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Jiu Gan Bai Du Zhi Sheng Dan (Eminent Healer Qi Tian Shi) treats Liver Abscess (Gan Yong).
Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba) (each 3 qian), Hei Shan Zhi (Gardeniae Fructus Carbonized), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma Recens) (each 3 qian), Jin Yin Hua (Lonicerae Japonicae Flos) (10 liang, decocted with 10 bowls of water to obtain 4 bowls of juice for later use).
Use 2 bowls of Jin Yin Hua juice mixed with 2 bowls of water, decoct together and take orally; the dregs are added with another 2 bowls of water, processed as before, retaining 2 bowls of Jin Yin Hua juice, decocted to 1 bowl. Take two doses to be cured.

The Classic states: If there is a dull pain at Zhangmen acupoint (Zhangmen), it is Spleen Carbuncle (Pi Ju); if the flesh above it slightly protrudes, it is Spleen Abscess (Pi Yong). (Zhangmen acupoint, also known as the Front-Mu point of the Spleen, is located 6 cun lateral to the umbilicus and 2 cun superior.)
Wang Kentang stated: At the onset of Spleen Abscess, Zhangmen acupoint must have dull pain and slight swelling. This results from overeating raw and cold foods, combined with damp-heat or blood stasis stagnating in the Spleen Meridian. It causes abdominal distension, dryness of the throat and pharynx, and scanty, dysuric urination. It is appropriate to combine Da Huang Tang (Rhubarb Decoction) and Chi Dou Yi Ren Tang (Adzuki Bean and Coix Seed Decoction). Once abdominal distension completely subsides, Liu Jun Zi Tang (Six Gentlemen Decoction) should be used to support the Spleen qi for regulation.

The Classic states: If Zhongfu acupoint is sunken and painful, it is Lung Carbuncle (Fei Ju); if the flesh above it slightly protrudes, it is Lung Abscess (Fei Yong). (Zhongfu acupoint is located 1 cun below Yunmen acupoint, in the intercostal space of the third rib above the nipple, where the arterial pulse is palpable.)
Su Wen states: Fullness in the Liver, Kidney, and Lung meridians all indicate excess patterns, which manifest as swelling. (Wang Bing’s commentary explains: "Fullness" refers to full and solid pulse qi; "swelling" refers to carbuncles/abscesses. Lung abscess presents with wheezing and bilateral chest fullness.)
Nei Jing states: When blood heat causes tissue corruption, and Ying and Wei qi fail to circulate, pus will inevitably form. Generally, Lung sores present with cough, shortness of breath, chest fullness, and frequent expectoration of pus and blood. If this persists until the sputum resembles rice porridge, it is difficult to treat. If vomiting of pus continues without stopping, it is incurable. If vomiting of pus stops spontaneously, it will heal itself; if the pulse is short and choppy, it will recover naturally. If the pulse is floating, surging, and large, it is difficult to treat. The complexion should be white but appears red instead; this indicates Fire overcoming Metal, and all such cases are incurable. (From Quan Shu)
Qian Jin Fang states: Coughing up pus and blood with a rapid and excess pulse indicates Lung Abscess. If one coughs and immediately experiences dull chest pain, and the pulse is slippery and rapid, this is Lung Abscess.
Zhang Zhongjing stated: Lung Abscess involves expectorating pus resembling rice porridge, with dry throat and chills.
He further stated: Upper jiao qi rebellion with facial edema, shoulder breathing, and a floating, large pulse indicates an untreatable condition; if accompanied by diarrhea, the prognosis is even worse.
Question: How do we know a patient with cough and rebellious qi has Lung Abscess? Will death occur upon expectorating pus and blood? What is the pulse like? Answer: The Cun position pulse is faint and rapid. Faint indicates Wind, Rapid indicates Heat. Faint implies sweating, Rapid implies aversion to cold. Wind invades the Wei level, preventing exhalation from entering; Heat forces the Ying level, preventing inhalation from exiting. Wind damages the skin and hair, Heat damages the blood vessels. Wind lodging in the Wei level causes cough, dry mouth, wheezing, and chest fullness, dry throat without thirst, copious expectoration of turbid foam, and intermittent chills. Where Heat passes, blood coagulates and stagnates, accumulating into an abscess/pus, expectorated like rice porridge. In the initial stage, it can be saved; once pus is formed, it is fatal.
