Diagnosis This is a clear case of retention of Phlegm-Heat with a background of
Spleen deficiency. The symptoms of Phlegm-Heat are: expectoration of
sticky-yellow phlegm, nasal discharge, feeling of oppression of the
chest, nausea, overweight body, Swollen tongue and Slippery pulse.
Although this is Phlegm-Heat because the mucus is yellow, the Heat is
only slight and the predominant aspect is the Phlegm rather than Heat.
There is also a slight, secondary Kidney-Yang deficiency as shown by
the slight deafness and pale urine.A third pathological condition is the retention of Phlegm-Heat in the
Stomach as shown by the acid regurgitation, bad digestion and Stomach
crack with rough, yellow coating inside it. The presence of Phlegm-Heat
induced Stomach-Qi to rebel upwards causing frequent hiccups. The
rebelling upwards of Stomach-Qi contributed to the asthma.The fact that her asthma started after stopping smoking is puzzling but
interesting. One possible explanation could be that the conditions to
cause asthma were already present but tobacco, which has a hot and
drying energy, constantly dried up Phlegm, thus delaying the onset of
the disease. A sudden cessation of smoking means that the drying action
of tobacco is abruptly withdrawn and Phlegm therefore overflows
profusely.Treatment principle Since this is a chronic condition the treatment principle is to treat Root
and Manifestation simultaneously, i.e. tonify the body's Qi and expel
pathogenic factors. Treating the Root involves primarily tonifying
Spleen-Qi and secondarily tonifying Kidney-Yang. Treating the
Manifestation involves resolving Phlegm from the Lungs, restoring the
descending of Lung-Qi, resolving Phlegm-Heat from the Stomach and
subduing rebellious Stomach-Qi.
Treatment This patient was treated with both acupuncture and herbs. The
acupuncture treatment was focused on tonifying the Spleen, restoring
the descending of Lung-Qi and subduing Stomach-Qi.
The main points used at various times were:SP-4 Gongsun on the right and P-6 Neiguan on the left, to open the
Penetrating Vessel and subdue rebellious Stomach-Qi. The Lung and
Stomach channels are closely connected and Qi rebelling upwards in
one channel easily affects the other. It was therefore important in this
case to subdue Stomach-Qi as well as stimulate the descending of
Lung-Qi. The Penetrating Vessel is excellent to subdue rebellious
Stomach-Qi, especially in overweight people.