论
《内经》曰∶诸气愤郁，皆属肺金。盖肺气郁则成热，热盛则生痰。丹溪曰∶自郁成积，自积成痰，痰挟瘀血，遂
成窠囊，此为痞、为痛、为噎膈翻胃之次第也。王隐君曰∶痰证古今未详，方书虽有悬饮、留饮、支饮、痰饮诸饮之异，
而莫知其为病之源。或头风目昏。眩运耳鸣，或口眼蠕动，眉棱耳叶瘙痒，或四肢游风肿硬，似痛非痛，或为齿颊痒痛，
牙床浮肿而痛痒不一，或嗳气吞酸，嘈杂呕哕，或咽嗌不利，咯之不出，咽之不下，色似煤 ，形如破絮桃胶蚬肉之
类，或心下如停冰雪，心头冷痛时作，或梦寐奇怪鬼魅之状，或足腕酸软，腰背卒痛，或四肢骨节烦疼，并无常所，乃
至手麻臂痛，状若挫闪，或脊中每有一掌如冰冻之寒痛者，或浑身习习如虫行者，或眼沿涩痒，口糜舌烂，甚为喉闭等
证，又或绕项结核，似 非 ，或胸腹间如有二气交纽，噎塞烦闷，有如烟气上冲，头面烘热，或为失志颠狂，或为中
风瘫痪，或为劳瘵荏苒之疾，或为风痹及香港脚之候，或心下怔忡，惊悸如畏人将捕，或喘嗽呕吐，或呕冷涎绿水黑汁，
甚为肺痈肠毒便脓挛跛，其为内外疾病，非止百端，皆痰之所致也。盖津液既凝为痰为饮，而汹涌上焦，故口燥咽干；
流而之下，则大小便闭塞，面如枯骨，毛发焦干。妇人则经闭不通，小儿则惊痫搐搦。治法宜先逐去败痰，然后看虚实
调理，故制沉香滚痰丸，为通治三焦痰饮之要药也。愚窃以其论证固详，不问虚实而以一峻药攻之，恐未中乎肯綮也欤。
盖资禀有浓薄，病邪有浅深，一或失手，何以收救。故丹溪有曰∶治痰用利药过多，致脾气虚，则痰反易生而多矣。又
曰∶中焦有食积与痰而生病者，胃气亦赖所养，卒不可便攻，攻尽则愈虚而病剧。夫滚痰丸，止可投之于形气壮实、痰
积胶固为病者；若气体虚弱之人，决不可轻用也。慎之慎之！
脉法
《要略》云∶脉双弦者，寒饮也。（或大下后善虚。）其脉偏弦者，饮也。肺饮不弦，但苦喘短气。
又云∶脉浮而细滑者，伤饮。脉弦数有寒饮，春夏难治。脉沉而弦者，悬饮内痛。其人短气而渴，四肢历节走痛，
脉沉者，有留饮。
陈无择云∶饮脉皆弦微沉滑。
或云∶左右手关前脉浮弦大而实者，膈上有稠痰也，宜吐之自愈。
病患百药不效，关上脉伏而大者，痰也。眼胞及眼下如炭烟熏黑者，亦痰也。
丹溪曰∶久得涩脉，痰饮胶固，脉道阻涩也。卒难得开，必费调理。
方法
丹溪曰∶有热痰，有湿痰，有酒痰，有食积痰，有风痰，有寒痰，有老痰。
热痰，用青黛、黄连及用青礞石丸最捷。
湿痰，身多软，而重用苍术、白术。又曰∶湿痰，用黄芩、香附、半夏、贝母。热痰，加栝蒌、青黛。
酒痰，用栝蒌、青黛，蜜丸噙化。
食积痰，用神曲、麦牙、山楂，或化痰丸、消积药攻之。
风痰，用南星、白附子。
寒痰用半夏。（卢氏注曰∶凝结清冷，其状若寒，非寒也。然亦有用温药者，盖寒因热用，使引导无捍格也。）
老痰，用海石、香附、半夏、栝蒌、五倍子。一云∶五倍子佐他药，大治顽痰。
痰结核在咽喉，嗽而不能出，化痰药加咸能软坚之味，栝蒌仁、杏仁、海石、桔梗、连翘，少佐以朴硝、姜汁，蜜
丸噙化。
痰在胁下，非白芥子不能达。痰在四肢，非竹沥不行。痰在肠胃间，可下而愈。痰之为物，随气升降，故无处不到。
脉浮当吐，痰在膈上必用吐，胶固稠浊必用吐，痰在经络中，非吐不可，吐中就有发散之义。
凡吐法，宜先升提其气，用防风、山栀、川芎、桔梗、芽茶、生姜之类，或就以此药探吐。吐时，须先以布勒腰腹，
而于不通风处行之。
吐法，用萝卜子半升擂，和以浆水一碗，去渣，入少油与蜜，温服。或用虾半斤，入酱、葱、姜等物料，水煮，先
吃虾，后饮汁，少时以鹅翎探吐。其鹅翎须先以桐油浸，而以皂角水洗，晒干待用。如服瓜蒂、藜芦等药，不用探法，
自吐。
凡虚弱人，中焦有痰，胃气亦赖所养，卒不可便攻，攻尽则愈虚。治痰用利药过多，致脾气虚，则痰反易生而多。
许学士用苍术治痰挟瘀血成窠囊，行痰极效。（即神术丸也。）
油炒半夏，大治湿痰，又治喘、心痛，粥丸，生姜汤下。
（以上丹溪方法凡十六条）
燥湿痰星夏丸
南星 半夏（各一两） 海蛤粉（三两）
上为细末，姜汁浸蒸饼为丸，青黛为衣，如梧桐子大，每服三、五十丸，姜汤送下。
中和丸 治湿痰气热。
苍术 黄芩 半夏 香附（各等分）
上为细末，姜汁调神曲糊为丸，如梧桐子大，每服五、七十丸，白汤送下。
小胃丹
上可取胸膈之痰，下可利肠胃之痰。能损胃不食，胃气虚而少食者，不可用。
大黄（酒拌，湿纸裹，煨熟焙干，再以酒炒润，一两五钱） 黄柏（炒褐色，二两） 甘遂（面裹煨熟，去面。） 大
戟（长流水煮一时许，洗净晒干用） 芫花（醋拌经宿，炒黑勿焦，各一两）
上为细末，粥丸麻子大，每服十丸，温汤送下。
坠痰丸 能利痰，从谷道中出。
风化硝 枳实（麸炒黄色） 黑牵牛（取头末，五钱） 生白矾（三钱） 猪牙皂角（去皮弦酥炙黄，三钱）
一本有贝母三钱
上为细末，莱菔汁丸如梧桐子大，每服五十丸，白汤下，鸡鸣时服，先见屎，次见痰（古方无硝、枳，而用水丸，
分两亦不同。）
青礞石丸 能化痰降痰。一云治食积，去湿痰。
青礞石（敲碎如骰子大，以焰硝同入锅， 黄色） 茯苓 半夏（汤泡七次去皮脐） 南星（慢火煨裂） 黄芩（各
五钱） 风化硝（三钱，盆净者，冬月以绢袋盛，悬风前化之）
上为细末，神曲糊入姜汁为丸，如梧桐子大，每服三、五十丸，姜汤送下。此药重在风化硝。一方加苍术五钱，滑
石一两。一方无南星，有白术。一方有枳实，倍青礞石。
枳实泻痰，能冲墙倒壁。黄芩治痰，假其下火也。天花粉，大能降上膈热痰。海粉，热痰能降，湿痰能燥，顽痰能
消。
人中黄，饭丸，如绿豆大，每服十数丸，白汤送下，能降阴火，清痰，又治食积。
痰因火盛逆上，治火为先，白术、黄芩、石膏之类。
凡久病，阴火上升，津液生痰不生血，宜补血制相火，其痰自除，血药必用姜汁传送。
痰成块、吐咯不出、气郁滞者，难治。
脾虚者清中气，二陈汤加白术之类，兼用提药。
实脾土，燥脾湿，是治其本。
二陈汤 一身之痰都管，治痰之要药也。欲下行加引下药，上行加引上药（引上，柴胡、升麻、防风之类。引
下，
黄柏、木通、防己之类）。又曰∶二陈加升提之药，能使大便润而小便长。
陈皮（去白，一钱） 半夏（汤泡七次，二钱） 茯苓（一钱） 甘草（五分）
上细切，作一服，加生姜三片，水一盏，煎至七分，温服。
（以上丹溪方法又七条）
导痰汤（局方） 治风湿痰等证。
半夏（二钱，汤泡七次） 南星（煨裂） 橘红（去白） 枳壳（麸炒黄色）甘草（炙） 茯苓（各一钱）
上细切，作一服，加生姜五片，水一盏半，煎至一盏，温服。如久嗽肺燥热者，去半夏，加五味子九枚，杏仁五分。
千缗汤（局方） 治风痰壅盛。
半夏（汤泡七次，七个四破） 皂角（一寸，去皮炒黄） 甘草（炙，一寸）
上细切，作一服，入生姜三片，水一盏，煎至七分，温服。
利膈化痰丸（丹溪）
南星（煨裂） 蛤粉 半夏（汤泡） 贝母（去心） 栝蒌仁（去壳） 香附（去皮，童便浸） 皂角（去皮弦） 杏
仁（去皮尖，炒） 青黛（各等分）
上以前六味研为细末，却以皂角杵碎煎浓汁，擂杏仁如泥，再以姜汁和蒸饼为丸，如绿豆大，青黛为衣，每服五十
