Zang Fu Patterns: LU/LI

Question 1

What are the two major functions of the Lungs?

Answer 1

1. Govern the Qi
   i) respiratory Qi
   ii) whole body Qi
2. Regulate water passages

Question 2

How does the Lung govern respiratory Qi?

Answer 2

Lung Qi

• Taking in of air or Pure qi, descending of this Clear Qi down and in
• Controls the ascending of Turbid qi exhaled up and out

Question 3

In what ways does the Lung govern whole body qi?

Answer 3

• Helps the Heart to move blood, controls the channels and vessels along with the heart
• Regulates Qi Ji (movement, moving qi)
• Formation of Zong Qi. Zong qi assists with controlling qi and respiration,

Question 4

What is the relationship between Qi and water? Talk about the Lung’s function of dispersing and descending.

Answer 4

Lung governs Qi and water follows qi.

(Kidney is the root of qi)

Dispersing: Lung Qi dispersing function, water goes up and out

Descending: Lung Qi descending function, water flows down and in, nutrients to nourish organs, turbid water through BL and LI

Question 5

Lung Associations:

a) Opens into
b) Outer manifestation
c) Colour
d) Liquid is
e) Pulse
f) Season
g) Houses
h) Upper Source of
i) Governs

Answer 5

a) Opens into nose
b) Outer manifestation skin, sweat glands and body hair (the exterior)
c) Colour is white
d) Liquid is snot or mucous, nasal discharge
e) Pulse is superficial
f) Season is Autumn
g) Houses the Po (Corporal Soul)
h) Upper source of water
i) Governs the voice

Question 6

What Vital Substances relate to the Lung?

Answer 6

Lung Qi

Lung Yin (Body Fluid considered as part of Yin)

Question 7

Lung governing of Qi and Respiration

Answer 7

The Lungs are also responsible for the actual formation of Qi. Food Qi (Gu Qi) is taken by the Spleen and directed to the Lungs where it combines with inhaled air (with help from Yuan Qi of Kidneys) to form Zong Qi, which is also called Qi of the Chest or Gathering Qi. The Zong Qi regulates involuntary movement of Heart and Lungs in turn is nourished by the Qi of the Heart and Lung. The Lungs then spread this Qi all over the body

Simultaneously formed: “Upright” or “normal” Qi (Zhen Qi) which is divided into Ying and Wei parts.

Lungs open to the Exterior, hence are called the “Tender Organ” because they are vulnerable to attack by exogenous pathogens.

Question 8

Lungs Regulate Water Passages. Talk about dispersing function and descending functions.

What happens if fluids are not evenly spread?

Answer 8

Lungs receive refined fluids from Spleen, reduce them to fine mist and “spray” them throughout Exterior under the skin (part of dispersing function). Fluids should be evenly spread and pores should be regulated: otherwise, fluids may accumulate: edema.

Lungs are “upper origin of Water”. Direct fluids down to Kidney and Bladder. Kidneys receive fluids and vaporize them, then send back up to Lung.

Question 9

As part of Governing Qi, Lungs control _____ and _____ ______.

How does this aid the heart? How are the Heart and Lung linked?

What happens with weak lung qi?

Answer 9

channels; blood vessels

Lungs govern Qi, which is essential to Heart to aid in Blood circulation. The Lungs and Heart are very closely linked (via Zong Qi). Lungs control circulation of Qi not only in Blood Vessels but in the channels.

Weak Lung Qi results in Qi being unable to push the Blood to nourish various areas. Hence, e.g. cold limbs, especially cold hands.

Question 10

As part of Regulating Water Passages, lungs control dispersing and descending functions

Answer 10

Dispersing Function

Lung spreads Wei Qi (defensive Qi) and Body Fluids all over body to area between skin and muscles (The Lungs are related to skin).

This ensures that Wei Qi equally distributed under skin to warm skin and muscles and protect body from exogenous pathogens (Symptoms of a “cold” = impairment of dispersing function: exterior Wind Cold obstructs skin, blocks pores and Qi circulation: Qi cannot be dispersed.

Lung spreads Body Fluids (Jin Ye) to skin in form of “mist” to moisten skin and regulate opening and closing of pores and sweating. In health, normal pore function and normal amount of sweating.

Descending Function

Lungs are uppermost Organ (“Lid of the Yin Organs”). Therefore their Qi descends to communicate with Kidney (which “holds down” the Qi).

