Due to the decline in the spleen’s ability to transform and transport water and dampness, or when the circulation and excretion of fluids in the body encounter obstacles, water and fluids cannot properly nourish the body, leading to abnormal accumulations that become pathological substances. This abnormal accumulation of fluids is referred to in Traditional Chinese Medicine (TCM) as “phlegm-dampness”.
Among these, the turbid, viscous, and thick portions are called “phlegm”, while the clear, thin, and transparent portions are referred to as “dampness”.
Therefore, in TCM, “phlegm” does not merely refer to the mucus produced in the lungs that can be expelled through coughing and is visible to us; TCM’s concept of “phlegm” also includes pathological products that arise due to metabolic disorders of fluids, characterized by turbid, viscous, and thick properties.
For example, obesity is referred to as “phlegm” in TCM. Since this type of “phlegm” is not as easily recognized as the phlegm from the lungs, it is termed “invisible phlegm”, while the phlegm produced in the lungs that can be expelled through coughing and is visible 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 fluids or external pathogenic factors invading the lungs. Once produced, this phlegm can be expelled through coughing and is observable, making it easier to understand.
We are quite familiar with visible phlegm, as we often encounter it during colds and coughs, but have we noticed a detail: even though it is all phlegm coughed up from the lungs, there are various differences in its characteristics.
For instance, some phlegm is white and viscous, some is white and thin, some is white and foamy, some is yellow and thick, some is gray-black, and some is yellow-green… Why does phlegm exhibit so many variations despite being the same substance?
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.
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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 colorless and transparent sugar water, what will happen? We can see that the sugar water gradually becomes thicker, and its color changes from transparent to light yellow and then to deep yellow.
From this phenomenon, we can deduce that the thickness and color of phlegm in the body are closely related to the presence of “heat” within. 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 classifies phlegm that is white and thin, or foamy, or viscous as “cold phlegm”, while phlegm that is yellow and thick, or even yellow-green, is classified as “heat phlegm”.
Since cold phlegm and heat phlegm reflect completely opposite natures, their treatments are also entirely different. To treat cold phlegm, warming and transforming methods are used, with commonly used herbs including Gan Jiang (Dried Ginger), Xi Xin (Asarum), Ban Xia (Pinellia), Chen Pi (Aged Tangerine Peel), Bai Jie Zi (White Mustard Seed), and Lai Fu Zi (Radish Seed); while to treat heat phlegm, clearing heat and transforming phlegm methods are employed, with commonly used herbs including Zhe Bei Mu (Zhejiang Fritillaria), Chuan Bei Mu (Sichuan Fritillaria), Tian Zhu Huang (Bamboo Shavings), Dan Nan Xing (Arisaema), Gua Lou (Trichosanthes), and Tian Hua Fen (Trichosanthes Root).
However, whether it is cold phlegm or heat phlegm, TCM emphasizes the concept of “transformation” in treatment. 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 turbid substances in the murky water, which is the essence of “transformation”.
The phlegm-transforming herbs used in TCM for various phlegm conditions serve a similar role to that of alum, helping to decompose and settle 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 few effective methods in Western medicine for phlegm caused by fungi, mycoplasma, or chlamydia infections, as well as for exudative phlegm. How does TCM view and treat these “phlegm” 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 reproduce in large numbers, thereby harming human health and causing various diseases.
Therefore, for these types of diseases, the true root cause lies in the “humidity” of the internal environment. Just as in the rainy season, the humid environment allows for the proliferation of fungi, making things prone to mold. If you can recognize that the humid environment is the main reason for the proliferation of fungi in natural phenomena, 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 the sun is shining, there will naturally be no humid environment.
There is a saying: “When the sun is blazing, the haze dissipates”; this is the principle. The blazing sun can drive away humidity, primarily relying on its heat. Therefore, when treating this type of phlegm, we should use warming herbs to create a “blazing sun” effect within the body, allowing the humid “haze” to dissipate, thus eliminating the root cause of water and dampness accumulation in the body and preventing the survival and reproduction of microorganisms such as fungi.
The Han Dynasty medical sage Zhang Zhongjing proposed in the “Jin Gui Yao Lue” that the principle for treating this condition is “for phlegm-dampness, one should use warming herbs to harmonize it”. This still seems remarkably insightful today, and we cannot help but admire the ancient methods and thoughts in exploring the mysteries of life and disease.
Next, let’s discuss invisible phlegm. We have talked about visible phlegm, but what is invisible phlegm, and how can we determine its presence? TCM has four criteria for identifying invisible phlegm in the body.
