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Symptoms: Cough, panting and shortness of breath aggravated on exer- tion, chest distension, white and thin sputum, reduced food intake and lassitude; white, thin and greasy tongue coating, as well as taut and slip- pery pulse; these symptoms are mostly present in cases of pulmonary functional defect with respiratory tract infection.

Analysis of symptoms: Prolonged affliction debilitates the lungs and spleen, resulting in reduced food intake and lassitude; insufficiency of healthy qi, coupled with invasion of pathogenic cold, leads to stagnation of lung qi and upward flow of turbid phlegm, manifesting as cough, pant- ing and excessive sputum; deficiency of the lungs is complicated by inhi- bition of qi movements due to phlegm, resulting in chest distension, cough and shortness of breath aggravated on exertion; the white, thin and greasy tongue coating, as well as taut and slippery pulse are manifestations of internal obstruction of cold phlegm.

2. Accumulation of heat-phlegm in the lungs

Symptoms: Cough with panting, yellow and thick sputum that is difficult to be expectorated, dry stools, yellowish or reddish urine and dry mouth; red tongue with yellow coating or yellow greasy coating, slippery and rapid pulse or rapid and taut pulse; these symptoms are commonly present in cases of pulmonary functional defect with respiratory tract infection. Analysis of symptoms: Turbid phlegm accumulates in the lungs and trans- forms into heat, resulting in yellow and sticky sputum; the lung qi rises upward, presenting as accelerated breathing; heat consumes body fluid and the lungs fail to distribute this heat, with such signs as dry mouth and yellowish or reddish urine; the lungs are interiorly and exteriorly associ- ated with the large intestine, so disorder of the lungs affects the large intestine, leading to dysfunction of the large intestine in transportation and transformation, this is marked by dry stools; red tongue with yellow or yellow-greasy coating and rapid-taut pulse or rapid-slippery pulse are manifestations of internal accumulation of phlegm and heat.

3. Clouding of the upper orifi ces by phlegm

Symptoms: Absent-mindedness, restlessness, apathy, lethargy and even coma, spasms of the limbs, cough, panting and expectoration of sputum; dark red or light purple tongue with white greasy or yellow greasy coating and thin, rapid and slippery pulse; these symptoms are mostly seen in pulmonary encephalopathy.

Analysis of symptoms: Phlegm obstructs the heart orifices as well as qi movements, resulting in symptoms such as absent-mindedness, restless- ness, apathy, lethargy and even coma; turbid phlegm stirs the liver wind, manifesting as limb spasms; turbid phlegm obstructs the lungs and causes adverse rising of qi, with cough, panting and expectoration of sputum; dark red or light purple tongue is a sign of blood stasis in the heart, while white greasy or yellow greasy tongue coating, as well as thin, rapid and slippery pulse is suggestive of internal accumulation of turbid phlegm.

4. Qi defi ciency of the lungs and kidneys

Symptoms: Cough with shortness of breath, aggravated upon physical exertion or even with opened mouth, raised shoulders and inability to lie flat, white and thin sputum with no strength to expectorate, chest distress, palpitations and sweating; pale or dark tongue and thin, rapid and deep pulse or knotted and intermittent pulse.

Analysis of symptoms: The deficient lungs fail to govern qi and defi- cient kidneys fail to receive qi, leading to shortness of breath, aggra- vated upon physical exertion or even with opened mouth, raised shoulders and inability to lie flat; insufficient lung qi fails to distribute body fluid, resulting in cough that is ineffective in removing sputum; the lung disease affects the heart and leads to deficiency of heart qi and inhibition of qi movements, with such signs as chest distress, palpita- tions and sweating; insufficient qi fails to promote the circulation of blood, bringing about pale or dark tongue; the thin, rapid and deep pulse or knotted and intermittent pulse is suggestive of deficient lung qi and kidney qi with blood stasis.

5. Yang defi ciency of the spleen and kidneys

Symptoms: Facial edema and swollen limbs, palpitations, cough, panting, expectoration of clear and thin sputum, gastric stuffiness, poor appetite, cold body and limbs, weakness and soreness of the waist and knees, clear and profuse urine, loose stools; dark and enlarged tongue, white and slip- pery coating, as well as thin and deep pulse.

Analysis of symptoms: Weakness of yang qi brings about overflowing of water, marked by facial edema and swollen limbs; water and fluid attack the heart and lungs, leading to palpitations, cough, panting and expectora- tion of clear and thin sputum; deficiency of spleen yang gives rise to gastric stuffiness, poor appetite and loose stools; deficiency of kidney yang is responsible for the cold body and limbs, weakness and soreness of the waist and knees, as well as clear, profuse urine; dark and enlarged tongue with white and slippery coating, as well as thin and deep pulse are indicative of yang deficiency, water retention and blood stasis.

Differential Treatment