Source원문
內經曰, 人感於寒, 微則爲咳, 甚者爲泄ㆍ爲痛.
Translation영역
The Inner Classic says: when a person is affected by cold, in a slight case there is cough, in a severe one diarrhoea and pain.
Naegyeong 內經
Formulas · Text · Donguibogam 東醫寶鑑
Cough
Haesu
한글 해수 · Pinyin Ke Sou
Cough, panting, wheezing and hiccup — fifteen kinds of cough, eight of panting, and the formulas for each
咳嗽
The longest chapter in the Miscellaneous Disorders, and the one where the Bogam's method of classification is most fully on display. 咳 is a cough with sound and no phlegm, 嗽 phlegm with no sound, 咳嗽 both together: the distinction is made in the first section and the whole chapter is built on it. Then come fifteen kinds of cough named by cause — wind, cold, heat, damp, depression, taxation, food accumulation, qi, phlegm, dry, blood, wine, long-standing, fire, night, and the epidemic kind — eight kinds of panting, the wheeze, lung distension, wilting lung, and finally hiccup, which the chapter argues is the same thing as the 噦 of the Vomiting chapter.
Two things make it worth reading closely. The first is that the classification is by cause and timing rather than by sound, and the timings are real observations: a cough worst at dawn is put down to food accumulation, one worst in the afternoon to yin vacuity, one at dusk to fire floating in the lung, one at night to fire in the yin. A clinician who asks when the cough is worst is doing what this chapter taught Korean medicine to do.
The second is the quantity of recorded practice. Nearly two hundred formulas stand in these pages, many of them nowhere else in the book, and they are the fullest record of seventeenth-century respiratory therapeutics in Korean. A number of them should not be made: arsenic sulfide for wheeze, aristolochia for long cough, opium poppy husk for the dry kind, lead and mercury here and there. Each of those entries carries its warning. What is left after the warnings is still substantial — ephedra, apricot kernel, pinellia, mulberry root bark, ophiopogon, schisandra, aster and stemona, in combinations a modern herbalist would recognize.
3.1 The Causes of Cough 咳嗽病因
Source원문
秋傷於濕, 冬生咳嗽. 又曰, 秋傷於濕, 上逆而咳, 發爲痿厥. 《內經》
Translation영역
Injured by damp in autumn, one engenders cough in winter. It says again: injured by damp in autumn, there is upward counterflow with cough, breaking out as wilting and reversal.
Naegyeong 內經
Source원문
形寒飮冷則傷肺, 肺傷則咳嗽. 《難經》
Translation영역
A chilled body and cold drink injure the lung, and when the lung is injured there is cough.
Clinical note임상 주석
形寒飮冷則傷肺 — a chilled body and cold drink injure the lung — is the line the whole tradition quotes for the cause of cough, and the two halves of it are the two routes: cold from outside on the skin, cold from inside by what is swallowed. It is why Korean practice still asks a coughing patient about cold drinks.
Nangyeong 難經
Source원문
秋傷於濕, 冬必咳嗽者, 盖秋傷於濕, 積於脾也. 大抵素秋之氣宜淸而肅, 若反動之, 則氣必上衝而爲咳嗽, 甚則動脾濕而爲痰也. 是知脾無留濕, 則雖傷肺氣亦不爲痰. 若有痰而寒少熱多, 故咳嗽. 咳嗽非專主乎肺病, 以肺主皮毛而司於外, 故風寒先能傷之也. 經曰, 五藏六府皆能使人咳, 非獨肺也. 各以其時主之而受病焉, 非其時則傳以與之也. 所病不等, 寒ㆍ燥ㆍ濕ㆍ風ㆍ火皆能令人咳. 惟濕病痰飮入胃, 留之而不行, 上入於肺則爲嗽. 假令濕在心經謂之熱痰, 濕在肝經謂之風痰, 濕在肺經謂之氣痰, 濕在腎經謂之寒痰. 所治不同, 各隨證用藥. 《河間》
Translation영역
That one injured by damp in autumn must cough in winter is because the damp contracted in autumn has accumulated in the spleen. In general the qi of plain autumn should be clear and austere; if it is stirred against its nature the qi must surge upward and there is cough, and in a severe case it stirs the spleen's damp and becomes phlegm. From this one knows that where no damp lodges in the spleen there is no phlegm even though the lung qi is injured. Where there is phlegm, the cold is little and the heat much, and hence the cough. Cough is not solely an illness of the lung; it is because the lung governs the skin and hair and has charge of the outside that wind and cold are able to injure it first. The classic says: the five viscera and six bowels can all make a person cough, not the lung alone. Each governs in its own season and takes the illness then; out of its season it is passed on from another. The illnesses are not alike: cold, dryness, damp, wind and fire can all make a person cough. But it is only in a damp illness that phlegm fluid enters the stomach, lodges there without moving, and rising into the lung becomes a cough with phlegm. Thus damp in the heart channel is called heat phlegm; damp in the liver channel, wind phlegm; damp in the lung channel, qi phlegm; damp in the kidney channel, cold phlegm. Their treatments are not the same, and the medicine follows the pattern in each.
Clinical note임상 주석
Hagan's argument, and it is the chapter's theoretical centre. The claim is that the lung supplies the cough and the spleen the phlegm — 脾無留濕則雖傷肺氣亦不爲痰, where no damp lodges in the spleen there is no phlegm even if the lung is injured — which is why almost every formula in the chapter contains a spleen drug alongside the lung drugs.
五藏六府皆能使人咳, 非獨肺也 is quoted here and set out in full at 3.3. Its practical force is that a cough with no lung findings is to be traced elsewhere, and the chapter's own list of the places includes the stomach, the gallbladder and the bladder.
Hagan 河間
Source원문
咳謂無痰而有聲, 肺氣傷而不淸也. 嗽謂無聲而有痰, 脾濕動而爲痰也. 咳嗽者, 有痰而有聲, 因傷肺氣ㆍ動於脾濕, 故咳而兼嗽也. 《河間》
Translation영역
咳 means no phlegm but a sound, the lung qi being injured and unclear. 嗽 means no sound but phlegm, the spleen's damp being stirred and becoming phlegm. 咳嗽 is phlegm with a sound: the lung qi has been injured and the spleen's damp stirred, and so there is coughing together with expectoration.
Clinical note임상 주석
The definition the chapter is named for. In English the three collapse into one word, and the distinction is worth keeping because it is a clinical one: a dry hacking cough, a productive one, and a productive one with the hacking. The Bogam assigns the first to the lung, the second to the spleen, and the third to both.
Hagan 河間
Source원문
咳者, 聲咳之咳, 俗謂之嗽者是也. 肺主氣, 形寒飮冷則傷之, 使氣上而不下ㆍ逆而不收, 衝擊膈咽, 令喉中淫淫如痒ㆍ習習如梗, 是冷嗽. 甚者續續不已ㆍ連連不息ㆍ坐卧不安ㆍ言語不竟ㆍ動引百骸ㆍ聲聞四隣矣. 《明理》
Translation영역
咳 is the cough of a coughing sound, which common speech calls 嗽. The lung governs the qi, and a chilled body and cold drink injure it, so that the qi goes up and not down, runs counter and is not gathered in, and strikes against the diaphragm and the throat, making the throat flow with an itch and prickle as though something were stuck in it: this is cold cough. In a severe case it goes on and on without stopping, one fit running into the next, the patient cannot rest sitting or lying, cannot finish a sentence, is shaken through every bone, and is heard by the neighbours on all four sides.
Clinical note임상 주석
The best description of a cough in the book, and all of it is observation: the tickle and the prickle in the throat, the inability to finish a sentence, the whole body shaken by the fit, the sound carrying to the neighbours. 聲聞四隣 is the detail that fixes it — a paroxysmal cough loud enough to be heard next door, which is how whooping cough and a severe tracheitis present.
Myeongni 明理
3.2 Pulse Method 脉法
Source원문
咳嗽所因, 浮風ㆍ緊寒ㆍ數熱ㆍ細濕ㆍ房勞澁難. 右關濡者, 飮食傷脾; 左關弦短, 疲極肝衰; 浮短肺傷, 法當咳嗽. 五藏之嗽, 各視本部. 浮緊虛寒ㆍ沉數實熱ㆍ洪滑多痰ㆍ弦澁少血. 形盛脉細, 不足以息; 沉小伏匿, 皆是死脉. 惟有浮大而嗽者生. 外證內脉, 參考秤停. 《脉訣》
Translation영역
As to the causes of cough: floating is wind, tight is cold, rapid is heat, fine is damp, and rough and hesitant is sexual taxation. A soggy right bar means food and drink have injured the spleen; a stringlike and short left bar, that exhaustion has worn the liver down; floating and short, that the lung is injured, and by rule there should be cough. For a cough of the five viscera, look to each one's own position. Floating and tight is vacuity cold; sunken and rapid, replete heat; surging and slippery, much phlegm; stringlike and rough, scant blood. A full build with a fine pulse means the breath is insufficient; sunken, small, buried and hidden are all death pulses. Only the one who coughs with a floating large pulse lives. Outward signs and inward pulse are to be weighed together and balanced.
Maekgyeol 脉訣
Source원문
關上脉微爲咳.
Translation영역
A faint pulse at the bar means cough.
Jeongjeon 正傳
Source원문
脉弦或緊爲寒.
Translation영역
A stringlike or tight pulse means cold.
Jeongjeon 正傳
Source원문
脉浮爲風.
Translation영역
A floating pulse means wind.
Jeongjeon 正傳
Source원문
脉細爲濕.
Translation영역
A fine pulse means damp.
Jeongjeon 正傳
Source원문
脉數爲熱.
Translation영역
A rapid pulse means heat.
Jeongjeon 正傳
Source원문
脉沉爲留飮.
Translation영역
A sunken pulse means lodged fluid.
Jeongjeon 正傳
Source원문
沉數爲實熱.
Translation영역
Sunken and rapid means replete heat.
Jeongjeon 正傳
Source원문
洪滑爲多痰.
Translation영역
Surging and slippery means much phlegm.
Jeongjeon 正傳
Source원문
脉浮軟者生, 沉小伏匿者死. 《正傳》
Translation영역
A pulse floating and soft means the patient lives; sunken, small, buried and hidden means he dies.
Jeongjeon 正傳
Source원문
喘急脉沉, 肺脹停水, 氣逆填胸, 脉必伏. 取沉而實滑ㆍ身溫易愈; 身冷脉浮ㆍ尺澁難補. 《回春》
Translation영역
In urgent panting with a sunken pulse, where the lung is distended and water has halted and the counterflow qi fills the chest, the pulse is certainly buried. Where it is taken as sunken but replete and slippery and the body is warm, the case mends easily; where the body is cold, the pulse floating and the cubit rough, it is hard to supplement.
Clinical note임상 주석
肺脹停水 with a buried pulse and the chest filled — breathlessness with a feeble pulse and fluid in the chest. The discrimination that follows is the useful part: a warm patient with a palpable forceful pulse does well, a cold one with a floating pulse and an empty cubit does not, which is a judgment about the circulation rather than about the lung.
Hoechun 回春
Source원문
喘脉滑而浮者生, 澁而數者死. 大抵宜浮遲, 不宜急數. 《正傳》
Translation영역
In panting, a pulse slippery and floating means the patient lives, rough and rapid that he dies. In general it should be floating and slow, and not urgent and rapid.
Jeongjeon 正傳
Source원문
喘鳴肩息者, 脉實大也. 緩則生, 急則死. 《內經》
Translation영역
Where there is wheezing and the shoulders heave with the breath, the pulse is replete and large. If it is moderate the patient lives; if urgent he dies.
Clinical note임상 주석
喘鳴肩息 — wheezing with the shoulders heaving — is the Inner Classic's name for severe respiratory distress, and the same sign appears in 審病 2.5 and 2.4. The prognostic rule attached to it is about rate: a fast pulse in a patient working that hard to breathe is the bad sign, which is what a modern assessment would also say.
Naegyeong 內經
Source원문
喘脉滑而手足溫者生, 脉澁而手足寒者死. 數者亦死, 爲其形損故也. 《脉經》
Translation영역
In panting, a slippery pulse with warm hands and feet means the patient lives; a rough pulse with cold hands and feet that he dies. A rapid pulse also means death, because the body has been damaged.
Maekgyeong 脉經
Source원문
咳逆脉浮而緩者易治.
Translation영역
In hiccup, a pulse floating and moderate is easy to treat.
Jeongjeon 正傳
Source원문
弦急而按之不鼓者難治.
Translation영역
Stringlike and urgent, and not drumming under pressure, is hard to treat.
Jeongjeon 正傳
Source원문
脉結或促或微, 皆可治.
Translation영역
A bound, hurried or faint pulse can all be treated.
Jeongjeon 正傳
Source원문
脉代者危.
Translation영역
An intermittent pulse is perilous.
Jeongjeon 正傳
Source원문
右關脉弦者, 木乘土位, 難治. 《正傳》
Translation영역
A stringlike pulse at the right bar means wood has overridden earth's position, and it is hard to treat.
Jeongjeon 正傳
Source원문
咳逆上氣, 脉散者死散卽數脉也. 咳逆脉數爲火刑金, 必死. 《入門》
Translation영역
In hiccup with qi rising, a scattered pulse means deathscattered is the rapid pulse. In hiccup a rapid pulse means fire punishing metal, and the patient must die.
Immun 入門
Source원문
咳唾膿血, 脉數虛爲肺痿, 數實爲肺癰. 《仲景》
Translation영역
Where pus and blood are coughed and spat, a rapid vacuous pulse means wilting lung and a rapid replete one a welling abscess of the lung.
Clinical note임상 주석
One sign, two diseases, told apart by whether the pulse has force in it. Coughing pus and blood with a weak rapid pulse is the chronic destructive process the Bogam calls 肺痿 — bronchiectasis or a late tuberculous lung in modern terms; with a forceful rapid pulse it is 肺癰, an acute lung abscess or empyema. The distinction matters because the two call for opposite treatment, and it is still the distinction a clinician makes between a chronic suppurative lung and an acute one.
Junggyeong 仲景
Source원문
肺痿唾血, 脉緊強者死, 滑者生. 《脉經》
Translation영역
In wilting lung with the spitting of blood, a tight hard pulse means death and a slippery one life.
Maekgyeong 脉經
Source원문
寸數虛澁, 肺痿之形. 《脉訣》
Translation영역
The inch rapid, vacuous and rough is the form of wilting lung.
Maekgyeol 脉訣
3.3 Though Cough Belongs to the Lung There Are Differences of Viscus and Bowel 咳嗽雖屬肺亦有臟腑之異
Source원문
內經曰, 咳嗽上氣, 厥在胸中, 過在手陽明大腸ㆍ太陰肺
Translation영역
The Inner Classic says: in cough with qi rising, the reversal is in the chest and the fault is in the hand yang brightnessthe large intestine and the hand greater yinthe lung
Naegyeong 內經
Source원문
帝曰, 肺之令人咳何也. 歧伯對曰, 五藏六府皆令人咳, 非獨肺也. 帝曰, 願聞其狀. 歧伯曰, 皮毛者肺之合也. 皮毛先受邪氣, 邪氣以從其合也. 其寒飮食入胃, 從肺系上至於肺則肺寒, 肺寒內外合邪, 因而客之, 則爲肺咳. 五藏各以其時受病, 非其時則各傳以與之. 乘秋則肺先受邪, 乘春則肝先受之, 乘夏則心先受之, 乘至陰則脾先受之, 乘冬則腎先受之. 帝曰, 何以異之. 歧伯曰, 肺咳之狀, 咳而喘息有音, 甚則唾血. 心咳之狀, 咳則心痛ㆍ喉中吤吤如梗狀, 甚則咽腫喉痺. 肝咳之狀, 咳則兩脇下痛, 甚則不可以轉, 轉則兩胠下滿. 脾咳之狀, 咳則右胠下痛ㆍ陰陰引肩背, 甚則不可以動, 動則咳劇. 腎咳之狀, 咳則腰背相引而痛, 甚則咳涎. 帝曰, 六府之咳奈何, 安所受病. 歧伯曰, 五藏之久咳, 乃移於六府. 脾咳不已則胃受之, 胃咳之狀, 咳而嘔, 嘔甚則長蟲出. 肝咳不已則膽受之, 膽咳之狀, 咳嘔膽汁. 肺咳不已則大腸受之, 大腸咳狀, 咳而遺矢. 心咳不已則小腸受之, 小腸咳狀, 咳而失氣. 腎咳不已則膀胱受之, 膀胱咳狀, 咳而遺尿. 久咳不已則三焦受之, 三焦咳狀, 咳而腹滿不欲食飮. 此皆聚於胃ㆍ關於肺, 使人多濁唾而面浮腫氣逆也. 《內經》
Translation영역
The Emperor said: why does the lung make a person cough? Gibaek replied: the five viscera and six bowels all make a person cough, not the lung alone. The Emperor said: I should like to hear how each appears. Gibaek said: the skin and hair are the lung's counterpart. The skin and hair receive the evil qi first, and the evil qi follows them to their counterpart. And when cold food and drink enter the stomach and go up by the lung's connections to the lung, the lung is chilled; the chilled lung joins the evil within to the evil without, and as it lodges there it becomes a lung cough. Each of the five viscera takes the illness in its own season; out of its season it is passed on from another. In autumn the lung receives the evil first, in spring the liver, in summer the heart, in the ultimate yin the spleen, in winter the kidney. The Emperor said: how are they distinguished? Gibaek said: in a lung cough the patient coughs and the breathing has a sound in it, and in a severe case he spits blood. In a heart cough, the coughing brings pain in the heart and a scratching in the throat as though something were stuck there, and in a severe case the throat swells and is blocked. In a liver cough, the coughing brings pain below both flanks, and in a severe case the patient cannot turn, and if he turns there is fullness below both sides. In a spleen cough, the coughing brings pain below the right side, drawing dully through to the shoulder and back, and in a severe case he cannot move, and if he moves the coughing is violent. In a kidney cough, the coughing brings pain drawing between the lumbus and the back, and in a severe case he coughs up drool. The Emperor said: and what of the coughs of the six bowels — where do they take their illness? Gibaek said: a long cough of the five viscera shifts to the six bowels. When a spleen cough does not end, the stomach receives it; in a stomach cough the patient coughs and retches, and if the retching is severe long worms come out. When a liver cough does not end, the gallbladder receives it; in a gallbladder cough he coughs and retches bile. When a lung cough does not end, the large intestine receives it; in a large intestine cough he coughs and loses his stool. When a heart cough does not end, the small intestine receives it; in a small intestine cough he coughs and loses wind. When a kidney cough does not end, the bladder receives it; in a bladder cough he coughs and loses urine. When a long cough does not end, the three burners receive it; in a three-burner cough he coughs with a full abdomen and no wish for food or drink. All of these gather in the stomach and are bound up with the lung, and they make a person spit much turbid phlegm with a puffy swollen face and qi running counter.
Clinical note임상 주석
The Inner Classic's eleven coughs, and read as clinical description a good deal of it holds. Pain in the flanks on coughing, pain drawing from the lumbus to the back, coughing that is made violent by movement: these are the referred and musculoskeletal pains of a hard cough. Loss of stool, of wind and of urine with coughing is stress incontinence, and the Bogam lists all three. Coughing until worms come up is ascariasis, which was common. Coughing bile is what happens when retching goes on past the point where the stomach is empty.
此皆聚於胃, 關於肺 — all of these gather in the stomach and are bound up with the lung — is the sentence that ties the eleven back together, and with the puffy face and turbid sputum at the end of it the passage closes on the picture of chronic lung disease that 3.18 and 3.27 return to.
Naegyeong 內經
3.4 Medicines for the Cough of Each Viscus and Bowel 臟腑治咳藥
Source원문
肺咳宜麻黃湯方見寒門, 心咳宜桔梗湯方見下, 肝咳宜小柴胡湯方見寒門, 脾咳宜升麻湯方見風門, 腎咳宜麻子附子細辛湯方見寒門, 胃咳宜烏梅丸方見蟲門, 膽咳宜黃芩湯加半夏ㆍ生薑半夏ㆍ黃芩ㆍ芍藥ㆍ甘草 各二錢, 薑棗煎, 大腸咳宜赤石脂禹餘粮湯方見寒門, 小腸咳宜芍藥甘草湯方見腹門, 膀胱咳宜茯苓甘草湯茯苓ㆍ桂枝 各二錢, 甘草 一錢, 入薑煎, 三焦咳宜錢氏異功散方見內傷○海藏
Translation영역
For a lung cough, Ephedra Decoctionthe formula is given in the Cold chapter; for a heart cough, Platycodon Decoctionthe formula is given below; for a liver cough, Minor Bupleurum Decoctionthe formula is given in the Cold chapter; for a spleen cough, Cimicifuga Decoctionthe formula is given in the Wind chapter; for a kidney cough, Ephedra, Aconite and Asarum Decoctionthe formula is given in the Cold chapter; for a stomach cough, Smoked Plum Pillthe formula is given in the Worms chapter; for a gallbladder cough, Scutellaria Decoction with pinellia and fresh ginger addedpinellia, scutellaria, peony and licorice, 2 don each, decocted with ginger and jujube; for a large intestine cough, Halloysite and Limonite Decoctionthe formula is given in the Cold chapter; for a small intestine cough, Peony and Licorice Decoctionthe formula is given in the Abdomen chapter; for a bladder cough, Poria and Licorice Decoctionporia and cinnamon twig, 2 don each, licorice, 1 don, decocted with ginger; for a three-burner cough, Jeon's Peculiar Merit Powderthe formula is given in the Inward Damage chapter ○ Haejang
Clinical note임상 주석
Eleven coughs, eleven formulas, one for each of the viscera and bowels of 3.3 — and Haejang's list is the clearest instance in the Bogam of a diagnostic scheme turned mechanically into a prescription table. Two of the eleven are given with their recipes in small characters rather than by reference, which is how the Bogam handles a formula it has nowhere else: the gallbladder's Scutellaria Decoction with pinellia, and the bladder's Poria and Licorice Decoction.
