桔梗一两 甘草二两
右二味,以水三升,煮取一升,分温再服,则吐脓血也。
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肺痿吐涎沫而不咳者,其人不渴,必遗尿,小便数。所以然者,以上虚不能制下故也
。此为肺中冷,必眩多涎唾,甘草干姜汤以温之;若服汤已渴者,属消渴。
【注】
咳而不吐涎沫者,肺燥咳也;咳而吐涎沫者,肺热痿也。若似肺痿之吐涎沫而不咳者
,此为肺中有冷饮,非为肺中成热痿也。肺中冷,则其人必不渴,遗尿小便数,头眩
多涎唾。所以然者,以上焦阳虚,不能约制下焦阴水,下焦之水泛上而唾涎沫,用甘
草干姜汤以温散肺之寒饮也。如服汤已渴者,属消渴,谓始先不渴,服温药即转渴者
,不但非肺中热,亦非肺中冷,乃胃中热也,则不当以属肺中冷寒饮治之,当以属胃
中热消渴治之也。
甘草(炙)四两 干姜(炮)二两
右□咀,以水三升,煮取一升五合,去滓,分温再服。
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咳而上气,喉中水鸡声,射干麻黄汤主之。
【注】
咳逆上气,谓咳则气上冲逆也。上条发明不咳而吐涎沫者,非为肺痿,是为肺冷也。
此条发明咳而不吐涎沫者,亦非肺痿,亦为肺冷也。上条以不渴,小便数,多唾涎沫
,为肺中冷,故以干姜佐甘草,是以温中为主也。此条以气上逆,喉中有水鸡声,为
肺经寒,故以生姜佐麻黄,是以散外为主也。病同冷饮,而有在外在内之别,方同辛
温,而有主温主散之异也。水鸡声者,谓水与气相触之声,在喉中连连不绝也。
Jiegeng Tang (Platycodon Decoction): Jiegeng Radix (1 liang), Gancao Radix et Rhizoma Preparata (2 liang).
The above two ingredients are decocted in 3 sheng of water, reduced to 1 sheng, and taken warm in two divided doses. (If it is lung abscess with heat), pus and blood will be vomited.
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In pulmonary consumptive disease (Fei Wei) characterized by expectoration of saliva and froth without coughing, the patient has no thirst and inevitably experiences enuresis and frequent urination. This occurs because deficiency-cold in the upper jiao fails to control the lower jiao.
This indicates cold in the lungs, accompanied by dizziness and abundant saliva/froth; Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) should be used to warm the lungs. If thirst develops after taking the decoction, it belongs to xiaoke (wasting-thirst syndrome).
[Annotation]
Coughing without expectorating saliva/froth indicates dryness-cough of the lungs; coughing with expectorating saliva/froth indicates pulmonary consumptive disease caused by lung-heat. If the symptoms resemble pulmonary consumptive disease, specifically expectorating saliva/froth without coughing, this indicates cold-fluid retention in the lungs, not pulmonary consumptive disease formed by heat.
When there is cold in the lungs, the patient will certainly have no thirst, experience enuresis and frequent urination, dizziness, and abundant saliva/froth. The reason for this is that yang-deficiency in the upper jiao cannot constrain the yin-water of the lower jiao, causing water from the lower jiao to overflow upward, resulting in the expectoration of saliva/froth. Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) should be used to warm and disperse the cold-fluid in the lungs.
If thirst occurs after taking the decoction, it belongs to xiaoke (wasting-thirst syndrome). This means that initially there was no thirst, but it turned into thirst after taking warming herbs. This indicates neither lung-heat nor lung-cold, but rather heat in the stomach. Therefore, it should not be treated as cold-fluid in the lungs, but rather as wasting-thirst caused by stomach-heat.
Gancao Radix et Rhizoma Preparata (Roasted) (4 liang), Ganjiang Rhizoma (Prepared) (2 liang).
Crush the ingredients, decoct in 3 sheng of water, reduce to 1.5 sheng, strain, and take warm in two divided doses.
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For coughing with rebellious qi ascending and a sound in the throat resembling that of a water-frog, Shexgan Mahuang Tang (Throatwort and Ephedra Decoction) is the primary formula.
[Annotation]
"Ke ni shang qi" refers to coughing accompanied by rebellious upward rushing of qi. The previous clause explained that expectorating saliva/froth without coughing is not pulmonary consumptive disease, but cold-lungs.
This clause explains that coughing without expectorating saliva/froth is also not pulmonary consumptive disease, but cold-lungs. In the previous clause, the absence of thirst, frequent urination, and abundant saliva/froth indicated cold in the lungs; thus, Ganjiang (Dried Ginger) assisted Gancao (Licorice) to primarily warm the middle jiao.
In this clause, rebellious qi and the "water-frog sound" in the throat indicate cold in the lung meridian; thus, Shengjiang (Fresh Ginger) assisted Mahuang (Ephedra) to primarily disperse exterior pathogens. Although the pathogenic factor is cold-fluid in both cases, there is a distinction between interior and exterior locations. Although the formulas share acrid-warm properties, there is a difference between primarily warming and primarily dispersing.
The term "water-frog sound" refers to the sound produced by the collision of fluid and qi, continuous in the throat.