The 'phlegm accumulation' spoken of in Donguibogam is not merely an antiquated concept. From the perspective of modern medicine, it shares many aspects with 'functional dyspepsia,' 'gastric motility disorder,' and chronic 'abdominal distension.' Even though no specific inflammation or lesion is detected on an endoscope or ultrasonography, patients continuously complain of discomfort such as dyspepsia, abdominal pain, nausea, and postprandial satiety. Why is this?
If the 'phlegm' of Korean medicine refers to sticky wastes accumulated around the stomach, modern medicine can explain this as a microinflammatory response in the gastrointestinal mucosa or an imbalance in the nervous system. Our stomach carries out peristalsis to digest food and push it downward, and the autonomic nervous system delicately regulates this movement. However, when stress, irregular meals, or excessive medication repeatedly occur, the autonomic nervous system balance breaks down, causing gastrointestinal movement to become sluggish or overly sensitive. Much like a broken elevator, food does not travel downward and continuously lingers in the stomach. As a result, food fermentation worsens and excessive gas is produced, leading to abdominal distension and, in severe cases, triggering a microinflammatory response in the stomach wall.
Recently, the concept of the 'gut-brain axis' has emerged with great importance. The gut and the brain communicate closely like inseparable friends; when stress occurs or emotional changes arise, signals transmitted from the brain to the gut can become distorted. A vicious cycle forms where an anxious brain makes the gut anxious, and an uncomfortable gut makes the brain sensitive. In this process, the secretion of neurotransmitters such as serotonin is also affected, which can lead to abnormalities in gastrointestinal motility and sensation. Furthermore, immune cells around the stomach can become excessively activated to secrete inflammatory substances like cytokines, further hindering gastrointestinal motility or triggering hypersensitive pain responses. Just as Donguibogam stated that phlegm blocks the circulation of qi and blood, modern medicine aligns closely in that microinflammation and nervous system imbalances reduce stomach function and cause chronic discomfort.
Therefore, simply suppressing gastric acid or taking prokinetic agents often fails to provide a fundamental solution. This is why an integrative approach is needed to restore autonomic nervous system balance, stabilize the gut-brain axis, and improve the microenvironment around the stomach. From this very standpoint, Korean medicine treatments focus on nurturing the body’s innate power to heal itself through improving gastrointestinal motility, promoting the circulation of qi and blood, and managing stress.
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