《病源论》云∶肺痈者,由风寒伤于肺,其气结聚所成也。肺痈之状,其人咳,胸内满,
隐隐痛而战寒。
又肺痈有脓而呕者,不须治其呕也,脓止自愈。
又云∶咽干,口内燥而不渴,时时出浊唾腥臭,久久吐脓如粳米粥,难治。
又云∶痈脓吐如粥,始萌可救,脓成则死。
又云∶肺痈者在胸间,咳有血也。
《千金方》云∶咳,胸中满而偏振寒,脉数咽干而不渴,时时浊唾腥臭,久久吐脓如粳
米粥,是为肺痈。桔梗汤主之∶
桔梗(三枚) 甘草(一两)
凡二物, 咀,以水三升,煮取一升,绞去滓。适寒温,分为再服。朝饮暮吐脓血即愈。
(《葛氏方》同之。)
《范汪方》治肺痈方∶
用薏苡一升, 咀,淳苦酒三升,煮得一升,适寒温一服,有脓血当吐之。(《葛氏方》
同之。)
《百济新集方》治肺痈方∶
黄 一两,以水三升,煮取一升,分二服。(《葛氏方》同之。)
《僧深方》治肺痈经时不瘥,桔梗汤主之方∶
桔梗(三两) 甘草 薏苡仁 败酱 干地黄 术(各二两) 当归(一两) 桑根皮
(一升)
凡八物,切,以水一斗五升煮大豆四升,取七升汁,去豆纳清酒三升,合药煮三升半,
去滓,服七合,日三夜再。禁生菜。
《医门方》疗肺痈喘气急,卧不得安者方∶
葶苈子(三两,熬,捣如泥) 大枣(三十枚,破。)
水二升,煮枣二沸,去滓,纳葶苈脂一两,煎取一升,又以布滤,顿服之。忌猪肉酸咸。
《诸病源候论》说:肺痈,是由于风寒侵袭肺部,导致肺气郁结凝聚而形成的。肺痈的症状是,患者咳嗽,胸部内部胀满,隐隐作痛并伴有寒战。
如果肺痈患者体内有脓液且出现呕吐,不需要治疗呕吐,待脓液排尽后症状会自然痊愈。
又说:咽喉干燥,口中燥热但不觉得口渴,时常吐出浑浊、带有腥臭味的唾液,久而久之吐出像粳米粥一样的脓液,这种情况难以治疗。
又说:痈脓吐出的样子像粥一样,如果在初期(始萌)可以救治,一旦脓液形成则预后不良(死)。
《千金方》说:咳嗽,胸部胀满且偏侧发冷,脉象数快,咽喉干燥但不觉得口渴,时常吐出浑浊、带有腥臭味的唾液,久而久之吐出像粳米粥一样的脓液,这就是肺痈。用桔梗汤主治:
桔梗(三枚) 甘草(一两)
以上两味药,切碎,用水三升,煮取一升,过滤去渣。温度适宜时,分两次服用。早晨服用,晚上吐出脓血即可痊愈。
(《葛氏方》与此相同。)
《范汪方》治疗肺痈的方剂:
使用薏苡仁一升,切碎,用纯苦酒(醋)三升,煮取一升,温度适宜时一次服用,若有脓血应当吐出。(《葛氏方》与此相同。)
《百济新集方》治疗肺痈的方剂:
黄芩一两,用水三升,煮取一升,分两次服用。(《葛氏方》与此相同。)
《僧深方》治疗肺痈经久不愈,用桔梗汤主治的方剂:
桔梗(三两) 甘草 薏苡仁 败酱草 干地黄 白术(各二两) 当归(一两) 桑根白皮(一升)
以上八味药,切碎,用水一斗五升煮大豆四升,取七升汁液,去掉豆渣,加入清酒三升,混合药物煮取三升半,过滤去渣,每次服用七合,白天三次,夜间两次。禁止吃生菜。
《医门方》治疗肺痈气喘急促,无法安卧的方剂:
葶苈子(三两,炒制,捣成泥状) 大枣(三十枚,掰开。)
水二升,煮枣至沸腾两次,过滤去渣,加入葶苈脂一两,煎取一升,再用布过滤,一次性服用。忌食猪肉、酸味和咸味食物。
The *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases) states: Fei Yong (Lung Abscess) is formed by wind-cold damaging the lung, causing the qi to knot and accumulate. The presentation of Fei Yong (Lung Abscess) includes cough, fullness in the chest, hidden pain, and aversion to cold with trembling.
