则治风，见热则退热，疼者则止疼，虚者则补血，卒妄治之，不知漫投以祛风退热止痛补血之剂，则无益反害
。故但见痰症与脉明白，投以痰气之药，百无不效。（《士林余业》）
夫精液既凝为痰，则不复生血以周润三焦，故口燥咽干，大便秘结，面如枯骨，毛发焦槁，妇人则因此月
水不通。若能化去败痰，自然服饵有效。然不得过行燥削，使痰湿既消，津液亦槁，去湿留热，又非其治矣。
务使化痰复为津液，犹化盗贼复为良民可也。（《锦囊》）
吐下例 痰在上者，以瓜蒂散吐之。在下者，以控涎丹利之。虽曰可吐可下，亦要观人之勇怯，察脉
之虚实，方可投之。切记不宜痛击暴下，所以初虞世有金虎碧霞之戒者此也。（《妇人良方》）
经曰∶客者除之，留者去之。谓非其固有而有之害也。如痰涎败浊之物，原非津精气血之类，一旦有之，
法当驱逐使之亟去也。苟执痰无补法之说，不审虚实汗下，以寒攻之，则为寒中，以热攻之，则为热中，应下
而吐者，则伤其上焦之气，应吐而下者，则伤其下焦之血，旧痰未除，新痰又起矣。如谓痰不可尽除，偏执专
补脾胃之说，使痰涎陈腐，占住于肠胃之间，养寇入室，宁非正气之贼邪，非天下之至神，不足以语此。故良
工之去痰，在上可吐则吐之，重则瓜蒂散，轻则用丹溪吐法。痰在中下者，可下则下之，重则十枣汤、控涎丹
，轻则滚痰丸。设有可吐可下之症，而无可攻之脉，则攻补兼行，不失先后之序可也。（《保命歌括》）
痰宜逐除 一切气急喘嗽，咯痰吐涎，世人皆知为痰病，方书备载于痰门。又曰治痰必先理气、气顺
痰消，于理甚明。盖曰忧思损志，气郁涎凝，气治则痰散也。然而痰因气结，气因痰滞，理气则其如痰何。余
故用滚痰丸，逐去滞碍恶物，如用兵讨叛，新民也。况有禀赋痰证者，婴儿出腹，啼声初出，已有痰涎。又有
大善知识，忘形忘骸，无思无虑者，顿抱痰疾，此岂唯因气而然乎，故学人不可固执一端而不通。（《养生主
论》）
按严氏谓气顺则痰自下之说，盖以人之七情郁结，气滞生涎，聚为痰饮，治者能使气道通利，则痰自降下
也。然有病患原有痰积，其气因痰而结滞者，岂但理气而痰能自行耶。必先逐去痰结，则滞气自行，岂可专主
一说。（《微义》）（按∶严氏说本为水饮而发，今《微义》本诸王隐居，主痰涎而言，故列于此。）
按痰标也，所以致痰者本也，治病固当求本，然须看痰势缓急。缓则治本固也，若痰势盛急，度难行散，
非攻无由去
者，虚人可标本并治，补攻兼施。若势甚紧急，则虽虚人亦当先攻后补，如中风之用三生饮控涎丹是也。当此
咽喉闭塞之时，不吐去其痰，立即堵塞而死矣。昧者乃畏其虚而不敢用，独不畏其死耶。夫人之虚，莫虚于中
风者矣，犹必先攻后补，乃于寻常虚人反畏之耶。《准绳》谓治痰固宜补脾，以复健运之常，使痰自化。然停
积既久，如沟渠壅遏，瘀浊臭秽，无所不有，若不疏通，而欲澄治已壅之水而使之清，决无是理。（《医碥》）
痰有宜清润 痰之本，水也，原于肾；痰之动，湿也，主于脾。古人用二陈汤为治痰通用者，所以实
脾燥湿，治其标也。然以之而治湿痰、寒痰、痰饮、痰涎，则固是矣。若夫痰因火上，肺气不清，咳嗽时作，
及老痰郁痰，结成粘块，凝滞喉间，吐咯难出，此等之痰，皆因火邪炎上，熏于上焦，肺气被郁，故其津液之
随气而升者，为火熏蒸凝浊，郁结而成，岁月积久，根深蒂固，故名老名郁，而其原则火邪也。病在上焦心
肺之分，咽喉之间，非中焦脾胃湿痰冷痰痰饮痰涎之比，故汤药难治，亦非半夏、茯苓、苍术、枳壳、南星
等药所能治也。惟在开其郁，降其火，清润肺金而消化凝结之痰，缓以治之，庶可效。（《杂着》）（按∶原
处化痰丸，其方用天门、黄芩、海粉、栝蒌仁、橘红、桔梗、连翘、香附、青黛、芒硝、姜汁丸。今不取。）
有阴血不足，阴火上逆，肺受火侮，不得清肃下行，由是津液凝浊，生痰不生血者，此则当以润剂，如门
冬、地黄、枸杞子之属滋其阴，使上逆之火，得返其宅而息焉，而痰自清矣。投以二陈，立见其殆。（《准绳》）
窠囊之痰治法 治痰之法，曰驱曰导曰涤曰化曰涌，曰理脾，曰降火，曰行气，前人之法，不为不详。
至于窠囊之
痰，如蜂子之穴于房中，如莲实之嵌于蓬内，生长则易，剥落则难，其外窄中宽，任行驱导涤涌之药，徒伤他
脏，此实闭拒而不纳耳。夫人身之气，经盛则注于络，络盛则注于经。窠囊之来，始于痰聚胃口，呕时数动胃
气，胃气动则半从上出于喉，半从内入于络。胃之络贯膈者也，其气奔上之急，则冲透膈膜，而痰得以居之。
痰入既久，则阻碍气道，而气之奔入者，复结一囊也。然痰饮结聚于膈膜而成窠囊，清气入之，浑然不觉，每
随浊气而动，乃至寒之亦发，热之亦发，伤酒伤食亦发，动怒动欲亦发，总由动其浊气，浊气随火而升转，使
清气逼处不安也。故治窠囊之痰甚难，必先凝神入气，以静自调，薄滋味以去胃中之痰，使胃经之气，不急奔
于络，转虚其胃，以听络中之气，返还于胃，逐渐以药开导其囊而涤去其痰，则自愈矣。（《医通》）（按∶
此说本出《寓意草》，而张氏颇加删正。）
治痰诸药 痰在胁下，非白芥子不能达。痰在皮里膜外，非姜汁、竹沥不能导达。痰在四肢，非竹沥
不开。痰结核在咽喉中，燥不能出入，用化痰药，加咸药软坚之味，栝蒌仁、杏仁、海石、桔梗、连翘，少佐
朴硝，以姜汁、蜜和丸，噙服之。海粉即海石，热痰能降，湿痰能燥，结痰能软，顽痰能消，可入丸子、末子，
不可入煎药。枳实泻痰，能冲墙壁。天花粉，大能降膈上热痰。薤汁，治血滞不行，中焦有饮，自然汁冷吃两
三银盏，必胸中烦躁不宁，而后愈。（《丹溪》）
药禁 今定药禁一十条∶阴虚枯燥，妄用二陈。阳虚多汗，妄用青龙。心虚神怯，妄用辛散。肺虚无
气，妄用苦泻。肝虚气刺，妄用龙荟。脾虚浮肿，妄用滚痰。胃虚津竭，妄用香燥，脏腑易动，妄行涌泄。本
非坚积，妄行峻
攻。血气虚羸，妄行针灸。（《法律》）
凡热痰乘风火上入，目暗耳鸣，多似虚证，误行温补，转锢其痰，永无出路，医之罪也。凡痰饮随食并出
，不开幽门，徒温其胃，束手无策，迁延误人，医之罪也。凡遇肾虚水泛，痰涌气高喘急之证，不补其下，反
清其上，必致气脱而死，医之罪也。（同上）
消痰诸方 导痰汤，治一切痰厥，头目旋运，或痰饮留积不散，胸膈痞塞，胁肋胀满，头痛吐逆，喘
急痰嗽，涕唾稠粘，坐卧不安，饮食不思。
