To better understand the clinical case studies of traditional Chinese medicine methods, it may be beneficial to have read at least the Case and Exam sheets.
Blond and curly like a cherub, Zachary, two and a half years old, has suffered from asthma since the age of six months following bronchitis. He had been treated with antibiotics, but since, with each change of season, Zachary catches a cold which degenerates into bronchitis. Her doctor therefore prescribed the usual medications, which are administered daily to prevent seizures.
Traditional Chinese Medicine (TCM) has an excellent record in combating respiratory ailments (see WHO and NIH1-2 reports). Even if his way of approaching the problem of asthma is very different from that of Western medicine, the solutions of the two medical approaches can very well be applied in complementarity.
What you will learn
The four stages of the exam
In order to establish an energy balance, the acupuncturist first conducts a careful questioning with Zachary’s parents about his symptoms. Here are the main conclusions:
- At the time of his seizures, Zachary not only has a cough, but his breathing becomes shorter and a hollow forms at the base of his neck with each breath (this is called a “pull”, a sign of distress. lungs).
- Overall, even if he remains active and in a good mood, he then eats very little and loses 1 to 1.5 kg with each attack.
- Little Zachary has a runny nose most of the time; its secretions are clear and almost liquid. (The color, texture, and amount of what ends up in handkerchiefs is a gold mine of information for the acupuncturist.)
- The first asthma attack occurred after a common cold, which passed from the upper respiratory tract to the lungs, developed into bronchitis, and eventually degenerated into asthmatic bronchitis.
- The progress of birth being a very important factor in establishing the energy balance of a childhood illness, Zachary’s parents specify that he was born prematurely, at the 37th week of pregnancy (while the lungs and digestive system are not quite mature, and therefore more vulnerable).
During the consultation, the acupuncturist listens to Zachary’s breathing. His wheezing is characteristic of a bronchospasm which may signal bronchitis, asthma, allergic reaction, or intensely experienced emotions. For more precision, the acupuncturist uses the stethoscope and auscultates Zachary’s breathing. The presence of wheezing on expiration confirms asthma. If snoring groans (also called ronchi) are added, one can suspect bronchitis. However, these signs are difficult to see during an examination performed outside of an asthma attack, because the drugs work to hide these symptoms.
The taking of the pulses being more difficult in the child, it will be replaced by the observation of the venule of the index, in the next step. On the other hand, palpation of the Mu and Shu points on the abdomen and the back makes it possible to check the energy state of the Organs that are linked to the respiratory system, namely the Lung, the Spleen / Pancreas and Kidneys. Our little Zachary makes significant faces while pressing these points.
Observation is particularly important when dealing with childhood illnesses.
- The venule of the index finger is reddish and engages slightly in the area of the first phalanx (see the middle finger in the illustration).
- Zachary’s tongue, which he shows without complaining like most of the little ones, is red.
- Her complexion reveals slightly dark circles under the eyes.
- Zachary is a thin, muscular child with a slender face and a lively gaze. Active and curious, he likes to come to his acupuncture sessions, despite being asked not to move for a few minutes.
Identify the causes
The causes of asthma in Chinese medicine are multiple, but invariably we find that the Lung is affected in its functions of diffusion and descent of the Qi. Very often, several causes can be combined in the same case:
- Too much Cold, Acidic, Sweet (Sweet) or fat in the diet.
- A deficiency ofDefensive energy of the lungs or Kidneys, resulting from a constitutional weakness (see Heredity) or from a condition caused by problems related to pregnancy or childbirth.
- A Wind permanently installed in the Lung (from dust, strong odors, inhaled irritants, smoke, allergens, repeated respiratory infections, etc.).
- An excess of emotions leading to Stagnation of Qi Liver that affects the Lung (see Five Elements). The seizures can then be triggered as a result of sudden anger, for example, or if a person experiences negative emotions over a long period.
- Overwork or, on the contrary, lack of exercise. For example, if you spend a lot of hours in front of the TV, in a posture that constrains your breathing.
- Overuse of bronchodilators and corticosteroids, which can deplete Yang Kidneys in the long run.
