西方白色。入通于肺。位居于兑为燥金。时列于秋为燥令。燥者火之余气也。所藉乎有以润
之。而不至于竭其液。则清肃下行。将天气降而云物不为之扰矣。肺位至高。风寒易侵。郁火于
中。使复加之辛热。则柔脆之金。一经消烁。有不损坏者乎。而肺痈于是乎作矣。又主元气。治
节一身。苟劳动喘乏。用而不息。将肺
气日促。口吐涎沫。无气以动。而肺痿于是乎成矣。盖二症者。一本外感。一本内伤。外感者。
非遽至于痈也。良由治疗失宜。过于解散。而以保之润之为急。多有得生者。虽破残之肺。可以
复完。内伤者。则因酒色过度。酒入气分。色伤阴分。辛热之性。既以耗于上。又以竭于下。日
渐月累。每成于不自觉。久乃痿 声嘶。肺气败坏而不复支。使欲嘘其既槁而润之。诚难为功。
孰谓二症可不辨哉。
一肺痈能食者生。赖有胃气。土为金之母也。其症咳唾稠痰。腥秽如脓。黄赤间杂。甚则咳
出白血。白血者肺之叶也。手掌干涩。皮肤不泽。脉数而疾。急以栝蒌仁汤。连进数剂。或一二
十剂。未有不愈者。余屡治神验。不易仆数。
一肺痿。咳唾涎沫。胸中隐痛。四肢乏力。无气以动。用补中益气汤去升麻、柴胡。加阿胶、
桑皮、麦冬、五味、白芨。
治验
一男子冬日咳嗽。自用发表。至春咳出臭痰。已七八日矣。昼夜不绝。脉得细数。展侧不能。
手如枯掌。但饮食犹进。余用栝蒌、贝母之属。连进八剂。减半。又八剂。全愈。以六味丸调之。
一人夏月饮火酒。患赤痢。脉洪数。与芍药汤服之。未愈更医。至冬。渐变咳嗽臭痰。疡科
作肺痈治。延至于
春。日吐红血盂许。上结白沫。臭秽异常。又经月余。咸谓必死。复延余诊。脉犹洪大带数。见
其食鸡子。连进七八枚。无恙。余因谓曰。可治。肺虽坏而胃气未败也。亦与前汤。服十六剂。
果愈。继以膏子药。调理而痊。
栝蒌仁汤
栝蒌霜 米仁（各二钱） 川贝母（去心） 天门冬（去心） 金银花 麦门冬（去心）
百合（各钱半） 甘草节（三分） 桑白皮（蜜炙） 桔梗（各一钱）
水煎。久而不敛。加白芨、阿胶。去桑皮。寒月。加款冬花、紫菀。夏月。加生地、牡丹皮。
若脾虚不食。用四君子汤。或六君子汤。但喘未除者。不可骤补。真阴不足。继以六味丸加阿胶。
西方对应白色，其气入通于肺。肺在八卦中位居兑卦，五行属燥金；在四季中列于秋季，主司燥令。燥是火的残余之气，需要依靠滋润之物来调和，以免耗竭体内津液，这样肺气才能清肃下行，使天气下降而云物不受干扰。肺的位置最高，风寒容易侵袭，若郁火在内，再误用辛热药物，那么柔脆的肺金一经消烁，岂有不损坏的道理？肺痈因此产生。肺又主管元气，治理调节全身。如果劳倦导致气喘乏力，过度使用攻伐药物而不加休止，将使肺气日益短促，出现口吐涎沫、无气以动的症状，肺痿因此形成。大概这两种病症，一个源于外感，一个源于内伤。外感所致者，并非立刻发展为肺痈，大多是因为治疗不当，过于发散解表，而以保护滋润为急务，多有存活者，即使破损的肺也能恢复完整。内伤者，则是因为酒色过度，酒进入气分，色欲损伤阴分，辛热的药性既在上部消耗，又在下面枯竭，日积月累，往往在不知不觉中形成，久而久之导致声音嘶哑，肺气败坏无法支撑，想要吹嘘已经干枯的肺部并加以滋润，确实难以奏效。谁说这两种病症可以不加以辨别呢？
肺痈患者若能进食，说明有胃气，因为土是金的母脏。其症状为咳嗽吐稠痰，气味腥臭如脓，黄赤相间，严重时咳出白血（指肺之叶）。手掌干涩，皮肤不润泽，脉象数而疾速，应立即服用栝蒌仁汤，连续服用数剂，或一二十剂，没有不痊愈的。我多次治疗，效果神奇，不胜枚举。
肺痿的症状为咳嗽吐涎沫，胸中隐痛，四肢乏力，无气以动。使用补中益气汤去掉升麻、柴胡，加入阿胶、桑白皮、麦冬、五味子、白芨。
治验案例：
一名男子冬日咳嗽，自行服用发表药物，到了春天咳出臭痰，持续七八天，昼夜不停，脉象细数，翻身困难，手如枯掌，但饮食还能进用。我使用栝蒌、贝母等药物，连续服用八剂，症状减半；又服八剂，完全痊愈。随后用六味丸调理。
另一人夏天饮用火酒，患赤痢，脉象洪数，给予芍药汤服用，未愈后更换医生。到了冬天，逐渐变为咳嗽臭痰，疡科按肺痈治疗，拖延到春天，每天吐出约一盂的红血，上面凝结白沫，气味异常腥臭。又经过一个多月，大家都认为必死无疑，再次请我诊治。脉象仍然洪大带数，见其吃鸡蛋，连吃七八个也无恙。我对他说：“可以治疗。肺虽然坏了，但胃气尚未败绝。”也给予前面的方药，服用十六剂，果然痊愈。继以膏滋药调理而康复。
栝蒌仁汤组成：
栝蒌霜、米仁（薏苡仁）各二钱；川贝母（去心）、天门冬（去心）、金银花、麦门冬（去心）、百合各钱半；甘草节三分；桑白皮（蜜炙）、桔梗各一钱。
水煎服。如果久不收敛，加白芨、阿胶，去掉桑白皮。寒月，加款冬花、紫菀；夏月，加生地、牡丹皮。如果脾虚不食，用四君子汤或六君子汤。但喘症未除者，不可骤然进补。真阴不足者，继以六味丸加阿胶。
