咳嗽症，虚劳门已言之。而未详及外感诸病因，故再言之。肺体属金譬若钟然，钟非叩
不鸣。风寒暑湿燥火，六淫之邪，自外击之则鸣，劳欲情志饮食炙爆之火，自内攻之则
亦鸣。医者不去其鸣钟之具，而日磨锉其钟，将钟损声嘶而鸣之者如故也。钟其能保乎？吾
愿治咳者，作如是观。
大法，风寒初起，头痛鼻塞，发热恶寒而咳嗽者，用止嗽散，加荆芥、防风、苏叶、生
姜以散邪。既散而咳不止，专用本方，调和肺气，或兼用人参胡桃汤，以润之；若汗多食少
此脾虚也，用五味异功散加桔梗，补脾土以生肺金。若中寒入里而咳者，但温其中而咳
自止。若暑气伤肺，口渴烦心溺赤者，其症最重，用止嗽散，加黄连、黄芩、花粉以直折其
火。若湿气生痰，痰涎稠粘者，用止嗽散，加半夏、茯苓、桑白皮、生姜、大枣以祛其湿。
若燥火焚金，干咳无痰者，用止嗽散加栝蒌、贝母、知母、柏子仁以润燥。此外感之治法也
》十二经见证而加减如法，则治无不痊。经云∶咳而喘息有音，甚则唾血者，属肺脏，此即
风寒咳血也，止嗽散加荆芥、紫苏、赤芍、丹参。咳而两胁痛，不能转侧，属肝脏，前方加
柴胡、枳壳、赤芍。咳而喉中如梗状，甚则咽肿喉痹，属心脏，前方倍桔梗，加蒡子。咳而
右胁痛，阴引肩背，甚则不可以动，动则咳剧，属脾脏，前方加葛根、秦艽、郁金。咳而腰
背痛，甚则咳涎者，属肾脏，前方加附子。咳而呕苦水者，属胆腑，前方加黄芩、半夏、生
姜。咳而失气者，属小肠腑，前方加芍药。咳而呕，呕甚则长虫出，属胃腑，前方去甘草，
加乌梅、川椒、干姜、有热佐之以黄连。咳而遗屎，属大肠腑，前方加白术、赤石脂。咳而
遗溺，属膀胱腑，前方加茯苓、半夏。久咳不止，三焦受之，其证腹满不食，令人多涕唾，
面目浮肿，气逆，以止嗽散，合五味异功散并用。投之对症，其效如神。
又以内伤论前症，若七情气结，郁火上冲者，用止嗽散，加香附、贝母、柴胡、黑山栀
若肾经阴虚，水衰不能制火，内热，脉细数者，宜朝用地黄丸滋肾水，午用止嗽散，去荆
芥，加知母、贝母以开火郁，仍佐以葳蕤胡桃汤。若客邪混合，肺经变生虚热者，更佐以团
鱼丸。若病势深沉，变为虚损，或尸虫入肺，喉痒而咳者，更佐以月华丸。若内伤饮食，口
干痞闷，五更咳甚者，乃食积之火，至此时流入肺经，用止嗽散，加连翘、山楂、麦芽、卜
子。若脾气虚弱，饮食不思，此气弱也，用五味异功散加桔梗。此内伤之治法也。
凡治咳嗽，贵在初起得法为善。经云∶微寒微咳。咳嗽之因，属风寒者十居其九。故初
治必须发散，而又不可以过散，不散则邪不去，过散则肺气必虚，皆令缠绵难愈。薛立斋云
∶肺有火，则风邪易入，治宜解表兼清肺火；肺气虚，则腠理不固，治宜解表兼补肺气，又
云∶肺属辛金，生于己土，久咳不已，必须补脾土以生肺金。此诚格致之言也。然清火之药
不宜久服。无论脉之洪大滑数，数剂后，即宜舍去。但用六味丸频频服之，而兼以白蜜、
胡桃润之，其咳自住。若脾肺气虚，则用五味异功散，六君子等药，补土生肺，反掌收功，
为至捷也。治咳者，宜细加详审。患咳者，宜戒口慎风。毋令久咳不除变为肺痿、肺疽、虚
损、劳瘵之候，慎之戒之。
咳嗽这一病症，在虚劳门中已经论述过。但当时没有详细涉及外感各种病因，所以这里再加以阐述。肺的质地属金，就像钟一样，钟不敲击就不会响。风寒暑湿燥火这六淫邪气，从外部侵袭它，它就会响；劳倦、欲望、情志失调、饮食不当以及炙烤爆炒产生的火热之邪，从内部攻击它，它也会响。医生如果不除去让钟发声的原因（即致病因素），却每天去打磨锉平钟体，结果钟体受损声音嘶哑，而发声的原因依然存在。钟还能保全吗？我希望治疗咳嗽的医生，能像这样看待问题。
基本治法：风寒初起，出现头痛鼻塞，发热恶寒并伴有咳嗽者，使用止嗽散，加入荆芥、防风、苏叶、生姜以发散邪气。邪气已散但咳嗽不止，专门使用本方（止嗽散），调和肺气，或者兼用人参胡桃汤，来滋润肺部；如果汗多食少，这是脾虚的表现，使用五味异功散加桔梗，补益脾土以滋生肺金。如果是中寒入里导致咳嗽的，只需温补中焦，咳嗽自然停止。如果是暑气伤肺，出现口渴心烦、小便赤黄的症状，病情最为严重，使用止嗽散，加入黄连、黄芩、花粉以直接折降其火势。如果是湿气生痰，痰涎稠粘的，使用止嗽散，加入半夏、茯苓、桑白皮、生姜、大枣以祛除湿气。如果是燥火焚金，干咳无痰的，使用止嗽散加入栝蒌、贝母、知母、柏子仁以润燥。这是外感咳嗽的治疗方法。根据十二经见证进行加减，只要方法得当，治疗没有不痊愈的。《内经》说：咳嗽且喘息有声音，严重时唾血的，属于肺脏病变，这就是风寒引起的咳血，止嗽散中加入荆芥、紫苏、赤芍、丹参。咳嗽且两胁疼痛，不能转身侧卧的，属于肝脏病变，前方加入柴胡、枳壳、赤芍。咳嗽且喉中如有物梗阻状，严重时咽喉肿痛喉痹的，属于心脏病变，前方加倍桔梗用量，加入牛蒡子。咳嗽且右胁疼痛，阴部牵引肩背，严重时不能活动，活动则咳嗽加剧的，属于脾脏病变，前方加入葛根、秦艽、郁金。咳嗽且腰背痛，严重时咳出涎沫的，属于肾脏病变，前方加入附子。咳嗽且呕吐苦水的，属于胆腑病变，前方加入黄芩、半夏、生姜。咳嗽且排气失气的，属于小肠腑病变，前方加入芍药。咳嗽且呕吐，呕吐严重时吐出蛔虫的，属于胃腑病变，前方去掉甘草，加入乌梅、川椒、干姜，如果有热象辅助加入黄连。咳嗽且大便失禁的，属于大肠腑病变，前方加入白术、赤石脂。咳嗽且小便失禁的，属于膀胱腑病变，前方加入茯苓、半夏。久咳不止，三焦受累，症状表现为腹部胀满不想进食，使人多涕唾，面目浮肿，气逆上冲，用止嗽散合五味异功散同时服用。投药对症，效果神速。
再从内伤角度论述前症，如果是七情气结，郁火上冲的，使用止嗽散，加入香附、贝母、柴胡、黑山栀。如果是肾经阴虚，水衰不能制火，出现内热，脉细数的，宜早晨用地黄丸滋补肾水，中午用止嗽散，去掉荆芥，加入知母、贝母以开解火郁，仍佐以葳蕤胡桃汤。如果是客邪混合，肺经变生虚热的，更佐以团鱼丸。如果病势深沉，变为虚损，或者尸虫入肺，喉痒而咳嗽的，更佐以月华丸。如果是内伤饮食，口干痞闷，五更时分咳嗽严重的，这是食积之火，到了这个时候流入肺经，使用止嗽散，加入连翘、山楂、麦芽、萝卜子。如果是脾气虚弱，不思饮食，这是气弱的表现，使用五味异功散加桔梗。这是内伤咳嗽的治疗方法。
