洪（三二）劳烦经营。阳气弛张。即冬温外因咳嗽。亦是气泄邪侵。辛以散邪。苦以降逆。希冀嗽止。而肺欲辛。
过辛则正气散失。音不能扬。色消吐涎喉痹。是肺痿难治矣。仿内经气味过辛。主以甘缓。（苦辛散邪伤肺胃津液）
北沙参 炒麦冬 饴糖 南枣
查（二四）脉细心热。呼吸有音。夜寤不寐。过服发散。气泄阳伤。为肺痿之 。仲景法以胃药补母救
子。祟生气也。 金匮麦门冬汤。
徐（四一）肺痿。频吐涎沫。食物不下。并不渴饮。岂是实火。津液荡尽。二便日少。宗仲景甘药理胃。乃
虚则补母。仍佐宣通脘间之 格。
人参 麦冬 熟半夏 生甘草 白粳米 南枣肉
沈 积劳忧思。固是内伤。冬温触入而为咳嗽。乃气分先虚。而邪得外凑。辛散。斯气分愈泄。滋
阴非能安上。咽痛音哑。虚中邪伏。恰值春暖阳和。脉中脉外。气机流行。所以小效旬日者。生
阳渐振之象。谷雨暴冷骤加。卫阳久弱。不能拥护。致小愈病复。诊得脉数而虚。偏大于右寸。
口吐涎沫。不能多饮汤水。面色少华。五心多热。而足背浮肿。古人谓金空则鸣。金实则无声。
金破碎亦无声。是为肺病显然。然内伤虚馁为多。虚则补母。胃土是也。肺痿之 。议宗仲景麦门冬汤。
王（三十）溃疡流脓经年。脉细色夺。声嘶食减。咳嗽。喉中梗痛。皆漏损脂液。阴失内守。阳失外卫。肺
痿之 。谅难全好。（液伤卫虚）
人参 黄 苡仁 炙草 归身 白芨
顾（三六）久咳神衰。气促汗出。此属肺痿。
黄 （蜜炙八两） 生苡仁（二两） 白百合（四两） 炙黑甘草（二两） 白芨（四两） 南枣（四两）
水熬膏米饮汤送。
汤 肺气不降。咳痰呕逆。（肺气不降）
鲜芦根 桃仁 丝瓜子 苡仁
肺痿一症。概属津枯液燥。多由汗下伤正所致。夫痿者。萎也。如草木之萎而不荣。为津亡而气竭也。然致痿之因。
非止一端。金匮云。或从汗出。或从呕吐。或从消渴。小便利数。或从便难。又被快药下之。重亡津液。故令肺热干痿
也。肺热干痿。则清肃之令不行。水精四布失度。脾气虽散。津液上归于肺。而肺不但不能自滋其干。亦不能内洒陈于
六腑。外输精于皮毛也。其津液留贮胸中。得热煎熬。变为涎沫。侵肺作咳。唾之不已。故干者自干。唾者自唾。愈唾
愈干。痿病成矣。金匮治法。贵得其精意。大意生胃津。润肺燥。补真气。以通肺之小管。清火热。以复肺之清肃。故
外台用炙甘草汤。在于益肺气之虚。润肺金之燥。千金用甘草汤。及生姜甘草汤。用参甘以生津化热。姜枣以宣上焦之
气。使胸中之阳不滞。而阴火自熄也。及观先生之治肺痿。每用甘缓理虚。或宗仲景甘药理胃。虚则补母之义。可谓得
仲景心法矣。（邹时乘）
洪某（三十二岁），因劳碌烦扰、操持生计，导致阳气弛缓外张。此时若感受冬温之邪引发咳嗽，也是气机泄越、邪气入侵的表现。使用辛味药以发散邪气，苦味药以降逆气，希望能使咳嗽停止。然而肺喜辛味，但过用辛味则会导致正气散失，出现声音嘶哑不能响亮、面色枯槁、吐涎沫、喉痹等症状，这属于肺痿，难以治愈。仿照《内经》中“气味过辛”的理论，主治以甘缓之法。（注：苦辛发散之品会损伤肺胃的津液）
北沙参、炒麦冬、饴糖、南枣
查某（二十四岁），脉象细而心热，呼吸时有杂音，夜间醒后无法入睡。因过服发散药物，导致气泄阳伤，形成肺痿。仲景的法则是用补益胃气的药物来补母救子，以滋生生气。方用《金匮要略》中的麦门冬汤。
徐某（四十一岁），患有肺痿，频繁吐出涎沫，食物难以下咽，并不口渴饮水。这难道是实火吗？其实是津液荡尽，二便日渐减少。遵循仲景甘药理胃的原则，这是虚则补母的方法。仍佐以宣通脘间格拒的药物。
人参、麦冬、熟半夏、生甘草、白粳米、南枣肉
沈某，长期积劳忧思，固然是内伤，又因冬温之邪侵入而引发咳嗽，这是气分先虚，而邪气得以从外部凑集。使用辛散药物，会使气分更加泄越；滋阴并非能安上焦。出现咽痛音哑，是虚证中邪气潜伏。恰逢春暖阳和之时，脉中脉外气机流行，所以小效旬日者，是生阳逐渐振奋的迹象。谷雨时节暴冷骤加，卫阳久弱，不能拥护肌表，致使小愈之后病情复发。诊得脉数而虚，偏大于右寸。口吐涎沫，不能多饮汤水，面色少华，五心多热，而足背浮肿。古人说金空则鸣，金实则无声，金破碎亦无声。这是肺病显然。然而内伤虚馁居多，虚则补母，胃土即是。肺痿之症，议宗仲景麦门冬汤。
王某（三十岁），溃疡流脓经年，脉细色夺，声嘶食减，咳嗽，喉中梗痛，皆是漏损脂液，阴失内守，阳失外卫，肺痿之症，谅难全好。（注：液伤卫虚）
人参、黄芪、苡仁、炙草、归身、白芨
顾某（三十六岁），久咳神衰，气促汗出，此属肺痿。
黄芪（蜜炙八两）、生苡仁（二两）、白百合（四两）、炙黑甘草（二两）、白芨（四两）、南枣（四两）。
水熬膏，米饮汤送服。
汤某，肺气不降，咳痰呕逆。（注：肺气不降）
鲜芦根、桃仁、丝瓜子、苡仁
