Richard Mandelbaum RH

March 2017

Chinese Herbalism
Common Patterns of Disharmony

Read this first! (no really read this)

• Patterns and herbs used are not intended to be comprehensive but to give a general
introduction.
• Many other herbs not listed here would be considered for an individual based on
specific indications. The herbs listed are meant as a starting point and to give the
reader an idea of what types of herbs can be applied to a particular pattern.
• A deeper understanding will lead one to being able to apply any herbs to this system;
non-Chinese herbs can be added that match the same patterns and energetics.
• Rarely does someone fit neatly into a single pattern!
• One characteristic does not make a pattern. Think of components of a given
pattern as clues you are using to build a case. When is the evidence sufficient? This
varies and involves some subjectivity, but the more experience you have the more you
will gain confidence.
• Complete or near-complete patterns are more severe and pronounced conditions;
in practice one often sees parts of patterns as a condition develops.
• Use great caution in trying to equate Western physiological conditions to patterns of
disharmony in any 1:1 manner; meaning, don’t do it. Rabbit holes abound! This is
distinct from seeing recurring correlations and overlaps between the two systems,
which can be important to pay attention to.
• In cases of combined patterns, the tongue and pulse can point to what is most
underlying or fundamental.

Yin Organ Pages

Heart 2-6
Kidney 7-12
Liver 13-17
Spleen 18-22
Lung 23-26

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HEART PATTERNS

Fire and Heat are most injurious to the Heart.

The Heart rules the Blood.
The Heart is less prone than other organs to Exterior/external patterns.

Emotional links:
The Heart houses the Shen (Mind), which is closely linked to the heath of the Qi and the
Jing
Some patterns include:
• Sadness can cause deficient Lung Qi and then eventually deficient Heart qi, and can
lead to qi stagnation which causes Heart fire.
• Anger causes Liver fire to rise which goes first to Heart, and can settle there.
• Some attribute Bladder imbalances with jealousy, suspicion, and holding of grudges.

In general with Heart Patterns:

Heart Yin: Calm spirit, steady, smooth pulse
Heart Yang: Active spirit, strong, forceful pulse

Deficiency = palpitations, anxiety (blood deficiency), sadness (qi deficiency), forgetfulness,

confusion, insomnia, cold or deficiency heat (vacuity heat)
Eat more cooked foods, meats, reduce cooling foods
Warming qi and blood tonics: ginseng, dang gui, dang shen, cooked Rehmannia, cinnamon,
ginger, Zanthoxylum, Capsicum

Excess=stress, mania, irritability, agitation, heat

Heat can arise from Excess Fire or from Stagnant Qi (Liver)
Avoid meats, limit heavy fats, eats lots of fresh veggies and fruit, cooling bitter foods
Herbs that are detoxifying, bitter, cooling, and cholagogue: huang qin, Coptis, Pueraria

Excess and Deficiency can appear to be concurrent for instance in cases of Deficient Heart
Yin leading to Vacuity Heat / False Heat – in which case, clear the Heat but also build Yin

To calm the Shen: Reishi, Albizia, Zizyphus, Poria, Polygala, Crataegus, Leonurus,
Selenicereus, Tilia, Melissa, Ocimum, Passiflora, Avena, Scutellaria, Piper methysticum,
other nervines

Deficient Heart Qi
Often with deficient Lung Qi and generalized Qi deficiency or deriving from Deficient Heart
blood; also sometimes with Deficient Spleen Qi
This pattern very often has emotional components if not causation; prolonged sadness can
damage the Lungs and then in turn the Heart, leading to depression.
If prolonged Qi will stagnate, generating Heat.
• Sometimes unrooted / Disturbed Shen; dementia and cognitive dysfunction
• Palpitations upon exertion

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• Chronic illness, sweating

• Pallor, fatigue, shortness of breath
Pulse: empty, weak, especially on first position on both wrists (Heart and Lung)
Tongue: normal color, midline crack to tip, tip may be indented, may be swollen on both
sides of center
Eat more cooked foods, increase physical activity
Herbs: Panax, Glycyrrhiza (baked is best), Crataegus, Selenicereus, Leonurus, Lycopus,
Hypericum, Valeriana, Piper methysticum, Actaea racemosa all regulate Heart Qi
Codonopsis if heat is present
Plus other cardiotonics and nervines

Deficient Heart Yang

Deficient Heart Qi (see all above signs) but more serious and deeper; with cold signs
Often with Deficient Kidney yang – “Water Insulting the Heart”
Often correlates to congestive heart disease
• Cold, cold limbs
• Spontaneous or excessive daytime sweating
• Shortness of breath, palpitations upon exertion, chest pain/discomfort
• Fatigue
• Bright pale face
Pulse: deep, weak, knotted (slow and stopping occasionally)
Tongue: pale (sometimes dark purple), wet, swollen
Use warming foods and herbs, cooked food
Herbs: Zingiber, Cinnamomum, Panax, Crataegus, Selenicereus, Albizia
(Collapsed Heart Yang is more acute and serious, always with an underlying Deficient
Kidney Yang: severe, shortened tongue, hidden pulse, cyanosis, coma, cardiac failure)

Deficiency of Heart Blood

(Distinguish this pattern from deficient Liver blood although both can occur together)
• Palpitations with anxiety (not just with physical exertion)
• Anxiety, restlessness, difficulty falling asleep, poor memory, dull thinking,
dizziness
• Affects thought, memory, sleep, especially in evening
• Cold extremities, lack of blood supply to other organs
• Deficient Heart blood leads to an unrooted Shen: excessive or disturbing dreams,
insomnia
• Can eventually lead to deficient Heart Qi
• More common in younger people especially women
• Pale lips and dull pale complexion
• Causes: Deficient Spleen Qi producing insufficient Blood, Liver Blood deficiency,
blood loss, mental strain, anxiety, worry, not enough Blood-nourishing foods, in rare
cases loss of blood from hemorrhaging (such as in post-partum depression)
Tongue: pale, thin, slightly dry
Pulse: fine, weak, irregular / choppy

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Herbs: Panax, Astragalus, Ganoderma, Dang Gui, Atractylodes, Poria, Polygala, Zizyphus,
Zingiber (fresh), Rehmannia (cooked), Urtica, Avena, Crataegus, Selenicereus, Leonurus,
Lycopus, Vaccinium fruit, Passiflora, Eschscholzia

*Look to Spleen Qi – weakened Spleen does not produce sufficient Blood.

