(见血门)
饮凡有六。悬溢交痰留伏。痰饮。特六饮之一耳。人病此而止曰痰饮者。盖停既久。未
有不
为痰。多因气道闭塞。津液不通。譬如沟渠壅遏。积淹停滞。则倒流逆上。瘀浊臭秽。无所
不有。若不疏决沟渠。而欲澄治已壅之水。而使之清。无是理也。
凡为喘、为咳、为呕、为泄、为眩、为晕、心嘈、怔忡、惊悸、为寒热、痛肿、为痞膈
、为
壅闭。或胸胁间辘辘有声。或背心一片常如水冷。皆饮食所致。此即如水之壅。有瘀浊臭秽
故善治痰者。不治痰而治气。气顺则一身之津液。亦随气而顺矣。并宜苏子降气汤。导痰
汤各半帖。和煎。或小半夏茯苓汤。加枳实木香各半钱。吞五套丸。或以五套丸料。根据分两
作饮子煎服。尤好。平居皆无他事。只有痰数口。或清或坚。宜二陈汤小半夏茯苓汤。痰多
间进青州白丸子。和来复丹服。来白丸如和以八神来复丹。即名青神丸。此非特治痰饮。
尤甚疗喘、嗽、呕、吐逆、翻胃。若服药未效者。二生汤。加木香半钱。若顽涎随气逆上
不为药解。当自下部利之宜五膈宽中散。加半夏半钱。吞破饮丸。仍佐以半硫丸。恐大便复
秘。饮利不尽。半硫丸当常服。若大便先不因药自利。及老人虚人。当利其小便。宜小半夏
茯苓汤。改用赤苓而倍之。或导痰汤。加猪苓半钱。
痰饮晕眩。及成饮厥者。宜别加木香二生汤吞青州白丸子和灵砂丹名青令丹或吞养正丹
半
硫丸痰饮流入四肢。令人肩背酸疼。两手软痹。医误以为风。则非其治。宜导痰汤。加木香
姜黄各半钱。
病痰饮而变生诸证。不当为诸证牵掣。妄言作名。且以治饮为先。饮消则诸证自愈。有
卒然
昏闷。口眼 斜。似中而实非中。四肢战曳。身如浮云。似虚而实非虚。皆痰饮所为也。又
有肾虚寒。不能摄水。致邪水溢上。故作痰饮。宜八味丸。
(见血门)
水饮共有六种。悬饮、溢饮与痰饮相互交结留伏。痰饮,仅仅是六饮中的一种罢了。人患病于此而只称为“痰饮”的,是因为停聚时间既久,没有不转化为痰的。多因气道闭塞,津液运行不通畅。譬如沟渠被堵塞,积水停滞,就会倒流逆上,瘀积浑浊臭秽之物,无所不有。如果不疏通决开沟渠,却想要澄清治理已经壅塞的水,使之变清,是没有道理的。
凡是表现为喘、咳、呕、泄、眩、晕、心中嘈杂、怔忡、惊悸,表现为寒热、痛肿,表现为痞膈、壅闭。或者胸胁间辘辘有声,或者背心一片常感觉像水冷一样,都是饮食所致。这就像水的壅塞,因为有瘀浊臭秽之物,所以善于治疗痰的人,不直接治痰而治气。气机顺则全身津液也随气机而顺畅。并宜用苏子降气汤和导痰汤各半帖,混合煎服;或者用小半夏茯苓汤,加枳实、木香各半钱,吞服五套丸;或者用五套丸的药料,按照分量做成饮子煎服,尤其好。平素如果没有其他事情,只有几口痰,或清或坚,宜用二陈汤或小半夏茯苓汤。痰多时间歇服用青州白丸子,配合来复丹服用。如果将白丸子与八神来复丹混合,就名为青神丸。这不仅是治疗痰饮,尤其擅长治疗喘、嗽、呕吐、吐逆、翻胃。如果服药无效,用二生汤,加木香半钱。如果是顽涎随气逆上,不为药物所化解,应当从下部通利它。宜用五膈宽中散,加半夏半钱,吞服破饮丸。仍辅助服用半硫丸,恐怕大便再次秘结,水饮不能排尽。半硫丸应当常服。如果大便先前不因药物作用自行通畅,以及老人、体虚之人,应当利其小便。宜用小半夏茯苓汤,改用赤茯苓并加倍用量;或者用导痰汤,加猪苓半钱。
痰饮引起的晕眩,以及发展为饮厥的,宜另外加木香于二生汤中,吞服青州白丸子和灵砂丹,名为青令丹;或者吞服养正丹、半硫丸。痰饮流入四肢,使人肩背酸痛,两手软弱麻痹。医生误认为是风邪,那就不是正确的治疗方法了。宜用导痰汤,加木香、姜黄各半钱。
患痰饮病而变生各种证候,不应当被各种证候牵制,妄自命名。且以治疗水饮为先。水饮消除则各种证候自然痊愈。有突然昏闷,口眼歪斜,似中风而实际上不是中风,四肢颤抖曳动,身体如浮云般轻飘,似虚证而实际上不是虚证,这些都是痰饮造成的。又有肾虚寒,不能摄纳水液,导致邪水泛滥上行,所以生成痰饮。宜用八味丸。
(See the Section on Hemoptysis)
There are six types of fluid retention (Yin). Suspended fluid (Xuan Yin), overflowing fluid (Yi Yin), and phlegm-fluid (Tan Yin) interlock and linger. Phlegm-fluid is merely one of the six types of fluid retention. When people suffer from this condition but it is only called "phlegm-fluid," it is because after long-term stagnation, it inevitably transforms into phlegm. This often occurs due to the blockage of the air passages and the obstruction of Jin-Ye (body fluids) circulation. It is like a ditch being blocked; when accumulated water stagnates, it flows backward and upward, accumulating turbid, foul-smelling substances without exception. If one does not dredge and open the ditch, but instead attempts to clarify and purify the already obstructed water to make it clear, such an approach is unreasonable.
