王节斋曰∶痰之本，水也，原于肾。痰之动，湿也，主于脾，余又从而续之曰∶“痰之
成，气也，贮于肺。（俗云∶治痰先治气，谓调其肺气，使之清肃下行也。又云∶脾为生痰之
源，肺为贮痰之器。）此六语，堪为痰病之纲领。大抵脾肺分其虚实，肾脏辨其水火。肺实者，
肺有邪也。若非寒邪，即火邪。寒邪，六安煎、小青龙汤。火邪，清肺饮、清燥救肺汤治之。
肺虚者，本脏自虚，治节不行，而痰聚之。或从脾以治之，为扶土生金之法。或从肾以治之，
为补子救母之法。盖肺，天也，脾，地也，地气上升，则天气下降。肺，天也，肾，水也，
天体不连地而连水。《内经》云∶其本在肾，其末在肺，以明水天一气也。脾土太过，气
滞郁热而生痰，宜王节斋化痰丸主之。脾土不及，气虚不运，食少化迟而生痰者，宜六君子
汤、理中汤加半夏、茯苓、枳实主之。肾具水火，赵养葵曰∶非水泛为痰，则水沸为痰，但
当分有火无火之异耳。肾虚不能制水，则水不归源，上泛滥为痰，是无火也，故用八味丸以
补肾火。阴虚火动，则水沸腾，动于肾者，犹龙火之出于海，龙兴而水附；动于肝者，犹雷
火之出于地，疾风豪雨，水随波涌而为痰，是有火也，故用六味丸补水以配火，此不治痰之
标，而治痰之本也。然则有火之痰，与无火之痰，何以辨之，曰∶无火者，纯是清水，有火
者，中有重浊白沫为别耳。
长孙男心典按∶痰起于肾，而动于脾，聚于肺，分之则有上中下之殊，合之则一以贯之
也。痰者，水也，治肾是使水归其壑，治脾是筑以防堤，治肺是导水必自高源也。
化痰丸（方见《三字经》）
王节斋曰∶古人用二陈汤为治痰通用，所以实脾燥湿，治其标也，然以之治湿痰、寒痰、
痰饮、痰涎，则固是矣。若夫痰因火上，肺气不清，咳嗽时作，及老痰郁痰，结成粘块，凝
滞喉间，吐咯难出。此等之痰，皆因火邪炎上，熏于上焦，肺气被郁，故其津液之随气而升
者，为火熏蒸，凝浊郁结而成，岁月积久，根深蒂固，故名老名郁。此方开其郁，降其火，
清润肺金，而消凝结之痰，缓以治之。
六味丸 八味丸 六君子汤 补中益气汤（各见《时方》）
理中丸（方见《伤寒》）
清肺饮
贝母（去心） 桔梗 橘红 茯苓 甘草 桑白皮 杏仁
水煎服。
仲景云∶其人素盛今瘦，水走肠间，沥沥有声，谓之痰饮，饮后水流在胁下，咳唾引痛，
谓之悬饮。饮水流行，归于四肢，当汗出而不汗出，身体疼重，谓之溢饮。咳逆倚息，气短
不得卧，其形如肿，谓之支饮。（后人不明四饮之义，加留饮为五饮，不知留饮即痰饮也。）
次男元犀按∶仲景《金匮要略》，分辨详尽，方治神奇，学人宜细心体认。今为初学立法，难以语上，不得不俯以从
时，而寻其简要，
只四字可以蔽其义，曰∶微甚虚实。微甚者，以病势而言；虚实者，以病患之身体而言也。
饮之微者，小青龙驱之于外，真武汤镇之于内，再以倍术丸以燥之，五苓散以利之，桂苓术
甘汤以化之，可以收功矣。饮之甚者，邪伏于背俞高处，内与中气相通，外与表气相接，故
邪动即大队俱起，势如伏兵，此当表里并治，宜小青龙汤，又木防己去石膏加芒硝茯苓汤治
之。又当上下分治，喘不能息，气闭上也。宜葶苈大枣泻肺汤主之。腹满肠间有水，气闭于
下也，宜防己椒目葶苈大黄丸主之。如饮甚内痛，必用十枣汤之峻，方可捣其巢穴，此治饮
之大略也。又当察其人之虚实，以为用药轻重缓急之准。
叶天士曰∶饮为阴邪，非离照当
空，氛雾焉能退避。若以地黄、五味阴药，附和其阴，则阴霾冲逆肆空，饮邪滔天莫制，宜
附子、人参、茯苓、大枣配生姜汁，除阴维阳为妙。
次孙男心兰按∶叶天士此论，为饮症之虚者而言。
又仲师云∶微饮气短，苓桂术甘汤主之，肾气丸亦主之。此二句可为治虚饮之法。
仲景治痰饮咳嗽诸方，列喘症门，宜细心研究。
倍术丸
白术（炒二两） 桂心 干姜（炒，各一两）
蜜丸桐子大，每服二十丸，米饮下，加至三十五丸，食前服。
小青龙汤 五苓散（方各见《伤寒》）
木防己汤（方见《金匮》）
开三焦水结，通上中下之气属虚者。
木防己去石膏加茯苓芒硝汤
水邪实结，愈而复发。
防己椒目葶苈大黄丸
腹满口舌干燥，肠间有水气。
程氏曰∶防己、椒目导饮于前，清者从小便而出，大黄、葶苈推饮于后，浊者从大便而
下，此前后分消，则腹满减而水饮行，脾气转而津液生矣。
肾气丸
苓桂术甘汤
治胸胁支满目眩，并治饮邪阻滞心肺之阳，令呼气短。
甘遂半夏汤
治饮邪流连不去，心下坚满。
程氏曰∶留者行之，用甘遂以决水饮，结者散之，用半夏散痰饮，甘遂之性直达，恐其
过于行水，缓以甘草、白蜜之甘，坚以芍药之苦，虽甘草、甘遂相反，而实以相使，此苦坚甘
缓，约之之法也。《灵枢经》曰∶约方犹约囊，斯之谓欤？
尤氏曰∶甘草与甘遂相反，而同用之者，盖欲其一战而留饮尽去，因相激而相成也，白
芍、白蜜不特安中。亦缓毒药耳。
十枣汤
治悬饮内痛，亦治支饮。
大青龙汤
