Lung patterns FTCM Maciocia Pg. 543Lungs functions:1. Governs Qi and Respiration,2. Controls Channels and Blood Vessels,3. Controls Diffusion and Descending of Qi & BF,4. Regulates all Physiological activities,5. Regulates Water passages,6. Opens into Nose,7. Manifests in the body hair,8. Controls Skin and the space between skin and muscles – (Cou Li space),9. Controls Nasal mucus,10. Houses the Corporeal soul (Po),11. Emotion –affected by: Worry, Grief &Sadness,12. Taste: Pungent,13. Smell: Rancid,14. Sound: Weeping15. Tissue: Skin and body hair,16. Development: Refining.17. Season: Autumn,

Feel for Lung pathology:-Qi Xu: weak voice, SoB,-Pallor,-Thin chest,-Sadness,-Skin problems: eczema like,-Atopic constitution (allergy, asthma and eczema),-Phlegm,-Exterior invasions of Wind (aversion to cold, sneezing, runny nose)

-No gynecological connection*.

General Etiology of Lung patterns:1. Exterior pathogenic factors,2. Diet,3. Emotional strain

SadnessGrief

4. Life habits

Exterior pathogenic factors:

Clinical note:-Lung Likes:-Lung Dislikes: Dryness.-When the Lung is invaded by Exterior pathogenic factors, it is only its “Exterior portion – Wei Qi” that is affected, not the organ itself.-Lungs are called “delicate” organs as they are the organ most likely to be invaded by Exterior pathogenic factors.

#1: Invasion of Lung by Dryness:

#2: Invasion of Lung by Dampness#3:

1. Lung Qi Deficiency:

Dg Tip: SoB and Empty Lung pulse Lu Qi XuSx: Slight SoB, slight cough, weak voice, spontaneous daytime sweating, dislike of speaking, bright-pale complexion, propensity to catch colds, tiredness, dislike of cold;T:/ Pale, P:/Empty (especially in the right front position).

TP: Tonify Lung Qi, Warm Yang.Ac-Treatment: Lu-9 (Source point – Tonifies Lu), Lu-7 (Tonify Lu Qi, stimulates Descending of Qi, particularly efficient if

there is any residual pathogenic factor from previous Wind attack), Ren-6 (Tonifies Qi), UB-13 (Tonifies Lu Qi),Du-12 (Tonifies Lu Qi – important for chronic cases), St-36, Ren-12 (Tonify St & Sp Qi – Tonify Earth to nourish Metal),Fx: Ren Shen Bu Fei Tang (Ginseng Tonify the Lungs Decoction),

Lung TCM Patterns, (Mirko Đorđević), Page 1

2. Lung Yin Deficiency:

Dg Tip: Dry Cough and rootless tongue coating in front area Lu Yin XuSx: Cough that is dry or w/ scanty sticky sputum, weak and hoarse voice, dry mouth and throat, tickly throat, tiredness, dislike of speaking, thin body and thin chest, night sweating, ,T:/ normal-cored tongue, dry w/o coating or w/ rootless coating, P:/ Floating-Empty.

TP: Tonify Lung Yin, Nourish Body Fluids, in necessary – clear Empty Heat.

Ac-Treatment: Lu-9 (Source point – it can tonify Lu Yin), Ren-17 (Tonifies Lu Qi & Lu Yin), UB-43 (Tonifies Lu Yin –

important for chronic cases), UB-13 , Du-12 (Tonifies Lu Qi & Lu Yin), Ren-4 (Tonifies Kid Yin, important when Lu Yin Xu is

associated with Kid Yin Xu), Ki-6 (Tonifys Kid Yin, benefits the throat, in combination w/ Lu-7 to open Ren channel = Tonifys Lu-Qi,

Lu-Yin, stimulates descending of Lu Qi, reestablishes Kid-Lu communication), Ren-12 (Tonifies St and nourishes fluids), Sp-6 (Nourishes Yin), Lu-10 (Clearing Xu Heat from Lu), LI-11 (Clearing Xu Heat),

Fx: Yang Yin Qing Fei Tang (Nourishing Yin and Clearing the Lungs Decoction),

3. Lung Dryness:

Dg Tip: A Dry cough, dry throat and hoarse voice Lung DrynessSx: Dry cough, dry skin, dry throat, dry mouth, thirst, hoarse voice, dry tongue,T:/ Dry, P:/Empty, especially at the right Cun.

