有湿、有热、有寒、有风、有老、有食积。脉浮当吐,膈上痰必用吐,痰在经络中,非吐不出,吐中就有发散之
义。假如痫病,因惊而得,惊则神出于舍,舍空则痰入也;痰入在舍,而拒其神,神不得而归焉。痰在肠胃间,
可下而愈。湿痰苍、白术类;热痰青黛,芩、连类;寒痰二陈类;风痰南星、白附类;老痰海石、栝蒌类;食积痰神
曲、麦 类。气实痰热结,吐难得出,或成块,或吐咯不出,气滞者,难治。在上胶固稠浊者,必用吐。吐
法多用芽茶、齑汁、姜汁、醋少许,芦瓜蒂散少许,加桔梗、防风、皆升动其气便吐也。又法用附子尖、桔梗、芦
人参、瓜蒂、藜芦。砒不甚用,非危急不用,艾叶、末茶此皆自吐,不用手法,但药、但汤皆可吐也。吐法先以
布搭膊勒腰,于不透风处行此法,用萝卜子半升,擂,和以浆水一碗,滤去渣,入少油与蜜,炖至半温服,以鹅翎
探吐之。鹅翎浸以桐油,却以皂角水洗去油,晒干方用。又虾汁吐法亦好。吐不止,须用解药,麝香解藜芦、瓜
蒂,葱白解瓜蒂,水与甘草总解。凡人身结核,不红、不痛、不作脓,皆痰注也。病患诸药不效,关脉伏而大者,
痰也。眼胞、眼下如烟熏黑者,亦痰也。凡人身上、中、下有块,是痰,问其平日好食何物,吐下后用相制药消之。
实脾土,燥脾湿,是治痰之本法也。许学士云∶用苍术
治痰饮成窠囊,行痰极有效,痰挟血遂成窠囊。痰病久得涩脉,卒难得开,必费调理。二陈汤加升麻、柴胡能
使大便润而小便长,胸膈宽。内伤挟痰,必用参、 、白术之类,多用姜汁传送,或加半夏之类,虚甚者加竹沥。
痰热者,多挟风,外证为多;或成块吐咯不出,兼郁者难治。湿痰多软,如身倦体重之类。风痰多见奇证。
食积痰,必用攻兼;气虚者,用补气药送之。因火盛逆上者,以治火为先,白术、黄芩、石膏之类;中气不足,则加
白术、人参,然后治痰。痰之为物,在人身随气升降,无处不到,无所不之,百病中多有兼此者,世所不识。脾
虚者,清中气以运痰降下,二陈汤加白术之类,兼用升麻提气。凡虚人中焦有痰,胃气亦赖所养,不可尽攻;若攻
之,尽则愈虚也。眩运嘈杂乃火动其痰,用二陈汤加栀子。黄芩、黄连之类。痰结核在咽,喉开燥不能出者,
化痰药加咸味软坚,栝蒌、杏仁、海石、桔梗、连翘,少佐以风硝、姜,蜜丸噙。痰在皮里膜外及经络中,非姜
汁、竹沥、荆沥不可治。痰在四肢,非竹沥不行。喉中如有物,咯不出,咽不下,此是痰。重者吐之,轻者用
栝蒌辈,气实必用荆沥。血滞不行,中焦有饮者,用韭汁冷冻饮料三、四酒盏,必胸中烦躁不宁,无妨,但服后即愈。
海粉热痰能降,湿痰能燥,结痰能软,顽痰能消,可入丸内,勿入煎药。黄芩能治痰热,以易降火也。枳实泻痰,能
冲墙壁。天花粉大治膈上热痰。五倍子佐他药,大治顽痰。栝蒌、滑石大治食积痰,洗涤脏腑。油炒半夏,大
治湿痰,亦治喘嗽心痛。粥丸姜汤下三十丸。小胃丹能损胃气,食积痰者,用之不宜多服。治湿痰方∶黄芩、半
夏、香附、贝母,若加栝蒌、青黛,能治热痰,作丸
服。痰之清者,二陈汤之类,凡治风痰,必用白附子、天麻、雄黄、牛黄、僵蚕、猪牙皂角之类。中和丸治湿痰气
热,苍术、黄芩、半夏、香附等分,为末,粥丸。燥湿痰方∶南星(一两) 半夏(二两) 蛤粉(三两) 上为
末,蒸饼丸,青黛为衣。治阴虚,内多食积痰方∶真川芎(七钱) 黄连 栝蒌仁 白术 神曲 麦芽(上各一两)
青黛(五钱) 人中白(三钱) 上为末,姜汁蒸饼为丸。竹沥治膈间有痰,或颠狂,或健忘,或风痰,亦能养血,
与荆沥同。小胃丹治湿热痰积,兼治白带,用甘遂以水湿面为衣,长流水煮令面透,再用水洗,晒干,大戟以长流
水煮一时,再用水洗,晒干,芫花好醋拌匀,过一宿,瓦器内炒,不住手搅,炒令黑色,不要焦了。大黄纸裹,
水湿,灰火煨,勿令焦,去纸切焙干,再以酒润炒,令热倍前药,黄柏炒倍大黄,各研秤末,用粥
丸,麻子大,每服十二丸。又方∶甘遂、大戟减三分之一,朱砂为衣,名辰砂化痰九。痰方∶南星、半夏(各一
两),蛤粉(二两),专治湿痰。热加青黛,湿加苍术,食积加神曲、麦 、山楂。又方∶黄芩、香附、半夏、栝
蒌、贝母、青黛,末之,粥丸。治食积痰火,又能大泻胃火,软石膏细末,酷丸,如绿豆大,每服十丸。青礞石丸∶
解食积,去湿痰,看病冷热虚实,作汤使,青礞石(半两,根据法 ) 半夏(七钱) 南星 茯苓 片芩(各半两)
法制硝(三钱) 以硝共萝卜水煮化,去萝卜,以绵滤过,令结风化,末之,面糊丸。一加苍术、滑石。又方∶半夏
(二两) 白术(一两) 茯苓 陈皮(各七钱半) 黄芩 礞石(各半两) 风化硝(二钱)。 痰喘方∶
皂角灰(半两) 海粉 萝卜子(蒸) 南星(用白矾一钱半泡汤晒干各一两) 栝蒌仁(一两) 上末之,姜蜜丸,
噙化。又方∶南星、半夏、杏仁、栝蒌、萝卜子、青黛、香附,曲糊丸。清金
丸去肺火,下膈上热痰,与清化丸同用,以黄芩炒末,水丸。清化丸方,苦能燥湿热,轻能治上,专治热嗽,及治
咽痛。细末,以醋调敷咽喉间。用灯笼草叶炒末,蒸饼丸。茯苓丸治痰,半夏(四两) 茯苓(二两) 枳壳(一
两) 风化硝(五钱)治郁痰,白僵蚕、杏仁、栝蒌仁。诃子、贝母、五倍子。导饮丸∶吴茱萸(制三钱) 茯苓(一
两) 黄连(五钱) 滑石(七钱半) 苍术(一两半甘水浸),上末之,曲糊丸,每服百丸,姜汤下。白玉
丸,江子(三十个) 南星 半夏 滑石 轻粉(各三钱)为末,皂角仁浸浓汁丸,桐子大,每服五、七丸。栝蒌
丸∶治食积,痰壅滞喘,栝蒌仁 半夏 山楂肉 神曲(各等分) 上为末,以栝蒌水丸,姜汤入竹沥,下二十丸。
又方∶半夏(一两) 苍术(二两) 香附(二两半) 黄芩 黄连 栝蒌(各一两) 上末之,曲糊丸。
清膈化痰方∶黄连(一两) 黄芩(一两) 黄柏(五钱) 山栀(五钱) 香附(二两半) 苍术(二两) 上为
末,曲糊丸。搜风化痰丸∶人参 僵蚕 槐角子 白矾 天麻 陈皮(去白) 荆芥(一两) 半夏(四两
姜汁浸) 辰砂(半两) 上末之,姜汁炊饼丸,阴干,辰砂为衣,姜汤下四十丸。坠痰九∶治痰饮效。枳实 枳壳(
半两炒去穣) 黑牵牛(半斤,取头末) 猪牙皂角(二钱酒炒) 明矾(三钱,飞一半) 朴硝
(三钱,风化为末) 上末之,用萝卜汁丸,每服四十丸,鸡鸣时服,初则有粪,次则有痰。治湿痰∶苍术(一钱)
白术(六钱) 香附(一钱) 酒白芍药(二钱) 上末之,炊饼丸。治肥人湿痰∶苦参 半夏(各一钱半) 白术
(二钱半) 陈皮(一钱) 上作一服,姜三片,入竹沥与水共一盏煎,食远,吞三补丸十五丸。治
上焦风痰∶栝蒌仁 黄连 半夏 猪牙皂角(各等分),上末,姜汁炊饼丸。治痰气∶片黄芩 陈皮 半夏(各五钱)
白术 白芍药(各一两) 茯苓(三钱) 上为末,姜汁炊饼丸。祛风痰,行浊气∶防风 川芎 牙皂 白矾 郁
金(各一两) 赤白蜈蚣(各
一条) 上末之,炊饼丸,桐子大,每服二十五丸,食前茶清汤下,春以芭蕉汤探吐痰。利膈化痰丸,治胸膈痰气最
妙∶贝母 半夏(各半两) 天南星 蛤粉(各一两) 栝蒌仁 香附(各半两),童便浸,以上并为细末,上用猪
牙皂角十四挺敲碎,水一碗半煮,杏仁(去皮尖一两)煮,水将干去皂角,擂杏仁如泥,入前药搜和,再入生姜汁,
炊饼丸如绿豆大,青黛为衣晒干,每服五十六十丸。清痰丸专主胸中痰积,一云专主中宫痰积∶乌梅(五钱) 枯明
矾(五钱) 南星 半夏(各一两) 黄芩(五钱) 苍术(五钱) 神曲(一两) 棠 (一两) 青皮 陈皮(
各五钱) 香附(一两) 滑石(炒五钱) 干生姜(一两) 枳实(一两) 上为末,炊饼丸。
一男子年七十九岁,头目昏而重,手足无力,吐痰口口相续,左手脉散大而缓,右手脉缓而大不及,于左重按皆无力,
饮食稍减而微渴,大便三四日一行,若与风药至春深必死,此大虚证,当以补药作大剂服之。与黄 、人参、当归身、
芍药、白术、陈皮,浓煎作汤,使下连柏丸三十丸,服一年半,精力如少壮时。连柏丸冬加干姜少许,作令药,余三时
