Phlegm-Damp Issues in Traditional Chinese Medicine

Phlegm-dampness issue

1.
Occasionally, I experience a pinching pain around the right chest area, specifically at the acupoints of Yingtian and Tianxi, as well as at the midpoint of the straight line between Yingtian and Zhongfu.
The pain seems to be located in the muscle layer.
The duration of the pain varies, and even after the pain subsides, there is still a lingering discomfort at the Yingtian acupoint.
2.
At the end of September, after recovering from a stiff neck, I began to experience intermittent numbness along the entire trapezius muscle on the left shoulder, sometimes accompanied by numbness in the shoulder joint.
The symptoms occur without any impairment in movement or grip strength.
3.
For the past two to three years, I have noticed that upon waking, my tongue coating is white and greasy, and my mouth feels sticky (without bad breath).
After a few hours, the tongue coating turns slightly yellow, and this cycle repeats daily.
I have experienced almost all symptoms related to phlegm-dampness and have consulted three traditional Chinese medicine practitioners, taking various herbal remedies, but the issues persist.
The first problem mentioned has only recently started.
I would appreciate your guidance, Dr.
Lu.
Thank you.

Lao Zhang, 50~59 year old female. Ask Date: 2018/12/14

Dr. Lü Bingcheng reply Traditional Chinese Medicine

Dear user, I hope you are well.
Regarding the three issues you raised, my responses are as follows:
1.
Firstly, you mentioned pain at the Yingchuan point and the Tianxi point, as well as discomfort at the midpoint between the Yingchuan and the Danzhong points.
I would initially consider these three pain points, as their anatomical locations are all situated on the pectoralis major muscle.
Clinically, pain arising from injuries to the pectoralis major can lead to meridian stagnation, qi stagnation, and blood stasis.
Please pay attention to whether you experience accompanying symptoms such as chest tightness, cough, rib pain, or belching.
Additionally, soft tissue injuries around the neck, shoulder blades, and upper back may also contribute to the anterior chest pain due to fascial connections.
Furthermore, issues with related organs can affect the normal functioning of their corresponding meridians, leading to the aforementioned pain symptoms, such as dysfunction of the heart, lungs, and spleen-stomach.
2.
Over the past 2-3 months, you have experienced occasional numbness in the upper trapezius of the left shoulder, sometimes extending to the shoulder joint, but it does not affect your movements or grip strength.
I personally recommend consulting a qualified professional, either a traditional Chinese medicine practitioner or a Western physician, to clarify any concerns regarding cervical or thoracic vertebral misalignment, soft tissue inflammation, or nerve root lesions through imaging or physical examination, followed by appropriate symptomatic treatment.
Regardless of the cause of the pain and numbness, during the treatment period, I suggest avoiding heavy lifting and maintaining a single posture for extended periods.
If you begin to feel soreness or numbness, immediately stop the heavy work, take a short break, and change your posture (for example, if you sit at a desk for long periods, stand up and move around to relax for 10-15 minutes).
3.
As for the symptoms of phlegm-damp constitution you have experienced over the past two to three years, it seems that there has been no progress despite treatment from three traditional Chinese medicine practitioners.
I believe that in addition to seeking a suitable professional for treatment, you should maintain a regular lifestyle, avoid staying up late, and refrain from consuming cold fruits, rich foods, and processed sugary items.
It is advisable to eat fruits that have been thawed and are consumed during warmer daytime hours.
Drink warm beverages that are not too hot, and avoid cold drinks.
When cooking, you can add ginger and scallions appropriately.
Besides the aforementioned suggestions, you should also allocate time for outdoor activities, engage in moderate exercise to promote sweating, train your cardiovascular function, and maintain a positive mood and mental stability.
Consistently following these practices can help alleviate your symptoms and improve your phlegm-damp constitution.
These are my personal insights, and I hope they will benefit your health.
Please forgive any oversights in my responses.
Finally, I sincerely wish you a swift recovery and overall well-being! The Chiayi Hospital of the Ministry of Health and Welfare cares for you.

Reply Date: 2018/12/14

More Info

Understanding Phlegm-Damp Issues in Traditional Chinese Medicine (TCM) requires a comprehensive look at the concepts of phlegm and dampness, their manifestations, and their implications for health. In TCM, phlegm and dampness are considered pathological factors that can disrupt the body's balance and lead to various health issues.

1. Phlegm and Dampness Defined: In TCM, phlegm is not merely a physical substance but a pathological condition that arises from an imbalance in the body's fluids. It can manifest as a thick, viscous substance that obstructs the flow of Qi (vital energy) and blood. Dampness, on the other hand, refers to an excess of moisture in the body, which can lead to stagnation and blockages. Both conditions can arise from dietary habits, environmental factors, and underlying health issues.

2. Symptoms and Manifestations: The symptoms you described, such as the pain in the chest area and the white, greasy tongue coating, are indicative of phlegm-damp accumulation. The pain you feel in the chest, particularly in the areas of the Yingxiang (鷹窗) and Tiankui (天溪) acupoints, may suggest that there is a blockage in the flow of Qi and blood, possibly due to phlegm-damp accumulation. The lingering pain after the initial discomfort could indicate that the underlying issue has not been fully resolved.

3. Shoulder and Muscle Symptoms: The tingling sensation in your trapezius muscle following a neck strain (落枕) could also be related to phlegm-damp. In TCM, the muscles and tendons are nourished by Qi and blood. If phlegm-damp obstructs these pathways, it can lead to sensations of numbness or tingling. The fact that your symptoms do not impede movement or grip strength suggests that the underlying issue may be more related to energy stagnation rather than a structural problem.

4. Tongue Coating and Digestive Health: The observation of a white, greasy tongue coating that turns slightly yellow after a few hours is a classic sign of dampness in TCM. This can be associated with digestive issues, as dampness often arises from improper diet, such as excessive consumption of greasy or sweet foods. The cyclical nature of your symptoms indicates that the root cause may not have been adequately addressed, leading to a persistent state of imbalance.

5. Treatment Approaches: Given your symptoms, a TCM practitioner may recommend herbal formulas specifically designed to resolve phlegm and dampness. Commonly used herbs include Ban Xia (Pinellia), Chen Pi (tangerine peel), and Fu Ling (Poria), which help to transform phlegm and strengthen the spleen, the organ responsible for fluid metabolism in TCM. Acupuncture may also be beneficial in alleviating pain and restoring the flow of Qi.

6. Lifestyle and Dietary Recommendations: To support your treatment, consider making dietary adjustments to reduce dampness. This includes avoiding cold, raw, and greasy foods, and incorporating warming, easily digestible foods like ginger, garlic, and whole grains. Staying hydrated with warm fluids can also help in maintaining a balanced internal environment.

7. Consultation with TCM Practitioners: Since you have already consulted multiple TCM practitioners, it may be beneficial to revisit one of them with a focus on phlegm-damp issues. Ensure that they are aware of all your symptoms, including the recent developments in your shoulder and chest pain, as well as your tongue condition.

In summary, phlegm-damp issues in TCM can manifest in various ways, including pain, tingling sensations, and digestive disturbances. Addressing these issues holistically through herbal medicine, acupuncture, and dietary changes can help restore balance and alleviate your symptoms. Regular follow-ups with your TCM practitioner will be essential in monitoring your progress and making necessary adjustments to your treatment plan.

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