Library

Restlessness in lying down and sitting up, and unstable sleep, is termed "Fan" (Vexation). The treatment principle should be to clear the Lung and eliminate phlegm; Zhichi Tang (Gardenia and Fermented Soybean Decoction) and Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) are suitable. (These two formulas are detailed in the Shanghan Section.) Restlessness ("Zao") refers to a state of mania, delirium, and trance; Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) is suitable. (See *Ju Fang* [Formulas of the Bureau]).

Dizziness and blurred vision of the head and eyes, weakness and lack of strength in the four limbs, emaciation, failure to gain muscle mass, occurring in youths with deficiency of both Qi and Blood, or due to excessive sexual indulgence causing tinnitus, are suitable for Buyin Buxin Dan (Yin-Nourishing Heart-Nourishing Pill). For the elderly with deficiency and damage to Qi and Blood, Gu'an Xinshe Dan (Gu'an Heart-Kidney Pill) and Huan Shao Dan (Return to Youth Pill) are suitable.
All the aforementioned formulas are recorded within *Gu Fang Kuo*.
The supplementary information on these symptoms largely covers conditions inevitably present in Phlegm-Fire disorders. Selecting several items from them, one should also, based on the observed symptoms, add one or two herbs according to the meridian theory to the main governing formula, to treat the branch manifestations. Any omissions herein are left for future scholars to supplement.

First, if Phlegm-Fire causes hemoptysis filling a basin with excessive blood loss, anorexia, and gradual wasting of muscles, this indicates that Heart Qi has been exhausted; it is a fatal condition and untreatable.
Second, if Phlegm-Fire causes pain in the left hypochondrium such that turning the body is impossible, this indicates that the liver lobes have dried up, known as Ganxue Tong (Dry Blood Pain); the Liver Meridian Qi has been exhausted; it is a fatal condition and untreatable. If pain in the right hypochondrium persists despite taking Lung-clearing and phlegm-resolving medicines, and the patient cannot lie down at night, this is a sign of impending Lung Qi exhaustion; it is untreatable.
Third, if Phlegm-Fire causes sore throat due to Gallbladder Fire flaming upward, and throat treatments prove ineffective until sores form and skin breaks, this indicates insect toxins attacking the pharynx; this is an incurable case of Zhai Ji (Consumption Disease/Tuberculosis); it is fatal.
Fourth, if Phlegm-Fire causes hoarseness, this indicates that Lung Meridian Qi has been exhausted; it is a fatal condition and untreatable.
Fifth, if Phlegm-Fire results in fleshless buttock tips, this indicates that Spleen Meridian Qi has been exhausted; it is a fatal condition and untreatable.
Sixth, if Phlegm-Fire causes coughing, counterflow qi, and vomiting of food, this indicates blazing Stomach Fire damaging Spleen Qi; it often leads to untreatability.
Seventh, if Phlegm-Fire causes diarrhea with undigested food, this indicates that Stomach Qi has been exhausted; it is a fatal condition and untreatable.

Commentary: The pulse of Phlegm-Fire disease, if floating and Kou (Hollow), Ru (Soggy), Xu (Deficient), Huan (Lax), Chi (Slow), large and powerless, or deep, slow, choppy, intermittent, and powerless, all indicate deficiency and insufficiency. If external signs include shortness of breath and panting, or cold extremities, these belong to deficiency of the Spleen, Lung, and Kidney organs; the pulse matches the syndrome, indicating the patient can tolerate tonification. If the pulse comes string-like, long, tight, and solid, with external signs of phlegm excess, qi stagnation, panting and coughing, or vexation, fever, sore throat, or recurrence of various bleeding syndromes, this indicates Yin deficiency with Fire hyperactivity; the pulse does not match the syndrome, indicating the patient cannot tolerate tonification. Furthermore, the *Mai Jing* states: Bone-steaming fever with a rapid but deficient pulse, or heat with choppy and small pulse, will surely result in death. It also states: Extreme fatigue and various deficiencies present with floating, soggy, weak pulses; Earth failure presents with double string-like pulses; Fire flaming upward presents with rapid and numerous pulses. It further states: In all diseases involving blood loss, the pulse must appear Kou (Hollow); slow and small is auspicious, rapid and large is ominous. It also states: In febrile diseases with Fire, Hong (Surging) and Shu (Rapid) pulses are treatable; Chen (Deep) and Wei (Micro) pulses without Fire, and Rootless pulses, are difficult to treat. These all discuss the appropriateness and contraindications of pulse-syndrome correspondence. All pulses relevant to Phlegm-Fire and Consumption Diseases are detailed below; those not pertinent to this syndrome are omitted.