Kai Wang,Ya-Jun Du,Zeng-Tao Sun,Xiao-Juan Li,En-Shun Liu

1Tianjin Teda Puhua International Hospital,Tianjin,China.2The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,China.

Treating winter diseases in summer is characterized by warming Yang,which is recuperating in summer,to treat some chronic diseases commonly seen in winter.Thistreatment belongs to the chronomedicine of TCM.Its treatment methods consist of taking oral Chinese medicine and using external medicine.Its indications include chronic pulmonary diseases such as COPD Asthma,chronic bronchitis,Nasopharyngitis(rhinitis pharynginis),coughing,and other respiratory diseases.

The origin of the theory of treating winter diseasesin summer

Treating winter diseases in summer is based on the theory of “harmony of human and nature” and“warming Yang in the spring and summer” of traditional Chinese medicine.These concepts originate from the second chapter of Plain Questions(the Warring States period and the Han dynasty,206 BC-23 AD).This chapter says,“Si Shi Yin Yang is the root of all things in the world,so the sages raise Yang in spring and summer and cultivate Yin in autumn and winter”.It means that in spring and summer,since life begin to grow and thrive,people should promote health and growth accordingly to warm Yang.However,since life preserves energy and remains dormant in autumn and winter,people should also focus on reserving their energy to cultivate Yin accordingly.Doctors in the Tang Dynasty first put forward the idea of treating diseases in dog days(July-August in the Chinese lunar calendar).Sun Simiao(581-682 AD)says,“Taking the soup of nourishing kidneys three times daily in dog days every year can treat kidney deficiency,urinary frequency,diabetes,and bladder distension.”This is the earliest record of using medicine to treat diseases during dog days.

Treatment of Winter Diseases in Summer:the proposal of external therapy

Taiping Holy Prescriptions for Universal Relief,written by Wang Huaiyin of the Song Dynasty in 992 AD,records that“Infantile emaciation is manifested as rectocele,emaciation,thirst and guantness.Many techniques have been used to treat it but they don’t work.The Yellow Emperor treats the infantile emaciation by moxibustion on the Weicui point with a moxacone the sizeof wheat.Qibo says:during thedog days,the infant needs to take showers with water that contains peach and willow.The moxibustion should be used at noon and the body should be wiped dry by silk.”It is very effective to treat infantile emaciation by external washing and moxibustion when the Yang Qiisthemost prosperousduring dog days.

Treatment of Winter Diseases in Summer:the proposal of the medication application theory

In Compendium of Materia Medica(1578 AD),Li Shizhen(1518-1593 AD)proposes that medicine should be chosen according to different seasons.The concrete method is described as:“It is more appropriate to choose Xinwen medicine in spring to adapt to the ascending of Qi,such as Bo He(Herba Menthae),Jing Jie(Herba Schizonepetae)etc.In summer,it is better to add Xinre medicine to adapt to the floating of Qi,such as Xiang Ru(Herba Moslae),Sheng Jiang (Rhizoma Zingiberis Recens) etc.However,in the long summer,Xinwen medicine can be selected to adapt to the transformation of Qi,such as Ginseng, Bai Zhu (Rhizoma Atractylodis Macrocephalae),Cang Zhu(Rhizoma Atractylodis),Sheng Jiang(Rhizoma Zingiberis Recens)etc.In autumn,Suanwen medicine can be chosen to adapt to the descending of Qi,such as Shao Yao(Paeonia Lactiflora),Wu Mei(Fructus Mume)etc.In winter,it is more reasonable to choose Kuhan medicine to adapt to the sinking of Qi,such as Huang Qin(Radix Scutellariae),Zhi Mu(Rhizoma anemarrhenae)etc.”The proposal of the addition of Xinwen medicine in the long summer lays the foundation for selecting drugsof Treatment of Winter Diseasesin Summer.

