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**Classic Theory (Jing Yi)**
Wind pathogen is the leader of all diseases. When a pathogen enters and resides in the Lung, it is called *Fei Bi* (Lung Bi, obstruction of Lung Qi), manifesting as cough and rebellious Qi ascending. ○ If the pulse arrives rapid and floating, accompanied by panting, it indicates deficiency above and excess below, susceptibility to fright, and stagnant Qi accumulating in the chest; this panting with emptiness is named *Fei Bi*, accompanied by alternating cold and fever. ○ Symptoms of *Fei Bi* include vexation and fullness, panting, and vomiting. ○ If excessive fluids cause panting, the Bi syndrome gathers in the Lung. (*Su Wen*)

**Philosophical Discourse (Zhe Yan)**
The Lung is the bellows of respiration, positioned at the highest point, receiving the clear Qi from the viscera that ascends to pay homage. It possesses a nature of clarity and descending, primarily governing descent. As a delicate organ, it cannot withstand pathogenic invasion; once any of the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) attaches, disease ensues. The Lung dislikes Cold, Heat, Dryness, and Dampness, and fears Fire and Wind most. When pathogens attach, it loses its clarity and descending function, causing obstruction and blockage. Treatment methods: For cases caused by Wind, use herbs like Bohe (Menthae Haplocalycis Herba), Sangye (Mori Folium), and Niubangzi (Arctii Fructus); if combined with Cold, use Mahuang (Ephedrae Herba) and Xingren (Armeniacae Semen Amarum); if obstructed by Warm-Heat, use Shegan (Belamcandae Rhizoma), Lianqiao (Forsythiae Fructus), Shanzhi (Gardeniae Fructus), Tuzhuhuang (Bambusae Concretio Silicea), Zhuye (Bambusae Folium), Shashen (Glehniae Radix), and Xiangbei (Fritillariae Thunbergii Bulbus); for Dampness, use Tongcao (Tetrapanacis Medulla), Huashi (Talcum), Sangpiao (Mori Cortex), and Yiren (Coicis Semen); for Dryness, use Lipi (Pyrifoliae Pericarpium), Lugeng (Phragmitis Rhizoma), Pipaye (Loquati Folium), and Ziwan (Asteris Radix); to open Qi, use Loupi (Trichosanthis Pericarpium), Xiangchi (Sojae Semen Praeparatum), Suzi (Perillae Fructus), Jiegeng (Platycodonis Radix), and Kourén (Amomi Fructus). Weijing Tang (Asparagi Ramulus Decoction) and Tingli Dazao Tang (Descurariae Semen and Jujubae Decoction) all prioritize light and floating properties, avoiding heavy and turbid flavors. This is described as slightly acrid to open and slightly bitter to descend, fitting the treatment of the light, clear, and delicate organ. The Lung governs all vessels and is prone to many diseases. The Lung and Large Intestine are exterior-interior partners, and the Lung communicates with the Bladder to regulate Qi transformation. Thus, the patency or obstruction of urination and defecation is closely related to the Lung. (*Lin Zheng Zhi Nan*)

The Lung is a clear and empty organ, favoring patency and discharging, abhorring stagnation and blockage, which must not be disturbed even slightly. Now blocked by turbid pathogens, only clear, empty, and patent medicines can resolve it. Ancients often used Xiebai San (White Powder Draining Decoction) with success for this condition. (Fang Xingyan)