If a patient with Fei Yong (Lung Abscess) has pus and vomits, there is no need to treat the vomiting; once the pus stops, it will heal spontaneously.
It further states: Dry throat, dry mouth without thirst, frequent expectoration of turbid saliva with a fishy odor, and eventually expectorating pus resembling rice porridge after a long time, are difficult to treat.
It further states: If the expectorated pus resembles porridge, it can be saved if treated at the initial stage (Shi Meng); once the pus is fully formed, it leads to death.
It further states: In cases of Fei Yong (Lung Abscess), the lesion is located between the chest, accompanied by coughing up blood.
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: Cough, chest fullness, alternating chills, rapid pulse, dry throat without thirst, frequent expectoration of turbid saliva with a fishy odor, and eventually expectorating pus resembling rice porridge constitute Fei Yong (Lung Abscess). It is primarily treated with Jiegeng Tang (Platycodon Decoction):
Jiegeng (Radix Platycodonis, three pieces) Gancao (Radix Glycyrrhizae, one tael)
These two herbs are crushed, boiled in three sheng of water until reduced to one sheng, strained to remove dregs. When the temperature is suitable, divide into two doses. Take in the morning; by evening, expectoration of pus and blood indicates recovery.
(The *Ge Shi Fang* agrees with this.)
The *Fan Wang Fang* prescription for treating Fei Yong (Lung Abscess):
Use Yiyi Ren (Semen Coicis, one sheng), crush it, boil in three sheng of pure Kujiu (bitter wine/vinegar) until reduced to one sheng. Take once when the temperature is suitable; pus and blood should be expelled. (The *Ge Shi Fang* agrees with this.)
The *Baegye Sinjip Bang* (New Collection of Baekje Prescriptions) prescription for treating Fei Yong (Lung Abscess):
Huangqin (Radix Scutellariae, one tael), boil in three sheng of water until reduced to one sheng, divide into two doses. (The *Ge Shi Fang* agrees with this.)
The *Seng Shen Fang* (Prescription of Monk Shen) for treating Fei Yong (Lung Abscess) that has persisted without improvement, primarily using Jiegeng Tang:
Jiegeng (Radix Platycodonis, three taels) Gancao (Radix Glycyrrhizae) Yiyi Ren (Semen Coicis) Baijiang (Herba Patriniae) Shengdi Huang (Radix Rehmanniae Preparata) Baizhu (Rhizoma Atractylodis Macrocephalae) Danggui (Radix Angelicae Sinensis) Sangbaipi (Cortex Mori Radicis)
Each of the first six herbs is two taels; Danggui is one tael; Sangbaipi is one sheng.
These eight herbs are cut, boiled with four sheng of soybeans in ten dou five sheng of water until seven sheng of juice remain. Remove the beans, add three sheng of clear wine, combine with the herbs, and boil until three sheng half remain. Strain and remove dregs. Take seven ge per dose, three times during the day and twice at night. Avoid raw vegetables.
The *Yimen Fang* (Prescriptions from the Medical Gate) for treating Fei Yong (Lung Abscess) with panting, urgent breathing, and inability to lie down comfortably:
Tinglizi (Semen Lepidii et Descurainiae, three taels, stir-fried and pounded into paste) Dazao (Fructus Jujubae, thirty pieces, broken open.)
Boil the dates in two sheng of water for two boils, strain to remove dregs, add one tael of Tingli Zhi (fat/oil of Tinglizi), decoct until one sheng remains, filter through cloth, and take in one dose. Avoid pork, sour, and salty foods.