某（六一） 高年卫阳式微。寒邪外侵。引动饮邪。上逆咳嗽。形寒。仲景云。治饮不治咳。当以温药通和
之。（外寒引动宿饮上逆）
杏仁（三钱） 粗桂枝（一钱） 淡干姜（一钱半） 茯苓（三钱） 苡仁（三钱） 炙草（四分）
周 向有耳聋鸣响。是水亏木火蒙窍。冬阳不潜。亦属下元之虚。但今咳聋。喉下有痰音。胁痛。
卧着气冲。乃冲阳升而痰饮泛。脉浮。当此骤冷。恐有外寒引动内饮。议开太阳以肃上。
云茯苓 粗桂枝 干姜 五味（同姜打） 白芍 炙草
当午时服。
某（二一） 新凉外束。肺受寒冷。气馁不降。宿饮上干。而病发矣。法当暧护背心。宿病可却。
淡生姜粉 半夏 蛤蜊粉 茯苓 桂枝木 苡仁煎汤。
某（五十） 背寒咳逆。此属饮象。先当辛通饮邪。以降肺气。（饮上逆肺气不降）
鲜枇杷叶 杏仁 茯苓 橘红 生姜 半夏
某（五二） 脉右大弦。气喘。咳唾浊沫。不能着枕。喜饮汤水。遇寒病发。此属饮邪留于肺卫。如见咳。投
以清润。愈投愈剧矣。
葶苈子 山东大枣
徐（氏） 痰饮上吐。喘不得卧。乃温邪阻蔽肺气。气不下降。壅滞不能着右。议用宣通。开气分方法。
小青龙去细辛麻黄加苡仁白糖炒石膏。
沈（妪） 冬温。阳不潜伏。伏饮上泛。仲景云。脉沉属饮。面色鲜明为饮。饮家咳甚。当治其饮。不当治
咳。缘高年下焦根蒂已虚。因温暖气泄。不主收藏。饮邪上扰乘肺。肺气不降。一身之气交阻。
熏灼不休。络血上沸。经云。不得卧。卧则喘甚痹塞。乃肺气之逆乱也。若以见病图病。昧于色
诊候气。必致由咳变幻。腹肿胀满。渐不可挽。明眼医者。勿得忽为泛泛可也。兹就管见。略述
大意。议开太阳。以使饮浊下趋。仍无碍于冬温。从仲景小青龙越婢合法。
杏仁 茯苓 苡仁 炒半夏 桂枝木 石膏
白芍 炙草
方（氏） 冷暖失和。饮泛气逆。为浮肿喘咳。腹胀。卧则冲呛。议用越婢方。
石膏 杏仁 桂枝 炒半夏 茯苓 炙草
施（四七） 劳烦太甚胃阳受伤。外卫单薄。怯寒畏冷。食物少运痰饮内起。气阻浊凝胸背皆痛。辛甘
理阳已效。当此长夏。脾胃主令。崇其生气。体旺病可全好。（脾胃阳虚） 六君子加益智木香。
黄（三四） 身居沿海。氛瘴雾露客邪。侵入清阳。阳伤畏寒。久嗽病患不知却病护身。犹然用力承办。
里结饮邪。沉痼不却病。茯苓桂枝汤。
胡（四六） 脉沉而微。微则阳气不足。沉乃寒水阴凝。心痛怔忡。渐及两胁下坠。由阳衰不主营运。痰
饮聚气欲阻。致痛之来。其心震之谓。亦如波撼岳阳之义。议用外台茯苓饮合桂苓方。
人参 茯苓 半夏 枳实 桂枝 姜汁
白（二六） 脉沉小弦。为阴浊饮邪。 质阳不充旺。胸中清气不得舒展旷达。偶触入寒冷。或误进寒
物饮邪暴冷。凝结胸痞。当平日食物。忌用酒肉腥浊。便清阳流行。常服仲景苓桂术甘汤百
剂。若病来因冷。即服大顺散。
戴 病去。神已爽慧。但本脉带弦。平素有饮。为阳气不足之体。年纪渐多。防有风痹。此酒肉宜
少用。劳怒当深戒矣。议外台茯苓饮方。
人参 茯苓 广皮 枳实 半夏 金石斛
朱（四九） 烦劳太过。阳伤。痰饮日聚。阳跷脉空。寤不成寐卫阳失护。毛发自坠。乃日就其衰夺矣。
初进通饮浊以苏阳。接服外台茯苓饮。
吴（氏） 脉弦。背中冷。左偏微痛。食少欲呕。四肢牵强。此饮邪内结。议通阳气。
桂枝 茯苓 半夏 姜汁 炙草 大枣
某 眩晕恶心胸脘不爽。脉右弦左弱。面色红亮。此乃痰饮上泛。有厥中之事。
炒半夏 制蒺藜 橘红 煨天麻 石菖蒲 茯苓 姜汁
尤 口中味淡。是胃阳虚。夫浊饮下降痛缓。向有饮湿为患。若不急进温通理阳。浊饮必致复
聚。议大半夏汤法。
人参 半夏 茯苓 枳实 姜汁
张（二七） 酒客谷少中虚。常进疏散表药。外卫之阳亦伤。其痰饮发时。胸中痞塞。自述或饥遇冷病
来。其为阳气受病何疑。不必见痰搜逐。但护中焦脾胃。使阳气健运不息。阴浊痰涎。焉有窃
踞之理。（脾阳不运）
生于术 川桂枝 茯苓 淡姜渣 苡仁 泽泻 姜枣汤法丸。
王（三二） 脉沉为痰饮。是阳气不足。浊阴欲蔽。当以理脾为先。俾中阳默运。即仲景外饮治脾之意。
苓桂术甘加半夏陈皮水法丸。
某（三四） 舌白。咳逆不渴。非饮象而何。宜宣温药和之。
杏仁 苡仁 半夏 干姜 粗桂枝 茯苓 浓朴 炙草
某 食后脘中痞阻。按之漉漉有声。手麻胁痛。心烦。耳目昏眩。是气不流行。痰饮内聚中焦。用
桂苓丸。竹沥姜汁法丸。
又 桂枝 人参 茯苓 半夏 广皮 炙草
黄 味过甘腻。中气缓。不主运。延绵百天。聚气结饮。东垣云。病久发不焦。毛不落。不食不饥。乃
痰饮为患。饮属阴类。故不渴饮。仲景五饮互异。其要言不繁。当以温药和之。通阳方法。固无
容疑惑。大意外饮宜治脾。内饮治肾。是规矩准绳矣。议用苓桂术甘汤。
某 形体似乎壮实。阳气外泄。畏风怯冷。脾阳消乏。不司健运。水谷悍气。蒸变痰饮。隧道日壅。
上实下虚。仲景谓饮邪当以温药和之。苓桂术甘得效。从外饮立方。
人参 淡附子 生于术 枳实 茯苓 泽泻
荆沥姜汁法丸。
某 老人久嗽妨食。议以外饮治脾。苓桂术甘汤。
王（三四） 脉沉。背寒。心悸如坠。形盛气衰。渐有痰饮内聚。当温通补阳方复辟。斯饮浊自解。
（脾肾阳虚）
人参 淡附子 干姜 茯苓 生于术 生白芍
冯 阳虚则形寒汗出。痰饮痞聚。都是阴浊成形。乘阳气衰微。致上干窃踞。古人法则。必通其
阳以扫阴氛。但宿病无急攻方。况平素忧郁。气滞血涩。久耗之体。不敢纯刚。防劫液耳。
人参 熟附子 淡干姜 炒川椒 川桂枝 乌梅肉 生白芍 另真武丸（三两）
程（四八） 左脉沉静。右脉微弦。四旬清阳日薄。脾脏鼓运渐迟。加以烦心萦思。水谷悍气。蕴蒸痰饮。
仲景谓外饮当治脾阳。况中年常有遗泄之患。按脉非龙相之动搏。议固下益肾。转旋运
脾二方。分早晚服。早服从还少聚精七宝。参用丸方。
熟地 苁蓉 枸杞 五味 萸肉 茯神
山药 菟丝 覆盆 鱼胶 菖蒲 远志 龙骨 青盐
熟蜜同枣肉捣丸。早服五七钱。
茅术 于术 半夏 茯苓 广皮 生益智 白蒺 钩藤
姜枣汤泛丸。晚服三钱。开水下。
徐 清阳未展。浊阴欲踞。久延必结痰饮。议用真武丸二钱五分。人参一钱煎汤送。胃阳得震。
浊当退避矣。十服。
某 脉沉弦。饮泛呛咳。乃下虚无以制上。议早服肾气丸。摄纳下焦散失。以治水泛之饮。午服
外台茯苓饮。转旋中焦。使食不致酿痰。茯苓饮去术。
某（七一） 高年久嗽。脉象弦大。寤不成寐。乃阳气微漓。浊饮上泛。仲景云。进温药和之。（脾胃阳
虚饮逆咳呕）
杏仁（三钱） 茯苓（三钱） 川桂枝（一钱） 生姜（一钱） 苡仁（三钱） 炙草（四分） 大
枣（二枚）
顾（二四） 咳嗽数月。呕出涎沫。建中不应。已非营卫损伤。视其面色鲜明。饮食仍进。仿饮邪主治。
小半夏汤加桂枝杏仁姜汁。
李（三八） 劳伤阳气。内起痰饮。卧着气钝饮阻。其咳为多。痰出稍通势缓。且体常汗泄。非风寒表邪
