《古今录验》五脏六腑皆令人咳,肺居外而近,上合于皮毛,皮毛喜受邪,故肺独易为
嗽也。邪客于肺,则寒热上气,喘,汗出,咳动肩背,喉鸣,甚者唾血。肺咳经久不已,传
入大肠,其状咳则遗粪。肾咳者,其状引腰背,痛甚则咳涎。肾咳经久不已,传入膀胱,其
状咳则遗尿。肝咳者,其状左胁痛,甚者不得转侧。肝咳经久不已,传入胆,其状咳则清苦
汁出。心咳者,其状引心痛,喉仲介介如鲠状,甚者喉痹咽肿。心咳经久不已,传入小肠,
其状咳则失气。脾咳者,其状右胁痛,阴阴则引肩背,甚者不得动,动便咳剧。脾咳经久不
已,则传入胃,其状咳即呕,甚则长虫出。久咳不已,则三焦受之,三焦咳之状,咳而腹痛
,不能食饮,此皆聚于胃,关于肺,使人多涕唾,而面浮肿,气逆也。又非时有风寒冷,人
触冒解脱,伤皮毛间,入腑脏为咳上气,如此也。又非时忽然暴寒伤皮肤,中与肺合,则咳
嗽上气,或胸胁又痛,咳唾有血者,是其热得非时之寒暴薄之,不得渐散,伏结深喜肺痈也
。因咳服温药,咳尤剧,及壮热吐浓血,汗出恶寒是也,天有非时寒者,急看四时方也。
又疗咳嗽上气,时时呕白唾沫数十岁者方。
吴茱萸 五味子 大黄 桂心 甘草(炙) 细辛 人参 紫菀 款冬花各一两 大戟
竹茹各三分
上十一味,切,以水一斗,煮取三升,分为三服。亦疗阴冷咳,至良。忌海藻、菘菜、
生菜、生葱。(《深师》同,并出第十九卷中)
《深师》疗诸咳,心中逆气,气欲绝。杏仁煎方。
杏仁(四两去尖、皮,末) 猪膏(二斤) 白蜜(二升) 生姜汁(三升)
上四味,着铜器中,于微火上先煎姜汁,次纳蜜膏令如饧,置器着地,乃纳杏仁末,
复令得一沸,煎成。服如枣大一丸含之,日三,不知,稍稍增之。
又疗气上迫满,或气不通,烦闷喘呕。苏子汤方。
苏子(一升) 干姜(三两) 半夏(四两洗) 桂心 人参(各一两) 橘皮 茯苓
(各三两) 甘草(一两炙)
上八味,切,以水八升,煮取二升半,分为三服。若虚热,去干姜,用生姜六两,加黄
芩二两。忌海藻、菘菜、羊肉、饧、生葱、酢等物。(并出第十八卷中)
《古今录验》记载:五脏六腑都能导致咳嗽。肺位于体表且位置较浅,上连皮毛,皮毛容易受邪气侵袭,所以肺最容易发生咳嗽。邪气侵犯肺脏,就会出现寒热交替、气逆上冲、喘息、出汗、咳嗽牵引肩背疼痛、喉间有鸣音,严重的会咳出血液。肺咳经久不愈,病邪传入大肠,症状表现为咳嗽时大便失禁。肾咳的症状是咳嗽时牵引腰背疼痛,痛得厉害时会咳出涎沫。肾咳经久不愈,病邪传入膀胱,症状表现为咳嗽时小便失禁。肝咳的症状是左侧胁肋部疼痛,严重时身体不能翻身转动。肝咳经久不愈,病邪传入胆,症状表现为咳嗽时吐出清苦的胆汁。心咳的症状是咳嗽时牵引心痛,喉咙里有异物感,像鱼刺卡住一样,严重时会导致喉痹和咽喉肿胀。心咳经久不愈,病邪传入小肠,症状表现为咳嗽时放屁。脾咳的症状是右侧胁肋部疼痛,隐隐作痛并牵引肩背,严重时不能活动,一动就咳嗽加剧。脾咳经久不愈,病邪传入胃,症状表现为咳嗽即呕吐,严重时会有蛔虫吐出。久咳不愈,病邪传入三焦,三焦咳的症状是咳嗽伴有腹痛,无法进食饮水,这些病症都是邪气聚集在胃,关联于肺,使人多涕唾,面部浮肿,气机上逆。另外,非时令的风寒冷气,人接触冒犯或衣着单薄,损伤了皮毛之间,邪气进入脏腑引起咳嗽和气逆,也是这种情况。还有,非时令突然的暴寒伤害皮肤,寒气与肺相合,就会引起咳嗽气逆,或者胸胁疼痛,咳嗽吐血的,这是因为热邪遇到非时令的暴寒,被骤然逼迫,不能逐渐消散,深伏结聚,容易导致肺痈。如果因为咳嗽服用温热药物,咳嗽反而更加剧烈,以及出现高热、吐脓血、出汗怕冷等症状,就是这种情况;遇到非时令的寒冷天气,应紧急查阅四季的方书。
另外,治疗咳嗽气逆,长期(数十年)时时呕吐白色唾沫的方剂。
吴茱萸、五味子、大黄、桂心、甘草(炙)、细辛、人参、紫菀、款冬花各一两,大戟、竹茹各三分。
以上十一味药,切碎,用水一斗,煎煮取汁三升,分三次服用。也能治疗阴冷咳嗽,效果很好。忌食海藻、菘菜(白菜)、生菜、生葱。(《深师方》相同,均出自第十九卷中)
《深师方》治疗各种咳嗽,心中气逆,气息将绝。杏仁煎方。
杏仁(四两,去尖、皮,研末)、猪膏(二斤)、白蜜(二升)、生姜汁(三升)。
以上四味药,放入铜器中,用微火先煎姜汁,然后加入蜂蜜和猪膏,熬炼得像饴糖一样稠厚,把容器放在地上冷却,再放入杏仁末,再次煮沸一次,煎成。服用时含服如枣大一丸的药丸,每日三次,若无效,逐渐增加剂量。
另外,治疗气上迫满闷,或者气机不通,烦闷喘息呕吐的苏子汤方。
苏子(一升)、干姜(三两)、半夏(四两,洗)、桂心、人参(各一两)、橘皮、茯苓(各三两)、甘草(一两,炙)。
以上八味药,切碎,用水八升,煎煮取汁二升半,分三次服用。如果是虚热证,去掉干姜,改用生姜六两,加黄芩二两。忌食海藻、菘菜、羊肉、饴糖、生葱、醋等物。(均出自第十八卷中)
According to *Gu Jin Lu Yan* (Ancient and Modern Records of Verification), the five zang organs and six fu organs can all cause coughing. The lung is located superficially near the exterior, connecting with the skin and hair. Since the skin and hair are prone to pathogenic invasion, the lung is particularly susceptible to coughing. When pathogens invade the lung, symptoms include alternating chills and fever, rebellious qi ascending, panting, sweating, coughing that pulls on the shoulders and back, wheezing