The longest and most ambitious chapter in the second volume of the Inner Landscape, and the one with the boldest claim. Heo Jun opens by separating three things English collapses into one — phlegm, drool and rheum — then sets out Zhongjing's eight rheums, sorted by where the water has stopped, and Danxi's ten phlegms, sorted by what set it moving. At the centre stands Wang Yinjun's treatise, which argues that a hundred disorders no physician has been able to account for are all one disease, and that a single prescription will answer them. Heo Jun records the claim in full, then records Liu Zonghou's objection to it in the next breath, and leaves both standing. What follows is the chapter's real work: the outward signs, the pulses, the colours of the phlegm, the presentations that mimic possession, and a treatment method that puts normalizing the qi before attacking the phlegm and fortifying the spleen before either.
Wang Yinjun's Treatise on Phlegm 王隱君痰論
痰證古今未詳. 方書雖有懸飮ㆍ留飮ㆍ支飮ㆍ痰飮ㆍ諸飮之異, 而莫知其爲病之源. 或頭風眩暈, 目昏耳鳴. 或口眼蠕動, 眉稜耳輪瘙痒. 或四肢遊風腫硬, 似痛非痛. 或爲齒頰痒痛, 牙床浮腫而痛痒不一. 或噫氣呑酸, 嘈雜嘔噦. 或咽嗌不利, 咯之不出, 嚥之不下, 色如煤炱, 形如敗絮, 桃膠, 蜆肉之類. 或心下如停氷雪, 心頭冷痛時作. 或夢寐奇怪鬼魅之狀. 或足腕痠軟, 腰背卒痛. 或四肢骨節煩疼, 幷無常所, 乃至手麻臂痛, 狀若挫閃. 或脊中每有一掌, 如氷凍之寒痛者. 或渾身習習如蟲行者. 或眼眶澁痒, 口糜舌爛, 甚爲喉閉等證. 又或遶項結核, 似癧非癧. 或胸腹間如有二氣交紐, 噎塞煩悶, 有如烟氣上衝, 頭面烘熱. 或爲失志癲狂. 或爲中風癱瘓. 或爲勞瘵荏苒之疾. 或爲風痺, 及脚氣之候. 或心下怔忡驚悸, 如畏人將捕. 或喘嗽嘔吐. 或嘔冷涎綠水黑汁, 甚爲肺癰, 腸毒, 便膿, 攣跛. 其爲內外疾病, 非止百端, 皆痰之所致也. 盖津液旣凝, 爲痰爲飮, 而洶涌上焦, 故口燥咽乾, 流而之下, 則大小便閉塞, 面如枯骨, 毛髮焦乾. 婦人則經閉不通, 小兒則驚癎搐搦. 治法宜先逐去敗痰, 然後看虛實調理. 故製沈香滾痰丸方見下, 爲通治三焦痰飮之劑也.
Phlegm patterns have never been set out clearly, past or present. The formularies distinguish suspended rheum, retained rheum, propping rheum, phlegm-rheum and the rest, yet none has known the source from which the disease arises. There may be head wind with dizziness, clouded vision and ringing in the ears. Or wriggling of the mouth and eyes, itching at the brow ridge and the rim of the ear. Or roving wind in the four limbs with swelling and hardness, something like pain and not quite pain. Or itching and pain in the teeth and cheeks, the gums puffy and swollen with pain and itch in no fixed measure. Or belching and swallowing of acid, gnawing discomfort, retching and vomiting. Or the throat not free, so that what will not be coughed up will not be swallowed down either — the colour of soot, the form of rotted silk floss, of peach gum, of clam flesh. Or a feeling below the heart as though ice and snow were standing there, with cold pain at the heart coming and going. Or dreams of strange and uncanny shapes, of goblins and spectres. Or aching weakness of the foot and ankle, sudden pain in the lumbus and back. Or vexing pain in the bones and joints of the four limbs with no fixed place, reaching to numbness of the hand and pain in the arm as though it had been wrenched. Or a patch in the spine the size of a palm, cold and painful as if frozen. Or a creeping over the whole body as though insects were walking on it. Or the eye sockets rough and itching, the mouth sore and the tongue ulcerated, in severe cases going on to closure of the throat. Or nodules ringing the neck, resembling scrofula and not scrofula. Or a sensation in the chest and abdomen as though two currents of qi were knotted together, with choking obstruction and vexing oppression, something like smoke surging upward and the head and face flushing hot. Or loss of the will, with mania and withdrawal. Or wind stroke with hemiplegia. Or the lingering disease of taxation consumption. Or the signs of wind impediment and leg qi. Or throbbing and fright palpitation below the heart, as though in fear of being seized. Or panting, coughing, retching and vomiting. Or the vomiting of cold drool, green water and black fluid, in severe cases going on to lung abscess, intestinal toxin, pus in the stool, and contracture and lameness. The diseases it makes, inner and outer, do not stop at a hundred, and all of them are brought about by phlegm. For once the fluids have congealed and become phlegm and rheum, they surge up into the upper burner, and so the mouth is parched and the throat dry; and flowing downward, they block the stool and urine, the face turns like withered bone, and the hair scorches dry. In women the menses close and will not pass; in children there is fright epilepsy with tugging and slackening. In treatment one should first drive out the spoiled phlegm, and only then look to vacuity or repletion and regulate accordingly. Hence Aquilaria Roll the Phlegm Pill formula below was composed, as a medicine to treat phlegm-rheum of the three burners generally.
Clinical note The chapter's centrepiece and its most consequential claim. Wang Yinjun's argument is that the formularies have catalogued the rheums by location without ever identifying the cause, and that the cause — for a list of complaints running from tinnitus to mania to lameness — is one thing. The catalogue is worth reading slowly rather than skimming: it is not padding but the evidence for the claim, and several of its images recur as diagnostic markers later in the chapter, particularly the phlegm the colour of soot and the shape of rotted silk floss, and the two currents of qi knotted in the chest.
Two things deserve attention. First, the treatment sequence — drive out the spoiled phlegm first, assess vacuity and repletion second — is the reverse of the order the chapter itself will recommend at 6.19, where normalizing the qi comes first and fortifying the spleen is called treating the root. Heo Jun does not reconcile the two. Second, the whole treatise terminates in a single prescription, which is an unusual move for a text that ordinarily differentiates before it prescribes, and it is precisely this that draws the objection recorded in the next passage.
A modern reader should hold the claim as a historical position rather than a clinical one. A list this broad — hemiplegia, epilepsy, lung abscess, amenorrhoea, mania — spans conditions that require quite different investigation today, and the passage is preserved here for what it shows about how a unifying aetiology was argued for, not as a diagnostic guide.
