By Shihan Mary Bolz
Master of Science Oriental Medicine
Doctoral Fellow, FBU
Master Martial Arts Instructor
As the long, warm days of summer give way to the brisk weather and bright colors of autumn, the natural world begins to prepare for the cold months ahead. Trees lose their leaves and conserve their energy, animals prepare their winter shelters, and summer flowers fade into the earth.
Our bodies, too, are a part of the natural flow of the seasons. Traditional Oriental Medicine (TOM) tells us that each season corresponds to a specific Meridian and Organ system. Autumn is the season when the lungs and large intestine are most active and thus the most susceptible to both positive and negative influences.
The lungs perform the important function of extracting Qi (the life-force energy) from the air we breathe. Qi nourishes the body’s systems providing energy and vitality. Another important function of the lungs is to produce Wei Qi. Wei Qi is similar to the Western concept of the immune system and protects the body against harmful external factors such as wind, cold, damp, germs and bacteria.
One condition that is prominently seen in the autumn is asthma. Asthma is a long-term condition that affects more than 20 million Americans. Caring for a chronic condition such as asthma can sometimes be frustrating, but it’s important to remember that it can be controlled and even cured. Acupuncture and TOM (Traditional Oriental Medicine) can be powerful allies in the management of asthma, and they work very well alone or in conjunction with other types of treatment. Even before Western medications were ever around, Asia has been controlling and treating asthma quite effectively. Why not now days? It is just as effective and needed more than ever, today, for helping the health of people. Traditional Oriental Medicine works at getting the body to correct itself and to deal with the environment, both internal and external. Though a complex medical system, it is based on simple universal truths of nature. When we understand and follow that path, then we can understand how to heal illnesses and imbalances, no matter what they may be.
For treatment of asthma, preventing attacks is the very best one can do and taking this approach is certainly important. In conventional allopathic medicine (Western medicine), this is usually done with regular use of anti-inflammatory medications, inhaled steroids and leukotriene inhibitors. Once an asthma attack is underway, quick-acting medications like corticosteroids may be able to relieve it.
Most of these medications can cause side effects such as nausea, headaches, muscle tremors and insomnia, and many others. Many people have found that acupuncture treatment helps reduce asthma attacks, improve lung function and even lower the amount of or eliminate the Western medication needed.
In TOM, asthma is known as “Xiao Chuan,” which means “wheezing” and “shortness of breath.” It is caused by a variety of factors that involve an imbalance with Wei Qi and an imbalance with one or more of the organ systems, either the lungs, spleen or kidney.
Oriental medicine doctors and acupuncturists take a holistic approach in order to determine what areas of the body are affected, out of balance, and contributing to the attacks. Once these are discovered, specific acupoints and herbs are used to rebalance and support the health of the body.
Physiologically, bronchial asthma is a typically episodic and remittent obstructive lung disorder characterized by narrowing of the large and small airways due to spasm of the smooth muscles of the bronchi, edema, inflammation of the bronchial mucosa, and production of tenacious phlegm. A great deal of bronchial asthma is allergic in nature. People differ greatly in the severity and frequency of their symptoms. Some people may be completely asymptomatic between attacks and others may seem to have it perennially, and get episodes of flare-up attacks that can be severe. A severe exacerbation may occur after exposure to known allergens, viral infections, exercise, or nonspecific irritants. Psychoemotional stress may also either precipitate attacks or aggravate their severity.
During acute attacks there is tight-sounding, generally unproductive coughing, dyspnea (shortness of breath), tachypnea (rapid breathing), a tightness or pressure feeling in the chest and wheezing. If dyspnea is severe, people may not be able to breathe lying down and may experience great anxiety. In life-threatening attacks, there may be rapid, shallow, ineffectual breathing, cyanosis ( a blue color to the skin), lethargy and confusion premonitory to respiratory failure. As the attack subsides, adult patients, but not young children, may expectorate tenacious, thick, sticky phlegm.
Western medicine diagnosis of asthma is based on the presence of wheezing, a family history, and a personal history of episodic wheezing and dyspnea, often beginning in childhood or early adulthood, and a family or personal history of allergies. If diagnosis from these factors above is difficult or complicated by other factors, especially in patients whose wheezing and dyspnea begin after age 50, chest x-rays, blood cell examination, pulmonary function tests, and allergic skin testing may all be used to confirm the diagnosis.
