Ye Tianshi was a famous doctor in the Qing Dynasty. He studied under 17 doctors, including Zi Zi, Xu Shi Jin, Ma Yuan Yi, Zhou Yang Jun, Qi Zheng Ming, Zhang Lu Yu, Ke Yun Bo, Wei Li Tong, etc. He had a wide knowledge and made outstanding contributions to Chinese medicine by treating many diseases. At the end of the Qing Dynasty, Yuan Zhuo commented that “Tian Shi enjoyed the reputation of Yong and Qian, and was a learned man, with a keen mind, who had the long and short of all the great men of the Han, Tang, Song and Yuan dynasties, and was one of them after the Han, Tang, Song and Yuan dynasties” [2]. We have compiled and summarized the medical cases related to chronic cough (prolonged cough and coughing) in the Clinical Guide to Medical Cases, with a view to providing reference for modern treatment ideas and methods for chronic cough. Yang Xiaobing, Department of Oncology, Guangdong Provincial Hospital of Traditional Chinese Medicine 1.1 Treatment of chronic cough from the upper jiao lung 1.1 Clearing damp-heat – Qianjin Reed Stem Soup Chronic cough caused by damp-heat closing the lung is more common in the southern region of China, but the etiology and treatment of chronic cough caused by damp-heat have not been given much attention since ancient times. The damp-heat chronic cough manifested as “prolonged coughing”, “hoarseness and turbidity”, “large and slow right-stringed pulse”, and “thin shape and yellow eyes”. In this case, Ye’s treatment was to remove winter melon seeds and peach kernel from Qianjin Reed Stem Soup, and add Mabu, Zhe Fu Ling, Chuan Dou and Tong Cao. For damp-heat prolonged cough, Ye’s cloud said, “This is a case of moisture contained in the water and grain, plus the damp heat of the season, congestion and obstruction of the qi, which makes coughing impossible, and long enough to become a cough of phlegm and fire in old age.” The first step in treatment is to get rid of the dampness, and Ye says that “heat comes out of the dampness, so the dampness should be the basic treatment” and that “clearing the heat in vain should not be done” and that “if the dampness does not go, the heat will not be removed.” Ye emphasizes giving the evil a way out, so that The evil of dampness and heat reaches from the inside and outside or comes out from the two stools. As Hua Xiuyun commented in his “Clinical Guide to Medical Cases. Wet” commented after the “now look at Mr. treatment, if dampness blocking the upper jiao, with open lung qi, for light seepage, through the bladder, that is, open the upper gate, spending river, guide water heat down the reason also. In the case, Coix Seed, Tong Cao, Fu Ling, and Lugen, etc., which are conducive to urination and “infiltration of dampness under the heat”, are designed to remove dampness; Mabu clears the heat and throat, opening the upper jiao damp-heat occlusion; the combination of all drugs, water and dampness are transformed, “dampness goes to the heat alone”, and the cough subsides. 1.2 Clear the lung and penetrate There are often cases of coughs caused by external evil that persist for a long time in the body. In his discussion of volatile Qi, Ye said: “If the external evil is first affected and leads to volatile heat in the body, it must be pungent and cool to resolve the new evil, followed by bitter and cold to clear the heat in the body. In the case of long-standing coughs caused by “external cold and internal heat, with the lung and body suffering from the same disease”, Ye used the addition and subtraction of Mao Xing Shi Gan Tang to relieve superficial evil and clear internal heat. There are two cases in the “Clinical Guide to Medicine”: one is a case of “prolonged cough of volatile evil with stomach deficiency and vomiting, which is called “stomach cough” in the “Nei Jing”. The addition of Hanxia was intended to dry dampness and dissolve phlegm, harmonize the stomach and subdue rebellion, and stop vomiting. In another case, “coughing for 100 days, the pulse is large on the right side,” is a summer heat depression, to Ma Heng Shi Gan Tang to remove ephedra, add mulberry leaves, coix