Lilja Katanka
TCM pathology and treatment formulation 3CTA 501
W0407020
Assignment 1: Study of transmission of aetiology
Lung Wind Cold:
To discuss the invasion of Lung by Wind Cold, it is important to begin
by mentioning the main functions of the Lung (particularly those
relevant to this discussion), and its ZangFu interrelationships.
The main Lung functions that we will discuss here are the functions of
governing Qi and respiration and controlling Dispersing and
Descending. They also assist the Heart in controlling Xue circulation.
In wuxing terms, they are associated with grief and dryness, closely
associated with the Kidney, as they control the descent of Qi to the
Kidneys. The Lung is the mother of Kidney, and the son of the Spleen,
and combined organ patterns between these Zang are often seen in
practice. The relationship between the Lungs and the Spleen is very
close, as Spleen and Stomach are the source of Qi, but Lungs govern
Qi. Though the Lung is paired with the Large Intestine, in clinical
practice this relationship is not particularly relevant (Ross, 1994).
The Lungs are the most ‘external’ of the yin organs, therefore are most
vulnerable to attack by exterior pathogenic factors such as Wind.
Wind engages in a “battle” with the defensive Qi (also controlled by the
Lungs) and impairs the dispersing and descending functions of the
Lung. When the Lungs are initially attacked by Wind-Cold it is the
Lung exterior portion which is invaded, not the Lung organ itself.
However, if the Wind-Cold invasion is not treated at this stage, it can
progress into an interior disease.
According to McDonald and Penner (1994), the two most likely
patterns following Wind-Cold attacking the Lungs are Phlegm Damp
obstructing the Lungs and Lung Qi xu.
Lilja Katanka
TCM pathology and treatment formulation 3CTA 501
W0407020
Assignment 1: Study of transmission of aetiology
Lung Qi xu is particularly likely if antibiotics are taken for a cold or flu
as this will “lock” the cold in the chest and interfere with the
dispersing and descending functions.
In clinical practice, Lung Qi xu and Spleen Qi xu often are seen
together; as the Lungs govern Qi, if Lung Qi is deficient, Spleen Qi will
be affected. (Macioca 1989).
In addition, if Spleen Qi xu is present, then insufficient Gu Qi will be
formed, and Lung Qi xu may follow- yet further reducing the
dispersing function of the Lung. Overall, Lung Qi xu is a likely
occurrence after an untreated Ling Wind-Cold invasion for these
reasons (in that so many different types of deficiency can lead to Lung
Qi xu. Chronic coughing may be seen in any Lung pattern, and will
also deplete the Lung Qi.) If Lung Qi is weak and its descending
function impaired, the spleen cannot transform and transport the
fluids, causing oedema.
Lung Qi xu can then lead to a number of pathologies involving other
organs especially as the Lungs govern the Qi, so Heart Qi xu and
Spleen Qi xu can follow, as could Kidney not grasping the Qi.
Phlegm-Damp obstructing the Lungs is another likely outcome if the
Wind-Cold Invasion is left untreated, especially if there is an
underlying Spleen Qi xu- which, as already mentioned, is often seen in
practice. Weakness of Spleen Qi leads to the formation of Phlegm,
which can accumulate in the Lung due to the reduction in the Lung
dispersing function. This in turn will exacerbate the situation, further
impairing the dispersing function of the Lung.
If the Lungs are obstructed by Phlegm, they can impair the circulation
of Heart Qi (Lungs insulting Heart in wuxing terms).
Lilja Katanka
TCM pathology and treatment formulation 3CTA 501
W0407020
Assignment 1: Study of transmission of aetiology
Phlegm Damp obstructing the Lungs, can then lead to Phlegm Heat
congesting the Lungs, as the stagnation of Phlegm can give rise to
the formation of Heat.
This Phlegm Heat Congesting the Lungs could be caused by Wind
Cold invasion via a different path, however. Wind Cold can easily be
transformed into Wind Heat. This is again due to the impairment of
the dispersing function of the Lung by Wind-Cold, leading to
stagnation and thereby Heat in the Lung. Wind-Heat can also
contribute directly to Lung Qi xu. This is clinically common (i.e. the
common Cold). Smoking will worsen this situation. This Wind Heat
(or the Phlegm Heat Congesting the Lungs) can then contribute to
Lung yin xu, as the Heat will dry the lungs (and the Lungs loathe
dryness).
Lung yin xu in turn can contribute to Kidney yin xu, and/or to
Phlegm Heat congesting the Lungs. As this can also derive from the
Phlegm Damp obstructing the Lung deriving from Lung Wind Cold
directly (i.e. whether the Wind Cold transforms into heat or not),
Phlegm Heat congesting the Lung is a possible and likely pattern
resulting from untreated Wind Cold invasion.
Word count: 750
Lilja Katanka
TCM pathology and treatment formulation 3CTA 501
W0407020
Assignment 1: Study of transmission of aetiology
References
Deadman P, Al-Khafaji M, Baker K, (1998) A Manual of Acupuncture.
East Sussex: Journal of Chinese Medicine
Kaptchuck, T., 2000. Chinese Medicine ; The Web that has no
Weaver. London: Rider
MaciocIa G. (1994) The Practice of Chinese Medicine: the treatment of
diseases with acupuncture and Chinese herbs. Edinburgh ; London :
Churchill Livingstone
Maciocia G.(1989) The Foundations of Chinese Medicine; A
comprehensive text for acupuncturists and herbalists. London:
Churchill Livingstone
McDonald J., Penner J., (1994) Zang Fu Syndromes: differential
diagnosis and treatment. California: Lone Wolf
Ross J., 1994. Zang Fu: The Organ Systems of Traditional Chinese
Medicine (2nd edition). Edinburgh; London: Churchill Livingstone
Zhang, Enquin, (1990). Basic Theory of Traditional Chinese Medicine.
