Strange diseases are mostly caused by phlegm.
Due to the decline of the spleen's function of transporting water and dampness, or the obstacle of water circulation and excretion in the body, water can not moisturize the human body normally, but will form abnormal accumulation in the body and become a pathological substance. This abnormal water accumulation will be called "phlegm" by Chinese medicine.
The turbid, sticky and viscous part is called "phlegm", and the thin, clear and transparent part is called "drinking".
Therefore, "phlegm" in the sense of traditional Chinese medicine not only refers to phlegm produced in the lungs, which can be excreted by coughing and can be seen by us. "Phlegm" in traditional Chinese medicine also includes pathological products that are turbid, sticky and thick due to the disorder of water-liquid metabolism.
For example, obesity is called "phlegm" in Chinese medicine. Because this kind of "phlegm" can't be intuitively understood by us like the phlegm in the lungs, it is also called "invisible phlegm" in Chinese medicine, and the visible phlegm produced in the lungs can be excreted by coughing is called "tangible phlegm". The isomorphism of the two forms the concept of phlegm in traditional Chinese medicine.
"Tangible phlegm" mainly exists in the lungs, which may be caused by the disorder of water and liquid metabolism, or it may be caused by exogenous pathogens invading the lungs. After this kind of sputum is produced, it can be excreted by coughing and can be observed, so it is easier to understand.
We should be familiar with "tangible phlegm", and we often come into contact with it when we have a cold and cough, but have we noticed such a detail: the same sputum coughed up by the lungs has various characteristics.
For example, some sputum is white and sticky, some is thin and white, some is white and foamy, some is yellow and sticky, some is gray-black, and some is yellow-green ... Why is it the same sputum, but there are so many changes?
After careful analysis, the characteristics of the above sputum can be summarized into two aspects: first, it is thick, thin and foamy; Second, the colors are white, gray-black, yellow and yellow-green.
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What do the different textures and colors of phlegm mean?
? Let's look at a daily phenomenon, sugar is soluble in water. A colorless and transparent liquid is obtained. What will happen if these colorless and transparent sugar water is heated on the fire? We can see that the sugar water will gradually thicken, and the color will gradually change from transparent to light yellow and dark yellow.
From this phenomenon, it is inferred that the thickness and color of sputum are closely related to the "heat" in the body. If there is heat in the body, the phlegm will be yellow and thick, while if there is no heat in the body, the phlegm will be thin and white. The higher the yellow consistency, the higher the body heat.
According to this truth, Chinese medicine calls white and thin, or foam-like, or peptone-like phlegm "cold phlegm", while yellow and thick, even yellow-green phlegm is called "hot phlegm".
? Because the essence of cold phlegm and hot phlegm is completely opposite, the treatment of cold phlegm and hot phlegm is also completely different. Commonly used drugs for treating cold phlegm are dried ginger, asarum, Jiang Banxia, dried tangerine peel, white mustard seed, radish seed, etc. To treat heat phlegm, it is necessary to clear heat and resolve phlegm. Commonly used drugs include Fritillaria thunbergii, Fritillaria cirrhosa, concretio silicea bambusae, Arisaema cum bile, Fructus Trichosanthis, Trichosanthis Radix, etc.
However, whether it is cold phlegm or hot phlegm, Chinese medicine focuses on the word "transformation" in treatment. What does "transformation" mean? When there was no running water before, if the water quality was turbid, we often added a small amount of alum to the water tank. After a period of time, the water will become clear, and alum plays the role of decomposing turbid substances in the precipitation mud, which is called "melting".
The expectorant used in TCM to treat various phlegm diseases is equivalent to "alum", which can decompose and deposit phlegm. Thereby eliminating diseases caused by phlegm.
? In fact, there are two understandings of phlegm in western medicine: one is infectious sputum, such as sputum caused by bacteria, mold, mycoplasma and chlamydia infection; The second type is exudative sputum, which is often formed by excessive secretion of mucus by respiratory mucosa cells.
Among them, the use of antibiotics has a certain effect on sputum caused by bacterial infection, but there are not many western medicine methods for sputum and exudative sputum infected by mold, mycoplasma and chlamydia. How does TCM treat and treat these "phlegm" diseases?
