脉
沉弦细滑，大小不匀，皆痰气为病。偏弦为饮。双弦为寒饮，左右手关前脉浮弦大而实者，膈上有
稠痰也，宜吐而愈。病患百药不效，关上脉伏而大者，痰也。眼胞及眼下如灰烟熏黑者，痰也。丹溪曰∶久
得涩脉，痰饮胶固，脉道阻滞也，卒难侍开，必费调理。
证
夫痰属湿，乃津液所化。因风寒湿热之感，或七情饮食所伤，以致气逆液浊，变为痰饮。或吐咯上出，或
凝滞胸膈，或留聚肠胃，或流注经络四肢，随气升降，遍身无处不到。其为病也，为喘
为咳，为恶心呕吐，为痞隔壅塞，关格异病，为泄利，为眩晕，
为嘈杂，为怔忡惊悸，为癫狂，为寒热，为痛，为胸膈辘辘有声，或背脊一点，常如冰冷，或四肢麻痹不仁，
皆痰所致。百病中多有兼痰者，世无不知也。痰有新久、轻重之殊，新而轻者，形色清白稀薄，气味亦淡；
久而重者，黄浊稠粘凝结，咳咯难出，渐成恶味，酸、辣、腥、臊、咸、苦，甚至带血而出。
治
痰生于脾胃，宜实脾燥湿，又随气而升，宜顺气为先，分导次之。又气升属火，顺气在于降火。热痰则
清之，湿痰则燥之，风痰则散之，郁痰则开之，顽痰则软之，食积痰则消之，在上者吐之，
在中者下之，又中气虚者，宜固中气以运痰，若攻之太重，则胃气虚而痰愈盛矣。
方
二陈汤 一身之痰都管，乃治痰之要药也。欲下行，加引下药，黄柏、木通、防己之类；欲上行，
加引上药，升麻、柴胡、防风之类。又曰∶二陈加升提之药，能使大便润而小便长。
陈皮（去白，一钱） 半夏（汤泡，二钱） 茯苓（去皮，一钱） 甘草（五分）
上锉一剂，生姜三片，水煎温服。湿痰多软，如身体倦怠之类，加苍术、白术。寒痰痞塞胸中，倍半夏。
甚者，加麻黄、细辛之类。痰厥头痛，倍半夏。风痰，加天竺黄、天南星、枳壳、白附子、天麻、僵蚕、牙
皂之类。气虚者，更加竹沥；气实者，加荆沥，俱用姜汁。热痰，加黄连、黄芩。因火盛逆上，降火为先，
加白术、黄芩、软石膏之类。眩晕嘈杂者，火动其痰也，加山栀子、黄连、黄芩。血虚有痰者，加天门冬、
知母、栝蒌仁、香附、竹沥、姜汁。滞血者，更加黄芩、白芍药、桑白皮。血滞不行，中焦有饮者，加竹沥、
姜汁、韭汁三五盏，必胸中烦躁不宁后愈。气虚有痰者，加人参、白术；脾虚者，宜补中益气降痰，加
白术、白芍药、神曲、麦芽，兼用升麻提起。食积痰，加麦芽、山楂、神曲、炒黄连、枳实。老痰，用海
石、半夏、栝蒌仁、香附、连翘之类。五倍子佐他药为丸，大治顽痰。喉中有物，咯
不出，咽不下，此结痰也。宜栝蒌仁、杏仁、海石、桔梗、连翘、香附，少佐朴硝、姜汁，炼蜜和丸噙化，
此咸能软坚也。久得涩脉，卒时难开，必费调理。气实痰热结者，吐不出，咽不下，气滞者难治。痰在膈
上，必用吐法吐之。泻之不去，胶固稠浊者，宜吐之。脉浮，吐之。痰在经络间，非吐不可，吐中就有发散
之义。凡用吐药，宜升提其气，便吐。如防风、川芎、桔梗、芽茶、生姜之类，或瓜蒂散。凡吐用布紧勒腹
于不通风处行之。痰在肠胃间，可下而愈。枳实、甘遂、巴豆、大黄、芒硝之类。凡痰用利药过
多，脾气虚则痰易生而转盛。痰在胁下，非白芥子不能达。痰在皮里膜外，非姜汁、竹沥不开。在经络中，亦
用竹沥，必佐以姜汁、韭汁。膈间有痰，或癫狂，或健忘，或风痰，俱用竹沥、荆沥。气虚少食，加竹沥；
气实能食，加荆沥。凡人上、中、下有块，痰也。问其平日好食何物，吐下后。方用药。凡人头面、颈
颊、腋下结核，不痛不红，作脓者，皆痰注也。宜随用药消之。
清热导痰汤〔批〕（按此方治痰迷之剂） 治憎寒壮热，头目昏沉迷闷，
上气喘急，口出涎沫，证类伤寒。此因内伤七情，以致痰迷心窍，神不守舍，神出则舍空，舍空则痰聚。
黄连（炒，一钱半） 枳实（炒，一钱半） 栝蒌仁（一钱） 南星（制，一钱半） 半
夏（制，一钱半） 陈皮（一钱） 白茯苓（一钱） 桔梗（一钱） 黄芩（炒，一钱） 白术
（炒，一钱） 人参（八分） 甘草（六分）
上锉一剂，姜枣水煎，入竹沥姜汁各三匙，同服。
滚痰丸〔批〕（按此方治诸痰之圣药） 洞虚子曰∶痰证古今未详，方书虽
有悬饮、流饮、支饮、痰饮、溢饮之异，而莫知其为病之原。或头风目昏，眩晕耳鸣；或口眼蠕动，眉棱、
耳叶瘙痒，或四肢游风肿硬，似痛非痛，或齿颊浮肿，痛痒不一；或嗳气吞酸，嘈杂呕哕；
或咽嗌不利，咯之不出，咽之不下，色如煤炱，形如破絮；或如
桃胶、蚬肉之状，或心下如停冰雪，冷痛时作；或梦寐奇怪鬼魅之类；或足腕痿软，腰背卒痛，或四肢骨节
