Heart Phlegm Fire ‘Harasses the Heart’

Over-friendly, too boisterous, raucous, often abusive, becoming incoherent and sometimes bipolar or manic-depressive: “Phlegm Fire Harassing the Heart”.

Jonathan Clogstoun-Willmott

November 19, 2024

What is Phlegm Fire Harassing the Heart?

Heart Phlegm Fire, also known as ‘Phlegm Fire Harassing the Heart’, has two forms.

They are interconnected and can change from one to the other. Because of that alternation they can resemble bipolar disorder.

On the one hand, there is the Fire phase, when there is crazy laughter, over-confidence, shouting, physical violence, incoherent behaviour and speech. (Read Heart Fire for the earlier stages of this condition.)

The other phase is the phlegm phase. This is less violent. There is more muttering to himself, with what seems like dullness and depression. He is often confused about his circumstances, and not quite living in the moment.

Either phase can lead to the inability to understand you or to speak, and even on to coma.

However, although the later stages of Heart Phlegm Fire are usually easy to recognise, the earlier stages may merely seem like somewhat wild behaviour: raucous with disproportionate laughter and fits of over-excitement, over-friendliness, over-joyfulness and hyperactivity.

Understanding Heart Phlegm Fire

In Phlegm Fire Harassing the Heart, Heat (from the causes given below) blazing over a period of time has not merely pushed energy upwards but has ‘thickened’ the body’s fluids. (Lots of cooking similes in Chinese medicine! Here the idea is that if you simmer a mixture over heat for long enough it will become thicker and more ‘phlegm’-like.)

Don’t think of the blood fluids moving through the Heart here: in Chinese Medicine, the Heart is seen as the governor of the Mind, for which the fluids are lighter and clearer.

However, when heated they thicken to form Phlegm which is said to block or obstruct the ‘orifices of the Heart’. The Mind is disturbed and cannot then function properly, if at all.

This is an ‘excess‘ condition, in whichever of the two forms the patient presents. The heat and the phlegm must be cleared to treat the patient successfully.

Causes of Heart Phlegm Fire

Tense, shen fire — Photo by Dasha Yukhymyuk on Unsplash

The causes of Heart Phlegm Fire share predisposing factors common with Heart Fire.

The main underlying factor is emotional. Strong emotions, often suppressed over a long period, (particularly resentment and anger) cause Qi stagnation. Qi stagnation is such a common cause of ill-health that I’ve written a book about it. See the link below.

This suppressed emotion eventually turns into Fire, much as someone sufficiently goaded will eventually ‘flare up’.

One should remember that Qi Stagnation occurs in a variety of different situations, including pre-menstrual syndrome, relationship problems, work conditions, and situations of fear and anxiety.

Qi stagnation here can be intense – though there are always other contributory factors – and any Qi stagnation eventually turns to Liver Yang rising or to Heat, causing Heart Fire, for example.

Other states can produce or contribute to Heart Phlegm Fire:

Over-excitement, even if pleasurable!
Always searching for stimulation and an adrenaline ‘rush’
Continually laughing or giggling at everything
All these point to a state of what Chinese medicine calls Excess Joy, which generates Heat.

Heat can also be generated externally, say from an invasion of Wind-Heat invading the Pericardium (an infectious disease, say). However, here there would normally be fewer Phlegm signs, just coma or confusion.

The other main contributory factor for Phlegm is the diet, although a tendency to worry all the time should not be overlooked (as in some women in pregnancy).

Read my book “Yuck! Phlegm!” for much more about what people on the web recommend for phlegm, what works and what doesn’t. It also suggests foods and herbs for different conditions.

Too much rich, dairy or greasy and hot, pungent and spicy food taken over too long a period provide a basis for Phlegm to form.

Why? Because all these foods have a heating effect on the body, being rich, oily or spicy – or all three.

Yuck Phlegm Book Cover

Indeed, even before the Heart Phlegm Fire begins, there may be signs of Phlegm-Heat, being …

Yellow catarrh or sputum and a
Yellow greasy coating on the tongue.
Stools may be offensive and urgent, even burning, with
Bad breath
There may be skin eruptions with thick yellow discharges.
All these are signs of phlegm-heat, a precursor – with Heart Fire – of Phlegm Fire Harassing the Heart.

