学汇函》）（按∶方名遂字，盖坠或逐讹。）
清气化痰丸。
陈皮（去白） 杏仁（去皮尖） 枳实（麸炒） 黄芩（酒炒） 栝蒌仁（去油） 茯苓（各一两） 胆南
星制半夏（各一两半） 姜汁为丸
此痰火通用之方也。（《医方考》）（更有一方，见导痰汤下。）
清湿化痰汤，治遍身四肢骨节走注疼痛，牵引胸背，亦作寒热，喘咳烦闷，或作肿块，痛难转侧，或四肢
麻痹不仁，或背心一点如冰冷，脉来沉滑，乃是湿痰流注经络，关节不利故也。
南星 半夏 陈皮 茯苓 苍术 羌活 酒芩 白芷 白芥子 甘草
上锉，水煎，入竹沥、姜汁，磨木香温服。（《济世全书》）
涌吐方法 （宜与脉法及吐下例参，更宜与《厥》门参，痰厥、呕吐、食青梅胸痛、气厥治验）顽痰满
胸，上脘填塞，其高者因而越之，法当从权取吐。或者津液不守，所以痰多，吐甚痰脱，则精竭而毙矣。（《
直指》）
撩膈散，主心上结痰饮实，寒冷心闷方。
瓜丁（二十八枚） 赤小豆（二七枚） 人参 甘草（各一分）
上四味治下筛，酒服方寸匕，日二。亦治诸黄。（《千金》）
风涎暴作，气塞倒卧，用瓜蒂为末，每用一二钱，腻粉一钱匕，以水半合调灌，良久涎自出。不出，含砂
糖一块，下咽即涎出也。（《本草衍义》）
一人病痰厥不知人，牙关紧急，诸药不能下，候死而已。戴人见之，问侍病者，口中曾有涎否。曰有。戴
人先以防风、藜芦煎汤，调瓜蒂末灌之，口中不能下，乃取长蛤甲磨去刃，以纸裹其尖，灌入右鼻窍中， 然
下咽有声，后灌其左窍亦然。戴人曰∶可治矣。良久涎不出，遂以砒石一钱，又投之鼻中，忽偃然仰面，似觉
有痛，斯须吐哕，吐胶涎数升，颇腥。砒石寻常勿用，以其病大，非如此莫能动。然无瓜蒂，亦不可便用，宜
消息之。（《十形三疗》）
李士材治秦景明，素有痰饮，每岁必四五发，发即呕吐不能食，此病久结成窠囊，非大涌之弗愈也。须先
进补中益气，十日后以瓜蒂散频投，涌如赤豆沙者数升，已而复得水晶色者升许，如是者七补之，七涌之，百
日而窠囊始尽，专服六君子八味丸，经年不辍。（《医通》）
治胸中多痰，头痛不欲食，及饮酒则瘀阻痰方。矾石一两，水二升，煮取一升，内蜜半合，顿服。须臾未
吐，饮少热汤。（《肘后》）治痰晕，明矾火 过，为末，姜汤调下，吐之即愈。（《众妙方》）（按∶《程
星海医案》一商中痰，不省人事而脉不绝，用此方。曰∶矾性咸，咸能软坚，所以能化顽痰也。）
吐痰丹，善吐顽痰，起死回生，牙关开后，即宜进此。
生雄黄（一钱） 生胆矾（一钱） 生滑石（一钱）
共为细末，大人五分，小儿三分，白汤调下，一时即吐顽痰。（《危症简便》）
治暴患痰厥，不省人事者，用生麻油一盏，灌入喉中，
须臾逐出风痰，立省。（《澹寮》）
虞恒德治一妇，因多食青梅得痰病，日间胸膈痛如刀锥，至晚胸中痛止而膝KT 大痛，此痰饮随气升降故
也。服丁、沉、姜、桂、乌、附诸药皆不效，乃以莱菔子研汁与半碗，吐痰半升，至夜痛尤甚而厥，此引动其
猖狂之势耳。次日用参芦一两，逆流水煎服，不吐。又次日苦参煎汤服，亦不吐。又与附子尖、桔梗芦，皆不
吐。后一日清晨用藜芦末一钱，麝香少许，酸浆水调服，始得大吐稠痰升许，其痛如失，调理脾胃而安。
（《医通》）（按∶此系《正传》节文。）
昔刘子正妻，病气厥，笑哭不常，人以为鬼祟所凭，后遇儒医倪惟德，诊其左右手曰∶脉俱沉，胃脘必有
所积，有所积必作疼。遂以二陈汤导之，吐痰升许，病果愈。（《续医说》）
今定吐禁一十二条∶
眩冒昏晕，不可吐。 气高气浅，不可吐。
积劳未息，不可吐。 病后新虚，不可吐。
脉道微弱，不可吐。 病势险急，不可吐。
阳虚多汗，不可吐。 素惯失血，不可吐。
风雨晦冥，不可吐。 冬气闭藏，不可吐。
多疑少决，不可吐。 吐后犯戒，不可吐。（《法律》）
泻下诸方 （寒热似疟、病热暮甚、粒米不进治验） 治膈上有痰，川芎丸。
川芎（二两细锉慢火熬熟） 川大黄（二两蒸令极熟）
上件焙干为末，用不蛀皂角五七梃，温水揉尽，绢滤去滓，瓦器中熬成膏，和前二味为丸，如绿豆大，每
服十五丸，生姜汤下。小儿三丸。（《本事续集》）（《杨氏》芎
黄丸，无皂角，出《大便不通》中。）
治痰茯苓丸，本治臂痛，具《指迷方》中（按∶原文此详载臂痛证候，今录入彼门中，宜参），用以治痰，
无不效者。