Donguibogam · Damum
劉宗厚曰, 痰之爲病, 仲景論四飮六證, 無擇叙三因內外, 俱爲切當. 惟王隱君, 論人之諸疾, 悉出於痰, 此發前人所未發, 可謂深識痰之情狀, 而得其奧者矣. 製滾痰丸一方, 總治斯疾, 固爲簡便, 較之仲景三因有表裏內外, 而分汗下溫利之法, 則疏闊矣. 況又有虛實寒熱之不同者哉.
Liu Zonghou said: on phlegm as a disease, Zhongjing's discussion of the four rheums and six patterns, and Wuze's account of the three causes inner and outer, are both exactly to the point. It is Wang Yinjun alone who argues that all a person's various diseases issue from phlegm — bringing out what no earlier writer had brought out. He may be said to have understood the true condition of phlegm deeply and to have reached what is hidden in it. But composing the single formula of Roll the Phlegm Pill to treat the whole of this disease, convenient though it certainly is, is loose and slack set beside Zhongjing's three causes with their exterior and interior, inner and outer, and his separate methods of sweating, purging, warming and freeing. How much more so, when there are further differences of vacuity and repletion, cold and heat.
Clinical note Heo Jun records the praise and the objection in the same section, and does not adjudicate. Liu Zonghou grants Wang Yinjun the insight — no earlier writer had reached it — and then says the therapeutic conclusion drawn from it is slack: one pill cannot answer exterior and interior, cold and heat, vacuity and repletion. This is the editorial method of the Bogam at its most characteristic, and it is worth naming because it recurs throughout the book. A strong claim is preserved intact, the strongest objection to it is set immediately beside it, and the reader is left to do the differentiating. The twenty-two sections that follow are, in effect, Heo Jun siding with Liu Zonghou in practice while keeping Wang Yinjun's treatise as the chapter's opening argument.
Donguibogam · Damum
The Outward Signs of Phlegm-Rheum 痰飮外證
靈樞曰, 尺膚麄如枯魚之鱗者, 水溢飮也.
The Lingshu says: when the skin of the forearm is coarse like the scales of a dried fish, this is water and spilling rheum.
Clinical note The section moves from the pulse to what can be seen and touched, and it opens at the forearm — the same stretch of skin the practitioner is already holding to take the pulse. Dried, scaled skin there indicates fluid that has gone to the limbs and stopped, which is spilling rheum as defined at 6.4.4.
Yeongchu 靈樞
色鮮明者, 有留飮. 又曰, 脉大, 心下有留飮, 其人背寒冷如氷.
When the complexion is vivid and bright, there is retained rheum. It is also said: when the pulse is large, there is retained rheum below the heart, and the person's back is cold as ice.
Clinical note 色鮮明 is counterintuitive and worth pausing on: a complexion that looks too vivid, not too dull, is the sign of retained rheum. The fluid standing beneath produces a surface sheen that reads as health at a glance.
Yeongchu 靈樞
凡有痰者, 眼皮及眼下, 必有烟灰黑色. 《丹心》
In anyone who has phlegm, the eyelids and the area below the eyes will certainly show a smoke-ash black colour.
Clinical note The single most-cited outward sign of phlegm in the whole chapter, and the one that returns four more times below as the fixed term for it. Darkening around and beneath the eyes is treated here as near-pathognomonic, and the four passages that close this section use it as the constant against which other signs are varied.
Dansim 丹心
眼胞及眼下, 如灰烟熏黑者, 痰也. 《醫鑑》
When the eyelids and the area below the eyes look blackened as though smoked with ash, this is phlegm.
Uigam 醫鑑
凡病百藥不效, 關上脉伏而大者, 痰也. 用控涎丹方見下. 《丹心》
In any disease where a hundred medicines have had no effect, if the pulse at the bar is hidden and large, this is phlegm. Use Control Drool Elixir. formula below
Clinical note A rule for the case that has defeated everything else, and one of the most practically useful lines in the chapter: when nothing has worked, feel the bar position, and a pulse that is both hidden and large points to phlegm. This is Wang Yinjun's argument at 6.3 converted into a bedside test — phlegm as the cause to suspect once the obvious causes have been exhausted.
**Control Drool Elixir contains kansui and euphorbia, both toxic drastic purgatives. It is not suitable for self-administration and is contraindicated in pregnancy and in depleted patients.**
Dansim 丹心
一切痰證, 食少肌色如故, 一切水證, 脇硬心下怔忡. 《入門》
In all phlegm patterns, food intake is small yet the flesh and complexion are as before. In all water patterns, the ribside is hard and there is throbbing below the heart.
Clinical note The differentiation between phlegm and water in one line, and the phlegm half is the surprising one: the patient eats little and yet does not waste. That mismatch — poor intake with preserved flesh — is what marks phlegm, and the passage below repeats it as the distinguishing feature.
Immun 入門
痰之爲患, 新而輕者, 形色淸白稀薄, 氣味亦淡. 久而重者, 黃濁稠粘凝結, 咯之難出, 漸成惡味, 酸辢, 腥臊, 醎苦, 甚至帶血而出. 但痰證初起, 頭痛發熱, 類外感表證, 久則潮咳夜重, 類內傷陰火. 又痰飮流注, 肢節疼痛, 類風證. 但痰證胸滿, 食減肌色如故, 脉滑不勻不定爲異耳. 《入門》
As an affliction, phlegm that is new and light is clear and white in form and colour, thin and watery, and bland in smell and taste. Phlegm that is long-standing and heavy is yellow and turbid, thick, sticky and congealed, hard to bring up, and gradually takes on a foul taste — sour and acrid, fishy and rank, salt and bitter — until in severe cases it comes up streaked with blood. But when a phlegm pattern first arises, with headache and fever, it resembles an exterior pattern of external contraction; and when it has lasted, with tidal cough worse at night, it resembles yin fire of internal damage. Again, when phlegm-rheum flows and lodges with pain in the limbs and joints, it resembles a wind pattern. What is different is only this: in a phlegm pattern the chest is full, food intake falls yet the flesh and complexion are as before, and the pulse is slippery, uneven and unsettled.
Clinical note The most clinically useful passage in the chapter, and it is a differential rather than a description. Phlegm is admitted to mimic three quite different things — an exterior contraction early on, yin fire of internal damage later, a wind pattern when it reaches the joints — and then three discriminating features are given: fullness in the chest, intake that falls without wasting, and a slippery pulse that is uneven and unsettled.
The progression from thin, clear and bland to thick, yellow and foul is a staging by time rather than by category, and it sits underneath the colour scheme at 6.9. Blood-streaked sputum is named here as the severe end of that progression; in current practice it warrants investigation rather than being read as advanced phlegm.
Immun 入門
凡人手臂或動不得, 或骨節遍身痛, 坐臥不寧, 此痰入骨也. 又曰, 眼黑而行步呻吟, 擧動艱難者, 入骨痰也. 其證遍身骨節疼痛.