皆根据本法。连柏皆以姜汁炒为末,用姜汁糊丸。一男子年近三十,浓味多怒,秋间于髀枢左右发痛,一点延及膝 ,
昼静夜剧,痛处恶寒,口或渴或否。医与治风,并补血药,至次春,膝渐肿痛甚,食渐减,形羸瘦,至春末,膝渐肿如
碗,不可屈伸,其脉弦大颇实,率皆数短,其小便必数而短,遂作饮食痰积在太阴、阳明治之。半夏(五钱) 黄柏(
一两酒炒) 生甘草梢(三钱) 苍术(三钱盐炒) 川芎(三钱) 生犀角屑(三钱) 陈皮 牛膝 木通 芍药(以
上五钱),遇喧热加条芩二钱,上为末,每服三钱重,与姜汁同研细适中,以水汤起令沸,带
热食前服之,一日夜四次与之,半月后,数脉渐减,痛缓,去犀角,加牛膝、败龟板半两,当归身尾半两,如前服之。
又与半月余,肿渐减,食渐进,不恶寒,惟膝痿软,未能久立久行,去苍术、黄芩,时夏月,加炒柏至一两半,余根据本
方内加牛膝,春夏用梗,秋冬用根,惟叶汁用尤效,须绝酒肉、湿面、胡椒,中年人加生地半两,冬加茱萸、桂枝。
一人面上才见些少风,如刀刮者,身背皆不怕冷,能食,脉弦,起居如常,先以川芎、桔梗、生姜、山栀、细茶,吐痰
后,服黄连导痰汤。外弟一日醉饱后,乱言妄见,且言伊芳亡兄生前事甚的。乃叔叱之曰∶食鱼腥与酒太过,痰所为
耳,灌盐汤一大碗,吐痰一升,汗因大作,困睡一宵而安。金氏妇壮年暑月赴筵回,乃姑询其坐次失序,自愧因成病,
言语失伦,又多自责之言,两脉皆弦数,予曰非鬼邪乃病也,但与补脾导痰清热,数日当自安。其家不信,以数
巫者喷水而恐之,旬余而死。一妇年五十余,夜多怒,因食烧猪肉,次早面胀不食身倦,六脉沉涩而豁大,此体虚,
痰膈不降,当补虚利痰,每早服二陈加参术大剂,服后探吐,令药出,辰时后与三和汤三倍加术二帖,至睡后服神
丸七丸,逐其痰去牵牛,服至一月而安。傅宪幕子,暑月因劳而渴,恣饮梅水,又连得大惊三四次,妄言妄见,病似
鬼邪,两脉皆虚弦而沉数,予曰∶数为有热,虚弦是大惊,又酸浆停于中脘,补虚清热,导去痰滞,病可安,与
参、术、陈皮、芩、连、茯苓,浓煎汤,入竹沥姜汁与服,浃旬未效,众尤药之未对,予知其虚未回,痰未导,仍与
前方加荆沥,又旬而安。一人阴虚有痰,神曲 麦芽 黄连 白术(各一两) 川芎(七钱) 栝蒌仁 青黛 人中
白(各半两) 上末之,姜汁擂,炊饼丸。一人湿热劳倦,新婚胸膈不快,觉有冷冻饮料,脉涩大,先多得辛温导散药,血
气俱伤。苍术 半夏 白术 陈皮(以上五钱) 白芍药(六钱) 龟板(七钱半)
炒柏(一钱半) 黄芩(三钱) 砂仁 甘草(各一钱) 上末之,炊饼丸,食前姜汤下,四五十丸。服后膈间冷痰
未除,用小陷胸汤加少茱萸作向导为丸服。一人气实形壮,常觉胸膈气不舒,三一承气汤下之,及与导痰之类。
一人食积,痰气脾弱∶贝母 连翘 麦芽 陈皮(各半两) 南星 黄芩 白术(各一两) 莱菔子(二钱半) 上末
之,炊饼丸。一老人,呕痰、胸满、寒热,因伤食起用二陈导饮,白术补脾,柴胡、黄芩退寒热,苍术解表寒,砂仁定
呕下气。一妇人舌上长起浓胎、并痛,心下时坚,阳明痰热∶黄柏 知母(俱蜜炙) 贝母各(二两)
栝蒌 枳实 麦芽 姜黄 牛膝(各半两) 为末,可留于舌上,再用白术(二两) 荜澄茄 莱菔子 连翘 石膏(
各半两) 青子 风硝 升麻(各三钱),上末,炊饼丸服。二陈治痰要药,世多忽之,且平胃散为常服之药,二
陈汤反不可服乎?但能随证加减,用之无不验。 世人贵耳贱目不特此也。
痰的形成,有因湿、因热、因寒、因风、因年老体虚、因食积所致。脉象浮的应当用吐法,膈膜以上的痰必须用吐法,痰在经络中的,不用吐法排不出来,吐法中本身就包含发散的含义。假如癫痫发作,是因为受惊而得病,受惊则神志离开心舍,心舍空虚则痰邪乘虚而入;痰邪进入心舍,阻碍神志回归,导致神志不能归位。痰在肠胃之间,可以用下法治愈。湿痰用苍术、白术类药物;热痰用青黛、黄芩、黄连类药物;寒痰用二陈汤类方剂;风痰用天南星、白附子类药物;老痰用海浮石、瓜蒌类药物;食积痰用神曲、麦芽类药物。如果气实且痰热互结,难以吐出,或者结成块状,或咳吐不出,属于气滞的,难治。位于上部胶固稠浊的痰,必须用吐法。吐法多用芽茶、腌菜汁、姜汁、少许醋,加上少量瓜蒂散,再加桔梗、防风,都是利用升提之气来引发呕吐。另一种方法是用附子尖、桔梗、芦人参、瓜蒂、藜芦。砒霜很少使用,除非危急情况才用,艾叶、末茶,这些都能引起自吐,不需要手法辅助,无论是药粉还是汤剂都可以催吐。施行吐法前,先用布带勒紧腰部,在不透风的地方进行此法。用萝卜子半升,研磨,与一碗浆水混合,滤去渣滓,加入少许油和蜜,炖至半温时服用,然后用鹅毛管探喉催吐。鹅毛管先浸桐油,再用皂角水洗去油脂,晒干后使用。还有虾汁催吐法也很好。如果呕吐不止,需要用解药:麝香能解藜芦、瓜蒂之毒,葱白能解瓜蒂之毒,水和甘草总解诸毒。凡是人身上的结核,不红、不痛、不化脓的,都是痰注。病人服用各种药物无效,关脉伏而大的,是痰证。眼睑、眼下像烟熏一样发黑的,也是痰证。凡人身体的上、中、下部位有肿块,是痰,询问其平时喜欢吃什么食物,在吐下之后,用相应的制药来消除它。健脾土、燥脾湿,是治疗痰的根本方法。许学士说:用苍术治疗痰饮形成的窠囊,行痰非常有效,痰挟血遂形成窠囊。痰病日久出现涩脉,突然很难开通,必定需要长时间调理。二陈汤加升麻、柴胡能使大便滋润而小便通长,胸膈宽畅。内伤挟痰,必须用人参、(此处原文缺字,推测为黄芪或类似补气药)、白术之类,多用姜汁送服,或加半夏之类,虚甚的加竹沥。痰热者,多挟风,外证较多;或者结成块状咳吐不出,兼有郁证的难治。湿痰多软,如身体疲倦、体重之类。风痰多见奇异症状。食积痰,必须攻补兼施;气虚者,用补气药送服。因火盛逆上者,以治火为先,用白术、黄芩、石膏之类;中气不足,则加白术、人参,然后治痰。痰这种物质,在人身随气升降,无处不到,无所不至,百病中多有兼夹此症的,世人大多不认识。脾虚者,清中气以运化痰浊并降下,用二陈汤加白术之类,兼用升麻提气。凡是虚人中有痰,胃气也依赖痰浊所养(此处意指脾胃虚弱需顾护胃气),不可完全攻伐;如果攻伐过度,就会更加虚弱。眩晕嘈杂是火动其痰,用二陈汤加栀子、黄芩、黄连之类。痰结核在咽喉,干燥不能排出的,化痰药加咸味以软坚,用瓜蒌、杏仁、海浮石、桔梗、连翘,少佐以风化硝、姜,制成蜜丸含化。痰在皮里膜外及经络中,非姜汁、竹沥、荆沥不可治。痰在四肢,非竹沥不行。喉中如有物,咳不出,咽不下,这是痰。重的用吐法,轻的用瓜蒌之类,气实的必用荆沥。血滞不行,中焦有水饮的,用韭汁冷冻饮料三、四酒杯,必然会出现胸中烦躁不安,无妨,服药后即愈。海粉能降热痰,燥湿痰,软化结痰,消除顽痰,可入丸剂,勿入煎药。黄芩能治痰热,因为它能降火。枳实泻痰,力量猛烈能冲墙壁。天花粉大治膈上热痰。五倍子配合其他药,大治顽痰。瓜蒌、滑石大治食积痰,洗涤脏腑。油炒半夏,大治湿痰,也治喘嗽心痛。粥丸用姜汤送下三十丸。小胃丹能损伤胃气,食积痰者,不宜多服。治疗湿痰方:黄芩、半夏、香附、贝母,若加瓜蒌、青黛,能治热痰,作丸服。清稀的痰,用二陈汤之类。凡治风痰,必用白附子、天麻、雄黄、牛黄、僵蚕、猪牙皂角之类。中和丸治湿痰气热,苍术、黄芩、半夏、香附等分,研为末,粥糊丸。燥湿痰方:南星(一两)半夏(二两)蛤粉(三两)研为末,蒸饼丸,青黛为衣。治阴虚,内多食积痰方:真川芎(七钱)黄连、瓜蒌仁、白术、神曲、麦芽(各一两)青黛(五钱)人中白(三钱)研为末,姜汁蒸饼为丸。竹沥治膈间有痰,或癫狂,或健忘,或风痰,也能养血,与荆沥同用。小胃丹治湿热痰积,兼治白带,用甘遂以水湿面为衣,长流水煮令面透,再用水洗,晒干,大戟以长流水煮一时辰,再用水洗,晒干,芫花用好醋拌匀,过一夜,瓦器内炒,不住手搅,炒令黑色,不要焦了。大黄用纸裹,水湿,灰火煨,勿令焦,去纸切焙干,再以酒润炒,令热倍前药,黄柏炒倍大黄,各研秤末,用粥糊丸,麻子大,每服十二丸。