（脉浮当吐。）
凡治痰，用利药过多，致脾气下虚，则痰反易生多。
湿痰用苍术。
老痰∶海石、半夏、栝蒌子、香附、五倍子。
热痰用青黛、黄连。
食积痰∶神曲、麦 、山楂子。
痰在肠胃间者，可下而愈。痰在经络中者，非吐不可出。吐法中就有发散之义也。
膈上之痰，必用吐之，泻亦不能去也。
气实痰热结在上者，则吐。吐难得出，或成块，或吐咯不出，气滞兼郁者，此则难治矣。
胶固者，必用吐之。
吐法兼用牙茶、齑水、姜汁、醋少许，栝蒌散少许，加防风、桔梗，皆升动其气，便吐也。
吐法∶用附子尖 桔梗芦 人参芦 瓜蒂 砒（不甚用） 藜芦 艾叶 末茶
上药，此皆自吐，不用手探。但药但汤，皆可吐。
吐法∶先以布搭膊勒腰，于不通风处行此法。
萝卜子半升擂和，以浆水一碗，滤去粗，入少油与蜜，旋至半温。服后，以鹅翎探吐。凡用鹅翎，须以
桐油浸，却以皂角水洗去肥，晒干用之。
又法∶用虾带壳半斤，入酱、葱、姜等料物煮汁。先吃虾，后饮汁，以翎勾引吐，必须紧勒肚腹。
二陈汤一身之痰都能管。如在下，加下引药；如在上，加上引药。
凡人身上中下有块者，多是痰也。问其平日好食何物，吐下后用药。
许学士用苍术治痰饮成窠囊一边，行极效。痰挟瘀血，遂成窠囊。
痰之清者属寒，用二陈汤之类。
内伤挟痰，必用人参、黄 、白术之属，多用姜汁传送。或用半夏之属。虚甚者，宜加竹沥。
痰热者多挟风，外证为多。
湿者多软，如身倦而重之类。热者清之；食积者必用攻之；兼气虚者，用补气药补之。
因火盛逆上者，治火为先。白术、黄芩、石膏之类。中气不足，则加人参、白术。痰之为物，随气升
降，无处不到。
脾虚者，清中气。二陈加白术之类，兼用提药。
中焦有痰与食积，胃气赖其所养，卒不便虚。若攻之尽，则虚矣。
眩晕嘈杂，乃火动其痰。用二陈汤加栀子芩连类。
噫气吞酸，此系食郁有热，火气上动。以黄芩为君，南星、半夏为臣，橘红佐之。热多者，加青黛。
痰在胁下，非白芥子不能达。
痰在皮里膜外者，非姜汁、竹沥不可达。
痰在膈间，使人颠狂健忘，宜用竹沥。风痰亦服竹沥，又能养血。痰在四肢，非竹沥不开。
痰结核在咽喉，燥不能出，入化痰药加软坚咸药。
杏仁 海石 桔梗 连翘 栝蒌仁
少佐朴硝，以姜汁、蜜、调丸。噙化之。
海粉即海石。热痰能降，湿痰能燥，结痰能软，顽痰能消。可入丸子、末子，不可入煎药。
黄芩治热痰，假以降其热也。
竹沥滑痰，非姜汁不能行经络也。
枳实泻痰，能冲墙壁。五倍子能治老痰。
小胃丹治膈上痰，热风痰，湿痰，肩膊诸痛，然能损胃气。食积痰实者，用之不宜多。
青礞石丸去湿痰，重在风化硝。
润下丸降痰最妙。
陈皮（半斤，去白，以水化盐半两，拌陈皮，令得所煮，候干，炒燥。一方，不去白） 甘草（一两，炙）
上为末，蒸饼丸，绿豆大。每服三十五丸，温水下。
油炒半夏，大治湿痰，又治喘，止心痛。粥丸。姜汤下三十丸。
痰方∶
黄芩（空心） 香附 半夏（姜制） 贝母 以上治湿痰。加栝蒌仁、青黛作丸子，治热痰。
中和丸治湿痰气热。
苍术 黄芩 香附 半夏 各等分，为末，粥丸。
燥湿痰方，亦治白浊因痰者。
南星（一两） 半夏（一两） 蛤粉（二两） 青黛（为衣）
上为末，神曲糊丸。
痰嗽方∶
黄芩（一两半，酒浸洗） 滑石（半两） 贝母（一两） 南星（一两） 风化硝（二钱半） 白芥子（半两，去
壳。）
上为末，汤浸，蒸饼为丸。
导痰汤∶
半夏（四两） 南星 橘皮 枳壳 赤茯苓（一两） 甘草（半两）
用生姜煎服之。
千缗汤
半夏（七枚泡制四片破之） 皂角（一寸二分去皮炙） 甘草（一寸炙） 生姜（如指大） 煎服之，治喘。
治痰方
南星 半夏 滑石 轻粉（各三钱） 巴豆（三十粒）
上用皂角仁浸浓汁，丸如梧桐子大。每服五十丸。
黄连化痰丸
黄连（一两） 陈皮（五钱） 吴茱萸（一钱，酒浸） 半夏（一两五钱）
上为末，入桃仁二十四个，研如泥，和匀，神曲糊丸，如绿豆大。每服百丸，姜汤送下。
消痰方
益元散（七钱） 吴茱萸（三钱）
治郁痰方
白僵蚕 杏仁 栝蒌 诃子 贝母
(When the pulse is floating, emesis should be employed.)
In the treatment of phlegm, excessive use of purgative or draining herbs can lead to deficiency and sinking of Spleen Qi, which paradoxically causes more phlegm to be generated.
For damp-phlegm, use *Cangzhu* (Atractylodis Rhizoma).
For old/phlegm: use *Haishi* (Pumix), *Banxia* (Pinelliae Rhizoma), *Gualouzi* (Trichosanthis Semen), *Xiangfu* (Cyperi Rhizoma), *Wubeizi* (Gallae Chinensis).