Zachary’s case is typical of children who experience asthmatic bronchitis at a young age where the trigger is a minor problem. The lungs were first invaded by a simple cold, that is to say a External perverse energy (a Wind-Cold or Wind-Heat). The constitutional weakness of the Lung (possibly attributable to premature birth) did not allow it to adequately fight against the Wind. He therefore found himself no longer adequately fulfilling its function of lowering the Qi to the other Organs, hence the accumulation of Hmoisture and phlegm. The Kidneys, where the root of the Qi of the Lungs is located, receiving less and less Qi have been particularly affected.
The inability of the Lung to lower the Qi ended up creating a persistent state ofExcess in the “top” (Lung and Upper Heater) and Vacuum in the “bottom” (Kidneys and Lower heater) (see Viscera). The affection then became chronic; from now on, the least Wind seeks the Already weakened lung, which triggers another asthma attack.
The energy balance
Among the analysis grids (see Examinations) allowing the energy balance, that of the viscera proves to be the most relevant here, because if the asthma mainly affects the lungs, there is often a significant disturbance of two other organs, the Spleen / Pancreas and the Kidneys. Exceptionally, two energy assessments are made rather than one in the case of asthmatic bronchitis: the first characterizes the periods of remissions (it is called the field assessment), the second focuses on crises.
Let us first examine the signs which will make it possible to establish an energy balance concerning the ground, which predisposes to the onset of crises. Among other things, we can determine to what extent the three Organs, the Lung, the Spleen / Pancreas and Kidneys, are affected.
- Zachary presents the typical symptom of a weakened Spleen / Pancreas Qi, which is the constant presence of liquid and clear secretions. The Spleen / Pancreas failing to eliminate theMoisture, this ends up in the nose,Sensory opening of the lung.
- The fact that Zachary eats little and that he loses weight during the attacks also reveals that the Qi of the Spleen / Pancreas is disturbed.
- Painful palpation of the Shu points on the back (which reflect the Yang of the Organs) confirms the weakness of the Qi of the Lung, Spleen / Pancreas and Kidneys.
- Slightly dark circles indicate a deficiency ofDefensive energy of the Kidneys, which begin to weaken in their role of supporting the Lung. They were put in heavy demand in the first weeks of Zachary’s life. Not only did they have to support the other Organs in their functions of digestion, respiration, elimination, circulation, etc., but also to supply the needs of the unfinished growth of the organism.
- Observation of the venule of the index finger reveals that between the attacks, a Wind-Cold reaches the surface layer of the organism (the Wind layer) ie openings like the nose and throat, but not the Organs. In the case of the venule, the redness is a sign of Cold (the reverse of the usual red-heat association).
- Zachary’s red tongue could be a sign that his side Yang is found in excess of Yin, possibly due to a weakening of his Kidney Yin. However, we must take into account the constitution of Zachary: thin and muscular, rather active, we have a child of the Wood type (see Five Elements) for whom the discovery of the world requires action. Its Yang aspect is therefore not attributable to an imbalance, but to its natural typology.
Now let’s take a look at the signs that appear around Zachary’s seizures:
- Cough shows obstruction of the Qi of Lung caused by External perverse energy.
- The pulling and the short breath confirm that the Lung has great difficulty in ensuring its function of lowering Qi.
The treatment plan
Zachary’s acupuncture treatments will be based on a combination of points aiming to lower the Qi of the Lung, to raise that of the Kidneys, to tone the Qi of the Spleen / Pancreas, to eliminate theMoisture, to promote the opening of the thorax and to calm the cough. A series of 10 to 12 sessions, at weekly intervals, will be necessary initially, and then maintenance sessions will have to be carried out as the seasons change. It will also be essential to treat Zachary as soon as possible if you have any cold symptoms. The session will then aim to drive out perverse energies and to strengthen theDefensive energy.
Advice and lifestyle
It will be important to protect and nourish Zachary’s weakened Kidneys and Spleen / Pancreas. This means, among other things, that he will have to avoid cold, fatty and sugary foods, of which ice cream is the best example. Ideally, Foods that are cold, and those that are physically cold (juices straight out of the refrigerator, for example) should be eliminated and replaced with Lukewarm Foods (see Diet). In order to maintain the good circulation of Qi, exercise, especially outdoors, is recommended. However, it is important to make sure that Zachary is well dressed, and it will be necessary to prevent too long exposures to the extreme cold so that the lung does not exhaust itself.