When a person cannot move the hand or arm, or has pain through the bones and joints of the whole body, and can find no ease sitting or lying, this is phlegm entering the bones. It is also said: when the eyes are black and the person groans on walking, finding all movement difficult, this is phlegm that has entered the bones; its pattern is aching pain through the bones and joints of the whole body.
Clinical note The four passages that close the section are a set, and they should be read together. The black around the eyes is held constant and one further sign is varied each time — difficulty moving points to bone, an earthy face with wilting limbs to wind-damp, shortness of breath to fright-wind, red cheeks to heat. It is a compact differential built on a single fixed finding.
Dansim 丹心
眼黑而面帶土色, 四肢痿痺, 屈伸不便者, 風濕痰也.
When the eyes are black and the face carries an earthy colour, the four limbs wilt and are impeded, and bending and stretching are not free, this is wind-damp phlegm.
Dansim 丹心
眼黑而氣短促者, 驚風痰也.
When the eyes are black and the breath is short and hurried, this is fright-wind phlegm.
Dansim 丹心
眼黑而頰赤, 或面黃色者, 熱痰也. 《丹心》
When the eyes are black and the cheeks red, or the face yellow in colour, this is heat phlegm.
Dansim 丹心
The Various Diseases of Phlegm-Rheum 痰飮諸病
水在心, 心下堅築, 短氣, 惡水不欲飮.
When water is in the heart, there is hardness and pounding below the heart, shortness of breath, and an aversion to water with no wish to drink.
Clinical note Five viscera, one line each, and the whole set is a lesson in how the same substance reads differently by location. Note the paradox in this first one: water has stopped in the heart, and the patient wants nothing to drink. Fluid already standing produces aversion to more.
Junggyeong 仲景
水在肺, 吐涎沫, 欲飮水.
When water is in the lung, there is vomiting of foamy drool, and a wish to drink water.
Junggyeong 仲景
水在脾, 少氣身重.
When water is in the spleen, the qi is scant and the body heavy.
Junggyeong 仲景
水在肝, 脇下支滿, 嚏而痛.
When water is in the liver, the area below the ribside is propped and full, and sneezing brings pain.
Junggyeong 仲景
水在腎, 心下悸. 《仲景》
When water is in the kidney, there is palpitation below the heart.
Clinical note The last of the five and the one that seems misplaced until the channel relations are recalled: water in the kidney shows itself below the heart, not at the lumbus. The kidney and the heart stand in the water-fire relation, and fluid rising along that axis produces palpitation. The same reasoning underlies the surging from the lower abdomen into the chest treated by Poria and Schisandra Decoction at 6.4.6.
Junggyeong 仲景
痰之作恙, 爲喘爲嗽, 爲吐爲嘔, 爲眩暈, 爲風癎, 爲狂迷, 爲忪悸, 或呑酸, 或短氣, 或痞隔, 或腫脹, 或寒熱, 或疼痛, 痰實主之. 《直指》
The troubles phlegm makes: panting and coughing, vomiting and retching, dizziness, wind epilepsy, mania and confusion, fright palpitation; or swallowing of acid, or shortness of breath, or glomus at the diaphragm, or swelling and distension, or cold and heat, or aching pain. Phlegm repletion governs them.
Clinical note Wang Yinjun's catalogue at 6.3 in short form. What the Jikji adds is the last clause — 痰實主之, phlegm repletion governs them — which narrows the claim: these are the presentations of phlegm in repletion, not of phlegm in general. That qualification is what Liu Zonghou was asking for.
Jikji 直指
俗云, 十病九痰, 誠哉斯言. 《入門》
The common saying has it that of ten diseases nine are phlegm — and true indeed is that saying.
Clinical note A proverb, quoted and endorsed. Its presence here shows that the position argued at length in Wang Yinjun's treatise had already passed into ordinary speech by the time the Bogam was compiled.
Immun 入門
咯痰不出者, 是痰結也. 又曰, 脇下痛, 作寒熱, 咳嗽氣急, 亦痰結也. 《回春》
When phlegm will not come up on coughing, this is bound phlegm. It is also said: pain below the ribside, with cold and heat arising, cough and hurried breathing, is likewise bound phlegm.
Clinical note Bound phlegm gets its own section at 6.15; this passage introduces the term here and gives its two presentations, one local and one systemic.
Hoechun 回春
The Pattern of Phlegm-Rheum Flowing and Lodging 痰飮流注證
凡人忽患, 胸背手脚腰胯隱痛不可忍, 連筋骨牽引釣痛, 坐臥不寧, 時時走易不定, 俗醫不曉, 謂之走注, 便用風藥及鍼灸, 皆無益. 又疑風毒結聚, 欲爲癰疽, 亂以藥貼, 亦非也. 此乃痰涎, 伏在心膈上下, 變爲此疾. 或令人頭痛不可擧, 或神意昏倦多睡, 或飮食無味, 痰唾稠粘, 夜間喉中如拽鋸聲, 多流涎, 手脚冷痺, 氣脉不通, 誤認爲癱瘓, 亦非也. 凡有此疾, 只服控涎丹方見下, 其疾如失. 《得效》
When a person is suddenly afflicted with hidden pain in the chest, back, hands, feet, lumbus and hips that cannot be borne, drawing and pulling through the sinews and bones, so that there is no ease sitting or lying, and it shifts from place to place without settling — the common physician does not understand it, calls it roving lodgement, and reaches at once for wind medicines and needling, all to no benefit. Or he suspects wind toxin gathering and binding, on its way to becoming an abscess, and applies plasters at random; this too is wrong. In fact this is phlegm-drool lying hidden above and below the heart and diaphragm, which has turned into this disease. It may cause headache so that the head cannot be lifted, or clouded weariness of the spirit with much sleeping, or food and drink without savour, phlegm and spittle thick and sticky, a sound in the throat at night like a saw being drawn, copious running drool, cold impediment of the hands and feet, and the qi and vessels not free — and it is mistaken for hemiplegia, which is also wrong. In any case of this disease, simply take Control Drool Elixir formula below, and the disease vanishes.
Clinical note The most polemical passage in the chapter. It names three mistakes in a row — treating it as roving wind, as an incipient abscess, as hemiplegia — and says flatly that all three are wrong. What is being argued is that pain which moves is not therefore wind, and the practical value of the passage lies in the accompanying signs it supplies for telling the difference: heavy sleepiness, food without taste, thick spittle, a sawing sound in the throat at night, and cold numb extremities.
