Clinical Examples

5 Clinical Examples



Analogy of Western Diagnoses with Syndromes in Traditional Chinese Medicine (TCM)


Respiratory Tract Disorders


Gastrointestinal Disorders


Obesity/Losing Weight


Physical and/or Emotional Fatigue


Cardiovascular Disorders


Eye Disorders


Skin Disorders


Urogenital Disorders


Gynecological Disorders


Any form of treatment for the disorders above, including the use of nutritional therapy, needs to be preceded by a clear diagnosis by a trained TCM practitioner.


Treatment should never take place without a prior consultation with the treating physician.


The analogies between Western diagnoses and syndromes in TCM are not limited to the disorders discussed in this book. These are intended as a starting point for connecting Eastern and Western medical systems.


Respiratory Tract Disorders


Main Symptom: Colds















Acute cases of flu


Wind–cold fettering the lung


(feng han shu fei)


Acute bronchitis


Wind–heat invading the lung


(feng re fan fei)


Bronchitis, sinusitis, with yellow secretion


Phlegm–heat obstructing the lung


(tan re zu fei)



According to TCM:


Cough (ke sou) and phlegm–rheum (tan yin) develop through the assault of external pathogenic factors, mostly cold, which block the flow of qi. These primarily occur due to lung, spleen, and kidney vacuity.


image Nutritional therapy, along with acupuncture and herbal therapy, can produce very good results during the onset, as well as the subsequent course of the disorder.


Acute Case of Flu

Wind–Cold Fettering the Lung (Feng Han Shu Fei) Wind–Cold Cough (Feng Han Ke Sou)

Symptoms


Stuffy or runny nose, with clear, watery phlegm, sneezing, cough, aversion to cold, aching limbs, headache, sore throat.













Tongue:


Thin white fur


Pulse:


Superficial, weak


Causes


External invasion of wind–cold into the lung due to weak defense qi. Lung function and flow of qi are impaired by cold.


Therapy



Clear body surface


image


Expel wind and cold


image


image Avoid:


Raw, cold, and cool foods, and dairy products (they encourage phlegm disorders).


image Recommended:































Thermal nature


Hot and warm


Organ network


Lung, spleen/pancreas


Direction


Floating


Preparation methods


Boiled, fried


Flavor


Acrid


Vegetables


Green onions, coriander


Beverages


Spiced tea, mulled wine, grog (beverage with rum, hot water, and sugar), whiskey


Spices


Aniseed, chili, ginger, garlic, pepper, rosemary, thyme (loosens phlegm, disinfects), cinnamon










image


Ginger tea:


Place thumb-sized pieces of ginger in0.5 L (two cups) of water, simmer for about 20 minutes; drink while warm; add licorice for sore throat


Mulled wine


Spiced tea


(Yogi tea with pepper, ginger, cardamom, and cinnamon)


image At the first onset of sneezing, shivering, and cold symptoms, expel cold and wind with hot and spicy foods for one day.










image


Decoction of spring onions and ginger


Chili con carne


image As soon as symptoms shift from wind–cold to wind–heat (possibly overnight), with the predominant symptom of fever with sweating, immediately change nutritional therapy and choose cool and cold foods.


Acute Bronchitis

Wind–Heat Invading the Lung (Feng Re Fan Fei)

Symptoms


Burning sore throat, frequent cough, yellow secretion, fever, aversion to cold, stuffy nose, aching body and aching limbs, headaches.













Tongue:


Thin yellow fur


Pulse:


Superficial, fast


Causes


Wind–heat attacks on the lung, summer flu, weakened defense qi or next stage of a wind–cold attack on the lung (transformation from cold to heat can occur within a few hours).


Therapy



Clear surface


Dispel wind–heat


image


image Avoid:


Warm and hot foods, dairy products (encourage congestion).


image Recommended:





































Thermal nature


Cool, possibly a little cold


Phase


Metal, earth


Flavor


Acrid, bitter, possibly a little sweet


Preparation methods


Raw, boiled, steamed


Fruit


Pears, watermelons


Vegetables


Chinese (napa) cabbage, mung beans (sprouts even cooler), radish, black soybeans, dandelion


Beverages


Pear juice (for dryness, sore throat, and phlegm), green tea, peppermint tea


Grains


Wheat


Spices


Chinese chrysanthemum blossoms, mulberry leaves, salt/salt water


Soy products


Tofu










image


Relief during initial stage:


Concentrated peppermint tea, Chinese chrysanthemum blossom tea


Dry cough:


Pear juice


Sore throat:


Figs, fresh lemon juice


Cough relief and loosening of phlegm:


Roasted almonds with salt


Cough and loss of voice:


Fresh radish juice and ginger


Bronchitis, Sinusitis with Yellow Secretion

Phlegm–Heat Obstructing the Lung (Tan Re Zu Fei)

Symptoms


Cough with copious yellow, possibly green, sputum; bloating and feeling of pressure in chest, exhaustion, lack of appetite, soft stools.


