Breakdown 1: Overview
First, the concept and origin of lung carbuncle
1. The concept of lung abscess
Lung carbuncle is a kind of disease in which the lung leaves get sore and form abscess, and it belongs to one kind of carbuncle. The main clinical manifestations are cough, chest pain, fever, foul smell and phlegm, and even purulent bloody stool.
2. The origin of lung abscess
The name of lung abscess first appeared in synopsis of golden chamber.
Don? Sun Simiao's "Bei Ji Qian Jin Fang" created a stomach meridian decoction for clearing away heat and expelling pus, promoting blood circulation and eliminating carbuncle, and became an important prescription for treating this disease in later generations.
Second, the relationship between lung abscess and the name of western medicine.
Breakdown 2: Etiology and Pathogenesis
First, the common causes of lung carbuncle
External causes: wind and heat, or wind and cold attacking the lungs, and internal stagnation turns into heat.
Internal causes: excessive drinking or eating, spicy frying and strong taste, excessive phlegm and heat. If phlegm-heat accumulates in the lungs, combined with exogenous wind-heat and internal and external evils, it is more likely to cause this disease.
Second, the main pathogenesis and transformation of lung abscess
The location of lung carbuncle is in the lung.
The pathological basis of abscess suppuration mainly lies in heat and blood stasis.
Basic pathogenesis: pathogenic heat accumulates in the lung, heat stagnation and blood stasis become carbuncle, and blood decays and festers.
Pathological properties: mainly manifested as excess evil and excess heat syndrome.
Breakdown 3: Diagnosis and Syndrome Differentiation
First, the main points of diagnosis of lung abscess
1. Clinical manifestations
The onset is more urgent, often accompanied by sudden chills and high fever, cough and chest pain, vomiting with sticky phlegm for about ten months, vomiting a lot of foul-smelling pus and phlegm, or purulent bloody stools, body fever dropping, symptoms getting better, and gradually recovering after several weeks. If purulent blood is unclean, continuous coughing, coughing up purulent blood and smelly phlegm, low fever and emaciation will become chronic.
2. Sputum test method
Patients with lung abscess cough up phlegm and spit water, what sinks is abscess pus, and what floats is phlegm. For example, Introduction to Medicine? Volume five? Lung abscess and lung flaccidity said: lung abscess coughs, vomits pus and vomits blood, but the water is heavy. ?
Taste it
Patients with lung abscess will not feel fishy when eating raw soybeans or raw soybean juice.
4. Symbols
It can be seen that fine particles are born under the tongue, and chronic patients will not heal after festering. You can also see that the nails are purple curved and the fingertips are drumsticks.
Second, the difference between lung abscess and wind temperature
Breakdown 4: Syndrome Differentiation and Treatment
First, the key points of syndrome differentiation of lung carbuncle
Judging from its clinical manifestations, syndrome differentiation is always excess-heat syndrome. Early stage and carbuncle stage. Symptoms include high fever, cough, shortness of breath and thick phlegm. It is confirmed by the accumulation of heat toxin in the lung, abscess formation and pus accumulation. In the late stage of suppuration, a large amount of purulent sputum is discharged, body heat gradually recedes, and cough is relieved. However, due to the accumulation of phlegm-heat and the failure of qi and yin in the lungs, it can be manifested as symptoms of deficiency and excess. In the recovery period, Yin is mainly harmful to qi, with residual poison and impurities.
Second, the treatment principle of lung abscess
The treatment should focus on eliminating pathogenic factors, and adopt the treatment methods of clearing away heat and toxic materials, removing blood stasis and expelling pus. If suppuration is not completed, it is necessary to clear lung and eliminate carbuncle, and pus needs to be discharged to detoxify.
Architecture diagram to remember
Third, the main symptoms, treatments and prescriptions of lung carbuncle in early stage, carbuncle stage, suppuration stage and recovery stage.
1. Primitive period
Main symptoms: aversion to cold, fever, cough, white sticky phlegm, increased sputum volume, chest carbuncle, severe cough, dyspnea, dry nose and mouth, thin yellow tongue coating, and slippery pulse.
Treatment: dispel wind and dissipate heat, clear lung and resolve phlegm.
Representative: Yinqiao powder.
Commonly used drugs: honeysuckle, forsythia, reed rhizome, bamboo leaves, platycodon grandiflorum, Fritillaria thunbergii, Arctium lappa, Peucedanum peucedanum and licorice.
2. Maturity
Main symptoms: body heat turns to be very intense, cold vibrates constantly, followed by high fever, excessive sweating and irritability, cough and shortness of breath, chest tightness and pain, and adverse lateral rotation. Cough with turbid phlegm, yellow-green, conscious of fishy smell in the throat, dry mouth and throat, yellow greasy tongue coating and slippery pulse.
Treatment: clearing away lung heat and toxic materials, removing blood stasis and eliminating carbuncle.
Representative: Qianjin Weijing Decoction combined with Rujin Jiedu Powder.
Commonly used drugs: Coicis Semen, Semen Benincasae, Semen Persicae, Radix Platycodi, Scutellariae Radix, Flos Lonicerae, Herba Houttuyniae, Caulis Sargentodoxae, Herba Taraxaci, Herba Violae, Radix Glycyrrhizae, and Rhizoma Phragmitis.
3. Purulent stage
Main symptoms: coughing up a lot of purulent sputum, such as rice porridge, or blood in sputum, with abnormal smell, sometimes hemoptysis, chest tightness and pain, even asthma, redness, thirst, yellow greasy tongue coating, red tongue, slippery or solid pulse.
Treatment: expel pus and detoxify.
Representative: Jiawei orange stem soup.
Commonly used drugs: Radix Platycodi, Coicis Semen, Semen Benincasae, Herba Houttuyniae, Buckwheat, Herba Patriniae, Flos Lonicerae, Scutellariae Radix and Rhizoma Phragmitis.
4. Recovery period
Main symptoms: body heat gradually recedes, cough is relieved, expectoration and pus are less and less, smell is weak, phlegm turns clear and thin, spirit is getting stronger and stronger, and appetite is getting better. Or dull pain in the chest and hypochondrium, difficulty in lying down, shortness of breath, spontaneous sweating and night sweats, low-grade fever, hot flashes in the afternoon, upset, dry mouth and throat, dull complexion, emaciation, listlessness, red or reddish tongue, thin fur, thready pulse or weakness in counting. Or cough, hemoptysis, sputum is not clean for a long time, or sputum is once thin, smelly and turbid, and the condition is light and heavy, and it does not heal.
Treatment: Nourish and nourish the lungs.
Representative: Shashen Qingfei Decoction or Platycodon grandiflorum and Almond Decoction.
Commonly used drugs: Radix Adenophorae, Radix Ophiopogonis, Lily, Polygonatum odoratum, Radix Codonopsis, Radix Pseudostellariae, Radix Astragali, Radix Angelicae Sinensis, Bulbus Fritillariae Cirrhosae, and Semen Benincasae.