论气沉血滞
天师曰∶扬治者，乃气沉而不能上，血滞而不能行是也。气得扬而展舒，血得扬而活动。倘沉抑不
扬，则必有呃逆 废之症。必用药以扬之，则气舒展而血活动也。方用当归三钱，白芍三钱，黄 三
钱，白术三钱，柴胡五分，熟地五钱，升麻五分，人参一钱，茯苓一钱，川芎一钱，水煎服。此八珍汤
也。妙是血气平补，若用甘草而不用黄 ，则不是八珍汤矣。气血平补，既无偏曲，而后以升麻、柴胡扬
之，使血气流动，自无气并血而成 废之症，亦无血并气而成呃逆之症矣。此扬治之不可废也，故又立一
门耳。设止补阳而不补
阴，则阳旺而阴愈消。设止补其阴而不补其阳，则阴旺而阳愈息。故必兼补之，而扬法始为有益，不可
与发散之一类而并观之也。
张公曰∶阐发细微，无可道。
论治初起之痰 已病之痰 久病之痰 论老痰 顽痰
天师曰∶痰治者，痰塞于咽喉之间，虽是小病，而大病实成于此，古人所以另立门以治之。然而所立
之方，皆是治痰之标，不足治痰之本也，故立二陈汤，以治上中下新暂久之病，通治之而无实效也。今另
立三方，一治初起之痰，一治已病之痰，一治久病之痰。痰病虽多，要不能越吾之范围也。初起者，伤风咳
嗽吐痰是也。用半夏一钱，陈皮一钱，天花粉一钱，茯苓一钱，甘草一钱，苏子一钱，水煎服。二剂可以
消痰矣。此方去上焦之痰也。上焦之痰，原止在胃中而不在肺。去其胃中之痰，而肺金气肃，何致火之上升
哉。已病之痰，痰在中焦也。必观其色之白与黄而辨之，最宜分明。黄者，乃火已将退也；白者，火正炽
也。火炽者，宜用寒凉之品∶火将退者，宜加祛逐之品。吾今立一方，俱可治之。白术三钱，茯苓五钱，陈
皮一钱，甘草一钱，白芥子三钱，栀子一钱，火痰加之，枳壳五分，水煎服。此方系健脾之剂，非祛痰之剂
也。然而痰之多者，多由于脾气之湿。今健其脾气，则水湿之气下行，水湿既不留于脾中，又何从而上出，
况又加之消痰之圣药，而痰有不安静速亡者乎。至于久病之痰，切不可以作脾湿生痰论之。盖久病不愈，未
有不肾水亏损者，非肾水泛上为痰，即肾火沸腾为痰。此久病之
痰，当补肾以祛逐之。方用熟地五钱，茯苓三钱，山药三钱，薏仁五钱，芡实五钱，山茱萸三钱，北五味
一钱，麦冬三钱，车前子一钱，益智仁三分，水煎服。此治水泛为痰之圣药。若火沸为痰者，内加肉桂一
钱。此方之妙，纯是补肾之味。而又兼祛湿之品，化痰之味。水入肾宫，自变化为真精，又安有升腾为痰
者乎。此治下焦有痰之法也。有此三方，再看何症，出入加减，治痰无余事矣。
张公曰∶三方极妙，可为治痰之圣方也，然予尚有方在。初起之痰，用天师方可也。已病之痰，予方
亦佳，并附于后。用白术三钱，茯苓三钱，陈皮一钱，天花粉二钱，益智仁三分，人参三分，薏仁三分。有
火者，加黄芩一钱∶无火者，加干姜一钱，水煎服。此方亦健脾而去湿，且不耗气，不助火之沸腾，二剂而
痰症自消。久病之痰，用予六味丸汤加麦冬、五味，实有奇功，可与天师方并传万古也。无火者，加附子、
肉桂可耳。
华君曰∶予尚有二方，治痰之久而成老痰者。方用白芍三钱，柴胡一钱，白芥子五钱，茯苓三钱，陈
皮三分，甘草一钱，丹皮二钱，天花粉八分，薏仁五钱，水煎服。此方妙在用白芥子为君，薏仁、白芍为
臣，柴胡、花粉为佐，使老痰无处可藏，自然渐渐消化。此方可用八剂，老痰无不消者，方名消渴散。又方
治顽痰成块而塞在咽喉者为顽痰，留在胸膈而不化者为老痰也。方用贝母三钱，甘草一钱，桔梗三钱，紫
菀二钱，半夏三钱，茯苓三钱，白术三钱，神曲三钱。白矾一钱，水煎服。此方妙在贝母与半夏同用，一
燥一湿，
使痰无处藏避，而又有白矾以消块，桔梗，紫菀以去邪，甘草调停中央，有不奏功如响者乎。二方亦不
可废也。
（火沸为痰，反加肉桂，此火不及水折也。李子永识。）
天师说：扬治法，是指气机下沉而不能上升，血液凝滞而不能运行的情况。气得到升扬就能舒展，血得到升扬就能流动。如果气机沉抑不能升扬，就必然会出现呃逆或肢体废用的病症。必须用药来升扬它，这样气才能舒展而血才能流动。方剂用当归三钱，白芍三钱，黄芪三钱，白术三钱，柴胡五分，熟地黄五钱，升麻五分，人参一钱，茯苓一钱，川芎一钱，加水煎服。这就是八珍汤。其妙处在于气血平补，如果使用甘草而不使用黄芪，那就不是八珍汤了。气血平补，既没有偏颇，然后再用升麻、柴胡来升扬，使气血流动，自然就不会出现气并血而导致肢体废用的病症，也不会出现血并气而导致呃逆的病症了。这种扬治法是不可废弃的，所以又设立了一个门类。假如只补阳而不补阴，那么阳气旺盛而阴气更加消减。假如只补阴而不补阳，那么阴气旺盛而阳气更加熄灭。所以必须阴阳兼补，然后扬法才有益处，不可将其与发散类药物混为一谈。
