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龚士澄谈止咳第一方:止嗽散-

龚士澄谈止咳第一方:止嗽散

《医学心悟》中止嗽散,以荆芥、桔梗散风利咽,宣通肺气;以紫菀、百部微温润肺,消痰宁嗽;白前辛甘微寒,长于下气,祛壅塞之痰以止咳;陈皮、甘草快膈利气而和中。合能宣肺肃肺,治诸般咳嗽,不论新久。

程钟龄自云:“此方温润和平,不寒不热,既无攻击过当之虞,大有启门驱贼之势,是以容邪易散,肺气安宁,宜其投之有效欤。”揆其本意,乃通治外感咳嗽之方。若治“诸般咳嗽”,必随证损益。运用得法,效实优于它方。

1.风寒咳嗽,鼻塞身重,加苏叶、杏仁,寒束皮毛,恶风冷,咳而且喘者,则以麻黄代荆芥,增杏仁、苏子,兼哮再入射干。

2.痰饮咳嗽去荆芥,加桂枝平降冲逆,加白术健脾,以杜生痰之源,加茯苓益土而渗水饮。若呕,去桔梗之升提,入半夏降逆祛痰;痰盛喘满而咳,不用荆芥,合三子养亲汤效佳。

3.风热咳嗽,咽喉红肿,身热有汗,减百部、紫菀、荆芥,加牛子、蝉蜕、浙贝、银、翘;胸胁振痛,再加蒌皮、橘络;热甚加淡黄芩;若寒热往来加柴胡。

4.小儿百日咳,止嗽散少用荆芥,重用百部、白前,加牵牛子散结气,加赭石重坠镇吐,初起即服甚验;若咳剧衄血,则去荆芥,加郁金、桑白皮、海蛤売;亦可只用百部、白前,煎2次,计并一起再熬,化入水糖至不太苦为度,日夜频饮,患儿易于接受,疗效甚佳。

紫菀止咳化痰,王海藏紫菀汤治咳血证,伍以甘、桔、参、苓、阿胶、知母、贝母等;百部润肺,新久咳嗽均效,《日华诸家本草》谓其“治传尸骨蒸痨热”。紫菀、百部二味,系止嗽散主药,吾常合夏枯草之益阴血,生黄精之补脾润肺、已燥咳,用于肺痨久咳,得标本两顾之宜。

本文摘自《跛鳖斋医草》,龚士澄 著,安徽科学技术出版社出版。版权对原作者所有。


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