又方:甘遂、大戟减三分之一,朱砂为衣,名辰砂化痰丸。痰方:南星、半夏(各一两),蛤粉(二两),专治湿痰。热加青黛,湿加苍术,食积加神曲、麦芽、山楂。又方:黄芩、香附、半夏、瓜蒌、贝母、青黛,研末,粥糊丸。治食积痰火,又能大泻胃火,用软石膏细末,醋糊丸,如绿豆大,每服十丸。青礞石丸:解食积,去湿痰,看病冷热虚实,作汤使,青礞石(半两,根据法制)半夏(七钱)南星、茯苓、片芩(各半两)法制硝(三钱)以硝共萝卜水煮化,去萝卜,以绵滤过,令结风化,研末,面糊丸。一加苍术、滑石。又方:半夏(二两)白术(一两)茯苓、陈皮(各七钱半)黄芩、礞石(各半两)风化硝(二钱)。痰喘方:皂角灰(半两)海粉、萝卜子(蒸)、南星(用白矾一钱半泡汤晒干各一两)、瓜蒌仁(一两)研末,姜蜜丸,含化。又方:南星、半夏、杏仁、瓜蒌、萝卜子、青黛、香附,曲糊丸。清金丸去肺火,下膈上热痰,与清化丸同用,以黄芩炒末,水丸。清化丸方,苦能燥湿热,轻能治上,专治热嗽,及治咽痛。细末,以醋调敷咽喉间。用灯笼草叶炒末,蒸饼丸。茯苓丸治痰,半夏(四两)茯苓(二两)枳壳(一两)风化硝(五钱)治郁痰,白僵蚕、杏仁、瓜蒌仁、诃子、贝母、五倍子。导饮丸:吴茱萸(制三钱)茯苓(一两)黄连(五钱)滑石(七钱半)苍术(一两半甘水浸),研末,曲糊丸,每服百丸,姜汤下。白玉丸,江子(三十个)南星、半夏、滑石、轻粉(各三钱)研末,皂角仁浸浓汁丸,桐子大,每服五、七丸。瓜蒌丸:治食积,痰壅滞喘,瓜蒌仁、半夏、山楂肉、神曲(各等分)研末,以瓜蒌水丸,姜汤入竹沥,下二十丸。又方:半夏(一两)苍术(二两)香附(二两半)黄芩、黄连、瓜蒌(各一两)研末,曲糊丸。清膈化痰方:黄连(一两)黄芩(一两)黄柏(五钱)山栀(五钱)香附(二两半)苍术(二两)研末,曲糊丸。搜风化痰丸:人参、僵蚕、槐角子、白矾、天麻、陈皮(去白)、荆芥(一两)半夏(四两姜汁浸)辰砂(半两)研末,姜汁炊饼丸,阴干,辰砂为衣,姜汤下四十丸。坠痰丸:治痰饮效。枳实、枳壳(半两炒去穣)黑牵牛(半斤,取头末)猪牙皂角(二钱酒炒)明矾(三钱,飞一半)朴硝(三钱,风化为末)研末,用萝卜汁丸,每服四十丸,鸡鸣时服,初则有粪,次则有痰。治湿痰:苍术(一钱)白术(六钱)香附(一钱)酒白芍药(二钱)研末,炊饼丸。治肥人湿痰:苦参、半夏(各一钱半)白术(二钱半)陈皮(一钱)作一服,姜三片,入竹沥与水共一盏煎,食远,吞三补丸十五丸。治上焦风痰:瓜蒌仁、黄连、半夏、猪牙皂角(各等分),研末,姜汁炊饼丸。治痰气:片黄芩、陈皮、半夏(各五钱)白术、白芍药(各一两)茯苓(三钱)研末,姜汁炊饼丸。祛风痰,行浊气:防风、川芎、牙皂、白矾、郁金(各一两)赤白蜈蚣(各一条)研末,炊饼丸,桐子大,每服二十五丸,食前茶清汤下,春以芭蕉汤探吐痰。利膈化痰丸,治胸膈痰气最妙:贝母、半夏(各半两)天南星、蛤粉(各一两)瓜蒌仁、香附(各半两),童便浸,以上并为细末,上用猪牙皂角十四挺敲碎,水一碗半煮,杏仁(去皮尖一两)煮,水将干去皂角,擂杏仁如泥,入前药搜和,再入生姜汁,炊饼丸如绿豆大,青黛为衣晒干,每服五六十丸。清痰丸专主胸中痰积,一说专主中宫痰积:乌梅(五钱)枯明矾(五钱)南星、半夏(各一两)黄芩(五钱)苍术(五钱)神曲(一两)棠梨(一两)青皮、陈皮(各五钱)香附(一两)滑石(炒五钱)干生姜(一两)枳实(一两)研末,炊饼丸。
一个男子七十九岁,头目昏沉且重,手足无力,吐痰口口相续,左手脉散大而缓,右手脉缓而大不及左,于左重按皆无力,饮食稍减而微渴,大便三四日一行,若用风药至春深必死,这是大虚证,当以补药作大剂服之。给予黄芪、人参、当归身、芍药、白术、陈皮,浓煎作汤,送服连柏丸三十丸,服一年半,精力如少壮时。连柏丸冬加干姜少许,作为引经药,其余三季皆根据本法。连柏皆以姜汁炒为末,用姜汁糊丸。
一个男子年近三十,嗜食厚味多怒,秋季于髀枢左右发痛,一点延及膝部,昼静夜剧,痛处恶寒,口或渴或不渴。医生给予治风药,并补血药,至次年春,膝渐肿痛甚,食渐减,形羸瘦,至春末,膝渐肿如碗,不可屈伸,其脉弦大颇实,率皆数短,其小便必数而短,遂作饮食痰积在太阴、阳明治之。半夏(五钱)黄柏(一两酒炒)生甘草梢(三钱)苍术(三钱盐炒)川芎(三钱)生犀角屑(三钱)陈皮、牛膝、木通、芍药(以上五钱),遇喧热加条芩二钱,研末,每服三钱重,与姜汁同研细适中,以水汤起令沸,带热食前服之,一日夜四次与之,半月后,数脉渐减,痛缓,去犀角,加牛膝、败龟板半两,当归身尾半两,如前服之。又与半月余,肿渐减,食渐进,不恶寒,惟膝痿软,未能久立久行,去苍术、黄芩,时夏月,加炒柏至一两半,余根据本方内加牛膝,春夏用梗,秋冬用根,惟叶汁用尤效,须绝酒肉、湿面、胡椒,中年人加生地半两,冬加茱萸、桂枝。
一人面上才见些少风,如刀刮者,身背皆不怕冷,能食,脉弦,起居如常,先以川芎、桔梗、生姜、山栀、细茶,吐痰后,服黄连导痰汤。
外弟一日醉饱后,乱言妄见,且言其亡兄生前事甚确。乃叔叱之曰:食鱼腥与酒太过,痰所为耳,灌盐汤一大碗,吐痰一升,汗因大作,困睡一宵而安。
金氏妇壮年暑月赴筵回,乃姑询其坐次失序,自愧因成病,言语失伦,又多自责之言,两脉皆弦数,予曰非鬼邪乃病也,但与补脾导痰清热,数日当自安。其家不信,以数巫者喷水而恐之,旬余而死。
一妇年五十余,夜多怒,因食烧猪肉,次早面胀不食身倦,六脉沉涩而豁大,此体虚,痰膈不降,当补虚利痰,每早服二陈加参术大剂,服后探吐,令药出,辰时后与三和汤三倍加术二帖,至睡后服神丸七丸,逐其痰去牵牛,服至一月而安。
傅宪幕子,暑月因劳而渴,恣饮梅水,又连得大惊三四次,妄言妄见,病似鬼邪,两脉皆虚弦而沉数,予曰:数为有热,虚弦是大惊,又酸浆停于中脘,补虚清热,导去痰滞,病可安,与参、术、陈皮、芩、连、茯苓,浓煎汤,入竹沥姜汁与服,浃旬未效,众尤药之未对,予知其虚未回,痰未导,仍与前方加荆沥,又旬而安。
一人阴虚有痰,神曲、麦芽、黄连、白术(各一两)川芎(七钱)瓜蒌仁、青黛、人中白(各半两)研末,姜汁擂,炊饼丸。
一人湿热劳倦,新婚胸膈不快,觉有冷饮,脉涩大,先多得辛温导散药,血气俱伤。苍术、半夏、白术、陈皮(以上五钱)白芍药(六钱)龟板(七钱半)炒柏(一钱半)黄芩(三钱)砂仁、甘草(各一钱)研末,炊饼丸,食前姜汤下,四五十丸。服后膈间冷痰未除,用小陷胸汤加少茱萸作向导为丸服。
一人气实形壮,常觉胸膈气不舒,三一承气汤下之,及与导痰之类。
一人食积,痰气脾弱:贝母、连翘、麦芽、陈皮(各半两)南星、黄芩、白术(各一两)莱菔子(二钱半)研末,炊饼丸。
一老人,呕痰、胸满、寒热,因伤食起用二陈导饮,白术补脾,柴胡、黄芩退寒热,苍术解表寒,砂仁定呕下气。
一妇人舌上长起浓胎、并痛,心下时坚,阳明痰热:黄柏、知母(俱蜜炙)贝母各(二两)瓜蒌、枳实、麦芽、姜黄、牛膝(各半两)为末,可留于舌上,再用白术(二两)荜澄茄、莱菔子、连翘、石膏(各半两)青子、风硝、升麻(各三钱),上末,炊饼丸服。
