Phlegm (tan), thin mucus (yin) and water (shui) are all products of disruption to normal food and fluid transformation, a phenomenon that has been termed ‘one root and three branches’. But the sheer variety of locations and symptoms for phlegm cannot be matched by either thin mucus or water, and so clinical differentiation of these three pathogens is essential, because a treatment designed for one will not necessarily be effective for another.
However, broadly defined phlegm presents such complex symptomatology in the clinic that it can be difficult for beginners to recognize, differentiate and treat. The ancients often noted that "strange afflictions are usually phlegm", even to the extent that Zhu Dan-Xi remarked: "[These phlegm] illnesses appear [the result of] an evil spirit; only when obstructed phlegm is expelled will the illness be allayed".
Phlegm
obstructing the
Heart may
arise in one of the following ways:
A- Excess of any of the seven
emotions results in stagnation of qi which hinders the smooth
circulation of body fluids, and by transforming into
fire, further condenses the stagnant body fluids to form
phlegm;
B - Stagnation of Liver qi impairs the Spleen’s
function of transforming and transporting fluids which form phlegm
and rise with stagnant qi to disturb the Heart;
C - High fever condenses the body fluids into phlegm, in
which case Chinese medicine convention ascribes the disorder to
the Pericardium;
D - Fright generates phlegm, a
concept expounded by Gong Juzhong:
“Phlegm is produced by fright. The
spirit leaves its residence, and
when the residence is empty,
the fluids will form phlegm”.
When phlegm or
phlegm-fire obstruct and agitate the portals of the Heart, the
spirit will be disturbed to varying degrees. There may be
milder symptoms such as agitation, apprehension, propensity
to fright, poor memory, restlessness and being
easily startled, or more severe
symptoms such as mania,
manic raving, epilepsy and what was known as ‘ghost evil’, a
disorder probably attributed to demonic possession.
