经曰∶湿气变物，水饮内蓄，中满不食，是言饮也，非言痰也。痰之与饮，虽曰同类，
而实
有不同也。盖饮为水液之属。凡呕吐清水，及胸腹膨胀，吞酸嗳腐等症，此皆水谷之余，停
积不行，是即所谓饮也。若痰之不同乎饮者，饮清澈而痰稠浊，饮惟水谷停积而化，痰则五
脏之伤皆能致之。然究其原，痰即人之津液，无非水谷所化，但化得其正，则形体强，营卫
充。若化失其正，则脏腑病，津液败，而血气即化为痰矣。后人治痰，开口便言痰火。有云
怪症为痰者，有云痰为百病之母者，痰之为害，不綦重乎？然则虚实之间，尤不可不辨。惟
验其年力犹盛，血气未伤，或以肥甘过度，或以湿热盛行，或风寒外闭皮毛，或逆气内连肝
膈，皆能生痰动火，害及于目。惟察其病气形气，俱属有余者，即实痰也，实痰则宜消伐。
若年及中衰，形气羸弱，或以多病，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，气短声喑者，皆有目暗不明之患。但察其形气病气，
本无有余者，即虚痰也。虚痰则宜扶助元气，使精血充旺，则痰自消矣。然痰之所生，无不
由乎脾肾。脾恶湿，湿胜则为痰，肾属水，水泛亦为痰。脾家之痰，有虚有实，肾家之痰，
则无非虚耳。痰病延及于目，治最棘手，惟调其寒热虚实，气血阴阳，则无有不愈。昔王隐
君谓内外百病，皆生于痰，悉以滚痰丸攻之，其亦但顾目前，而不知后患者也。
《黄帝内经》说：“湿气变化为物，水饮在体内蓄积，导致中焦胀满、不能进食”，这是指“饮”病，而不是指“痰”病。痰与饮，虽然说是同类，但实际上是有区别的。大概而言，饮属于水液一类。凡是呕吐清水，以及胸腹部膨胀、吞酸、嗳气腐臭等症状，这些都是水谷的余剩，停滞积聚而不能运行，这就是所谓的“饮”。至于痰不同于饮的地方，在于饮是清澈的而痰是稠浊的；饮只是由水谷停滞积聚而化生，而痰则是五脏受伤都能导致的。然而究其本源，痰就是人的津液，无不是由水谷所化生，但如果化生得正常，那么形体就强健，营卫之气就充盛。如果化生失去了正常规律，那么脏腑就会生病，津液败坏，而血气就会转化为痰了。后人在治疗痰病时，开口便说是痰火。有人说怪症是由痰引起的，有人说痰是百病的母亲，痰的危害，不是很重大吗？然而在虚实之间，尤其不可不加以辨别。只有检验患者年力仍然强盛，血气没有受损，或者是因为肥甘厚味过度摄入，或者是因为湿热盛行，或者是因为风寒从外部闭塞皮毛，或者是因为逆气在内部连接肝膈，这些都能生痰动火，危害到眼睛。只有观察患者的病气和形气，都属于有余（实证）的情况，就是实痰，实痰则适宜用消散攻伐的方法治疗。如果年龄到了中年衰退，形体和气息羸弱，或者因为多病，或者因为劳倦，或者因为忧思、饮酒、色欲，导致成为劳损，并非风邪突然厥逆的患者，或者脉象表现为细数，脏腑没有阳热邪气，时常出现呕吐恶心、泄泻，气短声音嘶哑的情况，都有眼睛昏暗不明的病患。只要观察其形气和病气，本来就没有有余的表现，就是虚痰。虚痰则适宜扶助元气，使精血充盛旺盛，那么痰自然就会消除。然而痰的产生，无不源于脾肾。脾厌恶湿气，湿气胜则产生痰；肾属水，水泛滥也产生痰。脾脏的痰，有虚有实；肾脏的痰，则无非是虚证罢了。痰病延及到眼睛，治疗最为棘手，只有调节其寒热虚实，气血阴阳，就没有不痊愈的。从前王隐君说内外百病，都生于痰，全部用滚痰丸来攻逐，这也是一只顾眼前利益，而不知道后患的做法啊。
The *Classic of Medicine* (*Huangdi Neijing*) states: "Dampness transforms into substances; water and fluids accumulate internally, causing fullness in the middle jiao and an inability to eat." This refers to "Yin" (fluid retention), not "Tan" (phlegm). Although Tan and Yin are said to be of the same category, they are actually different. Generally speaking, Yin belongs to the category of water and fluids. Symptoms such as vomiting clear fluid, distension of the chest and abdomen, acid regurgitation, and belching with a putrid odor are all remnants of food and drink that have stagnated and accumulated without moving; this is what is referred to as "Yin". The difference between Tan and Yin lies in the fact that Yin is clear and thin, whereas Tan is thick and turbid. Yin is transformed only from the stagnation and accumulation of food and drink, whereas Tan can be caused by injury to any of the five Zang organs. However, investigating its origin, Tan is essentially the body's Jin-Ye (body fluids), which are all transformed from food and drink. If this transformation occurs correctly, the physical form becomes strong, and Ying (nutritive Qi) and Wei (defensive Qi) become abundant. If the transformation loses its proper regulation, the Zang