Healing Beyond Boundaries: An In-depth Analysis of Allergy Treatment in Kampo and Western Medicine
In the realm of allergy treatment, a stark contrast emerges between Western medicine’s focus on symptom management and the personalized, versatile approach of Oriental Kampo medicine. Western medicine often perceives allergies as incurable, addressing only the symptoms, while Kampo Medicine takes a distinct path, delving into the body’s patterns of response. This fundamental difference in how diseases are perceived shapes the methodologies employed in their treatment. As we delve into four recent cases of my own patients illustrating the application of Kampo Medicine in allergy treatment, we unravel the intricacies of personalized medicine, recognizing patterns rather than labeling conditions. The essence lies in Kampo’s ability to understand the body’s unique responses patterns to allergens, emphasizing a holistic, pattern-based approach that transcends the reductionism prevalent in Western medicine.
How is Kampo Different from Traditional Chinese Medicine(TCM)?
While Kampo and TCM both originate from traditional healing practices in Eastern Asia, they exhibit differences in various aspects. Kampo, originally developed in Japan, maintains its theories and clinical application approaches, preserving a significant portion of Classical Chinese Medicine prior A.D 600. Its primary focus lies in clinical evidence. TCM, mostly developed in a much later times in China, is a consolidation of various Chinese medicine schools into a contemporary) system with a structure more like western medicine than classical Chinese medicine. While it encompasses a wealth of information, it may have potentially deviated from its traditional structure. TCM places a greater emphasis on the theoretical perception of health and diseases, in contrast to Kampo, which relies more heavily on clinical evidence. TCM also mixes the theory of acupuncture into its herbal branch which created unnecessary gap and inconsistency between the theoretical concept and the reality.
What are allergies and why I have allergies?
An allergy is a heightened reactivity, an exaggerated response of the immune system to a specific trigger that may go unnoticed by non-allergic individuals. The typical allergic response involves increased mucus production, fluid secretion, and redness and swelling of various body parts, including the eyes, throat, nose, and skin. This reaction can range from a minor itchy rash to a severe anaphylaxis attack, necessitating emergency room intervention.
At a pathophysiologic level, this immune response is mediated by IgE and histamine, which are responsible for the observed swelling and redness. According to National Institute of Health of United States(source: https://www.niehs.nih.gov/health/topics/agents/allergens/index.cfm), Common allergens include pollens, fungal spores, house-dust mites, and animal epithelial materials but can also include drugs, biologic products, and insect venoms. but unexpected triggers such as weather changes and atmospheric pressure variations can also elicit abnormal reactions. Clinicians have observed patients experiencing migraines, joint pain, and swelling, heaviness and fatigue in response to weather and pressure changes, all linked to histamine release.
Apart from allergies, there are other types of sensitivities, such as temperature, food and barometer in the air, which, while distinct from allergies, share a common thread of heightened histamine reaction. Allergies can manifest in diverse and perplexing syndromes. It’s not uncommon for neither the patient nor the treating physician to be aware of hidden hypersensitivities that may be causing or perpetuating illness. Some researchers argue that the conventional medical definition of “allergy” might be too narrow. Even if a patient doesn’t exhibit classic symptoms like sneezing or hives upon exposure to the allergen, the triggering substance could play a significant role in chronic disorders that may escape detection through conventional diagnostic methods.
I am totally on board with Western medicine about the nature of allergy, which is a abnormal immune reaction to environmental factors. However, Kampo Medicine looks deep than immune response to the realm of blood pathology, inflammatory mechanisms and also takes the whole body into a holistic picture. Kampo approach produces different treatment strategies and outcome. Western medicine think there is no cure for allergy, Kampo medicine thinks it is possible to cure allergy if we can correct the underlying imbalances that lead to overactive immune systems. I will come back to this in the later of this article.
How does conventional medicine treat allergies?
According to NIH (source: https://www.ncbi.nlm.nih.gov/books/NBK447112/), Conventional allergy management involves antihistamines for symptom relief, decongestants to address nasal issues, and corticosteroids for anti-inflammatory effects. Immunotherapy, through allergy shots, gradually desensitizes the immune system. Epinephrine serves as a life-saving measure for severe reactions. Conventional medicine proclaimed that allergen avoidance is key, with diagnostic tests aiding in identification.
Kampo/TCM Herbal Treatment of Allergies with Four Cases
Case #1: Treating chronic allergies in a child
Misha (male, 10 years old) Symptoms: Allergies, nasal congestion, constipation, difficulty sweating. Diagnosis: dysregulated Immune system, heat in lung and large intestine. Initial Kampo formula: Fang Feng Tong Sheng San with Xin Yi. Outcome: Improved nasal breathing and increased bowel movements from 1x per 2~3 days with difficulties to 1~2x per day with no difficulties.
I’ve been addressing the persistent complaints that the 10-year-old has experienced since birth. Misha’s primary concerns revolve around allergies to dogs and pollen, resulting in chronic nasal congestion(mouth breather) on the daily basis even without the presence of allergens. Additionally, Misha struggles with difficult and infrequent bowel movements occurring every 2 days. Despite these challenges, Misha is generally healthy, with normal sleep and digestion. During the Kampo “Fukushin” abdominal examination, I observed his lean abdominal muscles with good tone. however, I noticed that he didn’t tickle as many other children would react when their abdomen is pressed. Plus the fact that he doesn’t sweat, I decided to use Ma Huang formulas instead of Chai Hu formulas which is very commonly used to treat chronic allergic conditions in Kampo pediatrics.
What Chinese Herbs I Used for Children Allergy?
