lung patterns Flashcards
Wind-Cold invading the Lung vs. Wind-Heat invading the Lung
Compare/ contrast Qi deficiency of all of the following: LU, HT, KI, SP
Compare/contrast: Warm dryness invading the Lung, Wind heat invading the Lung, Lung yin deficiency, Heat congesting the Lung
What symptoms are common to BOTH Lung Yin Deficiency and Dryness Invading the Lung
Lung Qi Deficiency
Lung Yin Deficiency
Compare/Contrast: Warm dryness invading the Lung, Wind heat invading the Lung, Heat congesting the Lung, Heat phlegm obstructing the Lung
Identify the common symptoms that occur in ALL of the following: Wind cold invading the Lung, Cold invading the Lung, and Cold phlegm obstructing the Lung patterns
Compare/Contrast: wind cold invading the Lung, Cold invading the Lung, and Cold phlegm obstructing the Lung patterns
Difficult: Memorize exterior dryness invading Lung pattern and know which symptoms are NOT associated with it
What type of cough is characteristic of dry phlegm obstructed Lung? What is not? 17. Large Intestine deficiency cold causes what types of bowel symptoms? What types is it not associated with?
Compare/Contrast: Cold water shooting into the Lung, Lung qi deficiency, Dry phlegm obstructing the Lung, Heart yang deficiency
Compare/Contrast: Heat phlegm accumulate in the Lung, Lung qi and yin deficiency with heat phlegm, Wind dryness invade the Lung with phlegm accumulation, Lung qi deficiency with heat phlegm accumulation
Compare/Contrast: Wind cold attack Lung with damp cold in Large Intestine, Wind heat invade Lung with damp heat in Large Intestine, Wind cold attack Lung with damp heat in Large Intestine, Wind heat invade Lung with damp cold in Large Intestine
Compare/Contrast: Dry phlegm obstruct in the Lung, Lung yin deficiency, Cold phlegm obstruct in the Lung, Lung qi deficiency, Heat phlegm obstruct in the Lung, Exterior wind dryness invading the Lung
Compare/Contrast: Wind-cold invading the Lung, Lung qi deficiency, Lung yin deficiency, Lung Qi deficiency, cold phlegm accumulation, Wind cold invasion
Compare/Contrast: Heart blood deficiency, Lung qi deficiency, Heart qi deficiency, Cold phlegm obstructing the Lung, Cold water shooting into the Lung
LU fx
The Lung is a minister organ
● It is in charge of cooperation and coordination
● Help HT to function normally
● It’s spirit is the corporeal soul
● emotions: sadness, grief and worry
● the metal phase
● governs Qi
● autumn
● climate of dryness
LU dredging/regulating fx
Regulates water metabolism: ‘dredging and regulating’
1. Through the function of dispersing,
the Lung regulates excretion of
sweat
2. Through the function of
descending, the Lung ensures the
patency (‘the quality or state of
being open or unobstructed’) of the
water passage
“The Lung is the upper source of water”
Etiological Factors in Lung Patterns
Etiological Factors in Lung Patterns
1. The Six exterior pathogenic factors: wind-heat, cold, dryness, dampness and
summer heat
2. Improper diet: excessive consumption of raw, cold food, or sweet and greasy
food, generating phlegm
3. Long-term emotional stress: worry, sadness, and grief deplete the Lung qi
4. Smoking: consumes Lung yin and generates phlegm
5. Chronic illness: damages Lung qi, impairs Lung yin
Pathological changes and major clinical manifestations of Lung disease
- Chills and fever
- Abnormal respiration
- Cough
- Other signs:
○ Nasal congestion
○ Sneezing
○ Edema
○ Expectoration or hemoptysis
○ Sore or itching throat
○ Chest distress or pain
○ Voice changes
○ Dry and withered body hair
○ Abdoniral sweating
○ Superficial pulse
There are thirteen commonly seen Lung disease patterns in the clinic:
Excess + Deficiency patterns
● There are only two deficiency patterns: Lung Qi Deficiency and Lung Yin Deficiency
● Excess patterns are subdivided:
○ Exterior Excess Patterns
■ Wind-Cold Invading the Lung, Wind-Heat Invading the Lung, Dryness Invading the Lung,
Wind-Water Invading the Lung
○ Interior Excess Patterns
■ Pathogenic Heat Congesting the Lung, Pathogenic Cold Invading the Lung, Phlegm Obstructing
the Lung, and Cold-Water Shooting into the Lung
■ Phlegm Obstructing the Lung is divided into four subgroups: Damp-Phlegm, Heat-Phlegm,
