Allergic Rhinitis
By Shihan Mary Bolz, Licensed Acupuncturist
Master of Science Oriental Medicine
Doctoral Fellow, FBU
Master martial Arts Instructor, 6th Degree Black Belt
Seasonal allergic rhinitis is a medical term for what is commonly termed hay fever. It is actually a complex of symptoms characterized by seasonal or perennial sneezing, rhinorrhea (runny nose with a clear, watery discharge), nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens. Allergic rhinitis may not be just seasonal, however, it can be perennial. There are three basic types of seasonal allergic rhinitis: 1) spring type, 2) summer type, and 3) fall type. The allergens are different with each season. For example, in the spring the allergens are usually tree pollens, in summer the allergens are usually grass pollens and in fall the allergens are usually weed pollens, a common one being ragweed. Perennial allergic rhinitis will occur in some patients without regard to season, therefore, termed – perennial. The most common allergens in perennial rhinitis are fungi spores, dust containing insect feces and proteins, and animal dander.
The most common symptoms: itching of the nose, roof of the mouth, pharynx, and eyes. There is lacrimation, sneezing, and a clear, water nasal discharge. there can be frontal headache, irritability, anorexia, depress and insomnia. Coughing and asthmatic wheezing develops if the condition is more severe. Allopathic (Western) medical diagnosis is based on the clinical symptoms and history, allergen skin patch tests, and many eosinophils in the nasal secretions. Allopathic medicine treatment relies on mainly antihistamines and sympathomimetic type drugs, such as ephedrine and pseudo ephedrine. However, both of these drugs have side effects which many people find unacceptable. Glucocorticoid and corticosteroids may be resorted to if antihistamines are inadequate. Desensitization treatment is possible if antihistamines are poorly tolerated or if steroids are necessary.
Traditional Chinese Medicine (TCM) or Traditional Oriental Medicine (TOM), looks at both the branch (symptomatology) and the root (cause) of any disease or imbalance (anything less than optimal health). The main disease causes of allergic rhinitis are prenatal qi, the energy of the former heaven natural endowment in Oriental Medicine (OM) terms (hereditary factors), chronic bodily qi deficiency due to faulty diet (poor health and low function of the body organs and energy due to poor diet), iatrogenesis (drug-induced, caused by the consumption of too many modern medications, especially antibiotics), overwork causing severe depletion of the body energy, internal damage by the seven affects (more on this later), and external invasion of wind cold (external pathogens).
In Oriental Medicine, airborne pathogens are categorized as external wind invasions. So, during an acute attack of allergic rhinitis, patients are classified as displaying a wind-coldexterior pattern. This accounts for the itching, nasal congestion, sneezing, and clear, water nasal discharge. In OM, the lungs are the delicate organs. This means they are typically the first internal organ affected by externally invading pathogens and especially those entering through the nose, which is the orifice of the lungs. These pathogens stop and obstruct the lungs from diffusing and sending the energy downward, which is the normal direction that their energy flows. If the lungs are hindered from doing this, then there will eventually be a counter flow of the energy, upward which results in sneezing. Since the lungs are the upper source of water in the body, if the lungs fail to diffuse and make the fluids go downwards, these fluids may collect and accumulate, transforming into dampness and phlegm. There is then too much damp and phlegm in the upper part of the body and results in nasal discharge and nasal congestion. Wind causes the itching.
In OM, all people with allergic rhinitis are believe to have a deep-lying or hidden phlegm in their lungs which only becomes apparent when the lung function is damaged by the presence of some outward force.
For these exterior pathogens to invade, there must be an underlying defensive Qi deficiency, basically the body’s defense mechanisms are weak. Can we say the immune system is weak and needs to be strengthened? Some people will counterpoint with, the immune system is too strong in allergies and must be subdued, because it is falsely overactive, responding to these external happenings in nature. No! This is a very mechanistic view only. It is weak and can not keep the natural functions of the body moving in the correct direction. Not everyone has allergic rhinitis, after all, about 1 in 10 Americans. Other healthier people have no problem. “I didn’t have any allergies until I moved to Vacaville,” is often heard here. Well, that person’s deficiency just did not show until moving here. It is not the outside forces that are the cause, it is the internal forces.
If the fortress is strong, the outside invader can not affect those inside the fortress. The fortress of the body is termed in OM as wei Qi, or defensive life-force energy. A chronic weak wei Qi is usually weak because of a deeper weakness, the internal spleen Qi. A weak Spleen causes hidden or deep-lying phlegm inside the body. The lungs are a storehouse for the phlegm and is manifested there. In American patients, the two main causes of weak Spleen Qi are faulty diet and iatrogenesis.
