忌酢物。未好瘥更作。若兼服。其人或胸中寒。或直恶寒。及虚胀并痛者。加吴茱萸八两。○案此亦用芦根。
而治肺痿。可见痈痿虽虚实不同。然至热郁津枯。则一也。故附此以备考。
肺痈。胸满胀。一身面目浮肿。鼻塞清涕出。不闻香臭酸辛。咳逆上气。喘鸣迫塞。葶苈大枣泻肺汤
主之。（〔原注〕方见上。三日一剂。可至三四剂。此先服小青龙汤一剂乃进。小青龙方。见咳嗽门中。○千
金。胸下有胁字。无酸辛二字。外台。与本文同。唯胸下有胁字。千金外台。此条接于前
泻肺汤条。案方见上三字衍。自三日一剂。至乃进二十字。千金之文。而外台。引千金。
无此二十字。方后云。仲景伤寒论。范汪同。脉经。亦载此条。明是仲景旧文。今列于附方之后者。必后人编
次之误也。程氏。金鉴。揭为原文。删注三十二字。为是。沈魏尤诸家。以为附方。盖不考耳。）
〔程〕痈在肺则胸胀满。肺朝百脉。而主皮毛。肺病则一身面目浮肿也。肺开窍于鼻。肺气壅滞。则蓄
门不开。但清涕渗出。而浊脓犹塞于鼻肺之间。故不闻香臭酸辛也。以其气逆于上焦。则有喘鸣迫塞之证。
与葶苈大枣汤以泻肺。
〔鉴〕是邪外塞皮毛。内壅肺气。比之喘不得卧。殆尤甚焉。亦以
葶苈大枣泻肺汤者。因其脓未成故也。
忌食醋类食物。若病未痊愈，可再次制作服用。如果兼服此方后，患者出现胸中寒冷、或极度恶寒，以及虚胀并伴有疼痛的情况，需加入吴茱萸八两。○按语：此处也使用了芦根来治疗肺痿，可见肺痈与肺痿虽然虚实不同，但到了热邪郁结、津液枯竭的阶段，其病机是一致的。因此附在此处以供参考考证。
肺痈。症状表现为胸部胀满，全身及面目浮肿，鼻塞流清涕，嗅觉失灵，闻不到香、臭、酸、辛等气味，咳嗽气逆，喘息有声且气道阻塞。以葶苈大枣泻肺汤主治。（〔原注〕方剂见上文。每三日服用一剂，最多可服用三至四剂。此处应先服用小青龙汤一剂，然后再进服本方。小青龙汤的方剂组成，见“咳嗽”门中。○《千金方》记载：“胸下”后有“胁”字，无“酸辛”二字。《外台秘要》与本文相同，只是“胸下”后有“胁”字。《千金方》和《外台秘要》将此条接在之前的泻肺汤条文之后。按语认为，“方见上”三字为衍文，从“三日一剂”到“乃进”这二十个字，是《千金方》的文字，而《外台秘要》引用《千金方》时没有这二十个字。方后注云：出自张仲景《伤寒论》，范汪著作与之相同，《脉经》也载有此条，明明白白是张仲景的原文。现在列在附方之后，必然是后人编纂时的错误。程林氏、《医宗金鉴》将其揭出作为原文，删去了三十二字的注文，这是正确的。沈魏尤等各家认为是附方，大概是没有考证清楚。）
〔程林注〕痈毒在肺则胸部胀满。肺朝会百脉，主司皮毛。肺生病则全身及面目浮肿。肺开窍于鼻，肺气壅滞，则门户不开，只有清涕渗出，而浑浊的脓液仍堵塞在鼻肺之间，所以闻不到香、臭、酸、辛的气味。因为气逆于上焦，所以有喘息有声、气道阻塞的症状。给予葶苈大枣汤以泻除肺中邪气。
〔《医宗金鉴》注〕这是邪气外塞皮毛，内壅肺气，比起喘促不能卧倒的症状，恐怕更加严重。也是使用葶苈大枣泻肺汤的原因，是因为脓液尚未形成，故用此法。
Avoid vinegar and acidic foods. If the illness has not yet fully resolved, it may be prepared and administered again. If, upon concurrent administration, the patient experiences coldness in the chest, or severe aversion to cold, along with distension and pain due to deficiency, add *Evodiae Fructus* (Wuzhuyu) eight liang. ○ Note: This prescription also employs *Phragmitis Rhizoma* (Lugen) for the treatment of Lung Flaccidity (Fei Fei). This demonstrates that although Lung Abscess (Fei Yong) and Lung Flaccidity differ in terms of excess and deficiency, when heat pathogen stagnates and body fluids are depleted, the pathological mechanism is identical. Therefore, it is appended here for reference and verification.
Lung Abscess. Symptoms include chest fullness and distension, edema of the whole body and face, nasal congestion with clear discharge, loss of olfactory sensation (unable to perceive fragrant, foul, sour, or pungent odors), coughing with rebellious Qi, wheezing with rhonchi, and a sensation of obstruction in the airway. It is primarily treated with *Tingli Dazao Xiefei Tang* (Descurainia Seed and Jujube Decoction to Drain the Lungs). ([Original Annotation] The formula is seen above. Administer one dose every three days; up to three or four doses may be given. Here, one dose of *Xiao Qinglong Tang* (Minor Green Dragon Decoction) should be taken first before proceeding with this formula. The composition of *Xiao Qinglong Tang* can be found in the "Cough" section. ○ *Qianjin Fang*: After "under the chest," there is the character "hypochondrium"; the words "sour and pungent" are absent. *Waitai Miyao*: Same as the main text, except after "under the chest," there is the character "hypochondrium." Both *Qianjin Fang* and *Waitai Miyao* place this clause immediately after the previous clause regarding the Decoction to Drain the Lungs. Note: The three characters "formula seen above" are superfluous. The twenty characters from "one dose every three days" to "then proceed" belong to the text of *Qianjin Fang*, whereas *Waitai Miyao*, when citing *Qianjin Fang*, lacks these twenty characters. The post-prescription note states: From Zhang Zhongjing's *Shanghan Lun*, Fan Wang's work agrees. *Mai Jing* also records this clause, clearly indicating it is original text by Zhang Zhongjing. That it is now listed after the Supplementary Formulas must be an error in later compilation. Cheng Lin and *Yizong Jinjian* extracted it as original text and deleted the thirty-two characters of annotation, which is correct. Shen, Wei, You, and other scholars considered it a supplementary formula, likely due to lack of investigation.)
[Cheng Lin's Commentary] When an abscess is in the Lung, there is chest fullness and distension. The Lung receives all vessels and governs the skin and hair. When the Lung is diseased, edema occurs in the whole body and face. The Lung opens into the nose. When Lung Qi is stagnant, the orifice does not open properly; only clear mucus exudes, while turbid pus remains blocked between the nose and lungs, resulting in the inability to perceive fragrant, foul, sour, or pungent odors. Because Qi rebels upward in the Upper Jiao, symptoms such as wheezing with rhonchi and airway obstruction occur. Provide *Tingli Dazao Xiefei Tang* to drain the Lung.
[*Yizong Jinjian* Commentary] This is where pathogenic factors externally obstruct the skin and hair and internally congest Lung Qi. Compared to wheezing that prevents lying down, this condition is arguably even more severe. The reason for using *Tingli Dazao Xiefei Tang* is that the pus has not yet formed.