Treatments of Lung Diseases by Treating Liver, Kidney and Spleen with Kampo Medicines or Traditional Chinese Medicines

Background: Chronic lung diseases can be treated successfully, by applying five phases theory to the symptoms of lung disease results for 3 situations: (1) excessive Liver qi injures Lung qi (rebellion) (相侮or反侮), (2) Kidney deprives Lung qi through engendering route (child deprives mother qi; Kidney: child, Lung: mother) (相生), (3) Spleen deprives Lung qi through engendering route (Spleen: mother, Lung: child (相生). Preventing lung disease then requires one or more of the following approaches: (1) restraining Liver qi (sometimes with supporting Lung qi), (2) giving qi to Kidney so it will not take qi from Lung, and (3) giving qi to Spleen so it will not take qi from Lung. Objectives: Applying Kampo or Traditional Chinese Medicine (TCM), can cure patients with pulmonary disease by restoring Lung qi in the following ways: (1) suppressing hyperactive Liver qi, (2) decreasing Lung qi stolen by Kidney through engendering Lung-Kidney route through supplementation of Kidney qi, (3) decreasing Lung qi stolen by Spleen through engendering Spleen-Lung route, through supplementation of Spleen qi. Methods: In one case, author prescribed formulas like Jia-wei-shao-yao-san (加味逍遥散), gan-mai-da-zao-tang ( 甘麦大棗湯) or Si-ni-san (四逆散) and others to soothe Liver to stop rebellion from Liver to Lung. In second case, author prescribed a Kidney-tonic formula like Ba-wei-di-huang-wan (八味地黄丸) so the Kidney would not deprive Lung qi. In the final case, the author prescribed a spleen-tonic formula like Chuan-si-jun-zi-tang (喘四君子湯) to give qi to Spleen so the Spleen would not deprive qi from Lung. Results: In all three cases, lung symptoms such as cough, high susceptibility to colds and wheezing disappeared by prescribing the respective Kampo formulas mentioned above. Conclusions: Symptoms like cough, wheezing and user susceptibility caused by Liver rebellion Lung were prevented by soothing Liver with Jia-wei-shao-yao-san and gan-mai-da-zao-tang. In the Kidney invades Lung case, giving Qi to Kidney with Ba-wei-di-huang-wan resulted in recovery from Lung trouble. In Spleen invades Lung case, spleen-tonic formula, Chuan-si-jun-zi-tang cured the Lung disease. Discussion: Lung diseases are cured: (1) by restraining Liver qi with soothing Liver formula, (2) supplementing Kidney qi with warming Kidney formula and (3) supplementing Spleen qi-tonic formula so as not to deprive Lung qi. These findings suggest that in the Liver rebellion Lung, Lung qi is shunted from Lung to Kidney or from Lung to Spleen through the engendering route and that five phases theory has a physiologic regulatory correlate worthy of further investigation. *Corresponding author: Hijikata Y, Toyodo Hijikata Clinic, 567-0031 Kasuga 3-11-29 Ibaraki, Osaka, Japan, Tel: 81-726-27-3755; Fax: 81-726-27-399; E-mail: hijikata@hcn.zaq.ne.jp Received August 03, 2016; Accepted August 19, 2016; Published August 22, 2016 Citation: Hijikata Y (2016) Treatments of Lung Diseases by Treating Liver, Kidney and Spleen with Kampo Medicines or Traditional Chinese Medicines. J Tradi Med Clin Natur 5: 190. DOI: 10.4172/2573-4555.1000190 Copyright: © 2016 Hijikata Y. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Introduction
The author reported about Five phases theory and the application to the treatment of various diseases [1,2]. According to this five phases theory, we can treat lung diseases as reported below.
As shown in Figure 1, the five viscera, Lung, Kidney, Liver, Heart and Spleen (→Lung) have engendering relationships. Engendering denotes right side viscera nurtures, or transmits the Qi to next left side viscera. Furthermore, the five viscera, Lung, Liver, Spleen, Kidney, Heart (→Lung), have the restraining relations between opposite two viscera.
Restraining denotes the principle one viscus restrains the opposite side viscus to keep within normal condition of whole body (Figure 1).
When the restraining viscus (such as Liver) gets excessive power, so-called overwhelm occurs. Overwhelms is an abnormal, excessive restraint. This happens in two cases. First, it may occur when one viscus (such as Liver) becomes excessively powerful and so overwhelms the corresponding viscus (Spleen). Second, the corresponding viscus (Such as Spleen) becomes too weak the former viscus (Liver) overwhelms Spleen. But one viscus (such as Liver) becomes excessively powerful, it not only overwhelm the corresponding viscus (spleen) but also excessively restrains Lung to an opposite direction from Liver to Lung which is called rebellion, causing Lung disease. In this situation, Lung not only can't restrain Liver, but also is injured by Liver's excessive rebellion against Lung ( Figure 2). We often meet with the pathology Liver rebellions Lung. (Figure 2) When Lung diseases are not cured with prescriptions primarily for Lung, we must consider the Lung related viscera in five phase theory that is Spleen, Kidney regarding engendering relations, and Liver for rebellion.
In these cases, some medicines selected based on five element theory, sometimes dramatically works as described below.
Main three causes for intractable Lung diseases are shown below.
1. The lengthening of Liver qi stagnation produced by continuing stressful state, leads to rebelling of Liver against Lung followed by the appearance of incurable pulmonary diseases due to Liver fire invading Lung. This situation is sometimes accompanied by gastrointestinal symptoms as well. Because lengthening of Liver qi stagnation, not only rebell Lung but also overwhelm Spleen especially in cases with weak Spleen (Figure 3).
2. The chronicity of Kidney qi deficiency leads to Lung qi deficiency. Because Kidney steals qi from Lung through the engendering route between Kidney and Lung. By supplementing Kidney qi, the volume of Lung qi stolen by Kidney decreases, followed by an improvement in pulmonary diseases ( Figure 4).
3. The chronicity of Spleen qi deficiency leads to Lung qi deficiency. Because Spleen steals qi from Lung through the engendering route between Spleen and Lung. By supplementing Spleen qi, the volume of Lung qi stolen by Spleen decreases followed by an improvement in pulmonary diseases. When Spleen qi is very small, overwhelming from Liver to Spleen may happen but omitted here.
(We omit discussion of the relationship between Heart and Lung in spite of quite familiar relations of Heart and Lung because they are routinely treated with conventional therapies). Diagnosis of diseases of patients is carried out based on conventional medicines, traditional Chinese medicines (TCM) or Kampo Medicines.