茯苓（一两） 枳壳（麸炒去穣半两） 半夏（二两） 风化朴硝（一分）
上四味为细末，生姜自然汁煮糊为丸，如梧桐子大，每服三十丸，生姜汤下。（《是斋》）
控涎丹，凡人忽患胸背手脚颈项腰胯隐痛不可忍，连筋骨，牵引钓痛，坐卧不宁，时时走易不定。俗医不
晓，谓之走注，便用风药及针灸，皆无益，又疑是风毒结聚，欲为痈疽，乱以药贴，亦非也。此乃是痰涎伏在
心膈上下，变为此疾。或令人头痛不可举，或神意昏倦多睡，或饮食无味，痰唾稠粘，夜间喉中如锯声，多流
睡涎，手脚重 冷痹，气脉不通，误认为瘫痪，亦非也。凡有此疾，但以是药，不过数服，其疾如失。
甘遂（去心） 紫大戟（去皮） 白芥子（真者各等分）
上为末，煮糊丸，如梧子大，晒干，食后临卧，淡姜汤或熟水下五七丸至十丸。如疾猛气实，加丸数不妨
，其效如神。（《三因》）（按∶此方本出《圣济·风走注疼痛》门中，名趁痛丸，当参。）
三花神 丸，痰饮变生诸病，风热郁燥，支体麻痹，走注疼痛，痰嗽，气血壅滞，不得宣通，人壮气实者
，此方主之。（《医方考》）（方见《水气》中）
滚痰丸方诗括曰∶甑里翻身甲挂金（药性无毒，利痰顺气，荡涤腹中寒热，走而不守。有孕者不可单服）
，于今头戴草堂深（药性微寒，利痰清肺，除热安胎神妙，阳明引经之
药也），相逢二八求斤正，硝 青礞倍若沉，十七两中令半两，水丸桐子意常斟，千般怪证如神效，水泻双身
却不任。大抵服药，必须临睡就床，用熟水一口许，只送过咽，即便仰卧，令药在咽膈间，徐徐而下。
（《养生主论》）
滚痰丸
大黄（酒蒸） 黄芩（净各八两） 青礞石（硝 一两，《医林集要》青礞石一两半，焰硝两半，砂锅内
如金色，净一两研细。又《入门》礞石、焰硝各一两，同入砂罐内盖之，铁线缚定，盐泥固济晒干，火 红
，候冷取出，同前药为末。） 沉香（五钱）
每服五六十丸，量虚实加减服，茶清、温水任下，临卧食后服。（《袖珍》）《正传》治湿热食积成窠囊
老痰曰∶夫滚痰丸，止可投之于形气壮实，痰积胶固为病者。若气体虚弱之人，决不可轻用也。《准绳》加百
药煎（与礞石、沉香各五钱），曰∶此丸得百药煎，乃能收敛周身顽涎聚于一处，然后利下，甚有奇效。曰倍
若沉者，言五倍子与沉香，非礞倍于沉之谓也。
一老，年七十，因抑郁成病，气滞痰凝，胁有积块，尝作寒热，医者与病者俱不知也，以疟治之，又以虚
治之，凡十月服药六七十剂，不效，又以疟求方于予，予以久疟方与之，亦不效，亲就予诊脉。予细察其脉，
详问其症，谓之曰∶此乃郁火郁痰，凝滞胸膈，积成痞块，因作寒热，似疟而非疟也。以开郁清热化痰行气药
与之，服数剂后，忽然胁腹大痛，其子急求救于予。予知其痰热积滞已久，服此开导之药，发动其病根，是以
作痛。又询其大便久秘，知其必大利而后痛可除也。以牵牛大黄丸五钱与之，令用熟水，分二次服，已服而大
便不行。又以牵牛大黄丸四钱与之服，仍不行。因以炼蜜滚痰丸一两与之，令分三次服，大利数次，腹
痛立止，积滞俱除，痞块亦消，久病顿愈矣，此乃因药发病，胁腹大痛，遂不得已而峻行，用峻行而痼疾除于
一旦，是亦一奇也。又牵牛、滚痰二丸，每服二钱以上，无不即利者，此老一旦服二两而后大利，又一奇也。
然此老得此病，其犯必死者二∶当其痰热凝结胸胁，若不得对症之剂，逾年必郁闭而死，及其胁腹大痛，若不
得峻下之剂，三日必痛苦而死。犯此二死，乃得回生，此老亦大幸矣哉。（《奇效医述》）
小儿医陈日新，形体 羸，尝日病热，至暮尤甚。医以阴虚治，或以痨瘵治，荏苒半载，病势转危。日新
谓其父曰∶欲得大黄通利大肠，为之一快，虽死无憾。其父从之，遂以导痰汤入硝黄煎服，自辰至申，下结粪
一块，如核桃许。抉开视之，乃上元看灯时所食粉饵，因痰裹在外，不能化，由是致热，日渐销铄耳。向使日
新不自知医，则终为泉下人矣，谁谓刘张之法无补于世哉。（《类按》）
谏议姜公（讳性，巴陵人），素患痰证甚奇，每发时，即粒米匙羹不能进，重则四五旬，轻则二三旬，六
脉多沉滑，往虽用消痰通膈之药，然不甚效。戊午春，予过岳阳，适遇公病发，胸膈胀闷，间作水声。用二陈
汤去甘草，加南星、枳实、黄芩、萝卜子、香附，再加槟榔、浓朴、白芥子、苍术，亦未效，饮食亦不进。至
十二日，肾囊与脚俱肿，渐上至腰，大便秘结，脉则间有歇至，非所忌也。欲得一透关通秘之药未获，因思此
