〔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，有的伴有口渴饮水，有的则不渴不饮。虚证表现为咽喉间发出哽噎之声，常长出气（叹息）。
肺病出现胸闷烦乱、咽喉哽噎、长吁短叹、气短且呼吸急促。若肺有热邪，患儿会用手抓挠眉毛、眼睛、鼻子和面部，治疗应以甘桔汤为主。若肺气过盛，又感受风冷之邪，导致胸部胀满、气短、呼吸急促、咳嗽伴气逆上冲，应当先疏散肺经郁热，再发散风冷之邪。疏散肺热可用泻白散或大青膏；若仅是肺受伤寒，则不会出现胸满症状。若为肺脏虚热，嘴唇呈深红色，治疗应疏散肺中虚热，少量服用泻白散。若肺脏虚弱怯弱，嘴唇发白，当用补肺阿胶散治疗；如果出现胸闷烦乱、气息粗重、喘促及咽喉哽噎的症状，则难以治愈，这是因为肺脏虚损的缘故。脾肺两脏患病日久，都会变得虚弱而嘴唇发白，脾是肺的母脏，母子皆虚，不能相互滋养，所以称为“怯”。肺病见嘴唇白而有光泽者预后良好，若白如枯骨则预后不良。（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，用阿胶散治疗；若手寻衣领并胡乱捻弄物品，属肝热，宜用泻青丸；手抓挠眉目鼻面者，属肺热，宜用甘桔汤之类。）肺病见于春季，金气旺盛，肺胜肝木，应当泻肺，轻症则肺病消退，重症则眼睛淡青色，必定会发生惊风，若有赤色，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，用泻白散治疗。虚证表现为喘促且少气，先用益黄散，后用阿胶散治疗。心火乘肺，为贼邪，表现为发热喘咳，先用地黄丸，中间用导赤散，后用阿胶散治疗。肝木乘肺，为微邪，表现为恶风、眩晕昏沉、咳嗽，用羌活膏治疗。肾水乘肺，为实邪，表现为憎寒、咳嗽清稀，用百部丸治疗。脾土乘肺，为虚邪，表现为身体沉重、呕吐痰涎、泄泻、咳嗽，用人参白术散治疗。
【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，接着看脾脉，如果脾气虚冷，就不能相生，导致肺中生气不足，容易感受风邪，所以患肺寒病的，都是因脾虚所致。如果脾气盛实，则会痞塞中焦，大肠与肺互为表里而不能相通，中焦热邪阻隔，则肺与大肠不通，热毒之气必然上蒸于肺而生痰，所以患肺热病的，多因脾实所致。心气盛者泻之，脾气虚者补益之，脾气实者通利之，然后根据其肺部的寒热情况进行治疗，因此有抑心气、益脾气、通肺气这三种药物配合。如果诊察脉象发现心、脾两脏都调和，而肺脏自己产生疾病，则只需考察肺脏的虚实进行治疗。
【薛己】肺经郁热，用泻白散。肺气自虚，用四君子汤。外邪侵袭，用参苏饮。心火炎上致燥，用人参平肺散。中焦实邪痞塞，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。若肺虚而有热，拘泥于“肺热还伤肺”的说法而不用人参，那就错了，仍应根据证候治疗加以参详。
【张元素】肺苦气上逆，急食苦味以泻之，如诃子皮（一说用黄芩）。肺欲收敛，急食酸味以收之，如白芍药。用酸味补之，如五味子。用辛味泻之，如桑白皮。肺虚，用五味子补之，如果没有其他证候，钱乙的补肺阿胶散为主方。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，当用五味异功散以补脾。
【张元素】肺实，用桑白皮泻之，如果没有其他证候，以泻白散为主方。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，宜用此方直泻肺热。用山栀、黄芩方能泻肺，但应当区分气血进行辨证。
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 conditions, there is chest oppression and mental restlessness with rapid breathing; some patients desire to drink water, while others do not. In deficiency conditions, there is a choking sensation in the throat and frequent sighing (long exhalation).
