The Three Treasures Newsletters
SUMMER 2002
PHLEGM
The concept of Phlegm is very wide-ranging and important in Chinese
Medicine. Phlegm is extremely frequent in clinical practice and
is at the same time a pathological condition and an aetiological
factor. Phlegm which is retained over a long period of time becomes
itself a cause of disease.
Cause of Phlegm
The main cause of Phlegm is Spleen deficiency. If the Spleen fails
to transform and transport Body Fluids, these will accumulate and
change into Phlegm. The Lungs and Kidneys are also involved in the
formation of Phlegm. If the Lungs fail to disperse and lower fluids
and if the Kidneys fail to transform and excrete fluids, these may
accumulate into Phlegm. However, the Spleen is always the primary
factor in the formation of Phlegm.
Signs of Phlegm
The essential signs of Phlegm are a Swollen tongue body with a sticky
tongue coating and a Slippery or Wiry pulse.
Types of Phlegm
There are two types of Phlegm, one "substantial", one
"non-substantial". In the old classics, these were described
as Phlegm "having a form" and Phlegm "without a form".
Substantial Phlegm can be seen, such as the sputum that collects
in the Lungs and is spat during bronchitis or other Lung diseases.
Non-substantial Phlegm can be retained subcutaneously or in the
channels. It can obstruct the Heart-orifices or the Gall-Bladder
or Kidneys in the form of stones. It can settle in the joints in
the form of arthritic bone deformities.
Phlegm patterns
The patterns caused by Phlegm are as follows:
Wind-Phlegm
Severe dizziness, nausea, vomiting, numbness of the limbs, coughing
of phlegm, a feeling of oppression of the chest, blurred vision,
a rattling sound in the throat, slurred speech, Swollen tongue with
sticky coating, Wiry-Slippery pulse. In case of Wind-Stroke: aphasia,
deviation of eyes and mouth, hemiplegia, Swollen-Deviated tongue.
Three Treasures remedies: Clear Yang, Peaceful Sunset (in
the case of Wind-Stroke)
Phlegm-Heat
Cough with expectoration of profuse yellow sputum which may be blood-tinged,
a feeling of oppression of the chest, dark eye sockets, red cheek
bones, red face, thirst, oily skin, breathlessness, chest pain,
insomnia, dark urine, feeling of heat, mental restlessness, Red-Swollen
tongue with sticky-yellow coating, Rapid-Slippery pulse.
Three Treasures remedies: Ringing Metal, Clear the Soul
Cold-Phlegm
Cough with expectoration of white-watery sputum, feeling cold, cold
hands and feet, nausea, vomiting, a feeling of oppression of the
chest and epigastrium, dull-white complexion, pale urine, Pale-Swollen
tongue with wet-white coating, Slippery-Slow pulse.
Three Treasures remedies: Limpid Sea
Damp-Phlegm
Cough with easy expectoration of profuse, sticky-white sputum, a
feeling of oppression of the chest and epigastrium, breathlessness,
rattling sound in the throat, dark eye sockets, sallow-greyish complexion,
a feeling of heaviness, tendency to obesity, swollen hands and feet,
poor appetite, nausea, dizziness, blurred vision, oily skin, Swollen
tongue with sticky coating, Slippery pulse.
Three Treasures remedies: Limpid Sea
Dry-Phlegm
Sputum in the chest that is difficult to expectorate, bouts of dry
cough followed by expectoration of sticky sputum, breathlessness,
dull-white complexion, dark eye sockets, dry throat, dry nose and
lips, dry mouth but no desire to drink, Swollen tongue with sticky-dry
coating, Slippery pulse.
Three Treasures remedy: Limpid Sea and Jade Spring
Qi-Phlegm
A feeling of lump in the throat, difficulty in swallowing, a feeling
of oppression of the chest and diaphragm, mental depression, irritability,
nausea, sighing, Wiry pulse.
Three Treasures remedy: Open the Heart
Food-Phlegm
Cough with abundant sputum, nausea, vomiting, sour regurgitation,
belching, a feeling of fullness in the epigastrium, a feeling of
oppression of the chest and epigastrium, epigastric pain after eating
that is better after bowel movement, Swollen tongue with thick-sticky
tongue coating, Slippery pulse.
Phlegm with Blood Stasis
A feeling of oppression of the chest, numbness and tingling of the
limbs, pain in the joints, stiffness and rigidity of joints, abdominal
masses, fibroids, goitre, mental restlessness, insomnia, dark eye
sockets, Purple-Swollen tongue with sticky coating, Slippery-Wiry
or Slippery-Firm pulse.
Three Treasures remedies: Peaceful Sunset or Clear the Soul
with Red Stirring
Phlegm-Fluids
Phlegm-Fluids in Stomach and Intestines (Tan Yin): abdominal
fullness and distension, nausea, vomiting of watery fluids, splashing
sound in the stomach, dry mouth without desire to drink, palpitations,
shortness of breath, dizziness, a feeling of oppression of the chest,
loose stools, loss of weight, Swollen tongue with sticky coating,
Deep-Wiry or Deep-Slippery pulse.
