Due to the decline in the spleen’s ability to transform and transport water and dampness, or obstacles in the circulation and excretion of fluids within the body, 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 parts are called “Phlegm” (痰), while the clear, thin, and transparent parts are referred to as “Dampness” (饮).
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 from metabolic disorders of fluids, characterized by turbidity, viscosity, and thickness.
For example, obesity is referred to as “Phlegm” in TCM. Since this type of “Phlegm” is not as readily observable as the phlegm produced in the lungs, it is termed “Invisible Phlegm” (无形之痰), while the phlegm produced in the lungs that can be expelled through coughing and is visible is called “Visible Phlegm” (有形之痰). 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”; we often encounter it during colds and coughs. However, have we noticed the detail that even among phlegm coughed up from the lungs, there are various differences in characteristics?
For instance, some phlegm appears white and viscous, some is white and thin, some is white and foamy, some is yellow and thick, some is grayish-black, and some is yellow-green… Why does phlegm, which is essentially the same, exhibit so many variations?
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, grayish-black, yellow, or yellow-green.
What do the different textures and colors of phlegm reflect about the pathological characteristics within the body?
Let’s consider a common phenomenon: dissolving sugar in water. This creates 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, then to deep yellow.
From this phenomenon, we can deduce that the thickness and color of phlegm are closely related to the presence of “heat” within 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 phlegm that is white and thin, or foamy, or viscous as “Cold Phlegm” (寒痰), while phlegm that is yellow and thick, or even yellow-green, is categorized as “Heat Phlegm” (热痰).
Since the essence reflected by Cold Phlegm and Heat Phlegm is completely opposite, the treatments for Cold Phlegm and Heat Phlegm are also entirely different.To treat Cold Phlegm, one must warm and transform it, commonly using herbs such as Gan Jiang (干姜), Xi Xin (细辛), Ban Xia (半夏), Chen Pi (陈皮), Bai Jie Zi (白芥子), and Lai Fu Zi (莱菔子); while to treat Heat Phlegm, one must clear heat and transform phlegm, commonly using herbs such as Zhe Bei Mu (浙贝), Chuan Bei Mu (川贝), Tian Zhu Huang (天竺黄), Dan Nan Xing (胆南星), Gua Lou (瓜蒌), and Tian Hua Fen (天花粉).
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 impurities 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, enabling the phlegm turbidity to decompose and settle, thereby removing 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 formed due to excessive secretion of mucus by respiratory mucosal cells.
Among these, antibiotics can be effective against phlegm caused by bacterial infections, while there are limited options 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 health and causing various diseases.
Therefore, for these types of diseases, the “humidity” of the internal environment is the true root cause. Just like in the rainy season, when the environment is humid, fungi can proliferate abundantly, making things prone to mold. Since you can recognize that a humid environment is the main reason for fungal proliferation in natural phenomena, is the human body 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, a humid environment will not form.
There is a saying: “When the sun is blazing, the haze dissipates,” which illustrates this 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 an effect akin to “the sun blazing in the sky,” allowing the humid “haze” to dissipate. This eliminates the root cause of water and dampness accumulation in the body, preventing the environment for the survival and reproduction of fungi and other microorganisms, thus providing rapid efficacy against phlegm caused by fungi, mycoplasma, chlamydia infections, and exudative phlegm.
In the Han Dynasty, the medical sage Zhang Zhongjing already proposed in the “Jin Gui Yao Lue” that the principle for treating this disease is “For those with phlegm-dampness, one should use warming herbs to harmonize it.” This still seems remarkably insightful today, and we cannot help but admire the methods and thoughts of ancient people in exploring the mysteries of life and disease.
Invisible Phlegm
Having discussed Visible Phlegm, what is “Invisible Phlegm” and how can we determine its existence? TCM identifies four criteria for determining the presence of “Invisible Phlegm” in the body.
① Obesity.In TCM, it is said that “obese individuals have much phlegm-dampness,” referring to the presence of “Invisible Phlegm” in obese individuals, as fat possesses the characteristics of “Phlegm”—turbidity, viscosity, and thickness. It is formed from the turbid parts of water and dampness accumulated 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 tumor that is not red in color, protrudes from the skin surface, is nodular, and feels soft or resilient upon palpation, is referred to in TCM as a “Phlegm Mass” (痰块).
④ Slippery pulse.In TCM, the pulse is classified into more than twenty types based on different sensations felt under the fingers, and the slippery pulse is one of them. TCM describes the slippery pulse as “flowing smoothly, like beads rolling on a plate,” indicating that the pulse we feel is as smooth and swift as beads rolling on a smooth plate. The presence of a slippery pulse is one of the characteristic manifestations of phlegm turbidity in the body and is also 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 therefore be considered phlegm-related diseases. Thus, 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 through strengthening the spleen, assisting its function, and transforming phlegm to soften hard masses. 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, his tongue coating was pale white, and his pulse was thin and weak.
