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 its 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.

1- Question

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 is 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).

2- Auscultate

During the consultation, the acupuncturist listens to Zachary’s breathing. His wheezing is characteristic of bronchospasm which may signal bronchitis, asthma, an 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 may suspect bronchitis. However, these signs are difficult to see during a test done outside of an asthma attack, because the drugs hide these symptoms.

3- Palpate

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, the palpation of the Mu and Shu points on the abdomen and the back makes it possible to check the energy state of the Organs which are in connection with the respiratory system, that is to say the Lung, the Spleen / Pancreas and the Kidneys. Our little Zachary makes significant faces while pressing these points.

4- Observer

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.

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 Qi. Very often, several causes can be combined in the same case:

• Too much Cold, Acid, Sweet (Sweet) or fat in the diet.
• A deficiency in the Defensive Energy of the Lung 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 a Stagnation of the Qi of the Liver which repercussions on 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 Kidney Yang 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 Lung was first invaded by a simple cold, that is to say an external perverse Energy (a Wind-Cold or a 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 Qi to the other Organs, hence the accumulation of Moisture and phlegm. The Kidneys, where the root of the Lung’s Qi is located, receiving less and less Qi have been particularly affected.

The Lung’s inability to bring down Qi ended up creating a persistent state of Excess at the “top” (Lung and upper Heater) and Void at the “bottom” (Kidneys and Lower Heater) (see Viscera). The affection then became chronic; now, the slightest wind stresses the already weakened lung, which triggers a new asthma attack.

Among the analysis grids (see Examinations) allowing to establish the energy balance, that of the Viscera proves to be the most relevant here, because if the asthma mainly affects the lung, there is often a significant disturbance of two other organs, Spleen / Pancreas and 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, 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 not being able to eliminate the Moisture, this one ends up in the nose, the 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.
• The painful palpation of the Shu points of the back (which reflect the Yang aspect of the Organs) confirms the weakness of the Qi of the Lung, Spleen / Pancreas and Kidneys.
• The slightly dark circles indicate a deficiency of the defensive energy of the Kidneys, which begins 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.
• The observation of the venule of the index finger reveals that between the attacks, a Wind-Cold reaches the surface layer of the organism (the layer of Wind) that is to say the openings like the nose and the 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 Yang side is 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:

• The cough demonstrates an obstruction of Lung Qi caused by an external perverse Energy.
• The pulling and the short breath confirm that the Lung has great difficulty in ensuring its function of lowering Qi.

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 Moisture, to promote opening the chest and 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 the perverse Energies and strengthen the defensive Energy.

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.