138 Complementary Therapies in Medicine: Clinical forum
3. French S ed. Physiotherapy: a psychological approach. Oxford:
Butterworth Heinemann, 1992. pp33 i-332.
4. Cartwright-Adams N. A study of the osteopathic treatment for asth-
matics. BSO Project 1989/12.
TRADITIONAL CHINESE MEDICINE
BACKGROUND
In Traditional Chinese Medicine (TCM) asthma is not
a disease but a symptom of imbalance in all organ sys-
tems. At the heart of TCM are the life force Chi, which
sustains all things, and Yin and Yang, manifestations of
the complementary antagonistic opposites which char-
acterise all things. In health Chi is of a certain qual-
ity, quantity and direction of movement, if not, disease
occurs. In TCM asthma may be due to environmental
‘wind-heat’ or ‘wind-cold’ (air pollution, viral or bacte-
rial infections, inclement weather, poor diet etc.). Such
‘evils’ invade and weaken the lungs disrupting the move-
ment of Chi. Weak lungs can also be caused by dys-
function in the digestive (spleen/stomach) and heredi-
tary/immune (kidney) energy systems. This may lead to
excessive heat in the lungs and/or water retention which,
if it concentrates to form phlegm, may obstruct air-flow
and so cause asthma.
THE PATIENT
Janie is the second of two children, is nearly 10 years
old, has a family history of atopy (dermatitis, eczema,
asthma and hayfever), a classical chesty picture begin-
ning as a toddler of 4 with night coughs, being inhaler-
dependent by the age of 7 and on inhaled steroids by
the age of 8, on which she is currently maintained. Her
GP is well informed and sensitive, aware of both actual
and potential family tensions. Janie’s mother has given
up work, her father has a new stressful job, communi-
cation is difficult, and Janie has just had an acute respi-
ratory crisis necessitating hospitalisation. This involves
and reflects complex psycho-physical dynamics. From
the available information Janie is an ideal candidate for
TCM. We expect her to respond well after a few treat-
ments.
THE ASSESSMENT
Whilst in allopathic terms Janie has a clear diagnosis of
asthma, additional information is required for a proper
TCM diagnosis:
5. Coleshill A. Osteopathic treatment for asthmatics. Br Osteo J 1988;
II: 15-16.
6. Sutherland WC. In: Wales AL. ed. Teachings in the science of
osteopathy. Cambridge, Mass: Rudra Press, 199 I.
l At exactly what age did her symptoms first appear
and what precipitated them?
l Was there initial evidence of a viral infection or a
more sudden ‘allergic’ onset?
l At what time (am/pm) do symptoms appear?
l What factors are associated with symptoms, e.g.
sport, pets, weather, infections, house dust mite, or
emotional/stressful situations?
l Do food and time of eating matter? What mucogenic
foods such as milk, cheese, other dairy products, red
meat, chocolate, alcohol, yeast or gluten containing
foods is she eating?
For a TCM diagnosis the balance of Janie’s yin and
yang, i.e. hot and cold, wet and dry, wind and heat,
as internal and external conditions at organ, blood and
energy levels are assessed. The arterial pulses, tongue,
skin colour, texture and smell, facial and other signs
are noted. In TCM disturbed lung function in childhood
asthma is most often due to ‘lung heat and phlegm’. The
hereditary component indicates kidney energy dysfunc-
tion, the eczema indicates both disturbed lung and colon
energies (the lung, colon and skin are intimately linked in
TCM), but foods and infections are also important causes
of skin problems, particularly in Janie’s case.
THE TREATMENT
TCM treatment involves physical and systemic psycho-
logical approaches for both Janie and her parents. Chil-
dren are more sensitive than adults so acupressure, gen-
tle acupoint massage, or surface electro- or laser point
stimulation are often preferable to needle insertion. Min-
imal needle insertion may suffice. Always respect the
child’s fears and wishes and explain to the child what
is going to be done and why, as often as possible. This
will help her cope with the changes which treatment
will entail and bring about. The first aim is to promote
sleep and calm the child. When selecting herbs for chil-
dren try to select fruit plants which are well tolerated,
extensively researched and have known chemical pro-
files. The ongoing medication should not be stopped
precipitously and certainly not without consultation

with the GP.
