【歌】水谷消磨气血成，滋荣脉络壮元精。七情四气时冲逆，脾胃旋伤懒营运。胃口从此留宿饮，致令
津液作痰凝。因而隧道皆壅塞，却是痰涎滞在经。或痒或麻或痛痹，或留肌膜结瘤瘿。皮间肿痛燔如火，心下
寒疼冷似冰。流入胁稍成癖积，行来髀 作酸疼。或如绵絮如梅核，或若桃胶蚬肉形。吐不出而咽不下，分明
郁积在于胸。或为喘嗽心嘈杂，呕吐痰涎碧靛青。攻上头时眩晕倒，眼 口噤耳中鸣。咽喉闭塞牙关紧，噫气
吞酸呕逆频。夜卧不安奇怪梦，游风肿痛并无名。怔忡健忘时惊怖，癫走痴呆不识人。久泻形枯肠积垢，中风
瘫痪失声音。女人白带男儿浊，经血愆期赤白淋。
荏苒做成劳瘵病，风痫螈纵手挛筋。遍身习习如芒刺，一线寒牵背脊心。如斯怪异延缠病，都是痰涎里面生。
【论】夫人之气道，贵乎清顺，顺则津液流通，何痰之有也！若气血津液稍有一时不得营运，则隧道不通，
凝滞而为痰、为饮，故有五饮之证生焉。盖痰之为病匪一，王隐君备言之。然其原有因热而生痰者，亦有因痰
而生热者，有因风、寒、暑、湿而得者，有因惊而得者，有因气而得者，有因食积而得者，有因酒饮而得者，
有脾虚不能运化而生者，有肾虚不能制火而生者。若热痰则多烦热，风痰多成瘫痪奇证，冷痰多成骨痹，湿痰
多倦怠软弱，惊痰多成心痛、癫疾，饮疾多成胁痛、臂痛，食积痰多成癖块、痞满，其为病状，种种难名。治
法∶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，食积痰则消之，在上者吐之，在中者
下之。中气虚者，必固中气以运痰，肾气虚者，必壮肾水以制火。古方治痰饮类，用汗、吐、下法，此治其标
也。若汗、下过多，损其脾胃，则痰易生而转多，诚非王道之治也。莫若以顺气为先，分导次之。又，痰生于
脾胃，宜实脾燥湿，使脾胃调和，饮食运化而痰自不生，此治其本也。
【脉】偏弦为饮，或沉弦滑，或结芤伏，痰饮中节。
痰饮
痰饮有五。在膈上，瓜蒂散。在肠胃，滚痰丸。在经络及四肢，皮里膜外，姜汁、竹沥。在胁下，白芥
子。二陈汤治一身之痰。导痰汤、坠痰丸、抑痰丸、清膈化痰丸、润下丸，此皆治痰之要药也。
瓜蒂散
吐痰之圣药，治在膈上。
瓜蒂（七十五个） 赤小豆（七十五个） 人参（半两） 甘草（三钱）
上为末，每用一钱或半钱，空心韭汁汤下，以吐为度。
滚痰丸
坠痰之圣药，治在胃肠。
大黄（酒蒸，八两） 黄芩（酒洗，八两） 沉香（半两） 礞石（一两，捶碎，焰硝 过）
上为细末，水丸，梧子大，每服四、五十丸，量虚实加减，茶清送下。
二陈汤
总治一身之痰，都管药也。
陈皮（去白，五钱） 半夏（泡，二钱半） 茯苓（二钱半） 甘草（二钱）
上锉，一剂，姜三片，水煎服。
湿痰，加苍术、白术。寒痰，倍半夏，甚者，加麻黄、细辛、乌、附之类。痰厥头痛，亦加半夏。风痰，
加南星、枳壳、白附子、天麻、僵蚕、牙皂之类。气虚者，更加竹沥；气实加荆沥，俱加姜汁。热痰，加黄芩、
黄连。痰因火盛逆上，降火为先，加白术、黄芩、软石膏、黄连之类。眩晕、嘈杂者，火动其痰也，加山栀、
黄芩、黄连。血虚有痰，加天门冬、知母、栝蒌仁、竹沥、姜汁。滞血者，更加黄芩、白芍药、桑白皮。血滞
不行，中焦有饮者，取竹沥加生姜、韭汁，饮三、五杯，必胸中躁烦不宁后愈。气虚有痰，加人参、白术。脾
虚者，加白术、白芍药、神曲、麦芽、升麻。内伤挟痰，加人参、黄 、白术，姜汁传送。食积痰者，加神曲、
麦芽、山楂、炒黄连、枳实。老痰，加海石、半夏、栝蒌仁、香附米、连翘。
导痰汤
即二陈汤加南星（二钱，姜制） 枳壳（二钱，去穣）
坠痰丸
治痰饮。
黑丑（头末二两） 枳实（炒，一两半） 白矾（三钱，枯半） 朴硝（二钱，风化） 枳壳（炒，一两半）
牙皂（一钱，酒炒）
上为末，萝卜汁丸，如桐子大，每服五十丸，鸡鸣时服，初则有粪，后则有痰。
抑痰丸
栝蒌仁（一两） 半夏（二钱，汤泡） 贝母（三钱，去心）
上为末，蒸饼丸，如麻子大，每服一百丸，姜汤送下。
清膈化痰丸
黄连（一两） 黄芩（一两） 黄柏（半两） 山栀（半两） 香附（一两半） 苍术（二两）
上为末，蒸饼丸，如绿豆大，白汤送下。
润下丸
降痰甚妙。
南星（一两） 半夏（二两，各根据橘红制法） 黄芩（一两） 黄连（一两） 甘草（炙，一两） 橘红
（半斤，以水化盐五钱，拌令得所，煮干烘燥）
上为末，蒸饼丸，如绿豆大，每服五、七十丸，白汤下。
风痰
风痰多见半身不遂，口眼 斜，筋挛，语涩，癫狂，麻痹，眩晕之病。天麻、白附子、牛黄、胆星、姜制
半夏、牙皂、僵蚕、天竺黄治之。丹溪以竹沥入痰药化风痰，以稀涎散吐风痰。
稀涎散（方见中风条。）
湿痰
肥人多湿多痰。盖湿胜则生痰，故湿多见倦怠，痿弱，泄痢，肿胀之证。苍术、白术、南星、半夏、海
粉、陈皮，湿痰之要药也。青礞石丸最能消食积，化湿痰。若湿痰甚，
喘急者，千缗汤。白浊，因湿痰者，珍珠粉丸。湿痰兼风热，中和丸。星夏蛤粉丸最燥湿痰。
青礞石丸
风化硝（提净，三钱，冬月袋盛风化） 青礞石（捣碎，五钱，焰硝等分，同 金色，另研） 南星（五
钱） 半夏（五钱） 茯苓（五钱） 黄芩（五钱）
上为末，神曲糊丸，梧子大，每服三、五十丸，白汤下。
千缗汤（方见喘条。）
珍珠粉丸（方见白浊条。）
中和丸
治湿热气痰。
苍术 黄芩 半夏 香附（各等分）
上为末，粥糊丸，如桐子大，每服五、七十丸，姜汤下。
