Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)
01 Phlegm, Saliva, and Fluid Retention Are Different 痰涎飮三者不同 담, 연, 음 3가지는 같지 않다
Phlegm is another name for body fluid. People depend on this to grow well. It is called phlegm, saliva, or fluid retention. The origin is one but it manifests itself in different forms. Phlegm hides inside collaterals of the uterus and moves up along with qi and enters the lungs and is blocked in the lungs and then moves when a person coughs. Saliva assembles in the root of the spleen and overflows along with qi and flow along with the mouth. Fluid retention originates from the stomach and causes nausea and vomiting. One must know that fluid retention happens to patients with stomach problems.
02 Phlegm and Fluid Retention Are Divided into Clear and Turbid 痰飮分淸濁 담과 음은 청, 탁으로 나뉜다
① When body fluid receives heat, it becomes phlegm. Because heat steams body fluid to turbidity and stickiness, it is called phlegm.
② Water and fluid retention have the same origin but different names. When the spleen Earth becomes weak, drunken fluid cannot be transformed properly. Therefore, it can be congested in the pit of the stomach, in the sides, enter meridians, or overflows in the bladder. People get sick frequently because of this.
③ Fluid retention is originated from congestion of drunken water. Phlegm disease is originated from the steaming of Fire. Therefore, phlegm is sticky and turbid while fluid retention is clear. In the classics, phlegm was called fluid retention; whereas nowadays, people call it phlegm. However, both are the same.
03 Wang Yinjun’s Theory about Phlegm 王隱君痰論 왕은군의 담에 관한 이론
① The theory about phlegm has not been elaborated previously. In classical text, phlegm is categorized as pleural effusion, persistently excessive fluid, the rentention of fluid in the lungs and chest and phlegm. However, the origin of this disease is not yet discovered. The symptoms include head wind, dizziness, tinnitus, and reduced eyesight. The person might have a wriggling
sensation in the mouth and eyes. The eyebrows and auricles of the ears might have an itchy sensation. Wind moves through the arms and legs, and makes them hard and swollen. The person might feel pain. The person might feel pain or itchiness in the cheeks and teeth. The patient’s gingiva might swell and have intermittent pain and itchiness. Belching, indeterminate gnawing hunger, acid regurgitation, hiccuping, and nausea may occur.
Sometimes, the throat is blocked, but it will not be cleared by expectoration or swallowing. The color is like soot. The shape resembles an old cotton or resin of a peach tree or the flesh of a clam. Sometimes, the person feels as if ice is placed in the pit of the stomach. This causes coldness and pain in the chest. The person might dream about strange ghosts. There might be a
cold sensation and flaccidity in the ankles. There might be sudden pain in the back and waist. There might be a fever or pain in the articulations of the four limbs, but the pain is not regular. Furthermore, the hands might be paralyzed and the arms are painful as if they are sprained. The person might feel coldness and pain everywhere because the person feels as if there is a hand-sized piece of ice on the back. The person might feel as if worms move all around the body. The eyes might have an itchy or uncomfortable sensation. The mouth and tongue might be festered, and if this becomes worse, the throat might be blocked. There might be lumps around neck. This may resemble scrofula, but in fact, it is not.
Sometimes the person feels as if two different qi meet between the stomach and the chest. The person might feel a choking sensation because the person feels as if smoke is going upstream. The face and head become hot. The person might be out of mind or suffer from mania-withdrawal. Sometimes the person is paralyzed on one side of the body due to wind stroke. The person might have phthisis for a long time. Sometimes the person will have signs of arthralgia due to wind or flaccidity of the lower limbs. The pit of the stomach might be throbbing. The heart might be throbbing for fear that other people will come to catch him or her. The person might be out of breath or cough and vomit. Sometimes the person vomits bluish water or black juice or cold saliva. If it becomes worse, it becomes pulmonary carbuncle or watery feces due to deposited poison in the intestines or limps due to convulsions in the legs. These various diseases come from phlegm.
