大人痰饮。小儿涎痰。痰由涎结。涎乃脾泔。脾运胃液。肢体皆咸。脾气不足。风热相兼。壅遏中脘。口沫淹淹。
乃生壮热。
惊搐渐添。脾热乘心。涎亦中含。心忡心悸。胸膈常 。涎流口角。痰自喉探。或喘或嗽。皆痰之嫌。鸡声锯声。皆痰
之占。凡属惊痫。痰必深潜。凡属痞积。痰又牢坚。疟必有痰。寒热难堪。眩亦多痰。痰火上炎。凡诸痰病。涎亦均沾。
然痰与涎。津液所涵。实为元气。相附如缄。不图其本。痰涎是 。元虚而脱。难免 。钱氏遗法。白术散拈。涎痰
之治。此其大凡。勿求小效。心存二三。
钱乙曰。余治朱监簿子。五岁。夜发热。晓如故。医以铁粉丸下涎。病益甚。至五日大引饮。余取白术散一两煎三
升。任意饮。朱疑其泻。余曰。纵泻勿怪。但不可下耳。止泻治痰。清神退热。皆此药也。又煎三升。服稍尽。愈。三
日。又服三
升。不渴无涎。投阿胶散二服。安。
圣惠方曰。小儿多涎者。风热壅脾。积聚成涎。即乳食不下。涎沫结实。而生壮热。小儿多涎。亦由脾气不足。不
能四布津液而成。若不治其本。补益中气。而徒去其痰涎。痰涎虽病液。亦元气所附。去之不已。遂成虚脱。每见惊搐
壮
热等症。医以下痰小见功效。屡下之而致夭亡者多矣。姑备方。半夏丸、牛蒡子散、谭氏金珠丸、白附丸。
大人的痰饮，小儿的涎痰。痰是由涎凝结而成的，涎则是脾脏运化产生的津液（脾泔）。脾脏运化胃中的水液，使得肢体组织都呈现咸味。如果脾气不足，风邪与热邪相互兼夹，壅塞阻滞在中脘部位，导致口中唾液不断流出。进而产生高热，惊厥抽搐逐渐增加。脾热侵犯心脏，涎液中也就含有热邪。出现心慌心悸，胸膈部常常感到不适。涎水流出口角，痰从喉咙中发出声响。或者气喘或者咳嗽，都是痰病的嫌疑表现。声音像鸡鸣或锯木声，都是痰证的征象。凡是属于惊痫的病证，痰邪必定深伏潜藏。凡是属于痞积的病证，痰邪又变得牢固坚硬。疟疾必定有痰，寒热交替让人难以忍受。眩晕也多由痰引起，痰火向上炎升。凡是各种痰病，涎也都会受到牵连。
然而痰与涎，都是由津液包含涵养的，实际上依附于元气，两者相附如同密封一般。如果不探究其根本，只把痰涎当作病邪来对待，就会导致元气虚弱而脱失，难免出现虚脱危象。钱乙遗留下来的治疗方法，是用白术散来拮取治疗。对于涎痰的治疗，这是大概的原则。不要追求微小的疗效，心中要专一，不可三心二意。
钱乙说：我治疗朱监簿的儿子，五岁，夜间发热，早晨就像没事一样。医生用铁粉丸来攻下痰涎，病情更加严重。到了第五天，孩子大量饮水。我取白术散一两，煎煮成三升汤剂，让他随意饮用。朱家怀疑这药会致泻。我说：即使腹泻也不要奇怪，只是不可以再用攻下药罢了。止泻、治痰、清神、退热，都靠这个药。我又煎了三升，孩子服用了大部分后，病就好了。三天后，又服用了三升，不再口渴也没有痰涎了。再投服两剂阿胶散，病情安定。
《太平圣惠方》说：小儿多涎的，是因为风热壅滞脾脏，积聚形成涎液，导致乳食不下，涎沫结实，从而产生高热。小儿多涎，也是由于脾气不足，不能将津液布散到全身所致。如果不治疗其根本，补益中气，而仅仅去除痰涎，虽然痰涎是病态的津液，但也依附于元气，过度去除，最终会导致虚脱。经常见到惊厥抽搐、高热等症状，医生用攻下痰涎的方法初见功效，但屡次攻下而导致夭折的很多了。姑且准备以下方剂：半夏丸、牛蒡子散、谭氏金珠丸、白附丸。
Adults suffer from phlegm-fluid retention (Tan Yin), while children suffer from saliva-phlegm (Xian Tan). Phlegm is formed by the condensation of saliva; saliva is the fluid produced by the Spleen's transformation (Pi Jin). The Spleen transforms and transports fluids from the Stomach, making the limbs and tissues salty in nature. When Spleen Qi is insufficient, Wind and Heat pathogens combine, obstructing the Middle Jiao (Zhong Wan), causing excessive drooling. This leads to high fever, with gradual onset of fright and convulsions. Spleen Heat invades the Heart, so the saliva also contains heat. Symptoms include palpitations (Xin Chong) and anxiety, with frequent discomfort in the chest and diaphragm. Saliva flows from the corners of the mouth, and phlegm sounds are heard from the throat. Whether there is wheezing or coughing, these are signs of phlegm. Sounds resembling a chicken's crow or sawing wood are indicators of phlegm. In all cases of Fright Epilepsy (Jing Xian), phlegm must be deeply hidden. In all cases of Pi Accumulation (Pi Ji), phlegm becomes firm and solid. Malaria (Nue) necessarily involves phlegm, with unbearable alternating chills and fever. Dizziness (Xuan) is often caused by phlegm, where Phlegm-Fire flares upward. For all kinds of phlegm diseases, saliva is equally involved.
