Asthma symptoms are grouped into different classification patterns depending on their manifestations.
During an exacerbation of asthma, two different clinical patterns can present. These are the cold and heat types. Cold and heat influences are either environmental or physiological factors that trigger the exacerbation. They both belong to the "pernicious evils" in TCM.
1.Cold type asthma
Cold influences cause stasis (a condition where the flow of a substance is either slowed down or stopped), just as oil becomes viscous (thick) when its temperature is lowered. When a cold influence affects the body, phlegm turns white, thick and sticky, and it is not easily loosened with a cough. Cold phlegm has stasis properties, which lead to chest congestion and obstruction of qi movement and breathing. This results in wheezing and a feeling of chest tightness and fullness. Lastly, the lungs lose their ability to descend and disseminate qi properly.
Phlegm is a manifestation of an excessive yin pattern. (Yin is usually used to describe material things.) An accumulation of phlegm leads to an imbalance, which results in an excess of yin and a relative deficiency of yang. This causes a dim and bluish complexion, cold limbs, an aversion to cold temperatures, and a preference for warm drinks. Individuals may only sweat a small amount because the cold symptoms are unable to escape to the exterior of the body. People with cold type asthma have a white and greasy or white and slippery tongue coating and a floating, tight pulse.
2.Heat type asthma
Heat influences have "excitation" properties which manifest as excessive yang patterns. They produce yellow, sticky and thick phlegm and coarse breathing. As lung qi is reversed from its normal descending flow, a paroxysmal cough and a roaring wheezing sound occur because of an accumulation of "heat phlegm." With the flare up of "heat phlegm," individuals also experience chest discomfort and thirst. People with heat type asthma have a red face and a red tongue with a yellow, greasy coating. The pulse usually feels slippery and rapid.
During a non-exacerbation period, the symptoms of asthma can be classified into deficiencies of the lungs, spleen and kidneys or any combination of these.
1.Deficiency of lungs
Normal lung function affects the health of some exterior body parts such as the hair, skin and sweat glands. If the exterior is weak and lacks sufficient support from protective qi, (a type of qi which acts like the immune system), the body is easily attacked by the "pernicious evils" (environmental factors which cause illness). With weakened lung qi, spontaneous sweating and an aversion to wind occur. Because the lungs open into the nose, individuals may experience sneezing and nasal congestion with a clear discharge. Deficient lungs cannot properly rule qi, which leads to symptoms of shallow breathing and a cough with thin, white sputum. Individuals with a lung deficiency look pale and have a tongue with a thin white covering. A thin and weak pulse is felt upon palpation.
2.Deficiency of spleen
The spleen is an essential organ in TCM. It is responsible for digestion and transforming food into food essence, which is in turn transported to the lungs and distributed to the rest of the body. A spleen deficiency can cause asthma, because when it is unable to transform fluids, phlegm accumulates. People with a spleen deficiency have poor appetites and can develop epigastric (stomach region) problems, loose stools or even diarrhea. The spleen is also essential for production of qi and blood and rules the limbs. A deficiency can cause fatigue, shortness of breath and a low voice. A pale tongue with a thin, greasy or white, slippery coating and a thin, soft pulse are the usual signs of spleen deficiency.
3.Deficiency of kidneys
The kidneys rule the grasping of qi, which is responsible for healthy, deep inhalation when breathing. If there is a kidney deficiency, qi is said to be unable to return to its origin, (the kidney region), and shallow breathing occurs. The shallow breathing becomes worse on exertion and leads to wheezing or shortness of breath. The kidneys also rule the bone and are responsible for producing bone marrow. Soreness and weakness of the waist and legs and insufficient nourishment of the brain causing ringing in the ears are other symptoms that can occur with a kidney deficiency. If the kidney deficiency belongs to a yang deficiency, individuals have cold limbs and an aversion to cold, but if the deficiency belongs to a yin deficiency, individuals have red cheeks, night sweats and afternoon hot flashes.