Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)
11 Resemblance of Phlegm Diseases and Mental Derangement 痰病有似邪祟 담병이 사수와 유사한 것
① Blood and qi are like the spirit for human. When spirit qi is deficient, pathogens may invade. When blood and qi are deficient and lets phlegm invade the middle energizer, it interrupts the upbearing and downbearing of blood and qi. This causes the twelve viscera and bowels to lose functions making the person unable to see, hear, talk, or move properly. When the doctor considers treating it as a mental derangement, the patient will certainly die.
② First, make the patient drink a large amount of water boiled with ginger and salt. Then massage the patient’s throat to vomit. Alternatively, make the patient take a large amount of the leaf of Bambusae Caulis in Liquamen (竹瀝) or sesame oil and prescribe a Tao’s Guide Out Phlegm Decoction.
- Tao’s Guide Out Phlegm Decoction 陶氏導痰湯 도씨도담탕: It treats mental derangement-like symptoms induced by the obstruction of the heart’s orifice by phlegm. 1 don of Pinelliae Tuber (半夏), 8 pun of Poria Sclerotium (赤茯苓), Arisaematis Rhizoma (南星) and Ponciri Fructus Immaturus (枳實), 5 pun of Citrus Unshius Pericarpium (陳皮), Scutellariae Radix (黃芩), Coptidis Rhizoma (黃連), Atractylodis Rhizoma Alba (白朮) and Trichosanthis Semen (瓜蔞仁),
4 pun of Platycodonis Radix (桔梗), 3 pun of Ginseng Radix (人參), nd 2 pun of Glycyrrhizae Radix (甘草). Cut these herbs to make 1 package. Boil with 3 pieces of ginger and 2 dates and mix with the leaf of Bambusae Caulis in Liquamen (竹瀝) and the juice of Zingiberis Rhizoma Crudus (生薑汁) to take before going to bed. Phlegm should be removed before taking this prescription.
12 Phlegmatic Fainting 痰厥 담궐
Phlegm syncope occurs when phlegm qi is blocked due to a cold invasion to a deficient person. The persons’ hands and feet become cold and paralyzed and the person falls down due to dizziness. The pulse is sunken and fine. An Augmented Syzygii Flos Relieve Stomach Decoction (加味二陳湯), Clear Fire and Dissolve Phlegm Decoction, or Crane Skull Elixir should be prescribed. For pediatric use, Seize Life Powder may be prescribed.
- Augmented Syzygii Flos Relieve Stomach Decoction 加味二陳湯 가미이진탕: It treats phlegm syncope. 1 don of Pinelliae Tube Preparata (法製半夏), Citrus Unshius Pericarpium (陳皮), Poria Sclerotium (白茯苓), Angelica Gigantis Radix (當歸), Ponciri Fructus Immaturus (枳實), Porplatycodonis Radix (桔梗), and Armeniacae Semen (杏仁), 5 pun of Alpiniae Officinari Phizoma (良薑) and Amomi Fructus (砂仁), and 3 pun of Aucklandiae Radix (木香), Cinnamomi Cortex (桂皮), and Glycyrrhizae Radix (甘草). Cut these herbs to make make 1 package and boil with 5 pieces of ginger.
- Clear Fire and Dissolve Phlegm Decoction 淸火化痰湯 청화화담탕: It treats heat phlegm binded to the diaphragm, making it hard to expectorate, and causes chest discomfort and pain. This is called phlegm accumulation. 1 don of Pinelliae Tube Preparata (法製半夏), Citrus Unshius Pericarpium (陳皮) and Poria Sclerotium (赤茯苓), 7 pun of Platycodonis Radix (桔梗), Aruantii Fructus Immaturus (枳殼) and Trichosanthis Semen (瓜蔞仁), 5 pun of Coptidis Rhizoma (黃連), Scutellariae Radix (黃芩), Gardeniae Fructus (梔子), Bulbus Fritillariae Cirrhosae (貝母), Perillae Folium (蘇子), Mori Cortex (桑白皮), Armeniacae Semen (杏仁) and Natrii Sulfas (芒硝), and 3 pun of Aucklandiae Radix (木香)
and Glycyrrhizae Radix (甘草). Cut these herbs to make 1 package and boil with 3 pieces of ginger until the water level becomes half. Melt the Natrii Sulfas (芒硝) in this and remove the remnants. Add the leaf of Bambusae Caulis in Liquamen (竹瀝) and the juice of Zingiberis Rhizoma Crudus (生薑汁) before taking the prescription. - Crane Skull Elixir 鶴頂丹 학정단: ① It treats the following symptoms: sawing sound in the throat due to phlegm heat obstructing the throat, chest fullness and pain from phlegm binding in the diaphragm. 1 nyang of Alumen (白礬) and 5 don of Cinnabaris (朱砂) (Minium (Pb3O4) (黃丹) is also good). Grind these drugs and place 1 spoon of each in the bowl and melt. Knead while it is still hot to the size of a cherry. Take 1 pill with water boiled with Menthae Herba (薄荷). ②
The Renzhai’s Straight-forward Directions on Formulas recommended an excellent prescription for bringing phlegm down. Heat 1 nyang of Alumen (白礬) and Minium (Pb3O4) (黃丹) and grind these. Mix these with flour paste and make
pills to the size of a yam seed. This treats obstruction of the orifices to loss of voice by obstinate phlegm. Grind 30 pills and add some Scorpio (全蝎). Take this with water boiled with ginger. On taking the prescription, the person will vomit phlegm and be cured soon.
