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(Attached: Qingjin Ermiao Dan, Qingfei Sanniao Dan, Simple Prescriptions for Treating Lung Diseases)

The causes of lung diseases differ between internal injury and external contraction. However, regardless of whether it is internal injury or external contraction, there are generally symptoms of fever before the lung disease develops. This is because the lung is a delicate organ and belongs to Metal in the Five Elements, most fearing the constraint of Fire. For instance, the lung governs the skin and hair. When external wind pathogens invade, they sometimes enter the lung from the skin and hair, obstructing Qi transformation, thereby secretly generating internal heat. Since the skin and hair are bound by wind pathogens and cannot expel carbon dioxide through pores, the lung not only generates heat but also brews toxins; thus, lung disease originates here. In the initial stage, there may be frequent coughing, expectoration of sputum containing many bubbles, or widespread body pain, white tongue coating, occasional feeling of heat in the heart, and a pulse that is typically floating and forceful. One can first take Aspirin (Aspirin) one wa (approx. 0.6g), dissolved in water with white sugar, to induce sweating throughout the body. Subsequently, use Xuan Shen (Scrophulariae Radix) and Tian Hua Fen (Trichosanthis Radix) each five qian (approx. 15-18g), Jin Yin Hua (Lonicerae Japonicae Flos) and Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) each three qian (approx. 9-11g), Peng Sha (Borax) eight fen (ground into fine powder, taken in two doses), and Fen Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparatum cum Melle) fine powder three qian (taken in two doses), decocted in water and taken as a drink. Then take Aspirin one wa daily, divided into three doses, taken with water and white sugar, without inducing sweating. It is beneficial if there is slight sweating in one of these three doses. After taking this for several days, if the fever does not subside, add Sheng Shi Gao (Gypsum Fibrosum) seven to eight qian (approx. 23-27g) to the herbal decoction. If Shi Gao is not used, or Antifebrin (Antifebrinum, Phenacetinum) half wa (approx. 0.3g) is taken with the herbal decoction, it is also acceptable.

If untreated at this time, the condition gradually worsens, with white, sticky sputum or sputum with a fishy odor. At this point, Aspirin can still be used to induce sweating. However, fearing the patient's physical weakness cannot withstand diaphoresis, it is advisable to boil Sheng Huai Shan Yao (Dioscoreae Hypoglaucae Rhizoma) one liang (approx. 30g) or seven to eight qian into a tea-like liquid, taking Aspirin half wa with it, aiming for slight sweating after administration. Continue using the previous herbal decoction to take Fen Gan Cao fine powder and San Qi (Notoginseng Radix) fine powder, one qian (approx. 3g) each, administering these two medicines during the decoction of residues as before. Concurrently use Aspirin one-third wa, taken with water and white sugar, or take Sheng Huai Shan Yao fine powder four to five qian boiled into a tea-like liquid, twice daily. If coughing persists, take Chuan Bei fine powder three qian with the Shan Yao tea-like liquid. The Shan Yao tea has a slightly sour taste; to make it palatable, add a little white sugar or Shi Shuang (Diospyros Kaki Manna) as desired. If one prefers not to drink the tea-like liquid, use raw Shan Yao slices, doubling the dosage, boiling to extract clear soup, and drinking it instead of the tea.

If untreated then, the condition worsens further, with frequent expectoration of pus and blood, indicating the lung disease has reached the third stage, which ordinary medications cannot cure. It is necessary to use extremely precious Chinese medicinal materials, such as those described by Xu Lingtai: using cooling herbs to clear fire, moistening herbs to nourish blood, slippery-descending herbs to dispel phlegm, aromatic herbs to unblock Qi, pearl-and-cinnabar-type herbs to resolve toxicity, and mineral/herbal substances to fill cavities. Applying multiple methods simultaneously has proven effective repeatedly. Additionally, Mr. Zeng XX from my county, proficient in medicine, once told me: "For treating Lung Abscess (Fei Yong), only Xi Huang Wan (Calculus Bovis and Musk Pill) from Linwu Shanshan's *Waike Zhengzhi Quansheng Ji* is most effective. I have used it for decades, curing many cases." Later, in Fengtian (now Shenyang), I encountered patients with Lung Abscess expectorating pus and blood who failed to respond to other treatments. Having them take Xi Huang Wan alongside herbal decoctions yielded results exactly as Mr. Zeng stated, with exceptional efficacy. Refer to the case study following Qingliang Huagai Yin for reference. For the herbal decoction, add Niu Bang Zi (Arctii Fructus) and Gua Lou Ren (Trichosanthis Semen) several qian to drain pus, and take San Qi fine powder two qian (approx. 6g) to stop bleeding. Regarding the preparation and administration of Xi Huang Wan, refer to the original text; details are omitted here.