星夏蛤粉丸
燥湿痰，亦治白浊因痰者。
南星（一两） 半夏（一两） 青黛（一两） 苍术（一两） 蛤粉（二两）
上为末，神曲糊丸，桐子大，每服五、七十丸，姜汤下。
火痰
火痰者，痰因火盛也。盖痰即有形之火，火即无形之痰。未有有痰而无火，未有有火而无痰者也。痰少则
能养胃，火少则能健脾。痰胜，则泛滥洋溢，以生诸病。火胜，则煎熬攻击，以生诸病。痰随火而升降，火领
痰而横行。火者，助痰为虐之贼也。然亦各有所借∶火借气于五脏，而势始盛；痰借液于五味，而形乃成。气
有余，则化为火；液有余，则化为痰。气能发火，火能役痰，故治痰者必降其火，治火者必顺其气也。治火之
药，如∶芩、连、白术、青黛、软石膏等。火降，然后治痰。眩晕嘈杂者，是火动其痰也，二陈加芩、连、山
栀。噫气吞酸者，是痰因火上逆也，茱连丸，或
二陈加南星、芩、连、青黛。火盛生痰者，润下丸。痰稠浊，吐咯不出者，是火郁其痰，清膈化痰丸、栀子金
花丸主之。
茱连丸（方见火条。）
栀子金花丸（方见火条。）
食积痰
脾胃受伤，清气陷下，饮食不化，痰易生而多者，枳实、白术、曲 、半夏、陈皮、茯苓之类，是治其本
也，或枳术丸加橘、半、曲 。脾胃虚者，六君子加升麻提起。内伤挟痰者，必用黄 、白术、陈皮、半夏，
姜汁竹沥传送。食积痰，实者，坠痰丸；若虚，煎补气药送下。食积痰饮，喘急者，黄栝蒌丸，或青礞石丸。
枳术丸（方见内伤条。）
六君子汤
即四君子汤加陈皮、半夏。（方见脾胃条。）
黄栝蒌丸
栝蒌仁 半夏（姜制） 山楂 神曲（炒，各等分）
上为末，栝蒌水丸，如绿豆大，姜汤竹沥送下二、三十丸。
青礞石丸（方见前湿痰。）
老痰（附郁痰）
老痰者，积久稠粘，咯吐不出。惟在开其郁，降其火，顺其气，软其坚，化凝结之痰，缓以治之，庶可取
效。故宜海石、香附、栝蒌、半夏、贝母、芒硝、桔梗、五倍子之类。王汝言化痰丸、润下丸、青礞石丸皆能
治老痰也。
郁痰吐咯不出者，以苦梗开之，或用二陈汤探吐，鹅翎搅，去其痰，或用盐汤探吐。
王汝言化痰丸
天门冬（一两） 黄芩（酒炒，一两） 海粉（另研，一两） 栝蒌仁（另研，去油，一两） 橘红
（一两） 桔梗（五钱） 连翘（五钱） 香附（盐水浸周时，炒，五钱） 青黛（另研，二钱） 芒硝（另研，
三钱，风化用）
上为极细末，炼蜜，入姜汁少许，丸如小圆眼大，噙化一丸。或嚼烂，清汤细咽下。或丸如黍米大，淡
姜汤送下五、六十丸。
【歌诀】水谷经过消化转化为气血，滋养脉络并充实先天之精。七情（喜、怒、忧、思、悲、恐、惊）与四气（风、寒、暑、湿）时常冲逆，导致脾胃受损，运化功能减退。胃中因此停留宿饮，致使津液凝聚成痰。进而使得经络隧道全部壅塞，痰涎停滞在经脉之中。或者出现瘙痒、麻木或疼痛痹阻，或者停留在肌肉筋膜间结成瘤瘿。皮肤间的肿痛炽热如火，心下寒冷疼痛冷如冰。流入胁肋边缘形成癖积，行走时大腿酸疼。或者感觉像棉絮、像梅核堵塞，或者像桃胶、蚬肉形状。吐不出来也咽不下去，分明是郁结积聚在胸中。或者引起喘咳、心中嘈杂，呕吐出的痰涎呈碧靛青色。痰邪攻冲头部时导致眩晕跌倒，眼睛斜视、口噤不开、耳中鸣响。咽喉闭塞、牙关紧闭，嗳气吞酸、呕逆频繁。夜间睡眠不安，做奇怪的梦，游走性风邪肿痛且无名状。心悸怔忡、健忘、时常惊恐害怕，癫狂痴呆不识亲人。久泻导致形体枯瘦、肠道积垢，中风瘫痪、失音。女子白带、男子尿浊，月经延期、赤白淋带。拖延日久造成劳瘵病，风痫抽搐、手足拘挛。全身感觉如芒刺般刺痛，一线寒气牵引背脊心脏。如此怪异缠绵的疾病，都是由于痰涎在体内产生。
【论述】人的气道，贵在清顺，气机顺畅则津液流通，哪里会有痰呢！如果气血津液稍有一时不能正常运化，就会导致隧道不通，凝滞而成痰、成饮，所以产生了五饮的证候。大概痰作为疾病并非一种，王隐君对此有详尽论述。然而其起因有的是因热而生痰，也有的是因痰而生热，有的是因风、寒、暑、湿而得，有的是因惊吓而得，有的是因气滞而得，有的是因食积而得，有的是因饮酒而得，有的是因脾虚不能运化而生，有的是因肾虚不能制火而生。如果是热痰，则多伴有烦热；风痰多导致瘫痪等奇异病症；冷痰多导致骨痹；湿痰多导致倦怠软弱；惊痰多导致心痛、癫疾；饮疾多导致胁痛、臂痛；食积痰多导致癖块、痞满。其病症表现，种种难以名状。治疗方法：热痰则用清热法，湿痰则用燥湿法，风痰则用疏散法，郁痰则用开郁法，顽痰则用软坚法，食积痰则用消导法。病位在上者用吐法，在中者用下法。中气虚者，必须固护中气以运化痰饮；肾气虚者，必须壮补肾水以制约相火。古方治疗痰饮类疾病，多用汗、吐、下法，这是治标的方法。如果汗、下过多，损伤脾胃，则痰容易生成且增多，这确实不是王道般的正治之法。不如以顺气为先，分消导滞次之。另外，痰生于脾胃，宜健脾燥湿，使脾胃调和，饮食运化正常而痰自然不生，这是治本的方法。
痰饮
痰饮分为五种。在膈上的，用瓜蒂散。在肠胃的，用滚痰丸。在经络及四肢、皮里膜外的，用姜汁、竹沥。在胁下的，用白芥子。二陈汤治疗全身的痰。导痰汤、坠痰丸、抑痰丸、清膈化痰丸、润下丸，这些都是治疗痰的重要药物。
瓜蒂散
吐痰的圣药，治疗病位在膈上。
瓜蒂（七十五个） 赤小豆（七十五个） 人参（半两） 甘草（三钱）
以上研为末，每次用一钱或半钱，空腹时用韭汁汤送服，以吐出为度。
滚痰丸
坠痰的圣药，治疗病位在胃肠。
