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In cases of excessive phlegm not caused by wind-stroke (stroke), it is entirely due to deficiency in the Middle Jiao. Phlegm is essentially water; its root lies in the Kidney, and its branch manifestation lies in the Spleen. Regarding the Kidney aspect, it occurs because water fails to return to its origin, leading to water flooding and transforming into phlegm; regarding the Spleen aspect, it occurs because food and drink are not transformed, and Earth fails to control Water. Observe robust individuals: regardless of how much they drink and eat, food is digested immediately, and one does not see them producing phlegm. Only those who cannot eat tend to produce phlegm, because Spleen deficiency fails to transform food, causing food to stagnate and become phlegm. Therefore, in all cases of consumptive disease (Xu Lao), there must be excessive phlegm, and as the condition approaches critical danger, the phlegm becomes even more severe. This is precisely because Spleen Qi becomes increasingly deficient, completely failing to transform, so that all fluids turn into phlegm. Then, between phlegm and disease, does disease cause phlegm, or does phlegm cause disease? Is it not true that phlegm necessarily stems from deficiency? Thus, it can be seen that true excess-phlegm conditions are few in the world, and very few cases require purgative treatment for phlegm. Therefore, when treating phlegm, one must warm the Spleen and strengthen the Kidney to address the root cause. As the foundation gradually fills, the phlegm will disappear without specific treatment. Various methods for treating phlegm are detailed later and in the dedicated chapter on Phlegm-Fluids.

I have heard folk sayings claiming: "Phlegm circulates throughout the body, making its pathological manifestations unpredictable." Conditions such as paralysis, convulsions, and hemiplegia are all attributed to latent phlegm stagnating within. If such phlegm-fluids are indeed pathogenic factors, how can the disease heal without eliminating the phlegm-pathogen? I replied: Do you know the origin of phlegm? Phlegm in the meridians is actually transformed from Jin-Ye (body fluids) and Xue (blood). If Ying-Qi (Nutritive Qi) and Wei-Qi (Defensive Qi) are harmonious, then Jin-Ye remains Jin-Ye, and Xue remains Xue; where would phlegm come from? It is only when Yuan-Yang (Primordial Yang) is depleted and Shen-Ji (Spiritual Mechanism) is exhausted that there is no Qi in the water, causing Jin-Ye to coagulate and Xue to deteriorate, all transforming into phlegm. Is this truly phlegm, or is it Jing-Xue (Essence and Blood)? Are there really substances called "phlegm" existing apart from Essence and Blood? If one claims that phlegm in the meridians cannot be removed without aggressive purging, then one must purge both Essence and Blood entirely. Only then might it be acceptable. Otherwise, how can one attack only the phlegm while leaving Jin-Ye and Xue undisturbed? If Jin-Ye and Xue are further injured, Yuan-Qi becomes even more exhausted, and phlegm regenerates as fast as it is removed, becoming even more severe. This is why treatments for phlegm often fail, whereas what truly needs complete restoration is Yuan-Qi. Moreover, there are those who mistakenly identify non-phlegm conditions as phlegm and wrongly apply purgatives, which is extremely ignorant. Therefore, when using phlegm-treating formulas such as Gun Tan Wan (Rolling Phlegm Pill), Qing Qi Hua Tan Wan (Clear Qi and Transform Phlegm Pill), or Sou Feng Shun Qi Wan (Search Wind and Smooth Qi Pill), these should only be used temporarily to disperse accumulation if the patient's Yuan-Qi is intact, occasional Qi stagnation exists, and slight phlegm obstruction persists. In such cases, temporary dispersal is effective. However, if the disease has damaged Yuan-Qi, and one only knows how to treat the branch symptoms, the patient will inevitably deteriorate daily despite daily medication.