Phlegm-Heat in the Lungs

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At a glance

Key attributes

Chinese name: 痰热阻肺      Pinyin name: Tán Rè Zǔ Fèi

Pattern nature: Full

Pattern hierarchy: Specific pattern under Phlegm Heat

Causes

Precursor patterns: Kidney Yang Deficiency Spleen Qi Deficiency Wind-Cold invading the Lungs and one other possible precursors

Common causes: 1. Diet, 2. Smoking, 3. External Wind Heat, 4. Emotional stress

Diagnosis

Common symptoms: Thirst Coughing Wheezing Dizziness Feeling of heat and five other symptoms

Pulse type(s): Rapid (Shu), Slippery (Hua)

Tongue description: Red swollen tongue with a sticky yellow coating

Treatment

Treatment principle: Resolve Phlegm, clear Heat, facilitate the descending of Lung Qi

Common formulas: Wen Dan Tang Qing Qi Hua Tan Wan Ma Xing Shi Gan Tang and one other formulas

Pathology

This pattern is similar to Damp-Phlegm in the Lungs, but with additional Heat features, such as feeling of heat, thirst and profuse sticky yellow or green sputum. The typical manifestations of Phlegm are the coughing, short of breath, Phlegm in the throat and chest oppression. The Phlegm can also obstruct the head and cause heaviness and dizziness. 

There can be acute or chronic conditions. The acute cases are often caused by external Wind-Heat penetrating the Defense Qi and attacking the Lungs, which results in acute chest infection and fever. 

If the acute conditions are not treated completely, then the external Wind-Heat lingers and settles down in the Lungs, and it can become chronic eventually. Prolonged Spleen Qi Deficiency can also cause chronic condition. It is because the impaired Spleen can not transform and transport Body Fluids properly and thus Dampness and Phlegm forms. 

Causes

Precursor patterns: Phlegm-Heat in the Lungs can derive from Kidney Yang Deficiency Spleen Qi Deficiency Wind-Cold invading the Lungs Wind-Heat invading the Lungs

Diet: The normal function of ascending Spleen Qi and descending Stomach Qi can be greatly impaired due to irregular eating habit. It then gives rise to the formation of Phlegm, which then get stored in the Lungs.  In additional to that, overconsumption of hot or greasy foods can also cause Phlegm and Heat. Therefore, better avoid foods like fried meats, alcohol or any that are spicy or greasy.

Smoking : According to TCM, tobacco is hot in nature and it gives rise to the formation of internal Heat. On the other hand, smoking also dries up Body Fluids and thus causes Phlegm.

External Wind Heat: In acute cases, external Wind Heat penetrates the Defensive Qi and attack the Lungs directly.  If the acute condition is not treated completely and lingers for a long time, the Wind Heat can reside in the Lungs and become internal Heat. It then become chronic.

Emotional stress : Internal Heat can also be the result of Qi Stagnation, which happens due to emotional stress such as anger, frustration and resentment.

Diagnosing Phlegm-Heat in the Lungs

Pulse type(s): Rapid (Shu) or slippery (Hua)

Tongue description: Red swollen tongue with a sticky yellow coating

Main symptoms: Thirst Coughing Wheezing Dizziness Feeling of heat Phlegm in throat Shortness of breath Stifling sensation in the chest Coughing of copious thick yellow sputum Feeling of heaviness of the head and body

Diagnosis commentary: Key characteristic symptoms of this pattern are the barking cough with sticky yellow sputum and Rapid Slippery pulse.

Treating Phlegm-Heat in the Lungs

Treatment principle

Resolve Phlegm, clear Heat, facilitate the descending of Lung Qi

Herbal formulas used to treat Phlegm-Heat in the Lungs

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. Invented in 1174 AD, it belongs to the category of formulas that dry Dampness and transform Phlegm.

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

Read more about Er Chen Tang

Qing Qi Hua Tan Wan

Source date: 1584 AD

Number of ingredients: 8 herbs

Key actions: Clears Heat. Transforms Phlegm. Directs Rebellious Qi downwards. Stops coughing.

Formula summary

Qing Qi Hua Tan Wan is a 8-ingredient Chinese Medicine formula. Invented in 1584 AD, it belongs to the category of formulas that clear Heat and transform Phlegm.

Besides Phlegm-Heat in the Lungs, Qing Qi Hua Tan Wan is also used to treat Lung Heat or Phlegm-Heat.

Read more about Qing Qi Hua Tan Wan

Ma Xing Shi Gan Tang

Source date: 220 AD

Number of ingredients: 4 herbs

Key actions: Invigorates Lung Qi. Clears Heat. Calms wheezing by directing rebellious Qi downward.

Formula summary

Ma Xing Shi Gan Tang is a 4-ingredient Chinese Medicine formula. Invented in 220 AD, it belongs to the category of formulas that clear Heat from the Organs.

Besides Phlegm-Heat in the Lungs, Ma Xing Shi Gan Tang is also used to treat Lung Heat.

Read more about Ma Xing Shi Gan Tang

Diet recommendations

Avoid alcohol, red meat, tobacco, dairy or any foods that are spicy, greasy and fried. 

Try cupping over the chest or upper back, nasal wash and breathing exercises. Other than those, enough bed resting is also a good idea. 

Consequence patterns

Spleen Qi Deficiency

The Spleen is responsible for Body Fluids transformation and transportation. Therefore the impairment of Spleen Qi or Yang gives rise to Dampness and Phlegm. As a vicious circle, prolonged Phlegm worsen the Spleen function. 

Dryness

For the elderly, prolonged accumulation of Phlegm condenses Body Fluids and cause Dryness. 

Blood Stagnation

Both Phlegm and Blood are some form of Body Fluids. Prolonged accumulation of Phlegm, which is a kind of condensed Dampness,  can give rise to Blood Stagnation, especially for the elderly.