夫肺痈者，乃肺经感受风邪热毒所致也。此病多因久嗜炙爆肥腻，或劳伤气血，以致心
火炎炽，熏克肺金，致令咳嗽。咳而不已，遂成肺痿。若寸口脉数，其人咳中反有浊唾涎沫
者，亦为肺痿之疾。若口中辟辟燥，咳又胸中隐隐而痛，脉反滑数，此为肺痈，咳唾脓血。
脉数而虚者，为肺痿；脉数而实者，为肺痈。夫肺者五脏之华盖也，处于胸中，主于气，候
于皮毛。劳伤血气，腠理虚而风邪乘之，内感于肺也，则汗出恶风，咳嗽短气，鼻塞项强，
胸胁胀满，久久不瘥遂成前证，轻则为痿，甚则成痈。其候应乳上下隐隐而痛者肺痈也，若
肉微起者肺痈也。初起皆可救，若日久唾脓臭败者，不可治也。但诊其脉，微紧而数者，未
有脓也；若紧甚而数者，已有脓也。若脓如粳米粥及呕脓不止，其脉浮大而面色赤者，皆难
治；若脓自止，其脉短而涩，面色黄白者，皆可治。何以言之。盖脉浮大面赤，此心火克肺
金也，故难治。若脉短涩及面白者，此肺气未损也，故可治。治当补肺泻火，止嗽定喘为佳
。若不得卧者，可用葶苈大枣泻肺汤及桔梗薏苡黄 汤之类调之。全在保肺，活法施治，庶
可全生也。
升麻汤
治肺痈疽，胸乳间皆痛，口吐脓血，气作腥臭。
川升麻 苦梗 薏苡仁 地榆 黄芩（去心） 赤芍药 牡丹皮（去心） 生甘草（各三分）
上为粗末，每服一两，水一升半，煎至五合，去渣温服，日三服。
桔梗汤
治男子妇人咳而胸膈隐痛，两脚肿满，咽干口燥，烦闷多渴，时出浊唾腥臭，名曰肺痈
，小便赤黄，大便多涩。
桔梗 贝母 当归（酒浸） 栝蒌仁 橘壳（麸炒） 薏苡仁（微炒） 桑白皮 甘草节 防
己（去粗皮，各一两） 百合（蒸） 黄 （各一两半） 北五味子 甜葶苈 地骨皮 知母 杏
仁（各半两）
上锉碎，每服四钱，水一盏半，生姜三片，煎七分，不拘时温服。咳者加百药煎，热加
黄芩，大便不利加煨大黄少许，小便涩甚加木通车前子煎，躁烦加白茅根煎，咳而疼甚加人
参白芷煎。
葶苈散
治肺痈咳嗽气急，睡卧不安，心胸胀满。
甜葶苈子（二两半，隔纸炒赤色） 百合（炒） 白附子 北五味子（炒） 甘草节 罗参
款冬花 百药煎（各一两） 大朱砂（五钱，另研） 紫菀（去木，一两）
上为末，每服二钱，灯心汤调下。
补肺散
治肺痈已吐出脓血，以此润护。
真钟乳粉（一两） 白滑石（二两）
上为末，每服三钱，米饮调下。
理肺膏
治肺痈正作，咳唾不利，胸膈迫塞。
诃子（去核） 百药煎 五味子（微炒） 条参（去芦） 款冬花蕊 杏仁 知母 贝母 甜
葶苈子 紫菀 百合 甘草节（各五钱）
上为末，用白茅根净洗称三斤，研取自然汁，入瓷石器中熬成膏，更添入好蜜二两再熬
匀，候调和煎药为丸，如梧桐子大，温水吞下。
五香白术散
宽中和气，滋益脾土生肺金，进美饮食。
沉香 木香 明乳香 丁香 藿香叶（各半两） 白术 罗参 白茯苓 薏苡仁 山药
扁豆 桔梗 缩砂 白豆蔻 粉草 莲肉（各一两）
上为末，苏盐汤调，空心服，枣汤亦可。有汗，加浮麦煎汤下。
排脓散
治肺痈吐脓后，宜服此排脓补肺。
嫩黄 川白芷 北五味子（炒） 人参（各等分）
上为细末，每服二钱，食后蜜汤调服。
四顺汤
治肺痈吐脓，五心烦热，壅闷咳嗽。
贝母（去心） 紫菀（去苗土） 桔梗（炒，各一两） 甘草（炙，锉，半两）
上捣筛，每服三钱，水一盏，煎五七沸，去渣，不拘时稍冷服。如咳嗽甚，加去皮尖杏
仁三枚同煎，小儿量减。
治肺痈方
上用薏苡米为末，糯米饮调下，或入粥内煮吃亦可。一方用水煎服，当下脓血便愈。
Pulmonary abscess (Fei Yong) is a disease caused by the lung meridian contracting wind pathogenic factors and heat toxins. This illness often arises from long-term indulgence in fried, roasted, and fatty foods, or from labor-induced damage to Qi and Blood, leading to hyperactive heart fire that scorches and overacts on Lung Metal, resulting in cough. If the cough persists, it may eventually evolve into pulmonary consumptive disease (Fei Fei). If the Cun position of the pulse is rapid, and the patient produces turbid saliva and frothy sputum during coughing, this also belongs to pulmonary consumptive disease. If the mouth feels dry, coughing is accompanied by dull pain in the chest, and the pulse is slippery and rapid, this indicates pulmonary abscess, characterized by coughing up pus and blood. A rapid but deficient pulse indicates pulmonary consumptive disease; a rapid and excess pulse indicates pulmonary abscess.
