凡痰火之证，始于阴虚，于法当补。但证有虚实，法有宜忌，倘不以脉症互参，孟浪投
剂，则触处成滞，宁无颠覆之患乎！盖以脉之可补者，浮而芤濡虚大，迟缓无力，沉而迟涩
弱细，结代无力，皆虚而不足，可补者也。当君参、 ，佐以归、芎、芍、地，务使阳生阴
长，其病乃愈。若于此不补，或恣用苦寒，则虚虚之祸，岂不旋踵而至耶？其脉之不可补者
，弦长紧实，滑数有力，此皆火郁内实，不受补者也。法当君以四物，佐以二冬、二母、沙
参、玄参等味，滋阴抑阳，务使水升火降，阴秘阳平，病或可痊。若妄施补，则实实之灾，
将焉免之。夫脉既已辨，又当以证互验，如洁古所谓喘嗽不可补者，以痰实气壅也。若气短
不相接，证似喘促者，盖肾虚气短，当补者也。仲景所谓肺寒而嗽，不宜用补者，以寒束热
邪，壅郁在肺也。若自汗恶寒而咳者，表里俱虚，可补者也。东垣所谓久病脉实，郁热在肺
，宜微发不宜用补。若肺虚火旺，短气自汗者，阴虚气衰，可补者也。节斋所谓阴虚火动，
不可补者，以阴虚火亢能食，脉弦而数，凉之则伤脾，温之则伤肺，此不受补者。若自汗短
气，肢冷脉虚者，必补者也。若其人面赤面黑，气壮神强，不可行补。若面白面黄，面青黧
悴者，皆脾肺肾不足，宜补者也。若此细辨，则犹苍素并陈，而复误者，真盲瞽者矣。凡治
痰火之法，当以脉验证，脉证既明，虚实立辨，夫所谓虚者，真阴虚也，法当补之。所谓实
者，火邪实也，法当清之。然清补之品，亦犹朱紫相凌，卒未易辨。何也？如知母、玄参、
故纸，皆补肾之气也。黄柏、枸杞、熟地、阿胶、山茱萸、五味、琐阳、苁蓉，皆补肾之血
也。人参、山茱，补肾之母也。二冬、阿胶、贝母、百合、蛤蚧、天花粉，皆润肺之燥也。
石膏、知母、诃子、粳米，泻肺之火也。桑皮、地骨皮，皆泻肺之子也。五味、白芍、倍子
，皆敛肺气之散也。黄柏、知母、丹皮、地骨皮、生地、玄参、茯苓，皆泻命门相火也。芡
实、五味、山茱萸、牡蛎、金樱子、远志，皆固精药也。参、 、橘、草、扁豆，皆补脾之
气也。芍、术、大枣，补脾之血也。茯苓、茯神、远志、菖蒲，皆补心之气也。当归、熟地
，皆补心之血也。乌梅、酸枣、生姜，皆补心之母也。甘草、人参、赤苓、木通、黄柏皆
泻心经血分热也。丹参、丹皮、生地、玄参，皆泻心经血分火也。栀子、生地，皆凉心血之
品也。黄芩、竹叶、麦冬，皆清心经之客热也。当归、牛膝、白芍、芎 ，皆补肝之血也。
柏子、白术、决明，皆补肝之气也。枸杞、熟地、阿胶、杜仲、菟丝子，皆补肝之母也。丹
皮、红花，皆行肝之血也。青皮、香附，皆疏肝之逆也。芍药、乌梅，皆泻木气之实也。胆
草、黄连，皆泻肝之火也。五脏消补之品，宁越此乎，学人谙此，则左右逢源，虽不中不远
凡痰火之证，始于阴虚，法当滋补。葛氏昔擅专门，所遗诸方，未有不主参、 者。厥
因二王不经之论，致令医掣肘，遂视人参为蛇蝎，惟以苦寒为要药，种种杀人，犹不知悟。
岂不闻丹溪有曰∶虚火可补，须用参、 。又曰∶阴虚潮热喘嗽，吐血盗汗等证，四物加人
参、黄 、知母。是治阴虚痨瘵之证，未尝不用人参也。况阴虚之极，不用人参补阳，何以
生阴？若不服参、 得愈者，必真阴尚未甚亏，脾胃尚未衰败，脉必浮大而缓，故用补血降
火之药，或有可愈者，但亦稀少耳。予自总髻，医至于今，服参、 而愈者，十常五七。而
不服参、 得愈者，十无二三。盖阴藉阳生之理，历历可征。如产后孤阳绝阴之证，喘息目
瞪，心慌胆战，命在逡巡，此阴虚之极，于法急当补阴，而古人不用四物，而用人参、苏木
二味，亦名参苏饮，一服而验，效捷桴鼓，生平于此挽回者，奚啻百余人，古人之制，何其
神哉！噫，阴藉阳生之法，当的从之，但不明脉理者，未足语此。
For all syndromes of Phlegm-Fire (Tan Huo), the origin lies in Yin Deficiency (Yin Xu), and according to therapeutic principles, tonification is indicated. However, syndromes vary between deficiency (Xu) and excess (Shi), and treatments have their appropriateness and contraindications. If one does not cross-reference pulse and symptoms, and rashly administers medication, stagnation will occur everywhere, leading to the danger of collapse! Generally speaking, pulses that are suitable for tonification include those that are floating with Kong (Hollow), Ru (Soggy), Xu (Deficient), or Da (Large) qualities, slow and weak; or deep with Chi (Slow), Se (Choppy), Ruo (Weak), or Xi (Fine) qualities, as well as Jie (Intermittent) and Dai (Tied Pulse) without strength. These all indicate deficiency and insufficiency, and are suitable for tonification. In such cases, Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix) should be used as sovereign drugs, assisted by Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), and Shu Di Huang (Rehmanniae Radix Praeparata). The goal is to ensure Yang generates and Yin grows, so that the disease may heal. If tonification is neglected here, or if bitter-cold herbs are indiscriminately used, the disaster of "making deficiency more deficient" will surely follow immediately!