Phlegm formation arises from dampness, heat, cold, wind, advanced age (deficiency), and food stagnation. When the pulse is floating, emesis should be used; phlegm above the diaphragm must be expelled by emesis; phlegm in the meridians cannot be removed without emesis, which inherently contains the meaning of dispersing. For example, epilepsy may result from fright; fright causes the Shen (Spirit) to leave its residence (the Heart), leaving it empty so that pathogenic phlegm enters; once phlegm occupies the residence, it obstructs the Shen, preventing its return. Phlegm in the intestines and stomach can be cured with purgation. Damp-phlegm is treated with herbs like Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma); Heat-phlegm with Qingdai (Indigo Naturalis), Huangqin (Scutellariae Radix), and Lianqiao (Forsythiae Fructus) [Note: Original text says Qin, Lian, usually Huangqin, Huanglian]; Cold-phlegm with Erchen Tang (Two-Cured Decoction); Wind-phlegm with Tian Nanxing (Arisaematis Rhizoma) and Baifuzi (Girardiniae Semen); Old-phlegm with Haishi (Pumice) and Gualou (Trichosanthis Fructus); Food-stagnation phlegm with Shenqu (Massa Medicata Fermentata) and Maiya (Hordei Fructus Germinatus). If Qi is excess and phlegm-heat are knotted, making emesis difficult, or if it forms clumps that cannot be expectorated, indicating Qi stagnation, it is difficult to treat. Phlegm located superiorly that is sticky, solid, and turbid must be expelled by emesis. Emetic methods often use sprouted tea, pickled vegetable juice, ginger juice, a little vinegar, and a small amount of Gudi San (Melon Stalk Powder), plus Jiegeng (Platycodonis Radix) and Fangfeng (Saposhnikoviae Radix), all working by raising Qi to induce vomiting. Another method uses Fuzi Jian (Tip of Prepared Aconite Root Lateral Child Root), Jiegeng, Lurenshen (Asparagus Fern Root), Gudi, and Lilü. Arsenic (Pi) is rarely used, only in critical emergencies. Mugwort leaves and powdered tea can also induce spontaneous vomiting without manual stimulation; both powder and decoction can be used. Before inducing vomiting, bind the waist tightly with a cloth belt and perform this method in a draft-free area. Use half a sheng of radish seeds, grind them, mix with one bowl of fermented grain water, filter out the dregs, add a little oil and honey, simmer until lukewarm, drink, and stimulate vomiting with a goose feather. The goose feather should first be soaked in tung oil, then washed with soap pod water to remove the oil, and dried before use. Shrimp juice is also an effective emetic. If vomiting persists, antidotes are needed: Shexiang (Moschus) counteracts Lilü and Gudi; Congbai (Allii Fistulosi Bulbus) counteracts Gudi; water and Gancao (Glycyrrhizae Radix et Rhizoma) generally counteract toxins. Any nodules in the body that are not red, not painful, and do not suppurate are caused by phlegm accumulation. If a patient responds poorly to various medicines but the Guan pulse is deep and large, it indicates phlegm. Darkening of the eyelids and under-eye area resembling smoke stains also indicates phlegm. Any lumps in the upper, middle, or lower parts of the body are phlegm; inquire about dietary preferences, and after emesis or purgation, use specific medications to resolve them. Strengthening the Spleen Earth and drying Spleen Dampness is the fundamental method for treating phlegm. Scholar Xu stated: Using Cangzhu to treat phlegm-fluid forming "cocoons" is extremely effective; phlegm mixed with blood and fluid forms cocoons. Chronic phlegm diseases presenting with a choppy pulse are hard to open suddenly and