Question: Chills and fever with a slippery, rapid Cun pulse, while diet and daily activities remain normal, indicate an abscess. The doctor fails to recognize this and treats it as Cold Damage without effect. How do we know pus exists? How do we distinguish its location? Master says: If pus is in the chest, it is Lung Abscess. The pulse is rapid, with coughing up pus and blood. Assuming the pus has not yet formed, the pulse would naturally be tight. Only when the pulse is rapid does it indicate that pus has formed.
Jin Gui Yao Lue Fang Lun states: Heat in the upper jiao, due to cough, leads to Lung Flaccidity (Fei Fei). How is Lung Flaccidity acquired? Sometimes from excessive sweating, sometimes from vomiting, sometimes from Xiao Ke (wasting-thirst) with frequent urination, or from constipation treated with harsh purgatives causing severe fluid loss. Thus, the Cun Kou pulse is rapid, the person coughs, and the mouth contains turbid saliva and foam, indicating Lung Flaccidity. If the mouth is parched, coughing ensues, followed by dull chest pain, and the pulse is slippery and rapid, this is Lung Abscess, with coughing up pus and blood. A rapid and deficient pulse indicates Lung Flaccidity; a rapid and excess pulse indicates Lung Abscess.
Wang Kentang stated: For treating hemoptysis and purulent sputum resembling Lung Abscess, with bad breath, where other formulas fail, Xiao Feng San (Wind-Dispersing Powder) is suitable. (Jing Jie, Chuan Xiong, Qiang Huo, Ren Shen, Fu Ling, Fang Feng, Huo Xiang, Chan Tui each 2 qian; Hou Po, Chen Pi each 5 qian, ground into powder.) Add ash from human hair, finely ground, mix well, and take with clear rice soup to eradicate the root cause. Two doses suffice; it also treats hematemesis. (From Zhun Sheng)
He further stated: If Lung Abscess has ruptured and is exposed to Wind, it is untreatable.
Jing Yao states: Labor injury damaging Blood and Qi, leaving the Cou Li (pores/skin texture) deficient, allowing Wind pathogen to invade and accumulate internally in the Lung, causes sweating, aversion to wind, cough, shortness of breath, nasal congestion, neck stiffness, and chest/hypochondriac distension. If prolonged without healing, it becomes Lung Flaccidity.
It further states: Originating from Lung Abscess, this is caused by consuming spicy, hot, roasted foods, or drinking hot wine excessively, leading to dryness-heat injuring the Lung. Treatment should be early.
Wang Shi stated: Patients with Lung Carbuncle exhibit neck stiffness. Because the Lung channel connects to the neck, Lung injury damages the channel, causing traction that prevents turning the head. The Lung is the root of Qi, its luster manifests in the hair, and it fills the skin; thus, the skin lacks luster.
Zhang Jingyue stated: At the onset of this condition, when pathogens knot in the Lung, Jie Geng Xing Ren Jian (Platycodon and Apricot Kernel Decoction) is the primary formula. (From Quan Shu)
Qi Dezhi stated: The Lung is the canopy of the five Zang organs. Located in the chest, it governs Qi and corresponds to the skin and hair. Labor injury damages Blood and Qi, making the Cou Li deficient, allowing Wind pathogen to invade and affect the Lung internally. This causes sweating, aversion to wind, cough, shortness of breath, nasal congestion, neck stiffness, and chest/hypochondriac distension. If prolonged without healing, it becomes Lung Flaccidity.
He further stated: Symptoms of Lung Flaccidity include chronic unrelenting cough, excessive sweating, severe fluid loss, loose stools resembling rotten melon, liquid discharge like pig fat, frequent urination without thirst. Thirst indicates self-healing; desire to drink indicates impending recovery. This is because the Lung produces much saliva and foam but no pus; this is Lung Flaccidity.