治溢饮之病属经，表属热者，宜此凉发之。
泽泻汤
支饮虽不中正，而迫近于心，饮邪上乘清阳之位，其人苦冒眩。冒者，昏冒而神不清，
如有物冒蔽之也，眩者，目旋转而乍见眩黑也，宜此汤主之。
浓朴大黄汤
治支饮胸满。（支饮原不中正，饮盛则偏者，不偏故直驱之从大便出。）
葶苈大枣泻肺汤
治支饮不得息。
小半夏汤（各方见《金匮》）
治心下支饮，呕而不渴。
茯苓饮（《外台》）
治积饮既去，而虚气塞满其中，不能进食，此证最多，此方最妙。
茯苓 人参 白术（各一钱五分） 枳实（一钱） 橘皮（一钱二分五厘） 生姜（二钱）
水二杯，煎七分服，一日三服。
《三因》白散（方见《三字经》）
梨藕汁膏
治痰嗽诸虚，奇验如神。
梨汁 藕粉 萝卜汁 生姜 人乳 白糖 砂糖 童便（各四两）
将八味放瓷瓶内，用炭火熬煎至一斤为止，每日空心百滚汤调下四五钱，服完即愈，能
常服则精神强健，永无虚损。
款冬冰糖汤
小儿吼嗽，并大人咳嗽方。
款冬花（三钱） 晶糖（五钱）
将二味放茶壶内，泡汤当茶吃，自然渐愈。
海浮石滑石散
治小儿天哮，一切风湿燥热，咳嗽痰喘，并治大人等症。
海浮石 飞滑石 杏仁（各四钱） 薄荷（二钱）
上为极细末，每服二钱，用百部煎汤调下。
人参冬梨方
治痰火骨蒸，吐血，不足之证，重十服八服即愈。
人参 天冬 麦冬（各一钱五分） 茯苓（五分） 杏仁（二枚，去皮尖） 红枣（二
枚，去核） 莲子（六枚，去皮心） 人乳（二匙） 白蜜（三匙） 大甜梨（一个，削刀挖去心）
将前药制碎，纳梨内，仍以梨盖盖之，用绵纸封固，饭上蒸熟，日间吃其药，临卧吃此梨。
青黛蛤粉丸
治咳嗽吐痰，面鼻发红者，一服即愈，其效如神。
青黛（水飞极细，晒干，再研，用三四钱） 蛤粉（三钱）
二味炼蜜为丸，如指头大，临卧口噙三丸。
枇杷蜜汤
治痰火。
用枇杷五十叶，去毛，水五十杯，煎至五六杯，再重汤炖至三四杯，每药三茶匙，冬蜜一茶匙调下。
姜糖汤（各方见《种福堂》）
治老人上气喘嗽，不得卧。
生姜汁（五两） 黑砂糖（四两）
用水煎二十沸，时服半匙，渐渐咽之。
五味子汤
治伤燥，咳唾中有血，牵引胸胁痛，皮肤干枯。
五味子（五分，研） 桔梗 甘草 紫菀茸 竹茹 桑根皮 续断（各一钱） 生地（二
钱） 赤小豆（一撮）
上九味，水煎空心服，《秘旨》加白蜜一匙。
长孙男心典按∶赤豆易生扁豆五钱，囫囵不研，最能退热补肺，但有寒热往来忌之。去
续断、赤豆、地黄，加葳蕤、门冬、干姜、细辛，亦妙。
麦门冬汤（各见《千金》）
治大病后，火热乘肺，咳唾有血，胸膈胀满上气，羸瘦，五心烦热，渴而便秘。
麦冬（二钱，去心） 桔梗 桑根皮 半夏 生地 紫菀茸 竹茹（各一钱） 麻黄（七
分，去根节） 甘草（五分，炙） 五味子（十粒，研） 生姜（一片）
上十一味，水煎，空心服。
王节斋说：痰的根本是水，源头在肾。痰的流动，是因为湿，主宰在脾。我接着补充说：“痰的形成，在于气，贮存在肺。”（俗语说：治痰先治气，是指调理肺气，使其清肃下行。又说：脾是生痰之源，肺是贮痰之器。）这六句话，可以作为痰病的纲领。大致来说，脾和肺要分辨虚实，肾脏要辨别水火。肺实证，是肺有邪气。如果不是寒邪，就是火邪。寒邪用六安煎、小青龙汤治疗；火邪用清肺饮、清燥救肺汤治疗。肺虚证，是本脏自身虚弱，治节功能不行，导致痰聚积。或者从脾来治疗，这是“扶土生金”的方法。或者从肾来治疗，这是“补子救母”的方法。肺属天，脾属地，地气上升，则天气下降。肺属天，肾属水，天体不连地而连水。《内经》说：“其本在肾，其末在肺”，以说明水和天是一气的道理。脾土太过，气滞郁热而生痰，宜用王节斋化痰丸主治。脾土不及，气虚不运，食少消化迟缓而生痰者，宜用六君子汤、理中汤加半夏、茯苓、枳实主治。肾具有水火，赵养葵说：不是水泛为痰，就是水沸为痰，只应当区分有火无火的差异罢了。肾虚不能制水，则水不归源，上泛滥为痰，这是无火，所以用八味丸来补肾火。阴虚火动，则水沸腾，动于肾的，犹如龙火出于海，龙兴而水附；动于肝的，犹如雷火出于地，疾风豪雨，水随波涌而为痰，这是有火，所以用六味丸补水以配火，这是不治痰之标，而治痰之本。然而有火之痰与无火之痰，如何辨别呢？回答说：无火的，纯是清水；有火的，中有重浊白沫作为区别。
长孙男心典按语：痰起于肾，而动于脾，聚于肺，分之则有上中下之殊，合之则一以贯之也。痰，就是水，治肾是使水归其壑，治脾是筑以防堤，治肺是导水必自高源也。
化痰丸（方见《三字经》）
王节斋说：古人用二陈汤作为治痰通用方，所以能实脾燥湿，治其标，然而用它来治湿痰、寒痰、痰饮、痰涎，那确实是合适的。至于痰因火上，肺气不清，咳嗽时作，以及老痰郁痰，结成粘块，凝滞喉间，吐咯难出。这种痰，都是因为火邪炎上，熏于上焦，肺气被郁，所以津液随气而升者，被火熏蒸，凝浊郁结而成，岁月积久，根深蒂固，所以名叫老名郁。此方能开其郁，降其火，清润肺金，而消凝结之痰，缓以治之。