Cases above mentioned in (1): Rebellion of Liver against Lung
Liver fire invading Lung (Simultaneous Liver and Lung disease through restraining route) successfully treated clinical cases were reported below.

Case 1-1:
This case was written more than 200 years ago in Japanese literature which was translated into English below [3].
"Mr Tokumi an elderly male living in Nagasaki prefecture, had been suffering from empyema. He had been treated by various doctors for more than 3 years in vain. He wished to be treated by Dr Tokaku Wada who lived in Kyoto, because he was hoping to begin a new job far from his residence at the time. Dr Wada diagnosed Mr Tokumi's disease as being derived from his mental distress and accepted his request to treat him because he had successfully treated many similar cases.
Chief complaint: Dirty running snot with empyema.
Identification: Lengthy Liver qi stagnation (Liver miasma) caused Lung disease (Liver fire invading the lung through rebellion route between Liver and Lung). (In conventional medicine, empyema).
Treatment: Pacify Liver qi to decreases rebellion from Liver to Lung.

Result:
The patient's symptom had disappeared by the time he arrived at Shinagawa after departure from Kyoto for Edo (Tokyo) on foot.
Discussion: Dr Tokaku Wada diagnosed Mr Tokumi's symptoms as having originated due to lengthy Liver qi stagnation with mental conflicts. The diagnosis was also suspected due to uncomfortable fullness of abdominal muscle in hypochondrium which is one of the results of accumulated Liver qi stagnation (miasma). With the additional effect of wu-zhu-yu to warm gallbladder meridian which will support good circulation around nose and mu-li to decrease snivel, si-ni-san worked to pacify Liver qi and there by decrease the rebellion from Liver to Lung. This was followed by an improvement in Lung symptom, specifically the cessation of "Dirty running snot" stopped. Present history: Since she had a lot of psychological stress, she suffered particularly from, allergic rhinitis, hay fever, nasal congestion and dry coughs. Her menstruation got irregular, and she became quick of temper and suffered flushing of the soles and palms, night sweats, excessive dreaming, uneasiness, depilation and fragile nails. She had also been suffering from sensitivity to cold, chilblains during winter, and feels distress on rainy days and her digestive system was not working properly due to greasy food. In spite of modern medicines, her condition didn't improve at all. Coldness, rainy days and fatty food worsened her digestive condition.
Past history: She had been abused by school teachers and friends and she had been in depressive state. She had suffered from tonsillitis, hay fever, nasal congestion and dry coughs. She had been a habitual drinker.
Family history: The patient's mother had been bedridden due to rheumatic diseases more than 30 years. Father had senile dementia and her younger sister has rheumatism.
States praesens: Tongue body: red/slightly dark, fistura all over the body. Tongue coating is thick and white. Puls: strongly pressed her pulse feel week, and 78 beat/min, Blood Pressure: 130/76 mmHg. Abdominal muscle: fullness and tenderness of the hypochondrium.
Identification: Liver impacts Heart. Liver rebels against Lung. Yin deficiency with yang hyperactivity. In conventional medicine, she was diagnosed as autonomic imbalance.
Result: Twenty days after beginning her prescriptions, her nasal obstruction and mental stress improved (VAS: 10→5). After 39 days, her cough disappeared. She became quite relaxed and told me jia-weishao-yao-san had worked for her nagging cough. Panic attacks rarely appeared except in response to terrible events.