In cases where external latent pathogens lodge below the diaphragm, eventually entering the stomach, and their heat steams upward to the lung causing lung disease, the cough and sputum are initially thick and sticky, becoming fishy-smelling later. The tongue coating may be white with slight yellow, accompanied by dryness and heat in the chest, dizziness, and a slippery-solid pulse, often stronger on the right than the left. Use Sheng Shi Gao one liang (approx. 30g), Xuan Shen, Hua Fen, and Sheng Huai Shan Yao each six qian (approx. 18g), Zhi Mu and Niu Bang Zi each three qian (approx. 9g), decoct and take with Gan Cao and San Qi fine powders as before. Take Aspirin one-third wa with water and white sugar, twice daily. If fever persists and stool is not loose, increase the dose of Shi Gao. I once treated an elderly Mr. Xu in Fengtian with lung disease; his pulse was wiry, long, and forceful, distinct from usual. Each prescription contained four liang (approx. 120g) of Sheng Shi Gao. After several doses, the pulse became soft. This demonstrates that medication dosage should be determined by its ability to overcome the disease, not pre-limited. If the pulse is forceful yet rapid, change Shi Gao to one and a half liang (approx. 45g), Zhi Mu to six qian (approx. 18g), and add Lu Dang Shen (Codonopsis Radix) four qian (approx. 12g). A rapid pulse indicates deficiency of Yin; although Shi Gao and Zhi Mu clear heat, they are not strong in nourishing Yin. Adding Ginseng mimics the principle of Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) to nourish true Yin (cooling and moistening herbs combined with Ginseng can nourish true Yin), transforming the rapid pulse to a moderate one. If expectorating pus and blood, also take Xi Huang Wan alongside the decoction.

Regarding lung diseases caused by internal injury, the patterns vary. Some result from spleen and stomach damage, reduced appetite, and Earth deficiency failing to generate Metal, leading to lung disease. Generally, people with spleen/stomach deficiency suffer from Liver Wood overacting on Spleen Earth, preventing food from transforming into essence, instead generating excessive phlegm-dampness overflowing above the diaphragm, sticking to lung lobes causing cough, eventually injuring the lung. Reduced diet leads to easy generation of deficient heat; the Ministerial Fire housed in the Liver, exacerbated by Liver Wood overaction, combines with deficient heat to attack Lung Metal, causing upper jiao irritation and heat. Sputum is initially sticky, then fishy-smelling; hypochondriac pain occurs intermittently. The pulse is wiry and forceful, or wiry and rapid, lacking substance upon heavy pressure. Use Sheng Huai Shan Yao one liang (approx. 30g), Xuan Shen, Sha Shen (Glehniae Radix), Sheng Hang Shao (Paeoniae Radix Alba), and Chao Bai Zi Ren (Biota Seed, fried, oil retained) each four qian (approx. 12g), Jin Yin Hua two qian (approx. 6g), decoct and take with San Qi fine powder one qian (approx. 3g) and Peptone (Baibusheng) two wa (approx. 1.2g). Administer these during decoction of residues. If expectorating pus and blood, use this formula and take Xi Huang Wan. If taking Xi Huang Wan, San Qi may be omitted. Baibusheng must not be omitted due to its digestive benefits. It is best taken one hour after meals rather than simultaneously with the decoction.

