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Pineilia is the tuber of the plant Pineilia from the Arisaema family. It is mainly produced in Sichuan, Hubei, Anhui, Jiangsu, Shandong, and other regions. The original plant grows in wetlands, farmlands, near streams, and under forests. It has a pungent taste, warm nature, and is toxic. It belongs to the spleen, stomach, and lung meridians. Its effects include drying dampness and resolving phlegm, downbearing counterflow to stop vomiting, and dispersing masses and nodules. Clinical names include raw Pineilia, clear Pineilia, ginger Pineilia, Pro Formula Pinellia, Fermented Pineilia, and stir-fried Fermented Pineilia.

bubble_chart Compendium of Materia Medica

Shennong Bencao Jing: It has a pungent taste and neutral nature. It treats cold-damage disease with chills and fever, hardness below the heart, lowering qi, swollen and painful throat, dizziness, chest distension, cough, borborygmus, and stops sweating.

Mingyi Bielu: Raw, it is slightly cold; cooked, it is warm and toxic. It mainly disperses phlegm-heat fullness in the heart, abdomen, chest, and diaphragm, treats cough with upward qi, acute pain and hardness below the heart, seasonal epidemic vomiting, reduces abscesses, prevents miscarriage, treats sallow complexion, and beautifies the face. Raw, it induces vomiting; cooked, it promotes bowel movement.

Yaoxing Lun: It is an assistant herb, contraindicated with sheep blood, seaweed, and maltose. Bupleurum is its assistant. It is highly toxic. It must be washed ten times in hot water to remove the slime and reduce toxicity. It is used with Fresh Ginger Rhizome in equal parts. It disperses phlegm and saliva, opens the stomach, strengthens the spleen, stops vomiting, removes phlegm fullness in the chest, lowers lung qi, treats cough and nodules, and is used topically for non-resolving abscesses and hyperthyroidism. It is added for deficiency with phlegm and qi.

Rihuazi Bencao: It has a salty and pungent taste. It treats vomiting, regurgitation, cholera muscle cramps, cold intestines and abdomen, and phlegm malaria.

Kaibao Bencao: It has a pungent taste, neutral nature when raw, slightly cold, and warm when cooked. It is toxic. It disperses phlegm-heat fullness in the heart, abdomen, chest, and diaphragm, treats cough with upward qi, acute pain and hardness below the heart, seasonal epidemic vomiting, reduces abscesses, prevents miscarriage, treats sallow complexion, and beautifies the face. Raw, it induces vomiting; cooked, it promotes bowel movement.

Bencao Tujing: It is essential for treating stomach cold, vomiting, and hiccups.

Bencao Yanyi: Nowadays, people only know it removes phlegm but do not mention its benefit to the spleen, as it can separate water. The spleen dislikes dampness; dampness causes stagnation and inability to control water. The Classic says: Excessive dampness causes diarrhea. A man who frequently went to the bathroom at night was advised to take one liang of crushed Fresh Ginger Rhizome, Pineilia washed in soup, and thirty Chinese Dates, boiled in one liter of water in a porcelain bottle over slow fire, and sip it frequently. He recovered in a few days.

Yaolei Faxiang: It treats cold phlegm and cough caused by cold drinks damaging the lungs. It harmonizes stomach qi, removes stomach cold, and promotes appetite. It treats Taiyin phlegm syncope headache, which cannot be treated without this herb.

Yaoxing Fu: It has a bitter and pungent taste, cold when raw, warm when cooked, and is toxic. It descends and is yang in nature. Its uses include removing dampness-transformed phlegm and saliva, harmonizing spleen and stomach qi, and treating phlegm syncope headache, which cannot be treated without it.

Tangye Bencao: It has a slightly cold qi and pungent, neutral taste. It is bitter and pungent, with more pungency than bitterness, and is yang within yin. Raw, it is slightly cold; cooked, it is warm and toxic. It enters the Foot Yangming, Taiyin, and Shaoyang meridians.

Yaolei Faxiang: It treats cold phlegm and cough caused by cold drinks damaging the lungs. It harmonizes stomach qi, removes stomach cold, and promotes appetite. It treats Taiyin phlegm syncope headache, which cannot be treated without it. Yongyao Xinfa: It overcomes dampness in the spleen and stomach, hence resolving phlegm. It is contraindicated in cases of thirst.

Zhenzhunang: It disperses chest fullness and removes phlegm from the diaphragm.

Shennong Bencao Jing: It treats cold-damage disease with chills and fever, hardness below the heart, lowering qi, swollen and painful throat, dizziness, chest distension, cough, borborygmus, stops sweating, disperses phlegm-heat fullness in the heart, abdomen, chest, and diaphragm, treats cough with upward qi, acute pain and hardness below the heart, seasonal epidemic vomiting, reduces abscesses, prevents early abortion, treats sallow complexion, and beautifies the face. Raw, it induces vomiting; cooked, it promotes bowel movement. It is washed in soup to remove the slime completely. It is used with Fresh Ginger Rhizome in equal parts to disperse phlegm and saliva, open the stomach, and strengthen the spleen. Belamcanda Rhizome is its assistant. It is incompatible with Chinese Honeylocust Fruit, fears Realgar, Fresh Ginger Rhizome, Dried Ginger, ash bark, and Tortoise Carapace, and opposes Aconite Mother Root.

Yaoxing Lun states: Pineilia is used. It is contraindicated with sheep blood, seaweed, and maltose. Bupleurum serves as its adjuvant. It is commonly used as a lung medicine, which is incorrect. It stops vomiting for the Foot Yangming, and removes phlegm for the Foot Taiyin. Although small Bupleurum is used to stop vomiting, it also assists Bupleurum in alleviating aversion to cold, which is also for the Foot Shaoyang; it also assists Skullcap Root in removing heat, which is again for the Foot Yangming. The alternation of cold and heat lies between the exterior and interior, hence the use of this herb implies a half-and-half approach, originally used to treat the cold and heat of cold-damage disease, hence the name Pineilia. The "Classic" says: The kidney governs the five kinds of fluid, transforming into five dampnesses, naturally entering as saliva, entering the liver as tears, entering the heart as sweat, entering the spleen as phlegm, entering the lungs as nasal discharge. If there is drool, it is called a cough; if there is no drool, it is called a dry cough. Phlegm is the dampness of the spleen moved by coughing. Pineilia can drain the symptoms of phlegm, but not the root of phlegm. Draining the root means draining the kidney. Cough is formless, phlegm is formful; the formless is moist, the formful is dry, hence it is used to moisten the dry and dampen the wet.

Bencao Yanyi Buyi: Belongs to metal and earth. Zhongjing used it in Minor Bupleurum Decoction, taking its function of tonifying yang brightness. Isn't it the effect of drying the spleen earth? Pineilia is nowadays only known for removing phlegm, not for benefiting the spleen, as it can separate water. Also, for various hemorrhagic syndromes Jinfu. Zhongjing removed it for cold-damage disease with thirst, because Pineilia dries body fluids. Also, it is used stir-fried with ginger for pregnant women.

Bencao Fahui: Cheng Liaoshe said: Pungent disperses. The pungency of Pineilia disperses rebellious qi and eliminates vexation and vomiting. Pungent enters the lung and disperses qi. Pungent disperses stagnant qi, pungent promotes vocal sounds.

Jiegu said: Pineilia treats cold phlegm, and cough due to cold injury to the lung from cold drinks. It harmonizes stomach qi, eliminates stomach cold, and promotes appetite. It treats Taiyin phlegm syncope headache, which cannot be removed without it. "The Secret of Treatment" says: It is cool in nature, pungent and bitter in taste, with thin qi and flavor, sinking and descending, yin within yang. Its uses are four: drying spleen and stomach dampness, resolving phlegm, benefiting spleen and stomach qi, subduing swelling and dissipating bind. Thirst contraindicates it. Also, for removing phlegm use Pineilia, for hot phlegm add Skullcap Root, for wind phlegm add Arisaema, for chest cold with phlegm obstruction, use Dried Tangerine Peel and White Atractylodes Rhizome. However, overuse can purge the spleen and stomach.

Bencao Gangmu: The spleen does not retain dampness and thus does not produce phlegm, hence the spleen is the source of phlegm, the lung is the container of phlegm. Pineilia can treat phlegm-fluid retention and abdominal distension and fullness, because its body is warm and its taste is pungent and warm. Sliding saliva can moisten, pungent warmth can disperse and also moisten, hence it moves dampness and unblocks the bowels, opens the orifices and promotes urination. As they say, pungent moves qi, can transform fluids, pungent moistens. Jiegu said: Pineilia and Arisaema treat phlegm, and cough is naturally cured; Danxi said: Erchen can moisten the bowels and lengthen urination. Liaoshe Cheng: Pineilia is pungent and dispersing, moves water qi and moistens kidney dryness. Also Taiping Huimen Heji Jufang has Pineilia and Sulfur Pill for treating constipation of deficiency type, all taking its slippery and moistening properties. Common people think Arisaema and Pineilia are drying in nature, which is wrong. When dampness is removed, the earth dries, and phlegm and saliva do not form, it is not that the two are drying in nature. Ancient formulas for treating sore throat pharyngitis, hematemesis, and bloody stools often use these two, they are not contraindicated. The two can also disperse blood, hence they are used for injuries and bruises. Only for yin deficiency and labor damage, which are not dampness-heat evils, using orifice-opening and dampness-moving medicines, this is to further exhaust body fluids, the fault of the doctor, not the medicine. Jiayi Jing treats insomnia at night, is it really drying in nature?

Eliminates abdominal distension and fullness, inability to close the eyes, white turbidity nocturnal emission leukorrhea.

