Phlegm

Pattern factsheet

Chinese name:

Pinyin name: Tán

Associated TCM concepts: Body Fluids

Related conditions: Edema Ascites Cystitis and twenty one other conditions

Diagnosis

Common symptoms: Lumps Edema Nausea Oedema Nodules and thirty eight other symptoms

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

Tongue coating: Sticky coating, Thick coating

Tongue shape: Swollen

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

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

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.

Read more about Wu Ling San

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.

Read more about Liu Jun Zi Tang

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 Gallbladder Deficiency or Phlegm-Heat.

Read more about Wen Dan Tang

Xiang Sha Liu Jun Zi Tang

Source date: 1675 AD

Number of ingredients: 9 herbs

Key actions: Tonifies Spleen and Stomach Qi. Removes Dampness. Moves Qi. Alleviates pain.

Formula summary

Xiang Sha Liu Jun Zi Tang is a 9-ingredient Chinese Medicine formula with Ginseng (Ren Shen) as a principal ingredient. Invented in 1675 AD, it belongs to the category of formulas that dispel Phlegm.

Besides Phlegm, Xiang Sha Liu Jun Zi Tang is also used to treat Phlegm in the Uterus or Stomach Deficiency.

Read more about Xiang Sha Liu Jun Zi Tang

Ban Xia Hou Pu Tang

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Regulates the flow of Qi, treats esophageal spasm. Clears Phlegm.

Formula summary

Ban Xia Hou Pu Tang is a 5-ingredient Chinese Medicine formula with Crow-Dipper Rhizomes (Ban Xia) and Houpu Magnolia Bark (Hou Pu) as principal ingredients. Invented in 220 AD, it belongs to the category of formulas that promote Qi movement.

Besides Phlegm, Ban Xia Hou Pu Tang is also used to treat Stomach Qi Stagnation or Qi-Phlegm.

Read more about Ban Xia Hou Pu 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 with Crow-Dipper Rhizomes (Ban Xia) and Tangerine Peel (Chen Pi) as principal ingredients. 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 Stomach Deficiency or Damp-Cold Phlegm.

Read more about Er Chen 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 with Apricot Seeds (Xing Ren) and Perilla Leaves (Zi Su Ye) as principal ingredients. 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 Exterior Dry Cold invading the Lungs.

Read more about Xing Su San

Yue Ju Wan

Source date: 1481 AD

Number of ingredients: 5 herbs

Key actions: Promotes the movement of Qi. Releases all types of Stagnation (Qi, Blood, Phlegm, Fire, Food and Dampness).

Formula summary

Yue Ju Wan is a 5-ingredient Chinese Medicine formula with Atractylodes Rhizomes (Bai Zhu) and Szechuan Lovage Roots (Chuan Xiong) as principal ingredients. Invented in 1481 AD, it belongs to the category of formulas that promote Qi movement.

Besides Phlegm, Yue Ju Wan is also used to treat Liver Qi Stagnation or Qi Stagnation.

Read more about Yue Ju Wan

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 with Crow-Dipper Rhizomes (Ban Xia) and Gastrodia Rhizomes (Tian Ma) as principal ingredients. 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

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 with Sweet Wormwood Herbs (Qing Hao) and Baikal Skullcap Roots (Huang Qin) as principal ingredients. 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 Heat in Gall Bladder.

Read more about Hao Qin Qing Dan Tang

Cang Fu Dao Tan Wan

Source date: 1817 AD

Number of ingredients: 8 herbs

Key actions: Resolves Dampness and Phlegm.

Formula summary

Cang Fu Dao Tan Wan is a 8-ingredient Chinese Medicine formula with Coco-Grass Rhizomes (Xiang Fu) and Black Atractylodes Rhizomes (Cang Zhu) as principal ingredients. Invented in 1817 AD, it belongs to the category of formulas that dry Dampness and transform Phlegm.

Besides Phlegm, Cang Fu Dao Tan Wan is also used to treat Phlegm in the Uterus.

Read more about Cang Fu Dao Tan Wan

Ling Gui Zhu Gan Tang

Source date: 220 AD

Number of ingredients: 4 herbs

Key actions: Warms and transforms Phlegm-Fluids. Strengthens the Spleen. Resolves Dampness.

Formula summary

Ling Gui Zhu Gan Tang is a 4-ingredient Chinese Medicine formula with Poria-Cocos Mushrooms (Fu Ling) as a principal ingredient. Invented in 220 AD, it belongs to the category of formulas that warm and transform water and Dampness.

Besides Phlegm, Ling Gui Zhu Gan Tang is also used to treat Phlegm-Fluids in the hypochondrium.

Read more about Ling Gui Zhu Gan Tang

Xiong Gui Er Chen Tang

Source date: 1575 AD

Number of ingredients: 7 herbs

Key actions: Resolves Damp-Phlegm. Nourishes Blood.

Formula summary

Xiong Gui Er Chen Tang is a 7-ingredient Chinese Medicine formula with Dong Quai (Dang Gui) and Szechuan Lovage Roots (Chuan Xiong) as principal ingredients. Invented in 1575 AD, it belongs to the category of formulas that dry Dampness and transform Phlegm.

Read more about Xiong Gui Er Chen Tang

Xiao Ban Xia Tang

Source date: 220 AD

Number of ingredients: 2 herbs

Key actions: Alleviates and removes thin mucus. Directs rebellious Qi downward. Stops vomiting. Harmonizes the Stomach.

Formula summary

Xiao Ban Xia Tang is a 2-ingredient Chinese Medicine formula with Crow-Dipper Rhizomes (Ban Xia) as a principal ingredient. Invented in 220 AD, it belongs to the category of formulas for a rebellious Qi.

Read more about Xiao Ban Xia Tang

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

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