咳嗽必由于肺。而《内经》则曰；五脏六腑，皆令人咳，是不独在肺矣。盖痰有内伤外
感之
分，故自肺而传及五脏者有之，自五脏而传及于肺者亦有之。如风寒暑湿伤于外，则必先中
于皮毛，皮毛为肺之合，而受刑不解，此则自肺而复传于诸脏也。劳欲情志伤于内，则脏气
更
伤，先由阴分而病及上焦，此则自脏而传于肺也。但自表而入者，其病在阳，故必自表而出
之。治法宜辛宜温，求其属而散去外邪。则肺气清而咳自愈矣。自内而生者，伤于阴也，阴
虚于下，则阳浮于上，水涸金枯，则肺苦于燥，肺燥则痒，痒则咳不能已。治此者，宜甘以
养阴，润以养肺，使水壮气复，而肺自宁也。大法治表邪者，药不宜静，静则留滞不静，久
则必变生他病，故最忌寒凉收敛之剂。如五脏生成篇所云∶肺欲辛者此也。治里证者，药不
宜动，动则虚火不宁，真阴不复。燥痒愈增，病必日甚，故最忌辛香助阳等剂。如宣明五气
篇所云∶辛走气，气病无多食辛者此也。然表者虽宜动，动以散邪，若形病俱虚者，又当补
中而以和解。倘专于发散，恐肺益弱，腠理益疏，邪乘虚入，病反增剧也。治里者，虽宜静
以养阴，若命门火衰，不能归元，则参、 、桂、附，在所必用，否则气不化水，终无补于
阴也。至若因于火者宜清，因于湿者宜利，因痰者降其痰，因气者理其气。虽方书所载条目
极多，求其病本，则惟风寒劳损二者居其八九。风寒者责在阳实，劳损者责在阴虚，此咳证
之纲领，其他治标之法，亦不过随其所见之证调之而已。至于老人久咳，则元气既虚，本难
全愈，多宜温养脾肺，或兼治标，但保其不至羸困则善矣。观者详之。
咳嗽必定源于肺。然而《黄帝内经》却说：五脏六腑都能导致咳嗽，这说明咳嗽不仅仅局限于肺。这是因为痰饮有内伤和外感之分，所以既有从肺传变到五脏的情况，也有从五脏传变到肺的情况。例如风寒暑湿等外邪侵袭体表，必然先侵犯皮毛，而皮毛是肺的外合部位，若受邪后未能及时解除，病邪就会从肺再传变到其他脏腑。劳倦、房事过度或情志失调等内伤因素，会损伤脏腑之气，首先由阴分病变波及上焦，这就是从内脏传变到肺。凡是病邪从表入里的，病位在阳分，因此治疗必须通过发汗等方法使病邪从表排出。治法应当使用辛温药物，探寻病因所属的类别以驱散外邪。这样肺气得以清肃，咳嗽自然痊愈。凡是从内部产生的咳嗽，属于阴分受伤，下部阴虚则阳气浮越于上，肾水枯竭则肺金干燥，肺燥则产生痒感，痒则引发剧烈咳嗽不止。治疗这类咳嗽，宜用甘味药来滋养阴液，用润燥药来养护肺脏，使肾水充足、元气恢复，肺脏自然安宁。
治疗表证的大法，用药不宜过于静守（收敛），因为静守会导致邪气留滞不去，时间久了必然变生其他疾病，所以最忌讳使用寒凉收敛的药物。正如《素问·五脏生成篇》所说：“肺喜辛味”就是这个道理。治疗里证的大法，用药不宜过于动散（发散），因为动散会导致虚火不安，真阴无法恢复，燥痒症状更加严重，病情必然日益加重，所以最忌讳使用辛香助阳的药物。正如《素问·宣明五气篇》所说：“辛味走气，气病时不要多吃辛味食物”就是这个道理。然而，虽然表证适宜用动散之法以驱散邪气，但如果患者形体与病证都呈现虚弱状态，又应当采用补益中气并配合和解的方法。如果专门使用发散药物，恐怕会使肺气更弱，腠理更加疏松，邪气乘虚而入，病情反而加重。治疗里证，虽然适宜用静守之法以滋养阴液，但如果命门火衰，不能归元摄纳，那么人参、干姜、肉桂、附子就是必须使用的药物，否则气无法化生津液，终究无法补益阴液。至于因火邪引起的宜清热，因湿邪引起的宜利湿，因痰浊引起的宜降痰，因气滞引起的宜理气。虽然医书所载的治疗条目极多，但追根溯源，只有风寒和劳损这两种情况占到了八九成。风寒咳嗽责之于阳实，劳损咳嗽责之于阴虚，这是咳嗽病症的纲领，其他的治标方法，也不过是根据所见症状进行调理罢了。至于老年人久咳，由于元气已经虚弱，本来很难完全治愈，大多适宜温养脾肺，或者兼治标症，只要保证病人不至于极度消瘦困顿就可以了。请读者仔细审察。
Cough must originate from the Lung. However, the *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "The five zang organs and six fu organs all can cause cough," indicating that cough is not limited solely to the Lung. This is because phlegm-dampness has distinctions between internal injury and external contraction; thus, there are cases where pathology transmits from the Lung to the five zang organs, and cases where it transmits from the five zang organs to the Lung. For instance, when wind-cold-summerheat-dampness invade externally, they first affect the skin and hair (the exterior). Since the skin and hair are the exterior correspondence of the Lung, if the pathogenic factor remains unresolved after invasion, it will transmit from the Lung to the other zang-fu organs. Conversely, injuries caused by overwork, sexual excess, or emotional disturbances internally damage the qi of the zang organs. The disease initially arises in the yin aspect and affects the upper jiao, which represents transmission from the zang organs to the Lung. When pathogens enter from the exterior, the pathology resides in the yang aspect; therefore, treatment must aim to expel the pathogen from the exterior. The therapeutic method should employ acrid-warm herbs to identify the specific nature of the pathogen and disperse it. Once the Lung qi becomes clear, the cough will heal spontaneously. When cough originates internally, it involves injury to the yin. Yin deficiency in the lower jiao leads to floating yang in the upper jiao; depletion of kidney water results with dry lung metal. Lung dryness causes itching, which triggers incessant coughing. To treat this, one should use sweet-natured herbs to nourish yin and moistening herbs to protect the Lung, thereby replenishing kidney water and restoring qi, allowing the Lung to settle naturally.
