口开眼合，人事昏沉。诊之，六脉洪滑而数，遂用加味导痰汤，继之苏合丸，两剂才觉精神清。问用何药？以
前方告。乃怒曰∶我生平最忌燥剂，岂可服此！今后断不可用。乃郎心知父之非，每日以地黄汤一剂与验
过，暗以导痰之药以进，病愈后洞悉前情，不胜歉仄。
孙文垣治李古愚，每食后即大便，腹皮稍胀急，胸膈饱闷，服参、术则痞闷愈甚，小水清长。脉之，左寸
涩，右寸滑，按之如黄豆大且鼓指，关尺皆弦小，左手迢迢有神。据脉乃积痰郁于肺而莫能出，以致大便之气
不固也。当效丹溪治乃叔用吐法，吐去上焦痰积，大便自实矣。先用苦梗、萝卜子各三钱，白豆仁、橘红、山
栀各一钱，以川芎五分，生姜三片，葱三根，水煎服之取吐。服半时许吐出清痰，恶心未已，乃痰积胶固，未
易出也。又用萝卜一合擂浆水，加蜂蜜，与半碗饮之，始吐胶痰二碗许。平日每小水则大便并行，吐后小水始
能单去。连三四次，胸腹觉舒。初亦以吐为惧，至是豁然称快。大便五日一行，再以二陈加白术、旋复花、麦
芽，调理全愈。
李士材治章给谏，暑月心中大痛。医与香薷饮，痛转增而寸口弦急，此痰食交结也。服砂仁、二陈二剂，
痛虽略减，而困苦烦闷。更以胃苓汤加半夏二钱、大黄三钱，下黑矢数枚，痛减三四。仍以前汤用大黄四钱，
下胶痰十余碗始安。
徐主政劳且怒后，神气昏倦，汗出如浴，语言错乱，危困之极，脉大而滑且软，此气虚有痰也。用补中益
气汤料，并四剂为一剂，用参至一两，加熟附子一钱，熟半夏三钱，四日稍苏。更以六君加姜汁一钟，服数日，
兼进八味丸，两月而安。
王郡侯患痰嗽，辄服清气化痰丸，渐至气促不能食。李曰∶高年脾土不足，故有是症。若服前丸，则脾土
益弱矣。投以六君子汤加煨姜三钱，益智仁一钱五分，十剂而痰清。更以前方炼蜜为丸，约服一斤，饮食乃进。
朱文学遍体如虫螫，口?糜烂，朝起必见二鬼，执盘食以献。向李泣曰∶某年未三十，高堂有垂白之亲，
二鬼旦暮相侵，必无生理。诊其寸脉乍大乍小，意其为鬼祟，细察两关弦滑且大，遂断以痰。投滚痰丸三
钱，虽微有所下，而病患如旧。更以小胃丹二钱与之，复下痰积及水十余碗，遍体之痛减半，至未明早鬼亦不
见矣。更以人参三钱，术二钱，煎汤服小胃丹三钱，大泻十余行，约二十碗许，病若失矣。乃以六君子为丸，
服四斤而愈。
张路玉治一燕人，体肥痰盛，善肉善饮，患痰鸣喘嗽数年，食伤恒发，发则六脉迟滑，时见歇止，声如拽
锯，遍地皆痰。每岁或一二发，或三五发，深秋初冬尤甚，遂用倒仓法，（此亦可用滚痰丸治之，倒仓法未可
轻试也。）自言肢体皆轻，症遂愈。二年后因不禁牛肉复发，然其势较前不过十一，是亦不慎口腹所致耳。
郭邑侯夫人，素有败痰失道，左右两胁俱有结块，大如覆杯，发则咳嗽喘逆，腹胁掣痛，六脉至促，按之
少力。用六君子汤加胆星、枳实、香附、沉香二剂，服之大吐稠痰结垢一二升。因呕势太甚、促往诊之。至则
呕吐已宁，脉息调匀，不必更药矣。
黄履素曰∶立斋治痰，每言肾虚水泛为痰，法当补肾。予壬申秋咳嗽多痰，自知因于色，遵先生法，恪服
六味丸，更不治，痰嗽月余竟愈。时师治痰，最忌用熟地，以为腻膈，是乌知个中妙理哉！
龚子才治周藩海甥阳生，患痰嗽喘热，左足肿痛，日轻夜重，每年发一二次，已三十年，遍治勿效。诊
之，左微数，右弦数，此血虚有湿痰也。以四物汤加苍术、黄柏、木瓜、槟榔、木通、泽泻，空心服，以治下
元；茯苓补心汤卧时服，以治上焦。各三服而愈。后以神仙飞步丸空心服，清气化痰丸临卧服，各一料全愈。
张三锡治一中年妇，每夜发热，天明方止，症兼恶心不食，肢倦，且云体素肥，今渐消瘦。因忆古人有言，
昔肥而今瘦者，痰也。痰滞中宫，阻碍升降，宜乎不食，且作恶心痞闷。血无所滋，因而不足，故夜热，乃以
二陈治痰，参补其中气，枳实、麦芽宽中，香附、炒栀子清火，柴胡退热，凡二十剂，间服橘半枳术丸，一月
愈。后进人参汤，体渐复旧。
一人素肥盛，半年渐瘦，两膝与背互痛，两尺沉滑。古人有言，昔肥今瘦者，痰也。遂以加减豁痰汤，连
进数服。一日食后偶作恶心，乃以瓜蒂散一钱投之，吐稠痰半升而愈。
朱丹溪治一人，项强痛不可忍，不可以回顾，作痰客太阳经之症治之，用二陈汤加酒芩、羌活、红花，服
后二日而愈。
张路玉治吴别驾夫人，患痞眩呕逆。向因下体畏寒，肢体麻木，久服八味、参、附不彻。六脉弦滑，按之
则濡，此中焦素蕴痰湿，阳气不能周于四末之象。得桂、附辛热之力，有时虽可暂开，究非真阳之虚，且有地
黄之滞，所以痞晕漫无止期。遂与《局方》七气加沉香，一服豁然，再剂神爽食进而安。
薛立斋治一儒者，脾肾素虚而有痰。或用导之之法，痰甚作渴，头晕烦热。谓中气虚弱而变症，用补中益
