逆，背相引痛，为肺积。沉而芤，上下无常处，胸满悸，腹中热，名心积。弦而细，
二胁下痛，邪走心下，足肿寒重，名肝积。沉而急，苦肾与腰相引痛，饥见饱减，
名肾积。浮大而长，饥减饱见，腹满泄呕，胫肿，名脾积。寸口沉而横，胁下及腹
有横积痛，左手脉横症在左，右手脉横症在右，脉头大者在上，头小者在下。脉弦，
腹中急痛，为瘕。脉细微者，为 。脉沉重而中散者，因寒食成 ，脉左转而沉重
者，气症在胃中，右转出不至寸口者，内有肉症也。脉细而沉时直者，身有痈，若
腹中有伏梁。脉沉小而实者，胃中有积聚，不下食，食即呕吐。脉沉而紧者，心下
有寒时痛，有积聚。关上脉大而尺寸细者，必心腹冷积。迟而滑，中寒有 结。弦
而伏者，腹中有症不可转也，必死不治。虚弱者死，坚强急者生。
痰皆动于脾湿，寒少而热。湿在肝经，谓之风痰。湿在心经，谓之热痰。湿
在脾经，谓之湿痰。湿在肺经，谓之气痰。湿在肾经，谓之寒痰。风痰，脉弦面青，
四肢满闷，便溺秘涩，心多躁怒，水煮金花丸、川芎防风丸。热痰，脉洪面赤，烦
热心痛，唇口干燥，多喜笑，小黄丸、小柴胡汤加半夏。湿痰，脉缓面黄，肢体沉
重，嗜卧不收，腹胀而食不消，白术丸，《局方》防己丸。气痰，脉涩面白，气上喘
促，洒淅寒热，悲愁不乐，玉粉丸，《局方》桔梗汤。寒痰，脉沉面色黧黑，小便急
痛，足寒而逆，心多恐怖，姜桂丸、《局方》胡椒理中丸、《金匮》吴茱萸汤。心下
痞闷，加枳实五钱。身热甚，加黄连五钱。体重，加茯苓、白术各一两。气逆上，
加苦葶苈五钱。气促，加人参、桔梗各五钱。浮肿，加郁李仁、杏仁各五钱。大便
秘，加大黄五钱。（以上本出咳嗽门，咳嗽当参看。）
痰分五色∶色白，西方本色；色黄，逆而之坤；色红，甚而之内，金受火囚为
难治；青色受风之羁绊；黑如烟煤点，顺而之北方，不治自愈。
经曰∶饮入于胃，游溢精气，上输于脾，脾气散精，上归于肺，通调水道，下
输膀胱，水精四布，五经并行，安有所谓痰者哉。痰之生，由于脾气不足，不能致
精于肺，而淤以成焉者也。故治痰先补脾，脾复健运之常，而痰自化矣。然停积既
久，如沟渠壅遏淹久，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。《金匮》云∶其人素盛今瘦，水走肠间，辘辘有声，
谓之痰饮。当以温药和之。又云∶心下有痰饮者，桂苓甘术汤主之。饮后水流在胁
下，咳唾引痛，谓之悬饮，十枣汤主之。（此药太峻，以小胃丹代之差缓，然虚人切不
可用。）饮水流行归于四肢，当汗出而不汗出，身体疼重，谓之溢饮，当发其汗。大青
龙汤、小青龙汤主之。咳逆倚息短气，不得卧，其形如肿，谓之支饮。又云∶呕家本渴，今反
不渴，心下有支饮故也，小半夏汤主之。又云∶心下有支饮，其人苦冒眩，泽泻汤
主之。通用海藏五饮汤，《局方》倍术丸。丹溪曰∶痰之源不一，有因痰而生热者，
有因热而生痰者，有因气而生者，有因风而生者，有因惊而生者，有积饮而生者，
有多食而成者，有因暑而生者，有伤冷物而成者，有脾虚而成者，有嗜酒而成者。
其为病也，惊痰则成心包痛，颠疾。热痰则成烦躁，头风，烂眼燥结，怔忡懊 ，
惊眩。风痰成瘫痪大风，眩晕暗风，闷乱。饮痰成胁痛，四肢不举，每日呕吐。食
痰成疟痢，口出臭气。暑痰中晕眩冒，黄胆头疼。冷痰，骨痹四肢不举，气刺痛。
酒痰，饮酒不消，但得酒次日又吐。脾虚生痰，食不美，反胃呕吐。气痰，攻注走
刺不定。妇人于惊痰最多，盖因产内交接，月事方行，其惊因虚而入，结成块者为惊
痰，必有一块在腹，发则如身孕转动跳跃，痛不可忍。按热痰用黄连利膈丸，当下
者，用妙应丸加盆硝等分，每服三两丸，亦可用滚痰丸。惊痰用妙应丸加朱砂二钱，
全蝎三钱，每用八、九丸，常与之三、五服去尽。惊气成块，妙应丸加穿山甲炒、
鳖甲烧各三钱，玄胡索、蓬术各四钱，每服五十丸加至七十丸，以利为度。寒痰，
妙应丸加胡椒、丁香、蝎、桂各等分，每服二十五丸。风痰，祛风丸、导痰丸。酒
痰，妙应丸加雄黄、全蝎各二钱，每服十丸。饮痰，小胃丹。食痰，保和丸。暑痰，
消暑丹。庞安常有言人身无倒上之痰，天下无逆流之水，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亦
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，名来白丸，如和以八神来复丹，即名青神丸，此非特治痰饮，
尤甚疗喘嗽，呕逆翻胃。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。大凡病痰饮而变生诸证，不当为诸证牵
掣，妄言作名，且以治饮为先，饮消则诸证自愈。故如头风，眉棱角疼，累以风药
不效，投以痰药收功。如患眼赤羞明而痛，与之凉药弗瘳，畀以痰剂获愈。凡此之
