The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
Pattern factsheet
Chinese name: 痰
Pinyin name: Tán
Associated TCM concepts: Body Fluids
Related conditions: Edema Ascites Cystitis and twenty one other conditions
Diagnosis
Phlegm has a great importance in Chinese Medicine as it is both a condition in and of itself as well as a cause for other diseases.
The main cause for the formation of Phlegm is Spleen Deficiency since the Spleen rules the transformation and transportation of Body Fluids. If this function is impaired, Body Fluids accumulates and change into Phlegm.
The Lungs and Kidneys may also be involved since they each play a role in handling body Fluids: the Lungs disperse and descend Body Fluids while the Kidneys transform and excrete them. Again, if they fail to perform those roles, Body Fluids will accumulate and become Phlegm.
That being said, the Spleen malfunction is the fundamental reason behind the formation of Phlegm and, as such, treatments will focus on it first and foremost.
There are two broad types of Phlegm: so-called "Substantial Phlegm" and "Non-Substantial Phlegm". Simply put, Substantial Phlegm can be seen, such as sputum in the Lungs and throat. Non-Substantial Phlegm is more hidden and will manifest itself into, for instance, kidney stones, gallstones or arthritic bone deformities.
Phlegm can further be categorized according to its nature: there is Damp-Phlegm, Phlegm-Heat, Cold-Phlegm, etc.
Lastly, there is a type of Phlegm called "Phlegm-Fluids". It is very similar to Dampness and is very watery and thin. It can be heard splashing in the body, found usually in the Stomach, Intestines, hypochondrium, limbs or above the diaphragm.
Related conditions
Please keep in mind that a Western Medicine condition can be caused by several Chinese Medicine patterns of disharmony and vice versa. As such a patient suffering from one of the conditions below will not necessarily be suffering from Phlegm, it is just one pattern that's commonly associated with the condition. Click on a condition to learn what other patterns it's associated with.
Morning sickness Menopausal syndrome Scanty menstruation Late menstruation Low breast milk supply Hepatitis Cystitis Migraine Trigeminal neuralgia Conjunctivitis Pyelonephritis Edema Glomerulonephritis Nephrotic syndrome Hydrocele Motion sickness Menieres disease Gastrectasis Acute enteritis Ascites Congestive heart failure Pericardial and pleural effusions Hydrocephalus Polyhydramnios
Diagnosing Phlegm
Body Fluids (Jin Ye) is one of Chinese Medicine's vital subtances. Learn more about Body Fluids in Chinese Medicine
Pulse type(s): Slippery (Hua) or wiry (Xian)
Tongue coating: Sticky coating, Thick coating
Tongue shape: Swollen
Possible symptoms: Lumps Edema Nausea Oedema Nodules Fatigue Obesity Vertigo Belching Vomiting Dizziness Moodiness Overweight Bad breath Depression Watery milk Late period Heavy limbs Clear mucus Listlessness Palpitations Irritability Poor appetite Chest pressure Low metabolism Scanty periods Chest fullness Vagina discharge Breast distention Abdominal fullness Shortness of breath Sore and weak limbs Sputum in the chest Feeling of heaviness Thick tongue coating Pale menstrual blood Dizziness or vertigo Numbness in the limbs Thick menstrual blood Sticky menstrual blood Brown vaginal discharge Excessive vaginal discharge No feeling of distension of the breasts
Diagnosing a pattern in Chinese Medicine is no easy feat and should be left to professional practitioners.
In particular one has to know how to differentiate between different types of pulses and tongue coatings, shapes and colors. Here patients with Phlegm will tend to exhibit slippery (Hua) or wiry (Xian) pulses as well as a tongue with sticky coating, thick coating.
Practitioners also learn to read from a long list of seemingly unrelated symptoms. Here patients with Phlegm might experience symptoms like chest pressure, nausea, dizziness and feeling of heaviness (full list here above).
Herbal formulas used to treat Phlegm
Wu Ling San
Source date: 220 AD
Number of ingredients: 5 herbs
Key actions: Promotes urination,. Warms the Yang. Strengthens the Spleen. Promotes Qi transformation function. Drains Dampness. Clears edema.
Formula summary
Wu Ling San is a 5-ingredient Chinese Medicine formula with Water Plantain (Ze Xie) as a principal ingredient. Invented in 220 AD, it belongs to the category of formulas that promote urination and leach out Dampness.
Besides Phlegm, Wu Ling San is also used to treat Yin Excess or Oedema.
Liu Jun Zi Tang
Source date: 1107
Number of ingredients: 6 herbs
Key actions: Tonifies Qi. Strengthens the Spleen and Stomach. Clears Phlegm and mucus. Promotes appetite.
Formula summary
Liu Jun Zi Tang is a 6-ingredient Chinese Medicine formula with Ginseng (Ren Shen) as a principal ingredient. Invented in 1107, it belongs to the category of formulas that tonify Qi.
Besides Phlegm, Liu Jun Zi Tang is also used to treat Qi Deficiency or Spleen Qi Deficiency.
Wen Dan Tang
Source date: 1174 AD
Number of ingredients: 8 herbs
Key actions: Clears Hot-Phlegm. Clears Gallbladder heat. Regulates Qi. Harmonizes the Stomach.
Formula summary
Wen Dan Tang is a 8-ingredient Chinese Medicine formula with Crow-Dipper Rhizomes (Ban Xia) as a principal ingredient. Invented in 1174 AD, it belongs to the category of formulas that dry Dampness and transform Phlegm.
Besides Phlegm, Wen Dan Tang is also used to treat Phlegm-Heat or Stomach Fire or Stomach Heat.
Special highlight: the link between low breast milk supply and Phlegm
Coco-Grass Rhizomes (Xiang Fu) is the key herb for Cang Fu Dao Tan Wan, a formula used for low breast milk supply caused by Phlegm
Typical symptoms for low breast milk supply caused by Phlegm: Fatigue Overweight Bad breath Watery milk Low metabolism Thick tongue coating No feeling of distension of the breasts
Recommended herbal formulas: Milk Boost Tea, Cang Fu Dao Tan Wan
The main cause for the formation of Phlegm is Spleen Deficiency since the Spleen rules the transformation and transportation of Body Fluids. If the Spleen doesn't transform or transport Body Fluids they will accumulate and change into Phlegm, which often stay in the Spleen and Stomach.
The accumulated Phlegm then impairs the Stomach's function of ripening and rotting food as well as the Spleen's function of transforming and absorbing food. This leads to a situation where those Organs do not...Read more about low breast milk supply
Special highlight: the link between late menstruation and Phlegm
Dong Quai (Dang Gui) is the key herb for Xiong Gui Er Chen Tang, a formula used for late menstruation caused by Phlegm
Typical symptoms for late menstruation caused by Phlegm: Edema Fatigue Dizziness Overweight Late period Heavy limbs Listlessness Palpitations Scanty periods Chest fullness Vagina discharge Shortness of breath Pale menstrual blood Dizziness or vertigo Thick menstrual blood Sticky menstrual blood
Recommended herbal formulas: Xiong Gui Er Chen Tang, Xiang Sha Liu Jun Zi Tang
Whenever the body has Dampness or Phlegm, the Spleen is always the first Organ that should be checked since it controls body water metabolism. The Spleen transforms, transports, and distributes Body Fluids along with food Essence and Grain Qi. If its transforming ability is poor, the Body Fluids can congeal to create Phlegm and cause Edema. As a vicious cycle, Phlegm can further impair the Spleen's transforming function. Therefore, not enough new Blood can be created to overflow the Uterus and...Read more about late menstruation
