人有肠胃之间，沥沥有声，饮水更甚，吐痰如涌，人以为痰饮之病，谁知是胃气之虚乎
。夫胃为水谷之海，饮食无不入于胃中，游溢精气，上输脾胃，下输膀胱，水精四布，五经
并行，此胃气之旺而然也。倘胃气一虚，仅能消谷，不能消水，由是水入胃中，不存于胃而
下流于肠，故沥沥有声也。其症初犹不觉，久之水之精华，变为混浊，遂成痰饮，团聚于呼
吸难到之处而上涌矣。然则痰之来也，由于胃气之虚，痰之成也，由于水气之盛。治痰必先
消水，消水必先健胃，但徒补胃土，而胃气不能自旺。盖胃气之衰，由心包之气弱也，补胃
土必须补心包之火耳。
方用散痰汤∶
白术（三钱） 茯苓（五钱） 肉桂（五分） 陈皮（五分） 半夏（一钱） 薏仁（五钱） 山药（五钱） 人
参（一
水煎服。
此方即二陈汤之变也。二陈汤止助胃以消痰，未若此方助心包以健胃。用肉桂者，不特
助心包之火，且能引茯苓、白术入于膀胱，以分消其水湿之气，薏仁、山药又能燥脾，以泄
其下流之水，水泻而痰涎无党，不化痰而化精矣，岂尚有痰饮之不愈哉。
此症用运痰汤亦效。
人参 半夏（各三钱） 茯苓（一两） 陈皮（三分） 益智仁（五粒） 肉桂（一钱）
水煎服。
人有水流胁下，咳唾引痛，吐痰甚多，不敢用力，人以为悬饮之病，谁知是胃气之怯乎
。夫饮水宜入于肠，今入于胁，乃胃气之逆也。第胃不怯，则胃之气不逆，胃气旺而水怯，
胃气怯而水旺。欲使水逆而归于顺，必使胃旺而后可导其水势之下行，提其胃气之上升，自
然怯者不怯，逆者不逆也。
方用弱痰汤∶
人参（一钱） 茯苓（五钱） 荆芥（一钱） 薏仁（一两） 陈皮（五钱） 天花粉（三钱） 枳壳（三分） 白
芥子（二钱）
水煎服。
上能消膜膈之痰，下能逐肠胃之水，助气则气旺而水降矣。倘徒用消痰之药，不补其胃
气之虚，则气降而水升，泛滥之祸不止矣。
此症用加味四君汤亦效。
人参 白芍（各三钱） 白术 茯苓（各五钱） 陈皮（五分） 益智仁（一钱） 甘草（三分）
水煎服。
人有痰涎流溢于四肢，汗不出而身重，吐痰靡已，人以为溢饮之病，谁知是胃气之壅乎
。夫天一生水，流灌无处不到，一有瘀蓄，则秽浊丛积，水道泛滥而横流旁溢矣。凡水必入
胃，胃通而水何能积。惟胃土有壅滞，水不走膀胱而顺流，乃由胃而外渗于四肢，四肢无泄
水之路，必化汗而出。然水能化汗，由于胃气之行也。今胃既壅阻，胃气不行，何能化汗，
水又何从而出。身重者，正水湿之征也。四肢水湿不能出，自然上涌而吐痰矣。治法必顺其
性，因势利导之，庶几泛滥之害可除。开胃土之壅，而膀胱小肠之水道自通。然土壅由于肝
木之克，宣肝气之郁，补胃气之虚，胃壅可开矣。
方用启闭汤∶
白术（三钱） 茯苓（五钱） 白芍（三钱） 柴胡（五分） 猪苓（一钱） 浓朴（一钱） 泽泻（一钱） 半
夏（一钱）
水煎服。连服四剂而痰消，再服四剂而身轻矣。
此方即四苓散之变也。加入柴、芍以舒肝，加入浓朴以行气，加入半夏以消痰，自然气
行而水亦行，气化而痰亦化矣。
此症用白花饮亦佳。
白术（五钱） 薏仁 茯苓（各一两） 甘草（五分） 天花粉（三钱） 柴胡（一钱） 枳壳（五分）
水煎服。
人有咳逆倚息短气，其形如肿，吐痰不已，胸膈饱闷，人以为支饮之症，谁知是胃气之
逆乎。夫胃为水谷之海，宜顺不宜逆，顺则水化为精，逆则水化为痰。然逆有深浅之不同，
逆浅而痰入于胸，逆深而痰入于膈。然而胃气之逆，致痰饮上行，竟入于胸膈之间，则其逆
亦甚。而逆何以至此也，胃为肾之关，肾虚而气冲于胃，则胃失其启阖之权，关门不闭，反
随肾气而上冲，肾挟胃中之痰而入于肺，肺得水气而侵，故现水肿之状，咳逆倚息之病生。
其症似乎气之有余，而实气之不足，故短气而不可以接续也。治法转胃气之逆，而痰可降，
补肾气之虚，而胃可顺矣。
方用转胃汤∶
山药（一两） 薏仁（一两） 人参（一两） 白术（五钱） 牛膝（三钱） 附子（一分） 陈皮（三分） 苏
子（二钱） 麦冬（一两） 白芥子（三钱）
水煎服。一剂胃气平，二剂胃气转，三剂咳逆短气之症除，四剂全愈。
此方转胃为名，而实所以转肾气之逆也。肾逆而后胃逆，然则肾转正所以转胃也。此等
之病，非此大剂，则胃之气必不能通于胃之中，而肾之气必不能归于肾之内，倘日日治痰，
则耗损胃气，而肾气益逆，何日是降痰之时哉，势不至于死不已也。
此症用加味参术苓桂汤亦佳。
人参 茯苓 麦冬 山药（各五钱） 白术（一两） 破故纸（一钱） 苏子 肉桂（各一钱）
水煎服。
人有终日吐痰，少用茶水则心下坚筑，短气恶水，人以为水在于心，谁知火郁于心乎。
夫心属火，最恶者水也，若心气不虚，水之入胃，正足以养心，而水亦不敢直入以犯之。惟
心气之虚，火先畏水，而水即乘其畏以相攻，火欲出而不得出，自郁于内而气不得宣，故筑
动而短气，非气之真短也。火既与水相战，则水正火之仇也，伤水恶水又何疑乎。治法不可
徒利乎水也，利水必先消痰，而消痰必至损胃，胃气损而心气愈虚，水与痰终难去也。必须
补心以生胃，散郁以利水，则火气旺而水不能侵，自不至停于心下而变为湿痰也。
方用胜水汤∶
茯苓（一两） 车前子（三钱） 人参（三钱） 远志（一钱） 甘草（三分） 菖蒲（一钱） 柴胡（一钱） 白
术（一两） 陈皮（五分） 半夏（一钱）
水煎服。一剂轻，二剂又轻，四剂全愈。
此方六君子之变也。补心散郁并而行之，心气健而火气自通，火气通而胃之气自旺，土
旺自能制水，何畏于水之攻心哉。
此症用加减运痰汤亦效。
人参（三钱） 茯神（一两） 益智仁（一钱） 菖蒲（一钱） 泽泻（五钱） 肉桂（五分）
水煎服。
人有口吐涎沫，渴欲饮水，然饮水又不能多，仍化为痰而吐出，人以为水之在肺也，谁
知是肺气之热乎。夫肺主气，行营卫，布津液，周流于一身，不可停住者也。惟水邪入之，
塞其气道，气凝不通，液聚不达，遂变为涎沫。而清肃之令失，肺乃生火以自焚，故引外水
以救内火，然内火终非外水可息，外水亦非内火易消，故不化精津，仍变为痰涎而上吐也。
治法清肺金之热，不取给于外水，则水不入肺，而涎沫可解。然肺金失清肃之令，不止水邪
之故。盖水邪之入肺，因心火之克肺也。肺因火邪相侵，原思水以相济，水乃乘其渴而入之
，故欲解肺金之热，必须清心火之炎。
方用解炎汤∶
