Expectoration refers to the expulsion of phlegm through coughing, that is, the phlegm from the lungs and the respiratory tract (trachea), which is expelled through the throat and mouth via coughing. The ancient character for phlegm (痰) was the same as that for "thin" (澹), meaning "the appearance of water shaking" (Shuowen). Therefore, all conditions of water retention in the body (such as in the intestines, chest, flanks, or limbs) were referred to as phlegm or phlegm-fluid retention, which also means water or fluid retention. The phlegm produced by the lungs and respiratory tract was anciently called "saliva" (涎), "foam" (沫), "spittle" (唾), or "turbidity" (濁) (Jingui Yaolue).

Generally, the clearer and thinner ones could be called saliva or foam, while the stickier and thicker ones could be called spittle or turbidity. These saliva, foam, spittle, and turbidity are also formed due to the failure of water-dampness to transform, leading to the accumulation of phlegm in the lungs. Later generations referred to saliva, foam, spittle, and turbidity as phlegm or phlegm-fluid retention, with the clearer and thinner ones called "fluid" (飲) and the stickier and thicker ones called "phlegm" (Yizong Jinjian). Therefore, phlegm can be understood in a broad or narrow sense. In the broad sense, phlegm refers to water, and phlegm-fluid retention refers to fluid retention. In the narrow sense, phlegm is the product of the lungs and respiratory tract, with the thicker ones called phlegm and the thinner ones called fluid. This section only discusses the narrow sense of phlegm, or phlegm-fluid retention, expelled through coughing.

bubble_chart Syndrome Analysis

1. Dampness-heat Yun Lung︰Coughing up pus and bloody sputum or fishy sputum, high fever or tidal fever, chest tightness and pain, unfavorable turning, even breathing and being unable to lie down, sweating, dry mouth and throat without thirst, dysphoria, red tongue with yellow and greasy coating, slippery or rapid pulse And powerful. It can be due to the evil of external contraction dampness-heat or excessive phlegm and heat, or excessive consumption of wine, cheese, and spicy food, causing dampness-heat to accumulate in the lungs and steaming in the lungs; and there are signs of dampness-heat, such as abdominal distension and fullness. anorexia, greasy coating, etc.; red tongue, yellow and greasy coating are its main characteristics; Lonicera and Forsythia Powder can be used plus Skullcap Root, Coptis Rhizome, etc.
2. Dampness-heat Yun Lung︰Coughing up pus and bloody sputum or fishy sputum, high fever or tidal fever, chest tightness and pain, unfavorable turning, even breathing and being unable to lie down, sweating, dry mouth and throat without thirst, dysphoria, red tongue with yellow and greasy coating, slippery or rapid pulse And powerful. It can be due to the evil of external contraction dampness-heat or excessive phlegm and heat, or excessive consumption of wine, cheese, and spicy food, causing dampness-heat to accumulate in the lungs and steaming in the lungs; and there are signs of dampness-heat, such as abdominal distension and fullness. anorexia, greasy coating, etc.; red tongue, yellow and greasy coating are its main characteristics; Lonicera and Forsythia Powder can be used plus Skullcap Root, Coptis Rhizome, etc.
3. Dampness-heat Yun Lung︰Coughing up pus and bloody sputum or fishy sputum, high fever or tidal fever, chest tightness and pain, unfavorable turning, even breathing and being unable to lie down, sweating, dry mouth and throat without thirst, dysphoria, red tongue with yellow and greasy coating, slippery or rapid pulse And powerful. It can be due to the evil of external contraction dampness-heat or excessive phlegm and heat, or excessive consumption of wine, cheese, and spicy food, causing dampness-heat to accumulate in the lungs and steaming in the lungs; and there are signs of dampness-heat, such as abdominal distension and fullness. anorexia, greasy coating, etc.; red tongue, yellow and greasy coating are its main characteristics; Lonicera and Forsythia Powder can be used plus Skullcap Root, Coptis Rhizome, etc.
4. Dampness-heat Yun Lung︰Coughing up pus and bloody sputum or fishy sputum, high fever or tidal fever, chest tightness and pain, unfavorable turning, even breathing and being unable to lie down, sweating, dry mouth and throat without thirst, dysphoria, red tongue with yellow and greasy coating, slippery or rapid pulse And powerful. It can be due to the evil of external contraction dampness-heat or excessive phlegm and heat, or excessive consumption of wine, cheese, and spicy food, causing dampness-heat to accumulate in the lungs and steaming in the lungs; and there are signs of dampness-heat, such as abdominal distension and fullness. anorexia, greasy coating, etc.; red tongue, yellow and greasy coating are its main characteristics; Lonicera and Forsythia Powder can be used plus Skullcap Root, Coptis Rhizome, etc.
5. Dampness-heat Yun Lung︰Coughing up pus and bloody sputum or fishy sputum, high fever or tidal fever, chest tightness and pain, unfavorable turning, even breathing and being unable to lie down, sweating, dry mouth and throat without thirst, dysphoria, red tongue with yellow and greasy coating, slippery or rapid pulse And powerful. It can be due to the evil of external contraction dampness-heat or excessive phlegm and heat, or excessive consumption of wine, cheese, and spicy food, causing dampness-heat to accumulate in the lungs and steaming in the lungs; and there are signs of dampness-heat, such as abdominal distension and fullness. anorexia, greasy coating, etc.; red tongue, yellow and greasy coating are its main characteristics; Lonicera and Forsythia Powder can be used plus Skullcap Root, Coptis Rhizome, etc.
6. Dampness-heat Yun Lung︰Coughing up pus and bloody sputum or fishy sputum, high fever or tidal fever, chest tightness and pain, unfavorable turning, even breathing and being unable to lie down, sweating, dry mouth and throat without thirst, dysphoria, red tongue with yellow and greasy coating, slippery or rapid pulse And powerful. It can be due to the evil of external contraction dampness-heat or excessive phlegm and heat, or excessive consumption of wine, cheese, and spicy food, causing dampness-heat to accumulate in the lungs and steaming in the lungs; and there are signs of dampness-heat, such as abdominal distension and fullness. anorexia, greasy coating, etc.; red tongue, yellow and greasy coating are its main characteristics; Lonicera and Forsythia Powder can be used plus Skullcap Root, Coptis Rhizome, etc.