TP: Moisten the Lungs, nourish the fluids.

Ac-Treatment: Lu-9 (Moisten the Lu), Ren-4 ( Tonifies Kid Yin), Ki-6 (Nourishes fluids, benefits the throat),Sp-6 (Nourishes fluids), Ren-12, St-36 (Tonify Stomach and nourishes fluids),

Fx: Bai He Gu Jin Tang ( Lilium Consolidating Metal Decoction),

4. Invasion of Lung by Wind-Cold :Dg Tip: Aversion to Cold and “fever” Exterior Invasion of WindSx: Aversion to clod, fever, cough, itchy throat, slight breathlessness, stuffed or runny nose with clear watery discharge, sneezing, occipital headache, body aches, ,T:/ - w/ thin white coating, P:/ Floating - Tight.

TP: Release exterior, expel Cold, stimulate descending and diffusing of Lung-Qi.Ac-Treatment: Lu-7 (Expels Wind, stimulate descending and diffusing of Lung-Qi), UB-12 (Release exterior, expel Wind –

moxa can be used at this point after needling), Du-16 (Expels Wind, especially if w/ headache),

Fx: Ma Huang Tang (Ephedra Decoction),

Lung TCM Patterns, (Mirko Đorđević), Page 2

5. Invasion of Lung by Wind-Heat:

Dg Tip: Aversion to Cold and “fever” Exterior Invasion of WindSx: Aversion to cold, fever, cough, sore throat, stuffed and runny nose w/ yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils;T:/ slightly Red on the sides in the chest area or on the front part, P:/ Floating, Rapid.

TP: Release the Exterior, clear Heat, and stimulate descending and dispersing of Lung Qi.

Ac-Treatment: Lu-7 (Expels Wind, stimulate descending and diffusing of Lung-Qi), LI-4, LI-11 (Release Exterior, clear

Heat), Lu-11 ( for sore throat and swollen tonsils), Du-14 (clears Heat), UB-12, Du-16, BG-20 (expel Exterior Wind), SJ-5 (expels Wind-Heat & releases Exterior),

Fx: Sang Ju Yin (Morus, Chrysanthemum Decoction),

6. Invasion of Lung by Wind-Water:Dg Tip: Sx: Sudden swelling of eyes and face gradually spreading to the whole body, bright-shiny complexion, scanty pale urination, aversion to wind, fever, cough, slight breathlessness,T:/ - w/sticky, white coating, P:/Floating, slippery.

TP: Release Exterior, expel Cold, resolve Dampness, restore descending of Lung Qi, open the Water passages.

Ac-Treatment: Lu-7 (Release the Exterior, Stimulates descending of Lu Qi, opens Water passages),LI-6 (Opens the Lung Water passages), LI-4 (Releases Exterior and opens the Water passages),UB-12 ,UB-13 (Release Exterior and stimulate Descending of Lung Qi),Ren-9 (Opens the Water passages and resolves edema),Du-26 (Opens the Water passages and U-Jiao),

Fx: Xiao Qing Long Tang ( Small Green Dagon Decoction),

7. Lung Heat:Dg Tip: Cough w/ feeling of heat and red tongue Lung HeatSx: Cough, slight breathlessness, feeling of heat, chest ache, flaring nostrils, thirst, red face, ,T:/ Red w/ yellow coating, P:/ Overflowing, rapid pulse.

TP: Clear Lung-Heat, restore the descending of Lung Qi.

