一痨伤之人。土气日虚。不能生金。每至咳嗽。惟补其中土。则百病俱愈。宜
六君子汤。加干姜一钱五分。五味子细辛各八分。水煎服。方中虽有人参。久咳肺燥之
人。不忌也。（二）
一久嗽不已。时见喘促者。是肺肾俱虚。天水不交之症。宜
附子理中汤。加茯苓四钱。细辛五味子各八分。阿胶天门冬各三钱。（一百零七）
一咳嗽虽为肺病。其标在肺。其本在肾。肾具水火。水虚者滋之。宜猪苓汤。服四五剂
后。即服六味地黄丸。加蛤蚧麦冬五味。火虚者温之。宜真武汤。去生姜。加干姜细辛五味
子。四五剂后。即服桂附地黄丸。数方俱以利水为主。若读张景岳书辈必谓补肾不可利水。
求正录中有实漏卮之喻。而不知咳嗽必挟饮邪。标在肺而本在肾。天不连地而连水也。今于
水道一利。则上焦之水饮。亦必下行。源流俱清。咳嗽自愈。经云。上焦如雾。中焦如沤。
下焦如渎。但得三焦气化。水道通决。则云行雨施。乾坤有一番新景象矣。
一经云。肺恶寒。又云。形寒饮冷则伤肺。仲景不用人参。以参之性微寒也。然此为新
病而言。若久嗽之人。肺必干燥。且以多咳而牵引诸火而刑金。人参又为要药。如病在金脏
者。宜清燥救肺汤。如病在水脏者。宜琼玉膏。
一实症不可妄用虚症诸方。恐留邪为患也。而虚症。定不可废实症诸方。以咳嗽必有所
以致
有一位患痨伤（慢性消耗性疾病）的人，脾气日渐虚弱，无法滋养肺气。每当出现咳嗽症状时，只要补益中焦脾胃之气，各种疾病都能痊愈。适宜使用六君子汤，加入干姜一钱五分，五味子、细辛各八分，用水煎煮后服用。方剂中虽然含有人参，但对于久咳导致肺燥的患者，也不需忌讳。（二）
另一位长期咳嗽不止，时常出现气喘急促症状的，这是肺肾两虚，属于天水不交（肺金与肾水不能相互滋生）的病证。适宜使用附子理中汤，加入茯苓四钱，细辛、五味子各八分，阿胶、天门冬各三钱。（一百零七）
咳嗽虽然被认为是肺部的疾病，但其标症在肺，其本症在肾。肾脏兼具水火二气，若是肾水亏虚，应当滋补肾阴，适宜使用猪苓汤。服用四五剂后，接着服用六味地黄丸，并加入蛤蚧、麦冬、五味子。若是肾火亏虚，应当温补肾阳，适宜使用真武汤，去掉生姜，加入干姜、细辛、五味子。服用四五剂后，接着服用桂附地黄丸。这几个方剂都以利水为主要功效。如果读张景岳书籍的人，必定会说补肾不可利水，他们在《求正录》中用了“实漏卮”（底破的酒器，比喻补而不守）的比喻，却不知道咳嗽必然夹杂饮邪（痰饮水湿），标症在肺而本症在肾，就像天不直接连地而是通过水相连一样。如今只要水道通畅，上焦的水饮也必然下行，源头和流弊都清澈了，咳嗽自然痊愈。《内经》说：上焦像雾露一样弥漫，中焦像沤渍一样腐熟，下焦像沟渠一样排泄。只要三焦的气化功能正常，水道通利决渎，就会云行雨施，天地呈现一番新景象。
《内经》说：肺恶寒。又说：形体受寒、饮食生冷会损伤肺脏。张仲景在新病时不用人参，是因为人参的性质微寒。然而这是针对新病而言的。如果是久咳之人，肺部必然干燥，且因为频繁咳嗽牵引诸火来刑克肺金，人参又是重要的药物。如果病位在肺脏（金脏），适宜使用清燥救肺汤。如果病位在肾脏（水脏），适宜使用琼玉膏。
实证患者不可妄用治疗虚证的各方，恐怕会留滞邪气造成祸患。而虚证患者，也绝不能废弃治疗实证的各方，因为咳嗽必然有导致其实证的因素存在。
A patient suffering from *Lao Shang* (consumption/chronic debility) experiences a daily decline in Spleen Qi, which fails to generate Lung Metal. Whenever coughing occurs, tonifying the Middle Jiao Earth will cure all diseases. The appropriate prescription is Liu Jun Zi Tang (Six Gentlemen Decoction), with Gan Jiang (Dried Ginger) added at 1.5 qian, and Wu Wei Zi (Schisandra Fruit) and Xi Xin (Asarum) each at 0.8 fen, decocted in water for oral administration. Although Ren Shen (Ginseng Root) is included in the formula, it is not contraindicated for patients with chronic cough and Lung dryness. (2)
Another patient suffers from persistent chronic cough accompanied by occasional panting and shortness of breath. This indicates deficiency of both Lung and Kidney, a syndrome of failure of Heaven (Lung/Metal) and Water (Kidney/Water) to interact. The appropriate prescription is Fu Zi Li Zhong Tang (Aconite Decoction for Regulating the Middle), with Fu Ling (Poria) added at 4 qian, Xi Xin (Asarum) and Wu Wei Zi (Schisandra Fruit) each at 0.8 fen, and E Jiao (Donkey-hide Gelatin) and Tian Men Dong (Asparagus Root) each at 3 qian. (107)