半夏（汤泡七次四两） 天南星（炮去皮） 橘红 枳实（去穣麸炒） 赤茯苓（去皮各一两） 甘草（炙
半两）
上 咀，每服四钱，水二盏，生姜十片，煎至八分，去滓温服食后。（《济生》）（按∶此二陈汤药方。）
《修月鲁般经后录》清气化痰丸，治痰实，胸膈不利，头目不清，于本方加黄连、栝蒌仁、黄芩、杏仁为末
，水糊为丸。《经验秘方》加味导痰汤，治反胃呕吐，于本方去甘草，加桔梗、沉香、木香。
治气不顺，停痰上攻头疼。
二陈汤（气实脉盛者温胆汤） 加沉香 木香 天南星（生各少许）
上姜钱五片，热煎服。（《澹寮》引《增品易简方》）
二陈汤吞白丸子，治痰饮一证，眉心眉梁骨痛，状如头风。（《直指》）
二陈汤，加苍术、片子姜黄、制枳壳各少许，治酒面积毒，酿热生痰，攻眼肿痛。（同上）
参苏饮，因痰饮发热，但连日频进此药，以热退为期，不可便止。虽有前胡、干葛，但能解散肌热，枳壳、
橘红辈，自能宽中快膈，不致伤脾，（《易简》）（按，参苏饮方，
既录于《伤寒广要》中。）
化痰丸
天络丝，即丝瓜也，烧存性为细末，枣肉为丸，如弹子大，每服一丸，好酒下，化痰立效。（《摄生众妙
方》）
和胃诸方 平胃丸，治痰。（章运使浩方）
平胃散（四两） 半夏（姜制为末四两）
上和调，用好枣一百枚，灯草一小把，水一大碗，同煮候枣烂，去灯心，枣子去皮核，取肉为丸，如梧桐
子大，每服五十丸，空心姜汤下，熟水亦得。（《魏氏》）
顺气消食化痰丸。
制半夏 胆南星（各一斤） 神曲（炒） 杏仁（去皮尖） 陈皮（去白） 萝卜子（生用） 葛根 山楂
肉（炒） 青皮（去穣炒） 苏子（沉水者） 香附（制） 麦芽（各一两）
饮食生痰，胸膈膨闷者，此方主之。（《医方考》）
枳缩二陈汤，治涎在心膈上攻，走腰背，呕哕大痛。
枳实（麸炒） 砂仁 半夏（姜制炒） 陈皮 香附（各一两） 木香 草豆蔻 干姜（炒各五分） 浓朴
（姜汁炒） 茴香（酒炒） 玄胡索（各八分） 甘草（三分）
上剂姜三片煎，入竹沥磨木香同服。（《回春》）
温散诸方 （伤寒不眠治验，怪症昏愦治验。） 范汪旋复花汤，主胸膈痰结，唾如胶，不下食者方。
乌头（五枚去皮熬） 旋复花 细辛 前胡 甘草（炙） 茯苓（各二两） 半夏（一两洗） 生姜（八两）
桂心（四两）
上九味切，以水九升，煮取三升，分为三服。（《外台》）（按此方先教谕代乌头以附子，更见其效。）
彩帛铺刘员外，患伤寒六七日，昼夜不得眠，方眠即起，方起即倒，未尝少息，看待厌倦，召孙。孙曰∶
若言是
气，必喘作；今无此症，非气也。时复身上冷汗出，尺寸脉皆沉，关中亦沉，重诊之鼓击于指下，此痰积寒聚
于胸中也。遂用陈皮、半夏、干姜三物各一两为饮，姜半两捶碎，以水两碗，煎七分去渣，分二服。服药经时
遂睡，经一昼夜不醒，既觉下痰一块，如鸡子大，其疾遂愈。凡痰症皆有冷汗，其症明矣。（《纲目》引孙）
二生汤，专治痰。
附子（生去皮脐） 半夏（生用）
上等分 咀，每服四钱，水二盏，生姜十片，煎至七分，去滓温服空心，入少木香煎尤佳。（《济生》）
（当与《水饮》半夏汤相参。）
甲辰年，四都陈妇，患一怪症，潮烦迷闷，眼直，昏愦如尸，不省人事，更数医不效，请予治之。诊其脉
若平人，然不浮不沉，不虚不实，不数不迟，凝然在中。予曰∶此症不死，但寒痰在胸，非热药不能开。用附
子理中汤加砂仁，数帖而愈。后至庚戌年，旧疾复发，以原方服之即愈。（《医彀》）
半硫丸，下痰。
半夏（三两） 硫黄（二两）
上为细末，生姜面糊和丸，梧桐子大，每服三十丸，饮下，不以时。（《鸡峰》）
急救痰晕方。
生姜自然汁半小酒杯，好蜂蜜一二匙，服时入盐少许，再入白滚汤，共一处和匀灌之。（《危症简便》）
清凉诸方 （郁怒兼邪治验）龙胆丸，解暴热，化痰（馆本作涎），凉膈，清头目。
草龙胆 白矾（ 四两，案∶馆本云∶烧沸定，各四两。） 天
南星 半夏（各二两半，水浸切作片，用浆水、雪水各半，同煮三五沸，焙干。）
上为末，面糊为丸，梧桐子大，每服三十丸，腊茶清下，食后临卧服。面糊须极稀，如浓浆可也。应痰壅
膈热，头目昏重，服之顿清。（《苏沈》）《和剂》辰砂化痰丸，治风化痰，止咳嗽，除烦闷，于本方去龙胆
，加辰砂。
栝蒌枳实汤，治痰结咯吐不出，胸膈作痛，不能转侧，或痰结胸膈满闷，作寒热，气急，并痰迷心窍，不
能言语者，并治之。
栝蒌 枳实 桔梗 茯苓 贝母 陈皮 片芩 山栀（各一两） 当归（六分） 砂仁 木香（各五分）
甘草（三分）
上剂生姜煎，入竹沥、姜汁少许同服。痰迷心窍，不能言语，加石菖蒲，去木香。气喘，加桑白皮、苏子。
外用姜渣揉擦痛处。（《回春》）《寿世》开结化痰汤（主治同），于本方去当归、砂仁、竹沥，加半夏、黄
连、苏子、桑皮、朴硝、杏仁，入姜汁磨木香服。
丘祖山，年及三旬，经营生理，饮食失节，劳烦郁怒，兼遇风邪，服药表散，卧病伏枕，复因恚怒，咽喉
窒塞，手足厥冷，戴眼直视，口不能言，随服姜汤，痰堕声出而苏，六七日来，吐痰约有数十碗。他医投药不
应，延予诊之，六脉洪滑而数，咽膈胸腹热如汤火，口干烦渴，夜不成寐。投以温胆汤，加黄连、麦冬、滑石、
石膏，二剂而痰减热除，诸症脱然。（《一万社草》）
遂痰丸（李九河方）。
紫海蛤如鸡子大者一斤，火 红淬入童便内，如此三次为末，却用鲜栝蒌拌蛤粉，捣千百杵，乃匀稀稠得
宜，作成饼子，将麻绳穿，悬当风处吹干，为末，四两。
牛胆南星（二两） 半夏（四两用姜汁及水沓油煮过一两） 青黛 黄连（二两） 陈皮（去白二两）
木香（五钱） 大黄（五两酒拌九蒸九晒）
上为末，姜汁竹沥丸，如绿豆大，每服三四十丸，姜汤下。上方治痰，看病虚实选用，皆奇方也。（《医
