Summary of TCM Courses
01
All Courses by Ni Haixia
02
Comprehensive Guide to TCM Treatments for Common Diseases
03
Focused Study on TCM Topics
04
Online Reading of TCM Learning Books
Introduction
In Traditional Chinese Medicine (TCM), “phlegm” does not merely refer to the mucus produced in the lungs that can be expelled through coughing. TCM’s concept of “phlegm” also includes pathological products that arise from metabolic disorders of body fluids, characterized by turbidity, stickiness, and thickness.
When the spleen’s ability to transform and transport water and dampness declines, or when there are obstacles in the circulation and excretion of body fluids, these fluids cannot nourish the body properly and instead accumulate abnormally, becoming a pathological substance. This abnormal accumulation of fluids is referred to as “phlegm-dampness” in TCM.
The turbid, sticky, and thick part is called “phlegm,” while the clear, thin, and transparent part is referred to as “dampness.”
Therefore, TCM’s concept of “phlegm” encompasses more than just the mucus produced in the lungs; it also includes pathological products resulting from fluid metabolism disorders that exhibit characteristics of turbidity, stickiness, and thickness.
For instance, obesity is referred to as “phlegm” in TCM. Since this type of “phlegm” is not as easily recognized as the mucus from the lungs, it is termed “invisible phlegm,” while the mucus that can be seen and expelled from the lungs through coughing is called “visible phlegm.” Together, these two concepts form the TCM understanding of “phlegm.”
Visible phlegm primarily exists in the lungs and may arise from either internal metabolic disorders of body fluids or external pathogenic factors invading the lungs. Once produced, this phlegm can be expelled through coughing, making it easier to understand.
We are quite familiar with visible phlegm, especially when we have a cough during a cold. However, have we noticed that even among the phlegm coughed up from the lungs, there are various differences in characteristics?
For example, some phlegm is white and viscous, some is thin and white, some is foamy, some is yellow and thick, some is gray-black, and some is yellow-green… Why does phlegm exhibit such a variety of changes?
Upon careful analysis, the various characteristics of phlegm can be summarized into two aspects: one is the texture, which can be thick, thin, or foamy; the other is the color, which can be white, gray-black, yellow, or yellow-green.
1
What Do the Different Textures and Colors of Phlegm Mean?
Let’s consider a common phenomenon: dissolving sugar in water. We obtain a colorless and transparent liquid. If we heat this sugar water, what will happen? We can observe that the sugar water gradually becomes thicker, and its color changes from transparent to light yellow and then to deep yellow.
This phenomenon can be extrapolated to phlegm in the body. The thickness and color of phlegm are closely related to the presence of “heat” in the body. If there is heat in the body, the phlegm will be yellow and thick; if there is no heat, the phlegm will be thin and white. The greater the degree of yellow thickness, the higher the level of heat in the body.
According to this principle, TCM categorizes thin, white, or foamy phlegm as “cold phlegm,” while yellow and thick phlegm, or even yellow-green phlegm, is classified as “heat phlegm.”
Regardless of whether it is cold phlegm or heat phlegm, TCM treatment focuses on the concept of “transformation.” What does “transformation” mean? In the past, before the advent of running water, if the water quality was murky, we often added a small amount of alum to the water tank, and after a while, the water would become clear. The alum acted to decompose and settle the impurities in the murky water, which is the essence of “transformation.”
In TCM, the phlegm-resolving herbs used in the treatment of various phlegm conditions serve a role similar to that of alum, helping to decompose and settle the phlegm turbidity, thereby alleviating diseases caused by phlegm turbidity.
Western medicine also recognizes two types of phlegm: one is infectious phlegm, caused by bacteria, fungi, mycoplasma, or chlamydia infections; the other is exudative phlegm, often resulting from excessive secretion of mucus by respiratory mucosal cells.
In this case, antibiotics can be effective against phlegm caused by bacterial infections, but there are limited options for phlegm caused by fungi, mycoplasma, or chlamydia infections, as well as for exudative phlegm. How does TCM view and treat these phlegm-related diseases?
TCM believes that microorganisms such as fungi, mycoplasma, and chlamydia naturally exist in the air and do not harm the body under normal circumstances. Only when there is excessive accumulation of water and dampness in the body, creating an overly humid internal environment, do these microorganisms proliferate and harm health, leading to various diseases.