require prolonged regulation. Erchen Tang added with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) moistens the bowels and promotes urination, widening the chest and diaphragm. Internal injury with phlegm requires Renshen (Ginseng Radix et Rhizoma), [missing character, likely Huangqi], and Baizhu, often taken with ginger juice, or added with Banxia (Pinelliae Rhizoma); for severe deficiency, add Zhuli (Bambusae Caulis in Taenia). Heat-phlegm often accompanies wind, manifesting as exterior symptoms; if it forms clumps that cannot be expectorated and involves depression, it is difficult to treat. Damp-phlegm is soft, causing fatigue and heaviness. Wind-phlegm presents with unusual symptoms. Food-stagnation phlegm requires simultaneous attack and tonification; for Qi deficiency, send it down with Qi-tonifying herbs. If fire is excessive and rebellious, treat the fire first with Baizhu, Huangqin, and Shigao (Gypsum Fibrosum); if Middle Qi is insufficient, add Baizhu and Renshen, then treat the phlegm. Phlegm moves up and down with Qi, reaching everywhere; many diseases involve it, yet most people do not recognize it. For Spleen deficiency, clear the Middle Qi to transport and descend phlegm using Erchen Tang plus Baizhu, along with Shengma to raise Qi. In deficient patients with phlegm, Stomach Qi relies on nourishment, so do not completely attack; over-attacking increases deficiency. Vertigo and epigastric discomfort stem from fire agitating phlegm; treat with Erchen Tang plus Zhizi (Gardeniae Fructus), Huangqin, and Huanglian. Phlegm nodules in the throat that are dry and unable to exit require phlegm-resolving herbs with salty flavors to soften hardness, such as Gualou, Xingren (Armeniacae Semen), Haishi, Jiegeng, and Lianqiao, with a little Fengxiao (Natrii Sulfas Exsiccatus) and ginger, made into honey pills to be held in the mouth. Phlegm in the subcutaneous tissue and meridians requires Jiangzhi (Ginger Juice), Zhuli, and Jingli (Schizonepetae Herba Juice). Phlegm in the four limbs requires Zhuli. A sensation of a foreign body in the throat that cannot be coughed up or swallowed is phlegm. Severe cases require emesis; mild cases use Gualou; excess Qi cases require Jingli. For blood stasis with fluid retention in the Middle Jiao, drink three to four cups of chive juice chilled; temporary chest irritability is normal, and recovery follows. Haifen (Sea Powder) descends heat-phlegm, dries damp-phlegm, softens knotted-phlegm, and eliminates stubborn-phlegm; suitable for pills, not decoctions. Huangqin treats heat-phlegm by descending fire. Zhishi (Immature Bitter Orange Fruit) drains phlegm powerfully. Tianhuafen (Trichosanthis Radix) treats upper diaphragm heat-phlegm. Wubeizi (Chinese Gall) combined with other herbs treats stubborn-phlegm. Gualou and Huashi (Talcum) treat food-stagnation phlegm by cleansing the organs. Oil-fried Banxia treats damp-phlegm and wheezing/cough/heart pain; take thirty pill doses with congee and ginger decoction. Xiaowei Dan damages Stomach Qi; food-stagnation phlegm patients should not take it frequently. Formula for damp-phlegm: Huangqin, Banxia, Xiangfu (Cyperi Rhizoma), Beimu (Fritillariae Cirrhosae Bulbus); adding Gualou and Qingdai treats heat-phlegm as