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Diagnosing and Treating Based on Phlegm Observation

In TCM, treatment is determined by observing the color, quality, and quantity of phlegm expectorated during coughing, generally categorized into six types:
Retention of phlegm in the body not only promotes growth of pathogens in the respiratory tract, worsening inflammation, but also obstructs the bronchi, leading to hypoxia and respiratory distress.
1. Cold in the Lung with Phlegm Cough:
Cough produces white, thin, watery phlegm. Patients feel cold, cold limbs, severe chills with mild fever, coughing with chest pain, shortness of breath, pale complexion.
2. Heat in the Lung with Phlegm Cough:
Cough produces yellow, sticky phlegm with clumps, or blood-tinged phlegm. Accompanied by fever, coughing, chest pain, shortness of breath, flushed face, red eyes, sore throat, thirst, dry lips, short red urine, constipation, red tongue with yellow coating.
3. Wind Pathogen Invading the Lung:
Phlegm is thin and frothy. Accompanied by fever and chills, coughing, nasal congestion, runny nose, dry and itchy throat, headache, body aches, red tip and edges of the tongue, thin white coating.
4. Yin Deficiency with Dryness in the Lung:
Small amount of sticky phlegm difficult to expel, possibly with blood streaks. If due to dryness, symptoms include fever, chills, chest pain, black lips, dry nose, dry mouth and throat.
If due to yin deficiency, symptoms include restlessness, insomnia, tidal fever, night sweats, red cheeks, bright red tongue with little coating.
5. Dampness Invading the Lung:
Large volume of phlegm, white and slippery, easy to cough up. Limbs feel heavy and weak, dizziness, excessive sleepiness, poor appetite, chest fullness.
6. Damp-Heat Accumulating in the Lung:
Expectoration of thick, bloody, or foul-smelling phlegm, high fever or tidal fever, chest tightness and pain, inability to lie down due to shortness of breath, dry mouth and sore throat, restlessness.

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