气汤而愈。后劳役发热，此气虚不能上升也，用前汤加蔓荆子而愈。后又劳神，畏见风，四肢逆冷，口淡痰多，
此脾气虚寒真病，以六君子加炮姜、肉桂而愈。
一男子素肾气虚而咳痰，亦用导痰之法，虚症悉具，痰涎上涌，小便频数。谓足三阴虚而复损也，朝用补
养脾气汤，培养脾肺之虚气，夕用六味丸加五味子，收敛耗散之精而愈。
大尹陈克明导痰后痰益多，大便不实，喜极热饮食，手足逆冷。谓命门火衰而脾肺虚寒，不能摄涎归源，
用六味丸而愈。
进士张禹功饮食停滞，胸满吐痰。或用药导之，痰涎上涌，眩晕热渴，大便秘结，喜冷冻饮料食，手足发
热。谓肾水虚弱，津液难降，败液为痰，用六味丸而愈。
儒者杨文魁，素唾痰，诸药不应。服牛黄清心丸、吐痰甚多，或头晕，或热从胁起。左脉洪大有力，
右脉浮大而无力，薛曰∶此三阴亏损，火不能归源。用补中益气加麦冬、五味，及加减八味丸，补其化源而愈。
（雄按∶三阴亏损，补中益气汤何得浪施？）
秋官张碧崖，面赤作渴，痰甚头晕。此肾虚水泛为痰，用地黄丸而愈。
仪制贺朝卿，吞酸胸满，痰盛作泻，饮食少思。用清气化痰等药，前症益甚，两膝渐肿，寒热往来。谓脾
胃虚，湿热下注，用补中益气倍参、术，加茯苓、半夏、炮姜而愈。
考功杨林庵，呕吐痰涎，胸腹胀痛，饮食少思，左关脉弦长，按之微弱。此木克土，用六君子加柴胡、山
栀、木香而愈。
二守陈子忠，饮食少思，吐痰口干，常服二陈、枳实、黄连之类，脾胃受伤，乃问于薛。薛述东垣先生云∶
脾胃之症，实则枳实、黄连泻之，虚则白术、陈皮补之。彼遂以二味等分为丸常服，由是多食而不伤，过时而不饥。
赵以德云∶予近治一男子，肩井后肿痛，身热且嗽，其肿按之不坚。此乃酒痰流结者，遂用南星、半夏、
栝蒌根、芩、连、竹沥作煎饮，烧葱根敷肿处，另用芥子、白矾作小丸，就煎药吞二十丸。服后痰随嗽出，半
日约去三四碗，病即愈。（同上。）
罗成之既得丹溪之学，归隐崇明。三沙张太尉士诚，患痰疾气怔忡，诸名医治疗不效。迎成之诊之，主以
倒仓法，张卒用其方，诸病悉除，赐劳甚浓。（《医史》。同上。）
陆养愚治孙景阳室，年近五旬，向患痰火，发则头空眩晕，饮食减少，旋发旋愈，盖有年矣。近发转甚，
将及月余。诊之，六脉洪滑而数，按之无力，肢冷面赤，肌肉黄瘦，不时眩晕，甚则昏不知人，水谷不进。其
似不可攻，然其脉来有神，当弃症凭脉。乃用枳实、栝蒌、胆星、贝母、芩、连、橘红、牙皂，入姜汁、竹沥
服之，吐痰数碗，四肢渐温。再用川牛黄五分，配以蜡丸，顿服三丸，徐徐频饮竹沥催之，腹响后服润字丸三
钱，便垢秽若干，病顿减。后以清火消痰、健脾养血，调理而安。
吴淑止室，躯体壮盛，自来有痰，初退场门时稀白澄清，唾地良久反极稠腻，过劳即眩晕昏冒，近则两三日
一发，始则叫号，既而昏愦，角弓反张，食顷乃苏，四肢厥冷，胸腹满硬，六脉如细而且涩。以为寒痰凝滞中
焦，用二陈导痰汤，半夏与四五钱，服后一夜不安，痰壅愈甚，口舌燥渴。因想脉症不同，此当弃脉从症，改
用贝母、芩、连、桔梗、花粉、前胡、胆星、栝蒌、竹沥、姜汁煎汤，吞润字丸五分，数服后，胸膈柔软，昏晕
已除。大便数日不行，用滚痰丸三钱不应，又以润字丸三四钱催之，始得更衣，症减半。两日后遂晡热，唇红
面赤，干唾无痰，胸膈不畅，竟似弱症，乃清晨服丸药，生地、麦冬、银柴胡、黄连、知母、鳖甲、秋石、归、
芍、杜仲，食后服煎药，半、贝母、黄连、楂、橘、枳、术、前胡、花粉、白蔻仁。如是出入增损，养血顺气，
清火消痰，两月全愈。
薛立斋治一男子，素耽浓味，胸满痰盛。此膏粱之人，内多积热，与法制清气化痰丸而愈。彼以为有验，
修合馈送，脾胃虚者无不受害。
一妇人元气素弱，痰气时作，或咽间不利，或胸痞等症。以为郁结伤脾，以加味归脾汤治之而愈。后遇大
怒，前症仍作，惑于众言，以为痰饮，妄用祛痰之剂，吐泻数次，变诸异症，口噤不省。薛以为脾胃复伤，日
用六君子一剂，米饮浓煎，常服匙许。至四日渐进粥食，乃服前药，间以归脾和其胃，调养两月余，诸症悉愈。
傅青主治一老人，患痰涌喉间，气不得出入其间，具棺待殓。先生诊之曰∶不死。令捣蒜灌之，吐痰数升
而苏。（刘绍 《九畴古文》。）
王肯堂曰∶予初喜唾痰，愈唾愈多，已而戒之，喉间梗梗不可耐，辄呷白矾汤数口，咯入口中，用舌搅研
令碎，因之而漱之百余，津液满口。即从鼻中吸气，咽下以意送至丹田，默存少顷，咽间清泰。如未清再漱再
咽，以化尽为度。方咯出时，其味甚咸，漱久则甘。世人乃谓瘀浊之物，无澄而复清之理，何其谬哉。吾尝渡
河，见舟人掬浊水而入之瓮，糁入矾末数分，实时澄清，此可悟治痰之法也。