张公说：阐发得非常细致入微，无可挑剔。
天师说：痰治法，是针对痰阻塞在咽喉之间的情况，虽然看似是小病，但大病往往由此形成，古人因此单独设立门类来治疗它。然而前人设立的方剂，都是治疗痰的症状（标），不足以治疗痰的根本（本）。所以创立二陈汤，用来治疗上、中、下三焦新近、暂时及久远的各种痰病，通治却缺乏实效。现在另外设立三个方子，一个治疗初起的痰，一个治疗已病的痰，一个治疗久病的痰。痰病虽然繁多，但都不能超出我的治疗范围。初起的痰，就是伤风咳嗽吐痰的情况。用半夏一钱，陈皮一钱，天花粉一钱，茯苓一钱，甘草一钱，苏子一钱，加水煎服。服用两剂就可以消除痰了。这个方子是去除上焦的痰。上焦的痰，原本只在胃中而不在肺。去除胃中的痰，肺金之气肃降，怎么会引起火气上升呢？已病的痰，痰位于中焦。必须观察痰的颜色是白还是黄来辨别，这一点最为重要且分明。黄色，说明火气即将消退；白色，说明火气正炽盛。火气炽盛的，适宜使用寒凉的药物；火气将退的，适宜加入祛逐痰浊的药物。我现在设立一个方子，都可以治疗这两种情况。白术三钱，茯苓五钱，陈皮一钱，甘草一钱，白芥子三钱，栀子一钱，如果是火痰则加入枳壳五分，加水煎服。这个方子属于健脾的药剂，而不是单纯的祛痰药剂。然而痰多的情况，多是由于脾气的湿气所致。现在健运脾气，那么水湿之气就会下行，水湿既然不留在脾中，又从哪里向上溢出呢？况且又加入了消除痰浊的圣药，痰能不迅速安静消失吗？至于久病的痰，切不可当作脾湿生痰来论述。因为久病不愈，没有不导致肾水亏损的，如果不是肾水上泛为痰，就是肾火沸腾为痰。这种久病的痰，应当补肾以祛除它。方剂用熟地黄五钱，茯苓三钱，山药三钱，薏苡仁五钱，芡实五钱，山茱萸三钱，北五味子一钱，麦冬三钱，车前子一钱，益智仁三分，加水煎服。这是治疗水泛为痰的圣药。如果是火沸为痰的，在里面加入肉桂一钱。这个方子的妙处，纯粹是补肾的成分，而又兼有祛湿和化痰的成分。水进入肾宫，自然变化为真精，怎么还会有升腾化为痰的呢？这是治疗下焦有痰的方法。有了这三个方子，再看有什么症状，进行出入加减，治疗痰就没有遗漏的事情了。
张公说：这三个方子极其巧妙，可以作为治疗痰的圣方。然而我还有方子。初起的痰，使用天师的方子即可。已病的痰，我的方子也很好，一并附在后面。用白术三钱，茯苓三钱，陈皮一钱，天花粉二钱，益智仁三分，人参三分，薏苡仁三分。有火的，加入黄芩一钱；无火的，加入干姜一钱，加水煎服。这个方子也是健脾去湿，且不耗气，不助火气沸腾，两剂后痰症自然消除。久病的痰，使用我的六味丸汤加麦冬、五味子，确实有奇效，可以与天师的方子一起流传万古。无火的，加入附子、肉桂即可。
华君说：我还有两个方子，治疗痰久而成为老痰的情况。方剂用白芍三钱，柴胡一钱，白芥子五钱，茯苓三钱，陈皮三分，甘草一钱，牡丹皮二钱，天花粉八分，薏苡仁五钱，加水煎服。这个方子的妙处在于用白芥子作为主药，薏苡仁、白芍作为辅药，柴胡、天花粉作为佐药，使老痰无处藏身，自然渐渐消化。这个方子可以服用八剂，老痰没有不消除的，方名消渴散。另一个方子治疗顽痰成块堵塞在咽喉的叫顽痰，留在胸膈不化开的叫老痰。方剂用贝母三钱，甘草一钱，桔梗三钱，紫菀二钱，半夏三钱，茯苓三钱，白术三钱，神曲三钱，白矾一钱，加水煎服。这个方子的妙处在于贝母与半夏同用，一燥一润，使痰无处藏匿躲避，又有白矾来消除痰块，桔梗、紫菀来祛除邪气，甘草调和中央，哪有不起到如回声般迅速功效的呢？这两个方子也不可废弃。
On the Treatment of Sinking Qi and Stagnant Blood
