肺如华盖，司呼吸以覆脏腑。凡五脏六腑外受之邪气，必上干于肺而为咳嗽，此咳嗽之
实证也；凡五脏六腑损伤之病气，亦上熏于肺，而为咳嗽，此咳嗽之虚证也。病源娄氏《纲目》
，繁而难从。今照《景岳全书》，只以虚实分之，甚见简括。
何谓实证？外受之邪，非寒邪即热邪也。表寒则脉浮，带弦带紧，头痛身痛，或鼻塞时
流清涕。轻者六安煎，重者金沸草散，及小青龙汤主之。里寒者脉沉细，真武汤去生姜，加干
姜、五味、细辛主之。热轻则脉洪而长，或浮数而有力，口渴面红，溺赤而短者，泻白散加减
主之，重者竹叶石膏汤主之。寒热往来而咳者，小柴胡汤去人参、大枣、生姜，加五味、干
姜主之。
六安煎（方见《三字经》）
金沸草散
旋复花（二钱） 荆芥 前胡 麻黄 白芍 半夏（各一钱五分） 甘草（一钱）
加生姜五片，水煎服。（《活人方》有茯苓、细辛，无麻黄、白芍）
何谓虚证？咳嗽为痨伤之渐，非气虚即精虚也。气虚者，羸瘦怠倦，少食痰多，言微，脉
微细，六君子汤、补中益气汤、归脾汤主之。如干姜、五味、细辛、阿胶、半夏、二冬、二
母、紫菀之类，随宜加入。精虚者，面色黯，口燥舌干，干咳痰稀气喘，腰膝酸痛，或
面色浮红，昼轻夜重，脉浮数而虚。右尺脉弱者，八味丸；左尺脉弱者，六味丸。二方俱宜
加入麦冬、五味、阿胶、胡桃之类，为标本同治之法。大抵气虚证是得之劳役饥饱过度，及
思虑伤脾所致。气不化精，阳病必及于阴，精虚证是得之色欲过度，或先天不足。少年阳痿
之人，精不化气，阴病必及于阳。
感春温之气而咳嗽，宜加玉竹；感夏令暑气而咳嗽，宜加石膏、麦冬、五味之类；感秋
令燥金之气而咳嗽，用喻嘉言清燥汤，神效；感冬寒之气而咳嗽，无汗宜金沸草散，有汗宜桂
枝汤，加浓朴一钱五分、杏仁二钱、半夏一钱五分。又三焦虚嗽，宜温肺汤；中焦虚嗽，宜六
君子汤，加干姜、细辛、五味子；下焦虚嗽，宜七味丸加五味；三焦俱虚，宜三才汤。
喻嘉言清燥救肺汤
治愤郁喘呕，郁痰加川贝母。
三才汤
天冬（二钱） 熟地（三钱） 人参（一钱）
水煎服。
补中益气汤 归脾汤 六君子汤 六味丸 八味丸（各见《时方》）
温肺汤
陈皮 半夏 酒芍 干姜 炙草（各一钱） 杏仁（去皮尖） 肉桂（或用桂枝） 五味 细
辛（各五分）
水煎服。（《仁斋方》有阿胶，无芍药）
肺脏如同华盖（覆盖在五脏六腑之上的伞盖），主管呼吸并覆盖保护脏腑。凡是五脏六腑从外部感受的邪气，必定向上侵犯肺部而导致咳嗽，这是咳嗽的实证；凡是五脏六腑内部损伤产生的病气，也会向上熏蒸于肺，从而导致咳嗽，这是咳嗽的虚证。关于咳嗽的病源，娄氏《纲目》记载繁杂而难以遵循。现在依照《景岳全书》的观点，仅通过虚实来区分，非常简明扼要。
什么是实证？外感邪气，不是寒邪就是热邪。如果是表寒证，则脉象浮，兼见弦脉或紧脉，伴有头痛、身体疼痛，或者鼻塞、时常流出清涕。病情轻的，用六安煎治疗；病情重的，用金沸草散及小青龙汤主治。如果是里寒证，脉象沉细，用真武汤去掉生姜，加入干姜、五味子、细辛主治。热邪较轻时，脉象洪大且长，或者浮数而有力，伴有口渴、面色红赤、小便赤黄短少，用泻白散加减主治；病情重的，用竹叶石膏汤主治。出现寒热往来并伴有咳嗽的，用小柴胡汤去掉人参、大枣、生姜，加入五味子、干姜主治。
六安煎（方剂见《三字经》）
金沸草散
旋复花（二钱） 荆芥 前胡 麻黄 白芍 半夏（各一钱五分） 甘草（一钱）
加生姜五片，水煎服。（《活人方》中有茯苓、细辛，无麻黄、白芍）
什么是虚证？咳嗽是劳损（痨伤）的开始，不是气虚就是精虚。气虚的人，形体消瘦、怠倦乏力，食欲少、痰多，说话声音微弱，脉象微细，用六君子汤、补中益气汤、归脾汤主治。如干姜、五味子、细辛、阿胶、半夏、天冬麦冬（二冬）、知母贝母（二母）、紫菀之类的药物，根据情况适当加入。精虚的人，面色晦暗，口燥舌干，干咳、痰稀薄、气喘，腰膝酸痛，或者面色浮红，白天症状轻、晚上重，脉象浮数而虚弱。右尺脉弱的，用八味丸；左尺脉弱的，用六味丸。这两个方子都适宜加入麦冬、五味子、阿胶、胡桃等药，作为标本同治的方法。大抵气虚证是由于过度劳累、饥饱失常以及思虑伤脾所致。气不能化生精，阳病必然波及阴；精虚证是由于房事过度，或者先天不足。少年阳痿的人，精不能化气，阴病必然波及阳。
感受春季温热之气而咳嗽的，适宜加入玉竹；感受夏季暑气而咳嗽的，适宜加入石膏、麦冬、五味子之类；感受秋季燥金之气而咳嗽的，使用喻嘉言的清燥救肺汤，效果神奇；感受冬季寒气而咳嗽的，无汗的用金沸草散，有汗的用桂枝汤，加入厚朴一钱五分、杏仁二钱、半夏一钱五分。另外，三焦虚咳，适宜用温肺汤；中焦虚咳，适宜用六君子汤，加入干姜、细辛、五味子；下焦虚咳，适宜用七味丸加五味子；三焦全部虚损，适宜用三才汤。
喻嘉言清燥救肺汤
治疗因愤懑抑郁导致的喘逆呕吐，若有郁痰则加入川贝母。
补中益气汤 归脾汤 六君子汤 六味丸 八味丸（各方详见《时方》）
温肺汤
陈皮 半夏 酒白芍 干姜 炙甘草（各一钱） 杏仁（去皮尖） 肉桂（或用桂枝） 五味子 细辛（各五分）
水煎服。（《仁斋方》中有阿胶，无芍药）