seeds, Su Stem treatment; mulberry leaves to replace ephedra, change the pungent warm published for the pungent cool method, so that the evil heat within the ambush light and clear to penetrate, the ease of a medicine, but see Ye’s flexibility in the use of medicine; add Su Stem to regulate the qi and promote the lung to stop cough, both cases 1.3 The method of relieving the cough – Xiao Qing Long Tang phlegm drink refers to a type of disease in which the body’s water distribution, transportation and transformation are not normal and accumulate in certain parts of the body, and the organ of the disease is “a deficiency of vital energy, yin and yang decay, resulting in fluid stagnation, Ye briefly summarizes it as “yin and yang failure”, and points out that “if the true essence is sufficient and the stomach is strong and the spleen is healthy, then the diet will not lose its degree and the operation will not stop”, and that cold drinks remain in the chest and override the lung. The symptoms of prolonged cough are: “coughing saliva for a long time”, “desire to vomit”, “long summers with increased cold and heat”, “not thinking of eating “Ye’s teacher followed Zhongjing’s principle of “for those who suffer from phlegm-drinking, warm medicine should be used to harmonize them” and gave Xiao Qing Long plus Shi Fa Tang. On the other hand, the composition of Xiao Qing Long Tang after removing ephedra and fine spices is Gui Zhi, Bai Shao, Gan Cao, Han Xia, Gan Jiang and Wu Wei Zi, i.e. Gui Zhi Tang plus Gan Jiang, Wu Wei Zi and Han Xia, which can be seen that Ye categorized Xiao Qing Long Tang as a reduced formula of Gui Zhi Tang. For chronic cough caused by deficiency of the lung and the spleen and deficiency of the middle yang, Ye adopted the treatment of deficiency as a tonic for the mother, and often used Huangqi Jianzhong Tang or Xiao Jianzhong Tang with addition and subtraction. In the Clinical Guide to Medical Cases, Ye used Huangqi Jianzhong Tang in eight cases and Xiao Jianzhong Tang in two cases for the treatment of prolonged cough, which is the most numerous treatment method among many. Ye pointed out that the use of Jianzhong Tang “to treat prolonged coughing and deficiency of the middle palace is the meaning of tonic mother, with the correct method passed down from ancient sages. The clinical manifestations of this type of prolonged cough are “prolonged coughing cold and heat”, “body pain and sweating”, “color elimination”, “fear of wind and cold “, “thinness and loss of food”, “night fever”, “loss of flesh”, “coughing for a long time with short inhalation like asthma “, “muscle fever with daily thinness”, “thin pulse on the left, empty beat on the right”, etc., Ye used Huangqi Jianzhong Tang or Huangqi Jianzhong with ginger; if both pulse come to weakness, add ginseng and Wu Wei Zi for treatment; for For “cough for a long time after years, back cold, feet tarsal often cold, sweating color white, cough even can not sleep”, Ye believes that this is “Yang Wei Wei thin, external evil easy to touch, and turbid Yin clip drink on the offense also, when and Ying Wei, and protect its Yang”, to Huangqi Jianzhong Tang to remove syrup, add Radix et Rhizoma, Poria Warming Yang and promoting water. “prolonged cough with back cold”, “night sweats”, “reduced food”, “restless sleep at night”. “2.2 Spleen-healthy method to stop cough – Isokong San Ye’s cloud: “never long-standing disease, the spleen and stomach for the latter, cough for a long time, non-customer symptoms. The treatment of the spleen and stomach is to produce gold with the flourishing of the earth, so there is no need to investigate its cough”; coughing for a long time damages the lung qi, the son steals the mother’s qi, and the spleen and stomach qi becomes even more deficient, thus making the cough prolonged and unhealed. The clinical manifestations of this type of prolonged cough with spleen qi deficiency are “labor cough”, “preference for pungent and warm things”, “reduction of food for prolonged cough”, and “pulse deficiency”. “Ye often prescribed Sijunzi Tang or Isogong San with