薛立斋治一妇人，素血虚，发热咳嗽，服痰火之剂后，吐脓血，面赤脉数，其热甚危，此脓成而
气血虚也。
用八珍汤补元气，桔梗汤治之而愈。
一妇人感冒风寒，或用发表之剂，反咳嗽喘急，饮食少思，胸膈不利，大便不通，右寸关浮数，
欲用疏通之剂。薛曰∶此因脾土亏损，不能生肺金，若更利之，复耗津液，必患肺痈矣。不信，仍利
之，虚症悉至，后果吐脓。乃朝用补中益气汤，夕用桔梗汤，各数剂，吐脓渐止。又朝仍用前汤，夕
用十全大补汤，各五十剂，喜其善调理获愈。
一妇人咳嗽吐痰，胸膈作痛，右寸关浮滑，项下牵强，此脾胃积热之痰，非痈患也。以二陈、山
栀、白术、桔梗治之而安。
一妇人素血虚内热，时咳。甲辰孟冬，两尺浮洪，以脾不健请治。曰∶防患肺症。丙午孟春果咳
嗽，左右寸脉洪数，肺痈也。脓已成，右寸脉仍洪数，乃心火克肺金，夏令可忧。用壮水健脾之剂稍
愈。彼遽自忽，不自调摄，果殁于夏令。
喻嘉言治施眉苍肺痿，喘嗽吐清痰，肢体软痿，不能举动，脉来虚数，以蛤蚧二十枚，酒浸酥炙，
人参、黑参各十两，蜜丸，时时噙化，不终剂而痊。（出《张氏医通》）
张路玉治陆去非肺痿，声飒吐痰，午后发热，自汗，左脉弦细，右脉虚濡，平昔劳心耽色所致。
先与生脉散合保元汤，次与异功散加黄 并姜、枣，与都气丸，晨夕间进，调补半月，热除痰止，月
余方得声清。
孙起伯肺胀，服耗气药过多，脉浮大，而重按豁然，饮食不入。幸得溺清便坚，（金土未惫。）
与局方七气丸，每剂用人参三钱，肉桂、半夏曲、炙甘草各一钱，生姜四片，四剂霍然。盖肺胀实症
居多，此脉虚大，当不以寻常论也。
一尼患肺胀，喘鸣肩息，服下气止嗽药不应，渐至胸腹胀满。脉得气口弦细而涩。此必劳力气上，
误饮冷水伤肺，肺气不能收敛所致也。遂与越婢汤减麻黄，加细辛、葶苈，大泻肺气而安。
一酒客严冬醉卧，渴饮冷茶，肺胀喘咳，脉得气口沉紧搏指。与小青龙去白芍，加葶苈、半夏，
一剂而痊，则知肺胀喘满，当以葶苈为向导也，非实症未可轻投。
孙文垣治初阳侄妇，先时咳嗽，诸治无功，嗽急则吐，用碧玉散二钱，白汤调下立止。半年后咳
嗽，胸背隐隐疼痛，常内热，吐出桃红脓甚多且腥秽，右胁并乳胀痛。诊之，脉洪数，大便燥，肌骨
瘦立，此肺痈症也。用贝母、茜根、白芍各一钱，知母、麦冬、山栀、紫菀各八分，桑皮、当归、丹
皮、杏仁各七分，苡仁一钱五分，甘草、葶苈各五分，服之甚安，但稍停即发。或云∶肺窍中痰积瘀
血尚多，未能即去，宜缓图之，候脓尽当愈。孙谓∶丹溪虽有此言，亦不可执。设不以药消化之，必
俟其自已，恐岁月深而有他变，且中年之人，何能当此？莫若清热润肺，消痰化瘀，久服或早愈也。
或又谓∶久嗽伤肺宜补，每补必增热加痛加咳而脓转多。仍根据法治之，二年良愈。
喻嘉言治陆令仪母，平日持斋，肠胃素槁，天癸已绝，复淋沥不止，治之久痊。值秋月燥金太过，
湿虫不生，人多病咳。而血虚津槁之躯，受伤独猛，胸胁紧张，上气喘急，卧寐不宁，咳动则大痛，
痰中带血而腥，食不易入，声不易出，寒热交作。申酉二时，燥金用事，诸苦倍增，脉时大时小，时
牢伏时弦紧，服清肺药无进退。告以肺痈将成，高年难任，以葶苈大枣泻肺汤，先通肺气之壅。即觉
气稍平，食少入，痰稍易出，身稍可侧，大有生机。喻曰∶未也。因见来势太急，不得已取快一时，
暂开者易至复闭，迨复闭则前法不可再用矣。今乘其暂开，多方以图，必在六十日后，交立冬节，方
是愈期。盖身中之燥，与时令之燥，胶结不解，必俟燥金退气，肺金乃宁。后六十日间，屡危屡安。
大率皆用活法斡旋，缘病不可补，而脾虚又不能生肺，肺燥喜润，而脾滞又难于运食。今日脾虚，不
思饮食，则于清肺中少加参、术以补脾；明日肺燥，热盛咳嗽，则于清肺中少加阿胶以润燥。日复一
日，扶至立冬之午刻，病者忽自云∶内中光景，大觉清爽，可得生矣。奇哉，天时之燥去，而肺金之
燥遂下传大肠，五六日不一大便，略一润肠，旋即解散，正以客邪易去耳。至小雪节，康健加餐，倍
于曩昔。盖胃中空虚已久，势必复其容受之常，方为全愈也。
薛立斋治一男子神劳，冬月患咳嗽，服解毒之药，自以为便。曰∶此因肺气虚弱，腠理不密，而
外邪所感也。当急补其母，是治本也。始服六君子汤，内去参、术，反加紫苏、枳壳之类，以致元气
亦虚，生肺痈而殁。
一武职，因饮食起居失宜，咳嗽吐痰，用化痰止嗽之药。时仲夏，左尺洪数而无力，胸满面赤，
吐痰腥臭，自汗。曰∶肾虚水泛为痰，而反重亡津液，得非肺痈乎？不信，仍服前药。翌日吐脓，脉
数，右寸为甚，用桔梗汤一剂，脉数与脓顿减。又二剂将愈，佐以六味而痊。
一男子咳嗽喘急，发热烦躁，面赤咽痛，脉洪大，用黄连解毒汤，二剂少退。更以栀子汤，四剂
而安。（此肺痈将成未成之候。）
薛立斋治一男子患肺痿，咳嗽喘急，吐痰腥臭，胸满咽干，脉洪数，用人参平肺散六剂，及饮童
便，诸症悉退。更以紫菀茸汤而愈。童便虽云治虚火，常治疮疡 肿，疼痛发热作渴，及肺痿肺痈发
热口渴者尤效。
一仆年逾三十，嗽久不愈，（病久故可用涩。）气壅不利，睡卧不安，咯吐脓血，甚觉可畏，其
主已弃之矣。与宁肺散一服少愈，又服而止大半，乃以宁肺散汤数剂而痊。所以有是病必用是药，若
以前散性涩而不用，何以得愈？
上舍毛体仁素阴虚，春初咳嗽，胸中隐痛，肾脉洪数，肺脉数而时不见。曰∶内当结痈，先用六
味地黄丸料一剂服之。翌日来谓曰∶昨得良剂，嗽愈六七，务求一方，到监调理。曰∶阴虚火炎，患
痈之症，第因元气虚弱，未能发出，因其易忽，薛不能治。乃别用降火化痰等剂，愈甚。月余复请诊
之，脉洪滑而数。曰∶脓已成矣，当请常治之者同论针之，且免内溃之患。仍不决。又月余请视，他
医已先开疮孔偏上，兜脓不出，仍内溃，脉愈洪大。曰∶脉洪滑而数，其舌青黯，五内已坏，无能为
也。后果然。
一男子咳嗽，两胁胀满，咽干口燥，咳唾腥臭。以桔梗汤四剂而唾脓，以排脓散数服而止，乃以
补阴排脓之剂而瘳。
一男子咳而脓不止，脉不退，诸药不应，甚危。用柘黄丸一服少愈，再服即退，数服而痊。柘黄
一两为末，百齿霜（即梳垢。）二钱，用糊为丸如梧桐子大，每服三五丸，米饮下。柘黄乃柘树所生
者，其色黄，状似灵芝，江
南最多，北方鲜有。
一妇人吐脓，五心烦热，口渴胸闷。以四顺散三剂少止，以排脓散数服而安。排脓散∶黄 、白
芷、五味、人参。四顺散∶贝母、紫菀、桔梗各一钱，半夏、甘草各七分。作一剂，水煎食远服。
一男子因劳咳嗽不止，项强而痛，脉微紧而数，此肺痈也。尚未成脓，欲用托里益气药。彼不信，
仍服发散药，致血气愈虚，吐脓不止，竟不救。经曰∶肺内主气，外司皮毛。若肺气虚，则腠理不密，
皮毛不泽。肺受伤，则皮毛错纵。故患痈痿肠痈者，必致皮毛如此，以其气不荣养而然也。亦有服表
药，见邪不解而仍用发表，殊不知邪不解者，非邪不能解，多因腠理不密，而邪复入也。专用发表，
则腠理愈虚，邪愈易入，反为败症矣。宜诊其脉，邪在表者，止当和解而实腠理，乘虚复入者，亦当
和解兼实腠理，故用托里益气之药。若小便赤色，为肺热所传，短少为肺气虚。盖肺为母，肾为子，
母虚不能生子故也。亦有小便频者，亦为肺虚，不能约制耳。
一男子面白神劳咳嗽，胸臆隐痛，其脉滑数。以为肺痈，欲用桔梗汤。不信，服败毒散，致咳嗽
愈甚，吐痰腥臭始悟。仍服前汤四剂，咳嗽少定。又以四顺散四剂而脉静，更以托里药数剂而愈。大