The initial herbal treatment involved Fang Feng Tong Sheng San, composed by 16 herbal ingredients including Ma Huang, Shai Gao, Da Huang, Huang Qin, Fang Feng to address nasal congestion related to allergies. In the first week, there was a significant increase in bowel movements, reaching 2-3 times per day initially and stabilizing to once daily. While morning nasal breathing improved, Misha continued to experience nighttime breathing through the nose, accompanied by snoring.
In response to these ongoing symptoms, I modified the herbal prescription, adding Jie Geng(to resolve phlegm and clear throat), Chuang Xiong (to promote blood circulation), Shi Gao (to address heat/inflammation). This adjustment resulted in improved overall nasal function, especially during sleep, as Misha being a mouth breather for years, began breathing more comfortably through the nose, this breathing improvement is a significant sign of his underlying allergic response turning around.
In conclusion, the holistic approach, considering the lung and large intestine connection, has proved effective in addressing Misha’s complex symptoms. The incorporation of herbs like Da Huang to open up the large intestine played a crucial role in this positive outcome. Continued monitoring and potential adjustments to the herbal formula may be necessary to ensure sustained improvement in Misha’s overall well-being.
Case #2: Kampo medicine for allergic rhinitis and wheezing
39-Year-Old Male with Chronic Seasonal Allergies(rhinitis) and constant wheezing in the lung
Side notes: It is easier to treat Children in Chinese/Kampo Medicine than adults, because Chinese medicine believes children’s body is more pure and intact thus respond to treatment better than adults whose body is not operating as efficiently and smoothly as kids
Symptoms: Chronic wheezing, sneezing with clear discharges, seasonal allergies. Diagnosis: Allergic rhinitis with fluid in the lung. Initial Kampo Formula: Chai Hu Gui Zhi Tang with additional Jing Jie, Fang Feng Current formula: Xiao Qing Long Tang(XQLT) Outcome: Significant and lasting symptom reduction after changing to XQLT
As the attending practitioner for this 39-year-old male presenting with chronic seasonal allergies, I encountered a case marked by persistent wheezing and allergic rhinitis in the fall, winter and spring accompanied by a clear watery discharge. Notably, the wheezing extended beyond the typical allergy season, particularly during weather changes in spring and fall. Despite these symptoms, the patient reported normal sleep, regular bowel movements occurring 2-3 times per day, and normal digestion. The patient exhibited easy sweating, posing a contraindication for Ma Huang. During the physical examination, I observed a normal pale tongue with a white coating and a dark purple vein underneath, along with a deep pulse. With a medium build, the abdomen displayed a normal size, featuring a flat stomach with good tone. Pain on pressure was localized to the left side beside the belly button (St25)
The diagnosis pointed towards allergic rhinitis with fluid accumulation in the lungs, resulting in persistent wheezing. The initial prescription, Chai Hu Gui Zhi Tang, a general immune regulator, was augmented with Jin Jie and Fang Feng, alongside Mu Dan Pi, Shao Yao, and Gan Jiang, chosen for its role in clearing discharge. Despite several months of use, this formula did not yield the desired results. A shift in approach focused on treating phlegm, utilizing the Minor Blue-Green Dragon Concoction(Xiao Qing Long Tang). Within two weeks, a noticeable reduction in symptoms was reported, and this modified approach was successfully maintained over a span of two years. This case underscores the significance of tailoring herbal formulas to individual responses and adjusting treatment plans for effective and sustained relief.
Case #3: Comprehensive Approach in Resolving Multiple Health Issues with Kampo Medicine
24-Year-Old Female with Multiple Health Issues Symptoms: Lingering cough, allergies, hives, menstrual irregularities. Diagnosis: Multiple issues including allergies, hormonal imbalance, and cold. Initial Kampo Formula: Xiao Chai Hu Tang, Wen Dan Tang, various add-on single herbs. Outcome: Improvement in cough, allergies, and menstrual irregularities.
In my care of a 24-year-old female, she was initially presented with a reoccurring lingering cough post viral infection(flu) and nose congestion persisting for three weeks after a cold. The cough, accompanied by productive phlegm and nocturnal heat(night sweat), prompted a thorough examination. The patient, on oral contraception since 2020 and antibiotics recently, reported symptoms including severe menstrual cramps, heavy bleeding, irregular menstruation cycle(short), hives(random skin rashes), and UTI-like symptoms, and hay fever(Seasonal allergies). She has normal digestion, good sleep, and latent hemorrhoid. A thin, wiry pulse and a tongue with a white coat and pink body were observed during the examination. Abdominal palpation revealed rib cage hypochondrial discomfort and a water splashing sound.
The initial herbal formula comprised Xiao Chai Hu Tang, Wen Dan Tang, and Mai Men Dong to address the phlegm, lung health, immune function and support digestive function, supplemented by a team targeting nasal congestion that I borrowed from Japanese Kampo physicians (Gie Geng, Chuang Xiong, Shi Gao, and Xin Yi). After one week of treatment, improvements were noted in the cough, nasal congestion, and hives. experiencing a period with reduced bleeding, no cramps, and some itchiness. A modified formula over the next two weeks addressed seasonal allergy symptoms, genital discomfort, and hemorrhoids.
However, after two weeks, seasonal allergy symptoms returned, as the initial symptoms(cough, hives and genital discomfort) continued improving. The treatment switched gear to allergy, I prescribed the Minor Blue-Green Dragon Concoction(Xiao Qing Long Tang) combined with Yi Zi Tang to cover her hemorrhoids.