To tonify Spleen: Panax, Astragalus, Withania, Eleutherococcus, Ganoderma,

Deficient Heart yin

Heart Blood Deficiency at a deeper level: Deficient Blood together with deficient yin -
resulting in false heat signs.
Sometimes referred to as the “Heart Feeling Vexed”.
Usually also occurs with Kidney Yin deficiency: insufficient fluids from Kidney to cool the
Heart. Excess worry can consume Fluids, leading to dryness.
• Difficulty falling asleep and staying asleep, disturbed dreams
• Dry mouth, thirst
• Palpitations, mental restlessness
• False heat signs: five-center heat, Malar flushes, restlessness, night sweats, low
grade fever, hot hands, feet and chest, mouth sores
• Over-activity / never slowing down or resting, anxiety, fidgety, easily startled
• Often older people but can happen in younger people from excessive mental strain
• Signs of heat: low grade fever, night sweats
Tongue: peeled, dry, red, especially tip and papillae, deep central crack reaching tip
Pulse: rapid, and empty or thin; may also be weak in K position and floating / overflowing
in Heart and Lung positions.
Foods: more protein, both raw and cooked foods
Encourage sleep, gentle exercise, slowing down, meditation
Herbs: Platycodon, Angelica sinensis, Ophiopogon, Salvia miltiorrhiza, Schisandra, Poria,
Polygala, Selenicereus, Avena, Ocimum, Leonurus, Scutellaria lateriflora
With False Heat: Raw Rehmannia, which builds yin and clears heat; Selenicereus,
Eschscholzia, Leonurus, Paeonia suffruticosa,

Heart Fire
Sometimes called “Heart Fire Blazing”
True HEAT; can arise from deficiency and stagnation of Heart Qi.
• If sadness: often prolonged sadness or depression affecting both Lungs and Heart
• If anger: look for Liver Fire or Yang
• Reddened face / complexion (entire face not just flushing)
• Agitation, anxiety
• Palpitations
• Thirst, dry mouth
• Poor sleep, waking up frequently in the night
• Bitter taste in mouth
• Red, irritated tongue and mouth ulcerations
Pulse: rapid, full, especially in the Heart position

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Tongue: red, red/swollen tip, midline crack, yellow coating; with Liver Yang or Fire: red
sides
Use cooling herbs and foods: fresh fruits and vegetables, bitters, limit heavy fats and
animal foods
Herbs: Codonopsis, Coptis, Leonurus, Lycopus, Platycodon, Ganoderma, Crataegus,
Leonurus, Selenicereus, Gentiana, Theobroma, Humulus, Scutellaria, Eschscholzia,
Lactuca, Verbena, Salvia miltiorrhiza

Congealed / Stagnant Heart Blood

Not a stand-alone pattern; underlying Heart Fire, or Deficiency of Qi, Yang, or Blood
eventually can lead to this – this is mainly a final more severe stage of other Heart
disharmonies.
Prolonged sadness and depression can lead to qi stagnation which leads to Heat
Anger and Fire from the Liver can also stagnate Blood
• Palpitations
• Chest pain
• Long term emotional issues: repressed anger, anxiety, resentment, grief
• Sometimes signs of pain, cold pain
• Cold, cold hands
• Cyanosis/ pale blue to bluish-purple complexion
• Can manifest as angina, coronary artery disease
Tongue: purple
Pulse: knotted (slow and sputtering)
Treat as Heart Blood deficiency
Herbs: Raw Rehmannia, Angelica sinensis, Carthamus, Glycyrrhiza,
Crataegus, Aesculus, Hamamelis, Arnica, Rosmarinus, Ganoderma, Theobroma, Albizia,
Arnica* (caution)
With angina/pain: Salvia miltiorrhiza, Pueraria, Panax notoginseng, Selenicereus, Actaea
racemosa

Mucus Obstructing the Heart Orifices

Often divided into distinct patterns:
-Phlegm misting or Invading the Mind – generally without signs of Heat
-Phlegm-Fire Harassing the Heart
• Can be cold or hot
• Deficient Spleen Qi
• More severe Shen / mental disturbance
o scolding, talking to oneself or the opposite / aphasia
o including dementia, bipolar, psychosis, schizophrenia, violence
• Can be seen in some infectious states (Lyme)
Pulse: slippery; hot or cold but always full
Tongue: sticky coating, hot or cold, red swollen tip, red raised spots
Herbs: Poria, Ganoderma, Citrus, Acorus, Cyperus, Zizyphus, Rosmarinus, Actaea
racemosa
If hot add: Platycodon, Scutellaria baicalensis, Coptis, Leonurus, Verbena, etc.
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Combined patterns:
• It is common to have Deficient Lung Qi and Heart Qi together: sadness can cause
deficient Lung Qi and then eventually deficient Heart Qi, and can lead to qi
stagnation which causes Heart Fire. In turn Heart Fire can dry up the Lungs
resulting in dry cough, thirst, dry throat
o Shortness of breath, palpitations, fullness and congestion in the chest, cough,
fatigue, sweating
o Purple lips, normal to purplish tongue
o Empty weak pulse in both upper positions
• Spleen: Heart and Spleen nourish each other. Spleen provides Grain Qi to the Heart
to make blood. Weak Spleen Qi will result in Deficient Blood. Heart Blood in turn
nourishes the Spleen.
o Deficient Heart Blood and Deficient Spleen Qi: Spleen creates Blood and moves
fluids.
Insomnia, lassitude and lethargy, anorexia, palpitations, worry
Pale face
Fine, choppy pulse
Pale tongue
• Liver/GB: Provide the Mind with the courage to make decisions.
o Liver Yang or Fire Rising and Heart Fire or Deficient Heart Yin: Anger and Heat
causes Liver fire to rise which goes first to Heart and can settle there and cause
damage.
o Deficient Liver blood can lead to Deficient Heart Blood: insomnia, excessive
dreaming, palpitations
o Liver Qi stagnation can weaken the Mind
• Heart and Kidneys balance each other
o Fire Water
o Mind Essence
o Upper Burner Lower Burner
o Yang Yin
Kidney and Heart patterns: Healthy Kidneys provide cooling water element to the
Heart and prevents excess Heat. The Heart in turn provides heat to warm the
Kidneys.
o Heart and Kidney Yang Deficiency: cold, deep weak pulse, pale wet tongue.
Deficient Kidney Yang can also lead to Dampness Invading the Heart.
o Heart and Kidney Yin Deficiency: empty heat, floating, empty, rapid pulse,
tongue with red tip, peeling or cracked especially along the center

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KIDNEY PATTERNS

In general Dryness and Cold tax the Kidneys, whether External (weather, etc.) or Internal in
Origin (other organ disharmonies).
Deep-seated, congenital, and chronic illness generally express as Kidney disharmony.

