脉诀云浮而缓者为伤风 浮而紧者为伤寒
咳脉浮濡者生紧涩者死 肺脉沉数者咳血
沉滑者多痰
一伤风咳嗽声重恶寒宜用 华盖散 参苏饮
一感冒咳嗽头疼宜用 金沸草散 人参荆芥散
一痰饮咳嗽宜用 二陈汤 随症加减以治之
一火郁生痰面赤作嗽宜用 降火化痰丸
一劳瘵咳嗽宜用 滋阴降火之药治在本门
一肺胀动则喘满气急息重宜用 收敛之药
诃子 五味子 杏仁 青黛之类
一肺胀抑遏不得眠者难治
一上半日嗽多是胃中有火宜用 知母 石膏之药降之
一下半日嗽多者是阴虚宜滋阴降火宜用 四物汤加 知母 黄柏之类
一黄昏时咳嗽多者是火气浮于肺不宜用凉药以五味子敛之
一咳嗽胁痛者宜用 二陈汤加 青皮 青黛 以疏肝气或加 白芥子
一肺受虚寒久嗽不止宜用 人参清肺散
一冷嗽吐痰沫宜用 温肺汤
一肺萎咳嗽有痰胸旁肿痛午后热声飒者宜用 人参养肺汤
一咳嗽声哑便不可用凉药宜用 半夏 细辛 生姜之类以散之
一咳嗽咽干不可用 半夏 南星之药 宜用 贝母 蒌仁以润之
脉诀中记载:脉象浮而缓的,是伤风;脉象浮而紧的,是伤寒。
咳嗽的脉象若浮而濡软的,预后良好(生);若紧而涩滞的,预后不良(死)。
肺脉沉而数的,会出现咳血;
脉象沉而滑的,多伴有痰饮。
第一种情况:伤风引起的咳嗽,声音沉重,怕冷,适宜使用华盖散或参苏饮。
第二种情况:感冒引起的咳嗽、头痛,适宜使用金沸草散或人参荆芥散。
第三种情况:痰饮引起的咳嗽,适宜使用二陈汤,并根据症状加减药物来治疗。
第四种情况:火邪郁结生成痰浊,面部发红并咳嗽,适宜使用降火化痰丸。
第五种情况:劳瘵(虚劳传尸)引起的咳嗽,适宜使用滋阴降火的药物治疗,具体见本门相关章节。
第六种情况:肺胀导致稍微活动就气喘胸闷、气急呼吸沉重,适宜使用收敛性质的药物,如诃子、五味子、杏仁、青黛等。
第七种情况:肺胀导致气机抑遏无法入睡的,难以治疗。
第八种情况:上半日咳嗽较多的,多是胃中有火,适宜使用知母、石膏等药物来清降火势。
第九种情况:下半日咳嗽较多的,属于阴虚,适宜滋阴降火,可使用四物汤加入知母、黄柏等药物。
第十种情况:黄昏时咳嗽较多的,是火气浮越于肺,不宜使用凉药,而应用五味子来收敛肺气。
第十一种情况:咳嗽伴有胁肋疼痛的,适宜使用二陈汤加入青皮、青黛以疏理肝气,或者加入白芥子。
第十二种情况:肺受虚寒,久咳不止,适宜使用人参清肺散。
第十三种情况:冷嗽,吐出泡沫状痰液,适宜使用温肺汤。
第十四种情况:肺萎(肺叶枯萎)引起的咳嗽,有痰,胸旁肿痛,午后发热,声音嘶哑,适宜使用人参养肺汤。
第十五种情况:咳嗽声音嘶哑的,便不可使用凉药,适宜使用半夏、细辛、生姜等药物来发散。
第十六种情况:咳嗽咽干的,不可使用半夏、南星等燥烈药物,适宜使用贝母、瓜蒌仁等药物来润燥。
The Mai Jue (Pulse Manual) records: A pulse that is floating and slow indicates Shang Feng (Wind Injury); a pulse that is floating and tight indicates Shang Han (Cold Damage).
For cough, if the pulse is floating and soft (Ru), the prognosis is good (Sheng); if it is tight and choppy (Se), the prognosis is poor (Si).
If the Lung pulse is deep and rapid (Shu), hemoptysis may occur;
if the pulse is deep and slippery (Hua), there is likely excessive phlegm.