丹阳贺鲁庵，年七十余，膈间有不快，饮食少思。初无大害，就医京口，投以越鞠丸，清气化痰丸，胸次
少宽。日日吞之，遂不辍口，年余困顿不堪。僦舟来访，问脉于王，则大肉已脱，两手脉如游丝，太溪绝不至
矣。见王有难色，因曰∶吾亦自问必死，但膈满太甚，大便秘结不通，殊以为苦，但得少宽，即瞑目无憾也。
因求王疏方，以至亲难辞，教用人参、白术之类，大剂进之，少竟如厕，下积痰升余，胸膈少宽矣。更数日而
殁。盖此二方乃时师常用之物，本欲舒郁，适增其痞，本欲清痰，适速其毙，岂可恃哉！
薛立斋治一人，胃弱痰盛，口舌生疮。彼食滚痰丸愈盛，反泻不止，恶食倦怠。此胃气受伤也，以香砂六
君子汤，数剂少可。再以补中益气汤加茯苓、半夏，二十余剂而愈。夫胃气不足，饮食不化，亦能为痰，补中
益气，乃治痰之法也。苟虚症而用峻利之剂，鲜不危矣。
施沛然治莫进士公谟，患痰嗽，日吐痰数盂，形体瘦削。佥曰火症，纯用柔剂。诊之曰∶此肝木乘脾也。
脉浮而关弦，面黄而鼻青，补之则瘳，泻之则剧。用六君子加炒芍、姜汁制连二剂。不信，仍用山栀、黄柏之
类，更教以猪首佐饔飧。施曰∶三日大泻，绝粒奈何？经曰阴剂柔胜积凝，为洞泄寒中之属，则真火微而荣卫
至。三日后大泻脉脱，鼻息如冰，口不能言。彼医曰∶脉脱矣，大势其在今日乎！急投附子，或可救也。曰∶
无庸。昨栀、柏，而今附子、乌附，何冰炭反掌耶？寒凉过剂，脾气大伤，食复滞之，按之则楚。先取山楂作
液少服，旋进独参汤。
沈明生治玉峰李嘏侯之恙也，病萌于已亥夏风鹤之惊，至九月间夜读，忽觉神思昏沉，中心若坠，嗣后怔
忡不已。一友见其素禀清弱，勤于铅椠，虚症昭然，劝令服参，越两月困怠转加，眩晕特甚。则以参少力薄，
故益至五钱一剂，约三四两，后见病日深，辍参勿服。历叩医家，或以为阴火亢盛，当成劳瘵者。或谓其冬得
春脉，当其时不能再见者。或断之终至癫痫者。医更药杂，岁将暮矣。延诊曰∶从前所议皆不误也。所以不即
愈者，未治痰也。今当专事豁痰，徐议其虚可耳。遂用二陈汤加钩藤、菖蒲等味，渐进煎剂。书一案云∶思虑
伤神，痰乘包络，以致虚灵之宰不获自持，时觉心绕千丝，时觉腹无一物，独处则万绪纷纭，临事则五色眩瞀，
痰上逆也。痰为火扰，夜卧难宁，痰助阳明，多食不饱，流于精道则梦失，见之脉候则滑弦。治宜先标后本，
驱其壅闭，俾神明之官，仍安厥位。继以补血养心，庶滋润之品，不致泥膈，而余 不治自愈矣。归芍宁神
至宝丹一料送服，入春全愈。
钱国宾治无锡刘元女，咳嗽吐痰，气短经闭，骨瘦如柴，但不夜热。以新婿不相顾，病益剧。刘延诊以决
Mouth open, eyes closed, consciousness clouded. Upon examination, the six pulses were surging, slippery, and rapid; therefore, Jia Wei Dao Tan Tang (Modified Phlegm-Resolving Decoction) was administered, followed by Su He Wan (Styrax Pill). After just two doses, mental clarity was restored. When asked what medicine was used, the previous prescription was reported. The patient's father angrily exclaimed, "Throughout my life, I have always abhorred drying agents; how could I take this! It must never be used again." His son knew his father was wrong but daily administered one dose of Dihuang Tang (Rehmannia Decoction) to him for verification, while secretly feeding him phlegm-resolving medicines. After the illness subsided and the father fully understood the situation, he felt deeply ashamed and apologetic.
