尊夫人惊痰堵塞窍隧。肝肺心包络间。无处不有。三部脉虚软无力。邪盛正衰。不易开散。有欲用涌剂稍
吐十分之三。诚为快事。弟细筹之。此法殆不可行。盖涌法正如兵家劫营之法。安危反掌。原属险道。况痰迷
不过片晌耳。设以涌药投之。痰才一动。人即晕去。探之指不得入。咽之气不能下。药势与病势相扼。转致连
日不苏。将若之何。无已。如丹溪所云。惧吐者宜消息下之乎。不知窍隧之痰。万不能导。即导之下行。徒伤
脾气。痰愈窒塞。此法亦不可用也。为今之计。确以理脾为先。脾气者。人身健运之阳气。如天之有日也。阴
凝四塞者。日失其所。痰迷不省者。脾失其权耳。理脾则如烈日当空。片云纤翳。能掩之乎。其次莫如清肺。
肺为将帅之官。气清则严肃下行。气下行。则痰之藉为坚城固垒者。方示以暇。而可用其攻击之力。所谓
攻坚则暇者亦坚。攻暇则坚者亦暇是也。今四末肿麻。气壅已
甚。尤不可不亟亟矣。其理脾之法。须药饵与食饮相参。白饭香
蔬苦茗。便为佳珍。不但滑腻当禁。即粥亦不宜食。以粥饮之。结为痰饮易易耳。不但杂食当禁。即饭食亦
宜少减。以脾气不用以消谷。转用之消痰。较药力万万耳。其辛辣酒脯。及煎爆日曝之物。俱能伤肺。并不
宜食。至于用药。弟自有节次矩 。俟日渐轻安。来春方奏全最也。缘此病患不识治。前贤亦未见高出
手眼。弟思之累日。窃以为要领在是。所以必欲持久者。与金城方略同意。且先除胁从。后歼巨魁。自势所不
易捷得之事。惟台兄裁酌进教。毋谓小恙过矜。迂远不切。幸孔幸孔。
惊痰之来。始于肝胆。冬月水气归根。不敢攻治。故但以理脾药平调。必至春月木旺。才用四君子汤加
龙胆草芦荟代赭石黄连青黛等药为丸。服之痰迷之证。果获全瘳。此后不发。
胡卣臣先生曰。情形方略。指画无遗。古名将中求其人。不可多得也。
尊夫人的病情是惊痰堵塞了经络孔窍。在肝、肺和心包络之间，无处不有这种痰邪。三部脉象虚软无力，显示邪气盛而正气衰，难以通过常规方法开散。有人想用涌吐剂稍微吐出十分之三的痰液，这确实是一件痛快的事。但我仔细筹划后认为，这种方法恐怕不可行。因为涌吐法正如兵家劫营之法，安危只在反掌之间，原本就属于险招。况且痰迷心窍不过是一时片刻的事，如果投用涌吐药，痰刚一动，人就会晕厥过去，手指无法探入咽喉，咽下的气息也无法下行。药势与病势相互遏制，反而导致多日不能苏醒，那该怎么办呢？不得已，像丹溪所说的那样，对于害怕呕吐的患者，应当斟酌采用下法吗？却不知道经络孔窍中的痰，万难引导下行；即使强行引导下行，也只是徒然损伤脾气，使痰更加窒塞，所以这种方法也不可用。
现在的对策，确应以调理脾胃为优先。脾气是人体健运的阳气，就像天空中有太阳一样。阴寒凝滞、四周闭塞，是因为太阳失去了它的位置；痰迷不省，是因为脾失去了它的权能。调理脾胃就像烈日当空，片云纤翳（微小的云雾）怎么能遮蔽它呢？其次不如清肺。肺是将帅之官，气清肃则严肃下行；气下行，那么痰所凭借形成的坚城固垒，就会显露出空隙，从而可以使用攻击的力量。这就是所谓“攻坚则暇者亦坚，攻暇则坚者亦暇”的道理。现在四肢末端肿胀麻木，说明气机壅滞已经很严重，尤其不可不急于处理。
调理脾胃的方法，需要药物饮食相互配合。白米饭、香蔬、苦茶，便是极好的珍品。不仅滑腻的食物应当禁止，就是粥也不宜食用。因为喝粥容易凝结成痰饮。不仅杂食应当禁止，就是饭食也应当减少。因为脾气不再用于消化谷物，而是转而用于消除痰湿，这比药力要强万万倍。辛辣、酒肉以及煎炸暴晒的食物，都能伤害肺脏，都不宜食用。至于用药，我自有步骤规矩，等到病情日渐轻安，明年春天才能奏效痊愈。因为这个病患不懂得治疗的重要性，前贤也没有见到高出我一筹的手眼。我思考了好几天，私下认为要领就在这里。之所以必须持久治疗，是与金城方略同意，先清除胁从势力，后歼灭巨魁首领，这自然是势所不易迅速成功的事情。希望台兄裁酌进教，不要认为小病过分管束，迂阔遥远而不切实际，幸甚幸甚。
惊痰的产生，始于肝胆。冬季水气归根，不敢轻易攻治，所以只用理脾药平调。必定到了春季木气旺盛之时，才使用四君子汤加龙胆草、芦荟、代赭石、黄连、青黛等药制成丸剂服用。服药后，痰迷之证果然获得全愈。此后不再发作。
胡卣臣先生说：情形方略，指画无遗，在古名将中寻求这样的人，不可多得啊。
The patient, your respected wife, suffers from phlegm caused by fright blocking the orifices and collaterals. This pathogenic phlegm is present everywhere between the Liver, Lung, and Pericardium. The pulse at the three positions (Cun, Guan, Chi) is deficient, soft, and powerless, indicating that the pathogen is abundant while the healthy Qi is declining, making it difficult to disperse through conventional methods. Some suggest using an emetic agent to induce vomiting of about 30% of the phlegm, which would indeed be a relieving act. However, after careful deliberation, I believe this method is likely inadvisable. The emetic method is akin to the military tactic of raiding the enemy camp; safety and danger can reverse in the flip of a hand, and it inherently belongs to dangerous strategies. Moreover, the state of phlegm misting the mind lasts only for a short moment. If emetic drugs are administered, as soon as the phlegm moves, the patient will faint. Fingers cannot be inserted to probe, and the breath cannot descend. The force of the medicine and the force of the disease will choke each other, potentially leading to days of unconsciousness. What then should be done? Alternatively, as Danxi stated, for those afraid of vomiting, one might consider using purgatives with caution. Yet, phlegm within the orifices and collaterals cannot easily be guided downward. Even if forced downward, it merely injures Spleen Qi, causing the phlegm to become more obstructed. Thus, this method is also unusable.