Emotional Links:
• Kidneys are our source of Zhi / Will and will power.
• Fear / lack of self-confidence damages the Kidneys, in turn malnourishing the Liver
and leading to anger and resentment.
• Lack of emotional nurturing and support “to be oneself” can deplete Essence and
self-confidence, leading to fear and insecurity.
• This depletion of Essence which is a yin substance, leads to excess Fire in the Liver
and then Heart, resulting in testiness and aggression. Another way to look at this is
that this lack of emotional support to be who one is, can lead to aggressive
overcompensation, i.e. fiery behavior.

In general with Kidney Patterns:

• Kidney imbalances are generally Deficiencies of yin, yang, or both, not Excess.
• Kidneys provide Moisture and Warmth to all Organs, and are the source of Yin and
Yang of all organs. Therefore a weakness or disharmony in the Kidneys eventually
will damage other Organs, and vice versa. For this reason, Kidney patterns of
disharmony frequently involve other organs.
• Disharmonies of ageing, maturing, reproductive and sexual vitality, and overall
vitality are often Kidney imbalances.
• Likewise, deep-seated, chronic or long-standing disharmonies of other organs also
include Kidneys most of the time.
• Kidney yin and yang are interdependent and as Maciocia writes, “are fundamentally
one”. So we generally tonify both at once; many herbs are tonics to both at once but
pay attention to the need for warming vs. cooling herbs.
• Yin or Yang will always be more predominantly deficient in a given person.
• Kidneys house the Essence / pre-Heaven Qi, which is considered more of a yin
substance / fluid
• We can deplete Essence with poor sleep, emotional and/or physical stress, unhealthy
food, sexual excess, excessive work. Essence depletion is more closely associated
with Yin depletion but can often be indicative of both Yang and Yin depletion.

Deficient Kidney Yin:

Generally with leaking and depletion of Essence/Jing
A dry state, with empty heat when more severe
Often with Deficient Lung or Deficient Liver Yin and/or Blood
Excessive work, especially mental overwork, or sexual activity, chronic illness can damage
yin
• Fatigue but with signs of heat
o sweating, thirst, sweaty palms or feet: five-centered heat
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o night sweats, insomnia (waking up in the night), nervousness, anxiety

• “Workaholic” tendencies, overworked, under constant stress
• thin or emaciated
• inflammation esp in extremities: yin deficient sore throat, UTI or inflammation
• dry mouth, dry throat, thirst, constipation, scanty dark urine
• dry skin, hair, dry red face
• slight dizziness, vertigo, gradual, slow onset tinnitus, deafness
• poor memory
• premature hair loss or greying hair
• back ache, aching bones
• low sperm count or motility, insufficient or nutrient-deprived seminal fluid (low
seminal volume), premature ejaculation
• perimenopausal complaints including dry and brittle hair, skin, vaginal dryness, low
libido, false heat manifesting as hot flashes, night sweats, etc.
• constipation
• low tolerance for stress (physical or psychological)
• Heat can create Wind patterns in Middle and Upper Burners
• If false heat is predominant:
o Heightened libido with lack of fulfillment or satisfaction, sexual dreams and
nocturnal emissions
o Can sometimes be arrogant
• Can be associated with H-P-A dysregulation with depleted cortisol levels.
Pulse: rapid, weak, thready, or fine
Tongue: red all over with light or no coating (peeled), cracks
Eat more yin foods: oils, fats, animal foods, okra, nuts; ghee is best as it nourishes yin
without being heating
Herbs: yin tonics that are demulcent and astringent to prevent leakage of Essence
Mulberry fruit is a kidney yin tonic for premature graying of hair, tinnitus, dizziness,
insomnia:
Malva, Althaea, Avena, Panax quinquefolius, Polygonum (he shou wu), Eclipta, and
Ligustrum (privet), Lycium, Schisandra, Cornus, Rehmannia, Dipsacus, Serenoa, Zea,
Trifolium, Ulmus, Mitchella, Actaea, Paeonia lactiflora and P.suffruticosa, Ophiopogon,
Poria, Cordyceps, Selenicereus

Severe Deficient Kidney Yin - Empty Fire Rising or Blazing: dryness, mental restlessness
and anxiety, falling asleep easily but waking in the night, malar flush, low grade fever, dry
throat, night sweats.
Rapid empty pulse and peeled, red, cracked tongue.

Deficient Kidney Essence (Jing)

Manifests similar to Deficient Kidney yin but sometimes without overt heat
*However, often concurrent with Deficient Yin as well as sometimes Yang
• Can be a congenital or inherited condition or disharmony
• Stasis of Essence can lead to impotence, premature greying of hair, testicular and
perineal pain, sperm irregularities, discharge.
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• Children: poor bone development, mental dullness or lack of development

• Adults: weak knees, hair falling out or turning grey, sexual dysfunction including
infertility, bad or loose teeth, brittle or weak bones, sore back, premature senility and
aging
• Key symptoms: prematurely graying hair, loss of hair, sexual dysfunction, weak
knees
Pulse: floating, empty – hollow to spreading in more severe cases: weak, and dissipating
with pressure irregular and choppy if there is stasis of Essence – but can manifest with
more Yang deficiency
Tongue: red and peeled, purple if there is stasis of Essence – but can manifest with more
Yang deficiency
Eat foods that are sweet and rich in oils, healthy fats: nuts, especially walnuts are a Kidney
yang and Jing tonic
Herbs: other Kidney nourishing herbs, Selenicereus, Avena, Cordyceps, Panax, Schisandra,
Cornus, Polygonum, Serenoa, Vitex

Deficient Kidney Yang:

Coldness and aversion to cold
Excessive work, especially physical overwork, or sexual activity, chronic illness can damage
yang
Timid, fatigued with dark circles under eyes, apathetic, lack of libido
Often with Deficient Spleen Yang: poor appetite, loose stools
Often with:
• Feeling cold overall and in the back, not just in the extremities
• Fatigue with lethargy
• Pale, bright face
• Daytime sweating
• Cold pain in back and joints (esp lower back and knees), weak, cold knees or ankles
• Aversion to cold
• Edema
• Dizziness, tinnitus
• Lack of Kidney Qi/Yang leads to weakened Bladder Qi and Yang: frequent and
copious (or scanty only if more severe) but always clear urination, dysuria,
incontinence / enuresis
• Infertility,
o E.D. / impotence, premature ejaculation, spermatorrhea, low sperm count
and/or poor sperm motility, prostate swelling and enlargement
o vaginal discharge / leucorrhea, prostate swelling and irritation
o low libido / lack of enjoyment of sex
• loose teeth
• loss of hearing, tinnitus
• Lack of exercise or lack of desire to exercise exacerbates this.
• Lack of energy to apply oneself or be creative: withdrawal, detachment
• Too many cold foods
• Can be associated with adrenal depletion and/or exhaustion.
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• More severe: Yang can’t transform fluids resulting in edema, dyspnea, cold hands -
usually with Deficient Spleen, Lung, or Heart Yang
Pulse: slow, deep, weak
Tongue: pale, bloated, tooth marks, sometimes white coating especially in back of tongue,
central crack
Eat warming cooked foods, beans, grains, walnuts
Herbs: Selenicereus, Cinnamomum, Trigonella, Codonopsis, Panax ginseng, prepared
Rehmannia, Schisandra, Cornus, Lycium, Cordyceps, Cuscuta, Eleutherococcus, Serenoa,
Damiana, Allium sativum, Withania, Mitchella, Rubus
With back or joint pain: Eucommia and Dipsacus; for sexual dysfunction add Epimedium

