Dry/ lack of nasal secretions

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This is a post for the intermediate TCM students on the list.

 

In previous posts we looked at the significance of excessive nasal

mucus and its color. Today we look at the lack of nasal secretions.

 

Nasal pasages are supposed to be moist. The moistness is part of the

body's defense against pathogens in the environment. Being in a too

dry environment and having the nose dry out as a result is one of

the major predisposing factors for coming down with a cold. A too

dry environment can be natural (i.e., living in a desert) or it can

be artificial (i.e., the drying of air conditioning or certain

heating systems).

 

Like the other Perncious Evils, Dryness also can originate within

the Interior. Two of the main ways this can happen is if there is

Heat in the Lungs or in the Stomach.

 

" Drying-heat (zao) nasal mucus. Scanty sticky yellow mucus that may

inlude blood or pus or both. A blocked dry painful nasal passages,

accompanied by headache, chest and epigastric distention and

fullness. A dry throat, bitter taste, thirst for cold drinks, dry

stool, yellow urine, red tongue with a dry yellow tongue coat, and a

thready rapid pulse. " (Fluid Physiology and Pathology in Traditional

, Steven Clavey, p. 35.)

 

The physiology of how Heat in the Lungs can dry out nasal secretions

is obvious. But what about the Stomach connection? In the footnotes

at the end of Chapter 2, " Fluids of the Five Zang Organs, Clavey

writes: " Dr Dan Bensky comments that this is an oversimplification,

saying: Often respiratory symptoms are primarily Stomach problems as

in Mai Men Dong Tang ('Ophiopogonis Decoction', Formulas and

Strategies, p. 165) without any clear Stomach symptoms (but very

clear Stomach signs). (Personal communication.) " (p. 39.)

 

Mai Men Dong Tang (aka Ophiopogonis Decoction) is a formula that

tonifies both Lung and Stomach Yin. Even though the symptoms

primarily are those of Lung Yin Deficiency, the Lung Yin Deficiency

is the Branch and Stomach Yin Deficiency is the Root of the

problems. Stomach Yin Deficiency is one of the things which can

cause Stomach Qi to Rebel - ascend when it should be descending.

Bensky and Barolet write: " Although the symptoms are primarily

related to the Lungs, the condition is actually ccaused by heat from

deficiency in the Stomach, which rises in rebellion and scorches the

Lung yin. " (Chinese Herbal Medicine Formulas & Strategies, Dan

Bensky & Randall Barolet, p. 165.) They add, " The rebellious qi from

the Stomach prevents the Lung qi from descending properly, and

results in coughing and wheezing. " (p. 154.) (I want to call

attention again to the importance of Lung Qi descending properly. A

few days ago we looked at the condition Kidneys Refusing to Receive

Qi and the problems that can cause. Also, when Lung Qi fails to

descend to the intestines, this is one of the things that can cause

constipation or colonic inertia. Lung Qi descending properly is an

important concept in Chinese medicine.)

 

Ophiopogonis Decoction is for treating Stomach and Lung Yin

Deficiency and directing " rebellious qi downward " . (Bensky &

Barolet, p. 165.) BUT Heat in the Stomach from any cause can cause

Stomach Qi to rebel and dry out nasal passages and the Lungs.

Ophiopogonis Decoction would not be the proper formula for those

Roots (at least not by itself). For example, the Heat in the

Stomach may be from the person consuming too many foods and herbs

with warming thermal energy. (Has a warming effect on the body.) In

this case, the primary thrust of the treatment has to be eliminating

some of those warming foods. While it's true that over time Heat

from any source will damage Yin and this formula may be called for,

it's not going to be effective until the person also eliminates some

of the foods and herbs which are over-heating the Stomach. If the

Heat is Stomach Fire or Stomach Phlegm, the appropriate treatments

for those will need to be used.

 

Is it possible for a person to have both excessive nasal mucus and

nasal dryness? Yes. In some cases the dryness may appear only after

the person has been lying down asleep for a while. The person awakes

with dry nasal passages and a dry mouth. Take a scenario where there

is excess mucus because of Spleen (and/or Lung) Qi Deficiency but

dryness because of a dry environment or Stomach Yin Deficiency. The

excessive mucus may predominate while the person is awake and moving

about, but the dryness predominates when the person is asleep. Or,

far back in the nasal cavity, the mucus may dry to the consistency

of rubber. There can be some rather large and rubbery nasal plugs.

One rarely can get them out by blowing one's nose. They usually come

out when the person sneezes, and afterwards the person's nasal

passages feel much clearer than before.

 

Cautions and contraindications for Ophiopogonis Decoction: " Use with

caution in cases with high fever and irritability, where the

pathogenic infuence remains in the exterior, and the qi and yin have

yet to be affected. Contraindicated in cases with dampness, or Lung

atrophy due to cold from deficiency. " (Bensky and Barolet, p. 166.)