Ac-Treatment: Lu-5, Lu-10 (Clearing Lung Heat), Lu-7 (Restore the descending of Lung Qi), LI-11 (clears Heat),( Lu-1, UB-13 ) (Clears Lung Heat and restores descending of Lung Qi),

Fx: Ma Xing Shi Gan Tang (Ephedra, Prunus, Gypsum, Glycyrrhiza Decoction),

8. Damp-Phlegm in the Lungs :

Lung TCM Patterns, (Mirko Đorđević), Page 3

Dg Tip: A cough w/ profuse expectoration of sticky sputum Damp-Phlegm in the LungsSx: Chronic cough coming in bouts w/ profuse white sticky sputum that is easy to expectorate, pasty-white complexion, a feeling of oppression in the chest, phlegm in the throat, shortness of breath, dislike of lying down, cezing, nausea, a feeling of heaviness, muzziness and dizziness of the head,T:/ Swollen w/ sticky white coating, P:/ Slippery or Soggy.

TP: Resolve Dampness and Phlegm, restore the descending function of Lung Qi..Ac-Treatment: Lu-5 (Expel Phlegm from Lungs), Lu-7 (Restore the Descending function of Lung Qi), Lu-1 ( Stop

Coughing, restores descending function of Lu Qi), Ren-17 (restores descending function of Lu Qi), St-40 (Resolves Phlegm), PC-6 (Opens the Chest, expels Phlegm from chest), Ren-22 (Expels Phlegm from throat and w/ Lu-7 restores the descending

function of Lu Qi and stops Cough), Ren-12, UB-20 (Stimulates Spleen’s T&T function and resolves Dampness and Phlegm), Ren-9 (Stimulates Spleen’s T&T and resolves Dampness and Phlegm), UB-13 (Restores the Descending of Lung Qi),Fx: Er Chen Tang ( Two Old Decoction),

9. Cold-Phlegm in the Lungs:Dg Tip: A cold with expectoration of white watery sputum Cold-Phlegm in the Lungs.Sx: Cough with expectoration of white watery sputum, aggravated by exposure to cold, feeling cold, cold hands, phlegm in the throat, dizziness, a feeling of oppression in the chest, a feeling of heaviness, muzziness and dizziness of the head,T:/ Swollen and wet w/ sticky white coating, P:/ Slippery - Slow.

TP: Resolve Phlegm, Expel Cold, Warm Yang, restore the descending function of Lung Qi.Ac-Treatment: Lu-5 (Expel Phlegm from the Lungs), Lu-1 (Restore descending function of the Lu-Qi, Stops Cough),Ren-17 (Restores the descending function of the Lu-Qi), St-40 (Resolves Phlegm), PC-6 (Opens the chest and expels Phlegm

from Chest), Ren-22, Lu-7 (Expels Phlegm from the throat and Lu-7 restores the descending of Lu-Qi and Stops Cough),Ren-12, UB-20 (Tonify the Spleen to resolve Phlegm), Ren-9 (Stimulates the Spleen functions of T&T and resolves Phlegm), UB-13 (Restores the descending of Lu-Qi), UB-23 (reinforces and tonifies Kidney-Yang),Fx: She Gan Ma Huang Tang( Belamcanda, Ephedra, Decoction), Ling Gui Zhi Gan Tang (Poria, Ramulus Cinnamomi, Atractylodis, Glycyrrhiza Decoction) Ling Gan Wu Wei Jiang Xin Tang (Poria, Glycyrrhiza, Schisandra, Zingiberis, Asarum Decoction) San Zi Yang Qin Tang (Three Seed Nourishing the Ancestors Decoction)

10. Phlegm Heat in the Lungs:Dg Tip: A barking cough w/ expectoration of sticky yellow sputum Phlegm Heat in the LungSx: Barking dough w/ profuse sticky yellow or green sputum, SoB, wheezing, a feeling of oppression of the chest, phlegm in the throat, a feeling of heat, thirst, insomnia, agitation, a feeling of heaviness and muzziness of the head, dizziness,T:/ Red, Swollen w/ sticky yellow coating, P:/ Slippery-Rapid.