Some lung diseases result from Kidney Yin deficiency. Kidney and Lung are mother-child organs; Child deficiency draws Mother's Qi for self-rescue, secretly consuming Lung Qi. As Kidney is Water, Water deficiency fails to control Fire, causing Fire to move recklessly and attack Metal. Symptoms include evening tidal fever, cough, poor appetite, dry cough without sputum or fishy sputum, possibly panting. Pulse is thready, rapid, and weak. Use Sheng Shan Yao one liang (approx. 30g), Da Shu Di (Rehmanniae Radix Preparata), Gan Gou Qi (Lycii Fructus), Bai Zi Ren each five qian (approx. 15g), Xuan Shen, Sha Shen each four qian (approx. 12g), Jin Yin Hua, Chuan Bei each three qian (approx. 9g), decoct and take with Gan Cao and San Qi fine powders as before. If expectorating pus and blood, remove Shu Di, add Niu Bang Zi and Gua Lou Ren each three qian (approx. 9g), and take Xi Huang Wan. If the rapid pulse does not slow down after medication, take Aspirin twice daily, one-third wa each time.

Aspirin effectively treats pulmonary tuberculosis and reduces fever. Whether deficient or excess heat, if the pulse is rapid, Aspirin can gradually slow it. For excess heat, sweating reduces fever, so up to one wa can be taken. For deficient heat, sweating is contraindicated; it should only release the muscle layer. Slight or no sweating after intake reduces fever, so one wa must be divided into three doses. If the patient sweats easily, Aspirin is contraindicated regardless of heat type. If the patient sweats daily, regardless of cause (internal/external, deficient/excess heat), add Sheng Long Gu (Fossilia Ossis Mastodi), Sheng Mu Li (Concha Ostreae), and Jing Shan Yu Rou (Corni Fructus Purified) several qian to the decoction. Alternatively, take Hao Zhu Sha (Cinnabaris) fine powder five fen (approx. 1.5g) to stop sweating, as sweat is the fluid of the Heart, and Cinnabar cools Heart Blood.

Some patients with chronic hematemesis or epistaxis suffer Yin-blood damage and internal heat; or improper medical intervention forcibly stops bleeding, causing blood stasis in meridians that generates heat over time, leading to lung disease. Symptoms include chest stuffiness and heat, occasional pain, aversion to food, cough with shortness of breath, fishy sputum. Pulse is wiry and hard, or wiry and rapid. Use Sheng Huai Shan Yao one liang (approx. 30g), Xuan Shen, Tian Dong (Asparagi Radix) each five qian (approx. 15g), Dang Gui (Angelicae Sinensis Radix), Sheng Hang Shao, Ru Xiang (Olibanum), Mo Yao (Myrrha) each three qian (approx. 9g), Yuan Zhi (Polygalae Radix), Gan Cao, Sheng Tao Ren (Persicae Semen, raw with skin, as skin promotes blood circulation; distinguish from Apricot Kernel) each two qian (approx. 6g), decoct and take with San Qi fine powder one and a half qian (approx. 4.5g), administered during decoction of residues. San Qi stops bleeding and resolves stasis. If expectorating pus and blood, also take Xi Huang Wan.

Q: Jie Geng (Platycodonis Radix) guides herbs into the lungs, hence Jie Geng Tang in *Jinkui Yaolue* for Lung Abscess. Why are none of your lung formulas using Jie Geng?
A: Jie Geng ascends Qi. Lung disease patients often suffer from rebellious Qi and cough, making Jie Geng unsuitable. Thus, I dare not add it. If a lung disease patient does not have rebellious Qi, it may be considered.

