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Yu Jiayan stated: Fei Yong (Lung Abscess) arises from the accumulated pathogenic fire of the five zang organs and the stagnant heat in the stomach, which ascend to smolder the lung. When the lung is scorched by this fire and heat, the blood coagulates; once the blood coagulates, phlegm wraps around it, thereby forming a small abscess. As this accumulation grows day by day, the lung swells progressively, and the chest bone elevates, leading to frequent coughing, expulsion of thick turbid sputum like glue, fever, aversion to cold, with symptoms worsening significantly at dusk (rib hour), facial redness, dry nasal passages, and rough, scaly skin on the chest. If one can identify the pulse and symptoms at the onset, determining whether the pathology is in the exterior or interior, and vigorously employs methods to raise and disperse or purge and descend, there will be no case that cannot be cured. However, if one only recognizes the condition after pus and blood are expectorated, it is too late to save the patient. Occasionally, patients with small abscesses, strong vital energy, and good appetite may survive, but such cases account for only one or two out of ten. The key to treating this condition lies entirely before the abscess forms.

As for Fei Wei (Lung Withering), it develops gradually over time, not in a single day, and its manifestations of cold and heat vary. Ultimately, it results from the failure of stomach fluids to transmit to the lung, causing the lung to lose nourishment, becoming increasingly dry and arid until Fei Wei is formed. In reality, there are many ways in which stomach fluids are secretly damaged. Physicians often fail to protect them. For instance, if the couli (pores) are naturally loose, excessive sweating may occur without cause; if the middle qi is inherently deficient, frequent vomiting may deplete the stomach's contents; if damp-heat transforms into Xiao Zhong (wasting-thirst), drinking water fails to quench thirst, leading to internal exhaustion of fluids; or if the intestines are dry with constipation, forcing diuresis to achieve relief creates a leaky vessel that cannot sustain itself. Consequently, lung fire intensifies daily, lung heat deepens, and the small tubes within the lung become obstructed. Cough sounds gradually become weak and indistinct, the fatty membranes in the chest dry up, expectoration becomes difficult, and panting occurs after walking just a few steps. The general principle of treatment is to proceed slowly, generate stomach fluids, moisten lung dryness, direct rebellious qi downward, resolve accumulated phlegm, stop turbid saliva, tonify true qi to unblock the lung's small tubes, and dissipate fire-heat to restore the lung's clear and descending function. Even in cases of hemiplegic withering or flaccidity of the limbs and hands, proper treatment can lead to recovery.

However, Fei Yong involves tangible blood, so blood stasis should be attacked rapidly; Fei Wei involves intangible qi, so qi injury should be managed gradually. Fei Yong is an excess syndrome; treating it with methods for Fei Wei constitutes "treating excess as excess" (exacerbating an excess condition). Fei Wei is a deficiency syndrome; treating it with methods for Fei Yong constitutes "treating deficiency as deficiency" (exacerbating a deficiency condition). This is the general principle of syndrome differentiation and medication.

The *Jin Gui Yao Lue* discusses the pulses of Fei Yong and Fei Wei: A rapid pulse at the cunkou position, accompanied by cough and the presence of turbid saliva and froth in the mouth, indicates Fei Wei. If the mouth feels parched and dry, coughing causes hidden pain in the chest, and the pulse is slippery and rapid, this indicates Fei Yong, characterized by expectoration of pus and blood. A rapid and deficient pulse indicates Fei Wei, while a rapid and full pulse indicates Fei Yong.

It further states: A faint and rapid pulse at the cunkou position; faintness indicates wind, rapidity indicates heat; faintness leads to sweating, rapidity leads to aversion to cold. Wind invades the Wei (defensive) level, affecting exhalation so it does not penetrate deeply; heat overwhelms the Ying (nutritive) level, affecting inhalation so it does not exit smoothly. Wind damages the skin and hair; heat damages the blood vessels. When wind lodges in the lung, the patient coughs, experiences dry mouth, wheezing, and chest fullness, feels dry but not thirsty, spits turbid froth intermittently, and suffers from intermittent chills. Wherever heat passes, blood stagnates, accumulating to form pus and abscesses, with expectorated material resembling rice porridge. If treated at the initial stage, rescue is possible; once pus forms, death ensues.

When cough begins with immediate upper jiao wheezing and urgency, it is caused by external invasion of wind-cold. The pulse must be floating. It is appropriate to use the method of Yue Bi Jia Ban Xia Tang (Ephedra, Magnolia Flower, and Pinellia Decoction) or Xiao Qing Long Jia Shi Gao Tang (Minor Blue Green Dragon Decoction with Gypsum) to urgently disperse the exterior. Otherwise, this marks the beginning of Fei Yong or Fei Wei. One must urgently scatter pathogens and direct qi downward to clear the lung. However, treatment must distinguish between exterior/interior and excess/deficiency to avoid erroneous application, which would only increase the patient's distress.

Cheng Jiaoqian stated: In Fei Wei, qi deficiency prevents the transformation of blood, causing blood to dry and cease flowing, rising only with boiling fire. Excessive fire attacks Metal (lung), failing to generate qi and blood but instead generating phlegm. Thus, lacking blood and fluids, the withered Metal is scorched by fire; how can the lung lobes not become charred? The lung resides at the highest position among the zang organs, with fine orifices distributed between its lobes. The steaming moisture from the five zang organs enters through the lung root as qi, and exits through the spring-like openings as fluid during exhalation. This breathing is endless, irrigating the whole body, known as "water issuing from the high source." Once subjected to fire, the exhalation pathway becomes obstructed like inhalation; blood seeps through these openings, blocking the orifices, causing cough. Coughing leads to bleeding; more coughing leads to more seepage, and more seepage leads to more coughing. Over time, all fine orifices close. During inhalation, fire is drawn up to the throat, causing itching or sores; during exhalation, no fluid emerges, and the six lobes gradually wither and char. This is the origin of Fei Wei. In the Bu Fei San formula, Xing Ren (Almond Seed) and Da Li Zi (Arctii Fructus/Niu Bang Zi) are used to ventilate the orifices; E Jiao (Donkey-hide Gelatin) is used to resolve orifice stasis; Ma Ling (Aristolochiae Manshuriensis Fructus/Mar Luo Ling) is used to clear orifice heat. Although the formula contains no direct lung-tonifying herbs, Nuomi (Glutinous Rice) is used to tonify the spleen, taking advantage of the mother element (Earth generating Metal) reaching the lung. The intent of this prescription focuses entirely on the fine orifices of the lung, ensuring unobstructed respiration there, allowing qi to enter and fluid to exit, thereby tonifying the lung naturally without direct supplementation.