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Pleurisy

How Chinese medicine differentiates pleurisy into the six patterns described for it, and the points for each. Supportive reading only. Distinct from this site's Chest Pain and Costochondritis pages. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Pleurisy needs a medical diagnosis (its causes range from infection to autoimmune disease) and treatment of the underlying cause. Acupuncture is at most a supportive adjunct for the pain.
General Acupuncture Points

Acupuncture points traditionally used for pleurisy — 3 key points, used across the patterns below rather than tied to just one.

PointKey action
REN-17Tonifies Qi and strengthens the Gathering Qi (Zong Qi). Opens the chest, regulates Qi and promotes the descending of Qi. Benefits the breasts and promotes lactation.
P-6Opens the chest and moves Qi and Blood. Calms the Mind. Moves Liver-Qi.
BL-13Stimulates the diffusing and descending of Lung-Qi. Expels external Wind. Regulates Nutritive and Defensive Qi.
The Six Patterns

↑ reinforcing   ↓ reducing   ⊥ even method.

1. Half-Exterior Half-Interior (Shaoyang)

Clinical manifestations: Alternating chills and fever; chest and rib pain worse with coughing or breathing; bitter taste; dry throat; nausea; irritability.
Tongue: Normal or slightly red with redder sides, thin white or white-yellow coat. Pulse: Wiry.
Treatment principle: Harmonizes the Shaoyang, releases the pathogen and eases chest pain.
Note: no moxa. This site's decks have no Shaoyang/Half-Exterior-Half-Interior slide — no pattern link is given here.

2. Phlegm-Fluids in the Chest and Hypochondrium View full pattern →

Clinical manifestations: Distending, pulling pain worse with coughing and breathing; fullness along the ribs; inability to lie flat; visible chest bulging; thin white or watery sputum.
Tongue: Pale, swollen, white slippery or greasy coat. Pulse: Deep and wiry, possibly slippery.
Treatment principle: Drastically expels water accumulation, drains Phlegm-Fluids and relieves distension.
Note: moxa is appropriate. Linked to this site's own Phlegm-Fluids-obstructing-the-Lungs slide, the closest match.

3. Phlegm-Heat in the Lungs View full pattern →

Clinical manifestations: Burning or scorching chest pain; thick sticky yellow or green sputum; dry mouth with thirst; fever; chest tightness; breathlessness.
Tongue: Red, possibly swollen at the front, yellow greasy coat with possible red prickles. Pulse: Slippery and rapid.
Treatment principle: Clears Lung Heat, transforms Phlegm and calms wheezing.
Note: no moxa.

4. Qi and Blood Stagnation

Clinical manifestations: Fixed, stabbing chest pain worse at night; chest tightness and oppression.
Tongue: Dark purple, stasis spots, distended sublingual veins. Pulse: Wiry and choppy.
Treatment principle: Invigorates Blood, dispels stasis, moves Qi and eases the fixed pain.
Note: no moxa. No combined Qi-and-Blood-stagnation slide exists on this site's decks — no pattern link is given here.

5. Empty-Heat from Yin Deficiency View full pattern →

Clinical manifestations: Dull, lingering chest pain; low-grade afternoon fever; dry cough with little sputum; night sweats; dry mouth and throat with a desire to sip.
Tongue: Red, thin, dry, cracked, little or no coat. Pulse: Fine and rapid.
Treatment principle: Nourishes Lung and Stomach Yin, generates fluids and clears deficiency Heat.
Note: no moxa.

6. Yang Deficiency

Clinical manifestations: Dull, heavy chest pain relieved by warmth; aversion to cold with cold hands and feet; fatigue; pale, puffy face; swollen limbs; loose stools with clear urination; cough with thin white sputum.
Tongue: Pale, swollen, tooth-marked, white slippery coat. Pulse: Deep, slow and weak.
Treatment principle: Warms and unblocks chest Yang, transforms Phlegm-Fluids and relieves the distending pain.
Note: moxa is strongly indicated.
Related conditions

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