六味丸 八味丸 六君子汤 补中益气汤（各见《时方》）
理中丸（方见《伤寒》）
清肺饮
贝母（去心） 桔梗 橘红 茯苓 甘草 桑白皮 杏仁
水煎服。
仲景说：其人素盛今瘦，水走肠间，沥沥有声，谓之痰饮，饮后水流在胁下，咳唾引痛，谓之悬饮。饮水流行，归于四肢，当汗出而不汗出，身体疼重，谓之溢饮。咳逆倚息，气短不得卧，其形如肿，谓之支饮。（后人不明四饮之义，加留饮为五饮，不知留饮即痰饮也。）
次男元犀按语：仲景《金匮要略》，分辨详尽，方治神奇，学人宜细心体认。今为初学立法，难以语上，不得不俯以从时，而寻其简要，只四字可以蔽其义，曰：微甚虚实。微甚者，以病势而言；虚实者，以病患之身体而言也。饮之微者，小青龙驱之于外，真武汤镇之于内，再以倍术丸以燥之，五苓散以利之，桂苓术甘汤以化之，可以收功矣。饮之甚者，邪伏于背俞高处，内与中气相通，外与表气相接，故邪动即大队俱起，势如伏兵，此当表里并治，宜小青龙汤，又木防己去石膏加芒硝茯苓汤治之。又当上下分治，喘不能息，气闭上也。宜葶苈大枣泻肺汤主之。腹满肠间有水，气闭于下也，宜防己椒目葶苈大黄丸主之。如饮甚内痛，必用十枣汤之峻，方可捣其巢穴，此治饮之大略也。又当察其人之虚实，以为用药轻重缓急之准。
叶天士说：饮为阴邪，非离照当空，氛雾焉能退避。若以地黄、五味阴药，附和其阴，则阴霾冲逆肆空，饮邪滔天莫制，宜附子、人参、茯苓、大枣配生姜汁，除阴维阳为妙。
次孙男心兰按语：叶天士此论，为饮症之虚者而言。
又仲师云：微饮气短，苓桂术甘汤主之，肾气丸亦主之。此二句可为治虚饮之法。
仲景治痰饮咳嗽诸方，列喘症门，宜细心研究。
倍术丸
白术（炒二两） 桂心 干姜（炒，各一两）
蜜丸桐子大，每服二十丸，米饮下，加至三十五丸，食前服。
小青龙汤 五苓散（方各见《伤寒》）
木防己汤（方见《金匮》）
开三焦水结，通上中下之气属虚者。
木防己去石膏加茯苓芒硝汤
水邪实结，愈而复发。
防己椒目葶苈大黄丸
腹满口舌干燥，肠间有水气。
程氏说：防己、椒目导饮于前，清者从小便而出，大黄、葶苈推饮于后，浊者从大便而下，此前后分消，则腹满减而水饮行，脾气转而津液生矣。
肾气丸
苓桂术甘汤
治胸胁支满目眩，并治饮邪阻滞心肺之阳，令呼气短。
甘遂半夏汤
治饮邪流连不去，心下坚满。
程氏说：留者行之，用甘遂以决水饮，结者散之，用半夏散痰饮，甘遂之性直达，恐其过于行水，缓以甘草、白蜜之甘，坚以芍药之苦，虽甘草、甘遂相反，而实以相使，此苦坚甘缓，约之之法也。《灵枢经》说：约方犹约囊，斯之谓欤？
尤氏说：甘草与甘遂相反，而同用之者，盖欲其一战而留饮尽去，因相激而相成也，白芍、白蜜不特安中。亦缓毒药耳。
十枣汤
治悬饮内痛，亦治支饮。
大青龙汤
治溢饮之病属经，表属热者，宜此凉发之。
泽泻汤
支饮虽不中正，而迫近于心，饮邪上乘清阳之位，其人苦冒眩。冒者，昏冒而神不清，如有物冒蔽之也，眩者，目旋转而乍见眩黑也，宜此汤主之。
浓朴大黄汤
治支饮胸满。（支饮原不中正，饮盛则偏者，不偏故直驱之从大便出。）
葶苈大枣泻肺汤
治支饮不得息。
小半夏汤（各方见《金匮》）
治心下支饮，呕而不渴。
茯苓饮（《外台》）
治积饮既去，而虚气塞满其中，不能进食，此证最多，此方最妙。
茯苓 人参 白术（各一钱五分） 枳实（一钱） 橘皮（一钱二分五厘） 生姜（二钱）
水二杯，煎七分服，一日三服。
《三因》白散（方见《三字经》）
梨藕汁膏
治痰嗽诸虚，奇验如神。
梨汁 藕粉 萝卜汁 生姜 人乳 白糖 砂糖 童便（各四两）
将八味放瓷瓶内，用炭火熬煎至一斤为止，每日空心百滚汤调下四五钱，服完即愈，能常服则精神强健，永无虚损。
款冬冰糖汤
小儿吼嗽，并大人咳嗽方。
款冬花（三钱） 晶糖（五钱）
将二味放茶壶内，泡汤当茶吃，自然渐愈。
海浮石滑石散
治小儿天哮，一切风湿燥热，咳嗽痰喘，并治大人等症。
海浮石 飞滑石 杏仁（各四钱） 薄荷（二钱）
上为极细末，每服二钱，用百部煎汤调下。
人参冬梨方
治痰火骨蒸，吐血，不足之证，重十服八服即愈。
人参 天冬 麦冬（各一钱五分） 茯苓（五分） 杏仁（二枚，去皮尖） 红枣（二枚，去核） 莲子（六枚，去皮心） 人乳（二匙） 白蜜（三匙） 大甜梨（一个，削刀挖去心）
将前药制碎，纳梨内，仍以梨盖盖之，用绵纸封固，饭上蒸熟，日间吃其药，临卧吃此梨。
青黛蛤粉丸
治咳嗽吐痰，面鼻发红者，一服即愈，其效如神。
青黛（水飞极细，晒干，再研，用三四钱） 蛤粉（三钱）
二味炼蜜为丸，如指头大，临卧口噙三丸。
枇杷蜜汤
治痰火。
用枇杷五十叶，去毛，水五十杯，煎至五六杯，再重汤炖至三四杯，每药三茶匙，冬蜜一茶匙调下。