Conversely, pulses that are not suitable for tonification include those that are Xian (Wiry), Chang (Long), Jin (Tight), or Shi (Full), or Hua (Slippery) and Shu (Rapid) with strength. These all indicate Fire (Huo) depression and internal excess, which cannot accept tonification. The treatment method should use Si Wu Tang (Four Substances Decoction) as the sovereign formula, assisted by Dong Tian (Asparagi Radix), Dong Mai (Ophiopogonis Radix), Zhi Mu (Anemarrhenae Rhizoma), Mu Fen (Fritillariae Thunbergii Bulbus), Sha Shen (Glehniae Radix), and Xuan Shen (Scrophulariae Radix), to nourish Yin and suppress Yang. The aim is to make Water ascend and Fire descend, keeping Yin secure and Yang balanced, so the disease might recover. If tonification is wrongly applied, how can the disaster of "making excess more excessive" be avoided?
Once the pulse has been differentiated, it must be verified against symptoms. For instance, Jie Gu (Zhang Yuansu) stated that wheezing and coughing should not be tonified because of phlegm excess and Qi obstruction. However, if there is shortness of breath where inhalation and exhalation do not connect, resembling wheezing, this is actually Kidney Qi deficiency causing shortness of breath, which requires tonification. Zhong Jing (Zhang Zhongjing) stated that lung cold with coughing is not suitable for tonification because cold binds and heat pathogens obstruct the Lung. However, if there is spontaneous sweating, aversion to cold, and coughing, this indicates exterior and interior deficiency, which is suitable for tonification. Dong Yuan (Li Dongyuan) stated that chronic illness with a full pulse and depressed heat in the Lung favors slight diaphoresis rather than tonification. However, if there is Lung deficiency with Fire hyperactivity, shortness of breath, and spontaneous sweating, this is Yin deficiency with Qi decline, which is suitable for tonification. Jie Zhai (Dai Yuanli) stated that Yin deficiency with Fire movement is not suitable for tonification because Yin deficiency leads to Fire hyperactivity with good appetite, and the pulse is Wiry and Rapid; cooling herbs damage the Spleen, and warming herbs damage the Lung, making it unsuitable for tonification. However, if there is spontaneous sweating, shortness of breath, cold limbs, and a deficient pulse, it must be tonified.