丸，姜汤送下。
滚痰丸（王隐君方） 治湿热、食积，成窠囊、老痰。
大黄（酒拌蒸） 黄芩（去朽，各半斤） 沉香（五钱） 礞石（硝 黄金色，一两）
上为细末，滴水为丸，如梧桐子大，每服三、五十丸，量人强弱，加减丸数。
神术丸（丹溪） 治痰饮。
苍术（一斤，米泔浸） 生芝麻（五钱，用水二小盏研细取浆） 大枣（十五枚，煮肉研细）
上以苍术焙干为末，然后以芝麻浆及枣肉和匀，丸如梧桐子大，每服五、七十丸，温汤下。
黄芩利膈丸（东垣） 除胸中热，利膈上痰。
生黄芩 炒黄芩（各一两） 半夏（汤泡七次） 泽泻（去毛） 黄连（各五分） 天南星（煨裂） 枳壳（麸炒）
陈皮（去白，各三钱） 白术（二钱） 白矾（五分）
上为细末，汤浸蒸饼入姜汁为丸，如梧桐子大，每服三、五十丸，食远温水下。忌酒及湿面。
蠲饮枳实丸（丹溪） 逐饮消痰，导滞清膈。
枳实（麸炒） 半夏（泡） 陈皮（去白，各三两） 黑丑（半斤，取头末三两）
上为细末，面糊为丸，如梧桐子大，每服五十丸，姜汤送下。
十枣汤（仲景） 治悬饮内痛。
芫花（醋炒黑色） 甘遂（面包水煮） 大戟（各等分）
上为细末，以水一升半，煮大枣十枚，至八合，去渣，调药末，强人一钱，弱人五分，平旦服之。不下，更加五分。
下后，以糜粥调养之。河间曰∶芫花之辛以散饮，大戟之苦以泄水，其甘遂直达水气所结之处，乃泄水饮之圣药也。然
亦有大毒，人虚者不可轻用。
三花神 丸 治一切湿热沉积痰饮变生诸病，或风热燥郁，肢体麻痹，走注疼痛，风痰涎嗽，气血壅滞，不得
宣
通等证。人壮 气实者，可服。
甘遂（根据前制） 大戟 芫花（醋拌湿炒，各五钱） 黑丑（二两，取头末） 大黄（一两） 轻粉（一钱）
上为细末，滴水为丸，如小豆大，初服五丸，每服加五丸，温水下，日三服，加至快利，利后须服，至病根尽除为
度。痞闷极甚者，若便多服，则顿攻不开，转加痛闷，则当初服二丸，每服加二丸，至快利即止。
控涎丹（三因方） 治患胸背胁颈项及手足腰胯隐痛不忍，筋骨牵引钓痛，时时走易，乃是痰涎在胸膈间，随
气
升降，于经络中作楚而然。或手足冷痹，气脉不通，误认为瘫痪者。
甘遂（去心，根据前制） 大戟（去皮） 白芥子（主上气发汗，胸膈有冷痰）
上件各等分，为细末，糊丸如梧桐子大，每服五十丸，淡姜汤下，食后临卧服，量病患虚实加减丸数。一方名妙应
丸，治惊痰，加朱砂为衣。痛甚者，加全蝎。酒痰，加雄黄、全蝎。惊气痰成块者，加穿山甲、鳖甲、玄胡索、蓬莪术。
臂痛，加木鳖子霜、桂心。热痰，加盆硝。寒痰，加丁香、胡椒、肉桂。
半夏丸 治肺热痰嗽。
栝蒌仁（另研） 半夏（汤泡七次，去皮脐焙开，各一两）
上为细末和匀，姜汁打糊为丸服。
取竹沥法∶大治热痰，及能养血清热。有痰厥不省人事几死者，得竹沥灌之遂苏，诚起死回生药也。
用水竹、早 竹（俗名雷竹。苏东坡曰∶淡竹对苦竹为文耳，除苦竹之外，皆淡竹也。我丹溪先生存日，只用此二
竹。盖取其为诸竹中之最淡者，以其笋味之甘淡也），截长二尺许，每段劈作四片，以薄砖二块排定，将竹片架于砖
上，两头露一、二寸，下以烈火迫之，两头以盆盛沥，六分中加姜汁一分服之。痰热甚者，止可加半分耳。
取荆沥法∶能治热痰，功胜竹沥，但不补耳。
用黄荆截作短片，炙取沥，同上法。
（丹溪活套）云∶二陈汤，一身之痰，无所不治。但在上加引上药，在下加引下药。如偏头痛在右，本方加川芎、
白芷、防风、荆芥、薄荷、升麻之类；在左，本方合四物汤，亦加防风、荆芥、薄荷、细辛、蔓荆子、柴胡、酒片芩之
类。顶痛者，本方加川芎、 本、升麻、柴胡、蔓荆子、细辛、薄荷等药。如痰在腰胯膝下肿痛，本方加苍术、防
己、木通、黄柏、萆 、川牛膝之类。如痰在胸腹中作痛或痞满，本方加白术、神曲、麦芽、砂仁之类。如痰在胁下作
痛，或漉漉有声，本方加柴胡、青皮、川芎、芍药之类。如痰在经络中，或胸背手足臂膊作痛者，上加防风、羌活、葳
灵仙，在下加防己、牛膝、木通之类，冬月加乌、附行经。如风痰壅盛，喘急咳咳不宁，本方加防风、羌活、南星、枳
壳、皂角之类。如热痰为病，腹胀喘满，本方加黄芩、黄连、栀子、栝蒌仁、滑石、石膏、竹沥之类。如湿痰，身重倦
怠，本方加苍术、白术、南星之类。如酒痰，本方加葛根、枳 、砂仁、神曲、麦芽之类。寒痰，本方加干姜、附子、
益智、草豆蔻之类。气痰，本方加木香、槟榔、砂仁、枳壳、乌药、香附之类。燥痰，本方加栝蒌仁、杏仁、贝母、五
味子之类。阴虚咯血痰嗽，本方加天门冬、麦门冬、知母、黄柏、贝母、款冬花、紫菀、马兜铃之类。如痰在中焦，作
嗳气吞酸，胃脘当心而痛，或呕清水，恶心等证，本方多加白术、苍术、神曲、麦芽、川芎、砂仁、草豆蔻、枳实、猪
苓、泽泻、黄连、吴茱萸、栀子仁、木香、槟榔之类，作丸服之。
（医案）
论
《黄帝内经》说：各种气机逆乱郁结的病证，都归属于肺金。因为肺气郁滞就会化热，热势亢盛就会产生痰。朱丹溪说：由气郁形成积滞，由积滞形成痰，痰与瘀血相互搏结，于是形成像巢穴一样的病理产物，这是导致痞满、疼痛、噎膈、翻胃等病症的次第过程。王隐君说：痰证的记载古今都不详尽，虽然方书中有关于悬饮、留饮、支饮、痰饮等不同名称的论述，但没有人知道它们发病的根本源头。（痰证表现多样）有的表现为头风、目昏花、眩晕、耳鸣；有的表现为口眼肌肉跳动，眉毛棱部和耳叶瘙痒；有的表现为四肢游走性风肿，肿胀坚硬，似痛非痛；有的表现为牙齿和脸颊痒痛，牙床浮肿，痛痒感觉不一；有的表现为嗳气吞酸，胃中嘈杂，恶心呕吐；有的表现为咽喉不利，咳之不出，咽之不下，痰色像黑煤，形状像破絮、桃胶、蚬肉之类；有的表现为心下感觉像停着冰雪一样，心头冷痛不时发作；有的表现为梦中出现奇怪的鬼魅形象；有的表现为足踝酸软，腰背突然疼痛；有的表现为四肢骨节烦扰疼痛，没有固定部位，甚至到手麻臂痛，状如挫伤闪扭；有的表现为脊柱中有一掌大小的区域，感到像冰冻一样的寒痛；有的表现为全身皮肤如有虫爬行感；有的表现为眼睑涩痒，口腔糜烂舌头溃烂，严重的甚至出现喉闭等证候；还有的表现为颈部周围淋巴结结核，似瘰疬而非瘰疬；有的表现为胸腹间好像有两条气交纽在一起，噎塞烦闷，好像烟气上冲，头面烘热；有的表现为失志癫狂；有的表现为中风瘫痪；有的表现为劳瘵（肺结核等慢性消耗性疾病）缠绵难愈；有的表现为风痹及香港脚（脚气病）的症状；有的表现为心中悸动不安，惊悸害怕好像有人要抓捕自己；有的表现为气喘咳嗽呕吐，或者呕吐冷涎、绿水、黑汁，严重的甚至出现肺痈、肠毒、便脓、挛缩跛行等症状。这些内外疾病，不止百种，都是痰所致。因为津液凝结成为痰饮，如果汹涌上焦，就会导致口燥咽干；流注于下焦，则大小便闭塞，面色像枯骨，毛发焦干枯黄。妇女则月经闭止不通，小儿则发生惊痫抽搐。治疗方法应当先驱逐败痰，然后视虚实情况进行调理，所以制作了沉香滚痰丸，作为通治三焦痰饮的要药。我私下认为，他的论证固然详细，但不问虚实而用一味峻猛的药物攻伐，恐怕没有击中要害吧？因为人的体质禀赋有厚薄之分，病邪有浅深之别，一旦失误，如何挽救。所以丹溪说：治疗痰症使用利水药过多，会导致脾气虚弱，那么痰反而更容易产生且更多。又说：中焦有食积和痰导致生病的，胃气也依赖饮食滋养，绝不能立刻攻伐，攻伐尽则正气更虚而病情加重。滚痰丸，只可投用于形体气势壮实、痰积胶固致病的人；如果是气体虚弱的人，决不可轻易使用。谨慎啊！谨慎啊！