Tongue: Red, with thick, sticky, yellow fur


Pulse: Fast, slippery


Causes


Long-term damage or constitutional vacuity of lung qi, combined with a spleen qi vacuity, promotes the formation of dampness and phlegm; inappropriate diet, excess of fatty, hot dishes.


Therapy



Loosen phlegm


Clear heat


image


image Avoid:


Dairy products (promote congestion), bananas, alcoholic beverages, reduce consumption of meat.


image Recommended:






















































Thermal nature


Neutral and cool, later neutral and warm to supplement the spleen


Organ network


Lung, spleen


Flavor


Slightly acrid, slightly sweet, salty (transforms phlegm)


Preparation methods


Raw, boiled, steamed


Mucolytic (decongesting) and transforming:


Fruit


Pears, lemons


Beverages


Green tea


Grains


Soybeans


Vegetables


Bamboo sprouts, radish, red marine algae (dulse)


Cooling effect on lung:


Vegetables


Bamboo sprouts, watercress, radish, celery root (celeriac), asparagus


Beverages


Peppermint tea, green and black tea


Supplement spleen and remove dampness:


Grains


Millet, rice


Cough with phlegm:


Vegetables


Button or crimini/portobella mushrooms


Nuts and seeds


Pine nuts, salt-roasted almonds



Tip: Recurrent bronchial and sinus “phlegm conditions” respond very well to reducing the consumption of dairy products and meat.


Bronchitis/Chronic Bronchitis















Chronic lung function impairment; recurrent bronchitis/chronic bronchitis


Lung qi vacuity


Chronic bronchitis with phlegm production (and phlegm retention in lung)


Lung qi or spleen qi vacuity


Chronic bronchitis with constitutional lung function impairment


Lung yin and kidney yin vacuity



According to TCM:


Cough “ke sou” and phlegm “tan yin” are caused by chronic vacuity of lung, spleen, and kidney. Treatment should primarily consist of acupuncture and herbal therapy, accompanied by dietary measures. Over a longer period (weeks to months), nutritional therapy can noticeably strengthen organ function and reduce formation of phlegm.


image Chronic bronchitis is primarily a mixed syndrome of the above-mentioned primary syndromes. Treatment should target the primary syndrome. Treatment principles for nutritional therapy are supplementing the spleen for phlegm reduction and supplementing the lung and kidney to make up for chronic vacuity.


Chronic Lung Function Impairment; Recurrent Bronchitis/Chronic Bronchitis

Lung Qi Vacuity

Symptoms


Weak cough; thin, clear sputum; spontaneous perspiration, fatigue, susceptibility to infection.













Tongue:


Pale


Pulse:


Weak


Causes


Protracted and persistent cough weakens lung qi; constitutional weakness; general exhaustion (especially in old age).


Therapy



Supplement lung


image


image Avoid:


Raw, cool, and cold foods, and bitter flavor.


image Recommended:











































Thermal nature


Neutral and warm


Organ network


Lung, spleen


Flavor


Slightly acrid, slightly sweet


Preparation methods


Boiled, steamed, fried


Meat


Duck


Fish


Carp


Fruit


Grapes


Vegetables


Cauliflower, carrots, onions


Grains


Oats, short-grain (glutinous) rice


Spices


Aniseed, ginger, garlic, rosemary, thyme


Nuts and seeds


Chestnuts, almonds, black sesame, sunflower seeds, walnuts


Other


Alcoholic beverages










image


Congee (see p. 117) with rice, onion, and ginger


Chronic Bronchitis with Phlegm Production (and Phlegm Retention in Lung)

Spleen Qi Vacuity and Lung Qi Vacuity

Symptoms


Cough with excessive white sputum, sensation of fullness in chest, fatigue, lack of appetite, soft stools.













Tongue:


Whitish, slimy fur


Pulse:


Slippery


Causes


Protracted or constitutional damage to lung qi, chronic spleen qi vacuity caused by inappropriate diet and overwork.


Therapy



Transform phlegm


Supplement spleen


Supplement lung


image


image Avoid:


Raw, cold, and cool foods; dairy products, excess sweets, excess meat.


image Recommended:


(see “Lung Qi Vacuity,” p. 79)















































Thermal nature


Neutral and warm


Organ network


Spleen, heart, lung


Flavor


Slightly sweet, slightly bitter, slightly acrid


Preparation methods


Boiled, fried, steamed


Transform phlegm:


Fruit


Pears, cherries, apples


Vegetables


Leeks, radish


Grains


Millet


Spices


Ginger, garlic


Supplement spleen:


Meat


Poultry, beef


Vegetables


Fennel, carrots


Grains


Oats, millet, rice


Spices


Aniseed, basil, ginger, coriander, thyme










image


Millet or rice dishes with acrid seasonings


Chronic Bronchitis, Constitutional Lung Disorder

Lung Yin Vacuity and Kidney Yin Vacuity

Symptoms


Dry cough, dry throat, chronic shortness of breath, weakness in knee and back, hot hands and feet, subfebrile temperatures in the afternoon.













