寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Lung

Pyejang

한글 폐장  ·  Pinyin Fei Zang

The canopy over the viscera — shaped like a pair of shoulders, ruling autumn and metal, grief and the nose, the skin and the hair, and the breath that leaves without returning at death

肺臟

The fourth organ chapter. The lung is shaped like a person's shoulders, or like a stone chime, and hangs above the other viscera as their canopy; it weighs three geun three nyang and has six lobes and two ears, with twenty-four holes in rows that distribute the clear and turbid qi. It rules autumn and the days gyeong and sin, metal and dryness and the colour white, the nose and the skin and the body hair, grief and mucus and weeping, and cough is its movement. Its injury is a chilled body and cold drink; its disease is cough with the shoulders heaving, and Zhongjing's two diseases of the lung — wilting, with foamy spittle, and abscess, with a dull pain in the chest — are told apart here. Its vacuity is a short breath through a blocked nose, its repletion panting with the chest thrown back; it eases in winter and worsens in summer. The treatment is bitterness to send its qi down and sourness to gather it, and the three formulas are Qian Yi's glue for the dry lung and his two barks for the hot one, with Danxi's rhubarb behind them. The signs of its end are the hair breaking, the hair wet with sweat, and the mouth gaping as the breath goes out and does not come back.

5.1 The Form of the Lung 肺形象

5.1.1
Source원문

肺之形似人肩, 二布葉, 數小葉, 中有二十四孔行列, 以分布諸藏淸濁之氣, 主藏魄. 《內經註》

Translation영역
The lung is shaped like a person's shoulders, with two spreading lobes and several small lobes; within are twenty-four holes in rows, by which it distributes the clear and turbid qi of the viscera. It governs the storing of the corporeal soul.
Clinical note임상 주석
Twenty-four holes for the twenty-four solar terms — the Qi chapter's 4.10.1 gave the same count. The lung breathes the year as it breathes the day.

Naegyeong-ju 內經註

5.1.2
Source원문

肺重三斤三兩, 六葉兩耳, 共八葉. 《難經》

Translation영역
The lung weighs three geun three nyang, and has six lobes and two ears, eight lobes in all.

Nangyeong 難經

5.1.3
Source원문

肺形似人肩, 又如磬懸於五藏之上而爲華蓋. 《入門》

Translation영역
The lung is shaped like a person's shoulders, and also like a stone chime hung above the five viscera as their flowered canopy.
Clinical note임상 주석
華蓋, the flowered canopy — the parasol carried over an emperor, and the lung's title because it sits highest and covers the rest. The Sweating chapter's defence at the skin is the canopy's outer edge.

Immun 入門

5.2 The Position of the Lung 肺部位

5.2.1
Source원문

肺藏於右. 《內經》

Translation영역
The lung is stored on the right.
Clinical note임상 주석
The pair of the liver's 肝生於左 at 2.2.1, and the same reading: not anatomy but the direction of the qi. The liver's rises on the left and the lung's descends on the right, and the Body chapter's 1.3.5 gave the circuit.

Naegyeong 內經

5.2.2
Source원문

肺系有二, 一系上通喉嚨, 其中與心系相通, 一系自心入於肺兩大葉之間, 曲折向後. 《入門》

Translation영역
The lung has two cords: one goes up to the throat and communicates within with the heart's cord; the other goes from the heart into the space between the lung's two great lobes and bends back.
Clinical note임상 주석
The trachea above and the great vessels behind — the Immun's two cords, and the second is the pulmonary artery described from the outside. The Heart chapter's 3.2.2 gave the same cords from the heart's side.

Immun 入門

5.2.3
Source원문

中府二穴, 肺之募也. 在乳直上三肋間, 在背則肺兪, 在第三顀下, 是肺之部位也. 《銅人》

Translation영역
The two points Jungbu (中府, LU1) are the lung's alarm points, straight above the nipple in the third intercostal space; on the back, Pyesu (肺兪, BL13) is below the third vertebra. These are the lung's territory.