The Heavenly Master said: The method of "raising" (Yang Zhi) refers to conditions where Qi sinks and fails to ascend, and Blood stagnates and fails to circulate. When Qi is raised, it becomes relaxed and舒展 (unfolds); when Blood is raised, it becomes active and flows. If Qi remains sunk and suppressed without being raised, symptoms such as hiccups or limb paralysis will inevitably occur. Medication must be used to raise it, so that Qi becomes舒展 and Blood becomes active. The prescription consists of Dang Gui (Angelica Sinensis Root) 3 qian, Bai Shao (White Peony Root) 3 qian, Huang Qi (Astragalus Membranaceus Root) 3 qian, Bai Zhu (Atractylodes Macrocephala Rhizome) 3 qian, Chai Hu (Bupleurum Root) 5 fen, Shu Di Huang (Prepared Rehmannia Root) 5 qian, Sheng Ma (Cimicifuga Rhizome) 5 fen, Ren Shen (Ginseng Root) 1 qian, Fu Ling (Poria) 1 qian, and Chuan Xiong (Ligusticum Chuanxiong Rhizome) 1 qian, decocted in water and taken orally. This is Ba Zhen Tang (Eight Treasures Decoction). Its brilliance lies in the balanced tonification of Qi and Blood; if Gan Cao (Licorice Root) were used instead of Huang Qi, it would no longer be Ba Zhen Tang. By tonifying Qi and Blood in balance, avoiding bias, and subsequently using Sheng Ma and Chai Hu to raise them, the flow of Qi and Blood is promoted. Consequently, there will be no condition where Qi merges with Blood causing paralysis, nor where Blood merges with Qi causing hiccups. Since this raising method cannot be discarded, a separate category has been established. If one only tonifies Yang without tonifying Yin, Yang will flourish while Yin diminishes further. If one only tonifies Yin without tonifying Yang, Yin will flourish while Yang extinguishes further. Therefore, both must be tonified simultaneously for the raising method to be beneficial; it should not be conflated with the category of dispersing methods.
Lord Zhang said: The exposition is subtle and meticulous, leaving nothing to be criticized.
