治肺中腐烂，浸成肺痈，时吐脓血，胸中隐隐作疼，或旁连胁下亦疼者。
甘草（六钱） 生明没药（四钱，不去油） 丹参（四钱） 知母（四钱）
病剧者加三七二钱（捣细送服）。脉虚弱者，酌加人参、天冬各数钱。
肺痈者，肺中生痈疮也。然此证肺中成疮者，十之一二，肺中腐烂者，十之八九。故治此等证，若葶苈、
皂荚诸猛烈之药，古人虽各有专方，实不可造次轻用，而清火解毒化腐生肌之品，在所必需也。甘草为疮家解
毒之主药，且其味至甘，得土气最浓，故能生金益肺，凡肺中虚损糜烂，皆能愈之。是以治肺痈便方，有单用
生粉草四两煎汤，频频饮之者。而西人润肺药水，亦单有用甘草制成者。特其性微温，且有壅滞之意，而调以
知母之寒滑，则甘草虽多用无碍，且可借甘草之甘温，以化知母之苦寒，使之滋阴退热，而不伤胃也。丹参性
凉清热，色赤活血，其质轻松，其味微辛，故能上达于肺，以宣通脏腑之毒血郁热而消融之。乳香、没药同为
疮家之要药，而消肿止疼之力，没药尤胜，故用之以参赞丹参，而痈疮可以内消。三七化瘀解毒之力最优，且
化瘀血而不伤新血，其解毒之力，更能佐生肌药以速于生肌，故于病之剧者加之。至脉虚者，其气分不能运化
药力，方虽对证无功，又宜助以人参。而犹恐有肺热还伤肺之虞，是以又用天冬，以解其热也。
一人，年三十余，昼夜咳嗽，吐痰腥臭，胸中隐隐作疼，恐成肺痈，求为延医。其脉浮而有力，右胜于左，
而按之却非洪实。投以清金解毒汤，似有烦躁之意，大便又滑泻一次。自言从前服药，略补气分，即觉烦躁，
若专清解，又易滑泻，故屡次延医无效也。遂改用粉甘草两半、金银花一两、知母、牛蒡子各四钱，煎汤一大
碗，分十余次温饮下，俾其药力常在上焦，十剂而愈。后两月，因劳力过度旧证复发，胸中疼痛甚于从前，连
连咳吐，痰中兼有脓血。再服前方不效，为制此汤，两剂疼止。为脉象虚弱，加野台参三钱，天冬四钱，连服
十剂全愈。
邑曾××，精通医学，曾告愚曰∶治肺痈方，林屋山人犀黄丸最效。余用之屡次，皆随手奏功，今录其方于
下，以备参观。
《外科证治全生集》（王洪绪所着）犀黄丸，用乳香、没药末各一两，麝香钱半，犀牛黄三分，共研细。
取黄米饭一两捣烂，入药再捣为丸，莱菔子大，晒干（忌火烘）。每服三钱，热陈酒送下。
徐灵胎曰∶“苏州钱复庵咳血不止，诸医以血证治之，病益剧。余往诊，见其吐血满地，细审血中似有
脓而腥臭，因谓之曰∶此肺痈也，脓已成矣。《金匮》云‘脓成则死’，然有生者。余遂多方治之，病家亦始
终相信，一月而愈。盖余平日，因此证甚多，集唐人以来验方，用清凉之药以清其火，滋肺之药以养其血，滑
降之药以祛其痰，芳香之药以通其气，更以珠黄之药解其
毒，金石之药填其空，兼数法而行之，屡试必效。今治复庵，亦兼此数法而痊。”按∶此论诚为治肺痈者之准
绳，故录之以备参观。
西人、东人，对于肺结核，皆视为至险之证。愚治以中药汤剂，辅以西药阿斯匹林，恒随手奏效，参麦汤
下论之甚详。而于近今，又得一治法。奉天宿××之兄，年近五旬，素有肺病。东人以为肺结核，屡次医治皆
无效。一日忽给其弟来电报，言病势已革，催其速还。宿××因来院中，求为疏方，谓前数日来信言，痰嗽较
前加剧，又添心中发热，今电文未言及病情，大约仍系前证，而益加剧也。夫病势至此，诚难挽回，因其相求
恳切，遂为疏方∶玄参、生山药各一两，而佐以川贝、牛蒡、甘草诸药。至家将药煎服，其病竟一汗而愈。始
知其病之加剧者，系有外感之证。外感传里，阳明燥热，得凉润之药而作汗，所以愈也。其从前肺病亦愈者，
因肺中之毒热随汗外透，暂觉愉快，而其病根实犹伏而未除也。后旬余其肺病复发，咳嗽吐痰腥臭。宿××复来
询治法，手执一方，言系友人所赠，问可服否。视之林屋山人犀黄丸也。愚向者原拟肺结核可治以犀黄丸，及