Therefore, the true root cause of these diseases lies in the “humidity” of the internal environment. Just as in the rainy season, the humid environment allows fungi to proliferate, making things prone to mold. If you can recognize that humidity is the main cause of fungal proliferation in nature, why would the human body be any different?
So how should we treat phlegm caused by internal humidity? In daily life, humidity is often associated with overcast and rainy weather. If the sky is clear and sunny, there will be no humid environment.
There is a saying: “When the sun is high, the haze dissipates,” which illustrates this principle. The sun can drive away humidity primarily through its heat. Therefore, when treating this type of phlegm, we should use warming herbs to create a “high sun” effect in the body, allowing the humid “haze” to dissipate. This eliminates the root cause of water and dampness accumulation in the body, preventing the survival and proliferation of microorganisms such as fungi.
In the Han Dynasty, the medical sage Zhang Zhongjing proposed in the “Essentials of the Golden Chamber” that the principle for treating this condition is “for those with phlegm-dampness, one should use warming herbs to harmonize it.” This insight remains remarkably prescient even today, and we cannot help but admire the ancient methods and thoughts in exploring the mysteries of life and disease.
2
Invisible Phlegm
Having discussed visible phlegm, what is “invisible phlegm,” and how can we determine its presence? TCM identifies four criteria for diagnosing invisible phlegm in the body.
① Obesity. TCM states that “obese individuals often have phlegm-dampness,” indicating that those who are overweight have a significant presence of invisible phlegm, as fat possesses the characteristics of turbidity, stickiness, and thickness associated with phlegm. It is formed from the accumulation of turbid water and dampness in the body.
② Thick and greasy tongue coating. A thick and greasy tongue coating is the most direct manifestation of excessive water and dampness in the body.
③ Tumors. Any lump that is not red, protrudes from the skin surface, is nodular, and feels soft or resilient upon palpation is referred to as a “phlegm nodule” in TCM.
④ Slippery pulse. TCM classifies pulse sensations into more than twenty types, and slippery pulse is one of them. TCM describes slippery pulse as “flowing smoothly, like pearls rolling on a plate,” indicating that the pulse feels like beads rolling smoothly on a smooth surface. The presence of a slippery pulse is a characteristic manifestation of phlegm turbidity in the body and is one of the main diagnostic criteria for phlegm in TCM.
Based on TCM’s understanding of phlegm, combined with Western medicine’s microscopic examinations, the concept of invisible phlegm can be made more concrete and intuitive. For example, conditions such as hyperlipidemia, cysts, lymph node tuberculosis, and bone tuberculosis all exhibit characteristics of turbidity, stickiness, and thickness, and can thus be considered phlegm-related diseases. Therefore, Western medical examinations can be seen as an extension of TCM’s diagnostic methods of observation, listening, inquiry, and palpation.
Through TCM’s understanding of the mechanisms of phlegm formation, we can relate the occurrence of these diseases to the overall balance of the body, finding fundamental treatment methods. For instance, hyperlipidemia, cysts, and lymph node tuberculosis all align with the characteristics of TCM phlegm, and their root causes are related to the spleen’s dysfunction in transforming and transporting water and dampness, leading to excessive accumulation of phlegm turbidity in the body. Therefore, treatment can be approached through strengthening the spleen, assisting in the transformation of phlegm, and softening hard masses. Moreover, by addressing the root cause, the treatment effect is long-lasting.
Here, I can provide two examples. One patient with hyperlipidemia had taken medications such as Shujian and Lipingzhi without significant improvement. He felt dizzy and fatigued, had poor appetite, excessive daytime sleepiness, frequent dreams at night, palpitations, and his stool was often unformed. His complexion was pale, and his tongue coating was light white, with a weak and thin pulse in both hands.
I diagnosed him with spleen deficiency leading to the inability to transform and transport water and dampness, resulting in the accumulation of phlegm turbidity in the blood vessels, affecting the circulation of qi and blood, and causing illness. I prescribed a TCM formula to strengthen the spleen and resolve phlegm: 30g of roasted Bai Zhu (Atractylodes macrocephala), 15g of Dang Shen (Codonopsis pilosula), 10g of Chen Pi (Citrus reticulata), 10g of Ban Xia (Pinellia ternata), 6g of Gan Cao (Glycyrrhiza uralensis), 15g of Fu Ling (Poria cocos), 6g of Ju Luo (Citrus reticulata), 10g of Dan Nan Xing (Arisaema cumingii), 15g of Jiao Shan Zha (Crataegus pinnatifida), and 5 slices of Sheng Jiang (Zingiber officinale).