Traditional Chinese medicine believes that microorganisms such as mold, mycoplasma and chlamydia originally exist in the air and will not cause harm and influence to the human body under normal circumstances. Only when excessive moisture and humidity are accumulated in the body and an excessively humid internal environment is formed, will these microorganisms multiply and multiply in large numbers, thus causing damage to human health and various diseases.
Therefore, for this disease. The "humidity" of the human body's internal environment is the real source of this kind of disease. Just like the rainy season, when the environment is wet, mold can multiply in large quantities, so things are easy to get moldy. Now that you can realize that humid environment is the main cause of mold propagation in natural phenomena, isn't it the same for human body?
? So, how to treat phlegm caused by internal humidity? In daily life, humidity is often associated with rainy weather. If the sky is clear and Wan Li is clear, it will certainly not form a humid environment.
There is a saying that "when the sun is in the sky, the haze disappears", which is the truth. The scorching sun mainly relies on its heat to drive away dampness, so when we treat this kind of phlegm, we only need to use drugs with warm properties to make the body have a "scorching sun" effect, and the humid "haze" will dissipate, which eliminates the root of water and dampness gathering in the body, eliminates the living and breeding environment of microorganisms such as mold, mycoplasma and chlamydia, and has quick effect on sputum and exudative sputum caused by infection.
Zhang Zhongjing, a medical sage in the Han Dynasty, put forward the principle of treating this disease in synopsis of the golden chamber, that is, "those who suffer from phlegm and drink should be treated with warm medicine." Now, this is still so far-sighted, and I have to sincerely admire the methods and ideas of the ancients to explore the mysteries of life and disease.
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Invisible phlegm
The above is about visible phlegm, so what is "invisible phlegm" and how to judge its existence? There are four bases for TCM to judge that there is "invisible phlegm" in the body.
① Obesity. The term "obese people have too much phlegm and dampness" in Chinese medicine means that obese people have a lot of "invisible phlegm" in their bodies, because fat is turbid, sticky and thick, and it is formed by condensation of dirt accumulated in water and dampness in the body.
② Thick and greasy tongue coating. Thick and greasy tongue coating is the most intuitive manifestation of excessive water in the body.
③ lump. Generally, the mass is not red in color, protruding from the skin surface, nodular, soft or tough. Those containing water, mucus or peptone-like substances are called "phlegm blocks" in Chinese medicine.
4-pulse slippery. According to the different feelings of finger pulse, Chinese medicine divides it into more than 20 kinds, and slippery pulse is one of them. The description of slippery pulse in TCM is "flowing like water on a bead plate", which means that the pulse we touch is as smooth and rapid as a bead rolling on a smooth plate. The appearance of slippery pulse is one of the characteristic manifestations of phlegm in the body, and it is also one of the main basis for TCM diagnosis of phlegm.
According to the understanding of phlegm in traditional Chinese medicine, the concept of "invisible phlegm" can be made more concrete and intuitive with the help of microscopic examination in western medicine. Such as hyperlipidemia, cyst, lymphoid tuberculosis and bone tuberculosis. In the west, the characteristics of diseases are turbid, sticky and thick, so it can also be considered that these diseases are caused by phlegm. In this way, the examination of western medicine has become an extension of Chinese medicine.
By understanding the mechanism of phlegm in traditional Chinese medicine, we can link the occurrence of these diseases with the overall balance of the human body and find the fundamental treatment of the diseases. For example, hyperlipidemia, cyst, tuberculosis of lymph nodes, etc. all conform to the characteristics of phlegm in traditional Chinese medicine. The root cause of its occurrence is of course related to abnormal spleen transport and excessive water-dampness phlegm in the body, so it can be treated by strengthening the spleen to help transport, resolving phlegm and softening the hard mass. Moreover, because the production of phlegm is eliminated from the root, the treatment effect is lasting.
? I can give two examples here. A patient with hyperlipidemia has no obvious effect after taking Shujiangzhi and Lipitor. Feel dizzy and weak, listless, loss of appetite, drowsiness during the day, dreaminess at night, palpitation, irregular stool, dull complexion, pale tongue coating and weak pulse in both hands.
My diagnosis is that spleen deficiency can't transport water and dampness, which leads to phlegm congealing in the body and staying in blood vessels, which affects the circulation of qi and blood and leads to illness.
