痰饮证治。详于金匮。今述其要语冠诸首。
脉沉弦为饮。面色鲜明为饮。治饮当以温药和之。饮家咳嗽。当治饮。不当治
咳。外饮治脾。内饮治肾。（述仲景法）
寒邪犯肺饮发 凡外感寒邪。引动宿饮。上逆咳嗽。畏冷发热。当以温药和之。桂
枝、淡干姜、半夏、茯苓、杏仁、炙草。
温邪犯肺饮发 如温邪上犯气分。以致伏饮内发。上扰乘肺。肺气不降。喘不得
卧。发热无休。或见咳红。亦属络热。宜桂枝合越脾法。以开太阳。使浊饮下趋。且桂
枝得石膏辛凉。仍不碍于温邪之治。石膏、桂枝、半夏、茯苓、泽泻、杏仁、米仁、白芍、甘草。
痰饮挟燥火 凡咳嗽。喉中燥痛或痒。仍不渴饮者。此痰饮挟燥火也。夫脾家有
饮故不渴。而肺家有火。故喉间燥痒也。宜理气分之热。兼逐脾家之饮。勿以喉间
燥痛。而妄用滋清。半夏、茯苓、（重用）橘红、杏仁、川郁金、栝蒌皮、白通草、冰糖炒石膏。
（此条新法）
阳虚饮泛 如年高脾肾阳虚。气不收纳。痰饮上泛。以致呕咳。或着枕就呛。乃痰
饮伏于下焦肾络之中。至阴之界。阳气衰微。则形寒畏冷。下气上逆。则着枕就呛。
治法当以温药和之。宜桂苓术甘汤以和脾。都气饮加熟附、胡桃、以治肾。
络中伏饮 如胸胁刺痛。时吐酸饮。脉沉弦而口不渴者。此伏饮在络也。宜桂枝、
茯苓加姜汁、炒蒺藜、半夏、旋复花主之。
咳嗽呕出涎沫。面色鲜明。不得饮食者。非中虚也。作饮邪治。宜小半夏汤。加茯苓、桂枝、杏仁。
痰饮病的证治，在《金匮要略》中记载详尽。现在摘录其要点列于篇首。
脉象沉弦为饮邪之征。面色鲜明光亮为饮邪之征。治疗饮邪应当用温性药物调和。素有饮邪的人咳嗽，应当治疗饮邪，而不单纯治疗咳嗽。外来之饮邪治脾，内生之饮邪治肾。（阐述张仲景的治法）
寒邪犯肺引发饮邪：凡是外感寒邪，引动体内宿存的饮邪，向上逆乱导致咳嗽，伴有畏冷发热，应当用温性药物调和。药用桂枝、淡干姜、半夏、茯苓、杏仁、炙甘草。
温邪犯肺引发饮邪：如果温邪上犯气分，导致潜伏的饮邪在内发作，向上扰动乘袭肺脏，肺气不能肃降，气喘不能平卧，发热不止，或者出现咳血（此处原文作“咳红”，指咳出红色血液或痰中带血），这也属于络脉有热。适宜采用桂枝汤合越婢汤的方法，以开通太阳经气，使浊重的饮邪向下趋行。况且桂枝配合石膏，呈现辛凉之性，并不妨碍对温邪的治疗。药用石膏、桂枝、半夏、茯苓、泽泻、杏仁、薏苡仁、白芍、甘草。
痰饮夹杂燥火：凡是咳嗽，喉咙干燥疼痛或发痒，但仍然不觉得口渴想喝水的，这是痰饮夹杂燥火。因为脾家有饮邪所以不渴，而肺家有火热，所以喉咙间干燥发痒。适宜清理气分之热，兼逐脾家之饮。不要因为喉咙干燥疼痛，就妄用滋阴清热的药物。药用半夏、茯苓（重用）、橘红、杏仁、川郁金、瓜蒌皮、白通草、冰糖炒石膏。（此条为新法）
阳虚饮邪泛滥：如老年人脾肾阳气虚弱，气不能摄纳，痰饮向上泛溢，导致呕吐咳嗽，或者一躺下枕头就引发呛咳，这是因为痰饮潜伏在下焦肾络之中，处于至阴之地界。阳气衰微，则形体寒冷畏冷；下焦之气上逆，则躺下就引发呛咳。治疗方法应当用温性药物调和。适宜用苓桂术甘汤来调和脾胃，用都气饮加入熟附子、胡桃肉，来治疗肾脏。
络中潜伏饮邪：如胸胁部刺痛，时常吐出酸水饮液，脉象沉弦且口不渴的，这是伏饮在络脉之中。适宜用桂枝、茯苓加入姜汁、炒蒺藜、半夏、旋覆花为主药治疗。
The syndrome and treatment of Phlegm-Fluid (Tan Yin) are detailed in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet). Here, the key points are summarized and placed at the beginning.