不解。并不热渴。亦非火炎烁金。仲景云。饮家而咳。当治饮。不当治咳。
茯苓 桂枝木 苡仁 炙草 姜汁
陈 脉涩小。舌白不渴。身动呕痰。身如在舟车中。此寒热攻胃致伤。逆气痰饮互结。通补阳明
为正。白术甘草守中。未能去湿。宜缓商。
人参汁 半夏 枳实汁 茯苓 竹沥 姜汁
马（三四） 肌肉丰溢。脉来沉缓。始发右季胁痛。汤饮下咽。汨汨有声。吐痰涎头痛。此皆脾胃阳微。寒
湿滞聚。年方壮盛。不必介怀。温中佐其条达。运通为宜。
茅术 浓朴 半夏 茯苓 陈皮 淡姜渣 胡芦巴 炙草 姜汁泛丸
马（四十） 甘缓颇安。辛泄不受。此阳分气衰。将来饮邪日聚。然卧着咳多。清气失旋。先用苓桂术甘
汤。继进外台茯苓饮。
曹（四七） 中年阳气日薄。痰饮皆属阴浊。上乾清道。为冲逆咳嗽。仲景治法。外饮治脾。内饮治肾。分
晰甚明。昔年曾用桂苓泽术得效。是治支饮治法。数年真气更衰。古人谓饮邪当以温药和
之。须忌治嗽肺药。
先用小青龙去麻辛 接服外台茯苓饮。
程（五七） 昔肥今瘦为饮。仲景云。脉沉而弦。是为饮家。男子向老。下元先亏。气不收摄。则痰饮上泛。
饮与气涌。斯为咳矣。今医见嗽。辄以清肺降气消痰。久而不效。更与滋阴。不明痰饮皆属浊
阴之化。滋则堆砌助浊滞气。试述着枕咳呛一端。知身体卧着。上气不下。必下冲上逆。其痰
饮伏于至阴之界。肾脏络病无疑。形寒畏风。阳气微弱。而藩篱疏撤。仲景有要言不烦曰。
饮邪必用温药和之。更分外饮治脾。内饮治肾。不读圣经。焉知此理。（脾肾阳虚饮逆咳呕）
桂苓甘味汤 熟附都气加胡桃。
陈 痛久气乱。阳微。水谷不运。蕴酿聚湿。胃中之阳日薄。痰饮水湿。必倾囊上涌。而新进水谷
之气。与宿邪再聚复出。致永无痊期。仲景云。饮邪当以温药和之。又云不渴者。此为饮邪未
去故也。则知理阳通阳。诚有合于圣训。断断然矣。真武汤。
张（四一） 痰饮喘咳。肌肉麻痹。痞胀不堪纳谷。冬寒日甚。春暖日减。全是阳气已衰。阴浊逆干犯上。
肺药治嗽。无非辛泄滋润。盖辛散则耗阳。滋清助阴浊。浊阻在阳分。气不肃。为夜不得卧。小
青龙意。主乎由上以泄水寒。直从太阳之里以通膀胱。表中里药也。仲景谓饮邪当以温药
和之。驱阴邪以复阳。一定成法。
早肾气去萸换白芍。炒楂炭水法丸。晚外台茯苓饮。姜枣汤法丸。
程（六十） 肾虚不纳气。五液变痰上泛。冬藏失职。此病为甚。不可以肺咳消痰。常用八味丸。收纳阴
中之阳。临时撤饮。用仲景桂苓味甘汤。
孙 未交冬至。一阳来复。老人下虚。不主固纳。饮从下泛。气阻升降。而为喘嗽。发散寒凉苦泻
诸药。焉得中病。仲景云饮家而咳。当治饮。不当治咳。后贤每每以老人喘嗽。从脾肾温养定
论。是恪遵圣训也。
桂枝 茯苓 五味子 甘草汤代水。加淡姜枣。
李 肠红久病。不必攻治。今者气冲喘嗽。脘胁痞阻。是饮浊上僭。最宜究悉。
川桂枝（七分） 茯苓（三钱） 干姜（一钱） 五味子（同姜合捣一钱） 杏仁（一钱半） 白芍（一钱）
炙草（五分） 生左牡蛎（三钱）
吴（二七） 壮年下元久虚。收纳气泄。每交秋冬受冷。冷气深入。伏饮夹气上冲。为咳喘呕吐。疏肺降
气不效者。病在肾络中也。盖精血少壮不旺。难以搜逐。病根不去谓此。绝欲一年。小暑艾灸。
静养一百二十天可愈。附都气加车前。（肾阳虚饮逆喘咳呕）
潘（二九） 劳力喘甚。肩背恶寒。饮泛上逆。皆系下元虚损。莫以喘用泻肺等药。薛氏八味丸。
王 秋深天气收肃。背寒喘咳。饮浊上泛。缘体中阳气少振。不耐风露所致。最宜暖护背部。进
通阳以治饮。
茯苓 桂枝 半夏 姜汁 苡仁 炙草
又 早肾气丸 夜真武丸
陈 脉虚微。春阳地升浊阴上干。喘不得卧。治在少阴。
人参 淡熟附子 猪胆汁
又 照前方加淡干姜一钱半。
又 脉弦。暮夜浊阴冲逆。通阳得效。议真武法。以撤其饮。
人参 淡附子 生白芍 茯苓 姜汁
又 真武泄浊。脘通思食。能寐昨宵已有渴欲饮水之状。考金匮云。渴者饮邪欲去也。当健补
中阳。以资纳谷。
人参 生于术 淡附子 茯苓 泽泻
又 早服肾气丸四五钱。晚用大半夏汤。
人参 半夏 茯苓 姜汁
董 脉弦右濡。阳微恶寒。饮浊上干。咳吐涎沫。且食减胃衰。寒疝窃踞。阴浊见症。岂止一端。喻
嘉言谓浊阴上加于天。非离照当空。氛雾焉得退避。反以地黄五味阴药附和其阴。阴霾冲
逆肆虐。饮邪滔天莫制。议以仲景熟附配生姜法。扫群阴以驱饮邪。维阳气以立基本。况
尊年尤宜急护真阳为主。
人参 茯苓 熟附子 生姜汁 南枣
戴 十二月间。诊得阳微。浊饮上干为咳。不能卧。曾用小青龙汤。减去麻黄细辛。服后已得着
枕而卧。想更医接用不明治饮方法。交惊蛰阳气发泄。病势再炽。顷诊脉来濡弱无神。痰饮
咳逆未已。谅非前法可效。宗仲景真武汤法。以熟附配生姜。通阳逐饮立法。真武汤去白
术加人参。
计 不卧呛喘。泛起白沫。都是肾病。议通太阳膀胱。（肾阳虚膀胱气化不通降）
茯苓 川桂枝 淡干姜 五味子 白芍 炙草
顾 饮邪泛溢。喘嗽。督损头垂。身动喘甚。食则脘中痞闷。卧则喘咳不得息。肺主出气。肾主纳
某（61岁）：年事已高，卫阳衰弱。寒邪从外侵袭，引动体内停聚的饮邪，向上逆行导致咳嗽、怕冷。张仲景说：“治疗痰饮不应只治咳嗽，应当用温性药物来通调和中。”（外感寒邪引动宿疾之饮邪上逆）
杏仁（三钱） 粗桂枝（一钱） 淡干姜（一钱半） 茯苓（三钱） 苡仁（三钱） 炙甘草（四分）
周先生：向来有耳聋耳鸣的症状，这是肾水亏虚，肝木之火蒙蔽清窍。冬季阳气不能潜藏，也属于下元（肾）虚弱。但现在出现咳嗽、耳聋，喉间有痰音，胁肋疼痛，躺下时感觉气冲上逆，这是冲脉之气上升而痰饮泛滥。脉象浮。正值突然变冷，恐怕是外寒引动内饮。建议开通太阳经以肃降肺气。
云茯苓 粗桂枝 干姜 五味子（同生姜打碎） 白芍 炙甘草
中午服用。
某（21岁）：新受凉邪束表，肺受寒冷，肺气虚弱不能下降，宿饮上犯，于是发病。法度应当暖护背心部位，宿疾可除。
淡生姜粉 半夏 蛤蜊粉 茯苓 桂枝木 苡仁煎汤。
某（50岁）：背部发冷，咳嗽气逆，这属于饮邪的表现。先当用辛散通利之法祛除饮邪，以降肺气。（饮邪上逆导致肺气不降）
鲜枇杷叶 杏仁 茯苓 橘红 生姜 半夏
某（52岁）：脉右大且弦，气喘，咳吐浊沫，不能平卧，喜欢喝热汤水，遇寒病发。这属于饮邪留滞于肺卫。如果见到咳嗽，就投以清润之药，只会越治越重。
葶苈子 山东大枣
徐氏：痰饮上涌呕吐，喘促不能平卧，这是温邪阻蔽肺气，气不能下降，壅滞导致不能右侧卧。建议用宣通的方法，开通气分。
小青龙汤去掉细辛、麻黄，加苡仁、白糖炒石膏。
