哮证者,寒邪伏于肺 ,痰窠结于肺膜,内外相应,一遇风寒暑湿燥火六气之伤,即发。伤
酒,伤食,动怒,动气,役劳,房劳亦发。一发则肺 之寒气,与肺膜之浊痰,野狼狈相根据,窒塞
关隘,不容呼吸。若呼吸,则气触其痰,鼾 有声,非泛常之药,所能治也。以圣济射干丸主之。
圣济射干丸
射干 半夏(各一两) 陈皮 百部 款冬花 贝母 细辛 干姜 茯苓 五味子
郁李仁 皂荚(各五钱去皮子) 共为末,炼蜜为丸,如桐子大,空心米饮下三四十丸,一日两服。
肺痈者,湿热之郁蒸也。缘阳衰土湿,肺胃不降,湿郁成热,而复外感风邪,皮毛固闭,营郁不
得外达,则肺热愈炽矣。其证胸内隐隐疼痛,痞闷喘促,痰嗽弥增,口干咽燥,而不作渴,少饮汤水,
则津液沸腾,多吐浊沫,热邪内伤其津血,津血与痰涎郁蒸,腐化脓秽,吐如米粥,久而肺脏溃烂,是以
死也。如肺痈初起,以苏叶橘甘桔汤主之。如脓成,以二白散主之,或葶苈大枣泻肺汤主之。
苏叶橘甘桔汤
苏叶(三钱) 甘草(二钱) 桔梗(三钱) 杏仁(三钱) 茯苓(三钱) 贝母(三钱)
橘皮(三钱) 生姜(三钱) 水煎大半杯,温服。如胃逆胸满重,加半夏。如痰盛,宜逐以甘遂、葶
苈之属驱之。如脓成,当泄以丹皮、桃仁之类排之。剧者用仲景二白散。
二白散
桔梗(三分) 贝母(三分) 巴豆(一分去皮炒研如脂) 为末,饮服半钱匕,虚者减之
。脓在膈上则吐,在膈下则泄,下多,饮冷水一杯则止。
葶苈大枣泻肺汤
葶苈弹子大(炒黄研) 大枣(十二枚) 水三杯,煮枣,取二杯,
去枣,入葶苈,煮取一杯,顿服。脓未成,则痰下。脓已成,则脓下。
哮证,是寒邪潜伏于肺中,痰浊结聚在肺膜之上,内外相互感应,一旦遇到风、寒、暑、湿、燥、火六淫之气的侵袭,就会发作。此外,饮酒过度、饮食积滞、发怒、动气、劳累过度、房事不节也会诱发。一旦发作,肺中的寒气与肺膜上的浑浊痰涎狼狈为奸,互相勾结,阻塞气道关隘,导致呼吸不畅。如果进行呼吸,气流触动痰液,就会发出打鼾般的声响,这不是普通的药物所能治愈的。应当以圣济射干丸为主治方剂。
圣济射干丸
组成:射干、半夏(各一两)、陈皮、百部、款冬花、贝母、细辛、干姜、茯苓、五味子、郁李仁、皂荚(各五钱,去皮去籽)。
制法与用法:将上述药材共研为细末,用炼蜜制成丸药,大小如梧桐子大。空腹时米汤送服三四十丸,每日服用两次。
肺痈,是由于湿热郁蒸所致。原因在于阳气衰弱、脾土湿气重,导致肺气和胃气不能正常下降,湿气郁结化为热邪,再加上外感风邪,皮毛固密闭塞,营卫之气郁滞不得向外发散,从而导致肺热更加炽盛。其症状表现为胸内隐隐作痛,痞闷且气喘急促,咳嗽吐痰日益增多,口干咽燥但不想喝水,仅少量饮用汤水,则津液沸腾,大量吐出浑浊泡沫。热邪在内损伤津液和血液,津血与痰涎郁结蒸腾,腐败化为脓秽,吐出的痰像米粥一样,时间久了肺脏溃烂,因此会导致死亡。如果肺痈初起,以苏叶橘甘桔汤为主治方剂。如果脓液已成,以二白散为主治方剂,或者使用葶苈大枣泻肺汤主治。
苏叶橘甘桔汤
组成:苏叶(三钱)、甘草(二钱)、桔梗(三钱)、杏仁(三钱)、茯苓(三钱)、贝母(三钱)、橘皮(三钱)、生姜(三钱)。
制法与用法:用水煎煮至大半杯,温服。如果胃气上逆、胸部胀满严重,加入半夏。如果痰多,宜用甘遂、葶苈等药物驱除。如果脓液已成,当用丹皮、桃仁等药物排脓。病情严重者使用张仲景的二白散。
二白散
组成:桔梗(三分)、贝母(三分)、巴豆(一分,去皮炒熟研成脂状)。
制法与用法:研为细末,用温水送服半钱匕,体虚者减量。脓液在膈肌以上则通过呕吐排出,在膈肌以下则通过腹泻排出。如果腹泻过多,喝一杯冷水即可停止。
葶苈大枣泻肺汤
组成:葶苈子(弹子大小,炒黄后研磨)、大枣(十二枚)。
制法与用法:用水三杯,先煮大枣,取汁两杯,去掉枣肉,加入葶苈子,再煮取一杯,一次性服用。脓液未形成时,可排出痰液;脓液已形成时,可排出脓液。
Xiao Syndrome (Wheezing and Gurgling Syndrome) refers to cold pathogenic factors lurking in the Lung, with phlegm nests forming on the lung membrane. Internal and external factors correspond to each other; once injured by the six qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), it immediately manifests. Injury from alcohol, food stagnation, anger, Qi disturbance, physical exertion, and sexual exhaustion can also trigger it. Upon manifestation, the cold Qi in the Lung and the turbid phlegm in the lung membrane conspire together, blocking the airways and obstructing respiration. If breathing occurs, the Qi touches the phlegm, producing snoring-like sounds. This cannot be treated with ordinary medicines. Shengji Shegan Wan (Shengji Belamcanda Pill) should be used as the primary formula.
