论曰右手关前寸口阴实者,肺实也,苦上气胸中满膨膨,与肩相引,扁鹊曰,肺实热则
喘逆胸凭仰息,手太阴经为热气所加,故为肺实之病,甚则口赤张引饮无度,体背生疮,以
至股膝 胫皆痛,法宜泻之。
治肺气盛实,其气上蒸,发嗽多痰,心胸烦躁,往往咯血,黄 煮散方
黄 (锉) 桑根白皮(锉) 杏仁(去皮尖双仁炒) 紫菀(去苗土) 黄苓(去黑
心) 麻黄(去根节) 麦门冬(去心焙) 升麻 贝母(去心) 羌活(去芦头) 蛤蚧
(酥炙各一分) 胡黄连(一钱)
上一十二味,捣罗为散,每服三钱匕,水一盏,生姜一枣大拍碎,煎至九分,去姜,食
后临卧温服。
治肺实热,喘逆胸满,仰息气急,麻黄汤方
麻黄(去根节煎掠去沫焙) 半夏(汤洗七遍焙) 桑根白皮(锉各二两半) 杏仁(去
皮尖双仁炒三
上七味,锉如麻豆大,每服五钱匕,水一盏半,入生姜半分切,竹叶二七片,煎至八分
,去滓温服。
治肺实热,喘逆胸满,仰息气急,地骨皮汤方
地骨皮(五两) 白前(二两) 石膏(研六两) 杏仁(去皮尖双仁炒三两) 桑根
白皮(锉四两)
上五味,锉如麻豆大,每服六钱匕,水二盏,入竹叶十片,煎至一盏,去滓温服。
治肺脏实热,喘促上气,胸膈不利,烦躁鼻干,地骨皮汤方
地骨皮(二两) 桑根白皮(锉一两半) 甘草(炙锉) 紫苏茎叶(各一两)
上四味,粗捣筛,每服三钱匕,水一盏,煎至七分,去滓食后临卧温服。
治肺脏热实喘嗽,葶苈丸方
甜葶苈子(纸上炒) 大黄(蒸熟锉各一分) 杏仁(二十七枚去皮尖双仁灯上燎熟。)
上三味,捣研为末,用枣肉丸如梧桐子大,每服五丸至七丸,食后临卧,生姜乌梅汤下
治肺气盛实,上焦不通,面目浮肿,大便燥,桔梗汤方
桔梗(炒) 大黄(锉炒) 麻黄(去根节) 枳壳(去瓤麸炒) 大腹皮(锉) 柴
胡(去苗) 杏仁(去皮尖双
上九味,粗捣筛,每服三钱匕,水一盏,生姜一枣大拍碎,煎至七分,去滓食临卧温服
治肺热实,凡右手寸口气口以前,脉阴实者,苦肺胀汗出气喘逆,咽中寒如欲呕状,名
肺实,肺实则胸满仰息,泄气除热,枸杞汤方
枸杞根皮(锉炒) 石膏碎(各四两) 陈橘皮(汤浸去白焙) 白术(各二两半) 白
前杏仁(去皮
上六味,粗捣筛,每服三钱匕,水一盏,煎至七分,去滓入蜜半匙,再煎令沸,食后温
服、日三。
治肺热实咳嗽,涕唾稠粘,气促急,不思食,天门冬煎方
生天门冬(二两去心以水一升煮烂候水尽研细) 紫菀(去土一两) 贝母(去心三两)
桔梗 白茯苓(去黑皮) 桑根白皮 锉木通(锉各一两半) 生地黄汁(四合) 白蜜(二
两) 藕汁 生麦门冬汁(各三合) 牛酥(一合)
上一十二味,捣罗六味为末,先下地黄麦门冬藕汁,煎五六沸,次下天门冬并白蜜,煎
五六沸,次下紫菀等末搅匀,次下酥慢火煎搅如饧,倾于合中、待凝,每服一匙,食后夜卧
细细咽之,日三五服。
治肺热实,猝嗽气促急妨闷,喘息不安,马兜铃汤方
马兜铃(七个) 桑根白皮(锉三两) 升麻(一两) 甘草(炙锉二两)
上四味,锉如麻豆大,每服五钱匕,水二盏,煎至一盏,去滓温服。
治肺脏热实,涕唾稠粘,喉咽不利,黄芩汤方
黄芩(去黑心) 黄 (锉) 柴胡(去苗) 秦艽(去土) 赤茯苓(去黑皮) 人
参栀子仁(各一两) 甘
上一十叶,粗捣筛,每服三钱匕,水一盏,煎至六分,去滓食后温服。
治肺脏实热,喘嗽鼻塞,口干咽痛,百部汤方
百部 款冬花 杏仁(去皮尖双仁炒) 甘草(炙锉各一两)
上四味,粗捣筛,每服三钱匕,水一盏,入糯米少许,煎至七分,去滓温服,不拘时。
论述说:右手关前寸口脉象阴实,是肺实证,症状表现为气逆、胸中胀满膨隆,疼痛牵引至肩部。扁鹊说,肺实热则气喘逆乱、胸部憋闷、仰面呼吸,这是手太阴肺经受热气侵袭所致,因此成为肺实证。严重时会出现口唇红赤、张口引饮且无节制,身体背部生疮,甚至大腿、膝盖、小腿都疼痛,治疗法则应当采用泻法。
治疗肺气盛实,气机上蒸,引发咳嗽多痰,心胸烦躁,常常咯血,黄芩煮散方:
黄芩(切碎) 桑根白皮(切碎) 杏仁(去皮尖,双仁者炒制) 紫菀(去苗土) 黄芩(去黑心) 麻黄(去根节) 麦门冬(去心焙干) 升麻 贝母(去心) 羌活(去芦头) 蛤蚧(酥炙,各一分) 胡黄连(一钱)
以上十二味药,捣碎过筛成散剂,每次服用三钱匕,用水一盏,生姜一块如枣大拍碎,煎至九分,去掉生姜,饭后临睡前温服。
治疗肺实热,气喘逆乱、胸满、仰面呼吸、气急,麻黄汤方:
麻黄(去根节,煎煮掠去浮沫焙干) 半夏(汤洗七遍焙干) 桑根白皮(切碎,各二两半) 杏仁(去皮尖,双仁者炒制,三两)
以上七味药,切碎如麻豆大小,每次服用五钱匕,用水一盏半,加入生姜半分切细,竹叶十四片,煎至八分,去掉药渣温服。
治疗肺实热,气喘逆乱、胸满、仰面呼吸、气急,地骨皮汤方:
地骨皮(五两) 白前(二两) 石膏(研细六两) 杏仁(去皮尖,双仁者炒制三两) 桑根白皮(切碎四两)
以上五味药,切碎如麻豆大小,每次服用六钱匕,用水二盏,加入竹叶十片,煎至一盏,去掉药渣温服。
治疗肺脏实热,喘促气逆,胸膈不利,烦躁鼻干,地骨皮汤方:
地骨皮(二两) 桑根白皮(切碎一两半) 甘草(炙后切碎) 紫苏茎叶(各一两)
以上四味药,粗捣过筛,每次服用三钱匕,用水一盏,煎至七分,去掉药渣,饭后临睡前温服。
治疗肺脏热实引起的喘咳,葶苈丸方:
甜葶苈子(纸上炒制) 大黄(蒸熟切碎,各一分) 杏仁(二十七枚,去皮尖,双仁者,在灯火上燎熟)
以上三味药,捣碎研成末,用枣肉制成梧桐子大小的丸剂,每次服用五丸至七丸,饭后临睡前,用生姜乌梅汤送服。
治疗肺气盛实,上焦不通,面目浮肿,大便干燥,桔梗汤方:
桔梗(炒制) 大黄(切碎炒制) 麻黄(去根节) 枳壳(去瓤麸炒) 大腹皮(切碎) 柴胡(去苗) 杏仁(去皮尖,双仁者)
以上九味药,粗捣过筛,每次服用三钱匕,用水一盏,生姜一块如枣大拍碎,煎至七分,去掉药渣,饭后临睡前温服。
治疗肺热实,凡是右手寸口气口以前,脉象阴实的,苦于肺胀、汗出、气喘逆乱,咽喉中有寒气像要呕吐的样子,名为肺实,肺实则胸满仰面呼吸,泄气除热,枸杞汤方:
枸杞根皮(切碎炒制) 石膏碎(各四两) 陈橘皮(汤浸去白焙干) 白术(各二两半) 白前 杏仁(去皮尖)
以上六味药,粗捣过筛,每次服用三钱匕,用水一盏,煎至七分,去掉药渣加入蜂蜜半匙,再煎令沸腾,饭后温服,每日三次。
治疗肺热实引起的咳嗽,鼻涕唾沫稠粘,气促急,不思饮食,天门冬煎方:
生天门冬(二两,去心,用水一升煮烂,候水尽后研细) 紫菀(去土一两) 贝母(去心三两) 桔梗 白茯苓(去黑皮) 桑根白皮 锉木通(切碎,各一两半) 生地黄汁(四合) 白蜜(二两) 藕汁 生麦门冬汁(各三合) 牛酥(一合)
以上十二味药,将其中六味捣罗成末,先下地黄、麦门冬、藕汁,煎五六沸,次下天门冬和白蜜,煎五六沸,次下紫菀等药末搅匀,次下牛酥用慢火煎搅如饴糖状,倒入容器中,待凝固,每次服用一匙,饭后夜间细细咽下,每日三到五次。
治疗肺热实,突然咳嗽、气促急、胸闷,喘息不安,马兜铃汤方:
马兜铃(七个) 桑根白皮(切碎三两) 升麻(一两) 甘草(炙切碎二两)
以上四味药,切碎如麻豆大小,每次服用五钱匕,用水二盏,煎至一盏,去掉药渣温服。
治疗肺脏热实,鼻涕唾沫稠粘,喉咽不利,黄芩汤方:
黄芩(去黑心) 黄芪(切碎) 柴胡(去苗) 秦艽(去土) 赤茯苓(去黑皮) 人参 栀子仁(各一两) 甘草
以上十一味药,粗捣过筛,每次服用三钱匕,用水一盏,煎至六分,去掉药渣饭后温服。
治疗肺脏实热,喘嗽鼻塞,口干咽痛,百部汤方:
百部 款冬花 杏仁(去皮尖,双仁者炒制) 甘草(炙切碎,各一两)
以上四味药,粗捣过筛,每次服用三钱匕,用水一盏,加入少许糯米,煎至七分,去掉药渣温服,不拘时间。
