Traditional Chinese Internal Medicine Lung Disorders

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Internal Medicine – Lung Disorders

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Pulmonary Consumption

Pulmonary Abscess

Important: as with all items posted on TCM Health-info, it is very strongly recommended that you seek proper advise from your healthcare professional before administering any form of treatment to yourself. This website is for informational purposes and does not replace the proper diagnosis of your physician.

Overview Of Lung Function:

Lungs govern Qi and respiration and are in charge of inhaling air. They open in the skin and control the pores and therefore sweating. The lungs also help the heart Qi control blood circulation within blood vessels. They control water passages and play a major role in the movement of body fluids throughout the body. The lungs disperse defensive Qi (Wei Qi) and body fluids throughout the body protecting the body from external pathogens. The lungs send post-haven Qi and body fluids down to where the kidneys hold it. This is referred to as the lungs descending function. Disorders of the lungs include the common cold, coughing, asthma, dyspnea, pulmonary abscess, pulmonary consumption, lung distension and lung paralysis.

Click here for more TCM Lung foundations: Functions of the TCM Lungs

Asthma – Xiao Chuan Bing

Top of the Document

Acute sudden onset of difficult breathing (dyspnoea) with wheezing sound in throat, recurring with cough.

Caused by:

Hidden phlegm -dysfunction of spleen produces phlegm stored in lung)

External pathogens -attack lung creating lung dysfunction, produce hidden phlegm

Diet -over consumption of greasy, sweet, alcohol, smoking

Emotion -too much stress

Deficiency

Season -aggravated in fall season

Differentiate:

Cold - wheezing- water sounding gurgle with white clear phlegm

Hot - wheezing – loud, sawing rough sound with sticky yellow phlegm

Treat the branch of the problem during an attack and treat the root of the problem during remission.

DURING ATTACK

(Eliminate phlegm)

Cold Type

Wind cold symptoms, itchy throat/nose, watery phlegm with cough, tightness in chest, coldness on upper back, pale complexion,

T – pale, white slippery coating P – floating tense

Treatment expel wind cold, promote lung function to eliminate phlegm

Formula Shi Gan Ma Huang Tang

Xiao Gan Long Tang

Hou Pi Ma Huang Tang

Jiu Bao Tang

Hot Type

Wind heat symptoms, difficulty breathing, fast shallow (panting) breaths, loud wheezing, sweating, yellow sticky phlegm, irritable, tight chest, fever, thirst, constipation

T – Red, yellow coating P – slippery, rapid

Treatment clear heat, disperse lung function to eliminate phlegm

Formula Yue Bi Jia Ban Xia

Ding Chuan Tang

Kidney/Lung Deficient Type

Between attacks slight wheezing all the time, palpitations, spontaneous sweating, agg. By over exertion, weaker than hot/cold type

T – pale, white coating P – deep, weak

Treatment tonify lung and kidney, eliminate phlegm

Formula Ping Chuan Gu Ben

DURING REMISSION:

(treat organ deficiency, LU/SP/KD)

Lung Qi Deficiency

Pale, low voice, spontaneous sweat, easily gets cold

Treatment: Tonify lung Qi to eliminate hidden phlegm

Formula Yu Ping Feng San

Spleen Qi Deficiency

Digestive symptoms, easily bloated, tired after eating

Treatment: Tonify Spleen Qi to eliminate hidden phlegm

Formula Si Jun Zi Tang

Spleen Yang Deficiency

General cold symptoms, and spleen Qi deficiency symptoms, indigested food in stool

Treatment: Strengthen Spleen yang to eliminate cold and hidden phlegm

Formula Fu Zi Li Zhong

Kidney Yang Deficiency

Urine and bowel symptoms, usually spleen yang deficiency with kidney yang deficiency symptoms, lower back/knee pain

Treatment: Strengthen Kidney yang to eliminate hidden phlegm

Formula Shen Qi Wan

Kidney Yin Deficiency

Deficient heat symptoms (dizzy, vertigo, poor memory, lack of concentration, poor hearing, long term, 5-centre heat sensation, menstruation disorders

Treatment: Nourish Kidney yin to eliminate hidden phlegm

Formula Liu Wei Di Huang Wan

Common Cold – Gan Mao

Top of the Document

Gan Mao deals with lung system disorders resembling the common cold which include sudden onset, sore throat, fever, head ache and nasal discharge.

