Certificate in
TCM Assistant
TCM Disease Management
（中医疾病护理）
Lung Diseases 肺系病证
Leong Kwai Yin
Course Outline (Planned)
Introduction: What is TCM Disease Management
1.
History & Basics
10.
Cardiac-cerebral Diseases
2.
Daily Living
11.
Gastrointestinal Diseases
3.
Sleep Techniques
12.
Hepatobiliary Diseases
4.
Qigong & Tuina
13.
Kidney-bladder Diseases
5.
Guasha & Cupping
14.
Qi-blood-body fluid Diseases
6.
Bathing & Exercises
15.
Meridian and Extremities
7.
Acupuncture & Moxibustion
16.
Cancer
8.
Exogenous Diseases
17.
ENT (Otolaryngology)
9.
Lung Diseases
18.
Revision
Cough 咳嗽
咳：Ké denotes coughing with sound but
without production of sputum.
嗽：Sòu denotes productive cough with
sputum or without sound.
五脏六腑皆令人咳，非独肺也。《素问・咳论篇》
The five zang-organs and six fu-organs could
all cause coughing, not only the lung.
六气皆令人咳，风寒为主。《景岳全书・ 咳嗽篇》
All 6 pathogenic factors can cause cough,
especially Wind-Cold.
Cough 咳嗽
TCM Diagnoses and Treatments
Etiology & Pathology:
1. External pathogenic factors
2. Interior reasons
• Emotional stress
• Improper Diet
• Chronic illness
Etiology & Pathogenesis
Etiology & Pathogenesis
Acute & Chronic Cough
 Acute: a cough that had a sudden onset and may continue for a few
days or weeks.
 Chronic: either a cough that began insidiously without a previous
invasion of Wind and persisted for months or years, or one that began
with an exterior invasion of Wind and persisted for months or years.
 Acute cough may be caused by:  Chronic cough generally due to:
• Invasion of Wind
• Chronic retention of Phlegm in
the Lungs
• Heat or Phlegm in the interior
• Deficiency of Qi in the Lungs
• Dryness or Heat following an
external invasion
• Deficiency of Yin in the Lungs
• Deficiency of Qi-Yin in the
Lungs
Clinical Manifestations
 Exterior cough:
• Wind-Cold
• Wind-Heat
• Wind-Dryness
 Interior cough (excess):
• Lung-Heat
• Phlegm-Heat
• Damp-Phlegm
• Liver Fire attacking the Lung
 Interior cough (deficiency):
• Lung-Qi deficiency
• Lung-Yin deficiency
• Lung-Qi-Yin deficiency
Differentiation
Exterior
Interior
Onset
acute
chronic
Duration
Short
Long
Character
Mostly wind-cold
Occurred repeatedly;
Fullness & emptiness often
combined
Accompanied
symptoms
Exterior symptoms
Other organs’ symptoms
Tongue & pulse
Floating or tight pulse
…
Etiology
Invasion of wind-cold
Lung-phlegm-dampness
Invasion of wind-heat
Lung-phlegm-heat
Invasion of wind-dryness Liver fire attacking lung
Lung Yin deficiency
Wind-Cold 风寒咳嗽
Signs & Symptoms:
 Main Symptoms: Newly-occurred cough, coughing sound being lower
and vague, white & thin sputum
 Concurrent Symptoms: Headache, nasal stuffiness, nasal clear
discharge, painful sensation in the joints, aversion to cold & no sweating.
Tongue:
White body with thin coating
Pulse:
Floating
Treatment Protocol:
 Expel the Wind
 Release the Cold
 Restore the Descending and Dispersing Function of the LU Qi
Treatment for Wind-Cold
Xing Su San 杏苏散
Almond
杏仁
Perilla Leaf
紫苏
Tangerine Peel
陈皮
Pinellia Tuber
半夏
Fresh Ginger
生姜
Platycodon Root
桔梗
Hogfennel Root
前胡
Poria
茯苓
Licorice
甘草
Chinese Dates
大枣
Bitter Orange
枳壳
Jin Fei Cao San 金沸草散
Inula Flower
旋覆花
White Peony Root
白芍
Licorice
甘草
Roasted Licorice
炙甘草
Hogfennel Root
前胡
Schizonepeta
荆芥
Fresh Ginger
生姜
Chinese Dates
大枣
Ginger Pinellia Tuber
Ephedra
麻黄
姜半夏
Modifications:
Aversion to Cold
Ephedra 麻黄；Saposhnikovia Root 防风；
Notopterygium Rhizome 羌活
Headache
Lovage Rhizome 川芎；Dahurian Angelica
Root 白芷
Cough with sore & dry throat, thirst, severer
fever, yellow fur, floating rapid pulse
Ma Xing Shi Gan Tang 麻杏石甘汤
Sputum
Tangerine Peel 陈皮；Pinellia Tuber 半夏
Wind-Heat 风热咳嗽
Signs & Symptoms:
 Main Symptoms: Dry cough or cough with loud voice, thick sputum
 Concurrent Symptoms: Fever & aversion to wind, headache, sweating,
sore throat, thirst, runny nose with yellow discharge, sneezing, slight
thirst, slightly dark urine.