沈老太婆：冬温病，阳气不能潜伏，伏饮上泛。张仲景说：“脉沉属于饮，面色鲜明属于饮。患饮病的人咳嗽厉害，应当治饮，不应当治咳。”因为年高下焦根基已虚，因温暖之气外泄，不能主司收藏。饮邪上扰乘袭肺脏，肺气不降，一身之气交阻，熏灼不停，络血上涌沸腾。《内经》说：“不得卧，卧则喘甚痹塞”，这是肺气逆乱。如果见病治病，不明色诊候气，必然导致由咳嗽变幻为腹部肿胀满闷，逐渐无法挽回。明眼医者，不可轻视视为一般病症。此处根据浅见，略述大意。建议开通太阳经，使饮浊下行，同时不碍于冬温病。遵循张仲景小青龙汤与越婢汤合方的意思。
杏仁 茯苓 苡仁 炒半夏 桂枝木 石膏
白芍 炙甘草
方氏：冷暖失调，饮邪泛滥气逆，导致浮肿、喘咳、腹胀，躺下时气冲呛咳。建议用越婢汤。
石膏 杏仁 桂枝 炒半夏 茯苓 炙甘草
施某（47岁）：劳烦过度损伤胃阳，外卫单薄，怯寒畏冷，食物运化无力，痰饮内生，气机阻滞，浊气凝结，胸背皆痛。用辛甘理阳法已见效。正值长夏，脾胃主令，应崇奉其生气，身体强壮疾病可全愈。（脾胃阳虚）
六君子汤加益智仁、木香。
黄某（34岁）：身居沿海，瘴气雾露客邪侵入清阳之位，阳气受伤畏寒。久嗽病患不知保养护身，仍然用力操劳，导致里结饮邪，沉痼难愈。茯苓桂枝汤。
胡某（46岁）：脉沉而微，微则阳气不足，沉乃寒水阴凝。心痛怔忡，逐渐波及两胁下坠。由于阳衰不能主营运，痰饮聚气欲阻，导致疼痛发作，心中震动，正如“波撼岳阳楼”之意。建议用《外台秘要》茯苓饮合桂苓方。
人参 茯苓 半夏 枳实 桂枝 姜汁
白芍
白某（26岁）：脉沉小弦，为阴浊饮邪。体质阳气不充旺，胸中清气不得舒展旷达。偶然接触寒冷，或误进寒物，饮邪暴冷，凝结胸痞。平日饮食，忌用酒肉腥浊之物，以便清阳流行。常服张仲景苓桂术甘汤百剂。若病发因冷，即服大顺散。
戴某：病去后，神志已清爽聪慧。但本脉带弦，平素有饮，为阳气不足之体。年纪渐大，防有风痹。此酒肉宜少用，劳怒当深戒。建议用《外台秘要》茯苓饮方。
人参 茯苓 广皮 枳实 半夏 金石斛
朱某（49岁）：烦劳太过，阳气受伤，痰饮日聚，阳跷脉空虚，醒着不能入睡，卫阳失护，毛发自坠，这是日渐衰夺。初进通饮浊以苏醒阳气，接着服《外台秘要》茯苓饮。
吴氏：脉弦，背中冷，左偏微痛，食少欲呕，四肢牵强。这是饮邪内结。建议通阳气。
桂枝 茯苓 半夏 姜汁 炙草 大枣
某人：眩晕恶心，胸脘不爽，脉右弦左弱，面色红亮。这是痰饮上泛，有厥中的迹象。
炒半夏 制蒺藜 橘红 煨天麻 石菖蒲 茯苓 姜汁
尤某：口中味淡，是胃阳虚。浊饮下降则痛缓。向来有饮湿为患，若不急进温通理阳，浊饮必致复聚。建议大半夏汤法。
人参 半夏 茯苓 枳实 姜汁
张某（27岁）：酒客谷少中虚，常进疏散表药，外卫之阳亦伤。其痰饮发时，胸中痞塞。自述或饥遇冷病来，其为阳气受病何疑？不必见痰搜逐，但护中焦脾胃，使阳气健运不息，阴浊痰涎，焉有窃踞之理？（脾阳不运）
生于术 川桂枝 茯苓 淡姜渣 苡仁 泽泻 姜枣汤法丸。
王某（32岁）：脉沉为痰饮，是阳气不足，浊阴欲蔽。当以理脾为先，俾中阳默运，即张仲景外饮治脾之意。
苓桂术甘加半夏陈皮水法丸。
某（34岁）：舌白，咳逆不渴，不是饮邪是什么？宜宣温药和之。
杏仁 苡仁 半夏 干姜 粗桂枝 茯苓 浓朴 炙草
某人：食后脘中痞阻，按之漉漉有声，手麻胁痛，心烦，耳目昏眩。是气不流行，痰饮内聚中焦。用桂苓丸。竹沥姜汁法丸。
又方：桂枝 人参 茯苓 半夏 广皮 炙草
黄某：味过甘腻，中气缓，不主运，延绵百天，聚气结饮。李东垣说：“病久发不焦，毛不落，不食不饥”，乃痰饮为患。饮属阴类，故不渴饮。张仲景五饮互异，其要言不繁，当以温药和之，通阳方法，固无容疑惑。大意外饮宜治脾，内饮治肾，是规矩准绳矣。议用苓桂术甘汤。
某人：形体似乎壮实，阳气外泄，畏风怯冷。脾阳消乏，不司健运。水谷悍气，蒸变痰饮，隧道日壅。上实下虚。张仲景谓饮邪当以温药和之。苓桂术甘得效。从外饮立方。
人参 淡附子 生于术 枳实 茯苓 泽泻
荆沥姜汁法丸。
王某（34岁）：脉沉，背寒，心悸如坠，形盛气衰，渐有痰饮内聚。当温通补阳方复辟。斯饮浊自解。（脾肾阳虚）
人参 淡附子 干姜 茯苓 生于术 生白芍
冯某：阳虚则形寒汗出。痰饮痞聚，都是阴浊成形，乘阳气衰微，致上干窃踞。古人法则，必通其阳以扫阴氛。但宿病无急攻方，况平素忧郁，气滞血涩，久耗之体，不敢纯刚，防劫液耳。
人参 熟附子 淡干姜 炒川椒 川桂枝 乌梅肉 生白芍 另真武丸（三两）
程某（48岁）：左脉沉静，右脉微弦。四旬清阳日薄，脾脏鼓运渐迟。加以烦心萦思，水谷悍气，蕴蒸痰饮。张仲景谓外饮当治脾阳。况中年常有遗泄之患。按脉非龙相之动搏。议固下益肾，转旋运脾二方，分早晚服。早服从还少聚精七宝，参用丸方。
熟地 苁蓉 枸杞 五味 萸肉 茯神
山药 菟丝 覆盆 鱼胶 菖蒲 远志 龙骨 青盐
熟蜜同枣肉捣丸。早服五七钱。
茅术 于术 半夏 茯苓 广皮 生益智 白蒺 钩藤
姜枣汤泛丸。晚服三钱。开水下。
徐某：清阳未展，浊阴欲踞。久延必结痰饮。议用真武丸二钱五分，人参一钱煎汤送。胃阳得震，浊当退避矣。十服。
某人：脉沉弦，饮泛呛咳，乃下虚无以制上。议早服肾气丸，摄纳下焦散失，以治水泛之饮。午服《外台秘要》茯苓饮，转旋中焦，使食不致酿痰。茯苓饮去术。
某（71岁）：高年久嗽，脉象弦大，寤不成寐，乃阳气微漓，浊饮上泛。张仲景云：“进温药和之。”（脾胃阳虚饮逆咳呕）
杏仁（三钱） 茯苓（三钱） 川桂枝（一钱） 生姜（一钱） 苡仁（三钱） 炙草（四分） 大枣（二枚）
顾某（24岁）：咳嗽数月，呕出涎沫，建中不应，已非营卫损伤。视其面色鲜明，饮食仍进，仿饮邪主治。
小半夏汤加桂枝杏仁姜汁。
李某（38岁）：劳伤阳气，内起痰饮，卧着气钝饮阻，其咳为多，痰出稍通势缓。且体常汗泄，非风寒表邪不解，并不热渴，亦非火炎烁金。张仲景云：“饮家而咳，当治饮，不当治咳。”
茯苓 桂枝木 苡仁 炙草 姜汁
陈某：脉涩小，舌白不渴，身动呕痰，身如在舟车中，此寒热攻胃致伤，逆气痰饮互结。通补阳明为正。白术甘草守中，未能去湿，宜缓商。
人参汁 半夏 枳实汁 茯苓 竹沥 姜汁
马某（34岁）：肌肉丰溢，脉来沉缓。始发右季胁痛，汤饮下咽，汨汨有声，吐痰涎头痛。此皆脾胃阳微，寒湿滞聚。年方壮盛，不必介怀。温中佐其条达，运通为宜。
茅术 浓朴 半夏 茯苓 陈皮 淡姜渣 胡芦巴 炙草 姜汁泛丸
马某（40岁）：甘缓颇安，辛泄不受。此阳分气衰，将来饮邪日聚。然卧着咳多，清气失旋。先用苓桂术甘汤，继进《外台秘要》茯苓饮。
曹某（47岁）：中年阳气日薄，痰饮皆属阴浊，上乾清道，为冲逆咳嗽。张仲景治法，外饮治脾，内饮治肾，分晰甚明。昔年曾用桂苓泽术得效，是治支饮治法。数年真气更衰。古人谓饮邪当以温药和之，须忌治嗽肺药。
先用小青龙去麻辛，接服《外台秘要》茯苓饮。