Lungs also direct Body Fluids downward to Kidneys/Bladder. Impairment of descending function: Qi accumulates in chest (cough, asthma, stuffy chest, or accumulation of fluids; upper body edema).

Question 11

How does the lung nourish skin and hair?

Answer 11

Lung nourishes skin and hair by spreading Fluids to skin. Impaired Lung function can result in malnourished body hair and skin. Lungs influence Wei Qi, which circulates in skin.

Question 12

Lungs Govern Voice

Difference between healthy and weak lung qi?

Answer 12

Strength, tone and clarity of voice depend on Lung Qi (in health: like a bell). Weak Lung Qi = low voice.

Question 13

Lungs open into nose. Lungs house Corporeal Soul.

Answer 13

Nose is the opening of the Lungs. Lungs govern sense of smell.

Corporeal soul attached to body. Closely linked to breathing. Directly affected by sadness/grief which constrain its movement and affect breathing.

Question 14

What are the most common Lung symptoms?

Answer 14

Asthma (wheezing, dyspnea, shortness of breath)

Phlegm (expectoration, fullness of chest)

Coughing

Chest pain, hoarse voice, nosebleed

Question 15

Common Lung Etiologies

Answer 15

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.

Question 16

Common External Pathogenc Factors and Sx for Lung

Answer 16

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.

Question 17

Diet as disease factor for Lung

Answer 17

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.

Question 18

Sadness and _____ are the main emotions associated with the Lungs.

What happens with chronic sadness?

What happens with chronic _____?

Answer 18

Chronic sadness disperses Qi and causes Lung Qi Deficiency.

Chronic worry knots or ties up the Qi causing Stagnation of Qi in the chest.

Question 19

Lifestyle disease factors for Lung

Answer 19

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.

Question 20

Lung Qi Deficiency Etiology

Answer 20

Lifestyle factors:

• Emotions – sadness, grief
• Excessive use of voice
• Hereditary
• Slumped shoulders, Stooping over desk, constraining chest and not breathing deeply

1. Prolonged cough and dyspnea —> impairment of lung qi
2. Deficiency of SP & ST —> insufficient production of qi and blood
3. Failure of dispersing and descending of Lung Qi
4. Hypofunction of respiration
5. Ineffective protection against EPF’s
6. Hypofunction of whole body

2-6 —> Deficiency of Lung Qi —> Insufficient Pectoral Qi —> 3, 4, 5, 6

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.

Question 21

Western diseases related to Lung Qi Deficiency

Answer 21

Chronic bronchitis

Pulmonary emphysema

Prolonged TB of lung

Pulmonary heart disease

Question 22

Lung Qi Deficiency Sn/Sx

Answer 22

Weak breathing, shortness of breath on exertion
The Lungs govern respiration

Weak cough
Lungs are too weak to send Qi downward

Clear, 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
Qi Xu, Lungs circulate Wei Qi which governs the opening and closing of skin pores

Susceptiblity to Cold
Qi Xu, Lungs and Wei Qi warm the skin and muscles

Bright white complexion, fatigue
Qi Deficiency

Weakened Immunity
Weak Lung Qi is also closely tied to weak Wei Qi, which could lead to frequent colds.

Pulse: Weak, Empty pulse

Tongue: Pale or normal tongue body with white coating

Question 23

Lung Qi Deficiency POT and Herb Px

Answer 23

POT: Reinforce the lung qi

Herb: Jade Windscreen (Astragalus)

Bu Fei Tang

Ginseng

Question 24

Lung Qi Deficiency Points and Method

Answer 24

LI20 - Opens nasal passages; Expels wind and clears heat

LU1 - Front Mu of Lung; Disseminates and descends Lung qi; Transforms phlegm, clears heat

LU2 - Clear LU heat and descends LU qi

LU9 - Shu Stream/Earth Pt; Yuan Source: Meeting of Vessels; Tonifies LU and transforms phlegm

SI11 - Moves qi; Unbinds chest and lateral costal

ST14 - Descends rebellious qi and unbinds chest

ST15 - Descends rebellious qi and unbinds chest

ST36 - He-Sea/Earth Pt; Command Pt of Abdomen, Heavenly Star, Pt of Sea of Water and Grain; Supports correct qi and fosters original qi; Tonifies qi