**New, severe or migrating pain requires assessment before being attributed to any traditional category, and the formula named contains kansui and euphorbia, both toxic drastic purgatives. It is not suitable for self-administration and is contraindicated in pregnancy and in depleted patients.**
Deukhyo 得效
濕痰流注, 上行攻臂, 臂不能擧, 或左右轉移, 消痰茯苓丸主之. 方見手部
When damp phlegm flows and lodges, travelling upward to strike the arm so that the arm cannot be raised, or shifting from one side to the other, Phlegm-Dispersing Poria Pill governs it. formula in the Hand chapter
Clinical note An arm that cannot be raised, with the trouble moving from one side to the other, is the classic presentation for this formula, and the Hand chapter is where its composition sits. Compare Qianjin Point the Way Pill at 6.20.6, which shares its core of fermented pinellia, poria, bitter orange and efflorescent mirabilite and is the same prescription in another line of transmission.
Donguibogam · Damum
Phlegm Lumps 痰塊
人身上中下, 有塊如腫毒, 多在皮裏膜外, 此因濕痰流注, 作核不散. 問其平日好食何物, 用藥吐下後, 方用消痰散核之藥, 二陳湯, 加大黃ㆍ連翹ㆍ柴胡ㆍ䓀莄ㆍ白芥子ㆍ黃連(薑汁炒), 煎水, 入竹瀝, 多服自消. 《丹心》
When a person has lumps like swollen toxin in the upper, middle or lower body, mostly lying inside the skin and outside the membrane, this comes from damp phlegm flowing and lodging and forming nodules that do not disperse. Ask what foods they habitually favour; after using medicines to induce vomiting and purging, then use medicines that disperse phlegm and scatter nodules — Two Matured Ingredients Decoction with rhubarb, forsythia, bupleurum, platycodon, white mustard seed and coptis (ginger-juice fried) added, decocted in water with bamboo sap stirred in. Taken freely it disperses of itself.
Clinical note 皮裏膜外 — inside the skin and outside the membrane — is the anatomical space this section works in, and it is precise: not on the surface, not in the organs, but in the layer between. The instruction to ask what the patient habitually likes to eat is the striking one, and it follows from 6.5.7, where food phlegm forms a nest-sac from food that was never dispersed.
Dansim 丹心
痰飮流注於胸背, 頭項, 腋胯, 腰腿, 手足, 聚結腫硬, 或痛或不痛, 按之無血潮, 雖或有微紅, 亦淡薄, 不熱, 堅如石, 破之無膿, 或有薄血, 或淸水, 或如紫汁. 又有壞肉如敗絮, 或如瘰癧, 在皮肉之間, 如雞卵, 可移動, 軟活不硬. 惟覺咽喉痰結, 作寒作熱, 宜返魂湯方見癰疽, 加南星ㆍ半夏. 《醫鑑》
When phlegm-rheum flows and lodges in the chest and back, the head and nape, the armpit and hip, the lumbus and thigh, the hands and feet, it gathers and binds into swellings that are hard, sometimes painful and sometimes not. Pressed, there is no surge of blood; even where there is a faint redness it is thin and pale, and there is no heat. It is hard as stone, and on being opened there is no pus — only thin blood, or clear fluid, or something like purple juice. There may also be spoiled flesh like rotted silk floss, or something resembling scrofula, lying between skin and flesh, the size of a hen's egg, movable, soft and yielding rather than hard. There is only a sense of phlegm bound in the throat, with cold and heat arising. Return the Soul Decoction formula in the Abscess chapter with arisaema and pinellia added is appropriate.
Clinical note The most detailed physical description in the chapter, and it is written as a differential against abscess: no surge of blood on pressure, no heat, no pus on incision. Those three negatives are what separate a phlegm nodule from a suppurating one, and they matter because the treatments diverge completely.
**A new, hard, fixed or growing lump requires medical evaluation before it is treated as phlegm.** Everything described here — a stony hard mass, a movable egg-sized nodule between skin and flesh, thin blood or clear fluid on incision — covers presentations that today need imaging and tissue diagnosis to distinguish, and some of them are serious.
Uigam 醫鑑
遍身有塊, 多是痰注, 宜加味小胃丹ㆍ竹瀝達痰丸. 《入門》
Lumps over the whole body are mostly phlegm lodgement; Augmented Minor Stomach Elixir and Bamboo Sap Reach the Phlegm Pill are appropriate.
Clinical note The two formulas bracket the range of force the chapter is willing to apply. The first is built on Minor Stomach Elixir with its three drastic purgatives; the second claims to move phlegm out through the stool without damaging the original qi. Which to reach for depends on what the patient can bear.
Immun 入門
痰塊, 宜開氣消痰湯. 又天南星ㆍ草烏, 等分爲末, 薑汁調如膏, 敷核上, 立消. 《醫鑑》
For phlegm lumps, Open the Qi and Disperse Phlegm Decoction is appropriate. Also: arisaema and aconite (cao wu) in equal parts, powdered and mixed with ginger juice into a paste, spread over the nodule — it disperses at once.
Clinical note **The topical paste contains raw aconite, which is toxic and absorbed through the skin; it must not be prepared or applied.** It is recorded here as part of the text.
Uigam 醫鑑
治痰核, 商陸根, 生南星, 合擣令爛, 塗付立消. 《種杏》
To treat phlegm nodules: pokeweed root and raw arisaema, pounded together until pulpy, spread on and applied — it disperses at once.
Clinical note **Pokeweed root and raw arisaema are both toxic; this preparation must not be made or applied.** Recorded for textual completeness.
Jonghaeng 種杏
渾身有腫塊, 或骨體串痛, 都是濕痰流注經絡也, 通用二陳湯加減. 《回春》
Swollen lumps over the whole body, or pain running through the bones and body, are in every case damp phlegm flowing and lodging in the channels and network vessels; Two Matured Ingredients Decoction with additions and subtractions is used generally.
Clinical note The section closes by returning to the parent formula. After five passages of nodules, pastes and purgatives, the general answer is Ijin-tang modified to the case — which is the chapter's habitual move and the reason 6.20.1 gives that formula its own commentary.
Hoechun 回春
Phlegm Disease Patterns That Are Hard to Treat 痰病難治證
氣實熱痰, 吐難得出, 或成塊, 吐咯不出, 氣鬱滯者難治. 又曰, 氣實痰熱結者, 難治. 《丹心》
Heat phlegm with replete qi, hard to bring up by vomiting, or formed into lumps that will not come up by vomiting or coughing, with the qi depressed and stagnant — this is hard to treat. It is also said: where the qi is replete and phlegm heat is bound, it is hard to treat.
Dansim 丹心
喉中漉漉有聲, 喘急, 咯痰不出者, 難治. 又曰, 服藥後, 咯吐痰出爲效. 若咯痰不出者, 難治. 《回春》
A gurgling sound in the throat, hasty panting, and phlegm that will not come up on coughing — this is hard to treat. It is also said: after taking medicine, phlegm coming up on coughing or vomiting is the sign of effect; if the phlegm will not come up, it is hard to treat.