大黄（酒蒸，八两） 黄芩（酒洗，八两） 沉香（半两） 礞石（一两，捶碎，用焰硝煅过）
以上研为细末，用水泛丸，如梧桐子大，每次服用四五十丸，根据虚实加减用量，用茶清送下。
二陈汤
总治一身之痰，是统领诸药的药物。
陈皮（去白，五钱） 半夏（泡，二钱半） 茯苓（二钱半） 甘草（二钱）
以上锉碎，一剂药，加生姜三片，水煎服。
湿痰，加苍术、白术。寒痰，加倍半夏，严重的，加麻黄、细辛、乌头、附子之类。痰厥头痛，也加半夏。风痰，加南星、枳壳、白附子、天麻、僵蚕、牙皂之类。气虚者，再加竹沥；气实加荆沥，都加姜汁。热痰，加黄芩、黄连。痰因火盛逆上，以降火为先，加白术、黄芩、软石膏、黄连之类。眩晕、嘈杂者，是火动其痰，加山栀、黄芩、黄连。血虚有痰，加天门冬、知母、栝蒌仁、竹沥、姜汁。有瘀血者，再加黄芩、白芍药、桑白皮。血滞不行，中焦有饮者，取竹沥加生姜、韭汁，饮用三到五杯，必定在胸中躁烦不宁之后痊愈。气虚有痰，加人参、白术。脾虚者，加白术、白芍药、神曲、麦芽、升麻。内伤挟痰，加人参、黄芪、白术，用姜汁传送送服。食积痰者，加神曲、麦芽、山楂、炒黄连、枳实。老痰，加海浮石、半夏、栝蒌仁、香附米、连翘。
坠痰丸
治疗痰饮。
黑丑（头末二两） 枳实（炒，一两半） 白矾（三钱，枯半） 朴硝（二钱，风化） 枳壳（炒，一两半） 牙皂（一钱，酒炒）
以上研为末，用萝卜汁泛丸，如桐子大，每次服用五十丸，鸡鸣时服用，起初排粪，后来排痰。
抑痰丸
栝蒌仁（一两） 半夏（二钱，汤泡） 贝母（三钱，去心）
以上研为末，用蒸饼泛丸，如麻子大，每次服用一百丸，姜汤送下。
清膈化痰丸
黄连（一两） 黄芩（一两） 黄柏（半两） 山栀（半两） 香附（一两半） 苍术（二两）
以上研为末，用蒸饼泛丸，如绿豆大，白开水送下。
润下丸
降痰非常有效。
南星（一两） 半夏（二两，各根据橘红制法处理） 黄芩（一两） 黄连（一两） 甘草（炙，一两） 橘红（半斤，以水化盐五钱，拌令均匀，煮干烘燥）
以上研为末，用蒸饼泛丸，如绿豆大，每次服用五七十丸，白开水送下。
风痰
风痰多见半身不遂，口眼歪斜，筋脉拘挛，言语涩滞，癫狂，麻痹，眩晕等疾病。天麻、白附子、牛黄、胆南星、姜制半夏、牙皂、僵蚕、天竺黄治疗此症。丹溪认为用竹沥入痰药可化解风痰，用稀涎散吐风痰。
稀涎散（方见中风条。）
湿痰
肥人多湿多痰。因为湿胜则生痰，所以湿痰多见倦怠、痿弱、泄痢、肿胀等证候。苍术、白术、南星、半夏、海粉、陈皮，是湿痰的要药。青礞石丸最能消食积、化湿痰。如果湿痰严重，气喘急促者，用千缗汤。白浊，因湿痰所致者，用珍珠粉丸。湿痰兼风热，用中和丸。星夏蛤粉丸最燥湿痰。
青礞石丸
风化硝（提净，三钱，冬季袋装风化） 青礞石（捣碎，五钱，与焰硝等分，同煅至金色，另研） 南星（五钱） 半夏（五钱） 茯苓（五钱） 黄芩（五钱）
以上研为末，用神曲糊泛丸，如梧桐子大，每次服用三五十丸，白开水送下。
千缗汤（方见喘条。）
珍珠粉丸（方见白浊条。）
中和丸
治疗湿热气痰。
苍术 黄芩 半夏 香附（各等分）
以上研为末，用粥糊泛丸，如桐子大，每次服用五七十丸，姜汤送下。
星夏蛤粉丸
燥湿痰，也治疗因痰引起的白浊。
南星（一两） 半夏（一两） 青黛（一两） 苍术（一两） 蛤粉（二两）
以上研为末，用神曲糊泛丸，如桐子大，每次服用五七十丸，姜汤送下。
火痰
火痰，是指痰因火盛所致。大概痰即是有形的火，火即是无形的痰。没有有痰而无火的，也没有有火而无痰的。痰少则能养胃，火少则能健脾。痰胜，则泛滥洋溢，从而产生各种疾病。火胜，则煎熬攻击，从而产生各种疾病。痰随火而升降，火领痰而横行。火，是助长痰为虐的贼邪。但也各有凭借：火借五脏之气，势力才盛；痰借五味之液，形态才成。气有余，则化为火；液有余，则化为痰。气能发火，火能役使痰，所以治疗痰必须降其火，治疗火必须顺其气。治火的药物，如：黄芩、黄连、白术、青黛、软石膏等。火降，然后治痰。眩晕嘈杂者，是火动其痰，二陈汤加黄芩、黄连、山栀。嗳气吞酸者，是痰因火上逆，用茱连丸，或二陈汤加南星、黄芩、黄连、青黛。火盛生痰者，用润下丸。痰稠浊，吐咯不出者，是火郁其痰，用清膈化痰丸、栀子金花丸主治。
茱连丸（方见火条。）
栀子金花丸（方见火条。）
食积痰
脾胃受伤，清气陷下，饮食不化，痰易生且多者，用枳实、白术、神曲、半夏、陈皮、茯苓之类，这是治本的方法，或者用枳术丸加橘红、半夏、神曲。脾胃虚者，用六君子汤加升麻提起。内伤挟痰者，必用黄芪、白术、陈皮、半夏，用姜汁、竹沥传送送服。食积痰，实证者，用坠痰丸；若虚证，煎补气药送下。食积痰饮，气喘急促者，用黄栝蒌丸，或青礞石丸。
枳术丸（方见内伤条。）
黄栝蒌丸
栝蒌仁 半夏（姜制） 山楂 神曲（炒，各等分）
以上研为末，用栝蒌水泛丸，如绿豆大，姜汤、竹沥送下二三十丸。
青礞石丸（方见前湿痰。）
老痰（附郁痰）
老痰，是指积久稠粘，咯吐不出。只在开通其郁结，降其火，顺其气，软化其坚硬，化解凝结之痰，缓慢治疗，才可以取得疗效。所以适宜用海浮石、香附、栝蒌、半夏、贝母、芒硝、桔梗、五倍子之类。王汝言化痰丸、润下丸、青礞石丸都能治疗老痰。
郁痰吐咯不出者，用桔梗开之，或用二陈汤探吐，用鹅翎搅动，去除其痰，或用盐汤探吐。
王汝言化痰丸