Commentary states: A yin-excess pulse at the cunkou position anterior to the guan on the right hand indicates Lung Excess (Lung Shi). The patient suffers from rebellious Qi, chest fullness and distension, and pain radiating to the shoulder. Bian Que stated that Lung Excess-Heat manifests as panting and rebellious Qi, chest oppression, and orthopnea (breathing with the body leaning forward). This occurs because the Hand-Taiyin Lung Meridian is affected by pathogenic heat, resulting in Lung Excess. In severe cases, there may be redness of the lips, excessive thirst with uncontrolled drinking, sores on the back, and pain extending to the thighs, knees, and shins. The treatment principle should be to purge (Xie).
To treat Lung Qi Excess where Qi steams upward, causing cough with profuse phlegm, restlessness in the chest and heart, and frequent hemoptysis, use Huangqin Zhu San Decoction:
Huangqin (Scutellariae Radix, sliced) Sangbaipi (Mori Cortex, sliced) Xingren (Pruni Semen, peeled, core removed, twin-kernel stir-fried) Ziwan (Asterni Radix, stems and soil removed) Huangqin (Scutellariae Radix, black heart removed) Mahuang (Ephedrae Herba, roots and joints removed) Maimendong (Ophiopogonis Radix, heart removed, baked) Shengma (Cimicifugae Rhizoma) Beimu (Fritillariae Bulbus, heart removed) Qianghuo (Notopterygii Rhizoma et Radix, rhizome removed) Gejie (Gekko, prepared with butter, each 1 fen) Huhuanglian (Picrorhizae Rhizoma, 1 qian)
The above twelve ingredients are pounded, sifted into a powder. Take 3 qianbi per dose, add one zhan of water and one date-sized piece of fresh ginger smashed, decoct until 9/10 remains, remove the ginger, and take warm after meals and before bed.