Although cough is considered a Lung disease, its branch manifestation is in the Lung, while its root lies in the Kidney. The Kidney possesses both Water and Fire. If Kidney Water is deficient, it should be nourished; the appropriate prescription is Zhu Ling Tang (Polyporus Decoction). After taking four or five doses, one should then take Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), adding Ge Jie (Gecko), Mai Dong (Ophiopogon Tuber), and Wu Wei Zi (Schisandra Fruit). If Kidney Fire is deficient, it should be warmed; the appropriate prescription is Zhen Wu Tang (True Warrior Decoction), removing Sheng Jiang (Fresh Ginger), and adding Gan Jiang (Dried Ginger), Xi Xin (Asarum), and Wu Wei Zi (Schisandra Fruit). After four or five doses, one should then take Gui Fu Di Huang Wan (Cinnamon and Aconite Pill with Rehmannia). All these formulas primarily focus on promoting urination to drain dampness. Scholars who read Zhang Jingyue’s works would certainly argue that tonifying the Kidney should not involve draining water, citing the metaphor of a "leaking vessel" (*Lou Zhi*) from his book *Qiu Zheng Lu*. However, they fail to realize that cough inevitably involves the retention of fluid pathogens (*Yin Xie*). The branch is in the Lung, but the root is in the Kidney; just as Heaven connects to the earth via water rather than directly, once the water passages are cleared, the fluid retention in the Upper Jiao must descend downward. With both source and flow purified, the cough heals spontaneously. The Classic states: "The Upper Jiao is like mist," "the Middle Jiao is like maceration," and "the Lower Jiao is like a ditch." As long as the Qi transformation of the Three Jiao is normal and the water passages are open and regulated, clouds will move and rain will fall, presenting a new scene in the universe.
The Classic states: "The Lung dislikes cold." It also states: "Exposure to cold and consumption of cold drinks damage the Lung." Zhang Zhongjing did not use Ren Shen (Ginseng Root) for acute illnesses because Ren Shen has a slightly cold nature. However, this applies to new-onset diseases. For patients with chronic cough, the Lungs are necessarily dry, and frequent coughing draws upon various Fires to oppress Lung Metal; thus, Ren Shen remains an essential herb. If the pathology resides in the Metal Zang (Lung), Qing Zao Jiu Fei Tang (Clear Dryness and Rescue the Lung Decoction) is appropriate. If the pathology resides in the Water Zang (Kidney), Qiong Yu Gao (Jade Paste) is appropriate.
Patients with Excess syndromes must not recklessly use formulas for Deficiency syndromes, lest the pathogenic factors remain and cause complications. Conversely, patients with Deficiency syndromes must absolutely not discard formulas for Excess syndromes, because cough invariably arises from underlying causes that may involve excess conditions.