Asthma

Asthma is a common illness characterized by repeated attacks of paroxysmal dyspnea with wheezing . Generally speaking , it involves a variety of disorders resulting from disturbance ofqi activities , and can be divided into two types : deficiency and excess .

Etiology and Pathogenesis

The causative factors are varied from the exogenous pathogenic factors to weakened body resistance . Asthma due to exogenous pathogenic factors is of excess type , and that due to weakened body resistance is of deficiency type . a )

Excess type :

• Wind - cold type : It denotes asthma due to invasion of wind cold , which impairs the smooth flow of the lung qi , injures the skin and hair , and makes the pores closed . Since the lung and the superficial defensive system are weakened , the lung qi fails to disperse and descend , leading to cough .
• Phlegm - heat type : It refers to asthma due to failure of the spleen in transformation and transportation , resulting in production of phlegm from the accumulated dampness . Long - standing retention of phlegm turns into heat , or excessive fire of the lung evaporates the fluids to phlegm . When the phlegm fire stays in the lung , the lung qi is stagnated and the normal activity of the lung is impaired . Failure of the lung qi in descending function results in asthma .

Deficiency type :

• Lung deficiency : A prolonged and protracted cough can weaken and injure the lung qi . Overstrain and internal injury can also bring about deficiency of the lung qi . In either case , shortness of breath and dyspnea may occur .
• Kidney deficiency : Overwork and sexual indulgence can injure the kidney . A severe or chronic disease weakens the body resistance and damages the essential qi . Long - standing asthma also affects the kidney . In any of the above cases , failure of the kidney in receiving qi may give rise to asthma .

Differentiation

Excess type :

• Wind - cold type :

  Main manifestations : Cough with thin sputum , rapid breathing , accompanied by chills , fever , headache , and anhidrosis at the early stage , absence of thirst , white tongue coating , superficial and tense pulse .

  Analysis : The lung is in charge of respiration and is associated with the skin and hair , which are first attacked by wind cold in the invasive procedure . If wind cold resides in the lung , stagnation of qi and failure of the lung qi in dispersing result in cough with thin sputum and rapid breathing . If wind cold still resides in the superficial part of the body to make the pores close , there appear chills , fever , headache and anhidrosis . Since the wind cold has not transformed into heat yet , thirst is absent . White tongue coating , superficial and tense pulse are the signs of wind cold staying in the lung and the defensive system .

• Phlegm - heat type :

  Main manifestations : Rapid and short breathing , strong and coarse voice , cough with thick yellow sputum , sensation of chest stuffiness , fever , restlessness , dryness of the mouth , thick yellow or sticky coating , rolling and rapid pulse .

  Analysis : Phlegm heat turned from dampness or long - standing phlegm fire gathered in the lung blocks the air passage , causing impairment of the lung qi , and thus presenting rapid and short breathing , strong and coarse voice , and cough with thick yellow sputum . When the phlegm stays in the lung , sensation of chest stuffiness appears . Fever , restlessness and dryness of the mouth are due to the presence of the fire heat . Thick yellow or sticky coating , rolling and rapid pulse are the signs of the phlegm heat .

Deficiency type :

• Lung deficiency :

  Main manifestations : Short and rapid breathing , feeble voice , weak and low sound of coughing , sweating on exertion , pale tongue , pulse of deficiency type

  Analysis : The lung dominates qi . When there is deficiency of the lung qi the function of the lung is impaired . There appear short and rapid breathing , feeble voice , weak and low sound of coughing . When the lung qi is weak , and the superficial defensive system is not strong , even mild exertion will induce sweating . Pale tongue and pulse of deficiency type are the signs of deficiency of the lung qi .

• Kidney deficiency :

  Main manifestations : Dyspnea on exertion after longstanding asthma , severe wheezing , indrawing of the soft tissues of the neck , short breath , lassitude and weakness , sweating , cold limbs , pale tongue , deep and thready pulse .

  Analysis : Long - standing asthma affects the kidney which is the source of qi . The kidney in lowered functioning fails to receive qi , and therefore dyspnea on exertion , severe wheezing and short breath appear . When there is deficiency of the kidney qi in a chronic case , emaciation and lassitude happen . Exhausted kidney yang may lead to weakening of the superficial defensive yang , and hence sweating . If the yang qi fails to warm up the body surface , cold limbs appear . Pale tongue , deep and thready pulse are the signs of weakened kidney yang .