For heat-phlegm, use *Qingdai* (Indigo Naturalis), *Huanglian* (Coptidis Rhizoma).
For food-stagnation phlegm: use *Shenqu* (Massa Medicata Fermentata), *Mairen* (Hordei Fructus Germinatus), *Shanzhazhi* (Crataegi Fructus).
Phlegm located in the intestines and stomach can be cured by purgation. Phlegm located in the meridians and collaterals cannot be expelled except by emesis. The method of emesis inherently contains the principle of dispersing pathogenic factors.
Phlegm above the diaphragm must be treated with emesis; purgation alone cannot remove it.
When Qi is excess and phlegm-heat are knotted in the upper jiao, emesis should be used. If vomiting is difficult to induce, or if the phlegm comes out in clumps, or cannot be coughed up, and there is concurrent Qi stagnation and depression, this is difficult to treat.
For tenacious and fixed phlegm, emesis is mandatory.
Emesis methods can be combined with tooth tea, vinegar water, ginger juice, a little vinegar, a little *Gualou* powder, added with *Fangfeng* (Saposhnikoviae Radix) and *Jiegeng* (Platycodonis Radix); all these promote the ascending movement of Qi, thereby inducing vomiting.
Herbs for emesis: *Fuzi Jian* (Apex of Aconiti Lateralis Radix Preparata), *Jiegeng Lu* (Radix Platycodonis Caulis), *Renshen Lu* (Radix Ginseng Caulis), *Gua Di* (Cucumeris Fructus), Pi (Realgar - rarely used), *Lilu* (Veratri Radix), *Ai Ye* (Artemisiae Argyi Folium), powdered tea.
The above drugs naturally induce vomiting without the need for manual stimulation of the throat. Both powder and decoction forms can be used for emesis.
Procedure for emesis: First, bind the waist tightly with a cloth belt, and perform this method in a place free from drafts.
Half a sheng of radish seeds (*Luobozhong*) are ground and mixed, combined with one bowl of fermented grain water, filtered to remove dregs, then a small amount of oil and honey are added, and heated until lukewarm. After ingestion, the throat is stimulated with a goose feather to induce vomiting. When using a goose feather, it must first be soaked in tung oil, then washed with soapberry water to remove grease, dried, and then used.
