气。二脏失司。出纳失职。议用早进肾气丸三钱。以纳少阴。晚用小青龙法。涤饮。以通太阳经
腑。此皆圣人内饮治法。与乱投腻补有间矣。小青龙去麻辛甘芍。加茯苓杏仁大枣。
某 形盛面亮。脉沉弦。此属痰饮内聚。暮夜属阴。喘不得卧。仲景谓饮家而咳。当治其饮。不当
治咳。今胸满腹胀。小水不利。当开太阳以导饮逆。小青龙去麻辛合越婢。
桂枝 半夏 干姜 五味 杏仁 石膏 茯苓 白芍
某 服三拗汤。音出喘缓。可见苦寒沉降之谬。素多呕逆下血。中焦必虚。而痰饮留伏显然。议
治其饮。
桂枝汤去甘草加杏仁茯苓苡仁糖炒石膏。
某 太阳经气不开。小水不利。下肢肿浮渐上。着枕气塞欲坐。浊饮上干。竟有坐卧不安之象。
医者但以肺病刻治。于理未合。急用小青龙法。使膀胱之气无阻碍。浊饮痰气自无逆冲之患矣。
桂枝 杏仁 干姜 五味 半夏 茯苓
章 伏饮阴浊上干。因春地气主升而发。呕吐不饥。自然脾胃受伤。六君子宣补方法。未尝不
妙。今诊得吸气甚微。小溲晨通暮癃。足跗浮肿。其腑中之气开阖失司。最虑中满。夫太阳司
开。阳明司阖。浊阴弥漫。通腑即是通阳。仿仲景开太阳一法。
牡蛎 泽泻 防己 茯苓 五味 干姜
张（二七） 呛喘哮。坐不得卧。神迷如呆。气降则清。水寒饮邪。上冲膻中。用逐饮开浊法。
（寒饮浊邪上冲膻中）
姜汁炒南星 姜汁炙白附子 茯苓 桂枝 炙草 石菖蒲
某（三四） 咳缓。痰少。脘中不爽。肌腠瘙痒。皆湿邪未尽。痰饮窃踞之象。当用六安法。（肺胃湿痰）
杏仁 白芥子 炒半夏 茯苓 淡干姜 橘红
王 当年阳虚。浊饮上泛喘急。用真武汤丸而效。因平素嗜酒少谷。中虚湿聚。热蕴蒸痰。目黄
龈血。未可为实热论治。议方用外台茯苓饮。减甘草佐以微苦。清渗理其湿热。以酒客忌甜
故也。（中虚湿热）
茯苓（四两） 人参（二两） 苡仁（四两） 枳实（一两） 半夏（二两） 广皮（二两）
金石斛八两。煮汁为丸。
汪 面色鲜明。脘中漾漾欲呕。因郁勃热气。蒸为痰饮。宜暂缓参术。务清中焦热痰。（中焦痰热）
杏仁 枳实汁 橘红 栝蒌皮 郁金 半夏曲 桔梗 黑栀皮
张（氏） 痰饮挟燥。咳。喉中痒。（痰饮挟燥）
杏仁 花粉 茯苓 象贝母 橘红 半夏曲
陈（妪） 痰饮挟气火上踞。脘痞胀不爽。宜理气热。（气火不降）
半夏 茯苓 栝蒌皮 黑栀皮 橘红 郁金
某 脉弦右涩。面亮舌白。口干不喜饮。头重岑岑然。胸脘痹塞而痛。得嗳气稍舒。酒客谷少中
虚。痰饮聚蓄。当此夏令。地气上升。饮邪挟气上阻清空。遂令前症之来。金匮云。脉弦为饮。色
鲜明者为留饮。口干不欲饮水者。此为饮邪未去故也。况 汗出。岂是风寒。春夏温邪。辛
温发散为大禁。自云身体空飘。年已六旬又四。辛散再泄其阳。不亦左乎。
半夏 姜汁 川连 吴萸 茯苓 枳实 竹沥
潘（三八） 远客路途。风寒外受。热气内蒸。痰饮日聚于脏之外。络脉之中。凡遇风冷。或曝烈日。或劳
碌形体。心事不宁。扰动络中宿饮。饮泛气逆。咳嗽。气塞喉底胸膈。不思食物。着枕呛吐稠痰。
气降自愈。病名哮喘伏饮。治之得宜。除根不速。到老年岁。仍受其累耳。（哮喘伏饮）小青龙汤去
细辛。
童（五六） 背寒。短气。背痛映心。贯胁入腰。食粥噫气脘痞。泻出黄沫。饮邪伏湿。乃阳伤窃发。此温经
通络为要。缓用人参。（饮伏经络）
川桂枝 生白术 炒黑蜀漆 炮黑川乌 浓朴 茯苓
叶（四十） 脉右弦。舌黄不渴。当心似阻。昔形壮。今渐瘦。咳久不已。卧着则咳。痰出稍安。此清阳少旋。
支脉结饮。议通上焦之阳。（胸次清阳少旋支脉结饮）
鲜薤白 栝蒌皮 半夏 茯苓 川桂枝 姜汁
杨 头中冷痛。食入不消。筋脉中常似掣痛。此皆阳微不主流行。痰饮日多。气隧日结。致四末
时冷。先以微通胸中之阳。
干薤白 桂枝 半夏 茯苓 栝蒌皮 姜汁
又 微通其阳已效。痰饮阻气。用茯苓饮去广皮加姜汁。
程（三三） 支脉聚饮。寒月喘甚。初因寒湿而得。故食辛稍安。（支脉结饮）
杏仁 半夏 浓朴 苡仁 茯苓 姜汁法丸。
赵 支饮。胁痛咳逆。小青龙去麻辛。
汪（氏） 支脉结饮。阻气喘胀。入胁则痛。厥逆为眩。
茯苓 桂枝 半夏 杏仁 郁金 糖炒石膏
黄 支脉结饮。发必喘急。病发用。
桂枝 茯苓 五味 炙草
冯 悬饮流入胃中。令人酸痛。涌噫酸水。当辛通其阳以驱饮。（悬饮）
桂枝木 半夏 茯苓 炒黑川椒 姜汁
又 照前方加淡附子。
施 诊脉右虚。左小弦。面色黄。少华采。左胁肋痛。五六年未愈。凡久恙必入络。络主血。药不宜