程某（57岁）：昔肥今瘦为饮。张仲景云：“脉沉而弦，是为饮家。”男子向老，下元先亏，气不收摄，则痰饮上泛。饮与气涌，斯为咳矣。今医见嗽，辄以清肺降气消痰，久而不效，更与滋阴，不明痰饮皆属浊阴之化，滋则堆砌助浊滞气。试述着枕咳呛一端，知身体卧着，上气不下，必下冲上逆，其痰饮伏于至阴之界，肾脏络病无疑。形寒畏风，阳气微弱，而藩篱疏撤。张仲景有要言不烦曰：“饮邪必用温药和之”，更分外饮治脾，内饮治肾。不读圣经，焉知此理？（脾肾阳虚饮逆咳呕）
桂苓甘味汤 熟附都气加胡桃。
陈某：痛久气乱，阳微，水谷不运，蕴酿聚湿，胃中之阳日薄，痰饮水湿，必倾囊上涌，而新进水谷之气，与宿邪再聚复出，致永无痊期。张仲景云：“饮邪当以温药和之。”又云：“不渴者，此为饮邪未去故也。”则知理阳通阳，诚有合于圣训，断断然矣。真武汤。
张某（41岁）：痰饮喘咳，肌肉麻痹，痞胀不堪纳谷，冬寒日甚，春暖日减。全是阳气已衰，阴浊逆干犯上。肺药治嗽，无非辛泄滋润。盖辛散则耗阳，滋清助阴浊。浊阻在阳分，气不肃，为夜不得卧。小青龙意，主乎由上以泄水寒，直从太阳之里以通膀胱，表中里药也。张仲景谓饮邪当以温药和之，驱阴邪以复阳，一定成法。
早肾气去萸换白芍，炒楂炭水法丸。晚《外台秘要》茯苓饮，姜枣汤法丸。
程某（60岁）：肾虚不纳气，五液变痰上泛，冬藏失职，此病为甚。不可以肺咳消痰，常用八味丸，收纳阴中之阳。临时撤饮，用张仲景桂苓味甘汤。
孙某：未交冬至，一阳来复。老人下虚，不主固纳，饮从下泛，气阻升降，而为喘嗽。发散寒凉苦泻诸药，焉得中病？张仲景云：“饮家而咳，当治饮，不当治咳。”后贤每每以老人喘嗽，从脾肾温养定论，是恪遵圣训也。
桂枝 茯苓 五味子 甘草汤代水，加淡姜枣。
李某：肠红久病，不必攻治。今者气冲喘嗽，脘胁痞阻，是饮浊上僭，最宜究悉。
川桂枝（七分） 茯苓（三钱） 干姜（一钱） 五味子（同姜合捣一钱） 杏仁（一钱半） 白芍（一钱）
炙草（五分） 生左牡蛎（三钱）
吴某（27岁）：壮年下元久虚，收纳气泄，每交秋冬受冷，冷气深入，伏饮夹气上冲，为咳喘呕吐。疏肺降气不效者，病在肾络中也。盖精血少壮不旺，难以搜逐，病根不去谓此。绝欲一年，小暑艾灸，静养一百二十天可愈。附都气加车前。（肾阳虚饮逆喘咳呕）
潘某（29岁）：劳力喘甚，肩背恶寒，饮泛上逆，皆系下元虚损。莫以喘用泻肺等药。薛氏八味丸。
王某：秋深天气收肃，背寒喘咳，饮浊上泛，缘体中阳气少振，不耐风露所致。最宜暖护背部，进通阳以治饮。
茯苓 桂枝 半夏 姜汁 苡仁 炙草
又方：早肾气丸，夜真武丸
陈某：脉虚微，春阳地升浊阴上干，喘不得卧。治在少阴。
人参 淡熟附子 猪胆汁
又方：照前方加淡干姜一钱半。
又方：脉弦，暮夜浊阴冲逆，通阳得效。议真武法，以撤其饮。
人参 淡附子 生白芍 茯苓 姜汁
又方：真武泄浊，脘通思食，能寐昨宵已有渴欲饮水之状。考金匮云：“渴者饮邪欲去也。”当健补中阳，以资纳谷。
人参 生于术 淡附子 茯苓 泽泻
又方：早服肾气丸四五钱，晚用大半夏汤。
人参 半夏 茯苓 姜汁
董某：脉弦右濡，阳微恶寒，饮浊上干，咳吐涎沫，且食减胃衰，寒疝窃踞，阴浊见症，岂止一端。喻嘉言谓浊阴上加于天，非离照当空，氛雾焉得退避。反以地黄五味阴药附和其阴，阴霾冲逆肆虐，饮邪滔天莫制。议以张仲景熟附配生姜法，扫群阴以驱饮邪，维阳气以立基本。况尊年尤宜急护真阳为主。
人参 茯苓 熟附子 生姜汁 南枣
戴某：十二月间，诊得阳微，浊饮上干为咳，不能卧。曾用小青龙汤，减去麻黄细辛，服后已得着枕而卧。想更医接用不明治饮方法，交惊蛰阳气发泄，病势再炽。顷诊脉来濡弱无神，痰饮咳逆未已，谅非前法可效。宗张仲景真武汤法，以熟附配生姜，通阳逐饮立法。真武汤去白术加人参。
Certain patient (61 years old): In advanced age, the defensive Yang is declining. Cold pathogen invades from outside, stirring up accumulated fluid retention (Yin), which reverses upward causing cough and aversion to cold. Zhang Zhongjing said: "When treating fluid retention, do not merely treat the cough; one should use warm herbs to harmonize and unblock." (External cold stirs up chronic fluid retention reversing upward)
Xingren (Apricot Seed) (3 qian) Cujiaozhi (Coarse Cinnamon Twig) (1 qian) Danganjiang (Light Dried Ginger) (1.5 qian) Fuling (Poria) (3 qian) Yiren (Coix Seed) (3 qian) Zhigan (Honey-fried Licorice Root) (4 fen)
Mr. Zhou: Historically suffering from deafness and tinnitus, this indicates Kidney Water deficiency with Liver Fire clouding the orifices. Winter Yang fails to submerge, also belonging to Lower Yuan (Kidney) deficiency. However, currently presenting with cough, deafness, phlegm sound in the throat, hypochondriac pain, and sensation of Qi rushing upward when lying down, this is Chong Mai (Penetrating Vessel) Qi rising with fluid retention flooding. The pulse is floating. Given the sudden cold, it is feared that external cold is stirring internal fluid retention. It is proposed to open the Taiyang (Bladder) channel to肃降 (descend Lung Qi).
