救肝败毒至圣丹（岐天师）治肝痈。
当归 白芍（各三钱） 黑山栀 生甘草（各三钱） 金银花（十两，水十碗，煎汁四碗听用）
以金银花汁二碗加水二碗同煎服，渣又加水二碗同前存金银花汁二碗，煎一碗，服二剂愈。
经曰∶章门隐隐痛者脾疽，其上肉微起者脾痈。（章门穴，又名脾募，在脐旁开六寸，高上二寸。）
王肯堂曰∶脾痈始发，章门穴必隐痛微肿，由过飧生冷，兼湿热或瘀血郁滞脾
经而成。令人腹胀，咽嗌干燥，小水短涩，宜大黄汤、赤豆苡仁汤二方合而用之，腹
胀全消，宜六君子扶脾调理。
经曰∶中府陷陷痛者肺疽，其上肉微起者肺痈。（中府穴，在云门下一寸，乳上三肋间，动脉应指。）
《素问》曰∶肝满、肾满、肺满皆实，即为肿。（王注云∶满，为脉气满实；肿，谓痈肿，肺之痈喘而两 满。）
《内经》曰∶血热则肉败，营卫不行必将为脓。大凡肺疮当咳嗽短气，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。其呕脓而自止者，将自愈，其脉短而涩者，自痊。浮洪而大者
难治。其面色当白而反面赤者，此火之克金，皆不可治。（《全书》）
《千金》曰∶咳唾脓血，其脉数实，为肺痈。若口中咳，即胸中隐痛，脉反滑数，此肺痈也。
张仲景曰∶肺痈吐脓如米粥，咽燥振寒。
又曰∶上气面浮肿肩息，其脉浮大不治，又加利尤甚。
问曰∶病者咳逆，何以知其肺痈，当以脓血吐之则死，其脉何如？曰∶寸脉微
而数，微为风，数为热，微则汗出，数则恶寒。风中于卫，呼气不入；热逼于荣，吸
气不出；风伤皮毛，热伤血脉。风舍于卫，其人则咳，口干喘满，咽燥不渴，多吐浊
沫，时时振寒。热之所过，血为凝滞，蓄结痈脓，吐如米粥。始萌可救，脓成则死。
问曰∶振寒发热，寸脉滑数，其人饮食起居如故，此为痈肿。医反不知，以伤
寒治之不应。何以知有脓？脓之所在，何以别知其处？师曰∶假令脓在胸中者，为
肺痈。其脉数，咳吐有脓血，设脓未成， 其脉自数紧。但数为脓已成矣。
《金匮方论》曰∶热在上焦者，因咳为肺痿。肺痿之病，何从得之？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，故寸口脉数，其
人咳，口中反有浊唾涎沫者，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。
王肯堂曰∶治吐脓血如肺痈状，口臭，他方不应者，宜消风散。（荆芥、川芎、羌活、人
参、茯苓、防风、藿香、蝉退各二钱，浓朴、陈皮各五钱，为末是也。）入男子发灰研细，入和之，清
米汤下，可除根，只两服，亦治吐血。（《准绳》）
又曰∶肺痈已破，入风者不治。
《精要》曰∶劳伤血气，腠理虚而风邪乘之，内盛于肺也，则汗出恶风，咳嗽短
气，鼻塞项强，胸胁胀满，久久不瘥，已成肺痿也。
又曰∶起于肺痈者，由食啖辛热炙 ，或酣饮热酒，燥热伤肺所致。治之宜早。
王氏曰∶患肺疽者项强。盖肺系在项，肺伤则系伤，故牵引不能转侧。肺者气之
本，其华在毛，其充在皮，故皮肤不泽。
张景岳曰∶此证初起，邪结在肺者，惟桔梗杏仁煎为治此之第一方。（《全书》）
齐德之曰∶肺者，五脏之华盖也。处于胸中，主于气，候于皮毛，劳伤血气，腠
理虚而风邪乘之，内感于肺也。故汗出恶风，咳嗽短气，鼻塞项强，胸胁胀满，久久不瘥，已成肺痿也。
又曰∶肺痿之候，久嗽不已，汗出过度，重亡津液，便如烂瓜，下如豕膏，小
便数而不渴。渴者自愈；欲饮者将瘥。此由肺多唾涎，而无脓者，肺痿也。
又曰∶肺疮之候，口干喘满，咽燥而渴甚，则四肢微肿，咳唾脓血，或腥臭浊
沫，胸中隐隐微痛者，肺疽也。始萌则可救，脓成则多死。
马益卿曰∶肺痈治法要略，先以小青龙汤一贴，以解其风寒邪气，然后以葶苈
大枣泻肺汤、桔梗汤、苇茎汤，（见《金匮要略》）随证用之以取脓，此治肿疡之例也。终
以内补黄 汤以补里之阴气，此治溃疡之例也。
薛立斋曰∶凡劳伤血气，腠理不密，外邪所乘，内感于肺，或入房过度，肾水亏
损，虚火上炎，或醇酒炙 ，辛辣浓味，熏蒸于肺，或咳唾痰涎，汗下过度，重亡津液，皆能致之。
又曰∶大抵劳伤血气，则腠理不密，风邪乘肺，风热相搏，蕴结不散，必致咳嗽
者。若误用汗下过度，则津液重亡，遂成斯证。
又曰∶此证皆由脾土亏损，不能生肺
金，肺金不能生肾水，故始成则可救，脓成则多死。苟能补脾肺，滋肾水，庶有生
者，若专攻其疮，则脾胃益虚，鲜有不误者矣。
陈远公曰∶人有胸膈间作痛，咳嗽时更加痛，手按之更增气急，人以为肺咳也，
谁知肺热生痈乎！夫肺为娇脏，药食所不到者，故治之甚难，治法似宜泻火以救肺，
药既不入肺，而肺为脾子，脾经未尝不爱药也。补脾土则土能生金，平肝木则金不
克木，清心火则火不刑金，三经有益于肺，无损于金，则肺气得养，后以消毒之品解
肺之邪，何痈不散乎。全肺汤∶元参三两，金银花五两，麦冬二两，生甘草五钱，花
粉、茯苓、白芍各三钱。水煎服二剂，痛减内消矣。（《冰鉴》。按痈疽证必须内消，不可令其出
毒。内消之法，总不外心肝脾三经，而别无消痈之道也。或曰∶肺之于肾也，独不可治肾以消乎？然肺痈虽成于
火灼肺金之液，实因肺气之自虚也，补肾虽或能使肺不来生肾，但肺肾相通，补肾之水，恐肺气下降，而火毒
反不肯遽散，不若止治三经，使肺气得养，自化其毒，不遗于肾为妙也。）
又曰∶人有胸膈作痛，咳嗽不止，吐痰便觉疼甚，按之痛不可忍，喉间闻腥臭
之气，随吐脓血，此肺痈不但已成，而且已破矣。未破者易消，已破者难治，以脓
血未能遽尽耳。然得法亦无难也。夫肺之生痈者，因肺火不散也，然肺火之来，因
肺气之虚也，肺虚而后火留于肺，火盛而肺结为痈，不补虚以散火，而未成形者何
以消，已成形者何以散，即溃烂者又何以愈哉，是虚宜补矣。然补何脏乎？若补肺
虚，而肺不能直补，只补胃气，则肺气自旺也。今痈已破，多吐脓血，则肺气尤虚，
虽毒瓦斯尚存，不可纯泻其毒，于补气之中而行攻散之法，则毒易化，而正气无伤也。
完肺饮∶人参一两，元参、金银花各二两，蒲公英五钱，花粉、桔梗、生甘草各三钱，
黄芩二钱。水煎，一服脓必多，二剂渐少，又三剂疼止，脓血亦止，六剂全愈。（此方补
胃气，即泻胃中之火，旺胃气而肺气自不能衰，泻胃火
而肺火自不能旺，所以败毒生肉也。虽诸药亦能入肺，不单入胃，然入胃者十之八，入肺者十之二，仍是治胃益
肺之药也。或问肺痈已破，病已入里，似不宜升提肺气，南昌喻嘉言谓∶宜引之入肠，而先生仍用桔梗开提肺气，
恐不可以为训。嗟乎！余所用药，无非治胃之药，药入于胃，有不下引入肠者乎！然肺气困顿，整肃之令不行，
用桔梗以清肺，上气通而下行更速，然则上之开提，正下行之迅逐也。）
