不效者。盖因燥粪未尝不至肛门。奈肛门如钱大。燥粪如拳大。纵使竭力努挣。而终不肯
出。下既不得出。则上不能食而告危矣。余友教人。先以胆汁或蜜煎导之。俟粪既至肛门。
令病者亲手以中指染油。探入肛门内。将燥粪渐渐挖碎而出。中指须要有指甲者为妙。
竟有大便一次。燥粪挖作百余块而出者。据云此法辗转授人。已救四五十人矣。若患此
证者。切勿嫌秽而弃之。
徐评 方案重复可厌。
某 肺气痹阻。面浮胸痞。寒热。（上焦气分壅热） 苇茎汤。
某 肺痹。卧则喘急。痛映两胁。舌色白。二便少。（肺不开降） 苇茎汤。
曹（二二） 清邪在上。必用轻清气药。如苦寒治中下。上结更闭。
兜铃 牛蒡子 桔梗 生甘草 杏仁 射干 麻黄
某 经热津消。咳痰痹痛。
桂枝 桑枝 木防己 生石膏 杏仁 苡仁 花粉
又 渴饮咳甚。大便不爽。余热壅于气分。
紫菀 通草 石膏 花粉 木防己 苡仁 杏仁
陆 偏冷偏热。肺气不和。则上焦不肃。用微苦辛以宣通。
薄荷梗 桑叶 象贝 杏仁 沙参 黑山栀
某（女） 温邪。形寒。脘痹。肺气不通。治以苦辛。
杏仁 栝蒌皮 郁金 山栀 苏梗 香豉
曹（氏） 肺痹。右肢麻。胁痛。咳逆喘急不得卧。二便不利。脘中痞胀。得之忧愁思虑。所以肺脏受病。
宜开手太阴为治。
紫菀 栝蒌皮 杏仁 山栀 郁金汁 枳壳汁
某（二七） 温邪郁肺气痹。咳嗽。寒热头痛。开上焦为主。
活水芦根（一两） 大杏仁（三钱） 连翘（一钱半） 通草（一钱半） 桑皮（一钱） 桔梗（一钱）
某（十岁） 脘中稍爽。痰粘气逆。腹膨。开肺理气为主。
枇杷叶 浓朴 杏仁 滑石 茯苓皮 通草 白蔻仁 苡仁
王 脉搏劲。舌干赤。嗳气不展。状如呃忒。缘频吐胃伤。诸经之气上逆。填胸聚脘。出入几逆。周
行脉痹。肌肉着席而痛转加。平昔辛香燥药不受。先议治肺经。以肺主一身之气化耳。
枇杷叶汁 杏仁 共煎汤。冲桔梗枳实汁。
某 天气下降则清明。地气上升则晦塞。上焦不行。下脘不通。周身气机皆阻。肺药颇投。谓肺
主一身之气化也。气舒则开胃进食。不必见病治病。印定眼目。
枇杷叶 杏仁 紫菀 苡仁 桔梗 通草
朱 风温不解。邪结在肺。鼻窍干焦。喘急腹满。声音不出。此属上痹。急病之险笃者。急急开其
闭塞。葶苈大枣合苇茎汤。
又 风温喘急。是肺痹险症。未及周岁。脏腑柔嫩。故温邪内陷易结。前用苇茎汤。两通太阴气
血颇验。仍以轻药入肺。昼夜竖抱。勿令横卧为要。用泻白散法。
桑白皮 地骨皮 苡仁 冬瓜仁 芦根汁 竹沥
某 风温化热上郁。肺气咽喉阻塞。胸脘不通。致呻吟呼吸不爽。上下交阻。逆而为厥。乃闭塞
之症。病在上焦。幼科消食发散苦降。但表里之治。上气仍阻。久延慢惊。莫可救疗。
芦根 桑叶 滑石 梨皮 苡仁 通草
李 肺象空悬。气窒声音不出。舌乃心苗。热灼则舌本不展。以唇口肺微之病。乃辛热酒毒之
痹。主以轻扬为治。乃无质之病。（湿热伤肺）
羚羊角 连翘心 竹叶心 野赤豆皮 川贝母 金银花
又 暮服威喜丸二钱。
唐 脉小涩。失血呕逆之后。脘中痞闷。纳谷 胀。小便短赤。大便七八日不通。此怒劳致气分
逆乱。从肺痹主治。（怒劳气逆）
鲜枇杷叶 土栝蒌皮 黑栀皮 郁金 杏仁 杜苏子 紫降香 钩藤
又 更衣丸。
肺为呼吸之橐 。位居最高。受脏腑上朝之清气。 清肃之体。性主乎降。又为娇脏。不耐
邪侵。凡六淫之气。一有所着。即能致病。其性恶寒恶热。恶燥恶湿。最畏火风。邪着则失其
清肃降令。遂痹塞不通爽矣。今先生立法。因于风者。则用薄荷桑叶牛蒡之属。兼寒则用
麻黄杏仁之类。若温热之邪。壅遏而痹者。则有羚羊射干。连翘山栀兜铃竹叶沙参象贝。
因湿则用通草滑石。桑皮苡仁威喜丸。因燥则梨皮芦根。枇杷叶紫菀。开气则蒌皮香豉。
苏子桔梗蔻仁。其苇茎汤。葶苈大枣汤。一切药品。总皆主乎轻浮。不用重浊气味。是所谓