天门冬（一两） 黄芩（酒炒，一两） 海粉（另研，一两） 栝蒌仁（另研，去油，一两） 橘红（一两） 桔梗（五钱） 连翘（五钱） 香附（盐水浸一周，炒，五钱） 青黛（另研，二钱） 芒硝（另研，三钱，风化用）
以上研为极细末，炼蜜，加入少许姜汁，丸如小圆眼大，含化一丸。或者嚼烂，用清水细细咽下。或者丸如黍米大，淡姜汤送下五六十丸。
[Verse]
Water and grain are metabolized to transform into Qi and Blood, nourishing the collaterals and strengthening the primordial essence. The Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright) and Four Qi (Wind, Cold, Summer-heat, Dampness) often rebel and clash, damaging the Spleen and Stomach and impairing their transportive functions. Consequently, retained fluids remain in the stomach, causing body fluids to condense into Phlegm. This leads to the blockage of all meridians and tunnels, with phlegm-saliva stagnating in the channels. It may manifest as itching, numbness, or painful obstruction; or remain in the muscle membranes forming tumors and goiters. Swelling and pain in the skin feel burning like fire, while pain under the heart feels cold like ice. Flowing into the hypochondrium, it forms masses; walking causes soreness and pain in the thighs. One may feel as if cotton wadding or a plum pit is lodged, or resembling peach gum or clam meat. It cannot be vomited out nor swallowed down, clearly indicating depression and accumulation in the chest. It may cause wheezing, coughing, and gastric discomfort, vomiting bile-green phlegm. When attacking the head, it causes dizziness and fainting, squinting eyes, locked jaw, and tinnitus. Throat closure, tight jaw, belching, acid regurgitation, and frequent retching occur. Sleep is restless with strange dreams; wandering wind causes swelling and pain of unknown nature. Palpitations, amnesia, and frequent fright occur; mania, dementia, and inability to recognize people arise. Chronic diarrhea leads to emaciation and intestinal impaction; stroke, paralysis, and loss of voice appear. Women have leukorrhea, men have turbid urine; menstruation is delayed with red and white discharge. Dragging on for a long time, it becomes a consumptive disease; wind-phlegm epilepsy involves convulsions and hand spasms. The whole body feels prickly like thorns, with a line of cold pulling the spine and heart. Such strange and lingering diseases are all generated from phlegm-saliva within.
[Discussion]
