Phelgm Misting The Mind

Phelgm Misting The Mind-Collaged By LoLo Schaffer on Canva

PHELGM MISTING THE MIND

The Heart, in Traditional Chinese Medicine (TCM), governs the Blood, controls the Blood Vessels, and houses the Shen (mind), (Maciocia, 2015, p. 107), while the Small Intestine controls Receiving and Transforming, as well as Separates the Fluids (Maciocia, 2015, p. 201). One of the other aspects of the Small Intestine that pairs with the Heart is its effects on the mental aspect and dreams (Maciocia, 2015, p. 201), which correlates to the Heart because of its role in housing the mind. According to Maciocia (2015), the link between the Heart and Small Intestine is described to be found not so much in the body but more in the psychological aspects, where the “Heart houses the mind (Shen) and governs our mental and emotional life as a whole. Our mental activities all rely on our capacity for clear judgment and decisions, which are dependent on the Small Intestine. Conversely, the capacity of clear judgment must rely on our mental capacity and clarity as a whole, which is dependent on the Heart” (p203).

While the Heart and Small Intestine can be observed more in the role of psychological aspects, Maciocia (2015) points out that “it can sometimes be observed in certain pathological situations when Heart-Fire can be transmitted to the Small Intestine, with such manifestations as thirst, bitter taste, tongue ulcers, and blood in urine” (p203). The Heart and Small Intestine channels have synergistic interaction, which may not be a direct influence, such as other channels paired internally/externally with one another; they do affect one another in a way that influences the body enough to create harmony, or adversely when not in balance, disharmony.

I recently stumbled upon an essay written by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon, in a paper titled What is Phlegm-Mist Affecting the Orifices of the Heart? An Examination of a TCM Perspective on Causes of Stroke. In this paper, I could see the connection between the Heart and Small Intestine. The Small Intestine in TCM is a fu organ that separates the clear from the turbid, and in Western this organ is associated with the function of breaking down food for absorption. When this is disturbed with something such as phlegm, the disharmony connects with the Heart and then continues to affect other organs.

“Phlegm mist is a concept that can be traced back at least to the Song Dynasty. By that time, Chinese doctors were distinguishing "substantial" phlegm (such as sputum, which is described as "condensed pathological fluid") and "insubstantial phlegm" or "hidden phlegm" (such as the mist of the heart orifices; a "thin pathological fluid"). The substantial phlegm would mainly accumulate in the Lungs and Stomach, while the insubstantial phlegm would accumulate in the meridians, distributing to various parts of the body, such as the heart orifices and the brain (e.g., causing dizziness or loss of consciousness), the lymph nodes (causing nodules and swellings), and the limbs (e.g., causing numbness). The two types of phlegm were thought to have the same origin and the same fundamental nature, but would permeate different parts of 2 the body (the thick sputum could not penetrate the meridians, but the insubstantial phlegm could). Further, insubstantial phlegm could combine with other pathological influences to yield phlegm-fire, wind-phlegm, and phlegm-turbidity. According to the doctrine that evolved, the phlegm mist could cause the other pathological factors, such as fire, wind, or damp, to produce more severe symptoms. Further, its material nature would capture the more ethereal forces of fire or wind to make the disease persist; similarly, the phlegm-mist could blend with damp to yield turbidity that obscures the clear flow of qi and yang to the brain, interfering with normal mental and sensory functions, though not completely blocking the circulation to the brain. Diseases and symptoms attributed to phlegm mist affecting the heart orifices include dizziness, loss of consciousness (coma), hemiplegia (stroke), mania (emotional outbursts, disturbed speech), convulsions (especially epilepsy), sudden sensory loss (deafness, blurred vision, loss of taste and smell, inability to speak), lockjaw, and stiff tongue. Diseases currently treated in China by herbs that resolve phlegm-mist affecting the heart orifices, also include manic-depressive disorder and senile dementia (Alzheimer's disease).