脉法
《金匮要略》说：脉象双弦的，是寒饮。（或者是经过猛烈泻下后导致的善虚。）脉象偏弦的，是饮邪。肺中有饮邪不一定见弦脉，只是苦于气喘短气。
又说：脉浮而细滑的，是伤饮。脉弦数而有寒饮的，春夏季节难治。脉沉而弦的，是悬饮内痛。其人短气且口渴，四肢关节走窜疼痛，脉沉的，是有留饮。
有人说：左右手关前脉象浮弦大而实的，是膈上有稠痰，应当用吐法自愈。
病人服用多种药物无效，关上脉伏而大的，是痰。眼睑及眼下像炭烟熏黑一样的，也是痰。
丹溪说：久病得到涩脉，是痰饮胶固，脉道阻滞涩滞。很难开通，必须费心调理。
方法
丹溪说：有热痰，有湿痰，有酒痰，有食积痰，有风痰，有寒痰，有老痰。
湿痰，身体多松软，重用苍术、白术。又说：湿痰，用黄芩、香附、半夏、贝母。热痰，加栝蒌、青黛。
寒痰用半夏。（卢氏注释说：凝结清冷，其状像寒，其实不是寒。然而也有用温药的，这是因为寒因热用，使引导没有抵触。）
老痰，用海浮石、香附、半夏、栝蒌、五倍子。一说：五倍子辅助其他药物，大治顽痰。
痰结核在咽喉，咳嗽而不能吐出，化痰药中加入咸能软坚的味道，如栝蒌仁、杏仁、海浮石、桔梗、连翘，少佐以朴硝、姜汁，蜜丸含化。
痰在胁下，非白芥子不能到达。痰在四肢，非竹沥不行。痰在肠胃间，可以攻下而愈。痰这种病邪，随着气机升降，所以无处不到。
脉浮应当用吐法，痰在膈上必须用吐法，胶固稠浊必须用吐法，痰在经络中，非吐不可，吐法中就有发散的意义。
凡是吐法，应当先升提其气，用防风、山栀、川芎、桔梗、芽茶、生姜之类，或者就用这些药物探吐。吐的时候，必须先以布勒紧腰腹，并在不通风的地方进行。
吐法，用萝卜子半升研磨，和一碗浆水，去渣，加入少许油和蜜，温服。或者用虾半斤，加入酱、葱、姜等材料，水煮，先吃虾，后喝汁，过一会儿用鹅毛管探吐。鹅毛管须先用桐油浸泡，然后用皂角水洗，晒干备用。如果服用瓜蒂、藜芦等药物，不用探吐法，自然会吐。
凡是虚弱的人，中焦有痰，胃气也依赖饮食滋养，绝不能立刻攻伐，攻伐尽则正气更虚。治疗痰症使用利水药过多，导致脾气虚弱，那么痰反而更容易产生且更多。
（以上丹溪的方法共十六条）
燥湿痰星夏丸
南星 半夏（各一两） 海蛤粉（三两）
上面研为细末，用姜汁浸蒸饼做成丸，青黛为衣，如梧桐子大，每次服用三、五十丸，姜汤送下。
中和丸 治疗湿痰气热。
苍术 黄芩 半夏 香附（各等分）
上面研为细末，用姜汁调神曲糊做成丸，如梧桐子大，每次服用五、七十丸，白开水送下。
小胃丹
上面可取胸膈之痰，下面可利肠胃之痰。能损伤胃气导致不食，胃气虚而少食的，不可用。
大黄（酒拌，湿纸包裹，煨熟焙干，再以酒炒润，一两五钱） 黄柏（炒褐色，二两） 甘遂（面粉包裹煨熟，去面。） 大戟（长流水煮约一时辰，洗净晒干用） 芫花（醋拌过夜，炒黑勿焦，各一两）
上面研为细末，粥糊做成丸如麻子大，每次服用十丸，温水送下。
坠痰丸 能利痰，从谷道（肛门）排出。
风化硝 枳实（麸炒黄色） 黑牵牛（取头末，五钱） 生白矾（三钱） 猪牙皂角（去皮弦酥炙黄，三钱）
另一版本有贝母三钱
上面研为细末，莱菔汁做成丸如梧桐子大，每次服用五十丸，白开水送下，鸡鸣时服用，先见大便，次见痰（古方无硝、枳，而用水丸，分量也不同。）
青礞石丸 能化痰降痰。一说治疗食积，去湿痰。
青礞石（敲碎如骰子大，以焰硝同入锅，煅至黄色） 茯苓 半夏（汤泡七次去皮脐） 南星（慢火煨裂） 黄芩（各五钱） 风化硝（三钱，盆净者，冬月以绢袋盛，悬风前化之）
上面研为细末，神曲糊加入姜汁做成丸，如梧桐子大，每次服用三、五十丸，姜汤送下。此药重在风化硝。一方加苍术五钱，滑石一两。一方无南星，有白术。一方有枳实，倍青礞石。
枳实泻痰，能冲墙倒壁。黄芩治痰，借其下火之力。天花粉，大能降上膈热痰。海粉，热痰能降，湿痰能燥，顽痰能消。
人中黄，饭丸，如绿豆大，每次服用十数丸，白开水送下，能降阴火，清痰，又治食积。
凡是久病，阴火上升，津液生痰不生血，宜补血制相火，其痰自然消除，血药必用姜汁传送。
二陈汤 一身之痰都管，是治痰的要药。想要下行加引下药，上行加引上药（引上，柴胡、升麻、防风之类。引下，黄柏、木通、防己之类）。又说：二陈加升提之药，能使大便润而小便长。
陈皮（去白，一钱） 半夏（汤泡七次，二钱） 茯苓（一钱） 甘草（五分）
上面细切，作一服，加生姜三片，水一盏，煎至七分，温服。
（以上丹溪的方法又七条）
导痰汤（局方） 治疗风湿痰等证。
半夏（二钱，汤泡七次） 南星（煨裂） 橘红（去白） 枳壳（麸炒黄色）甘草（炙） 茯苓（各一钱）
上面细切，作一服，加生姜五片，水一盏半，煎至一盏，温服。如久嗽肺燥热者，去半夏，加五味子九枚，杏仁五分。
千缗汤（局方） 治疗风痰壅盛。
半夏（汤泡七次，七个四破） 皂角（一寸，去皮炒黄） 甘草（炙，一寸）
上面细切，作一服，入生姜三片，水一盏，煎至七分，温服。
利膈化痰丸（丹溪）
南星（煨裂） 蛤粉 半夏（汤泡） 贝母（去心） 栝蒌仁（去壳） 香附（去皮，童便浸） 皂角（去皮弦） 杏仁（去皮尖，炒） 青黛（各等分）
上面以前六味研为细末，却以皂角杵碎煎浓汁，擂杏仁如泥，再以姜汁和蒸饼做成丸，如绿豆大，青黛为衣，每次服用五十丸，姜汤送下。
滚痰丸（王隐君方） 治疗湿热、食积，成窠囊、老痰。
大黄（酒拌蒸） 黄芩（去朽，各半斤） 沉香（五钱） 礞石（硝煅黄金色，一两）
上面研为细末，滴水做成丸，如梧桐子大，每次服用三、五十丸，根据人强弱，加减丸数。
神术丸（丹溪） 治疗痰饮。
苍术（一斤，米泔浸） 生芝麻（五钱，用水二小盏研细取浆） 大枣（十五枚，煮肉研细）
上面以苍术焙干为末，然后用芝麻浆及枣肉和匀，丸如梧桐子大，每次服用五、七十丸，温水送下。
黄芩利膈丸（东垣） 除胸中热，利膈上痰。
生黄芩 炒黄芩（各一两） 半夏（汤泡七次） 泽泻（去毛） 黄连（各五分） 天南星（煨裂） 枳壳（麸炒） 陈皮（去白，各三钱） 白术（二钱） 白矾（五分）
上面研为细末，汤浸蒸饼加入姜汁做成丸，如梧桐子大，每次服用三、五十丸，饭后温水送下。忌酒及湿面。
蠲饮枳实丸（丹溪） 逐饮消痰，导滞清膈。
枳实（麸炒） 半夏（泡） 陈皮（去白，各三两） 黑丑（半斤，取头末三两）
上面研为细末，面糊做成丸，如梧桐子大，每次服用五十丸，姜汤送下。
十枣汤（仲景） 治疗悬饮内痛。
芫花（醋炒黑色） 甘遂（面包水煮） 大戟（各等分）
上面研为细末，以水一升半，煮大枣十枚，至八合，去渣，调药末，强壮人一钱，体弱人五分，平旦服之。不下，更加五分。
下后，以糜粥调养之。河间说：芫花的辛以散饮，大戟的苦以泄水，其甘遂直达水气所结之处，乃是泄水饮的圣药。然而也有大毒，人虚者不可轻用。