13 Phlegmatic Nodule 痰塊 담괴
① When a mass that resembles pyogenic infection forms in the upper, middle, or lower energizer, it usually forms between the skin and internal membrane. It is formed when the nodule amassed by moving damp phlegm is not resolved. The doctor should thoroughly ask the patient what kind of food he or she usually takes, and use the emetic or purgation method.
Then, a prescription that resolves phlegm and relieves the nodules should be used. Add Rhei Radix et Rhizoma (大黃), Forsythiae Fructus (連翹), Bupleuri Radix (柴胡), Platycodonis Radix (桔梗), Brassicae Junceae Folium (白芥子) and Coptidis
Rhizoma (黃連) (soaked in the juice of Zingiberis Rhizoma Crudus (生薑汁) and stir-fried) to a Syzygii Flos Relieve Stomach Decoction and boil in water. Mix these with the leaf of Bambusae Caulis in Liquamen (竹瀝) before taking the prescription and phlegm will be removed by itself.
② Phlegm and fluid retention move around the chest, back, head, nape, axilla, groin, lower back, thighs, hands and feet, and bind to swell firmly. The person may complain of pain. The swelling is pale in color and light red at best even if pressed. It does not manifest in a fever and is firm like stone. It does not emit pus after bursting and contains watery blood, clear water or wine-colored liquid. Also, old cotton-like festered flesh or a scrofula-like object is between the skin and flesh. It is soft, not firm and an egg-like substance may move inside. There is a phlegm bind in the throat and the person will feel chills and a fever. Add Arisaematis Rhizoma (南星) and Pinelliae Tuber (半夏) to an Revive Spirit Elixir (The formula is found in the
chapter on Abscess)
③When masses are present all around the body, it is because of phlegm. Prescribe an Augmented Minor Stomach Elixir or
Bamboo Sap Thrust Out Phlegm Pill.
④ Use an Open Qi and Eliminate Phlegm Decoction for phlegmatic nodules. Also grind the same amounts of Arisaematis Rhizoma (南星) and Aconiti Ciliare Tuber (草烏) and mix with the juice of Zingiberis Rhizoma Crudus (生薑汁) to form a plaster. Paste this plaster to the nodule and it will disappear.
⑤ To remove the phlegmatic nodule (痰核), grind Phytolaccae Radix (商陸根) and Arisaematis Rhizoma (南星) (raw one) and paste it on to the nodule and it will be removed soon.
⑥ When phlegmatic nodules are all around the body or the person suffers from bone-piercing pain, it is damp phlegm moving along the meridians. A common prescription is a Syzygii Flos Relieve Stomach Decoction (二陳湯) with the addition of herbs.
