论肺痈开刀 论欠伸两手不能下
天师曰∶缚治者，乃肺中生痈，必须开刀，有不可内消者。必其人不守禁忌，犯色而变者也。毒结成
于肺叶之下，吐痰即痛欲死，手按痛处，亦痛欲死。此等肺痈，必须开刀。将病患用绵丝绳缚在柱上，必
须牢紧妥当，不可使病患知，手执二寸之刀，令一人以凉水急浇其头面，乘病患惊呼之际，看定痛处，以
刀刺入一分，必有脓射出如注，乃解其缚，任其流脓流血，不可以药敷之，后以前膏药贴之。不可遽入生
肌散，三日后加之可也。此缚治之法也。问服煎药否？天师曰∶方用金银花一两，元参五钱，人参三
钱，甘草三钱，足矣。可用四剂，不必再用。肝痈不用刺。
张公曰，缚治法妙极，亦无可言。
华君曰∶同。然予尚有一症。凡人有伸欠，而两手不能下者，将人抱住，缚在柱上，又把木棒打
去，病患自然把手来遮隔，而两手自下矣。下后用当归一两，川芎五钱，红花五分，生地五钱，桃仁五
个，甘草一钱，大黄一钱，丹皮二钱，水煎服。二帖全愈。比有妇人而得此症者，亦缚在柱上，令一人
解其下衣，而彼怕羞，自然以两手下来遮隔，亦一时手下，亦以前汤与之可愈也。
论气虚多痰
天师曰∶肥治者，治肥人之病也。肥人多痰，乃气虚也。虚则气不能营运，故痰生之。则治痰焉
可仅治痰哉，必须补其气，而后带消其痰为得耳。然而气之补法，又不可纯补脾胃之土，而当兼补其命门
之火。盖火能生士，而土自生气，气足而痰自消，不治痰，正所以治痰也。方用人参三两，白术五两，
茯苓二两，薏仁五两，芡实五两，熟地八两，山茱萸四两，北五味一两，杜仲三两，肉桂二两，砂仁五钱，
益智仁一两，白芥子三两，桔红一两，各为末，蜜为丸。每日白滚水送下五钱，（〔批〕火土两培丹。）
此方之佳，全在肉桂之妙，妙在补命门心包之火。心包之火足，自能开胃以去痰；命门之火足，始能健脾
以去湿。况方中纯是补心补肾之味，肉桂于补药之中，行其地天之泰，水自归经，痰从何积。此肥人之
治法有如此。
张公曰∶妙。肥人治法，不过如此，无可再言。此乃丸
药方也，若有人不肯服丸药，当用煎方。予定一方，用人参三钱，白术五钱，茯苓三钱，熟地一两，山
茱萸四钱，肉桂一钱，砂仁一钱，益智仁一钱，半夏一钱，陈皮五分，神曲一钱，水煎服。（〔批〕补气
消痰饮。）此方治气虚而兼补肾水、肾火者也。肾中水火足，而脾胃之气自健，痰亦渐消矣。此方肥
人可常用也。
华君曰∶同。
On the Incision Treatment for Lung Abscess and on the Condition of Inability to Lower Hands During Yawning and Stretching
The Heavenly Master said: The "binding treatment" (Fu Zhi) is used for lung abscesses where incision is necessary, as some cases cannot be resolved through internal medication. This condition invariably arises from patients failing to observe dietary and lifestyle taboos, specifically engaging in sexual activity which exacerbates the illness. Toxic pathogens accumulate beneath the pulmonary lobes; expectoration causes excruciating pain, bordering on death, and palpation of the painful area also induces severe agony. Such lung abscesses require surgical incision. The patient must be bound tightly and securely to a pillar with silk ropes, without their knowledge. Holding a two-cun long knife, an assistant should rapidly pour cold water over the patient's head and face. Seizing the moment of the patient's startled cry, the surgeon identifies the precise point of pain and inserts the knife one fen deep. Pus will then gush out like a stream. The bindings are then removed, allowing pus and blood to drain freely. No topical medication should be applied initially; instead, apply the previously mentioned plaster afterward. Do not immediately apply Shengji San (Regenerate Flesh Powder); it may be added after three days. This constitutes the binding treatment method. Question: Is decoction required? Answer: The prescription consists of Jin Yin Hua (Lonicerae Japonicae Flos, Honeysuckle Flower) 1 liang, Yuan Shen (Scrophulariae Radix, Figwort Root) 5 qian, Ren Shen (Ginseng Radix, Ginseng Root) 3 qian, and Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) 3 qian. This is sufficient. Four doses may be administered; no further dosage is needed. Liver abscesses do not require puncturing.
Master Zhang said: The binding treatment is extremely ingenious, leaving little to add.