黄连（五分） 天花粉（二钱） 黄芩（一钱） 麦冬（一两） 茯苓（五钱） 桔梗（一钱） 甘草（三分） 陈
皮（三分） 神曲（五分）
水煎服。一剂渴解，二剂痰消，不必三剂。
此方清心肺之热，而痰气过升，亦非所宜。加入茯苓下行于膀胱，则火随水走，其势自
顺，既能消痰，又能降火，何至肺气之壅塞乎。且此方虽消痰降火，不耗损肺金之气，此痰
之所以易消，火之所以易降也。
此症用息沸饮亦佳。
麦冬（二钱） 款冬花（一钱） 茯神（二钱） 甘草（一钱） 桔梗（三钱） 黄芩（二钱） 天花粉（二钱） 竹
叶（三十片）
水煎服。
人有少气身重，日吐清水、清痰，人以为水在脾也，谁知是脾气之寒乎。夫脾为湿土，
所恶者水，喜者火也。火衰则水旺，水旺则火衰，必然之理也。盖无火则土为寒土，水不能
燥，而且有凝冻之忧，即有微火，仅可化水，而不能化津，但能变痰，而不能变液。且火既
衰微，止可化上焦之水，不能解下焦之冻。此清痰、清水所以上吐而不下行也。湿流于四体
，身安得不重乎。治法必须利水清痰，以燥脾土之气。然而脾中无火，虽脾土之衰，由于肾
火之弱也。不补肾中之火，则釜下无薪，土如冰炭，安能大地阳回，变湿污之地为膏壤之区
乎。故必须补肾火之旺，而土自燥，土燥而湿自除耳。
方用燥土汤∶
白术（一两） 茯苓（一两） 肉桂（二钱） 人参（三钱） 破故纸（一钱） 山药（五钱） 芡实（五钱） 砂
仁（三粒） 益智仁（一钱） 半夏（二钱）
水煎服。
此方燥脾者居其七，燥肾者居其三，似乎仍重在补脾，而轻在补肾。不知脾喜燥，而肾
恶燥，使燥肾之药太多，则肾先受损，何以益脾乎。此用药之妙于权衡也。
此症亦可用加减运痰汤∶
人参 茯神（各三钱） 白术（五钱） 肉桂（一钱） 白豆蔻（一枚） 陈皮（五分） 神曲（一钱） 半夏（一
钱）
水煎服。
人有痰气流行，胁下肢满，发嚏而痛，轻声吐痰，不敢重咯，此非水气在肝，乃郁气在
肝也。夫肝藏血而不藏水，宜水之所不到。然而肝气郁则血不藏矣，血不藏而水乘隙而入肝
而肝终不藏水，水乃留伏于肝之外而不散，肝气本郁以招水，又因水而愈郁，肝气之逆可知
矣。胁下正肝之部位，肝气已郁，即无水邪相犯，尚有胀急之症，水停胁下，安得不支满
乎。发嚏而痛者，以火郁未宣，得嚏则火欲出而不得出，因吊动作痛也。治法必须达肝气
之郁，少佐以消痰分水之药，则随手奏功矣。
方用开痰饮∶
柴胡（一钱） 半夏（一钱） 甘草（一钱） 炒栀子（一钱） 陈皮（一钱） 薄荷（一钱） 枳壳（三分） 苍
术（二钱） 茯苓（五钱）
水煎服。二剂肝气之郁舒，四剂胁满之痛去，不必五剂。
此方专解肝郁，郁舒火散，自不下克脾胃之土，上引痰涎之闭矣。宁尚有水停胁下，以
增痛满者哉。
此症可用疏痰汤∶
白芍 茯神（各五钱） 甘草 神曲 半夏（各一钱）
水煎服。
人有水泛为痰，涎如清水，入水即化，人亦不知为肾中之痰，岂知肾寒而精变为痰乎。
夫各经之痰，皆外水入而化痰，惟肾中之痰乃内水所成，故心肝脾肺之痰，可以用攻，而独
治肾中之痰，必须用纯补之药，不可少间攻痰之味。盖肾中之痰，乃纯阴之水也，阴火非阳火
不能摄。阳火者，水中之火也。阴水泛而火微，阳水旺而火伏，大补其水中之火，不必降痰
而痰自降矣。
方用八味地黄汤∶
熟地（一两） 山药（五钱） 山茱萸（五钱） 泽泻（三钱） 丹皮（三钱） 茯苓（一两） 肉桂（二钱） 附
子（一钱）
水煎服。一剂水泛为痰者立时即消。
天下治痰之捷效，未有胜于此方者也。然亦止可治肾寒而痰泛者，不可执此方以概治痰
也。盖痰非肾泛，则痰为外邪，何可以治内痰者移而治外痰乎。惟真正是肾水上泛者，用此
方实效应如响，然亦必须多用茯苓与熟地之分两相同，则肾水归源，而上、中、下三焦之湿
气尽行消化，始无伏留之弊。万勿执定仲景夫子原方，谓茯苓不可多用，故又表而出之。
此症用复阴丹亦妙。
熟地（一两） 山茱萸（五钱） 芡实 山药（各一两） 肉桂（一钱）
水煎服。
人有吐痰纯是白沫，咳嗽不已，日轻夜重，人以为肺火之痰也，谁知肾热而火沸为痰乎
。此等之痰，乃阴虚火动，大约成痨瘵者居多，即古之所谓吐白血也。其痰一似蟹涎，吐之
不已，必色变如绿涕之色，即痨瘵之已成，而不可救疗者也。然而痨瘵而吐白沫，是肾绝之
痰也。亦有未成痨瘵，与阴虚之火初动，而即成此痰，与痨瘵已成者尚有分别，何可置之不
救。世人一味治痰，绝不识治肾中之阴，不变成痨瘵而不止。夫火沸为痰者，成于肾火之太
旺，由于水衰之极也。肾可补不可泻，补肾水之衰，即所以泻肾火之旺，故用补阴之药以制
阳，不可用泻阳之品以救阴也。倘见其肾火之旺，而轻用黄柏、知母，毋论火不可以骤息，
痰不可以遽消，且击动其火，以变为痨瘵者比比也。治法但补水以逐痰，则痰消于乌有矣。
方用定沸汤∶
熟地（二两） 山茱萸（一两） 麦冬（一两） 北五味（二钱） 茯苓（一两） 山药（一两） 玄参（一两） 白
芥子（三钱）
水煎服。连服二剂，火沸之痰不知其何以去也。此方宜连服十剂，不可见二剂之效，便
撤饮不服。
盖火沸之痰，实本于阴虚，而阴虚之火，非多服补阴之药，则阴不能大长，火不能急散
也。病者以此方为续命之汤，医者以此方为夺命之剂，幸勿轻弃之也。
此症用归沫汤亦大妙。
熟地（二两） 山萸肉 玄参（各一两） 天冬 女贞子 生地 百合（各三钱） 款冬花（一钱）
水煎服。
人有偶感风邪，鼻塞咳嗽，吐痰黄浊，人以为痰塞胸膈也，法宜吐，谁知风邪塞于肺经
乎。夫邪在肺，古人亦有用吐而效者，以肺气闭塞，谓吐中有发散之义也。然必大满大实之
有人在肠胃之间，听到沥沥的水声，喝水后声音更明显，呕吐痰液像涌出一样，人们认为这是痰饮病，谁知道这是胃气虚弱呢？
胃是水谷汇聚的海，饮食没有不进入胃中的，（胃气）游溢精气，向上输送到脾和肺，向下输送到膀胱，水精四布，五脏经脉并行，这是胃气旺盛的表现。如果胃气一旦虚弱，只能消化谷物，不能消化水液，因此水进入胃中，不存留在胃里而向下流入肠道，所以发出沥沥的声音。这种症状起初还不觉察，时间久了水的精华变成混浊，于是形成痰饮，团聚在呼吸难以到达的地方而上涌。既然这样，痰的产生，是由于胃气虚弱；痰的形成，是由于水气盛旺。治疗痰必须先消除水，消除水必须先健运胃，但如果单纯补益胃土，胃气不能自然旺盛。因为胃气的衰弱，是由心包之气虚弱造成的，补益胃土必须补益心包之火才行。