又曰∶人有久嗽后肺受损伤，皮肤黄瘦，咽喉嘶哑，自汗盗汗，不得卧，吐稠
痰腥臭，毛悴色焦，嗽时必忍气须臾，轻轻吐痰，始觉膈上不疼，否则大痛，气息
奄奄，入以为肺痈也，谁知肺痿生疮乎！本不可救，然治之得法，亦有生者。夫肺痈
与肺痿不同，肺痈生于火毒，治之宜速；肺痿成于劳伤，治之宜缓。火毒宜补中用泻，
劳伤宜补中带清。清与泻不同，而补则同也。泻中用补，可用大剂，清中用补，只
宜小剂，勿伐勿助，若有若无，始奏功也。养肺去痿汤∶金银花、麦冬各三钱，生地、
百合各二钱，紫菀、百部各五分，生甘草五钱，款冬花、贝母、白薇各三分，天冬
一钱。水煎服，十剂膈疼少减，便有生机矣。又十剂更轻，又十剂渐愈，共六十剂
始全愈也。（此方不寒不热，养肺气于将危，保肺叶于将痿，实有奇功，若图效捷于一旦，必致轻丧于须臾，宁
忍耐以全生，勿欲速而送死。）
又曰∶有膏粱子弟，多食燔熬浓味，美醴香醪，以至舌干喉燥，吐痰吐血，喘急
膈疼，不得安卧，人以为肺经火炽，谁知肺痈已成乎！夫肺为五脏华盖，喜清气畅
达，恶燥气炎蒸。今所食无非辛热，则五脏之中，一团火气，火性炎上，而肺独受
其害，不能下生肾水，肾水无源则益加燥势，必取资于肺，肺金又病，不益虚其虚
而燥其燥乎！况各经纷纷来逼，火烈金刑，肺间生痈，必至之势也。治法化毒之中，益
以养肝降火之内，济之补肾，庶有成者可痊，未成者可散也。扶桑清肺丹∶桑叶五
钱，紫苑二钱，贝母、生甘草、百合、阿胶、人参各三钱，犀角屑五分，款冬花一
钱，杏仁七粒，金银花、熟地各一两，水煎调犀末，服数剂可收功也。（此方肺肾同治，全
不降火，盖五脏之火，因饮食而旺，乃虚火也。故补水而金气坚，虚火息，况补中带散，则非呆补，火毒又易解也。）
朱丹溪曰∶痈疽发于内者，肺痈、肝痈、肾痈、肠痈、囊内痈、附骨痈。惟肺痈须先解表，今特表而出之。
陈实功曰∶夫肺痈者，金受火刑之证也。盖肺为五脏华盖，其位至高，其气至
清，内主乎气，中主声音，外司皮毛，故肺金独旺于秋者，应其清轻之候也。倘有
所克，其病自生。先因感受风寒，未经发越，停留肺中，初出其候毛耸恶风，咳嗽
声重，胸膈隐痛，项强不能转侧者，是其真候也。久则鼻流清涕，咳吐脓痰，黄色
腥秽，其则胸胁胀满，呼吸不利，饮食减少，脉洪自汗，法当清金甘桔汤主之，麦
冬清肺饮调之。亦有七情饥饱劳役，损伤脾肺者；亦有劳力内伤，迎风喊叫，外寒
侵入，未经解散，致生肺痈者。脉必浮而微数，胸热气粗，寒热往来，咳嗽痰生，通
用金鲤汤、蜡矾丸、太乙膏，相间服之，亦效。（《正宗》）
又曰∶如手掌皮粗，六脉洪数，气急颧红，污脓白血，呕哕溺水，鼻塌不飧饮食者，俱为不治。
又曰∶如身凉脉细，脓血交流，痰色鲜明，饮食知味，脓血渐止者无妨，反此则死。
又曰∶如久嗽劳伤，咳吐痰血，寒热往来，形体消削，咯吐瘀脓，声哑咽痛，其
候传为肺痿，百死一生之候。治宜知母茯苓汤主之，人参五味汤调之。
岐伯曰∶凡人有病气喘呕咳者，乃肺病也。肺乃金脏，又娇脏也，居于心之上，
瓣如莲花，色红蒂紫，咽管之下，即是肺经司气之出入，不容食物。咽之上有胃厌，
即小舌头也，胃厌遮住咽门，饮食之类始能直入食管，而下通于胃。倘人饮食之时
多言，胃厌不及遍蔽咽门，设有米食之类入于气管，则必咳不已，可见气管不容一
物，可知药亦不能直入也。治肺之法，正治甚难，转治以脾，脾气有养，则土自生
金，喘咳自已。故五脏这中，除肺一经之外，俱可正治，独肺经不可正治。然则肺
经生痈疡，何以治之耶？清金消毒汤主之。（《秘录》）
又曰∶盖痈生胸腹之内，无不生于火与邪，若外用末药调敷，则相隔甚遥，必
须内消为得。然痈势甚大甚急，一杯水何能救车薪之火，故必大剂救肺消毒至圣丹
煎饮，而火邪自散，而痈疡自消。倘日以敷药调治于皮肤之外，或以小剂而求散于
汤饵之中，吾见其必死而已矣。
张仲景曰∶疮疡之疾，发于火邪之盛，其由来非一日矣。欲消其火邪，岂是寻常
细小之药所能去乎？故必多用重药以劫治之。然而散邪之药，俱耗真阴，多用重用，
皆能取败，惟金银花败毒而又不伤气，去火而又能补阴，故必须此品为君，第此品
性纯而正，乃正人君子也。譬如正人君子，必同郡攻击于群小之中，始不致偾事而召
祸，所以多至十两或一斤，始可取胜于眉睫。然徒借此一味，又觉势单力薄，当以
他药相助成功，各有妙理，非泛然而用之者也。或加麦冬以滋肺，或加归芍以润肝，
或加地榆以凉大肠，或加甘草以泻火，或加栀子以清热，或加薏苡仁以去湿，惟在用者审之。
冯鲁瞻曰∶肺痈者，劳伤气血，内有积热，外受风寒，胸中满急，隐隐作痛，咽
干口燥，时出浊唾腥臭，若吐脓如米粥者死。脉滑数或实大，凡患者右胁按之必痛，
须用肺痈神汤，未成即消，已成即溃，已溃即愈，屡用屡验者也。（《锦囊》）
又曰∶夫人一身之气全关于肺，肺清则气行，肺浊则气壅，肺热则津不行而肌
肉甲错，（甲错者，肌不润泽也。）多生肺痈。痈者，壅也，肺气郁热久壅而成也。盖咳久伤肺，
元气渐虚，其人有寒热往来，自汗 ，口中有浊唾涎沫，或咳嗽唾中有红线脓血，或
多唾涎沫而无脓，寸口脉数而虚涩，或虚洪者，名曰肺痿，热在上焦故也。如口中
辟辟燥咳，即胸中隐隐痛，咽燥喘渴，四肢微肿，先吐血而后吐脓，胸中甲错，或
救肝败毒至圣丹（岐天师）治疗肝痈。
当归、白芍（各三钱）、黑山栀、生甘草（各三钱）、金银花（十两，加水十碗，煎取汁液四碗备用）。
用金银花汁二碗加水二碗共同煎煮服用；药渣再加水二碗，与前法相同，保留金银花汁二碗，煎取一碗，服用两剂即可痊愈。
经文说：章门穴隐隐作痛的是脾疽，该处肌肉微微隆起的是脾痈。（章门穴，又名脾募穴，位于脐旁开六寸，向上二寸处。）
王肯堂说：脾痈刚开始发作时，章门穴必定隐痛微肿，这是由于过食生冷食物，兼有湿热或瘀血郁滞于脾经所致。使人出现腹胀，咽喉干燥，小便短少涩滞的症状，适宜使用大黄汤、赤豆苡仁汤两方合用。待腹胀完全消除后，宜用六君子汤扶助脾气进行调理。
经文说：中府穴深陷疼痛的是肺疽，该处肌肉微微隆起的是肺痈。（中府穴，位于云门穴下一寸，乳头上方第三肋骨间隙，动脉搏动应手。）
《素问》说：肝脉满实、肾脉满实、肺脉满实皆属于实证，就会形成肿胀。（王冰注解说：满，指脉气满实；肿，指痈肿，肺的痈证表现为气喘且两侧胸部胀满。）
《内经》说：血热则肌肉腐败，营卫之气运行不畅必将化为脓液。大凡肺疮应当出现咳嗽、气短、胸部胀满、时常吐出脓血，时间久了像米粥一样的，难以治愈。如果呕吐脓液而不停止的，也不可治愈。其呕吐脓液而自然停止的，将会自愈；其脉象短而涩的，会自行痊愈。脉象浮洪而大的，难以治愈。其面色本应发白反而发红，这是火克金的表现，都不可治愈。（出自《全书》）