Cold-Phlegm, Dry-Phlegm
LU XU etiology
Congenital insufficiency, aging, chronic illness, improper diet, improper treatment, smoking or long-term emotional stress
indicates
Lung Qi Deficiency,
Lung Yin Deficiency
LU SHI etiology
Exopathogens attacking, improper diet, improper treatment, smoking or chronic illness
indicates
Wind-Cold Invading the Lung,
Wind-Heat Invading the Lung,
Dryness Invading the Lung,
Wind-Water Invading the Lung,
Pathogenic Heat Congesting the Lung,
Pathogenic Cold Invading the Lung,
Phlegm Obstructing the Lung, and
Cold-Water Shooting into the Lung
Lung Qi Deficiency Pattern 肺氣虛证 fèi qì xū zhèng
Definition: Lung hypofunction
Clinical Manifestations:
Feeble cough and panting that is worse with exertion, **copious
thin, clear sputum; ** shortage of Qi, shortness of breath, aversion to speaking, weak voice, fatigue, low energy, spontaneous sweating, sensitivity to wind, easily catches cold, pale complexion
Tongue: Pale tongue with thin white coating
Pulse: Weak
Key points:
Feeble cough, panting, worse w exertion + qi xu sx
Etiology
● Insufficient production of qi
● Excessive consumption of qi
● Aging
Pathogenesis of Lung Qi Deficiency Pattern 肺氣虛证 fèi qì xū zhèng
Lack of the production of qi can arise in cases of congenital insufficiency, chronic illness with Spleen and Stomach deficiency, and improper diet - all lessen the generation and transformation and transportation of qi
● Excessive consumption of qi arises in disease, serious illness, injury to the vital qi, and long-term mental overstrain
● A low feeble voice, feeble cough or panting arises when there is Lung qi deficiency, since the Lungs govern qi as well as dispersing and descending
● When Lung Qi is deficient, water metabolism is also disrupted, leading to pathological fluids accumulating inside, which generate phlegm, and cause cough with thin white sputum
● When deficient, Lung qi may fail to protect the body’s surface, causing susceptibility to catching colds
Qi is the motive force in the body, and when it is insufficient, it fails to push and promote
● Lack of qi: fatigue, shortness of breath, aversion to speaking and low voice, etc.
● insufficient generation of blood: pale tender tongue and thin deficient pulse
● fails to secure the body surface, no containment of the pores: spontaneous sweating
Lung Qi Deficiency Pattern 肺氣虛证 fèi qì xū zhèng
Treatment Principle
Tonify Lung qi, warm yang
Herbal Formula: 妊娠不肺汤 rèn shēn bù fèi tāng [bu fei tang] Ginseng Tonifying the Lungs Decoction
Lung Yin Deficiency Pattern 肺阴虛证 fèi yīn xū zhèng
Definition: signs and symptoms due to Lung Yin Deficiency, which leads to the Lung losing nourishment, generating deficiency heat, and failing to descend and disperse
Clinical Manifestations: Dry cough without sputum, sticky scanty sputum, or blood-tinged sputum, difficult expectoration, dry mouth, emaciation, hoarse voice, low-grade fever in the afternoon and evening, malar flush, night sweats, five-center heat
Tongue: Red tongue with scanty coating
Pulse: Thin rapid
Key Points: Dry cough no sputum, or sticky scanty sputum, bleeding + yin xu sx
Lung Yin Deficiency - Yin deficiency leading to deficiency heat
Low-grade fever in the afternoon
and evening, malar flush, night
sweats, five centered heat, red
tongue with scanty coating, thin
rapid pulse
Lung Yin Deficiency Pattern 肺阴虛证 fèi yīn xū zhèng
Treatment Principle
Tonify Lung yin, nourish body fluids, if necessary clear deficiency heat
Herbal Formulae:
● 百合固金湯 bǎi hé gù jīn tāng, Lily Bulb Decoction to Preserve the Metal
● 養陰清肺湯 yǎng yīn qīng fèi tāng, Nourish the Yin and Clear the Lungs
Decoction
● 生脈散 shēng mài sǎn, Generate the Pulse Powder
Wind-Cold Invading the Lung Pattern 風寒束肺 fēng hán shù fèi
Wind-Cold disrupting the Lung’s
dispersing and descending function. Also called Wind-Cold attacking, assailing or insulting
the Lung
Clinical Manifestations: Cough with thin clear sputum, aversion to cold, fever, headache, body ache, and nasal congestion and discharge with snivel, hoarseness or loss of voice
Tongue: Thin white coating
Pulse: Superficial and tight