The Lung is like a canopy (a cover resembling an umbrella that covers the five zang and six fu organs), governing respiration and covering/protecting the viscera. Any pathogenic factors affecting the five zang and six fu organs from the exterior must ascend to invade the Lung, resulting in cough; this constitutes the Excess syndrome of cough. Any pathological qi arising from damage within the five zang and six fu organs will also ascend to smolder in the Lung, causing cough; this constitutes the Deficiency syndrome of cough. Regarding the etiology of cough, Lou's *Gangmu* is too complex and difficult to follow. Currently, following the *Jingyue Quanshu*, distinguishing solely by Excess and Deficiency is very concise.
What is the Excess syndrome? External pathogens are either Cold or Heat. If it is Exterior Cold, the pulse is Floating, accompanied by Wiry or Tight qualities, with headache and body pain, or nasal congestion with frequent clear discharge. For mild cases, Liu'an Decoction is used; for severe cases, Jinfengcao Powder and Xiao Qinglong Tang are indicated. If it is Interior Cold, the pulse is Deep and Fine; Zhenwu Tang, removing Shengjiang (Fresh Ginger), adding Ganjiang (Dried Ginger), Wuweizi (Schisandra Fruit), and Xixin (Asarum) is indicated. When Heat is mild, the pulse is Surging and Long, or Floating, Rapid, and Forceful, accompanied by thirst, red face, and dark, scanty urine; Xiebai San, modified, is indicated. For severe cases, Zhuye Shigao Tang is indicated. For cough with alternating chills and fever, Xiaochaihu Tang, removing Renshen (Ginseng), Dazao (Jujube), and Shengjiang (Fresh Ginger), adding Wuweizi (Schisandra Fruit) and Ganjiang (Dried Ginger) is indicated.
Liu'an Decoction (Formula seen in *San Zi Jing*)
Jinfengcao Powder
Xuanfuhua (Inula Flower, 2 qian) Jingjie (Schizonepeta) Qianhu (Peucedani Radix) Mahuang (Ephedrae Herba) Baishao (Paeoniae Radix Alba) Banxia (Pinelliae Rhizoma) (each 1.5 qian) Gancao (Licorice Root, 1 qian)
Add five slices of Shengjiang (Fresh Ginger), decoct in water and take orally. (Huoren Fang contains Fuling (Poria) and Xixin (Asarum), but lacks Mahuang (Ephedrae Herba) and Baishao (Paeoniae Radix Alba)).