三花神 丸 治疗一切湿热沉积痰饮变生诸病，或风热燥郁，肢体麻痹，走注疼痛，风痰涎嗽，气血壅滞，不得宣通等证。人壮气实者，可服。
甘遂（根据前制） 大戟 芫花（醋拌湿炒，各五钱） 黑丑（二两，取头末） 大黄（一两） 轻粉（一钱）
上面研为细末，滴水做成丸，如小豆大，初服五丸，每服加五丸，温水送下，日三服，加至快利，利后须服，至病根尽除为度。痞闷极甚者，若便多服，则顿攻不开，转加痛闷，则当初服二丸，每服加二丸，至快利即止。
控涎丹（三因方） 治疗患胸背胁颈项及手足腰胯隐痛不忍，筋骨牵引钓痛，时时走易，乃是痰涎在胸膈间，随气升降，于经络中作楚而然。或手足冷痹，气脉不通，误认为瘫痪者。
甘遂（去心，根据前制） 大戟（去皮） 白芥子（主上气发汗，胸膈有冷痰）
上面件各等分，为细末，糊丸如梧桐子大，每次服用五十丸，淡姜汤下，食后临卧服，量病患虚实加减丸数。一方名妙应丸，治疗惊痰，加朱砂为衣。痛甚者，加全蝎。酒痰，加雄黄、全蝎。惊气痰成块者，加穿山甲、鳖甲、玄胡索、蓬莪术。臂痛，加木鳖子霜、桂心。热痰，加盆硝。寒痰，加丁香、胡椒、肉桂。
半夏丸 治疗肺热痰嗽。
栝蒌仁（另研） 半夏（汤泡七次，去皮脐焙开，各一两）
上面研为细末和匀，姜汁打糊做成丸服。
取竹沥法∶大治热痰，及能养血清热。有痰厥不省人事几死者，得竹沥灌之遂苏，诚起死回生药也。
用水竹、早竹（俗名雷竹。苏东坡曰：淡竹对苦竹为文耳，除苦竹之外，皆淡竹也。我丹溪先生存日，只用此二竹。盖取其为诸竹中之最淡者，以其笋味之甘淡也），截长二尺许，每段劈作四片，以薄砖二块排定，将竹片架于砖上，两头露一、二寸，下以烈火迫之，两头以盆盛沥，六分中加姜汁一分服之。痰热甚者，止可加半分耳。
取荆沥法∶能治热痰，功胜竹沥，但不补耳。
用黄荆截作短片，炙取沥，同上法。
（丹溪活套）云：二陈汤，一身之痰，无所不治。但在上加引上药，在下加引下药。如偏头痛在右，本方加川芎、白芷、防风、荆芥、薄荷、升麻之类；在左，本方合四物汤，亦加防风、荆芥、薄荷、细辛、蔓荆子、柴胡、酒片芩之类。顶痛者，本方加川芎、藁本、升麻、柴胡、蔓荆子、细辛、薄荷等药。如痰在腰胯膝下肿痛，本方加苍术、防己、木通、黄柏、萆薢、川牛膝之类。如痰在胸腹中作痛或痞满，本方加白术、神曲、麦芽、砂仁之类。如痰在胁下作痛，或漉漉有声，本方加柴胡、青皮、川芎、芍药之类。如痰在经络中，或胸背手足臂膊作痛者，上加防风、羌活、葳灵仙，在下加防己、牛膝、木通之类，冬月加乌、附行经。如风痰壅盛，喘急咳咳不宁，本方加防风、羌活、南星、枳壳、皂角之类。如热痰为病，腹胀喘满，本方加黄芩、黄连、栀子、栝蒌仁、滑石、石膏、竹沥之类。如湿痰，身重倦怠，本方加苍术、白术、南星之类。如酒痰，本方加葛根、枳椇、砂仁、神曲、麦芽之类。寒痰，本方加干姜、附子、益智、草豆蔻之类。气痰，本方加木香、槟榔、砂仁、枳壳、乌药、香附之类。燥痰，本方加栝蒌仁、杏仁、贝母、五味子之类。阴虚咯血痰嗽，本方加天门冬、麦门冬、知母、黄柏、贝母、款冬花、紫菀、马兜铃之类。如痰在中焦，作嗳气吞酸，胃脘当心而痛，或呕清水，恶心等证，本方多加白术、苍术、神曲、麦芽、川芎、砂仁、草豆蔻、枳实、猪苓、泽泻、黄连、吴茱萸、栀子仁、木香、槟榔之类，作丸服之。
（医案）
Treatise
The *Neijing* (Yellow Emperor's Inner Classic) states: "All disorders of Qi stagnation and depression belong to the Metal element of the Lung." This is because when Lung Qi is stagnant, it generates heat; when heat becomes excessive, phlegm is produced. Zhu Danxi said: "From stagnation arises accumulation; from accumulation arises phlegm. When phlegm combines with blood stasis, it forms 'nest-like' pathological masses. This is the sequential process leading to sensations of fullness (Pi), pain, dysphagia (Yege), and vomiting of undigested food (Fangwei)." Wang Yinjun said: "Records of phlegm syndromes have never been detailed in ancient or modern times. Although medical texts distinguish between various types of fluid retention such as Xuan Yin (Hanging Fluid), Liu Yin (Retained Fluid), Zhi Yin (Branching Fluid), and Tan Yin (Phlegm-Fluid), no one knows their root source. [Phlegm manifestations are diverse:] Some present as head wind, blurred vision, vertigo, and tinnitus; some as twitching of the mouth and eyes, itching of the brow ridge and ear lobes; some as wandering wind-swelling of the four limbs, hard and swollen, painful yet not quite painful; some as itching and pain in the teeth and cheeks, swelling of the gums with varying sensations of pain and itch; some as belching with acid regurgitation, gastric discomfort, nausea, and retching; some as throat obstruction, where phlegm cannot be coughed up nor swallowed down, appearing like black coal, broken cotton wadding, peach gum, or