痰属湿热，乃津液所化，因风寒湿热之感，或七情饮食所伤，以致气逆液浊，变为痰饮，或吐咯上出，
或凝滞胃膈，或留聚肠胃，或客于经络四肢，随气升降，遍身上下无处不到。其为病也，为喘，为咳，为恶
心呕吐，为痞隔壅塞、关格异病，为泄，为眩晕，为嘈杂、怔忡、惊悸，为癫狂，为寒热，为痛肿，或
胸间辘辘有声，或背心一点常如冰冷，或四肢麻痹不仁，皆痰所致。百病中多有兼痰者，世所不知也。痰
有新久、轻重之殊。新而轻者，形色清白，气味亦淡；久而重者，黄浊稠结，咳之难出，渐成恶味酸辣腥臊
咸苦，甚至带血而出。治法∶痰生于脾胃，宜实脾燥湿；又随气而升，宜顺气为先，分导次之；又气升属火，
顺气在于降火。热痰则清之，湿痰则燥之，风痰则散
之，郁痰则开之，顽痰则软之，食积则消之，在上者吐之，在中者下之。又中气虚者，宜固中气以运痰，
若攻之太重，则胃气虚而痰愈甚矣。
主方∶二陈汤
橘红 半夏（汤泡） 白茯苓 甘草（炙） 生姜
上方总治一身之痰。如要下行，加引下药；上行，加引上药。
若湿痰多软，如身体倦怠之类，加苍、白术；寒痰痞塞胸中，倍加半夏，甚者加麻黄、细辛、乌头
之类。
愚按痰者，脾胃之津液，或为饮食所伤，或因七情、六淫所扰，故气壅痰聚。谚云肥人多痰，而在瘦
人亦有之，何也？盖脾统血、行气之经，气血俱盛，何痰之有？皆由过思与饮食所伤，损其经络，脾血既
虚，胃气独盛，脾为己土，胃为戊土，戊癸化火，是以湿因气化，故多痰也。游行周身，无所不至。痰气
既盛，客必胜主，或夺于脾之大络之气，则倏然仆地者，此痰厥也，升于肺者，则喘急咳嗽；迷于心，则
怔忡恍惚；走于肝，则眩晕不仁，胁肋胀痛；关于肾，不哈而多痰唾；留于胃脘，则呕泻而作寒热；注于
胸，则咽膈不利，眉棱骨痛；入于肠，则漉漉有声，散则有声，聚则不利。窃谓若脾气虚弱，不能消湿，
宜用补中益气汤加茯苓、半夏；若因脾气虚弱湿热所致，
宜用东垣清燥汤；若因胃气虚弱，寒痰凝滞者，宜用人参理中汤；若因脾胃虚寒而痰凝滞者，宜用理中化
痰丸；若因脾虚而痰滞气逆，宜用六君子加木香；若因脾胃虚弱而肝木乘侮，宜用六君子加柴胡，头痛宜
用半夏白术天麻汤；若因脾肾虚弱，寒邪所乘，以致头痛，宜用附子细辛汤。
若风痰，加南星、枳壳、白附子、天麻、僵蚕、猪牙皂角之类；气虚者，更加竹沥，气实加荆沥，俱
用姜汁。
愚按《脉诀》云∶热则生风，故云风自火出。若风邪气滞，痰蕴于胸中者，宜用之；若因肺经风热而
生痰者，宜用金沸草散；若因风火相搏，肝经风热炽盛而生痰者，宜用牛黄抱龙丸或牛黄清心丸；若因肝
经血燥而生痰者，宜用六味地黄丸；若因热盛制金，不能平木而生痰者，宜用柴胡栀子散；若因中气虚弱，
不能运化而生痰者，宜用六君、柴胡、钩藤。
若热痰，加黄芩、黄连。痰因火盛逆上，降火为先，加白术、黄芩、软石膏、黄连之类。眩晕、嘈杂者，
火动其痰也，亦加山栀、黄芩、黄连。
愚按前方若肺胃实火者，宜用之；若风寒郁热，宜用参苏饮加山栀、片芩；若中气虚热，宜用补中益
气加半夏、桔梗；若肾虚阴火炎上，宜用六味丸；若肾气虚，寒痰上涌，用八味丸。
若血虚有痰者，加天门冬、知母、栝蒌仁、香附米、竹沥、姜汁；带血者，再加黄芩、白芍药、桑
白皮；血滞不行，中焦有饮者，取竹沥和生姜、韭菜自然汁，服三、五盏，必胃中烦躁不宁，后自愈。
愚按前方苦寒甘寒辛辣降火化痰行气破血之剂，须审有是病而乃服是药可也。病去六七，即当止之，
过剂则反伤中气，而病益甚。大凡内因之症，原属脾胃虚弱，当审所致之由，而调养之，若稍重其剂，复
伤胃气，虚症蜂起。
若气虚有痰者，加人参、白术；脾虚者，宜补中气，以运痰降下，加白术、白芍药、神曲、麦芽，兼
用升麻提起；内伤挟痰，加人参、黄 、白术之类，姜汁传送，或加竹沥尤效。
愚按前症若脾肺气虚，不能运化而有痰者，宜用六君子加木香；若肺气虚弱，不能清化而有痰者，宜
用六君子加桔梗；若因脾经气滞而痰中有血者，宜用加味归脾汤；若因肝经血热而痰中有血者，宜用加味
逍遥散；若因肝肾阴虚而痰中有血者，宜用六味地黄丸；若因过服寒凉之剂而唾痰有血者，必用四君子汤
之类以主之。
若食积痰，加神曲、麦芽、山楂、黄连（炒）、枳实以消之，甚者必用攻之，宜丸药。若兼血虚
者，用补药送下；中焦有痰者，食积也，胃气亦赖所养，若攻之
尽，则虚矣。
愚按前症若元气素实，偶因饮食过多而致者，宜用主方消导宿滞。盖食痰多因脾虚，食难消化而作痰
也；血虚者，多因脾气衰弱不能生血也，皆当调补脾胃之气，则无食积之患，而血自生矣。故东垣云∶脾
胃之气实，用黄连、枳实泻之；虚，用白术、陈皮补之。其方内用神曲、麦芽。说见上卷。
府庠沈文姬母，食湿面，吞酸，呕吐，绝食，服芩连等剂，加寒热，口干，流涎，又食冬瓜一星，而
呕吐愈甚。余谓此脾气虚寒也，急用盐、艾、附子炒热，熨脐腹；又以其子口气接其母气，神气少苏；以
参、术、附子、陈皮为末，丸如粟米大，津咽五、七粒，次日加至十余粒，渐服煎剂一二匙，乃思粥饮；
又以参、术等药，五十余剂而愈。（详见《内科摘要》。）
若喉中有物，咯不出，咽不下，此痰结也。用药化之，加咸药软坚之类，宜栝蒌仁、杏仁、海石、
桔梗、连翘、香附，少佐朴硝、姜汁，炼蜜和丸，噙服之。脉涩者，卒难开，必费调理。气实痰热结者，
吐难得出，或成块吐咯不出，气滞者难治。
愚按此方治形症充实之法也。前症有因脾经郁结而伤阴血者；有因肾水亏损而阴火上炎者；有因脾
肺火郁而生痰者。治法∶若因七情郁结，痰涎滞于喉间者，先用局方四七汤调和滞气，后用归脾汤调补
脾血。脾火伤血，用加味归脾汤；肾水亏损，用六味地黄丸；肺经郁火，用知母茯苓汤。若妇人患此，而
