Introduction: In Traditional Chinese Medicine (TCM), phlegm-dampness is a pathological condition that arises in the human body. This article will clarify how phlegm-dampness forms, how to identify and analyze the strange diseases caused by it, and how to select appropriate treatments and herbal formulas. This article is worth keeping for reference.
What is Phlegm-Dampness in TCM, and what strange diseases can it cause? Phlegm-dampness occurs when the spleen’s ability to transform and transport water and dampness is impaired, or when there are obstacles in the circulation and excretion of fluids within the body. As a result, fluids fail to nourish the body properly and instead accumulate abnormally, forming a pathological substance known as “phlegm fluid” in TCM. Among this accumulation, the turbid, viscous, and thick parts are referred to as “phlegm,” while the clear, thin, and transparent parts are called “fluid” (yin). 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 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 produced in 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. However, have we noticed the detail that even phlegm expelled from the lungs can vary in characteristics? For instance, some phlegm may be white and viscous, some may be thin and white, some may be foamy, some may be yellow and thick, and some may be gray-black or yellow-green… Why does phlegm exhibit such a variety of changes 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. 1. What do the different textures and colors of phlegm signify? Let’s consider a common phenomenon: dissolving sugar in water. This results in a colorless and transparent liquid. If we heat this sugar water, what happens? We can observe 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 thickness of the yellow phlegm, the higher the level of heat in the body. Based on this principle, TCM categorizes thin, white, or foamy phlegm as “cold phlegm,” while yellow and thick or yellow-green phlegm 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 common 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 for heat phlegm, clearing heat and transforming phlegm methods are employed, with common herbs including Zhe Bei Mu (Zhejiang Fritillaria), Chuan Bei Mu (Sichuan Fritillaria), Tian Zhu Huang (Bamboo Sugar), 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 turbid, 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 water, which is the essence of “transformation.” In TCM, the phlegm-transforming herbs used in treating various phlegm conditions serve a similar role to that of alum, helping to decompose and settle the phlegm and turbid substances, thereby alleviating diseases caused by phlegm and 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 tract 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, chlamydia infections, and 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 dampness in the body, creating an overly humid internal environment, do these microorganisms proliferate and harm health, leading to various diseases. Therefore, for these types of diseases, the true root cause lies in the “dampness” 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 in nature is the main reason for the proliferation of fungi, why would the human body be any different? So, how should we treat phlegm caused by internal dampness? In daily life, dampness is often associated with overcast and rainy weather. If the sky is clear and sunny, there will naturally be no damp environment. There is a saying, “When the sun is high, the haze dissipates,” which illustrates this principle. The sun can drive away dampness primarily through its heat, so when treating this type of phlegm, we should use warming herbs to create a “high sun” effect within the body, dispersing the damp “haze.” This eliminates the root cause of dampness accumulation in the body, preventing the survival and proliferation of microorganisms such as fungi, mycoplasma, and chlamydia, thus providing rapid relief for phlegm caused by these infections and exudative phlegm. In the Han Dynasty, the medical sage Zhang Zhongjing proposed in the “Synopsis of Prescriptions of the Golden Chamber” that the principle for treating this condition is “for phlegm fluid diseases, one should use warming herbs to harmonize it.” This perspective remains remarkably insightful 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 the existence of “invisible phlegm” in the body. ① Obesity. The TCM saying “fat people have more phlegm-dampness” refers 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 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 tumor that is not red in color, protrudes from the skin surface, is nodular, and feels soft or resilient upon palpation, is referred to as a “phlegm mass” in TCM, containing water, mucus, or gelatinous substances. ④ Slippery pulse. TCM classifies pulse sensations into more than twenty types based on different feelings under the fingers, with slippery pulse being one of them. The description of slippery pulse in TCM is “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 a slippery pulse is a characteristic manifestation of phlegm 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 extend the TCM diagnostic methods of observation, listening, inquiry, and pulse-taking. 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 fluids, leading to excessive accumulation of dampness and phlegm in the body. Therefore, treatments that strengthen the spleen and assist in fluid metabolism, as well as transform phlegm and soften hard masses, can be effective. Moreover, by addressing the root cause, the treatment effects are 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 pale white, with a weak pulse in both hands. I diagnosed him with spleen deficiency leading to an inability to transform and transport fluids, resulting in the accumulation of phlegm and turbidity in the blood vessels, affecting the circulation of qi and blood, thus causing the disease. 