卜 心咳之状，咳则心痛，喉仲介介如梗状，甚则咽肿喉痹。盖因风温袭肺，引动心包之火上逆，故治
法仍宜宣散肺经风邪，参入宁心缓火之品。仲景方法，略示其端，但语焉而未详，后人未细审耳。
前胡 杏仁 象贝 桔梗 射干 远志（甘草汤制） 麦冬 沙参
小麦一两煎汤代水。（微妙在此一味。）
渊按∶非深入仲景堂奥不能道。用宣散肺金风温之方，加小麦一两，清心热，即补心虚，何等灵敏。
胡 咳嗽呕吐，痰浓头痛，风热上蕴，肺胃失降。
前胡 杏仁 苏子 橘红 款冬花 桑白皮 防风 桑叶 冬瓜子
丁 形寒饮冷则伤肺，两寒相感，中外皆伤，故气逆而为咳嗽。自秋冬历春夏，每每夜甚，气升不得卧。
近来吐血数口，是伏寒化热，而阳络受伤矣。祛其伏寒，退其伏热，必兼降气化痰。
紫菀 杏仁 款冬花 橘红 川贝 茯苓 桂枝 淡黄芩 桔梗 半夏 桑白皮 枇杷叶
胡 肺有风邪则咳，胃有湿痰则满。肾虚则腰痛，肝虚则目花。既不可徒散，亦未可徒补，拟两顾法。
苏子降气汤去桂枝，加茯苓、玉竹、 豆衣、桑叶、胡桃肉、枇杷叶。
某 素有寒嗽，时发时止。上年岁底发时，寒热六七日方止。至春初，喉痛三日，声音遂哑，而咳嗽
作。总因风温袭于肺部。宜宣邪降气，冀免喘急。
旋复花 荆芥 杏仁 款冬花 前胡 苏子 枳壳 川贝 川芎 桔梗 蛤壳 枇杷叶
许 寒嗽交冬则发，兼患颈项强急。
大熟地（六钱，麻黄一钱煎汁浸，炒松） 茯苓（三钱，细辛五分煎汁浸，炒）
胡桃肉（四钱） 五味子（八分，淡姜一钱同炒） 陈皮（二钱，盐水炒） 半夏（钱半，炒） 川
贝（三钱） 款冬花（三钱） 苡仁（四钱） 杏仁霜（三钱） 归身（三钱，酒炒） 党参（三钱，元米炒）
上药为末，炼蜜为丸。每晨开水送下三钱。
渊按∶久嗽宜此方。若颈项强急，未免有外风袭三阳经也，何不以汤剂兼治之。
僧 咳嗽七八年，咳甚必汗出。近半年以来痰中见血两次，肺气肾阴亏损矣。虑加内热，延成劳怯。
大熟地 归身 蛤壳 北沙参 麦冬 川贝 甜杏仁 苏子 桑白皮 炙甘草 枇杷叶
又 久嗽肺肾交虚，犹幸胃气尚旺。法以金水同治，冀精气渐生。
大熟地 归身 炙甘草 潞党参 桂枝 款冬花 炮姜 麦冬 半夏 阿胶 蛤壳
此方炙甘草合麦门冬汤。病由寒伏肺底，致成咳嗽，日久伤及精气，故于滋补中兼化痰。
又 久嗽汗出，诸药不效。用宁肺散。
粟壳（一两六钱，醋炒） 炙乌梅肉（四钱）
共研末，每服三钱，下午开水调服。朝服金水六君子丸四钱，开水送下。
张 十年前三疟之后，盗汗常出，阴津大伤。去秋咳嗽气升，
痰中带血。至今行动气喘，内热多汗，食少无力，脉虚细数，劳损根深。
四君子汤加五味子、熟地、焦六曲、粟壳、紫石英、熟附子、黄 、白芍、麦冬。
又 肺主出气，肾主纳气。肾虚不能纳气，气反上逆而喘。
痰饮留中，加以汗出阳虚，咳血阴虚，内热食少，肺肾虚劳之候。
四君子汤加麦冬、紫石英、熟附子、丹皮、大熟地、半夏、白芍、沉香、五味子、粟壳、乌梅。
渊按∶夺血毋汗，夺汗毋血。血，阴也；汗，亦阴也。何以
言阴虚阳虚？盖汗出为阳气失卫，咳血为阴火所迫，故有阴阳之分。
又 盗汗气喘，咳嗽脉细。精气两虚，舍补摄肺肾之外，更
将何法以治！景岳云∶大虚之症即微补尚难见效，而况于不补乎？
前方加归身、牡蛎、龙骨、黄 。
姚 咳嗽将及一年，阴阳之气各造其偏。阳虚则外寒，阴虚
生内热。夏令湿热用事，迩日寒暄不调，脾胃伤戕，恐致成劳，毋忽！
沙参 茯苓 五味子 麦冬 黄 川贝 苡仁 沙苑子 玉竹 枇杷叶
又 脉数未退，阴虚未复。咳嗽不止，肺气日虚。夏暑将临，病尚未稳，仍宜小心安养为要。
大生地 生洋参 麦冬 川贝 玉竹 五味子 黄 沙参 茯苓 枇杷露
唐 七旬有六之年，面色红润，脉形坚搏，外似有余，里实
不足。屡患咳嗽，娇脏暗伤。本月初旬微感风温，咳嗽又
作。舌苔薄白，底有裂纹，饮食略减。风温久恋，劫胃津，灼肺阴。不可再投辛散，当以甘润生津。
花粉 沙参 玉竹 麦冬 苡仁 杏仁 川贝 桑叶
李 咳嗽喉痒，痰或稀或浓，浓则腥臭。脉象右弦而滑，左弦小数。肝经有郁勃之热，肺家有胶粘之痰。
此痰为火郁而臭，并非肺痈可比。当以平肝开郁，参清金化痰。
沙参 橘红 苏子 杏仁 石决明 川贝 茯苓 丹皮 蛤壳 枇杷叶 陈海蜇（漂淡） 地栗
许 咳嗽面白为金伤，脉数而洪属虚火，是脉克色而火胜金也。夏至一阴生，正属火令，为剥极则
复之际。倘若剥而不复，颇有火灼金销之虑。
党参 黄 炙甘草 茯苓 怀山药 麦冬 沙参 五味子 紫菀 陈皮
此生脉散合六君子汤加紫菀。夫四君去术加黄 、山药、陈皮，亦名六君，在《医方集解》中。
王 暑风从背俞而内薄于肺，湿热从胃脉而上注于肺，外内合邪，其气并于胸中，气不得通，因而上逆，
气升作咳。舌苔薄白，口腻不渴，治属饮家。
半夏 陈皮 枳壳 马兜铃 杏仁 射干 通草 冬瓜子 枇杷叶
渊按∶宜佐开泄暑风之药一二味，如香薷、苏梗之类。
阙 体弱素亏，频年屡患咳嗽。今春产后悲伤，咳嗽复作，背寒内热，气逆痰多，脉虚数，大便溏。延
今百日，病成蓐劳。按产后血舍空虚，八脉之气先伤于下，加以悲哀伤肺，咳嗽震动，
冲脉之气上逆。经云∶冲脉为病，逆气里急。阳维为病苦寒热。频进疏风清热，脾胃再伤，以致腹痛便溏，食
减无味，斯皆见咳治咳之弊。越人谓上损及脾，下损过胃，俱属难治。姑拟通补奇经，
镇摄冲脉，复入扶脾理肺。未能免俗，聊复尔尔。
大熟地（砂仁炒炭） 当归（小茴三分拌炒） 紫石英 白芍（桂枝三分拌炒） 白茯苓 川贝 牛膝（盐水炒）
张 稚龄形瘦色黄，痰多食少，昼日微咳，夜寐则喉中 吼有声。病已半载，性畏服药。此脾虚湿
热蒸痰阻肺也。商用药枣法。
人参 炙甘草 冬术 茯苓 制川朴 苍术 宋半夏 陈皮 川贝 榧子
上药各研末，和一处。用好大枣一百枚，去核，将药末纳入枣中，以线扎好。每枣一枚大约纳药二分
