Phlegm

At a glance

Key attributes

Chinese name: 痰      Pinyin name: Tán

Pattern nature: Full

Pattern hierarchy: General pattern with specific forms like Phlegm Misting the Heart or Phlegm-Fire harassing the Heart

Common combinations: Heart Vessel obstructed Phlegm-Fluids

Causes

Precursor patterns: Damp-Heat in the Liver Spleen Yang Deficiency Stomach Qi Deficiency and fifteen other possible precursors

Common causes: 1. Emotional stress, 2. External environments, 3. Diet

Diagnosis

Common symptoms: Dizziness Muzziness of the head Feeling of oppression of the chest

Pulse type(s): Slippery (Hua), Wiry (Xian)

Tongue description: swollen tongue with sticky coating

Treatment

Treatment principle: Remove Phlegm, tonify the Spleen, Kidneys and Lungs

Common formulas: Er Chen Tang Liu Jun Zi Tang Ban Xia Bai Zhu Tian Ma Tang and three other formulas

Pathology

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 accumulate and settle down in different parts of the body and lead to corresponding symptoms. For example, if it stays in the joints, muscles and Channels, there are muscle numbness, bone deformities and etc. If it mists the Heart, it causes many mental illness. If it settles in the Gall Bladder or Kidney, it leads to stones in these Organs. 

Phlegm can further be categorized according to its nature: there is Damp-Phlegm, Phlegm-Heat, Cold-Phlegm, Wind-Phlegm, Qi-Phlegm, Phlegm-Fluids and etc. 

"Phlegm-Fluids" is very similar to Dampness and is very watery and thin. It can be heard splashing in the body, found usually in the Stomach and Small Intestines, hypochondrium, limbs or above the diaphragm.

Causes

Precursor patterns: Phlegm can derive from Damp-Heat in the Liver Spleen Yang Deficiency Stomach Qi Deficiency Heart Blood Stagnation Spleen Qi Sinking Stomach Deficient and Cold Stomach Qi Stagnation Spleen Blood Deficiency Spleen not controlling Blood Damp-Heat invading the Spleen Spleen and Lung Qi Deficiency Obstruction Of the Spleen By Dampness with Liver Qi Stagnation Pericardium Blood Stagnation Liver Fire insulting the Lungs Kidneys failing to receive Qi Kidney and Spleen Yang Deficiency Damp-Heat in the Stomach Food Stagnation in the Stomach

Emotional stress : Emotional stress can damage the Qi movement functions of the Lungs, Spleen and Kidneys. Therefore they are not able to circulate Body Fluids and accumulate Phlegm.

External environments : External Wind, Cold, Heat, Fire and Summer Heat and Dampness can invade body and give rise to the formation of Phlegm.

Diet : Excessive intake of fried or greasy foods such as deep-fried foods, milk, cheese, butter, avocados, nuts and nut butter, chips and fried foods produce Dampness and obstruct the Spleen function. This leads to Phlegm, which causes symptoms such as sinusitis, nasal discharge, heavy and fuzzy feeling in the head, dull headaches and etc.

Diagnosing Phlegm

Pulse type(s): Slippery (Hua) or wiry (Xian)

Tongue description: swollen tongue with sticky coating

Main symptoms: Dizziness Muzziness of the head Feeling of oppression of the chest

Diagnosis commentary: Key characteristic symptoms of this pattern are the general feeling of oppression and heaviness, dizziness and lumps.

Treating Phlegm

Treatment principle

Remove Phlegm, tonify the Spleen, Kidneys and Lungs 

Herbal formulas used to treat Phlegm

Wen Dan Tang

Source date: 1174 AD

Number of ingredients: 8 herbs

Key actions: Clears Phlegm. Clears Gallbladder. Regulates Qi. Harmonizes the Stomach.

Formula summary

Wen Dan Tang is a 8-ingredient Chinese Medicine formula. 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 Misting the Heart or Gallbladder Deficiency.

