- Pulse: Floating, tense
- Tongue: Normal with a thin white coat
Wind-Heat Invading the Lung
In contrast to Wind-Cold, Wind-Heat involves a more inflammatory presentation. The cough is often accompanied by a sore throat and a runny nose with yellow mucus. Patients may experience fever, headache, thirst, and a slight sweat.
- Pulse: Floating-rapid
- Tongue: Red with a thin yellow coat
Wind-Damp Invading the Lung
Wind-Damp is a more unique presentation characterized by rapid physical changes. Patients may experience sudden swelling of the eyes and face that spreads quickly across the body. This is often accompanied by a cough and scanty, pale urination.
- Pulse: Floating-slippery
- Tongue: White, wet coat
Exam Tip: When differentiating between Wind-Cold and Wind-Heat, always look at the mucus color and the patient's temperature preference. Clear/watery mucus suggests Cold, while yellow mucus suggests Heat.
Internal Pathologies: Phlegm and Fluid Accumulation
When the Lung's ability to regulate fluids is compromised internally, "phlegm" (a TCM concept representing various types of abnormal fluid) can accumulate.
Phlegm-Heat in the Lung
This is a high-intensity pattern where heat transforms fluids into thick, smelly phlegm. Symptoms include a "barking" cough, profuse yellow-green thick mucus, shortness of breath, asthma, and chest stuffiness.
- Pulse: Slippery-rapid-full
- Tongue: Red, thick, sticky-yellow coat
Phlegm-Fluids in the Lung
This pattern is more "damp" than "heat" in nature. It is characterized by a cough that may produce a "splashing" sound in the chest. Patients often present with shortness of breath, vomiting, and white, watery, or frothy sputum, often accompanied by a sense of chilliness.
- Pulse: Weak, slippery floating
- Tongue: Pale, thick, sticky-white coat
Deficiency Patterns
Deficiency patterns represent a lack of vital substances (Qi, Yin, or Fluids) within the Lung organ.
Lung Qi Deficiency
This is a state of exhaustion of the Lung's functional energy. Patients often present with shortness of breath, a cough with watery sputum, a weak voice, and fatigue. They may also experience "day sweat" (spontaneous sweating) and are prone to catching colds easily.
- Pulse: Weak
- Tongue: Pale or pink
Lung Yin and Fluid Deficiency
These patterns involve the depletion of the Lung's cooling and moistening aspects.
- Lung Yin Deficiency: Characterized by a dry cough with little mucus or even blood in the mucus, low-grade fever, a hoarse voice, red cheeks, and a dry mouth/throat. The tongue is typically red and peeled.
- Lung Fluid Deficiency: This is a more "dry" state, presenting with a dry cough, dry skin, dry throat, and thirst. The tongue will have a dry coat.
The Lung-Kidney Connection
In TCM, the Lung and Kidney are closely linked in the regulation of water and the movement of Qi. The Lung is the "upper source" and the Kidney is the "lower source".
Kidney Failing to Receive Lung Qi
Normally, the Lung Qi descends, and the Kidney Qi receives it. If the Kidney is too weak to "grasp" or receive the descending Lung Qi, the patient may experience asthma, shortness of breath, and difficulty inhaling. Other symptoms include cold limbs, swelling of the face, a sore back, and clear urination during asthma attacks.
- Pulse: Weak, deep-tense
- Tongue: Pale
Water Flowing Back to the Lung due to Kidney Deficiency
When the Kidney's function in regulating water fails, fluids can "reflux" upward toward the Lung. This results in a pattern of cough, asthma, and shortness of breath, but with thin, watery, frothy sputum. Because the Kidney is involved, the patient will also show signs of lower body water retention, such as edema in the legs and ankles, a sore back, a cold body, and scanty clear urine.
- Pulse: Deep-weak, slow
- Tongue: Pale, swollen, with a white coat
