Phlegm nodule multiple abscess refers to the formation of lumps of varying sizes and numbers in different parts of the body due to the accumulation of damp phlegm under the skin.

This condition is not red, not hot, not hard, and not painful, resembling a soft and smooth fruit pit that cannot be moved when pushed. It generally does not suppurate or ulcerate. Phlegm nodules mostly occur in the neck and jaw area, but can also be seen in the limbs, shoulders, and back.

bubble_chart Pattern Analysis

1. Spleen Deficiency with Dampness Retention︰Subcutaneous nodes, neither red nor hot, rarely painful or with a sense of distension, initially soft and movable upon touch, mostly occur on the neck. Those appearing on the arms, shoulders, or back may cause slight pain, but the swelling is not red. Nodes in the armpit are hard as stone. There are no obvious systemic symptoms, with a pale tongue and white greasy coating, and a slippery pulse. Generally, there are no significant systemic symptoms, mostly caused by spleen deficiency failing to transport, leading to damp-phlegm accumulation and the formation of subcutaneous nodules. Treatment should focus on invigorating the spleen and draining dampness, resolving phlegm to soften hardness. For nodes on the neck, Kelp Pill can be used; severe cases may add kelp or combine with Nodule-Resolving Pill. For nodes on the arms, shoulders, or back, Two Old Ingredients Decoction can be used with additions such as Saposhnikovia Root, wine-processed Skullcap Root, Forsythia, Sichuan Lovage Rhizome, Gleditsia Spine, and Atractylodes Rhizome. For nodes in the armpit, the Nodule-Dissipating Powder can be used.
2. Wind Phlegm︰The local symptoms are the same as the previous syndrome, and may also include headache, vertigo, reluctance to open the eyes, lethargy, heavy body and fatigue, chest tightness and nausea, or bluish-yellow cheeks, or expectoration of phlegm and saliva, white and slippery tongue coating, and wiry and slippery pulse. There are obvious systemic symptoms, such as headache, vertigo, reluctance to open the eyes, lethargy, heavy body and fatigue, chest tightness and nausea, or bluish-yellow cheeks, or expectoration of phlegm and saliva. The treatment should focus on dispelling wind and resolving phlegm, dispersing stagnation and softening hardness. Xiaofeng Huatan Tang (Wind-Dispelling and Phlegm-Resolving Decoction) can be used.
3. Dampness-heat︰The local symptoms are the same as the previous syndrome, and may also include dark and scanty urine, yellow and greasy tongue coating, soggy and rapid pulse, and other signs of heat. There are obvious systemic symptoms, such as dark and scanty urine, yellow and greasy tongue coating, and soggy and rapid pulse. The treatment should focus on drying dampness and resolving phlegm, dispersing nodules, and softening hardness. Modified Xiaowei Dan or Bomboo Juice Phlegm-Resolving Pill can be used.

bubble_chart Documentation

1. Zabing Yuanliu Xizhu．Neck Disease Origins: "Phlegm nodules are formed by the accumulation of damp phlegm into lumps... There are also cases where the chest and stomach area to the throat become narrow like a thread, causing pain, and there are lumps like walnut kernels in the hands and feet. There are also cases of subcutaneous nodules in the throat causing swelling and pain, preventing the neck from turning, and hard lumps like stones under the armpits. There are also cases where wind phlegm accumulates to form nodules, or where alcohol and anger cause swelling, pain, and pus, with phlegm nodules forming under the armpits and not healing for a long time. There are also cases where clusters of nodules form behind the ears and down the neck, neither red nor swollen, and not forming pus. There are also cases of hard, red, and painful lumps in the Shaoyang meridian at the back of the neck. There are also cases of phlegm nodules with redness, swelling, and alternating chills and fever, resembling scrofula. There are also cases where phlegm forms behind the head, causing brain issues when central, and paralysis when lateral."
2. Yixue Rumen．Brain and Neck Section: "Phlegm nodules in the neck are completely painless, while those in the arm may be painful but not red. Lumps all over the body are often due to phlegm accumulation, but in the upper body, they are often accompanied by wind-heat, and in the lower body, they are often accompanied by dampness-heat. It is advisable to use Modified Xiaowei Dan and Bamboo Juice Phlegm-Resolving Pill, adjusting the dosage according to the body's deficiency and excess. Kelp pills are commonly used."