and Fu organs become diseased, the Jin-Ye deteriorate, and the blood and Qi transform into Tan. Later practitioners, when treating Tan diseases, immediately speak of "Tan-Huo" (Phlegm-Fire). Some claim that bizarre symptoms are caused by Tan, while others assert that Tan is the mother of a hundred diseases. Is not the harm caused by Tan extremely significant? Therefore, it is crucial not to fail to distinguish between deficiency (Xu) and excess (Shi). One must examine whether the patient's age and strength are still robust, and their blood and Qi are unharmed; or if the cause is excessive consumption of rich and sweet foods, prevalent damp-heat, external closure of the skin and hair pores by wind-cold, or rebellious Qi connecting internally to the liver and diaphragm. All these can generate Tan and stir Huo (Fire), harming the eyes. If one observes that both the pathogenic Qi and the constitutional Qi belong to the state of "excess," it is Shix Tan (Excess Phlegm), which should be treated with methods of dissipation and purgation. Conversely, if the patient has reached middle age and decline, with a frail physical form and weak Qi, or due to frequent illness, overwork, or emotional distress, alcohol, and sexual indulgence leading to consumptive damage (not sudden stroke or syncope due to wind), or presenting with a fine and rapid pulse, absence of Yang pathogens in the Zang organs, frequent nausea/vomiting and diarrhea, shortness of breath, and hoarseness, these individuals suffer from dim vision. If one observes that their constitutional Qi and pathogenic Qi originally lack signs of "excess," it is Xux Tan (Deficiency Phlegm). Deficiency Phlegm should be treated by supporting the Yuan Qi (Primary Qi), so that Jing (Essence) and Xue (Blood) become abundant and vigorous, whereupon the Tan will naturally dissipate. However, the generation of Tan invariably stems from the Spleen and Kidney. The Spleen dislikes dampness; when dampness prevails, Tan is produced. The Kidney belongs to Water; when Water floods, Tan is also produced. Tan in the Spleen system can be either deficient or excess, whereas Tan in the Kidney system is exclusively deficient. When Tan disease extends to the eyes, treatment is most difficult; however, by regulating Cold and Heat, Deficiency and Excess, Qi and Blood, and Yin and Yang, there is no case that will not heal. In the past, Wang Yinjun stated that internal and external diseases of all kinds arise from Tan, and he treated them all with Gongtan Wan (Rolling Phlegm Pill) for purgation. This approach focuses only on the immediate situation without considering the subsequent consequences.