〔钱〕肺主喘。实则闷乱喘促，有饮水者，有不饮水者。虚则哽气，长出气。
肺病闷乱，哽气长出气，气短喘急。肺热，手掐眉目鼻面，甘桔汤主之。肺盛，
复有风冷，胸满短气，气急喘嗽上气，当先散肺，后发散风冷。散肺，泻白散、大
青膏主之，肺只伤寒，则不胸满。肺虚热，唇深红色，治之散肺虚热，少服泻白
散。肺脏怯，唇白色，当补肺阿胶散主之，若闷乱气粗，喘促哽气者难治，肺虚
损故也。脾肺病久则虚而唇白，脾者肺之母也，母子皆虚，不能相营，故名曰怯。
肺主唇白而泽者吉，白如枯骨者死。（此以唇诊肺之法也，唇白色者肺脏怯也，阿胶散主之，若手寻衣领及
乱捻物者，肝热也，宜泻青丸，手掐眉目鼻面者，肺热也，宜甘桔汤之类是也。） 肺病见春，金旺，肺胜肝也，
当泻肺，轻者肺病退，重者目淡青，必发惊，更有赤者，当搐。（海藏云∶为肝怯，故目淡青
也。）〔洁〕肺主燥，自病则喘嗽，燥则润之。实则喘而气盛，泻白散主之。虚则
喘而少气，先益黄散，后阿胶散主之。心乘肺，贼邪，热而喘嗽，先地黄丸，中
导赤散，后阿胶散主之。肝乘肺，微邪，恶风眩冒昏愦嗽，羌活膏主之。肾乘
肺，实邪，憎寒嗽清利，百部丸主之。脾乘肺，虚邪，体重吐痰泄泻嗽，人参白
术散主之。〔刘〕凡肺之得病，必先观心脾二脏之虚实，若心火烁金，即当先抑心
气，后吃肺药。若心气和，即便看脾脉，若脾气虚冷，即不能相生，而肺家生气不
足，则风邪易感，故患肺寒者，皆脾虚得之。若脾气盛实，则亦痞隔中焦，而大肠
与肺表里不能相通，夫中焦热隔，则肺与大肠不通，其热毒之气，必上蒸于肺而生
痰，故患肺热者，多脾实得之。心气盛者泻之，脾气虚者益之，脾气实者通之，然
后随其肺之寒热以治之，故有抑心气、益脾气、通肺气、三药。若诊其脉气心、脾、
两脏俱和，而肺自生疾，则但察肺家虚实而治之。〔薛〕肺经郁热，用泻白散。肺
气自虚、用四君子汤。外邪所乘，用参苏饮。心火炎燥，用人参平肺散。中焦实痞、
用大承气汤。脾不能生肺，用异功散。夫肺气盛者，肺中之邪气盛也，其脉右寸必
浮而有力，宜用泻白散以泻之。若肺虚而有热者，执肺热还伤肺之说而不用人参，
则误矣，仍参其证治之。
〔海〕肺苦气上逆，急食苦以泻之，诃子皮。一作黄芩。肺欲收，急食酸以收
之，白芍药。以酸补之，五味子。以辛泻之，桑白皮。肺虚，以五味子补之，
如无他证，钱氏补肺阿胶散主之，虚则补其母，脾乃肺之母，以甘草补脾。
阿胶散（钱氏） 又名补肺散
阿胶（一两半，麸炒） 黍粘子（炒香） 甘草（炙，各二钱半） 马兜铃（半两，焙） 杏仁（七个，去皮尖，
炒） 糯米（一两，炒）
上为末。每服一二钱，水一盏，煎至六分，食后温服。
〔海〕杏仁，本泻肺，非若人参、天门冬、麦门冬之补也，当以意消息之。
〔薛〕前方乃通治肺金之剂，经云∶虚则补其母，若前药未应，当用五味异功散以补脾。