Yunfuling (Cloud Poria) Cujiaozhi (Coarse Cinnamon Twig) Ganjiang (Dried Ginger) Wuwei (Schisandra Berry - pounded with ginger) Baishao (White Peony Root) Zhigan (Honey-fried Licorice Root)
Take at noon.
Certain patient (21 years old): Newly constrained by cool pathogen externally, the Lung suffers cold. Lung Qi is deficient and fails to descend, while chronic fluid retention attacks upward, thus the disease manifests. The method should be to keep the back warm; the chronic illness can be resolved.
Dan Shengjiangfen (Light Raw Ginger Powder) Banxia (Pinellia Tuber) Geli Fen (Clam Shell Powder) Fuling (Poria) Guizhimu (Cinnamon Twig Wood) Yiren (Coix Seed) decocted in water.
Certain patient (50 years old): Back coldness with cough and rebellious Qi, this belongs to the manifestation of fluid retention. First, use acrid and unblocking methods to dispel fluid retention, thereby descending Lung Qi. (Fluid retention reverses upward, causing Lung Qi failure to descend)
Xian Pipaye (Fresh Loquat Leaf) Xingren (Apricot Seed) Fuling (Poria) Juhong (Tangerine Red Peel) Shengjiang (Fresh Ginger) Banxia (Pinellia Tuber)
Certain patient (52 years old): Pulse is large and wiry on the right, panting, coughing up turbid froth, unable to lie flat, preferring hot drinks, triggered by cold. This belongs to fluid retention lingering in the Lung and Wei (Defensive) levels. If one sees cough and administers moistening/clearing drugs, the condition will worsen with each dose.
Tinglizi (Lepidium Seed) Shandong Dazao (Shandong Jujube)
Ms. Xu: Phlegm-fluid retention vomiting upwards, panting unable to lie down, this is warm pathogen obstructing Lung Qi, Qi failing to descend, stagnation preventing right-side lying. It is proposed to use methods to ventilate and unblock, opening the Qi level.
Xiao Qinglong Tang (Minor Blue Dragon Decoction) minus Xixin (Asarum) Mahuang (Ephedra), plus Yiren (Coix Seed) and Shitao Gujiao (Gypsum stir-fried with white sugar).
Granny Shen: Winter-warmth disease, Yang fails to submerge, latent fluid retention floods upward. Zhang Zhongjing said: "Pulse sinking belongs to fluid retention; bright facial complexion belongs to fluid retention. Patients with fluid retention who cough severely should have their fluid retention treated, not the cough." Because in advanced age, the lower Jiao foundation is already deficient. Due to warmth causing Qi leakage, it fails to govern storage. Fluid retention disturbs and attacks the Lung, Lung Qi fails to descend, Qi of the whole body becomes obstructed, scorching incessantly, collateral blood boils upward. The Classic says: "Unable to lie down, lying down causes severe panting and obstruction," this is reversal and chaos of Lung Qi. If one treats the symptom without understanding color diagnosis and Qi inspection, it will inevitably transform from cough into abdominal swelling and fullness, gradually irretrievable. Astute physicians must not neglect this as a trivial matter. Here, based on limited insight, I briefly state the main idea. It is proposed to open the Taiyang channel to direct fluid turbidity downward, without hindering the winter-warmth disease. Following Zhang Zhongjing's combination of Xiao Qinglong Tang and Yuebi Tang.
Xingren (Apricot Seed) Fuling (Poria) Yiren (Coix Seed) Chao Banxia (Stir-fried Pinellia) Guizhimu (Cinnamon Twig Wood) Shigao (Gypsum)
Baishao (White Peony Root) Zhigan (Honey-fried Licorice Root)
Ms. Fang: Imbalance of cold and warmth, fluid retention flooding with Qi rebellion, causing edema, panting, cough, abdominal distension, and choking sensation when lying down. It is proposed to use Yuebi Tang.
Shigao (Gypsum) Xingren (Apricot Seed) Guizhi (Cinnamon Twig) Chao Banxia (Stir-fried Pinellia) Fuling (Poria) Zhigan (Honey-fried Licorice Root)
Mr. Shi (47 years old): Excessive labor and worry injure Stomach Yang, external defense is thin, aversion to cold, food transport is weak, phlegm-fluid retention arises internally, Qi obstruction and turbid condensation cause chest and back pain. Acrid-sweet Yang-regulating method has been effective. During late summer, Spleen and Stomach rule; nourish its generating Qi, the body will become strong and the disease fully resolve. (Spleen-Stomach Yang Deficiency)
Liujunzi Tang (Six Gentlemen Decoction) plus Yizhi (Alpinia Oxyphylla) and Muxiang (Aucklandia Root).
Mr. Huang (34 years old): Dwelling by the coast, miasma, fog, and dew pathogenic factors invade the clear Yang, injuring Yang causing aversion to cold. Chronic cough patients fail to protect themselves from illness, still exerting effort, leading to internal binding of fluid retention, chronic and stubborn. Fuling Guizhi Tang (Poria and Cinnamon Twig Decoction).
Mr. Hu (46 years old): Pulse sinking and faint; faint indicates insufficient Yang, sinking indicates cold-water Yin coagulation. Heart pain and palpitations, gradually extending to heaviness under both hypochondria. Due to Yang decline failing to manage circulation, phlegm-fluid retention gathers and Qi attempts to block, causing pain, described as heart trembling, similar to the meaning of "waves shaking Yueyang Tower." It is proposed to use Waitai Fuling Yin (Poria Drink from External Cabinet) combined with Guiling Fang (Cinnamon-Poria Formula).
Renshen (Ginseng Root) Fuling (Poria) Banxia (Pinellia Tuber) Zhishi (Immature Bitter Orange) Guizhi (Cinnamon Twig) Jiangzhi (Ginger Juice)
Baishao (White Peony Root)
Mr. Bai (26 years old): Pulse sinking, small, and wiry, indicating Yin-turbid fluid retention. Constitution lacks robust Yang, clear Qi in the chest cannot expand freely. Occasional exposure to cold or mistaken intake of cold substances causes fluid retention to become violently cold, condensing into chest stuffiness. Daily diet must avoid alcohol, meat, and fishy/turbid foods, allowing clear Yang to circulate. Frequently take Zhang Zhongjing Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) for 100 doses. If the disease arises due to cold, immediately take Dashun San (Great Smooth Powder).
Mr. Dai: After the disease subsides, spirit is clear and wise. But the root pulse carries wiriness, historically having fluid retention, constituting a body with insufficient Yang. As age increases, prevent wind-bi. Alcohol and meat should be used sparingly; labor and anger must be strictly avoided. It is proposed to use Waitai Fuling Yin (Poria Drink from External Cabinet).