抵劳伤血气则腠理不密，风邪乘肺，风热相搏，蕴结不散，必致喘咳。又因汗下过度，则津液重亡，
遂成斯症。若寸脉数而虚者为肺痈，数而实者为肺疽。脉微紧而数者，未有脓也；紧甚而数者，已有
脓也。唾脓而止，脉短而面白者，易治；脓不止，脉洪大而面赤色者，不治。使其治早可救，脓成则
无及矣。《金匮方论》热在上焦者，因咳为肺痿。得之或从汗出，或从呕吐，或从消渴，小便利数，
或从便难。人被下药快利，重亡津液，故寸口脉数。其人燥咳，胸中隐隐时痛，脉反滑数，此为肺痈。
咳吐脓血，脉数虚者为肺痿，数实者为肺痈。
一童子气禀不足，患肺痈，吐脓腥臭，皮毛枯槁，脉浮，按之涩，更无力，用钟乳粉汤治之。
一男子患之，形症皆同，惟咽喉时或作痒，痰多，胁痛，难于睡卧，用紫菀茸汤治之而病愈。
一弱人咳脓，日晡发热，夜间盗汗，脉浮数而紧。用人参五味子汤，数剂而愈，以菀茸汤月余而
痊。
一男子患肺痿，咳嗽喘急，吐痰腥臭，胸满咽干，脉洪数。用人参平肺散六剂及饮童便，诸症悉
退，更以紫菀茸汤而愈。童便虽云专治虚火，常治疮疡肿 疼痛，发热作渴及肺痿肺痈，发热口渴者
尤效。
一妇人患肺痿咳嗽，吐痰腥臭，日晡发热，脉数无力。用地骨皮治之热止，更用人参养肺汤，月
余而安。
一男子前病肺痈，后又患咳嗽，头眩吐沫，饮食少思，小便频数，服解毒散、化痰药不应。诊之，
脾肺二脉虚甚，谓晕眩唾涎，属脾气不能上升；小便无度，乃肺气不得下降，尚未成脓耳。投以加味
理中汤四剂，诸症已退大半，更用钟乳粉汤而安。河间曰∶《金匮》云，肺痿属热，如咳嗽肺瘪，声
哑声嘶，咯血，此属阴虚热甚然也。本论治肺痿吐涎沫而不咳者，其人不渴，必遗尿，小便数，以上
虚不能制下故也。此为肺中冷，必眩，多涎唾，用甘草、干姜，此属寒也。脉痿，涎唾多，心中温温
液液者，用炙甘草汤，此补虚劳也。亦与补阴虚火热不同，是皆宜分治，故肺痿又有寒热之异也。
赵以德治一妇人，年二十余患肺痈，胸膺间患一窍，口中所咳脓血，与窍相应而出。以人参、黄
、当归补气血剂，加退热排脓等药，服之，不一月而安。（《药要或问》）
治肺痈，目击神效，其法用百年芥菜卤久窨地中者，数匙立起。此卤嘉兴府城中大家多藏之。
《广笔记》∶鱼腥草不住口食之，治肺痈吐脓血，神方也。正名蕺草，兼治鱼口。（雄按∶此方
可治鸦片烟瘾。）
薛立斋治陆司厅子仁，春间咳嗽，吐痰腥秽，胸满气促，皮肤纵，项强脉数，此肺疽也。盖肺系
在项，肺伤则系伤，故牵引不能转侧。肺者气之本，其华在毛，其充在皮，肺伤不能摄气，故胁胀气
促而皮肤纵。东垣云∶肺疮之脉微紧而数者，未有脓也；紧甚而数者，已有脓也。其脉来紧数，则脓
已成，遂以人参、黄 、当归、川芎、白芷、贝母、麦冬、蒌仁、桔梗、防风、甘草，兼以蜡矾丸及
太乙膏治之，脓尽脉涩而愈。至冬，脉复数。经云，饮食劳倦则伤脾，脾伤不能生肺金。形寒饮冷则
伤肺，肺伤不能生肾水，肾水不足则心火炽盛，故脉来洪数。经云，冬见心脉而不治。后果殁于火旺
之月。（凡肺疽愈而复作，多不治。余常治三人，一间三年，两间一年，皆复作
而殁。）
周国用年逾三十，患咳嗽，项强气促，右寸脉数，此肺疽也。东垣云∶风中于胃，呼气不入，热
攻于荣，吸气不出。风伤皮毛，热伤血脉，风热相搏，血气稽留于肺，变成疮疽。诊其脉数而虚者，
肺痿也，数而实者，肺疽也。今诊脉滑，此疽脓已成。以排脓托里之药，及蜡矾丸治之，脉渐涩而愈。
锦衣李大器亦患此，吐脓，面赤脉大。谓肺病脉宜涩，面宜白，今脉大面赤，火克金也，不可治。果
殁。
一男子年逾四十，喘咳胁痛，胸满气促，右寸脉大，此风热蕴于肺也。尚未成疮，属有余之症，
意欲以泻白散治之。彼谓肺气素怯，不然之，乃服补药，喘咳愈甚。两月后复请视之，汗出如油，喘
而不休，此肺气已绝，不治。果殁。夫肺气充实（二语赘），邪何从袭？邪气既入，则宜去之，故用
泻白散，所以泻肺气之邪也。邪气既去，则真自实矣。
姚应凤治某叟，患胀满，诸医多云隔症。应凤曰∶此肺痈耳。令病者闭目，取一大盘水，向病者
项上倾之，病者陡大惊，亟举刀直刺心坎，泻脓血数碗而愈。人问之，应凤曰∶心尖下垂，水泼而惊，
惊则心系提，吾刀可入也。（《仁和县志》）
沈夫人患嗽血，昼夜不休。应凤曰∶肺虑痿，不虑溃，今溃至第三叶，尚可生也。先投洗肺汤已，
令食猪肺数十斤遂愈。
王洪绪曰∶诸患易识，独肺中患毒难觉。凡两脚骨疼痛者，或脚骨不痛而舌下生如细豆一粒者，
再心口直上，内作微疼及咳嗽口干咽燥，皆肺中生毒之候也。即用甘草、桔梗各三钱煎服，服后如觉
薛立斋治疗一位妇人，她原本血虚，出现发热咳嗽的症状，服用治痰火的药物后，吐出脓血，面色发红，脉搏快，热势非常危险，这是脓液已经形成而气血虚弱。
使用八珍汤补益元气，桔梗汤治疗，痊愈了。
另一位妇人感冒风寒，有人用发汗解表的药物，反而导致咳嗽气喘急促，饮食减少不想吃，胸膈部不适，大便不通，右寸关脉浮数，想要用疏通的药物。薛立斋说：这是因为脾土亏损，不能生养肺金，如果再使用利下的药物，会进一步耗伤津液，必定会患上肺痈。病人不信，仍然使用利下的药物，虚证全部出现，后来果然吐出脓液。于是早上服用补中益气汤，晚上服用桔梗汤，各服几剂，吐脓逐渐停止。之后早上仍用前一种药，晚上服用十全大补汤，各服五十剂，庆幸她善于调理而痊愈。
又一位妇人咳嗽吐痰，胸膈疼痛，右寸关脉浮滑，颈部牵拉僵硬，这是脾胃积热产生的痰，不是肺痈。用二陈汤、山栀、白术、桔梗治疗而安定。
又一位妇人原本血虚内热，时常咳嗽。甲辰年孟冬（初冬），两尺脉浮洪，因脾不健运请求治疗。我说：预防肺部病症。丙午年孟春（初春）果然咳嗽，左右寸脉洪数，是肺痈。脓液已经形成，右寸脉仍洪数，这是心火克伐肺金，夏季令人担忧。使用壮水健脾的药物稍微好转。那人随即疏忽大意，不调理摄养，果然在夏季去世。
喻嘉言治疗施眉苍的肺痿，气喘咳嗽吐清稀痰，肢体软弱萎废，不能举动，脉象虚数，用蛤蚧二十枚，酒浸酥炙，人参、黑参各十两，蜜丸，时时含化，未服完一剂就痊愈了。（出自《张氏医通》）
张路玉治疗陆去非的肺痿，声音嘶哑吐痰，午后发热，自汗，左脉弦细，右脉虚濡，平素用心过度且纵欲所致。先用生脉散合保元汤，接着用异功散加黄芩并姜、枣，配合都气丸，早晚进服，调补半月，热除痰止，月余才声音清亮。
孙起伯患肺胀，服用耗气药过多，脉浮大，重按豁然空虚，饮食不进。幸好小便清长大便干结（说明金土之气未衰竭）。给予局方七气丸，每剂用人参三钱，肉桂、半夏曲、炙甘草各一钱，生姜四片，四剂后霍然病愈。大概肺胀实证居多，此脉虚大，不应按常理论治。
一位尼姑患肺胀，喘鸣抬肩呼吸，服用下气止咳药无效，逐渐至胸腹胀满。脉得气口弦细而涩。这一定是劳力气上，误饮冷水伤肺，肺气不能收敛所致。于是给予越婢汤减麻黄，加细辛、葶苈子，大泻肺气而安。
一位嗜酒客人在严冬醉卧，口渴喝冷茶，肺胀喘咳，脉得气口沉紧搏指。给予小青龙汤去白芍，加葶苈子、半夏，一剂而痊愈，则知道肺胀喘满，当以葶苈子为向导，如果不是实证不可轻投。
孙文垣治疗初阳侄妇，先前咳嗽，各种治疗无效，咳嗽急则呕吐，用碧玉散二钱，白开水调下立即停止。半年后咳嗽，胸背隐隐疼痛，常内热，吐出桃红色脓液甚多且腥秽，右胁及乳房胀痛。诊之，脉洪数，大便燥，肌骨消瘦站立，这是肺痈症。用贝母、茜根、白芍各一钱，知母、麦冬、山栀、紫菀各八分，桑皮、当归、丹皮、杏仁各七分，苡仁一钱五分，甘草、葶苈各五分，服用后很安稳，但稍停即发作。有人说：肺窍中痰积瘀血尚多，未能即去，宜缓图之，候脓尽当愈。孙文垣说：丹溪虽有此言，也不可固执。如果不以药消化它，必等其自己好，恐怕岁月深而有他变，况且中年之人，怎能承受这种病？不如清热润肺，消痰化瘀，久服或早愈也。
