Lungs

A tongue that is still normal, a pulse that floats, a coating that gives away the colour of the phlegm: which pattern of the Lungs do you read, and what tells the neighbours apart?

After this lesson you know where to read the Lungs (the front part of the tongue and right cun), you read from the floating pulse whether the pathogen is on the outside or there is deficiency, you know the tongue and pulse of every Lung pattern, you link the coating to the phlegm, you know which tongues and pulses go to a doctor first, and you read a lingering cough from finding to principle.

Schematic: Wind-Cold. Almost normal, thin white coating.

Schematic: Wind-Heat. Red tip and front, thin coating with a yellow tinge.

Schematic: Wind-Water. Thin white, slippery and wet coating.

Schematic: Lung-Heat. Red, yellow coating, dry.

Schematic: Phlegm-Heat. Red, Swollen at the front, sticky yellow coating.

Schematic: Damp-Phlegm. Swollen, thick sticky white coating.

Schematic: Cold-Phlegm. Pale, Swollen, wet white coating.

Schematic: Lung-Qi deficiency. Pale.

Schematic: Lung-Yin deficiency. Red, without coating, dry, fine cracks at the front.

Schematic: Lung Dryness. Normal colour, dry.

Know by heart

Where you read the Lungs. On the tongue, the zone directly behind the tip; at the wrist, right cun. Floating says: it is on the outside; mnemonic: the Lungs lie just behind the Heart, top right.
From outside: the pulse first. Wind-Cold: tongue almost normal, thin white; floating, tight. Wind-Heat: red tip or sides, thin white to thin yellow; floating, rapid. Wind-Water: thin white, slippery coating; floating, slippery; mnemonic: if the pulse floats, it is outside; if the edge colours, it is warm.
Inside: Heat. Lung-Heat: Red, yellow coating; big and rapid (overflowing or full), no longer floating. Phlegm-Heat: Red, often Swollen at the front, sticky yellow; slippery-rapid; mnemonic: once the pulse stops floating, the Heat is inside.
Phlegm: the coating is the sample. Damp-Phlegm: Swollen, thick sticky white; slippery. Cold-Phlegm: Pale, Swollen, wet white; slippery, slow. Phlegm-Fluids: Pale, thick wet white; slippery, sometimes wiry; mnemonic: the colour of the coating is the colour of the phlegm, a wet coating is cold phlegm.
Deficiency. Lung-Qi deficiency: Pale; empty, especially right cun. Lung-Yin deficiency: Red without coating, cracks at the front (textbook); thin-rapid or floating-empty. Lung Dryness: dry, normal colour; empty or thin; mnemonic: strength shows in the colour, moisture in the sheen.
Floating: outside or deficiency? With strength, acute, with chills or fever: outside, release first. Without strength, for months, empty under pressure: Yin deficiency (floating-empty).
Red flags. Blue lips or tongue with breathlessness, unable to speak in sentences: emergency services (112 in Europe, 999 in the UK, 911 in North America). Fever with fast breathing or shortness of breath: the same day. Coughing up blood, a cough lasting more than three weeks, night sweats with weight loss: a GP or primary care doctor.

The rest of this lesson is reference.

Three practice questions from this lesson

Where do you read the Lungs on the tongue and at the wrist?

The root of the tongue and right chi
The zone just behind the tip and right cun
The sides of the tongue and left guan

Answer: The zone just behind the tip and right cun. Directly behind the tip lies the zone of the Lungs, right cun is the position of the Lungs. The root and chi belong to the Kidneys and lower abdomen, the sides and left guan to the Liver.

Why does the tongue change so little with a cold from Wind-Cold?

Because the Lungs have no zone of their own on the tongue
Because the pathogen is still in the outermost layer
Because with the Lungs the tongue only shows Heat

Answer: Because the pathogen is still in the outermost layer. A pathogen from outside first sits in the skin and the muscles: the body only changes over weeks and the coating stays thin white. The tongue only follows when it moves inwards; the pulse does float straight away.

Case. Man, 33, chilly since this morning, sneezing, clear nasal discharge, stiff neck, no sweating. Tongue normal with thin white coating. Pulse clear and taut with light pressure. What does the pulse say that the tongue does not say yet?

That the Lung-Qi is empty and the Wei-Qi falls short
That there is Phlegm in the Lungs that is not yet visible
That the pathogen is on the outside and is Cold

Answer: That the pathogen is on the outside and is Cold. Floating is outside, tight is Cold. The tongue is still normal because the pathogen does not lie deeper. High fever with neck stiffness on bending forward, or drowsiness: emergency services (112).

The rest of this lesson

In the course you get the step-by-step explanation with illustrated tongues and animated pulse models, 16 case-based practice questions, 19 spaced-repetition flashcards, the pitfalls, the bridge to physiology and the visual trainer. This lesson belongs to module 4: Organ by organ.

Try two lessons free See Tongue and Pulse