姜糖汤（各方见《种福堂》）
治老人上气喘嗽，不得卧。
生姜汁（五两） 黑砂糖（四两）
用水煎二十沸，时服半匙，渐渐咽之。
五味子汤
治伤燥，咳唾中有血，牵引胸胁痛，皮肤干枯。
五味子（五分，研） 桔梗 甘草 紫菀茸 竹茹 桑根皮 续断（各一钱） 生地（二钱） 赤小豆（一撮）
上九味，水煎空心服，《秘旨》加白蜜一匙。
长孙男心典按语：赤豆易生扁豆五钱，囫囵不研，最能退热补肺，但有寒热往来忌之。去续断、赤豆、地黄，加葳蕤、门冬、干姜、细辛，亦妙。
麦门冬汤（各见《千金》）
治大病后，火热乘肺，咳唾有血，胸膈胀满上气，羸瘦，五心烦热，渴而便秘。
麦冬（二钱，去心） 桔梗 桑根皮 半夏 生地 紫菀茸 竹茹（各一钱） 麻黄（七分，去根节） 甘草（五分，炙） 五味子（十粒，研） 生姜（一片）
上十一味，水煎，空心服。
Wang Jiezhai stated: The root of phlegm is water, originating from the Kidney. The movement of phlegm is due to dampness, governed by the Spleen. I further add: "The formation of phlegm lies in Qi, and it is stored in the Lung." (Common saying: To treat phlegm, first treat Qi, meaning to regulate Lung Qi so that it descends clearly and turbidly downward. Another saying: The Spleen is the source of phlegm production, the Lung is the vessel storing phlegm.) These six phrases can serve as the outline for phlegm diseases. Generally speaking, the Spleen and Lung are distinguished by deficiency and excess, while the Kidney is distinguished by Water and Fire. In Lung Excess patterns, there is pathogenic factor in the Lung. If not Cold pathogen, then it is Fire pathogen. Cold pathogen is treated with Liu'an Decoction or Xiao Qing Long Tang (Minor Blue Dragon Decoction). Fire pathogen is treated with Qing Fei Yin (Lung-Clearing Drink) or Qing Zao Jiu Fei Tang (Clear Dryness and Rescue the Lung Decoction). In Lung Deficiency patterns, the organ itself is deficient, the regulation function fails, leading to phlegm accumulation. One may treat from the Spleen, employing the method of "Supporting Earth to Generate Metal." Or one may treat from the Kidney, employing the method of "Tonifying the Child to Save the Mother." The Lung belongs to Heaven, the Spleen to Earth; when Earth Qi rises, Heaven Qi descends. The Lung belongs to Heaven, the Kidney to Water; the structure of Heaven connects with Water rather than Earth. The *Neijing* states: "Its root is in the Kidney, its branch is in the