pills. Clear phlegm uses Erchen Tang. Treating wind-phlegm requires Baifuzi, Tianma (Gastrodiae Rhizoma), Xionghuang (Realgar), Niuhuang (Calculus Bovis), Jiangcan (Bombyx Batryticatus), and Zhuya Zaojiao (Ziziphus Spinosae Spina/Pulse). Zhonghe Wan treats damp-phlegm with Qi-heat: equal parts Cangzhu, Huangqin, Banxia, Xiangfu, powdered and formed into congee pills. Formula for drying damp-phlegm: Nanxing (1 liang), Banxia (2 liang), Ge Fen (Concha Meretricis et Cyclinae), powdered, steamed dough pills coated with Qingdai. Formula for Yin deficiency with internal food-stagnation phlegm: Zhen Chuanxiong (7 qian), Huanglian, Gualou Ren, Baizhu, Shenqu, Maiya (1 liang each), Qingdai (5 qian), Renzhongbai (3 qian), powdered, ginger juice steamed dough pills. Zhuli treats inter-diaphragmatic phlegm, mania, amnesia, or wind-phlegm, and nourishes blood; used with Jingli. Xiaowei Dan treats damp-heat phlegm accumulation and leukorrhea: Gansui coated in wet flour, boiled in running water until permeable, washed, dried; Daye boiled in running water for one hour, washed, dried; Yuanhua mixed with good vinegar, left overnight, stir-fried in a clay pot until black without burning; Dahuang wrapped in paper, moistened, baked in ash fire until dry, unwrapped, cut, dried, then fried with wine until hot; Huangbai stir-fried double the amount of Dahuang; all ground, mixed, formed into congee pills size of hemp seeds, 12 pills per dose. Alternative: Reduce Gansui and Daye by one-third, coat with Cinnabar, named Chen Sha Hua Tan Wan. Phlegm formula: Nanxing, Banxia (1 liang each), Ge Fen (2 liang), specifically for damp-phlegm. Add Qingdai for heat, Cangzhu for damp, Shenqu, Maiya, Shanzha for food stagnation. Alternative: Huangqin, Xiangfu, Banxia, Gualou, Beimu, Qingdai, powdered, congee pills. Treat food-stagnation phlegm-fire and purge Stomach fire: Ruanguoshi (Soft Gypsum) fine powder, vinegar pills, mung bean size, 10 pills per dose. Qingmengshi Wan resolves food stagnation and removes damp-phlegm; adjust for cold/heat/excess/deficiency. Qingmengshi (0.5 liang, processed), Banxia (7 qian), Nanxing, Fuling, Pianqin (0.5 liang each), Fazhi Xiao (3 qian): Boil Xiao with radish, remove radish, filter through silk, let crystallize, powder, form with wheat paste. Add Cangzhu and Huashi. Alternative: Banxia (2 liang), Baizhu (1 liang), Fuling, Chenpi (0.75 liang each), Huangqin, Mengshi (0.5 liang each), Fenghua Xiao (2 qian). Phlegm-wheezing formula: Zaogui Hui (0.5 liang), Haifen, Luobozi (steamed), Nanxing (soaked in Bai Fan, dried, 1 liang each), Gualou Ren (1 liang), powdered, ginger-honey pills to be held in mouth. Alternative: Nanxing, Banxia, Xingren, Gualou, Luobozi, Qingdai, Xiangfu, malt paste pills. Qingjin Wan clears Lung fire and descends upper diaphragm heat-phlegm; use with Qinghua Wan. Huangqin powdered, water pills. Qinghua Wan formula: Bitterness dries damp-heat, lightness treats upper jiao, specifically for heat-cough and sore throat. Powdered, mixed with vinegar to apply to throat. Denglong Cao leaf powdered, steamed dough pills. Fuling Wan treats phlegm: Banxia (4 liang), Fuling (2 liang), Zhike (1 liang), Fenghua Xiao (5 qian). Treat depressed phlegm: Bai Jiangcan, Xingren, Gualou