In Part I we learned about the many signs and symptoms of Damp Stagnation and its far reaching affects on health. In this segment we’ll cover how to treat and prevent Damp Stagnation and Phlegm. Of course you’ll be immediately interested in the herbs and formulas to use, but first I’ll cover other therapies since they are integral, even essential, to preventing and treating this issue.

Therapies for Damp Stagnation

Diet Therapy

Foods to Eat: Protein, grains, legumes, cooked vegetables, cooked fruits, spices added to food, warm drinks

Foods to Avoid: Cold foods and/or drinks; iced foods and drinks; raw foods such as raw veggies in salads, fried and fatty foods, greasy foods, dairy (yogurt is the consistency of mucus, right?!), sugar, alcohol, tofu, soy milk, and all flour products (bread, muffins, bagels, pastries, doughnuts, cake, crackers, pasta, and so on!)

Emotional Therapy

Appropriately express and release emotions on a regular basis

Lifestyle Therapies

Regular eating habits; alternate work with rest and play; sufficient exercise and activity; limit pharmaceuticals as much as possible

Other Therapies

Moxibustion, cupping (be sure to dress any water blisters that may appear); if working or living in damp environments such as concrete floors and rooms, wear protective shoes and sufficient clothing; avoid prolonged wearing of wet clothing (bathing suits for example) or standing in water

Herbal Therapy

Both diuretics and Phlegm-resolving herbs are used depending on the severity of the Damp Stagnation.

Diuretics/Herbs that Drain Dampness

• coriander seed (Coriandrum sativum)
• parsley leaf and seed (Petroselinum sativum)
• hoelen (Sclerotium Poriae Cocos, fu ling)
• pipsissewa (Chimaphilla umbellata)
• water plantain (Alisma plantago)
• cleavers (Galium aparine)
• dandelion leaf (Taraxacum officinalis)
• coix (Coicis lachryma-jobi, yi yi ren)
• akebia (Caulis mutong, mu tong)
• plantain seed (Plantago asiatica, P. depressa, che qian zi)
• musk mallow seeds (Malva verticillata, dong kui zi)

Transform Phlegm

The following expectorants are used according to whether it is Cold Phlegm or Hot Phlegm.

Cold Phlegm:

• pinellia (Rhizoma Pinelliae ternatae, ban xia)
• platycodon (Platycodon grandiflorum, jie geng)
• elecampane (Inula spp., xuan fu hua)
• jack-in-the-pulpit rhizome (Arisaema spp., tian nan xing)
• white mustard seed (Brassica alba, bai jie zi)

Hot Phlegm:

• fritillary bulb (Fritillaria spp., chuan bei mu)
• trichosanthes (all parts of Trichosanthes kirlowii: seed gua lou, peel gua lou pi, root tian hua fen, seeds gua lou ren)
• bamboo (all parts of Bambusa breviflora, B. textilis, tian zhu huang, zhu li, zhu ru)
• hogfennel root (Peucedanum praeruptorum, qian hu)
• clam shell (Cyclinae sinensis, hai ge ke)
• seaweeds

Kitchen medicine

For quick use around the home use parsley, coriander seed, celery, peas, carrots, corn silk, or aduki beans (especially with carp or other fish) as diuretics; for Phlegm use cardamom or cloves.

Note: Because Drain Damp and Transform Phlegm herbs tend to be drying, use with caution in those with Deficient Blood or Yin. As well, combine with herbs to clear Heat or warm Internal Cold as appropriate.

Formulas for Damp Stagnation and Phlegm

Citrus and Pinellia Combination (Er Chen Tang or Two Cured Decoction)

This is the best general formula for most types of Damp Stagnation or Phlegm.

• Pinellia (Pinellia ternate, ban xia) 15 g
• Citrus peel (Citri reticulatae, chen pi) 15 g
• Poria (Poria cocos, fu ling) 9 g
• Baked licorice (Glycyrrhizae uralensis, zhi gan cao) 4 g

Prepare as a decoction adding 3 g of fresh ginger (sheng jiang) and one piece of umeboshi plum (dried or salt-preserved).

Properties and Actions

a) Dries Damp and dispels Phlegm

b) Regulates Qi and harmonizes the Middle Warmer (Stomach and Spleen).

Indications: Cough with Damp-Cold Phlegm caused by Damp-Cold of the Spleen and Stomach. Symptoms may include chest and epigastric fullness, nausea, vomiting, lassitude, feeling of heaviness (from excess mucus), possibly vertigo and palpitations in extreme cases. May be considered for upper respiratory tract infection, chronic bronchitis, cough, goiter, chronic gastritis, peptic ulcer and Meniere’s disease.