疼痛，并无常处，乃至手麻臂痛，状若挫闪；或脊中每有一掌，如冰冻之寒痛者；或浑身习
习如虫行者，或眼沿涩痒，口糜舌烂，甚为咽肿喉闭；或绕项结核，似 非 。肿块初起，色白不红者，皆
痰也。或胸胁间如有二气交纽，噎塞烦闷；或如烟气上冲；头面烘热，或为失志癫狂；或
为中风瘫痪；或为劳瘵荏苒之疾；或为风痹香港脚，或心下怔忡惊悸，如畏人将捕；或喘嗽呕吐，冷涎绿水
黑汁；甚为肺痈、肠毒，便脓、挛跛。其为内外奇怪疾病，非止百端，皆痰之所致也。盖
津液既凝，为痰为饮。而汹涌上焦，故口燥咽干；流滞于下，则大小便闭塞，面如枯骨，毛发焦干；妇人则
经闭不通；小儿则惊痫搐搦。治法以此先逐去败痰，然后调理。括曰∶甑里翻身甲挂金，子今
头戴草堂深。相逢二八求斤正，硝 青礞倍若沉。十七两中零半两，水丸梧子意常斟。千般怪症如神效，水
泻双身却不任。
大黄（酒拌，蒸，半斤） 黄芩（去梗，半斤） 沉香石（五钱） 青礞石（一两，捶
碎，焰硝一两，同入砂罐内，瓦片盖之，铁钱缚定，盐泥固济，晒干 红，候冷取出）
上为细末，净水为丸，如梧桐子大。每服三五十丸，量虚实加减，各随引下。一切丧心失志，或癫痫
狂妄等症，每服百丸。人壮气实，能饮食，狂甚者，一百二十丸，以上至二三百丸，以效
为度。一切中风瘫痪，痰涎壅塞，大便或通或闭者，每服八十丸。人壮气实者百丸，常服三二十丸。无大便
不利之患，自然上清下润之妙。一切阳症风毒香港脚，遍身游走疼痛，每服八九十丸，未效再加丸数。一切走
刺气痛，每服七八十丸、未效随症再加，一切无病之人，遍身筋骨平白疼痛，不能明状者，每服七八十丸，以
效为度。一切头痛，非头风证牙疼，或浮或痒，非风蛀牙者，每服八十丸。一切因风因寒，鼻塞身重，身体不疼，非
伤寒症者，每服八九十丸。一切嗳气吞酸及噎膈反胃，痞块攻心，呕吐痰沫者，每服八九十丸。进退加减，
存乎病者元气之虚实。一切心下怔忡恍惚，如畏人将捕之状，怵惕不安，阴阳关格，变生乖症，每服七八十
丸。一切伤饥失饱。忧思过虑，至于心下嘈杂，饥不能食，每服七八十丸。一切新久痰气喘嗽，
或呕吐涎沫，或痰结实热，或头目眩晕；每服八九十丸。虚羸者五六十丸，未效再加十丸。一切急慢喉
闭赤眼，每服八九十丸。一切颈项腮颊肿硬，环绕结核，成瘰 者，正服此药。若年深岁久，宜多服之。一切
口糜舌烂，咽喉生疮者，每服六七十丸，同蜜少许一处嚼破噙睡，徐徐咽下。些小口疮，如此噙二三
夜，即瘥。一切遍身无故游走疼痛，或肿或挛，或无常痛，无定所，肿不在一处，酸软沉滞者，每服七八
十丸，量虚实加减。一切心气冷痛，如停冰块、或通身散入腹中绞痛，上攻头面肿硬，遍身四肢痿软，或
痛或痒，或溃或不溃，或穿而复闭，或此消而彼长，渐成笃疾，皆系痰毒内攻。或使烂痰臭，或作肠痈内疽，
服之以下恶物立效。日浅脓近者，刻日全安。一切胃脘作痛，下连小腹，面黄羸瘦，痛阵日发，必呕吐绿
水黑汁冷涎，乃至气绝，心下温暖者，每服八九十丸，立见生意。然后续续服之，以瘥为度。
一切痢疾，不拘赤白相杂；或带血块恶物者，每服八九十丸。次日热退，再进二三十丸，即服止痢药，万无
一失。若兼寒热痰涎者，并用仓廪散。一切荏苒之疾，男子女人日久之患，非伤寒内外之证。或酒色过度；
或月水愆期，心烦志乱；或腹胀胁痛，目瞀耳聩鼻窒，骨节疼痛，呕吐恶心，百药无效。病者莫能喻其状，
方书未尝载其疾，医人不能辨其症。并根据前法，加减服之，无有不效之理也。凡服此药者，必须临睡卧床，
用熟水一口送，只送过咽，即便仰卧。令药在咽膈之间，徐徐而下，半日不可饮食汤水，及不
可起身行坐言语。直候药丸徐逐上焦痰滞恶物过膈入腹，然后动作，方能中病。每次须连进两夜，先夜所服，
次日痰物既下三五次者，次夜减十丸；下一、二次者，仍服前数；下五、七次，或只二、三次，而病势
顿减者，次夜减二十丸；头夜所服，并不下恶物者，次夜加十丸；壮人病实者，多至百丸。惟狂疾劲实及暴卒恶
候，多服无妨。其或服罢仰卧，咽喉沉滞稠粘，壅塞不利者，乃痰气从上，药病相攻之故也。少顷药力既胜，
自然宁帖。又或百中有一，稍稍肠痛，腰背拘急者，盖有一种顽痰恶物滞 ，闭气滑肠，里急后重，状如痢
疾，片晌即已。若其痰涎易下者，快利不可胜言，顿然满口生津，百窍爽快，间有片时倦怠者，盖连日病苦不