Sun Wen Yuan treated Li Guyu, who had bowel movements immediately after every meal, with slight abdominal distension and urgency, and fullness/stuffiness in the chest and diaphragm. Taking Ginseng (Renshen) and Atractylodes Macrocephala (Baizhu) worsened the stuffiness, while urination was clear and copious. Palpation revealed a choppy pulse at the left Cun position, and a slippery pulse at the right Cun position, which felt like a soybean under pressure and bulged against the finger. The Guan and Chi positions on both sides were wiry and small, while the left hand's pulse was long and spirited. Based on the pulse, it was determined that accumulated phlegm was stagnating in the lungs and unable to exit, causing the Qi of the large intestine to lose its firmness in controlling defecation. One should emulate Danxi's treatment of his uncle using emesis to expel upper jiao phlegm accumulation, after which stool would naturally solidify. Initially, Platycodon Root (Jiegeng) and Radish Seed (Luobozi), each 3 qian, White Cardamom Kernel (Baidouren), Tangerine Peel (Juhong), and Gardenia Fruit (Shanzhi), each 1 qian, along with Ligusticum Wallichii (Chuanxiong) 0.5 qian, Ginger (Shengjiang) 3 slices, and Scallion (Cong) 3 roots, were decocted in water to induce vomiting. After about half an hour, clear phlegm was vomited, but nausea persisted because the phlegm accumulation was sticky and stubborn, difficult to expel. Then, one he of radish was ground into pulp, mixed with fermented rice water and honey, and half a bowl was drunk, resulting in the expulsion of approximately two bowls of sticky phlegm. Previously, stool passed simultaneously with urine; after emesis, urine could pass alone. After three or four such episodes, the chest and abdomen felt comfortable. Although initially fearful of emesis, he felt suddenly relieved and happy. Bowel movements became once every five days. Subsequently, Er Chen Tang (Two-Cured Decoction) was modified with Atractylodes Macrocephala (Baizhu), Inula Flower (Xuanfuhua), and Malt (Maiya) for regulation, leading to complete recovery.
Li Shi Cai treated Zhang Gejian, who suffered severe heart pain during summer heat. The physician prescribed Xiangru Yin (Elsholtzia Decoction), but the pain intensified, and the Cun pulse became wiry and urgent. This indicated an interlocking of phlegm and food retention. After taking Amomum Villosum (Sharen) and Er Chen Tang for two doses, pain slightly decreased, but suffering and irritability remained. Weiling Tang (Gastrodia and Poria Decoction) was then modified with Pinellia Tuber (Banxia) 2 qian and Rhubarb (Dahuang) 3 qian, resulting in the passage of several black stools, reducing pain by three or four tenths. Using the same formula with Rhubarb increased to 4 qian, over ten bowls of sticky phlegm were expelled before stability was achieved.
Zhu Zheng suffered exhaustion and anger, leading to mental fatigue, profuse sweating as if bathing, confused speech, and extreme peril. The pulse was large, slippery, and soft, indicating Qi deficiency with phlegm. Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) ingredients were combined into one dose, using up to 1 liang of Ginseng (Renshen), 1 qian of Prepared Aconite Root (Fuzi), and 3 qian of Prepared Pinellia Tuber (Banxia). After four days, there was slight revival. Then, Liujunzi Tang (Six Gentlemen Decoction) with Ginger Juice (Jiangzhi) 1 zhong was taken for several days, alongside Bawei Wan (Eight-Treasure Pill), stabilizing the condition after two months.
Wang Junhou suffered from phlegm-cough and always took Qingqi Huatan Wan (Clear Qi and Resolve Phlegm Pill), gradually developing shortness of breath and inability to eat. Li stated, "In advanced age, Spleen Earth is insufficient, hence this symptom. If the previous pill is taken, Spleen Earth will become even weaker." Liu Junzi Tang (Six Gentlemen Decoction) was prescribed with Roasted Ginger (Weijiang) 3 qian and Alpinia Oxyphylla (Yizhiren) 1.5 qian. After ten doses, phlegm cleared. The same formula was made into honey pills, taken for about one jin, allowing diet to resume.
Zhu Wenxue experienced whole-body itching like insect bites, oral erosion, and saw two ghosts every morning offering food. He wept to Li, saying, "I am under thirty, my parents are elderly with white hair. With ghosts harassing me day and night, I surely have no life left." Palpation showed the Cun pulse fluctuating between large and small. Suspecting supernatural influence, careful examination revealed wiry, slippery, and large pulses at both Guan positions, leading to a diagnosis of phlegm. Guntan Wan (Rolling Phlegm Pill) 3 qian was given; although slight evacuation occurred, the patient remained unchanged. Xiaowei Dan (Small Stomach Pill) 2 qian was then administered, resulting in the expulsion of over ten bowls of phlegm accumulation and water. Body pain halved, and the ghosts disappeared by early morning. Three qian of Ginseng (Renshen) and two qian of Atractylodes Macrocephala (Baizhu) decoction was used to swallow Guntan Wan 3 qian, causing massive diarrhea over ten times, totaling about twenty bowls. The illness vanished. Liu Junzi Tang pills were taken for four jin, achieving cure.