刚。病属内伤。勿事腻补。录仲景旋复花汤。加柏子仁归须桃仁。
又 初服旋复花汤。未应。另更医谓是营虚。用参归熟地桂芍炙草。服后大痛。医又转方。用金
铃半夏桃仁延胡茯苓。服之大吐大痛。复延余治。余再议方。谓肝络久病。悬饮流入胃络。致
痛不已。议太阳阳明开阖方法。
人参 茯苓 炙草 桂枝 煨姜 南枣
服苦药痛呕。可知胃虚。以参苓阖阳明。用草桂开太阳。并辛香入络。用姜枣通营卫。生姜
恐伐肝。故取煨以护元气。而微开饮气也。
又 前方服之痛止议丸方。
人参 半夏 川椒 茯苓 桂枝 煨姜南枣汤丸。
某 夏季阳气大升。痰多呛咳。甚至夜不得卧。谷味皆变。大便或溏或秘。诊脉右大而弦。议以
悬饮流入胃络。用开阖导饮法。
人参 茯苓 桂枝 炙草 煨姜 南枣
又 早诊脉。两手皆弦。右偏大。凡痰气上涌。咳逆愈甚。日来小溲少。下焦微肿。议通太阳以撤
饮邪。
人参 茯苓 桂枝 炙草 五味 干姜
又 脉弦略数。不渴不思饮。此饮浊未去。清阳不主营运。前方甘温。主乎开阖。能令胃喜。次法
开太阳以撤饮邪。亦主阳通。据自述心下胃口。若物阻呆滞。其浊锢阳微大着。其治咳滋阴。
适为阴浊横帜矣。议用大半夏汤法。大半夏汤加炒黑川椒。
内经止有积饮之说。本无痰饮之名。两汉以前谓之淡饮。仲景始分痰饮。因有痰饮悬饮
溢饮支饮之义。而立大小青龙半夏苓桂术甘肾气等汤。以及内饮外饮诸法。可谓阐发
前贤。独超千古。与后人所立风痰湿痰热痰酒痰食痰之法迥异。总之痰饮之作。必由
元气亏乏。及阴盛阳衰而起。以致津液凝滞。不能输布。留于胸中。水之清者悉变为浊。水
积阴则为饮。饮凝阳则为痰。若果真元充足。胃强脾健。则饮食不失其度。营运不停其机。
何痰饮之有。故仲景云。病痰饮者。当以温药和之。乃后人不知痰饮之义。妄用滚痰丸。茯
苓丸。消痰破气。或滋填腻补等法。大伤脾胃。堆砌助浊。其于仲景痰饮之法。岂不大相乖
谬乎。然痰与饮。虽为同类。而实有阴阳之别。阳盛阴虚。则水气凝而为痰。阴盛阳虚。则水
气溢而为饮。故王晋三先生取仲景之小半夏茯苓。及外台饮三汤。从脾胃二经分痰饮
立治法。而先生又取仲景之苓桂术甘。外台茯苓饮。肾气丸。真武汤。分内饮外饮治法。而
于痰饮之症。无遗蕴矣。愚历考先生治痰饮之法。则又有不止于此者。然而病变有不同。
治法亦有异。如脾肾阳虚。膀胱气化不通者。取仲景之苓桂术甘汤。茯苓饮。肾气真武等
法。以理阳通阳。及固下益肾。转旋运脾为主。如外寒引动宿饮上逆。及膀胱气化不通。饮
逆肺气不降者。以小青龙合越婢等法。开太阳膀胱为主。如饮邪伏于经络。及中虚湿热
成痰者。则有川乌蜀漆之温经通络。外台茯苓饮去甘草。少佐苦辛清渗理湿之法。其饮
邪上冲膻中。及悬饮流入胃中而为病者。又有姜附南星菖蒲旋复川椒等。驱饮开浊。辛
通阳气等法。丝丝入扣。一以贯之。病情治法。胸有成竹矣。非深于得道者。其孰能之。（邹滋九）
气机失调。肺肾两脏功能失职，出纳失常。建议早晨服用肾气丸三钱，以收纳少阴之气；晚上采用小青龙汤的方法，涤除饮邪，以疏通太阳经腑。这些都是圣人治疗内饮的治法，与胡乱投用滋腻补药有着本质的区别。（小青龙汤）去掉麻黄、细辛、甘草、白芍，加入茯苓、杏仁、大枣。
某患者形体丰腴面色光亮，脉象沉弦。这属于痰饮在体内积聚。夜晚属阴，喘促不能平卧。张仲景说，有饮邪的人咳嗽，应当治疗饮邪，而不应当单纯治疗咳嗽。如今胸满腹胀，小便不利，应当开通太阳经以引导饮邪上逆。（小青龙汤）去掉麻黄、细辛，合用越婢汤。
桂枝 半夏 干姜 五味子 杏仁 石膏 茯苓 白芍
某患者服用三拗汤后，声音发出，喘息减缓，可见苦寒沉降药物的误用。平时多有呕吐逆气和便血，中焦脾胃必然虚弱，而痰饮留伏显然。建议治疗其饮邪。
桂枝汤去掉甘草，加入杏仁、茯苓、薏苡仁、糖炒石膏。
某患者太阳经气不开通，小便不利，下肢浮肿逐渐向上蔓延，躺下时气塞想要坐起，浊饮上犯心胸，竟然有坐卧不安的现象。医生仅仅把此病当作肺病来急治，从医理上讲并不合适。紧急使用小青龙汤的方法，使膀胱之气没有阻碍，浊饮和痰气自然就没有逆冲的祸患了。
桂枝 杏仁 干姜 五味子 半夏 茯苓
章姓患者，伏匿的饮邪和阴浊之气上犯心胸。因为春季地气主升发而诱发，呕吐不想进食，自然损伤了脾胃。六君子汤宣通补益的方法，未尝不巧妙。如今诊得吸气非常微弱，清晨小便通畅，傍晚尿闭，足背浮肿。这是腑气的开阖功能失职，最担心出现中满胀病。太阳经主管开，阳明经主管阖，浊阴弥漫，疏通腑气就是疏通阳气。仿照张仲景开通太阳经的方法。
