Asthma is an allergic disease which relapses frequently and is characterized by mucosal (粘膜) edema of the bronchus, profuse mucous discharge ad smooth muscle spasm (痙攣) of the bronchiole. Its clinical manifestations are paroxysamal difficulty in expiration and bronchal stridor (支氣管喘鳴). It is usually seen in the ages between infancy and 4 or 5 years.
The allergens of asthma are numerous, but the pathogens and their toxins that cause acute upper respiratory tact infection are the most common causes that give rise to asthma. In clinical practice, we find that among pathogens, hepatophilic virus infection is one of the main causes which lead to asthmatic attacks.
Clinically, hepatic pulmonary disease such as pulmonary interstitial edema, increase of intrapulmonary vascular shunt and decrease of pulmonary elasticity may all cause pulmonary dysfunction hyperventilation, hypoxemia and pulmonary edema. These, in turn, may lead to the commonly seen symptoms, like paroxysmal choking cough, shortness of breath, profuse sputum and even stridor (喘鳴) which can be easily mistaken for asthma. If, clinically, the aim of treatment simply stresses on asthma, and the use of simple anti-spasmotic drugs (解喘藥) and steroids (類固醇藥物) is to relieve the symptoms, the result may unfortunately be aggravation of the hepatic pulmonary disease and pulmonary dysfunction may become more serious. The side effect of steroids is retention of water and sodium which can certainly aggravate the retention of wetness-heat as well as the symptoms of the disease. Therefore, in dealing with patients having history of liver disease or abnormality of margin of liver dullness, during the remission stage, one should consider systemic TCM treatment of the hepatic disease. This management provides great advantage in relief of symptoms and prevention of relapse.
It deserves to mention that treatment of asthma should aim at the cause. Hepatophilic virus is only one of the common causes. The allergens which can produce asthma are many; the patient should ask for assistance from the doctor in searching for them. The commonly used drugs in treating asthma all have toxicity and easily form addiction. Patients should seek for proper medical treatment and should not indulge in over usage of the drugs privately, otherwise, there is danger of death from disease of the heart.
The previous article mentioned about the danger of development of hepatogenic pulmonary pathology; most of the data was based on the condition of cirrhosis of liver. In fact, cirrhosis of liver originates from chronic active hepatitis and if the early symptoms of hepatic pulmonary disease can be recognized, systemic TCM treatment can delay or prevent the change of chronic hepatitis to cirrhosis of liver. This is the first choice. The following is a repeated description of the early symptoms of hepatic pulmonary disease with the aim of demonstrating that the development of liver stagnation and lung dryness symptoms may eventually turn into the moribund outcome in a certain number of patients, for examples:
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The above symptoms are by no means mild and often times the patient must be hospitalized. At present, TCM is effective in treating hepatophilic virus disease to some extent in clinical practice. Based on clinical observation, systemic TCM management is often times effective in treating hepatic pulmonary disease and therefore, if the diagnosis of hepatogenic pulmonary disease is established, during the remission stage, one should consider the possibility of using TCM treatment. In addition, some clinical cases of asthma are able to discard the long term dependence on asthmatic spray after TCM treatment. Although drugs that relax smooth muscle fibers of the trachea can temporarily relieve the asthma, but if the asthma is induced by pulmonary interstitial edema caused by hepatophilic virus, systemic TCM treatment can quickly improve the respiratory function and relieve the dyspnea and cough.
Case 1
Zheng (code number 314) male, age 3 years.
His first visit was on February 1997. The compliant was presented by the mother who said that the child had asthma and infantile eczema (小兒濕疹) for a rather long time. He had been hospitalized for 3 days because of asthma and had also frequent attacks of exogenous evils, coughing, shortness of breath and wheezing.
Physical examination revealed a thin child with dry, coarse, rugous, fissuring and desquamating skin (脫屑). The abdomen was soft and the lower margin of the liver dullness at costal margin.
After administration of TCM, the symptoms of exogenous insults gradually disappeared and there was no more asthma. After 14 parcels of TCM, the liver was 1.5 cm above costal margin. The skin was smooth and desquamation decreased. The following 21 parcels of drugs caused the skin to return to normal and there was neither dryness nor desquamation. Wheeze and cough was not seen and treatment was stopped for observation.
By WONG Kwok Hung
16th January 2001
(translated by Professor ZHENG Hua En in May 2002)