Renshen (Ginseng Root) Fuling (Poria) Guangpi (Tangerine Peel) Zhishi (Immature Bitter Orange) Banxia (Pinellia Tuber) Jinshihu (Dendrobium Stem)
Mr. Zhu (49 years old): Excessive mental labor injures Yang, phlegm-fluid retention accumulates daily, Yang Qiao Mai (Yang Heel Vessel) is empty, awake but unable to sleep, Defensive Yang loses protection, hair falls out spontaneously, this is gradual depletion. Initially advance unblocking fluid turbidity to revive Yang, then continue taking Waitai Fuling Yin (Poria Drink from External Cabinet).
Ms. Wu: Pulse wiry, back center cold, left side slightly painful, poor appetite with desire to vomit, limbs stiff. This is fluid retention knotting internally. It is proposed to unblock Yang Qi.
Guizhi (Cinnamon Twig) Fuling (Poria) Banxia (Pinellia Tuber) Jiangzhi (Ginger Juice) Zhigan (Honey-fried Licorice Root) Dazao (Jujube)
Certain patient: Vertigo, nausea, chest and epigastrium discomfort, pulse right wiry left weak, face red and bright. This is phlegm-fluid retention flooding upward, indicating signs of Jue Zhong (Stroke-like condition).
Chao Banxia (Stir-fried Pinellia) Zhi Jili (Processed Tribulus Fruit) Juhong (Tangerine Red Peel) Wei Tianma (Baked Gastrodia Rhizome) Shichangpu (Acorus Rhizome) Fuling (Poria) Jiangzhi (Ginger Juice)
Mr. You: Tasteless mouth indicates Stomach Yang deficiency. When turbid fluid descends, pain alleviates. Historically suffering from fluid-dampness, if one does not urgently advance warm-unblocking Yang-regulating methods, turbid fluid will surely re-accumulate. It is proposed to follow the method of Banxia Houpo Tang (modified Banxia Decoction).
Renshen (Ginseng Root) Banxia (Pinellia Tuber) Fuling (Poria) Zhishi (Immature Bitter Orange) Jiangzhi (Ginger Juice)
Mr. Zhang (27 years old): Wine drinkers have little grain intake and middle emptiness, frequently taking dispersing exterior drugs, injuring external defensive Yang. When phlegm-fluid retention manifests, there is chest stuffiness. Self-reported: illness comes when hungry and exposed to cold. Who doubts it is Yang Qi pathology? Do not merely search for and expel phlegm; instead, protect Middle Jiao Spleen and Stomach, making Yang Qi healthy and transporting ceaselessly. How can Yin-turbid phlegm-saliva occupy? (Spleen Yang fails to transport)
Sheng Baizhu (Raw Atractylodes Macrocephala Rhizome) Chuan Guizhi (Szechwan Cinnamon Twig) Fuling (Poria) Dan Jiangzha (Light Ginger Residue) Yiren (Coix Seed) Zexie (Alisma Rhizome) made into pills using Jiangzao Tang (Ginger-Jujube Decoction) method.
Mr. Wang (32 years old): Pulse sinking indicates phlegm-fluid retention, caused by insufficient Yang, turbid Yin attempting to obscure. One must prioritize regulating Spleen, allowing Middle Yang to silently operate, which is Zhang Zhongjing's meaning of "treating external fluid retention via Spleen."
Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) plus Banxia (Pinellia) and Chenpi (Aged Tangerine Peel) made into pills using water method.
Certain patient (34 years old): White tongue, cough-reversal without thirst, what else could this be but fluid retention? Suitable to use acrid-warm herbs to harmonize.
Xingren (Apricot Seed) Yiren (Coix Seed) Banxia (Pinellia Tuber) Ganjiang (Dried Ginger) Cu Guizhi (Coarse Cinnamon Twig) Fuling (Poria) Nongpo (Magnolia Bark) Zhigan (Honey-fried Licorice Root)
Certain patient: Epigastric stuffiness after eating, gurgling sound upon pressure, hand numbness, hypochondriac pain, irritability, blurred vision and hearing. This is Qi flow obstruction, phlegm-fluid retention gathering internally in Middle Jiao. Use Guiling Wan (Cinnamon-Poria Pill). Made with Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice) method.
Another formula: Guizhi (Cinnamon Twig) Renshen (Ginseng Root) Fuling (Poria) Banxia (Pinellia Tuber) Guangpi (Tangerine Peel) Zhigan (Honey-fried Licorice Root)
Mr. Huang: Overly sweet and greasy taste slows Middle Qi, failing to transport, lingering for hundreds of days, gathering Qi and knotting fluid retention. Li Dongyuan said: "Long-standing illness, hair does not fall, no hunger despite not eating," this is caused by phlegm-fluid retention. Fluid retention belongs to Yin category, hence no thirst. Zhang Zhongjing distinguished five types of fluid retention, stating concisely: one should harmonize with warm herbs. Unblocking Yang methods are unquestionable. Generally, external fluid retention should treat Spleen, internal fluid retention should treat Kidney; this is the standard rule. It is proposed to use Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction).
Certain patient: Body appears robust, but Yang leaks outward, aversion to wind and cold. Spleen Yang declines, failing to govern transportation. Vigorous Qi of food and drink steams and transforms into phlegm-fluid retention, tunnels clog daily. Upper excess, lower deficiency. Zhang Zhongjing stated fluid retention should be harmonized with warm herbs. Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) was effective. Formulated based on external fluid retention.
Renshen (Ginseng Root) Dan Fuzi (Light Processed Aconite Root) Sheng Baizhu (Raw Atractylodes Macrocephala Rhizome) Zhishi (Immature Bitter Orange) Fuling (Poria) Zexie (Alisma Rhizome)
Made into pills with Jingli (Phragmites Sap) and Jiangzhi (Ginger Juice) method.
Certain patient: Elderly with chronic cough affecting eating. Proposed to treat external fluid retention via Spleen, using Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction).
Mr. Wang (34 years old): Pulse sinking, back cold, palpitations feeling like dropping, robust form but deficient Qi, gradually developing internal phlegm-fluid retention. Must use warm-unblocking and tonifying Yang formulas to restore. Thus fluid turbidity resolves itself. (Spleen-Kidney Yang Deficiency)
Renshen (Ginseng Root) Dan Fuzi (Light Processed Aconite Root) Ganjiang (Dried Ginger) Fuling (Poria) Sheng Baizhu (Raw Atractylodes Macrocephala Rhizome) Sheng Baishao (Raw White Peony Root)
Mr. Feng: Yang deficiency leads to cold form and sweating. Phlegm-fluid retention stagnation are all Yin-turbidity taking form, taking advantage of declining Yang to disturb and occupy. Ancient rules require unblocking Yang to sweep away Yin atmosphere. But chronic diseases have no urgent attack formulas. Moreover, habitual depression causes Qi stagnation and Blood涩 (sluggishness), a long-exhausted constitution dare not use purely acrid-hot herbs, fearing fluid consumption.
Renshen (Ginseng Root) Shu Fuzi (Prepared Aconite Root) Dan Ganjiang (Light Dried Ginger) Chao Chuanjiao (Stir-fried Sichuan Pepper) Chuan Guizhi (Szechwan Cinnamon Twig) Wumei Rou (Dark Plum Flesh) Sheng Baishao (Raw White Peony Root) Additionally, Zhenwu Wan (True Warrior Pill) (3 liang)
Mr. Cheng (48 years old): Left pulse calm/sinking, right pulse faint/wiry. At forty, Clear Yang thins daily, Spleen pumping/transport slows. Added to anxious thoughts, vigorous Qi of food/drink steams and transforms into phlegm-fluid retention. Zhang Zhongjing stated external fluid retention should treat Spleen Yang. Moreover, middle-aged often suffers emission issues. Pulse analysis shows no Dragon/Fire movement. It is proposed to secure lower and benefit Kidney, rotate Spleen transport using two formulas, taken morning and evening separately. Morning takes Cong Huan Shao Ju Jing Qi Bao (Eight Immortals Preserving Essence Seven Treasures), referencing pill formula.
Shudi (Rehmannia Root) Rongrong (Cistanche Stem) Gouqi (Goji Berry) Wuwei (Schisandra Berry) Yurou (Cornus Fruit) Fushen (Poria with Hostwood)
Shanyao (Chinese Yam) Tusiren (Cuscuta Seed) Fupenzi (Raspberry) Yu jiao (Fish Maw) Changpu (Acorus Rhizome) Yuanzhi (Polygala Root) Longgu (Fossilized Bone) Qingyan (Blue Salt)
Pounded into pills with ripe honey and jujube flesh. Take 5-7 qian in the morning.