微辛以开之。微苦以降之。适有合乎轻清娇脏之治也。肺主百脉。为病最多。就其配合之
脏腑而言。肺与大肠为表里又与膀胱通气化。故二便之通闭。肺实有关系焉。其他如肺
痿肺痈哮喘咳嗽失音。各自分门。兹不重赘。（华岫云）
徐评 所列诸症。不过喘咳气逆耳。另立肺痹一门。甚属无谓。内经有肺痹之名。却非此义。当
考之。
没有疗效。大概是因为燥结的粪便虽然已经到了肛门，但肛门开口仅如铜钱大小，而燥结的粪便却大如拳头。即使竭尽全力努挣，粪便终究排不出来。下部既不能排出，上部就不能进食，病情就危险了。我的朋友教导人，先用胆汁或蜜煎作为导引剂（塞入肛门以润滑肠道、刺激排便），等到粪便到达肛门时，让病人亲手用中指蘸油，探入肛门内，将燥结的粪便渐渐挖碎并排出。中指最好有指甲，这样比较方便。竟然有一次大便，将燥结的粪便挖成一百多块排出的。据他说，这个方法辗转传授给别人，已经救活四五十人了。如果患这种病证的人，千万不要因为嫌脏而放弃使用这种方法。
徐评：方案重复，令人厌烦。
某患者：肺气痹阻，面部浮肿，胸中痞闷，寒热往来。（上焦气分壅滞生热） 给予苇茎汤。
某患者：肺痹，平卧时气喘急促，疼痛牵引两胁，舌色白，大小便量少。（肺气不能开宣肃降） 给予苇茎汤。
曹某（二十二岁）：清邪在上焦，必须使用轻清的气分药。如果用苦寒药治疗中下焦，会使上焦的结滞更加闭塞。
紫菀、牛蒡子、桔梗、生甘草、杏仁、射干。
某患者：经热导致津液消耗，咳嗽痰多，痹痛。
桂枝、桑枝、木防己、生石膏、杏仁、苡仁、花粉。
又诊：口渴饮水，咳嗽严重，大便不爽。余热壅滞在气分。
紫菀、通草、石膏、花粉、木防己、苡仁、杏仁。
陆姓患者：偏冷偏热，肺气不和，导致上焦不肃降。用微苦辛味的药物来宣通。
薄荷梗、桑叶、象贝母、杏仁、沙参、黑山栀。
某患者（女）：温邪，形寒，脘部痹阻，肺气不通。治疗用苦辛法。
杏仁、栝蒌皮、郁金、山栀、苏梗、香豉。
曹氏：肺痹，右肢麻木，胁痛，咳逆喘急不能平卧，大小便不利，脘中痞胀。起因于忧愁思虑，所以肺脏受病。
宜从手太阴肺经入手治疗。
紫菀、栝蒌皮、杏仁、山栀、郁金汁、枳壳汁。
某患者（二十七岁）：温邪郁闭肺气致痹，咳嗽，寒热头痛。以开通上焦为主。
活水芦根（一两）、大杏仁（三钱）、连翘（一钱半）、通草（一钱半）、桑皮（一钱）、桔梗（一钱）。
某患者（十岁）：脘中稍感爽快，但痰粘气逆，腹部膨隆。以开肺理气为主。
枇杷叶、浓朴、杏仁、滑石、茯苓皮、通草、白蔻仁、苡仁。
王某：脉搏强劲，舌干赤，嗳气不畅，状如呃逆。因为频繁呕吐损伤胃气，诸经之气上逆，填塞胸脘，出入几乎逆乱，周身脉道痹阻，肌肉贴着席子而疼痛加重。平时不服用辛香燥药。先议治肺经，因为肺主一身的气化。
枇杷叶汁、杏仁，共煎汤，冲服桔梗枳实汁。
某患者：天气下降则清明，地气上升则晦塞。上焦不行，下脘不通，周身气机皆受阻。用肺药很合适，因为肺主一身的气化。气舒则开胃进食，不必见病治病，要印定眼目（指辨证准确）。
枇杷叶、杏仁、紫菀、苡仁、桔梗、通草。
朱姓患者：风温不解，邪气结在肺，鼻窍干焦，喘急腹满，声音不出。这属于上痹，是急病中险恶严重的，急急开通其闭塞。葶苈大枣合苇茎汤。
又诊：风温喘急，是肺痹的险症。未满周岁，脏腑柔嫩，所以温邪内陷容易结聚。前用苇茎汤，两通太阴气血颇有效验。仍以轻药入肺，昼夜竖抱，不要令横卧为关键。用泻白散法。
桑白皮、地骨皮、苡仁、冬瓜仁、芦根汁、竹沥。
某患者：风温化热上郁，肺气咽喉阻塞，胸脘不通，导致呻吟呼吸不爽，上下交阻，逆而为厥，这是闭塞之症。病在上焦，幼科（儿科）消食发散苦降，但表里之治，上气仍阻，久延慢惊，莫可救疗。
芦根、桑叶、滑石、梨皮、苡仁、通草。
李某：肺象空悬，气窒声音不出。舌乃心苗，热灼则舌本不展。以唇口肺微之病，乃是辛热酒毒之痹。主以轻扬法治疗，这是无质之病。（湿热伤肺）