- Augmented Minor Stomach Elixir 加味小胃丹 가미소위단: ① It treats the following symptoms: impediment and accumulation from wind phlegm, dizziness, throat impediment, hemiplegia, and aphasia and the formation of mass in the abdomen. A Minor Kidneys Elixir 1 je (The formula is written in a later part of the book), 2.5 nyang of Arisaematis
Rhizoma (南星) and Pinelliae Tuber (半夏) (boiled in water 15 times with Alumen (白礬), Gleditsiae Fructus (皂角), the juice of Zingiberis Rhizoma Crudus (生薑汁)) 2 nyang of Atractylodis Rhizoma (蒼朮) (soaked in rice water with Alumen (白礬) and Gleditsiae Fructus (皂角) for a day and stir-fried), and 1 nyang of Persicae Semen (桃仁) and Armeniacae Semen (杏仁) (together soaked in water with Alumen (白礬) and Gleditsiae Fructus (皂角) with the pointy ends removed), Carthami Flos (紅花) (steamed in alcohol), Citrus Unshius Pericarpium (陳皮) and Ponciri Fructus Immaturus (枳實) (soaked in water with Alumen (白礬) for a day and stir-fried), Atractylodis Rhizoma Alba (白朮), and Brassicae Junceae Folium (白芥子) (stir-fried one). Grind these drugs and mix with paste boiled with the juice of Zingiberis Rhizoma Crudus (生薑汁), and the leaves of Bambusae Caulis in Liquamen (竹瀝) and Massa Medicata Fermentata (神麯). Make pills to the size of mung beans. Take 20 – 30 pills with water boiled with ginger. ② The Medical Mirror of Past and Present (醫鑑) refered to this as a Minor Guide Out Phlegm from the Stomach Elixir. ③ The Recovery from the Myriad Diseases referred to this as a Bamboo Sap Pill to Dissolve Phlegm. - Bamboo Sap Thrust Out Phlegm Pill 竹瀝達痰丸 죽력달담환: ① It has the special effect of forcing phlegm out with feces without damaging original qi. Zhu Zhenheng says, “When phlegm is in the four limbs, only the leaf of Bambusae Caulis in Liquamen (竹瀝) can penetrate it.” It refers to this formula. 2 nyang of Pinelliae Tuber (半夏) (soaked in the juice of Zingiberis Rhizoma Crudus (生薑汁) and then dried), Citrus Unshius Pericarpium (陳皮) (removal of white inner peel), Atractylodis Rhizoma Alba (白朮) (slightly stir-fried one), Poria Sclerotium (白茯苓), Rhei Radix et Rhizoma (大黃) (soaked in alcohol and steamed, and then dried under the sun) and Scutellariae Radix (黃芩) (soaked in alcohol and then stir-fried), 1.5 nyang of Ginseng Radix (人參) and Glycyrrhizae Radix (甘草) (roasted one), 2 nyang of smashed Chalcocitum (靑礞石) (heated with 1 nyang of Mirabilitum (焰硝) until it gains a golden color), and 5 don of Aquillariae Lignum (沈香). Powder these drugs and then mix these with 1.5 bowls of the leaf of Bambusae Caulis in Liquamen (竹瀝)
and 3 spoons of the juice of Zingiberis Rhizoma Crudus (生薑汁). Dry this under the sun. Repeat this procedure for 5 – 6 times. Mix these with the leaf of Bambusae Caulis in Liquamen (竹瀝) and the juice of Zingiberis Rhizoma Crudus (生薑汁), and make pills to the size of a red bean. Take 100 pills with gruel or water boiled with ginger before going to sleep. ② It is also known as a Bamboo Sap Pill to Move Phlegm. - Open Qi and Eliminate Phlegm Decoction 開氣消痰湯 개기소담탕: It treats the following symptoms: pain due to the narrowing of the passage from the stomach to pharynx and walnut-like lumps on the hands and feet. 1 don of Platycodonis Radix (桔梗), Cyperi Rhizoma (香附子) (便香附子) and Batryticatus Bombyx (白殭蠶) (stir-fried one), 7 pun of Citrus Unshius Pericarpium (陳皮), Scutellariae Radix (黃芩) (thick and friable one), and Aruantii Fructus Immaturus (枳殼), 5 pun of Angelicae Decursivae Radix (前胡), Pinelliae Tuber (半夏), Ponciri Fructus Immaturus (枳實), Osterici Radix (羌活), Schizonepetae Spica (荊芥), Arecae Semen (檳榔), Belamcandae Rhizoma (射干), and Clematidis Radix (威靈仙), and 3 pun of Aucklandiae Radix (木香), and Glycyrrhizae Radix (甘草). Cut these drugs to make 1 package. Boil with water with 3 pieces of ginger.
14 Frequent Expectoration of Phlegm 喜唾痰 가래침을 자주 뱉는 것
① When coldness is in the chest, the person expectorates phlegm frequently.
② When the person cannot control kidney Water due to a deficiency of the spleen, the person will spit phlegm frequently but will not cough. The person should take an Eight Ingredients Formula. [The formula is written in the chapter on Deficiency Vexation ]. It treats the frequent spitting of phlegm without coughing caused by deficiencies of the spleen and kidneys.
③ When the patient spits phlegm frequently after suffering from a serious disease, it is because of coldness in the stomach. Use an Order the Center Decoction (理中湯). (The formula is written in the chapter on Cold.).