TP: Resolve Phlegm, clear Heat, simulate descending of Lung Qi.Ac-Treatment: Lu-5 (Clear Heat & Phlegm from Lungs), Lu-7 (Restores the descending function of Lung Qi, stops cough), Lu-10 (Clears Heat from Lungs), LI-11 (Clears Heat), Lu-1 (Restores the descending function of Lung Qi, clears Lung Heat), UB-13 (clears Lung Heat), Ren-12 (Resolves Phlegm), St-40 (Resolves Phlegm);Fx: Wen Dan Tang ( Warm the Gall-Bladder Decoction), Qing Qi Hua Tan Tang (Clearing Qi and Resolving Phlegm Decoction)

11. Dry Phlegm in the Lungs:Dg Tip: A Dry cough w/ difficult expectoration of scanty phlegm Dry Phlegm in the Lungs Lung TCM Patterns, (Mirko Đorđević), Page 4

Sx: Dry cough but occasional, difficult expectoration of scanty sputum, SoB, a feeling of oppression in the chest, scanty phlegm in the throat, a feeling of heaviness and muzziness of the head, dizziness, dry throat, wheezing, pasty-dry complexion,T:/ Swollen w/ dry sticky coating, P:/ Fine-Slippery.

TP: Resolve Phlegm, nourish fluids, nourish Lung-Yin, restore the descending of Lung Qi.Ac-Treatment: Lu-9(Nourishes Lu Yin), Lu-7 (Restores descending of Lu Qi), Lu-7 & Kid-6 (Opens Ren Mai),Ren-12, St-36, Sp-6 (Nourishes fluids), St-40 (resolves Phlegm), UB-13 , Ren-17 (restores descending of Lu Qi),Fx: Bei Mu Gua Lou San ( Fritillaria, Trichosanthes Powder),

12. Phlegm Fluids obstructing the Lungs:Dg Tip: A cough w/ the expectoration of white watery sputum in an elderly person Phlegm Fluids obstructing the LungsSx: Cough w/ expectoration of white watery sputum, breathlessness, splashing sound in the chest, vomiting of white watery sputum, a feeling of oppression of the chest, a feeling of heaviness and muzziness of the head, dizziness, a feeling of cold, coughing that may be elicited by a scare,T:/ Pale, w/ thick, sticky white coating; P:/ Fine-Slippery or Wiry pulse.

TP: Resolve Phlegm and tonify Spleen, Lung and Kidney-Yang.Ac-Treatment: Lu-5 (Clear Phlegm from Lungs), Lu-9 (Tonifies Lu-Qi, resolves Phlegm, indicated in chronic conditions), Ren-17 (Restore descending of Lu-Qi), UB-13 (Restore descending of Lu-Qi), St-40 (Resolves Phlegm),UB-43 (Tonifies Lu-Qi and indicated in chronic conditions), Ren-12 (Resolves Phlegm), St-36, UB-20 (Tonify Sp-Qi), Ren-9 (resolves Phlegm and promotes T&T of fluids), Sp-9 (Resolves Dampness), UB-23 (Tonifies Kid-Yang),Fx: Ling Gan Wu Wei Jiang Xin Tang ( Poria, Glycyrrhiza, Schisandra, Zingiberis, Asarum Decoction),

13. Lung & Heart Qi Deficiency :Dg Tip: Sx: Slight SoB, slight cough, weak voice, dislike to speak, bright-white complexion, propensity to catch cold, tiredness, palpitations, shortness of breath on exertion, depression, spontaneous sweating, sighing,T:/ Pale, P:/Empty.Clinical Note: A simultaneous deficiency of Lung- & Heart-Qi is seen frequently when the patient is affected by emotional problems such as sadness and grief.

