More on My Humble Views on Treating Allergic Rhinitis

I now mainly treat cancer, and have not studied the treatment of allergic rhinitis for a long time. But because in the past I treated some patients with allergic rhinitis and allergic skin disease, the patients I cured never stop referring fellow sufferers to me, so allergic-rhinitis patients still come to see me from time to time.

Some patients are so sincere in seeking treatment that no amount of turning them away works; they insist on coming to me, so sometimes I have no choice but to grit my teeth and treat a few.

I am not an expert in treating allergic disease. I am told that some TCM doctors specialize in treating allergic disease; I may not be as specialized as they, and dare not show off in front of the masters by saying too much.

It is just that some of the patients I treated had gone to these experts for their titles, yet treatment along the experts' lines of research did not work well. By the time they came to me, being less bound by specialized, fixed ways of thinking, I instead cured some of them.

Of course I believe those doctors who specialize in allergic disease cure more than I do. This is not modesty; it is because my patient base is too small, and I am certainly less experienced than they. Besides, I now have far too many long-term tumor patients under my follow-up; honored by their misplaced affection, they pin their last hope for survival on me, so I ought to single-mindedly seek a way out for them.

No doctor dares to boast that he can cure a certain type of disease one hundred percent—unless he is a fraud. So I understand very well when some experts fail in treatment. Put me in their place, seeing all kinds of allergic patients every day, I would no doubt also have many I could not cure.

My own humble view is this: TCM should draw on the experience of modern medicine, but should not study disease treatment entirely with modern-medical thinking; it should still respect history and recognize the value of TCM pattern-based treatment (bianzheng lunzhi).

At present many of my TCM colleagues research the anti-allergic effect of some herb, taking modern pharmacological research as the standard. Following this fashionable research method, the papers and monographs they write are very handsome, but the clinical efficacy is hard to be satisfied with.

I believe traditional Chinese medicine has a great advantage in treating allergic disease. TCM pays special attention to the "six excesses from external contraction" and the "seven emotions from internal injury." One could say that, in studying the effects of environment and emotion on the human body, TCM doctors from ancient times to today have accumulated extremely rich clinical experience.

Whether in the Shanghan Lun (Treatise on Cold Damage) or the Wenbing Tiaobian (Systematized Identification of Warm Diseases), the formulas all emphasize the effects of environmental and climatic changes on the body; these provide us with very precious experience.

One could say TCM places great emphasis on the relationship between nature and human beings. The "Four Qi Regulating the Spirit" and "Resonance with the Heavenly Qi" chapters of the Huangdi Neijing (Yellow Emperor's Inner Canon) are almost entirely about how much influence climatic and seasonal changes, and the various substances of the natural world, have on our bodies.

The "Resonance with the Heavenly Qi" chapter especially stresses that humans and all of nature are one body; the pores and organs of the human being are constantly exchanging substances with the outside, so external wind, rain, darkness, and clear skies, even fog, haze, and miasma, invade our bodies at every moment. For those whose righteous qi is deficient and weak, becoming ill under these influences is quite normal.

The greatest hallmark of allergic disease is precisely that it is triggered by environment and climate. These fit very closely the features of TCM's pattern-based treatment of the "six excesses from external contraction" (the six excesses being wind, cold, summer-heat, dampness, dryness, and fire).

Today we are easily swayed by fashionable ideas into denying the written records these ancient doctors left us over two thousand years ago.

In fact, when it comes to IQ and brain volume, humankind had already evolved to roughly today's level ten thousand years ago. Intellectually, we are not much superior to the people of two thousand years ago. To mock them as backward and ignorant is precisely a sign of our own ignorance.

By observing the characteristics of disease, ancient doctors found that some people's bodies were very sensitive, and that external stimuli would cause them to fall ill in various ways; they worked out some targeted treatments.

From my own clinical experience, I greatly admire the therapeutic experience left by those wise predecessors, because when I treat illness according to their experience, the results are surprisingly swift.

I have no ill will toward Western medicine. On the contrary, I have studied a great deal of Western medical knowledge, and when family members' illnesses warrant Western treatment I do not hesitate. Moreover, I may in future sum up my years of study and fuse Western and Chinese understandings of cancer, writing some monographs.

But nowadays I do not much like treating many of my relatives' ailments with Western medicine. Not because I distrust it, but because, compared with the quick effect of TCM, Western medicine works far too slowly.

