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Lung Pattern Differentiation in Chinese Medicine

Lung Patterns

Etiology

Lung patterns can be of either Excess or Deficiency. With Deficient patterns, Lung Qi Deficiency is more common than Lung Yin Deficiency. In Excess patterns, the Lungs are usually invaded by external pathogens, mostly Wind, Cold, and Heat.

Pathogens

Wind can combine with Cold or Heat to form Wind-Cold and Wind-Heat. Exogenous pathogenic factors commonly first attack the Wei Qi (defensive energy) and exterior of the body. This would result in exterior condition, as the Lungs have not yet been affected. Common symptoms such as fever, chills, aversion to Cold, aching, sneezing, and stuffy nose indicate the struggle between the Body's Wei Qi and the invading pathogen (such as external Wind Heat). As the condition worsens, the Lungs can easily become involved.

Dryness, both internal and external, can affect the lungs creating symptoms such as dry throat, cough, and dry skin (the Lungs control the skin).

Although uncommon, Dampness can combine with Wind causing an Exterior disorder with facial edema.

Diet

Excessive consumption of Cold and raw (salads, dairy, etc.) foods decreases the Spleen's ability to transform and transport nutrients. When the Spleen's ability is impaired, Internal Dampness and eventually Phlegm accumulates in the Body. In Chinese Medicine it is said that while the Spleen is the producer of Phlegm, the Lungs are the container for Phlegm.

Emotions

Both sadness and worry are associated with the Lungs. Chronic sadness disperses Qi and causes Lung Qi Deficiency. Chronic worry knots or ties up the Qi causing Stagnation of Qi in the chest.

Lifestyle

Activities (or non activities) that restrict movement of the chest and breathing such as being hunched over a desk in computer work, reading, or studying can deplete the Lung Qi. Excessive laziness and lounging can also weaken Lung Qi.

Lung Qi Deficiency

Signs

  • Weak breathing, shortness of breath on exertion
    The Lungs govern respiration
  • Weak cough
    Lungs are too weak to send Qi downward
  • Thin watery sputum
    Lung Qi too weak to regulate water passages
  • Weak voice, lack of desire of speaking
    Weak Zong Qi
  • Spontaneous sweating, easily sweats, daytime sweating
    Lungs circulate Wei Qi which governs the opening and closing of skin pores
  • Aversion to Cold
    Lungs and Wei Qi warm the skin and muscles
  • Bright white complexion
    Qi Deficiency
  • Weakened Immunity
    Weak Lung Qi is also closely tied to weak Wei Qi, which could lead to frequent colds.

Pulse

Empty pulse

Tongue

Pale or normal tongue body

Etiology/Pathology

Chronic Lung problems may be hereditary, especially if a parent had Lung tuberculosis. There may be transverse cracks in Lung area and the Lung's pulse position may be more medial than normal.

Exterior Wind Cold or Wind Heat may remain in the body and eventually cause Lung Qi Deficiency. There is often a chronic cough following an exterior Wind Cold or Wind Heat invasion. This situation can be worsened when taking antibiotics for cold or flu, as they contain the Cold in the chest and interfere with Lung's dispersing & descending functions.

Lung Yin Deficiency

Signs

  • Dry cough or cough with sticky sputum
    Lung Yin not nourishing Lung
  • Dry mouth and throat, Hoarse voice
    Deficient fluids
  • Blood tinged sputum
    Yin Deficient Heat burns the vessels
  • Lover grade fever or heat sensation in the evening time, malar flush, night sweats, five palm heat
    Yin Deficiency producing empty heat
  • Insomnia
    Yin Deficiency and Heat disturb the Shen

Tongue

  • Red peeled tongue with cracks in the Lung area
    In early stage, tongue signs are not as pronounced

Pulse

  • Empty, floating, and rapid pulse

Etiology

  1. Lung Yin Deficiency can develop from prolonged Lung Qi Deficiency.
  2. Can be due to Stomach Yin Deficiency, which can be caused by irregular eating habits or diet.
  3. Can result from Kidney Yin Deficiency, which can be caused by chronic overwork.
  4. Can develop from Lung Dryness (from external or internal causes)