兼带下，皆由郁结伤损肝脾，当佐以四七汤，送青州白丸子。此等症候，属脾胃气虚为本，而气滞痰结为
末也。古方用十枣汤、控涎丹、神佑丸、滚痰丸，异香枳实、利膈涤痰、透罗破饮、降气化痰等汤，苏合
香丸之类，皆形病充实之药也，西北人用之，多有效验。其属虚弱者，皆致肚腹胀满而殁。
大参李北泉，时吐痰涎，内热作渴，肢体倦怠，劳而足热。余曰∶此肾水泛而为痰，法当补肾。不信，
另用化痰汤、滚痰丸，吐泻不食，头晕眼闭。余用六君子汤数剂，胃气渐复；用六味丸，诸症渐愈。
一儒者，咳嗽痰盛，胸腹不利，饮食少思，肢体倦怠，脉浮大，按之微弱。服二陈、枳壳等药，愈
盛。余曰∶脾肺肾虚也。用补中益气汤、六味地黄丸而愈。
若痰在肠胃间，可下而愈，枳实、甘遂、巴豆、大黄、芒硝之类；痰在脾里膜外，非姜汁、竹沥
不能及；在四肢，非竹沥不开；在经络中，亦用竹沥，必佐以姜、韭汁。膈间有痰，或癫狂，或健忘，或风
痰，俱用竹沥，与荆沥同功。气虚少食，用竹沥；气实能食，用荆沥。痰在胁下，非白芥子不能达。
愚按前症多因饮食、起居、七情失宜，耗损元气，内火动而为患者，当求其属，而治其本可也。前法
乃悍之剂，非灼见形气俱充实者，决不可用。必先察其病形脉症，则知所挟之邪，随其表里、上下、虚实
以治之。若夫挟寒、挟虚之症，不可不论也。
一儒者，脾气虚弱，呕吐痰涎，因怒胸腹膨胀，饮食少思。左关脉弦长，按之无力；右关脉弦长，按
之微弱。此木克土也。用六君子加柴胡、山栀、木香治之而愈。
一妇人，脾胃虚弱，饮食素少，忽痰壅气喘，头摇目扎，手扬足掷，难以候脉，视其面色，黄中兼
青。此肝木乘脾胃也。用六君子加柴胡、升麻治之而苏；更以补中益气加半夏调理而痊。
若老痰，用海石、半夏、栝蒌仁、香附米、连翘之类。五倍子佐他药，大治顽痰，宜作丸服。
愚按前症若脾气壅滞，痰客中焦者，宜先用此方以治其痰，后用六君子以调补脾气，其痰自消。若始
未悉治其痰，则脾气益虚，津液不行，而痰益盛矣。
一男子，吐痰，胸膈不利，饮食少思，服海石、栝蒌之类，不应。余曰∶此脾气虚弱，不能消导而
为痰，当健脾为主。彼不信，又服驱逐之剂，其痰如涌，四肢浮肿，小腹肿胀，小便涩滞。余曰∶此复
损脾肾所致也。先用金匮加减肾气丸、补中益气汤治
之，诸症渐减；又用八味丸兼前汤而愈。
一男子，素吐痰，遇怒其痰益甚，胸膈痞满。此肝木制脾土也。用六君加木香治之而痊。
一妇人，素郁结，胃膈不宽，吐痰如胶。用加味归脾汤乃瘥。
一妇人，吐痰，头晕，带下青黄。用四七汤送白丸子，小柴胡加白术、茯苓治之而安。
人身上中下有块，是痰也。问其平日好食何物？吐下后方用药。
若头面颈颊身中有结核，不痛、不红、不作脓者，皆痰注也，宜随处用药消之。
愚按前症若脾肺气逆，而痰滞于肉里，或散，或作肉色不变，亦不作痛，按之不硬，此为痰核，宜推
其因，而治其本，则痰自消。若因郁怒，亏损肝脾，或因暴怒，触动肝胆经火，以致血病结核，或筋挛于项
侧耳前后，或胸胁肿痛，或发寒热，此为瘰 ，宜用柴胡清肝散加钩藤钩、山栀，以养血气、清肝火。若
肉色不变，晡热内热，属肝经血虚火旺，宜用逍遥散加龙胆草，以养肝血、清肝火。或结于肢节，或累累
如贯珠，其色不变，亦为肝火血燥而筋挛，宜用柴芍参苓散加钩藤以养血气，佐以六味丸以生肾水。
儒者杨泽之，性躁好色，缺盆结一核。此肝火血燥筋挛，法当滋肾水、生肝血。不信，乃内服降火化
痰，外敷南星、商陆，转大如碗。余用补中益气及六味地黄，间以芦荟丸，年余元气渐复而肿消。
一妇人，经事不调，肝胆经分结核，如榛如豆，不计其数，肉色不变，大按方痛。或投化痰消毒之
药，不按自痛，发热作渴，日晡益甚。余谓属肝火之症，用养血、解郁、清肝之药，百余剂诸症已退，
惟项核未消；更以当归龙荟丸数服，及四物、柴胡、山栀而愈。
一妇人，耳前后结核，耳内微肿，寒热，口苦，用小柴胡、山栀、桔梗、川芎，四剂而愈，后因恚
怒，耳前后、头两角俱痛，发热憎寒，以小柴胡、山栀、川芎、桔梗、羌活，二剂而愈。（详见《外科枢要》。）
滚痰丸攻泻肠胃痰积及小儿食积痰、急惊风痰甚者，最为要药，常宜合备，但须量人虚实而用之。
愚按滚痰丸夺旗斩关回生起死之剂，必痰滞胸膈，秘结不利，形气病气俱实者，乃可用之。或脾气
不能摄涎而上泛，或肾气不能摄水而上溢，苟误认为实痰而用之，祸在反掌，江南人尤慎之。
一妇人，元气素弱，痰气时作，或咽间不利，或胸痞等症。余以为郁结伤脾，用加味归脾汤治之而
愈。后遇恚怒，前症仍作，惑于众言，以为痰饮，妄用祛痰之剂，吐泻数次，变诸异症，口噤不醒。余以为
脾胃复伤，日用六君子一剂，米饮浓煎，常服匙许，至四日渐进粥食，乃服前药，间以归脾汤，喜其善调
养，两月余诸症悉愈。
痰属于湿热性质，是由津液转化而成的。由于感受风寒湿热之邪，或因七情内伤、饮食不节，导致气机逆乱、津液浑浊，从而变成痰饮。有的从口吐或咯出，有的凝滞于胃膈之间，有的留聚在肠胃之中，有的客居于经络四肢，随着气机的升降，遍布全身无处不到。它引起的病症有：气喘、咳嗽、恶心呕吐、痞满隔塞、关格等异常病证，腹泻，眩晕，嘈杂感、怔忡、惊悸，癫狂，寒热往来，疼痛肿胀；或者胸中辘辘有声，或者背部一点常感觉像冰冷一样，或者四肢麻木不仁，这些都是痰所致。百种疾病中多有兼夹痰证的，世人往往不知道这一点。
痰有新发与久病、轻症与重症的区别。新发且轻的，颜色形态清白，气味也淡；日久且重的，颜色黄浊、质地稠结，咳吐困难，逐渐形成酸、辣、腥、臊、咸、苦等恶味，甚至带血而出。
治疗方法：痰生于脾胃，应当健脾燥湿；又因痰随气升，应以顺气为先，分消导滞次之；气升多属火，顺气关键在于降火。热痰则清热，湿痰则燥湿，风痰则疏散，郁痰则开郁，顽痰则软坚，食积则消导。病位在上者用吐法，在中者用下法。另外，中气虚者，宜固护中气以运化痰湿，如果攻伐太重，则胃气更虚，痰反而更盛。
