1．问曰∶热在上焦者，因咳为肺痿。肺痿之病，从何得之？师曰∶或从汗出，或从呕吐，或从消渴，小便
利数，或从便难，又被快药下利，重亡津液，故得之。曰∶寸口脉数，其人咳，口中反有浊唾涎沫者何？师曰∶
为肺痿之病。若口中辟辟燥，咳即胸中隐隐痛，脉反滑数，此为肺痈，咳唾脓血。
脉数虚者为肺痿，数实者为肺痈。
2．问曰∶病咳逆，脉之何以知此为肺痈？当有脓血，吐之则死，其脉何类？师曰∶寸口脉微而数，微则为
风，数则为热；微则汗出，数则恶寒。风中于卫，呼气不入；热过于营，吸而不出。风伤皮毛，热伤血脉。风舍
于肺，其人则咳，口
干，喘满，咽燥不渴，时唾浊沫，时时振寒。热之所过，血为之凝滞，蓄结痈脓，吐如米粥。始萌可救，脓成则
死。
3．上气面浮肿，肩息，其脉浮大不治，又加利尤甚。
4．上气喘而躁者，属肺胀，欲作风水，发汗则愈。
5．肺痿吐涎沫而不咳者，其人不渴，必遗尿，
小便数。所以然者，以上虚不能制下故也。此为肺中冷，必眩、多涎唾，甘草干姜汤以温之。若服汤已渴者，属
消渴。
甘草干姜汤方
甘草（四两，炙） 干姜（二两，炮）
上 咀，以水三升，煮取一升五合，去滓，分温再服。
6．咳而上气，喉中水鸡声，射干麻黄汤主之。
射干麻黄汤方
射干（十三枚，一法三两） 麻黄（四两） 生姜（四两） 细辛 紫菀 款冬花（各三两） 五味子（半
升） 大枣（七枚） 半夏（大者洗，八枚，一法半升）
上九味，以水一斗二升，先煮麻黄两沸，去上沫，纳诸药，煮取三升，分温三服。
7.咳逆上气，时时唾浊，但坐不得眠，皂荚丸主之。
皂荚丸方
皂荚（八两，刮去皮，用酥炙）
上一味，末之，蜜丸梧子大，以枣膏和汤服三
丸，日三夜一服。
8．咳而脉浮者，浓朴麻黄汤主之。
浓朴麻黄汤方
浓朴（五两） 麻黄（四两） 石膏（如鸡子大） 杏仁（半升） 半夏（半升） 干姜（二两） 细辛（二
两） 小麦（一升） 五味子（半升）
上九味，以水一斗二升，先煮小麦熟，去滓，纳诸药煮取三升，温服一升，日三服。
9．脉沉者，泽漆汤主之。
泽漆汤方
半夏（半升） 紫参（五两，一作紫菀） 泽漆（三斤，以东流水五斗煮取一斗五升） 生姜（五两） 白
前（五两） 甘草 黄芩 人参 桂枝（各三两）
上九味， 咀，纳泽漆汁中煮取五升，温服五合，至夜尽。
10．火逆上气，咽喉不利，止逆下气者，麦门冬汤主之。
麦门冬汤方
麦门冬（七升） 半夏（一升） 人参（二两） 甘草（二两） 粳米（三合） 大枣（十二枚）
上六味，以水一斗二升，煮取六升，温服一升，
日三夜一服。
11．肺痈，喘不得卧，葶苈大枣泻肺汤主之。
葶苈大枣泻肺汤方
葶苈（熬令黄色，捣丸如弹子大） 大枣（十二枚）
上先以水三升，煮枣取二升，去枣纳葶苈，煮取一升，顿服。
12．咳而胸满，振寒脉数，咽干不渴，时出浊唾腥臭久久吐脓如米粥者，为肺痈，桔梗汤主之。
桔梗汤方（亦治血痹）
桔梗（一两） 甘草（二两）
上二味，以水三升，煮取一升，分温再服，则吐脓血也。
13．咳而上气，此为肺胀，其人喘，目如脱状，脉浮大者，越婢加半夏汤主之。
越婢加半夏汤方
麻黄（六两） 石膏（半升） 生姜（三两） 大枣（十五枚） 甘草（二两） 半夏（半升）
上六味，以水六升，先煮麻黄，去上沫，纳诸药，煮取三升，分温三服。
14．肺胀，咳而上气，烦躁而喘，脉浮者，心下有水，小青龙加石膏汤主之。
小青龙加石膏汤方（《千金》证治同，外更加胁下痛引缺盆。）
麻黄 芍药 桂枝 细辛 甘草 干姜（各三两） 五味子 半夏（各半升） 石膏（二两）
上九味，以水一斗，先煮麻黄，去上沫，纳诸药，煮取三升，强人服一升，羸者减之，日三服，小儿服四合。
附方
《外台》炙甘草汤 治肺痿涎唾多，心中温温液液者。（方见虚劳中。）
《千金》甘草汤
甘草 上一味，以水三升，煮减半，分温三服。
《千金》生姜甘草汤 治肺痿咳唾，涎沫不止，咽燥而渴。
生姜（五两） 人参（三两） 甘草（四两） 大枣（十五枚）
上五味，以水七升，煮取三升，分温三服。
《千金》桂枝去芍药加皂荚汤 治肺痿吐涎沫。
桂枝 生姜（各三两） 甘草（二两） 大枣（十枚） 皂
荚（一枚，去皮子，炙焦）
上五味，以水七升，微微火温取三升，分温三服。
《外台》桔梗白散 治咳而胸满，振寒，脉数，咽干不渴，时出浊唾腥臭，久久吐脓如米粥者，为肺痈。
桔梗 贝母（各三分） 巴豆（一分，去皮，熬研如脂）
上三味，为散，强人饮服半钱匕，羸者减之。病在膈上者，吐脓血；膈下者泻出；若下多不止，饮冷水一杯
则定。
《千金》苇茎汤 治咳有微热，烦满，胸中甲错，是为肺痈。
苇茎（二升） 薏苡仁（半升） 桃仁（五十枚） 瓜瓣（半升）
上四味，以水一斗，先煮苇茎得五升，去滓，纳诸药，煮取二升，服一升，再服，当吐如脓。
15．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。（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。）
1. Question: When heat is located in the Upper Jiao (Upper Burner), it causes coughing leading to Lung Flaccidity Syndrome (Fei Wei). How is this disease of Lung Flaccidity acquired? The Master said: It may arise from excessive sweating, or from vomiting, or from Xiao Ke (Wasting and Thirsting Syndrome) causing frequent urination, or from constipation followed by purgation with harsh medicines leading