I diagnosed him with spleen deficiency leading to an inability to transform water and dampness, resulting in the accumulation of phlegm turbidity in the body, which affected the circulation of qi and blood, causing the disease.I prescribed a TCM formula to strengthen the spleen and transform phlegm: 30g of Chao Bai Zhu (炒白术), 15g of Dang Shen (党参), 10g of Chen Pi (陈皮), 10g of Ban Xia (半夏), 6g of Gan Cao (甘草), 15g of Fu Ling (茯苓), 6g of Ju Luo (橘络), 10g of Dan Nan Xing (胆南星), 15g of Jiao Shan Zha (焦山楂), and 5 slices of Sheng Jiang (生姜).
After taking the 7 doses of medicine, the patient felt a significant improvement in his spirit and appetite, his 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 the patient returned for a follow-up, his various symptoms had become minimal, and a recheck of his blood lipids showed that they had returned to normal levels.
The second patient, who had a popliteal cyst, came for consultation due to 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 removing the cyst.
Based on this approach, I prescribed a formula to strengthen the spleen, transform phlegm, and reduce swelling: 45g of Chao Bai Zhu (炒白术), 15g of Ze Xie (泽泻), 15g of Hua Shi (滑石), 10g of Zhu Ling (猪苓), 15g of Fu Ling (茯苓), 10g of Gui Zhi (桂枝), 20g of Ban Xia (半夏), 10g of Zhi Nan Xing (制南星), 30g of Yi Yi Ren (薏苡仁), and 10g of Qing Pi (青皮).
The patient took this formula continuously 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, and the turbid substances within the water and dampness can condense in certain areas of the body to form phlegm masses, 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 possess viscous characteristics, 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 and tissues, 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, drowsiness, and even coma, hemiplegia, or speech difficulties, which Western medicine refers to as cerebral infarction. Many cases in TCM are considered phlegm-related.
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 heart rate, 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 and dampness obstructs normal mental and cognitive activities, it can lead to symptoms such as incessant talking, depression, and unexplained sadness, which are classified as depressive 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” (痰迷心窍).
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 those 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 adds a new perspective to 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-transforming methods, which often yield unexpectedly good results.
I once treated a patient with vertigo who had experienced it 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 all day, had low energy, spoke softly, and had a pale complexion. His appetite was average, and his bowel movements were normal. His tongue was pale red with a thin white coating, and his pulse was weak and thin. In the past month, his vertigo seemed to have worsened.Western medicine diagnosed it as insufficient blood supply to the brain.
At that time, I thought this was a typical case of qi sinking. Qi deficiency leads to an inability to nourish the head with qi and blood, which should be easy to treat. So, I prescribed 5 doses of Bu Zhong Yi Qi Tang (补中益气汤), and after prescribing the formula, 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 vertigo! He also reassured me that it might take time to improve since he had this problem for a long time. Upon further inquiry, I concluded that it was indeed qi sinking. Since there was no diagnostic error, why was there no effect?
Recalling Zhu Danxi’s saying that “many diseases are accompanied by phlegm,” I suddenly had an epiphany. 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 (黄芪), 15g of Dang Shen (党参), 12g of Chao Bai Zhu (炒白术), 10g of Ban Xia (半夏), 10g of Fu Ling (茯苓), 6g of Chen Pi (陈皮), 10g of Chuan Xiong (川芎), 3g of Sheng Ma (升麻), 3g of Chai Hu (柴胡), 6g of Jie Geng (桔梗), 6g of Ju Luo (橘络), and 6g of Zhi Nan Xing (制南星). I prescribed this for another 5 doses.
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 had him take Xiang Sha Liu Jun Wan (香砂六君丸) for consolidation, and after about a month of treatment, I followed up with the patient a year later, and he had not experienced any recurrence of vertigo.
Phlegm-Dampness Induced Ménière’s Disease
Here, I would like to mention Ménière’s disease (previously known as Ménière’s syndrome).
This disease is clinically characterized by 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 headache. 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 that this disease is caused by increased lymphatic fluid in the inner ear, leading to ear-related vertigo.
According to Zhang Zhongjing’s “Jin Gui Yao Lue” regarding the “Mao Xuan” syndrome (“Mao” refers to nausea and vomiting, and “Mao Xuan” refers to a disease characterized by vertigo, nausea, and vomiting occurring simultaneously), Zhang Zhongjing believed it was caused by “fluid retention in the heart region,” which closely resembles the description of Ménière’s disease, as well as modern medicine’s understanding that this disease is caused by fluid retention in the inner ear. The use of the “Ze Xie Decoction” (泽泻汤) from the “Jin Gui Yao Lue” has shown excellent clinical efficacy.
The composition of Ze Xie Decoction consists of just two herbs—Ze Xie (泽泻) and Bai Zhu (白术). Ze Xie, as recorded in the “Shen Nong’s Herbal Classic,” has the effect of “relieving wind, cold, and dampness, and eliminating water”; Bai Zhu, as described in the “Bie Lu” by the Jin Dynasty physician Tao Hongjing, is said to “eliminate phlegm and water, expel wind-water accumulation, and warm the stomach to digest grains.”
