From the viewpoint of modern medicine, the Donguibogam's concept of phlegm-fluid closely parallels functional dyspepsia. Functional dyspepsia is defined by chronic symptoms such as fullness, epigastric pain, early satiety, and nausea without an identifiable organic disease, such as an ulcer or active inflammation. It is common for an endoscopy to show no abnormalities even while discomfort continues, which can be deeply frustrating.
A primary mechanism behind these symptoms is decreased gastrointestinal motility. When food enters the stomach, smooth peristalsis is required to move it downward. When this motility declines, food lingers in the stomach, directly mirroring the classical description of the spleen and stomach failing to transport and transform water and grain. Delayed gastric emptying leads directly to distension, trapped gas, and persistent belching.
Autonomic nervous system imbalance also plays a major role. Ongoing stress, overwork, and irregular daily habits disrupt the balance between sympathetic and parasympathetic nerves. When parasympathetic activity, which supports digestion, is suppressed and sympathetic tension dominates, gastrointestinal motility slows and digestive secretions drop, aggravating dyspepsia. This aligns with the Donguibogam's observation that emotional strain weakens the spleen and stomach.
Recent research on the gut-brain axis further explains this link. The gut and brain communicate continuously; mental stress alters gut function, while an irritated gastrointestinal tract sends distress signals back to the brain. This feedback loop worsens reduced gastrointestinal motility and visceral hypersensitivity, intensifying functional dyspepsia. Low-grade mucosal inflammation, Helicobacter infection, and gut dysbiosis can also contribute to these chronic, phlegm-fluid-like symptoms.
Modern medicine therefore approaches chronic dyspepsia not as an isolated stomach problem, but as a systemic imbalance involving gastrointestinal motility, the autonomic nervous system, the gut-brain axis, and the microbiome. Just as the Donguibogam viewed phlegm-fluid as a reflection of impaired overall circulation rather than a localized fluid pocket, lasting relief often requires restoring the broader balance of the body rather than relying solely on temporary stomach medication.