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). The patient reported significant improvement in energy and appetite after completing the 7 doses, with dizziness reduced by more than half, and his stool had become mostly formed. I advised him to continue with the same formula for another 7 doses. When he returned for a follow-up, most of his symptoms had resolved, and his blood lipid levels had returned to normal. Another patient with a popliteal cyst came to consult me out of fear of surgery. In TCM, the formation of cysts is seen as a result of the accumulation of phlegm and turbidity in a specific area, and the production of phlegm and turbidity is directly related to the spleen’s ability to transform and transport fluids. Therefore, by improving and enhancing the spleen’s ability to transform and transport fluids, we can eliminate the accumulation of phlegm and turbidity in the body, thus resolving 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). This formula was taken 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 herbs remained as prescribed. These two examples clearly demonstrate that the theory of phlegm in TCM withstands practical testing. The spleen’s insufficient ability to transform and transport fluids leads to the accumulation of dampness in the body, and the turbid substances within the dampness can condense in specific areas, forming phlegm masses, such as cysts, lymph node tuberculosis, and bone tuberculosis mentioned earlier. 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 possess viscous properties, 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 instance, 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 may classify as cerebral infarction, but many cases in TCM are attributed to phlegm. Phlegm in the limbs can lead to blood supply disorders in the extremities, resulting in symptoms such as numbness in the limbs and cold extremities; phlegm in the blood vessels can lead to insufficient blood supply to the heart, causing palpitations, irregular heartbeat, and chest pain, which in Western medicine may be referred to as coronary heart disease, and in many cases, it is closely related to phlegm. Additionally, phlegm can also affect a person’s mental state. If the turbid qi of phlegm-dampness obstructs normal mental and cognitive activities, it can lead to symptoms such as excessive talking, depression, and unexplained sadness, which are classified as 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.” 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 diseases or conditions with poor treatment outcomes to “phlegm.” Thus, there is a saying in TCM that “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 positive results. I once treated a patient with vertigo who had experienced dizziness for over a year. After squatting or sitting for a long time, if he suddenly stood up, he would experience blackouts and even fainting. He felt drowsy throughout the 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 in both hands. Recently, his dizziness seemed to be worsening. Western medicine diagnosed him with insufficient cerebral blood supply. At that time, 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 Decoction) and 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, stating that there had been no improvement in his dizziness! He reassured me that it might take time to improve since he had this condition for a long time. After further inquiry, I concluded that it was indeed qi deficiency, but why was there no effect? At this point, 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 have led to abnormal fluid metabolism, resulting in internal phlegm and turbidity obstructing the brain, causing the dizziness. The previous treatment was ineffective because I had only considered qi deficiency without accounting for the phlegm and 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. After about a month of treatment, I followed up with the patient a year later, and he had not experienced any recurrence of dizziness. 4. Strange Disease: Ménière’s Disease Also Caused by Phlegm-Dampness Here, I would like to mention Ménière’s disease (formerly known as Meniere’s disease). The clinical features of this disease include paroxysmal vertigo that occurs frequently, during which the patient feels that surrounding objects are spinning, similar to the sensation of being on a moving vehicle, 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 “Synopsis of Prescriptions of the Golden Chamber” regarding the “Mao Xuan” syndrome (“Mao” refers to nausea and vomiting, and “Mao Xuan” indicates a disease characterized by vertigo, nausea, and vomiting occurring simultaneously), it is believed that this disease is caused by fluid retention in the inner ear. I used the “Ze Xie Decoction” from the “Synopsis of Prescriptions 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) and Bai Zhu (Atractylodes). Ze Xie is recorded in the “Shennong’s Herbal Classic” as having the effect of “treating wind, cold, dampness, and 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, expel wind-water swelling,” and is also known to “warm the stomach and eliminate food stagnation.” These two herbs work together: Ze Xie primarily promotes urination to eliminate internal water and fluid 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 production due to spleen deficiency, resulting in rapid efficacy despite the small number of herbs. I once treated a 43-year-old female patient with Ménière’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. She would vomit clear fluid upon drinking water. Lying still with her eyes closed provided slight relief, 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 fluid. 