论曰内经谓肺之痈,喘而两 满,盖肺主气而合于息,其脉支别者,从肺经横出腋下,
故邪气蕴积于肺,则上为喘急,下连两 满,治宜泻其肺脏之邪毒也。
治肺痈,气逆喘咳,平肺汤方
黄 (一两锉) 沉香(半两) 紫菀(去土) 人参 紫苏(去梗各二两) 杏仁
(去皮尖双仁麸炒)
上七味, 咀如麻豆,每服五钱匕,水一盏半,煎至八分,去滓温服,日三。
治肺痈喘不得卧,葶苈大枣泻肺汤方
葶苈(五两熬捣末取五钱匕)
上一味,先以水三盏,入大枣二十枚,煮取二盏,去枣入葶苈末五钱匕服之,间日一服
治肺痈喘急,坐卧不得,泻肺汤方
桑根白皮(锉) 甜葶苈(隔纸炒各一两)
上二味,粗捣筛,每服三钱,水一盏,煎至六分,去滓食后温服,微利为度。
治肺痈喘急,杏仁丸方
杏仁(去皮尖双仁麸炒研入) 甜葶苈(隔纸炒) 皂荚刮(去黑皮蜜炙各一两)
上三味,捣罗为末,炼蜜和丸,如梧桐子大,生姜蜜汤下十丸,至二十丸,食后临卧服
治肺痈咳嗽上气喘,急不得卧,涕唾稠粘,胸膈不利,方
葶苈(隔纸后炒紫色别研如膏) 桑根白皮(微炙细锉) 大枣(拣洗去核)
上三味,用水三盏,先煎桑白皮一两,枣十二枚,取一盏半,去滓入葶苈膏一弹子大搅
化,煎取八分温服,良久当吐恶物,或微利三两行,其疾减后,宜服补肺药,七日外病未退
,量人加减,更一服。
治肺痈咳喘,体有微热烦满,胸前皮甲错者,夜合汤方
夜合白皮(一两锉)
上一味,以水三盏,取一盏半,分温二服。
治肺痈上喘咳嗽,胸膈满闷,口干烦热及吐血,华盖散方
赤茯苓(去黑皮) 甜葶苈(隔纸炒) 桑根白皮(锉各一两) 大黄(半两湿纸裹煨
熟)
上四味,捣罗为散,每服二钱匕,生姜汤调下,食后临卧服。
论述说:《内经》中提到肺部的痈疽,症状表现为气喘且两侧胸部胀满。这是因为肺主司气并主管呼吸,其经脉的分支从肺经横向走出腋下,所以邪气蕴积在肺部,就会向上导致气喘急促,向下牵连两侧胸部胀满,治疗应当泻除肺脏中的邪毒。
治疗肺痈,气逆喘咳的平肺汤方:
黄(一两,锉碎) 沉香(半两) 紫菀(去土) 人参 紫苏(去梗,各二两) 杏仁(去皮尖、双仁,用麸皮炒)
以上七味药,切碎如麻豆大小,每次服用五钱匕,加水一盏半,煎煮至八分,滤去药渣,温服,每日三次。
治疗肺痈气喘不能平卧的葶苈大枣泻肺汤方:
葶苈(五两,熬制后捣成末,取五钱匕)
以上一味药,先用水三盏,加入大枣二十枚,煮取二盏水,去掉枣肉,加入葶苈末五钱匕服用,每隔一天服用一次。
治疗肺痈气喘急促,坐卧不安的泻肺汤方:
桑根白皮(锉碎) 甜葶苈(隔纸炒,各一两)
以上两味药,粗捣筛过,每次服用三钱,加水一盏,煎煮至六分,滤去药渣,饭后温服,以轻微腹泻为度。
治疗肺痈气喘急促的杏仁丸方:
杏仁(去皮尖、双仁,用麸皮炒后研入) 甜葶苈(隔纸炒) 皂荚刮(去黑皮,蜜炙,各一两)
以上三味药,捣碎过筛成末,用炼蜜和丸,如梧桐子大小,用生姜蜜汤送服十丸,最多二十丸,饭后及睡前服用。
治疗肺痈咳嗽上气喘急不能平卧,涕唾稠粘,胸膈不利的方剂:
葶苈(隔纸后炒至紫色,另研如膏状) 桑根白皮(微炙细锉) 大枣(挑选洗净去核)
以上三味药,用水三盏,先煎桑白皮一两、大枣十二枚,取汁一盏半,滤去药渣,加入一弹子大小的葶苈膏搅匀化开,再煎取八分,温服。过一会儿应当吐出恶物,或者轻微腹泻两三行,病情减轻后,适宜服用补肺药,七日后病未退,根据患者情况加减剂量,再服用一次。
治疗肺痈咳喘,身体有微热烦闷胀满,胸前皮肤粗糙如鳞甲状的夜合汤方:
夜合白皮(一两,锉碎)
以上一味药,用水三盏,煎取一盏半,分两次温服。
治疗肺痈上气喘咳,胸膈满闷,口干烦热及吐血的华盖散方:
赤茯苓(去黑皮) 甜葶苈(隔纸炒) 桑根白皮(锉碎,各一两) 大黄(半两,用湿纸包裹煨熟)
以上四味药,捣碎过筛成散剂,每次服用二钱匕,用生姜汤调下,饭后及睡前服用。
It is stated in the discussion: The *Neijing* (Classic of Internal Medicine) mentions that lung abscess (Fei Yong, pulmonary carbuncle/abscess) presents with panting and distension on both sides. This is because the Lung governs Qi and controls respiration; its collateral branches emerge horizontally from the Lung meridian to the axilla. Therefore, when pathogenic factors accumulate in the Lung, they cause upward panting and urgency, and downward distension of both flanks/chest. Treatment should focus on purging the pathogenic toxins from the Lung organ.