If a person has a red or black complexion, robust Qi, and strong spirit, tonification should not be performed. If the complexion is pale or yellow, or greenish-dark and haggard, these indicate deficiencies of the Spleen, Lung, and Kidney, and require tonification. If one distinguishes these carefully, it is like distinguishing black from white; further errors would truly be blindness.
The general method for treating Phlegm-Fire is to verify symptoms by pulse. Once pulse and symptoms are clear, deficiency and excess can be distinguished immediately. What is called "deficiency" refers to true Yin deficiency, requiring tonification. What is called "excess" refers to Fire pathogen excess, requiring clearing. However, clearing and tonifying agents can be confusing, like mixing vermilion and purple. Why? For example, Zhi Mu (Anemarrhenae Rhizoma), Xuan Shen (Scrophulariae Radix), and Guo Zhi (Bursae Vaccariae Semen) all tonify Kidney Qi. Huang Bo (Phellodendri Cortex), Gou Qi Zi (Lycii Fructus), Shu Di Huang (Rehmanniae Radix Praeparata), E Jiao (Colla Corii Asini), Shan Zhu Yu (Corni Fructus), Wu Wei Zi (Schisandrae Chinensis Fructus), Suo Yang (Cynomorii Herba), and Cong Rong (Cistanches Herba) all tonify Kidney Blood. Ren Shen (Ginseng Radix et Rhizoma) and Shan Zhu Yu (Corni Fructus) tonify the "Mother" of the Kidney. Dong Tian (Asparagi Radix), Dong Mai (Ophiopogonis Radix), E Jiao (Colla Corii Asini), Bei Mu (Fritillariae Bulbus), Bai He (Lilii Bulbus), Ge Jie (Geckos), and Tian Hua Fen (Trichosanthis Radix) all moisten Lung dryness. Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma), He Zi (Terminalia Chebulae Fructus), and Jing Mi (Oryzae Sativa Semen) drain Lung Fire. Sang Bai Pi (Mori Cortex) and Di Gu Pi (Lycii Cortex) drain the "Child" of the Lung. Wu Wei Zi (Schisandrae Chinensis Fructus), Bai Shao (Paeoniae Radix Alba), and Bei Zi (Galae Chinensis) astringe dispersing Lung Qi. Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), Dan Pi (Moutan Cortex), Di Gu Pi (Lycii Cortex), Sheng Di Huang (Rehmanniae Radix), Xuan Shen (Scrophulariae Radix), and Fu Ling (Poria) drain Ministerial Fire (Xiang Huo) of the Gate of Vitality. Qian Shi (Euryales Semen), Wu Wei Zi (Schisandrae Chinensis Fructus), Shan Zhu Yu (Corni Fructus), Mu Li (Ostreae Concha), Jin Ying Zi (Chrysanthemi Indici Fructus), and Yuan Zhi (Polygalae Radix) consolidate Essence. Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix), Ju Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Bian Dou (Viciae Semen) tonify Spleen Qi. Bai Shao (Paeoniae Radix Alba), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Da Zao (Jujubae Fructus) tonify Spleen Blood. Fu Ling (Poria), Fu Shen (Poria cum Radice), Yuan Zhi (Polygalae Radix), and Chang Pu (Acori Tatarinowii Rhizoma) tonify Heart Qi. Dang Gui (Angelicae Sinensis Radix) and Shu Di Huang (Rehmanniae Radix Praeparata) tonify Heart Blood. Wu Mei (Mume Fructus), Suan Zao Ren (Ziziphi Spinosae Semen), and Sheng Jiang (Zingiberis Rhizoma Recens) tonify the "Mother" of the Heart. Gan Cao (Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Chi Ling (Poria cum Rubro), Mu Tong (Akebiae Caulis), and Huang Bo (Phellodendri Cortex) drain Heat in the Blood aspect of the Heart Meridian. Dan Shen (Salviae Miltiorrhizae Radix), Dan Pi (Moutan Cortex), Sheng Di Huang (Rehmanniae Radix), and Xuan Shen (Scrophulariae Radix) drain Fire in the Blood aspect of the Heart Meridian. Zhi Zi (Gardeniae Fructus) and Sheng Di Huang (Rehmanniae Radix) cool Heart Blood. Huang Qin (Scutellariae Radix), Zhu Ye (Bambusae Folium), and Mai Dong (Ophiopogonis Radix) clear Guest Heat of the Heart Meridian. Dang