Alternating dispersal and collection of phlegm and damp

[Guest guest]

The following is taken from Fluid Physiology and Pathology in

Traditional

, Steven Clavey, pp. 173-174, and concerns one of

Clavey's

patients:

 

" My patient was an Australian male, 30 years of age, who had been

noticing over the last few years an unusual cycle of symptoms: for

several weeks he would be happy and energetic, with good urine flow

and a clear tongue coat, but after a period of time he would start to

feel heavy and tired, the urine would become frequent but scanty, the

bowels irregular - either loose or constipated - and he would notice

a 'line of tenderness' which traced exactly the right side Gall

Bladder channel, from Feng Chi (GB-20) to the foot. The most telling

sign was perhaps the tongue coat, which would change from relatively

clear to thick greasy yellow at the root.

 

" It was plain that the condition stemmed from the alternating

dispersal and collection of phlegm and damp, combined with

obstruction of the qi in the Liver and Gall Bladder channels, with

each blockage able to provoke the other. Liver qi stasis failing to

move fluids and failing to support the Spleen could begin the process

of phlegm and damp gathering, which itself could further obstruct qi

flow, initiating a vicious cycle that would culminate in the above

constellation of symptoms. Alternatively, overeating or the wrong

type of foods could begin the process with Spleen damp and phlegm

assembling and then hampering Liver and Gall Bladder qi flow, with

the same result.

 

" The scantiness of the urine was the result of damp and phlegm

preventing normal Urinary Bladder function, while the irregular bowel

functions demonstrated the twin process of the condition: when the qi

flow was obstructed, the peristaltic action of the bowels was

arrhythmic and led to constipation; the build-up of heavy sinking

damp and phlegm, on the other hand, finally resulted in loose stool.

 

" Treatment combined removal of phlegm and damp with support for both

the Spleen and the Liver function, using a combination of Xiang Sha

Liu Jun Zi Tang ('Six Gentlemen Decoction with Aucklandia and

Amomum', Formulas and Strategies, p. 238) and Xiao Yao San ('Rambling

Powder', Formulas and Strategies, p. 147.)

 

I posted this to illustrate how sometimes symptoms will vary. The

previous post to this one was about Phlegm-constipation and how if

the Excess problem (the Phlegm) was the most pressing problem at the

moment, then a good bowel movement would make the person feel much

better. But, if the Phlegm was not so pressing, and the underlying

Spleen Deficiency (which allows the Phlegm to form) was the most

pressing at the time, then the patient would report feeling worse

after a bowel movement.

 

This variation of symptoms can be very confusing to new students of

TCM. What you're looking at are different phases, and you frequently

will see this variation of symptoms in cases of Phlegm.

 

Clavey titled this section " Alternating dispersal and collection of

phlegm and damp. " Unfortunately, he does not tell what was causing

the Phlegm to disperse. Perhaps the original treatment took into

account the Phlegm and dispersed it, but failed to address the dual

problems of Spleen weakness and Liver Qi Stagnation allowing Phlegm

to form. The result of inadequate treatment would be that Phlegm

would be dispersed, but would reform because both the Spleen and the

Liver problems were not adequately addressed. Eventually the Phlegm

would build up to the point where the client would start having

symptoms that could not be ignored.

 

Or, maybe the client found something on his own that was dispersing

Phlegm or correcting another imbalance. This does happen. The

person may not know anything about TCM or any other school of

healing, but learns over time that if s/he eats certain foods or

takes a certain herb or takes a laxative or whatever, s/he feels

better. The problem is, the person may not know how to address the

total problem and all imbalances, having found something that works

just on one imbalance. Because the Roots have not been addressed, the

problem builds up again over time. In this case, there is

alternating dispersal and collection of phlegm and damp. The person

does whatever it is s/he does that causes the dispersal of Phlegm and

lessening of symptoms, but because s/he is not correcting the reason

Phlegm is forming, it keeps forming. Thus, the alternating dispersal

and collection of Phlegm and the variation in symptoms.

 

Victoria