羚羊角、连翘心、竹叶心、野赤豆皮、川贝母、金银花。
又诊：暮服威喜丸二钱。
唐姓患者：脉小涩，失血呕逆之后，脘中痞闷，纳谷腹胀，小便短赤，大便七八日不通。此因怒劳导致气分逆乱，从肺痹主治。（怒劳气逆）
鲜枇杷叶、土栝蒌皮、黑栀皮、郁金、杏仁、杜苏子、紫降香、钩藤。
又诊：更衣丸。
肺像空悬的袋子，位居最高，受脏腑上朝之清气，清肃之体，性主乎降。又为娇脏，不耐邪侵。凡六淫之气，一有所着，即能致病。其性恶寒恶热，恶燥恶湿，最畏火风。邪着则失其清肃降令，遂痹塞不通爽矣。现在先生立法，因于风者，则用薄荷桑叶牛蒡之属；兼寒则用麻黄杏仁之类；若温热之邪，壅遏而痹者，则有羚羊射干、连翘山栀、兜铃竹叶、沙参象贝；因湿则用通草滑石、桑皮苡仁、威喜丸；因燥则梨皮芦根、枇杷叶紫菀；开气则蒌皮香豉、苏子桔梗、蔻仁。其苇茎汤、葶苈大枣汤，一切药品，总皆主乎轻浮，不用重浊气味，是所谓微辛以开之，微苦以降之，适有合乎轻清娇脏之治也。肺主百脉，为病最多。就其配合之脏腑而言，肺与大肠为表里，又与膀胱通气化，故二便之通闭，肺实有关系焉。其他如肺痿、肺痈、哮喘、咳嗽、失音，各自分门，兹不重赘。（华岫云）
Ineffective. This is because the dry feces may indeed reach the anus, but the anal opening is only as large as a coin, while the dry feces are as large as a fist. Even if one exerts all strength to strain, the feces ultimately cannot be expelled. Since they cannot be expelled from below, food intake from above ceases, and the condition becomes critical. My friend instructs people to first use bile or honey suppositories (a method of inserting lubricating substances into the rectum to stimulate defecation) as a guide. Once the feces reach the anus, let the patient use their middle finger dipped in oil to probe into the anus, gradually breaking up the dry feces and extracting them. It is best for the middle finger to have a nail for this purpose. There have been cases where a single bowel movement resulted in over a hundred pieces of dry feces being excavated and expelled. He claims that this method has been passed on repeatedly and has already saved forty or fifty people. Those suffering from this condition must not discard this method due to disgust with filth.