A deep and taut pulse indicates Fluid retention. A bright and lustrous complexion indicates Fluid retention. The treatment for Fluid retention should employ warm herbs to harmonize. In patients with chronic Fluid retention who cough, one should treat the Fluid retention rather than merely treating the cough. External Fluid retention is treated by addressing the Spleen; internal Fluid retention is treated by addressing the Kidney. (Elucidating Zhang Zhongjing’s methods)
Cold Pathogen invading the Lung triggering Fluid retention: Whenever an external Cold pathogen triggers latent Fluid retention, causing it to rebel upward leading to cough, accompanied by aversion to cold and fever, one should use warm herbs to harmonize. Use Cinnamon Twig Decoction (Guizhi Tang), light dried ginger, Pinellia Rhizome (Banxia), Poria (Fuling), Apricot Seed (Xingren), and honey-fried Licorice Root (Zhigancao).
Warm Pathogen invading the Lung triggering Fluid retention: If a Warm pathogen invades the Qi level, causing latent Fluid retention to erupt internally, disturbing and attacking the Lung, resulting in failure of Lung Qi to descend, wheezing with inability to lie flat, and unceasing fever, or even hemoptysis (coughing up blood), this also belongs to Heat in the collaterals. It is appropriate to combine Cinnamon Twig Decoction (Guizhi Tang) with Yuebi Decoction (Yuebi Tang) to open the Taiyang channel, allowing turbid Fluids to drain downward. Moreover, when Cinnamon Twig is combined with Gypsum, it assumes a pungent-cool nature, which does not hinder the treatment of the Warm pathogen. Use Gypsum (Shigao), Cinnamon Twig (Guizhi), Pinellia Rhizome (Banxia), Poria (Fuling), Alisma Rhizome (Zexie), Apricot Seed (Xingren), Coix Seed (Yiyiren), White Peony Root (Baishao), and Licorice Root (Gancao).
Phlegm-Fluid complicated by Dryness-Fire: Whenever there is cough, dry pain or itching in the throat, yet without thirst or desire to drink, this is Phlegm-Fluid complicated by Dryness-Fire. Because there is Fluid retention in the Spleen, there is no thirst; because there is Fire in the Lung, there is dryness and itching in the throat. One should clear Heat in the Qi level while simultaneously expelling Fluid retention from the Spleen. Do not rashly use moistening and cooling herbs simply because of dry pain in the throat. Use Pinellia Rhizome (Banxia), Poria (Fuling) (heavy dose), Tangerine Peel (Juhong), Apricot Seed (Xingren), Curcuma Zedoina Rhizome (Chanyujin), Trichosanthes Peel (Gualoupi), Taro Stem (Baitongcao), and Gypsum fried with rock sugar (Shigao). (This is a new method)
Yang Deficiency with overflowing Fluid retention: For example, in elderly individuals with Spleen and Kidney Yang deficiency, Qi fails to receive and hold, causing Phlegm-Fluid to rebel upward, leading to vomiting and coughing, or choking upon lying down on a pillow. This is because Phlegm-Fluid is latent within the lower Jiao Kidney collaterals, in the realm of extreme Yin. With declining Yang Qi, there is cold form and aversion to cold; with rebellious Qi from below moving upward, choking occurs upon lying down. The treatment method should employ warm herbs to harmonize. It is appropriate to use Linggui Zhugan Decoction (Linggui Zhugan Tang) to harmonize the Spleen, and Duqi Decoction (Duqi Yin) added with Prepared Aconite Root (Shufu) and Walnut Kernel (Hutao), to treat the Kidney.
Latent Fluid retention in the collaterals: For instance, stabbing pain in the chest and hypochondrium, frequent spitting of sour fluid, a deep and taut pulse, and no thirst indicate latent Fluid retention in the collaterals. It is appropriate to use Cinnamon Twig (Guizhi) and Poria (Fuling) added with Ginger Juice (Jiangzhi), fried Tribulus Fruit (Baili), Pinellia Rhizome (Banxia), and Inula Flower (Xuanjinhua) as the main prescription.
Coughing and vomiting saliva/phlegm, with a bright and lustrous complexion, and inability to eat, is not due to Middle Qi deficiency, but should be treated as Fluid pathogen. It is appropriate to use Xiao Banxia Decoction (Xiao Banxia Tang) added with Poria (Fuling), Cinnamon Twig (Guizhi), and Apricot Seed (Xingren).