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TCVM Lung Disharmonies. TCVM Lung Disease Lung Physiology Lung Physiology Lung Pathology Lung Pathology Cases Cases.

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Presentation on theme: "TCVM Lung Disharmonies. TCVM Lung Disease Lung Physiology Lung Physiology Lung Pathology Lung Pathology Cases Cases."— Presentation transcript:

1 TCVM Lung Disharmonies

2 TCVM Lung Disease Lung Physiology Lung Physiology Lung Pathology Lung Pathology Cases Cases

3 Metal Sound Sound –weeping Emotion Emotion –grief Climate Climate –dry-cool Season Season –autumn Direction Direction –west Opening Opening –nose Body Part Body Part –skin Zang/Fu Zang/Fu –LU/LI

4 Relationship Between LU & LI LI is husband of LU LI is husband of LU Both are related to elimination of wastes Both are related to elimination of wastes Another reason to beware of airport infrared security Another reason to beware of airport infrared security

5 Lung TCVM Physiology The Lung is the Metal Phase Zang organ in Wu Xing or Five Phase theory The Lung is the Metal Phase Zang organ in Wu Xing or Five Phase theory It is benefited by proper use of the Pungent flavor It is benefited by proper use of the Pungent flavor

6 The Lung is benefited by the Pungent flavor Smelly garlic: A lung tonic? Smelly garlic: A lung tonic? From San Diego, at the Experimental Biology 2005 meeting From San Diego, at the Experimental Biology 2005 meeting –Many people suffer from acute pulmonary hypertension, where blood pressure is selectively elevated in the lungs –The potentially lethal condition can make the right side of the heart work too hard and thus lead to heart failure –This particular form of high blood pressure might be prevented by a daily downing of two cloves of fresh garlic or its powdered equivalent, a new study in rats suggests

7 Lung TCVM Physiology The Earth Phase (Spleen/Stomach) is the nourishing parent of the Lung, while the Water Phase (Kidney/Bladder) is the draining child of the Lung The Earth Phase (Spleen/Stomach) is the nourishing parent of the Lung, while the Water Phase (Kidney/Bladder) is the draining child of the Lung It is also thought that since perturbed Spleen function creates Phlegm, the Lung then stores Phlegm It is also thought that since perturbed Spleen function creates Phlegm, the Lung then stores Phlegm The emotion correlated with the Lung is grief The emotion correlated with the Lung is grief

8 Lung TCVM Physiology The TCVM Lung is commonly the first to be invaded by Wind- Heat, Wind-Cold and Dry pathogens The TCVM Lung is commonly the first to be invaded by Wind- Heat, Wind-Cold and Dry pathogens Thus it is said in TCVM that the Lung is the delicate organ and dislikes dry Thus it is said in TCVM that the Lung is the delicate organ and dislikes dry

9 The Lung is the delicate organ and dislikes dry Drug for dry mouth may prevent lung cancer Drug for dry mouth may prevent lung cancer From San Francisco, at a meeting of the American Association for Cancer Research From San Francisco, at a meeting of the American Association for Cancer Research A drug that has been prescribed for 30 years for a condition known as dry mouth can also stymie the formation of precancerous lung lesions in cigarette smokers, particularly those who have quit A drug that has been prescribed for 30 years for a condition known as dry mouth can also stymie the formation of precancerous lung lesions in cigarette smokers, particularly those who have quit

10 Lung TCVM Physiology Since we know the above functions of the TCVM Lung, we can predict that Lung Disharmonies will affect: Since we know the above functions of the TCVM Lung, we can predict that Lung Disharmonies will affect: –the energetic status of our patients –the respiratory system –water metabolism and build-up in the body (particularly the upper body)

11 Lung TCVM Physiology Since we know the above functions of the TCVM Lung, we can predict that Lung Disharmonies will affect: Since we know the above functions of the TCVM Lung, we can predict that Lung Disharmonies will affect: –the ability to adequately ventilate with deep and unobstructed inspirations and expirations –and contribute to rhinitis and sinusitis –and be involved in the emotions of sadness and grief

12 TCM LUNG Physiology Governs Qi & Respiration Governs Qi & Respiration Dominates Ascending & Descending Dominates Ascending & Descending Control the Body Surface Control the Body Surface Opens in the Nose Opens in the Nose

13 TCVM Lung Disharmonies: Introduction The Lung functions include all of the following in TCVM: The Lung functions include all of the following in TCVM: –Govern Qi and respiration –Control channels and blood vessels –Control dispersing and descending –Regulate the water passages –Control skin and hair –Open into the nose –House the Corporeal Soul (Po)

14 TCVM Lung Disharmonies: Introduction Western Lungs: Western Lungs: –Govern aerobic metabolism and respiration –Are the site of modification of ACE enzymes –Interact with hormones utilized by the kidney system –Are derived from ectoderm like the skin and hair –Are involved with emotional sadness depresses breathing and increases sighing depresses breathing and increases sighing

15 Govern Qi and respiration Breath training aids sprint power Breath training aids sprint power From San Diego, at the Experimental Biology 2005 meeting From San Diego, at the Experimental Biology 2005 meeting Athletes who perform short, high-intensity activities benefit from training their lungs as well as their arms and legs Athletes who perform short, high-intensity activities benefit from training their lungs as well as their arms and legs

16 TCM LUNG Physiology Governs Qi & Respiration Governs Qi & Respiration –Inhales clear Qi –Exhales stale Qi –Forms Zong Qi from Gu Qi & clear Qi –Qi help propel the Blood so Lung and Heart work together –Stagnation of Lung Qi leads to cough and asthma

17 Lung TCVM Physiology Lungs govern Qi and respirationLungs govern Qi and respiration The Lung inhales pure Qi and exhales dirty Qi and this exchange is essential to the proper functioning of all of the bodys physiological processes The Lung inhales pure Qi and exhales dirty Qi and this exchange is essential to the proper functioning of all of the bodys physiological processes The second way that the Lungs govern Qi is due to their role in the generation of Zong Qi (Gathering Qi) of the body The second way that the Lungs govern Qi is due to their role in the generation of Zong Qi (Gathering Qi) of the body

18 Lung TCVM Physiology The Spleen sends Gu Qi (Food Qi) to the Lungs where it is combined with the Qing Qi (clear Qi of the atmosphere) in the chest (the Upper Sea of Qi) to make the Zong Qi The Spleen sends Gu Qi (Food Qi) to the Lungs where it is combined with the Qing Qi (clear Qi of the atmosphere) in the chest (the Upper Sea of Qi) to make the Zong Qi The Lung then spreads Qi all over the body to nourish all the tissues and Zang-Fu organs The Lung then spreads Qi all over the body to nourish all the tissues and Zang-Fu organs

19 Lung TCVM Physiology The Lung controls Channels and blood vesselsThe Lung controls Channels and blood vessels The Lungs govern Qi and Qi is the force that empowers the Heart to circulate Blood The Lungs govern Qi and Qi is the force that empowers the Heart to circulate Blood Further, Lung Qi controls the circulation of Ying Qi (Nutritive Qi) in the channels Further, Lung Qi controls the circulation of Ying Qi (Nutritive Qi) in the channels

20 Lung TCVM Physiology If Lung Qi is strong the circulation of Qi and Blood will be uncompromised and the limbs and digits will be warm If Lung Qi is strong the circulation of Qi and Blood will be uncompromised and the limbs and digits will be warm If the Lung Qi is weak, Qi will be inadequate to move the Blood and the limbs and especially the digits will be cool or cold If the Lung Qi is weak, Qi will be inadequate to move the Blood and the limbs and especially the digits will be cool or cold

21 TCM LUNG Physiology Dominates Ascending & Descending Dominates Ascending & Descending –Distributes defensive (wie) Qi and body fluid to entire body –Helps maintain normal descending function, while receiving the ascending water vapor from the kidney

22 Lung TCVM Physiology The Lungs control the dispersing and descending function The Lungs control the dispersing and descending function By dispersing it is meant that the Lungs control the spreading of Wei Qi (Defensive Qi) and Body Fluids throughout the body surface in the space between the skin and muscles By dispersing it is meant that the Lungs control the spreading of Wei Qi (Defensive Qi) and Body Fluids throughout the body surface in the space between the skin and muscles

23 Lung TCVM Physiology This dispersion of Wei Qi both warms the skin and protects against exterior pathogenic invasion This dispersion of Wei Qi both warms the skin and protects against exterior pathogenic invasion Weak Lung function may lead to a decrease in Wei Qi in the skin and an increased incidence of exterior pathogenic invasion Weak Lung function may lead to a decrease in Wei Qi in the skin and an increased incidence of exterior pathogenic invasion

24 Lung TCVM Physiology The Lung also spreads Body Fluids to the skin in the form of a mist The Lung also spreads Body Fluids to the skin in the form of a mist This mist or Body Fluids both moistens the skin and regulates the opening and closing of pores and sweating This mist or Body Fluids both moistens the skin and regulates the opening and closing of pores and sweating

25 Lung TCVM Physiology Excess conditions such as Wind-Cold (Cold predominate) may lead to a cessation of sweating while Deficiency conditions such as Wind-Cold (Wind predominate) or Yang deficiency may lead to spontaneous sweating Excess conditions such as Wind-Cold (Cold predominate) may lead to a cessation of sweating while Deficiency conditions such as Wind-Cold (Wind predominate) or Yang deficiency may lead to spontaneous sweating If the Lung function of dispersing is compromised, edematous fluids may accumulate under the skin of the upper body and face If the Lung function of dispersing is compromised, edematous fluids may accumulate under the skin of the upper body and face