Ren, Hezi, Beimu, Wubeizi. Dao Yin Wan: Wu Zhu Yu (processed 3 qian), Fuling (1 liang), Huanglian (5 qian), Huashi (0.75 liang), Cangzhu (1.5 liang soaked in sweet water), powdered, malt paste pills, 100 pills per dose with ginger decoction. Baiyu Wan: Jiangzi (30), Nanxing, Banxia, Huashi, Qingfen (3 qian each), powdered, soap pod juice pills, sesame seed size, 5-7 pills per dose. Gualou Wan: Treats food stagnation, phlegm obstruction wheezing. Gualou Ren, Banxia, Shanzha Rou, Shenqu (equal parts), powdered, Gualou water pills, take 20 with ginger juice and Zhuli. Alternative: Banxia (1 liang), Cangzhu (2 liang), Xiangfu (2.5 liang), Huangqin, Huanglian, Gualou (1 liang each), powdered, malt paste pills. Qing Ge Hua Tan Fang: Huanglian (1 liang), Huangqin (1 liang), Huangbai (5 qian), Shanzhi (5 qian), Xiangfu (2.5 liang), Cangzhu (2 liang), powdered, malt paste pills. Sou Feng Hua Tan Wan: Renshen, Jiangcan, Huaiguozhi, Bai Fan, Tianma, Chenpi (deveined), Jingjie (1 liang), Banxia (4 liang soaked in ginger juice), Chen Sha (0.5 liang), powdered, ginger juice steamed dough pills, dried in shade, coated with Chen Sha, 40 pills with ginger decoction. Zhui Tan Wan: Effective for phlegm-fluid. Zhishi, Zhike (stir-fried, deveined, 0.5 liang), Hei Qianniu (half jin, head powder), Zhuya Zaojiao (2 qian wine-fried), Mingfan (3 qian, refined half), Pu Xiao (3 qian, exsiccated), powdered, radish juice pills, 40 pills at dawn; initially stools, then phlegm. Treat damp-phlegm: Cangzhu (1 qian), Baizhu (6 qian), Xiangfu (1 qian), Jiu Baishaoyao (2 qian), powdered, steamed dough pills. Treat obese person's damp-phlegm: Kushen, Banxia (1.5 qian each), Baizhu (2.5 qian), Chenpi (1 qian), one dose, 3 slices ginger, Zhuli and water, boil to one bowl, take far from meals, swallow Sanbu Wan 15 pills. Treat upper jiao wind-phlegm: Gualou Ren, Huanglian, Banxia, Zhuya Zaojiao (equal parts), powdered, ginger juice steamed dough pills. Treat phlegm-Qi: Pian Huangqin, Chenpi, Banxia (5 qian each), Baizhu, Baishaoyao (1 liang each), Fuling (3 qian), powdered, ginger juice steamed dough pills. Dispel wind-phlegm, move turbid Qi: Fangfeng, Chuanxiong, Ya Zao, Bai Fan, Yujin (1 liang each), Chi Bai Wugong (one each), powdered, steamed dough pills, sesame seed size, 25 pills before meals with tea soup; in spring, use Bajiao soup to probe for emesis. Li Ge Hua Tan Wan: Excellent for chest-diaphragm phlegm-Qi. Beimu, Banxia (0.5 liang each), Tian Nanxing, Ge Fen (1 liang each), Gualou Ren, Xiangfu (0.5 liang each), soaked in child's urine, powdered. Use 14 pods of Zhuya Zaojiao, crushed, boiled in 1.5 bowls water, add Xingren (de-skinned, de-pitted, 1 liang), boil until water nearly dry, remove pods, grind Xingren to paste, mix with previous powders, add ginger juice, form into green bean-sized pills, coat with Qingdai, dry, 50-60 pills per dose. Qing Tan Wan specifically treats chest phlegm accumulation (or Middle Jiao phlegm accumulation): Wumei (5 qian), Ku Mingfan (5 qian), Nanxing, Banxia (1 liang each), Huangqin (5 qian), Cangzhu (5 qian), Shenqu (1 liang), Tangli (1 liang), Qingpi, Chenpi (5 qian each), Xiangfu (1 liang), Huashi (stir-fried 5 qian), Gan Jiangsheng (1 liang), Zhishi (1 liang), powdered, steamed dough pills.
