Processed Pinellia Rhizome (Banxia): Its ability to resolve phlegm is miraculous. If you do not believe it, take seven or eight grains of Pinellia Rhizome, grind them into powder, and put them into a bowl of phlegm; the phlegm will turn into clear water. For patients suffering from phlegm disorders and stroke resulting in aphasia (loss of speech), take seven or eight grains of Pinellia Rhizome, administer with well-water (Jinghua Shui), and massage the abdomen for the duration of one incense stick. The patient will then wake up and regain the ability to speak.

Preparation Method: Take one jin (approx. 500g) of large Pinellia Rhizome and one jin of calcined stone (Duanshi). Pour seven or eight bowls of boiling water into a basin, stir, and let cool. Clarify the liquid and remove the dregs. Place the Pinellia Rhizome in the basin and stir by hand. Expose it to sunlight during the day and dew at night for seven days. Remove it, wash it three or four times with well-water, soak it for three days changing the water three times daily, then remove and drain. Separately, take eight liang of alum (Baifan) and one jin of mirabilite (Pinxiao). Pour seven or eight bowls of boiling water into a basin, add the alum and mirabilite, stir, and let cool to warm. Soak the Pinellia Rhizome in this solution for seven days, exposing it to sunlight and dew. Upon completion, remove, wash with clean water three or four times, soak for three days changing the water three times daily, then remove and drain before use.

Ingredients: Licorice Root (Gancao) and Southern Mint (Nan Bohe) (each 4 liang); Clove (Dingxiang) (5 qian); White Cardamom Seed (Baidoukou) (3 qian); Agarwood (Chenxiang) (1 qian); Immature Bitter Orange (Zhishi), Costus Root (Muxiang), Szechuan Lovage Rhizome (Chuanxiong) (each 3 qian); Tangerine Peel (Chenpi) (5 qian); Cinnamon Bark (Rougui) (3 qian); Bitter Orange (Zhiqiao), Schisandra Berry (Wuweizi), Green Tangerine Peel (Qingpi), Amomum Fruit (Sharen) (each 5 qian).

The above fourteen ingredients are sliced. Pour fifteen bowls of boiling water into a container and let cool to warm. Add the processed Pinellia Rhizome and the herbs together into the basin. Soak for two periods of seven days (14 days), exposing to sunlight and dew while stirring. Upon completion, remove the herbs. Wrap the Pinellia Rhizome in white cloth, place it on a hot pit, cover with a vessel for the duration of three incense sticks. The herbs and Pinellia Rhizome will separate. Dry the Pinellia Rhizome and store it. Patients with phlegm-fire symptoms who take this will excrete substance resembling fish mucus in their stool after one day, eliminating the root of phlegm overnight so that it never recurs.

Commentary: The above prescriptions are all suitable for treating conditions of excess phlegm-fire in robust individuals. For deficient individuals with phlegm-fire, treatment should follow the subsequent discussion. If phlegm arises due to deficiency of Lung and Spleen Qi failing to transform fluids, use Liu Jun Zi Tang (Six Gentlemen Decoction) augmented with Costus Root (Muxiang). (Prescription see Tonification Chapter). If phlegm arises due to weak Spleen Qi failing to clear and transform fluids, use Liu Jun Zi Tang augmented with Platycodon Root (Jiegeng). (Prescription see Tonification Chapter). If blood in phlegm results from Qi stagnation in the Lung Meridian, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). (Prescription see Tonification Chapter). If blood in phlegm results from Blood-heat in the Liver Meridian, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). (Prescription see Women's Deficiency Labor Chapter). If blood in phlegm results from Yin deficiency in the Liver Meridian, use Jia Wei Di Huang Wan (Modified Rehmannia Pill). (Prescription see Tonification Chapter). If hemoptysis results from overconsumption of cold-natured agents, treat primarily with Si Jun Zi Tang (Four Gentlemen Decoction) or similar formulas. (Prescription see Tonification Chapter). If severe phlegm results from deficiency of Middle Qi, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) augmented with Poria (Fuling) and Pinellia Rhizome (Banxia). If ineffective, adding Ginger Juice (Jiangzhi) is particularly excellent.

Phlegm-Scouring Powder (Di Tan San): This medicine clears the Lungs, resolves phlegm, stops coughing, relieves alcohol toxicity, and eliminates all types of phlegm-fire.

Preparation: Wash Guang Chenpi (Guang Tangerine Peel) with clean water first. For every jin of peel, add four liang of salt, soak in water overnight, then boil in a pot until the water is dry. Remove the fibrous membrane, slice into small pieces, and stir-fry until dry. For every one liang of Chenpi, add two qian of Licorice Root (Fencao). Grind both into powder. Take two spoonfuls each morning and evening, mixed with plain boiled water.

Case 1: A scholar, obese in constitution, suffered from phlegm-wheezing in midsummer. He used Er Chen Tang (Two Old Ones Decoction) combined with Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), and Platycodon Root (Jiegeng), but his wheezing worsened. Adding Lungwort Herb (Sangpiai), Apricot Kernel (Xingren), and Trichosanthes Fruit (Gualou) led to night sweats and shortness of breath. Adding Fritillaria Bulb (Beimu) and Bitter Orange (Zhiqiao) resulted in intermittent fever and reduced appetite. His pulse was large but powerless. I diagnosed this as Cold-deficiency of the Spleen and Lungs. I used Ba Wei Wan (Eight-Ingredient Pill) to tonify the Mother of Earth (Kidney to support Spleen) and Bu Zhong Yi Qi Tang to replenish Middle Qi, leading to recovery.

Case 2: A man who usually ate little suddenly suffered from phlegm obstruction, wheezing, head shaking, eye blinking, and flailing limbs, making pulse diagnosis difficult. His complexion was yellow with a bluish tint, indicating Liver Wood overacting on Spleen Earth, resembling slow convulsion in children. He was cured initially using Liu Jun Zi Tang augmented with Bupleurum Root (Chaihu) and Cimicifuga Rhizome (Shengma); subsequently recovered using Bu Zhong Yi Qi Tang augmented with Pinellia Rhizome.

Case 3: Zhang Qiuguan presented with red face, thirst, excessive phlegm, and dizziness. This was diagnosed as Kidney deficiency causing Water flooding to form Phlegm. He was cured using Liu Wei Wan (Six-Ingredient Pill with Rehmannia).