《救急》疗肺气积聚，心肋下满，急发即咳逆上气方。
麻黄（三两去节） 杏仁（去双仁、尖、皮） 柴胡 生姜 半夏（洗十遍） 葶苈子
（熬，
研如脂各四两） 干枣（十二枚擘） 槟榔（十枚）
上八味，切，以水一斗，煮取二升八合，去滓，分温三服，每服相去如人行八九里久。
七日忌食生冷、猪、鱼、羊肉。此方服一剂讫，将息满七日，则服后方。忌羊肉、饧。
又方
茯苓 干苏茎菜 橘皮 麻黄（各三两） 杏仁（去尖、皮、两仁者） 柴胡 生姜（各
四
两）
上七味，切，以水一斗，煮取二升七合，去滓，分温三服，每服如人行八九里久。禁酢
物、蒜、热面、猪肉。五日服一剂。（并出第六卷中）
《千金》论曰∶病咳唾，其脉数，实者属肺痈，虚者属肺痿。咳而口中自有津液，舌上
苔滑，此为浮寒，非肺痿也。若口中辟辟燥，咳即胸中隐隐痛，脉反滑数，此为肺痈也。问
曰，病者咳逆，师脉之，何以知此为肺痈？当有脓血，吐之则死，后终吐脓死。其脉何类？
何
以别之？师曰，寸口脉微而数，微则为风，数则为热，微则汗出，数则恶寒，风中于卫，呼
气不入，热过于营，吸而不出，风伤皮毛，热伤血脉，风舍于肺，其人则咳，口干喘满，咽
燥不渴，唾而浊沫，时时振寒，热之所过，血为凝滞，蓄结痈脓，吐如米粥，始萌可救，脓
已成则难治。寸口脉数，趺阳脉紧，寒热相搏，故振寒而咳。趺阳脉浮缓，胃气如经，此为
肺痈。趺阳脉浮缓，少阴微紧，微为血虚，紧为微寒，此为鼠乳，其病属肺也。问曰，振寒
发热，寸口脉滑而数，其人饮食起居如故，此为痈肿病，医反不知，而以伤寒治之，应不愈
也。何以知有脓？脓之所在，何以别知其处？师曰，假令在胸中者为肺痈，其脉数，咳唾，
设
脓未成，其脉自紧数，紧去但数，脓为已成也。（出第十七卷中）
仲景《伤寒论》∶咳，胸中满而振寒，脉数，咽干不渴，时出浊唾腥臭，久久吐脓如粳
米粥者，肺痈也。桔梗白散主之方。
桔梗（三分） 贝母（三分） 巴豆（一分去皮、心，熬，研作脂）
上三味，捣筛。强人饮服半钱匕，羸人减之。若病在膈上者必吐，膈下者必利。若利不
止者，饮冷水一杯则定。忌猪肉、芦笋等。（出第十八卷中）
《集验》疗胸中满而振寒，脉数，咽燥而不渴，时时出浊唾腥臭，久久吐脓如粳米粥，
是为肺痈。桔梗汤方。
桔梗（二两《千金》古今方云用一两） 甘草（二两炙）
上二味，切，以水三升，煮取一升，分再服，朝暮吐脓血则瘥。（张文仲、《千金》、《
备急》、《古今录验》、《范汪》同，此本仲景《伤寒论》方，出第四卷中）
《千金》疗咳有微热，烦满，胸心甲错，是为肺痈。黄昏汤方。
黄昏（手掌大一枚即合欢木皮）
上一味，切，以水三升，煮得一升，分再服。（《范汪》同）
又肺痈喘不得卧，葶苈大枣泻肺汤主之。兼疗胸胁胀满，一身面目浮肿，鼻塞清涕出，
不闻香臭酸辛，咳逆上气，喘鸣迫塞方。
葶苈（三熬令色紫）
上一味，捣，令可丸，以水三升，煮擘大枣二十枚，得汁二升，纳药如弹丸一枚，煎取
一升，顿服。（《古今录验》、《删繁》、仲景《伤寒论》、《范汪》同，并出第十七卷中）
《备急》疗肠痈、肺痈方。
升麻 白蔹 漏芦 芒硝（各一两） 黄芩 枳实（炙） 连翘 蛇衔（各三两） 栀
子（二
十枚擘） 蒴 根（四两）
上十味，捣令细，以水三升，渍经半日，以猪脂五升，煎令水竭。去滓敷之，日三。若
交急合水煎。（出第四卷中）
《古今录验》疗肺痈方。
薏苡仁（一升） 醇苦酒（三升）
上二味，煮取一升，温令顿服，有脓血当吐。（《范汪》、《经心录》同）
又疗肺痈。苇茎汤方。
锉苇（一升） 薏苡仁（半升） 桃仁（五十枚去尖、皮、两仁者） 瓜瓣（半升）
上四味， 咀，以水一斗，先煮苇令得五升，去滓，悉纳诸药，煮取二升，分再服，当
吐如脓。（仲景《伤寒论》云苇叶切二升，《千金》、《范汪》同，《千金》云苇茎二升，先以
水
二斗煮五升）
又疗肺痈，经时不瘥。桔梗汤方。
桔梗（三升） 白术（二两） 当归（一两） 地黄（二两） 甘草（炙） 败酱 薏
苡仁（各二
两） 桑白皮（一升切）
上八味，切，以水一斗五升，煮大豆四升，取七升汁，去豆，纳清酒三升，合诸药煮之
，取三升，去滓，服六合，日三夜再。忌猪肉、芜荑、桃、李、雀肉、海藻、菘菜等。
又疗肺痈。生地黄汁汤方。
生地黄汁（一升） 当归 甘草（炙） 白石英（绵裹） 人参（各一两） 附子（二
分炮） 白
小豆（三十颗） 白鸡一头（男用雌，女用雄，疗如食法，一作雉）
上八味，切，以水一斗五升，煮鸡，取七升汁，去滓，纳地黄汁诸药等，煮取三升，去
滓，分服六合，日三夜二。忌芜荑、海藻、菘菜、冷水、猪肉等。（并出第二十一卷中）
The *Jiuji Fang* (Emergency Rescue Formulas) treats Lung Qi accumulation and mass, fullness under the heart and ribs, and acute onset of cough with rebellious Qi rushing upward.