《千金方》说：咳嗽吐脓血，脉象数而实，是肺痈。如果口中咳嗽，随即胸中隐痛，脉象反而滑数，这是肺痈。
张仲景说：肺痈吐出脓液如米粥状，咽喉干燥，战栗恶寒。
又说：上气喘息，面部浮肿，抬肩呼吸，脉象浮大者不治，如果再伴有腹泻，情况更加严重。
问曰：病人咳嗽气逆，怎么知道是肺痈？当吐出脓血就会死亡吗？脉象如何？答曰：寸脉微而数，微代表风邪，数代表热邪，微则汗出，数则恶寒。风邪伤及卫分，呼气不能入内；热邪逼迫营分，吸气不能外出；风邪损伤皮毛，热邪损伤血脉。风邪留舍于卫分，人就会咳嗽，口干气喘胸满，咽喉干燥但不口渴，多吐出浑浊泡沫，时时寒战。热邪所经过的地方，血液凝滞，蓄积结聚成痈脓，吐出物如米粥。病初起时可救治，脓已成则难治。
问曰：寒战发热，寸脉滑数，其人饮食起居如常，这是痈肿。医生反而不知道，用治疗伤寒的方法治疗无效。怎么知道有脓？脓在何处，怎么辨别它的位置？老师说：假如脓在胸中，就是肺痈。其脉数，咳嗽吐出脓血，假设脓未形成，其脉自紧。只要脉数，说明脓已形成了。
《金匮要略方论》说：热在上焦，因咳嗽导致肺痿。肺痿的病，是怎么得来的呢？有的因为出汗过多，有的因为呕吐，有的因为消渴症，小便频数，或者因为大便困难，又被峻下药攻下导致腹泻，再次亡失津液，所以寸口脉数，其人咳嗽，口中反而有浑浊唾液和泡沫的，是肺痿的病。如果口中干燥，咳嗽，随即胸中隐痛，脉象反而滑数，这是肺痈，咳嗽吐脓血。脉数而虚的，是肺痿；脉数而实的，是肺痈。
王肯堂说：治疗吐血吐脓像肺痈症状，口臭，其他方剂无效的，宜用消风散。（荆芥、川芎、羌活、人参、茯苓、防风、藿香、蝉蜕各二钱，厚朴、陈皮各五钱，研为细末。）加入男子头发烧成的灰研细，混合均匀，用清米汤送服，可以除根，只需两服，也能治疗吐血。（出自《准绳》）
又说：肺痈已经溃破，感受风邪的，无法治愈。
《精要》说：劳损伤及血气，腠理空虚而风邪乘虚而入，内盛于肺，就会汗出恶风，咳嗽气短，鼻塞项强，胸胁胀满，久久不愈，就形成了肺痿。
又说：起因于肺痈的，是由于食用辛辣燥热的炙烤食物，或大量饮用热酒，燥热损伤肺部所致。治疗应当尽早。
王氏说：患肺疽的人颈部僵硬。因为肺系连接颈部，肺受伤则肺系受伤，所以牵引导致不能转头侧身。肺是气的根本，其荣华表现在毛发，其充实在皮肤，所以皮肤没有光泽。
张景岳说：此证初起，邪气结聚在肺部的，只有桔梗杏仁煎是治疗此证的第一方。（出自《全书》）
齐德之说：肺，是五脏的华盖。处于胸中，主管气，候应于皮毛，劳损伤及血气，腠理空虚而风邪乘虚而入，内感于肺。所以汗出恶风，咳嗽气短，鼻塞项强，胸胁胀满，久久不愈，就形成了肺痿。
又说：肺痿的症状，久咳不止，出汗过度，再次亡失津液，大便像烂瓜一样稀溏，泻下如猪油般滑腻，小便频数而不口渴。口渴的会自愈；想喝水的将痊愈。这是因为肺多唾液和泡沫，而没有脓液的，是肺痿。
又说：肺疮的症状，口干气喘胸满，咽喉干燥且极度口渴，则四肢轻微肿胀，咳嗽吐脓血，或腥臭浊沫，胸中隐隐微痛的，是肺疽。病初起时可救治，脓已成则大多死亡。
马益卿说：肺痈的治疗法则概要，先用小青龙汤一帖，以解除风寒邪气，然后用葶苈大枣泻肺汤、桔梗汤、苇茎汤（见《金匮要略》），根据证候选用以排出脓液，这是治疗肿疡的常规方法。最后以内补黄芪汤来补益体内的阴气，这是治疗溃疡的常规方法。
薛立斋说：凡是劳损伤及血气，腠理不紧密，外邪乘虚而入，内感于肺，或者房事过度，肾水亏损，虚火上炎，或者醇酒炙烤食物、辛辣浓味，熏蒸于肺，或者咳嗽吐痰涎，发汗攻下过度，再次亡失津液，都能导致此病。
又说：大抵劳损伤及血气，则腠理不紧密，风邪乘袭肺部，风热相搏，蕴结不散，必然导致咳嗽。如果误用发汗攻下过度，则津液再次亡失，遂形成此证。
又说：此证皆由脾土亏损，不能生肺金，肺金不能生肾水，所以初起时可救治，脓已成则大多死亡。如果能补脾肺，滋肾水，或许有生存的希望，如果专门攻伐疮疡，则脾胃更加虚弱，很少有不误事的。
陈远公说：有人胸膈间作痛，咳嗽时疼痛加重，用手按压则更加气急，人们以为是肺咳，谁知道是肺热生痈呢！肺是娇脏，药物和食物达不到的地方，所以治疗很难，治法似乎应该泻火以救肺，但药物既然不能直接进入肺，而肺是脾之子，脾经未曾不爱惜药物。补脾土则土能生金，平肝木则金不克木，清心火则火不刑金，这三经有益于肺，不损伤金，则肺气得到滋养，随后用消毒的药物解除肺的邪气，什么痈不散呢？全肺汤：玄参三两，金银花五两，麦冬二两，生甘草五钱，天花粉、茯苓、白芍各三钱。水煎服两剂，疼痛减轻，内部消散。（出自《冰鉴》。按：痈疽证必须内部消散，不可令其排出毒素。内部消散的方法，总离不开心、肝、脾三经，而没有其他消除痈的方法。有人说：肺对于肾，难道不可以治疗肾来消除吗？然而肺痈虽然形成于火灼肺金之液，实际上是因为肺气自身虚弱，补肾虽然可能使肺不来生肾，但肺肾相通，补肾之水，恐怕肺气下降，而火毒反而不肯迅速消散，不如只治疗三经，使肺气得到滋养，自然化解其毒，不遗留于肾为好。）
又说：有人胸膈作痛，咳嗽不止，吐痰觉得疼痛加剧，按压疼痛难忍，喉间闻到腥臭气味，随之吐出脓血，这是肺痈不但已经形成，而且已经溃破了。未溃破的容易消散，已溃破的难治，因为脓血不能完全立即排尽。然而得法也不难。肺之所以生痈，是因为肺火不散，然而肺火的到来，是因为肺气虚弱，肺虚之后火留在肺，火盛而肺结聚成痈，不补虚以散火，未成形的怎么能消散，已成形的怎么能解散，即溃烂的又怎么能愈合呢，这是虚证应当补益了。然而补哪个脏腑呢？如果补肺虚，而肺不能直接补，只补胃气，则肺气自然旺盛。现在痈已破，多吐脓血，则肺气尤其虚弱，虽然毒瓦斯尚存，不可单纯泻其毒，在补气之中施行攻散的方法，则毒易化，而正气不受损伤。完肺饮：人参一两，玄参、金银花各二两，蒲公英五钱，天花粉、桔梗、生甘草各三钱，黄芩二钱。水煎，一服脓必增多，两剂逐渐减少，再三剂疼痛停止，脓血也停止，六剂完全痊愈。（此方补胃气，即是泻胃中之火，旺胃气而肺气自然不能衰弱，泻胃火而肺火自然不能旺盛，所以败毒生肉。虽然诸药也能入肺，不单入胃，然而入胃的占十分之八，入肺的占十分之二，仍然是治胃益肺的药物。有人问：肺痈已破，病已入里，似乎不宜升提肺气，南昌喻嘉言认为：宜引之入肠，而先生仍用桔梗开提肺气，恐怕不可以作为典范。唉！我所用的药，无非是治胃的药，药进入胃中，有不向下引入肠的吗！然而肺气困顿，整肃的命令不行，用桔梗来清肺，上气通畅而下行的速度更快，那么上面的开提，正是下面迅疾驱逐的作用。）