to severe loss of body fluids, thus acquiring the disease. Question: If the Cun Kou pulse is rapid, the person coughs, and there is instead turbid saliva and froth in the mouth, what is the reason? The Master said: This is a disease of Lung Flaccidity. If the mouth feels dry, coughing causes dull pain in the chest, and the pulse is instead slippery and rapid, this is Lung Abscess (Fei Yong), characterized by coughing up pus and blood. A rapid and deficient pulse indicates Lung Flaccidity; a rapid and excess pulse indicates Lung Abscess.
2. Question: In cases of coughing and rebellious Qi, how can one know from the pulse that this is Lung Abscess? There should be pus and blood; if vomited, death ensues. What does its pulse resemble? The Master said: The Cun Kou pulse is faint and rapid. Faint indicates Wind; rapid indicates Heat. Faint leads to sweating; rapid leads to aversion to cold. Wind invades the Ying-Wei (Defensive) level, so exhalation cannot penetrate inward; Heat overwhelms the Ying (Nutritive) level, so inhalation cannot be expelled outward. Wind damages the skin and hair pores; Heat damages the blood vessels. When Wind lodges in the Lung, the person coughs, has a dry mouth, wheezing and fullness, dry throat without thirst, occasionally spits turbid froth, and experiences occasional chills. Wherever Heat passes, blood coagulates and stagnates, accumulating to form an abscess and pus, which is vomited like rice porridge. In the early stage, it can be saved; once pus is formed, it is fatal.
3. Rebellious Qi with facial edema, breathing with shoulder movement (shoulder breathing), and a floating and large pulse are difficult to treat. If diarrhea also occurs, the condition is even more severe.
4. Rebellious Qi with wheezing and restlessness belongs to Lung Distension (Fei Zhang), which desires to develop into Feng Shui (Wind Water edema); inducing sweating will lead to recovery.
5. In Lung Flaccidity, if the patient spits saliva and froth but does not cough, and is not thirsty, they must experience urinary incontinence and frequent urination. The reason for this is that deficiency-cold in the Upper Jiao fails to control the Lower Jiao. This is Cold in the Lung, inevitably accompanied by dizziness and abundant saliva and froth; Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction) should be used to warm it. If after taking the decoction the patient becomes thirsty, it belongs to Xiao Ke (Wasting and Thirsting Syndrome).
