lung patterns

Question 1

Wind-Cold invading the Lung vs. Wind-Heat invading the Lung

Question 2

Compare/ contrast Qi deficiency of all of the following: LU, HT, KI, SP

Question 3

Compare/contrast: Warm dryness invading the Lung, Wind heat invading the Lung, Lung yin deficiency, Heat congesting the Lung

Question 4

What symptoms are common to BOTH Lung Yin Deficiency and Dryness Invading the Lung

Question 5

Lung Qi Deficiency

Question 6

Lung Yin Deficiency

Question 7

Compare/Contrast: Warm dryness invading the Lung, Wind heat invading the Lung, Heat congesting the Lung, Heat phlegm obstructing the Lung

Question 8

Identify the common symptoms that occur in ALL of the following: Wind cold invading the Lung, Cold invading the Lung, and Cold phlegm obstructing the Lung patterns

Question 9

Compare/Contrast: wind cold invading the Lung, Cold invading the Lung, and Cold phlegm obstructing the Lung patterns

Question 10

Difficult: Memorize exterior dryness invading Lung pattern and know which symptoms are NOT associated with it

Question 11

What type of cough is characteristic of dry phlegm obstructed Lung? What is not? 17. Large Intestine deficiency cold causes what types of bowel symptoms? What types is it not associated with?

Question 12

Compare/Contrast: Cold water shooting into the Lung, Lung qi deficiency, Dry phlegm obstructing the Lung, Heart yang deficiency

Question 13

Compare/Contrast: Heat phlegm accumulate in the Lung, Lung qi and yin deficiency with heat phlegm, Wind dryness invade the Lung with phlegm accumulation, Lung qi deficiency with heat phlegm accumulation

Question 14

Compare/Contrast: Wind cold attack Lung with damp cold in Large Intestine, Wind heat invade Lung with damp heat in Large Intestine, Wind cold attack Lung with damp heat in Large Intestine, Wind heat invade Lung with damp cold in Large Intestine

Question 15

Compare/Contrast: Dry phlegm obstruct in the Lung, Lung yin deficiency, Cold phlegm obstruct in the Lung, Lung qi deficiency, Heat phlegm obstruct in the Lung, Exterior wind dryness invading the Lung

Question 16

Compare/Contrast: Wind-cold invading the Lung, Lung qi deficiency, Lung yin deficiency, Lung Qi deficiency, cold phlegm accumulation, Wind cold invasion

Question 17

Compare/Contrast: Heart blood deficiency, Lung qi deficiency, Heart qi deficiency, Cold phlegm obstructing the Lung, Cold water shooting into the Lung

Question 18

LU fx

Answer 18

The Lung is a minister organ
● It is in charge of cooperation and coordination
● Help HT to function normally
● It’s spirit is the corporeal soul
● emotions: sadness, grief and worry
● the metal phase
● governs Qi
● autumn
● climate of dryness

Question 19

LU dredging/regulating fx

Answer 19

Regulates water metabolism: ‘dredging and regulating’
1. Through the function of dispersing,
the Lung regulates excretion of
sweat
2. Through the function of
descending, the Lung ensures the
patency (‘the quality or state of
being open or unobstructed’) of the
water passage
“The Lung is the upper source of water”

Question 20

Etiological Factors in Lung Patterns

Answer 20

Etiological Factors in Lung Patterns
1. The Six exterior pathogenic factors: wind-heat, cold, dryness, dampness and
summer heat
2. Improper diet: excessive consumption of raw, cold food, or sweet and greasy
food, generating phlegm
3. Long-term emotional stress: worry, sadness, and grief deplete the Lung qi
4. Smoking: consumes Lung yin and generates phlegm
5. Chronic illness: damages Lung qi, impairs Lung yin

Question 21

Pathological changes and major clinical manifestations of Lung disease

Answer 21

1. Chills and fever
2. Abnormal respiration
3. Cough
4. Other signs:
   ○ Nasal congestion
   ○ Sneezing
   ○ Edema
   ○ Expectoration or hemoptysis
   ○ Sore or itching throat
   ○ Chest distress or pain
   ○ Voice changes
   ○ Dry and withered body hair
   ○ Abdoniral sweating
   ○ Superficial pulse

Question 22

There are thirteen commonly seen Lung disease patterns in the clinic:

Answer 22

Excess + Deficiency patterns
● There are only two deficiency patterns: Lung Qi Deficiency and Lung Yin Deficiency
● Excess patterns are subdivided:
○ Exterior Excess Patterns
■ Wind-Cold Invading the Lung, Wind-Heat Invading the Lung, Dryness Invading the Lung,
Wind-Water Invading the Lung
○ Interior Excess Patterns
■ Pathogenic Heat Congesting the Lung, Pathogenic Cold Invading the Lung, Phlegm Obstructing
the Lung, and Cold-Water Shooting into the Lung
■ Phlegm Obstructing the Lung is divided into four subgroups: Damp-Phlegm, Heat-Phlegm,
Cold-Phlegm, Dry-Phlegm