牡蛎 泽泻 防己 茯苓 五味子 干姜
张某（十七岁），呛咳气喘哮鸣，坐不得卧，神志昏迷像痴呆一样。气降则清朗。这是水寒饮邪，上冲膻中。使用逐饮开浊的方法。
（寒饮浊邪上冲膻中）
姜汁炒胆南星 姜汁炙白附子 茯苓 桂枝 炙甘草 石菖蒲
某患者（三十四岁），咳嗽缓解，痰少，胃脘中不爽快，肌肤腠理瘙痒，都是湿邪未尽，痰饮窃踞占据的迹象。应当使用六安煎的方法。（肺胃湿痰）
杏仁 白芥子 炒半夏 茯苓 淡干姜 橘红
王某，当年阳虚，浊饮上泛导致喘急，使用真武汤丸剂而见效。因为平时嗜酒少吃谷物，中焦虚弱湿气聚集，热蕴蒸腾成痰，目黄牙龈出血，不可以当作实热证来治疗。建议方药用《外台秘要》茯苓饮，减去甘草，佐以微苦的药物，清利渗泄以调理湿热。因为嗜酒之人忌讳甜味。
茯苓（四两） 人参（二两） 薏苡仁（四两） 枳实（一两） 半夏（二两） 广陈皮（二两）
金石斛八两，煮汁为丸。
汪某，面色鲜明，胃脘中荡漾欲呕。因为郁勃的热气，蒸腾成为痰饮。宜暂缓使用人参、白术。务必清化中焦的热痰。（中焦痰热）
杏仁 枳实汁 橘红 瓜蒌皮 郁金 半夏曲 桔梗 黑栀子皮
张氏，痰饮挟带燥邪，咳嗽，喉中痒。（痰饮挟燥）
杏仁 花粉 茯苓 象贝母 橘红 半夏曲
陈某（老妇），痰饮挟带气火占据上部，胃脘痞闷胀满不爽。宜理气清热。（气火不降）
半夏 茯苓 瓜蒌皮 黑栀子皮 橘红 郁金
某患者，脉象弦而右脉涩，面色光亮舌苔白，口干但不喜欢喝水，头部沉重感明显，胸脘痹塞而痛，打嗝后稍舒。嗜酒且谷物摄入少导致中焦虚弱，痰饮聚蓄。正值夏令，地气上升，饮邪挟气上阻清空，于是导致前述症状的到来。《金匮要略》说：脉弦为饮，面色鲜明者为留饮，口干不欲饮水者，此为饮邪未去。况且出汗，难道是风寒？春夏季节温邪盛行，辛温发散是大禁忌。自述身体空飘，年已六十四岁，再用辛散药物发泄阳气，不是错了吗？
半夏 姜汁 黄连 吴茱萸 茯苓 枳实 竹沥
潘某（三十八岁），远行客居路途，风寒外受，热气内蒸，痰饮日益积聚于脏腑之外，络脉之中。凡遇到风冷，或暴晒烈日，或形体劳碌，心事不宁，扰动络中宿存的饮邪，饮邪泛滥气机上逆，咳嗽，气塞喉底胸膈，不思食物，躺下呛吐稠痰。气降则自愈。病名哮喘伏饮，治疗得当，除根不易。到了老年岁数，仍会受其拖累。（哮喘伏饮）小青龙汤去掉细辛。
童某（五十六岁），背部寒冷，短气，背痛牵连心脏，贯穿胁肋进入腰部，喝粥打嗝胃脘痞闷，泻出黄沫。饮邪伏留湿气，是阳气受损暗中发作。此时温经通络是关键。缓用人参。（饮邪伏留经络）
川桂枝 生白术 炒黑蜀漆 炮黑川乌 厚朴 茯苓
叶某（四十岁），脉象右弦，舌黄不渴，当心部位似有阻滞，以前形体壮实，现在渐渐消瘦，咳嗽长久不愈，躺下则咳，痰出稍安。这是清阳之气很少旋转，支脉结聚饮邪。建议通调上焦之阳。（胸次清阳少旋支脉结饮）
鲜薤白 瓜蒌皮 半夏 茯苓 川桂枝 姜汁
杨某，头中冷痛，食入不消化，筋脉中常似牵掣痛。这都是阳气微弱不能正常流行，痰饮日益增多，气隧日益结滞，导致四肢末端时常寒冷。先以微微通调胸中之阳。
干薤白 桂枝 半夏 茯苓 瓜蒌皮 姜汁
又诊，微微通阳已经见效。痰饮阻气，使用茯苓饮去掉广陈皮加姜汁。
程某（三十三岁），支脉聚饮，寒月喘甚。起初因寒湿而得病，所以吃辛辣食物稍安。（支脉结饮）
杏仁 半夏 厚朴 薏苡仁 茯苓 姜汁法丸。
汪氏，支脉结饮，阻气喘胀。进入胁肋则痛，厥逆导致眩晕。
茯苓 桂枝 半夏 杏仁 郁金 糖炒石膏
黄某，支脉结饮，发病必喘急。病发时使用。
桂枝 茯苓 五味子 炙甘草
冯某，悬饮流入胃中，令人酸痛，涌吐酸水。应当辛通其阳以驱除饮邪。（悬饮）
桂枝木 半夏 茯苓 炒黑川椒 姜汁
又诊，照前方加淡附子。
施某，诊脉右虚，左小弦，面色黄，缺少神采，左胁肋痛，五六年未愈。凡是久病必定入络，络主血，药物不宜刚猛。病属内伤，不要从事滋腻补益。记录张仲景的旋复花汤，加入柏子仁、归须、桃仁。
又诊，初服旋复花汤，未见效。另请医生说是营血虚弱，用人参、当归、熟地黄、桂枝、白芍、炙甘草。服用后大痛。医生又转方，用金铃子散、半夏、桃仁、延胡索、茯苓。服用后大吐大痛，又延请我诊治。我再议方，认为肝络久病，悬饮流入胃络，导致疼痛不止。建议太阳阳明开阖的方法。
人参 茯苓 炙甘草 桂枝 煨姜 南枣