属膏痼之痰，非缓药能瘳，古云快剂攻疾，有病则病受之，真气何伤。用甘遂直达行水之药为君，佐以木香、
麝香通窍以顺气。公病时，即末药，胃亦不能纳。将上三味共约五分，浸酒徐服，随觉胸膈有响声，次日增至
八分，遂下弹子粪一碗许，并水数碗而膈通。人咸谓虚极有用人参
五分，入调脾养血药者，服五六剂，反觉胀闷，大便复闭。予曰∶此痰初行时，不宜即补，又非调脾养血所宜，
脾药多塞，血药多湿故也。当以开胃气为主，候胃气开，能进饮食，方可议补。先用猪胆汁入醋数匙，导通大
便，再用陈皮、半夏、茯苓、香附、砂仁、白豆蔻、木香开胃，再加丁香、干姜，饮食渐进，再后用人参、附
子、肉桂、茯苓、砂仁、牛膝、陈皮、泽泻、车前子，人参初用一钱，后用一钱五分，服二三十剂，足冷及
肾囊下部浮肿俱消而愈。（《程星海医按》）
神仙坠痰丸，治痰壅胸痞气凑，此药下痰。（《史府判验》）
黑牵牛（一斤取头末四两） 皂角（无虫蛀者去皮弦酥炙黄色去子净，一两六钱） 生白矾（一两二钱）
上为细末，清水为丸，如梧桐子大，每服三五十丸，渐加至百丸，空心温酒送下。看病轻重，五日、十日
一服。病轻者半月、一月一服，久服永无瘫痪之疾。（《瑞竹堂方》）（按∶此方本于王氏《博济》利膈丸，彼
无白矾，见本草。）丹溪坠痰丸，于本方加枳实、朴消、枳壳，用萝卜汁丸。
痰饮宿水，桃花散，收桃花阴干为末，温酒服一合取利。觉虚，食少粥，不似转下药也。（《本草纲目》）
（按∶此方本出崔氏，既见《香港脚》中。）
乌巴丸，治胸膈间久年顽痰为害，积成痰气，面目青白色无时，浮肿，全不进食，遍身疼痛，夜间上壅，
不得睡卧，寒热往来，手足疼痛，不能转侧。用南星、半夏、黑 、灵砂，不计服数，坠之则不下，取之则不
出。此是痰母坚滞，宜服此药，须臾利下顽痰如鱼冻。如未利，再服，决然洞利，可除终身之疾。
大乌梅（取肉三两） 巴豆（五枚去壳皮膜）
上用水二碗，于瓦石器内，将乌梅慢火煮烂，候水稍干，入巴豆在内，将竹篦搅干，直使如干糊方住火，
摊冷研烂，就丸如绿豆大，每服七丸、九丸、十五丸、二十一丸，不拘时，用生姜汤送下。（《奇效》）
镇坠诸方 养正丹，治肾虚，气不归元，痰涎上壅，亦治寒痰，每服二十丸，用降气汤送下。（《直指》）
灵砂，治上盛下虚，痰涎壅塞。此药最能镇坠，升降阴阳，安和五脏，扶助元气。（主治据《大成》录）
水银（一斤） 硫黄（四两）
上二味，用新铁铫炒成砂子，或有烟焰，即以醋洒，候研细，入水火鼎，醋调赤石脂封口，铁线扎缚晒干，
盐泥固济，用炭二十斤 。如鼎子裂，笔蘸赤石脂频抹其处，火尽为度。经宿取出，研为细末，糯米糊为丸，
如麻子大，每服三粒，空心枣汤、米饮、井花水、人参汤任下。量病轻重，增至五、七粒。（《和剂》）
灸法 痰涎等证，不一而足，惟劳瘵有痰为难治。最宜灸膏肓穴，壮数既多，当有所下，砻砻然如流水
之状，盖痰下也，余当随证治之。（《资生经》）
食忌 胡椒、干姜、辛辣、烧炙、煎 、性热等物，发痰助壅。合锅热面，大发风痰，必须过水离汤，
还汁令热，食之无毒。芋头、山药、鱼腥、油腻、粘滑等物，惹痰，不利肠胃。熟鸡鸭蛋、熟栗子，但是酥腻之
物，滞膈闭气生痰。素有痰者，宜食清凉果木，饱上多食无妨。暴感风寒痰病者，皆宜禁之。（《养生主论》）
*Note: The source text contains several OCR errors or archaic abbreviations (e.g., "栝蒌" for 瓜蒌, "KT" likely referring to knee/leg pain context, "黑 " likely missing character like 牵牛 or similar, " " likely 硝). I have translated based on standard TCM interpretations of these contexts.*
**Xuehui Han**: "The name of the formula is 'Sui Zi' (Fallen Word), probably 'Zhui' (Pierce/Drop) or 'Zhu' (Drive out) is a textual error."