The lung is the canopy of the five zang organs, located in the chest, governing Qi, and its condition is reflected in the skin and hair. If labor damages Qi and Blood, causing the interstices (Cou Li) to become deficient, wind pathogens can invade internally affecting the lungs, leading to sweating, aversion to wind, cough, shortness of breath, nasal congestion, stiffness of the neck and back, and distension and fullness in the chest and hypochondrium. If these symptoms persist without resolution, they develop into the aforementioned conditions: mild cases become pulmonary consumptive disease, while severe cases become pulmonary abscess. Symptoms manifesting as dull pain above and below the breasts indicate pulmonary abscess; slight swelling of the flesh also indicates pulmonary abscess. Early stages are treatable; however, if pus is coughed up after a long duration with a foul, rancid odor, it becomes difficult to treat.
Regarding pulse diagnosis: a slightly tight and rapid pulse indicates that pus has not yet formed; a very tight and rapid pulse indicates that pus has already formed. If the pus resembles rice gruel, vomiting of pus continues incessantly, the pulse is floating and large, and the complexion is red, all these are difficult to treat. If the pus stops spontaneously, the pulse is short and choppy, and the complexion is yellowish-white, these are treatable. Why? Because a floating, large pulse with a red complexion indicates heart fire overacting on Lung Metal, hence difficult to treat. A short, choppy pulse with a pale complexion indicates that Lung Qi is not severely damaged, hence treatable. Treatment should focus on tonifying the lung, draining fire, stopping cough, and calming asthma. If the patient cannot lie flat, Tingli Dazao Xiefei Decoction (Tingli Dazao Xiefei Tang) or Jiegeng Yiyi Huangqi Decoction (Jiegeng Yiyi Huangqi Tang) may be used for regulation. The key lies in protecting Lung Qi and applying flexible treatment methods to preserve life.
Shengma Decoction (Shengma Tang)
Treats pulmonary abscess and carbuncle, with pain throughout the chest and between the breasts, spitting of pus and blood, and breath with a fishy odor.
Chuan Shengma (Rhizoma Cimicifugae), Ku Geng (Radix Platycodonis, i.e., Jiegeng), Yi Yi Ren (Semen Coicis), Di Yu (Herba Sanguisorbae), Huang Qin (Radix Scutellariae, heart removed), Chi Shao Yao (Radix Paeoniae Rubra), Mu Dan Pi (Cortex Moutan, heart removed), Sheng Gan Cao (Radix Glycyrrhizae, each 3 fen).
Grind the above into coarse powder. Take 1 liang per dose, add 1.5 sheng of water, decoct until 0.5 sheng remains, strain, and take warm. Administer three times daily.
Jiegeng Decoction (Jiegeng Tang)
Treats men and women with cough and dull pain in the chest and diaphragm, swelling and fullness in both legs, dry throat and mouth, irritability and excessive thirst, occasional discharge of turbid sputum with a fishy odor, named pulmonary abscess, red and yellow urine, and frequent constipation.
Jiegeng (Radix Platycodonis), Bei Mu (Bulbus Fritillariae Cirrhosae), Dang Gui (Radix Angelicae Sinensis, soaked in wine), Gua Lou Ren (Semen Benincasae), Ju Qiao (Pericarpium Citri Reticulatae, stir-fried with bran), Yi Yi Ren (Semen Coicis, lightly stir-fried), Sang Bai Pi (Cortex Mori), Gan Cao Jie (Radix Glycyrrhizae, knotted), Fang Ji (Radix Stephaniae Tetrandrae, outer bark removed, each 1 liang), Bai He (Bulbus Lilii, steamed), Huang Qi (Radix Astragali, each 1.5 liang), Bei Wu Wei Zi (Fructus Schisandrae Chinensis), Tian Ting Li (Semen Lepidii et Descurainiae), Di Gu Pi (Cortex Lycii), Zhi Mu (Rhizoma Anemarrhenae), Xing Ren (Semen Pruni Armeniaci, each 0.5 liang).
Crush the above ingredients. Take 4 qian per dose, add 1.5 cups of water and 3 slices of fresh ginger, decoct until 0.7 cup remains, and take warm at any time. For cough, add Bai Yao Jian; for heat, add Huang Qin; for constipation, add a small amount of Wei Da Huang; for severe dysuria, add Mu Tong and Che Qian Zi; for restlessness, add Bai Mao Gen; for severe cough and pain, add Ren Shen and Bai Zhi.