〔海〕肺实，以桑白皮泻之，如无他证，以泻白散主之，实则泻其子，肾乃肺之
子，以泽泻泻肾。
泻白散（钱氏） 又名泻肺散
桑白皮（细锉，炒黄） 地骨皮（洗去土，焙。各一两） 甘草（炒，半两）
上件为末。每服一二钱，水一中盏，入粳米百粒，同煎至六分，食后温服。
〔海〕治肺热骨蒸自汗，宜用此直泻之。用山栀、黄芩方能泻肺，但当以气血分之。
甘桔汤（方见咽喉） 大青膏 羌活膏（俱见惊搐） 百部丸（方见咳嗽） 人参白术散（方
见痘渴） 四君子
汤（方见杂病虚劳） 参苏饮（杂病发热） 人参平肺散（杂病咳嗽）
【钱乙】肺主司喘息。实证表现为胸闷烦乱、呼吸急促，有的患者想喝水，有的不想喝水。虚证表现为咽喉间发出哽噎之声，喜欢长出气。
肺病出现胸闷烦乱、咽喉哽噎、喜欢长叹气、气短且呼吸急促。肺有热邪，患儿会用手抓挠眉毛、眼睛、鼻子和面部，治疗以甘桔汤为主方。肺气盛实，又感受风冷之邪，出现胸中胀满、气短、呼吸急促、咳嗽气喘、气逆上冲等症状，应当先疏散肺经邪气，再发散风冷。疏散肺经邪气，可用泻白散或大青膏主治；若肺仅受伤寒侵袭，则不会出现胸中胀满的症状。肺脏虚而有热，嘴唇呈深红色，治疗应疏散肺虚之热，少量服用泻白散。肺脏怯弱（功能低下），嘴唇发白，应当用补肺阿胶散主治；如果出现胸闷烦乱、气息粗重、喘促伴咽喉哽噎声的情况，则难以治疗，这是因为肺脏虚损的缘故。脾肺疾病日久则导致虚证而嘴唇发白，脾是肺的母脏，母子两脏皆虚，不能相互滋养，所以名叫“怯”。肺病见嘴唇白色而有光泽为吉兆，若白如枯骨则为死证。（这是通过观察嘴唇来诊断肺病的方法：嘴唇白色者属肺脏怯弱，用阿胶散主治；如果手去摸索衣领并胡乱捻弄物品，属于肝热，宜用泻青丸；手抓挠眉目鼻面者，属于肺热，宜用甘桔汤之类。）肺病出现在春季，金气旺盛，肺胜肝木，应当泻肺，轻症肺病可退，重症者眼睛淡青色，必定会发生惊风，如果有赤色表现，应当使用搐鼻法通窍。（张元素云：因为肝气怯弱，所以眼睛呈淡青色。）
【李杲】肺主燥，自病则出现喘咳，燥邪当用滋润之法。实证表现为喘促且气盛，用泻白散主治。虚证表现为喘促且少气，先用益黄散，后用阿胶散主治。心火乘袭肺脏，为贼邪，表现为发热而喘咳，先用地黄丸，中间用导赤散，后用阿胶散主治。肝木乘袭肺金，为微邪，表现为恶风、眩晕昏冒、咳嗽，用羌活膏主治。肾水乘袭肺金，为实邪，表现为憎寒、咳嗽清利，用百部丸主治。脾土乘袭肺金，为虚邪，表现为身体沉重、呕吐痰涎、泄泻、咳嗽，用人参白术散主治。