Lung functions: descending and dispersing \ governing Zi \ regulating temperature \ controlling breathing \ controlling open/close of pores \ regulate water passage \ controls vessels

Pathology:

Cold on top of Fire -patient usually hot but catches cold Gan Mao

Wind Heat -impairs lung descending function

Summer Heat -usually appears in summer, commonly accompanied with dampness

Qi Deficiency -patient usually catch’s colds throughout the year, has general fatigue shortness of breath and a weak voice.

Yang Deficiency -all Qi deficient symptoms but feels more cold

Blood Deficiency -general blood deficient symptoms

Yin Deficiency -general yin deficient symptoms

Distinguish between: Wind cold or Wind heat

Dryness or Dampness

Deficiency or Excess

Cold on top of Fire

Fever, aversion to cold, no perspiration, H/A, body ache, stuffy nose, sore throat, cough with white/yellow phlegm.

Treatment: promote lung function, expel wind cold, to relieve superficial symptoms.

Formula Cong chi tang

With Damp - Huo Xiang Zheng Qi San

With Heat - Ma Xing Shi Gan Tang

Wind Heat

Fever, sweating, aversion to wind, cough, sore throat, H/A, yellow phlegm

T - thin yellow coat P - floating, rapid

Treatment: promote lung function, expel wind heat, and relieve superficial area

Formula Sang Ju Yin

Yin Qiao San

Summer Heat

Similar to wind heat symptoms but hotter. Thirst, nausea, dizzy, heavy head, high fever.

T – yellow greasy coat P – rapid soft, floating

Treatment: Clear summer heat and dampness and relieve superficial area.

Formula Xin Jia Xiang Ru Yin

Qi Deficiency

Easily feels cold, spontaneous sweating, general wind cold superficial symptoms.

T – white coating P – floating, weak

Treatment: Nourish Qi, harmonize defensive Qi and relieve superficial area.

Formula Huang Qi Gui Zhi Wu Wu Tang

Shen Su Yin

Yang Deficiency

Spontaneous sweating, (more cold after sweat), aching muscle/joint with cold sensation, pale complexion, puffy face.

T – pale swollen with white coating P - deep, thin, weak

Treatment: warm up yang, relieve superficial area

Formula Fu Zi Gui Zhi Tang

Blood Deficiency:

Aversion to wind, fever, H/A, dizziness, floaters, lips/fingers pale, poor memory, insomnia

T – pale P – thin

Treatment: nurish blood, relieve superficial area

Formula Cong Bai Qi Wei Yin

Yin Deficiency:

- low grade fever in evening, 5-centre heat sensation, night sweat, emaciation, dry mouth/skin and throat, aversion to wind, H/A

T – red, peeled P – thin, rapid

Treatment: nurish yin, relieve superficial area

Formula Jia Jian Wei Rui Tang

Cough – Ke Sou

Top of the Document

Bronchitis / Cough is due to lung Qi up surging, the Qi can’t descend meaning the lung cannot complete it’s descending function.

Ke Sou can be caused by both external pathogens and internal pathogens

Internal: - slow onset – may be induced by anger

External: - quick onset – agg. by wind and cold – joint and muscle aching.

Pathology:

Heat - thirst and/or fever, constant continual cough

Dry - itchy throat with dry symptoms

Damp - aching joints, heavy body, foggy in head

Yin deficient - dry hacking cough, hoarseness, sticky phlegm

Qi deficient - weak cough, large amount of thin phlegm

Distinguish between:

Pulmonary Tuberculosis: - cough blood, chest pain, tidal fever

Asthma - wheezing cough, lung distension, breathing

difficult

Wind Cold

Cough with white thin phlegm, superficial syndrome, tickle in throat

T – thin white coat P – floating / tense

Treatment: expel wind cold, promote lung function, disperse lung Qi to relieve cough.

Formulas Xing Su San

Jin Fuo Cao San

External Cold with Internal Heat

Heavy hacking cough, thick phlegm, chest pain, thirst, sore throat

T – white greasy yellow coat P – rapid, tense

Treatment: Expel cold and clear heat

Formula Ma Xing Shi Gan Tang

Cool Dry

Dry cough, dry nose, dry mouth, dry throat, superficial wind cold symptoms, no sweat.