Symptoms manifesting as wheezing, cough, vomiting, diarrhea, dizziness, vertigo, heart palpitations with restlessness (Xin Cao), panic attacks (Zheng Chong), fright palpitations (Jing Ji), alternating chills and fever, pain and swelling, chest fullness and diaphragmatic oppression (Pi Ge), or complete obstruction. Or there may be gurgling sounds in the chest and hypochondrium, or a sensation of cold water on the back. All these are caused by dietary factors. This is akin to water obstruction where turbid and foul substances accumulate. Therefore, those skilled in treating phlegm do not treat the phlegm directly but regulate Qi. When Qi flows smoothly, the body's Jin-Ye also flow smoothly along with it. One should use Su Zi Jiang Qi Tang (Perilla Fruit Descending Qi Decoction) and Dao Tan Tang (Phlegm-Draining Decoction), half a dose of each, decocted together. Alternatively, use Xiao Ban Xia Fu Ling Tang (Minor Pinellia and Poria Decoction) with Zhi Shi (Immature Bitter Orange) and Mu Xiang (Aucklandiae Radix), half a qian each, taken with Wu Tao Wan (Five-Pellet Pill). Or, prepare the ingredients of Wu Tao Wan according to their proportions as a herbal drink. This method is particularly good. In daily life, if there are no other issues, only a few mouthfuls of phlegm, either clear or hard, use Er Chen Tang (Two-Cured Decoction) or Xiao Ban Xia Fu Ling Tang. If there is much phlegm, take Qingzhou Bai Wan Zi (Qingzhou White Pills) intermittently, combined with Lai Fu Dan (Reviving Pill). If Bai Wan Zi is mixed with Ba Shen Lai Fu Dan (Eight-God Reviving Pill), it is named Qing Shen Wan. This is not only for treating phlegm-fluid but is especially effective for wheezing, cough, vomiting, retching, and food regurgitation (Fan Wei). If medication is ineffective, use Er Sheng Tang (Two-Life Decoction) with half a qian of Mu Xiang. If stubborn phlegm-fluid rises with rebellious Qi and resists pharmacological resolution, it should be purged from the lower jiao. Use Wu Ge Kuan Zhong San (Five Diaphragms Midst-Widening Powder) with half a qian of Ban Xia, taken with Po Yin Wan (Fluid-Breaking Pill). Assist with Ban Shu Wan (Half-Sulfur Pill), lest constipation recur and fluid retention remain uneliminated. Ban Shu Wan should be taken regularly. If stool passes spontaneously without medication, or in the case of the elderly and debilitated individuals, promote urination. Use Xiao Ban Xia Fu Ling Tang, substituting Chi Fu Ling (Red Poria) and doubling the dosage. Or use Dao Tan Tang with half a qian of Zhu Ling (Polyporus).
For dizziness and vertigo caused by phlegm-fluid, or cases developing into Yin-Jue (Cold-Faintness due to Fluid Retention), add Mu Xiang to Er Sheng Tang and swallow Qingzhou Bai Wan Zi and Ling Sha Dan (Cinnabar Pill), named Qing Ling Dan. Or swallow Yang Zheng Dan (Upright-Qi Pill) or Ban Shu Wan. When phlegm-fluid enters the four limbs, causing soreness and pain in the shoulders and back, and softness and numbness in both hands, physicians may mistakenly diagnose it as Wind pathogen, which is incorrect treatment. Use Dao Tan Tang with Mu Xiang and Jiang Huang (Curcuma Longa Rhizome), half a qian each.
When suffering from phlegm-fluid disease that generates various syndromes, one should not be constrained by these symptoms nor arbitrarily name them. Prioritize treating the fluid retention. Once the fluid retention dissipates, the various symptoms will heal themselves. There are cases of sudden faintness and confusion, deviation of the mouth and eyes, resembling Stroke (Zhong Feng) but actually not Stroke; trembling and dragging of the four limbs, feeling light as floating clouds, resembling Deficiency but actually not Deficiency. All these are caused by phlegm-fluid. Additionally, Kidney Deficiency Cold fails to control water, causing evil water to overflow upward, thus generating phlegm-fluid. Use Ba Wei Wan (Eight-Ingredient Pill).