Question 23

LU XU etiology

Answer 23

Congenital insufficiency, aging, chronic illness, improper diet, improper treatment, smoking or long-term emotional stress

indicates

Lung Qi Deficiency,
Lung Yin Deficiency

Question 24

LU SHI etiology

Answer 24

Exopathogens attacking, improper diet, improper treatment, smoking or chronic illness

indicates

Wind-Cold Invading the Lung,
Wind-Heat Invading the Lung,
Dryness Invading the Lung,
Wind-Water Invading the Lung,
Pathogenic Heat Congesting the Lung,
Pathogenic Cold Invading the Lung,
Phlegm Obstructing the Lung, and
Cold-Water Shooting into the Lung

Question 25

Lung Qi Deficiency Pattern 肺氣虛证 fèi qì xū zhèng

Answer 25

Definition: Lung hypofunction Clinical Manifestations: Feeble cough and panting that is worse with exertion, **copious thin, clear sputum; ** shortage of Qi, shortness of breath, aversion to speaking, weak voice, fatigue, low energy, spontaneous sweating, **sensitivity to wind, easily catches cold, pale complexion** Tongue: Pale tongue with thin white coating Pulse: Weak Key points: Feeble cough, panting, worse w exertion + qi xu sx Etiology ● Insufficient production of qi ● Excessive consumption of qi ● Aging

Question 26

Pathogenesis of Lung Qi Deficiency Pattern 肺氣虛证 fèi qì xū zhèng

Answer 26

Lack of the production of qi can arise in cases of congenital insufficiency, **chronic illness with Spleen and Stomach deficiency**, and improper diet - all lessen the generation and transformation and transportation of qi ● Excessive consumption of qi arises in disease, serious illness, injury to the vital qi, and long-term mental overstrain ● A low feeble voice, feeble cough or panting arises when there is Lung qi deficiency, since the Lungs govern qi as well as dispersing and descending ● When Lung Qi is deficient, water metabolism is also disrupted, leading to **pathological fluids accumulating inside, which generate phlegm,** and cause cough with thin white sputum ● When deficient, Lung qi may fail to protect the body’s surface, causing susceptibility to catching colds Qi is the motive force in the body, and when it is insufficient, it fails to push and promote ● Lack of qi: fatigue, shortness of breath, aversion to speaking and low voice, etc. ● insufficient generation of blood: pale tender tongue and thin deficient pulse ● fails to secure the body surface, no containment of the pores: spontaneous sweating

Question 27

Lung Qi Deficiency Pattern 肺氣虛证 fèi qì xū zhèng Treatment Principle

Answer 27

Tonify Lung qi, warm yang Herbal Formula: 妊娠不肺汤 rèn shēn bù fèi tāng [bu fei tang] Ginseng Tonifying the Lungs Decoction

Question 28

Lung Yin Deficiency Pattern 肺阴虛证 fèi yīn xū zhèng

Answer 28

Definition: signs and symptoms due to Lung Yin Deficiency, which leads to the Lung losing nourishment, generating **deficiency heat**, and failing to descend and disperse Clinical Manifestations: **Dry cough without sputum, sticky scanty sputum, or blood-tinged sputum**, difficult expectoration, dry mouth, emaciation, hoarse voice, low-grade fever in the afternoon and evening, malar flush, night sweats, five-center heat Tongue: Red tongue with scanty coating Pulse: Thin rapid **Key Points**: Dry cough no sputum, or sticky scanty sputum, bleeding + yin xu sx

Question 29

Lung Yin Deficiency - Yin deficiency leading to deficiency heat

Answer 29

Low-grade fever in the afternoon and evening, malar flush, night sweats, five centered heat, red tongue with scanty coating, thin rapid pulse

Question 30

Lung Yin Deficiency Pattern 肺阴虛证 fèi yīn xū zhèng Treatment Principle

Answer 30

Tonify Lung yin, nourish body fluids, if necessary clear deficiency heat Herbal Formulae: ● 百合固金湯 bǎi hé gù jīn tāng, Lily Bulb Decoction to Preserve the Metal ● 養陰清肺湯 yǎng yīn qīng fèi tāng, Nourish the Yin and Clear the Lungs Decoction ● 生脈散 shēng mài sǎn, Generate the Pulse Powder

Question 31

Wind-Cold Invading the Lung Pattern 風寒束肺 fēng hán shù fèi

Answer 31

Wind-Cold disrupting the Lung’s dispersing and descending function. Also called Wind-Cold attacking, assailing or insulting the Lung Clinical Manifestations: Cough with thin clear sputum, aversion to cold, fever, headache, body ache, and nasal congestion and discharge with snivel, hoarseness or loss of voice Tongue: Thin white coating Pulse: Superficial and tight **Key Points**: Cough with thin clear sputum, plus exterior wind-cold signs and symptoms