Another method: Use half a jin of shrimp with shells, boiled with sauce, green onion, ginger, and other seasonings to extract the juice. Eat the shrimp first, then drink the juice, and use a feather to induce vomiting; the abdomen must be tied tightly.
*Erchen Tang* (Two-Aged Decoction) can manage phlegm throughout the entire body. If the phlegm is in the lower part, add descending guiding herbs; if the phlegm is in the upper part, add ascending guiding herbs.
Generally, lumps found on the surface, middle, or interior of the body are mostly due to phlegm. Inquire about the patient's dietary preferences, and after emesis or purgation, administer medication accordingly.
Xu Xueshi (Academician Xu Shuwei) used *Cangzhu* to treat phlegm-fluid retention forming "cocoons" (pockets of accumulation) on one side, achieving excellent results. When phlegm is accompanied by blood stasis, it forms such cocoons.
Clear and thin phlegm belongs to cold; use formulas like *Erchen Tang*.
For internal injury complicated by phlegm, herbs such as *Renshen* (Ginseng Radix et Rhizoma), *Huangqi* (Astragali Radix), and *Baizhu* (Atractylodis Macrocephalae Rhizoma) must be used, often transmitted via ginger juice. Or use herbs like *Banxia*. For severe deficiency, *Zhuli* (Bambusae Caulis in Taenia) should be added.
Heat-phlegm often accompanies wind, presenting with many external symptoms.
Damp-phlegm tends to be soft, manifesting as bodily fatigue and heaviness. Heat-phlegm is cleared; food-stagnation phlegm must be attacked/purged; if accompanied by Qi deficiency, tonifying Qi herbs are used to supplement.
When fire is excessive and rebels upward, treating the fire takes precedence. Use herbs like *Baizhu*, *Huangqin* (Scutellariae Radix), *Shigao* (Gypsum Fibrosum). If Middle Qi is insufficient, add *Renshen* and *Baizhu*. Phlegm, as a pathogen, ascends and descends with Qi, reaching everywhere.
For Spleen deficiency, clear the Middle Qi. Use *Erchen Tang* plus *Baizhu*, along with lifting herbs.
If there is phlegm and food stagnation in the Middle Jiao, Stomach Qi relies on them for nourishment and will not suddenly become deficient. However, if they are completely purged, deficiency will ensue.
Vertigo and gastric discomfort (zaochi) result from fire stirring up phlegm. Use *Erchen Tang* plus *Zhizi* (Gardeniae Fructus), *Huangqin*, *Huanglian*.
Belching and acid regurgitation are caused by food depression with heat, where fire qi moves upward. Use *Huangqin* as the sovereign herb, *Nanxing* (Arisaematis Rhizoma Preparatum) and *Banxia* as minister herbs, and *Juhong* (Citri Reticulatae Pericarpium Rubrum) as assistant/herald. If heat is predominant, add *Qingdai*.
Phlegm in the hypochondrium cannot reach its target without *Baijiezi* (Sinapis Semen).
Phlegm in the subcutaneous tissue and between membranes cannot reach its target without ginger juice and *Zhuli*.
Phlegm in the diaphragm region causes mania, madness, and forgetfulness; *Zhuli* is suitable. Wind-phlegm also benefits from *Zhuli*, which can also nourish blood. Phlegm in the four limbs cannot be opened without *Zhuli*.
Phlegm nodules in the throat that are dry and difficult to expectorate require the addition of salty herbs that soften hardness to the phlegm-resolving formula.
*Xingren* (Armeniacae Semen Amarum), *Haishi*, *Jiegeng*, *Lianqiao* (Forsythiae Flos), *Gualou Ren* (Trichosanthis Semen).
Add a small amount of *Pu Xiao* (Natrii Sulfas), mix with ginger juice and honey to form pills. Hold in the mouth to dissolve.
*Haifen* is *Haishi*. It can descend heat-phlegm, dry damp-phlegm, soften knotted-phlegm, and eliminate stubborn-phlegm. It can be used in pills and powders, but not in decoctions.
*Huangqin* treats heat-phlegm by descending heat.
*Zhuli* slides down phlegm; without ginger juice, it cannot travel through the meridians.
*Zhishi* (Aurantii Fructus Immaturus) drains phlegm with great force, capable of breaking through walls. *Wubeizi* treats old-phlegm.