Kidney Failing to Receive / Hold Qi

A type of Yang deficiency
• Dyspnea exp with exertion, esp difficulty inhaling
• Lung Qi may also be deficient
• Often with daytime sweating, cold, dysuria (as with Kidney Yang patterns)
• Facial swelling, sore back, sweating
Pulse: weak, tight, deep
Tongue: pale
Treat as deficient Kidney Yang but especially Schisandra, Serenoa, Panax, Lung Qi tonics
and herbs such as Inula, Lobelia, Ginkgo, Tussilago, etc. for asthmatic conditions if
indicated

Deficient Kidney Qi
Similar to Yang Deficiency but without overt signs of Cold
• Incontinence, urinary dribbling, difficulty voiding bladder, dysuria, nocturnal
emissions or urination, copious urine, miscarriage, infertility, spermatorrhea,
leucorrhea, uterine or bladder prolapse,
• Similar approach without being overly warming
Tongue: crack down center of tongue, pale
Pulse: deep, weak

Bladder Patterns
• Always look to the Kidneys
• Prone to both External Influences and to Emotional Disharmonies.
• Damp Heat Affecting Bladder (and Kidneys): This acute condition is generally
speaking the only excess pattern affecting the Kidneys. Can be an infection in some
cases.
o Frequent, urgent urination, burning, dysuria, dark urine, blood in urine
o Tongue red with yellow coating in back of tongue, raised red spots
o Rapid, slippery
• Damp Cold Affecting the Bladder:
o Frequent, urgent urination, feeling of heaviness, pale urine
o Tongue with white sticky coating in back of tongue
o Pulse slippery, slow
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Common combined patterns:

• Since the Kidneys are the root of all yin and yang, Deficient Kidney Qi, yin, or yang
often results in deficiency in other organs, and vice versa.
o Yin: to Heart, Liver, as well as Lung
o Yang: to Lung, Spleen, as well as Heart
• As the Lower burner, Kidneys are also the source of warmth and moisture for the
body, so Cold or Dry in the Kidneys often leads to Cold or Dry in other Organs.
• Kidney yin deficiency leads to Heat which can induce Wind in the middle and Upper
Burners.

Heart:
• Kidney and Heart patterns: Healthy Kidneys provide cooling water element to the
Heart and prevents excess Heat. The Heart in turn provides heat to warm the
Kidneys. Water and Fire.
o Essence (K) and Mind (H) are interdependent. A weak Essence can lead to fear
and self-loathing, and cause depression. A disturbed Mind can lead to
depression, and cause fatigue and lack of motivation and will.
o Heart and Kidney Yang Deficiency: Deficient Kidney Yang can lead to
Dampness Invading the Heart, with cold, deep weak pulse, pale wet tongue
o Heart and Kidney Yin Deficiency: Deficient Kidney Yin can lead to Heart Fire,
with empty heat, palpitations, night sweats, insomnia (trouble falling asleep),
poor memory, dizziness, tinnitus, floating, empty, rapid pulse, tongue with red
tip, peeling or cracked especially along the center. This pattern is common
when there is sadness from a shocking loss.

Spleen: Just as the Kidneys and Heart nourish each other with warmth, the Kidneys and
Spleen nourish each other with Fluids. They also together form one’s vitality, with pre-
natal Qi (Essence) and post-natal Qi (Spleen Qi), which nourish each other.
o Deficient Kidney Yang / Qi and Deficient Spleen Yang / Qi: Kidneys provide
heat to Spleen to transform fluids therefore Kidney Yang deficiency leads to
Spleen Yang deficiency, with Cold, diarrhea, poor digestion
o Likewise, Deficient spleen qi is too weak to replenish Kidney Essence: fatigue,
lack of appetite, tinnitus, dizziness, lower back pain
o Patterns of Damp Stagnation can often involve both Spleen and Kidneys

Liver: Liver Blood nourishes Essence, and Essence contributes to the formation of Blood.
The following two combined patterns are closely related:
o Kidney Yin deficiency with Liver Yin (Blood) deficiency- excess Heat in Lower
Burner (def Yin), leading to deficient Liver Yin with Liver Fire: low semen
volume, dry, red faced, headaches, blurry vision, dry eyes, headache, dizziness,
tinnitus, anger, frustration, depression, scanty menstruation, amenorrhea,
floating pulse, red peeled tongue
o Deficient Essence with Deficient Liver Blood: dizziness, blurry vision, tinnitus,
choppy pulse. Deficient Liver blood will also weaken Essence.

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Lung: The Kidneys keep the Lungs moist; Lungs send Qi down to the Kidneys.
o Kidney Yin deficiency with Lung Yin deficiency – dryness in throat, dry cough,
weakness, easily exhausted, night sweating and five-center heat
Tongue red, peeled, two cracks in Lung area
Pulse: floating, empty
o Deficient Lung Yang /qi with Kidney Yang /qi Deficiency – cold, diarrhea,
indigestion, edema, profuse clear urine, breathlessness, poor appetite
Tongue swollen, pale
Pulse deep, slow
o Deficient Lung Qi can also fail to send adequate fluids to Kidneys and Bladder,
resulting in urinary dysfunction (Sadness – Bladder link)
o Kidneys Helps Lung pull in and hold down Air Qi: asthma, breathlessness,
panting, difficulty breathing

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LIVER PATTERNS

• Can de deficient, stagnant, or excess

o Deficient blood or yin (not deficient qi)
o Stagnant qi with distention
o Excess heat / yang
• Wind injures the Liver

Emotional profiles:
Liver / gall bladder represent courage to make decisions (as opposed to having mental
clarity to make decisions which is Spleen and SI)

Deficiency:
• Complete lack of anger a sign of deficiency
• Depression, lack of motivation, not defending yourself, not expressing yourself
• Tends toward stagnation of Qi, Blood, and Fluids, menstrual problems
• Can still be controlling but in a “covert” way - maybe passive aggressive
• Herbs to regulate Liver Qi: Peony, Bupleurum, jujube, dang gui

