郁热者，由肺先有热，而寒复客之，热为寒郁，肺不得通，则喘咳暴作。其候恶寒，时
有热，口
中干，咽中痛，或失音不出是也。宜辛以散寒，凉以除热，或只用辛散，使寒去则热自解。
若遽以苦寒折之，邪气被抑，遗祸不少。
《本事》利膈汤
鸡苏叶 荆芥 桔梗 牛蒡子 甘草 僵蚕 元参（各一两）
上为末，每服一钱，沸汤点服，日三。
方古庵云∶肺主皮毛。人无病之时，营卫周流，内气自皮肤腠理普达于外，一或风寒外
束，
则内气不得外达，便从中起，所以火升痰上，故咳嗽。宜用辛温或辛凉之剂，以发散风寒，
则邪退正复嗽止也。
饮气嗽者，其症喘咳上气，胸膈注闷，难于偃卧。许仁则云∶由所饮之物，停澄在胸，
水气
上冲入肺，便成咳嗽，此而不治，则为水气。《医余》亦云∶此症宜利水道，化痰下气，不
尔则成水。
深师白前汤
白前（二两） 半夏 紫菀（各三两） 大戟（七合）
水一斗，渍一宿，煮取三升，作分数服。
芫花散
芫花 干姜 白蜜（等分）
上用前二味为末，内蜜中搅令相和，微火煎如糜，服如枣核一枚，日三夜一。《备急方
》用枳壳二两炒，水煮去滓，内白糖一斤，服如枣大。
葶苈大枣泻肺汤
葶苈（不拘多少，炒金黄）
上件细研，丸如弹子大，水三盏，枣十枚，煎一盏，去枣入药，煎七分，食后服。
孙兆治一人吐痰，顷间已升余，咳不已，面色郁暗，精神不快。兆告曰∶肺中有痰，胸
膈不
利，当服仲景葶苈大枣汤，一服讫，已觉胸中快利，略无痰唾矣。《外台》用葶苈、杏仁各
一升，大枣六十枚，合捣如膏，加蜜作丸梧子大，桑白皮饮下六七十丸，以大便通利为度。
《本事》枣膏丸，无杏仁，有陈皮、苦桔梗，枣肉丸梧子大，每服五七丸，饮下。许叔微云
∶余常患停饮，久渍肺经，食已必嚏，渐喘，觉肺系急，服此良验。
苏子降气汤 治年久肺气，咳嗽喘逆，上盛下虚，痰涎壅盛，胸膈噎塞。
紫苏子（炒） 半夏（制，各钱半） 前胡 甘草（炙） 浓朴（姜汁炒） 陈皮（去白，各一
钱） 当归（一钱半） 沉香（七分）
水二盅，生姜三片，煎至一盅，不拘时服。虚冷人加桂五分，黄 一钱。
一人痰嗽，胁下痛，以白芥子、栝蒌、桔梗、连翘、风化硝、竹沥、姜汁加蜜丸噙化，
茶清下。
按∶痰饮有寒有热，凡咳而面赤，胸腹胁常热，惟手足乍有凉时，其脉洪者，热痰在胸
膈也
。宜寒润清膈之剂下之。面白悲嚏，胁急胀痛，脉沉细弦迟者，寒痰在胸膜，宜以辛热去
之。
痰热久嗽，气急胸满，知母、杏仁、萝卜子、贝母各二钱，生姜一斤，水煎服。
玉液丸 治热痰壅盛，咳嗽烦热。
寒水石（烧令赤，出火毒，水飞过，三十两） 半夏（洗焙为末，十两） 白矾（枯，十两
，细研）
上合研，面糊丸梧子大，每服三十丸，食后淡姜汤下。
治妇人形瘦，有时夜热痰嗽，月经不调。
香附（童便浸，晒干，上） 栝蒌（中） 青黛（下）
上为末，姜汁蜜调，噙化豆大一丸。
郁热咳嗽，是由于肺中先有内热，又受外寒侵袭，导致热邪被寒邪郁闭，肺气不得宣通，从而突然发作气喘和咳嗽。其症状表现为怕冷，时而发热，口中干燥，咽喉疼痛，或者声音嘶哑甚至失音。治疗应当用辛味药来发散寒邪，用凉性药来清除内热；或者仅用辛散药物，使寒邪散去则热邪自然解除。如果急于使用苦寒药物强行折损热势，会导致邪气被压抑在内，留下不少后患。
《本事方》利膈汤：
鸡苏叶、荆芥、桔梗、牛蒡子、甘草、僵蚕、玄参（各一两）
以上药物研为细末，每次服用一钱，用沸水冲服，每日三次。
方古庵说：肺主皮毛。人在无病的时候，营气和卫气周流全身，体内的正气从皮肤腠理普遍通达于体表。一旦风寒束缚于外，体内的正气就不能向外发散，于是从中焦产生变化，导致火气上炎、痰涎上涌，所以发生咳嗽。适宜使用辛温或辛凉的药剂，以发散风寒，这样邪气退去，正气恢复，咳嗽就会停止。
饮气咳嗽，其症状是气喘咳嗽、气逆上冲，胸膈部胀满憋闷，难以仰卧。许仁则说：由于所饮用的水液，停滞澄清在胸中，水气上冲进入肺部，便形成咳嗽，此症如果不治疗，就会发展为水气病。《医余》也说：此症适宜利水道、化痰降气，否则就会演变成水气病。
深师白前汤：
白前（二两）、半夏、紫菀（各三两）、大戟（七合）
用水一斗，浸泡一夜，煮取三升药液，分次服用。
芫花散：
芫花、干姜、白蜜（等分）
以上将前两味药研为细末，加入蜂蜜中搅拌调和，用微火煎煮成糊状，每次服用如枣核大小的一枚，每日三次，夜间一次。《备急方》用炒枳壳二两，水煮去渣，加入白糖一斤，制成如枣大的丸剂服用。
