李 曰。五脏传变。皆痰为患。盖痰乃风苗。火静则伏于脾。风动则壅于肺。痰火交作。则为急惊。或成嗽痹。痰
火结滞。则为痫钓。或为咳嗽。痰火来去。则为泻青。皆由脾湿而成。所以惊风忌纯用风药。当以养血药为使。古方保
元汤加白芍。为慢惊美剂也。
脾肺母子也。二脏俱虚。则生 涎。 涎者。脾肺所出也。涎则流溢在于咽喉。如水鸡之声。喘嗽烦闷。宜抱龙丸、
夺命散。
咳嗽哮喘。肺脏所招。为虚为实。有本有标。析而治之。理无或淆。咳则无痰。其声必高。嗽则无声。其痰若胶。
声痰俱有。咳嗽名昭。大抵咳嗽。由伤肺杓。或风乘肺。头痛汗饶。或寒乘肺。肢冷酸 。或热乘肺。面赤热潮。或火
乘肺。涕唾血条。或燥乘肺。毛发如烧。惟嗽之痰。脾湿未消。更详时令。四序分 。秋冬多实。春夏虚劳。更分久暂。
莫任 。初时感冒。邪舍皮毛。淫淫习习。喉痒难搔。嗽久液耗。华盖难浇。声连气促。涎沫盈瓢。更参脏腑。仔细
推敲。呕苦属胆。胁痛肝挠。小肠失气。喉梗心苗。长虫胃呕。吐乳脾嘈。大肠遗粪。喘息肺摇。膀胱遗溺。肾痛背腰。
腹满面肿。此属三焦。须明种种。咳嗽堪标。哮喘相近。细核实遥。哮专主痰。与气相撩。或嗜咸醋。膈腕煎熬。口开
呷吸。口闭呀嗷。呀呷二音。乃合成哮。喘气促急。专主热燎。痰声喝喝。肚撷胸尧。抬肩张口。鼻扇气 。俱为恶候。
非可易调。故知肺病。不自一朝。金为火克。热被寒包。根因不一。辨析厘毫。整肃娇脏。永令坚牢。
李中梓说：五脏疾病的传变，都是由痰邪作祟引起的。因为痰是风邪的先兆，火邪静止时潜伏在脾脏，风邪发动时壅塞在肺脏。痰与火相互交争，就会形成急惊风；或者形成咳嗽痹阻。痰与火结滞不通，就会形成痫证或抽搐（钓风）；或者引发咳嗽。痰火往来游走，就会导致泻青（肝木乘脾）。这些病症都是由脾虚湿盛而形成的。所以治疗惊风忌讳单纯使用祛风药物，应当以养血药作为引导。古方保元汤加入白芍，是治疗慢惊风的良方。
脾和肺是母子关系。如果这两脏都虚弱，就会产生涎沫。涎沫是由脾和肺产生的。涎液流溢到咽喉部位，发出像水鸡叫一样的声音，伴有气喘、咳嗽、心烦闷乱的症状，适宜使用抱龙丸、夺命散治疗。
咳嗽和哮喘，是肺脏受邪招致的。病情有虚证和实证之分，有本证和标证之别，需要分析清楚后分别治疗，道理不会混淆。咳嗽时没有痰，声音必然高亢；嗽时没有声音，但痰液像胶一样粘稠。既有声音又有痰，才称为咳嗽。大抵来说，咳嗽是由于损伤了肺的肃降功能。或者是风邪侵袭肺脏，出现头痛、出汗多的症状；或者是寒邪侵袭肺脏，出现四肢发冷、酸痛的症状；或者是热邪侵袭肺脏，出现面红、身热的症状；或者是火邪侵袭肺脏，出现鼻涕唾液中带血条的症状；或者是燥邪侵袭肺脏，出现毛发干枯如烧焦的症状。只有嗽出来的痰，是因为脾湿未除，还需要详细辨别季节时令。四季之中，秋冬多实证，春夏多虚劳证。还要区分病程的长短，不要放任不管。初起时是感冒，邪气停留在皮毛，皮肤感觉如水湿浸渍般不适，喉痒难忍。咳嗽久了会耗伤津液，导致肺阴不足（华盖难浇），声音连续且气息急促，涎沫增多如瓢满。还要参考脏腑情况，仔细推敲。呕吐苦水属于胆病，胁肋疼痛属于肝病，小肠气机失调，喉咙梗塞属于心病，蛔虫扰动导致胃呕，吐乳属于脾病嘈杂，大肠失固导致遗粪，喘息剧烈属于肺气摇动，膀胱失约导致遗尿，肾痛牵连背腰，腹部胀满全身浮肿，这属于三焦病变。必须明白各种情况，才能将咳嗽作为诊断的标准。哮喘与咳嗽相近，但要仔细核实其差异。哮证专门主因于痰，与气机相互撩动。有的人嗜好咸味醋味，导致膈间烦闷煎熬，张口吸气，闭口呼气发出呀呷的声音。“呀”和“呷”两个声音合成即为“哮”。喘证气息急促，专门主因于火热燎原，痰声呼呼作响，肚腹内陷胸部高耸，抬肩张口，鼻翼扇动，这些都是恶候，不容易调理。所以知道肺病不是一朝一夕形成的，肺金被火克制，热气被寒气包裹，根本原因不一，需要辨析毫厘。要整肃娇嫩的肺脏，使其永远坚固牢靠。
Li Zhongzi stated: The transmission of diseases among the five Zang organs is all caused by Phlegm (Tan, 痰). Phlegm is the seedling of Wind (Feng, 风); when Fire (Huo, 火) is still, it lies latent in the Spleen (Pi, 脾); when Wind moves, it obstructs the Lung (Fei, 肺). When Phlegm and Fire interact violently, they manifest as Acute Convulsion (Ji Jing Feng, 急惊风); or they may form Cough Bi (Sou Bi, 嗽痹). When Phlegm and Fire stagnate and knot, they manifest as Epilepsy (Xian, 痫) or Tendon Crisis (Diao Feng, 钓风); or they cause Cough (Ke Sou, 咳嗽). When Phlegm and Fire come and go, they lead to Liver Wood overacting on Earth (Xie Qing, 泻青). All these conditions arise from Dampness (Shi, 湿) in the Spleen. Therefore, in treating Convulsions (Jing Feng, 惊风), one must avoid using purely Wind-expelling medicines; instead, Blood-nourishing herbs should be used as guides. The ancient formula Baoyuan Tang (Preserve Origin Decoction) added with Bai Shao (Radix Paeoniae Alba) is an excellent remedy for Slow Convulsion (Man Jing Feng, 慢惊风).