*Xiaowei Dan* (Minor Stomach Pill) treats phlegm above the diaphragm, wind-heat phlegm, damp-phlegm, and pains in the shoulders and arms, but it damages Stomach Qi. It should not be used excessively for patients with food-stagnation and excess phlegm.
*Qingmengshi Wan* (Green Mengshi Pill) removes damp-phlegm, relying heavily on *Fenghua Xiao* (Natrii Sulfas Exsiccatus).
*Runxia Wan* (Moistening and Descending Pill) is excellent for descending phlegm.
*Chenpi* (half a jin, peel removed, mixed with half a liang of salt dissolved in water, allowed to absorb, boiled, dried, and stir-fried dry. Another prescription does not remove the peel) *Gancao* (one liang, roasted).
Grind into powder, make pills with steamed bread paste, size of mung beans. Take thirty-five pills per dose with warm water.
Oil-fried *Banxia* greatly treats damp-phlegm, also treats asthma, and stops heart pain. Make pills with congee. Take thirty pills with ginger soup.
Phlegm Formula:
*Huangqin* (take on an empty stomach) *Xiangfu* *Banxia* (prepared with ginger) *Beimu* (Fritillariae Bulbus). The above treat damp-phlegm. Add *Gualou Ren* and *Qingdai* to make pills for heat-phlegm.
*Zhonghe Wan* (Harmonizing Pill) treats damp-phlegm with Qi heat.
*Cangzhu*, *Huangqin*, *Xiangfu*, *Banxia* in equal parts, grind into powder, roll into pills with congee.
This drying-damp-phlegm formula also treats leukorrhea caused by phlegm.
*Nanxing* (one liang) *Banxia* (one liang) *Ge Fen* (Concha Meretricis et Cyclinae Pulvis) (two liang) *Qingdai* (used as coating).
Grind into powder, make pills with *Shenqu* paste.
Phlegm-Cough Formula:
*Huangqin* (one and a half liang, soaked and washed in wine) *Huashi* (Talcum) (half a liang) *Beimu* (one liang) *Nanxing* (one liang) *Fenghua Xiao* (two qian and a half) *Baijiezi* (half a liang, shell removed).
Grind into powder, soak in decoction, make pills with steamed bread.
*Daotan Tang* (Guiding Phlegm Decoction):
*Banxia* (four liang) *Nanxing* *Jupi* (Citri Reticulatae Pericarpium) *Zhiqiao* (Aurantii Fructus Immaturus) *Chifuling* (Poria cum Radix Pini Rubra) (one liang) *Gancao* (half a liang).
Decoct with fresh ginger and take.
*Qianmin Tang*:
*Banxia* (seven pieces, soaked, cut into four slices) *Zaojiao* (Gleditsiae Sinensis Spina) (one cun and two fen, skin removed, roasted) *Gancao* (one cun, roasted) *Shengjiang* (fresh ginger, size of a finger). Decoct and take, treats asthma.
Phlegm Treatment Formula:
*Nanxing* *Banxia* *Huashi* *Qingfen* (Calomelas) (three qian each) *Badou* (Crotonis Fructus) (thirty grains).
Soak *Zaoren* (Gleditsiae Sinensis Semen) in concentrated juice, make pills the size of paulownia seeds. Take fifty pills per dose.
*Huanglian Huatan Wan* (Coptis Phlegm-Resolving Pill):
*Huanglian* (one liang) *Chenpi* (five qian) *Wuzhuyu* (Evodiae Fructus) (one qian, soaked in wine) *Banxia* (one liang and five qian).
Grind into powder, add twenty-four *Taoren* (Persicae Semen), grind into paste, mix evenly, make pills with *Shenqu* paste, size of mung beans. Take one hundred pills per dose, delivered with ginger soup.
Phlegm-Dissolving Formula:
*Yiyuan San* (Seven qian) *Wuzhuyu* (three qian).
Depressed-Phlegm Treatment Formula:
*Baijiangcan* (Bombyx Batryticatus) *Xingren* *Gualou* *Hezi* (Terminalia Chebulae Fructus) *Beimu*.