T6 Huatuo - Regulate and harmonize 5 Zang and 6 Fu

UB13 - Back Shu of Lung; Tonifies LU Qi and nourishes LU yin

UB42 - Tonifies and nourishes Lung; Soothes dyspnea and alleviates cough

Question 25

Lung Yin Deficiency Etiology

Answer 25

1. Prolonged cough or asthma 2. Febrile disease in its later period 3. Prolonged Lung Qi Xu 4. Stomach Yin Xu (irregular eating habits or diet) 5. Kidney Yin Xu (overwork 6. Lung Dryness 1-6 ---\> Impairment of Lung Yin ---\> Deficient Fire

Question 26

Lung Yin Deficiency Western Diseases1

Answer 26

Chronic bronchitis TB Walking pneumonia

Question 27

Lung Yin Deficiency Sn/Sx

Answer 27

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: Thready (empty, floating) and rapid pulse

Question 28

Lung Yin Deficiency POT and Herb Px

Answer 28

Tonify Lung Yin Nourish body fluids Clear empty heat Herb: Bai He Gu Jin Tang (Lily Bulb Decoction to Preserve the Metal)

Question 29

Lung Yin Deficiency Points and Methody

Answer 29

``` LU 9 (Taiyuan - Supreme Abyss) *Meeting Pt of Vessels, Shu Stream/Earth Pt; Yuan Source point*; Tonify Lung Yin ``` REN-17 (Shanzhong - Chest Centre) *Front Mu of PC; Meeting Pt of Qi; Point of Sea of Qi;* Tonifies Qi and Lung Yin ``` BL 43 (Gaohuangshu - Vital Region Shu) Tonifies Lung Yin, especially good in chronic cases ``` ``` BL 13 (Feishu - Lung Shu) *Back Shu of Lung;* Tonifies Lung Qi & Yin ``` ``` Du 12 (Shenzhu - Body Pillar) Clears heat from LU and HT; Tonifies Lung Qi & Yin ``` REN-4 (Guanyuan - Gate of Origin) *Front Mu of SI*; Tonifies Kidney Yin & conducts Empty Heat downwards ``` KI 6 (Zhaohai - Shining Sea) 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 - Middle Cavity) *Front Mu of ST; Meeting Pt of Fu*; Tonifies Stomach & nourishes fluids (Stomach is origin of fluids) ``` LU 10 (Yuji - Fish Border) *Ying Spring/Fire Pt;* Sedate to clear Empty Heat from Lungs ``` *Method:* Tonify all Points except LU 10 which is sedated. No moxa.

Question 30

Invasion of Lung by Dryness Etiology/Pathology

Answer 30

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. If it is an Invasion it will have exterior syndrome sn/sx such as superficial pulse, fever and chills at same time. 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.). 1. Invasion by dryness 2. Infection by febrile diseases 1-2 ---\> Consumption of body fluids ---\> Dryness of Lung

Question 31

Invasion of Lung by Dryness Sn/Sx

Answer 31

Dry cough, Dry throat, Dry mouth, Dry skin, no sputum or sticky, difficult expectoration, thirst, hoarse voice Hemoptysis *Heat burning blood vessels* Fever and aversion to cold (if *Exterior Syndrome)* Tongue: Dry, but not Red; white or yellow coating Pulse: Empty and rapid, especially in the Lung position \*Lung HATES dryness, Dry damages Lung quickly

Question 32

Lung Dryness POT and Herb Px

Answer 32

Moisten Lungs Nourish Body Fluids Herb: Qing Zao Jiu Fei Tang Eliminate Dryness and Rescue the Lung

Question 33

Lung Dryness Points

Answer 33

``` LU 9 (Taiyuan - Supreme Abyss) *Meeting of Vessels; Shu Stream/Earth Pt; Yuan Source;* Moistens Lungs ``` REN-4 (Guanyuan - Gate of Origin) *Front Mu of SI;* Tonify Kidney Yin & nourishes fluids ``` KI 6 (Zhaohai - Shinging Sea) *Confluent with Yin Motility (Yin Qiao);* Nourishes Fluids, benefits throat ``` ``` Sp 6 (SanYinjiao - Three Yin Intersection) Nourishes Fluids ``` REN-12 (Zhongwan Middle Cavity) *Front Mu of ST; Meeting Pt of ST*; Tonifies Stomach & nourishes Fluids Method: Tonify all points

Question 34

Invasion of Lung by Wind Cold Etiology

Answer 34

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. Artificial sources of Wind Cold, such as air conditioning can also cause Wind Cold. Pathogenic wind-coldness ---\> Body surface ---\> Lung ---\> Defensive mechanism damaged ---\> Lung qi fails to disperse