My personal advice to colleagues interested in treating allergic disease is still to focus on reading the four great classical TCM originals closely; lay this foundation well, and treating allergic disease does not seem so hard after all.

Let me give an example.

There was a severe allergy patient who himself worked in medicine in Beijing; in the past he had sought out many famous Beijing doctors for treatment, all to no avail. One day his wife read some of my articles and stubbornly insisted that he come to me. Helpless, he came to see me half believing, half doubting.

I then performed the four examinations on him. Judging by his features, I determined that his allergic rhinitis was caused by lung heat, fitting the indication of Maxing Shigan Tang (Ephedra-Apricot-Gypsum-Licorice Decoction) from the Shanghan Lun. So I prescribed Maxing Shigan Tang; not quite trusting the potency of modern ephedra, I also added some zisu (perilla) to the formula. I prescribed seven doses.

The patient went to the pharmacy to buy the herbs; each dose cost only about one yuan. He found it unbelievable, but before finishing the seven doses, the allergic rhinitis that had plagued him for years was gone. Because of this unexpected effect, his years of prejudice against TCM were also cured.

I may have told this patient's story in a previous essay. The couple later repeatedly begged to send their son to me to study TCM; I now, besides my own son, have taken on three apprentices of the same age, one of whom is their son.

In the last few days this patient's rhinitis flared up again. He wanted to come see me, but my schedule was tight and could not accommodate him, so I told him first to take Qingfei Tang granules (the medicine that had worked for his son); if ineffective, come back to me. It was ineffective.

The other day, unable to help it, he came to me. I took a floating, moderate pulse. It is now late summer and early autumn, when a floating pulse is normal; but a floating, moderate pulse together with his actual symptoms should make one consider the taiyang wind-strike syndrome of the Shanghan Lun. So I pressed him on whether he had been using air conditioning all summer; he said yes, that he could not live without it and spent all day in an air-conditioned room.

This cannot be treated according to modern pharmacological research; it can only be treated as having contracted cold, one of the six external excesses. From his experience, we must understand the features of modern people's lives: we must not think that in summer warming herbs that expel cold should not be used. Modern equipment like air conditioners and heaters mean people often live out-of-season lives, so one must be flexible.

I then asked about his urination and defecation: his stools were loose and his urine yellowish-red. Continuing to ask about shoulder and back aching, I got an affirmative answer; the pain was bad enough that he had even had cupping done. I asked whether he had spontaneous sweating; his wife said he felt sticky all over all day, and this stickiness is involuntary spontaneous sweating.

This is the indication for Guizhi Jia Gegen Tang (Cinnamon Twig plus Kudzu Decoction) from the Shanghan Lun. His son has now studied TCM with me for a year and a half; I have lectured him on the Shanghan Lun, and together we have made a very detailed comparative study of the cinnamon series of formulas. I told him his son could even treat this illness; it is just that the boy lacks the nerve yet.

I prescribed another seven doses: Guizhi (Cinnamon twig) 10 g, Baishao (white peony) 10 g, Gancao (Licorice) 6 g, Gegen (Kudzu) 18 g, Shengjiang (fresh ginger) 7 slices, Dazao (jujube) 5 pieces, Huashi (talc, wrapped) 15 g. Why add talc here? It is actually because he now has a mixed cold-heat pattern, and his urine is yellowish-red; so this formula is in fact a combination of Guizhi Jia Gegen Tang and Liu Yi San (Six-One Powder), the latter to address his urination.

That evening he drank a bowl of the medicine; by the next morning his nose was open and his sneezing greatly reduced. He drank several more doses; by today, roughly three days in all, the sneezing and nasal discharge are basically gone.

In modern-medical terms, this patient is just an atopic person who can only be treated as an atopic person; but regrettably, he had seen many Western experts on this in Beijing and never solved the problem. Following the approach of certain TCM colleagues who specialize in allergic rhinitis would not have solved it either.

Yet half a volume of the Shanghan Lun has solved his problem twice already.

So I sincerely hope that TCM colleagues who specialize in allergic disease will not be too deeply influenced by modern science, drilling into a blind alley to hunt for anti-allergic components in Chinese herbs. Even if you find the most powerful anti-allergic herb, could its anti-allergic effect be stronger than those Western drugs of modern medicine? Let us return to the root of TCM, carefully analyze the cause of the patient's illness, and prescribe accordingly.

