Phlegm syncope

　　Phlegm syncope often occurs on the basis of chronic respiratory diseases such as chronic bronchitis, bronchial asthma, emphysema, pulmonary heart disease, cerebral arteriosclerosis, and coronary heart disease, and is triggered by severe coughing. Patients with cardiovascular diseases such as coronary heart disease and cerebral arteriosclerosis already have reduced cardiac pumping function and insufficient brain blood supply. Under severe coughing, it is very easy to develop phlegm syncope and cause accidental injuries.

　　Chronic bronchitis and other respiratory system diseases can affect lung gas exchange, hinder the excretion of carbon dioxide and the intake of oxygen, causing varying degrees of hypoxia in the body. The brain is very sensitive to hypoxia, and persistent and severe coughing itself can make people feel short of breath. Moreover, when coughing, the increase in intra-abdominal and thoracic pressure can hinder the return of venous blood, reduce cardiac output, and worsen brain hypoxia and ischemia. In addition, the increased intracranial pressure due to the increased cerebrospinal fluid pressure during coughing can also cause transient ischemia in the brain. Phlegm syncope often occurs on the basis of chronic bronchitis, bronchial asthma, emphysema, pulmonary heart disease, cerebral arteriosclerosis, coronary heart disease, and other chronic respiratory and cardiovascular diseases, and is triggered by severe coughing. Patients with cardiovascular diseases such as coronary heart disease and cerebral arteriosclerosis already have reduced cardiac pumping function and insufficient brain blood supply. Under severe coughing, it is even more like adding fuel to the fire, making it very easy to develop phlegm syncope and cause accidental injuries.

　　What diseases can phlegm syncope trigger? Briefly described as follows:

　　1. Main complications include fractures after traumatic injury, subcutaneous hemorrhage, tissue laceration, and local edema and hemorrhage, etc.

　　2. Clinical data show that transient cerebral ischemia and consciousness disorders during the onset of phlegm syncope are not very serious for most people, but for the elderly, they often cause serious accidental injuries due to sudden falls. Therefore, it is necessary to be vigilant and actively prevent.

　　For those with cold phlegm and cold limbs, use ginger and附汤; with cold limbs, vomiting of sputum, phlegm sound in the throat, sudden dizziness, chest tightness, shortness of breath, and poor speech, use thin saliva powder. Closing eyes, dizziness, not responding to calls, sputum in the throat blocking the breath, and slight breath.脉诊左右弦硬而长，重按有力，知其证不但痰厥，实素有脑充血病也。

　　How to prevent phlegm syncope? Briefly described as follows:

　　1. Actively treat respiratory and cardiovascular diseases, try to improve the blood supply to the whole body, especially the brain, eliminate triggers, eliminate hidden dangers, and play the role of removing the root cause.

　　2. In winter, the elderly with respiratory and cardiovascular diseases should pay attention to keeping warm to prevent the onset of chronic diseases. Especially, attention should be paid to preventing respiratory tract infections. Severe coughing and frequent respiratory tract infections often lead to the onset or exacerbation of existing diseases such as pulmonary heart disease and cardiovascular diseases, causing serious consequences. Early medical treatment and active treatment of respiratory tract infections are required.

　　3. Once a severe cough or sputum production occurs, the body should be kept as relaxed as possible, and a sitting or semi-recumbent position can be adopted, especially for the elderly with multiple diseases. It is禁忌 frequent movement during coughing to avoid falling and injury when syncope occurs suddenly. When dizziness, nausea, and other prodromal symptoms of syncope occur during severe coughing, one should immediately lie down and rest; for those with abundant sputum, some expectorant drugs (such as phlegm coughing net, fresh bamboo juice, etc.) can be taken to moisten the lungs and relieve severe coughing; if conditions permit, a home oxygen bag can be prepared. Paying attention to the above points, phlegm syncope is preventable.

　　What examinations should be done for phlegm syncope? Briefly described as follows:

　　1. Blood count.The total white blood cell count of most patients is elevated, usually between (10-20)×10⁹The cell count is significantly increased, up to 90% or more, between /L.