Tongue:
Slightly red, thin yellow coating sides
Pulse:
Floating & rapid
Treatment Protocol:
 Release the Exterior
 Expel the Wind
 Clear the Heat
 Restore the Descending Lung Qi
stop cough
Treatment for Wind-Heat
Sang Ju Yin 桑菊饮
Mulberry Leaf
桑叶
Chrysanthemum
菊花
Peppermint
薄荷
Almond
杏仁
Forsythia
连翘
Platycodon Root
桔梗
Reed Root
芦根
Licorice
甘草
Modifications:
Aversion to Wind
Fineleaf Schizonepeta Herb 荆芥；
Saposhnikovia Root 防风
Cough
Burdock Fruit 牛蒡子；Hogfennel Root 前胡；
Fritillary Bulb 浙贝母；Loquat Leaf 枇杷叶
Severe lung heat
Skullcap Root 黄芩；Gypsum 石膏
Sputum being difficult to be expectorated
Snakegourd 栝楼
Nosebleed
Lalang Root 茅根； Lotus Node 藕节
Restlessness, thirsty, dark urine in summer
Patchouli Herb 藿香；Eupatorium Herb 佩兰
Oppressed feeling in the chest, soft pulse
Magnolia Bark 厚朴；Job’s Tears 薏苡仁
Sore throat
Burdock Fruit 牛蒡子；Lilactic Puffball 马勃；
Isatis Root 板蓝根
Throat itching
Saposhnikovia Root 防风
Wind-Dryness 风燥咳嗽
Signs & Symptoms:
 Main Symptoms: Dry and ticklish cough without sputum or sputum being
difficult to be expectorated, dry-itchy-sore throat
 Concurrent Symptoms: Sore sensation in the upper chest, cough with
blood sputum, dry lips, dry mouth, stuffed nose, headache, slight
aversion to cold and slight shivers.
Tongue:
Slightly red side & tip of the body, thin yellow dry coating
Pulse:
Floating or slightly rapid
Treatment Protocol:
 Release the Exterior
 Promote fluids and stop cough
 Restore the Descending of the Lung Qi
Treatment for Wind-Dryness
Sang Xing Tang 桑杏汤
Mulberry Leaf
桑叶
Almond
杏仁
Fourleaf Ladybell Root
沙参
Fermented Soy
淡豆豉
Cape Jasmine Fruit
山栀子
Pear Skin
梨皮
Thunberg Fritillary Bulb
浙贝母
Modifications:
Severe cough with itching throat
Hogfennel Root 前胡； Cicada Molt 蝉蜕；
Platycodon Root桔梗；Licorice 甘草
Dryness
Fragrant solomonseal 玉竹；Dwarf Lilyturf
Tuber 麦冬；Snakegourd Root 天花粉
Severe lung heat
Anemarrhena Rhizome 知母；Gypsum 石膏
Sore throat
Lilactic Puffball 马勃；Figwort Root 玄参
Nosebleed or bloody sputum
Lalang Root 茅根； Rehmannia Root 生地
Cough
Burdock Fruit 牛蒡子； Hogfennel Root 前胡
Dry-cold attack lung
Schizonepeta 荆芥；Saposhnikovia 防风；
Tatarian Aster 紫菀；Coltsfoot Flower 款冬花
(Reduce jasmine fruit, fritillary bulb, pear skin)
Wind-Cold & Wind-Heat
Symptoms
Wind-Cold
Wind-Heat
Aversion to
wind & cold
wind & heat
Fever
slight
high
Sweating (Perspiration)
none/slight
Lots (heavy)
Thirst
none
Big (severe)
Nose
runny
congested
Nasal discharge
thin, watery
thick, yellow
Throat
itchy
bad sore throat
Cough
slight
strong
Tongue
no change
red (heat, fever)
Pulse
slow (cold)
rapid (heat)
Headaches
usually occipital (Tai-Yang), and not severe
can be throbbing, temporal, frontal, more severe
Aching/Stiffness
upper shoulder muscle aches and stiff neck
Body aches especially in upper shoulders and neck
Sneezing
yes
-
Chills
yes
-
Phlegm Dampness 痰湿蕴肺
Signs & Symptoms:
 Main Symptoms: Chronic cough, abundant sputum being white and easy to
be expectorated.
 Concurrent Symptoms: Chest distress, poor appetite, tiredness, weakness
and frequent loose stool, cough is aggravated in the morning or after intake
of sweet and greasy food.
Tongue:
Pink, White greasy coating (indicates dampness)
Pulse:
Slippery
Treatment Protocol:
 Strengthen the spleen
 Removing dampness
 Restore the Descending of Lung Qi
Treatment for Phlegm-Dampness
Er Chen Tang 二陈汤
Tangerine Peel
陈皮
Pinellia Tuber
半夏
Poria
茯苓
Processed Licorice
炙甘草
San Zi Yang Qin Tang 三子养亲汤
Perilla Seed
紫苏子
Mustard Seed
白芥子
Radish Seed
莱菔子
Modifications:
Oppressed feeling in the chest
Atractylodes Rhizome 苍术；Almond 杏仁；
Magnolia Bark 厚朴；Job’s Tears 薏苡仁
Spleen deficiency (weak pulse, diarrhoea)
Pilose Asiabell Root 党参；Largehead
Atractylodes Rhizome 白术
Severe cough
Ephedra 麻黄；Perilla Leaf 紫苏叶；
Almond 杏仁
Aversion to Cold
Manchurian Wild Ginger 细辛；
Dried Ginger 干姜
Phlegm-Heat 痰热郁肺
Signs & Symptoms:
 Main Symptoms: Cough, shortness of breath, yellow greasy phlegm.
 Concurrent Symptoms: Distending and painful sensation in the chest when
coughing, bitter taste, dry mouth, thirst, stinking phlegm or bloody phlegm or
fever.
