鸡胸龟背，古方书列于一门，未能条分缕晰，治法甚略。予按∶鸡胸发于肺，龟背则肝脾肾肺皆有之。肺位最高，
处于胸中，积而生热，肺气上浮，胸骨高起，是为鸡胸。咳嗽或无，气粗必见，日久羸瘦，发热毛焦，唇红面赤，即成
气疳之候。气疳者，即肺疳也，宜清降肺气，气降痰消，胸骨自平。又有鸡胸龟背并发者，肺有痰热，客风从风门而入
于肺，其背庀于脊之第三椎，乃肺气壅遏，胸背之骨撑凸而起。有单脊凸而胸不高者，其候短气头低，兼咳嗽，腰背板
强，久则两足软弱，甚至不能站立。肺为肾母，肾为肺子，清肃不降，肾水不生，肺虚不能荣运，脏腑灌溉经络，上元
竭而下源惫。经云∶所谓肺热叶焦，为痿 是也。虽然下枯，还当治肺，肺气清肃，金来生水，子受其荫矣。古方之龟
胸丸用硝黄，未免伤其正气。龟背，之用六味鹿茸，奈地萸之滞腻，鹿茸之助阳，非不中病，必致增剧。且肺为清虚之
脏，病在上者只可轻清。余经验数方录后，以为后学人参考，非可云法，聊补前人之未备耳。
枇杷叶膏（自制） 治鸡胸及龟背，肺俞脊庀发热，咳嗽，气粗喘促，呼吸有痰音者，其
叶气味俱薄，肺胃二经之药清肺降气，开胃消痰。
鲜枇杷叶五斤，拭去毛，煎浓汁去渣滤清，熬至稠浓，加冰糖十两，溶化收膏。
清肺饮（自制） 治鸡胸内有痰热，兼受外风者。
杏仁（二钱） 苏梗（一钱） 栝蒌皮（三钱） 川贝母（一钱） 橘红（一钱） 桑叶（一钱） 枳壳
（八分） 枇杷叶（三钱，去毛） 牛蒡子 桔梗（一钱）
加味泻白散（自制） 治鸡胸气粗身热。
桑白皮（二钱） 苏梗（一钱） 川贝母（一钱） 橘红（一钱） 甘草（三分） 栝蒌皮（三钱）
杏仁（二钱） 地骨皮（钱半） 茯苓（二钱） 悉尼（三片）
加味白薇汤（自制） 治肺胃痰热壅于膈上，身热咳嗽，气粗痰鸣，口干作渴。
白薇（二钱） 蒌仁（三钱） 橘红（一钱） 杏仁（二钱） 象贝（二钱） 丹皮（五钱） 桑白皮
（二钱） 青蒿（一钱） 竹茹（一钱） 浮石（三钱） 悉尼（三片）
麦冬汤（自制） 治肺虚有热，胃有湿痰。
南沙参（三钱） 麦冬（二钱） 橘红（一钱） 栝蒌皮（三钱） 蛤粉（二钱） 清半夏（一钱） 川贝（一钱）
茯苓（二钱） 苡米（三钱） 竹茹（六分）
补肺清金饮（自制） 治鸡胸龟背，脉虚数，身热少食者。
淮山药（三钱） 北沙参（三钱） 麦冬（二钱） 杏仁（二钱） 蒌皮（三钱） 茯苓（二钱） 橘红
（一钱） 川石斛（三钱） 毛燕（二钱） 莲子（十粒，去心） 大贝（二钱）
金水准调散（自制） 治鸡胸龟背，内无痰，脚弱不能站立。
麦冬（二钱） 茯苓（二钱） 女贞子（三钱） 料豆（三钱） 玉竹（三钱） 当归（钱半） 毛燕
（三钱） 怀牛膝（钱半） 旱莲草（钱半） 北沙参（三钱） 淮山药（二钱） 桑寄生（三钱） 红枣（三个）
鸡胸和龟背，古代医书将其归为一类论述，但未能条理清晰地分析，治疗方法也非常简略。我考察认为：鸡胸是由肺引起的，而龟背则与肝、脾、肾、肺都有关系。肺的位置最高，位于胸中，若积热内生，肺气上浮，导致胸骨高起，这就称为鸡胸。可能伴有咳嗽，也可能没有，但必然会出现气粗的症状；日久身体消瘦，发热，毛发干枯焦黄，嘴唇红，面色赤，这就是气疳的证候。气疳，就是肺疳，应当清降肺气，气降则痰消，胸骨自然平复。又有鸡胸和龟背同时并发的情况，这是肺中有痰热，客风从风门穴侵入肺部，背部第三椎处凹陷（庀），这是因为肺气壅滞遏阻，导致胸背骨骼撑凸而起。有仅脊柱凸起而胸部不高的，其症状为短气、头低垂，兼有咳嗽，腰背僵硬板强，时间久了两足软弱，甚至无法站立。肺为肾之母，肾为肺之子，若肺的清肃功能不降，肾水就无法滋生，肺虚不能滋养运行，脏腑无法灌溉经络，导致上元枯竭而下源疲惫。《内经》说：“所谓肺热叶焦，发为痿躄”，说的就是这个道理。虽然病根在下部枯槁，但仍应当治肺，肺气清肃，金能生水，子脏（肾）就能受到母脏（肺）的荫庇了。古方中的龟胸丸使用硝石、大黄，未免损伤正气。治疗龟背用的六味地黄丸加鹿茸，无奈山茱萸性质滞腻，鹿茸助阳，虽然并非不对症，但必定会导致病情加重。况且肺是清虚之脏，病在上焦只可用轻清之品。我将自己经验有效的几个方剂记录如下，供后学者参考，不敢说是定法，只是姑且弥补前人的不足罢了。
枇杷叶膏（自制） 治疗鸡胸及龟背，肺俞穴处脊柱凹陷发热，咳嗽，气粗喘促，呼吸有痰音者。枇杷叶气味俱薄，是入肺、胃二经的药物，能清肺降气，开胃消痰。
鲜枇杷叶五斤，擦去毛，煎煮浓汁去渣滤清，熬至稠浓，加入冰糖十两，溶化收膏。
清肺饮（自制） 治疗鸡胸内有痰热，兼受外风者。
杏仁（二钱） 苏梗（一钱） 栝蒌皮（三钱） 川贝母（一钱） 橘红（一钱） 桑叶（一钱） 枳壳（八分） 枇杷叶（三钱，去毛） 牛蒡子 桔梗（一钱）
加味泻白散（自制） 治疗鸡胸气粗身热。
桑白皮（二钱） 苏梗（一钱） 川贝母（一钱） 橘红（一钱） 甘草（三分） 栝蒌皮（三钱） 杏仁（二钱） 地骨皮（钱半） 茯苓（二钱） 悉尼（三片）
加味白薇汤（自制） 治疗肺胃痰热壅于膈上，身热咳嗽，气粗痰鸣，口干作渴。
白薇（二钱） 蒌仁（三钱） 橘红（一钱） 杏仁（二钱） 象贝（二钱） 丹皮（五钱） 桑白皮（二钱） 青蒿（一钱） 竹茹（一钱） 浮石（三钱） 悉尼（三片）
