症始可用吐，如瓜蒂散涌出其痰是也。若鼻塞咳嗽，吐痰黄浊，非大满大实可比，何必用吐
法哉。且不宜吐而吐，必有损伤胃气之忧，胃气伤而肺气亦伤。肺胃两伤，旧疾虽去，而新
痰复生，一吐不已而再，再吐不已而三，必变为不可治之症矣。故毋论虚人不可吐，即实人
亦不可轻吐，以吐后必须守戒，五脏反复而气未易复，一犯戒而变症蜂起也。况肺邪闭塞之
痰，亦易于表散。盖肺气闭塞于风邪。非闭塞于痰也。散其邪而肺气自通，肺气通而痰自化
，王道原自平平，尚吐者霸道也。霸道可间用，不可常用，慎勿谓吐法神于表散，而尽用吐
方用散痰汤∶
桔梗（三钱） 紫苏（二钱） 黄芩（一钱） 麦冬（五钱） 半夏（二钱） 甘草（一钱） 陈皮（一
钱） 茯苓（三钱）
水煎服一剂鼻塞通，二剂咳嗽止，三剂痰浊化，四剂全愈。
此方名为散痰，其实散肺之邪也。
此症用二紫汤亦效。
紫苏叶 紫菀（各一钱） 桔梗（二钱） 甘草 枳壳 黄芩（各一钱） 天花粉（三钱）
水煎服。
人有寒气入胃，结成寒痰，日日呕吐，人以为寒痰在胃，谁知是胃气之虚，而寒结为痰
乎。凡人胃气旺，则水谷入而化精，原不生痰。惟胃气虚，仅能消谷，不能消水，则水积而
为痰矣。然而胃虚者，火气之衰也。火旺则土旺，火衰则土衰，土衰不能制水，故不变精
而变痰也。夫胃土自寒，尚且水变为痰，况外寒又侵胃乎。内外之寒合，自然痰涎日多，下
不能化，必至上涌而吐矣。祛寒其可缓乎，惟是祛胃土之寒，必须补心火之旺，火旺土坚，
何痰不化哉。
方用六君子汤加味治之。
人参（三钱） 白术（五钱） 茯苓（三钱） 陈皮（一钱） 甘草（三分） 半夏（一钱） 肉桂（二钱）
水煎服。
六君子汤原是补脾胃之圣药。胃病而治脾者，脾胃为表里，脾健而胃更健也。肉桂上补
心火，而下尤补肾火也，心火旺而胃温，肾火旺而脾热，脾胃两热，寒痰有不立消者哉。
此症用加味参术苓附汤亦甚效。
人参（一钱） 白术（三钱） 茯苓（三钱） 附子（二分） 神曲（一钱） 麦芽（一钱） 白芥子（三钱）
水煎服。
人有热气入胃，火郁成痰，痰色黄秽，败浊不堪，人以为热痰作祟，谁知是胃火之未消
乎。夫胃本属土，胃火之盛，由于胃土之衰也。胃土衰而外热犯之，似与胃相宜，何以反化
为痰乎。盖胃土既虚，则水谷之入不能生津以润土，而土气太干，必索外水以相救，水多火
胜，而不相化，胃土抑郁而不伸，胃火亦搏结而不发，痰何能消，必变为黄秽败浊之色矣。
然则治法不必治痰，补胃气之虚，少加散火抒郁之味，则胃土复强，消痰更易。
方用疏土汤∶
白术（三钱） 茯苓（五钱） 干葛（五分） 人参（一钱） 甘草（三分） 陈皮（五分） 天花粉（三钱） 竹
叶（三十片） 甘菊（二钱） 柴胡（五分）
水煎服。一剂胃郁解，二剂胃火散，三剂胃痰消，四剂全愈。
此方补胃重而泻火轻，以郁火之痰原未常大旺也。故补胃而火可散，散火而郁自解，况
方中原有葛根、柴胡以解其郁乎，郁开痰豁，必至之势也。
此症亦可用玄石花粉散∶
石膏（二钱） 白术（三钱） 茯苓（五钱） 天花粉 玄参（各三钱）
水煎服。
人有感雨露之湿，或墙垣土房之湿，以致湿变为痰，成为痰饮。肢节酸痛，背心作疼，
脐下有悸，人以为湿痰成病，谁知是脾气之湿，湿以助湿乎。夫脾最恶湿，必得肾火以燥之
，则汗泥之土，始成膏壤，水入脾中，散精而无留伏之害，惟肾火衰微，不能生脾土，而
脾土愈湿，土湿自易成痰，又加天地之水气，两相感召，则湿以添湿，痰更添痰矣。治法补
肾火以生土，补火之药，仍于补脾之中用之，则火无亢炎之祸，土有健顺之宜。
方用五苓散治之∶
白术（一两） 猪苓（三钱） 泽泻（二钱） 茯苓（一两） 肉桂（二钱） 半夏（三钱）
水煎服。一剂脐下之悸除，二剂肢节、背心之疼痛止，三剂痰饮尽消，四剂全愈。
五苓散乃利水之神剂也。肉桂温命门之火，更能引湿痰化水，尽趋于膀胱而出。尚恐旧
痰已化，而新痰又生，故加入半夏以消之，助苓、术之醒脾，尤能奏健土之功也。土生火中
，火旺土内，一方而火土两安，脾肾兼补，此五苓散之功也。
此症用制涎汤亦效。
茯苓 薏仁 白术 山药（各五钱） 肉桂（一钱） 半夏（二钱）
水煎服。
人有阴虚枯槁，肺气困乏，嗌塞喉干，咯痰动嗽，此肺气之燥也。夫肺之燥，必非一日
，夏伤于热，秋必病燥。肺属金，而金最畏火，夏火炎炎，肺金不能敌火气之克耳。但金既
畏火克，即宜发燥，何待火退金旺之时反现燥象。不知金畏火刑，而金尚出其肺中之液，犹
可以敌火气之炎，迨火令既过，金无所畏，不足之气形焉，转难济肺气之乏，势必求外水以
止渴。然而外水止可入胃，终不可以入肺，且肺气既燥，肺难自顾，何能下生肾水，乃肾中
取给又不免，则燥且益燥，咳嗽吐痰之症生矣。治法似宜补脾胃，以生肺金矣。然健脾助胃
之药，性多燥烈，以燥投燥，则肺中之津液未能遽生，反足以添其火炎。必须于润肺之中而
大补其肾水，肾水足而肺金得养，子富而母自不贫也。且肺金之气，夜藏于肾，向因肾涸，
力难迎肺金，以归藏于肾之内，肺乃取给于肾，而肾之水不足以供肺之用。肺乃半途而返，
不忍入于肾子之宫，肾见肺金之燥，出其涸竭之水以济之。涸竭之水，水中有火也，肺不敢
受，于是不变津而变痰。此痰也，肺未常欲其上升，无如上焦火旺，肺液干枯，不得不取资
于痰，以暂救其嗌燥，故咯而升痰。迨痰既上升，而上焦之火，彼此相斗，嗽又生矣。
方用润燥饮∶