又有人说：久嗽伤肺宜补，每补必增热加痛加咳而脓转多。仍根据法治之，二年良愈。
喻嘉言治疗陆令仪的母亲，平日持斋，肠胃素来干枯，天癸已绝，复淋沥不止，治疗很久痊愈。正值秋月燥金太过，湿虫不生，人多病咳。而血虚津枯之躯，受伤独猛，胸胁紧张，上气喘急，卧寐不宁，咳动则大痛，痰中带血而腥，食不易入，声不易出，寒热交作。申酉二时，燥金用事，诸苦倍增，脉时大时小，时牢伏时弦紧，服清肺药无进退。告知她是肺痈将成，高年难任，以葶苈大枣泻肺汤，先通肺气之壅。即觉气稍平，食少入，痰稍易出，身稍可侧，大有生机。喻嘉言说：还没完。因为见来势太急，不得已取快一时，暂开者易至复闭，等到复闭则前法不可再用矣。现在乘其暂开，多方以图，必在六十日后，交立冬节，方是愈期。盖身中之燥，与时令之燥，胶结不解，必俟燥金退气，肺金乃宁。后六十日间，屡危屡安。
大率皆用活法斡旋，缘病不可补，而脾虚又不能生肺，肺燥喜润，而脾滞又难于运食。今日脾虚，不思饮食，则于清肺中少加参、术以补脾；明日肺燥，热盛咳嗽，则于清肺中少加阿胶以润燥。日复一日，扶至立冬之午刻，病者忽自云：内中光景，大觉清爽，可得生矣。奇哉，天时之燥去，而肺金之燥遂下传大肠，五六日不一大便，略一润肠，旋即解散，正以客邪易去耳。至小雪节，康健加餐，倍于曩昔。盖胃中空虚已久，势必复其容受之常，方为全愈也。
薛立斋治疗一男子神劳，冬月患咳嗽，服解毒之药，自以为便。曰：此因肺气虚弱，腠理不密，而外邪所感也。当急补其母，是治本也。始服六君子汤，内去参、术，反加紫苏、枳壳之类，以致元气亦虚，生肺痈而殁。
一武职，因饮食起居失宜，咳嗽吐痰，用化痰止嗽之药。时仲夏，左尺洪数而无力，胸满面赤，吐痰腥臭，自汗。曰：肾虚水泛为痰，而反重亡津液，得非肺痈乎？不信，仍服前药。翌日吐脓，脉数，右寸为甚，用桔梗汤一剂，脉数与脓顿减。又二剂将愈，佐以六味而痊。
一男子咳嗽喘急，发热烦躁，面赤咽痛，脉洪大，用黄连解毒汤，二剂少退。更以栀子汤，四剂而安。（此肺痈将成未成之候。）
薛立斋治疗一男子患肺痿，咳嗽喘急，吐痰腥臭，胸满咽干，脉洪数，用人参平肺散六剂，及饮童便，诸症悉退。更以紫菀茸汤而愈。童便虽云治虚火，常治疮疡肿，疼痛发热作渴，及肺痿肺痈发热口渴者尤效。
一仆年逾三十，嗽久不愈，（病久故可用涩。）气壅不利，睡卧不安，咯吐脓血，甚觉可畏，其主已弃之矣。与宁肺散一服少愈，又服而止大半，乃以宁肺散汤数剂而痊。所以有是病必用是药，若以前散性涩而不用，何以得愈？
上舍毛体仁素阴虚，春初咳嗽，胸中隐痛，肾脉洪数，肺脉数而时不见。曰：内当结痈，先用六味地黄丸料一剂服之。翌日来谓曰：昨得良剂，嗽愈六七，务求一方，到监调理。曰：阴虚火炎，患痈之症，第因元气虚弱，未能发出，因其易忽，薛不能治。乃别用降火化痰等剂，愈甚。月余复请诊之，脉洪滑而数。曰：脓已成矣，当请常治之者同论针之，且免内溃之患。仍不决。又月余请视，他医已先开疮孔偏上，兜脓不出，仍内溃，脉愈洪大。曰：脉洪滑而数，其舌青黯，五内已坏，无能为也。后果然。
一男子咳嗽，两胁胀满，咽干口燥，咳唾腥臭。以桔梗汤四剂而唾脓，以排脓散数服而止，乃以补阴排脓之剂而瘳。
一男子咳而脓不止，脉不退，诸药不应，甚危。用柘黄丸一服少愈，再服即退，数服而痊。柘黄一两为末，百齿霜（即梳垢。）二钱，用糊为丸如梧桐子大，每服三五丸，米饮下。柘黄乃柘树所生者，其色黄，状似灵芝，江南最多，北方鲜有。
一妇人吐脓，五心烦热，口渴胸闷。以四顺散三剂少止，以排脓散数服而安。排脓散∶黄芪、白芷、五味子、人参。四顺散∶贝母、紫菀、桔梗各一钱，半夏、甘草各七分。作一剂，水煎食远服。
一男子因劳咳嗽不止，项强而痛，脉微紧而数，此肺痈也。尚未成脓，欲用托里益气药。彼不信，仍服发散药，致血气愈虚，吐脓不止，竟不救。经曰：肺内主气，外司皮毛。若肺气虚，则腠理不密，皮毛不泽。肺受伤，则皮毛错纵。故患痈痿肠痈者，必致皮毛如此，以其气不荣养而然也。亦有服表药，见邪不解而仍用发表，殊不知邪不解者，非邪不能解，多因腠理不密，而邪复入也。专用发表，则腠理愈虚，邪愈易入，反为败症矣。宜诊其脉，邪在表者，止当和解而实腠理，乘虚复入者，亦当和解兼实腠理，故用托里益气之药。若小便赤色，为肺热所传，短少为肺气虚。盖肺为母，肾为子，母虚不能生子故也。亦有小便频者，亦为肺虚，不能约制耳。
一男子面白神劳咳嗽，胸臆隐痛，其脉滑数。以为肺痈，欲用桔梗汤。不信，服败毒散，致咳嗽愈甚，吐痰腥臭始悟。仍服前汤四剂，咳嗽少定。又以四顺散四剂而脉静，更以托里药数剂而愈。大抵劳伤血气则腠理不密，风邪乘肺，风热相搏，蕴结不散，必致喘咳。又因汗下过度，则津液重亡，遂成斯症。若寸脉数而虚者为肺痈，数而实者为肺疽。脉微紧而数者，未有脓也；紧甚而数者，已有脓也。唾脓而止，脉短而面白者，易治；脓不止，脉洪大而面赤色者，不治。使其治早可救，脓成则无及矣。《金匮方论》热在上焦者，因咳为肺痿。得之或从汗出，或从呕吐，或从消渴，小便利数，或从便难。人被下药快利，重亡津液，故寸口脉数。其人燥咳，胸中隐隐时痛，脉反滑数，此为肺痈。咳吐脓血，脉数虚者为肺痿，数实者为肺痈。
一童子气禀不足，患肺痈，吐脓腥臭，皮毛枯槁，脉浮，按之涩，更无力，用钟乳粉汤治之。
一男子患之，形症皆同，惟咽喉时或作痒，痰多，胁痛，难于睡卧，用紫菀茸汤治之而病愈。
一弱人咳脓，日晡发热，夜间盗汗，脉浮数而紧。用人参五味子汤，数剂而愈，以菀茸汤月余而痊。
一男子患肺痿，咳嗽喘急，吐痰腥臭，胸满咽干，脉洪数。用人参平肺散六剂及饮童便，诸症悉退，更以紫菀茸汤而愈。童便虽云专治虚火，常治疮疡肿疼痛，发热作渴及肺痿肺痈，发热口渴者尤效。
一妇人患肺痿咳嗽，吐痰腥臭，日晡发热，脉数无力。用地骨皮治之热止，更用人参养肺汤，月余而安。
一男子前病肺痈，后又患咳嗽，头眩吐沫，饮食少思，小便频数，服解毒散、化痰药不应。诊之，脾肺二脉虚甚，谓晕眩唾涎，属脾气不能上升；小便无度，乃肺气不得下降，尚未成脓耳。投以加味理中汤四剂，诸症已退大半，更用钟乳粉汤而安。河间曰：《金匮》云，肺痿属热，如咳嗽肺瘪，声哑声嘶，咯血，此属阴虚热甚然也。本论治肺痿吐涎沫而不咳者，其人不渴，必遗尿，小便数，以上虚不能制下故也。此为肺中冷，必眩，多涎唾，用甘草、干姜，此属寒也。脉痿，涎唾多，心中温温液液者，用炙甘草汤，此补虚劳也。亦与补阴虚火热不同，是皆宜分治，故肺痿又有寒热之异也。
赵以德治疗一妇人，年二十余患肺痈，胸膺间患一窍，口中所咳脓血，与窍相应而出。以人参、黄芪、当归补气血剂，加退热排脓等药，服之，不一月而安。（《药要或问》）
治肺痈，目击神效，其法用百年芥菜卤久窨地中者，数匙立起。此卤嘉兴府城中大家多藏之。
《广笔记》：鱼腥草不住口食之，治肺痈吐脓血，神方也。正名蕺草，兼治鱼口。（雄按：此方可治鸦片烟瘾。）
