肺中伏风,有专寒者,有夹温者。专寒是口鼻吸受风寒于内,其证呛咳不已,入夜尤甚
,为
日稍久,肺气不能清肃,即挟水饮上犯,面目 肿,隐见青色。治之宜用温散,如桂枝、茯
苓、干姜、细辛,皆要药也。夹温是先吸受天地亢燥之气,肺中津液为亢气扰耗,大气出入
不得滑利,呼吸喘促。因之表气不充,腠理不固,或夜寐盗汗,或劳汗当风,风寒乘虚内袭
,遂时觉恶寒发的热,肺气愈不得畅,亢气愈菀于中,时作呛咳,遇劳即甚,痰涎干结,成
块成裹,气味腥腐,舌苔薄黄干燥,唇焦引饮,脉象浮候弦而带滑,中沉洪大而散,大便秘
结,小便赤涩,甚至胸中腹中有一点结痛。是时正当仿大青龙、越婢之意,以两解之,即愈
矣。而医乃有意深求,以为此肺痈也;又不遵古肺痈治法,而用桑叶、桔梗、连翘、银花,
一派苦寒沉降之品,致温燥之气愈结愈深,毫无出路,呛唾脓血,而肺真腐矣。当肺未坏之
先,挽回得法,间有发为斑疹、疮疡而愈者,然而难矣。其死也,面白唇枯,发焦目陷,
吾
见屡矣。此病近时极多,医者不可不知。《内经》劳风一病,证候与此相近。(巢氏风热候
正引此文。)是因劳倦津液内伤,风温外袭,久不得出。蔓延于太阳、少阴之经脉,以内达
于脏,致肺肾肺气为之扰乱浮越。所以然者,正气先伤。其力不能撑邪外出也。治之惟有滋
助肝肾元气,宣通肺与膀胱之经气,需以时日,庶有瘳乎!
肺中潜伏的风邪,有单纯受寒的,也有兼夹温热的。单纯受寒是指口鼻吸入风寒之气入于体内,其症状为呛咳不止,入夜更加严重,病程稍久后,肺气不能清肃下降,就会挟带水饮上犯,导致面目浮肿,隐约可见青色。治疗应当使用温散之法,如桂枝、茯苓、干姜、细辛,都是重要的药物。
兼夹温热是指先吸受了天地间亢盛的燥气,肺中的津液被亢盛之气扰动耗伤,大气出入不得滑利,呼吸喘促。因此表气不充实,腠理不固密,或者夜间睡觉时盗汗,或者出汗时当风,风寒乘虚内袭,于是时常觉得恶寒发热,肺气更加不得通畅,亢盛之气更加郁结在体内,时常发作呛咳,劳累后即加重,痰涎干结,成块成裹,气味腥臭腐败,舌苔薄黄干燥,嘴唇焦裂想喝水,脉象浮取弦而带滑,中取沉取洪大而散,大便秘结,小便赤涩,甚至胸中腹中有一点结痛。这时正当仿效大青龙汤(发汗解表,清里除烦)、越婢汤(发汗利水)的意思,以表里双解,就能痊愈了。然而医生却有意深究,认为这是肺痈(肺部生疮化脓的病证);又不遵循古代治疗肺痈的方法,而使用桑叶、桔梗、连翘、金银花,一派苦寒沉降的药物,致使温燥之气更加郁结深入,毫无出路,呛咳吐出脓血,导致肺脏真正腐烂败坏。在肺脏尚未败坏之前,如果挽回得法,间或有发出斑疹、疮疡而痊愈的,然而很难了。其死亡时,面色白而嘴唇枯槁,头发焦枯,眼睛凹陷,我见过很多次了。这种病近来极多,医生不可不知道。《内经》中的劳风一病,证候与此相近。(巢元方《诸病源候论》风热候正引用此文。)这是因为劳倦导致津液内伤,风温外袭,久久不得排出。蔓延于太阳经、少阴经的经脉,由内到达脏腑,导致肺肾之气为之扰乱浮越。之所以这样,是因为正气先已受伤,其力量不能支撑将邪气排出体外。治疗只有滋助肝肾元气,宣通肺与膀胱的经气,需要花费时日,才可能有痊愈的希望!
Wind pathogen latent in the Lung may be purely cold or accompanied by warmth. Purely cold wind results from inhaling wind-cold through the nose and mouth into the interior. The manifestations include incessant hacking cough, worsening at night. After a relatively long duration, the Lung Qi fails to descend and clear, leading to water-fluid retention ascending to invade the upper body, causing swelling of the face and eyes with a bluish hue. Treatment should employ warming and dispersing methods; Cinnamon Twig (Guizhi), Poria (Fuling), Dried Ginger (Ganjiang), and Asarum (Xixin) are essential herbs.
Accompanied by warmth occurs when one first inhales the excessive dryness of heaven and earth, damaging Lung fluids. The movement of Qi becomes obstructed, leading to panting and rapid breathing. Consequently, the defensive Qi is insufficient, and the interstices (Couli) are not secure. Night sweats may occur, or wind-cold may invade due to sweating exposed to wind. This leads to alternating chills and fever, further obstructing Lung Qi, while excessive heat becomes trapped within. Hacking coughs occur frequently, worsening with exertion. Phlegm is dry and sticky, forming clumps or masses with a fishy, putrid odor. The tongue coating is thin, yellow, and dry; lips are scorched with a desire to drink. The pulse is wiry and slippery on superficial palpation, and large, scattered on deep palpation. Constipation and dark, scanty urination may occur, along with localized pain in the chest or abdomen. At this stage, one should emulate the principles of Da Qing Long Tang (Major Green Dragon Decoction) and Yue Bi Tang (Yuebi Decoction) to resolve both exterior and interior simultaneously, leading to recovery. However, some physicians mistakenly diagnose this as Lung Abscess (Fei Yong). Instead of following ancient protocols for Lung Abscess, they use bitter-cold and descending herbs such as Mulberry Leaf (Sangye), Platycodon (Jiegeng), Forsythia (Lianqiao), and Honeysuckle (Yinhua). This causes the warm-dry pathogen to become more deeply trapped without an exit route, resulting in coughing up pus and blood, ultimately rotting the Lung tissue. Before irreversible damage, if treated correctly, recovery via eruption of macules, papules, or sores is possible but rare. Death presents with pale face, withered lips, brittle hair, and sunken eyes, a scenario I have witnessed repeatedly. This disease is common nowadays, and physicians must understand it. The "Labor Wind" (Lao Feng) described in the *Neijing* has similar symptoms. (Cited in Chao Yuanfang's *Zhubing Yuanhou Lun* under Wind-Heat Syndromes.) It arises from internal fluid injury due to overwork and external invasion of wind-warmth, which lingers and spreads through the Taiyang and Shaoyin meridians to affect the Zang organs, disturbing and floating the Qi of the Lung and Kidney. This happens because the healthy Qi is initially damaged and lacks the strength to expel the pathogen. Treatment requires nourishing and assisting the Yuan Qi of the Liver and Kidney, and unblocking the meridian Qi of the Lung and Bladder. Recovery takes time.