安，一时为药所胜，气体暂和，如醉得醒，如浴初出，如睡方起，即非虚倦也。此药并不洞泄，刮肠大泻，但
能取痰积恶物，自肠胃次第穿凿而下。腹中糟粕，并不相伤，惟下部 肠之粪，乃药力不到之处，是故先
去其余，余不备述耳。
导痰小胃丹〔批〕（按此方治湿痰峻攻之剂） 治中风眩晕，喉痹，头风，
哮吼等症。上可取胸膈之顽痰，下可利胃肠之坚结。
天南星 半夏（二味，用白矾、皂荚，姜汁，水煮透熟，各二两半） 陈皮
枳实（二味，用白矾、皂荚，水泡半日，去白矾，晒干，炒，各一两） 白术（炒，一两
）苍术（米泔，白矾、皂荚，水浸一宿，去黑皮，晒干，炒，一两） 桃仁 杏仁（二味，
同白矾、皂荚水，泡去皮、尖，各一两） 红花（酒蒸，一两） 大戟（长流水煮一时，晒
干，一两） 白芥子（炒，一两） 芫花（醋拌一宿，炒黑，一两） 甘遂（面裹煨，一两）
黄柏（炒褐色，一两） 大黄（酒蒸，纸裹煨，焙干，再以酒炒，一两半）
上为细末，姜汁，竹沥煮，蒸饼糊为丸，如绿豆大。每服二、三十丸，极甚者，五七十丸，量虚实
加减。再不可太多，恐损胃气也。一切痰饮，卧时白汤下，一日服一次。一中风不语，瘫
痪初起，用浓姜汤下三十五丸，少时即能言语一切风头痛，多是湿痰上攻，临卧姜汤下二十一丸。一眩
晕多属痰火，食后姜汤下二十五丸，然后二陈汤、四物汤、加柴胡、黄芩、苍术、白芷，倍川芎。热
多加知母、石膏。一痰痞积块、临卧白汤送下三十丸，一日一次。虽数年久患，亦不过五七服见效。一哮吼，
乃痰火在膈上。临睡姜汤下二十五丸，每夜一次，久久自然取效。一喉痹肿痛，食后白汤送下。
竹沥达痰丸〔批〕（按此方治虚痰平和之剂） 此药能运痰如神，不损元
气，其痰从大便中出。丹溪云∶痰在四肢，非竹沥不开。
半夏（二两，汤泡七次，生姜汁浸透，晒干切片，瓦上微炒熟用之） 橘红（二两
）人参（一两五钱） 茯苓（二两） 大黄（二两，酒蒸晒干） 黄芩（二两，酒炒） 沉香（五钱
）甘草（炙，一两半） 礞石（一两， 法见前）
上为细末，竹沥二大碗，生姜自然汁三钟，为丸如桐子大。每服五七十丸，食后白汤送下。
清气化痰丸（刘少保传） 治一切痰饮咳嗽，头旋目眩，胸膈痞闷气滞，食积酒积，呕吐恶心。
天南星 半夏 白矾 牙皂（不锉） 生姜（各二两）
上先将南星、半夏、牙皂、生姜，用水浸一宿，将星、半、姜
锉作粗片，入白矾同煮至南星无白点，去皂，不用余者，晒干入后药。
青皮（麸炒，五钱） 陈皮（去白，一两） 枳实（麸炒，一两） 白术（一两） 干葛
（五钱） 白茯苓（一两） 苏子（炒，一两） 莱菔子（炒，一两） 栝蒌仁（一两） 黄连
（五钱） 黄芩（八钱） 海粉（七钱） 香附（一两） 神曲（炒，二两） 麦芽（炒，二两） 山楂肉（一两）
气滞加白豆蔻（一两）。一方去海粉、黄连，加人参、干姜各五钱，
杏仁、桔梗、前胡、甘草各一两。
上为细末，竹沥姜汁，调蒸饼作丸，如梧桐子大。每服五七十丸，食后姜汤送下。
清火豁痰丸（高冢宰传） 治上焦郁火，痰涎壅盛，胸膈不利，咽喉
烦躁噎塞，吐不出，咽不下，如鲠状。
大黄（酒蒸，三两） 礞石（ ，五钱） 沉香（二钱） 黄芩（酒炒，二两） 黄连（酒
Pulse
A pulse that is deep (Chen), wiry (Xian), fine (Xi), or slippery (Hua), or irregular in size, all indicate disease caused by phlegm and qi. A wiry pulse on one side indicates fluid retention (Yin). Bilateral wiry pulses indicate cold-fluid retention. If the pulse at the front of the guan position on both left and right hands is floating, wiry, large, and excess, it indicates thick phlegm above the diaphragm; vomiting therapy should be used for cure. If a patient has taken many medicines