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. I prescribed Ze Xie Decoction: 30g of Ze Xie and 45g of Chao Bai Zhu (Fried Atractylodes). I instructed her to use one and a half bowls of water, decocting it down to half a bowl, and to take it warm. I also advised her 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 damp-dispelling 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 yang, it can lead to dizziness, headache, and a feeling of heaviness in the head. Headaches, dizziness, and heaviness in the head that are substantial are often seen in cases of hypertension. Western medicine considers hypertension to be caused by cerebral 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 is heavy and tangible, and combined with the characteristic of phlegm being able to rise and fall with qi, 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 patients with hypertension 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 conflicts with the substantial nature of the problem. If stubborn phlegm and stagnant blood accumulate and solidify, they can form tumors that reside in the brain or other parts of the body. Without resolving the stubborn phlegm and stagnant blood, the tumor cannot be eliminated. 2. Nausea or vomiting phlegm and saliva, or a gurgling sound in the stomach, or a sticky, greasy mouth with a dry sensation and a lack of desire to drink water. The turbid evil of phlegm-dampness can reside in the stomach and intestines, causing the stomach to lose its harmony and descent, leading to obstruction of the qi. This often results in nausea or vomiting of phlegm and saliva, or a gurgling sound in the stomach. Phlegm fluid can rise, causing 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 a dry mouth, as excessive drinking only increases the phlegm evil, resulting in nausea and vomiting. These symptoms are often clinically diagnosed as gastrointestinal neurosis, and medications may often be ineffective. However, treating with methods to warm and transform phlegm fluid or simultaneously promoting liver qi and assisting spleen function can yield rapid results. 3. A sensation of obstruction in the throat, difficulty swallowing, and intermittent symptoms. The occurrence of this condition 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 obstructs the throat. This results in a sensation of obstruction in the throat and difficulty swallowing. The characteristic of phlegm is that it can accumulate and disperse, and since this condition begins with liver qi stagnation, followed by spleen dysfunction leading to phlegm accumulation, it manifests as a sensation of obstruction in the throat that varies with emotional states. These symptoms are often seen in female patients. If the condition persists, it can 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 combine sufficient nourishing yin fluids to nourish while transforming, allowing for the resolution of phlegm and 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 conditions. 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 disorders of brain cortical function. For these types of conditions, 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. When phlegm turbidity resides in the stomach and intestines, it can lead to stools coated with phlegm and saliva. Treating with methods to strengthen the spleen and transform phlegm can yield results. If phlegm turbidity resides in the intestines, obstructing the 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 can 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, making it prone to internal retention. When phlegm turbidity is retained internally, it obstructs yang qi, leading to a situation where yin does not match with yang, resulting in the stagnation of yang qi and the manifestation of 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 a heavy body with no significant increase in temperature. Many cases of unexplained low-grade fever without signs of yin deficiency or qi deficiency fall into this category. If one carelessly administers nourishing yin and tonifying qi formulas, it may further assist phlegm retention, leading to persistent low-grade fever and body heaviness. If one can carefully examine the tongue and pulse, and accurately assess the symptoms, focusing on transforming and dispersing phlegm-dampness can yield satisfactory results. 7. Localized heat or cold in the limbs (or a sensation of coolness 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 show no abnormalities). “Phlegm follows qi and reaches everywhere,” and “the symptoms vary depending on the affected area, leading to various diseases.” When phlegm turbidity is retained and obstructs the flow of qi and blood, the above symptoms can occur. 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 and scaling without exudation. Phlegm-dampness retention or heat phlegm accumulation can affect the flow of qi and blood in the affected area, leading to the exudation of phlegm and turbid substances. If this condition persists, 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 condition begins with phlegm turbidity accumulation, leading to qi and yin deficiency, accompanied by stubborn phlegm retention. 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 weather fluctuates between cold and warm. Phlegm fluid stagnates in the chest, obstructing the flow of yang qi (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, which is why patients often sigh loudly or pound their chests for relief. If phlegm turbidity obstructs the flow excessively, it can lead to temporary stagnation of qi and blood circulation, resulting in pain in the chest area, 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 on the skin surface, or a slight sensation of coolness, or a dull skin color.