Seven doses of traditional Chinese medicine for invigorating spleen and resolving phlegm were given: fried atractylodes 30g, Codonopsis pilosula 15g, Pericarpium Citri Tangerinae 10g, Pinellia ternata 10g, Glycyrrhrizae Radix 6g, Poria cocos 15g, Tangluo 6g, Arisaema cum bile 10g, and Hawthorn 15g.
After taking seven doses of medicine, the patient felt that his spirit and appetite were obviously improved, his dizziness was reduced by more than half, and his stool basically took shape, so I asked the patient to take another seven doses according to the original prescription. When the patient came back for follow-up, the symptoms were basically not obvious, and the blood lipid returned to the normal range.
Another patient with popliteal cyst came to our office for consultation because he was afraid of surgery.
Traditional Chinese medicine believes that the formation of cysts is the result of the accumulation of sputum in a certain part of the body, and the production of sputum is directly related to the function of spleen in transporting, transforming and wetting water. Therefore, by improving and enhancing the spleen's ability to transport water and dampness, the accumulation of phlegm and turbidity in the body can be eliminated, thus eliminating cysts.
Based on this idea, I prescribed prescriptions for strengthening the spleen, resolving phlegm, inducing diuresis and reducing swelling for patients: fried atractylodes 45g, Alisma orientalis 15g, Talcum 15g, Polyporus umbellatus 10g, Poria cocos 15g, Cinnamomum cassia twig 10g, Pinellia tuber 20g, and Rhizoma Arisaematis 650.
After taking this prescription for about one month, the popliteal cyst was completely eliminated. During this period, according to the change of symptoms, the drugs increased or decreased slightly, but the above drugs were the main ones. It is not difficult to see from these two examples that the phlegm theory of traditional Chinese medicine can stand the test of practice completely.
? Deficiency of water and dampness in spleen transport leads to accumulation of water and dampness in the body, and turbid substances in water and dampness will condense in a certain part of the human body to form sputum blocks, such as cysts, lymph nodes and bone tuberculosis mentioned above; With the movement of qi and blood, it will enter the meridians and blood vessels and reach all parts of the body, such as blood lipids mentioned above.
These filthy substances are sticky, so they often lead to the obstruction of qi and blood circulation in meridians and blood vessels, leading to pathological changes of ischemia and hypoxia in zang-fu organs and causing various diseases. For example, phlegm in the head affects the blood supply to the brain, which can lead to dizziness, forgetfulness, lethargy, and even coma, hemiplegia, language difficulties and other symptoms, such as cerebral infarction in western medicine, many of which are caused by phlegm in Chinese medicine.
Too much phlegm in meridians and limbs will lead to blood supply disorders in limbs, numbness in limbs, cold hands and feet and other symptoms; Phlegm in blood vessels will lead to insufficient blood supply to the heart itself, resulting in palpitations, arrhythmia, chest pain and other symptoms, such as coronary heart disease in western medicine, which is also closely related to phlegm in many cases.
In addition, phlegm can also affect people's mental state. If phlegm and turbid qi hinder the normal mental thinking activities of the human body, it will cause people to have depressive mental disorders such as soliloquy, unhappiness and unprovoked sadness. Because Chinese medicine believes that "heart" is the master of human mind, this mental disorder caused by excessive phlegm is called "phlegm fan" in Chinese medicine.
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Phlegm wandering
Regarding the vagrancy of phlegm, Zhu Danxi, a great doctor in the Yuan Dynasty, said: "Phlegm is a thing, rising and falling with qi, and it is everywhere." It is precisely because of the "ubiquitous" characteristics of phlegm that many strange diseases or diseases with poor therapeutic effect are attributed to "phlegm" in traditional Chinese medicine.
Therefore, Chinese medicine has the saying that "strange diseases are mostly caused by phlegm". Zhu Danxi also put forward the theory of "multiple diseases with phlegm", which added new ideas for the diagnosis and treatment of diseases. Although some diseases are correct in syndrome differentiation and medication, their clinical effects are not ideal. At this time, you can consider adding expectorant method, which can often achieve unexpected results.
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I once treated a dizzy patient who had been dizzy for more than a year. If he sits for a long time or suddenly stands up after sitting for a long time, his eyes will turn black and even dim.
