this is a form of lung atrophy (fèi wěi). although the symptoms are primarily related to the lungs, the condition is actually caused by heat from deficiency in the stomach, which rises in rebellion and scorches the lung yin. it may also be understood by reference to the theory of the five phases, wherein the ‘mother’ (stomach) transmits the problem to the ‘child’ (lungs).

the lungs are the most delicate of the yin organs and serve as a canopy for the trunk. they depend on the earth (spleen/stomach) for nourishment and for some of its fluids. if, over an extended period of time, the lungs do not receive proper nourishment or moisture, they shrivel up or ‘atrophy.’

the rebellious qi from the stomach prevents the lung qi from descending properly, and results in coughing and wheezing. the scorching of the lung yin causes shortness of breath and depletes the fluids. the depletion of the fluids leaves only saliva or a thick, viscous sputum that becomes lodged in the throat and causes a dry, uncomfortable sensation. the dry mouth, and the tongue and pulse signs, are classic indications of heat from deficiency leading to internal dryness.

this is warm-dryness injuring the lung qi at a relatively superficial level (exterior stage). because the lungs are responsible for respiration and control the skin, they are the organ most influenced by the external environment.

when the weather is dry, dryness will affect the lungs first. at a relatively exterior level, this leads to moderate fever and headache. disruption in the flow of lung qi and the scorching effect of warm-dryness causes a dry, hacking cough. dryness also depletes the lung fluids, which manifests as thirst, a red tongue, and a dry tongue coating. the floating, rapid pulse indicates a superficial disorder. it is especially floating on the right side (cun position).

this is primarily a liver qi stagnation pattern, often accompanied by a disharmony of the liver and spleen.

the distending pain in the hypochondria and chest, sensation of fullness or oppression, frequent sighing, irritability, and wiry pulse are indicative of liver qi stagnation. these symptoms reflect the failure of the liver to ensure the free flow of qi.

the emotional depression or irritability further illustrates liver involvement, as emotional stress readily constrains liver qi and disrupts the overall movement of qi in the body.

the abdominal pain, bloating, indigestion, constipation or irregular bowel movements point to secondary impairment of the spleen. this occurs when stagnant liver qi overacts on the spleen, disturbing its functions of transformation and transportation.

when liver qi stagnation persists, it may transform into heat, reflected in a bitter taste in the mouth, dry mouth, red tongue sides, and a wiry or slightly rapid pulse.

this is a concurrent shao yang (lesser yang)- and yang ming (brightness)-stage disorder.

the alternating fever and chills, sensation of fullness in the chest and hypochondria, bitter taste in the mouth, vomiting, and wiry pulse are indicative of a shao yang-stage disorder.

the sensation of firm masses or distention and pain in the epigastrium, absence of bowel movements or hot, burning diarrhea, yellow coating on the tongue, and forceful pulse are indicative of a yang ming organ-stage disorder.

it is not uncommon to find a flooding or excessive pulse. the symptoms of uncontrolled vomiting, despondency, and irritability will be more severe than the occasional vomiting and irritability associated with a purely shao yang condition. in terms of organ-pattern differentiation, this condition is viewed as heat excess in the gallbladder and stomach. one of the key symptoms from this perspective is the continuous vomiting. this reflects the concept that vomiting is not an intrinsic problem of the stomach, but only occurs when the stomach is attacked by gallbladder qi.

this is constipation due to dried-out intestines, a common condition among the elderly and debilitated. it is also frequently seen after childbirth when the loss of blood injures the yin and depletes the fluids. the other signs and symptoms are characteristic of yin deficiency with depleted fluids.

this pattern is one of early-stage intestinal abscess, a condition of excess with interior clumping of heat and blood.

poor dietary habits like binging or over-eating in general, or a diet which is high in greasy, rich, raw, or cold foods in particular, can lead to stagnation and obstruction of the stomach and intestines. obstruction of any kind constrains the flow of qi and blood; constraint gives rise to heat, which putrifies the qi and blood in the intestines and eventually forms an abscess.

this condition is also commonly attributed to damp-heat accumulating in the intestines, which similarly obstructs the flow of qi and blood. the clumping of heat and stasis of blood in the intestines manifests as pain (usually in the lower right quadrant of the abdomen) that increases upon pressure, with rebound tenderness. although the pain may extend to the genitals, it can be differentiated from painful urinary dysfunction because urination is normal.

gradually, as the qi and blood continue to putrify, the abscess will form a palpable mass. the ebb and flow of the struggle between the body’s normal qi and the pathogenic influences disturbs the nutritive and protective qi, which manifests as irregular, intermittent fever followed by chills and sweating. the yellow, greasy tongue coating and the slippery, rapid pulse reflect the clogging of the intestines by heat.

this is summerheat injuring the qi and fluids.

when summerheat penetrates to the interior there is fever, irritability, dark, scanty urine, and a rapid pulse. the heat ‘steaming’ internally forces open the interstices and pores and causes profuse sweating. summerheat, a yang pathogenic influence, is very apt to injure the fluids, which is compounded by profuse sweating. this results in thirst with a desire to drink, a desire to curl up, shortness of breath, apathy and a deficient pulse.

this is steaming bone disorder due to liver and kidney yin deficiency.

yin deficiency gives rise to fire, which disturbs the internal harmony of the body. the primary manifestations include afternoon tidal fever or unremitting, chronic low-grade fever. the kidneys, which store the true yin and are associated with the bones, are affected by this condition. when fire from yin deficiency occurs at this level, the patient often experiences a sensation of heat deep in the body (at the level of the bones), while the flesh itself is not warm to the touch. it is therefore called steaming bone disorder. the same process may also disturb the spirit and cause irritability and insomnia.

long-term deficiency at the nutritive level, when further injured by blazing fire, leads to emaciation and lethargy. the deficient yin cannot control the yang, which allows the fire from deficiency to blaze upward where it manifests as red lips and dark-red cheeks. the deficient yin is unable to contain the fluids during the night (yin). it is at this time that the blazing fire from deficiency forces the fluids out of the body in the form of sweat.

yin deficiency also prevents the upper parts of the body from receiving moisture, giving rise to thirst and a dry throat. the red tongue with little coating and the thin, rapid pulse are classic signs of heat from yin deficiency.

this is painful obstruction of the throat due to damp-heat collecting in the lungs.

when damp-heat or a damp-warm-febrile disease invades the body, it often begins by attacking the lungs. damp-heat constrains the qi level of the lungs, which results in obstruction of the throat. damp-heat attacking the blood level of the lungs causes sore throat.

the red tongue and rapid pulse reflect the presence of heat, while the thick tongue coating and slippery pulse indicate dampness. if the damp-heat only penetrates to a relatively superficial level, the tongue coating will be white and the pulse will float; if it penetrates deeper, the tongue coating will turn yellow and the pulse will no longer float.

this is damp-heat excess with interior clumping. fever, irritability and restlessness, flushed face, red eyes, dark urine, constipation, a greasy, yellow tongue coating, epigastric focal distention, jaundice, diarrhea, and dysenteric disorders are manifestations of damp-heat excess and interior clumping.

vomiting of blood and nosebleed are caused by the reckless movement of hot blood.

red and swollen eyes and ears, ulcerations of the mouth and tongue, and abscesses are associated with fire toxin.