Ephedrae Herba (Mahuang, 麻黄) [3 liang, nodes removed], Armeniacae Semen Amarum (Xingren, 杏仁) [remove double kernels, tips, and skins], Bupleuri Radix (Chaihu, 柴胡), Zingiberis Rhizoma Recens (Shengjiang, 生姜), Pinelliae Rhizoma Preparatum (Banxia, 半夏) [washed ten times], Lepidii et Descurainiae Semen (Tinglizi, 葶苈子) [stir-fried, ground into paste, each 4 liang], Jujubae Fructus (Ganzao, 干枣) [12 pieces, split open], Arecae Semen (Binglang, 槟榔) [10 pieces].
These eight herbs are chopped, boiled in one dou (approx. 10 liters) of water until reduced to 2.8 sheng (approx. 2.8 liters). Strain the dregs, and divide into three warm doses. The interval between doses should be equivalent to the time it takes a person to walk 8-9 li.
For seven days, avoid raw/cold foods, pork, fish, and mutton. After completing one dose of this formula, rest for seven days, then take the subsequent formula. Avoid mutton and maltose syrup.
Another formula:
Poria (Fuling, 茯苓), Dried Perilla Stem and Leaf (Gansu Jingye, 干苏茎菜), Citri Reticulatae Pericarpium (Chenpi, 橘皮), Ephedrae Herba (Mahuang, 麻黄) [each 3 liang], Armeniacae Semen Amarum (Xingren, 杏仁) [remove tips, skins, and double kernels], Bupleuri Radix (Chaihu, 柴胡), Zingiberis Rhizoma Recens (Shengjiang, 生姜) [each 4 liang].
These seven herbs are chopped, boiled in one dou of water until reduced to 2.7 sheng. Strain the dregs, and divide into three warm doses. The interval between doses should be equivalent to the time it takes a person to walk 8-9 li. Avoid vinegar, garlic, hot noodles, and pork. Take one dose every five days. (All from Volume 6)
The *Qianjin Fang* states: In cases of coughing and spitting saliva, if the pulse is rapid, excess patterns belong to Lung Abscess (Fei Yong, 肺痈), while deficiency patterns belong to Lung Flaccidity (Fei Wei, 肺痿). If there is natural saliva in the mouth during coughing, and the tongue coating is slippery, this indicates floating cold, not Lung Flaccidity. If the mouth feels parched and dry, and coughing causes dull pain in the chest, with a pulse that is instead slippery and rapid, this is Lung Abscess.
Question: When a patient has coughing and rebellious Qi, how does the physician know through pulse diagnosis that this is Lung Abscess? There should be pus and blood; if vomited, death ensues, and ultimately death occurs from spitting pus. What does the pulse resemble? How to distinguish it?