麦冬（一两） 熟地（一两） 苏子（一钱） 白芥子（二钱） 甘草（一钱） 桔梗（三钱） 天门冬（三钱） 山
茱萸（五钱） 北五味（五分） 人参（一钱）
水煎服。二剂肺润，四剂肾润，十剂全愈。
此方用二冬以润肺，用熟地、茱萸以补肾，肺肾相通，加人参、五味以益气，气旺而津
液尤易生也。又恐过于补肾，而不上走益肺，故加升提之味，使益肺多于益肾。尚虑用参以
助燥，更入苏子、甘草使之调和于上焦之间，同白芥子以消膜膈之痰，又不动火以增燥，亦
何致有痰嗽之患哉。
此症亦可用润稿汤治之。
熟地 麦冬 葳蕤（各一两） 甘草（五分） 百合（五钱） 贝母（一钱）
水煎服。
小儿痰气壅阻，窍隧不开，手足逆冷，有如风症，人以为慢脾风也，谁知是脾虚而痰盛
乎。夫小儿以脾健为主，脾土不旺，则所食之水谷，尽变为痰。痰气既盛，则经络之间无非
痰结，窍隧闭塞，气即不能展舒矣。脾主四肢，手足者，脾之所属也，脾气既不能展舒，何
能运动夫手足乎，此逆冷之所以成，而非外风之中也。风性甚动而且急，使真有风入，则疾
风豪雨，势不可当，安有迂缓舒徐者乎。无奈前人巧立名色，谓是慢惊之风，创造牛黄、犀
角、蛇、蝎等药以疗之，遂至杀小儿如草菅，深可痛惜。使早用健脾之剂，少佐之以祛痰之
药，则无儿不可活也。
方用健土开涎散∶
人参（五分） 茯苓（二钱） 陈皮（二分） 薏仁（二钱） 干姜（二分） 砂仁（一粒） 白术（二钱） 天
花粉
水煎服。一剂风定，二剂痰消，三剂全愈。
此方健土以消痰，与六君子汤不相上下。然六君子用半夏以消痰，未免有耗气之失，不
若此方专利脾中之湿，又能通气温中，更胜于六君子也。倘执此方，概治小儿之痰，庶几全
治者众矣。
此症用健运汤亦佳。
人参（一钱） 茯苓（三钱） 甘草 枳壳 苏叶 半夏（各三分） 益智仁（三粒） 白豆蔻（一粒）
水煎服。
人有老痰结成粘块，凝滞喉咙之间，欲咽不下，欲吐不能，人以为气不清，谁知是肝气
之甚郁乎。此等之痰，必成黄秽之色。盖留于膜膈之上也，老人虚人最多。此痰非舒发肝木
之气断然难消，然徒舒肝木之气，不大补肝中之血，则胁间之燥不能除，膜膈之痰亦不能化
。然而肝中之血，肾水之所滋也，补肝必须补肾，而兼消痰。
方用润燥破痰汤∶
白芍（一两） 香附（一钱） 青黛（五分） 天花粉（二钱） 白芥子（二钱） 玄参（五钱） 茯苓（三钱） 山
药（三钱）
水煎服。一剂痰易吐，二剂痰易咽矣。连服四剂而痰块开矣，再服四剂而老痰尽消。
此方肝肾两治，肝气宣而肝血养，则肝火不搏聚于胸中，自然老痰不凝滞于胁内。惟是
老痰最难速化，此方必须多用，但不可责其近功耳。
此症用宽膜汤亦效。
白芍（三钱） 枳壳（三分） 甘草（五分） 神曲（三钱） 白芥子（三钱） 炒栀子（一钱） 白术（二钱） 郁
金（一钱）
水煎服。
人有痰在膈上，大满大实，气塞不能伸，药祛而不得下，人以为邪在上也，谁知是邪在
下乎。夫上病宜疗下，何以古人用上治吐法而能愈乎。此亦一时权宜之法，非可常用之道。
世人遵张子和之教，一见满实之症，便用吐药，谁知尽可不吐哉。凡见满实之症，下之自愈
。但下不同耳。下之者，乃祛入胃中，非祛入肠中也。痰涎上壅于膈，原是胃气之盛，而本
于胃火之盛也。泻胃火之有余，自然现胃气之不足，胃气无满实之象，膈中满实，安能重满
重实耶。势必痰气顿消，尽落于胃中矣。何必涌痰上吐，损伤胃气，使五脏之尽反复哉。
方用降痰舒膈汤∶
石膏（三钱） 天花粉（三钱） 浓朴（一钱） 枳壳（一钱） 半夏（一钱） 茯苓（五钱） 益智仁（五分）
水煎服。一剂满实平，二剂满实尽除，痰亦尽下。
此方泻胃火而降痰，实有奇功。虽其性亦迅烈不平，然胜于吐法实多也。世人欲用吐法
者，先用此方，不效后再用吐药，有益于生命无穷，幸勿哂医学平庸，谓用药之胆怯也。
此症亦可用伸膈汤治之。
栝蒌（三钱） 半夏（三钱） 枳壳（一钱） 甘草（一钱）
水煎服。
人有遍身俱长大小之块，累累不一，人以为痰块也，谁知是气之不行，而痰因结之而不
散乎。夫怪病多生于痰，身中长块，亦怪病之一也。然而痰生块结，必有其故。盖痰之生本
于湿，块之结成于火，故无湿不能生痰，而无痰不能成块。第痰之生也。虽生于湿，块之成
也，虽成于火，苟气旺而湿又何留，湿苟不留，火又何从而起，是消块不必去火，惟在于消
痰，亦不必全消夫痰，又在亟补其气，盖气旺则痰消，痰消则块亦消也。
方用二陈汤加味治之。
人参（三钱） 茯苓（三钱） 白术（五钱） 陈皮（二钱） 半夏（三钱） 白芥子（三钱） 姜炒黄连（五分）
水煎服。十剂消半，三十剂全消。
此方本消痰之圣药，亦消块之神剂，块成于痰，消痰即所以消块也。
此症亦可用矾石消垒散。
泽泻 半夏（各三钱） 茯神 白术（各五钱） 薏仁（一两） 附子（二分） 人参（二钱） 甘草（五分）
白矾（一钱） 黄连（三分）
水煎服。十剂自消。
人有性喜食酸，因多食青梅，得痰饮之病。日间胸膈中如刀之刺，至晚而胸膈痛止，膝
KT大痛，人以为胃中之寒，谁知痰饮随气升降而作痛乎。夫痰在上宜吐，痰在中宜消，在
下宜降。今痰饮在胸膈之间，是痰在上焦也。不可用消痰，降痰之法，必当用吐药吐之。惟
是吐痰必伤其气，毋论大吐之后，使脏腑反复，多伤胃气。而多食酸味之人，则肝木必旺，
而恣肆其横逆之势，以伤中州之土矣。土伤则胃气更损，虽久积之痰顿失，新长之痰安保其