without effect, and the pulse at the guan position is hidden (Fu) yet large, it indicates phlegm. If the eyelids and the area under the eyes are dark like smoke-stained ash, it indicates phlegm. Zhu Danxi said: A long-standing涩 (Se/rough) pulse indicates that phlegm-fluid retention is firmly consolidated, blocking the pulse channels; it is difficult to open suddenly and requires prolonged regulation.
Symptoms
Phlegm belongs to dampness and is transformed from body fluids. Due to invasion by wind-cold, wind-heat, dampness, or heat, or due to injury from the seven emotions or diet, qi rebellion and turbid fluids occur, transforming into phlegm-fluid retention. It may come out through vomiting or coughing, stagnate in the chest and diaphragm, accumulate in the stomach and intestines, or flow into the meridians and limbs. Following the rise and fall of qi, it reaches every part of the body. The diseases it causes include: wheezing, cough, nausea, vomiting, fullness and obstruction, Guan-Ge syndrome and other diverse diseases, diarrhea and dysentery, dizziness, acid regurgitation with hunger pangs, palpitations and fright, mania, alternating chills and fever, pain, gurgling sounds in the chest and diaphragm, or a specific point on the back feeling constantly cold, or numbness and loss of sensation in the four limbs. All these are caused by phlegm. In hundreds of diseases, many involve concurrent phlegm, which everyone knows. Phlegm differs in newness and duration, and severity. New and mild phlegm is clear in color and form, thin in consistency, and faint in odor; old and severe phlegm is yellow, turbid, thick, sticky, and coagulated, difficult to expectorate, gradually developing a foul odor, sour, spicy, fishy, gamey, salty, or bitter, even containing blood.
