（内经只有积饮之说，并无痰证之名。至仲景始立四饮之名，而痰饮居其一。今后世相
传，
必
者
必
以
者
或以劳倦，或以忧思酒色，致成劳损非风卒厥者。或脉见细数，脏无阳邪，时为呕恶泄泻气
短声喑等证。但察其形气病气，本非有余者，皆虚痰也。此则但宜调补，若或攻之，无不危
矣。总之治痰之法，但能使元气日强，则痰必日少。即有微痰，亦自不能为害，而且充助胃
气。若元气日衰，则水谷津液，无非痰尔。随去随生，有能攻之使尽，而且保元气无恙者乎
。故善治痰者，惟能使之不生，方是补天之手。苟不辨其虚实，而欲一概攻之。如王隐君所
论，内外百病皆生于痰，悉用滚痰丸之类。其亦但知目前，而不知日后之患哉。诸家治痰之
法，多有治其标者，虽不可执，亦不可窃也。详列如下。）
（金匮） 治心下有痰饮，胸胁支满，目眩。
茯苓（四两） 桂枝 白术（三两） 甘草（二两。）
痰饮阴象，阻抑其阳，用此阳药化气以伸其阳，此正法也。兹所主乃在胸胁支满目眩者，
何
痰
卫
肺
反
去
旨
出
（局方。陈皮半夏，贵其陈久，则少燥散之性，故名二陈）治一切痰饮为病，咳嗽胀
满，呕吐恶心，头眩心悸。（稠者为痰，稀者为饮，水湿其本也。得火则结为痰，随气升降
。在肺则咳，在胃则呕，在头则眩，在心则悸，在背则冷，在胁则胀，中脘有痰。令人憎寒
壮热头痛，类外感表证。久则潮咳夜重，又类阴火内伤。走注肢节疼痛，又类风证，但肌色
如故，脉滑不匀为异。）
半夏（姜制二钱） 陈皮（去白） 茯苓（一钱） 甘草（五分） 加姜煎。（姜能制
半夏之毒。）
黛，湿痰加苍术
加香附枳壳。胁
半夏辛温，体滑性燥，行水利痰为君。痰因气滞，气顺则痰降。（庞安常曰∶善治痰者，
不
故以茯苓渗湿为臣。中不和则痰涎聚，又以甘草和中补土为佐也。（或曰∶有痰而渴，宜去
半夏，代以栝蒌贝母。吴鹤皋曰∶渴而喜饮水者，易之。渴而不能饮水者，虽渴犹宜半夏也
。此湿为本，热为标，湿极而兼胜已之化，非真象也，按贝母寒润，主肺家燥痰。半夏温燥
，主脾家湿痰。虽俱化痰，而寒湿燥润各异。脱或误施，贻害匪浅，用者宜审之。有血不足
，阴火上逆，肺受火伤，整肃之令，不得下行。由是津液混浊，生痰不生血者，名燥痰，当
用润剂。如地黄门冬枸杞之类，滋阴降火，而痰自清。若投二陈，立见危殆。有头风眉梢骨
痛，投以风药不效，投以痰药见功。又有眼赤羞明，与之凉药不瘳，异以痰剂获愈。有人坐
处吐痰满地，不甚稠粘，只是沫多，此气虚不能摄涎，不可用利药，宜六君子加益智仁一钱
以摄之。）
去茯苓甘草，名陈皮半夏汤。再加桔梗，名桔梗半夏汤。去陈皮甘草，名半夏茯苓汤，
治水
姜汤，
加胆星
墙倒壁
香片子
痰结胸
名加味
名温中化
丸。治痰
单用半夏
奈者。
《黄帝内经》中只有“积饮”的说法，并没有“痰证”这一名称。直到张仲景才确立了“四饮”的名称，而痰饮是其中的一种。后世沿袭此说，认为凡是导致劳损、非风卒厥（因虚劳而非外感风邪引起的突然昏倒）的病症，或者脉象细数、脏腑没有阳热邪气、时常出现呕吐恶心、泄泻、气短、声音嘶哑等症状，且观察其形体气息和病势，原本就不是实证有余的，都属于虚痰。对于这类情况，只应当进行调理补益，如果反而使用攻伐之法，无不造成危险。总之，治疗痰的方法，只要能使元气日益强盛，那么痰必然会日益减少。即使有少量的痰，自然也不能为害，而且还能充助胃气。如果元气日益衰弱，那么水谷津液就都会变成痰。痰随去随生，哪有能将其攻尽而又能保证元气安然无恙的呢？所以善于治痰的人，唯独能做到使痰不再产生，这才是补天之手的高明手段。如果不辨别虚实，就想一概攻伐，像王隐君所论述的那样，认为内外百病都生于痰，全都使用滚痰丸之类的方剂。这也是一时之见，而不顾日后的祸患啊。各家治疗痰的方法，大多有治标的成分，虽然不可固执，也不可轻视。详细列举如下：
《金匮要略》：治疗心下有痰饮，胸胁部支撑胀满，头晕目眩。
茯苓（四两） 桂枝 白术（三两） 甘草（二两）。
痰饮属于阴邪，阻抑阳气，使用这些阳药来化气以伸展阳气，这是正法。此处主治的是胸胁支满、目眩的症状，其主旨在于……（原文此处有缺漏或排版错误，意指通过温阳化饮来解决上述症状）。
《局方》（即《太平惠民和剂局方》）：陈皮、半夏，珍贵之处在于它们陈放得久，则少了燥散的性质，所以名叫“二陈”。治疗一切痰饮引起的疾病，咳嗽、胀满、呕吐、恶心、头晕、心悸。（稠浊的叫痰，稀薄的叫饮，水湿是其根本。遇到火邪则凝结成痰，随着气机升降。在肺则咳嗽，在胃则呕吐，在头部则眩晕，在心则心悸，在背部则发冷，在胁肋则胀满，中脘有痰，使人憎寒壮热头痛，类似外感表证。时间久了则潮咳夜间加重，又类似阴火内伤。游走性的肢节疼痛，又类似风证，但肌肉颜色如故，脉滑且不匀是其特征。）
半夏（姜制二钱） 陈皮（去白） 茯苓（一钱） 甘草（五分） 加生姜煎服。（生姜能制约半夏的毒性。）
如果是湿痰，加苍术；如果有气滞，加香附、枳壳。
半夏辛温，质地滑利，性质燥烈，作为君药行水利痰。痰是因为气机阻滞而产生的，气顺则痰降。（庞安常说：善于治痰的人，不……[原文此处有缺漏]）所以用茯苓渗湿作为臣药。中焦不和则痰涎聚集，又用甘草调和middle、补益脾土作为佐药。（有人说：有痰且口渴，应该去掉半夏，改用瓜蒌、贝母。吴鹤皋说：口渴喜欢喝水的，可以替换。口渴但不能喝水的，虽然口渴仍宜用半夏。这是因为湿是本，热是标，湿极盛而兼有胜己之化，并非真热象。按贝母性寒润，主治肺家燥痰。半夏性温燥，主治脾家湿痰。虽然都是化痰，但寒湿燥润各不相同。如果误用，危害不小，使用者应当审慎。有血不足，阴火上逆，肺受火伤，肃降之令不能下行。因此津液混浊，生痰不生血，这叫燥痰，应当用润剂。如地黄、麦冬、枸杞之类，滋阴降火，痰自然清除。如果投用二陈汤，立刻会见危殆。有头风眉梢骨痛，用风药无效，用痰药见效。又有眼红怕光，用凉药不愈，用痰剂获愈。有人坐着吐痰满地，不太稠粘，只是泡沫多，这是气虚不能摄纳涎液，不可用利水药，宜用六君子汤加益智仁一钱来摄纳它。）
