(内经只有积饮之说,并无痰证之名。至仲景始立四饮之名,而痰饮居其一。今后世相
传,
必
者
必
以
者
或以劳倦,或以忧思酒色,致成劳损非风卒厥者。或脉见细数,脏无阳邪,时为呕恶泄泻气
短声喑等证。但察其形气病气,本非有余者,皆虚痰也。此则但宜调补,若或攻之,无不危
矣。总之治痰之法,但能使元气日强,则痰必日少。即有微痰,亦自不能为害,而且充助胃
气。若元气日衰,则水谷津液,无非痰尔。随去随生,有能攻之使尽,而且保元气无恙者乎
。故善治痰者,惟能使之不生,方是补天之手。苟不辨其虚实,而欲一概攻之。如王隐君所
论,内外百病皆生于痰,悉用滚痰丸之类。其亦但知目前,而不知日后之患哉。诸家治痰之
法,多有治其标者,虽不可执,亦不可窃也。详列如下。)
(金匮) 治心下有痰饮,胸胁支满,目眩。
茯苓(四两) 桂枝 白术(三两) 甘草(二两。)
痰饮阴象,阻抑其阳,用此阳药化气以伸其阳,此正法也。兹所主乃在胸胁支满目眩者,
何
痰
卫
肺
反
去
旨
出
(局方。陈皮半夏,贵其陈久,则少燥散之性,故名二陈)治一切痰饮为病,咳嗽胀
满,呕吐恶心,头眩心悸。(稠者为痰,稀者为饮,水湿其本也。得火则结为痰,随气升降
。在肺则咳,在胃则呕,在头则眩,在心则悸,在背则冷,在胁则胀,中脘有痰。令人憎寒
壮热头痛,类外感表证。久则潮咳夜重,又类阴火内伤。走注肢节疼痛,又类风证,但肌色
如故,脉滑不匀为异。)
半夏(姜制二钱) 陈皮(去白) 茯苓(一钱) 甘草(五分) 加姜煎。(姜能制
半夏之毒。)
黛,湿痰加苍术
加香附枳壳。胁
半夏辛温,体滑性燥,行水利痰为君。痰因气滞,气顺则痰降。(庞安常曰∶善治痰者,
不
故以茯苓渗湿为臣。中不和则痰涎聚,又以甘草和中补土为佐也。(或曰∶有痰而渴,宜去
半夏,代以栝蒌贝母。吴鹤皋曰∶渴而喜饮水者,易之。渴而不能饮水者,虽渴犹宜半夏也
。此湿为本,热为标,湿极而兼胜已之化,非真象也,按贝母寒润,主肺家燥痰。半夏温燥
,主脾家湿痰。虽俱化痰,而寒湿燥润各异。脱或误施,贻害匪浅,用者宜审之。有血不足
,阴火上逆,肺受火伤,整肃之令,不得下行。由是津液混浊,生痰不生血者,名燥痰,当
用润剂。如地黄门冬枸杞之类,滋阴降火,而痰自清。若投二陈,立见危殆。有头风眉梢骨
痛,投以风药不效,投以痰药见功。又有眼赤羞明,与之凉药不瘳,异以痰剂获愈。有人坐
处吐痰满地,不甚稠粘,只是沫多,此气虚不能摄涎,不可用利药,宜六君子加益智仁一钱
以摄之。)
去茯苓甘草,名陈皮半夏汤。再加桔梗,名桔梗半夏汤。去陈皮甘草,名半夏茯苓汤,
治水
姜汤,
加胆星
墙倒壁
香片子
痰结胸
名加味
名温中化
丸。治痰
单用半夏
奈者。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) only mentions "accumulated fluid" (Ji Yin), but does not use the term "phlegm syndrome" (Tan Zheng). It was Zhang Zhongjing who first established the name of the "Four Types of Fluid Retention" (Si Yin), among which "Phlegm-Fluid" (Tan Yin) is one. Since then, passed down through generations... [Text contains gaps/corruptions]. Or due to overwork and fatigue, or due to worry, thinking, excessive alcohol consumption, and sexual indulgence, leading to consumptive diseases, non-wind sudden syncope, etc. Or the pulse appears fine and rapid, with no yang pathogenic factors in the zang organs, accompanied by symptoms such as occasional vomiting, nausea, diarrhea, shortness of breath, and hoarseness. As long as one observes that the patient's form, qi, and disease condition are originally not excess types, they all belong to Deficiency Phlegm (Xu Tan). In such cases, only tonification and regulation should be employed; if attack methods are used instead, danger is inevitable. In summary, the method for treating phlegm is to strengthen the Yuan Qi (Original Qi) day by day, so that phlegm will naturally decrease day by day. Even if there is a small amount of phlegm, it cannot cause harm, and it can even assist stomach qi. If Yuan Qi declines day by day, then water, grain, and body fluids will all turn into phlegm. As soon as it is generated, it is removed; is there anyone who can attack it until it is completely gone while preserving the Yuan Qi unharmed? Therefore, those skilled in treating phlegm are those who can prevent its generation, which is like mending the sky (a metaphor for supreme skill). If one does not distinguish between deficiency and excess, yet desires to attack uniformly, as Wang Yinjun argued that internal and external diseases all arise from phlegm, and using drugs like Gun Tan Wan (Rolling Phlegm Pill) indiscriminately. This shows knowledge only of the present, ignoring future consequences. Various schools' methods for treating phlegm often treat the branch (symptoms); although one should not be rigid, nor should one steal (blindly copy). Listed in detail below.)
