to satiety for excellent results. The Lung and Large Intestine are exterior-interior paired organs. If fire stagnates in the fu organs, Lung Qi cannot descend, leading to increased cough, constipation, and a deep, excess, slippery, and rapid pulse. Use Da Chaihu Tang (Major Bupleurum Decoction) to purge, or use Zhuli Jiang Tang (Bamboo Sap and Ginger Decoction) to purge, or Wang Yinjun's Guntan Wan (Rolling Phlegm Pill).
For wheezing cough unrelenting due to vinegar irritating the throat, where various medicines fail, Gandan Wan (Licorice and Pig Gallbladder Pill) is effective. Take two liang of Licorice Root (Gancao, Glycyrrhizae Radix et Rhizoma), peeled and cut into three sections. Soak five pig gallbladders for three days, remove them, dry them over fire, grind into powder, make pills with honey. Take 40-50 pills each time, swallowed with tea water before bed.
The Lung governs the skin and hair. In healthy individuals, Ying and Wei Qi circulate throughout the body, and internal Qi naturally disseminates outward from the skin and interstices to protect the whole body. Once bound by external Wind-Cold, internal Qi flow becomes obstructed, and pathology arises internally. Thus, Qi rises and Phlegm ascends, causing cough. It must be treated with acrid dispersants so that internal stagnation is relieved, pathogens retreat, Zheng Qi (Upright Qi) is secured, and cough stops. Moreover, the Lung is the "Canopy" (Hua Gai) and its nature is most pure and descending. If irregular eating or excessive labor occurs, or if Seven Emotions cause internal injury, turbid Yin Qi rises. Or, if one consumes alcohol, meat, rich foods, roasted/fried items, or strong flavors, Damp-Heat steams upward. The Lung loses tranquility, all leading to cough. The Lung governs Qi and circulates Blood, moistening the whole body. Now, if the Lung is constrained by pathogens, Qi transforms via Fire, fluids transform into Phlegm, there is ascending but no descending, Qi and Blood decline daily, forming Lao Zhai (Consumption/Tuberculosis). The practitioner must seek the source, prescribe accurately, and only then can success be hoped for without failure. If one treats according to the ancient classification of Coughs of the Five Zang and Six Fu organs, seeking treatment by category, it leads to the lament of "losing the sheep due to diverging paths"!
Regarding the pulse of cough: Floating indicates Wind, Tight indicates Cold, Rapid indicates Heat, Fine indicates Dampness, Slippery/Difficult indicates sexual exhaustion. A soggy pulse at the Right Guan position indicates dietary injury to the Spleen; a wiry and short pulse at the Left Guan position indicates extreme fatigue injuring the Liver; Floating and Short pulses injure the Lung, indicating cough is likely; Full and Slippery pulses indicate much Phlegm; Wiry and Choppy pulses indicate little Blood; Pulse emerging to the Yuji area (radial artery extending beyond the styloid process) with rebellious Qi and急促 panting; Floating, straight, and soggy pulses are easy to treat. Rebellious Qi with panting and edema, body lifting and chest heaving, with a Floating and Large pulse, indicates death. Chronic cough with a Weak pulse is treatable; an Excess, Large, and Rapid pulse indicates death. Cough with emaciation, body heat, and Small, firm, rapid pulse is a counter-indication (Ni), death within ten days. Cough with emaciation and a Firm, Large pulse shape indicates death. Cough with a Deep and Tight pulse indicates death. A Floating and Soft pulse indicates survival. A Deep, Small, and Hidden pulse indicates death. Cough with vomiting, abdominal fullness, diarrhea, and a Wiry, Rapid pulse nearing extinction indicates death. The Classic states: Ying Qi always travels with Wei Qi. Chronic cough damages Qi, thus Blood is also insufficient, fluids transform into Phlegm, True Yin declines daily, so chronic cough inevitably becomes Consumption (Lao Bing).