类，非一而足，散在各证门中，不复繁引。有阴血不足，阴火上逆，肺受火侮，不
得清肃下行，由是津液凝浊生痰不生血者，此则当以润剂，如门冬、地黄、枸杞子
之属，滋其阴，使上逆之火得返其宅而息焉，而痰自清矣。投以二陈，立见其殆。
肾虚不能纳气归原，出而不纳则积，积而弗散则痰生焉，八味丸主之。脉来细滑或
缓，痰涎清薄，身体倦怠，手足酸软，此脾虚挟湿。六君子汤，或补中益气加半夏、
茯苓。脉来结涩，胸膈不利，或作刺痛，此挟气郁。宜七气汤、越鞠丸。有人坐处，
率吐痰涎满地，其痰不甚稠粘，只是沫多，此气虚不能摄涎，不可用利药，宜六君
子汤加益智仁一钱以摄之。丹阳贡鲁庵，年七十余，膈间有痰不快，饮食少思，初
无大害，就医京口，投以越鞠丸、清气化痰丸，胸次稍宽，日日吞之，遂不辍口，
年余困顿不堪，僦舟来就予延医，则大肉已脱，两手脉如游丝，太溪绝不至矣。见
予有难色，因曰吾亦自分必死，但膈间胀不可忍，大便秘结不通，诚为宽须更，即
死瞑目矣。固强予疏方，以至亲难辞，教用大剂人参、白术煎汤进之，少顷如厕，
下积痰数升，胸膈宽舒，更数日而殁。
（脉象）逆乱，背部相互牵引疼痛，称为肺积。脉象沉而芤，痛处上下无固定位置，胸部胀满、心悸，腹中发热，称为心积。脉象弦而细，两侧胁下疼痛，邪气走窜至心下部，足部肿胀发冷沉重，称为肝积。脉象沉而急，苦于肾脏与腰部相互牵引疼痛，饥饿时症状显现，饱食后减轻，称为肾积。脉象浮大而长，饥饿时症状减轻，饱食后显现，腹部胀满、泄泻呕吐，小腿肿胀，称为脾积。寸口脉沉而横，胁下及腹部有横向积聚疼痛，左手脉横表示病证在左侧，右手脉横表示病证在右侧，脉头大者病位在上，脉头小者病位在下。脉弦，腹中拘急疼痛，为瘕聚。脉细微的，为癥积。脉沉重而中部散乱的，因寒邪和饮食停滞形成癥积；脉向左转且沉重的，气滞之症在胃中；向右转且脉搏达不到寸口的，体内有肉癥。脉细而沉且时而直挺的，身体有痈肿，若腹中有伏梁。脉沉小而实的，胃中有积聚，不能进食，进食即呕吐。脉沉而紧的，心下有寒邪时常疼痛，有积聚。关脉大而尺脉、寸脉细的，必定是心腹冷积。脉迟而滑的，中寒且有痰结。脉弦而伏的，腹中有癥块不可转动，必死无疑。脉虚弱的死亡，脉坚强紧急的存活。
痰皆由脾湿而动，寒少而热。湿邪在肝经，称为风痰。湿邪在心经，称为热痰。湿邪在脾经，称为湿痰。湿邪在肺经，称为气痰。湿邪在肾经，称为寒痰。风痰，脉弦面色青，四肢胀闷，大小便秘涩，心中多躁怒，用《局方》水煮金花丸、川芎防风丸治疗。热痰，脉洪面色红赤，烦热心痛，嘴唇口腔干燥，多喜笑，用小黄丸、小柴胡汤加半夏治疗。湿痰，脉缓面色黄，肢体沉重，嗜睡懒动，腹胀且食物不消化，用白术丸、《局方》防己丸治疗。气痰，脉涩面色白，气上逆喘促，忽冷忽热，悲伤忧愁不快乐，用玉粉丸、《局方》桔梗汤治疗。寒痰，脉沉面色黧黑，小便急痛，足部寒冷逆冷，心中多恐惧，用姜桂丸、《局方》胡椒理中丸、《金匮要略》吴茱萸汤治疗。心下部痞闷，加枳实五钱。身热严重，加黄连五钱。体重，加茯苓、白术各一两。气逆向上，加苦葶苈五钱。气促，加人参、桔梗各五钱。浮肿，加郁李仁、杏仁各五钱。大便便秘，加大黄五钱。（以上条文原本出自咳嗽门，咳嗽应当参考查看。）
痰分为五色：色白，是西方的本色；色黄，是逆而归于坤土之色；色红，是甚而归于内火，金受火囚禁为难治；青色受风邪羁绊；黑色如烟煤点，顺而归于北方水色，不治自愈。
经典说：饮水进入胃中，游溢精气，向上输送给脾，脾气散布精微，向上回归于肺，通调水道，向下输送到膀胱，水精四布，五脏经脉并行，哪里有所谓的痰呢？痰的产生，是由于脾气不足，不能将精微送达于肺，从而淤积而成。所以治疗痰先补脾，脾恢复健运的常态，痰自然化解。然而停积已久，如同沟渠堵塞淹久，则倒流逆上，瘀浊臭秽，无所不有。如果不疏通决堤沟渠，却想澄清治理已经堵塞的水使之清澈，是没有道理的。《金匮要略》说：那人平素肥胖现在消瘦，水流走于肠间，辘辘有声，称为痰饮。应当用温药调和它。又说：心下有痰饮的，用桂苓甘术汤主治。饮水后水流停留在胁下，咳嗽吐唾牵引疼痛，称为悬饮，用十枣汤主治。（此药太峻猛，用小胃丹替代较缓和，但体虚之人切不可使用。）饮水流行归于四肢，应当出汗而不汗出，身体疼痛沉重，称为溢饮，应当发汗。用大青龙汤、小青龙汤主治。咳逆倚靠呼吸短气，不能躺卧，身形如肿，称为支饮。又说：呕吐的人本应口渴，现在反而不渴，是因为心下有支饮的缘故，用小半夏汤主治。又说：心下有支饮，其人苦于头晕目眩，用泽泻汤主治。通用海藏五饮汤、《局方》倍术丸。朱丹溪说：痰的来源不一，有因痰而生热的，有因热而生痰的，有因气而生的，有因风而生的，有因惊而生的，有积饮而生的，有多食而成的，有因暑而生的，有伤冷物而成的，有脾虚而形成的，有嗜酒而形成的。