additional flavor. Sigunzi Tang is derived from “Taiping Huimin Hodong Bureau Formula”, which has the function of strengthening the spleen and benefiting Qi, and is the basic formula for tonifying Qi, mainly treating Qi deficiency in the spleen and stomach. It is a basic formula for tonifying qi, mainly treating qi deficiency in the spleen and stomach. Isogong San, on the other hand, is made by adding Chen Pi to Sijunzi Tang, which is derived from Qian Yi’s “Straight Tips on Pediatric Medicine”. It can also move Qi and remove stagnation. By strengthening the spleen and nourishing the mother, the spleen is able to transport water and grain, so that phlegm can be transferred, lung Qi can be generated, and the cough can be cured. 2.3 Nourishing stomach and yin, generating fluid and relieving cough Lung deficiency and mother, one is Yang Qi and the other is yin fluid, and the lack of Yang Qi is blamed on the spleen, while the lack of yin fluid is blamed on the stomach. The purpose of “cultivating earth to produce gold” is not lost. Therefore, for prolonged cough caused by deficiency of stomach yin, deficiency of fluid and loss of moistening of the lung, Ye often uses sweet-cooling to nourish yin and moisten the lung to stop the cough. There are four cases of Maimendong Tang in the “Clinical Guide to Medical Cases”, whose clinical manifestations are “prolonged cough with reduced food” and “cold form and fear of wind and cold”, which is due to the weakness of the two qi outside the body and the internal response to the stomach, and the Yang pulse is not used, following the principle of “Do not be biased in the use of medicine to treat If the clinical manifestations are: “prolonged coughing”, “slow coughing in summer”, “fatigue and reduced appetite”, “thirsty drinking”, and “cold and cold”, then we should follow the principle of “not to treat cold and heat, but to regulate them with sweet herbs” and give the original formula of Maimendong Tang for treatment. If the clinical manifestations are: “prolonged cough”, “slow cough in summer”, “tiredness and reduced appetite”, “thirsty drinking”, “tendons and bones unbound, soreness in both feet”, this is a case of prolonged warmth, injury to fluids, summer warmth and deficiency of gastric juice, the method is to be sweet and slow, to benefit the yin of the stomach, to give Maimendong Tang to remove the half summer and round-grained rice, add northern sage If there is fatigue and burning in the stomach and epigastrium, he gives Maimendong Tang with Radix Panax and Ginseng, plus Bei Sha Shen and Huang Qi Pi; if “the pulse is right, the throat is dry, and the nose is hot, even in the morning and evening, the right descending is not enough, the stomach is deficient in fluid, and the sympathetic yang is disturbed”, he gives Maimendong Tang with Radix Panax and Bei Sha Shen. From the above cases, Ye used “Jin Kui” Maimendong Tang to remove the bitter and warm Han Xia, and added Bei Sha Shen to nourish Yin and promote fluids, added raw lentils to sweeten the spleen and harmonize the stomach, and added Huang Qi to benefit Qi and strengthen the spleen in order to restore the function of the spleen and earth to strengthen the movement. There are two cases in which Sha Shen Mai Dong Tang with addition and subtraction was applied to treat prolonged cough, with the following clinical manifestations: “prolonged cough”, “sputum with little food”, “body moving with breath sounding like wheezing”, and “feeling of internal fire burning”. If the clinical manifestations were: “prolonged cough”, “sputum with little food”, “body moving with breath sounding like asthma”, “feeling burnt by internal fire”, “pulse left pulsating and small right pulsating”, the patient was given Sha Shen Mai Dong Tang with the addition of Fu Shen and Chuan Shi Dendrobium without Yu Zhu, Sang Ye and Gan Cao. If the clinical manifestations are: “prolonged coughing with loss of tone”, “late and firm pulse on the left”, “redness in summer”, “coughing at daybreak”, and “loss of nourishment”, then Sha Shen 3. Treating chronic cough from the lower jiao, liver