Excess:
• Shouter, dominant, Alpha, classic Type A
• irritability, aggression, anger
o this can also lead to depression with anger and resentment underlying it (as
opposed to sadness)
• hypertension, heart disease, GI problems
• Diet: vegetarian diet helps, low protein,
• Cholagogues: huang qin, Coptis
• Herbs to calm and sedate
• Herbs to relieve congestion: Cyperus
• laxatives

Wind:
• emotional swings, volatility
• external wind: cold, flu, allergies
• internal: migraines, tremors, seizures, moving pain, stiff neck

Patterns
o Liver disharmonies most often involve:
o Blood: menstruation, blood volume in general
o Disharmony in the smooth flow of Qi leading to stagnation, Heat, Wind
o Anger, frustration, which can also lead to depression
o Liver most affected by Wind and Dampness
o If the Kidneys are deficient this will in turn directly affect the Liver
o Prone to stagnation and subsequent build up of Heat and Wind, especially if deprived
of adequate moisture (Yin)
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o External Wind aggravates Internal Wind already present (unlike Lung), stagnates
Liver Qi then Blood
o Exacerbating, heating: foods: greasy fatty foods, meats, protein, dairy, nuts, alcohol,
coffee
o Cleansing helpful foods: bitters, greens, lemons

Stagnant Liver Qi
Most common liver pattern, an Excess pattern.
Liver Qi does not flow smoothly, results in Heat and Excess. This can lead to Stagnation of
Blood and Reckless Blood.
• Symptoms tend to come and go.
• Anger, resentment, frustration – often seen as the main cause of this pattern when
long-standing
• Can be worsened by drugs, alcohol, hot foods, red meat, caffeine
• Symptoms:
o chest congestion, abdominal, hypochondriac, uterine distension
o sighing, hiccups
o moodiness and mood swings, frustration and anger that can lead to
depression, feeling on edge with lump in throat
o PMS irritability, swollen breasts, irregular periods, dysmenorrhea,
o nausea, vomiting, abdominal pain, poor appetite, excess belching and bloating
(Stagnant Liver Qi Invading the Stomach)
• Pulse: wiry especially on left side
• Tongue: normal or somewhat red on sides
Herbs: do not use not tonics unless there is underlying Blood Deficiency (look to tongue
and pulse) - an exception is Angelica
Use herbs to clear heat and regulate Qi: Paeonia, Bupleurum, Angelica sinensis, Citrus
peel, Cyperus, Coptis, Phellodendron, Gentiana, Prunella
For anger and frustration: Hypericum, Verbena hastata, Chrysanthemum

Stagnant Liver Blood

Always a result of Stagnant Liver Qi – pain is more predominant whereas in Stagnant Liver Qi
distension is more predominant.
• Irregular menses
• Pain before onset of or during menses, with dark, clotted blood
• masses/growths/fibroids
• abdominal pain
Pulse: wiry
Tongue: purplish especially on sides, if severe with purple spots
Herbs to break up stagnation: Salvia miltiorrhiza, Leonurus, Angelica sinensis, Ginkgo,
Artemesia (mugwort), tonics if indicated, lymphatics

Liver Fire (Liver Fire Blazing Upward)

Can be caused by stagnant Liver Qi
• Irritability, “short fuse”, anger, resentment
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• Insomnia
• Heat rises: headaches in face, eyes, temporal headache
• Bloodshot, red, swollen, painful eyes
• Bitter taste in mouth (constant)
• Red face
• Sudden onset tinnitus (as opposed to gradual Kidney-tinnitus), dizziness, dry mouth,
dark scanty urine, constipation, thirst, tight neck and shoulders, nose bleeds,
coughing blood
• Can be worsened by drugs, alcohol, hot foods, red meat, caffeine
Pulse: full, wiry, rapid
Tongue: red with prominent red sides, dry, yellow coating
Use cooling bitter foods and herbs: Gentiana, Chrysanthemum, Tanacetum, Prunella,
Lycium, Eschscholzia, Passiflora, Verbena hastata

Liver Wind
Three main types (below)
• Spasms, tics, tremors, numbness, dizziness, paralysis, convulsions
• Symptoms exacerbated or triggered by windy weather
Pulse: choppy or bowstring
Tongue: pale, quivering
Herbs: Gastrodia, Uncaria, Lycium, Passiflora, Paeonia, Verbena hastata, Scutellaria
lateriflora, Cuscuta
Acrid herbs: Lobelia, Actaea, Symplocarpus
o Extreme Heat causing wind
o acute febrile disease, less common: measles, mumps, encephalitis
o Tongue: red, stiff, thick yellow coating
o Pulse: wiry, rapid, full
o Deficient Liver Yin / Liver Yang Rising causing Wind
o Aphasia, stroke, stronger convulsions
o Tongue: red, peeled, deviated
o Pulse: wiry, rapid, fine, or floating
o Deficient Liver Blood causing Wind
o Numbness of limbs, shaking tremors (milder in appearance)
o Tongue: pale, deviated
o Pulse: choppy

Damp Heat in Liver and Gall Bladder

Often a Spleen Deficiency resulting in Dampness, combining with Heat in the Liver; Liver Qi
then Invades the Stomach
• UTIs, dysuria, vaginal discharge / itching
• Fever, nausea, jaundice, loss of appetite, bitter taste in mouth, abdominal
distention, hypochondriac fullness or in chest
• Yellow, ridged nails
• Caused by Spleen deficiency, Liver Heat, anger, resentment, greasy foods, damp hot
weather
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Pulse: slippery, rapid, wiry

Tongue: red body, sticky yellow coating
Herbs: Nourish and strengthen the Spleen, plus Gentiana, Scutellaria baicalensis, bitters
If External heat (infection): Forsythia, Lonicera, Isatis, Hydrastis or Coptis

Deficient Liver Blood

Often result of Deficient Spleen Qi, loss of blood, Deficient Jing / Kidney Yin
• *Amenorrhea, scanty menstrual flow, dull pale lips and face
• Dry eyes, blurred vision, floaters, night blindness
• Dry skin/hair, hair falling out
• Numbness in the extremities, tics, tremors, dizziness, muscle weakness and cramps
• Insomnia, excessive dreaming, waking up in the night
• Brittle, soft, or thin nails
• Caused by not enough blood building foods, loss of blood from trauma or childbirth,
and/or Kidney Essence or Qi deficiency.
• Deficient Liver Yin basically the same as Deficient Liver Blood but with Dryness and
Deficient Heat (not considered a separate pattern)
Pulse: choppy or fine
Tongue: pale especially on sides, dry, thin (or swollen if there is dampness)
Eat warming foods
Herbs: Angelica sinensis, Paeonia, Lycium, Zingiber, prepared Rehmannia, Salvia
miltiorrhiza, Leonurus, Urtica, Kidney yin and Essence tonics

