脉经曰关上脉微为咳○脉浮缓者为伤风○脉紧者肺寒咳○脉浮直者生○浮软者生
内经曰五脏六腑皆令人咳。非独肺也。皮毛者肺之舍也。皮毛先受邪气。邪气听从其令
也
。五脏之咳久乃移于六腑。又病机式要云咳谓无痰而有声肺气伤而不清也。嗽谓无声而有痰
。脾湿动而为痰也咳嗽谓有声有痰也。因伤肺气。动于脾湿。故咳而嗽也又生气通天论云秋
伤于湿。冬必咳嗽。大抵素秋之气。宜清而肃。反动之。则气上冲而为咳嗽。甚则动于脾湿
而为痰也。盖风乘肺者。日夜无度。汗出头痛。痰涎不利。热乘肺者。急
喘而嗽。面
赤潮热。手足寒冷。小儿多有之。火乘肺者。咳嗽上壅。涕唾出血。甚者七窍血溢。燥乘肺
者。气壅不利。百节内痛。头面汗出。寒热往来。皮肤干燥。细疮燥痒。大便秘涩。涕唾稠
粘
。寒乘肺者。或因形寒饮冷。冬月坐卧湿地。或冷风春秋之气。或因外感。夏是火气炎上最
重。秋是湿热伤肺。冬是风寒外来也。宜各随其证而治之。
钱氏曰嗽者肺感微寒八九月肺气大旺病嗽者其病必实非久病也其证面赤痰盛身热法当以
葶苈
丸下之若久者不可下也十一十二月嗽者伤风嗽也风从背脊第三椎肺俞穴入也以麻黄汤汗之有
热证面赤便水涎热咽喉不利者甘桔汤治之若五七日之间其身热痰盛涕唾稠粘者以褊银丸下之
有肺盛者咳而后喘面肿欲饮水者有不饮水者其身即热以泻白散泻之若伤寒咳嗽五七日无热证
而但嗽者亦葶苈丸主之后用化痰药而肺虚者咳而哽气时时长出气喉中有声此久病也以阿胶散
补之痰盛者先实脾后以褊银丸下之涎退即补肺如上法有嗽而吐水或青绿水者以百祥丸下之有
嗽而吐痰涎乳食者以白饼子下之有嗽而痰咳脓血者乃肺热食后服甘桔汤久嗽者肺亡津液阿胶
散补之咳而痰实不甚喘而面赤时饮水者褊银丸下之治嗽大法盛即下之久则补之更量虚实以意
增减
《脉经》说：关部脉象微弱是咳嗽的表现。○脉象浮缓的是伤风。○脉象紧的是肺寒咳嗽。○脉象浮直（有力）的预后良好。○脉象浮软的预后良好。
《内经》说：五脏六腑都能使人咳嗽，并不仅仅是肺脏。皮毛是肺的外合部位。皮毛先受到邪气侵袭，邪气就会顺着肺的指令内传。五脏的咳嗽日久不愈，就会转移影响到六腑。另外，《病机式要》中说：咳嗽是指没有痰但有声音，这是肺气受伤而不清肃的表现。嗽是指没有声音但有痰，这是脾湿扰动而产生痰液。咳嗽则是有声音又有痰。这是因为损伤了肺气，又动摇了脾湿，所以既咳又嗽。另外，《生气通天论》说：秋季受湿气伤害，到了冬天必定会咳嗽。大抵秋天的气候，应当清肃，如果反常，就会导致气机上冲而引发咳嗽，严重时触动脾湿而产生痰液。大概风邪侵犯肺脏的，日夜不停，出汗头痛，痰涎不利；热邪侵犯肺脏的，急促喘息并咳嗽，面色发红，潮热，手足寒冷，小儿多有此症；火邪侵犯肺脏的，咳嗽气逆上壅，鼻涕唾液中带血，严重的七窍出血；燥邪侵犯肺脏的，气机壅滞不利，全身关节内部疼痛，头面出汗，寒热往来，皮肤干燥，出现细小的疮疡且燥痒，大便秘结涩滞，鼻涕唾液粘稠；寒邪侵犯肺脏的，可能是因为形体受寒、饮食生冷，冬天坐在卧于潮湿之地，或者是春秋季节的冷风，或者是外感风寒。夏季是火气炎上最重的时候，秋季是湿热伤害肺脏，冬季是风寒从外部侵入。应当各自根据证候来治疗。
钱乙说：咳嗽是肺感受微寒。在八九月间，肺气旺盛，患咳嗽病的，其病势必然属实，不是久病。其症状是面色发红，痰多，身体发热，治法应当用葶苈丸攻下。如果是久病，则不可攻下。十一二月间的咳嗽，是伤风咳嗽，风邪从背脊第三椎的肺俞穴进入，应当用麻黄汤发汗。如果有热证，表现为面色发红，大便稀水，口水多，咽喉不利，用甘桔汤治疗。如果在五到七天之间，身体发热，痰多，鼻涕唾液粘稠，用褊银丸攻下。有肺盛证的，先咳嗽后气喘，面部浮肿，想喝水或不喝水，身体发热，用泻白散清泻肺热。如果是伤寒引起的咳嗽，五到七天没有热证，只是咳嗽，也用葶苈丸主治，之后用化痰药。肺虚的，咳嗽时哽气，时常长出气，喉中有声音，这是久病，用阿胶散补益。痰多的，先健脾实脾，后用褊银丸攻下，涎液退去后再补肺，像上面的方法。有咳嗽并吐出清水或青绿色水的，用百祥丸攻下。有咳嗽并吐出痰涎乳食的，用白饼子攻下。有咳嗽并咳出脓血的，是肺热，饭后服用甘桔汤。久咳的，肺中津液耗亡，用阿胶散补益。咳嗽痰实，不太喘，面色发红，时常想喝水的，用褊银丸攻下。治疗咳嗽的大法是：实证就攻下，久病就补益，更要衡量虚实情况，酌情增减。
The *Mai Jing* (Pulse Classic) states: A faint pulse at the Guan position indicates coughing. ○ A floating and moderate pulse indicates wind injury. ○ A tight pulse indicates lung cold cough. ○ A floating and straight (forceful) pulse indicates a favorable prognosis. ○ A floating and soft pulse indicates a favorable prognosis.