徐氏所论治肺痈诸药。为其价皆甚昂，恐病者辞费，未肯轻于试用。今有所见与愚同者，意其方必然有效。怂
恿制其丸，服之未尽剂而愈。
奉天赵××，年四十许。心中发热、懒食、咳嗽、吐痰腥臭，羸弱不能起床。询其得病之期，至今已迁延三
月矣。其脉一分钟八十五至，左脉近平和，右脉滑而实，舌有黄苔满布，大便四五日一行且甚燥。知其外感，
稽留于肺胃，久而不去，以致肺脏生炎，久而欲腐烂也。西人谓肺结核证至此，已不可治。而愚慨然许为治愈，
投以清金解毒汤，去黄 ，加生山药六钱、生石膏一两，三剂后热大清减，食量加增，咳嗽吐痰皆见愈。遂去
山药，仍加黄 三钱，又去石膏，以花粉六钱代之，每日兼服阿斯匹林
四分之一瓦，如此十余日后，病大见愈。身体康健，而间有咳嗽之时，因忙碌遂停药不服。二十日后，咳嗽又
剧，仍吐痰有臭，再按原方加减治之，不甚效验。亦俾服犀黄丸病遂愈。
治疗肺中腐烂，逐渐形成肺痈，时常吐出脓血，胸中隐隐作痛，或者疼痛牵连胁下的情况。
甘草（六钱） 生明没药（四钱，不去油） 丹参（四钱） 知母（四钱）
病情严重者加三七二钱（捣碎细末，冲服）。脉象虚弱者，酌情加入人参、天冬各数钱。
所谓肺痈，是指肺中生疮疡。然而此证中肺中真正成疮的，仅占十分之一二；而肺中腐烂的，却占十分之八九。因此治疗这类病症，虽然古人对于葶苈子、皂荚等猛烈药物各有专方，但实际上不可轻易冒昧使用，而清热泻火、解毒化腐、生肌长肉的药物，则是所必需的。甘草是疮疡家解毒的主药，且其味道极甘，得土气最浓，所以能补益肺气（金），凡是肺中虚损糜烂，都能治愈。因此治疗肺痈的简便方剂中，有用单味生甘草四两煎汤，频频饮用的。而西方人的润肺药水，也有单用甘草制成的。只是甘草性微温，且有壅滞之意，若配合知母的寒滑之性，则甘草虽多用也无妨碍，而且可以借助甘草的甘温，来化解知母的苦寒，使其滋阴退热而不伤胃气。丹参性凉能清热，色赤能活血，质地轻松，味道微辛，所以能上行到达肺部，宣通脏腑中的毒血郁热并消融它。乳香、没药同为疮疡家的要药，而在消肿止痛方面，没药尤其胜过乳香，所以用它来辅助丹参，使痈疮可以从内部消散。三七化瘀解毒的力量最优，且化瘀血而不损伤新血，它的解毒力量，更能辅助生肌药物以加速生肌，所以在病情严重时加入。至于脉象虚弱的人，其气分不能运化药力，方剂即使对症也无效，此时适宜用人参来扶助正气。而又担心有“肺热还伤肺”的顾虑，所以又用天冬，来解除热邪。
有一人，三十多岁，昼夜咳嗽，吐出的痰腥臭，胸中隐隐作痛，恐怕要形成肺痈，请求我为他请医生诊治。他的脉象浮而有力，右侧胜过左侧，但重按却不是洪大充实。投以清金解毒汤后，似乎出现了烦躁的症状，大便又滑泻了一次。他自己说以前服药，稍微补气分，就感到烦躁；如果专门清热解表，又容易滑泻，所以屡次请医都无效。于是改用粉甘草一两半、金银花一两、知母、牛蒡子各四钱，煎成一碗大汤，分十几次温服，使得药力常停留在上焦，服用十剂后痊愈。两个月后，因过度劳累旧病复发，胸中疼痛比从前更甚，连连咳嗽，痰中兼有脓血。再服前方无效，为此配制此汤（清凉华盖饮），服用两剂后疼痛停止。因为脉象虚弱，加入野台参三钱、天冬四钱，连续服用十剂完全痊愈。
邑人曾某某，精通医学，曾告诉我：治疗肺痈的方剂，林屋山人犀黄丸最为有效。我多次使用，都随手奏效，现在记录其方如下，以备参考。
《外科证治全生集》（王洪绪所著）犀黄丸，用乳香、没药末各一两，麝香一钱半，犀牛黄三分，共同研细。取黄米饭一两捣烂，加入药末再捣成丸，大小如莱菔子（萝卜籽），晒干（忌用火烘）。每次服用三钱，用热的陈酒送下。