Dongin 銅人

5.3 The Season and Days the Lung Rules 肺主時日

5.3.1
Source원문

肺主秋, 手太陰陽明主治, 其日庚辛.

Translation영역
The lung rules autumn; the hand greater yin and yang brightness govern its treatment; its days are gyeong and sin.

Naegyeong 內經

5.3.2
Source원문

西方生燥, 燥生金, 金生辛, 辛生肺.

Translation영역
The west engenders dryness, dryness engenders metal, metal engenders acridity, and acridity engenders the lung.

Naegyeong 內經

5.3.3
Source원문

肺爲陽中之太陰, 通於秋氣. 《內經》

Translation영역
The lung is the greater yin within yang, and communicates with the qi of autumn.
Clinical note임상 주석
Autumn, west, dryness, metal, acrid — and gyeong and sin, the metal stems, which are the days the liver's disease at 2.9.2 worsened on. Metal overcomes wood, and the calendar keeps the rule.

Naegyeong 內經

5.4 The Things That Belong to the Lung 肺屬物類

5.4.1
Source원문

肺在天爲燥, 在地爲金, 在卦爲兌, 在體爲皮毛, 在藏爲肺, 在色爲白, 在音爲商, 在聲爲哭, 在變動爲咳, 在竅爲鼻, 在味爲辛, 在志爲憂, 其脉爲手太陰, 其液爲涕, 其榮爲毛, 其臭爲腥, 其數爲九, 其穀爲稻, 其畜爲雞一作馬, 其蟲爲介, 其果爲桃, 其菜爲葱. 《內經》

Translation영역
The lung in heaven is dryness, on earth metal, in the trigrams tae, in the body the skin and hair, among the viscera the lung, in colour white, in the notes sang, in sounds weeping, in change cough, in the orifices the nose, in flavours acrid, in the minds grief; its channel is the hand greater yin, its fluid mucus, its bloom the body hair, its odour rank, its number nine, its grain rice, its animal the fowl one version says the horse, its creatures the shelled, its fruit the peach, its vegetable the scallion.
Clinical note임상 주석
The lung's column. 在變動爲咳 — cough is the lung's change, as grasping was the liver's and hiccup the spleen's. 其液爲涕, mucus: the Nose chapter's whole diagnosis, and 5.7.4 reads the lung from sneezing.

Naegyeong 內經

5.5 The Size of the Lung 肺臟大小

5.5.1
Source원문

五藏六府, 肺爲之盖.

Translation영역
Of the five viscera and six bowels, the lung is the cover.

Yeongchu 靈樞

5.5.2
Source원문

白色小理者肺小, 麄理者肺大. 巨肩反膺陷喉者肺高, 合腋張脇者肺下. 好肩背厚者肺堅, 肩背薄者肺脆. 背膺厚者肺端正, 脇偏疏者肺偏傾也.

Translation영역
A white complexion with fine skin-grain means a small lung, with coarse grain a large one. Big shoulders, a chest thrown back and a sunken throat mean a high lung; armpits drawn in and ribs spread, a low one. A good, thick shoulder and back mean a firm lung; a thin shoulder and back, a brittle one. A thick back and chest mean an upright lung; ribs loose on one side, a tilted one.

Yeongchu 靈樞

5.5.3
Source원문

肺小則少飮不病喘喝, 肺大則多飮善病胸痺喉痺逆氣. 肺高則上氣肩息咳, 肺下則氣賁迫肺善脇下痛. 肺堅則不病咳上氣, 肺脆則苦病消癉易傷. 肺端正則和利難傷, 肺偏傾則胸偏痛也. 《靈樞》

Translation영역
A small lung drinks little and is not troubled with panting; a large one drinks much and is prone to chest impediment, throat impediment and counterflow of qi. A high lung has qi ascent, shoulder-breathing and cough; a low one has the qi rushing and pressing on the lung, and pain under the ribs. A firm lung is not troubled with cough and qi ascent; a brittle one suffers wasting thirst and is easily injured. An upright lung is harmonious and hard to injure; a tilted one has pain on one side of the chest.
Clinical note임상 주석
The lung read from the shoulders, as the liver was from the ribs and the heart from the xiphoid. 巨肩反膺 — big shoulders and a thrown-back chest — for the high lung, and the barrel-chested build does go with the breathing disorders the passage lists.