On Treating Newly Onset Phlegm, Established Phlegm, and Chronic Phlegm; On Old Phlegm and Stubborn Phlegm
The Heavenly Master said: The method of treating phlegm addresses phlegm obstructing the throat. Although it may seem like a minor illness, major diseases often arise from it, which is why ancient masters established a separate category for its treatment. However, prescriptions established by predecessors primarily treat the branch (biao/symptoms) of phlegm and are insufficient to treat the root (ben/origin). Thus, Er Chen Tang (Two Aged Ingredients Decoction) was created to treat new, temporary, and chronic phlegm across the Upper, Middle, and Lower Jiao, but it lacks practical efficacy when used universally. I now establish three new prescriptions: one for newly onset phlegm, one for established phlegm, and one for chronic phlegm. Although phlegm diseases are numerous, they do not exceed the scope of my methods. Newly onset phlegm manifests as wind-cold affecting the lungs with coughing and expectoration. It is treated with Ban Xia (Pinellia Tuber) 1 qian, Chen Pi (Aged Tangerine Peel) 1 qian, Tian Hua Fen (Trichosanthes Root) 1 qian, Fu Ling (Poria) 1 qian, Gan Cao (Licorice Root) 1 qian, and Su Zi (Perilla Fruit) 1 qian, decocted in water and taken orally. Two doses can eliminate the phlegm. This prescription removes phlegm from the Upper Jiao. Phlegm in the Upper Jiao originally resides in the Stomach, not the Lung. Removing phlegm from the Stomach allows Lung Metal Qi to descend and肃 (purify), preventing Fire from rising. Established phlegm resides in the Middle Jiao. One must distinguish it by observing whether the color is white or yellow, which is crucial. Yellow indicates that Fire is about to recede; white indicates that Fire is blazing. For blazing Fire, cold and cool herbs are suitable; for receding Fire, herbs that expel phlegm are added. I have established a single prescription for both cases: Bai Zhu (Atractylodes Macrocephala Rhizome) 3 qian, Fu Ling (Poria) 5 qian, Chen Pi (Aged Tangerine Peel) 1 qian, Gan Cao (Licorice Root) 1 qian, Bai Jie Zi (White Mustard Seed) 3 qian, Zhi Zi (Gardenia Fruit) 1 qian, and if it is Fire-Phlegm, add Zhi Ke (Aurantium Fruit) 5 fen, decocted in water and taken orally. This prescription belongs to the category of strengthening the Spleen, not merely expelling phlegm. However, excessive phlegm often results from Dampness due to Spleen Qi deficiency. By strengthening Spleen Qi, Water-Dampness descends. Since Water-Dampness does not remain in the Spleen, how can it emerge upwards? Moreover, with the addition of the supreme herb for resolving phlegm, how could the phlegm not quickly subside and disappear? As for chronic phlegm, it must not be diagnosed simply as Spleen-Dampness generating phlegm. Prolonged illness invariably leads to Kidney Water deficiency. It is either Kidney Water flooding upward as phlegm or Kidney Fire boiling upward as phlegm. This type of chronic phlegm requires tonifying the Kidney to expel it. The prescription uses Shu Di Huang (Prepared Rehmannia Root) 5 qian, Fu Ling (Poria) 3 qian, Shan Yao (Dioscorea Rhizome) 3 qian, Yi Yi Ren (Coix Seed) 5 qian, Qian Shi (Euryale Seed) 5 qian, Shan Zhu Yu (Cornus Fruit) 3 qian, Bei Wu Wei Zi (Schisandra Berry) 1 qian, Mai Dong (Ophiopogon Tuber) 3 qian, Che Qian Zi (Plantago Seed) 1 qian, and Yi Zhi Ren (Alpinia Oxyphylla Fruit) 3 fen, decocted in water and taken orally. This is the supreme medicine for treating phlegm caused by water flooding. If it is phlegm caused by boiling Fire, add Rou Gui (Cinnamon Bark) 1 qian internally. The brilliance of this prescription lies purely in its Kidney-tonifying ingredients, combined with dampness-resolving and phlegm-resolving agents. When Water enters the Kidney Palace, it naturally transforms into True Essence; thus, how could it rise and transform into phlegm? This is the method for treating phlegm in the Lower Jiao. With these three prescriptions, one can adjust based on specific symptoms, leaving no aspect of phlegm treatment unaddressed.