After taking the 7 doses of medicine, the patient felt a significant improvement in energy and appetite, dizziness decreased by more than half, and his stool had become mostly formed. I then advised him to continue taking the same formula for another 7 doses. When he returned for a follow-up, his various symptoms had largely resolved, and a recheck of his blood lipids showed they had returned to normal levels.
Another patient with a popliteal cyst came to consult me out of fear of surgery.
TCM believes that the formation of cysts is the result of phlegm turbidity accumulating in a specific area, and the production of phlegm turbidity is directly related to the spleen’s ability to transform and transport water and dampness. Therefore, by improving and enhancing the spleen’s ability to transform and transport water and dampness, we can eliminate the accumulation of phlegm turbidity in the body, thus resolving the cyst.
Based on this reasoning, I prescribed a formula to strengthen the spleen, resolve phlegm, and promote diuresis: 45g of roasted Bai Zhu, 15g of Ze Xie (Alisma orientale), 15g of Hua Shi (Talc), 10g of Zhu Ling (Polyporus umbellatus), 15g of Fu Ling, 10g of Gui Zhi (Cinnamon twig), 20g of Ban Xia, 10g of Zhi Nan Xing (Arisaema cumingii), 30g of Yi Yi Ren (Coix lacryma-jobi), and 10g of Qing Pi (Citrus reticulata).
The patient took this formula for about a month, and the popliteal cyst completely disappeared. During this time, the formula was slightly adjusted based on symptom changes, but the main ingredients remained as described. These two examples clearly demonstrate that the theory of phlegm in TCM withstands practical testing.
The spleen’s insufficient ability to transform and transport water and dampness leads to the accumulation of water and dampness in the body. The turbid substances in the water and dampness can condense into phlegm masses in specific areas, such as the cysts, lymph node tuberculosis, and bone tuberculosis mentioned above. They can also enter the meridians and blood vessels, traveling throughout the body with the circulation of qi and blood, as seen in the case of blood lipids.
These turbid substances have sticky characteristics, often obstructing the flow of qi and blood in the meridians and blood vessels, causing pathological changes due to ischemia and hypoxia in the organs, leading to various diseases. For example, if phlegm accumulates in the head, it can affect blood supply to the brain, resulting in symptoms such as dizziness, forgetfulness, drowsiness, and even coma, hemiplegia, or speech difficulties, which Western medicine refers to as cerebral infarction. Many cases in TCM are attributed to phlegm.
If phlegm accumulates in the limbs, it can lead to blood supply disorders in the limbs, resulting in symptoms such as numbness in the limbs and cold extremities. If phlegm accumulates in the blood vessels, it can lead to insufficient blood supply to the heart, causing palpitations, irregular heartbeat, and chest tightness, which Western medicine often associates with coronary heart disease, and in many cases, it is closely related to phlegm.
Moreover, phlegm can also affect a person’s mental state. If the turbid qi of phlegm-dampness obstructs normal mental activities, it can lead to symptoms such as excessive talking, depression, and unexplained sadness, which are classified as depressive disorders in TCM.
Since TCM believes that the “heart” governs the mind, mental disorders caused by excessive phlegm-turbidity are referred to as “phlegm obstructing the heart orifices.”
3
The Mobility of Phlegm
Regarding the mobility of phlegm, the great physician Zhu Danxi from the Yuan Dynasty stated: “Phlegm, as a substance, rises and falls with qi, reaching everywhere.” It is precisely because of the characteristic that phlegm can reach anywhere that TCM attributes many strange illnesses or diseases that do not respond well to various treatments to phlegm.
Thus, there is a saying in TCM: “Strange diseases often arise from phlegm.” Zhu Danxi also proposed the theory that “many diseases are accompanied by phlegm,” which provides new insights into disease diagnosis and treatment.
Some diseases may have correct differentiation and appropriate medication, yet the clinical outcomes are not ideal. In such cases, we can consider incorporating phlegm-resolving methods, which often yield unexpectedly good results.
I once treated a patient with vertigo who had experienced dizziness for over a year. If he stood up suddenly after squatting or sitting for a long time, he would feel black in front of his eyes and even faint.