It is tempting to try to correlate the traditional Chinese concept of phlegm-mist with a substance or condition defined by modern medicine so that the Chinese diagnostic category could be explained in terms of our current knowledge of physiology. Attempts to find correlations between modern medical knowledge and other traditional Chinese concepts, such as qi, blood, and even the organ functions, are often unsatisfactory. However, we may be able to link some of the TCM concepts to modern interpretations. Thus, for example, the condition of atherosclerosis, where plaques that include fatty materials (e.g., cholesterol and lipoproteins) coat the arteries, might be one case of phlegm-mist affecting the orifices; certainly, stroke is frequently associated with this type of blockage of the carotid arteries. The accumulation of amyloid plaques in the brain of persons with Alzheimer's disease might also correspond, to some extent, to phlegm mist. Disorders of the thick fluid in the eardrum, which might be depicted as a phlegm-type disorder (e.g., phlegm-turbidity), can yield dizziness. The formation of blood clots in the arteries or veins, while seeming to fit the category of blood stasis, may be an example of phlegm accumulation, in the sense that phlegm is a sticky substance, and the clot forms by the coagulation of various blood components (such as fibrin and platelets) into a spongy mass. By contrast, extensive bruising, where clotted blood resides outside the vessels and forms a firm mass, more clearly fits the blood stasis description.

The ancient doctors saw phlegm-mist primarily involved with sudden and dramatic change: the person would faint, go into a convulsion, or suddenly erupt with crazy behavior. For example, as described in the Advanced Textbook of Traditional Chinese Medicine and Pharmacology: "voracious eating, overdrinking alcohol, and emotional irritation combine to cause food retention in the stomach, which causes stomach qi to disturb upward, blocking the clear cavity and thus resulting in loss of consciousness." The idea was that a substantial amount of phlegm would suddenly rush to the heart. Then, when the phlegm blockage cleared, the person would return to normal, though in some cases, there could be persisting symptoms (e.g., hemiplegia). The condition being described parallels what happens when a blood clot forms in the arteries supplying the heart or brain, causing the person to collapse. If the clot clears out quickly enough (spontaneously or with medical intervention), the person recovers; if not, there may be persisting symptoms or the person may die. This connection between the traditional concept of phlegm blockage and the modern understanding of formation of obstructive blood clots in the vessels is well illustrated in the presentation by Wang Yongyan and his colleagues describing their work with stroke patients, presented at a 1987 TCM conference in Shanghai. They differentiated the disease conditions of 158 patients who suffered from "upward disturbances of wind-phlegm and accumulation of phlegm-heat." Using the TCM criteria, they divided these cases into: 120 of "channel stroke" (phlegm blocking the heart orifices); 32 cases of fu-organ stroke (e.g., phlegm originating from the stomach or gallbladder); and 6 cases of zang-organ stroke (e.g., phlegm blocking the heart). Turning to Western medical diagnosis for these same patients yielded: 145 cases of thrombosis of the carotid artery system; 8 cases of thrombosis of the vertebro-basilar system; and 5 cases of embolism. The treatment administered to the patients was based on expelling phlegm and purging the intestines, using a formula that included bile-treated arisaema, rhubarb, and trichosanthes seed (which has a laxative effect due to the thick seed oils; this herb also phlegm-resolving). After a few days of this purging therapy (generally less than two weeks), the focus of treatment shifted to "clearing heat, expelling phlegm, vitalizing blood, and invigorating the channels." Liquid bamboo sap (zhuli) was used as an essential ingredient in most of the cases.” 1

Thus, the separation of turbidity, the clear from the unclear, that the Small Intestine offers, is highly influential in how the Heart functions. I see both the influences of herbs and acupuncture in helping this condition because with the Heart and Small Intestine being both elements of Fire, points and herbs to help reduce heat symptoms and expel the phlegm, which will help restore the balance within the body and clear the flow between the Heart and Small Intestine, thus restoring homeostasis.

References 1. Dharmananda, S. (n.d.). What is Phlegm-Mist Affecting the Orifices of the Heart? Institute for Traditional Medicine. Retrieved February 14, 2024, from http://www.itmonline.org/arts/phlegmmist.htm