薛立斋治疗陆司厅子仁，春间咳嗽，吐痰腥秽，胸满气促，皮肤纵，项强脉数，此肺疽也。盖肺系在项，肺伤则系伤，故牵引不能转侧。肺者气之本，其华在毛，其充在皮，肺伤不能摄气，故胁胀气促而皮肤纵。东垣云：肺疮之脉微紧而数者，未有脓也；紧甚而数者，已有脓也。其脉来紧数，则脓已成，遂以人参、黄芪、当归、川芎、白芷、贝母、麦冬、蒌仁、桔梗、防风、甘草，兼以蜡矾丸及太乙膏治之，脓尽脉涩而愈。至冬，脉复数。经云，饮食劳倦则伤脾，脾伤不能生肺金。形寒饮冷则伤肺，肺伤不能生肾水，肾水不足则心火炽盛，故脉来洪数。经云，冬见心脉而不治。后果殁于火旺之月。（凡肺疽愈而复作，多不治。余常治三人，一间三年，两间一年，皆复作而殁。）
周国用年逾三十，患咳嗽，项强气促，右寸脉数，此肺疽也。东垣云：风中于胃，呼气不入，热攻于荣，吸气不出。风伤皮毛，热伤血脉，风热相搏，血气稽留于肺，变成疮疽。诊其脉数而虚者，肺痿也，数而实者，肺疽也。今诊脉滑，此疽脓已成。以排脓托里之药，及蜡矾丸治之，脉渐涩而愈。
锦衣李大器亦患此，吐脓，面赤脉大。谓肺病脉宜涩，面宜白，今脉大面赤，火克金也，不可治。果殁。
一男子年逾四十，喘咳胁痛，胸满气促，右寸脉大，此风热蕴于肺也。尚未成疮，属有余之症，意欲以泻白散治之。彼谓肺气素怯，不然之，乃服补药，喘咳愈甚。两月后复请视之，汗出如油，喘而不休，此肺气已绝，不治。果殁。夫肺气充实（二语赘），邪何从袭？邪气既入，则宜去之，故用泻白散，所以泻肺气之邪也。邪气既去，则真自实矣。
姚应凤治疗某叟，患胀满，诸医多云隔症。应凤曰：此肺痈耳。令病者闭目，取一大盘水，向病者项上倾之，病者陡大惊，亟举刀直刺心坎，泻脓血数碗而愈。人问之，应凤曰：心尖下垂，水泼而惊，惊则心系提，吾刀可入也。（《仁和县志》）
沈夫人患嗽血，昼夜不休。应凤曰：肺虑痿，不虑溃，今溃至第三叶，尚可生也。先投洗肺汤已，令食猪肺数十斤遂愈。
王洪绪曰：诸患易识，独肺中患毒难觉。凡两脚骨疼痛者，或脚骨不痛而舌下生如细豆一粒者，再心口直上，内作微疼及咳嗽口干咽燥，皆肺中生毒之候也。即用甘草、桔梗各三钱煎服，服后如觉
Xu Lizhai treated a woman who originally had blood deficiency, presenting with fever and cough. After taking medicines for phlegm-fire, she expectorated pus and blood, her face was red, and her pulse was rapid. The heat was extremely critical; this indicated that the abscess had formed while Qi and Blood were deficient.
Ba Zhen Tang (Eight Treasures Decoction) was used to tonify Yuan Qi (Primal Qi), and Jiegeng Tang (Platycodon Decoction) was used for treatment, resulting in recovery.
Another woman contracted wind-cold. Someone administered diaphoretic agents, which instead caused coughing, wheezing, and urgency of breathing, reduced appetite, chest and epigastrium discomfort, and constipation. Her right Cun and Guan pulses were floating and rapid. There was an intention to use unblocking agents. Xu said: "This is due to Spleen Earth deficiency failing to generate Lung Metal. If we further use purgatives, it will consume body fluids, inevitably leading to Lung Abscess." The patient did not believe him and continued with purgatives. All deficiency symptoms appeared, and she subsequently expectorated pus. Then, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was administered in the morning, and Jiegeng Tang in the evening, each for several doses, until expectoration of pus gradually stopped. Afterwards, the former decoction was continued in the morning, and Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) in the evening, each for fifty doses. Fortunately, her good management led to recovery.
Another woman suffered from cough with sputum expectoration and chest/epigastric pain. Her right Cun and Guan pulses were floating and slippery, and her neck felt tight and stiff. This was phlegm generated by accumulated heat in the Spleen and Stomach, not an abscess. Er Chen Tang (Two Aged Medicines Decoction), Gardenia (Zhi Zi), Atractylodes Macrocephala Rhizome (Bai Zhu), and Platycodon Root (Jie Geng) were used for treatment, bringing relief.