主方：二陈汤（Orange Peel and Pinellia Decoction）
橘红、半夏（汤泡）、白茯苓、甘草（炙）、生姜。
上方总治一身之痰。若要引药下行，加引下药；若欲引药上行，加引上药。
若是湿痰较多且身体柔软无力，如身体倦怠之类，加苍术、白术；寒痰痞塞胸中，加倍使用半夏，严重者加麻黄、细辛、乌头之类。
我按语：痰是脾胃的津液，或因饮食所伤，或因七情、六淫干扰，导致气壅痰聚。谚语说“肥人多痰”，但瘦人也有痰，为什么呢？脾是统血、行气的经脉，气血俱盛，哪里有痰呢？这都是因为过度思虑和饮食损伤，损及经络，脾血既虚，胃气独盛。脾为己土，胃为戊土，戊癸化火，因此湿气因气化而生成痰，所以多痰。痰游行周身，无所不至。痰气既盛，客邪必胜主气，若夺去脾之大络之气，则突然仆倒在地，这是痰厥；上冲于肺，则喘急咳嗽；迷于心，则怔忡恍惚；走于肝，则眩晕不仁，胁肋胀痛；关乎肾，不哈欠却多痰唾；留于胃脘，则呕吐腹泻并伴有寒热；注于胸，则咽膈不利，眉棱骨痛；入于肠，则漉漉有声，散则有声，聚则不利。我认为若脾气虚弱，不能消湿，宜用补中益气汤加茯苓、半夏；若因脾气虚弱湿热所致，宜用东垣清燥汤；若因胃气虚弱，寒痰凝滞者，宜用人参理中汤；若因脾胃虚寒而痰凝滞者，宜用理中化痰丸；若因脾虚而痰滞气逆，宜用六君子汤加木香；若因脾胃虚弱而肝木乘侮，宜用六君子汤加柴胡，头痛宜用半夏白术天麻汤；若因脾肾虚弱，寒邪所乘，以致头痛，宜用附子细辛汤。
若是风痰，加南星、枳壳、白附子、天麻、僵蚕、猪牙皂角之类；气虚者，再加竹沥，气实加荆沥，均用姜汁送服。
我按语：《脉诀》云：“热则生风”，所以说“风自火出”。若风邪气滞，痰蕴于胸中者，宜用此法；若因肺经风热而生痰者，宜用金沸草散；若因风火相搏，肝经风热炽盛而生痰者，宜用牛黄抱龙丸或牛黄清心丸；若因肝经血燥而生痰者，宜用六味地黄丸；若因热盛制金，不能平木而生痰者，宜用柴胡栀子散；若因中气虚弱，不能运化而生痰者，宜用六君子汤、柴胡、钩藤。
若是热痰，加黄芩、黄连。痰因火盛逆上，以降火为先，加白术、黄芩、软石膏、黄连之类。眩晕、嘈杂者，是火动其痰，也加山栀、黄芩、黄连。
我按语：前方若用于肺胃实火者，宜用此法；若风寒郁热，宜用参苏饮加山栀、片芩；若中气虚热，宜用补中益气汤加半夏、桔梗；若肾虚阴火炎上，宜用六味地黄丸；若肾气虚，寒痰上涌，用八味地黄丸。
若是血虚有痰者，加天门冬、知母、栝蒌仁、香附米、竹沥、姜汁；带血者，再加黄芩、白芍药、桑白皮；血滞不行，中焦有饮者，取竹沥和生姜、韭菜自然汁，服用三、五盏，必然出现胃中烦躁不宁，之后自愈。
我按语：前方多为苦寒、甘寒、辛辣降火、化痰、行气、破血之剂，必须审察确有是病才服用是药。病去六七成，即当停药，过剂则反伤中气，而病情加重。大凡内因之症，原属脾胃虚弱，应当审察致病原因而调养，若稍加重药量，再次损伤胃气，虚症便会蜂拥而起。
若是气虚有痰者，加人参、白术；脾虚者，宜补中气，以运痰降下，加白术、白芍药、神曲、麦芽，兼用升麻提起；内伤挟痰，加人参、黄芪、白术之类，姜汁传送，或加竹沥尤效。
我按语：前症若脾肺气虚，不能运化而有痰者，宜用六君子汤加木香；若肺气虚弱，不能清化而有痰者，宜用六君子汤加桔梗；若因脾经气滞而痰中有血者，宜用加味归脾汤；若因肝经血热而痰中有血者，宜用加味逍遥散；若因肝肾阴虚而痰中有血者，宜用六味地黄丸；若因过服寒凉之剂而唾痰有血者，必用四君子汤之类以主之。
若是食积痰，加神曲、麦芽、山楂、黄连（炒）、枳实以消之，甚者必用攻下法，宜用丸药。若兼血虚者，用补药送下；中焦有痰者，也是食积，胃气亦赖所养，若攻之尽，则虚矣。
我按语：前症若元气素实，偶因饮食过多而致者，宜用主方消导宿滞。盖食痰多因脾虚，食难消化而作痰也；血虚者，多因脾气衰弱不能生血也，皆当调补脾胃之气，则无食积之患，而血自生矣。故李东垣云：脾胃之气实，用黄连、枳实泻之；虚，用白术、陈皮补之。其方内用神曲、麦芽。说见上卷。
府庠沈文姬之母，吃湿面，吞酸，呕吐，绝食，服用黄芩、黄连等剂后，出现寒热，口干，流涎，又吃冬瓜一小块，而呕吐更甚。我说这是脾气虚寒，急用盐、艾叶、附子炒热，熨烫脐腹；又以其子口气接其母气，神气稍苏；用参、术、附子、陈皮为末，丸如粟米大，津液吞咽五、七粒，次日加至十余粒，渐服煎剂一二匙，乃思粥饮；又以参、术等药，五十余剂而愈。（详见《内科摘要》。）
若喉中有物，咯不出，咽不下，这是痰结也。用药化解它，加咸味药软坚之类，宜用栝蒌仁、杏仁、海浮石、桔梗、连翘、香附，少佐朴硝、姜汁，炼蜜和丸，噙服之。脉涩者，卒难开通，必费调理。气实痰热结者，吐难得出，或成块吐咯不出，气滞者难治。
我按语：此方治形症充实之法也。前症有因脾经郁结而伤阴血者；有因肾水亏损而阴火上炎者；有因脾肺火郁而生痰者。治法：若因七情郁结，痰涎滞于喉间者，先用局方四七汤调和滞气，后用归脾汤调补脾血。脾火伤血，用加味归脾汤；肾水亏损，用六味地黄丸；肺经郁火，用知母茯苓汤。若妇人患此，而兼带下，皆由郁结伤损肝脾，当佐以四七汤，送青州白丸子。此类症候，属脾胃气虚为本，而气滞痰结为标也。古方用十枣汤、控涎丹、神佑丸、滚痰丸，异香枳实、利膈涤痰、透罗破饮、降气化痰等汤，苏合香丸之类，皆是形病充实之药也，西北人用之，多有效验。其属虚弱者，皆致肚腹胀满而死亡。