不再聚乎。治法于吐中而仍行其补胃、平肝之法，使痰去而正又不亏之为得也。（症伤
于酸，必用吐法以开之也，乃吐不伤经，尤善用吐也。
方用∶
参芦（一两） 瓜蒂（七枚） 白芍（一两） 白芥子（一两） 竹沥（二合）
水煎服。一剂必大吐，尽去其痰，其痛如失。然后用二陈汤调理，不再痛。
前方名为倒痰汤，用参芦以扶胃土，用白芍以平肝木，用白芥子、竹沥共入于瓜蒂之中
，吐痰即用消痰之药，使余痰尽化，旧痰去而新痰不生，得治痰之益，又绝其伤气之忧也。
此症用蒌苏饮亦佳。
栝蒌（三钱） 甘草（一钱） 半夏（三钱） 苏叶（三钱） 竹沥（一合） 陈皮（一钱）
水煎服。
人有偶食难化之物，忽然动惊，因而饮食减少，形体憔悴，面色黄瘦，颠寒作热，数载
不愈，人以为劳瘵之症也，谁知痰裹其食而不化乎。夫伤食之病，未有手按之而不痛者，况
痰裹其食，其痛尤甚，何以经岁、经年而人未知也。且食至岁月之久，宜当消化，何久留在
腹乎。不知食因惊而留于腹者，食存于两胁之旁，外有肋骨护之，手按痛处不能及也。食因
Vomiting therapy can be used at the initial stage of phlegm syndromes, such as using Gualti San (Melon Seed Powder) to induce vomiting and expel phlegm. However, if nasal congestion and coughing occur, with yellow and turbid sputum being expectorated, this condition cannot be compared to severe fullness and excess patterns; why resort to vomiting therapy? Moreover, if vomiting is inappropriate yet forced, there will inevitably be concerns about damaging Stomach Qi (Stomach Energy). Damage to Stomach Qi leads to damage in Lung Qi. If both the Lung and Stomach are injured, although old pathogens may be removed, new phlegm will regenerate. If one vomiting does not stop, followed by repeated vomiting, it will eventually transform into an incurable syndrome. Therefore, regardless of whether the patient is deficient or strong, vomiting should not be used lightly. After vomiting, strict adherence to dietary and lifestyle restrictions is necessary because the Qi of the Five Zang Organs fluctuates repeatedly and is difficult to restore; violating these restrictions causes various complications to arise like swarms of bees. Furthermore, phlegm caused by obstruction of Lung pathogens can also be easily dispersed through exterior-releasing methods. This is because Lung Qi is obstructed by Wind pathogens, not by phlegm itself. Once the pathogen is dispersed, Lung Qi naturally flows freely, and phlegm transforms spontaneously. The "Kingly Way" (gentle treatment) is inherently mild, whereas vomiting belongs to the "Hegemonic Way" (harsh treatment). Harsh treatments can be used occasionally but not routinely. One must not believe that vomiting is superior to exterior-dispersing methods and thus overuse vomiting formulas.