**(Appendix: Fei Zhang [Lung Distension], Various Internal Abscesses)**

**Philosophical Discourse**
Question: When heat is in the Upper Jiao, it causes cough leading to *Fei Wei* (Lung Flaccidity). How is *Fei Wei* contracted? The Master said: Sometimes from excessive sweating, sometimes from vomiting, sometimes from Xiao Ke (Wasting-Thirst) with frequent urination, or from constipation followed by harsh purgation, leading to severe loss of body fluids, thus contracting the disease. ○ Question: Why does a rapid pulse at the Cun Kou position with cough and copious turbid saliva and froth indicate disease? The Master said: This is *Fei Wei*. ○ If the mouth feels parched and dry, and coughing causes dull pain in the chest with a slippery and rapid pulse, this is *Fei Yong* (Lung Abscess), characterized by coughing up pus and blood. ○ Question: In a patient with cough and rebellious Qi, how can one know it is *Fei Yong* based on the pulse? There should be pus and blood; if vomited, death ensues. What kind of pulse is it? The Master said: The Cun Kou pulse is faint and rapid. Faint indicates Wind, rapid indicates Heat. Faint implies sweating, rapid implies aversion to cold. Wind injures the Wei (Defensive) level, so exhalation fails to enter deeply; Heat overwhelms the Ying (Nutritive) level, so inhalation fails to go out. Wind damages the skin and hair; Heat damages the blood vessels. Wind residing in the Lung causes cough, dry mouth, panting, and fullness, dry throat without thirst, copious turbid froth, and periodic chills. Where Heat passes, blood coagulates and stagnates, forming an abscess and pus, expelled like congee. If caught early, it can be saved; once pus forms, it is fatal. (*Jin Gui Yao Lue*)

Lung lobes are like flowers and leaves of plants. *Fei Wei* due to heat is like withering under sun exposure; *Fei Wei* due to cold is like drying after frost damage. (Wei Litong)

*Fei Wei* generally belongs to fluid exhaustion and dryness, mostly caused by injury to healthy Qi through sweating or purging. "Wei" means "wither," like plants losing vigor due to fluid loss and Qi depletion. However, causes of Wei are not limited to one aspect. *Jin Gui* states: Due to sweating, vomiting, Xiao Ke with frequent urination, or constipation treated with harsh purgatives, severe fluid loss leads to Lung Heat and dry Wei. Lung Heat and dry Wei impair the descending and clearing function. Although the Spleen distributes fluids upward to the Lung, the Lung cannot moisten itself nor distribute essence to the Six Fu organs and skin/hair. Fluids accumulate in the chest, are boiled by Heat into froth, invade the Lung causing cough, and are continuously expectorated. Thus, the dry remains dry, the expectoration continues, becoming drier with each expectoration, forming *Fei Wei*. (*Lin Zheng Zhi Nan*)

The presentation of *Fei Wei* resembles but differs from *Fei Yong*. *Fei Wei* occurs after chronic illness and deficiency; *Fei Yong* occurs at the onset when previously healthy. *Fei Wei* involves coughing white phlegm and saliva; *Fei Yong* involves foul-smelling pus and chest/flank pain. Patients with *Fei Wei* are emaciated and fatigued; patients with *Fei Yong* are robust. *Fei Wei* develops chills and tidal fever late; *Fei Yong* begins with piloerection and aversion to wind. *Fei Wei* pulse is hollow and rapid without spirit; *Fei Yong* pulse is floating and rapid with strength. These differences are significant. Generally, *Fei Yong* caused by external factors requires urgent regulation; although injured, the Lung can still be rescued. *Fei Wei* caused by internal factors requires extensive tonification; since the Lung is withered, few methods work. (Wang Yungu)