The current strategy must prioritize regulating the Spleen. Spleen Qi is the Yang Qi responsible for robust transportation and transformation in the body, analogous to the Sun in the sky. When Yin cold condenses and blocks all directions, it is because the Sun has lost its proper position. When phlegm mists the mind and causes loss of consciousness, it is because the Spleen has lost its authority. Regulating the Spleen is like the scorching sun shining overhead; how can a wisp of cloud obscure it? The next best approach is to clear the Lungs. The Lung is the official of generalship; when Lung Qi is clear, it descends solemnly. As Lung Qi descends, the solid fortresses formed by the phlegm reveal gaps, allowing for effective attack. This corresponds to the principle: "When attacking the strong, the weak becomes vulnerable; when attacking the weak, the strong becomes exposed." Currently, swelling and numbness in the four extremities indicate severe Qi stagnation, which urgently requires attention.
The method for regulating the Spleen must combine medicinal herbs with diet. Plain rice, fragrant vegetables, and bitter tea are excellent choices. Greasy foods must be strictly prohibited, and even congee (rice porridge) should not be consumed, as liquid intake easily consolidates into phlegm-fluids. Not only miscellaneous foods but also regular meals should be reduced. This is because Spleen Qi, instead of being used to digest grains, is redirected to resolve phlegm, which is vastly more effective than medicinal power alone. Spicy foods, alcohol, meat preserves, and fried or sun-dried items all damage the Lungs and should be avoided. Regarding medication, I have my own step-by-step protocol. As the condition gradually improves, full recovery may be achieved in the coming spring. Since this patient lacks understanding of treatment principles, and previous experts have not shown superior insight, I have pondered this for days and believe the key lies here. The necessity for prolonged treatment aligns with the strategy of besieging a fortified city: first eliminate the followers, then annihilate the leaders. Such matters are rarely resolved quickly. I hope you, dear brother, will review and advise. Do not think that managing a minor illness is overly restrictive or impractical. It would be a great favor.
The onset of fright-phlegm originates in the Liver and Gallbladder. In winter, when Water Qi returns to its root, aggressive treatment is avoided, so only Spleen-regulating herbs are used for mild regulation. It is not until spring, when Wood Qi flourishes, that pills made from Si Jun Zi Tang (Four Gentlemen Decoction) plus Long Dan Cao (Gentian Root), Lu Hui (Aloe), Dai Zhe Shi (Hematite), Huang Lian (Coptis Rhizome), and Qing Dai (Indigo Naturalis) are administered. After taking these, the symptoms of phlegm-misting-the-mind were completely cured, and there has been no recurrence since.
Mr. Hu Youchen remarked: "The situation and strategy are depicted without omission. One would find such individuals among ancient famous generals with difficulty."