Phlegm

Phlegm with a Canadian quarter for scale.

Phlegm (pronounced /flɛm/) is sticky fluid secreted by the mucus membranes of humans and other animals. Its definition is limited to the mucus produced by the respiratory system, excluding that from the nasal passages, and particularly that which is expelled by coughing (sputum). Its composition varies, depending on climate, genetics and state of the immune system, but basically is a water-based gel consisting in glycoproteins, immunoglobulins, lipids, etc.

In ancient (and now entirely discredited) Hippocratic medicine phlegm was counted as one of the four bodily humours, possessing the properties of coldness and wetness, and was responsible for apathetic and sluggish behaviour. This old belief is preserved in the word phlegmatic.

Alternate definitions of phlegm from TheFreeDictionary are: "sluggishness of temperament" and "calm self-possession; equanimity." The latter was used by Sir William Osler in Aequanimitas.

Colors of phlegm

Phlegm may be of several different colors.

• "Healthy" phlegm is normally clear or white; however, the initial state of the common flu when the phlegm is still clear can also be the most infectious period.
• Yellow phlegm means that the immune system is responding and may be a sign of an infection.
• Greenish or brownish phlegm is nearly always a sign of infection. Greenish or rusty phlegm or phlegm with rusty spots can also be a sign of pneumonia and/or internal micro-bleedings.
• Coughing up brown phlegm is also a common symptom of smoking. This is due to resin sticking to the viscous texture of the phlegm and being ejected by the body.
• Another type of phlegm often associated with smoking is brownish gray in color. This variant is encased in clear saliva. When spread out, the brown-gray "core" is shown to be grainy in composition, as opposed to holding together. This is simply dust and other foreign matter and may be caused by damage to the cilia, as in COPD patients.

Illnesses related to phlegm

Phlegm may be a carrier of larvae of intestinal parasites (see hookworm). Bloody sputum can be a symptom of serious disease (such as tuberculosis and lung cancer), but can also be a relatively benign symptom of a minor disease (such as bronchitis). In the latter case, the sputum is normally lightly streaked with blood. Coughing up any significant quantity of blood is always a serious medical condition, and any person who experiences this should seek medical attention.

Phlegm and humourism

Humourism is an ancient theory that the human body is filled with four basic substances, called the four humours, which are held in balance when a person is healthy. It is closedly related to the ancient theory of the four elements and states that all diseases and disabilities result from an excess or deficit in black bile, bile, phlegm, and blood. Hippocrates, an ancient Greek thinker, is credited for this theory, about 400 BC. It influenced medical thinking for more than 2,000 years, until finally discredited in the 1800s.

Phlegm as equanimity

Sir William Osler’s 1889 Aequanimitas discusses the imperturbability or calmness in a storm required of physicians. "Imperturbability means coolness and presence of mind under all circumstances, calmness amid storm, clearness of judgment in moments of grave peril, immobility, impassiveness, or, to use an old and expressive word, phlegm." This was his farewell speech at the University of Pennsylvania in 1889 before becoming Physician-in-Chief at the recently founded Johns Hopkins Hospital in Baltimore, Maryland. This is from "Celebrating the Contributions of William Osler" in the Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions." (Editorial Note: Equanimity is a trait needed in fields and philosophies other than medicine.)

Lorna Phlegming

The term "Phlegm" comes from it's discoverer Lorna Fleming. Lorna is an administrative worker living in Scotland. Although now known as Fleming her surname was originally "Phlegming" and this is where the term originated from. Lorna has become famous worldwide since discovering phlegm and is now know throughout the world as FlemBot, FlemStain and FlemBreath. She is sometimes also referred to as Wee Maggie Fleming or Wee Mags. This is a direct reference to her middle name of Margaret.