脉∶寸口脉数而实者,肺痈也。若脉微紧而数者,未有脓也;若紧甚而数者,已有脓也。又脉短而涩者,
自痊;浮大者难治。
肺痈之候,口干喘满、咽燥而渴,甚则四肢浮肿、咳唾脓血,或腥臭浊味,胸中隐隐而微痛者,肺痈也。
大凡肺痈当咳嗽短气、胸满时唾脓血,久久如粳米粥者,难治。若呕脓而不止者,亦不可治也,其呕而脓自止者
,自愈。其面色当白而反赤者,此火克金,不可治也。
肺痈者,咳唾有脓血也。
桔梗汤 治肺痈咳唾脓血、咽喉多渴、大小便不利。
桔梗 贝母 当归 栝蒌仁 桑白皮 防风 杏仁(去皮尖) 百合 黄 (蜜炒) 枳壳(麸炒) 薏苡
仁甘草(各等分)
上锉剂,生姜煎,食后服。大便闭加大黄;小便闭加木通,喘急加葶苈;口燥加片芩;一方加玄参、地骨皮。
治肺痈方 用薏苡仁略炒为末,糯米饮调服;或入粥煮
吃亦可;或水煎服。当下脓血自安。
焊肺丹 凡治肺痈,必以此药间而服之,以护膈膜不致溃透心肺,最为切当。即蜡矾丸,用蜜水送下。
(方见痈疽。)
一男子,咳吐痰脓,胸腹膨胀,两寸及右关脉皆洪数,此火不能生土,而土不能生金也。用桔梗汤为主,
佐以补中益气汤而愈。(方见补益。)
脉∶寸口脉数而虚,肺痿也。
肺痿之候,久嗽不已,汗出过度,重亡津液,便如烂瓜,下如豕脂,小便数而不渴。渴者自愈,欲饮水者
欲瘥,此由肺。多唾涎沫而无脓血者,肺痿也。有汗出恶风、咳嗽短气、鼻塞项强、胸胀胁满,久而不瘥,已
成肺痿也。
肺痿者,久嗽不已,无脓血也。
薏苡散 治肺痿咳嗽,其症辟辟燥咳,胸隐隐而痛,肺弱无力。
当归 白芍(酒炒) 黄芩 人参(去芦) 五味子 黄 (蜜炙) 麦门冬(去心) 桑白皮 百部
薏苡仁(各等分)
上锉一剂,生姜三片,水煎服。
胸前有孔,常出血水者,谓之心漏也。
鹿子丸 治胸前有孔,兼治腰痛。
嫩鹿茸(去毛,酥炙微黄) 大附子(泡去皮脐) 盐花(各等分)
上为末,枣肉为丸。每服三十丸,空心好酒送下。
脉象:寸口脉数而实的,是肺痈。如果脉微紧且数,说明还没有成脓;如果脉紧得很且数,说明已经成脓了。另外,脉短而涩的,会自愈;脉浮大的,难治。
肺痈的症状,表现为口干、气喘胸满、咽喉干燥而渴,严重时四肢浮肿、咳嗽吐脓血,或者痰液有腥臭浊味,胸部隐隐作痛且轻微疼痛的,就是肺痈。
大凡肺痈应当出现咳嗽、气短、胸部胀满、时常吐出脓血,时间久了像粳米粥一样的,难治。如果呕吐脓血不止的,也不可治;如果呕吐后脓血自止的,会自愈。其面色应当白却反而发赤的,这是火克金(心火克制肺金),不可治。
桔梗汤 治疗肺痈咳嗽吐脓血、咽喉多渴、大小便不利。
桔梗 贝母 当归 栝蒌仁 桑白皮 防风 杏仁(去皮尖) 百合 黄芪(蜜炒) 枳壳(麸炒) 薏苡仁 甘草(各等分)
以上药材切碎为一剂,用生姜煎煮,饭后服用。大便闭塞加大黄;小便闭塞加木通,喘急加葶苈子;口燥加黄芩;另一版本加玄参、地骨皮。
治疗肺痈方 用薏苡仁略炒为粉末,用糯米饮调服;或者放入粥中煮熟吃也可以;或者用水煎服。当下出脓血后自然安宁。
焊肺丹 凡是治疗肺痈,必须间隔服用此药,以保护膈膜不致使心肺溃破穿透,最为恰当。即蜡矾丸,用蜜水送下。
(方剂见痈疽章节。)
有一个男子,咳嗽吐痰脓,胸腹膨胀,两手寸口及右关脉都洪大数急,这是火不能生土,而土不能生金。用桔梗汤为主,佐以补中益气汤而痊愈。(方剂见补益章节。)
肺痿的症状,久咳不愈,出汗过度,严重耗伤津液,大便像烂瓜一样,下身排出如猪脂般的物质,小便频数但不口渴。口渴的会自愈,想喝水的病情将好转,这由肺引起。多唾涎沫而没有脓血的,是肺痿。有汗出恶风、咳嗽气短、鼻塞项强、胸胀胁满,时间久了不愈,已成肺痿。
肺痿,就是久咳不愈,没有脓血。
薏苡散 治疗肺痿咳嗽,症状为辟辟作响的燥咳,胸部隐隐作痛,肺气虚弱无力。
当归 白芍(酒炒) 黄芩 人参(去芦头) 五味子 黄芪(蜜炙) 麦门冬(去心) 桑白皮 百部 薏苡仁(各等分)
以上药材切碎为一剂,加生姜三片,水煎服。
鹿子丸 治疗胸前有孔,兼治腰痛。
嫩鹿茸(去毛,用酥炙至微黄) 大附子(泡过,去皮脐) 盐花(各等分)
以上研为粉末,用枣肉做丸。每次服用三十丸,空腹时用好酒送下。
Pulse: A rapid and full pulse at the Cun Kou (Radial Pulse) indicates Lung Abscess (Fei Yong). If the pulse is slightly tight and rapid, pus has not yet formed; if the pulse is very tight and rapid, pus has already formed. Additionally, a short and choppy pulse indicates spontaneous recovery; a floating and large pulse indicates difficult treatment.