Bencao Jingshu: Pineilia obtains the qi of earth and metal, and also the dryness qi of heaven, hence its taste is pungent, neutral, bitter, and warm, fire and metal clash, hence pungent and toxic. Jiegu said its taste is pungent and bitter, nature is warm, qi and flavor are thin, sinking and descending. Haogu said its pungency is thick and bitterness is light, yang within yin. It enters the foot Taiyin, Yangming, Shaoyang, and also the hand Shaoyang channels. Bupleurum is its envoy. Pungent warmth is good at dispersing, hence it treats cold-damage disease with evil between the exterior and interior, alternating chills and fever. Bitterness is good at descending and purging, evil in the chest causes hardness below the heart, chest distension and cough; evil in the upper energizer causes dizziness; evil in the Shaoyin causes swollen and sore throat. Bielu also says it eliminates phlegm-heat fullness and binding in the heart, abdomen, chest, and diaphragm, cough with upward qi, urgent pain and hardness below the heart, seasonal epidemic vomiting, all caused by evil in the upper energizer chest, hence it treats all. The middle energizer is governed by the foot Taiyin, with dampness and heat, clear and turbid not separated causes borborygmus, dampness-heat

Jian Wu: Pineilia, pungent and warm in nature, dry and toxic, although it can dispel dampness and strengthen the spleen, resolve cold-dampness phlegm, and alleviate qi depression and phlegm accumulation, its major contraindications lie in yin deficiency, blood deficiency, and insufficient body fluids. Therefore, the ancients established three prohibitions, referring to those with blood disorders, thirst disorders, and sweating disorders. Hence, all conditions such as hematemesis, epistaxis, hemoptysis, gingival hemorrhage, tongue bleeding, incised wounds, excessive postpartum bleeding, hematuria, hematochezia, kidney water and true yin deficiency causing thirst, summerheat stroke causing thirst, yang deficiency spontaneous sweating, yin deficiency night sweating, internal heat dysphoria causing sweating, and other syndromes should be avoided. However, beyond these three prohibitions, there are many more contraindications, which are detailed below: Any cough due to yin deficiency and empty fire flaring up, scorching the lungs and causing throat itching, leading to coughing, and internal heat condensing body fluids into phlegm, not due to cold-dampness, Bingben originating from the lungs and not the spleen. Vomiting due to fire rushing and stomach heat, not due to cold-dampness phlegm obstruction. Indigestion due to spleen yin deficiency, not due to dampness and spleen sluggishness. Vomiting, hiccups, dizziness, palpitations, and inability to digest food due to stomach qi deficiency; aversion to food, not due to cold-dampness evil intrusion. Cholera abdominal distension and fullness due to spleen deficiency and pathogenic heat in the middle energizer, not due to cold-dampness and food stagnation. Sore throat due to yin deficiency, kidney water deficiency leading to dryness and yang having no attachment, thus empty fire flaring up and causing sore throat, not due to cold-damage disease shaoyin disease pathogenic heat unresolved. Panting due to qi deficiency, not due to wind-cold qi depression. Headache due to blood deficiency, not due to phlegm syncope. Children's phlegm vomiting due to heat injury, not due to spleen and stomach issues. Insomnia due to heart collateral blood deficiency, not due to post-illness gallbladder deficiency. Spontaneous sweating due to exterior deficiency and unsecured striae and interstice, not due to dampness-heat internal invasion. The above syndromes are all contraindicated. What is most easily mistaken and difficult to understand is that many doctors, seeing its ability to dispel phlegm, often prescribe it first for any phlegm cough, not realizing that cough with phlegm, cold and heat, steaming bone fever, are often signs of yin deficiency, lung heat, and insufficient body fluids. Misuse of this medicine further depletes body fluids, making the lungs drier, yin qi more deficient, and phlegm more condensed, leading to hoarseness and death. If combined with ginseng and atractylodes, disaster is imminent. This is because it is fundamentally a spleen and gastrointestinal system medicine, not a lung and kidney medicine. Cold-dampness phlegm-fluid retention causing cough, belonging to stomach disease, is indeed suitable, but this is only one or two out of a hundred. Yin deficiency fire blazing, scorching true yin, body fluids transforming into condensed phlegm, leading to throat itching and coughing, is often the case. Therefore, any phlegm with blood, thirst, dry throat, yin deficiency cough should be strictly avoided. Also, conditions resembling apoplexy with phlegm obstruction, aphonia, hemiplegia, spasms, constipation, blood deficiency abdominal pain, are all contraindicated. Excessive use can lead to irreparable harm, with unpredictable outcomes, and regret will be too late. The responsibility lies with the physician, be cautious! Be warned!

Bencao Mengquan: Pungent in taste, slightly bitter, with a neutral qi, cold when raw and warm when cooked. Sinks and descends, yang within yin. Toxic. Incompatible with Aconite Mother Root, antagonistic to Chinese Honeylocust Fruit. Avoid Realgar, Fresh Ginger Rhizome, Dried Ginger, Ash Bark, Tortoise Carapace. Contraindicated with mutton, sheep blood, seaweed, maltose. Best used with Belamcanda Rhizome and Bupleurum, enters the gallbladder, spleen, and stomach meridians. Effective when stored for a long time, combined with tangerine peel known as Er Chen. Slices are potent, while fermented forms are milder. Primarily treats various phlegm conditions, verified by clinical evidence. For black phlegm due to fire and sticky old phlegm, add Scutellaria Root, Coptis Rhizome, Trichosanthis Fruit, and seaweed powder. For clear cold phlegm and white damp phlegm, add ginger, Aconite, Atractylodes Rhizome, and Dried Tangerine Peel. For wind phlegm causing apoplexy and unconsciousness, use Chinese Honeylocust Fruit and Arisaema. For phlegm nodules and swelling, use Bamboo Juice and white mustard seed. Alleviates phlegm syncope and headache, stops phlegm-fluid retention and hypochondriac pain. Disperses rebellious qi, relieves nausea and vomiting, opens stagnant qi, and restores voice. Also treats spleen diarrhea and calms heart palpitations. Since the spleen dislikes dampness, Pinellia specializes in drying dampness and overcoming water. Contraindicated in pregnancy due to risk of miscarriage. If necessary, use after stir-frying with ginger juice. Avoid in consumptive thirst and hemorrhagic syndromes as it may exacerbate dryness and fire pathogens, harming true yin and depleting fluids and blood, leading to critical conditions. Raw Pinellia reduces abscesses and swelling; grind into water for scorpion stings, apply topically for quick relief. For postpartum fainting, form into pills and insert into nostrils for immediate revival. This is Bian Que's swift method.

Commentary: Neijing states: The kidney governs five kinds of fluids, transforming into five dampnesses. Internally, it becomes saliva; in the liver, tears; in the heart, sweat; in the spleen, phlegm; in the lungs, nasal discharge. Danxi also said: Cough with phlegm is called 'sou', without phlegm is 'ke', caused by cough stirring the spleen's dampness. Pinellia only enters the spleen to drain the symptoms of phlegm, not the kidney to address the root. However, 'ke' is formless, 'sou' is formed. Formless requires moistening, formed requires drying, hence it serves as a moistening and drying agent. Also added in Minor Bupleurum Decoction to treat cold-damage disease with chills and fever. Half assists Bupleurum in managing aversion to cold, half assists Skullcap Root in removing heat, used for alternating chills and fever, embodying the concept of half and half, hence named Pinellia. Benjing also refers to it as 'Shou Tian' because around mid-summer, people often work in the fields, thus naming it with a meaningful intent.

《Materia Medica Chenya》: Pinellia grows according to the lunar calendar, around mid-summer. A time when heaven and earth meet, and all things flourish. With pure dryness exhausted, a single yin appears thereafter, thus governing the half of yin-yang opening and closing, the pivot of key points, such as half wanting to open, half wanting to close, half wanting to open and close, all obeying its command, explaining its therapeutic effects, ancestors have detailed its medicinal properties.

Mostly from the aspect of half wanting to open, such as cold-damage disease with chills, fever, and dizziness; the pivot of Shaoyang half wanting to open, sore throat; the pivot of Shaoyin half wanting to open, firmness below the heart, chest fullness, cough; the body's half wanting to open, borborygmus also the body's half wanting to open and half wanting to close; lowering qi and sweating, this is the body's center wanting to close, the exterior wanting to close.

Yaoxing Jie: Pungent and neutral in taste, cold when raw, warm when cooked, toxic, enters the lung, spleen, and stomach meridians. Lowers qi, stops vomiting, opens stagnation, disperses exterior pathogens, removes dampness transforming into phlegm, greatly harmonizes the spleen and stomach. Belamcanda Rhizome and Bupleurum as guides, antagonistic to Chinese Honeylocust Fruit, avoid Realgar, Fresh Ginger Rhizome, Dried Ginger, Ash Bark, Tortoise Carapace, incompatible with Aconite Mother Root, contraindicated with sheep blood, mutton, maltose, seaweed.

Note: Pinellia, pungent in taste, enters the lung, dry in nature, enters the spleen and stomach. Poisoning causes lockjaw and vomiting. Avoid in cases of thirst and blood disorders, only in cases of qi disorders causing thirst is it not contraindicated.

Yaojian: Slightly cold in nature, pungent and bitter in taste, with pungency stronger than bitterness. Both the qi and flavor are light, and it has slight toxicity. It is yin within yang, descending in nature. It enters the three meridians of Foot Yin Ming, Taiyin, and Shaoyang. It is primarily used to treat damp phlegm but is ineffective against heat phlegm. Its widespread use in medicine is a mistake. The spleen and stomach favor dryness and dislike dampness. Pineilia has a drying nature and removes dampness, thus benefiting the spleen and stomach. For black phlegm caused by fire and sticky old phlegm, add Scutellaria, Coptis, Trichosanthis Fruit, and seaweed powder. For clear cold phlegm and white damp phlegm, add ginger, aconite, Atractylodes Rhizome, and Dried Tangerine Peel. For wind phlegm causing apoplexy and unconsciousness, add Chinese Honeylocust Fruit and Arisaema. For phlegm nodules and swelling, add bamboo juice and white mustard seed. It should not be used in cases of hemorrhagic syndromes, pregnancy, Shaoyang cold-damage disease with thirst, or any thirst-related conditions. Pineilia, due to its drying nature, can damage blood and qi and dry up body fluids. It treats cough caused by cold injury to the lungs and relieves phlegm syncope headaches. It stops vomiting as a Foot Yangming medicine and disperses phlegm as a Foot Taiyin medicine. In small Bupleurum decoctions, it aids in stopping vomiting and assists Bupleurum in dispelling cold, making it also a Foot Shaoyang medicine. In small Bupleurum decoctions, it helps dispel cold and assists Skullcap Root in removing dampness-heat, thus also acting as a Foot Yangming medicine. For alternating chills and fever between the exterior and interior, it is used with a half-and-half intention, hence the name Pineilia. The classic text states: The kidneys govern the five kinds of fluids, which transform into five dampnesses. In the kidneys, it becomes saliva; in the liver, tears; in the heart, sweat; in the spleen, drool; and in the lungs, mucus. Cough with phlegm and drool is called "sou," while cough without phlegm and drool is called "ke." Phlegm arises from cough disturbing the spleen's dampness. Pineilia can address the symptoms of phlegm but not its root cause. The root cause lies in the kidneys. Cough is formless, while phlegm has form. The formless requires moistening, while the formed requires drying, hence the principle of flowing dampness toward dryness. The spleen governs dampness and phlegm. When the spleen is overwhelmed by dampness, it loses its transformative function, leading to the stagnation of fluids and blood, causing various body fluids to condense and rise with qi, forming phlegm through coughing and spitting. Over time, this stagnation leads to various phlegm-related diseases. Therefore, Pineilia, with its hot nature and pungent taste, dries dampness. Pungency benefits metal (lungs), which overcomes wood (liver), thus rescuing the spleen earth. Belamcanda Rhizome is its guiding herb. It is incompatible with Chinese Honeylocust Fruit and should be avoided with Realgar, Fresh Ginger Rhizome, Dried Ginger, ash bark, and tortoise shell. It is antagonistic to Aconite Mother Root and Wu Hui.