葶苈大枣泻肺汤：
葶苈子（不拘多少，炒至金黄）
以上药材细细研磨，制成如弹子大小的丸剂。用水三盏，大枣十枚，煎煮至一盏，去掉大枣，放入药丸，再煎至七分，饭后服用。
孙兆治疗一人，呕吐痰涎，片刻之间已有一升多，咳嗽不止，面色晦暗，精神不佳。孙兆告诉他说：肺中有痰，胸膈不利，应当服用张仲景的葶苈大枣汤。服药一次后，已经觉得胸中畅快便利，几乎没有痰唾了。《外台秘要》用葶苈子、杏仁各一升，大枣六十枚，一起捣烂如膏，加蜂蜜制成梧桐子大小的丸剂，用桑白皮汤送服六七十丸，以大便通畅为度。《本事方》的枣膏丸，没有杏仁，含有陈皮、苦桔梗，用枣肉制成梧桐子大小的丸剂，每次服用五到七丸，饮水送下。许叔微说：我常患有停饮之症，久渍肺经，进食后必打喷嚏，逐渐气喘，感觉肺系拘急，服用此方疗效很好。
苏子降气汤：治疗年久肺气失调，咳嗽气喘逆乱，上盛下虚，痰涎壅盛，胸膈噎塞。
紫苏子（炒）、半夏（制，各一钱半）、前胡、甘草（炙）、厚朴（姜汁炒）、陈皮（去白，各一钱）、当归（一钱半）、沉香（七分）
用水二盅，生姜三片，煎至一盅，不拘时候服用。虚寒体质的人加桂枝五分，黄芩一钱。
一人患痰嗽，胁下疼痛，用白芥子、栝楼、桔梗、连翘、风化硝、竹沥、姜汁加蜂蜜制成丸剂含化，茶清送下。
按语：痰饮有寒证和热证之分。凡是咳嗽且面赤，胸腹胁部经常发热，只有手足偶尔发凉，脉象洪大的，是热痰在胸膈。适宜用寒润清膈的药物攻下。面色苍白、悲伤易嚏，胁肋拘急胀痛，脉象沉细弦迟的，是寒痰在胸膜，适宜用辛热药物祛除。
痰热久咳，气急胸满，用知母、杏仁、萝卜子、贝母各二钱，生姜一斤，水煎服。
玉液丸：治疗热痰壅盛，咳嗽烦热。
寒水石（烧至通红，去除火毒，水飞，三十两）、半夏（洗焙研末，十两）、白矾（枯矾，十两，细研）
以上混合研磨，用面糊制成梧桐子大小的丸剂，每次服用三十丸，饭后用淡姜汤送下。
治疗妇人形体消瘦，有时夜间发热痰嗽，月经不调。
香附（童便浸，晒干，上等）、栝楼（中等）、青黛（下等）
以上研为细末，用姜汁和蜂蜜调匀，含化如豆大一丸。
Cough due to constrained heat arises when there is pre-existing internal heat in the Lung, which is then invaded by external cold. The heat becomes constrained by the cold, preventing the free flow of Lung Qi, resulting in sudden onset of wheezing and coughing. Symptoms include aversion to cold, intermittent fever, dry mouth, sore throat, hoarseness, or even aphonia (loss of voice). Treatment should employ acrid herbs to disperse cold and cool herbs to clear heat, or simply use acrid dispersants so that once the cold is resolved, the heat dissipates naturally. If bitter-cold herbs are hastily used to forcibly subdue the heat, the pathogenic factor may be suppressed internally, leading to significant aftereffects.
Lige Decoction from *Ben Shi Fang*:
*Hemionitis artemisiifoliae Folium* (Jisu Ye), *Schizonepetae Herba* (Jingjie), *Platycodonis Radix* (Jiegeng), *Akebiae Fructus* (Niubangzi), *Glycyrrhizae Radix et Rhizoma* (Gancao), *Bombyx Batryticatus* (Jiangcan), *Scrophulariae Radix* (Yuanshen) (each 1 liang).