Tongue:


Red, dry, possibly no fur


Pulse:


Thin


Causes


Protracted smoldering illness, chronic exhaustion, physiological process of aging.


Therapy



Supplement lung yin and kidney yin


image


image Avoid:


Warm and hot foods, excess bitter and acrid flavor.


image Recommended:

































































Thermal nature


Neutral and cool


Organ network


Lung, spleen, kidney


Flavor


Sweet, slightly salty


Preparation methods


Raw, steamed, boiled


Supplementing lung yin:


Meat


Duck, pork


Fruit


Pears, tangerines, apricots, figs


Vegetables


Eggplant, button or crimini/portobella mushrooms, carrots, water chestnuts


Spices


Honey


Nuts and seeds


Peanuts, almonds, sunflower seeds, pine nuts


Dairy products


Butter, yogurt, farmer’s cheese, cottage cheese, cow’s milk


Soy products


Soy milk


Supplementing kidney yin:


Meat


Duck, pork


Fish


Oysters, perch, octopus


Fruit


Cherries, grapes


Vegetables


Carrots


Grains


Wheat, corn


Nuts and seeds


Black sesame, walnuts


Other


Sheep’s milk and goat’s milk products










image


For dry cough:


Milk with honey, almond milk


Restorative soup with carrots and pork


Main Symptom: Cough


















Acute weak cough


Wind–cold fettering the lung


(feng han shu fei)


Acute violent cough


Wind–heat invading the lung


(feng re fan fei)


Chronic cough with sputum


Phlegm–damp cough


(tan shi ke sou)


Chronic dry cough


Lung yin vacuity with dryness


(fei yin xu, fei zao)



According to TCM:


Counterflow lung qi; differential diagnosis based on frequency, severity, secretion and fever. Good results can be achieved with nutritional therapy, acupuncture, and herbs. Requires extended therapy over several weeks.


Acute Weak Cough

Wind–Cold Fettering the Lung (Feng Han Shu Fei)

Symptoms


Weak, quiet cough with thin white secretion, sore throat, fever without sweating, aversion to cold.


Therapy



Dispel wind and cold


Downbear qi


image


image Avoid:


Cold and cool foods.


image Recommended:
















Beverages


Thyme tea with honey


Spices


Thyme, watercress, aniseed


Nuts and seeds


Roasted almonds with salt, walnuts with honey, almond butter










image


Aniseed tea


Acute Severe Cough

Wind–Heat Invading the Lung (Feng Re Fan Fei)

Symptoms


Frequent strong cough with yellow or greenish thin or viscous secretion, sore throat, fever, headaches.


Therapy



Expel wind and cold


image


image Avoid:


Warm and hot foods.


image Recommended:
















Fruit


Pears, pear juice, grapefruit, lemons


Vegetables


Radish, bamboo sprouts


Beverages


Radish juice, green tea


Radish juice, pear juice, radish juice with ginger


Chronic Cough with Sputum

Phlegm–Damp Cough (Tan Shi Ke Sou)

Symptoms


Cough with excessive white sputum, exhaustion, bloating in thorax and epigastric region, loss of appetite.


Tongue: White, sticky fur


Pulse: Slippery


Causes


Chronic lung qi vacuity and spleen qi vacuity caused by external pathogenic factors and incorrect nutrition.


Therapy



Loosen phlegm


Supplement spleen qi and lung qi


image


image Avoid:


Raw, cold, and cool foods, dairy products, meat, acrid and fatty foods, excess sweets.


image Recommended:


































Thermal nature


Neutral and warm


Organ network


Stomach, spleen, pancreas, lung


Flavor


Slightly sweet, bitter, acrid


Preparation methods


Raw, boiled


Fruit


Lemons, pears, apricots


Vegetables


Button or crimini/portobella mushrooms, fennel, radish, carrots, cauliflower, kohlrabi


Grains


Millet, rice, corn, oats


Spices


Ginger, aniseed, watercress, pepper


Nuts and seeds


Pine nuts, salted almonds, salted peanuts


Chronic Dry Cough

Lung Yin Vacuity with Dryness (Fei Yin Su, Fei Zao)

Symptoms


Persistent, dry, intense cough, little or no secretion, dry throat, thirst, fever in the afternoon, heat sensation in hands and feet.


Tongue: Red, dry, possibly thin, yellow fur


Pulse: Thin


Causes


Damage caused by external or internal heat, depletion of body fluids.