Liver Yang Rising

“Arrogant Liver Yang”; long-standing resentment or anger is a common cause.
Very similar to Liver Fire but caused by Liver Blood/Yin deficiency; therefore Yang is in
Excess but yin is Deficient. Can also be the result of Kidney Yin (and Yang) Deficiency.
• Often causes Wind
• Excessive activity
• Anger and shouting, irritability
• Insomnia
• Headache on temples, eyes, tight neck and shoulders
• Bloodshot, red, swollen, painful eyes
• Convulsions, unconsciousness, dizziness, tinnitus
Pulse: rapid, floating, empty, wiry
Tongue: red and peeled especially on sides (or pale if more deficient)
Practice meditation, rest
Eat yin-nourishing and blood building foods
Herbs: Liver fire herbs and yin/blood tonics, Kidney tonics

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Common Combined Patterns:

Kidney: Liver Blood nourishes Essence, and Essence contributes to the formation of Blood.
Kidney Yin nourishes Liver Yin.
• Kidney Yin deficiency with Liver Yin deficiency- excess Heat in Lower Burner (def
Yin), leading to deficient Liver Yin with Liver Fire: low semen volume, dry, red faced,
headaches, blurry vision, dizziness, tinnitus
• Deficient Essence with Deficient Liver Blood: dizziness, blurry vision, tinnitus.
Deficient Liver blood will also weaken Essence.

Heart:
• Liver Yang or Fire Rising and Heart Fire or Deficient Heart Yin: Anger and Heat
causes Liver fire to rise which goes first to Heart and can settle there and cause
damage.
• Deficient Heart Blood with Deficient Liver Blood

Spleen/ Stomach: Liver Qi aids in digestion.

• Spleen Deficiency causing Dampness combining with Liver Heat, causes Damp-Heat
in Liver and Gall Bladder
• Stagnant Liver Qi from Heat can invade the Spleen and Stomach: nausea, belching,
alternating loose (Spleen deficiency) and hard stools (Liver Qi stagnation), abdominal
distention and pain, fatigue, irritability. Weak right pulse, wiry left pulse; tongue
sides pale or red.

Lung:
• Deficient lung qi can stagnate Liver qi
• “Liver-Fire Insulting the Lungs”: asthma, dyspnea, cough, headache, constipation,
thirst. Red tongue with red sides, swollen in Lung area, yellow coating. Wiry and
slippery pulse.

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SPLEEN PATTERNS

• The Spleen assists the Stomach in digestion, and is the central organ responsible for
the formation of Qi.
• Overall energy levels are a reflection of Spleen health.
• The Spleen is healthy when it is “misty” and warm. Excessive Cold and Dampness
tend to damage and stagnate the Spleen – this can derive from imbalanced diet,
mental and emotional imbalances, or poor digestion and assimilation. External
Dampness can also affect the Spleen.
• The Spleen cannot suffer from Yin deficiency but does suffer from Yang deficiency.
The Stomach on the other hand can frequently suffer from Stomach yin deficiency.
The Spleen is more often deficient if in disharmony, whereas the Stomach can suffer
from Excess / Fire and is vulnerable to Heat.
• Whenever there is Dampness, edema, phlegm, etc. Spleen health must be addressed
as part of the protocol.
• The Spleen houses Thought / the Gut-Mind: patterns of disharmony in the gut often
mirror patterns in the Mind.
• Excessive worry and brooding, being self-absorbed, rehashing thoughts, lack of
purpose, and rushed, irregular, or worried eating also all tax the Spleen.
• Being able to concentrate and problem-solve, work something out, being grounded
(EARTH), all reflect a healthy Spleen (mental digestion and assimilation).
• Sweet foods tonify the Spleen but in excess can cause stagnation. Formulating that
balances sweet with more dispersive and drying action is key.
• The Spleen is vulnerable to disharmony just before and during menses; digestive
changes during a woman’s period are common.
• The Spleen and Kidneys are intricately linked.
o The Kidneys provide our pre-Heaven Qi or Essence, and the Spleen our post-
Heaven Qi. Both work in tandem nourishing and maintaining our vitality.
o In the Five Phases the Spleen rules the Kidneys – if Spleen Qi is strong, the
Essence is kept vital; if Spleen Qi is weakened the Essence will suffer.
o The Kidneys are considered the “pilot light” for the Spleen: Kidney deficiencies
can lead directly to equivalent Spleen patterns, and potentially vice versa.

Deficient Spleen Qi
Most common Spleen disharmony and perhaps most common disharmony in general.
Often combined with other Qi deficiencies (Kidney, especially Lung, etc.).
Can take multiple forms – see below patterns.
• Abdominal distention and pain, loose stools
• Lack of appetite, nausea
• Heaviness, lethargy, fatigue, weak limbs
• Sallow complexion
• May be accompanied by Dampness as well
• Worry, brooding, self-absorption; poor concentration / memory
Pulse: empty, hollow, slow, weak; mildly slippery if damp

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Tongue: Normal to pale, sometimes with a central crack, sometimes swollen on the sides
only in the middle of tongue and with transversal cracks if more pronounced, coating thin
white, or if also Damp, greasy and sticky.
Moderate exercise, mindful and balanced eating, and meditation are helpful.
Foods should be more warming, reducing sugar is important but use sweet Spleen Qi
tonics
Herbs: Glycyrrhiza, Poria, Panax, Codonopsis, Astragalus, Eleutherococcus, Atractylodes,
Zizyphus, Inula

Spleen Qi Sinking
Deficient Spleen Qi with:
• Prolapse of stomach, bladder, uterus, etc.
• Dysuria – urinary frequency and urgency
• hemorrhoids, varicosities
• Poor muscle tone
• Too much standing exacerbates this
Pulse: empty, weak
Tongue: pale
Exacerbated by too much standing.
Spleen Qi tonics, and add astringents, vascular tonics

Reckless Blood
Deficient Spleen Qi with:
• Bleeding: menorrhagia, blood in stools, urine, nosebleeds
• Shortness of breath, cold
• Deficiency bleeding without signs of Heat- distinguish from Reckless Blood from
Excess Heat (Liver Fire or Stagnant Liver Qi).
Pulse: thready, fine
Tongue: pale
Support Spleen Qi and add: Raw Rehmannia, Artemisia, Panax notoginseng, styptics such
as Scutellaria baicalensis, Achillea, Panax notoginseng, Capsella

Deficient Spleen Yang

Similar to Deficient Spleen Qi but with overt signs of cold, generally deeper seated and
more serious a disharmony.
• Abdominal distention and pain after eating
• Lack of appetite, nausea
• Sallow or bright white complexion
• Sensations of cold / aversion to cold
• Muscle weakness and cold in limbs
• Sometimes edema and excess mucus
• Pronounced fatigue
• Loose stools with cold / undigested food in stools
• White or sallow complexion
Pulse: deep/sinking, slow, weak
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Tongue: pale, overly moist, swollen, tooth marks (scallops)