方用散痰汤：
白术（三钱） 茯苓（五钱） 肉桂（五分） 陈皮（五分） 半夏（一钱） 薏仁（五钱） 山药（五钱） 人参（一钱）
水煎服。
这个方子是二陈汤的变方。二陈汤只是帮助胃来消除痰，不如这个方子帮助心包来健运胃。使用肉桂，不仅助心包之火，而且能引导茯苓、白术进入膀胱，以分消其水湿之气，薏仁、山药又能燥脾，以泄去下流的水，水泻则痰涎失去依附，不化痰而化精了，难道还有痰饮治不好的吗？
这个症状用运痰汤也有效。
人参 半夏（各三钱） 茯苓（一两） 陈皮（三分） 益智仁（五粒） 肉桂（一钱）
水煎服。
有人水流在胁下，咳嗽吐唾引致疼痛，吐痰很多，不敢用力，人们认为是悬饮病，谁知道这是胃气怯弱呢？
饮水应该进入肠道，现在进入胁下，这是胃气上逆。只要胃不怯弱，胃的气机就不上逆，胃气旺盛而水势怯弱，胃气怯弱而水势旺盛。想要使水逆乱而归于顺行，必须使胃气旺盛，然后才可以引导水势下行，提举胃气上升，自然怯弱的不再怯弱，逆乱的不再逆乱。
方用弱痰汤：
人参（一钱） 茯苓（五钱） 荆芥（一钱） 薏仁（一两） 陈皮（五钱） 天花粉（三钱） 枳壳（三分） 白芥子（二钱）
水煎服。
上方上部能消除膈膜的痰，下部能驱逐肠胃的水，助长气机则气旺而水降。如果只用消痰的药，不补益胃气的虚弱，那么气降而水升，泛滥的祸患就不会停止。
这个症状用加味四君汤也有效。
人参 白芍（各三钱） 白术 茯苓（各五钱） 陈皮（五分） 益智仁（一钱） 甘草（三分）
水煎服。
有人痰涎流溢在四肢，不出汗而身体沉重，吐痰不停，人们认为是溢饮病，谁知道这是胃气壅滞呢？
天一生水，流灌无处不到，一旦有瘀积蓄留，则秽浊丛聚，水道泛滥而横流旁溢。凡水必入胃，胃通畅而水怎么能积聚。只有胃土有壅滞，水不走膀胱而顺流，乃由胃向外渗透于四肢，四肢没有排泄水的路径，必然化为汗而出。然而水能化为汗，是由于胃气的运行。现在胃既壅阻，胃气不行，怎么能化汗，水又从哪里排出。身体沉重，正是水湿的征象。四肢水湿不能排出，自然上涌而吐痰。治疗方法必须顺应其本性，因势利导，差不多泛滥的危害可以消除。开通胃土的壅滞，而膀胱小肠的水道自然通畅。然而土壅是由于肝木克制，宣发肝气的郁结，补益胃气的虚弱，胃壅就可以开通了。
方用启闭汤：
白术（三钱） 茯苓（五钱） 白芍（三钱） 柴胡（五分） 猪苓（一钱） 浓朴（一钱） 泽泻（一钱） 半夏（一钱）
水煎服。连服四剂而痰消，再服四剂而身体轻快。
这个方子是四苓散的变方。加入柴胡、白芍以舒肝，加入浓朴以行气，加入半夏以消痰，自然气行而水亦行，气化而痰亦化。
这个症状用白花饮也很好。
白术（五钱） 薏仁 茯苓（各一两） 甘草（五分） 天花粉（三钱） 柴胡（一钱） 枳壳（五分）
水煎服。
有人咳嗽气逆倚靠呼吸短气，身形如肿，吐痰不停，胸膈饱闷，人们认为是支饮症，谁知道这是胃气上逆呢？
胃是水谷之海，宜顺不宜逆，顺则水化为精，逆则水化为痰。然而逆有深浅的不同，逆浅而痰进入胸，逆深而痰进入膈。然而胃气上逆，导致痰饮上行，竟进入胸膈之间，那么它的逆也很严重。而逆为什么会到这种地步，胃是肾的关口，肾虚而气冲于胃，则胃失去开启闭合的权力，关门不闭，反而随肾气而上冲，肾挟带胃中的痰进入肺，肺得水气而受侵，所以出现水肿的状态，咳逆倚息的病产生。
这种症状似乎气有余，而实际上是气不足，所以短气而不能接续。治疗方法转顺胃气上逆，而痰可降，补肾气虚弱，而胃可顺。
方用转胃汤：
山药（一两） 薏仁（一两） 人参（一两） 白术（五钱） 牛膝（三钱） 附子（一分） 陈皮（三分） 苏子（二钱） 麦冬（一两） 白芥子（三钱）
水煎服。一剂胃气平，二剂胃气转，三剂咳逆短气症状除，四剂全愈。
这个方子以转胃为名，而实际是用来转顺肾气上逆。肾逆而后胃逆，那么肾转正所以转胃。这种病，不用这种大剂量药，那么胃的气一定不能通于胃之中，而肾的气一定不能归于肾之内，如果天天治痰，则耗损胃气，而肾气更加上逆，哪一天是降痰的时候呢，势必不到死不止。
这个症状用加味参术苓桂汤也很好。
人参 茯苓 麦冬 山药（各五钱） 白术（一两） 破故纸（一钱） 苏子 肉桂（各一钱）
水煎服。
有人整天吐痰，少用茶水则心下坚硬跳动，短气恶水，人们认为水在心，谁知道是火郁于心呢？
心属火，最厌恶的是水，如果心气不虚，水进入胃，正足以养心，而水也不敢直接侵入侵犯它。只有心气虚，火先畏惧水，而水就乘其畏惧来相攻，火想出来却出不来，自然郁结在内而气不得宣通，所以跳动而短气，不是气真的短。火既与水相战，则水是火的仇敌，伤水恶水又有什么可疑呢。治疗方法不可只利水，利水必先消痰，而消痰必至于损胃，胃气损而心气更虚，水与痰终究难去除。必须补心以生胃，散郁以利水，则火气旺而水不能侵，自然不至于停于心下而变为湿痰。
方用胜水汤：
茯苓（一两） 车前子（三钱） 人参（三钱） 远志（一钱） 甘草（三分） 菖蒲（一钱） 柴胡（一钱） 白术（一两） 陈皮（五分） 半夏（一钱）
水煎服。一剂轻，二剂又轻，四剂全愈。
这个方子是六君子汤的变方。补心散郁并而行之，心气健而火气自通，火气通而胃之气自旺，土旺自能制水，何畏于水之攻心哉。
这个症状用加减运痰汤也有效。
人参（三钱） 茯神（一两） 益智仁（一钱） 菖蒲（一钱） 泽泻（五钱） 肉桂（五分）
水煎服。
有人口吐涎沫，口渴想喝水，然而喝水又不能多，仍化为痰而吐出，人们认为是水在肺，谁知道是肺气热呢？
肺主气，行营卫，布津液，周流于一身，不可停住。只有水邪进入，塞其气道，气凝不通，液聚不达，遂变为涎沫。而清肃的政令丧失，肺乃生火以自焚，所以引外水来救内火，然而内火终究不是外水可熄，外水也不是内火易消，所以不化精津，仍变为痰涎而上吐。
治疗方法清肺金的热，不取给于外水，则水不入肺，而涎沫可解。然而肺金失清肃的政令，不只是水邪的缘故。盖水邪之入肺，因心火克肺。肺因火邪相侵，原思水以相济，水乃乘其渴而入之，故欲解肺金的热，必须清心火的炎。
方用解炎汤：