它引发的病症，惊痰则成心包痛、癫疾。热痰则成烦躁、头风、烂眼燥结、怔忡懊恼、惊眩。风痰成瘫痪大风、眩晕暗风、闷乱。饮痰成胁痛、四肢不能举起、每日呕吐。食痰成疟痢、口出臭气。暑痰中晕眩冒、黄疸头疼。冷痰，骨痹四肢不能举起、气刺痛。酒痰，饮酒不消，只要喝酒次日又吐。脾虚生痰，食欲不佳，反胃呕吐。气痰，攻注走刺不定。妇人在惊痰方面最多，大概因为产后交接，月经刚行，其惊因虚而入，结成块者为惊痰，必有一块在腹中，发作时如身孕转动跳跃，痛不可忍。按热痰用黄连利膈丸，当下者，用妙应丸加盆硝等分，每服三两丸，也可用滚痰丸。惊痰用妙应丸加朱砂二钱，全蝎三钱，每次用八、九丸，常与之三、五服去尽。惊气成块，妙应丸加炒穿山甲、烧鳖甲各三钱，玄胡索、蓬术各四钱，每服五十丸加至七十丸，以利为度。寒痰，妙应丸加胡椒、丁香、蝎、桂各等分，每服二十五丸。风痰，祛风丸、导痰丸。酒痰，妙应丸加雄黄、全蝎各二钱，每服十丸。饮痰，小胃丹。食痰，保和丸。暑痰，消暑丹。庞安常有言人身无倒上之痰，天下无逆流之水，所以善于治痰的人，不治痰而治气，气顺则一身之津液亦随气而顺了。并宜苏子降气汤、导痰汤各半帖合煎。或小半夏茯苓汤加枳实、木香各半钱，吞服五套丸。或以五套丸料，根据分量作饮子煎服也好。平时都没有其他事，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，名叫来白丸，如果和以八神来复丹，就名叫青神丸，这不仅是治疗痰饮，尤其擅长治疗喘嗽、呕逆翻胃。痰饮流入四肢，令人肩背酸痛，两手软痹，医生误以为风，则不是正确的治疗，宜导痰汤加木香、姜黄各半钱。大凡病痰饮而变生诸证，不当被诸证牵掣，妄言作名，且以治饮为先，饮消则诸证自愈。所以如头风，眉棱角疼，屡用风药不效，投以痰药收功。如患眼赤羞明而痛，给它凉药不愈，给它痰剂获愈。凡此类，不止一个，散在各证门中，不再繁引。有阴血不足，阴火上逆，肺受火侮，不得清肃下行，由此津液凝浊生痰不生血的，这则应当用润剂，如麦冬、地黄、枸杞子之类，滋其阴，使上逆之火得返其宅而息焉，而痰自清了。投以二陈汤，立刻见到危险。肾虚不能纳气归原，出而不纳则积，积而不散则痰生，用八味丸主治。脉来细滑或缓，痰涎清薄，身体倦怠，手足酸软，这是脾虚挟湿。六君子汤，或补中益气汤加半夏、茯苓。脉来结涩，胸膈不利，或作刺痛，这是挟气郁。宜七气汤、越鞠丸。有人坐处，往往吐痰涎满地，其痰不甚稠粘，只是沫多，这是气虚不能摄涎，不可用利药，宜六君子汤加益智仁一钱以摄之。丹阳贡鲁庵，年七十余，膈间有痰不快，饮食少思，初无大害，就医京口，投以越鞠丸、清气化痰丸，胸次稍宽，日日吞之，遂不辍口，年余困顿不堪，租船来找我延医，则大肉已脱，两手脉如游丝，太溪脉绝不至矣。见我有难色，于是说我也自己断定必死，但膈间胀不可忍，大便秘结不通，诚为宽须更，即死瞑目矣。固强我开方，以至亲难辞，教用大剂人参、白术煎汤进之，少顷如厕，下积痰数升，胸膈宽舒，更数日而殁。
The pulse is rebellious, with pain drawing between the back and chest, termed *Fei Ji* (Lung Accumulation). The pulse is deep and hollow (*Kou*), with no fixed location for the pain above or below, accompanied by chest fullness, palpitations, and heat in the abdomen, termed *Xin Ji* (Heart Accumulation). The pulse is wiry and thin, with pain under both hypochondria, pathogenic factors moving to the epigastrium, swelling and cold heaviness in the feet, termed *Gan Ji* (Liver Accumulation). The pulse is deep and rapid, suffering from drawing pain between the kidney and waist, appearing when hungry and diminishing when full, termed *Shen Ji* (Kidney Accumulation). The pulse is floating, large, and long, diminishing when hungry