Gui (Angelicae Sinensis Radix), Niu Xi (Achyranthis Bidentatae Radix), Bai Shao (Paeoniae Radix Alba), and Chuan Xiong (Ligustici Chuanxiong Rhizoma) tonify Liver Blood. Bai Zi Ren (Platycladi Semen), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Jue Ming Zi (Cassiae Semen) tonify Liver Qi. Gou Qi Zi (Lycii Fructus), Shu Di Huang (Rehmanniae Radix Praeparata), E Jiao (Colla Corii Asini), Du Zhong (Eucommiae Cortex), and Tu Si Zi (Cuscutae Semen) tonify the "Mother" of the Liver. Dan Pi (Moutan Cortex) and Hong Hua (Carthami Flos) move Liver Blood. Qing Pi (Citri Reticulatae Pericarpium Viride) and Xiang Fu (Cyperi Rhizoma) soothe Liver Qi rebellion. Shao Yao (Paeoniae Radix) and Wu Mei (Mume Fructus) drain excess Wood Qi. Dan Cao (Gentianae Radix) and Huang Lian (Coptidis Rhizoma) drain Liver Fire. Are the tonifying and draining agents for the Five Viscera beyond this scope? If students master this, they will find resources on all sides; though not always hitting the mark exactly, they will not be far off.
All Phlegm-Fire syndromes originate from Yin deficiency, and the treatment method should be nourishing and tonifying. Ge Shi (Ge Kejiu) was previously an expert in this field, and his remaining formulas all primarily featured Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix). This was due to the unorthodox theories of the Two Wangs, which caused physicians to hesitate, viewing Ren Shen (Ginseng Radix et Rhizoma) as venomous, and relying solely on bitter-cold herbs as essential medicines, killing many without realizing it. Have they not heard Dan Xi (Zhu Zhenheng) say: "Deficient Fire can be tonified, using Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix)." And again: "For Yin deficiency tidal fever, wheezing, coughing, hematemesis, and night sweats, use Si Wu Tang (Four Substances Decoction) plus Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix), and Zhi Mu (Anemarrhenae Rhizoma)." This treats Yin deficiency consumption syndromes, never failing to use Ren Shen (Ginseng Radix et Rhizoma). Moreover, when Yin deficiency is extreme, without Ren Shen (Ginseng Radix et Rhizoma) to tonify Yang, how can Yin be generated? Those who recovered without taking Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix) must have had Yin deficiency that was not severe, and Spleen and Stomach function not yet collapsed, with a pulse that was Floating, Large, and Slow. Thus, using blood-nourishing and fire-descending herbs might occasionally lead to recovery, but such cases are rare. Since my childhood until now, among those treated with Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix), five or six out of ten recovered. Among those who did not take them, less than two or three out of ten recovered. This illustrates the principle that Yin relies on Yang for generation, which is evident and verifiable. For example, in postpartum syndromes of isolated Yang and severed Yin, characterized by panting, staring eyes, palpitations, and fear, with life hanging in the balance, this is extreme Yin deficiency. According to method, one should urgently tonify Yin. Yet ancients did not use Si Wu Tang (Four Substances Decoction), but used only Ren Shen (Ginseng Radix et Rhizoma) and Su Mu (Daemonorops Draco Resina), named Shen Su Yin (Ginseng and Dragon's Blood Decoction). One dose proved effective, with speed like striking a drum. In my lifetime, I have saved over a hundred people this way. How miraculous are the formulations of the ancients! Alas, the method of Yin relying on Yang for generation should be strictly followed, but those who do not understand pulse theory are not worthy of discussing this.