Nowadays many students of TCM have lost confidence in TCM itself and dare not use TCM pattern-based thinking to treat disease; this is very embarrassing for those of us who practice TCM. Why have they no confidence? Because the teachers who trained them had poor clinical results. They themselves keep failing in clinical practice and have been discouraged.

One mesothelioma patient I saw this year has a daughter who is a master's student at a nationally key TCM university, and a son-in-law who is an orthopedist. When she fell ill, she went to see her daughter's teacher, who used Shi Zao Tang (Ten-Jujube Decoction) to drain her pleural effusion; the more he treated, the worse she got. In my view, this is purely using a Chinese herbal formula according to modern-medical thinking, with not the slightest refinement of pattern differentiation.

The daughter—a TCM physician now working clinically at a Beijing hospital—was at a loss and wanted her mother to have Western radiotherapy and chemotherapy; it was her parents who insisted on seeking TCM treatment. When she came to me, she was wheeled into my workroom in a wheelchair; after a month of Chinese medicine, she was bouncing again, back to normal, and no longer needed a wheelchair. Eight months on, she has recovered to be indistinguishable from a healthy person. Her cancer markers have dropped, her pleural effusion has lessened, and the lesion has thinned.

A female doctor, a TCM-university graduate, once told me that after studying five years at school and doing clinical work with several teachers, she found the effect negligible and so lost confidence in TCM. She once begged me to take her on for a while, and I politely declined.

Over the years many undergraduates and graduates like her from TCM colleges—even some experienced TCM or Western-medicine doctors at the associate-chief level or above—have wanted to come do clinical work with me.

I have always refused, because I feel that as a self-taught TCM practitioner who switched into medicine midway, I am only a half-filled bucket; I have not yet mastered TCM myself, and am not qualified to be their teacher.

So now I am only willing to train a few ten-odd-year-old children, hoping to guide them for about ten years and grow up together with them.

This is not modesty; it is because I know full well that the TCM classics I have read are only a small part of the TCM canon. As I said in an earlier essay, the TCM physicians who have thoroughly read the Qing Imperial Medical Academy textbook Yizong Jinjian are now as scarce as morning stars. Ashamedly, I myself have not even properly finished reading the Yizong Jinjian, let alone mastered it.

I always think that if I could read all these TCM classics and study them deeply, I would no longer have this cat-skill of mine but be a true, fully initiated TCM master. I hope one day to reach that level; it still takes accumulation over time. If one day I truly reach that level and am fit to be a teacher, I will take on doctors.

The son of the rhinitis patient mentioned above—my young apprentice—has inherited his father's atopic constitution and severe allergic rhinitis; every weekend when he comes to my class, a whole day's lesson uses up a whole pack of tissues.

Seeing this wrings my heart. After the four examinations, I judged his rhinitis also to be caused by lung heat. I prescribed a decoction and brewed it for him in my studio-cum-study. But the young apprentice, having suffered little, found the decoction bitter and vomited it all up; my other apprentice, a few months older than him, at once helped my son clean up after him.

Later I prescribed the Japanese kampo Qingfei Tang granules. This is a Chinese herbal formula the Japanese turned into a patent medicine, but it tastes far better than a decoction, so he could take it. Before finishing one box of Qingfei Tang granules, his rhinitis was gone. I have long hoped to learn the Japanese pharmaceutical technology and turn some classic TCM formulas for treating tumors into such directly dissolved granules, convenient for the vast number of patients; regrettably, I do not yet have the means.

A female allergic-rhinitis patient once joked with me that, for her, tissues were far more important than a boyfriend; she could not live without them, because her nose was like a tap that would not turn off, with nonstop sneezing and runny discharge. For a young woman to have such a disease is both painful and self-esteem-shattering.

Her own mother was an experienced Western doctor, helpless against her daughter's illness. I later cured this patient too with a few doses of Chinese medicine, the formula again being Maxing Shigan Tang plus perilla leaf and perilla seed.

As a result she brought a whole crowd of allergic-rhinitis patients to me. Those patients referred still others, so that each time I had to explain, more than was comfortable, that I now specialize in TCM anticancer work and have not spent effort on their disease, fearing I would delay them and waste their money; I asked them to seek a better expert.

