治肺痿吐涎沫。
桂枝 生姜(各三两。) 甘草(三两) 大枣(十二枚。) 皂荚(一枚。去皮子。
炙焦。)
上五味。以水七升。微火煮取三升。分温三服。
歌曰 桂枝去芍本消阴。痰饮挟邪迫肺金。一个皂驱粘腻浊。桂枝运气是良箴。
元犀按。非辛温之品。不能行阳运气。非甘润之品。不能补土生津。君以姜、桂之辛温。
行阳消阴。佐以大枣、甘草之甘润。补阴生液。若夫开壅塞。涤污垢。以净其涎沫者。则皂
荚丸
(歌解见长沙方歌括。)治咳而胸满振寒。脉数。咽干不渴。时出浊唾腥臭。
如米粥者。为肺痈。
桔梗 贝母(各三分。) 巴豆(一分。去皮熬。研如霜。)
上三味为散。强人饮服半钱匕。羸者减之。病在膈上者吐脓。在膈下者泻出。若下多不
止。
治咳有微热烦满。胸中甲错。是为肺痈。
苇茎(二升。) 薏苡仁(半升。) 桃仁(五十粒。) 瓜瓣(半升。)
上四味。以水一斗。先煮苇茎。得五升。去滓。内诸药。煮取二升。服一升。再服。当
吐如
歌曰 胸中甲错肺痈成。烦满咳痰数实呈。苡瓣半升桃五十。方中先煮二升茎。
元犀按。此方以湿热为主。咳有微热烦满。胸中甲错者。是湿热之邪结在肺也。肺既结。
则
之源。瓜瓣排瘀。开结热之路。方下注云。再服当吐如脓者。指药力行。肺痈溃矣。
治疗肺痿,症状为吐出涎沫。
桂枝、生姜(各三两)、甘草(三两)、大枣(十二枚)、皂荚(一枚,去皮和籽,炙烤至焦黑)。
以上五味药,用水七升,用小火煮取三升药液,分三次温服。
歌诀说:桂枝汤去掉芍药是为了消除阴邪。痰饮挟带邪气逼迫肺金。一枚皂荚驱除粘腻浑浊之物。桂枝运行阳气是良策。
元犀按语:如果不是辛温性质的药物,就不能运行阳气、消除阴邪;如果不是甘润性质的药物,就不能补益脾胃、生津液。以姜、桂的辛温作为君药,运行阳气、消除阴邪;佐以大枣、甘草的甘润,补益阴液、滋生津液。至于开通壅塞、涤荡污垢,以清除涎沫的,则是皂荚丸的作用。(歌诀解释见《长沙方歌括》。)
治疗咳嗽且胸满、恶寒战栗、脉数、咽干但不口渴、时常吐出浑浊腥臭如米粥样的唾沫,这是肺痈。
桔梗、贝母(各三分)、巴豆(一分,去皮炒熟,研成霜状)。
以上三味药制成散剂,体质强壮的人服用半钱匕的量,体弱的人减少剂量。病位在膈膜以上的,通过呕吐排出脓液;病位在膈膜以下的,通过腹泻排出。如果泻下过多不止,需采取措施止泻。
治疗咳嗽伴有轻微发热、烦闷胀满、胸部皮肤粗糙如鳞甲交错,这是肺痈。
苇茎(二升)、薏苡仁(半升)、桃仁(五十粒)、瓜瓣(半升)。
以上四味药,用水一斗,先煮苇茎,煮取五升药液,去渣,加入其他药物,再煮取二升药液,每次服用一升,每日两次。应当吐出类似脓样的物质。
歌诀说:胸部皮肤粗糙如鳞甲交错说明肺痈已成。烦闷胀满、咳嗽吐痰、脉象数而实。薏苡仁和瓜瓣各半升,桃仁五十粒,方中先煮苇茎二升。
元犀按语:此方以湿热为主要病机。咳嗽伴有轻微发热、烦闷胀满、胸部皮肤粗糙如鳞甲交错的,是湿热邪气结聚在肺脏。肺脏既已结聚,则……之源(原文此处似有缺漏或断句问题,依文意理解为肺气受阻),瓜瓣排除瘀血,开通结热的路径。方剂下方注释说:“再次服用后应当吐出如脓样的东西”,是指药效发挥,肺痈溃破。
Treats Lung Wei (Lung Atrophy) with symptoms of spitting out saliva and foam.
