Source 出处 · Jingui Yaolüe · Doses are not given here: they are set by a licensed practitioner for the individual.
Safety. Two ingredients. This is among the shortest formulas in this library, and the line that records it is longer than the formula. It says: 肺痿, frothy saliva spat out, no cough, no thirst, 必遗尿 — the person does pass urine involuntarily — 小便数, urination is frequent; the reason given is that the upper cannot govern the lower; this is cold in the lung; there is dizziness and much saliva, and the formula warms it.
The clause a reader today is most likely to skip is the one about urine. A chapter on the lung records urinary incontinence and frequency, and the ordinary move is to treat it as a detail of a system one does not share. Incontinence and frequency in an older person have a short checklist and ordinary tests: urinary tract infection, enlargement of the prostate, diabetes, overactive bladder, a neurogenic bladder, the overflow incontinence that accompanies retention, interstitial cystitis, and medicines — diuretics above all, but also sedatives, anticholinergics and alpha blockers. Polyuria specifically points to uncontrolled diabetes, to high calcium, to diabetes insipidus and to diuretics. Urinalysis and a blood glucose are cheap; a post-void residual is an ultrasound.
The second clause worth pausing on is 不渴 — not thirsty. Its absence of thirst is recorded as part of the picture, and it is worth saying what thirst does and does not tell us today: the sensation of thirst is documented to diminish with age, so an older person can be short of fluid and not report thirst. Absence of thirst is not evidence of adequate hydration.
必眩 — dizziness — points in several directions at once: positional vertigo, vestibular neuritis, Ménière disease, posterior circulation stroke, low blood sugar, postural hypotension and medicines. What the line does not say is whether the dizziness comes with the change of posture, and that single question separates several of those from the rest.
肺痿 itself is not a diagnosis a reader can carry into a clinic today. The classical name bundles a direction — wasting, shrinking, a chronic destructive course — and the conditions that bundle now answers to are separate ones with separate names: the interstitial lung diseases and pulmonary fibrosis, bronchiectasis, and the aftermath of destructive infection. This library records the mapping as descriptive; it does not convert one name into the other.
Copious saliva without cough is also a thing that has a list today: sialorrhea from medicines (clozapine and the cholinesterase inhibitors are the standard examples), Parkinson disease, motor neuron disease, reflux, oral and dental disease, pregnancy, and poisoning. The part that matters clinically is not the volume but that saliva that is not swallowed goes somewhere else — and the swallowing problem behind it is what leads to aspiration.
Both materials carry records. 甘草 is licorice root, and its glycyrrhizin can produce a state resembling excess mineralocorticoid: salt and water retention, potassium loss and raised blood pressure, described at ordinary amounts taken over weeks, and more consequential in someone already taking a diuretic or digoxin. 干姜 is dried ginger rhizome; it is not 生姜, the fresh rhizome, and drying shifts its constituents towards the shogaols. Antiplatelet effects of ginger have been discussed and this library does not adjudicate them.
Reliable safety data for pregnancy and breastfeeding are lacking, and this library does not recommend use in either. Chinese-language clinical literature reports observations of formulas of this class in chronic cough and in the classical 肺痿 picture, mostly small in scale and methodologically limited. This library records that such studies exist; it does not record that benefit has been established.
两味药。这是本库最短的方之一，而记载它的那条条文比方本身长得多：**肺痿**，吐涎沫，不咳，不渴，**必遗尿**，**小便数** —— 给出的理由是「上虚不能制下」；此为肺中冷，必眩，多涎唾，以本方温之。
今天的人最容易跳过的正是关于尿的那一句。一篇讲肺的章节记下失禁与尿频，通常的反应是把它当成另一套体系里的细节。对一个上了年纪的人来说，失禁与尿频的清单很短、检查也很普通：尿路感染、前列腺增生、糖尿病、膀胱过度活动、神经源性膀胱、尿潴留引起的**溢出性尿失禁**、间质性膀胱炎，以及药物 —— 首先是利尿剂，也包括镇静药、抗胆碱药与α受体阻滞剂。若重点在多尿，则指向血糖未控制的糖尿病、高钙血症、尿崩症与利尿剂。尿常规与血糖很便宜；残余尿量只是一次超声。
第二句值得停一下的是**不渴**。条文把「不渴」当作这个画面的一部分，而今天口渴能说明什么、不能说明什么值得说清：**口渴感随年龄减弱**这一点有文献记载，所以一个缺水的老年人可以不觉得渴。不渴不能当作水分充足的证据。
**必眩** —— 眩晕 —— 同时指向好几个方向：体位性眩晕、前庭神经元炎、梅尼埃病、后循环卒中、低血糖、体位性低血压与药物。条文没说的是这个眩晕是否随体位改变而来，而这一个问题就能把其中几项与其余分开。
**肺痿**本身不是今天能带进诊室的诊断。这个古典名字捆住的是一个方向 —— 萎缩、消耗、慢性破坏的病程；而今天与这个方向对应的病各有各的名字：间质性肺疾病与肺纤维化、支气管扩张、以及破坏性感染之后的残余状态。本库把这种对应记成**描述性的**，不把一个名字换算成另一个。
唾液多而不咳，今天也有一张表：药物引起的流涎（氯氮平与胆碱酯酶抑制剂是最常被引用的例子）、帕金森病、运动神经元病、反流、口腔与牙齿疾病、妊娠、以及中毒。临床上要紧的不是量，而是**没有咽下去的唾液会去别的地方** —— 真正通向后果的是它背后的吞咽问题，而吞咽问题通向误吸。
两味药各有一条记载。**甘草**的根含甘草酸，可引起**假性醛固酮增多症**：钠水潴留、失钾、血压升高，在「普通量连服数周」的情形下亦有报告，对已经在用利尿剂或强心苷的人只会更重要。**干姜**是姜的干燥根茎，**不是生姜**（鲜根茎），干燥使其成分向姜烯酚一侧偏移。姜的抗血小板作用有讨论，本库不裁决。
**孕期与哺乳期缺乏可靠的安全性数据**，本库不主张使用。中文临床文献有本方一类方剂用于久咳与「肺痿」一类画面的观察报告，多为小规模、方法学有限。本库记「有这类研究」，不记「疗效已被确立」；本条目也不构成对一次咳嗽或一次尿失禁的处置。