又说：有人久咳后肺受损伤，皮肤黄瘦，咽喉嘶哑，自汗盗汗，不能卧睡，吐出稠痰腥臭，毛发憔悴，面色枯焦，咳嗽时必须憋气片刻，轻轻吐痰，才觉得膈上不疼，否则剧烈疼痛，气息奄奄，人们以为是肺痈，谁知道是肺痿生疮呢！本来不可救，然而治疗得法，也有生存的。肺痈与肺痿不同，肺痈生于火毒，治疗应当迅速；肺痿成于劳伤，治疗应当缓慢。火毒宜补中用泻，劳伤宜补中带清。清与泻不同，而补则相同。泻中用补，可用大剂量，清中用补，只宜小剂量，不要攻伐也不要助长，若有若无，才能奏效。养肺去痿汤：金银花、麦冬各三钱，生地、百合各二钱，紫菀、百部各五分，生甘草五钱，款冬花、贝母、白薇各三分，天冬一钱。水煎服，十剂膈痛稍减，便有生机了。再十剂更轻，再十剂逐渐痊愈，共六十剂才完全痊愈。（此方不寒不热，在危急时刻养护肺气，保护肺叶防止萎废，确实有奇功，如果图求效果迅速于一朝一夕，必然导致轻易丧命，宁可忍耐以保全生命，不要欲速而送死。）
又说：有富贵子弟，多吃烧烤浓味美食美酒，以至于舌干喉燥，吐痰吐血，喘急膈疼，不能安卧，人们以为是肺经火炽，谁知道肺痈已经形成呢！肺是五脏的华盖，喜欢清气畅达，厌恶燥气炎蒸。现在所吃的无非是辛热，则五脏之中，一团火气，火性炎上，而肺独受其害，不能下生肾水，肾水无源则更加燥烈，必然取资于肺，肺金又生病，不是更加虚其虚而燥其燥吗！况且各经纷纷来逼，火烈金刑，肺间生痈，是必然的趋势。治疗方法在化毒之中，增益以养肝降火的内在，济之以补肾，或许能有痊愈的可能，未形成的可消散。扶桑清肺丹：桑叶五钱，紫菀二钱，贝母、生甘草、百合、阿胶、人参各三钱，犀角屑五分，款冬花一钱，杏仁七粒，金银花、熟地各一两，水煎调犀角末，服用几剂可收功效。（此方肺肾同治，完全不降火，因为五脏之火，因饮食而旺盛，乃是虚火。所以补水而金气坚固，虚火平息，何况补中带散，则不是呆补，火毒又容易解。）
朱丹溪说：痈疽发于内部的，有肺痈、肝痈、肾痈、肠痈、囊内痈、附骨痈。只有肺痈需要先解表，现在特别列出来说明。
陈实功说：肺痈，是金受火刑的证候。肺是五脏的华盖，位置最高，气最清，内主气，中主声音，外司皮毛，所以肺金独旺于秋季，应和其清轻的时令。如果有被克制，病自然产生。先因感受风寒，未经发散，停留肺中，初起表现毛耸恶风，咳嗽声重，胸膈隐痛，项强不能转侧的，是其真实症状。久了则鼻流清涕，咳吐脓痰，黄色腥秽，进而胸胁胀满，呼吸不利，饮食减少，脉洪大自汗，法当用清金甘桔汤主治，麦冬清肺饮调治。也有因七情饥饱劳役，损伤脾肺的；也有因劳力内伤，迎风喊叫，外寒侵入，未经解散，导致生肺痈的。脉必浮而微数，胸热气粗，寒热往来，咳嗽痰生，通用金鲤汤、蜡矾丸、太乙膏，相间服用，也有效。（出自《正宗》）
又说：如手掌皮粗糙，六脉洪数，气急颧红，污脓白血，呕哕溺水，鼻塌不能进食的，都属于不治之症。
又说：如身体凉脉细，脓血交流，痰色鲜明，饮食知味，脓血渐止的无妨，与此相反则死。
又说：如久咳劳伤，咳吐痰血，寒热往来，形体消瘦，咯吐瘀脓，声哑咽痛，其症状传变为肺痿，是百死一生的证候。治疗宜用知母茯苓汤主治，人参五味汤调治。
岐伯说：凡人有病气喘呕吐咳嗽的，是肺病。肺是金脏，又是娇脏，位于心之上，瓣如莲花，色红蒂紫，咽管之下，就是肺经司气出入的地方，不容许食物进入。咽之上有胃厌，即小舌头，胃厌遮住咽门，饮食之类才能直入食管，而下通于胃。如果人在饮食之时多说话，胃厌来不及遍蔽咽门，设有米食之类进入气管，则必然咳嗽不停，可见气管不容一物，可知药物也不能直接进入。治肺的方法，正治很难，转而治脾，脾气有滋养，则土自生金，喘咳自然停止。所以五脏之中，除肺一经之外，都可正治，唯独肺经不可正治。然而肺经生痈疡，怎么治疗呢？用清金消毒汤主治。（出自《秘录》）
又说：痈生在胸腹之内，无不生于火与邪，如果外用粉末药物调敷，则相隔甚远，必须内部消散才算得当。然而痈势很大很急，一杯水怎能救车薪之火，所以必须用大剂量的救肺消毒至圣丹煎服，而火邪自然消散，而痈疡自然消除。如果每天以外敷药调理于皮肤之外，或以小剂量寻求消散于汤药之中，我见其必死而已。
张仲景说：疮疡的疾病，发于火邪的盛大，由来非一日矣。想要消除火邪，难道是寻常细小药物所能去除的吗？所以必须多用重药以劫治之。然而散邪的药物，都耗损真阴，多用重用，都能导致失败，只有金银花败毒而不伤气，去火而又能补阴，所以必须以此品为君药，只是此品性质纯正，是正人君子。譬如正人君子，必须在群小之中攻击，始不至于败事而招祸，所以多至十两或一斤，始可在眉睫之间取胜。然而仅借这一味药，又觉得势单力薄，应当以其他药物相助成功，各有妙理，不是泛然使用的。或者加麦冬以滋润肺，或者加归芍以润肝，或者加地榆以凉大肠，或者加甘草以泻火，或者加栀子以清热，或者加薏苡仁以祛湿，只在使用者审慎选择。
冯鲁瞻说：肺痈，是劳伤气血，内有积热，外受风寒，胸中满急，隐隐作痛，咽干口燥，时常吐出浊唾腥臭，如果吐脓如米粥的死亡。脉滑数或实大，凡是患者右胁按压必定疼痛，须用肺痈神汤，未成即消，已成即溃，已溃即愈，屡用屡验。（出自《锦囊》）
又说：夫人一身之气全关于肺，肺清则气行，肺浊则气壅，肺热则津液不行而肌肉甲错。（甲错，指肌肤不润泽。）多生肺痈。痈，是壅塞的意思，肺气郁热久壅而成。大概咳久伤肺，元气渐虚，其人寒热往来，自汗，口中有浊唾涎沫，或咳嗽唾中有红线脓血，或多唾涎沫而无脓，寸口脉数而虚涩，或虚洪的，名叫肺痿，热在上焦的缘故。如果口中干燥咳嗽，随即胸中隐痛，咽喉干燥气喘口渴，四肢轻微肿胀，先吐血而后吐脓，胸中肌肤甲错，或者
Jiu Gan Bai Du Zhi Sheng Dan (Eminent Healer Qi Tian Shi) treats Liver Abscess (Gan Yong).
Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba) (each 3 qian), Hei Shan Zhi (Gardeniae Fructus Carbonized), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma Recens) (each 3 qian), Jin Yin Hua (Lonicerae Japonicae Flos) (10 liang, decocted with 10 bowls of water to obtain 4 bowls of juice for later use).
