Chronic Asthma & Golden Qi

by Bob Flaws

In standard professional Chinese medicine, the textbook treatment of bronchial asthma is divided into acute and remission stages. During the acute stage, all one has to do is determine if the pattern is hot or cold and then use appropriate medicinals to either clear heat or scatter cold, transform phlegm, diffuse the lungs, and level panting. All the famous formulas which are standard for use during the acute stage contain Ma Huang whose use in dietary supplements has recently been banned by the F.D.A. During the remission stage, i.e., when there are no symptoms of asthma, one is supposed to treat the underlying root disease mechanisms so as to prevent paroxysmal attacks. These root disease mechanisms typically include deep-lying or hidden phlegm, lung-spleen vacuity, liver depression, blood stasis, and kidney qi vacuity. However, in real life, many patients do not present such clear-cut divisions between paroxysmal attacks and symptom-free periods. Many patients suffer from a little asthma every single day. This may be better or worse but is typically always there, lurking for a chance to get even worse. Formulas containing Ma Huang are usually not appropriate for these kinds of patients, even if they were still legal. In Chinese medical terms, they are too harsh and attacking. In more every-day parlance, they are overkill.

One of the most commonly seen patterns in patients with this kind of chronic or subacute asthma is phlegm heat due to an underlying liver-spleen disharmony, and that is exactly what Blue Poppy Herbs' formula Golden Qi is designed to treat. This is a research formula from the People's Republic of China created by Yuan Xin-shun of the Xin Xiang Municipal Cement Factory Workers Hospital in Henan. It is a combination of Zhi Sou San (Stop Coughing Powder) and Xiao Chai Hu Tang (Minor Bupleurum Decoction) with additions and subtractions. If, due to either external contraction or internal damage, the lungs lose their depuration and downbearing, the lung qi will not clear and the qi mechanism will become inhibited. If the lung qi becomes inhibited, phlegm fluids will typically be engendered, in which case there will be coughing with profuse phlegm. If phlegm fluids cause depression that transforms heat or becomes mixed with depressive heat floating upward from the liver and stomach, phlegm dampness will become phlegm heat. The tendency to engender phlegm is all the greater if there is an underlying spleen qi vacuity. In this case, the spleen qi is too vacuous and weak to move and transform water fluids. These collect and transform into dampness. If dampness lingers and endures, it will congeal into phlegm. Thus it is said, "The spleen is the root of phlegm engenderment; the lungs are the place where phlegm is stored." Further, because the liver and lungs have a reciprocal relationship in terms of the flow of qi, if the lungs lose their diffusion and downbearing, liver depression will be aggravated. Conversely, if there is liver depression, it makes it even harder for the lungs to recuperate. Therefore, this formula not only clears heat and transforms phlegm, stops cough and levels panting, but also harmonizes the liver and spleen.

Within this formula, Zi Wan, Bai Qian, Bai Bu, Ban Xia, Sheng Jiang, and Chen Pi rectify the qi, transform phlegm, and stop cough. Zi Wan, Ban Xia, and Bai Qian are an important combination for coughing and wheezing associated with profuse, difficult to expectorate phlegm. Jie Geng loosens the chest, diffuses the lungs, and transforms phlegm. It also acts to guide the other medicinals to the lungs and chest. Gan Cao and Jie Geng together are able to clear and disinhibit the throat. Zi Su Ye and Sang Bai Pi clear the lungs, stop coughing, and level panting. Fu Ling aids Ban Xia, Chen Pi, and Sheng Jiang eliminate dampness and transform phlegm. Huang Qin clears the lungs, while Dang Shen and Da Zao fortify the spleen and support the righteous. Chai Hu rectifies the qi and disinhibits the qi mechanism of all three burners.

In a study published on page 89 in issue #2, 2003 of the An Hui Zhong Yi Lin Chuang Za Zhi (Anhui Journal of Clinical Chinese Medicine), this formula achieved a 76.5% cure rate and a 94.9% total effectiveness rate in a group of 98 patients with chronic cough and asthma.

If there is more marked spleen qi vacuity, this formula can be combined with Xiao Chai Hu Tang Wan (Minor Bupleurum Decoction Pills) or with Liu Jun Zi Wan (Six Gentlemen Pills). The first formula harmonizes the liver and spleen, clears heat and transforms phlegm, while the second formula primarily fortifies the spleen and supplements the qi at the same time as eliminating dampness and rectifying the qi. If there is concomitant qi vacuity with a defensive qi insecurity, this formula may be combined with Yu Ping Feng San Wan (Jade Windscreen Powder Pills). If there is phlegm dampness, if may be combined with Er Chen Wan (Two Aged [Ingredients] Pills). If there is concomitant blood stasis with cyanotic lips and fingertips, it may be combined with Xue Fu Zhu Yu Tang Wan (Blood Mansion Dispel Stasis Decoction Pills). If there is dry phlegm with a dry, unproductive cough, it may be combined with Ning Sou Wan (Calm Cough Pills) or Bai He Gu Jin Wan (Lily Secure Metal Pills). If there is simulataneous kidney yin vacuity, it may be combined with Mai Wei Di Huang Wan (Ophiopogon & Schisandra Rehmannia Pills). If there is lung qi loss of securing due to enduring disease, it may be combined with Shen Qi Wu Wei Zi Wan (Codonopsis, Astragalus & Schisandra Pills), and, if phlegm heat is more pronounced, it may be combined with Qing Qi Hua Tan Wan (Clear the Qi & Transform Phlegm Pills).

Unlike Ma Huang formulas which can only be taken during acute attacks or root formulas which do not address the symptoms of coughing, panting, and wheezing, Golden Qi includes ingredients to treat root and branch simultaneously. It is not too harsh and attacking. Therefore, it does not further damage the righteous qi. However, it does diffuse the lungs and transform phlegm, stop coughing and level panting. Thus it is perfect for many cases of chronic, persistent, or subacute asthma.