Key Points: Cough with thin clear sputum, plus exterior wind-cold signs and symptoms
Treatment of Wind-Cold Invading the Lung Pattern 風寒束肺 fēng hán shù fèi
Treatment Principle: Release the Exterior, expel Cold, stimulate the descending and diffusing of Lung Qi
Acupuncture: Reducing method, moxibustion is applicable after needling
● LU-7
● LI-4
● BL-12, BL-13
● GB-20,
● GV-14, GV-16
● TB-17
Herbal Formulae:
● 麻黃湯 má huáng tāng Ephedra Decoction
● 小青龍湯 xiǎo qīng lóng tāng Minor Black Dragon Decoction
● 桂枝湯 guì zhī tāng Cinnamon Twig Decoction
Wind-Cold Invading the Lung vs. Exterior Wind-Cold
Similar etiology:
● similar symptoms, etiology and pathological location, but from two different systems of pattern identification
● Wind-Cold invading the Lungs: zàngfǔ pattern identification, functions of the Lung organ
○ Main symptoms involve the disruption of the Lung’s dispersing and descending function: coughing with clear thin sputum
● Exterior Wind-Cold: Eight Principles Pattern Identification 八綱辨證 , bā gāng biàn zhèng, pathological changes at the body’s surface, the protective qi
○ major symptoms of chills and fever
Wind-Heat Invading the Lung Pattern 風熱犯肺 fēng rè fàn fèi
wind-heat disrupting the Lung’s
dispersing and descending functions. Also called wind-heat attacking, assailing, or insulting the Lung.
Clinical Manifestations: Cough with sticky yellow sputum, nasal congestion with thick yellow discharge, fever, slight aversion to wind or cold, slight thirst, and sore throat.
Tongue: Tongue has a red tip with thin yellow coating.
Pulse: Superficial and rapid.
Etiology
● Exterior wind-heat
● Wind-cold may also be a factor if it
transforms into heat
Key Points: Cough w sticky yellow sputum + exterior wind-heat sx
Treatment of Wind-Heat Invading the Lungs Pattern 風熱犯肺 fēng rè fàn fèi
Treatment Principle: Release the exterior, clear Heat, stimulate the descending and diffusing of Lung Qi; cool/cold and pungent herbs to promote sweating, clear heat, and alleviate toxicity
Acupuncture: Reduction method, no moxibustion
● LU-7
● LI-4, LI-11
● GV-14, GV-16
● BL-12
● GB-20
● TB-5
Formulae: 桑菊飲 sāng jú yǐn, Mulberry Leaf and Chrysanthemum Drink
銀翹散 yín qiào sǎn, Honeysuckle and Forsythia Decoction
Wind-Cold Invading the Lung vs. Wind-Heat Invading the Lungs
Key Points to distinguish these two patterns:
1. Coughing sounds
2. Quality and color of sputum
3. Presence of sore throat (not itchy)
4. Rapid vs. right pulse
Dryness Invading the Lung Pattern 燥邪犯肺 zào xié fàn fèi
exterior pathogenic dryness attacking the Lung and damaging Lung yin. Also called ‘lung dryness’ or ‘exterior dryness’. Depending on accompanying pathogens, it may manifest as
warm-dryness 溫燥 wēn zào, or
cool-dryness 涼燥 liáng zào
Clinical Manifestations: Dry cough, scanty sticky sputum or blood-stained sputum, difficult expectoration, dry mouth, dry throat and dry nose, or nosebleeds, cough with blood, dry stool, scanty urine. Symptoms are accompanied by fever, slight chills, and absent or slight sweating.
Tongue: Thin and dry tongue coating
Pulse: Superficial and rapid, or superficial and tight
Etiology
● Exterior pathogenic dryness
Key Points: dry cough w scanty sticky sputum, dry mouth, throat and nose + mild exterior signs and symptoms
Dryness Invading the Lung Pattern 燥邪犯肺 zào xié fàn fèi Treatment Principle
Treatment Principle: Moisten the Lungs, nourish fluids
Acupuncture: Reinforcing method, no moxibustion
● BL-13, BL17
● LU-1, LU-6, LU-7
● KI-6
Herbal Formulae:
● 百合固金湯 bǎi hé gù jīn tāng, Lily Bulb Decoction to Preserve the Metal Decoction
● 清燥救肺湯 qīng zào jiù fèi tāng, Clearing Dryness and Rescuing the Lung Decoction
● 沙參麥-冬湯 shā shēn mài dōng tāng, Adenophora/Glehnia and Ophiopogon Decoction
Wind-Water Invading the Lung Pattern 風水犯肺 fēng shuǐ fàn fèi
pathogenic wind attacking the Lung, leading to dysfunction in the draining of water passages, resulting in water-dampness penetrating muscular
interstices and skin. Called ‘wind-water pattern’ 風水證 fēngshui zhèng
Clinical Manifestations: Edema with acute onset and rapid development, starting from the eyelids and then spreading to the entire body, with difficult urination. Accompanied by fever, aversion to cold and no sweating.
