Migraine Unresponsive to Analgesics: Could It Be Due to 'Phlegm-Fluid' in the Body?

Modern medicine primarily classifies this presentation as migraine. A migraine is not a simple headache, but a neurological condition arising from brain dysfunction. It features throbbing or pulsing pain accompanied by nausea, vomiting, and marked sensitivity to bright light, loud sounds, or particular odors. These symptoms closely mirror the clinical manifestations of phlegm-fluid described in Donguibogam. Modern neurology attributes migraine pathogenesis to activation of the trigeminal nervous system, vascular neuroinflammation, and cortical spreading depression across the cerebral cortex. When the neuropeptide calcitonin gene-related peptide (CGRP) is released excessively, it dilates cerebral blood vessels and drives surrounding inflammation, provoking intense pain. Imbalances in neurotransmitters like serotonin also contribute significantly to migraine onset. The classical concept of phlegm-fluid aligns well with modern concepts of chronic inflammation, fluid imbalance, and gut-brain axis dysfunction. Stagnant fluid metabolism and waste buildup reflect a state of chronic low-grade inflammation or disrupted electrolyte balance that alters nervous system signaling. An altered gut microbiome produces inflammatory mediators that travel via circulation to the brain, disrupting cerebral function and triggering or aggravating migraines. Elevated stress hormones and sex hormone fluctuations, such as those around menstruation, further heighten brain sensitivity. Phlegm-fluid represents an overarching state of physiological imbalance, showing how classical observations parallel contemporary neurovascular findings.