Question 35

Invasion of Lung by Wind-Cold Western Dx

Answer 35

Cold Acute bronchitis

Question 36

Invasion of Lung by Wind Cold Sn/Sx

Answer 36

Fever *Wind Cold pathogen battles with Wei Qi* Aversion to Cold *Exterior Cold impairs circulation of Wei Qi which cannot warm muscles* Absence of Sweating *Cold congeals and closes pores* 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; superficial and tense

Question 37

Invasion of Lung by Wind-Cold POT and Herb Px

Answer 37

POT: * Release Exterior * Disperse Cold * Stimulate Lung descending and dispersing function * Relieve the exterior syndrome and promote dispersing function of lung with herbs pungent in flavor and warm in property Herb: Xing Su San

Question 38

Invasion of Lung by Wind-Cold Point Px

Answer 38

``` LU 7 (Lieque - Broken Sequence) *Luo Connecting, Heavenly Star, Command Pt of Head/Posterior Neck;* Disperses Wind Cold, releases Exterior, stimulates Lung dispersing/descending ``` ``` BL 12 (Fengmen Wind Gate) Releases Exterior, Expels Wind (esp cupped) Moxa after needling. ``` ``` Du 16 (Fengfu - Palace of Wind) *Point of Sea of Marrow, Window of Heaven, Ghost Point;* Expels wind ``` Method: Sedation; moxa applicable after needling.

Question 39

Compare Exterior Wind-Cold Syndrome with Invasion of Lung by Wind-Cold

Answer 39

Both share the symptoms of fever and chills, body aching, cough and shortness of breath. Exterior W-C: Fever and chills, body aching dominant symptoms Invasion of Lung by W-C: Cough and lung problems such as dyspnea and SOB dominating

Question 40

Invasion of Lung by Wind-Heat Etiology

Answer 40

Exterior pathogenic Wind combines with Heat and invades Lung Exterior portion (Lung Defensive Qi portion) 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. Can also be caused by pathogenic wind-cold invading and later turning into wind-heat.

Question 41

Invasion of Lung by Wind-Heat Western Dx

Answer 41

Cold Acute bronchitis Pneumonia

Question 42

Invasion of Lung by Wind-Heat Sn/Sx

Answer 42

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 with thick yellow sputum, stuffy nose, runny nose with thick 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

Question 43

Invasion of Lung by W-H POT and Herb Px

Answer 43

POT * Clear heat from lung * Release Exterior * Stimulate Lung descending and dispersing functions Herb Px Sang Ju Yin (Mulberry Leaf and Chrysanthemum Decoction)

Question 44

Invasion of Lung by W-H Point Px

Answer 44

``` LI 4 (Hegu - Joining Valley) *Command Pt of Head and Face, Heavenly Star, Entry Pt, Yuan Source;* Release Exterior & clear Heat ``` ``` LI 11 (Quchi - Pool at the Crook) *He Sea/Earth, Ghost Point, Heavenly Star;* Release Exterior & clear Heat ``` ``` Lu 11 (Shaoshang - Lesser Shang) *Jing Well/Wood, Ghost P*t; Clears Lung Heat. Esp good for sore throat ``` ``` Du 14 (Dazhui - Great Vertebra) *Meeting of GV with Six Yang Channels, Sea of Qi Pt;* Clear heat ``` ``` BL 12 (Fengmen - Wind Gate) Meeting of BL with GV; Expel Exterior Wind ``` ``` Du 16 (Fengfu - Palace of Wind) *Pt of Sea of Qi, Window of Heaven, Ghost Pt*; Expel Exterior Wind ``` ``` GB 20 (Fengchi - Wind Pool) Expel Exterior Wind ``` Method: Sedate. No moxa. LU-11 can be bled for sore throat

Question 45

Damp-Phlegm Obstructing Lungs Etiology

Answer 45

This is an Excess Exterior Cold Syndrome. Usually arises from chronic deficiency of Spleen Qi or Spleen Yang Frequent or reoccurring invasions of exterior pathogenic factors will weaken the Lungs (and SP) ---\> Lung Qi fails to distribute fluids over body ---\>formation of Phlegm ---\> Phlegm ultimately settles in Lungs Excessive consumption of greasy, cold, or raw foods ---\> damage Spleen ---\> Spleen fails to transport and transform water ---\> leads to the formation of Phlegm ---\> Phlegm settles in Lungs

Question 46

Damp Phlegm Obstructing Lungs Western Dx

Answer 46

Chronic bronchitis Bronchiectasis (permanent enlargement of parts of the lung, chronic cough) Bronchial asthma Pulmonary abscess