Use Santan Tang (Phlegm-Dispersing Decoction):
Jiegeng (Platycodonis Radix), 3 qian; Zisu (Perillae Folium), 2 qian; Huangqin (Scutellariae Radix), 1 qian; Maidong (Ophiopogonis Tuber), 5 qian; Banxia (Pinelliae Rhizoma Preparatum), 2 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 1 qian; Chenpi (Citri Reticulatae Pericarpium), 1 qian; Fuling (Poria), 3 qian.
Decoct in water and take orally. Nasal congestion resolves after one dose; cough stops after two doses; turbid phlegm dissipates after three doses; complete recovery occurs after four doses.
Although named "Phlegm-Dispersing," this formula actually disperses pathogens from the Lung.
This syndrome is also effectively treated with Erzi Tang (Two Purples Decoction).
Zisuye (Perillae Folium), Ziwan (Astagi Radix), each 1 qian; Jiegeng (Platycodonis Radix), 2 qian; Gancao (Glycyrrhizae Radix et Rhizoma); Zhike (Aurantii Fructus Immaturus); Huangqin (Scutellariae Radix), each 1 qian; Tianhuafen (Trichosanthis Radix), 3 qian.
Decoct in water and take orally.
Some individuals have Cold invading the Stomach, condensing into Cold Phlegm, causing daily vomiting. People assume the Cold Phlegm resides in the Stomach, unaware that it stems from Deficiency of Stomach Qi, where Cold condenses to form phlegm. Generally, when Stomach Qi is robust, ingested food and water transform into Essence, producing no phlegm. Only when Stomach Qi is deficient, capable of digesting grain but failing to process fluids, do fluids accumulate and transform into phlegm. However, Stomach deficiency implies a decline in Fire energy. When Fire is prosperous, Earth is prosperous; when Fire declines, Earth declines. Declining Earth fails to control Water, leading to transformation into phlegm rather than Essence. If internal Stomach Earth is cold, water turns to phlegm; how much more so when external Cold invades the Stomach? The combination of internal and external Cold naturally increases salivary phlegm daily. Unable to descend and transform, it surges upward, causing vomiting. Can dispelling Cold be delayed? To dispel Cold from Stomach Earth, one must tonify the prosperity of Heart Fire. When Heart Fire is strong, Earth becomes firm; what phlegm would not then transform?
Use Liujunzi Tang (Six Gentlemen Decoction) with modifications:
Renshen (Ginseng Radix et Rhizoma), 3 qian; Baizhu (Atractylodis Macrocephalae Rhizoma), 5 qian; Fuling (Poria), 3 qian; Chenpi (Citri Reticulatae Pericarpium), 1 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 3 fen; Banxia (Pinelliae Rhizoma Preparatum), 1 qian; Rougui (Cinnamomi Cortex), 2 qian.
Decoct in water and take orally.
Liujunzi Tang is originally a sacred medicine for tonifying the Spleen and Stomach. Treating the Spleen for Stomach disease works because the Spleen and Stomach are interior-exterior partners; a healthy Spleen strengthens the Stomach further. Rougui (Cinnamon Bark) tonifies Heart Fire above and Kidney Fire below. Prosperous Heart Fire warms the Stomach; prosperous Kidney Fire heats the Spleen. With both Stomach and Spleen warm, how could Cold Phlegm fail to vanish instantly?
This syndrome is also effectively treated with Jiawei Shen Zhu Ling Fu Tang (Modified Ginseng, Atractylodes, Poria, and Aconite Decoction).
Renshen (Ginseng Radix et Rhizoma), 1 qian; Baizhu (Atractylodis Macrocephalae Rhizoma), 3 qian; Fuling (Poria), 3 qian; Fuzi (Aconiti Lateralis Radix Preparata), 2 fen; Shenqu (Massa Medicata Fermentata), 1 qian; Maiya (Hordei Fructus Germinatus), 1 qian; Baijiezi (Sinapis Semen), 3 qian.
Decoct in water and take orally.
