Phlegm Syndrome

SYMPTOMS AND SIGNS: Phlegm syndrome is a group of symptoms caused by phlegm. If phlegm stays at the lung organ, then cough, asthma, shortness of breath may show up. If phlegm obstructs Middle Jiao (middle burner, the position of spleen and stomach), it can cause the oppression and fullness of the gastric region, vomiting, dizziness, heaviness of limbs and body, or diarrhea. If phlegm obstructs inside of channels and collaterals, a stroke will occur. Toe tongue of phlegm syndrome is usually greasy; its typical pulse is slippery. 

Phlegm syndrome include the following diseases of western medicine: Acute or chronic bronchitis, bronchial asthma, laryngopharyngitis, esophagitis, vertigo of otogenic type, sequela of cardiovascular accident, neurosis, schizophrenia, epilepsy, and goiter. 

ETIOLOGY AND PATHOLOGY: Phlegm is caused by the dysfunctions of internal organs, especially lung, spleen and kidney organs, which lead to the disharmony of Qi and blood and the loss of normal distribution of body fluids and water metabolism. The lung is the organ of governing and regulating of Qi. The dispersing and descending functions of the lung play an important role for the distribution transportation and excretion of body fluids. The spleen is the major organ for the transportation and transformation of food essence and body fluids. The kidney is a "water organ", its functions play the fundamental role for the water metabolism. When the lung, spleen and kidney are working normally, there is normal distribution, transportation and excretion of body fluids and water metabolism. Once there are any dysfunctions of these organs, body fluids and water stay in certain parts of the body which gradually become the pathogenic phlegm to cause certain illnesses. 

DIFFERENTIATIONS: 

1. Phlegm of Excessive Type:

1). Turbid Phlegm Obstructs Lung: 

Indications: Suffocating and fullness of chest, coughing, shortness of breath, gurgling sound from throat, profuse yellow or white phlegm, loose or sticky, greasy tongue coating, slippery pulse. 

Treatment & Formula: Resolve phlegm and clean the lung obstruction. 

Products:

    • Xing Su San (Apricot and Perilla Combination, Item No. 2104): A very good formula to open the lung Qi, dispel wind factor and eliminate the phlegm. 

(2). Phlegm Obstructs Middle Burner: 

Indications: Oppression and fullness at epigastric region, vomiting, nausea, dizziness, feeling of unclear head, poor or no appetite, heaviness of limbs and body, or diarrhea, borborygmus, white greasy tongue coating, slippery pulse. 

Treatment & Formula: Harmonize the middle burner (stomach) and resolve phlegm. 

Products:

    • Er Chen Tang (Citrus & Pinellia Combination, Item No. 2003): This is a typical formula to resolve phlegm by drying the internal dampness; it regulates the functions of spleen and stomach at the same time. 

(3). Phlegm Combined with Stagnated Qi: 

Indications: Palpitation, insomnia, easily angered, pain or fullness at chest and epigastric areas, sighs often, or obstructed feeling at throat which can not be relieved by swallowing or vomiting, or lymphadenosis. Red tongue, thick greasy tongue coating, or white or yellow coating, wiry and slippery pulse. 

Treatment & Formulas: Regulate the stagnated Qi and resolve phlegm. 

Products:

    • Wen Dan Tang (Bamboo and Hoelen Combination Item No. 2228): It resolves phlegm and harmonizes the liver and stomach. It is a very good formula for these symptoms: profuse sputum of white color, foaming, nausea, vomiting, dizziness, palpitation, insomnia, restlessness, white and greasy tongue coating, slippery pulse. 
    • Ban Xia Hou Po Tang (Pinellia and Magnolia Combination, Item No. 2064): This is a formula for the sensation of a lump in the throat or abdomen due to depression, neurosis, nervousness, emotional instability. 

(4). Phlegm Combined with Wind Obstructs Channels: 

Indications: Deviation of eyes and mouth, hemiplegia, numbness of four limbs, or sudden loss of consciousness, gurgling sound from throat, thick and greasy tongue coating, wiry and slippery pulse. 

Treatment & Formulas: Dispel wind and resolve phlegm, promote the circulation of channels and open the orifice. 

Products:

    • Wen Dan Tang (Bamboo and Hoelen Combination, Item No. 2228), plus Tian NanXing(Arisaema Rhizoma, Item No. 1042), Shi Chang Pu (Acorus Rhizoma, Item No. 1067), or Jiang Can (Bombyx  Batryticatus, Item No. 1290). 

2. Phlegm of Deficient Type:

(1). Phlegm Stasis due to the Lung Deficiency: 

Indications: Chronic cough or asthma, worse after any activities, sticky scanty sputum or profuse sticky sputum, aversion to cold, easy to catch cold, or tidal fever (fever at afternoon), flushed cheeks. Red tongue, thin and white tongue coating, thready and slippery or weak pulse

Treatment & Formulas: Tonify the lung and resolve phlegm.

Products:

    • Bai He Gu Jin Tang (Lily Combination, Item No. 2092): It treats cough, asthma with scanty sticky sputum due to the lung Yin  deficiency.
    • Lin Shau Wan (Fritillaria and Platycodon Formula, Item No. 2250): This formula is for the chronic or acute cough due to the internal heat with lung Yin deficiency at the same time. 
    • Qing Zao Jiu Fei Tang (Eriobotrya and Ophiopogon Combination, Item No. 2186): It moistions the lungs and relieves the cough with dry phlegm. It is very often used during the autumn. 

(2). Phlegm due to Spleen Deficiency: 

Indications: Nausea, vomiting with foaming phlegm, fatigue, tired easily, lusterless complexion, or facial edema, abdominal fullness, loose stool. Greasy tongue coating, thready and soft pulse. 

Treatment & formulas: Resolve phlegm by promoting the functions of spleen and stomach. 

Products:

    • Liu Jun Zi Tang (Major Six Herb Combination, Item No. 2050): A popular formula used to eliminate t_he damp phlegm by promoting the functions of spleen and stomach. So It is often used for anorexia, vomiting, chronic gastroenteritis, gastroptosis, gastrointestinal weakness. 
    • Shen Ling Bai Zhu San (Ginseng and Atractylodes Formula, Item No. 2173): lt tonifies the spleen and stomach so as to eliminate the damp stasis in middle burner. It is often used for diarrhea, indigestion, chronic gastroenteritis due to the deficiency of spleen. 
    • Bu Zhong Yi Qi Tang (Ginseng and Astragalus Combination, Item No. 2225): It is a Qi tonic for spleen. 

(3). Phlegm due to the Kidney Deficiency: 

Indications: Chronic asthma or cough, inhaled Qi is less than exhaled Qi, worse after any activities, profuse loose sputum, edema in face or lower part of body, dislike coldness, cold and pain at lumbar region and knees, morning diarrhea, frequent urination. Pale tongue, thin coating, deep, thready and weak pulse. 

Treatment & Formulas: Tonify the kidney so as to eliminate the water retention or damp factor. 

Products:

    • Ba Wei Di Huang Wan (Rehmannia Eight Formula, Item No. 2011): A kidney tonic for both Yin and Yang. 

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