Although the contributing factors to this, (Heart Fire and Phlegm from a poor diet) may take a while to appear, sometimes the onset of Phlegm Fire harassing the Heart can appear quite suddenly, prompted by some emotional trigger or feverish condition.

Mental Symptoms of Heart Phlegm Fire

Just to repeat: the early stages of this condition may not be anything like as extreme as you’ll read below.

Those early stages may include rather extreme, raucous laughter and behaviour; a bit manic perhaps, always up for excitement and enjoying the rush of anticipation, but not completely outside the bounds of behaviour (depending on your society’s customs, of course!).

The individual may seem overtly friendly, bordering on the rude. However, if there is a background of resentment or anger, which then combines with a diet full of rich, greasy, hot-spicy foods, you have all the ingredients for Phlegm Fire Harassing the Heart.

Now all it needs is either a fever, a fright or a fury to set it off.

Very common are the palpitations, the ‘loudness’, the yellow tongue coating and what is called a Heart tongue-line. This line on the tongue runs along the tongue’s mid-line reaching the tip. Quite often there are ulcers or burning soreness and/or swelling at the tongue-tip.

As symptoms develop the following begin to appear:

Woman on a rock — Image by Free-Photos from Pixabay

Anxiety and severe agitation, with muttering, confusion and abusive behaviour: – this can alternate with a dull depression.
There may be hallucinations, phobias, and hearing voices. Speech is incoherent, with mental confusion.
Behaviour – manic, rash and violent, with scolding or hitting out at people.
Uncontrolled laughing and crying, then suddenly he is muttering to himself.
Easily startled – a sign of the Heart not being grounded.
As the condition worsens there may be aphasia (impaired ability for language, such as complete inability to remember words or to speak or understand you, to read or write). This can lead to coma.

Phlegm Fire harassing the Heart is seen in Bipolar disorder. We used to call this manic-depression.

Physical Symptoms of Heart Phlegm Fire

Sleep: insomnia. Difficulty getting to sleep and frequent waking. Sleep is light and restless, dream-disturbed.
Hypertension – high blood pressure – is often a feature of Heart Phlegm Fire
Slight tremor
Palpitations: heart rate races. Distressing although not always a serious matter: lots of fairly healthy people have the this occasionally. But with Heart Phlegm Fire it becomes frequent: it shows how Heart Fire lacks any brake on its speed, just as the individual can’t put a brake on his behaviour.
In the heart region, there is often a sensation of heat. The chest feels oppressed, making breathing difficult.
Complexion is red, eyes are blood-shot.
In the mouth, there’s a bitter taste with thirst. The tongue is red and painful.
In the throat you can hear the rattle of sputum which if expectorated is yellow and thick.
Urine is dark
Pulse: slippery and rapid and overflowing (These are technical terms to describe the sensation an acupuncturist feels when ‘taking’ the pulse. A ‘slippery’ pulse feels like an oily pearl slipping under your fingers: it means there is phlegm in the body (it can also mean pregnancy, the foetus acting like a great lump of ‘fat’ or ‘phlegm’ in the body!). Pulse rapidity indicates heat. ‘Overflowing’ means ‘excess’: it often appears after the first stage of infectious disease and shows excess heat. It is felt immediately under the surface of the skin – you don’t need any pressure to feel it. It comes up like a wave surging up forcefully at your finger, and then retreats suddenly – as if the blood is jittery or jumpy.)
Tongue: tongue body is red, especially at the tip, which is often swollen and painful. The tongue coating is yellow and thick. There is very often a mid-line crack extending to the tip, with yellow moss in it.

Treatment Strategy

This is definitely not a do-it-yourself strategy. Get professional help! The aim of treatment is to clear the Phlegm and reduce the Heat.

There are various acupuncture points that do this. Also herbs.

However, what you can do to help yourself:

Avoid situations that upset or inflame you.
Avoid rich, spicy, oily, fatty, alcoholic food or drink. (Christmas is a particularly bad time because nearly all Christmas-like foods are exactly the wrong thing for you. What is more, Christmas often brings rows. Hence the fall-outs in January, some of them undoubtedly due to this syndrome.)