〔钱〕肺主喘。实则闷乱喘促，有饮水者，有不饮水者。虚则哽气，长出气。
肺病闷乱，哽气长出气，气短喘急。肺热，手掐眉目鼻面，甘桔汤主之。肺盛，
复有风冷，胸满短气，气急喘嗽上气，当先散肺，后发散风冷。散肺，泻白散、大
青膏主之，肺只伤寒，则不胸满。肺虚热，唇深红色，治之散肺虚热，少服泻白
散。肺脏怯，唇白色，当补肺阿胶散主之，若闷乱气粗，喘促哽气者难治，肺虚
损故也。脾肺病久则虚而唇白，脾者肺之母也，母子皆虚，不能相营，故名曰怯。
肺主唇白而泽者吉，白如枯骨者死。（此以唇诊肺之法也，唇白色者肺脏怯也，阿胶散主之，若手寻衣领及
乱捻物者，肝热也，宜泻青丸，手掐眉目鼻面者，肺热也，宜甘桔汤之类是也。） 肺病见春，金旺，肺胜肝也，
当泻肺，轻者肺病退，重者目淡青，必发惊，更有赤者，当搐。（海藏云∶为肝怯，故目淡青
也。）〔洁〕肺主燥，自病则喘嗽，燥则润之。实则喘而气盛，泻白散主之。虚则
喘而少气，先益黄散，后阿胶散主之。心乘肺，贼邪，热而喘嗽，先地黄丸，中
导赤散，后阿胶散主之。肝乘肺，微邪，恶风眩冒昏愦嗽，羌活膏主之。肾乘
肺，实邪，憎寒嗽清利，百部丸主之。脾乘肺，虚邪，体重吐痰泄泻嗽，人参白
术散主之。〔刘〕凡肺之得病，必先观心脾二脏之虚实，若心火烁金，即当先抑心
气，后吃肺药。若心气和，即便看脾脉，若脾气虚冷，即不能相生，而肺家生气不
足，则风邪易感，故患肺寒者，皆脾虚得之。若脾气盛实，则亦痞隔中焦，而大肠
与肺表里不能相通，夫中焦热隔，则肺与大肠不通，其热毒之气，必上蒸于肺而生
痰，故患肺热者，多脾实得之。心气盛者泻之，脾气虚者益之，脾气实者通之，然
后随其肺之寒热以治之，故有抑心气、益脾气、通肺气、三药。若诊其脉气心、脾、
两脏俱和，而肺自生疾，则但察肺家虚实而治之。〔薛〕肺经郁热，用泻白散。肺
气自虚、用四君子汤。外邪所乘，用参苏饮。心火炎燥，用人参平肺散。中焦实痞、
用大承气汤。脾不能生肺，用异功散。夫肺气盛者，肺中之邪气盛也，其脉右寸必
浮而有力，宜用泻白散以泻之。若肺虚而有热者，执肺热还伤肺之说而不用人参，
则误矣，仍参其证治之。
〔海〕肺苦气上逆，急食苦以泻之，诃子皮。一作黄芩。肺欲收，急食酸以收
之，白芍药。以酸补之，五味子。以辛泻之，桑白皮。肺虚，以五味子补之，
如无他证，钱氏补肺阿胶散主之，虚则补其母，脾乃肺之母，以甘草补脾。
阿胶散（钱氏） 又名补肺散
阿胶（一两半，麸炒） 黍粘子（炒香） 甘草（炙，各二钱半） 马兜铃（半两，焙） 杏仁（七个，去皮尖，
炒） 糯米（一两，炒）
上为末。每服一二钱，水一盏，煎至六分，食后温服。
〔海〕杏仁，本泻肺，非若人参、天门冬、麦门冬之补也，当以意消息之。
〔薛〕前方乃通治肺金之剂，经云∶虚则补其母，若前药未应，当用五味异功散以补脾。
〔海〕肺实，以桑白皮泻之，如无他证，以泻白散主之，实则泻其子，肾乃肺之
子，以泽泻泻肾。
泻白散（钱氏） 又名泻肺散
桑白皮（细锉，炒黄） 地骨皮（洗去土，焙。各一两） 甘草（炒，半两）
上件为末。每服一二钱，水一中盏，入粳米百粒，同煎至六分，食后温服。
〔海〕治肺热骨蒸自汗，宜用此直泻之。用山栀、黄芩方能泻肺，但当以气血分之。
甘桔汤（方见咽喉） 大青膏 羌活膏（俱见惊搐） 百部丸（方见咳嗽） 人参白术散（方
见痘渴） 四君子
汤（方见杂病虚劳） 参苏饮（杂病发热） 人参平肺散（杂病咳嗽）
[Qian Yi] The Lung governs panting. In excess patterns, there is chest oppression and restlessness with rapid breathing; some patients desire water, while others do not. In deficiency patterns, there is a choking sensation in the throat and sighing (long exhalation).