Yeongchu 靈樞

5.6 The Patterns of Lung Injury 肺傷證

5.6.1
Source원문

形寒飮冷則傷肺. 《靈樞》

Translation영역
A chilled body and cold drink injure the lung.
Clinical note임상 주석
Two colds, outside and in — the Ojangyukbu chapter's 1.11 gave the mechanism, that the two meet and the qi counterflows. The Cough chapter's whole account of the cold cough rests on this line.

Yeongchu 靈樞

5.6.2
Source원문

肺傷者, 其人勞倦則咳唾血, 其脉細緊浮數, 皆吐血, 此爲躁擾嗔怒, 得之肺傷氣壅所致. 《脉經》

Translation영역
Where the lung is injured, when the person is taxed and weary they cough and spit blood, and the pulse is fine, tight, floating and rapid — all vomit blood. This comes of agitation and rage, and is got from the lung injured and the qi congested.

Maekgyeong 脉經

5.6.3
Source원문

熱在上焦, 因咳爲肺痿. 其人咳, 口中反有濁唾涎沫, 寸口脉數, 此爲肺痿也. 若口中辟辟燥咳, 咳則胸中隱隱痛, 脉反滑數, 此爲肺癰也. 《仲景》

Translation영역
Heat in the upper burner, and through coughing it becomes lung wilting: the person coughs, and the mouth has turbid spittle and foamy drool, and the inch-opening pulse is rapid — this is lung wilting. If the mouth is dry and the cough hacking, and coughing brings a dull pain in the chest, and the pulse is slippery and rapid instead — this is lung abscess.
Clinical note임상 주석
Zhongjing's two lung diseases from the Jingui, told apart by the spittle and the pain. 肺痿, wilting, with foam and no pain, is the wasting lung of tuberculosis; 肺癰, abscess, with a dry cough and a dull ache, is suppuration. The Blood chapter's 1.14.3 gave the abscess as a cause of vomiting blood. **Chronic cough with foamy or bloody sputum requires investigation.**

Junggyeong 仲景

5.7 The Patterns of Lung Disease 肺病證

5.7.1
Source원문

邪在肺則病皮膚痛, 寒熱, 上氣喘, 汗出, 咳動肩背. 《靈樞》

Translation영역
Where the evil is in the lung, the disease is pain in the skin, cold and heat, qi ascent and panting, sweating, and cough that moves the shoulders and back.
Clinical note임상 주석
咳動肩背 — cough that shakes the shoulders. The lung's cough is the one that uses the whole upper body, and 5.5.3 gave shoulder-breathing as the sign of the high lung.

Yeongchu 靈樞

5.7.2
Source원문

風寒入舍於肺, 名曰肺痺, 發咳上氣.

Translation영역
Where wind and cold enter and lodge in the lung, it is named lung impediment, and breaks out as cough and qi ascent.

Naegyeong 內經

5.7.3
Source원문

肺病者, 喘咳逆氣, 肩背痛, 汗出, 尻陰股膝髀腨胻足皆痛. 虛則少氣不能報息, 耳聾嗌乾.

Translation영역
In lung disease there is panting, cough and counterflowing qi, pain in shoulder and back, sweating, and pain in the buttock, genitals, thigh, knee, hip, calf, shin and foot alike. Where it is vacuous the qi is scant and cannot answer a breath, the ears are deaf and the throat dry.
Clinical note임상 주석
Pain running down the whole leg in a lung disease — the Suwen's list follows the bladder channel, which is the lung's paired yang channel by the six-channel scheme. 少氣不能報息, scant qi that cannot answer a breath, is the Qi chapter's 4.20.2.

