Dryness evil invading the lung

Also dryness qì damaging the lung (燥气伤肺 zào xié fàn fèi).

A disease pattern chiefly characterized by cough with little or no phlegm; dry nose, pharynx, mouth, and tongue; exterior signs (heat effusion and aversion to cold).

Description: Dry cough without phlegm or with scant phlegm that is difficult to expectorate; in severe cases, phlegm streaked with blood, chest pain; in some cases, nosebleed; dry mouth, lips, nose, pharynx, and skin; scant urine; bound stool; thin tongue fur with little liquid; in some cases, slight heat effusion and aversion to cold; a pulse that is floating and rapid or floating and tight.

Diseases: Cough; dispersion-thirst.

Pathogenesis: Dryness evil invading the lung and causing non-diffusion of lung qì.

In China, dryness evil is most prevalent in autumn. Distinction is made between warm dryness and cool dryness. Warm dryness occurs at the beginning of autumn and represents a combination of dryness and heat, and hence is similar to wind-heat. Cool dryness, which is less common, occurs at the end of autumn and represents a combination of dryness and cold and hence is similar to wind-cold fettering the lung. Despite the similarities, dryness signs predominate.

Analysis of signs

• Non-diffusion of lung qì: Dry cough.
• Damage to network vessels: In severe cases, dryness damages the network vessels of the lung, giving rise to phlegm streaked with blood, chest pain, or nosebleed.
• Dryness: Scant sticky phlegm and dry lips, tongue, pharynx, and nose; scant urine; bound stool.
• Exterior: Mild heat effusion with aversion to cold.
• Tongue: Red with thin yellow or thin white fur.
• Pulse: Floating and rapid (warm dryness) or floating and tight (cool dryness). A floating pulse reflects exterior evil. A rapid pulse reflects heat. A tight pulse reflects cold.

Comparison: See table.

Treatment

Medicinal therapy: For warm dryness, clear heat and moisten dryness; relieve cough and transform phlegm using sāng xìng tāng (桑杏汤 Mulberry Leaf and Apricot Kernel Decoction) or, for mild cases, qīng zào jiù fèi tāng (清燥救肺汤 Dryness-Clearing Lung-Rescuing Decoction). For cool dryness, disperse cold, moisten dryness, and transform phlegm, using xìng sū sǎn (杏苏散 Apricot Kernel and Perilla Powder).

Acumoxatherapy: Base treatment mainly on LU, LI, and KI. Needle BL-13 (Lung Transport, 肺俞 fèi shù), LU-5 (Cubit Marsh, 尺泽 chǐ zé), LU-7 (Broken Sequence, 列缺 liè quē), and LI-4 (Union Valley, 合谷 hé gǔ), applying a draining stimulus. Needle KI-6 (Shining Sea, 照海 zhào hǎi) with a supplementing stimulus. For generalized heat and aversion to cold, drain BL-12 (Wind Gate, 风门 fēng mén), GB-20 (Wind Pool, 风池 fēng chí), and BL-11 (Great Shuttle, 大杼 dà zhù).

Comparison: Wind-heat invading the lung: Dryness evil invading the lung is characterized by cough without phlegm or with scant phlegm and by dry lips, tongue, pharynx, and nose. Wind-heat invading the lung is marked by pronounced heat effusion and mild aversion to cold. Lung yīn vacuity: Cough and scant sticky phlegm that is not easily expectorated are observed in both dryness evil invading the lung and in lung yīn vacuity. However, lung yīn vacuity has yīn vacuity with effulgent fire signs such as postmeridian tidal heat, and vexing heat in the five hearts. Dryness evil is marked by exterior signs such as aversion to cold with heat effusion. See autumn dryness.