If wind pathogen is observed, treat the wind; if heat is observed, clear the heat; if pain is present, alleviate the pain; if deficiency exists, tonify the blood. If one treats rashly without understanding, blindly administering formulas for dispelling wind, clearing heat, stopping pain, and tonifying blood, it will be of no benefit but rather cause harm. Therefore, as long as phlegm syndromes and pulse patterns are clear, administering medicines for resolving phlegm and regulating qi will be effective in every case. (From *Shilin Yuye*)
Once essence and fluids coagulate into phlegm, they can no longer generate blood to moisten the Triple Burner. Consequently, dryness of the mouth and throat, constipation, a face resembling withered bone, and scorched, brittle hair appear. In women, this leads to amenorrhea. If the corrupt phlegm can be resolved, medicinal intake will naturally be effective. However, one must not excessively use drying and reducing agents, which would eliminate damp-phlegm but also deplete body fluids, leaving heat behind after removing dampness; this does not conform to proper treatment principles. The goal should be to transform phlegm back into body fluids, just as transforming thieves into law-abiding citizens. (From *Jinnang*)
[Methods of Vomiting and Purging] For phlegm located above, induce vomiting using Gua Di San (Melon Seed Powder). For phlegm located below, promote drainage using Kong Xian Dan (Control Saliva Pill). Although vomiting and purging are indicated, one must observe the patient's courage or timidity and examine the pulse for deficiency or excess before administering treatment. It is crucial to remember that violent attacking and drastic purging should be avoided; this is the reason for Chu Yushi's warning regarding "Jinhu Bixia." (From *Furen Liangfang*)
The Classics state: "Remove what is external/invading; eliminate what is retained/stagnant." This refers to harmful factors that are not originally inherent. Substances like corrupt salivary phlegm are not part of normal body fluids, essence, or qi-blood. Once present, they should be driven out quickly. If one rigidly adheres to the saying that "phlegm has no tonification method," without assessing deficiency or excess, and uses sweating or purging methods, employing cold herbs to attack results in Cold Centering, while using hot herbs to attack results in Heat Centering. Using vomiting when purging is indicated damages Upper Jiao Qi; using purging when vomiting is indicated damages Lower Jiao Blood. Old phlegm remains undissipated, and new phlegm arises. If one argues that phlegm cannot be completely eliminated and rigidly insists on solely tonifying Spleen and Stomach, allowing stale phlegm to occupy