**Pingfei Tang (Lung-Pacifying Decoction)** for treating lung abscess with rebellious Qi, panting, and cough:
Huang (1 liang, sliced) Chenxiang (Sandalwood Wood, 0.5 liang) Ziwan (Asteris Radix et Rhizoma, earth removed) Renshen (Ginseng Radix) Zisu (Perillae Folium, stems removed, each 2 liang) Xingren (Prunus Armeniacae Semen, peel and tips removed, double-kernel, stir-fried with bran)
The above seven ingredients are cut into pieces the size of hemp seeds. Each dose consists of 5 qianbi (approx. 3-5g), decocted in 1.5 zhan (approx. 300ml) of water until reduced to 0.8 zhan. Strain and take warm, three times daily.
**Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction for Purging the Lung)** for treating lung abscess with panting preventing lying down:
Tingli (Descurainiae Semen seu Fructus, 5 liang, roasted and pounded into powder, take 5 qianbi)
Take this single ingredient. First, boil 3 zhan of water with 20 jujubes until reduced to 2 zhan. Remove the jujubes, add 5 qianbi of Tingli powder, and take. Administer every other day.
**Xiefei Tang (Purging Lung Decoction)** for treating lung abscess with urgent panting, inability to sit or lie comfortably:
Sangbaipi (Mori Cortex, sliced) Tian Tingli (Sweet Descurainiae Semen seu Fructus, stir-fried between paper, each 1 liang)
The above two ingredients are coarsely crushed and sieved. Each dose is 3 qian, decocted in 1 zhan of water until reduced to 0.6 zhan. Strain and take warm after meals. Mild diarrhea is the desired effect.
**Xingren Wan (Apricot Kernel Pill)** for treating lung abscess with urgent panting:
Xingren (Prunus Armeniacae Semen, peel and tips removed, double-kernel, stir-fried with bran, ground and incorporated) Tian Tingli (Sweet Descurainiae Semen seu Fructus, stir-fried between paper) Zaojiao (Gleditsiae Sinensis Fructus, scraped, black skin removed, honey-roasted, each 1 liang)
The above three ingredients are pounded, sifted into powder, and mixed with refined honey to form pills the size of paulownia seeds. Take 10 to 20 pills with ginger-honey soup after meals and before bedtime.
Formula for treating lung abscess with cough, upper Qi rebellion, urgent panting, inability to lie down, thick sticky sputum, and chest/diaphragm discomfort:
Tingli (Descurainiae Semen seu Fructus, stir-fried between paper until purple, separately ground into paste) Sangbaipi (Mori Cortex, slightly roasted and finely sliced) Dazao (Jujubae Fructus, selected, washed, pitted)
Use 3 zhan of water. First decoct 1 liang of Sangbaipi and 12 jujubes until reduced to 1.5 zhan. Strain, then add a pill-sized amount of Tingli paste, stir to dissolve, and decoct until reduced to 0.8 zhan. Take warm. After some time, vomitus of foul matter or mild diarrhea of 2-3 movements may occur. Once the condition alleviates, suitable tonifying Lung medicines should be taken. If the disease persists after seven days, adjust the dosage according to the patient's constitution and administer again.
**Yihe Tang (Albizia Bark Decoction)** for treating lung abscess with cough and panting, slight fever, irritability, fullness, and rough, scaly skin on the anterior chest:
Yihe Bapi (Albiziae Cortex, 1 liang, sliced)
This single ingredient is decocted in 3 zhan of water until reduced to 1.5 zhan. Divide into two warm doses.
**Huagai San (Canopy Powder)** for treating lung abscess with upper panting, cough, chest/diaphragm fullness and oppression, dry mouth, irritability, heat, and hemoptysis:
Chifuling (Polyporus, black skin removed) Tian Tingli (Sweet Descurainiae Semen seu Fructus, stir-fried between paper) Sangbaipi (Mori Cortex, sliced, each 1 liang) Dahuang (Rhei Radix et Rhizoma, 0.5 liang, wrapped in wet paper and roasted until cooked)
The above four ingredients are pounded, sifted into powder. Each dose is 2 qianbi, taken with ginger soup after meals and before bedtime.