半夏半升 紫参（一作紫苑）五两 泽漆（以东流水五斗，煮取一斗五升）三升 生
姜五两 白前五两 甘草 黄芩 人参 桂枝各三两
右九味，□咀，内 泽漆汁中，煮取五升，温服五合，至夜尽。
【集解】
李□曰：欬者，水寒射肺也。脉浮者，停水而又挟风以鼓之也。麻黄去风散肺逆，与
半夏、细辛、干姜、五味子、石膏同用，即前小青龙加石膏，为解表行水之剂也。然
土能制水，而地道壅塞，则水亦不行，故用厚朴疏敦阜之土，使脾气健运，而水自下
泄矣，杏仁下气去逆，小麦入心经能通火气，以火能生土助脾，而共成决水之功也。
又云：脉沉为水，以泽漆为君者，因其功专于消痰行水也，水性阴寒，桂枝行阳气以
导之。然所以停水者，以脾土衰不能制水，肺气逆不能通调水道，故用人参、紫参、
白前、甘草补脾顺肺，同为制水利水之方也。黄芩苦以泄之，半夏、生姜辛以散之也
。
沈明宗曰：详『金匮』欬嗽病，本于肺则一，大纲有三：一者，热刑肺，气弱不振，
欬而唾沫为肺痿；二者，风伤卫分，则病欬上气喘为肺胀；三者，邪传荣血，凝而不
行为肺痈。然肺胀之中，又分风、寒、表、里，饮多、风少、风多、饮少之治。故气
喘而躁，脉浮者，为心下有水，欲作风水，当以小青龙两解表里，加石膏以清风热。
目如脱状，乃风寒多而饮少，以越婢驱风，加半夏而下痰逆。风寒外束，火热内郁，
喉中水鸡声者，射干麻黄汤，宣通表里之邪。风热壅逆，津液不布，化而为涎，时时
唾浊，但坐不得眠者，皂荚丸以驱风郁之涎。若欬而脉浮，邪居肺气，以厚朴麻黄汤
，俾从表解。欬而脉沉，邪入于荣，将成肺痈，以泽漆而破壅结。火逆上气，咽喉不
利，是无外邪，治当麦门冬汤，清润滋降。若见浮肿肩息，脉浮大而下利，真气上浮
下脱，则为不治。以上皆外邪兼内饮合病，微细之辨，临证又当合『内经』五藏六府
，互相传乘之欬而辨之，则尽善矣。
半夏半升，紫参（一作紫菀）五两，泽漆（用东流水五斗，煮取一斗五升汁液）三升，生姜五两，白前五两，甘草、黄芩、人参、桂枝各三两。
以上九味药，切碎，放入泽漆汁中，煮取五升药液，每次温服五合，直到夜间服完。
【集解】
李珣曰：咳嗽，是水寒之邪射入肺脏所致。脉象浮的，是体内停水又兼挟风邪鼓动所致。麻黄能祛风散肺逆，与半夏、细辛、干姜、五味子、石膏同用，就是前文的小青龙加石膏汤，属于解表行水的方剂。然而土能制水，如果地道壅塞不通，水也不能下行，所以用厚朴疏通敦厚壅滞的脾土，使脾气健运，水自然向下排泄；杏仁降气去逆，小麦入心经能通火气，因为火能生土助脾，共同完成决泄水湿的功效。又说：脉沉主水饮，以泽漆为君药，是因为它的功效专于消痰行水。水性阴寒，用桂枝通行阳气来引导它。之所以停水，是因为脾土衰弱不能制水，肺气上逆不能通调水道，所以用人参、紫参、白前、甘草补脾顺肺，共同组成制约和水利水湿的方剂。黄芩苦寒以泄热，半夏、生姜辛温以散邪。
沈明宗曰：详细考察《金匮要略》中的咳嗽病，根本都在肺，大纲有三类：一是热邪刑伤肺脏，气弱不振，咳嗽吐泡沫，这是肺痿；二是风邪伤及卫分，导致咳嗽气喘，这是肺胀；三是邪气传入营血，凝滞不行，这是肺痈。然而在肺胀之中，又分为风、寒、表、里，以及饮多风少、风多饮少等不同治法。所以气喘而烦躁，脉浮的，是心下有停水，欲发展为风水证，应当用小青龙汤两解表里，加石膏以清风热。眼睛像要脱出状，是风寒多而饮少，用越婢汤驱风，加半夏以降痰逆。风寒外束，火热内郁，喉中有如水鸡叫声的，用射干麻黄汤，宣通表里之邪。风热壅逆，津液不布，化为涎沫，时时唾吐浊痰，只能坐着不能躺卧的，用皂荚丸以驱除风郁之涎。如果咳嗽而脉浮，邪气在肺气，用厚朴麻黄汤，使邪气从表而解。咳嗽而脉沉，邪气入于营血，将成肺痈，用泽漆汤破壅结。火逆上气，咽喉不利，这是没有外邪，治疗应当用麦门冬汤，清润滋降。如果出现浮肿、肩息（呼吸时耸肩）、脉浮大而下利，真气上浮下脱，这就属于不治之症。以上都是外邪兼内饮合病，需要微细辨别，临证时还应当结合《内经》五脏六腑互相传乘的咳嗽理论来辨证，那就尽善尽美了。
Banxia (Pinelliae Rhizoma) half sheng, Zishen (Pulsatillae Radix, also known as Ziwan/Adenophorae Radix) five liang, Zeqi (Euphorbiae Helioscopiae Herba) three sheng [prepared by boiling five dou of flowing water from the east to obtain one dou and five sheng of juice], Shengjiang (Zingiberis Rhizoma Recens) five liang, Baiqian (Cynanchi Stauntonii Rhizoma et Radix) five liang, Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix), and Guizhi (Cinnamomi Ramulus) each three liang.