Symptoms of Lung Abscess include dry mouth, panting and chest fullness, dry throat with thirst, and in severe cases, edema of the four limbs, coughing up purulent blood, or sputum with a foul, turbid odor, along with dull, slight pain in the chest. This is Lung Abscess.
Generally, Lung Abscess presents with cough, shortness of breath, chest fullness, and frequent expectoration of purulent blood. If it persists for a long time resembling rice gruel porridge, it is difficult to treat. If vomiting of pus continues without stopping, it is untreatable; however, if vomiting ceases spontaneously after pus expulsion, it will heal itself. If the complexion should be white but appears red instead, this represents Fire overcoming Metal (Heart Fire overacting on Lung Metal), which is untreatable.
Lung Abscess refers to coughing up purulent blood.
Jiegeng Tang (Platycodon Decoction) treats Lung Abscess with coughing up purulent blood, excessive thirst in the throat, and difficulty in urination and defecation.
Jie Geng (Platycodonis Radix), Bei Mu (Fritillariae Bulbus), Dang Gui (Angelicae Sinensis Radix), Gua Lou Ren (Trichosanthis Semen), Sang Bai Pi (Mori Cortex), Fang Feng (Saposhnikoviae Radix), Xing Ren (Armeniacae Semen Amarum, peeled and tip removed), Bai He (Lilii Bulbus), Huang Qi (Astragali Radix, honey-fried), Zhi Ke (Aurantii Fructus, bran-fried), Yi Yi Ren (Coicis Semen), Gan Cao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Crush these into one dose, decoct with fresh ginger, and take after meals. For constipation, add Da Huang (Rhei Radix et Rhizoma); for urinary retention, add Mu Tong (Akebiae Caulis); for wheezing and urgency, add Ting Li Zi (Lepidii Semen); for dry mouth, add Huang Qin (Scutellariae Radix); another formula adds Xuan Shen (Scrophulariae Radix) and Di Gu Pi (Lycii Cortex).
Formula for treating Lung Abscess: Use Yi Yi Ren (Coicis Semen) lightly roasted and powdered, taken mixed with Rice Gruel Drink (Nuomi Yin); or cooked in congee; or decocted in water. Once purulent blood is discharged, peace will return.
Han Fei Dan (Lung-Sealing Pill): Whenever treating Lung Abscess, this medicine must be administered intermittently to protect the diaphragm membrane from perforating into the heart and lungs, which is most appropriate. It is the same as La Fan Wan (Beeswax and Alum Pill), taken down with honey water.
(See the section on Carbuncles and Ulcers.)
A male patient coughed up phlegm and pus, with abdominal distension. Both Cun positions and the Right Guan position had surging and rapid pulses. This indicated that Fire could not generate Earth, and Earth could not generate Metal. Using Jiegeng Tang as the principal formula, supplemented by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), he recovered.
(See the section on Tonification.)
Pulse: A rapid and deficient pulse at the Cun Kou indicates Lung Flaccidity (Fei Wei).
Symptoms of Lung Flaccidity include persistent cough, excessive sweating, severe depletion of body fluids, stools resembling rotten melon, discharge resembling pig fat, frequent urination without thirst. Thirst indicates spontaneous recovery; desire to drink water indicates impending cure. This originates from the Lung. Excessive salivation and froth without purulent blood indicate Lung Flaccidity. Symptoms include sweating with aversion to wind, cough and shortness of breath, nasal congestion and stiff neck, chest distension and hypochondriac fullness. If these persist for a long time without improvement, Lung Flaccidity has formed.
Lung Flaccidity refers to persistent cough without purulent blood.
Yiyi San (Coix Powder) treats Lung Flaccidity with cough, characterized by dry coughing with a barking sound, dull chest pain, and weak lung qi.
Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba, wine-fried), Huang Qin (Scutellariae Radix), Ren Shen (Ginseng Radix, radix removed), Wu Wei Zi (Schisandrae Fructus), Huang Qi (Astragali Radix, honey-roasted), Mai Men Dong (Ophiopogonis Tuber, core removed), Sang Bai Pi (Mori Cortex), Bai Bu (Stemonae Radix), Yi Yi Ren (Coicis Semen) (equal parts).
Crush these into one dose, add three slices of fresh ginger, decoct in water, and take.
If there is a hole in the chest emitting blood and fluid constantly, it is called Heart Fistula (Xin Lou).
Luzi Wan (Deer Cub Pill) treats holes in the chest and also lumbar pain.
Nen Lu Rong (Cervi Cornu Pantotrichum, hair removed, fried with butter until slightly yellow), Da Fu Zi (Aconiti Lateralis Radix Praeparata, soaked, skin and umbilicus removed), Yan Hua (Sal Crystallisatum) (equal parts).
Grind into powder, form pills with jujube flesh. Take thirty pills each time, swallowed with good wine on an empty stomach.