Xu's Commentary: The repeated prescriptions are tedious.
A certain patient: Lung Qi obstruction (Lung Qi Obstruction), facial edema, chest fullness, alternating chills and fever. (Heat stagnation in the Upper Jiao Qi level) Weijing Decoction (Eupatorium Root Decoction).
A certain patient: Lung Bi (Lung Impediment), wheezing when lying down, pain radiating to both hypochondria, white tongue coating, scanty urination and defecation. (Failure of Lung to open and descend) Weijing Decoction (Eupatorium Root Decoction).
Cao (22 years old): Clear pathogens in the Upper Jiao require light and clear Qi-level herbs. Using bitter-cold herbs for the Middle and Lower Jiao would further close the upper constriction.
Adenophorae Radix (Zi Wan), Arctii Fructus (Niu Bang Zi), Platycodonis Radix (Jie Geng), Glycyrrhizae Radix et Rhizoma Preparata (Sheng Gan Cao), Armeniacae Semen Amarum (Xing Ren), Belamcandae Rhizoma (She Gan).
A certain patient: Heat from meridians consuming fluids, cough with phlegm, Bi pain.
Cinnamomi Ramulus (Gui Zhi), Mori Ramulus (Sang Zhi), Akebiae Caulis (Mu Fang Ji), Gypsum Fibrosum (Sheng Shi Gao), Armeniacae Semen Amarum (Xing Ren), Coicis Semen (Yi Yi Ren), Ophiopogonis Radix (Hua Fen).
Second visit: Thirst with drinking, severe cough, unsatisfactory defecation. Residual heat stagnating in the Qi level.
Adenophorae Radix (Zi Wan), Tectonae Herba (Tong Cao), Gypsum Fibrosum (Shi Gao), Ophiopogonis Radix (Hua Fen), Akebiae Caulis (Mu Fang Ji), Coicis Semen (Yi Yi Ren), Armeniacae Semen Amarum (Xing Ren).
Lu: Alternating cold and heat, Lung Qi disharmony leading to failure of Upper Jiao to purify and descend. Use slightly bitter and acrid herbs to diffuse and unblock.
Menthae Haplocalycis Caulis (Bo He Geng), Morus Folium (Sang Ye), Fritillariae Thunbergii Bulbus (Xiang Bei), Armeniacae Semen Amarum (Xing Ren), Ophiopogonis Radix (Sha Shen), Gardeniae Fructus Preparata (Hei Shan Zhi).
A certain patient (Female): Warm pathogen, aversion to cold, epigastric Bi, Lung Qi blockage. Treatment uses bitter and acrid methods.
Armeniacae Semen Amarum (Xing Ren), Benincasae Pericarpium (Gua Lou Pi), Curcumae Rhizoma (Yu Jin), Gardeniae Fructus (Shan Zhi), Perillae Caulis (Su Geng), Fermented Soybean (Xiang Chi).
Mrs. Cao: Lung Bi, right limb numbness, hypochondriac pain, cough with counterflow and wheezing unable to lie flat, difficulty in urination and defecation, epigastric fullness. Caused by sorrow and overthinking, thus the Lung organ is diseased.
