《金匮》云∶其人咳，口中有浊唾涎沫，脉数虚者，此为肺痿。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，故得之。治肺痿，大要当以甘草汤调和营卫为
君，臣以润燥、清热、降气、消痰之剂，煎膏时时噙化，缓以图之，方可挽回于万一。若大驱涎
沫，欲求速效，反速毙也。
《金匮》甘草汤 治肺痿咳嗽，唾涎沫不止。〔肺热而痿，清肃失令，则上输之精气，不能收
摄运化，故吐浊涎。〕
甘草〔一味水煎，频饮之，热自渐化。但最难服处，半月后方得效。〕加二冬、百合、梨汁、
贝母、苏子、枇杷叶皆可用。
此治痿独取阳明之义。徐忠可云∶余外家病肺痿，初时痰沫成碗，服一味甘草汤，半月始痰少而得愈。
《金匮》云∶若口中辟辟燥，咳则胸中隐隐痛，脉数实者，此为肺痈。始荫可救，脓成则死。又
云∶咳而胸满，振寒脉数，咽不干渴，时出浊唾腥臭，此为肺痈，久之吐脓如米粥者死。嘉言云∶凡见
咳逆上气，即宜防痈痿之症。肺受火热熏蒸，即血为之凝，血凝即痰为之裹，遂成小痈。若能初起即
识，当血结而脓未成之时，急泻其肺，方为恰当。迨至血化为脓，泻之无益，肺叶朽坏，倾囊吐出而死。
间有痈小，气壮胃强善食，其脓不从口出，或顺趋肛门，或旁穿胁肋，仍可得生，然亦不过十中二、三耳。
《金匮》葶苈大枣泻肺汤 治肺痈，喘不得卧。
甜葶苈〔泻其肺实，下其败浊，不致腐溃吐脓。二、三钱。〕大枣〔固脾胃之元，数枚。〕
或合甘桔汤。〔亦治肺痈之剂。〕如连翘〔能散血结气聚。〕牛蒡〔能散诸痈肿毒。〕金
银花〔解毒圣药。〕陈年芥卤〔肺痈神丹。〕贝母〔散结消肿。〕花粉〔清热消肿。〕皆
可采用。
此治肺痈吃紧方也，随症加减治之。
咳嗽之脉，浮濡易治，〔嗽乃肺病，脉浮为宜，兼见
细软，病将退也。〕沉、浮而紧者死。〔与症相反，病必深矣。〕久嗽脉弱者生，实大数者死，上气
喘嗽，面肿息肩，脉浮大者死。
《金匮要略》中说：病人咳嗽，口中吐出浑浊的唾液和涎沫，脉象数而虚弱的，这是肺痿病。这种病有的因为发汗过度，有的因为呕吐，有的因为消渴症导致小便频数，有的因为大便困难，又被峻下药物强行通便，导致津液严重耗伤，因此患病。治疗肺痿，大原则应当以甘草汤调和营卫作为主药（君药），辅以润燥、清热、降气、消痰的药物，煎制成膏剂，时时含服，缓慢调理，才有可能挽回生机。如果猛烈驱除涎沫，追求速效，反而会加速死亡。
《金匮要略》中的甘草汤，治疗肺痿咳嗽，吐涎沫不止。（肺热导致肺叶枯萎，清肃功能失常，则上输的精气不能收摄运化，所以吐出浊涎。）
甘草（单味药水煎，频繁饮用，热邪自然逐渐化解。但最难服用之处在于，半个月后才会见效。）可以加入天冬、麦冬、百合、梨汁、贝母、苏子、枇杷叶，这些都可以使用。
这体现了“治痿独取阳明”的意义。徐忠可说：我的外家亲属患肺痿，起初痰沫多如碗许，服用一味甘草汤，半个月后痰减少而痊愈。
《金匮要略》又说：如果口中感觉干燥，咳嗽时胸中隐隐作痛，脉象数而实的，这是肺痈。初期尚可救治，脓液形成则预后不良（致死）。又说：咳嗽且胸部胀满，恶寒战栗，脉数，咽喉不干不渴，时常吐出浑浊腥臭的唾沫，这是肺痈，日久吐出如米粥般的脓液者死。嘉言说：凡是见到咳逆上气，就应当预防痈或痿的症状。肺受到火热熏蒸，血液就会凝结，血凝滞则被痰包裹，遂形成小痈。如果在初起时就能识别，应当在血结而脓未成之时，急泻肺气，这才是恰当的治疗方法。等到血化为脓，再泻就无益了，肺叶朽坏，倾囊吐出脓液而死。偶尔有痈较小，正气壮实、胃气强盛、食欲好的人，其脓液不从口出，或者顺趋肛门排出，或者旁穿胁肋，仍可得生，但也只有十分之二三罢了。
《金匮要略》中的葶苈大枣泻肺汤，治疗肺痈，气喘不能平卧。
甜葶苈（泻除肺中实邪，下行败浊之气，防止腐溃吐脓。用量二至三钱。）大枣（固护脾胃元气，数枚。）
也可以合用甘桔汤。（也是治疗肺痈的方剂。）如连翘（能消散血结气聚。）牛蒡（能消散各种痈肿毒。）金银花（解毒圣药。）陈年芥卤（治疗肺痈的神丹。）贝母（散结消肿。）花粉（清热消肿。）都可以采用。
这是治疗肺痈的关键方剂，随症状加减治疗。
咳嗽的脉象，浮濡脉容易治疗。（嗽是肺病，脉浮为宜，兼见细软脉，表示病将退去。）沉脉、浮而紧脉者死。（脉与症相反，病必深入。）久嗽脉弱者生，脉实大数者死，上气喘嗽，面部浮肿，呼吸抬肩，脉浮大者死。
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: If a patient coughs, has turbid saliva and froth in the mouth, and presents with a rapid and deficient pulse, this is Lung Wei (Lung Atrophy). This condition may arise from excessive sweating, vomiting, Xiao Ke (Wasting and Thirsting Syndrome) causing frequent urination, or constipation treated with harsh purgatives that severely deplete body fluids. In treating Lung Wei, the general principle is to use Gancao Tang (Licorice Decoction) as the sovereign herb to harmonize Ying and Wei (Nutritive and Defensive Qi), assisted by ministers that moisten dryness, clear heat, descend Qi, and resolve phlegm. These should be decocted into an electuary, taken frequently by holding in the mouth, allowing for slow recovery; only then can there be a slight chance of survival. If one aggressively expels saliva and froth seeking rapid results, death will be hastened instead.
