Cor Pulmonare, Pulmonary Heart Disease

General

Clinical Manifestations
Treatment Principle
Herb Formulas	Ma Zi Ren Wan
Points

Wind-Cold Attacks The Lungs (Severe)

Clinical Manifestations	Fever and chills (chills predominant) Anhidrosis Cough Wheezing (asthma) Copious, white, stringy, difficult to expectorate sputum Stifling sensation in the chest Lacrimation General heaviness (especially upper body) General body aches No thirst Floating edema (severe) Considerable difficulty breathing while lying down (severe) Intolerance of Cold Periorbital edema Dyspnea Vomiting of frothy saliva during pregnancy Chest distention Dry heaves Decreased urine Subcardiac edema Stridor Occasional chills on the back Hiccups Retching Dysphagia Diarrhea Dysuria Flushed face Dizziness Headache Inflammation of the tear ducts T: Pink C: Moist or White and greasy P: Superficial and tight
Treatment Principle	Release the Exterior Transform congested Fluids (Thin Mucus) Transform Phlegm Warm the Lungs Descend Qi Relieve wheezing and cough
Herb Formulas	Xiao Qing Long Tang
Points

Wind-Cold-Damp- Bi

Clinical Manifestations	Aversion to Cold Stuffy nose Neck and back spasms Joint pain Headache Anhidrosis Muscular pain Joint swelling Slight fever Slight expectoration of white Phlegm Heaviness of the body and joints Cold feeling in the joints Cough Heaviness of the head Preference of the joints for warmth Limited movement of the joints T: Normal C: Thin and white or Thin, white and greasy P: Superficial and tight
Treatment Principle	Warm the channels Activate Qi and Blood.
Herb Formulas	Gui Zhi Shao Yao Zhi Mu Tang With Accumulation of Phlegm-Damp in the collaterals: Ling Gui Zhu Gan Tang
Points

Lung Qi Deficiency

Clinical Manifestations	Soft, weak cough with clear thin sputum Physical and mental exhaustion Soft, weak voice Reluctance to speak Shortness of breath Pale face With Wei Qi Deficiency: Spontaneous perspiration (daytime) Low resistance to common cold Tendency to a blocked nose T: Pale C: Thin and white P: Weak
Treatment Principle	Reinforce the Lungs Strengthen Qi
Herb Formulas	Yu Ping Feng San Bu Fei Tang
Points	LU-9, REN-17, ST-36, UB-13, UB-43

Lung Qi And Yin Deficiency

Clinical Manifestations	Chronic cough or Dry cough Insomnia Night sweats Spontaneous perspiration Weakness Palpitations Shortness of breath Fever Irritability T: Red and dry or Red and swollen C: Little or None P: Thready and weak
Treatment Principle	Tonify Qi Nourish Yin
Herb Formulas	Sheng Mai Yin Wan
Points

Lung And Kidney Qi Deficiency With Phlegm-Heat

Clinical Manifestations	Chronic cough Wheezing Thick, yellow sputum Sensation of Heat and irritability in the chest Gradual emaciation Facial edema Chronic Lung atrophy Coughing of pus and Blood Dyspnea T: Purple C: Thin and white or Thin, yellow and greasy P: Superficial and Deficient especially in the first position
Treatment Principle	TonifY Qi Replenish Jing Strengthen the Kidneys Clear the Lungs Clear Heat Transform Phlegm Stop cough Arrest wheezing
Herb Formulas	Ren Shen Ge Jie San
Points	UB-13, UB-23, UB-43, ST-36, REN-6, LU-9, KI-3, DU-4

Lung And Kidney Yin Deficiency With Fire Flaring

Clinical Manifestations	Cough with blood streaked sputum Wheezing Dry, sore throat Five sole Heat Afternoon fever Low grade fever Malar flush Irritability Insomnia Shortness of breath Nocturnal emission Steaming bones Vivid dreaming Fatigue Tinnitus Dizziness Dyspnea Dysphoria Hoarseness Night sweats Maybe hemoptysis Restlessness T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs Transform Phlegm Stop Cough Clear Heat Nourish the Blood
Herb Formulas	Bai He Gu Jin Tang
Points	HT-7, KI-2, KI-3, KI-6, LU-6, LU-9, PC-6, UB-13, UB15, UB-23