Lung disease presenting with chest oppression, mental restlessness, choking sensations, 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; Ganjie Tang (Licorice and Platycodon Decoction) is the primary formula. If Lung Qi is excessive and complicated by wind-cold, leading to chest fullness, shortness of breath, urgent panting, coughing with rebellious Qi, one should first dissipate Lung heat, then disperse wind-cold. To dissipate Lung heat, Xiebai San (White Powder to Drain the Lung) or Daqing Gao (Great Blue Ointment) are indicated. If it is merely Lung affected by cold damage, chest fullness will not occur. If there is deficiency-heat in the Lung, the lips will be deep red; treatment should dissipate Lung deficiency-heat, administering small doses of Xiebai San. If the Lung organ is weak and deficient, the lips will be white; Bufeijiao'ou San (Donkey-Hide Gelatin Decoction for Tonifying the Lung) is indicated. If accompanied by chest oppression, mental restlessness, coarse breathing, urgent panting, and choking sensations, the prognosis is poor due to severe Lung deficiency. Chronic diseases of the Spleen and Lung lead to deficiency and white lips; since the Spleen is the mother of the Lung, if both mother and child are deficient and fail to nourish each other, it is termed "weakness" (Qie). White lips with luster indicate a favorable outcome in Lung disease; white lips like dried bone indicate death. (This method diagnoses Lung disease via the lips: white lips indicate Lung weakness, treated with Ejiao San; scratching at clothes collars and fidgeting indicates Liver heat, treated with Xieqing Wan; scratching eyebrows, eyes, nose, and face indicates Lung heat, treated with Ganjie Tang.) When Lung disease appears in spring, Metal is prosperous, and Lung overcomes Liver; one should drain the Lung. In mild cases, the Lung disease recedes; in severe cases, the eyes appear pale blue, convulsions (Jing Feng) will inevitably occur, and if redness is present, nasal insufflation should be used. (Zhang Yuansu states: This is because Liver Qi is weak, hence the pale blue eyes.)
[Li Dongyuan] The Lung governs dryness; self-originating disease manifests as panting and coughing; dryness should be moistened. Excess conditions manifest as panting with abundant Qi, treated with Xiebai San. Deficiency conditions manifest as panting with scanty Qi, initially treated with Yihuang San, followed by Ejiao San. Heart fire attacking the Lung (Thief Evil) presents with heat, panting, and coughing; initially treat with Dihuang Wan, then Daochi San, followed by Ejiao San. Liver wood attacking the Lung (Minor Evil) presents with aversion to wind, dizziness, fainting, and coughing, treated with Qianghuo Gao. Kidney water attacking the Lung (Excess Evil) presents with aversion to cold, clear coughing, and profuse urination/stool, treated with Baibu Wan. Spleen earth attacking the Lung (Deficiency Evil) presents with heavy body, vomiting phlegm, diarrhea, and coughing, treated with Renshen Baizhu 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], resulting in insufficient vital Qi in the Lung, making it susceptible to wind pathogens. Thus, Lung cold diseases often arise 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 pairs). Heat stagnation in the Middle Jiao blocks Lung and Large Intestine communication; toxic heat qi steams upward into the Lung generating phlegm. Thus, Lung heat diseases often arise from Spleen excess. Excess Heart Qi is drained; deficient Spleen Qi is tonified; excessive Spleen Qi is unblocked. Only then should the Lung be treated according to its cold or heat. Hence, there are three herbs/methods: suppressing Heart Qi, tonifying Spleen Qi, and unblocking Lung Qi. If the pulse reveals that both Heart and Spleen are harmonious, yet the Lung itself is diseased, one should simply examine the Lung's excess or deficiency and treat accordingly.
