Do you suffer from persistent coughing with phlegm, excessive mucus blocking your throat, with constant white or yellow phlegm? In Singapore's hot and humid climate, over 60% of the population suffers from phlegmy coughs.
What causes coughing with excessive phlegm?
❶ Spleen Deficiency Generating Dampness → Dampness Accumulates into Phlegm (Accounts for 70%)
Symptoms: White, sticky phlegm, especially worse in the morning, poor appetite, sticky stools.
Pathology: Spleen fails in transportation, leading to internal retention of water-dampness (Singapore's hot and humid climate exacerbates this).
❷ Kidney Deficiency with Water Flooding → Phlegm Roots Deeply (Key to Stubborn Phlegmy Cough)
Symptoms: Salty-tasting, foamy phlegm, sore and weak lower back and knees, frequent nighttime urination.
Pathology: Kidney Yang deficiency, inability to steam and transform fluids, flooding upwards to form phlegm.
❸ Lung Fails to Disperse and Descend → Phlegm Stored Causes Harm
Symptoms: Chest tightness, shortness of breath, heavy, turbid cough sound.
Pathology: The lung is the container for phlegm; rebellious Qi causes coughing.
How does Traditional Chinese Medicine (TCM) regulate coughing with excessive phlegm?
Facing stubborn coughing with excessive phlegm, Gong Fang Tang TCM expert Dr. Que Poh Yuen Albert, based on clinical practice in Singapore, especially advocates the formula created by the renowned Qing Dynasty physician Zhang Xichun – Li Tan Tang (Phlegm-Regulating Decoction). This formula does not forcefully suppress coughing. Instead, it directly targets the root source of phlegm production, restarting the body's fluid metabolism to cut off phlegm and stop coughing from the root!
Li Tan Tang is composed of Euryale seed (Qian Shi), Pinellia (Ban Xia), Black Sesame (Hei Zhi Ma), Arborvitae Seed (Bai Zi Ren), White Peony (Bai Shao), Tangerine Peel (Chen Pi), and Poria (Fu Ling).
In the formula: Euryale seed fortifies the spleen and secures the kidneys, blocking the generation of "waste fluids" at the source. Pinellia dries dampness and transforms phlegm, powerfully breaking down already formed sticky phlegm.
Tangerine Peel regulates Qi and moves stagnation, leaving no place for damp-phlegm to hide. Poria fortifies the spleen and leaches out dampness, guiding waste fluids to be expelled via urine. Black Sesame and Arborvitae Seed moisten the lungs and lubricate the intestines, opening "drainage channels" for damp-phlegm.
White Peony restrains Yin and softens the liver, preventing drying herbs from damaging fluids.
Modifications:
Yellow phlegm with heat signs: Add Houttuynia (Yu Xing Cao) 15g, Scutellaria (Huang Qin) 9g.
White phlegm with severe cold: Add Dried Ginger (Gan Jiang) 6g, Asarum (Xi Xin) 3g.
Singapore hot and humid constitution: Add Coix Seed (Yi Yi Ren) 30g, Eupatorium (Pei Lan) 9g.
Medical Case
Patient: Ms. Liu, 31 years old.
Complaint: Main complaint of coughing with excessive phlegm for ten years, especially erupting during rainy seasons and times of high stress. Coughed up large amounts of white sticky phlegm daily, throat felt glued shut, awakened multiple times at night suffocating. Chronic stomach bloating and acid reflux, head feeling heavy and wrapped. Physical examinations showed "no abnormalities." Tried cough suppressants, antibiotics, and lung-clearing folk remedies to no avail, feeling utterly desperate.
Initial Consultation: Pale, swollen tongue with white greasy coating; slippery and wiry pulse.
Diagnosis: Spleen and Kidney dual deficiency as the root, with Liver Qi invading the Stomach and phlegm-Qi binding as the branch.
Prescription: Modified Li Tan Tang. Heavy dose of Euryale seed and Poria to fortify spleen and kidney function. Added Pinellia and Magnolia bark (Hou Po) to dry dampness and transform phlegm. Added Bupleurum (Chai Hu) and Bitter Orange (Zhi Ke) to soothe Liver Qi and regulate Qi. Added a small amount of Amomum fruit (Sha Ren) to awaken the spleen and open the stomach.
Medical Advice: Forbidden cold drinks, sweets, dairy products, fried foods.
Result: On day 3, phlegm volume increased (healing crisis reaction), but coughing frequency slightly decreased. By day 7, morning nausea disappeared, phlegm became thinner and easier to expectorate. By day 15, nighttime coughing essentially stopped, daytime phlegm volume reduced by 70%, stomach bloating significantly alleviated.