麦冬汤（自制） 治疗肺虚有热，胃有湿痰。
南沙参（三钱） 麦冬（二钱） 橘红（一钱） 栝蒌皮（三钱） 蛤粉（二钱） 清半夏（一钱） 川贝（一钱） 茯苓（二钱） 苡米（三钱） 竹茹（六分）
补肺清金饮（自制） 治疗鸡胸龟背，脉虚数，身热少食者。
淮山药（三钱） 北沙参（三钱） 麦冬（二钱） 杏仁（二钱） 蒌皮（三钱） 茯苓（二钱） 橘红（一钱） 川石斛（三钱） 毛燕（二钱） 莲子（十粒，去心） 大贝（二钱）
金水准调散（自制） 治疗鸡胸龟背，内无痰，脚弱不能站立。
麦冬（二钱） 茯苓（二钱） 女贞子（三钱） 料豆（三钱） 玉竹（三钱） 当归（钱半） 毛燕（三钱） 怀牛膝（钱半） 旱莲草（钱半） 北沙参（三钱） 淮山药（二钱） 桑寄生（三钱） 红枣（三个）
Chicken breast (pectus carinatum) and turtle back (kyphosis) were grouped into one category in ancient medical texts, but the analysis was not detailed and clear, and the treatment methods were very brief. I have examined this: Chicken breast originates from the Lung, whereas turtle back involves the Liver, Spleen, Kidney, and Lung. The Lung is located at the highest position, within the chest. If heat accumulates and generates internally, Lung Qi floats upward, causing the sternum to protrude; this is called chicken breast. Cough may or may not be present, but coarse breathing will definitely be seen. After a long time, the body becomes emaciated, fever occurs, hair becomes dry and brittle, lips are red, and the face is flushed; this constitutes the syndrome of Qi Gan (Lung Wasting-Thirst). Qi Gan refers to Lung Gan, and the appropriate treatment is to clear and descend Lung Qi. When Qi descends, phlegm dissipates, and the sternum naturally flattens. There are also cases where chicken breast and turtle back occur simultaneously. This is due to phlegm-heat in the Lung, with exogenous wind entering the Lung via the Fengmen (BL12) acupoint. The third thoracic vertebra on the back becomes concave (Pi), caused by the obstruction and stagnation of Lung Qi, leading to the protrusion of the chest and back bones. In cases where only the spine protrudes without chest elevation, the symptoms include shortness of breath, drooping head, accompanied by cough, stiffness and rigidity of the waist and back. Over time, both legs become weak, and even standing becomes impossible. The Lung is the mother of the Kidney, and the Kidney is the child of the Lung. If the Lung's clearing and descending function fails, Kidney Water cannot be generated. Lung deficiency fails to nourish and circulate, and the Zang-Fu