Lord Zhang said: These three prescriptions are extremely ingenious and can serve as supreme formulas for treating phlegm. However, I have additional prescriptions. For newly onset phlegm, the Heavenly Master's prescription is sufficient. For established phlegm, my prescription is also excellent and is attached below. Use Bai Zhu (Atractylodes Macrocephala Rhizome) 3 qian, Fu Ling (Poria) 3 qian, Chen Pi (Aged Tangerine Peel) 1 qian, Tian Hua Fen (Trichosanthes Root) 2 qian, Yi Zhi Ren (Alpinia Oxyphylla Fruit) 3 fen, Ren Shen (Ginseng Root) 3 fen, and Yi Yi Ren (Coix Seed) 3 fen. If there is Fire, add Huang Qin (Scutellaria Root) 1 qian; if there is no Fire, add Gan Jiang (Dried Ginger) 1 qian, decocted in water and taken orally. This prescription also strengthens the Spleen and eliminates Dampness, without consuming Qi or aggravating boiling Fire. After two doses, phlegm symptoms will naturally subside. For chronic phlegm, using my Liu Wei Wan Tang (Six Ingredient Pill Decoction) modified with Mai Dong (Ophiopogon Tuber) and Wu Wei Zi (Schisandra Berry) yields miraculous results and can be transmitted alongside the Heavenly Master's prescriptions for eternity. If there is no Fire, add Fu Zi (Aconite Lateral Root) and Rou Gui (Cinnamon Bark).
Lord Hua said: I have two more prescriptions for treating phlegm that has become old phlegm due to duration. The prescription uses Bai Shao (White Peony Root) 3 qian, Chai Hu (Bupleurum Root) 1 qian, Bai Jie Zi (White Mustard Seed) 5 qian, Fu Ling (Poria) 3 qian, Chen Pi (Aged Tangerine Peel) 3 fen, Gan Cao (Licorice Root) 1 qian, Dan Pi (Moutan Cortex) 2 qian, Tian Hua Fen (Trichosanthes Root) 8 fen, and Yi Yi Ren (Coix Seed) 5 qian, decocted in water and taken orally. The brilliance of this prescription lies in using Bai Jie Zi (White Mustard Seed) as the sovereign herb, Yi Yi Ren (Coix Seed) and Bai Shao (White Peony Root) as minister herbs, and Chai Hu (Bupleurum Root) and Tian Hua Fen (Trichosanthes Root) as assistant herbs, leaving no place for old phlegm to hide, allowing it to gradually digest. Eight doses of this prescription will eliminate all old phlegm. The formula name is Xiao Ke San (Thirst-Quenching Powder). Another prescription treats stubborn phlegm forming lumps obstructing the throat as "stubborn phlegm," and phlegm remaining in the chest and diaphragm without dissolving as "old phlegm." The prescription uses Bei Mu (Fritillaria Bulb) 3 qian, Gan Cao (Licorice Root) 1 qian, Jie Geng (Platycodon Root) 3 qian, Zi Wan (Aster Root) 2 qian, Ban Xia (Pinellia Tuber) 3 qian, Fu Ling (Poria) 3 qian, Bai Zhu (Atractylodes Macrocephala Rhizome) 3 qian, Shen Qu (Medicated Leaven) 3 qian, and Bai Fan (Alumen) 1 qian, decocted in water and taken orally. The brilliance of this prescription lies in the combination of Bei Mu (Fritillaria Bulb) and Ban Xia (Pinellia Tuber); one is drying and one is moistening, leaving no refuge for phlegm. Additionally, Bai Fan (Alumen) eliminates lumps, Jie Geng (Platycodon Root) and Zi Wan (Aster Root) remove pathogens, and Gan Cao (Licorice Root) harmonizes the center. How could it fail to produce immediate efficacy? These two prescriptions should not be discarded.
(Note: Adding Rou Gui (Cinnamon Bark) for phlegm caused by boiling Fire is because the Fire is insufficient to overcome the Water, requiring a counter-agent strategy. Recorded by Li Zi Yong.)