Jingyue Quanshu: The taste is very pungent and slightly bitter, the qi is warm. It can rise or fall, being yang within yin. It is toxic. Its texture is smooth and moist, its nature dries dampness and reduces phlegm, entering the spleen, stomach, and gallbladder meridians. Chewing it raw irritates the throat, processed use is Fresh Ginger Rhizome. It lowers lung qi, opens the stomach and strengthens the spleen, disperses phlegm and relieves fullness, stops cough and upward qi, heart pain and hypochondriac pain, eliminates vomiting and regurgitation, cholera and muscle cramps, head and abdominal distension and fullness, insomnia and qi stagnation, phlegm nodules and swelling, removes phlegm syncope and headache, disperses wind and relieves hoarseness, treats spleen dampness and diarrhea, seminal emission and turbid discharge, resolves Yongju swelling and toxins, kills centipede and bee stings and insect toxins. Its nature can cause early abortion, although pregnant women should avoid it, if stomach disharmony and vomiting persist, add ginger juice and lightly fry, it can be used without harm. If consumptive thirst and vexing heat, as well as yin deficiency hemorrhagic syndrome, it is most contraindicated and should not be added. Li Shi-zhen said: Pinellia can treat phlegm-fluid retention and abdominal distension and fullness, because its texture is smooth, its taste is pungent, and its nature is warm. Smoothness can moisten, pungent and warm can disperse and also moisten, thus it moves dampness and unblocks the bowels, opens the orifices and discharges urine, so-called pungent moves qi, can transform fluids, pungent to moisten is this. Danxi said: Two Old Ingredients Decoction can make the bowels moist and urine long. Cheng Liaoshe said: Pinellia is pungent and dispersing, moves water and moistens kidney dryness. Also Taiping Huimin Heji Jufang uses Pinellia and Sulfur Pill to treat elderly constipation of deficiency type, all taking its smooth and moistening nature. Common people all think Pinellia and Southern Star are of drying nature, which is wrong. When dampness is removed, the earth dries, and phlegm and saliva do not arise, it is not the drying nature of these two substances. Ancient formulas treat sore throat and pharyngitis, hematemesis and bleeding, often use these two substances, they are not contraindicated. These two substances can also disperse blood, thus they treat wounds and injuries.

Bencao Beiyao: Dries dampness and phlegm, moistens kidney dryness, promotes the flow of yin-yang.

Pungent and warm, toxic. Slippery in texture and drying in nature, it can move and disperse, dry and moisten, harmonize the stomach and strengthen the spleen, remove dampness. It tonifies the liver and disperses with its pungency. It moistens the kidneys, eliminates dampness transformation phlegm, releases the exterior and opens depression, lowers rebellious qi, stops vexation and vomiting, promotes vocalization, and benefits the water passages. Drying removes dampness, thus benefiting water; pungency unblocks qi, able to transform fluids, thus moistening dryness. Niu Danxi stated that the Two Old Ingredients Decoction can moisten the bowels and lengthen urination. Sudden death. Ge Sheng said: Whenever encountering the five sudden death syndromes, using Pineilia powder blown into the nose can revive, as it induces sneezing. The five sudden deaths refer to hanging, drowning, crushing, nightmare, and childbirth deaths. Treats cough, dizziness, as fire flares and phlegm rises causing dizziness. Phlegm syncope headache, pain of the supraorbital bone, wind-heat with phlegm. Sore throat, Cheng Wuji said: Pineilia is pungent and dispersing, moving water qi and moistening kidney dryness. Also Taiping Huimin Heji Jufang Pineilia and Sulfur Pill, treats elderly constipation of deficiency type, all taking advantage of its lubricating properties. Common belief that Pineilia and Nanxing are drying in nature is mistaken. When dampness is removed, the earth becomes dry, and phlegm and saliva do not arise, not because these two substances are drying in nature. Ancient formulas used to treat sore throat, pharyngitis, hematemesis, and bleeding, not as prohibited agents. These two substances can also disperse blood, thus treating trauma and beatings. Only in yin deficiency and fatigue damage, where it is not dampness-heat evil, using orifice-opening and dampness-moving drugs, is to further deplete body fluids, the fault of the physician, not the medicine! Jiayi Jing Used to treat insomnia, is it truly drying in nature? Pineilia and Sulfur in equal parts, Fresh Ginger Rhizome flour and water paste pill, named Pineilia and Sulfur Pill. Chest distension, Zhongjing's Minor Chest Bind Decoction uses it. Cold-damage disease with chills and fever. Thus Minor Bupleurum Decoction uses it. Phlegm malaria insomnia. Suwen Says: Stomach disharmony leads to restless sleep. Pineilia can harmonize stomach qi and unblock yin-yang. Lingshu Says: When yang qi is full, it cannot enter yin, yin qi is deficient, thus the eyes cannot close, drinking Pineilia decoction, yin-yang is unblocked, and sleep comes immediately. Also, for wheezing and cough preventing sleep, left-sided insomnia belongs to liver distension, should clear the liver; right-sided insomnia belongs to lung distension, should clear the lungs. Reflux vomiting of food. Phlegm diaphragm. Disperses masses and removes goiter, goiter mostly belongs to phlegm. Reduces swelling and stops sweating. Overcomes dampness. Contraindicated in pregnancy, Wang Hao-gu said: The kidneys govern the five kinds of fluid, transforming into five dampnesses. Benjing As saliva, entering the liver as tears, entering the heart as sweat, entering the lungs as mucus, entering the spleen as phlegm. Phlegm moves due to coughing, the spleen's dampness. Pineilia drains the branch of phlegm, cannot treat the root of phlegm, treating the root means treating the kidneys. Cough is formless, phlegm has form, formless then moist, formed then dry, thus it is a spleen-dampness-moving and kidney-dryness-moistening agent. Common belief that Pineilia is a lung medicine is incorrect. Stops vomiting for the foot yangming, removes phlegm for the foot taiyin. Bupleurum serves as its envoy, thus Bupleurum decoction uses it. Although said to stop vomiting, also assists Bupleurum and Scutellaria, governs alternating chills and fever, thus also for the foot shaoyang. Li Shizhen said: The spleen without dampness does not produce phlegm, thus the spleen is the source of phlegm, the lung is the container of phlegm. Note that sound without phlegm is called cough, as it injures lung qi; phlegm without sound is called expectoration, as it moves spleen dampness; sound with phlegm is called cough. Either due to fire, wind, cold, dampness, deficiency fatigue, or food accumulation, should differentiate syndromes for treatment. The general method for treating cough should prioritize treating phlegm, and treating phlegm should prioritize smoothing qi, should use Pineilia and Nanxing to dry its dampness, Submature Bitter Orange and red tangerine exocarp to benefit its qi, lung deficiency adds warming and astringent flavors, lung heat adds cooling and purging agents. Zhao Jizong said: The Two Chen treat phlegm, worldly physicians adhere to it, containing Pineilia, its nature is drying and intense, if wind-cold dampness food various phlegm then it is suitable, as for fatigue phlegm, blood loss various phlegm, using it can instead dry blood fluids and worsen illness. Note ancient three prohibitions: blood family, sweat family, thirst family avoid it, yet sometimes it is used. Common belief that Pineilia is solely for removing phlegm, and Pineilia's functions, are no longer known to the world. Minor Bupleurum Decoction, Pineilia drains the heart and intestines all use Pineilia, is it solely for removing phlegm? Fire binds to form phlegm, qi smooth then fire descends and phlegm dissipates. Nature stomach Fresh Ginger Rhizome, used to control toxicity, with ginger its efficacy is more pronounced. Bupleurum, Belamcanda Rhizome as envoys. Fears Fresh Ginger Rhizome, ash bark, Tortoise Carapace, Realgar, avoids mutton, seaweed, maltose, dislikes Chinese Honeylocust Fruit. Opposes Aconite Mother Root. Combined with Dried Tangerine Peel, Poria, Liquorice Root named Two Old Ingredients Decoction, as the general phlegm-treating formula, cold phlegm assisted by Dried Ginger, india mustard seed; heat phlegm assisted by Skullcap Root, Trichosanthis Fruit; damp phlegm assisted by Atractylodes Rhizome, Poria; wind phlegm assisted by Nanxing, Peucedanum; mass phlegm assisted by Immature Orange Fruit, White Atractylodes Rhizome, further observe phlegm's location, add conduction exercise medicine. Only dry phlegm is not within Pineilia's jurisdiction.

