Phlegm-Heat: Hot phlegm

Phlegm-Heat has lots of green/yellow sputum and a noisy honk of a cough. If acute it comes early in a cold or ‘flu. If chronic, you probably took antibiotics for it.
green liquid in yellow

Phlegm Heat comes in two main forms:

  • Acute phlegm heat
  • Chronic phlegm heat


Acute Phlegm Heat

When your problem is ‘acute’ it usually resolves quickly, moving on to a different condition. With acute phlegm heat you are probably catching a bug, a cold or influenza, and your body is putting up a stiff fight. That means strong but short-lived symptoms which, if successful, quickly vanquish the invader and return you to health:

  • Yellow or green phlegm, tending towards thickness. See phlegm colour for more on this fascinating subject!
  • Heat – this could be a fever, and/or a red face
  • Dryness and thirst though depending on the kind of phlegm, you aren’t always thirsty
  • Blocked nose and breathing, may be sinus complications, probably a headache
  • If thirsty, it’s usually for cold or even iced liquids
  • You may like ice-cream to cool your throat
  • Cough! Noisy, honking, better if you can get the phlegm out
  • Restlessness: hard to settle and rest quietly
  • Sleeping flat is difficult
  • Pulse: usually rapid or faster than normal
  • Tongue: may show little change unless the condition repeats or becomes chronic, see below


Cause of Acute Phlegm Damp

Phlegm Heat can occur from an invasion of Wind
Green and yellow kite on air, in the Wind
  • What you and I call an acute infection (cold, cough, ‘flu etc), Chinese medicine calls an ‘Invasion by external Wind.
  • This Wind attacks your immune system, forcing its way inwards past your body’s attempts to repel it (like your sneezes, coughs and shivers – these are your body’s convulsive reactions to it).
  • Once the external Wind manages to get past this, your body moves on to creating Heat, a (mild) fever perhaps, to try to burn – and therefore kill – the bug off. So the Wind ‘turns into’ Heat.
  • This Heat cooks the natural fluids in your digestion and lungs, thickening them and turning them yellow or green. This becomes a cosy home for the bugs.
  • The Heat also speeds up your metabolism, giving you a slightly hectic feel and a faster pulse.
  • Heat rises so affects the fluids in the upper part of your body, in chest and throat and nose. So it is hard to sleep flat – better to sleep half-inclined. 
  • Heat can produce a fever.
  • You’ll prefer open windows.
  • Heat makes you irritable


How to make it worse!

You can prolong this in several ways.

three capsules on person's palm
Antibiotics – Photo by Mark Fletcher-Brown
  1. Take antibiotics. Yes, these kill the bug (if it’s a bacterium and not a virus) but they don’t help your body since they kill off a good bit of your immune system too.
  2. Take painkillers that also reduce your fever. After sneezing and coughing didn’t work, your body’s next best defence, developed over millions of years, is fever. The fever would also have speeded up antibody production but your painkiller stopped that. Taking something to combat fever slows your body’s productivity.
  3. With no fever to inconvenience it, the invader romps onward, upsetting the normal functions of your lungs and digestion …
  4. … until, in time, with luck, your body produces antibodies.
  5. By then, you are very tired and will take ages to recover.
  6. A short-sharp response (yang) by your body often prevents a long disease followed by a period of slow recovery (yin). Read ‘balancing yin and yang‘ to make more sense of this. I hope.


What to do about an ACUTE attack of Phlegm Heat

  1. Do what’s necessary to help your body deal with the disease itself so …
  2. Avoid antibiotics
  3. Avoid painkillers that also reduce your fever
  4. Absolutely avoid dairy foods, sweet foods, greasy food, alcohol. These foods will tend to worsen your Phlegm Heat condition. Read more under Damp-Heat foods to avoid.
  5. Also, avoid heating foods.
  6. Drink plenty of warm water.
  7. Sniffing up warm, very slightly salty water then spitting it out may help to clear nose and sinuses.
  8. Rest. Sleep – lots, if you can. (Yes, I know I said sleep was difficult and often easier half-propped up!)
  9. Rest your eyes. Listen to the radio. Avoid your computer monitor and other screens, even your Kindle! Don’t watch TV or films – it tires your eyes and depletes your Liver Blood. You need that to keep you stable!
  10. Any food you eat should be warm and be easily digestible. And don’t over-eat or eat too fast! Take  your time. Chew well.
  11. Exercise? No. Not a lot when you have an acute disease. Did I mention Rest? 


Rest is good for phlegm heat!
Rest, and something warm to drink.