Some individuals have Heat entering the Stomach, where Fire stagnation forms phlegm. The sputum is yellow, foul, and extremely turbid. People attribute this to Hot Phlegm, unaware that it results from unextinguished Stomach Fire. The Stomach belongs to Earth; excessive Stomach Fire arises from the weakness of Stomach Earth. When Stomach Earth is weak and external Heat attacks, it seems compatible with the Stomach, yet why does it transform into phlegm? Since Stomach Earth is deficient, ingested food and fluids cannot generate Jin-Ye (Body Fluids) to moisten the Earth, causing the Earth Qi to become too dry. It desperately seeks external moisture to rescue itself. Excess water and dominant Fire fail to interact harmoniously; Stomach Earth becomes depressed and unable to extend, while Stomach Fire knots together without releasing. How can phlegm dissolve? It inevitably turns yellow, foul, and turbid.
Therefore, treatment need not focus on the phlegm directly. Tonify the deficiency of Stomach Qi and add a small amount of herbs that disperse Fire and relieve stagnation. Once Stomach Earth regains strength, eliminating phlegm becomes easier.
Use Shutu Tang (Soil-Loosening Decoction):
Baizhu (Atractylodis Macrocephalae Rhizoma), 3 qian; Fuling (Poria), 5 qian; Genge (Puerariae Radix), 5 fen; Renshen (Ginseng Radix et Rhizoma), 1 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 3 fen; Chenpi (Citri Reticulatae Pericarpium), 5 fen; Tianhuafen (Trichosanthis Radix), 3 qian; Zhuye (Bambusae Folium), 30 leaves; Ganju (Chrysanthemi Flos), 2 qian; Chaihu (Bupleuri Radix), 5 fen.
Decoct in water and take orally. Stomach depression resolves after one dose; Stomach Fire disperses after two doses; Stomach phlegm eliminates after three doses; complete recovery after four doses.
This formula emphasizes tonifying the Stomach while lightly clearing Fire, as stagnant Fire-phlegm is rarely excessively vigorous. Thus, tonifying the Stomach allows Fire to scatter, and scattering Fire resolves stagnation. Moreover, the formula contains Gegen (Puerariae Radix) and Chaihu (Bupleuri Radix) to resolve depression. Once depression opens, phlegm clears—a inevitable outcome.
This syndrome can also use Xuanshi Huafen San (Xuan Shen and Trichosanthes Powder):
Shigao (Gypsum Fibrosum), 2 qian; Baizhu (Atractylodis Macrocephalae Rhizoma), 3 qian; Fuling (Poria), 5 qian; Tianhuafen (Trichosanthis Radix); Xuanshen (Scrophulariae Radix), each 3 qian.
Decoct in water and take orally.
Some individuals contract dampness from rain/dew or from walls/earth houses, causing Dampness to transform into Phlegm, resulting in Phlegm-Fluid retention. Symptoms include soreness and pain in limbs/joints, back pain, and palpitations below the umbilicus. People assume this is Damp-Phlegm disease, unaware that it is Spleen Dampness aiding Dampness. The Spleen detests Dampness most; it requires Kidney Fire to dry it. Only then can muddy earth become fertile soil. When water enters the Spleen, Jing-Qi (Essence-Qi) scatters without residual harm. However, if Kidney Fire is weak and fails to generate Spleen Earth, Spleen Earth becomes increasingly damp. Damp Earth easily forms phlegm. Combined with environmental water vapor, mutual induction occurs: Damp adds to Damp, Phlegm adds to Phlegm. Treatment involves tonifying Kidney Fire to generate Earth. Herbs that tonify Fire should be used within Spleen-tonifying formulas to prevent Fire from flaring excessively, ensuring Earth remains healthy and compliant.
Use Wuling San (Five-Ingredient Powder with Poria):
Baizhu (Atractylodis Macrocephalae Rhizoma), 1 liang; Zhuling (Polyporus), 3 qian; Zexie (Alismatis Rhizoma), 2 qian; Fuling (Poria), 1 liang; Rougui (Cinnamomi Cortex), 2 qian; Banxia (Pinelliae Rhizoma Preparatum), 3 qian.
Decoct in water and take orally. Palpitations below the umbilicus cease after one dose; limb/back pain stops after two doses; Phlegm-Fluids fully eliminate after three doses; complete recovery after four doses.
Wuling San is a divine agent for promoting urination. Rougui (Cinnamon Bark) warms Mingmen Fire (Gate of Life Fire) and guides Damp-Phlegm to transform into water, directing it toward the Bladder for excretion. To prevent new phlegm from forming after old phlegm dissolves, Banxia (Pinelliae Rhizoma) is added to eliminate it, assisting Fuling and Baizhu in awakening the Spleen, thereby achieving the function of strengthening Earth. Earth is born from Fire; Fire prospers within Earth. This formula ensures harmony between Fire and Earth, tonifying both Spleen and Kidney—this is the merit of Wuling San.
This syndrome is also effectively treated with Zhixian Tang (Saliva-Restraining Decoction).
Fuling (Poria); Yiren (Coicis Semen); Baizhu (Atractylodis Macrocephalae Rhizoma); Shanyao (Dioscoreae Rhizoma), each 5 qian; Rougui (Cinnamomi Cortex), 1 qian; Banxia (Pinelliae Rhizoma Preparatum), 2 qian.
Decoct in water and take orally.