Tingli Powder (Tingli San)
Treats pulmonary abscess with cough,急促 breathing, restless sleep, and distension and fullness in the chest and heart.
Tian Ting Li Zi (Semen Lepidii et Descurainiae, 2.5 liang, stir-fried through paper until reddish), Bai He (Bulbus Lilii, stir-fried), Bai Fu Zi (Rhizoma Typhonii), Bei Wu Wei Zi (Fructus Schisandrae Chinensis, stir-fried), Gan Cao Jie (Radix Glycyrrhizae, knotted), Luo Shen (Radix Panacis Japonici), Kuan Dong Hua (Flos Farfarae), Bai Yao Jian (each 1 liang), Da Zhu Sha (Mineral Cinnabar, 5 qian, ground separately), Zi Wan (Radix Asteris, woody parts removed, 1 liang).
Grind the above into fine powder. Take 2 qian per dose, mix with Deng Xin Tang (Decoction of Junci Medullia).
Bufei Powder (Bufei San)
Used after pulmonary abscess has expelled pus and blood, to moisten and protect the lungs.
Zhen Zhong Ru Fen (Calcareous Sparum Pulveratum, 1 liang), Bai Hua Shi (Talcum, 2 liang).
Grind the above into fine powder. Take 3 qian per dose, mix with Mi Yin (rice drink).
Lufei Paste (Lufei Gao)
Treats active pulmonary abscess with difficulty in expectoration and oppression in the chest and diaphragm.
He Zi (Fructus Terminaliae Chebulae, pitted), Bai Yao Jian, Wu Wei Zi (Fructus Schisandrae Chinensis, lightly stir-fried), Tiao Shen (Radix Panacis Japonici, rhizome removed), Kuan Dong Hua Rui (Flos Farfarae), Xing Ren (Semen Pruni Armeniaci), Zhi Mu (Rhizoma Anemarrhenae), Bei Mu (Bulbus Fritillariae Cirrhosae), Tian Ting Li Zi (Semen Lepidii et Descurainiae), Zi Wan (Radix Asteris), Bai He (Bulbus Lilii), Gan Cao Jie (Radix Glycyrrhizae, knotted, each 5 qian).
Grind the above into powder. Wash 3 jin of clean Bai Mao Gen (Radix Imperatae), grind to extract natural juice, boil in porcelain or earthenware until it becomes a paste, add 2 liang of good honey, and continue boiling until uniform. Mix with decocted medicine to form pills the size of Sophora seeds, swallow with warm water.
Wuxiang Baizhu Powder (Wuxiang Baizhu San)
Broadens harmony and regulates Qi, nourishes Spleen Earth to generate Lung Metal, and improves appetite.
Chen Xiang (Lignum Aquilariae Resinatum), Mu Xiang (Radix Aucklandiae), Ming Ru Xiang (Resina Olibani), Ding Xiang (Flos Caryophylli), Huo Xiang Ye (Folium Pogostemonis, each 0.5 liang), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Luo Shen (Radix Panacis Japonici), Bai Fu Ling (Poria), Yi Yi Ren (Semen Coicis), Shan Yao (Rhizoma Dioscoreae), Bian Dou (Semen Phaseoli), Jie Geng (Radix Platycodonis), Suo Sha (Fructus Amomi Rotundus), Bai Dou Kou (Fructus Cardamomi Albi), Fen Cao (Radix Glycyrrhizae), Lian Rou (Semen Nelumbinis, each 1 liang).
Grind the above into powder. Take with Su Yan Tang (decoction of Perilla salt), on an empty stomach; Zao Tang (jujube decoction) is also acceptable. If sweating occurs, take with Fu Mai decoction.
Painong Powder (Painong San)
After pulmonary abscess expels pus, take this formula to drain pus and tonify the lung.
Nen Huang Qi (Radix Astragali, tender), Chuan Bai Zhi (Radix Angelicae Dahuricae), Bei Wu Wei Zi (Fructus Schisandrae Chinensis, stir-fried), Ren Shen (Radix Ginseng, equal parts).
Grind the above into fine powder. Take 2 qian per dose, mix with honey water after meals.
Sishun Decoction (Sishun Tang)
Treats pulmonary abscess after expelling pus, five-palm heat, oppression, and cough.
Bei Mu (Bulbus Fritillariae Cirrhosae, heart removed), Zi Wan (Radix Asteris, seedlings and soil removed), Jie Geng (Radix Platycodonis, stir-fried, each 1 liang), Gan Cao (Radix Glycyrrhizae, honey-fried, crushed, 0.5 liang).
Pound and sieve the above. Take 3 qian per dose, add 1 cup of water, boil for 5-7 boils, strain, and take slightly cool at any time. If cough is severe, add 3 peeled and de-seeded Xing Ren to decoct together; reduce dosage for children.
Formula for Treating Pulmonary Abscess
Take Yi Yi Mi (Semen Coicis), grind into powder, mix with Nuomi Yin (glutinous rice drink) to take, or cook in porridge and eat. Another method: decoct with water to take; once pus and blood are passed, recovery ensues.