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When Seemingly Unrelated Symptoms Come Together

Dr. Dr. Heo Ji-young, Director of Kyunghee Meerae Korean Medicine Clinic, Gwangjin
의료 감수 Dr. Heo Ji-young Representative Director · KMD

People like this come to my consultation room.

Their legs swell, their head feels heavy, digestion is poor, sleep is shallow, and their shoulders are always knotted. Each symptom got a different medicine from a different hospital. A diuretic, a painkiller, a digestive, a sleep aid, a muscle relaxant. There are five medicines, but the body is one.

And none of them touches the root.

I Look First at the Breathing

To these patients I say this: "Let me watch how you breathe for a moment."

Most are startled. Why look at breathing, they ask, when the legs are swelling.

And most are like this: only the chest heaves, while the belly barely moves. The breath is short, and the muscles of the neck and shoulders lift along with it.

Why Is This a Problem

The real work of breathing is not only to draw in oxygen. Breathing creates a wave of pressure inside the torso.

When you breathe in, the diaphragm descends. The pressure inside the chest falls and the pressure inside the belly rises. As this wave repeats some twenty thousand times a day, it pushes along the body's various flows.

The heart pushes blood out, but its power to draw returning blood back in is weak. When the pressure inside the chest falls, venous blood is sucked up into the heart. Lymph has no pump of its own that beats at all, so it flows only when carried by breathing and movement.

But shallow breathing where only the chest heaves cannot make this wave.

Then What Happens

When the wave does not rise, these things unfold in order.

The legs swell — the veins and lymph cannot be drawn upward. They pool below.

The head feels heavy — venous blood descending from the head also drains well when the pressure inside the chest falls. Without the wave, it stagnates up top. The nasal lining swelling easily is for the same reason.

Digestion falters — the intestines are pushed along when the pressure inside the belly rises and falls. When the diaphragm does not move, the intestines move less.

Sleep is shallow — with each breath in and out, the heart rate minutely speeds up and slows down. Breathing is a switch that alternately turns on the two axes of the autonomic nervous system. Short, hurried breathing keeps the tension-side switch turned on.

The shoulders knot — when the diaphragm does not work, the body recruits the muscles of the neck and shoulders to lift the chest. Muscles recruited twenty thousand times a day cannot help but knot.

These are not five symptoms, but five faces of a single cause.

But "Just Breathe Deeply" Is Not Enough

When I explain this far, many ask: "So should I just work hard at deep breathing?"

It helps. But often that alone is not enough. There is a reason the diaphragm cannot descend.

It may not be that the diaphragm fails to move because the breath is shallow, but that the breath is shallow because the diaphragm cannot descend.

  • Is the pressure inside the belly high, pressing from above?
  • Has the fascia around the diaphragm been stiff for a long time?
  • Is pooled fluid pushing up from below?
  • Has posture collapsed so that the ribs cannot move?

No matter how large a breath you take from above while leaving what pushes up from below in place, the diaphragm cannot descend all the way to where it belongs.

That Is Why There Is an Order to Treatment

I set the order this way.

  1. Lower the pressure inside the belly — drain what has pooled, soften what has stiffened
  2. Release the stiffness around the diaphragm — not by forcibly bending, but by gradually changing its quality
  3. Then teach the breathing anew — because now there is room for the diaphragm to descend
  4. Herbal medicine bridges the gaps — it drains what has pooled and creates conditions in which things will not stiffen. It works in the hours after leaving the treatment room

When the order is kept, the five symptoms do not each get better separately but retreat together. Only then do you confirm that this was one thing all along.

Finally

That breathing is involved in venous return, lymphatic flow, and autonomic regulation is a well-known fact. But the way of threading several symptoms onto the single axis of breathing is a perspective I have built through clinical practice and study. I distinguish between established fact and my own interpretation.

And not all swelling and headache can be explained this way. It may be a problem of the heart, the kidneys, or the thyroid, and there are signs that must be confirmed by testing. When I see such signs, I recommend testing first.

But if you feel that you are taking five medicines and yet not one of them touches the root, it is worth checking, at least once, the possibility that those five began in one place.

We breathe twenty thousand times a day. That is how much work it does.


Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)

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Dr. Dr. Heo Ji-young, Director of Kyunghee Meerae Korean Medicine Clinic, Gwangjin

Dr. Heo Ji-young Representative Director · KMD

A graduate of the College of Korean Medicine at Kyung Hee University, with master's and doctoral degrees in pathology — the mechanisms of disease — from its graduate school. Later served as a research professor in the university's Herbology department, studying medicinal substances. Studying both disease and medicine from both sides is the foundation of this practice: explaining "why a given medicine works for a given illness" in the language of both pathology and pharmacology. Explains autonomic, chronic, and intractable conditions — and structural problems of the body — in the language of modern science, and proposes treatment matched to the cause. Has taught prescribing and clinical practice to Korean medicine doctors for over ten years, and is a co-author of "Korean Medicine, Explained by Korean Medicine Doctors," selected for the 2018 Sejong Books list (general category).

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