Clinical note A criterion for judging whether treatment is working, stated in one line: phlegm coming up is the sign of effect. The chapter uses the same logic at 6.20.6, where stool turning soft after about ten days is given as the sign that an accumulation is quietly dispersing. Both are attempts to give the practitioner something observable to measure progress against.
**A gurgling throat with hasty panting is an airway presentation requiring urgent assessment.**
Hoechun 回春
痰涎等病不一而足, 惟勞瘵有痰, 爲難治. 最宜早灸膏肓ㆍ四花穴詳見鍼灸. 《資生經》
Diseases of phlegm and drool are more than can be counted, but only phlegm in taxation consumption is hard to treat. It is best to moxa Gohwang (膏肓, BL43) and the Four Flowers early see the Acupuncture chapter for details.
Clinical note Taxation consumption covers the wasting diseases, tuberculosis among them, and the judgement that phlegm in that setting is the hard case is a judgement about the underlying depletion rather than about the phlegm. The recommendation is moxa early rather than medicine, and the same passage returns in the acupuncture section at 6.22 with the sign of success added.
Jasaenggyeong 資生經
肺胃經虛則生粘痰, 痰者, 肺胃所出也. 痰涎凝滯在於咽喉, 如牽鋸之聲, 時復瘈瘲, 或因吐瀉所致, 脾虛肺亦虛. 痰涎流溢, 變成癲癎, 尤爲難治. 《全嬰方》
When the lung and stomach channels are vacuous, sticky phlegm is engendered — for phlegm is what the lung and stomach put out. When phlegm and drool congeal and stagnate in the throat, with a sound like a saw being drawn, and there are recurrent spasms of tugging and slackening, or when it is brought about by vomiting and diarrhoea so that the spleen is vacuous and the lung vacuous with it, then the phlegm and drool spill over and turn into epilepsy — and this is hardest of all to treat.
Clinical note The source is a paediatric formulary, and the picture is a child's: vomiting and diarrhoea depleting the spleen, the lung following, and convulsions supervening. The sawing sound in the throat is the same sign that appears at 6.10 and again with Crane's Crest Elixir at 6.12 — stridor, and in a small child with convulsions it is an emergency.
**Convulsions, particularly in a child, and particularly with noisy breathing, require emergency care.**
Jeonyeongbang 全嬰方
The Treatment Method for Phlegm-Rheum 痰飮治法
實脾土, 燥脾濕, 是治其本. 《丹心》
Make the spleen earth substantial and dry the spleen damp — this is to treat the root.
Clinical note The chapter's conclusion stated in eight graphs, and it should be read against Wang Yinjun at 6.3, who put driving out the spoiled phlegm first and assessing vacuity second. Here the order is reversed: the root is the spleen, and the phlegm is what the spleen's failure produces. Heo Jun sets the two positions in the same chapter without reconciling them, and the seven passages that follow argue for this one.
Dansim 丹心
虛人中焦有痰, 胃氣亦賴所養, 卒不可便攻, 攻盡則愈虛. 《丹心》
When a depleted person has phlegm in the middle burner, the stomach qi is in fact nourished by it as well; one must not attack outright, for attacking it to exhaustion leaves them more depleted still.
Clinical note The therapeutic consequence of the strange idea recorded at 6.16 — that the phlegm accumulation feeds the stomach qi. If part of the patient's nourishment is coming from what you intend to remove, removing all of it at once takes that support away with it.
Dansim 丹心
凡治痰, 用利藥過多, 致脾氣下虛, 則痰反易生而多. 法當補脾胃, 淸中氣, 則痰自然運下, 乃治本之法也. 《丹心》
In treating phlegm generally, using too many freeing medicines brings the spleen qi to vacuity below, and then phlegm is engendered the more easily and the more abundantly. The method should be to supplement the spleen and stomach and to clear the centre qi; then the phlegm is carried downward of itself. This is the method of treating the root.
Clinical note The argument against over-treatment, and it is causal rather than cautionary: freeing medicines used too freely deplete the spleen, and a depleted spleen makes more phlegm. The treatment produces the disease. 自然運下 — carried downward of itself — is the standard being set against attacking, and it is the phrase the chapter uses for a cure that does not need forcing.
Dansim 丹心
治痰, 順氣爲先, 分導次之. 然氣升屬火. 因氣動者曰痰氣, 宜順氣導痰湯. 因火動者曰痰火, 宜淸熱導痰湯方見上. 因濕動者曰濕痰, 導痰湯, 通用二陳湯. 《入門》
In treating phlegm, normalizing the qi comes first and dividing and guiding it out comes second. Yet qi that ascends belongs to fire. What is set moving by qi is called phlegm qi, and Normalize the Qi and Guide Out Phlegm Decoction is appropriate. What is set moving by fire is called phlegm fire, and Clear Heat and Guide Out Phlegm Decoction formula above is appropriate. What is set moving by damp is called damp phlegm, and Guide Out Phlegm Decoction; Two Matured Ingredients Decoction is used generally.
Clinical note The most practical passage in the section, and the one that organizes the chapter's formulary. Three movers — qi, fire, damp — and a formula for each, all three built on the same Ijin-tang base. The sequencing rule at the front is what distinguishes this from Wang Yinjun's approach: normalize the qi first, guide the phlegm out second.
Immun 入門
陽虛腎寒, 冷痰溢上, 或昏暈夜喘上氣者, 八味丸方見虛勞ㆍ黑錫丹方見虛勞鎭墜之. 《入門》
Where yang is vacuous and the kidney cold, so that cold phlegm spills upward, or there is clouded dizziness with panting at night and qi rising, Eight-Ingredient Pill formula in the Vacuity Taxation chapter and Black Tin Elixir formula in the Vacuity Taxation chapter settle and weigh it down.
Clinical note The one place the chapter reaches below the spleen. Phlegm that spills upward because the kidney yang cannot hold it down is treated by weighting the lower burner rather than by working on the phlegm at all — 鎭墜, settling and weighing down, is a different therapeutic verb from anything else in the chapter.
**Panting at night with dizziness may indicate cardiac failure and warrants medical assessment. Black Tin Elixir contains lead and must not be prepared or taken.**
Immun 入門
脾虛不能運化者, 六君子湯, 加竹瀝ㆍ薑汁. 或補中益氣湯, 加半夏ㆍ竹瀝ㆍ薑汁. 《入門》
Where the spleen is vacuous and cannot move and transform, Six Gentlemen Decoction with bamboo sap and ginger juice added; or Supplement the Centre and Boost the Qi Decoction with pinellia, bamboo sap and ginger juice added.
Clinical note Two supplementing formulas with a phlegm medicinal grafted on, which is the practical form of the section's opening principle. Bamboo sap and ginger juice appear together throughout the chapter as the standing pair added at service — the sap cooling and phlegm-dissolving, the ginger juice offsetting its cold.