26 Lung TCVM Physiology The Lung controls the descending function since it is the uppermost organ and the Qi generated in the Lung must descend The Lung controls the descending function since it is the uppermost organ and the Qi generated in the Lung must descend Lung Qi especially descends to the Kidney where the Kidney then grasps it Lung Qi especially descends to the Kidney where the Kidney then grasps it

27 Lung TCVM Physiology The Body Fluids are also descended down to the Kidneys and Bladder The Body Fluids are also descended down to the Kidneys and Bladder Compromised descending function of Lung Qi may cause cough, breathlessness and stuffiness in the chest Compromised descending function of Lung Qi may cause cough, breathlessness and stuffiness in the chest If the Large Intestine (Yang husband of the Lung) does not receive the Lung Qi, Qi deficient constipation may occur If the Large Intestine (Yang husband of the Lung) does not receive the Lung Qi, Qi deficient constipation may occur

28 Lung TCVM Physiology The Lung regulates the water passagesThe Lung regulates the water passages –in relation to its dispersing and descending function If the dispersing function of misting under the skin is blocked If the dispersing function of misting under the skin is blocked –edematous fluids may accumulate beneath the skin

29 Lung TCVM Physiology Since the Lung descends fluids down to the Kidneys and Bladder, the Kidney is kept moist (and may steam fluids back up to moisten the Lung) and the Bladder is influenced to release its urine Since the Lung descends fluids down to the Kidneys and Bladder, the Kidney is kept moist (and may steam fluids back up to moisten the Lung) and the Bladder is influenced to release its urine If Lung Qi is impaired, urinary retention may occur If Lung Qi is impaired, urinary retention may occur

30 TCM LUNG Physiology Control the Body Surface Control the Body Surface –Distributes body fluid to the tissues which in turn helps regulate skin moisture and sweating –Provides Wei Qi

31 Lung TCVM Physiology The Lung controls the skin and hair is also related to the dispersing/descending and regulating the water passages functions of the Lung The Lung controls the skin and hair is also related to the dispersing/descending and regulating the water passages functions of the Lung The Lungs receive, along with Gu Qi, fluids from the Spleen and spreads them over the entire body, skin, and hair to give nourishment and moisture The Lungs receive, along with Gu Qi, fluids from the Spleen and spreads them over the entire body, skin, and hair to give nourishment and moisture If the Lung is functioning normally, the fur will have luster and the opening and closing of the pores will be normal If the Lung is functioning normally, the fur will have luster and the opening and closing of the pores will be normal

32 Lung TCVM Physiology If the Lung function is somehow compromised the skin and hair will lack nourishment and moisture and may be dry and rough If the Lung function is somehow compromised the skin and hair will lack nourishment and moisture and may be dry and rough Of course we remember that the Lungs maintain the flow of Wei Qi under the skin when functioning normally Of course we remember that the Lungs maintain the flow of Wei Qi under the skin when functioning normally Abnormal function or Wind invasion of the skin can lead to a blockage and impair Lung dispersing function leading to sneezing and coughing Abnormal function or Wind invasion of the skin can lead to a blockage and impair Lung dispersing function leading to sneezing and coughing

33 Lung TCVM Physiology The Lung opens into the nose and thus receives the Qing Qi of the atmosphere in order to make Zong Qi The Lung opens into the nose and thus receives the Qing Qi of the atmosphere in order to make Zong Qi The Jing-Shen of a healthy Lung leads to good olfactory sensation and good Lung Qi leads to open nostrils and healthy respiration The Jing-Shen of a healthy Lung leads to good olfactory sensation and good Lung Qi leads to open nostrils and healthy respiration

34 Lung TCVM Physiology If Lung Qi is weak or there is an invasion of an exogenous pathogen, the nose may be blocked and there may be a loss or reduction in olfaction or sneezing If Lung Qi is weak or there is an invasion of an exogenous pathogen, the nose may be blocked and there may be a loss or reduction in olfaction or sneezing If the Lungs are invaded by pathogenic Heat, the nares may flare and there may be epistaxis If the Lungs are invaded by pathogenic Heat, the nares may flare and there may be epistaxis

35 If Lung Qi is weak there can be an invasion of an exogenous pathogen Conduit to the Brain: Particles enter the nervous system via the nose Conduit to the Brain: Particles enter the nervous system via the nose Like stealthy intruders, minute airborne particles can apparently invade the brain through a vulnerable portal Like stealthy intruders, minute airborne particles can apparently invade the brain through a vulnerable portal At least some such particles, when inhaled into the nose, shimmy up the nerve bundle that governs smell and infiltrate the central nervous system, bypassing the natural firewall between brain tissue and the main circulatory system At least some such particles, when inhaled into the nose, shimmy up the nerve bundle that governs smell and infiltrate the central nervous system, bypassing the natural firewall between brain tissue and the main circulatory system

36 Lung TCVM Physiology The Lungs house the Po or Corporeal Soul The Lungs house the Po or Corporeal Soul The Po The Po –pertains to the body –is the spirit of the body –is Yin and quiescent –is related to Essence –represents the movement of Essence inwardly –is connected to Qi and Yang –is purely individual and at death dissolves and returns to the earth Disharmony of the Po tends to cause problems in the daytime and causes a lack of vigor and vitality Disharmony of the Po tends to cause problems in the daytime and causes a lack of vigor and vitality

37 TCM LUNG Physiology Opens in the Nose Opens in the Nose –Lung is a canopy over the other organs and very delicate –Easily affected by pathogens (wind, heat, cold or dryness)

38 Lung TCVM Physiology Since they have intimate contact with the outer world through the air, the Lungs are considered the most external Yin organ Since they have intimate contact with the outer world through the air, the Lungs are considered the most external Yin organ Because of this external position, the Lung is considered the tender organ and is most vulnerable to attack by exogenous pathogenic factors Because of this external position, the Lung is considered the tender organ and is most vulnerable to attack by exogenous pathogenic factors

39 the tender organ Inhaled particles damage vascular lining Inhaled particles damage vascular lining Though arteries and veins move large flows of blood around the body, tinier vessels called arterioles distribute blood to the capillaries in tissues Though arteries and veins move large flows of blood around the body, tinier vessels called arterioles distribute blood to the capillaries in tissues

40 To regulate this microflow minute to minute according to tissues' needs, arterioles continually dilate and constrict To regulate this microflow minute to minute according to tissues' needs, arterioles continually dilate and constrict An animal experiment now indicates that breathing soot and other airborne particles compromises the arterioles' capacity to dilate An animal experiment now indicates that breathing soot and other airborne particles compromises the arterioles' capacity to dilate The finding, reported in Pittsburgh in October at the Society of Environmental Journalists annual meeting, offers one explanation for epidemiological studies that have linked cardiovascular disease and polluted air The finding, reported in Pittsburgh in October at the Society of Environmental Journalists annual meeting, offers one explanation for epidemiological studies that have linked cardiovascular disease and polluted air the tender organ

41 Diesel fumes suppress immune response Diesel fumes suppress immune response Recurring exposure to soot particles from diesel exhaust reduces the immune system's capacity to fend off infection more persistently than does a one-time exposure to an equivalent amount of particles, tests on rodents indicate Recurring exposure to soot particles from diesel exhaust reduces the immune system's capacity to fend off infection more persistently than does a one-time exposure to an equivalent amount of particles, tests on rodents indicate Inhaling particles less than 2.5 μm across is harmful to the heart and lungs Inhaling particles less than 2.5 μm across is harmful to the heart and lungs the tender organ

42 Is the Increase in Asthma Prevalence Linked to an Increase in Allergic Antigen Load," Allergy, 1995;50: #24296 What role does air pollution have in asthma prevalence? What role does air pollution have in asthma prevalence? AW & JP: Industrial air pollutants are not thought to have been important in increasing the prevalence of asthma AW & JP: Industrial air pollutants are not thought to have been important in increasing the prevalence of asthma There is no doubt that some countries in Eastern Europe, such as East Germany and Poland, have had high levels of industrial pollutants, such as sulfur dioxide and nitrogen dioxide in recent years There is no doubt that some countries in Eastern Europe, such as East Germany and Poland, have had high levels of industrial pollutants, such as sulfur dioxide and nitrogen dioxide in recent years These pollutants appear to be responsible for high levels of respiratory infections in children but the prevalence of asthma is lower than in Western Europe These pollutants appear to be responsible for high levels of respiratory infections in children but the prevalence of asthma is lower than in Western Europe

43 Lung Patterns

44 TCM 24 Hour Clock

45 Common TCVM Lung Pathology Patterns Wind-Cold Invading the Lungs Wind-Cold Invading the Lungs Wind-Heat Invading the Lungs Wind-Heat Invading the Lungs Wind(-Heat)-Dampness Wind(-Heat)-Dampness Wind-Dryness (with Heat) Wind-Dryness (with Heat) Lung-Heat Lung-Heat Lung Phlegm-Heat Lung Phlegm-Heat Damp-Phlegm (or Cold Phlegm) in the Lungs Damp-Phlegm (or Cold Phlegm) in the Lungs Lung Qi Deficiency Lung Qi Deficiency Lung Qi Obstructed Lung Qi Obstructed Lung Yin Deficiency Lung Yin Deficiency Lung Dryness Lung Dryness Lung Yin Deficiency with Empty-Heat Lung Yin Deficiency with Empty-Heat