However, despite how effective this formula was in Case #2 for seasonal allergy, It was not as effective as expected to this patient, after a thorough reassessment the patient’s condition, I chose a new formula combined with formulas Si Ni San(for immune regulation), Qing Shang Fang Feng Tang(for inflammation control), added single herbs Tao Ren and Mu Dan Pi to address the blood pathology associated with inflammation, and Shi Gao and Gie Geng for clearing heat and phlegm in throat area( throat is surrounded by dense lymphatic cells and nodes as the first line of defense of our immune system). This regimen continued for three weeks, notably, allergy symptoms improved, leading to a reevaluation and renewed focus on treating the cold that she caught recently again.
This case underscores the intricacies of tailoring treatments to individual responses, necessitating ongoing adjustments for comprehensive and sustained relief. Also reveals that Kampo medicine is a versatile, general practice that is able to manage conditions across multiple systems, which requires multiple western medical specialists in immunology, dermatology, gynecology allergy etc.
Case #4: Kampo medicine for extreme fatigue associated with seasonal changes
44-Year-Old Female with Allergies and Blood Stagnation Symptoms: Dizziness, brain fogs and severe fatigue around weather changes Kampo/TCM findings: abdominal pain, thin and wiry pulse, cyclical patterns. Diagnosis: Blood stagnation, phlegm accumulation Initial Formula: Si Ni San, Wen Dan Tang, Gui Zhi Fu Ling Wan. Outcome: Significant reduction in symptoms during the weather changing seaons.
This 44-year-old female patient has been practicing vegetarianism for over two decades. She presented with recurring symptoms that worsened during weather changes. She described experiencing a foggy brain, headaches, dizziness, heaviness, and fatigue, especially heightened during spring and fall. Notably, these symptoms also surfaced acutely after intense workouts, coinciding with an increase in body size. Menstruation occurred every 25 days with minimal discomfort. Upon physical examination, the patient displayed a healthy body type, a thin and wiry pulse with normal force, and reported abdominal pain upon pressing the right lower quadrant, indicative of the “Oketsu” (Blood stagnation). The tongue exhibited a red bottom and a dark purple vein underneath.
The diagnosis centered around identifying blood stagnation, phlegm, and dampness, considering the cyclical nature of the issues. The patient’s heightened immune response to various stressors, encompassing environmental factors, dampness, food, pollen, bacteria, and drugs, suggested an overreacting immune response. From a Western perspective, there was consideration for regulating the hypothalamic, neuro-endocrine, and immune systems.
The prescribed herbal formula addressed these concerns, comprising Si Ni San for overall immune regulation, Wen Dan Tang for managing phlegm and relieving headaches and dizziness, and Gui Zhi Fu Ling Wan for alleviating right lower quadrant abdominal pain. Administered over five weeks, this treatment resulted in a reported decrease in sensitivity to weather, and the pain upon palpation in the lower abdomen disappeared.
This case underscores the importance of identifying and addressing symptoms usually ignored or missed by other medical professionals, such as sign of “Oketsu”, the pain in the right lower quadrant upon pressure or on its own, the “Oketsu” in Kampo medicine, it indicates blood pathology and vascular inflammation. The potential relationship between “Oketsu” and various pathologies, including liver cirrhosis, thrombosis, and atherosclerosis, was highlighted.
P.S. This patient also developed Amenorrhea(no period) and Alopecia(boldness) at different times after, and my Kampo medicine treatment brought her periods and hair fully back online! That will be another case study in the future to discuss the hair loss issue and Kampo treatment. Stay tuned!
Can allergy be cured? Kampo’s answer is Yes!
Deep Exploration of Fang Feng Tong Sheng San (FFTSS)
This formula FFTSS was used in the management of the first pediatric allergy case, which was unique because of the chronic allergy symptoms paired with constipation. This comprehensive herbal formula comprises 18 distinct herbal and mineral ingredients, each carries unique actions and mechanisms. Particularly effective for Wind-Heat(TCM term) disorders, it addresses symptoms like constipation, dark and rough urination, and red, sore eyes as many other inflammatory symptoms. It is traditionally considered a DETOX formula, Kampo medicine thinks the toxicity in the body underlies many different conditions across the board, including various allergies. That is a totally different approach from Western medicine’s approach that focuses on the allergens. In short, Western medicine treats allergies with the presumption that it is caused by external triggers; Kampo medicine treats allergies as if the cause is the internal toxicity/imbalance, the Kampo treatment aims to clean and reset the body internally so the immune system no longer overreacts to benign/foreign substances. The differences produce opposite prognosis of allergy treatment: Western medicine thinks there is no cure for allergy because there is no way to completely avoid the allergens; Kampo medicine believes allergy can be cured as long as the internal system is balanced and clear from pathological toxicity level.
The chief herbs actions of FFTSS:
Da Huang: Targeting constipation and toxicity accumulation, Da Huang plays a pivotal role in detoxification, a crucial aspect in managing allergies. Its purgative function helps detoxify constipation, eliminating toxins through stool, a key link to allergic mechanisms. Ging Gie: This herb specifically targets the IgE pathway, the main culprit of the immune mediated allergic response. Its pharmacological effects disrupt the chain of allergy reactions, providing a strategic intervention in managing allergic responses.
Shi Gao: Serving as a major systemic anti-inflammatory agent, Shi Gao effectively reduces heat, inflammation, and immune responses. Reflecting the holistic approach of Chinese medicine, it emphasizes the quality and attributes of minerals rather than Western medicine’s focus on chemical components (Shi Gao is recognized for its cooling properties).