To treat Lung Excess-Heat with panting, rebellious Qi, chest fullness, orthopnea, and rapid breathing, use Mahuang Tang Decoction:
Mahuang (Ephedrae Herba, roots and joints removed, boiled to skim foam, then baked) Banxia (Pinelliae Rhizoma, washed seven times in hot water, then baked) Sangbaipi (Mori Cortex, sliced, each 2 liang 5 qian) Xingren (Pruni Semen, peeled, core removed, twin-kernel stir-fried, 3 liang)
The above seven ingredients are cut into sizes similar to hemp seeds. Take 5 qianbi per dose, add 1.5 zhan of water, half a qian of sliced fresh ginger, and fourteen leaves of Zhuye (Bambusae Folium), decoct until 8/10 remains, remove the dregs, and take warm.
To treat Lung Excess-Heat with panting, rebellious Qi, chest fullness, orthopnea, and rapid breathing, use Digupi Tang Decoction:
Digupi (Lycii Cortex, 5 liang) Baiqian (Cynanchi Stellati Radix, 2 liang) Shigao (Gypsum Fibrosum, ground, 6 liang) Xingren (Pruni Semen, peeled, core removed, twin-kernel stir-fried, 3 liang) Sangbaipi (Mori Cortex, sliced, 4 liang)
The above five ingredients are cut into sizes similar to hemp seeds. Take 6 qianbi per dose, add 2 zhan of water and ten leaves of Zhuye (Bambusae Folium), decoct until 1 zhan remains, remove the dregs, and take warm.
To treat Lung Organ Excess-Heat with rapid panting, rebellious Qi, chest and diaphragm discomfort, restlessness, and dry nose, use Digupi Tang Decoction:
Digupi (Lycii Cortex, 2 liang) Sangbaipi (Mori Cortex, sliced, 1.5 liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and sliced) Zisu Jingye (Perillae Caulis et Folium, each 1 liang)
The above four ingredients are coarsely pounded and sifted. Take 3 qianbi per dose, add 1 zhan of water, decoct until 7/10 remains, remove the dregs, and take warm after meals and before bed.
To treat Lung Organ Heat-Excess causing panting and cough, use Tingli Wan Pill:
Tian Tinglizi (Descurainiae Semen, stir-fried on paper) Dahuang (Rhei Radix et Rhizoma, steamed, ripe, and sliced, each 1 fen) Xingren (Pruni Semen, 27 kernels, peeled, core removed, twin-kernel, roasted over lamp flame)
The above three ingredients are pounded and ground into powder. Form pills using jujube paste, sized like paulownia seeds. Take 5 to 7 pills per dose, after meals and before bed, taken down with a decoction of fresh ginger and sour plum (Wumei).
To treat Lung Qi Excess where Upper Jiao (Upper Burner) is blocked, causing edema of the face and eyes, and dry stool, use Jiegeng Tang Decoction:
Jiegeng (Platycodonis Radix, stir-fried) Dahuang (Rhei Radix et Rhizoma, sliced and stir-fried) Mahuang (Ephedrae Herba, roots and joints removed) Zhike (Aurantii Fructus Immaturus, placenta removed, bran-fried) Dafupi (Arecae Pericarpium, sliced) Chaihu (Bupleuri Radix, sprouts removed) Xingren (Pruni Semen, peeled, core removed, twin-kernel)
The above nine ingredients are coarsely pounded and sifted. Take 3 qianbi per dose, add 1 zhan of water and one date-sized piece of fresh ginger smashed, decoct until 7/10 remains, remove the dregs, and take warm after meals and before bed.