黄连（五分） 天花粉（二钱） 黄芩（一钱） 麦冬（一两） 茯苓（五钱） 桔梗（一钱） 甘草（三分） 陈皮（三分） 神曲（五分）
水煎服。一剂渴解，二剂痰消，不必三剂。
这个方子清心肺的热，而痰气过升，也不适宜。加入茯苓下行于膀胱，则火随水走，其势自然顺，既能消痰，又能降火，何至肺气之壅塞乎。且此方虽消痰降火，不耗损肺金之气，这痰之所以易消，火之所以易降的原因。
这个症状用息沸饮也很好。
麦冬（二钱） 款冬花（一钱） 茯神（二钱） 甘草（一钱） 桔梗（三钱） 黄芩（二钱） 天花粉（二钱） 竹叶（三十片）
水煎服。
有人少气身重，每天吐清水、清痰，人们认为是水在脾，谁知道是脾气寒呢？
脾为湿土，所厌恶的是水，喜欢的是火。火衰则水旺，水旺则火衰，是必然的道理。盖无火则土为寒土，水不能燥，而且有凝冻之忧，即有微火，仅可化水，而不能化津，但能变痰，而不能变液。且火既衰微，止可化上焦之水，不能解下焦之冻。这清痰、清水所以上吐而不下行的原因。湿流于四体，身体安得不重呢。治疗方法必须利水清痰，以燥脾土之气。然而脾中无火，虽然脾土之衰，由于肾火之弱。不补肾中之火，则釜下无薪，土如冰炭，安能大地阳回，变湿污之地为膏壤之区乎。故必须补肾火之旺，而土自燥，土燥而湿自除耳。
方用燥土汤：
白术（一两） 茯苓（一两） 肉桂（二钱） 人参（三钱） 破故纸（一钱） 山药（五钱） 芡实（五钱） 砂仁（三粒） 益智仁（一钱） 半夏（二钱）
水煎服。
这个方子燥脾者占七分，燥肾者占三分，似乎仍重在补脾，而轻在补肾。不知脾喜燥，而肾恶燥，使燥肾的药太多，则肾先受损，何以益脾乎。这是用药的妙在于权衡。
这个症状也可用加减运痰汤：
人参 茯神（各三钱） 白术（五钱） 肉桂（一钱） 白豆蔻（一枚） 陈皮（五分） 神曲（一钱） 半夏（一钱）
水煎服。
有人痰气流行，胁下肢满，打喷嚏而痛，轻声吐痰，不敢重咯，这不是水气在肝，乃是郁气在肝。
肝藏血而不藏水，宜水之所不到。然而肝气郁则血不藏矣，血不藏而水乘隙而入肝，而肝终不藏水，水乃留伏于肝之外而不散，肝气本郁以招水，又因水而愈郁，肝气之逆可知矣。胁下正是肝的部位，肝气已郁，即无水邪相犯，尚有胀急之症，水停胁下，安得不支满乎。打喷嚏而痛的，是因为火郁未宣，得嚏则火欲出而不得出，因吊动作痛。治疗方法必须达肝气之郁，少佐以消痰分水之药，则随手奏功。
方用开痰饮：
柴胡（一钱） 半夏（一钱） 甘草（一钱） 炒栀子（一钱） 陈皮（一钱） 薄荷（一钱） 枳壳（三分） 苍术（二钱） 茯苓（五钱）
水煎服。二剂肝气之郁舒，四剂胁满之痛去，不必五剂。
这个方子专解肝郁，郁舒火散，自然不下克脾胃之土，上引痰涎之闭。宁尚有水停胁下，以增加痛满者哉。
这个症状可用疏痰汤：
白芍 茯神（各五钱） 甘草 神曲 半夏（各一钱）
水煎服。
有人水泛为痰，涎如清水，入水即化，人也不知道是肾中之痰，岂知肾寒而精变为痰呢？
各经之痰，皆外水入而化痰，惟肾中之痰乃内水所成，故心肝脾肺之痰，可以用攻，而独治肾中之痰，必须用纯补之药，不可少间攻痰之味。盖肾中之痰，乃纯阴之水也，阴火非阳火不能摄。阳火者，水中之火也。阴水泛而火微，阳水旺而火伏，大补其水中之火，不必降痰而痰自降。
方用八味地黄汤：
熟地（一两） 山药（五钱） 山茱萸（五钱） 泽泻（三钱） 丹皮（三钱） 茯苓（一两） 肉桂（二钱） 附子（一钱）
水煎服。一剂水泛为痰者立时即消。
天下治痰的捷效，没有胜过这个方的。然而也只可治肾寒而痰泛者，不可执此方以概治痰。盖痰非肾泛，则痰为外邪，何可以治内痰者移而治外痰乎。惟真正是肾水上泛者，用此方实效应如响，然也必须多用茯苓与熟地的分量相同，则肾水归源，而上、中、下三焦之湿气尽行消化，始无伏留之弊。万勿执定仲景夫子原方，谓茯苓不可多用，故又表而出之。
这个症状用复阴丹也妙。
熟地（一两） 山茱萸（五钱） 芡实 山药（各一两） 肉桂（一钱）
水煎服。
有人吐痰纯是白沫，咳嗽不已，日轻夜重，人们认为是肺火之痰，谁知道肾热而火沸为痰呢？
这种痰，乃阴虚火动，大约成痨瘵者居多，即古之所谓吐白血。其痰一似蟹涎，吐之不已，必色变如绿涕之色，即痨瘵之已成，而不可救疗。然而痨瘵而吐白沫，是肾绝之痰。也有未成痨瘵，与阴虚之火初动，而即成此痰，与痨瘵已成者尚有分别，何可置之不救。世人一味治痰，绝不识治肾中之阴，不变成痨瘵而不止。夫火沸为痰者，成于肾火之太旺，由于水衰之极。肾可补不可泻，补肾水之衰，即所以泻肾火之旺，故用补阴之药以制阳，不可用泻阳之品以救阴。倘见其肾火之旺，而轻用黄柏、知母，毋论火不可以骤息，痰不可以遽消，且击动其火，以变为痨瘵者比比。治疗方法但补水以逐痰，则痰消于乌有。
方用定沸汤：
熟地（二两） 山茱萸（一两） 麦冬（一两） 北五味（二钱） 茯苓（一两） 山药（一两） 玄参（一两） 白芥子（三钱）
水煎服。连服二剂，火沸之痰不知其何以去。此方宜连服十剂，不可见二剂之效，便撤饮不服。
盖火沸之痰，实本于阴虚，而阴虚之火，非多服补阴之药，则阴不能大长，火不能急散。病者以此方为续命之汤，医者以此方为夺命之剂，幸勿轻弃。
这个症状用归沫汤也大妙。
熟地（二两） 山萸肉 玄参（各一两） 天冬 女贞子 生地 百合（各三钱） 款冬花（一钱）
水煎服。
有人偶感风邪，鼻塞咳嗽，吐痰黄浊，人们认为是痰塞胸膈，法宜吐，谁知道风邪塞于肺经。
邪在肺，古人也有用吐而效的，以肺气闭塞，谓吐中有发散之义。然而必大满大实之……
There are cases where there is a gurgling sound in the intestines and stomach, which becomes more pronounced after drinking water, and vomiting of phlegm occurs like a surge. People consider this to be a disease of Phlegm-Fluid (Tan Yin), but who would know that it is due to Deficiency of Stomach Qi?