Gan Cao Gan Jiang Tang Formula
Gan Cao (Four liang, honey-fried) Gan Jiang (Two liang, processed)
Crush the above two ingredients, add three sheng of water, boil to obtain one sheng five he, remove the dregs, and divide into two doses for warm administration.
6. For coughing with rebellious Qi and a sound in the throat resembling a water frog, She Ye Ma Huang Tang (Belamcanda and Ephedra Decoction) is the primary treatment.
She Ye Ma Huang Tang Formula
She Ye (Thirteen pieces, alternatively three liang) Ma Huang (Four liang) Sheng Jiang (Four liang) Xi Xin Zi Wu Wan Kuan Dong Hua (each three liang) Wu Wei Zi (Half sheng) Da Zao (Seven pieces) Ban Xia (Eight large pieces, washed, alternatively half sheng)
Take the above nine ingredients, add twelve sheng of water, first boil Ma Huang for two boils, remove the foam on top, add the remaining herbs, boil to obtain three sheng, and divide into three doses for warm administration.
7. For coughing and rebellious Qi, frequent spitting of turbid sputum, and inability to lie down due to discomfort, Zao Ying Wan (Soap Fruit Pill) is the primary treatment.
Zao Ying Wan Formula
Zao Ying (Eight liang, scraped of skin, roasted with su oil)
Pulverize the above single ingredient, mix with honey to make pills the size of wu zi (Chinese quince seeds), and take three pills at a time mixed with jujube paste and water. Take three times during the day and once at night.
8. For coughing with a floating pulse, Nong Po Ma Huang Tang (Magnolia Bark and Ephedra Decoction) is the primary treatment.
Nong Po Ma Huang Tang Formula
Nong Po (Five liang) Ma Huang (Four liang) Shi Gao (Size of a chicken egg) Xing Ren (Half sheng) Ban Xia (Half sheng) Gan Jiang (Two liang) Xi Xin (Two liang) Xiao Mai (One sheng) Wu Wei Zi (Half sheng)
Take the above nine ingredients, add twelve sheng of water, first boil Xiao Mai until cooked, remove the dregs, add the other herbs, boil to obtain three sheng, take one sheng warm, three times a day.
9. For a sinking pulse, Ze Qi Tang (Phytolacca Root Decoction) is the primary treatment.
Ze Qi Tang Formula
Ban Xia (Half sheng) Zi Shen (Five liang, alternatively Zi Wan) Ze Qi (Three jin, boiled with five dou of east-flowing water to obtain one dou five sheng) Sheng Jiang (Five liang) Bai Qian (Five liang) Gan Cao Huang Qin Ren Shen Gui Zhi (each three liang)
Crush the above nine ingredients, add them to the Ze Qi juice, boil to obtain five sheng, take five he warm, finishing by nightfall.
10. For fire-pathology causing rebellious Qi and unfavorable sensation in the throat, aiming to stop rebellion and descend Qi, Mai Men Dong Tang (Ophiopogon Decoction) is the primary treatment.
Mai Men Dong Tang Formula
Mai Men Dong (Seven sheng) Ban Xia (One sheng) Ren Shen (Two liang) Gan Cao (Two liang) Jing Mi (Three he) Da Zao (Twelve pieces)
Take the above six ingredients, add twelve sheng of water, boil to obtain six sheng, take one sheng warm, three times during the day and once at night.
11. For Lung Abscess with wheezing and inability to lie flat, Ting Li Da Zao Xie Fei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung) is the primary treatment.
Ting Li Da Zao Xie Fei Tang Formula
Ting Li (Stir-fried until yellow, pounded into pills the size of a bullet) Da Zao (Twelve pieces)
First, boil the jujubes in three sheng of water to obtain two sheng, remove the jujubes, add Ting Li, boil to obtain one sheng, and take all at once.
12. For coughing with chest fullness, chills, rapid pulse, dry throat without thirst, occasional expulsion of foul-smelling turbid sputum, and long-term expectoration of pus like rice porridge, this is Lung Abscess; Jie Geng Tang (Platycodon Decoction) is the primary treatment.
Jie Geng Tang Formula (Also treats Blood Bi)
Jie Geng (One liang) Gan Cao (Two liang)
Take the above two ingredients, add three sheng of water, boil to obtain one sheng, divide into two doses for warm administration, then pus and blood will be vomited.
13. For coughing with rebellious Qi, this is Lung Distension. If the person wheezes, eyes protrude as if about to fall out, and the pulse is floating and large, Yue Bi Jia Ban Xia Tang (Yuebi Decoction plus Pinellia) is the primary treatment.