Treatment should focus on the Hand-Taiyin Lung Meridian.
Adenophorae Radix (Zi Wan), Benincasae Pericarpium (Gua Lou Pi), Armeniacae Semen Amarum (Xing Ren), Gardeniae Fructus (Shan Zhi), Cyperi Tuber Juice (Yu Jin Zhi), Aurantii Fructus Immaturus Juice (Zhi Ke Zhi).
A certain patient (27 years old): Warm pathogen depressing Lung Qi causing Bi, cough, chills, fever, headache. Focus on opening the Upper Jiao.
Fresh Eupatorii Herba (1 liang), Large Armeniacae Semen Amarum (3 qian), Forsythiae Fructus (1.5 qian), Tectonae Herba (1.5 qian), Mori Cortex (1 qian), Platycodonis Radix (1 qian).
A certain patient (10 years old): Epigastrium slightly relieved, but sticky phlegm and counterflow Qi, abdominal distension. Focus on opening Lung and regulating Qi.
Loquat Leaf (Pi Pa Ye), Magnoliae Officinalis Bark (Nou Pu), Armeniacae Semen Amarum (Xing Ren), Talcum (Hua Shi), Poria Peel (Fu Ling Pi), Tectonae Herba (Tong Cao), Amomi Fructus Rotundus (Bai Kou Ren), Coicis Semen (Yi Yi Ren).
Wang: Pulse is forceful, tongue is dry and red, belching without relief, resembling hiccup. Due to frequent vomiting damaging Stomach Qi, Qi of all meridians counterflows upward, filling the chest and epigastrium, entering and exiting nearly reversed, systemic pulse Bi, muscle pain worsening when touching the mat. Previously intolerant of acrid-aromatic dry herbs. First discuss treating the Lung Meridian, as the Lung governs the Qi transformation of the whole body.
Loquat Leaf Juice (Pi Pa Ye Zhi), Armeniacae Semen Amarum (Xing Ren), decocted together, mixed with Platycodonis Radix and Aurantii Fructus Immaturus juice.
A certain patient: When Heaven Qi descends, it is clear; when Earth Qi rises, it is turbid. If Upper Jiao does not move, Lower Stomach does not unblock, and systemic Qi mechanism is obstructed. Lung herbs are very suitable because the Lung governs the Qi transformation of the whole body. When Qi relaxes, it opens the appetite for eating; there is no need to treat the disease directly, but rather to fix the diagnostic focus.
Loquat Leaf (Pi Pa Ye), Armeniacae Semen Amarum (Xing Ren), Adenophorae Radix (Zi Wan), Coicis Semen (Yi Yi Ren), Platycodonis Radix (Jie Geng), Tectonae Herba (Tong Cao).
Zhu: Wind-Warmth unresolved, pathogen結 (knots) in the Lung, nasal passages dry and scorched, wheezing with abdominal fullness, voicelessness. This belongs to Upper Bi, an acute and dangerous condition. Urgently open the blockage. Tingli Dazao Decoction combined with Weijing Decoction.
Second visit: Wind-Warmth wheezing is a dangerous Lung Bi syndrome. Under one year old, Zang-Fu organs are tender, so Warm pathogens sinking inward easily knot. Previously used Weijing Decoction, which effectively opened Taiyin Qi and Blood. Continue using light herbs entering the Lung. Hold upright day and night, do not allow lying horizontally, which is crucial. Use Xiebai San method.
Mori Cortex (Sang Bai Pi), Lycii Cortex (Di Gu Pi), Coicis Semen (Yi Yi Ren), Benincasae Semen (Dong Gua Ren), Eupatorii Herba Juice (Lu Gen Zhi), Bambusa Textilis Sap (Zhu Li).
A certain patient: Wind-Warmth transforming into heat and depressing upward, Lung Qi and throat blocked, chest and epigastrium unblocked, causing groaning and unsatisfactory respiration, upper and lower obstructed, counterflow leading to Jue (reversal cold), this is a blockage syndrome. Disease in Upper Jiao. Pediatric digestion-promoting, dispersing, and bitter-depressing methods fail because although exterior-interior treatment is applied, Upper Qi remains obstructed. Prolonged delay leads to slow convulsions, incurable.
