🌿 Folk Prescriptions

In TCM, phlegm is primarily associated with the lungs and spleen. The lungs govern respiration and regulate the rise and fall of vital energy (primordial qi). If lung function fails to descend properly, symptoms such as coughing, wheezing, and difficulty lying down may occur. When wind or cold pathogens invade the lungs, they cause fluid retention in the lungs, forming phlegm. The spleen governs transportation and transformation, i.e., digesting and distributing nutrients to various organs. If dampness invades the body, or if there is excessive worry, fatigue, or irregular diet, the spleen can be damaged, losing its ability to transform fluids, leading to internal retention of water and dampness, which then condenses into phlegm.I. TCM Syndrome Differentiation and Treatment for Excessive PhlegmTCM classifies phlegm into cold phlegm, wind-phlegm, heat phlegm, damp phlegm, and dry phlegm.1. Cold Phlegm: Caused by cold pathogen invading the lungs, resulting in fluid accumulation forming phlegm. The phlegm is white, patients feel cold, prefer warm drinks, have thin white or greasy tongue coating, and use Modified Xiao Qing Long Tang: Ramulus Cinnamomi 6g, Processed Pinellia 10g, Dried Ginger 6g, Fine Xixin 3g, Apricot Kernel 10g, White Mustard Seed 6g. Add processed Ephedra 6–9g if asthma is present.2. Wind-Phlegm: Caused by wind pathogen invading the lungs (i.e., catching a cold), initially presenting with clear, thin phlegm that later turns yellow and sticky. Patients fear wind, have white tongue coating initially, which turns thin yellow later. Use Modified Xing Su Decoction: Apricot Kernel 10g, Perilla Leaf 6g, Schizonepeta 6g, Preparatae Peucedani 10g, Platycodon Root 10g, Bupleurum 10g. If phlegm turns yellow, add Prepared Star of Bile 6g, Forsythia 10g, Honeysuckle 12g.3. Heat Phlegm: Caused by heat pathogen invading the lungs or after initial wind or cold invasion followed by high fever lasting several days, causing fluid depletion and transformation into yellow, sticky phlegm. Patients feel hot and prefer cool drinks, have red tongue with yellow, greasy coating. Use Modified Xie Bai San: Cortex Mori 10g, Lycium Root Bark 10g, Glycyrrhiza 5g, Gypsum 30g, Scutellaria 10g, Apricot Kernel 10g, Prepared Star of Bile 6g.4. Damp Phlegm: Caused by dampness invading the body (e.g., living in a damp environment) or dietary indiscretion leading to dysfunction of the lungs and spleen. Phlegm is white and watery. Patients experience heaviness, fatigue, or loose stools, with thin white or white greasy tongue coating. Use Modified Er Chen Tang: Processed Pinellia 10g, Tangerine Peel 10g, Poria 10g, Fried Licorice 5g, Apricot Kernel 10g, Coix Seed 15g, Atractylodes Macrocephala and Atractylodes Lancea each 10g.5. Dry Phlegm: Caused by prolonged dry weather and dry pathogen invading the lungs, resulting in thick, sticky phlegm difficult to expectorate or even blood-streaked sputum. Patients feel dryness in nose, mouth, and throat, with thin yellow tongue coating. Use Modified Qing Zao Jiu Fei Tang: Northern Sand-Participate 15g, Heavenly and Winter Melon Each 10g, Gypsum 30g, Stir-fried Loquat Leaf 10g, Apricot Kernel 10g, Rehmannia 15g, Zhebeizi 10g, Ophiopogon 15g.TCM Patent Medicines for Phlegm Dissolution:1. Fresh Bamboo Juice: 3–4 times daily, 10–15ml each time.2. Compound Bamboo Juice (Phlegm-Relieving Spirit): 3 times daily, 2 vials each time.3. Phlegm-Cough Relief: 3 times daily, 1 spoonful each time.II. Western Medicine Diagnosis and Treatment for Excessive PhlegmNormal individuals produce very little phlegm. In smokers or those with respiratory tract diseases, phlegm volume increases. Below are common conditions associated with excessive phlegm:1. Chronic Bronchitis: Easily triggered by cold exposure, causing cough, wheezing, and excessive phlegm. If untreated long-term, it may lead to emphysema and cor pulmonale. When bacterial infection occurs, phlegm becomes yellow and sticky with fever.2. Pneumonia: Large lobe pneumonia presents with rust-colored sputum, accompanied by chills and fever.3. Tuberculosis: Fever and night sweats; when lung cavities form, phlegm volume increases, and tubercle bacilli can be detected in sputum, sometimes with hemoptysis.4. Bronchiectasis: Massive amounts of phlegm, often layered into thin, viscous, and extremely viscous layers, sometimes with hemoptysis.5. Lung Abscess: Extremely large amounts of foul-smelling phlegm, accompanied by fever.6. Pseudomonas aeruginosa Infection: Green or yellow-green phlegm, sticky, accompanied by fever.7. Lung Cancer: Sputum is either thin or thick, sometimes bloody; in late stages, phlegm may also be foul-smelling.To determine the underlying cause of excessive phlegm, one should undergo detailed medical examination at a hospital, including chest X-ray. If lung cancer is suspected, tomography or CT scans of the chest are recommended. Sputum tests should be performed to detect cancer cells, and bronchoscopy is best for early diagnosis, enabling timely surgery, radiation therapy, or chemotherapy. If infection is suspected, sputum culture should be done. After identifying the causative bacteria, drug sensitivity testing should be conducted to guide targeted antibiotic use.Below are three commonly used Western medicines for phlegm dissolution:1. Ammonium Chloride: 3 times daily, 0.3–0.6g orally after meals.2. Bromhexine: 3 times daily, 8–16mg each time.3. Carbocisteine: 3 times daily, 0.6g (1 tablet) each time.