Another woman originally had blood deficiency with internal heat and occasional cough. In the early winter of the Jiachen year, both Chi pulses were floating and surging. She sought treatment for weak Spleen function. I advised: "Prevent lung diseases." In the early spring of the Bingwu year, she indeed developed cough. Both left and right Cun pulses were surging and rapid, indicating Lung Abscess. The pus had already formed, and the right Cun pulse remained surging and rapid, indicating Heart Fire overcoming Lung Metal, which was concerning for the summer season. Medicines to nourish Water and strengthen the Spleen were used, resulting in slight improvement. However, she became negligent and failed to regulate her lifestyle, and unfortunately died in the summer.
Yu Jiayan treated Shi Meicang's Lung Withered Lung (Fei Fei), characterized by wheezing, coughing, expectoration of clear sputum, soft and flaccid limbs unable to move, and a deficient, rapid pulse. Twenty Gecko (Ge Jie) were soaked in wine, fried with butter, combined with ten taels each of Ginseng Radix (Ren Shen) and Black Scutellaria Root (Hei Shen), made into honey pills, and held in the mouth frequently. Recovery occurred before one dose was finished. (From *Zhang Shi Yi Tong*)
Zhang Luyu treated Lu Qufei's Lung Withered Lung (Fei Fei), characterized by hoarseness, sputum expectoration, afternoon fever, spontaneous sweating, wiry-thin left pulse, and deficient-soft right pulse. This was caused by excessive mental labor and indulgence in lust. Sheng Mai San (Generate the Pulse Powder) was combined with Bao Yuan Tang (Protect the Origin Decoction) first, followed by Yi Gong San (Benefit the Work Powder) added with Scutellaria Radix (Huang Qin) and Ginger/Jujube, along with Du Qi Wan (Nine Ingredients Pill). Taken morning and evening for half a month, the fever subsided, sputum stopped, and voice clarity returned after over a month.
Sun Qibo suffered from Lung Distension (Fei Zhang) due to excessive consumption of Qi-depleting medicines. The pulse was floating and large but hollow upon heavy pressure, and he could not eat. Fortunately, his urine was clear and stool firm (indicating Metal and Earth qi were not exhausted). Ju Fang Qi Qi Wan (Local Formula Seven Qi Pills) was given, with three qian of Ginseng Radix (Ren Shen), one qian each of Cinnamon Bark (Rou Gui), Fermented Pinellia (Ban Xia Qu), and Roasted Licorice Root (Zhi Gan Cao), and four slices of Fresh Ginger per dose. After four doses, he recovered suddenly. Generally, Lung Distension is mostly excess syndrome; this case with a deficient-large pulse should not be judged by ordinary standards.
A nun suffered from Lung Distension (Fei Zhang), wheezing with shoulder lifting, and diaphoretic coughing medicines were ineffective. Gradually, chest and abdomen became distended. The pulse at the Qi Kou position was wiry, thin, and choppy. This must be due to physical exertion causing Qi to rise, mistakingly drinking cold water injuring the Lung, preventing Lung Qi from converging. Yuebi Tang (Yuebi Decoction) with Ephedra Herb (Ma Huang) reduced, plus Asarum Root (Xi Xin) and Lepidium Seed (Ting Li), was used to greatly drain Lung Qi, resulting in peace.