Q: Formulas treat Lung Abscess with Zao Jiao Wan (Soap Pod Pill) or Ting Li Da Zao Tang (Descurainia Seed and Jujube Decoction) to purge turbid matter before treatment. These are excellent formulas from *Jinkui*. Why are they not mentioned?
A: Their properties are fierce. Modern lung patients are often weak, so I dare not use them lightly. Purging Lung excess wheezing is correct treatment, but purging turbid phlegm to prevent putrefaction is adjunctive. I have used Ting Li Da Zao Tang successfully for Lung excess wheezing in non-weak patients. I have never used Zao Jiao Wan because Zao Jiao is hot, unsuitable for lung heat. To purge turbidity and prevent putrefaction, fierce herbs are unnecessary. Borax, San Qi, Ru Xiang, and Mo Yao in my formulas are excellent for resolving putrefaction and generating new tissue. Borax treats Phlegm-Jue (syncope due to phlegm); I cured a half-day unconsciousness case by giving Boiled Borax, which expelled thick phlegm. Borax's power to open phlegm and purge Lung rivals Zao Jiao and Ting Li. Its value lies in clearing Lung Heat, moistening Dryness, and resolving Toxicity. People know Borax mouthwash cures oral ulcers (Bingpeng San), but not that it treats lung putrefaction similarly. My Anfei Ningsou Wan (Calming Lung and Stopping Cough Pill) uses Borax extensively, showing great efficacy for lung depression-phlegm-fire cough and TB cough.

Q: Ancient texts use four liang of Gan Cao decocted for Lung Abscess. Why do you use Gan Cao only as powder, not in decoctions?
A: Gan Cao detoxifies and clears heat; raw is better than processed. Raw is neutral and opening; processed (roasted/boiled) is warm and tonifying. Thus, raw is superior for detoxification. Processing makes it cooked; decocting also cooks it. Powder form is better. Also, grinding Gan Cao finely is difficult; if roasted before grinding, raw becomes cooked. Therefore, prepare the powder yourself. I once made Qingjin Ermiao Dan: Fen Gan Cao fine powder two liang (approx. 60g), Yuan Zhi fine powder one liang (approx. 30g), mixed. Take one and a half qian (approx. 4.5g) per dose; highly effective for consumptive cough. For Lung heat, add Hao Zhu Sha fine powder two qian (approx. 6g) per liang of Ermiao Dan, named Qingfei Sanniao Dan. Effective for persistent TB cough. Initially, add small amounts of Aspirin (1/4 or 1/5 wa) for the first few doses. Omit if sweating is profuse.

[Simple Prescriptions for Treating Lung Diseases]
Fresh Bai Mao Gen (Imperatae Rhizoma), peeled and chopped, one large bowl. Boil in two large bowls of water until boiling twice. Wait half an hour until roots float. Boil again until simmering. Wait until roots sink. Strain and drink warm as tea.

Fresh Xiao Ji Gen (Cirsii Root), two liang (approx. 60g), chopped fine. Boil two to three times. Drink warm as tea. Cures lung disease with pus/blood expectoration.

White Lotus Root (Ou) one jin (approx. 500g), sliced thin. Boil to extract thick juice, one large bowl. Dissolve Shi Shuang one liang (approx. 30g) in it. Drink warm slowly. These common items clear lung disease. Often, using one alone cures lung disease within a week. "San Xian Yin" (Three Fresh Drinks) mixes fresh Mao Gen, Xiao Ji Gen, and Ou, boiled and drunk. Effective for heat-induced hematemesis and lung disease. Adding Shi Shuang is better.

My Ning Sou Ding Chuan Yin (Stopping Cough and Panting Decoction) is also excellent for lung disease, especially for cough with panting.

Bei Sha Shen (Glehniae Radix) fine powder, take two qian (approx. 6g) daily with tofu milk. Three qian (approx. 9g) if upper jiao heat. Treats lung disease and consumptive panting.

Western Olive Oil (Oliva Oleum) clears lungs, tastes good. Can replace sesame oil for lung patients, or take seven to eight drops in water.

Diet should be bland. Avoid heavily processed, strong-flavored, or salty foods. Eat more vegetables like lotus root, fresh bamboo shoots, cabbage, radish, winter melon. Fruits like watermelon, pear, mulberry, apple, water chestnut, sugarcane are suitable. Avoid peach and apricot. Quit tobacco, alcohol, and all spicy foods. Avoid fermented/spoiled foods like pickled fish, century egg, brine shrimp paste, fermented bean curd, stinky tofu.