Grind the above into powder. Take 1 qian per dose, mixed with boiling water. Take three times daily.
Fang Gu'an stated: The Lung governs the skin and hair. When a person is healthy, Ying (Nutritive) and Wei (Defensive) Qi circulate freely, and internal Qi extends outward through the skin and interstices. If wind-cold binds externally, internal Qi cannot reach the exterior, causing disturbances from within. This leads to rising fire and ascending phlegm, resulting in cough. It is appropriate to use acrid-warm or acrid-cool preparations to disperse wind-cold; thus, the pathogen retreats, Zheng Qi recovers, and the cough stops.
Cough due to fluid retention presents with wheezing, coughing, rebellious Qi, chest and diaphragm fullness and oppression, and difficulty lying flat. Xu Renze said: This occurs because ingested fluids stagnate and settle in the chest. Fluid Qi rushes upward into the Lung, forming cough. If untreated, this condition develops into fluid disease (*Shui Qi*). *Yi Yu* also states: This condition requires promoting urination, resolving phlegm, and directing Qi downward; otherwise, it will evolve into fluid disease.
Baishen Baiqian Decoction from *Shenshi*:
*Baiqian* (2 liang), *Banxia*, *Ziwan* (each 3 liang), *Daji* (7 he).
Soak in 1 dou of water overnight, decoct to obtain 3 sheng of liquid. Divide into doses for administration.
Yuanhua Powder:
*Yuanhua*, *Ganjiang*, *Bai Mi* (equal parts).
Grind the first two ingredients into powder, mix with honey, and simmer over low heat until paste-like. Take one pill the size of a jujube pit, three times daily and once at night. *Beiji Fang* uses stir-fried *Zhike* (2 liang), boiled in water, strained, and mixed with 1 jin of white sugar to form pills the size of jujubes.
Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung):
*Tinglizi* (amount not fixed, stir-fried until golden yellow).
Grind finely and form pills the size of marbles. Decoct 3 cups of water with 10 jujubes until reduced to 1 cup. Remove jujubes, add the pill, and decoct until 0.7 cup remains. Take after meals.
Sun Zhao treated a patient who vomited more than 1 sheng of phlegm in a short time, with persistent cough, dark complexion, and poor spirit. Sun Zhao said: "There is phlegm in the Lung causing obstruction in the chest and diaphragm. You should take Zhang Zhongjing's Tingli Dazao Tang." After one dose, the patient felt relief in the chest, and the phlegm disappeared almost completely. *Waitai Miyao* uses *Tinglizi* and *Xingren* (each 1 sheng) and 60 jujubes, pounded into a paste, mixed with honey to form pills the size of mulberry seeds. Take 60-70 pills with *Sangbaipi* decoction, stopping when bowel movements become unobstructed. *Ben Shi Fang*'s Zaogao Wan contains no *Xingren* but includes *Chenpi* and *Kujiegeng*, formed into pills the size of mulberry seeds using jujube flesh. Take 5-7 pills with water. Xu Shuwei said: "I often suffer from retained fluids stagnating in the Lung meridian. I sneeze immediately after eating, gradually develop wheezing, and feel tightness in the lung channels. Taking this formula yields excellent results."
Suzi Jiangqi Tang: Treats chronic Lung Qi dysfunction, cough, wheezing, and rebellious Qi, characterized by excess above and deficiency below, copious saliva and phlegm, and chest/diaphragm blockage.
*Zisuzi* (stir-fried), *Banxia* (processed, each 1.5 qian), *Qianhu*, *Gancao* (honey-fried), *Houpo* (stir-fried with ginger juice), *Chenpi* (peeled, each 1 qian), *Danggui* (1.5 qian), *Chenxiang* (0.7 fen).
Decoct with 2 cups of water and 3 slices of *Shengjiang* until 1 cup remains. Take as needed. For patients with deficiency-cold, add *Guizhi* (0.5 fen) and *Huangqin* (1 qian).
A patient with phlegm-cough and hypochondriac pain was treated with pills made from *Baijiezhi*, *Gualou*, *Jiegeng*, *Lianqiao*, *Fenghuaxiao*, *Zhuli*, and *Jiangzhi* mixed with honey for sucking, taken with tea infusion.
Note: Phlegm-fluids can be cold or hot. Cough with red face, frequent heat in the chest/abdomen/hypochondrium, occasional cold extremities, and a surging pulse indicates hot phlegm in the chest/diaphragm. Use cold-moistening and diaphragm-clearing purgatives. Pale face, sadness/sneezing, hypochondriac tightness/pain/distension, and deep/thin/wiry/slow pulse indicate cold phlegm in the chest membrane. Use acrid-hot herbs to dispel it.
For chronic cough due to phlegm-heat with shortness of breath and chest fullness, decoct *Zhimu*, *Xingren*, *Luobozhong* (radish seed), *Beimu* (each 2 qian) and 1 jin of *Shengjiang* in water.
Yuye Wan: Treats copious hot phlegm, cough, and irritability with heat.
*Han Shui Shi* (calcined until red, remove fire toxicity, water-triturated, 30 liang), *Banxia* (washed, dried, powdered, 10 liang), *Baifan* (calcined, 10 liang, finely ground).
Mix and grind, form pills with wheat starch paste the size of mulberry seeds. Take 30 pills after meals with light ginger soup.
Treats emaciated women with nocturnal heat, phlegm-cough, and irregular menstruation.
*Xiangfu* (steeped in child's urine, sun-dried, top grade), *Gualou* (medium grade), *Qingdai* (lower grade).
Grind into powder, mix with ginger juice and honey, suck one bean-sized pill.