Benjing Fengyuan: Pineilia is the primary herb for the Shaoyang foot channel and also enters the Yangming and Taiyin foot channels. For deficiency with phlegm and qi, it is appropriate to add it. It is the most important herb for treating hiccups due to cold stomach and vomiting. It stops vomiting by acting on the Yangming foot channel and removes phlegm by acting on the Taiyin foot channel. Bupleurum serves as its assistant, and it is used in Minor Bupleurum Decoction. Although it primarily stops vomiting, it also assists Bupleurum and Skullcap Root in treating alternating chills and fever. Benjing: It treats cold-damage disease with chills and fever, not because of its acrid and warm properties to disperse stagnation? It treats hardness below the heart and chest distension, not because of its ability to break up hardness and dissolve masses? It treats cough and dizziness, not because of its ability to clear phlegm and disperse pathogens? It treats swollen and sore throat, not because of its ability to resolve yin fire? It treats borborygmus, lowers qi, and stops sweating, not because of its ability to promote urination and dissolve phlegm? Combined with Atractylodes Rhizome and Poria, it treats damp phlegm; combined with Trichosanthis Fruit and Skullcap Root, it treats heat phlegm; combined with Arisaema and Peucedanum, it treats wind phlegm; combined with mustard seed and ginger juice, it treats cold phlegm. Only dry phlegm should be treated with Trichosanthis Fruit and Fritillaria Bulb, which Pineilia cannot treat. Pineilia is drying in nature and can remove dampness, dissolve phlegm, and strengthen the spleen. Nowadays, people only know that Pineilia removes phlegm but do not mention its benefits to the spleen and its ability to promote urination. If the spleen retains no dampness, phlegm will not be produced. Hence, the spleen is the source of phlegm, and the lung is the container of phlegm. Pineilia can treat phlegm-fluid retention and abdominal distension and fullness because it is slippery in texture, acrid in taste, and warm in nature. Two Old Ingredients Decoction can moisten the stool and promote urination. It is a common misconception that Pineilia and Arisaema are drying in nature. When dampness is removed, the earth becomes dry, and phlegm and saliva do not form; it is not due to the drying nature of these two herbs. Ancient formulas for treating sore throat, pharyngitis, hematemesis, and bleeding often use these two herbs, and they are not contraindicated. According to Lingshu, when yang qi is full, the yang qiao becomes excessive and cannot enter yin. Yin deficiency leads to insomnia. Drinking a dose of Pineilia Decoction can harmonize yin and yang, and sleep will come immediately. Pineilia combined with Trichosanthis Fruit and Coptis Rhizome is called Minor Chest Bind Decoction, which treats minor thoracic accumulation in cold-damage disease. Combined with egg white and vinegar, it is called Vinegar Decoction, which treats sore throat, sores, and loss of voice in Shaoyin disease. Combined with Fresh Ginger Rhizome, it is called Minor Pinellia Decoction, which treats thoracic fluid retention and vomiting. Combined with Ginseng and white honey, it is called Major Pineilia Decoction, which treats vomiting and regurgitation. Combined with Ephedra and honeyed pills, it is called Pineilia Ephedra Pill, which treats palpitations below the heart. Combined with Poria and Liquorice Root, cooked with vinegar, and made into a paste with ginger juice and flour, it is called Summerheat-Clearing Pill, which treats latent summerheat, excessive drinking, and disharmony of the spleen and stomach. These are all the wonderful uses of Pineilia. However, it is contraindicated in cases of yin deficiency, emaciation, steaming bone fever, sweating, fire stagnation headache, heat-induced cough, consumptive thirst, lung atrophy, cough with blood loss, and emaciated limbs. Using a dampness-removing and phlegm-dissolving herb when there is no damp-heat pathogen will severely deplete body fluids, which is the fault of the physician, not the herb!

Bencao Chongyuan: According to the "Monthly Ordinances," Pineilia grows in May, which is the middle of summer. Maijie Pian: The Yangming channel corresponds to the noon hour. May is the peak of yang within yin. Pineilia grows in the middle of summer, is white in color, and acrid in taste, embodying the qi transformation of Yangming's dry metal. It treats cold-damage disease with chills and fever because its acrid nature disperses pathogens. The Yangming stomach channel connects upward to the heart. If the stomach channel does not connect to the heart, there will be hardness below the heart. The chest is the domain of the lung, and the Yangming metal qi harmonizes with the lung. If the metal qi does not harmonize with the lung, there will be chest distension and cough. Pineilia, being white and belonging to metal, governs the dispersion of Yangming qi, thus treating these conditions. Metal can control wind, hence it treats dizziness and swollen, sore throat. Dryness can overcome dampness, hence it treats borborygmus, lowers qi, and stops sweating.

Bencao Qiuzhen: [Comment] Primarily disperses damp phlegm in the intestines and stomach.

Pineilia specifically enters the spleen, stomach, and gallbladder, and also enters the heart. The texts say it is acrid, warm, and toxic, with a slippery body and drying nature. It can move and disperse, dry and moisten, harmonize the stomach, strengthen the spleen, tonify the liver, and moisten the kidneys. These phrases already summarize its main therapeutic effects. However, without detailed annotations, it remains unclear. Pineilia has an acrid taste, and acridity liquefies and facilitates urination, hence it is said to moisten kidney dryness. Cheng Wu-ji said: Pineilia disperses with acridity, promotes water movement, and moistens kidney dryness. When dryness is removed, dampness is eliminated, and water flows smoothly; when acridity transforms fluids, dryness is moistened. Taiping Huimin Heji Jufang Pineilia and Sulfur Pill treats constipation of deficiency type in the elderly, utilizing its lubricating properties. Common belief that Pineilia and Arisaema are drying in nature is mistaken. When dampness is removed, the earth (spleen) becomes dry, and phlegm and saliva do not form; it is not that these two substances are inherently drying. The spleen suffers from dampness and must be treated with acrid and warm substances to dry it. Pineilia, being acrid and warm, can clear phlegm and remove filth from the spleen. When phlegm is removed, the spleen naturally strengthens, hence it is said to strengthen the spleen. Wang Hao-gu said: The kidneys govern the five kinds of fluids, which transform into five dampnesses: in the kidneys, it is saliva; in the liver, tears; in the heart, sweat; in the lungs, nasal mucus; and in the spleen, phlegm. Phlegm is the dampness of the spleen moved by coughing. Pineilia drains the branch of phlegm but cannot drain its root; draining the root means draining the kidneys. Cough is formless, while phlegm has sound; the formless is moistened, while the sounding is dried, hence it is a remedy that flows spleen dampness and moistens kidney dryness. When the stomach is congested with phlegm and qi, it reaches extreme disharmony. Pineilia can warm the spleen to eliminate phlegm and, combined with Fresh Ginger Rhizome, warm the stomach to stop vomiting. If combined with Bupleurum and Scutellaria to treat alternating chills and fever of the shaoyang, the stomach becomes even more harmonious, hence it is said to harmonize the stomach. Wang Hao-gu said: Common belief that Pineilia is a lung medicine is incorrect. Stopping vomiting pertains to the foot yangming (stomach), and eliminating phlegm pertains to the foot taiyin (spleen). Bupleurum serves as its envoy, hence it is used in Bupleurum Decoction. Although it is said to stop vomiting, it also assists Bupleurum and Scutellaria in treating alternating chills and fever, thus it is also a medicine for the foot shaoyang (gallbladder). Li Shizhen said: The spleen does not produce phlegm without dampness, hence the spleen is the source of phlegm, and the lung is the container of phlegm. Note that coughing with sound but no phlegm is due to injury to lung qi; coughing with phlegm but no sound is due to movement of spleen dampness. Coughing with both sound and phlegm is called cough, which may be caused by fire, wind, cold, dampness, deficiency fatigue, or food accumulation, and should be treated according to the syndrome. The general method for treating cough should prioritize treating phlegm, and treating phlegm should focus on regulating qi. Pineilia should be used to dry dampness, Submature Bitter Orange and red tangerine exocarp to regulate qi, and for lung deficiency, warming and astringent medicines should be added; for lung heat, cooling and purging agents should be added. Others, such as qi counterflow, can be directed downward; when phlegm is removed, qi naturally descends. Stagnation can be opened; when phlegm is removed, stagnation and knots also open. For sudden death, blowing its powder into the nose can save lives, such as in cases of hanging, drowning, crushing, nightmare death, or childbirth death. For insomnia, Pineilia Decoction can regulate yin-yang and induce sleep. Suwen says: Stomach disharmony leads to restless sleep; Pineilia can harmonize stomach qi and regulate yin-yang. Lingshu says: When yang qi is full and cannot enter yin, and yin qi is deficient, the eyes cannot close. Drinking Pineilia Decoction regulates yin-yang, and sleep comes immediately. For those who cannot sleep due to cough, inability to sleep on the left side is due to liver distension, and on the right side is due to lung distension, and the lungs should be cleared. For chest distension, combine with Trichosanthis Fruit, Immature Orange Fruit, and Rhubarb Rhizoma to form Minor Chest Bind Decoction for treatment. For sore throat and sores in the shaoyin, with loss of voice, combine with egg and vinegar to form Vinegar Decoction for ingestion. Zhang Zhongjing used this to treat sore throat in the shaoyin. All these are the wonderful uses of Pineilia as a medicine for resuscitation and draining dampness. Combined with Dried Tangerine Peel, Poria, and Liquorice Root, it forms Two Old Ingredients Decoction, a general remedy for phlegm. For cold accumulation, add Dried Ginger and India Mustard Seed; for heat accumulation, add Skullcap Root and Trichosanthis Fruit; for damp phlegm, add Atractylodes Rhizome and Poria; for wind phlegm, add Arisaema and Peucedanum; for phlegm stagnation, add Immature Orange Fruit and White Atractylodes Rhizome. Additionally, depending on the location of the phlegm, add conduction exercise medicines, but dry phlegm is not within Pineilia's scope. However, for yin deficiency with excessive fire, heat accumulation, slippery fetus, and phlegm surging, it is not suitable and must be used with caution. Zhao Jizong said: Two Chen Decoction treats phlegm, and many physicians adhere to it. It contains Pineilia, which is drying and strong. It is suitable for wind-dampness and food-related phlegm, but for phlegm due to fatigue and blood loss, using it can dry the blood and worsen the condition. According to ancient texts, Pineilia has two contraindications: it should be avoided by those who sweat excessively and those who are thirsty, but there are exceptions.

Depei Bencao: Belamcanda Rhizome, Bupleurum is its adjuvant. It is averse to Fresh Ginger Rhizome, Dried Ginger, Ash Bark, Tortoise Carapace, Realgar. It is incompatible with Chinese Honeylocust Fruit. It is antagonistic to Aconite Mother Root. It should avoid seaweed, mutton, sheep blood, maltose.

Pungent, warm. Toxic. Enters the foot Taiyin, Yangming, and Shaoyang meridians' qi aspect. Benefits the orifices and harmonizes the stomach, and connects yin-yang. It is a sacred medicine for eliminating dampness transformation, resolving phlegm, opening depression, and stopping vomiting. It promotes voice, rescues sudden collapse, treats insomnia, cures leukorrhea, removes goiter, dissipates masses, treats palpitations, and stops malaria.