the intestines and stomach, it is like harboring bandits within the house—acting as a thief against righteous Qi. Only those of supreme wisdom can discuss this matter. Thus, skilled physicians remove phlegm by inducing vomiting if it is superior (heavy cases use Gua Di San, light cases use Danxi's vomiting method) and purging if it is inferior or middle/lower (heavy cases use Shi Zao Tang or Kong Xian Dan, light cases use Gun Tan Wan). If symptoms indicate vomiting or purging are possible but the pulse does not support aggressive attack, combine attacking and tonifying methods without losing the correct sequence. (From *Baoming Ge Kuo*)
[Phlegm Should Be Driven Out] All conditions involving rapid breathing, wheezing, coughing, expectoration of phlegm and saliva are known by laypeople as phlegm diseases, and medical texts detail them extensively under Phlegm categories. It is said that treating phlegm requires first regulating Qi; when Qi flows smoothly, phlegm dissipates. This logic is clear: worry and thought damage willpower, leading to Qi stagnation and saliva coagulation; thus, regulating Qi disperses phlegm. However, phlegm causes Qi knotting, and Qi stagnation is caused by phlegm obstruction. Merely regulating Qi does little to resolve phlegm. Therefore, I use Gun Tan Wan to drive out stagnant obstructive evil substances, akin to using military force to suppress rebellion and pacify the people. Moreover, some individuals have congenital phlegm syndromes; even infants have phlegm-saliva upon birth and crying. Even great sages who forget form and body, having no thoughts or worries, suddenly develop phlegm diseases. Is this solely due to Qi? Therefore, students of medicine must not stick rigidly to one aspect without understanding flexibility. (From *Yangsheng Zhu Lun*)
According to Yan Shi, the theory that "smooth Qi leads to descending phlegm" suggests that emotional stagnation causes Qi obstruction, generating saliva that gathers into phlegm-fluids. If the physician can unblock the Qi pathways, phlegm will descend naturally. However, in patients with existing phlegm accumulation where Qi is knotted due to phlegm, merely regulating Qi will not make phlegm disappear on its own. One must first drive out the phlegm knots so that stagnant Qi can flow freely; one cannot rely exclusively on this single theory. (From *Wei Yi*) [Note: Yan Shi's theory was originally issued for water-fluids; now *Wei Yi* bases its discussion on Wang Yinju's views focusing on phlegm-saliva, hence listed here.]