徐灵胎说：“苏州钱复庵咳血不止，各位医生按照血证治疗，病情更加严重。我去诊察，见他吐血满地，仔细审视血液中似乎有脓且腥臭，便对他说：这是肺痈，脓已经形成了。《金匮要略》说‘脓成则死’，但也有存活的情况。我于是多方治疗，病人家属也始终信任，一个月后痊愈。大概我平日因此证很多，收集唐人以来的验方，用清凉药以清其火，滋肺药以养其血，滑降药以祛其痰，芳香药以通其气，再用珠黄类药物解其毒，金石类药物填其空洞，兼用这几法，屡试必效。如今治疗复庵，也是兼用这几法而痊愈。”按语：这段论述确实是治疗肺痈者的准则，所以记录下来以备参考。
西方人和东方人，都将肺结核视为极其危险的病症。我用中药汤剂治疗，辅以西药阿斯匹林，常常随手奏效，参麦汤在下文中有详细论述。而在近期，我又得到一种治疗方法。奉天宿某某的哥哥，年近五十，素有肺病。东方医生认为是肺结核，屡次医治都无效。一天忽然给弟弟发来电报，说病势危急，催促他速回。宿某某来到我的诊所，请求开方，说前几天来信讲，痰嗽比以前加剧，又添心中发热，今天电文中未提及病情，大约仍是前证，而且更加严重了。病势到了这种地步，确实难以挽回，但因为对方恳切相求，于是为他开方：玄参、生山药各一两，辅以川贝、牛蒡、甘草等药。到家将药煎服，竟然一汗而愈。这才知道病情加剧的原因，是有外感证候。外感传入体内，阳明燥热，遇到凉润的药物而发汗，所以痊愈。他以前的肺病也好了，是因为肺中的毒热随汗液外透，暂时觉得愉快，但其病根实际上仍然潜伏未除。十多天后他的肺病复发，咳嗽吐痰腥臭。宿某某又来询问治疗方法，手里拿着一张方子，说是朋友赠送的，问是否可以服用。我看是林屋山人犀黄丸。我向来原本打算肺结核可以用犀黄丸治疗，以及徐氏所论述的治疗肺痈的各种药物。但因为它们的价格都很昂贵，担心病人推辞花费，没有肯轻易试用。现在有人与我见解相同，料想这个方子必然有效。怂恿他制作丸药，服用完一半剂量就痊愈了。
奉天赵某某，四十岁左右。心中发热、食欲不振、咳嗽、吐痰腥臭，身体羸弱不能起床。询问他得病的时间，到现在已经拖延三个月了。他的脉搏一分钟八十五次，左脉接近平和，右脉滑而实，舌苔满布黄色，大便四五日一次且非常干燥。知道这是外感邪气，稽留于肺胃，久而不去，导致肺脏发炎，久而想要腐烂。西方人说肺结核证到了这一步，已经不可治疗。而我慷慨地承诺能治愈，投以清金解毒汤，去掉黄芩，加入生山药六钱、生石膏一两，三剂后热势大减，食量增加，咳嗽吐痰都见好转。于是去掉山药，仍加入黄芩三钱，又去掉石膏，用天花粉六钱代替，每天同时服用阿斯匹林四分之一瓦，如此十多天后，病情大有好转。身体恢复健康，但偶尔还有咳嗽的时候，因为忙碌便停药不服。二十天后，咳嗽又剧烈，仍然吐痰有臭味，再按原方加减治疗，效果不明显。也让病人服用犀黄丸，病才痊愈。
Treats the condition of putrefaction in the lungs, gradually forming Lung Abscess (Fei Yong), characterized by frequent expectoration of pus and blood, dull pain in the chest, or pain radiating to the hypochondrium.
Gancao (Radix Glycyrrhizae Preparata) (6 qian), Shengming Moyao (Resina Myrrhae) (4 qian, oil not removed), Danshen (Radix Salviae Miltiorrhizae) (4 qian), Zhimu (Cortex Anemarrhenae) (4 qian).
