Lung Heat: often cough, acne & tiredness

Lung Heat is a syndrome in Chinese medicine. It describes what may seem like quite diverse conditions, from acne to breathlessness, cough to feeling hot.

Jonathan Clogstoun-Willmott

October 15, 2019

Key Learning Points

Lung Heat: Symptoms of this common, debilitating problem
Why people get it
What NOT to do
What helps Lung Heat

Lung Heat is a syndrome in Chinese medicine. It describes what may seem like quite diverse conditions, from acne to breathlessness, cough to feeling hot.

Chinese medicine is very different to Western medicine. It is much older – at least 3000 years old as compared to modern Western medicine, which scrapes along with just a couple of hundred years.

The ancient Chinese didn’t have all our wonderful modern scientific systems of enquiry and analysis. Instead they did something that has been lost. They observed, smelled, touched and listened. Then they thought carefully about what all that meant.

In its own way, it is as scientific as Western medicine.

This lead to the development of a system of medicine that is termed ‘energetic’: not a very good name because Western scientists think of energy in terms of joules and Relativity! But anyway, ‘energy’ medicine is what we’ve got.

You can read more about the functions of the Lung in Chinese medicine here. Then read about the idea of Heat.

Lung Heat is an ‘Interior’ syndrome

Lung Heat is considered to be what is called an Interior syndrome. Interior syndromes either come about through long-term illness or sometimes after a severe acute illness.

Interior syndromes are chronic and come into being over a longer time. Sometimes they are harder to cure.

However, Lung Heat can actually also be acute! If so, it can be severe.

Lung Heat Symptoms

Cough: when acute, usually loud and often painful. If chronic, then frequent and somewhat disabling.
Sensation of Heat. This is felt mainly in the chest but can be all over. If you’ve had Lung Heat for a while, then you may also have some Lung Yin deficiency, in which case you’ll find you sweat when you wouldn’t expect to. Commonly this will be in the afternoon or during the night. When Lung Heat is acute, you’ll also have a fever.
Short of breath, breathlessness. Not all the time, unless severe, but worse when you are hot or your environment is hot and dry, and during exertion.
Pain in your chest. This can be a mild ache, worse for coughing, or very severe, making it impossible to breathe deeply. If so, you probably won’t even want to move.
Thirst – usually for cold fluids. Lots of chilled drinks. You gulp them down, or sip them frequently.
Your face is red and may have a rash, even eruptions such as acne.
If acute, your nostrils tend to flare as you breathe.
Easily leads to tiredness or weakness
Pulse: typically this is fast and has a quality called ‘overflowing’. If you don’t know what this means and if you have sensitive finger-tips, you may find that when you feel the pulse, especially in the distal position on the right wrist – but it can be in all positions – it really comes out and hits your finger!
Tongue: the colour of the body of your tongue is red. It has a coating on it that is yellow.

Why do you have Lung Heat?

There are several ways to acquire Lung Heat:

From an acute illness. Your Lungs are so important for your general health and immunity that just about any acute illness may affect them. More to the point, the energy of that illness, which may be Cold or Wind or Heat or even Damp or Dryness can ‘transmit‘ to your Lungs. Depending on your metabolism, these can then be turned into various syndromes, one of which is this one.
From a chronic condition, called a remaining pathogenic factor. This has become much more common in the last fifty years and is thought to be because of the increased use of antibiotics – though it can occur after vaccinations and other medications. You can think of this as if the antibiotics killed the bug but didn’t dispose of its remains, which festered, causing Heat. Why did you need the antibiotics in the first place? Probably because you had an invasion of what is called Wind, more probably Wind-Heat. After the medication you felt better but then found, possibly some time later, that you had a niggling little cough, with thirst and some of the other symptoms mentioned. Later still, you began to get the redness on your face, possibly with a rash or even an eruption like acne. If so, the front of your tongue would be redder than the rest of it.

Smoke

From inhaling tobacco smoke for years. (Probably the same applies to other substances smoked, but I haven’t seen enough to be sure.) Inhaled smoke, from any source, if it goes on for too long, heats your Lungs. If you can’t get away from the smoke, the heat builds up. This is made worse if your diet is also very heating, from eating too many Hot foods – see below. (Both my parents smoked heavily both before and for years after I was born, so my Lungs are predisposed to mild Lung Heat and Lung Yin deficiency.)