【刘完素】凡是肺脏得病，必须先观察心、脾二脏的虚实情况。如果心火灼伤肺金，就应当先抑制心气，然后再服用治肺的药物。如果心气调和，便接着看脾脉，如果脾气虚冷，就不能相生，导致肺中生气不足，那么风邪就容易入侵，所以患肺寒病的，都是因脾虚所致。如果脾气盛实，也会痞塞中焦，导致大肠与肺这一表里关系不能相通。如果中焦被热邪阻隔，则肺与大肠不通，其热毒之气必然向上蒸腾于肺而生痰，所以患肺热病的，多因脾实所致。心气盛的予以泻除，脾气虚的予以补益，脾气实的予以通导，然后根据其肺部的寒热情况进行治疗，所以有抑心气、益脾气、通肺气这三类药物。如果诊察脉象发现心、脾两脏都调和，而肺脏自己产生疾病，那么就只考察肺脏的虚实并进行治疗。
【薛己】肺经郁热，用泻白散。肺气自虚，用四君子汤。外邪所乘，用参苏饮。心火炎燥，用人参平肺散。中焦实痞，用大承气汤。脾不能生肺，用异功散。所谓肺气盛，是指肺中的邪气盛，其脉象右寸必浮而有力，宜用泻白散以泻之。如果肺虚而有热，拘泥于“肺热还伤肺”的说法而不使用人参，那就错了，仍应根据证候进行治疗。
【张元素】肺苦气上逆，急食苦味以泻之，如诃子皮。（一作黄芩）。肺欲收敛，急食酸味以收之，如白芍药。以酸味补之，如五味子。以辛味泻之，如桑白皮。肺虚，用五味子补之，如果没有其他证候，钱乙的补肺阿胶散主治；虚则补其母，脾乃肺之母，用甘草补脾。
补肺阿胶散（钱乙方） 又名补肺散
阿胶（一两半，麸炒） 黍粘子（炒香） 甘草（炙，各二钱半） 马兜铃（半两，焙） 杏仁（七个，去皮尖，炒） 糯米（一两，炒）
以上研为末。每次服用一二钱，用水一盏，煎至六分，饭后温服。
【张元素】杏仁，本是泻肺的药，不像人参、天门冬、麦门冬那样是补药，应当根据具体情况斟酌使用。
【薛己】前方乃是通治肺金疾病的方剂，《内经》说：虚则补其母，如果前面的药无效，应当用五味异功散来补脾。
【张元素】肺实，用桑白皮泻之，如果没有其他证候，以泻白散主治；实则泻其子，肾乃肺之子，用泽泻泻肾。
泻白散（钱乙方） 又名泻肺散
桑白皮（细锉，炒黄） 地骨皮（洗去土，焙。各一两） 甘草（炒，半两）
以上研为末。每次服用一二钱，用水一中盏，加入粳米一百粒，同煎至六分，饭后温服。
【张元素】治疗肺热骨蒸、自汗，宜用此方直泻之。用山栀、黄芩方能泻肺，但应当区分气血层面。
甘桔汤（方见咽喉篇） 大青膏 羌活膏（均见惊搐篇） 百部丸（方见咳嗽篇） 人参白术散（方见痘渴篇） 四君子汤（方见杂病虚劳篇） 参苏饮（杂病发热篇） 人参平肺散（杂病咳嗽篇）
[Qian Yi] The Lung governs panting. In excess patterns, there is chest oppression and restlessness with rapid breathing; some patients desire water, while others do not. In deficiency patterns, there is a choking sensation in the throat and sighing (long exhalation).
