TCVM Lung Disharmonies

TCVM Lung Disharmonies

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

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

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

Lung TCVM Physiology 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

The Lung is benefited by the Pungent flavor
Smelly garlic: A lung tonic? 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

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 It is also thought that since perturbed Spleen function creates Phlegm, the Lung then stores Phlegm The emotion correlated with the Lung is grief

Lung TCVM Physiology 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

The Lung is the “delicate” organ and dislikes dry
Drug for dry mouth may prevent lung cancer 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

Lung TCVM Physiology 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)

Lung TCVM Physiology 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

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

TCVM Lung Disharmonies: Introduction
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)

TCVM Lung Disharmonies: Introduction
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

Govern Qi and respiration
Breath training aids sprint power 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

TCM LUNG Physiology 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

Lung TCVM Physiology “Lungs 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 body’s 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

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 Lung then spreads Qi all over the body to nourish all the tissues and Zang-Fu organs

Lung TCVM Physiology “The Lung controls Channels and blood vessels”
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

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 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

TCM LUNG Physiology 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

Lung TCVM Physiology 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

Lung TCVM Physiology 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

Lung TCVM Physiology 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

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 If the Lung function of dispersing is compromised, edematous fluids may accumulate under the skin of the upper body and face

Lung TCVM Physiology 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 TCVM Physiology 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 If the Large Intestine (Yang husband of the Lung) does not receive the Lung Qi, Qi deficient constipation may occur

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

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 If Lung Qi is impaired, urinary retention may occur

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

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 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

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 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

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 Jing-Shen of a healthy Lung leads to good olfactory sensation and good Lung Qi leads to open nostrils and healthy respiration

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 the Lungs are invaded by pathogenic Heat, the nares may flare and there may be epistaxis

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 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

Lung TCVM Physiology The Lungs house the Po or Corporeal Soul 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

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

Lung TCVM Physiology 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

the “tender” organ 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

the “tender” organ 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 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 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 Inhaling particles less than 2.5 μm across is harmful to the heart and lungs

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? 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 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

Lung Patterns

TCM 24 Hour Clock

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

Wind-Cold Invading the Lungs
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 Tongue: thin white coat Pulse: superficial, tight Treatment Principle: release the Exterior, expel Wind-Cold, calm asthma, calm the Shen

Gui Zhi Tang Cinnamon Twig Decoction
Gui Zhi cinnamomum warm kidneys, fortify Yang, disperse Cold Bai Shao Yao paeonia nourish blood & perserve Yin Sheng Jiang zingiber warms middle & expels Cold Da Zao ziziphus tonify Qi, hamronize, calm shen Gan Cao glycyrriza tonify Qi, harmonize Actions: releases pathogenic influences from the muscle layer and regulates the Ying (Nutritive) and Wei (Defensive)

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

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

Zhi Sou San Bai Bu Stamona Moisten Lung, stop cough
Bai Qian Cynanchum Descend Lung Qi, stop cough Chen Pi Citrus Move Qi, transform phlegm Fu Ling Poria Drain Damp, strengthen Spleen Gan Cao Licorice Harmonize Zi Wan Aster Moisten Lung, stop cough Action: Moisten the Lung, transform phlegm and stop cough

Wind-Heat Invading the Lungs
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 Tongue: red sides towards the front Pulse: superficial, rapid Treatment principles: release the Exterior, restore the descending of Lung Qi, expel Wind-Heat, calm asthma, calm the Shen

Sang Ju Yin Mulberry Leaf and Chrysanthemum Decoction
Sang Ye morus fruit expel wind & clear Lung heat Ju Hua chrysanthemum disperse wind & clear heat Bo He mentha disperse wind heat Xing Ren prunus stop cough & calm wheezing Lu Gen phragmites clear heat (LU) & generate fluids Jie Geng platycodon open & disseminate Lung Qi, expels phlegm, transporter Lian Qiao forsythia clear heat & toxins, dissipate nodules Gan Cao glycyrriza tonify Spleen & Qi, moisten Lungs & stops cough Actions: releases exterior Wind-Heat and stops coughing by facilitating the correct flow of Lung Qi

