My last theory-heavy post for the month is going to be on the disharmonies of the Lung system. Like with the post on Liver disharmonies, I am going to discuss common patterns with the Lung system and what they might look like from a Western perspective as well as some general advice for preventing or coping with lung disharmonies.
The Traditional Additional Disclaimer
On all of my blog posts, I have a disclaimer on the top (you can see it right above this section) that states, “The information in this post is for general purposes only and does not constitute medical advice.”
I have another disclaimer at the bottom that goes into more detail about who I am, what my qualifications are, my scope of practice and that despite all of that, I am probably not your acupuncturist and you should check with your acupuncturist and a primary care provider before making any lifestyle changes.
And on these types of posts, in particular, I start off with a third disclaimer.
Diagnosing yourself is hard.
Reading pattern diagnoses on the internet is like reading sun sign only horoscopes – they’re going to be general enough that you can convince yourself you have almost every pattern.
Talking to an appropriately trained practitioner is key. We use other diagnostic measures in addition to an interview that can help narrow down your patterns (because most people have a couple if they’re not feeling well.)
To find a properly trained Chinese herbalist or acupuncturist, check out the NCCAOM find a practitioner directory. Or, if you’re in the Twin Cities, book an appointment with me!
Like with the liver disharmony post I am mainly going to focus on the zang organ or yin organ disorders. With the liver disharmony post, it’s because I wanted to keep it short. For this post, it’s more that there aren’t a whole lot of things to say about large intestine disorders.
For the most part, issues in the bowels are covered by other conditions in the digestive system (in TCM, that’s the spleen and stomach) and are classified as Earth disharmonies.
Another thing to note is that a lot of things you might think are metal patterns like colds and the flu are not issues in the metal system, per se. They’re called EPIs or “external pernicious influences.” It’s a modern way of saying “evils”; something from outside of our body attacking us.
While some Metal disharmonies can make us more susceptible to EPIs, invasions like this are best saved for another blog post. If you want a quick intro, though, check out this post on the three herb broth for colds and the flu.
The Deficient or Empty patterns
Diagnosis always comes back to yin or yang.
Did it come from inside or outside of the body? Is it hot or cold? Is there too much or too little of a needed substance?
In the case of these two patterns, the issue originated from inside the body (because we are saving EPIs for a future blog post) and there is not enough of a substance for them to be functioning optimally so they are “deficient”.
And if you remember from the Acupuncture 101 post, a pattern is:
a constellation of signs and symptoms that form the root for many possible diseases, which arise before the disease manifests and can predict likely outcomes.Acupuncture 101: How to talk to your acupuncturist
Lung qi deficiency
Lung qi deficiency overlaps two categories of patterns: qi deficiency and all of the low energy and reduced functionality that entails combined with breathing issues.
The symptoms of lung qi deficiency are a slightly hunched posture, a weak or timid voice, a slight cough (like you always have a tickle at the back of your throat), avoiding speaking (because it’s tiring), and shortness of breath. If you feel fine generally but exhausted after speaking you may be developing lung qi deficiency.
This pattern is associated with Western conditions like sick building syndrome, computer posture (that’s the hunched shoulders), asthma, certain types of allergies, smoker’s cough, and many of the breathing complications caused by pneumonia.
Lung qi deficiency is usually a sign that your last cold or flu damaged your vital substances and, because of the lung’s relationship with your defensive function, puts you at risk for more colds or the flu. Resting and taking care of yourself while fighting off an infection is the easiest way to prevent lung qi deficiency.
Lung qi deficiency can also be hereditary or caused by poor fitness. In these cases, measured actions to improve fitness levels and support breath health will be crucial.
Lung yin deficiency
Lung yin deficiency is caused by two main factors:
- overuse of the voice (people who sing or speak for a living)
- and smoking
The most common reason I’ve seen lung yin deficiency in the clinic is smoking. Smoking depletes qi first and the eventually consumes the yin fluids.
The symptoms of lung yin deficiency are drier and hotter than with lung qi deficiency. We see a dry cough that is stronger than the qi deficient cough. This cough might have sticky phlegm associated with it. The voice is weak and the person tends not to like talking. They might even sound sick or hoarse.
We see these symptoms in the singers who smoke because they like how it makes their voice sound, long term smokers that cough up phlegm every morning upon waking, and people who have attended concerts and screamed all night (though this is acute and far easier to treat.)
Treating yin deficiency is critical because if left untreated it can lead to cancer.
The Excess or Full Patterns
These are the patterns that are created when there is too much of something. Most of the time, full patterns that come into the clinic are EPIs but we are saving those for a future blog post. If you want a quick intro, you could always check out the three herb broth post.
The difference between EPIs and the patterns I’m going to discuss here is whether they’re internal or external. Remember that “EPI” stands for “external pernicious influence”.
Internal patterns can be caused by several things: a prolonged infection, recurrent infection, underlying patterns, diet, and emotional health.
Cold-phlegm in the lungs
The symptoms of cold-phlegm are, well, cold. You feel cold, exposing yourself to cold makes it worse, your phlegm looks cold. It’s a sort of white and watery glop that’s much different than hot phlegm. You feel a pressure in your chest, possibly in your sinuses, and if the phlegm accumulation is bad enough you might even have vertigo.
This is usually what we mean when we say that a cold has moved into our chest. I think it’s weird that in the West we see this as a good sign; how many of you have said something along the lines of, “Overall, I’m feeling better. It seems to have settled into my chest for now.” I know I have, and I hear it from my patients all the time.
The external wind that was just an annoying cold has moved inward into an organ system. This is not progress, this is a worsening disease state. This is what happens when we don’t expel wind in the early stages of an invasion.