① Obesity. TCM states that “obese individuals often have phlegm-dampness”, referring to the presence of invisible phlegm in obese individuals, as fat possesses the turbid, viscous, and thick characteristics of phlegm, formed from the accumulation of turbid substances in the water and dampness within 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 Masses. Any mass that is not red, protrudes from the skin surface, is nodular, and feels soft or firm upon palpation, is referred to in TCM as a “phlegm nodule”.
④ Slippery pulse. TCM classifies pulse sensations into over 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 as if beads are rolling smoothly on a smooth surface. The presence of 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, viscosity, and thickness, and can thus be considered phlegm-related diseases. In this way, Western medical examinations become an extension of TCM’s observation, listening, inquiry, and pulse diagnosis.
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 conform to the characteristics of TCM phlegm, and their fundamental 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 by strengthening the spleen and assisting its function, transforming phlegm and softening hardness. Moreover, by eliminating the generation of phlegm from the root, 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 effect. 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 dull, and his tongue coating was pale white, with a weak pulse in both hands.
I diagnosed him with spleen deficiency leading to an inability to transform 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 transform phlegm: 30g of Chao Bai Zhu (Fried Atractylodes), 15g of Dang Shen (Codonopsis), 10g of Chen Pi (Aged Tangerine Peel), 10g of Ban Xia (Pinellia), 6g of Gan Cao (Licorice), 15g of Fu Ling (Poria), 6g of Ju Luo (Tangerine Peel), 10g of Dan Nan Xing (Arisaema), 15g of Jiao Shan Zha (Hawthorn), and 5 slices of Sheng Jiang (Fresh Ginger).
After taking the 7 doses of medicine, the patient felt a significant improvement in energy and appetite, dizziness was reduced by more than half, and his stool had basically 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 water and dampness. Therefore, by improving and enhancing the spleen’s ability to transform water and dampness, we can eliminate the accumulation of phlegm turbidity in the body, thus removing the cyst.
Based on this understanding, I prescribed a formula to strengthen the spleen, transform phlegm, and reduce swelling: 45g of Chao Bai Zhu (Fried Atractylodes), 15g of Ze Xie (Alisma), 15g of Hua Shi (Talc), 10g of Zhu Ling (Polyporus), 15g of Fu Ling (Poria), 10g of Gui Zhi (Cinnamon Twig), 20g of Ban Xia (Pinellia), 10g of Zhi Nan Xing (Arisaema), 30g of Yi Yi Ren (Job’s Tears), and 10g of Qing Pi (Green Tangerine Peel).
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 water and dampness leads to the accumulation of water and dampness in the body, and the turbid substances within 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 with blood lipids.
These turbid substances have viscous properties, often leading to obstruction of qi and blood flow in the meridians and blood vessels, causing pathological changes due to ischemia and hypoxia in the organs, resulting in various diseases. For example, if phlegm accumulates in the head, it can affect blood supply to the brain, leading to symptoms such as dizziness, forgetfulness, excessive sleepiness, and even coma, hemiplegia, or speech difficulties, which Western medicine refers to as cerebral infarction, but 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, cold extremities, etc.; if phlegm accumulates in the blood vessels, it can lead to insufficient blood supply to the heart, causing palpitations, anxiety, arrhythmias, and chest pain, 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 incessant talking, depression, and unexplained sadness, which are classified as depressive mental disorders in TCM. Since TCM believes that the “heart” governs the mind, this type of mental disorder caused by excessive “phlegm turbidity” is referred to as “phlegm obstructing the heart orifices”.
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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 “reaches everywhere” that TCM attributes many strange diseases or conditions with poor treatment outcomes 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 for diagnosing and treating diseases. Sometimes, even when the syndrome differentiation is correct and the medication is appropriate, the clinical outcomes may not be ideal; at this point, we can consider incorporating phlegm-transforming methods, which can often yield unexpected results.
I once treated a patient with vertigo who had experienced it for over a year. After squatting or sitting for a long time, if he suddenly stood up, he would feel black in front of his eyes and even faint.
He felt heavy-headed all day, lacked energy, spoke softly, and had a pale complexion. His appetite was average, and his bowel and bladder functions were normal. His tongue was pale red with a thin white coating, and his pulse was weak in both hands. In the past month, his vertigo seemed to have worsened. Western medicine diagnosed him with insufficient cerebral blood supply.
I thought this was a typical case of qi sinking. 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 Tang (Tonify the Middle and Augment the Qi). After prescribing the medicine, 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 had been no improvement in his vertigo! He comforted me, saying that perhaps it was because he had this problem for a long time, and improvement wouldn’t come so quickly. I carefully inquired about his condition and concluded that it was still qi sinking. Since there was no error in syndrome differentiation, why was there no effect?
