Children’s health is a special branch of Chinese Medicine, as the Chinese recognize that children’s bodies and minds are quite different from those of adults. Accordingly, there are special ways of diagnosing and treating that are unique to children. In this two-part series of articles, we will discuss the causes of pediatric asthma and its treatment with bodywork, herbs, and nutritional counseling.
What is Asthma?
Taken in a broad sense, asthma refers to a dysfunctional reaction of the upper airways, leading to either progressive tightening and difficulty in breathing, or periodic spasms and coughing. Oriental Medicine offers a clear understanding of the issues behind these events.
First, the spasms themselves are simply a protective response, initiated by the Liver, to prevent things from the outside from coming further in and things from the inside from coming further out. Basically, the body is temporarily overwhelmed by ‘phlegm’ bottlenecking in the upper chest. The nature of this phlegm, and the condition of the Lungs themselves, determines the type and course of asthma. To see more closely, let’s take a look at the events happening outside and inside the body.
The external event is simply a natural movement of something from the outside in. This can be a common bug, or even ‘allergens’ if the child has allergies (allergies are a similar dysfunction to asthma, and will be discussed in future articles). The body normally responds to outside invaders by generating a mucous coating around them to help usher them back out. This is the source of the external phlegm, which by itself is a helpful thing. The internal issues are what make this phlegm a problem.
The first of these is Lung dysfunction. This means the Lungs are not properly taking in and letting out qi (air, debris, pathogens, wastes, etc.); it includes both under and over reactions of the mucous membranes (or ‘cold’ and ‘hot’, ‘deficient’ and ‘excess’). This results from the cycle of events that make up any chronic Lung disease, where phlegm gathers to disrupt the smooth in and out rhythm of Lung qi. Excessive sadness and worry are usually a part of this picture, causing a physical bowing in of the chest, compromised air flow, and susceptibility to outside influences. Even before a child is born, these events contribute to his Lung condition, as they have been played out in his parents and other ancestors. These influences are called ‘constitutional’ in Chinese Medicine. They have a similar meaning to ‘genetic’, though the Chinese understanding lends room for continuity, responsibility, and change: one can actually see and change these patterns regardless of how many generations they have been entrenched.
As the Lung’s function suffers and qi stagnates, the conditions become ripe for things to accumulate and linger. This brings us to the second pre-existing factor: internal phlegm. There are several potential causes of internal phlegm. Here we focus only on the two most common in Lung conditions: digestive dysfunction and chronic ‘Lung Heat’.
When the body’s digestive system cannot break down food and drink, the result is what Chinese Medicine calls ‘dampness’, a useless sludge that clogs the body’s mucous membranes. The reasons for this dysfunction are basically over and under nourishment. In modern times, many children’s diets are grossly over-nourishing, meaning that the majority of their food is of a sweet, warm, and heavy nature. Consequently, they lack in cleansing, light fare, particularly in food that is bitter, spicy, and cooling to the body (e.g., dark leafy greens and most other vegetables, spices, and whole grains and legumes). The emotional parallel to this is that children’s desires are too easily granted, while attentive love (including proper discipline) is neglected them.
The excess sweetness itself is a direct source of phlegm (a spoiling of sorts), while the deficiencies lead to poor digestive function (including the inability to focus on thoughts), with a subsequent accumulation of dampness. To see this more clearly, picture the digestive system as a pot with a fire underneath. When the diet is too richly sweet and gooey, this fire is easily ‘dampened’ and grows cold; instead of the food being transformed, it accumulates in the pot. The resulting goo, when accumulated in the Lungs, is known as ‘cold-type phlegm’, and presents as large amounts of loose, often whitish, mucous that chronically runs from the nose and rattles in the throat.
The other kind of phlegm that harasses the Lungs is from heat that dries up fluids and causes irritation to the mucous membranes. The Lungs respond by putting out the fire with a coating of mucous. This ‘hot-type phlegm’ presents as thick, ropy, often discolored mucous that is difficult to discharge or expectorate. The heat behind it has two main sources: pent-up emotions and lingering infections.
First, any emotion, allowed to brood, will create internal friction and heat. Secondly, there may be a lingering infection in the upper respiratory tract that generates heat at a low level and occasionally expresses itself as an acute illness. This is of the ubiquitous ‘itis’ group: sinusitis, rhinitis, tracheitis, tonsillitis, otitis, etc. The reasons why the infections do not get resolved include all the things we’ve talked about, and also improper treatment and prevention of common childhood illnesses. The history always reveals these details.
So, putting all this together, the child suffering from asthma is confronted with an impasse of phlegm coming from both the inside and outside, unable to either expel it with the Lungs or transform it through the digestion. The result is an emergency situation where the Liver, likened to the ‘general’ in Chinese Medicine, halts the progression of phlegm production by clamping down on ALL activity. Unfortunately, this includes normal airflow too. Given this picture, how do we go about changing it?
First, a diagnosis is made by history and examination, revealing the relative extent and nature of phlegm and organ dysfunction. Next, the child is treated to a combination of hands-on work, herbal medicine, and nutritional guidance (for the parents, mostly).
Pediatric ‘Tui Na’ is the most common system of medical massage for children. The practitioner uses either his hands only or a set of small tools that gently scrape or tap the skin. The children generally love this part of the treatment, and respond exceptionally well (adults often need greater stimulation to effect a change). The primary aim of the bodywork is to change patterns of tension that form either in response to the child’s dis-ease, or lead to it (as in the case of emotional dis-position leading to a collapsed chest). This goes a long way towards improving qi flow, allowing for the proper movement of wastes out and fresh air in, and also for proper transformation of food and thought, and smooth transition between emotions.
Simply working to change these patterns from the outside can stop an acute spasm, and over time can improve the function of the body to the point where the factors that precipitate the asthma are resolved. When herbs and nutrition are added to the treatment, a swifter and more effective result is obtained. We will pick up on these latter two treatments next month.