Library

For any disease, there is none that does not present with fever and phlegm generation. Thus, phlegm and heat are symptoms often seen concurrently in miscellaneous diseases, seemingly leaving no room for establishing specific treatment protocols. However, when the miscellaneous disease is mild but the phlegm-fluid retention is severe, the treatment should focus primarily on resolving the phlegm-fluid. Medical texts mention "Five Phlegms," attributing them to the five Zang organs; and "Five Fluids," named according to clinical manifestations. In reality, these classifications are not entirely accurate. Generally speaking, phlegm is distinguished by dryness and dampness, while fluids are differentiated by exterior and interior locations.

Damp-phlegm is slippery and easy to expectorate, mostly arising from the Spleen. When the Spleen is excess (pathogenic fullness), it should be reduced using Er Chen Tang (Two-Aged Decoction); if severe, Gun Tan Wan (Rolling Phlegm Pill) is used. If the Spleen is deficient, it should be tonified using Liu Jun Zi Tang (Six Gentlemen Decoction). For cases complicated by cold or heat, herbs are added according to the specific symptoms. Dry-phlegm is astringent and difficult to expectorate, mostly arising from the Lung. When the Lung is dry, it should be moistened using Bei Mu Gua Lou San (Fritillaria and Trichosanthes Powder). If the Lung suffers from Fire oppression and fails to descend, causing True Water to float upward, Yin should be nourished using Liu Wei Wan (Six-Ingredient Pill with Rehmannia).

Fluids located in the Exterior manifest as dry retching, fever, and cough, with edema of the face, eyes, and limbs; Xiang Su Wu Pi San (Aromatic Perilla Five-Rind Powder) is indicated. Fluids located in the Interior may stagnate below the heart (epigastrium), lurk in both axillae, cause pain upon coughing due to traction, or flow into the intestines producing gurgling sounds; Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia with Poria Decoction) is used, treating them according to their specific locations. This constitutes the general principles for treating phlegm and fluids. Texts state: "To treat phlegm, one must regulate the Spleen, because phlegm belongs to dampness, and when Spleen Earth is prosperous, it can overcome dampness." The same applies to treating fluids. For phlegm-fluid in the Spleen Meridian, one should strengthen the Spleen to dispel dampness. If Kidney deficiency causes water overflow leading to phlegm-fluid, the Kidney must be nourished. For insufficient Kidney Water, Liu Wei Wan is used; if Mingmen True Fire is weak and Cold-Phlegm floats upward, Ba Wei Shen Qi Wan (Eight-Ingredient Kidney Qi Pill) is employed. By tonifying Fire to generate Earth, opening the gates of the Stomach-House, and guiding the spring water to flow downward, the phlegm-fluid will naturally dissipate.

[Formula Composition]
Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Chen Pi (Citri Reticulatae Pericarpium, white part removed, each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 2 slices), Da Zao (Jujubae Fructus, 2 pieces). Decoct and take orally. Adding Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma), each 1 qian, creates Liu Jun Zi Tang (Six Gentlemen Decoction).

[Indications for Gun Tan Wan]
Treats solid-heat old-phlegm that generates bizarre syndromes.
Da Huang (Rhei Radix et Rhizoma, steamed briefly), Huang Qin (Scutellariae Radix, stir-fried, each 4 liang), Qing Meng Shi (Calcareous Schist, treated with saltpeter until golden), Chen Xiang (Aquilariae Lignum Resinatum, finely sliced, each 3 qian), Chen Sha (Cinnabaris, finely ground and levigated, 2 qian).
Make pills using water, coating with Cinnabar. Take 1–2 qian per dose, washed down with clear water. This medication targets phlegm accumulation without causing drastic intestinal purgation, specifically for old-phlegm.