and appearing when full, with abdominal fullness, diarrhea, vomiting, and swelling of the shins, termed *Pi Ji* (Spleen Accumulation). At the Cun Kou position, the pulse is deep and transverse; there is transverse accumulation pain under the hypochondria and in the abdomen. A transverse pulse on the left indicates the syndrome is on the left; a transverse pulse on the right indicates the syndrome is on the right. A larger pulse head indicates the lesion is upper; a smaller pulse head indicates the lesion is lower. A wiry pulse with urgent pain in the abdomen indicates *Jia* (mobile mass). A fine and minute pulse indicates *Zheng* (fixed mass). A heavy pulse with a scattered center indicates a *Zheng* mass formed by cold and food stagnation. A pulse turning left and heavy indicates Qi stagnation in the stomach; a pulse turning right and failing to reach the Cun Kou position indicates a flesh *Zheng* mass inside. A fine, deep pulse that is sometimes straight indicates an abscess in the body; if there is *Fu Liang* (hidden beam) in the abdomen. A deep, small, and solid pulse indicates accumulation in the stomach, inability to eat, and vomiting immediately after eating. A deep and tight pulse indicates cold at the epigastrium with intermittent pain and accumulation. A large Guan pulse with fine Chi and Cun pulses indicates cold accumulation in the heart and abdomen. A slow and slippery pulse indicates interior cold with phlegm binding. A wiry and hidden pulse indicates an immobile *Zheng* mass in the abdomen, which is fatal and untreatable. Weakness leads to death; firmness and urgency lead to survival.
Phlegm arises from Spleen dampness, being rarely cold but often hot. Dampness in the Liver channel is called Wind Phlegm. Dampness in the Heart channel is called Heat Phlegm. Dampness in the Spleen channel is called Damp Phlegm. Dampness in the Lung channel is called Qi Phlegm. Dampness in the Kidney channel is called Cold Phlegm. For Wind