Tongue:
Red side & tip of the body, yellow greasy coating
Pulse:
Slippery and rapid
Treatment Protocol:
 Strengthen the spleen
 Removing dampness
 Restore the Descending of the Lung Qi
Treatment for Phlegm-Heat
Qing Jin Hua Tan Tang 清金化痰汤
Skullcap Root
黄芩
Cape Jasmine Fruit
山栀子
Platycodon Root
桔梗
Dwarf Lilyturf Tuber
麦冬
Mulberry Root Bark
桑白皮
Fritillary Bulb
贝母
Anemarrhena Rhizome
知母
Snakegourd Fruit
栝楼
Red Tangerine Peel
橘红
Poria
茯苓
Licorice
甘草
Modifications:
Sticky phlegm
Houttuynia Herb 鱼腥草；Job’s Tears 薏苡仁；
Forsythia Capsule 连翘；Wintermelon Seed 冬
瓜仁
Purulent sputum
Bile Arisaema 胆南星；Job’s Tears 薏苡仁；
Wintermelon Seed 冬瓜仁
Phlegm heat damage fluid: thirsty
Ladybell Root 沙参；Snakegourd Root 天花
粉
Feeling of oppression in the chest with severe
cough and constipation
Pepperweed Seed 葶苈子；Rhubarb Root 大黄 Cough
Burdock Fruit 牛蒡子； Hogfennel Root 前胡
Fluids being injured
Ladybell Root 沙参；Dwarf Lilyturf Tuber 麦冬；
Snakegourd Root 天花粉
Liver-Fire 肝火犯肺
Signs & Symptoms:
 Main Symptoms: Cough induced pain involving the chest & hypochondrium.
 Concurrent Symptoms: Flushed face, dry throat & mouth, pain on coughing,
bitter taste, dark urine, dry stools, irritability and a dry mouth, symptoms are
along with the change of emotional activity.
Tongue:
Red sides, yellow thin coating with less moisture
Pulse:
Wiry rapid
Treatment Protocol:
 Smooth the liver qi
 Clear the lung heat
 Restore the descending of Lung-Qi and stop cough
Treatment for Liver-Fire
Huang Qin Xie Bai San 黄芩泻白散
Skullcap Root
黄芩
Mulberry Root Bark
桑白皮
Wolfberry Root-Bark
地骨皮
Licorice
生甘草
Dai Ge San 黛蛤散
Natural Indigo
青黛
Clam Shell
蛤壳
Modifications:
Fever
Baical Skullcap Root 黄芩；Cape Jasmine
Fruit 山栀子；Peony Bark 牡丹皮
Cough
Platycodon Root 桔梗；Licorice 甘草
Symptoms of rebellious Qi: Fullness of chest
Green Tangerine Peel 青皮；Tangerine Peel 陈
皮；Immature Bitter Orange Fruit 枳实
Chest Pain
Tumeric Root 郁金
Sputum & sever cough
Fritillary Bulb 贝母；Snakegourd 栝楼；
Bamboo Shaving 竹茹； Perilla Seed 紫苏子；
Loquat Leaf 枇杷叶
Liver Fire
Chinese Gentian Root 龙胆草
Yin Deficiency
Ladybell Root 沙参；Dwarf Lilyturf Tuber 麦
冬；Snakegourd Root 天花粉
Lung Yin-Deficiency 肺阴亏耗
Signs & Symptoms:
 Main Symptoms: Chronic cough, dry cough with less sputum or with bloody
sputum, afternoon tidal fever.
 Concurrent Symptoms: Flushed cheeks, feverish sensation in the palms
and soles, insomnia, night sweating, lack of vitality, tiredness and
restlessness.
Tongue:
Red body with little coating
Pulse:
Thready and rapid
Treatment Protocol:
 Nourish Yin
 Clear the lung heat
 Resolving sputum and relieving cough
Treatment for Lung Yin-Deficiency
Sha Shen Mai Dong Tang 沙参麦冬汤
Fourleaf Ladybell
Root
沙参
Dwarf Lilyturf
Tuber
麦冬
Solomonseal
Rhizome
玉竹
Tendrilleaf
Fritillary Bulb
川贝母
White Hyacinth
Bean
扁豆
Snakegourd Root
天花粉
Almond
杏仁
Mulberry Leaf
桑叶
Lily Bulb
百合
Licorice
甘草
Modifications:
Tidal fever
Turtle Shell 鳖甲；Wolfberry Root-Bark 地骨皮；
Sweet Wormwood Herb 青蒿；Starwort Root
银柴胡；Swallowwort Root 白薇
Bloody phlegm
Lotus Node 藕节；Hairyvein Agrimonia Herb
仙鹤草；Bletilla Tuber 白芨；Donkey Hide
Gelatin 阿胶；Notoginseng 三七
Severe cough
Chinese Magnoliavine Fruit 五味子；Terminalia
Fruit 诃子
Profuse night sweating
Smoked Plum 乌梅；Blighted Wheat 浮小麦
Cough with yellow sputum
Common Anemarrhena Rhizome 知母；Baical
Skullcap Root 黄芩
Wheezing & Panting 哮喘
哮：Xiāo refers to a characteristic lowpitched breathing sound that occurs
when there is panting.
喘：Chuǎn refers to laboured or difficult
breathing with flaring of the nostrils,
gaping of the mouth, raised
shoulders, and inability to lie flat.
