【肺虚身肿之症】泻利喘咳,面色惨白,或肿或退,小便清利,或气化不及,小便时闭
,大便时溏,即《金匮》脉沉自喘之正水,此肺虚肿症也。
【肺虚身肿之因】劳役过度,肺气久虚,清肃之令不行,下降之权失职,卫气壅遏,营
【肺虚身肿之脉】寸口细数,肺液干少;右关虚软,土不生金;尺脉细数,肾水不足
【肺虚身肿之治】肺燥者,生脉散。土不能生金者,四君子加杏仁、贝母。肾水不足,人
参固本丸。肺气不能收摄,都气丸。
生肺散
人参 拣麦冬 北五味
气逆加橘红,有痰加贝母,嗽多喘满加桑白皮,小便不利加杏仁。
四君子汤 治肺气不足。
人参 白术 白茯苓 甘草
气逆加橘红。
人参固本丸
生地 熟地 天冬 麦冬 人参
痰加贝母。
都气丸 即六味地黄丸加五味子。
凡治虚证,当明阴阳,如阴虚当养阴,阳虚当养阳。如面色惨白,二便清利,气怯神离
,肺之真阳虚也,当用四君子汤。若喘咳骨蒸,痰火上逆,痰中带血,此肺之真阴虚也,又当
【肺热身肿之症】喘咳烦满,不得仰卧,喘息倚肩,身首皆肿,小便赤涩,此即《内经
》诸气 郁,肺热成肿之症也。
【肺热身肿之因】肺热叶焦,肺气怫郁,升降之令不行;治节之官失职,则经络壅闭,
营卫不谐,而遍身头面皆肿矣。
【肺热身肿之脉】右寸洪数,肺热之诊。关脉实大,胃火刑金。尺脉数大,肾火上炎。
左关弦数,木火侮金。左寸洪数,心火克金。
【肺热身肿之治】宜清肺者,家秘泻白散。兼风者,加防风。燥者,二冬二母汤。心火
克金,泻心汤。肝火刑金,泻青丸、龙胆泻肝汤。肾火刑金,凉八味丸。阳明多火,肺受熏蒸,葛
根石膏汤。水饮射肺,面浮喘逆,不得卧者,葶苈清肺饮。
家秘泻白散
川连 黄芩 石膏 甘草 桑白皮 地骨皮
二冬二母汤
天冬 麦冬 知母 贝母
泻心汤
黄连 半夏 甘草
泻青丸
当归 川芎 栀子 龙胆草 川大黄 羌活 防风 甘草
大便滑者去大黄,身无痛不发热,去羌活、防风,有寒热加柴胡,舌赤加黄连
龙胆泻肝汤
胆草 柴胡 黄芩 甘草 山栀 知母 天冬 麦冬 黄连 人参
凉八味丸 即六味丸加黄柏、知母。
干葛石膏汤
干葛 石膏 知母
葶苈清肺饮
葶苈子 桑白皮 地骨皮 甘草 大腹皮 马兜铃
【肺虚身肿的症状】出现腹泻、痢疾、气喘和咳嗽,面色苍白无华,身体时而肿胀时而消退,小便清澈通畅,或者因气化功能不及导致小便时而闭塞,大便时而稀溏。这正是《金匮要略》中所述的脉象沉而自喘的“正水”,属于肺虚引起的浮肿病症。
【肺虚身肿的原因】过度劳累,导致肺气长期虚弱,清肃下降的功能不能正常行使,下降的职权失职,卫气壅滞遏阻,营气……(原文此处中断)
【肺虚身肿的脉象】寸口脉细数,表明肺液干枯稀少;右关脉虚软,表明脾土不能生肺金;尺脉细数,表明肾水不足。
【肺虚身肿的治疗】肺燥者,使用生脉散。脾土不能生肺金者,使用四君子汤加杏仁、贝母。肾水不足者,使用人参固本丸。肺气不能收摄者,使用都气丸。
生肺散
人参、拣选麦冬、北五味子
气逆加橘红,有痰加贝母,咳嗽多且喘满加桑白皮,小便不利加杏仁。
四君子汤 治疗肺气不足。
人参、白术、白茯苓、甘草
气逆加橘红。
都气丸 即六味地黄丸加五味子。
凡是治疗虚证,应当明辨阴阳,如阴虚应当养阴,阳虚应当养阳。如果面色苍白,二便清澈通畅,气怯神疲,这是肺的真阳虚,应当使用四君子汤。如果出现喘咳、骨蒸潮热,痰火上逆,痰中带血,这是肺的真阴虚,又应当……(原文此处中断)
【肺热身肿的症状】气喘咳嗽,烦躁胀满,不能仰卧,喘息时需倚靠肩膀,头身皆肿,小便赤涩,这正是《内经》中所述的各种气机郁结,肺热导致浮肿的症状。
【肺热身肿的原因】肺热导致肺叶焦枯,肺气怫郁不舒,升降的功能不能正常行使;治节之官(肺)失职,导致经络壅闭,营卫不和,从而全身头面都发生浮肿。
【肺热身肿的脉象】右寸脉洪数,是肺热的诊候。关脉实大,是胃火刑克肺金。尺脉数大,是肾火上炎。左关脉弦数,是木火侮害肺金。左寸脉洪数,是心火克制肺金。
【肺热身肿的治疗】适宜清肺热的,使用家秘泻白散。兼有风邪的,加防风。燥邪重的,使用二冬二母汤。心火克金,使用泻心汤。肝火刑金,使用泻青丸、龙胆泻肝汤。肾火刑金,使用凉八味丸。阳明经火盛,肺受熏蒸,使用葛根石膏汤。水饮射肺,面部浮肿、气喘逆乱、不能平卧的,使用葶苈清肺饮。
泻青丸
当归、川芎、栀子、龙胆草、川大黄、羌活、防风、甘草
大便滑泄的去大黄,身体无痛且不发热,去羌活、防风,有寒热症状加柴胡,舌质红加黄连。
[Symptoms of Edema due to Lung Deficiency] Diarrhea, dysentery, asthma, and cough; the facial complexion is pale and lusterless. The body swells intermittently or subsides. Urine is clear and free-flowing, or due to insufficient Qi transformation, urination may be intermittently obstructed while stool is intermittently loose. This corresponds to "Zheng Shui" (True Water) described in *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), characterized by a deep pulse with spontaneous asthma, representing edema caused by Lung deficiency.
[Etiology of Edema due to Lung Deficiency] Excessive physical labor leads to chronic Lung Qi deficiency. The function of clearing and descending fails to operate normally, and the authority of descent is lost. Wei Qi (Defensive Qi) becomes stagnant and obstructed, Ying Qi (Nutritive Qi)... [Text cuts off here]