Naegyeong 內經

5.7.4
Source원문

肺熱者, 色白而毛敗. 《內經》

Translation영역
Where the lung is hot, the complexion is white and the body hair spoils.

Naegyeong 內經

5.7.5
Source원문

外證, 面白, 善嚏, 悲愁不樂欲哭, 內證, 臍右有動氣, 按之牢若痛, 其病喘咳, 洒浙寒熱. 《難經》

Translation영역
The outer signs are a white face, much sneezing, grief and sorrow without pleasure and a wish to weep; the inner sign is stirring qi to the right of the navel, firm under pressure and painful. Its disease is panting and cough, and shivering cold and heat.
Clinical note임상 주석
The Nanjing's test for the lung: sneezing, sadness, a wish to cry — and the pulsation to the right of the navel, where the liver's was to the left. Four organs, four quadrants of the belly.

Nangyeong 難經

5.7.6
Source원문

大骨枯槁, 大肉陷下, 胸中氣滿, 喘息不便, 其氣動形, 期六月死, 眞藏脉見, 乃予之期日. 此肺之藏也. 一百八十日內死. 《內經》

Translation영역
The great bones withered, the great muscles sunken, the chest full of qi, the breath laboured and the breathing shaking the body — death is expected within six months, and when the true viscus pulse appears the day is set. This is the lung as a viscus; death within a hundred and eighty days.
Clinical note임상 주석
其氣動形 — the breathing shakes the body. Six months for the lung, and the sign is the whole frame moving with each breath, which is the end-stage of any lung disease.

Naegyeong 內經

5.8 Vacuity and Repletion in Lung Disease 肺病虛實

5.8.1
Source원문

肺氣虛, 則鼻息不利少氣, 實則喘喝胸憑仰息. 《靈樞》

Translation영역
Where the lung qi is vacuous the nose is blocked and the breath scant; where it is replete there is panting and gasping, the chest thrust out and the head thrown back to breathe.
Clinical note임상 주석
胸憑仰息 — leaning the chest forward and tipping the head back to breathe. The posture of air hunger, and the Lingshu makes it the sign of the full lung against the blocked nose of the empty one.

Yeongchu 靈樞

5.8.2
Source원문

肺藏氣. 氣有餘則喘咳上氣, 氣不足則息利少氣.

Translation영역
The lung stores qi. Where qi is in surplus there is panting, cough and qi ascent; where it is insufficient the breath is easy but scant.

Naegyeong 內經

5.8.3
Source원문

肺實, 則令人逆氣而背痛, 慍慍然, 虛則令人喘, 呼吸少氣而咳, 上氣見血, 下聞病音. 《內經》

Translation영역
Where the lung is replete it makes the qi counterflow and the back ache, with a sullen oppression; where it is vacuous it makes one pant, the breath scant and coughing, with blood on qi ascent and a sick sound heard below.

Naegyeong 內經

5.9 Remission and Worsening of Lung Disease 肺病間甚

5.9.1
Source원문

病在肺, 愈在冬, 冬不愈, 甚於夏, 夏不死, 持於長夏, 起於秋.

Translation영역
Where the disease is in the lung it heals in winter; if it does not heal in winter it worsens in summer; if it does not kill in summer it holds in late summer and rises in autumn.

Naegyeong 內經

5.9.2
Source원문

肺病者, 愈在壬癸, 壬癸不愈, 加於丙丁, 丙丁不死, 持於戊己, 起於庚辛.

Translation영역
Lung disease heals on im and gye days; if it does not heal on im and gye it worsens on byeong and jeong; if it does not kill on byeong and jeong it holds on mu and gi and rises on gyeong and sin.