**Qingqi Huatan Wan (Clear Qi and Transform Phlegm Pill)**
Chenpi (Tangerine Peel, peeled of white pith) Xingren (Apricot Seed, skin and tip removed) Zhishi (Immature Bitter Orange, bran-fried) Huangqin (Scutellaria Root, wine-fried) Gualouren (Trichosanthes Seed, oil removed) Fuling (Poria, each 1 liang) Danshenxing (Bile-treated Aconite) Banxia (Prepared Pinellia, each 1.5 liang). Make pills with Ginger Juice.
This is a general formula for treating Phlegm-Fire. (*Yifang Kao*) (There is another formula, see under Daotan Tang.)
**Qingshi Huatan Tang (Clear Dampness and Transform Phlegm Decoction)**
Treats wandering pain in bones and joints throughout the body and limbs, radiating to the chest and back, accompanied by alternating chills and fever, wheezing, coughing, restlessness, or formation of lumps, making turning difficult; or numbness and insensitivity of the four limbs; or a cold sensation like ice at a point on the back; pulse is deep and slippery. This is due to Damp-Phlegm flowing into the meridians, causing joint dysfunction.
Nanxing (Arisaema) Banxia (Pinellia) Chenpi (Tangerine Peel) Fuling (Poria) Cangzhu (Atractylodes) Qianghuo (Notopterygium) Jiuqin (Wine-fried Scutellaria) Baizhi (Angelica Dahurica) Baijiezi (White Mustard Seed) Gancao (Licorice).
Cut into pieces, decoct in water, add Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice), grind Muxiang (Aucklandia), and take warm. (*Jishi Quanshu*)
**Vomiting Methods**
(Should be consulted with Pulse Diagnosis and Vomiting/Purging examples, and further with the *Jue* chapter, including cases of Phlegm-Jue, vomiting, chest pain after eating green plums, and Qi-Jue.) When stubborn phlegm fills the chest and blocks the upper epigastrium, since the pathology is high, it should be expelled upwards according to the principle of "treating high pathologies by inducing vomiting." One must use flexible methods. Some people fail to retain body fluids, leading to excessive phlegm; if vomiting is too severe, phlegm loss leads to essence depletion and death. (*Zhizhi*)
**Liao Ge San (Lift Diaphragm Powder)**
Mainly treats excess phlegm-fluid accumulation in the heart region, causing cold-induced chest oppression and pain.
Guading (Melon Seeds, 28 pieces) Chixiaodou (Red Adzuki Bean, 14 pieces) Renshen (Ginseng) Gancao (Licorice, each 1 fen).
