Phlegm in the Lungs is synonymous with Substantial Phlegm. It is Phlegm that is located in the Lungs and that can be seen. It is manifested by the swollen tongue. The main symptoms, on top of general Phlegm symptoms, are the heavy sputum that develops in the Lungs and throat as well as, in some cases, asthma or difficulty to breath.

This Phlegm is associated with or deriving from Dampness. This type of Damp-Phlegm can be reflected by the sticky white tongue coating and profuse white sputum.

The pattern can be acute or chronic. In acute cases, it is normally caused by Wind invasion of the Lungs. If the patient's immune system is not strong enough to defense this Pernicious Evil, the patient then develops acute cough with profuse sputum.

In chronic cases, it is often the result of Spleen Deficiency. It is because the Spleen is responsible for Body Fluids transformation and transportation and its dysfunction leads to Phlegm formation, which then get stored in the Lungs.

As a result, the descending of Lung Qi is greatly disturbed, thus the symptoms of coughing and short of breath. The Pale complexion shows the Spleen and Lung Yang Deficiency.

The patients usually dislike lying down, because the horizontal position make the chest pain, stifling and distention condition even worse due to the obstructed chest and Lungs by Phlegm. This Phlegm also obstructed the head's orifices which then cause the feeling of muzziness, dizziness and head heaviness.

In acute cases, the patient's Qi is usually not weakened which indicates a purely Full pattern, then the pulse is Slippery. However, the pulse is Soggy in chronic cases,  which means the Qi is harmed to certain degree.