Some individuals suffer from Yin Deficiency and emaciation, with Lung Qi fatigue, throat obstruction, dryness, expectoration, and coughing. This is Dryness of Lung Qi. Lung Dryness does not occur overnight; Summer Heat injury in summer leads to Autumn Dryness disease. The Lung belongs to Metal, which fears Fire most. In blazing Summer, Lung Metal cannot withstand the controlling force of Fire. Although Metal fears Fire control and tends toward dryness, why does dryness manifest only after Fire recedes and Metal strengthens? Unknown is that when Metal fears Fire punishment, it still expels Lung fluids to combat Fire heat. Once the Fire season passes, Metal feels no fear, revealing its deficient state. It struggles to support Lung Qi, inevitably seeking external water to quench thirst. However, external water enters the Stomach, not the Lung. With Lung Qi already dry and unable to self-nourish, it cannot descend to generate Kidney Water. Seeking resources from the Kidney, the Kidney’s water is insufficient for Lung needs. Lung Qi returns halfway, unwilling to enter the Kidney palace. Seeing Lung Dryness, the Kidney offers its depleted water to assist. This depleted water contains Fire; the Lung dares not accept it, transforming Jin-Ye (Body Fluids) into Phlegm. The Lung did not intend for this phlegm to rise, but due to Upper Jiao Fire dominance and Lung fluid depletion, it relies on phlegm to temporarily relieve throat dryness, causing expectoration and rising phlegm. Once phlegm rises, Upper Jiao Fire clashes with it, generating cough.
Use Runzao Yin (Moistening-Dryness Drink):
Maidong (Ophiopogonis Tuber), 1 liang; Shudi (Rehmanniae Radix Preparata), 1 liang; Suzi (Perillae Fructus), 1 qian; Baijiezi (Sinapis Semen), 2 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 1 qian; Jiegeng (Platycodonis Radix), 3 qian; Tiandong (Asparagi Radix), 3 qian; Shanzhuyu (Corni Fructus), 5 qian; Beiweizi (Schisandrae Chinensis Fructus), 5 fen; Renshen (Ginseng Radix et Rhizoma), 1 qian.
Decoct in water and take orally. Lungs moistened after two doses; Kidneys moistened after four doses; complete recovery after ten doses.
This formula uses Dongtong (Tianshidong and Maidong) to moisten the Lung, and Shudi (Prepared Rehmannia Root) plus Shanzhuyu (Cornelian Cherry Fruit) to tonify the Kidney. Since Lung and Kidney are connected, adding Renshen (Ginseng) and Wuweizi (Schisandra) boosts Qi; abundant Qi facilitates fluid generation. To prevent excessive Kidney tonification from failing to benefit the Lung, lifting herbs are added to prioritize Lung nourishment. Concerned that Renshen might aid dryness, Suzi (Perilla Fruit) and Gancao (Licorice) are included to harmonize the Upper Jiao, working with Baijiezi (Mustard Seed) to eliminate phlegm in the diaphragm without igniting Fire or increasing dryness, thus preventing phlegm-cough complications.
This syndrome can also be treated with Rugao Tang (Moisten-Wilted Grass Decoction).
Shudi (Rehmanniae Radix Preparata); Maidong (Ophiopogonis Tuber); Weirui (Polygonati Odorati Rhizoma), each 1 liang; Gancao (Glycyrrhizae Radix et Rhizoma), 5 fen; Baihe (Lilii Bulbus), 5 qian; Beimu (Fritillariae Cirrhosae Bulbus), 1 qian.
Decoct in water and take orally.
In children, Phlegm-Qi obstruction blocks orifices and channels, causing cold extremities resembling Wind syndromes. People diagnose Man Pi Feng (Slow Spleen Wind), unaware it is Spleen Deficiency with abundant Phlegm. Children rely primarily on Spleen health; if Spleen Earth is weak, ingested food/water transforms entirely into phlegm. Abundant Phlegm-Qi creates phlegm knots throughout meridians, blocking orifices and preventing Qi expansion. The Spleen governs the four limbs; hands and feet belong to the Spleen. If Spleen Qi cannot expand, how can it move the limbs? This causes cold extremities, not external Wind invasion. Wind nature is dynamic and rapid; true Wind invasion brings violent storms, not sluggishness. Regrettably, predecessors coined terms like "Slow Convulsion Wind" and created remedies using Niuhuang (Calculus Bovis), Xijiao (Rhinocerotis Cornu), snakes, and scorpions, killing children carelessly—a profound pity. Early use of Spleen-strengthening agents with minor Phlegm-resolving adjuncts could save every child.
Use Jiantu Kai Xian San (Earth-Strengthening Saliva-Opening Powder):
Renshen (Ginseng Radix et Rhizoma), 5 fen; Fuling (Poria), 2 qian; Chenpi (Citri Reticulatae Pericarpium), 2 fen; Yiren (Coicis Semen), 2 qian; Jiang (Zingiberis Rhizoma), 2 fen; Sharen (Amomi Fructus), 1 seed; Baizhu (Atractylodis Macrocephalae Rhizoma), 2 qian; Tianhuafen (Trichosanthis Radix).
Decoct in water and take orally. Wind settles after one dose; phlegm eliminates after two doses; complete recovery after three doses.
This formula strengthens Earth to eliminate phlegm, comparable to Liujunzi Tang (Six Gentlemen Decoction). However, Liujunzi Tang uses Banxia (Pinelliae Rhizoma) to eliminate phlegm, which may consume Qi. This formula specifically drains Spleen Dampness, promotes Qi circulation, and warms the Middle, surpassing Liujunzi Tang. If consistently applied to pediatric phlegm, many more children could be cured.