He further stated: Symptoms of Lung Sores include dry mouth, wheezing, chest fullness, extreme throat dryness and thirst, slight swelling of the four limbs, coughing up pus and blood, or foul-smelling turbid foam, and dull, slight chest pain; this is Lung Carbuncle. In the initial stage, it can be saved; once pus forms, most die.
Ma Yiqing stated: The general principles for treating Lung Abscess involve first using Xiao Qing Long Tang (Minor Blue Dragon Decoction) to resolve Wind-Cold pathogens, then using Ting Li Da Zao Xie Fei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung), Jie Geng Tang (Platycodon Decoction), or Wei Jing Tang (Reed Shoot Decoction) (see Jin Gui Yao Lue), selecting based on symptoms to expel pus. This is the example for treating swollen ulcers. Finally, Nei Bu Huang Qi Tang (Internal Tonification with Astragalus Decoction) is used to tonify internal Yin. This is the example for treating ulcerated lesions.
Xue Lizhai stated: Whenever labor injury damages Blood and Qi, making the Cou Li insecure, external pathogens invade and affect the Lung internally; or excessive sexual activity depletes Kidney Water, causing Deficient Fire to flare upward; or rich wines, roasted foods, and pungent/spicy strong flavors steam the Lung; or excessive coughing/sputtering of phlegm, or excessive sweating/purging causing severe fluid loss—all can cause this disease.
He further stated: Generally, labor injury damages Blood and Qi, making the Cou Li insecure. Wind pathogen attacks the Lung; Wind and Heat struggle, accumulating and failing to disperse, inevitably causing cough. If mistakenly treated with excessive sweating or purging, fluid loss occurs again, forming this syndrome.
He further stated: This syndrome arises from Spleen Earth deficiency failing to generate Lung Metal, and Lung Metal failing to generate Kidney Water. Thus, it can be saved in the beginning, but dies mostly once pus forms. If one can tonify Spleen and Lung, nourish Kidney Water, there may be hope for survival. If one only attacks the sore, the Spleen and Stomach become more deficient, and few avoid error.
Chen Yuangong stated: Some people have pain in the chest and diaphragm, worsening with cough, and pressing increases shortness of breath. People think it is Lung Cough, but who knows it is Lung Heat generating an Abscess! The Lung is a delicate organ, unreachable by medicine and food directly, so treatment is very difficult. The method seems to require clearing Fire to save the Lung, but since medicine cannot enter the Lung directly, and the Lung is the child of the Spleen, the Spleen meridian loves medicine. Tonifying Spleen Earth allows Earth to generate Metal; calming Liver Wood prevents Metal from being controlled by Wood; clearing Heart Fire prevents Fire from punishing Metal. These three meridians benefit the Lung without harming Metal, allowing Lung Qi to be nourished. Then, using detoxifying agents to resolve Lung pathogens, what abscess would not dissipate? Quan Fei Tang (Complete Lung Decoction): Xuan Shen 3 liang, Jin Yin Hua 5 liang, Mai Dong 2 liang, Sheng Gan Cao 5 qian, Hua Fen, Fu Ling, Bai Shao each 3 qian. Decoct in water, take two doses; pain decreases and internal resolution occurs. (From Bing Jian. Note: Carbuncles and sores must be resolved internally; they should not be allowed to discharge toxins. The method of internal resolution generally involves the Heart, Liver, and Spleen meridians, with no other way to eliminate abscesses. Someone asked: Regarding the Lung and Kidney, why not treat the Kidney to eliminate the Lung abscess? Although Lung Abscess forms from Fire scorching Lung Metal fluids, it is actually due to Lung Qi deficiency. Tonifying the Kidney might stop the Lung from generating Kidney Water, but since Lung and Kidney are connected, tonifying Kidney Water might cause Lung Qi to descend, and Fire-Toxin might not dissipate quickly. It is better to treat only the three meridians, nourishing Lung Qi so it naturally transforms toxins, leaving no residue in the Kidney.)