Still, I would rather see cold-phlegm in my clinic than…
Hot-phlegm in the lungs
In general, pathogenic heat (more heat than is healthy) is not good in Chinese medicine. It’s louder, more brightly colored, and a general pain in the behind.
Like with cold-phlegm, you still have a heaviness in your chest and maybe some dizziness – that’s the phlegm. But when you cough it up it’s yellow or green. You feel hot and you may be running a fever. You’re thirsty but you can’t drink a lot of fluids at once, and you can’t sleep. And your cough is a barking, loud cough that in the West we associate with croup.
This is a bit of a generalization because there are very few direct analogs between Traditional Chinese medicine and modern Western medicine but cold-phlegm is often the result of a virus and hot-phlegm is often the result of a bacteria.
Because of this, it’s often a good idea to check in with a nurse practitioner. A bacterial infection could result in pneumonia but could be cleared up with a round of antibiotics. And I’d much rather support you through antibiotic recovery than see you end up in the ER needing chest x-rays.
One of the characteristics of the Lung is that it is “the receptacle that holds phlegm.” But while many excess lung conditions are phlegmy conditions, this is a common one that isn’t: lung heat.
The symptoms of lung heat are hot – feverish feelings, thirst, and even your cough feels hot. Your chest hurts but it doesn’t feel heavy like with phlegm conditions and the cough is dry. You might be a little short of breath but it’s an annoyance, not oppression.
Like with cold-phlegm, in the West we tend to see lung heat as “the next step” of a cold. We see this is progress rather than a worsening condition. It doesn’t need to be this way! If you treat an EPI in the early stages it won’t internalize. But if you cover up the symptoms and don’t take the time to rest, there’s a good chance it will linger and worsen.
But wait, there’s more!
This is not an exhaustive list of Lung patterns. There’s also phlegm fluid obstructing the lungs. This is not a condition I want to see in clinic and if I do it’s something I’m going to refer because it’s serious – it’s likely pneumonia.
Phlegm dryness is kind of like the patterns I did get into above with just the change you’d expect – the phlegm is dry and sticky. It has that same sorts of causes and similar treatments.
And just like with all other patterns, Lung patterns can be combined with patterns elsewhere in the body. Asthmatics often have both Lung and Spleen problems (because Earth is the mother of Metal) or Lung and Kidney problems (because Metal is the mother of Water).
People with social anxiety may have Heart and Lung qi deficiency. People who get short of breath when angry may have Liver and Lung issues.
Pattern diagnosis is complicated but when done correctly, it can be an eye-opening experience for issues you’ve had for years and can open the door to bringing you back into balance.
Treating Metal Disharmonies
1. Rest and take care of yourself when you get sick
This is the best way to prevent complications. If you catch a cold or flu, make sure you are resting, drinking your fluids, and taking your herbs. Even once you start to feel better, it’s best to take it easy for a couple of days to make sure that your vital substances (qi, blood, yin, and yang) have an appropriate amount of time to recover.
2. Don’t smoke
Smoking leads to qi and yin fluid deficiency. It also causes a whole host of issues elsewhere in the body and is, in general, a bad idea. I’m also anti-vaping except in one specific circumstance – if you’ve picked up vaping to stop smoking AND you have a plan to eventually not vape any more either then I believe it is a healthy decision and I fully support your commitment to your long term health.
3. Wash your hands and cover your mouth
This is the simplest method to prevent the spread of upper respiratory disease. Your skin belongs to the Lung system and your wei qi, defensive function. It is an excellent barrier to a lot of things that can make us sick. But if we touch our noses or eyes, or touch our food, the microbes can get into our mucous membranes and make us sick.
If you already are sick, covering your mouth when you sneeze and cough prevents the microbes from landing on surfaces others may touch.
4. Process your grief
One of the things I didn’t have time to touch on was how grief played into the etiology (development) of many of these patterns. Remember that grief weakens the Lung and a weakened Lung means weakened wei qi.
5. Change your diet
Phlegm is contained in the Lung but it is created by the Spleen. A weak Spleen/Earth element creates dampness which can eventually become phlegm. Changing your diet can cut the production of phlegm off at the source.
The usual culprit is dairy because it is dense, cold, and hard to process. But if you’ve tried many an elimination diet and you haven’t found something you’re sensitive too, look at how often you’re eating. Irregular diets are hard on the Spleen as well. Earth likes predictability. Space your meals throughout the day, eating when you’re hungry, and your Earth will dry up from a flooded swamp to a happy, well-watered field.
On to the next element
As autumn comes to a close we need to start thinking of the next element – Water. Water is the element of winter and the kidneys. Protecting ourselves in the autumn by eating an appropriate diet, harvesting what we need, and taking care of ourselves when we get sick sets us up for success for our long hibernation.
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Resources and Links
The NCCAOM Find a Practitioner Directory
Disclaimer: I am an acupuncturist in the state of Minnesota, and the information falls within my scope of practice in my state. However, unless I have directed you here as your homework I am probably not your acupuncturist. The information in this post is for general purposes only and does not constitute medical advice. As always, check with your own acupuncturist or primary care provider before making any lifestyle changes. This post does not create a patient-practitioner relationship and I am not liable for any losses or damages resulting or relating to the content in this post.
Jessica Gustafson is a licensed acupuncturist in St Paul, MN specializing in women’s health and fertility. She loves working with patients through the Health Foundations Birth Center on Grand Avenue in St Paul, at Naturally Well in White Bear Lake, and doing home visits in the Twin Cities area. Check out the services page for more information!
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