Shen Shi Zun Sheng Shu

Author: Shen Jinjiao
Editor-in-Chief: Wu Shaozhen
Publisher:
Publishing Date: 1997-10-01
Features:
Excerpt: There are cases where sudden coughing occurs after a prolonged illness, and although the cough is persistent, it becomes severe. This is a new cough, likely caused by wind or food. For wind-induced cough, Xiao Feng Ning Sou Decoction is recommended. For food-induced cough, Da An Wan without Lindera and Coptis, with added Fritillaria and Bupleurum, is effective. Persistent cough is often due to deficiency or depression. For qi deficiency, Bu Zhong Yi Qi Tang is suitable. For blood deficiency, Ejiao Si Wu Decoction is recommended. For blood deficiency with excessive heat, causing coughing, wheezing, and hoarseness, Qin Lian Si Wu Decoction is appropriate. For qi and blood deficiency, Ning Fei Tang is prescribed. For consumptive cough with phlegm-heat, thirst, and sweating, Zi Yin Qing Hua Wan is effective. For consumptive cough with blood-tinged phlegm and wheezing, Wu Ji Gao is recommended. For consumptive cough with a single or two coughs, no phlegm, night sweats, alternating chills and fever, and frequent dreams, Jie lao San is used. For fire stagnation in the lungs, causing cough with sound but no phlegm, Jie Geng Tang is prescribed. For damp phlegm stagnation, causing cough relief after phlegm expulsion but recurrence shortly after, Jia Wei Er Chen Tang is recommended. For prolonged cough injuring the spleen, leading to facial sores, Ren Shen Hua Xi San is suitable. For prolonged cough with voice loss, Xing Ren Gao and Qing Fei Tang are effective. For prolonged cough with shortness of breath, Jie Sou Wan is used. For prolonged cough with facial swelling, Ting Lai San is prescribed. For persistent cough unresponsive to medication, Qin Hua Wan and Li Xiao Fang are recommended. For prolonged cough leading to consumptive disease, Bao He Tang is used. For prolonged cough lasting years, unresponsive to various treatments, without other symptoms, but different from consumptive cough, Bu Bu Gao and Wu Mei Gao are suitable. For dry cough caused by phlegm and fire stagnation in the middle, leading to persistent dry cough, this condition is extremely difficult to treat. First, an opening agent like Xiao Yao San with added Fritillaria is used. Then, nourishing yin herbs like Ben Shi Bie Jia Wan with prepared rhubarb, Angelica, white peony root, Ophiopogon, Ejiao, and Poria are prescribed. Coughing can vary with seasons and times of day:
Spring cough occurs due to the ascending spring qi, so Qing Qi Tang with Chuan Xiong is recommended. If coughing occurs every spring, it indicates spleen disease, so Jian Gong San with cough-relieving herbs is used. Summer cough is caused by scorching heat pressing on the lungs, so Jie Geng Tang with Gypsum and Coptis is effective. Autumn cough occurs when dry metal dominates, so Er Chen Tang with Mulberry and Asparagus is recommended. Late autumn cough, resolving only when summer arrives, is due to cold trapping heat, requiring herbal formulas like Er Chen Tang with Bupleurum and Pueraria. Winter cough is caused by wind-cold external binding, so Er Chen Tang with Ephedra, Apricot Kernel, Angelica Sinensis, and Saposhnikovia is used.
Coughing at 5 a.m. or in the morning is often due to spleen deficiency, so Liu Jun Zi Tang with prepared ginger is prescribed. Coughing only in the morning after a period of no coughing is due to empty heat, so Er Chen Tang with Scutellaria, Fritillaria, and Mulberry is used. Coughing throughout the day but worse in the morning may indicate food stagnation in the stomach, with fire flowing into the lungs, so Xie Bai San with Anemarrhena or Er Mu San is used, similar to 5 a.m. cough. Morning cough with thick yellow phlegm is due to stomach fire, so Er Chen Tang with Polyporus, Fritillaria, and Gypsum is recommended. Afternoon cough with black sticky phlegm is due to yin deficiency and fire, so Liu Wei Tang with cough-relieving herbs is used. Evening cough occurs when the kidney's yang is weak and yin is deficient, causing virtual fire to rise, so the spleen, lungs, and kidney water should be nourished, not just cough remedies like Liu Wei Wan or Liu Jun Zi Tang.
Coughing in the deep sleep of adults or children at 5 a.m. is due to food stagnation and phlegm, so Er Chen Tang with Chen Pi, Shen Qu, and Malt is used. Late night cough is due to wind, so Er Chen Tang with Saposhnikovia is prescribed. Coughing worse at night than during the day indicates blood deficiency, so Er Chen Tang with more Angelica is used.