Whether the table was ever used as it stands is doubtful — a cough with incontinence treated with peony and licorice is a long way from the rest of the chapter's practice — but it preserves the formulas, and 麻黃附子細辛湯 for a cough with back pain in a cold patient is a prescription still made.
Haejang 海藏
3.5 Cough Differs by the Season and by the Hour 嗽作有四時早晏之異
Source원문
凡咳嗽, 春是春升之氣, 夏是火炎上最重, 秋是濕熱傷肺, 冬是風寒外束. 《丹心》
Translation영역
In any cough: in spring it is the rising qi of spring; in summer it is fire blazing upward, and that is the worst; in autumn it is damp heat injuring the lung; in winter it is wind cold binding from without.
Dansim 丹心
Source원문
大槩春氣上升, 宜潤肺抑肝; 夏火上炎, 宜淸金降火; 秋濕熱甚, 宜淸熱瀉濕; 冬風寒重, 宜解表行痰. 用藥發散之後, 以半夏等藥逐去其痰, 庶不再來. 《入門》
Translation영역
In general: where the spring qi is rising, moisten the lung and restrain the liver; where summer fire blazes upward, clear the metal and bring the fire down; where autumn damp heat is severe, clear the heat and drain the damp; where winter wind cold is heavy, release the exterior and move the phlegm. After using medicines to disperse it outward, drive the phlegm out with such drugs as pinellia, so that it may not come back.
Clinical note임상 주석
Four seasons, four methods, and the sequence at the end is the part that matters: disperse first, then clear the phlegm, so that it does not return. Treating the residue of an acute cough rather than stopping at the acute phase is the chapter's standing advice, and 庶不再來 — so that it may not come back — is its reason.
Immun 入門
Translation영역
Where the cough is worst in the early morning, there is food accumulation in the stomach, and at that hour the fire qi flows up into the lung; give Drain the White Powder with anemarrhena added, or Two Mothers Powderthe cough of the fifth watch is the same
Clinical note임상 주석
A cough worst on waking, attributed to last night's food. The association is real enough — a cough that is worst in the early hours and on rising is what reflux produces, and reflux is worse for a late heavy meal — and the Bogam's reading of it as 食積 in the stomach throwing heat up into the lung is not a bad description of the mechanism in its own vocabulary.
Immun 入門
Translation영역
Where the cough is worst in the first half of the day, it belongs to fire in the stomach, and fritillary and gypsum are used to bring the stomach fire down. One account says: where the coughing is worst in the first half of the daythat is, before noon there is replete fire in the stomach, and Gypsum Alone Pillthe formula is given in the Fire chapter with anemarrhena and fritillary added. If the stool is shut, with panting, thirst and thick phlegm, Cool the Diaphragm Powderthe formula is given in the Fire chapter is appropriate
Immun 入門
Translation영역
Where the cough is worst after noon, it belongs to yin vacuity; Four Substances Decoction with anemarrhena and dry-fried phellodendron added, to bring the fire down first. One account says: a cough worst after noonthat is, the latter half of the day mostly belongs to yin vacuity, and Four Substances combined with Two Matured Ingredients Decoction, with anemarrhena, phellodendron and ophiopogon added. Where there are chills and fever, night sweats and seminal emission, Nourish the Yin and Bring Down Fire Decoctionthe formula is given in the Fire chapter is appropriate
Clinical note임상 주석
The afternoon cough with chills, night sweats and wasting is tuberculosis, and the Bogam's own name for the pattern, 陰虛, is the one Korean medicine still uses for it. **A cough worse in the afternoon with night sweats and weight loss requires investigation for tuberculosis.**
Immun 入門
Source원문
黃昏嗽多, 此火氣浮於肺, 不宜用凉藥, 五味子ㆍ五倍子歛而降之. 一云, 黃昏嗽多者夜嗽也, 潤肺丸以歛之卽潤肺散作丸也. 通用二陳湯去半夏, 加貝母ㆍ瓜蔞ㆍ靑黛ㆍ梔子ㆍ黃芩ㆍ桑白皮.
Translation영역
Where the cough is worst at dusk, this is fire qi floating in the lung, and cooling medicines are not suitable; schisandra and gallnut astringe and bring it down. One account says: where the cough is worst at duskthat is, the night cough, Moisten the Lung Pill astringes itthat is, Moisten the Lung Powder made into pills. For general use, Two Matured Ingredients Decoction with the pinellia removed and fritillary, trichosanthes, indigo, gardenia, scutellaria and mulberry root bark added.
Immun 入門
Source원문
夜嗽用降陰分火. 《丹心》
Translation영역
For a night cough, bring down the fire in the yin aspect.
Dansim 丹心
Source원문
風寒鬱熱夜嗽者, 三拗湯加知母ㆍ黃芩ㆍ生薑. 《正傳》
Translation영역
For a night cough from wind cold with depressed heat, Three Unruly Ingredients Decoction with anemarrhena, scutellaria and fresh ginger added.
Clinical note임상 주석
Four hours and four readings: dawn for food in the stomach, morning for stomach fire, afternoon for yin vacuity, dusk and night for fire floating in the lung. The scheme is the chapter's most distinctive contribution and the question it rests on — when is the cough worst? — is one a modern clinician asks for the same reason, because the answer separates reflux from asthma from infection from tuberculosis.
Jeongjeon 正傳
3.6 The Various Patterns of Cough 咳嗽諸證
Source원문
有風嗽ㆍ寒嗽ㆍ熱嗽ㆍ濕嗽ㆍ鬱嗽ㆍ勞嗽ㆍ食積嗽ㆍ氣嗽ㆍ痰嗽ㆍ乾嗽ㆍ血嗽ㆍ酒嗽ㆍ久嗽ㆍ火嗽ㆍ夜嗽ㆍ天行嗽ㆍ通治咳嗽藥.
Translation영역
There are the wind cough, the cold cough, the hot cough, the damp cough, the depression cough, the taxation cough, the food-accumulation cough, the qi cough, the phlegm cough, the dry cough, the blood cough, the wine cough, the long-standing cough, the fire cough, the night cough and the epidemic cough; and then the medicines that treat cough generally.
Clinical note임상 주석
Sixteen kinds, and the list is worth reading as what it is: not sixteen diseases but sixteen causes for one symptom. Four are climatic (wind, cold, heat, damp), four are about what the body is doing (depression, taxation, qi, blood), three are about what is in it (food accumulation, phlegm, wine), two are about its course (dry, long-standing), two about when it happens (fire, night) and one about where it came from (epidemic). A modern clinician works the same way — the cough is the presentation and the work is finding what is behind it — and the chapter's divisions correspond, loosely but recognizably, to the questions asked in a cough history.
Donguibogam · Haesu
Source원문
咳因氣動爲聲, 嗽乃血化爲痰. 肺氣動則咳, 脾濕動則嗽. 脾肺二藏俱動, 則咳嗽俱作也. 《入門》
Translation영역
咳 comes of the qi stirring and making a sound; 嗽 is blood transformed into phlegm. When the lung qi stirs there is 咳; when the spleen's damp stirs there is 嗽. When both viscera, spleen and lung, are stirred, then 咳嗽 arises with both together.
Immun 入門
3.6.1 The Wind Cough 風嗽
Source원문
風乘肺則鼻塞ㆍ聲重ㆍ口乾ㆍ喉痒ㆍ語未竟而咳. 《入門》
Translation영역
When wind overrides the lung there is a blocked nose, a heavy thick voice, a dry mouth, an itching throat, and coughing before a sentence can be finished.
Clinical note임상 주석
喉痒 — an itching throat — and 語未竟而咳, coughing before a sentence is finished, are the two signs that make this the wind cough. Both are what a patient reports in the irritable post-viral or allergic cough, and the tickle in the throat is still the symptom by which that cough is recognized.
Immun 入門
Source원문
傷風咳者, 脉浮ㆍ增寒ㆍ壯熱ㆍ自汗ㆍ惡風ㆍ口乾ㆍ煩燥ㆍ鼻流淸涕ㆍ欲語未竟而咳. 《醫鑑》
Translation영역
In a cough from wind damage the pulse is floating, with mounting chills, vigorous fever, spontaneous sweating, aversion to wind, a dry mouth, vexed agitation, clear snivel running from the nose, and coughing before the patient can finish what he wishes to say.
Uigam 醫鑑
Translation영역
For a cough from wind damage, Divine Atractylodes Powder, Coltsfoot Flower Powder, Ginseng and Schizonepeta Powderthe formula is given in the Voice chapter, Inula Powder, Three Unruly Ingredients Decoction, Five Unruly Ingredients Decoction and Modified Three Unruly Ingredients Decoction are appropriatethe formulas follow
Jebang 諸方
3.6.2 The Cold Cough 寒嗽
Source원문
寒傷肺者, 咳則胸緊聲啞. 《入門》
Translation영역
Where cold has injured the lung, the coughing brings a tight chest and a voice gone hoarse.
Immun 入門
Source원문
脉緊ㆍ增寒ㆍ發熱ㆍ無汗ㆍ惡寒ㆍ煩燥ㆍ不渴ㆍ遇寒而咳. 《醫鑑》
Translation영역
The pulse is tight, with mounting chills, fever, no sweating, aversion to cold, vexed agitation, no thirst, and coughing on meeting cold.
Uigam 醫鑑
Source원문
風寒者, 鼻塞ㆍ聲重ㆍ惡寒, 二陳湯加麻黃ㆍ杏仁ㆍ桔梗. 《醫鑑》
Translation영역
In the wind-cold kind there is a blocked nose, a heavy thick voice and aversion to cold: Two Matured Ingredients Decoction with ephedra, apricot kernel and platycodon added.
Uigam 醫鑑
Source원문
一種咳嗽, 每遇寒則發, 乃寒包熱也. 解表則熱自除. 枳梗湯卽桔梗枳殼湯加麻黃ㆍ防風ㆍ杏仁ㆍ陳皮ㆍ紫蘇葉ㆍ木通ㆍ黃芩. 《入門》
Translation영역
There is a kind of cough that breaks out whenever the patient meets cold, and this is cold wrapping heat; release the exterior and the heat is dispelled of itself. Bitter Orange and Platycodon Decoctionthat is, Gilgyeongjigak-tang with ephedra, siler, apricot kernel, tangerine peel, perilla leaf, akebia and scutellaria added.
Clinical note임상 주석
寒包熱 — cold wrapping heat — is the chapter's name for a cough that is set off by cold air while the process underneath is an inflamed one, and the treatment follows from the image: open the outside and the heat finds its way out. It is the pattern 3.17 says lies behind most wheezing, and cold-air-provoked cough in an inflamed airway is exactly what a modern clinician would call it.
Immun 入門
Source원문
脾肺皆受寒邪, 則面白ㆍ脉弦微ㆍ涎出ㆍ口甘ㆍ水反侮土, 寡於畏也. 腹中大寒ㆍ痰白作泡ㆍ口甘涎沫者, 胃中寒而不和, 以辛甘熱去之. 《東垣》
Translation영역
Where spleen and lung have both taken a cold evil, the face is white, the pulse stringlike and faint, drool comes out, the mouth tastes sweet, and water insults earth in return, having little to fear from it. Where there is great cold in the abdomen, white frothy phlegm and a sweet taste with frothy drool, the stomach is cold and out of harmony, and it is to be dispelled with acrid, sweet and hot drugs.
Dongwon 東垣
Translation영역
For the cold cough, Nine Treasures Decoction, Flowery Canopy Powder, Apricot Kernel Decoction, Perilla Drink, Tangerine Peel and Perilla Drink, Ginger and Cinnamon Pill, Ginseng and Coltsfoot Paste, Pinellia Warm the Lung Decoction, Apricot Kernel and Perilla Decoction, White Pill, Ginseng Moisten the Lung Decoction, Warm the Lung Decoction, Supplemented Regulate the Centre Decoction, Eight Ingredient Coltsfoot Flower Powder and Malt Sugar and Ginger Pill are appropriatethe formulas follow
Jebang 諸方
3.6.3 The Hot Cough 熱嗽
Source원문
傷於暑熱而得, 咳則口燥ㆍ聲嘶ㆍ吐沫. 《入門》
Translation영역
Got by damage from summerheat: the coughing brings a parched mouth, a hoarse voice and the spitting of froth.
Immun 入門
Source원문
傷暑咳者, 脉數ㆍ煩熱ㆍ引飮ㆍ口燥, 或吐涎沫ㆍ聲嘶ㆍ咯血. 《醫鑑》
Translation영역
In a cough from summerheat damage the pulse is rapid, with vexing heat, drinking, a parched mouth, and sometimes the spitting of frothy drool, hoarseness and the coughing of blood.
Uigam 醫鑑
Source원문
凡咳嗽面赤ㆍ胸腹脇常熱, 惟足乍有凉時, 其脉洪滑者, 熱痰在內也. 宜小陷胸湯方見寒門, 能治熱嗽胸滿. 《綱目》
Translation영역
In any cough with a red face and the chest, abdomen and flanks always hot, while only the feet are cool for a time, and with a surging slippery pulse, there is hot phlegm within. Minor Sinking into the Chest Decoctionthe formula is given in the Cold chapter is appropriate, and can treat the hot cough with a full chest.
Gangmok 綱目
Translation영역
For the hot cough, Cinnabar Six-to-One Powderthe formula is given in the Summerheat chapter, Wash the Lung Powder, Ginseng Drain the Lung Decoction, Fritillary Powder, Ginseng and Atractylodes Regulate the Centre Decoction, Scutellaria and Pinellia Pill, Minor Yellow Pill, Coptis Transform Phlegm Pill and Four Juices Paste are appropriatethe formulas follow
Jebang 諸方
3.6.4 The Damp Cough 濕嗽
Source원문
濕勝肺者, 咳則身重ㆍ骨節煩疼ㆍ洒淅. 《入門》
Translation영역
Where damp has overcome the lung, the coughing brings heaviness of the body, vexing pain in the bones and joints, and shivering.
Immun 入門
Source원문
濕傷咳者, 脉細ㆍ骨節煩疼ㆍ四肢重着, 或有汗ㆍ小便不利. 《醫鑑》
Translation영역
In a cough from damp damage the pulse is fine, with vexing pain in the bones and joints, the four limbs heavy and encumbered, and sometimes sweating and inhibited urination.
Uigam 醫鑑
Translation영역
For the damp cough, Unchangeable Gold Correct Qi Powderthe formula is given in the Cold chapter, White Atractylodes Decoction and White Atractylodes Pill are appropriate.
Donguibogam · Haesu
3.6.5 The Depression Cough 鬱嗽
Translation영역
That is, the fire cough. In a severe case it is a dry cough with no phlegm, the kidney water being scorched dry and the evil fire blazing alone in the lung. Drain the White Powderthe formula is given in the Five Viscera chapter, Clear Transformation Pill, Chebule Pill and Rosy Cloud Pastethe formula is given in the Vomiting chapter are appropriate
Donguibogam · Haesu
Source원문
火鬱者, 有聲ㆍ痰少ㆍ面赤者是也. 宜用淸金降火湯.
Translation영역
In fire depression there is sound, little phlegm and a red face; that is it. Clear the Metal and Bring Down Fire Decoction should be used.
Clinical note임상 주석
有聲痰少 — a sound with little phlegm — is the mark of the dry inflamed cough, and the chapter uses the same three words at 3.6.14 to define the fire cough. 鬱嗽 and 火嗽 are treated as the same thing here and separated fifteen sections later, which is the sort of duplication the sixteen-fold scheme produces.
Donguibogam · Haesu
3.6.6 The Taxation Cough 勞嗽
Source원문
虛勞咳嗽也.
Translation영역
It is the cough of vacuity taxation.
Donguibogam · Haesu
Source원문
勞嗽者, 盜汗出, 兼痰多, 作寒熱. 宜補陰淸金, 四物湯加竹瀝ㆍ薑汁.
Translation영역
In the taxation cough night sweats come out, with much phlegm besides, and chills and fever. The yin should be supplemented and the metal cleared: Four Substances Decoction with bamboo sap and ginger juice added.
Clinical note임상 주석
盜汗 with phlegm and alternating fever: tuberculosis, and the chapter's whole 勞嗽 section is about it. **Chronic cough with night sweats, fever and weight loss requires investigation for tuberculosis; it is curable with modern treatment and was not with this.**
Uigam 醫鑑
Translation영역
For a cough from stirring fire on a vacuous yin, Four Substances combined with Two Matured Ingredients, with phellodendron and anemarrhena added.
Uigam 醫鑑
Source원문
陰虛喘嗽, 或吐血, 四物加黃栢ㆍ知母ㆍ五味子ㆍ麥門冬ㆍ桑白皮ㆍ地骨皮. 《醫鑑》
Translation영역
For panting cough on a vacuous yin, or with the spitting of blood, Four Substances with phellodendron, anemarrhena, schisandra, ophiopogon, mulberry root bark and lycium bark added.
Uigam 醫鑑
Source원문
好色之人, 元氣虛弱, 咳嗽不愈, 宜瓊玉膏方見身形, 治虛勞乾咳嗽最捷. 《丹心》
Translation영역
In a man given to women, whose original qi is vacuous and weak and whose cough will not heal, Jade Spring Pastethe formula is given in the Bodily Form chapter is appropriate, and it is quickest of all for the dry cough of vacuity taxation.
Dansim 丹心
Translation영역
For the taxation cough, Ginseng Clear the Lung Decoction, Supplemented Two Mothers Pill, Ginseng, Chuanxiong and Angelica Decoction, Supplemented Ginseng and Aster Powder, Moisten the Lung Pill, Supplement the Lung Decoction, Warm Metal Powder, Major Quiet the Cough Decoction, Anemarrhena Decoction, Quiet the Cough Paste and Major Ass-Hide Glue Pill are appropriatethe formulas follow
Jebang 諸方
Source원문
酒色過度, 虛勞少血, 津液內耗, 心火自炎, 遂使燥熱乘肺, 咯唾膿血ㆍ上氣涎潮, 其嗽連續而不已, 須用六味地黃丸方見虛勞加橘紅ㆍ貝母ㆍ黃栢ㆍ知母. 《入門》
Translation영역
Where wine and women have been taken to excess, with vacuity taxation and scant blood, the fluids consumed within and the heart fire blazing of itself, so that dry heat overrides the lung, with the coughing and spitting of pus and blood, qi rising and drool welling up, and the cough running on without a break, Six Ingredient Rehmannia Pillthe formula is given in the Taxation chapter with red tangerine peel, fritillary, phellodendron and anemarrhena added must be used.
Immun 入門
3.6.7 The Food-Accumulation Cough 食積嗽
Source원문
因食積生痰, 咳嗽ㆍ胸滿ㆍ噫酸, 宜二陳湯加厚朴ㆍ山査子ㆍ麥芽. 《入門》
Translation영역
Phlegm engendered by food accumulation, with cough, a full chest and sour belching: Two Matured Ingredients Decoction with magnolia bark, crataegus and malt added is appropriate.
Clinical note임상 주석
胸滿噫酸 — a full chest with sour belching — is reflux, and the cough that goes with it is the one 3.5 placed at dawn. The three drugs added are all digestive, which is to say the chapter treats the cough by treating the stomach; that is still the approach to a cough caused by reflux.
Immun 入門
Source원문
食積嗽, 非靑黛ㆍ瓜蔞實不除. 又云, 有食積人, 面靑白黃色不常, 面上如蟹瓜路, 一黃一白者是也.
Translation영역
The food-accumulation cough is not to be removed without indigo and trichosanthes fruit. It is said again: a person with food accumulation has a face of no settled colour, blue-green, white or yellow, and on the face something like the tracks of a crab's claw, now yellow and now white; that is it.
Dansim 丹心
Source원문
食積痰嗽發熱者, 半夏ㆍ南星並製爲君, 瓜蔞實ㆍ蘿葍子爲臣, 靑黛ㆍ石磏爲使, 薑汁糊爲丸服. 《丹心》
Translation영역
Where a food-accumulation phlegm cough has fever, processed pinellia and arisaema are made the sovereigns, trichosanthes fruit and radish seed the ministers, indigo and talc the envoys, and they are made into pills with ginger juice paste and taken.