服用苦药痛呕，可知胃虚。用人参、茯苓闭合阳明，用甘草、桂枝开通太阳，并配合辛香入络，用姜枣通调营卫。生姜恐怕伐肝，所以取煨姜以保护元气，从而微微开通饮气。
又诊，前方服用后痛止，建议丸方。
人参 半夏 川椒 茯苓 桂枝 煨姜南枣汤丸。
某患者，夏季阳气大升，痰多呛咳，甚至夜间不能平卧，谷味皆变，大便或溏或秘。诊脉右大而弦。建议以悬饮流入胃络，使用开阖导饮法。
人参 茯苓 桂枝 炙甘草 煨姜 南枣
又诊，早诊脉，两手皆弦，右偏大。凡痰气上涌，咳逆愈甚。日来小便少，下焦微肿。建议通太阳以撤除饮邪。
人参 茯苓 桂枝 炙甘草 五味子 干姜
又诊，脉弦略数，不渴不思饮，这是饮浊未去，清阳不主营运。前方甘温，主乎开阖，能令胃喜。次法开通太阳以撤除饮邪，也主阳气通调。据自述心下胃口，若物阻呆滞，其浊锢阳微大着，其治咳滋阴，适为阴浊横行了。建议使用大半夏汤法。大半夏汤加炒黑川椒。
《内经》只有积饮的说法，本无痰饮之名。两汉以前谓之淡饮。张仲景才开始区分痰饮，因此有痰饮、悬饮、溢饮、支饮的含义，而立大小青龙汤、半夏苓桂术甘汤、肾气汤等方，以及内饮外饮诸法。可谓阐发前贤，独超千古。与后人所立的风痰、湿痰、热痰、酒痰、食痰之法迥然不同。总之痰饮的产生，必由元气亏乏，及阴盛阳衰而起，以致津液凝滞，不能输布，留于胸中。水之清者悉变为浊。水积阴则为饮，饮凝阳则为痰。如果果真元充足，胃强脾健，则饮食不失其度，营运不停其机，何痰饮之有？所以张仲景说：病痰饮者，当以温药和之。乃是后人不知痰饮之义，妄用滚痰丸、茯苓丸，消痰破气，或滋填腻补等法，大伤脾胃，堆砌助浊。其于仲景痰饮之法，岂不大相乖谬乎？然而痰与饮，虽为同类，而实有阴阳之别。阳盛阴虚，则水气凝而为痰；阴盛阳虚，则水气溢而为饮。所以王晋三先生取张仲景的小半夏茯苓汤，及《外台秘要》饮三汤，从脾胃二经分痰饮立治法。而先生又取张仲景的苓桂术甘汤，《外台》茯苓饮，肾气丸，真武汤，分内饮外饮治法。而对于痰饮之症，无遗蕴矣。我历考先生治痰饮之法，则又有不止于此者。然而病变有不同，治法亦有异。如脾肾阳虚，膀胱气化不通者，取张仲景的苓桂术甘汤，茯苓饮，肾气真武等法，以理阳通阳，及固下益肾，转旋运脾为主。如外寒引动宿饮上逆，及膀胱气化不通，饮逆肺气不降者，以小青龙合越婢等法，开太阳膀胱为主。如饮邪伏于经络，及中虚湿热成痰者，则有川乌蜀漆之温经通络，《外台》茯苓饮去甘草，少佐苦辛清渗理湿之法。其饮邪上冲膻中，及悬饮流入胃中而为病者，又有姜附南星菖蒲旋复川椒等，驱饮开浊，辛通阳气等法。丝丝入扣，一以贯之。病情治法，胸有成竹矣。非深于得道者，其孰能之。（邹滋九）
Qi mechanism dysfunction. The Lung and Kidney organs fail in their duties, leading to impaired intake and discharge. It is proposed to administer Shengdi Wan (Kidney Qi Pill) three qian in the morning to gather Qi from the Shaoyin channel, and use the method of Xiao Qing Long Tang (Minor Blue Dragon Decoction) in the evening to eliminate fluid retention and unblock the Taiyang channel-fu. These are all methods for treating internal fluid retention taught by the Sages, distinct from the reckless use of cloying tonics. [Xiao Qing Long Tang] remove Ephedrae Herba (Mahuang), Asari Radix (Xixin), Glycyrrhizae Radix et Rhizoma (Gancao), and Paeoniae Radix Alba (Baishao); add Poria (Fuling), Armeniacae Semen Amarum (Xingren), and Jujubae Fructus (Dazao).