Eupatorii Herba (Lu Gen), Morus Folium (Sang Ye), Talcum (Hua Shi), Pyri Fructus (Li Pi), Coicis Semen (Yi Yi Ren), Tectonae Herba (Tong Cao).
Li: Lung resembles a suspended empty bag, Qi obstruction causes voicelessness. Tongue is the sprout of the Heart, heat scorching makes the tongue root stiff. With minor diseases of lips, mouth, and Lung, this is actually Bi caused by acrid-hot wine toxins. Treatment prioritizes light and ascending herbs. This is a disease without substantial form. (Damp-Heat injuring Lung)
Antelope Horn (Ling Yang Jiao), Forsythiae Fructus Heart (Lian Qiao Xin), Lophatheri Herba Heart (Zhu Ye Xin), Vigna Angularis Seed Coat (Ye Chi Dou Pi), Fritillariae Cirrhosae Bulbus (Chuan Bei Mu), Lonicerae Japonicae Flos (Jin Yin Hua).
Second visit: Take Wei Xi Pill 2 qian at dusk.
Tang: Pulse small and choppy, after blood loss and vomiting/counterflow, epigastric fullness, poor appetite with bloating, short dark urine, no defecation for 7-8 days. This is Qi level reversal caused by anger and labor, treated primarily as Lung Bi. (Qi reversal from anger and labor)
Fresh Loquat Leaf (Xian Pi Pa Ye), Wild Benincasae Pericarpium (Tu Gua Lou Pi), Gardeniae Fructus Peel (Hei Zhi Pi), Curcumae Rhizoma (Yu Jin), Armeniacae Semen Amarum (Xing Ren), Perillae Seed (Du Su Zi), Dalbergiae Odoriferae Lignum (Zi Jiang Xiang), Uncariae Ramulus cum Uncis (Gou Teng).
Second visit: Geng Yi Pill.
The Lung resembles a suspended bellows, located highest, receiving clear Qi from the Zang-Fu organs ascending. Its nature is clear and pure, tending toward descent. It is also a delicate organ, intolerant of pathogenic invasion. Any of the Six Excesses (Six Pathogens), once attached, can cause disease. It dislikes cold, heat, dryness, and dampness, and fears fire and wind most. When pathogens attach, it loses its clear, pure, descending function, becoming Bi-obstructed and unsmooth. Now, the Master's prescription law: For Wind, use Mint, Mulberry Leaf, Arctii Fructus; combined with Cold, use Ephedra, Armeniacae Semen Amarum; for Warm-Heat pathogens causing stagnation and Bi, use Antelope Horn, Belamcandae Rhizoma, Forsythia, Gardenia, Chaenomeles Fructus, Lophatheri Herba, Ophiopogonis Radix, Fritillaria; for Dampness, use Tectonae Herba, Talcum, Mori Cortex, Coicis Semen, Wei Xi Pill; for Dryness, use Pyri Fructus, Eupatorii Herba, Loquat Leaf, Adenophorae Radix; to open Qi, use Benincasae Pericarpium, Fermented Soybean, Perillae Seed, Platycodonis Radix, Amomi Fructus Rotundus. Weijing Decoction, Tingli Dazao Decoction, all medicines generally emphasize lightness and floating, avoiding heavy and turbid flavors. This is what is meant by slightly acrid to open, slightly bitter to descend, fitting the treatment of the light, clear, delicate organ. The Lung governs all vessels, causing many diseases. Regarding its paired Zang-Fu, Lung and Large Intestine are interior-exterior pairs, and it communicates with Bladder for Qi transformation. Thus, the patency or closure of urination and defecation is truly related to the Lung. Others such as Lung Atrophy, Lung Abscess, Asthma, Cough, Aphonia are classified separately, not repeated here. (Hua Xiuyun)
Xu's Commentary: The listed symptoms are merely wheezing, coughing, and Qi counterflow. Establishing a separate category of Lung Bi is quite meaningless. The Nei Jing mentions Lung Bi, but it does not mean this. It should be investigated.