Usually, I feel sleepy all day, my spirit is low, my voice is low, my face is pale and unpretentious, my appetite is average, my urine and stool are normal, my tongue is red and my fur is thin and white, and my hands are weak. In the past month, dizziness seems to be getting worse and worse. Western medicine diagnosis: cerebral blood supply is insufficient.
I thought at that time, isn't this a typical air trap? Qi deficiency sinks, leading to qi and blood can not rise and nourish the head, which is not easy to treat? So I prescribed five pieces of Buzhong Yiqi decoction for the patient. After the prescription was finished, I confidently told the patient that you would get well after taking these five pieces of medicine.
But five days later, the patient came back and poured cold water on my head. He told me that dizziness has not improved! At the same time, he also comforted me that it may be that I have had this problem for a long time and I haven't recovered so quickly. I asked the patient's condition carefully again, and the conclusion was that qi deficiency subsided. Since there is no mistake in syndrome differentiation, why is it invalid?
At this moment, I remembered Zhu Danxi's phrase "many diseases with phlegm", and my heart was suddenly enlightened and the mystery in my heart was solved. Since it is qi deficiency, it will inevitably lead to abnormal transport of water and dampness, endogenous phlegm, stagnation in the brain, and dizziness.
The previous treatment was ineffective, because only qi deficiency was considered, and phlegm in meridians and vessels was not considered, so I re-prescribed a prescription for benefiting qi and resolving phlegm for the patient: Astragalus membranaceus 15g, Codonopsis pilosula 15g, fried atractylodes l2 2g, Jiang Banxia 10g, Poria cocos 10g, Pericarpium Citri Tangerinae 6g and Chuanxiong 65438. Or take five jobs.
Five days later, the patient said with joy that the medicine was really effective. I have only eaten for five days, and my head is not dizzy. Later, the patient was asked to take Xiangsha Liu Jun Pill for consolidation. After taking it for about one month, he was followed up for one year, and there was no dizziness.
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Meniere's disease, a strange disease, is also caused by phlegm-dampness
Here, I want to mention Meniere's disease syndrome (also known as Meniere's disease).
The clinical features of this disease are: paroxysmal dizziness and frequent attacks. When dizzy, the patient will feel the objects around him spinning, as if sitting in a car or a boat, accompanied by nausea, vomiting and dull pain in the head. Exercise can lead to dizziness and vomiting.
Therefore, during the attack, patients often lie still, close their eyes and dare not move. Some patients will feel blocked and oppressed in their ears, or accompanied by nystagmus.
Western medicine believes that this disease is caused by the increase of lymph and pressure in the inner ear.
According to Zhang Zhongjing's synopsis of the golden chamber, "dizziness" means nausea and vomiting. Dizziness refers to a disease in which dizziness, nausea and vomiting occur at the same time. ) syndrome (Zhang Zhongjing thinks that it is caused by "a drink under the heart", which is very similar to Meniere's syndrome) and the understanding of Meniere's syndrome in modern medicine think that the disease is caused by drinking water staying in the inner ear, and it is treated with Alisma Decoction in Synopsis of the Golden Chamber, which has achieved good clinical effect.
Alisma Decoction is composed of Alisma orientalis and Atractylodes macrocephala. Alisma orientalis recorded in Shennong's Herbal Classic has the function of "controlling cold and dampness and benefiting water"; Atractylodes macrocephala, Tao Hongjing, a doctor in Jin Dynasty, called it "resolving phlegm and promoting diuresis, reducing swelling by geomantic omen", which can "warm stomach and eliminate valley".
These two medicines are combined together, Alisma orientalis is mainly used for promoting diuresis and relaxing bowels, while Atractylodes macrocephala is supplemented with water to strengthen spleen and resolve phlegm. It can not only eliminate the accumulation of water and drink, but also eliminate the root of spleen deficiency and phlegm turbidity, so the medicine has little taste and quick effect.
I once treated a 43-year-old female patient named Xia, who had Meniere's disease for more than three years. This time, it was induced by fatigue, feeling very dizzy, nausea and vomiting, unable to eat, and vomiting as soon as I entered the water. Lying motionless in bed with your eyes closed, I feel a little better and my movements are getting worse as before.
