一、外感之嗽，无论四时，必皆因于寒邪，盖寒随时气入客肺中，所以致嗽。但治以
辛温，其邪自散，惟六安煎加生姜为最妙。
凡属外感，悉宜先以此汤加减主之。若肺脘燥涩，痰气不利，或年老血衰，咳嗽费力者
，于本方加当归二三钱。若寒气太盛，或中寒肺气不温，邪不能解者，于此方加北细辛七八
分或一钱。若冬月寒盛气闭，邪不易散者，即麻黄、桂枝俱可加用，或用小青龙汤。若伤风
见寒，或伤寒见风，而往来寒热，咳嗽不止者，宜柴陈煎主之。若寒邪不甚，痰气不多者，
但以二陈汤加减主之，则无有不愈。
一、外感之嗽，凡属阴虚少血，或脾肺虚寒之辈，则最易感邪。但察其脉体稍弱，胸膈
无滞，或肾气不足，水泛为痰，或心 呕恶，饥不欲食，或年及中衰，血气渐弱，而咳
嗽不能愈者，悉宜金水六君煎加减主之，足称神剂。若兼阳分气虚，而脉微神困，懒言多汗
者，必加人参，勿疑也；若但以脾胃土虚不能生金，而邪不能解，宜六君子汤以补脾肺；或
脾虚不能制水，泛而为痰，宜理中汤，或理阴煎、八味丸之类以补土母，皆良法也。
一、外感咳嗽而兼火者，必有内热喜冷脉滑等证，亦但以二陈、六安等汤酌加凉药佐之
，热微者可加黄芩一二钱，热甚者再加知母、栀子之属。若火在阳明而兼头痛热渴者，惟加
石膏为宜。
一、外感之证，春多升浮之气，治宜兼降，如泽泻、前胡、海石、栝蒌之属是也。夏多
炎热之气，治宜兼凉，如芩、连、知、柏之属是也。秋多阴湿之气，治宜兼燥，如苍术、白
术、干姜、细辛之属是也。冬多风寒之气，治宜兼散，如防风、紫苏、桂枝、麻黄之属是也
。经言岁气天和，即此之类。然时气固不可不知，而病气尤不可不察，若当其时而非其病，
及时证有不相合者，又当舍时从证也。至于各脏之气，证有兼见者，又当随宜兼治，故不可
任胶柱之见。
一、咳嗽凡遇秋冬即发者，此寒包热也，但解其寒，其热自散，宜六安煎、二陈汤、金
水六君煎三方，察其虚实壮老，随宜用之。如果内热甚者，不妨佐以黄芩、知母之类。
一、外感引起的咳嗽，无论哪个季节，必定是因为寒邪所致。因为寒邪随着时令之气侵入肺中，从而导致咳嗽。治疗应当使用辛温性质的药物，邪气自然就会消散，其中六安煎加生姜的效果最为奇妙。
凡是属于外感引起的咳嗽，都适宜先用这个方剂进行加减作为主方。如果肺部和胃脘部干燥涩滞，痰气和利不畅，或者是年老体弱血液亏虚，咳嗽费力的人，在本方中加入当归二到三钱。如果寒气太盛，或者中焦受寒导致肺气不温暖，邪气无法解除的，在这个方子中加入北细辛七八分或一钱。如果是冬季寒气极盛、气机闭塞，邪气不易散去的，麻黄和桂枝都可以加入使用，或者使用小青龙汤。如果是伤风兼见寒象，或者伤寒兼见风象，出现往来寒热、咳嗽不止的情况，适宜用柴陈煎主治。如果寒邪不严重，痰气不多的，只用二陈汤加减主治，就没有治不好的。
一、外感引起的咳嗽，凡是属于阴虚血少，或者脾肺虚寒体质的人，最容易感受邪气。只要观察其脉象稍弱，胸膈没有停滞感，或者是肾气不足，水液泛滥形成痰饮，或者心中烦闷、恶心呕吐，饥饿但不想进食，或者是年纪到了中年衰退期，气血逐渐虚弱，而咳嗽不能痊愈的，都适宜用金水六君煎加减主治，这足以称为神效的方剂。如果兼有阳气分的气虚，脉象微弱、精神困倦、懒言多汗的，必须加入人参，不要犹豫；如果只是由于脾胃土虚不能生养肺金，导致邪气不能解除，适宜用六君子汤来补益脾肺；或者是脾虚不能制约水湿，水湿泛溢成为痰饮，适宜用理中汤，或者理阴煎、八味丸之类的方剂来补益脾土（母脏），这些都是很好的方法。
一、外感咳嗽兼有火邪的，必然会有内热、喜冷饮、脉滑等症状，也只需以二陈汤、六安煎等方剂酌情加入凉性药物辅助治疗，热势轻微的可以加入黄芩一二钱，热势严重的再加知母、栀子之类的药物。如果火邪在阳明经且兼有头痛、发热口渴的症状，只有加入石膏才合适。
一、外感的病证，春季多升浮之气，治疗适宜兼顾降气，如泽泻、前胡、海浮石、瓜蒌之类的药物就是这类。夏季多炎热之气，治疗适宜兼顾清凉，如黄芩、黄连、知母、黄柏之类的药物就是这类。秋季多阴湿之气，治疗适宜兼顾燥湿，如苍术、白术、干姜、细辛之类的药物就是这类。冬季多风寒之气，治疗适宜兼顾发散，如防风、紫苏、桂枝、麻黄之类的药物就是这类。医经所说的顺应岁气保持天和状态，就是指的这一类道理。然而时令之气固然不可不知，但病邪的性质尤其不可不仔细考察，如果处于某个季节却不是该季节的典型病症，或者时令症状与病情不相符合时，又应当舍弃时令因素而从实际证候出发。至于各个脏腑的气机，证候有兼见的情况，又应当根据具体情况兼顾治疗，所以不可以拘泥固执。
一、咳嗽凡是遇到秋冬季节就发作的，这是寒包热的证候，只要解除了寒邪，内热自然就会消散，适宜使用六安煎、二陈汤、金水六君煎这三个方剂，根据患者的虚实、强弱、年龄大小，酌情选用。如果确实内热严重的，不妨辅助加入黄芩、知母之类的药物。
1. Cough caused by external contraction, regardless of the season, is invariably due to Cold pathogen (Han Xie), as Cold enters the Lung (Fei) along with the seasonal Qi, thereby inducing cough. Treatment should employ Pungent-Warm (Xin Wen) methods to disperse the pathogen naturally; among these, Liu'an Decoction (Liu'an Jian) with added Fresh Ginger (Sheng Jiang) is most excellent.
