Feeling like something sticky is stuck in your throat, unable to cough it up or swallow it down? Always needing to clear your throat before speaking? This lingering phlegm sensation is truly annoying and downright embarrassing in public! It's often a signal of internal "phlegm-dampness" at work.
Where does phlegm come from? It's not just the lungs!
As Dr. Qiu Baorun from Gong Fang Tang TCM Singapore points out, the TCM concept of "phlegm" is more complex than you think. It includes not only the visible phlegm coughed up, but also invisible "phlegm-dampness" lurking within, blocking Qi and blood flow. The throat, being the gateway to the lungs, is a common trouble spot for rising phlegm-dampness. The root cause, however, often lies in dysfunction of three organs:
Spleen - Source of Phlegm: Spleen deficiency weakens digestion, leading to poor metabolism of food essence and fluid accumulation into phlegm.
Lungs - Container of Phlegm: Impaired lung Qi fails to properly distribute fluids or expel phlegm-turbidity.
Kidneys - Root of Phlegm (in chronic cases): Kidney Yang deficiency can't warm the Spleen Yang to transform dampness, or kidney deficiency fails to aid lung Qi reception.
The Solution: Regulate Organs, Expel Phlegm-Dampness
1. Lifestyle Adjustments are Foundational:
Dietary Avoidance: Cut down on sweet, greasy foods, icy drinks, fried foods, BBQ, and dairy – these easily promote dampness and phlegm. Spicy foods might offer brief relief but can create dry-heat, combining with phlegm-dampness to make it harder to clear.
Warm the Spleen & Stomach: Start your day with a warm bowl of multigrain porridge. Sip tea made with dried tangerine peel (Chen Pi) and ginger slices (just a few pieces are enough).
Moderate Exercise: Gentle activities like brisk walking or Ba Duan Jin (gentle qigong exercises), until you sweat lightly, help Qi flow and transform dampness.
Environment & Habits: Avoid damp surroundings. Keep warm, especially your neck. Avoid direct exposure to cold AC drafts.
2. Classical Formulas Require Diagnosis:
Er Chen Tang (Two Matured Substances Decoction): For excessive phlegm-dampness (copious white phlegm, chest/abdominal fullness, thick white greasy tongue coating). Dries dampness, transforms phlegm, regulates Qi.
Ban Xia Hou Po Tang (Pinellia & Magnolia Bark Decoction): For phlegm-Qi obstruction (feeling of throat obstruction, chest/rib-side distension, worsened by emotions). Moves Qi, resolves masses, descends rebellion, transforms phlegm.
Liu Jun Zi Tang (Six Gentlemen Decoction): For spleen deficiency with phlegm-dampness (copious easy-to-expectorate phlegm, fatigue, poor appetite, loose stools). Tonifies Qi, strengthens spleen, dries dampness, transforms phlegm.
Wen Dan Tang (Warm the Gallbladder Decoction): For phlegm-heat disturbing internally or gallbladder stagnation with phlegm (yellow sticky phlegm, bitter taste, irritability, insomnia, anxiety, yellow greasy tongue coating). Regulates Qi, transforms phlegm, clears gallbladder, harmonizes stomach.
Case Study
Patient: Ms. Zhang, 45
Chief Complaint: Throat obstruction with white phlegm for nearly 1 year, worse after meals and mornings. Easily bloated. Pale, swollen tongue with thick, white, greasy coating.
Diagnosis: Spleen Deficiency with Dampness Excess
Prescription: Focus on strengthening the Spleen and tonifying Qi (e.g., based on Xiang Sha Liu Jun Zi Tang), assisted by drying dampness and transforming phlegm (Chen Pi, Ban Xia) and moving Qi to reduce bloating (Zhi Ke, Hou Po). Combined with dietary advice.
Result: After about 3 weeks of treatment, phlegm significantly reduced; bloating and obstruction sensation largely resolved.
Key Insight from Dr. Qiu Baorun:
"Throat phlegm obstruction manifests in the lungs, but its root often lies in the spleen. Don't just treat the lungs when you see phlegm. Carefully diagnose if the patient's constitution is cold or hot, deficient or excess – is it simple phlegm-dampness, or combined with Qi stagnation, Qi deficiency, or Yang deficiency? Treatment must combine phlegm transformation, Qi regulation, and spleen fortification; sometimes warming the kidneys is also needed. Long-standing phlegm-dampness can easily stagnate and transform into heat, increasing treatment difficulty."