In Lung disease, symptoms include chest oppression and restlessness, choking sensation, sighing, shortness of breath, and urgent panting. If there is Heat in the Lung, the child may scratch at the eyebrows, eyes, nose, and face; Gan Jie Tang (Licorice and Platycodon Decoction) is the primary formula. If Lung Qi is excessive and complicated by Wind-Cold, presenting with chest fullness, shortness of breath, urgent panting, coughing, and rebellious Qi ascending, one should first dissipate pathogenic factors from the Lung, then dispel Wind-Cold. To dissipate Lung pathogens, Xie Bai San (Drain White Powder) or Da Qing Gao (Great Blue Ointment) are indicated. If the Lung is affected solely by Cold Damage (Shang Han), chest fullness will not occur. If the Lung is deficient with Heat, the lips will be deep red; treatment should dissipate Lung deficiency-Heat, administering small doses of Xie Bai San. If the Lung organ is weak (Lung Qie), the lips will be white; Bu Fei E Jiao San (Tonify Lung Donkey-Hide Gelatin Powder) is indicated. If accompanied by chest oppression, coarse breathing, panting, and choking sensations, the prognosis is poor due to severe Lung deficiency and damage. Chronic Spleen-Lung disease leads to deficiency and white lips; since the Spleen is the Mother of the Lung, if both mother and child organs are deficient and fail to nourish each other, it is termed "Qie" (Timidity/Weakness). A white but lustrous lip color in Lung disease is auspicious; white like dried bone indicates death. (This describes the method of diagnosing the Lung via the lips: white lips indicate Lung weakness, treated with E Jiao San; picking at clothes collars and fidgeting indicates Liver Heat, treated with Xie Qing Wan; scratching eyebrows, eyes, nose, and face indicates Lung Heat, treated with Gan Jie Tang.) When Lung disease manifests in Spring, Metal Qi is prosperous, and Lung overcomes Liver Wood; one should drain the Lung. In mild cases, the Lung pathology recedes; in severe cases, the eyes appear pale cyan, and convulsions (Jing Feng) are certain. If redness is present, nasal insufflation (Chu) should be used. (Zhang Yuansu states: This is because Liver Qi is weak, hence the pale cyan eyes.)
[Li Dongyuan] The Lung governs Dryness. Self-originating disease presents as panting and coughing; Dryness requires moistening. Excess patterns present with panting and abundant Qi, treated with Xie Bai San. Deficiency patterns present with panting and scanty Qi, initially treated with Yi Huang San, followed by E Jiao San. If Heart Fire attacks the Lung (Thief Pathogen), presenting with Heat, panting, and coughing, treat initially with Di Huang Wan, subsequently with Dao Chi San, and finally with E Jiao San. If Liver Wood attacks Lung Metal (Minor Pathogen), presenting with aversion to wind, dizziness, faintness, and coughing, treat with Qiang Huo Gao. If Kidney Water attacks Lung Metal (Excess Pathogen), presenting with aversion to cold, clear coughing, and frequent urination/stool, treat with Bai Bu Wan. If Spleen Earth attacks Lung Metal (Deficient Pathogen), presenting with heavy body, vomiting phlegm, diarrhea, and coughing, treat with Ren Shen Bai Zhu San.
[Liu Wansu] Whenever the Lung becomes diseased, one must first observe the excess or deficiency of the Heart and Spleen. If Heart Fire scorches Lung Metal, one must first suppress Heart Qi before administering Lung medicines. If Heart Qi is harmonious, examine the Spleen pulse next. If Spleen Qi is deficient and cold, it cannot generate [Lung Qi], leading to insufficient vital Qi in the Lung, making it susceptible to Wind pathogens; thus, Lung Cold diseases often result from Spleen deficiency. If Spleen Qi is excessive and solid, it causes stagnation in the Middle Jiao, preventing communication between the Large Intestine and the Lung (which are exterior-interior paired). If the Middle Jiao is blocked by Heat, Lung and Large Intestine cannot communicate; toxic Heat steams upward into the Lung generating phlegm; thus, Lung Heat diseases often result from Spleen excess. Excess Heart Qi is drained; deficient Spleen Qi is tonified; excessive Spleen Qi is unblocked. Thereafter, treat according to Lung Cold or Heat. Hence, there are three types of medicines: suppressing Heart Qi, tonifying Spleen Qi, and unblocking Lung Qi. If the pulse diagnosis shows both Heart and Spleen are harmonious, yet the Lung develops disease independently, treat based solely on Lung deficiency or excess.
[Xue Ji] Lung Meridian Stagnant Heat is treated with Xie Bai San. Lung Qi self-deficiency is treated with Si Jun Zi Tang (Four Gentlemen Decoction). Invasion by external pathogens is treated with Shen Su Yin (Ginseng and Perilla Drink). Heart Fire blazing and dryness is treated with Ren Shen Ping Fei San (Ginseng Lung-Pacifying Powder). Middle Jiao Excess Stagnation is treated with Da Cheng Qi Tang (Major Order the Qi Decoction). Spleen failing to generate Lung is treated with Yi Gong San (Benefit the Work Powder). What is called "Lung Qi Excess" refers to an abundance of pathogenic factors within the Lung; the pulse at the Right Cun position will be floating and forceful, indicating the use of Xie Bai San to drain it. If the Lung is deficient with Heat, adhering rigidly to the saying "Lung Heat harms the Lung again" and avoiding Ren Shen would be an error; one must still consider the syndrome for treatment.