Immun 入門
張子和曰, 飮無補法, 必當去水. 故用汗吐下三法, 治人常愈. 然亦有挾寒挾虛之證, 又有血氣虧乏之人, 理宜導去痰滯, 又當補接兼行, 又難拘於子和之三法也. 《丹心》
Zhang Zihe said: rheum admits of no supplementing method; the water must be removed. And so by using the three methods of sweating, vomiting and purging he treated people and they commonly recovered. Yet there are also patterns that carry cold or carry vacuity, and there are people whose blood and qi are depleted; in principle the phlegm stagnation should be guided out, and yet supplementing and reinforcing should go along with it. So it is hard to be bound by Zihe's three methods.
Clinical note The chapter's second recorded dispute, and it has the same shape as the first. Zhang Zihe's position is stated in full and with respect for its results, then qualified: the three attacking methods will not do for a patient carrying cold or vacuity, and supplementation has to run alongside. 難拘 — hard to be bound by — is the same judgement Liu Zonghou passed on Wang Yinjun at 6.3. Twice in one chapter Heo Jun records a powerful single method and then declines to be governed by it.
Dansim 丹心
痰生於脾胃, 治法, 宜實脾燥濕. 又隨氣而升, 宜順氣爲先, 分導次之. 又氣升屬火, 順氣在於降火. 《醫鑑》
Phlegm is engendered in the spleen and stomach, and the treatment method should be to make the spleen substantial and dry the damp. Again, it ascends following the qi, so normalizing the qi comes first and dividing and guiding it out second. Again, qi that ascends belongs to fire, so normalizing the qi lies in downbearing fire.
Clinical note A summary that chains the three principles into one line: treat the spleen because that is where phlegm is made, normalize the qi because that is what carries it up, and downbear fire because that is what drives the qi up. Each step explains the one before it.
Uigam 醫鑑
難經曰, 腎主五液, 化爲五濕. 濕能生痰, 痰者, 因咳而動脾之濕也. 半夏能泄痰之標, 不能泄痰之本. 泄本者, 泄腎也. 十棗湯ㆍ三花神佑丸, 是也. 幷見下門
The Nanjing says: the kidney governs the five humours, which transform into the five damps. Damp can engender phlegm; and phlegm is the damp of the spleen set moving by coughing. Pinellia can drain the branch of phlegm but cannot drain its root. To drain the root is to drain the kidney — Ten Jujube Decoction and Three Flowers Spirit-Aid Pill are such medicines. both formulas in the Purging chapter
Clinical note A dissenting account of where the root lies. Everything else in this section locates it in the spleen; this passage moves it down to the kidney, on the reasoning that the kidney governs the humours from which damp and then phlegm derive. The clinical consequence is blunt — pinellia treats only the branch — and the formulas named are drastic purgatives rather than spleen supplements.
Heo Jun places it eighth, after seven passages arguing for the spleen, and does not adjudicate. **The two formulas named are toxic drastic purgatives and are not suitable for self-administration.**
Nangyeong 難經
熱痰則淸之, 用石膏ㆍ靑黛ㆍ梔子ㆍ黃芩ㆍ黃連. 寒痰則溫之, 用半夏ㆍ乾薑ㆍ附子ㆍ肉桂. 燥痰則潤之, 用瓜蔞仁ㆍ杏仁ㆍ五味子ㆍ天花粉. 濕痰則燥之, 用蒼朮ㆍ白朮ㆍ厚朴ㆍ茯苓. 風痰則散之, 用南星ㆍ皂角ㆍ白附子ㆍ竹瀝. 老痰則軟之, 用海石ㆍ芒硝ㆍ瓜蔞仁ㆍ枳殼ㆍ便香附. 食積痰則消之, 用山楂子ㆍ神麴ㆍ麥芽. 大要, 人參ㆍ甘草以補脾, 白朮ㆍ半夏以燥濕, 陳皮ㆍ靑皮以利氣, 茯苓ㆍ澤瀉以滲水. 《丹心》
Heat phlegm is cleared: use gypsum, indigo, gardenia, scutellaria and coptis. Cold phlegm is warmed: use pinellia, dry ginger, aconite and cinnamon bark. Dry phlegm is moistened: use trichosanthes seed, apricot kernel, schisandra and trichosanthes root. Damp phlegm is dried: use atractylodes lancea, white atractylodes, magnolia bark and poria. Wind phlegm is dispersed: use arisaema, gleditsia pod, typhonium and bamboo sap. Old phlegm is softened: use pumice, mirabilite, trichosanthes seed, bitter orange and child-urine-processed cyperus. Food accumulation phlegm is dispersed: use hawthorn, medicated leaven and barley sprout. In sum: ginseng and licorice to supplement the spleen, white atractylodes and pinellia to dry damp, tangerine peel and green tangerine peel to free the qi, poria and alisma to percolate off water.
Clinical note The chapter's formulary in one passage. Seven kinds of phlegm, one verb and one set of medicinals for each — clear, warm, moisten, dry, disperse, soften, dissolve — and then four pairs that hold for every case. The categories map onto the ten of 6.5 with two absences: qi phlegm and fright phlegm have no entry here, because both are treated through their cause rather than through the phlegm.
It is worth setting this beside the six-line summary appended to Rosy Heaven Paste at 6.5.5.3, which sorts the same problem by what the phlegm is doing rather than by what kind it is. Between the two, a practitioner has the chapter's therapeutics on a single page.
Dansim 丹心
Simple Medicinals 單方
凡二十三種.
Twenty-three kinds in all.
Donguibogam · Damum
白礬 吐去胸中痰飮. 取一兩, 水二升煮取一升, 入蜜半合, 頓服須臾卽吐, 未吐則當飮少熱湯. 《本草》
Alum (白礬): Vomits out phlegm-rheum from the chest. Take 1 nyang, boil in 2 seung of water down to 1 seung, add half a hop of honey and take at one draught; vomiting follows shortly. If it does not, a little hot water should be drunk.
Clinical note **A violent emetic. Inducing vomiting carries real risks of aspiration and injury, and this should not be attempted.**
Boncho 本草
蒼朮 消痰水. 能治痰飮成窠囊極效, 卽上神朮丸也. 性燥能勝濕. 《本草》
Atractylodes lancea (蒼朮): Disperses phlegm and water. It treats phlegm-rheum that has formed a nest-sac with the greatest effect — this is Spirit Atractylodes Pill above. Its nature is drying and it can overcome damp.
Boncho 本草
貝母 消痰, 又治胸膈痰氣最妙. 《本草》 貝母丸, 取貝母, 童便浸三日, 洗曬爲末, 糖霜調和, 不時服. 《入門》
Fritillaria (貝母): Disperses phlegm, and treats phlegm qi of the chest and diaphragm most excellently. Fritillaria Pill: take fritillaria, steep it three days in child's urine, wash and sun-dry it, powder it, mix with sugar frost, and take at any time.