Dansim 丹心
Source원문
一方, 三補丸芩ㆍ連ㆍ栢也加二母炒知母ㆍ貝母爲末, 水丸椒核大, 以竹瀝ㆍ藕汁呑之. 《丹心》
Translation영역
One formula: Three Supplements Pillthat is, scutellaria, coptis and phellodendron with the two mothers dry-fried and addedanemarrhena and fritillary, powdered and made into water pills the size of a peppercorn, swallowed down with bamboo sap and lotus root juice.
Dansim 丹心
Translation영역
For the food-accumulation cough, Trichosanthes Pill, Green Metal Pill, Two Mothers Quiet the Cough Decoction, Warm the Spleen Decoction and Cyperus Pill are appropriatethe formulas follow
Jebang 諸方
3.6.8 The Qi Cough 氣嗽
Source원문
七氣積傷成咳嗽, 痰涎凝結, 或如敗絮ㆍ或如梅核, 滯塞咽喉, 咯不出ㆍ嚥不下, 婦人多有之. 《入門》
Translation영역
The seven affects accumulating and doing injury make a cough, with the phlegm and drool congealed and knotted, like rotten wadding or like a plum stone, stuck in the throat so that it cannot be coughed out or swallowed down; women have it most.
Clinical note임상 주석
如梅核, like a plum stone: this is 梅核氣, the globus sensation, which the 咽喉 chapter treats at length and which 嘔吐 2.7 describes in the same words. Grouping it among the coughs is reasonable — the sensation provokes constant throat clearing, which is what the patient reports as a cough.
Immun 入門
Translation영역
For the qi cough, Perilla Seed Bring Down the Qi Decoctionthe formula is given in the Qi chapter, Supplemented Four Sevens Decoctionthe formula is given in the Spirit chapter, Ginseng Ball Drink, Blue Dragon Powder, Three Seeds Nourish the Parent Decoction, Perilla Seed Decoct, Jade Powder Pill, Asterisk and Aromatic Pill and Tangerine Peel and Ginger Pill are appropriatethe formulas follow
Jebang 諸方
3.6.9 The Phlegm Cough 痰嗽
Source원문
痰嗽者, 痰出嗽止, 胸膈多滿. 盖濕痰在胃, 上干於肺, 則必作咳嗽. 《入門》
Translation영역
In the phlegm cough, when the phlegm comes out the coughing stops, and the chest and diaphragm are often full. For when damp phlegm is in the stomach and rises to offend the lung, there must be a cough.
Immun 入門
Source원문
痰嗽者, 嗽動便有痰聲, 痰出則嗽止也. 《丹心》
Translation영역
In the phlegm cough, as soon as the coughing stirs there is a sound of phlegm, and when the phlegm is out the coughing stops.
Clinical note임상 주석
痰出則嗽止 — when the phlegm is out the coughing stops — is the defining sign, and it separates a productive cough from the dry one of 3.6.10, where ten or twenty coughs bring nothing up. The distinction decides the treatment: the productive cough is helped along and the dry one moistened.
Dansim 丹心
Translation영역
Where phlegm is depressed in the lung channel and the coughing brings much drool, Two Matured Ingredients Decoction with bitter orange peel, platycodon, trichosanthes seed, scutellaria and fritillary added; Half a Melon Pill is also used.
Jeongjeon 正傳
Source원문
寒熱交作而痰嗽者, 小柴胡湯方見寒門加知母ㆍ白芍藥ㆍ五味子ㆍ桑白皮. 《正傳》
Translation영역
For a phlegm cough with chills and fever alternating, Minor Bupleurum Decoctionthe formula is given in the Cold chapter with anemarrhena, white peony, schisandra and mulberry root bark added.
Jeongjeon 正傳
Source원문
痰盛有熱, 宜滾痰丸方見痰門
Translation영역
Where the phlegm is abundant and there is heat, Rolling Phlegm Pillthe formula is given in the Phlegm chapter is appropriate
Jeongjeon 正傳
Translation영역
For the phlegm cough, Wash the Lung Powder, Tangerine Peel and Licorice Powder, Dripped Oil Powder, Two Mothers Powder, Jade Mushroom Pill, Clarifying Drink, Three Sages Elixir, Indigo Lacquer Decoct, Settle the Lung Powder and Ginseng Powder are appropriate.
Donguibogam · Haesu
3.6.10 The Dry Cough 乾嗽
Source원문
乾咳嗽者, 無痰有聲是也. 此證本於氣澁. 澁微者, 連咳十數聲方有痰出; 澁甚者, 雖咳十數聲亦無痰出, 是爲乾咳嗽也. 《綱目》
Translation영역
The dry cough is a sound with no phlegm. This pattern is rooted in the qi being rough. Where the roughness is slight, ten or a dozen coughs together bring a little phlegm out at last; where it is severe, ten or a dozen coughs bring none out at all, and that is the dry cough.
Gangmok 綱目
Source원문
乾咳者, 肺中無津液也. 《入門》
Translation영역
In the dry cough there is no fluid in the lung.
Immun 入門
Source원문
乾咳嗽極難治. 此係火鬱之證, 乃痰鬱火邪在肺中, 用苦桔梗以開之, 下用補陰降火之劑. 不已則成勞, 須行倒倉法. 此不得志者有之. 用四物湯加竹瀝ㆍ炒黃栢之類. 《丹心》
Translation영역
The dry cough is extremely hard to treat. It belongs to the pattern of fire depression, phlegm having depressed a fire evil in the lung; bitter platycodon is used to open it, and below that a preparation to supplement the yin and bring the fire down. If it does not end it becomes taxation, and the method of emptying the granary must be used. This is found in those who have not got what they wished for. Four Substances Decoction with bamboo sap and dry-fried phellodendron and the like.
Clinical note임상 주석
此不得志者有之 — this is found in those who have not got what they wished for — is the chapter's one piece of psychological aetiology for the dry cough, and it is Dansim's own observation rather than a quotation. 倒倉法, emptying the granary, is the radical cleansing regimen of the 內傷 chapter.
Dansim 丹心
Source원문
燥痰不出者, 用蜜水吐之. 蜜煎生薑湯ㆍ蜜煎陳皮湯ㆍ燒生薑胡桃方, 皆治無痰而嗽者, 以辛甘潤其肺也. 《易老》
Translation영역
Where dry phlegm will not come out, make the patient vomit with honey water. Honey decocted with ginger, honey decocted with tangerine peel, and the method of roasted ginger with walnut all treat a cough with no phlegm, by moistening the lung with the acrid and the sweet.
Yi Lao 易老
Source원문
治乾嗽補肺. 生地黃 二斤(洗净)ㆍ杏仁 二兩ㆍ生薑ㆍ蜂蜜 各四兩. 右擣如泥, 盛磁器, 置飯上蒸五七度, 每於五更挑三匙嚥下. 《本事》
Translation영역
To treat the dry cough and supplement the lung: raw rehmannia, 2 geun, washed clean; apricot kernel, 2 nyang; fresh ginger and honey, 4 nyang each. Pound them to a paste, put it in a porcelain vessel, steam it over rice five or seven times, and every day at the fifth watch take three spoonfuls and swallow them.
Bonsa 本事
Source원문
又方, 白蜜 一斤ㆍ生薑 二斤(取汁). 先秤銅器知斤兩訖, 內蜜復秤知數, 次內薑汁, 以微火煮, 令薑汁盡, 惟蜜斤兩在則止. 每服如棗子大, 含化, 日三. 《千金》
Translation영역
Another method: white honey, 1 geun, and fresh ginger, 2 geun, for its juice. Weigh a copper vessel first and note its weight; put the honey in and weigh again to know the amount; then put in the ginger juice and boil over a low fire until the ginger juice is all gone and only the weight of the honey remains, and then stop. Give a jujube-sized portion each time, held in the mouth to dissolve, three times a day.
Clinical note임상 주석
The instruction to weigh the vessel first, then the honey, then boil until the weight is the honey's again, is the closest thing to a controlled procedure in the chapter: it is how one knows the ginger juice has gone and the preparation is finished. Honey and ginger held in the mouth to dissolve, three times a day, is a cough linctus.
Cheongeum 千金
Translation영역
For the dry cough, Jade Spring Pastethe formula is given in the Bodily Form chapter, Moisten the Lung Powder, Supplemented Two Mothers Pill, Chebule Pill and Restrain Phlegm Pillthe formula is given in the Phlegm chapter should be used
Donguibogam · Haesu
3.6.11 The Blood Cough 血嗽
Source원문
瘀血咳嗽者, 喉間有腥氣, 或吐唾血. 瘀因打撲傷損而致, 四物湯加大黃ㆍ蘇木爲末, 酒調服, 或水煎服. 《入門》
Translation영역
In a cough of static blood there is a rank smell in the throat, or the spitting of blood. The stasis comes of a blow or an injury: Four Substances Decoction with rhubarb and sappanwood added, powdered and given stirred into wine, or decocted in water.
Clinical note임상 주석
喉間有腥氣 — a rank smell in the throat — in a patient who has had a blow to the chest. **Haemoptysis after chest trauma requires imaging and assessment, not a decoction**; what the passage describes could be a pulmonary contusion or a haemothorax.
Immun 入門
Source원문
生桃仁 七粒, 以韭汁送下, 最佳. 《丹心》
Translation영역
Seven raw peach kernels, sent down with Chinese chive juice, are best of all.
Dansim 丹心
Translation영역
For the blood cough, Ginseng and Lily Decoction, Mulberry Bark Powder and Chinese Angelica Drink should be takenthe formulas follow
Jebang 諸方
3.6.12 The Wine Cough 酒嗽
Source원문
酒性大熱, 因傷引飮冷, 與熱凝於胃中不散而成濕, 故痰作咳嗽. 《保命》
Translation영역
Wine is of a greatly hot nature; where it has done injury and cold drink is taken, the cold congeals with the heat in the stomach and does not disperse, and becomes damp — and so phlegm makes a cough.
Bomyeongjip 保命
Source원문
飮酒多咳嗽, 靑黛ㆍ瓜蔞仁, 右爲末, 薑汁ㆍ煉蜜和丸櫻桃大, 常常含化, 散肺毒. 《丹心》
Translation영역
For a cough from much wine drinking: indigo and trichosanthes seed, powdered and made into pills the size of a cherry with ginger juice and refined honey, held in the mouth to dissolve again and again, to disperse the lung's toxin.
Dansim 丹心
Translation영역
Where wine has injured the lung and made a phlegm cough, decoct perilla in bamboo sap, add Chinese chive juice, and with it swallow Trichosanthes, Apricot Kernel and Coptis Pill. Bee and Ginger Pill is also appropriate.
Immun 入門
3.6.13 The Long-Standing Cough 久嗽
Source원문
乃積痰久留肺脘, 粘滯如膠, 氣不升降, 或挾濕與酒而作. 《丹心》
Translation영역
It is accumulated phlegm long lodged in the lung's duct, sticky and clinging like glue, so that the qi neither rises nor falls; or it comes of damp and wine together.
Dansim 丹心
Translation영역
For the long-standing cough, Bee and Ginger Pill, Supplemented Two Mothers Pill, Ginseng Clear the Lung Decoction, Fritillary Decoction, Nine Immortals Powder, Ginseng and Coltsfoot Powder, Heavenly Mouse Powder, Clear the Lung Decoction, Birthwort Pill, Supplemented Hundred Flowers Paste and Moisten the Lung and Dispel the Cough Drink are appropriatethe formulas follow
Clinical note임상 주석
**Birthwort Pill contains aristolochia and must not be used; Nine Immortals Powder and Ginseng and Coltsfoot Powder contain opium poppy husk, a controlled substance; Heavenly Mouse Powder is made from a bat.** Each entry carries its own warning. The chapter's list for the long cough is the one most heavily loaded with such materials, which is itself a measure of how little else could be done.
Jebang 諸方
3.6.14 The Fire Cough 火嗽
Source원문
火嗽有聲ㆍ痰少ㆍ面赤者是, 或煩渴引飮ㆍ脉洪數. 《丹心》
Translation영역
The fire cough is a sound with little phlegm and a red face; that is it, or with vexing thirst and drinking and a surging rapid pulse.
Dansim 丹心
Translation영역
For the fire cough, Fritillary Powder, Clear the Lung Drink, Bupleurum, Bitter Orange and Platycodon Decoction, Clear the Metal and Bring Down Fire Decoction, Two Mothers Quiet the Cough Decoction, Restrain the Heart and Clear the Lung Pill, Black Frost and Snow Pear Paste, Ginseng Clear and Settle Pill, Nourish the Yin and Clear Transformation Paste and Sea Green Pill are appropriatethe formulas follow
Jebang 諸方
3.6.15 The Night Cough 夜嗽
Source원문
夜間咳嗽屬陰虛, 宜降陰分火. 《入門》
Translation영역
A cough at night belongs to yin vacuity, and the fire in the yin aspect should be brought down.
Immun 入門
Source원문
陰分嗽者多屬陰虛, 治之用知母止嗽, 勿用生薑, 以其辛散故也. 《丹心》
Translation영역
A cough in the yin hours mostly belongs to yin vacuity; treat it with anemarrhena to stop the cough, and do not use fresh ginger, since it is acrid and disperses.
Clinical note임상 주석
The chapter's own chief drug withheld, and for a stated reason: ginger is acrid and dispersing, and a cough that comes of dryness is made worse by it. 3.26 turns the same judgment into a formal prohibition.
Dansim 丹心
Translation영역
Any night cough or long-standing cough mostly belongs to the kidney qi being depleted, the fire blazing and the water dried up, or to the fluids welling up and becoming phlegm; Six Ingredient Rehmannia Pillthe formula is given in the Taxation chapter with phellodendron, anemarrhena, asparagus, fritillary and red tangerine peel added must be used, to enrich the source of transformation. Nourish the Yin and Bring Down Fire Decoctionthe formula is given in the Fire chapter is also good.
Hoechun 回春
Translation영역
For the night cough, Nourish the Yin and Clear Transformation Paste and Ephedra and Atractylodes Decoction should be usedthe formulas follow
Jebang 諸方
3.6.16 The Epidemic Cough 天行嗽
Translation영역
Where the season's weather is out of course, many people take cold and cough; Ginseng Drink and One Dose Powder are appropriate.
Clinical note임상 주석
天行, going through heaven, is the Bogam's word for an epidemic, and a cough that goes through a whole district at once is given its own category here rather than being assigned to any of the fifteen causes. It is the same reasoning as 辨證 3.49's — illnesses that look alike across a population point to a shared external cause — and it is the chapter's nearest approach to an infectious aetiology.
Deukhyo 得效
Source원문
四時感冒咳嗽, 宜服參蘇飮方見寒門○回春
Translation영역
For a cough from taking cold in any of the four seasons, Ginseng and Perilla Drink should be takenthe formula is given in the Cold chapter ○ Hoechun
Hoechun 回春
3.7 Medicines That Treat Cough Generally 通治咳嗽藥
Source원문
咳而無痰者, 以辛甘潤其肺. 故咳嗽治痰爲先, 治痰者下氣爲上. 是以南星ㆍ半夏勝其痰而咳嗽自愈, 枳殼ㆍ橘紅利其氣而痰飮自下. 痰而能食者, 小承氣湯方見寒門微利之; 痰而不能食者, 厚朴湯方未詳踈導之. 夏月嗽而發熱者, 謂之熱嗽, 小柴胡湯 四兩入石膏 一兩ㆍ知母 五錢; 冬時嗽而發寒者, 謂之寒嗽, 小靑龍湯加杏仁. 此治法之大體也. 《易老》
Translation영역
In a cough with no phlegm, moisten the lung with the acrid and the sweet. So in cough the first thing is to treat the phlegm, and in treating phlegm the best way is to bring the qi down. Hence arisaema and pinellia overcome the phlegm and the cough heals of itself, and bitter orange peel and red tangerine peel disinhibit the qi and the phlegm fluid goes down of itself. Where there is phlegm and the patient can eat, disinhibit gently with Minor Qi-Coordinating Decoctionthe formula is given in the Cold chapter; where there is phlegm and he cannot eat, lead it out with Magnolia Bark Decoctionthe formula is not given. A cough in the summer months with fever is called the hot cough: four nyang of Minor Bupleurum Decoction with one nyang of gypsum and five don of anemarrhena. A cough in winter with chills is called the cold cough: Minor Blue Dragon Decoction with apricot kernel added. This is the broad frame of the method of treatment.
Yi Lao 易老
Source원문
咳之爲病有二. 咳卽出痰者, 脾濕勝而痰滑也; 有連咳十數不能出痰者, 肺燥勝痰濕也. 滑者宜南星ㆍ半夏ㆍ皂角灰之屬燥其脾, 澁者宜枳殼ㆍ紫蘇ㆍ杏仁之屬利其肺. 《丹心》
Translation영역
Cough as an illness is of two kinds. Where the phlegm comes out as soon as one coughs, the spleen's damp prevails and the phlegm is slippery; where ten or a dozen coughs together cannot bring the phlegm out, the lung's dryness prevails over the phlegm's damp. For the slippery kind, drugs such as arisaema, pinellia and soapberry ash dry the spleen; for the rough kind, drugs such as bitter orange peel, perilla and apricot kernel disinhibit the lung.
Clinical note임상 주석
The chapter reduced to two kinds and two methods, which is as practical as it gets: productive cough is dried, dry cough is loosened. Everything in the sixteen-fold scheme of 3.6 can be sorted into one or the other, and this is the passage a working physician would keep.
Dansim 丹心
Source원문
外感久則鬱熱, 內傷久則火炎, 俱宜開鬱潤燥. 《入門》
Translation영역
An external contraction, if long, brings depressed heat; an inward damage, if long, brings blazing fire; and both should have the depression opened and the dryness moistened.
Immun 入門
Source원문
嗽而脇下痛, 宜以靑皮踈肝氣, 兼用白芥子之類. 後以二陳湯加南星ㆍ香附ㆍ靑皮ㆍ靑黛, 薑汁糊爲丸服. 《丹心》
Translation영역
For a cough with pain below the flanks, unripe tangerine peel should be used to free the liver qi, with such drugs as white mustard seed besides; and afterwards Two Matured Ingredients Decoction with arisaema, cyperus, unripe tangerine peel and indigo added, made into pills with ginger juice paste and taken.
Dansim 丹心
Source원문
二陳湯治咳嗽ㆍ去痰ㆍ伐病根之藥. 除陰虛ㆍ血虛ㆍ火盛乾咳嗽者勿用. 《丹心》
Translation영역
Two Matured Ingredients Decoction is the medicine that treats cough, removes phlegm and cuts at the root of the illness. Only it is not to be used in a dry cough from yin vacuity, blood vacuity or abundant fire.
Dansim 丹心
Translation영역
For cough in general, Clear the Metal Drink and Five Coughs Pill are usedthe formulas follow
Jebang 諸方
3.8 The Pattern of Panting Has Eight Kinds 喘證有八
Source원문
喘急者, 氣因火鬱而成稠痰在肺胃也. 《丹心》
Translation영역
In urgent panting the qi has been depressed by fire and has become thick phlegm in the lung and stomach.
Dansim 丹心
Source원문
喘者, 火氣甚則氣盛而息麄也. 《河間》
Translation영역
In panting, when the fire qi is severe the qi is abundant and the breath coarse.
Hagan 河間
Source원문
呼吸急促者謂之喘, 喉中有聲響者謂之哮. 虛者氣乏ㆍ身冷ㆍ痰如氷; 實者氣壯ㆍ胸滿ㆍ身熱ㆍ便硬. 《入門》
Translation영역
Breathing hurried and pressed is called panting; a sound in the throat is called wheezing. In the vacuous kind the qi is spent, the body cold and the phlegm like ice; in the replete kind the qi is strong, the chest full, the body hot and the stool hard.
Clinical note임상 주석
The distinction between 喘 and 哮 is made by what the examiner hears: rate for panting, a sound in the throat for wheezing. That is the distinction between dyspnoea and wheeze, and the chapter keeps them apart through the whole of 3.8 and 3.17.
Immun 入門
Source원문
喘者, 肺主氣, 形寒飮冷則傷肺, 故其氣逆而上行, 衝衝而氣急ㆍ喝喝而息數ㆍ張口擡肩ㆍ搖身滾肚者, 是爲喘也. 《明理》
Translation영역
As for panting: the lung governs the qi, and a chilled body and cold drink injure the lung, so that its qi runs counter and travels upward — surging up with the breath urgent, rasping with the breaths counted fast, the mouth open, the shoulders lifted, the body rocking and the belly rolling — and that is panting.
Clinical note임상 주석
張口擡肩ㆍ搖身滾肚 — mouth open, shoulders lifted, body rocking, belly rolling — is the best description of severe respiratory distress in the Bogam, and every item in it is what a modern examiner records as accessory-muscle use and paradoxical breathing. 3.27 repeats the phrase among the signs that cannot be treated.
Myeongni 明理
Source원문
有起居如故而息有音者, 乃肺之絡脉逆而不得隨經上下故也. 《入門》
Translation영역
Where the patient goes about as usual and yet the breath has a sound in it, the lung's network vessels are running counter and cannot follow the channels up and down.