Patient: The physique is robust with a lustrous complexion, pulse is deep and wiry. This belongs to internal accumulation of phlegm-fluid. Night belongs to Yin; wheezing prevents lying down. Zhang Zhongjing stated that for those with fluid retention who cough, one should treat the fluid, not merely the cough. Currently, there is chest fullness and abdominal distension, with difficult urination. One should open the Taiyang channel to guide the counterflow of fluid. [Xiao Qing Long Tang] remove Ephedrae Herba (Mahuang) and Asari Radix (Xixin), combined with Yue Bi Tang (Yuebi Decoction).
Cinnamomi Ramulus (Guizhi) Pinelliae Tuber (Banxia) Zingiberis Rhizoma Recens (Ganjiang) Schisandrae Fructus (Wuweizi) Armeniacae Semen Amarum (Xingren) Gypsum Fibrosum (Shigao) Poria (Fuling) Paeoniae Radix Alba (Baishao)
Patient: After taking San Ao Tang (Three Unbinding Decoction), voice was produced and wheezing slowed, revealing the error of bitter-cold descending drugs. There is a history of frequent vomiting, regurgitation, and lower bleeding, indicating deficiency in the Middle Jiao, while phlegm-fluid stagnation is evident. It is proposed to treat the fluid.
Guizhi Tang (Cinnamon Twig Decoction) remove Glycyrrhizae Radix et Rhizoma (Gancao), add Armeniacae Semen Amarum (Xingren), Poria (Fuling), Coicis Semen (Yiren), and Sugar-roasted Gypsum Fibrosum (Shigao).
Patient: Taiyang channel Qi does not open, urination is difficult, lower limb edema gradually ascends, gas blockage upon lying down necessitates sitting up, turbid fluid invades upward, presenting as restlessness day and night. The physician treated it solely as a Lung disease urgently, which contradicts medical principles. Urgently apply the method of Xiao Qing Long Tang (Minor Blue Dragon Decoction) so that Bladder Qi faces no obstruction, and turbid fluid and phlegm-qi will naturally have no risk of counterflow.
Cinnamomi Ramulus (Guizhi) Armeniacae Semen Amarum (Xingren) Zingiberis Rhizoma Recens (Ganjiang) Schisandrae Fructus (Wuweizi) Pinelliae Tuber (Banxia) Poria (Fuling)
Zhang: Latent fluid and Yin-turbidity invade upward. Triggered by the rising Earth Qi in Spring, causing vomiting and loss of appetite, naturally injuring the Spleen and Stomach. Liu Jun Zi Tang (Six Gentlemen Decoction) for spreading and tonifying is not without merit. However, diagnosis reveals very weak inspiration, clear urination in the morning but retention in the evening, and edema on the dorsum of the foot. The opening and closing function of the Fu organs is dysfunctional; middle-fullness is most feared. Taiyang governs opening, Yangming governs closing. Turbid Yin permeates; unblocking the Fu is equivalent to unblocking Yang. Imitate Zhang Zhongjing’s method of opening Taiyang.
Ostrea Concha (Muli) Alismatis Rhizoma (Zexie) Stephaniae Tetrandrae Radix (Fangji) Poria (Fuling) Schisandrae Fructus (Wuweizi) Zingiberis Rhizoma Recens (Ganjiang)
Zhang (17 years old): Choking asthma, unable to lie down, spirit confused like dementia. Qi descending brings clarity. Cold-water fluid pathogen rushes upward to Danzhong (Pericardium). Use the method of expelling fluid and opening turbidity.