Answer: The Cun Kou (Inch Port) pulse is faint and rapid. Faintness indicates Wind, rapidity indicates Heat. Faintness leads to sweating, rapidity leads to aversion to cold. Wind invades the Wei (Defensive) level, so exhalation cannot enter; Heat overwhelms the Ying (Nutritive) level, so inhalation cannot exit. Wind damages the skin and hair; Heat damages the blood vessels. Wind lodges in the Lung, causing cough, dry mouth, wheezing, and distension, dry throat without thirst, spitting of turbid froth, and frequent chills. Where Heat passes, blood coagulates and stagnates, accumulating to form an abscess and pus, which is spat out like rice porridge. Early stages can be saved; once pus is formed, it is difficult to treat.
The Cun Kou pulse is rapid, and the Fu Yang pulse is tight. Cold and Heat struggle, causing chills and cough. If the Fu Yang pulse is floating and moderate, and the Stomach Qi is normal, this is Lung Abscess. If the Fu Yang pulse is floating and moderate, and the Shao Yin pulse is faintly tight, faintness indicates Blood deficiency, tightness indicates slight cold; this is "Shu Ru" (a type of tumor/abscess), belonging to the Lung.
Question: With chills and fever, a slippery and rapid Cun Kou pulse, yet diet and daily life remain normal, this is a swelling/abscess disease. If the physician fails to recognize this and treats it as Taiyang Cold Damage (Shanghan, 伤寒), it will not heal. How to know there is pus? How to locate it?
Answer: If located in the chest, it is Lung Abscess, with a rapid pulse and coughing/spitting. If pus has not yet formed, the pulse is naturally tight and rapid; when the tightness disappears leaving only rapidity, the pus has formed. (From Volume 17)
Zhang Zhongjing's *Shanghan Lun*: Cough, chest fullness with chills, rapid pulse, dry throat without thirst, frequent discharge of turbid saliva with a fishy odor, and eventually spitting pus like millet porridge indicates Lung Abscess. Treat with Jiegeng Bai San (Platycodon and White Powder Formula).
Platycodonis Radix (Jiegeng, 桔梗) [3 fen], Fritillariae Bulbus (Beimu, 贝母) [3 fen], Crotonis Fructus (Badou, 巴豆) [1 fen, skin and heart removed, stir-fried, ground into paste].
These three herbs are crushed and sifted. Strong individuals take half a qianbi (coin-sized measure) with drink; weak individuals reduce the dose. If the disease is above the diaphragm, vomiting will occur; if below, diarrhea will occur. If diarrhea persists, drinking one cup of cold water will stop it. Avoid pork and Asparagus cochinchinensis (Lusun). (From Volume 18)
The *Jiyan Fang* treats chest fullness with chills, rapid pulse, dry throat without thirst, frequent discharge of turbid saliva with a fishy odor, and eventually spitting pus like millet porridge, indicating Lung Abscess. Treat with Jiegeng Tang (Platycodon Decoction).
Platycodonis Radix (Jiegeng, 桔梗) [2 liang; *Qianjin Fang* ancient and modern formulas say use 1 liang], Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [2 liang, honey-fried].
These two herbs are chopped, boiled in 3 sheng of water until reduced to 1 sheng. Divide into two doses. Spitting pus and blood in the morning and evening indicates recovery. (Same as Zhang Wenzhong, *Qianjin Fang*, *Beiji Fang*, *Gujin Luyan*, *Fan Wang*; this is originally from Zhang Zhongjing's *Shanghan Lun*, From Volume 4)
The *Qianjin Fang* treats cough with slight fever, irritability and fullness, and rough, scaly skin on the chest and heart, indicating Lung Abscess. Treat with Huanghun Tang (Twilight Decoction).
Huanghun (Huanghun, 黄昏) [One piece the size of a palm, i.e., Albiziae Cortex (Hehuanpi, 合欢皮)].
This single herb is chopped, boiled in 3 sheng of water until reduced to 1 sheng. Divide into two doses. (Same as *Fan Wang*)
Additionally, for Lung Abscess with wheezing preventing lying down, Tingli Dazao Xiefei Tang (Lepidii and Jujube Decoction to Drain the Lung) is the primary treatment. It also treats chest and hypochondriac fullness, edema of the whole body and face, nasal congestion with clear discharge, loss of smell, cough with rebellious Qi, wheezing, and airway obstruction.
Lepidii et Descurainiae Semen (Tinglizi, 葶苈子) [3 liang, stir-fried until purple].
This single herb is crushed into pill-sized balls. Boil 20 split Jujubae Fructus (Dazao, 大枣) in 3 sheng of water to obtain 2 sheng of juice. Add one pill-sized ball of the herb, simmer to obtain 1 sheng, and take in one dose. (Same as *Gujin Luyan*, *Shanfan*, Zhang Zhongjing's *Shanghan Lun*, *Fan Wang*, all from Volume 17)
The *Beiji Fang* treats Intestinal Abscess and Lung Abscess.