大参李北泉，时常吐痰涎，内热作渴，肢体倦怠，劳累而足热。我说：这是肾水泛而为痰，法当补肾。他不信，另用化痰汤、滚痰丸，结果吐泻不食，头晕眼闭。我用六君子汤数剂，胃气渐复；用六味地黄丸，诸症渐愈。
一儒者，咳嗽痰盛，胸腹不利，饮食少思，肢体倦怠，脉浮大，按之微弱。服用二陈汤、枳壳等药，症状更盛。我说：这是脾肺肾虚也。用补中益气汤、六味地黄丸而愈。
若痰在肠胃间，可下而愈，用枳实、甘遂、巴豆、大黄、芒硝之类；痰在脾里膜外，非姜汁、竹沥不能到达；在四肢，非竹沥不能开通；在经络中，亦用竹沥，必佐以姜、韭汁。膈间有痰，或癫狂，或健忘，或风痰，俱用竹沥，与荆沥同功。气虚少食，用竹沥；气实能食，用荆沥。痰在胁下，非白芥子不能到达。
我按语：前症多因饮食、起居、七情失宜，耗损元气，内火动而为患者，当求其属，而治其本可也。前法乃是悍烈之剂，非灼见形气俱充实者，决不可用。必先察其病形脉症，则知所挟之邪，随其表里、上下、虚实以治之。若夫挟寒、挟虚之症，不可不论也。
一儒者，脾气虚弱，呕吐痰涎，因怒胸腹膨胀，饮食少思。左关脉弦长，按之无力；右关脉弦长，按之微弱。这是木克土也。用六君子汤加柴胡、山栀、木香治之而愈。
一妇人，脾胃虚弱，饮食素少，忽痰壅气喘，头摇目扎，手扬足掷，难以候脉，视其面色，黄中兼青。这是肝木乘脾胃也。用六君子汤加柴胡、升麻治之而苏；更以补中益气汤加半夏调理而痊。
若是老痰，用海浮石、半夏、栝蒌仁、香附米、连翘之类。五倍子佐他药，大治顽痰，宜作丸服。
我按语：前症若脾气壅滞，痰客中焦者，宜先用此方以治其痰，后用六君子汤以调补脾气，其痰自消。若始未悉治其痰，则脾气益虚，津液不行，而痰益盛矣。
一男子，吐痰，胸膈不利，饮食少思，服用海浮石、栝蒌之类，不应。我说：这是脾气虚弱，不能消导而为痰，当健脾为主。他不信，又服驱逐之剂，其痰如涌，四肢浮肿，小腹肿胀，小便涩滞。我说：这是复损脾肾所致也。先用金匮加减肾气丸、补中益气汤治之，诸症渐减；又用八味地黄丸兼前汤而愈。
一男子，素吐痰，遇怒其痰益甚，胸膈痞满。这是肝木制脾土也。用六君子汤加木香治之而痊。
一妇人，吐痰，头晕，带下青黄。用四七汤送白丸子，小柴胡汤加白术、茯苓治之而安。
人身上中下有块，是痰也。问其平日好食何物？吐下后方用药。
若头面颈颊身中有结核，不痛、不红、不作脓者，皆痰注也，宜随处用药消之。
我按语：前症若脾肺气逆，而痰滞于肉里，或散，或作肉色不变，亦不作痛，按之不硬，此为痰核，宜推其因，而治其本，则痰自消。若因郁怒，亏损肝脾，或因暴怒，触动肝胆经火，以致血病结核，或筋挛于项侧耳前后，或胸胁肿痛，或发寒热，此为瘰疬，宜用柴胡清肝散加钩藤、山栀，以养血气、清肝火。若肉色不变，晡热内热，属肝经血虚火旺，宜用逍遥散加龙胆草，以养肝血、清肝火。或结于肢节，或累累如贯珠，其色不变，亦为肝火血燥而筋挛，宜用柴芍参苓散加钩藤以养血气，佐以六味地黄丸以生肾水。
儒者杨泽之，性躁好色，缺盆结一核。这是肝火血燥筋挛，法当滋肾水、生肝血。他不信，乃内服降火化痰，外敷南星、商陆，转大如碗。我用补中益气汤及六味地黄丸，间以芦荟丸，年余元气渐复而肿消。
一妇人，经事不调，肝胆经分结核，如榛如豆，不计其数，肉色不变，大按方痛。或投化痰消毒之药，不按自痛，发热作渴，日晡益甚。我说属肝火之症，用养血、解郁、清肝之药，百余剂诸症已退，惟项核未消；更以当归龙荟丸数服，及四物汤、柴胡、山栀而愈。
一妇人，耳前后结核，耳内微肿，寒热，口苦，用小柴胡汤、山栀、桔梗、川芎，四剂而愈，后因恚怒，耳前后、头两角俱痛，发热憎寒，以小柴胡汤、山栀、川芎、桔梗、羌活，二剂而愈。（详见《外科枢要》。）
滚痰丸攻泻肠胃痰积及小儿食积痰、急惊风痰甚者，最为要药，常宜合备，但须量人虚实而用之。
我按语：滚痰丸是夺旗斩关、回生起死之剂，必痰滞胸膈，秘结不利，形气病气俱实者，乃可用之。或脾气不能摄涎而上泛，或肾气不能摄水而上溢，苟误认为实痰而用之，祸在反掌，江南人尤慎之。
一妇人，元气素弱，痰气时作，或咽间不利，或胸痞等症。我以为郁结伤脾，用加味归脾汤治之而愈。后遇恚怒，前症仍作，惑于众言，以为痰饮，妄用祛痰之剂，吐泻数次，变诸异症，口噤不醒。我以为脾胃复伤，日用六君子汤一剂，米饮浓煎，常服匙许，至四日渐进粥食，乃服前药，间以归脾汤，喜其善调养，两月余诸症悉愈。
Phlegm belongs to the category of damp-heat, transformed from body fluids. Due to invasion by wind-cold-damp-heat pathogens, or injury from seven emotions and diet, leading to rebellious qi and turbid fluids, it transforms into phlegm-fluids. It may be vomited or coughed up, stagnate in the stomach and diaphragm, accumulate in the intestines and stomach, lodge in the meridians and limbs, and rise and fall with qi, reaching every part of the body without exception. The diseases it causes include: asthma, cough, nausea and vomiting, fullness and obstruction, Guan-Ge (obstruction syndrome) and other abnormal conditions, diarrhea, dizziness, gastric discomfort, palpitations, fright and anxiety, manic-depressive psychosis, alternating chills and fever, pain and swelling; or rumbling sounds in the chest, a cold sensation at a specific point on the back, or numbness and insensitivity in the limbs. All these are caused by phlegm. In many of the hundred diseases, there are cases complicated by phlegm, which people often do not realize.
There is a difference between new and old phlegm, and between mild and severe cases. New and mild phlegm is clear in color and form, and faint in odor; old and severe phlegm is yellow, turbid, thick and sticky, difficult to cough out, gradually developing foul tastes such as sour, spicy, fishy, musky, salty, and bitter, and even containing blood.
Treatment methods: Phlegm originates in the spleen and stomach, so one should strengthen the spleen and dry dampness. Since phlegm rises with qi, regulating qi should come first, followed by separating and guiding. Qi rising is often related to fire, so regulating qi lies in descending fire. For heat-phlegm, clear it; for damp-phlegm, dry it; for wind-phlegm, disperse it; for stagnant-phlegm, open it; for stubborn-phlegm, soften it; for food stagnation-phlegm, resolve it. For phlegm located above, use emesis; for phlegm in the middle, use purgation. Additionally, for deficiency of middle qi, secure the middle qi to transform phlegm; if attack is too heavy, stomach qi becomes deficient and phlegm increases.
Main Formula: Er Chen Tang (Orange Peel and Pinellia Decoction)
Ju Hong (Exocarpium Citri Reticulatae), Ban Xia (Rhizoma Pinelliae Praeparatum, soaked in decoction), Bai Fu Ling (Poria), Zhi Gan Cao (Radix Glycyrrhizae Preparata), Sheng Jiang (Rhizoma Zingiberis Recens).
The above formula treats phlegm throughout the body. To guide medicine downward, add descending agents; to guide medicine upward, add ascending agents.
For excessive damp-phlegm with softness, such as physical fatigue, add Cang Zhu (Rhizoma Atractylodis Macrocephalae) and Bai Zhu (Rhizoma Atractylodis Macrocephalae); for cold-phlegm obstructing the chest, double the dose of Ban Xia, and in severe cases add Ma Huang (Herba Ephedrae), Xi Xin (Radix et Rhizoma Asari), and Wu Tou (Radix Aconiti Lateralis Preparata).