The Stomach is the sea of water and grain; all food and drink enter the Stomach. The Stomach qi circulates and overflows with essence and qi, transporting them upward to the Spleen and Lung, and downward to the Bladder. Water essence distributes throughout the body, and the five meridians run in parallel. This is the result of vigorous Stomach qi. However, if Stomach qi becomes deficient, it can only digest grains but not fluids. Consequently, when water enters the Stomach, it does not stay in the Stomach but flows downward into the intestines, producing a gurgling sound. Initially, these symptoms may go unnoticed, but over time, the essence of the water turns turbid, forming Phlegm-Fluid. This accumulates in areas difficult to reach by respiration and surges upward. Thus, the origin of phlegm lies in the deficiency of Stomach qi, while its formation results from the abundance of fluid qi. To treat phlegm, one must first eliminate fluids; to eliminate fluids, one must strengthen the Stomach. Yet, merely tonifying Stomach earth will not allow Stomach qi to flourish spontaneously. The decline of Stomach qi stems from the weakness of Pericardium qi. Therefore, tonifying Stomach earth requires tonifying the fire of the Pericardium.
Prescribe San Tan Tang (Scatter Phlegm Decoction):
Bai Zhu (Atractylodis Rhizoma) - 3 qian
Fu Ling (Poria) - 5 qian
Rou Gui (Cinnamomi Cortex) - 5 fen
Chen Pi (Citri Reticulatae Pericarpium) - 5 fen
Ban Xia (Pinelliae Rhizoma Preparatum) - 1 qian
Yi Yi Ren (Coicis Semen) - 5 qian
Shan Yao (Dioscoreae Rhizoma) - 5 qian
Ren Shen (Ginseng Radix et Rhizoma) - 1 qian
Decoct in water and take orally.
This formula is a variation of Er Chen Tang (Two-Aged Decoction). Er Chen Tang only assists the Stomach to resolve phlegm, whereas this formula assists the Pericardium to strengthen the Stomach. Rou Gui is used not only to aid the fire of the Pericardium but also to guide Fu Ling and Bai Zhu into the Bladder to separate and eliminate damp-fluid qi. Yi Yi Ren and Shan Yao dry the Spleen to drain the downward-flowing water. Once water is drained, phlegm loses its support; essence is transformed without directly resolving phlegm. How could Phlegm-Fluid fail to heal?
For this syndrome, Yun Tan Tang (Transport Phlegm Decoction) is also effective:
Ren Shen (Ginseng Radix et Rhizoma) - 3 qian
Ban Xia (Pinelliae Rhizoma Preparatum) - 3 qian
Fu Ling (Poria) - 1 liang
Chen Pi (Citri Reticulatae Pericarpium) - 3 fen
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) - 5 grains
Rou Gui (Cinnamomi Cortex) - 1 qian
Decoct in water and take orally.
There are cases where fluid flows under the hypochondrium, causing pain upon coughing or spitting saliva, with excessive phlegm expectoration, making the patient afraid to exert force. People consider this Xuan Yin (Hanging Fluid), but who would know it is due to timidity/weakness of Stomach qi?
Water should normally enter the intestines; entering the hypochondrium indicates reversal of Stomach qi. If the Stomach is not weak, its qi does not reverse. When Stomach qi is vigorous, water is subdued; when Stomach qi is weak, water prevails. To restore order to rebellious water, one must first strengthen Stomach qi, guiding water downward and lifting Stomach qi upward. Naturally, weakness ceases, and rebellion stops.
Prescribe Ruo Tan Tang (Weak Phlegm Decoction):
Ren Shen (Ginseng Radix et Rhizoma) - 1 qian
Fu Ling (Poria) - 5 qian
Jing Jie (Schizonepetae Spica) - 1 qian
Yi Yi Ren (Coicis Semen) - 1 liang
Chen Pi (Citri Reticulatae Pericarpium) - 5 qian
Tian Hua Fen (Trichosanthis Radix) - 3 qian
Zhi Ke (Aurantii Fructus Immaturus) - 3 fen
Bai Jie Zi (Sinapis Semen) - 2 qian
Decoct in water and take orally.
The above herbs resolve phlegm in the upper diaphragm and drive water from the lower intestines and stomach. Strengthening qi makes qi vigorous and water descend. If one uses only phlegm-resolving drugs without tonifying deficient Stomach qi, qi descends while water rises, leading to unending flooding disasters.
For this syndrome, Jia Wei Si Jun Zi Tang (Modified Four Gentlemen Decoction) is also effective:
Ren Shen (Ginseng Radix et Rhizoma) - 3 qian
Bai Shao (Paeoniae Radix Alba) - 3 qian
Bai Zhu (Atractylodis Rhizoma) - 5 qian
Fu Ling (Poria) - 5 qian
Chen Pi (Citri Reticulatae Pericarpium) - 5 fen
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) - 1 qian
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 3 fen
Decoct in water and take orally.
There are cases where phlegm-saliva overflows into the four limbs, accompanied by anhidrosis and heavy body sensation, with continuous expectoration. People consider this Yi Yin (Overflowing Fluid), but who would know it is due to stagnation of Stomach qi?