For severe cases, add Sanqi (Rhizoma Notoginseng) 2 qian (finely ground, taken with decoction). For weak pulse,酌情 (discretionarily) add Renshen (Radix Ginseng) and Tiandong (Tuber Ophiopogonis) each several qian.
Lung Abscess refers to sores/ulcers formed in the lungs. However, among this syndrome, only one or two out of ten cases involve true ulceration in the lungs, whereas eight or nine out of ten involve putrefaction. Therefore, when treating such conditions, although ancient physicians had specific prescriptions for fierce medicines like Tinglizi (Semen Lepidii et Descurainiae) and Zaojia (Fructus Gleditsiae Sinensis), they should not be used lightly or rashly. Instead, herbs that clear heat, detoxify, resolve putrefaction, and generate flesh are essential. Gancao is the principal herb for detoxification in sore/ulcer cases. Its taste is extremely sweet, and it possesses the strongest Earth Qi, thus it can tonify Metal (Lung) and benefit the Lungs. It can heal any deficiency damage and erosion in the lungs. Hence, in simple prescriptions for Lung Abscess, there are instances of using single-herb decoctions of raw Gancao (4 liang) drunk frequently. Western lung-moistening syrups also sometimes consist solely of Gancao. However, its nature is slightly warm and has a cloying/stagnant tendency. When harmonized with the cold and slippery nature of Zhimu, Gancao can be used in large doses without harm. Moreover, the sweet-warm nature of Gancao can transform the bitter-cold nature of Zhimu, allowing it to nourish Yin and reduce fever without damaging the Stomach. Danshen has a cool nature to clear heat, red color to invigorate blood, light texture, and slightly acrid taste, enabling it to ascend to the Lungs, diffuse toxic blood stasis and stagnant heat in the zang-fu organs, and dissolve them. Xiangru (Resina Olibani) and Moyao are both key herbs for sores/ulcers, but Moyao excels more in reducing swelling and stopping pain. Thus, it is used to assist Danshen, allowing the abscess to resolve internally. Sanqi has the best power to resolve stasis and detoxify; it resolves blood stasis without damaging new blood. Its detoxifying power further assists flesh-generating herbs to accelerate tissue regeneration, hence it is added for severe cases. For those with weak pulses, their Qi level cannot transport the medicinal force; even if the prescription matches the syndrome, it will be ineffective. It is appropriate to aid with Renshen. Yet, fearing the risk of "lung heat injuring the lung again," Tiandong is used to resolve the heat.
A patient, over thirty years old, coughed day and night, expectorated foul-smelling sputum, and had dull chest pain, fearing the development of Lung Abscess. He sought medical attention. His pulse was floating and forceful, stronger on the right than the left, but deep pressure revealed it was neither surging nor full. A prescription of Qingjin Jiedu Tang (Clear Metal Detoxify Decoction) was administered. Subsequently, he seemed to experience irritability, and had one episode of loose stool. He stated that previously, taking medicine that slightly tonified Qi caused irritability, while purely clearing and resolving led to loose stools, which is why previous treatments failed. Thus, the formula was changed to Fen Gancao (Prepared Licorice Root) 1.5 liang, Jinyinhua (Flos Lonicerae Japonicae) 1 liang, Zhimu 4 qian, and Niubangzi (Fructus Arctii) 4 qian. This was decocted into a large bowl of soup, taken in over ten warm doses, ensuring the medicinal force remained in the Upper Jiao. After ten doses, he recovered. Two months later, due to excessive labor, the old symptoms recurred. Chest pain was worse than before, with continuous coughing and expectoration of sputum containing pus and blood. Re-administering the previous formula was ineffective. This new formula (Qingliang Huagai Yin) was prepared. After two doses, the pain stopped. Due to the weak pulse, Yetaishen (Wild Ginseng from Taihang Mountains) 3 qian and Tiandong 4 qian were added. After ten consecutive doses, he fully recovered.
Zeng XX from the county, proficient in medicine, told me: "For treating Lung Abscess, Xi Huang Wan (Calculus Bovis Pill) by Linwu Shanshan is most effective. I have used it repeatedly with immediate success. I record the formula below for reference."