Question 47

Damp Phlegm Obstructing Lung Sn/Sx

Answer 47

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, Gurgling in throat *Phlegm obstructing Lung Qi* Symptoms are worse lying down Tongue: Thick sticky white coat Pulse: Slippery pulse, or soggy and weak pulse

Question 48

Damp-Phlegm Obstructing Lungs POT and Herb Px

Answer 48

_POT_ * Eliminate dampness to reduce phlegm * Resolve phlegm * Restore Lung descending function _Herbs_ Xiao Qin Long Tang (Minor Blue-Green Dragon Concoction)

Question 49

Phlegm-Damp Obstructing Lungs Point Px

Answer 49

``` LU 5 (Chize Cubit Marsh) *He Sea/Water Pt*; Expels Phlegm from Lungs ``` ``` LU 7 (Lieque - Broken Sequence) *Luo Connecting; Heavenly Star; Command of Head/Posterior Neck;* Stimulates Lung descending function. Stops cough ``` ``` LU 1 (Zhongfu Middle Palace) *Front Mu of Lung*; Stops cough & resolves Phlegm ``` ``` Ren 17 (Shanzhong Chest Centre) *Front Mu of PC, Meeting Point of Qi, Sea of Qi*; Stimulates Lung descending function ``` ``` ST 40 (Fenglong Abundant Bulge) *Luo Connecting of ST*; Resolves Phlegm ``` PC-6 (Neiguan - Inner Pass) *Luo Connecting of PC, Confluent of Yin Wei Mai;* Opens the chest and expels Phlegm ``` Ren 22 (Tiantu Heavenly Prominence) *Window of Heaven;* Expels Phlegm from throat & stimulates descending function of the Lung ``` ``` Ren 12 (Zhongwan Middle Cavity) *Front Mu of ST, Meeting Pt of Fu;* Tonifies Spleen to resolve Phlegm ``` ``` Ren 9 (Shuifen Water Separation) Stimulates Spleen function of transformation/transportation & resolves Dampness ``` ``` BL 20 (Pishu Spleen Shu) *Back shu of SP*; Tonifies Spleen to resolve Phlegm ``` ``` BL 13 (Feishu Lung Shu) *Back Shu of Lung;* Stimulates Lung descending function ``` Method: Tonify BL-20 and REN-12, Sedate all other points.

Question 50

Phlegm-Heat Obstructing Lungs (Retention of Heat) Etiology

Answer 50

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. 1. Exterior Wind Heat (or Wind Cold) can weaken Lung Qi and leaves pathogenic Heat and Phlegm, which eventually become chronic. 2. Overconsumption of greasy and hot foods 3. Smoking

Question 51

Phlegm-Heat Obstructing Lungs (Retention of Heat) Western Dx

Answer 51

Acute or chronic bronchitis Pneumonia Infection complicated by bronchiectasis Pulmonary abscess Asthma

Question 52

Phlegm-Heat Obstructing Lungs (Retention of Heat if Exterior) Sn/Sx

Answer 52

Cough *Lung Qi not properly descending* Profuse yellow, green, or brownish, possibly foul smelling sputum *Due to Phlegm and Heat* Shortness of breath, Asthma, Stuffiness in the chest *Phlegm obstructing descending Lung Qi* High fever *If "Retention of Heat" pattern, clearly a lingering infection* Thirst with desire to drink, constipation *Heat burning body fluids* scanty, deep red urine, epistaxis, hemoptysis *Heat causes extravasation of Blood* Tongue: Red tongue with thick sticky yellow coating Pulse: Slippery, rapid, and full pulse

Question 53

Phlegm-Heat Obstructing Lung (Retention of Heat) POT and Herb Px

Answer 53

_POT_ * Resolve phlegm * Clear heat * Stimulate lung descending function _Herbs_ Ma Xin Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction)

Question 54

Phlegm-Heat Obstructing Lung (Retention of Heat in Lung) Point Px

Answer 54

