we can now turn our attention to Wind as the main Manifestation of this disease.
Wind is the main pathogenic factor in asthma: not in the sense of an invasion of external Wind,
but as a kind of chronic external Wind locked in the bronchi. The Lungs are the most exterior of
the Yin organs as they control the skin. The bronchial mucosa could be seen as an extension of
the skin. Thus, just as Wind invades the skin, it may invade the bronchi, lodge itself there and
cause bronchospasm. Even from a Western point of view, animal studies suggest that the
pathological features of skin and pulmonary actions are very similar.23(131)
This can happen only against a background of deficiency of the Lung and Kidney's Defensive-Qi
systems which allows Wind to lodge in the bronchi for a long time. Thus, asthma is
characterized by Wind, a non-substantial pathogenic factor. This may explain how X-rays have
no diagnostic value in asthma as they may show phlegm but not "Wind", and also how in
asthmatic children or young people the tongue is nearly always not Swollen and the pulse not
Slippery as one would expect were Phlegm the main pathogenic factor; instead, the tongue is
often Thin and the pulse Tight.
The Chinese idea of Wind may be compared to the Western concept of allergens. The inhalation
of dust, faecal matter from house-dust mites, pollen and animal dander could be compared to
invasion of "Wind" as conceived in Chinese medicine. In fact, the Chinese character for Wind
includes the radical for "insect" or "worm", i.e. comparable to allergens and germs carried by
the wind.
Thus, the main problem in asthma is a deficiency of the Lung and Kidney's Defensive-Qi
systems which allows Wind to penetrate and lodge itself in the bronchi causing bouts of
bronchospasm. When Dr Ye Gui (1766) said, as mentioned above, that "in breathlessness
[Chuan] if the pathogenic factor [Phlegm] is expelled it will never return ... in wheezing [Xiao]
the pathogenic factor is hidden in the Interior and in the Lungs ... and there are frequent
episodes over the years", he correctly highlighted the difference between wheezing (Xiao) and
breathlessness (Chuan). Breathlessness is due to Phlegm and once this is resolved, the condition
is cured permanently. Allergic asthma is due to Wind in the bronchi causing periodic bouts of
wheezing. The reason this is difficult to expel is not that it is particularly deep in the Interior, but
that it is linked to a deficiency of the Lung and Kidney's Defensive-Qi systems. Until this
deficiency is addressed, the Wind cannot be expelled.
Another phenomenon which points to Wind rather than Phlegm as the main pathogenic factor in
asthma is the remarkable effectiveness of acupuncture in stopping an acute asthma attack. This is
because Wind is a non-substantial pathogenic factor and, as such, more responsive to
acupuncture treatment. When Phlegm is the main pathogenic factor as in chronic bronchitis,
acupuncture has only a limited efficacy in relieving breathlessness in the short term as it
obviously takes a long time to resolve Phlegm.
As for late-onset asthma, although this is usually not allergic, its pathology is similar, with the