Click Heart Medicine Young Doctor↑ Accompanying You to Grow TogetherAuthor｜Jia Dailin (WeChat ID: tcmjdl) Source｜Heart Medicine Young Doctor (WeChat Official Account)Record of the “Qiang Qiang Traditional Chinese Medicine” Salon on February 16, 2022
【Abstract】
This article is an excerpt from the sharing session of Teacher Jia Haizhong during the recording of the “Qiang Qiang Traditional Chinese Medicine” exchange on February 16, 2022. The sharing mainly includes Teacher Jia’s insights on the relationship between the nose and the physiology and pathology of the five internal organs, as well as how to treat nasal diseases and the connection between nasal and internal injury diseases.
Image from previous on-site exchange
Recording of Teacher Jia Haizhong’s experience sharing
After listening to everyone, I really feel that our event is wonderful. The experts invited by Teacher Zhao are all excellent. I hope we can maintain this quality in the future. Actually, I have a lot to say, but what everyone has just discussed is already very comprehensive. However, I still want to systematically share my understanding with everyone. Of course, I will simplify what has already been discussed by the experts.
First of all, as mentioned earlier, the nose is used for breathing. All our tastes and gases pass through the nose. In Traditional Chinese Medicine (TCM), the term “qi” actually refers to a sensation related to the nose. The true five qi are clearly described in the “Huangdi Neijing” (Yellow Emperor’s Inner Canon). The true five qi are: sour, bitter, fragrant, fishy, and rotten. The sour taste enters the liver, the bitter taste enters the heart, the fragrant taste enters the spleen, the fishy taste enters the lungs, and the rotten taste enters the kidneys—this is the relationship between the five qi and the five internal organs.
However, for the five internal organs to perceive the gas molecules in the air, it must be through the nose. Therefore, the nose is the external orifice of the five internal organs. It is not just the orifice of the lungs; it is related to the flow of gases and the lungs, so the lungs open to the nose. In fact, in terms of the content of the five qi, it directly connects to the five internal organs, which is clearly stated in the “Huangdi Neijing”.
However, the development of TCM in this area, especially in modern times, has lagged far behind. To this day, the use of nasal inhalation in TCM for treatment is still very rare. More than a decade ago, there was a book on nasal therapy that discussed treating systemic diseases through the nasal cavity, including drug delivery via the nasal cavity. Ancient records mention using radish juice to treat headaches by nasal drops, and using Xi Xin (Asarum) and Zao Jiao (Gleditsia) to induce sneezing and awaken the spirit in cases of coma. Including our acupuncture technique of needling the Ren Zhong (Yintang) point, which was established by a master of acupuncture in Tianjin, involves needling the nasal septum. The awakening of the brain through the nose is a method of treating systemic diseases. In fact, our ancient knowledge is extremely rich. I will stop here regarding the relationship with the five internal organs, as Professor Zhang has summarized it very well.
In terms of diagnosis, I would like to add that the relationship between the nose and diagnosis is that we not only need to diagnose nasal diseases but also use abnormalities in the nose to diagnose other diseases. For example, infectious diseases can cause olfactory abnormalities. I want to add something that was not mentioned earlier because today I had a patient in my clinic. He had a temporal lobe brain tumor, and after surgery, he often experienced paroxysmal auditory sensations, which manifested as sensory epilepsy in the form of tinnitus.
In clinical practice, we also have an experience: a military officer from a certain city in Henan came to see me a few years ago, and he reported a paroxysmal olfactory sensation of rubber smell, which would come and go. This is also a form of paroxysmal epilepsy. When encountering this, one must consider that there may be a problem in the brain, particularly in areas related to olfaction, and he should undergo a cranial MRI.
Today, we have a case of paroxysmal tinnitus, and previously, this military officer had a case of paroxysmal olfactory abnormality. Regardless of the nature, one must consider the possibility of a brain tumor, which is a type of epilepsy known as sensory epilepsy. This should draw our attention.
Additionally, regarding diagnosis, since the nose is an outlet for air, the temperature of the air we exhale can be hot or cold. The temperature of the air from the mouth and nose is very helpful in judging internal cold and heat. For instance, a patient with a fever will have particularly hot air coming from the nose; if you place your hand there, you will feel it is very hot. If a patient has heart failure, yang deficiency, and cold limbs, the air from the mouth and nose will be cold. Therefore, we can also judge internal cold and heat through the temperature of the air. This is what I wanted to add.
Regarding nasal treatment, Professor Zhang Yuping has already discussed a lot. I would like to add one more point: in the “Huangdi Neijing,” there is a method called the “Famen” method. The Famen method is used to treat tinnitus. This tinnitus is actually caused by eustachian tube dysfunction, and using the Famen method involves needling the Ting Gong (Tinggong) point, then sitting and pinching the nose to lie down for ten minutes, leaving the needles in place, which can alleviate the feeling of ear fullness and tinnitus. This method has proven effective in clinical practice.