clam meat; some as a sensation of ice and snow stopping in the epigastrium, with intermittent cold pain in the heart region; some as strange dreams of ghosts and demons; some as soreness and weakness of the ankles, sudden pain in the lower back; some as vexatious pain in the joints of the four limbs without fixed location, even extending to numbness of the hands and pain in the arms, resembling sprains or contusions; some as a palm-sized area of freezing cold pain along the spine; some as a crawling sensation over the whole body; some as dryness and itching of the eyelids, oral ulcers and tongue sores, severe cases presenting as throat closure; others as cervical lymphadenopathy resembling scrofula but distinct; some as a sensation of two Qi streams knotting in the chest and abdomen, causing choking, distress, and a feeling of smoke rising, with flushing of the face and head; some as mania due to loss of will; some as stroke with paralysis; some as chronic consumption diseases (Lao Zhai) lingering for a long time; some as wind-bi and Hong Kong foot (Gouty arthritis/Charcot joint); some as palpitations and fright, fearing capture by others; some as wheezing, coughing, and vomiting, or vomiting of cold saliva, green water, or black juice, severe cases presenting as lung abscess, intestinal toxicity, pus in stool, contracture, and limping. These internal and external diseases, numbering more than a hundred, are all caused by phlegm. When body fluids coagulate into phlegm and fluid retention, surging upward to the Upper Jiao, it causes dry mouth and throat; flowing downward to the Lower Jiao, it causes constipation and urinary retention, a face like dried bones, and scorched, dry hair. In women, it causes amenorrhea; in children, it causes convulsive epilepsy. The treatment method should first expel the foul phlegm, then regulate based on deficiency or excess. Therefore, Chenxiang Guntan Wan (Agarwood Phlegm-Rolling Pill) was formulated as a key medicine for treating phlegm-fluid in the Three Jiao. I privately believe that although his argumentation is detailed, using a harsh drug to attack without distinguishing deficiency or excess may not hit the mark. Since constitution varies in thickness and thinness, and pathogens vary in depth, a single error makes rescue difficult. Thus, Danxi said: "Using too many draining medicines to treat phlegm leads to Spleen Qi deficiency, causing phlegm to be generated even more easily and abundantly." He also said: "When disease arises from food stagnation and phlegm in the Middle Jiao, Stomach Qi relies on nourishment; one must not attack abruptly. If attacked completely, deficiency increases and the disease worsens." Guntan Wan is only suitable for those with robust physique and solid phlegm accumulation; for those with weak Qi and essence, it must absolutely not be used lightly. Be cautious! Be cautious!