大凡治疗咳嗽，贵在初起时得法为善。《内经》说：微寒则微咳。咳嗽的原因，属于风寒的占十分之九。所以初治必须发散，但又不可以过度发散，不散则邪气不去，过散则肺气必虚，都会导致缠绵难愈。薛立斋说：肺有火，则风邪易入，治疗宜解表兼清肺火；肺气虚，则腠理不固，治疗宜解表兼补肺气。又说：肺属辛金，生于己土，久咳不已，必须补脾土以生肺金。这确实是格物致知的言论。然而清火之药不宜久服。无论脉象是洪大滑数还是数脉，服药几剂后，就应当舍弃不用。只需用六味丸频频服用，并兼用白蜜、胡桃来滋润，咳嗽自然停止。如果是脾肺气虚，则使用五味异功散、六君子等药，补土生肺，很快就能收效，这是最快捷的方法。治疗咳嗽的人，应该仔细详审。患咳嗽的人，应该忌口慎风。不要让久咳不除演变为肺痿、肺疽、虚损、劳瘵的证候，务必谨慎戒除。
Coughing, as a syndrome, has already been discussed in the section on Consumption (Xu Lao). However, the various causes of external contraction were not detailed therein; therefore, it is discussed again here. The lung tissue belongs to Metal, resembling a bell; a bell does not ring unless struck. The six exogenous pathogens—Wind, Cold, Summer-heat, Dampness, Dryness, and Fire—when attacking from the outside, cause it to ring. Similarly, exhaustion, sexual desire, emotional disturbances, improper diet, and the fire generated from roasting or frying foods, when attacking from the inside, also cause it to ring. If a physician fails to remove the cause that makes the bell ring, but instead daily polishes and files the bell itself, the bell will be damaged and its voice hoarse, while the cause of ringing remains unchanged. Can the bell be preserved? I wish those who treat coughing would view it in this manner.
The general principle: When Wind-Cold first arises, accompanied by headache, nasal congestion, fever, aversion to cold, and cough, use Zhisou San (Stop Cough Powder) with added Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Ziye (Perillae Folium), and Shengjiang (Zingiberis Rhizoma Recens) to disperse the pathogen. Once the pathogen is dispersed but cough persists, use this formula exclusively to harmonize Lung Qi, or alternatively combine it with Renshen Huta Tang (Ginseng and Walnut Decoction) to moisten; if there is excessive sweating and poor appetite, indicating Spleen deficiency, use Wuyi Yigong San (Five Agents and Four Gentlemen Powder) with added Jiegeng (Platycodonis Radix) to tonify Spleen Earth to generate Lung Metal. If Cold invades the interior causing cough, warming the Middle Jiao will naturally stop the cough. If Summer-heat injures the Lung, presenting with thirst, vexation, and dark urine, the condition is most severe; use Zhisou San with added Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and Huafen (Trichosanthis Radix) to directly subdue the Fire. If Dampness generates phlegm, with thick and sticky sputum, use Zhisou San with added Banxia (Pinelliae Rhizoma), Fuling (Poria), Sangbaipi (Mori Cortex), Shengjiang, and Dazao (Jujubae Fructus) to dispel Dampness. If Dryness-Fire burns the Metal, causing dry cough without sputum, use Zhisou San with added