Phlegm is the branch (symptom), while the cause of phlegm is the root. Treating disease should indeed seek the root, but one must assess the urgency of the phlegm condition. If slow, treating the root is appropriate. If the phlegm condition is severe and urgent, difficult to disperse, and cannot be removed without attack, deficient patients may receive simultaneous root-and-branch treatment, combining tonification and attack. If the situation is extremely urgent, even deficient patients must be attacked first and tonified later, such as using San Sheng Yin or Kong Xian Dan for stroke. When the throat is blocked, failing to vomit out the phlegm leads to immediate death by suffocation. Ignorant practitioners fear deficiency and dare not use these methods; do they not fear death? Among humans, deficiency is most severe in stroke patients, yet they still require attack before tonification; why then fear doing so for ordinary deficient patients? *Zhunsheng* states that treating phlegm should indeed involve tonifying the Spleen to restore its transport function, allowing phlegm to dissolve naturally. However, if phlegm has accumulated for a long time, blocking channels like a clogged ditch filled with turbid, foul matter, attempting to clarify already blocked water without dredging it is impossible. (From *Yi Que*)
[Phlegm May Require Moistening and Clearing] The origin of phlegm is water, rooted in the Kidney; the movement of phlegm is dampness, governed by the Spleen. Ancients used Er Chen Tang as a general formula for phlegm to solidify the Spleen and dry dampness, treating the branch. This is suitable for damp-phlegm, cold-phlegm, phlegm-fluids, and salivary phlegm. However, for phlegm generated by fire, where Lung Qi is unclear, causing intermittent coughing, or for old/phlegm and depressed/phlegm forming sticky clumps stuck in the throat, difficult to expectorate, these types of phlegm result from Fire Pathogen flaring upward, steaming the Upper Jiao, and depressing Lung Qi. Body fluids rising with Qi are steamed by fire, becoming turbid and coagulating through depression. Accumulated over years, they become deeply rooted, hence named "old" and "depressed" phlegm, with Fire Pathogen as the root cause. The pathology lies in the Upper Jiao (Heart/Lung regions) and throat, differing from Middle Jiao Spleen/Stomach damp-cold-phlegm or fluids. Thus, decoctions are difficult to treat, and herbs like Ban Xia, Fu Ling, Cang Zhu, Zhi Ke, and Nan Xing are ineffective. Treatment requires opening depression, descending fire, clearing and moistening Lung Metal, and digesting condensed phlegm slowly. Only then can efficacy be expected. (From *Zazhe*) [Note: The original Huatan Wan formula uses Tian Men Dong, Huang Qin, Hai Fen, Gua Lou Ren, Ju Hong, Jie Geng, Lian Qiao, Xiang Fu, Qing Dai, Mang Xiao, pillized with Jiang Zhi. This is not adopted here.]
In cases of insufficient Yin-Blood with counterflow of Yin-Fire, where Lung is insulted by fire and cannot descend clearly and purely, body fluids become turbid, generating phlegm instead of blood. Here, moistening agents such as Mai Dong, Di Huang, and Gou Qi Zi should be used to nourish Yin, allowing counterflowing fire to return to its residence and subside, clearing the phlegm. Administering Er Chen Tang would immediately lead to danger. (From *Zhunsheng*)
[Treatment of Honeycomb-Nest Phlegm] Methods for treating phlegm include driving, guiding, washing, resolving, inducing vomiting, regulating Spleen, descending fire, and moving Qi. Previous methods are detailed. However, for honeycomb-nest phlegm—which resembles bee cells in a hive or lotus seeds embedded in a pod—it is easy to grow but hard to remove. Its structure is narrow outside and wide inside. Regardless of using driving, guiding, washing, or vomiting drugs, only other organs are injured because the nest rejects entry. Human Qi flows from meridians to collaterals when full, and from collaterals to meridians when full. Honeycomb-nest formation begins with phlegm gathering at the Stomach Gate. Frequent vomiting disturbs Stomach Qi; once moved, half exits via the throat, half enters the collaterals. Stomach collaterals pierce the diaphragm. Rapid ascending Qi bursts through the diaphragm membrane, allowing phlegm to settle. Long-standing phlegm obstructs airways, causing incoming Qi to form another nest. Phlegm-fluids condensing in the diaphragm membrane create nests. Clear Qi enters unnoticed, moving with turbid Qi. Attacks occur with cold, heat, dietary errors (wine/food), anger, or desire. All stem from disturbing turbid Qi, which rises with fire, displacing clear Qi. Thus, treating honeycomb-nest phlegm is very difficult. One must first concentrate spirit into Qi, regulate quietly, avoid rich flavors to remove Stomach phlegm, prevent Stomach Qi from rushing to collaterals, empty the Stomach to allow Collateral Qi to return, and gradually use medicine to open and wash the nest. Then self-healing occurs. (From *YiTong*) [Note: This theory originates from *Yuyi Cao*, modified by Zhang Shi.]