Use 2 bowls of Jin Yin Hua juice mixed with 2 bowls of water, decoct together and take orally; the dregs are added with another 2 bowls of water, processed as before, retaining 2 bowls of Jin Yin Hua juice, decocted to 1 bowl. Take two doses to be cured.
The Classic states: If there is a dull pain at Zhangmen acupoint (Zhangmen), it is Spleen Carbuncle (Pi Ju); if the flesh above it slightly protrudes, it is Spleen Abscess (Pi Yong). (Zhangmen acupoint, also known as the Front-Mu point of the Spleen, is located 6 cun lateral to the umbilicus and 2 cun superior.)
Wang Kentang stated: At the onset of Spleen Abscess, Zhangmen acupoint must have dull pain and slight swelling. This results from overeating raw and cold foods, combined with damp-heat or blood stasis stagnating in the Spleen Meridian. It causes abdominal distension, dryness of the throat and pharynx, and scanty, dysuric urination. It is appropriate to combine Da Huang Tang (Rhubarb Decoction) and Chi Dou Yi Ren Tang (Adzuki Bean and Coix Seed Decoction). Once abdominal distension completely subsides, Liu Jun Zi Tang (Six Gentlemen Decoction) should be used to support the Spleen qi for regulation.
The Classic states: If Zhongfu acupoint is sunken and painful, it is Lung Carbuncle (Fei Ju); if the flesh above it slightly protrudes, it is Lung Abscess (Fei Yong). (Zhongfu acupoint is located 1 cun below Yunmen acupoint, in the intercostal space of the third rib above the nipple, where the arterial pulse is palpable.)
Su Wen states: Fullness in the Liver, Kidney, and Lung meridians all indicate excess patterns, which manifest as swelling. (Wang Bing’s commentary explains: "Fullness" refers to full and solid pulse qi; "swelling" refers to carbuncles/abscesses. Lung abscess presents with wheezing and bilateral chest fullness.)
Nei Jing states: When blood heat causes tissue corruption, and Ying and Wei qi fail to circulate, pus will inevitably form. Generally, Lung sores present with cough, shortness of breath, chest fullness, and frequent expectoration of pus and blood. If this persists until the sputum resembles rice porridge, it is difficult to treat. If vomiting of pus continues without stopping, it is incurable. If vomiting of pus stops spontaneously, it will heal itself; if the pulse is short and choppy, it will recover naturally. If the pulse is floating, surging, and large, it is difficult to treat. The complexion should be white but appears red instead; this indicates Fire overcoming Metal, and all such cases are incurable. (From Quan Shu)
Qian Jin Fang states: Coughing up pus and blood with a rapid and excess pulse indicates Lung Abscess. If one coughs and immediately experiences dull chest pain, and the pulse is slippery and rapid, this is Lung Abscess.