He felt drowsy throughout the day, had low energy, spoke softly, and had a pale complexion. His appetite was average, and his bowel and bladder functions were normal. His tongue was pale with a thin white coating, and his pulse was weak and thin in both hands. In the past month, his dizziness seemed to worsen.
Western medicine diagnosed him with insufficient blood supply to the brain.
At that time, I thought this was a typical case of qi deficiency. Qi deficiency leads to the inability of qi and blood to rise and nourish the head, which should be easy to treat. So, I prescribed 5 doses of Bu Zhong Yi Qi Decoction, and I confidently told the patient that he would definitely see significant improvement after taking the 5 doses.
However, five days later, the patient returned for a follow-up and poured cold water on my confidence, telling me that there was no improvement in his dizziness! He also reassured me that it might take time to improve since he had this problem for a long time. I carefully inquired about his condition and concluded that it was still qi deficiency. Since there was no diagnostic error, why was there no effect?
At this point, I recalled Zhu Danxi’s saying that “many diseases are accompanied by phlegm,” and I suddenly understood. Since there was qi deficiency, it must lead to abnormal transformation and transportation of water and dampness, resulting in internal phlegm turbidity, which obstructed the brain and caused dizziness.
The previous treatment was ineffective because I only considered qi deficiency and did not take into account the phlegm turbidity present in the meridians and blood vessels. Therefore, I prescribed a new formula to tonify qi and resolve phlegm: 15g of Huang Qi (Astragalus membranaceus), 15g of Dang Shen, 12g of roasted Bai Zhu, 10g of Ban Xia, 10g of Fu Ling, 6g of Chen Pi, 10g of Chuan Xiong (Ligusticum chuanxiong), 3g of Sheng Ma (Cimicifuga foetida), 3g of Chai Hu (Bupleurum chinense), 6g of Jie Geng (Platycodon grandiflorum), 6g of Ju Luo, and 6g of Zhi Nan Xing. I still prescribed 5 doses.
Five days later, the patient joyfully reported that this time the medicine was effective; after just five days, his dizziness had significantly decreased. I then advised him to take Xiang Sha Liu Jun Wan to consolidate the treatment, and after about a month, I followed up with the patient, and he had not experienced any recurrence of dizziness for a year.
4
Meniere’s Disease Is Also Caused by Phlegm-Dampness
Here, I would like to mention Meniere’s disease (formerly known as Ménière’s disease). The clinical features of this condition include:paroxysmal vertigo that occurs frequently, during which the patient feels that surrounding objects are spinning, as if they are on a moving vehicle, accompanied by nausea, vomiting, and head pain. Movement can exacerbate the severity of vertigo and vomiting.
During an episode, patients often lie still with their eyes closed, afraid to move. Some patients may feel a sensation of blockage and pressure in the ear, or experience nystagmus.
Western medicine believes that this condition is caused by increased lymphatic fluid and pressure in the inner ear, leading to ear-related vertigo.
Based on Zhang Zhongjing’s records in the “Essentials of the Golden Chamber” regarding the “Mao Zhuang” syndrome (“Mao” refers to nausea and vomiting, and “Mao Zhuang” indicates a disease characterized by vertigo and nausea/vomiting occurring simultaneously), which he attributed to “water retention in the heart,” I believe this condition is caused by water and dampness stagnating in the inner ear. I used the “Ze Xie Decoction” from the “Essentials of the Golden Chamber” to treat it, achieving excellent clinical results.
The composition of Ze Xie Decoction consists of just two herbs—Ze Xie (Alisma orientale) and Bai Zhu (Atractylodes macrocephala). Ze Xie is recorded in the “Shennong’s Herbal Classic” as being effective for “wind, cold, and dampness, and for eliminating water.” Bai Zhu, as noted in the “Record of Famous Physicians” by the Jin Dynasty physician Tao Hongjing, is said to “eliminate phlegm and water, and expel wind-water accumulation,” and it is also known to “warm the stomach and eliminate food stagnation.”
These two herbs work together: Ze Xie primarily promotes urination to eliminate water retention, while Bai Zhu supports the spleen to eliminate phlegm and water. This combination effectively addresses both the symptoms of water retention and the root cause of phlegm-dampness due to spleen deficiency, resulting in rapid therapeutic effects despite the small number of ingredients.
