Sunday, January 24, 2010

Child Development Disorder - Autism In Traditional Chinese Medicine Perspective

I. Definition

Unlike conventional medicine, traditional Chinese medicine defines autism as a health condition of five delays, five weakness and middle burner stagnation
1. 5 delays (wuchi) is also meant 5 kinds of retardation in which represent the delay of
a) Hair growth
b) Teeth eruption or development
c) Standing
d) Walking and
e) Speaking

2. 5 weakness (wuruan) is also meant 5 kinds of flaccidity in which represent the weakness and softness of
a) Neck
b) Mouth
c) Upper extremities
d) Lower extremities and
e) Muscles
3. Middle burner stagnation (ganji) is also meant disorders of organs which are located above the belly button and below the heart and lung, including the diaphragm and includes the spleen in which represents
a) Malnutrition and
b) Foods stagnation

II. Symptoms of Autism
Before discussing further, let us recapture the symptoms of autism.
A. Here is The Autism symptoms checklist from the DSM-IV (Diagnostic and statistical manual of mental disorders)
A.A. A total of six (or more) items from (1), (2), and (3), with at
least two from (1), and one each from (2) and (3)

(1) qualitative impairment in social interaction, as manifested by at least two of the following:

a) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction

b) failure to develop peer relationships appropriate to developmental level

c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)

d) lack of social or emotional reciprocity ( note: in the description, it gives the following as examples: not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or"mechanical" aids )

(2) qualitative impairments in communication as manifested by at least one of the following:

a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)

b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others

c) stereotyped and repetitive use of language or idiosyncratic language

d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(3) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:

a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

b) apparently inflexible adherence to specific, nonfunctional
routines or rituals

c) stereotyped and repetitive motor mannerisms (e.g hand or finger flapping or twisting, or complex whole body movements)

d) persistent preoccupation with parts of objects

A.B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

(1) social interaction

(2) language as used in social communication

(3) symbolic or imaginative play

A.C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder

B. Symptoms of Autism in TCM perspective
1. Chronic bronchitis
2. Chronic gastritis
3. Chronic hepatitis
4. Distension of the chest, dizziness
5. Nausea
6. Peptic ulcer
7. Profuse phlegm
8. Schizoid personality behavior
10. Anxiety
11. Bitter taste
12. Loss of consciousness
13. Shyness
14. Slight thirst
15. Red tongue
16. Greasy-yellow coating
17. Slippery-rapid pulse
18. Rapid-wiry pulse
19. Etc.
and the list also includes the symptoms of Kidney, spleen and lung deficiency and liver heat and heart yin and qi deficiency as we will mentioned below.

III. General analysis in traditional Chinese perspective (differentiations)
1. Kidney
Kidney essence ( Jing) is vital for fetus develops properly. If the kidney essence ( in this case, it is the prenatal essence) is weak and deficient (that is the case of autism), the fetus is underdeveloped, leading to weakened constitution and internal weather and physical and mental retardation.
a) Kidney produces marrow to fill the brain, this controlling the brain in garnering the intelligence and concentration as well as in charge of a person's will and determination.
b) Kidney channels opens to the ears
Any hearing disorder can be attributed to kidney qi deficiency
c) Controlling the hair growth
The slow depletion of kidney essence is associated with aging, we have less hair as we get older.
e) In charge of fluid metabolism
The kidneys control the bladder in holding and releasing fluid and for the large and small intestines to separate pure and turbid.
Now we can see how kidney deficiency can cause symptoms of autism by comparing the function of kidney and the symptoms above.
Any disorder related to hearing is attributed to kidney deficiency

2. Spleen
Spleen is an organ responsible for qi and food absorption, transformation and distribution after food intake entering the stomach.
a) Muscles and tissues in the body
It is the organ that helps to nourish and develop the muscles and tissues in the body. Its channel open to the extremities of 4 limbs.
b) One to the mouth
Any function of the mouth is depended to the spleen qi, if the qi is weak, it may affect the blood in tongue nourishment and taste.
c) Mental related problem
It is said that the capacity of thinking and remembering is depended totally psychological activity of spleen. If the spleen can not control the qi and blood that it sends to the brain and heart, leading to forgetfulness and inability to think logically.
d) Control downward moment of the secretion of turbid of bladder, large intestine.
e) Control the upward movement of qi to supply blood and qi movement of heart and lung.

3. Heart
The heart is considered as an emperor of the body organs, because it governs the circulation of blood and qi in transporting the nutrient to the body needs. It is said that the heart control the "shen" (spirit) and open to tongue.
a) Metal activity
Deficiency of heart causes lack of enthusiasm and vitality, mental restlessness, depression, insomnia, despair.
b) Emotional and physical reaction
It controls the movement of body involuntary auto expression such as facial expression, gesture, sighing, body movement, etc.
c) The use of speech
As it open to the tongue.
d) Metal thinking
Such as self awareness, self control, thinking, remembering, censoring the information received.

4. Liver
Liver is considered as an organ in charge of blood formation and storing and assistance of blood circulation through its upright qi. It open to the eye, therefore any disorder of eye related symptoms can be considered as liver abnormal function.
a) Emotion
Any expression of emotion such as anger, resentment, frustration, irritability, bitterness can distort the blood flow through the blood vessel and qi flow through the channels.
b) Digestive tracts (spleen and stomach)
It also controls the downward movement of stomach and upward movement of qi of the spleen.
c) Prenatal energy
Since it links to the prenetrating and conception vessels, it nourishes the yang in men and yin in women, there by helping kidney in regulating the women menstrual cycle and menstruation.
d) Open to the eye
Any eye related disorder is considered to liver problem.
e) Logical thinking
It governs the information collection through precisely thinking before making decision.