Treatment Principles
Phlegm originates in the spleen and stomach; treatment should strengthen the spleen and dry dampness. Since phlegm rises with qi, regulating qi should come first, followed by separating and draining. Qi rising often involves fire; regulating qi lies in descending fire. Heat-phlegm should be cleared; damp-phlegm should be dried; wind-phlegm should be dispersed; stagnant-phlegm should be opened; stubborn-phlegm should be softened; food-stagnation phlegm should be eliminated. Phlegm in the upper jiao should be induced to vomit; phlegm in the middle jiao should be purged. If middle qi is deficient, securing middle qi to transport phlegm is appropriate; if attack is too heavy, stomach qi becomes deficient and phlegm increases.
Formulas
Er Chen Tang (Two-Aged Decoction): Manages phlegm throughout the body and is an essential medicine for treating phlegm. To direct action downward, add guiding drugs such as Huangbai (Phellodendri Cortex), Mutong (Akebiae Caulis), and Fangji (Stephaniae Radix); to direct action upward, add guiding drugs such as Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), and Fangfeng (Saposhnikoviae Radix). It is also said: Adding lifting drugs to Er Chen Tang can moisten the stool and increase urination.
Chenpi (Exocarpium Citri Reticulatae, white removed, 1 qian), Banxia (Rhizoma Pinelliae, soaked in boiling water, 2 qian), Fuling (Poria, peel removed, 1 qian), Gancao (Radix Glycyrrhizae, 0.5 qian).
Grind into pieces for one dose, add three slices of fresh ginger, decoct in water, and take warm. For damp-phlegm manifesting as physical fatigue, add Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma). For cold-phlegm causing chest oppression, double the dosage of Banxia. For severe cases, add Mahuang (Ephedrae Herba) and Xixin (Asari Radix et Rhizoma). For phlegm-jue headache, double Banxia. For wind-phlegm, add Tianzhuhuang (Calami Tuber), Tiannanxing (Arisaematis Rhizoma), Zhike (Aurantii Fructus Immaturus), Baifuzi (Typhonii Rhizoma), Tianma (Gastrodiae Rhizoma), Jiangcan (Bombyx Batryticatus), and Yazao (Gleditsiae Spina). For qi deficiency, add Zhuli (Bambusae Caulis in Artroculum); for qi excess, add Jingli (Schizonepetae Herba), both using Jiangzhi (Zingiberis Rhizoma Recens Juice). For heat-phlegm, add Huanglian (Coptidis Rhizoma) and Huangqin (Scutellariae Radix). For fire excess causing rebellion, descend fire first; add Baizhu, Huangqin, and Ruangaojia (Gypsum Fibrosum). For dizziness and acid regurgitation, which is fire stirring phlegm, add Shanzhizi (Gardeniae Fructus), Huanglian, and Huangqin. For blood deficiency with phlegm, add Tiandong (Asparagi Radix), Zhimu (Anemarrhenae Rhizoma), Gualouren (Trichosanthis Semen), Xiangfu (Cyperi Rhizoma), Zhuli, and Jiangzhi. For blood stasis, add Huangqin, Baishao (Paeoniae Radix Alba), and Sangbaipi (Mori Cortex). For blood stasis not moving with fluid retention in the middle jiao, add Zhuli, Jiangzhi, and Jiujiang (Allii Tuberosi Juice) 3-5 cups; recovery occurs only after chest irritability. For qi deficiency with phlegm, add Renshen (Ginseng Radix et Rhizoma) and Baizhu; for spleen deficiency, tonify middle qi and boost yang to descend phlegm, adding Baizhu, Baishao, Shenqu (Massa Medicata Fermentata), Maiya (Hordei Fructus Germinatus), and Shengma to lift. For food-stagnation phlegm, add Maiya, Shanzha (Crataegi Fructus), Shenqu, Chao Huanglian, and Zhishi (Aurantii Fructus Immaturus). For old phlegm, use Haishi (Lapisis Lazuli/Floating Stone), Banxia, Gualouren, Xiangfu, and Lianqiao (Forsythiae Fructus). Wubeizi (Galla Chinensis) assists other drugs in pill form to treat stubborn phlegm. A foreign body in the throat, impossible to spit out or swallow, is knotted phlegm. Use Gualouren, Xingren (Armeniacae Semen Amarum), Haishi, Jiegeng (Platycodonis Radix), Lianqiao, Xiangfu, with a small amount of Xiaokuniao (Natrii Sulfas) and Jiangzhi, honey-pilled for holding in the