Combined with Glutinous Sorghum, it harmonizes nutrient-defense; dampness is thus removed. Combined with Polyporus and oyster shell, it treats nocturnal emission; combined with Japanese Ampelopsis Root, it treats metal blades entering the bone. When added to bitter-cold medicines, it can disperse fire; pungent to disperse. When added to qi-aspect medicines, it harmonizes middle qi; damp qi is removed, middle qi is harmonized. When added to yin-aspect medicines, it disperses depressive heat; pungent to disperse. Assisting yin-tonifying medicinals, it can open dryness. Dampness-heat descending, then zang-fu organs are moistened. Assisted by Bamboo Shavings, it treats palpitations; phlegm gathering in the meridians causes heart palpitations. Assisted by Trichosanthes Seed, it treats pathogenic heat thoracic accumulation; assisted by Scutellaria and Coptis, it treats fire phlegm; old phlegm; assisted by Ginger and Aconite, it treats cold phlegm, damp phlegm.

Ground into powder and blown into the nose, it treats the five extremities, and also treats the condition where the intestines protrude during childbirth and do not retract postpartum, known as intestinal prolapse. Frequent sniffing into the nose will also help. Lung disease cough, pulmonary tuberculosis expectoration, yin deficiency with scant blood, phlegm moving due to fire, pregnant women, combined with Fresh Ginger Rhizome is harmless. Those with sweating, thirst, and blood disorders should avoid use.

Bencao Jing Jie: Pinellia's qi is balanced, embodying the metal qi of autumn dryness, entering the hand Taiyin lung meridian; its flavor is pungent and toxic, obtaining the harsh metal flavor of the west, entering the foot Yangming stomach meridian and hand Yangming large intestine meridian. Balanced qi and pungent flavor, it is yang.

It primarily treats cold-damage disease with cold and heat and firmness below the heart, which is the area of the spleen and lung, the region traversed by the Taiyin meridian. Cold-damage disease with cold and heat and firmness below the heart indicates damp phlegm in the Taiyin, Pinellia's pungent and balanced nature disperses phlegm and removes dampness, thus it treats this. The chest is the region of the lung, distension is qi counterflow, Pinellia's pungent and balanced nature, pungent to open, balanced to descend, thus it treats this.

Cough with dizziness indicates phlegm in the lung causing qi not to descend, qi counterflow causing dizziness. Dongyuan said: "Taiyin headache must involve phlegm," Pinellia's pungent and balanced nature disperses phlegm, thus it treats this. The throat is traversed by the Taiyin meridian, fire knotting causes swelling and pain, it treats this because pungent can disperse knots, balanced can lower qi, qi descending then fire descends. Borborygmus indicates the large intestine receiving dampness, causing intestinal cutting pain and gurgling sounds, pungent and balanced drying dampness, thus it treats borborygmus lowering qi, Pinellia enters the lung, lung balanced then qi descends. Yangming's qi originally descends, ascending counterflow then sweat spontaneously exits, balanced can descend qi, thus it stops sweat.

Shennong Bencao Jingdu: Pinellia's qi is balanced, embodying the dryness qi of autumn metal, entering the hand Taiyin; its flavor is pungent and toxic, obtaining the harsh flavor of the west, entering the hand and foot Yangming. Pungent then can open various knots, balanced then can lower various counterflows.

Cold-damage disease with cold and heat and firmness below the heart indicates evil knotting between the half exterior and half interior, it treats this because it is pungent and can open. Throat swelling and pain, dizziness and ascending qi indicate evil counterflowing above the crown and chest diaphragm, it treats this because it is balanced and can lower. Borborygmus indicates the large intestine receiving dampness, causing intestinal cutting pain and gurgling sounds, it treats this because it is pungent and balanced and can dry dampness.

Also said to stop sweat, additionally noted for its pungent and balanced function. Zhongjing used it in Minor Bupleurum Decoction to treat cold and heat; Heart-Draining Decoction used it to treat chest fullness and borborygmus; Shaoyin throat pain also used it; "Jingui" dizziness also used it, and for vomiting, this flavor must be added, greatly achieving its purpose of opening knots and lowering counterflow, using medicine entirely following Benjing, thus it is the sage among physicians.

Also said: Today people use Pinellia's function specifically for dispelling phlegm, generally cooking it with Alum, those who take it often vomit, and also cause heartburn and reduced eating, the method of preparation is a long-standing flaw. The ancients only washed it seven times in soup to remove the slime, today people fear its numbing mouth, and dare not follow this. I annually collect tens of pounds of dried Pinellia, wash off the rough skin, soak it in ginger juice and Liquorice Root water for a day and night, wash it clean, then soak it in river water for three days, changing the water once a day, lift it up and steam it until cooked, dry it in the sun, slice it, and use it after a year with great effect. This medicine is the Rhubarb Rhizoma of Taiyin, Yangming, and Shaoyang, dispelling phlegm is not its specialty, Zhongjing's various formulas add or subtract, all say for vomiting add Pinellia, for much phlegm add Poria, never heard of adding Pinellia for much phlegm.

Shennong Bencao Jing Hundred Species Record: Pungent in taste, neutral. Treats cold-damage disease, chills and fever, those occurring between the lungs and stomach. Firmness below the heart, lowering qi, pungency can open the lungs and lower rebellion. Swelling and pain in the throat, dizziness, opens and lowers the fire of the upper energizer. Chest distension, cough, borborygmus, when qi is lowered, it becomes smooth and harmonious, thus it can cure various ailments. Stops sweating. Astringes and consolidates lung qi.

Pineilia is white in color and pungent in taste, hence it can be used as a medicine for drying dampness in the lung meridian.

The lungs belong to metal, which prefers to contract rather than disperse. When contracted, the lung lobes hang down and the qi flows smoothly; when dispersed, the lung lobes expand and qi counterflows. The pungency of Pineilia is distinctly different from that of ginger and cinnamon. When it enters the throat, it causes closure and inability to speak; when applied to an incised wound, it stops the bleeding. Its pungency carries astringency, thus it can both disperse and contract. Moreover, the astringency of pungency differs from that of sourness; sourness primarily focuses on astringency, while pungency contains a dispersing intention within astringency, which is particularly compatible with the lungs.

Benjing Shuzheng: Pineilia has a pungent taste and a neutral qi, with a smooth body and a dry nature. Therefore, its uses are: the pungency helps to open blockages, the neutrality helps to stop counterflow, the smoothness helps to enter the yin, and the dryness helps to assist the yang. It grows at the meeting of yang growth and matures at the intersection of yin birth, thus its efficacy can make the healthy qi of the body enter from yang to yin, and can prevent the pathogenic qi of the body from entering from yang to yin. Making the healthy qi enter from yang to yin, then as Neijing says, the defense qi travels in the yang and cannot enter the yin, causing insomnia. Drinking Pineilia soup, the yin-yang is connected, and sleep comes immediately, that is it; preventing the pathogenic qi from entering from yang to yin, then as the cold-damage disease theory says, if one can eat and does not vomit, it means the three yin are not invaded by evil, Pineilia is then the specific remedy to stop vomiting. Cold-damage disease is a yang pattern of cold and heat; cold-damage disease with cold and heat and a hard feeling under the heart, then yang has left and entered the yin pattern. Cough is an interior pattern; chest distension and cough, then it is a half exterior and half interior syndrome. The head is the meeting place of all yang, when yang is blocked by yin, it causes dizziness; the throat is the intersection of all yin, when yin is struck by yang, it causes swelling and pain. Borborygmus is when yang has descended but cannot enter; qi counterflow is when yang is rising but cannot descend; sweating is when yang is added to yin, and yin does not harmonize with yang. For all these syndromes, there is no need to seek complicated treatments, just ensure that yin does not repel yang, and yang can enter yin, once yin-yang is connected, the condition can be immediately resolved. Therefore, Pineilia is not capable of dispersing; when yin does not repel yang, yang harmonizes and qi spreads. Pineilia is not capable of descending; when yin can enter yin, yin harmonizes and fluids do not stagnate. The merits are too numerous to detail, but with these few words, who can say there is still any meaning left out?

The Minor Bupleurum Decoction, Bupleurum Plus Sodium Sulfate Decoction, Bupleurum with Fossil Bone and Oyster Shell Decoction, Bupleurum and Cinnamon Twig Decoction, are remedies for cold-damage disease with cold and heat and a hard feeling under the heart. The Minor Green-Blue Dragon Decoction, Minor Green-Blue Dragon Plus Gypsum Decoction, Belamcanda and Ephedra Decoction, Magnolia Bark and Ephedra Decoction, Sun Euphorbia Decoction, Spleen-Qi Effusing plus Pinellia Decoction, Cinnamon and Poria Five Flavors Liquorice Root Decoction without Cinnamon plus Dried Ginger, Asarum, and Pineilia Decoction, are remedies for chest distension and cough. The Minor Pinellia plus Poria Decoction is a remedy for dizziness. The Vinegar Decoction, Pineilia Powder and Decoction, are remedies for throat swelling and pain. The Pineilia Heart-Draining Decoction, Fresh Ginger Rhizome Heart-Draining Decoction, Licorice Heart-Draining Decoction, are remedies for borborygmus. The Pueraria Root plus Pineilia Decoction, Skullcap plus Pinellia and Fresh Ginger Decoction, Bamboo Leaf and Gypsum Decoction, Ophiopogon Decoction, Major Pineilia Decoction, are remedies for lowering qi. Benjing mainly treats, only the phrase to stop sweating, Zhongjing has no specific formula, the rest are all in agreement.