Zhang Luyu treated a man from Yan, who was obese with abundant phlegm, loved meat and alcohol, and suffered from phlegm-rattling asthma and cough for years. Food injury often triggered attacks, where the six pulses were slow and slippery, with intermittent pauses, voice like sawing wood, and phlegm everywhere. Attacks occurred one to five times a year, worse in late autumn and early winter. Daocang Fa (Stomach Purging Method) was used (Guntan Wan could also be used; Daocang Fa should not be tried lightly). He claimed limbs felt light, and the illness cured. Two years later, relapse occurred due to eating beef, but severity was only one-tenth of before, caused by dietary indiscretion.
Madam of Gu Yihou had chronic defective phlegm misdirected, with masses in both hypochondria the size of inverted cups. Attacks involved cough, wheezing, abdominal/hypochondriac pulling pain, rapid pulse, and weak pressure. Liu Junzi Tang (Six Gentlemen Decoction) modified with Areca Seed (Dansheng), Immature Bitter Orange (Zhishi), Cyperus Rotundus (Xiangfu), and Aquilaria Wood (Chenxiang) for two doses resulted in vomiting one to two sheng of thick, dirty phlegm. Due to excessive vomiting, a follow-up visit found vomiting ceased and pulse normalized, requiring no further medication.
Huang Lusu said: Lizhai often stated that Kidney deficiency causes water flooding to form phlegm, so the method should be tonifying the Kidney. In the autumn of Ren Shen year, I had cough with much phlegm, knowing it was due to sexual excess, I strictly followed the master's method, taking Liuwei Wan (Six-Ingredient Pill with Rehmannia) diligently. Without other treatments, the cough and phlegm healed in over a month. Contemporary doctors treating phlegm most avoid Shudi (Prepared Rehmannia Root), considering it cloying to the diaphragm. How can they know the subtle principle within?
Gong Zicai treated Zhou Fan Hai Sheng Yangsheng, who suffered phlegm-cough, wheezing, heat, left foot swelling and pain, lighter by day and heavier by night, occurring one or twice yearly for thirty years, unresponsive to various treatments. Pulse was slightly rapid on the left, wiry and rapid on the right, indicating Blood deficiency with damp-phlegm. Siwu Tang (Four Substance Decoction) modified with Atractylodes Lancea (Cangzhu), Phellodendron Bark (Huangbai), Papaya (Mugua), Betel Nut (Binglang), Akebia Stem (Mutong), and Alisma Rhizome (Zexie) was taken on an empty stomach to treat the lower yuan. Fuling Buxin Tang (Poria Heart-Nourishing Decoction) was taken before sleep to treat the upper jiao. Each cured after three doses. Later, Shenxian Feibu Wan (Immortal Flying Step Pill) was taken on an empty stomach, and Qingqi Huatan Wan (Clear Qi and Resolve Phlegm Pill) before sleep, each course fully curing the condition.
Zhang Sanxi treated a middle-aged woman with nightly fever stopping at dawn, accompanied by nausea, anorexia, limb fatigue. She mentioned she was formerly fat but now thinning. Recalling the ancients' words, "Formerly fat, now thin, it is phlegm," Zhang reasoned that phlegm stagnating in the central palace (Spleen/Stomach) obstructs ascending and descending, causing anorexia and nausea. Blood lacks nourishment, becoming deficient, hence nightly fever. Er Chen Tang (Two-Cured Decoction) was used to resolve phlegm, Ginseng (Renshen) to tonify middle Qi, Zhishi (Immature Bitter Orange) and Maiya (Malt) to broaden the middle, Xiangfu (Cyperus) and Fried Gardenia (Chao Zhizi) to clear fire, and Chaihu (Bupleurum) to reduce fever. Twenty doses were taken, interspersed with Ju Ban Zhi Zhu Wan (Tangerine Peel, Pinellia, Atractylodes, and Poria Pill), curing in one month. Subsequently, Renshen Tang (Ginseng Decoction) was taken, and the body gradually recovered.
Another person, formerly fat, thinned over half a year, with alternating knee and back pain, deep and slippery Chi pulses. Recalling the ancients' words, "Formerly fat, now thin, it is phlegm," Ji Jian Huo Tan Tang (Modified Phlegm-Expelling Decoction) was taken continuously for several doses. One day after a meal, nausea occurred, so Gouti San (Melon Sprout Powder) 1 qian was administered, expelling half a sheng of thick phlegm, curing the illness.
Zhu Danxi treated a person with stiff and painful neck, unable to turn the head, treating it as phlegm lodging in the Taiyang Meridian. Er Chen Tang (Two-Cured Decoction) modified with Wine-fried Scutellaria Root (Jiu Qin), Notopterygium Rhizome (Qianghuo), and Safflower (Honghua) was taken, curing in two days.