mouth; this uses saltiness to soften hardness. Long-standing rough pulse indicates sudden difficulty in opening, requiring regulation. Excess qi with heat-phlegm knotting, unable to spit or swallow, with qi stagnation, is difficult to treat. Phlegm above the diaphragm must be vomited. If purging fails and phlegm is consolidated and turbid, vomiting is indicated. Floating pulse indicates vomiting. Phlegm in meridians requires vomiting, which contains dispersing properties. When using emetics, lift qi to facilitate vomiting, using Fangfeng, Chuanxiong (Ligustici Chuanxiong Rhizoma), Jiegeng, Yacha (Camelliae Sinensis Bud), Jiangsheng (Fresh Ginger), or Guitisan (Melon Dispersal Powder). Perform vomiting with abdomen tightly bound in a non-ventilated place. Phlegm in stomach/intestines can be purged using Zhishi, Gansui (Kansui Radix), Badou (Crotonis Fructus), Dahuang (Rhei Radix et Rhizoma), or Mangxiao (Natrii Sulfas). Overuse of draining drugs damages spleen qi, generating more phlegm. Phlegm in hypochondrium requires Baijiezi (Brassicae Semis White). Phlegm in subcutaneous tissue requires Jiangzhi and Zhuli. In meridians, use Zhuli assisted by Jiangzhi and Jiujiang. Phlegm in diaphragm, mania, amnesia, or wind-phlegm use Zhuli and Jingli. Qi deficiency with little appetite adds Zhuli; qi excess with good appetite adds Jingli. Masses anywhere in the body are phlegm. Ask about dietary preferences, then apply vomiting/purging before medication. Non-painful, non-red tubercles in head/face/neck/armpits turning to pus are phlegm infiltration; resolve with appropriate herbs.
Qingre Daotan Tang (Clear Heat and Guide Out Phlegm Decoction) [Commentary: Formula for phlegm confusing the mind] Treats aversion to cold with high fever, dizziness and confusion, upper body wheezing, salivation, symptoms resembling Taiyang disease. Caused by emotional injury leading to phlegm confusing heart orifices, spirit losing its residence.
Huanglian (Stir-fried, 1.5 qian), Zhishi (Stir-fried, 1.5 qian), Gualouren (1 qian), Nanxing (Processed, 1.5 qian), Banxia (Processed, 1.5 qian), Chenpi (1 qian), Bai Fuling (1 qian), Jiegeng (1 qian), Huangqin (Stir-fried, 1 qian), Baizhu (Stir-fried, 1 qian), Renshen (0.8 qian), Gancao (0.6 qian).
Grind for one dose, decoct with ginger and jujube water, add 3 spoons each of Zhuli and Jiangzhi, take together.
Gun Tan Wan (Rolling Phlegm Pill) [Commentary: Holy medicine for various phlegms] Dongxuzi said: Phlegm syndromes are unclear in ancient and modern texts. Although books mention Xuan Yin, Liu Yin, Zhi Yin, Tan Yin, Yi Yin, the root is unknown. Symptoms include: wind-head and blurry vision, dizziness/tinnitus; mouth/eye twitching, brow/ear itching; wandering wind swelling/hardness in limbs, painful/non-painful; cheek/jaw swelling, varying pain/itch; belching/acid regurgitation, acid regurgitation/vomiting; throat obstruction, cannot spit/swallow, color like soot, shape like torn cotton; like peach gum/clam meat; heart feels like ice/cold pain; strange dreams; weak ankles/back pain, joint pain without fixed location, hand/arm numbness/pain like sprain; palm-sized frozen cold pain on spine; body crawling sensation; eye itch, mouth ulcers, swollen throat/laryngeal closure; neck tubercles; chest/flank sensation of two qi twisting, choking/stuffiness; smoke rushing up; hot face/head; madness; stroke paralysis; chronic consumption; wind-bi/Hong Kong foot (gout); palpitations/fear of capture; wheezing/cough/vomiting cold saliva/green-black juice; lung abscess/intestinal toxin, pus/dysentery, spasms/limping. These bizarre internal/external diseases are all caused by phlegm. Fluid condenses into phlegm/fluid. Surging to upper jiao causes dry mouth/throat; flowing down causes constipation/oliguria, skeletal face, dry hair; women have amenorrhea; children have convulsions. Treatment: purge bad phlegm first, then regulate. Summary verse describes ingredients and processing.