bubble_chart Documentation

1. Suwen．Ping Rebing Lun：「Emperor said: How is the disease of common cold due to overstrain? Qibo said: The method for common cold due to overstrain lies below the lungs, and the disease it causes makes people forcefully look upwards with dim vision, spit out as if it were mucus, have an aversion to wind and shiver with cold. This is the disease of common cold due to overstrain. Emperor said: How to treat it? Qibo said: To save from bending and lifting. For those with strong yang essence, it takes three days, for middle-aged people five days, and for those without essence seven days. They will cough out green-yellow mucus, which looks like pus and is as big as a pellet, coming out from the mouth or nose. If it does not come out, it will injure the lungs, and injuring the lungs leads to death.」
2. Zhengyin Maizhi．external contraction phlegm syndrome/pattern》：「The cause of wind phlegm is external wind pathogens attacking the body's surface, binding the internal depressed fire, preventing it from venting. When external pathogens transmit internally, and internal and external steaming occurs, then the symptoms of wind phlegm arise. The pulse of wind phlegm is mostly floating and slippery; floating and rapid indicates wind-heat, floating and tight indicates wind-cold. If deep and slippery is seen, it indicates internal binding of wind pathogens; large and full is easy to treat, deep and thin is difficult to cure.」「The cause of damp phlegm is either sitting or lying in low and damp places, or rushing through wind and rain, then dampness attacks the body, internally congealing with the body's fluids to form abdominal mass. Lingshu says, wind and rain attack the deficiency of yin, the disease arises from above and forms accumulations; clear dampness attacks the deficiency of yin, the disease arises from below and forms gatherings. This is the cause of damp phlegm. The pulse of damp phlegm is mostly floating and large; floating and moderate indicates wind, floating and rough indicates dampness, floating and slippery indicates damp phlegm, deep and slippery indicates stubborn binding.」「The cause of dry phlegm is either excessive yang activity, encountering the fire season, dryness-heat qi dries the lung system, causing panting and coughing, injuring the intestines and stomach, causing phlegm and cough, thus external contraction dry phlegm arises. The pulse of dry phlegm is necessarily large and rapid; floating and rapid injures the exterior, deep and rapid injures the interior, left pulse large and rapid indicates dryness injuring the liver and gallbladder, right pulse large and rapid indicates dryness injuring the lungs and stomach.」
3. Zhengyin Maizhi．internal damage phlegm syndrome》：「The cause of dry phlegm is the fire of five emotions, sometimes moving within, or excessive sexual desire, true water drying up, or rich food accumulating heat, intestines and stomach being scorched, steaming the lungs, refining into phlegm, then the symptoms of dry phlegm arise. The pulse of dry phlegm is rapid and large in the right inch, indicating heat in the lung system; deep and rapid in the right guan indicates heat in the intestines and stomach; rapid in the left guan indicates wood-fire pathogens; deep and rapid in both chi indicates dryness exhausting kidney water.」「The cause of damp phlegm is insufficient middle qi, stomach yang unable to digest, spleen yang unable to distribute, then water and grain stagnate, forming phlegm and fluid, and the symptoms of damp phlegm are formed. The pulse of damp phlegm is mostly deep and slippery; slippery and solid indicates stubborn phlegm, slippery and soft indicates deficiency stagnation, slippery but not rapid indicates spleen dampness forming phlegm, slippery and rapid indicates dampness-heat.」