[Herbs for Treating Phlegm] For phlegm in the hypochondrium, only Bai Jie Zi can reach it. For phlegm between skin and fascia, only Jiang Zhi (Ginger Juice) and Zhu Li (Bamboo Sap) can guide it. For phlegm in the four limbs, only Zhu Li can open it. For phlegm nodules in the throat, dry and unable to move, use phlegm-resolving herbs combined with salty substances to soften hardness: Gua Lou Ren, Xing Ren, Hai Shi, Jie Geng, Lian Qiao, with a small amount of Po Xiao. Pillize with Ginger Juice and Honey, and hold in the mouth. Hai Fen is Hai Shi; it descends heat-phlegm, dries damp-phlegm, softens knotted phlegm, and dissolves stubborn phlegm. It can be used in pills or powders but not in decoctions. Zhi Shi drains phlegm, capable of breaking through walls. Tian Hua Fen greatly descends upper-diaphragm heat-phlegm. Xie Zhi treats blood stasis and Middle Jiao fluid retention; drinking two or three silver cups of fresh cold juice resolves chest irritability before healing. (From *Danxi*)
[Contraindications] Ten drug contraindications are established:
1. Yin-deficiency with dryness: Do not recklessly use Er Chen Tang.
2. Yang-deficiency with excessive sweating: Do not recklessly use Qing Long Tang.
3. Heart-deficiency with fearful spirit: Do not recklessly use acrid-dispersing herbs.
4. Lung-deficiency with lack of Qi: Do not recklessly use bitter-draining herbs.
5. Liver-deficiency with stabbing Qi: Do not recklessly use Long Dan Xie Gan Tang.
6. Spleen-deficiency with edema: Do not recklessly use Gun Tan Wan.
7. Stomach-deficiency with fluid exhaustion: Do not recklessly use aromatic-drying herbs.
8. Easily disturbed Zang-Fu: Do not recklessly use emetic/purgative methods.
9. Non-solid accumulations: Do not recklessly use harsh attacks.
10. Qi-Blood emaciation: Do not recklessly use acupuncture/moxibustion. (From *Falü*)
For heat-phlegm riding wind-fire upward, causing dim vision and tinnitus, often mistaken for deficiency: mistakingly applying warm-tonics binds the phlegm permanently, leaving no exit. This is the doctor's fault. For phlegm-fluids emerging with food, failing to open the幽门 (Pylorus/Gastric outlet) and merely warming the Stomach leads to helplessness and delay. This is the doctor's fault. For Kidney-deficiency with water flooding, surging phlegm, high Qi, rapid breathing, and asthma: failing to tonify the lower and instead clearing the upper leads to Qi collapse and death. This is the doctor's fault. (Same source)
[Formulas for Resolving Phlegm]
Dao Tan Tang treats all phlegm-jue (fainting), vertigo, or retained phlegm-fluids not dissipating, chest oppression, hypochondriac distension, headache, vomiting, rapid breathing, coughing with phlegm, thick sputum, restlessness, and loss of appetite.
Ban Xia (soaked in boiling water 7 times, 4 liang), Tian Nan Xing (pounded, peeled), Ju Hong, Zhi Shi (pulp removed, bran-fried), Chi Fu Ling (peeled, each 1 liang), Gan Cao (honey-fried, 0.5 liang).
Chop ingredients. Take 4 qian per dose, with 2 zhan water and 10 slices of fresh ginger. Decoct to 0.8 zhan, strain, and take warm after meals. (From *Jisheng*) [Note: This is essentially Er Chen Tang.]
*Xiuyue Luban Jing Houlü*: Qingqi Huatan Wan treats phlegm-excess, chest discomfort, and unclear head/eyes. Add Huang Lian, Gua Lou Ren, Huang Qin, Xing Ren to the base formula, powderize, and pillize with water paste.
*Jingyan Mifang*: Jiawei Dao Tan Tang treats retrograde vomiting. Remove Gan Cao from the base formula, add Jie Geng, Chen Xiang, Mu Xiang.
Treats irregular Qi, retained phlegm attacking upward causing headache.
Er Chen Tang (use Wendan Tang if Qi-excess and pulse-full): Add Chen Xiang, Mu Xiang, Tian Nan Xeng (raw, small amounts).
