Academic Origins And Governance. Zhongjing The Discourse Tanyin Disease Is Discussed

The first mention on phlegm retention is under the chapter of treatments for phlegm retention and cough syndromes from pulse diagnosis in the Synopsis of Golden Chamber. More specific discussions on the types of phlegm retention and its symptoms, causes, patient pulse and treatments can be found in 33 places within the chapter. Zhongjing used phlegm retention, pleural fluid retention, subcutaneous fluid retention and thoracic fluid retention to classify fluid-retention syndromes with theories on lodged rheum and deep-lying rheum to provide a detailed illustration on the cause, mechanism, name classification, treatment and prescription of fluid-retention syndrome, setting a good foundation for the development of fluid-retention theoryThe use of "mild drugs in neutralizing phlegm retention symptoms" was regarded as the foundation of phlegm/fluid retention treatment. For generations there are many academic debates amongst medical practitioners on the treatment of phlegm/fluid retention and most medical practitioners believe that such method is only applicable in water-retention or cold-phlegm. This paper will discuss the content of Zhongjing's treatment principles on phlegm/fluid retention in two major aspects of "mild drugs" and "neutralization" as well as the scope of its application. In summary, to "neutralize symptoms of phlegm retention with mild drugs" is a general guideline in the treatment of phlegm retention and not a treatment method. It can be applied in fluid retention as well as phlegm retention except for patients with yin deficiency and yang hyperactivity due to the nature of their "overheated" symptoms.This paper will also investigate on the cause and mechanism of phlegm retention as well as discuss on whether the formation of phlegm retention can affect the running of qi mentioned in the "Treatise on Exogenous Febrile Disease" and "Synopsis of Golden Chamber" from aspects of "opening-closing-pivoting of the 6 Meridians", " purity of the 5 major internal organs", "qi mechanism of the three warmers", "yin-yang balance" and "factors on physical constitution". Furthermore, this paper also probes into the pattern of Zhongjing's prescriptions on the treatment of phlegm retention in attempt to understand the true meaning of phlegm retention treatment. From "Treatise on Exogenous Febrile Disease" and "Synopsis of Golden Chamber", Zhongjing also used herbs of cold and cool nature to treat patients with phlegm retentions, but still aimed at reducing the yin-qi and strengthening the yang-qi. Therefore, for phlegm treatment, Zhongjing mentioned to treat patients by "neutralizing symptoms with mild drugs" instead of "treating symptoms with mild drugs".Lastly, this paper will discuss principles and guidelines of phlegm treatment used by past medical practitioners and analyze academic sources containing conversations with Zhongjing on phlegm/fluid retention from aspects of treatment thinking and the pattern of prescriptions in attempt to understand the realization of Zhongjing's ideas in phlegm treatment and its relative alterations by medical practitioners of the later generation. After compilation, little difference is found on using mild drugs in the treatment of phlegm/fluid retention with some discrepancies in areas of mild drug application. However, Zhongjing's concept on the "neutralization" and "smooth-running qi" of phlegm retention was a unanimous agreed by all later generation medical practitioners.