Xi Huang Wan from *Waike Zhengzhi Quansheng Ji* (written by Wang Hongxu): Uses Xiangru powder and Moyao powder, 1 liang each; Shexiang (Moschus) 1.5 qian; Xiniuhuang (Calculus Bovis) 3 fen. All finely ground. Take 1 liang of yellow rice flour, mash it, mix with the medicine, and pound into pills the size of Raphani Semen (radish seeds). Dry in the sun (avoid fire roasting). Take 3 qian per dose, washed down with hot aged wine.
Xu Lingtai said: "Qian Fu'an from Suzhou suffered from incessant hemoptysis. Physicians treated it as a bleeding disorder, worsening the condition. Upon examination, I saw blood covering the floor. Carefully inspecting the blood, it seemed to contain pus and smelled foul. I told him, 'This is Lung Abscess; the pus has already formed.' The *Jin Gui Yao Lue* states 'when pus forms, death ensues,' yet survival is possible. I employed various methods, and the family maintained trust throughout. He recovered in one month. Generally, because I encounter this syndrome often, I have collected effective formulas since the Tang Dynasty, using cooling herbs to clear fire, lung-nourishing herbs to nourish blood, slippery/descending herbs to expel phlegm, aromatic herbs to unblock Qi, pearl/cow-bezoar herbs to detoxify, and mineral/metal herbs to fill cavities. Combining these methods yields consistent results. Treating Fu'an involved combining these methods for recovery." Commentary: This discussion is indeed the standard for treating Lung Abscess, so it is recorded for reference.
Westerners and Easterners regard Pulmonary Tuberculosis (TB) as an extremely dangerous syndrome. I treat it with Chinese herbal decoctions supplemented by the Western drug Aspirin, often achieving immediate results (detailed in Shenmai Tang below). Recently, I discovered another treatment method. The elder brother of Su XX from Fengtian, nearly fifty years old, had chronic lung disease. Eastern doctors diagnosed TB, but repeated treatments failed. One day, he sent a telegram to his younger brother stating his condition was critical and urging his return. Su XX came to my clinic requesting a prescription, reporting that recent letters indicated worsened cough with sputum and internal heat sensation. Although the telegram lacked details, the condition likely persisted and intensified. Given the severity, recovery seemed difficult, but due to earnest pleading, I prescribed: Xuanshen (Radix Scrophulariae) and Sheng Shanyao (Rhizoma Dioscoreae Hypoglaucae) each 1 liang, assisted by Chuanbei (Bulbus Fritillariae Cirrhosae), Niubangzi, and Gancao. Upon returning home and taking the decoction, he recovered after sweating once. It turned out the exacerbation was due to an exterior contraction. The exterior pathogen transmitted inward, causing Yangming dryness-heat, which resolved via sweating upon receiving cooling and moistening herbs. His prior lung disease also improved because the toxic heat in the lungs was vented through sweat, providing temporary relief, though the root cause remained latent. More than ten days later, his lung disease relapsed with coughing and foul-smelling sputum. Su XX returned asking for treatment, holding a prescription gifted by a friend. It was Xi Huang Wan. I had originally considered Xi Huang Wan and Xu's discussed herbs for TB, but due to high cost, I hesitated to try them. Seeing someone share my view, I anticipated efficacy. Encouraged to prepare the pills, he recovered before finishing the course.
Zhao XX from Fengtian, around forty years old. Symptoms included internal heat sensation, anorexia, cough, foul-smelling sputum, and emaciation preventing him from getting out of bed. Onset was three months prior. Pulse rate was 85 beats/min. Left pulse was near normal; right pulse was slippery and full. Tongue coating was fully yellow. Bowel movements occurred every 4-5 days and were very dry. Diagnosis: Exterior pathogen lingering in Lungs and Stomach, leading to long-term inflammation and impending putrefaction of the Lung. Western medicine considers TB at this stage incurable. I confidently promised a cure and administered Qingjin Jiedu Tang, removing Huangqin (Radix Scutellariae), adding Sheng Shanyao 6 qian and Sheng Shigao (Gypsum Fibrosum) 1 liang. After three doses, heat significantly decreased, appetite increased, and cough/sputum improved. Then, Shanyao was removed, Huangqin 3 qian was reinstated, Shigao was removed and replaced with Huafen (Radix Trichosanthis) 6 qian. Simultaneously, Aspirin 1/4 grain was taken daily. After more than ten days, significant improvement was observed. Body health restored, but occasional coughs persisted. Due to busyness, medication was stopped. Twenty days later, cough worsened, and foul sputum returned. Re-treatment with modified original formula showed little effect. Finally, Xi Huang Wan was administered, resulting in recovery.