The West corresponds to the color white, and its qi enters into communication with the Lung. In the Bagua (Eight Trigrams), the Lung is located in the Dui trigram, belonging to Dry Metal in the Five Elements; in the four seasons, it is listed in Autumn, governing the Dry command. Dryness is the residual qi of Fire. It requires moistening agents to prevent the exhaustion of body fluids, so that the Lung's Qi can descend clearly and turbidly, allowing Heaven's Qi to descend without disturbing clouds and objects. The Lung is positioned at the highest point, making it susceptible to invasion by Wind-Cold. If internal Stagnant Fire exists, and acrid-warm herbs are additionally applied, the soft and fragile Metal will be consumed and scorched; how could it not be damaged? Thus, Lung Abscess arises. The Lung also governs Yuan Qi (Primal Qi) and regulates the entire body. If labor leads to panting and fatigue, and tonics or treatments are used incessantly without rest, Lung Qi will become increasingly short, leading to symptoms such as spitting saliva and foam, and lack of energy to move, resulting in Lung Withered Disease. Generally, these two conditions stem from one source being external contraction and the other internal injury. External contraction does not immediately lead to abscess; rather, it often results from improper treatment, excessive dispersing and resolving of the exterior, prioritizing protection and moistening. Many survive, and even a damaged lung can recover. Internal injury stems from excess alcohol and sexual indulgence. Alcohol enters the Qi level, while sexual excess damages the Yin level. The acrid-warm nature consumes upwards and exhausts downwards. Day by day and month by month, this accumulates unconsciously, eventually causing hoarseness and irreversible damage to Lung Qi. Trying to revive a dried-out Lung and moisten it is indeed difficult. How can one fail to distinguish between these two conditions?