Therapy



Nourish yin


Dispel heat


Moisten dryness


image


image Avoid:


Acrid and hot foods.


image Recommended:











































Thermal nature


Neutral, cool, and cold


Organ network


Stomach, spleen/pancreas, lung


Flavor


Sweet


Preparation methods


Boiled, steamed, baked (au gratin)


Meat


Duck, pork


Fruit


Pears


Beverages


Pear juice, aniseed tea


Spices


Honey, aniseed, watercress


Dairy products


Butter, cream


Nuts and seeds


Almond butter, pine nuts, sesame, walnuts with honey, peanuts


Soy products


Tofu, soymilk


Other


Chicken eggs










image


Peanut milk, peanut butter, and almond butter mixed with honey, paste of ground pine nuts, almonds, and walnuts.


Main Symptom: Sore Throat
















Acute tonsillitis


Wind–heat invading the lung (feng re fan fei)


Acute laryngitis


Wind–cold fettering the lung (feng han shu fei)


Acute/chronic laryngitis


Dryness–heat damaging the lung (zao re shang fei)



According to TCM:


The most common cause of these disorders is attack of external pathogenic factors (wind–heat, wind–cold). Acute disorders are usually a repletion syndrome, whereas chronic illnesses generally appear as a vacuity syndrome. Acute disorders can be treated with good results by immediate application of acupuncture, nutritional therapy, and herbs.


Acute Tonsillitis

Wind–Heat Invading the Lung (Feng Re Fan Fei)

Symptoms


Painful reddened and swollen throat, burning pain, trouble swallowing, hoarseness, thirst, sometimes cough with thick yellow sputum; reddened swollen, possibly yellow–whitish tonsils.













Tongue:


Yellow fur


Pulse:


Superficial


Causes


Penetration of external wind and heat factors that deplete body fluids (summer heat, central heating, steel workers).


Therapy


Remove external pathogenic heat



Supplement lung


image


image Avoid:


Foods with sour flavor, for example lemon, poultry (they draw pathogenic factors deeper into the body); foods with hot and warm thermal natures (too drying).


image Recommended:












































Thermal nature


Cool and cold


Organ network


Lung, spleen/pancreas


Flavor


Mildly acrid (to expel pathogenic factors, but avoid creating heat), sweet (moistens)


Preparation methods


Raw, boiled, steamed


For cooling:


Fruit


Mulberries, watermelons, lemons, mangos


Vegetables


Dandelion, mung beans, radish, tomatoes


Beverages


Green tea


Grains


Wheat


Spices


Peppermint


To moisten dryness:


Fruit


Pears


Beverages


Pear juice, melon juice, tomato juice










image


Mixture of tomato and watermelon juices. For dryness, drink pear juice with honey. Gargle with or drink fresh juice of one to two lemons.


Acute Laryngitis

Wind–Cold Fettering the Lung (Feng Han Shu Fei)

Symptoms


Scratchy throat, hoarseness, weak cough with whitish sputum, aversion to cold.


Tongue: Thin, white fur


Pulse: Superficial


Causes


External wind–cold factors block qi, for example cold air, draft, air conditioners, cool storage rooms.


Therapy



Expel wind–cold


Supplement lung


image


image Avoid:


Raw, cool, and cold, as well as sour foods. Thermal nature: Hot for a short time, then warm, neutral.


image Recommended:

























Thermal nature


Hot for a short time; then warm, neutral


Organ network


Lung


Flavor


Acrid


Preparation methods


Boiled, steamed, fried


Vegetables


Green onions


Spices


Ginger, coriander, garlic, pepper, thyme, cinnamon


image This syndrome can quickly change into wind–heat. If this happens, adapt therapy immediately!










image


Decoction of fresh ginger and green onions


Acute/Chronic Laryngitis

Dryness in Lung

Symptoms


Acute or chronic dry sore throat, hoarseness, dry cough, dry skin.













Tongue:


Reddish


Pulse:


Fast


Causes


External dryness enters the lung, vacuity of body fluids, condition shortly before lung yin vacuity develops, dry surroundings, heated air.


Therapy



Moisten lung


Replenish fluids


image


image Avoid:


Acrid, sour, bitter foods with warm and hot thermal nature.


image Recommended:































Thermal nature


Neutral and cool


Organ network


Spleen


Flavor


Sweet


Preparation methods


Boiled, steamed


Fruit


Pears, honeydew melons


Vegetables


Eggplant, button mushrooms


Nuts and seeds


Peanuts, pine nuts


Soy products


Soy milk










image


Banana with honey (But not with phlegm conditions!)


Main Symptom: Frontal Sinusitis and Maxillary Sinusitis















Acute sinusitis


Wind–heat invading the lung


(feng re fan fei)


Acute/chronic sinusitis


Liver–gallbladder damp–heat


(gan dan shi re)


Recurrent sinusitis


Lung qi vacuity, spleen qi vacuity Damp–heat in spleen


(pi wei shi re)



According to TCM:


Belongs to the “bi yuan” category, which literally means “nose pond,” and refers to deep-source nasal congestion.


The main cause of sinusitis is repeated external attack of wind–heat or wind–cold (usually wind–heat). Sinusitis responds very well to acupuncture and herbal treatments, supported by dietary measures. Other causes of sinusitis are lung qi vacuity and spleen qi vacuity, both of which can be easily treated with nutritional therapy. Spleen qi vacuity, responsible for acute and chronic phlegm production, responds especially well to dietary measures.