　　2. Cerebrospinal fluid examination.The cerebrospinal fluid is clear and transparent, with increased cerebrospinal fluid pressure, increased cell count, and (50-500)×10/L, mainly composed of lymphocytes, with no change in sugar and chloride, and normal or increased protein.⁶The cerebrospinal fluid is clear and transparent, with increased cerebrospinal fluid pressure, increased cell count, and (50-500)×10/L, mainly composed of lymphocytes, with no change in sugar and chloride, and normal or increased protein.

　　3. Viral isolation.Units with conditions can obtain cerebrospinal fluid for viral isolation, but the positive rate is low at the beginning of the disease. After death, brain tissue can be collected for viral isolation.

　　4. PCR examination.Detection of viral RNA in serum or CSF of early patients by RT-PCR technology has high sensitivity and specificity.

　　The dietary therapy for phlegm syndrome patients has a good effect on the prevention and treatment of the disease, which is briefly described as follows:

　　Sheng Zhe Shi (one liang, pounded into powder), Huaai Xue (one liang), Sheng Huaai Di Huang (one liang), Da Gan Gou Qi (eight liang), Sheng Hang Shao (six liang), Jing Yu Rou (six liang), Sheng Long Gu (five liang, pounded), Sheng Mu Li (five liang, pounded), Bai Zi Ren (five liang, fried and pounded), Yin Chen (half liang), Gan Cao (half liang), decoct with concentrated water of rusted iron, and take the decoction as a large cup, warm.

　　How is the treatment method for phlegm syndrome? Briefly described as follows:

　　1. Chinese Medicine

　　Xia Zhu Tian Ma Decoction is used to treat phlegm syndrome, weak spleen and stomach, headache as if split, body feeling as heavy as a mountain, cold limbs, vomiting and dizziness, and unable to open eyes.

　　1. Composition: Ban Xia, Chen Pi, Mai Ya (fried, each one liang), Bai Zhu, Shen Qu (fried with ginger, each seven fen), Ren Shen, Cang Zhu, Huang Qi (coated with honey, each five fen), Tian Ma, Bai Fu Ling, Zexie, each five fen, Huang Bai (fried with wine, two fen), ginger three slices.

　　2. Modifications: For those with excess fire and dry blood due to thinness, remove Cang Zhu and Zexie, and add seven fen of Dang Gui and seven fen of Bai Shao Yao (fried with wine) respectively. Ban Xia is dry and should not be taken for a long time, so add one liang of Beimu. Zhishi has the effect of treating phlegm with a forceful action, so it is advisable to add five or six fen.

　　If fire descends, phlegm will naturally disappear, add five fen of Shan Zao Zi. Shan Zao can reduce fire, and it is because it is excreted through urine.

　　If Qi descends, phlegm will naturally descend, add five fen of Wu Yao and five fen of Fu Zi.

　　If the spleen and stomach are weak, double the amount of Ren Shen and add three fen of Bai Dou Kou (fried and roasted).

　　If abdominal pain is as if split, add five fen of Bai Zhi, three fen of Chuanxiong and three fen of Xixin.

　　If the body feels as heavy as a mountain, double the amount of Zexie.

　　If vomiting is severe, add five fen of Huoxiang (washed with wine) and five fen of Sha Ren (crushed and fried).

　　If dizziness is severe, double the amount of Tianma, and add five fen of Chuanxiong.

　　If the limbs are cold, add five fen of Guizhi.

　　Bai Fuzi can lead various drugs to the upper part of the head and has the power to induce phlegm. For phlegm in the head, it cannot be removed without Bai Fuzi. For treating phlegm syndrome, it is advisable to slightly add two or three points. For those newly diagnosed with this disease, the main treatment is to promote Qi and reduce fire to eliminate phlegm. For those with long-standing diseases, the main treatment is to tonify Qi and blood, and regulate Qi.

　　2. Acupuncture and Moxibustion

　　For headache as if split, apply Moxibustion to Baihui and Shangxing each for five times, needle Taian and Lieque, and purge. For all kinds of phlegm diseases, vomiting is the best, and it is advisable to take Quail Tongue Tea, which is very effective for induce vomiting, but it should not be tried by the weak.