**Supplementary Compilation**
*Fei Wei* with expectoration of froth but no cough, non-thirsty, inevitably with enuresis and frequent urination. This is because Spleen Earth deficiency fails to control Water. This is named Cold in the Lung, causing dizziness and copious froth; treat with Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) to warm. ○ Cough with rebellious Qi and a sound like a water frog in the throat; treat with Shegan Mahuang Tang (Belamcanda and Ephedra Decoction). ○ Cough with rebellious Qi, frequent expectoration of turbid matter, unable to lie down; treat with Zaojiao Wan (Soapberry Pill). ○ Cough with floating pulse; treat with Nongpo Mahuang Tang (Magnolia Bark and Ephedra Decoction). ○ Pulse sinking; treat with Zeqi Tang (Zeaxia Decoction). ○ Fire rebellion causing ascending Qi and throat discomfort; to stop rebellion and descend Qi, treat with Maimendong Tang (Ophiopogon Decoction). ○ *Fei Yong* with panting preventing lying down; treat with Tingli Dazao Xiefei Tang (Descuraria and Jujube Decoction to Drain the Lung). ○ Cough with chest fullness, chills, rapid pulse, dry throat without thirst, occasional foul-smelling turbid sputum, long-term expectoration of pus like congee indicates *Fei Yong*; treat with Jiegeng Tang (Platycodon Decoction). ○ Cough with rebellious Qi, this is *Fei Zhang* (Lung Distension). Patient pants, eyes bulge, pulse floating and large; treat with Yeshibi Jia Banxia Tang (Ma Huang and Gypsum plus Pinellia Decoction). ○ *Fei Zhang*, cough with rebellious Qi, irritability, and panting. Pulse floating indicates Water retention below the Heart; treat with Xiao Qinglong Jia Shigao Tang (Minor Green Dragon plus Gypsum Decoction).
○ *Waitai Mi Yao*'s Zhigancao Tang treats *Fei Wei* with copious froth and a warm, liquid sensation in the epigastrium. ○ *Qianjin Fang*'s Shengjiang Gancao Tang treats persistent *Fei Wei* with coughing froth, dry throat, and thirst. ○ *Qianjin Fang*''s Guizhi Qu Shaoyao Jia Zaojiao Tang treats *Fei Wei* with expectoration of froth. ○ *Waitai Mi Yao*'s Jiegeng Baisan treats *Fei Yong* with chest fullness, chills, rapid pulse, dry throat without thirst, foul sputum, and pus like congee. ○ *Qianjin Fang*'s Weijing Tang treats cough with slight fever, vexation, fullness, and crusty skin in the chest, indicating *Fei Yong*. (*Jin Gui Yao Lue*)

The Master established Gancao Ganjiang Tang for Lung Cold and dryness impending *Wei*; and Maimendong Tang for Lung Heat and scorching impending *Wei*, both as preventive measures for *Fei Wei*.
For external pathogens causing Lung depression risking *Wei* and *Yong*, he established Shegan Mahuang Tang; for internal Qi rebellion without external pathogens risking *Yong*, he established Zaojiao Wan; for external pathogens requiring preemptive Lung regulation, he established Nongpo Mahuang Tang; for external pathogens with internal Heat, he established Zeqi Tang. All aim to prevent Qi stagnation from forming *Wei* or *Yong*.
For external pathogens causing *Fei Zhang*, he urgently established Yeshibi Jia Banxia Tang; for external pathogens with internal Heat causing *Fei Zhang* and irritability, he established Xiao Qinglong Jia Shigao Tang. These also aim to prevent Qi stagnation from forming *Yong* or *Wei*. If practitioners select and apply these appropriately, what worry would there be of disease formation? Once *Fei Yong* has formed, using Tingli Dazao Xiefei Tang; or long-term pus expectoration treated with Jiegeng Tang, are measures of last resort, yet already too late. Observing this, we know prevention is crucial, especially for the Lung, which is vital to Qi and life. Do not miss the opportunity early and regret it late. (Wei Litong)

