When phlegm accumulates pathologically in the body, severe cases may manifest as sudden fainting spells. Patients collapse without warning, and improper (used in traditional contexts) can lead to fatality, making this a critical condition. The root cause is often qi stagnation (stagnation of vital energy), which allows phlegm to congest the stomach region, impairing consciousness. Traditional emergency (used in traditional contexts) employs San Sheng Yin (Three Raw Herbs Decoction) to induce vomiting and rapidly clear phlegm from the stomach. However, if phlegm obstructs the lung airways (rather than the stomach), the situation becomes dire. Such patients remain conscious but experience labored breathing (exhalation without inhalation), arching of the back, and an inability to swallow—attempting to swallow triggers violent coughing and wheezing.
Case Study: Merchant An Rong
An Rong, a respected cloth merchant from Shanxi, suffered a series of tragedies during the summer of the Xinyou year (a Chinese calendar designation):
- His one-year-old second son died.
- His third daughter succumbed to illness at home.
- Within a month, his second daughter’s husband and grandson passed away on the same day.
Family members exploited the chaos to seize his second daughter’s inheritance, neglecting the deceased. After An Rong intervened to resolve the dispute, the cumulative grief and anger triggered chest distension and diarrhea. During my examination:
- Pulse diagnosis: Wiry and sluggish pulse.
- Diagnosis: Qi stagnation with dampness accumulation.
- Prescription: Xiang Sha Wei Ling Wan (Aucklandia and Amomum Stomach-Calming Pill).
An Rong discontinued (used in traditional contexts) due to frugality. Ten days later, his condition deteriorated:
- Symptoms: Gasping breaths, inability to swallow saliva, icy limbs.
- Pulse diagnosis: Slippery and rapid pulse at the cun position (wrist pulse).
- Diagnosis: Phlegm obstructing the lung airways.
With conventional treatments ineffective, I reluctantly prescribed Mu Xiang Shun Qi Yin (Costus Root Qi-Regulating Decoction) to alleviate symptoms and advised his associates to prepare for his passing. By dawn, An Rong could no longer speak, gasping with his mouth agape. His cousin summoned me again, but the case was beyond remedy. The family then conducted a spirit-writing ritual (fuji), obtaining a formula that briefly restored his speech. An Rong summoned his family to settle his affairs before passing away.
Key Terms:
- San Sheng Yin: Traditional formula using raw Aconite (fuzi), Arisaema (tiannanxing), and Aucklandia (muxiang) to purge phlegm.
- Xiang Sha Wei Ling Wan: Pill combining Aucklandia (muxiang), Amomum (sharen), Poria (fuling), and Atractylodes (baizhu) to regulate qi and resolve dampness.
- Mu Xiang Shun Qi Yin: Decoction featuring Costus Root (muxiang), Perilla Leaf (zisu), and Citrus Peel (chenpi) to promote qi circulation.
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