Western Biomedicine: URTI, influenza, early-stage acute bronchitis, acute tonsillitis, acute conjunctivitis 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

Yin Qiao San Honeysuckle and Forsythia Powder
Ban Lan Gen Isatis Clear Heat-toxin Bo He Mentha Clear Wind-Heat Dan Zhu Ye Bamboo Clear Heat and benefit the urination Gan Cao Licorice Harmonize Jie Geng Platycodon Open the Lung and eliminate phlegm Jin Yin Hua Lonicera Clear Heat-toxin, dissipate the exterior Jing Jie Schizonapeta Clear Wind-Cold Lian Qiao Forsythia Clear Heat-toxin, dissipate the swelling Lu Gen Phragmites Clear Heat and promote body fluid Niu Bang Zi Arctium Clear Wind-Heat, benefit the throat Actions: disperses Wind-Heat, clears Heat and relieves toxicity

Western Biomedicine: URTI, influenza, acute bronchitis, measles, acute endometritis, early-stage encephalitis or meningitis 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 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

Equine Yin Qiao (E0130) Ban Lan Gen Isatis clear heat-toxin
Bo He Mentha clear wind-heat Dan Zhu Ye Bamboo clear heat & benefit urination Gan Cao Licorice harmonize Jie Geng Platycodon open Lung & eliminate phlegm Jin Yin Hua Lonicera clear heat-toxin, dissipate exterior Jing Jie Schizonapeta clear wind-cold Lian Qiao Forsythia clear heat-toxin, dissipate swelling Lu Gen Phragmites clear heat & promote body fluid Niu Bang Zi Arctium clear wind-heat, benefit the throat Action: Relieve the Exterior, dispel Wind-Heat, eliminate Interior Heat and detoxify

Wind(-Heat)-Dampness
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 Tongue: sticky yellow coating Pulse: slippery and floating Treatment Principle: release the Exterior, expel Wind-Heat and resolve Dampness

Western Biomedicine: influenza, intestinal flu, nonspecific acute colitis and acute gastroenteritis 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

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

Huo Xiang Zheng Qi San Agastache Powder to Rectify the Qi
Huo Xiang agastaches transform damp, harmonize middle burner, stop vomiting Hou Po cortex magnolia move Qi, transform damp, resolve stagnation Zi Su Ye folium perilla release exterior & disperse cold, move Qi, expand chest Bai Zhi angelica dahurica expel wind, alleviate pain, reduce swelling & expel pus & damp Ban Xia pinella dry damp, transform phlegm, descend rebellious Qi, stop vomiting Da Fu Pi areca move Qi down, reduce food stagnation, expel damp, promote urination Bai Zhu actractylodes tonify Spleen & Qi, strengthen Spleen & dry damp Fu Ling poria drain damp, strengthen Spleen Jie Geng platycodon open Lung & eliminate phlegm Zhi Gan Cao honey-fry licorice tonify Spleen & Kidney Qi & Yang, moisten Lungs & stops cough Actions: releases the exterior, transforms Dampness, regulates the Qi, and harmonizes the middle burner

Wind-Dryness (with Heat)
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 Tongue: slightly red near the tip, dry Pulse: floating, may be rapid Treatment Principles: release the exterior, expel Wind, restore the descending function of Lung Qi, benefit Body Fluids

Sang Xing Tang Mulberry Leaf and Apricot Kernel Decoction
Sang Ye folium mori expel wind & clear Lung heat Zhi Zi gardenia clear heat, reduce irritability, drain damp heat Dan Dou Chi prep soybean release exterior hot or cold Xing Ren apricot seed stop cough & calm wheezing Zhe Bei Mu fritillaria clear & transform phlegm heat Sha shen glehnia moisten lungs & clear heat Li Pi pyri fruit clear heat, strengthen Spleen Actions: clears and disperses warm-dryness

Wind-Dryness (with Heat)
Western Biomedicine: URTI, pharyngitis, pertussis, bronchitis, and bronchiectasis 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