Grind the four ingredients and sieve. Take one cunbi (measure) with wine, twice daily. Also treats various jaundices. (*Qianjin Fang*)
When Wind-Phlegm suddenly attacks, causing qi blockage and collapse, use Gudi (Melon Seed) powder. Take 1-2 qian per dose, mixed with Nifen (Calomel/Calamine - *Note: Historical toxic mineral, often Calomel or Zinc compounds in ancient texts, here likely Calomel/HgCl2 historically but context suggests a purgative/vomitive agent*), 1 qunbi. Mix with half he of water and administer. After some time, phlegm will flow out naturally. If it does not come out, hold a piece of rock sugar in the mouth and swallow; the phlegm will then emerge. (*Bencao Yanyi*)
A patient suffered from Phlegm-Jue (collapse due to phlegm) and lost consciousness, with locked jaw, unable to take any medicine, awaiting death. Dai Ren examined him and asked the attendants if there was phlegm in the mouth. They said yes. Dai Ren first decocted Fengfang (Saposhnikovia) and Lili (Veratrum) in water, mixed with Gudi powder, and attempted to instill it. Since it could not go down the throat, he took a long clam shell, ground off the sharp edge, wrapped the tip in paper, and instilled it into the right nostril. Then he induced swallowing sounds, and repeated this in the left nostril. Dai Ren said, "It can be cured." After a long time, no phlegm came out, so he placed 1 qian of Pishi (Arsenic Trioxide) into the nose again. Suddenly, the patient lay supine, appearing to feel pain, and shortly after vomited, expelling several sheng of gelatinous phlegm, quite fishy in smell. Pishi should not be used ordinarily, but because the disease was severe, such strong measures were necessary to move the root. However, without Gudi, one should not use it directly; discretion is required. (*Shi Xing San Liao*)
Li Shicai treated Qin Jingming, who had chronic phlegm-fluid retention, attacking 4-5 times a year. Attacks involved vomiting and inability to eat. This disease had formed "nest-like sacs" over time, which could only be cured by vigorous vomiting. First, he administered Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). After ten days, he frequently administered Gudi San (Melon Seed Powder). The patient vomited several sheng of substance resembling red bean paste, followed by about one sheng of crystal-clear fluid. This cycle of tonifying seven times and vomiting seven times continued. After one hundred days, the nest-like sacs were exhausted. He then exclusively took Liujunzi Bawei Wan (Six Gentlemen Eight Ingredients Pill) without interruption for a year. (*Yitong*)
For treating excessive phlegm in the chest, headache, anorexia, and phlegm obstruction after drinking alcohol: Fan Shi (Alum), 1 liang. Water, 2 sheng. Boil to obtain 1 sheng. Add Mi (Honey), half he. Take in one dose. If vomiting does not occur shortly after, drink a small amount of hot water. (*Zhouhou Beiji Fang*) For treating phlegm-induced dizziness: Calcined Mingfan (Alum), ground to powder, taken with Ginger Soup. Vomiting leads to cure. (*Zhongmiao Fang*) (Note: In *Cheng Xinghai Yi An*, a merchant suffered from phlegm strike, unconscious but with a non-interrupted pulse. This formula was used. It is said: Alum is salty; salt softens hardness, thus it can dissolve stubborn phlegm.)
**Tutan Dan (Expectorate Phlegm Pellet)**
Excellent for expelling stubborn phlegm, reviving the dying. Use after the jaw opens.
Sheng Xionghuang (Realgar, 1 qian) Sheng Danfan (Blue Vitriol, 1 qian) Sheng Huashi (Talcum, 1 qian).
Grind to fine powder. Adults: 5 fen; Children: 3 fen. Take with warm water. Stubborn phlegm will be vomited within one shichen (2 hours). (*Weizheng Jianbian*)
For sudden Phlegm-Jue with loss of consciousness: Pour 1 zhan (measure) of raw Sesame Oil into the throat. Shortly after, wind-phlegm will be expelled, and consciousness will return immediately. (*Danliao Fang*)
Yu Hengde treated a woman who developed a phlegm disease from eating too many green plums. During the day, her chest and diaphragm hurt like knife thrusts. At night, the chest pain stopped, but her knees/knees area hurt severely. This is because phlegm-fluid moves up and down with Qi. She took Dingxiang (Clove), Chenxiang (Agarwood), Shengjiang (Ginger), Rougui (Cinnamon Bark), Wutou (Aconite), Fuzi (Prepared Aconite), etc., all ineffective. Then, Radish juice (Laifuzi) was given, half a bowl. She vomited half a sheng of phlegm. At night, the pain worsened significantly, leading to Jue (collapse). This was due to stimulating the rampant pathogenic factor. The next day, Shenlu (Ginseng Stalk) 1 liang was decocted in reverse-flowing water and taken, but no vomiting occurred. The day after, Kushen (Sophora Root) decoction was taken, still no vomiting. Then Fuzijian (Tip of Aconite) and Jiegenglu (Platycodon Stalk) were given, still no vomiting. Finally, early one morning, Lili (Veratrum) powder 1 qian and a little Shexiang (Musk) were taken mixed with sour water. Only then did she vomit a large amount of thick phlegm, about one sheng. The pain disappeared. She recovered after regulating the Spleen and Stomach. (*Yitong*) (Note: This is an excerpt from *Zhengchuan*.)
Previously, Liu Zizheng's wife suffered from Qi-Jue, laughing and crying irregularly. People thought she was possessed by ghosts. Later, the Confucian physician Ni Weide examined her left and right pulses and said: "Both pulses are deep. There must be accumulation in the stomach region. Accumulation causes pain." He then used Erchen Tang (Two Aged Things Decoction) to guide the expulsion. She vomited about one sheng of phlegm, and the illness was cured. (*Xu Yishuo*)
Now, twelve contraindications for vomiting are established:
Dizziness and fainting: Do not vomit.
High and shallow breathing: Do not vomit.
Accumulated fatigue not yet rested: Do not vomit.
New deficiency after illness: Do not vomit.
Weak and thready pulse: Do not vomit.
Dangerous and urgent disease state: Do not vomit.
Yang deficiency with profuse sweating: Do not vomit.
History of habitual blood loss: Do not vomit.
During stormy or dark weather: Do not vomit.
In winter when Qi is stored: Do not vomit.
Indecisive and suspicious constitution: Do not vomit.