In summary, there are 16 causes of cough:
1. Wind cough: caused by wind attacking the lungs, with a floating pulse, often accompanied by nasal congestion, runny nose, heavy voice, dry throat, chills, fever, spontaneous sweating, aversion to wind, restlessness, and coughing after speaking. Qiong Dong Hua San and Jin Fei Cao San are recommended.
2. Cold cough: caused by cold invading the spleen and lungs, with a wiry and weak pulse, often accompanied by pale face, sweet taste in mouth, abdominal cold, white bubbly phlegm, and sweet saliva, indicating stomach cold. Xiang Su Yin Zi and Ban Xia Wen Fei Tang are effective. If coughing occurs upon exposure to cold, it may be cold trapping heat, so Jie Biao Tang with Ephedra, Saposhnikovia, Apricot Kernel, Orange Peel, Perilla, Woodworthia, and Scutellaria is used. Cold injuring the lungs causes a tight pulse, often with nasal congestion, heavy voice, chills, fever, no sweating, restlessness, thirst, tight chest, and hoarseness. Er Chen Tang with Ephedra, Apricot Kernel, and Fritillaria is prescribed.
3. Heat cough: caused by summer heat, with a rapid pulse, often accompanied by dry mouth, hoarseness, fever, thirst, or spitting of saliva, even blood-tinged phlegm. Xi Fei San, Qin Ban Wan, and Huang Lian Huatan Wan are effective. If coughing with red face and chest-abdominal-liver area heat, but occasional cold in feet, a pulse indicates heat phlegm stagnation, causing cough and chest fullness. Er Huang Wan and Xiao Xian Cheng Tang are recommended.
4. Damp cough: caused by dampness injuring the spleen, with a slippery and fine pulse, often accompanied by joint pain, heavy limbs, sweating, poor urination, and excessive phlegm. Bai Zhu Tang and Bai Zhu Wan are used.
5. Stagnation cough (fire cough): with a rapid pulse, often accompanied by red face or lung distension with shortness of breath, insomnia, and little phlegm. Severe cases have dry cough with no phlegm, due to depleted kidney water and isolated fire. Qing Hua Wan and Qing Jin Jiang Huo Tang are prescribed.
6. Consumptive cough: with a fine and rapid pulse, often accompanied by night sweats, excessive phlegm, alternating chills and fever, fire rising with wheezing. This is due to excessive alcohol and sex, leading to blood deficiency, internal fluid depletion, and heart fire rising, causing dry heat to attack the lungs, leading to blood-tinged phlegm, shortness of breath, and continuous coughing. Ren Shen Qing Fei Tang, He Li Le Wan, and Ren Shen Chuan Gui Tang are used.
7. Food stagnation cough: caused by food stagnation leading to phlegm and prolonged coughing, with a rapid and hard pulse, often accompanied by chest fullness, belching, fever, or thick phlegm causing shortness of breath. This is due to stomach fire rising and pressing lung qi, leading to prolonged coughing. Qing Dai Gualou Wan and Er Mu Ning Sou Tang are effective. Food stagnation is often indicated by a face that is not constantly green, yellow, or white, with a pattern like crab claws (alternating yellow and white).
8. Qi cough: caused by qi stagnation, with a floating,, rapid pulse, often accompanied by shortness of breath, phlegm, or phlegm like rotten cotton or plum kernels, obstructing the throat, unable to vomit or swallow. Often due to emotional stagnation or spleen-lung injury, leading to frequent vomiting of blood and eventual lung atrophy. Qi cough is common in women, so Tuan Ren Yin Zi, Su Zi Jiang Qi Tang, and Xing Xiang Wan are used.
9. Phlegm cough: coughing with phlegm sound, stopping after phlegm expulsion. With a floating and slippery pulse, often accompanied by chest-obstruction, excessive phlegm, or alternating chills and fever, face like a plate, due to damp phlegm in the stomach drying the lungs. Ban Gua Wan, Di You San, and Qing Ming Yin are used. A type of cough where vomiting all food and phlegm provides relief is due to liver wood overcoming spleen earth, with severe wind-phlegm stagnation. Bai Yuan Zi is prescribed.
10. Dry cough: due to lack of fluids in the lungs, with a fine and thready pulse, often accompanied by weak or rapid breathing. Light cases have coughing for dozens of sounds before phlegm appears, while severe cases have coughing with no phlegm. Extremely difficult to treat, start with bitter Fritillaria to open, then use nourishing yin and cooling fire formulas. If ineffective, it may lead to consumptive disease, common in those who suffer setbacks. Gan Sou Bu Fei Gao, Jia Wei Er Mu Wan, and Qiong Yu Gao are used.
11. Blood cough: coughing with excessive blood-tinged phlegm, with a floating and thready rapid pulse, often accompanied by a foul smell in the throat, or blood-tinged phlegm due to upper body heat and blood stagnation, causing continuous coughing and inability to breathe. Sang Pi San or Angelica San is used. If coughing with black blood due to trauma injuring lung qi, Dang Gui San is prescribed.