Acute Sinusitis

Wind–Heat Invading the Lung (Feng Re Fan Fei)

Symptoms


Stuffy nose with white, mostly yellow secretion and crusting, partly blood-stained; headache, dry mouth, slight fever, aversion to wind.













Tongue:


Thin, yellow fur


Pulse:


Fast and superficial


Therapy



Expel wind–heat


Balance lung qi


image


image Avoid:


Foods with sour flavor, for example lemon, or poultry (which pull pathogenic factors deeper into the body), foods with hot and warm thermal natures (too drying).


image Recommended:









































Thermal nature


Cool and cold


Organ network


Lung, spleen


Flavor


Mildly acrid (to expel pathogenic factors, but avoid producing heat), sweet (to moisten)


Preparation methods


Raw, boiled, steamed


To cool:


Fruit


Mulberries, watermelons, pears, lemons, grapefruit


Vegetables


Dandelion, mung beans, radish, tomatoes


Grains


Wheat


Spices


Peppermint


For dryness:


Fruit


Pears


Beverages


Pear juice, tomato juice, melon juice













image


Juice mix made from tomatoes and watermelon


 


For dryness:


Pear juice with honey


Acute/Chronic Sinusitis

Liver–Gallbladder Damp–Heat (Gan Dan Shi Re)

Symptoms


Stuffy nose, dryness, sticky and yellowish purulent secretion; foul-smelling, bitter taste in mouth; dry mouth and throat, headaches.













Tongue:


Reddened on the side, yellow fur


Pulse:


Fast, lateral


Causes


Combination of external wind–heat, excess heat and phlegm-producing foods (e.g., fatty and fatty foods, alcohol abuse); emotional strain, such as anger, rage, stress.


Therapy



Dispel liver–gallbladder damp–heat


Promote downbearing of lung qi


image


image Avoid:


Thermally hot and warm foods, grilled food, acrid spices, alcoholic beverages, very fatty dishes, dairy products.


image Recommended:






































Thermal nature


Cool and cold


Organ network


Liver, gallbladder


Flavor


Bitter, salty, slightly sweet


Preparation methods


Raw, boiled, steamed


To disperse heat and remove dampness:


Fish


Crayfish


Vegetables


Bamboo sprouts, mung beans, dandelion, celery root (celeriac)


Beverages


Green tea


To disperse heat:


Vegetables


Bamboo shoots, Belgian endive hearts


Beverages


Gentian tea, green tea













image


Gentian tea, green tea


 


Pear juice with fresh lemon


Recurrent Sinusitis

Lung Qi Vacuity, Spleen Qi Vacuity

Symptoms


Stuffy nose, copious white–sticky or yellow–sticky viscous secretion, sometimes cough with watery or yellow–sticky sputum, loss of appetite, soft stools.













Tongue:


Slightly red, white fur


Pulse:


Weak and empty


Therapy



Supplement lung and spleen


image


image Avoid:


Raw, cool, or cold foods, and bitter flavor.


image Recommended:











































Thermal nature


Neutral and warm


Organ network


Lung, spleen


Flavor


Slightly acrid, slightly sweet


Preparation methods


Boiled, steamed, fried


Meat


Duck


Fish


Carp


Fruit


Grapes


Vegetables


Cauliflower, carrots, onions


Grains


Oats, short-grain (glutinous) rice


Spices


Aniseed, ginger, garlic, rosemary, thyme


Nuts and seeds


Chestnuts, almonds, black sesame, sunflower seeds, walnuts


Other


Alcoholic beverages










image


Congee (see p. 117) made with rice, onions, and ginger


image Avoid:


Raw, cold, and cool food, dairy products, excess sweets, excess meat.


image Recommended:


(see also “Lung Qi Vacuity,” p. 79)















































Thermal nature


Neutral and warm


Organ network


Spleen, heart, lung


Flavor


Slightly sweet, slightly bitter, slightly acrid


Preparation methods


Boiled, fried, steamed


To transform phlegm:


Fruit


Pears, cherries, apples


Vegetables


Leeks, radish


Grains


Millet


Spices


Ginger, garlic


To supplement spleen:


Meat


Poultry, beef


Vegetables


Fennel, carrots


Grains


Oats, millet, rice


Spices


Aniseed, basil, ginger, coriander, thyme


Recurrent Sinusitis

Damp–Heat in Spleen (Pi Wei Shi Re)

Symptoms


Stuffy nose with copious yellow, foul-smelling secretion; pressure in head, sensation of heaviness in head and limbs; bitter, sticky taste in mouth.













Tongue:


Yellow, sticky fur


Pulse:


Fast, slippery


Causes


External dampness and heat, nutritional errors (irregular eating, too many acrid and fatty dishes).