为准。再用甜葶苈一两，河水两大碗，用枣煮，候枣软熟，不可太烂，取出，晒干。
候饥时，将枣细嚼一枚。一日可用五、六枚。余枣汤去葶苈，将汤煎浓至一茶杯，分三次先温服。
此平胃、六君子汤加川贝、榧子也。制法极好。治脾虚湿热
蒸痰阻肺，喉中痰多者，从葛可久白凤膏化出，颇有巧意。服之遂愈。
渊按∶心思巧妙，触发后学不少。
毕 劳心苦志，耗损营阴。阴虚生内热，热胜则风动，由是心悸少寐，头眩咳嗽，晡热朝凉，种种病情，
相因而至。前议甘凉生津，微苦泄热，服后热减咳稀，原得小效。而或谓外感，改
投辛散，杂入消导苦寒，以致咳频汗多。犹云邪未尽达，再欲发
汗。大言不惭，岂非痴人说梦耶！余今仍用甘凉，窃恐见此方者，又訾议于后也。呵呵！
沙参 玉竹 麦冬 地骨皮 茯苓 川贝 豆衣 茯神 钟乳石 悉尼肉 红枣
奚 风邪袭肺，肺气失宣。一月以来咳嗽，上引头痛，乃振动肝胆之阳也。幸胃旺能食，邪未延及
于中。第久恋于肺者，势必渐化为热。乃咳而喉痛、音哑，肺阴为热耗矣。宣风散热，润
肺化痰，是其治法。然非数剂所能治。盖风入肺系，祛之亦不易也。
牛蒡子 马兜铃 川贝 桔梗 杏仁 生甘草 海浮石 蛤壳 阿胶 桑叶 枇杷叶
另∶蛤粉一两，青黛二钱，蝉蜕七分，共三味，研为细末。分七服，药汁调下，每日一服。
肺阴已伤，引动肝阳，咳作头痛，青蛤散颇合。皂荚子不可用，恐劫液也。
戴 五脏皆有咳，总不离乎肺。肺为娇脏，不耐邪侵，感寒则咳，受热则咳，初起微有寒热，必夹
表邪。邪恋肺虚，脉形空大。前方降气化痰，保肺涤饮，俱无少效。据云得汗则身体轻
快，想由肺气虽虚，留邪未尽。补虚而兼化邪，亦一法也。用钱氏法。
牛蒡子（元米炒） 马兜铃 杏仁 阿胶（蛤粉炒） 苏子 桑白皮
款冬花 炙甘草 茯苓 桑叶 枇杷叶
沈 脉虚软而似数，内伤虚弱奚疑！夫邪之所凑，其气必虚。虚处受邪，其病则实。咳嗽虽由外感，而
实则因于气虚。以为风寒固不可，以为虚损未必可。玉竹饮子主之。
玉竹 杏仁 苏子 桑白皮 款冬花 旋复花 沙参（元米炒） 象贝 橘红 枇杷叶
岑 烦劳疲极则伤肝，肝伤则气逆而上迫，为胁痛，为咳嗽。
秦氏所谓先胁痛而后咳者，肝伤肺也。治法不在肺而在于肝。夏令将临，恐有失血之虞。
旋复花 桃仁炭 杏仁 川贝 苏子 冬瓜子 黑山栀 丹皮 郁金 苡仁 枇杷露
祝 咳嗽夜重，风寒伤于肺，劳碌伤于肾。肾气上逆，故重咳于夜也。
前胡 杏仁 象贝 橘红 半夏 旋复花 紫菀 茯苓 沉香 沙苑子
渊按∶治风寒则可矣，治肾虚则未也。
某 咳嗽白痰味咸，是肾虚水泛为痰也。小便黄，阴虚内热。
初起虽有风寒，日久亦从热化，而元气渐虚矣。今从肺肾图治。
沙参 玉竹 橘红 甜杏仁 茯苓 川贝 紫菀 蛤壳 金狗脊 十大功劳
平 病起伤风咳嗽，邪留肺系。久咳伤阴，火起于肾，上冲于心，心中热痒则咳甚而肤热，迨火降则热亦
退而稍平。其所以发热者，由于阴虚也。惟胃纳甚少，滋阴之药不宜过，当以金土
水三脏皆调。立夏在前，冀其热减为妙。
大生地（蛤粉拌捣） 阿胶（米粉拌炒） 怀山药 炙甘草 川贝 五味
子茯苓 牛蒡子 丹皮（炒焦） 橘红 紫菀 枇杷叶
仁渊曰∶咳嗽一证，最为难治。外感固不可擅用清滋，即内伤之咳，亦未可擅用冬、地，须察其病因在
何脏腑而施治。疗久咳必先顾其胃气，未有胃不顺而咳可愈者。经谓∶十二经皆有
咳，非独肺也。皮毛者，肺之合也。皮毛先受邪气，邪气以从其合也。其寒饮食入胃，则肺寒。肺寒则内外
合邪，因而客之，则为肺咳。此言外感之咳，从感寒饮寒而起，邪由皮毛而内合于肺，
或散或温或凉，从肺主治。其饮热受热者，亦可隅反。若内伤之咳，则五脏十二经皆有，断不可专治其肺。
盖咳在肺，所以致咳不在肺。五脏六腑苟有一气之逆，触动肺气，即能作咳。医经
旨“聚于胃、关于肺”二语，深得咳嗽要言。夫胃有五窍，如闾里门户。水谷入胃，渣滓由下脘传小肠，水
液即从旁窍而出，传布三焦，由中焦蒸化，至上焦为津液，渗下焦为便溺。今脏腑之
气失顺，逆击于肺作咳，胃窍之水饮不能尽化津液，聚于上脘而为痰涎，寒则痰稀，热则痰浓。前人论脾乃
生痰之源，肺为贮痰之器。今读西国医书，谓咳痰不从肺出，即从胃脘而来。证以经
文“聚于胃、关于肺”二语，始知前人所论非是。按前贤论咳嗽
者甚多，至“聚于胃”三字，从未论及，岂《内经》此言漫无着落耶？今得西医剖视之书，益见《内经》
之精。至何脏何腑之逆，虚实之辨，当详参脉证。经文于此尤为精细，不难按证用药。
兹集外感内伤为一编，读者宜细绎之，勿混治也。
卜：心咳的症状，咳嗽时伴有心痛，咽喉中有异物感如梗塞状，严重时会出现咽肿喉痹。这是因为风温之邪侵袭肺脏，引动心包之火上逆，所以治法仍宜宣散肺经的风邪，并参入宁心安神、清缓虚火的药物。张仲景的方法，略微展示了其端倪，但论述不够详尽，后人没有仔细审察罢了。
前胡 杏仁 象贝母 桔梗 射干 远志（用甘草汤炮制） 麦冬 沙参
小麦一两煎汤代替水煎药。（精妙之处就在这味药。）
渊按：不是深入钻研张仲景医学的精髓就不能说清楚。使用宣散肺金风温的方剂，加入一两小麦，既能清心热，又能补心虚，何等灵敏巧妙。
胡：咳嗽呕吐，痰液浓稠头痛，这是风热上蕴，导致肺胃之气失于肃降。
丁：形体怕冷且饮食生冷会损伤肺脏，内外两寒相感，导致身体内外都受伤，所以气机上逆而引发咳嗽。从秋冬到春夏，往往夜间加重，气机上冲无法平卧。
近来吐血几口，这是潜伏的寒气化为热邪，损伤了阳络（体表及上部的血络）。祛除潜伏的寒气，消退潜伏的热邪，必须兼用降气化痰的方法。
紫菀 杏仁 款冬花 橘红 川贝母 茯苓 桂枝 淡黄芩 桔梗 半夏 桑白皮 枇杷叶
胡：肺有风邪就会咳嗽，胃有湿痰就会胀满。肾虚就会腰痛，肝虚就会眼花。既然不能单纯发散，也不能单纯进补，拟采用兼顾两者的方法。