sounds in the throat, and in severe cases, hemoptysis (coughing up blood). If a lung cough persists without resolution, the pathology transmits to the large intestine; the manifestation is fecal incontinence during coughing. For kidney cough, the symptom involves pulling pain in the lower back and back, and in severe cases, expectoration of saliva. If a kidney cough persists, it transmits to the bladder, manifesting as urinary incontinence during coughing. For liver cough, the symptom is pain in the left hypochondrium, and in severe cases, inability to turn or change position. If a liver cough persists, it transmits to the gallbladder, manifesting as the discharge of bitter, clear fluid during coughing. For heart cough, the symptom involves pulling pain in the heart region, a sensation of obstruction in the throat as if a fishbone were stuck, and in severe cases, throat bi syndrome (obstruction) and pharyngeal swelling. If a heart cough persists, it transmits to the small intestine, manifesting as flatus during coughing. For spleen cough, the symptom is pain in the right hypochondrium, dull pain pulling to the shoulders and back, and in severe cases, inability to move; movement exacerbates the cough. If a spleen cough persists, it transmits to the stomach, manifesting as vomiting upon coughing, and in severe cases, expulsion of roundworms. If chronic cough persists, the sanjiao (Triple Burner) is affected. The manifestation of sanjiao cough includes coughing with abdominal pain and inability to eat or drink. These conditions generally involve pathogenic accumulation in the stomach and involvement of the lung, causing excessive nasal discharge and saliva, facial edema, and rebellious qi. Furthermore, non-seasonal cold wind can injure the interstices of the skin and hair when people are exposed to the elements or dress inadequately, allowing pathogens to enter the fu and zang organs, causing cough and rebellious qi. Additionally, sudden exposure to extreme cold injuring the skin, combining with the lung, causes cough, rebellious qi, chest and hypochondriac pain, or hemoptysis. This occurs because heat pathogens encounter non-seasonal cold, are abruptly constrained, fail to dissipate gradually, and become deeply lodged, potentially leading to lung abscess (Fei Yong). If warm herbs are taken for cough and the condition worsens, accompanied by high fever, expectoration of purulent blood, sweating, and aversion to cold, this indicates such a pattern. In times of non-seasonal cold, one should urgently consult formulas for the four seasons.