Heaven generates water, flowing everywhere. Any stasis leads to accumulation of turbid matter, causing water channels to flood and overflow laterally. All water enters the Stomach; if the Stomach is open, how can water accumulate? Only when Stomach earth is stagnant does water fail to flow smoothly into the Bladder, instead seeping outward from the Stomach into the limbs. Since the limbs have no pathway to excrete water, it must transform into sweat. However, water transforms into sweat only through the movement of Stomach qi. Now, with Stomach obstruction and halted Stomach qi, how can sweat be produced, and where can water exit? Heavy body sensation is a sign of damp-water. With damp-water unable to exit the limbs, it surges upward, causing expectoration. Treatment must follow nature and guide according to circumstances to remove flooding hazards. Opening Stomach earth stagnation allows water channels of the Bladder and Small Intestine to clear naturally. Earth stagnation is caused by Liver wood counteracting; thus, one must soothe Liver qi depression and tonify Stomach qi deficiency to open Stomach stagnation.
Prescribe Qi Bi Tang (Open Closure Decoction):
Bai Zhu (Atractylodis Rhizoma) - 3 qian
Fu Ling (Poria) - 5 qian
Bai Shao (Paeoniae Radix Alba) - 3 qian
Chai Hu (Bupleuri Radix) - 5 fen
Zhu Ling (Polyporus) - 1 qian
Nong Po (Magnoliae Officinalis Cortex) - 1 qian
Ze Xie (Alismatis Rhizoma) - 1 qian
Ban Xia (Pinelliae Rhizoma Preparatum) - 1 qian
Decoct in water and take orally. After four doses, phlegm dissipates; after another four doses, the body feels light.
This formula is a variation of Si Ling San (Four Poria Powder). Chai Hu and Bai Shao soothe the Liver; Nong Po moves qi; Ban Xia resolves phlegm. Naturally, qi moves and water follows; qi transforms and phlegm dissolves.
For this syndrome, Bai Hua Yin (White Flower Drink) is also excellent:
Bai Zhu (Atractylodis Rhizoma) - 5 qian
Yi Yi Ren (Coicis Semen) - 1 liang
Fu Ling (Poria) - 1 liang
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 5 fen
Tian Hua Fen (Trichosanthis Radix) - 3 qian
Chai Hu (Bupleuri Radix) - 1 qian
Zhi Ke (Aurantii Fructus Immaturus) - 5 fen
Decoct in water and take orally.
There are cases of cough with air-reversal, leaning on objects for breath, shortness of breath, swelling-like appearance, continuous expectoration, and chest/diaphragm fullness. People consider this Zhi Yin (Supporting Fluid), but who would know it is due to reversal of Stomach qi?
The Stomach is the sea of water and grain; it prefers smoothness over rebellion. Smoothness transforms water into essence; rebellion transforms water into phlegm. Rebellion has depth: shallow rebellion puts phlegm in the chest, deep rebellion puts phlegm in the diaphragm. When Stomach qi rebels, driving phlegm-fluid upward into the chest and diaphragm, the rebellion is severe. Why does it reach this state? The Stomach is the gate of the Kidney. Kidney deficiency causes qi to rush into the Stomach, causing the Stomach to lose its opening/closing control. The gate fails to close, and qi rushes upward following Kidney qi. The Kidney carries phlegm from the Stomach into the Lung. The Lung is invaded by water qi, presenting edema, giving rise to cough with air-reversal and shortness of breath.
Although symptoms suggest excess qi, it is actually qi deficiency, hence shortness of breath without continuity. Treatment involves reversing Stomach qi rebellion to descend phlegm, and tonifying Kidney qi deficiency to smooth the Stomach.
Prescribe Zhuan Wei Tang (Turn Stomach Decoction):
Shan Yao (Dioscoreae Rhizoma) - 1 liang
Yi Yi Ren (Coicis Semen) - 1 liang
Ren Shen (Ginseng Radix et Rhizoma) - 1 liang
Bai Zhu (Atractylodis Rhizoma) - 5 qian
Niu Xi (Achyranthis Bidentatae Radix) - 3 qian
Fu Zi (Aconiti Lateralis Radix Preparata) - 1 fen
Chen Pi (Citri Reticulatae Pericarpium) - 3 fen
Su Zi (Perillae Fructus) - 2 qian
Mai Dong (Ophiopogonis Radix) - 1 liang
Bai Jie Zi (Sinapis Semen) - 3 qian
Decoct in water and take orally. One dose calms Stomach qi; two doses turn Stomach qi; three doses eliminate cough, air-reversal, and shortness of breath; four doses bring complete recovery.
Named "Turning Stomach," this formula actually turns rebellious Kidney qi. Kidney rebellion precedes Stomach rebellion; thus, rectifying the Kidney rectifies the Stomach. Such diseases require large doses; otherwise, Stomach qi cannot penetrate the Stomach interior, nor can Kidney qi return to the Kidney interior. Daily treatment of phlegm consumes Stomach qi, worsening Kidney rebellion. When will phlegm descend? It will not stop until death.
For this syndrome, Jia Wei Shen Zhu Ling Gui Tang (Modified Ginseng, Atractylodes, Poria, and Cinnamon Twig Decoction) is also good:
Ren Shen (Ginseng Radix et Rhizoma) - 5 qian
Fu Ling (Poria) - 5 qian
Mai Dong (Ophiopogonis Radix) - 5 qian
Shan Yao (Dioscoreae Rhizoma) - 5 qian
Bai Zhu (Atractylodis Rhizoma) - 1 liang
Po Gu Zhi (Psoraleae Fructus) - 1 qian
Su Zi (Perillae Fructus) - 1 qian
Rou Gui (Cinnamomi Cortex) - 1 qian
Decoct in water and take orally.
There are cases of whole-day expectoration. Using little tea/water causes hardness and palpitations below the heart, shortness of breath, and aversion to water. People think water is in the Heart, but who knows it is Fire Depression in the Heart?
The Heart belongs to Fire and fears water most. If Heart qi is not deficient, water entering the Stomach nourishes the Heart, and water dares not invade directly. Only when Heart qi is deficient does Fire fear water, allowing water to attack. Fire wants to emerge but cannot, depressing internally, blocking qi circulation, causing palpitations and shortness of breath—not true qi deficiency. Since Fire battles Water, Water is Fire's enemy; injuring/averting water is expected. Treatment should not merely promote urination. Promoting urination requires resolving phlegm, which damages Stomach qi. Damaged Stomach qi worsens Heart qi, making water and phlegm hard to remove. One must tonify the Heart to generate Stomach qi, scatter depression to facilitate water passage. Then Fire qi becomes vigorous, preventing water invasion, stopping fluid retention below the heart and transformation into Damp-Phlegm.
Prescribe Sheng Shui Tang (Overcome Water Decoction):
Fu Ling (Poria) - 1 liang
Che Qian Zi (Plantaginis Semen) - 3 qian
Ren Shen (Ginseng Radix et Rhizoma) - 3 qian
Yuan Zhi (Polygalae Radix) - 1 qian
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 3 fen
Shi Pu (Acori Tatarinowii Rhizoma) - 1 qian
Chai Hu (Bupleuri Radix) - 1 qian
Bai Zhu (Atractylodis Rhizoma) - 1 liang
Chen Pi (Citri Reticulatae Pericarpium) - 5 fen
Ban Xia (Pinelliae Rhizoma Preparatum) - 1 qian
Decoct in water and take orally. One dose brings relief; two doses further relief; four doses bring complete recovery.
