🌿 Folk Prescriptions

In traditional Chinese medicine, phlegm formation is primarily associated with the lungs and spleen. The lungs govern respiration and regulate the rise and fall of zongqi (vital energy). If lung function fails to descend properly, symptoms such as cough, shortness of breath, and difficulty lying down may occur. When wind or cold pathogens invade the lungs, body fluids may congeal into phlegm. The spleen governs transportation and transformation, meaning digestion and distribution of nutrients to various organs. If dampness invades the body, or if excessive worry, fatigue, or irregular diet damages the spleen, impaired spleen function leads to internal retention of water and dampness, which condenses into phlegm.
1. TCM Differentiation and Treatment for Excessive Phlegm
TCM classifies phlegm into cold phlegm, wind-phlegm, heat-phlegm, damp-phlegm, and dry-phlegm.
1. Cold Phlegm results from invasion of cold pathogen into the lungs, causing fluid accumulation into phlegm. The phlegm is white, patients feel cold and prefer warm drinks, the tongue coating is thin white or greasy, and the prescription is modified Xiaoqinglong Tang: Cinnamon twig 6g, processed Pinellia 10g, dried ginger 6g, fine cinnamon 3g, apricot seed 10g, white mustard seed 6g. Add fried Ephedra 6–9g if asthma is present.
2. Wind-Phlegm arises from wind pathogen invading the lungs (common cold), initially producing clear, thin phlegm, later turning yellow and sticky. Patients feel aversion to wind, the tongue coating starts white and later turns thin yellow. Modified Xingsu Yin: Apricot seed 10g, perilla leaf 6g, schizonepeta 6g, foresight root 10g, platycodon 10g, white front 10g. If phlegm turns yellow, add bear bile 6g, honeysuckle 10g, and chrysanthemum 12g.
3. Heat-Phlegm results from heat pathogen invading the lungs or from initial wind/cold exposure followed by high fever lasting several days, causing body fluids to burn and transform into yellow, sticky phlegm. Patients feel hot and prefer cool drinks, the tongue is red with yellow greasy coating. Modified Xiebai San: Mulberry bark 10g, lycium root bark 10g, licorice 5g, raw gypsum 30g, coptis 10g, apricot seed 10g, bear bile 6g.
4. Damp-Phlegm results from external dampness invading the body (e.g., living in a damp environment) or from dietary indiscretion impairing spleen function, disrupting transportation and transformation. Phlegm is white and watery, patients feel heavy, fatigued, or have loose stools, the tongue coating is thin white or white greasy. Modified Erchen Tang: Processed pinellia 10g, tangerine peel 10g, poria 10g, honey-fried licorice 5g, apricot seed 10g, coix seed 15g, white atractylodes and common atractylodes each 10g.
5. Dry-Phlegm results from prolonged dry weather and dry pathogen invading the lungs, causing thick, sticky phlegm difficult to expectorate or accompanied by hemoptysis. Patients feel dryness in mouth, nose, and throat, the tongue coating is thin yellow. Modified Qingzao Jiufei Tang: Northern sand-participant 15g, tianmen dong and mai men dong each 10g, raw gypsum 30g, stir-fried loquat leaf 10g, apricot seed 10g, raw rehmannia 15g, zhebei 10g, polygonatum 15g.
TCM Patent Medicines for Phlegm Dissolution:
1. Fresh bamboo juice: 3–4 times daily, 10–15 ml each time.
2. Compound bamboo juice (Phlegm-Relieving Spirit): 3 times daily, 2 vials each time.
3. Phlegm-Cough Relief: 3 times daily, 1 spoon each time.
2. Western Medicine Diagnosis and Treatment of Excessive Phlegm
Normal individuals produce very little sputum. Sputum volume increases in smokers or those with respiratory tract disease. Common conditions associated with excessive phlegm include:
1. Chronic bronchitis: prone to relapse with cough, wheezing, and excessive phlegm after exposure to cold, potentially leading to emphysema and cor pulmonale. When bacterial infection occurs, sputum becomes yellow and sticky with fever.
2. Pneumonia: large lobe pneumonia presents with rust-colored sputum and chills with fever.
3. Tuberculosis: fever and night sweats; when lung cavities form, sputum volume increases, tubercle bacilli can be detected in sputum tests, sometimes accompanied by hemoptysis.
4. Bronchiectasis: copious sputum, often layered as thin, viscous, and highly viscous, sometimes with hemoptysis.
5. Lung abscess: extremely large amounts of foul-smelling sputum with fever.
6. Pseudomonas aeruginosa infection: green or yellow-green sputum, sticky, with fever.
7. Lung cancer: sputum may be thin or thick, occasionally bloody; in late stages, sputum may also be foul-smelling.
To determine the underlying cause of excessive phlegm, patients should seek detailed hospital examinations, such as chest X-ray. If lung cancer is suspected, tomography or CT scans of the chest are recommended. Sputum examination for cancer cells is advised, and bronchoscopy is best performed for early diagnosis, early surgery, early radiotherapy, or chemotherapy. If infection is suspected, sputum culture should be done. After identifying the causative bacteria, antibiotic sensitivity testing should be conducted to guide targeted antibiotic use.
Three commonly used Western medications for phlegm dissolution are:
1. Ammonium chloride: 3 times daily, 0.3–0.6g after meals.
2. Bromhexine: 3 times daily, 8–16 mg each time.
3. Carbocisteine: 3 times daily, 0.6g (1 tablet) each time.