I once treated a female patient named Xia, 43 years old, who had suffered from Meniere’s disease for over three years. This time, her condition was triggered by fatigue, and she experienced severe vertigo, nausea, and vomiting, making it impossible for her to eat. Any water she consumed would be vomited. She felt slightly better when lying still with her eyes closed, but any movement would exacerbate her symptoms.
She felt heavy-headed and spoke softly. During the consultation, she ran to the door to vomit twice, and the vomit was clear liquid. She reported that she had not eaten for a day and still felt nauseous. Her tongue was pale with a greasy white coating, and her pulse was wiry.
Based on the idea of “water stagnating in the inner ear,” I prescribed Ze Xie Decoction: 30g of Ze Xie and 45g of roasted Bai Zhu. I instructed her to use one and a half bowls of water, boil it down to half a bowl, and take it warm.
I also advised the patient not to drink it all at once; instead, she should take a sip, wait about five minutes, and if there were no adverse reactions, take another sip, and so on, until she finished the half bowl of medicine.
Surprisingly, the patient did not vomit after taking the medicine, gradually fell asleep, and did not wake up until the next morning. Upon waking, she felt as if her illness had disappeared. After two days of adjusting her diet with spleen-strengthening and dampness-resolving herbs, she was completely well and has not experienced a recurrence since.
Self-Assessment for Phlegm-Dampness Constitution:
1. Dizziness, headache, and heaviness in the head.
TCM believes that the head is the residence of the clear and spiritual essence, which must be nourished by qi, blood, and essence, and should not be disturbed by turbid evils. When phlegm-dampness ascends and obstructs the clear yang, it leads to dizziness, headache, and a feeling of heaviness in the head.
Headaches, dizziness, and heaviness in the head are often associated with hypertension.
Western medicine attributes hypertension to vascular spasms or loss of elasticity in blood vessels, leading to obstructed blood flow and increased pressure.
From a TCM perspective, the turbid evil of phlegm-dampness, being heavy and tangible, combined with the characteristic of phlegm being able to rise and fall with qi, can obstruct the clear yang, filling and blocking the blood vessels, which may also lead to vascular spasms and loss of elasticity, resulting in elevated blood pressure.
Therefore, for hypertensive patients who exhibit symptoms of phlegm-dampness obstructing the clear yang in the head, treating them with methods to clear and resolve phlegm-dampness can yield significant results.
Symptoms of dizziness, headache, and heaviness in the head caused by phlegm-dampness may persist or fluctuate, but they are fundamentally different from those caused by qi and blood deficiency. Using tonics may not only be ineffective but may also worsen the condition, as it can exacerbate the obstruction of turbid evils.
If stubborn phlegm and stagnant blood accumulate, they can condense into tumors, residing in the brain or other parts of the body. Without resolving and dispersing the stubborn phlegm and stagnant blood, the tumor cannot be eliminated.
2. Nausea or vomiting of phlegm and saliva, or a gurgling sound in the stomach and intestines, or a sticky, greasy mouth, or dry mouth with no desire to drink water.
The turbid evil of phlegm-dampness lingers in the stomach and intestines, causing the stomach to lose its harmony and descent, obstructing the qi of the bowels, leading to frequent nausea or vomiting of phlegm and saliva, or a gurgling sound in the stomach and intestines.
Phlegm and dampness rising can lead to a sticky sensation in the mouth. Phlegm turbidity is originally transformed from body fluids, but it can also obstruct the movement of body fluids, leading to dry mouth. If one drinks too much water, it can exacerbate the phlegm, causing nausea and vomiting.
These symptoms are often clinically diagnosed as gastrointestinal neurosis, and medication may often be ineffective. However, treating with warming methods to resolve phlegm-dampness or simultaneously promoting liver and spleen function can yield rapid results.
3. A sensation of obstruction in the throat, difficulty swallowing, and symptoms that appear intermittently.
The occurrence of this symptom generally begins with liver qi stagnation and emotional imbalance, leading to liver depression and spleen deficiency. When the liver and spleen are not in harmony, the spleen’s qi is also suppressed, leading to the accumulation of body fluids as phlegm, which rises and obstructs the throat, causing a sensation of obstruction and difficulty swallowing.
The characteristic of phlegm is that it can accumulate and disperse, and since this symptom begins with liver qi stagnation, followed by spleen dysfunction leading to phlegm accumulation, this condition manifests as a sensation of obstruction in the throat, which can vary with emotional states.