This syndrome is also well-treated by Jianyun Tang (Strengthening-Transportation Decoction).
Renshen (Ginseng Radix et Rhizoma), 1 qian; Fuling (Poria), 3 qian; Gancao (Glycyrrhizae Radix et Rhizoma); Zhike (Aurantii Fructus Immaturus); Zuye (Perillae Folium); Banxia (Pinelliae Rhizoma Preparatum), each 3 fen; Yizhiren (Alpiniae Oxyphyllae Fructus), 3 seeds; Baidoukou (Amomi Fructus Rotundus), 1 seed.
Decoct in water and take orally.
Elderly or deficient individuals often have Old Phlegm forming sticky masses stuck in the throat, impossible to swallow or spit out. People attribute this to unclear Qi, unaware it stems from severe Liver Qi stagnation. Such phlegm appears yellow and foul, residing above the diaphragm. Eliminating this phlegm requires soothing Liver Wood Qi; however, merely soothing Qi without significantly tonifying Liver Blood fails to remove rib-side dryness or dissolve diaphragmatic phlegm. Liver Blood is nourished by Kidney Water; tonifying the Liver requires tonifying the Kidney while simultaneously resolving phlegm.
Use Runzao Potan Tang (Moisten-Dryness Break-Phlegm Decoction):
Baishao (Paeoniae Radix Alba), 1 liang; Xiangfu (Cyperi Rhizoma), 1 qian; Qingdai (Indigo Naturalis), 5 fen; Tianhuafen (Trichosanthis Radix), 2 qian; Baijiezi (Sinapis Semen), 2 qian; Xuanshen (Scrophulariae Radix), 5 qian; Fuling (Poria), 3 qian; Shanyao (Dioscoreae Rhizoma), 3 qian.
Decoct in water and take orally. Phlegm becomes easy to expectorate after one dose; easy to swallow after two doses. Continuous use for four doses opens phlegm masses; another four doses eliminate all Old Phlegm.
This formula treats both Liver and Kidney. Soothed Liver Qi and nourished Liver Blood prevent Liver Fire from knotting in the chest, naturally stopping Old Phlegm stagnation in the hypochondrium. Old Phlegm is hardest to resolve quickly; this formula requires prolonged use, though immediate results should not be expected.
This syndrome is also effectively treated by Kuanmo Tang (Diaphragm-Widening Decoction).
Baishao (Paeoniae Radix Alba), 3 qian; Zhike (Aurantii Fructus Immaturus), 3 fen; Gancao (Glycyrrhizae Radix et Rhizoma), 5 fen; Shenqu (Massa Medicata Fermentata), 3 qian; Baijiezi (Sinapis Semen), 3 qian; Chao Zhizi (Gardeniae Fructus), 1 qian; Baizhu (Atractylodis Macrocephalae Rhizoma), 2 qian; Yujin (Curcumae Longae Radix), 1 qian.
Decoct in water and take orally.
When phlegm accumulates above the diaphragm causing severe fullness and excess, blocking Qi extension, and resisting downward expulsion, people assume pathology is in the Upper Jiao, unaware it originates from the Lower/Middle. Upper diseases are often treated via lower approaches. Why did ancients use vomiting successfully? This was a temporary expedient, not a routine method. Followers of Zhang Hezi (Zhang Zihé) use emetics for any fullness/excess pattern, assuming vomiting is unnecessary. For fullness/excess, purgation heals naturally. However, "purging" here means removing pathogens from the Stomach, not the Intestines. Phlegm-fluids surging to the diaphragm stem from robust Stomach Qi, rooted in excessive Stomach Fire. Clearing excess Stomach Fire reveals underlying Stomach Qi deficiency. Without Stomach fullness/excess signs, diaphragmatic fullness/excess cannot persist. Phlegm-Qi vanishes instantly, falling into the Stomach. Why force upward vomiting, damaging Stomach Qi and disrupting Five Zang Qi?
Use Jiangtan Shuge Tang (Phlegm-Descending Diaphragm-Relaxing Decoction):
Shigao (Gypsum Fibrosum), 3 qian; Tianhuafen (Trichosanthis Radix), 3 qian; Houpo (Magnoliae Officinalis Cortex), 1 qian; Zhike (Aurantii Fructus Immaturus), 1 qian; Banxia (Pinelliae Rhizoma Preparatum), 1 qian; Fuling (Poria), 5 qian; Yizhiren (Alpiniae Oxyphyllae Fructus), 5 fen.
Decoct in water and take orally. Fullness/ease stabilizes after one dose; completely resolved after two doses, with phlegm descending.
This formula clears Stomach Fire and descends phlegm, achieving remarkable effects. Though potent and sharp, it far exceeds vomiting therapy. Those wishing to vomit should try this first; if ineffective, then use emetics. This preserves life infinitely. Do not mock this approach as mediocre or timid.
This syndrome can also use Shenge Tang (Diaphragm-Stretching Decoction).
Gualou (Trichosanthis Fructus), 3 qian; Banxia (Pinelliae Rhizoma Preparatum), 3 qian; Zhike (Aurantii Fructus Immaturus), 1 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 1 qian.
Decoct in water and take orally.