Zhang Zhongjing stated: Lung Abscess involves expectorating pus resembling rice porridge, with dry throat and chills.
He further stated: Upper jiao qi rebellion with facial edema, shoulder breathing, and a floating, large pulse indicates an untreatable condition; if accompanied by diarrhea, the prognosis is even worse.
Question: How do we know a patient with cough and rebellious qi has Lung Abscess? Will death occur upon expectorating pus and blood? What is the pulse like? Answer: The Cun position pulse is faint and rapid. Faint indicates Wind, Rapid indicates Heat. Faint implies sweating, Rapid implies aversion to cold. Wind invades the Wei level, preventing exhalation from entering; Heat forces the Ying level, preventing inhalation from exiting. Wind damages the skin and hair, Heat damages the blood vessels. Wind lodging in the Wei level causes cough, dry mouth, wheezing, and chest fullness, dry throat without thirst, copious expectoration of turbid foam, and intermittent chills. Where Heat passes, blood coagulates and stagnates, accumulating into an abscess/pus, expectorated like rice porridge. In the initial stage, it can be saved; once pus is formed, it is fatal.
Question: Chills and fever with a slippery, rapid Cun pulse, while diet and daily activities remain normal, indicate an abscess. The doctor fails to recognize this and treats it as Cold Damage without effect. How do we know pus exists? How do we distinguish its location? Master says: If pus is in the chest, it is Lung Abscess. The pulse is rapid, with coughing up pus and blood. Assuming the pus has not yet formed, the pulse would naturally be tight. Only when the pulse is rapid does it indicate that pus has formed.
Jin Gui Yao Lue Fang Lun states: Heat in the upper jiao, due to cough, leads to Lung Flaccidity (Fei Fei). How is Lung Flaccidity acquired? Sometimes from excessive sweating, sometimes from vomiting, sometimes from Xiao Ke (wasting-thirst) with frequent urination, or from constipation treated with harsh purgatives causing severe fluid loss. Thus, the Cun Kou pulse is rapid, the person coughs, and the mouth contains turbid saliva and foam, indicating Lung Flaccidity. If the mouth is parched, coughing ensues, followed by dull chest pain, and the pulse is slippery and rapid, this is Lung Abscess, with coughing up pus and blood. A rapid and deficient pulse indicates Lung Flaccidity; a rapid and excess pulse indicates Lung Abscess.
Wang Kentang stated: For treating hemoptysis and purulent sputum resembling Lung Abscess, with bad breath, where other formulas fail, Xiao Feng San (Wind-Dispersing Powder) is suitable. (Jing Jie, Chuan Xiong, Qiang Huo, Ren Shen, Fu Ling, Fang Feng, Huo Xiang, Chan Tui each 2 qian; Hou Po, Chen Pi each 5 qian, ground into powder.) Add ash from human hair, finely ground, mix well, and take with clear rice soup to eradicate the root cause. Two doses suffice; it also treats hematemesis. (From Zhun Sheng)
He further stated: If Lung Abscess has ruptured and is exposed to Wind, it is untreatable.
Jing Yao states: Labor injury damaging Blood and Qi, leaving the Cou Li (pores/skin texture) deficient, allowing Wind pathogen to invade and accumulate internally in the Lung, causes sweating, aversion to wind, cough, shortness of breath, nasal congestion, neck stiffness, and chest/hypochondriac distension. If prolonged without healing, it becomes Lung Flaccidity.
It further states: Originating from Lung Abscess, this is caused by consuming spicy, hot, roasted foods, or drinking hot wine excessively, leading to dryness-heat injuring the Lung. Treatment should be early.
Wang Shi stated: Patients with Lung Carbuncle exhibit neck stiffness. Because the Lung channel connects to the neck, Lung injury damages the channel, causing traction that prevents turning the head. The Lung is the root of Qi, its luster manifests in the hair, and it fills the skin; thus, the skin lacks luster.
Zhang Jingyue stated: At the onset of this condition, when pathogens knot in the Lung, Jie Geng Xing Ren Jian (Platycodon and Apricot Kernel Decoction) is the primary formula. (From Quan Shu)
Qi Dezhi stated: The Lung is the canopy of the five Zang organs. Located in the chest, it governs Qi and corresponds to the skin and hair. Labor injury damages Blood and Qi, making the Cou Li deficient, allowing Wind pathogen to invade and affect the Lung internally. This causes sweating, aversion to wind, cough, shortness of breath, nasal congestion, neck stiffness, and chest/hypochondriac distension. If prolonged without healing, it becomes Lung Flaccidity.
He further stated: Symptoms of Lung Flaccidity include chronic unrelenting cough, excessive sweating, severe fluid loss, loose stools resembling rotten melon, liquid discharge like pig fat, frequent urination without thirst. Thirst indicates self-healing; desire to drink indicates impending recovery. This is because the Lung produces much saliva and foam but no pus; this is Lung Flaccidity.
He further stated: Symptoms of Lung Sores include dry mouth, wheezing, chest fullness, extreme throat dryness and thirst, slight swelling of the four limbs, coughing up pus and blood, or foul-smelling turbid foam, and dull, slight chest pain; this is Lung Carbuncle. In the initial stage, it can be saved; once pus forms, most die.
Ma Yiqing stated: The general principles for treating Lung Abscess involve first using Xiao Qing Long Tang (Minor Blue Dragon Decoction) to resolve Wind-Cold pathogens, then using Ting Li Da Zao Xie Fei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung), Jie Geng Tang (Platycodon Decoction), or Wei Jing Tang (Reed Shoot Decoction) (see Jin Gui Yao Lue), selecting based on symptoms to expel pus. This is the example for treating swollen ulcers. Finally, Nei Bu Huang Qi Tang (Internal Tonification with Astragalus Decoction) is used to tonify internal Yin. This is the example for treating ulcerated lesions.
Xue Lizhai stated: Whenever labor injury damages Blood and Qi, making the Cou Li insecure, external pathogens invade and affect the Lung internally; or excessive sexual activity depletes Kidney Water, causing Deficient Fire to flare upward; or rich wines, roasted foods, and pungent/spicy strong flavors steam the Lung; or excessive coughing/sputtering of phlegm, or excessive sweating/purging causing severe fluid loss—all can cause this disease.
He further stated: Generally, labor injury damages Blood and Qi, making the Cou Li insecure. Wind pathogen attacks the Lung; Wind and Heat struggle, accumulating and failing to disperse, inevitably causing cough. If mistakenly treated with excessive sweating or purging, fluid loss occurs again, forming this syndrome.
He further stated: This syndrome arises from Spleen Earth deficiency failing to generate Lung Metal, and Lung Metal failing to generate Kidney Water. Thus, it can be saved in the beginning, but dies mostly once pus forms. If one can tonify Spleen and Lung, nourish Kidney Water, there may be hope for survival. If one only attacks the sore, the Spleen and Stomach become more deficient, and few avoid error.