46 Wind-Cold Invading the Lungs Commonly seen as asthma, allergic rhinitis, cough, and influenza Commonly seen as asthma, allergic rhinitis, cough, and influenza Clinical signs: chills greater than fever, sneezing and clear watery nasal discharge, body aches, itchy throat Clinical signs: chills greater than fever, sneezing and clear watery nasal discharge, body aches, itchy throat Tongue: thin white coat Tongue: thin white coat Pulse: superficial, tight Pulse: superficial, tight Treatment Principle: release the Exterior, expel Wind-Cold, calm asthma, calm the Shen Treatment Principle: release the Exterior, expel Wind-Cold, calm asthma, calm the Shen

47 Gui Zhi Tang Cinnamon Twig Decoction Gui Zhi cinnamomumwarm kidneys, fortify Yang, disperse Cold Gui Zhi cinnamomumwarm kidneys, fortify Yang, disperse Cold Bai Shao Yao paeonianourish blood & perserve Yin Bai Shao Yao paeonianourish blood & perserve Yin Sheng Jiangzingiberwarms middle & expels Cold Sheng Jiangzingiberwarms middle & expels Cold Da Zao ziziphustonify Qi, hamronize, calm shen Da Zao ziziphustonify Qi, hamronize, calm shen Gan Cao glycyrrizatonify Qi, harmonize Gan Cao glycyrrizatonify Qi, harmonize –Actions: releases pathogenic influences from the muscle layer and regulates the Ying (Nutritive) and Wei (Defensive)

48 Wind-Cold Invading the Lungs Western Biomedicine: URTI, influenza, allergic rhinitis, angioedema, eczema, urticaria Western Biomedicine: URTI, influenza, allergic rhinitis, angioedema, eczema, urticaria Acupuncture: Acupuncture: –Dingchuan to stop acute asthma –BL 12 to expel Wind –BL 13, CV 22, LU 7, to normalize descending Lung Qi

49 Wind-Cold Invading the Lungs –LU 6 Xi-Cleft point for acute process –HT 7, CV 15 (or 17) calm the Shen, unblock the chest and descend chest Qi –GB 20, GB 21 relax the neck (ease breathing) and descend Qi –ST 36, SP 6 to harmonize Ying and Wei Qi Jing-Tang: Zhi Sou San (F0045) to moisten the Lung, transform phlegm and stop cough Jing-Tang: Zhi Sou San (F0045) to moisten the Lung, transform phlegm and stop cough

50 Zhi Sou San Bai BuStamonaMoisten Lung, stop cough Bai BuStamonaMoisten Lung, stop cough Bai QianCynanchumDescend Lung Qi, stop cough Bai QianCynanchumDescend Lung Qi, stop cough Chen PiCitrusMove Qi, transform phlegm Chen PiCitrusMove Qi, transform phlegm Fu LingPoriaDrain Damp, strengthen Spleen Fu LingPoriaDrain Damp, strengthen Spleen Gan CaoLicoriceHarmonize Gan CaoLicoriceHarmonize Zi WanAsterMoisten Lung, stop cough Zi WanAsterMoisten Lung, stop cough –Action: Moisten the Lung, transform phlegm and stop cough

51 Wind-Heat Invading the Lungs Commonly seen as asthma, allergic rhinitis, sinusitis, cough, and influenza Commonly seen as asthma, allergic rhinitis, sinusitis, cough, and influenza Clinical signs: fever and aversion to cold, headache, tightness of the chest, loud wheezing, barking cough, asthma, mental restlessness, slight thirst Clinical signs: fever and aversion to cold, headache, tightness of the chest, loud wheezing, barking cough, asthma, mental restlessness, slight thirst Tongue: red sides towards the front Tongue: red sides towards the front Pulse: superficial, rapid Pulse: superficial, rapid Treatment principles: release the Exterior, restore the descending of Lung Qi, expel Wind-Heat, calm asthma, calm the Shen Treatment principles: release the Exterior, restore the descending of Lung Qi, expel Wind-Heat, calm asthma, calm the Shen

52 Sang Ju Yin Mulberry Leaf and Chrysanthemum Decoction Sang Ye morus fruitexpel wind & clear Lung heat Sang Ye morus fruitexpel wind & clear Lung heat Ju Hua chrysanthemumdisperse wind & clear heat Ju Hua chrysanthemumdisperse wind & clear heat Bo He menthadisperse wind heat Bo He menthadisperse wind heat Xing Ren prunusstop cough & calm wheezing Xing Ren prunusstop cough & calm wheezing Lu Gen phragmitesclear heat (LU) & generate fluids Lu Gen phragmitesclear heat (LU) & generate fluids Jie Geng platycodonopen & disseminate Lung Qi, expels phlegm, transporter Jie Geng platycodonopen & disseminate Lung Qi, expels phlegm, transporter Lian Qiaoforsythiaclear heat & toxins, dissipate nodules Lian Qiaoforsythiaclear heat & toxins, dissipate nodules Gan Cao glycyrrizatonify Spleen & Qi, moisten Lungs & stops cough Gan Cao glycyrrizatonify Spleen & Qi, moisten Lungs & stops cough –Actions: releases exterior Wind-Heat and stops coughing by facilitating the correct flow of Lung Qi

53 Wind-Heat Invading the Lungs Western Biomedicine: URTI, influenza, early-stage acute bronchitis, acute tonsillitis, acute conjunctivitis Western Biomedicine: URTI, influenza, early-stage acute bronchitis, acute tonsillitis, acute conjunctivitis Acupuncture: Acupuncture: –LU 5 clears Lung Heat –LU 7, LU 1, BL 13 restore the descending function of the Lung –LU 6 Xi-Cleft for acute onset –LU 11 expels Wind-Heat and soothes the throat –Ding Chuan stops acute asthma –HT 7, CV 15 calm the Shen

54 Yin Qiao San Honeysuckle and Forsythia Powder Ban Lan GenIsatisClear Heat-toxin Ban Lan GenIsatisClear Heat-toxin Bo HeMenthaClear Wind-Heat Bo HeMenthaClear Wind-Heat Dan Zhu YeBambooClear Heat and benefit the urination Dan Zhu YeBambooClear Heat and benefit the urination Gan CaoLicoriceHarmonize Gan CaoLicoriceHarmonize Jie GengPlatycodonOpen the Lung and eliminate phlegm Jie GengPlatycodonOpen the Lung and eliminate phlegm Jin Yin HuaLoniceraClear Heat-toxin, dissipate the exterior Jin Yin HuaLoniceraClear Heat-toxin, dissipate the exterior Jing JieSchizonapetaClear Wind-Cold Jing JieSchizonapetaClear Wind-Cold Lian QiaoForsythiaClear Heat-toxin, dissipate the swelling Lian QiaoForsythiaClear Heat-toxin, dissipate the swelling Lu GenPhragmitesClear Heat and promote body fluid Lu GenPhragmitesClear Heat and promote body fluid Niu Bang ZiArctiumClear Wind-Heat, benefit the throat Niu Bang ZiArctiumClear Wind-Heat, benefit the throat –Actions: disperses Wind-Heat, clears Heat and relieves toxicity

55 Wind-Heat Invading the Lungs Western Biomedicine: URTI, influenza, acute bronchitis, measles, acute endometritis, early- stage encephalitis or meningitis Western Biomedicine: URTI, influenza, acute bronchitis, measles, acute endometritis, early- stage encephalitis or meningitis Acupuncture: Acupuncture: –LU 5 clears Lung Heat –LU 7, LU 1, BL 13 restore the descending function of the Lung –LU 6 Xi-Cleft for acute onset

56 Wind-Heat Invading the Lungs –LU 11 expels Wind-Heat and soothes the throat –LI 11, ST 36, GV 14 to dispel Heat –Ding chuan stops acute asthma –HT 7, CV 15 calm the Shen Jing-Tang: Equine Yin Qiao (E0130) to relieve the exterior, dispel Wind-Heat, eliminate Interior Heat and detoxify Jing-Tang: Equine Yin Qiao (E0130) to relieve the exterior, dispel Wind-Heat, eliminate Interior Heat and detoxify

57 Equine Yin Qiao (E0130) Ban Lan GenIsatisclear heat-toxin Ban Lan GenIsatisclear heat-toxin Bo HeMenthaclear wind-heat Bo HeMenthaclear wind-heat Dan Zhu YeBambooclear heat & benefit urination Dan Zhu YeBambooclear heat & benefit urination Gan CaoLicoriceharmonize Gan CaoLicoriceharmonize Jie GengPlatycodonopen Lung & eliminate phlegm Jie GengPlatycodonopen Lung & eliminate phlegm Jin Yin HuaLoniceraclear heat-toxin, dissipate exterior Jin Yin HuaLoniceraclear heat-toxin, dissipate exterior Jing JieSchizonapetaclear wind-cold Jing JieSchizonapetaclear wind-cold Lian QiaoForsythiaclear heat-toxin, dissipate swelling Lian QiaoForsythiaclear heat-toxin, dissipate swelling Lu GenPhragmitesclear heat & promote body fluid Lu GenPhragmitesclear heat & promote body fluid Niu Bang ZiArctiumclear wind-heat, benefit the throat Niu Bang ZiArctiumclear wind-heat, benefit the throat –Action: Relieve the Exterior, dispel Wind-Heat, eliminate Interior Heat and detoxify

