凡痰火证，额上自汗者，阳虚，不可作痰火治。用四君子汤加半夏、五味子。
喘嗽痰火，用半夏、南星各二两，滚汤泡九次。将生姜汁二碗，浸药晒干，汁尽为度，
炒焦黄色研末，白糖调服；或用茯苓补心汤，散火消痰。
验案
一人痰火，身肥多疮，气不足。用百合、紫菀各六两，生姜一两，熬膏。再用半夏一两
五钱，茯苓一两，生甘草、陈皮（去白、）莲肉、山药各一两，苡仁一两五钱，共末，煎膏为丸。
每服七十丸，淡姜汤下。
凡痰饮涌甚，用六君子汤加干姜，宜多服之。腹痛、身胀加肉桂。
痰涌难言，用山楂根、青木香，磨水服。
痰之本在肾，人参、黄 、甘草、天冬、麦冬、生地、熟地、北味、苁蓉。凡用苁蓉，
必配北五味为使。盖苁蓉补阴，五味补阴中之阳也。二味丸服，则痰从大便下，信乎治其本
痰来多而连吐不绝，六君子汤加生姜，人参多用；或四君子汤加半夏、生姜汁。
痰之本在肾者，肾主五液也。若脾不虚，痰从何来？盖土有防水之功，水有润土之力也。
痰攻两臂，南星、白术、甘草、陈皮、半夏、香附、茯苓、各五分，姜、水煎服。
痰饮由于脾虚、肾弱，若不温之，水何由散？小青龙汤、温肺汤、六君子汤、二陈汤加细辛，皆饮证大法也。
验案
一妇年六旬，患痰饮，头目疼痛，身热不食，二便俱闭，脉洪大有力，右关略弦。此君主失
令，相火横行而伤金，故头目疼痛，木不受制，则肝邪起，脾土受侮，则肺金更弱。须泻火
补金，则木自平，火自降，所谓金浮水升、木沉火降也。宜用麦冬、甘草、白芍清心肺肝之
火；苏梗、广皮引阳气下达，使胃无凝滞；茯苓、山药固其脾阴∶病可痊也。若云脾恶湿，
且有痰饮，麦冬似非所宜，是正不然。盖脾虽恶湿，今之脾病，邪在肝木，清火则木安，木
安则土宁，病自己矣。若必用半夏治其饮，燥则火就之，又将奈何？古人云∶见痰休治痰，
一妇血崩后。咳嗽痰涌，十月未愈，夜间发热自汗，此肾虚也。痰之本在肾，吐痰身瘦
，肾之脾胃虚也。用熟地一钱，茯苓七分，山药、肉桂、小茴、五味、益智、姜汁炒杜仲各五分
。三帖愈。丸方用八味丸。
一人痰吐盈盆不止，肺脉豁大无力。此内伤不足，脾虚不能统痰，再清其肺，益虚其脾
，速死之道也。用人参、附子各五钱，炮姜、荜茇、槟榔、枳壳，再帖而愈。
一人患饮，面目鲜明，六脉弦，两胁痛，身热。先用十枣汤泻之，后以小青龙汤行之，
For all Phlegm-Fire syndromes, if there is spontaneous sweating on the forehead, it indicates Yang Deficiency and should not be treated as Phlegm-Fire. Use Sijunzi Tang (Four Gentlemen Decoction) with added Banxia (Pinelliae Rhizoma) and Wuweizi (Schisandrae Fructus).
For wheezing, coughing, and Phlegm-Fire, use Banxia (Pinelliae Rhizoma) and Nanxing (Arisaematis Rhizoma), each two liang. Soak them nine times in boiling water. Then soak the herbs in two bowls of fresh ginger juice, dry them after soaking until the juice is fully absorbed. Stir-fry until scorched yellow, grind into powder, and take mixed with white sugar; alternatively, use Fuling Buxin Tang (Poria Decoction for Nourishing the Heart) to dissipate fire and resolve phlegm.
Clinical Case:
A patient suffered from Phlegm-Fire, was obese, had many sores, and lacked Qi. Use Baihe (Lilii Bulbus) and Ziwan (Asturi Radix), each six liang, and Shengjiang (Zingiberis Rhizoma Recens), one liang, decocted into a paste. Then use Banxia (Pinelliae Rhizoma), one liang five qian, Fuling (Poria), one liang, Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium - peeled), Lianrou (Nelumbinis Semen), Shanyao (Dioscoreae Rhizoma), each one liang, and Yiren (Coicis Semen), one liang five qian. Grind all into fine powder, decoct with medicine paste to make pills. Take seventy pills each time, washed down with light ginger soup.
For severe surging of Phlegm-Fluids, use Liujunzi Tang (Six Gentlemen Decoction) with added Ganjiang (Zingiberis Rhizoma). It should be taken frequently. If accompanied by abdominal pain and body distension, add Rougui (Cinnamomi Cortex).
For severe phlegm surging causing inability to speak, use Shanzha Gen (Crataegi Radix) and Qingmuxiang (Vitalbae Radix), ground with water and taken orally.