Boncho 本草
前胡 治熱痰, 又治痰滿胸痞. 剉取三錢, 水煎服之. 《本草》
Peucedanum (前胡): Treats heat phlegm, and treats phlegm filling the chest with glomus. Cut up and take 3 don, decocted in water.
Boncho 本草
乾薑 治寒痰, 又消痰下氣. 丸服, 煎服皆可. 《本草》
Dry ginger (乾薑): Treats cold phlegm, and disperses phlegm and downbears qi. It may be taken in pills or in decoction.
Boncho 本草
生薑 去痰下氣. 又去冷痰, 調胃氣. 《本草》 治痰癖, 生薑四錢, 附子生二錢. 右剉, 水煎服. 《本草》 治寒痰, 能勝脾胃之濕, 所以化痰. 《湯液》
Fresh ginger (生薑): Removes phlegm and downbears qi. It also removes cold phlegm and regulates the stomach qi. For phlegm aggregation: fresh ginger 4 don, raw aconite 2 don; cut up and decoct in water. It treats cold phlegm, being able to overcome the damp of the spleen and stomach, and thereby transforms phlegm.
Clinical note **The second preparation contains raw aconite, which is toxic and must not be prepared or taken.**
Boncho 本草
半夏 能消痰涎, 去胸中痰滿. 《本草》 油炒半夏, 大治濕痰. 《丹心》 去痰, 須用半夏. 熱加黃芩, 風加南星, 痞加陳皮ㆍ白朮. 《入門》 半夏丸, 治痰喘, 心痛. 半夏, 香油炒爲末, 粥丸梧子大, 薑湯下三五十丸. 《入門》
Pinellia (半夏): Disperses phlegm and drool and removes phlegm fullness from the chest. Pinellia fried in oil greatly treats damp phlegm. To remove phlegm, pinellia must be used: for heat add scutellaria, for wind add arisaema, for glomus add tangerine peel and white atractylodes. Pinellia Pill treats phlegm panting and heart pain: pinellia fried in sesame oil and powdered, made into congee pills the size of a firmiana seed, thirty to fifty taken down with ginger decoction.
Clinical note The chapter's chief phlegm medicinal, and the three-way modification given here — scutellaria for heat, arisaema for wind, tangerine peel and atractylodes for glomus — is the compressed form of what Ijin-tang and its derivatives do at length.
Boncho 本草
半夏麴 痰分之病, 半夏爲主. 然必造而爲麴. 又入霞天膏, 白芥子ㆍ薑汁ㆍ礬湯ㆍ竹瀝, 造麴. 治痰積沈痾者, 自能使腐敗, 隨大小便出, 或散而爲瘡, 此半夏麴之妙也. 佐以南星, 治風痰. 佐以薑汁ㆍ酒浸炒芩連, 及瓜蔞仁ㆍ香油拌麴略炒, 治火痰. 佐以麩炒枳實ㆍ薑汁浸蒸海粉之類, 治老痰. 佐以蒼ㆍ白朮, 俱米泔薑汁浸炒, 甚至乾薑ㆍ烏頭, 皆治濕痰. 製法詳見雜方 《丹心》
Fermented pinellia (半夏麴): In diseases of the phlegm division, pinellia is the chief medicinal — yet it must be worked into a leaven. Rosy Heaven Paste is also put in, with white mustard seed, ginger juice, alum solution and bamboo sap, and the leaven made. In treating deep-seated phlegm accumulation it is able of itself to make the matter rot and come out with the stool and urine, or else disperse and emerge as sores; this is the marvel of fermented pinellia. Assisted by arisaema, it treats wind phlegm. Assisted by ginger juice, wine-steeped and fried scutellaria and coptis, and trichosanthes seed with the leaven mixed in sesame oil and lightly fried, it treats fire phlegm. Assisted by bran-fried bitter orange and ginger-juice-steeped and steamed sea hare egg mass and the like, it treats old phlegm. Assisted by atractylodes lancea and white atractylodes, both steeped in rice-washing water and ginger juice and fried, and even by dry ginger and aconite, it treats damp phlegm in every case. for the method of preparation see the Miscellaneous Formulas chapter
Clinical note The longest of the twenty-three and the one that justifies giving fermented pinellia its own entry rather than folding it into pinellia. The claim is that fermentation changes what the medicinal can do: raw or ginger-processed pinellia dries damp, but the leaven is said to make a lodged accumulation rot so that it leaves by the stool and urine. Four assisted forms are then given, one for each kind of phlegm.
Dansim 丹心
法製半夏 大半夏 一斤, 石灰 一斤, 滾水 七椀, 入盆內, 攪晾, 澄淸去滓, 將半夏浸之, 手攪, 日曬夜露, 七日撈出. 井華水洗淨三四次, 泡三日, 每日換水三次, 撈起控乾. 用白礬 八兩, 皮硝 一斤, 滾水 七八椀, 入盆內, 攪晾, 浸半夏七日, 日曬夜露, 取出水洗三四次, 泡三日, 每日換水三次, 取出控乾. 入甘草ㆍ薄荷 各四兩, 丁香ㆍ枳實ㆍ木香ㆍ白薑ㆍ陳皮ㆍ靑皮ㆍ枳殼ㆍ五味子ㆍ縮砂 各五錢, 白豆蔲ㆍ肉桂 各三錢, 沈香 一錢. 右切片, 滾水 十五椀, 將半夏同藥共入盆內, 泡二七日, 日曬夜露, 攪之. 日足, 取出藥與半夏, 用白布包住, 放在熱炕, 用器皿覆住, 三炷香時, 藥與半夏分胎, 半夏乾, 收用. 《回春》
Processed pinellia (法製半夏): Large pinellia 1 geun and lime 1 geun; put 7 bowls of boiling water into a basin, stir and let it cool, settle it clear and discard the dregs, then steep the pinellia in it, stirring by hand, sunned by day and dewed by night, and after seven days scoop it out. Wash clean three or four times in fresh well water, soak three days changing the water three times daily, then lift out and drain. Take alum 8 nyang and crude mirabilite 1 geun with 7 or 8 bowls of boiling water, put into a basin, stir and let cool, and steep the pinellia seven days, sunned by day and dewed by night; take it out, wash three or four times, soak three days changing the water three times daily, then take out and drain. Add licorice and mint 4 nyang each; clove, bitter orange, costus, white ginger, tangerine peel, green tangerine peel, bitter orange fruit, schisandra and amomum 5 don each; round cardamom and cinnamon bark 3 don each; aloeswood 1 don. Slice these, and with 15 bowls of boiling water put the pinellia and the medicinals together into a basin and soak for fourteen days, sunned by day and dewed by night, stirring. When the days are complete, take out the medicinals and the pinellia, wrap in white cloth, set on a heated floor and cover with a vessel; after the time of three incense sticks the medicinals and the pinellia part from one another, the pinellia is dry, and it is stored for use.