Best Kampo/TCM herbal formula for hay fever/seasonal allergy
Exploring Xiao Qing Long Tang(XQLT), the Minor Green-Blue Dragon Decoction
The Minor Blue Dragon Decoction, known as Xiao Qing Long Tang(XQLT)in TCM, represents a traditional herbal formula with significant relevance in allergy treatments. Comprising a synergistic blend of herbs, this decoction is rooted in the principles of Kampo, a Japanese adaptation of traditional Chinese medicine. The chief herbs in this formula are Chinese Ephedra(Ephedra sinica, Ma Huang), Pinellia (Pinelliae Tuber, Ban Xia), Dry ginger(Ginger root, Gan Jiang) and among others. Each herb plays a specific role in addressing the complex pathologies of allergy, such as endocrine function support(Ma Huang), reduction of the fluid production(Gan Jiang) from mucosal glands as well as fluid removal(Ban Xia), down-regulating immune response(Xin xin, Shao Yao) to name a few.
In contemporary Kampo medicine understanding, the XQLT is believed to work by opening the airways, resolving phlegm and support the endocrine system, thereby mitigating the inflammatory response associated with allergies and clearing the fluid in the lungs that causes the wheezing and triggers the coughing reflex. The formula is thought to modulate the immune system, helping to restore balance and reduce hypersensitivity reactions. The XQLT, in this context, is chosen for its ability to address both acute and chronic allergic conditions, such as Allergic Rhinitis, Chronic Bronchitis, with a presentation of coughing with watery phlegm, wheezing and shortness of breath, which is evident in the second case. After administration of this formula, the patient began to experience alleviation of symptoms and got his allergy response under control.
Why herbal formulas are superior to conventional medicine
First of all, I am not at all against pharmaceutical drugs, Epipen is the best treatment when you have a severe allergic attacks such as anaphylaxis. Chinese Medicine actually has a similar treatment using Mu Huang and Gan Cao, which enact similar actions of epinephrine and corticosteroid to treat acute conditions. Antibiotics have saved many lives especially during the war. However, when it comes to chronic conditions, I think Kampo/TCM herbal medicine has its advantages over the western medicine.
Western medicine, is developed from the “Germ theory”, is a reductionist system that focuses narrowly on a hypothetical single causality point, either is A bacteria, or A chemical that involved in A pathological pathway,
In contrast, herbal formulas, originating from traditional medicine systems like Kampo, stand out for their holistic approach that concurrently engages and supports multiple physiological systems and pathways. These time-tested, well-designed formulas adopt a comprehensive strategy for promoting health and treat diseases with hundreds of natural active ingredients. In addressing allergies, they have the unique ability to target respiratory symptoms, as well as endocrine, nervous, and circulatory systems simultaneously.
This differs from conventional approaches, where specific medications are selected to treat individual symptoms separately, such as decongestants for respiration, corticosteroids for inflammation. The integrative approach in Kampo medicine underscores the interconnected nature of bodily functions, emphasizing a deeper understanding of health as a dynamic equilibrium within the entire organism.
How Kampo Medicine Delivers Personalized Medicine
Tailored Approach to match the individual differences
In each of the presented cases, Kampo medicine showcased the paramount importance of a tailored approach, crafting personalized formulas that directly addressed individual symptoms and constitutional nuances. For instance, in the case of the 10-year-old child with allergies and nasal congestion, modifications to the herbal formula were made based on the patient’s evolving response, ensuring that the treatment plan aligned with the child’s unique constitution. Similarly, the 44-year-old female with seasonal allergy received a custom combination of Si Ni San, Wen Dan Tang, and Gui Zhi Fu Ling Wan to address her specific symptoms, exemplifying the precision inherent in Kampo medicine.
Dynamic Working Process with ongoing adjustments
The need for ongoing adjustments in herbal formulas to accommodate evolving symptoms and enhance overall patient well-being was evident across all cases. For instance, in the case of the 39-year-old male with chronic seasonal allergies, the continuous adjustment of herbal formulas, shifting from Xiao Chai Hu Tang to the Small Blue-Green Dragon Decoction, demonstrated the dynamic nature of Kampo medicine. This adaptability allowed for a responsive and tailored treatment approach, ensuring that the patient’s changing needs were consistently addressed over time.
Patient-Centered Health Care vs Diseases-Centered SickCare
Kampo medicine can treats diseases and reduces symptoms, but also promotes health at the same time. Patient-centered care was a consistent theme throughout the cases, emphasizing the importance of considering both symptomatic relief and underlying patterns to promote long-term health. In the case of the 24-year-old female with lingering cough and allergies, the focus on the patient’s evolving response guided dynamic adjustments in the treatment plan, prioritizing individualized care. The continuous effort to tailor the approach to the patient’s unique constitution and symptoms reflects the inherent patient-centered philosophy of Kampo medicine, fostering a holistic understanding of each individual’s health journey.
The exploration of these diverse cases paints a vivid picture of Kampo medicine’s ability to tailor solutions to the intricate nuances of individual health journeys. The dynamic adjustments made in response to evolving symptoms, the seamless integration of Traditional Chinese Medicine and Western insights, and the unwavering focus on patient-centered care collectively highlight the efficacy and adaptability of Kampo medicine. The nuanced understanding of the body’s mechanisms in Kampo, which transcends reductionist approaches, provides a refreshing alternative, emphasizing the prevention of outcomes rather than symptom control. The divergence in these approaches prompts reflection on the profound impact of one’s worldview on medical methodologies and the pursuit of comprehensive, patient-centric healthcare.
I hope this article can answer some of the questions that you have about Kampo medicine and Chinese medicine in general. Due to the limitation of my knowledge, the content in the article only reflect my personal opinion with my own bias and should not be used for medical advice.
Feel free to drop me a line or contact me if you have any questions and health concerns. Be well and put your health at your own hands.
