There are many conditions described in Oriental Medicine which are characterized by wheezing and breathlessness; asthma is seen as a special subtype of this larger category of respiratory problems. It is a mixed condition of both deficiency and excess. It is the underlying constitutional deficiency which makes possible the invasion of an external pathogen (Wind) which causes the actual asthma symptoms of wheezing and breathlessness, with more difficulty breathing out, and often a tightness in the chest and stiff neck and shoulders. Many additional symptoms may be seen which are used by Chinese medicine practitioners to distinguish the particular type of asthma, and the relative deficiency and excess in various organ systems. The incidence of asthma is much higher in Western countries, than in Asia, and many practitioners see asthma as a disease of modern civilization, perhaps relating to stress, pollution exposure, and diet. Chinese who move to the west and adopt a western lifestyle also have an increased incidence of asthma.
In western terms, asthma is described as a condition of partial obstruction of the bronchi which results in restricted airflow and difficulty in breathing. Phlegm accumulates in the restricted passageways which coughing is ineffective in clearing. Asthma may start in childhood, called early onset type, or in a person’s 30s or 40s, called late onset asthma. The early onset type is related to allergies and correlates to a high incidence of eczema. These disease mechanisms are explained in Chinese medicine primarily through deficiencies in two organ systems: the Lungs and the Kidneys, which allow Wind, an external pathogen, to become locked in the bronchi.
- The Lungs are known as the “canopy” or covering of the body organs. This is the most external of the organ systems and, in fact, includes the skin, along with the lungs, throat, nose, and sinuses. This is the point at which an external pathogen, such as a cold or flu virus, first enters the body, and for this reason, the lungs have an important defensive function. They control the body’s defensive qi which is responsible for expelling entering pathogens, and with the Kidneys, control respiration. A deficiency in this system allows the body to more easily become ill.
- The Kidneys are one of the lower organs of the body. The basic vital fire or energy of the body is found in the kidneys. This is also the place where a person’s constitutional essence resides. In a way, this essence may be thought of as a person’s genetic inheritance, which may include a predisposition towards a disease such as asthma. However, there is also an aspect of essence which reflects medical history and lifestyle; for instance, the essence and one’s likelihood of experiencing disease -- may be improved by herbs, acupuncture, and lifestyle changes, and made worse by stress and poor diet. The Kidneys aid the lung function of respiration by receiving or grasping the qi which the lungs bring into the body. The kidneys also play an important role in hormone and immune function, both very important in understanding allergy mechanisms. There is a natural decline of Kidney energy as one ages; this progression may be slowed through use of herbs and acupuncture.
- Wind this is the most common external pathogen. It is usually associated with cold or heat, and its symptoms are familiar to everyone who has had a common cold. Wind usually moves quickly into the body and is quickly expelled. However, in the special case of asthma, the Lung-Kidney system is too weak to expel the Wind, and it becomes locked in and blocks the lung passageways. Phlegm is seen as an uncomfortable side-effect of this process.
Although Wind and Phlegm cause the uncomfortable, even life-threatening, symptoms of asthma, in Chinese medicine, they are not seen as the true root of the disorder. In fact, treating the symptoms will only temporarily alleviate the problem, and no resolution is possible until the underlying deficiencies are removed. It is here that Chinese medicine is particularly effective as a complementary therapy in resolving chronic asthma.
Several factors may contribute to a Lung-Kidney deficiency: constitutional inheritance, poor diet, emotional problems, fatigue/chronic illness, excessive sexual activity, problems during pregnancy (shock, alcohol/tobacco/drug use), difficult delivery. Suggestions to reduce risk of disease include: adequate rest, moderate sexual activity, reduced intake of dairy foods, sweets and greasy foods, wearing warm clothing and avoiding exposure to cold and wind. Breast feeding mothers may wish to avoid cow’s milk, eggs and fish for the first 6 months of their child’s life as these foods may be correlated with higher infant IgE antibody levels which are associated with increased asthma risk. The late autumn (August) is a time of year associated with the Lungs; it is a particularly good time for preventative treatment for asthma, and there are several special treatment protocols designed to be used at this time.
Acupuncture is highly effective in stopping an acute asthma attack. The focus is on releasing Wind, calming the mind, and restoring respiration. Between attacks the focus shifts to strengthening the Lung-Kidney defensive function. This is the aspect of asthma which is not normally addressed in Western medicine and traditional Chinese medicine (TCM) is particularly effective in enhancing these functions and reducing the future incidence of attacks. Herbal formulas used often include small quantities of the herb ma huang which has a strong adrenergic effect, relaxing the bronchi. Anti-allergy herbs such as wu wei zi or wu mei are frequently used, along with tonic herbs such as walnut and ginseng. A recent addition to asthma herbal therapies is dan shen, which has been shown to reduce IgE immunoglobulins, thus, reducing the trigger for allergic asthma. For any child with a history of eczema or asthma, it is very important to treat any cold or flu. A lingering, partially resolved cold or flu can further injure the Lung-Kidney system, increasing the risk of this serious illness.
In general, there is no problem with treating patients who are concurrently using Western drug therapies. However, corticosteroid use may slow the rate of response to TCM therapy, and reduction of corticosteroid use is a goal. It should be noted that patients with concurrent eczema may see a temporary increase in the severity of their eczema during corticosteroid clearance. For patients who use inhalant sprays, the frequency of use of these sprays becomes a measure of the progression in treatment. Most patients see an immediate reduction in usage; however, to truly strengthen the Lung-Kidney system in chronic asthma may require several months of treatment, and followup treatment during the fall of the following year is recommended.