Maoyu (Coarse Atractylodes Rhizome) Yuyu (Fine Atractylodes Rhizome) Banxia (Pinellia Tuber) Fuling (Poria) Guangpi (Tangerine Peel) Sheng Yizhi (Raw Alpinia Oxyphylla) Baiji (Tribulus Fruit) Gouteng (Uncaria Ramulus cum Uncis)
Made into pills using Jiangzao Tang (Ginger-Jujube Decoction) method. Take 3 qian in the evening, washed down with boiling water.
Mr. Xu: Clear Yang not yet expanded, turbid Yin desires to occupy. Prolonged delay will knot into phlegm-fluid retention. It is proposed to use Zhenwu Wan (True Warrior Pill) 2.5 qian, sent down with Renshen (Ginseng Root) 1 qian decoction. Once Stomach Yang vibrates, turbidity will retreat. Ten doses.
Certain patient: Pulse sinking-wiry, fluid flooding causing choking cough, due to lower deficiency failing to control upper. Proposed to take Shenqi Wan (Kidney Qi Pill) in the morning to grasp and retain scattered Lower Jiao, to treat water-flooding fluid retention. Take Waitai Fuling Yin (Poria Drink from External Cabinet) at noon to rotate Middle Jiao, preventing food from brewing phlegm. Fuling Yin minus Baizhu.
Certain patient (71 years old): Advanced age chronic cough, pulse string-large, awake unable to sleep, Yang Qi slightly leaking, turbid fluid retention floods upward. Zhang Zhongjing said: "Advance warm herbs to harmonize." (Spleen-Stomach Yang Deficiency with fluid-reversal cough/vomiting)
Xingren (Apricot Seed) (3 qian) Fuling (Poria) (3 qian) Chuan Guizhi (Szechwan Cinnamon Twig) (1 qian) Shengjiang (Fresh Ginger) (1 qian) Yiren (Coix Seed) (3 qian) Zhigan (Honey-fried Licorice Root) (4 fen) Dazao (Jujube) (2 pieces)
Mr. Gu (24 years old): Cough for months, vomiting saliva/froth, Jianzhong (Build the Middle) ineffective, no longer Ying-Wei injury. Observing bright facial complexion, diet still advancing, imitating fluid retention treatment.
Xiao Banxia Tang (Minor Pinellia Decoction) plus Guizhi (Cinnamon Twig), Xingren (Apricot Seed), Jiangzhi (Ginger Juice).
Mr. Li (38 years old): Labor injures Yang, phlegm-fluid retention arises internally, lying down causes dull Qi and fluid obstruction, cough is frequent, slightly relieved when phlegm exits. Body frequently sweats, not unresolved Wind-Cold exterior pathogen, no heat/thirst, nor Fire scorching Metal. Zhang Zhongjing said: "Patients with fluid retention who cough should have their fluid retention treated, not the cough."
Fuling (Poria) Guizhimu (Cinnamon Twig Wood) Yiren (Coix Seed) Zhigan (Honey-fried Licorice Root) Jiangzhi (Ginger Juice)
Mr. Chen: Pulse choppy-small, white tongue without thirst, body moving induces vomiting phlegm, sensation as if in boat/car, this is Cold-Heat attacking Stomach causing injury, rebellious Qi and phlegm-fluid retention inter-knoting. Tonifying and supplementing Yangming is correct. Baizhu (Atractylodes) and Zhigan (Licorice) guard the middle but fail to remove dampness, suitable to deliberate slowly.
Renshen juice (Ginseng Root Juice) Banxia (Pinellia Tuber) Zhishi juice (Immature Bitter Orange Juice) Fuling (Poria) Zhuli (Bamboo Sap) Jiangzhi (Ginger Juice)
Mr. Ma (34 years old): Muscles plump, pulse sinking-slow. Initially right hypochondriac pain, soup/drinks make gurgling sounds when swallowed, vomiting phlegm-saliva headache. All due to Spleen-Stomach Yang slightness, Cold-Damp stagnation gathering. Young and robust, no need to worry. Warm middle assisting smoothness, promoting transport is suitable.
Maoyu (Coarse Atractylodes Rhizome) Nongpo (Magnolia Bark) Banxia (Pinellia Tuber) Fuling (Poria) Chenpi (Aged Tangerine Peel) Dan Jiangzha (Light Ginger Residue) Huluoba (Phaseolus Vulgaris Seed) Zhigan (Honey-fried Licorice Root) Made into pills with Jiangzhi (Ginger Juice).
Mr. Ma (40 years old): Sweet/mellow soothing is comfortable, acrid-draining is not tolerated. This is Yang-level Qi decline, future fluid retention will accumulate daily. However, lying down causes much cough, Clear Qi loses rotation. First use Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction), then advance Waitai Fuling Yin (Poria Drink from External Cabinet).
Mr. Cao (47 years old): Middle age Yang thins daily, phlegm-fluid retention all belong to Yin-turbidity, attacking clear pathways, causing rebellious cough. Zhang Zhongjing's treatment method: external fluid retention treats Spleen, internal fluid retention treats Kidney, clearly distinguished. Previously used Guiling Zeshu (Cinnamon-Poria-Alisma-Atractylodes) with effect, this is treatment method for Zhi Yin (Branch Fluid Retention). True Qi declined further over years. Ancients said fluid retention must be harmonized with warm herbs, must avoid Lung drugs for cough.
First use Xiao Qinglong Tang (Minor Blue Dragon Decoction) minus Mahuang (Ephedra) and Xixin (Asarum), then take Waitai Fuling Yin (Poria Drink from External Cabinet).
Mr. Cheng (57 years old): Formerly fat, now thin indicates fluid retention. Zhang Zhongjing said: "Pulse sinking and wiry indicates fluid retention patient." Men aging, Lower Yuan deficits first, Qi fails to grasp, thus phlegm-fluid retention floods upward. Fluid and Qi surge, thus cough. Current doctors seeing cough, immediately use Lung-clearing, Qi-descending, phlegm-expelling drugs, ineffective over time, further using Yin-nourishing, not understanding phlegm-fluid retention all transform from Turbid Yin, nourishing piles up helping turbidity blocking Qi. Consider the aspect of choking cough when lying down: knowing body lying down, upper Qi does not descend, must rush upward from below, phlegm-fluid retention hides in the realm of Extreme Yin, undoubtedly Kidney collateral disease. Cold form, aversion to wind, Yang Qi slight, fences loose. Zhang Zhongjing said concisely: "Fluid retention must use warm herbs to harmonize," further distinguishing external fluid retention treats Spleen, internal fluid retention treats Kidney. Not reading the Classics, how to know this principle? (Spleen-Kidney Yang Deficiency with fluid-reversal cough/vomiting)
Guiling Ganwei Tang (Cinnamon-Poria-Licorice-Schisandra Decoction) Shu Fu Duqi (Prepared Aconite Plus Kidney Qi Pill) plus Hetao (Walnut Kernel).
Mr. Chen: Pain long-term causes Qi chaos, Yang slight, food/water not transported, brewing dampness, Stomach Yang thins daily, phlegm-fluid retention/water-dampness must pour upward like emptying a bag, new food/water Qi reunites with old pathogen and re-emerges, causing eternal lack of recovery. Zhang Zhongjing said: "Fluid retention must use warm herbs to harmonize." Also said: "Without thirst, this is because fluid retention has not gone." Then knowing regulating Yang and unblocking Yang truly matches Sage instructions, undeniably. Zhenwu Tang (True Warrior Decoction).
Mr. Zhang (41 years old): Phlegm-fluid retention panting-cough, muscle paralysis, unbearable stuffiness preventing food intake, worse in winter cold, better in spring warmth. Entirely due to Yang Qi decline, Yin-turbidity reverses attacking upper. Lung drugs for cough are nothing but acrid-draining and moistening. Acrid disperses consuming Yang, moistening-cooling assists Yin-turbidity. Turbidity blocks Yang level, Qi not肃降 (descending), causing inability to sleep at night. Xiao Qinglong Tang (Minor Blue Dragon Decoction) intent focuses on draining cold-water from above, directly unblocking Bladder from Taiyang interior, medicine between exterior and interior. Zhang Zhongjing stated fluid retention must use warm herbs to harmonize, driving Yin pathogen to restore Yang, fixed established method.