He further stated: Some people have chest/diaphragm pain, unrelenting cough, severe pain upon expectorating phlegm, unbearable tenderness on pressure, foul smell in the throat, followed by expectoration of pus and blood. This indicates Lung Abscess is not only formed but ruptured. Unruptured ones are easy to resolve; ruptured ones are hard to treat because pus and blood cannot be completely expelled immediately. However, with proper method, it is not difficult. The reason the Lung generates an abscess is because Lung Fire does not dissipate; however, Lung Fire arises from Lung Qi deficiency. After Lung deficiency, Fire remains in the Lung; Fire excess knots the Lung into an abscess. Without tonifying deficiency to scatter Fire, how can unformed abscesses dissipate? How can formed abscesses disperse? How can ulcerated ones heal? Thus, deficiency requires tonification. But which organ to tonify? If tonifying Lung deficiency, the Lung cannot be directly tonified; only by tonifying Stomach Qi can Lung Qi flourish. Now that the abscess has ruptured with copious pus and blood, Lung Qi is especially deficient. Although Toxin-Qi remains, one must not purely purge the toxin. By employing dispersing methods within Qi tonification, the toxin transforms easily without damaging Righteous Qi. Wan Fei Yin (Complete Lung Drink): Ren Shen 1 liang, Xuan Shen, Jin Yin Hua each 2 liang, Pu Gong Ying 5 qian, Hua Fen, Jie Geng, Sheng Gan Cao each 3 qian, Huang Qin 2 qian. Decoct in water. First dose: pus increases; second dose: decreases gradually; next three doses: pain stops, pus/blood stops; six doses: fully cured. (This formula tonifies Stomach Qi, which clears Stomach Fire. Flourishing Stomach Qi ensures Lung Qi does not decline; clearing Stomach Fire ensures Lung Fire does not flourish, thus defeating toxin and generating flesh. Although all herbs can enter the Lung, not just the Stomach, 80% enter the Stomach and 20% the Lung; they are still Stomach-tonifying and Lung-benefiting herbs. Someone asked: Lung Abscess has ruptured, disease entered the interior, so lifting Lung Qi seems inappropriate. Yu Jiayan of Nanchang said: It should be guided into the Intestines, yet Mr. still uses Jie Geng to lift Lung Qi, which may not be a model. Alas! My medicines are all Stomach-treating. Once entering the Stomach, do they not go down to the Intestines? However, with stagnant Lung Qi and failed regulatory commands, using Jie Geng to clear the Lung makes Upper Qi smooth and Lower descent faster. Thus, lifting from above is precisely the rapid expulsion from below.)
He further stated: Some people suffer lung damage after chronic cough, with yellow/thin skin, hoarse voice, spontaneous/night sweats, inability to lie down, expectoration of thick/foul sputum, emaciated hair and burnt complexion. During cough, one must hold breath briefly and spit gently to relieve diaphragmatic pain; otherwise, severe pain occurs. Breath is faint. People think it is Lung Abscess, but who knows it is Lung Flaccidity generating sores! Originally incurable, but with proper treatment, survival is possible. Lung Abscess differs from Lung Flaccidity: Abscess arises from Fire-Toxin, requiring rapid treatment; Flaccidity arises from Labor Injury, requiring slow treatment. Fire-Toxin requires tonification with purging; Labor Injury requires tonification with clearing. Clearing and purging differ, but tonification is the same. Purging with tonification allows large doses; clearing with tonification requires small doses. Do not attack, do not assist; act as if present yet absent, to achieve efficacy. Yang Fei Qu Wei Tang (Nourish Lung Eliminate Flaccidity Decoction): Jin Yin Hua, Mai Dong each 3 qian, Sheng Di, Bai He each 2 qian, Zi Wan, Bai Bu each 5 fen, Sheng Gan Cao 5 qian, Kuan Dong Hua, Bei Mu, Bai Wei each 3 fen, Tian Dong 1 qian. Decoct in water, take orally. Ten doses: diaphragm pain lessens, vitality returns. Another ten doses: lighter. Another ten doses: gradually healed. Total sixty doses for complete cure. (This formula is neither cold nor hot, nourishing Lung Qi in crisis, protecting Lung Lobes from flaccidity, truly miraculous. Seeking quick results leads to sudden death; endure to preserve life, do not seek speed to deliver death.)