Hot working conditions lead to Lung Heat — Photo by Hemant Latawa on Unsplash

Working in very hot environments, such as a bakery, or beside a furnace – all the more so if there is smoke. As with inhaled tobacco smoke, the Heat takes a while to build up. But I have seen many bakers with a tendency to a rash on their faces.
Frequent exposure to smoke from coal or wood fires, or from particles in the atmosphere arising from industry or traffic

Food

Eating the wrong foods too often. Wrong foods here mean Hot foods – foods that have a heating effect on you. We all eat them from time to time – think of curries, spicy Thai or Chinese food. If you were brought up in those or similar cultures, this may matter less. (But if so, even you will have a tendency to Lung Heat and when away from the hot climate which naturally forces your body to adapt to the heat by sweating, could develop Lung Heat.) For those of us raised in cold climates, too much spicy food and other hot-type foods could lead to Lung Heat, especially if you inhale tobacco too.

Age

Finally … Just being an adolescent! Adolescents often have vigorous yang energies (think hormones). Combine that with the frustrations typical of that age group and you get Qi stagnation. Add the tendency to experiment with hot, spicy foods and alcohol, and to smoke (see more about this below) and you get signs of Yang excess. This can all lead to rashes and fever, coughs and acute diseases. And … Horrors! This includes skin rashes like acne.

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What happens next if you do nothing about Lung Heat symptoms?

This depends on your metabolism, your energy and your circumstances.

The most frequent next-step syndrome is Lung Yin deficiency.
Any such long-term syndrome can lead in time to other forms of Yin deficiency, such as Heart and Kidney Yin deficiency with deficient Heat.
But having Heat trapped inside you could make you more susceptible to other hot-type syndromes.
This residual Heat has a dissipating effect on your health. If you get Lung Yin deficiency, for example, you may sweat unexpectedly at times, when otherwise well. This could lead to being more susceptible to chills and further invasions of, for example, Wind-Heat. You become someone always going down with something, even in good weather and warmth.
Heat may dry things out. So you get symptoms of Dryness, specifically Lung Dryness, with a chronic dry cough.

What sort of illnesses might have this Lung Heat syndrome?

The list is long, depending on your particular circumstances. The ones I’ve listed below are Western-medically defined illnesses which could have various explanations and syndromes in Chinese medicine, not just Lung Heat. They could also be due to several combinations of syndromes in Chinese medicine.

some forms of acne
some forms of facial rash
various intermittent types of fever
pleurisy
pneumonia
bronchitis
tuberculosis (this also develops into Yin deficiency)
asthma
many diseases where there is a cough

How is Lung Heat treated, in Chinese medicine?

Acupuncture Forehead at Yintang to descend Shen qi and calm excess such as lung heat

The basic treatment for Lung Heat is to clear out the Heat and help the Lungs to start descending again.

When you cough or can’t get a proper deep breath, your Lungs are said to be ascending energy or unable to descend it.

Once this descending function is repaired, you will be able to breathe comfortably and properly, you won’t cough, and your energy will return, assuming there are no other complicating syndromes.

Chinese medicine has several ways to do this. Obviously acupuncture and Chinese herbs have been used for this for millennia, but there are other ancillary ways that help, including cupping.

What can YOU do to help Lung Heat?

Some of the following apply even if you have severe Lung or Wind-Heat. Other suggestions apply if you are receiving treatment and are improving.

You will need to learn better posture, breathing and diet.

Posture

If you sit at a desk to work, be aware that you are probably slightly compressing your lungs for many hours daily.

You have to learn to sit up so that your lungs are able to breathe deeply and easily throughout both their upper and lower spaces.

Make sure, as you sit, that you bum is slightly above the level of your knees, because this will help to tilt your pelvis forward a little. That small tilt makes it easier to open you lungs as you arch your back to compensate for the forward pelvic tilt.

In bed, you probably already sleep slightly propped up but this can compress your lungs too.