Dahuang (Mixed with wine, steamed, 0.5 jin), Huangqin (Stems removed, 0.5 jin), Chenxiangshi (Agarwood Stone, 5 qian), Qingmengshi (Green Calamine, 1 liang, crushed, Yanxiao 1 liang, fired in clay pot covered with tile, bound with iron coin, sealed with salt mud, dried red, cooled).
Grind to fine powder, make pills with clean water, size of Sophora seeds. Take 30-50 pills, adjust for deficiency/excess. For mental loss/epilepsy/manic psychosis, take 100 pills. For strong/excess patients, 120-200+ pills until effective. For stroke paralysis/phlegm obstruction, take 80 pills (100 for strong), daily maintenance 30-20 pills. No constipation issues, naturally clears upper/moistens lower. For Yang-type wind-toxic gout/wandering pain, take 80-90 pills, increase if ineffective. For stabbing qi pain, take 70-80 pills. For unexplained bone/joint pain, take 70-80 pills. For headache (not wind-toothache), take 80 pills. For wind-cold congestion/heaviness (not Taiyang), take 80-90 pills. For belching/acid/choking/regurgitation, take 80-90 pills. Adjust based on yuan qi. For palpitations/fear/Yin-Yang Guan-Ge, take 70-80 pills. For hunger/fullness irregularity/worry/anxiety, take 70-80 pills. For acute/chronic phlegm-wheezing/cough, take 80-90 pills (50-60 for weak). For acute/chronic laryngeal closure/red eyes, take 80-90 pills. For neck/jaw swelling/tubercles/Luo Li, take regularly. For mouth ulcers/throat sores, take 60-70 pills with honey, hold in mouth overnight. For wandering pain/swelling/spasm, take 70-80 pills. For cold heart pain/abdominal cramping/head swelling/limb weakness/ulcers/abscesses caused by phlegm-toxin, take to purge evil matter. For stomach pain radiating to lower abdomen/yellow/emaciation/green-black vomit, take 80-90 pills immediately. For dysentery (red/white/blood clots), take 80-90 pills; next day reduce fever, take 20-30 pills, then stop-dysentery medicine. For cold/heat/phlegm-saliva, combine with Canglin San. For chronic vague illnesses (alcohol/sex excess, menstrual irregularity, abdominal distension, deafness/nasal block, joint pain, vomiting), follow previous methods. Administration: Lie down before sleep, swallow with warm water, lie supine. Do not eat/drink/speak for half day until pills pass diaphragm. Continue two nights. Reduce/increase dosage based on expulsion frequency. Strong patients may take up to 100 pills. Mania/acute conditions tolerate more. If throat feels heavy/sticky after lying down, it is phlegm/qi attacking medicine; wait for effect. Rarely, intestinal pain/back stiffness occurs due to stubborn phlegm/slipping intestines; resolves quickly. If phlegm comes out easily, mouth generates saliva, orifices feel fresh; slight fatigue is temporary relief, not deficiency. This pill does not cause severe diarrhea but purges phlegm accumulation from intestines. Waste is unaffected. Lower intestine feces are untouched by drug power.
Daotan Xiaowei Dan (Guide Phlegm Little Stomach Pill) [Commentary: Harsh formula for damp-phlegm] Treats stroke dizziness, throat bi, wind-head, asthma. Removes stubborn phlegm from chest/diaphragm, drains hard knots in stomach/intestines.
Tiannanxing, Banxia (Both processed with Baifan, Zaogiao, Jiangzhi, boiled thoroughly, 2.5 liang each), Chenpi, Zhishi (Both soaked in Baifan/Zaogiao water half day, remove Baifan, dry, stir-fry, 1 liang each), Baizhu (Stir-fried, 1 liang), Cangzhu (Soaked in rice wash/Baifan/Zaogiao overnight, remove black skin, dry, stir-fry, 1 liang), Taoren, Xingren (Both soaked in Baifan/Zaogiao water, remove skin/seed, 1 liang each), Honghua (Wine-steamed, 1 liang), Daji (Boiled in running water one hour, dried, 1 liang), Baijiezi (Stir-fried, 1 liang), Yuanhua (Vinegar-soaked overnight, stir-fry black, 1 liang), Gansui (Wrapped in flour, baked, 1 liang), Huangbai (Stir-fried brown, 1 liang), Dahuang (Wine-steamed, paper-wrapped baked, dried, wine-stir-fried, 1.5 liang).