Discussion:
The patient had many stressing factors which caused an accumulation of Liver qi, "Liver miasma" overflow. Because of the rebellion of Liver to Lung, her cough continued. Jia-wei-shao-yao-san soothed Liver and Gan-mai-da-zao-tang tranquilized Heart which helped to soothe Liver.
Chief Complaint: Dyspnea, cough and heavy stomach with increasing need to care for her parents.

Present history:
With the patient's increasing responsibilities for her parents' care, her dyspnea and cough gradually increased. Treatments by the respiratory division of a hospital did not work. She didn't sweat during exercise in the summer. Dull arbitrarily positioned headache, shoulder stiffness, difficulty in sleeping, light tinnitus, heavy stomach, belching gas, bruising long-standing heart beat connected with stomach condition and susceptibility to cold. She likes warm foods and cooling caused diarrhea. She has two children.
Past history: The patient suffered from alopecia areata in her 20s and during pregnancy and had severe menstrual cramps. Atopic dermatitis with onset in her 40s.

Family history:
The patient's father suffered a ruptured aortic aneurysm and lung cancer successfully resected at age 74. Her mother also suffered from lung cancer with onset at age 78 and successfully resected. Identification: Liver qi depression with blood stasis. Liver rebellions against Lung. Liver overwhelms spleen. In conventional medicine, diagnosed as asthma bronchitis.   Result: At 13 days after starting her prescription, the patient's dyspnea and cough disappeared, and her palpitations decreased. She continued to take the same prescription. At 86 days after starting herbal medicines, her good condition continued with this treatment After 1 year, she began taking half portions, and after 2 years began to use the medicines only when her condition was bad. Overworking sometimes brings on palpitations but the patient's cough and dyspnea have so far not returned.

Discussion:
The patient's weak irregular pulse (Heart qi deficiency) continued since long before the onset of her current symptoms this time and she notes that episode of irregular pulse synchronize with digestive function. Accordingly, a Heart qi deficiency will not be the primary reason for aggravation of her asthma-like symptoms. Furthermore her chief complaints with her increasing responsibility for her parents' care, reflecting Liver qi depression followed by Liver rebellions against Lung and overwhelming Spleen.
In Xiong-gui-tiao-xue-yin, Chai-fu, Xiang-Fuzi, U-yao, Chen-pi will soothe Liver, regulate qi, inhibit the rebellion against Lung, and block Liver from overwhelming Spleen. Chuan-xiong, Yi-mu-cao and Mu-dan-pi will resolve blood stasis and improve circulating. Chief complaint: Fatigue and difficulty in expiration with wheezing after improvement of a common cold.
Present illness: As a medical doctor, the patient leads a stressful life which often causes diarrhea with stress. She took bu-zhong-yi-qi-tang '(補中益気湯) and Jia-wei-xiao-yao-sang (加味逍遥散) and routinely wore a belly band to warm her body. On June 2, she got a common cold with a temperature 38.5°C after overworking. This was followed by a cough with wheezing, diarrhea and fatigue. She took Qin-fei-tang (清 肺湯) and an antibiotic. Two days later, only her cough had improved.
Identification: Liver qi depression with blood stagnation lung qi deficiency kidney yang deficiency in conventional medicine, asthma bronchitis.
Results: As no improvement was observed, on the next day, she changed to another antibiotic and herbal medicines, Mai-men-dongtang (麦門冬湯) together with Jie-geng (桔梗) and Xuan-shen (玄 参). With the newly applied medications which did not work, so author diagnosed she had Kidney Yang deficiency. Author added 鹿 茸 (lurong) to tonic Kidney yang, next day her wheezing and diarrhea disappeared and continued 鹿茸 one more day and stopped without recurrence.
Discussion: As no improvement was observed with herbs for Lung, the author diagnosed her condition as Kidney yang deficiency because she had been very sensitive to cold so far. The author prescribed 鹿茸 which worked dramatically which will mean Qi stolen from Lung by Kidney must be decreased which would lead to an disappearance of wheezing which is a symbol of Lung yang deficiency.

Present illness:
If the patient took Ge-gen-tang (葛根湯) upon catching a cold, she improved quickly, but a few days later she would again catch cold and this pattern repeated.