去掉茯苓、甘草，名叫陈皮半夏汤。再加桔梗，名叫桔梗半夏汤。去掉陈皮、甘草，名叫半夏茯苓汤，治疗……（原文此处有缺漏）。
……（原文最后部分存在大量乱码或缺失，无法完整翻译，仅保留可识别的部分意图：针对不同类型的痰结胸等，有相应的加减方或单味药应用，如加胆南星等，以及温中化痰丸等。）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) only mentions "accumulated fluid" (Ji Yin), but does not use the term "phlegm syndrome" (Tan Zheng). It was Zhang Zhongjing who first established the name of the "Four Types of Fluid Retention" (Si Yin), among which "Phlegm-Fluid" (Tan Yin) is one. Since then, passed down through generations... [Text contains gaps/corruptions]. Or due to overwork and fatigue, or due to worry, thinking, excessive alcohol consumption, and sexual indulgence, leading to consumptive diseases, non-wind sudden syncope, etc. Or the pulse appears fine and rapid, with no yang pathogenic factors in the zang organs, accompanied by symptoms such as occasional vomiting, nausea, diarrhea, shortness of breath, and hoarseness. As long as one observes that the patient's form, qi, and disease condition are originally not excess types, they all belong to Deficiency Phlegm (Xu Tan). In such cases, only tonification and regulation should be employed; if attack methods are used instead, danger is inevitable. In summary, the method for treating phlegm is to strengthen the Yuan Qi (Original Qi) day by day, so that phlegm will naturally decrease day by day. Even if there is a small amount of phlegm, it cannot cause harm, and it can even assist stomach qi. If Yuan Qi declines day by day, then water, grain, and body fluids will all turn into phlegm. As soon as it is generated, it is removed; is there anyone who can attack it until it is completely gone while preserving the Yuan Qi unharmed? Therefore, those skilled in treating phlegm are those who can prevent its generation, which is like mending the sky (a metaphor for supreme skill). If one does not distinguish between deficiency and excess, yet desires to attack uniformly, as Wang Yinjun argued that internal and external diseases all arise from phlegm, and using drugs like Gun Tan Wan (Rolling Phlegm Pill) indiscriminately. This shows knowledge only of the present, ignoring future consequences. Various schools' methods for treating phlegm often treat the branch (symptoms); although one should not be rigid, nor should one steal (blindly copy). Listed in detail below.)