If a patient with Lung Abscess can eat, it indicates the presence of Stomach Qi, as Earth is the Mother of Metal. Symptoms include coughing up thick phlegm with a fishy, foul odor resembling pus, mixed yellow and red colors. In severe cases, "white blood" (referring to lung tissue/lobes) is coughed up. The palms are dry and rough, the skin lacks luster, and the pulse is rapid and hurried. One should immediately administer Gualou Ren Tang (Trichosanthes Seed Decoction). Continuous administration for several doses, or ten to twenty doses, invariably leads to recovery. I have treated many cases with miraculous efficacy, too numerous to recount.
For Lung Withered Disease, characterized by coughing up saliva and foam, dull pain in the chest, weakness in the four limbs, and lack of energy to move, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) removing Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix), adding Ejiao (Donkey-Hide Gelatin), Sangbaipi (Mori Cortex), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), and Baiji (Bletillae Rhizoma).
Clinical Cases:
A man suffered from cough in winter. He self-administered exterior-releasing herbs. By spring, he was coughing up foul-smelling sputum for seven or eight days, day and night without cessation. His pulse was fine and rapid, he could not turn his side, and his hands were like withered palms, yet his appetite remained. I administered herbs such as Gualou (Trichosanthis Fructus) and Beimu (Fritillariae Bulbus) continuously for eight doses, reducing symptoms by half. After another eight doses, he was completely cured. He was then regulated with Liuwei Wan (Six-Ingredient Pill with Rehmannia).
Another person drank fiery wine in summer and developed bloody dysentery. His pulse was surging and rapid. He took Shaoyao Tang (Peony Decoction) but did not improve and changed doctors. By winter, he gradually developed coughing of foul-smelling sputum. The Surgeon Department treated it as Lung Abscess. By spring, he was vomiting about a bowlful of red blood daily, topped with white foam, with an exceptionally foul odor. Over a month later, everyone believed he would surely die. He sought my consultation again. His pulse was still surging, large, and rapid. Seeing him eating eggs, consuming seven or eight consecutively without ill effect, I said, "It is treatable. Although the Lung is damaged, the Stomach Qi has not failed." I prescribed the same decoction as before. After sixteen doses, he recovered. He was subsequently treated with paste medicines and fully recuperated.
Gualou Ren Tang (Trichanthes Seed Decoction):
Gualou Shuang (Processed Trichosanthes Fruit Powder) and Yiren (Coix Seed, *Coicis Semen*) each 2 qian; Chuanbeimu (Fritillariae Cirrhosae Bulbus, heart removed), Tianmendong (Asparagi Radix, heart removed), Jinyinhua (Lonicerae Japonicae Flos), Maimendong (Ophiopogonis Radix, heart removed), Baihe (Lilii Bulbus) each 1.5 qian; Gancao Jie (Licorice Joint, *Glycyrrhizae Radix et Rhizoma*) 3 fen; Sangbaipi (Mori Cortex, honey-fried) and Jiegeng (Platycodonis Radix) each 1 qian.
Decoct in water. If healing is slow, add Baiji (*Bletillae Rhizoma*) and Ejiao (*Asini Corii Colla*), remove Sangbaipi. In cold months, add Kuandonghua (Farfarae Flos) and Ziwan (Adenophorae Radix). In summer months, add Shengdi (Rehmanniae Radix) and Mudanpi (Moutan Cortex). If Spleen deficiency leads to poor appetite, use Sijunzi Tang (Four Gentlemen Decoction) or Liujunzi Tang (Six Gentlemen Decoction). However, if wheezing persists, do not tonify abruptly. For insufficiency of True Yin, follow up with Liuwei Wan (Six-Ingredient Pill with Rehmannia) added with Ejiao.