My commentary: Phlegm is the body fluid of the spleen and stomach. It arises from dietary injury or disturbance by seven emotions and six excesses, causing qi stagnation and phlegm accumulation. The proverb says "fat people have much phlegm," but thin people also have phlegm. Why? The spleen governs blood and moves qi. If qi and blood are abundant, where would phlegm come from? This is due to excessive thinking and dietary injury damaging the meridians. When spleen blood is deficient, stomach qi stands alone. Spleen is Ji Earth, Stomach is Wu Earth; Wu and Gui transform into fire. Thus, dampness transforms via qi into phlegm, hence the abundance of phlegm. Phlegm travels throughout the body. When phlegm-qiang is strong, the pathogen defeats the host. If it deprives the great collateral of the spleen of qi, sudden collapse occurs, known as Phlegm Jue (syncope). Rising to the lung, it causes asthma and cough; confusing the heart, it causes palpitations and confusion; moving to the liver, it causes dizziness, numbness, and hypochondriac distending pain; affecting the kidney, it causes excessive saliva without yawning; staying in the stomach, it causes vomiting, diarrhea, and chills/fever; pouring into the chest, it causes throat obstruction and supraorbital pain; entering the intestines, it causes gurgling sounds; scattered it makes noise, aggregated it causes obstruction. I believe that if spleen qi is weak and cannot transform dampness, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fu Ling and Ban Xia; if caused by spleen deficiency with damp-heat, use Dong Yuan Qing Zao Tang (Dong Yuan's Clear Dryness Decoction); if due to stomach qi deficiency with cold-phlegm stagnation, use Ren Shen Li Zhong Tang (Ginseng Regulate the Middle Decoction); if due to spleen-stomach deficiency-cold with phlegm stagnation, use Li Zhong Hua Tan Wan (Regulate the Middle Transform Phlegm Pill); if due to spleen deficiency with phlegm stagnation and rebellious qi, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Mu Xiang; if due to spleen-stomach weakness with liver wood overacting, use Liu Jun Zi Tang plus Chai Hu; for headache, use Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes, and Gastrodia Decoction); if due to spleen-kidney weakness with cold pathogen causing headache, use Fu Zi Xi Xin Tang (Aconite and Asarum Decoction).
For wind-phlegm, add Nan Xing (Rhizoma Arisaematis Cum Bile), Zhi Qiao (Fructus Aurantii), Bai Fu Zi (Rhizoma Typhonii), Tian Ma (Rhizoma Gastrodiae), Jiang Can (Bombyx Batryticatus), and Zhu Ya Zao Jiao (Semen Gleditsiae Sinensis). For qi deficiency, add Zhu Li (Nodus Bambusae in Taedia); for qi excess, add Jing Li (Nodus Bambusae in Taedia), both taken with Jiang Zhi (Zingiberis汁).
My commentary: Mai Jue states: "Heat generates wind," thus saying "wind comes from fire." If wind pathogen causes qi stagnation and phlegm accumulates in the chest, this method is suitable; if phlegm is generated by wind-heat in the lung meridian, use Jin Fei Cao San (Boiling Grass Powder); if phlegm is generated by intense wind-heat in the liver meridian due to wind-fire conflict, use Niu Huang Bao Long Wan (Calculus Bovis Encasing Dragon Pill) or Niu Huang Qing Xin Wan (Calculus Bovis Clear Heart Pill); if phlegm is generated by liver blood dryness, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia); if phlegm is generated because heat controls metal and fails to subdue wood, use Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder); if phlegm is generated because middle qi is weak and cannot transform, use Liu Jun Zi Tang, Chai Hu, and Gou Teng.
For heat-phlegm, add Huang Qin (Radix Scutellariae) and Huang Lian (Rhizoma Coptidis). If phlegm rebels upward due to excessive fire, descending fire is priority; add Bai Zhu, Huang Qin, Ruan Shi Gao (Gypsum Fibrosum), and Huang Lian. For dizziness and gastric discomfort, which are fire stirring phlegm, also add Shan Zhi (Fructus Gardeniae), Huang Qin, and Huang Lian.
My commentary: The previous formulas are suitable for excess fire in the lungs and stomach; for wind-cold with constrained heat, use Shen Su Yin (Ginseng and Perilla Decoction) plus Shan Zhi and Pian Qin; for middle qi deficiency with heat, use Bu Zhong Yi Qi Tang plus Ban Xia and Jie Geng; for kidney deficiency with yin fire flaming upward, use Liu Wei Di Huang Wan; for kidney qi deficiency with cold-phlegm surging upward, use Ba Wei Di Huang Wan (Eight-Ingredient Pill with Rehmannia).
For blood deficiency with phlegm, add Tian Men Dong (Radix Asparagi), Zhi Mu (Rhizoma Anemarrhenae), Gua Lou Ren (Semen Benincasae), Xiang Fu Mi (Rhizoma Cyperi), Zhu Li, and Jiang Zhi; if bleeding is present, add Huang Qin, Bai Shao Yao (Radix Paeoniae Alba), and Sang Bai Pi (Cortex Mori Radicis); if blood stagnation prevents flow and there is fluid retention in the middle jiao, take Zhu Li mixed with fresh juice of Sheng Jiang and Jiu Cai, drinking three to five cups; gastric irritability will occur, then self-healing follows.
My commentary: The previous formulas consist of bitter-cold, sweet-cold, and pungent-warm herbs to descend fire, transform phlegm, move qi, and break blood stasis. One must examine whether the disease matches the medicine before taking it. Stop when the disease is 60-70% resolved; overdosing damages middle qi and worsens the condition. Generally, internal causes belong to spleen-stomach weakness; investigate the cause and nourish. Heavy dosages again damage stomach qi, causing multiple deficiency syndromes.
For qi deficiency with phlegm, add Ren Shen (Radix Ginseng) and Bai Zhu; for spleen deficiency, strengthen middle qi to transform and descend phlegm, adding Bai Zhu, Bai Shao Yao, Shen Qu (Massa Medicata Fermentata), Mai Ya (Fructus Hordei Germinatus), and concurrently use Sheng Ma (Rhizoma Cimicifugae) to lift. For internal injury with phlegm, add Ren Shen, Huang Qi (Radix Astragali), and Bai Zhu, transmitted with Jiang Zhi, or adding Zhu Li is more effective.
My commentary: For previous symptoms due to spleen-lung qi deficiency failing to transform phlegm, use Liu Jun Zi Tang plus Mu Xiang; for lung qi deficiency failing to clear and transform, use Liu Jun Zi Tang plus Jie Geng; for phlegm with blood due to spleen meridian qi stagnation, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction); for phlegm with blood due to liver meridian blood heat, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder); for phlegm with blood due to liver-kidney yin deficiency, use Liu Wei Di Huang Wan; for spitting phlegm with blood due to excessive intake of cold-cooling agents, use Si Jun Zi Tang (Four Gentlemen Decoction) as the main treatment.
For food stagnation-phlegm, add Shen Qu, Mai Ya, Shan Zha (Fructus Crataegi), Chao Huang Lian (Rhizoma Coptidis stir-fried), and Zhi Shi (Fructus Aurantii Immaturus) to resolve it. In severe cases, purgation is necessary, using pills. If combined with blood deficiency, use tonics to deliver the medicine; if phlegm is in the middle jiao, it is also food stagnation, and stomach qi relies on nourishment; if attacked completely, deficiency results.