In Lung disease, symptoms include chest oppression and restlessness, choking sensation, sighing, shortness of breath, and urgent panting. If there is Heat in the Lung, the child may scratch at the eyebrows, eyes, nose, and face; Gan Jie Tang (Licorice and Platycodon Decoction) is the primary formula. If Lung Qi is excessive and complicated by Wind-Cold, presenting with chest fullness, shortness of breath, urgent panting, coughing, and rebellious Qi ascending, one should first dissipate pathogenic factors from the Lung, then dispel Wind-Cold. To dissipate Lung pathogens, Xie Bai San (Drain White Powder) or Da Qing Gao (Great Blue Ointment) are indicated. If the Lung is affected solely by Cold Damage (Shang Han), chest fullness will not occur. If the Lung is deficient with Heat, the lips will be deep red; treatment should dissipate Lung deficiency-Heat, administering small doses of Xie Bai San. If the Lung organ is weak (Lung Qie), the lips will be white; Bu Fei E Jiao San (Tonify Lung Donkey-Hide Gelatin Powder) is indicated. If accompanied by chest oppression, coarse breathing, panting, and choking sensations, the prognosis is poor due to severe Lung deficiency and damage. Chronic Spleen-Lung disease leads to deficiency and white lips; since the Spleen is the Mother of the Lung, if both mother and child organs are deficient and fail to nourish each other, it is termed "Qie" (Timidity/Weakness). A white but lustrous lip color in Lung disease is auspicious; white like dried bone indicates death. (This describes the method of diagnosing the Lung via the lips: white lips indicate Lung weakness, treated with E Jiao San; picking at clothes collars and fidgeting indicates Liver Heat, treated with Xie Qing Wan; scratching eyebrows, eyes, nose, and face indicates Lung Heat, treated with Gan Jie Tang.) When Lung disease manifests in Spring, Metal Qi is prosperous, and Lung overcomes Liver Wood; one should drain the Lung. In mild cases, the Lung pathology recedes; in severe cases, the eyes appear pale cyan, and convulsions (Jing Feng) are certain. If redness is present, nasal insufflation (Chu) should be used. (Zhang Yuansu states: This is because Liver Qi is weak, hence the pale cyan eyes.)
[Li Dongyuan] The Lung governs Dryness. Self-originating disease presents as panting and coughing; Dryness requires moistening. Excess patterns present with panting and abundant Qi, treated with Xie Bai San. Deficiency patterns present with panting and scanty Qi, initially treated with Yi Huang San, followed by E Jiao San. If Heart Fire attacks the Lung (Thief Pathogen), presenting with Heat, panting, and coughing, treat initially with Di Huang Wan, subsequently with Dao Chi San, and finally with E Jiao San. If Liver Wood attacks Lung Metal (Minor Pathogen), presenting with aversion to wind, dizziness, faintness, and coughing, treat with Qiang Huo Gao. If Kidney Water attacks Lung Metal (Excess Pathogen), presenting with aversion to cold, clear coughing, and frequent urination/stool, treat with Bai Bu Wan. If Spleen Earth attacks Lung Metal (Deficient Pathogen), presenting with heavy body, vomiting phlegm, diarrhea, and coughing, treat with Ren Shen Bai Zhu San.
[Liu Wansu] Whenever the Lung becomes diseased, one must first observe the excess or deficiency of the Heart and Spleen. If Heart Fire scorches Lung Metal, one must first suppress Heart Qi before administering Lung medicines. If Heart Qi is harmonious, examine the Spleen pulse next. If Spleen Qi is deficient and cold, it cannot generate [Lung Qi], leading to insufficient vital Qi in the Lung, making it susceptible to Wind pathogens; thus, Lung Cold diseases often result from Spleen deficiency. If Spleen Qi is excessive and solid, it causes stagnation in the Middle Jiao, preventing communication between the Large Intestine and the Lung (which are exterior-interior paired). If the Middle Jiao is blocked by Heat, Lung and Large Intestine cannot communicate; toxic Heat steams upward into the Lung generating phlegm; thus, Lung Heat diseases often result from Spleen excess. Excess Heart Qi is drained; deficient Spleen Qi is tonified; excessive Spleen Qi is unblocked. Thereafter, treat according to Lung Cold or Heat. Hence, there are three types of medicines: suppressing Heart Qi, tonifying Spleen Qi, and unblocking Lung Qi. If the pulse diagnosis shows both Heart and Spleen are harmonious, yet the Lung develops disease independently, treat based solely on Lung deficiency or excess.