58 Wind(-Heat)-Dampness Commonly seen as headaches with or without influenza Commonly seen as headaches with or without influenza Clinical Signs: aversion to cold, shivering, fever, nausea, vomiting, swollen lymph nodes, headache, feeling worse in the afternoon, chest oppression, sticky feeling in mouth Clinical Signs: aversion to cold, shivering, fever, nausea, vomiting, swollen lymph nodes, headache, feeling worse in the afternoon, chest oppression, sticky feeling in mouth Tongue: sticky yellow coating Tongue: sticky yellow coating Pulse: slippery and floating Pulse: slippery and floating Treatment Principle: release the Exterior, expel Wind-Heat and resolve Dampness Treatment Principle: release the Exterior, expel Wind-Heat and resolve Dampness

59 Wind(-Heat)-Dampness Western Biomedicine: influenza, intestinal flu, nonspecific acute colitis and acute gastroenteritis Western Biomedicine: influenza, intestinal flu, nonspecific acute colitis and acute gastroenteritis Acupuncture: Acupuncture: –LI 4 Hegu and LI 11 to release the exterior, expel Wind- Heat and resolve Damp-Heat –SP 9 resolves Damp-Heat –CV 13 resolves Dampness, harmonizes the middle burner and subdues rebellious Stomach Qi

60 Wind(-Heat)-Dampness –TH 5 expels Wind-Heat –GV 14 clears Heat –LU 11 hemo-AP expels Wind-Heat and benefits the throat (may substitute LU 10 in small animals) Jing-Tang: Huo Xiang Zheng Qi Jing-Tang: Huo Xiang Zheng Qi

61 Huo Xiang Zheng Qi San Agastache Powder to Rectify the Qi Huo Xiang agastachestransform damp, harmonize middle burner, stop vomiting Huo Xiang agastachestransform damp, harmonize middle burner, stop vomiting Hou Po cortex magnoliamove Qi, transform damp, resolve stagnation Hou Po cortex magnoliamove Qi, transform damp, resolve stagnation Zi Su Ye folium perillarelease exterior & disperse cold, move Qi, expand chest Zi Su Ye folium perillarelease exterior & disperse cold, move Qi, expand chest Bai Zhi angelica dahuricaexpel wind, alleviate pain, reduce swelling & expel pus & damp Bai Zhi angelica dahuricaexpel wind, alleviate pain, reduce swelling & expel pus & damp Ban Xia pinelladry damp, transform phlegm, descend rebellious Qi, stop vomiting Ban Xia pinelladry damp, transform phlegm, descend rebellious Qi, stop vomiting Da Fu Pi arecamove Qi down, reduce food stagnation, expel damp, promote urination Da Fu Pi arecamove Qi down, reduce food stagnation, expel damp, promote urination Bai Zhu actractylodestonify Spleen & Qi, strengthen Spleen & dry damp Bai Zhu actractylodestonify Spleen & Qi, strengthen Spleen & dry damp Fu Ling poriadrain damp, strengthen Spleen Fu Ling poriadrain damp, strengthen Spleen Jie Geng platycodonopen Lung & eliminate phlegm Jie Geng platycodonopen Lung & eliminate phlegm Zhi Gan Caohoney-fry licoricetonify Spleen & Kidney Qi & Yang, moisten Lungs & stops cough Zhi Gan Caohoney-fry licoricetonify Spleen & Kidney Qi & Yang, moisten Lungs & stops cough –Actions: releases the exterior, transforms Dampness, regulates the Qi, and harmonizes the middle burner

62 Wind-Dryness (with Heat) Commonly seen as cough, nasal or lung bleeding, or influenza Commonly seen as cough, nasal or lung bleeding, or influenza Clinical Signs: aversion to cold, fever, slight sweating, dryness of nose, mouth and throat, dry skin with dry cough and desire to drink Clinical Signs: aversion to cold, fever, slight sweating, dryness of nose, mouth and throat, dry skin with dry cough and desire to drink Tongue: slightly red near the tip, dry Tongue: slightly red near the tip, dry Pulse: floating, may be rapid Pulse: floating, may be rapid Treatment Principles: release the exterior, expel Wind, restore the descending function of Lung Qi, benefit Body Fluids Treatment Principles: release the exterior, expel Wind, restore the descending function of Lung Qi, benefit Body Fluids

63 Sang Xing Tang Mulberry Leaf and Apricot Kernel Decoction Sang Ye folium moriexpel wind & clear Lung heat Sang Ye folium moriexpel wind & clear Lung heat Zhi Zi gardeniaclear heat, reduce irritability, drain damp heat Zhi Zi gardeniaclear heat, reduce irritability, drain damp heat Dan Dou Chi prep soybeanrelease exterior hot or cold Dan Dou Chi prep soybeanrelease exterior hot or cold Xing Ren apricot seedstop cough & calm wheezing Xing Ren apricot seedstop cough & calm wheezing Zhe Bei Mu fritillariaclear & transform phlegm heat Zhe Bei Mu fritillariaclear & transform phlegm heat Sha shen glehniamoisten lungs & clear heat Sha shen glehniamoisten lungs & clear heat Li Pi pyri fruitclear heat, strengthen Spleen Li Pi pyri fruitclear heat, strengthen Spleen –Actions: clears and disperses warm-dryness

64 Wind-Dryness (with Heat) Western Biomedicine: URTI, pharyngitis, pertussis, bronchitis, and bronchiectasis Western Biomedicine: URTI, pharyngitis, pertussis, bronchitis, and bronchiectasis Acupuncture: Acupuncture: –LU 7, LI 4, LI 11 release the exterior and expel Wind-Heat –CV 12, SP 6 and KID 6 promote Body Fluids –KID 6 soothes the throat

65 Lung Heat Commonly seen as sinusitis, cough, atrophy syndrome, or influenza Commonly seen as sinusitis, cough, atrophy syndrome, or influenza Clinical Signs: high fever, feeling of heat, cough, breathlessness, coughing of yellow sputum, thirst, restlessness, sweating, panting Clinical Signs: high fever, feeling of heat, cough, breathlessness, coughing of yellow sputum, thirst, restlessness, sweating, panting Tongue: red with yellow coat Tongue: red with yellow coat Pulse: overflowing and rapid Pulse: overflowing and rapid Treatment Principles: clear Lung-Heat, prevent injury of Yin by Heat Treatment Principles: clear Lung-Heat, prevent injury of Yin by Heat

66 Ma Xing Shi Gan Tang Ephedra, Apricot Kernel, Gypsum and Licorice Decoction Ma Huang ephedrarelease exterior, disperse cold, move lung Qi, promote urination Ma Huang ephedrarelease exterior, disperse cold, move lung Qi, promote urination Shi Gao gypsumclear heat & drain fire Shi Gao gypsumclear heat & drain fire Xing Ren apricot seedstop cough & calm wheezing, moisten intestines Xing Ren apricot seedstop cough & calm wheezing, moisten intestines Zhi Gan Cao honey-fry licoricetonify Spleen & Kidney Qi & Yang, moisten Lungs & stops cough Zhi Gan Cao honey-fry licoricetonify Spleen & Kidney Qi & Yang, moisten Lungs & stops cough –Actions: facilitates the flow of Lung Qi, clears Heat, and calms wheezing by directing rebellious Qi downward

67 Lung Heat Western Biomedicine: URTI, lobar pneumonia, bronchial pneumonia, bronchial asthma, bronchiolitis, pertussis Western Biomedicine: URTI, lobar pneumonia, bronchial pneumonia, bronchial asthma, bronchiolitis, pertussis Acupuncture: Acupuncture: –LU 10 clears Lung Heat –LU 5 resolves Phelgm-Heat from the Lungs –LU 1 clears Lung Heat –GV 14 clears Heat –SP 6 prevents injury of Yin by Heat Jing-Tang: Wei Jing Tang (E0084) to clear Lung Heat and dispel pus Jing-Tang: Wei Jing Tang (E0084) to clear Lung Heat and dispel pus

68 Red Lung (B0071) Red Lung (B0071) Huang Qin scutellariaClear Lung Heat Huang Qin scutellariaClear Lung Heat Huang Yao Zi dioscoreaClear Lung Heat Huang Yao Zi dioscoreaClear Lung Heat Chuan Bei MufritillariaMoisten Lung & clear phlegm Chuan Bei MufritillariaMoisten Lung & clear phlegm Jie Geng platycodonOpen Lung & benefit the upper Jiao Jie Geng platycodonOpen Lung & benefit the upper Jiao Dan Shen condonopsisTonify Qi Dan Shen condonopsisTonify Qi Wu Wei Zi schisandraConsolidate & nourish Lung Yin Wu Wei Zi schisandraConsolidate & nourish Lung Yin Dan Shen salviaCool & activate Blood Dan Shen salviaCool & activate Blood Sheng Di Huang raw rehmanniaNourish Yin Sheng Di Huang raw rehmanniaNourish Yin Xuan Shen scrophulariaCool Blood & nourish Yin Xuan Shen scrophulariaCool Blood & nourish Yin –Actions: Clear Fire, cool the Lung