Chronic Phlegm Heat

Additional symptoms for chronic Phlegm Heat to those listed above under Acute Phlegm Heat:

  • Heavy, oppressed chest and breathing
  • Phlegm will be harder to hawk up and out
  • Phlegm will be thicker but still yellow/green
  • Cough is still noisy, but not quite as noisy, since you are more tired
  • Phlegm may worsen after eating, especially if you eat the wrong food or too fast.
  • Sometimes you have nausea, or coughing makes your nauseous and you need to vomit to clear the cough: it can be distressing for your companions
  • Face is redder than usual – you may even look healthy to those who don’t know you – but with an underlying pallor – from tiredness
  • Compared with acute phlegm heat you can more easily sleep flat, or nearly flat, but sleep is easily disturbed by oppressed breathing or coughing
  • Thirst and dryness won’t be so acute and you may like warm fluids, especially tea
  • You’ll still prefer open windows
  • You probably prefer fresh fruit and salads to eat
  • Physical exertion soon warms you up but you probably don’t have a fever
  • Tongue: swollen (from Phlegm and some Damp) and red (from Heat). You’ll probably also have a dirty yellow viscid coating over it, especially over the front part or front half.
  • Pulse: a bit fast, and ‘slippery’


Causes of Chronic Phlegm Heat

To get chronic phlegm heat you usually start with an acute attack of phlegm heat – see above. Then …

boy standing in front of lamp

  • either because your body wasn’t strong enough to clear it or
  • you did something that prolonged its stay (see above for frequent causes), the phlegm heat settled in.
  • It could also have come about because another external source of Wind attacked before you had fully recovered from the first one. This could happen several times.
  • Already somewhat weakened by the first, your body couldn’t dislodge the second attack.
  • Because phlegm heat produces phlegm (yes – well, obviously!) which also lodges in your nose, you may feel impelled to pick your nose to clear its phlegm. This is not a good idea, though can be hard to resist. Picking your nose does several things. Firstly it introduces more pathogens because they’re on your fingers. Those join the jolly party going on inside to your body’s disadvantage. Secondly, in Chinese medicine your Lungs ‘rule’ your nose so manhandling your nose in a way manhandles your lungs, which aren’t made for it, further weakening their action. That prolongs the presence of your phlegm heat.
  • Mostly chronic phlegm heat settles in your lungs, giving chronic Lung Phlegm Heat. However, it can also affect your Stomach (with burning epigastric pain, bleeding gums and constipation) and sometimes your Heart (with palpitations, insomnia, agitation and tendency to manic behaviour).
  • Once it settles in, it can become a remaining pathogenic factor, itself a cause of further diseases. Click the link to find out more.


What to do about Chronic Phlegm Heat

If this has become a remaining pathogenic factor (it probably has become it, or soon will, if you do the wrong thing!), recovering fully will take time. Get used to the idea.

Specific things to do about Chronic Phlegm Heat

Overwork is not good if you're trying to clear phlegm-heat

  1. Wrong diet and overwork (see below) both weaken your Spleen. It’s your Spleen that has the job, in Chinese medicine, of clearing out the garbage – that’s your phlegm. Weaken the Spleen and your recovery will take longer. Or put another way, you’ll keep getting ill with it again.
  2. Wrong diet? Certain foods will slow down your Spleen. See Damp-Heat foods to avoid. Most unfortunately, these foods include alcohol.
  3. Overwork? This means long hours of mental application or worry, even if you enjoy it.
  4. Over-excitement? Try to avoid it, as this also upsets your Spleen’s actions.
  5. The same goes for social drugs that ‘speed’ you up.
  6. Don’t pick your nose. Or if you must, do it through a clean tissue – and be very gentle about it.
  7. Don’t take any exercise that exhausts you. However, make sure what you do keeps your spine flexible and strong. Yoga is good, if you know how, but go easy on the upside-down postures. As you recover, fresh air will be good.
  8. Right diet? Increase food only slowly. Eat slowly. Chew well. Eat easily digestible foods, warm. Cooked vegetables. Clogstoun congee. Avoid raw or uncooked food for a while. Don’t overeat.
  9. Be very cautious of pungent spicy foods which you may rather desire and find improvement from, short-term. Unfortunately, the experience of Chinese medicine is that if you eat too many of them you will sweat and may weaken the energy in your Lungs.
  10. Keep warm. Avoid drafts.
  11. Sleep lots.
  12. Acupuncture is good for this phlegm-heat syndrome.
  13. Herbs are good. See someone who practises Chinese herbs: s/he will probably give you an adaptation of a famous formula called wen dan tang. You’ll need to keep taking it for a while.
  14. Read more about Phlegm.


Finding balance in life, yin and yang, helps deal with phlegm-heat
Balancing yin and yang


Jonathan Brand colours

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