Special thanks to Leeza Lapshina to compose this long artical, Leeza is currently pursuing her naturopathic study/career as a senior student in ***, who is interested into Kampo/Chinese Medicine
Healing Beyond Boundaries: An In-depth Analysis of Allergy Treatment in Kampo and Western Medicine
In the realm of allergy treatment, a stark contrast emerges between Western medicine’s focus on symptom management and the personalized, versatile approach of Oriental Kampo medicine. Western medicine often perceives allergies as incurable, addressing only the symptoms, while Kampo Medicine takes a distinct path, delving into the body’s patterns of response. This fundamental difference in how diseases are perceived shapes the methodologies employed in their treatment. As we delve into four recent cases of my own patients illustrating the application of Kampo Medicine in allergy treatment, we unravel the intricacies of personalized medicine, recognizing patterns rather than labeling conditions. The essence lies in Kampo’s ability to understand the body’s unique responses patterns to allergens, emphasizing a holistic, pattern-based approach that transcends the reductionism prevalent in Western medicine.
How is Kampo Different from Traditional Chinese Medicine(TCM)?
While Kampo and TCM both originate from traditional healing practices in Eastern Asia, they exhibit differences in various aspects. Kampo, originally developed in Japan, maintains its theories and clinical application approaches, preserving a significant portion of Classical Chinese Medicine prior A.D 600. Its primary focus lies in clinical evidence. TCM, mostly developed in a much later times in China, is a consolidation of various Chinese medicine schools into a contemporary) system with a structure more like western medicine than classical Chinese medicine. While it encompasses a wealth of information, it may have potentially deviated from its traditional structure. TCM places a greater emphasis on the theoretical perception of health and diseases, in contrast to Kampo, which relies more heavily on clinical evidence. TCM also mixes the theory of acupuncture into its herbal branch which created unnecessary gap and inconsistency between the theoretical concept and the reality.
What are allergies and why I have allergies?
An allergy is a heightened reactivity, an exaggerated response of the immune system to a specific trigger that may go unnoticed by non-allergic individuals. The typical allergic response involves increased mucus production, fluid secretion, and redness and swelling of various body parts, including the eyes, throat, nose, and skin. This reaction can range from a minor itchy rash to a severe anaphylaxis attack, necessitating emergency room intervention.
At a pathophysiologic level, this immune response is mediated by IgE and histamine, which are responsible for the observed swelling and redness. According to National Institute of Health of United States(source: https://www.niehs.nih.gov/health/topics/agents/allergens/index.cfm), Common allergens include pollens, fungal spores, house-dust mites, and animal epithelial materials but can also include drugs, biologic products, and insect venoms. but unexpected triggers such as weather changes and atmospheric pressure variations can also elicit abnormal reactions. Clinicians have observed patients experiencing migraines, joint pain, and swelling, heaviness and fatigue in response to weather and pressure changes, all linked to histamine release.
Apart from allergies, there are other types of sensitivities, such as temperature, food and barometer in the air, which, while distinct from allergies, share a common thread of heightened histamine reaction. Allergies can manifest in diverse and perplexing syndromes. It’s not uncommon for neither the patient nor the treating physician to be aware of hidden hypersensitivities that may be causing or perpetuating illness. Some researchers argue that the conventional medical definition of “allergy” might be too narrow. Even if a patient doesn’t exhibit classic symptoms like sneezing or hives upon exposure to the allergen, the triggering substance could play a significant role in chronic disorders that may escape detection through conventional diagnostic methods.
I am totally on board with Western medicine about the nature of allergy, which is a abnormal immune reaction to environmental factors. However, Kampo Medicine looks deep than immune response to the realm of blood pathology, inflammatory mechanisms and also takes the whole body into a holistic picture. Kampo approach produces different treatment strategies and outcome. Western medicine think there is no cure for allergy, Kampo medicine thinks it is possible to cure allergy if we can correct the underlying imbalances that lead to overactive immune systems. I will come back to this in the later of this article.
How does conventional medicine treat allergies?
According to NIH (source: https://www.ncbi.nlm.nih.gov/books/NBK447112/), Conventional allergy management involves antihistamines for symptom relief, decongestants to address nasal issues, and corticosteroids for anti-inflammatory effects. Immunotherapy, through allergy shots, gradually desensitizes the immune system. Epinephrine serves as a life-saving measure for severe reactions. Conventional medicine proclaimed that allergen avoidance is key, with diagnostic tests aiding in identification.
Kampo/TCM Herbal Treatment of Allergies with Four Cases
Case #1: Treating chronic allergies in a child
Misha (male, 10 years old)
Symptoms: Allergies, nasal congestion, constipation, difficulty sweating.
Diagnosis: dysregulated Immune system, heat in lung and large intestine.
Initial Kampo formula: Fang Feng Tong Sheng San with Xin Yi.
Outcome: Improved nasal breathing and increased bowel movements from 1x per 2~3 days with difficulties to 1~2x per day with no difficulties.
I’ve been addressing the persistent complaints that the 10-year-old has experienced since birth. Misha’s primary concerns revolve around allergies to dogs and pollen, resulting in chronic nasal congestion(mouth breather) on the daily basis even without the presence of allergens. Additionally, Misha struggles with difficult and infrequent bowel movements occurring every 2 days. Despite these challenges, Misha is generally healthy, with normal sleep and digestion. During the Kampo “Fukushin” abdominal examination, I observed his lean abdominal muscles with good tone. however, I noticed that he didn’t tickle as many other children would react when their abdomen is pressed. Plus the fact that he doesn’t sweat, I decided to use Ma Huang formulas instead of Chai Hu formulas which is very commonly used to treat chronic allergic conditions in Kampo pediatrics.
What Chinese Herbs I Used for Children Allergy?