Shengji Shegan Wan (Shengji Belamcanda Pill)
Ingredients: Shegan (Belamcandae Rhizoma), Banxia (Pinelliae Rhizoma Praeparatum) (each 1 liang); Chenpi (Citri Reticulatae Pericarpium), Baibu (Stemonae Radix), Kuandonghua (Farfarae Flos), Beimu (Fritillariae Cirrhosae Bulbus), Xixin (Asari Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma Recens), Fuling (Poria), Wuweizi (Schisandrae Chinensis Fructus), Yuliren (Pruni Semen), Saojia (Gleditsiae Sinensis Spina) (each 5 qian, peeled and seeds removed).
Preparation and Administration: Grind all ingredients into fine powder. Mix with refined honey to form pills the size of tung tree seeds. Take 30-40 pills with rice water on an empty stomach, twice daily.
Fei Yong (Lung Abscess) is caused by the stagnation and steaming of damp-heat. The root cause lies in deficient Yang and damp Earth, leading to the failure of Lung and Stomach Qi to descend. Dampness stagnates and transforms into heat. Combined with external Wind invasion, the skin pores become closed, preventing Ying Qi (Defensive Qi) from dispersing outward, thereby intensifying Lung Heat. Symptoms include dull pain in the chest, fullness, shortness of breath, increasing cough with sputum, dry mouth and throat without thirst, and a desire to drink only small amounts of liquid. Drinking fluids causes fluid boiling, resulting in the expectoration of large amounts of turbid foam. Heat pathogens damage Yin fluids and blood internally; these fluids and blood stagnate and steam with phlegm, rotting into pus and foul matter. The expectorated material resembles congee. Over time, the Lung organ ulcerates, leading to death. In the early stage of Fei Yong, Zisu Ju Gan Jie Tang (Perilla Leaf, Tangerine Peel, Licorice, and Platycodon Decoction) should be used. Once pus has formed, Er Bai San (Two Whites Powder) or Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung) may be used.
Zisu Ju Gan Jie Tang (Perilla Leaf, Tangerine Peel, Licorice, and Platycodon Decoction)
Ingredients: Zisu Ye (Perillae Folium) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (2 qian), Jiegeng (Platycodonis Radix) (3 qian), Xingren (Armeniacae Semen Amarum) (3 qian), Fuling (Poria) (3 qian), Beimu (Fritillariae Cirrhosae Bulbus) (3 qian), Chuan Pi (Citri Reticulatae Pericarpium) (3 qian), Shengjiang (Zingiberis Rhizoma Recens) (3 qian).
Preparation and Administration: Decoct in water until half a cup remains. Take warm. If there is severe rebellious Stomach Qi and chest fullness, add Banxia (Pinelliae Rhizoma Praeparatum). If phlegm is abundant, expel it using drugs such as Gansui (Kansui Radix) and Tinglizi (Descurainiae Semen Lepidii seu Sisymbrii). If pus has formed, drain it using drugs such as Danpi (Moutan Cortex) and Taoren (Persicae Semen). For severe cases, use Zhang Zhongjing's Er Bai San (Two Whites Powder).
Er Bai San (Two Whites Powder)
Ingredients: Jiegeng (Platycodonis Radix) (3 fen), Beimu (Fritillariae Cirrhosae Bulbus) (3 fen), Badou (Crotonis Fructus) (1 fen, peeled, stir-fried, and ground into paste).
Preparation and Administration: Grind into powder. Take half a qian bi (a small measuring spoon) with water. Reduce dosage for deficient patients. If pus is above the diaphragm, it will be expelled via vomiting; if below the diaphragm, via diarrhea. If diarrhea is excessive, drinking a cup of cold water will stop it.
Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung)
Ingredients: Tingli Zi (Descurainiae Semen Lepidii seu Sisymbrii) (size of a bean, stir-fried until yellow and ground), Dazao (Jujubae Fructus) (12 pieces).
Preparation and Administration: Add three cups of water. Boil the jujubes until two cups remain. Remove the jujubes, add Tingli Zi, and boil until one cup remains. Take in one dose. If pus has not yet formed, phlegm will be discharged; if pus has formed, pus will be discharged.