苏子降气汤去掉桂枝，加入茯苓、玉竹、豆衣、桑叶、胡桃肉、枇杷叶。
某：素有寒性咳嗽，时发时止。去年年底发作时，寒热症状持续六七天才停止。到了春初，喉咙痛三天，声音随即嘶哑，咳嗽随之发作。总因风温之邪侵袭肺部。适宜宣散邪气、降气，希望避免喘息急促。
旋复花 荆芥 杏仁 款冬花 前胡 苏子 枳壳 川贝母 川芎 桔梗 蛤壳 枇杷叶
许：寒性咳嗽在冬季发作，同时患有颈项强直拘急。
大熟地黄（六钱，用一钱麻黄煎汁浸泡，炒至松脆） 茯苓（三钱，用五分细辛煎汁浸泡，炒）
胡桃肉（四钱） 五味子（八分，与一钱淡生姜同炒） 陈皮（二钱，用盐水炒） 半夏（一钱半，炒） 川贝母（三钱） 款冬花（三钱） 薏苡仁（四钱） 杏仁霜（三钱） 当归身（三钱，酒炒） 党参（三钱，用元米炒）
以上药物研为末，炼蜜制成丸药。每晨用开水送服三钱。
渊按：久咳适合此方。如果伴有颈项强直拘急，恐怕有外风侵袭三阳经的情况，为何不用汤剂兼治呢？
僧：咳嗽七八年，咳嗽剧烈必然出汗。近半年来痰中两次见血，这是肺气肾阴亏损的表现。担心加重内热，拖延成劳损虚怯之症。
大熟地黄 当归身 蛤壳 北沙参 麦冬 川贝母 甜杏仁 苏子 桑白皮 炙甘草 枇杷叶
又：久咳导致肺肾两虚，幸好胃气尚旺盛。治法以金（肺）水（肾）同治，希望精气逐渐滋生。
大熟地黄 当归身 炙甘草 潞党参 桂枝 款冬花 炮姜 麦冬 半夏 阿胶 蛤壳
此方是炙甘草合麦门冬汤。病由寒气潜伏肺底，导致形成咳嗽，日久伤及精气，所以在滋补之中兼用化痰之法。
又：久咳出汗，各种药物无效。使用宁肺散。
罂粟壳（一两六钱，醋炒） 炙乌梅肉（四钱）
共研为末，每次服用三钱，下午用开水调服。早晨服用金水六君子丸四钱，开水送下。
张：十年前三疟疾之后，盗汗经常出，阴津大伤。去年秋天咳嗽气机上逆，痰中带血。至今行动气喘，内热多汗，食少无力，脉象虚细数，这是劳损根深蒂固。
四君子汤加五味子、熟地黄、焦六曲、罂粟壳、紫石英、熟附子、黄芪、白芍、麦冬。
又：肺主呼气，肾主纳气。肾虚不能纳气，气反而上逆而喘。
痰饮留滞体内，加上出汗导致阳虚，咳血导致阴虚，内热食少，这是肺肾虚劳的征候。
四君子汤加麦冬、紫石英、熟附子、丹皮、大熟地黄、半夏、白芍、沉香、五味子、罂粟壳、乌梅。
渊按：夺血者无汗，夺汗者无血。血属阴；汗也属阴。为什么说阴虚阳虚？大概出汗是因为阳气失于卫外功能，咳血是因为阴火逼迫所致，所以有阴阳之分。
又：盗汗气喘，咳嗽脉细。精气两虚，除了补益摄纳肺肾之外，还有什么治疗方法呢？张景岳说：大虚之症，即使轻微补益也难以见效，何况不补呢？
姚：咳嗽将近一年，阴阳之气各自偏颇。阳虚则外寒，阴虚生内热。夏令湿热当令，近日寒暖不调，脾胃受损，恐怕会导致成劳损之症，不可忽视！
沙参 茯苓 五味子 麦冬 黄芪 川贝母 薏苡仁 沙苑子 玉竹 枇杷叶
又：脉数未退，阴虚未恢复。咳嗽不止，肺气日渐虚弱。夏暑将至，病情尚未稳定，仍宜小心调养为主。
大生地 生西洋参 麦冬 川贝母 玉竹 五味子 黄芪 沙参 茯苓 枇杷露
唐：七十六岁高龄，面色红润，脉象坚搏有力，外表看似有余，实则内部不足。屡次患咳嗽，娇嫩的肺脏暗中受伤。本月初旬微感风温，咳嗽又发作。舌苔薄白，底部有裂纹，饮食略减。风温久留不去，劫耗胃津，灼伤肺阴。不可再投辛散药物，应当用甘润生津之法。
李：咳嗽喉痒，痰或稀或浓，浓稠时带有腥臭味。脉象右弦而滑，左弦小数。肝经有郁勃之热，肺家有胶粘之痰。
这种痰是因为火郁而臭，并非肺痈可比。应当平肝开郁，参以清金化痰。
沙参 橘红 苏子 杏仁 石决明 川贝母 茯苓 丹皮 蛤壳 枇杷叶 陈海蜇（漂洗去咸） 地栗（荸荠）
许：咳嗽面白为金（肺）受伤，脉数而洪属于虚火，这是脉克色而火胜金（火克金）的表现。夏至一阴生，正值火令，是剥极则复之际。倘若剥而不复，颇有火灼金销的忧虑。
党参 黄芪 炙甘草 茯苓 怀山药 麦冬 沙参 五味子 紫菀 陈皮
此方是生脉散合六君子汤加紫菀。夫四君子汤去掉白术加黄芪、山药、陈皮，也叫六君汤，见于《医方集解》中。
王：暑风从背俞穴内迫于肺，湿热从胃脉上注于肺，外内合邪，气并聚于胸中，气不得通畅，因而上逆，气升作咳。舌苔薄白，口腻不渴，治疗属于饮家（痰饮水湿病）。
阙：体质素来虚弱亏虚，连年屡次患咳嗽。今年春天产后悲伤，咳嗽复发，背寒内热，气逆痰多，脉虚数，大便溏泻。拖延至今百日，病成蓐劳（产后虚劳）。据产后血室空虚，八脉之气先伤于下，加上悲哀伤肺，咳嗽震动，冲脉之气上逆。经云：冲脉为病，逆气里急。阳维为病苦寒热。频繁进用疏风清热药，脾胃再次受伤，以致腹痛便溏，食减无味，这都是见咳治咳的弊端。越人（秦越人/扁鹊）谓上损及脾，下损过胃，都属于难治之症。姑且拟定通补奇经，镇摄冲脉，再入扶脾理肺之法。未能免俗，聊且如此处理。
大熟地黄（砂仁炒炭） 当归（小茴香三分拌炒） 紫石英 白芍（桂枝三分拌炒） 白茯苓 川贝母 牛膝（盐水炒）
张：年幼时形体瘦弱面色黄，痰多食少，白天轻微咳嗽，夜间睡眠时喉中有哮鸣声。病程已半年，性格畏惧服药。这是脾虚湿热蒸腾痰浊阻肺。商量用药枣法。
人参 炙甘草 冬术（白术） 茯苓 制川朴（厚朴） 苍术 宋半夏（姜半夏） 陈皮 川贝母 榧子
以上药物各研为末，混合一处。用好大枣一百枚，去核，将药末纳入枣中，用线扎好。每枚枣大约纳入药二分为准。再用甜葶苈一两，河水两大碗，用枣煮，等到枣软熟，不要太烂，取出，晒干。
等到饥饿时，将枣细嚼一枚。一天可用五、六枚。剩下的枣汤去掉葶苈，将汤煎浓至一杯茶量，分三次先温服。
此方是平胃散、六君子汤加川贝母、榧子。制法极好。治疗脾虚湿热蒸痰阻肺，喉中痰多者，从葛可久白凤膏化出，颇有巧意。服用后遂愈。