The air pathways of humans value clarity and smoothness. If smooth, body fluids flow freely, so how can there be phlegm? If Qi, Blood, and body fluids fail to circulate normally even for a moment, the tunnels become blocked, condensing into phlegm and fluid retention, thus generating the syndromes of the Five Fluid Retentions. Phlegm as a disease is not singular; Wang Yinjun has discussed it exhaustively. However, its origins vary: some generate phlegm due to Heat, others generate Heat due to phlegm; some result from Wind, Cold, Summer-heat, or Dampness; some from Fright; some from Qi stagnation; some from Food Stagnation; some from alcohol consumption; some from Spleen deficiency failing to transform and transport; some from Kidney deficiency failing to control Fire. Heat-phlegm often presents with vexation and heat; Wind-phlegm often leads to paralysis and strange syndromes; Cold-phlegm often leads to bone bi; Damp-phlegm often leads to fatigue and weakness; Fright-phlegm often leads to heart pain and epilepsy; Fluid retention often leads to hypochondriac and arm pain; Food-stagnation phlegm often leads to masses and fullness. Its manifestations are myriad and hard to name. Treatment methods: Clear Heat-phlegm, dry Damp-phlegm, disperse Wind-phlegm, open Depressed-phlegm, soften Stubborn-phlegm, digest Food-stagnation phlegm. For pathology above, use emesis; for pathology in the middle, use purgation. For Middle Qi deficiency, one must consolidate Middle Qi to transport phlegm; for Kidney Qi deficiency, one must strengthen Kidney Water to control Fire. Ancient formulas treating phlegm-fluid retention often use sweating, emetic, and purgative methods; this treats the branch. If sweating and purgation are excessive, damaging the Spleen and Stomach, phlegm will easily generate and increase, which is indeed not the royal way of treatment. It is better to prioritize regulating Qi, followed by separating and guiding. Furthermore, since phlegm originates in the Spleen and Stomach, one should solidify the Spleen and dry Dampness, harmonizing the Spleen and Stomach so that food and drink are transformed and phlegm naturally does not generate; this treats the root.
