Other organs are involved in breathlessness too. A deficiency of the Spleen leads to the
formation of Phlegm which obstructs the descending of Lung-Qi. Phlegm is often present,
especially in bronchitic breathlessness.

Liver-Yang or Liver-Fire rising can impair the descending of Lung-Qi and lead to chronic
breathlessness.

In very chronic cases in old people, the Heart may also be involved in two ways. First of all, the
Heart vessels fill the lungs and Lung-Qi moves Blood. If Lung-Qi is deficient, Blood is not
moved and it stagnates in the lungs. This leads to right-heart failure due to retention of fluids in
the lungs. Secondly, Kidney-Yang is the basis for Heart-Yang. When Kidney-Yang is deficient,
the Fire of Ming Men fails to warm the Heart, fluids are not transformed and accumulate in the
Lungs and Heart. This is manifested with a profuse expectoration of white, watery, dilute and
frothy sputum. There will also be a pronounced feeling of oppression of the chest and
palpitations. It is called "Kidney-Yang deficient with Water overflowing to Lungs and Heart". In
even more chronic cases, the deficient Heart-Yang fails to move Blood in the chest and the
stagnant fluids in the chest further obstruct Blood. This leads to stasis of Blood in the chest with
symptoms of chest pain, cyanotic lips, dark nails and a Purple and Swollen tongue.

Thus we can summarize the aetiology and pathology of chronic breathlessness with a diagram
(Figure 3.1 (95)Figure 3.1).

Differentiation and Treatment

For the treatment of breathlessness it is most important to differentiate Excess from Deficiency.
In Excess-type of breathlessness, breathing is shallow and long, the person exhales quickly with
a loud noise, there are loud wheezing sounds, there may be a cough and the pulse is Slippery or
Tight and Full. In Deficiency-type of breathlessness, breathing is short and rapid, the person
inhales quickly with a low noise and the pulse is Weak.The "Complete Book of Jing Yue" (1624)
says:

In Excess-breathlessness breathing is long, there is a feeling of oppression of the

chest, the breathing sounds are loud, the person cannot hold the breath in and

breathes out quickly. In Deficiency-breathlessness breathing is short, the person

is flustered, Qi is weak, breathing sounds are weak, breathing is interrupted and

is worse on exertion ....6(96)

For the treatment of Excess conditions one concentrates on treating the Manifestation and on
expelling pathogenic factors. For the treatment of Deficiency cases one concentrates on treating
the Root and tonifying the body's Qi. For example, in breathlessness from Phlegm-Heat (the
Manifestation), even though it is a Spleen deficiency (the Root) that leads to Phlegm, the first