Violating taboos after vomiting: Do not vomit. (*Falü*)
**Purgative Formulas**
(Cases of chills and fever resembling malaria, worsening heat in the evening, inability to eat rice.)
For phlegm above the diaphragm, Chuanxiong Wan.
Chuanxiong (Szechwan Lovage Root, 2 liang, finely cut and slow-roasted) Dahuang (Rhubarb, 2 liang, steamed until very soft).
Dry the above ingredients and grind to powder. Use uncavitated Soap Pod (Zaojiao), 5-7 pods. Rub in warm water until clean, filter through silk cloth to remove dregs. Boil in a clay vessel to form a paste. Mix with the two powders to make pills, size of mung beans. Take 15 pills per dose with Ginger Soup. Children: 3 pills. (*Benshi Xuji*) (*Yangshi* Xionghuang Wan has no soap pod, see *Constipation* section.)
**Zhitan Fuling Wan (Phlegm-Resolving Poria Pill)**
Originally for arm pain, detailed in *Zhimi Fang*. Used for phlegm, it is always effective.
Fuling (Poria, 1 liang) Zhike (Bitter Orange, bran-fried, rind removed, 0.5 liang) Banxia (Pinellia, 2 liang) Fenghua Puxiao (Weathered Mirabilite, 1 fen).
Grind to fine powder. Use natural Ginger Juice to cook into a paste for pills, size of paulownia seeds. Take 30 pills per dose with Ginger Soup. (*Shizhai*)
**Kongxian Dan (Draining Phlegm Pellet)**
When a person suddenly suffers from unbearable hidden pain in the chest, back, hands, feet, neck, waist, and hips, radiating to the bones and muscles, causing pulling pain, restlessness, and wandering pain that changes location. Unskilled doctors call this "Wangzhu" (Wandering Injection) and use wind-dispelling medicines or acupuncture, which are useless. They may suspect wind-toxin accumulation forming carbuncles and apply wrong medicated plasters. This is actually phlegm-fluid hiding above and below the heart and diaphragm, causing these diseases. It may cause severe headache preventing lifting the head, mental confusion and drowsiness, loss of taste, sticky phlegm/saliva, sawing sounds in the throat at night, excessive salivation during sleep, heavy/cold/bi-sensation in limbs, blocked qi and vessels, mistakenly diagnosed as paralysis. For such diseases, this medicine usually cures it in a few doses.
Gansui (Euphorbia, heart removed) Zijda Ji (Purple Big Euphorbia, skin removed) Baijiezi (White Mustard Seed, authentic, equal parts).
Grind to powder. Cook paste for pills, size of paulownia seeds. Dry in sun. Take 5-10 pills after meals and before bed with light Ginger Soup or warm water. If the disease is fierce and Qi is excess, increasing the number of pills is acceptable. The effect is miraculous. (*Sanyin Fang*) (Note: This formula originally comes from *Shengji Zonglu · Wind Wangzhu Pain* section, named Tentong Wan, consult there.)
**Sanhua Shen Wan (Three Flowers Divine Pill)**
For diseases generated from phlegm-fluid transformation, wind-heat stagnation and dryness, limb numbness, wandering pain, phlegm-cough, qi-blood congestion, lack of free flow. Suitable for robust individuals with strong Qi. Main formula for such cases. (*Yifang Kao*) (See *Water Qi* section for formula.)
Poem summarizing **Gun Tan Wan (Rolling Phlegm Pill)**:
"Turning over in the steamer, armor hangs gold" (Medicine is non-toxic, promotes phlegm and smooths Qi, sweeps cold and heat in abdomen, moves without staying. Pregnant women should not take alone.)
"Now wearing a thatched hat deep in the hall" (Medicine is slightly cold, promotes phlegm and clears Lung, removes heat and calms fetus miraculously, Yangming meridian guiding drug.)
"Meeting two eight seeks correct weight," "Nitrate and Qingmengshi double Ruochen/Sink," "Half liang among seventeen taels," "Water pills paulownia seed size, always measured."
"Thousand strange symptoms like divine effect," "Diarrhea and double body cannot bear."
Generally, take medicine before bed. Swallow one mouthful of warm water, lie supine immediately, letting the medicine descend slowly from the throat and diaphragm. (*Yangsheng Zhulun*)
**Gun Tan Wan (Rolling Phlegm Pill)**
Dahuang (Rhubarb, wine-steamed) Huangqin (Scutellaria, cleaned, each 8 liang) Qingmengshi (Green Migong Stone, nitrate-fired 1 liang. *Yilin Jiyao*: Qingmengshi 1.5 liang, Yanxiao 2.5 liang, fired in clay pot until golden, cleaned and ground 1 liang. *Rumen*: Mengshi and Yanxiao each 1 liang, put in clay jar, covered, bound with iron wire, sealed with salt mud, dried, fired red, cooled, taken out, ground with previous medicines.) Chenxiang (Aquilaria, 5 qian).
