Lung Phlegm Heat: can be both acute or chronic

Lung Phlegm Heat is a syndrome in Chinese medicine. It describes many kinds of acute chest infection, but older people sometimes get a chronic version of it that becomes acute from time to time. It also arises as a kind of ongoing or chronic condition after too much use of antibiotics. See below for why.

Lung Phlegm Heat Symptoms

You won’t necessarily have all these symptoms, though having them all when the syndrome is acute is not uncommon.

If you have the chronic sort, then the cough won’t be so strong, you won’t get the same fever and ongoing symptoms like dizziness and weakness will be more marked. Also, it may be hard to cough up the phlegm.

• Cough: barking, short, strong
• Phlegm/catarrh that is green or yellow and sticky or adhesive and sometimes stringy, or thick: even blood-streaked. It can occur in the chest or throat or nose. If you can cough it up, it eases the cough.
• Breathing wheezes
• Easily short of breath on talking or exertion
• Feeling of a bar across the chest
• Thirst, often for very cold drinks
• Feels hot
• Head feels heavy and foggy: no desire for mental or physical exertion

• Anxious, easily upset: can have critical, fixed ideas, that are hard to persuade otherwise once they’ve made up their mind though often just haven’t got the energy to think at all
• Often some dizziness
• Nose and/or throat often stuffed up with catarrh
• Snores: sleep is unrefreshing
• Tongue: red and swollen. Its coating is yellow and adhesive.
• Pulse: fast and ‘slippery’

Causes of Lung Phlegm Heat

Anything that has previously weakened the Spleen may cause or worsen Lung Phlegm Heat, including:

• Qi stagnation from emotions such as fury, frustration, resentment and jealousy.
• Too much of the wrong kinds of food, especially very rich or greasy food, spicy food, foods with a heating effect such as roasted or fried meat and hot curries; also alcohol: all these over time can exhaust your Spleen leading to the formation of Phlegm and Heat.
• Eating habits that give your Stomach and Spleen no rest. This includes eating on-the-go, over-eating and rushed eating, swallowing before food has been chewed properly. Usually this will have been a habit over many years.
• Environments or habits that introduce heat or keep you hot. These include working in very hot conditions and smoking tobacco which, although it temporarily calms and cools has a secondary action that is drying and heating.
• Catching a ‘bug’ – a technical term, explained in Chinese medicine as ‘Invasion of Wind-Heat‘.
• As you grow old, your Kidney energy decreases. Your Kidney energy supports your Spleen energy so when Kidney energy weakens your Spleen energy becomes more susceptible to this syndrome.
• If you have had Phlegm for some time, it can turn to Heat, which causes Dryness. So the phlegm gets thicker and more resistant to expectoration. 
• Continuing Phlegm can block the movement of Qi, leading to Qi Stagnation, the emotions of which produce more Heat.
• In older people, continued Heat, whether or not from Phlegm, weakens Yin, leading to Yin Deficiency which itself, like a vicious circle, makes it easier for Heat to appear, drying the fluids to form (more) Phlegm.
• Antibiotics kill the bugs (assuming they’re the correct antibiotic, of course, otherwise they just kill many of your ‘good’ or ‘friendly’ bugs as well as only some of the bad ones). They also reduce your ability to produce a fever, a vital natural resource in killing bad bugs. Their secondary action is to weaken your Spleen, which is short-hand for your digestion, where you keep all the good bugs and most of your immune system. The bad bugs tend to recover faster, like weeks in your garden. They go on to produce heat which gradually takes you back to lung phlegm heat.
• If all this yin-yang stuff gets you down, try our page on yin and yang!

Treatment of Lung Phlegm Heat

The aim of Lung Phlegm Heat treatment is to enable your body to clear its Phlegm, to clear its Heat, and to help your Lungs return to being able to descend Qi rather than let it ascend, as in coughing, expectorating, angry outbursts etc.

Acupuncture and Chinese medicine have their own, time-honoured approaches to this syndrome.

What can YOU do about this?

• Avoid or manage better Qi stagnation and the emotions that lead to it. (You might benefit from the insights in my book on Qi Stagnation, see column on the right.)
• Read my book “Yuck! Phlegm!”  written to explain all this, with a survey of the suggestions made on other websites and why some work, and many don’t, for your type of phlegm.
• Avoid foods that have a heating or drying or phlegm-forming effect on the body. These include pungent and greasy foods, including curries, though you may well be tempted by hot curries, because their primary effect is to stimulate your lungs to cough up the phlegm, to breathe more easily, and to warm your digestion; also to make you sweat some of the Heat away. Unfortunately, their secondary effect is often the opposite which can lead to more Lung Phlegm Heat!
• Other foods to avoid include meat, especially roast or fried or dried meat eg jerky; greasy and rich food, sweets and sweeteners. Read more under hot foods.
• Avoid alcohol, drinks and other drugs that heat.
• Stop smoking tobacco. I suspect even e-vapes are heating.
• Eat slowly and carefully, chewing well before swallowing. Don’t overeat.
• Don’t drink too much cold or iced fluid or food. Better take it luke-warm or cool.
• If you can, go for short walks in the open air – unless the weather is extremely hot or humid. This opens the lungs and moves their Qi.
• See an acupuncturist or practitioner of Chinese herbal medicine. An acupuncturist might well employ, besides needles, cupping or guasha. Chronic Lung Phlegm Heat definitely takes more than one treatment – in fact, usually quite a few.