and kidney 3.1 Filling the essence and tonifying the kidney – Liu Wei Di Huang Wan The lung is the main respirator and the kidney is the main receiver of qi. Lung disease is bound to affect the kidneys over time, as the saying goes: “When the five organs are injured, the kidneys must be affected. Chronic coughs can lead to a deficiency of kidney essence over time, resulting in recurrent coughs that cannot be cured for a long time. There are two cases in the Clinical Guide to Medicine. The clinical manifestations were: “prolonged coughing and vomiting”, “thinness”, “drooping pulse”, and “not cured in half a year”. This is the result of kidney deficiency syncopal Qi dryness, given Six Flavors Dihuang Wan to remove Shu Di, Ze Di, Dan Pi, add Zi He Che, Human Milk Powder, Fructus Lycii, Wu Wei Zi, Walnut Pulp, Bacopa Monniera; Zhang Jingyue believes that “Yin supplementation is not conducive to water, water is not Yin supplementation, and the method of Yin supplementation should not penetrate”, so remove the penetration of Ze Di and clear heat Dan Pi, add Fructus Lycii, Wu Wei Zi, Zi He Che, Human Milk Powder, Walnut Pulp Therefore, we should remove the exudative Ze Xie and heat-clearing Dan Pi, and add Fructus Lycii, Wu Wei Zi, Zi He Che, Human Milk Powder, Walnut Meat, and Ba Ji Meat to fill the essence and tonify the kidney, so that the kidney water is sufficient and the lung qi descends to stop coughing. If the clinical manifestation is “weak, long cough phlegm, before noon is very much”, Ye to take six-flavored Dihuang Wan plus Wu Wei Zi three money in the morning, lunch is to take the different Gong San treatment, the lung, spleen and kidney together, this imitates Xue Ji treatment method also. 3.2 Tongluo stop cough method – spinulosa flower soup spinulosa flower soup from the It is a treatment for “liver attack, the person often wants to go over his chest, before bitterness, but wants to drink heat”, and a treatment for women with half-birth leakage, the function is to invigorate blood and open the ligaments. The “Ben Jing” contains the whirlpool flower to treat “knotted gas, fullness under the duress … remove water … down the gas”, “the famous doctor said:” whirlpool flower to eliminate the upper chest phlegm knot, spittle like glue paint … to benefit the large intestine, blood vessels …”, it can be seen that the whirlflower has a phlegm, and blood, the function of the internal organs; Ye’s commonly used whirlflower soup to treat long-standing disease into the complex of dysmenorrhea, headache, etc.. Long-term cough also belongs to the lung-loop blockage, and the “Clinical evidence guide medical case” records a case of “long-time cough with dysmenorrhea”, which is also treated by adding peach kernel and cypress kernel with Radix et Rhizoma Polygonati. 4 Summary of the “clinical guide to medical cases” recorded a total of 32 cases of “prolonged cough” and “prolonged cough”, focusing on Ye’s academic thinking in the treatment of prolonged cough and prolonged cough: First, “all five organs and six internal organs are coughing, not only the lungs. Ye’s medical cases involve many internal organs such as lung, spleen, stomach, liver and kidney; secondly, “to keep to the disease mechanism, each in its own way”, Ye’s medical cases emphasize treating the root cause for different disease mechanisms, and rarely use “special medicine” for cough. “Thirdly, Ye is good at cutting and applying ancient prescriptions, such as Xiao Qing Long Tang with the removal of hemp and pungency, Jin Kui’s Mai Men Dong Tang with the removal of Semen and the addition of Sha Shen, Huang Qi Jian Zhong Tang with Poria and Radix et Rhizoma, Xuan Bu Hua Tang, Liu Wei Di Huang Wan, Iso Gong San, Ma Heng Shi Tang, etc., all of which are from the ancients and former sages, but by Ye’s cutting and application, they have a new face. Ye’s learning can be seen in the origin, division of ancient and not mud ancient; fourth, good at creating. Ye’s sweet and gentle stomach, nourishing Yin to stop cough, and clearing heat and dampness to stop cough has the merit of pioneering.