He further stated: Wealthy youths eating too much fried/rich food and sweet wines develop dry tongue/throat, expectorating phlegm/blood, wheezing/chest pain, inability to sleep. People think it is Lung Meridian Fire Blazing, but who knows Lung Abscess has formed! The Lung is the canopy of the five Zang organs, preferring clear Qi circulation, hating dryness-heat steaming. Current diet is spicy/hot, creating a mass of Fire in the five Zang organs. Fire flares upward, harming the Lung exclusively, unable to generate Kidney Water downward. With no source for Kidney Water, dryness intensifies, drawing resources from the Lung. Lung Metal is diseased, further exhausting deficiency and drying dryness. Moreover, other meridians press in, Fire fierce, Metal punished. Abscess in the Lung is inevitable. Treatment: amidst detoxification, add Liver-nourishing and Fire-descending measures, supplemented by Kidney-tonification. Perhaps formed ones can heal, unformed ones can dissipate. Fu Sang Qing Fei Dan (Mulberry Leaf Lung-Clearing Pill): Sang Ye 5 qian, Zi Wan 2 qian, Bei Mu, Sheng Gan Cao, Bai He, E Jiao, Ren Shen each 3 qian, Xi Jiao Xie 5 fen, Kuan Dong Hua 1 qian, Xing Ren 7 grains, Jin Yin Hua, Shu Di each 1 liang. Decoct in water, mix with Xi Jiao powder, take several doses for success. (This formula treats Lung and Kidney simultaneously, completely avoiding Fire-descending. Five Zang Fires, intensified by diet, are Deficient Fires. Thus, tonifying Water strengthens Metal Qi, extinguishing Deficient Fire. Plus, tonification with dispersion avoids static tonification, making Fire-Toxin easier to resolve.)
Zhu Danxi stated: Internal carbuncles/sores include Lung Abscess, Liver Abscess, Kidney Abscess, Intestinal Abscess, Scrotal Internal Abscess, and Subperiosteal Abscess. Only Lung Abscess requires initial exterior-resolving. I specifically highlight this here.
Chen Shigong stated: Lung Abscess is a pattern of Metal suffering Fire punishment. The Lung is the canopy of the five Zang organs, highest in position, purest in Qi, governing Qi internally, Voice centrally, Skin/Hair externally. Thus, Lung Metal peaks in Autumn, corresponding to its light/clear nature. If overcome, disease arises. Initially due to Wind-Cold invasion, unresolved, lingering in the Lung. Early signs: hair erection, aversion to wind, heavy cough, dull chest/diaphragm pain, neck stiffness preventing turning—these are true signs. Later: nasal clear discharge, coughing yellow/foul pus/phlegm, chest/hypochondriac distension, breathing difficulty, reduced appetite, surging pulse, sweating. Method: Qing Jin Gan Jie Tang (Clear Metal Sweet Platycodon Decoction) as main treatment, Mai Dong Qing Fei Yin (Ophiopogon Lung-Clearing Drink) for regulation. Also caused by Seven Emotions, hunger/fullness, labor injury damaging Spleen/Lung; or physical labor internal injury, shouting in wind, external Cold invading, unresolved, causing Lung Abscess. Pulse must be floating and slightly rapid, chest heat, coarse breathing, alternating chills/fever, cough with phlegm. General use: Jin Li Tang (Gold Carp Decoction), La Fan Wan (Beeswax Alum Pills), Tai Yi Gao (Supreme Paste), taken alternately, also effective. (From Zheng Zong)
He further stated: Rough palm skin, surging/rapid six pulses, shortness of breath, malar flush, foul pus/white blood, vomiting/regurgitation/aspiration, collapsed nose, inability to eat—all indicate untreatable conditions.
He further stated: Cool body, fine pulse, flowing pus/blood, bright sputum color, appetite returning, gradual cessation of pus/blood—no harm. Opposite indicates death.
He further stated: Chronic cough/labor injury, coughing phlegm/blood, alternating chills/fever, emaciation, spitting bloody pus, hoarse voice/sore throat, transmitting to Lung Flaccidity—a hundred deaths, one life. Treatment: Zhi Mu Fu Ling Tang (Anemarrhena and Poria Decoction) as main treatment, Ren Shen Wu Wei Tang (Ginseng and Schisandra Decoction) for regulation.