For all cases of cough due to external contraction, it is appropriate to first use this decoction with modifications as the primary formula. If there is dryness and astringency in the Lung and epigastrium, with obstructed Phlegm-Qi, or if the patient is elderly with declining Blood, experiencing laborious coughing, add Dang Gui (Angelicae Sinensis Radix) 2-3 qian to the base formula. If Cold pathogen is excessively strong, or Middle Jiao Cold causes Lung Qi to be unwarmed such that the pathogen cannot be resolved, add Bei Xi Xin (Asari Radix) 7-8 fen or 1 qian to this formula. In winter, when Cold is severe and Qi is closed, making the pathogen difficult to disperse, both Ma Huang (Ephedrae Herba) and Gui Zhi (Cinnamomi Ramulus) may be added, or Xiao Qing Long Tang (Minor Blue Green Dragon Decoction) may be used. If Wind Strike presents with Cold signs, or Cold Damage presents with Wind signs, accompanied by alternating chills and fever and incessant coughing, Chai Chen Jian (Chai Chen Decoction) is indicated. If the Cold pathogen is not severe and Phlegm-Qi is scant, treating solely with Er Chen Tang (Two-Cured Decoction) with modifications will ensure recovery.
1. For cough due to external contraction, individuals with Yin deficiency and Blood insufficiency, or those with Spleen-Lung Deficient-Cold constitutions, are most susceptible to pathogens. Observe if the pulse is slightly weak and the chest/diaphragm lacks stagnation, or if Kidney Qi is insufficient causing Water overflow into Phlegm, or if there is mental restlessness, nausea/vomiting, hunger without desire to eat, or if the patient has reached middle age decline with gradually weakening Qi and Blood, yet cough persists, all such cases should be treated primarily with Jin Shui Liu Jun Jian (Golden Water Six Gentlemen Decoction) with modifications, which deserves the title of a miraculous formula. If accompanied by Qi deficiency in the Yang aspect, manifesting as faint pulse, spiritual fatigue, reluctance to speak, and profuse sweating, Ren Shen (Ginseng Radix et Rhizoma) must be added without hesitation; if the issue is merely Spleen Earth deficiency failing to generate Lung Metal, preventing pathogen resolution, Liu Jun Zi Tang (Six-Gentlemen Decoction) should be used to tonify Spleen and Lung; or if Spleen deficiency fails to control Water, leading to Phlegm overflow, Li Zhong Tang (Regulate the Middle Decoction), or Li Yin Jian (Nourish Yin Decoction), or Ba Wei Wan (Eight-Ingredient Pill) may be used to tonify the Mother organ (Spleen Earth); these are all sound methods.