毕：劳心苦志，耗损营阴。阴虚生内热，热盛则风动，由此心悸少寐，头眩咳嗽，午后发热早晨凉，种种病情，相继而至。前议甘凉生津，微苦泄热，服后热减咳稀，原本得到小效。但有人说是外感，改投辛散，杂入消导苦寒药，以致咳嗽频繁汗多。还说邪气未尽达，再欲发汗。大言不惭，岂非痴人说梦吗！我如今仍用甘凉法，窃恐见此方者，又在后面非议。呵呵！
沙参 玉竹 麦冬 地骨皮 茯苓 川贝母 豆衣 茯神 钟乳石 悉尼肉（核桃肉） 红枣
奚：风邪袭肺，肺气失宣。一个月以来咳嗽，上引头痛，这是振动肝胆之阳。幸好胃旺能食，邪气未延及中焦。只是久恋于肺者，势必渐化为热。乃咳而喉痛、音哑，肺阴为热耗损了。宣风散热，润肺化痰，是其治法。然而不是几剂药所能治愈的。盖风入肺系，祛之亦不易也。
牛蒡子 马兜铃 川贝母 桔梗 杏仁 生甘草 海浮石 蛤壳 阿胶 桑叶 枇杷叶
另：蛤粉一两，青黛二钱，蝉蜕七分，共三味，研为细末。分七服，药汁调下，每日一服。
肺阴已伤，引动肝阳，咳作头痛，青蛤散颇合拍。皂荚子不可用，恐怕劫耗津液。
戴：五脏皆有咳，总不离乎肺。肺为娇脏，不耐邪侵，感寒则咳，受热则咳，初起微有寒热，必夹表邪。邪恋肺虚，脉形空大。前方降气化痰，保肺涤饮，俱无少效。据云得汗则身体轻快，想由肺气虽虚，留邪未尽。补虚而兼化邪，也是一法。用钱氏法。
牛蒡子（元米炒） 马兜铃 杏仁 阿胶（蛤粉炒） 苏子 桑白皮
款冬花 炙甘草 茯苓 桑叶 枇杷叶
沈：脉虚软而似数，内伤虚弱无疑！夫邪之所凑，其气必虚。虚处受邪，其病则实。咳嗽虽由外感，而实则因于气虚。以为风寒固不可，以为虚损未必可。玉竹饮子主之。
玉竹 杏仁 苏子 桑白皮 款冬花 旋复花 沙参（元米炒） 象贝母 橘红 枇杷叶
岑：烦劳疲极则伤肝，肝伤则气逆而上迫，为胁痛，为咳嗽。
秦氏所谓先胁痛而后咳者，肝伤肺也。治法不在肺而在于肝。夏令将临，恐有失血之虞。
旋复花 桃仁炭 杏仁 川贝母 苏子 冬瓜子 黑山栀 丹皮 郁金 薏苡仁 枇杷露
祝：咳嗽夜重，风寒伤于肺，劳碌伤于肾。肾气上逆，故重咳于夜也。
前胡 杏仁 象贝母 橘红 半夏 旋复花 紫菀 茯苓 沉香 沙苑子
某：咳嗽白痰味咸，是肾虚水泛为痰也。小便黄，阴虚内热。
初起虽有风寒，日久亦从热化，而元气渐虚矣。今从肺肾图治。
沙参 玉竹 橘红 甜杏仁 茯苓 川贝母 紫菀 蛤壳 金狗脊 十大功劳
平：病起伤风咳嗽，邪留肺系。久咳伤阴，火起于肾，上冲于心，心中热痒则咳甚而肤热，待火降则热亦退而稍平。其所以发热者，由于阴虚也。惟胃纳甚少，滋阴之药不宜过，当以金土水三脏皆调。立夏在前，冀其热减为妙。
大生地（蛤粉拌捣） 阿胶（米粉拌炒） 怀山药 炙甘草 川贝母 五味子 茯苓 牛蒡子 丹皮（炒焦） 橘红 紫菀 枇杷叶
仁渊曰：咳嗽一证，最为难治。外感固不可擅用清滋，即内伤之咳，亦未可擅用冬、地（麦冬、地黄），须察其病因在何脏腑而施治。疗久咳必先顾其胃气，未有胃不顺而咳可愈者。经谓：十二经皆有咳，非独肺也。皮毛者，肺之合也。皮毛先受邪气，邪气以从其合也。其寒饮食入胃，则肺寒。肺寒则内外合邪，因而客之，则为肺咳。此言外感之咳，从感寒饮寒而起，邪由皮毛而内合于肺，或散或温或凉，从肺主治。其饮热受热者，亦可隅反。若内伤之咳，则五脏十二经皆有，断不可专治其肺。盖咳在肺，所以致咳不在肺。五脏六腑苟有一气之逆，触动肺气，即能作咳。医经旨“聚于胃、关于肺”二语，深得咳嗽要言。夫胃有五窍，如闾里门户。水谷入胃，渣滓由下脘传小肠，水液即从旁窍而出，传布三焦，由中焦蒸化，至上焦为津液，渗下焦为便溺。今脏腑之气失顺，逆击于肺作咳，胃窍之水饮不能尽化津液，聚于上脘而为痰涎，寒则痰稀，热则痰浓。前人论脾乃生痰之源，肺为贮痰之器。今读西国医书，谓咳痰不从肺出，即从胃脘而来。证以经文“聚于胃、关于肺”二语，始知前人所论非是。按前贤论咳嗽者甚多，至“聚于胃”三字，从未论及，岂《内经》此言漫无着落耶？今得西医剖视之书，益见《内经》之精。至何脏何腑之逆，虚实之辨，当详参脉证。经文于此尤为精细，不难按证用药。兹集外感内伤为一编，读者宜细绎之，勿混治也。
Bu: The manifestation of Heart Cough (Xin Ke) involves coughing accompanied by heart pain, a sensation of obstruction in the throat as if something is stuck, and in severe cases, swelling of the pharynx and throat bi syndrome (Hou Bi). This occurs because Wind-Warmth (Feng Wen) invades the Lung, stirring up Fire from the Pericardium to rebel upward. Therefore, the treatment method should still focus on dispersing Wind pathogens from the Lung Meridian, incorporating herbs that calm the Heart and moderate Fire. Zhang Zhongjing's methods briefly indicate the principle, but the description is not detailed, leading later generations to fail in careful examination.