Decoct with 5 slices of ginger in hot water. (From *Danliao*, citing *Zengpin Yijian Fang*)
Er Chen Tang swallowed with Bai Wan Zi treats a phlegm-fluid syndrome with pain in the glabella and supraorbital ridge, resembling wind-headache. (From *Zhizhi*)
Er Chen Tang plus Cang Zhu, Pian Jiang Huang, Zhi Zhi Ke (small amounts each) treats alcohol-induced toxicity, fermenting heat to generate phlegm, attacking eyes causing swelling and pain. (Same source)
Shen Su Yin treats fever due to phlegm-fluids. Continue administration daily until fever subsides; do not stop prematurely. Although containing Qian Hu and Gan Ge, which only release muscle heat, Zhi Zhi Ke and Ju Hong naturally broaden the middle and relieve chest oppression without damaging the Spleen. (From *Yijian*) [Note: Shen Su Yin formula is also recorded in *Shanghan Guangyao*.]
Huatan Wan
Tian Luo Si (Silk Gourd/Vine), burn until charred but retain nature, powderize finely. Mix with jujube flesh to form pills the size of bullet seeds. Take one pill per dose with good wine; resolves phlegm immediately. (From *Shesheng Zhongmiao Fang*)
[Formulas for Harmonizing Stomach]
Ping Wei Wan treats phlegm. (Formula of Commissioner Zhang Hao)
Ping Wei San (4 liang), Ban Xia (ginger-processed, powdered, 4 liang).
Mix well. Use 100 good jujubes, a small bundle of rush wicks, and 1 large bowl of water. Boil together until jujubes are soft. Remove wicks. Peel jujubes, remove pits, take flesh, and pillize to size of paulownia seeds. Take 50 pills per dose on an empty stomach with ginger soup; cooked water is also acceptable. (From *Wei Shi*)
Shun Qi Xiao Shi Huatan Wan.
Zhi Ban Xia, Dan Nan Xing (each 1 jin), Shen Qu (fried), Xing Ren (skin and tip removed), Ju Pi (white pith removed), Luobo Zi (raw), Ge Gen, Shan Zha Rou (fried), Qing Pi (pulp removed, fried), Su Zi (sinking in water), Xiang Fu (processed), Mai Ya (each 1 liang).
Primary formula for phlegm generated by diet, causing chest/epigastric bloating and stuffiness. (From *Yifang Kao*)
Zhi Suo Er Chen Tang treats saliva attacking upward from heart/diaphragm, radiating to waist/back, with severe retching and pain.
Zhi Shi (bran-fried), Sha Ren, Ban Xia (ginger-processed, fried), Ju Pi, Xiang Fu (each 1 liang), Mu Xiang, Cao Dou Kou, Gan Jiang (fried, each 0.5 fen), Hou Po (ginger juice-fried), Hui Xiang (wine-fried), Yuan Hu Suo (each 0.8 fen), Gan Cao (0.3 fen).
Decoct with 3 slices of ginger. Add Zhu Li and grind Mu Xiang into it before taking. (From *Huichun*)
[Warming and Dispersing Formulas] (Case studies: Insomnia from Cold-Heat, Strange Coma)
Fan Wang's Xuan Fu Hua Tang treats chest/diaphragm phlegm-knots, saliva like glue, inability to eat.
Wu Tou (5 pieces, peeled, roasted), Xuan Fu Hua, Xi Xin, Qian Hu, Gan Cao (honey-fried), Fu Ling (each 2 liang), Ban Xia (1 liang, washed), Sheng Jiang (8 liang), Gui Xin (4 liang).
Cut nine ingredients. Use 9 sheng water, boil to 3 sheng. Divide into three doses. (From *Waitai*) [Note: Later instructors substituted Wu Tou with Fu Zi for better efficacy.]
Liu Yuanwai of Caibo Shop suffered from Cold-Heat for 6-7 days, unable to sleep day or night. As soon as he slept, he rose; as soon as he rose, he fell. No rest. Doctors grew weary and summoned Sun. Sun said: "If this were Qi disorder, there would be wheezing; currently absent, so it is not Qi." Occasional cold sweat on body. Cun and Guan pulses both deep. Heavy pressing feels drum-like under fingers. This is phlegm accumulation and cold gathering in the chest. Used Chen Pi, Ban Xia, Gan Jiang (each 1 liang) as a drink. Crushed 0.5 liang ginger, added 2 bowls water, decocted to 0.7, strained, divided into two doses. After some time, patient slept, unconscious for a day and night. Upon waking, expelled a phlegm mass the size of a chicken egg; disease cured. All phlegm syndromes present with cold sweat; symptoms are clear. (Cited from Sun in *Gangmu*)
Er Sheng Tang specializes in treating phlegm.
Fu Zi (raw, peeled, navel removed), Ban Xia (raw).
Equal parts, chopped. Take 4 qian per dose, with 2 zhan water and 10 slices of fresh ginger. Decoct to 0.7, strain, take warm on empty stomach. Adding small amount of Mu Xiang during decoction is excellent. (From *Jisheng*) [Compare with Ban Xia Tang in *Shuiyin* chapter.]