Guizhi (Cinnamon Twig), Shengjiang (Fresh Ginger) (each 3 liang), Gancao (Licorice Root) (3 liang), Dazao (Jujube) (12 pieces), Zaojiao (Gleditsia Sinensis Fruit) (1 piece, peeled and seeded, roasted until charred).
The above five herbs are boiled in 7 sheng of water over low heat to obtain 3 sheng of decoction. Divide into three doses and take warm.
Song says: Removing Shaoyao from Guizhi Tang eliminates Yin pathogens. Phlegm-fluid retention carrying evil forces the Metal of the Lung. One piece of Zaojiao drives away sticky turbidity. Guizhi moving Yang Qi is a good prescription.
Yuexi's commentary: Without acrid-warm substances, one cannot move Yang Qi and eliminate Yin; without sweet-moist substances, one cannot tonify Earth and generate fluids. Using the acrid-warm nature of Jiang (Ginger) and Gui (Cinnamon) as sovereign drugs moves Yang and eliminates Yin. Assisting with the sweet-moist nature of Dazao (Jujube) and Gancao (Licorice) tonifies Yin and generates fluids. As for opening blockages, cleansing filth, and purifying saliva and foam, this is the function of Zaojiao Wan (Gleditsia Pill). (Explanation of the song is found in Changsha Fang Ge Kuo.)
Treats cough with chest fullness, aversion to cold with trembling, rapid pulse, dry throat but no thirst, and occasional expectoration of turbid, foul-smelling sputum resembling rice porridge. This is Fei Yong (Lung Abscess).
Jiegeng (Platycodon Root), Beimu (Fritillaria Bulb) (each 3 fen), Badou (Croton Seed) (1 fen, peeled, roasted, ground into a paste/rime).
The above three herbs are made into a powder. Strong individuals take half a qianbi dose; weak individuals reduce the dose. If the disease is above the diaphragm, pus is vomited; if below the diaphragm, it is discharged via diarrhea. If diarrhea is excessive and does not stop, [treatment should be adjusted].
Treats cough with slight fever, irritability and fullness, and rough, scaly skin on the chest (Xiongzhong Jiacuo). This is Fei Yong (Lung Abscess).
Weijing (Reed Shoot) (2 sheng), Yiyiren (Coix Seed) (0.5 sheng), Taoren (Peach Kernel) (50 grains), Gaban (Melon Seeds) (0.5 sheng).
The above four herbs are boiled in 1 dou of water. First boil Weijing (Reed Shoot) until 5 sheng remains, strain off the dregs, then add the other herbs. Boil until 2 sheng remains. Take 1 sheng per dose, twice daily. One should expectorate material resembling pus.
Song says: Rough, scaly skin on the chest indicates Fei Yong (Lung Abscess) has formed. Irritability, fullness, cough with phlegm, and rapid, excess pulse appear. Half a sheng each of Yiyi (Coix Seed) and Ban (Melon Seed), fifty Taoren (Peach Kernels); first boil two sheng of Jing (Reed Shoot) in the formula.
Yuexi's commentary: This formula primarily addresses damp-heat. Cough with slight fever, irritability, fullness, and rough, scaly skin on the chest indicates damp-heat pathogenic factors knotting in the Lung. Once the Lung is knotted... [text incomplete], Gaban (Melon Seeds) expel blood stasis and open the pathway for knotted heat. The note under the formula states: "After taking again, one should expectorate like pus," referring to the action of the medicine where the Fei Yong (Lung Abscess) ruptures.