Prepared Peucedani Radix (Qianhu), Apricot Seed (Xingren), Fritillaria Thunbergii Bulb (Xiangbei), Platycodon Root (Jiegeng), Belamcanda Rhizome (Shegan), Polygala Root (Yuanzhi - processed with Licorice Decoction), Ophiopogon Tuber (Maidong), Glehnia Root (Shashen).
Wheat (Xiaomai) one liang, decocted to replace water for cooking the other herbs. (The subtlety lies in this single herb.)
Yu'an (Commentary): Only by deeply mastering the essence of Zhang Zhongjing's medicine can one explain this. Using a formula to disperse Wind-Warmth from Metal (Lung), adding one liang of Wheat, clears Heart Heat and simultaneously tonifies Heart Deficiency. How agile and effective!
Hu: Cough, vomiting, thick sputum, and headache are caused by Wind-Heat accumulating upward, leading to failure of Lung and Stomach Qi to descend.
Prepared Peucedani Radix (Qianhu), Apricot Seed (Xingren), Perilla Fruit (Suzi), Tangerine Peel (Juhong), Dodecatheon Flower (Kuandonghua), Mulberry Root Bark (Sangbaipi), Saposhnikovia Root (Fangfeng), Mulberry Leaf (Sangye), Benincasa Seed (Dongguazi).
Ding: Cold body and cold diet injure the Lung. When internal and external Cold interact, both inside and outside are injured, causing Qi rebellion resulting in cough. From autumn/winter through spring/summer, symptoms worsen at night, with Qi rising preventing lying down.
Recently, spitting up blood indicates latent Cold transforming into Heat, injuring Yang collaterals. To eliminate latent Cold and clear latent Heat, one must combine descending Qi and resolving Phlegm.
Sinensis Aster Root (Ziwan), Apricot Seed (Xingren), Dodecatheon Flower (Kuandonghua), Tangerine Peel (Juhong), Sichuan Fritillaria Bulb (Chuanbei), Poria (Fuling), Cinnamon Twig (Guizhi), Light Scutellaria Root (Dan Huangqin), Platycodon Root (Jiegeng), Pinellia Tuber (Banxia), Mulberry Root Bark (Sangbaipi), Loquat Leaf (Pipaye).
Hu: Wind pathogen in the Lung causes cough; damp-Phlegm in the Stomach causes fullness. Kidney Deficiency causes lower back pain; Liver Deficiency causes blurred vision. Since it cannot be treated solely by dispersing, nor solely by tonifying, a dual approach is proposed.
Perilla Fruit Decoction (Suzi Jiangqi Tang) minus Cinnamon Twig (Guizhi), plus Poria (Fuling), Polygonatum Rhizome (Yuzhu), Soybean Testa (Douyi), Mulberry Leaf (Sangye), Walnut Meat (Hutaorou), Loquat Leaf (Pipaye).
Certain case: Chronic Cold Cough comes and goes. At year-end last year, chills and fever lasted six or seven days before stopping. In early spring, sore throat for three days led to hoarseness and cough. The root cause is Wind-Warmth invading the Lung. Treatment should disperse pathogens and descend Qi to prevent asthma.
Inula Flower (Xuanfuhua), Schizonepeta Spike (Jingjie), Apricot Seed (Xingren), Dodecatheon Flower (Kuandonghua), Prepared Peucedani Radix (Qianhu), Perilla Fruit (Suzi), Bitter Orange (Zhike), Sichuan Fritillaria Bulb (Chuanbei), Szechuan Lovage Rhizome (Chuanxiong), Platycodon Root (Jiegeng), Clam Shell (Geke), Loquat Leaf (Pipaye).
Xu: Cold Cough flares in winter, accompanied by stiffness and tension of the neck and nape.
Large Prepared Rehmannia Root (D Shudihuang) - 6 qian, soaked in decoction of Ephedra Herb (Mahuang) 1 qian, fried until loose. Poria (Fuling) - 3 qian, soaked in decoction of Asarum Root (Xixin) 0.5 qian, fried. Walnut Meat (Hutaorou) - 4 qian. Schisandra Berry (Wuweizi) - 0.8 fen, stir-fried with Fresh Ginger (Danjiang) 1 qian. Tangerine Peel (Chenpi) - 2 qian, stir-fried with salt water. Pinellia Tuber (Banxia) - 1.5 qian, fried. Sichuan Fritillaria Bulb (Chuanbei) - 3 qian. Dodecatheon Flower (Kuandonghua) - 3 qian. Coix Seed (Yiren) - 4 qian. Apricot Frost (Xingrenshuang) - 3 qian. Angelica Sinensis Root (Guishen) - 3 qian, wine-fried. Codonopsis Root (Dangshen) - 3 qian, stir-fried with Yuanmi (glutinous rice).
Grind all herbs into powder, make pills with refined honey. Take 3 qian with warm water every morning.
Yu'an (Commentary): This formula suits chronic cough. If neck stiffness exists, it suggests external Wind attacking the Three Yang Meridians. Why not treat with a decoction concurrently?
Monk: Cough for seven or eight years, sweating profusely when coughing severely. In the past half-year, blood appeared in sputum twice, indicating deficiency of Lung Qi and Kidney Yin. Concern arises of worsening internal Heat progressing to Consumption (Lao Qie).
Large Prepared Rehmannia Root (D Shudihuang), Angelica Sinensis Root (Guishen), Clam Shell (Geke), Northern Glehnia Root (Beishashen), Ophiopogon Tuber (Maidong), Sichuan Fritillaria Bulb (Chuanbei), Sweet Apricot Seed (Tian Xingren), Perilla Fruit (Suzi), Mulberry Root Bark (Sangbaipi), Honey-fried Licorice Root (Zhi Gancao), Loquat Leaf (Pipaye).