In Jiachen year, Mrs. Chen of Sidu suffered a strange syndrome: tidal irritability, confusion, staring eyes, coma like a corpse, unconsciousness. Multiple doctors failed. Summoned me. Pulse felt normal, neither floating nor sinking, neither deficient nor excess, neither rapid nor slow, firm in the center. I said: "This is not fatal. Only cold-phlegm in the chest; only hot medicines can open it." Used Fuzi Lizhong Tang plus Sha Ren. Several doses led to recovery. In Gouxu year, old disease relapsed; taking original formula cured it again. (From *Yigou*)
Ban Liu Wan, drains phlegm.
Ban Xia (3 liang), Liu Huang (Sulfur, 2 liang).
Powderize finely. Mix with ginger-flour paste to form pills paulownia-seed sized. Take 30 pills per dose with water, anytime. (From *Jifeng*)
Emergency Formula for Phlegm-Dizziness.
Half small wine cup of fresh ginger juice, 1-2 spoons of good honey. Add a pinch of salt when taking. Mix with plain boiling water and administer. (From *Weizheng Jianbian*)
[Cooling Formulas] (Case study: Depression/Anger combined with Evil)
Long Dan Wan clears sudden heat, resolves phlegm (manuscript version says xian/saliva), cools diaphragm, clears head/eyes.
Cao Long Dan, Bai Fan (4 liang; note: manuscript says calcined until stable, each 4 liang), Tian Nan Xing, Ban Xia (each 2.5 liang, soaked in water, sliced, boiled 3-5 boils in half浆水/sherry-water and half snow-water, dried).
Powderize. Pillize with flour paste, paulownia-seed sized. Take 30 pills per dose with winter tea clear liquid, after meals and before bed. Flour paste must be very thin, like thick syrup. Effective for phlegm-turbidity, diaphragm heat, heavy head/eyes; brings instant clarity. (From *Su Shen*)
*Heji* Chen Sha Huatan Wan: Treats wind-phlegm, stops cough, removes irritability. Remove Long Dan from base formula, add Chen Sha.
Gua Lou Zhi Shi Tang treats phlegm-knots unable to be expectorated, chest/diaphragm pain, inability to turn sides, or phlegm-knots causing chest fullness, alternating chills/fever, rapid breathing, and phlegm-misting Heart Orifices causing muteness. Treats all these.
Gua Lou, Zhi Shi, Jie Geng, Fu Ling, Bei Mu, Ju Pi, Pian Qin, Shan Zhi (each 1 liang), Dang Gui (0.6 fen), Sha Ren, Mu Xiang (each 0.5 fen), Gan Cao (0.3 fen).
Decoct with ginger. Add small amounts of Zhu Li and Jiang Zhi. For phlegm-misting Heart Orifices/muteness, add Shi Chang Pu, remove Mu Xiang. For asthma/wheezing, add Sang Bai Pi, Su Zi. Externally, rub painful area with ginger residue. (From *Huichun*)
*Shoushi* Kaijie Huatan Tang (same indications): Remove Dang Gui, Sha Ren, Zhu Li from base formula. Add Ban Xia, Huang Lian, Su Zi, Sang Pi, Po Xiao, Xing Ren. Grind Mu Xiang with ginger juice and take.
Qiu Zushan, around 30 years old, managed business, irregular diet, labor/worry/depression/anger, exposed to wind pathogen. Took exterior-releasing drugs, lay sick in bed. Further angered, throat blocked, extremities cold, eyes rolling up, staring, mute. Drank ginger soup, expelled phlegm, voice returned, consciousness restored. Over 6-7 days, expectorated dozens of bowls of phlegm. Other doctors' meds failed. Consulted me. Six pulses were surging, slippery, and rapid. Throat/diaphragm/chest/abdomen hot as soup/fire. Dry mouth, irritability/thirst, insomnia. Administered Wendan Tang plus Huang Lian, Mai Dong, Hua Shi, Shi Gao. Two doses reduced phlegm, cleared heat, symptoms vanished. (From *Yiwanshe Cao*)
Suitan Wan (Li Jiuhe's Formula).
Zi Hai Ge (Purple Seashell) the size of a chicken egg, 1 jin. Calcine red-hot, quench in child's urine. Repeat three times. Powderize. Mix fresh Gua Lou with shell powder, pound thousands of times until uniform consistency. Make into cakes, thread with hemp rope, hang in wind to dry. Powderize, 4 liang.
Niu Dan Nan Xing (Ox Gall Nan Xing, 2 liang), Ban Xia (4 liang, boiled in ginger juice and water with oil, take 1 liang), Qing Dai, Huang Lian (2 liang), Ju Pi (peeled white, 2 liang), Mu Xiang (0.5 liang), Da Huang (5 liang, wine-mixed, steamed and sun-dried nine times).
Powderize. Pillize with ginger juice and bamboo sap, mung-bean sized. Take 30-40 pills per dose with ginger soup. Above formulas for treating phlegm: select based on deficiency/excess. All are miraculous formulas. (From *Yi