Therapy



Supplement spleen


Remove heat and dampness


image


image Avoid:


Raw, thermally hot and warm foods, excess sweets, dairy products, and alcoholic beverages.


image Recommended:




























Thermal nature


Cool, cold, and neutral


Organ network


Spleen


Flavor


Bitter


Preparation methods


Steamed, boiled


Vegetables


Artichokes, Belgian endive hearts, cucumbers, mung beans, celery


Beverages


Gentian tea, green tea, corn silk tea


Grains


Millet













image


Decoction of corn silk tea:


Steep about 50 g (1.5 oz) of corn silk in 1 L (four cups) of hot water; drink 1–2 L (four to eight cups) daily. Clears damp–heat and cools.


 


Decoction of corn silk tea and dandelion:


Steep about 50 g (1.5 oz) each of corn silk and dandelion in 1 L (four cups) of hot water; drink 1–2 L (four to eight cups) daily. Combining dandelion with corn silk increases the cooling and clearing effect of decoction.


Bronchial Asthma















Intrinsic (nonallergic) asthma


Phlegm–heat obstructing the lung (tan re zu fei)


Extrinsic (allergic) asthma


Wind–cold fettering the lung (feng han shu fei)


Chronic asthma


Lung qi vacuity and spleen qi vacuity


Lung qi vacuity and kidney yang vacuity



According to TCM:


Shortness of breath (qi chuan bing) with or without accompanying sounds (gasping [xiao] due to phlegm) and with or without dyspnea (chuan).


Acute bronchial asthma is often caused by pathogenic factors such as wind–cold, heat, and phlegm. A chronic course or remission signifies an underlying lung, spleen, or kidney vacuity. These syndromes often overlap. Consistent therapy combining acupuncture and herbs, supported by dietary measures and breathing exercise, for example qi gong, can produce good results.


Intrinsic (Nonallergic) Asthma

Phlegm–Heat Obstructing the Lung (Tan Re Zu Fei)

(Acute Heat-Type Asthma)

Symptoms


Thick yellow viscous sputum that is difficult to cough up, frequent flat respiratory sounds, hasty breathing, thirst for cold drinks, fever.













Tongue:


Yellow, sticky fur


Pulse:


Fast, slippery


Causes


Inappropriate nutrition leading to spleen qi vacuity, external wind heat factors.


Therapy



Transform phlegm


Cool heat inside lung


Stimulate qi coursing


image


image Avoid:


Cold and overly acrid foods, excess sweet flavor, excess dairy products and meat (promotes production of phlegm), foods of a hot thermal nature (e.g., acrid spices).


image Recommended:























































Thermal nature


Neutral and cool, small amounts of cold


Organ network


Lung, spleen


Flavor


Mildly acrid, mildly sweet


Preparation methods


Raw, steamed, braised, boiled


Transformation of hot phlegm:


Fruit


Pears, tangerines (peel), grapefruit (peel), lemons (peel preferably from organically grown fruit)


Vegetables


Bamboo sprouts, button or crimini/portobella mushrooms, dandelion, mung beans, radish, red marine algae (rhodophyta, red sea-weed, or dulse)


Clear heat in lung:


Fruit


Apples, pears


Vegetables


Seaweed, bamboo sprouts, watercress, Chinese (napa) cabbage, asparagus, radish, water chestnuts


Beverages


Peppermint tea


Grains


Pearl barley


Supplementing spleen:


Meat


Poultry, beef


Vegetables


Fennel, carrots, sweet potatoes


Grains


Millet, rice


Spices


Aniseed










image


Radish juice, pear juice with fresh lemon


Extrinsic (Allergic) Asthma

Wind–Cold Fettering the Lung (Feng Han Shu Fei) (Acute Cold-Type Asthma)

Symptoms


Often copious whitish, watery sputum, gasping breathing sounds, aversion to cold, scratchy throat.













Tongue:


White fur, damp


Pulse:


Superficial


Causes


External pathogenic wind cold binds qi in lungs, causing nondiffusion of lung qi; constitutional weakness.


Therapy



Expel of wind–cold


Transform phlegm


image


image Avoid:


Raw, cool, and cold foods, foods that cause phlegm (dairy products, sweets, meat).


image Recommended:




























Thermal nature


Warm and neutral, possibly mildly hot


Organ network


Lung


Flavor


Acrid


Preparation methods


Boiled, steamed, fried


Vegetables


Green onions


Grains


Oats


Spices


Aniseed, ginger, coriander, thyme










image


Decoction of fresh ginger and green onions


Chronic Asthma

Lung Qi Vacuity and Spleen Qi Vacuity

Symptoms


Copious white sputum, fatigue, swollen extremities, lack of appetite, bloating in epigastric region after eating.













Tongue:


Swollen, pale, white fur


Pulse:


Weak


Causes


Persistent cough, weakened lung qi, constitutional weakness, lack of exercise, inappropriate diet that weakens the spleen.