The Lung is the canopy of the Five Viscera, high and clear, governing Qi internally, voice centrally, and skin/hair externally. When Blood and Qi are sufficient internally, and Water and Fire root each other, the delicate organ fears no Fire inflammation, and Metal and Water generate each other, so why would Lung Qi be constrained and wither? Alas, congenital deficiency combined with reckless sexual activity damages True Yuan, shaking the root, causing Kidney Water deficiency and Ministerial Fire flourishing, steaming Lung Metal. Metal punished by Fire manifests as cough and hemoptysis; alternating cold and fever; night sweats; hoarseness and sore throat; upper vomiting and lower diarrhea. Pulses may be floating, large, empty, and rapid; or wiry, fine, choppy, and rapid. At this stage, the body wastes away, coughing up stasis and pus like peach blossoms or congee. This severe disease transforming into *Fei Wei* is a critical prognosis. Although difficult to save, if one must legislate a cure, the focus is tonifying Kidney Water to suppress Yin Fire, generating fluids to moisten Lung dryness. Further, use Renshen (Ginseng Radix et Rhizoma), [Missing Character], and Heche (Placentae Humanæ) to fill the Lower Yuan. Tonifying the Lung benefits Qi; tonifying the Kidney benefits Essence. Only then might one recover from the brink of death. ○ *Fei Yong* is hardest to recognize in its initial stage. Physicians mistake it for Wind-Cold, treating only the cough, failing with medication. By the time pus matures and is expectorated, they realize the Lung Abscess is intractable. Symptoms include aversion to cold and fever, heavy cough, dull chest pain, nasal congestion, and neck stiffness. Prolonged Qi and Blood stagnation leads to clear nasal discharge, coughing pus and blood, foul and thick sputum, chest/flank distension, and breathing difficulty. Pulses before rupture: floating-tight-rapid or flooding-rapid; after rupture: hollow-large-rapid or wiry-fine-rapid. Initial stage: Ganjie Tang (Licorice and Platycodon Decoction) or Douko Tang (Black Soybean Decoction) to detoxify and lift; formed stage: Baihe Gujin Tang (Lily Bulb to Secure the Metal Decoction) to nourish Water and clear Metal; post-rupture: Liuwei Dihuang Tang (Six Ingredient Pill with Rehmannia) to tonify Yin and protect the Lung, clearing Heat and saving Qi, preventing Lung corruption. Clearing Lung Heat preserves Lung Qi. Clearing Heat must dissipate Fire knots and drain stagnation, directing the pathogen to the Large Intestine, allowing pus and turbid matter to move downward. This is the good method.
The Lung is a delicate organ, belonging to Taiyin and having a dry constitution. It must not be attacked by Fire toxicity, causing organ damage and pus/blood leakage. Physicians who fail to tonify Lung deficiency, rescue Lung dryness, and generate Lung fluids, instead recklessly administering drying-hot drugs, subject the patient to the disaster of "tonifying excess." (*Huixin Lu*)