Zhang Luyu treated Madam of Wu Biejia, suffering from epigastric fullness, vertigo, and vomiting. Previously, fearing cold in the lower body and numbness in limbs, she long-term consumed Bawei Wan (Eight-Treasure Pill), Renshen (Ginseng), and Fuzi (Aconite) without thorough cure. Six pulses were wiry and slippery, soft upon pressure, indicating middle jiao phlegm-dampness accumulation, with Yang Qi unable to circulate to the four extremities. While Cinnamon Twig (Guizhi) and Aconite (Fuzi) provide acrid-warm power for temporary relief, it is not true Yang deficiency, and Rehmannia (Dihuang) causes stagnation, making epigastric fullness and vertigo endless. Ju Fang Qi Qi Tang (Seven Qi Decoction from the Bureau Formulary) modified with Agarwood (Chenxiang) was given. One dose brought sudden relief, and two doses improved spirit, appetite, and stability.
Xue Lizhai treated a scholar with inherent Spleen-Kidney deficiency and phlegm. Someone used phlegm-draining methods, worsening phlegm, thirst, dizziness, and irritability. This was identified as a change due to weak middle Qi, cured by Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi). Later, fatigue-induced fever was due to Qi failing to ascend, cured by adding Verbenaceae Leaf (Manjingzi) to the previous formula. Subsequent mental exertion led to wind aversion, cold limbs, bland taste, and much phlegm, identified as true Spleen Qi deficiency-cold, cured by Liujunzi Tang (Six Gentlemen Decoction) with Fried Ginger (Pao Jiang) and Cinnamon Bark (Rougui).
A man with inherent Kidney Qi deficiency and coughing phlegm also used phlegm-draining methods, resulting in all deficiency symptoms, surging saliva, and frequent urination. This was deemed damage to the Foot Three Yin meridians. Morning use of Buyang Piqi Tang (Tonify Spleen Qi Decoction) cultivated Spleen-Lung Qi deficiency; evening use of Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Schisandra Berry (Wuweizi) converged scattered essence, achieving cure.
Dayin Chen Keming had more phlegm after draining, loose stools, craving hot drinks, and cold limbs. This was Mingmen Fire decline with Spleen-Lung deficiency-cold, unable to control saliva return to source, cured by Liuwei Wan (Six-Ingredient Pill with Rehmannia).
Jinshi Zhang Yugong had food stagnation, chest fullness, and phlegm vomiting. Medicinal drainage caused surging saliva, vertigo, heat-thirst, constipation, craving cold foods/drinks, and hot limbs. This was Kidney Water weakness, difficulty in fluid descent,敗液 turning to phlegm, cured by Liuwei Wan (Six-Ingredient Pill with Rehmannia).
Scholar Yang Wenkui constantly spat phlegm, unresponsive to various drugs. Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill) caused much phlegm vomiting, sometimes dizziness, sometimes heat rising from hypochondrium. Left pulse large and forceful, right pulse floating-large and powerless. Xue said, "This is Three Yin deficiency, Fire unable to return to source." Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) plus Ophiopogon Tuber (Maidong) and Schisandra Berry (Wuweizi), plus Ji Jian Bawei Wan (Modified Eight-Treasure Pill), tonified the transformation source, achieving cure. (Xiong An note: With Three Yin deficiency, how can Buzhong Yiqi Tang be casually applied?)
Qiuguan Zhang Biya had red face, thirst, much phlegm, and vertigo. This was Kidney deficiency with water flooding forming phlegm, cured by Dihuang Wan (Rehmannia Pill).
Yizhi He Zhaoqing had acid regurgitation, chest fullness, much phlegm, diarrhea, and poor appetite. Qingqi Huatan Wan (Clear Qi and Resolve Phlegm Pill) etc. worsened symptoms, knees swelled, alternating chills and fever. This was Spleen-Stomach deficiency with damp-heat pouring downward. Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) with doubled Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala), plus Poria (Fuling), Pinellia (Banxia), and Fried Ginger (Pao Jiang), achieved cure.
Kaogong Yang Lin'an had vomiting of phlegm-saliva, chest/abdominal distension-pain, poor appetite, wiry-long left Guan pulse, weak upon pressure. This was Wood overcoming Earth. Liujunzi Tang (Six Gentlemen Decoction) plus Bupleurum (Chaihu), Gardenia (Shanzhi), and Costus Root (Muxiang), achieved cure.
Ershou Chen Zizhong had poor appetite, phlegm vomiting, dry mouth, frequently taking Er Chen Tang (Two-Cured Decoction), Zhishi (Immature Bitter Orange), Coptis Rhizome (Huanglian), damaging Spleen-Stomach. Asked Xue Lizhai. Xue quoted Dongyuan: "For Spleen-Stomach disorders, excess uses Zhishi and Huanglian to drain; deficiency uses Baizhu and Chenpi to tonify." He made these two equal parts into pills for regular use, thus eating much without harm, and passing time without hunger.
Zhao Yi De said: I recently treated a man with swelling and pain behind Jianjing, fever and cough, soft upon pressure. This was wine-phlegm flowing and knotting. Nanxing (Arisaema Cum Bile), Banxia (Pinellia), Trichosanthes Root (Gualougen), Huangqin (Scutellaria), Huanglian (Coptis), and Zhuli (Bamboo Juice) were decocted. Burned Scallion Root was applied to the swelling. Mustard Seed (Jiezi) and Alum (Baifan) made into small pills were swallowed with the decoction, twenty pills. After taking, phlegm came out with cough, about three to four bowls in half a day, illness cured. (Same as above.)
