Phlegm-Fluids above the diaphragm

Home > Patterns of disharmony > Phlegm-Fluids above the diaphragm

Pattern factsheet

Chinese name: 支饮

Pinyin name: Zhī Yǐn

Associated TCM concepts: Phlegm Body Fluids

Related conditions: Epilepsy Enuresis Cirrhosis and seventeen other conditions


Common symptoms: Wheezing No thirst Dizziness Pain in the muscles Absence of sweating and six other symptoms

Pulse type(s): Wiry (Xian)

Tongue coating: Thick white coating

Tongue shape: Swollen

When Lung Qi is stagnant (because, for instance, of Wind-Cold), Phlegm-Fluids (a type of Phlegm characterized by white, very watery and thin sputum) accumulates in the Lungs because they cannot fulfill their function of sending the Fluids down to the Kidneys or to the skin and muscles. See our chapter on the formation of Body Fluids for an explanation of this process.

This leads to symptoms such as coughing and wheezing (with copious, white, watery sputum), a stifling sensation in the chest, and, in very severe cases, difficulty in breathing while lying down. The symptoms of absence of thirst and the moist tongue coating indicate a overabundance of Fluids in the body. All the symptoms tend to be aggravated by exposure to cold.

Related conditions

Peptic ulcers Cirrhosis Epilepsy Conjunctivitis Bacillary dysentery Bronchitis Emphysema Upper respiratory tract infections Rheumatic heart disease Periarthritis of the shoulder Cardiopulmonary disease Enuresis Bronchial asthma Allergic rhinitis Nephritis Hay fever Dacryosolenitis Enteritis Atrophic gastritis Pleuritis

Diagnosing Phlegm-Fluids above the diaphragm

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-Fluids above the diaphragm will tend to exhibit wiry (Xian) pulses as well as a tongue with thick white coating.

Practitioners also learn to read from a long list of seemingly unrelated symptoms. Here patients with Phlegm-Fluids above the diaphragm might experience symptoms like general sensation of heaviness, pain in the muscles, absence of sweating and no thirst (full list here above).

Herbal formulas used to treat Phlegm-Fluids above the diaphragm

Xiao Qing Long Tang

Source date: 220 AD

Number of ingredients: 8 herbs

Key actions: Releases the Exterior. Transforms Phlegm-Fluids. Warms the Lungs. Directs Rebellious Qi downward.

Formula summary

Xiao Qing Long Tang is a 8-ingredient Chinese Medicine formula with Ephedra (Ma Huang) and Cinnamon Twigs (Gui Zhi) as principal ingredients. Invented in 220 AD, it belongs to the category of formulas that clear Wind-Cold.

Read more about Xiao Qing Long Tang

Most important herbs used to treat Phlegm-Fluids above the diaphragm