Lung," illustrating that Water and Heaven are one Qi. When Spleen Earth is excessive, Qi stagnation and郁 heat generate phlegm; Wang Jiezhai's Huatan Wan (Phlegm-Resolving Pill) should be used. When Spleen Earth is insufficient, Qi deficiency leads to poor transportation, slow digestion, and phlegm generation; Liu Jun Zi Tang (Six Gentlemen Decoction) or Li Zhong Tang (Regulate the Middle Decoction) added with Banxia (Pinelliae Rhizoma), Fuling (Poria), and Zhishi (Aurantii Fructus Immaturus) should be used. The Kidney possesses both Water and Fire. Zhao Yangkui said: It is either water flooding causing phlegm, or water boiling causing phlegm; one only needs to distinguish whether there is Fire or not. When Kidney Deficiency fails to control Water, Water does not return to its source, flooding upward to become phlegm; this is without Fire, so Ba Wei Wan (Eight-Ingredient Pill) is used to tonify Kidney Fire. When Yin Deficiency causes Fire agitation, Water boils; agitation originating in the Kidney is like Dragon Fire emerging from the sea, where the Dragon rises and Water follows; agitation originating in the Liver is like Thunder Fire emerging from the earth, with fierce winds and heavy rains, Water surging with waves to become phlegm; this is with Fire, so Liu Wei Wan (Six-Ingredient Pill) is used to tonify Water to balance Fire. This treats the root of phlegm rather than its branch. However, how to distinguish phlegm with Fire from phlegm without Fire? The answer is: Phlegm without Fire is purely clear water; phlegm with Fire contains heavy, turbid white foam.
Eldest grandson Xin Dian commented: Phlegm originates in the Kidney, moves in the Spleen, and gathers in the Lung. Divided, it has upper, middle, and lower distinctions; united, it is consistent throughout. Phlegm is water. Treating the Kidney makes water return to its channel; treating the Spleen builds dikes to prevent flooding; treating the Lung guides water from its high source.