Again: Chronic cough leads to joint deficiency of Lung and Kidney. Fortunately, Stomach Qi remains strong. The method treats Metal (Lung) and Water (Kidney) together, hoping for gradual regeneration of Essence and Qi.
Large Prepared Rehmannia Root (D Shudihuang), Angelica Sinensis Root (Guishen), Honey-fried Licorice Root (Zhi Gancao), Ludong Codonopsis (Ludangshen), Cinnamon Twig (Guizhi), Dodecatheon Flower (Kuandonghua), Roasted Ginger (Paojiang), Ophiopogon Tuber (Maidong), Pinellia Tuber (Banxia), Donkey-hide Gelatin (Ejiao), Clam Shell (Geke).
This formula combines Honey-fried Licorice with Maidong Decoction. The disease originated from latent Cold in the Lung base causing cough, damaging Essence and Qi over time. Thus, tonification is combined with Phlegm resolution.
Again: Chronic cough with sweating, unresponsive to various medicines. Use Ningfei San.
Poppy Capsule (Yusuoke) - 1 liang 6 qian, vinegar-fried. Honey-fried Dark Plum Flesh (Zhi Wumei Rou) - 4 qian.
Grind into powder, take 3 qian each time, mixed with warm water in the afternoon. In the morning, take Jinshui Liujunzi Wan 4 qian with warm water.
Zhang: Ten years ago, after recurrent Malaria, nocturnal sweating was frequent, severely damaging Yin fluids. Last autumn, cough with Qi rebellion and blood in sputum occurred. Now, walking causes panting, internal heat, excessive sweating, poor appetite, weakness, and a deficient, fine, rapid pulse. This is deep-rooted Consumption.
Four Gentlemen Decoction (Sijunzi Tang) plus Schisandra Berry (Wuweizi), Prepared Rehmannia Root (Shudi), Charred Medicated Leaven (Jiao Liuqu), Poppy Capsule (Yusuoke), Purple Quartz (Zishi), Prepared Aconite Root (Shu Fuzi), Astragalus Root (Huangqi), White Peony Root (Baishao), Ophiopogon Tuber (Maidong).
Again: The Lung governs exhalation; the Kidney governs grasping Qi. Kidney Deficiency fails to grasp Qi, causing Qi to rebel upward leading to asthma.
Phlegm-fluid retention in the middle, combined with sweating (Yang Deficiency), hemoptysis (Yin Deficiency), internal heat, and poor appetite, indicates Lung-Kidney Deficiency Consumption.
Four Gentlemen Decoction (Sijunzi Tang) plus Ophiopogon Tuber (Maidong), Purple Quartz (Zishi), Prepared Aconite Root (Shu Fuzi), Moutan Cortex (Danpi), Large Prepared Rehmannia Root (Da Shudihuang), Pinellia Tuber (Banxia), White Peony Root (Baishao), Agarwood (Chenxiang), Schisandra Berry (Wuweizi), Poppy Capsule (Yusuoke), Dark Plum (Wumei).
Yu'an (Commentary): "Those who lose blood should not sweat; those who sweat excessively should not lose blood." Blood is Yin; Sweat is also Yin. Why speak of Yin and Yang Deficiency? Sweating results from Yang failing to guard the exterior; hemoptysis results from forced Yin Fire. Hence the distinction.
Again: Nocturnal sweating, asthma, cough, and fine pulse indicate joint deficiency of Essence and Qi. Besides tonifying and securing Lung and Kidney, what other method exists? Jingyue said: "For severe deficiency, even mild tonification may show little effect, let alone no tonification."
Previous formula plus Angelica Sinensis Root (Guishen), Oyster Shell (Muli), Dragon Bone (Longgu), Astragalus Root (Huangqi).
Yao: Cough nearing one year, Yin and Yang Qi are each biased. Yang Deficiency causes external cold; Yin Deficiency generates internal heat. Summer damp-heat is prevalent; recent temperature fluctuations have damaged Spleen and Stomach. Fear of developing Consumption; do not neglect!
Glehnia Root (Shashen), Poria (Fuling), Schisandra Berry (Wuweizi), Ophiopogon Tuber (Maidong), Astragalus Root (Huangqi), Sichuan Fritillaria Bulb (Chuanbei), Coix Seed (Yiren), Astragalus Complanatus Seed (Shayuanzi), Polygonatum Rhizome (Yuzhu), Loquat Leaf (Pipaye).
Again: Rapid pulse persists, Yin Deficiency not recovered. Cough continues, Lung Qi daily weakens. Summer heat approaches, condition unstable. Careful nourishment is essential.
Large Raw Rehmannia Root (Da Shengdi), Raw American Ginseng (Sheng Yangshen), Ophiopogon Tuber (Maidong), Sichuan Fritillaria Bulb (Chuanbei), Polygonatum Rhizome (Yuzhu), Schisandra Berry (Wuweizi), Astragalus Root (Huangqi), Glehnia Root (Shashen), Poria (Fuling), Loquat Syrup (Pipaye Lu).
Tang: At seventy-six, complexion ruddy, pulse firm and forceful. Exterior seems excess, interior is actually deficient. Recurrent coughs secretly injure the delicate Zang. Early this month, slight Wind-Warmth invasion triggered cough again. Thin white tongue coating with cracks underneath, slightly reduced appetite. Wind-Warmth lingers, consuming Stomach fluids and burning Lung Yin. Do not use acrid dispersants; use sweet-moistening to generate fluids.
Trichosanthes Root (Huafen), Glehnia Root (Shashen), Polygonatum Rhizome (Yuzhu), Ophiopogon Tuber (Maidong), Coix Seed (Yiren), Apricot Seed (Xingren), Sichuan Fritillaria Bulb (Chuanbei), Mulberry Leaf (Sangye).
Li: Cough with itchy throat, sputum varying from thin to thick, thick sputum having a fishy odor. Pulse right wiry and slippery, left wiry and slightly rapid. Liver Meridian has stagnant Heat; Lung House has sticky Phlegm.
This Phlegm smells due to Fire stagnation, distinct from Lung Abscess. Treat by soothing Liver and opening stagnation, combined with clearing Metal and resolving Phlegm.
Glehnia Root (Shashen), Tangerine Peel (Juhong), Perilla Fruit (Suzi), Apricot Seed (Xingren), Abalone Shell (Shijueming), Sichuan Fritillaria Bulb (Chuanbei), Poria (Fuling), Moutan Cortex (Danpi), Clam Shell (Geke), Loquat Leaf (Pipaye), Aged Sea Jellyfish (Chen Haizhe - washed fresh), Water Chestnut (Dili).
Xu: Pale face with cough indicates Metal (Lung) injury; rapid and surging pulse belongs to Deficient Fire. Pulse controls Color, and Fire overcomes Metal. At Summer Solstice, one Yin is born, belonging to Fire command, a time of extreme peeling turning to recovery. If peeling does not recover, fear of Fire burning Metal dissolving.