[Xue Ji] Lung meridian depression-heat is treated with Xiebai San. Self-deficiency of Lung Qi is treated with Sijunzi Tang (Four Gentlemen Decoction). Invasion by external pathogens is treated with Shensu Yin (Ginseng and Perilla Drink). Heart fire flaring causing dryness is treated with Renshen Pingfei San (Ginseng Formula to Calm the Lung). Excess stagnation in the Middle Jiao is treated with Dachengqi Tang (Major Order the Qi Decoction). Spleen failing to generate Lung is treated with Yigong San (Extraordinary Aid Powder). What is termed "excessive Lung Qi" refers to an abundance of pathogenic Qi within the Lung; the pulse at the Right Cun position will be floating and forceful, indicating the use of Xiebai San to drain it. If there is Lung deficiency with heat, adhering strictly to the saying "Lung heat injures the Lung again" and omitting Ginseng would be an error; one must still consider the syndrome differentiation.
[Zhang Yuansu] The Lung suffers from rebellious Qi; urgently consume bitter substances to drain it, such as Heqie Pi (Pericarpium Chebulae) [or Huangqin (Scutellariae Radix)]. The Lung desires consolidation; urgently consume sour substances to consolidate it, such as Baishaoyao (Paeoniae Radix Alba). Use sour substances to tonify it, such as Wuweizi (Schisandrae Fructus). Use pungent substances to drain it, such as Sangbaipi (Mori Cortex). For Lung deficiency, tonify with Wuweizi; if there are no other symptoms, Qian Yi's Bufeijiao'ou San is the primary formula. Deficiency requires tonifying the mother; the Spleen is the mother of the Lung, so tonify the Spleen with Gancao (Glycyrrhizae Radix et Rhizoma).
Bufeijiao'ou San (Qian Yi Formula) Also known as Bufei San
Ejiao (1 liang 5 qian, stir-fried with bran) Shuniuzi (Stir-fried until fragrant) Gancao (Honey-fried, 2.5 qian each) Madouling (0.5 liang, baked) Xingren (7 kernels, skin and tip removed, stir-fried) Nuomi (1 liang, stir-fried)
Grind all into powder. Take 1-2 qian per dose, decoct with 1 cup of water until reduced to 6 fen, take warm after meals.
[Zhang Yuansu] Xingren (Prunus Armeniacae Semen) primarily drains the Lung; it is not tonifying like Renshen (Ginseng Radix), Tianmendong (Asparagi Radix), or Maidong (Ophiopogonis Radix). Its use should be judged according to circumstances.
[Xue Ji] The preceding formulas are general treatments for Lung Metal disorders. The Classic states: "In deficiency, tonify the mother." If the previous medicines are ineffective, use Wuwei Yigong San (Six-Ingredient Powder with Schisandra) to tonify the Spleen.
[Zhang Yuansu] Lung excess is drained with Sangbaipi; if there are no other symptoms, Xiebai San is the primary formula. Excess requires draining the child; the Kidney is the child of the Lung, so drain the Kidney with Zexie (Alismatis Rhizoma).
Xiebai San (Qian Yi Formula) Also known as Xiefei San
Sangbaipi (Finely chopped, stir-fried until yellow) Digupi (Washed free of soil, baked. Each 1 liang) Gancao (Stir-fried, 0.5 liang)
Grind all into powder. Take 1-2 qian per dose, add 1 cup of water and 100 grains of Jingmi (Oryza Sativa Germ), decoct together until reduced to 6 fen, take warm after meals.
[Zhang Yuansu] To treat Lung heat with bone-steaming fever and spontaneous sweating, this formula should be used to directly drain the heat. Zhizi (Gardeniae Fructus) and Huangqin (Scutellariae Radix) can drain the Lung, but one must differentiate based on Qi and Blood.
Ganjie Tang (See Throat Chapter) Daqing Gao Qianghuo Gao (Both see Convulsions Chapter) Baibu Wan (See Cough Chapter) Renshen Baizhu San (See Measles-Thirst Chapter) Sijunzi Tang (See Miscellaneous Diseases Consumption Chapter) Shensu Yin (Miscellaneous Diseases Fever Chapter) Renshen Pingfei San (Miscellaneous Diseases Cough Chapter)