My commentary: For previous symptoms where original qi was originally solid, accidentally caused by overeating, use the main formula to digest retained stagnation. Food-phlegm is mostly due to spleen deficiency making food hard to digest and turning into phlegm; blood deficiency is mostly due to spleen qi weakness failing to generate blood. All should regulate and tonify spleen-stomach qi, eliminating food stagnation and generating blood naturally. Thus, Li Dong Yuan said: If spleen-stomach qi is excess, use Huang Lian and Zhi Shi to purge; if deficient, use Bai Zhu and Chen Pi to tonify. The formulas use Shen Qu and Mai Ya, discussed in the upper volume.
Shen Wenji's mother, a student at the provincial academy, ate wet noodles, experienced acid regurgitation, vomiting, and anorexia. After taking Huang Qin and Huang Lian preparations, she developed chills and fever, dry mouth, and salivation. Eating a small piece of winter melon made vomiting worse. I said this is spleen qi deficiency and cold. Urgently apply salt, Ai Ye (Folium Artemisiae Argyi), and Fu Zi (Radix Aconiti Lateralis Preparata) heated, moxa-fuming the umbilicus and abdomen. Also, use her son's breath to connect with her spirit, slightly reviving her. Make powder of Ren Shen, Bai Zhu, Fu Zi, and Chen Pi, pill size of millet grains, swallow 5-7 grains with saliva, increasing to over ten the next day, gradually taking 1-2 spoons of decoction, then desiring porridge. With 50+ doses of Ren Shen and Bai Zhu, she recovered. (See *Nei Ke Yao Yao*).
If there is an object in the throat, impossible to spit out or swallow, this is phlegm knot. Use medicine to dissolve it, adding salty herbs to soften hardness, such as Gua Lou Ren, Xing Ren (Semen Armeniacae Amarum), Hai Shi (Lapis Calcitae), Jie Geng, Lian Qiao (Fructus Forsythiae), and Xiang Fu, with a little Po Xiao (Natrii Sulfas) and Jiang Zhi, refined honey and pill, held in the mouth. If pulse is choppy, opening is difficult and requires long regulation. For excess qi and heat-phlegm knot, difficult to spit out, or forming clumps, qi stagnation is hard to treat.
My commentary: This formula treats fullness of form and symptoms. Previous symptoms include those injuring yin blood due to spleen meridian depression; those with yin fire flaming upward due to kidney water deficiency; those with phlegm generated by spleen-lung fire depression. Treatment: For seven emotions depression with phlegm-saliva stuck in the throat, first use Ju Fang Si Qi Tang (Four Seven Decoction from the Bureau) to harmonize stagnant qi, then use Gui Pi Tang to tonify spleen blood. For spleen fire injuring blood, use Jia Wei Gui Pi Tang; for kidney water deficiency, use Liu Wei Di Huang Wan; for lung meridian depressed fire, use Zhi Mu Fu Ling Tang. For women with this condition plus leukorrhea, all due to depression injuring liver-spleen, assist with Si Qi Tang delivered with Qing Zhou Bai Wan Zi (Qingzhou White Pills). These syndromes have spleen-stomach qi deficiency as root and qi stagnation-phlegm knot as branch. Ancient formulas like Shi Zao Tang (Ten Date Decoction), Kong Xian Dan (Control Fluid Pellet), Shen You Wan (Divine Protection Pill), Gun Tan Wan (Rolling Phlegm Pill), Yi Xiang Zhi Shi (Rare Fragrant Aurantium), Li Ge Di Tan (Clear Diaphragm Eliminate Phlegm), Tou Luo Po Yin (Penetrate Net Break Fluid), Jiang Qi Hua Tan (Descend Qi Transform Phlegm) decoctions, and Su He Xiang Wan (Styrax Pill) are medicines for fullness of form and disease. People in the northwest use them with good results. Those who are deficient develop abdominal distension and die.
Li Beiquan, Grand Secretary, frequently spat phlegm-saliva, had internal heat and thirst, limb fatigue, and hot feet after exertion. I said: This is kidney water flooding transforming into phlegm, method should tonify kidney. He did not believe, used another phlegm-resolving decoction and Gun Tan Wan, resulting in vomiting, diarrhea, anorexia, dizziness, and closed eyes. I used Liu Jun Zi Tang for several doses, stomach qi gradually recovered; used Liu Wei Di Huang Wan, various symptoms gradually healed.
A scholar, with severe cough and phlegm, chest-abdominal discomfort, poor appetite, limb fatigue, floating-large pulse, weak upon pressure. Taking Er Chen Tang and Zhi Qiao worsened it. I said: This is spleen-lung-kidney deficiency. Used Bu Zhong Yi Qi Tang and Liu Wei Di Huang Wan, and he recovered.
If phlegm is in the intestines and stomach, it can be cured by purgation, using Zhi Shi, Gan Sui (Radix Kansui), Ba Dou (Semen Crotonis), Da Huang (Radix et Rhizoma Rhei), and Mang Xiao (Natrii Sulfas). If phlegm is outside the spleen membrane, only Jiang Zhi and Zhu Li can reach it; in the limbs, only Zhu Li can open it; in the meridians, also use Zhu Li, assisted by Jiang and Jiu Cai juice. If phlegm is in the diaphragm, or manic-depression, or amnesia, or wind-phlegm, all use Zhu Li, same effect as Jing Li. For qi deficiency with little eating, use Zhu Li; for qi excess with good eating, use Jing Li. If phlegm is in the hypochondrium, only Bai Jie Zi (Semen Sinapis Albae) can reach it.
My commentary: Previous symptoms are mostly due to improper diet, lifestyle, and seven emotions, consuming original qi, moving internal fire and causing disease. Seek the origin and treat the root. The previous methods are harsh agents; only use if form and qi are clearly full. First examine disease form, pulse, and symptoms to know the pathogen, treating according to exterior-interior, upper-lower, deficiency-excess. Cold and deficiency complications must be considered.
A scholar, with spleen qi deficiency, vomiting phlegm-saliva, abdominal distension after anger, poor appetite. Left Guan pulse string-long, weak upon pressure; Right Guan pulse string-long, weak upon pressure. This is wood overcoming earth. Treated with Liu Jun Zi Tang plus Chai Hu, Shan Zhi, and Mu Xiang, and recovered.
A woman, with spleen-stomach weakness, usually little food intake, suddenly phlegm congestion and asthma, head shaking, eye rolling, hand waving, foot kicking, difficult to feel pulse. Face color yellow mixed with green. This is liver wood overacting on spleen-stomach. Treated with Liu Jun Zi Tang plus Chai Hu and Sheng Ma, revived; further regulated with Bu Zhong Yi Qi Tang plus Ban Xia, and recovered.
