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Phlegm-fire harassing the spirit
痰火扰神 〔痰火擾神〕tán huǒ rǎo shén
Also phlegm-fire harassing the heart (痰火扰心 tán huǒ rǎo xīn).
A disease pattern chiefly characterized by manic agitation or clouded spirit; phlegm-heat signs.
Description: Spirit-mind disturbances; heat signs; red tongue with slimy fur; a pulse that is slippery and rapid. This pattern takes two different forms:
- External contraction: Externally contracted heat stirring phlegm gives rise to heat effusion; rough breathing; red face and eyes; constipation; yellow urine; manic agitation and delirious speech; oppression in the chest; phlegm rale in the throat.
- Internal damage: Heart vexation; insomnia; manic derangement of spirit-mind with abnormal behavior (beating people and smashing objects, talking nonsense, and abnormal crying and laughing, regardless of who is present); physical strength; red tongue with slimy fur; slippery rapid pulse.
Pathogenesis: Phlegm-fire confounding the orifices of the heart as a result of either external contraction or internal damage.
- externally contracted heat evil condensing the fluids into phlegm;
- excesses among the seven affects, causing qì depression that transforms into fire and then scorches liquid into phlegm.
Analysis of signs
- Evil qì harassing the spirit: Disquieted spirit and disturbances of spirit-mind.
- Phlegm: Oppression in the chest, rough breathing, thick yellow phlegm, and phlegm rale in the throat.
- Fire-heat: Heat effusion, red face and eyes, constipation, and dark-yellow urine.
- Tongue: Red with slimy yellow fur. A red tongue indicates heat, while a slimy fur indicates phlegm.
- Pulse: Slippery and rapid.
Disease-specific signs
- External contraction: Heat signs, such as high fever, are pronounced. Spirit-mind signs take the form of manic agitation.
- Internal damage: Disturbances of spirit-mind are more pronounced than heat signs. Mild cases manifest in heart vexation and insomnia. Severe cases manifest in manic derangement of spirit-mind with abnormal behavior.
| Comparison Between Phlegm Clouding the Heart Spirit and Phlegm-Fire Harassing the Spirit | ||
|---|---|---|
| Hyperactive Heart Fire | Phlegm-Fire Harassing the Spirit | |
| Common Signs | Manic agitation, delirious speech, and clouded spirit | |
| Differences | Vomiting of blood or nosebleed | Oppression in the chest, rough breathing, thick yellow phlegm, and phlegm rale in the throat. |
| Tongue | Red or crimson, esp. at the tip, with yellow tongue fur; mouth and tongue sores | Red with slimy yellow fur |
| Pulse | Rapid and forceful | Slippery and rapid |
Diseases: Mania and withdrawal; insomnia; wind stroke.
Treatment
Medicinal therapy: Clear the heart and drain fire; sweep phlegm and open the orifices. Use
Acumoxatherapy: Base treatment mainly on HT, PC, ST, and GV. Select
Comparisons: Abnormalities of the spirit occur in three heart patterns, but in different ways and with different accompanying signs.
- Hyperactive heart fire harassing the heart spirit manifests in manic agitation, delirious speech, and clouded spirit. This has heat signs without phlegm signs.
- Phlegm clouding the heart spirit manifests in clouding collapse, withdrawal, feeblemindedness, or deranged spirit. This has phlegm signs without heat signs.
- Phlegm-fire harassing the spirit manifests in both fire-heat and phlegm signs. See table.
Clinical sketch: A 25-year-old male has suffered from abnormality of essence-spirit for two years, experiencing episodes of abnormal joy and anger. He is often very jolly, singing while going about his business, chatting and laughing with everyone, and frequently making obscene jokes with young women. However, he is sloppy in his work, and this has caused problems with his coworkers. When they criticize him, he beats and curses people, regardless of who is present. He suffers from insomnia and has an abnormally large appetite. His tongue is red, with prickles at the tip and fissures. The tongue fur is white. His pulse is stringlike and rapid. He is diagnosed as suffering from mania attributable to liver depression transforming into fire giving rise to phlegm-fire that harasses the heart spirit.