To treat Lung Heat-Excess, specifically when the pulse at the cunkou position anterior to the qi kou on the right hand is yin-excess, suffering from Lung distension, sweating, panting, and rebellious Qi, with a sensation of cold in the throat resembling nausea, this is named Lung Excess. Lung Excess presents with chest fullness and orthopnea. To vent Qi and eliminate Heat, use Gouqi Tang Decoction:
Gouqigenpi (Lycii Cortex, sliced and stir-fried) Shigao (Gypsum Fibrosum, crushed, each 4 liang) Chenpi (Citri Reticulatae Pericarpium, soaked in water, white pith removed, baked) Baizhu (Atractylodis Macrocephalae Rhizoma, each 2.5 liang) Baiqian (Cynanchi Stellati Radix) Xingren (Pruni Semen, peeled, core removed)
The above six ingredients are coarsely pounded and sifted. Take 3 qianbi per dose, add 1 zhan of water, decoct until 7/10 remains, remove the dregs, add half a spoon of honey, boil again until bubbling, take warm after meals, three times daily.
To treat Lung Heat-Excess causing cough, thick and sticky sputum, rapid breathing, and loss of appetite, use Tianmendong Jian Decoction:
Sheng Tianmendong (Asparagi Radix, raw, 2 liang, heart removed, boiled in 1 sheng of water until soft, water evaporated, then ground fine) Ziwan (Asterni Radix, soil removed, 1 liang) Beimu (Fritillariae Bulbus, heart removed, 3 liang) Jiegeng (Platocodonis Radix) Baifuling (Poria, black skin removed) Sangbaipi (Mori Cortex) Cutong (Akebiae Caulis, sliced, each 1.5 liang) Sheng Dihuangzhi (Rehmanniae Radix Juice, 4 he) Baimi (White Honey, 2 liang) Ouji (Loti Nymphaeae Nelumbinisque Semen Placenta Juice) Sheng Maimendongzhi (Ophiopogonis Radix Juice, each 3 he) Niusu (Bovis Butter, 1 he)
The above twelve ingredients: pound and sift six of them into powder. First, decoct Dihuang juice, Maimendong juice, and Ouji for five or six boils. Then add Tianmendong and Baimi, decoct for five or six boils. Next, add the Ziwan powder and others, stir evenly. Then add Niusu, simmer slowly while stirring until it resembles maltose syrup. Pour into a container, let it solidify. Take one chi per dose, swallow slowly after meals and at night, three to five times daily.
To treat Lung Heat-Excess with sudden cough, rapid breathing, chest stuffiness, and restless panting, use Madouling Tang Decoction:
Madouling (Aristolochiae Fructus, 7 fruits) Sangbaipi (Mori Cortex, sliced, 3 liang) Shengma (Cimicifugae Rhizoma, 1 liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and sliced, 2 liang)
The above four ingredients are cut into sizes similar to hemp seeds. Take 5 qianbi per dose, add 2 zhan of water, decoct until 1 zhan remains, remove the dregs, and take warm.
To treat Lung Organ Heat-Excess with thick and sticky sputum and throat/pharynx obstruction, use Huangqin Tang Decoction:
Huangqin (Scutellariae Radix, black heart removed) Huangqi (Astragali Radix, sliced) Chaihu (Bupleuri Radix, sprouts removed) Qinjiao (Gentianae Macrophyllae Radix, soil removed) Chifuling (Poria with Red Skin, black skin removed) Renshen (Ginseng Radix) Zhiziren (Gardeniae Semen, each 1 liang) Gancao (Glycyrrhizae Radix et Rhizoma)
The above eleven ingredients are coarsely pounded and sifted. Take 3 qianbi per dose, add 1 zhan of water, decoct until 6/10 remains, remove the dregs, and take warm after meals.
To treat Lung Organ Excess-Heat with panting, cough, nasal congestion, dry mouth, and sore throat, use Baibu Tang Decoction:
Baibu (Stemonae Radix) Kuandonghua (Farfarae Flos) Xingren (Pruni Semen, peeled, core removed, twin-kernel stir-fried) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and sliced, each 1 liang)
The above four ingredients are coarsely pounded and sifted. Take 3 qianbi per dose, add 1 zhan of water and a small amount of glutinous rice, decoct until 7/10 remains, remove the dregs, and take warm at any time.