(From *Jingui Yaolue*) Treats phlegm-fluid under the heart, with fullness and distension in the chest and hypochondrium, and dizziness.
Fuling (Poria) (4 liang) Guizhi (Cinnamon Twig) Baizhu (Atractylodis Rhizoma) (3 liang) Gancao (Licorice Root) (2 liang).
Phlegm-fluid is a yin pathogen that obstructs and suppresses yang. Using these yang-promoting herbs to transform qi and extend yang is the correct method. The indication here focuses on fullness in the chest and hypochondrium and dizziness; the purport lies in... [Text contains gaps/corruptions].
(From *Ju Fang*. Chenpi (Tangerine Peel) and Banxia (Pinellia Tuber) are valued for being aged, which reduces their drying and dispersing properties, hence the name "Er Chen" (Two Aged Substances).) Treats all diseases caused by phlegm-fluid, including cough, distension, vomiting, nausea, dizziness, and palpitations. (Thick substance is called phlegm; thin substance is called fluid; water-dampness is the root. When combined with fire, it condenses into phlegm and ascends/descends with qi. In the lung, it causes cough; in the stomach, vomiting; in the head, dizziness; in the heart, palpitations; in the back, coldness; in the hypochondrium, distension. Phlegm in the Zhongwan area causes aversion to cold with high fever and headache, resembling exterior syndromes. Over time, it causes tidal cough worsening at night, resembling internal injury from yin-fire. Migratory joint pain resembles wind syndromes, but muscle color remains normal, and the pulse is slippery and irregular, which distinguishes it.)
Banxia (Pinellia Tuber processed with ginger) (2 qian) Chenpi (Citri Reticulatae Pericarpium, white part removed) (1 qian) Fuling (Poria) (1 qian) Gancao (Licorice Root) (5 fen). Decoct with fresh ginger slices. (Ginger can neutralize the toxicity of Banxia.)
For damp-phlegm, add Cangzhu (Atractylodis Rhizoma); for hypochondriac discomfort, add Xiangfu (Cyperi Rhizoma) and Zhiqiao (Aurantii Fructus).
Banxia is acrid and warm, smooth in texture and dry in nature, acting as the Sovereign herb to move water and resolve phlegm. Phlegm arises from qi stagnation; when qi flows smoothly, phlegm descends. (Pang Anchang said: Those skilled in treating phlegm do not... [Text gap]. Therefore, Fuling is used as the Minister herb to leach out dampness. Disharmony in the middle jiao leads to accumulation of phlegm-saliva, so Gancao is used as the Assistant herb to harmonize the middle and tonify earth. (Some say: If there is phlegm with thirst, Banxia should be removed and replaced with Gualou (Trichosanthis Fructus) and Beimu (Fritillariae Bulbus). Wu Hegao said: If thirsty and desiring to drink water, substitution is possible. If thirsty but unable to drink, Banxia is still appropriate despite thirst. This is because dampness is the root and heat is the branch; extreme dampness mimics the transformation of its conqueror, which is not the true image. Note: Beimu is cold and moistening, treating dry-phlegm of the lung. Banxia is warm and drying, treating damp-phlegm of the spleen. Although both resolve phlegm, their cold/warm and dry/moist natures differ greatly. Misapplication causes significant harm; users must be cautious. In cases of blood deficiency with counter-flow of yin-fire injuring the lung, causing turbid fluids and phlegm production instead of blood, this is named Dry-Phlegm (Zao Tan). Moistening agents should be used, such as Dihuang (Rehmanniae Radix), Maidong (Ophiopogonis Radix), and Gouqi (Lycii Fructus), to nourish yin and descend fire, clearing phlegm naturally. Using Er Chen Tang here leads to immediate danger. For cephalalgia with bone pain at the eyebrow temples, wind-dispelling herbs fail, but phlegm-resolving herbs succeed. For red eyes and photophobia, cooling herbs fail, but phlegm-resolving herbs cure. If a person spits copious frothy sputum that is not thick, this is qi deficiency failing to control saliva; diuretics are contraindicated. Use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Yizhiren (Alpiniae Oxyphyllae Semen) 1 qian to secure it.)
Removing Fuling and Gancao yields Chenpi Banxia Tang (Tangerine Peel and Pinellia Decoction). Adding Jiegeng (Platycodonis Radix) yields Jiegeng Banxia Tang. Removing Chenpi and Gancao yields Banxia Fuling Tang, used for water retention... [Text garbled].
Add Dansheng (Arisaematis Cum Bile) ... [Text garbled].
Qiangdaobi ... [Text garbled].
Xiangpianzi ... [Text garbled].
Tan Jie Xiong ... [Text garbled].
Ming Jiawei ... [Text garbled].
Ming Wenzhong Hua ... [Text garbled].
Wan. Treats phlegm ... [Text garbled].
Dan Yong Banxia ... [Text garbled].
Nai Zhe. [Text garbled].