An alcoholic lay drunk in deep winter and drank cold tea when thirsty. He developed Lung Distension (Fei Zhang) with wheezing and cough. The pulse at the Qi Kou position was deep, tight, and forceful. Xiao Qing Long Tang (Minor Blue Dragon Decoction) without White Peony Root (Bai Shao), added with Lepidium Seed (Ting Li) and Pinellia Tuber (Ban Xia), cured him in one dose. Thus, it is known that for Lung Distension with wheezing and fullness, Lepidium Seed (Ting Li) should be used as a guide; it cannot be lightly administered if not an excess syndrome.
Sun Wen yuan treated the wife of Chuyang's nephew. Previously, she had cough which various treatments failed to cure; urgent cough led to vomiting. Bi Yu San (Jade Green Powder), two qian, mixed with white water, stopped it immediately. Half a year later, she coughed again with hidden pain in the chest and back, frequent internal heat, and expectorated much peach-red pus that was foul-smelling. Her right hypochondrium and breasts were swollen and painful. Diagnosis revealed surging-rapid pulse, dry stool, emaciated muscles and bones. This was Lung Abscess (Fei Yong). Fritillaria Bulb (Bei Mu), Rubia Root (Qian Gen), and White Peony Root (Bai Shao), each one qian; Anemarrhena Rhizome (Zhi Mu), Ophiopogon Tuber (Mai Dong), Gardenia Fruit (Zhi Zi), and Aster Root (Zi Wan), each eight fen; Mulberry Root Bark (Sang Bai Pi), Angelica Sinensis Root (Dang Gui), Moutan Cortex (Dan Pi), and Apricot Kernel (Xing Ren), each seven fen; Coix Seed (Yi Yi Ren), one qian five fen; Licorice Root (Gan Cao) and Lepidium Seed (Ting Li), each five fen. Administration brought great comfort, but relapse occurred upon stopping. Some said: "There is still much phlegm accumulation and stasis in the lung orifices, difficult to remove quickly. It is better to plan slowly; once the pus is gone, she will heal." Sun said: "Although Danxi said this, one cannot adhere rigidly. If we do not use medicine to resolve it, waiting for self-healing might lead to changes over time. Moreover, how can a middle-aged person endure this? It is better to clear heat, moisten the lungs, resolve phlegm, and transform stasis. Long-term administration may lead to early recovery."
Others said: "Long-term cough damages the Lung, requiring tonification. But every tonification increases heat, pain, and cough, turning more pus." Still following the original method, she healed well after two years.
Yu Jiayan treated the mother of Lady Lu. She usually kept vegetarian fasts, so her intestines and stomach were naturally dry. Tian Gui (menstruation) had ceased, yet she suffered from continuous dripping discharge, which took long to cure. During autumn, Dry Metal was excessive, damp insects did not breed, and many people suffered from cough. Her body, being blood-deficient and fluid-dry, was severely injured. Chest and ribs felt tense, upper body wheezed urgently, sleep was restless, coughing caused severe pain, sputum contained blood and smelled foul, eating was difficult, voice was hard to produce, alternating chills and fever. During Shen and You hours (3-7 PM), Dry Metal was active, worsening all suffering. Pulses varied from large to small, sometimes deep-hidden, sometimes wiry-tight. Clearing Lung medicines showed no progress. It was told that Lung Abscess was forming, and for an elderly person, it was hard to bear. Tingli Dazao Xiefei Tang (Lepidium and Jujube Decoction to Drain the Lung) was used first to open Lung Qi obstruction. Immediately, Qi felt slightly calmer, food intake increased slightly, sputum came out easier, and she could turn her body slightly, showing great vitality. Yu said: "Not yet." Seeing the rapid onset, forced to take quick relief, temporary opening easily leads to re-closure. When re-closed, the previous method cannot be used again. Now, taking advantage of the temporary opening, multiple strategies are employed. Recovery must wait until sixty days later, entering the Start of Winter solar term. The dryness within the body and the seasonal dryness are knotted together; only when Dry Metal qi retreats can Lung Metal be peaceful. Over the next sixty days, there were repeated crises and recoveries.
Generally, flexible methods were used to manage the situation. Because the disease could not be tonified, yet Spleen deficiency prevented generating Lung Metal; Lung dryness liked moisture, yet Spleen stagnation made transporting food difficult. Today, Spleen deficiency meant no desire to eat, so Ginseng and Atractylodes were slightly added to clearing Lung medicines to tonify Spleen; tomorrow, Lung dryness with intense heat and cough meant Asparagus Tuber (E Jiao) was slightly added to clearing Lung medicines to moisten dryness. Day after day, supporting her until noon on the Start of Winter, the patient suddenly said: "The internal feeling is very refreshing; I can survive." Strange indeed, when the seasonal dryness went away, the Lung Metal dryness descended to the Large Intestine. For five or six days without a major bowel movement, slight intestinal moistening resolved it quickly, precisely because the pathogenic factor was easy to expel. By the Minor Snow solar term, health improved, eating doubled compared to before. Since the Stomach had been empty for a long time, it inevitably returned to its normal capacity, marking complete recovery.
Xu Lizhai treated a man with spiritual fatigue. In winter, he suffered from cough and took detoxifying medicines, thinking them suitable. Xu said: "This is due to Lung Qi deficiency, loose interstices, and external pathogen invasion. One must urgently tonify the Mother (Spleen); this treats the root." Initially, Liu Jun Zi Tang (Six Gentlemen Decoction) was taken, but Ginseng and Atractylodes were removed, and Perilla Leaf (Zi Su) and Aurantium Fruit (Zhi Ke) were added instead. This led to Yuan Qi deficiency, development of Lung Abscess, and death.
A military officer, due to improper diet and lifestyle, had cough with sputum and used phlegm-resolving and cough-stopping medicines. It was mid-summer. The left Chi pulse was surging-rapid but powerless. His chest was full, face red, sputum foul-smelling, and he had spontaneous sweating. Xu said: "Kidney deficiency causes water to flood and form phlegm, yet fluids are heavily lost. Could this not be Lung Abscess?" He did not believe it and continued the previous medicines. The next day, he expectorated pus. The pulse was rapid, especially at the right Cun. One dose of Jiegeng Tang (Platycodon Decoction) significantly reduced the rapid pulse and pus. Two more doses nearly cured him, assisted by Liu Wei Di Huang Wan (Six Ingredient Pill with Rehmannia), leading to recovery.
A man suffered from cough, wheezing urgency, fever, irritability, red face, sore throat, and a surging-large pulse. Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) was used for two doses, showing slight reduction. Then Zhizi Tang (Gardenia Decoction) for four doses brought peace. (This indicates the stage where Lung Abscess is about to form or has not yet formed.)
Xu Lizhai treated a man with Lung Withered Lung (Fei Fei), suffering from cough, wheezing urgency, foul-smelling sputum, chest fullness, dry throat, and surging-rapid pulse. Ren Shen Ping Fei San (Ginseng Peace the Lung Powder) for six doses, along with drinking child's urine, relieved all symptoms. Then Zi Ruan Rong Tang (Aster Bud Decoction) cured him. Although Child's Urine (Tong Bian) is said to treat deficient fire, it often treats sores, ulcers, swelling, pain, fever, thirst, and is particularly effective for Lung Withered Lung and Lung Abscess with fever and thirst.