This type of symptom is often seen in female patients. If the condition persists, it can lead to deficiency of yin and phlegm. If one focuses solely on resolving phlegm, it may further deplete yin fluids, exacerbating the sensation of obstruction and dryness in the throat. It is essential to combine sufficient nourishing yin herbs to nourish while resolving phlegm, allowing for a comprehensive approach to treat phlegm obstruction.
4. Palpitations, insomnia, or fainting, convulsions, or mental disorders, but neurological examinations show no abnormalities, nor are there signs of yin deficiency or yang excess.
“Phlegm qi obstructing the heart” and “phlegm obstructing the heart orifices” refer to these types of symptoms. TCM states that the “heart” also refers to brain function, as in “the heart governs the spirit” and “the brain is the residence of the original spirit.”
Thus, when phlegm qi obstructs the heart orifices, it often manifests as dysfunction of the cerebral cortex. Treating these symptoms with phlegm-clearing and orifice-opening methods can often yield satisfactory results.
5. Stools coated with phlegm and saliva, or constipation and difficulty passing stools.
Phlegm turbidity lingers in the stomach and intestines, leading to stools coated with phlegm and saliva. Treating with spleen-strengthening and phlegm-resolving methods should yield results. If phlegm turbidity lingers in the intestines, obstructing bowel qi, it can lead to constipation (though the stools are not dry). This condition can worsen with laxatives, as the more one tries to moisten, the more constipated it becomes. Using qi-moving and phlegm-resolving methods can quickly relieve constipation.
6. Low-grade fever and body heaviness, or a sensation of heat without a significant increase in body temperature.
Phlegm is a yin evil, characterized by its sticky nature and tendency to remain hidden. When phlegm and turbidity accumulate, they obstruct yang qi, preventing it from expanding, leading to a situation where yin does not match yang, resulting in heat due to obstruction. The heat caused by phlegm and turbidity is distinct from that caused by external pathogens or from blood, yin, or qi deficiency, characterized by heaviness without significant elevation in temperature. Many unexplained low-grade fevers without signs of yin or qi deficiency fall into this category.
If one mistakenly uses tonics to nourish yin and qi, it can further promote phlegm and turbidity, leading to persistent low-grade fever and heaviness. By carefully examining the tongue and pulse, and accurately diagnosing the symptoms, focusing on resolving phlegm-dampness can yield satisfactory results.
7. Localized heat or cold in the limbs (or a cold sensation in the back, or numbness without pain or itchiness, or differences in size or sensation in certain areas of the body, but neurological, orthopedic, and dermatological examinations show no abnormalities).
“Phlegm follows qi and reaches everywhere,” and “the sensations vary depending on the location of the obstruction.” When phlegm and turbidity accumulate and obstruct the flow of qi and blood, the above symptoms can occur. If phlegm and turbidity remain unresolved, the affected area may also exhibit swelling or nodules.
8. Ulcers, erosions, or exudation of thick phlegm, which do not heal for a long time, and may also present with thickened skin that does not exude fluid.
Phlegm-dampness lingers, or heat phlegm condenses, affecting the flow of qi and blood in the affected area, leading to the exudation of phlegm and turbidity. If this condition persists, the body’s righteous qi may weaken, and the affected area may be exposed to external wind, cold, or heat, making it difficult for the qi and blood to return to normal, resulting in prolonged non-healing. This condition begins with phlegm and turbidity accumulation, leading to qi and yin deficiency, often accompanied by stubborn phlegm that does not resolve.
If the affected area exhibits thickened skin, it indicates a deficiency of qi and yin, along with the presence of stubborn phlegm accumulation.
9. Chest tightness and shortness of breath, with a feeling of fullness in the back, often exacerbated in humid or fluctuating weather.
Phlegm-dampness stagnates in the chest, obstructing the yang qi in the chest (causing lung qi to lose its ability to descend), leading to a sensation of chest tightness and shortness of breath. If phlegm and turbidity stagnate in the back, it can lead to a feeling of fullness or coldness in the back. Patients often sigh or pound their chests to temporarily relieve the discomfort. If phlegm and turbidity obstruct the yang qi excessively, it can lead to temporary stagnation of qi and blood flow, resulting in pain due to obstruction, which can manifest as severe acute myocardial infarction in some cases.
10. Lumps or nodules, either beneath the skin or within the abdomen, can also occur in other tissues or organs, with no changes to the skin surface, or a slight cold sensation, or a dull complexion.