Lung Heat 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 Tongue: red with yellow coat Pulse: overflowing and rapid Treatment Principles: clear Lung-Heat, prevent injury of Yin by Heat

Ma Xing Shi Gan Tang Ephedra, Apricot Kernel, Gypsum and Licorice Decoction
Ma Huang ephedra release exterior, disperse cold, move lung Qi, promote urination Shi Gao gypsum clear heat & drain fire Xing Ren apricot seed stop cough & calm wheezing, moisten intestines Zhi Gan Cao honey-fry licorice tonify 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

Lung Heat Western Biomedicine: URTI, lobar pneumonia, bronchial pneumonia, bronchial asthma, bronchiolitis, pertussis 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

Red Lung (B0071) Huang Qin scutellaria Clear Lung Heat
Huang Yao Zi dioscorea Clear Lung Heat Chuan Bei Mu fritillaria Moisten Lung & clear phlegm Jie Geng platycodon Open Lung & benefit the upper Jiao Dan Shen condonopsis Tonify Qi Wu Wei Zi schisandra Consolidate & nourish Lung Yin Dan Shen salvia Cool & activate Blood Sheng Di Huang raw rehmannia Nourish Yin Xuan Shen scrophularia Cool Blood & nourish Yin Actions: Clear Fire, cool the Lung

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

Xie Bai San Drain the White Powder
Chao Sang Bai Pi dry-fried mulberry cortex drains Lung heat, calm wheezing & cough Di Gu Pi lycium root clears deficient heat Zhi Gan Cao honey-fried licorice tonify Spleen & Kidney Qi & Yang, moisten Lungs, stop cough Geng Mi nonglutinous rice protect Spleen Actions: drains Heat from the Lungs and calms wheezing

Lung Heat Western Biomedicine: bronchitis, pneumonia, pulmonary tuberculosis, pleurisy 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

Lung Phlegm-Heat 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

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

Qing Jin Hua Tan Tang Clear Metal and Absorb Phlegm Decoction
Huang Qi scutellaria tonify Spleen Qi Zhi Zi gardenia clears heat, drain damp heat Fu Ling poria promote urination, drain damp, strengthen Spleen Zhe Bei Mu fritillaria clear & transform phlegm heat Jie Geng platycodon open & disseminate Lung Qi, expels phlegm, transporter Gua Lou trichosanthes clear & transform phlegm heat Zhi Mu anemarrhena clear heat & drain fire Sang Bai Pi mulberry stop cough & wheezing, drain Lung heat Mai Men Dong ophiopogon moisten Lungs & stop cough Gan Cao glycyrriza tonify Qi, harmonize Actions: clears Heat from the Lungs, dispels Phlegm and preserves the Yin of the Lung

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

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

Wei Jing Tang (E0084) Ban Lan Gen Isatis clear Lung heat
Dong Gua Zi Cordyceps transform phlegm, dispel pus Jie Geng Platycodon transform phlegm, dispel pus Lu Gen Phragmites clear Lung heat Tao Ren Persica move blood Yi Yi Ren Coix drain damp & dispel pus Action: Clear Lung Heat and dispel pus

Damp-Phlegm (or Cold Phlegm) in the Lungs
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

Tongue: white slippery or greasy coating Pulse: weak, slippery Treatment Principles: warm the Lung, scatter Cold, resolve Phlegm and relieve breathlessness

Su Zi Jiang Qi Tang Perilla Fruit Decoction for Directing Qi Downward
Zhi Gan Cao glycyrriza tonify Spleen & Kidney Qi & Yang, moisten Lungs, stop cough Ban Xia pinellia dry damp, transform phlegm, descends rebellious Qi Zi Su Zi perilla seed stop cough & wheezing, redirect Qi down, dissolve phlegm Dang Gui angelica tonify blood Hou Po magnolia move Qi, transform damp, resolve stagnation Qian Hu peucedanum redirects Qi downwards, expel phlegm Rou Gui cinnamomum tonify Qi, warms channels, disperse cold, unblock yang Sheng Jiang zingiber release exterior, disperse cold in middle jiao Zi Su Ye perilla leaf releaseexterior & disperse cold Da Zao ziziphus tonify Qi, harmonize Actions: directs rebellious Qi downward, arrests wheezing, stops coughing, warms and transforms Phlegm-Cold