``` LU 5 (Chize Cubit Marsh) *He Sea/Water;* Clears Heat & Phlegm from Lungs ``` ``` LU 7 (Lieque Broken Sequence) *Luo Connecting, Command Pt of Posterior Neck/Head, Confluent with CV;* Stops cough; restores descending/dispersing ``` ``` LU 10 (Yuji Fish Border) *Ying Spring/Fire Pt*; Clears Lung Heat ``` ``` LU 1 (Zhongfu Middle Palace) *Front Mu Pt of Lung, Entry Pt from LV14*; Restores descending function, clears Lung Heat ``` ``` BL 13 (Feishu Lung Shu) *Back Shu of Lung*; Sedate to clear Lung Heat ``` ``` LI 11 (Quchi Pool at the Crook) *He Sea/Earth, Ghost Pt, Heavenly Star*; Clears heat ``` ``` Ren 12 (Zhongwan Middle Cavity) *Front Mu of ST, Meeting Pt of Fu;* Resolves Phlegm ``` ``` ST 40 (Fenglong Abundant Bulge) *Luo Connecting*; Resolves Phlegm ``` Method: Use even method on REN-12. Sedate all other points.

Question 55

Invasion of Lungs by Wind-Water Etiology

Answer 55

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. Exposure to exterior Wind-Cold and Dampness

Question 56

Invasion of Lungs by Wind Water Sn/Sx

Answer 56

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

Question 57

Invasion of Lungs by Wind-Water POT

Answer 57

* Release the Exterior * Disperse Cold * Resolve Dampness * Restore Lung descending function * Open Water Passages

Question 58

Invasion of Lungs by Wind-Water Point Px

Answer 58

LU-7 (Lieque Broken Sequence) *Luo Connecting, Command Pt of Head/Posterior Neck, Confluent Point with CV;* Releases Exterior, stimulates Lung descending function - Opens Water passages LI-6 (Pianli Veering Passage) *Luo Connecting Pt*; Opens Lung Water passages LI-7 (Wenliu Warm Flow) *Xi Cleft point of LI channel*, use for acute conditions LI-4 (Hegu Joining Valley) *Yuan Source, Command Pt of Head/Face, Heavenly Star, Entry Pt from LU7;* Release Exterior, opens Water Passages REN-9 (Shuifen Water Separation) Opens Water Passages, resolves edema BL-12 (Fengmen Wind Gate) Release the Exterior, stimulate Lung Qi to descend BL-13 (Feishu Lung Shu) Release the Exterior, stimulate Lung Qi to descend Method: Sedate

Question 59

Phlegm Fluids Obstructing Lungs Etiology

Answer 59

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

Question 60

Phlegm-Fluids Obstructing Lungs Sn/Sx

Answer 60

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

Question 61

Phlegm-Fluids Obstructing Lungs POT

Answer 61

Resolve Phlegm Tonify Spleen and Lung Qi

Question 62

Phlegm Fluids Obstructing Lungs Point Px

Answer 62

``` LU 5 (Chize Cubit Marsh) *He Sea/Water;* Clears Phlegm from Lungs ``` ``` LU 9 (Taiyuan Supreme Abyss) *Shu Stream/Earth, Yuan Source, Meeting Pt of Vessels;* Tonifies Lung Qi & resolves Phlegm esp chronic ``` ``` Ren 17 (shanzhong Chest Centre) *Pt of Sea of Qi, Front Mu of PC, Meeting Point of Qi;* Tonifies Lung Qi & stimulates descending function ``` ``` BL 13 (Feishu Lung Shu) Tonifies Lung Qi ``` ``` Ren 9 (Shuifen Water Separation) Resolves dampness ``` ``` ST 40 (Fenglong Abundant Bulge) *Luo Connecting of ST*; Resolves Phlegm ``` ``` Ren 12 (Zhongwan Middle Cavity) *Front Mu of ST;* Tonifies the stomach to resolve phlegm ``` ``` BL 43 (Gaohuangshu Vital Region Shu) Tonifies Lung Qi; ESP good in chronic conditions ``` ``` ST 36 (Zusanli Three Leg Mile) *Command Pt of Abdomen, Pt of Sea of Water and Grain, Heavenly Star, He Sea/Earth;* Tonifies Spleen Qi ``` Method: Sedate LU-5, ST-40, REN-9. Tonify other points. Moxa applicable.

Question 63

Damp Heat in Large Intestine Etiology

Answer 63

1. Invasion of damp-heat 2. Improper diet forming damp heat 3. Emotional problems aggravating internal heat 1-3 ---\> Invasion of damp heat into LI leading to dysfunction of its transportation Too much hot and greasy foods plus emotional problems Example: worry and anxiety over long period. All cause interior Heat. May accompany other patterns involving Interior Heat such as Liver Qi Stagnation with Liver Fire.

Question 64

Damp-Heat in LI Western Dx

Answer 64

Acute enteritis Acute bacillary dysentery (food poisoning) Acute episode of chronic dysentery and amebic dysentery

Question 65

Damp-Heat in LI Sn/Sx

Answer 65

Abdominal Pain *Excess pattern* Diarrhea *Dampness impairs fluid absorption in the intestines* Mucus and Blood in the Stool *Damp causes mucus, heat causes extravasation of Blood* Foul stool, burning anus, scanty and dark urine, fever and sweating, halitosis *Heat* Thirst without a desire to drink *Heat causes thirst, Dampness causes a lack of desire to drink* Heavy sensation in the body and limbs *Dampness* Stuffiness in the chest and epigastrium *Dampness* Aversion to Cold and Fever *May or may not have, depends if it is exterior invasion* Tenesmus (feeling of needing to go and cramps but unable to) *Dampness or Qi Stagnation* Tongue: Red body with a sticky yellow coat Pulse: Slippery and Rapid

Question 66

Damp-Heat in LI POT and Herb Px

Answer 66

_POT_ * Clear heat * Resolve dampness * Stop diarrhea _Herbs_ Bai Tou Wen Tang (Decoction of Pulsatillae)

Question 67

Damp-Heat in LI Point Px

Answer 67

