典藏书目

The classics state that diseases of the five zang organs and six fu organs can all lead to cough. Generally, there are those entering from the exterior, such as wind, cold, summerheat, dampness, dryness, and fire; and those originating from the interior, such as the seven emotions (joy, anger, worry, thought, sadness, fear, fright), dietary irregularities (hunger and fullness), and overstrain.

Wind-cold and other pathogenic factors first enter through the skin and hair. The skin and hair are the external correspondence of the Lung. When the skin and hair are invaded by pathogens, the evil follows its correspondence and enters internally to affect the Lung, causing cough; this is considered entering from the exterior.

Injury from the seven emotions or dietary and physical overstrain causes internal damage, leading to the counterflow of pathogenic factors upward. Since the Lung is the pathway for the entry and exit of qi, when pathogens from other zang organs attack the Lung from below, it also results in cough; this is considered originating from the interior.

However, not all invasions by various pathogenic factors result in coughing. If the pathogenic factor is particularly severe, it directly injures the zang and fu organs without lingering in the skin and hair, no cough will occur. Similarly, injury from the seven emotions does not always cause coughing. If the pathogenic factor is still shallow, remaining in its original zang organ without immediately attacking upward, no cough will occur. Therefore, in Cold Damage (Shanghan) diseases, cough is considered a mild symptom, whereas in miscellaneous diseases, cough is considered a serious symptom.

Cough is a syndrome with many excess (shi) etiologies. If differentiation of syndromes is unclear and medications are administered blindly in hopes of efficacy, how can one rely on medical treatment? One should follow the descriptions of past sages, categorizing cough into types such as wind, cold, fire, consumption (lao), phlegm, and lung distension.

Wind-cold cough presents with nasal congestion, heavy voice, aversion to wind and cold; it is suitable for treatment with methods that release the exterior and move phlegm. There is also cough with asthma, hoarseness, or sore throat triggered by cold exposure; this is termed "Cold Enveloping Heat" (exterior cold binding with interior heat); resolving the exterior will naturally eliminate the heat. For those with phlegm in the Lung, symptoms may also be triggered by cold; treatment should involve releasing the exterior and expelling thick phlegm.

Fire-stagnation cough presents with frequent coughing but little sputum, red face, and vexation; it is treated by clearing heat. Consumption cough presents with night sweats, copious sputum mixed with blood, and alternating chills and fever; it is treated by nourishing yin and clearing deficiency heat. Phlegm cough presents with coughing upon movement, stopping only after sputum is expectorated; it is treated by drying dampness and resolving phlegm. Lung distension presents with panting and chest fullness upon exertion, rapid breathing, and heavy voice; it is treated by descending rebellious qi and unblocking the lungs.

Master Danxi synthesized these categories, observing them in conjunction with lifestyle and environmental factors, and integrating them with the patient's constitution. Although occasional inaccuracies may exist, they are generally close to the truth.

The most crucial aspect of treating cough is to distinguish between the deficiency and excess of the Lung, the slippery or sticky nature of the phlegm, the cold or hot nature of the pathogen, whether other zang organs are invading the Lung with abnormal qi, and whether there are stagnant materials in the six fu organs.

For deficiency patterns, use herbs like Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi) to tonify, so that when qi is sufficient, the zang organs become naturally secure. For excess patterns, use herbs like Lepidii Fructus (Tinglizi) and Armeniacae Semen Amarum (Xingren) to purge, so that when the pathogen is removed, the Lung becomes naturally tranquil.

For slippery phlegm, use Arisaematis Rhizoma preparatum (Nanxing) and Pinelliae Rhizoma preparatum (Banxia) to dry dampness. For sticky or difficult-to-expectorate phlegm, use Trichosanthis Fructus (Gualou) and Armeniacae Semen Amarum (Xingren) to moisten dryness. For cold patterns, use Zingiberis Rhizoma (Ganjiang) and Asari Radix et Rhizoma (Xixin) to warm. For heat patterns, use Scutellariae Radix (Huangqin) and Gardeniae Fructus (Zhizi) to clear heat.

When qi from other organs invades, use Schisandrae Fructus (Wuweizi) and Paeoniae Radix Alba (Shaoyao) to astringe the qi, preventing it from being disturbed by pathogens. When there are stagnant accumulations, use Immature Bitter Orange (Zhishi) and Trichosanthis Fructus (Gualou) to drive away the intruding pathogens, preventing further invasion.