The initial herbal treatment involved Fang Feng Tong Sheng San, composed by 16 herbal ingredients including Ma Huang, Shai Gao, Da Huang, Huang Qin, Fang Feng to address nasal congestion related to allergies. In the first week, there was a significant increase in bowel movements, reaching 2-3 times per day initially and stabilizing to once daily. While morning nasal breathing improved, Misha continued to experience nighttime breathing through the nose, accompanied by snoring.
In response to these ongoing symptoms, I modified the herbal prescription, adding Jie Geng(to resolve phlegm and clear throat), Chuang Xiong (to promote blood circulation), Shi Gao (to address heat/inflammation). This adjustment resulted in improved overall nasal function, especially during sleep, as Misha being a mouth breather for years, began breathing more comfortably through the nose, this breathing improvement is a significant sign of his underlying allergic response turning around.
In conclusion, the holistic approach, considering the lung and large intestine connection, has proved effective in addressing Misha’s complex symptoms. The incorporation of herbs like Da Huang to open up the large intestine played a crucial role in this positive outcome. Continued monitoring and potential adjustments to the herbal formula may be necessary to ensure sustained improvement in Misha’s overall well-being.
Case #2: Kampo medicine for allergic rhinitis and wheezing
39-Year-Old Male with Chronic Seasonal Allergies(rhinitis) and constant wheezing in the lung
Side notes: It is easier to treat Children in Chinese/Kampo Medicine than adults, because Chinese medicine believes children’s body is more pure and intact thus respond to treatment better than adults whose body is not operating as efficiently and smoothly as kids
Symptoms: Chronic wheezing, sneezing with clear discharges, seasonal allergies.
Diagnosis: Allergic rhinitis with fluid in the lung.
Initial Kampo Formula: Chai Hu Gui Zhi Tang with additional Jing Jie, Fang Feng
Current formula: Xiao Qing Long Tang(XQLT)
Outcome: Significant and lasting symptom reduction after changing to XQLT
As the attending practitioner for this 39-year-old male presenting with chronic seasonal allergies, I encountered a case marked by persistent wheezing and allergic rhinitis in the fall, winter and spring accompanied by a clear watery discharge. Notably, the wheezing extended beyond the typical allergy season, particularly during weather changes in spring and fall. Despite these symptoms, the patient reported normal sleep, regular bowel movements occurring 2-3 times per day, and normal digestion. The patient exhibited easy sweating, posing a contraindication for Ma Huang. During the physical examination, I observed a normal pale tongue with a white coating and a dark purple vein underneath, along with a deep pulse. With a medium build, the abdomen displayed a normal size, featuring a flat stomach with good tone. Pain on pressure was localized to the left side beside the belly button (St25)
The diagnosis pointed towards allergic rhinitis with fluid accumulation in the lungs, resulting in persistent wheezing. The initial prescription, Chai Hu Gui Zhi Tang, a general immune regulator, was augmented with Jin Jie and Fang Feng, alongside Mu Dan Pi, Shao Yao, and Gan Jiang, chosen for its role in clearing discharge. Despite several months of use, this formula did not yield the desired results. A shift in approach focused on treating phlegm, utilizing the Minor Blue-Green Dragon Concoction(Xiao Qing Long Tang). Within two weeks, a noticeable reduction in symptoms was reported, and this modified approach was successfully maintained over a span of two years. This case underscores the significance of tailoring herbal formulas to individual responses and adjusting treatment plans for effective and sustained relief.
Case #3: Comprehensive Approach in Resolving Multiple Health Issues with Kampo Medicine
24-Year-Old Female with Multiple Health Issues
Symptoms: Lingering cough, allergies, hives, menstrual irregularities.
Diagnosis: Multiple issues including allergies, hormonal imbalance, and cold.
Initial Kampo Formula: Xiao Chai Hu Tang, Wen Dan Tang, various add-on single herbs.
Outcome: Improvement in cough, allergies, and menstrual irregularities.
In my care of a 24-year-old female, she was initially presented with a reoccurring lingering cough post viral infection(flu) and nose congestion persisting for three weeks after a cold. The cough, accompanied by productive phlegm and nocturnal heat(night sweat), prompted a thorough examination. The patient, on oral contraception since 2020 and antibiotics recently, reported symptoms including severe menstrual cramps, heavy bleeding, irregular menstruation cycle(short), hives(random skin rashes), and UTI-like symptoms, and hay fever(Seasonal allergies). She has normal digestion, good sleep, and latent hemorrhoid. A thin, wiry pulse and a tongue with a white coat and pink body were observed during the examination. Abdominal palpation revealed rib cage hypochondrial discomfort and a water splashing sound.
The initial herbal formula comprised Xiao Chai Hu Tang, Wen Dan Tang, and Mai Men Dong to address the phlegm, lung health, immune function and support digestive function, supplemented by a team targeting nasal congestion that I borrowed from Japanese Kampo physicians (Gie Geng, Chuang Xiong, Shi Gao, and Xin Yi). After one week of treatment, improvements were noted in the cough, nasal congestion, and hives. experiencing a period with reduced bleeding, no cramps, and some itchiness. A modified formula over the next two weeks addressed seasonal allergy symptoms, genital discomfort, and hemorrhoids.
However, after two weeks, seasonal allergy symptoms returned, as the initial symptoms(cough, hives and genital discomfort) continued improving. The treatment switched gear to allergy, I prescribed the Minor Blue-Green Dragon Concoction(Xiao Qing Long Tang) combined with Yi Zi Tang to cover her hemorrhoids.