④ When the patient spits saliva with white foam, it indicates coldness in the opening of the stomach. Add Alpiniae Oxyphyllae Fructus (益智仁) to the forementioned formulae.
⑤ Use a Pinellia Warm Lungs Decoction to treat frequent spitting of phlegm. Or add Syzygii Flos (丁香) and Amomi Fructus (砂仁) to a Syzygii Flos Relieve Stomach Decoction (二陳湯).
- Pinellia Warm Lungs Decoction 半夏溫肺湯 반하온폐탕: It treats the following symptoms: phlegm water in the middle part of the stomach dispersed to the pit of the stomach, intermittent gnawing hunger, vomiting clear water, and loss of appetite. This indicates a deficiency and cold of the stomach. The pulse is sunken, string-like, fine and slow. 1 don
of Pinelliae Tuber (半夏), Citrus Unshius Pericarpium (陳皮), Inulae Flos (旋覆花), Ginseng Radix (人參), Asiasari Radix et Rhizoma (細辛), Cinnamomi Cortex (桂心), Platycodonis Radix (桔梗), Paeoniae Radix (白芍藥), Poria Sclerotium (赤茯苓), and Glycyrrhizae Radix (甘草). Cut these drugs to make 1 package. Boil with 5 pieces of ginger and water.
15 Phlegm Knot 痰結 담결
① When something is stuck in the throat but does not come out when the person spits out or does not go down when the person swallows, it is a phlegm knot.
② When something is stuck in the throat but does not come out when the person spits out or does not go down when the person swallows, it is old phlegm. When it is serious, make the person vomit. When it is not serious, use Trichosanthes Guiding Powder. (The formula is written in the chapter on Vomit). When qi is excessive, use Vitex negundo L. Var. Cannabifolia (Sieb. et Zucc.) Hand.-Mazz. in Liquamen (荊瀝).
③ When phlegm is stuck in the throat and the person cannot spit it out or swallow it, use the formula that can resolve phlegm with a salty herb that can soften firm phlegm. A Jiezhai’s Pill to Dissolve Phlegm (the formula is mentioned in the previous chapter) has the most profound effect. This kind of old phlegm is frequent among drinkers. Alcohol’s heat moves up and accumulates in the stomach and lungs to become phlegm. Asparagi Tuber (天門冬) and Scutellariae Radix (黃芩) (thick and friable one) remove lung Fire. Anodontae Caro (海粉) and Natrii Sulfas (芒硝) soften firmness with their salty properties. Trichosanthis Semen (瓜蔞仁) moistens the lungs and brings phlegm down. Cyperi Rhizoma (香附子) relieves and brings qi down. Forsythiae Fructus (連翹) and Platycodonis Radix (桔梗) relieve stagnation and bring Fire down. Polygoni Tinctori Fructus (靑黛) relieves stagnated Fire. Do not use pungent and dry drugs like Pinelliae Tuber (半夏) or Arisaematis Rhizoma (南星).
16 Phlegm Disease Does Not Make a Person Die Suddenly 痰病不卒死 담병으로는 갑자기 죽지 않는다
If the person does not die suddenly despite suffering from a disease for a long time, it is always caused by food accumulation and the phlegm-retention syndrome. Stomach qi can also be nurtured by phlegm and fluid retention and food accumulation. Therefore, even if the person eats only a small amount, stomach qi does not become deficient suddenly.
17 Obstinate Cases of Phlegm Disease 痰病難治證 담병의 난치증
① qi becoming excessive to form heat phlegm or mass making it hard to spit out is hard to treat. These symptoms result from qi stagnation. Also, when qi becomes excessive and causes stagnation of phlegm-heat, it is difficult to treat.
② Extraordinary sounds from the throat and phlegm that are hard to expectorate is hard to treat. After taking the prescription, the person should vomit phlegm to see the effect. It no phlegm comes out, it is hard to treat.
③ Various diseases of phlegm and saliva cannot be concluded in one word, but phlegm from phthisis is hard to treat. Give
moxibustion treatment on BL-43 and BL-17and BL-19 (together called the four flower points). (The detailed description is written in the chapter on Acupuncture and Moxibustion).
④ When the lung meridian and stomach meridian are deficient, sticky phlegm is formed. This phlegm originates from the lungs and stomach. When phlegm and saliva attached to the throat make a sawing sound and sometimes cause spasms, and make the person suffer from vomiting and diarrhea, the spleen and the lungs become deficient with overflowing phlegm and saliva. This makes treatment all the more difficult.
