天南星，味苦、辛，气平，可升可降，阴中阳也，有毒。入脾、肺、心三经。善能化痰，
利
膈下气，散瘀血，坠胎，破坚积，消痈肿，治中风不语，极能开关，兼治破伤风。又斩关夺
门之将，可一用，而不可再用也。三生饮用之，佐附子以出奇，祛痰而化滞，非借其清肺而
安心，故只可暂用耳。虽然三生饮中，若无人参为君，则附子、南星皆无用矣。即一三生饮
，可以悟用药之妙也。
或问天南星消顽痰以开关，破积坚捣 ，其勇往之气，实又藉附子以鼓勇，无附子，恐
不能
如是之猛矣。或三生饮不可常用，在他方或可以常用乎？盖消痰之药，未有如南星峻猛者也
。中风闭关，不得不用之斩关直入。若其他痰病，原未有关之坚闭，又何必用南星哉。
半夏，味辛、微苦，气平，生寒，熟温，沉而降，阴中阳也。入胆、脾、胃三经。研末，
每
一两，用入枯矾二钱、姜汁一合，捏饼，楮叶包裹，阴干，又名半夏曲也。片则力峻，曲则
力柔，统治痰涎甚验。无论火痰、寒痰、湿痰、老痰与痰饮、痰核、痰涎、痰结、痰迷，俱
可用，但不可治阴火之痰。孕妇勿用，恐坠胎元。然有不可不用之时，暂用亦无碍。吐血家
亦不可用，恐性愈动火也。片半夏为末，吹鼻中，可救五绝，并产后血晕甚效。
人身原无痰也，饮食入胃，化精而不化痰。惟肾中真火虚，则火沸为痰，亦肾之真水虚，
则
水泛为痰矣。火沸为痰与水泛为痰，虽原于肾，而痰乃留于脾也。半夏既治痰，岂难消化，
况痰已入脾中，安在不能化之。然而终不能消者，以其能消已入脾中之痰，而不能断其将入
脾中之痰也。盖肾中之痰也，必须肾气丸，始得逐之，非半夏所能祛也，半夏泄痰之标，不
能治痰之本。半夏性沉而降，似乎能入至阴之中，然而阳多于阴，止可浅入脾阴，而不能深
入肾阴也。况半夏泻阴而不补阴，而肾又可补而不可泻，半夏欲入于肾，而肾所以不受也。
半夏既不能入肾之内，又何以化肾中之痰哉。可见痰在脾为标，痰在肾为本，以脾之痰出于
肾也。消脾之痰，不可以见标本之异哉。
肾气丸治痰，是择其本也。水不上泛为痰，何必更消其痰。火不上沸为痰，何必再清其
痰。
用肾气丸而痰已绝。用半夏以治标，恐及动其祛痰也。半夏燥气之药，再耗肾中之气，气一
耗，则火动水燥，不生精而生痰，势所必至，不特无益，反害之矣。故既治本，不必更治标
也。
或疑半夏性燥，故便子治湿痰也，不识用何药以制其燥，并可以治热痰乎？夫燥湿之性
各殊
，虽制之得宜，只可去其大过，而不能移其性也。然而未制其燥，与已制其燥，自然少异。
铎有制法，并传于此。用半夏一斤、生姜片四两，先煮数沸，取起晒干。用桑叶一百片，水
十碗，煎汁二碗，将半夏泡透，又晒干。复用盐一两、滚水一碗，又泡透，切片用之，则燥
性去其六，湿之性得其四。寒热之痰，与水火泛沸之痰，俱可少用，以为权宜之计矣。然又
只可暂用，而不可据之为久治也。
或疑制半夏，以治燥热之痰妙矣，恐反不宜于寒湿之痰，奈何？此则无容虑也。半夏性
燥，
治寒湿之痰正宜，制过燥，而无伤气之忧与损肺之失，可用之而无恐也。
或疑半夏治湿痰，而不可治燥痰；治寒痰，而不可治热痰，俱闻命矣。痰之中更有吐黑
痰者
，其故何也？吾观其人则甚健，谓是火而口不渴，谓是虚而肾不亏，又可以半夏治之乎？此
乃
邪结于肾之中，非痰塞于肺之窍也。此症本起于久旷之夫，思女色而不可得，又不敢御外色
以泄精，于是邪入于肾中，精即化痰，而若吐有如墨之黑者矣。宜用于降火之药，佐之白芥
子以消痰，而更用于荆芥之类，以散其火于血分之中。否则，必有失血之患，温疟之苦矣。
数剂之后，身必畏寒，然后用于加味逍遥散，大用于半夏，以清于其表里之邪，则寒热乃除
去，而黑痰又乃以渐愈矣也。此等之病症，尝实亲试之，而往往有效验也，故敢论之于书也
。
天南星，味道苦、辛，药性平，既能上升又能下降，属于阴中涵阳的药物，有毒。归入脾、肺、心三经。善于消除痰浊，疏通膈下气机阻滞，消散瘀血，导致堕胎，破除坚硬的积块，消除痈肿，治疗中风后不能言语，极能开通闭塞，兼治破伤风。它又像是一位斩关夺门的猛将，可以使用一次，但不能反复使用。在三生饮中使用它，是借助附子来出奇制胜，祛除痰浊并化解停滞，并不是依靠它来清肺安心，所以只能暂时使用罢了。虽然在三生饮中，如果没有人参作为主药，那么附子和天南星都起不到作用了。仅从这一张三生饮，就可以领悟用药的奥妙了。
有人问：天南星消除顽固痰浊以开通闭塞，破除坚硬积块，其勇往直前的气势，实际上是借助附子来鼓动勇气，没有附子，恐怕不能如此猛烈。或者三生饮不可常用，在其他方剂中可以常用吗？大概消除痰浊的药物，没有比天南星更峻猛的了。中风导致闭塞不通，不得不使用它来斩关直入。如果是其他痰病，原本并没有坚固闭塞的情况，又何必使用天南星呢。
半夏，味道辛、微苦，药性平，生用性寒，熟用性温，沉降而降泄，属于阴中涵阳的药物。归入胆、脾、胃三经。研成粉末，每用一两，加入枯矾二钱、姜汁一合，捏成饼状，用楮叶包裹，阴干，又名半夏曲。片状的半夏药力峻猛，曲状的半夏药力柔和，治疗痰涎非常有效。无论是火痰、寒痰、湿痰、老痰，还是痰饮、痰核、痰涎、痰结、痰迷，都可以使用，但不可治疗因阴虚火旺引起的痰。孕妇不要使用，恐怕会导致堕胎。然而有不得不用的时候，暂时使用也无妨碍。吐血患者也不可使用，恐怕其药性会进一步煽动火热。将片状半夏研末，吹入鼻中，可以救治五绝症，对产后血晕也非常有效。