Phlegm, the pulse is wiry and the complexion green, limbs are full and stuffy, urination and defecation are obstructed, and the mind is prone to irritability and anger; treat with *Shuizhu Jinhua Wan* (Boiled Golden Flower Pill) or *Chuanxiong Fangfeng Wan*. For Heat Phlegm, the pulse is surging and the complexion red, with vexation, heart pain, dry lips and mouth, and excessive laughter; treat with *Xiao Huang Wan* or *Xiao Chai Hu Tang* (Minor Bupleurum Decoction) plus Banxia. For Damp Phlegm, the pulse is moderate and the complexion yellow, limbs are heavy, there is lethargy, abdominal distension, and indigestion; treat with *Baizhu Wan* or *Fangji Wan* from *Ju Fang*. For Qi Phlegm, the pulse is choppy and the complexion pale, with upward rushing Qi causing panting, alternating chills and fever, sorrow, and unhappiness; treat with *Yufen Wan* or *Jiegeng Tang* from *Ju Fang*. For Cold Phlegm, the pulse is deep and the complexion dark black, with urgent painful urination, cold and rebellious feet, and frequent fear; treat with *Jiangui Wan*, *Hujiao Lizhong Wan* from *Ju Fang*, or *Wuzhuyu Tang* from *Jinkui Yaolue*. If there is epigastric stuffiness, add Zhishi (5 qian). If body heat is severe, add Huanglian (5 qian). If weight is heavy, add Fuling and Baizhu (1 liang each). If Qi rebels upward, add Ku Tingli (5 qian). If Qi is short, add Renshen and Jiegeng (5 qian each). If edema occurs, add Yuliren and Xingren (5 qian each). If constipation occurs, add Dahuang (5 qian). (These items originally appeared in the Cough section; refer to it for coughs.)
Phlegm is divided into five colors: White corresponds to the original color of the West; Yellow corresponds to reversing towards Kun (Earth); Red corresponds to extreme internal heat, where Metal is imprisoned by Fire, making it difficult to treat; Green corresponds to entanglement by Wind; Black like soot spots corresponds to smoothing towards the North (Water), healing without treatment.