Immun 入門
Source원문
火氣甚爲夏熱, 衰爲冬寒. 故病寒則氣衰而息微, 病熱則氣盛而息麄. 又寒水爲陰, 主乎遲緩; 熱火爲陽, 主乎急數. 是以寒則息遲氣微, 熱則息數氣盛而爲喘也. 《河間》
Translation영역
When the fire qi is severe it is summer's heat, and when it wanes it is winter's cold. So in an illness of cold the qi wanes and the breath is faint; in an illness of heat the qi is abundant and the breath coarse. Again, cold water is yin and governs the slow and moderate; hot fire is yang and governs the urgent and rapid. Hence in cold the breath is slow and the qi faint, and in heat the breath is counted fast and the qi abundant, and that is panting.
Hagan 河間
Source원문
喘非風寒傷肺, 則痰火脹肺. 風寒則祛散, 痰火則踈導. 但火急者亦不可純用苦寒, 宜溫以劫之. 劫藥見下. 《入門》
Translation영역
Panting is either wind cold injuring the lung or phlegm fire distending it. For wind cold, drive it off and disperse it; for phlegm fire, lead it out. But where the fire is urgent, bitter cold drugs must not be used alone either, and it should be seized with warmth. The seizing medicines are given below.
Immun 入門
Source원문
凡喘未發, 以扶正氣爲主; 已發, 以散邪爲主. 《丹心》
Translation영역
In any panting, before it breaks out the chief thing is to support the true qi; once it has broken out, the chief thing is to disperse the evil.
Clinical note임상 주석
未發 … 已發 — before it breaks out and after — is the chapter's framework for asthma, and it is the modern one: between attacks you build the patient up, during an attack you relieve the obstruction. The reliever and the preventer are the same two halves, and 3.15's 劫藥 are the relievers.
Dansim 丹心
Source원문
喘有風寒喘ㆍ痰喘ㆍ氣喘ㆍ火喘ㆍ水喘ㆍ久喘ㆍ胃虛喘ㆍ陰虛喘ㆍ諸病發喘嗽ㆍ通治喘嗽藥《諸方》
Translation영역
Panting has the wind-cold panting, the phlegm panting, the qi panting, the fire panting, the water panting, the long-standing panting, the stomach-vacuity panting and the yin-vacuity panting; and then panting and cough breaking out in various illnesses, and the medicines that treat panting and cough generallythe formulas follow
Jebang 諸方
3.8.1 The Wind-Cold Panting 風寒喘
Translation영역
An ordinary cold taken from wind and cold, depressed within so that the lung is distended, runs counter and becomes panting. For the wind kind, Inula Powderthe formula is given above, Ephedra Powder, Ginseng Moisten the Lung Powder and Nine Treasures Decoctionthe formula is given above are appropriate
Donguibogam · Haesu
Translation영역
For the cold kind, Supplemented Three Unruly Ingredients Decoction, Ginseng Arrest Panting Decoction, Minor Blue Dragon Decoctionthe formula is given in the Cold chapter, Ginseng, Perilla and Warm the Lung Decoction, Schisandra Decoction, Nine Ingredient Regulate the Centre Decoction, Five Tigers Decoction and Stop Panting Pill are appropriatethe formulas follow
Jebang 諸方
Source원문
冷喘則遇寒而發. 《醫鑑》
Translation영역
The cold panting breaks out on meeting cold.
Uigam 醫鑑
Source원문
肺寒ㆍ肺虛, 必有氣乏ㆍ表怯ㆍ冷痰如氷之證. 《醫鑑》
Translation영역
In a cold lung and a vacuous lung there must be the signs of spent qi, a timid surface, and cold phlegm like ice.
Uigam 醫鑑
3.8.2 The Phlegm Panting 痰喘
Source원문
痰喘者, 凡喘便有痰聲. 《入門》
Translation영역
In the phlegm panting, whenever the patient pants there is a sound of phlegm.
Immun 入門
Source원문
肺實ㆍ肺熱, 必有壅盛ㆍ胸滿ㆍ外閧上炎之狀. 《醫鑑》
Translation영역
In a replete lung and a hot lung there must be the look of blockage and fullness, a full chest, and a clamour without and blazing above.
Uigam 醫鑑
Translation영역
For the phlegm panting, Thousand Strings Decoction, Thousand Strings Lead Out Phlegm Decoction, Modified Three Wonders Decoction, Fritillary Powder, Level the Lung Powder, Perilla and Pinellia Decoction, Arrest Panting and Transform Phlegm Decoction, Moisten the Lung Paste, Perilla Seed Lead Out Phlegm and Bring Down Qi Decoction, Major Radish and Soapberry Pill and Dispel Phlegm Pill are appropriatethe formulas follow
Jebang 諸方
Source원문
凡喘正發時無痰, 而將愈時却吐痰者, 乃痰在正發之時閉塞不通而喘. 當其時開其痰路則易安, 宜桔梗ㆍ瓜蔞仁ㆍ枳殼ㆍ杏仁ㆍ蘇葉ㆍ前胡等引出其痰. 然後調其虛實, 實者用沉香滾痰丸方見痰門, 虛者補以參ㆍ芪ㆍ歸ㆍ朮. 《綱目》
Translation영역
In any panting where there is no phlegm at the height of the attack and the patient brings phlegm up as he is recovering, it is that the phlegm was shut in and not passing at the height of it, and that was the panting. Open the road for the phlegm at that moment and he is easily settled: platycodon, trichosanthes seed, bitter orange peel, apricot kernel, perilla leaf and peucedanum and the like draw the phlegm out. Afterwards regulate his vacuity or repletion — for the replete, Aquilaria Rolling Phlegm Pillthe formula is given in the Phlegm chapter; for the vacuous, supplement with ginseng, astragalus, angelica and atractylodes.
Clinical note임상 주석
The observation is acute and the inference from it is right: no phlegm during the attack, phlegm as it eases, means the phlegm was trapped — 閉塞不通而喘 — and that the obstruction was the panting. Mucus plugging in an asthma attack, with expectoration as the airways open, is exactly the sequence, and the treatment the chapter draws from it is to open the airway rather than to suppress the cough.
Gangmok 綱目
3.8.3 The Qi Panting 氣喘
Source원문
七情所傷, 氣急而無聲響.
Translation영역
Injury by the seven affects: the breath is urgent and there is no sound.
Immun 入門
Source원문
驚憂氣鬱, 惕惕悶悶, 引息鼻張, 呼吸急促而無痰聲者是也. 《入門》
Translation영역
Fright and anxiety with the qi depressed, the patient startled and oppressed, drawing the breath with the nostrils flaring, the breathing hurried and pressed and with no sound of phlegm: that is it.
Clinical note임상 주석
Breathlessness with flaring nostrils and a hurried rate but no wheeze and no phlegm, in a frightened and oppressed patient. That is what a modern clinic calls a panic or hyperventilation attack, and the chapter puts it among the pantings with its own treatment, the qi-moving formulas rather than the lung ones.
Immun 入門
Source원문
喘者, 上氣急促, 不能以息之謂也. 《醫鑑》
Translation영역
Panting means the qi rising urgent and pressed, so that the patient cannot breathe with it.
Uigam 醫鑑
Source원문
氣虛ㆍ氣短而喘, 不可用苦寒之藥, 火盛故也. 宜用人參ㆍ蜜灸黃栢ㆍ麥門冬ㆍ地骨皮之類. 《丹心》
Translation영역
Where the qi is vacuous and the breath short with panting, bitter cold drugs must not be used, because the fire is abundant. Such drugs as ginseng, honey-roasted phellodendron, ophiopogon and lycium bark should be used.
Dansim 丹心
Source원문
氣實人因服黃芪過多而喘, 用三拗湯方見上以瀉其氣. 《丹心》
Translation영역
Where a person of replete qi pants from having taken too much astragalus, Three Unruly Ingredients Decoctionthe formula is given above is used to drain the qi.
Clinical note임상 주석
A drug reaction recorded as such: breathlessness caused by too much astragalus, treated by draining what the astragalus added. The Bogam notices iatrogenic illness in several places — 嘔吐 2.2's over-sweated patient is another — and records the remedy without embarrassment.
Dansim 丹心
Translation영역
For the qi panting, Supplemented Four Sevens Decoctionthe formula is given in the Spirit chapter, Four Ground Ingredients Decoction, Six Ground Ingredients Decoction, Clear the Metal Decoction, Perilla Seed Bring Down the Qi Decoctionthe formula is given in the Qi chapter, Supplemented White Atractylodes Powder, Settle the Lung Decoction, Apricot Kernel and Pinellia Decoction, Apricot Kernel and Perilla Drink, Regulate and Bring Down Decoction, Supplemented Four Gentlemen Decoction and Aquilaria Bring Down the Qi Decoctionthe formula is given in the Qi chapter are appropriate
Donguibogam · Haesu
3.8.4 The Fire Panting 火喘
Source원문
手太陰之脉, 是動則肺脹滿ㆍ膨膨而喘咳. 所生病者, 咳嗽上氣ㆍ喘喝ㆍ煩心ㆍ胸滿. 《靈樞》
Translation영역
The hand greater yin vessel: when it is stirred the lung is distended and full, swollen out with panting and cough. The illnesses it engenders are cough with qi rising, panting and rasping, vexation of the heart, and a full chest.
Yeongchu 靈樞
Source원문
是皆衝脉之火行于胸中而作也.
Translation영역
All these come of the thoroughfare vessel's fire travelling in the chest.
Dongwon 東垣
Source원문
平居則氣平和, 行動則氣促而喘者, 是衝脉之火上攻也. 有老人素有喘, 或吐唾血痰, 平居則不喘, 稍行動則氣促喘急, 以滋腎丸方見小便空心服七八十丸, 其證大減. 此泄衝脉之火邪, 故如此其效也. 《東垣》
Translation영역
Where the qi is level and harmonious while the patient sits still and the breath is hurried into panting when he moves, this is the thoroughfare vessel's fire attacking upward. There was an old man who had long had panting and sometimes spat blood and phlegm; sitting still he did not pant, and at the least movement his breath was hurried and the panting urgent. Seventy or eighty pills of Enrich the Kidney Pillthe formula is given in the Urine chapter on an empty stomach greatly lessened the pattern. This drains the thoroughfare vessel's fire evil, and that is why it worked so.
Clinical note임상 주석
平居則氣平和, 行動則氣促 — comfortable at rest, breathless on moving — is exertional dyspnoea, described exactly and distinguished from breathlessness at rest. It is the cardinal symptom of chronic lung and heart disease, and the case given, an old man who is well sitting and breathless at the least movement, with blood in the sputum, is one a modern clinic would investigate for chronic obstructive disease, heart failure or cancer.
Dongwon 東�h
Source원문
火炎於肺胃而喘者, 乍進乍退, 得食則減, 食已則喘. 大槩胃中有實火ㆍ膈上有稠痰, 食入於咽, 墜下稠痰, 喘卽暫止; 稍久食已入胃, 反助其火, 痰再升上, 喘反大作. 俗不知此, 作胃虛治以燥熱之藥, 以火濟火也. 昔葉都督患此, 諸藥不愈, 後以導水丸方見下門利五六次而安. 《丹心》
Translation영역
Where fire blazes in the lung and stomach and there is panting, it comes and goes by turns, eases when food is taken, and pants once the eating is done. In general there is replete fire in the stomach and thick phlegm above the diaphragm; when the food goes into the throat it carries the thick phlegm down and the panting stops for the moment, and a little later, the food having entered the stomach, it aids the fire instead, the phlegm rises again, and the panting breaks out worse than before. Common practice does not know this and treats it as stomach vacuity with drying hot drugs, which is helping fire with fire. Formerly Commander Yeop suffered from this and no medicine cured him, until Lead Out Water Pillthe formula is given in the Precipitation chapter disinhibited him five or six times and he was well.
Clinical note임상 주석
Panting that eases while eating and worsens after the meal, with the mechanism worked out by observation: the food carries the phlegm down for a moment and then the stomach fills and the pressure returns. A modern reader would reach for reflux and for a distended stomach splinting the diaphragm, and would recognize 作胃虛治以燥熱之藥 — treating it as stomach vacuity with warming drugs — as the mistake it is.
Dansim 丹心
Source원문
熱喘者發于夏, 不發于冬. 《醫鑑》
Translation영역
The hot panting breaks out in summer and not in winter.
Uigam 醫鑑
Translation영역
For the fire panting, White Tiger Decoctionthe formula is given in the Cold chapter with trichosanthes seed, bitter orange peel and scutellaria added, decocted and taken, is wonderfully effective. Twin Jade Powder also works.
Gangmok 綱目
Source원문
火喘以導痰湯方見痰門加芩ㆍ連ㆍ梔子ㆍ杏仁ㆍ瓜蔞仁, 以淸金降火消痰. 《入門》
Translation영역
For the fire panting, Lead Out Phlegm Decoctionthe formula is given in the Phlegm chapter with scutellaria, coptis, gardenia, apricot kernel and trichosanthes seed added, to clear the metal, bring the fire down and disperse the phlegm.
Immun 入門
Translation영역
For the fire panting, Ophiopogon Decoction, Modified Drain the White Powder, Nourish the Yin and Bring Down Fire Decoctionthe formula is given in the Fire chapter, Supplemented Engender the Pulse Powder, Drain Fire and Clear the Lung Decoction, Jade Humour Powder and Jade Flower Powder are appropriatethe formulas follow
Jebang 諸方
Source원문
華佗云, 盛則爲喘, 減則爲枯. 活人書云, 發喘者氣有餘也. 凡看文字, 須會得本意. 肺氣若盛而有餘, 則當淸肅下行而不喘; 以其火入于肺, 衰與不足而爲喘焉. 故言盛者, 言肺中之火盛也; 有餘者, 言肺中之火有餘也. 故瀉肺火以苦寒之劑, 實補肺也. 《綱目》
Translation영역
Hwata says: when it is abundant there is panting, when it is diminished there is withering. The Hwarinseo says: one who breaks out in panting has a surplus of qi. In reading a text one must get at the meaning behind it. If the lung qi were truly abundant and in surplus, it would descend clear and austere and there would be no panting; it is because fire has entered the lung and the lung is waning and insufficient that there is panting. So to say abundant is to say that the fire in the lung is abundant, and to say in surplus is to say that the fire in the lung is in surplus. Hence draining the lung's fire with bitter cold preparations is in truth supplementing the lung.
Clinical note임상 주석
A piece of careful reading, and the point it makes matters clinically: when the old texts say the qi is in surplus in a panting patient, they mean the fire is in surplus, not the lung's own strength — the lung in such a patient is failing. 瀉肺火…實補肺也 — draining the lung's fire is in truth supplementing the lung — is how the chapter licenses cooling drugs in a breathless patient who looks depleted.
Gangmok 綱目
3.8.5 The Water Panting 水喘
Source원문
水氣者, 漉漉有聲ㆍ怔忡ㆍ喘息, 宜葶棗散. 《入門》
Translation영역
In water qi there is a sloshing sound, fearful throbbing and panting breath; Lepidium and Jujube Powder is appropriate.
Clinical note임상 주석
漉漉有聲 — a sloshing sound — with palpitation and breathlessness. That is fluid in the chest, and the three signs together are what a modern examiner finds in heart failure with an effusion. 審病 2.5 gathers the same picture under 水.
Immun 入門
Source원문
病人飮水多, 必暴喘滿.
Translation영역
A patient who drinks much water must break out in panting and fullness.
Junggyeong 仲景
Source원문
支飮喘不得息, 葶藶大棗瀉肺湯甚效. 《仲景》
Translation영역
Where propping fluid brings panting so that the patient cannot breathe, Lepidium and Jujube Drain the Lung Decoction is very effective.
Junggyeong 仲景
Source원문
水腫腹脹而喘者, 盖喘必生脹, 脹必生喘, 二證相因. 皆小便不利. 肺主氣, 先喘而後脹者, 宜淸金降火而行水次之; 脾主濕, 先脹而後喘者, 宜燥濕行水而淸金次之. 《入門》
Translation영역
Where there is water swelling with a distended abdomen and panting: panting must engender distension and distension must engender panting, the two patterns causing each other, and in both the urine is inhibited. The lung governs the qi, so where panting comes first and distension after, clear the metal and bring the fire down, and move the water second; the spleen governs damp, so where distension comes first and panting after, dry the damp and move the water, and clear the metal second.
Clinical note임상 주석
Which came first, the breathlessness or the swelling — the same question 辨證 3.5 asks of pain and swelling, and here it decides between treating the lung and treating the fluid. It is a real clinical distinction: breathlessness followed by oedema points to the lung or the heart, oedema followed by breathlessness to the kidney or the liver, and the order of onset is still the first thing asked.
Immun 入門
Source원문
支飮喘不得卧, 加短氣倚息, 其脉平, 小靑龍湯方見寒門主之. 《仲景》
Translation영역
Where propping fluid brings panting so that the patient cannot lie down, with shortness of breath and leaning to breathe besides, and the pulse is level, Minor Blue Dragon Decoctionthe formula is given in the Cold chapter governs it.
Junggyeong 仲景
Source원문
夫不得卧, 卧則喘者, 是水氣之客也. 水者循津液而流也. 腎者水藏, 主津液, 主卧與喘也. 宜神秘湯. 《綱目》
Translation영역
One who cannot lie down, and pants when he lies, has water qi lodging in him. Water flows along with the fluids. The kidney is the water viscus and governs the fluids, and governs lying down and panting. Mystical Decoction is appropriate.
Clinical note임상 주석
卧則喘 — panting on lying down — is orthopnoea, and it is attributed here to water lodged in the body. The inference is right: a patient who becomes breathless when flat has fluid, and the fluid redistributes when the chest is no longer above the abdomen. 3.27 lists the same sign among the untreatable.
Gangmok 綱目
Translation영역
For panting made by damp heat, Level the Qi Powder and Modified Drain the White Powder are appropriate.
Bogam 寶鑑
Translation영역
In the water panting, with fluid halted, the chest and diaphragm full and oppressed, and the legs swelling first, Level the Lung Decoction and Apricot Kernel and Perilla Drink are appropriatethe formulas follow
Jebang 諸方
3.8.6 The Long-Standing Panting 久喘
Translation영역
Where in a long illness the breath is short and cannot be carried on, and it is like panting and is not panting, Ginseng Alone Decoction or Regulate the Centre and Boost the Qi Decoctionthe formula is given in the Inward Damage chapter is to be taken.
Clinical note임상 주석
似喘非喘 — like panting and not panting — for a breath that cannot be carried through to the end. It is a distinction between the laboured breathing of an obstructed airway and the shallow insufficiency of an exhausted patient, and the treatment follows it: ginseng rather than ephedra.
Immun 入門
Translation영역
For any panting long unstopped, Minor Radish and Soapberry Pill is appropriate, or Ginseng Clear the Lung Drinkthe formula is given above with the poppy husk doubled to astringe it.
Immun 入門
Translation영역
In long-standing panting, take Ginseng and Pinellia Pill before an attack and use Aquilaria Rolling Phlegm Pillthe formula is given in the Phlegm chapter; that is, Rolling Phlegm Pill once it has broken out; it has worked again and again.
Clinical note임상 주석
The before-and-after division of 3.8 put into two prescriptions, one for the quiet period and one for the attack. It is the clearest statement of a preventer-and-reliever regimen in the Bogam.
Hagan 河間
Translation영역
For the long-standing panting, Ginseng and Aster Decoction, Arrest Panting Decoction, Wax Decoct Powder, Gold Unexchanged Powder and Ginseng Moisten the Lung Pill are appropriatethe formulas follow
Jebang 諸方
3.8.7 The Stomach-Vacuity Panting 胃虛喘
Source원문
胃虛極則氣上逆ㆍ擡肩擷肚ㆍ喘而不休, 生脉散加杏仁ㆍ陳皮ㆍ白朮服. 《入門》
Translation영역
Where the stomach's vacuity is extreme the qi runs counter upward, the shoulders are lifted and the belly drawn in, and the panting does not let up; Engender the Pulse Powder with apricot kernel, tangerine peel and white atractylodes added is taken.
Immun 入門
Source원문
胃喘則身熱而煩. 經云, 胃爲氣逆. 又云, 犯賊風虛邪者陽受之, 陽受之則入六府, 入六府則身熱不時卧ㆍ上爲喘呼. 又云, 陽明厥則喘而惋, 惋則惡人. 或喘而死者, 或喘而生者, 何也. 厥逆連藏則死, 連經則生. 此胃喘宜加減白虎湯之類. 《綱目》
Translation영역
In the stomach panting there is fever and vexation. The classic says: the stomach is for qi counterflow. It says again: one who meets a robber wind or a vacuity evil has it received by the yang, and the yang receiving it, it enters the six bowels, and entering the six bowels there is fever with no settled time for lying down, and above there is panting and gasping. It says again: when yang brightness reverts there is panting and distress, and in distress the patient hates people. Why do some die of panting and some live? When the reversal connects with a viscus the patient dies; when it connects with a channel he lives. For this stomach panting, Modified White Tiger Decoction and the like are appropriate.