Western Biomedicine: chronic bronchitis, emphysema, bronchial asthma, cardiogenic asthma Acupuncture: LU 7, BL 13 and LU 1 restore the descending of Lung Qi and stop wheezing LU 6 stops wheezing in acute cases

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

Zhi Sou San (F0045) Bai Bu Stamona moisten Lung, stop cough
Bai Qian Cynanchum descend Lung Qi, stop cough Chen Pi Citrus move Qi, transform phlegm Fu Ling Poria drain damp, strengthen SP Gan Cao Licorice harmonize Zi Wan aster moisten Lung, stop cough Action: Moisten the Lung, transform phlegm and stop cough

Lung Qi Deficiency 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

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

Lung Qi Deficiency Western Biomedicine: fatigue, exercise intolerance
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

Bu Fei Tang Tonify the Lungs Decoction
Bai Guo Gingko astringently consolidate Lung, stop asthma/cough Dang Shen Codonopsis tonify Qi Di Long Lumbricus activate channel, stop asthma Gan Cao Licorice harmonize Huang Qi Astragalus tonify Lung Qi Jie Geng Platycodon open the Lung, transform phlegm Wu Wei Zi Schisandra astringently consolidate Lung Zi Su Zi Perillae clear Wind-Heat, stop cough Zi Wan aster moisten Lung, stop cough/asthma Actions: Tonify Lung Qi, stop cough and asthma

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

Wu Mo Yin Zi Five Milled-Herb Decoction
Mu Xiang aucklandia move Qi, alleviate pain Chen Xiang aquilaria move Qi, stop pain Bing Lang areca move Qi, reduce stagnation Zhi Shi im citri aurantium break up stagnant Qi Wu Yao lindera move Qi, stop pain Actions: promotes the movement of Qi and sends upward rebelling Qi downward

Lung Qi Obstructed Western Biomedicine: emotionally generated hypochondriac pain and breathlessness 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

Lung Yin Deficiency 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

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

Bai He Gu Jin Tang Lily Bulb Decoction to Preserve the Metal
Bai He lily bulb moisten Lungs, clear heat & stop cough Sheng Di Huang prep rehmannia clear heat, cool blood, nourish Yin Mai Men Dong ophiopogon moisten Lungs & stop cough Xuan Shen scrophularia clear heat, cool blood, nourish Yin Bei Mu fritillaria clear heat, transform phlegm, stop cough Jie Geng platycodon open the Lung, transform phlegm Dang Gui angelica tonify blood Bai Shao peony nourish blood & Yin Gan Cao glycyrizza tonify Qi, harmonize Actions: nourishes the Yin, moistens the Lungs, transforms phlegm, stops coughing

Lung Yin Deficiency Western Biomedicine: chronic bronchitis, bronchiectasis, pharyngitis, spontaneous pneumothorax, cor pulmonale, silicosis 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

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: Breath Easer (F0082) to tonify Lung and Kidney, nourish Lung Yin, stop asthma and cough

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

Sha Shen Mai Men Dong Tang Glehnia and Ophiopogon Decoction
Sha Shen glehnia moisten Lungs Mai Men Dong ophiopogon moisten Lungs & stop cough Yu Zhu polygonum nourish Yin, moistens dryness Sang Ye mulberry expel wind & clear Lung heat Tian Hua Fen trichosanthis clear & drain Lung heat, transform phlegm, moisten Lung Bai Bian Dou dolichoris clear summerheat Gan Cao glycyrizza tonify Qi, harmonize Actions: clears and nourishes the Lungs and Stomach, generates fluids, and moistens dryness

