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The discussions on Lung Abscess (Fei Yong) and Lung Withering (Fei Wei) in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), who can illuminate them from within like holding a candle, seeing through them clearly? Please allow me to offer my humble insight and presumptuously elaborate.

The Qi of the human body is endowed by the Lung. When Lung Qi is clear and descending, the Qi of the entire body is governed and flows smoothly; when Lung Qi is obstructed and turbid, the Qi of the entire body easily becomes rebellious and attacks upward. Therefore, Lung Abscess refers to Lung Qi being obstructed and not flowing freely; Lung Withering refers to Lung Qi being withered and failing to rise. Upon observing chronic cough and Qi rebelling upward, one must first guard against these two conditions.

Lung Abscess arises from the accumulated fire of the five Zang organs and the stagnant heat in the Stomach ascending to the Lung. The Lung is scorched by this fire-heat, causing blood to coagulate. Once blood coagulates, phlegm wraps around it. This leads to frequent coughing, a dry sensation in the mouth as if crackling, hidden pain in the chest, thick turbid phlegm resembling glue, fever and aversion to cold (which are worse in the late afternoon), red face, dry nose, rough skin on the chest resembling armor scales (Ji Cuo), and a slippery, rapid, and full pulse at the Cun Kou position. This is an abscess formed by congestion in the Lung. As it grows day by day, the Lung swells, and the ribs protrude. If one can distinguish whether the syndrome belongs to the Exterior or Interior at the beginning, and vigorously employ methods to raise and release or purge downward, there will be no case that cannot be cured.

Alas, physicians only know to treat cough when they see cough. Some use Niuhuang (Calculus Bovis) and Xijiao (Rhinoceros Horn) hoping to resolve heat; some use sticky pastes or oils hoping to moisten dryness; some administer Buyin Wan (Nourish Yin Pill) in the morning, and Qingwei San (Clear Stomach Powder) at night. Countless paths, none but schemes for killing. Patients also consider themselves to suffer from consumptive disease (Shi Zhai), helpless. Only when blood transforms into pus and lung tissue rots, vomiting out the contents like emptying a bag, do they realize the nature of the disease, but it is already ten deaths without hope. Sigh, it is too late. Occasionally, those with small abscesses and strong Qi, or strong Stomach Qi and good appetite, may have pus exit not from the mouth, but flow down to the anus or pierce sideways through the hypochondrium, still surviving, but this accounts for only two or three out of ten.

The treatment principles in the *Jin Gui Yao Lue* are most exquisite, exerting effort entirely before the pus forms. Today, physicians apply treatments after pus has already formed; what benefit can there be?

Lung Withering accumulates gradually over days and months. Its cold and heat manifestations are not limited to one aspect. It generally results from Stomach fluids failing to transmit to the Lung, causing the Lung to lose nourishment, turning withered and dry, thus forming the disease. The generation of water by Lung Metal and the distribution of its essence rely entirely on the abundance of Stomach Earth fluids to supply upwards without deficiency. However, there are many ways for Stomach fluids to be secretly damaged. Physicians, being coarse and bold, fail to protect them; or patients have loose interstices (Cou Li) and induce excessive sweating without cause; or patients have deficient Middle Qi and frequent vomiting empties their reserves; or they suffer from diabetes-like thirst (Dan Cheng Xiao Zhong), drinking water yet thirst remains unquenched, with the spring drying up from within; or intestines are dry with constipation, forcing diuresis for relief, like a leaking vessel hard to replenish. These upper-supplying fluids are wasted on wrong paths. Thus, Lung fire intensifies daily, Lung heat deepens, small tubes in the Lung become obstructed daily, cough sounds become fainter, mediastinal membranes dry out, expectoration becomes difficult, panting and wheezing occur after walking a few steps, gasping continues, and phlegm finally responds. The Cun Kou pulse is rapid and deficient. The patient coughs, and instead of clear sputum, there is turbid saliva and froth in the mouth; this is the disease of Lung Withering.

The treatment methods in the *Jin Gui Yao Lue* are not unclear, but they are mixed under the category of Lung Abscess, making it difficult to grasp their profound meaning. Generally, one should plan slowly: generate Stomach fluids, moisten Lung dryness, descend rebellious Qi, open accumulated phlegm, stop turbid saliva, supplement true Qi, to unblock the small tubes of the Lung; dissipate fire-heat to restore the clarity and descending function of Qi. Even hemiplegic flaccidity and flaccidity of limbs, if treated correctly, can recover. Although Lung disease is close in the chest, concerning respiration, how can one neglect treating it?

Lung Abscess pertains to tangible Blood; blood stasis should be attacked rapidly. Lung Withering pertains to intangible Qi; Qi injury should be managed gradually. Lung Abscess is Excess; treating it with Lung Withering methods constitutes "Excess reinforcing Excess" (Shi Shi). Lung Withering is Deficiency; treating it with Lung Abscess methods constitutes "Deficiency reinforcing Deficiency" (Xu Xu). This is the general principle of syndrome differentiation and medication.