Maidong Pingfei Yin (Ophiopogon Lung-Calming Drink) for Lung Abscess

Fei yong (lung abscess) is a TCM disease name. TCM holds it usually arises when heat-toxin congeals and binds in the lung, so that the lung lobes develop sores; within the lung, flesh putrefies and blood decomposes to form an abscess, hence the name. Clinically the patient may or may not have fever, with cough, chest pain, and expectoration of foul, purulent sputum, even bloody pus. This corresponds mostly to modern medical respiratory infections; its symptoms closely resemble lung abscess, and some lung-cancer patients also show them. TCM treatment should combine nourishing yin and clearing heat, activating blood and resolving stasis, and resolving phlegm to stop cough.

In the Ming-dynasty surgical master Chen Shigong’s Waike Zhengzong (Orthodox Manual of External Medicine) there is a formula called “Maidong Pingfei Yin,” composed of: Ginseng (Renshen), Ophiopogon (Maidong), red Paeonia (Chishao), Areca (Binglang), red Poria (Chifuling), tangerine peel (Chenpi), and Platycodon (Jiegeng), each 1 qian (3 g), and Licorice 0.5 qian (1.5 g). Add one bowl (about 300 ml) of water, decoct to eight-tenths (about 240 ml), strain, and take warm on an empty stomach, twice daily.

This formula boosts qi and nourishes yin, resolves phlegm and expels pus. Its Platycodon and Licorice are the main components of Pai Nong Tang (Pus-Expelling Decoction) from Jingui Yaolüe (composed of Platycodon, Licorice, ginger, and jujube), which was originally used for lung abscess. On top of Pus-Expelling Decoction, this formula adds Ginseng to tonify qi and blood, Ophiopogon to nourish yin and moisten the lung, red Paeonia to cool and activate blood, Areca to move qi and stop pain, and red Poria and tangerine peel to fortify the spleen and resolve phlegm—addressing both healthy-qi support and pathogen expulsion, for a stronger effect.

Chen Shigong set the indications as: early-stage lung abscess with cough and shortness of breath, dull chest pain, and expectoration of purulent sputum; or toxin settling in the lung after measles, with a scorched lung and raised lobes, cough, high-pitched panting in endless paroxysms, even coughing up blood or choking out food and drink. This is a rather violent cough and is difficult to treat. TCM holds the lung is a delicate organ belonging to the upper jiao, which “like feathers, can only be lifted by light herbs”; hence in treating lung abscess the medicinals should be light and clear, and each dose here is small, exactly suiting the principle.