``` SP 9 (Yinlingquan Yin Mound Spring) *He Sea/Water Pt;* Clear Damp from Lower Burner ``` ``` SP 6 (SanYinjiao Three Yin Meeting) Clear Damp from Lower Burner ``` ``` REN 3 (Zhongji Centre Pole) *Front Mu of BL*; Clear Damp from Lower Burner ``` ``` BL 22 (Sanjiaoshu Triple Energizer Shu) Clear Damp from Lower Burner ``` ``` BL 25 (Dachangshu) *Back Shu of Large Intestine;* stops diarrhea ``` ``` BL 17 (Geshu Diaphragm Shu) *Meeting Pt of Blood*; Stops Bleeding ``` ``` REN 12 (Zhongwan Middle Cavity) *Front Mu of ST, Meeting Pt of Fu;* Resolves Dampness ``` ``` LI 11 (Quchi Pool at Crook) *Ghost Pt, Heavenly Star, He Sea/Earth Pt;* Clears Heat and Dampness ``` ``` ST 37 (Shangjuxu Upper Great Void) *Lower He Sea point of Large Intestine;* Stops diarrhea ``` ``` BL 20 (Pishu Spleen Shu) Regulates Spleen to resolve Dampness ``` ST25 (Tianshu Heaven's Pivot) *Front Mu of LI*; Resolves dampness and damp-heat, Regulates Intestines LI10 (Shou San Li Arm Three Miles) Relationship with ST36; Harmonizes intestines and Stomach Method: Sedate, moxa not applicable

Question 68

Deficiency of Fluids in LI (Dryness) Etiology

Answer 68

This pattern usually accompanies other patterns, Example: Yin or Blood Deficiency. Yin Deficiency produces a red or red and peeled Tongue, whereas Blood Deficiency produces a Tongue that is pale. This pattern is most common in older people and in women after childbirth. 1. Deficiency of Yin-Blood in older people 2. EPF Invasion, heat consume fluid. Consumption of yin fluid in febrile diseases or prolonged diseases 3. Excessive bleeding after delivery (postpartum hemorrhage) 4. Take laxative, constipation later 5. Diet not enough fiber 1-4---\> Deficiency of fluids in LI ---\> fail to moisten intestines

Question 69

Deficiency of Fluids in LI (Dryness) Western Dx

Answer 69

Habitual constipation Inflammation of intestinal tract Anorectal diseases Febrile disease

Question 70

Deficiency of Fluids in LI (Dryness) Sn/Sx

Answer 70

Dry stools that are hard to pass, constipation causing bowel movement every 2-7 (in other patterns you could have constipation with loose stools, qi xu) Dry mouth and throat, halitosis, possible thin body type *Chronic Yin or Blood Deficiency* Tongue: Dry, pale, and red with no coating or with dry yellow coating Pulse: Fine, thready and unsmooth

Question 71

Deficiency of Fluids in LI (Dryness) POT and Herb Px

Answer 71

_POT_ Moisten intestines to relieve constipation _Herbs_ Zeng Ye Cheng Qi Tang (Increase the Fluids and Order the Qi Decoction) _Foods_ nuts, oils, banana, seeds, black sesame seeds