organs fail to irrigate the meridians, resulting in the exhaustion of the upper source and the fatigue of the lower source. The Classics state: "What is meant by lung heat scorching the leaves, leading to Wei syndrome (flaccidity syndrome)," is precisely this. Although the lower part is withered, treatment should still focus on the Lung. If Lung Qi is clear and descending, Metal generates Water, and the child organ (Kidney) receives its benefit. Ancient formulas like Guixiong Wan use Nuxiao (Mirabilite) and Huanglian (Rhubarb), which inevitably damage healthy Qi. For turtle back, Liuwei Dihuang Wan plus Lurong (Deer Antler) is used; however, Shanzhuyu (Cornus officinalis) is cloying and stagnant, and Lurong aids Yang. Although not entirely inappropriate for the disease, it must inevitably exacerbate the condition. Moreover, the Lung is a pure and empty organ; diseases in the upper jiao can only be treated with light and clear agents. I record several empirically effective formulas below for reference by future students. These are not definitive methods, but merely an attempt to supplement the deficiencies of predecessors.
Pipa Ye Gao (Self-made): Treats chicken breast and turtle back, with fever at Feishu (BL13) and spinal concavity, cough, coarse breathing, wheezing, and rattling sounds during respiration. Pipa Ye (Loquat Leaf) has a thin aroma and flavor; it enters the Lung and Stomach meridians, clears the Lung, descends Qi, opens the stomach, and eliminates phlegm.
Fresh Pipa Ye (Loquat Leaf) 5 jin, wipe off hairs, decoct to make a thick juice, remove dregs and filter clearly, boil until thick and concentrated, add Bingtang (Rock Sugar) 10 liang, dissolve to form a paste.
Qingfei Yin (Self-made): Treats chicken breast with internal phlegm-heat, complicated by external wind.
Xingren (Apricot Seed) 2 qian, Sugeng (Perilla Stem) 1 qian, Gualoupi (Trichosanthes Peel) 3 qian, Chuanbeimu (Fritillaria Bulb) 1 qian, Juhong (Tangerine Red Peel) 1 qian, Sangye (Mulberry Leaf) 1 qian, Zhike (Bitter Orange Fruit) 8 fen, Pipaye (Loquat Leaf) 3 qian (remove hairs), Niubangzi (Arctium Fruit), Jiegeng (Platycodon Root) 1 qian.