Human Qi derives its command from the Lung. If Lung Qi is clear and descending, all Qi obeys and flows smoothly; if Lung Qi is turbid and stagnant, Qi easily rebels and attacks upward. *Fei Yong* is Lung Qi obstruction and blockage; *Fei Wei* is Lung Qi flaccidity and lack of vigor. Upon seeing chronic cough and rebellious Qi, one must first guard against these two conditions. *Fei Yong* arises from accumulated Fire in the Five Viscera and retained Heat in the Stomach ascending to the Lung. Lung scorched by Fire causes blood coagulation; coagulated blood is wrapped by Phlegm, forming a small abscess. As the mass grows, the Lung distends, ribs elevate, cough becomes frequent, sputum becomes glue-like, fever and chills worsen at dusk, face turns red, nose dries, and chest skin becomes crusty. If identified early as Exterior or Interior and treated with lifting and purging, recovery is certain. Regrettably, medical transmission is lost; doctors only see cough and treat cough, hoping to clear Heat and moisten dryness. By the time blood turns to pus and Lung lobes rot, expectorating copiously, they recognize the condition, but ten out of ten die. *Jin Gui* treatment is exquisite, focusing on the pre-pus stage. Modern application post-pus formation is futile. *Fei Wei* accumulates gradually over days, with various causes of cold and heat, ultimately due to Stomach fluids failing to reach the Lung, causing malnourishment, desiccation, and dryness. Lung Metal generates Water, distributing essence, relying entirely on abundant Stomach Earth fluids. Physicians fail to protect these; some induce massive sweating in those with loose pores; some cause frequent vomiting in those with weak Middle Qi; some forcibly purge constipation. These actions deplete the fluids meant for the Lung. Lung Fire intensifies, Heat deepens, Lung micro-tubes obstruct, cough becomes muffled, chest membranes dry, sputum is hard to expel, panting occurs after short walks, and wheezing sounds accompany expectoration. *Jin Gui* methods are clear but often confused with *Fei Yong*. The key is gradual management: generate Stomach fluids, moisten Lung dryness, descend rebellious Qi, open accumulated Phlegm, stop turbid froth, tonify True Qi to unblock Lung tubes, and dissipate Fire to restore Lung clarity. *Fei Yong* involves tangible Blood clots, requiring aggressive attack; *Fei Wei* involves intangible Qi injury, requiring gentle regulation. *Fei Yong* is Excess; treating it as Deficiency (*Wei*) is "Excess reinforcing Excess." *Fei Wei* is Deficiency; treating it as Excess (*Yong*) is "Deficiency reinforcing Deficiency." This is the general principle of differentiation and medication. ○ Furthermore, both *Fei Wei* and *Fei Yong* are Dryness diseases. The Lung receives clear and descending commands, being a Metal-Water organ. Prolonged Fire scorching destroys clarity, creating Dryness. In *Fei Yong*, fluids surround the abscess and do not overflow, causing mouth dryness. In *Fei Wei*, fluids transform into froth due to Heat, often without thirst, differing from Stomach fluid exhaustion affecting the Child (Lung). Here, fluids transform into froth, depriving the Lung of nourishment. In *Wei*, fluids fail to extinguish Fire, turning into Fire, creating a fire cluster in the Lung lobes over years. Cooling agents cannot penetrate. Although rejection occurs, it is harmless; however, administering drying-hot drugs adds Fire to Fire, leading to death. Banxia (Pinelliae Rhizoma) is a drying herb; adding it to the Lung increases harm. But since cooling agents cannot enter, only Dryness matches Dryness. Thus, using Banxia's dryness within cooling-fluid-generating herbs allows entry, opening dryness, driving turbid froth downward with rebellious Qi. Over time, fluids no longer form froth, and the Lung gains moisture, recovering *Wei*. People know Banxia dries fluids, but few know skilled use drives dried fluids. This is the profound essence. ○ Generally, *Fei Wei* patients are non-thirsty. Using this to neglect fluid-generating herbs, letting the Lung dry daily, is the physician's fault. Using this to recklessly administer drying-hot herbs, ensuring untreatability, is a greater fault. ○ Treating *Fei Wei* with weak vitality using harsh methods to drive froth for quick results accelerates death; this is the physician's fault. ○ Treating *Fei Yong* must differ from *Fei Wei*. *Fei Yong* is Excess; *Fei Wei* is Deficiency. *Fei Yong* is Yang-Excess; *Fei Wei* is Yin-Deficiency. Yang-Excess requires dispersing pathogens then descending Qi; Yin-Deficiency requires tonifying Stomach fluids and moistening Lung dryness. Misdiagnosis and mistreatment kill the patient. (*Yi Men Fa Lv*)

**Pulse Diagnosis**
Rapid and deficient pulse indicates *Fei Wei*; rapid and excess pulse indicates *Fei Yong*. (*Jin Gui Yao Lue*)
In early *Fei Yong*, rapid pulse is unfavorable; after rupture, short and choppy pulses are taboo. Slow and slippery pulse with pale face indicates survival; wiry and urgent pulse with red face indicates death. (Zhang Shiwang)

