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Arisaema (Tian Nan Xing), with bitter and acrid flavors, neutral nature, capable of ascending and descending, belongs to yang within yin, and is toxic. It enters the Spleen, Lung, and Heart meridians. It excels at resolving phlegm, unblocking Qi stagnation below the diaphragm, dispersing blood stasis, inducing abortion, breaking down hard accumulations, eliminating carbuncles and swellings, treating aphasia due to wind-stroke, opening orifices extremely well, and treating tetanus. It is like a general who breaches gates and seizes doors; it can be used once, but not repeatedly. In San Sheng Yin (Three Lives Decoction), it is used with Aconite (Fu Zi) to achieve unexpected results, dispelling phlegm and transforming stagnation, not relying on it to clear the lungs and calm the mind, thus it should only be used temporarily. Although in San Sheng Yin, without Ginseng (Ren Shen) as the sovereign drug, both Aconite and Arisaema would be ineffective. From this single prescription of San Sheng Yin, one can comprehend the subtleties of herbal combination.

One may ask: Arisaema resolves stubborn phlegm to open orifices and breaks down hard accumulations; its courageous momentum actually relies on Aconite to鼓动 courage. Without Aconite, it might not be so fierce. Or perhaps San Sheng Yin cannot be used frequently; can it be used frequently in other formulas? Generally, among drugs that resolve phlegm, none are as harsh and fierce as Arisaema. Wind-stroke causes closure, necessitating its use to breach the gate and enter directly. If it is other types of phlegm diseases, where there is originally no firm closure, why use Arisaema?

Pinellia (Ban Xia), with acrid and slightly bitter flavors, neutral nature, cold when raw and warm when cooked, sinking and descending, belongs to yang within yin. It enters the Gallbladder, Spleen, and Stomach meridians. When ground into powder, for every one tael, add two qian of Alum (Ku Fan) and one he of Ginger Juice (Jiang Zhi), knead into cakes, wrap in Broussonetia leaves (Chu Ye), and dry in shade, also known as Pinellia Qu (Ban Xia Qu). The sliced form has fierce potency, while the fermented cake form has mild potency, both being very effective in treating salivary phlegm. Whether fire-phlegm, cold-phlegm, damp-phlegm, old-phlegm, or phlegm-fluids, phlegm-nodules, salivary phlegm, phlegm-knots, or phlegm-confusion, they can all be treated, but it cannot treat phlegm caused by deficiency-fire. Pregnant women should avoid using it, fearing it may induce abortion. However, when absolutely necessary, temporary use is harmless. Patients with hemoptysis should also avoid it, fearing its nature may further stir up fire. Powdered sliced Pinellia blown into the nose can rescue cases of five types of death-like states and is very effective for postpartum blood fainting.

The human body originally has no phlegm; food and drink enter the Stomach, transform into essence, and do not transform into phlegm. Only when the true fire in the Kidney is deficient does the fire boil and transform into phlegm; or when the true water in the Kidney is deficient, does the water overflow and transform into phlegm. Fire boiling into phlegm and water overflowing into phlegm, although originating from the Kidney, the phlegm remains in the Spleen. Since Pinellia treats phlegm, how could it be difficult to digest? Moreover, since the phlegm has entered the Spleen, how can it not be transformed? However, the reason it ultimately cannot eliminate it completely is that it can eliminate phlegm that has already entered the Spleen, but cannot cut off the phlegm that is about to enter the Spleen. For phlegm in the Kidney, Kidney Qi Pill (Shen Qi Wan) must be used to drive it out; this is beyond Pinellia's ability to dispel. Pinellia drains the branch of phlegm but cannot treat the root of phlegm. Pinellia's nature is sinking and descending, seemingly able to enter the utmost yin, yet its yang exceeds its yin, allowing it to only shallowly enter Spleen-yin, but not deeply enter Kidney-yin. Furthermore, Pinellia drains yin but does not tonify yin, while the Kidney can only be tonified, not drained. Pinellia desires to enter the Kidney, but the Kidney does not accept it. Since Pinellia cannot enter the interior of the Kidney, how can it transform phlegm within the Kidney? Thus, it is visible that phlegm in the Spleen is the branch, and phlegm in the Kidney is the root, because Spleen phlegm originates from the Kidney. To eliminate Spleen phlegm, one should not distinguish based on branch and root differences.

Kidney Qi Pill (Shen Qi Wan) treats phlegm by addressing the root. If water does not float upward to become phlegm, why eliminate phlegm? If fire does not boil upward to become phlegm, why clear heat and resolve phlegm? Using Kidney Qi Pill causes phlegm to cease naturally. Using Pinellia to treat the branch may disturb the root and hinder phlegm resolution. Pinellia is a drying agent; consuming it further depletes Qi in the Kidney. Once Qi is depleted, fire moves and water dries, failing to generate essence and instead generating phlegm, which is inevitable. This brings not only no benefit but harm. Therefore, if the root is treated, there is no need to treat the branch.

One may doubt that Pinellia's drying nature makes it suitable for damp-phlegm, asking what drug is used to control its dryness and whether it can treat hot-phlegm? The properties of drying and dampening are distinct; even if controlled appropriately, it only removes the excess, but cannot change its nature. However, uncontrolled dryness and controlled dryness differ naturally. I have a method of preparation, which I transmit here. Use one jin of Pinellia and four liang of fresh Ginger slices, boil for several boils, take out and dry. Use one hundred Mulberry leaves (Sang Ye), ten bowls of water, decoct to obtain two bowls of juice, soak Pinellia thoroughly, then dry again. Then use one liang of Salt and one bowl of boiling water, soak thoroughly again, slice and use. This removes sixty percent of its dry nature and retains forty percent of its damp nature. Hot and cold phlegms, as well as phlegms from water and fire boiling over, can all be used in small amounts as a temporary measure. However, it can only be used temporarily and not relied upon for long-term treatment.

One may worry that prepared Pinellia, though excellent for dry-heat phlegm, may not be suitable for cold-damp phlegm. What then? There is no need to worry. Pinellia is drying, making it perfectly suitable for cold-damp phlegm; after processing, the dryness is moderated, avoiding concerns of damaging Qi or harming the Lungs, so it can be used without fear.

One may doubt that Pinellia treats damp-phlegm but not dry-phlegm; treats cold-phlegm but not hot-phlegm, which is understood. Among phlegms, there are those who spit black phlegm; what is the cause? Observing such a person, they appear robust; saying it is fire, the mouth is not thirsty; saying it is deficiency, the Kidneys are not depleted. Can Pinellia treat this? This is evil qi knotting in the interior of the Kidney, not phlegm blocking the orifices of the Lungs. This condition originates from a man who has been celibate for a long time, desiring women but unable to obtain them, and daring not to engage with external women to release essence. Thus, evil qi enters the Kidney, essence transforms into phlegm, resulting in spitting black phlegm like ink. It is appropriate to use drugs that descend fire, assisted by White Mustard Seed (Bai Jie Zi) to resolve phlegm, and further combined with Schizonepeta (Jing Jie) type herbs to dissipate fire in the blood level. Otherwise, there will inevitably be the risk of hemorrhage and the suffering of warm malaria. After several doses, the body will likely feel aversion to cold, then use Modified Xiao Yao Powder (Jia Wei Xiao Yao San), heavily utilizing Pinellia to clear exterior and interior evils, thereby removing cold and heat, and the black phlegm will gradually heal. I have personally tested such conditions and often found them effective, so I dare to discuss them in this book.