Library

Initially, phlegm arises due to deficiency; subsequently, phlegm accumulation transforms into excess. Tonification will make the phlegm more entrenched, while purgation will fail to support the healthy Qi. Only by incorporating purgation within tonification can the healthy Qi be restored and the proliferation of phlegm prevented; or by incorporating tonification within purgation, the phlegm can be eliminated without damaging the healthy Qi. This depends on distinguishing the proportion of deficiency and excess to apply appropriate treatment.

Jupi Tang (Tangerine Peel Decoction)
Banxia (Prepared Pinellia Rhizome, five liang) Fuling (Poria) Chenpi (Aged Tangerine Peel, three liang each) Xixin (Asarum) Qingpi (Green Tangerine Peel) Jiegeng (Platycodon Root) Zhike (Bitter Orange Fruit) Gancao (Honey-fried Licorice Root, two liang each) Renshen (Ginseng Root) Xuanfuhua (Inula Flower, one liang each, calyx removed)
Crush all ingredients into a powder. Take three qian per dose, with five thick slices of Shengjiang (Fresh Ginger), decocted in water and taken orally. (From *Zhizhi Fang*)

Liujunzi Tang (Six Gentlemen Decoction)
Renshen (Ginseng Root) Baizhu (Atractylodes Macrocephala Rhizome) Fuling (Poria) Gancao (Licorice Root, halved dosage) Chenpi (Aged Tangerine Peel) Banxia (Pinellia Rhizome, one qian each)
Add two zhan of water and five slices of Shengjiang (Fresh Ginger). Decoct until one zhou remains, strain, and take at any time.

Phlegm is essentially water; its root lies in the Kidney. Phlegm is essentially body fluids; its root lies in the Spleen. In the case of the Kidney, it is Qi deficiency causing water overflow; in the case of the Spleen, it is Earth deficiency failing to transform dampness. Purgation will cause it to flourish further, while tonification will cause it to dissipate secretly. Unless one possesses sage-like wisdom, it is rare to understand the underlying principle.

Jisheng Shenqi Wan (Kidney Qi Pill from *Jisheng Fang*)
Sijunzi Tang (Four Gentlemen Decoction)
Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction)

Whenever phlegm-fluid retention stagnates above and below the chest and diaphragm, presenting as fullness, vomiting, or diarrhea, and persists for a long time or recurs after temporary relief, the method should be to warm. Since phlegm originates from the Spleen, warmth strengthens the Spleen; since phlegm is born from dampness, warmth facilitates its movement.

*Qianjin Fang* Banxia Tang (Pinellia Decoction): Treats cold-phlegm.
Baizhu (Atractylodes Macrocephala Rhizome, three liang) Banxia (Pinellia Rhizome, one sheng) Shengjiang (Fresh Ginger, eight liang) Fuling (Poria) Renshen (Ginseng Root) Guixin (Cinnamon Twig) Gancao (Honey-fried Licorice Root) Fuzi (Prepared Aconite Root)
Add eight sheng of water, boil down to three sheng, divide into three warm doses.

Wuzhuyu Tang (Evodia Decoction)
Wuzhuyu (Evodia Fruit) Renshen (Ginseng Root) Banxia (Pinellia Rhizome, ginger-processed) Guixin (Cinnamon Twig, two liang each) Fuling (Poria, two liang) Gancao (Licorice Root, one liang)
Decoct three qian with Shengjiang (Fresh Ginger) and Dazao (Jujube), take warm on an empty stomach, twice daily.

*Shengji Zonglu* states: Qi belongs to Yang. Those with insufficient Yang cannot guide and transform fluid retention, leading to aggregation into phlegm. This infiltrates the intestines and stomach, manifesting upwards as vomiting of sour fluid, and downwards as severe watery diarrhea with cold sensation in the middle jiao. If prolonged, it causes emaciation, shortness of breath with reliance on forced respiration, and impedes eating. Ancients treated phlegm-fluid retention mostly with warming herbs to harmonize.