[Pulse]
A pulse that is slanting and wiry indicates fluid retention; or sinking, wiry, and slippery; or knotted, hollow, and hidden; these are signs of phlegm-fluid retention.
Phlegm-Fluid Retention
Phlegm-fluid retention is divided into five types. In the diaphragm area, use Gengti San (Melon Vine Powder). In the intestines and stomach, use Guntan Wan (Rolling Phlegm Pill). In the meridians, limbs, and between skin and fascia, use Ginger Juice and Bamboo Sap. In the hypochondrium, use Baijiezi (White Mustard Seed). Erchen Tang (Two-Cured Decoction) treats phlegm throughout the body. Daotan Tang (Guiding Phlegm Decoction), Zhuitan Wan (Dropping Phlegm Pill), Yitan Wan (Suppressing Phlegm Pill), Qingge Huatan Wan (Clearing Diaphragm Resolving Phlegm Pill), and Runxia Wan (Moistening and Descending Pill) are all essential medicines for treating phlegm.
Gengti San (Melon Vine Powder)
The holy medicine for inducing vomiting of phlegm, treating pathology in the diaphragm.
Gengti (Melon Vine Fruit, 75 pieces) Chixiaodou (Red Adzuki Bean, 75 pieces) Renshen (Ginseng Root, half tael) Gancao (Licorice Root, 3 qian)
Grind into powder. Use 1 qian or half qian each time, taken on an empty stomach with Chinese Chive Juice Soup. Stop when vomiting occurs.
Guntan Wan (Rolling Phlegm Pill)
The holy medicine for dropping phlegm, treating pathology in the intestines and stomach.
Dahuang (Rhubarb Root, wine-steamed, 8 liang) Huangqin (Scutellaria Root, wine-washed, 8 liang) Chenxiang (Agarwood, half tael) Mengshi (Calamine, 1 liang, crushed, calcined with Saltpeter)
Grind into fine powder. Make water pills the size of Sophora seeds. Take 40-50 pills each time, adjusting dosage according to deficiency or excess. Take with clear tea.
Erchen Tang (Two-Cured Decoction)
Treats phlegm throughout the body; the commander medicine.
Chenpi (Aged Tangerine Peel, pith removed, 5 qian) Banxia (Pinellia Tuber, soaked, 2.5 qian) Fuling (Poria, 2.5 qian) Gancao (Licorice Root, 2 qian)
Cut into pieces. For one dose, add 3 slices of fresh ginger. Decoct in water and take.
For Damp-phlegm, add Cangzhu (Atractylodes Rhizome) and Baizhu (White Atractylodes Rhizome). For Cold-phlegm, double the Banxia; for severe cases, add Mahuang (Ephedra Stem), Xixin (Asarum Root), Wutou (Aconite Lateral Root), and Fuzi (Prepared Aconite Root). For Phlegm-Jue headache, also add Banxia. For Wind-phlegm, add Tianxing (Arisaema Rhizome), Zhike (Bitter Orange Fruit), Baifuzi (Typhonium Rhizome), Tianma (Gastrodia Rhizome), Jiangcan (Bombyx Batryticatus), and Yazao (Gleditsia Sinensis Fruit). For Qi deficiency, add Zhuli (Bamboo Sap); for Qi excess, add Jingli (Schisandra Sap); both add Jiangzhi (Fresh Ginger Juice). For Heat-phlegm, add Huangqin and Huanglian (Coptis Rhizome). If phlegm rebels upward due to excessive Fire, prioritize descending Fire; add Baizhu, Huangqin, Ruangao (Soft Gypsum), and Huanglian. For dizziness and gastric discomfort, caused by Fire agitating phlegm, add Zhizi (Gardenia Fruit), Huangqin, and Huanglian. For Blood deficiency with phlegm, add Tiandong (Asparagus Root), Zhimu (Anemarrhena Rhizome), Gualouren (Trichosanthes Seed), Zhuli, and Jiangzhi. For Blood stasis, add Huangqin, Baishao (White Peony Root), and Sangbaipi (Mulberry Bark). If Blood stasis does not move and there is fluid retention in the Middle Jiao, take Zhuli added with Shengjiang (Fresh Ginger) and Jiuzhi (Chinese Chive Juice), drinking 3-5 cups. Recovery follows after central restlessness and agitation. For Qi deficiency with phlegm, add Renshen and Baizhu. For Spleen deficiency, add Baizhu, Baishao, Shenqu (Medicated Leaven), Maiya (Sprouted Grain), and Shengma (Cimicifuga Rhizome). For internal injury complicated by phlegm, add Renshen, Huangqi (Astragalus Root), and Baizhu, transmitted with Jiangzhi. For Food-stagnation phlegm, add Shenqu, Maiya, Shanzha (Hawthorn Fruit), fried Huanglian, and Zhishi (Immature Bitter Orange). For Old Phlegm, add Haishi (Floating Limestone), Banxia, Gualouren, Xiangfu (Cyperi Rhizome), and Lianqiao (Forsythia Fruit).
Daotan Tang (Guiding Phlegm Decoction)
Is Erchen Tang plus Nanxing (Arisaema Rhizome, 2 qian, ginger-processed) and Zhike (Bitter Orange Fruit, 2 qian, pulp removed).