When lumps of varying sizes appear all over the body, people assume they are Phlegm masses, unaware they result from stagnant Qi causing phlegm to knot and not disperse. Strange diseases often arise from phlegm; body lumps are among them. Phlegm formation and lump knotting have causes: Phlegm originates from Dampness; lumps form from Fire. Without Dampness, no phlegm; without phlegm, no lumps. Although phlegm arises from Dampness and lumps from Fire, if Qi is robust, Dampness has nowhere to stay; if Dampness stays not, Fire has no basis to rise. Thus, eliminating lumps need not target Fire directly but focuses on resolving phlegm, and ultimately on urgently tonifying Qi. Robust Qi eliminates phlegm; eliminated phlegm eliminates lumps.
Use Erchen Tang (Two-Aged Decoction) with modifications:
Renshen (Ginseng Radix et Rhizoma), 3 qian; Fuling (Poria), 3 qian; Baizhu (Atractylodis Macrocephalae Rhizoma), 5 qian; Chenpi (Citri Reticulatae Pericarpium), 2 qian; Banxia (Pinelliae Rhizoma Preparatum), 3 qian; Baijiezi (Sinapis Semen), 3 qian; Jiang Chao Huanglian (Coptidis Rhizoma stir-fried with Ginger), 5 fen.
Decoct in water and take orally. Half eliminated after ten doses; fully eliminated after thirty doses.
This formula is the sacred medicine for resolving phlegm and the divine agent for eliminating lumps. Since lumps form from phlegm, resolving phlegm eliminates lumps.
This syndrome can also use Fanshi Xiaolei San (Alum Lump-Eliminating Powder):
Zexie (Alismatis Rhizoma); Banxia (Pinelliae Rhizoma Preparatum), each 3 qian; Fushen (Poria cum Radix); Baizhu (Atractylodis Macrocephalae Rhizoma), each 5 qian; Yiren (Coicis Semen), 1 liang; Fuzi (Aconiti Lateralis Radix Preparata), 2 fen; Renshen (Ginseng Radix et Rhizoma), 2 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 5 fen; Bainfan (Alumen), 1 qian; Huanglian (Coptidis Rhizoma), 3 fen.
Decoct in water and take orally. Naturally eliminated after ten doses.
Individuals fond of sour foods, having eaten many green plums, develop Phlegm-Fluid disease. Daytime chest/diaphragm pain feels like knife stabbing; evening sees chest pain cease but knee joints ache severely. People assume Stomach Cold, unaware Phlegm-Fluid moves with Qi升降 (ascending/descending) to cause pain. Phlegm in the upper part requires vomiting; middle part requires resolving; lower part requires descending. Current Phlegm-Fluid in the chest/diaphragm is in the Upper Jiao. Resolving or descending methods are unsuitable; vomiting is mandatory. However, vomiting damages Qi, especially post-vomiting organ fluctuation and Stomach Qi loss. Sour food consumers have hyperactive Liver Wood, which aggressively attacks Central Earth (Spleen/Stomach). Earth injury worsens Stomach Qi damage. Even if accumulated phlegm vanishes, new phlegm may reaccumulate. Treatment should combine vomiting with Stomach tonification and Liver soothing, ensuring phlegm removal without righteous Qi deficit. (Sour-induced symptoms require vomiting to open pathways; this is vomiting without damaging meridians, demonstrating skillful use of emesis.)
Use Formula:
Shenlu (Ginseng Stem and Leaf), 1 liang; Guali (Melonis Fructus), 7 pieces; Baishao (Paeoniae Radix Alba), 1 liang; Baijiezi (Sinapis Semen), 1 liang; Zhuli (Bambusae Succus), 2 he.
Decoct in water and take orally. Profuse vomiting occurs after one dose, eliminating all phlegm and pain. Follow with Erchen Tang (Two-Aged Decoction) for regulation; pain will not recur.
The previous formula, Daotan Tang (Phlegm-Inverting Decoction), uses Shenlu (Ginseng Stem) to support Stomach Earth, Baishao (White Peony Root) to soothe Liver Wood, and Baijiezi (Mustard Seed) with Zhuli (Bamboo Sap) combined with Guali (Melon Seed) to induce vomiting. Using phlegm-resolving herbs during vomiting ensures residual phlegm dissolves, old phlegm leaves, and new phlegm does not form, gaining therapeutic benefits while avoiding Qi damage.
This syndrome is also well-treated by Lou Su Yin (Trichosanthes and Perilla Drink).
Gualou (Trichosanthis Fructus), 3 qian; Gancao (Glycyrrhizae Radix et Rhizoma), 1 qian; Banxia (Pinelliae Rhizoma Preparatum), 3 qian; Zuye (Perillae Folium), 3 qian; Zhuli (Bambusae Succus), 1 he; Chenpi (Citri Reticulatae Pericarpium), 1 qian.
Decoct in water and take orally.
Accidental ingestion of indigestible food causes sudden fright, reduced appetite, emaciation, sallow complexion, alternating chills and fever, persisting for years. People diagnose Lao Zhai (Consumption Disease), unaware Food is wrapped in Phlegm and undigested. Food injury always causes tenderness on pressure; Phlegm-wrapped food causes even greater pain. Why remain unnoticed for years? Food should digest over time; why linger in the abdomen? Unbeknownst to many, food trapped by fright lodges beside the hypochondrium, protected by ribs, making palpation ineffective. Food trapped