bubble_chart Concept

The pattern of heart-lung qi deficiency is a general term for a series of symptoms caused by the functional decline of both the heart and lung, leading to insufficient lung qi and depletion of heart qi. This syndrome is often caused by internal damage due to overstrain, long-term mutual influence of heart and lung diseases, or diseases of other organs affecting the heart.

Main clinical manifestations: palpitation, shortness of breath, cough, shortage of qi, panting and rapid breathing, especially upon exertion, pale complexion, spontaneous sweating, susceptibility to common cold, and in severe cases, facial puffiness, cyanosis of lips, pale and dark tongue texture, thin white coating, and deep, thin, and weak pulse.

This syndrome is commonly seen in diseases such as "cough and asthma," "deficiency fatigue," "sweating syndrome," and "syncope."

Clinically, this syndrome should be differentiated from "heart qi deficiency pattern" and "lung-qi deficiency pattern."

bubble_chart Differentiation and Treatment

The pattern of heart-lung qi deficiency often arises from the mutual influence of heart qi deficiency pattern or lung-qi deficiency pattern, leading to insufficient function of both the heart and lungs. Since the heart and lungs reside in the chest, the heart governs blood, while the lungs control breathing and govern the qi of the entire body. Qi is the commander of blood; when qi flows, blood flows. Blood carries qi and is the mother of qi, as qi and blood mutually generate each other. Deficiency of heart qi impairs the ability to assist lung qi in spreading and distributing, leading to lung qi deficiency. Conversely, lung qi deficiency impairs the ability to support the heart vessels, resulting in insufficiency of heart qi. Whether the deficiency originates from the heart affecting the lungs or vice versa, it can lead to the syndrome of heart-lung qi deficiency. Symptoms include palpitations, shortness of breath, weak respiration, worsening with exertion, cough, panting, spontaneous sweating, and facial puffiness. However, the manifestations of this syndrome vary depending on the disease.

1. For example, in the pattern of heart-lung qi deficiency associated with chronic cough and panting, symptoms include weak cough, palpitations and sweating upon exertion, shortness of breath, and even cyanosis of the lips. This is due to lung qi deficiency affecting the heart, leading to poor blood circulation. Treatment should focus on tonifying the lungs to relieve panting, replenishing qi, and nourishing the heart. The formula Lung-Nourishing Decoction (Lung-Nourishing Decoction, from *Yonglei Qianfang*) can be modified for this purpose.
2. In the pattern of heart-lung qi deficiency associated with "deficiency fatigue," the main symptoms are shortness of breath, palpitations, low voice, spontaneous sweating, pale complexion, restless sleep, fatigue, and possibly cough and panting. This is caused by heart-lung qi deficiency leading to insufficient pectoral qi, poor qi circulation, and weak heart vessels. Treatment should focus on tonifying and replenishing the qi of the heart and lungs. The formula Lung-Nourishing Decoction (Lung-Nourishing Decoction, from Yonglei Qianfang) combined with Original-Qi Preserving Decoction (Jingyue Quanshu) can be modified for this purpose.
3. In the pattern of heart-lung qi deficiency associated with "sweating syndrome," the main symptoms include sweating with aversion to wind, palpitations, restless sleep, pale complexion, susceptibility to common colds, thin and weak pulse, and thin white tongue coating. Sweat is the fluid of the heart, and the lungs are related to the skin and body hair. Therefore, heart-lung qi deficiency leads to unconsolidated skin and hair, causing excessive sweating. Treatment should focus on nourishing the heart, tonifying qi, and consolidating the exterior. The formula Jade Screen Powder (Jade Screen Powder, from Danxi Xinfa) combined with Cinnamon Twig and Liquorice Root Decoction (Liquorice Root Decoction, from *Treatise on Cold Damage*) can be modified for this purpose.
4. In the pattern of heart-lung qi deficiency associated with "syncope," symptoms include shortness of breath, weak respiration, palpitations, cold limbs, sweating, and even sudden fainting with a pale complexion. This is often due to constitutional weakness, overexertion, or emotional distress. As stated in Neijing, "overexertion leads to qi consumption," "sorrow causes qi consumption," and "fear causes qi sinking." The qi of the heart and lungs may either disperse outward or sink downward, leading to chaotic qi movement or even collapse. Treatment should focus on tonifying qi and consolidating collapse. The formula Duzhong Decoction (Shiyao Shenshu) or Four-Ingredient Yang-Restoring Decoction (Jingyue Quanshu) can be modified for this purpose.