Therapy



Supplement lung and spleen


image


image Avoid:


Raw, cool, and cold foods, dairy products, excess sweet, excess meat.


image Recommended:


(see also “Lung Qi Vacuity,” p. 79)










































































Thermal nature


Neutral and warm


Flavor


Slightly acrid, slightly sweet


Organ network


Lung, spleen


Flavor


Mildly acrid, mildly sweet


Preparation methods


Boiled, steamed, fried


Meat


Duck


Fish


Carp


Fruit


Grapes


Vegetables


Cauliflower, carrots, onions


Grains


Oats, short-grain (glutinous) rice


Spices


Aniseed, ginger, garlic, rosemary, thyme


Nuts and seeds


Chestnuts, almonds, black sesame, sunflower seeds, walnuts


Other


Alcoholic beverages


To transform phlegm:


Fruit


Pears, cherries, apples


Vegetables


Leeks, radish


Grains


Millet


Spices


Ginger, garlic


To supplement spleen:


Meat


Poultry, beef


Vegetables


Fennel, carrots


Grains


Oats, millet, rice


Spices


Aniseed, basil, ginger, coriander, thyme










image


Congee (see p. 117) made with rice, onions, and ginger


Chronic Asthma

Lung Qi Vacuity and Kidney Yang Vacuity (Kidney is Unable to Receive Qi)

Symptoms


Cough, dyspnea, predominantly during inhalation (which is governed by the kidneys), dizziness, listlessness, clear urination during asthma attack, pain and weakness in knees and back.













Tongue:


Moist, swollen, and pale


Pulse:


Weak


Causes


Long-lasting chronic illnesses that weaken lung and kidney; inherited vacuity of the organ networks, excessive tension and strain. Because of kidney qi vacuity, the downbearing qi of the lungs can not be received, and accumulation of qi leads to a repletion condition, with fullness in the chest and dyspnea.


Therapy



Supplement and warm kidneys


Supplement lung


image


image Avoid:


Excess hot and acrid foods as well as raw, cold, and cool foods.


image Recommended:





















































Thermal nature


Warm and a little hot, neutral


Organ network


Kidney, lung


Flavor


Salty, bitter


Preparation methods


Boiled, baked, fried, and grilled


To supplement and warm kidneys:


Meat


Chicken, lamb, venison


Fish


Mussels, shrimp, oysters


Fruit


Raisins, grapes, cherries


Vegetables


Fennel


Grains


Oats, corn


Nuts and seeds


Chestnuts, walnuts


To supplement and downbear lung qi:


Meat


Pork, duck


Fish


Mussels, pollack, carp, squid


Vegetables


Cauliflower, olives, onions


Other


Salted almonds


Gastrointestinal Disorders


Main Symptom: Diarrhea


















Acute and chronic diarrhea


Stomach qi and spleen qi vacuity


Stomach yang and spleen yang vacuity


Large intestine qi and yang vacuity


Acute/chronic diarrhea


Damp–cold encumbering the spleen


(han shi kun pi)


Infectious enteritis/traveler’s diarrhea


Damp–heat in spleen or large intestine


Chronic morning diarrhea


Spleen yang and kidney yang vacuity


(“fifth watch diarrhea”)



According to TCM:


“Xie xie” means “flow discharge” and indicates soft and watery stools. This condition generally responds well to nutritional therapy, acupuncture, and possibly herbal therapy. Supplementing the center burner is also important.


image General Nutritional Therapy


Rice, short-grain (glutinous) rice, millet, blueberries, button or crimini/portobella mushrooms, shredded apple; cooked, warm food.


Acute and Chronic Diarrhea

Stomach Qi and Spleen Qi Vacuity Stomach Yang and Spleen Yang Vacuity Large Intestine Qi and Yang Vacuity

Symptoms


Usually chronic diarrhea, watery and soft stools with undigested food particles, bloating after meals, improvement with pressure and warmth, flatulence after meals, physical weakness, lack of appetite.













Tongue:


Pale, swollen with impressions


Pulse:


Weak


Causes













Diet:


Inappropriate diet that is too thermally cold, irregular meals.


General:


Excessive worries, mental overexertion.


Therapy



Supplement spleen and stomach


image


image Avoid:


Raw and thermally cool or cold foods (salads, fruit, fruit juices), dairy products, denatured foods, frozen food, canned food.


image Recommended:


Boiled or steamed warming foods that build up spleen and stomach, combined with mildly acrid spices.































Thermal nature


Warm, neutral, possibly initially hot for a brief period


Organ network


Spleen, stomach


Flavor


Sweet–warm, sweet–neutral, possibly sweet–hot (briefly)


Meat


Poultry, beef


Fruit


Steamed apples, blueberries


Vegetables


Fennel, pureed carrots, button or crimini/portobella mushrooms, possibly some honey or brown sugar


Beverages


Fennel tea


Grains


Rolled oats, millet, rice, rice soup, short-grain (glutinous) rice with cinnamon and honey, slightly acrid rice dishes (warming effect)
















image


Boiled millet porridge with cinnamon and raisins;


 


Rice cooked for a long time, with apple and cinnamon;


 


Carrot congee (see p. 117).