哮以声响名，喘以气息言。夫喘促喉间
如水鸡声者谓之哮，气促而连续不能卧
息者谓之喘。
《医学正传》
Wheezing 哮病
TCM Diagnoses
Wheezing (Xiao) indicates a wheezing sound
which may resemble that of whistling,
snoring or sawing. It is usually accompanied
by breathlessness with an inability to breathe
when lying down.
Etiology:
1. External pathogenic factors
- wind-cold, wind-heat
2. Diet
3. Weak body condition
- Lung, Spleen, Kidney
Wheezing 哮病
Due to Diet
 《医说・卷四》：因食盐虾过多，遂得齁喘之疾。
 Taking too much salty fish will lead to asthma due to fish
(Houchuan).
Due to Weather
 《素问・太阴阳明论》：犯贼风虚邪者，…阳受
之则入六腑…入六腑则身热，不时卧，上为喘呼。
 When the body is infected by occult evil wind, …
yang six FU-organs are affected if yang is involved, …
then the patient has a fever and fails to sleep flat, leading
to whooping upward.
Wheezing 哮病
Due to Emotional Stress
 《丹溪心法・喘十五》：六淫七
情之所感伤，饱食动作，脏气不
和，呼吸之息，不得宣畅而为喘
急。亦有脾肾俱虚，体弱之人，
皆能发喘。
 Damaged by six exopathogens
and seven emotions as well as
action after full stomach, the
visceral qi will be disharmonized
resulting in obstructive
respiration and rapid gasping.
Anybody whose spleen and
kidney are deficient can develop
gasping syndrome.
Wheezing 哮病
Due to Morbidity or Overwork
 《症因脉治・喘》：气虚喘逆之
因，或本元素虚，或大病后，大
劳后，失于调养，元气大伤。
 The cause of wheezing
conversely with qi deficiency is
due to failure of recovery leading
to damaging primordial qi after
severe disease or exhaustion.
Summary
wind
emotion
morbidity
cold
diet
overwork
Etiology & Pathogenesis
Differentiation & Treatment
Acute Phase
 Cold Phlegm
 Heat Phlegm
Chronic Phase
 Lung Deficiency
 Spleen Deficiency
 Kidney Deficiency
Treatment Principle:
Treatment principle:
 Resolve Phlegm
 Restore the descending
 Tonify Lung
 Tonify Spleen
 Tonify Kidney
of Lung Qi
Heat & Cold
Differentiation of cold & heat
Heat type
Cold type
Sputum
Thick, yellow & sticky
Thin, while & clear
Expectoration
Difficult
Easy
Onset due to
Summer-heat
Cold-evil, allergy
Accompanied by
Headache, sore throat, fever, Headache, aversion to cold,
slight aversion to cold
fever,
Tongue
Red body with yellow greasy
coating
White greasy or white
slippery coating
Pulse
Slippery rapid
Floating & tight
Deficiency & Excess
Differentiation of Deficiency & Excess
Deficiency type
Excess type
Pathology
Chronic wheezing
Newly-occurred
Stage
Intermission stage
During the attack stage
Symptoms
Spontaneous sweating,
aversion to wind, pale face
complexion
Breathlessness, distended
chest, cough, feeling
comfortable if having a long
expiration
Tongue
Red body with less coating
Red tongue with thin coating
Pulse
weak
strong
Cold Phlegm 寒痰
Signs & Symptoms:
 Main Symptoms: Rapid breathing, wheezing, full & oppress feeling of the
chest, cough, scanty phlegm
 Concurrent symptoms: A blush-white complexion, no thirst, or a desire for
warm drinks, feeling cold, worse in cold weather.
Tongue:
Swollen with a sticky-white coating
Pulse:
Tight and slippery
Treatment Protocol:
 Warm the lung & expel the cold
 Resolve phlegm
 Relieve breathlessness
《金匮要略》：“咳而上气，喉中水鸡声，
射干麻黄汤主之。”
Treatment for Cold Phlegm
She Gan Ma Huang Tang 射干麻黄汤
Blackberrylily Rhizome
射干
Ephedra
麻黄
Dried Ginger
干姜
Manchurian Wildginger
细辛
Pinellia Tuber
半夏
Tatarian Aster Root
紫菀
Coltsfoot Flower
款冬花
Licorice
甘草
Magnoliavine Fruit
五味子
Chinese Date
大枣
White Hyacinth Bean
扁豆
Modifications:
Severe exterior syndrome with internal phlegm
小青龙汤
Abundant phlegm
三子养亲汤；
Long illness with Kidney Yang deficiency
苏子降气汤 + Pilose Asiabell 党参；Walnut
Pulp 胡桃肉；Fluorite 紫石英；Agarwood 沉香
Kidney Yang deficiency
Chinese Aconite 附子；Malaytea Scurfpea
Fruit 补骨脂
Formula for Cold Phlegm
Xiao Qing Long Tang 小青龙汤
Ephedra
麻黄
White Peony Root
白芍
Manchurian Wild Ginger
细辛
Dried Ginger
干姜
Roasted Licorice
炙甘草
Cinnamon Twig
桂枝
Magnoliavine Fruit
五味子
Pinellia Tuber
半夏
San Zi Yang Qin Tang 三子养亲汤
Perilla Seed
紫苏子
Mustard Seed
白芥子
Radish Seed
莱菔子
Su Zi Jiang Qi Tang 苏子降气汤
Perilla Seed
紫苏子
Pinellia Tuber
半夏
Hogfennel Root
前胡
Magnolia Bark
厚朴
Tangerine Peel
陈皮
Licorice
甘草
Chinese Angelica
当归
Fresh Ginger
生姜
Chinese Dates
大枣
Cinnamon Twig
桂枝
Heat Phlegm 痰热
Signs & Symptoms:
 Main Symptoms: Wheezing with a loud voice, breathlessness, distended
chest, cough, yellow-sticky sputum.