Luo Chengzhi, having learned Danxi's studies, retired to Chongming. Taiewei Zhang Shicheng of Sansha suffered from phlegm disease and palpitations, ineffective treatments by famous physicians. Luo Chengzhi was invited,主张 Daocang Fa (Stomach Purging Method). Zhang finally used his formula, all illnesses removed, rewarded generously. (History of Medicine. Same as above.)
Lu Yangyu treated Sun Jingyang's wife, nearly fifty, formerly suffering from phlegm-fire. Attacks caused empty-headed vertigo, reduced diet, quick onset and resolution, for many years. Recently worsened, lasting over a month. Pulse surging, slippery, rapid, powerless upon pressure, cold limbs, red face, yellow-thin muscles, frequent vertigo, sometimes unconscious, unable to eat/drink. Seemed non-attackable, but pulse had spirit; abandon symptoms, rely on pulse. Zhishi (Immature Bitter Orange), Trichosanthes Fruit (Gualou), Dansheng (Areca Seed), Fubei (Fritillaria), Huangqin (Scutellaria), Huanglian (Coptis), Juhong (Tangerine Peel), Yazao (Gleditsia Spine) with Jiangzhi (Ginger Juice) and Zhuli (Bamboo Juice) were taken, vomiting several bowls of phlegm, limbs warmed. Chuan Niuhuang (Calculus Bovis) 0.5 fen paired with wax pills, taken at once, three pills, slowly drinking bamboo juice to induce. Abdominal rumbling followed by Runzi Wan (Moistening Pill) 3 qian, evacuating filth, illness greatly reduced. Later regulated with clearing fire, resolving phlegm, strengthening Spleen, nourishing Blood, achieving peace.
Wu Shuzhi's wife, robust constitution, had phlegm. Initially thin white clear, spat out thick after time, overwork caused vertigo/fainting, recent attacks every two-three days, screaming then coma, opisthotonos, recovering after a moment, cold limbs, full/hard chest/abdomen, fine/choppy six pulses. Considered cold-phlegm stagnating in middle jiao. Erchen Daotan Tang (Two-Cured Phlegm-Resolving Decoction) with Banxia (Pinellia) 4-5 qian taken. One night restless, phlegm obstruction worse, dry mouth/tongue/thirst. Realizing pulse/symptom mismatch, abandon pulse, rely on symptoms. Modified with Beimu (Fritillaria), Huangqin (Scutellaria), Huanglian (Coptis), Jiegeng (Platycodon), Huafen (Trichosanthes Root), Qianhu (Peucedanum), Dansheng (Areca Seed), Gualou (Trichosanthes Fruit), Zhuli (Bamboo Juice), Jiangzhi (Ginger Juice) decoction, swallowing Runzi Wan (Moistening Pill) 0.5 fen. Several doses softened chest/diaphragm, removed vertigo. Constipation for days, Guntan Wan (Rolling Phlegm Pill) 3 qian ineffective, Runzi Wan 3-4 qen induced bowel movement, symptoms halved. Two days later, afternoon fever, red lips/face, dry spitting no phlegm, chest discomfort, resembling deficiency. Morning pill: Dihuang (Rehmannia), Maidong (Ophiopogon), Yin Chaihu (Stellaria Root), Huanglian (Coptis), Zhimu (Anemarrhena), Biejia (Turtle Shell), Qiushi (Halloysitum), Danggui (Angelica Sinensis), Shaoyao (Peony), Duzhong (Eucommia). Post-meal decoction: Banxia (Pinellia), Beimu (Fritillaria), Huanglian (Coptis), Zhaza (Hawthorn), Ju (Tangerine Peel), Zhishi (Immature Bitter Orange), Baizhu (Atractylodes Macrocephala), Qianhu (Peucedanum), Huafen (Trichosanthes Root), Baixiangdou (White Cardamom). Such adjustments nourished blood, smoothed Qi, cleared fire, resolved phlegm, cured in two months.
Xue Lizhai treated a man indulging in rich flavors, chest fullness, much phlegm. This is a person of rich food, internal heat accumulation. Given processed Qingqi Huatan Wan (Clear Qi and Resolve Phlegm Pill), cured. Believing it effective, he prepared and gifted it; those with Spleen-Stomach deficiency suffered harm.
A woman with inherent weak Yuan Qi, occasional phlegm-Qi, throat discomfort, chest stuffiness. Considered depression injuring Spleen. Jiawei Guipi Tang (Modified Restore the Spleen Decoction) cured. Later, great anger caused recurrence. Confused by others, thought it phlegm-fluid, wrongly used phlegm-dispelling agents, vomiting/diarrhea several times, changing to strange symptoms, locked jaw unconscious. Xue considered Spleen-Stomach re-injured. Daily Liujunzi Tang (Six Gentlemen Decoction) one dose, strong rice drink decoction, spoonfuls regularly. By fourth day, congee gradually accepted, then previous medicine taken, interspersed with Guipi Tang to harmonize Stomach. Regulated over two months, all symptoms cured.
Fu Qingzhu treated an old man with phlegm surging in throat, air unable to enter/exit, coffin prepared for burial. Master diagnosed, "Not dead." Ordered crushed garlic灌服, vomiting several sheng of phlegm, revived. (Liu Shao, *Jiuchou Guwen*.)