Treatment Principle

  • Tonify Lung Yin, nourish Body fluids clear Empty Heat

Points

  • LU 9 (Taiyuan)
    Source point; can tonify Lung Yin
  • REN-17 (Shanzhong)
    Tonifies Qi and Lung Yin
  • BL 43 (Gaohuangshu)
    Tonifies Lung Yin, especially good in chronic cases
  • BL 13 (Feishu)
    Tonifies Lung Qi & Yin
  • Du 12 (Shenzhu)
    Tonifies Lung Qi & Yin
  • REN-4 (Guanyuan)
    Tonifies Kidney Yin & conducts Empty Heat downwards
  • KI 6 (Zhaohai )
    Tonifies Kidney Yin & benefits throat esp. good where throat is dry. Can combine LU 7 and KI 6 to tonify Lung Qi and Lung Yin, tonify KI Yin & benefit throat, reconnect Lungs & Kidneys
  • REN-12 (Zhongwan )
    Tonifies Stomach & nourishes fluids (Stomach is origin of fluids)
  • LU 10 (Yuji)
    Sedate to clear Empty Heat from Lungs

Method

Tonify all Points except LU 10 which is sedated. No moxa.

Lung Dryness

Lung Dryness is characterized by signs of Dryness with deficient fluids, but it is not yet of Yin Deficiency. It could be considered less severe and a precursor to Lung Yin Deficiency.

Signs

  • Dry cough, Dry throat, Dry mouth, Dry skin
  • Thirst
  • Hoarse Voice

Tongue

  • Dry, but not Red

Pulse

  • Empty, especially in the Lung position

Etiology/Pathology

Lung Dryness can be either Exterior or Interior. Exterior Dryness damages Lung fluids, such as in long periods of dry and hot weather. Internal Dryness can occur from Stomach Yin Deficiency (i.e. - from irregular eating times, irregular diet, etc.).

Treatment Principle

  • Moisten the Lungs and Nourish Fluids

Points

  • LU 9 (Taiyuan)
    Moistens Lungs
  • REN-4 (Guanyuan)
    Tonify Kidney Yin & nourishes fluids
  • KI 6 (Zhaohai)
    Nourishes Fluids, benefits throat
  • Sp 6 (SanYinjiao)
    Nourishes Fluids
  • REN-12 (Zhongwan)
    Tonifies Stomach & nourishes Fluids

Method

  • Tonify all points

Invasion of Lungs by Wind Cold

Signs

  • Fever
    Wind Cold pathogen battles with Wei Qi
  • Aversion to Cold
    Exterior Cold impairs circulation of Wei Qi which cannot warm muscles
  • Occipital headache, whole head headache
  • Body aches
    Exterior Cold impairs circulation of Wei Qi which cannot warm muscles
  • Cough, sneezing, stuffy nose or runny nose with thin clear mucus, Itching throat
    Lungs descending and dispersing ability is impaired

Tongue

  • Thin white tongue coating

Pulse

  • Floating pulse

Etiology/Pathology

  1. Environmental Wind and Cold can enter the body (to superficial or deep levels) depending on the strength of body's Wei Qi in relation to a pathogen.
  2. Artificial sources of Wind Cold, such as air conditioning can also cause Wind Cold.

Treatment Principle

  • Release Exterior, disperse Cold, stimulate Lung descending and dispersing function

Points

  • LU 7 (Lieque)
    Disperses Wind Cold, releases Exterior, stimulates Lung dispersing/descending
  • BL 12 (Fengmen)
    Releases Exterior, Expels Wind (esp cupped) Moxa after needling.
  • Du 16 (Fengfu)
    Expels wind

Method

sedation; moxa applicable after needling.