69 Red Lung (B0071) Red Lung (B0071) Western Biomedicine: Exercised-induced pulmonary hemorrhage (EIPH) and nosebleed, prevention and treatment Western Biomedicine: Exercised-induced pulmonary hemorrhage (EIPH) and nosebleed, prevention and treatment Related Jing-Tang Formulas: Single Immortal (B0072) to stop pulmonary hemorrhage Related Jing-Tang Formulas: Single Immortal (B0072) to stop pulmonary hemorrhage Red Lung Plus (B0073) to stop pulmonary hemorrhage (more powerful than Single Immortal) Red Lung Plus (B0073) to stop pulmonary hemorrhage (more powerful than Single Immortal)

70 Xie Bai San Drain the White Powder Chao Sang Bai Pi dry-fried mulberry cortexdrains Lung heat, calm wheezing & cough Chao Sang Bai Pi dry-fried mulberry cortexdrains Lung heat, calm wheezing & cough Di Gu Pi lycium rootclears deficient heat Di Gu Pi lycium rootclears deficient heat Zhi Gan Cao honey-fried licoricetonify Spleen & Kidney Qi & Yang, moisten Lungs, stop cough Zhi Gan Cao honey-fried licoricetonify Spleen & Kidney Qi & Yang, moisten Lungs, stop cough Geng Mi nonglutinous riceprotect Spleen Geng Mi nonglutinous riceprotect Spleen –Actions: drains Heat from the Lungs and calms wheezing

71 Lung Heat Western Biomedicine: bronchitis, pneumonia, pulmonary tuberculosis, pleurisy Western Biomedicine: bronchitis, pneumonia, pulmonary tuberculosis, pleurisy Acupuncture: Acupuncture: –LU 10 clears Lung Heat –LU 5 resolves Phelgm-Heat from the Lungs –LU 1 clears Lung Heat –GV 14 clears Heat –SP 6 prevents injury of Yin by Heat –Ding Chuan arrests coughing Jing-Tang: Qing Fei San (E0087) to clear Lung Heat and stop cough/asthma Jing-Tang: Qing Fei San (E0087) to clear Lung Heat and stop cough/asthma

72 Lung Phlegm-Heat Commonly seen as breathlessness, cough, and/or influenza Commonly seen as breathlessness, cough, and/or influenza Clinical Signs: high fever, restlessness, thirst, vomiting after drinking, cough, breathlessness, chest pain, coughing of profuse amounts of yellow-sticky sputum, nausea, dry stools, dark urine Clinical Signs: high fever, restlessness, thirst, vomiting after drinking, cough, breathlessness, chest pain, coughing of profuse amounts of yellow-sticky sputum, nausea, dry stools, dark urine

73 Lung Phlegm-Heat Tongue: red with a sticky-yellow coating Tongue: red with a sticky-yellow coating Pulse: slippery and rapid Pulse: slippery and rapid Treatment Principles: clear Lung-Heat, resolve Phlegm, restore the descending of Lung Qi and prevent injury to Yin Treatment Principles: clear Lung-Heat, resolve Phlegm, restore the descending of Lung Qi and prevent injury to Yin

74 Qing Jin Hua Tan Tang Clear Metal and Absorb Phlegm Decoction Huang Qi scutellariatonify Spleen Qi Huang Qi scutellariatonify Spleen Qi Zhi Zi gardeniaclears heat, drain damp heat Zhi Zi gardeniaclears heat, drain damp heat Fu Ling poriapromote urination, drain damp, strengthen Spleen Fu Ling poriapromote urination, drain damp, strengthen Spleen Zhe Bei Mu fritillariaclear & transform phlegm heat Zhe Bei Mu fritillariaclear & transform phlegm heat Jie Geng platycodonopen & disseminate Lung Qi, expels phlegm, transporter Jie Geng platycodonopen & disseminate Lung Qi, expels phlegm, transporter Gua Lou trichosanthesclear & transform phlegm heat Gua Lou trichosanthesclear & transform phlegm heat Zhi Mu anemarrhenaclear heat & drain fire Zhi Mu anemarrhenaclear heat & drain fire Sang Bai Pi mulberrystop cough & wheezing, drain Lung heat Sang Bai Pi mulberrystop cough & wheezing, drain Lung heat Mai Men Dong ophiopogonmoisten Lungs & stop cough Mai Men Dong ophiopogonmoisten Lungs & stop cough Gan Cao glycyrrizatonify Qi, harmonize Gan Cao glycyrrizatonify Qi, harmonize –Actions: clears Heat from the Lungs, dispels Phlegm and preserves the Yin of the Lung

75 Lung Phlegm-Heat Western Biomedicine: bronchitis, pneumonia, bronchopneumonia, pulmonary tuberculosis, all with mucopurulent material Western Biomedicine: bronchitis, pneumonia, bronchopneumonia, pulmonary tuberculosis, all with mucopurulent material Acupuncture: Acupuncture: –LU 5 resolves Phlegm-Heat from Lungs –LU 1 clears Lung Heat –ST 40 resolves Phlegm

76 Lung Phlegm-Heat –CV 22 resolves Phlegm and descends Lung Qi –PC 6 opens the chest –GV 14 clears Heat Jing-Tang: Wei Jing Tang (E0084) to clear Lung Heat and dispel pus Jing-Tang: Wei Jing Tang (E0084) to clear Lung Heat and dispel pus

77 Wei Jing Tang (E0084) Ban Lan GenIsatisclear Lung heat Ban Lan GenIsatisclear Lung heat Dong Gua ZiCordycepstransform phlegm, dispel pus Dong Gua ZiCordycepstransform phlegm, dispel pus Jie GengPlatycodontransform phlegm, dispel pus Jie GengPlatycodontransform phlegm, dispel pus Lu GenPhragmitesclear Lung heat Lu GenPhragmitesclear Lung heat Tao RenPersicamove blood Tao RenPersicamove blood Yi Yi RenCoixdrain damp & dispel pus Yi Yi RenCoixdrain damp & dispel pus –Action: Clear Lung Heat and dispel pus

78 Damp-Phlegm (or Cold Phlegm) in the Lungs Commonly seen as breathlessness, wheezing, and cough Commonly seen as breathlessness, wheezing, and cough Clinical Signs: coughing and wheezing with watery, copious sputum, shortness of breath with labored inspiration and smooth expiration Clinical Signs: coughing and wheezing with watery, copious sputum, shortness of breath with labored inspiration and smooth expiration

79 Damp-Phlegm (or Cold Phlegm) in the Lungs Tongue: white slippery or greasy coating Tongue: white slippery or greasy coating Pulse: weak, slippery Pulse: weak, slippery Treatment Principles: warm the Lung, scatter Cold, resolve Phlegm and relieve breathlessness Treatment Principles: warm the Lung, scatter Cold, resolve Phlegm and relieve breathlessness

80 Su Zi Jiang Qi Tang Perilla Fruit Decoction for Directing Qi Downward Zhi Gan Cao glycyrrizatonify Spleen & Kidney Qi & Yang, moisten Lungs, stop cough Zhi Gan Cao glycyrrizatonify Spleen & Kidney Qi & Yang, moisten Lungs, stop cough Ban Xia pinelliadry damp, transform phlegm, descends rebellious Qi Ban Xia pinelliadry damp, transform phlegm, descends rebellious Qi Zi Su Zi perilla seedstop cough & wheezing, redirect Qi down, dissolve phlegm Zi Su Zi perilla seedstop cough & wheezing, redirect Qi down, dissolve phlegm Dang Gui angelicatonify blood Dang Gui angelicatonify blood Hou Po magnoliamove Qi, transform damp, resolve stagnation Hou Po magnoliamove Qi, transform damp, resolve stagnation Qian Hu peucedanumredirects Qi downwards, expel phlegm Qian Hu peucedanumredirects Qi downwards, expel phlegm Rou Gui cinnamomumtonify Qi, warms channels, disperse cold, unblock yang Rou Gui cinnamomumtonify Qi, warms channels, disperse cold, unblock yang Sheng Jiang zingiberrelease exterior, disperse cold in middle jiao Sheng Jiang zingiberrelease exterior, disperse cold in middle jiao Zi Su Ye perilla leafreleaseexterior & disperse cold Zi Su Ye perilla leafreleaseexterior & disperse cold Da Zao ziziphustonify Qi, harmonize Da Zao ziziphustonify Qi, harmonize –Actions: directs rebellious Qi downward, arrests wheezing, stops coughing, warms and transforms Phlegm-Cold

81 Damp-Phlegm (or Cold Phlegm) in the Lungs Western Biomedicine: chronic bronchitis, emphysema, bronchial asthma, cardiogenic asthma Western Biomedicine: chronic bronchitis, emphysema, bronchial asthma, cardiogenic asthma Acupuncture: Acupuncture: –LU 7, BL 13 and LU 1 restore the descending of Lung Qi and stop wheezing –LU 6 stops wheezing in acute cases

82 Damp-Phlegm (or Cold Phlegm) in the Lungs –CV 22 restores the descending of Lung Qi and resolves Phlegm –CV 17 moves Qi in the chest –ST 40 and PC 6 open the chest, relieve breathlessness and resolve Phlegm Jing-Tang: Zhi Sou San (F0045) to moisten the Lung, transform phlegm and stop cough Jing-Tang: Zhi Sou San (F0045) to moisten the Lung, transform phlegm and stop cough