Qi Bo stated: Anyone with asthma, vomiting, coughing has Lung disease. The Lung is a Metal organ, also a delicate organ, located above the Heart, lobed like a lotus, red petals purple stem. Below the pharyngeal tube is where Lung Qi enters/exits, excluding food. Above the pharynx is the Uvula (Wei Yan), the little tongue. The Uvula covers the pharyngeal gate, allowing food/drink to enter the esophagus and pass to the Stomach. If one speaks much while eating, the Uvula fails to cover the gate, and rice/food enters the trachea, causing incessant cough. Thus, the trachea admits no object, proving medicine cannot enter directly. Treating the Lung via direct method is very difficult; turn to treating the Spleen. If Spleen Qi is nourished, Earth generates Metal, asthma/cough stops. Therefore, among the five Zang organs, except the Lung, all can be treated directly; only the Lung cannot. So how to treat Lung Carbuncles/Sores? Use Qing Jin Xiao Du Tang (Clear Metal Detoxifying Decoction). (From Mi Lu)
He further stated: Carbuncles inside the chest/abdomen arise from Fire and Pathogens. External powder applications are too distant; internal resolution is essential. However, if the carbuncle is huge and urgent, a cup of water cannot save a burning cartload of firewood. Thus, large doses of Jiu Fei Xiao Du Zhi Sheng Dan (Save Lung Detoxify Supreme Holy Pill) decocted and drunk are necessary to scatter Fire-Pathogens and eliminate carbuncles. If one relies on external skin applications or small-dose oral remedies daily, I see only death.
Zhang Zhongjing stated: Sores/ulcers arising from abundant Fire-Pathogens have not developed overnight. To eliminate Fire-Pathogens, can ordinary small medicines remove them? Thus, heavy medicines must be used in large amounts to subdue them. However, pathogen-dispersing medicines consume True Yin; heavy use leads to failure. Only Jin Yin Hua defeats toxin without damaging Qi, removes Fire while tonifying Yin. Thus, it must be the Sovereign herb. Its nature is pure and upright, like a gentleman. Just as a gentleman fights villains among the crowd to avoid disaster, one needs 10 liang or even 1 jin to succeed quickly. Relying on this single herb seems weak; other medicines must assist, each with subtle logic, not used randomly. Add Mai Dong to moisten Lung; Gui/Shao to moisten Liver; Di Yu to cool Large Intestine; Gan Cao to drain Fire; Zhi Zi to clear Heat; Yi Yi Ren to remove Dampness. The user must discern.
Feng Luzhan stated: Lung Abscess results from Labor injury to Blood/Qi, internal accumulated Heat, external Wind-Cold, chest fullness/urgency, dull pain, dry throat/mouth, occasional turbid/foul sputum. Vomiting pus like rice porridge indicates death. Pulse slippery/rapid or excess/large. Pressing right hypochondrium causes pain. Must use Fei Yong Shen Tang (Divine Decoction for Lung Abscess): unformed resolves, formed suppurates, suppurated heals. Repeatedly used, repeatedly effective. (From Jin Nang)
He further stated: Qi of the whole body relates entirely to the Lung. Lung clear, Qi moves; Lung turbid, Qi obstructs; Lung hot, Fluids do not move, muscles become rough (Jia Cuo means skin not moist/nourished). Many develop Lung Abscess. Yong (Abscess) means obstruction, formed by long-term stagnation of Lung Qi and Heat. Generally, chronic cough injures Lung, Yuan Qi gradually deficiences. Patient has alternating chills/fever, spontaneous sweating, turbid saliva/foam in mouth, or cough with red-line pus/blood, or much saliva/foam without pus. Cun Kou pulse rapid, deficient/choppy, or deficient/surging. Named Lung Flaccidity, due to Heat in Upper Jiao. If mouth parched, coughing, dull chest pain, dry throat/wheezing/thirst, slight limb swelling, hemoptysis followed by purulent sputum, chest Jia Cuo, or