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

Lung Yin Deficiency with Empty-Heat
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) Tongue: red, dry, no coating Pulse: floating, empty Treatment Principles: nourish Lung Yin, clear Empty Heat, and stop bleeding

Bai He Gu Jin Tang Lily Bulb Decoction to Preserve the Metal
Bai He lily bulb moisten Lungs, clear heat & stop cough Sheng Di Huang prep rehmannia clear heat, cool blood, nourish Yin Mai Men Dong ophiopogon moisten Lungs & stop cough Xuan Shen scrophularia clear heat, cool blood, nourish Yin Bei Mu fritillaria clear heat, transform phlegm, stop cough Jie Geng platycodon open the Lung, transform phlegm Dang Gui angelica tonify blood Bai Shao peony nourish blood & Yin Gan Cao glycyrizza tonify Qi, harmonize Actions: nourishes the Yin, moistens the Lungs, transforms phlegm, stops coughing

Lung Yin Deficiency with Empty-Heat
Western Biomedicine: chronic bronchitis, bronchiectasis, pharyngitis, spontaneous pneumothorax, corpulmonale, silicosis 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 KID 3 nourishes Yin LU 10 clears Lung Heat LU 6 stops bleeding

Conclusion 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

Respiratory Disease Starts with Nose Sinuses Upper Airways Bronchitis
Pneumonia

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

Lung 8 Principle

Basic Lung Formulas Detemine the pattern Evaluate 8 principle
Choose formulas

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

Comparing Sinusitis, Cold, and Allergy Symptoms
Facial Pressure/pain Yes Sometimes 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 No Headache Bad Breath Cough Nasal congestion Sneezing Fatigue/ Weakness Sore throat

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

Wind Cold Damp Early onset of “common cold” Tongue: pale-purple
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 Pulse : superficial/slow AP: LU6, LU7, LI4, LI20, GB20, Bi Tong

Allergic Rhinitis (Wind Heat)
Common in cats 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 Pulse: superficial/fast AP: LU5, LU6, LI4/11, LI20, GV14, Bi Tong

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

Huey’s Formula Bai Zhi Angelica Clear Wind-cold, relieve pain
Bo He Mentha Clear Wind-Heat Cang Er Zi Xanthium Clear Wind-Cold, open noses Xin Yi Hua Magnolia Clear Wind-Cold, dissipate the brain and open noses -Action: Clear Wind Heat and Wind-Cold, open nose

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

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

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

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

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

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

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

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

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

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

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

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

Silver (2 yr M TB) Fever- -104.5 (3 days)
Thick, yellow nasal discharge Slight cough Tongue: Red and dry Pulse: Surging and fast No other signs 4 other horses on farm affected Dx: Wind-heat invasion of the lung

Silver Treatment Acupuncture Herbal EA DN Aqua Equine Yin Qiao
GV-14→Bai Hui DN BL-13, Ding Chuan Aqua LI-4, LI-11 Herbal Equine Yin Qiao 30-50 gm BID 7-10 days

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

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

Xin Yi San Bai Zhi Angelica Clear Wind-cold, relieve pain
Bo He Mentha Clear Wind-Heat Cang Er Zi Xanthium Clear Wind-Cold, open noses Chuan Xiong Ligusticum Move Blood, open orifices, transform phlegm E Bu Shi Cao Centipeda Move Blood, unblock orifices, transform phlegm Gao Ben Ligusticum Clear Wind-Damp, dispel Cold Huang Qi Astragalus Tonify Qi, strengthen surfaces Huo Xiang Pogostemon Clear Damp Jiang Can Bombyx Clear Wind Xin Yi Hua Magnolia Clear Wind-Cold, dissipate the brain and open noses - Action: Clear Wind-Cold, clear Wind-Heat, unblock orifices and open nose

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

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

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

Relationship between LU & KID

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

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

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

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

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

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

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

Bad Dog Treatment AP Herbal: Equine Yin Qiao
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

Top 3 or take-home messages
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. Integrated Medicine allows you to find optimal health by understanding your individual needs for achieving balance and harmony.

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

TCVM Lung Disharmonies

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