(Cold-fluid turbid pathogen rushing upward to Danzhong)
Arisaematis Cum Bile (Nanxing) processed with Ginger Juice Aconiti Kusnezoffii Radix Preparata (Baifuzi) processed with Ginger Juice Poria (Fuling) Cinnamomi Ramulus (Guizhi) Glycyrrhizae Radix et Rhizoma (Gancao) processed with Honey Acori Tatarinowii Rhizoma (Shichangpu)
Patient (34 years old): Cough eased, less phlegm, discomfort in epigastrium, itching of skin and pores. All indicate incomplete elimination of Dampness, with phlegm-fluid occupying the space. Use the method of Liu An San (Six Peace Powder). (Phlegm-dampness in Lung and Stomach)
Armeniacae Semen Amarum (Xingren) Brassicae Semenis Albus (Baijiezi) Pinelliae Tuber (Banxia) stir-fried Poria (Fuling) Lightly dried Zingiberis Rhizoma (Ganjiang) Citri Reticulatae Pericarpium (Juhong)
Wang: In past years, Yang deficiency caused turbid fluid to float upward leading to urgent wheezing. Zhen Wu Tang (True Warrior Decoction) pills were effective. Due to habitual alcohol consumption and low grain intake, Middle deficiency led to damp accumulation, heat steaming into phlegm. Yellow eyes and bleeding gums should not be treated as Excess Heat. Propose using Wutai Fuling Yin (Poria Drink from External Cabinet), reduce Glycyrrhizae Radix et Rhizoma (Gancao), assist with slightly bitter drugs to clear and drain damp-heat. Because alcohol drinkers avoid sweetness.
Poria (Fuling) four liang Ginseng Radix (Renshen) two liang Coicis Semen (Yiren) four liang Immature Tangerine Fruit (Zhishi) one liang Pinelliae Tuber (Banxia) two liang Broad-leaved Mandarin Peel (Guangpi) two liang
Dendrobii Noduli (Shihu Jinshi) eight liang, decoct juice to make pills.
Wang: Bright complexion, waves of nausea in epigastrium. Due to stagnant vigorous heat steaming into phlegm-fluid. Temporarily postpone Ginseng Radix (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu). Must clear Middle Jiao heat-phlegm. (Middle Jiao Phlegm-Heat)
Armeniacae Semen Amarum (Xingren) Immature Tangerine Fruit (Zhishi) juice Citri Reticulatae Pericarpium (Juhong) Trichosanthis Pericarpium (Gualoupi) Curcumae Radix (Yujin) Pinelliae Fermentatum (Banxiaqu) Platycodonis Radix (Jiegeng) Gardeniae Fructus Rubefactus (Heizhizi) peel
Zhang (Lady): Phlegm-fluid mixed with Dryness, cough, throat itch. (Phlegm-fluid mixed with Dryness)
Armeniacae Semen Amarum (Xingren) Polygonati Reticulati Bulbus (Huafen) Poria (Fuling) Fritillariae Thunbergii Bulbus (Xiangbeimu) Citri Reticulatae Pericarpium (Juhong) Pinelliae Fermentatum (Banxiaqu)
Chen (Elderly Lady): Phlegm-fluid mixed with Qi-Fire occupying upper regions, epigastric stuffiness and distension. Regulate Qi-Heat. (Qi-Fire failing to descend)
Pinelliae Tuber (Banxia) Poria (Fuling) Trichosanthis Pericarpium (Gualoupi) Gardeniae Fructus Rubefactus (Heizhizi) peel Citri Reticulatae Pericarpium (Juhong) Curcumae Radix (Yujin)
Patient: Pulse wiry, right side choppy. Complexion lustrous, tongue white. Dry mouth but no desire to drink. Head feels heavy and dense. Chest and epigastrium blocked and painful, relieved slightly by belching. Alcohol consumer with low grain intake leads to Middle deficiency, phlegm-fluid accumulates. During Summer, Earth Qi rises, fluid pathogen mixes with Qi obstructing the Clear Orifices, causing previous symptoms. *Jinkui Yaolue* states: Wiry pulse indicates fluid; bright complexion indicates retained fluid; dry mouth without desire to drink indicates fluid pathogen has not left. Moreover, sweating—is this Wind-Cold? Warm pathogens prevail in Spring and Summer; Acrid-Warm dispersal is strictly forbidden. Self-reports body feeling empty and floating, age sixty-four. Using Acrid dispersal again depletes Yang, is this not wrong?
Pinelliae Tuber (Banxia) Ginger Juice Coptidis Rhizoma (Chuanlian) Evodiae Fructus (Wuzhuyu) Poria (Fuling) Immature Tangerine Fruit (Zhishi) Bamboo Sap (Zhuli)
Pan (38 years old): Traveler on road, Wind-Cold externally received, Heat steaming internally. Phlegm-fluid daily accumulates outside Zang organs, within Collaterals. Whenever encountering cold wind, exposure to scorching sun, or physical labor, restless mind disturbs latent fluid in collaterals. Fluid overflows, Qi rebels, cough, Qi blocks throat base and chest-diaphragm, no desire for food, lying down causes choking and vomiting thick phlegm. Qi descending heals itself. Disease name: Asthma Latent Fluid. Treatment appropriate, root removal is not immediate. In old age, still suffer from it. (Asthma Latent Fluid) Xiao Qing Long Tang (Minor Blue Dragon Decoction) remove Asari Radix (Xixin).