However, despite how effective this formula was in Case #2 for seasonal allergy, It was not as effective as expected to this patient, after a thorough reassessment the patient’s condition, I chose a new formula combined with formulas Si Ni San(for immune regulation), Qing Shang Fang Feng Tang(for inflammation control), added single herbs Tao Ren and Mu Dan Pi to address the blood pathology associated with inflammation, and Shi Gao and Gie Geng for clearing heat and phlegm in throat area( throat is surrounded by dense lymphatic cells and nodes as the first line of defense of our immune system). This regimen continued for three weeks, notably, allergy symptoms improved, leading to a reevaluation and renewed focus on treating the cold that she caught recently again.
This case underscores the intricacies of tailoring treatments to individual responses, necessitating ongoing adjustments for comprehensive and sustained relief. Also reveals that Kampo medicine is a versatile, general practice that is able to manage conditions across multiple systems, which requires multiple western medical specialists in immunology, dermatology, gynecology allergy etc.
Case #4: Kampo medicine for extreme fatigue associated with seasonal changes
44-Year-Old Female with Allergies and Blood Stagnation
Symptoms: Dizziness, brain fogs and severe fatigue around weather changes
Kampo/TCM findings: abdominal pain, thin and wiry pulse, cyclical patterns.
Diagnosis: Blood stagnation, phlegm accumulation
Initial Formula: Si Ni San, Wen Dan Tang, Gui Zhi Fu Ling Wan.
Outcome: Significant reduction in symptoms during the weather changing seaons.
This 44-year-old female patient has been practicing vegetarianism for over two decades. She presented with recurring symptoms that worsened during weather changes. She described experiencing a foggy brain, headaches, dizziness, heaviness, and fatigue, especially heightened during spring and fall. Notably, these symptoms also surfaced acutely after intense workouts, coinciding with an increase in body size. Menstruation occurred every 25 days with minimal discomfort. Upon physical examination, the patient displayed a healthy body type, a thin and wiry pulse with normal force, and reported abdominal pain upon pressing the right lower quadrant, indicative of the “Oketsu” (Blood stagnation). The tongue exhibited a red bottom and a dark purple vein underneath.
The diagnosis centered around identifying blood stagnation, phlegm, and dampness, considering the cyclical nature of the issues. The patient’s heightened immune response to various stressors, encompassing environmental factors, dampness, food, pollen, bacteria, and drugs, suggested an overreacting immune response. From a Western perspective, there was consideration for regulating the hypothalamic, neuro-endocrine, and immune systems.
The prescribed herbal formula addressed these concerns, comprising Si Ni San for overall immune regulation, Wen Dan Tang for managing phlegm and relieving headaches and dizziness, and Gui Zhi Fu Ling Wan for alleviating right lower quadrant abdominal pain. Administered over five weeks, this treatment resulted in a reported decrease in sensitivity to weather, and the pain upon palpation in the lower abdomen disappeared.
This case underscores the importance of identifying and addressing symptoms usually ignored or missed by other medical professionals, such as sign of “Oketsu”, the pain in the right lower quadrant upon pressure or on its own, the “Oketsu” in Kampo medicine, it indicates blood pathology and vascular inflammation. The potential relationship between “Oketsu” and various pathologies, including liver cirrhosis, thrombosis, and atherosclerosis, was highlighted.
P.S. This patient also developed Amenorrhea(no period) and Alopecia(boldness) at different times after, and my Kampo medicine treatment brought her periods and hair fully back online! That will be another case study in the future to discuss the hair loss issue and Kampo treatment. Stay tuned!
Can allergy be cured? Kampo’s answer is Yes!
Deep Exploration of Fang Feng Tong Sheng San (FFTSS)
This formula FFTSS was used in the management of the first pediatric allergy case, which was unique because of the chronic allergy symptoms paired with constipation. This comprehensive herbal formula comprises 18 distinct herbal and mineral ingredients, each carries unique actions and mechanisms. Particularly effective for Wind-Heat(TCM term) disorders, it addresses symptoms like constipation, dark and rough urination, and red, sore eyes as many other inflammatory symptoms. It is traditionally considered a DETOX formula, Kampo medicine thinks the toxicity in the body underlies many different conditions across the board, including various allergies. That is a totally different approach from Western medicine’s approach that focuses on the allergens. In short, Western medicine treats allergies with the presumption that it is caused by external triggers; Kampo medicine treats allergies as if the cause is the internal toxicity/imbalance, the Kampo treatment aims to clean and reset the body internally so the immune system no longer overreacts to benign/foreign substances. The differences produce opposite prognosis of allergy treatment: Western medicine thinks there is no cure for allergy because there is no way to completely avoid the allergens; Kampo medicine believes allergy can be cured as long as the internal system is balanced and clear from pathological toxicity level.
The chief herbs actions of FFTSS:
Da Huang: Targeting constipation and toxicity accumulation, Da Huang plays a pivotal role in detoxification, a crucial aspect in managing allergies. Its purgative function helps detoxify constipation, eliminating toxins through stool, a key link to allergic mechanisms. Ging Gie: This herb specifically targets the IgE pathway, the main culprit of the immune mediated allergic response. Its pharmacological effects disrupt the chain of allergy reactions, providing a strategic intervention in managing allergic responses.
Shi Gao: Serving as a major systemic anti-inflammatory agent, Shi Gao effectively reduces heat, inflammation, and immune responses. Reflecting the holistic approach of Chinese medicine, it emphasizes the quality and attributes of minerals rather than Western medicine’s focus on chemical components (Shi Gao is recognized for its cooling properties).