The Western medical treatment of asthma is mostly drug-based, and a wide range of medications may be prescribed based on the severity and staging of the disease. These medications include orally administered and inhaled prescriptions. The main classes of Western drugs used in the treatment of asthma are 1) beta-adrenergic agents, such as epinephrine, ephedrine, isoproterenol, and theophylline to relax the smooth muscles of the bronchi and bronchioles, 2) corticosteroids to inhibit allergic reactions, 3) anticholinergic agents to block the cholinergic pathways that cause airway obstruction, and 4) cromolyn sodium used prophylactically to reduce airway hyper-reactivity. During severe attacks, patients may also be treated with oxygen to reduce hypoxia and with fluids and electrolytes to prevent or treat dehydration. When vital respiratory tract infections become complicated by secondary bacterial infections, antibiotics, such as ampicillin, erythromycin, or tetracycline, may be given. All of the above medications have side effects, and satisfactory asthma control in adults may be difficult to achieve.
In Traditional Oriental Medicine (TOM) what do we say are the causes of the disease? We say that external environmental factors or stresses of cold, heat, wind, summer heat, dryness, and excess dampness, are causes. Internal causes are damage by various factors; faulty diet, iatrogenesis (medical treatment which causes the disease), immaturity and aging.
The disease mechanisms in TCM are similar to those of allergic rhinitis. There is typically a spleen QI deficiency resulting in (1) Wei (defensive) Qi not strong enough or balanced enough to do its job, or (2) phlegm dampness accumulation inside of the body. Defensive Qi not securing allows easy entry of external factors which hinder and obstruct the lung Qi’s ability to ensure normal flow of the air and Qi within the body. When external factors mix with accumulated deep-lying phlegm in the lungs, the lungs’ function becomes even more impaired.
If there is enduring phlegm and dampness inside the body and especially the lungs or severe Qi stagnation, this leads to transformation of heat, and phlegm dampness by become harder phlegm heat. Non-diffusion and stagnation of the Qi can lead to more severe phlegm dampness and lead to obstruction of the movement of blood, thus we have blood stasis. A weak constitution from birth, youth, chronic disease, or aging may lead to yin and/or yang deficiency. Especially in children and the elderly, the kidneys may fail to function in cooperation with the lungs. Then the three main organs involved in asthma are the lungs, spleen and kidneys. Most cases of asthma also involve stagnation of the liver Qi, since the lungs and liver cooperate together in governing the flow of Qi throughout the entire body.
The following diagnostic patterns are often seen in asthma from an Oriental medicine perspective:
1. Wind-cold attacking the lungs.
2. Wind heat invading the lungs.
3. Exterior cold coupled with interior heat.
4. Phlegm obstructing the lungs.
5. Phlegm heat obstructing the lungs.
6. Phlegm and Qi deficiency and phlegm and Qi becoming bound together.
7. Lung Qi and Yin Deficiency together.
8. Lung-Kidney Yin deficiency pattern.
9. Lung-Spleen Qi deficiency.
10. Kidneys not absorbing the Qi.
11. Yang deficiency coupled with an overflow of water. This means there is not only wheezing and panting, but heart palpitations, fear of cold, scanty urination, edema, pale, swollen tongue, chilled extremities, and possibly low back pain.
The treatment of asthma with Traditional Oriental Medicine is typically divided into two phases, the acute attack phase and the remittent, asymptomatic phase. During the acute phase, the manifesting symptoms must be treated, not only the underlying deficiencies. In the remittent phase, emphasis is placed on strengthening or balancing the underlying factors and causes in each individual, based on the above diagnostic patterns. At each phase, the treatment would be personalized and different for each individual. Indeed each treatment and choice of acupoints may vary each time the patient is seen because the person has to be treated as the condition shows changes. There are many factors to consider, many imbalances inside each individual and the Oriental medicine doctor being able to distinguish this in each individual is the key to successful treatment. In this way, the symptoms can be relieved and the causes addressed to prevent further attacks. Traditional Chinese Herbal Medicine is quite advanced and very effective in treating asthma, both in the chronic and acute phases, and when combined with acupuncture, a most effective, natural, and side-effect-free treatment can be obtained.
As far as eating patterns, the fall is the time to organize the open and perhaps scattered patterns of the previous warmer seasons. To stimulate this activity in the body, to focus mentally, and to begin the process of contraction, add more sour flavored foods. These include sourdough bread, sauerkraut, olives, pickles, leeks, azuki beans, umeboshi (salt plums), rose hip tea, vinegar, lemons, limes, grapefruit and the sour varieties of apples, plums, and grapes. Do not eat too many or extremely sour foods, small amounts have a better effect.
A food that is especially good for the lungs in the autumn is pears. Pears help generate fluids inside the lungs when the air tends to be dry in the fall. They strengthen the lung Qi and Yin. Others that are good in autumn for the lungs are persimmons, loquats, apples, Japanese pear-apple, barley, millet, almonds, pinenuts, sesame seed, especially black ones, honey, eggs, clams, crabs, oysters, barley malt and rice syrup for sweeteners.
If you are suffering from asthma of any kind, you owe it to yourself to begin treatment with Traditional Oriental Medicine, you may find a renewed life. Breathe the life-force!