Zhuitan Wan (Dropping Phlegm Pill)
Treats phlegm-fluid retention.
Heiqiu (Black Morning Glory Seed, first powder, 2 liang) Zhishi (Immature Bitter Orange, fried, 1.5 liang) Baifan (Alum, 3 qian, half calcined) Puxiao (Mirabilite, 2 qian, weathered) Zhike (Bitter Orange Fruit, fried, 1.5 liang) Yazao (Gleditsia Sinensis Fruit, 1 qian, wine-fried)
Grind into powder. Make pills with Radish Juice, size of Sesame seeds. Take 50 pills at cock-crow time. Initially, stool is passed; subsequently, phlegm is passed.
Yitan Wan (Suppressing Phlegm Pill)
Gualouren (Trichosanthes Seed, 1 liang) Banxia (Pinellia Tuber, 2 qian, boiled) Beimu (Fritillaria Bulb, 3 qian, heart removed)
Grind into powder. Make pills with steamed wheat cake, size of Hemp seeds. Take 100 pills each time, with Ginger Soup.
Qingge Huatan Wan (Clearing Diaphragm Resolving Phlegm Pill)
Huanglian (Coptis Rhizome, 1 liang) Huangqin (Scutellaria Root, 1 liang) Huangbai (Phellodendron Bark, half tael) Zhizi (Gardenia Fruit, half tael) Xiangfu (Cyperi Rhizome, 1.5 liang) Cangzhu (Atractylodes Rhizome, 2 liang)
Grind into powder. Make pills with steamed wheat cake, size of Mung beans. Take with plain water.
Runxia Wan (Moistening and Descending Pill)
Excellent for descending phlegm.
Nanxing (Arisaema Rhizome, 1 liang) Banxia (Pinellia Tuber, 2 liang, processed according to Ju Hong method) Huangqin (Scutellaria Root, 1 liang) Huanglian (Coptis Rhizome, 1 liang) Gancao (Licorice Root, roasted, 1 liang) Ju Hong (Tangerine Peel, half jin, mixed with 5 qian salt dissolved in water, boiled until dry, and dried)
Grind into powder. Make pills with steamed wheat cake, size of Mung beans. Take 50-70 pills each time, with plain water.
Wind-Phlegm
Wind-phlegm commonly manifests as hemiplegia, deviation of mouth and eyes, tendon spasms, dysarthria, mania, numbness, and dizziness. Tianma (Gastrodia Rhizome), Baifuzi (Typhonium Rhizome), Niuhuang (Calculus Bovis), Dansheng (Arisaema with Bos Taurus Gallstone), ginger-processed Banxia, Yazao, Jiangcan, and Tianzhu Huang (Bambusa Textilis Sap) treat this. Danxi believed that adding Zhuli (Bamboo Sap) to phlegm-resolving medicines transforms Wind-phlegm, and Xixian San (Thin Saliva Powder) induces vomiting of Wind-phlegm.
Xixian San (See Stroke section.)
Damp-Phlegm
Obese people often have much Dampness and Phlegm. Since Dampness excess generates phlegm, Damp-phlegm commonly presents with fatigue, flaccidity, diarrhea/dysentery, and edema. Cangzhu, Baizhu, Nanxing, Banxia, Haifen (Sea Flour), and Chenpi are essential medicines for Damp-phlegm. Qingmengshi Wan (Blue Calamine Pill) best digests food stagnation and transforms Damp-phlegm. If Damp-phlegm is severe with panting and urgency, use Qianmin Tang. For turbid urine due to Damp-phlegm, use Zhenzhu Fen Wan. For Damp-phlegm combined with Wind-Heat, use Zhonghe Wan. Xingxia Hafan Wan is most effective at drying Damp-phlegm.
Qingmengshi Wan (Blue Calamine Pill)
Fenghua Xiao (Weathered Mirabilite, purified, 3 qian, stored in bag in winter to weather) Qingmengshi (Blue Calamine, crushed, 5 qian, equal parts with Saltpeter, calcined to gold color, ground separately) Nanxing (Arisaema Rhizome, 5 qian) Banxia (Pinellia Tuber, 5 qian) Fuling (Poria, 5 qian) Huangqin (Scutellaria Root, 5 qian)
Grind into powder. Make pills with Medicated Leuen paste, size of Sophora seeds. Take 30-50 pills each time, with plain water.
Qianmin Tang (See Panting section.)
Zhenzhu Fen Wan (See Turbid Urine section.)
Zhonghe Wan (Neutralizing Pill)
Treats Damp-Heat and Qi-phlegm.
Cangzhu Cangzhu Huangqin Banxia Xiangfu (Equal parts)
Grind into powder. Make pills with porridge paste, size of Sesame seeds. Take 50-70 pills each time, with Ginger Soup.
Xingxia Hafan Wan (Arisaema, Pinellia, and Clam Shell Powder Pill)
Dries Damp-phlegm; also treats turbid urine due to phlegm.
Nanxing (Arisaema Rhizome, 1 liang) Banxia (Pinellia Tuber, 1 liang) Qingdai (Indigo Naturalis, 1 liang) Cangzhu (Atractylodes Rhizome, 1 liang) Hafan (Clam Shell Powder, 2 liang)
Grind into powder. Make pills with Medicated Leaven paste, size of Sesame seeds. Take 50-70 pills each time, with Ginger Soup.
