论曰肺痈之病,脉数而实,盖以风中于卫,呼气不入,热过于营,吸而不出,风热凝滞
,蓄结为痈。其证恶寒口干,胸中隐隐痛,咳而胸满,时出腥唾者是也。宜速治之,久则吐
脓如米粥,始萌可救,脓成难治。
治肺痈,苇叶汤方
苇叶(细切二升) 桃仁(五十枚去皮尖双仁炒研) 瓜子 薏苡仁(各半升)
上四味,以水一斗,先煮苇得五升,去滓纳诸药,煮取二升,再去滓,分温三服,当吐
如脓。
治肺痈,甜葶苈丸方
甜葶苈(隔纸炒别研细罗过) 杏仁(去皮尖双仁麸炒别研如膏各一两) 贝母(煨
令黄色去心
上三味,先使不 皂荚肥者二两,生椎碎,入在无灰酒半升内,熟 滤去滓,入净铫子
中,慢火熬成膏,次将前三味药拌匀,旋入皂荚膏,和丸如梧桐子大,每服二十丸,温水下
,如肺气喘急,浓煎桑白皮汤下,不拘时候。
治肺痈,防己葶苈丸方
防己(一两) 葶苈(隔纸炒三分) 杏仁(去皮尖双仁炒研如脂一分)
上三味,先捣前二味,细罗为末,与杏仁同研令匀,取枣肉和丸,如梧桐子大,每日空
腹,煎桑白皮汤下二十丸,日三服。
治肺痈咳嗽,防己丸方
防己 杏仁(去皮尖双仁麸炒) 贝母(去心) 甘草(炙锉各二两) 甜葶苈(四
两隔纸炒香)
上五味,捣研为末,面糊和丸,如绿豆大,每服三十丸,不拘时候,温水下。
治肺痈,生地黄汤方
生地黄汁(一升) 当归(切焙) 甘草(炙) 白石英(碎绵裹) 人参(各一两) 附
子(炮裂去皮脐一两)
上八味,除地黄汁鸡外,锉如麻豆,以水一斗五升,先煮鸡取七升汁去鸡,纳地黄汁
诸药等,煮取三升,去滓每服一盏,日三夜二。
治肺痈,薏苡仁汤方
薏苡仁(一升) 苦酒(三升)
上二味,同煮取一升,去滓微温顿服,有脓血吐出,验。
治肺痈,吐脓如粳米粥,桔梗汤方
桔梗(锉炒一两半) 甘草(炙锉半两)
上二味,粗捣筛,每服六钱匕,水二盏,煎至一盏,去滓空腹温服,须臾吐脓数合瘥。
治肺痈涕唾涎沫,吐脓如粥,麦门冬汤方
麦门冬(去心焙二两) 桔梗(去芦头五两) 甘草(炙锉三分)
上三味,粗捣筛,每服三钱匕,水一盏,青蒿心叶十片,同煎至七分,去滓温服,稍轻
者粥饮调下亦得,不计时候。
治肺痈吐脓,五心烦热,壅闷咳嗽,四顺汤方
贝母(去心) 桔梗(炒) 紫菀(去苗土各一两) 甘草(炙锉半两)
上四味,粗捣筛,每服三钱匕,水一盏,煎五七沸去滓,不拘时候稍冷服,如咳嗽甚,
入去皮尖杏仁三枚,同煎,小儿量减。
治肺痈吐脓,经时不瘥,桔梗白术汤方
桔梗(锉三分) 白术 生干地黄(焙) 薏苡仁 甘草(炙) 败酱(各二两) 当
归(切焙一两) 桑
上八味,锉如麻豆,以水一斗五升,煮大豆四升,取七升,去豆,纳清酒三升,合诸
药煮之,去滓取三升,每服一盏,日三夜二。
论述说:肺痈这种病,脉象数而实,这是因为风邪侵袭卫分,呼气时气机不能内入;热邪深入营分,吸气时气机不能外出。风热之邪凝滞体内,积聚结聚而形成痈肿。其症状表现为恶寒、口干,胸中隐隐作痛,咳嗽且胸部胀满,时常吐出带有腥味的唾沫。应当迅速治疗,若拖延日久,则会咳吐如米粥般的脓液。在疾病初起阶段尚可救治,一旦脓液形成则难以治愈。
治疗肺痈的苇叶汤方:
苇叶(细切二升)、桃仁(五十枚,去皮尖及双仁,炒后研碎)、瓜子、薏苡仁(各半升)。
以上四味药,用水一斗,先煮苇叶至五升,滤去药渣,加入其余药物,再煮取二升,再次滤去药渣,分三次温服,服药后应当会吐出类似脓液的物质。
治疗肺痈的甜葶苈丸方:
甜葶苈(隔纸炒制,另研细并过筛)、杏仁(去皮尖及双仁,用麸皮炒制,另研如膏状,各一两)、贝母(煨至黄色,去心)。
以上三味药,先取肥大的皂荚二两,捣碎,放入无灰酒半升中,煮熟后滤去药渣,将药汁倒入干净的锅中,用慢火熬成膏状。然后将前三味药粉拌匀,逐渐加入皂荚膏,调和制成梧桐子大小的丸剂。每次服用二十丸,温水送下;如果肺气喘急,可用浓煎的桑白皮汤送服,不限时间。
治疗肺痈的防己葶苈丸方:
防己(一两)、葶苈(隔纸炒三分)、杏仁(去皮尖及双仁,炒后研如脂状一分)。