12. Alcohol cough: caused by alcohol, which is hot and toxic, or drinking both hot and cold, gradually injuring the stomach, causing damp phlegm and cough. Gualou Qing Dai Wan, Gualou Xing Lian Wan, and Feng Jiang Wan are used.
13. Prolonged cough: various prolonged coughs, due to accumulated phlegm in the lungs, sticky like glue, causing poor qi circulation or shortness of breath. Feng Jiang Wan, Bei Mu Tang, and Jia Wei Bai Hua Gao are effective. Some cases last for decades, using Ma Dou Ling Wan or Run Fei Chong Sou Yin.
14. Fire cough: caused by fire, with a pulse, often accompanied by red face, thirst, and little phlegm. If due to lung heat, Qing Fei Yin is used. If due to cold fever with phlegm and chest-liver pain, Chai Hu Zhi Jie Tang is prescribed. If due to fire-lung distension with shortness of breath, Hai Qing Wan is used. Since the lungs and kidneys are the body's transformation sources, deficiency leads to phlegm-fire and persistent coughing. Zi Yin Qing Hua Wan is recommended.
15. Night cough: due to yin deficiency, often kidney qi deficiency, fire inflammation, water depletion, or fluid stagnation forming phlegm. At night, yin prevails, so coughing continues until morning, possibly with bitter taste, chest fullness, liver pain, and excessive saliva, poor appetite. Night cough requires Anemarrhena, avoiding ginger due to its dispersing nature, which may further injure yin. Ancient formulas like Liu Wei Wan with Anemarrhena, Coptis, Asparagus, Fritillaria, and Orange Peel nourish the transformation source. Zi Yin Qing Hua Wan or Mahuang Cang Zhu Tang is used.
16. Epidemic cough: caused by seasonal pathogens, due to improper seasons and common colds, leading to phlegm, fever, or nasal congestion. Ren Shen Yin Zi or Yi Fu San is used. Some also have four-season wind-cold coughs not solely due to seasonal pathogens, using Can Su Yin.
Thus, treating various coughs with proper understanding ensures effective results.
[Pulse Method]
Coughing, asthma, lung atrophy, and lung paralysis.
The Inner Canon says: Wheezing with shoulder breathing indicates a solid pulse; slow is life, fast is death.
The Pulse Decree says: Coughing causes floating for wind, tight for cold, rapid for heat, fine for dampness, and difficult for sexual exhaustion.
Right Guan pulse is slippery for dietary injury to the lungs. Left Guan pulse is wiry for extreme liver exhaustion. Floating and short pulse indicates lung injury, leading to cough.
Coughs of the five organs are treated based on their origin. Floating and tight pulse indicates virtual cold; deep and rapid pulse indicates actual heat; pulse indicates excessive phlegm; wiry and fine pulse indicates blood deficiency.
Strong body with fine pulse, unable to breathe, deep and small hidden pulse are all death pulses. Only floating and large pulse with coughing indicates life.
External symptoms and internal pulses should be referenced and adjusted.
The True Transmission says: Micro pulse on Guan indicates cough; wiry or tight pulse indicates cold; floating pulse indicates wind; fine pulse indicates dampness; rapid pulse indicates heat; deep pulse indicates retained fluid; deep and rapid pulse indicates actual heat; pulse indicates excessive phlegm; floating and soft pulse indicates life; deep and small hidden pulse indicates death.
Also says: Wheezing with slippery and floating pulse indicates life; and rapid pulse indicates death; generally, floating and slow is better than and rapid.
Also says: Coughing with floating and slow pulse is easy to treat; wiry and tight pulse without rapid on palpation is difficult to treat; or or micro pulse can be treated; pulse indicates death; right Guan pulse is wiry, indicating wood overcoming earth, difficult to treat.
Zhong Jing says: Coughing with blood-tinged phlegm, rapid and virtual pulse indicates lung atrophy; rapid and actual pulse indicates lung abscess.
The Pulse Classic says: Wheezing with warm hands and feet indicates life; with cold hands and feet indicates death; rapid pulse also indicates death, as the body is damaged.
Also says: Lung abscess with blood-tinged phlegm, tight and strong pulse indicates death; slippery pulse indicates life.
Hui Chun says: Wheezing with deep pulse indicates lung distension with retained water, qi inversion filling the chest; deep pulse must be taken, deep and pulse with warm body indicates easy recovery; deep and floating pulse with cold body and on the indicates difficulty in replenishing.
The Entrance says: Coughing with scattered pulse indicates death; scattered pulse is the same as rapid; coughing with rapid pulse indicates fire punishing metal, so it is certain death.