Codonopsis Root (Dangshen), Astragalus Root (Huangqi), Honey-fried Licorice Root (Zhi Gancao), Poria (Fuling), Huai Yam (Huai Shanyao), Ophiopogon Tuber (Maidong), Glehnia Root (Shashen), Schisandra Berry (Wuweizi), Sinensis Aster Root (Ziwan), Tangerine Peel (Chenpi).
This is Shengmai San combined with Liujunzi Tang plus Sinensis Aster Root (Ziwan). Removing Atractylodes from Sizijunzi Tang and adding Astragalus, Yam, and Tangerine Peel is also called Liujunzi, as recorded in *Yifang Jijie*.
Wang: Summer Wind enters internally from Back-Shu points to press on Lung; Damp-Heat flows upward from Stomach Meridian to inject into Lung. External and internal pathogens combine, Qi gathers in the chest, obstructs flow, rebels upward, causing cough. Thin white tongue coating, greasy mouth without thirst. Treatment belongs to Fluid Retention (Yin Jia).
Pinellia Tuber (Banxia), Tangerine Peel (Chenpi), Bitter Orange (Zhike), Aristolochia Root (Madouling), Apricot Seed (Xingren), Belamcanda Rhizome (Shegan), Tongcao, Benincasa Seed (Dongguazi), Loquat Leaf (Pipaye).
Yu'an (Commentary): Should assist with one or two herbs to open and drain Summer Wind, such as Elsholtzia Herb (Xiangru) or Perilla Stem (Sugeng).
Que: Constitution inherently deficient, suffering recurrent coughs for years. This spring, postpartum sorrow triggered cough recurrence. Chills in back, internal heat, Qi rebellion with much sputum, deficient rapid pulse, loose stool. Persisting for a hundred days, illness becomes Postpartum Consumption (Rulao). Postpartum blood chamber is empty, Qi of Eight Extraordinary Vessels first injured below. Added to sorrow injuring Lung, cough vibration causes Chong Mai Qi to rebel. Classics say: Chong Mai disease involves rebellious Qi and abdominal urgency. Yang Wei disease suffers chills and fever. Frequent use of Wind-dispersing and Heat-clearing herbs further injured Spleen and Stomach, causing abdominal pain, loose stools, reduced appetite, and loss of taste. These are faults of treating only cough. Yue Ren (Bian Que) stated: Upper damage reaching Spleen, lower damage passing Stomach, are both difficult to treat. Tentatively propose unblocking and tonifying Extraordinary Vessels, stabilizing Chong Mai, then supporting Spleen and regulating Lung. Cannot avoid conventionality, merely doing so.
Large Prepared Rehmannia Root (Da Shudihuang - fried carbon with Amomum Cardamomum), Angelica Root (Danggui - stir-fried with 3 fen Fennel), Purple Quartz (Zishi), White Peony Root (Baishao - stir-fried with 3 fen Cinnamon Twig), White Poria (Bai Fuling), Sichuan Fritillaria Bulb (Chuanbei), Achyranthes Root (Niuxi - stir-fried with salt water).
Zhang: Young age, thin body, yellow complexion, much sputum, poor appetite. Slight cough during day, wheezing sound in throat during sleep. Illness half a year, fears taking medicine. This is Spleen Deficiency with Damp-Heat steaming Phlegm obstructing Lung. Propose using dates for medication delivery.
Ginseng Root (Renshen), Honey-fried Licorice Root (Zhi Gancao), Winter Atractylodes (Dongzhu), Poria (Fuling), Processed Magnolia Bark (Zhi Chuanpu), Atractylodes Lancea (Cangzhu), Song Banxia (Processed Pinellia), Tangerine Peel (Chenpi), Sichuan Fritillaria Bulb (Chuanbei), Torreya Seed (Feizi).
Grind each herb into powder, mix well. Take 100 good large dates, remove pits, insert powder into dates, tie securely with thread. Each date takes about 2 fen of powder. Add 1 liang sweet Descurainia Seed (Tingli) and two bowls river water, boil dates. When dates are soft but not mushy, remove and dry.
When hungry, chew one date finely. Use five or six per day. Remaining date soup, remove Tingli, boil soup concentrated to one teacup, divide into three doses, take warm first.
This is Pingwei San and Liujunzi Tang plus Sichuan Fritillaria Bulb and Torreya Seed. Excellent preparation method. Treats Spleen Deficiency Damp-Heat steaming Phlegm obstructing Lung with much throat sputum. Derived from Ge Kelou's Baifeng Gao, showing great ingenuity. Patient cured upon taking.
Yu'an (Commentary): Ingenious mind, inspiring many later learners.
Bi: Mental labor and bitter will deplete Ying Yin. Yin Deficiency generates internal heat; Heat excess moves Wind. Thus palpitations, insomnia, dizziness, cough, afternoon fever morning coolness, various symptoms follow sequentially. Previous proposal of sweet-cool generating fluids and slightly bitter clearing heat reduced heat and cough frequency, achieving small effect. But some claimed external contraction, changed to acrid dispersants, mixed with digestion-promoting bitter-cold herbs, causing frequent cough and sweating. Still claiming pathogens not fully expelled, desiring more sweating. Shameless talk, akin to dreams of fools! I now still use sweet-cool method, fearing critics will slander this formula later. Hehe!
Glehnia Root (Shashen), Polygonatum Rhizome (Yuzhu), Ophiopogon Tuber (Maidong), Groundcherry Root (Digupi), Poria (Fuling), Sichuan Fritillaria Bulb (Chuanbei), Soybean Testa (Douyi), Spirit of Poria (Fushen), Zeolite (Zhonglushi), Walnut Meat (Xini Rou), Red Date (Hongzao).
Xi: Wind pathogen attacks Lung, Lung Qi fails to diffuse. For one month, cough radiates to headache, vibrating Liver-Gallbladder Yang. Fortunately Stomach is strong, food intake normal, pathogens haven't spread to Middle Jiao. However, lingering in Lung will gradually transform into Heat. Cough with sore throat and hoarseness indicates Lung Yin consumed by Heat. Disperse Wind and clear Heat, moisten Lung and resolve Phlegm is the method. But not curable in a few doses. Wind entering Lung system is hard to expel.
Burdock Fruit (Niubangzi), Aristolochia Root (Madouling), Sichuan Fritillaria Bulb (Chuanbei), Platycodon Root (Jiegeng), Apricot Seed (Xingren), Raw Licorice Root (Sheng Gancao), Pumice Stone (Haifushi), Clam Shell (Geke), Donkey-hide Gelatin (Ejiao), Mulberry Leaf (Sangye), Loquat Leaf (Pipaye).
Separately: Clam Powder (Ge Fen) 1 liang, Indigo Naturalis (Qingdai) 2 qian, Cicada Slough (Chantui) 0.7 fen. Grind three herbs to fine powder. Divide into seven doses, take with medicine juice, one dose daily.
Lung Yin already injured, stirring Liver Yang, cough with headache. Qingge San fits well. Soap Pod (Zaojiazi) must not be used, fearing fluid depletion.
Dai: All Five Zang organs have cough, never separate from Lung. Lung is delicate organ, intolerant of pathogen invasion. Cold induces cough, Heat induces cough. Initial stage slight chills/fever, must involve exterior pathogen. Pathogen lingers in Lung Deficiency, pulse hollow and large. Previous formulas descending Qi and resolving Phlegm, protecting Lung and draining fluid, showed no effect. Claimed relief after sweating, suggesting although Lung Qi is deficient, residual pathogens remain. Tonifying deficiency while resolving pathogens is also a method. Use Qian Shi's method.