Pulse Diagnosis
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: "A double-wiry pulse indicates Cold Fluid Retention (or severe deficiency after drastic purgation). A unilateral wiry pulse indicates Fluid Retention. Pulmonary Fluid Retention may not show a wiry pulse, but the patient suffers from wheezing and shortness of breath."
It also states: "A floating, fine, and slippery pulse indicates injury by Fluid Retention. A wiry and rapid pulse with Cold Fluid Retention is difficult to treat in Spring and Summer. A deep and wiry pulse indicates Hanging Fluid Retention with internal pain. Shortness of breath and thirst indicate the presence of Retained Fluid if the pulse is deep."
Chen Wuyue stated: "The pulses of Fluid Retention are all wiry, faint, deep, and slippery."
Some say: "If the pulse at the Guan position before the Cunkou on both hands is floating, wiry, large, and excess, there is thick phlegm above the diaphragm; expectoration should induce self-healing."
If a patient fails to respond to hundreds of medicines, a hidden and large pulse at the Guan position indicates phlegm. Darkening of the eyelids and under-eye areas like charcoal smoke also indicates phlegm.
Danxi said: "A long-standing choppy pulse indicates phlegm-fluid retention obstructing the pulse vessels. It is difficult to open and requires careful regulation."
Methods
Danxi said: "There is Heat Phlegm, Damp-Phlegm, Wine Phlegm, Food-Stagnation Phlegm, Wind Phlegm, Cold Phlegm, and Old Phlegm."
For Heat Phlegm, use Qingdai (Indigo Naturalis), Huanglian (Coptis Rhizome), and Qingmengshi Wan (Green Malachite Pill) for best results.
For Damp-Phlegm, the body is often soft/flaccid; use Cangzhu (Atractylodes Rhizome) and Baizhu (White Atractylodes Rhizome) heavily. He also said: For Damp-Phlegm, use Huangqin (Scutellaria Root), Xiangfu (Cyperus Rhizome), Banxia (Pinellia Tuber), and Beimu (Fritillaria Bulb). For Heat Phlegm, add Gualou (Trichosanthes Fruit) and Qingdai.
For Wine Phlegm, use Gualou and Qingdai, made into honey pills for holding in the mouth to dissolve.
For Food-Stagnation Phlegm, use Shenqu (Medicated Leaven), Maiya (Barley Sprout), Shanzha (Hawthorn Fruit), or attack with Huatan Wan (Phlegm-Resolving Pill) and food-resolving medicines.
For Wind Phlegm, use Nanxing (Arisaema Rhizome) and Baifuzi (Typhonium Rhizome).
For Cold Phlegm, use Banxia. (Lu's annotation: Coagulated and clear/cold, its appearance seems cold, but it is not cold. However, warm medicines are sometimes used, employing 'cold for heat' guidance to avoid resistance.)
For Old Phlegm, use Haishi (Floating Limestone), Xiangfu, Banxia, Gualou, and Wubeizi (Galla Chinensis). One theory says: Wubeizi assists other medicines to greatly treat stubborn phlegm.
For phlegm nodules in the throat that cannot be coughed out, add salty substances that soften hardness to phlegm-resolving medicines, such as Gualou Ren (Trichosanthes Seed), Xingren (Apricot Seed), Haishi, Jiegeng (Platycodon Root), and Lianqiao (Forsythia Fruit), with a small amount of Puxiao (Niter) and Jiangzhi (Ginger Juice), made into honey pills for holding in the mouth.
Phlegm in the hypochondrium cannot reach without Baijiezi (White Mustard Seed). Phlegm in the four limbs cannot move without Zhuli (Bamboo Sap). Phlegm in the intestines and stomach can be cured by purgation. Phlegm, as a pathogen, rises and falls with Qi, thus reaching everywhere.
If the pulse is floating, expectoration should be used. Phlegm above the diaphragm must use expectoration. Solid, thick, and turbid phlegm must use expectoration. Phlegm in the meridians must use expectoration; expectoration contains the meaning of dispersing.
For any expectoration method, first lift the Qi using Fangfeng (Saposhnikovia Root), Shanzhi (Gardenia Fruit), Chuanxiong (Ligusticum Rhizome), Jiegeng, Yacha (Bud Tea), Jiangsheng (Fresh Ginger), etc., or use these medicines to probe for vomiting. During vomiting, tighten the waist and abdomen with cloth and perform in a non-drafty place.
Expectoration method: Grind Luobozhong (Radish Seed) half a sheng, mix with one bowl of Jiangshui (fermented rice water), strain, add a little oil and honey, and take warm. Or use half a jin of shrimp, boil with sauce, scallion, ginger, etc.; eat the shrimp first, then drink the broth, and shortly after probe for vomiting with a goose feather. The feather must be soaked in Tung oil, washed with Soapberry water, and dried for use. If using Gadie (Melon Pedicle) or Lilu (Veratrum), probing is unnecessary as vomiting occurs naturally.
For weak persons with phlegm in the Middle Jiao, Stomach Qi relies on nourishment; do not attack abruptly. Complete attack leads to greater deficiency. Using too many draining medicines for phlegm causes Spleen Qi deficiency, making phlegm easier to generate.
Xu Xueshi used Cangzhu to treat phlegm combined with blood stasis forming nests, which is extremely effective for moving phlegm (i.e., Shenzhu Wan).
Oil-fried Banxia greatly treats Damp-Phlegm, and also treats asthma and heart pain; make into congee pills, taken with Ginger Decoction.
(Above are sixteen methods of Danxi)
Zaoshi Tan Xingxia Wan (Dry-Damp Phlegm Star-Banxia Pill)
Nanxing, Banxia (each 1 liang), Haige Fen (Clam Shell Powder, 3 liang)
Grind into fine powder, soak steamed biscuit dough in Ginger Juice, make pills the size of Sophora seeds, coat with Qingdai. Take 30-50 pills per dose, delivered with Ginger Decoction.
Zhonghe Wan (Harmonizing Pill) Treats Damp-Phlegm with Qi Heat.
Cangzhu, Huangqin, Banxia, Xiangfu (equal parts)
Grind into fine powder, mix with Shenqu paste adjusted with Ginger Juice, make pills the size of Sophora seeds. Take 50-70 pills per dose, delivered with plain warm water.
Xiaowei Dan (Little Stomach Pill)
Removes phlegm from the chest/diaphragm above, drains phlegm from the intestines/stomach below. Can damage Stomach Qi causing anorexia; contraindicated for those with deficient Stomach Qi and low appetite.
Dahuang (Rhubarb Root, mixed with wine, wrapped in wet paper, baked until cooked, then fried with wine to moisten, 1.5 liang), Huangbai (Phellodendron Bark, fried brown, 2 liang), Gansui (Kansui Root, wrapped in flour, baked until cooked, remove flour), Daji (Euphorbia Root, boiled in running water for about one hour, washed and dried), Yuanhua (Genkwa Flower, mixed with vinegar overnight, fried black but not burnt, each 1 liang)
Grind into fine powder, make pills the size of hemp seeds using congee paste. Take 10 pills per dose, delivered with warm water.
Zhuitan Wan (Phlegm-Sinking Pill) Drains phlegm, excreting via the anus.