Gangmok 綱目
3.8.8 The Yin-Vacuity Panting 陰虛喘
Source원문
血虛則陽無所依附而上奔, 宜四物湯倍芍藥加人參ㆍ五味子以收之. 《入門》
Translation영역
Where the blood is vacuous the yang has nothing to cleave to and rushes upward; Four Substances Decoction with the peony doubled and ginseng and schisandra added is appropriate, to gather it in.
Immun 入門
Source원문
陰虛者, 氣從臍下直衝淸道而上, 宜降氣滋陰. 《醫鑑》
Translation영역
In the yin-vacuity kind the qi surges straight up the clear passage from below the navel; the qi should be brought down and the yin enriched.
Uigam 醫鑑
Translation영역
In the yin-vacuity panting the heart fire should be brought down, the true yin supplemented and the essence and blood boosted: Four Substances Decoction combined with Two Matured Ingredients Decoction, with bitter orange peel, scutellaria, anemarrhena and phellodendron added.
Immun 入門
Translation영역
Where fire stirs on a vacuous yin and the phlegm panting never ceases its sound, treat the branch when it is urgent — Black Frost and Snow Pear Paste; treat the root when it is slow — Nourish the Yin and Clear Transformation Paste.
Hoechun 回春
Source원문
凡喘不得卧, 其脉浮, 按之虛而澁者, 爲陰虛, 去死不遠, 慎勿下之, 必死. 宜四物湯加竹瀝ㆍ童便ㆍ靑黛ㆍ麥門冬ㆍ五味子ㆍ枳殼ㆍ紫蘇葉. 《綱目》
Translation영역
In any panting where the patient cannot lie down and the pulse is floating but, pressed, is vacuous and rough, it is yin vacuity and death is not far off; take care not to purge, for he would surely die. Four Substances Decoction with bamboo sap, a boy's urine, indigo, ophiopogon, schisandra, bitter orange peel and perilla leaf added is appropriate.
Clinical note임상 주석
按之虛而澁 — vacuous and rough under pressure — is the pulse of 辨證 3.21, and the warning attached to it is the same: the patient looks like a case for draining and is not. 慎勿下之, 必死 is as strong a contraindication as the Bogam gives.
Gangmok 綱目
Translation영역
For the yin-vacuity panting, Quiet the Lung Decoction, Moisten the Lung, Open the Phlegm and Quiet the Cough Decoction and Ginseng and Schisandra Powder are appropriatethe formulas follow
Jebang 諸方
3.9 Panting and Cough Breaking Out from Various Injuries 諸傷發喘嗽
Source원문
凡人夜行則喘出於腎, 淫氣病肺; 有所墮恐, 喘出於肝, 淫氣害脾; 有所驚恐, 喘出於肺, 淫氣傷心; 渡水跌仆, 喘出於腎與骨. 當是之時, 勇者氣行則已, 怯者着而爲病也. 《內經》
Translation영역
When a person walks by night the panting comes out of the kidney, and the excessive qi makes the lung ill; where there has been a fall and fright, the panting comes out of the liver and the excessive qi harms the spleen; where there has been a start and fear, the panting comes out of the lung and the excessive qi injures the heart; where one has forded water and slipped and fallen, the panting comes out of the kidney and the bones. At such a time, in the bold the qi moves and it is over; in the timid it settles and becomes an illness.
Clinical note임상 주석
勇者氣行則已, 怯者着而爲病 — in the bold the qi moves on and it is over, in the timid it settles and becomes an illness — is the Inner Classic's account of why the same accident leaves one person well and another ill, and it is the same constitutional reasoning as 辨證 3.16's. Breathlessness after a fright or a fall that does not settle is what a modern clinic would read as an anxiety response, and the chapter's own treatment for it is at 3.8.3.
Naegyeong 內經
Translation영역
For a cough made by eating sour things, Licorice and Gall Pill; for a cough brought on by eating hot things, Lepidium Powder and Aster Down Decoction; for a cough brought on by fording water and falling, Apricot Kernel and Ginseng Powder; for a cough brought on by a blow, Chinese Angelica Drinkthe formula is given above
Donguibogam · Haesu
3.10 Medicines That Treat Panting and Cough Generally 喘嗽通治藥
Translation영역
Apricot Kernel and Ginseng Powder, Paste-Holding Pill, Arrest Panting and Transform Phlegm Powder, Apricot Kernel and Glue Drink, and the two Cock-Crow Pills are appropriate.
Clinical note임상 주석
**Apricot Kernel and Glue Drink and both Cock-Crow Pills contain aristolochia and must not be used; Arrest Panting and Transform Phlegm Powder contains musk.** The entries carry their own warnings. The list is the chapter's general-purpose set for panting with cough, and it is the one most loaded with materials now withdrawn.
Donguibogam · Haesu
3.11 In Panting and Cough, Cold and Heat Should Be Distinguished 喘嗽宜辨寒熱
Source원문
因風者, 遇風則嗽甚; 因寒者, 值寒則嗽劇; 因熱者, 遇熱則嗽卽發. 更有一驗甚的, 但問遇夜飮酒ㆍ夜間如何. 若喫酒後嗽甚則有熱也, 喫酒了嗽減則有寒也. 涎淸白者有寒也, 黃濁者有熱也. 《局方》
Translation영역
Where the cause is wind, the cough is worse when the patient meets a wind; where it is cold, the cough is violent when he meets cold; where it is heat, the cough breaks out at once when he meets heat. There is one further test, and a very sure one: simply ask how he is at night when he drinks wine. If the cough is worse after drinking, there is heat; if it eases after drinking, there is cold. Clear white sputum means cold; yellow and turbid means heat.
Clinical note임상 주석
Two questions and one look, and all three still work. Does cold air or warm air set it off; does alcohol make it better or worse; and what colour is the sputum. The sputum rule — clear and white for cold, yellow and thick for heat — is the single most used sign in Korean respiratory practice, and it corresponds well enough to the distinction between a viral or allergic cough and a bacterial one.
更有一驗甚的 — one further test, and a very sure one — is the Gukbang's own estimate of the alcohol question, and the mechanism it implies is real: alcohol is a vasodilator and will worsen a hot inflamed airway while warming a cold one.
Gukbang 局方
3.12 In Panting and Cough, Vacuity and Repletion Should Be Divided 喘嗽宜分虛實
Source원문
治法最要分肺虛實. 若肺虛久嗽, 宜五味子ㆍ欵冬花ㆍ紫菀ㆍ馬兠鈴之類補之; 若肺實有火邪, 或新嗽, 宜黃芩ㆍ天花粉ㆍ桑白皮ㆍ葶藶子之類瀉之. 《正傳》
Translation영역
In the method of treatment the first necessity is to divide lung vacuity from lung repletion. Where the lung is vacuous with a long cough, supplement with such drugs as schisandra, coltsfoot, aster and birthwort; where the lung is replete with a fire evil, or the cough is new, drain with such drugs as scutellaria, trichosanthes root, mulberry root bark and lepidium seed.
Clinical note임상 주석
The chapter's drug policy in one line: supplementing drugs for the old cough, draining drugs for the new one. The division by duration is a good rough guide and it is the one the formula sections follow throughout.
**馬兠鈴, birthwort, is an aristolochia and must not be used. Aristolochic acid causes irreversible kidney failure and urothelial cancer, and preparations containing it have been withdrawn in Korea and elsewhere. It appears repeatedly in this chapter and every entry containing it carries this warning.**
Jeongjeon 正傳
Source원문
久病氣虛而喘, 宜阿膠ㆍ人參ㆍ五味子; 新病氣實而喘, 宜桑白皮ㆍ苦葶藶. 《丹心》
Translation영역
For panting from qi vacuity in a long illness, ass-hide glue, ginseng and schisandra are appropriate; for panting from replete qi in a new illness, mulberry root bark and bitter lepidium.
Dansim 丹心
Source원문
肺之生病嗽喘, 大抵秋冬則實, 春夏則虛. 若實則面赤ㆍ飮水ㆍ身熱ㆍ痰盛ㆍ涕唾稠粘, 或咽乾ㆍ面腫; 若虛則面白脫色ㆍ氣少不語ㆍ喉中有聲ㆍ痰唾淸利.
Translation영역
In the cough and panting that the lung engenders, it is in general replete in autumn and winter and vacuous in spring and summer. In repletion the face is red, the patient drinks water, the body is hot, the phlegm abundant and the snivel and spittle thick and sticky, or the throat dry and the face swollen. In vacuity the face is white and has lost its colour, the qi is scant and the patient does not speak, there is a sound in the throat, and the phlegm and spittle are clear and free.
Clinical note임상 주석
Two columns of signs for the same illness, and between them they cover the two presentations a modern clinician separates as an acute infective exacerbation and chronic airflow limitation. The second column — pale, short of breath, too breathless to talk, with an audible wheeze and thin sputum — is advanced chronic obstructive lung disease, and 氣少不語, too little breath to speak, is the sign that still decides severity at the bedside.
Jeoneul 錢乙
Source원문
肺感微寒, 八九月間肺氣大旺, 病嗽者病必實, 非久病也, 宜瀉之. 《錢乙》
Translation영역
Where the lung has taken a slight cold, and in the eighth or ninth month the lung qi is at its height, a patient who falls ill with cough is certainly replete and it is no long-standing illness; it should be drained.
Jeoneul 錢乙
3.13 Hoarseness in Panting and Cough 喘嗽聲嘶
Source원문
喘嗽聲嘶, 乃血虛受熱. 靑黛ㆍ蛤粉爲末, 蜜丸, 常常噙化. 《丹心》
Translation영역
Hoarseness in panting and cough is blood vacuity taking on heat. Powder indigo and clam shell, make honey pills, and let the patient hold them in the mouth to dissolve, again and again.
Dansim 丹心
Source원문
宜用芩連四物湯醫鑑○詳見聲音門
Translation영역
Scutellaria and Coptis Four Substances Decoction is appropriateUigam ○ treated in full in the Voice chapter
Clinical note임상 주석
A lozenge held in the mouth rather than a decoction swallowed, which is the right route for a hoarse larynx: the drug is meant to reach the throat and stay there. The Bogam uses the same form for throat conditions in the 咽喉 chapter, and the reasoning behind 常常噙化 — holding it to dissolve, again and again — is exactly that of a modern throat lozenge.
Uigam 醫鑑
3.14 Panting and Cough with Qi Rising Comes of Kidney Vacuity 喘嗽上氣出於腎虛
Source원문
夫腎虛爲病, 不能納諸氣以歸元, 故氣逆而上, 咳嗽痰盛, 或喘或脹, 髓虛多唾, 足冷骨痿, 胸腹百骸俱爲之牽掣. 其嗽愈重, 其聲愈乾. 君子當於受病之處圖之可也.
Translation영역
When the kidney is vacuous and ill it cannot take the qi in and return it to its origin, and so the qi runs counter and rises, with cough and abundant phlegm, panting or distension, marrow vacuity with much spittle, cold feet and wilting bones, and the chest, abdomen and every bone of the body dragged and pulled by it. The heavier the cough, the drier the sound of it. A thoughtful physician should plan his treatment at the place where the illness was taken.
Jikji 直指
Source원문
抑猶有說焉. 肺出氣也, 腎納氣也. 肺爲氣之主, 腎爲氣之藏. 凡咳嗽暴重ㆍ動引百骸, 自覺氣從臍下逆奔而上, 此腎虛不能收氣也. 當以補骨脂ㆍ安腎元方見虛勞主之, 毋徒從事於寧肺. 《直指》
Translation영역
There is more to be said. The lung puts the qi out and the kidney takes it in; the lung is the governor of the qi and the kidney its storehouse. Where the cough is suddenly severe and shakes every bone of the body, and the patient feels the qi rushing up in counterflow from below the navel, this is the kidney vacuous and unable to gather the qi in. Psoralea and Settle the Kidney Pillthe formula is given in the Taxation chapter should govern it, and one should not busy oneself with quieting the lung alone.
Clinical note임상 주석
肺出氣也, 腎納氣也 — the lung puts the qi out, the kidney takes it in — is the sentence behind the whole doctrine of 腎不納氣, and this section is its locus classicus. The clinical sign it offers is specific and unusual: the patient feels the breath rushing up from below the navel rather than from the chest. In a modern clinic the same complaint, breathlessness felt low and with exhaustion rather than in the throat, is what one hears from a patient with long-standing disease rather than an acute one, and 毋徒從事於寧肺 — do not busy yourself with quieting the lung alone — is sound advice about it.
Jikji 直指
Translation영역
Where the lower origin is vacuous and cold and the kidney qi cannot return to its origin, with panting above and urgent breath, Settle the Kidney Pill and Eight Ingredient Pillboth formulas are given in the Taxation chapter are appropriate, swallowed down with a ginseng decoction on an empty stomach.
Deukhyo 得效
Source원문
咳嗽煩寃者, 腎氣之逆也. 《內經》
Translation영역
Cough with vexed distress is the kidney qi running counter.
Naegyeong 內經
3.15 Seizing Medicines for Panting and Cough 喘嗽劫藥
Source원문
諸喘不止, 椒目極細末, 每一二錢, 薑湯調服止之. 止後, 因痰治痰ㆍ因火治火. 虛弱者勿用. 《丹心》
Translation영역
For any panting that will not stop, powder zanthoxylum seed exceedingly fine and give 1 or 2 don each time stirred into ginger decoction to stop it. Once it has stopped, treat the phlegm if phlegm is the cause and the fire if fire is the cause. In a weak patient it is not to be used.
Clinical note임상 주석
劫藥, a seizing medicine, is the Bogam's term for a drug given to break an attack rather than to treat the illness, and the section states the logic plainly: stop the paroxysm first, then find the cause and treat that. It is the structure of modern asthma management — reliever first, then the controller — and the caution 虛弱者勿用, not for a weak patient, is the same caution that attaches to a strong bronchodilator.
Dansim 丹心
Source원문
諸喘劫藥, 蘿葍子(蒸熟) 一兩ㆍ皂角(燒灰) 三錢. 右爲末, 薑汁加蜜丸服. 《丹心》
Translation영역
A seizing medicine for any panting: radish seed steamed until done, 1 nyang, and soapberry burnt to an ash, 3 don. Powder them and make pills with ginger juice and honey, and give.
Dansim 丹心
Source원문
治嗽劫藥, 五味子 五錢ㆍ甘草 二錢半ㆍ五倍子ㆍ芒硝 各一錢, 末, 蜜丸噙化. 《丹心》
Translation영역
A seizing medicine to treat cough: schisandra, 5 don; licorice, 2 don 5 fun; gallnut and mirabilite, 1 don each. Powder them, make honey pills and let them dissolve in the mouth.
Dansim 丹心
3.16 Fumigating Medicines for Panting and Cough 喘嗽熏藥
Source원문
久喘嗽, 非此不除. 南星ㆍ欵冬花ㆍ鵝管石無則石鍾乳代ㆍ佛耳草ㆍ雄黃等分爲末, 拌艾, 以生薑一片留舌上, 次用艾燒之, 須令烟入喉中. 一方, 無佛耳草, 有鬱金. 《丹心》
Translation영역
For a long-standing panting cough, nothing but this will remove it. Arisaema, coltsfoot, goose-quill stalactiteif it is not to be had, stalactite may be used instead, cudweed and realgar, in equal parts, powdered and mixed with mugwort; have the patient hold a slice of fresh ginger on the tongue, then burn the mugwort, and the smoke must be made to go into the throat. One formula has no cudweed and has curcuma.
Clinical note임상 주석
Medicated smoke drawn into the throat, which is the classical tradition's inhaler — and the slice of ginger held on the tongue is there to stop the patient coughing the smoke straight back out.
**The powder contains realgar, an arsenic sulfide, and arisaema. Inhaling the smoke of arsenic is dangerous and this must not be prepared.** The idea of a medicated inhalation for a chronic cough is sound and survives in modern practice; the materials are not.
Dansim 丹心
Source원문
久咳ㆍ夜咳ㆍ冬咳ㆍ風入肺竅者, 宜熏之. 《入門》
Translation영역
For a long cough, a night cough, a winter cough, or where wind has entered the lung's orifices, fumigation is appropriate.
Immun 入門
Source원문
久嗽風入肺, 鵝管石ㆍ雄黃ㆍ鬱金 各一錢ㆍ欵冬花 三錢, 爲末, 每取二錢, 拌艾捲作筒子, 燒烟吸入口中, 溫茶常呷下. 《入門》
Translation영역
For a long cough with wind in the lung: goose-quill stalactite, realgar and curcuma, 1 don each, and coltsfoot, 3 don, powdered; take 2 don each time, mix it with mugwort and roll it into a tube, burn it and draw the smoke into the mouth, sipping warm tea from time to time.
Clinical note임상 주석
**Contains realgar — arsenic sulfide — and must not be prepared.** The preparation is a medicated cigarette, rolled from mugwort with the powder in it, and smoked; asthma cigarettes of the same design, made with stramonium, were sold in Europe and America into the twentieth century on the same reasoning.
Immun 入門
Source원문
欵冬花如雞子大, 蜜拌潤之, 用有觜瓦缾中燒藥, 却以缾觜當口吸烟嚥之, 甚效. 《綱目》
Translation영역
Take coltsfoot the size of a hen's egg, moisten it with honey, burn it in an earthenware bottle with a spout, and put the spout to the mouth to draw in the smoke and swallow it; very effective.
Gangmok 綱目
Source원문
無欵冬花, 則用紫菀茸如上法熏之亦佳. 《俗方》
Translation영역
If coltsfoot is not to be had, aster down used in the same way is also good.
Sokbang 俗方
3.17 The Pattern of Wheezing 哮證
Source원문
哮以聲響言, 喘以氣息言.
Translation영역
Wheezing is spoken of by the sound it makes, panting by the breath.
Immun 入門
Source원문
哮卽痰喘甚而常發者. 《入門》
Translation영역
Wheezing is the phlegm panting when it is severe and breaks out again and again.
Immun 入門
Source원문
哮吼者, 肺竅中有痰氣也. 《回春》
Translation영역
In wheezing and roaring there is phlegm qi within the lung's orifices.
Hoechun 回春
Source원문
治哮專主乎痰, 宜吐法. 吐藥中多用醋, 不可用凉藥, 必帶表散, 此寒包熱也. 必須薄滋味. 《丹心》
Translation영역
In treating wheezing the phlegm alone is the object, and the method of inducing vomiting is appropriate. Vinegar is much used among the emetic drugs; cooling drugs must not be used, and the prescription must carry something to disperse the exterior, for this is cold wrapping heat. The diet must be kept thin.
Clinical note임상 주석
寒包熱 again, and here it is the whole account of wheezing: an inflamed airway set off by cold, so that cooling it makes it worse and opening the surface makes it better. That is close to how cold-induced bronchoconstriction in an inflamed airway is understood now, and 必須薄滋味, the diet must be kept thin, is the chapter's recognition that food provokes attacks — 3.17 names rich food explicitly two passages later.
Dansim 丹心
Source원문
哮喘遇冷則發者有二證. 一者屬中外皆寒, 宜東垣參蘇溫肺湯方見上; 一者屬寒包熱, 宜越婢加半夏湯等發表之劑方見下, 或預於八九月未寒之時用承氣湯方見寒門下其熱, 至冬寒時無熱可包, 自不發作. 《綱目》
Translation영역
Wheezing panting that breaks out on meeting cold has two patterns. One belongs to cold both within and without, and Dongwon's Ginseng, Perilla and Warm the Lung Decoctionthe formula is given above is appropriate. The other belongs to cold wrapping heat, and an exterior-dispersing preparation such as越婢 Decoction with Pinellia Addedthe formula is given below is appropriate; or, in the eighth or ninth month before the cold comes, Qi-Coordinating Decoctionthe formula is given in the Cold chapter may be used in advance to precipitate the heat, so that when the winter cold comes there is no heat to be wrapped and no attack occurs of itself.
Clinical note임상 주석
Treatment given in autumn to prevent attacks in winter, on the reasoning that there will then be no heat for the cold to wrap. Whatever one makes of the mechanism, the strategy is seasonal prophylaxis, and it is the same thinking behind stepping up asthma treatment before the cold months.
Gangmok 綱目
Source원문
一少年病哮, 十月則發一遍, 正當九月十月之交. 此疾不得汗泄, 宜溫散. 麻黃ㆍ黃芩, 每貼用一錢半, 爲細末, 入薑汁水煎, 臨卧時服之, 與小胃丹方見痰門 十二丸, 津嚥下. 《丹心》
Translation영역
A young man had wheezing, which broke out once in the tenth month, just at the turn of the ninth and tenth. This illness cannot be let out by sweating and should be warmed and dispersed: ephedra and scutellaria, 1 don 5 fun to the packet, powdered fine, decocted in water with ginger juice and taken at bedtime, with twelve pills of Minor Stomach Elixirthe formula is given in the Phlegm chapter swallowed down with the saliva.
