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The pathology of Phlegm (Tan, 痰) was discussed by Zhang Zhongjing with four leading principles and six syndromes, while Wu Ze narrated the three categories of causes (internal, external, and neither internal nor external), both being quite appropriate. The "four leading principles" describe various symptoms manifesting due to Phlegm, whereas the "three categories of causes" discuss how injuries lead to the formation of Phlegm. Only Wang Yinjun argued that all diseases in humans originate from Phlegm; this elucidates what predecessors had not discussed, demonstrating a profound understanding of the nature and essence of Phlegm. He formulated the Gun Tan Wan (Rolling Phlegm Pill), which generally treats excessive Phlegm syndromes, indeed offering simplicity. However, compared to Zhang Zhongjing and Wu Ze, who differentiated treatments such as sweating (Han, 汗), purging (Xia, 下), warming (Wen, 温), and draining (Li, 利) based on exterior-interior and internal-external distinctions, Wang's approach appears less comprehensive, especially considering the variations of deficiency-excess and cold-heat.

Phlegm pathology includes cases where heat generates Phlegm: heat steams body fluids into Phlegm; or cases where Phlegm generates heat: Phlegm obstructs airways causing heat. Etiologies include wind-cold, fire-heat, fright, Qi stagnation, alcohol consumption, and food retention. It also arises from Spleen deficiency failing to transform and transport, or Kidney deficiency allowing water to overflow into Phlegm. Wind-Phlegm often leads to stroke and paralysis; Cold-Phlegm leads to cold Bi-syndrome and bone pain; Fire-Phlegm leads to irritability, fever, wheezing, and coughing; Damp-Phlegm leads to fatigue and desire to lie down; Fright-Phlegm leads to heart pain and epilepsy; Qi-Phlegm leads to chest and abdominal distension; Alcohol-Phlegm leads to vomiting and diarrhea. Phlegm-fluids (Tan Yin, 痰饮) lead to hypochondriac fullness and chest/arm pain; Food-retention Phlegm leads to masses and stuffiness. Spleen-deficiency Phlegm, caused by overwork injuring the Spleen, presents with clear Phlegm and poor appetite. Kidney-deficiency Phlegm, caused by sexual exhaustion injuring the Kidney, presents with flaccidity, coldness, dizziness, and fainting. However, some Phlegm may appear cold but belong to heat pathologically, presenting complex symptoms difficult to name, as detailed in Wang Yinjun's treatise. Practitioners should observe the patient's form, pulse, and signs to identify the accompanying pathogens and treat according to their location (exterior-interior, upper-lower) and nature (deficiency-excess).

Generally, chronic lingering diseases that do not result in death are often caused by food retention and Phlegm-fluids. Why? Because Stomach Qi relies on Phlegm accumulation for nourishment; although dietary intake is low, the Stomach does not suddenly become critically deficient due to this support. Conversely, if too many harsh and draining medicines are used to treat Phlegm, Spleen Qi becomes more deficient, body fluids fail to circulate, and Phlegm generation worsens. In such cases, the method should be to tonify Stomach Qi and clear the Middle Jiao, allowing Phlegm to naturally descend and transform; this is the fundamental principle of treatment.