《病源》五脏皆禀气于肺,肺感微寒则成咳嗽也。寒搏于气,气聚还肺,而邪有动息,
邪动则气奔逆上,气上则五脏伤动,动于胃气者,则胃气逆而呕吐也,此是肺咳,连滞气动
于胃而呕吐者也。又有季夏脾王之时,而脾气虚不能王,有寒气伤之而咳嗽者,谓之脾咳,
其状咳则右胁下痛,阴阴引膊背,甚则不可动,动则咳发。脾与胃合,脾咳不已,则胃受之
。其状咳嗽而呕,呕甚则长虫出是也。凡诸咳嗽甚则呕吐,各随证候知其腑脏也。(出第十
四卷中)
《深师》疗咳嗽上气,喉咽中腥臭,虚气搅心,头痛眼疼,耳中嘈嘈,风邪毒注天行,
食不生肌,胸中隔塞,呕逆多唾,恶心,心下坚满,饮多食少,疗疰并淋。通气丸方。
胶饴(五斤) 蜀椒(二升汗) 乌头(七分炮) 桂心(六分) 大附子(五枚炮) 干
姜人
参(各四分) 杏仁(一升) 天门冬(十分) 蜈蚣(五节去头,炙)
上十味,末之,捣杏仁作膏,稍稍纳药末捣千过,烊胶饴,乃纳药中,搅令调和。合如
半枣一枚,日六七,夜二三服,令胸中温为度。若梦与鬼神交通及饮食者,全用蜈蚣。食不
消者,加杏仁五合;有虚气,少腹急,腰痛,加天门冬、杜仲;有风,加乌头二枚、附子一
枚,立夏后勿加也;有留饮,加葶苈子一两熬,末之。忌猪肉、冷水、生葱、鲤鱼等物。(
《千金》同)
又疗上气咳逆,口干,手足寒,心烦满,积聚下利,呕逆,若坠瘀血,上气,胸胁胀满
,少气肠鸣,饱食伤中里急,妇人乳饮滞下有邪湿,阴不足,大小便不利,肢节皆痛。硝石
丸方。
硝石(一升) 干姜 前胡 大黄(各一斤) 杏仁(一升)
上五味,捣筛,蜜和。饮服如梧子三丸,日再。五日后心腹诸疾,随大小便去,月经绝
则通,下长虫数十,亦利血及冷热,赤白汁,症瘕毒悉主之,药利以意消息。
又疗上气,烦闷呕逆不得饮食。浓朴汤方。
浓朴(一两炙) 人参(一两) 半夏(四两洗) 生姜(八两) 茯苓 甘草(炙) 橘
皮桂
心(各二两) 枳实(二两炙)
上九味,切,以水八升,煮取三升,分三服。忌海藻、菘菜、羊肉、饧、生葱、醋物。
(并出第十八卷中)
《必效》疗上气咳嗽,呕逆不下食,气上方。
橘皮 紫菀(各三两) 人参 茯苓 柴胡 杏仁(去尖、皮)
上六味,切,以水六升,煮取二升,分为三服。患冷,加生姜二两;患热,加麦门冬三
两去心;不能食,加白术二两、浓朴二两炙。忌醋物、桃、李、雀肉等。(出第一卷中)
《诸病源候论》指出,五脏的气血都禀受于肺,肺感受了微寒就会形成咳嗽。寒邪与气相搏结,气聚集并返还于肺,而邪气有动有静,邪气发动则气机奔逆向上,气机上逆则损伤五脏,扰动到胃气时,就会导致胃气上逆而发生呕吐,这是肺咳,牵连滞碍气机扰动胃气而导致呕吐的情况。又有在季夏(夏季最后一个月)脾脏当令之时,如果脾气虚弱不能胜任当令之职,有寒气伤害它而导致咳嗽的,称为脾咳,其症状是咳嗽时右胁下疼痛,隐隐牵引肩背,严重时身体不可动弹,一动弹就引发咳嗽。脾与胃相表里,脾咳久治不愈,病邪就会传至胃。其症状是咳嗽伴随呕吐,呕吐严重时会有蛔虫吐出。大凡各种严重的咳嗽都会导致呕吐,应当根据证候来判断是哪一脏腑的病变。(出自第十四卷中)
《深师方》治疗咳嗽气逆,喉咽中有腥臭味,虚气搅动心胸,头痛眼疼,耳中嗡嗡作响,风邪毒气注入引起时行疫病,饮食不能生肌长肉,胸中隔塞不通,呕逆多唾沫,恶心,心下坚硬胀满,饮水多进食少,治疗疰病及淋证。通气丸方。
胶饴(五斤) 蜀椒(二升,出汗处理) 乌头(七分,炮制) 桂心(六分) 大附子(五枚,炮制) 干姜、人参(各四分) 杏仁(一升) 天门冬(十分) 蜈蚣(五节,去头,炙烤)
以上十味药,研成细末,捣碎杏仁制成膏状,逐渐加入药末,再捣一千次,熔化胶饴,然后加入药粉中,搅拌使其调和均匀。做成如半颗枣大小的丸剂,白天服六七次,晚上服二三次,以感到胸中温暖为度。如果梦见与鬼神交合或进食者,全用蜈蚣。消化不良者,加杏仁五合;有虚气,小腹部急迫,腰痛者,加天门冬、杜仲;有风邪者,加乌头二枚、附子一枚,立夏之后不要添加;有停饮者,加熬过的葶苈子一两,研成末。忌食猪肉、冷水、生葱、鲤鱼等食物。(《千金方》与此相同)
又治疗气逆咳嗽,口干,手足寒冷,心烦闷满,积聚腹泻,呕逆,如果有瘀血坠落感,气逆,胸胁胀满,气短肠鸣,饱食后伤及中焦导致里急后重,妇人乳汁停滞下有邪湿,阴精不足,大小便不利,肢体关节皆痛。硝石丸方。
硝石(一升) 干姜 前胡 大黄(各一斤) 杏仁(一升)
以上五味药,捣碎过筛,用蜂蜜调和。用温水送服,如梧桐子大小的三丸,每日两次。五日后,心腹的各种疾病,会随大小便排出,月经停止则会通畅,排出数十条蛔虫,也能治疗血痢及冷热杂下的赤白脓汁,症瘕积聚毒气全都主治,药物疗效需根据实际情况斟酌调整。
又治疗气逆,烦闷呕逆无法进食。浓朴汤方。
浓朴(一两,炙烤) 人参(一两) 半夏(四两,洗净) 生姜(八两) 茯苓 甘草(炙烤) 橘皮、桂心(各二两) 枳实(二两,炙烤)