Clinical note임상 주석
A case with a season attached: attacks once a year at the turn of the ninth and tenth months. Seasonal asthma with that regularity points to an allergen — autumn moulds or a pollen — and the patient's own history was precise enough for Dansim to record the date.
Dansim 丹心
Source원문
喘促喉中如水雞響者, 謂之哮; 氣促而連續不能以息者, 謂之喘. 《正傳》
Translation영역
Where the panting is hurried and there is a sound in the throat like a water fowl, it is called wheezing; where the breath is hurried and runs on so that the patient cannot breathe with it, it is called panting.
Clinical note임상 주석
如水雞響 — like a water fowl — is the classical simile for a wheeze, and it is a good one: the high whistling call of a moorhen is close to what is heard at the mouth in an asthmatic attack. The phrase is still quoted in Korean and Chinese texts for the sound.
Jeongjeon 正傳
Source원문
哮病氣實者, 用紫金丹二十丸, 吐去其痰; 虛者止服二三丸則不吐. 臨發時用此劫之. 丹溪方去豆豉更妙.
Translation영역
In wheezing where the qi is replete, twenty pills of Purple Gold Elixir are used to vomit the phlegm away; in the vacuous, only two or three pills are taken and there is no vomiting. It is used to seize the attack as it comes on. The Dansim formula, with the fermented beans left out, is better still.
Clinical note임상 주석
**Purple Gold Elixir is an arsenic preparation. It must not be prepared.** Arsenic was used for asthma into the nineteenth century in Europe as well, and it does suppress the attack; the dose that does so is close to the dose that poisons, which is why the chapter distinguishes twenty pills from two or three.
Immun 入門
Translation영역
The water wheeze comes of water gathered in the lung in childhood and become phlegm; Inula Powderthe formula is given above, Minor Blue Dragon Decoctionthe formula is given in the Cold chapter or Lepidium and Jujube Powder is appropriate.
Clinical note임상 주석
因幼時水蓄於肺 — water gathered in the lung in childhood — is an aetiology that begins in infancy, and for a wheezing illness that is not a bad guess: childhood-onset asthma and the bronchiectasis that follows a childhood pneumonia both begin exactly there.
Immun 入門
Source원문
風痰哮者, 千緡導痰湯方見上
Translation영역
For the wind-phlegm wheeze, Thousand Strings Lead Out Phlegm Decoctionthe formula is given above
Immun 入門
Translation영역
For one who would cut the root of it, Arrest Panting Decoction and Scutellaria Disinhibit the Diaphragm Pillthe formula is given in the Phlegm chapter should be taken
Immun 入門
Translation영역
For one in whom it breaks out on meeting rich food, Clear the Metal Pill; for one who has long been unable to sleep, Birthwort Pill.
Clinical note임상 주석
遇厚味發 — breaking out on meeting rich food — is a food-provoked attack, recorded as a distinct trigger alongside cold and the seasons. **Birthwort Pill contains aristolochia and must not be used.**
Immun 入門
Translation영역
For wheezing panting, Seize Life Elixir, Stand and Settle Powder, Release the Exterior Two Matured Ingredients Decoction, Five Tigers Two Matured Ingredients Decoction, Three Whites Pill and Purple Gold Elixir should be usedthe formulas follow
Jebang 諸方
3.18 The Pattern of Lung Distension 肺脹證
Source원문
咳而上氣ㆍ煩躁者爲肺脹, 欲作風水, 發汗卽愈.
Translation영역
Cough with qi rising and agitation is lung distension; it is about to become wind water, and sweating cures it.
Junggyeong 仲景
Source원문
咳而上氣, 此爲肺脹, 其人喘ㆍ目如脫狀ㆍ脉浮大者, 越婢加半夏湯主之.
Translation영역
Cough with qi rising is lung distension; where the patient pants, the eyes look as though they would start out of the head, and the pulse is floating and large, 越婢 Decoction with Pinellia Added governs it.
Clinical note임상 주석
目如脫狀 — the eyes as though they would start out of the head — is the Jingui's phrase for the look of a patient straining to breathe, and it is exact: the bulging stare of severe air trapping. 肺脹 is the Bogam's name for what a modern clinician calls hyperinflation, and the chapter's description of it — cough, qi rising, agitation, bulging eyes, a large floating pulse — is emphysema in an acute exacerbation.
Junggyeong 仲景
Source원문
肺脹咳而上氣ㆍ煩燥而喘ㆍ脉浮者, 心下有水氣, 小靑龍湯方見寒門加石膏主之. 《仲景》
Translation영역
In lung distension with cough and qi rising, agitation and panting, and a floating pulse, there is water qi below the heart, and Minor Blue Dragon Decoctionthe formula is given in the Cold chapter with gypsum added governs it.
Junggyeong 仲景
Source원문
肺脹主收歛. 用訶子ㆍ靑黛ㆍ杏仁, 佐以海粉ㆍ便香附ㆍ瓜蔞仁ㆍ半夏麴, 薑汁與蜜調和作丸噙化.
Translation영역
Lung distension calls chiefly for gathering in and astringing. Chebule, indigo and apricot kernel are used, assisted by clam shell powder, urine-soaked cyperus, trichosanthes seed and pinellia leaven, mixed with ginger juice and honey, made into pills and held in the mouth to dissolve.
Dansim 丹心
Source원문
肺脹而嗽, 或左或右不得眠, 此痰挾瘀血碍氣而病. 宜養血以流動乎氣ㆍ降火踈肝以淸痰, 四物湯加桃仁ㆍ訶子ㆍ靑皮ㆍ竹瀝之類. 《丹心》
Translation영역
Lung distension with cough, where the patient cannot sleep on one side or the other, is phlegm carrying static blood with it and obstructing the qi. The blood should be nourished so that the qi flows, and the fire brought down and the liver freed so that the phlegm is cleared: Four Substances Decoction with peach kernel, chebule, unripe tangerine peel and bamboo sap and the like.
Clinical note임상 주석
One-sided orthopnoea again, as at 3.29's last passage, and here it is read as blood mixed with the phlegm. The sign points to disease on one side of the chest, and the chapter's attention to which side the patient can lie on is worth keeping even where its explanation is not.
Dansim 丹心
Source원문
肺脹痰嗽睡不安, 宜淸化丸方見上
Translation영역
For lung distension with phlegm cough and unquiet sleep, Clear Transformation Pillthe formula is given above is appropriate
Dansim 丹心
3.19 The Pattern of Wilting Lung 肺痿證
Source원문
熱在上焦者, 因咳爲肺痿. 肺痿之病從何得之. 師曰, 或從汗出, 或從嘔吐, 或從消渴小便利數, 或從便難, 又被快藥下利, 重亡津液, 故得之.
Translation영역
Where the heat is in the upper burner, the coughing becomes wilting lung. How is the illness of wilting lung got? The master says: either from sweating, or from vomiting, or from wasting-thirst with frequent free urination, or from difficulty of stool, and then being purged with a drastic drug so that the fluids are lost over again — and so it is got.
Clinical note임상 주석
Every route listed is a loss of fluid, and one of them is iatrogenic: a patient already dry purged with a drastic drug. 重亡津液, the fluids lost over again, is the chapter's explanation of how a cough becomes a destructive lung disease, and the warning against purging a dry patient is the practical content.
Junggyeong 仲景
Source원문
肺痿吐涎沫而咳者, 宜生薑甘草湯.
Translation영역
In wilting lung where the patient spits frothy drool and coughs, Fresh Ginger and Licorice Decoction is appropriate.
Junggyeong 仲景
Source원문
肺痿吐涎沫而不咳者, 其人不渴, 必遺尿ㆍ小便數. 所以然者, 以上虛不能制下故也. 此爲肺中冷, 必眩ㆍ多吐涎, 甘草乾薑湯以溫之. 《仲景》
Translation영역
In wilting lung where the patient spits frothy drool and does not cough, he is not thirsty and must have incontinence and frequent urination. The reason is that the upper being vacuous cannot control the lower. This is cold within the lung; he will certainly be dizzy and spit much drool, and Licorice and Dried Ginger Decoction warms it.
Clinical note임상 주석
上虛不能制下 — the upper being vacuous cannot control the lower — offered as the mechanism for incontinence in a patient with lung disease. The association is real: stress incontinence with a chronic cough is common, and 3.3 lists coughing and losing urine among the eleven coughs.
Junggyeong 仲景
Source원문
肺痿咳唾ㆍ咽燥ㆍ欲飮水者自愈; 自張口者短氣也. 《脉經》
Translation영역
In wilting lung with coughing and spitting, a parched throat and a wish to drink water, the patient recovers of himself; one whose mouth hangs open of itself is short of breath.
Maekgyeong 脉經
Source원문
寸口脉數, 其人咳, 口中反有濁唾涎沫者, 此爲肺痿之病. 若口中辟辟燥ㆍ咳ㆍ胸中隱隱痛ㆍ脉反滑數, 此爲肺癰. 《仲景》
Translation영역
Where the pulse at the inch opening is rapid and the patient coughs, and there is turbid spittle and frothy drool in the mouth, this is the illness of wilting lung. But if the mouth is dry and cracking, with cough, a dull hidden pain in the chest, and a pulse slippery and rapid instead, this is a welling abscess of the lung.
Clinical note임상 주석
The pair of diagnoses 3.2 gave by the pulse alone, here given with their symptoms: copious frothy sputum for the chronic destructive process, a dry mouth with pleuritic chest pain for the acute abscess. **Both require investigation; a productive cough with chest pain and fever is a lung abscess or an empyema and needs antibiotics and drainage.**
Junggyeong 仲景
Translation영역
In the pattern of wilting lung, with chills and fever coming and going, spontaneous sweating, coughing and spitting, and much drool in the mouth, Anemarrhena and Poria Decoction governs it. Where the fire is abundant, Ginseng Level the Lung Powder governs it, or it may be made into pills held in the mouth to dissolve. Where the panting is urgent and the face puffy, Lepidium and Jujube Powderthe formula is given above. In general: nourish the lung, nourish the qi, nourish the blood, clear the metal and bring the fire down.
Immun 入門
Source원문
肺痿將變爲癰, 宜紫菀散. 《海藏》
Translation영역
Where wilting lung is about to turn into an abscess, Aster Powder is appropriate.
Haejang 海藏
Translation영역
A cough with turbid spittle and frothy drool, or a cough with red threads of pus and blood in the spittle, is called wilting lung, and it is because the heat is in the upper burner. Ophiopogon Clear the Lung Drink, Ginseng Nourish the Lung Decoction, Seize the Taxation Powder and the Immortal's Formula to Hold and Dissolve are appropriatethe formulas follow
Clinical note임상 주석
唾中有紅線膿血 — red threads of pus and blood in the spittle — is blood-streaked purulent sputum, and the Bogam names it as the sign of 肺痿. In modern terms that is the sputum of bronchiectasis or of a tuberculous cavity. **Blood-streaked sputum requires chest imaging and sputum examination.**
Jebang 諸方
3.20 The Pattern of Hiccup 咳逆證
Source원문
咳逆一曰吃逆, 乃氣病也. 氣自臍下直衝上出於口而作聲之名也. 內經曰, 諸逆衝上, 皆屬於火. 古方悉以胃弱言之而不及火, 且以丁香ㆍ柿蔕ㆍ竹茹ㆍ陳皮等劑治之, 未審孰爲降火ㆍ孰爲補虛. 人之陰氣依胃爲養, 胃土損傷則木來侮之矣. 陰爲火所乘, 不得內守, 木挾相火乘之, 故直衝淸道而上. 言胃弱者, 陰弱也, 虛之甚也. 《丹心》
Translation영역
Hiccup, also called gyeugyeok, is an illness of the qi. It is the name for the qi surging straight up from below the navel and coming out at the mouth with a sound. The Inner Classic says: all counterflow surging upward belongs to fire. The old formulas speak of it entirely as stomach weakness and do not reach the fire, and they treat it with such preparations as clove, persimmon calyx, bamboo shavings and tangerine peel, without considering which of these brings fire down and which supplements vacuity. A person's yin qi depends on the stomach for its nourishment, and when the stomach earth is damaged wood comes and insults it. The yin, overridden by fire, cannot keep its guard within; wood, carrying the ministerial fire with it, overrides it, and so the qi surges straight up the clear passage. To say the stomach is weak is to say the yin is weak, and that the vacuity is severe.
Clinical note임상 주석
Dansim arguing with the standard treatment, and the argument is about mechanism: the four drugs everyone uses for hiccup are a mixture of fire-descending and vacuity-supplementing ones, given without deciding which the patient needs. His own reading — that hiccup in a sick patient means the yin is severely depleted — is why the chapter divides it at 3.22 into the surplus and the shortfall kinds before prescribing anything.
Dansim 丹心
Source원문
孫眞人云, 咳逆遍尋方論, 無此名稱. 盖咳逆者噦逆之名, 古人以咳逆爲噦耳. 大抵咳逆者, 卽內經所謂病甚者其聲噦是也. 啘者, 今人所謂乾嘔是也. 《類聚》
Translation영역
Master Son says: search the formula literature through and this name is not to be found. Hiccup is the name for retching counterflow, and the ancients used 咳逆 for 噦. In general hiccup is what the Inner Classic means when it says that in a severe illness the sound is 噦. And 啘 is what people now call dry retching.
Yuchwi 類聚
Source원문
咳逆者, 氣逆上衝而作聲也, 俗謂之𩚚逆是也. 其發也, 或三五聲而止, 或七八聲而止, 或有連續不絶ㆍ收氣不回者, 或有病久脾胃衰敗而發咳逆ㆍ額上出汗ㆍ連聲不絶者, 最爲惡候, 乃不治之證也. 《醫鑑》
Translation영역
Hiccup is the qi running counter and surging upward with a sound, which common speech calls ggakkeuk. When it breaks out it may stop after three or five sounds, or after seven or eight; or it may run on unbroken so that the breath cannot be gathered back; or, in a long illness where the spleen and stomach have failed, the hiccup breaks out with sweat on the forehead and sound following sound without a break — and that is the worst of signs and a pattern that cannot be treated.
Clinical note임상 주석
Counting the hiccups is the chapter's own severity grading, and the terminal form is described exactly: unbroken hiccup with sweating on the forehead in a patient already wasted by long illness. Intractable hiccup in advanced disease is still a recognized and grave sign — it accompanies uraemia, hepatic failure and brainstem lesions — and the Bogam's 最爲惡候 is not an exaggeration.
Uigam 醫鑑
3.21 Hiccup and Retching Are One 咳逆與噦爲一
Source원문
噦病, 成無己ㆍ許學士謂之吃逆是也. 或曰, 東垣ㆍ海藏以噦爲乾嘔, 陳無擇又以爲咳逆, 何也. 荅曰, 靈樞經云, 噦, 以草剌鼻令嚏, 嚏而已; 無息而疾迎引之, 立已; 大驚之, 亦可已. 詳此三法, 正是治吃逆之法. 今人用紙撚剌鼻便嚏, 嚏則吃逆立止; 或閉口鼻氣使之無息, 亦立已; 或作寃盜賊大驚駭之, 亦已. 此以噦爲咳逆爲得經旨也. 謂之噦者, 吃聲之重也; 謂之吃者, 噦聲之輕也. 皆因病聲之輕重而名之也. 《綱目》
Translation영역
The illness 噦 is what Seong Muhgi and the scholar Heo call hiccup. It is objected: Dongwon and Haejang take 噦 to be dry retching, and Jin Mutaek takes it to be hiccup — how is this? The answer: the Yeongchu says of 噦 that pricking the nose with a blade of grass to make the patient sneeze ends it; that holding the breath and quickly drawing it in ends it at once; and that giving the patient a great fright can also end it. Consider these three methods and they are precisely the methods for treating hiccup. People now prick the nose with a twist of paper to make a sneeze, and the hiccup stops at once; or they shut the mouth and nose so that the patient cannot breathe, which also ends it at once; or they cry thief and startle him badly, which ends it too. In this, taking 噦 to be hiccup is to have grasped the classic's meaning. What is called 噦 is the heavier sound of hiccup, and what is called 吃 the lighter; both are named by the weight of the sound in the illness.
Clinical note임상 주석
A terminological dispute settled by what works. The Gangmok's argument is that the three remedies the Yeongchu gives for 噦 — induce a sneeze, hold the breath, startle the patient — are manifestly remedies for hiccup rather than for retching, so 噦 must mean hiccup.
All three are still in use and all three are physiologically sound: a sneeze and a fright interrupt the reflex, and breath-holding raises the carbon dioxide, which is the mechanism behind every folk cure for hiccups from a paper bag to a glass of water drunk upside down. This is one of the few places in the Bogam where a textual question is decided by clinical evidence.
Gangmok 綱目
Source원문
咳逆, 古人謂之𩜺是也. 《仲景》
Translation영역
What the ancients called 𩜺 is hiccup.
Junggyeong 仲景
3.22 Treatment of Hiccup 咳逆治法
Source원문
咳逆當分有餘不足. 不足者, 因內傷及大病後發, 其證胃弱ㆍ面靑ㆍ肢冷ㆍ便軟.
Translation영역
In hiccup, surplus and shortfall should be divided. In the shortfall kind it breaks out after inward damage or after a great illness, and its signs are a weak stomach, a blue-green face, cold limbs and a soft stool.
Immun 入門
Source원문
有餘者, 因外感胃燥及大怒ㆍ大飽而發, 其證面紅ㆍ體熱ㆍ便閉. 《入門》
Translation영역
In the surplus kind it breaks out from an external contraction with a dry stomach, or from great anger or a great meal, and its signs are a red face, a hot body and a shut stool.
Immun 入門
Source원문
凡吐利後多作噦. 此由胃中虛ㆍ膈上熱, 故噦. 或至八九聲相連ㆍ收氣不回至於驚人者. 若傷寒及久病得此, 甚惡. 《三因》
Translation영역
After vomiting and diarrhoea hiccup often arises. It is because the stomach is vacuous and there is heat above the diaphragm, and so there is hiccup. Sometimes it runs to eight or nine sounds together so that the breath cannot be gathered back, to the alarm of those about him. Where it comes on in cold damage or in a long illness, it is very bad.
Samin 三因
Translation영역
For the yin pattern of hiccup, with a cold stomach and a fine pulse, or extreme vacuity after vomiting and purging, Tangerine Peel and Dried Ginger Decoction, Tangerine Peel, Pinellia and Fresh Ginger Decoction, Clove and Persimmon Calyx Powder, Notopterygium and Aconite Decoction, or Three Aromatics Powder are appropriate.
Immun 入門
Translation영역
For the yang pattern of hiccup, with fever, a bitter mouth, a full chest and a rapid pulse, Minor Bupleurum Decoctionthe formula is given in the Cold chapter with tangerine peel and bamboo shavings added, or Tangerine Peel and Bamboo Shavings Decoction, or Pinellia and Fresh Ginger Decoction, are appropriate.
Hwarinseo 活人
Translation영역
In a cold-damage heat illness where yang brightness is replete within and hiccup breaks out because precipitation was omitted, Regulate the Stomach Qi-Coordinating Decoction and Major Bupleurum Decoction are appropriate.
Yi Lao 易老
Translation영역
In hiccup the fire heat rushes urgently upward and the lung's yin does not take it in — how fitting it is. So where the stool is bound, precipitate with Major Qi-Coordinating Decoction; where the stool is soft, Drain the Heart Decoction governs itall four formulas are given in the Cold chapter ○ Yi Lao
Yi Lao 易老
Source원문
又有雜病咳逆五條, 詳見于下.
Translation영역
There are also five cases of hiccup in miscellaneous illnesses, treated in full below.
Donguibogam · Haesu
3.22.1 Hiccup After Dysentery 痢後咳逆
Source원문
痢後咳逆, 以人參ㆍ白朮煎湯, 調益元散方見暑門頻服自止.
Translation영역
For hiccup after dysentery, decoct ginseng and white atractylodes and stir Benefit the Origin Powderthe formula is given in the Summerheat chapter into it, taken often, and it stops of itself.
Immun 入門
Source원문
胃氣不足ㆍ不能接續而噦作者, 宜補中益氣湯方見內傷加竹茹ㆍ生薑ㆍ炮附子一片煎服.
Translation영역
Where the stomach qi is insufficient and cannot be carried on and hiccup arises, Supplement the Centre and Boost the Qi Decoctionthe formula is given in the Inward Damage chapter with bamboo shavings, fresh ginger and one slice of blast-fried aconite added, decocted and taken, is appropriate.
Immun 入門
Source원문
氣從臍下逆上ㆍ夜分轉甚者, 四物湯加黃栢ㆍ知母ㆍ陳皮ㆍ竹茹ㆍ生薑. 《入門》
Translation영역
Where the qi rises in counterflow from below the navel and is worse in the night hours, Four Substances Decoction with phellodendron, anemarrhena, tangerine peel, bamboo shavings and fresh ginger added.
Immun 入門
Translation영역
Hiccup mostly breaks out after dysentery, because the central qi is severely vacuous. Supplement the Centre and Boost the Qi Decoction and Regulate the Centre and Boost the Qi Decoctionthe formulas are given in the Inward Damage chapter used freely are very good.