Chenxiang Fuling Wan (Agarwood and Poria Pill): Warms the Spleen and Stomach, benefits the chest and diaphragm, and harmonizes Qi and Blood.
Chenxiang (Agarwood) Fuling (Poria) Zhibanxia (Prepared Pinellia Rhizome) Renshen (Ginseng Root) Dingxiang (Clove, two liang each) Gancao (Licorice Root) Chenpi (Aged Tangerine Peel, pith removed)
Grind into powder, mix with honey to form pills the size of paulownia seeds. Take twenty pills with ginger soup.

*Benshi Fang* Shenzhu Wan (Divine Efficacy Pill)
Maoshan Cangzhu (Rhizoma Atractylodis Lanatae from Maoshan, one jin, peeled and ground into powder) Shengzhima (Raw Sesame Seed, half liang, ground with two zhan of water, filtered for juice) Dazao (Jujube, fifteen pieces, boiled)
Mix the three ingredients thoroughly, pound in a mortar while hot to form pills the size of paulownia seeds, and dry. Swallow fifty pills with warm water on an empty stomach daily, gradually increasing to one hundred, then two hundred. Avoid peaches, plums, sparrows, and clams. Initially, there may be slight dryness in the chest and diaphragm; taking Shanzi San (Gardenia Powder) once resolves this dryness.

Xu Shuwei said: I have had two ailments throughout my life: one is bleeding from the lower organs, and the other is fluid retention in the diaphragm. The bleeding stops occasionally, but the fluid retention is constant. It originated from when I was young, sitting up late writing, leaning left over the desk, causing food to settle more on the left side. After midnight, when slightly tired, I drank two or three cups of wine. When lying down to sleep, I also slept on my left side. When my Qi and blood were vigorous, I felt nothing abnormal. However, after three to five years, I felt the wine flowing only down the left side with a sloshing sound, accompanied by hypochondriac pain and significantly reduced appetite. Every ten days or so, I would vomit several sheng of sour fluid. In summer, only the right side of my body sweated and remained moist, while the left diseased side was completely dry. I visited many famous doctors and sought overseas prescriptions, but few were effective. Occasionally, the medicine worked, but the condition relapsed after a month or so. Their tonifying methods used herbs like Tianxiong (Aconitum Lateralis Preparatum), Fuzi (Prepared Aconite Root), and Fanshi (Alumen); their draining methods used herbs like Qianniu (Morning Glory Seed), Daji (Euphorbia Root), and Gansui (Kansui Root). I tried them all. Later, I analyzed the condition and realized it had formed a "Pi Nang" (a type of mass/accumulation), like water accumulating in a depression. Water does not flow until the depression is filled; once filled, it flows. The clear part could flow, but the turbid part remained stagnant because there was no outlet below. Thus, after accumulating for five to seven days, I would vomit some out, feel slightly relieved, but relapse after a few days. The Spleen Earth dislikes dampness, and water flows to damp places. It is best to dry the Spleen to overcome dampness and fortify the Earth to fill the depression, so the disease would go away. Therefore, I discarded all other medicines and took only Cangzhu (Atractylodes Rhizome). After three months, the disease was cured. I continued taking it for several years thereafter, with no vomiting, a wide chest and diaphragm, and normal appetite. In summer, sweat covered my whole body and my body felt cool, and drinking water flowed normally downward. Previously, fluid infiltration affected the Liver, causing frequent dizziness and blurred vision; later, I could write small characters under a lamp, all due to the power of Cangzhu. I initially used Maoshan Cangzhu; after half a year, I used only those with extremely pungent and drying properties, peeled without soaking. They were very potent yet naturally did not cause dryness. Shanzi San uses only Shanzi (Gardenia Fruit), dried and ground into powder, taken with boiling water. Thus, one knows that prolonged sitting should not involve leaning to one side constantly; occasional movement is also a method of regulation.