Read more about Wen Dan Tang

Er Chen Tang

Source date: 1148 AD

Number of ingredients: 5 herbs

Key actions: Dries Damp and dispels Phlegm. Regulates Qi and harmonizes the Middle Burner (Stomach and Spleen).

Formula summary

Er Chen Tang is a 5-ingredient Chinese Medicine formula. Invented in 1148 AD, it belongs to the category of formulas that dry Dampness and transform Phlegm.

Besides Phlegm, Er Chen Tang is also used to treat Damp-Phlegm in the Lungs or Phlegm-Heat in the Lungs.

Read more about Er Chen Tang

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. 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 and Lung Qi Deficiency.

Read more about Liu Jun Zi Tang

Xing Su San

Source date: 1798 AD

Number of ingredients: 11 herbs

Key actions: Clears Dry-Cold. Disseminates the Lung Qi and relieves cough. Transforms thin mucus.

Formula summary

Xing Su San is a 11-ingredient Chinese Medicine formula. Invented in 1798 AD, it belongs to the category of formulas that disperse Dryness and moisten.

Besides Phlegm, Xing Su San is also used to treat Body Fluids Deficiency or Dry-Heat or Dry-Fire.

Read more about Xing Su San

Hao Qin Qing Dan Tang

Source date: Qing Dynasty

Number of ingredients: 10 herbs

Key actions: Clears Heat and relieves acute conditions of the Gallbladder. Relieves acute Damp-Heat syndromes. Resolves Phlegm. Harmonizes the Stomach.

Formula summary

Hao Qin Qing Dan Tang is a 10-ingredient Chinese Medicine formula. Invented in Qing Dynasty, it belongs to the category of formulas that harmonize lesser Yang-warp disorders.

Besides Phlegm, Hao Qin Qing Dan Tang is also used to treat Gallbladder Heat or Heat in Gall Bladder.

Read more about Hao Qin Qing Dan Tang

Ban Xia Bai Zhu Tian Ma Tang

Source date: 1732 AD

Number of ingredients: 8 herbs

Key actions: Dries and dissolves Phlegm. Strengthens the Spleen. Smoothes the Liver and calms Liver Wind (antispasmodic).

Formula summary

Ban Xia Bai Zhu Tian Ma Tang is a 8-ingredient Chinese Medicine formula. Invented in 1732 AD, it belongs to the category of formulas that transform Phlegm and extinguish Wind.

Besides Phlegm, Ban Xia Bai Zhu Tian Ma Tang is also used to treat Wind-Phlegm.

Read more about Ban Xia Bai Zhu Tian Ma Tang

Diet recommendations

Avoid fried or greasy foods such as deep-fried foods, milk, cheese, butter, avocados, nuts and nut butter, chips and fried foods. It is because they cause Dampness and harm the Spleen function.

Related conditions

Morning sickness Menopausal syndrome 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

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 menopausal syndrome and Phlegm

Atractylodes Rhizomes (Bai Zhu) is the key herb for Yue Ju Wan, a formula used for menopausal syndrome caused by Phlegm

This pattern often appears among young women with premature menopause. The symptoms are due to Phlegm or Dampness accumulating in the Lower Burner instead of the more typical decline of Kidneys Essence, normally the key cause for menopausal syndrome. As for absence of menstruationSpleen Qi Deficiency is the fundamental reason leading to Phlegm. This is because the Spleen rules the transformation and transportation of Body Fluids. The malfunction of this Organ leads to the accumulation of...Read more about menopausal syndrome

Consequence patterns

Dry Phlegm in the Lungs

Phlegm, regardless of its association with Dampness, Cold or Heat, is a form of condensed Body Fluids and it can give rise to Dryness if it lasts for a long period of time. 

Blood Stagnation

Phlegm does not lead to Blood Stagnation directly, but in a supportive way. 

Liver Blood Stagnation

Phlegm can cause Blood Stagnation. Since one of the Liver's major responsibility is  to store Blood. Therefore, general Blood Stagnation can cause Liver Blood Stagnation.