Clinical note임상 주석
Hiccup after dysentery, attributed to the depletion the dysentery caused. A patient who has lost a great deal of fluid and salt and then hiccups intractably is one a modern clinic would check for electrolyte derangement and for uraemia, which is the commonest cause of persistent hiccup in a depleted patient.
Immun 入門
3.22.2 Hiccup from Food Blocking 食塞咳逆
Translation영역
Where food and drink have filled and stopped up the chest, or too much has been eaten, so that it is blocked and will not go down and hiccup breaks out, Two Matured Ingredients Decoction with bitter orange peel, cardamom and perilla leaf added, or Three Aromatics Powder, is appropriate.
Immun 入門
Source원문
帝曰, 人之噦者何氣使然. 歧伯曰, 穀入于胃, 胃氣上注于肺. 今有故寒氣與新穀氣俱還入于胃, 新故相亂, 眞邪相攻, 氣幷相逆, 復出于胃, 故爲噦. 《靈樞》
Translation영역
The Emperor said: what qi brings about a person's hiccup? Gibaek said: grain enters the stomach and the stomach qi pours up into the lung. Now when an old cold qi and the new grain qi both return into the stomach, the new and the old throw each other into disorder, the true and the evil attack each other, the qi merges and runs counter, and comes out of the stomach again — and so there is hiccup.
Yeongchu 靈樞
Source원문
宜服藥, 且取嚏以通之. 《入門》
Translation영역
Medicine should be taken, and a sneeze induced besides to open it through.
Immun 入門
3.22.3 Hiccup from Phlegm Shutting In 痰閉咳逆
Source원문
痰閉於上ㆍ火動於下, 無別證, 忽然發噦從胸中起者, 宜用二陳湯加芩ㆍ連ㆍ桔梗ㆍ梔子薑汁炒煎服, 或人參蘆煎湯服而吐之則愈. 盖參蘆瀉肺, 肺衰氣降而火土復位矣. 《入門》
Translation영역
Where phlegm is shut in above and fire stirs below, with no other pattern, and hiccup suddenly breaks out rising from the chest, Two Matured Ingredients Decoction with scutellaria, coptis, platycodon and gardenia dry-fried in ginger juice added, decocted and taken, is appropriate; or a decoction of ginseng rootlet taken to make the patient vomit cures it. For ginseng rootlet drains the lung, and the lung waning, the qi descends and fire and earth return to their places.
Clinical note임상 주석
人參蘆, the rootlet of the ginseng, used as an emetic — the same drug as the body of the root but with the opposite action, which the Bogam notes elsewhere as well. Giving it to induce vomiting for an intractable hiccup is a counter-stimulation of the same kind as the sneeze of 3.21.
Immun 入門
Source원문
痰挾氣虛發噦, 宜六君子湯方見痰門○正傳
Translation영역
Where phlegm together with qi vacuity brings on hiccup, Six Gentlemen Decoctionthe formula is given in the Phlegm chapter ○ Jeongjeon is appropriate
Jeongjeon 正傳
3.22.4 Hiccup from Water Binding 水結咳逆
Source원문
胃中虛冷ㆍ不能食者, 飮水則噦. 《仲景》
Translation영역
Where the stomach is vacuous and cold and the patient cannot eat, drinking water brings on hiccup.
Junggyeong 仲景
Translation영역
Or where too much water has been drunk and become water bound in the chest so that hiccup breaks out, Minor Sinking into the Chest Decoction is appropriate, or Minor Blue Dragon Decoction with the ephedra removed and blast-fried aconite added, decocted and takenboth formulas are given in the Cold chapter ○ Jeongjeon
Jeongjeon 正傳
Source원문
飮水過多而吃逆者, 別無惡候, 五苓散主之方見寒門○綱目
Translation영역
Where hiccup comes of drinking too much water and there is no other bad sign, Five Ingredient Powder with Poria governs itthe formula is given in the Cold chapter ○ Gangmok
Gangmok 綱目
3.22.5 Hiccup from Too Much Laughter 過笑咳逆
Source원문
笑噦ㆍ食噦, 皆屬有餘之證, 以紙撚探鼻取嚏, 或久閉氣可止. 《綱目》
Translation영역
The hiccup of laughter and the hiccup of eating both belong to the pattern of surplus; probing the nose with a twist of paper to induce a sneeze, or holding the breath a long while, can stop them.
Clinical note임상 주석
The two harmless hiccups, named and dismissed in one line, with the two remedies that work: a sneeze or a long breath-hold. Both raise the intrathoracic pressure and interrupt the reflex arc, and the chapter's placing of them among the surplus patterns — the kind that need no medicine — is the right judgment.
Gangmok 綱目
3.23 Signs of Hiccup Easy and Hard to Treat 咳逆易治難治證
Source원문
噦聲頻密相連者爲實, 可治. 若半時噦一聲者爲虛, 難治, 多死, 死在朝夕.
Translation영역
Where the sound of the hiccup comes thick and fast, one upon another, it is repletion and can be treated. But where there is one hiccup in half an hour, it is vacuity, hard to treat, and most such patients die, and die within a day.
Clinical note임상 주석
The paradox is deliberate and worth keeping: the loud frequent hiccup is the treatable one and the slow solitary hiccup the fatal one. What is being read is how much strength the patient has left, not how troublesome the symptom is — and a single hiccup every half hour in a dying patient is a description anyone who has sat at such a bedside will recognize.
Gangmok 綱目
Source원문
咳逆至七八聲相連ㆍ收氣不回者難治. 《綱目》
Translation영역
Hiccup running to seven or eight sounds together, so that the breath cannot be gathered back, is hard to treat.
Gangmok 綱目
3.24 The Method of Inducing a Sneeze 取嚏法
Source원문
一人患傷寒將愈, 忽患咳逆, 百藥無效, 遂用皂角末吹鼻, 得嚏而止. 少時又吃, 又吹又止, 凡百餘次, 自是漸疏, 二三日而止. 此合靈樞草汗鼻嚏之法同. 《綱目》
Translation영역
A man ill of cold damage and nearly recovered was suddenly taken with hiccup, and a hundred medicines had no effect; so soapberry powder was blown into his nose and a sneeze stopped it. In a little while the hiccup came again, and again it was blown in and again it stopped, more than a hundred times in all; from then on they grew farther apart, and in two or three days it ended. This agrees with the Yeongchu's method of pricking the nose with a blade of grass to make a sneeze.
Clinical note임상 주석
A case report of a hundred sneezes, and it is honest about the limits of the remedy: each sneeze stopped the hiccup and the hiccup came back, and what cured the patient in the end was time. Intractable hiccup after an acute illness, resolving over two or three days, is exactly how it behaves.
Gangmok 綱目
3.25 The Method of Inhaling 齅法
Source원문
咳逆久不止, 服藥無效, 宜用齅法ㆍ灸法治之. 《活人》
Translation영역
Where hiccup has gone on long and medicines taken have had no effect, it should be treated by the method of inhaling and by moxibustion.
Hwarinseo 活人
3.25.1 Inhaling Sulphur 硫黃齅法
Source원문
硫黃ㆍ乳香 各二錢, 以酒煎之, 急令患人當鼻下嗅其氣. 《活人》
Translation영역
Sulphur and frankincense, 2 don each, decocted in wine; quickly hold it under the patient's nose and have him smell the fumes.
Clinical note임상 주석
**Sulphur fumes are irritant and the vapour of burning or heated sulphur is sulphur dioxide, which provokes bronchospasm. This must not be prepared, and least of all for a patient with a respiratory illness.**
Hwarinseo 活人
3.25.2 Inhaling Realgar 雄黃齅法
Source원문
雄黃 二錢ㆍ酒 一盞, 煎至七分, 急令患人嗅其熱氣卽止. 《活人》
Translation영역
Realgar, 2 don, with a cup of wine, decocted down to seven tenths; quickly have the patient smell the hot vapour and it stops.
Clinical note임상 주석
**Realgar is an arsenic sulfide and heating it releases arsenic. This must not be prepared.**
Hwarinseo 活人
3.25.3 Another Method 一方
Source원문
治咳逆久不止. 將乳香紙捲作筒, 燒烟熏鼻中吸之. 《回春》
Translation영역
To treat hiccup that has long not stopped: roll frankincense in paper to make a tube, burn it, and have the patient draw the smoke into the nose.
Clinical note임상 주석
The one of the three inhalations that is merely aromatic smoke. Of the methods in 3.24 and 3.25 the sneeze is the one to keep; irritating the nasal mucosa does interrupt the hiccup reflex, which is why a twist of paper and a pinch of pepper have outlasted the sulphur and the arsenic.
Hoechun 回春
3.26 What Is Forbidden 禁忌法
Source원문
凡火嗽, 忌用人參ㆍ半夏ㆍ陳皮等燥藥. 《入門》
Translation영역
In any fire cough, the drying drugs — ginseng, pinellia, tangerine peel and the like — are to be avoided.
Immun 入門
Source원문
凡氣嗽, 忌用鸎粟殼ㆍ肉豆蔲等澁藥. 《入門》
Translation영역
In any qi cough, the astringent drugs — poppy husk, nutmeg and the like — are to be avoided.
Immun 入門
Source원문
凡咳嗽口乾咽燥有痰者, 不可用南星ㆍ半夏, 宜用瓜蔞仁ㆍ貝母. 若飮水者, 又不宜瓜蔞, 恐泥膈不鬆快耳. 《丹心》
Translation영역
In any cough with a dry mouth and parched throat and with phlegm, arisaema and pinellia must not be used, and trichosanthes seed and fritillary should be used instead. But if the patient is drinking water, trichosanthes is also unsuitable, for fear of its clogging the diaphragm and leaving no ease.
Clinical note임상 주석
Three contraindications, and all three turn on the same principle: do not dry a patient who is already dry. A hacking cough with a parched throat is made worse by pinellia and arisaema, which is why the chapter's dry-cough formulas use fritillary and trichosanthes instead; and the qualification that trichosanthes too is wrong for a patient drinking water shows the rule being applied twice over.
The caution against poppy husk in a qi cough is worth noting for its reason: an astringent that suppresses the cough leaves the qi stopped up. **Poppy husk is an opium preparation and a controlled substance; cough suppressants of that class are now restricted for the same clinical reason the Immun gives.**
Dansim 丹心
3.27 Signs in Cough, Panting and Hiccup That Cannot Be Treated 嗽喘咳逆不治證
Source원문
咳而羸瘦, 脉堅大者死.
Translation영역
A cough with emaciation and a hard large pulse means death.
Yeongchu 靈樞
Source원문
咳而脫形ㆍ發熱ㆍ脉小堅急者死. 《靈樞》
Translation영역
A cough with the body stripped away, fever, and a pulse small, hard and urgent means death.
Clinical note임상 주석
Cough with wasting and fever: the pairing is tuberculosis, and the Bogam's own name for the condition, 勞嗽, stands at 3.6 among the fifteen coughs. **Chronic cough with weight loss and fever requires investigation for tuberculosis and for malignancy.**
Yeongchu 靈樞
Source원문
凡咳喘至肺脹, 有咽瘡ㆍ失音者必死. 《入門》
Translation영역
In any cough and panting that has reached lung distension, where there are sores in the throat and loss of voice, the patient must die.
Immun 入門
Source원문
脉數有熱ㆍ喘咳ㆍ吐血ㆍ上氣不得卧者死.
Translation영역
A rapid pulse with heat, panting and cough, the spitting of blood, and qi rising so that the patient cannot lie down, means death.
Jeongjeon 正傳
Source원문
上氣ㆍ面浮腫ㆍ肩息ㆍ脉浮大, 不治. 又加脹尤甚. 《正傳》
Translation영역
Qi rising, a puffy swollen face, the shoulders heaving with the breath, and a floating large pulse: not to be treated; and if distension is added besides, worse still.
Clinical note임상 주석
Orthopnoea, facial oedema and accessory-muscle breathing, with abdominal distension making it worse: that is cor pulmonale, right heart failure following chronic lung disease, and it is the end state of the 肺脹 of 3.18. **A patient who cannot lie flat for breathlessness needs urgent assessment.**
Jeongjeon 正傳
Source원문
咳嗽肺脹ㆍ鬱遏不得眠者難治. 《丹心》
Translation영역
Cough with lung distension, pent up and oppressed so that the patient cannot sleep, is hard to treat.
Dansim 丹心
Source원문
凡喘煩燥ㆍ無脉ㆍ身冷ㆍ神昏者死. 《仲景》
Translation영역
In any panting with agitation, no pulse, a cold body and clouded spirit, the patient dies.
Junggyeong 仲景
Source원문
髮汗如油ㆍ干出如珠不流ㆍ擡肩擷肚ㆍ喘而不休.
Translation영역
Sweat on the hair like oil, standing out in beads that do not run, the shoulders lifted and the belly drawn in, and panting that does not let up.
Immun 入門
Source원문
胸前高起ㆍ手足厥冷ㆍ脉散及數者, 皆死. 《入門》
Translation영역
A chest raised high in front, hands and feet cold in reversal, and a pulse scattered or rapid: all mean death.
Clinical note임상 주석
胸前高起 — the chest raised high in front — is the barrel chest of advanced emphysema, and with it the beaded sweat that does not run, the lifted shoulders and the indrawn belly. Taken together these four passages are a clinical description of a patient dying of respiratory failure, set down with no theory attached at all.
Immun 入門
Source원문
汗出髮潤ㆍ喘者爲肺絶.
Translation영역
Sweating with the hair damp, and panting, is the lung cut off.
Immun 入門
Source원문
身汗如油ㆍ喘者爲命絶.
Translation영역
The body sweating like oil, and panting, is life cut off.
Immun 入門
Source원문
直視ㆍ譫語ㆍ喘滿者不治.
Translation영역
A fixed stare, delirious speech and panting fullness: not to be treated.
Immun 入門
Source원문
諸有篤病, 正氣欲絶之時, 邪氣盛行, 多壅逆而爲喘. 然則喘之危惡, 又安可以尋常目之. 《直指》
Translation영역
In any grave illness, when the true qi is at the point of being cut off, the evil qi travels in force and mostly dams up and runs counter, making panting. So the peril and malignity of panting is not to be looked at as an ordinary thing.
Clinical note임상 주석
The section's summing-up, and it is the right one: breathlessness at the end of any serious illness is not a respiratory symptom but the body failing, and 安可以尋常目之 — it is not to be looked at as an ordinary thing — is as good a statement of that as the literature offers.
Jikji 直指
Source원문
久嗽不止成勞, 或聲啞, 或喉生瘡者不治. 《回春》
Translation영역
A long cough that will not stop and has become taxation, with a hoarse voice or sores in the throat: not to be treated.
Hoechun 回春
Source원문
凡咳逆小便閉澁, 或腹滿者不治. 脉見沉微散者死. 《仲景》
Translation영역
In any hiccup with urine shut and sluggish, or with a full abdomen, the case is not to be treated; and where the pulse is found sunken, faint and scattered, the patient dies.
Clinical note임상 주석
Hiccup with oliguria and abdominal distension: in modern terms uraemia, and intractable hiccup is one of its classic features. The chapter has arrived at the association by observation, and its judgment of the prognosis was correct before dialysis.
Junggyeong 仲景
Source원문
瀉痢後咳逆, 及傷寒結胸ㆍ發黃而咳逆, 俱難治. 《回春》
Translation영역
Hiccup after diarrhoea and dysentery, and hiccup with chest binding or jaundice in cold damage, are both hard to treat.
Hoechun 回春
Source원문
傷寒及久病得咳逆, 俱爲惡候. 服藥不效則宜灸之, 必差. 灸而不差, 則必不救矣. 《資生》
Translation영역
Hiccup coming on in cold damage or in a long illness is in both cases a bad sign. Where medicines taken have no effect, moxa should be given and it will certainly mend; and if moxa does not mend it, the patient will certainly not be saved.
Jasaeng 資生
3.28 Simple Medicinals 單方
Source원문
凡二十三種. 有人參胡桃湯ㆍ參桃湯.
Translation영역
Twenty-three kinds in all. There are Ginseng and Walnut Decoction and Ginseng and Peach Decoction.
Donguibogam · Haesu
Source원문
人參 主肺虛氣短ㆍ氣促ㆍ咳嗽喘急. 人參膏方見氣門ㆍ獨參湯方見上皆有奇效. 《丹心》 ○治氣虛喘. 人參 一寸ㆍ胡桃 二箇(去殼不去皮). 右剉, 入薑五, 水煎服, 名人參胡桃湯, 一名參桃湯. 盖人參定喘, 帶皮胡桃歛肺也. 《直指》 ○肺虛合用人參. 如初感風寒邪盛, 及久嗽鬱熱, 不可用, 反增喘滿嗽劇, 宜以沙參或玄參代之. 《丹心》
Translation영역
Ginseng (人參): Governs lung vacuity with short breath, hurried breath, cough and urgent panting. Ginseng Pastethe formula is given in the Qi chapter and Ginseng Alone Decoctionthe formula is given above are both wonderfully effective. ○ Treats panting from qi vacuity: ginseng, one inch, and two walnuts with the shells removed but not the skins; cut them up, add five slices of ginger and decoct in water. It is called Ginseng and Walnut Decoction, and also Ginseng and Peach Decoction. For ginseng settles the panting and walnut with its skin astringes the lung. ○ Ginseng is for the vacuous lung. In a newly contracted wind cold with the evil in force, and in a long cough with depressed heat, it must not be used, for it increases the panting and fullness and makes the cough violent; sand root or scrophularia should be used instead.
Clinical note임상 주석
The entry is three things at once: the indication, a two-drug formula, and a contraindication. The last is the most useful — ginseng is wrong in an acute cold and wrong in a long cough with trapped heat, and the substitutes offered, 沙參 and 玄參, are both cooling. 反增喘滿嗽劇, it increases the panting and makes the cough violent, is a description of a mistake made often enough to be worth recording.
帶皮胡桃歛肺 — walnut with its skin astringes the lung — is why the shell is removed and the thin brown skin left on; the astringency is in the skin.
Dansim 丹心
Source원문
五味子 主咳嗽上氣ㆍ身熱. ○五味收肺氣, 乃火熱必用之藥. 《東垣》 ○人參ㆍ五味子ㆍ麥門冬治肺虛自汗, 或少氣而喘, 盖聖藥也. 《綱目》 ○久嗽必用五味子, 東垣之法. 然驟用之, 恐閉住其邪, 必先發散之, 或兼用可也. 《丹心》
Translation영역
Schisandra (五味子): Governs cough with qi rising and a hot body. ○ Schisandra gathers the lung qi in, and is a drug that must be used where there is fire heat. ○ Ginseng, schisandra and ophiopogon treat lung vacuity with spontaneous sweating, or scant breath with panting, and they are sage medicines. ○ That a long cough must be treated with schisandra is Dongwon's rule. But to use it suddenly may shut the evil in; it must first be dispersed outward, or the two may be used together.
Clinical note임상 주석
The three drugs named here — ginseng, schisandra and ophiopogon — are Saengmaek-san, and the indication given for them is exact: lung vacuity with spontaneous sweating or breathlessness on little exertion.
恐閉住其邪 — it may shut the evil in — is the caution that governs every astringent in the chapter, and 3.26 makes it a formal prohibition. Stopping a productive cough before the infection has cleared is a real error, and the tradition's way of putting it is this.
Dansim 丹心
Source원문
生薑 主咳嗽上氣. ○生與乾並治嗽. 《本草》 ○治嗽多用生薑, 以其辛能發散也. 《正傳》 ○咳嗽喘急, 生薑 一升半ㆍ砂糖 五兩, 同煎減半, 常服之. 《千金》 ○久患咳逆, 生薑汁 半合ㆍ蜜 一匙, 煎令熟, 溫分三服. 《本草》
Translation영역
Fresh ginger (生薑): Governs cough with qi rising. ○ Both the fresh and the dried treat cough. ○ Ginger is much used in treating cough because its acridity can disperse outward. ○ For cough with urgent panting: fresh ginger, 1 seung 5 hop, and sugar, 5 nyang, decocted together down to half, and taken regularly. ○ For long-standing hiccup: half a hop of ginger juice and a spoonful of honey, decocted until done and taken warm in three doses.
Boncho 本草
Source원문
瓜蔞實 治痰嗽, 利胸膈. 取實肥大者, 割開取子净洗, 槌破瓜細切焙乾ㆍ半夏 四十九枚(湯洗十遍, 切焙)爲末, 用洗瓜蔞水幷子瓤同熬成膏, 硏細爲丸梧子大, 薑湯下二十丸. 《本草》 ○瓜蔞子甘能補肺ㆍ潤能降氣, 宜爲治嗽要藥也. 《丹心》
Translation영역
Trichosanthes fruit (瓜蔞實): Treats phlegm cough and disinhibits the chest and diaphragm. Take a large plump fruit, cut it open and take out the seeds and wash them clean; crush the fruit, cut it fine and bake it dry, and with it forty-nine pinellia tubers washed ten times in hot water, sliced and baked, powder them; boil the water the fruit was washed in together with the seeds and pulp down to a paste, grind it fine and make pills the size of a paulownia seed, and give twenty down with ginger decoction. ○ Trichosanthes seed, being sweet, can supplement the lung, and being moistening can bring the qi down; it is rightly an essential drug for treating cough.
