Phlegm

Phlegm is a pathological fluid retention resulting from dysfunction of the Spleen's transformation and transportation functions, combined with Lung qi's failure to regulate water passages. This viscous substance obstructs qi movement and clouds the Shen, manifesting as both visible expectoration and invisible systemic obstruction. Phlegm patterns represent fundamental metabolic dysfunction requiring restoration of normal fluid dynamics.

Clinical Presentation

Expectoration of thick, viscous sputum
Chest fullness and oppression
Nausea or tendency to vomit
Heavy sensation in head or limbs
Dizziness or mental fogginess
Gurgling sounds in throat or chest
Sensation of obstruction in throat (plum pit qi)
Tongue: thick, greasy coating (white or yellow)
Pulse: slippery (hua), may be slow or rapid depending on Heat/Cold

Pattern Differentiation

vs. Dampness

Phlegm produces thick, viscous secretions and pronounced chest oppression, while Dampness causes diffuse heaviness without significant expectoration. Phlegm coating is notably thick and adherent; Dampness coating is thin to moderate. Phlegm creates distinct gurgling sounds; Dampness does not.

vs. Lung Dryness

Phlegm sputum is thick and difficult to expectorate with slippery pulse, while Lung Dryness produces scanty, sticky sputum that may be blood-streaked with thin, rapid pulse. Phlegm tongue has thick greasy coating; Lung Dryness shows red tongue with little or no coating.

vs. Blood Stasis

Phlegm obstruction is mobile and produces audible gurgling with slippery pulse, while Blood Stasis creates fixed, stabbing pain with choppy or wiry pulse. Phlegm tongue shows greasy coating; Blood Stasis presents purple tongue body or stasis spots.

Treatment Principle

Transform phlegm and resolve dampness, regulate qi to promote fluid movement, strengthen Spleen transformation function, restore Lung's regulation of water passages

Formulas for Phlegm in Our Catalog

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Related Patterns

Frequently Asked Questions

Cold phlegm presents with white or clear sputum, white greasy tongue coating, slow slippery pulse, and preference for warmth. Hot phlegm shows yellow or green sputum, yellow greasy coating, rapid slippery pulse, and signs of Heat such as thirst or irritability.

Yes. Invisible phlegm (wu xing zhi tan) obstructs internally without expectoration, commonly causing mental symptoms like confusion, depression, or mania, plus systemic signs like chest oppression and slippery pulse with greasy tongue coating.

Substantial phlegm produces visible, thick secretions with pronounced chest sounds and thick greasy coating. Insubstantial phlegm creates minimal visible phlegm but causes significant Shen disturbance, subcostal distension, and thin greasy coating with emotional lability.

Phlegm typically produces slippery-slow pulse in Cold patterns, slippery-rapid in Heat patterns. When combined with qi stagnation, pulse becomes slippery-wiry. In severe cases with Shen involvement, pulse may be slippery-weak or slippery-soggy indicating underlying Spleen yang deficiency.

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