The Classics state: Water enters the Stomach, its essence floats and overflows, moves up to the Spleen, the Spleen scatters the essence, sends it up to return to the Lungs, regulates the water passages, and transports it down to the Bladder. Water essence distributes in four directions, running through the five meridians. Where does such a thing as "phlegm" come from? Phlegm is generated because Spleen Qi is insufficient, unable to deliver essence to the Lungs, resulting in stagnation and formation. Therefore, treating phlegm begins with tonifying the Spleen; once the Spleen restores its normal transportation function, phlegm transforms naturally. However, if stagnation persists for a long time, like a blocked canal flooding, it flows backward and upward, becoming turbid, foul, and diverse. If one does not dredge the canal but tries to clarify the already blocked water, it is impossible. *Jinkui Yaolue* states: A person who was formerly fat but is now thin, with water moving in the intestines making a gurgling sound, is termed *Tan Yin* (Phlegm-Fluid). It should be treated with warm herbs to harmonize it. It also states: For Tan Yin at the epigastrium, *Guiling Gan Zhu Tang* (Cinnamon Twig, Poria, Licorice, and Atractylodes Macrocephala Decoction) is the primary formula. When drinking water flows into the hypochondria, causing pain upon coughing and spitting, it is termed *Xuan Yin* (Hanging Fluid), treated with *Shi Zao Tang* (Ten Jujube Decoction). (This medicine is too harsh; substitute with *Xiao Wei Dan* for a milder effect, but it must not be used in deficient persons.) When drinking water flows into the limbs, sweating should occur but does not, causing body pain and heaviness, it is termed *Yi Yin* (Overflowing Fluid), requiring diaphoresis. Treat with *Da Qing Long Tang* (Major Green Dragon Decoction) or *Xiao Qing Long Tang* (Minor Green Dragon Decoction). For coughing, rebellion, leaning to breathe, shortness of breath, inability to lie down, and swelling-like appearance, it is termed *Zhi Yin* (Supporting Fluid). It also states: Vomiting patients usually feel thirsty; if they do not feel thirsty now, it is due to Zhi Yin at the epigastrium, treated with *Xiao Banxia Tang* (Minor Pinellia Decoction). It also states: For Zhi Yin at the epigastrium causing dizziness and vertigo, *Zexie Tang* (Alisma Decoction) is the primary formula. Commonly use *Haizang Wu Yin Tang* or *Beizhu Wan* from *Ju Fang*. Zhu Danxi said: The sources of phlegm are varied. There is phlegm generating heat, heat generating phlegm, phlegm arising from Qi, from Wind, from Shock, from accumulated fluids, from excessive eating, from Summerheat, from cold-damaging foods, from Spleen deficiency, and from alcohol indulgence. Its diseases include: Shock Phlegm causes Pericardium pain and epilepsy. Heat Phlegm causes vexation, headache, rotting eyes, dry constipation, palpitations, and distress. Wind Phlegm causes paralysis, severe wind stroke, vertigo, silent wind, and confusion. Fluid Phlegm causes hypochondriac pain, inability to move limbs, and daily vomiting. Food Phlegm causes malaria and dysentery, bad breath. Summerheat Phlegm causes fainting, dizziness, jaundice, and headache. Cold Phlegm causes bone bi, inability to move limbs, and stabbing Qi pain. Alcohol Phlegm causes indigestion of alcohol, vomiting the next day after drinking. Spleen Deficiency Phlegm causes poor appetite, regurgitation, and vomiting. Qi Phlegm causes wandering stabbing pain. Women suffer most from Shock Phlegm, likely due to intercourse postpartum while menstruation is just starting; shock enters due to deficiency, forming lumps. There must be a lump in the abdomen; during attacks, it moves and jumps like pregnancy, unbearable pain. For Heat Phlegm, use *Huanglian Lige Wan*; for downward purging, use *Miaoying Wan* plus Penxiao in equal parts, 3 liang per dose; *Tun Tan Wan* is also usable. For Shock Phlegm, use *Miaoying Wan* plus