Chen Yuangong stated: Some people have pain in the chest and diaphragm, worsening with cough, and pressing increases shortness of breath. People think it is Lung Cough, but who knows it is Lung Heat generating an Abscess! The Lung is a delicate organ, unreachable by medicine and food directly, so treatment is very difficult. The method seems to require clearing Fire to save the Lung, but since medicine cannot enter the Lung directly, and the Lung is the child of the Spleen, the Spleen meridian loves medicine. Tonifying Spleen Earth allows Earth to generate Metal; calming Liver Wood prevents Metal from being controlled by Wood; clearing Heart Fire prevents Fire from punishing Metal. These three meridians benefit the Lung without harming Metal, allowing Lung Qi to be nourished. Then, using detoxifying agents to resolve Lung pathogens, what abscess would not dissipate? Quan Fei Tang (Complete Lung Decoction): Xuan Shen 3 liang, Jin Yin Hua 5 liang, Mai Dong 2 liang, Sheng Gan Cao 5 qian, Hua Fen, Fu Ling, Bai Shao each 3 qian. Decoct in water, take two doses; pain decreases and internal resolution occurs. (From Bing Jian. Note: Carbuncles and sores must be resolved internally; they should not be allowed to discharge toxins. The method of internal resolution generally involves the Heart, Liver, and Spleen meridians, with no other way to eliminate abscesses. Someone asked: Regarding the Lung and Kidney, why not treat the Kidney to eliminate the Lung abscess? Although Lung Abscess forms from Fire scorching Lung Metal fluids, it is actually due to Lung Qi deficiency. Tonifying the Kidney might stop the Lung from generating Kidney Water, but since Lung and Kidney are connected, tonifying Kidney Water might cause Lung Qi to descend, and Fire-Toxin might not dissipate quickly. It is better to treat only the three meridians, nourishing Lung Qi so it naturally transforms toxins, leaving no residue in the Kidney.)
He further stated: Some people have chest/diaphragm pain, unrelenting cough, severe pain upon expectorating phlegm, unbearable tenderness on pressure, foul smell in the throat, followed by expectoration of pus and blood. This indicates Lung Abscess is not only formed but ruptured. Unruptured ones are easy to resolve; ruptured ones are hard to treat because pus and blood cannot be completely expelled immediately. However, with proper method, it is not difficult. The reason the Lung generates an abscess is because Lung Fire does not dissipate; however, Lung Fire arises from Lung Qi deficiency. After Lung deficiency, Fire remains in the Lung; Fire excess knots the Lung into an abscess. Without tonifying deficiency to scatter Fire, how can unformed abscesses dissipate? How can formed abscesses disperse? How can ulcerated ones heal? Thus, deficiency requires tonification. But which organ to tonify? If tonifying Lung deficiency, the Lung cannot be directly tonified; only by tonifying Stomach Qi can Lung Qi flourish. Now that the abscess has ruptured with copious pus and blood, Lung Qi is especially deficient. Although Toxin-Qi remains, one must not purely purge the toxin. By employing dispersing methods within Qi tonification, the toxin transforms easily without damaging Righteous Qi. Wan Fei Yin (Complete Lung Drink): Ren Shen 1 liang, Xuan Shen, Jin Yin Hua each 2 liang, Pu Gong Ying 5 qian, Hua Fen, Jie Geng, Sheng Gan Cao each 3 qian, Huang Qin 2 qian. Decoct in water. First dose: pus increases; second dose: decreases gradually; next three doses: pain stops, pus/blood stops; six doses: fully cured. (This formula tonifies Stomach Qi, which clears Stomach Fire. Flourishing Stomach Qi ensures Lung Qi does not decline; clearing Stomach Fire ensures Lung Fire does not flourish, thus defeating toxin and generating flesh. Although all herbs can enter the Lung, not just the Stomach, 80% enter the Stomach and 20% the Lung; they are still Stomach-tonifying and Lung-benefiting herbs. Someone asked: Lung Abscess has ruptured, disease entered the interior, so lifting Lung Qi seems inappropriate. Yu Jiayan of Nanchang said: It should be guided into the Intestines, yet Mr. still uses Jie Geng to lift Lung Qi, which may not be a model. Alas! My medicines are all Stomach-treating. Once entering the Stomach, do they not go down to the Intestines? However, with stagnant Lung Qi and failed regulatory commands, using Jie Geng to clear the Lung makes Upper Qi smooth and Lower descent faster. Thus, lifting from above is precisely the rapid expulsion from below.)
He further stated: Some people suffer lung damage after chronic cough, with yellow/thin skin, hoarse voice, spontaneous/night sweats, inability to lie down, expectoration of thick/foul sputum, emaciated hair and burnt complexion. During cough, one must hold breath briefly and spit gently to relieve diaphragmatic pain; otherwise, severe pain occurs. Breath is faint. People think it is Lung Abscess, but who knows it is Lung Flaccidity generating sores! Originally incurable, but with proper treatment, survival is possible. Lung Abscess differs from Lung Flaccidity: Abscess arises from Fire-Toxin, requiring rapid treatment; Flaccidity arises from Labor Injury, requiring slow treatment. Fire-Toxin requires tonification with purging; Labor Injury requires tonification with clearing. Clearing and purging differ, but tonification is the same. Purging with tonification allows large doses; clearing with tonification requires small doses. Do not attack, do not assist; act as if present yet absent, to achieve efficacy. Yang Fei Qu Wei Tang (Nourish Lung Eliminate Flaccidity Decoction): Jin Yin Hua, Mai Dong each 3 qian, Sheng Di, Bai He each 2 qian, Zi Wan, Bai Bu each 5 fen, Sheng Gan Cao 5 qian, Kuan Dong Hua, Bei Mu, Bai Wei each 3 fen, Tian Dong 1 qian. Decoct in water, take orally. Ten doses: diaphragm pain lessens, vitality returns. Another ten doses: lighter. Another ten doses: gradually healed. Total sixty doses for complete cure. (This formula is neither cold nor hot, nourishing Lung Qi in crisis, protecting Lung Lobes from flaccidity, truly miraculous. Seeking quick results leads to sudden death; endure to preserve life, do not seek speed to deliver death.)
He further stated: Wealthy youths eating too much fried/rich food and sweet wines develop dry tongue/throat, expectorating phlegm/blood, wheezing/chest pain, inability to sleep. People think it is Lung Meridian Fire Blazing, but who knows Lung Abscess has formed! The Lung is the canopy of the five Zang organs, preferring clear Qi circulation, hating dryness-heat steaming. Current diet is spicy/hot, creating a mass of Fire in the five Zang organs. Fire flares upward, harming the Lung exclusively, unable to generate Kidney Water downward. With no source for Kidney Water, dryness intensifies, drawing resources from the Lung. Lung Metal is diseased, further exhausting deficiency and drying dryness. Moreover, other meridians press in, Fire fierce, Metal punished. Abscess in the Lung is inevitable. Treatment: amidst detoxification, add Liver-nourishing and Fire-descending measures, supplemented by Kidney-tonification. Perhaps formed ones can heal, unformed ones can dissipate. Fu Sang Qing Fei Dan (Mulberry Leaf Lung-Clearing Pill): Sang Ye 5 qian, Zi Wan 2 qian, Bei Mu, Sheng Gan Cao, Bai He, E Jiao, Ren Shen each 3 qian, Xi Jiao Xie 5 fen, Kuan Dong Hua 1 qian, Xing Ren 7 grains, Jin Yin Hua, Shu Di each 1 liang. Decoct in water, mix with Xi Jiao powder, take several doses for success. (This formula treats Lung and Kidney simultaneously, completely avoiding Fire-descending. Five Zang Fires, intensified by diet, are Deficient Fires. Thus, tonifying Water strengthens Metal Qi, extinguishing Deficient Fire. Plus, tonification with dispersion avoids static tonification, making Fire-Toxin easier to resolve.)