Question 72

Deficiency of Fluids in LI (Dryness) Point Px

Answer 72

``` ST 36 (Zusanli) Promotes fluids in Large Intestine (Stomach is the Origin of Fluids) ``` ``` SP 6 (SanYinjiao ) Tonify Yin and promote Fluids ``` ``` Ren 4 (Guanyuan) Tonify Yin and promote Fluids ``` ``` KI 6 (Zhaohai) Tonifies Yin and promotes Fluids, moistens stool. ``` Method Tonify all points

Question 73

Heat in LI Etiology

Answer 73

Too much hot foods (alcohol, lamb, beef) and dry foods (baked or broiled meats)

Question 74

Heat in LI Sn/Sx

Answer 74

Constipation with Dry Stools *Heat burning fluids* Burning sensation in mouth *Heat* Burning sensation in Anus *Heat* Scanty and dark urine *Heat in the Lower Jiao* Tongue: Thick yellow coating (possible brown or black coating) Pulse: Full and rapid Pulse

Question 75

Heat in LI POT

Answer 75

Clear heat in LI and ST Promote body fluids

Question 76

Heat in LI Point Px

Answer 76

``` REN 4 (Guanyuan Gate of Origin) *Front Mu of SI*; Tonifies Yin and Fluids ``` ``` LI 11 (Quchi Pool at the Crook) *He Sea/Earth, Heavenly Star, Ghost Pt;* Clears Heat in Large Intestine ``` ``` ST 37 (Shangjuxu Upper Great Void) *Lower He Sea point of LI., Point of Sea of Blood;* Good for chronic conditions ``` ``` ST 44 (Neiting Inner Courtyard) *Ying Spring/Water Pt, Heavenly Star;* Clears Stomach Heat ``` ``` LI 2 (Erjian Second Space) Ying Spring/Water; Clears Heat in Large Intestine ``` ``` SP 6 (SanYinjiao Three Yin Intersection) Nourish Yin and promote Body Fluids ``` ``` REN 12 (Zhongwan Middle Cavity) *Front Mu of ST, Meeting Pt of Fu*; Nourish Yin and promote Body Fluids ``` ``` Ki 6 (Zhaohai Shining Sea) *Confluent of Yin Qiao;* Nourish Yin and promote Body Fluids ```

Question 77

Cold in LI (Lingering Diarrhea d/t Xu of LI) Etiology

Answer 77

1. Prolong diarrhea or dysentery ---\> insufficiency of SP and KI Yang 2. Anything that causes SP Yang Xu This pattern is a subcategory of SP Yang Xu

Question 78

Cold in LI (Lingering Diarrhea d/t Xu of LI) Western Dx

Answer 78

Chronic enteritis Chronic dysentery Ulcerative colitis

Question 79

Cold in LI Sn/Sx

Answer 79

Loose stools or even severe diarrhea *Yang fails to transform fluids* Dull abdominal pain which can be relieved by warmth and pressure *Deficiency and cold* Borborygmus *Spleen and Large Intestine Qi Deficiency* Possible prolapse of rectum *SP Qi not lifting* Pale urine *Yang Deficiency* Cold Limbs Tongue: Pale tongue, white and slippery coating Pulse: Fine, deep and weak

Question 80

Cold in LI POT and Herb Px

Answer 80

_POT_ Warm Yang to arrest discharge Tonify and warm LI and SP Note: There is no xie qi left in this pattern so tonifying warming is appropriate. Do not tonify in early stages of diarrhea. _Herbs_ Zhen Ren Yan Zang Tang (True Man's Formula to Nourish the Organs) Astringent herbal to consolidate. Poppy.

Question 81

Cold in LI Point Px

Answer 81

``` REN 6 (Qihai Sea of Qi) Tonifies Qi and stops chronic diarrhea ``` ``` ST 25 (Tianshu Heaven's Pivot) *Front Mu point of LI;* Stops diarrhea and pain. ``` ``` ST 36 (Zusanli Three Leg Mile) *He Sea/Earth, Pt of Sea of Water and Grain; Command Pt of Abdomen, Heavenly Star;*Tonifies Spleen Qi ``` ``` ST 37 (Shangjuxu Upper Great Void) *Lower Sea point of LI, Pt of Sea of Blood*; Stops chronic diarrhea ``` ``` BL 25 (Dachangshu LI Shu) *Back Shu point of Large Intestine.* Tonifies Large Intestine ``` ``` BL 20 (Pishu Spleen Shu) Tonifies Spleen Qi ```