秦子曰∶浓浊者为痰，清稀者为饮；痰属火化，饮属水湿，《金匮》论之甚详，分立痰
饮、悬饮、溢饮、支饮。四者条目外，又有留饮、伏饮二者。今余先将仲景所立六者，详别
明之。至燥痰、火痰、风痰等，另立痰症内。
【痰饮之症】其人素肥渐瘦，水走肠间，沥沥有声，心下胸胁支满，目眩，谓之痰饮
【痰饮之因】饮食不节，水浆不忌，胃虽能纳，脾不能运，肺不通调，停积于胃，则
成痰饮。痰饮内积，外不荣于肌表，则素肥渐瘦；由胃下流，水走肠间，则沥沥有声矣。
【痰饮之脉】或见弦数，或见弦紧，或见双弦，甚则沉伏。弦紧寒饮，弦数热痰。
【痰饮之治】《金匮》立法二条，一曰病痰饮者，当以温药和之，而不立方，以水寒
，温中健脾，则气化痰行，若用寒凉，反凝结不散矣。一曰心下有痰饮，胸胁支满，目眩，
苓桂术甘汤主之；若短气，有微饮，当从小便去之，苓桂术甘汤主之，肾气丸亦主之。痰饮
胸满，推展苍朴二陈汤。
苓桂术甘汤 治心下有痰饮，胸胁支满，目眩。
茯苓 桂枝 白术 甘草
肾气丸 治痰饮短气，当从小便去者。
怀生地 泽泻 白茯苓 山药 丹皮 山茱萸 附子 肉桂
推展苍朴二陈汤 治胃家有水饮，胸满呕吐不渴者，饮伤肺则喘咳，饮伤胃则呕
熟半夏 广皮 甘草 白茯苓 熟苍术 浓朴
身热口渴加葛根。小便不利加泽泻。脉数者加山栀、川连。脉迟加煨姜。
秦子说：质地浓稠浑浊的是痰，质地清稀的是饮；痰属于火邪化生，饮属于水湿之邪，《金匮要略》对此论述得非常详细，分别立出痰饮、悬饮、溢饮、支饮这四种类型。在这四种类型之外，又有留饮、伏饮这两种。现在我先将张仲景所确立的这六种情况，详细辨别清楚。至于燥痰、火痰、风痰等，则另外在痰症章节中论述。
【痰饮的症状】患者平时身体肥胖却逐渐消瘦，水液流注于肠间，发出沥沥的声音，心下及胸胁部位支撑胀满，头晕目眩，这称为痰饮。
【痰饮的成因】饮食没有节制，饮水不忌口，胃虽然能够受纳食物，但脾不能运化水湿，肺不能通调水道，导致水湿停积在胃中，从而形成痰饮。痰饮内积，不能外荣于肌表，所以原本肥胖的人逐渐消瘦；水湿由胃向下流注，流经肠间，所以会发出沥沥的声音。
【痰饮的脉象】或者见到弦数脉，或者见到弦紧脉，或者见到双弦脉，严重时甚至出现沉伏脉。弦紧脉主寒饮，弦数脉主热痰。
【痰饮的治疗】《金匮要略》确立了两个治疗原则：一是“病痰饮者，当以温药和之”，但没有具体列出方剂，因为用水寒之性配合温中健脾的药物，就能使气机通畅、痰化行散，如果误用寒凉药物，反而会导致凝结不散。二是“心下有痰饮，胸胁支满，目眩”，用苓桂术甘汤主治；如果有短气症状，且有轻微的水饮，应当通过小便排出，也用苓桂术甘汤主治，肾气丸也可以主治。对于痰饮导致的胸部胀满，使用推展苍朴二陈汤。
苓桂术甘汤：治疗心下有痰饮，胸胁支撑胀满，头晕目眩。
组成：茯苓、桂枝、白术、甘草。
肾气丸：治疗痰饮导致的短气，需要通过小便排出的情况。
组成：怀生地、泽泻、白茯苓、山药、丹皮、山茱萸、附子、肉桂。
推展苍朴二陈汤：治疗胃中有水饮，胸部胀满、呕吐且不口渴的情况；若水饮伤肺则出现喘咳，伤胃则出现呕吐。
组成：熟半夏、广皮（陈皮）、甘草、白茯苓、熟苍术、浓朴（厚朴）。
加减法：身体发热、口渴者加葛根；小便不利者加泽泻；脉数者加山栀、川连（黄连）；脉迟者加煨姜。
Qin Zi said: The substance that is thick and turbid is phlegm (Tan, 痰), while the substance that is clear and thin is fluid retention (Yin, 饮); phlegm arises from fire transformation, whereas fluid retention arises from water-dampness. This was discussed in great detail in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), which separately categorizes Tan Yin (Phlegm-Fluid), Xuan Yin (Hanging Fluid), Yi Yin (Overflowing Fluid), and Zhi Yin (Piercing Fluid). Beyond these four categories, there are also two others: Liu Yin (Retained Fluid) and Fu Yin (Hidden Fluid). Now, I will first elaborate on and distinguish the six types established by Zhang Zhongjing. As for dry phlegm, fire phlegm, wind phlegm, etc., they will be discussed separately under the chapter on Phlegm Syndromes.