(From *Jingui Yaolue*) Treats phlegm-fluid under the heart, with fullness and distension in the chest and hypochondrium, and dizziness.
Fuling (Poria) (4 liang) Guizhi (Cinnamon Twig) Baizhu (Atractylodis Rhizoma) (3 liang) Gancao (Licorice Root) (2 liang).
Phlegm-fluid is a yin pathogen that obstructs and suppresses yang. Using these yang-promoting herbs to transform qi and extend yang is the correct method. The indication here focuses on fullness in the chest and hypochondrium and dizziness; the purport lies in... [Text contains gaps/corruptions].
(From *Ju Fang*. Chenpi (Tangerine Peel) and Banxia (Pinellia Tuber) are valued for being aged, which reduces their drying and dispersing properties, hence the name "Er Chen" (Two Aged Substances).) Treats all diseases caused by phlegm-fluid, including cough, distension, vomiting, nausea, dizziness, and palpitations. (Thick substance is called phlegm; thin substance is called fluid; water-dampness is the root. When combined with fire, it condenses into phlegm and ascends/descends with qi. In the lung, it causes cough; in the stomach, vomiting; in the head, dizziness; in the heart, palpitations; in the back, coldness; in the hypochondrium, distension. Phlegm in the Zhongwan area causes aversion to cold with high fever and headache, resembling exterior syndromes. Over time, it causes tidal cough worsening at night, resembling internal injury from yin-fire. Migratory joint pain resembles wind syndromes, but muscle color remains normal, and the pulse is slippery and irregular, which distinguishes it.)
Banxia (Pinellia Tuber processed with ginger) (2 qian) Chenpi (Citri Reticulatae Pericarpium, white part removed) (1 qian) Fuling (Poria) (1 qian) Gancao (Licorice Root) (5 fen). Decoct with fresh ginger slices. (Ginger can neutralize the toxicity of Banxia.)
For damp-phlegm, add Cangzhu (Atractylodis Rhizoma); for hypochondriac discomfort, add Xiangfu (Cyperi Rhizoma) and Zhiqiao (Aurantii Fructus).
Banxia is acrid and warm, smooth in texture and dry in nature, acting as the Sovereign herb to move water and resolve phlegm. Phlegm arises from qi stagnation; when qi flows smoothly, phlegm descends. (Pang Anchang said: Those skilled in treating phlegm do not... [Text gap]. Therefore, Fuling is used as the Minister herb to leach out dampness. Disharmony in the middle jiao leads to accumulation of phlegm-saliva, so Gancao is used as the Assistant herb to harmonize the middle and tonify earth. (Some say: If there is phlegm with thirst, Banxia should be removed and replaced with Gualou (Trichosanthis Fructus) and Beimu (Fritillariae Bulbus). Wu Hegao said: If thirsty and desiring to drink water, substitution is possible. If thirsty but unable to drink, Banxia is still appropriate despite thirst. This is because dampness is the root and heat is the branch; extreme dampness mimics the transformation of its conqueror, which is not the true image. Note: Beimu is cold and moistening, treating dry-phlegm of the lung. Banxia is warm and drying, treating damp-phlegm of the spleen. Although both resolve phlegm, their cold/warm and dry/moist natures differ greatly. Misapplication causes significant harm; users must be cautious. In cases of blood deficiency with counter-flow of yin-fire injuring the lung, causing turbid fluids and phlegm production instead of blood, this is named Dry-Phlegm (Zao Tan). Moistening agents should be used, such as Dihuang (Rehmanniae Radix), Maidong (Ophiopogonis Radix), and Gouqi (Lycii Fructus), to nourish yin and descend fire, clearing phlegm naturally. Using Er Chen Tang here leads to immediate danger. For cephalalgia with bone pain at the eyebrow temples, wind-dispelling herbs fail, but phlegm-resolving herbs succeed. For red eyes and photophobia, cooling herbs fail, but phlegm-resolving herbs cure. If a person spits copious frothy sputum that is not thick, this is qi deficiency failing to control saliva; diuretics are contraindicated. Use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Yizhiren (Alpiniae Oxyphyllae Semen) 1 qian to secure it.)
Removing Fuling and Gancao yields Chenpi Banxia Tang (Tangerine Peel and Pinellia Decoction). Adding Jiegeng (Platycodonis Radix) yields Jiegeng Banxia Tang. Removing Chenpi and Gancao yields Banxia Fuling Tang, used for water retention... [Text garbled].
Add Dansheng (Arisaematis Cum Bile) ... [Text garbled].
Qiangdaobi ... [Text garbled].
Xiangpianzi ... [Text garbled].
Tan Jie Xiong ... [Text garbled].
Ming Jiawei ... [Text garbled].
Ming Wenzhong Hua ... [Text garbled].
Wan. Treats phlegm ... [Text garbled].
Dan Yong Banxia ... [Text garbled].
Nai Zhe. [Text garbled].