以上三味药,先将前两种药捣碎,细罗为末,与杏仁一同研匀,取枣肉调和制成梧桐子大小的丸剂。每日空腹时,用煎好的桑白皮汤送服二十丸,每日三次。
治疗肺痈咳嗽的防己丸方:
防己、杏仁(去皮尖及双仁,用麸皮炒制)、贝母(去心)、甘草(炙制锉碎,各二两)、甜葶苈(四两,隔纸炒香)。
以上五味药,捣碎研末,用面糊调和制成绿豆大小的丸剂。每次服用三十丸,不限时间,温水送下。
治疗肺痈的生地黄汤方:
生地黄汁(一升)、当归(切片焙干)、甘草(炙制)、白石英(打碎后用绵布包裹)、人参(各一两)、附子(炮裂,去皮脐,一两)、鸡一只。
以上八味药,除生地黄汁和鸡以外,将其他药材锉碎如麻豆大小。用水一斗五升,先煮鸡取七升汁,去掉鸡肉,加入生地黄汁及其他药物,煮取三升,滤去药渣。每次服用一盏,白天三次,夜间两次。
治疗肺痈的薏苡仁汤方:
薏苡仁(一升)、苦酒(三升)。
以上两味药,同煮取一升,滤去药渣,微温后一次性服下,若有脓血吐出,即为有效。
治疗肺痈咳吐脓液如粳米粥的桔梗汤方:
桔梗(锉碎炒制一两半)、甘草(炙制锉碎半两)。
以上两味药,粗捣筛过,每次服用六钱匕,用水二盏,煎至一盏,滤去药渣,空腹温服,不久便会吐出脓液,病情即可好转。
治疗肺痈涕唾涎沫、吐脓如粥的麦门冬汤方:
麦门冬(去心焙干二两)、桔梗(去芦头五两)、甘草(炙制锉碎三分)。
以上三味药,粗捣筛过,每次服用三钱匕,用水一盏,加青蒿心叶十片,同煎至七分,滤去药渣温服。症状较轻者,也可用米粥饮调服,不限时间。
治疗肺痈吐脓、五心烦热、壅闷咳嗽的四顺汤方:
贝母(去心)、桔梗(炒制)、紫菀(去苗土,各一两)、甘草(炙制锉碎半两)。
以上四味药,粗捣筛过,每次服用三钱匕,用水一盏,煎煮五六沸后滤去药渣,不限时间,稍凉后服用。如果咳嗽严重,可加入去皮尖的杏仁三枚,同煎,小儿用量酌情减少。
治疗肺痈吐脓,经久不愈的桔梗白术汤方:
桔梗(锉碎三分)、白术、生干地黄(焙干)、薏苡仁、甘草(炙制)、败酱草(各二两)、当归(切片焙干一两)、大豆四升。
以上八味药,锉碎如麻豆大小,用水一斗五升,先煮大豆四升,取七升汁,去掉大豆,加入清酒三升,混合诸药一起煮,煮取三升,滤去药渣。每次服用一盏,白天三次,夜间两次。
Discussion: Lung abscess (Fei Yong) is characterized by a rapid and full pulse. This occurs because wind pathogen invades the Wei level (Defensive Level), preventing Qi from entering during exhalation; heat pathogen penetrates the Ying level (Nutritive Level), preventing Qi from exiting during inhalation. Wind-heat stagnates, accumulates, and consolidates to form an abscess. The symptoms include aversion to cold, dry mouth, dull pain in the chest, cough with chest fullness, and expectoration of foul-smelling saliva. It should be treated promptly; if delayed, pus resembling congee will be coughed up. Early intervention can save the patient, but once pus has formed, it is difficult to treat.