Tongue: Moist, greasy white coat

Pulse: Slippery

There are many, many formulas for Damp stagnation and Phlegm. Following is a general list:

Upper Warmer Formulas

Phlegm-Heat Obstructing Lungs

Ephedra and Apricot Seed Combination (Ma Xin Shi Gan Tang)

• Ephedra (Ephedra sinica, ma huang) 6-9 g
• Apricot seed (Prunus armeniaca, xing ren) 6-9 g
• Gypsum (Calcium sulfate, shi gao) 15-30 g
• Baked licorice (Glycyrrhiza uralensis, zhi gan cao) 3-6 g

Properties and Actions:

a) Clears External conditions

b) anti-asthmatic

Indications: For External Wind Heat and Interior Lung Heat. Symptoms include fever, with or without perspiration, asthma, thirst and dryness.

Tongue: Either a thin white or yellow coat

Pulse: Floating, rapid and slippery

Contraindication: Not for asthma caused by Wind Cold

Other useful upper warmer formulas

Dampness or Phlegm Obstructing the Head: Pinellia and Gastrodia Combination

Damp Phlegm Obstructing the Lungs: Perilla Seed Decoction

Middle Warmer Formulas

Poria Five Herbs formula (Wu Ling San)

• Poria (Poria cocos, fu ling) 6-9 g
• Water plantain (Alisma plantago-aquatica, ze xie) 9-12 g
• Polyporus (Polyporus umbellatus, zhu ling) 6-9 g
• Cinnamon twig (Cinnamomum cassia, gui zhi) 6-9 g
• White atractylodes (Atractylodes alba, bai zhu) 6-9 g

Properties and Actions:

a) Diuretic, clears edema

b) Diaphoretic

c) Digestive, strengthens the Spleen

Indications: This is the primary diuretic formula. It is used for Spleen dampness conditions, edema, thirst, headache, nausea and vomiting after drinking water, urinary retention, ascites, cardiac edema, digestive problems including acute gastritis, gastrectasis, ascites caused by liver cirrhosis, acute enteritis with diarrhea as well as swollen testicles.

Tongue: white and moist

Pulse: floating, slippery

Other useful Middle Warmer formulas

Phlegm and Dampness caused by Deficient Spleen: Six Gentlemen Decoction (Liu Jun Zi Tang)

Magnolia and Ginger Formula (Ping Wei San)

Magnolia and Hoelen Combination (Wei Ling Tang)

Obstruction of Spleen by Dampness with Stagnation of Liver Qi: Capillaris Combination (Yin Chen Hao Tang)

Stagnation of Phlegm in the Gall Bladder: Bamboo and Poria Combination (Wen Dan Tang; Gall Bladder Warming Decoction)

Lower Warmer Formulas

Two Effective Ingredients (Er Miao San)

• Phellodendron (Phellodendron amurense, huang bai) 6-9 g
• Black Atractylodes (Atractylodes lancea, cang zhu) 9-12 g

Properties and Actions: Clears Damp-Heat.

Indications: Lower back pain caused by Damp-Heat with symptoms of pain in the knees, eczema, leukorrhea, dark colored and scanty urine, tinea pedis (athlete’s feet), eczema, gonorrhea

Tongue: Yellow and greasy coat

Pulse: Soft and rapid

Other useful Lower Warmer formulas:

Vitality Combination (Zhen Wu Tang; Black Warrior Decoction)

Polyporus Combination (Zhu Ling Tang)

In the Channels and Meridians

Damp Stagnation or Phlegm in the Channels

Stephania and Astragalus Combination (Fang Ji Huang Qi Tang)

• Stephania (Stephania tetrandra, fang ji) 6 g
• Astragalus (Astragalus membranaceus, huang qi) 9 g
• White atractylodes (Atractylodes alba, bai zhu) 6 g
• Dry ginger (Zingiberis officinalis, gan jiang) 6 g
• Jujube dates (Zizyphus jujube, da zao) 3-5 pieces
• Licorice (Glycyrrhiza uralensis, gan cao) 1.5 g

Properties and Actions:

a) Diuretic, clears Excess fluid and removes edema

b) Tonifies the Spleen Qi

c) Calms External Wind

Indications: For swollen abdomen, ascites, edema with a Deficient exterior. Other symptoms include spontaneous perspiration, pale and puffy skin, obesity (especially useful with Ledebouriella and Platycodon Combination), arthritis and rheumatic problems. It can be considered for congestive heart conditions and nephritic edema.

Tongue: Pale with a white coat

Pulse: Floating, weak, soft or thready

Contraindications: Not used if there are no signs of fluid retention.