**Appendix: Fei Zhang (Lung Distension)**
*Fei Zhang* is characterized by panting and fullness upon movement,急促 breathing, heavy sighing, and inability to sleep on either side. If Phlegm and Blood Stasis obstruct Qi mechanism, promote Blood circulation to move Qi, and descend Fire to clear Phlegm, use Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Taoren (Persicae Semen), Zhike (Aurantii Fructus), Chenpi (Citri Reticulatae Pericarpium), Gualou (Trichosanthis Fructus), and Zhuli (Bambusae Succus). If Wind-Cold stagnates in the Lung, causing panting, cough, and distension, induce sweating to dispel pathogens and benefit the Lung to smooth Qi, use Mahuang Yeshibi Jia Banxia Tang (Ma Huang, Gypsum, and Pinellia Decoction). If retained Water fails to transform, preventing Lung Qi descent and causing distension, with symptoms of vomiting immediately after drinking, use Siling San (Four Ling Powder) plus Tingli, Jiegeng, and Sangpiao. If Kidney Water deficiency and dryness prevent Lung Metal transformation, causing dry cough and distress, use Liuwei Dihuang Tang plus Maidong and Wuweizi. Other types: Qi dispersion causing distension requires tonifying Qi; Qi rebellion causing distension requires descending Qi. *Fei Zhang* with obstruction preventing lying down,急促 panting, and nasal flaring is difficult to treat. (*Zhengzhi Huibu*)

**Appendix: Various Internal Abscesses**
Yellow Emperor asked: How to diagnose Stomach Epigastrium Abscess? Qibo replied: Examine the Stomach pulse. It should be deep and fine. Deep and fine indicates Qi rebellion. Rebellion causes the Renying pulse to be very full. Fullness indicates Heat. Renying is the Stomach pulse. Rebellion and fullness mean Heat gathers at the stomach opening and cannot flow, causing Stomach Epigastrium Abscess. (*Su Wen*)
Various floating and rapid pulses usually indicate Fever. If accompanied by shivering aversion to cold and a painful area, an Abscess will develop. The Master said: To determine if an Abscess has pus, press on the swelling. Heat indicates pus; no heat indicates no pus. ○ Intestinal Abscess presents with crusty skin, tight abdominal wall, soft upon pressure, swollen appearance, no abdominal masses, no fever, and rapid pulse. This is intestinal pus; treat with Yiyi Fuzi Baijiang San (Coix Seed, Aconite, and Patrinia Powder). ○ Swollen Abscess: Swelling and痞 in the lower abdomen, painful upon pressure resembling strangury, normal urination, periodic fever, spontaneous sweating, abdominal aversion to cold. Delayed and tight pulse indicates unformed pus; purgation is indicated, expecting blood. Flooding and rapid pulse indicates formed pus; purgation is contraindicated. Treat with Dahuang Mudan Tang (Rhubarb and Moutan Decoction). (*Jin Gui Yao Lue*)
Internal Abcesses have several types: Lung, Liver, Stomach Epigastrium, Small Intestine, Large Intestine, Bladder. Only Lung Abscess with foul sputum is easily identified. Others are mistaken for痞结 (Stagnation), Blood Stasis, Cold Phlegm, or Food Retention. Mixed treatments lead to missed opportunities once pus forms. Differentiate clearly: Stagnation and Stasis have causes and develop gradually. Cold Phlegm has shifting pain and other Phlegm signs. Food Retention has a history of injury and resolves with bowel movement. Internal Abscesses have fixed pain that worsens over time. *Jin Gui* states: Floating and scattered pulses with Fever but shivering aversion to cold and pain indicate Abscess. Pressing heat confirms pus. This is the truth of internal Abscesses. Also: Intestinal Abscess with crusty skin, tight abdomen, soft pressure, swollen look, no masses, no fever. Liver Abscess has hidden flank pain and eventual pus/blood expectoration. Small Intestine Abscess resembles Large Intestine but is higher. Bladder Abscess pain is in the lower lower abdomen near the pubis, tender to touch, with difficult/painful urination. Stomach Epigastrium Abscess has Excess and Deficiency types. Excess resolves easily; if pus forms, copious pus/blood expulsion cures it. Deficiency is often untreatable: initial stomach pain/fullness, gradually rising hardness below the heart like stone, alternating cold/fever, anorexia, extreme tenderness, emaciation. This is Spleen injury from overthinking, not waiting for pus...