Boncho 本草
Source원문
半夏 治痰嗽上氣, 及形寒飮冷傷肺而咳. 半夏(製)ㆍ生薑(切) 各半兩, 煎服卽效. 《易老》
Translation영역
Pinellia (半夏): Treats phlegm cough with qi rising, and the cough of a chilled body and cold drink injuring the lung. Processed pinellia and sliced fresh ginger, half a nyang each, decocted and taken; it works at once.
Clinical note임상 주석
**Pinellia is toxic in the raw state and must be properly processed.** The pairing with an equal weight of ginger is the standard corrective, and the two together are Sobanha-tang, as in the Vomiting chapter's 單方.
Yi Lao 易老
Source원문
葶藶子 主肺氣壅ㆍ上氣喘促, 或面浮. 取子炒黃色爲末 二錢, 棗湯調下. 《得效》
Translation영역
Lepidium seed (葶藶子): Governs the lung qi blocked, qi rising with hurried panting, or a puffy face. Dry-fry the seed to a yellow colour, powder it, and give 2 don stirred into a jujube decoction.
Clinical note임상 주석
Lepidium with jujube is Jeongryeok-daejo-sapye-tang in miniature, and the indication given — breathlessness with a puffy face — is the fluid-overload picture 3.18's 肺脹 describes. The drug is a strong diuretic and the jujube is there to protect the stomach from it, which is the same reasoning as in the full formula.
Deukhyo 得效
Source원문
苧麻根 治哮喘. 取根和砂糖爛煮, 時時細嚼嚥下, 永絶病根, 神效. 《正傳》
Translation영역
Ramie root (苧麻根): Treats wheezing panting. Take the root, boil it soft with sugar, and let the patient chew and swallow a little from time to time; it cuts the root of the illness for good, with wonderful effect.
Jeongjeon 正傳
Source원문
馬兠鈴 主咳嗽喘促ㆍ氣急ㆍ坐息不得. 兠鈴 二兩(去殼, 只取裏面子, 童便拌炒)ㆍ甘草(灸) 一兩. 右爲末, 每一錢水煎溫呷, 或含末嚥汁亦得. 《本草》 ○馬兠鈴去肺熱ㆍ補肺也. 《正傳》
Translation영역
Birthwort (馬兠鈴): Governs cough with hurried panting, urgent breath, and inability to sit or breathe. Birthwort, 2 nyang, husked, only the inner seeds taken, mixed with a boy's urine and dry-fried; honey-roasted licorice, 1 nyang. Powder them and give 1 don at a time decocted in water and sipped warm, or the powder may be held in the mouth and the juice swallowed. ○ Birthwort dispels lung heat and supplements the lung.
Clinical note임상 주석
**Birthwort is an aristolochia and must not be used. Aristolochic acid causes irreversible kidney failure and cancer of the urinary tract; the outbreak of end-stage kidney disease it produced in Belgium in the 1990s, and the much larger one in Taiwan, came from preparations exactly like this one. Products containing it are banned in Korea and in most other countries.**
It appears throughout this chapter — in 3.12's drug list, in 馬兠鈴丸, 杏膠飮, 兠鈴丸 and 雞鳴丸 — and every one of those entries carries the same warning. Of everything in the Bogam this is the item a modern reader most needs to know about, because the drug was in common use until very recently.
Boncho 本草
Source원문
桑白皮 治肺氣喘滿ㆍ咳嗽, 或吐血. 桑皮 四兩(泔浸三宿, 剉細)ㆍ糯米 一兩(焙乾). 右同爲末, 米飮調下一二錢. 《本草》 ○桑白皮瀉肺氣, 然性不純良, 用之多者當戒, 盖以出土者有毒故也. 《丹心》
Translation영역
Mulberry root bark (桑白皮): Treats lung qi with panting fullness and cough, or the spitting of blood. Mulberry root bark, 4 nyang, steeped three nights in rice-washing water and cut fine; glutinous rice, 1 nyang, baked dry. Powder them together and give 1 or 2 don stirred into rice water. ○ Mulberry root bark drains the lung qi, but its nature is not wholly good, and one who uses much of it should be warned, since the part that has come out of the ground is poisonous.
Clinical note임상 주석
出土者有毒 — the part that has come out of the ground is poisonous — is a real pharmacognostic instruction and not a superstition: the root bark is prepared from the portion below ground, and the aerial root is discarded. The caution against using much of it stands alongside the chapter's free use of it in the draining formulas.
Boncho 本草
Source원문
皂莢 主咳嗽上氣ㆍ唾濁ㆍ坐不得卧. 酥灸爲末, 蜜丸梧子大, 棗湯呑下三丸, 日三. 《湯液》
Translation영역
Soapberry (皂莢): Governs cough with qi rising, turbid spittle, and sitting unable to lie down. Roast it with butter, powder it, make honey pills the size of a paulownia seed, and swallow three down with jujube decoction, three times a day.
Tangaek 湯液
Source원문
鯉魚肉 主咳嗽. 燒爲灰, 糯米飮調下一二錢, 或取肉作膾, 以薑醋食之亦佳. 《本草》
Translation영역
Carp flesh (鯉魚肉): Governs cough. Burn it to an ash and give 1 or 2 don stirred into glutinous rice water; or take the flesh as a raw salad eaten with ginger and vinegar, which is also good.
Boncho 本草
Source원문
橘皮 治咳嗽上氣. 橘紅 四兩ㆍ甘草(灸) 一兩, 爲末, 每二錢白湯點服, 日三. ○又治吃逆. 橘皮 一兩, 濃煎, 乘熱頓服. 《本草》
Translation영역
Tangerine peel (橘皮): Treats cough with qi rising. Red tangerine peel, 4 nyang, and honey-roasted licorice, 1 nyang, powdered; 2 don each time dripped into plain hot water, three times a day. ○ It also treats hiccup: tangerine peel, 1 nyang, decocted strong and taken hot all at once.
Boncho 本草
Source원문
胡桃 治痰喘, 能歛肺. 取胡桃 三箇(去殼不去皮), 與生薑 三片, 臨卧細嚼, 以溫湯呷下. 《得效》
Translation영역
Walnut (胡桃): Treats phlegm panting and can astringe the lung. Take three walnuts with the shells removed but not the skins, and three slices of fresh ginger; chew them small at bedtime and wash them down with warm water.
Deukhyo 得效
Source원문
杏仁 主咳嗽上氣ㆍ喘促及哮嗽. 杏仁 一兩(去皮尖, 童便浸半月, 每日一換尿), 取出硏取, 每服一棗子大, 薄荷葉ㆍ蜜水少許, 煎服二劑永差. 《綱目》 ○又治老人久喘嗽. 杏仁ㆍ胡桃仁等分, 蜜丸彈子大, 薑湯嚼下. 《回春》 ○杏仁散肺氣風熱, 然性實, 有熱因於寒者爲宜. 《丹心》 ○童便浸杏仁, 取其利肺氣ㆍ潤劑也. 《綱目》
Translation영역
Apricot kernel (杏仁): Governs cough with qi rising, hurried panting and wheezing cough. Apricot kernel, 1 nyang, with the skin and tip removed, steeped half a month in a boy's urine with the urine changed daily; take it out and grind it, and give a jujube-sized portion each dose with mint leaf and a little honey water, decocted — two courses and it is cured for good. ○ It also treats long-standing panting cough in the old: apricot kernel and walnut kernel in equal parts, honey pills the size of a bullet, chewed down with ginger decoction. ○ Apricot kernel disperses lung qi and wind heat, but its nature is solid, and it suits a heat that has come of cold. ○ Steeping apricot kernel in a boy's urine is to take it as a drug that disinhibits the lung qi and moistens.
Clinical note임상 주석
Apricot kernel is the chapter's most used drug after pinellia, and the skin and tip are removed in every formula — the instruction is universal because the tip and skin carry the most amygdalin, which releases cyanide. **Apricot kernels contain cyanogenic glycosides and are poisonous in quantity; the processing in these recipes reduces but does not remove the risk.**
Gangmok 綱目
Source원문
梨 主熱嗽. ○卒咳嗽, 梨一顆, 剌作五十孔, 每孔納胡椒一粒, 麪裹煨熟, 停冷去椒食之. 《本草》 ○咳嗽胸痞, 取雪梨去心, 納蜜蒸熟, 停冷食之. 《入門》
Translation영역
Pear (梨): Governs hot cough. ○ For a sudden cough: take one pear, prick fifty holes in it, put a peppercorn in each hole, wrap it in dough and bake it in the ashes until done, let it cool, remove the peppercorns and eat it. ○ For cough with a stuffed chest: take a snow pear, remove the core, fill it with honey, steam it until done, let it cool and eat it.
Clinical note임상 주석
A pear cored and steamed with honey is still made in Korean households for a dry cough, and it is the one remedy in the chapter that needs no defending: it is warm, sweet, moist and soothing, and the mechanism — coating a dry irritated throat — is the same as a modern linctus.
Immun 入門
Source원문
紫蘇子 治肺氣喘急咳嗽. 蘇子水擣取汁, 和粳米煮粥食之, 和杏仁汁尤佳. 《本草》
Translation영역
Perilla seed (紫蘇子): Treats lung qi with urgent panting and cough. Pound the perilla seed with water, strain the juice, boil it with rice into a gruel and eat it; mixing in apricot kernel juice is better still.
Boncho 本草
Source원문
鸎粟殼 歛肺止咳喘, 然乃收功後藥也, 不可驟用. 《醫鑑》 ○穀氣素壯人久嗽卽效. 粟殼蜜炒爲末, 每一錢, 蜜湯調下. 《得效》
Translation영역
Poppy husk (鸎粟殼): Astringes the lung and stops cough and panting; but it is a medicine for gathering in the gains at the end, and must not be used suddenly. ○ In a person of naturally strong grain qi with a long cough it works at once: poppy husk dry-fried with honey and powdered, 1 don each time stirred into honey water.
Clinical note임상 주석
**Poppy husk is an opium preparation and a controlled substance.** The warnings around it are the Bogam's own: 不可驟用, not to be used suddenly, 3.26's prohibition of it in a qi cough, and the phrase 收功後藥 — a medicine for gathering in the gains at the end — which is as clear a statement as one could want that the drug suppresses the symptom and does not treat the illness. Codeine and its relatives are restricted today on precisely that reasoning.
Deukhyo 得效
Source원문
雞子 治哮喘. 取十箇, 略敲損殼, 不得損膜, 浸尿缸內, 經三日, 臨夜暫煮食之, 連日服. 盖能去風痰故也. 《丹心》
Translation영역
Hen's egg (雞子): Treats wheezing panting. Take ten eggs and tap them so that the shell is cracked but the membrane not broken; steep them in a urine vat for three days, boil them briefly at nightfall and eat them, and take them day after day. For they are able to dispel wind phlegm.
Clinical note임상 주석
**Not to be prepared.** Eggs with cracked shells steeped three days in a urine vat are a culture medium; the membrane is no barrier to bacteria.
Dansim 丹心
Source원문
猪肺 治咳嗽喘急ㆍ肺痿吐血. 猪肺 一箇, 洗去血水, 若病人每歲用杏仁 一箇(去皮尖), 將肺以竹簽穿眼, 每眼入杏仁一箇, 麻扎, 重湯煮熟, 去杏仁, 只吃肺卽效. 《回春》 ○上氣咳嗽ㆍ身熱口乾, 猪肪膏 一斤切碎, 煮熟, 入鹽豉調和食之. 《入門》
Translation영역
Pig's lung (猪肺): Treats cough with urgent panting, and wilting lung with the spitting of blood. Take one pig's lung and wash the blood out of it; use one apricot kernel, skinned and detipped, for each year of the patient's age; pierce holes in the lung with a bamboo skewer, put one kernel in each hole, tie it up with hemp, cook it in a double boiler until done, remove the kernels and have the patient eat the lung alone; it works. ○ For qi rising with cough, a hot body and dry mouth: pig's fat, 1 geun, cut small, boiled until done, seasoned with salt and fermented beans and eaten.
Clinical note임상 주석
One apricot kernel for each year of the patient's age, set into a pig's lung — the dose is by age, which is unusual in the Bogam, and a sixty-year-old would receive sixty kernels. **That is a dangerous quantity of amygdalin, and the preparation is not to be made.** Like treating like, lung for lung, is the thinking behind the vehicle.
Immun 入門
Source원문
阿膠 治肺虛損極ㆍ咳嗽ㆍ唾膿血, 非阿膠不補. ○喘甚須用阿膠. 《湯液》 ○阿膠炒爲末, 米飮調服, 止喘. 《本草》
Translation영역
Ass-hide glue (阿膠): Treats lung vacuity damaged to the utmost, with cough and the spitting of pus and blood; nothing but ass-hide glue will supplement it. ○ Where the panting is severe, ass-hide glue must be used. ○ Ass-hide glue dry-fried and powdered, given stirred into rice water, stops panting.
Boncho 本草
Source원문
猯肉 主上氣咳嗽. 灸爲末, 每二錢溫酒和服, 日二. ○肺痿上氣氣急, 猯脂 一合, 煖酒和服. 《本草》
Translation영역
Badger flesh (猯肉): Governs qi rising with cough. Roast it, powder it, and give 2 don each time in warm wine, twice a day. ○ For wilting lung with qi rising and urgent breath, a hop of badger fat taken in warmed wine.
Clinical note임상 주석
**Not to be prepared.** Badgers are a reservoir of tuberculosis and of rabies, and the patients this is offered to — wilting lung with the spitting of pus and blood — were in many cases tuberculous themselves.
Boncho 本草
Source원문
貓頭骨 治哮喘不得睡. 取頭骨燒爲灰, 溫酒調下二錢, 卽止. 《入門》
Translation영역
Cat's skull (貓頭骨): Treats wheezing panting with inability to sleep. Burn the skull to an ash and give 2 don stirred into warm wine; it stops at once.
Clinical note임상 주석
**Not to be prepared.** Calcined bone is lime and nothing more, and the material carries the infection risks of any cat tissue.
Immun 入門
Source원문
人尿 主咳喘ㆍ肺痿, 又止勞渴嗽. 取溫尿飮之, 童子尿尤好. 又主久嗽失音. 《本草》
Translation영역
Human urine (人尿): Governs cough and panting and wilting lung, and also stops the thirst and cough of taxation. Take it warm and drink it; a boy's urine is better still. It also governs loss of voice in a long cough.
Clinical note임상 주석
童便, a boy's urine, is used throughout the Bogam as a vehicle and a cooling drug, and here it is given on its own. **It is not to be taken internally**; the steroid and salt content the tradition was reaching for is negligible, and the infection risk is not.
Boncho 本草
3.29 Needling and Moxa Methods 鍼灸法
Source원문
咳嗽有痰, 宜灸天突ㆍ肺兪, 以泄火熱ㆍ瀉肺氣. 《丹心》
Translation영역
For cough with phlegm, moxa at cheondol and pyeyu is appropriate, to discharge the fire heat and drain the lung qi.
Dansim 丹心
Source원문
咳嗽上氣ㆍ多唾冷痰, 灸肺兪五十壯; 又灸兩乳下黑白肉際各百壯.
Translation영역
For cough with qi rising and much spitting of cold phlegm, fifty cones of moxa at pyeyu; also a hundred cones at the border of the dark and pale flesh below each nipple.
Deukhyo 得效
Source원문
咳嗽聲破喉嘶, 灸天突五十壯. 《得效》
Translation영역
For cough with a broken voice and a hoarse throat, fifty cones of moxa at cheondol.
Deukhyo 得效
Source원문
久患喘嗽ㆍ夜不得卧, 夏月亦衣裌溫背心, 是膏肓病也, 灸之而愈. 《資生》
Translation영역
Where a patient has long suffered panting cough and cannot lie down at night, and even in the summer months wears a lined coat to keep the back warm, this is a disease of gohwang, and moxa there cures it.
Clinical note임상 주석
The sign is a good one: a patient who keeps his back covered even in summer. Cold felt between the shoulder blades in chronic lung disease is a real complaint, and 膏肓, BL-43, lies exactly there — the point is named for the region and the region is where the patient points.
Jasaeng 資生
Source원문
久嗽, 宜灸膏肓, 次灸肺兪. 《資生》
Translation영역
For a long cough, moxa at gohwang is appropriate, and then at pyeyu.
Jasaeng 資生
Source원문
喘急, 灸肺兪十一壯ㆍ天突七壯. 《得效》
Translation영역
For urgent panting, eleven cones of moxa at pyeyu and seven at cheondol.
Deukhyo 得效
Source원문
傷寒咳甚, 灸天突卽差. 《資生》
Translation영역
For a severe cough in cold damage, moxa at cheondol brings relief at once.
Jasaeng 資生
Source원문
遠年咳嗽, 灸直骨穴卽愈. 如不愈, 其病不可治矣. 艾炷如小豆大, 灸三壯, 男左女右. 《醫鑑》
Translation영역
For a cough of many years, moxa at the jikgol point cures it at once; and if it does not cure it, the illness cannot be treated. The moxa cone is the size of a small bean, three cones, on the left in a man and the right in a woman.
Uigam 醫鑑
Source원문
哮喘, 灸肺兪; 又取天突ㆍ膻中ㆍ璇璣ㆍ腧府ㆍ乳根ㆍ氣海. 《資生》
Translation영역
For wheezing panting, moxa at pyeyu; also take cheondol, danjung, seongi, sububu, yugeun and gihae.
Jasaeng 資生
Source원문
喘滿痰實如膠, 取太谿.
Translation영역
For panting fullness with phlegm as thick as glue, take taegye.
Gangmok 綱目
Source원문
咳喘不得卧, 取雲門ㆍ太淵. 《綱目》
Translation영역
For cough and panting with inability to lie down, take unmun and taeyeon.
Gangmok 綱目
Source원문
咳嗽寒痰, 取列缺. 《綱目》
Translation영역
For cough with cold phlegm, take yeolgyeol.
Gangmok 綱目
Source원문
氣逆發噦, 取膻中ㆍ中脘ㆍ肺兪ㆍ三里ㆍ行間. 《綱目》
Translation영역
For qi counterflow breaking out as hiccup, take danjung, junggwan, pyeyu, samni and haenggan.
Gangmok 綱目
Source원문
吃逆服藥無效, 灸中脘ㆍ膻中ㆍ期門必效. 《綱目》
Translation영역
Where medicines taken for hiccup have no effect, moxa at junggwan, danjung and gimun is certain to work.
Gangmok 綱目
Source원문
吃逆, 灸關元七壯立愈. 《綱目》
Translation영역
For hiccup, seven cones of moxa at gwanwon cure it on the spot.
Gangmok 綱目
Source원문
又法, 乳下一指許, 正與乳相直骨間𨺻中, 婦人卽屈乳頭向下度之, 乳頭齊處是穴. 艾炷如小豆大, 灸三壯, 男左女右, 火到肌卽差. 一云, 其穴當取乳下骨間動脉處是也. 《得效》
Translation영역
Another method: about a finger's breadth below the nipple, straight below it, in the hollow between the ribs — in a woman, bend the nipple downward and measure, and where the nipple comes to is the point. The moxa cone is the size of a small bean, three cones, on the left in a man and the right in a woman, and as soon as the fire reaches the flesh there is relief. One account says the point is to be taken where the pulse beats between the ribs below the nipple.
Clinical note임상 주석
A point located by measurement from the nipple, with a separate instruction for women, and an alternative that locates it by a palpable pulsation between the ribs. This is 乳根, ST-18, and the care taken over finding it — two methods, one by measurement and one by palpation — is characteristic of the Bogam's acupuncture sections.
Deukhyo 得效
Source원문
咳逆不止, 灸乳根二穴卽止如神. 又灸臍下氣海五壯或七壯, 亦立止. 《正傳》
Translation영역
For hiccup that will not stop, moxa at the two yugeun points stops it at once, wonderfully. Also five or seven cones at gihae below the navel stop it on the spot.
Jeongjeon 正傳
Source원문
肺脹痰嗽不得卧, 但可一𨘢眠者, 可左側者灸右足三陰交, 可右側者灸左足三陰交, 立安. 《丹心》
Translation영역
In lung distension with phlegm cough and inability to lie down, where the patient can sleep only on one side: if he can lie on the left, moxa the right leg's sameumgyo; if on the right, the left leg's sameumgyo; and he settles at once.
Clinical note임상 주석
A patient who can lie on one side only, treated on the opposite leg. The observation itself is worth keeping: unilateral orthopnoea — being able to lie on one side and not the other — points to disease on one side of the chest, a pleural effusion or a consolidated lobe, and asking which side a breathless patient can lie on is still a useful question. The treatment given is SP-6 sameumgyo on the opposite side, which is the crossed needling the Bogam uses throughout.
Dansim 丹心
About this translation 凡例
Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 5, Cough chapter. The Chinese text is collated against the Kyujanggak transcription of the 1613 edition; collation notes are given on the passages they concern. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.