肺痿一症，概属津枯液燥，多由汗下伤正所致。夫痿者，萎也，如草木之萎而不荣，为津亡而气竭也。然致痿之因，非止一端。《金匮》云：或从汗出，或从呕吐，或从消渴，小便利数，或从便难，又被快药下之，重亡津液，故令肺热干痿也。肺热干痿，则清肃之令不行，水精四布失度，脾气虽散，津液上归于肺，而肺不但不能自滋其干，亦不能内洒陈于六腑，外输精于皮毛也。其津液留贮胸中，得热煎熬，变为涎沫，侵肺作咳，唾之不已，故干者自干，唾者自唾，愈唾愈干，痿病成矣。《金匮》治法，贵得其精意，大意生胃津，润肺燥，补真气，以通肺之小管，清火热，以复肺之清肃。故《外台》用炙甘草汤，在于益肺气之虚，润肺金之燥。《千金》用甘草汤，及生姜甘草汤，用参甘以生津化热，姜枣以宣上焦之气，使胸中之阳不滞，而阴火自熄也。及观先生之治肺痿，每用甘缓理虚，或宗仲景甘药理胃，虚则补母之义，可谓得仲景心法矣。（邹时乘评）
Hong (32 years old), due to laborious toil and mental worry, leading to the flaccid expansion of Yang Qi. If external winter-warmth pathogens cause coughing at this time, it is also a case of Qi leakage and pathogen invasion. Using acrid flavors to disperse pathogens and bitter flavors to direct rebellious Qi downward, hoping to stop the cough. However, the Lung desires acridity; excessive use of acrid substances causes the loss of healthy Qi, resulting in hoarseness with inability to project voice, emaciation, salivation, and throat obstruction. This constitutes Fei Wei (Lung Atrophy/Withering), which is difficult to treat. Following the principle in *Neijing* regarding "excessive acrid flavor," the main treatment employs sweet and緩 (soothing/relaxing) methods. (Note: Bitter-acrid dispersing agents damage the fluids of the Lung and Stomach).
Glehniae Radix (Beishashen), Stir-fried Ophiopogonis Tuber (Chao Maidong), Malt Sugar (Yitang), Jujubae Fructus (Nanzao).
Zha (24 years old), pulse is fine with heart-heat, breathing has abnormal sounds, waking at night with insomnia. Overuse of diaphoretic drugs caused Qi leakage and Yang injury, leading to Fei Wei (Lung Atrophy/Withering). The method of Zhang Zhongjing is to tonify the mother (Stomach/Spleen) to save the child (Lung) using stomach-tonifying medicines, thereby generating vital Qi. Formula: *Maidong Tang* (Ophiopogon Decoction) from *Jinkui Yaolue*.
Xu (41 years old), suffering from Fei Wei (Lung Atrophy/Withering), frequently spitting saliva and foam, unable to eat, not thirsty for drink. Could this be excess heat? No, it is the exhaustion of body fluids, with daily reduction in urination and defecation. Following Zhang Zhongjing’s principle of sweet medicine to regulate the Stomach, applying the theory that deficiency requires tonifying the mother. Additionally, using herbs to unblock the obstruction in the epigastrium.