Grind to powder, cook with Jiangzhi/Zhuli, mix with steamed dough paste, make pills mung-bean sized. Take 20-30 pills (50-70 for severe), adjust for deficiency/excess. Do not overdose to protect stomach qi. Take with plain water at bedtime, once daily. For stroke mutism/paralysis onset, take 35 pills with strong ginger tea, speech returns soon. For wind-headache (damp-phlegm), take 21 pills with ginger tea at bedtime. For dizziness (phlegm-fire), take 25 pills with ginger tea after meal, then use Er Chen Tang + Si Wu Tang + Chaihu/Huangqin/Cangzhu/Baizhi, double Chuanxiong. Add Zhimu/Shigao for heat. For phlegm-fullness/masses, take 30 pills with plain water at bedtime, once daily. Effective in 5-7 doses even for years-long illness. For asthma (phlegm-fire above diaphragm), take 25 pills with ginger tea nightly. For throat bi swelling/pain, take after meal with plain water.
Zhuli Datang Wan (Bamboo Juice Reaching Phlegm Pill) [Commentary: Gentle formula for deficiency-phlegm] Moves phlegm miraculously without damaging yuan qi; phlegm exits via stool. Danxi said: Phlegm in limbs requires Zhuli.
Banxia (2 liang, soaked in boiling water 7 times, soaked in Jiangzhi, dried, sliced, lightly stir-fried), Juhong (Exocarpium Citri Reticulatae Rubrum, 2 liang), Renshen (1.5 liang), Fuling (2 liang), Dahuang (2 liang, wine-steamed dried), Huangqin (2 liang, wine-stir-fried), Chenxiang (Agarwood, 5 qian), Gancao (Roasted, 1.5 liang), Mengshi (Calamine, 1 liang, processed as before).
Grind to powder, use 2 large bowls Zhuli and 3 bells Fresh Ginger Juice, make pills sesame-seed sized. Take 50-70 pills after meal with plain water.
Qingqi Huatan Wan (Clear Qi Resolve Phlegm Pill) (Passed down from Vice Minister Liu) Treats all phlegm-fluid cough, dizziness, chest oppression/qi stagnation, food/wine stagnation, vomiting/nausea.
Tiannanxing, Banxia, Baifan, Yazao (Unchopped), Jiangsheng (Each 2 liang).
Soak Nanxing, Banxia, Yazao, Jiangsheng in water overnight. Chop Nanxing, Banxia, Jiangsheng into coarse slices, boil with Baifan until Nanxing has no white spots. Remove Yazao, do not use residue. Dry and add following herbs: Qingpi (Bran-stir-fried, 5 qian), Chenpi (White removed, 1 liang), Zhishi (Bran-stir-fried, 1 liang), Baizhu (1 liang), Qianjin Ge (Puerariae Radix, 5 qian), Bai Fuling (1 liang), Suzi (Perillae Fructus, stir-fried, 1 liang), Laifuzi (Radish Seed, stir-fried, 1 liang), Gualouren (1 liang), Huanglian (5 qian), Huangqin (8 qian), Haifen (Sea Flour, 7 qian), Xiangfu (1 liang), Shenqu (Stir-fried, 2 liang), Maiya (Stir-fried, 2 liang), Shanzha Rou (Crataegi Flesh, 1 liang).
For qi stagnation add Baidoukou (Amomi Fructus Rotundus, 1 liang). Alternative: Remove Haifen/Huanglian, add Renshen/Ganjiang (5 qian each), Xingren/Jiegeng/Qianhu (Peucedani Radix)/Gancao (1 liang each).
Grind to powder, mix with Zhuli/Jiangzhi and steamed dough paste, make pills Sophora-seed sized. Take 50-70 pills after meal with ginger tea.
Qinghuo Huotan Wan (Clear Fire Open Phlegm Pill) (Passed down from Grand Treasurer Gao) Treats upper jiao stagnant fire, abundant phlegm-saliva, chest discomfort, throat irritability/choking, inability to spit/swallow, feeling like a fishbone.
Dahuang (Wine-steamed, 3 liang), Mengshi (Processed, 5 qian), Chenxiang (Agarwood, 2 qian), Huangqin (Wine-stir-fried, 2 liang), Huanglian (Wine