Heat phlegm

1. A phlegm pattern characterized by cough with thick sticky yellow or white phlegm that is difficult to expectorate and by rapid breathing. General signs include heat effusion, dry mouth, sore swollen throat, red tongue with yellow fur, and slippery rapid pulse, all of which indicate heat. In internal damage miscellaneous disease, repeated incidence of heat phlegm signs often gives rise to phlegm-fire. This occurs when phlegm heat failing to clear brews internally and Transforms into fire.

Comparison: Heat phlegm should be distinguished from dryness phlegm. Dryness phlegm is caused by dryness evil or lung (or lung-kidney) yīn vacuity and is characterized by scant phlegm that is difficult to expectorate, and signs of yīn humor depletion such as dry mouth, tongue, throat, and nose. In contrast, heat phlegm is characterized by thick yellow or white phlegm, rapid breathing, and pronounced heat signs. Dryness phlegm is either vacuity or repletion; heat phlegm is always a repletion pattern.

Biomedical correspondence: Heat phlegm usually falls within the scope of acute inflammatory respiratory diseases (or acute attacks in chronic conditions) in Western medicine.

Medicinal therapy: Clear heat and resolve toxin; transform phlegm. Commonly used medicinals include scutellaria (Scutellariae Radix, 黄芩 huáng qín), lonicera (Lonicerae Flos, 金银花 jīn yín huā), dandelion (Taraxaci Herba, 蒲公英 pú gōng yīng), houttuynia (Houttuyniae Herba, 鱼腥草 yú xīng cǎo), mulberry root bark (Mori Cortex, 桑白皮 sāng bái pí), lepidium/descurainiae (Lepidii/Descurainiae Semen, 葶苈子 tíng lì zǐ), Sichuan fritillaria (Fritillariae Cirrhosae Bulbus, 川贝母 chuān bèi mǔ), trichosanthes (Trichosanthis Fructus, 栝楼 guā lóu), bamboo sap (Bambusae Succus, 竹沥 zhú lì), fresh phragmites (Phragmititis Rhizoma Recens, 鲜芦根 xiān lú gēn), and wax gourd seed (Benincasae Semen, 冬瓜子 dōng guā zǐ). Formulas include Lonicera and Phragmites Mixture (银苇合剂 yín wěi hé jì) and its variations.

Acumoxatherapy: Base treatment mainly on LU, LI, and back transport points. Select BL-13 (Lung Transport, 肺俞 fèi shù), LU-5 (Cubit Marsh, 尺泽 chǐ zé), GV-14 (Great Hammer, 大椎 dà zhuī), LI-11 (Pool at the Bend, 曲池 qū chí), LI-4 (Union Valley, 合谷 hé gǔ), ST-40 (Bountiful Bulge, 丰隆 fēng lóng), and CV-22 (Celestial Chimney, 天突 tiān tú); needle with drainage. For sore swollen throat, drain LU-11 (Lesser Shang, 少商 shào shāng) or prick to bleed.

2. A disease pattern arising in patients suffering from phlegm disease, when eating hot spicy foods and rich fried or roasted meats, using excessively thick clothing or bedclothes, and from heat evil due to hot weather triggers panting, expectoration, cough, and spitting.

3. Phlegm-heat confounding the heart arising when phlegm and heat contend with each other, gather and bind. It is characterized by turbid thick gluey yellow phlegm that is sometimes flecked with blood and that is difficult to expectorate, and by a surging pulse, red face, heat vexation and heart pain, frequent laughing, mania and withdrawal, clamoring stomach, anguish, fearful throbbing, and dry mouth and lips.

Medicinal therapy: Clear the heart, drain fire, and abduct phlegm. Use Qì-Clearing Phlegm-Transforming Pill (清气化痰丸 qīng qì huà tán wán) or Chlorite/Mica Phlegm-Rolling Pill (礞石滚痰丸 méng shí gǔn tán wán).

Acumoxatherapy: Base treatment mainly on GV, HT, ST, and PC. Select GV-26 (Water Trough, 水沟 shuǐ gōu), BL-15 (Heart Transport, 心俞 xīn shù), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), ST-40 (Bountiful Bulge, 丰隆 fēng lóng), ST-44 (Inner Court, 内庭 nèi tíng), HT-7 (Spirit Gate, 神门 shén mén), PC-7 (Great Mound, 大陵 dà líng), and PC-5 (Intermediary Courier, 间使 jiān shǐ); needle with drainage.

4. Fire phlegm.