 Concurrent Symptoms: Irritability, sweating, a red face, bitter taste, thirst, a
feeling of heat
Tongue:
Red with a yellow greasy coating
Pulse:
Slippery and rapid
Treatment Protocol:
 Clear the heat
 Resolve phlegm
 Restore the descending of Lung-Qi & stop wheezing
Treatment for Heat Phlegm
Ding Chuan Tang 定喘汤
Ephedra
麻黄
Skullcap Root
黄芩
Mulberry Bark
桑白皮
Almond
杏仁
Perilla Seed
苏子
Coltsfoot Flower
款冬花
Gingko Nut
白果
Licorice
甘草
Pinellia Tuber
半夏
Modifications:
Cough
Inula Herb 金沸草；Hogfennel Root 前胡；
Willowleaf Swallowwort Rhizome 白前
Wheezing
Inula Flower 旋覆花；Mulberry Bark 桑白皮；
Earthworm 地龙
Yin Deficiency
Ladybell Root 沙参；Chinese Magnoliavine
Fruit 五味子；麦门冬汤
Yellow sticky sputum
Anemarrhena Rhizome 知母；Clam shell 海
蛤壳；Blackberrylily Rhizome 射干；
Heartleaf Houttuynia Herb 鱼腥草
Abundant sputum
Tendrilleaf Fritillary Bulb 川贝母；Tangerine
Peel 陈皮；Platycodon Root 桔梗
Fever
Gypsum 石膏；Anemarrhena Rhizome 知母
Constipation
Rhubarb Root 大黄；Mirabilite 芒硝
Lung Deficiency 肺虚
Signs & Symptoms:
 Main Symptoms: spontaneous sweating, aversion to wind, sneezing, runny
nose, pale complexion, frequent common cold due to abnormal changes of
climate.
 Concurrent Symptoms: Shortness of breath, low voice, slight wheezing with
a low sound.
Tongue:
Pale tongue with thin white coating
Pulse:
Weak or deficiently large pulse
Treatment Protocol:
 Tonify the lungs
 Consolidate the Exterior
Treatment for Lung Deficiency
Yu Ping Feng Shan 玉屏风散
Milkvetch Root
黄芪
Saposhnikovia Root
防风
Atractylodes Rhizome
白术
Modifications:
Qi deficiency
Falsetarwort Root 太子参；Pilose Asiabell 党参
Yang deficiency
Chinese Aconite 附子；Cassia Bark 肉桂
Yin deficiency
Dried Rehmannia Root 生地；Ladybell Root 南
沙参；Cordyceps 冬虫夏草
Severe exterior syndrome
Cinnamon Twig 桂枝；White Peony Root 白
芍；Chinese Date 大枣
Blood stasis
Salvia Root 丹参；Lovage Rhizome 川芎
Spleen deficiency
六君子汤
Cough
Tatarian Aster Root 紫菀；Mulberry Bark 桑白
皮
Spleen Deficiency 脾虚
Signs & Symptoms:
 Main Symptoms: Poor appetite, loosing stools, slight abdominal distension,
intolerance to certain foods.
 Concurrent Symptoms: Tiredness, shortness of breath, dislike of speaking,
desire to lie down, weariness.
Tongue:
Pale tongue with thin white coating
Pulse:
Weak or deficiently large pulse
Treatment Protocol:
 Tonify the spleen
 Resolve phlegm
Treatment for Spleen Deficiency
Liu Jun Zi Tang 六君子糖
Pilose Asiabell
党参
Atractylodes Rhizome
白术
Tangerine Peel
陈皮
Pinellia Tuber
半夏
Modifications:
Qi deficiency
Falsetarwort Root 太子参；Pilose Asiabell 党参
Poria
茯苓
Licorice
甘草
Kidney Deficiency 肾虚
Signs & Symptoms:
 Main Symptoms: Shortness of breath, worsening while making exertion,
dyspnoea, soreness & weakness of the waist & legs.
 Concurrent Symptoms: Poor memory, tinnitus.
Tongue:
Pale
Pulse:
Deep weak
Treatment Protocol:
 Tonify the kidney
 Resolve phlegm
Treatment for Kidney Deficiency
Ding Chuan Tang 定喘汤
Cooked
Rehmannia Root
熟地黄
Asiatic Cornelian
Cherry Fruit
山茱萸
Common Chinese
Yam Rhizome
山药
Chinese
Magnoliavine Fruit
五味子
Poria
茯苓
Dwarf Lilyturf
Tuber
麦冬
Oriental
Waterplantain
泽泻
Malaytea
Scurfpea Fruit
补骨脂
Peony Bark
牡丹皮
Walnut Pulp
胡桃肉
Modifications:
Cough with sputum
Almond 杏仁；Perilla Seed 苏子；Pinellia
Tuber 半夏
Yang deficiency
Cinnamon Twig 桂枝；Dried Ginger 干姜；
Tokay Gecko 蛤蚧
Yin deficiency
Glossy Privet Fruit 女贞子；Dendrobium 石斛
Bad appetite
Hawthorn Fruit 山楂；Medicated Leaven 神曲
Panting 喘病
TCM Diagnoses
Panting syndrome is one of the respiratory
disease characterized by rapid breathing
even with mouth open and shoulders
elevated, flaring of nares, dyspnoea,
worsening while making exertion.
