Damp-Phlegm in the Lungs

Understanding Damp-Phlegm in the Lungs

The Spleen produces Phlegm and the Lungs store it. When the Spleen fails to transform fluids, the resulting Damp-Phlegm rises to the Lungs, which is why the treatment addresses both the storehouse and the source.

The phlegm is plentiful, white and sticky, and coughing it up brings relief. The chest feels full or heavy. The person may be tired and prone to feeling cold.

The tongue is pale, swollen and teeth-marked with a thick white greasy coat and a wet surface. The pulse is slippery.

It comes from damp environments, Spleen deficiency, cold and raw food, and a sedentary life.

Treatment transforms Phlegm in the Lungs and strengthens the Spleen so it stops being produced. The distinction from Phlegm-Heat is colour and heat: this phlegm is white and the picture cold.

Signs and symptoms

Key signs

• Cough with copious white sticky phlegm that is easy to expectorate
• Fullness or heaviness in the chest
• White greasy tongue coating
• Slippery pulse

Also seen

• Relief after coughing up phlegm
• Wheeze or rattling breathing
• Tiredness
• Poor appetite
• Aversion to cold
• Puffiness in the face

Variations

• Phlegm that is worse in the morning
• A rattling cough on lying down
• A heavy feeling in the limbs

Timing

• The cough is worse in the morning and in damp weather.
• It is chronic rather than a short acute illness.

Practitioner notes

• The tongue is pale, swollen and teeth-marked with a thick white greasy coat and a wet surface.
• The pulse is slippery, the classic Phlegm pulse.
• The distinction from Phlegm-Heat is colour and heat: here white phlegm, a pale tongue and no heat signs.
• The distinction from Wind-Cold invading the Lungs is duration: that is acute with chills, this is chronic.

Causes

Common causes

• Exposure to damp environments
• Spleen Qi deficiency from chronic illness or overwork
• Cold and raw food
• A sedentary lifestyle

How it develops

• It develops slowly from accumulating Dampness.
• If Heat is added it becomes Phlegm-Heat, which changes the treatment.

Diagnosis

Diagnosis rests on the volume and colour of the phlegm with a pale wet greasy tongue.

Tongue

• Body: Pale, swollen and teeth-marked.
• Coating: Thick white greasy, with a wet surface.
• Note: A yellow coat would indicate Phlegm-Heat.

Pulse

Slippery, Wiry

Slippery is the Phlegm quality.

Observation

• Pale, puffy face
• A rattling cough
• A heavy bearing

Listening

• A loose, rattling cough with abundant sputum

Palpation

• Abdomen: Mild fullness in the middle with a soft quality.
• Channels: BL-13 and ST-40 may be sensitive; the chest may sound congested.

Questions that separate it from look-alikes

• What colour is the phlegm, and how much?
• Is it easy or hard to cough up?
• How long has the cough lasted?
• Any breathlessness or blood in the phlegm?

Treatment

Principles

• Transform Phlegm in the Lungs
• Dry Dampness
• Strengthen the Spleen so Phlegm does not reform
• Move Lung Qi downward

Herbs

Formulas

• Er Chen Tang - The reference formula for Damp-Phlegm, drying and transforming.
• San Zi Yang Qin Tang - For Phlegm with cough and fullness, often in older or depleted people.
• Liu Jun Zi Tang - For the Spleen deficiency underneath the Phlegm.
• Xing Su San - For cough with Phlegm and chest congestion, warming and descending.

Acupoints

• BL-13 (Feishu) - The Lung back-shu point, used for chronic cough and Phlegm.
• ST-36 (Zusanli) - Builds Spleen Qi, the source treatment.
• LU-9 (Taiyuan) - The Lung source point, used for cough and Phlegm.
• REN-12 (Zhongwan) - Transforms Dampness and Phlegm in the middle.
• SP-9 (Yinlingquan) - Drains Dampness from the body.

Personalising the plan

• If the cough dominates, descending herbs are increased.
• If the Spleen deficiency dominates, Spleen support is increased.
• If wheeze is present, herbs that open the Lungs are added.
• If Heat appears, cooling herbs are added and the pattern becomes Phlegm-Heat.

Self-care

Diet

• Warm cooked food; reduce dairy, sugar and fried food
• Barley, turnip and small amounts of ginger are traditionally used
• Avoid cold and raw food

Lifestyle

• Regular gentle exercise, especially walking
• Avoid damp environments
• Do not lie down immediately after eating
• Keep warm

Qigong and movement

• Gentle practice emphasising the breath and the middle of the body.

How it differs from look-alikes

Patterns that can be mistaken for damp-phlegm in the lungs, and the contrast that separates them.

Where it appears

Skin conditions in which this pattern is commonly seen.

Safety and when to get help

For anything severe, sudden or spreading quickly, read when a skin problem needs urgent care.

This page describes a TCM pattern, not a diagnosis, and a pattern can accompany more than one skin condition. Get urgent medical help for a rash with fever, confusion or feeling very unwell; skin that is blistering, peeling or spreading quickly; swelling of the face, lips or throat, or difficulty breathing; or a lesion with increasing pain, warmth, red streaks or pus. For anything persistent, severe or changing, have it assessed by a clinician before treating it yourself.

Read the skin condition pages for the red flags that belong to a specific presentation.

Urgent-sign guidance is based on standard sources: NHS anaphylaxis, NHS cellulitis, NHS Stevens-Johnson syndrome, NHS melanoma.

Evidence note

No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.

Related patterns