Zhang Zhicong(1616-1674 AD)in the Qing Dynasty puts forward the following theory in his Variorum for Plain Questions:“Yang Qi and Yin Qi should be strengthened depending on the season.In spring and summer,uplifting Yang Qi outside would result in Yang Qi deficiency inside,so food that replenishes Yang should be eaten.In autumn and winter,nourishing Yin is more suitable.” Lu Zhiyi(1368-1644 AD)points out in Ben Cao Cheng Ya Ban Ji that the characteristic of ginger is spicy,which can be used to raise Yang Qi during Dog days.This provides the theoretical basis and possible applications of ginger therapy on specific acupoints for asthma during Dog days.

Figure 1 Acupuncture Points were need to stick in the body

Table1 Composition and treatment opportunity of theacupoint plaster therapy recorded in Zhang Shi Yi Tong

Table2:Themain characteristicsof included studies.

Treatment of Winter Diseases in Summer:the establishment of the acupoint plaster therapy for asthma

Most acupoint plaster treatment methods applied today are based on Zhang Shi Yi Tong[1].In the chapter of Zhu Qi Men Xia Chuan of this book(1695),Zhang Lu(1617-1698)clearly states the specific method of Treatment of Winter Diseases in Summer:“For cold asthma,the regular treatment of doing moxibustion on Feishu,Gaohuang,and Tiantu does not always take effect.In dog days,the external use of Bai Jie Zi is more effective.The recipe:Bai Jie Zi(semen brassicaer)30g,Yan Hu Suo(Rhizoma Corydalis)15g,Gan Sui(Radix Euphorbiae Kansui)15g,Xi Xin(Herba Asari)15g,She Xiang(Moschus)1.5g(Table 1).After grinding and mixing these herbs with ginger juice,plaster them on Feishu,Gaohuang,and Bailao etc(Table 1).Keep the herb plaster on for 30 minutes and do not remove it even if the patient feels numbness,dizziness,or pain.Repeat this process every 10 days for 3 sets,then thepatient will becured thoroughly.”

This is the most detailed record of using Dog days plaster to treat asthma.“Cold asthma”refers to asthma that people easily acquire in cold weather(usually during winter).Since the Yang Qi of the human body decreases during cold winter days,it also lessons people’s resistance to disease.Usually real-time treatment can only relieve symptoms,leaving the etiologic factor unresolved.

Treatment of Winter Diseases in Summer:modern researches on the acupoint plaster therapy for asthma

Recently,480 researches have completed 5 RCT papers on the field of the acupoint plaster therapy for asthma(Table2).

Although most of the studies show that the acupoint plaster therapy for asthma(Treatment of Winter Diseases in Summer)is effective,there are also some shortcomingsof thesestudies:

1)The lack of data from multiple centers and large samples;

2)Thestochastic method applied isnot standard,and the utilization of blinding is too infrequent,both of which can easily lead to offsets in selectivity and implementation.

3)No description or analysis on the fall-off and seceding in all of these studies,which can easily lead to an amplification effect.

4)The lack of inclusion and exclusion on standards and being short of uniform standards;The final method should be standardized,as the evaluation index ismostly regulated subjectively.

1.Liu K,Huang YJ.Exploration of semen brassicae instruction recorded in Zhang Shi Yi Tong.Tradit Chin med Neimenggu 2014,33(17):157-157.

2.The clinical observation of Dog-days Paste used traditional acupuncture point and Shenque point in the treatment of infantile cough variant asthma.J New Chin Med 2014,7(7):159-160.

3.Li F.clinical observation of Dog-days Paste in the treatment of bronchial asthma.Today Nurs 2013,9:84-85.

4.Acupuncture Points in Hot Summer Days on clinical observation in the treatment of immune function of patients with stable asthma.Tradit Chin Med Trib 2010,11(32):128-129.

5.Shen SY,Zhang GY.Dog stuck on clinical observation in the treatment of bronchial asthma.Tradit Chin Med Trib 2013,15(7):1243-1244.

6.Huang BR.Therapeutic Effect and Nursing of Stick to Acupuncture Points in Hot Summer Days in Patients with Asthma Remission.Med Innov Chin 2014,7(19):69-70.