Fire-Phlegm
Fire-phlegm refers to phlegm caused by excessive Fire. Phlegm is essentially visible Fire; Fire is invisible phlegm. There is no phlegm without Fire, nor Fire without phlegm. Little phlegm nourishes the Stomach; little Fire strengthens the Spleen. Excess phlegm floods and overflows, generating various diseases. Excess Fire boils and attacks, generating various diseases. Phlegm rises and falls with Fire; Fire leads Phlegm to traverse horizontally. Fire is the thief that aids Phlegm in wreaking havoc. However, each has its reliance: Fire borrows Qi from the Five Zang organs to gain strength; Phlegm borrows fluids from the Five Flavors to form shape. Excess Qi transforms into Fire; excess fluids transform into Phlegm. Qi can emit Fire; Fire can enslave Phlegm. Therefore, treating phlegm requires descending Fire; treating Fire requires smoothing Qi. Medicines for treating Fire include: Huangqin, Huanglian, Baizhu, Qingdai, Ruangao, etc. After Fire descends, then treat phlegm. For dizziness and gastric discomfort, caused by Fire agitating phlegm, use Erchen Tang plus Huangqin, Huanglian, and Zhizi. For belching and acid regurgitation, caused by phlegm rebelling upward due to Fire, use Zhulian Wan, or Erchen Tang plus Nanxing, Huangqin, Huanglian, and Qingdai. For Fire excess generating phlegm, use Runxia Wan. For thick and turbid phlegm that cannot be spat out, caused by Fire depressing phlegm, use Qingge Huatan Wan and Zhizi Jinhua Wan.
Zhulian Wan (See Fire section.)
Zhizi Jinhua Wan (See Fire section.)
Food-Stagnation Phlegm
When Spleen and Stomach are injured, Clear Qi sinks, food and drink are not transformed, and phlegm easily generates and increases, use Zhishi, Baizhu, Shenqu, Banxia, Chenpi, and Fuling to treat the root. Or use Zhizhu Wan plus Ju Hong, Banxia, and Shenqu. For Spleen and Stomach deficiency, use Liujunzi Tang plus Shengma to lift. For internal injury complicated by phlegm, must use Huangqi, Baizhu, Chenpi, and Banxia, transmitted with Ginger Juice and Bamboo Sap. For Food-stagnation phlegm, excess type, use Zhuitan Wan; if deficiency, decoct Qi-tonifying medicine to send down. For Food-stagnation phlegm-fluid retention with panting, use Huanggualong Wan or Qingmengshi Wan.
Zhizhu Wan (See Internal Injury section.)
Liujunzi Tang (Six-Gentlemen Decoction)
Is Sijunzi Tang plus Chenpi and Banxia. (See Spleen and Stomach section.)
Huanggualong Wan (Trichosanthes and Astragalus Pill)
Gualouren (Trichosanthes Seed) Banxia (Pinellia Tuber, ginger-processed) Shanzha (Hawthorn Fruit) Shenqu (Medicated Leaven, fried, equal parts)
Grind into powder. Make pills with Trichosanthes water, size of Mung beans. Take 20-30 pills with Ginger Soup and Bamboo Sap.
Qingmengshi Wan (See Damp-Phlegm above.)
Old Phlegm (Attached: Depressed Phlegm)
Old phlegm accumulates over time, becoming thick and sticky, unable to be spat out. One must only open its depression, descend its Fire, smooth its Qi, soften its hardness, and resolve condensed phlegm, treating it slowly to expect efficacy. Thus, Haishi, Xiangfu, Gualou, Banxia, Beimu, Mangxiao (Mirabilite), Jiegeng (Platycodon Root), and Wubeizi (Gallnut) are suitable. Wang Ruyan's Huatan Wan, Runxia Wan, and Qingmengshi Wan can all treat old phlegm.
For depressed phlegm that cannot be spat out, use Jiegeng to open it, or use Erchen Tang to induce vomiting, stir with a goose feather to remove phlegm, or use Salt Soup to induce vomiting.
Wang Ruyan's Huatan Wan (Wang Ruyan's Phlegm-Resolving Pill)
Tiandong (Asparagus Root, 1 liang) Huangqin (Scutellaria Root, wine-fried, 1 liang) Haifen (Sea Flour, ground separately, 1 liang) Gualouren (Trichosanthes Seed, ground separately, oil removed, 1 liang) Ju Hong (Tangerine Peel, 1 liang) Jiegeng (Platycodon Root, 5 qian) Lianqiao (Forsythia Fruit, 5 qian) Xiangfu (Cyperi Rhizome, soaked in salt water for a week, fried, 5 qian) Qingdai (Indigo Naturalis, ground separately, 2 qian) Mangxiao (Mirabilite, ground separately, 3 qian, weathered use)
Grind into extremely fine powder. Refine honey, add a little Ginger Juice. Make pills the size of small raisins. Hold one pill in the mouth to dissolve. Or chew thoroughly and swallow carefully with clear water. Or make pills the size of Millet seeds, take 50-60 pills with light Ginger Soup.