Jiawei Xiebai San (Self-made): Treats chicken breast with coarse breathing and body heat.
Sangbaipi (Mulberry Root Bark) 2 qian, Sugeng (Perilla Stem) 1 qian, Chuanbeimu (Fritillaria Bulb) 1 qian, Juhong (Tangerine Red Peel) 1 qian, Gancao (Licorice Root) 3 fen, Gualoupi (Trichosanthes Peel) 3 qian, Xingren (Apricot Seed) 2 qian, Digupi (Groundcherry Root Bark) 1.5 qian, Fuling (Poria) 2 qian, Xini (Sydney? *Note: Likely a typo in original text for a specific herb, possibly Xi Xin or similar, kept as transliteration*), 3 slices.
Jiawei Baiwei Tang (Self-made): Treats phlegm-heat of Lung and Stomach obstructing above the diaphragm, with body heat, cough, coarse breathing with rattling phlegm, dry mouth, and thirst.
Baiwei (Cynanchum Atratum Root) 2 qian, Louren (Trichosanthes Seed) 3 qian, Juhong (Tangerine Red Peel) 1 qian, Xingren (Apricot Seed) 2 qian, Xiangbei (Fritillaria Thunbergii Bulb) 2 qian, Danpi (Moutan Cortex) 5 qian, Sangbaipi (Mulberry Root Bark) 2 qian, Qinghao (Sweet Wormwood) 1 qian, Zhuru (Bamboo Shavings) 1 qian, Fushi (Pumice) 3 qian, Xini (Sydney?), 3 slices.
Maidong Tang (Self-made): Treats Lung deficiency with heat and Stomach damp-phlegm.
Nanshashen (Adenophora Root) 3 qian, Maidong (Ophiopogon Tuber) 2 qian, Juhong (Tangerine Red Peel) 1 qian, Gualoupi (Trichosanthes Peel) 3 qian, Hafeng (Clam Shell Powder) 2 qian, Qingbanxia (Pinellia Rhizome) 1 qian, Chuanbei (Fritillaria Bulb) 1 qian, Fuling (Poria) 2 qian, Yimi (Coix Seed) 3 qian, Zhuru (Bamboo Shavings) 6 fen.
Bufei Qingjin Yin (Self-made): Treats chicken breast and turtle back with deficient and rapid pulse, body heat, and poor appetite.
Huai shanyao (Chinese Yam) 3 qian, Beishashen (Glehnia Root) 3 qian, Maidong (Ophiopogon Tuber) 2 qian, Xingren (Apricot Seed) 2 qian, Loupi (Trichosanthes Peel) 3 qian, Fuling (Poria) 2 qian, Juhong (Tangerine Red Peel) 1 qian, Chuan shihu (Dendrobium Stem) 3 qian, Mao Yan (Bird's Nest) 2 qian, Lianzi (Lotus Seed) 10 grains (remove heart), Dabe (Fritillaria Thunbergii Bulb) 2 qian.
Jinshui Zhuntiao San (Self-made): Treats chicken breast and turtle back with no internal phlegm, weak legs unable to stand.
Maidong (Ophiopogon Tuber) 2 qian, Fuling (Poria) 2 qian, Nvzhenzi (Ligustrum Fruit) 3 qian, Liaodou (Sojae Semen Praeparatum) 3 qian, Yuzhu (Polygonatum Rhizome) 3 qian, Danggui (Angelica Sinensis Root) 1.5 qian, Mao Yan (Bird's Nest) 3 qian, Huainiuxi (Achyranthes Root) 1.5 qian, Hanliancao (Eclipta Herb) 1.5 qian, Beishashen (Glehnia Root) 3 qian, Huai shanyao (Chinese Yam) 2 qian, Sangjisheng (Taxillus Branch) 3 qian, Hongzao (Jujube) 3 pieces.