Tong (56 years old): Back cold, shortness of breath, back pain reflecting heart, penetrating ribs into waist. Eating porridge causes belching and epigastric stuffiness, diarrhea of yellow foam. Fluid pathogen latent in Dampness, Yang injury secretly manifesting. Warming channels and unblocking collaterals is essential. Use Ginseng Radix (Renshen) slowly. (Fluid latent in channels/collaterals)
Cinnamomi Ramulus (Guizhi) Raw Atractylodis Macrocephalae Rhizoma (Baizhu) Artemisiae Scopariae Herba (Shuqi) stir-fried black Aconiti Radix Preparata (Chuanwu) processed black Magnoliae Officinalis Cortex (Houpo) Poria (Fuling)
Ye (40 years old): Right pulse wiry, tongue yellow no thirst, sensation of blockage at heart. Formerly robust, now gradually thin. Chronic cough, worse when lying down, relief after expectoration. Clear Yang rarely rotates, branch vessels knot fluid. Propose unblocking Upper Jiao Yang. (Upper Jiao Clear Yang rarely rotating, branch vessels knotting fluid)
Fresh Allii Macrostemonis Bulbus (Xiebai) Trichosanthis Pericarpium (Gualoupi) Pinelliae Tuber (Banxia) Poria (Fuling) Cinnamomi Ramulus (Guizhi) Ginger Juice
Yang: Cold pain in head, food not digesting, muscles/tendons feel pulling pain. All due to slight Yang failing to circulate, phlegm-fluid increasing daily, Qi tunnels knotting daily, causing cold extremities. First, slightly unblock Chest Yang.
Dried Allii Macrostemonis Bulbus (Xiebai) Cinnamomi Ramulus (Guizhi) Pinelliae Tuber (Banxia) Poria (Fuling) Trichosanthis Pericarpium (Gualoupi) Ginger Juice
Second visit: Slight unblocking of Yang was effective. Phlegm-fluid obstructs Qi. Use Fuling Yin (Poria Drink) remove Citri Reticulatae Pericarpium (Guangpi) add Ginger Juice.
Cheng (33 years old): Branch vessel fluid accumulation, severe wheezing in cold months. Initially caused by Cold-Damp, so eating Acrid foods brings slight relief. (Branch vessel knotting fluid)
Armeniacae Semen Amarum (Xingren) Pinelliae Tuber (Banxia) Magnoliae Officinalis Cortex (Houpo) Coicis Semen (Yiren) Poria (Fuling) Pill method with Ginger Juice.
Zhao: Branch fluid, rib pain, cough/reversal. Xiao Qing Long Tang (Minor Blue Dragon Decoction) remove Ephedrae Herba (Mahuang), Asari Radix (Xixin).
Wang (Lady): Branch vessel knotting fluid, obstructing Qi causing wheezing/distension. Entering ribs causes pain, reversal leads to dizziness.
Poria (Fuling) Cinnamomi Ramulus (Guizhi) Pinelliae Tuber (Banxia) Armeniacae Semen Amarum (Xingren) Curcumae Radix (Yujin) Sugar-roasted Gypsum Fibrosum (Shigao)
Huang: Branch vessel knotting fluid, onset must be urgent wheezing. Use at onset.
Cinnamomi Ramulus (Guizhi) Poria (Fuling) Schisandrae Fructus (Wuweizi) Glycyrrhizae Radix et Rhizoma (Gancao) processed with Honey
Feng: Suspended fluid flows into Stomach, causing soreness/pain, gurgling acid water. Should Acrid-unblock Yang to drive out fluid. (Suspended Fluid)
Cinnamomi Ramulus (Guizhi) wood Pinelliae Tuber (Banxia) Poria (Fuling) Piperis Fructus (Chuanjiao) stir-fried black Ginger Juice
Second visit: Add Aconiti Lateralis Radix Preparata (Fuzi) pale to previous formula.
Shi: Diagnosis pulse Right deficient, Left slightly wiry. Complexion yellow, lacking luster. Left hypochondriac pain, unresolved for 5-6 years. Long illness enters collaterals, collaterals govern Blood. Drugs should not be harsh. Disease is Internal Injury, do not use cloying tonics. Record Zhang Zhongjing’s Xuan Fu Dai Zhe Tang (Inula and Hematite Decoction), add Bai Zi Ren (Biota Seed), Dang Gui Xu (Angelica Root tips), Tao Ren (Peach Kernel).
Second visit: Initial dose of Xuan Fu Dai Zhe Tang ineffective. Another doctor said Ying deficiency, used Ginseng Radix (Renshen), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix Preparata (Shudihuang), Cinnamomi Ramulus (Guizhi), Paeoniae Radix Alba (Baishao), Glycyrrhizae Radix et Rhizoma (Gancao) processed with Honey. Severe pain after ingestion. Doctor changed prescription to Jin Ling Zi San (Melia Toosendan Fruit Powder), Banxia (Pinellia), Taoren (Peach Kernel), Yanhusuo (Corydalis), Fuling (Poria). Severe vomiting and pain. Hired me again. Re-proposed prescription: Liver collateral long-term disease, suspended fluid flows into Stomach collateral, causing persistent pain. Propose Taiyang/Yangming Opening/Closing method.
Ginseng Radix (Renshen) Poria (Fuling) Glycyrrhizae Radix et Rhizoma (Gancao) processed with Honey Cinnamomi Ramulus (Guizhi) Roasted Ginger (Weijiang) Jujubae Fructus (Nanzao)
Taking bitter medicine causes pain/vomiting, indicating Stomach deficiency. Use Renshen/Fuling to close Yangming, Gancao/Guizhi to open Taiyang, plus Acrid-aromatic entering collaterals, Jiang/Zao to harmonize Ying/Wei. Fresh Ginger may damage Liver, so use Roasted Ginger to protect Yuan Qi and slightly open fluid Qi.
Third visit: Pain stopped after previous formula, propose pill formula.
Ginseng Radix (Renshen) Pinelliae Tuber (Banxia) Piperis Fructus (Chuanjiao) Poria (Fuling) Cinnamomi Ramulus (Guizhi) Roasted Ginger Jujubae Fructus (Nanzao) decoct juice for pills.