[Pulse Diagnosis for Edema due to Lung Deficiency] The Cun position at the radial artery is fine and rapid, indicating dryness and scarcity of Lung fluids. The Guan position on the right is deficient and soft, indicating that Spleen Earth fails to generate Lung Metal. The Chi position is fine and rapid, indicating insufficiency of Kidney Water.
[Treatment for Edema due to Lung Deficiency] For Lung dryness, use Sheng Mai San (Generate the Pulse Powder). When Spleen Earth fails to generate Lung Metal, use Si Jun Zi Tang (Four Gentlemen Decoction) added with Xing Ren (Apricot Seed) and Bei Mu (Fritillaria Bulb). For Kidney Water insufficiency, use Ren Shen Gu Ben Wan (Ginseng Root-Stabilizing Pill). When Lung Qi fails to secure and retain, use Du Qi Wan (All-Qi Pill).
Sheng Fei San (Generate Lung Powder)
Ren Shen (Ginseng Root), Jie Mai Dong (Selected Ophiopogon Tuber), Bei Wu Wei Zi (Northern Schisandra Fruit).
For rebellious Qi, add Ju Hong (Tangerine Peel); for phlegm, add Bei Mu; for frequent cough with asthma and fullness, add Sang Bai Pi (Mulberry Root Bark); for difficult urination, add Xing Ren.
Si Jun Zi Tang (Four Gentlemen Decoction) Treats Lung Qi insufficiency.
Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), Bai Fu Ling (Poria), Gan Cao (Licorice Root).
For rebellious Qi, add Ju Hong.
Ren Shen Gu Ben Wan (Ginseng Root-Stabilizing Pill)
Sheng Di Huang (Rehmannia Root), Shu Di Huang (Prepared Rehmannia Root), Tian Dong (Asparagus Tuber), Mai Dong (Ophiopogon Tuber), Ren Shen (Ginseng Root).
For phlegm, add Bei Mu.
Du Qi Wan (All-Qi Pill) Is Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) added with Wu Wei Zi (Schisandra Fruit).
Generally, when treating deficiency syndromes, one must distinguish between Yin and Yang. If Yin is deficient, nourish Yin; if Yang is deficient, nourish Yang. If the facial complexion is pale, urine and stool are clear and free, Qi is timid, and spirit is detached, this indicates true Yang deficiency of the Lung, and Si Jun Zi Tang should be used. If there is asthma, cough, bone-steaming fever, rebellious Phlegm-Fire, and blood in sputum, this indicates true Yin deficiency of the Lung, and treatment should... [Text cuts off here]
[Symptoms of Edema due to Lung Heat] Asthma, cough, irritability, and fullness; inability to lie flat; breathing requires leaning on the shoulders; swelling of both body and head; red and scanty urine. This corresponds to the symptoms of various Qi stagnations causing edema due to Lung heat as described in *Nei Jing* (The Inner Canon).