Naegyeong 內經

5.9.3
Source원문

肺病者, 下晡慧, 日中甚, 夜半靜. 《內經》

Translation영역
Lung disease is clear in the late afternoon, worse at noon, and quiet at midnight.
Clinical note임상 주석
Metal's clock: winter and water ease it, summer and fire worsen it, late summer and earth hold it, autumn and metal stir it. Worst at noon, which is fire's hour — and the lung's disease, heat in the canopy, does flare in the heat of the day.

Naegyeong 內經

5.10 The Treatment of Lung Disease 肺病治法

5.10.1
Source원문

肺苦氣上逆, 急食苦以泄之. 註曰, 肺氣上逆, 是其氣有餘也. 肺欲收, 急食酸以收之, 用酸補之, 辛瀉之. 《內經》

Translation영역
The lung suffers from the qi counterflowing upward; quickly eat bitter things to discharge it. The commentary says: the lung's qi counterflowing upward is its qi in surplus. The lung wishes to be gathered; quickly eat sour things to gather it — use sourness to supplement it and acridity to drain it.
Clinical note임상 주석
Bitter to send down, sour to gather — the lung's rules. 肺欲收, the lung wishes to be gathered: the organ of autumn wants to draw in, as the liver of spring at 2.10.1 wanted to spread. The two organs are opposites in the five-phase table, and their treatments are mirror images.

Naegyeong 內經

5.10.2
Source원문

肺苦氣上逆, 宜訶子皮一作黃芩. 肺欲收, 宜白芍藥. 以酸補, 宜五味子, 以辛瀉, 宜桑白皮. 《東垣》

Translation영역
For the lung suffering from the qi counterflowing upward, chebula rind one version says scutellaria is suitable. For the lung wishing to be gathered, white peony. To supplement with sourness, schisandra; to drain with acridity, mulberry root bark.
Clinical note임상 주석
Dongwon's medicinals — and mulberry bark for the acrid drain is Sabaek-san's chief, and schisandra for the sour supplement is Saengmaek-san's. The two standing lung formulas come out of this one line.

Dongwon 東垣

5.10.3
Source원문

肺病, 宜食黍ㆍ雞肉ㆍ桃ㆍ葱, 取本味也. 《甲乙經》

Translation영역
In lung disease it is suitable to eat millet, fowl, peach and scallion, taking the organ's own flavour.

Gabeulgyeong 甲乙經

5.10.4
Source원문

肺病, 宜食麥ㆍ羊肉ㆍ杏ㆍ薤, 取苦能下氣. 《內經》

Translation영역
In lung disease it is suitable to eat wheat, mutton, apricot and scallion, taking bitterness's power to send the qi down.
Clinical note임상 주석
The heart's four foods from 3.11.4, given to the lung for their bitterness — which is fire's flavour, and 5.10.1 said bitter sends the lung's qi down. The two food lists disagree on purpose: one feeds the organ its own, one feeds it what corrects it.

Naegyeong 內經

5.10.5
Source원문

肺病, 禁寒飮食寒衣. 《內經》

Translation영역
In lung disease, cold food and drink and cold clothing are forbidden.
Clinical note임상 주석
Cold, which 5.6.1 said injures it — and the mirror of the heart's prohibition at 3.11.6, which was heat.

Naegyeong 內經

5.10.6
Source원문

肺虛, 宜補肺散ㆍ獨參湯方見氣門, 肺實, 宜瀉白散ㆍ人參瀉肺湯.

Translation영역
For lung vacuity, Supplement the Lung Powder and Lone Ginseng Decoction formula in the Qi chapter are appropriate; for lung repletion, Drain the White Powder and Ginseng Drain the Lung Decoction.
Clinical note임상 주석
Two each way, and three of the four are registered here. The empty lung gets glue and ginseng; the full lung gets the two barks, and rhubarb if it is hot enough.