1. External cough accompanied by Fire pathogen necessarily presents with internal heat, preference for cold drinks, and slippery pulse. Treat primarily with Er Chen Tang or Liu'an Jian, adding cooling herbs as adjuvants: for mild heat, add Huang Qin (Scutellariae Radix) 1-2 qian; for severe heat, additionally add Zhi Mu (Anemarrhenae Rhizoma) and Zhi Zi (Gardeniae Fructus). If Fire is in the Yangming channel accompanied by headache, fever, and thirst, Shi Gao (Gypsum Fibrosum) is most appropriate.
1. In external contraction diseases, Spring features ascending and floating Qi; treatment should incorporate descending agents such as Ze Xie (Alismatis Rhizoma), Qian Hu (Peucedani Radix), Hai Shi (Fossilia Osseum), and Gua Lou (Trichosanthis Fructus). Summer features hot and scorching Qi; treatment should incorporate cooling agents such as Huang Qin (Scutellariae Radix), Lian Lian (Coptidis Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), and Bai Zhu (Atractylodis Macrocephalae Rhizoma - *Note: Text says Bai Zhu but context implies Bai Xie/Bai Hu? Actually text says "Bai" likely referring to Huang Bo or similar, standard interpretation often includes Huang Bo here, but strictly translating text "Bai" usually refers to Bai Zhu or Bai Xian Pi, however in context of cooling summer heat, it likely implies Huang Bo or similar bitter-cold herbs. The text lists "Qin, Lian, Zhi, Bai". In TCM context for clearing heat, "Bai" often refers to Huang Bo (Phellodendri Cortex) or sometimes Bai Tou Weng, but given the list, it's likely a shorthand for a bitter-cold herb. I will translate as "Bai [Herb]" or infer Huang Bo based on standard pairing, but strict translation requires caution. Let's stick to the literal "Bai" implying a specific herb mentioned in context, often interpreted as Huang Bo in this specific grouping in Zhang Jingyue's works, or potentially Bai Xian Pi. However, WHO standards prefer precise names. Given "Qin, Lian, Zhi", "Bai" is almost certainly Huang Bo (Phellodendri Cortex) in this classical context of clearing heat/fire. I will use Huang Bo (Phellodendri Cortex) with a note or just translate as the herb name provided in context. Actually, looking at Zhang Jingyue's style, he often abbreviates. I will translate as "Huang Bo (Phellodendri Cortex)" assuming standard medical context, or keep generic if unsure. Let's look at Autumn: "Cang Zhu, Bai Zhu, Gan Jiang, Xi Xin". Winter: "Fang Feng, Zi Su, Gui Zhi, Ma Huang". So "Bai" in Summer likely parallels "Bai Zhu" in Autumn? No, Bai Zhu is damp-drying. For Summer Heat, one needs cooling. It is highly likely Huang Bo. I will translate as Huang Bo (Phellodendri Cortex)).* Correction: In many editions, this line reads "Qin, Lian, Zhi, Bai" where Bai refers to Huang Bo. I will use Huang Bo (Phellodendri Cortex).
Autumn features yin and damp Qi; treatment should incorporate drying agents such as Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Jiang (Zingiberis Rhizoma), and Xi Xin (Asari Radix). Winter features Wind-Cold Qi; treatment should incorporate dispersing agents such as Fang Feng (Saposhnikoviae Radix), Zi Su (Perillae Folium), Gui Zhi (Cinnamomi Ramulus), and Ma Huang (Ephedrae Herba). The Classics state "harmonizing the annual Qi to maintain Heavenly Harmony," referring to such principles. Although seasonal Qi must be known, the nature of the disease pathogen must be examined even more carefully. If the season does not match the disease, or if seasonal symptoms do not align with the clinical presentation, one must abandon the seasonal consideration and follow the syndrome. Regarding the Qi of various Zang organs, if syndromes present concurrently, treatment must be adapted accordingly; thus, one must not adhere rigidly to fixed rules.
1. Cough that recurs every autumn and winter is due to Cold enveloping Heat. Resolving the Cold will naturally dissipate the Heat. Suitable formulas include Liu'an Jian (Liu'an Decoction), Er Chen Tang (Two-Cured Decoction), and Jin Shui Liu Jun Jian (Golden Water Six Gentlemen Decoction); select appropriately based on the patient's deficiency/excess, robustness, and age. If internal heat is indeed severe, adjuvant use of Huang Qin (Scutellariae Radix) and Zhi Mu (Anemarrhenae Rhizoma) is permissible.