When fluid and humor are accumulated, they become phlegm and fluid retention. When it moves to the upper energizer, the throat and mouth become dry. When it flows down, feces and urine will be blocked and the face becomes like a dry bone and the hair becomes dry. If the person is a woman, she will not experience menstruation. If the person is a child, it becomes a convulsive disease and the child may experience fright and seizures. First, remove phlegm and then observe the excesses or deficiencies and then regulate. Therefore, prepare an Aquilaria Pill to Rid Phlegm (the formula is introduced later) and treat phlegm in the triple energizer.
② Liu Zonghou (劉宗厚) says, “Zhongjing talked about the four fluid retentions and six patterns and syndromes about phlegm diseases, and Chen Yan described three main causes of phlegm diseases. These all have validity. However, only Wang Yinjun (王隱君) said, “All diseases are caused by phlegm.” He discovered what ancestors did not know. He knew about phlegm deeply and the profound meaning of it. Also, he made the Rid Phlegm Pill, Powder for Dispersing Phlegm, and treated various diseases. This is a simple method. However, it is less elaborate than treating phlegm by the sweating method, purgation, warming method, and inducing diarrhea as Zhongjing (仲景), Treatise on and Formulas for the Three Categories of Pathogenic Factors (三因方) did by classifying interior, exterior, and inside and outside. Furthermore, phlegm diseases have cold-heat and excess-deficiency.”
04 Eight Kinds of Fluid Retention Diseases 飮病有八 8가지 음병
There are eight kinds of fluid retention diseases. They are persistently excessive fluid, pleural effusion, phlegm-retention syndrome, reoccuring retention of fluid, the rentention of fluid in the lungs and chest, fluid retention in the hypochondrium, anasarca, and general edema. They result from exposure to cold after drinking or excessive water intake.
04-1 Persistently Excessive Fluid 留飮유음
① If there is persistently excessive fluid in the chest, the person will be thirsty and short of breath. Also, articulations of the four limbs will be painful, and the pulse will be sunken and fine.
② Persistently excessive fluid is formed when water qi stays in the pit of the stomach and renders hand-size portions of the back of the person cold. Sometimes the person is thirsty or short of breath, and articulations of the four limbs are painful. Also, the person might experience a painful pulling sensation from the side of the body to the supraclavicular fossa with a worsening cough.
③ Symptoms of persistently excessive fluid are: articulations of the four limbs are painful, the person is short of breath, and the pulse is sunken. When the person becomes old, articulations become extraordinary and may lead to epilepsy. Use a modified Guide Out Phlegm Decoction or Chuanxiong and Pinellia Decoction. (Both formulas will come on a later page).
04-2 Wall Fluid 癖飮 벽음
Wall fluid is water aggregation along the ribcage. When it is moving, sound follows. Use a Ten Jujubes Decoction. (The formula is written in the chapter on Cold.) Or a Triple Transformation Spiritual Blessing Pill. (The formula is written in a later chapter)
04-3 Phlegm-retention Syndrome 痰飮 담음
① When a fat person becomes thin, and water qi flows into the intestines and makes growling sounds, it is the phlegm-retention syndrome. A Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction should be prescribed. When the phlegm-retention syndrome is located in the pit of the stomach, the chest and the side of the body will be painful, and the eyes will be
dizzy.[P30] ② The phlegm-retention syndrome changes a fat person thin and vice versa by accumulated water qi in the intestine, making growling sounds. Prescribe a Spiritual Atractylodes Pill.
- Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction 苓桂朮甘湯 영계출감탕: It treats the phlegm-retention syndrome. Cut 2 don (錢) of Poria Sclerotium (赤茯苓), 1.5 don of Cinnamomi Cortex (桂枝) and Atractylodis Rhizoma Alba (白朮)each and 1 don of Glycyrrhizae Radix (甘草) to make 1 package. Boil these with water and drink.
