忌酢物。未好瘥更作。若兼服。其人或胸中寒。或直恶寒。及虚胀并痛者。加吴茱萸八两。○案此亦用芦根。
而治肺痿。可见痈痿虽虚实不同。然至热郁津枯。则一也。故附此以备考。
肺痈。胸满胀。一身面目浮肿。鼻塞清涕出。不闻香臭酸辛。咳逆上气。喘鸣迫塞。葶苈大枣泻肺汤
主之。(〔原注〕方见上。三日一剂。可至三四剂。此先服小青龙汤一剂乃进。小青龙方。见咳嗽门中。○千
金。胸下有胁字。无酸辛二字。外台。与本文同。唯胸下有胁字。千金外台。此条接于前
泻肺汤条。案方见上三字衍。自三日一剂。至乃进二十字。千金之文。而外台。引千金。
无此二十字。方后云。仲景伤寒论。范汪同。脉经。亦载此条。明是仲景旧文。今列于附方之后者。必后人编
次之误也。程氏。金鉴。揭为原文。删注三十二字。为是。沈魏尤诸家。以为附方。盖不考耳。)
〔程〕痈在肺则胸胀满。肺朝百脉。而主皮毛。肺病则一身面目浮肿也。肺开窍于鼻。肺气壅滞。则蓄
门不开。但清涕渗出。而浊脓犹塞于鼻肺之间。故不闻香臭酸辛也。以其气逆于上焦。则有喘鸣迫塞之证。
与葶苈大枣汤以泻肺。
〔鉴〕是邪外塞皮毛。内壅肺气。比之喘不得卧。殆尤甚焉。亦以
葶苈大枣泻肺汤者。因其脓未成故也。
Avoid vinegar and acidic foods. If the illness has not yet fully resolved, it may be prepared and administered again. If, upon concurrent administration, the patient experiences coldness in the chest, or severe aversion to cold, along with distension and pain due to deficiency, add *Evodiae Fructus* (Wuzhuyu) eight liang. ○ Note: This prescription also employs *Phragmitis Rhizoma* (Lugen) for the treatment of Lung Flaccidity (Fei Fei). This demonstrates that although Lung Abscess (Fei Yong) and Lung Flaccidity differ in terms of excess and deficiency, when heat pathogen stagnates and body fluids are depleted, the pathological mechanism is identical. Therefore, it is appended here for reference and verification.
Lung Abscess. Symptoms include chest fullness and distension, edema of the whole body and face, nasal congestion with clear discharge, loss of olfactory sensation (unable to perceive fragrant, foul, sour, or pungent odors), coughing with rebellious Qi, wheezing with rhonchi, and a sensation of obstruction in the airway. It is primarily treated with *Tingli Dazao Xiefei Tang* (Descurainia Seed and Jujube Decoction to Drain the Lungs). ([Original Annotation] The formula is seen above. Administer one dose every three days; up to three or four doses may be given. Here, one dose of *Xiao Qinglong Tang* (Minor Green Dragon Decoction) should be taken first before proceeding with this formula. The composition of *Xiao Qinglong Tang* can be found in the "Cough" section. ○ *Qianjin Fang*: After "under the chest," there is the character "hypochondrium"; the words "sour and pungent" are absent. *Waitai Miyao*: Same as the main text, except after "under the chest," there is the character "hypochondrium." Both *Qianjin Fang* and *Waitai Miyao* place this clause immediately after the previous clause regarding the Decoction to Drain the Lungs. Note: The three characters "formula seen above" are superfluous. The twenty characters from "one dose every three days" to "then proceed" belong to the text of *Qianjin Fang*, whereas *Waitai Miyao*, when citing *Qianjin Fang*, lacks these twenty characters. The post-prescription note states: From Zhang Zhongjing's *Shanghan Lun*, Fan Wang's work agrees. *Mai Jing* also records this clause, clearly indicating it is original text by Zhang Zhongjing. That it is now listed after the Supplementary Formulas must be an error in later compilation. Cheng Lin and *Yizong Jinjian* extracted it as original text and deleted the thirty-two characters of annotation, which is correct. Shen, Wei, You, and other scholars considered it a supplementary formula, likely due to lack of investigation.)
[Cheng Lin's Commentary] When an abscess is in the Lung, there is chest fullness and distension. The Lung receives all vessels and governs the skin and hair. When the Lung is diseased, edema occurs in the whole body and face. The Lung opens into the nose. When Lung Qi is stagnant, the orifice does not open properly; only clear mucus exudes, while turbid pus remains blocked between the nose and lungs, resulting in the inability to perceive fragrant, foul, sour, or pungent odors. Because Qi rebels upward in the Upper Jiao, symptoms such as wheezing with rhonchi and airway obstruction occur. Provide *Tingli Dazao Xiefei Tang* to drain the Lung.
[*Yizong Jinjian* Commentary] This is where pathogenic factors externally obstruct the skin and hair and internally congest Lung Qi. Compared to wheezing that prevents lying down, this condition is arguably even more severe. The reason for using *Tingli Dazao Xiefei Tang* is that the pus has not yet formed.