Best Kampo/TCM herbal formula for hay fever/seasonal allergy
Exploring Xiao Qing Long Tang(XQLT), the Minor Green-Blue Dragon Decoction
The Minor Blue Dragon Decoction, known as Xiao Qing Long Tang(XQLT)in TCM, represents a traditional herbal formula with significant relevance in allergy treatments. Comprising a synergistic blend of herbs, this decoction is rooted in the principles of Kampo, a Japanese adaptation of traditional Chinese medicine. The chief herbs in this formula are Chinese Ephedra(Ephedra sinica, Ma Huang), Pinellia (Pinelliae Tuber, Ban Xia), Dry ginger(Ginger root, Gan Jiang) and among others. Each herb plays a specific role in addressing the complex pathologies of allergy, such as endocrine function support(Ma Huang), reduction of the fluid production(Gan Jiang) from mucosal glands as well as fluid removal(Ban Xia), down-regulating immune response(Xin xin, Shao Yao) to name a few.
In contemporary Kampo medicine understanding, the XQLT is believed to work by opening the airways, resolving phlegm and support the endocrine system, thereby mitigating the inflammatory response associated with allergies and clearing the fluid in the lungs that causes the wheezing and triggers the coughing reflex. The formula is thought to modulate the immune system, helping to restore balance and reduce hypersensitivity reactions. The XQLT, in this context, is chosen for its ability to address both acute and chronic allergic conditions, such as Allergic Rhinitis, Chronic Bronchitis, with a presentation of coughing with watery phlegm, wheezing and shortness of breath, which is evident in the second case. After administration of this formula, the patient began to experience alleviation of symptoms and got his allergy response under control.
Why herbal formulas are superior to conventional medicine
First of all, I am not at all against pharmaceutical drugs, Epipen is the best treatment when you have a severe allergic attacks such as anaphylaxis. Chinese Medicine actually has a similar treatment using Mu Huang and Gan Cao, which enact similar actions of epinephrine and corticosteroid to treat acute conditions. Antibiotics have saved many lives especially during the war. However, when it comes to chronic conditions, I think Kampo/TCM herbal medicine has its advantages over the western medicine.
Western medicine, is developed from the “Germ theory”, is a reductionist system that focuses narrowly on a hypothetical single causality point, either is A bacteria, or A chemical that involved in A pathological pathway,
In contrast, herbal formulas, originating from traditional medicine systems like Kampo, stand out for their holistic approach that concurrently engages and supports multiple physiological systems and pathways. These time-tested, well-designed formulas adopt a comprehensive strategy for promoting health and treat diseases with hundreds of natural active ingredients. In addressing allergies, they have the unique ability to target respiratory symptoms, as well as endocrine, nervous, and circulatory systems simultaneously.
This differs from conventional approaches, where specific medications are selected to treat individual symptoms separately, such as decongestants for respiration, corticosteroids for inflammation. The integrative approach in Kampo medicine underscores the interconnected nature of bodily functions, emphasizing a deeper understanding of health as a dynamic equilibrium within the entire organism.
How Kampo Medicine Delivers Personalized Medicine
Tailored Approach to match the individual differences
In each of the presented cases, Kampo medicine showcased the paramount importance of a tailored approach, crafting personalized formulas that directly addressed individual symptoms and constitutional nuances. For instance, in the case of the 10-year-old child with allergies and nasal congestion, modifications to the herbal formula were made based on the patient’s evolving response, ensuring that the treatment plan aligned with the child’s unique constitution. Similarly, the 44-year-old female with seasonal allergy received a custom combination of Si Ni San, Wen Dan Tang, and Gui Zhi Fu Ling Wan to address her specific symptoms, exemplifying the precision inherent in Kampo medicine.
Dynamic Working Process with ongoing adjustments
The need for ongoing adjustments in herbal formulas to accommodate evolving symptoms and enhance overall patient well-being was evident across all cases. For instance, in the case of the 39-year-old male with chronic seasonal allergies, the continuous adjustment of herbal formulas, shifting from Xiao Chai Hu Tang to the Small Blue-Green Dragon Decoction, demonstrated the dynamic nature of Kampo medicine. This adaptability allowed for a responsive and tailored treatment approach, ensuring that the patient’s changing needs were consistently addressed over time.
Patient-Centered Health Care vs Diseases-Centered SickCare
Kampo medicine can treats diseases and reduces symptoms, but also promotes health at the same time. Patient-centered care was a consistent theme throughout the cases, emphasizing the importance of considering both symptomatic relief and underlying patterns to promote long-term health. In the case of the 24-year-old female with lingering cough and allergies, the focus on the patient’s evolving response guided dynamic adjustments in the treatment plan, prioritizing individualized care. The continuous effort to tailor the approach to the patient’s unique constitution and symptoms reflects the inherent patient-centered philosophy of Kampo medicine, fostering a holistic understanding of each individual’s health journey.
The exploration of these diverse cases paints a vivid picture of Kampo medicine’s ability to tailor solutions to the intricate nuances of individual health journeys. The dynamic adjustments made in response to evolving symptoms, the seamless integration of Traditional Chinese Medicine and Western insights, and the unwavering focus on patient-centered care collectively highlight the efficacy and adaptability of Kampo medicine. The nuanced understanding of the body’s mechanisms in Kampo, which transcends reductionist approaches, provides a refreshing alternative, emphasizing the prevention of outcomes rather than symptom control. The divergence in these approaches prompts reflection on the profound impact of one’s worldview on medical methodologies and the pursuit of comprehensive, patient-centric healthcare.
I hope this article can answer some of the questions that you have about Kampo medicine and Chinese medicine in general. Due to the limitation of my knowledge, the content in the article only reflect my personal opinion with my own bias and should not be used for medical advice.
Feel free to drop me a line or contact me if you have any questions and health concerns. Be well and put your health at your own hands.
Special thanks to Leeza Lapshina to compose this long artical, Leeza is currently pursuing her naturopathic study/career as a senior student in ***, who is interested into Kampo/Chinese Medicine