Case 1: Cough caused by Wind Injury, characterized by heavy voice and aversion to cold, is suitable for treatment with Huagai San (Canopy Powder) or Shensu Yin (Ginseng and Perilla Decoction).
Case 2: Cough and headache caused by Cold Damage are suitable for treatment with Jinfeicao San (Boiling Grass Powder) or Renshen Jingjie San (Ginseng and Schizonepeta Powder).
Case 3: Cough caused by Phlegm-Fluid retention is suitable for treatment with Erchen Tang (Two-Cured Decoction), modified according to symptoms.
Case 4: Cough with facial redness due to fire stagnation generating phlegm is suitable for treatment with Jianghuo Huatan Wan (Fire-Reducing and Phlegm-Resolving Pill).
Case 5: Cough caused by Lao Zhai (Consumption Disease/TB) should be treated with drugs that nourish Yin and reduce fire; refer to the relevant section in this book.
Case 6: Fei Zhang (Lung Distension) causing panting, chest fullness, and heavy breathing upon slight exertion is suitable for treatment with astringent herbs such as Hezi (Chebula Fruit), Wuweizi (Schisandra Berry), Xingren (Apricot Seed), and Qingdai (Indigo Naturalis).
Case 7: Fei Zhang causing inability to sleep due to constrained Qi is difficult to treat.
Case 8: Cough occurring mostly in the first half of the day is often due to fire in the Stomach; it is suitable to use Zhimu (Anemarrhena Rhizome) and Shigao (Gypsum Fibrosum) to clear and descend the fire.
Case 9: Cough occurring mostly in the second half of the day indicates Yin deficiency; it is suitable to nourish Yin and reduce fire, using Siwu Tang (Four Substance Decoction) added with Zhimu (Anemarrhena Rhizome) and Huangbai (Phellodendron Bark).
Case 10: Cough occurring mostly at dusk indicates floating fire in the Lung; cool/cold-natured drugs should not be used. Instead, Wuweizi (Schisandra Berry) should be used to astringe the Lung Qi.
Case 11: Cough accompanied by hypochondriac pain is suitable for treatment with Erchen Tang (Two-Cured Decoction) added with Qingpi (Aged Tangerine Peel) and Qingdai (Indigo Naturalis) to soothe Liver Qi, or added with Baijiezi (White Mustard Seed).
Case 12: Chronic cough due to empty-cold in the Lung is suitable for treatment with Ren Shen Qingfei San (Ginseng Lung-Clearing Powder).
Case 13: Cold cough with frothy sputum is suitable for treatment with Wenfei Tang (Warming Lung Decoction).
Case 14: Cough due to Fei Wei (Withered Lung/Emphysema), accompanied by phlegm, swelling and pain in the chest sides, afternoon fever, and hoarseness, is suitable for treatment with Ren Shen Yangfei Tang (Ginseng Lung-Nourishing Decoction).
Case 15: For cough with hoarseness, cool/cold-natured drugs must not be used. Instead, Banxia (Pinellia Tuber), Xixin (Asarum Root), and Shengjiang (Fresh Ginger) should be used to disperse the pathogen.
Case 16: For cough with dry throat, desiccating drugs like Banxia (Pinellia Tuber) and Nanting (Arisaema Rhizome) must not be used. Instead, Beimu (Fritillaria Bulb) and Louren (Trichosanthes Seed) should be used to moisten.
Treatment for Lung injury due to Wind-Cold:
Mahuang (Ephedrae Herba), Zisu (Perillae Folium), Xingren (Armeniacae Semen Amarum), Sangpi (Mori Cortex), Chifuling (Poria cum Ligno Rubrum), Juhong (Citri Reticulatae Pericarpium Rubrum), Gancao (Glycyrrhizae Radix et Rhizoma).
Add two cups of water and three slices of ginger, decoct until eight-tenths remain. Take at any time.
Treatment for Lung affected by Wind Pathogen:
Jingjie (Schizonepetae Spica), Mahuang (Ephedrae Herba), Qianhu (Peucedani Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Chishaoyao (Paeoniae Radix Rubra), Banxia (Pinelliae Rhizoma), Jinfeicao (Verbenae Herba).
Add two cups of water, three slices of ginger, and one jujube, decoct and take.