The general principle for treating exterior syndromes dictates that medications should not be overly static (astringent), as stagnation prevents the expulsion of pathogens, potentially leading to further complications over time. Therefore, cold-natured and astringent formulas are strictly contraindicated. As stated in the *Suwen: Wuzang Shengcheng Pian* (Chapter on the Generation of the Five Zang Organs): "The Lung desires acridity," which explains this principle. For treating interior syndromes, medications should not be overly dispersing, as excessive dispersion unsettles deficient fire and prevents the restoration of true yin, exacerbating dryness and itching, and worsening the condition. Thus, acrid-aromatic and yang-assisting formulas are strictly contraindicated. As stated in the *Suwen: Xuanming Wuqi Pian* (Chapter on the Manifestation of the Five Qi): "Acidity moves qi; those with qi disorders should consume little acrid food," illustrating this point. However, although exterior syndromes generally benefit from dispersing methods to eliminate pathogens, if both the physical constitution and the syndrome indicate deficiency, tonification of the middle jiao combined with harmonizing methods should be employed. Exclusive use of dispersing agents may weaken the Lung further and loosen the couli (pores), allowing pathogens to enter due to deficiency, thereby aggravating the illness. Regarding interior treatments, while static methods are suitable for nourishing yin, if the fire of the Mingmen (Gate of Life) is deficient and fails to return to its source, herbs such as Renshen (Ginseng Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Guizhi (Cinnamon Twig), and Fuzi (Aconiti Lateralis Radix Praeparata) become essential. Otherwise, qi cannot transform fluids, and yin cannot be effectively replenished. Furthermore, cases caused by fire should be cleared, those by dampness should be drained, those by phlegm should have phlegm descended, and those by qi stagnation should have qi regulated. Although medical texts list numerous specific entries, tracing back to the root cause reveals that wind-cold and consumptive injuries account for eight or nine out of ten cases. Wind-cold coughs are attributed to excess in the yang aspect, while consumptive coughs are attributed to yin deficiency. These constitute the general principles of cough syndromes; other symptomatic treatments merely adjust based on observed manifestations. In the case of elderly patients with chronic cough, since primordial qi is already deficient, complete recovery is difficult. Treatment usually favors warming and nourishing the Spleen and Lung, possibly combined with symptomatic relief, aiming primarily to prevent severe emaciation and debility. Readers are advised to examine this carefully.