Gualou (Trichosanthis Fructus), Beimu (Fritillariae Bulbus), Zhimu (Anemarrhenae Rhizoma), and Baiziren (Biota Semen) to moisten dryness. These are the treatment methods for exogenous coughs. By adding and subtracting according to the manifestations of the twelve meridians, if the method is correct, cure is assured. The Classic states: "Cough with wheezing and audible sounds, progressing to expectoration of blood, belongs to the Lung organ." This refers to hemoptysis caused by Wind-Cold; add Jingjie, Zisu (Perillae Folium), Chishao (Paeoniae Radix Rubra), and Danshen (Salviae Miltiorrhizae Radix et Rhizoma) to Zhisou San. Cough with pain in both hypochondria, inability to turn the body, belongs to the Liver organ; add Chaihu (Bupleuri Radix), Zhike (Aurantii Fructus), and Chishao to the previous formula. Cough with a sensation of obstruction in the throat, progressing to sore throat and bi-syndrome, belongs to the Heart organ; double the dose of Jiegeng in the previous formula and add Bangzi (Arctii Fructus). Cough with pain in the right hypochondrium, radiating to the shoulder and back, worsening with movement, belongs to the Spleen organ; add Gegen (Puerariae Lobatae Radix), Qinjiao (Gentianae Macrophyllae Radix), and Yujin (Curcumae Longae Radix) to the previous formula. Cough with lower back and waist pain, progressing to expectoration of saliva, belongs to the Kidney organ; add Fuzi (Aconiti Lateralis Radix Praeparata) to the previous formula. Cough with vomiting of bitter fluid belongs to the Gallbladder organ; add Huangqin, Banxia, and Shengjiang to the previous formula. Cough with flatus belongs to the Small Intestine organ; add Shaoyao (Paeoniae Radix Alba) to the previous formula. Cough with vomiting, progressing to expulsion of roundworms, belongs to the Stomach organ; remove Gancao (Glycyrrhizae Radix et Rhizoma) from the previous formula and add Wumei (Mume Fructus), Chuanjiao (Zanthoxyli Pericarpium), Ganjiang (Zingiberis Rhizoma), and add Huanglian if heat signs are present. Cough with fecal incontinence belongs to the Large Intestine organ; add Baizhu (Atractylodis Macrocephalae Rhizoma) and Chishizhi (Halloysitum Rubrum) to the previous formula. Cough with urinary incontinence belongs to the Bladder organ; add Fuling and Banxia to the previous formula. For chronic cough persisting, affecting the San Jiao (Triple Burner), presenting with abdominal fullness, anorexia, excessive mucus and saliva, edema of the face and eyes, and rebellious Qi, combine Zhisou San with Wuyi Yigong San. If the prescription matches the syndrome, the effect is miraculous.