人体原本没有痰，饮食进入胃中，化为精微而不化为痰。只有肾中真火虚弱，则火沸腾化为痰；或者是肾中真水虚弱，则水泛滥化为痰。火沸腾化为痰和水泛滥化为痰，虽然根源在于肾，但痰却停留在脾脏。半夏既然能治疗痰，难道难以消化吗？况且痰已经进入脾中，怎么就不能化除呢。然而终究不能完全消除的原因，是因为它能消除已经进入脾中的痰，而不能阻断即将进入脾中的痰。对于肾脏中的痰，必须使用肾气丸，才能将其驱逐，这不是半夏所能祛除的，半夏只能泻除痰浊的表象，不能治疗痰的根本。半夏药性沉降，似乎能进入至阴之地，然而其阳多于阴，只能浅入脾阴，而不能深入肾阴。况且半夏泻阴而不补阴，而肾脏只可补不可泻，半夏想要进入肾脏，而肾脏因此不接受它。半夏既然不能进入肾脏内部，又怎么能化除肾脏中的痰呢？由此可见，痰在脾脏表现为标，痰在肾脏表现为本，因为脾的痰来源于肾。消除脾的痰，不可以因为标本不同而有所区别啊。
肾气丸治疗痰，是选择治本的方法。如果水不向上泛溢成为痰，何必再去消除痰？如果火不向上沸腾成为痰，何必再去清热化痰？使用肾气丸而痰自然绝迹。如果使用半夏来治标，恐怕会触动根本，损害祛痰的效果。半夏是燥气的药物，再耗损肾中的气，气一旦耗损，则火动水燥，不生精微而生痰，这是必然的趋势，不仅无益，反而有害。所以既然治本，就不必再治标了。
有人怀疑半夏性燥，所以适宜治疗湿痰，不知道用什么药来制约它的燥性，并且可以治疗热痰吗？燥和湿的性质各不相同，即使制约得当，也只能去除其过度的部分，而不能改变其本性。然而未经制约的燥性和经过制约的燥性，自然略有差异。我有制约的方法，一并传述于此。使用半夏一斤、生姜片四两，先煮数沸，取出晒干。使用桑叶一百片，水十碗，煎取汁液二碗，将半夏浸泡透彻，又晒干。再用盐一两、滚水一碗，再次浸泡透彻，切片使用，这样燥性去除了六成，湿性保留了四成。寒热之痰，以及水火泛沸之痰，都可以少量使用，作为权宜之计。然而也只可暂时使用，不能作为长期治疗的依据。
有人怀疑经过制约的半夏，治疗燥热之痰很巧妙，恐怕反而不适合寒湿之痰，怎么办？这则无需忧虑。半夏性燥，治疗寒湿之痰正合适，经过制约后，没有伤气和损肺的担忧，可以放心使用。
有人怀疑半夏治疗湿痰，而不能治疗燥痰；治疗寒痰，而不能治疗热痰，都已经听明白了。痰之中还有吐出黑痰的，这是什么原因？我看其人身体很健壮，说是火邪但口不渴，说是虚证但肾不亏虚，可以用半夏治疗吗？这是邪气结聚在肾脏内部，不是痰阻塞于肺窍。此症本来起因于长期独居的男子，思慕女色而不可得，又不敢与外室女子交合以泄精，于是邪气进入肾脏，精气即化为痰，从而吐出如墨汁般的黑痰。适宜使用降火的药物，佐以白芥子来消痰，并且配合荆芥之类，以散解血分中的火热。否则，必定会有失血的祸患，以及温疟的痛苦。服用数剂之后，身体必定畏寒，然后使用加味逍遥散，大量使用半夏，以清除表里的邪气，那么寒热就会除去，黑痰也会逐渐痊愈。这种病症，我曾经亲自尝试过，往往有疗效，所以敢在书中论述它。
Arisaema (Tian Nan Xing), with bitter and acrid flavors, neutral nature, capable of ascending and descending, belongs to yang within yin, and is toxic. It enters the Spleen, Lung, and Heart meridians. It excels at resolving phlegm, unblocking Qi stagnation below the diaphragm, dispersing blood stasis, inducing abortion, breaking down hard accumulations, eliminating carbuncles and swellings, treating aphasia due to wind-stroke, opening orifices extremely well, and treating tetanus. It is like a general who breaches gates and seizes doors; it can be used once, but not repeatedly. In San Sheng Yin (Three Lives Decoction), it is used with Aconite (Fu Zi) to achieve unexpected results, dispelling phlegm and transforming stagnation, not relying