The *Nei Jing* (Inner Canon) states: The five zang organs and six fu organs can all cause coughing; it is not solely due to the lungs. The skin and hair are the external abode of the lungs. When the skin and hair are first invaded by pathogenic factors, these pathogens follow the command of the lungs and transmit internally. Coughs originating from the five zang organs, if prolonged, will transfer to affect the six fu organs. Furthermore, the *Bing Ji Shi Yao* (Essentials of Pathogenesis) states: "Ke" (cough) refers to having sound but no phlegm; this is caused by lung qi being injured and failing to clear and descend properly. "Sou" (phlegm-rattling) refers to having phlegm but no sound; this is caused by spleen dampness stirring up phlegm production. "Ke Sou" (cough with phlegm) involves both sound and phlegm. This occurs because lung qi is damaged and spleen dampness is agitated, resulting in both coughing and phlegm production. Additionally, the *Sheng Qi Tong Tian Lun* (Treatise on Vital Energy Connecting with Heaven) states: Injury by dampness in autumn leads to coughing in winter. Generally, the qi of late autumn should be clear and肃 (descending/clearing); if it acts contrary to this, qi rushes upward causing coughing. In severe cases, it agitates spleen dampness leading to phlegm production. Roughly speaking, when wind pathogen invades the lungs, there is ceaseless coughing day and night, sweating, headache, and difficult expectoration of saliva; when heat pathogen invades the lungs, there is rapid panting and coughing, flushed face, tidal fever, and cold hands and feet, which is common in children; when fire pathogen invades the lungs, there is coughing with qi rebelling upward, bloody sputum and nasal discharge, and in severe cases, bleeding from the seven orifices; when dryness pathogen invades the lungs, there is qi stagnation and obstruction, internal pain in all joints, sweating on the head and face, alternating chills and fever, dry skin, fine sores with dry itching, constipation, and thick sticky sputum and nasal discharge; when cold pathogen invades the lungs, it may be due to physical exposure to cold or consuming cold drinks, sitting or lying on wet ground in winter, or encountering cold winds in spring and autumn, or suffering from external contraction of wind-cold. Summer is when fire qi flares up most heavily; autumn is when damp-heat injures the lungs; winter is when wind-cold enters from outside. Treatment should vary according to each syndrome.
Qian Yi stated: Coughing results from the lungs contracting slight cold. In the eighth and ninth months, lung qi is vigorous; those suffering from coughing have an excess condition, not a chronic one. Symptoms include flushed face, abundant phlegm, and fever. The treatment method should involve purging with Tingli Wan (Descurainia Seed Pill). If it is a chronic condition, purging is contraindicated. Coughing in the eleventh and twelfth months is wind-injury coughing; wind enters through the Feishu (BL13) acupoint at the third thoracic vertebra on the back. It should be treated with Mahuang Tang (Ephedra Decoction) to induce sweating. If there are heat signs such as flushed face, watery stools, excessive saliva, and throat discomfort, Ganjie Tang (Licorice and Platycodon Decoction) should be used. If within five to seven days there is fever, abundant phlegm, and thick sticky sputum, Pianyin Wan (Polygonum Aviculare Pill) should be used for purging. For lung excess syndromes, characterized by cough followed by wheezing, facial edema, thirst (or lack thereof), and body heat, Xiebai San (White Powder for Purging) should be used to purge the lungs. If it is a cough caused by cold damage, without heat signs after five to seven days but only coughing, Tingli Wan should be the primary treatment, followed by phlegm-resolving medicines. For lung deficiency, characterized by choking gasps, frequent deep sighing, and sounds in the throat due to chronic illness, Ejiao San (Donkey-Hide Gelatin Powder) should be used to tonify. If phlegm is abundant, strengthen the spleen first, then use Pianyin Wan for purging; once saliva recedes, tonify the lungs using the aforementioned method. For coughing with vomiting of clear water or green-blue water, Baixiang Wan (Hundred Auspicious Pills) should be used for purging. For coughing with vomiting of phlegm, saliva, milk, or food, Baibing Zi (White Cake Pill) should be used for purging. For coughing with pus and blood in the sputum, indicating lung heat, Ganjie Tang should be taken after meals. For chronic coughing where lung fluids are exhausted, Ejiao San should be used to tonify. For coughing with solid phlegm, mild wheezing, flushed face, and frequent thirst, Pianyin Wan should be used for purging. The general principle for treating coughing is: treat excess by purging, treat chronic conditions by tonifying, and adjust dosages based on assessment of excess and deficiency.