Moderate exercise, mindful eating, and meditation
Avoid cold, damp environmental / external factors
Eat warming animal foods and spices (cardamom), reduce sugar but use sweet Spleen Qi
tonics
Focus on warming Spleen tonics
Warming herbs: Cinnamomum, Zingiber, cardamom, Zanthoxylum, Acorus, Foeniculum

Damp Cold in Spleen

Excess condition; Dampness / Phlegm stagnates the movement of Qi
Is it more Cold or more Damp? This determines the exact remedies used.
• Sensations of cold
• Congestion in head and chest
• Lack of thirst
• Reduced sensation of taste
• Heaviness in limbs, lethargy
• Diarrhea, loose stools
• Vaginal discharge, spermatorrhea, urinary dribbling
• Edema
Pulse: full-slippery, slow
Tongue: pale, thick white sticky coating
For food and herbs distinguish how cold vs. damp the condition is
Herbs: Panax, cardamom, Poria, Atractylodes, Citrus peel, Lavendula, Rosmarinus,
Zingiber, Zanthoxylum, Inula, Acorus
Binding, stabilizing sour herbs: sumac, Schisandra, Filipendula, Rubus, rosehips,
hawthorn

Damp Heat Invading the Spleen

Often coupled with Damp Heat in the Liver / Gallbladder. An Excess pattern often caused
by hot, humid weather, food poisoning.
• No appetite
• Feeling of heaviness, distention, dull pain and discomfort in the abdomen
• Nausea, vomiting
• Loose, odorous stools
• Dark, scanty, burning urine
• Low-grade fever
• Headache
Tongue: red body with sticky tacky yellow coating
Pulse: slippery, rapid
Reduce hot, greasy, fatty foods, alcohol. Increase cooling foods, fresh fruits and vegetables,
bitters.
Herbs: Scutellaria baicalensis, Berberis, Hydrastis, Coptis, Taraxacum, Cichorum

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Stomach Patterns of disharmony:

Deficient Stomach Qi
• Fatigue (esp in the morning)
• Lack of appetite
• Loose stools, weak limbs
• Pale tongue, empty pulse

Stomach Yin deficiency

• No appetite
• Fever or feeling of heat (esp afternoon)
• Dry mouth / thirst
• Red peeled tongue, floating pulse

Stomach Fire
• Burning and pain
• Thirst, constant hunger
• Swollen, bleeding, painful gums
• Insomnia, mania
• Constipation, nausea, vomiting
• Red tongue with thick yellow coating, full, rapid pulse

Stomach Qi Rebelling Upward / Failing to Descend

Often resulting from Liver Qi stagnation; often emotional in its origin (worry, anxiety)
• Fullness, distention
• Belching, regurgitation
• Hiccups
• Nausea, vomiting
• Pulse tight and wiry in Spleen pulse

Common Combined Patterns

Kidneys:
• The Spleen and Kidneys are intricately linked.
o The Kidneys provide our pre-Heaven Qi or Essence, and the Spleen our post-
Heaven Qi. Both work in tandem nourishing and maintaining our vitality.
o In the Five Phases the Spleen rules the Kidneys – if Spleen Qi is strong, the
Essence is kept vital; if Spleen Qi is weakened the Essence will suffer.
o The Kidneys are considered the “pilot light” for the Spleen: Kidney deficiencies
can lead directly to equivalent Spleen patterns, and potentially vice versa.
o Kidney yang deficiency can lead to Damp Cold in the spleen including
“daybreak diarrhea”.
o Stomach and Kidneys share a role in governing fluids – Stomach yin deficiency
usually goes along with Kidney yin deficiency

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Liver / Gallbladder:
• Stagnant Liver Qi disrupting Stomach / Spleen: abdominal distention, hypochondriac
pain, diarrhea, thick sticky yellow tongue coating. Generally diet-induced.
• Weak Spleen Qi in turn can disrupt the Liver’s ability to move qi harmoniously.
• Damp Heat in both
• Spleen Qi Deficiency with Liver Blood Deficiency: dizziness, loose stools, blurred
vision, fatigue
Heart: The Spleen makes Blood.
• Spleen weakness will lead to Heart blood deficiency.
• Spleen Qi deficiency will lead to Heart Qi deficiency.
• Heart Yang in turn supplies Blood to the Spleen, so deficient Heart Yang will weaken
the Spleen.
Lungs:
• Deficient Spleen Qi leading to Deficient Lung Qi is common: lack of appetite, fatigue,
breathlessness
• Dampness and Phlegm resulting from Spleen weakness often moves to the Lungs
first.

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LUNG PATTERNS

• Lungs are most prone to Wind, most often Dry, leading to deficient yin and also
COLD, over time, which is why pungent is associated with the Lungs. That said, any
energetic disharmony can be seen.
• “Intermediary organ between the organism and the environment” - Maciocia
• -Inhaling air, skin
• The Tender Organ – the most susceptible of all to External Influences / Climate.
• Spirit (respiring)
• Defensive / Wei Qi
• Sense of Self, conscientiousness, sense of right and wrong - ethics, empathy,
openness and receptivity
• What we hold on to and what we let go – grief, sadness
• Sensitive – direct contact with outside world
• Wind can be either hot or cold, internal or external.
• (Wind damp can also occur but is usually more specific to a particular illness)
• Dampness originates in the Spleen but next affects the Lungs.
• Too many cold raw foods, including ice cold drinks, damage and dampen the Spleen,
with the dampness then stored in the Lung.
• Foods that encourage excess Dampness include dairy, oranges, and wheat
• Exercise helps to break up excess dampness.

• Lung Patterns can change rapidly and are generally divided into External and
Internal Patterns.