以上九味药,切碎,用水八升,煮取三升,分三次服用。忌食海藻、菘菜、羊肉、饴糖、生葱、醋制品。
(均出自第十八卷中)
《必效方》治疗气逆咳嗽,呕逆不能进食,气机上冲。
橘皮 紫菀(各三两) 人参 茯苓 柴胡 杏仁(去尖、皮)
以上六味药,切碎,用水六升,煮取二升,分为三次服用。患冷证者,加生姜二两;患热证者,加麦门冬三两去心;不能进食者,加白术二两、炙浓朴二两。忌食醋制品、桃、李、雀肉等。(出自第一卷中)
*Suwen* (Source of Diseases) states that the Qi of the five Zang organs is derived from the Lung. When the Lung is affected by slight cold, coughing ensues. Cold combats with Qi, causing Qi to gather and return to the Lung. As pathogens have periods of activity and rest, when pathogens move, Qi rushes upward in rebellion. When Qi rebels upward, it injures the five Zang organs. If it disturbs the Stomach Qi, Stomach Qi rebels, leading to vomiting. This is pulmonary cough, where the condition lingers, disturbing Qi and affecting the Stomach, resulting in vomiting. Furthermore, during the late summer when the Spleen is in command, if Spleen Qi is deficient and cannot fulfill its function, cold pathogenic factors may injure it, causing coughing; this is called Spleen Cough. Its manifestation includes pain in the right hypochondrium during coughing, dull pain radiating to the shoulder and back, severe cases being unable to move, as movement triggers coughing. The Spleen and Stomach are exteriorly-interiorly related. If Spleen Cough persists, the disease transmits to the Stomach. Its symptoms include coughing accompanied by vomiting; severe vomiting may result in the expulsion of roundworms. Generally, severe coughing leads to vomiting; one should determine the affected Zang or Fu organ based on the syndrome patterns. (From Volume XIV)
*Shenshi Fang* treats coughing with rebellious Qi, a fishy odor in the throat and pharynx, deficiency Qi churning the heart, headache and eye pain, buzzing in the ears, wind-pathogen toxicity invading causing epidemic diseases, food failing to nourish flesh, chest obstruction and blockage, vomiting with excessive saliva, nausea, hardness and fullness below the heart, drinking much but eating little, treating Zhu diseases and strangury. Tongqi Wan Formula.