Someone asked about Pineilia, that for cold-damage disease with chills and fever, it is not used unless there is firmness below the heart; for cough, it is not used unless there is chest distension; and for throat swelling and borborygmus, it can all be attributed to lowering qi. Now, with the Pueraria Root plus Pineilia, Skullcap Root plus Pineilia Fresh Ginger Rhizome and other decoction systems, is treating vomiting what is called lowering qi? It is said that other substances that lower qi may not necessarily stop vomiting, such as Benjing Citrus and Evodia Fruit; other substances that lower qi may not necessarily stop vomiting, such as Benjing Inula Flower and Apricot Kernel. Pineilia lowering qi may not necessarily be solely due to stopping vomiting, such as in cases of firmness below the heart, chest distension, throat swelling, and borborygmus. Pineilia stopping vomiting may not necessarily be solely due to lowering qi, such as in Jingui Yaolue Magnolia Bark Seven Ingredients Decoction, White Atractylodes Powder, and Bamboo Leaf Decoction. Since it is not qi counterflow that causes vomiting, therefore in the Qianjin Fang chapter on women's deficiency damage, Milkwort Root Decoction, if the person has qi counterflow in the chest, Pineilia is added; in the light Bamboo Shavings Decoction for qi counterflow, Pineilia is added; in the Bamboo Leaf Decoction for qi counterflow, Pineilia is added; in the Minor Bupleurum Decoction for chest vexation without vomiting, Pineilia is removed. It can be seen that vomiting is due to qi counterflow, and qi counterflow is caused by the interaction of water and qi, so Pineilia is indeed the appropriate remedy. It is said that then the Benjing records the effects of other substances, where all that is said about upward qi is different from this. What is the difference? It is said that examining the Benjing Acorus, Schisandra Fruit, Cinnamon, Belamcanda Rhizome, Lilac Daphne, and Apricot Kernel all record their effects as: governing upward qi, but none are without connection to cough, thus knowing that all substances that govern upward qi can cause rebellious qi to descend from the upper energizer. Pineilia and others that govern lowering qi can only prevent qi from rebelling from the middle energizer, which is their difference. Although, Jingui Yaolue says: malpractice of heat therapy causing upward qi, throat discomfort, stopping rebellion and lowering qi, Ophiopogon Decoction governs it. Discussing the syndrome it is called upward qi, discussing the treatment it is called lowering qi, and it can also be seen that all qi gathering in the lungs is called upward qi. Qi rebelling from the middle energizer, although it does not necessarily reach the lungs, can also be called upward qi. Specifically, Pineilia governs middle energizer qi counterflow and does not treat all qi rushing to the lungs. Moreover, Benjing for Apricot Kernel says it governs cough and upward qi, and also lowering qi, thus it can be seen that upward qi and lowering qi ultimately cannot be confused. Since upward qi and lowering qi ultimately cannot be confused, then Pineilia's effect of lowering qi is certainly in the middle and not in the upper, so how can they be confused?

Question: In the Minor Green-Blue Dragon Decoction, Pinellia is removed for those who are thirsty. In the Minor Bupleurum Decoction, Pinellia is removed for those with chest discomfort but no vomiting, and for those who are thirsty. Does this mean that Pinellia is useless for those who are thirsty, have chest discomfort, and do not vomit? The answer is no. The symptoms must have a cause. If the cause is the conflict between water and qi, then thirst and chest discomfort without vomiting cannot occur. If the cause is different, then the Meridian-Warming Decoction, which treats women's diarrhea, evening fever, lower abdominal rectal urgency, abdominal distension and fullness, hot palms, and dry lips, addresses all three conditions simultaneously. Why? Because the cause of the disease is static blood in the lower abdomen. Qi governs warmth, and blood governs moisture and nourishment. If qi stagnates, it becomes excessive, and if blood stagnates, it becomes excessive. Excessive qi generates fire, and excessive blood also generates fire. However, the fire from the qi aspect can deplete water and yin, manifesting in the front, while the fire that does not deplete water and yin manifests only on the sides. Therefore, instead of saying "body heat and heart vexation," it is said "hot palms," and instead of "thirst and desire to drink," it is said "dry lips." This does not mean that Pinellia cannot be used when there is water retention and qi conflict in the middle burner. For qi-related illnesses, vomiting and thirst are contradictory. Therefore, it is said that if vomiting precedes thirst, it indicates resolution. If thirst precedes vomiting, it indicates water retention below the heart, which belongs to the category of fluid retention. Vomiting patients are usually thirsty, but if they are not thirsty, it is due to thoracic fluid retention. This is also a case of thoracic fluid retention, and Minor Pinellia Decoction is used to treat it. The use of Pinellia for vomiting has been repeatedly clarified. In cases where both vomiting and thirst are present, such as in Polyporus Decoction for cough, vomiting, and thirst, or Five Ingredients with Poria Powder for difficulty urinating, thirst, and vomiting upon drinking water, Pinellia is not used. This strictness is evident. Even in cases of vomiting with pus, where vomiting should not be treated and the pus must be expelled naturally, Pinellia is not mentioned, but the principle of not using Pinellia is implicitly understood. Pinellia is a specific remedy for vomiting. However, in cases of vomiting with abscesses, the pulse is rapid, and the mouth is thirsty, indicating that the vomiting is due to fire qi attacking the stomach, not just qi and fluid conflict. Expanding on this, not only is Pinellia not used for vomiting with thirst, but it can also be said that Pinellia is unsuitable for any illness accompanied by thirst.

The names of formulas like Green Dragon, Bupleurum, Chest-Draining, Qi-Regulating, Center-Fortifying, and Pinellia have the distinction of "major" and "minor." Is this distinction based on the degree of cold or heat? If we follow the Green Dragon formula, this makes sense, but applying it to others does not. Is it based on warmth or heat? Following the Center-Fortifying formula, this makes sense, but applying it to others does not. The "major" in Bupleurum does not mean harmony, while the "major" in Pinellia does mean harmony. The "major" in Chest-Draining refers to addressing urgent conditions, while the "major" in Qi-Regulating warns against careless use. In other cases, a major formula should not be tested with a minor one first, but Qi-Regulating is an exception. Similarly, a minor formula should not be followed by a major one, but Bupleurum achieves success this way. There is no fixed rule or clear principle to follow. Do these six formulas merely have the names "major" and "minor" attached without any deeper meaning? This is not the case. The Green Dragon formula is like a cloud bringing rain; the Chest-Draining formula breaks through hardness and searches for hidden pathogens; the Qi-Regulating formula balances yin and yang; the Center-Fortifying formula stands firm against common ailments. These four formulas are named based on their functions, with "major" indicating a greater responsibility and "minor" indicating a lesser one. As for Bupleurum and Pinellia, they are named based on their medicinal properties. Bupleurum primarily disperses, so the "major" form disperses more, and the "minor" form disperses less. Pinellia primarily harmonizes, so the "major" form harmonizes more, and the "minor" form harmonizes less. However, in cases of vomiting where food cannot be retained, this is not a minor issue, and regurgitation vomiting is not necessarily a major issue. Yet, the major Minor Pinellia Decoction is used. Is this not contradictory? No, because vomiting with food retention indicates a stomach disorder, and regurgitation vomiting also indicates a stomach disorder. However, food retention with vomiting suggests stomach rebellion with fire, showing that the stomach still has some control. In contrast, vomiting in the morning what was eaten in the evening, or vomiting in the evening what was eaten in the morning, with undigested food, indicates the stomach has almost lost control. Therefore, the Minor Pinellia Decoction disperses the fire, calming the stomach, while the Major Pinellia Decoction transforms barrenness into fertility, using ginseng and white honey, and even water must be light and floating, not drastic in purgation, turning Pinellia's pungent and drying nature into a gentle, moistening agent. The Minor Pinellia Decoction is like plowing and breaking up hard soil to allow vitality to flow, while the Major Pinellia Decoction is like irrigating barren land to make it fertile, allowing vitality to accumulate. This shows that Pinellia's harmonizing effect can be major or minor, moistening or drying, not strictly limited to transforming fluids and stabilizing the middle burner. It also shows that the Minor Pinellia Decoction is like a well-trained horse pulling a cart on a familiar path, with Wang Liang and Zao Fu leading the way, while the Major Pinellia Decoction is like turning hardened steel into something as soft as silk.

Both ginger and pinellia are used in the same formula, which may be called Minor Pinellia Decoction, or Pinellia and Dried Ginger Powder, or Fresh Ginger and Pinellia Decoction. The distinct properties of ginger and pinellia can be discerned, and their functions can be followed and applied. Both ginger and pinellia are used for their pungent taste. The nature of ginger is primarily dispersing horizontally, while the nature of pinellia is primarily descending counterflow. Vomiting, hiccups, and panting are all diseases of upward counterflow. Specifically, vomiting involves both sound and substance, while retching and hiccups involve sound without substance. The presence of substance indicates excess, while the absence of substance indicates deficiency. Retching and hiccups also differ in terms of deficiency and excess. Retching involves restless movement of qi, while hiccups involve stable qi that clashes. Thus, retching is a deficiency within deficiency, while hiccups are an excess within deficiency. Observe that Minor Pinellia Decoction is primarily used for vomiting with undigested food, thoracic fluid retention without thirst, jaundice with unchanged urine color, a desire to self-purge, abdominal distension and fullness with panting, and hiccups caused by heat. Pinellia and Dried Ginger Powder is primarily used for retching, vomiting, and spitting frothy saliva. Fresh Ginger and Pinellia Decoction is primarily used for patients who feel as if they are panting but not panting, vomiting but not vomiting, hiccuping but not hiccuping, and who are deeply distressed and helpless. In one case, there is qi counterflow with excess, and in the other, qi counterflow with deficiency. For excess, Fresh Ginger Rhizome is used as an adjuvant, which moves but does not hold. For deficiency, Dried Ginger is used as an adjuvant, which holds but does not move. Moreover, the nature of pinellia is more intense than that of ginger, but ginger is sufficient to moderate its intensity. Therefore, in cases of excess, ginger is doubled, while in cases of deficiency, pinellia and ginger are used in equal amounts. Thus, Minor Pinellia Decoction and Pinellia and Dried Ginger Powder are not only different in meaning but also distinct in preparation. In cases of excess, the dosage is increased and repeated, while in cases of deficiency, only a square-cun spoon is used, and it is decocted with water to harmonize its nature. It is indeed difficult to discuss them together. As for the indications of Fresh Ginger and Pinellia Decoction, they are entirely within the patient's mind and not manifested in physical form. In cases of extreme confusion and distress, it is unlikely that descending counterflow alone will bring relief. Therefore, Fresh Ginger Rhizome is doubled and pounded to induce sweating, and Pinellia is decocted first before adding the ginger, so that the sharpness of ginger and the mellowness of pinellia can rapidly disperse and gently descend. This approach is completely opposite to that of Minor Pinellia Decoction and should not be compared. In all cases where Pinellia is used to lower qi, one must understand the appropriate adjustments and adjuvants to avoid the criticism of being rigid and inflexible.