Fenghua Xiao (Weathered Niter), Zhishi (Immature Bitter Orange, bran-fried yellow), Heiqianniu (Black Morning Glory Seed, head powder, 5 qian), Sheng Baifan (Raw Alum, 3 qian), Zhuya Zaojiao (Tooth-shaped Soapberry Pod, remove skin/string, roast with酥 until yellow, 3 qian)
Another version has 3 qian of Beimu.
Grind into fine powder, make pills the size of Sophora seeds using Radish Juice. Take 50 pills per dose, delivered with plain warm water at cockcrow. Expect stool first, then phlegm. (Ancient formulas lacked Xiao and Zhishi, used water pills, and had different dosages.)
Qingmengshi Wan (Green Malachite Pill) Resolves and descends phlegm. One theory says it treats food stagnation and removes damp-phlegm.
Qingmengshi (Green Malachite, crushed like dice, calcined with Yanxiao until yellow), Fuling (Poria), Banxia (boiled 7 times, remove skin/navel), Nanxing (slow-fire roasted until cracked), Huangqin (each 5 qian), Fenghua Xiao (3 qian, pure ones; in winter, hang in silk bag in wind to melt).
Grind into fine powder, mix Shenqu paste with Ginger Juice, make pills the size of Sophora seeds. Take 30-50 pills per dose, delivered with Ginger Decoction. This medicine relies heavily on Fenghua Xiao. One formula adds Cangzhu 5 qian, Huashi (Talcum) 1 liang. One formula lacks Nanxing but has Baizhu. One formula has Zhishi and doubles Qingmengshi.
Zhishi drains phlegm, capable of breaking walls. Huangqin treats phlegm by borrowing its fire-draining power. Tianhuafen (Trichosanthes Root) greatly drains Upper Diaphragm Heat Phlegm. Haifen (Sea Powder) drains Heat Phlegm, dries Damp-Phlegm, and dissolves Stubborn Phlegm.
Renzhonghuang (Human Manure Yellow), made into rice pills the size of mung beans, take 10+ pills per dose with plain warm water. It drains Yin Fire, clears phlegm, and treats food stagnation.
When phlegm reverses upward due to excessive Fire, treating Fire is primary; use Baizhu, Huangqin, Shigao (Gypsum), etc.
In chronic illness, if Yin Fire rises, body fluids generate phlegm instead of blood, benefit from tonifying blood to control Ministerial Fire; the phlegm will naturally resolve. Blood-tonifying medicines must be delivered with Ginger Juice.
Phlegm forming lumps, unable to be vomited or spat out, with Qi stagnation, is difficult to treat.
For Spleen deficiency, clear Middle Qi using Erchen Tang plus Baizhu, combined with lifting medicines.
Strengthening Spleen Earth and drying Spleen Dampness is treating the root.
Erchen Tang (Two-Aged Decoction) Manages all phlegm in the body; it is the essential medicine for treating phlegm. To direct downward, add guiding-downward medicines; to direct upward, add guiding-upward medicines (Upward: Chaihu, Shengma, Fangfeng, etc. Downward: Huangbai, Mutong, Fangji, etc.). He also said: Adding lifting medicines to Erchen Tang can moisten the bowels and increase urination.
Chenpi (Tangerine Peel, white removed, 1 qian), Banxia (boiled 7 times, 2 qian), Fuling (1 qian), Gancao (Licorice Root, 0.5 qian)
Finely cut, one dose, add 3 slices of fresh ginger, 1 cup of water, decoct to 0.7 cups, take warm.
(Above are seven more methods of Danxi)
Daotan Tang (Phlegm-Guiding Decoction - Bureau Formula) Treats Wind-Damp Phlegm syndromes.
Banxia (2 qian, boiled 7 times), Nanxing (roasted until cracked), Juhong (Orange Peel, white removed), Zhike (Bitter Orange, bran-fried yellow), Gancao (roasted), Fuling (each 1 qian)
Finely cut, one dose, add 5 slices of fresh ginger, 1.5 cups of water, decoct to 1 cup, take warm. For chronic cough with Lung dryness-heat, remove Banxia, add Jiuni Zi (Schisandra Berry) 9 grains, Xingren (Apricot Seed) 0.5 qian.
Qianmin Tang (Thousand-Min Thread Decoction - Bureau Formula) Treats abundant Wind Phlegm.
Banxia (boiled 7 times, 7 pieces, quartered), Zaojiao (Soapberry Pod, 1 cun, remove skin, fry yellow), Gancao (roasted, 1 cun)
Finely cut, one dose, add 3 slices of fresh ginger, 1 cup of water, decoct to 0.7 cups, take warm.
Lige Huatan Wan (Diaphragm-Opening Phlegm-Resolving Pill - Danxi)
Nanxing (roasted until cracked), Ge Fen (Clam Powder), Banxia (boiled), Beimu (remove heart), Gualou Ren (seed removed), Xiangfu (skin removed, soaked in child's urine), Zaojiao (remove skin/string), Xingren (skin/kernel removed, fried), Qingdai (equal parts)
Grind the first six ingredients into fine powder. Crush Zaojiao, decoct thick juice, grind Xingren into paste. Mix with Ginger Juice and steamed biscuit dough, make pills the size of mung beans, coat with Qingdai. Take 50 pills per dose, delivered with Ginger Decoction.
Guntan Wan (Phlegm-Rolling Pill - Wang Yinjun Formula) Treats Damp-Heat, Food Stagnation, nest-like formations, and Old Phlegm.
Dahuang (mixed with wine, steamed), Huangqin (remove rotten parts, each half jin), Chenxiang (Agarwood, 5 qian), Mengshi (Malachite, calcined with niter to gold color, 1 liang)
Grind into fine powder, make pills with dripping water, size of Sophora seeds. Take 30-50 pills per dose, adjust number based on patient strength.
Shenzhu Wan (Divine Atractylodes Pill - Danxi) Treats Phlegm-Fluid.
Cangzhu (1 jin, soaked in rice wash water), Raw Sesame (5 qian, grind finely with 2 small cups of water, extract juice), Large Dates (15 pieces, cook meat, grind fine)
Roast Cangzhu until dry, grind to powder. Mix with sesame juice and date pulp, make pills the size of Sophora seeds. Take 50-70 pills per dose, delivered with warm water.
Huangqin Lige Wan (Scutellaria Diaphragm-Opening Pill - Dongyuan) Clears chest heat, opens diaphragm phlegm.
Raw Huangqin, Fried Huangqin (each 1 liang), Banxia (boiled 7 times), Zexie (Alisma, remove hairs), Huanglian (Coptis, each 0.5 qian), Tian Nanxing (roasted until cracked), Zhike (bran-fried), Chenpi (white removed, each 3 qian), Baizhu (2 qian), Baifan (Alum, 0.5 qian)
Grind into fine powder, soak steamed biscuit dough in water, add Ginger Juice, make pills the size of Sophora seeds. Take 30-50 pills per dose, delivered with warm water far from meals. Avoid alcohol and wet noodles.
Juan Yin Zhishi Wan (Drink-Expelling Bitter Orange Pill - Danxi) Expels drinks, resolves phlegm, guides stagnation, clears diaphragm.