Formula for Treating Lung Abscess: Weie Decoction (Reed Leaf Decoction)
Reed leaf (Weie, finely cut, 2 sheng); Peach kernel (Taoren, 50 seeds, skin and pointed ends removed, twin kernels discarded, stir-fried and crushed); Melon seed (Gua Zi); Coix seed (Yiyiren, each 0.5 sheng).
Take the above four herbs. Add 1 dou of water, first decoct the Reed leaf until 5 sheng remain. Strain out the dregs, add the remaining herbs, and decoct until 2 sheng remain. Strain again. Divide into three warm doses. After administration, the patient should expectorate material resembling pus.
Formula for Treating Lung Abscess: Tiantingli Pill (Sweet Descurainia Seed Pill)
Sweet Descurainia seed (Tiantingli, stir-fried between papers, separately ground fine and sieved); Apricot kernel (Xingren, skin and pointed ends removed, twin kernels discarded, stir-fried with bran, separately ground into paste, each 1 liang); Fritillaria bulb (Beimu, roasted until yellow, heart removed).
Take the above three herbs. First, take 2 liang of plump Sophora japonica pod (Zaojiao), crush it raw, place it in 0.5 sheng of unadulterated wine, cook thoroughly, strain out the dregs, and pour the liquid into a clean pot. Slowly boil down to a paste. Then mix the powders of the first three herbs evenly, gradually incorporate the Sophora japonica pod paste, and blend to form pills the size of Sophora seeds (Wutongzi). Take 20 pills per dose with warm water. If lung qi rebellion causes panting and urgency, administer with thickly decocted Morus alba root bark (Sangbaipi) tea. No specific time restriction.
Formula for Treating Lung Abscess: Fangji Tiantingli Pill
Stephania root (Fangji, 1 liang); Descurainia seed (Tiantingli, stir-fried between papers, 3 qian); Apricot kernel (Xingren, skin and pointed ends removed, twin kernels discarded, stir-fried and ground like fat, 1 fen).
First, crush the first two herbs and sieve them into fine powder. Mix evenly with the ground Apricot kernel. Use date flesh to bind and form pills the size of Sophora seeds. Take 20 pills on an empty stomach daily, administered with decocted Morus alba root bark (Sangbaipi) tea. Three times a day.
Formula for Treating Lung Abscess Cough: Fangji Pill
Stephania root (Fangji); Apricot kernel (Xingren, skin and pointed ends removed, twin kernels discarded, stir-fried with bran); Fritillaria bulb (Beimu, heart removed); Licorice root (Gancao, honey-fried and chopped, each 2 liang); Sweet Descurainia seed (Tiantingli, 4 liang, stir-fried between papers until fragrant).
Crush and grind the above five herbs into powder. Bind with wheat flour paste to form pills the size of mung beans. Take 30 pills per dose at any time, with warm water.