The Spleen and Lung are in a mother-son relationship. If both Zang organs are deficient, they produce Saliva (Xian, 涎). Saliva originates from the Spleen and Lung. When Saliva flows and overflows into the throat, it produces sounds like that of a water chicken, accompanied by panting, coughing, irritability, and oppression. One should use Baolong Wan (Embrace Dragon Pill) and Duoming San (Snatch Life Powder).
Cough (Ke Sou, 咳嗽) and Asthma (Xiao Chuan, 哮喘) are induced by pathogenic factors affecting the Lung. Conditions can be Excess (Shi, 实) or Deficiency (Xu, 虚), having Root (Ben, 本) and Branch (Biao, 标) aspects, which must be analyzed and treated separately without confusion. In Cough without phlegm, the voice is necessarily high. In Sou (a type of cough with phlegm but no distinct sound), there is no sound, but the phlegm is sticky like glue. When both sound and phlegm are present, it is clearly called Ke Sou. Generally, cough arises from damage to the Lung's descending function. It may be due to Wind invading the Lung, presenting with headache and profuse sweating; or Cold invading the Lung, presenting with cold limbs and soreness; or Heat invading the Lung, presenting with red face and feverish sensation; or Fire invading the Lung, presenting with bloody streaks in nasal discharge and saliva; or Dryness invading the Lung, presenting with dry, burnt-looking hair. The phlegm produced by Sou indicates that Spleen Dampness has not yet dissipated, requiring detailed differentiation according to seasonal timing. In the four seasons, Autumn and Winter tend toward Excess patterns, while Spring and Summer tend toward Deficiency-Wasting patterns. One must also distinguish between acute and chronic cases and not let them progress unchecked. Initially, it is a common cold where pathogens reside in the skin and hair, causing a creeping discomfort and unbearable throat itching. Chronic cough consumes fluids, making it difficult to moisten the Lung (Huagai, 华盖 - metaphor for Lung). The voice becomes continuous with shortness of breath, and saliva and foam fill the bowl. One must further consult the Zang-Fu organs for careful deduction. Vomiting bitter fluid belongs to the Gallbladder (Dan, 胆); hypochondriac pain belongs to the Liver (Gan, 肝); small intestine failing to move Qi causes throat obstruction, belonging to the Heart (Xin, 心); roundworms disturbing the Stomach (Wei, 胃) cause vomiting; vomiting milk belongs to Spleen Cacao (irritability); large intestine failing to retain feces leads to enuresis/incontinence; severe panting indicates Lung instability; bladder failing to control urine leads to incontinence; Kidney (Shen, 肾) pain radiating to the back and waist; abdominal distension and whole-body edema belong to the Triple Burner (San Jiao, 三焦). One must understand these various manifestations to correctly identify Cough. Asthma is similar to Cough but requires careful verification of differences. Xiao (Asthma with phlegm-rattle) is primarily caused by Phlegm interacting with Qi. Some who indulge in salty or sour foods suffer from stifling heat in the chest and diaphragm, opening their mouth to inhale and closing it to exhale, producing "ya" and "xia" sounds. The combination of these two sounds constitutes "Xiao". Chuan (Panting/Asthma without rattle) is characterized by rapid breathing and is primarily caused by scorching Heat. With rattling phlegm sounds, the abdomen retracts and the chest protrudes, shoulders lift, mouth opens, and nasal wings flare. These are all ominous signs and difficult to regulate. Thus, one knows that Lung disease does not develop overnight. Metal (Lung) is controlled by Fire, and Heat is wrapped by Cold. The root causes vary, requiring meticulous differentiation. One must rectify the delicate Lung organ to keep it firm and secure forever.