Huatan Wan (Formula seen in *San Zi Jing*)
Wang Jiezhai stated: Ancients used Er Chen Tang (Two Aged Ingredients Decoction) as a general formula for treating phlegm, thereby strengthening the Spleen and drying Dampness to treat the branch. However, using it for Damp-phlegm, Cold-phlegm, Fluid retention, or salivary phlegm is indeed appropriate. But for phlegm caused by Fire ascending, unclear Lung Qi, frequent coughing, as well as old phlegm and stagnant phlegm forming sticky clumps, obstructing the throat, difficult to expectorate, such phlegm arises because Fire pathogen flares upward, steaming the Upper Jiao, depressing Lung Qi. Thus, body fluids rising with Qi are steamed by Fire, condensing into turbid, stagnant knots. Accumulated over years, they take deep root, hence named "old" and "stagnant." This formula opens stagnation, descends Fire, clears and moistens Lung Metal, and dissolves condensed phlegm, treating it slowly.
Liu Wei Wan (Six-Ingredient Pill) Ba Wei Wan (Eight-Ingredient Pill) Liu Jun Zi Tang (Six Gentlemen Decoction) Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction) (Each seen in *Shi Fang*)
Li Zhong Wan (Regulate the Middle Pill) (Formula seen in *Shanghan*)
Qing Fei Yin (Lung-Clearing Drink)
Beimu (Fritillariae Bulbus, heart removed) Jiegeng Platycodonis Radix Juhong Citri Reticulatae Pericarpium Fuling Poria Gancao Glycyrrhizae Radix Sangbaipi Mori Cortex Xingren Armeniacae Semen
Decoct in water and take orally.
Jingue said: When a person was formerly robust but is now emaciated, water flows between the intestines with gurgling sounds, it is called Tan Yin (Phlegm-Fluid). After drinking, if water flows under the hypochondrium, causing pain upon coughing and spitting, it is called Xuan Yin (Hanging Fluid). If drinking water flows to the four limbs, sweating should occur but does not, resulting in body heaviness and pain, it is called Yi Yin (Overflowing Fluid). If there is coughing and wheezing requiring leaning to breathe, shortness of breath preventing lying down, and swelling-like appearance, it is called Zhi Yin (Piercing Fluid). (Later generations, not understanding the meaning of the Four Fluids, added Liu Yin (Retained Fluid) to make Five Fluids, not knowing that Liu Yin is Tan Yin.)
Second son Yuan Xi commented: Jingyue's *Jingui Yaolue* distinguishes thoroughly and prescribes miraculously; students should study carefully. Now, establishing laws for beginners, it is difficult to discuss profound theories, so we must conform to current times and seek simplicity. Only four characters can summarize its meaning: Mild/Severe, Deficiency/Excess. Mild/Severe refers to disease progression; Deficiency/Excess refers to the patient's physical condition. For mild fluid retention, Xiao Qing Long Tang expels it externally, Zhen Wu Tang stabilizes it internally, Bei Shu Wan (Doubling Atractylodes Pill) dries it, Wu Ling San (Five-Ingredient Powder with Poria) promotes urination, Gui Ling Zhu Gan Tang (Cinnamon, Poria, Atractylodes, and Licorice Decoction) transforms it, achieving success. For severe fluid retention, pathogens hide at the high points of the Back-Shu points, connecting internally with Middle Qi and externally with Exterior Qi. Thus, when pathogens move, the whole group rises like an ambush; this requires simultaneous exterior and interior treatment, suitable for Xiao Qing Long Tang or Mu Fang Ji Qu Shi Gao Jia Mang Xiao Fu Ling Tang (Wood Evodia Decoction minus Gypsum plus Natrii Sulfas and Poria). Also, upper and lower parts should be treated separately. Wheezing preventing rest indicates Qi closure above; Tingli Dazao Xie Fei Tang (Descurainia Seed and Jujube Decoction Draining the Lung) should be used. Abdominal fullness and water in intestines indicate Qi closure below; Fangji Peemu Tingli Dahuang Wan (Stephania, Lepidium, Descurainia, and Rhubarb Pill) should be used. If fluid retention is severe with internal pain, the harsh Shizao Tang (Ten Dates Decoction) must be used to destroy the nest; this is the general approach to treating fluid retention. Furthermore, one must observe the patient's deficiency or excess to determine the weight, speed, and urgency of medication.
Ye Tianshi said: Fluid retention is a Yin pathogen. Without the sun shining brightly, how can mist retreat? If using Rehmannia and Schisandra (Yin herbs) to support Yin, then Yin mist will surge uncontrollably, and fluid pathogens will flood heaven without restraint. It is best to use Aconite, Ginseng, Poria, and Jujube paired with Ginger Juice to eliminate Yin and maintain Yang.
Grandson Xin Lan commented: Ye Tianshi's discussion applies to deficiency-type fluid retention cases.
Furthermore, Master Jingyue said: For mild fluid retention with shortness of breath, Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) is indicated, and Shen Qi Wan (Kidney Qi Pill) is also indicated. These two sentences provide the method for treating deficiency-type fluid retention.
Jingyue's formulas for treating phlegm-fluid cough are listed in the Asthma chapter; they should be studied carefully.
