According to Traditional Chinese Medicine (TCM), phlegm-dampness can be divided into four distinct stages: Spleen Qi Deficiency (脾虚), Spleen Qi Deficiency with Excess Dampness (脾虚湿盛), Internal Generation of Phlegm-Dampness (痰湿内生), and Phlegm-Stasis Interlocking (痰瘀互结).
Each of these stages presents different tongue appearances and clinical manifestations, and the treatment methods vary significantly at each stage.
The first stage is Spleen Qi Deficiency (脾虚).
In this stage, the tongue is generally pale, with a white coating and a noticeable indentation in the center.
The main clinical manifestations include poor appetite, lack of interest in food, and persistent fatigue.
The treatment for this stage primarily focuses on strengthening the Spleen, utilizing formulas such as Xiao Jian Zhong Tang (小建中汤) and Li Zhong Tang (理中汤) with modifications.
The second stage is Spleen Qi Deficiency with Excess Dampness (脾虚湿盛).
In this stage, due to the presence of dampness, the tongue becomes moist and enlarged, with clear tooth marks on the sides.
Symptoms include unformed stools, a heavy sensation in the body, dizziness, and persistent lethargy.
The treatment focuses on strengthening the Spleen and eliminating dampness, commonly using formulas like Shen Ling Bai Zhu San (参苓白术散) and Ling Gui Zhu Gan Tang (苓桂术甘汤).
The third stage is Internal Generation of Phlegm-Dampness (痰湿内生).
When dampness accumulates in the body for a long time, it transforms into phlegm.
At this stage, the tongue appears enlarged with tooth marks, and the coating becomes thick and greasy.
Over time, phlegm-dampness can generate heat, causing the tongue coating to turn yellow and thick.
Symptoms include a heavy and fatigued body, poor appetite, and reduced food intake.
Some individuals may feel phlegm in the throat, a persistent sensation of needing to clear it, nausea, vomiting, or experience dizziness, chest tightness, and palpitations.
These individuals often have a tendency to be overweight.
At this stage, treatment should focus on strengthening the Spleen, eliminating dampness, and resolving phlegm, using formulas like Er Chen Tang (二陈汤) and Wen Dan Tang (温胆汤) with modifications.
The fourth stage is Phlegm-Stasis Interlocking (痰瘀互结).
Phlegm-dampness has a sticky nature, akin to chewing gum, which can obstruct the flow of Qi and blood, leading to blood stasis. Phlegm-dampness and blood stasis can interlock, resulting in the issue of phlegm-stasis interlocking.
At this point, the tongue appears dark purple with spots of stasis.
Wherever phlegm-dampness accumulates, it is prone to disease, leading to nodules, polyps, or even tumors.
Individuals may also experience chest tightness, excessive phlegm, and numbness in the limbs.
At this stage, treatment should focus on resolving phlegm, eliminating dampness, and invigorating blood circulation, potentially combining Er Chen Tang (二陈汤) and Wen Dan Tang (温胆汤) with Xue Fu Zhu Yu Tang (血府逐瘀汤) for treatment.
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