T - dry coating P – floating, tense

Treatment: expel wind-cold, moisten lung to relieve cough

Formula Xing Su San

External Fire

Loud, dry cough, scanty bloody phlegm, thirst, red complexion, chest/hypochondriac pain, constipation, red tongue

T – red P – forceful, rapid

Treatment: Purge lung fire, induce bowel movement

Formula Liang Ge San

Internal Phlegm Damp

Cough with large amount of phlegm(white/sticky), fullness in chest, poor appetite, fatigue

T – greasy white coating P – slippery, soft

Treatment: Invigorate spleen, dry dampness, promote lung Qi to eliminate phlegm.

Formula Er Chen Tang

Excess Phlegm - San Zi Yang Qin Tan

Wind Heat

Thick yellow sticky phlegm, dry mouth, sore throat, fever, H/A, aversion to wind, nasal discharge, (sweating?)

T – tip/sides red P – floating, rapid

Treatment: expel wind, clear heat and descend Qi by promoting lung function to relieve cough.

Formula Yin Chao San

Sang Jue Yin

Wind Damp-Heat

Thick yellow sticky phlegm, dry mouth, sore throat, fever, H/A, aversion to wind, nasal discharge, sticky sweat - MORE PHLEGM, TIGHT/FULL CHEST

T - greasy white P – soft, rapid

Treatment: expel wind, clear heat, expel dampness and descend lung Qi by promoting lung function to relieve cough.

Formula

With Summer Heat – Ching Hao / Xiang Ru

Warm Dryness

Small amount of phlegm (sticky, possible blood spots), dry mouth, nose, throat, nose bleed, chest pain, aversion to wind, fever, H/A

T – tip/sides red, thin yellow dry coat P – thin, rapid

Treatment: clear lung heat, moisten dryness, expel wind to relieve cough

Formula Sand Xing Tang *diet-pears lubricate dry lung.

Phlegm Heat

Yellow thick sticky phlegm, chest fullness, dry mouth bitter taste in mouth, sore throat

T – red, yellow greasy P – slippery, rapid

Treatment: Clear heat, eliminate phlegm, promote lung function

Formula Qing Jing Hua Tang

Liver Fire Cough

(liver qi stagnation turns into fire attacking lung)

Cough fresh blood, agg by anger/stress, moving pain in chest/hypochondria

T – red, yellow coat P – wiry, rapid

Treatment: purge lung and liver fire

Formula: Dai Ge San

Xie Bai San

Yin Deficiency

Dryness, evening dry cough, little/no phlegm, dry symptoms, night sweat

T – red P – thin, rapid

Treatment: nourish lung yin, lubricate lung

Formula: Er Dong

Tian Meng Dong

Lung Qi Deficiency

Weak cough, low voice, shortness of breath, thin phlegm, easily catch cold all year, aversion to cold, spontaneous sweat.

T – pale, thin, white P – weak

Treatment: nourish Qi, transform phlegm

Formula Bu Fei Tong

Yang Deficiency

(originates as sp/kd deficiency)

Cough with watery frothy clear phlegm, palpitation, dizziness, edema, averion to cold

T – swollen purple, white coat P – deep, slippery

Treatment: Warm up spleen, kidney yang, eliminate water, expel cold

Formula Zhen Wu Tang

Dyspnea – Chuan Zheng

Top of the Document

Breathing disorder – shortness of breath, cannot lay down flat, must sit up, must rise shoulders to breath, flapping of ala nazi, purple lips/tongue (pneumonia, chronic bronchitis, emphysema)

Caused by

- External pathogen – invades lung blocking respiratory tract (acute dyspnoea)

- Internal pathogens – fluid/phlegm retention blocking respiratory tract

- Emotion - all seven emotions cause stagnation of Qi – causes fluid

retention or blood stasis

- diet - spleen produces phlegm, phlegm blocks function of lung

- deficiency - Lung and Kidney def.

Differentiate between:

Excess - more acute onset, rise shoulders, loud, rough sounding

Deficient - onset slow, difficult to inhale, inhale is shallow, fast respiration, quiet sounding, agg by activity

Asthma - difficulty catching breath with WEEZING (disease)

Dyspnea - difficulty catching breath (symptoms)

Wind Cold

Fullness in chest, rising shoulder, aversion to cold, shivering, sneezing, cough, runny nose, watery mucus, slight or no fever, no sweating, no thirst

