By Robert A. Victor, L.Ac.
With the advent of the spring season, warmer weather, and the new growth of flowering plants and grasses, many people become afflicted with allergies and hayfever. Traditional Chinese Medicine does not identify specific patterns in relation to this allergic symptomology. But, in applying the reasoning process of Chinese medicine one can gain insight into the pathology behind the sneezing, runny nose, irritability, and malaise that accompany this affliction.
Allergies can be viewed in terms of Root, the TCM basis of disease, Branch, the manifesting symptomology, and miscellaneous exogenous factors. Sneezing, runny nose, irritability, and malaise are the Branches of the disease. The exterior cause of the symptomology is from pathogenic factors such as pollen and molds from external sources. The Root causes may be one of several patterns of internal organ, or Zang-Fu, disharmony.
The primary organ affected in these internal disharmonies is the Lung. When the Qi of the Lung is deficient, its function of regulating the water passages is impaired so that fluids cannot be transformed in the upper burner. Since the nose is the orifice of the Lungs, it is the site of watery discharge produced in that organ. When external pathogens in the form of Wind, Heat, or Cold attack the Lungs, the result is often allergic rhinitis or sinusitis. Effective preventative formulas from Health Concerns include Astra C and Astra 8 to keep the immune system strong and Lung Qi adequate.
Two ancient formulas recently discussed during the October Health Concerns Herbal Symposium by Dr. Jian-Fu Jang are known for their effectiveness in dealing with allergic rhinitis. These are “Powder of Xanthium” (Cang Er Zi San) and “Decoction of Magnolia” (Xin Yi San).
One of the chief herbs common to both formulas is Xanthium (Cang Er Zi). This herb is well known to both modern research and Traditional Chinese Medicine. The substance falls into the category of herbs that expel Wind-Dampness. The Chinese Herbal Medicine Materia Medica states that the herb, “opens nasal passages, disperses Wind, expels Dampness, and expels Exterior Wind”. Modern pharmacological and clinical research has shown Xanthium (Cang Er Zi) to have in vitro inhibitory antimicrobial effect on staphylococcus aureus.
The most telling study of this herb involved 207 clinical cases of chronic rhinitis. Local applications of this herb were applied to the nasal passages of these patients 2-3 times daily for two weeks. Only 3 out of the 207 cases showed no improvement. The remaining 204 cases showed cessation of symptoms. In these cases there was no recurrence during the follow-up period which lasted for up to three years.
Another clinical study of cases of allergic rhinitis used a tableted extract form of Xanthium equaling the equivalent of three grams crude herb taken twice daily for two weeks. The effectiveness rate in 47 cases was 72.4%.
By combining modern clinical research and the rationale of Traditional Chinese Medicine Health Concerns has made available an effective formula for the treatment of allergic rhinitis and its accompanying hay fever symptoms. Xanthium Relieve Surface Formula is a combination of two ancient formulas with additional herbs to increase its effectiveness. This formula, as discussed in the following section on allergy formulas, addresses the allergy symptomatology discussed above. The synergistic effects of the fourteen herbs in the formula give it effective action for all aspects of seasonal allergy without inducing the side effects, such as sedation, that are found in Western medications that deal with the same problem.
An additional aspect of the Xanthium Relieve Surface Formula is that it includes Blood-activating herbs such as Ligusticum (ChuanXiong). Dr. Jang states that many allergy treatments fail because they do not include Blood-activation as part of the therapy. Blood-moving herbs in this formula also make it more effective in alleviating hot skin rashes, an allergic response similar to the irritation that occurs in the nasal mucosa.
Practitioners report excellent results in treating allergies with Xanthium formulas. However, many patients with allergic complaints have complex problems that require the practitioner to address complicated Zang-Fu relationships in order to attain results. This is clearly the case in my practice where the number of wiry pulses and the degree of distress felt by allergy sufferers indicate Liver involvement. We turned to Dr. Efrem Korngold, co-author of “Between Heaven and Earth”, for his insights into the conditions that account for this complexity. Dr. Korngold, in addition to his many years of clinical practice and teaching, is a graduate of the advanced herbal program at Kunming Traditional Medicine Research Institute in China.