Cimicifugae Rhizoma (Shengma, 升麻), Ampelopsis Radix (Bailian, 白蔹), Leuzeae Radix (Loulu, 漏芦), Natrii Sulfas (Mangxiao, 芒硝) [each 1 liang], Scutellariae Radix (Huangqin, 黄芩), Aurantii Fructus Immaturus (Zhishi, 枳实) [fried], Forsythiae Fructus (Lianqiao, 连翘), Ophiopogonis Radix (Shejian, 蛇衔) [each 3 liang], Gardeniae Fructus (Zhizi, 栀子) [20 pieces, split open], Tetrapanacis Medulla (Suodiegen, 蒴藋根) [4 liang].
These ten herbs are finely crushed, soaked in 3 sheng of water for half a day, then decocted with 5 sheng of Pig Fat (Zhuzhi, 猪脂) until the water is exhausted. Strain the dregs and apply externally three times daily. If urgent, add water and boil together. (From Volume 4)
The *Gujin Luyan* treats Lung Abscess.
Coicis Semen (Yiyiren, 薏苡仁) [1 sheng], Fermented Rice Wine (Chun Kujiu, 醇苦酒) [3 sheng].
These two ingredients are boiled to obtain 1 sheng. Drink warm in one dose; pus and blood should be expectorated. (Same as *Fan Wang*, *Jingxin Lu*)
Another formula for Lung Abscess: Weijing Tang (Reed Shoot Decoction).
Chopped Reed Shoots (Weijing, 苇茎) [1 sheng], Coicis Semen (Yiyiren, 薏苡仁) [0.5 sheng], Persicae Semen (Taoren, 桃仁) [50 pieces, remove tips, skins, and double kernels], Benincasae Semen (Guaiban, 瓜瓣) [0.5 sheng].
These four herbs are chopped. Boil Reed Shoots in 1 dou of water first until reduced to 5 sheng. Strain the dregs, add all other herbs, and boil to obtain 2 sheng. Divide into two doses. Pus-like material should be expectorated. (*Shanghan Lun* says cut Reed Leaves 2 sheng; *Qianjin Fang* and *Fan Wang* agree; *Qianjin Fang* says Reed Stems 2 sheng, boil first in 2 dou of water to 5 sheng).
Another formula for Lung Abscess that has persisted without healing: Jiegeng Tang (Platycodon Decoction).
Platycodonis Radix (Jiegeng, 桔梗) [3 sheng], Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) [2 liang], Angelicae Sinensis Radix (Danggui, 当归) [1 liang], Rehmanniae Radix (Dihuang, 地黄) [2 liang], Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [fried], Patriniae Herba (Baijiang, 败酱), Coicis Semen (Yiyiren, 薏苡仁) [each 2 liang], Mori Cortex (Sangbaipi, 桑白皮) [1 sheng, chopped].
These eight herbs are chopped. Boil 4 sheng of Sojae Semen Praeparatum (DaDou, 大豆) in 1.5 dou of water to obtain 7 sheng of juice. Remove the beans, add 3 sheng of clear wine, mix with the herbs, and boil to obtain 3 sheng. Strain the dregs, take 6 he, three times daily and twice at night. Avoid pork, Myrobalan (Wuyi), peach, plum, sparrow meat, Sargassum (Haizao), and Chinese Cabbage (Songcai).
Another formula for Lung Abscess: Shengdihuang Zhi Tang (Fresh Rehmannia Juice Decoction).
Fresh Rehmanniae Radix Juice (Shengdihuangzhi, 生地黄汁) [1 sheng], Angelicae Sinensis Radix (Danggui, 当归), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [fried], Quartz (Baishiyin, 白石英) [wrapped in cotton], Ginseng Radix (Renshen, 人参) [each 1 liang], Aconiti Lateralis Radix Praeparata (Fuzi, 附子) [2 fen, processed], Phaseoli Radiatus (Baixiaodou, 白小豆) [30 grains], White Chicken (Baiji, 白鸡) [one head; female for men, male for women, prepared for eating; alternatively Pheasant].
These eight herbs are chopped. Boil the chicken in 1.5 dou of water to obtain 7 sheng of juice. Strain the dregs, add Fresh Rehmanniae Radix Juice and other herbs, boil to obtain 3 sheng. Strain the dregs, divide into doses of 6 he, three times daily and twice at night. Avoid Myrobalan, Sargassum, Chinese Cabbage, cold water, and pork. (All from Volume 21)