Yue Bi Jia Ban Xia Tang Formula
Ma Huang (Six liang) Shi Gao (Half sheng) Sheng Jiang (Three liang) Da Zao (Fifteen pieces) Gan Cao (Two liang) Ban Xia (Half sheng)
Take the above six ingredients, add six sheng of water, first boil Ma Huang, remove the foam on top, add the other herbs, boil to obtain three sheng, divide into three doses for warm administration.
14. For Lung Distension with coughing and rebellious Qi, irritability and wheezing, and a floating pulse, indicating water retention below the heart, Xiao Qing Long Jia Shi Gao Tang (Minor Blue Green Dragon Decoction plus Gypsum) is the primary treatment.
Xiao Qing Long Jia Shi Gao Tang Formula (Symptoms and treatment same as in Qian Jin Fang, additionally including pain under the ribs radiating to the clavicle.)
Ma Huang Shao Yao Gui Zhi Xi Xin Gan Cao Gan Jiang (each three liang) Wu Wei Zi Ban Xia (each half sheng) Shi Gao (Two liang)
Take the above nine ingredients, add one dou of water, first boil Ma Huang, remove the foam on top, add the other herbs, boil to obtain three sheng. Strong persons take one sheng, weak persons reduce the dose, three times a day. Children take four he.
Attached Formulas
Wai Tai Mi Yao Zhi Gan Cao Tang (Honey-Fried Licorice Decoction from Wai Tai Mi Yao) Treats Lung Flaccidity with abundant saliva and froth, and a feeling of warmth and fluidity in the heart. (Formula seen in Xu Lao chapter.)
Qian Jin Fang Gan Cao Tang (Licorice Decoction from Qian Jin Fang)
Gan Cao Take the above single ingredient, add three sheng of water, boil to half, divide into three doses for warm administration.
Qian Jin Fang Sheng Jiang Gan Cao Tang (Ginger and Licorice Decoction from Qian Jin Fang) Treats Lung Flaccidity with coughing and spitting, incessant saliva and froth, dry throat and thirst.
Sheng Jiang (Five liang) Ren Shen (Three liang) Gan Cao (Four liang) Da Zao (Fifteen pieces)
Take the above five ingredients, add seven sheng of water, boil to obtain three sheng, divide into three doses for warm administration.
Qian Jin Fang Gui Zhi Qu Shao Yao Jia Zao Ying Tang (Cinnamon Twig Decoction minus Peony plus Soap Fruit from Qian Jin Fang) Treats Lung Flaccidity with spitting of saliva and froth.
Gui Zhi Sheng Jiang (each three liang) Gan Cao (Two liang) Da Zao (Ten pieces) Zao Ying (One piece, skin and seeds removed, roasted until charred)
Take the above five ingredients, add seven sheng of water, warm slowly over low fire to obtain three sheng, divide into three doses for warm administration.
Wai Tai Mi Yao Jie Geng Bai San (Platycodon and White Powder from Wai Tai Mi Yao) Treats coughing with chest fullness, chills, rapid pulse, dry throat without thirst, occasional expulsion of foul-smelling turbid sputum, and long-term expectoration of pus like rice porridge, indicating Lung Abscess.
Jie Geng Bei Mu (each three fen) Ba Dou (One fen, skin removed, roasted and ground into fat-like consistency)
Grind the above three ingredients into powder. Strong persons drink half a qian bi (coin measure), weak persons reduce the dose. If the disease is above the diaphragm, pus and blood are vomited; if below the diaphragm, it is purged. If purging is excessive and uncontrolled, drinking one cup of cold water will stop it.
Qian Jin Fang Wei Jing Tang (Reed Shoot Decoction from Qian Jin Fang) Treats cough with slight fever, irritability and fullness, rough skin in the chest, indicating Lung Abscess.
Wei Jing (Two sheng) Yi Yi Ren (Half sheng) Tao Ren (Fifty pieces) Gua Ban (Half sheng)
Take the above four ingredients, add one dou of water, first boil Wei Jing to obtain five sheng, remove dregs, add other herbs, boil to obtain two sheng. Take one sheng, then take again; pus-like material should be vomited.
15. For Lung Abscess with chest fullness and distension, edema of the whole body and face, nasal congestion with clear discharge, loss of smell for fragrant, foul, sour, or pungent odors, coughing and rebellious Qi, wheezing and noisy breathing with obstruction, Ting Li Da Zao Xie Fei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung) is the primary treatment. (Formula seen above. One dose every three days, can be taken up to three or four doses. First take one dose of Xiao Qing Long Tang before proceeding; Xiao Qing Long formula seen in Cough chapter.)