When these two herbs are combined, 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 named Xia, 39 years old, who had suffered from Ménière’s disease for over three years. This time, her condition was triggered by fatigue, and she felt dizzy, nauseous, and unable to eat, with water causing her to vomit. 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, and the vomit was clear liquid. She reported that she had not eaten anything 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 “fluid retention in the inner ear,” I prescribed Ze Xie Decoction: 30g of Ze Xie (泽泻) and 45g of Chao Bai Zhu (炒白术). I instructed her to use one and a half bowls of water to decoct until half a bowl remains, and to 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-transforming 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.
In TCM, the head is considered the residence of the clear and spiritual essence, 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 a feeling of heaviness.
Headaches, dizziness, and heaviness in the head that are substantial are often seen in hypertension. Western medicine believes that hypertension is caused by spasms of cerebral blood vessels or loss of elasticity due to vascular hardening, leading to obstructed blood flow and increased pressure.
From a TCM perspective, the turbid evil of phlegm-dampness is heavy and tangible, and combined with the characteristic of “phlegm being a problem that rises and falls with qi, reaching everywhere,” it can obstruct the clear yang, filling and blocking the blood vessels, which can 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 transform phlegm-dampness can yield significant results.
Headaches, dizziness, and heaviness caused by phlegm-dampness may either persist or fluctuate, but they are fundamentally different from symptoms caused by qi and blood deficiency. Using tonics is not only ineffective but may worsen the condition, as it aggravates the obstruction of substantial evils.
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 qi in the bowels, hence frequent nausea or vomiting of phlegm and saliva, or a gurgling sound in the stomach and intestines.
Phlegm and fluids 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 occasional dry mouth. If one drinks too much water, it only increases the phlegm evil, causing water to enter and lead to nausea and vomiting.
The above symptoms are often clinically diagnosed as gastrointestinal neurosis, and medications are 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, with symptoms appearing intermittently.
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, the spleen’s qi is also suppressed, leading to impaired transformation and accumulation of fluids into 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 phlegm accumulation due to spleen dysfunction, it manifests as a sensation of obstruction in the throat that appears intermittently based on emotional states.
This type of symptom is often seen in female patients. If the condition persists for a long time, it can lead to yin deficiency with phlegm. If one focuses solely on transforming phlegm and dispersing it, it may further deplete yin fluids, exacerbating the sensation of obstruction and dryness in the throat. It is essential to simultaneously incorporate sufficient nourishing yin substances to nourish while dispersing, allowing phlegm and qi obstruction to resolve without recurrence.
4. Easy palpitations, insomnia, or fainting, convulsions, or mental disturbances, 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. In TCM, 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 methods to clear phlegm and open the orifices can often yield satisfactory results.
5. Stools coated with phlegm and saliva, or constipation with difficulty passing stools.
Phlegm turbidity lingers in the stomach and intestines, leading to sticky stools coated with phlegm. Treating with methods to strengthen the spleen and transform phlegm should yield results. If phlegm turbidity lingers in the intestines, obstructing the qi in the bowels, it can lead to constipation (but the stools are not dry). This condition can worsen with excessive moistening, leading to constipation. If one uses methods to move qi and transform phlegm, the stools will quickly become smooth.
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 viscosity and tendency to remain hidden. When phlegm turbidity remains hidden, it obstructs yang qi, preventing it from expanding, leading to a situation where yin does not match yang, resulting in heat due to yin obstructing yang. Phlegm turbidity obstructing yang leads to heat, which is different from the heat caused by external pathogens or the symptoms of blood deficiency, yin deficiency, or qi deficiency. Its characteristic is heaviness in the body without significant elevation in temperature. Many cases of unexplained low-grade fever, where there are no signs of yin deficiency or qi deficiency, belong to this category.
If one carelessly administers yin-nourishing and qi-tonifying herbs, it may 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 in the limbs, or coldness in the back, or numbness without pain or itchiness, or differences in size and sensation in certain areas of the body, but neurological, orthopedic, and dermatological examinations reveal no abnormalities.
“Phlegm travels with qi and reaches everywhere,” and “the sensations experienced vary, leading to numerous pathological changes.” When phlegm turbidity lingers and obstructs, it can lead to the aforementioned changes. If phlegm turbidity accumulates and does not disperse, the affected area may also exhibit swelling or nodules.
8. Ulcers, erosions, or exudation of viscous phlegm, which do not heal for a long time, or localized skin thickening with scaling but no exudation.
Phlegm-dampness lingers, or heat phlegm condenses, affecting the circulation of qi and blood in the affected area, leading to the exudation of tangible phlegm. This results in persistent exudation of viscous fluids or even ulceration. If this condition persists for a long time, the righteous qi may weaken, and the affected area may become susceptible 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 accumulation of phlegm turbidity, which subsequently leads to qi and yin deficiency, accompanied by stubborn phlegm that does not transform.
If the affected area exhibits skin thickening and scaling, it indicates qi and yin deficiency, along with the presence of stubborn phlegm accumulation.
9. Chest tightness and shortness of breath, with a feeling of fullness in the back, a tendency 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 (causing lung qi to lose its ability to descend), leading to 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 obstruction, which is why patients often sigh loudly or pound their chests to feel better. 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 due to obstruction, manifesting as a squeezing sensation in the chest, which can lead to severe acute myocardial infarction in some cases.
10. Tumors 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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