Bei Shu Wan (Doubling Atractylodes Pill)
Baizhu (Stir-fried, 2 liang) Guixin Cinnamon Twig Ganjiang (Stir-fried, 1 liang each)
Pill size of paulownia seeds, take 20 pills per dose with rice drink, increase to 35 pills, taken before meals.
Xiao Qing Long Tang (Minor Blue Dragon Decoction) Wu Ling San (Five-Ingredient Powder with Poria) (Formulas seen in *Shanghan*)
Mu Fang Ji Tang (Stephania Decoction) (Formula seen in *Jingui*)
Opens Water knot in the Three Jiao, unblocks Qi in Upper, Middle, and Lower Jiao for deficiency patterns.
Mu Fang Ji Qu Shi Gao Jia Fu Ling Mang Xiao Tang (Wood Evodia Decoction minus Gypsum plus Poria and Natrii Sulfas)
For solid Water pathogen knots that recur after healing.
Fangji Peemu Tingli Dahuang Wan (Stephania, Lepidium, Descurainia, and Rhubarb Pill)
Abdominal fullness, dry mouth and tongue, water qi in intestines.
Master Cheng said: Fangji and Peomu guide fluid forward, clear parts exit via urine; Dahuang and Tingli push fluid backward, turbid parts exit via stool. This anterior-posterior dispersion reduces abdominal fullness, moves water-fluid, turns Spleen Qi, and generates body fluids.
Shen Qi Wan (Kidney Qi Pill)
Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction)
Treats chest/hypochondriac distension and dizziness; also treats fluid pathogen blocking Heart-Lung Yang, causing short exhalation.
Gansui Banxia Tang (Kansui and Pinellia Decoction)
Treats lingering fluid pathogen, hardness/fullness in the epigastrium.
Master Cheng said: Retained items are moved using Gansui to break water-fluid; knotted items are scattered using Banxia to dissipate phlegm-fluid. Gansui acts directly; fearing it moves water too excessively, its action is moderated by the sweetness of Gancao and Bai Mi (White Honey), and hardened by the bitterness of Shaoyao. Although Gancao and Gansui are contrary, they actually assist each other. This is the method of bitter-hardening and sweet-moderating. The *Lingshu Jing* says: "Regulating a formula is like tying a bag," which is what this means.
Master You said: Gancao and Gansui are contrary, yet used together to ensure one battle eliminates all retained fluid, achieving mutual completion through mutual stimulation. Baishao and Bai Mi not only calm the Middle but also moderate toxic drugs.
Shizao Tang (Ten Dates Decoction)
Treats internal pain of Xuan Yin (Hanging Fluid), also treats Zhi Yin (Piercing Fluid).
Da Qing Long Tang (Major Blue Dragon Decoction)
Treats Yi Yin (Overflowing Fluid) belonging to the meridians with Exterior Heat; use this cooling diaphoretic.
Zexie Tang (Alisma Decoction)
Although Zhi Yin is not central, it presses near the Heart. Fluid pathogen ascends to the clear Yang position, causing severe dizziness and vertigo. "Mao" means mental confusion and lack of clarity, as if covered by an object; "Xuan" means eyes spinning and sudden blackouts. This decoction is indicated.
Noupo Dahuang Tang (Magnolia Bark and Rhubarb Decoction)
Treats chest fullness of Zhi Yin. (Zhi Yin is originally not central; when fluid is excessive, it deviates; thus, it is driven straight out via stool.)
Tingli Dazao Xie Fei Tang (Descurainia Seed and Jujube Decoction Draining the Lung)
Treats Zhi Yin preventing breathing.
Xiao Banxia Tang (Minor Pinellia Decoction) (Formulas seen in *Jingui*)
Treats subcardial Zhi Yin, vomiting without thirst.
Fuling Yin (Poria Drink) (*Waitai*)
Treats cases where accumulated fluid is gone but empty Qi fills the space, preventing eating. This pattern is common, and this formula is excellent.
Fuling Poria Ren Shen Ginseng Baizhu Atractylodes Macrocephala (each 1.5 qian) Zhishi Aurantii Fructus Immaturus (1 qian) Chupi Citri Reticulatae Pericarpium (1.25 qian) Shengjiang Fresh Ginger (2 qian)
Decoct 2 cups of water to 0.7 cup, take three times daily.
*Sanyin* Baisan (White Powder) (Formula seen in *San Zi Jing*)
Li Ou Zhi Gao (Pear and Lotus Root Juice Paste)
Treats various deficiencies in phlegm-cough, miraculous efficacy.
Lizhi Pear Juice Oufen Lotus Root Powder Luobozhi Radish Juice Shengjiang Fresh Ginger Renru Human Milk Baitang White Sugar Shatang Brown Sugar Tongbian Child Urine (each 4 liang)
Place eight ingredients in a porcelain bottle, simmer over charcoal fire until reaching 1 jin. Take 4-5 qian mixed with boiling water on an empty stomach daily. Cure upon finishing; regular consumption strengthens spirit and prevents deficiency forever.