She was dizzy and had a low voice. She ran to the door and vomited twice during the treatment. The vomit was watery, and she said that she had not eaten for a day. She still has an uncomfortable feeling, her tongue is pale, her fur is white and greasy, and her pulse is weak.
According to the idea of "drinking in the inner ear", I used Alisma Decoction: Alisma 30g, fried atractylodes 45g. Use a bowl and a half of water, fry it into a half bowl, and take it warm.
And told the patient not to drink it all at once, but to take a sip first. After about 5 minutes, if there is no discomfort, take another sip and slowly finish this half bowl of medicine.
After drinking, the patient did not vomit and gradually fell asleep. He didn't wake up until dawn the next day. After waking up, he felt sick and lost. After two days of invigorating spleen and eliminating dampness, his body is safe and has not recurred so far.
Self-test of phlegm-dampness constitution.
1. Dizziness, headache and heavy head.
Traditional Chinese medicine believes that the head is the house of clearing away deficiency, where the Yuan God lives, and it must be nourished by qi and blood, and cannot be disturbed by turbid pathogens. If phlegm goes up and interferes with emptying, dizziness, headache and suffocation will occur.
Hypertension is common with headache, dizziness and dull pain in the head.
Western medicine believes that hypertension is cerebral vasospasm, or vascular sclerosis loses elasticity, so blood circulation is blocked and pressure rises.
From the perspective of traditional Chinese medicine, the evil of phlegm-dampness is heavy and turbid, combined with the characteristics of "phlegm is a disease, rising and falling with qi, everywhere". Therefore, phlegm-dampness attack inhibits yang clearing, flooding and obstruction inside and outside blood vessels, and can also lead to vasospasm, loss of elasticity and increase of blood pressure.
Therefore, in patients with hypertension, the symptoms of clearing yang appear when the head is covered with phlegm-dampness, and the effect is extremely significant according to the treatment of clearing phlegm-dampness.
Dizziness, headache, heavy head caused by phlegm-dampness invasion, or prolonged unhealed, sometimes occur, which is essentially different from the symptoms of deficiency of both qi and blood. Tonifying medicine is not only ineffective, but also aggravated, which is due to excessive discipline.
If the stubborn phlegm and dead blood do not coagulate, they can coagulate into tumors, and occupy the brain or other parts of the body. If the phlegm and dead blood are not dissipated, the tumors cannot be eliminated.
2. Nausea or vomiting, excessive phlegm and saliva, or watery sounds in the gastrointestinal tract, or sticky mouth, greasy mouth, dry mouth and no desire to drink water.
The pathogen of phlegm-dampness stays in the gastrointestinal tract, causing the stomach to fall off balance and the viscera to be blocked, so it is often disgusting or spitting, or whispering in the gastrointestinal tract.
Phlegm is not conducive to the upper side, so the mouth is often sticky. Phlegm is originally dissolved by body fluid, but in turn inhibits the operation of body fluid, so it sometimes dries up. If you drink too much water, it will increase the evil of drinking, and the water will go in and vomit.
The above symptoms are often diagnosed as gastrointestinal neurosis in clinic, so taking medicine is often ineffective. For example, it is effective to treat diseases by warming and resolving phlegm, or to soothe the liver and transport the spleen.
There seems to be a blockage in the throat, and the throughput is unfavorable.
The occurrence of this disease generally begins with stagnation of liver qi and emotional disharmony, and then stagnation of liver qi and depression of spleen. Disharmony between liver and spleen, depression of spleen, accumulation of body fluid into phlegm, and stagnation of qi in throat. So there seems to be an obstruction in the throat, which is not conducive to throughput.
Phlegm is characterized by stagnation of liver qi and stagnation of spleen qi, so it is a disease of throat obstruction, which is characterized by depression and joy.
This symptom is more common in female patients. If the disease persists for a long time, it can cause deficiency due to illness, which can form a syndrome of yin deficiency with phlegm. If you specialize in resolving phlegm and resolving stagnation, Yin qi and body fluid will be more exhausted, and the symptoms of dry throat will be more serious. At the same time, it is necessary to combine enough products of nourishing yin, mainly nourishing, nourishing the symptoms of phlegm and qi obstruction, in order to recover but not develop.