A servant over thirty years old had chronic cough that would not heal (chronic illness allows for astringents). Qi was obstructed and unfavorable, sleep was uneasy, expectorating pus and blood, which seemed terrifying. His master had abandoned him. Ning Fei San (Calming the Lung Powder) one dose brought slight improvement; another dose stopped more than half. Then Ning Fei Tang (Calming the Lung Decoction) for several doses led to recovery. Therefore, having the disease requires using the specific medicine. If one does not use the previous powder because of its astringent nature, how could one recover?
Shangshe Mao Tiren originally had Yin deficiency. In early spring, he had cough and hidden chest pain. The Kidney pulse was surging-rapid, and the Lung pulse was rapid but occasionally absent. Xu said: "Internal abscess should form. First, take one dose of Liu Wei Di Huang Wan (Six Ingredient Pill with Rehmannia) ingredients." The next day he came and said: "Yesterday I got a good remedy; cough improved by six or seven parts. I beg for a prescription to take to prison for regulation." Xu said: "Yin deficiency with flaming fire, suffering from abscess. Merely because Yuan Qi is weak, it cannot erupt. Due to negligence, Xu cannot treat it." So others used descending-fire and resolving-phlegm agents, making it worse. Over a month later, he requested diagnosis again. The pulse was surging-slippery and rapid. Xu said: "Pus has formed. One should invite regular practitioners to discuss acupuncture to avoid internal rupture." He still hesitated. Another month later, he was examined again. Other doctors had already opened a wound hole higher up, trapping pus inside, leading to internal rupture. The pulse became even more surging-large. Xu said: "Surging-slippery-rapid pulse, blue-dark tongue, internal organs are ruined. Nothing can be done." This indeed happened.
A man had cough, distension in both hypochondria, dry throat and mouth, and foul-smelling expectoration. Four doses of Jiegeng Tang (Platycodon Decoction) led to expectoration of pus. Several doses of Pai Nong San (Drain Pus Powder) stopped it. Then, Yin-tonifying and pus-draining agents cured him.
A man coughed and pus did not stop. Pulse did not recede. Various medicines were ineffective. Condition was critical. Zhe Huang Wan (Zhe Huang Pill) one dose brought slight improvement; two doses caused recession; several doses led to recovery. Zhe Huang (one tael) was powdered, Baichi Shuang (Comb Dirt, two qian) added, made into pills like Sophora seeds with paste. Take three to five pills with rice drink. Zhe Huang grows on Zhe trees, is yellow in color, resembles Lingzhi mushroom, most abundant in Jiangnan, rare in the North.
A woman expectorated pus, had five-center heat, thirst, and chest oppression. Si Shun San (Four Smooth Powder) for three doses slightly stopped it. Pai Nong San (Drain Pus Powder) for several doses brought peace. Pai Nong San: Astragalus Root (Huang Qi), Angelica Dahurica Root (Bai Zhi), Schisandra Berry (Wu Wei Zi), Ginseng Radix (Ren Shen). Si Shun San: Fritillaria Bulb (Bei Mu), Aster Root (Zi Wan), Platycodon Root (Jie Geng), each one qian; Pinellia Tuber (Ban Xia), Licorice Root (Gan Cao), each seven fen. Make one dose, decoct in water, take far from meals.
A man suffered from continuous cough due to labor, neck stiffness and pain, micro-tight and rapid pulse. This was Lung Abscess. Pus had not yet formed. Intent was to use interior-supporting and Qi-tonifying medicines. He did not believe it, continued taking diaphoretic medicines, causing Qi and Blood to become more deficient, expectoration of pus continued, and ultimately, he could not be saved. The Classics say: "The Lung internally governs Qi and externally controls skin and hair. If Lung Qi is deficient, interstices are loose, and skin/hair lack luster. If Lung is injured, skin/hair become disordered. Thus, those suffering from abscesses, Withered Lung, or Intestinal Abscess will inevitably have such skin/hair conditions, because Qi fails to nourish them." Also, some take exterior-releasing medicines, see pathogens not resolved, and continue using exterior-releasing methods. They do not know that unresolved pathogens are not because they cannot be resolved, but often because loose interstices allow pathogens to re-enter. Exclusively using exterior-releasing methods makes interstices more deficient, pathogens enter more easily, turning into defeat syndromes. One should diagnose the pulse. If pathogen is in the exterior, one should only harmonize and solidify interstices. If pathogens re-enter due to deficiency, one should also harmonize and solidify interstices. Hence, interior-supporting and Qi-tonifying medicines are used. If urine is red, it is transmitted Lung Heat; if short and scant, it is Lung Qi deficiency. Because Lung is the Mother and Kidney is the Son, Mother deficiency cannot generate the Son. There are also cases of frequent urination, which is also Lung deficiency failing to control.
A man with pale face, spiritual fatigue, and cough, with hidden chest pain, had a slippery-rapid pulse. Suspected Lung Abscess, intended to use Jiegeng Tang (Platycodon Decoction). He did not believe it, took Baidu San (Eliminate Toxin Powder), causing cough to worsen. Only when expectorating foul-smelling sputum did he realize. Still took the former decoction for four doses, cough settled slightly. Then Si Shun San (Four Smooth Powder) for four doses made the pulse calm. More interior-supporting medicines for several doses led to recovery. Generally, labor damaging Qi and Blood makes interstices loose. Wind pathogen enters Lung. Wind and Heat struggle, accumulate and do not disperse, inevitably leading to wheezing and cough. Furthermore, excessive sweating and purging heavily lose body fluids, thus forming this syndrome. If Cun pulse is rapid and deficient, it is Lung Abscess; rapid and excess, it is Lung Carbuncle. Micro-tight and rapid pulse means no pus yet; very tight and rapid means pus has formed. Expectoration of pus stops, pulse is short, face is white: easy to treat. Pus does not stop, pulse is surging-large, face is red: untreatable. If treated early, it can be saved; once pus forms, it is too late. *Jinkui Fanglun* says: Heat in the Upper Jiao, due to cough, becomes Lung Withered Lung. It arises from sweating, vomiting, Xiao Ke (Wasting-Thirst) with frequent urination, or difficulty defecating. People subjected to harsh purgatives heavily lose body fluids, hence Cun Kou pulse is rapid. The person has dry cough, hidden chest pain occasionally, pulse reverses to slippery-rapid. This is Lung Abscess. Coughing and expectorating pus and blood, rapid-deficient pulse is Lung Withered Lung; rapid-excess pulse is Lung Abscess.
A boy with insufficient constitution suffered from Lung Abscess, expectorating foul-smelling pus, withered skin and hair, floating pulse, choppy upon pressure, even more powerless. Zhong Ru Fen Tang (Stalactite Powder Decoction) was used for treatment.
A man suffered similarly, same signs and symptoms, except throat occasionally itchy, much sputum, hypochondriac pain, difficulty sleeping. Zi Ruan Rong Tang (Aster Bud Decoction) cured him.
A weak person coughed pus, afternoon fever, night sweats, floating-rapid-tight pulse. Ren Shen Wu Wei Zi Tang (Ginseng and Schisandra Decoction) for several doses cured him; Zi Ruan Rong Tang (Aster Bud Decoction) for over a month completed recovery.
A man suffered from Lung Withered Lung (Fei Fei), cough, wheezing urgency, foul-smelling sputum, chest fullness, dry throat, surging-rapid pulse. Ren Shen Ping Fei San (Ginseng Peace the Lung Powder) for six doses and drinking child's urine relieved all symptoms. Then Zi Ruan Rong Tang (Aster Bud Decoction) cured him. Although Child's Urine (Tong Bian) is said to specifically treat deficient fire, it often treats sores, ulcers, swelling, pain, fever, thirst, and is particularly effective for Lung Withered Lung and Lung Abscess with fever and thirst.
