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Phlegm disorders present both true and false manifestations; how can people distinguish between them? True phlegm is known to everyone, and treating symptoms of true phlegm is within the capability of most practitioners; therefore, I will not establish new prescriptions for it. However, regarding the false manifestations of phlegm, a detailed discussion is necessary to dispel worldly confusion.

For instance, when a person expectorates phlegm resembling crab saliva throughout the year or month, this is not true phlegm. It is actually kidney essence transformed into phlegm under the influence of kidney fire, similar to water boiling in a pot—here, fire causes the transformation into phlegm. If one treats this condition with herbs targeting upper jiao phlegm, the condition worsens; if treated with herbs targeting middle jiao phlegm resolution, the phlegm increases further. This occurs because the root cause is not addressed, and treatment directly targets the kidney, akin to using water to extinguish fire. So, what medication should be used? One must employ yin-nourishing herbs that also moisten the lung metal qi, allowing metal to generate water, and water to control fire. When water is sufficient, fire naturally returns to its origin. The prescription is Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) added with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus), decocted in large doses for drinking. The phlegm-qi will clear naturally; this resolves essence rather than dissolving phlegm. Nevertheless, such conditions must be treated early for optimal results. If neglected, they will inevitably transform into greenish, foul-smelling phlegm, leading to Fei Wei (Lung Atrophy). Thus, I specifically highlight the category of false phlegm to teach people to use Liuwei Dihuang Tang prophylactically once symptoms appear, rather than waiting until the condition becomes critical. Whenever white, frothy phlegm is observed, one should advise immediate use of this decoction at the onset, ensuring success with ease.

The true and false nature of Da Man (Great Fullness) is difficult to discern; accurate differentiation is essential to avoid errors. Generally, true fullness involves pathogenic qi obstructing the stomach, often resulting from Shang Han (Cold Damage) disorders. Zhang Zhongjing employed Xianxiong Tang (Chest-Sinking Decoction) for such cases. However, this formula is harsh and purgative; if taken by healthy individuals by mistake, it may cause a sensation of the heart collapsing. How much more dangerous would it be for weak individuals? Therefore, one must inquire whether any substances were used after the recovery from Shang Han before the onset of great fullness. If food stagnation blocks the stomach, Xianxiong Tang may be used for purgation. Yet, this is merely a temporary expedient and should not be rigidly applied to all cases of great fullness. In cases of post-Shang Han fullness, if tolerable, fasting may be preferable to healing naturally; there is no absolute need to use Xianxiong Tang. Moreover, if there is no genuine great fullness, nor excess fullness, how can one recklessly administer drugs that might shorten life? Regarding false fullness, symptoms include mental restlessness and insomnia, abdominal distension that feels empty upon palpation without pain, and a hollow sound when tapped with fingers. Liquids can be swallowed, but solid food is difficult to ingest. These are all signs of false fullness. The treatment principle should be to soothe liver wood stagnation, strengthen spleen and stomach earth, drain lower jiao dampness, and ventilate upper jiao obstruction. Naturally, the central jiao will stabilize, transport functions will resume, and manipulation will have a foundation, eliminating worries about middle-fullness. Such diseases require prolonged treatment and cannot be expected to yield quick results. I have formulated a prescription, Huaxiao Tang (Resolution and Dissipation Decoction), for regular consumption to resolve stagnation and eliminate fullness. This formula is applicable regardless of food injury; additionally, add Chaihu (Bupleuri Radix) 0.7 qian and Shaoyao (Paeoniae Radix) 3 qian. It can be applied to any fullness condition, representing the method for treating false fullness.

Huaxiao Tang: Renshen (Ginseng Radix) 1 qian, Gancao (Licorice Root) 1 fen, Luobozhi (Raphani Semen) 1 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 5 qian, Yiren (Coicis Semen) 5 qian, Zhiqiao (Aurantii Fructus) 1 qian, Chenpi (Citri Reticulatae Pericarpium) 0.5 qian, Houpo (Magnoliae Officinalis Cortex) 0.5 qian, Shenqu (Massa Medicata Fermentata) 0.5 qian, Shanzha (Crataegi Fructus) 5 pieces, Maiya (Hordei Fructus Germinatus) 2 qian, Sharen (Amomi Fructus) 1 piece. Decoct in water and take orally.