Master Hua said: I agree. However, I have another condition to discuss. When a person yawns and stretches but cannot lower their hands, one should embrace the person, bind them to a pillar, and strike their lower body with a wooden stick. The patient will naturally raise their hands to shield themselves, thereby lowering them. Afterward, administer a decoction of Dang Gui (Angelicae Sinensis Radix, Dong Quai Root) 1 liang, Chuan Xiong (Chuanxiong Rhizoma, Szechwan Lovage Rhizome) 5 qian, Hong Hua (Carthami Flos, Safflower) 5 fen, Sheng Di Huang (Rehmanniae Radix, Rehmannia Root) 5 qian, Tao Ren (Persicae Semen, Peach Kernel) 5 pieces, Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root) 1 qian, Da Huang (Rhei Radix et Rhizoma, Rhubarb Root) 1 qian, and Mu Dan Pi (Moutan Cortex, Tree Peony Bark) 2 qian. Decoct in water and take orally. Two doses result in complete recovery. Recently, a woman suffered from this condition; she was also bound to a pillar. When someone attempted to undress her lower garments, her modesty caused her to instinctively use her hands to cover herself, thus lowering them instantly. She too was cured using the aforementioned decoction.
On Phlegm Excess Due to Qi Deficiency
The Heavenly Master said: The "fatness treatment" (Fei Zhi) addresses diseases prevalent in obese individuals. Obese people tend to have excessive phlegm due to Qi deficiency. When Qi is deficient, it fails to circulate and transport effectively, leading to phlegm production. Therefore, treating phlegm cannot rely solely on resolving phlegm; one must tonify Qi and simultaneously resolve phlegm. However, the method of tonifying Qi should not focus exclusively on tonifying the Earth element of the Spleen and Stomach, but must also supplement the Fire of the Mingmen (Gate of Vitality). Since Fire generates Earth, Earth subsequently generates Qi. When Qi is sufficient, phlegm dissipates naturally. Thus, by not directly targeting phlegm, one effectively treats it. The prescription uses Ren Shen (Ginseng Radix, Ginseng Root) 3 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma, White Atractylodes Rhizome) 5 liang, Fu Ling (Poria, Poria Cocos), Yi Yi Ren (Coicis Semen, Job's Tears Seed) 5 liang, Qian Shi (Euryales Semen, Foxnut) 5 liang, Shu Di Huang (Rehmanniae Radix Praeparata, Prepared Rehmannia Root) 8 liang, Shan Zhu Yu (Corni Fructus, Dogwood Fruit) 4 liang, Bei Wu Wei Zi (Schisandrae Chinensis Fructus, Schisandra Berry) 1 liang, Du Zhong (Eucommiae Cortex, Eucommia Bark) 3 liang, Rou Gui (Cinnamomi Cortex, Cinnamon Bark) 2 liang, Sha Ren (Amomi Fructus Rotundus, Cardamom Fruit) 5 qian, Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, Alpinia Fruit) 1 liang, Bai Jie Zi (Sinapis Semen, Mustard Seed) 3 liang, and Ju Hong (Citri Reticulatae Pericarpium Rubrum, Red Tangerine Peel) 1 liang. Each ingredient is powdered, and honey is used to form pills. Take 5 qian daily with warm boiled water. (Annotation: Huo Tu Liang Pei Dan [Fire and Earth Dual Tonification Pill].) The excellence of this formula lies entirely in the efficacy of Rou Gui (Cinnamomi Cortex, Cinnamon Bark), which benefits the Fire of the Mingmen (Gate of Vitality) and Xin Bao (Pericardium). When the Fire of the Xin Bao (Pericardium) is sufficient, it naturally opens the stomach and resolves phlegm; when the Fire of the Mingmen (Gate of Vitality) is sufficient, it strengthens the Spleen to eliminate dampness. Moreover, since the formula primarily tonifies the Heart and Kidney, Rou Gui facilitates the harmonious interaction between Heaven and Earth within the context of these tonic herbs, ensuring fluids return to their proper channels, preventing phlegm accumulation. This illustrates the treatment approach for obesity.
Master Zhang said: Ingenious. The treatment for obese individuals is essentially as described, with nothing further to add. This is a pill formula. If a patient refuses pills, a decoction should be used. A prescribed formula includes: Ren Shen (Ginseng Radix, Ginseng Root) 3 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma, White Atractylodes Rhizome) 5 qian, Fu Ling (Poria, Poria Cocos) 3 qian, Shu Di Huang (Rehmanniae Radix Praeparata, Prepared Rehmannia Root) 1 liang, Shan Zhu Yu (Corni Fructus, Dogwood Fruit) 4 qian, Rou Gui (Cinnamomi Cortex, Cinnamon Bark) 1 qian, Sha Ren (Amomi Fructus Rotundus, Cardamom Fruit) 1 qian, Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, Alpinia Fruit) 1 qian, Ban Xia (Pinelliae Rhizoma, Pinellia Tuber) 1 qian, Chen Pi (Citri Reticulatae Pericarpium, Tangerine Peel) 5 fen, and Shen Qu (Medicated Leaven, Medicated Leaven) 1 qian. Decoct in water and take orally. (Annotation: Bu Qi Xiao Tan Yin [Qi-Tonifying and Phlegm-Resolving Decoction].) This formula treats Qi deficiency while simultaneously tonifying Kidney Water and Kidney Fire. When the Water and Fire within the Kidneys are sufficient, the Qi of the Spleen and Stomach becomes robust, and phlegm gradually dissipates. This formula can be commonly used by obese individuals.
Master Hua said: I agree.