Phlegm-Fluids in the hypochondrium (Xuan Yin): hypochondrial
pain which is worse on coughing and breathing, a feeling of distension
and pulling of the hypochondrium, shortness of breath, Swollen tongue
with sticky coating, Deep-Slippery-Wiry pulse.
Phlegm-Fluids in the limbs (Yi Yin): a feeling of heaviness
of the body, pain in the muscles, absence of sweating, no desire
to drink, cough with profuse watery sputum, swelling of the limbs,
lethargy, breathlessness, Swollen tongue with sticky coating, Wiry-Slippery
or Tight-Slippery pulse.
Phlegm-Fluids above the diaphragm (Zhi Yin): cough with white-watery
sputum, breathlessness, swelling of limbs, dizziness, inability
to lie down, swollen face, feeling cold, Swollen tongue with white-sticky
coating, Slippery pulse.
Phlegm Under the Skin
Lumps or nodules under the skin, nerve-ganglia swellings, swelling
of lymph-nodes, swelling of the thyroid, lipoma.
Phlegm in the Channels
Numbness and tingling in the limbs.
Phlegm Misting the Heart
Inappropriate laughter or crying, dull thinking, hypomania, manic
behaviour, manic depression, psychosis.
Three Treasures remedies: Clear the Soul
Phlegm in the Joints
Swelling and deformities of joints seen in Chronic Painful Obstruction
Syndrome (often seen in rheumatoid arthritis).
Three Treasures remedies: Benefit the Sinews
Phlegm in the Gall Bladder
Gall-Bladder stones.
Phlegm in the Kidneys
Kidney stones.
Shock-Phlegm
Pain in the heart region, a feeling of oppression in the chest,
anxiety, mental restlessness following a shock, Moving pulse. This
pattern occurs when a severe shock displaces the Spirit from the
Heart and its place is taken
by Phlegm.
Three Treasures remedy: Clear the Soul
Wine-Phlegm
Nausea, vomiting, a feeling of fullness of the epigastrium, foul
breath, a rattling sound in the throat, purple nose, purple complexion,
a feeling of oppression of the chest, Reddish-Purple and Swollen
tongue with a sticky-yellow coating, Slippery pulse. This pattern
is seen in older people with Phlegm deriving from excessive alcohol
consumption.
Three Treasures remedy: Peaceful Sunset
THREE TREASURES REMEDIES USED IN THE TREATMENT OF PHLEGM
Limpid Sea
Pattern: Phlegm (damp, cold or hot) in the Middle and Upper
Burner
Actions: Dry Dampness and resolve Phlegm
Indications: Cough with abundant sputum, catarrh in teh chest,
nose or throat, white or yellow sputum, a feeling of oppression
of the chest, nausea, vomiting, palpitations, dizziness, insomnia,
lipoma.
Tongue: Pale, swollen with a sticky-white coating in case
of Damp- or Cold-Phlegm, or red, swollen with a sticky-yellow coating
in case of Hog-Phlegm.
Pulse: Slippery and slow in case of Cold-Phlegm, or slippery
and rapid in case of Hot-Phlegm.
Ringing Metal
Pattern: Phlegm-Heat in the Lungs
Action: resolve Phlegm, clear Heat, restore the descending
of Lung-Qi, stop cough
Indications: acute cough with expectoration of profuse, yellow
sputum following an upper respiratory infection, a feeling of oppression
of the chest, fever, thirst, insomnia, feeling of heat, red cheeks
Tongue: normal, red or red only in the front with a thick-sticky-yellow
coating
Pulse: Slippery-Rapid
Clear the Soul
Pattern: Phlegm-Heat obstructing the chest and Mind, Lung-Qi
not descending
Action: Resolves Phlegm-Heat, calms the Mind, open the orifices,
relaxes the chest
Indications: Anxiety, a feeling of oppression of the chest
and epigastrium, palpitations, a bitter-sticky taste, sighing, feeling
un-easy, phlegm in the chest, poor digestion, slight nausea, insomnia,
dream-disturbed sleep, dull complexion, mental restlessness, depression,
jumpiness, a flustered feeling in the heart region, vomiting, dizziness,
pre-menstrual tension
Tongue: Red or normal, swollen, sticky-yellow coating, Stomach
crack or Stomach-Heat crack with rough yellow coating inside it
Pulse: Slippery, rapid. The Heart pulse may feel relatively
Overflowing
Benefit the Sinews
Pattern: Blood stasis, Phlegm and Dampness in the joints,
Kidney deficiency
Action: invigorate Blood, resolve Phlegm, expel Wind-Dampness,
dry Dampness
Indications: chronic Painful Obstruction Syndrome, chronic
joint pain with swelling of the joints and bone deformities, rigidity
of joints, backache, dizziness, tinnitus, tiredness, lack of will-power,
mental confusion, anxiety, mental restlessness
Tongue: Pale, red or purple, swollen, sticky coating
Pulse: Choppy or slightly Slippery
Clear Yang
Pattern: Liver-Yang rising, Phlegm clouding the head, Blood
deficiency, Kidney Yang deficiency
Action: Subdue Liver-Yang, extinguish Liver-Wind, resolve
Phlegm, nourish Blood, tonify Kidney-Yang, tonify Spleen-Qi
Indications: Headaches which may be throbbing or dull in
nature, dizziness, a feeling of heaviness and muzziness of the head
which is worse in the morning, catarrh, a feeling of oppression
of the chest, nausea, a sticky taste, blurred vision, vomiting during
migraine attacks, tics, high blood pressure
Tongue: Pale or normal-coloured, swollen, sticky-white, coating.
Pulse: Weak and slightly Slippery
Peaceful Sunset
Pattern: Liver-Fire, Liver-Wind, Blood-Heat, Liver-Phlegm-Heat,
Blood stasis
Action: Clear Liver-Fire, subdue Liver-Wind, resolve Phlegm,
clear Heat, cool Blood, move Blood
Indications: Insomnia, dizziness, tinnitus, trigeminal neuralgia,
headaches, coughing up phlegm, constipation, thirst, chest pains,
purpura, high blood pressure
Tongue: Reddish-purple, stiff, dry-thick-sticky coating.
Possibly moving or deviated.
Pulse: Full, slippery and wiry.
TABLE TO COMPARE THREE TREASURES REMEDIES WHICH
TREAT PHLEGM
| |
Type of Phlegm
|
Symptoms
|
Tongue and pulse
|
Frequently combined patterns
|
| Limpid Sea |
Damp-Phlegm
Cold-Phlegm |
Cough with sputum, catarrh, overweight,
oppression of the chest |
Swollen and with a sticky-coating
Slippery |
Spleen- and Kidney deficiency |
| Ringing Metal |
Phlegm-Heat |
Acute cough with yellow sputum |
Thick-sticky-yellow tongue coating, Slippery-Rapid
pulse |
Spleen- and Lung-Qi deficiency |
| Clear the Soul |
Phlegm-Heat |
Anxiety, oppression of the chest, depression,
chronic cough with yellow sputum |
Swollen tongue with a sticky coating and
a Stomach or Heart crack. Slippery-Rapid pulse (Heart
position Overflowing |
Lung-Qi not descending |
| Benefit the Sinews |
Phlegm in the joints |
Chronic joint pain, swelling of joints
an bone deformities |
Swollen tongue with sticky coating; Choppy
or slightly Slippery pulse |
Blood stasis, Kidney deficiency |
| Peaceful Sunset |
Wind-Phlegm |
Insomnia, constipation, dizziness, high
blood pressure |
Reddish-Purple, stiff tongue with sticky
coating; Full, Slippery or Wiry pulse |
Liver-Fire, Liver-Wind, Blood stasis |
| Clear Yang |
Wind-Phlegm |
Headaches, dizziness, heaviness of head |
Swollen tongue with a sticky coating;
Weak or slighty Slippery pulse |
Liver-Yang rising, Blood deficiency, Kidney-Yang
deficiency |
|
CASE HISTORIES
Case History 1
A 32-year-old woman had suffered from an acute cough with profuse
yellow sputum since a respiratory infection three months previously.
Her chest felt tight and she was hotter than normal, complaining
of a "funny taste" in her mouth and an extreme thirst.
The cough was particularly bad at night. Her tongue had a sticky-yellow
coating and her pulse was Slippery and slightly Rapid.
I prescribed Ringing Metal (8 tablets a day). The patient took them
for three weeks, after which time the cough had totally cleared
up. I combined this with acupuncture to strengthen Spleen- and Lung-Qi,
both of which had been weakened over the three months since the
infection.
Case History 2
A 25-year-old woman had suffered from benign vertigo since childhood.
She experienced periods of intense dizziness, when she felt "the
world was literally spinning around her". The dizziness was
sometimes so severe as to make her lose her balance. She also felt
nauseous during the attacks. In between times, she felt extremely
tired and weak. Her tongue was a normal colour with a sticky coating,
while her pulse was Wiry on the right and Choppy on the left.
I prescribed Clear Yang (6 tablets a day between attacks and 9 tablets
a day during attacks). At the same time, I gave her acupuncture
to subdue Liver-Yang, resolve Phlegm, nourish Blood and strengthen
the Kidneys. After six months of treatment, the attacks are less
frequent and less severe. She also has more energy. The patient
has found if she takes a high dose of Clear Yang as soon as she
senses an attack beginning, she can sometimes stop it from materializing
or it lasts a shorter time than it previously would have.
Researched and edited by Rebecca Avern Lic.Ac, M.B.Ac.C
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