Invasion of the Lungs by Wind Heat

Exterior pathogenic Wind combines with Heat and invades Lung Exterior portion (Lung Defensive Qi portion)

Signs

  • Fever
    External Wind battles with Wei Qi
  • Aversion to Cold
    Wind obstructs Wei Qi circulation
  • Sore throat, Swollen tonsils, thirst
    Pathogenic Heat drying body fluids
  • cough, stuffy nose, runny nose with yellow mucus
    External pathogen disrupts descending and dispersing function of the Lungs
  • Headache and body aches
  • Slight sweating

Tongue

  • Red body on sides or tip, thin white or yellow coating

Pulse

  • Floating and rapid pulse

Etiology/Pathology

  • Exposure to Wind may turn to Wind Heat in a person with a tendency toward Heat.
  • Wind Heat may be caused by virus or bacteria contracted through the nose and mouth.
  • Exposure to environmental wind and heat

Treatment Principle

  • Release Exterior, clear Heat, stimulate Lung descending and dispersing functions

Points

  • LI 4 (Hegu)
    Release Exterior & clear Heat
  • LI 11 (Quchi)
    Release Exterior & clear Heat
  • Lu 11 (Shaoshang)
    Clears Lung Heat. Esp good for sore throat
  • Du 14 (Dazhui)
    Clear heat
  • BL 12 (Fengmen)
    Expel Exterior Wind
  • Du 16 (Fengfu)
    Expel Exterior Wind
  • GB 20 (Fengchi)
    Expel Exterior Wind

Method

Sedate. No moxa. LU-11 can be bled for sore throat

Invasion of the Lungs by Wind-Water

This is an Exterior invasion of Wind-Cold and Damp pathogens. In addition to Wind-Cold signs, there are signs of Dampness as well. Because the Lung's function of controlling Water passages is impaired, this results in facial edema.

Signs

  • Sudden swelling of the face and eyes, which may spread to the whole body, scanty urination
    Lungs are obstructed by Wind-Cold-Damp and can not properly send Fluids downward
  • Pale urination, bright shiny complexion
    Wei Qi and Yang movement is impeded
  • Aversion to Wind
    Impaired Wei Qi
  • Fever
    Exterior pathogen struggling with the Wei Qi
  • Cough and shortness of breath
    Lung Qi not descending

Tongue

  • White slippery tongue coat

Pulse

  • Floating and slippery

Etiology/Pathology

Exposure to exterior Wind-Cold and Dampness

Treatment Principle

  • Release the Exterior, disperse Cold, resolve Dampness, restore Lung descending function, open Water Passages

Points

  • LU-7 (Lieque)
    Releases Exterior, stimulates Lung descending function - Opens Water passages
  • LI-6 (Pianli)
    Opens Lung Water passages
  • LI-7 (Wenli)
    Xi Cleft point of LI channel, use for acute conditions
  • LI-4 (Hegu)
    Release Exterior, opens Water Passages
  • REN-9 (Shuifen)
    Opens Water Passages, resolves edema
  • BL-12 (Fengmen)
    Release the Exterior, stimulate Lung Qi to descend
  • BL-13 (Feishu)
    Release the Exterior, stimulate Lung Qi to descend

Method

  • Sedate

Damp-Phlegm Obstructing the Lungs

This is an Excess Interior Cold syndrome. While Phlegm is obstructing the Lungs, the pattern usually arises from chronic Spleen Deficiency with Dampness that eventually turns to Phlegm

Signs

  • Chronic cough with acute attacks
    Phlegm obstructing the descending function of the Lung Qi
  • Profuse white phlegm that is easily expectorated
  • Pale or pasty looking face
    Spleen and Yang Qi Deficiency of the Lungs and Spleen (pale) or presence of dampness (pasty)
  • Stuffiness in the chest
    Phlegm obstructing the chest
  • Dyspnea
    Phlegm obstructing Lung Qi
  • Symptoms are worse lying down

Tongue

  • Think sticky white coat

Pulse

  • Slippery pulse, or soggy and weak pulse

Etiology/Pathology

  • Deficiency of Spleen Qi or Spleen Yang
  • Frequent or reoccurring invasions of exterior pathogenic factors will weaken the Lungs and Spleen. This leads to formation of Phlegm. Phlegm ultimately settles in Lungs.
  • Excessive consumption of greasy, cold, or raw foods leads to the formation of Phlegm