According to Dr. Korngold, in clinical practice congestion of the Liver is often a significant pathogenic influence in upper respiratory allergy conditions. Because of the Five Phase interactions between the Liver and Spleen and the Liver and Lung, Liver Qi stagnation and the consequent Liver Heat can suppress the digestive and assimilative functions of the Spleen and inhibit the Qi circulating and downbearing functions of the Lung.
Interference with the Spleen leads to Dampness and Phlegm formation in the stomach, throat and chest, while interference with the Lung leads to Heat, Phlegm, Dryness, and Qi stagnation in the head, nose, throat, and sinuses. In such cases where both disharmonies exist, acupuncture and herbal therapy will have to be directed at both tonifying the Spleen and decongesting the Lung and Liver. If the Liver disharmony is the predominant pattern, then decongesting the Liver will enable tonification of the Spleen and Lung to work more effectively.
Liver-Lung disharmony is demonstrated by individuals complaining of acute rhinitis or sinusitis characterized by purulent mucus discharge, sore and inflamed mucus membranes, and aggravation from hot or dry environments, spicy or greasy food, alcohol or sugar, and intense emotional or mental distress. This type of condition requires therapy which cools and disperses the Heat and Phlegm from the Liver and Lungs (and by association, the Large Intestine as well). For such an individual, Dr. Korngold feels that Nasal Caps 2 will perform quite successfully.
In another common pattern, chronic asthma exists along with recurring bouts of allergic rhinitis and sinusitis. In these cases, there is generally marked deficiency of the Lung and Kidney characterized by tiredness, susceptibility to colds, sensitivity to drafts and changes in temperature, and aggravation from physical or mental strain and weariness. Acute symptoms include profuse watery nasal discharge with itchy, inflamed nostrils, wheezing, coughing with white sputum, frequent sneezing, sweating, and aggravation from exposure to cold air (as when arising in the morning and moving quickly from a warm bed into a chilly room). For this scenario, Dr. Korngold recommends a combination of Clear Air together with Nasal Caps 2. This pair of remedies addresses both the deficiency pattern of Lung and Kidney as well as the excess pattern of Lung and Liver.
Yet another common pattern occurs in individuals with a long history of respiratory allergies who developed sensitivities to milk products, sugar and wheat early in childhood or infancy. As young children they were troubled by frequent colds, bronchitis, ear infections, and perhaps asthma. When they entered adolescence, their condition changed, and the symptoms became more those of seasonal hayfever and sensitivity reactions to airborne chemicals and pollutants. And finally, when they are seen by an acupuncturist or herbalist in their mid-thirties or early forties, they are again plagued by a return of childhood complaints in addition to the ones they picked up as teenagers. This is because the deficiencies that developed in childhood reappear in the adult years after the tremendous growth period of adolescence and young adulthood has petered-out.
The early childhood pattern represented a debilitation of the Spleen and Stomach leading to chronic weakness and vulnerability of the Lung. If this situation is not properly addressed when people are young, it will need to be treated when they are middle-aged. So, in many of the cases that we see in our clinics, we need to aggressively strengthen the Qi of the Spleen and Stomach while managing the secondary problems of upper respiratory allergy. Health Concerns offers several excellent formulas for treating weakness and congestion of the Stomach and Spleen, including Astra 8, Stomach Caps, Quiet Digestion, and Astra C (which also helps to boost the Lung Qi and Defensive Qi).
As you can see, there are many conditions that can provide for the common diagnosis of allergic rhinitis or sinusitis. Careful differentiation and formula selection will lead to the best results for your patients. Because long-term life and environmental stresses play such a strong role in allergic conditions, many formulas are necessary to treat individuals afflicted with allergies. Health Concerns offers a number of superb formulas, discussed further below, to assist you in treating this most common of problems.
REFERENCES ARE FROM:
“The Foundations of Chinese Medicine”, by Giovanni Maciocia, 1989. “Chinese Herbal Medicine: Materia Medica” by Dan Bensky and Andy Gamble, 1986.
“Pharmacology and Applications of Chinese Materia Medica”, by Hson-Mou Chang and Paul Pui- Hay But, 1986.
Robert Victor, L.Ac., holds a Masters in Traditional Chinese Medicine. He is an Herbalist in Residence with Health Concerns, and maintains a clinical practice in Berkeley, California.
ALLERGY FORMULA DESCRIPTIONS
The following formulas are useful in treating allergic nasal and sinus conditions. Please consult the Health Concerns Clinical Handbook for detailed information about the formulas and a listing of their ingredients.
XANTHIUM RELIEVE SURFACE FORMULA
As described in the article above, this formula is effective for the treatment of sinus allergies. The combination of herbs dries excessive fluid from the nasal passages, opens circulation to the head, and dispels Wind (itch and irritability). Xanthium (cang er zi) and magnolia (hou po) are widely used Chinese herbal decongestants. Platycodon (jie geng) directs the actions of the herbs to the lungs and nose and diffuses lung qi, schisandra (wu wei zi) and licorice (gan cao) have anti-allergenic and adaptogenic properties. Fragrant angelica (bai zhi), siler (fang feng) and schizonepeta (jing jie) have wind relieving properties that help relieve acute nasal and skin symptoms. Further, angelica leads herbs to the nasal passages and sinuses. Astragalus (huang qi) and bai-zhu atractylodes (bai zhu) bolster defensive energy. Wild chrysanthemum (ye ju hua) enters the lung channel and is included for respiratory conditions.
NASAL CAPS 2
Nasal Caps 2 treat acute and chronic sinus congestion with excess Heat signs present. The formula acts to open the Lungs and promote circulation to the head, thus opening sinus cavities. Xanthium (cang er zi) opens the nasal
passages and transforms damp wind. It also has antibacterial properties. Chinese cinnamon (gui zhi) unblocks the meridians and dispels cold. Fragrant angelica (bai zhi) reduces nasal congestion and pain; it leads herbs to the nose and sinuses. Ligusticum (chuan xiong) and Chinese peony (chi shao) activate blood circulation, and furthermore, Chinese peony (chi shao) cools the blood. Black cohosh (sheng ma) is used to guide the herbs upward, and it reduces pathogenic fungus. Eucalyptus leaf (Eucalyptus globulus) reduces phlegm and nasal congestion. Thyme (Thymus vulgaris) reduces bronchial spasms and possesses anti-fungal and antibacterial activity. Licorice (gan cao) is a harmonizing ingredient.
ASTRA C
The basis of this combination is the traditional formula, Jade Screen Powder (Yu Ping Feng San). The formula includes Astragalus (Huang Qi) strongly tonifies the Qi of the Lungs and Spleen and Atractylodes (Bai Zhu) tonifies the Qi and facilitates the Spleen in removing wetness. Together, these herbs strengthen the Defensive Qi (Wei Qi) of the body. Vitamin C, Rose Hips and Zinc have been added to the formula for their known effects on boosting the body’s system to resist colds, flus and allergy. “The Handbook of Chinese Herbs and Formulas” by Him-che Yeung states that Jade Screen Powder has application for the common cold, influenza, chronic rhinitis and allergic rhinitis.
The following formulas are useful adjuncts in the treatment of sinus allergies.
Astra 8 is applicable for immune enhancement. Its action is to deeply tonify all aspects of the Spleen and Lung Qi, thereby affecting the way the body reacts to adverse conditions in the environment. This formula can be used to treat the Root causes of many allergic conditions.
Stomach Caps addresses the symptom complex involved when Liver Qi stagnation accompanies stagnation in the Stomach. The formula is used to improve digestion, eliminate food allergies and improve absorption of nutrients. Since it resolves Spleen Dampness it helps to eliminate Phlegm accumulations that contribute to allergic rhinitis and sinusitis.
Phellostatin: There is strong evidence that candida is a factor in allergic scenarios. This formula gently cleanses the colon and treats candidiasis by combining the properties of tonification herbs with herbs that have anti-fungal properties.
Quiet Digestion strongly resolves the Spleen Dampness and Phlegm accumulations associated with intestinal flu and gastric distress. In some cases of allergic nasal or sinus conditions, Dr. Jake Fratkin recommends taking a course of this formula to dispel Dampness before placing patients on a combination of Spleen tonic and Lung clearing formulas.