Take 50-60 pills per dose, adjust according to deficiency/excess. Take with tea liquor or warm water, after food and before bed. (*Xiuzhen Fang*) *Zhengchuan* says regarding old phlegm formed from damp-heat and food accumulation: Gun Tan Wan should only be used for those with robust physique and solid, sticky phlegm accumulation. It must not be lightly used for those with weak Qi and body. *Zhunsuo* adds Baiyaojian (with Mengshi and Chenxiang each 5 qian), saying: With Baiyaojian, this pill can gather stubborn phlegm from the whole body to one place, then purge it downwards, having miraculous effects. "Double Ruochen/Sink" refers to Wubeizi (Chinese Gallnut) and Chenxiang, not Mengshi being double Chenxiang.
An elderly man, 70 years old, fell ill due to depression, causing Qi stagnation and phlegm condensation, with a mass in the hypochondrium, experiencing chills and fever. Doctors and patient did not know the cause, treating it as malaria and deficiency. Took 60-70 doses over 10 months, ineffective. Asked me for a malaria prescription, also ineffective. I examined his pulse and symptoms, saying: This is depressed fire and depressed phlegm, stagnating in the chest and diaphragm, forming a lump, causing chills and fever, resembling malaria but not malaria. Prescribed Qi-opening, heat-clearing, phlegm-resolving, and Qi-moving herbs. After a few doses, sudden severe pain in hypochondrium and abdomen. His son sought emergency help. I knew the phlegm-heat stagnation was long-standing, and the opening herbs stimulated the root cause, causing pain. Asking about constipation, I knew he needed severe purgation to relieve pain. Gave Qianniandahuang Wan (Nerium and Rhubarb Pill) 5 qian, taken in two doses with warm water. No bowel movement. Gave 4 qian, still no movement. Then gave Honey-cooked Gun Tan Wan 1 liang, taken in three doses. Severe diarrhea several times, abdominal pain stopped immediately, stagnation cleared, lump disappeared, chronic illness cured instantly. This is disease manifestation due to medicine, severe pain necessitating drastic action, curing stubborn disease in a day, a miracle. Also, Qiannian and Gun Tan pills usually cause immediate purgation at 2 qian+. This old man took 2 liang before severe purgation, another miracle. However, this old man faced two deaths: 1) When phlegm-heat condensed in chest/hypochondrium, without correct medicine, he would die of closure within a year. 2) When severe abdominal pain occurred, without drastic purgatives, he would die of pain within three days. Surviving these two deaths, he was very fortunate. (*Qixiao Yishu*)
Pediatrician Chen Rixin was emaciated, suffering from daily fever, worse at dusk. Doctors treated as Yin deficiency or Consumption. After half a year, condition worsened. Rixin told his father: "I want Rhubarb to unblock the large intestine for relief, even if I die, I have no regrets." Father agreed. Decocted Daotan Tang with Xiaobai and Dahuang. From Chen hour to Shen hour, passed one hard stool, walnut-sized. Opened it, it was flour pastry eaten during Lantern Festival, wrapped in phlegm, unable to digest, causing heat and wasting. If Rixin hadn't known medicine, he would have died. Who says Liu and Zhang's methods are useless? (*Lei'an*)
Advisor Jiang Gong (Name Xing, from Baling) suffered from strange phlegm syndrome. Attacks prevented eating/drinking. Severe episodes lasted 40-50 days, mild 20-30 days. Six pulses mostly deep and slippery. Previously used phlegm-resolving and diaphragm-unblocking drugs, but ineffective. Spring of Wuwu year, I passed Yueyang, met him during an attack. Chest/diaphragm distension, intermittent water sounds. Used Erchen Tang minus Gancao, added Nanxing, Zhishi, Huangqin, Luobozi, Xiangfu, plus Binglang, Houpo, Baijiezi, Cangzhu. Still ineffective, no intake. On the 12th day, scrotum and feet swelled, spreading to waist. Constipation. Pulse had intermittent stops (not contraindicated). Needed a drug to open blockage. Realized this was pasty/stubborn phlegm, slow drugs won't work. Ancient saying: Fast drugs attack disease, disease takes the hit, how will true Qi be harmed? Used Gansui (direct water-draining drug) as sovereign, assisted by Muxiang and Shexiang to open orifices and smooth Qi. Patient couldn't take powder. Mixed approx 5 fen of the three, soaked in wine, taken slowly. Felt rumbling in chest/diaphragm. Next day increased to 8 fen. Passed one bowl of pellet-like stool and several bowls of water, diaphragm cleared. People said for extreme deficiency, add 5 fen Renshen to Spleen-tonifying/Blood-nourishing drugs. Taken 5-6 doses, felt more distension, constipation returned. I said: When phlegm starts moving, tonification is inappropriate, nor is Spleen/Blood nourishment suitable (Spleen drugs are cloying, Blood drugs are damp). Focus on opening Stomach Qi. Wait for appetite, then consider tonification. First used Pig Bile with vinegar to induce bowel movement. Then Chenpi, Banxia, Fuling, Xiangfu, Sharen, Baixiandou, Muxiang to open Stomach. Added Dingxiang, Ganjiang. Diet gradually improved. Later used Renshen, Fuzi, Rougui, Fuling, Sharen, Niuxi, Chenpi, Zexie, Cheqianzi. Renshen started at 1 qian, later 1.5 qian. Took 20-30 doses. Cold feet and scrotal swelling resolved, cured. (*Cheng Xinghai Yi An*)
**Shenxian Zhuitan Wan (Divine Drop-Phlegm Pill)**
Treats phlegm obstruction, chest fullness, Qi rushing. This drug drops phlegm. (*Shi Fujian Yan*)
Heiqianniu (Black Morning Glory Seed, 1 jin, take top 4 liang of powder) Zaojiao (Soap Pod, worm-free, skin/string removed, fried yellow, seeds removed, net 1.6 qian) Sheng Baifan (White Alum, 1.2 qian).