Clinical note Twenty-eight days of processing described step by step — the most elaborate single procedure in the chapter, and the reason processed pinellia stands as its own entry. The Hoechun appends extravagant claims for the finished drug which are not carried into this translation; what is worth keeping is the method, which shows how much labour the tradition was prepared to spend converting a harsh medicinal into a mild one.
**Lime and crude mirabilite are caustic. This is a historical preparation record, not a procedure to attempt.**
Hoechun 回春
瓜蔞仁 治熱痰ㆍ酒痰ㆍ老痰ㆍ燥痰. 潤肺, 化痰, 降氣, 洗滌胸膈中垢膩. 作丸, 或煎服皆佳. 《丹心》
Trichosanthes seed (瓜蔞仁): Treats heat phlegm, alcohol phlegm, old phlegm and dry phlegm. It moistens the lung, transforms phlegm, downbears qi, and washes away the grime and grease in the chest and diaphragm. Made into pills or taken in decoction, either is good.
Clinical note Four of the ten kinds in one medicinal, and all four are the dry or heated varieties — which is why trichosanthes seed leads the formulas at 6.5.5 where drying medicinals are deliberately left out.
Dansim 丹心
葶藶子 除胸中痰飮, 能逐肺經之水. 末服, 煎服皆可. 《本草》
Lepidium seed (葶藶子): Removes phlegm-rheum from the chest and can expel water from the lung channel. It may be taken as a powder or in decoction.
Boncho 本草
旋覆花 消胸上痰結, 唾如膠漆, 除心脇痰水. 水煎服, 或丸服. 《本草》
Inula flower (旋覆花): Disperses bound phlegm above the chest, with spittle like glue or lacquer, and removes phlegm and water from the heart and ribside. Taken in water decoction or in pills.
Boncho 本草
枳實 除胸脇痰癖. 水煎服, 或作丸服之. 《本草》 枳實瀉痰, 能衝墻壁. 《丹心》
Bitter orange fruit (枳實): Removes phlegm aggregation from the chest and ribside. Taken in water decoction or made into pills. Bitter orange fruit drains phlegm with force enough to charge through a wall.
Clinical note The Dansim's line about charging through a wall is the most quoted phrase attached to this medicinal and marks it as the forceful member of the qi-moving group.
Boncho 本草
枳殼 消痰, 散胸膈痰滯. 煎服, 末服皆可. 《本草》
Bitter orange (枳殼): Disperses phlegm and scatters phlegm stagnation in the chest and diaphragm. Taken in decoction or as a powder.
Boncho 本草
天南星 治風痰. 炮黃色, 入生薑 七片, 水煎服. 或薑汁糊丸服. 《本草》
Arisaema (天南星): Treats wind phlegm. Blast-fried to a yellow colour, with 7 slices of fresh ginger added, decocted in water and taken; or made into pills with ginger juice paste.
Boncho 本草
靑礞石 治食積痰. 同焰硝, 火煆服, 能利痰積, 從大便而出. 作丸服, 或末服皆可. 《入門》
Chlorite schist (靑礞石): Treats food accumulation phlegm. Calcined with niter and taken, it frees the phlegm accumulation so that it comes out with the stool. Taken in pills or as a powder.
Immun 入門
木瓜 消痰, 止痰唾. 《本草》 木瓜煎, 治痰益脾胃. 木瓜蒸爛取肉, 硏搗篩去滓, 量入煉蜜ㆍ薑汁ㆍ竹瀝, 攪和作煎. 每取一大匙, 嚼下, 日三四次. 《俗方》
Chaenomeles (木瓜): Disperses phlegm and stops the spitting of phlegm. Chaenomeles Decoct treats phlegm and benefits the spleen and stomach: steam chaenomeles until soft and take the flesh, grind and pound it, sieve out the dregs, add measured amounts of refined honey, ginger juice and bamboo sap, stir together and make a decoct. Take one large spoonful at a time, chewed down, three or four times a day.
Boncho 本草
烏梅 去痰止渴. 可作茶飮. 《本草》
Mume fruit (烏梅): Removes phlegm and stops thirst. It may be made into a tea and drunk.
Boncho 本草
白芥子 主胸膈痰冷. 《本草》 痰在脇下, 非白芥子不能達. 末服, 煎服皆佳. 《丹心》
White mustard seed (白芥子): Governs phlegm and cold in the chest and diaphragm. Phlegm below the ribside cannot be reached except by white mustard seed. Taken as a powder or in decoction, either is good.
Clinical note The Dansim's claim that nothing else reaches phlegm below the ribside is why this medicinal appears in the lump formulas at 6.13 and in Control Drool Elixir, where the target is precisely fluid lodged in that space.
Boncho 本草
瓜蔕 吐痰. 痰塞心胸, 令人悶絶, 用瓜蔕散吐之卽甦. 方見吐門
Melon pedicel (瓜蔕): Vomits out phlegm. When phlegm blocks the heart and chest so that a person is oppressed to the point of collapse, Melon Pedicel Powder is used to make them vomit and they revive at once. formula in the Vomiting chapter
Clinical note **Melon pedicel is toxic and a violent emetic. It must not be used, and collapse from any cause is a medical emergency.**
Donguibogam · Damum
海粉 熱痰能降, 濕痰能燥, 結痰能軟, 頑痰能消. 不可入湯, 可入丸藥用. 製法詳見雜方 《丹心》
Sea hare egg mass (海粉): Heat phlegm it can downbear, damp phlegm it can dry, bound phlegm it can soften, stubborn phlegm it can disperse. It must not be put into decoctions; it may be used in pill medicines. for the method of preparation see the Miscellaneous Formulas chapter
Clinical note Four actions and one prohibition, and the prohibition is the useful part: not for decoctions, pills only. This is why it appears in Jeoljae's Transform Phlegm Pill and Clear Fire and Sweep Phlegm Pill and never in any of the chapter's decoctions.
Dansim 丹心
蛤粉 能墜痰, 軟堅. 卽固濟火煆, 海蛤粉也. 末服, 丸服幷佳. 《丹心》
Clam shell powder (蛤粉): Can sink phlegm and soften hardness. That is, clam shell powder sealed under lute and calcined. Taken as a powder or in pills, either is good.
Dansim 丹心
蜆殼 燒爲白灰, 飮調服. 除心胸痰水. 《本草》
Marsh clam shell (蜆殼): Burnt to a white ash and taken stirred into a drink. It removes phlegm and water from the heart and chest.
Boncho 本草