Question 32

Treatment of Wind-Cold Invading the Lung Pattern 風寒束肺 fēng hán shù fèi

Answer 32

Treatment Principle: Release the Exterior, expel Cold, stimulate the descending and diffusing of Lung Qi Acupuncture: Reducing method, moxibustion is applicable after needling ● LU-7 ● LI-4 ● BL-12, BL-13 ● GB-20, ● GV-14, GV-16 ● TB-17 Herbal Formulae: ● 麻黃湯 má huáng tāng Ephedra Decoction ● 小青龍湯 xiǎo qīng lóng tāng Minor Black Dragon Decoction ● 桂枝湯 guì zhī tāng Cinnamon Twig Decoction

Question 33

Wind-Cold Invading the Lung vs. Exterior Wind-Cold

Answer 33

Similar etiology: ● similar symptoms, etiology and pathological location, but from two different systems of pattern identification ● **Wind-Cold invading the Lungs:** *zàngfǔ pattern identification*, functions of the Lung organ ○ Main symptoms involve the disruption of the Lung’s dispersing and descending function: **coughing with clear thin sputum** ● **Exterior Wind-Cold:** *Eight Principles Pattern Identification* 八綱辨證 , bā gāng biàn zhèng, pathological changes at the body’s surface, the protective qi ○ major symptoms of **chills and fever**

Question 34

Wind-Heat Invading the Lung Pattern 風熱犯肺 fēng rè fàn fèi

Answer 34

wind-heat disrupting the Lung’s dispersing and descending functions. Also called wind-heat attacking, assailing, or insulting the Lung. Clinical Manifestations: Cough with sticky yellow sputum, nasal congestion with thick yellow discharge, fever, slight aversion to wind or cold, slight thirst, and **sore throat.** Tongue: Tongue has a red tip with thin yellow coating. Pulse: Superficial and rapid. Etiology ● Exterior wind-heat ● Wind-cold may also be a factor if it transforms into heat **Key Points:** Cough w sticky yellow sputum + exterior wind-heat sx

Question 35

Treatment of Wind-Heat Invading the Lungs Pattern 風熱犯肺 fēng rè fàn fèi

Answer 35

Treatment Principle: Release the exterior, clear Heat, stimulate the descending and diffusing of Lung Qi; cool/cold and pungent herbs to promote sweating, clear heat, and alleviate toxicity Acupuncture: Reduction method, no moxibustion ● LU-7 ● LI-4, LI-11 ● GV-14, GV-16 ● BL-12 ● GB-20 ● TB-5 Formulae: 桑菊飲 sāng jú yǐn, Mulberry Leaf and Chrysanthemum Drink 銀翹散 yín qiào sǎn, Honeysuckle and Forsythia Decoction

Question 36

Wind-Cold Invading the Lung vs. Wind-Heat Invading the Lungs

Answer 36

Key Points to distinguish these two patterns: 1. Coughing sounds 2. Quality and color of sputum 3. Presence of sore throat (not itchy) 4. Rapid vs. right pulse

Question 37

Dryness Invading the Lung Pattern 燥邪犯肺 zào xié fàn fèi

Answer 37

exterior pathogenic dryness attacking the Lung and damaging Lung yin. Also called ‘lung dryness’ or ‘exterior dryness’. Depending on accompanying pathogens, it may manifest as warm-dryness 溫燥 wēn zào, or cool-dryness 涼燥 liáng zào Clinical Manifestations: Dry cough, scanty sticky sputum or blood-stained sputum, difficult expectoration, dry mouth, dry throat and dry nose, or nosebleeds, cough with blood, dry stool, scanty urine. Symptoms are accompanied by fever, slight chills, and absent or slight sweating. Tongue: Thin and dry tongue coating Pulse: Superficial and rapid, or superficial and tight Etiology ● Exterior pathogenic dryness **Key Points**: dry cough w scanty sticky sputum, dry mouth, throat and nose + mild exterior signs and symptoms

Question 38

Dryness Invading the Lung Pattern 燥邪犯肺 zào xié fàn fèi Treatment Principle

Answer 38

Treatment Principle: Moisten the Lungs, nourish fluids Acupuncture: Reinforcing method, no moxibustion ● BL-13, BL17 ● LU-1, LU-6, LU-7 ● KI-6 Herbal Formulae: ● 百合固金湯 bǎi hé gù jīn tāng, Lily Bulb Decoction to Preserve the Metal Decoction ● 清燥救肺湯 qīng zào jiù fèi tāng, Clearing Dryness and Rescuing the Lung Decoction ● 沙參麥-冬湯 shā shēn mài dōng tāng, Adenophora/Glehnia and Ophiopogon Decoction