This formula is a variation of Liu Jun Zi Tang (Six Gentlemen Decoction). Tonifying the Heart and scattering depression work together. Healthy Heart qi allows Fire qi to flow freely; flowing Fire qi strengthens Stomach qi. Strong Earth controls Water, fearing no water attack on the Heart.
For this syndrome, Jia Jian Yun Tan Tang (Modified Transport Phlegm Decoction) is also effective:
Ren Shen (Ginseng Radix et Rhizoma) - 3 qian
Fu Shen (Poria with Hostwood) - 1 liang
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) - 1 qian
Shi Pu (Acori Tatarinowii Rhizoma) - 1 qian
Ze Xie (Alismatis Rhizoma) - 5 qian
Rou Gui (Cinnamomi Cortex) - 5 fen
Decoct in water and take orally.
There are cases of mouth salivation, thirst wanting to drink, but inability to drink much, as ingested water transforms into phlegm and is vomited. People think water is in the Lung, but who knows it is Heat in Lung qi?
The Lung governs qi, circulates Ying and Wei, distributes body fluids, flowing throughout the body without stagnation. Only when Water Evil enters, blocking airways, does qi congeal and fluids gather, transforming into saliva/phlegm. Loss of Lung's clearing/descending function leads to internal Fire self-burning, prompting intake of external water to save internal Fire. However, internal Fire cannot be extinguished by external water, nor is external water easily consumed by internal Fire. Thus, it fails to transform into essence/fluids, remaining as phlegm-saliva and vomiting upward.
Treatment clears Lung Metal heat without relying on external water; then water does not enter the Lung, and saliva resolves. However, loss of Lung's clearing function is not solely due to Water Evil. Water Evil entering the Lung is caused by Heart Fire insulting Lung. Insulted by Fire, the Lung seeks Water to balance it; Water takes advantage of thirst to enter. Thus, to clear Lung heat, one must clear Heart Fire flare-up.
Prescribe Jie Yan Tang (Resolve Flare-up Decoction):
Huang Lian (Coptidis Rhizoma) - 5 fen
Tian Hua Fen (Trichosanthis Radix) - 2 qian
Huang Qin (Scutellariae Radix) - 1 qian
Mai Dong (Ophiopogonis Radix) - 1 liang
Fu Ling (Poria) - 5 qian
Jie Geng (Platycodonis Radix) - 1 qian
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 3 fen
Chen Pi (Citri Reticulatae Pericarpium) - 3 fen
Shen Qu (Massae Fermentatae Medicinalis) - 5 fen
Decoct in water and take orally. One dose relieves thirst; two doses dissipate phlegm; no need for three doses.
This formula clears Heart and Lung heat. If phlegm-qiang rises excessively, it is unsuitable. Adding Fu Ling guides downward to the Bladder, so Fire follows Water, restoring natural flow. It resolves phlegm and descends Fire, preventing Lung congestion. Although resolving phlegm and descending Fire, it does not consume Lung Metal qi, explaining why phlegm and Fire are easily resolved.
For this syndrome, Xi Fei Yin (Extinge Boiling Drink) is also good:
Mai Dong (Ophiopogonis Radix) - 2 qian
Kuan Dong Hua (Farfarae Flos) - 1 qian
Fu Shen (Poria with Hostwood) - 2 qian
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 1 qian
Jie Geng (Platycodonis Radix) - 3 qian
Huang Qin (Scutellariae Radix) - 2 qian
Tian Hua Fen (Trichosanthis Radix) - 2 qian
Zhu Ye (Bambusae Folium) - 30 leaves
Decoct in water and take orally.
There are cases of shortness of breath, heavy body, daily expectoration of clear fluid and clear phlegm. People think water is in the Spleen, but who knows it is Cold in Spleen qi?
The Spleen is Wet Earth, disliking Water and preferring Fire. Fire decline leads to Water prosperity, and Water prosperity leads to Fire decline—a necessary principle. Without Fire, Earth becomes Cold Earth; Water cannot dry and risks freezing. Even slight Fire can only transform water, not fluids; it creates phlegm, not liquid. Weak Fire can only transform Upper Jiao water, not resolve Lower Jiao freezing. This explains why clear phlegm/fluid vomits upward rather than descending. Dampness flowing to the four limbs causes heaviness. Treatment must promote urination, clear phlegm, and dry Spleen Earth qi. However, Spleen lacks Fire; Spleen Earth decline stems from weak Kidney Fire. Without tonifying Kidney Fire, there is no fuel under the cauldron; Earth is like ice/charcoal. How can solar warmth return, turning wet/muddy land into fertile soil? Thus, one must tonify Kidney Fire to dry Earth; dried Earth removes dampness.
Prescribe Zao Tu Tang (Dry Earth Decoction):
Bai Zhu (Atractylodis Rhizoma) - 1 liang
Fu Ling (Poria) - 1 liang
Rou Gui (Cinnamomi Cortex) - 2 qian
Ren Shen (Ginseng Radix et Rhizoma) - 3 qian
Po Gu Zhi (Psoraleae Fructus) - 1 qian
Shan Yao (Dioscoreae Rhizoma) - 5 qian
Qian Shi (Euryales Semen) - 5 qian
Sha Ren (Amomi Fructus) - 3 grains
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) - 1 qian
Ban Xia (Pinelliae Rhizoma Preparatum) - 2 qian
Decoct in water and take orally.
Seven parts of this formula dry the Spleen, three parts dry the Kidney. It seems to focus on tonifying the Spleen and lightly tonifying the Kidney. However, the Spleen likes dryness, while the Kidney dislikes dryness. Too many drying-Kidney herbs damage the Kidney first, hindering Spleen benefit. This shows the subtlety of dosage balancing.
For this syndrome, Jia Jian Yun Tan Tang (Modified Transport Phlegm Decoction) is also usable:
Ren Shen (Ginseng Radix et Rhizoma) - 3 qian
Fu Shen (Poria with Hostwood) - 3 qian
Bai Zhu (Atractylodis Rhizoma) - 5 qian
Rou Gui (Cinnamomi Cortex) - 1 qian
Bai Dou Kou (Amomi Fructus Rotundus) - 1 pod
Chen Pi (Citri Reticulatae Pericarpium) - 5 fen
Shen Qu (Massae Fermentatae Medicinalis) - 1 qian
Ban Xia (Pinelliae Rhizoma Preparatum) - 1 qian
Decoct in water and take orally.
There are cases of circulating phlegm-qiang, hypochondriac fullness/pain upon sneezing, light expectoration, avoiding forceful coughing. This is not Water Qi in the Liver, but Depressed Qi in the Liver.
The Liver stores Blood but not Water; it avoids water. However, Liver qi depression prevents Blood storage; unstored Blood allows Water to enter the Liver gap. The Liver never stores water; water stays outside the Liver without dispersing. Depressed Liver qi attracts water, and water worsens depression, indicating Liver qi rebellion. The hypochondrium is the Liver's territory. Even without Water Evil, depressed Liver qi causes distension/tightness; with water stagnating there, fullness is inevitable. Sneezing pain occurs because trapped Fire wants to exit via sneeze but cannot, causing pain upon muscle contraction. Treatment must unblock Liver qi depression, aided slightly by phlegm-resolving and water-separating herbs, achieving immediate results.