4. Easy to panic, insomnia, or fainting, convulsions, or insanity, but there is no abnormality in nervous system examination and no symptoms of yin deficiency and yang hyperactivity.
"Phlegm attacking the heart" and "Phlegm confusing the mind" refer to this kind of disease. The concept of "heart" in TCM also refers to the functions of the brain, such as "the heart governs the gods", "the brain is the home of the Yuan gods" and "the idea of a brainwave lies in the brain".
Therefore, phlegm invades the heart and is trapped by phlegm, which is often manifested as pathological changes of cerebral cortex dysfunction. This kind of disease, treated by resolving phlegm and inducing resuscitation, can often get satisfactory results.
5. The stool is sticky and phlegm, or constipation is not smooth.
Phlegm stays in the gastrointestinal tract, and if it goes down casually, the stool will be full of phlegm and saliva, which is effective in strengthening the spleen and resolving phlegm. If the phlegm stays in the intestine and inhibits the qi of the fu organs, the stool will be blocked (but the stool is not dry). The more moist the disease is, the more secretive the stool will be. If you take the agent of promoting qi circulation, resolving phlegm and dispersing lung, your stool will be smooth quickly.
6.● Warm-up lethargy, or conscious hypothermia, and the body temperature does not increase significantly.
Phlegm is yin evil, sticky and easy to lie down. Phlegm turbidity inhibits Yang Qi, which can't be extended, resulting in yin not matching with yang, and yin suppressing yang depression and causing fever. Phlegm blocking yang heat is different from pathogenic fire caused by exogenous evil and six evils, and also different from symptoms of blood deficiency, yin deficiency and qi deficiency. It is characterized by drowsiness and low fever. Many unexplained low-grade fever in clinic, such as those without signs of yin deficiency and qi deficiency, belong to this category.
If you throw in the prescription of nourishing yin and benefiting qi, it will help to resolve phlegm and love evil, leading to low warm-up and drowsiness. If we can carefully examine the tongue pulse, judge the true meaning of the disease, and mainly eliminate phlegm and dampness, we can get satisfactory results.
7. The limbs have local fever or chills, or the back is as cold as a palm, or numbness and itching, or the thickness and feeling of some parts of the limbs are different, but no lesions have been found in neurology, orthopedics, dermatology and other examinations.
"Phlegm is everywhere with pneumatology", "Abnormal (combined) sensation leads to pathological changes", phlegm and blood stasis block each other, and local qi and blood circulation is blocked, so there are changes in the above syndromes. If the phlegm does not disperse, swelling or nodules may appear in the affected area.
8. Ulcer, erosion, nourishing water seeping into body fluids or oozing thick phlegm, which is not closed for a long time, and there are also local skin thickening and dander seeping into body fluids without running water.
Stagnation of phlegm-dampness, or coagulation of hot phlegm, affects local qi and blood circulation, and visible phlegm seeps out, so nourishing water seeps into the body fluid, even festering and phlegm flows. The disease is incurable for a long time, and the vital qi is weak. In addition, the affected area is open and often attacked by external wind, cold evil and summer heat, so it is difficult to return to normal with blood, so the affected area has not been closed for a long time. This begins with turbid phlegm coagulation, which leads to deficiency of both qi and yin, accompanied by intractable phlegm.
If the skin of the affected area is thickened and flaky, it is a loss of qi and yin, disharmony between camp and health, and phlegm and blood stasis.
9. Chest tightness and suffocation, swelling in the back, sighing and jumping. The symptoms are particularly obvious when it is rainy and sultry, or when the weather changes alternately.
Sputum stays in the chest, and the yang in the chest is suppressed (including the loss of lung qi in the downward direction), so people often feel chest tightness and hold their breath. If phlegm stagnates in the back and the yang in the back is not smooth, the back will swell or catch cold. Sighing and hammering temporarily stretch qi, so patients often sigh loudly or hammer quickly. For example, excessive phlegm will completely block the yang in the chest, and may also lead to temporary stagnation of qi and blood, which may lead to pain, squeezing pain in the precordial area, and even lead to acute myocardial infarction.
10. Masses and nodules, which coagulate under the skin or in the abdomen, can also occur in other tissues and organs, with no change in the skin surface, slight chills or dull skin color.