人之有形，藉水饮以滋养。水之所化，凭气脉以宣流。盖三焦者，水谷之道路，气脉之
始也。若三焦调适，气脉平均，则能宣通水液，行入于经，化而为血，灌溉周身。设三焦气
涩，脉道不通，则水饮停滞，不得宣行。因之聚成痰饮，为病多端。古方论痰有四∶痰饮、
悬饮、溢饮、支饮是也。详见《金匮要略》。然又有留饮、癖饮、流饮、伏饮之异。其聚而
不散者曰留饮；僻处胁下者曰癖饮；流移不定者曰流饮∶沉伏于内者曰伏饮。又因酒而成癖
者曰酒癖。因寒多所致者曰冷痰。因热邪所伤者曰热痰。病虽多端，悉由三焦不调，气道否
涩而生病焉。是以气行即水行，气滞即水滞，故知饮之为病，在人最多。善治者，以宣通其
气脉为先，则饮无所凝滞。所以治痰饮者，当以温药和之。盖人之气血，得温则宣流也。及
结而成坚癖，则兼以消痰破饮之剂攻之。
痰之源不一，有因热而生者；有因气而生者；有因风而生者；有因惊而生者；有因积饮而生
者；有多食而生者；有因暑而生者；有伤冷物而成者；有因脾虚而成者。其为病也，惊痰则
成心痛癫疾。热痰则成烦躁懊 、头风烂眼。风痰则成瘫痪，大风眩晕，暗风闷乱。饮痰成
胁痛、四肢不举，每日呕吐。食痰成疟痢，口臭痞气。暑痰头昏眩晕，黄胆头疼。冷痰骨痹
，四肢不举，气刺痛。酒痰饮酒不消，但得酒次日又吐。脾虚生痰，食不美，反胃呕吐。气
痰生于脾胃，宜实脾燥湿。又随气而升，宜顺气为先，分导次之。又气升属火，顺气在
于降火。热痰则清之，湿痰则燥之，风痰则散之，郁痰
则开之，顽痰则软之，食痰则消之，在上者吐之，在中者下之。又中气虚者，宜固中气以运
痰，若攻之太过，则胃气虚而痰愈盛矣。（节斋）
The human form relies on fluids for nourishment. The transformation of water depends on Qi and meridians to circulate and flow. The Sanjiao (Triple Burner) is the pathway for food and fluids, and the origin of Qi and meridians. If the Sanjiao is harmonious and Qi and meridians are balanced, it can promote the circulation of body fluids, allowing them to enter the meridians, transform into blood, and irrigate the entire body. However, if the Qi of the Sanjiao becomes stagnant and the meridian pathways are obstructed, fluids will stagnate and fail to circulate. Consequently, phlegm and fluid retention (Tan Yin) accumulate, causing a variety of diseases. Ancient texts classify phlegm into four categories: Tan Yin (Phlegm-Fluid), Xuan Yin (Hanging Fluid), Yi Yin (Overflowing Fluid), and Zhi Yin (Supporting Fluid). These are detailed in *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet). Furthermore, there are distinctions such as Liu Yin (Retained Fluid), Pi Yin (Accumulated Fluid), Liu Yin (Flowing Fluid), and Fu Yin (Hidden Fluid). That which accumulates and does not disperse is called Liu Yin; that which resides eccentrically in the hypochondrium is called Pi Yin; that which moves without fixed location is called Liu Yin; and that which lies deep within is called Fu Yin. Additionally, accumulation caused by alcohol consumption is called Jiu Pi (Alcohol Accumulation). Caused by excessive cold, it is called Leng Tan (Cold Phlegm). Caused by injury from heat pathogens, it is called Re Tan (Heat Phlegm). Although the diseases are numerous, they all arise from the disharmony of the Sanjiao and the obstruction of Qi pathways. Therefore, when Qi moves, fluids move; when Qi stagnates, fluids stagnate. Thus, it is known that fluid retention is the most common pathology in humans. A skilled practitioner prioritizes promoting the circulation of Qi and meridians, so that fluids do not coagulate. Hence, to treat Tan Yin, one should use warm herbs to harmonize. This is because human Qi and Blood circulate freely when warmed. When condensation forms hard accumulations, one should additionally employ formulas that resolve phlegm and break down fluid retention.
The sources of phlegm are diverse: some arise from heat; some from Qi stagnation; some from wind; some from fright; some from retained fluids; some from overeating; some from summerheat; some from damage by cold substances; and some from Spleen deficiency. The diseases they cause include: Jing Tan (Fright Phlegm) leading to Heart pain and Dian Ji (Epilepsy); Re Tan (Heat Phlegm) leading to irritability, restlessness, Tou Feng (Head Wind), and ulcerated eyes; Feng Tan (Wind Phlegm) leading to paralysis, severe vertigo, and An Feng (Hidden Wind) confusion; Yin Tan (Fluid Phlegm) leading to hypochondriac pain, inability to move the limbs, and daily vomiting; Shi Tan (Food Phlegm) leading to malaria, dysentery, bad breath, and epigastric fullness; Shu Tan (Summerheat Phlegm) leading to dizziness, vertigo, Huang Dan (Jaundice), and headache; Leng Tan (Cold Phlegm) leading to bone bi (painful obstruction), inability to move the limbs, and stabbing Qi pain; Jiu Tan (Alcohol Phlegm) manifesting as indigestion after drinking and vomiting the next day; Spleen deficiency generating phlegm, manifesting as poor appetite and regurgitation/vomiting. Qi Tan (Qi Phlegm) originates in the Spleen and Stomach; it is appropriate to strengthen the Spleen and dry dampness. Since it rises with Qi, regulating Qi is primary, followed by draining and guiding. As rising Qi belongs to Fire, regulating Qi involves descending Fire. Heat Phlegm should be cleared; Damp Phlegm should be dried; Wind Phlegm should be dispersed; Depressed Phlegm should be opened; Stubborn Phlegm should be softened; Food Phlegm should be digested; Phlegm in the upper jiao should be expelled via emesis; Phlegm in the middle jiao should be purged. For those with deficient Middle Qi, it is appropriate to consolidate the Middle Qi to transport phlegm; if attacked too aggressively, Stomach Qi will become deficient, and phlegm will increase further. (Jie Zhai)