T – thin white coat P – floating, tense

Treatment: pungent warm herbs

Formula Ma Huang Tang

External Cold, Internal Fluid Retention

Fluid retention in chest, distended chest, copious sputum

Treatment: warm lung, expel cold, transform fluids

Formula Xiao Qing Long Tong

Phlegm Damp in Lung

Cough with yellow phlegm and dyspnoea, fullness in chest, nauseous,

T – white greasy coating P – slippery, rapid

Treatment: eliminate phlegm and damp, promote lung function

Formula Er Chen Tang

San Zi Yang Qin

Wind Heat Invasion

Wind heat superficial symptom and dyspnoea

Treatment: expel wind heat, promote lung function

Formula Sang Jue Yin

Dry Heat in Lung

Dry symptoms with dyspnoea, sore/dry throat, dry tongue, hoarse, fever

T – red, yellow coat P - rapid

Treatment clear heat, lubricate lung

Formula San Xing Tang

Accumulation of Phlegm Heat

Full onset of Pneumonia, fever, thirst, yellow phlegm

T – thick sticky yellow coat P – slippery, rapid

Treatment clear heat, eliminate phlegm

Formula Ma Xing Shi Gan Tang

Deficient Lung and Spleen Qi

Shortness of breath, weak voice, bright white complexion, no appetite, loose stools, lung and spleen Qi deficiency signs

T – pale, puffy P - empty

Treatment Nourish spleen and Lung Qi

Formula Bu Zhong Yi Qi Tang

Sheng Mai San

Kidney Yang Deficiency

Shallow inhale, difficult to catch breath, kidney yang deficiency symptoms frequent urination, edema of lower extremities, coldness, cold/weak back

T – pale P – deep/thin

Treatment warm up kidney yang Qi

Formula Shen Qi Wan

Kidney Yin Deficiency

Reproductive system deficient symptoms, dry mouth at night, night sweats

T- red, peeled P – thin, rapid

Treatment nourish kidney yin

Formula Liu Wei Di Huang Wan

Essence - Qi Wei Du Qi Wan

Grasping - He Che Da Zao Wan

Lung Distention – Fei Zhang

Top of the Document

Chronic lung disorders become Fei Zhang, emphysema

Chronic condition – chronic cough – asthma – dyspnea (lung/spleen/kidney become def.) with phlegm, distended chest and edema.

Long term Respiratory diseases cause STAGNATION.

Fullness in chest, distended chest aggravated by activity

cough with phlegm, edema

Worse case = purple lips and tongue, dark complexion with edema

EXCESS

Cold Fluid Attack Lung

(spleen/kidney yang def.)

Superficial wind cold symptoms, cough, thin-frothy large amount of phlegm, dyspnea, full-distended chest.

T - white, slippery P - Floating, tense

Treatment: expel wind cold, eliminate internal fluids

Formula Xiao Qing Long Tang

Phlegm Heat in Lung

(invasion of wind-heat (or wind-cold turn to heat))

Wind heat symptoms, cough, phlegm, dyspnea, edema

T - red, yellow coat P - floating, rapid

Treatment: clear lung heat, resolve phlegm, descend lung Qi to relieve distension

Formula Qing Qi Hua Tan Tang

DEFICIENCY

Lung and Kidney Qi Deficiency

Shortness of breath, fullness in chest, kidney and lung deficiency symptoms, fatigue, weak voice, easily catch cold

T - pale, white coat P - deep, weak

Treatment: nourish lung and kidney Qi

Formula Ren Shen Ge Jie San

Lung and Kidney Yin Deficiency

Shortness of breath, fullness in chest, kidney and lung deficiency symptoms, fatigue, weak voice, easily catch cold, deficient heat symptoms

T - pale, white coat P - deep, weak

Treatment: nourish lung and kidney Yin

Formula Bai He Gu Jin Tang

Spleen and Kidney Yang Deficiency

Problems inhaling, general yang deficiency symptoms, pale, puffy complexion

T - pale, white coating P - weak

Treatment: Nourish spleen and kidney yang

Formula Shen Qi Wan

Lung Paralysis – Fei Wei

Top of the Document

Resolves from chronic lung disorders

Shortness of breath, white-frothy thin phlegm (possible blood), emaciation, fatigue, dry mouth/lips, weak voice, recurrent, lung becomes stiff, slowly gets worse and worse

Differentiate:

Lung paralysis: not contagious

Lung T.B. bacterium contagious

Deficient Heat:

Blood in phlegm-sticky, general yin deficiency symptoms, dry symptoms, emaciation, dry mouth/skin