Acute/Chronic Diarrhea

Damp–Cold in Spleen or Large Intestine

Symptoms


Tendency to clear watery stool with undigested food particles, gurgling bowel sounds; improvement of stomach aches with warmth, worsening with pressure; aversion to cold, headaches, sensation of heaviness.













Tongue:


White fur, moist, possibly slimy


Pulse:


Slow, slippery


Causes













Diet:


Excess cold foods (e.g., ice tea) is a common cause of diarrhea in children during summer.


General:


Penetration of external cold and dampness (e.g., too much time spent in the swimming pool, wet clothes).


Therapy



Expel cold


Warm center burner


image


image Avoid:


Raw, cold, and cool foods.


image Recommended:































Thermal nature


Warm to hot, neutral


Organ network


Earth


Flavor


Sweet–warm, bitter–warm


Preparation methods


Boiled; steamed, possibly with alcohol; warming spices (e.g., ginger, pepper).


Vegetables


Fennel, carrots, sweet potatoes


Beverages


Fennel tea, spiced tea, coffee with cardamom


Grains


Oats, millet, rice with mildly acrid spices


Spices


Aniseed, chili, ginger, pepper, licorice, cinnamon
















image


Ginger tea with cinnamon bark;


 


Coffee with cinnamon or cardamom;


 


Cinnamon rice with steamed apples.


Infectious Enteritis, Traveler’s Diarrhea

Damp–Heat in Spleen or Large Intestine

Symptoms


Watery, soft, and foul smelling to stinking stools, tenesmus (constant feeling of the need to empty the bowel, accompanied by pain, cramping, and involuntary straining efforts), possibly bowel movement with blood, stomach aches that improve after bowel movement, hot burning sensation around anus, sparse dark urine, thirst.













Tongue:


Thick, yellow fur, possibly slimy


Pulse:


Fast and slippery


Causes










Diet:


Inappropriate or spoiled foods.


General:


Infections, penetration of external heat, and dampness into intestines.


Therapy



Dispel heat


Dry dampness


image


image Avoid:


Acrid, hot, and fatty foods.


image Recommended:








































Thermal nature


Cool, cold, and neutral


Organ network


Earth


Flavor


Sweet, bitter


Preparation methods


Raw, boiled, steamed


Fruit


Bananas, pears, honeydew melons, oranges, cranberries


Vegetables


Eggplant, bamboo sprouts, cucumbers, spinach, mung beans, dandelion


Beverages


Green tea, black tea, chamomile tea, wheat beer


Grains


Amaranth, corn


Spices


Yellow gentian


Dairy products


Yogurt


Soy products


Soy yogurt, tofu










image


Increase consumption of green or black tea and dried cranberries


Chronic Morning Diarrhea

Spleen Yang and Kidney Yang Vacuity

Symptoms


Chronic morning diarrhea! Stomach aches that improve with warmth, cold extremities, weakness in back and knees.













Tongue:


Pale, impressions


Pulse:


Weak, deep


Causes










General:


Overwork, long-lasting illness, emotional stress, dissipated sex life, many births, exposure to cold.


Therapy



Warm kidneys


Supplement spleen


image


image Avoid:


Raw, cool, and cold foods.


image Recommended:





































Thermal nature


Warm to hot (briefly), neutral


Organ network


Kidney, spleen/pancreas


Flavor


Slightly salty, sweet


Preparation methods


Steamed, boiled, fried


Meat


Lamb, chicken


Fruit


Raisins, cherries


Vegetables


Fennel, leeks, carrots


Grains


Oats, short-grain (glutinous) rice, corn, millet


Spices


Aniseed, cinnamon, pepper, ginger


Nuts and seeds


Walnuts, chestnuts










image


Master Soup three times a week. Suggested ingredients: carrots, leek, beef, ginger, etc.


Main Symptom: Constipation


















Constipation in elderly patients, postnatal constipation


Qi vacuity or yang vacuity


Constipation primarily in elderly patients


Yin vacuity


Constipation caused by stress or travel


Liver qi stagnation


 


Chronic internal heat or heat in stomach and large intestine



According to TCM:


Infrequent bowel movements, abnormal stool shape, dry stools.


image Responds very well to consistent dietary therapy, and also to combination of acupuncture and herbal therapy.


image General Nutritional Therapy


Give preference to fruits and vegetables rich in fiber.


Constipation in Elderly Patients and Postnatal Constipation

Qi Vacuity or Yang Vacuity

Symptoms


Thinly formed, long stools; exertion and exhaustion after defecation, pale face, cold extremities. Seen especially in elderly patients and post-partum.











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Jun 13, 2016 | Posted by in ENDOCRINOLOGY | Comments Off on Clinical Examples

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Tongue:


Pale, swollen, moist


Pulse: