Allergic Rhinitis & Chinese Medicine

Townsend Letter for Doctors and Patients, May, 2001 by Bob Flaws

Introduction

The clinical symptoms of allergic rhinitis include paroxysmal attacks of sneezing, runny nose, nasal congestion, anosmia, and itching in the eyes and back of the throat caused by exposure to airborne allergens such as pollen and animal dander. Often such attacks are seasonally recurrent due to the patient being allergic to specific types of pollen released at specific times of the year. The common name of such seasonally recurrent types of allergic rhinitis is hayfever, while pollinosis is its technical Western medical moniker. Chinese doctors have recognized allergic rhinitis as a specific disease for many centuries. It is called bi qiu in Chinese medicine or "sniveling nose," and there are effective preventive and remedial treatments for hayfever within Chinese medicine. However, to understand how these work, one must understand the Chinese medical view of the pathogenesis and pathophysiology of this condition.

Chinese medical disease causes & mechanisms

Because ancient Chinese doctors did not have microscopes, they referred to all unseen airborne pathogens as species of evil wind. They knew that some special something was in the air that provoked attacks of upper respiratory symptoms, but they could not see the offending substance, just as one cannot see the wind though one can feel its effects. Chinese doctors also knew that some diseases are seasonal. These are referred to as seasonal diseases in Chinese medicine and are associated with seasonal contraction of evil wind. If external wind evils enter the body where they are not supposed to be, they hinder and obstruct the free flow of qi. Chinese doctors knew that most externally invading or contracted wind evils enter the upper part of the body, typically first attacking the lungs. However, according to the Nei Jing (Inner Classic), the 2,500 year old "bible" of Chinese medicine, if the righteous or healthy qi of the body is full, evils cannot enter. In particular, it is the defensive qi which guards the e xterior of the body against invasion from external wind evils.

Therefore, it is axiomatic that everyone with allergic rhinitis does have a defensive qi vacuity according to Chinese medicine, at least at the time of the attack. Further, because the defensive qi issues from the middle burner and is made from the finest essence of water and grains (i.e., food and drink), a defensive qi vacuity is mainly due to a spleen vacuity. It is the spleen which upbears the finest essence of water and grains to the lungs to be transformed into the qi. According to five phase theory, the spleen is the mother of the lungs and, although the lungs govern the qi of the entire body, they especially govern the defensive qi. Therefore, spleen vacuity in those with allergic rhinitis leads to lung and defensive qi vacuity. "When the spleen and stomach are vacuous and weak, the qi of the upper burner is insufficient." [1] In Chinese medicine, the causes of spleen vacuity are inherent weakness due to immaturity, faulty diet, such as overeating, uncooked chilled foods, sugars and sweets, and oily, fatty foods, too much thinking, worry, and anxiety, overtaxation and fatigue, too little physical exercise, contraction or internal engenderment of dampness, damp heat, and/or summer heat, chronic disease, aging, and iatrogenesis due to overuse of "bitter, cold" medicinal (which includes antibiotics).

Not only is the spleen the root of the engenderment and transformation of the defensive qi, the spleen is also the main viscus in the movement and transformation of water fluids in the body. If, for any reason, the spleen is vacuous and weak, it may fail to properly move and transform water fluids which, instead, stop, collect, and transform into damp evils. Once produced, these damp evils further damage the spleen since, "The spleen is averse to dampness." However, these damp evils may also obstruct the free flow of qi and, therefore, either lead to or aggravate liver depression qi stagnation. Since the qi moves the fluids throughout the body, qi stagnation may lead to or aggravate dampness, while dampness may lead to or aggravate qi stagnation. Further, if damp evils linger, they may be transformed into phlegm. If the qi accumulates and counterflows upward, this phlegm may rise up and lodge in the lungs. Thus it is said in Chinese medicine, "The spleen is the root of phlegm engenderment; the lungs are where phlegm is stored." Because one of the main symptoms of allergic rhinitis is a congested, runny nose with clear white, watery mucus, the overwhelming majority of hayfever sufferers do have phlegm rheum according to Chinese medicine. (Phlegm rheum means this clear, wet, watery discharge.) However, because this phlegm rheum is not always apparent, it is spoken of as being deep-lying or hidden during normal times.

Putting all this together, we can say that most sufferers of allergic rhinitis manifest the following Chinese medical patterns: spleen-lung vacuity giving rise to a defensive qi insecurity complicated by deep-lying phlegm rheum and liver depression qi stagnation. Because the spleen and kidneys are mutually rooted and spleen disease eventually reaches the kidneys, many hayfever sufferers also have a kidney vacuity as well. This is especially so in the young whose kidneys are inherently immature and in the elderly whose kidneys have become vacuous and weak due to age. Thus many Chinese doctors identify the three main viscera in allergic rhinitis as the lungs, spleen, and kidneys. [2]