TP: Tonify Qi, strengthen the Heart and the Lungs, Calm the Mind.Ac-Treatment: Lu-9, Lu-7, UB-13, Du-12 (Tonify Lung Qi), Ren-6 (Tonifies Qi in general, also specifically Lung Qi), St-36, Ren-12 (Tonifies Qi in general, also specifically Lung Qi as 土 is 母 of 金), He-5 , PC-6, UB-15 (Tonify Ht-Qi),Ren-17 (Tonifies Gathering Qi and therefore both Lung- and Heart-Qi),

Fx: Si Jun Zi Tang ( Four Gentlemen Decoction plus Huang Qi), Bao Yuan Tang (Preserve the Source Decoction) Bu Fei Tang (Tonify the Lung Decoction) Sheng Mai San (Generate the Pulse Powder)

LEARNING OUTCOMES How Exterior Wind, combined w/ Heat or Cold,

can invade the Lung Exterior portion to cause exterior patterns;

DG-TIPS: Combined Lung & ___ patterns:

Lung Qi & Heart Qi Xu: SoB, weak voice, Lung TCM Patterns, (Mirko Đorđević), Page 5

The effects of Dryness and Dampness on the Lungs;

The importance of diet in Lung disease, particularly Phlegm-forming foods,

How Sadness, grief and worry can cause a Lung disharmony,

The significance of posture and smoking in the etiology of Lung disharmony,

Identifying of following Deficiency patterns:oLung Qi Xu: SoB, weak voice, Empty lung

pulse,oLung Yin Xu: a dry cough, night sweating and

rootless tongue coating in the front tongue area,

oLung Dryness: dry cough, dry throat, a hoarse voice and a dry tongue,

Identifying some Excess Exterior patterns:o Invasion of Lungs by Wind-Cold: aversion to

Cold, sneezing, fever and a Floating pulse,o Invasion of Lungs by Wind-Heat: aversion to

cold, fever and a Floating-Rapid pulse.o Invasion of Lungs by Wind-Water: aversion

to Wind, sudden swelling of face and a Floating-Slippery pulse,

Identifying some Excess Interior patterns:oLung-Heat: cough, feeling of heat and a Red

tongue w/ yellow coating,oDamp-Phlegm in the Lungs: chronic cough

w/ profuse white sputum and a sticky white tongue coating,

oCold-Phlegm in the Lungs: cough w/ white watery sputum, phlegm in the throat and a Swollen tongue w/ a sticky white coating,

oPhlegm-Heat in the Lungs: barking cough w/ sticky yellow of green sputum,

oDry-Phlegm in the Lungs: dry cough w/ difficult expectoration of scanty phlegm,

oPhlegm-Fluids obstructing the Lungs: cough w/ expectoration of white watery foamy sputum,

palpitations and Empty pulse,

AWARENESS of Combined Lung & _ patterns: Lung Qi & Kidney Yang Xu,

Lung Yin & Kidney Yin Xu,

Liver Fire insulting Lungs,

Lung Qi & Spleen Qi Xu,

LEARNING TIPS:Lung Yin Deficiency:1st: think of general symptoms of Yin Xu: night sweating, dry mouth, tongue w/o coating,

Lungs invaded by Wind:1st: Remember the cardinal symptoms of Invasion of Exterior Wind: simultaneous

Lung TCM Patterns, (Mirko Đorđević), Page 6

Floating-Empty pulse.Remembering that the Lung influence breathing, voice and throat, add: dry cough, hoarse voice, and dry throat.

Lung Qi deficiency:1st: thin of general sx. of Qi Xu: tiredness, Empty pulse, and Pale tongue.Than add the Qi deficiency symptoms that are Lung related, bearing in mind the influence of Lung on breathing and voice: slight SoB, weak voice.

aversion to cold and fever,Lungs control breathing: cough.The Lungs open into the nose: sneezing, nasal congestion.When external winds is involved, think always of invasion of the Tai Yang channels, hence occipital stiffness and headache.

Phlegm in the Lungs:1st: remember the general manifestations of Phlegm: feeling of oppression in the chest, sputum in throat, nausea, feeling of heaviness, dizziness, muzziness of the head,Swollen tongue w/ sticky coating; Slippery pulse.In all Phlegm patterns of the Lungs there is coughing.Differentiate sputum; i.e.:o profuse and sticky = Damp-Phlegm,o watery white = Cold-Phlegm,o sticky yellow = Phlegm-Heat

Lung TCM Patterns, (Mirko Đorđević), Page 7