Zhishi (bran-fried), Banxia (soaked), Chenpi (white removed, each 3 liang), Heiqiu (Black Morning Glory, half jin, take head powder 3 liang)
Grind into fine powder, make pills with flour paste, size of Sophora seeds. Take 50 pills per dose, delivered with Ginger Decoction.
Shizao Tang (Ten Date Decoction - Zhang Zhongjing) Treats Hanging Fluid with internal pain.
Yuanhua (vinegar-fried black), Gansui (flour-wrapped water-boiled), Daji (equal parts)
Grind into fine powder. Boil 10 dates in 1.5 sheng water until 0.8 sheng remains, strain, mix with powder. Strong person takes 1 qian, weak person takes 0.5 qian, take at dawn. If no effect, increase by 0.5 qian. After purgation, nourish with millet porridge. Hejian said: Yuanhua's pungency disperses fluid, Daji's bitterness drains water, Gansui reaches directly to where water-Qi knots; it is the holy medicine for draining water-fluid. However, it is highly toxic; do not use lightly in deficient persons.
Sanhua Shenwan (Three-Flower Divine Pill) Treats all diseases arising from damp-heat deposition, phlegm-fluid transformation, or wind-heat dryness-stagnation, limb numbness, migrating pain, wind-phlegm salivary cough, Qi-blood congestion, inability to circulate, etc. Suitable for robust persons with strong Qi.
Gansui (prepared previously), Daji, Yuanhua (vinegar-moistened fried, each 5 qian), Heiqiu (2 liang, head powder), Dahuang (1 liang), Qingfen (Calomel, 1 qian)
Grind into fine powder, make pills with dripping water, size of small beans. Start with 5 pills, increase by 5 pills per dose, deliver with warm water, three times daily. Increase until brisk purgation. Continue taking after purgation until the root cause is eliminated. For extreme fullness/distress, if too much is taken immediately, it may fail to open and worsen pain/distress; start with 2 pills, increase by 2 pills per dose, stop when brisk purgation occurs.
Kongyan Dan (Saliva-Controlling Pill - San Yin Fang) Treats hidden pain in chest, back, hypochondrium, neck, limbs, waist, and hips that is unbearable, pulling pain in tendons/bones, migrating pain, caused by phlegm-saliva in the chest/diaphragm rising and falling with Qi, causing pain in meridians. Or cold bi in limbs, blocked Qi-vessels, misdiagnosed as paralysis.
Gansui (remove heart, prepared previously), Daji (remove skin), Baijiezi (White Mustard Seed, directs upper Qi, induces sweating, treats cold-phlegm in chest/diaphragm)
Equal parts, grind to fine powder, make pills with paste, size of Sophora seeds. Take 50 pills per dose, delivered with light Ginger Decoction after meals and before sleep. Adjust dosage based on patient deficiency/excess. Another name is Miaoying Wan, treats fright-phlegm, coat with Cinnabar. For severe pain, add Quanxie (Scorpion). For wine-phlegm, add Xionghuang (Realgar), Quanxie. For fright-Qi phlegm forming lumps, add Shanjia (Pangolin Scale), Biejia (Turtle Shell), Yansuhu (Corydalis Rhizome), Peng'e Zhu (Curcuma Longa). For arm pain, add Mubiezi Frost (Mumier Seed Frost), Guixin (Cinnamon Twig). For heat-phlegm, add Penxiao (Basin Niter). For cold-phlegm, add Dingxiang (Clove), Hujiao (Pepper), Rougui (Cinnamon Bark).
Banxia Wan (Pinellia Pill) Treats Lung Heat Phlegm Cough.
Gualou Ren (separately ground), Banxia (boiled 7 times, remove skin/navel, roast open, each 1 liang)
Grind into fine powder, mix evenly, make pills with Ginger Juice paste.
Method for Extracting Bamboo Sap: Greatly treats Heat Phlegm, nourishes blood, clears heat. For phlegm-jue unconsciousness near death, pouring bamboo sap revives them; truly a life-restoring medicine.
Use Shuizhu (Water Bamboo) and Zaozhu (Early Bamboo, common name Lei Bamboo. Su Dongpo said: Light bamboo vs bitter bamboo is just pattern; except bitter bamboo, all are light bamboo. My Master Danxi used only these two in his life. They are chosen as the lightest among bamboos for their sweet/light shoot taste). Cut into ~2 chi lengths, split each section into 4 pieces. Arrange two thin bricks, place bamboo strips on bricks, exposing 1-2 inches at ends. Apply fierce fire underneath, collect sap in basins at both ends. Ratio: 6 parts sap to 1 part Ginger Juice. For severe phlegm-heat, add only 0.5 part Ginger Juice.
Method for Extracting Vitex Sap: Treats Heat Phlegm, superior efficacy to bamboo sap, but does not tonify.
Cut Huangjing (Vitex trifolia) into short sections, roast to extract sap, same method as above.
(Danxi Flexible Patterns) states: Erchen Tang treats all phlegm in the body. Add guiding-upward medicines for upper symptoms, guiding-downward for lower. For right-sided hemi-cephalgia, add Chuanxiong, Baizhi, Fangfeng, Jingjie, Bohe, Shengma, etc. For left-sided, combine with Siwu Tang, also add Fangfeng, Jingjie, Bohe, Xixin, Manjingzi, Chaihu, Jiupian Qin, etc. For vertex pain, add Chuanxiong, Gaoben, Shengma, Chaihu, Manjingzi, Xixin, Bohe. For phlegm swelling/pain in waist/hips/knees, add Cangzhu, Fangji, Mutong, Huangbai, Bixie, Chuan Niuxi. For phlegm pain/fullness in chest/abdomen, add Baizhu, Shenqu, Maiya, Sharen. For phlegm pain in hypochondrium with gurgling sounds, add Chaihu, Qingpi, Chuanxiong, Shaoyao. For phlegm in meridians causing pain in chest/back/limbs/arms, add Fangfeng, Qianghuo, Weilingxian above; Fangji, Niuxi, Mutong below; in winter add Wu Tou, Fu Zi to move channels. For abundant Wind Phlegm, wheezing, restless cough, add Fangfeng, Qianghuo, Nanxing, Zhike, Zaojiao. For Heat Phlegm disease, abdominal distension/wheezing, add Huangqin, Huanglian, Zhizi, Gualou Ren, Huashi, Shigao, Zhuli. For Damp-Phlegm, heavy body/fatigue, add Cangzhu, Baizhu, Nanxing. For Wine Phlegm, add Gegen, Zhiju, Sharen, Shenqu, Maiya. For Cold Phlegm, add Ganjiang, Fuzi, Yizhi, Caodoukou. For Qi Phlegm, add Muxiang, Binglang, Sharen, Zhike, Wuyao, Xiangfu. For Dry Phlegm, add Gualou Ren, Xingren, Beimu, Wuweizi. For Yin-deficiency hemoptysis/phlegm-cough, add Tiandong, Maidong, Zhimu, Huangbai, Beimu, Kuandonghua, Ziwan, Madouling. For phlegm in Middle Jiao causing belching/acid regurgitation, epigastric pain, vomiting clear water, nausea, add Baizhu, Cangzhu, Shenqu, Maiya, Chuanxiong, Sharen, Caodoukou, Zhishi, Zhuling, Zexie, Huanglian, Wuzhuyu, Zhiziren, Muxiang, Binglang, make into pills.
(Medical Cases)