Ginseng Radix et Rhizoma (Renshen), Ophiopogonis Tuber (Maidong), Pinelliae Rhizoma Preparatum (Shu Banxia), Glycyrrhizae Radix et Rhizoma (Sheng Gancao), Oryza Sativa (Baijingmi), Jujubae Fructus (Nanzao Rou).
Shen, chronic accumulation of labor and worry constitutes internal injury. Winter-warmth pathogens invading further cause coughing, indicating prior deficiency of Qi in the Qi aspect, allowing external pathogens to gather. Acrid dispersal further depletes Qi; nourishing Yin cannot settle the upper jiao. Sore throat and hoarseness indicate latent pathogens within deficiency. Coinciding with warm spring weather, Qi mechanism flows freely inside and outside the pulses, hence slight improvement over ten days indicates gradual revitalization of Sheng Yang (Vital Yang). However, sudden cold after Grain Rain weakened Wei Yang (Defensive Yang) for a long time, failing to protect the exterior, causing relapse after slight recovery. Pulse is rapid and deficient, larger on the right Cun position. Spitting saliva and foam, unable to drink much liquid, complexion lacks luster, five-center heat, but dorsal foot edema. Ancients said: empty metal rings, solid metal is silent, broken metal is also silent. This clearly indicates Lung disease. However, internal injury with deficiency is predominant; deficiency requires tonifying the mother, which is Stomach Earth. For Fei Wei (Lung Atrophy/Withering), we propose following Zhang Zhongjing’s *Maidong Tang*.
Wang (30 years old), ulcer draining pus for years, fine pulse, sallow complexion, hoarse voice, reduced appetite, cough, throat obstruction and pain. All result from leakage damaging fatty fluids, Yin failing to hold internally, Yang failing to guard externally. Fei Wei (Lung Atrophy/Withering) is unlikely to fully heal. (Fluid injury and Wei deficiency).
Ginseng Radix et Rhizoma (Renshen), Astragali Radix (Huangqi), Coicis Semen (Yiren), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhicao), Angelicae Sinensis Radix (Guishen), Bletillae Rhizoma (Baiji).
Gu (36 years old), chronic cough with spirit fatigue, shortness of breath, and sweating. This belongs to Fei Wei (Lung Atrophy/Withering).
Astragali Radix (Honey-fried 8 liang), Coicis Semen (Raw 2 liang), Lilii Bulbus (4 liang), Blackened Honey-fried Glycyrrhizae Radix et Rhizoma (2 liang), Bletillae Rhizoma (4 liang), Jujubae Fructus (4 liang).
Decocted into paste, taken with Rice Decoction.
Tang, Lung Qi fails to descend, causing cough with phlegm and vomiting/reversal. (Lung Qi failing to descend).
Phragmitis Rhizoma (Fresh), Persicam Semen, Trichosanthis Fructus Seed, Coicis Semen.
Fei Wei (Lung Atrophy/Withering) generally belongs to fluid exhaustion and dryness, mostly caused by sweat or purgation injuring healthy Qi. Wei means withering, like plants that wither and lose vigor, due to loss of fluids and exhaustion of Qi. However, causes of withering are not limited to one source. *Jinkui* states: either from sweating, or from vomiting, or from Xiao Ke (Wasting-Thirst) with frequent urination, or from constipation treated with harsh purgatives, heavily losing fluids, thus causing Lung Heat and Dry Withering. Lung Heat and Dry Withering prevent the clear and descending function from operating, disrupting the distribution of water essence. Although Spleen Qi scatters fluids upward to the Lung, the Lung cannot moisten itself nor distribute essence inward to the Six Fu organs or outward to skin and hair. Fluids retained in the chest, boiled by heat, transform into saliva and foam, invading the Lung causing cough. Continuous spitting leads to greater dryness, forming the disease of Withering. Treatment methods in *Jinkui* emphasize understanding the essence: generating Stomach fluids, moistening Lung dryness, tonifying true Qi to open Lung micro-vessels, clearing heat/fire to restore Lung clarity. Thus, *Waitai* uses *Zhigancao Tang* (Honey-Fried Licorice Decoction) to benefit Lung Qi deficiency and moisten Lung Metal dryness. *Qianjin* uses *Gancao Tang* and *Shengjiang Gancao Tang*, using Ginseng and Licorice to generate fluids and resolve heat, Ginger and Jujube to disseminate Upper Jiao Qi, preventing stagnation of Yang in the chest so Yin fire extinguishes itself. Observing Mr. Ye’s treatment of Fei Wei, he often uses sweet-soothing methods to manage deficiency, or follows Zhang Zhongjing’s sweet medicine to regulate the Stomach, embodying the principle of tonifying the mother when deficient. This can be said to have grasped Zhang Zhongjing’s core methodology. (Commentary by Zou Shicheng)