The use of Pinellia is most common for epigastric fullness and vomiting, but it is not used for epigastric fullness with irritability or vomiting with thirst, as previously detailed. For throat conditions, are there cases outside of shaoyin throat pain where it is appropriate or inappropriate to use? For throat sores, inability to speak, and loss of voice, Vinegar Decoction is used; for throat pain alone, Pinellia Powder and Decoction are used, which are shaoyin pattern. For cough with upward qi, throat with a frog-like sound, Belamcanda and Ephedra Decoction is used; for malpractice of heat therapy with upward qi, throat discomfort, and stopping reverse qi, Ophiopogon Decoction is used; for women with a sensation of a grilled meat lump in the throat, Pinellia and Magnolia Bark Decoction is used, which are not shaoyin pattern. The grilled meat lump describes the shape, the frog-like sound describes the sound, and the sores with inability to speak and loss of voice describe the painful condition, while discomfort indicates obstruction. From this, it can be seen that the throat pain treated by Pinellia must involve phlegm and qi obstruction, causing difficulty in breathing and eating, unlike Liquorice Root Decoction, Platycodon Decoction, and Pig Skin Decoction, which merely treat throat pain. Not only are there indications and contraindications for treating throat conditions, but also for treating dizziness and borborygmus, each with its own indications and contraindications. For example, for sudden vomiting, epigastric fullness, water qi in the diaphragm causing dizziness and palpitations, Minor Pinellia plus Poria Decoction is used; for thin people with umbilical palpitations, vomiting frothy saliva, and dizziness, Five Ingredients with Poria Powder is used. From this, it can be seen that dizziness caused by water is suitable for Pinellia, but if water is in the diaphragm, it is used, whereas if water is below the navel, it is not used, indicating the indications and contraindications for dizziness. Pinellia Heart-Draining Decoction, Fresh Ginger Heart-Draining Decoction, and Licorice Heart-Draining Decoction all involve borborygmus and diarrhea, indicating that borborygmus without diarrhea is not suitable for Pinellia.

For abdominal distension and fullness after sweating, Magnolia Bark Fresh Ginger Rhizome Liquorice Root Pinellia Ginseng Decoction is used; for thirst followed by vomiting due to water retention in the epigastrium, Minor Pinellia plus Poria Decoction is used; for sudden vomiting, epigastric fullness, water in the diaphragm causing dizziness and palpitations, Minor Pinellia plus Poria Decoction is used; for persistent vomiting during pregnancy, Dried Ginger, Ginseng and Pinellia Pill is used; for women with a sensation of a grilled meat lump in the throat, Pinellia and Magnolia Bark Decoction is used. Cold-damage disease is different from miscellaneous syndromes, and once the exterior is resolved, it is not different from miscellaneous syndromes. Pregnancy is also different from miscellaneous syndromes, but the diseases during pregnancy are not significantly different from those without pregnancy. Therefore, among the four formulas, all contain Minor Pinellia Decoction, yet the diseases they treat are quite different. Why is that? Minor Pinellia Decoction treats the conflict between qi and water in the middle burner, aiming to reverse emetic therapy. If water overcomes qi, Poria is added; if qi deficiency leads to water counterflow, Ginseng is added; if both qi and water are excessive, causing obstruction in the stomach, Magnolia Bark, Perilla Leaf, and Poria are added. The principles are closely interconnected, and the efficacy of Pinellia is not different from usual. If in cold-damage disease the exterior is resolved but the interior is not harmonized, and the qi neither rises nor descends, causing only distension and fullness in the chest without afternoon tidal fever, periumbilical pain, dry mouth and throat, sweating, or spontaneous urination, then it cannot be treated as yangming with purgative formulas; if there is no spontaneous warmth in the hands and feet, no slow pulse, and no intermittent pain, then it cannot be treated as taiyin with regulating middle formulas. However, if there is only distension and fullness, it is closer to taiyin and farther from yangming. Qi without restraint causes distension, and water without restraint causes fullness. With both distension and fullness, how can it not rise to cause vomiting or descend to cause diarrhea? Adding half of the regulating middle formula to Minor Pinellia Decoction, using Pinellia and Fresh Ginger Rhizome to regulate the middle burner and prevent upward reversal, and using Ginseng and Liquorice Root to tonify the middle burner and prevent downward diarrhea, but also fearing that tonification may outweigh harmonization. Therefore, Magnolia Bark, which reduces fullness, is chosen from the purgative formulas to balance the tonification. It is not a tonic formula, nor a purgative formula, nor a sweating formula, but a harmonizing middle formula, with its main effect lying in Minor Pinellia Decoction. The use of Pinellia demonstrates extreme flexibility.

Disease arising from yang with inappropriate purgation leads to heat entering and causing thoracic accumulation; disease arising from yin with inappropriate purgation leads to epigastric fullness. The formation of thoracic accumulation is due to purgation being too early. Both involve pathogenic qi entering from the outside, but thoracic accumulation refers to heat entering, while epigastric fullness does not mention early purgation, indicating that disease arising from yin is not heat and should never be purged. If purgation is done too early in cases where it should never be done, yin pathogens will enter from the outside. When yin pathogens enter from the outside, those that settle in the lower body are not discussed, but those that occupy yang positions must be treated with Pinellia. Therefore, Pinellia Heart-Draining Decoction, Fresh Ginger Heart-Draining Decoction, Licorice Heart-Draining Decoction, and Inula Flower Hematite Decoction all contain Pinellia, making Pinellia the key herb for yin pathogens occupying yang positions.

Wherever yin and yang harmonize, vitality is generated. Therefore, things with a hot nature often grow in extreme cold, while those with a cold nature often thrive in warmth. Pineilia grows after the three yang energies open to prosperity and matures at the time when the first yin energy just begins to interact. Thus, it is evident that Pineilia accumulates yin qi to reach the initial yang. Being able to reach the initial yang, it remains moist despite being yin. Because it accumulates yin qi, it can still enter the yin even though it is dry. Endowed with the virtue of alternating yin and yang and the ability to be both smooth and dry, how could it not move from yang to yin to treat evils occupying yang positions? However, there are cases of fullness where Pineilia is not used, such as in Rhubarb and Coptis Heart-Draining Decoction and Aconite Heart-Draining Decoction. There are also cases of thoracic accumulation where Pineilia is used, such as in Minor Chest Bind Decoction. Where there is entry, there must be something carried along. Since what enters has both yin and yang, what is carried must also have yin and yang. If what enters is heat and what is carried is also heat, the combined force will be strong. If what enters is cold and what is carried is also cold, the combined chill will be deep. Therefore, in treating heat, one does not shy away from the harshness of Rhubarb and Rhizoma Mirabilite, and in treating cold, one does not avoid the warmth of Ginseng and Dried Ginger. However, the location of the occupation must be carefully considered. Although the chest is a yang position, it is actually where fluids accumulate. Therefore, even when using purgatives like Rhubarb, one cannot do without Gansui Root and Pepperweed Seed. Similarly, when using Ginseng and Dried Ginger, one still incorporates Pineilia, Scutellaria, and Coptis. If what enters is cold and what is carried is heat, or if what enters is heat and what is carried is cold, then one must use light and sharp cold to drain the carried heat, and a combination of cold and warm to treat the carried cold. This is the principle behind Rhubarb and Coptis Heart-Draining Decoction and Minor Chest Bind Decoction. To use a water analogy, the Yellow River is the most turbulent, the Huai River is next, and the Yangtze River is broad and flows calmly. Nowadays, the Huai River's territory is being encroached upon by the Yellow River, and its waters are flowing into the Yangtze. Since the Huai's territory is occupied by the Yellow River, it must be treated with methods for the Yellow River. As for the Huai, since its waters have entered the Yangtze, it no longer needs to be treated. The treatment with Pineilia is for yin pathogens occupying yang positions. For evils in yang positions, whether they enter from the outside or combine from within, as long as the current symptoms do not belong to yin, Pineilia should not be used indiscriminately. Isn't this clear?

In the case of cold-damage disease, after the resolution through sweating, vomiting, or purging, if there is epigastric fullness and hardness with persistent belching, the Inula Flower Hematite Decoction is prescribed. If there is heat in the chest and pathogenic qi in the stomach, with abdominal pain and a desire to vomit, the Coptis Decoction is prescribed. The efficacy of Pinellia is indeed remarkable. After the resolution of cold-damage disease, if there is debility, shortness of breath, and counterflow qi with a desire to vomit, the Bamboo Leaf and Gypsum Decoction is prescribed. In cases of malpractice of heat therapy leading to upward qi, throat discomfort, and the need to stop counterflow and lower qi, the Ophiopogon Decoction is prescribed. For chest pain preventing lying down and heart pain radiating to the back, the Trichosanthes, Chinese Chive, and Pinellia Decoction is prescribed. For regurgitation vomiting, the Major Pinellia Decoction is prescribed. The versatility of Pinellia is indeed extensive. In cases of strong pathogenic influence, it relies on its ability to dispel phlegm and awaken the middle, not aligning with the lower-ranking troops. In cases of mild pathogenic influence, it particularly relies on its ability to lower qi and harmonize the spleen, thus serving as a crucial regulatory agent. The value of substances lies in their timely use, and their application must be tailored to the situation. Although the conditions treated by these decoctions are complex, the key points are epigastric fullness, vomiting, upward qi, and heart pain. For mild epigastric fullness, the Rhubarb and Coptis Heart-Draining Decoction is preferred over Pinellia. For vomiting where food is regurgitated immediately upon ingestion, the Dried Ginger Coptis Rhizome Skullcap Root Ginseng Decoction is preferred over Pinellia. The most severe case of upward qi is lung abscess with dyspnea preventing lying down, for which the Pepperweed Seed Chinese Date Lung-Draining Decoction is used. For the most severe heart pain, which radiates to the back and vice versa, the Aconite Mother Root Red Halloysite Pill is used. Does this mean Pinellia is unnecessary? On the contrary, the true value of Pinellia lies in its non-use, which highlights its utility. In the context of warm dryness, it is not used for irritability or thirst, but in the context of cool moistening, it serves as an excellent remedy for irritability and thirst, as seen in the Bamboo Leaf and Gypsum Decoction and the Ophiopogon Decoction. Although these decoctions do not explicitly mention irritability and thirst, their use of cool, sweet, and bitter ingredients suggests their presence. In the Major Pinellia Decoction, the inclusion of Ginseng and white honey for tonification and moistening indicates that irritability and thirst are not entirely absent. Understanding this, Pinellia serves as a sharp tool in strong formulas and a decisive element in mild formulas, its efficacy undeniable.

Bencao Xinbian : Pinellia, pungent and slightly bitter in taste, neutral in qi, cold when raw, warm when cooked, sinking and descending, is a yang within yin herb. It enters the gallbladder, spleen, and stomach meridians. When ground into powder, for every one liang, two qian of dried alum and one ge of ginger juice are added, kneaded into cakes, wrapped in paper mulberry leaves, and dried in the shade, it is also known as Fermented Pinellia. The slices are potent, while the fermented form is milder, both effective in treating phlegm and drool, regardless of whether it is fire phlegm, cold phlegm, damp phlegm, or old fire phlegm. Pregnant women should avoid it due to the risk of early abortion. However, there are times when its use is necessary, and temporary use is permissible. It should not be used in cases of hematemesis, as its nature may exacerbate fire. Pinellia slices ground into powder and blown into the nose can rescue from the five extremities and are very effective for postpartum dizziness due to hemorrhage.

