TCM concepts : Phlegm and the Lungs

Mucus is generated in the body by the intake of diary, flour, sugar, and soy and can also be produced by allergies related to the liver. Raw diets (especially in cool, humid, cold climates) can also be a main factor in mucus formation. When digestion is weak and digestive Agni (fire) is dampened by poor food combining, mucus forms. The accumulation of improperly digested foods typically results in illness and toxic build-up which often further contributes to excess mucus, sluggish liver, and a variety of other debilities. With practice and application, it is becomes more physically visible when Excess Yin or other dietary/constitutional imbalances present a phlegmatic appearance. 

Phlegm is a diagnostic concept in TCM that is indicated by congealed fluids, fibroids, nodules, cysts, and a situation called, "phlegm misting the mind." Unreasonable, manic, anxious behavior paired with a fat, greasy tongue and slippery pulse are strong pointers towards phlegm in the system.

When the spleen generates mucus, it connected to and stored in the Lungs. When phlegm reaches the lungs, it negatively affects its neighbor, the heart, which can cause further blood stagnation and foggy thinking. With thin or watery mucus, a pattern of Invasion of the Lungs by Wind-Cold occurs. In cases of darker, yellow mucus an Invasion of the Lungs by Wind-Heat occurs which often results in a cough. The Lungs control vital energy, Wei Qi (immune system) and are responsible for the function of the skin. When they are filled with mucus, external invasions can occur more easily and result in pneumonia and/or a sub-health state of heavy fatigue. This potentially allows a suppressed immunity to create degenerative disease and depletion. Digestive bitters and tonics are great to give with coughs due to this spleen-lung connection. 

Physically, phlegm manifests as varying levels of laziness and heaviness, which can look like swollen/pudgy body, often a distended abdomen, and overall fatigue. Mentally, excess pathogenic mucus presents itself by blocking the function of the mind and preventing expression of the Shen. 

Different levels of tongue diagnosis can be used to assess pathogenic mucus: generally, the thicker the coat; the more present and advanced the phlegm.

**When a wet tongue is present: this can indicate dampness, deficient Qi and accumulation of fluids. This can represent excess Yin, whereas with deficient Yin, the toungue has little or no coat because the dry body heat has consumed all the Fluids. 

**When a greasy, white tongue coat becomes yellow: this indicates phlegm heat in stomach which can be treated by bitter tonics that clear damp heat : gentiana, barberry, Chapparal, greater celandine, or goldenseal. 

**A cheesy or furry coat indicates more extreme damp heat or phlegm heat, which can grow into candida. This can be treated with bitter tonics or digestives like hawthorn and radish seed. 

**When the tongue shape appears swollen or scalloped (when the swelling of the tongue causes pressure on teeth and creates dents on outer rim), this indicates Internal phlegm. This situation benefits from Spleen Qi tonics along with Phlegm clearing formulas.

Herbal Treatment:  Citrus & Pinelia (Er Chen Wan) is one of the Chinese mother formulas to transform phlegm and dry dampness. This can be modified for application to Hot or Cold conditions. In the case of a greasy tongue with with thick yellow or greenish phlegm representing Heat; coptis, honeysuckle, poke, forsynthia, and echinacea can all be added to Two Cured Decoction (Er chen wan). Coldness, Dampness, and Deficiency are indicated with watery, thin, clear mucus. For this, Ayurvedic Trikatu warms the interior and can be combined with garlic to fight infection. 

**Recipe for Trikatu: powder equal parts pippili long pepper, black pepper and ginger with a dash of anise and mix into a paste with honey - 1 teaspoon per dose to warm the body. Sito Paladi Churna, composed of inner bamboo bark, cardamom, cinnamon, and pippali, is an Ayurvedic formula also used for thin mucus and watery Kapha phlegm coughs. 

When mucus secretions become thick, yellow or white, possibly blood tinged, this Damp Heat situation calls for cholagogues that stimulate the liver to discharge bile. Gentiana Combination (Long Dan xie gan tang), singles containing berberine, yellow dock, dandelion root, and fringe tree bark can be applied here. 

Although it might seem that water and earth are the rulers or creators of mucus because together they make mud (like what is seen in Kapha excess), metal is the element of primary correspondence to the bodily secretion of mucus. Metal embodies the Powers of elimination, letting go, and the physical conduction of energy. When the metal element becomes imbalanced, vital energy and the sense of flowing with destiny and purpose can become blocked. Often metal blockages can manifest as a clinging onto of phenomena of the past, whether they be traumatic or joyful, which can give rise to an inability to release emotions and habits. With this comes coughs, sinus congestion, stiffness, fatigue and weakness, holding grief in the lungs, and a major tendency towards mucus. When pathogenic mucus 'mists the mind' a inability to detach and process can arise as the supremely spiritual element of metal becomes dimmed and stifled from transmuting the refined nectar of Water, Wood, Fire, and Earth into gold. When I think of metal, I think of alchemy and breath..and there is no room for phlegm in alchemy. Often, I look around a room of muggles eating dairy, sneezing, grasping onto the comparison of material nonsense, and acting with a complete inability to problem solve and think critically...and I see this societal cloak of phlegm draped around the mainstream culture in our nation of America. To add onto this, I see grief saturating them/us through the waves of media mind-control, which gets lodged in the suppressed immunities of the Lungs to be driven deeper into internal and collective illness. This is a lack of alchemy, and the lapse of true breath. Without breath and alchemy, it becomes opaque as to how we receive the cosmic energy that has the power to connect our spirits. I am learning through shedding phlegm and balancing metal, that focus is what strengthens our rhythm, and rhythm is what feeds our spirit.  When the house (Lungs) of our Corporeal Soul (Po) is clouded in attachment, it is nearly impossible to truly feel into the grief that resides and sit with our discomforts enough to find the clarity to shed it all and continue to authentically feel. 

With a rise in emphysema and asthma in our culture... we are losing our breath. Spiritual breathlessness inhibits our ability to cultivate superpowers, protect ourselves from viruses, and be in harmony. Through refinement of our breath and release of negative tendencies including withdrawal from the dangers of media and sugar, I believe our society or conscious sub-cultures within it, can slowly create harmony in the Metal element. 

When recognizing Metal imbalance in a client, it's important to keep the nature of this element in mind as well the (very common) increased vulnerability to External diseases due to compromised Wei Qi. In addition to herbal diagnostics and formulas, cultivating rhythm through breathwork & Qi Gong and strengthening the Lungs though rituals of release are highly beneficial in re-entering the realm of alchemy. 

This information is composed from personal studies, education & seminars at East West Planetary Herbs and Chinese Traditional Herbal Medicine - Vol I. DIagnosis and Treatment by Dr. Michael and Lesley Tierra

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