Donguibogam · Pye

5.11 The Signs of the Lung Expiring 肺絶候

5.11.1
Source원문

手太陰氣絶, 則皮毛焦. 太陰者, 行氣, 溫于皮毛者也. 故氣不榮則皮毛焦, 皮毛焦則津液去皮節傷, 皮節傷則爪枯毛折, 毛折者則毛先死, 丙日篤, 丁日死.

Translation영역
Where the hand greater yin's qi is cut off, the skin and hair scorch. The greater yin is what moves the qi and warms the skin and hair; so where the qi does not nourish, the skin and hair scorch; where they scorch, the fluids leave and the skin and joints are injured; where those are injured the nails wither and the hair breaks; and where the hair breaks, the hair has died first. Grave on a byeong day, death on a jeong day.
Clinical note임상 주석
The lung's death read on the skin and hair, which it rules — scorched skin and hair that snaps. Death on a fire day, which overcomes metal.

Yeongchu 靈樞

5.11.2
Source원문

肺絶三日死, 何以知之. 口張一云口鼻虛張短氣, 但氣出而不返. 《脉經》

Translation영역
The lung expiring, death in three days — how is it known? The mouth gapes one version says mouth and nose gape emptily and the breath is short, and the breath only goes out and does not return.
Clinical note임상 주석
但氣出而不返 — the breath goes out and does not come back. The Maekgyeong's sign of the lung's end, and it is the last breath described.

Maekgyeong 脉經

5.11.3
Source원문

汗出髮潤, 喘不休者, 此爲肺絶. 《仲景》

Translation영역
Where sweat comes out and the hair is wet, and the panting does not stop — this is the lung expiring.

Junggyeong 仲景

5.12 The Method of Cultivating the Lung 肺臟修養法

5.12.1
Source원문

常以七月八月九月朔望旭旦, 西面坐鳴天鼓七, 飮玉漿三, 然後瞑目正心思, 兌宮白氣入口七呑之, 閉氣七十息. 《養性書》

Translation영역
Always on the first and fifteenth of the seventh, eighth and ninth months at sunrise, sit facing west, sound the heavenly drum seven times, drink the jade liquor three times, then close the eyes and set the mind straight, breathe the white qi of the tae palace in through the mouth and swallow it seven times, and hold the breath for seventy breaths.
Clinical note임상 주석
Autumn, west, the trigram tae, the colour white, seven swallowings — the lung's set. The liver's was nine and the heart's three; the number is the organ's own from the five-phase table.

Yangseongseo 養性書

5.13 The Guided Stretch for the Lung 肺臟導引法

5.13.1
Source원문

可正坐, 以兩手據地, 縮身曲脊向上五擧, 去肺家風邪積勞. 亦可反拳搥脊上左右各三五度, 此法去胸臆間風毒. 閉氣爲之良久, 閉目嚥液, 三叩齒爲止. 《臞仙》

Translation영역
Sit upright, brace both hands on the ground, draw the body in and arch the spine upward five times; this removes the wind evil and accumulated taxation of the lung. Or turn the fists back and pound the spine left and right three to five times each; this method removes the wind toxin between chest and breast. Do it holding the breath for a good while, close the eyes and swallow the saliva, and click the teeth three times to finish.
Clinical note임상 주석
Arching the back like a cat and drumming the spine with the fists — Zhu Quan's stretch for the organ behind the ribs. The Body chapter's 1.20.4 gave his full set; this is the lung's part.

Guseon 臞仙

5.14 Simple Medicinals 單方

5.14.1
Source원문

凡二十二種.

Translation영역
Twenty-two kinds in all.
Clinical note임상 주석
Twenty-two simples for the lung — mica, ginseng, the two ophiopogons, schisandra, adenophora, scutellaria, aster, fritillaria, platycodon, aristolochia, mulberry root bark, lepidium, tangerine peel, bitter orange, walnut, mume, apricot kernel, peach, millet, milk and egg white. The cough medicinals of the Cough chapter, and the peach and millet are 5.4's own.

Donguibogam · Pye

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 3, The Lung chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.