on it to clear the lungs and calm the mind, thus it should only be used temporarily. Although in San Sheng Yin, without Ginseng (Ren Shen) as the sovereign drug, both Aconite and Arisaema would be ineffective. From this single prescription of San Sheng Yin, one can comprehend the subtleties of herbal combination.
One may ask: Arisaema resolves stubborn phlegm to open orifices and breaks down hard accumulations; its courageous momentum actually relies on Aconite to鼓动 courage. Without Aconite, it might not be so fierce. Or perhaps San Sheng Yin cannot be used frequently; can it be used frequently in other formulas? Generally, among drugs that resolve phlegm, none are as harsh and fierce as Arisaema. Wind-stroke causes closure, necessitating its use to breach the gate and enter directly. If it is other types of phlegm diseases, where there is originally no firm closure, why use Arisaema?
Pinellia (Ban Xia), with acrid and slightly bitter flavors, neutral nature, cold when raw and warm when cooked, sinking and descending, belongs to yang within yin. It enters the Gallbladder, Spleen, and Stomach meridians. When ground into powder, for every one tael, add two qian of Alum (Ku Fan) and one he of Ginger Juice (Jiang Zhi), knead into cakes, wrap in Broussonetia leaves (Chu Ye), and dry in shade, also known as Pinellia Qu (Ban Xia Qu). The sliced form has fierce potency, while the fermented cake form has mild potency, both being very effective in treating salivary phlegm. Whether fire-phlegm, cold-phlegm, damp-phlegm, old-phlegm, or phlegm-fluids, phlegm-nodules, salivary phlegm, phlegm-knots, or phlegm-confusion, they can all be treated, but it cannot treat phlegm caused by deficiency-fire. Pregnant women should avoid using it, fearing it may induce abortion. However, when absolutely necessary, temporary use is harmless. Patients with hemoptysis should also avoid it, fearing its nature may further stir up fire. Powdered sliced Pinellia blown into the nose can rescue cases of five types of death-like states and is very effective for postpartum blood fainting.