Wang Kentang said: I initially liked spitting phlegm, the more I spat, the more there was. Then I stopped. Throat felt blocked unbearable, sipping Bai Fan Tang (Alum Decoction) few mouthfuls, spat into mouth, tongue ground it碎, rinsed over hundred times, saliva filled mouth. Inhale through nose, swallow sending intent to Dantian, hold briefly, throat clear. If not clear, rinse/swallow again until dissolved. Freshly spat phlegm tasted salty, after rinsing sweet. People say turbid matter cannot clarify again, how absurd! I crossed a river, saw boatman scoop turbid water into jar, sprinkle alum powder, instantly clarified. This reveals phlegm treatment method.
Danyang He Lu'an, over seventy, chest discomfort, poor appetite. Initially harmless, sought doctor in Jingkou, given Yueju Wan (Regulating Qi Pill), Qingqi Huatan Wan (Clear Qi and Resolve Phlegm Pill), chest slightly wider. Took daily, never stopped, over a year exhausted. Rented boat to visit, Wang palpated, flesh wasted, pulses like wandering silk, Taixi absent. Seeing Wang's difficulty, he said, "I also ask myself surely dying, but chest fullness too severe, constipation, very bitter. Just get some relief, I die content." Asked Wang for prescription. Reluctantly taught Renshen (Ginseng), Baizhu (Atractylodes Macrocephala) etc., large dose taken. Soon defecated, over a sheng of accumulated phlegm, chest slightly wide. Died several days later. These two formulas are commonly used by contemporary doctors, intended to regulate depression, instead increased fullness; intended to clear phlegm, instead accelerated death. How can one rely on them!
Xue Lizhai treated a person, weak Stomach, much phlegm, mouth/tongue ulcers. Taking Guntan Wan (Rolling Phlegm Pill) increased phlegm, diarrhea continued, anorexia fatigue. Stomach Qi injured. Xiangsha Liujunzi Tang (Amomum and Cyperus Six Gentlemen Decoction), several doses slightly better. Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) plus Fuling (Poria), Banxia (Pinellia), over twenty doses cured. Insufficient Stomach Qi, undigested food forms phlegm; Buzhong Yiqi is a phlegm treatment method. If deficiency uses harsh purgatives, rarely without danger.
Shi Peiran treated Mo Jinshi Gongmo, phlegm-cough, vomiting several basins of phlegm daily, emaciated. All said Fire syndrome, purely used soft agents. Diagnosed, "Liver Wood overcoming Spleen." Pulse floating, Guan wiry, yellow face, blue nose. Tonify improves, drain worsens. Liujunzi Tang (Six Gentlemen Decoction) plus Fried Shaoyao (Peony), Ginger-processed Huanglian (Coptis), two doses. Disbelieved, still used Zhizi (Gardenia), Huangbai (Phellodendron), instructed pig head meat with meals. Shi said, "Three days later massive diarrhea, fasting, what then?" Classic says Yin agents soften accumulation, causing hole-diarrhea cold-middle type, then True Fire weak, Ying-Wei arrive. Three days later massive diarrhea, pulse lost, breath like ice, unable to speak. That doctor said, "Pulse lost,大势 likely today!" Urgently inject Fuzi (Aconite), perhaps save. Shi said, "No need. Yesterday Zhizi/Huanglian, today Fuzi/Wu Fu, how ice/fire reverse palm?" Cold-cool overdosed, Spleen Qi severely damaged, food stagnates, painful on pressure. First take Hawthorn liquid little dose, then Du Shen Tang (Single Ginseng Decoction).
Shen Mingsheng treated Li Gahou of Yufeng. Illness started with panic in summer of Ji Hai year. By September, night reading, suddenly mental cloudiness, heart sinking, subsequent palpitations. Friend saw inherent clear-weak constitution, diligent study, obvious deficiency, advised Ginseng. Over two months fatigue worsened, severe vertigo. Thought Ginseng dose too low, increased to 5 qian per dose, total 3-4 liang. Later seeing illness deepen, stopped Ginseng. Consulted many doctors: some said Yin Fire hyperactivity, consumption; some said Winter got Spring pulse, unlikely to survive season; some predicted epilepsy. Doctors changed medicines, year ending. Invited diagnosis: "Previous discussions not wrong. Why not healing? Not treating phlegm. Now focus on expelling phlegm, discuss deficiency later." Er Chen Tang (Two-Cured Decoction) plus Gouteng (Uncaria), Changpu (Acorus) etc., gradual decoction. Case record: "Thoughtfulness injures Spirit, Phlegm invades Pericardium, causing Virtual Ruler unable to hold itself, feeling heart entangled in thousand threads, belly empty, alone thoughts chaotic, facing matters dizzy colors, Phlegm counterflows. Phlegm disturbed by Fire, hard to sleep at night, Phlegm aids Yangming, eats much not full, flows to Essence Path causes dream loss, pulse shows slippery-wiry. Treatment should first address branch then root, drive blockage, let Spirit Officer return to position. Then nourish Blood tonify Heart, so moistening items don't stick diaphragm, rest self-heals." Guishao Ningshen Zhibao Dan (Angelica and Peony Calm Spirit Precious Pill) one course sent down, spring fully cured.
Qian Guobin treated Liu Yuannv of Wuxi, coughing phlegm, shortness of breath, amenorrhea, skeletal thinness, no nightly fever. New husband neglected her, illness worsened. Liu invited diagnosis to decide...