83 Zhi Sou San (F0045) Bai BuStamonamoisten Lung, stop cough Bai BuStamonamoisten Lung, stop cough Bai QianCynanchumdescend Lung Qi, stop cough Bai QianCynanchumdescend Lung Qi, stop cough Chen Pi Citrusmove Qi, transform phlegm Chen Pi Citrusmove Qi, transform phlegm Fu LingPoriadrain damp, strengthen SP Fu LingPoriadrain damp, strengthen SP Gan CaoLicoriceharmonize Gan CaoLicoriceharmonize Zi Wanastermoisten Lung, stop cough Zi Wanastermoisten Lung, stop cough –Action: Moisten the Lung, transform phlegm and stop cough

84 Lung Qi Deficiency Commonly seen as breathlessness, wheezing, asthma, allergic rhinitis, cough, tiredness, enuresis and incontinence Commonly seen as breathlessness, wheezing, asthma, allergic rhinitis, cough, tiredness, enuresis and incontinence Clinical Signs: tiredness, slight breathlessness, weak vocalizations, slight spontaneous weak panting, timidity, propensity to Lung Wind-Heat or Wind-Cold invasion Clinical Signs: tiredness, slight breathlessness, weak vocalizations, slight spontaneous weak panting, timidity, propensity to Lung Wind-Heat or Wind-Cold invasion

85 Lung Qi Deficiency Tongue: slightly pale Tongue: slightly pale Pulse: weak or empty, especially in the Lung position Pulse: weak or empty, especially in the Lung position Treatment Principles: tonify Lung Qi Treatment Principles: tonify Lung Qi

86 Lung Qi Deficiency Western Biomedicine: fatigue, exercise intolerance Western Biomedicine: fatigue, exercise intolerance Acupuncture: Acupuncture: –LU 9 tonifies Lung Qi –ST 36 tonifies ST Qi and is the Mother of Metal –CV 6 tonifies global Qi and the deep Lung Channel passes through CV 6 –BL 13 tonifies Lung Qi and descends Lung Qi Jing-Tang: Bu Fei San (A0085) to tonify Lung Qi, stop cough and asthma Jing-Tang: Bu Fei San (A0085) to tonify Lung Qi, stop cough and asthma

87 Bu Fei Tang Tonify the Lungs Decoction Bai GuoGingkoastringently consolidate Lung, stop asthma/cough Bai GuoGingkoastringently consolidate Lung, stop asthma/cough Dang ShenCodonopsistonify Qi Dang ShenCodonopsistonify Qi Di LongLumbricusactivate channel, stop asthma Di LongLumbricusactivate channel, stop asthma Gan Cao Licoriceharmonize Gan Cao Licoriceharmonize Huang QiAstragalustonify Lung Qi Huang QiAstragalustonify Lung Qi Jie GengPlatycodonopen the Lung, transform phlegm Jie GengPlatycodonopen the Lung, transform phlegm Wu Wei ZiSchisandraastringently consolidate Lung Wu Wei ZiSchisandraastringently consolidate Lung Zi Su ZiPerillaeclear Wind-Heat, stop cough Zi Su ZiPerillaeclear Wind-Heat, stop cough Zi Wanastermoisten Lung, stop cough/asthma Zi Wanastermoisten Lung, stop cough/asthma –Actions: Tonify Lung Qi, stop cough and asthma

88 Lung Qi Obstructed Commonly seen as sudden breathlessness Commonly seen as sudden breathlessness Clinical Signs: sudden attacks of breathlessness precipitated by emotional stress, no wheezing sounds, palpitations, chest oppression, restless sleep Clinical Signs: sudden attacks of breathlessness precipitated by emotional stress, no wheezing sounds, palpitations, chest oppression, restless sleep Tongue: red sides Tongue: red sides Pulse: wiry Pulse: wiry Treatment Principles: soothe the Liver, move Qi, restore descending of Lung Qi, stop breathlessness Treatment Principles: soothe the Liver, move Qi, restore descending of Lung Qi, stop breathlessness

89 Wu Mo Yin Zi Five Milled-Herb Decoction Mu Xiang aucklandiamove Qi, alleviate pain Mu Xiang aucklandiamove Qi, alleviate pain Chen Xiang aquilariamove Qi, stop pain Chen Xiang aquilariamove Qi, stop pain Bing Lang arecamove Qi, reduce stagnation Bing Lang arecamove Qi, reduce stagnation Zhi Shi im citri aurantiumbreak up stagnant Qi Zhi Shi im citri aurantiumbreak up stagnant Qi Wu Yao linderamove Qi, stop pain Wu Yao linderamove Qi, stop pain –Actions: promotes the movement of Qi and sends upward rebelling Qi downward

90 Lung Qi Obstructed Western Biomedicine: emotionally generated hypochondriac pain and breathlessness Western Biomedicine: emotionally generated hypochondriac pain and breathlessness Acupuncture: Acupuncture: –LIV 3 and LIV 14 (local on chest) soothe the Liver and relieve stagnation –SP 4 and PC 6 open the Chong Mai, free the chest and subdue rebellious Qi in the chest –LU 1, CV 17 and LU 7 restore the descending of Lung Qi, free the chest and relieve fullness –ST 40 is used to resolve insubstantial Phlegm –HT 7 calms the Shen

91 Lung Yin Deficiency Commonly seen as breathlessness, asthma, cough, and tiredness Commonly seen as breathlessness, asthma, cough, and tiredness Clinical Signs: coughing with blood-streaked or yellow sputum that is difficult to expectorate, wheezing, a dry and sore throat, hot feet, restless at night Clinical Signs: coughing with blood-streaked or yellow sputum that is difficult to expectorate, wheezing, a dry and sore throat, hot feet, restless at night

92 Lung Yin Deficiency Tongue: red with scanty coating Tongue: red with scanty coating Pulse: thin and rapid Pulse: thin and rapid Treatment Principles: nourish Lung Yin and restore the descending function of Lung Qi Treatment Principles: nourish Lung Yin and restore the descending function of Lung Qi

93 Bai He Gu Jin Tang Lily Bulb Decoction to Preserve the Metal Bai He lily bulbmoisten Lungs, clear heat & stop cough Bai He lily bulbmoisten Lungs, clear heat & stop cough Sheng Di Huang prep rehmanniaclear heat, cool blood, nourish Yin Sheng Di Huang prep rehmanniaclear heat, cool blood, nourish Yin Mai Men Dong ophiopogonmoisten Lungs & stop cough Mai Men Dong ophiopogonmoisten Lungs & stop cough Xuan Shen scrophulariaclear heat, cool blood, nourish Yin Xuan Shen scrophulariaclear heat, cool blood, nourish Yin Bei Mu fritillariaclear heat, transform phlegm, stop cough Bei Mu fritillariaclear heat, transform phlegm, stop cough Jie Geng platycodonopen the Lung, transform phlegm Jie Geng platycodonopen the Lung, transform phlegm Dang Gui angelicatonify blood Dang Gui angelicatonify blood Bai Shao peonynourish blood & Yin Bai Shao peonynourish blood & Yin Gan Cao glycyrizzatonify Qi, harmonize Gan Cao glycyrizzatonify Qi, harmonize –Actions: nourishes the Yin, moistens the Lungs, transforms phlegm, stops coughing

94 Lung Yin Deficiency Western Biomedicine: chronic bronchitis, bronchiectasis, pharyngitis, spontaneous pneumothorax, cor pulmonale, silicosis Western Biomedicine: chronic bronchitis, bronchiectasis, pharyngitis, spontaneous pneumothorax, cor pulmonale, silicosis Acupuncture: Acupuncture: –LU 9 nourish Lung Yin –LU 7, KID 6 open the Ren Mai, nourish Yin, restore Lung Qi descending function and benefit throat –BL 43 nourishes Lung Yin in chronic disease

95 Lung Yin Deficiency –BL 13, GV 12 tonify Lung Qi –CV 4, KID 3 and SP 6 nourishes global Yin Jing-Tang: Lily Combination (A0050) to nourish Yin, moisten the Lung, stop cough and asthma Jing-Tang: Lily Combination (A0050) to nourish Yin, moisten the Lung, stop cough and asthma Jing-Tang: Breath Easer (F0082) to tonify Lung and Kidney, nourish Lung Yin, stop asthma and cough Jing-Tang: Breath Easer (F0082) to tonify Lung and Kidney, nourish Lung Yin, stop asthma and cough

96 Lung Dryness Commonly seen as chronic mild cough Commonly seen as chronic mild cough Clinical Signs: dry cough, dry and sore throat, sore trachea, dry lips, dry mouth, stuffed nose, headache Clinical Signs: dry cough, dry and sore throat, sore trachea, dry lips, dry mouth, stuffed nose, headache Tongue: slightly red front or front sides Tongue: slightly red front or front sides Pulse: floating Pulse: floating Treatment Principles: release the exterior, restore the descending Lung Qi, promote fluids, stop cough Treatment Principles: release the exterior, restore the descending Lung Qi, promote fluids, stop cough