Morning: Shenqi Wan (Kidney Qi Pill) minus Yurou (Cornus), replace with Baishao (White Peony), stir-fried Shan Zha Tan (Hawthorn Charcoal) made into pills with water method. Evening: Waitai Fuling Yin (Poria Drink from External Cabinet), made into pills with Jiangzao Tang (Ginger-Jujube Decoction) method.
Mr. Cheng (60 years old): Kidney deficiency fails to grasp Qi, Five Fluids transform into phlegm flooding upward, Winter storage fails, this disease is severe. Cannot treat lung cough by expelling phlegm, commonly use Bawei Wan (Eight Flavor Pill) to grasp Yang within Yin. Temporarily withdraw fluid, use Zhang Zhongjing Guiling Ganwei Tang (Cinnamon-Poria-Licorice-Schisandra Decoction).
Mr. Sun: Before Winter Solstice, One Yang returns. Elderly lower deficiency, fails to solidify/grasp, fluid floods from below, Qi obstruction升降 (ascending-descending), causing panting-cough. Dispersing, cold-cooling, bitter-draining drugs, how can they hit the target? Zhang Zhongjing said: "Patients with fluid retention who cough should have their fluid retention treated, not the cough." Later sages often conclude elderly panting-cough should be treated with Spleen-Kidney warming/nourishing, this strictly follows Sage instructions.
Guizhi (Cinnamon Twig) Fuling (Poria) Wuweizi (Schisandra Berry) Gancao (Licorice Root) decocted as water, add light Jiang (Ginger) Zao (Jujube).
Mr. Li: Chronic intestinal bleeding, no need for attack treatment. Currently Qi rushing panting-cough, epigastric-hypochondriac stuffiness, this is fluid turbidity usurping upward, most suitable to investigate thoroughly.
Chuan Guizhi (Szechwan Cinnamon Twig) (7 fen) Fuling (Poria) (3 qian) Ganjiang (Dried Ginger) (1 qian) Wuweizi (Schisandra Berry - pounded with ginger) (1 qian) Xingren (Apricot Seed) (1.5 qian) Baishao (White Peony Root) (1 qian)
Zhigan (Honey-fried Licorice Root) (5 fen) Sheng Zuomuli (Raw Left Oyster Shell) (3 qian)
Mr. Wu (27 years old): Young adult Lower Yuan long-term deficiency, grasping Qi leaks, every entering autumn/winter catching cold, cold Qi enters deeply, latent fluid retention夹 (carries) Qi rushing upward, causing cough-panting-vomiting. Lung-dispersing Qi-descending ineffective because disease is in Kidney collaterals. Essence/Blood young/robust not flourishing, difficult to search/expel, this is why disease root remains. Abstain from sexual desire for one year, moxibustion at Minor Heat, quiet rest for 120 days can cure. Fuduqi (Aconite Plus Kidney Qi Pill) plus Cheqian (Plantago Seed). (Kidney Yang Deficiency with fluid-reversal panting-cough-vomiting)
Mr. Pan (29 years old): Labor-induced severe panting, shoulder-back aversion to cold, fluid flooding upward, all due to Lower Yuan deficiency. Do not use Lung-draining drugs for panting. Xueshi Bawei Wan (Dr. Xue's Eight Flavor Pill).
Mr. Wang: Late autumn weather contracts and肃 (clears), back cold panting-cough, fluid turbidity floods upward, due to body Yang lacking vibration, unable to endure wind/dew. Most suitable to keep back warm, advance unblocking Yang to treat fluid retention.
Fuling (Poria) Guizhi (Cinnamon Twig) Banxia (Pinellia Tuber) Jiangzhi (Ginger Juice) Yiren (Coix Seed) Zhigan (Honey-fried Licorice Root)
Another formula: Morning Shenqi Wan (Kidney Qi Pill), Evening Zhenwu Wan (True Warrior Pill).
Mr. Chen: Pulse void-slight, Spring Yang rises from earth, turbid Yin attacks upper, panting unable to lie down. Treatment in Shaoyin (Kidney/Heart).
Renshen (Ginseng Root) Dan Shufuzi (Light Prepared Aconite Root) Zhuyedan (Pig Gallbladder Bile)
Another formula: Follow previous formula add Dan Ganjiang (Light Dried Ginger) 1.5 qian.
Another formula: Pulse wiry, night turbid Yin rushes upward, unblocking Yang effective. Propose Zhenwu method to withdraw fluid.
Renshen (Ginseng Root) Dan Fuzi (Light Processed Aconite Root) Sheng Baishao (Raw White Peony Root) Fuling (Poria) Jiangzhi (Ginger Juice)
Another formula: Zhenwu drains turbidity, epigastrium opens thinking of food, slept last night already had thirst desire to drink water. Examining Jingui (Essential Prescriptions of the Golden Cabinet): "Thirst indicates fluid retention desires to go." Should strengthen-supplement Middle Yang to assist food intake.
Renshen (Ginseng Root) Sheng Baizhu (Raw Atractylodes Macrocephala Rhizome) Dan Fuzi (Light Processed Aconite Root) Fuling (Poria) Zexie (Alisma Rhizome)
Another formula: Morning take Shenqi Wan (Kidney Qi Pill) 4-5 qian, Evening use Banxia Houpo Tang (Modified Banxia Decoction).
Renshen (Ginseng Root) Banxia (Pinellia Tuber) Fuling (Poria) Jiangzhi (Ginger Juice)
Mr. Dong: Pulse wiry right soggy, Yang slight aversion to cold, fluid turbidity attacks upper, coughing vomiting saliva/froth, and food reduction Stomach decline, Cold Hernia occupies, Yin-turbidity symptoms, how only one end? Yu Jiayan said turbid Yin adds to Heaven, unless sun shines brightly, how can mist retreat? Instead using Dihuang (Rehmannia) Wuwei (Schisandra) Yin drugs to attach/support Yin, Yin-mist rushes/rebels tyrannically, fluid retention waves heaven-high uncontrollable. Propose Zhang Zhongjing's Shu Fu (Prepared Aconite) pairing with Sheng Jiang (Fresh Ginger) method, sweep group Yin to drive fluid retention, maintain Yang Qi to establish foundation. Moreover, venerable age especially urgent to protect True Yang as main.
Renshen (Ginseng Root) Fuling (Poria) Shu Fuzi (Prepared Aconite Root) Shengjiangzhi (Fresh Ginger Juice) Nanzao (Southern Jujube)
Mr. Dai: December, diagnosed Yang slight, turbid fluid retention attacks upper causing cough, unable to lie down. Previously used Xiao Qinglong Tang (Minor Blue Dragon Decoction), minus Mahuang (Ephedra) Xixin (Asarum), after taking obtained ability to lie on pillow. Likely subsequent doctor used unclear fluid treatment methods, arriving at Awakening of Insects (Jingzhe) Yang Qi emits, disease势头 (momentum) reignites. Recently diagnosed pulse soggy-weak without spirit, phlegm-fluid retention cough-reversal not ceased, likely former method ineffective. Follow Zhang Zhongjing's Zhenwu Tang (True Warrior Decoction) method, using Shu Fu (Prepared Aconite) pairing with Sheng Jiang (Fresh Ginger), unblocking Yang driving fluid legislation. Zhenwu Tang minus Baizhu (Atractylodes) add Renshen (Ginseng Root).
Mr. Ji: Unable to lie down choking panting, flooding white froth, all Kidney disease. Propose unblocking Taiyang Bladder. (Kidney Yang Deficiency with Bladder Qi transformation failure to descend)
Fuling (Poria) Chuan Guizhi (Szechwan Cinnamon Twig) Dan Ganjiang (Light Dried Ginger) Wuweizi (Schisandra Berry) Baishao (White Peony Root) Zhigan (Honey-fried Licorice Root)
Mr. Gu: Fluid retention flooding, panting-cough, Du Mai (Governor Vessel) damaged head drooping, body movement severe panting, eating causes epigastric stuffiness, lying down panting-cough unable to breathe. Lung governs exhalation, Kidney governs inhalation/grasping