Moreover, there is another method of treating diseases through the nose, aside from inducing sneezing with medication. The “Huangdi Neijing” also records that using a soft herb to stimulate the nose to induce sneezing can treat hiccups, leading to rapid improvement, almost immediate disappearance. This is something everyone can verify; I have used this method quite a bit. Sometimes, sticking a hair into the nose to induce a sneeze can make hiccups disappear. This is something everyone can verify, and I find that the methods recorded in the “Huangdi Neijing” are indeed verifiable.
Additionally, using the nasal cavity for health maintenance can help keep our brains sharp. In Buddhism, there is a six-syllable mantra: Om (ōng) Ma (ma) Ni (nī) Pad (bēi) Me (mēi) Hung (hōng). Pay attention to the pronunciation of Om (ōng) and Hung (hōng); when pronounced slowly and drawn out, you can feel a strong vibrational effect on the brain, as if the entire brain is being massaged by sound.
What is the effect of these two syllables? According to the literature, they can lead to achievements and fulfill the wishes of the Buddha. This actually enhances wisdom; when people have wisdom, they can achieve anything. Therefore, we should not treat these as superstitions, as we can benefit from the vibrational effects of sound on the brain. Of course, we should not use superstitious explanations; perhaps we can gain benefits.
Regarding the therapeutic effects of sound and pronunciation, I was once skeptical. This was when I learned the six-syllable mantra from Teacher Li Shaobo in Lanzhou, Gansu. At that time, I practiced it and found that the different sounds you make engage different muscle groups in your body, and you can see that the source of strength varies. Therefore, using sound to treat diseases has profound scientific principles that have yet to be revealed. This method of using nasal sound vibrations for health maintenance and treatment is worth our attention.
Another method is inhaling medicinal vapors for treatment. Nowadays, nebulized inhalation provides a faster route for medication. For instance, in treating cardiovascular diseases like angina pectoris, using isosorbide dinitrate crushed and inhaled can quickly relieve angina. In fact, we can select different flavors based on the relationship between the nose and the five qi to regulate different internal organs.
Specifically regarding nasal diseases, there are many varieties in clinical practice. As Professor Zhang Yuping has summarized, almost all five internal organs can lead to nasal diseases. However, from my clinical experience, I believe there are two or three important causes of nasal diseases.
First, cold air is a significant cause of disease. So, how can we improve the nose’s adaptability to cold pathogens? The best method is to run in the coldest weather. Due to exercise, the nose becomes less sensitive to cold because the body generates more heat, keeping it warm. Therefore, the cold air inhaled becomes warm when exhaled, reducing sensitivity to cold air and improving tolerance, making it less likely for cold to cause functional abnormalities.
The second important cause is air pollution, such as smog. A few years ago, during the smog in Beijing, many respiratory diseases occurred, and many patients had nasal congestion. When I was in college at Hebei Medical University, I could see a yellow haze from the North China Pharmaceutical Factory during winter. At that time, I didn’t know the reason, but within three days of starting school, I developed nasal congestion, and it cleared up within a week after returning home. No medication worked while I was at school, but I recovered once I left. Therefore, air pollution is crucial for disease prevention; we must wear masks, especially in polluted environments, which is the second important reason.
The third important cause is specific substances in the air. Seasonal allergens, such as pollen and mold, appear in different seasons. Some people are allergic to spring pollen, some to summer humidity, and others to autumn dryness. For instance, mugwort pollen tends to appear in autumn and in desert areas. Therefore, (nasal diseases) are related to the substances present in the air. The main external causes are these.
In clinical practice, the most common diseases are various types of rhinitis. I believe we should first identify these causes and then take preventive measures. Additionally, we must regulate the functions of the internal organs, as having healthy organ functions can prevent the onset of these diseases even in the presence of these causative factors.
Allergic rhinitis (patients) do not have allergies in every season; it is clearly related to constitution and the state of organ dysfunction. Therefore, regulating organ function is the fundamental way to prevent allergic recurrence, while wearing masks is a symptomatic method to avoid contact with harmful substances. However, it is very important. Additionally, for nasal congestion, sneezing, and runny nose, especially in allergic rhinitis, Professor Zhang Yuping has introduced his experience. In clinical practice, using Professor Li Xinwu’s method of needling the nasal palatine ganglion for treating allergic rhinitis is also very effective. This method is also very good for treating ordinary rhinitis. If medication is combined with acupuncture, moxibustion at the Yingxiang (Yingxiang) point should be done while lying flat; do not sit up, as the smoke can easily be inhaled. When moxibustion is performed in a supine position, the smoke rises and does not enter the nasal cavity. This can treat nasal congestion and rapidly improve symptoms; acupuncture is also effective.