T – red, scanty coat P – thin, rapid

Treatment clear deficient heat and nourish yin

Formula Bai Hu Gu Jin Tang

Zhu Ye Shi Gao

Deficient Cold:

Cough, large amount of clear-thin-frothy phlegm, whole body deficiency cold symptoms, frequent urination (possible spleen or kidney deficiency)

T - puffy P - weak

Treatment: warm up lung and spleen Qi to expel cold

Formula Shen Qi Wan

Gan Cao Gan Jiang

Deficient Heat and Deficient Cold

Upper jiao heat with lower jiao cold,

Treatment: warming and clearing to harmonize cold and heat

Formula Ma Huang Sheng Ma Tang

Pulmonary Consumption – Fei Lao

Top of the Document

Infectious, chronic disease with cough, coughing up of blood, tidal fever, night sweat, chest pain and emaciation (possible Tuberculosis)

Distinguish:

Tuberculosis: chronic, tidal fever, yin deficient cough

Lung Abscess: acute, high fever, large amount of sticky-yellow phlegm, toxic

heat, cough from excess heat

Lung Yin Deficiency

-deficient heat in lung, night sweat, 5-centre heat sensation

T – tip/sides red, scanty coating P - thin, rapid

Treatment: Nourish lung yin, clear def heat

Formula Yue Hua Wan

Lung and Kidney Yin Deficiency

severe yin deficiency syndromes, steaming bone with tidal fever, tinnitus, reproductive disorders, menses disorders, insomnia

T - red, geographic peeling, dry coat P - thin, rapid, weak

Treatment: nourish lung and kidney, clear deficient fire, kill lao chong

Formula Bai He Gu Jin Tang & Kidney essence tonic.

Qi and Yin Deficiency

Lung yin deficiency and Spleen Qi Deficiency symptoms, no prominent fever, aversion to wind, spontaneous sweat, night sweat, easily catch cold, spleen qi deficient symptoms, pale/puffy complexion, zygomatic flush

T - pale P - weak, thin, rapid

Treatment: nourish spleen Qi and lung Yin

Formula Bao Zhen Tang

Deficient Ying and Yang

(later stage) – Yang and Yin def. = lung/spleen/kidney are all deficient.

Tidal fever, cold symptoms, very weak, emaciation, spontaneous sweat, night sweat, morning diarrhea, amenorhhea, impodence, spermatorrhea, frothy-purple phlegm with blood

Tongue- Dark purple Pulse- floating big or deep thin

Treatment: nourish ying and yang, strengthen primary(original) Qi.

Formula Bu Tian Da Zao Wan

Pulmonary Abscess – Fei Yong

Top of the Document

Acute infection of the lung with fever, cough, chest pain, smelly-large amount of phlegm coughed up with possible blood.

Four stages:

- Primary Stage – external pathogen invasion (wind heat or wind cold turns to wind heat)

- Secondary Stage - Abscess forming stage, accumulation of phlegm heat in lung (stagnation and heat)

- Third Stage - Bursting stage – lots of phlegm (pus)

- Fourth Stage - Recovery stage – deficiency of Qi and yin of lung.

Differentiate between Lung Abscess and Phlegm/Fluid retention

- Lung Abscess - Acute, pain, phlegm with significant odour

- Phlegm Retention - Slow, chronic with little or no odour.

Lung Abscess has to have HEAT AND STAGNATION.

4 STAGES

First Stage (primarily wind heat)

One area on chest is painful, sticky phlegm

Treatment: expel wind heat and promote lung function

Formula Ying Chao San

Second Stage (Forming stage)

noon and afternoon high fever, cough, hypochondriac pain (where abscess is forming) breathing difficult due to pain, thick-pusy-phlegm with odour, irritable, thirst.

T – yellow, greasy P – slippery, rapid

Treatment: Clear heat, detoxify, promote lung function and relieve stagnation

Formula Qian Jin Wei Jin Tang

Third Stage (Bursting Stage) – 3 layer phlegm

large amount of pusy phlegm with strong-intense odour, thirst, dysphoria

T – yellow, greasy P – slippery, rapid

Treatment: Clear heat, detoxify, dissolve stagnation and discharge pus.

Formula Qian Jin Wei Jin Tang

Jia We Jie Geng Tang

Fourth Stage (Recovery)

Slight fever, cough and phlegm reduce, deficiency signs (tidal fever, night sweat)

T - P – Thin, rapid