A woman suffered from Lung Withered Lung (Fei Fei) with cough, foul-smelling sputum, afternoon fever, rapid-powerless pulse. Gu Pi (Phellodendron Bark) was used to stop fever. Then Ren Shen Yang Fei Tang (Ginseng Nourish Lung Decoction) for over a month brought peace.
A man previously had Lung Abscess, then suffered from cough again, dizziness, spitting foam, reduced appetite, frequent urination. Detoxifying powder and phlegm-resolving medicines were ineffective. Diagnosis showed Spleen and Lung pulses very deficient. Dizziness and spitting saliva belong to Spleen Qi failing to ascend; unlimited urination belongs to Lung Qi failing to descend. Pus has not yet formed. Jia Wei Li Zhong Tang (Modified Regulate the Middle Decoction) for four doses relieved most symptoms. Then Zhong Ru Fen Tang (Stalactite Powder Decoction) brought peace. Hejian said: *Jinkui* states Lung Withered Lung belongs to heat. Such as cough, collapsed lung, hoarse voice, hemoptysis, this belongs to Yin deficiency with intense heat. This treatise treats Lung Withered Lung with salivary froth expectoration without cough. The person is not thirsty, must have enuresis, frequent urination, because upper deficiency cannot control lower. This is Cold in the Lung, must have dizziness, much salivary froth. Use Licorice Root (Gan Cao) and Dried Ginger (Gan Jiang). This belongs to cold. Pulse Withered Lung, much salivary froth, warm liquid sensation in heart. Use Roasted Licorice Root Decoction (Zhi Gan Cao Tang). This tonifies deficiency and labor. It is also different from tonifying Yin deficiency with fire heat. All these should be treated separately. Thus, Lung Withered Lung has differences between cold and heat.
Zhao Yi de treated a woman in her twenties suffering from Lung Abscess. A cavity appeared between the chest and sternum, and pus-blood expectorated from the mouth corresponded to the cavity. Ren Shen (Ginseng), Huang Qi (Astragalus), Dang Gui (Angelica) tonifying Qi and Blood agents, added with heat-clearing and pus-draining medicines. Taken for less than a month, she recovered. (*Yao Yao Huo Wen*)
Treating Lung Abscess, witnessing miraculous effect. The method uses century-old mustard brine buried in the ground for a long time. A few spoons bring immediate rise. This brine is stored by many families in Jiaxing Prefecture city.
*Guang Biji*: Fish Mint (Yu Xing Cao) eaten continuously is a divine formula for treating Lung Abscess with pus and blood expectoration. Official name is Ji Cao (Houttuynia Herb), also treats fish mouth abscess. (Xiong notes: This formula can treat opium addiction.)
Xu Lizhai treated Lu Sitings son, Ren. In spring, he had cough, foul-smelling sputum, chest fullness, shortness of breath, loose skin, neck stiffness, rapid pulse. This was Lung Carbuncle (Fei Ju). The Lung meridian connects to the neck. Lung injury means meridian injury, hence traction prevents turning. Lung is the root of Qi, its brilliance is in hair, its filling is in skin. Lung injury fails to grasp Qi, hence hypochondriac distension, shortness of breath, and loose skin. Dongyuan said: Lung carbuncle pulse micro-tight and rapid means no pus yet; very tight and rapid means pus has formed. Its pulse comes tight and rapid, so pus has formed. Then Ren Shen (Ginseng), Huang Qi (Astragalus), Dang Gui (Angelica), Chuan Xiong (Ligusticum), Bai Zhi (Angelica Dahurica), Bei Mu (Fritillaria), Mai Dong (Ophiopogon), Gua Lou Ren (Trichosanthes Seed), Jie Geng (Platycodon), Fang Feng (Saposhnikovia), Gan Cao (Licorice) were used, combined with La Fan Wan (Beeswax Alum Pill) and Tai Yi Gao (Great One Plaster). When pus was exhausted and pulse became choppy, he recovered. In winter, pulse became rapid again. Classics say: Diet and labor fatigue injure Spleen. Spleen injury fails to generate Lung Metal. Cold shape and cold drinks injure Lung. Lung injury fails to generate Kidney Water. Kidney Water deficiency leads to blazing Heart Fire, hence surging-rapid pulse. Classics say: Winter seeing Heart pulse is untreatable. Indeed, he died in the month of strong fire. (Whenever Lung Carbuncle heals and recurs, it is mostly untreatable. I often treated three people, one interval three years, two intervals one year, all recurred and died.)
Zhou Guoyong over thirty, suffered from cough, neck stiffness, shortness of breath, right Cun pulse rapid. This was Lung Carbuncle (Fei Ju). Dongyuan said: Wind attacks Stomach, exhalation does not enter. Heat attacks Ying, inhalation does not exit. Wind injures skin and hair, Heat injures blood vessels. Wind and Heat struggle, Qi and Blood stagnate in Lung, transforming into sores and carbuncles. Diagnose pulse rapid and deficient: Lung Withered Lung. Rapid and excess: Lung Carbuncle. Now diagnose pulse slippery. This carbuncle pus has formed. Drain pus and support interior medicines, plus La Fan Wan (Beeswax Alum Pill) for treatment. Pulse gradually became choppy and recovered.
Jinyi Li Daqi also suffered from this, expectorating pus, red face, large pulse. Said: Lung disease pulse should be choppy, face should be white. Now pulse large, face red. Fire overcomes Metal. Untreatable. Indeed died.
A man over forty, wheezing cough, hypochondriac pain, chest fullness, shortness of breath, right Cun pulse large. This is Wind-Heat accumulating in Lung. Not yet formed sore, belongs to excess syndrome. Intended to use Xie Bai San (Drain White Powder) for treatment. He said Lung Qi is inherently timid, disagreed. Took tonifying medicines. Wheezing and cough worsened. Two months later, requested examination again. Sweat like oil, continuous wheezing. This is Lung Qi exhausted, untreatable. Indeed died. If Lung Qi is substantial (these two words are redundant), how can pathogen attack? Once pathogen enters, it should be expelled. Hence Xie Bai San (Drain White Powder) is used to drain Lung pathogen. Once pathogen is gone, true Qi becomes substantial itself.
Yao Yingfeng treated an old man suffering from distension and fullness. Many doctors said it was Ge Zheng (Diaphragmatic Constraint). Yingfeng said: "This is Lung Abscess." Ordered the patient to close eyes, took a large basin of water, poured it towards the patient's neck. Patient suddenly startled, quickly raised knife to stab directly into the heart pit. Drained several bowls of pus and blood, and recovered. People asked him. Yingfeng said: "Heart tip hangs down. Water splashed causes startle. Startle lifts Heart connection. My knife can enter." (*Renhe County Gazetteer*)
Lady Shen suffered from coughing blood, day and night without rest. Yingfeng said: "Lung fears Withered Lung, not rupture. Now ruptured to the third lobe, still can live." First gave Xi Fei Tang (Wash Lung Decoction), then ordered eating dozens of jin of pig lungs, finally recovered.
Wang Hongxu said: Various ailments are easy to recognize. Only poison in Lung is hard to perceive. Anyone with pain in both foot bones, or foot bone not painful but a bean-sized growth under the tongue, plus slight internal pain straight up from the heart pit, cough, dry mouth, dry throat, are all signs of poison generating in Lung. Immediately use Licorice Root (Gan Cao) and Platycodon Root (Jie Geng), three qian each, decoct and take. After taking, if one feels...