Treatment

Excess type

• Wind cold :

  Method : Points of the Hand - Taiyin and Hand - Yangming Meridians are selected as the principal points . Reducing method is applied in combination with moxibustion to eliminate wind cold and soothe asthma .

  Prescription : Feishu ( B 13 ) , Fengmen ( B 12 ) , Dazhui ( Du 14 ) , Lieque ( L 7 ) , Hegu ( LI 4 ) .

  Explanation : Feishu ( B 13 ) and Fengmen ( B 12 ) are the points of the Foot - Taiyang Meridian and located in the vicinity of the lung . They are able to clear the lung and eliminate wind . Dazhui ( Du 14 ) , Lieque ( L 7 ) and Hegu ( LI 4 ) are in function to eliminate wind and cold , clear the lung and soothe asthma .

• Phlegm heat :

  Method : Points of the Hand - Taiyin and Foot - Yangming Meridians are selected as the principal points with reducing method applied to resolve phlegm , reduce heat and soothe asthma .

  Prescription : Feishu ( B 13 ) , Dingchuan ( Extra ) , Tiantu ( Ren 22 ) Chize ( L 5 ) , Fenglong ( S 40 ) .

  Explanation : Chize ( L 5 ) , the He - ( Sea ) point of the Hand - Taiyin Meridian , is able to reduce phlegm heat and soothe asthma . Fenglong ( S 40 ) , a point of the Foot - Yangming Meridian , is able to strengthen the spleen function and resolve phlegm . Feishu ( B 13 ) is applied to clear the lung and regulate the flow of . qi . Tiantu ( Ren 22 ) is in function to descend qi and resolve phlegm . Dingchuan ( Extra ) is an empirical point to pacify breathing .

Deficiency type :

• Lung deficiency :

  Method : Points of the Hand - Taiyin and Foot - Yangming Meridians are selected as the principal points with reinforcing method applied to strengthen the lung qi . Moxibustion is also advisable .

  Prescription : Feishu ( B 13 ) , Taiyuan ( L 9 ) , Zusanii ( S 36 ) , Taibai ( Sp 3 ) .

  Explanation : Taiyuan ( L 9 ) , the Yuan - ( Primary ) point of the Lung Meridian , is able to reinforce the lung qi . Feishu ( B 13 ) used in acupuncture and moxibustion , can strengthen the lung qi . Zusanii ( S 36 ) is the He - ( Sea ) point of the Stomach Meridian of Foot - Yangming . Taibai ( Sp 3 ) is the Yuan - ( Primary ) point of the Spleen Meridian . The lung pertains to metal and the spleen to earth , which is able to promote metal . Reinforce the mother in case of deficiency . Zusanii ( S 36 ) and Taibai ( Sp 3 ) are selected here to strengthen the lung through invigorating the spleen and stomach .

• Kidney deficiency :

  Method : Points of the Foot - Shaoyin and Ren Meridians are selected as the principal points with reinforcing method applied to strengthen the kidney function in receiving qi . Moxibustion is also advisable .

  Prescription : Taixi ( K 3 ) , Shenshu ( B 23 ) , Feishu ( B 13 ) , Tanzhong ( Ren 17 ) , Qihai ( Ren 6 ) . Supplementary points : Persistent asthma : Shenzhu ( Du 12 ) , Gaohuang ( B 43 )

  Deficiency of the spleen : Zhongwan ( Ren 12 ) , Pishu ( B 20 ) .

  Explanation : Taixi ( K 3 ) , the Yuan - ( Primary ) point of the Kidney Meridian , is able in combination with Shenshu ( B 23 ) to strengthen the primary qi of the kidney . Tanzhong ( Ren 17 ) , the qi point of the Eight Influential Points , and Feishu ( B 13 ) , the Back - Shu point of the lung , are needled to reinforce qi and pacify breathing . Qihai ( Ren 6 ) , an important point to reinforce qi , is able to regulate qi in the lower jiao , reinforce the kidney , strengthen the primary qi , invigorate yang and control essence . Puncture on these points strengthens the kidney in receiving qi and pacify breathing . Moxibustion on Shenzhu ( Du 12 ) and Gaohuang ( B 43 ) may relieve chronic asthma , while moxibustion on Zhongwan ( Ren 12 ) and Pishu ( B 20 ) may strengthen the function of the spleen and reinforce qi .

Remarks

This condition includes bronchial asthma , asthmatic bronchitis , obstructive pulmonary emphysema and dyspnea present in some other diseases . However , for symptomatic dyspnea , a combined treatment should be taken into account .