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Lengshi Gun Tan Wan (Mica and Nitre Pill for Rolling Out Phlegm) is a potent formula for treating severe phlegm caused by excess heat; it is not suitable for those with deficiency-cold constitutions.
Huangqin (Scutellariae Radix, 黄芩) eight liang, Dahuang (Rhei Radix et Rhizoma, 大黄) eight liang (steamed with wine), Chenxiang (Aquilariae Lignum Resinatum, 沉香) five qian, Mengshi (Calaminae Lapis, 礞石) one liang (processed by stir-frying with Yanxiao [Saltpeter], then buried underground for seven days). The above four ingredients are ground into fine powder and made into water pills the size of Sichuan pepper seeds. Dosage should be adjusted according to the patient's body size. Upon administration, swallow the pill with a mouthful of warm water, then lie supine immediately to allow the medicine to descend gradually. For half a day, refrain from eating, drinking, rising, moving, or speaking. Wait until the medicinal qi has gradually descended from the epigastrium to the large and small intestines before resuming activity and diet. If a sensation of thick, sticky obstruction and discomfort occurs in the throat after taking the medicine, this is due to the struggle between the medicinal force and the pathogen, causing phlegm-qi to surge upward. After a short while, when the medicinal force takes effect, it will gradually expel the foul matter downwards, yielding a response as swift as an echo.

Zhi Mi Fu Ling Wan (Pill for Guiding Lostness with Poria) treats retained phlegm and hidden fluid retention in the middle jiao.
Banxia (Pinelliae Rhizoma Preparatum, 半夏) two liang, Fuling (Poria, 茯苓) one liang, Zhike (Aurantii Fructus Immaturus, 枳壳) five qian, Fenghua Xiao (Natrii Sulfas Exsiccatus, 风化硝) two qian and half. The above four ingredients are mixed with ginger juice to form a paste and made into pills.
[Note] The *Classic of Internal Medicine* states: "When fluids enter the stomach, their essence circulates and overflows, ascending to transport to the spleen." "Circulate" (You) means movement; "overflow" (Yi) means seepage; "transport" (Shu) means distribution; "essence" (Jingqi) refers to the refined substance derived from water metabolism. This statement means that the refined essence generated by the transformation of water in the stomach seeps out beyond the intestines and stomach and ascends to be distributed to the spleen. It further states: "The spleen scatters its essence, which returns upward to the lungs." This means the clear part of water rises, akin to rain and dew in the sky. It also states: "Regulating the water passages, it descends to transport to the bladder." This means the turbid part of water descends, akin to rivers on earth. These statements describe the cycle of water transforming from turbid to clear, transporting from fu organs to zang organs, and from clear to turbid, transporting from zang organs to fu organs. It further states: "Water essence distributes in all directions, running parallel through the five meridians." This means water originates from the spleen, distributes around the four zang organs, and runs parallel through the five meridians. All these statements describe how water internally nourishes the zang and fu organs and externally moistens the limbs and bones, highlighting the subtle changes of water. Under such conditions, how can phlegm exist? If dietary intake is immoderate and disrupts the middle jiao, the water essence fails to seep outward and instead flows directly downward into the large and small intestines, resulting in diarrhea. If the triple burner loses its transportation function and qi fails to steam and transform, the clear part of water does not ascend, and the turbid part does not descend. Essence transforms into water, leading to internal retention causing distension, external overflow causing edema, upward attack causing panting and crying, and downward accumulation causing strangury and stifling pain. If the lung qi in the upper jiao is not clear and肃 (solemn/clear) enough to distribute properly, water remains in the chest, and the refined part of water entirely transforms into turbidity. Excess yang scorches fluids to form phlegm, while excess yin condenses and accumulates to form fluid retention (yin). Therefore, treating phlegm focuses primarily on clearing fire: using purgation for excess patterns and resolution for deficiency patterns. Treating fluid retention focuses primarily on drying dampness: using expulsion for excess patterns and warming for deficiency patterns. Thus, ancient physicians had warming and tonifying methods for treating fluid retention but none for treating phlegm. Wang Yinjun created Lengshi Gun Tan Wan to treat old phlegm. In this formula, Huangqin clears formless heat in the chest, and Dahuang purges substantial fire in the intestines and stomach, illustrating that treating phlegm requires clearing fire. Mengshi’s dry and fierce nature illustrates that treating phlegm requires removing dampness. Chenxiang’s rapid descending action illustrates that treating phlegm requires promoting qi movement. With Mengshi and Chenxiang, Huangqin and Dahuang can swiftly sweep and directly attack the nests of old phlegm, leaving no trace of turbid and greasy filth, which is why it is named "Rolling Phlegm." If yang qi is not vigorous and both phlegm and fluid retention occur simultaneously, this formula is not suitable. Instead, Zhi Mi Fu Ling Wan should be used in combination. Banxia dries dampness, Fuling leaches out dampness, Fenghua Xiao softens hardness, and Zhike promotes qi movement. Unlike the sweet and緩 (slow/mild) nature of Erchen Tang, and far from the harsh and fierce nature of Dahuang and Mengshi, this is likely a moderate formula for attacking pathogens!