At that moment, I recalled Zhu Danxi’s saying that “many diseases are accompanied by phlegm”, and suddenly everything became clear. Since there was qi deficiency, it must lead to abnormal transformation of water and dampness, resulting in internal phlegm turbidity, which obstructed the brain and caused vertigo.
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 transform phlegm: 15g of Huang Qi (Astragalus), 15g of Dang Shen (Codonopsis), 12g of Chao Bai Zhu (Fried Atractylodes), 10g of Ban Xia (Pinellia), 10g of Fu Ling (Poria), 6g of Chen Pi (Aged Tangerine Peel), 10g of Chuan Xiong (Szechuan Lovage), 3g of Sheng Ma (Cimicifuga), 3g of Chai Hu (Bupleurum), 6g of Jie Geng (Platycodon), 6g of Ju Luo (Tangerine Peel), and 6g of Zhi Nan Xing (Arisaema). I prescribed 5 doses again.
Five days later, the patient joyfully reported that this time the medicine was effective; after just five days, his dizziness had significantly reduced. I then advised him to take Xiang Sha Liu Jun Wan (Fragrant Sand Six Gentlemen Decoction) for consolidation, and after about a month of taking it, I followed up with the patient a year later, and he had not experienced any recurrence of vertigo.
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Meniere’s Disease: A Phlegm-Dampness Induced Condition
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 sitting on a vehicle that is swaying, accompanied by nausea, vomiting, and head heaviness. Movement can exacerbate the severity of vertigo and vomiting.
Therefore, during an episode, patients often lie still with their eyes closed, afraid to move, and some may feel a sense of blockage and pressure in the ear, or experience nystagmus.
Western medicine believes this condition is caused by increased lymphatic fluid in the inner ear, leading to ear-related vertigo.
Based on Zhang Zhongjing’s records in the “Jin Gui Yao Lue” regarding the “Mao Zhuang” syndrome (“Mao” refers to nausea and vomiting, and “Zhuang” refers to a disease characterized by vertigo, nausea, and vomiting occurring simultaneously), Zhang Zhongjing believed it was caused by “fluid retention in the heart”, which closely resembles Meniere’s disease. I treated it using the “Ze Xie Tang” (Alisma Decoction) from the “Jin Gui Yao Lue”, achieving excellent clinical results.
The composition of Ze Xie Tang consists of just two herbs—Ze Xie (Alisma) and Bai Zhu (Atractylodes). Ze Xie, as recorded in the “Shen Nong Ben Cao Jing”, is effective for “wind, cold, dampness, and phlegm obstruction”; Bai Zhu, as noted in the “Ming Yi Bie Lu” by the Jin Dynasty physician Tao Hongjing, is said to “eliminate phlegm and water, expel wind and dampness, and warm the stomach to eliminate food stagnation”.
These two herbs work together: Ze Xie primarily promotes urination to eliminate internal water retention, while Bai Zhu assists in strengthening the spleen and eliminating phlegm. This combination effectively addresses both the symptoms of water retention and the root cause of phlegm production due to spleen deficiency, resulting in rapid efficacy despite the small number of ingredients.
I once treated a female patient surnamed Xia, aged 43, 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, unable to eat, with water being vomited immediately. She lay still with her eyes closed, feeling slightly better, but any movement exacerbated her symptoms.
She felt heavy-headed and spoke softly. During the consultation, she ran to the door to vomit twice, with the vomit being clear liquid. She reported that she had not eaten for a day and still felt nauseous. Her tongue was pale with a white greasy coating, and her pulse was wiry.
Based on the idea of “fluid retention in the inner ear”, I prescribed Ze Xie Tang: 30g of Ze Xie and 45g of Chao Bai Zhu (Fried Atractylodes). I instructed her to use one and a half bowls of water to decoct until half a bowl remained, to be taken warm.
I 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 the half bowl was finished.
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 using spleen-strengthening and dampness-transforming herbs, her body was completely fine, and she 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 the spirit, requiring nourishment from qi, blood, and essence, and should not be disturbed by turbid evils. If phlegm-dampness ascends and obstructs the clear, it leads to dizziness, headache, and heaviness in the head.
Headaches, dizziness, and heaviness in the head are often seen in cases of hypertension. Western medicine attributes hypertension to cerebral vascular spasms or loss of elasticity in blood vessels, leading to obstruction of 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 a problem that rises and falls with qi, reaching everywhere”, can lead to obstruction of the clear yang, filling and blocking the blood vessels, which may also cause 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 transform 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 tonifying agents is not only ineffective but may worsen the condition, as it is due to the obstruction of tangible phlegm.
If stubborn phlegm and stagnant blood do not disperse, they can condense into tumors, residing in the brain or other parts of the body. Without transforming and dispersing stubborn phlegm and stagnant blood, the issue of tumors cannot be resolved.