Furthermore, a formula for treating cough and rebellious qi, with frequent expectoration of white saliva over many years:
Wuzhuyu (Evodiae Fructus), Wuweizi (Schisandrae Chinensis Fructus), Dahuang (Rhei Radix et Rhizoma), Guixin (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma, prepared), Xixin (Asari Radix et Rhizoma), Renshen (Ginseng Radix), Ziwan (Asteris Radix), Kua Donghua (Farfarae Flos) each 1 liang, Daji (Euphorbiae Pekinensis Radix), Zhuru (Bambusae Caulis in Taenia) each 3 fen.
The above eleven ingredients are cut, boiled in 1 dou of water until reduced to 3 sheng, and divided into three doses. It also treats cold-type cough effectively. Avoid consuming Haizao (Sargassum), Songcai (Brassica rapa var. pekinensis), raw vegetables, and raw scallions. (Same as in *Shen Shi Fang*, both from Volume 19)
*Shen Shi Fang* treats various coughs with rebellious qi in the heart and impending suffocation. Xingren Jian (Apricot Kernel Decoction):
Xingren (Apricot Kernel, 4 liang, remove tips and skins, powdered), Zhigao (Pig Fat, 2 jin), Baimi (White Honey, 2 sheng), Shengjiang Zhi (Ginger Juice, 3 sheng).
Place the above four ingredients in a copper vessel. First, simmer the ginger juice over low heat. Then add the honey and pig fat, boiling until the consistency resembles maltose syrup. Place the vessel on the ground to cool slightly, then add the apricot kernel powder. Boil once more until complete. Take a pill-sized amount (size of a jujube) to be held in the mouth. Administer three times daily. If ineffective, gradually increase the dose.
Furthermore, Su Zi Tang (Perilla Seed Decoction) for treating oppressive fullness due to ascending qi, blocked qi, restlessness, panting, and vomiting:
Suzi (Perillae Fructus, 1 sheng), Ganjiang (Zingiberis Rhizoma, 3 liang), Banxia (Pinelliae Rhizoma, 4 liang, washed), Guixin (Cinnamomi Cortex), Renshen (Ginseng Radix) each 1 liang, Ju Pi (Citri Reticulatae Pericarpium), Fuling (Poria) each 3 liang, Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, prepared).
The above eight ingredients are cut, boiled in 8 sheng of water until reduced to 2.5 sheng, and divided into three doses. For deficiency-heat patterns, remove Ganjiang and use 6 liang of Shengjiang (Fresh Ginger), adding Huangqin (Scutellariae Radix) 2 liang. Avoid Haizao (Sargassum), Songcai (Brassica rapa var. pekinensis), mutton, Yi Tang (Maltose), raw scallions, and vinegar. (Both from Volume 18)