Shanghai : Shanghai College of Traditional Chinese Medicine
Lilja Katanka
TCM pathology and treatment formulation 3CTA 501
W0407020
Assignment 1: Study of transmission of aetiology
Stomach Yin Xu:
To discuss the Stomach Yin Xu, it is important to begin by mentioning
the main functions of the Stomach (those relevant to this discussion),
and its Zangfu interrelationships, as well as the main qualities of Yin
xu.
The Stomach controls the “rotting and ripening” of food, controls
transformation of food essences, controls the descending of Qi, and is
the origin of fluids. The stomach function as origin of fluids is closely
related to the Kidneys. The Kidneys are sometimes called the “Gate of
the Stomach”, because they transform fluids in the Lower Burner.
Spleen and Stomach are the main source of blood (Maciocia 1989).
The Stomach is of the Earth element in terms of wuxing, and is
therefore said to be the son of the Small Intestine and the mother of
the Large Intestine. The Small Intestine does not appear to have a
close relationship with the Stomach in clinical practice.
Yin xu is a pattern of deficient yin, relative to the Yang. This usually
gives an impression of Yang being in excess though this is not the
case. Therefore empty heat signs will become apparent in yin xu
patterns and pathologies, such as a feeling of heat without thirst,
night sweats, restlessness, malar flush, dizziness.
Stomach yin xu usually derives from irregular eating habits leading to
Stomach Qi xu and leading to Stomach Yin xu. Eating late at night is
particularly associated with Stomach Yin xu, though it can also be
caused by chronic illness, excessive vomiting and fever, and Stomach
fire Blazing.
Lilja Katanka
TCM pathology and treatment formulation 3CTA 501
W0407020
Assignment 1: Study of transmission of aetiology
The Stomach is the root of all fluids, so when its Yin is deficient, there
will be dryness in the body. In association with the Spleen, the
Stomach is the source of the Jin Ye from food and drink, so Jin Ye
deficiency would be expected to follow Stomach yin xu. However, Jin
Ye xu is usually included under patterns of yin xu, empty heat or
excess heat.
According to McDonald and Penner, (1994) the most likely next stages
after Stomach yin xu are Spleen yin xu, and Kidney yin xu.
In general, Stomach and Spleen are so closely related and their
functions are so interdependent that it is often difficult to separate
Stomach and Spleen patterns. Thus, Stomach yin xu can occur with
Spleen yin xu in chronic cases- especially if it is the result of
prolonged vomiting with diarrhoea, as the vomiting depletes the
stomach fluids while the diarrhoea depletes the spleen fluids.
However, some texts do not mention Spleen Yin xu as an observed
pattern, as it is difficult for the Spleen to be affected by Yin xu, being a
Yin Organ- also because the Spleen prefers dryness, yin xu is less
likely to manifest as a disease. The Spleen is more likely to suffer with
Yang xu than yin xu (Ross, 1994).
A long standing deficiency of Stomach Fluids will often lead to a
deficiency of Kidney Yin, so that in chronic cases, Stomach Yin xu is
nearly always associated with Kidney yin xu. As we mentioned, the
Kidneys have a close relationship with the Stomach, and they loathe
dryness so will be affected by yin xu of other organs too.
Though Lung dryness, with deficiency of body fluids, is usually
caused by exterior dryness, it can also be interiorly produced and this
is often following Stomach yin xu. Lung Dryness is the stage
preceding Lung yin deficiency, so Lung Yin xu may indeed follow if
the Dryness is not properly treated.
Lilja Katanka
TCM pathology and treatment formulation 3CTA 501
W0407020
Assignment 1: Study of transmission of aetiology
As Stomach is the mother of Large Intestine, and the Large Intestine is
related to the Stomach within the Bright Yang, a deficiency of fluids
(yin) of the Stomach is easily transmitted to the Large Intestine. Large
Intestine Dry is therefore also a possible and likely disharmony
resulting from Stomach yin xu.
Lilja Katanka
TCM pathology and treatment formulation 3CTA 501
W0407020
Assignment 1: Study of transmission of aetiology
References
Deadman P, Al-Khafaji M, Baker K, (1998) A Manual of Acupuncture.
East Sussex: Journal of Chinese Medicine
Kaptchuck, T., 2000. Chinese Medicine ; The Web that has no
Weaver. London: Rider
Larre E., Rochat de la Vallée E., 1990. Chinese medicine from the
classics:Spleen and Stomach. Cambridge: Monkey Press
Maciocia G. (1994) The Practice of Chinese Medicine: the treatment of
diseases with acupuncture and Chinese herbs. Edinburgh ; London :
Churchill Livingstone
Maciocia G.(1989) The Foundations of Chinese Medicine; A
comprehensive text for acupuncturists and herbalists. London:
Churchill Livingstone
McDonald J., Penner J., (1994) Zang Fu Syndromes: differential
diagnosis and treatment. California: Lone Wolf
Ross J., 1994. Zang Fu: The Organ Systems of Traditional Chinese
Medicine (2nd edition). Edinburgh; London: Churchill Livingstone
Zhang, Enquin, (1990). Basic Theory of Traditional Chinese Medicine.
Shanghai : Shanghai College of Traditional Chinese Medicine