Cycling with low-slung handlebars forces you to adopt a bent-over posture. Upright handlebars are better (though I admit, they don’t look quite the thing.)

Breathing

First, you need a supply of clean, preferably fresh air, not hot or dry.

Then … You should stop smoking tobacco, and also the E-Vape which may be purer but is still heating even with mint flavours.

You should avoid drafts, because they can lead to Wind invasion.

Keep your working environment clean. Dust everywhere can clog your lungs but also harbours bugs.

As you improve, wrap up well and go hill-walking, but don’t get too tired. Start with very small walks.

Food

Think carefully about your diet. Reduce the quantity of Hot foods. Possibly increase their balance with Cold Foods (eaten hot) but first read our page on Nutrition. Chinese medicine is all about balance so don’t over-compensate!

Avoid phlegm-forming foods such as dairy products (cheese, milk, cream, even sweetened yogurt), sweet food and cold or raw food. These all challenge your Spleen energy.

Dairy - Cheese Cream Butter - can exacerbate Lung Heat and lead to Lung Phlegm — Dairy

Your Lungs and your Spleen work very closely and if one goes down, it can bring down the other too.

With Lung Heat you want ice-cream because it is cooling and sweet and cools you and energises you BUT ice-cream is not recommended – sorry to be a spoil-sport! It can be too much of a challenge for your Spleen. Too many phlegm-forming foods and you’ll have not just Lung Heat but Lung Phlegm Heat too: you don’t want that! Click here and look it up!

If you get Lung Phlegm-Heat, your family will want you to go straight back to your doctor for more antibiotics (though you should instead go to your acupuncturist!)

Worse, you might get Lung Phlegm Heat with Lung and Spleen deficiency plus your Lung Heat. All the coughing and sleeplessness will almost certainly lead on to Lung Yin deficiency too. Bad news.

Some herbs and foods that help recover Lung Yin quality include:

Comfrey: often thought of in relation to bone repair, but is a great herb for strengthening Lung yin, repairing tissue and reducing inflammation. Make an infusion of the leaf, though, if you know how, make a syrup from either root or leaf.
Iceland or Irish moss: make a decoction – it should taste bitter. Do not use this if you still have a fever.
Barley: barley contains gluten, so is not appropriate for people with gluten intolerance but otherwise include barley in soups and stews.
Fritillaria: many herbalists and some pharmacies sell syrups containing fritillaria.
Ginger root: benefits Lung and Spleen and digestion in general. Add a slice to hot water and sip or add slices to other hot dishes.
Onion: chop small then fry very slowly in a little olive oil or butter then make into a soup with vegetable stock. Can use scallions and other members of the onion family including leaks too.
Pears: the juice from cooked pears helps throat and lungs.
Apples: cooked apples with a little sugar soothe lung tissues.
Nuts: almonds, pine nuts and walnuts are considered the best nuts for lung health. Chew well before swallowing or include in teas or cooked dishes.
Citrus peel. Prepare dried peel from tangerines and mandarin oranges, which you would otherwise discard after eating the flesh. (NB Before eating the fruit, wash it carefully in soap and water to clean the skin of pesticides. Better still, buy organic.) Let the peel dry fully in the sun or in an oven set really low for some hours. Make a small amount into a tea, or use in cooking stews and other dishes. Relaxes and opens the lungs.
General: a little food eaten frequently is best. Don’t overeat because that overloads your Spleen energy and besides, if your belly, stomach and intestines, are stuffed full, there’s no space for your lungs to expand into!

Fluids and Lung Heat

If you have Lung Heat, you will almost certainly like cold fluids to drink. To digest this, your body needs a good supply of Stomach warmth. Unfortunately, a considerable amount of your energy is diverted into producing the Heat in your Lungs so cold or chilled fluids may not be properly absorbed.

Chinese medicine would recommend that what you drink be either warm or luke-warm. Indian and Chinese teas are mostly slightly cooling in action, even when taken warm, so you may find this form of warm liquid easier to take.

I’m also very sorry to have to tell you that alcohol is heating. However, I agree, it seems just fine at the time! You will have to decide whether the short-term pleasure outweighs the long-term pain.