Faulty diet means that infants are children are given the wrong foods, such as feeding infants too many uncooked, chilled foods, too many, hard to digest foods which are high in flavor, or simply overfeeding, even if this is breast milk. It also means eating too many sugars and sweets, eating too many uncooked, chilled foods (including chilled drinks) and eating too many foods which strongly produce fluids such as dairy products, fruits, and fruit juices, and yeasted grain products (such as yeasted breads). Iatrogenesis means inappropriate and/or over use of antibiotics which are described in OM as bitter, cold medicinal which damage the Spleen. Because the lungs, spleen and kidneys are the three organs involved in fluid movement and transformation of fluid, many patients with allergic rhinitis also have a kidney weakness. If there is allergic rhinitis in teenagers, there is a deficiency of the kidney energy as well as the spleen. If it doesn’t manifest until the person is older, the spleen is weaker fist and gradually the spleen weakness reaches the kidneys. So many older patients also have a spleen-kidney double weakness.
Because the lungs and liver share a close relationship, the weakness of these organs starts to bother the liver. Then liver energy deficiency develops. Oppositely, liver deficiency may be due to emotional frustration and result in damage of the spleen and then the lungs. So the cause could originally be from the liver, which originally can be caused by an overly stressful life. Treatment in OM during acute attacks and between acute attacks will be different. The underlying cause of allergic rhinitis must be addressed, otherwise it will always be there.
Chasing the symptoms with medications only will not work, in fact, in can cause the spleen, kidneys and liver to be even weaker, compounding the problem. In OM, treatment during the acute attack with herbs will consist of herbs that open the nose, redirect the energy of the lungs downward, its normal direction, scatter cold, redirect wind. A common herbal formula in the form of teas for drinking or pills may be Xanthium Powder with Additions and subtractions. This formula is for symptomatic use only. There are acupuncture points for symptomatic use on the Governing Vessel, Large Intestine, Bladder, and Lung meridians.
The Oriental Medicine practitioner may herbally treat only the symptoms at the acute stage and then wait to treat the underlying causes between the attacks, or address both at the same time, depending on the severity of the condition. The more severe the symptoms, the more symptomatic treatment must be addressed. With acupuncture, many times, both the symptoms are cause are addressed. In between attacks, the patient should take whatever herbal formula is indicated for their habitual bodily condition and deficiency and deep-underlying phlegm. If the rhinitis is seasonal, the patient should begin supplementing the root (cause) six weeks to three months before the offending season. The formulas need to be modified often according to the changing seasons and the changing condition of the patient. The same is true of the acupuncture point prescriptions.
Your OM practitioner can prescribe both the correct acupuncture and herbs for your condition. Appropriate dietary therapy is of utmost importance in this condition since a damaged spleen always plays a part in re-life Western patients. This means primarily avoidance of foods which damage the spleen as well as foods which strongly proliferate fluids, and sticking to a clear, bland diet.
Dietary factors which contribute to dampness and phlegm: Too much raw, cold, sweet, or mucusforming food. Highly sweet and mucus-forming foods include: meats, eggs, dairy products, fats such as lard and butter (avoid hydrogenated fats-such as margarine altogether), oils, oily foods such as nuts and seeds (especially peanuts), and foods containing concentrated sweeteners. Simple sugars from sweeteners and fruits, eating in excess, also encourage the growth of infections and yeasts. Other contributors include: Food that is refined or highly processed, rotten, stale, parasite-infested, or chemically treated too many ingredients in a meal (poor food combining), late-night eating, and overeating. Some products with damp-causing properties seem to have much worse effects than the mere sum of their properties. One such example is ice cream. It is very sweet, very cold, highly mucus-producing and often full of chemical additives, furthermore, its concentrated sweeteners and often added sweet fruits do not combine well with dairy, a high-fat protein. some foods which dry dampness are rye, amaranth, corn, azuki beans, celery, lettuce, pumpkin, scallion, alfalfa, turnip, kohlrabi, white pepper and bitter herbs such as chaparral and chamomile. A good substitute sweetener is brown rice syrup or barley malt in recipes where one would normally use sugar. These are 50% maltose, as opposed to mostly sucrose, such as the other refined sugars and honey.
External steams of nasal opening herbs can be prepared and the steam inhaled while cooking them. Here are some good ones:
- bai zhi (Angelica dahurica)
- qiang huo (Notopterygium root)
- xin yi hua (Magnolia liliflora Dest.)
- cang er zi (Xanthium sibiricum)
- fang feng (Ledebouriella seseloides)
- ge gen (Pueraria lobata)
- These herbs would be available in a complete Chinese herbal pharmacy.
