THE GREAT BRITISH MED OFF: IV

Lungs and Airways Conditions, Allergies and Hayfever

Hello everybody. It’s nice to be back again writing about Health issues rather than Politics – although I have to admit it was fun to write my last one! Fun may be an exaggeration. Let’s say it sometimes feels good to get things off your chest!

Today we are going to discuss lungs and airways conditions, allergies and hayfever. These are not accidentally put together. In Chinese Medicine terms these are very much related. Hayfever is a type of allergic reaction and most allergies, in Chinese medicine, are a result of the lungs Immune system dysfunction.

We’ll start from the most common airways conditions: colds, flus and chest infections. I put these together as they are all Acute infection type conditions. Colds and flus are caused by a virus whilst chest infections can be caused by a virus or bacteria. The Western medicine approach to these upper respiratory tract infections (URTI) is mainly to help with the symptoms until the infection will clear by itself. The reason for this approach is that we still haven’t got an effective medicine for viruses. The medicines that are available to reduce the symptoms are varied but, generally speaking, are based on chemicals which aim to reduce the body’s natural immune reaction to the virus e.g. paracetamol or aspirin. This may sound counter intuitive but the principle here is that a lot of the symptoms we feel, such as a high temperature for example, are as a result of our immune system trying to fight the invader. Stop this reaction and you stop the symptoms! These medications tend to be quite effective in reducing the symptoms and help us to continue to function but is this necessarily a good thing for our long term health? The answer, in my opinion, is most probably not! I can’t see how stopping our immune system from doing its job is a healthy approach. I understand that sometimes in life we need a fast relief but I will recommend to use it as sparingly as possible. I feel there will be long term consequences to our immune system’s ability to deal with invaders if we use it on a regular basis. This advice is particularly important for parents who tend to feed Calpol (Children’s paracetamol) to their kids on a very regular basis. In the case of chest infection, as a result of a bacteria rather than a virus, the Western medicine treatment with antibiotics will be often very effective. However, in my opinion antibiotics for chest infections should be used only in the difficult and stubborn cases since it is clear that regular use of antibiotics has a weakening effect on our digestive and immune systems.

The approach of Chinese medicine to URTI is very different We are not looking at the type of bug which has invaded the body, instead we are looking at the reaction of the body to this invasion and then treat it accordingly. An experienced TCM Practitioner will be able to identify one of many patterns of Acute URTI and will then be able to choose the right combination of Herbs and /or Acupuncture points to remedy this pattern and restore normality. In some cases (particularly with children and the elderly) herbs to support and strengthen the immune system will be added. The treatment of URTI with TCM is, in most cases, highly effective. The old belief that a cold will clear within a week without treatment and within seven days with treatment is not applicable in the case of Chinese medicine. In most cases we can shorten the duration and help with the symptoms without damaging the immune system in the process. So, in the case of Acute URTI (colds, flus and chest infections) there is a clear advantage to Chinese medicine with one exception being the most severe and stubborn bacterial chest infection that may end up needing antibiotics!

The second most common lung condition is Asthma. Asthma is a condition characterized by shortness of breath, wheezing and coughing caused by the narrowing of the airways. This narrowing is a result of a contraction of the airways or a secretion of phlegm in the airways or both. The reason for the contraction and the phlegm is largely unknown. In some cases there is a clear link to Allergic reaction but in the majority of cases the cause remains a mystery (at least according to modern medicine knowledge). Asthma is very common and, alarmingly, is getting more and more common over the last 30 years. The reason for this increase is again mainly unknown although air pollution, stress and bad nutrition are the usual suspects. Asthma can affect all ages and in severe cases can be lethal.

The treatment of asthma from a Western medicine point of view is aimed initially at reducing the symptoms by reversing the contraction of the airways and the main medicine used for this is the famous Ventolin inhaler. Ventolin is very popular due to its fast effect: short of breath? take a puff and feel better almost immediately. However, medical studies have shown that long term use of Ventolin increases morbidity and mortality (the severity of the condition and the death rate!). The other type of inhaler is more for prevention of attacks and contains steroids. Steroids are a very effective anti inflammatory and asthma is no exception. Steroid based inhalers are fairly effective in prevention of asthma attacks. The problem is, as usual in the case of steroid use, the side effects. Since the use here is targeted and local (not passing through the digestive system) it was hoped therefore that it wouldn’t spread through the body. However, studies into the effects of a long-term use of steroid based inhalers showed risks that are very similar to those caused by the use of oral steroids e.g. diabetes, high blood pressure and osteoporosis.