Case 1: A 79-year-old man had heavy, dizzy head and weak limbs, continuous expectoration of phlegm. Left pulse was scattered, large, and slow; right pulse was slow and large but weaker than left, powerless upon deep pressure. Slight decrease in appetite, slight thirst, bowel movement every 3-4 days. Using wind-dispersing herbs would lead to death by late spring; this is a severe deficiency syndrome. Treat with large doses of tonics: Huangqi, Renshen, Danggui Shen, Shaoyao, Baizhu, Chenpi, decocted strongly, taken with 30 Wanbi Pills. After 1.5 years, energy returned to youth levels. Wanbi Pill adds dried ginger in winter as a guiding herb; other seasons follow the base method. Huanglian and Huangbai are stir-fried with ginger juice to powder, formed into pills with ginger paste.
Case 2: A man near 30, fond of rich food and prone to anger, developed pain around the hip joint extending to the knee in autumn, worse at night, cold sensation at pain site, occasional thirst. Treated with wind-dispersing and blood-nourishing herbs, leading to swollen, painful knees by next spring, weight loss, knee swelling like a bowl, inability to bend/extend. Pulse string-like, large, somewhat excess, rapid, short. Frequent, short urination. Diagnosed as food-stagnation phlegm accumulation in Taiyin and Yangming. Banxia (5 qian), Huangbai (1 liang wine-fried), Sheng Gancao Shao (3 qian), Cangzhu (3 qian salt-fried), Chuanxiong (3 qian), Sheng Xijiao Xie (3 qian), Chenpi, Niuxi, Mutong, Shaoyao (5 qian each). Add Tiaohuangqin (2 qian) in heat/noise. Powdered, 3 qian per dose, ground with ginger juice, boiled with water, taken hot before meals, 4 times/day/night. After half month, rapid pulse decreased, pain eased, remove Xijiao, add Niuxei and Baiguiban (0.5 liang), Danggui Shenwei (0.5 liang). Continue. After another half month, swelling reduced, appetite improved, no longer cold-sensitive, only knee weakness. Remove Cangzhu, Huangqin. Summer: add Chao Huangbai to 1.5 liang. Add Niuxi. Spring/Summer use stem, Autumn/Winter use root; leaf juice is best. Avoid alcohol, meat, damp noodles, pepper. Middle-aged: add Shengdi (0.5 liang). Winter: add Yuzhu, Guizhi.
Case 3: A person had slight facial wind sensation like knife scraping, back not sensitive to cold, good appetite, string-like pulse, normal daily life. First use Chuanxiong, Jiegeng, Shengjiang, Shanzhi, Xiacha to induce phlegm emesis, then take Huanglian Daotan Tang.
Case 4: Brother-in-law, after drunken binge, spoke nonsense, saw hallucinations, accurately described deceased brother's past. Uncle scolded him: "Excessive fish and alcohol caused this phlegm." Gave large bowl of salt water, vomited one sheng of phlegm, profuse sweating, slept soundly, recovered.
Case 5: Jin family woman, young adult, returned from summer banquet, scolded by mother-in-law for seating error, felt ashamed, became ill with disordered speech and self-blame. Pulses string-like and rapid. I said: Not ghost evil, but disease. Prescribed Spleen-tonifying, phlegm-draining, heat-clearing. Should recover in days. Family disbelieved, consulted shamans who splashed water to frighten her; died after ten days.
Case 6: Woman over 50, angry at night, ate roasted pork, next morning face swollen, anorexic, fatigued. Six pulses deep, choppy, and hollow-large. Body deficiency, phlegm-obstruction failing to descend. Tonify deficiency, promote phlegm drainage. Morning: Large dose of Erchen Tang plus Renshen and Baizhu, followed by probing emesis to expel medicine. After Chen hour: Sanhe Tang tripled with extra Baizhu, two doses. Before sleep: Shen Wan seven pills to drain phlegm, remove Qianniu. Recovered after one month.
Case 7: Fu Xian's clerk, thirsty from labor in summer, drank plum water excessively, suffered 3-4 major frights, hallucinations, seemed possessed. Pulses deficient, string-like, deep, rapid. I said: Rapid indicates heat, deficient string-like indicates major fright, sour liquid retained in Middle Jiao. Tonify deficiency, clear heat, guide out phlegm stagnation. Prescribed Renshen, Baizhu, Chenpi, Huangqin, Huanglian, Fuling, strong decoction with Zhuli and Jiangzhi. No effect after ten days, others doubted prescription. I knew deficiency hadn't recovered, phlegm not guided out. Added Jingli to previous formula. Recovered after another ten days.
Case 8: Person with Yin deficiency and phlegm. Shenqu, Maiya, Huanglian, Baizhu (1 liang each), Chuanxiong (7 qian), Gualou Ren, Qingdai, Renzhongbai (0.5 liang each), powdered, ground with ginger juice, steamed dough pills.
Case 9: Person with damp-heat and fatigue, post-marriage chest discomfort, sensation of cold drink, choppy-large pulse. Previously took too many acrid-warm dispersing herbs, damaging Qi and Blood. Cangzhu, Banxia, Baizhu, Chenpi (5 qian each), Baishaoyao (6 qian), Guiban (7.5 qian), Chao Huangbai (1.5 qian), Huangqin (3 qian), Sharen, Gancao (1 qian each), powdered, steamed dough pills, 40-50 pills before meals with ginger decoction. Cold phlegm in diaphragm remained, so Xiaoxianxiong Tang added with small amount of Zhuyu as guide, formed into pills.
Case 10: Person with excess Qi and robust build, chronic chest-diaphragm Qi discomfort. Treated with Sanyi Chengqi Tang and phlegm-guiding herbs.
Case 11: Person with food stagnation, phlegm-Qi, weak Spleen. Beimu, Lianqiao, Maiya, Chenpi (0.5 liang each), Nanxing, Huangqin, Baizhu (1 liang each), Laifuzi (2.5 qian), powdered, steamed dough pills.
Case 12: Elderly person, vomiting phlegm, chest fullness, alternating chills and fever due to food injury. Used Erchen Dao Yin, Baizhu to tonify Spleen, Chaihu/Huangqin to reduce chills/fever, Cangzhu to release exterior cold, Sharen to stop vomiting and direct Qi downward.
Case 13: Woman with thick coating on tongue and pain, hardness below heart, Yangming phlegm-heat. Huangbai, Zhimu (honey-fried), Beimu (2 liang each), Gualou, Zhishi, Maiya, Jianghuang, Niuxi (0.5 liang each), powdered, kept on tongue. Then Baizhu (2 liang), Bidengqie, Laifuzi, Lianqiao, Shigao (0.5 liang each), Qingzi, Fengxiao, Shengma (3 qian each), powdered, steamed dough pills.
Erchen Tang is a key herb for phlegm, often ignored by the world. Pingwei San is commonly taken; why not Erchen Tang? With appropriate modifications, it is always effective. People value hearsay over sight, not just in this case.