Gancao Tang from the *Jin Gui Yao Lue* treats Lung Wei cough with incessant expectoration of froth. [When lung heat causes atrophy and loss of descending function, the essence transported upward cannot be retained and transformed, leading to the expulsion of turbid saliva.]
Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) alone, decocted in water and drunk frequently, gradually resolves heat. However, it is difficult to administer, as efficacy is not seen until after half a month. Er Dong (Tian Dong and Mai Dong, *Asparagi Radix* and *Ophiopogonis Radix*), Baihe (Lily Bulb, *Lilii Bulbus*), Li Zhi (Pear Juice), Beimu (Fritillaria Bulb, *Fritillariae Cirrhosae Bulbus*), Suzi (Perilla Seed, *Perillae Fructus*), and Pipaye (Loquat Leaf, *Eriobotryae Folium*) are all usable.
This reflects the principle of "treating Wei syndromes by focusing on the Yangming channels." Xu Zhongke stated: My relative suffered from Lung Wei; initially, the phlegm and froth filled bowls. After taking single-herb Gancao Tang, the phlegm decreased after half a month, and they recovered.
The *Jin Gui Yao Lue* further states: If the mouth feels dry ("pipi" dryness), coughing causes dull pain in the chest, and the pulse is rapid and excess, this is Fei Yong (Lung Abscess). It is curable in the early stage, but fatal once pus forms. It also states: Cough with chest fullness, chills, rapid pulse, non-dry/non-thirsty throat, and occasional expectoration of turbid, foul-smelling sputum indicates Lung Abscess. If, over time, one expects pus like rice porridge, it is fatal. Jiayan stated: Whenever one sees rebellious Qi rising and coughing, one must guard against symptoms of Yong or Wei. When the lung is steamed by fire-heat, blood coagulates; coagulated blood becomes wrapped by phlegm, forming a small abscess. If recognized at the onset, while blood is knotted but pus has not yet formed, urgently draining the lung Qi is appropriate. Once blood transforms into pus, draining is useless; the lung tissue rots, and death occurs when the contents are expelled. Occasionally, if the abscess is small and the patient’s Qi is strong, stomach robust, and appetite good, the pus may exit via the anus or perforate through the ribs, allowing survival, though this accounts for only two or three out of ten cases.
Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung) from the *Jin Gui Yao Lue* treats Lung Abscess with wheezing and inability to lie down.
Tian Tingli (Sweet Descurainia Seed, *Descurainiae Semen Lepidii Seminis*), drains lung excess and descends turbid pathogens, preventing putrefaction and pus expectoration. Dosage: 2-3 qian. Dazao (Jujube Fruit, *Ziziphi Jujubae Fructus*), secures the source of Spleen and Stomach Qi. Dosage: Several pieces.
It may be combined with Ganjie Tang (Licorice and Platycodon Decoction), which is also a formula for Lung Abscess. Lianqiao (Forsythia Fruit, *Forsythiae Fructus*) disperses blood knots and Qi stagnation. Niubangzi (Arctium Fruit, *Arctii Fructus*) disperses various sores and toxic swellings. Yinjinhua (Honeysuckle Flower, *Lonicerae Japonicae Flos*) is a supreme drug for detoxification. Chen Nian Jie Lu (Aged Mustard Brine) is a divine pill for Lung Abscess. Beimu (Fritillaria Bulb, *Fritillariae Cirrhosae Bulbus*) dissipates nodules and reduces swelling. Huafen (Trichosanthes Root, *Trichosanthis Radix*) clears heat and reduces swelling. All may be adopted.
This is a critical formula for treating Lung Abscess; modify it according to symptoms.
Regarding the pulse of cough: A floating and soft pulse is easy to treat. [Cough is a lung disease; a floating pulse is appropriate. If accompanied by fine and soft qualities, the disease is receding.] A deep pulse, or a floating and tight pulse, indicates death. [The pulse contradicts the syndrome, indicating deep disease.] For chronic cough, a weak pulse indicates survival; an excess, large, and rapid pulse indicates death. For rebellious Qi with wheezing cough, facial edema, and breathing with shoulder elevation, a floating and large pulse indicates death.