肺盛
Etiology: Kidney & Lung
Excess Type: obstruction of the lung
by exogenous evils
Deficiency Type: Hypofunction of Lung
& Kidney
喘由外感者治肺，内伤者治肾。
《类证治裁卷二・哮症论治》
肾虚
Panting 喘病
 《丹溪心法卷二・哮喘十五》：实喘气实肺盛，虚喘由肾虚。
 The excessive wheezing syndrome due to excessive
lung qi and deficient wheezing syndrome due to kidney
deficiency.
 《景岳全书・杂证》：实喘者有邪，邪气实也；虚喘者无邪，
元气虚也。
 Excessive gasping syndrome has evil qi in which evil
qi is excessive and deficient gasping syndrome has no
evil in which vital qi is deficient.
Etiology & Pathogenesis
Deficiency & Excess
Deficiency Type
Excess Type
Breathing
Rapid breathing, dyspnea,
comfort if having a deep
inspiration, lower voice
Deep & long; feeling
comfortable when exhaling,
coarse respiration
Duration
Long
short
Onset
Repeated attack
Sudden & acute attack
Accompanied by
Lune or Kid def. sym.
Exterior syndromes
Tongue
Pale
Thin white coating
Pulse
Large, hollow, weak
Rapid & forceful
Panting & Shortness of breath
Panting Syndrome
Breathing
Shortness of Breath
Dyspnoea with mouth open & Feeble breathing
shoulder lifting or even being
unable to lie flat
Type
Excess & Def.
Def. type only
Which is often seen in
various acute & chronic
disease
(Asthma)
Onset
Repeated attack
Usually happened after doing
light physical labor
Lune or Kid deficiency
symptoms
Lassitude, being reluctant to
speak
Accompanied by
Panting & Wheezing
Panting Syndrome
Breathing
Type
Pathology
Etiology
Onset
Wheezing
Rapid breathing without
production of louder sound,
Loud sound in the throat,
Syndromes is short, combined with
rattles due to phlegm in the throat
Excess & Deficiency
Deficiency type only
Which is often seen in various acute
& chronic disease (Asthma)
Qi disorder
Obstruction of Qi by phlegm
Invasion of evils or chronic
of disease but no perennial
root
Has its perennial root and
predisposing causes
No this character
Paroxysm, repeated attack &
stubborn
Independence A complication of multiple
chronic disease.
A dependent disease ( could
include panting syndrome)
Wind-Cold 风寒壅肺
Signs & Symptoms:
 Main Symptoms: Rapid breathing, distending feeling in the chest,
abundant white thin sputum.
 Concurrent Symptoms: Headache, aversion to cold, cough, no
sweating, not thirsty.
Tongue:
White, thin and slippery tongue coating
Pulse:
Floating, tight
Treatment Protocol:
 Expel the Wind
 Dispersing the Lung Qi
Treatment for Wind-Cold
Ma Huang Tang 麻黄汤
Ephedra
麻黄
Cinnamon Twig
桂枝
Almond
杏仁
Licorice
甘草
Hua Gai San 华盖散
Ephedra
麻黄
Mulberry Bark
桑白皮
Perilla Seed
紫苏子
Pink Poria
赤茯苓
Tangerine Peel
陈皮
Processed Licorice
炙甘草
Almond
杏仁
Modifications:
Headache
Lovage Rhizome 川芎；Dahurian Angelica
Root 白芷
Distending feeling in the chest
Snakegourd 栝楼；Longstamen Onion 薤白
Abundant Sputum
Mustard Seed 白芥子；Radish Seed 莱菔子
Cough with sputum
Platycodon Root 桔梗；Licorice 甘草
Wind-Heat 表寒肺热
Signs & Symptoms:
 Main Symptoms: Rapid breathing, flaring of nares, yellow sticky & thick
sputum difficult to be expectorated.
 Concurrent Symptoms: Chest pain, irritability, headache, fever,
sweating, constipation, thirsty, dark urine.
Tongue:
Thin white or yellow tongue coating
Pulse:
Floating, slippery rapid
Treatment Protocol:
 Clear the exterior-heat
 Ventilating the Lung & stopping panting
Treatment for Wind-Heat
Modified Ma Xing Shi Gan Tang 麻杏石甘汤加减
Ephedra
麻黄
Baical Skullcap Root
黄芩
Almond
杏仁
Gypsum
石膏
Licorice
甘草
Snakegourd
栝楼
Forsythia
连翘
Rhaponticum Root
漏芦
Platycodon Root
桔梗
Modifications:
Headache
Lovage Rhizome 川芎；Chastetree Fruit 蔓荆子
Constipation
Rhubarb Root 大黄
Dark urine
Talcum 滑石；Rice Paper Plant Pith 通草；
Adzuki bean 赤小豆
Yellow Sputum
Hogfennel Root 前胡；Snakegourd 栝楼；
Fritillary Bulb 贝母
Irritability
Cape Jasmine Fruit 山栀子
Phlegm Accumulation 痰浊阻肺
Signs & Symptoms:
 Main Symptoms: : Panting, cough, profuse, white & sticky phlegm,
fullness sensation in the chest.
 Concurrent Symptoms: Poor appetite, stickiness in the mouth, no
thirsty, nausea or vomiting in severe cases.