[Xue Ji] Lung Meridian Stagnant Heat is treated with Xie Bai San. Lung Qi self-deficiency is treated with Si Jun Zi Tang (Four Gentlemen Decoction). Invasion by external pathogens is treated with Shen Su Yin (Ginseng and Perilla Drink). Heart Fire blazing and dryness is treated with Ren Shen Ping Fei San (Ginseng Lung-Pacifying Powder). Middle Jiao Excess Stagnation is treated with Da Cheng Qi Tang (Major Order the Qi Decoction). Spleen failing to generate Lung is treated with Yi Gong San (Benefit the Work Powder). What is called "Lung Qi Excess" refers to an abundance of pathogenic factors within the Lung; the pulse at the Right Cun position will be floating and forceful, indicating the use of Xie Bai San to drain it. If the Lung is deficient with Heat, adhering rigidly to the saying "Lung Heat harms the Lung again" and avoiding Ren Shen would be an error; one must still consider the syndrome for treatment.
[Zhang Yuansu] The Lung dislikes rebellious Qi ascending; urgently consume Bitter flavors to drain it, such as He Zi Pi (Pericarpium Arecae Semen). (Alternatively, Huang Qin / Scutellaria Root). The Lung desires consolidation; urgently consume Sour flavors to consolidate it, such as Bai Shao Yao (Radix Paeoniae Alba). Tonify with Sour flavors, such as Wu Wei Zi (Fructus Schisandrae Chinensis). Drain with Pungent flavors, such as Sang Bai Pi (Cortex Mori Radicis). For Lung deficiency, tonify with Wu Wei Zi. If there are no other symptoms, Qian Yi's Bu Fei E Jiao San is indicated. Deficiency requires tonifying the Mother; the Spleen is the Mother of the Lung, so use Gan Cao (Radix Glycyrrhizae Uralensis) to tonify the Spleen.
Bu Fei E Jiao San (Qian Yi Formula) Also known as Bu Fei San
E Jiao (1 liang 5 qian, stir-fried with bran) Shi Nian Zi (Stir-fried until fragrant) Gan Cao (Honey-fried, 2 qian 5 each) Ma Dou Ling (0.5 liang, baked) Xing Ren (7 kernels, skin and tip removed, stir-fried) Nuo Mi (1 liang, stir-fried)
Grind into powder. Take 1-2 qian per dose, decoct in 1 cup of water until reduced to 60%, take warm after meals.
[Zhang Yuansu] Xing Ren (Semen Armeniacae Amarum) primarily drains the Lung; it is not tonifying like Ren Shen (Radix Ginseng), Tian Men Dong (Rhizoma Asparagi) or Mai Men Dong (Radix Ophiopogonis). Its use should be judged according to circumstances.
[Xue Ji] The aforementioned formulas are general treatments for Lung Metal disorders. The Classic states: "In deficiency, tonify the Mother." If previous medications are ineffective, use Wu Wei Yi Gong San (Schisandra and Benefit-the-Work Powder) to tonify the Spleen.
[Zhang Yuansu] For Lung Excess, drain with Sang Bai Pi. If there are no other symptoms, Xie Bai San is indicated. In excess, drain the Child; the Kidney is the Child of the Lung, so use Ze Xie (Rhizoma Alismatis Orientales) to drain the Kidney.
Xie Bai San (Qian Yi Formula) Also known as Xie Fei San
Sang Bai Pi (Finely chopped, stir-fried until yellow) Di Gu Pi (Washed free of soil, baked. Each 1 liang) Gan Cao (Stir-fried, 0.5 liang)
Grind the above into powder. Take 1-2 qian per dose, add 1 cup of water and 100 grains of Jing Mi (Semen Oryzae Sativum), decoct together until reduced to 60%, take warm after meals.
[Zhang Yuansu] To treat Lung Heat causing bone-steaming fever and spontaneous sweating, this formula should be used to directly drain it. Using Shan Zhi (Fructus Gardeniae Jasminoidis) and Huang Qin can drain the Lung, but differentiation between Qi and Blood levels is necessary.
Gan Jie Tang (See Throat section) Da Qing Gao Qiang Huo Gao (Both see Convulsions section) Bai Bu Wan (See Cough section) Ren Shen Bai Zhu San (See Measles-Thirst section) Si Jun Zi Tang (See Miscellaneous Disease Consumption section) Shen Su Yin (Miscellaneous Disease Fever) Ren Shen Ping Fei San (Miscellaneous Disease Cough)