[Zhang Yuansu] The Lung dislikes rebellious Qi ascending; urgently consume Bitter flavors to drain it, such as He Zi Pi (Pericarpium Arecae Semen). (Alternatively, Huang Qin / Scutellaria Root). The Lung desires consolidation; urgently consume Sour flavors to consolidate it, such as Bai Shao Yao (Radix Paeoniae Alba). Tonify with Sour flavors, such as Wu Wei Zi (Fructus Schisandrae Chinensis). Drain with Pungent flavors, such as Sang Bai Pi (Cortex Mori Radicis). For Lung deficiency, tonify with Wu Wei Zi. If there are no other symptoms, Qian Yi's Bu Fei E Jiao San is indicated. Deficiency requires tonifying the Mother; the Spleen is the Mother of the Lung, so use Gan Cao (Radix Glycyrrhizae Uralensis) to tonify the Spleen.
Bu Fei E Jiao San (Qian Yi Formula) Also known as Bu Fei San
E Jiao (1 liang 5 qian, stir-fried with bran) Shi Nian Zi (Stir-fried until fragrant) Gan Cao (Honey-fried, 2 qian 5 each) Ma Dou Ling (0.5 liang, baked) Xing Ren (7 kernels, skin and tip removed, stir-fried) Nuo Mi (1 liang, stir-fried)
Grind into powder. Take 1-2 qian per dose, decoct in 1 cup of water until reduced to 60%, take warm after meals.
[Zhang Yuansu] Xing Ren (Semen Armeniacae Amarum) primarily drains the Lung; it is not tonifying like Ren Shen (Radix Ginseng), Tian Men Dong (Rhizoma Asparagi) or Mai Men Dong (Radix Ophiopogonis). Its use should be judged according to circumstances.
[Xue Ji] The aforementioned formulas are general treatments for Lung Metal disorders. The Classic states: "In deficiency, tonify the Mother." If previous medications are ineffective, use Wu Wei Yi Gong San (Schisandra and Benefit-the-Work Powder) to tonify the Spleen.
[Zhang Yuansu] For Lung Excess, drain with Sang Bai Pi. If there are no other symptoms, Xie Bai San is indicated. In excess, drain the Child; the Kidney is the Child of the Lung, so use Ze Xie (Rhizoma Alismatis Orientales) to drain the Kidney.
Xie Bai San (Qian Yi Formula) Also known as Xie Fei San
Sang Bai Pi (Finely chopped, stir-fried until yellow) Di Gu Pi (Washed free of soil, baked. Each 1 liang) Gan Cao (Stir-fried, 0.5 liang)
Grind the above into powder. Take 1-2 qian per dose, add 1 cup of water and 100 grains of Jing Mi (Semen Oryzae Sativum), decoct together until reduced to 60%, take warm after meals.
[Zhang Yuansu] To treat Lung Heat causing bone-steaming fever and spontaneous sweating, this formula should be used to directly drain it. Using Shan Zhi (Fructus Gardeniae Jasminoidis) and Huang Qin can drain the Lung, but differentiation between Qi and Blood levels is necessary.
Gan Jie Tang (See Throat section) Da Qing Gao Qiang Huo Gao (Both see Convulsions section) Bai Bu Wan (See Cough section) Ren Shen Bai Zhu San (See Measles-Thirst section) Si Jun Zi Tang (See Miscellaneous Disease Consumption section) Shen Su Yin (Miscellaneous Disease Fever) Ren Shen Ping Fei San (Miscellaneous Disease Cough)