However, phlegm and saliva are contained within body fluids (Jin Ye) and actually adhere to Yuan Qi (Primordial Qi), attached like a sealed container. If one does not seek the root cause, but merely treats phlegm and saliva as pathogenic factors, it will lead to deficiency and collapse of Yuan Qi, inevitably resulting in collapse. The method left by Qian Yi is to use Baizhu San (Atractylodes Macrocephala Decoction) to address this. This is the general principle for treating saliva-phlegm. Do not seek minor effects; keep your mind focused and do not be indecisive.
Qian Yi said: "I treated the son of Supervisor Zhu, who was five years old. He had fever at night and was normal in the morning. A physician used Tie Fen Wan (Iron Powder Pill) to purge phlegm, which made the condition worse. By the fifth day, he was drinking excessively. I took one liang of Baizhu San (Atractylodes Macrocephala Decoction), decocted it into three sheng, and allowed him to drink it freely. Mr. Zhu suspected it would cause diarrhea. I said, 'Even if he has diarrhea, do not be surprised; just do not use purgatives. This medicine stops diarrhea, treats phlegm, clears the spirit, and reduces fever.' I decocted another three sheng. After he consumed most of it, he recovered. Three days later, he took another three sheng, after which he was no longer thirsty and had no more phlegm. Then, two doses of Ejiao San (Donkey-Hide Gelatin Decoction) were administered, and his condition stabilized."
The *Taiping Shenghui Fang* states: "Children with excessive saliva suffer from Wind-Heat obstructing the Spleen, leading to accumulation and formation of saliva, resulting in inability to take milk and food, solidified saliva foam, and subsequent high fever. Excessive saliva in children is also due to Spleen Qi insufficiency, preventing the distribution of fluids throughout the body. If the root is not treated by tonifying Middle Qi, and only phlegm-saliva is removed, although phlegm-saliva is pathological fluid, it adheres to Yuan Qi. Over-removal leads to deficiency and collapse. It is common to see cases of fright, convulsions, and high fever where physicians initially see efficacy with phlegm-purging methods, but repeated purging leads to premature death in many instances. Prepared here are the following formulas: Banxia Wan (Pinellia Pill), Niubangzi San (Arctium Fruit Decoction), Tan Shi Jinzhu Wan (Mr. Tan's Golden Pearl Pill), and Bai Fu Wan (Hohenbuehelia Pill)."