Zhu Danxi stated: Internal carbuncles/sores include Lung Abscess, Liver Abscess, Kidney Abscess, Intestinal Abscess, Scrotal Internal Abscess, and Subperiosteal Abscess. Only Lung Abscess requires initial exterior-resolving. I specifically highlight this here.
Chen Shigong stated: Lung Abscess is a pattern of Metal suffering Fire punishment. The Lung is the canopy of the five Zang organs, highest in position, purest in Qi, governing Qi internally, Voice centrally, Skin/Hair externally. Thus, Lung Metal peaks in Autumn, corresponding to its light/clear nature. If overcome, disease arises. Initially due to Wind-Cold invasion, unresolved, lingering in the Lung. Early signs: hair erection, aversion to wind, heavy cough, dull chest/diaphragm pain, neck stiffness preventing turning—these are true signs. Later: nasal clear discharge, coughing yellow/foul pus/phlegm, chest/hypochondriac distension, breathing difficulty, reduced appetite, surging pulse, sweating. Method: Qing Jin Gan Jie Tang (Clear Metal Sweet Platycodon Decoction) as main treatment, Mai Dong Qing Fei Yin (Ophiopogon Lung-Clearing Drink) for regulation. Also caused by Seven Emotions, hunger/fullness, labor injury damaging Spleen/Lung; or physical labor internal injury, shouting in wind, external Cold invading, unresolved, causing Lung Abscess. Pulse must be floating and slightly rapid, chest heat, coarse breathing, alternating chills/fever, cough with phlegm. General use: Jin Li Tang (Gold Carp Decoction), La Fan Wan (Beeswax Alum Pills), Tai Yi Gao (Supreme Paste), taken alternately, also effective. (From Zheng Zong)
He further stated: Rough palm skin, surging/rapid six pulses, shortness of breath, malar flush, foul pus/white blood, vomiting/regurgitation/aspiration, collapsed nose, inability to eat—all indicate untreatable conditions.
He further stated: Cool body, fine pulse, flowing pus/blood, bright sputum color, appetite returning, gradual cessation of pus/blood—no harm. Opposite indicates death.
He further stated: Chronic cough/labor injury, coughing phlegm/blood, alternating chills/fever, emaciation, spitting bloody pus, hoarse voice/sore throat, transmitting to Lung Flaccidity—a hundred deaths, one life. Treatment: Zhi Mu Fu Ling Tang (Anemarrhena and Poria Decoction) as main treatment, Ren Shen Wu Wei Tang (Ginseng and Schisandra Decoction) for regulation.
Qi Bo stated: Anyone with asthma, vomiting, coughing has Lung disease. The Lung is a Metal organ, also a delicate organ, located above the Heart, lobed like a lotus, red petals purple stem. Below the pharyngeal tube is where Lung Qi enters/exits, excluding food. Above the pharynx is the Uvula (Wei Yan), the little tongue. The Uvula covers the pharyngeal gate, allowing food/drink to enter the esophagus and pass to the Stomach. If one speaks much while eating, the Uvula fails to cover the gate, and rice/food enters the trachea, causing incessant cough. Thus, the trachea admits no object, proving medicine cannot enter directly. Treating the Lung via direct method is very difficult; turn to treating the Spleen. If Spleen Qi is nourished, Earth generates Metal, asthma/cough stops. Therefore, among the five Zang organs, except the Lung, all can be treated directly; only the Lung cannot. So how to treat Lung Carbuncles/Sores? Use Qing Jin Xiao Du Tang (Clear Metal Detoxifying Decoction). (From Mi Lu)
He further stated: Carbuncles inside the chest/abdomen arise from Fire and Pathogens. External powder applications are too distant; internal resolution is essential. However, if the carbuncle is huge and urgent, a cup of water cannot save a burning cartload of firewood. Thus, large doses of Jiu Fei Xiao Du Zhi Sheng Dan (Save Lung Detoxify Supreme Holy Pill) decocted and drunk are necessary to scatter Fire-Pathogens and eliminate carbuncles. If one relies on external skin applications or small-dose oral remedies daily, I see only death.
Zhang Zhongjing stated: Sores/ulcers arising from abundant Fire-Pathogens have not developed overnight. To eliminate Fire-Pathogens, can ordinary small medicines remove them? Thus, heavy medicines must be used in large amounts to subdue them. However, pathogen-dispersing medicines consume True Yin; heavy use leads to failure. Only Jin Yin Hua defeats toxin without damaging Qi, removes Fire while tonifying Yin. Thus, it must be the Sovereign herb. Its nature is pure and upright, like a gentleman. Just as a gentleman fights villains among the crowd to avoid disaster, one needs 10 liang or even 1 jin to succeed quickly. Relying on this single herb seems weak; other medicines must assist, each with subtle logic, not used randomly. Add Mai Dong to moisten Lung; Gui/Shao to moisten Liver; Di Yu to cool Large Intestine; Gan Cao to drain Fire; Zhi Zi to clear Heat; Yi Yi Ren to remove Dampness. The user must discern.
Feng Luzhan stated: Lung Abscess results from Labor injury to Blood/Qi, internal accumulated Heat, external Wind-Cold, chest fullness/urgency, dull pain, dry throat/mouth, occasional turbid/foul sputum. Vomiting pus like rice porridge indicates death. Pulse slippery/rapid or excess/large. Pressing right hypochondrium causes pain. Must use Fei Yong Shen Tang (Divine Decoction for Lung Abscess): unformed resolves, formed suppurates, suppurated heals. Repeatedly used, repeatedly effective. (From Jin Nang)
He further stated: Qi of the whole body relates entirely to the Lung. Lung clear, Qi moves; Lung turbid, Qi obstructs; Lung hot, Fluids do not move, muscles become rough (Jia Cuo means skin not moist/nourished). Many develop Lung Abscess. Yong (Abscess) means obstruction, formed by long-term stagnation of Lung Qi and Heat. Generally, chronic cough injures Lung, Yuan Qi gradually deficiences. Patient has alternating chills/fever, spontaneous sweating, turbid saliva/foam in mouth, or cough with red-line pus/blood, or much saliva/foam without pus. Cun Kou pulse rapid, deficient/choppy, or deficient/surging. Named Lung Flaccidity, due to Heat in Upper Jiao. If mouth parched, coughing, dull chest pain, dry throat/wheezing/thirst, slight limb swelling, hemoptysis followed by purulent sputum, chest Jia Cuo, or