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Home > Education > Theory > Phlegm

Where Does Phlegm Come From?

By Victoria Dragon

There is a relation between Qi Stagnation and Phlegm. Qi Stagnation can cause Phlegm, and Phlegm can block the flow of Qi. This is a snowballing relationship.
There are several things which can trigger the formation of Phlegm. If the Spleen is weak, Dampness can accumulate. If Evil Heat and/or Dryness are present, these can cause Dampness (even normal Dampness) to congeal into Phlegm. Cold can turn Dampness into Phlegm - just as cold can freeze water. Wind can trigger the formation of Phlegm. Etc.

Chinese Herbal Medicine Formulas & Strategies, compiled and translated by Dan Bensky & Randall Barolet, has the following to say about Phlegm in the chapter on "Formulas that Treat Phlegm":

"Although there may be other contributing factor, the basis of all phlegm is the disruption of the transformative and transportive function of the Spleen, and of the Kidney yang which supports them. For this reason, herbs that strengthen the Spleen are included in almost all of these formulas. Similarly, impediment to the flow of qi is both a cause and an effect of phlegm; the smooth flow of qi dissipates phlegm. These principles were concisely summarized by the Ming-dynasty author, Wang Ken-Tang, in Standards of Patterns and Treatments: 'Those who are best at treating phlegm treat the qi instead of (directly treating) phlegm. When the qi flows smoothly, all the body's fluids will then flow smoothly.' Accordingly, herbs that regulate the qi are also included in these formulas." (pp. 431-432)

Remember that one of the functions of Qi is to "transform and transport". This includes fluids as well as food. If the Qi and/or the Spleen (which is the main Organ connected with the production of Qi) are weak, fluids don't get properly transformed and transported, and Dampness accumulates. The Dampness congeals into Phlegm when it sticks around too long.

Spleen Deficiency is the number one Root of Phlegm. However, Lung and Kidney Deficiency also can trigger Phlegm. "If the Lungs fail to disperse and lower fluids and if the Kidneys fail to transform and excrete fluids, these may accumulate into Phlegm. However, the Spleen is always the primary factor in the formation of Spleen." (Giovanni Maciocia, The Foundations of Chinese Medicine, p. 195.)

According to C.S. Cheung, MD. L.Ac., in Comprehensive Management Phlegm Fluid (Tan Yin), the Liver, Heart, and Triple Heater also can participate in the production of Phlegm. (p. 3) "Triple Warmer is responsible for maintaining the patency of Water Channels." "Abnormal Qi activation (Qi Hua) of Triple Warmer or blockage of Qi vessels may interfere with normal circulation and transformation of Fluid: producing Phlegm." (p. 7)

Some authorities believe that any Organ can produce Phlegm, but the Spleen is the main culprit.

The Organ which Phlegm has the most affinity for are the Lungs. However, Phlegm can collect anywhere in the body. It can cause problems in any Organ - like stones in the Gall Bladder or Kidneys. It can block the Heart orifices, and in doing so, "mist the mind", giving rise to some mental illnesses . It can appear in and under the skin in the form of lumps. (Not all lumps and tumors are due to Phlegm.) It can be the cause of swelling of the thyroid as well as some fibroids and lipomas. It can block channels, causing numbness. (Not the only possible cause of numbness.) It can deform joints (like in chronic rheumatoid arthritis. (Maciocia, Foundations, p. 196) Phlegm can show up about anywhere in the body, but it's especially prone to show up in the Lungs. "Phlegm can the cause of hundred diseases. Evil Spirit of hundred ailments is the Phlegm." (Cheung, Phlegm Fluid Evil, p. 1.) In other words, Phlegm is very versatile in the problems it can cause.

Suspect Phlegm in conditions which are "bizarre" and hard to treat. Phlegm can figure into some very complex clinical pictures. It can take a long time to resolve Phlegm problems once they get established, and especially after they've been around for a while.

The main points to remember is that Qi Stagnation is one of the things which can produce Phlegm, and Phlegm can cause Qi Stagnation. The Spleen is the main culprit involved in the production of Phlegm, but the Lungs and Kidneys also frequently are culprits. Phlegm has a particular affinity for collecting in the Lungs, but it can show up anywhere in the body, including channels. Phlegm can create a lot of different problems throughout the body. Suspect Phlegm if the condition is bizarre, unusually complex, and/or doesn't respond very well to treatment.

Victoria Dragon

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