97 Sha Shen Mai Men Dong Tang Glehnia and Ophiopogon Decoction Sha Shenglehniamoisten Lungs Sha Shenglehniamoisten Lungs Mai Men Dongophiopogonmoisten Lungs & stop cough Mai Men Dongophiopogonmoisten Lungs & stop cough Yu Zhupolygonumnourish Yin, moistens dryness Yu Zhupolygonumnourish Yin, moistens dryness Sang Yemulberryexpel wind & clear Lung heat Sang Yemulberryexpel wind & clear Lung heat Tian Hua Fentrichosanthisclear & drain Lung heat, transform phlegm, moisten Lung Tian Hua Fentrichosanthisclear & drain Lung heat, transform phlegm, moisten Lung Bai Bian Doudolichorisclear summerheat Bai Bian Doudolichorisclear summerheat Gan Caoglycyrizzatonify Qi, harmonize Gan Caoglycyrizzatonify Qi, harmonize –Actions: clears and nourishes the Lungs and Stomach, generates fluids, and moistens dryness

98 Lung Dryness Western Biomedicine: chronic bronchitis, chronic exposure to Exogenous Wind-Dry Western Biomedicine: chronic bronchitis, chronic exposure to Exogenous Wind-Dry Acupuncture: Acupuncture: –LU 7 releases the exterior and restores the descending of Lung Qi to stop cough –LU 9 nourishes the Lungs fluids –CV 12 promotes fluids –KID 6 promotes fluids and benefits and moistens the throat –SP 6 promotes fluids and nourishes global Yin

99 Lung Yin Deficiency with Empty- Heat Commonly seen as blood in sputum Commonly seen as blood in sputum Clinical Signs: cough with scanty blood-tinged sputum, dry throat, afternoon fever, night agitation, 5-Palm Heat (four soles and center of chest) Clinical Signs: cough with scanty blood-tinged sputum, dry throat, afternoon fever, night agitation, 5-Palm Heat (four soles and center of chest) Tongue: red, dry, no coating Tongue: red, dry, no coating Pulse: floating, empty Pulse: floating, empty Treatment Principles: nourish Lung Yin, clear Empty Heat, and stop bleeding Treatment Principles: nourish Lung Yin, clear Empty Heat, and stop bleeding

100 Bai He Gu Jin Tang Lily Bulb Decoction to Preserve the Metal Bai He lily bulbmoisten Lungs, clear heat & stop cough Bai He lily bulbmoisten Lungs, clear heat & stop cough Sheng Di Huang prep rehmanniaclear heat, cool blood, nourish Yin Sheng Di Huang prep rehmanniaclear heat, cool blood, nourish Yin Mai Men Dong ophiopogonmoisten Lungs & stop cough Mai Men Dong ophiopogonmoisten Lungs & stop cough Xuan Shen scrophulariaclear heat, cool blood, nourish Yin Xuan Shen scrophulariaclear heat, cool blood, nourish Yin Bei Mu fritillariaclear heat, transform phlegm, stop cough Bei Mu fritillariaclear heat, transform phlegm, stop cough Jie Geng platycodonopen the Lung, transform phlegm Jie Geng platycodonopen the Lung, transform phlegm Dang Gui angelicatonify blood Dang Gui angelicatonify blood Bai Shao peonynourish blood & Yin Bai Shao peonynourish blood & Yin Gan Cao glycyrizzatonify Qi, harmonize Gan Cao glycyrizzatonify Qi, harmonize –Actions: nourishes the Yin, moistens the Lungs, transforms phlegm, stops coughing

101 Lung Yin Deficiency with Empty- Heat Western Biomedicine: chronic bronchitis, bronchiectasis, pharyngitis, spontaneous pneumothorax, corpulmonale, silicosis Western Biomedicine: chronic bronchitis, bronchiectasis, pharyngitis, spontaneous pneumothorax, corpulmonale, silicosis Acupuncture: Acupuncture: –LU 9 nourishes Lung Yin –CV 12, SP 6, ST 36 strengthen the Earth to nourish Metal ST is post-heaven origin of body fluids ST is post-heaven origin of body fluids –KID 3 nourishes Yin –LU 10 clears Lung Heat –LU 6 stops bleeding

102 Conclusion The TCVM Lungs The TCVM Lungs –Govern Qi and respiration –Control channels and blood vessels –Control dispersing and descending –Regulate the water passages –Control skin and hair –Open into the nose –House the Corporeal Soul (Po) Pattern Differentiation allows us to choose both the appropriate herbal and acupunctural prescriptions for our patients Pattern Differentiation allows us to choose both the appropriate herbal and acupunctural prescriptions for our patients

103 Respiratory Disease Starts with Nose Starts with Nose Sinuses Sinuses Upper Airways Upper Airways Bronchitis Bronchitis Pneumonia Pneumonia

104 TCVM Respiratory Patterns Each part of respiratory system Each part of respiratory system –Excess causes –Deficiency causes

105 Lung 8 Principle

106 Basic Lung Formulas Detemine the pattern Detemine the pattern Evaluate 8 principle Evaluate 8 principle Choose formulas Choose formulas

107 Rhinitis and Sinusitis Inflammation of nasal epithelium with stimulation of serous glandular secretion Inflammation of nasal epithelium with stimulation of serous glandular secretion Western Medicine Western Medicine –Infectious Viral Viral Bacterial Bacterial Fungal Fungal Protozoal Protozoal –Parasitic –Neoplastic –Congenital –Immune Mediated

108 Comparing Sinusitis, Cold, and Allergy Symptoms SymptomSinusitisColdAllergy Facial Pressure/pain YesSometimesSometimes Duration of illness More than 10 days Less than 10 days Varies Nasal discharge Thick, yellow- green Thick and whitish, Thin and watery Clear, thin, watery Itchy eyes NoNoYes HeadacheYesSometimesSometimes Bad Breath SometimesNoNo CoughSometimesYesSometimes Nasal congestion YesYesSometimes SneezingNoYesYes Fatigue/ Weakness SometimesYesSometimes Sore throat SometimesYesSometimes

109 Common Nasal Patterns Most TCVM changes are acute Most TCVM changes are acute –Early signs of respiratory disease –Allergic conditions –Associated with invasion of wind

110 Wind Cold Damp Early onset of common cold Early onset of common cold –Cold invades nose and obstructs the nasal passages –Wei Qi attempts to dispel the pathogen leading to watery nasal discharge and sneezing Tongue: pale-purple Tongue: pale-purple Pulse : superficial/slow Pulse : superficial/slow AP: LU6, LU7, LI4, LI20, GB20, Bi Tong

111 Allergic Rhinitis (Wind Heat) Common in cats Common in cats Pathogenic wind and heat invades nose Pathogenic wind and heat invades nose –Heat can damage vessels leading to bloody or yellow discharge –Heat also dries up fluids making material thicker Tongue: red & dry Tongue: red & dry Pulse: superficial/fast Pulse: superficial/fast AP: LU5, LU6, LI4/11, LI20, GV14, Bi Tong

112 Phlegm Stagnation Combined wind-heat & wind-cold Combined wind-heat & wind-cold –Leads to accumulation of pus in nasal passages & sinuses Tongue: greasy/red or purple Tongue: greasy/red or purple Pulse: deep or fast Pulse: deep or fast Tx: Hueys formula Tx: Hueys formula AP: LU5, CV22, LI4/11, LI20, GV14, ST40, SP9, Bi Tong

113 Hueys Formula Bai Zhi AngelicaClear Wind-cold, relieve pain Bo HeMenthaClear Wind-Heat Cang Er ZiXanthiumClear Wind-Cold, open noses Xin Yi HuaMagnoliaClear Wind-Cold, dissipate the brain and open noses -Action: Clear Wind Heat and Wind-Cold, open nose

114 Chronic Rhinitis (Fungal) Chronic alterations in nasal tubinates Chronic alterations in nasal tubinates Usually secondary to Aspergillus sp. Usually secondary to Aspergillus sp. Identify on culture or biopsy Identify on culture or biopsy TCVM TCVM –Garlic (fresh) –Ku Shen Si Wu Tang

115 AllergyWind-Heat Allergic Rhinitis Allergic Rhinitis SInusitis SInusitis Sneezing Sneezing Nasal congestion with thick discharge Nasal congestion with thick discharge Tongue: Red and dry Tongue: Red and dry Pulse: Fast Pulse: Fast Tuo Ming Tang Wind Cold Damp Nasal congestion with clear discharge Nasal congestion with clear discharge Sneezing Sneezing Cool-seeking Cool-seeking Tongue: Pale Tongue: Pale Pulse: Tight (wiry) Pulse: Tight (wiry) Xin Yin San Phlegm Stagnation Thick, yellow, smelly nasal discharge Thick, yellow, smelly nasal discharge Tongue: Red or purple Tongue: Red or purple Pulse: Deep and fast Pulse: Deep and fast Hueys Formula

116 Ginger Tea Grate 1 teaspoon fresh ginger Grate 1 teaspoon fresh ginger Add 1 Tablespoon brown sugar Add 1 Tablespoon brown sugar Seep in 1 cup boiling water Seep in 1 cup boiling water Repeat every 1-2 hours Repeat every 1-2 hours Tx Principle: diaphoresis (expel wind-cold/heat) Tx Principle: diaphoresis (expel wind-cold/heat)

117 Irrigations Decongestions antihistamines Steroid Sprays antibiotics Oral steroids Surgery Stepwise Western approach to Sinusitis Treatment

118 Sinusitis Usually more chronic in nature Usually more chronic in nature Patterns Patterns –Lung Yin deficiency –Lung/Kidney Yin deficiency –ST Damp Heat (Excess) Treat what you see Treat what you see