Dietary regulation is a cornerstone of TCM. It can pro-
foundly affect sleep, hyperactivity and breathlessness.
Intake of mucous-forming foods should be minimised,
well-cooked white meat should be eaten instead of red,
apple juice is the least heat-forming and fatty, spicy
foods should be avoided. Light, early evening meals help
prevent abdominal distension and nocturnal gastric acid
regurgitation, all of which cause wakefulness, coughing,
bronchospasm and therefore breathlessness. According
to the Chinese energy clock the asthmatic child’s clas-
sic pattern of waking between 2 and 3 a.m. reflects liver
energy dysfunction due to late eating, slowed night-time
digestion, and consequent hyper-acidity and breathless-
ness.
Gentle breathing exercises may be beneficial. Any
eczema and sinusitis must be treated to prevent recur-
rent bronchospasm. To this end bowel function should be
regular. Janie should be seen every week for the first 7
weeks, bi-weekly thereafter. Monitor lung function with
a peak-flow meter before and after treatment, and morn-
ings and evenings. This will help monitor progress and
also capture her interest. Ideally, Janie should have a
check-up at the change of each season. With the help
of her GP, her other medication may then be gradually
withdrawn.
Janie’s parents, Helen and Bob, are crucial to Janie’s
wellbeing. They need to be reassured, to have an oppor-
tunity to talk freely; together and separately. Janie’s GP
may be the best person for this and may then involve
the TCM physician. Guilt is probably important at many
levels; they married only when Helen became pregnant.
Janie will almost certainly be responding to their cur-
rently tense dynamic. Both Helen and Bob may also
benefit from acupuncture, herbs, relaxation and Tai Chi
exercises. It will be particularly important to help Helen;
first to sleep and then with other aspects of her asthma.
Optimal management will involve liaison with the GP at
HOMOEOPATHY
BACKGROUND
This article is not a suitable forum to discuss or describe
the rationale of homoeopathy. Let me just say that
there are 2 basic homoeopathic approaches to desen-
sitise patients to their major allergens. This can be done
without any deep homoeopathic knowledge and will pro-
duce an amelioration of the patient’s asthma. On the
other hand, it is possible to treat the whole patient
using a deep-acting, individually selected, constitutional
homoeopathic remedy. In practice I would normally try
Childhood asthma 139
all times. In this case he is supportive and interested and
should be kept informed professionally so as to nurture
the relationship he has with Helen and Bob.
SUGGESTIONS FOR TREATMENT
TCM treatment should be individualised, hence our brief
suggestions only. Nothing can substitute for experience
and training.
Acupuncture points: Lung: 5,7,9; Colon: 4, 10, 1I ; Con-
ception vessel: 17; Stomach: 36; Spleen: 6; Kidney: 3;
Back shu points: extra 19, 17; Bladder 13, 15. 17, 21.
Herbal prescriptions: Qing Chi hua Tan Tang and Xiao
Qing long Tang are both effective but should be carefully
adjusted according to the patient’s condition.
Jing Hua Chen MD,
Asthma Research Physician,
Osler Chest Unit,
Churchill Hospital,
Headington,
Oxford OX3 7LJ, UK
Kim Jobst MA, MRCP,
Clinical Director,
Oxford Project to Investigate
Memory and Ageing (OPTIMA),
Radcliffe Infirmary Trust,
Woodstock Road
Oxford OX2 6HE, UK
Recommended reading
Scott J. Natural medicine for children. London: Unwin, 1990.
Jobst KA, Chen JH, McPherson K et al. Controlled trial of
acupuncture in chronic disabling breathlessness. Lancet 1986; ii:
14161418. Also Lancet 1987; i: 802.
Lane DJ, Lane TV. Alternative and complementary medicine for
asthma (editorial).Thorax 1991;46(ii): 787-797.
to do both of these to achieve the best possible result.
The treatment of the acute attack of asthma is also
beyond the scope of this article. Asthma is a life-
threatening condition and modern allopathic medicine
has developed good and safe ways of dealing with the
acutely distressed asthmatic. There are some homoeo-
pathic remedies that can be used acutely by a skilled
prescriber, with good effect, such as Antimonium Tartar-
icum, Arsenicurn Album, fpecacuana and K&i Carbon-
icum. Indications for these different remedies are com-
plex and should only be attempted by a trained person.