Question 39

Wind-Water Invading the Lung Pattern 風水犯肺 fēng shuǐ fàn fèi

Answer 39

pathogenic wind attacking the Lung, leading to dysfunction in the draining of water passages, resulting in water-dampness penetrating muscular interstices and skin. Called ‘wind-water pattern’ 風水證 fēngshui zhèng Clinical Manifestations: Edema with acute onset and rapid development, starting from the eyelids and then spreading to the entire body, with difficult urination. Accompanied by fever, aversion to cold and no sweating. Tongue: White tongue coating Pulse: Superficial and tight Note: There may also be a sore throat, red tongue and superficial and rapid pulse Etiology ● Exopathogenic factors: ○ Wind-Cold ○ Wind-Heat ○ Wind-Dampness **Key Points:** Acute onset, edema that starts from the eyelids, puls exterior wind-cold or wind-heat signs and symptoms

Question 40

Treatment of Wind-Water Invading the Lung Pattern

Answer 40

Treatment Principle: Release the Exterior, expel Cold, resolve Dampness, restore the Descending of Lung-Qi and open the Water passages Acupuncture: ● LU-7 ● LI-4, LI-6 ● SP-9 ● BL-39 Herbal Formulae: ● 越婢湯 yuè bì tāng, Maidservant from Yue’s Decoction (Spleen-Effusing Decoction) ● 小青龍湯 xiǎo qīng lóng tāng, Minor Bluegreen Dragon Decoction

Question 41

Cold Invading the Lung Pattern 寒邪客肺 hán xié kè fèi

Answer 41

exopathogenic cold directly attacking the Lung, disrupting the Lung’s dispersing and descending function. Clinical Manifestations: Coughing, panting, hoarseness or loss of voice, thin white or clear sputum, cold limbs and body. Tongue: Pale tongue with white coating. Pulse: Deep and slow pulse. **Key Points**: Acute onset, coughing or panting, plus interior excess cold signs and symptoms.

Question 42

Treatment of Cold Invading the Lung Pattern 寒邪客肺 hán xié kè fèi

Answer 42

Treatment Principle: Warm the Lung, stop cough Acupuncture: ● LU-7 ● LI-4 ● BL-12 ● BL-13 ● GV-14 Formula: 溫肺化飲湯 wēn fèi huà yǐn tāng, Lung-Warming Rheum-Transforming Decoction

Question 43

Turbid Phlegm Obstructing the Lung Pattern 痰濁阻肺 tán zhuó zǔ fèi

Answer 43

phlegm accumulating inside the Lung, obstructing the Lung and disrupting its dispersing and descending function. According to the accompanying pathogens and pathogenesis, there are four major patterns: 1. Phlegm-Dampness Obstructing the Lung 2. Heat-Phlegm Obstructing the Lung 3. Cold-Phlegm Obstructing the Lung 4. Phlegm-Dryness Obstructing the Lung

Question 44

Turbid Phlegm Obstructing the Lung Pattern 痰濁阻肺 tán zhuó zǔ fèi

Answer 44

Clinical Manifestations: Productive cough, panting, wheezing, tightness and distress in the chest, phlegm in the throat, feeling of heaviness. Tongue: Thick tongue coating Pulse: Slippery **Key Points**: Productive cough, panting, wheezing, or phlegm sounds in the throat

Question 45

Heat Congesting the Lung Pattern 熱邪壅肺 rè xié yōng fèi

Answer 45

excess heat congesting the Lung, disruption the Lung’s dispersing and descending function. Clinical Manifestations: Coughing, panting, high fever with flaring nostrils, sore throat, rapid breathing, thirst, pain in the chest, cough with foul pus and blood, dry stools, dark urine Tongue: Red tongue with yellow coating Pulse: Rapid **Key Points:** Coughing, panting, plus interior excess heat signs and symptoms

Question 46

Cold-Water Shooting into the Lung Pattern 寒水射肺 hán shuǐ shè fèi

Answer 46

pathogenic cold combining with water-thin mucus, invading the Lung, and causing Lung dysfunction. Clinical Manifestations: Coughing with profuse white foamy sputum, panting or wheezing, chest pain with difficulty breathing, inability to lie down flat because of difficulty breathing facial or body edema, scanty urine, intolerance of cold, cold limbs, stifling sensation in the chest, no thirst. Tongue: White and greasy tongue coating Pulse: Slow, slippery or wiry Note: If the pattern arrives with the appearance of exopathogenic cold, it will then be accompanied by aversion to cold, fever, body aches and a a superficial pulse **Key Points**: Cough with profuse white foamy sputum, panting or wheezing, inability to lie down flat