Phlegm always shows with a Swollen tongue body, a sticky coating and a Slippery pulse.
Phlegm-Fire
Phlegm-Fire obstructs the Mind but it also agitates it. It therefore makes the person agitated,
restless and anxious. In some cases, the person may alternate between periods of depression and
confusion (due to Phlegm) and periods of abnormal elation, agitation and manic behaviour (due
to Fire). In severe cases this leads to manic-depression. Chinese books always describe this
condition as alternation of periods of severe depression (the depressive phase called Dian) and
periods of manic behaviour (the manic phase called Kuang). The manic phase is usually
described as shouting, scolding or hitting people, climbing mountains, taking off clothes, crying
or laughing uncontrollably. It is important to realize that, in practice, much milder versions of
this condition appear fairly frequently and one should not always expect such violent
symptomatology in order to diagnose this condition.
Phlegm-Fire manifests with a Slippery and Rapid pulse and a Red-Swollen tongue with a sticky
yellow coating and a Heart-crack in the midline.
Empty-Heat
Empty-Heat agitates the Mind and causes severe anxiety, insomnia, agitation, mental
restlessness and fidgetiness. This is sometimes called the rising of Minister-Fire, i.e. Empty-Fire
arising from the Kidneys and disturbing the Pericardium and the Mind. It is frequently caused by
excess joy, craving, jealousy and excessive love (in the sense outlined before).
It manifests with a Floating-Empty or Fine-Rapid pulse and a Red tongue without coating,
possibly with a Heart crack in the midline and a redder tip.
Internal Wind
Internal Wind agitates the Mind and causes nervous tics and tremors.
Thus, the mental effects of emotions and other pathogenic factors may be summarized in three
broad types:
- Mind obstructed, characterized by confused thinking, clouding of the Mind and, in severe
cases, complete loss of insight - Mind unsettled, characterized by agitation, restlessness and anxiety