Heart Qi Deficiency

Clinical Manifestations	Palpitations Shortness of breath (especially on exertion) Excessive perspiration (in daytime) Symptoms worse after exertion or when tired Facial pallor Fatigue Weakness Suffocating sensation in chest T: Pale and swollen C: White P: Weak or Big and weak or Intermittent
Treatment Principle	Reinforce and Strengthen Heart Qi
Herb Formulas	Zhi Gan Cao Tang
Points	HT-7, PC-6, REN-6, REN-14, REN-17, ST-36, UB-15

Heart Blood Deficiency

Clinical Manifestations	Palpitations Irritability Anxiety Easily startled Insomnia Much dreaming Poor memory Dizziness Pale face and lips T: Pale P: Thready and weak
Treatment Principle	Nourish Heart Blood Calm the Heart and Shen
Herb Formulas	Dang Gui Bu Xue Tang Gui Pi Tang With Heart Blood Stagnation: Gu Ben Hua Xue Tang I Hao Gu Ben Hua Xue Tang II Hao
Points	HT-7, PC-6, REN-4, REN-14, SP-6, ST-36, UB-15, UB-17, UB-20, Rice-grain moxa SP-1

Heart Blood Stagnation

Clinical Manifestations	Palpitations Stabbing pain in the anterior region over the Heart Suffocating sensation in the chest Maybe drawing pain down the internal aspect of arm (especially the left arm) Pain (in chest and/or arm) tends to be severe and intermittent Severe cases: Cold limbs Cyanosis of lips and nails T: Dark red with purple spots or Purple body C: Little P: Minute (scarcely perceptible) and thready or Knotted
Treatment Principle	Clear Yang Invigorate the Blood Transform Stagnation
Herb Formulas	Xue Fu Zhu Yu Tang Di Dang Tang Gua Lou Xie Bai Bai Jiu Tang Huo Xue Hua Yu With Qi Deficiency: Bu Yang Huan Wu Tang
Points

Heart Blood Stagnation With Heat

Clinical Manifestations	Palpitations Stabbing pain in the anterior region over the Heart Suffocating sensation in chest Maybe drawing pain down internal aspect of arm (especially the left arm) Pain (in the chest and/or arm) tends to be severe and intermittent Palpitations Easily startled Insomnia Much dreaming Fever Perspiration Irritability Restlessness Dry mouth Thirst Dry throat T: Dark red with purple spots or Purple body or Red and dry C: Little or None P: Hasty or Choppy and rapid
Treatment Principle	Invigorate the Blood Break up Blood Stasis Clear Heat
Herb Formulas	Qing Hua Zhu She Yi
Points

Heart Yin And Yang Deficiency

Clinical Manifestations	Palpitations Shortness of breath Excessive perspiration (daytime) Above symptoms worse after exertion or when tired Cold limbs Fatigue Weakness Maybe chills Cyanosis Suffocating sensation in chest Depression Facial pallor Irritability Easily startled Insomnia Much dreaming Poor memory Low grade fever Night sweats Five sole Heat Restlessness Dry mouth Thirst Dry throat Malar flush T: Pale and swollen or Reddish and dry C: White or Little or None P: Thready and weak or Knotted or Intermittent or Thready and rapid
Treatment Principle	Warm and Clear Heart Yang Nourish Yin Clear Heat Reinforce the Heart Calm the Shen
Herb Formulas	With Heart Blood Stagnation: Gu Ben Hua Xue Tang I Hao Gu Ben Hua Xue Tang II Hao Gu Ben Huo Xue Wan
Points

