So there are so many types of phlegm, no wonder sometimes expectorant medicine doesn't work.

"When it comes to phlegm, most people only know about purulent phlegm and thin phlegm. But did you know? In traditional Chinese medicine, there is 'formless phlegm' and 'form phlegm', as well as cold phlegm, hot phlegm, damp phlegm, dry phlegm, phlegm with blood, and purulent phlegm. What are all these?"

Phlegm is pathological mucus discharged from the lungs and airways. Normally, people produce very little phlegm; when there is an excessive amount or a significant change compared to usual, it often indicates the occurrence of disease.

From the perspective of traditional Chinese medicine, phlegm can be divided into "tangible phlegm" and "intangible phlegm." "Tangible phlegm" refers to the phlegm that we can see or hear when coughing, such as coughing up phlegm or phlegm sounds in the throat. "Intangible phlegm" is a concept unique to traditional Chinese medicine; it is identified only by its symptoms without seeing a specific form or substance, but it requires treatment methods aimed at resolving phlegm, and when the clinical effect is significant, it is inferred that the occurrence of a certain disease is related to phlegm. For example, dizziness and mania can be effectively treated by methods that dispel phlegm, which in turn suggests that the disease is caused by phlegm. Additionally, by observing the color, texture, and amount of phlegm, it can be further classified into the following types:

Phlegm that is white and clear is mostly cold phlegm. Due to cold evil obstructing the lungs, the normal body fluids become stagnant and do not transform, accumulating to form phlegm, or due to insufficient spleen yang, which cannot transport and transform dampness, causing accumulation inside the body and invading the lungs, thus forming phlegm. Phlegm caused by external wind-cold is often accompanied by symptoms such as chills, fever, headache, itchy throat, and cough. At this time, the phlegm is clear and thin but not abundant, commonly seen in the early stage of acute upper respiratory tract infection. When caused by spleen yang deficiency, symptoms such as cold limbs, dull abdominal pain, preference for warmth and pressure, poor appetite, and loose stools appear. At this time, the phlegm is white but more abundant and mixed with foam.

Thick yellow phlegm with clumps is mostly attributed to hot phlegm. It is caused by heat evil invading the lungs or cold evil transforming into heat inside the body, damaging the body fluids, which continuously condense into phlegm and accumulate in the lungs. It is often accompanied by cough, fever, dry throat, dizziness, red face, preference for cool drinks, red tongue with yellow greasy coating, and other symptoms.

Phlegm that is white, slippery, and abundant, and easy to expectorate, is mostly classified as damp phlegm. Since the spleen governs the transportation and transformation of water and dampness, if the spleen's function is abnormal, water and dampness will stagnate in the body, accumulating into phlegm. When this phlegm invades the lungs, it results in phlegm-related diseases. This condition is often accompanied by symptoms such as upper abdominal distension, loss of appetite, fatigue in the limbs, heaviness or edema in the lower limbs, sticky and unsatisfactory stools, and a swollen tongue coating.

In contrast to phlegm with dampness, dry phlegm is characterized by scanty and sticky sputum that is difficult to expectorate. This is caused by dryness invading the lungs, which easily damages lung fluids, or by an inherent deficiency of lung yin fluids, leading to a loss of the lung's dispersing and descending functions. It is often accompanied by dryness of the mouth, nose, lips, and skin, reduced urination, and constipation. It is commonly seen in diseases such as whooping cough and dry syndrome.

Occasionally coughing up phlegm with blood streaks is not a cause for concern, but frequent bleeding with bright red color is called hemoptysis. It is caused by lung yin deficiency or liver fire attacking the lungs, fire heat scorching the lung collaterals, or phlegm heat and pathogenic toxins obstructing the lungs, damaging the lung collaterals.

Coughing up purulent and bloody sputum with a fishy odor is often seen in lung abscess. It is mostly caused by external pathogens invading the lungs, or by excessive phlegm-heat toxins inside the body that scorch the lungs, obstruct lung vessels, stagnate qi and blood, leading to blood decay and tissue necrosis with pus formation. It may be accompanied by fever, cough, chest pain, and other symptoms. In such cases, one should rest quietly in bed, monitor changes in body temperature and pulse daily, and observe changes in the color, texture, quantity, and taste of sputum and pus.

"Don't just take expectorants"

If the condition has lasted for a long time, it is recommended to avoid blindly overusing expectorant medications. The above various syndromes still need to be diagnosed by a qualified professional Chinese medicine practitioner through pulse diagnosis and inquiry, and prescriptions should be given (Chinese herbal powders do not need to be decocted, just brewed with hot water) in order to prescribe the right medicine more accurately according to the symptoms.