What is the Deficiency syndrome? Cough is the beginning of consumptive disease (Lao Shang); it is either Qi Deficiency or Essence/Jing Deficiency. Those with Qi Deficiency are emaciated and fatigued, have poor appetite with much phlegm, speak softly, and have a Micro and Fine pulse; Liujunzi Tang, Buzhong Yiqi Tang, and Guipi Tang are indicated. Drugs such as Ganjiang (Dried Ginger), Wuweizi (Schisandra Fruit), Xixin (Asarum), Ejiao (Donkey-hide Gelatin), Banxia (Pinelliae Rhizoma), Erdong (Tian Dong and Mai Dong), Ermu (Zhi Mu and Bei Mu), and Ziwan (Aster Root) may be added as appropriate. Those with Essence Deficiency have a dark complexion, dry mouth and tongue, dry cough with thin sputum, asthma, soreness and weakness of the waist and knees, or a floating red complexion, with symptoms lighter during the day and heavier at night, and a Floating, Rapid, and Empty pulse. If the Right Chi pulse is Weak, Bawei Wan is used; if the Left Chi pulse is Weak, Liuwei Wan is used. Both formulas are suitable for adding Maidong (Ophiopogon Root), Wuweizi (Schisandra Fruit), Ejiao (Donkey-hide Gelatin), and Hutaorenr (Walnut Kernel) as a method of treating both root and branch simultaneously. Generally, Qi Deficiency syndrome results from overexertion, irregular diet, and excessive worry damaging the Spleen. Qi fails to transform into Essence; Yang pathology inevitably affects Yin. Essence Deficiency syndrome results from excessive sexual activity or congenital insufficiency. Young men with impotence fail to transform Essence into Qi; Yin pathology inevitably affects Yang.
For cough caused by contracting Spring Warmth Qi, Yuzhu (Polygonatum Odorati Rhizoma) should be added; for cough caused by Summer Heat Qi, Shigao (Gypsum Fibrosum), Maidong (Ophiopogon Root), and Wuweizi (Schisandra Fruit) should be added; for cough caused by Autumn Dry Metal Qi, Yu Jiayan's Qingzao Jiufei Tang is indicated, which is miraculous; for cough caused by Winter Cold Qi, if there is no sweating, Jinfengcao Powder is used; if there is sweating, Guizhi Tang is used, adding Houpo (Magnolia Bark, 1.5 qian), Xingren (Prunus Seed, 2 qian), and Banxia (Pinelliae Rhizoma, 1.5 qian). Additionally, for Three Burner Deficiency Cough, Wenfei Tang is indicated; for Middle Burner Deficiency Cough, Liujunzi Tang with Ganjiang (Dried Ginger), Xixin (Asarum), and Wuweizi (Schisandra Fruit) is indicated; for Lower Burner Deficiency Cough, Qiwei Wan with Wuweizi (Schisandra Fruit) is indicated; for deficiency of all Three Burners, Santang Tang is indicated.
Yu Jiayan's Qingzao Jiufei Tang
Treats wheezing and vomiting due to resentment and depression; add Chuanbeimu (Fritillaria Cirrhosa Bulb) if there is stagnant phlegm.
Santang Tang
Tian Dong (Asparagus Root, 2 qian) Shudi (Rehmanniae Radix Preparata, 3 qian) Renshen (Ginseng Root, 1 qian)
Decoct in water and take orally.
Buzhong Yiqi Tang Guipi Tang Liujunzi Tang Liuwei Wan Bawei Wan (See *Shifang* for each formula)
Wenfei Tang
Chenpi (Citrus Reticulatae Pericarpium) Banxia (Pinelliae Rhizoma) Jiushao (Prepared Paeoniae Radix Alba) Ganjiang (Dried Ginger) Zhigancao (Prepared Licorice Root) (each 1 qian) Xingren (Prunus Seed, peeled and tips removed) Rougui (Cinnamon Bark, or Guizhi/Cinnamon Twig) Wuweizi (Schisandra Fruit) Xixin (Asarum) (each 0.5 qian)
Decoct in water and take orally. (Renzhai Fang contains Ejiao (Donkey-hide Gelatin) but lacks Shaoyao (Paeonia Root)).