119 Clyde-O (6 yr M/C Mix) Rescue puppy Rescue puppy Water dog Water dog –Thunderstormphobia –LS stenosis Nasal congestion in right nostril Nasal congestion in right nostril Sneezing Sneezing Tongue: Red and purple Tongue: Red and purple Pulse: Forceful Pulse: Forceful Dx: Wind Heat Dx: Wind Heat

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121 Clyde-O Treatment Acupuncture Acupuncture –LI-4, LI-20, GV-14, Long Hui Herbal Herbal –Tuo Ming Tang

122 TCVM Cough Upper or lower airway disease Upper or lower airway disease Patterns Patterns –Excess –Deficiency (Qi/Yin) Phelgm obstructs airways and leads to cough Phelgm obstructs airways and leads to cough

123 Western Medicine- -Cough Sudden forceful expiration of air through the glottis associated with audible sound. Sudden forceful expiration of air through the glottis associated with audible sound. –Preceeded by an exaggrerated insiratory effort Work up to find the cause Work up to find the cause –Just about every diagnostic available Treat according to cause Treat according to cause –Cough suppressants –Antibiotics

124 TCVM Patterns Excess Excess –Wind-Cold –Wind-Heat –Lung Heat Deficiency Deficiency –Lung Yin deficiency –Lung Qi deficiency

125 Cough Pattern Invasion of Lungs by Wind Cold Invasion of Lungs by Wind Heat Phlegm Heat Cough Yin Deficiency Cough Lung Qi Deficiency Lung Yin and Qi deficiency Excess Deficiency

126 Invasion of the Lung with Wind-Cold Wind-Cold Etiology attack Lung Qi flow is obstructed Cough

127 Silver (2 yr M TB) Fever (3 days) Fever (3 days) Thick, yellow nasal discharge Thick, yellow nasal discharge Slight cough Slight cough Tongue: Red and dry Tongue: Red and dry Pulse: Surging and fast Pulse: Surging and fast No other signs No other signs 4 other horses on farm affected 4 other horses on farm affected Dx: Wind-heat invasion of the lung Dx: Wind-heat invasion of the lung

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129 Silver Treatment Acupuncture Acupuncture –EA GV-14Bai Hui GV-14Bai Hui –DN BL-13, Ding Chuan BL-13, Ding Chuan –Aqua LI-4, LI-11 LI-4, LI-11 Herbal Herbal –Equine Yin Qiao gm BID 7-10 days gm BID 7-10 days

130 Cappy (9 yr M/C Mix) Chronic cough and nasal discharge for 3 months Chronic cough and nasal discharge for 3 months Cold, wet nose Cold, wet nose Prefers warm Prefers warm Metal dog Metal dog Tongue: Pale and wet Tongue: Pale and wet Pulse: weak on right Pulse: weak on right Dx: Lung Qi deficiency with stagnation Dx: Lung Qi deficiency with stagnation

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132 Cappy Treatment Acupunture Acupunture –LI-20, Bi Tong, Long Hui, LI-4, LU-7, LU-9, CV-17 Herbal Herbal –Bu Fei Wan –Xin Yi San

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134 Xin Yi San Bai ZhiAngelicaClear Wind-cold, relieve pain Bo HeMenthaClear Wind-Heat Cang Er ZiXanthiumClear Wind-Cold, open noses Chuan XiongLigusticumMove Blood, open orifices, transform phlegm E Bu Shi CaoCentipedaMove Blood, unblock orifices, transform phlegm Gao BenLigusticumClear Wind-Damp, dispel Cold Huang QiAstragalusTonify Qi, strengthen surfaces Huo XiangPogostemonClear Damp Jiang CanBombyxClear Wind Xin Yi HuaMagnoliaClear Wind-Cold, dissipate the brain and open noses - Action: Clear Wind-Cold, clear Wind-Heat, unblock orifices and open nose

135 TCVM Dyspnea/Asthma In TCM, asthma is shortness/weakness of breath In TCM, asthma is shortness/weakness of breath Acute/Excess causes Acute/Excess causes Chronic/Deficiency causes Chronic/Deficiency causes –Most common

136 Dyspnea/Asthma Pattern Invasion of Lungs by Wind Cold Accumulation of Phlegm Heat in Lungs Excess Deficiency Lung Qi Deficiency Lung Yin Deficiency Lung-Kidney Qi Deficiency

137 obstruct Wind ColdWind Heat Attack Lung flow of the Lung Qi control Qi Flow Kidney Def reception of Qi upward the Qi Flow Dyspnea/Asthma Lung Def Dyspnea/Asthma Pattern

138 Relationship between LU & KID

139 AllergyHeat Allergic heaves Allergic heaves Worse in Summer Worse in Summer Cool-seeking Cool-seeking Tongue: Red and dry Tongue: Red and dry Pulse: Strong and fast Pulse: Strong and fast LU-5/7, BL-13, Ding- chuan, CV-22, LI-4/11, GV-14, Er-jian, Wei- jian Schisandra 5 Lung Yin Deficiency Chronic heaves/asthma Chronic heaves/asthma Emaciation Emaciation Dry hair Dry hair Dry and thick nasal discharge Dry and thick nasal discharge Dry cough Dry cough Cool-seeking Cool-seeking Tongue: Red and dry Tongue: Red and dry Pulse: Thready and rapid Pulse: Thready and rapid BL-13, KID-3, BL-23, SP-6, LU-7/9 Lily Combination Lung Qi Deficiency Chronic heaves/asthma Chronic heaves/asthma Dyspnea worse when moving Dyspnea worse when moving Weak voice Weak voice Fatigue Fatigue Exercise intolerance Exercise intolerance Tongue: Pale and wet Tongue: Pale and wet Pulse: Deep and weak Pulse: Deep and weak BL-13, Qi-hai-shu, LU-7/9, ST-36, LI-10, BL-23/26 Bu Fei San Kidney and Lung Qi Deficiency Prolonged course of asthma Prolonged course of asthma Feeble asthma with low sound of respiration Feeble asthma with low sound of respiration Exercise intolerance Exercise intolerance Loss of breath Loss of breath Worse asthma when moving Worse asthma when moving Obvious heaves/asthma groove Obvious heaves/asthma groove Tongue: Pale with thin coating Tongue: Pale with thin coating Pulse: Deep and weak Pulse: Deep and weak BL-13, BL-23, BL-26, KID-7/10, LU-7/9, LI- 10, ST-36, Ding-chuan, CV-22 Breath Easer

140 CDR Monkey (55 yr M Mix) Metal personality Metal personality Overworking at perfection Overworking at perfection Recent problems with anger Recent problems with anger Occasional loose stools Occasional loose stools Exercise-induced asthma Exercise-induced asthma Tongue: Pale with tooth marks Tongue: Pale with tooth marks Pulse: Weak lung and kidney on right Pulse: Weak lung and kidney on right Dx: Kidney and Lung Qi deficiency Dx: Kidney and Lung Qi deficiency

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142 CDR Monkey Treatment Acupuncture Acupuncture –DN LU-9, KID-3, LIV-3, Shen Shu (caudal), CV-17 LU-9, KID-3, LIV-3, Shen Shu (caudal), CV-17 –Moxa ST-36 ST-36 –Aqua HT-7 HT-7 Herbal Herbal –Gecko formula

143 Western Pneumonia Pathology in the lung secondary to Pathology in the lung secondary to –Infection Viral Viral Bacterial Bacterial Fungal Fungal –Aspiration –Immune dysfunction –Interstitial disorder

144 TCVM Pneumonia Excess Excess –Wind-Heat –Excess Heat Deficiency Deficiency –Lung Yin deficiency –Lung Qi deficiency

145 Excess TCVM Pneumonia Animals tend to be acutely ill Animals tend to be acutely ill Tongue: red & dry (may have yellow coating) Tongue: red & dry (may have yellow coating) Pulse: superficial & fast Pulse: superficial & fast Heat invades lung dries up fluids & damages yin Heat invades lung dries up fluids & damages yin Cough: productive/dry Cough: productive/dry

146 Bad Dog Acute onset of cough with fever of 105º F Acute onset of cough with fever of 105º F Tongue: Red Tongue: Red Pulse: superficial & fast Pulse: superficial & fast Wood personality Wood personality Asculation revealed crackles & rales ventrally Asculation revealed crackles & rales ventrally Dx: Wind-Heat in Lung Dx: Wind-Heat in Lung

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148 Bad Dog Treatment AP AP –LU 11 help dissipate LU heat –LU 5 move fluid support LU –GV 14 strengthen chest & dissipate heat –LI 4 dissipate wind & heat –LI 11 dissipate wind & heat –TH 5 strengthen Wei Qi Herbal: Equine Yin Qiao Herbal: Equine Yin Qiao

149 Top 3 or take-home messages Chinese medicine is very effective in regenerating organic function and treating chronic diseases. Chinese medicine is very effective in regenerating organic function and treating chronic diseases. Diagnosis with conventional medicine, such as MRI, CT scans, needle biopsy: BUT, Treatment with Chinese medicine. Diagnosis with conventional medicine, such as MRI, CT scans, needle biopsy: BUT, Treatment with Chinese medicine. Integrated Medicine allows you to find optimal health by understanding your individual needs for achieving balance and harmony. Integrated Medicine allows you to find optimal health by understanding your individual needs for achieving balance and harmony.

150 TCM Lung Disease I hope you all breath a little easier I hope you all breath a little easier Look for the pattern and treat what you find Look for the pattern and treat what you find


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