2. Nausea or vomiting 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.
The turbid evil of phlegm-dampness lingers in the stomach and intestines, causing the stomach to lose its harmony and descent, leading to obstruction of the bowel qi, hence the frequent occurrence of nausea or vomiting phlegm and saliva, or a gurgling sound in the stomach and intestines.
Phlegm-dampness rising can lead to a sticky mouth. Phlegm turbidity is originally transformed from body fluids, but it can also obstruct the movement of body fluids, leading to dry mouth, as if drinking too much water only increases the phlegm evil, resulting in nausea and vomiting.
These symptoms are often clinically diagnosed as gastrointestinal neurosis, and medication is often ineffective. However, treating with methods to warm and transform phlegm-dampness or simultaneously promoting liver and spleen function can yield rapid results.
3. A sensation of obstruction in the throat, difficulty swallowing, and intermittent symptoms.
The occurrence of this symptom generally begins with liver qi stagnation and emotional disharmony, leading to liver depression and spleen deficiency. When the liver and spleen are not in harmony, spleen qi is also suppressed, leading to the accumulation of fluids and phlegm, which rises and obstructs the throat, causing a sensation of obstruction and difficulty swallowing.
The characteristic of phlegm is that it can gather and disperse, and since this symptom begins with liver qi stagnation, followed by spleen dysfunction leading to phlegm accumulation, this condition is characterized by a sensation of obstruction in the throat that may appear or disappear depending on emotional states.
This type of symptom is often seen in female patients. If the condition persists for a long time, it may lead to yin deficiency with phlegm. If only phlegm-transforming methods are used, it may further deplete yin fluids, exacerbating the sensation of obstruction and dryness in the throat. It is essential to simultaneously include sufficient nourishing yin substances to nourish while transforming, so that phlegm and qi obstruction can be resolved.
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, phlegm qi obstructing the heart and phlegm obstructing the heart orifices often manifest as disorders of brain cortical function. For these types of symptoms, treating with methods to clear phlegm and open the orifices 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 methods to strengthen the spleen and transform phlegm should yield results. If phlegm turbidity lingers in the intestines, obstructing bowel qi, it can lead to constipation (but the stools are not dry). In this case, the more one tries to moisten the stools, the more constipated they become. If one uses methods to move qi and transform phlegm, the stools will pass quickly.
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 viscous nature and tendency to remain hidden. When phlegm turbidity lingers, it obstructs yang qi, preventing it from expanding, leading to a situation where yin does not match with yang, causing yin to obstruct yang and resulting in fever. Phlegm turbidity obstructing yang and causing fever is different from the fever caused by external pathogens or the symptoms of blood deficiency, yin deficiency, or qi deficiency. Its characteristic is heaviness in the body without significant fever. Clinically, many cases of unexplained low-grade fever, where there are no signs of yin deficiency or qi deficiency, belong to this category.
If one mistakenly uses nourishing yin and tonifying qi formulas, it will further promote phlegm and evil, causing persistent low-grade fever and heaviness. If one can carefully examine the tongue and pulse, and accurately assess the true nature of the symptoms, focusing on transforming and dispersing phlegm-dampness will 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 affected, leading to numerous diseases”. When phlegm turbidity lingers and obstructs, the local circulation of qi and blood is hindered, resulting in the aforementioned symptoms. If phlegm turbidity accumulates and does not disperse, the affected area may also exhibit swelling or nodules.
8. Ulcers, erosions, or exudation of thick phlegm fluid, 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 local qi and blood circulation, leading to the external manifestation of phlegm turbidity. This can result in persistent exudation of thick phlegm fluid or even ulceration. If this condition persists for a long time, the 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 begins with the condensation of phlegm turbidity, which subsequently leads to qi and yin deficiency, often accompanied by stubborn phlegm that does not transform.
If the affected area exhibits thickened skin and scaling, it indicates qi and yin deficiency, along with the presence of stubborn phlegm.
9. Chest tightness and shortness of breath, with a feeling of fullness in the back, preferring to sigh or pound the chest. These symptoms are particularly pronounced during overcast or rainy weather or when the temperature fluctuates.
Phlegm-dampness stagnates in the chest, obstructing the yang qi in the chest (leading to the lung qi’s failure to descend), resulting in a feeling of chest tightness and shortness of breath. If phlegm turbidity stagnates in the back, it can lead to a feeling of fullness or coldness in the back. Sighing and pounding the chest can temporarily relieve the qi, which is why patients often sigh loudly or pound their chests for relief. If phlegm turbidity obstructs excessively, it can completely block the yang qi in the chest, leading to temporary stagnation of qi and blood flow, resulting in pain, and causing severe acute myocardial infarction.
10. Masses 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 skin color.
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