- Mysterious Effect Atractylodes Pill 神朮丸 신출환: It treats cysts, growling sounds, and acid regurgitation caused by the
phlegm-retention syndrome. Make the clear ointment by mixing 1 geun of Atractylodis Rhizoma (蒼朮) (Soak this in rice water and remove the peel, dry on a fire, and then grind this), 5 don of Sesami Semen Alba (白脂麻) (Grind this with 2 glasses of water to make juice.) And 30 Zizyphi Fructus (大棗) (Boil this, remove the peel and seeds, and take the flesh to powder it) with sesame juice. Mix this ointment with powdered Atractylodis Rhizoma (蒼朮) and grind this with a mortar. Make pill to the size of the seed of the royal foxglove tree. Take 100 ~ 200 pills before breakfast everyday. The chest - Gardenia Powder 山梔子散 산치자산: Dry a branch of Gardeniae Fructus (梔子) and grind this. Mix 1 don of this to boiled water.
04-4 Overflowing Fluid 溢飮일음
① Drunken water should flow into the four limbs and sweat must come out. However, if sweat does not come out and the body feels heavy and pain, it is overflowing fluid. A Minor Bluegreen Decoction (the formula is written in the chapter on Cold) is commonly prescribed.
② Overflowing fluid is heaviness and pain in the body due to water qi in the four limbs.
04-5 Suspending Fluid 懸飮 현음
① A painful or pulling sensation when coughing and spitting caused by water qi under the side of the body after drinking water is called suspending fluid. A Ten Jujubes Decoction (the formula is written in the chapter on Cold) is commonly prescribed.
② Suspending fluid is also called flowing fluid. When water qi is located in the side of the body, a growling sound will be heard.
③ Suspending fluid is where water qi under the side of the body causes pain on coughing with thirst. A Triple Transformation
Spiritual Blessing Pill (the formula is written in a later chapter) is prescribed.
04-6 Branching Fluid 支飮 지음
① The person with branch fluid might experience hiccups and lean on the wall to breathe. Also, the person cannot lie down on the ground due to a shortness of breath, and the body of the person might swell. Commonly prescribe a Minor Bluegreen Decoction (The formula is written in the chapter on Cold). Also, when the pulse is rapid, the person will suffer from dizziness. This is because of branch fluid. Treat this with a Poria and Schizandra Decoction.
② The person with branch fluid cannot lie down because of dyspnea. The person’s breath is short but the pulse is regular.
③ Branch fluid is caused by an aggregation of water qi in the chest and diaphragm. The symptoms are the hiccups, leaning to wall to breathe and shortness of breath.
- Poria and Schizandra Decoction 茯苓五味子湯 복령오미자탕: It treats coldness and numbness in the hands and feet, excessive saliva, counterflow of lower abdomen qi to the chest and throat, drunken-like flushing of the face, and dizziness due to branch fluid. Cut 2 don of Poria Sclerotium (赤茯苓), 1.5 don of Cinnamomi Cortex (桂心) and Glycyrrhizae Radix
(甘草) and 1.25 don of Schisandrae Fructus (五味子) to make 1 package. Boil this with water. Branch fluid leads to dizziness and nausea. For chest discomfort from nausea, add Pinelliae Tuber to remove phlegm, and fluid retention. When phlegm and fluid retention is removed, vomiting will stop.
04-7 Hidden Fluid 伏飮 복음
① The person with hidden fluid might experience dyspnea, coughing, vomiting, fever and chills, pain in the back and waist, spontaneous tears and spasms in flesh due to phlegm in the diaphragm and chest.
② Hidden fluid is formed when water qi is aggregated in the chest and diaphragm. The person with this might experience vomiting, dyspnea, coughing, fever, chills, pain in the back and waist, spontaneous tears, or spasms in the body. A Triple Transformation Spiritual Blessing Pill (the formula is mentioned later in the chapter) and Control Saliva Elixir (控涎丹) (the formula is explained later) should be prescribed.