[Symptoms of Tan Yin] The patient, who was previously obese, gradually becomes thin; water flows through the intestines, producing a gurgling sound; there is a sensation of fullness and distension supporting the epigastrium and hypochondrium; dizziness occurs. This is called Tan Yin (Phlegm-Fluid).
[Etiology of Tan Yin] Indiscretion in diet and lack of restriction in drinking fluids lead to a situation where the stomach can receive food, but the spleen cannot transport it, and the lungs fail to regulate water passages. Consequently, dampness accumulates in the stomach, forming Tan Yin (Phlegm-Fluid). Internal accumulation of Tan Yin prevents nourishment of the muscle surface, causing the previously obese person to become thin; as water flows downward from the stomach into the intestines, the gurgling sound occurs.
[Pulse of Tan Yin] The pulse may appear wiry and rapid (Xian Shu), wiry and tight (Xian Jin), or double-wiry (Shuang Xian); in severe cases, it may be deep and hidden (Chen Fu). A wiry-tight pulse indicates cold-fluid retention, while a wiry-rapid pulse indicates heat-phlegm.
[Treatment of Tan Yin] The *Jingui Yaolue* establishes two principles: First, "For patients with phlegm-fluid, warm herbs should be used to harmonize," though no specific formula is given initially, because using warm herbs to warm the middle and strengthen the spleen allows qi to circulate and phlegm to transform; if cold-cooling herbs are used, it will instead cause condensation and stagnation. Second, "When there is phlegm-fluid in the heart region, with fullness and distension in the chest and hypochondrium, and dizziness, Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractodes, and Licorice Decoction) is the primary treatment." If there is shortness of breath due to slight fluid retention, it should be eliminated via urination, treated with Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractodes, and Licorice Decoction), or Shen Qi Wan (Kidney Qi Pill). For chest fullness due to phlegm-fluid, Tui Zhan Cang Po Er Chen Tang (Extended Cangpo Erchen Decoction) is used.
Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractodes, and Licorice Decoction): Treats phlegm-fluid in the heart region, with fullness and distension in the chest and hypochondrium, and dizziness.
Ingredients: Poria (*Poria cocos*), Cinnamon Twig (*Ramulus Cinnamomi*), Atractodes Rhizome (*Rhizoma Atractylodis Macrocephalae*), Licorice Root (*Radix Glycyrrhizae*).
Shen Qi Wan (Kidney Qi Pill): Treats shortness of breath due to phlegm-fluid, indicating elimination via urination.
Ingredients: Prepared Rehmannia Root (*Radix Rehmanniae Praeparata*), Alisma Rhizome (*Rhizoma Alismatis), Poria (*Poria cocos*), Chinese Yam (*Rhizoma Dioscoreae*), Moutan Bark (*Cortex Moutan*), Cornus Fruit (*Fructus Corni*), Aconite Root (*Radix Aconiti Lateralis Preparata*), Cinnamon Bark (*Cortex Cinnamomi*).
Tui Zhan Cang Po Er Chen Tang (Extended Cangpo Erchen Decoction): Treats water-fluid retention in the stomach, with chest fullness, vomiting, and absence of thirst; if fluid damages the lungs, wheezing and cough occur; if it damages the stomach, vomiting occurs.
Ingredients: Prepared Pinellia Tuber (*Rhizoma Pinelliae Preparatum*), Tangerine Peel (*Pericarpium Citri Reticulatae*), Licorice Root (*Radix Glycyrrhizae*), Poria (*Poria cocos*), Prepared Atractodes Rhizome (*Rhizoma Atractylodis Macrocephalae*), Magnolia Bark (*Cortex Magnoliae Officinalis*).
Modifications: Add Kudzu Root (*Radix Puerariae*) for body heat and thirst; add Alisma Rhizome (*Rhizoma Alismatis*) for difficult urination; add Gardenia Fruit (*Fructus Gardeniae*) and Coptis Rhizome (*Rhizoma Coptidis*) for a rapid pulse; add Roasted Ginger (*Rhizoma Zingiberis Preparatum*) for a slow pulse.