[Etiology of Edema due to Lung Heat] Lung heat causes the lung leaves to become scorched and dry; Lung Qi becomes stifled and depressed, failing to execute ascending and descending functions. The official responsible for regulation (the Lung) loses its duty, leading to blockage of meridians and collaterals, disharmony of Ying and Wei Qi, resulting in generalized swelling of the entire body and face.
[Pulse Diagnosis for Edema due to Lung Heat] The right Cun position is surging and rapid, indicating Lung heat. The Guan position is solid and large, indicating Stomach Fire punishing Lung Metal. The Chi position is rapid and large, indicating Kidney Fire flaming upward. The left Guan position is wiry and rapid, indicating Wood-Fire insulting Lung Metal. The left Cun position is surging and rapid, indicating Heart Fire overcoming Lung Metal.
[Treatment for Edema due to Lung Heat] For cases suitable for clearing Lung heat, use Jia Mi Xie Bai San (Secret Family White-Lung Clearing Powder). If accompanied by Wind, add Fang Feng (Saposhnikovia Root). For dryness, use Er Dong Er Mu Tang (Two Winter and Two Mother Decoction). For Heart Fire overcoming Lung Metal, use Xie Xin Tang (Drain the Heart Decoction). For Liver Fire punishing Lung Metal, use Xie Qing Wan (Drain the Green Pill) or Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction). For Kidney Fire punishing Lung Metal, use Liang Ba Wei Wan (Cooling Eight-Ingredient Pill). For excessive fire in the Yangming channel steaming the Lung, use Ge Gen Shi Gao Tang (Kudzu and Gypsum Decoction). For water-fluid invading the Lung, presenting with facial edema, asthmatic rebellion, and inability to lie down, use Ting Li Qing Fei Yin (Descurainia Lung-Clearing Infusion).
Jia Mi Xie Bai San (Secret Family White-Lung Clearing Powder)
Chuan Lian (Melia Toosendan? Note: Context suggests Coptis/Scutellaria/Gypsum mix, likely Chuan Lian Zi or typo for Huang Lian/Huang Qin contextually, but strictly translating text: Chuan Lian), Huang Qin (Scutellaria Root), Shi Gao (Gypsum Fibrosum), Gan Cao (Licorice Root), Sang Bai Pi (Mulberry Root Bark), Di Gu Pi (Lycium Bark).
Er Dong Er Mu Tang (Two Winter and Two Mother Decoction)
Tian Dong (Asparagus Tuber), Mai Dong (Ophiopogon Tuber), Zhi Mu (Anemarrhenae Rhizoma), Bei Mu (Fritillariae Bulbus).
Xie Xin Tang (Drain the Heart Decoction)
Huang Lian (Coptidis Rhizoma), Ban Xia (Pinelliae Rhizoma), Gan Cao (Licorice Root).
Xie Qing Wan (Drain the Green Pill)
Dang Gui (Angelica Sinensis), Chuan Xiong (Ligusticum Chuanxiong), Zhi Zi (Gardeniae Fructus), Long Dan Cao (Gentianae Radix), Chuan Da Huang (Rhei Radix et Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Gan Cao (Licorice Root).
If stool is slippery/loose, remove Da Huang. If there is no body pain and no fever, remove Qiang Huo and Fang Feng. If there are alternating chills and fever, add Chai Hu (Bupleuri Radix). If the tongue is red, add Huang Lian.
Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction)
Dan Cao (Gentian Root), Chai Hu (Bupleuri Radix), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root), Shan Zhi Zi (Gardeniae Fructus), Zhi Mu (Anemarrhenae Rhizoma), Tian Dong (Asparagus Tuber), Mai Dong (Ophiopogon Tuber), Huang Lian (Coptidis Rhizoma), Ren Shen (Ginseng Root).
Liang Ba Wei Wan (Cooling Eight-Ingredient Pill) Is Liu Wei Wan (Six-Ingredient Pill) added with Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma).
Gan Ge Shi Gao Tang (Kudzu and Gypsum Decoction)
Gan Ge (Puerariae Lobatae Radix), Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma).
Ting Li Qing Fei Yin (Descurainia Lung-Clearing Infusion)
Ting Li Zi (Descurainiae Semen), Sang Bai Pi (Mori Cortex), Di Gu Pi (Lycii Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma), Da Fu Pi (Arecae Pericarpium), Ma Dou Ling (Aristolochiae Fructus).