Burdock Fruit (Niubangzi - stir-fried with Yuanmi), Aristolochia Root (Madouling), Apricot Seed (Xingren), Donkey-hide Gelatin (Ejiao - fried with Clam Powder), Perilla Fruit (Suzi), Mulberry Root Bark (Sangbaipi).
Dodecatheon Flower (Kuandonghua), Honey-fried Licorice Root (Zhi Gancao), Poria (Fuling), Mulberry Leaf (Sangye), Loquat Leaf (Pipaye).
Shen: Pulse deficient, soft, seemingly rapid. Internal injury weakness is undeniable! Where pathogens gather, Qi must be deficient. Deficient area receives pathogen, disease becomes excess. Cough though caused by external contraction, essentially due to Qi deficiency. Assuming Wind-Cold is incorrect; assuming Deficiency Consumption is not necessarily correct. Use Yuzuk Yinzi as main treatment.
Polygonatum Rhizome (Yuzhu), Apricot Seed (Xingren), Perilla Fruit (Suzi), Mulberry Root Bark (Sangbaipi), Dodecatheon Flower (Kuandonghua), Inula Flower (Xuanfuhua), Glehnia Root (Shashen - stir-fried with Yuanmi), Fritillaria Thunbergii Bulb (Xiangbei), Tangerine Peel (Juhong), Loquat Leaf (Pipaye).
Cen: Extreme fatigue injures Liver; Liver injury causes Qi rebellion pressing upward, causing hypochondriac pain and cough.
Qin Shi said: Hypochondriac pain preceding cough indicates Liver injuring Lung. Treatment focuses on Liver, not Lung. Summer approaching, fear of hemorrhage risk.
Inula Flower (Xuanfuhua), Peach Kernel Charcoal (Taoren Tan), Apricot Seed (Xingren), Sichuan Fritillaria Bulb (Chuanbei), Perilla Fruit (Suzi), Benincasa Seed (Dongguazi), Black Gardenia Fruit (Hei Shanzhi), Moutan Cortex (Danpi), Curcuma Root (Yujin), Coix Seed (Yiren), Loquat Syrup (Pipaye Lu).
Zhu: Cough worse at night. Wind-Cold injures Lung; labor injures Kidney. Kidney Qi rebels upward, hence severe cough at night.
Prepared Peucedani Radix (Qianhu), Apricot Seed (Xingren), Fritillaria Thunbergii Bulb (Xiangbei), Tangerine Peel (Juhong), Pinellia Tuber (Banxia), Inula Flower (Xuanfuhua), Sinensis Aster Root (Ziwan), Poria (Fuling), Agarwood (Chenxiang), Astragalus Complanatus Seed (Shayuanzi).
Yu'an (Commentary): Treating Wind-Cold is acceptable, but treating Kidney Deficiency is incomplete.
Certain case: Cough with white salty sputum indicates Kidney Deficiency causing Water flooding to form Phlegm. Yellow urine indicates Yin Deficiency internal Heat.
Initially Wind-Cold existed, but long duration transformed into Heat, and Original Qi gradually weakened. Now treat from Lung and Kidney perspective.
Glehnia Root (Shashen), Polygonatum Rhizome (Yuzhu), Tangerine Peel (Juhong), Sweet Apricot Seed (Tian Xingren), Poria (Fuling), Sichuan Fritillaria Bulb (Chuanbei), Sinensis Aster Root (Ziwan), Clam Shell (Geke), Gold Dogbone (Jin Gouji), Mahonia Leaf (Shida Gonglao).
Ping: Illness started with Wind-Cold cough, pathogen remained in Lung system. Chronic cough injures Yin, Fire rises from Kidney, rushes to Heart. Itchy heat in Heart causes severe cough and skin heat; when Fire descends, heat retreats and calms slightly. Fever originates from Yin Deficiency. Stomach intake is very low, Yin-nourishing herbs should not be excessive. Must regulate Metal, Earth, and Water three Zang organs. Before Start of Summer, hope heat reduces.
Large Raw Rehmannia Root (Da Shengdi - mixed and pounded with Clam Powder), Donkey-hide Gelatin (Ejiao - stir-fried with Rice Flour), Huai Yam (Huai Shanyao), Honey-fried Licorice Root (Zhi Gancao), Sichuan Fritillaria Bulb (Chuanbei), Schisandra Berry (Wuweizi), Poria (Fuling), Burdock Fruit (Niubangzi), Moutan Cortex (Danpi - charred), Tangerine Peel (Juhong), Sinensis Aster Root (Ziwan), Loquat Leaf (Pipaye).
Ren Yuan said: Cough is most difficult to treat. External contraction definitely should not arbitrarily use cooling/moistening; even internal injury cough should not arbitrarily use Ophiopogon and Rehmannia. Must examine which Zang organ is the cause and treat accordingly. Treating chronic cough must first protect Stomach Qi; there is no case where cough cures if Stomach is not harmonious. Classics state: All Twelve Meridians have cough, not just Lung. Skin and hair are the exterior of Lung. Skin/hair first receive pathogen, pathogen follows its exterior to enter. Cold food/drink entering Stomach causes Lung Cold. Lung Cold means internal and external pathogens combine, lodging there causes Lung Cough. This describes external cough starting from catching cold/drinking cold, pathogen entering Lung via skin/hair. Disperse, warm, or cool according to Lung governance. Those drinking hot/suffering heat can infer similarly. If internal injury cough, all Five Zang and Twelve Meridians have it, absolutely cannot treat only Lung. Cough manifests in Lung, but the cause of cough is not in Lung. If any Qi rebels in Five Zang and Six Fu organs, touching Lung Qi causes cough. Medical classics emphasize "Gathering in Stomach, Related to Lung," capturing the essence of cough. Stomach has five orifices, like village gates. Food/water enters Stomach, dregs pass from Lower Confluence to Small Intestine, fluids exit via side orifices, distribute to Triple Burner, vaporize in Middle Jiao, become fluids in Upper Jiao, seep to Lower Jiao as urine/feces. Now Zang-Fu Qi loses smoothness, rebels striking Lung causing cough. Stomach orifice fluids cannot fully transform into fluids, gather in Upper Confluence as Phlegm-saliva. Cold makes Phlegm thin, Heat makes Phlegm thick. Predecessors said Spleen is source of Phlegm generation, Lung is container of Phlegm storage. Now reading Western medical books, stating cough-phlegm doesn't come from Lung, but from Stomach/Duodenum. Verifying with classics "Gathering in Stomach, Related to Lung," realizing predecessors' views were incomplete. Many ancients discussed cough, but never mentioned "Gathering in Stomach." Could this statement in Neijing be groundless? Now obtaining Western autopsy books, seeing greater precision in Neijing. Regarding which Zang/Fu rebels, differentiation of deficiency/excess, must carefully consult pulse and symptoms. Classics are particularly precise here, making symptom-based prescription easy. Collecting external and internal cough into one volume, readers should analyze carefully, do not mix treatments.