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.