The above nine herbs are coarsely crushed, added to the Zeqi juice, and boiled to obtain five sheng of liquid. Take five he of the decoction warm at a time, finishing it by nightfall.
[Collected Explanations]
Li Xun stated: Cough is caused by cold-water pathogenic factors invading the Lung. A floating pulse indicates retained water combined with wind pathogens agitating the body. Mahuang (Ephedrae Herba) dispels wind and disperses Lung rebellious Qi; when used together with Banxia, Xixin (Asari Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Wuweizi (Schisandrae Fructus), and Shigao (Gypsum Fibrosum), it forms the Xiao Qinglong Tang (Minor Blue Dragon Decoction) plus Shigao, which is an agent for releasing the exterior and promoting water metabolism. However, Earth controls Water; if the earthly pathways are obstructed, water cannot flow downward. Therefore, Houpo (Magnoliae Officinalis Cortex) is used to unblock the stagnated Spleen Earth, strengthening Spleen transportation so that water naturally drains downward. Xingren (Pruni Semen) descends Qi and eliminates rebellion; Xiaomai (Tritici Fructus) enters the Heart Meridian to circulate Fire Qi. Since Fire generates Earth and assists the Spleen, they jointly accomplish the function of draining water. Furthermore, a deep pulse indicates water retention. Zeqi is used as the sovereign herb because its efficacy specializes in resolving phlegm and promoting water metabolism. The nature of water is yin and cold, so Guizhi is used to circulate Yang Qi to guide it. The reason for water retention is that Spleen Earth is deficient and unable to control Water, and Lung Qi is rebellious and unable to regulate water passages. Therefore, Renshen, Zishen, Baiqian, and Gancao are used to tonify the Spleen and harmonize the Lung, forming a prescription to restrain and promote the flow of water. Huangqin uses bitterness to drain heat, while Banxia and Shengjiang use pungency to disperse pathogens.
Shen Mingzong stated: In detail, regarding cough diseases in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), the root lies in the Lung. There are three main categories: First, heat pathogenic factors damage the Lung, causing weak Qi and inability to rise, resulting in cough with frothy sputum, known as Fei Wei (Lung Atrophy). Second, wind pathogens injure the Wei (Defensive) level, leading to cough, upper qi, and wheezing, known as Fei Zhang (Lung Distension). Third, pathogens transmit into the Ying (Nutritive) and Blood levels, condensing and failing to circulate, known as Fei Yong (Lung Abscess). However, within Fei Zhang, treatments differ based on wind, cold, exterior, interior, and the ratios of fluid retention versus wind. Thus, if there is wheezing with restlessness and a floating pulse, indicating water below the heart intending to develop into Feng Shui (Wind Edema), Xiao Qinglong Tang should be used to resolve both exterior and interior, adding Shigao to clear wind-heat. If the eyes appear as if protruding, it indicates abundant wind-cold and little fluid retention; Yuebi Tang (Yuebi Decoction) is used to expel wind, adding Banxia to descend rebellious phlegm. If wind-cold binds the exterior and fire-heat stagnates internally, producing a sound like a water chicken in the throat, Shegan Mahuang Tang (Belamcanda and Ephedra Decoction) is used to ventilate and unblock exterior and interior pathogens. If wind-heat obstructs and rebels, fluids fail to distribute, transform into saliva, and cause frequent expectoration of turbid sputum, where the patient can only sit and cannot lie down, Zaojiao Wan (Soap Fruit Pill) is used to expel wind-stagnant saliva. If coughing occurs with a floating pulse, the pathogen resides in Lung Qi; Houpo Mahuang Tang (Magnolia Bark and Ephedra Decoction) is used to allow the pathogen to resolve from the exterior. If coughing occurs with a deep pulse, the pathogen has entered Ying-Blood and is about to become a Lung Abscess; Zeqi Tang is used to break up stagnation and knots. If fire rebellion causes upward Qi and throat discomfort without external pathogens, Maidong Tang (Ophiopogon Decoction) should be used for clearing, moistening, nourishing, and descending. If edema, orthopnea (shoulder breathing), a floating-large pulse, and diarrhea are seen, indicating floating True Qi and sinking collapse, it becomes an untreatable condition. All the above involve combined diseases of external pathogens and internal fluid retention, requiring subtle differentiation. In clinical practice, one must also combine the theory of mutual transmission among the Five Zang and Six Fu organs from the *Nei Jing* (Inner Canon) to differentiate coughs, thereby achieving perfection.