Prescribe Kai Tan Yin (Open Phlegm Drink):
Chai Hu (Bupleuri Radix) - 1 qian
Ban Xia (Pinelliae Rhizoma Preparatum) - 1 qian
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 1 qian
Chao Zhi Zi (Gardeniae Fructus Praeparatus) - 1 qian
Chen Pi (Citri Reticulatae Pericarpium) - 1 qian
Bo He (Menthae Haplocalycis Herba) - 1 qian
Zhi Ke (Aurantii Fructus Immaturus) - 3 fen
Cang Zhu (Atractylodis Rhizoma) - 2 qian
Fu Ling (Poria) - 5 qian
Decoct in water and take orally. Two doses soothe Liver qi depression; four doses relieve hypochondriac fullness/pain; no need for five doses.
This formula specifically resolves Liver depression. As depression lifts and Fire scatters, it no longer insults Spleen/Stomach Earth or draws up phlegm-saliva closure. How could water remain under the hypochondrium increasing pain/fullness?
For this syndrome, Shu Tan Tang (Ventilate Phlegm Decoction) is usable:
Bai Shao (Paeoniae Radix Alba) - 5 qian
Fu Shen (Poria with Hostwood) - 5 qian
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 1 qian
Shen Qu (Massae Fermentatae Medicinalis) - 1 qian
Ban Xia (Pinelliae Rhizoma Preparatum) - 1 qian
Decoct in water and take orally.
There are cases where water floods into phlegm, saliva like clear water, dissolving immediately in water. People do not know it is Phlegm in the Kidney. Who knows Kidney Cold transforms Essence into Phlegm?
Phlegm in other meridions forms from external water entering; only Phlegm in the Kidney forms from internal water. Thus, Phlegm in Heart, Liver, Spleen, and Lung can be treated with attacking methods, but Phlegm in the Kidney requires pure tonification, avoiding any phlegm-attacking ingredients. Kidney phlegm is Pure Yin Water; Yin Fire cannot be controlled without Yang Fire. Yang Fire is Fire within Water. When Yin Water floods and Fire is weak, or Yang Water is strong and Fire is hidden, greatly tonifying Fire within Water causes phlegm to descend spontaneously without direct phlegm-resolving action.
Prescribe Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill):
Shu Di Huang (Rehmanniae Radix Preparata) - 1 liang
Shan Yao (Dioscoreae Rhizoma) - 5 qian
Shan Zhu Yu (Corni Fructus) - 5 qian
Ze Xie (Alismatis Rhizoma) - 3 qian
Dan Pi (Moutan Cortex) - 3 qian
Fu Ling (Poria) - 1 liang
Rou Gui (Cinnamomi Cortex) - 2 qian
Fu Zi (Aconiti Lateralis Radix Preparata) - 1 qian
Decoct in water and take orally. One dose instantly eliminates flooding-phlegm.
No faster remedy for phlegm exists under heaven. However, it treats only Kidney Cold with flooding phlegm; do not apply this formula universally to all phlegm. If phlegm is not from Kidney flooding, it is External Evil. How can internal phlegm treatment apply to external phlegm? Only for true Kidney Water flooding does this formula yield prompt results. Crucially, use equal amounts of Fu Ling and Shu Di Huang so Kidney Water returns to its source, digesting dampness in Upper, Middle, and Lower Jiao, preventing lingering pathology. Do not rigidly adhere to Zhang Zhongjing's original prescription stating Fu Ling should not be used in large doses; thus, I clarify this point.
For this syndrome, Fu Yin Dan (Restore Yin Pill) is also wonderful:
Shu Di Huang (Rehmanniae Radix Preparata) - 1 liang
Shan Zhu Yu (Corni Fructus) - 5 qian
Qian Shi (Euryales Semen) - 1 liang
Shan Yao (Dioscoreae Rhizoma) - 1 liang
Rou Gui (Cinnamomi Cortex) - 1 qian
Decoct in water and take orally.
There are cases of expectorating pure white foam, continuous coughing, lighter by day, heavier at night. People think it is Lung Fire phlegm, but who knows Kidney Heat boils Fire into phlegm?
Such phlegm results from Yin Deficiency with Fire stirring, mostly leading to Consumption Disease (Lao Zhai), known anciently as expectorating white blood. The phlegm resembles crab saliva; continuous expectoration changes color to green mucus, indicating advanced, incurable Consumption. However, Consumption with white foam expectoration is Kidney Exhaustion phlegm. There are also cases before Consumption develops, or initial Yin Deficiency Fire stirring, distinct from advanced Consumption. How can they be ignored? People blindly treat phlegm, failing to recognize treating Kidney Yin, continuing until Consumption develops. Boiling Fire phlegm results from excessive Kidney Fire due to extreme Water deficiency. The Kidney can be tonified but not purged. Tonifying declining Kidney Water drains excessive Kidney Fire. Thus, use Yin-tonifying herbs to control Yang, not Yang-purging herbs to save Yin. If seeing strong Kidney Fire and lightly using Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma), regardless of whether Fire extinguishes quickly or phlegm disappears, striking Fire often transforms it into Consumption frequently. Treatment simply supplements Water to expel phlegm; phlegm vanishes into nothingness.
Prescribe Ding Fei Tang (Stabilize Boiling Decoction):
Shu Di Huang (Rehmanniae Radix Preparata) - 2 liang
Shan Zhu Yu (Corni Fructus) - 1 liang
Mai Dong (Ophiopogonis Radix) - 1 liang
Bei Wu Wei Zi (Schisandrae Chinensis Fructus) - 2 qian
Fu Ling (Poria) - 1 liang
Shan Yao (Dioscoreae Rhizoma) - 1 liang
Xuan Shen (Scrophulariae Radix) - 1 liang
Bai Jie Zi (Sinapis Semen) - 3 qian
Decoct in water and take orally. After two doses, one wonders how boiling phlegm disappeared. This formula should be taken continuously for ten doses; do not stop after seeing effects in two doses.
Boiling Fire phlegm originates from Yin Deficiency. Yin Deficiency Fire requires prolonged Yin-tonifying herbs to significantly increase Yin and rapidly dissipate Fire. Patients view this formula as life-extending soup; physicians view it as life-saving agent. Do not discard it lightly.
For this syndrome, Gui Mo Tang (Return Foam Decoction) is also excellent:
Shu Di Huang (Rehmanniae Radix Preparata) - 2 liang
Shan Yu Rou (Corni Fructus) - 1 liang
Xuan Shen (Scrophulariae Radix) - 1 liang
Tian Dong (Asparagi Radix) - 3 qian
Nv Zhen Zi (Ligustri Lucidi Fructus) - 3 qian
Sheng Di Huang (Rehmanniae Radix) - 3 qian
Bai He (Lilii Bulbus) - 3 qian
Kuan Dong Hua (Farfarae Flos) - 1 qian
Decoct in water and take orally.
There are cases of sudden Wind Evil invasion, nasal congestion, coughing, expectorating yellow turbid phlegm. People think phlegm blocks chest/diaphragm, suggesting emesis therapy. Who knows Wind Evil blocks Lung meridians?
When Evil is in the Lung, ancients sometimes used emesis effectively because Lung qi blockage implies emesis contains dispersing meaning. However, it must be severe fullness/excess...