This pill, containing only one ingredient which opens the orifices, is suitable for Chest Painful
Obstruction from Phlegm. It is stronger than the previous remedy.
The tongue presentation appropriate to this remedy is a Swollen tongue with a dirty-white-sticky
coating.
Case History 13.2
Chest Painful Obstruction Syndrome: Turbid Phlegm-Female, Age 59
A 59-year-old woman complained of a feeling of oppression and pain in the chest. She had
experienced this since a heart attack 5 years previously. Her blood pressure was raised
(180/100). She also suffered from pain and swelling of her knees, ankles and wrists.
She was quite overweight. Her tongue was very Pale and very Swollen (Plate 13.1(367)). Her
pulse was very Deep and Weak especially on both Rear positions.
Diagnosis The pain and feeling of oppression in the chest are due to a combination
of Phlegm and Cold stagnating in the chest, with predominance of
Phlegm. This woman does not have many symptoms but the feeling of
oppression in the chest, her being overweight and the very Swollen
tongue are sufficient for a diagnosis of obstruction by Phlegm. This
occurs on a background of severe deficiency of Yang of the Spleen and
Kidneys. Again, she does not have many symptoms but the very Pale
tongue and very Deep and Weak pulse on both Rear positions are
definite signs of Kidney-Yang deficiency. We can also deduce
Spleen-Yang deficiency from the presence of Phlegm. Both these
conditions, i.e. Kidney deficiency and Phlegm, are contributory factors
to the development of Painful Obstruction Syndrome from Cold and
Dampness.
Treatment principle This case (like most cases of Chest Painful Obstruction) is characterized
by a combination of Deficiency (of Yang of Spleen and Kidneys) and
Excess (itself a combination of Phlegm and Cold). The correct approach
to treatment is to deal with the Excess condition during the acute or
sub-acute stage and with the Deficiency afterwards. In this case, since
this woman had quite a pronounced and distressing feeling of
oppression and pain in the chest, attention was paid to treating the
Excess condition, i.e. resolve Phlegm and dispel Cold. She was treated
with acupuncture only and for the first 10 (weekly) sessions, the
treatment was aimed at resolving Phlegm and removing obstruction
from the chest.
Acupuncture ST-40 Fenglong, P-6 Neiguan, P-4 Ximen, Ren-17 Shanzhong, BL-14