Tongue: White tongue coating
Pulse: Superficial and tight
Note: There may also be a sore throat, red tongue and superficial and rapid pulse
Etiology
● Exopathogenic factors:
○ Wind-Cold
○ Wind-Heat
○ Wind-Dampness
Key Points: Acute onset, edema that starts from the eyelids, puls exterior wind-cold or wind-heat
signs and symptoms
Treatment of Wind-Water Invading the Lung Pattern
Treatment Principle: Release the Exterior, expel Cold, resolve Dampness, restore the Descending
of Lung-Qi and open the Water passages
Acupuncture:
● LU-7
● LI-4, LI-6
● SP-9
● BL-39
Herbal Formulae:
● 越婢湯 yuè bì tāng, Maidservant from Yue’s Decoction (Spleen-Effusing Decoction)
● 小青龍湯 xiǎo qīng lóng tāng, Minor Bluegreen Dragon Decoction
Cold Invading the Lung Pattern 寒邪客肺 hán xié kè fèi
exopathogenic cold directly attacking
the Lung, disrupting the Lung’s dispersing and descending function.
Clinical Manifestations: Coughing, panting, hoarseness or loss of voice, thin white or clear sputum, cold limbs and body.
Tongue: Pale tongue with white coating.
Pulse: Deep and slow pulse.
Key Points: Acute onset, coughing or panting, plus interior excess cold signs and symptoms.
Treatment of Cold Invading the Lung Pattern 寒邪客肺 hán xié kè fèi
Treatment Principle: Warm the Lung, stop cough
Acupuncture:
● LU-7
● LI-4
● BL-12
● BL-13
● GV-14
Formula: 溫肺化飲湯 wēn fèi huà yǐn tāng, Lung-Warming Rheum-Transforming Decoction
Turbid Phlegm Obstructing the Lung Pattern 痰濁阻肺 tán zhuó zǔ fèi
phlegm accumulating inside the Lung,
obstructing the Lung and disrupting its dispersing and descending function. According to the
accompanying pathogens and pathogenesis, there are four major patterns:
1. Phlegm-Dampness Obstructing the Lung
2. Heat-Phlegm Obstructing the Lung
3. Cold-Phlegm Obstructing the Lung
4. Phlegm-Dryness Obstructing the Lung
Turbid Phlegm Obstructing the Lung Pattern 痰濁阻肺 tán zhuó zǔ fèi
Clinical Manifestations: Productive cough, panting, wheezing, tightness and distress in the chest, phlegm in the throat, feeling of heaviness.
Tongue: Thick tongue coating
Pulse: Slippery
Key Points: Productive cough, panting, wheezing, or phlegm sounds in the throat
Heat Congesting the Lung Pattern 熱邪壅肺 rè xié yōng fèi
excess heat congesting the Lung, disruption the Lung’s dispersing and descending function.
Clinical Manifestations: Coughing, panting, high fever with flaring nostrils, sore throat, rapid breathing, thirst, pain in the chest, cough with foul pus and blood, dry stools, dark urine
Tongue: Red tongue with yellow coating
Pulse: Rapid
Key Points: Coughing, panting, plus interior excess heat signs and symptoms
Cold-Water Shooting into the Lung Pattern 寒水射肺 hán shuǐ shè fèi
pathogenic cold combining with water-thin mucus, invading the Lung, and causing Lung dysfunction.
Clinical Manifestations: Coughing with profuse white foamy sputum, panting or wheezing, chest pain with difficulty breathing, inability to lie down flat because of difficulty breathing facial or body edema, scanty urine, intolerance of cold, cold limbs, stifling sensation in the chest, no thirst.
Tongue: White and greasy tongue coating
Pulse: Slow, slippery or wiry
Note: If the pattern arrives with the appearance of exopathogenic cold, it will then be accompanied by aversion to cold, fever, body aches and a a superficial pulse
Key Points: Cough with profuse white foamy sputum, panting or wheezing, inability to lie down flat
