痰饮证治。详于金匮。今述其要语冠诸首。
脉沉弦为饮。面色鲜明为饮。治饮当以温药和之。饮家咳嗽。当治饮。不当治
咳。外饮治脾。内饮治肾。（述仲景法）
寒邪犯肺饮发 凡外感寒邪。引动宿饮。上逆咳嗽。畏冷发热。当以温药和之。桂
枝、淡干姜、半夏、茯苓、杏仁、炙草。
温邪犯肺饮发 如温邪上犯气分。以致伏饮内发。上扰乘肺。肺气不降。喘不得
卧。发热无休。或见咳红。亦属络热。宜桂枝合越脾法。以开太阳。使浊饮下趋。且桂
枝得石膏辛凉。仍不碍于温邪之治。石膏、桂枝、半夏、茯苓、泽泻、杏仁、米仁、白芍、甘草。
痰饮挟燥火 凡咳嗽。喉中燥痛或痒。仍不渴饮者。此痰饮挟燥火也。夫脾家有
饮故不渴。而肺家有火。故喉间燥痒也。宜理气分之热。兼逐脾家之饮。勿以喉间
燥痛。而妄用滋清。半夏、茯苓、（重用）橘红、杏仁、川郁金、栝蒌皮、白通草、冰糖炒石膏。
（此条新法）
阳虚饮泛 如年高脾肾阳虚。气不收纳。痰饮上泛。以致呕咳。或着枕就呛。乃痰
饮伏于下焦肾络之中。至阴之界。阳气衰微。则形寒畏冷。下气上逆。则着枕就呛。
治法当以温药和之。宜桂苓术甘汤以和脾。都气饮加熟附、胡桃、以治肾。
络中伏饮 如胸胁刺痛。时吐酸饮。脉沉弦而口不渴者。此伏饮在络也。宜桂枝、
茯苓加姜汁、炒蒺藜、半夏、旋复花主之。
咳嗽呕出涎沫。面色鲜明。不得饮食者。非中虚也。作饮邪治。宜小半夏汤。加茯苓、桂枝、杏仁。
The syndrome and treatment of Phlegm-Fluid (Tan Yin) are detailed in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet). Here, the key points are summarized and placed at the beginning.
A deep and taut pulse indicates Fluid retention. A bright and lustrous complexion indicates Fluid retention. The treatment for Fluid retention should employ warm herbs to harmonize. In patients with chronic Fluid retention who cough, one should treat the Fluid retention rather than merely treating the cough. External Fluid retention is treated by addressing the Spleen; internal Fluid retention is treated by addressing the Kidney. (Elucidating Zhang Zhongjing’s methods)
Cold Pathogen invading the Lung triggering Fluid retention: Whenever an external Cold pathogen triggers latent Fluid retention, causing it to rebel upward leading to cough, accompanied by aversion to cold and fever, one should use warm herbs to harmonize. Use Cinnamon Twig Decoction (Guizhi Tang), light dried ginger, Pinellia Rhizome (Banxia), Poria (Fuling), Apricot Seed (Xingren), and honey-fried Licorice Root (Zhigancao).
Warm Pathogen invading the Lung triggering Fluid retention: If a Warm pathogen invades the Qi level, causing latent Fluid retention to erupt internally, disturbing and attacking the Lung, resulting in failure of Lung Qi to descend, wheezing with inability to lie flat, and unceasing fever, or even hemoptysis (coughing up blood), this also belongs to Heat in the collaterals. It is appropriate to combine Cinnamon Twig Decoction (Guizhi Tang) with Yuebi Decoction (Yuebi Tang) to open the Taiyang channel, allowing turbid Fluids to drain downward. Moreover, when Cinnamon Twig is combined with Gypsum, it assumes a pungent-cool nature, which does not hinder the treatment of the Warm pathogen. Use Gypsum (Shigao), Cinnamon Twig (Guizhi), Pinellia Rhizome (Banxia), Poria (Fuling), Alisma Rhizome (Zexie), Apricot Seed (Xingren), Coix Seed (Yiyiren), White Peony Root (Baishao), and Licorice Root (Gancao).
Phlegm-Fluid complicated by Dryness-Fire: Whenever there is cough, dry pain or itching in the throat, yet without thirst or desire to drink, this is Phlegm-Fluid complicated by Dryness-Fire. Because there is Fluid retention in the Spleen, there is no thirst; because there is Fire in the Lung, there is dryness and itching in the throat. One should clear Heat in the Qi level while simultaneously expelling Fluid retention from the Spleen. Do not rashly use moistening and cooling herbs simply because of dry pain in the throat. Use Pinellia Rhizome (Banxia), Poria (Fuling) (heavy dose), Tangerine Peel (Juhong), Apricot Seed (Xingren), Curcuma Zedoina Rhizome (Chanyujin), Trichosanthes Peel (Gualoupi), Taro Stem (Baitongcao), and Gypsum fried with rock sugar (Shigao). (This is a new method)
Yang Deficiency with overflowing Fluid retention: For example, in elderly individuals with Spleen and Kidney Yang deficiency, Qi fails to receive and hold, causing Phlegm-Fluid to rebel upward, leading to vomiting and coughing, or choking upon lying down on a pillow. This is because Phlegm-Fluid is latent within the lower Jiao Kidney collaterals, in the realm of extreme Yin. With declining Yang Qi, there is cold form and aversion to cold; with rebellious Qi from below moving upward, choking occurs upon lying down. The treatment method should employ warm herbs to harmonize. It is appropriate to use Linggui Zhugan Decoction (Linggui Zhugan Tang) to harmonize the Spleen, and Duqi Decoction (Duqi Yin) added with Prepared Aconite Root (Shufu) and Walnut Kernel (Hutao), to treat the Kidney.
Latent Fluid retention in the collaterals: For instance, stabbing pain in the chest and hypochondrium, frequent spitting of sour fluid, a deep and taut pulse, and no thirst indicate latent Fluid retention in the collaterals. It is appropriate to use Cinnamon Twig (Guizhi) and Poria (Fuling) added with Ginger Juice (Jiangzhi), fried Tribulus Fruit (Baili), Pinellia Rhizome (Banxia), and Inula Flower (Xuanjinhua) as the main prescription.
Coughing and vomiting saliva/phlegm, with a bright and lustrous complexion, and inability to eat, is not due to Middle Qi deficiency, but should be treated as Fluid pathogen. It is appropriate to use Xiao Banxia Decoction (Xiao Banxia Tang) added with Poria (Fuling), Cinnamon Twig (Guizhi), and Apricot Seed (Xingren).