Zhusha (2 qian) and Quanxie (3 qian), 8-9 pills per dose, taken 3-5 times to eliminate completely. For Shock Qi forming lumps, use *Miaoying Wan* plus fried Shanzhijia and calcined Biejia (3 qian each), Yanhusuo and Pengze (4 qian each), 50-70 pills per dose, stopping when loose stools occur. For Cold Phlegm, use *Miaoying Wan* plus Hujiao, Dingxiang, Quanxie, and Rougui in equal parts, 25 pills per dose. For Wind Phlegm, use *Qufeng Wan* or *Daotan Wan*. For Alcohol Phlegm, use *Miaoying Wan* plus Xionghuang and Quanxie (2 qian each), 10 pills per dose. For Fluid Phlegm, use *Xiao Wei Dan*. For Food Phlegm, use *Baohe Wan*. For Summerheat Phlegm, use *Xiaoshu Dan*. Pang Anchang said: In the human body, phlegm never rises inversely; in the world, water never flows upstream. Thus, skilled phlegm doctors treat Qi, not phlegm; when Qi is smooth, body fluids follow Qi smoothly. Use *Suzi Jiangqi Tang* and *Daotan Tang* half doses mixed and decocted. Or *Xiao Banxia Fuling Tang* plus Zhishi and Muxiang (half qian each), swallowing *Wutao Wan*. Or decoct *Wutao Wan* ingredients as a drink. If otherwise healthy but with a few mouthfuls of phlegm, clear or hard, use *Erchen Tang* or *Xiao Banxia Fuling Tang*. For abundant phlegm, intermittently take *Qingzhou Baiwanzi* and *Laifu Dan*, named *Laibai Wan*; if mixed with *Bashen Laifu Dan*, it is named *Qingshen Wan*. This treats not only phlegm-fluid but especially wheezing, cough, vomiting, and regurgitation. When phlegm-fluid flows into limbs, causing shoulder/back soreness and soft numbness in hands, misdiagnosed as Wind, it is incorrect treatment; use *Daotan Tang* plus Muxiang and Jianghuang (half qian each). Generally, when phlegm-fluid generates various syndromes, do not be dragged by them or invent new names; prioritize treating the fluid. Once fluid resolves, other syndromes heal themselves. For example, headache and angular eye pain unresponsive to wind herbs respond to phlegm herbs. Red, light-sensitive, painful eyes unresponsive to cooling herbs heal with phlegm formulas. Such cases are numerous and scattered in various sections, not repeated here. For insufficient Yin blood with ministerial fire rebelling upwards, insulting the Lungs, preventing clear descending, leading to turbid fluids forming phlegm instead of blood, use moistening agents like Maidong, Dihuang, and Gouqizi to nourish Yin, allowing rebelling fire to return home and rest, clearing phlegm. Using *Erchen Tang* here leads to danger. Kidney deficiency failing to grasp Qi leads to accumulation; if accumulation does not disperse, phlegm forms; treat with *Bawei Wan*. Fine, slippery, or moderate pulse with thin phlegm-saliva, fatigue, and weak limbs indicates Spleen deficiency with dampness; use *Liujunzi Tang* or *Buzhong Yiqi Tang* plus Banxia and Fuling. Knotted, choppy pulse with chest oppression or stabbing pain indicates Qi depression; use *Qi Qi Tang* or *Yueju Wan*. Some people sitting spit phlegm-saliva everywhere, not sticky but frothy, indicating Qi deficiency failing to control saliva; do not use draining medicines, use *Liujunzi Tang* plus Yizhiren (1 qian) to control it. Gong Lu'an from Danyang, over seventy years old, had uncomfortable phlegm in the diaphragm, poor appetite, initially harmless. He sought medical care in Jingkou, taking *Yueju Wan* and *Qingqi Huatan Wan*, feeling slightly relieved, took them daily without stopping. After more than a year, he was exhausted, rented a boat to seek my help. His muscles were wasted, pulses like wandering threads, Taixi pulse absent. Seeing my difficulty, he said, "I expect to die, but diaphragmatic bloating is unbearable, constipation is severe. Please relieve me briefly before I die." Insisting I prescribe, out of kinship duty, I taught using large doses of Renshen and Baizhu decocted in water. Shortly after, he went to toilet, passed several liters of accumulated phlegm, chest felt relieved, but died a few days later.