Tongue:
Thick, greasy, white tongue coating
Pulse:
Slippery
Treatment Protocol:
 Resolving sputum
 Restore the reversed flow of Qi
Formula for Phlegm Accumulation
Er Chen Tang 二陈汤
Tangerine Peel
陈皮
Pinellia Tuber
半夏
Poria
茯苓
Processed Licorice
炙甘草
San Zi Yang Qin Tang 三子养亲汤
Perilla Seed
紫苏子
Mustard Seed
白芥子
Radish Seed
莱菔子
Modifications:
Panting
Inula Flower 旋覆花
Fullness sensation in the chest
Snakegourd 栝楼；Bitter Orange 枳壳
Dampness
Black Atractylodes Rhizome 苍术；Villous
Amomum Fruit 砂仁
Nausea or Vomiting
Bamboo Shavings 竹茹；FreshGinger 生姜
Poor appetite
White Atractylodes Rhizome 白术；Chinese
Yam 山药
Phlegm-Heat 痰热郁肺
Signs & Symptoms:
 Main Symptoms: : Panting, cough, dyspnoea, irritable feverish
sensation & distending pain in the chest, yellow sticky sputum.
 Concurrent Symptoms: Thirsty, like cold drinking, flushed face, dry
throat, dark urine, constipation or bloody sputum.
Tongue:
Yellow greasy coating
Pulse:
Slippery & rapid
Treatment Protocol:
 Resolving sputum
 Eliminate lung heat
Treatment for Phlegm-Heat
Sang Bai Pi Tang 桑白皮汤
Mulberry Bark
桑白皮
Golden Thread
黄连
Fritillary Bulb
贝母
Perilla Seed
紫苏子
Baical Skullcap Root
黄芩
Almond
杏仁
Cape Jasmine Fruit
山栀子
Pinellia Tuber
半夏
Modifications:
Fever
Gypsum 石膏；Anemarrhena Rhizome 知母
Sticky sputum
Clam Shell 海蛤壳
Stinking sputum
Heartleaf Houttuynia Herb 鱼腥草；Job’s Tears
薏苡仁；Wintermelon Seed 冬瓜仁；Reed
Rhizome 芦根
Abundant sputum + constipation
Rhubarb Root 大黄；Mirabilite 芒硝；
Pepperweed Seed 葶苈子
Stagnated Qi impairs the Lung肺气郁闭
Signs & Symptoms:
 Main Symptoms: Panting, short and rapid breathing, a feeling of
obstruction in the throat, which are evoked usually by mental stress.
 Concurrent Symptoms: Frequent insomnia, palpitation, chest stuffiness,
chest pain.
Tongue:
Thin coating
Pulse:
Thready
Treatment Protocol:
 To deal with the mental depression
 Descending adverse flow of Lung Qi
Treatment for Stagnated Qi
Wu Mo Ying Zi 五磨饮子
Agarwood
沉香
Aucklandia Root
木香
Betel Nut
槟榔
Lindera Root
乌药
Bitter Orange
枳壳
Modifications:
Palpitation & insomnia
Lily Bulb 百合；Sour Jujube Seed 酸枣仁；
Silktree Flower 合欢花；Polygala Root 远志
Qi stagnation + Liver fire
丹栀逍遥散
Chest distension & pain
Nut-grass Rhizome 香附；Inula Flower 旋覆花
Comparison of Medicinals
Aucklandia Root
木香
Nut-grass Rhizome
香附
Lindera Root
乌药
Regulate Qi movement & stop the pain
Spleen Stomach
Liver
Kidney
Smoothen Qi
Regulate Qi
Warm
Middle Jiao Qi
Stagnation;
Digestive problem
Hypochondrium pain;
dysmenorrhea
Hernia;
dysmenorrhea;
frequent urine
Treatment
2) Def.-type
a) Qi deficiency (Lung & Spleen)
Signs & Symptoms:
Main Sym. : dyspnea, tachypnea, short breath, low & weak voice, lower
cough sound
Concurrent sym.: spontaneous sweating & aversion to wind, pale
complexion, lassitude, epigastric distension & loose stool after meal, or
defecation soon after meal.
Tongue:
thin white or white & greasy coating
Pulse:
thready
Treatment Protocol:
Formula:
Yu Ping Feng San + Liu Jun zi Tang
Dang Shen
Huang Qi
Jie Geng
Gan Cao
Bai Zhu
FuLing
Ban Xia
Modifications:
Thin sputum + aversion to cold
-- Gan jiang
Loose stools
-- Shan Yao, bian dou
Chen Pi
Treatment
2) Def.-type
b) Yin deficiency (Kidney & Lung)
Signs & Symptoms:
Main Sym. : Panting & short breath worsening on exertion, thirsty, tidal
fever, night sweating, sticky sputum with less amount and difficulty to be
expectorated
Concurrent sym.: flushed face, irritability, feverish sensation in the palm &
soles
Tongue:
red tongue with thin yellow coating
Pulse:
thready & rapid
Treatment Protocol:
Formula:
Shen Mai San + Liu Wei Di Huang Wan
Dang Shen
Mai Dong
Dan Pi
Gan Cao
Tian dong
Shen di
Shan yu rou
Ze xie
Modifications:
Lung Yin Def.
-- Bai He, Sha Sheng, Yu Zu
Kid Yin Def.