These are all examples of treating by the external six excesses. Let me now tell of another allergic-rhinitis patient, whose illness was related to the internal seven emotions.

This patient was a staff member at a Shandong university. Years ago, while studying for her master's, excessive pressure plus newly renovated office space triggered her allergic rhinitis. She was treated for over ten years, seeing every TCM and Western doctor, to no avail; they could not solve her problem.

She insisted on coming to me. I refused again and again, because my mind is not now on allergic disease and I am not confident about it, fearing she would spend money for no effect. But she almost pleaded, and in the end I truly could not refuse, so I gritted my teeth and agreed to take her.

Her first visit to me was around this time last year. Based on her pulse and signs then, I differentiated the rhinitis flare-up as caused by bound-up heat in the lung and stomach, and prescribed Yünü Jian (Jade Woman Decoction), a formula that clears heat from the lung and stomach. After a few doses she was fine and sailed smoothly through one allergy season.

Around this year's May Day, her rhinitis flared again. This time she went to the hospital herself to buy Yünü Jian; a hospital TCM expert who was supposedly a specialist in allergic disease persuaded her to try his own formula instead. The result was poking a hornet's nest: her condition worsened disastrously.

Helpless, she turned to me again. This time she did not come in person; based only on her reported symptoms such as a bitter taste in the mouth, I prescribed Chaihu Guizhi Tang (Bupleurum-Cinnamon Decoction), a case I once mentioned when introducing that formula. After a few doses of Chaihu Guizhi Tang, she at last escaped the hellish life after her allergic-rhinitis flare-up.

This summer vacation she brought her son to see me. She had a cold at the time, relieved by a patent medicine, and was a bit worried about an allergic-rhinitis flare-up. I told her to observe first and not rush to medicine. But a few days ago her allergic rhinitis flared again, and her nose even swelled up.

Because it was the same season as the first visit last year, I told her: if she had a bitter taste in the mouth, take Chaihu Guizhi Tang; if not, use Yünü Jian. She used Yünü Jian; before finishing one dose, the nasal swelling subsided and the rhinitis symptoms greatly improved.

But regrettably, she fell out with her family and flew into a great rage, and the rhinitis flared up again. Incidentally, when she came for treatment this summer, I had told her that to cure her illness she needed to cultivate herself, and I urged her not to be critical of the family and friends around her.

This time Yünü Jian could not control it. I told her to switch to Chaihu Guizhi Tang, because the bupleurum series of formulas soothe the liver and resolve depression. But before she could switch, her mood settled and the illness cleared.

Today, as I write this, she messaged me asking me to record her experience for the reference of future patients. As a patient long tormented by allergic rhinitis, out of fellow-feeling for fellow sufferers she is very sympathetic and hopes others will not have to suffer this disease.

This is a typical example of disease caused by the internal seven emotions. In fact, once a doctor's work reaches a certain level, he should be able to help patients resolve emotional problems that stem from their character.

In the past patients respected doctors immensely, regarding them as elders of deep learning and sterling character, capable of helping them rebuild their outlook on life and the world and resolve problems of excessive seven emotions. I am ashamed that my own character and learning are both so poor that I cannot yet fully guide my patients in the right direction.

I have rambled on so much that this does not read like a medical article at all, but like a chat at home. Honestly, when I read the TCM papers published in today's medical journals, I get a headache. If I were made to write such papers myself, I would feel a grave sense of being raped or castrated. The value of these papers, written entirely with modern-scientific thinking, is questionable.

Of course I believe the authors suffer greatly writing such papers too; hospitals require publications for professional titles, and it is not that they want to write such papers against their conscience, but a knife is at their necks and they have no choice. No knife is at my neck, and in this life I have no wish to wear any dazzling cap or title, so when I write I write as I please.

My level is still low, my thinking immature and unsystematic; many allergic-rhinitis patients come to me full of hope and leave disappointed. I know there must be many TCM physicians far above my level and understanding, whom I cannot hold a candle to; my writing on this topic is showing off my poor skills.

But I hope these below-the-salt views may serve as a brick to attract jade. I look forward to future, more brilliant TCM masters of allergic disease writing monographs that have truly grasped the essence of TCM, to point the way for future practitioners.

May readers not fault me for my shallow views.

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