External Patterns
Wind Cold
Factors: a weakened Defensive Qi, weather, environment, air conditioning, pathogens. An
Excess condition.
• Cough, runny nose, sneezing, itchy throat
• fever, chills
• lack of sweating – blocked pores from Lung Qi not reaching the skin
• aches
• aversion to cold
• occipital headache
• thin white mucus
Pulse: floating (due to the external surface nature of the pattern)
Tongue: thin white coating
Warming foods and herbs: Zingiber, Glycyrrhiza, Allium (garlic), Capsicum, Tussilago,
Ligusticum (osha), honey, Trigonella
Herbs to Open the Exterior
(do not tonify qi)
Wind Damp

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Usually a Wind Cold pattern but with added:

• facial edema
• fever
• cough
• Drying /mucolytic foods: nuts (almonds, walnuts), fennel, flax, Alliums, radishes,
mushrooms, turnips, ginger, horse radish

Wind Heat
Can lead to long standing yin deficiency
• high fever, sweating, aversion to cold
• sore throat, runny nose with yellow mucus
• swollen tonsils
• thirst
• body aches
pulse: floating, rapid
tongue: red on sides or tip, white or yellow coating
Eat more raw foods, consider fasting
Cooling foods: watercress, melon, apples, peaches, pears, berries, pumpkin, papaya
Herbs: Lonicera, Forsythia, antimicrobial herbs, Platycodon, Phragmites, Morus (mulberry)
leaf, Mentha, Chrysanthemum, Tussilago leaf, Lactuca, Inula, Marrubium, Trifolium
Herbs to Open the Exterior: Sambucus, Achillea, Eupatorium

Internal Patterns

Cold Damp
Often with Def Spleen Qi or Def Kidney Qi
• Chronic cough, white profuse mucus, congestion
• wheezing, shortness of breath
• pale urine
• aversion to wind
• pasty or pale complexion, facial edema
Pulse: slippery, (weak, floating if Qi is depleted)
Tongue: greasy, thick white coating
Avoid damp mucus producing foods: oranges, wheat, dairy.
Eat warming, dispersing foods: ginger, garlic, horseradish
Drying /mucolytic foods: nuts (almonds, walnuts), fennel, flax, Alliums, radishes,
mushrooms, turnips, ginger, horse radish
Warming foods: ginger, Alliums, hot peppers, radishes, horse radish, ginger, mushrooms
Herbs: Glycyrrhiza, Citrus peel, Poria, Platycodon, Allium sativum, Thymus, Zingiber,
Ligusticum (osha), Foeniculum, onion and ginger poultices
Herbs to Open the Exterior
Heat/Phlegm Obstructing Lungs
Often with Deficient Spleen Qi and External Heat. Excess condition.
Can be exacerbated by a diet with too much greasy, spicy food and meat, smoking, alcohol,
infection or other external pernicious influences
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• Barking cough with yellow green sputum,

• dyspnea, asthma, congestion
Pulse: slippery, rapid, full
Tongue: thick, yellow coating
Eat more fresh vegetables and fruits, consider fasting.
Herbs: Scutellaria baicalensis (huang qin), Salvia officinalis, Eucalyptus, Thymus, Berberis,
Lactuca, Usnea, Prunus serotina, Coptis, Platycodon, Morus (mulberry) bark, Tussilago
flowers, Glechoma, Lonicera, Asclepias
Cooling foods: watercress, melon, apples, peaches, pears, berries, pumpkin, papaya
Drying /mucolytic foods: nuts (almonds, walnuts), fennel, flax, Alliums, radishes,
mushrooms, turnips, ginger, horse radish

Deficient Lung Qi (Yang)

Often with Deficient Heart Qi
• Excessive sweating
• fatigue, weakness
• weak voice, aversion to speaking
• weak cough with phlegm / watery sputum
• Aversion to cold
• mild shortness of breath, worse with exertion
• bright white complexion
• Dull, splitting hair
• Vulnerability to illness and infection from a weakened Wei or Defensive qi
• Sadness can deplete and weaken Lung Qi
Pulse: empty
Tongue: pale or normal, sometimes dip or cracks in Lung area (two small cracks can signify
an inherited lung weakness)
Moderate exercise, qi gong
Herbs: Astragalus, Panax, Glycyrrhiza, Pseudostellaria, Inula, Verbascum, Thymus
Lung Qi tonic foods: rice, oats (but not other grains), carrots, Brassicas, yam, potatoes,
garlic, ginger, nuts

Deficient Lung Yin

Caused by Lung Qi deficiency and dryness, Stomach yin deficiency, or Kidney yin deficiency
(tongue will be red, short, small)
Can be brought on by smoking, dry air, dust, irritants, overuse of voice
• Loss of voice, hoarse throat
• Dry unproductive cough
• dry skin, thirst, night sweats, insomnia,
• sensations of heat, low grade fever, flush cheeks or malar flush, especially in the
afternoon
• Five center heat
Pulse: empty, rapid, floating
Tongue: red, peeled, dry, transversal cracks in Lung area; very red if severe or if with
Kidney yin deficiency.
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*A mild dryness/deficient yin: tongue will look normal or only slightly red, pulse will not be
floating, and there will not much overt signs of empty heat.
Rest, limit exercise to mild and tonifying: tai chi, qi gong
Herbs: Ophiopogon, Panax, Glycyrrhiza, Polygonatum, Pseudostellaria, Althaea, Trifolium,
Asparagus, Trifolium
Moistening foods: seaweeds, oranges, peaches, pears, fermented soy, butter, eggs, seafoods

Deficiency of Gathering Qi
Dryness, asthma, cough
Often with Deficient Lung Qi (difficulty breathing) and/or Deficient Kidney Yang (difficulty
inhaling)
Pulse: weak, tight, deep
Tongue: depression in anterior third
qi gong, deep breathing
Herbs: Schisandra, Ammi visnaga (khella), Thymus, Symplocarpus (skunk cabbage),
Grindelia, Ginkgo, Curcuma, Serenoa, Tussilago, Ephedra*, Lobelia, Lactuca

Common Combined Patterns:

• Lung Qi and Heart Qi are intimately linked and when deficient together often
manifest as depression
• Spleen Damp leads often to Lung Damp
• Kidney Yang supports Gathering Qi / descending of Lung qi

Kidneys:
• Deficient Lung Qi and Kidney Yang: Often originates in Kidneys; blockage of fluids
can lead to Lung Qi deficiency. Dry cough that is worse in evening, night sweats,
flush face, hoarse voice, sore lower back
Pulse: empty, floating
Tongue: swollen, sometimes red, cracked and dry in Lung area
Spleen:
• Deficient Spleen Qi will starve the Lungs of Qi resulting in Lung weakness.
• Swollen in Lung area: retention of fluids, phlegm - Dampness in the Spleen often
moves first to the Lungs
Heart:
• Deficient Lung Qi and Heart Qi: sadness can cause deficient Lung Qi and then
eventually deficient Heart qi, and can lead to qi stagnation which causes Heart fire.
Pale or purple tongue, empty pulse in the first position on both wrists, shortness of
breath, palpitations, chest congestion, cough, fatigue
Liver:
• Deficient Lung Qi and Stagnant Liver Qi: cough, moving pain, dizziness, headache,
sadness and depression, listlessness, empty and tight pulse, pale or normal tongue.
• Liver Fire Invading the Lungs: asthma, wheezing, headache, irritability, cough,
dyspnea, yellow or bloody cough, scanty dark urine, dizziness, constipation. Red
tongue, swollen in Lung area, yellow coating.

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