Phlegm-Fire Harassing the Heart

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The following is taken from The Foundation of by Giovanni

Maciocia, pp. 209-210. Due to the seriousness of this condition, I am

quoting quite a bit.

 

" Clinical manifestations

 

" Mental restlessness, palpitations, bitter taste, insomnia, dream disturbed

sleep, propensity to be startled, incoherent speech, mental confusion, rash

behaviour, tendency to hit or scold people, uncrontrolled laughter or cry,

agitation, shouting, muttering to oneself, mental depression and dullness;

in severe cases aphasia and coma.

 

" Tongue: Red, yellow-sticky coating, midline crack with yellow prickles in

it. The tip may be redder and swollen with red points.

 

" Pulse: Full-Rapid-Slippery or Rapid-Overflowing-Slippery or

Rapid-Full-Wiry.

 

" Key symptoms: all the variour mental symptoms and the Red tongue with

sticky-yellow coating.

 

" Pathology

 

" This is an Excess pattern characterized by the presence of Fire and Phlegm

obstruction the Heart. All the mental symptoms are due to Phlegm

obstructing the Heart orifices and disturbing the Mind. Although the main

manifestations derive from dysfunction of the Heart, this pattern is also

characterized by deficient Spleen-Qi being unable to transform and transport

fluids which accumulate into Phlegm. The interior Heat facilitates this

process by condensing the fluids into Phlegm. There are actually two

separate aspects to this pattern which may appear separately or alternately

(as in manic-depression):

 

" 1). Mental depression and dullness, muttering to oneself: this is called

DIAN in Chinese, meaning 'insanity'

 

" 2) Uncontrolled laughter or cry, shouting, violent behaviour, hitting or

scolding people, incoherent speech: this is called KUANG in Chinese, meaning

'violent behaviour'

 

Both these patterns are of the Excess type and are caused by Phlegm and Fire

obstructing the Heart and mind. It is important not to be misled by the Yin

nature of the symptoms in the DIAN type and think that it is a Deficiency

pattern requiring tonification.

 

" The obstruction of the Heart orifices can, in extreme cases blur the Mind

entirely and lead to aphasia and coma. In Chinese medical terminology this

is described as 'Phlegm obstructing the Heart orifices'. This coma is of

the Excess type (contrary to that from Heart-Yang Collapse) as is caused by

obstruction by Phlegm.

 

" The yellow-sticky coating on the tongue reflects the presence of Phlegm and

the Red body colour reflects the presence of Heat. The yellow prickles

inside the midline crack also indicate the presence of Phlegm in the Heart.

 

" The Slippery quality of the Pulse indicates Phlegm.

 

" Aetiology

 

" 1) Severe emotional problems and depression leading to stagnation of Qi

which, over a long period of time, turns to Fire.

 

" 2) Excessive consumption of hot-greasy foods creates Heat and Phlegm.

 

" 3) This pattern can also appear during fevers from exterior Heat invading

the Pericardium. In this case there would not be all the mental symptoms,

but only mental confusion and unconscioursness. Exterior Heat can also be a

contributing factor to the formation of Interior Phlegm-Fire.

 

" Treatment

 

" Principle of treatment: clear Heart-Fire, resolve Phlegm, pacify the Mind.

 

" Points: Jianshi P-5, Shenmen HE-7, Shaofu HE-8, Shaochong HE-9, Daling P-7,

Jiuwei Ren-15, Xinshu BL-15, Zhongwan Ren-12, Fenglong ST-40, Sanyingiao

SP-6, Taichong LIV-3, Xingjian LIV-2, Pishu BL-20, Benshen GB-13, Toulinqi

GB-15, Shenting Du-24. " (For those new to TCM, this is what the

abbreviations stand for: P = Pericardium, HE = Heart, BL = Bladder, ST =

Stomach, SP = Spleen, LIV = Liver, and GB = Gallbladder. Ren is the

Conception Vessel which runs up the middle of the front of the body, and Du

is the Governor Vessel which runs up the middle of the back of the body.

 

" Method: all with reducing method, except Ren-12 and BL-20 which should be

reinforced. No moxa.

 

" Explanation

 

" P-5 resolves Phlegm from the Heart and clears orifices.

 

" HE-7 clears Heat and pacifies the Mind.

 

" HE-8 and HE-9 clear Heart=Fire and restore consciousness.

 

" P-7 pacifies the Mind and clears Heart-Fire.

 

" Ren-15 pacifies the Mind.

 

" BL-15 clears Heart-Fire.

 

" Ren-12 tonifies the Spleen to resolve Phlegm.

 

" ST-40 resolves Phlegm.

 

" SP-6 resolves Phlegm and pacifies the Mind.

 

" LIV-3 pacifies the Mind and subdues Fire (it brings Fire down, away from

the top part of the body).

 

" LIV-2 subdues Fire (the same way as LIV-3).

 

" Du-20 restores consciousness in the case of coma.

 

" GB-13 and Du-24 pacify the Mind.

 

" GB-15 pacifies the Mind and balances the mental state (when it oscillates

between mania and depression). "

 

In addition there are various herbs which may be helpful, such as herbs to

Resolve Phlegm. In a case like this I definitely would be researching for

acupuncture and herbs.

 

Maciocia has a section on his website where readers can ask him questions.

Just do a search for Maciocia.

 

Victoria

 

 

 

 

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