Patient: Summer Yang Qi greatly rises, much phlegm/choking cough, even unable to lie down at night. Food tastes change, stool loose or constipated. Pulse Right large and wiry. Propose suspended fluid flowing into Stomach collateral, use Opening/Closing guiding fluid method.
Ginseng Radix (Renshen) Poria (Fuling) Cinnamomi Ramulus (Guizhi) Glycyrrhizae Radix et Rhizoma (Gancao) processed with Honey Roasted Ginger (Weijiang) Jujubae Fructus (Nanzao)
Second visit: Morning pulse, both hands wiry, Right larger. Whenever Phlegm-Qi surges upward, cough/reversal worsens. Recent days little urine, lower Jiao slightly swollen. Propose unblocking Taiyang to withdraw fluid pathogen.
Ginseng Radix (Renshen) Poria (Fuling) Cinnamomi Ramulus (Guizhi) Glycyrrhizae Radix et Rhizoma (Gancao) processed with Honey Schisandrae Fructus (Wuweizi) Zingiberis Rhizoma Recens (Ganjiang)
Third visit: Pulse wiry slightly rapid, no thirst/desire to drink. This is turbid fluid not gone, Clear Yang not governing transport. Previous formula Acrid-Warm, focuses on Opening/Closing, makes Stomach pleased. Next method opens Taiyang to withdraw fluid pathogen, also focuses on Yang unblocking. Self-reports epigastric sensation like object blocking/stagnant. Turbidity binds Yang slightly prominent. Treating cough with Yin-nourishing is suitable for Yin-turbidity dominance. Propose Ban Xia Hou Po Tang (Pinellia and Magnolia Bark Decoction) method. Ban Xia Hou Po Tang add stir-fried black Piperis Fructus (Chuanjiao).
*Neijing* only mentions Ji Yin (Accumulated Fluid), originally no name Tan Yin (Phlegm-Fluid). Before Han Dynasty called Dan Yin (Pale Fluid). Zhang Zhongjing first distinguished Tan Yin, thus establishing meanings of Tan Yin, Xuan Yin, Yi Yin, Zhi Yin. Established formulas like Da/Xiao Qing Long Tang, Ban Xia Ling Gui Zhu Gan Tang, Shen Qi Tang, and methods for internal/external fluid. Truly elucidated former sages, surpassing millennia. Distinct from later methods of Feng Tan (Wind Phlegm), Shi Tan (Damp Phlegm), Re Tan (Heat Phlegm), Jiu Tan (Alcohol Phlegm), Shi Tan (Food Phlegm). In summary, Tan Yin arises from Yuan Qi deficiency and Yin excess/Yang decline, causing Jin Ye (Body Fluids) to coagulate, unable to distribute, remaining in Chest. Clear water becomes turbid. Water accumulating in Yin becomes Yin (Fluid); Fluid condensing in Yang becomes Tan (Phlegm). If Yuan Qi sufficient, Stomach strong/Spleen healthy, diet regulated, transport continuous, how could Tan Yin exist? Thus Zhang Zhongjing said: For diseases of Tan Yin, harmonize with warm medicines. Later generations did not understand Tan Yin meaning, recklessly used Gun Tan Wan (Rolling Phlegm Pill), Fu Ling Wan (Poria Pill), eliminating phlegm/breaking Qi, or cloying tonification, severely damaging Spleen/Stomach, piling up to aid turbidity. How different from Zhang Zhongjing’s Tan Yin methods! Although Tan and Yin are similar, they have Yin/Yang distinction. Yang excess/Yin deficiency causes Water Qi to coagulate into Tan; Yin excess/Yang deficiency causes Water Qi to overflow into Yin. Thus Mr. Wang Jin San took Zhang Zhongjing’s Xiao Ban Xia Fu Ling Tang and Wutai Yin San Tang, establishing treatment methods for Tan/Yin based on Spleen/Stomach channels. And Mr. took Zhang Zhongjing’s Ling Gui Zhu Gan Tang, Wutai Fuling Yin, Shen Qi Wan, Zhen Wu Tang, dividing internal/external fluid treatments. Regarding Tan Yin symptoms, nothing was omitted. I have examined Mr.’s Tan Yin methods, finding more than this. However, diseases vary, treatments differ. E.g., Spleen/Kidney Yang deficiency, Bladder Qi transformation blocked, take Ling Gui Zhu Gan Tang, Fuling Yin, Shen Qi/Zhen Wu methods, focusing on regulating/unblocking Yang, securing lower/nourishing Kidney, rotating transporting Spleen. E.g., External Cold triggering latent fluid counterflow, Bladder Qi blocked, fluid reversing Lung Qi failing to descend, use Xiao Qing Long combined with Yue Bi etc., focusing on opening Taiyang/Bladder. E.g., Fluid pathogen latent in collaterals, Middle deficiency damp-heat forming phlegm, use Chuanwu/Shuqi warming channels/unblocking collaterals, Wutai Fuling Yin removing Gancao, assisting with bitter-acrid clearing draining dampness methods. Fluid pathogen rushing upward to Danzhong, suspended fluid flowing into Stomach causing disease, use Jiang/Fu/Nanxing/Shichuanpu/Xuanfu/Chuanjiao etc., driving fluid/opening turbidity, Acrid-unblocking Yang methods. Meticulous, consistent throughout. Disease condition and treatment, bamboo in chest (clear plan). Only those deeply understanding Dao can achieve this. (Zou Zijiu)