Kuandong Bingtang Tang (Coltsfoot and Rock Sugar Decoction)
Formula for pediatric whooping cough and adult cough.
Ku donghua Coltsfoot Flower (3 qian) Jingtang Crystal Sugar (5 qian)
Place two ingredients in a teapot, steep as tea, drink naturally for gradual recovery.
Haifushi Huashi San (Sea Floating Stone and Talcum Powder)
Treats pediatric Tian Xiao (Congenital Asthma), all wind-damp-dry-heat, cough, phlegm-wheezing, and adult conditions.
Haifushi Sea Floating Stone Feihuashi Prepared Talcum Xingren Armeniacae Semen (each 4 qian) Bohe Menthae Herba (2 qian)
Grind to fine powder, take 2 qian per dose mixed with Baibu Decoction.
Renshen Dongli Fang (Ginseng Winter Pear Formula)
Treats Phlegm-Fire bone-steaming, hemoptysis, deficiency syndromes; cures after 8-10 doses.
Renshen Ginseng Tiandong Asparagi Radix Maidong Ophiopogonis Radix (each 1.5 qian) Fuling Poria (0.5 qian) Xingren Armeniacae Semen (2 pieces, skin and tip removed) Hongzao Jujubae Fructus (2 pieces, pit removed) Lianzi Nelumbinis Semen (6 pieces, skin and plumule removed) Renru Human Milk (2 spoons) Baimi White Honey (3 spoons) Datianli Large Sweet Pear (1 piece, core hollowed out)
Crush previous medicines, place inside pear, cover with pear lid, seal with cotton paper, steam over rice. Eat medicine during day, eat pear before bed.
Qingdai Hafan Wan (Indigo Naturalis and Clam Shell Powder Pill)
Treats cough with sputum, red face and nose; cures after one dose, miraculous effect.
Qingdai Indigo Naturalis (Water-ground extremely fine, dried, ground again, 3-4 qian) Hafan Clam Shell Powder (3 qian)
Refine honey into pills finger-sized, hold 3 pills in mouth before sleep.
Pipa Mitang (Loquat and Honey Decoction)
Treats Phlegm-Fire.
Use 50 Loquat leaves, remove hairs, decoct in 50 cups water to 5-6 cups, then double-boil to 3-4 cups. Take 3 teaspoons medicine mixed with 1 teaspoon winter honey per dose.
Jiangtang Tang (Ginger and Sugar Decoction) (Formulas seen in *Zhongfutang*)
Treats elderly upper asthma and cough, unable to lie down.
Shengjiangzhi Fresh Ginger Juice (5 liang) Heishashantang Black Brown Sugar (4 liang)
Decoct in water for 20 boils, take half spoon occasionally, swallow gradually.
Wuweizi Tang (Schisandra Decoction)
Treats injury from Dryness, coughing/spitting blood, pulling pain in chest/hypochondrium, dry skin.
Wuweizi Schisandrae Fructus (0.5 fen, ground) Jiegeng Platycodonis Radix Gancao Glycyrrhizae Radix Ziwan Zygonis Radix Zhuru Bamboo Rhus Solida Sanggenpi Morus Radicis Cortex Xuduan Dipsaci Radix (each 1 qian) Shengdi Rehmanniae Radix (2 qian) Chixiaodou Red Adzuki Bean (a pinch)
Nine ingredients, decoct in water, take on empty stomach. *Mizhi* adds 1 spoon white honey.
Eldest grandson Xin Dian commented: Replace Red Adzuki Bean with 5 qian broad bean (unground), best for clearing heat and tonifying Lung, but contraindicated in alternating chills and fever. Removing Xuduan, Chixiaodou, Shengdi, adding Weirui (Polygonatum Odoratum), Mendong (Ophiopogon), Ganjiang, Xixin is also excellent.
Maidong Tang (Ophiopogon Decoction) (Seen in *Qianjin*)
Treats post-severe illness, Fire-Heat attacking Lung, coughing/spitting blood, chest/diaphragm fullness with rebellious Qi, emaciation, five-palm heat, thirst with constipation.
Maidong Ophiopogonis Radix (2 qian, heart removed) Jiegeng Platycodonis Radix Sanggenpi Morus Radicis Cortex Banxia Pinelliae Rhizoma Shengdi Rehmanniae Radix Ziwan Zygonis Radix Zhuru Bamboo Rhus Solida (each 1 qian) Mahuang Ephedrae Herba (0.7 fen, roots and nodes removed) Gancao Glycyrrhizae Radix (0.5 fen, honey-fried) Wuweizi Schisandrae Fructus (10 grains, ground) Shengjiang Fresh Ginger (1 slice)
Eleven ingredients, decoct in water, take on empty stomach.