Treatment Principle

  • Resolve Phlegm, restore Lung descending function

Points

  • LU 5 (Chize)
    Expels Phlegm from Lungs
  • LU 7 (Lieque)
    Stimulates Lung descending function. Stops cough
  • LU 1 (Zhongfu)
    Stops cough & resolves Phlegm
  • Ren 17 (Shanzhong)
    Stimulates Lung descending function
  • ST 40 (Finagling)
    Resolves Phlegm
  • PER-6 (Neiguan)
    Opens the chest and expels Phlegm
  • Ren 22 (Tiantu)
    Expels Phlegm from throat & stimulates descending function of the Lung
  • Ren 12 (Zhongwan)
    Tonifies Spleen to resolve Phlegm
  • Ren 9 (Shuifen )
    Stimulates Spleen function of transformation/transportation & resolves Dampness
  • BL 20 (Pishu)
    Tonifies Spleen to resolve Phlegm
  • BL 13 (Feishu)
    Stimulates Lung descending function

Method

Tonify BL-20 and REN-12, Sedate all other points.

Phlegm-Heat Obstructing the Lungs

This is an Excess Hot Interior condition. Lung Phlegm Heat is often chronic. The pattern is similar to Damp-Phlegm, but with the added component of Heat.

Signs

  • Cough
    Lung Qi not properly descending
  • Profuse yellow, green, or brownish, possibly foul smelling
    Due to Phlegm and Heat
  • Shortness of breath, Asthma, Stuffiness in the chest
    Phlegm obstructing descending Lung Qi

Tongue

  • Thick sticky yellow coating

Pulse

  • Slippery, rapid, and full pulse

Etiology/Pathology

  1. Over-consumption of greasy and hot foods
  2. Smoking
  3. Exterior Wind Heat can weaken Lung Qi and leaves pathogenic Heat and Phlegm, which eventually become chronic.

Treatment Principle

  • Resolve Phlegm, clear Heat, stimulate Lung descending function

Points

  • LU 5 (Chize)
    Clears Heat & Phlegm from Lungs
  • LU 7 (Lieque)
    Stops cough; restores descending/dispersing
  • LU 10 (Yuji)
    Clears Lung Heat
  • LU 1 (Zhongfu)
    Restores descending function, clears Lung Heat
  • BL 13 (Feishu)
    Sedate to clear Lung Heat
  • LI 11 (Quchi)
    Clears heat
  • Ren 12 (Zhongwan)
    Resolves Phlegm
  • ST 40 (Finagling)
    Resolves Phlegm

Method

Use even method on REN-12. Sedate all other points.

Phlegm-Fluids Obstructing the Lungs

Chronic condition where very watery, dilute & frothy Phlegm (Phlegm-Fluids) obstructs Lungs Only seen in old/middle aged people.

Signs

  • Cough with frothy white and watery sputum
  • Dyspnea
    Lung Qi can not properly descend
  • Splashing sounds in the chest
    Weak Spleen and Phlegm Fluids
  • Vomiting of frothy sputum
  • Chills
    Yang Deficiency of Spleen and Lungs

Tongue

  • Pale body with a thick sticky white coating

Pulse

  • Slippery weak or Floating weak pulse

Treatment Principle

  • Resolve Phlegm and Tonify the Spleen and Lung Qi

Points

  • LU 5 (Chize)
    Clears Phlegm from Lungs
  • LU 9 (Taiyuan)
    Tonifies Lung Qi & resolves Phlegm esp chronic
  • Ren 17 (shanzhong)
    Tonifies Lung Qi & stimulates descending function
  • BL 13 (Feishu)
    Tonifies Lung Qi
  • Ren 9 (Shuifen)
    Resolves dampness
  • ST 40 (Finagling)
    Resolves Phlegm
  • Ren 12 (Zhongwan)
    Tonifies the stomach to resolve phlegm
  • BL 43 (Gaohuangshu)
    Tonifies Lung Qi; ESP good in chronic conditions
  • ST 36 (Zusanli)
    Tonifies Spleen Qi

Method

  • Sedate LU-5, ST-40, REN-9. Tonify other points. Moxa applicable.