Heart Yin And Blood Deficiency

Clinical Manifestations
Treatment Principle
Herb Formulas	With Heart Blood Stagnation: Gu Ben Hua Xue Tang I Hao Gu Ben Hua Xue Tang II Hao Gu Ben Huo Xue Wan
Points

Heart Yang Not Vigorous: Water Qi Insults The Heart

Clinical Manifestations	Palpitations Cardiac arrhythmia Chest and abdominal fullness Vertigo Scanty urine Edema Inability to lie down There may be audible fluid sounds in the abdomen when palpitating T: Pale C: White P: Slippery and maybe deep
Treatment Principle	Warm Yang Transform Fluid
Herb Formulas	Zhen Wu Tang
Points

Heart And Lung Qi Deficiency

Clinical Manifestations	Chronic cough with sparse sputum Sputum difficult to expectorate Shortness of breath Spontaneous perspiration Dry mouth and tongue Palpitations with a stifling sensation in chest Fatigue Thirst Dry throat Insomnia Listless speech T: Red and dry or Pink and dry C: Thin and dry P: Deficient and rapid or Irregular and slow or Thready and deficient or Consistently irregular
Treatment Principle	Augment Qi Generate Fluids Clear Heat Preserve Yin Stop Excess perspiration
Herb Formulas	Sheng Mai San
Points	HT-7, LU-9, REN-17, UB-13, UB-15

Qi Stagnation In The Liver Channel Affecting The Lungs

Clinical Manifestations	A sensation of fullness, distention and pain in the chest which is improved with massage Cough Prefers warm drinks P: Wiry and large
Treatment Principle	Unblock Yang Expand the chest Dredge Stasis Transform clumps
Herb Formulas	Xuan Fu Hua Tang
Points

Kidney Yang Deficiency

Clinical Manifestations	Chronic wheezing Inhalation more difficult than exhalation Worse with exertion, fatigue or Cold Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale or cyanotic face Dark rings under the eyes Facial puffiness Spontaneous sweating Frequent colds Urinary frequency with abundant, clear urine or Oliguria with pitting edema Maybe nocturia Lethargy Listlessness Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen or Pueplish/bluish C: Thin and white P: Deep and thready - maybe slow or Imperceptible or Large, deficient and rootless
Treatment Principle	Warm and Reinforce Kidney Yang Support Wei Qi
Herb Formulas	Jin Gui Shen Qi Wan modified With Phlegm Accumulation: Su Zi Jiang Qi Tang With Heart Yang Deficiency: Zhen Wu Tang With Heart Yang Collapse: Si Ni Jia Ren Shen Tang Hei Xi Dan Shen Fu Tang Scarring plaster: Place a plaster of Bul. Allii Sativi Da Suan or Hb. cum Rx. Asari Xi Xin on DU-14 and/or UB-43 for two to three days to strengthen Wei Qi. Chinese Patent Medicines: Jin Gui Shen Qi Wan Ren Shen Lu Rong Wan Ge Jie Bu Shen Wan
Points	KI-3, LU-9, REN-4, REN-6, UB-13, UB-23 With congested Fluids: + KI-7, REN-9, SP-6, SP-9, ST-28

Phlegm-Heat Stagnation In The Chest

Clinical Manifestations	Focal distention in the chest and epigastrium with or without nodules which is painful when pressed Coughing up yellow, viscous sputum Constipation A bitter taste in the mouth T: Normal C: Yellow and greasy P: Slippery and floating or Slippery and rapid
Treatment Principle	Clear Heat Transform Phlegm Expand the chest Dissipate Stagnation
Herb Formulas	Xiao Xian Xiong Tang
Points

Han Tan

Clinical Manifestations	Cough with sputum Cough Wheezing Copious sputum Chest distention Anorexia Indigestion Hiccup Shortness of breath T: Normal C: Greasy, white P: Slippery
Treatment Principle	Warm Cold Descend Qi
Herb Formulas	San Zi Yang Qin Tang
Points