Grind to fine powder. Make pills with clear water, size of paulownia seeds. Take 30-50 pills, gradually increase to 100 pills. Take on empty stomach with warm wine. Frequency depends on severity: every 5-10 days for severe, every half month/month for mild. Long-term use prevents paralysis. (*Ruizhutang Fang*) (Note: Based on Wangshi *Boji* Lige Wan, which lacks Alum, see Materia Medica.) Danxi Zhuitan Wan adds Zhishi, Paxiao, Zhike to this formula, made with Radish Juice pills.
**Taohua San (Peach Blossom Powder)**
For phlegm-fluid and old water. Collect peach blossoms, shade-dry, grind to powder. Take 1 he with warm wine to induce purgation. If feeling weak, eat thin porridge. Not like harsh purgatives. (*Bencao Gangmu*) (Note: Originally from Cuishi, see *Hongzhang* section.)
**Wuba Wan (Black Plum and Croton Pill)**
Treats harmful stubborn phlegm in chest/diaphragm accumulated over years, forming phlegm-Qi. Face appears blue-white intermittently, edema, complete anorexia, body pain, nighttime oppression, insomnia, alternating chills/fever, hand/foot pain, inability to turn. Uses Nanxing, Banxia, Black [Missing Char], Lingsha. Countless doses. Dropping it won't pass, taking it won't exit. This is the "Mother of Phlegm," hard and stagnant. Take this medicine. Soon, stubborn phlegm like fish jelly will pass. If not, take again. Definitively clears lifelong disease.
Da Wumei (Large Black Plum, flesh 3 liang) Badou (Croton Seed, 5 kernels, shell/membrane removed).
Use 2 bowls of water. Boil Wumei slowly in clay/pot until soft. When water reduces slightly, add Badou. Stir with bamboo stick until dry paste. Stop fire. Cool, grind, make pills size of mung beans. Take 7, 9, 15, or 21 pills at any time with Ginger Soup. (*Qixiao Liangfang*)
**Settling and Dropping Formulas**
**Yangzheng Dan (Nourish Righteousness Pellet)**
Treats Kidney deficiency, Qi failing to return to origin, phlegm-fluid rising. Also treats Cold-Phlegm. Take 20 pills with Jiangqi Tang (Descend Qi Decoction). (*Zhizhi Fang*)
**Lingsha (Spirit Sand/Cinnabar)**
Treats excess above, deficiency below, phlegm-fluid obstruction. This drug best settles and drops, regulates Yin/Yang, harmonizes Five Zang, supports Yuan Qi. (Indications from *Dacheng*)
Shuiyin (Mercury, 1 jin) Huang (Sulfur, 4 liang).
Stir-fry the two in a new iron pan until granular. If smoke/flames appear, sprinkle vinegar. Grind fine. Put in water-fire tripod. Seal with vinegar-mixed Chishizhi (Red Stone Earth), bind with iron wire, dry, seal with salt mud. Burn with 20 jin charcoal. If tripod cracks, brush with Chishizhi. Burn until charcoal is gone. Remove overnight, grind fine. Make pills with glutinous rice paste, size of hemp seeds. Take 3 pills on empty stomach with Jujube Soup, Rice Drink, Well Water, or Renshen Soup. Increase to 5-7 pills based on severity. (*Heji Jufang*)
**Moxibustion Method**
Phlegm-fluid syndromes vary, but Phthisis with phlegm is hardest to treat. Best to moxa Gaohuang (BL43). After many moxa cones, discharge should occur, flowing like water, which is phlegm exiting. Rest should be treated according to symptoms. (*Zisheng Jing*)
**Dietary Taboos**
Pepper, Dried Ginger, Spicy, Roasted/Fried, Hot-natured foods stimulate phlegm and aid obstruction. Hot noodles from the pot strongly trigger Wind-Phlegm. Must rinse with water away from heat, reheat juice, then eat safely. Taro, Yam, Fishy smells, Greasy, Slippery foods provoke phlegm, bad for intestines/stomach. Cooked chicken/duck eggs, cooked chestnuts, and other rich/fatty foods obstruct diaphragm, close Qi, generate phlegm. Those with chronic phlegm should eat cool fruits/vegetables; eating too much when full is okay. Acute Wind-Cold phlegm patients should avoid all these. (*Yangsheng Zhulun*)