-- Long Gu, Mu Li
Panting
-- Ci Shi ( specify for kid yin def. type panting)
Treatment
2) Def.-type
c) Yang deficiency (Kidney & Spleen)
Signs & Symptoms:
Main Sym. : Chronic panting, more expiration & less inspiration, worse
while making exertion, shortness of breath
Concurrent sym.: sweating, cold limbs, edema of face & legs, profuse, clear
thin sputum, soreness of waist, lower back pain, pale or darkish
complexion, frequent urination and polyuria during night
Tongue:
Pale and enlarged tongue
Pulse:
thready & deep & week ;
large and rootless
Treatment Protocol:
Formula:
Jin Gui Shen Qi Wan + Shen Ge san
Gui Zhi
Fu Zi
Ren Sheng
Shen di
Shan yu rou
Ze xie
Dan Pi
Gan Cao
Ge Jie
Bai Guo
Wu wei zi
Zu Ri
Modifications:
Up-adverse flow of Qi
-- Zi Shi yin, Ci Shi, Cheng Xiang
Edema
-- Ting Li Zi, Fang Ji,
Prevention:
1. Fresh air, full sunlight, suitable temperature &
humidity in the room
2. No smoking, no drinking
3. Have light food, avoiding too salty, too sore, hot or
irritable food
4. In the stage of attack, patient should lie in bed.
When necessary, give the patient with oxygen
inhalation.
5. In the stage of intermission of panting, courage the
patient to do more exercise to strengthen
constitution.
Formula for Cold Phlegm
Xiao Qing Long Tang 小青龙汤
Ephedra
麻黄
White Peony Root
白芍
Manchurian Wild Ginger
细辛
Dried Ginger
干姜
Roasted Licorice
炙甘草
Cinnamon Twig
桂枝
Magnoliavine Fruit
五味子
Pinellia Tuber
半夏
San Zi Yang Qin Tang 三子养亲汤
Perilla Seed
紫苏子
Mustard Seed
白芥子
Radish Seed
莱菔子
Su Zi Jiang Qi Tang 苏子降气汤
Perilla Seed
紫苏子
Pinellia Tuber
半夏
Hogfennel Root
前胡
Magnolia Bark
厚朴
Tangerine Peel
陈皮
Licorice
甘草
Chinese Angelica
当归
Fresh Ginger
生姜
Chinese Dates
大枣
Cinnamon Twig
桂枝
Formula for Cold Phlegm
Ma Huang Tang 麻黄汤
Ephedra
麻黄
Cinnamon Twig
桂枝
Almond
杏仁
Licorice
甘草
Su Zi Jiang Qi Tang 苏子降气汤
Ephedra
麻黄
Mulberry Bark
桑白皮
Perilla Seed
紫苏子
Almond
杏仁
Pink Poria
赤茯苓
Tangerine Peel
陈皮
Processed Licorice
炙甘草
Fresh Ginger
生姜
Tangerine Peel
陈皮
Licorice
甘草
Perilla Seed
紫苏子
Pinellia Tuber
半夏
Case History
1. Male 73 years
Medical history: Panting & coughing for several years, especially worse in winter.
First visiting:
Main complain: panting & coughing for several days
Got cold several days ago and started coughing. Not stopping cough in the whole
day, flaring of nares, yellow sticky & thick sputum difficult to be expectorated. distension
feeling in the chest. Panting at night even can not fall in sleep. Fever & aversion to cold
in every afternoon. Thirsty, no appetite, constipation, dark urine
Tongue: red body less moisture with dry yellow coating
slippery & rapid
Pulse: floating &
TCM diagnose:
Wind-cold invasion + phlegm-heat accumulation + Yin Def. + lu. dryness
Treatment protocol:
Release the cold + clear the lung heat
Formula:
Ma Xing Shi Gan Tang:
Case History
1. Male 73 years
Medical history: Panting & coughing for several years, especially worse in winter.
Second visiting:
Main complain: Panting & coughing
Fever is almost gone, no aversion to cold, appetite is getting better, still cough &
panting, however, patient could take a half lying position now, sticky sputum with little
blood, dark urine
Tongue: moisture red body with thin yellow coating
TCM diagnose:
Lung Dryness & heat
Treatment protocol:
Clear the lung heat, moisten the lung dryness
Formula:
Qin Zao Jiu Fei Tang:
Pulse: slippery & rapid
Case History
1. Male 73 years
Medical history: Panting & coughing for several years, especially worse in winter.
Third visiting:
Main complain: Panting & coughing
No fever, cough is getting better, no bloody sputum, still little sticky sputum,
panting is getting calm down at night, appetite is better, Still feel tired and exhausted,
little dizziness,
Tongue: moisture red body with thin yellow coating
Pulse: thready rapid
TCM diagnose:
Yin Def. + Lu. Dryness + Sp Qi Def.
Treatment protocol:
Nourish Yin, moisten the lung dryness, tonify the Sp Qi
Formula:
Sha Sheng mai Dong Tang:
Lung Distension
TCM Diagnoses and Treatments
Lung distension results from development of multiple
chronic pulmonary disease and is characterized as thoracic
bulge & fullness, cough, panting with reversed flow of qi,
worsening while making exertion, stuff chest & abundant
sputum.
Etiology & Pathology:
Etiology:
1) Lung def. due to chronic disease ( chronic
pulmonary disease: obstruction emphysema, cough,
asthma, pneumonectomy, chronic pulmonary heart disease,
senile pneumonectomy, etc)
2) Exogenous pathogens affection
Main Points for differentiation
Lung Qi Def.
Lung Qi & Yin Def.
Lung & Spleen Def.
Lung & Kidney Def.
Spleen & Kidney Yang Def.
Wheeze, Panting & Lung distension
Dao Tan Tang 导痰汤
Orange Peel
陈皮
Pinellia Tuber
半夏
Poria
茯苓
Unripe Bitter
Orange
枳实
Jackinthepulpit
Tuber
天南星
Fresh Ginger
生姜