Malt Sugar (Jiaoyi) (5 jin) Sichuan Pepper (Shujiao) (2 sheng, processed to release moisture) Aconite Root (Wutou) (7 fen, processed) Cinnamon Twig Heart (Guixin) (6 fen) Large Prepared Aconite Root (Dafuzi) (5 pieces, processed) Dried Ginger (Ganjiang), Ginseng Root (Renshen) (each 4 fen) Almond Seed (Xingren) (1 sheng) Ophiopogon Tuber (Tianmendong) (10 fen) Centipede (Wugong) (5 segments, head removed, roasted)
The above ten ingredients are powdered. Almonds are pounded into a paste. The powder is gradually added to the paste and pounded a thousand times. Malt sugar is melted and mixed with the powder until uniform. Form pills the size of half a jujube. Take six or seven times daily, two or three times at night, aiming for warmth in the chest. If dreaming of intercourse with spirits or eating, use whole centipedes. For indigestion, add 5 he of almonds; for deficiency Qi with lower abdominal urgency and lumbar pain, add Ophiopogon Tuber and Eucommia Bark (Duzhong); for wind, add 2 pieces of Aconite Root and 1 piece of Prepared Aconite Root, but do not add after Start of Summer; for retained fluid, add 1 liang of roasted Lepidium Seed (Tinglizi), powdered. Avoid pork, cold water, raw green onion, carp, etc. (Same as *Qianjin Fang*)
Also treats rebellious Qi and coughing, dry mouth, cold hands and feet, vexation and fullness, accumulation with diarrhea, vomiting and rebellion, sensation of falling blood stasis, rebellious Qi, distension and fullness of the chest and hypochondrium, shortness of breath, borborygmus, epigastric urgency after overeating injuring the middle, women with stagnant milk and damp-evil below, Yin deficiency, difficulty in urination and defecation, pain in all joints. Xiaoshi Wan Formula.
Niter (Xiaoshi) (1 sheng) Dried Ginger (Ganjiang) Peucedanum Root (Qianhu) Rhubarb (Dahuang) (each 1 jin) Almond Seed (Xingren) (1 sheng)
The above five ingredients are pounded and sifted, then mixed with honey. Take three pills the size of a wu seed with water, twice daily. After five days, various ailments of the heart and abdomen will be expelled via stool or urine. Menstruation will cease and flow will be unobstructed. Dozens of roundworms may be passed. It also treats bloody dysentery, mixed cold-heat discharges of red and white pus, and toxic accumulations (Zhengjia). Adjust dosage according to clinical response.
Also treats rebellious Qi, vexation, fullness, vomiting, and inability to eat. Houpo Tang Formula.
Magnolia Bark (Houpo) (1 liang, roasted) Ginseng Root (Renshen) (1 liang) Pinellia Tuber (Banxia) (4 liang, washed) Fresh Ginger Shengjiang (8 liang) Poria (Fuling) Licorice Root (Gancao) (roasted) Tangerine Peel (Chenpi), Cinnamon Twig Heart (Guixin) (each 2 liang) Immature Bitter Orange (Zhishi) (2 liang, roasted)
The above nine ingredients are sliced. Decoct with 8 sheng of water to obtain 3 sheng. Divide into three doses. Avoid seaweed, Chinese cabbage, mutton, malt sugar, raw green onion, and vinegar products. (All from Volume XVIII)
*Bixiao Fang* treats rebellious Qi and coughing, vomiting and inability to eat, rising Qi.
Tangerine Peel (Chenpi) Aster Tataricus Root (Ziwan) (each 3 liang) Ginseng Root (Renshen) Poria (Fuling) Bupleurum Root (Chaihu) Almond Seed (Xingren) (remove tip and skin)
The above six ingredients are sliced. Decoct with 6 sheng of water to obtain 2 sheng. Divide into three doses. For cold syndromes, add 2 liang of Fresh Ginger; for heat syndromes, add 3 liang of Ophiopogon Tuber (remove heart); for inability to eat, add 2 liang of Atractylodes Macrocephala Rhizome (Baizhu) and 2 liang of roasted Magnolia Bark. Avoid vinegar products, peaches, plums, sparrow meat, etc. (From Volume I)