For old phlegm, use Hai Shi, Ban Xia, Gua Lou Ren, Xiang Fu Mi, and Lian Qiao. Wu Bei Zi (Galla Chinensis) assists other herbs, greatly treating stubborn phlegm, suitable as pills.
My commentary: For previous symptoms where spleen qi is congested and phlegm lodges in the middle jiao, first use this formula to treat phlegm, then use Liu Jun Zi Tang to tonify spleen qi, phlegm will disappear. If initially failing to treat phlegm thoroughly, spleen qi becomes more deficient, fluids do not move, and phlegm increases.
A man, spitting phlegm, chest-diaphragm discomfort, poor appetite, taking Hai Shi and Gua Lou, ineffective. I said: This is spleen qi deficiency, unable to digest and transform into phlegm, should focus on strengthening spleen. He did not believe, took expelling agents, phlegm surged, limbs swollen, lower abdomen swollen, urine difficult. I said: This is re-injuring spleen-kidney. First treated with Jin Gui Jian Shen Qi Wan (Golden Cabinet Kidney Qi Modified Pill) and Bu Zhong Yi Qi Tang, symptoms gradually decreased; then used Ba Wei Wan combined with previous decoction, and recovered.
A man, usually spitting phlegm, phlegm worsens after anger, chest-diaphragm fullness. This is liver controlling spleen earth. Treated with Liu Jun Zi Tang plus Mu Xiang, and recovered.
A woman, usually depressed, stomach-diaphragm not wide, spitting phlegm like glue. Treated with Jia Wei Gui Pi Tang, and healed.
A woman, spitting phlegm, dizziness, yellow-green leukorrhea. Treated with Si Qi Tang delivering Bai Wan Zi, and Xiao Chai Hu Tang plus Bai Zhu and Fu Ling, and stabilized.
Lumps in the upper, middle, or lower body are phlegm. Ask what foods they usually like? After emesis and purgation, then use medicine.
If nodules appear in head, face, neck, cheeks, or body, non-painful, non-red, non-suppurating, all are phlegm deposits, use medicine locally to resolve them.
My commentary: For previous symptoms where spleen-lung qi rebels and phlegm stays in muscles, scattered or unchanged skin color, non-painful, non-hard upon pressure, these are phlegm nodules. Investigate the cause and treat the root, phlegm will disappear. If due to depression and anger, injuring liver-spleen, or violent anger stirring liver-gallbladder fire, causing blood disease nodules, or tendon spasms at neck sides and ear fronts, or chest-hypochondriac swelling and pain, or chills and fever, these are Luoli (scrofula). Use Chai Hu Qing Gan San (Bupleurum Clear Liver Powder) plus Gou Teng and Shan Zhi to nourish blood-qi and clear liver fire. If skin color unchanged, afternoon fever and internal heat, belonging to liver blood deficiency and fire hyperactivity, use Xiao Yao San plus Long Dan Cao (Radix Gentianae) to nourish liver blood and clear liver fire. Or nodules at joints, bead-like, unchanged color, also liver fire and blood dryness causing tendon spasms, use Chai Shao Shen Ling San (Bupleurum, Peony, Ginseng, and Poria Powder) plus Gou Teng to nourish blood-qi, assisted by Liu Wei Di Huang Wan to generate kidney water.
Scholar Yang Zezhi, irritable and lustful, had a nodule in the collarbone depression. This is liver fire, blood dryness, and tendon spasm. Method should nourish kidney water and generate liver blood. He did not believe, internally took fire-descending and phlegm-transforming medicine, externally applied Nan Xing and Shang Lu (Radix Phytolaccae), turning large as a bowl. I used Bu Zhong Yi Qi Tang and Liu Wei Di Huang Wan, interspersed with Lu Hui Wan (Aloe Pill), over a year original qi gradually recovered and swelling subsided.
A woman, irregular menstruation, nodules in liver-gallbladder meridians, like hazelnuts and beans, countless, unchanged skin color, painful only upon deep pressure. Or giving phlegm-resolving and detoxifying medicine, spontaneous pain without pressure, fever and thirst, worsening at dusk. I said this is liver fire syndrome. Used blood-nourishing, depression-resolving, and liver-clearing medicine, over 100 doses symptoms retreated, only neck nodules remained; further took Dang Gui Long Hui Wan (Angelica and Gardenia Pill) several times, and Si Wu Tang, Chai Hu, and Shan Zhi, and recovered.
A woman, nodules around ears, slight ear swelling, chills and fever, bitter taste, treated with Xiao Chai Hu Tang, Shan Zhi, Jie Geng, and Chuan Xiong (Radix Ligustici Chuanxiong), four doses and recovered. Later due to anger, pain around ears and two corners of head, fever and aversion to cold, treated with Xiao Chai Hu Tang, Shan Zhi, Chuan Xiong, Jie Geng, and Qiang Huo (Radix Notopterygii), two doses and recovered. (See *Wai Ke Shu Yao*).
Gun Tan Wan attacks and purges intestinal and gastric phlegm accumulation, pediatric food-stagnation-phlegm, and severe acute convulsive phlegm, is the most important medicine, always prepare, but must measure person's deficiency-excess before use.
My commentary: Gun Tan Wan is a life-saving agent of seizing flags and breaking gates. Only usable for phlegm stagnating in chest-diaphragm, constipation and difficulty, where form, qi, and disease qi are all excess. Or spleen qi cannot control saliva and it floods upward, or kidney qi cannot control water and it overflows. Mistakenly using it for excess phlegm brings disaster instantly; Jiangnan people especially caution against it.
A woman, originally weak original qi, phlegm-qiang occasionally acting, throat discomfort, chest fullness, etc. I thought depression injured spleen, treated with Jia Wei Gui Pi Tang, and recovered. Later met anger, previous symptoms returned, confused by public opinion, thought it was phlegm-fluid, wrongly used phlegm-resolving agents, vomited and diarrhea several times, changed to various strange symptoms, jaw locked and unconscious. I thought spleen-stomach re-injured. Daily used one dose of Liu Jun Zi Tang, thick decoction with rice drink, spoonfuls frequently taken. By fourth day, gradually advanced to porridge food, then took previous medicine, interspersed with Gui Pi Tang. Glad of her good nourishment, over two months all symptoms healed.