Nasal bleeding is indeed difficult to treat, as some teachers have mentioned. Simple cases are easy to treat, but difficult cases are not. However, I have a bit of experience to share. I remember when I was young and just starting my career, there was an old doctor who was younger than I am now. After seeing patients, we often liked to chat with him to learn something. One time, he talked about a doctor in Tianjin who had persistent nasal bleeding and could not stop it. One day, his classmate visited him and jokingly asked why he didn’t seek help for such a simple problem. The doctor quickly asked what good advice his classmate had. The classmate said to boil some Da Huang (Rhubarb) and drink the decoction. After drinking it, the bleeding stopped.
Later, I heard this story, and even after 30 years, I still remember it. Why? Because later I verified that it is indeed very effective for treating nasal bleeding, especially for patients with recurrent bleeding. Da Huang is an excellent medicine. Additionally, for internal heat causing persistent nasal bleeding, using Zengye Decoction is a good choice. In the “Xiaopin Fang” (Minor Prescriptions), it consists of Sheng Di (Rehmannia), Mai Dong (Ophiopogon), and Xuan Shen (Scrophularia), which is also a very good option, especially for those with a tendency to heat and significant bleeding. If the bleeding is severe and persistent, aside from the above, if decocting Da Huang is possible, in emergencies, San Huang Pian (Three Yellow Pills) can also be effective. However, it is slower. To stop nasal bleeding quickly, needling the Shangxing (Shangxing) point is effective. Ancient acupuncture texts record it as a special point for treating nasal bleeding. Generally, needling this point can stop the bleeding within five to ten minutes; in most cases, it will stop, so Shangxing is a very good acupoint for treating nasal bleeding. After needling, it is essential to maintain the needling.
Common nasal diseases encountered in clinical practice also include snoring. If someone does not snore regularly but does so at certain times, it is often due to inflammation in the nasopharynx, which is related to rhinitis. Treating rhinitis will reduce snoring. The methods for treating rhinitis have been discussed extensively, so I will not repeat them. I will just add one point that no one has mentioned: Sang Bai Pi (Mulberry Bark). Sang Bai Pi opens the nasal orifices and is very effective for treating rhinitis, especially for wind-heat external pathogens affecting the entire respiratory system from the nose to the lungs. Before I found this herb, I had used many other herbs, but the results were not very satisfactory. After discovering Sang Bai Pi, I felt more confident in treating this condition. This herb is recorded in the “Xianxing Zhai Yixue Guang Biji” (Comprehensive Medical Notes of Xianxing Zhai), though I cannot recall exactly. In any case, it is based on the experience of an ancient famous doctor, and we have verified that it is indeed reliable. That is all I want to add regarding disease treatment.
Overall, I believe the treatment principles should combine precise treatment with syndrome differentiation. Precise treatment involves selecting medications based on the nature of the pathogenic factors at the time, while syndrome differentiation focuses on regulating the dysfunction of the internal organs. Combining these approaches allows for comprehensive treatment, leading to better efficacy.
Note: The formulas, medications, specific dosages, and treatment methods listed in this article are for the reference of clinical practitioners only.
Introduction to the “Qiang Qiang Traditional Chinese Medicine Academic Salon”:
Supported by relevant departments of Beijing University of Chinese Medicine and Dongzhimen Hospital, the “Qiang Qiang Traditional Chinese Medicine” academic salon was jointly initiated by Professor Zhao Jinxie and Professor Jia Haizhong as a purely public welfare TCM academic salon. The term “Qiang Qiang” signifies a strong and resonant voice for TCM, implying academic debate and the rapid development of TCM. The “Qiang Qiang Traditional Chinese Medicine” event is held monthly, with each session discussing important, hot, and misunderstood academic topics in TCM. Through exchanges and discussions among experts, some popular but incorrect viewpoints in TCM are clarified, and in-depth discussions on various issues in TCM education, research, and clinical practice are conducted. To ensure that the salon closely integrates with clinical efficacy, most invited experts are TCM practitioners working on the front lines. The original intention of the “Qiang Qiang Traditional Chinese Medicine” is to cultivate excellent TCM clinical talents, with each discussion naturally revolving around the central theme of “improving TCM clinical efficacy.” After each “Qiang Qiang Traditional Chinese Medicine” event, Zhao Jinxie arranges for graduate students to transcribe the recordings into written documents. The “Global Traditional Chinese Medicine” magazine has a special column to publish these discussion documents. At the end of 2017, the “Qiang Qiang Traditional Chinese Medicine” column in the “Global Traditional Chinese Medicine” magazine was selected as an excellent promotional work by the National Health and Family Planning Commission’s publishing unit.
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