The pattern of heart-lung qi deficiency is commonly seen in the elderly, especially those with chronic cough and panting. Due to the instability of heart-lung qi and insufficient defensive function, patients are prone to external pathogens, particularly in cold autumn and winter seasons, which exacerbate the condition. Additionally, impaired lung function in spreading and distributing leads to the accumulation of body fluids, forming phlegm-fluid retention. When heart qi deficiency affects heart yang, it fails to warm and transform fluids, potentially causing edema. Therefore, this syndrome often involves phlegm-fluid retention and dampness, presenting as a deficiency-excess complex with root deficiency and superficial excess. The presence of external pathogens and phlegm-fluid retention further impairs heart and lung function, worsening symptoms such as cough, panting, shortness of breath, and palpitations. The pattern of heart-lung qi deficiency can also lead to static blood due to poor blood circulation, manifesting as cyanosis of the lips, dark purple tongue texture, and choppy pulse. Treatment should focus on tonifying and replenishing the qi of the heart and lungs, with slight additions of blood-activating and stasis-resolving herbs.

Moreover, the pattern of heart-lung qi deficiency can further affect the functions of the spleen and kidneys over time. Whether it is due to lung deficiency affecting the spleen, a disorder of the child-organ affecting the mother-organ, or due to fire failing to generate earth, a disorder of the mother-organ affecting the child-organ, it can all transmit to the spleen, leading to spleen qi deficiency. If lung deficiency affects the kidneys, or if heart yang fails to warm kidney yang, it can cause a deficiency of kidney qi, resulting in the failure of the kidney to receive qi, and exacerbating symptoms such as shortness of breath and coughing. If kidney qi is insufficient, it can lead to the overflow of water-dampness, causing the syndrome of water rising to overwhelm the heart and lungs, further complicating the condition. The progression of the pattern of heart-lung qi deficiency can ultimately lead to qi collapse above and the separation of yin and yang, endangering life.

bubble_chart Differentiation of Similar Patterns

1. Heart qi deficiency pattern and pattern of heart-lung qi deficiency: Refer to heart qi deficiency pattern.
2. Lung-qi deficiency pattern and pattern of heart-lung qi deficiency: Lung-qi deficiency pattern is a pathological condition caused by excessive fatigue or chronic cough disease damaging qi, or other organ diseases affecting the insufficient function of the lungs. Since pattern of heart-lung qi deficiency also manifests lung qi deficiency, the two should be differentiated. Lung-qi deficiency pattern mainly affects the lung's function of governing respiration, hence the main symptoms are cough and shortness of breath. Additionally, since the lung governs ascent and dispersion and is externally connected to the skin and hair, qi deficiency leads to the lung's failure to disperse, resulting in malnutrition of the skin and hair, thus symptoms such as aversion to wind, fear of cold, and spontaneous sweating occur. There are also manifestations of insufficient pectoral qi, such as a weak voice, fatigue, and reluctance to speak. On the other hand, pattern of heart-lung qi deficiency not only exhibits the manifestations of lung-qi deficiency pattern but also includes manifestations of heart qi deficiency, such as palpitations and a pale complexion. If insufficiency of heart qi affects the blood circulation, symptoms of poor blood flow such as cyanotic lips and a pale, purplish tongue may also be seen. Moreover, the heart belongs to fire and is the taiyang within yang. Insufficient heart yang qi fails to warm and transform water, leading to symptoms such as phlegm-fluid retention and edema. These are different from the simple lung-qi deficiency pattern and are not difficult to distinguish.

bubble_chart Documentation

1. Lingshu-Dahuo Lun: "Qibo said: Abnormal rising of qi is insufficient, lowering qi is excessive, the intestines and stomach are in excess while the heart and lungs are deficient. Deficiency leads to the retention of nutrient qi below, and fire not rising at the proper time, hence forgetfulness."
2. Jingyue Quanshu‧Miscellaneous Syndromes: "The spirit of the five zang-organs is all received from the heart. Therefore, when the heart is worried, the lungs will respond. If the worry does not cease, and one becomes deeply sorrowful, then the yang qi will diminish daily, and the nutrient-defense will dissipate daily, leading to injury to the lungs, which will not cease until death." "The heart stores the spirit, and the lungs store qi; these are the two yang organs. Therefore, excessive sudden joy can damage yang, and the spirit and qi will thus be dissipated. Or, if joy is indulged without restraint, it can lead to dissipation and loss, resulting in mental fatigue and exhaustion, which is incurable."