The human body originally has no phlegm; food and drink enter the Stomach, transform into essence, and do not transform into phlegm. Only when the true fire in the Kidney is deficient does the fire boil and transform into phlegm; or when the true water in the Kidney is deficient, does the water overflow and transform into phlegm. Fire boiling into phlegm and water overflowing into phlegm, although originating from the Kidney, the phlegm remains in the Spleen. Since Pinellia treats phlegm, how could it be difficult to digest? Moreover, since the phlegm has entered the Spleen, how can it not be transformed? However, the reason it ultimately cannot eliminate it completely is that it can eliminate phlegm that has already entered the Spleen, but cannot cut off the phlegm that is about to enter the Spleen. For phlegm in the Kidney, Kidney Qi Pill (Shen Qi Wan) must be used to drive it out; this is beyond Pinellia's ability to dispel. Pinellia drains the branch of phlegm but cannot treat the root of phlegm. Pinellia's nature is sinking and descending, seemingly able to enter the utmost yin, yet its yang exceeds its yin, allowing it to only shallowly enter Spleen-yin, but not deeply enter Kidney-yin. Furthermore, Pinellia drains yin but does not tonify yin, while the Kidney can only be tonified, not drained. Pinellia desires to enter the Kidney, but the Kidney does not accept it. Since Pinellia cannot enter the interior of the Kidney, how can it transform phlegm within the Kidney? Thus, it is visible that phlegm in the Spleen is the branch, and phlegm in the Kidney is the root, because Spleen phlegm originates from the Kidney. To eliminate Spleen phlegm, one should not distinguish based on branch and root differences.
Kidney Qi Pill (Shen Qi Wan) treats phlegm by addressing the root. If water does not float upward to become phlegm, why eliminate phlegm? If fire does not boil upward to become phlegm, why clear heat and resolve phlegm? Using Kidney Qi Pill causes phlegm to cease naturally. Using Pinellia to treat the branch may disturb the root and hinder phlegm resolution. Pinellia is a drying agent; consuming it further depletes Qi in the Kidney. Once Qi is depleted, fire moves and water dries, failing to generate essence and instead generating phlegm, which is inevitable. This brings not only no benefit but harm. Therefore, if the root is treated, there is no need to treat the branch.
One may doubt that Pinellia's drying nature makes it suitable for damp-phlegm, asking what drug is used to control its dryness and whether it can treat hot-phlegm? The properties of drying and dampening are distinct; even if controlled appropriately, it only removes the excess, but cannot change its nature. However, uncontrolled dryness and controlled dryness differ naturally. I have a method of preparation, which I transmit here. Use one jin of Pinellia and four liang of fresh Ginger slices, boil for several boils, take out and dry. Use one hundred Mulberry leaves (Sang Ye), ten bowls of water, decoct to obtain two bowls of juice, soak Pinellia thoroughly, then dry again. Then use one liang of Salt and one bowl of boiling water, soak thoroughly again, slice and use. This removes sixty percent of its dry nature and retains forty percent of its damp nature. Hot and cold phlegms, as well as phlegms from water and fire boiling over, can all be used in small amounts as a temporary measure. However, it can only be used temporarily and not relied upon for long-term treatment.
One may worry that prepared Pinellia, though excellent for dry-heat phlegm, may not be suitable for cold-damp phlegm. What then? There is no need to worry. Pinellia is drying, making it perfectly suitable for cold-damp phlegm; after processing, the dryness is moderated, avoiding concerns of damaging Qi or harming the Lungs, so it can be used without fear.
One may doubt that Pinellia treats damp-phlegm but not dry-phlegm; treats cold-phlegm but not hot-phlegm, which is understood. Among phlegms, there are those who spit black phlegm; what is the cause? Observing such a person, they appear robust; saying it is fire, the mouth is not thirsty; saying it is deficiency, the Kidneys are not depleted. Can Pinellia treat this? This is evil qi knotting in the interior of the Kidney, not phlegm blocking the orifices of the Lungs. This condition originates from a man who has been celibate for a long time, desiring women but unable to obtain them, and daring not to engage with external women to release essence. Thus, evil qi enters the Kidney, essence transforms into phlegm, resulting in spitting black phlegm like ink. It is appropriate to use drugs that descend fire, assisted by White Mustard Seed (Bai Jie Zi) to resolve phlegm, and further combined with Schizonepeta (Jing Jie) type herbs to dissipate fire in the blood level. Otherwise, there will inevitably be the risk of hemorrhage and the suffering of warm malaria. After several doses, the body will likely feel aversion to cold, then use Modified Xiao Yao Powder (Jia Wei Xiao Yao San), heavily utilizing Pinellia to clear exterior and interior evils, thereby removing cold and heat, and the black phlegm will gradually heal. I have personally tested such conditions and often found them effective, so I dare to discuss them in this book.