Formula for Treating Lung Abscess: Shengdihuang Decoction
Fresh Rehmannia juice (Shengdihuang Zhi, 1 sheng); Angelica sinensis root (Danggui, sliced and baked); Licorice root (Gancao, honey-fried); White quartz (Bai Shiyin, crushed and wrapped in silk); Ginseng (Renshen, each 1 liang); Prepared Aconite root (Fuzi, processed, cracked, skin and navel removed, 1 liang); Chicken (one whole chicken).
Except for the Fresh Rehmannia juice and the chicken, chop the other herbs as small as hemp seeds. Add 1 dou 5 sheng of water, first decoct the chicken to obtain 7 sheng of broth. Remove the chicken meat. Add the Fresh Rehmannia juice and the other herbs. Decoct until 3 sheng remain. Strain. Take one cup per dose, three times during the day and twice at night.
Formula for Treating Lung Abscess: Yiyiren Decoction
Coix seed (Yiyiren, 1 sheng); Vinegar (Ku Jiu, 3 sheng).
Decoct the above two ingredients together until 1 sheng remains. Strain. Drink while slightly warm in one dose. If pus and blood are expectorated, this indicates efficacy.
Formula for Treating Lung Abscess with Expectoration of Pus Like Glutinous Rice Congee: Jiegeng Decoction
Platycodon root (Jiegeng, chopped and stir-fried, 1.5 liang); Licorice root (Gancao, honey-fried and chopped, 0.5 liang).
Coarsely crush and sieve the above two herbs. Take 6 qianbi (approx. 6-9 grams) per dose. Add 2 zhan of water, decoct until 1 zhan remains. Strain. Take warm on an empty stomach. Shortly after, pus will be expectorated, and the condition will improve.
Formula for Treating Lung Abscess with Nasal Discharge, Saliva, Phlegm, and Expectoration of Pus Like Congee: Maimendong Decoction
Ophiopogon tuber (Maimendong, heart removed and baked, 2 liang); Platycodon root (Jiegeng, radix removed, 5 liang); Licorice root (Gancao, honey-fried and chopped, 3 qian).
Coarsely crush and sieve the above three herbs. Take 3 qianbi per dose. Add 1 zhan of water and 10 leaves of Artemisia annua heart and leaves (Qinghao Xin Ye). Decoct together until 0.7 zhan remains. Strain and take warm. For mild cases, it may also be taken mixed with rice gruel drink. No specific time restriction.
Formula for Treating Lung Abscess with Expectoration of Pus, Five-Center Heat, Chest Oppression, and Cough: Sishun Decoction
Fritillaria bulb (Beimu, heart removed); Platycodon root (Jiegeng, stir-fried); Aster root (Ziwan, stems and soil removed, each 1 liang); Licorice root (Gancao, honey-fried and chopped, 0.5 liang).
Coarsely crush and sieve the above four herbs. Take 3 qianbi per dose. Add 1 zhan of water, boil for 5-7 boils. Strain. Take when slightly cool, at any time. If cough is severe, add 3 peeled and pointed-end-removed Apricot kernels (Xingren) and decoct together. Reduce dosage for children.
Formula for Treating Lung Abscess with Expectoration of Pus That Persists Without Cure: Jiegeng Baizhu Decoction
Platycodon root (Jiegeng, chopped, 3 qian); Atractylodes macrocephala rhizome (Baizhu); Dried Rehmannia root (Sheng Gan Dihuang, baked); Coix seed (Yiyiren); Licorice root (Gancao, honey-fried); Patrinia root (Baijiang, each 2 liang); Angelica sinensis root (Danggui, sliced and baked, 1 liang); Soybeans (4 sheng).
Chop the above eight ingredients as small as hemp seeds. Add 1 dou 5 sheng of water, first decoct 4 sheng of soybeans until 7 sheng of broth remains. Remove the soybeans. Add 3 sheng of clear wine. Combine with the other herbs and decoct. Obtain 3 sheng of liquid. Strain. Take one cup per dose, three times during the day and twice at night.