The human body originally has no phlegm. When food enters the stomach, it transforms into essence without producing phlegm. Only when the true fire of the kidney is deficient does fire boil into phlegm, and when the true water of the kidney is deficient does water overflow into phlegm. Although the boiling fire and overflowing water originate from the kidney, the phlegm remains in the spleen. Since Pinellia treats phlegm, it should not be difficult to resolve, especially since the phlegm has already entered the spleen and cannot be prevented from entering the spleen. However, for phlegm in the kidney, the Kidney Qi Pill is necessary to expel it, as Pinellia cannot remove it. Pinellia addresses the symptoms of phlegm but cannot treat its root. Pinellia's nature is sinking and descending, seemingly able to enter the deepest yin, yet it is more yang than yin, only able to shallowly enter spleen yin and not deeply enter kidney yin. Moreover, Pinellia drains yin without tonifying it, and the kidney can be tonified but not drained. Pinellia seeks to enter the kidney, but the kidney does not accept it. Since Pinellia cannot enter the kidney, how can it resolve phlegm within the kidney? It is evident that phlegm in the spleen is a symptom, while phlegm in the kidney is the root, as spleen phlegm originates from the kidney. The phlegm of middle consumptive thirst cannot be seen as different in root and symptom.

The Kidney Qi Pill treats phlegm by addressing its root. If water does not overflow into phlegm, why resolve the phlegm? If fire does not boil into phlegm, why clear the phlegm? Using the Kidney Qi Pill eliminates phlegm. Using Pinellia to treat symptoms may inadvertently trigger phlegm dispelling. Pinellia, a drying qi herb, further depletes kidney qi, leading to fire agitation and water dryness, producing essence rather than phlegm, which is inevitable. Not only is it ineffective, but it is also harmful. Therefore, once the root is treated, there is no need to treat the symptoms.

Some may doubt that Pineilia is dry in nature, hence it is suitable for treating damp phlegm, but do not know what medicine to use to control its dryness and also treat hot phlegm. The nature of drying dampness varies; even if controlled appropriately, it can only remove its excess and cannot change its nature. However, there is a slight difference between not controlling its dryness and having controlled its dryness. Duo has a method of preparation, which is also passed down here. Use one pound of Pineilia and four taels of Fresh Ginger Rhizome slices, boil them several times, then take them out and dry them in the sun. Use one hundred Mulberry Leaves, ten bowls of water, and boil down to one bowl of juice, soak the Pineilia thoroughly, then dry it again. Then use one tael of salt and one bowl of boiling water, soak it thoroughly again, slice it and use it. This way, six parts of its dryness are removed, and four parts of its dampness are retained. It can be used sparingly for cold and hot phlegm, as well as for phlegm caused by the boiling of water and fire, as a temporary measure. However, it should only be used temporarily and not relied upon for long-term treatment.

Some may doubt that the preparation of Pineilia is excellent for treating phlegm caused by dryness-heat, but fear it may not be suitable for phlegm caused by cold-dampness. There is no need to worry about this. Pineilia is inherently drying, making it suitable for treating phlegm caused by cold-dampness. When properly prepared to moderate its drying nature, it does not harm the qi or injure the lungs, and can be used without fear.

Some may suspect that Pineilia treats damp phlegm but not dry phlegm, and treats cold phlegm but not hot phlegm. This is understood. But what about cases where black phlegm is expectorated? Observing the patient, they appear robust, without thirst indicating fire, and without kidney deficiency indicating deficiency. Can Pineilia still be used? This condition arises from pathogenic factors accumulating in the kidneys, not from phlegm obstructing the lung orifices. It often occurs in men who have abstained from sexual activity for a long time, desiring but not engaging in sexual activity, and not releasing essence through external means, leading to pathogenic factors entering the kidneys. The essence then transforms into phlegm, resulting in the expectoration of black, ink-like phlegm. It is appropriate to use fire-reducing medicines, assisted by white mustard seed to disperse phlegm, and Schizonepeta to disperse fire in the blood aspect. Otherwise, there may be risks of blood loss and the suffering of warm malaria. After several doses, if the body feels cold, then use Supplemented Peripatetic Powder with a large dose of Pineilia to clear pathogenic factors from both the exterior and interior, thereby eliminating cold and heat, and gradually curing the black phlegm. This type of condition has been personally tested and often proves effective, hence it is discussed here.

Bencao Fenjing : Pineilia is pungent, warm, smooth in texture, and drying in nature. It harmonizes the stomach and strengthens the spleen, also acting on the gallbladder meridian. It releases the exterior, opens depression, lowers qi to stop vomiting, eliminates damp phlegm, benefits the two excretions, promotes water qi to moisten kidney dryness, and harmonizes stomach qi to regulate yin-yang. It treats all spleen dampness conditions, but should be used cautiously in cases of blood disorders, thirst, and sweating. Those with lung dryness should not mistakenly take it; it must be prepared, and some forms are made into a ferment.

Bencao Sibianlu : Pineilia tastes pungent and has a neutral qi. Its pungency opens blockages, and its neutrality lowers rebellion, making it an essential medicine for treating vomiting and chest fullness. Vomiting and chest fullness are signs of shaoyang pattern, hence Minor Bupleurum Decoction cannot do without it. It is also used to treat heart stuffiness, abdominal distension and fullness, cough, and throat discomfort, all due to its ability to open blockages and lower rebellion. The reason for blockages and rebellion is the presence of lingering phlegm and fluid retention, taking advantage of yang deficiency to cause trouble. Pineilia, being smooth and drying, is capable of clearing these.

Those who use Pineilia often rely on Two Old Ingredients Decoction to moisten the bowels and Pineilia and Sulfur Pill to treat constipation of deficiency type cold constipation, claiming it moistens rather than dries. However, it is indeed drying and can cause harm if given to those with fluid deficiency and no dampness. Only the sage Zhongjing took its strengths and avoided its weaknesses. For regurgitation due to spleen injury and inability to digest, without stagnation or turbidity, he paired it with Ginseng and enhanced it with white honey, so that Pineilia's drying nature is completely lost, and the grain qi in the stomach can move. Also, Bamboo Leaf and Gypsum Decoction, Ophiopogon Decoction, and Meridian-Warming Decoction should not be used with Pineilia to deplete fluids. Instead, they are combined with Bamboo Leaf, Gypsum, Ginseng, Ophiopogon Tuber, Liquorice Root, rice, Donkey-hide Gelatin, and Moutan bark, transforming Pineilia's drying nature and expanding its ability to open and lower, as the saying goes, transforming and tailoring depends on change.

Minor Green-Blue Dragon Decoction says to remove Pineilia if there is thirst, and Minor Bupleurum Decoction also says to remove Pineilia if there is thirst, which clearly indicates that Pineilia is indeed drying. However, Pineilia's drying nature is smooth, capable of opening blockages and lowering rebellion, unlike drying and astringent substances.

Yixue Zhongzhong Canxilu : It tastes pungent, is warm in nature, and toxic. Substances with an extremely pungent taste all possess the autumn metal's contracting and descending nature, hence their power to descend and act as the main medicine for calming the stomach and settling the rushing. Because it can calm the stomach and settle the rushing, it can stop vomiting, guide dampness stroke phlegm from the lungs and stomach downward, and regulate qi to stabilize panting. It can treat stomach qi cold extremities, hematemesis, and nosebleeds. However, pharmacies, due to its toxicity, often boil it in Alum water, excessively neutralizing it, leaving no pungent taste but a strong alum flavor, causing vomiting. Even the clear Pineilia sold in pharmacies contains alum, which is acceptable for draining damp phlegm but not suitable for stopping vomiting, hematemesis, or nosebleeds. For these conditions, I always wash it several times with lukewarm water before use, though repeated washing reduces its potency, hence the dosage must be increased.

Due to the improper preparation of Pineilia in the pharmacy, every year during mid-spring and mid-autumn, several pounds of raw Pineilia are used. They are soaked in hot water, which is changed daily. After ten days, the Pineilia is split into two halves, then placed back into a pot with plenty of cold water, boiled once, and quickly removed with the water into a basin. Once the water cools, it is dried cleanly for later use. Each time, one ounce is used to boil two teacups of soup, mixed with two ounces of pure honey, and slowly swallowed. No matter how severe the vomiting, it will stop. The ancients used Pineilia by soaking it seven times in its original soup and then using it directly, without ever using Alum in its preparation.

bubble_chart Modern Pharmacology

1. Pineilia has antitussive and expectorant effects. The ethanol extract of processed Pineilia has expectorant effects. Some believe that the volatile alkaloids contained in Pineilia have inhibitory effects on the central and peripheral nervous systems, and its antitussive effect may be related to the inhibition of the cough center.
2. Pineilia has anti-silicosis effects, and its active ingredient may be the alum added during the processing of materia medica.
3. Pineilia has both antiemetic and emetic effects. Various preparations of Pineilia processed with heat or with alum and ginger juice during the processing of materia medica have certain antiemetic effects on vomiting induced by apomorphine, digitalis, and copper sulfate. Its antiemetic effect is likely related to the inhibition of the vomiting center. However, raw Pineilia powder taken orally has an emetic effect, and high-temperature treatment can remove its emetic components.
4. Pineilia has an inhibitory effect on saliva secretion.
5. The derivatives of glucuronic acid contained in Pineilia have certain detoxifying effects.
6. Pineilia has anti-fertility and teratogenic effects.
7. Pineilia has an inhibitory effect on trypsin hydrolysis.
8. Pineilia has inhibitory effects on cardiac function, lowers blood pressure, and has anti-arrhythmic effects on the cardiovascular system.
9. Effects of Pineilia on the digestive system: Pineilia can significantly inhibit gastric acid secretion in mice, reduce gastric acidity, inhibit the occurrence of stress-induced gastric ulcers, promote bile secretion in rabbits, reduce the tension of the sphincter of Oddi, significantly enhance intestinal transport capacity, and relax smooth muscle contractions of the intestine induced by acetylcholine, histamine, and barium chloride in vitro.
10. Pineilia has an inhibitory effect on adrenal cortical function.
11. Pineilia has hypnotic and anticonvulsant effects.
12. Pineilia has anti-tumor effects.
13. Pineilia has an activating effect on the immune system.
14. Pineilia has effects of lowering intraocular pressure, diuresis, promoting cell division, and agglutinating red blood cells.