The Chinese medicine view of asthma is a bit different to the Western medicine one. Most importantly we don’t see it as one condition. I often use asthma as an example when I try to explain the difference between TCM and WM thinking. If you take a step back and look at it carefully you can see clearly that asthma can manifest in a different way in different people. The main symptom can be shortness of breath in some cases or cough in others. The cough can be phlegmy in some and completely dry in others. The phlegm can be thick or loose or watery, white or yellow or green. Triggers differ largely-some are triggered by stress, some by exercise, some by the weather (humidity or dryness), some react to allergent, and so on. In Chinese medicine each one of these will be considered to be a different condition and will therefore be treated differently. For example, a dry type asthma will be treated with herbs and acupuncture points that aim to help the airways and lungs produce the moisture needed for normal function. The phlegmy and wet asthma, however, will be treated with herbs and acupuncture points that will do just the opposite this time, helping the airways and lungs to dry up and get rid of the phlegm. There are of course a few other considerations when choosing the treatment in each case, most importantly-as ever in TCM-treating the underlying cause as well as the symptoms. The point is the treatment is tailored for each individual case! This approach combined with a deep understanding of the asthma symptoms and causes leads to a very high success rate in the treatment of Chronic Asthma with TCM.

So, to sum up asthma. In the case of acute attacks WM has the upper hand in its ability to bring fast relief. In the case of the treatment of Chronic Asthma TCM is much more effective.

The next lung condition is COPD (chronic obstructive pulmonary disease). COPD is very common and it actually includes a few conditions, most commonly emphysema and chronic bronchitis. Here the comparison is easy since WM doesn’t offer any effective treatment for these conditions, except oxygen support in the very late stages. Chinese medicine however has more to offer. These conditions are chronic in nature and often cannot be reversed, but with a good course of Acupuncture and Chinese herbs the symptoms can be reduced and the deterioration in the lung function slowed down.

Next is Bronchiectasis. This condition is characterized by a formation of air pockets in the lungs. These pockets tend to fill up with phlegm resulting in chronic cough and deterioration in the normal lung function. The WM treatment is limited to breathing physiotherapy. It is important since it is helping the patient to release some of the phlegm which is stuck in the lung. However, the effect on the patient’s symptoms is fairly limited. From my experience the effect of Chinese medicine on this condition is much more substantial. Treatment with herbs and acupuncture points which clear phlegm and strengthen the lungs result in significant and long-lasting improvement in most cases! CM will have a similar effect in most cases of chronic cough.

Next for Allergies. To simplify and shorten things I’ll try and consider all types of Allergies in one section. This will include skin allergies, airways related allergies and Hayfever. Generally speaking, allergic reactions occur when our Immune systems hyperreact to a stimulant. In other words, instead of having the normal measured and effective Immune response as a normal response to what the body identifies as an unwanted invader, the Immune system will overreact and will activate mechanisms in the body which are inappropriate for this situation and will therefore cause problems (symptoms).We are all familiar with hayfever, allergies to cats or other animals, dust mite allergies etc. These are all different materials or organisms which will commonly trigger an inadequate Immune reaction in susceptible individuals.

The Western medicine treatment for allergies is mainly with Antihistamines. Antihistamines are, generally speaking, quite effective in reducing the symptoms of allergic reaction. The problem here is that they don’t treat the root of the problems but are purely for the symptoms. They are fairly safe medications but can cause drowsiness. The Chinese medicine approach to allergies is a) treat the symptoms and b) calm and regulate the Immune system (stop it from over-reacting). As a result of this approach the improvement is long lasting and often even permanent.

 To sum up, lungs, airways conditions and allergies are a good demonstration of the difference between WM and CM approaches. If you need a quick relief of your symptoms then WM is probably more effective. However, if you are a bit more patient,  care about your health and are interested in long term relief or a cure then CM is your preferred option.

Best of health everyone,

Dr Ilan Shahor.