Furthermore, discussing these symptoms from the perspective of internal injury: If Qi stagnation due to seven emotions leads to upward surging of constrained Fire, use Zhisou San with added Xiangfu (Cyperi Rhizoma), Beimu, Chaihu, and Heishanzhi (Gardeniae Fructus). If Kidney Yin deficiency results in Water failing to control Fire, leading to internal heat and a fine, rapid pulse, use Dihuang Wan (Rehmannia Pill) in the morning to nourish Kidney Water, and Zhisou San at noon, removing Jingjie and adding Zhimu and Beimu to resolve Fire constraint, still assisted by Weirui Huta Tang (Polygonati Rhizoma and Walnut Decoction). If exogenous pathogens mix and generate deficient heat in the Lung meridian, further assist with Tuanyu Wan (Softshell Turtle Pill). If the disease is deep-seated, transforming into deficiency damage, or if corpse worms enter the Lung causing throat itching and cough, further assist with Yuehua Wan (Moonlight Pill). If internal injury from diet causes dry mouth and chest stuffiness, with worse cough at dawn (5-7 AM), this is Fire from food accumulation flowing into the Lung meridian at this time; use Zhisou San with added Lianqiao (Forsythiae Fructus), Shanzha (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), and Lopizi (Raphani Semen). If Spleen Qi is weak, with no desire for food, indicating Qi deficiency, use Wuyi Yigong San with added Jiegeng. These are the treatment methods for internal injury coughs.
In general, treating cough requires proper method in the early stages. The Classic states: "Slight cold causes slight cough." Nine out of ten cases of cough are due to Wind-Cold. Therefore, initial treatment must involve dispersing, but not excessively. Failure to disperse leaves the pathogen; excessive dispersing damages Lung Qi. Both lead to lingering difficulty in cure. Xue Lizhai stated: "If the Lung has Fire, Wind pathogens easily enter; treatment should release the exterior and clear Lung Fire simultaneously. If Lung Qi is deficient, the cou li (skin pores) are not secure; treatment should release the exterior and tonify Lung Qi simultaneously." He also said: "Lung belongs to Xin Metal, born from Ji Earth. For chronic cough that does not cease, one must tonify Spleen Earth to generate Lung Metal." This is indeed profound wisdom. However, drugs that clear Fire should not be taken for long. Regardless of whether the pulse is洪大 (surging-large), 滑数 (slippery-rapid), or merely rapid, after a few doses, they should be discontinued. Instead, frequently administer Liuwei Wan (Six-Ingredient Pill with Rehmannia) and assist with white honey and walnuts to moisten; the cough will naturally cease. If Spleen and Lung Qi are deficient, use Wuyi Yigong San, Liujunzi Tang (Six-Gentlemen Decoction), etc., to tonify Earth and generate Lung; success can be achieved quickly, which is the most expedient method. Those treating cough should examine carefully. Patients suffering from cough should observe dietary restrictions and avoid wind. Do not allow chronic cough to remain untreated, evolving into Lung Wei (Flaccidity), Lung Ju (Abscess), deficiency damage, or Lao Zhai (Consumption). Be cautious and vigilant.