The root of phlegm lies in the Kidney. Herbs include Renshen (Ginseng Radix et Rhizoma), Huang [character missing in text, likely Huangqi (Astragali Radix)], Gancao (Glycyrrhizae Radix et Rhizoma), Tiandong (Asparagi Radix), Maidong (Ophiopogonis Radix), Shengdi (Rehmanniae Radix), Shudi (Rehmanniae Radix Preparata), Bei Wuwei (Schisandrae Chinensis Fructus), and Congrong (Cynomorii Herba). Whenever using Congrong (Cynomorii Herba), it must be paired with Bei Wuwei (Schisandrae Chinensis Fructus) as an guiding herb. This is because Congrong (Cynomorii Herba) nourishes Yin, while Wuwei (Schisandrae Chinensis Fructus) tonifies the Yang within Yin. Taking these two together causes phlegm to pass out through the stool; this is indeed true.
If phlegm is abundant and continuous vomiting occurs, use Liujunzi Tang (Six Gentlemen Decoction) with added Shengjiang (Zingiberis Rhizoma Recens), using a larger dose of Renshen (Ginseng Radix et Rhizoma); or use Sijunzi Tang (Four Gentlemen Decoction) with added Banxia (Pinelliae Rhizoma) and Shengjiang Zhi (Fresh Ginger Juice).
When the root of phlegm lies in the Kidney, it is because the Kidney governs the five fluids. If the Spleen is not deficient, where would the phlegm come from? Earth has the function of preventing water overflow, and water has the power to moisten earth.
When phlegm attacks both arms, use Nanxing (Arisaematis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Xiangfu (Cyperi Rhizoma), and Fuling (Poria), each five fen. Decoct with ginger and water and take orally.
Phlegm-fluids arise from Spleen deficiency and Kidney weakness. If not warmed, how can the water disperse? Xiaoqinglong Tang (Minor Blue Dragon Decoction), Wenfei Tang (Warming Lung Decoction), Liujunzi Tang (Six Gentlemen Decoction), and Erchen Tang (Two Aged Substances Decoction) with added Xixin (Asari Radix et Rhizoma) are all major principles for treating fluid retention syndromes.
Clinical Case:
A sixty-year-old woman suffered from Phlegm-Fluids, with headache and eye pain, fever, loss of appetite, and obstruction of both urination and defecation. The pulse was large, forceful, and slightly wiry at the Right Guan position. This indicates that the Sovereign Fire has lost its command, and Ministerial Fire runs rampant, damaging Metal (Lung). Hence, headache and eye pain occur. Since Wood (Liver) is uncontrolled, Liver Pathogen arises; since Earth (Spleen) is insulted by Wood, Metal (Lung) becomes weaker. One must purge fire and tonify Metal, so that Wood naturally levels out and fire descends. This is what is meant by "Metal floats, Water rises; Wood sinks, Fire descends." It is appropriate to use Maidong (Ophiopogonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), and Shaoyao (Paeoniae Radix Alba) to clear fire from the Heart, Lung, and Liver; Su Geng (Perillae Caudata Caulis) and Guang Pi (Citri Reticulatae Pericarpium) guide Yang Qi downward to prevent gastric stagnation; Fuling (Poria) and Shanyao (Dioscoreae Rhizoma) consolidate Spleen Yin. The illness will recover. Some might argue that since the Spleen dislikes dampness and there is Phlegm-Fluid, Maidong (Ophiopogonis Radix) seems inappropriate. This is incorrect. Although the Spleen dislikes dampness, the current pathology involves the Liver Wood. Clearing fire calms the Wood; when Wood is calm, Earth is tranquil, and the disease resolves itself. If one insists on using Banxia (Pinelliae Rhizoma) to treat the fluid, its dryness will attract fire, leading to further complications. As the ancients said, "When seeing phlegm, do not merely treat the phlegm."
After a woman suffered from uterine bleeding (blood flooding), she experienced coughing and surging phlegm that lasted ten months without healing, with night fever and spontaneous sweating. This is Kidney Deficiency. The root of phlegm lies in the Kidney; vomiting phlegm leads to emaciation, indicating deficiency of the Kidney and Spleen-Stomach. Use Shudi (Rehmanniae Radix Preparata), one qian; Fuling (Poria), seven fen; Shanyao (Dioscoreae Rhizoma), Rougui (Cinnamomi Cortex), Xiaohui (Foeniculi Fructus), Wuwei (Schisandrae Chinensis Fructus), Yizhi (Alpiniae Oxyphyllae Fructus), and Duzhong (Eucommiae Cortex stir-fried with ginger juice), each five fen. Three doses cured her. For pills, use Bawei Wan (Eight-Ingredient Pill).
A patient vomited phlegm filling basins continuously, and the Lung pulse was hollow, large, and powerless. This is internal injury and insufficiency; Spleen deficiency fails to control phlegm. Further clearing the Lung would only further weaken the Spleen, which is a path to rapid death. Use Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Preparata), each five qian; Pao Jiang (Zingiberis Rhizoma Preparatum), Bibo (Piperis Longi Fructus), Binglang (Arecae Semen), and Zhike (Aurantii Fructus Immaturus). Another few doses led to recovery.
A patient suffered from Fluid Retention, with bright facial features, wiry pulses in all six positions, hypochondriac pain, and body heat. First, use Shizao Tang (Ten Jujube Decoction) to purge; subsequently, use Xiaoqinglong Tang (Minor Blue Dragon Decoction) to circulate fluids,