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Lung Disease Pattern Differentiation
肺病辨证

Lung diseases mainly result in dysfunctions of the lungs in their ability to control respiration, regulate waterways, govern diffusion and depurative downbearing*, as well as inability to govern the skin. The usual clinical symptoms and signs include cough, dyspnea, expectoration*, chest pain, itchy or sore throat, voice change, stuffy nose, runny nose, and edema.

Deficiency lung disease is usually caused by prolonged cough, or another organ's disease affecting the lung; while excess lung diseases are usually due to invasion of pathogenic wind, cold, dryness and heat, or phlegm-retained fluid.

Deficiency Patterns
虚证类

The common deficiency patterns of lung diseases are lung qi deficiency and lung yin deficiency.

Lung qi deficiency pattern arises when deficient lung qi fails to govern respiration and weakened defense qi fails to protect the superficies. This pattern is marked by pale complexion, shortness of breath, feeble voice, intolerance of wind and spontaneous sweating.

Lung yin deficiency pattern is attributed to yin deficiency of the lung with endogenous heat, manifested by unproductive cough*, afternoon fever, night sweating, flushed cheeks, dry throat, red and dry tongue, and rapid fine pulse

Excess Patterns
实证类

Common excess patterns of lung diseases are listed in Fig. 11-3.

Fig. 11-3 Common excess patterns of lung diseases

The pattern of wind-cold fettering the hung* arises when wind-cold invades the lung causing non-diffusion* of lung qi. This pattern is manifested by cough with thin white phlegm, aversion to cold with possible mild fever, stuffy nose with clear nasal discharge, itchy throat, oppression in the chest, white tongue coating and floating tight pulse.

The pattern of wind-heat invading the lung* arises when wind-heat in the lung causes non-diffusion of lung qi. This is usually caused by wind-heat external contraction, marked by fever with mild chilliness, headache, sore throat, cough, reddened tip of the tongue with thin yellowish coating, and rapid floating pulse.

This pattern pertains to upper energizer pattern in triple energizer pattern differentiation and pertains to defense aspect in defense, qi, and nutrient and blood pattern differentiation.

The pattern of dryness invading the lung arises when dryness attacks the lung and damages lung yin. This pattern is mostly caused by dryness pathogen external contraction, marked by dry cough without sputum or with scanty sticky sputum difficult to expectorate, chest pain, mild chills and fever, thirst, dry lips, mouth, throat and nose, and floating pulse.

Intense lung heat pattern* arises when intense heat accumulates in the lung causing failure of lung qi in diffusion and depurative downbearing. This is mostly attributed to wind-heat entering the interior and binding in the lung, or wind-cold entering the interior and transforming into heat and binding in the lung, marked by fever, thirst, cough, dyspnea or chest pain, constipation, dark urine, and reddened tongue with yellow coating.

The pattern of phlegm-heat obstructing the lung arises when phlegm and heat combine in the lung and cause failure of the lung qi in diffusion and depurative downbearing. This pattern is mostly ascribed to external heat pathogen invading the lungs or excessive stagnation of phlegm in the lungs, marked by cough, dyspnea, expectoration of thick, yellow or bloodstained sputum, chest pain, reddened tongue with yellowish slimy coating, and rapid slippery pulse.

The pattern of cold-phlegm obstructing the lung* occurs when cold phlegm in the lungs impairs the diffusing and depurative downbearing functions of the lungs. This is marked by cough with profuse whitish phlegm that is easy to expectorate, as well as a feeling of pressure in the chest, or phlegmatic wheezing, aversion to cold, cold limbs, pale tongue with white slimy or slippery coating, and string-like slippery pulse.

The pattern of fluid retention in the chest and hypochondrium arises when lung qi fails to regulate waterways resulting in fluid retention in the chest and hypochondriac regions. This pattern is characterized by pain in the chest and hypochondrium, which is aggravated by twisting movements or breathing, and particularly by coughing. It is associated with thoracic distension, a feeling of pressure in the chest and shortness of breath, white and slippery tongue coating, and string-like pulse.

Dampness-phlegm pattern occurs when dampness-phlegm impairs the diffusion and depurative downbearing functions of the lungs and impairs the spleen qi. This condition is marked by cough with profuse expectoration, sensation of heavy limbs, feeling of stuffiness in the chest, reduced food intake, stickiness of the mouth, white slimy tongue coating and slippery pulse.

The pattern of mutual contention of wind and water arises when pathogenic wind attacking the lung causes dysfunction of lung qi in diffusion and depurative downbearing. This gives rise to abnormal accumulation of water under the skin, and is manifested by acute onset of edema of the head and face, and then generalized and associated with aversion to cold, fever, absence of sweating, reduced amount of urine, thin white tongue coating and floating pulse.