5. Lung
Lung is considered as an organ in controlling the qi movement and respiration.
a) Regulating the downward and outward movement
It regulates the downward movement of qi and fluid sent by spleen and spread also expand them to the entire body by discharging waste through sweating.
b) Open to the nose
It controls the breathing and smelling of the human body. Disorders may cause stuffy nose, running nose and inability to smell, leading asthma, coughing, etc.
c) Controlling the skin and hair
As it expands out ward to the entire body, it moistens the hair and skin, thereby reducing the risk of skin diseases and loss of hair.
d) Constrict emotion
Such as grief, sadness, detached, etc.
As we went through the function of 5 zang organs and compare them with the symptoms as we mention in II, we can see that autism not only is caused by congenital deficiency, but also deficiency of all zang fu organs.

IV. Causes of autism
1. External causes
External causes can be classified as prenatal and postnatal causes
a) Prenatal causes
Autism can be caused by physical damage to the kidney of the unborn or emotional stress causes of kidney damage when he or she still in the womb of the mother due to intake of food additives, preservatives or environment pollution.
b) Postnatal causes
i. It may be caused by the intake of man made chemical entering the baby body such as food additives, preservatives, environment pollution, artificial ingredients, etc. and vaccinations' affects.
ii) It may be caused by the mother diet that affects the baby spleen function in food digestion and absorption, if the mother is breast feeding.
iii) It can be caused by the mother emotional stress the affect the liver qi function in the baby, leading to liver qi stagnation.
2. Prenatal deficiency
For what ever reason, traditional Chinese medicine indicates that prenatal deficiency of autism is caused by emotional stress such as seven emotions: anger, joy, pensiveness, grief, fear, shock and sadness of the mother when the baby still in the womb, leading to kidney qi deficiency and that affects all other organs of the baby before the baby is born.

3. Postnatal disorders
a) Spleen deficiency and symptoms
Since the spleen in the organ in-charge of food essence and qi absorption and qi and fluid transformation and distribution, deficiency of kidney causes excessive accumulation of fluid, leading to dampness in the digestive system that affects the function of kidney in nourishing the body muscles causing muscles underdevelopment that controls the moto skill. Excessive accumulation of dampness also increases the risk of forming of phlegm in the digestive system that causes digestive disorder and affects the stomach in vitamins and mineral absorption, causing malnutritions and foods stagnation.
Symptoms of spleen deficiency include
i) Weakness,
ii) Pale complexion, bright face
iii) Shallow breathing
iv) Low, soft voice
v) Little desire to speak
vi) Poor appetite
vii)Prolonged headache
viii) Fatigue
ix) Etc.

b) Liver heat and symptoms
Liver besides is the organ in blood formation and storing, it also is vital in assisting the heart in blood circulation. If the dampness is allowed to accumulate in a prolong period of time, it may generates liver heat, leading to blood hyperactive that affect the liver function in controlling the emotional factors such as anger, resentment, frustration, irritability, bitterness and logical thinking resulting in symptoms of metal retardation.
Symptoms of liver heat include
i) Headache
ii) Irritability
iii) Anger,
iv) Dizziness
v) Bitter taste in the mouth
vi) Red face and red eyes
vii) sleep disturbance
viii) Insomnia
xi) Constipation
xii) Etc.

c) Heart qi deficiency and symptoms
As we mentioned above, the accumulation of dampness in the baby body for a prolong period of time causes the production of phlegm accumulated in the body organs. If phlegm is accumulated in the heart organ, it may affect the function in controlling metal activity, such as lack of enthusiasm and vitality, mental restlessness, depression, insomnia, despair, leading to symptom of autism.
Symptoms of heart qi deficiency include
i) Shortness of breath and/or
ii) oppression in the chest,
iii) Sweating,
iv) Fatigue
v) Pale complexion,
vi) Avoid connect with people,
vii) Difficult making conversation,
viii) trouble with intentional communication
ix) Lack of emotion.
x) Etc.

d) Heart yin deficiency and symptoms
Heart yin may be deficiency if the dampness is accumulated for a prolong period of time, it causes the rise of heat or heat generated due to liver qi deficiency to move blood smoothly through the blood vessels, leading to hypertension that causes the inability in controlling self awareness, self control, thinking, remembering, censoring the information received.
Symptoms of heart yin deficiency include
i) Palpitations,
ii) Irritability, dream disturbed
iii) Sleep disturbance, easily startled,
iv) Insomnia
v) Anxiety
vi) Restless
vii) Sweating
viii) Dry mouth, throat, and lips, cankers of the tongue,
ix) Avoid public speaking,
x) Difficulty in meaningful speech
xi) Poor memory
xii) Fever
xiii) Etc.

e) Kidney deficiency and symptoms
As we mention many time, kidney is the organ that control the development of the baby. Deficiency of kidney either caused by prenatal or postnatal health conditions affect the growth of the bone and marrow of the baby, leading to delay of hair growth, teeth eruption or development, standing, walking and speaking.
Symptoms of kidney deficiency include
i) Late puberty
ii) Fatigue
iii) Weakness and dizziness,
iv) Night sweats or cold extremities
v) Delayed development in children
vi) Constitutional weakness
vii) Disorders of urination
viii) Etc.

f) Lung qi deficiency and symptoms
As the kidney no long function in moving qi and fluids upward, it affects the function of lung qi in controlling the downward movement to support the entire body system and respiration that affect the lynax function in phonetic development, leading to delay of speech. On the other hand, deficiency of lung qi can cause depletion of the fluids of the lungs or heat generated due to over accumulated of dampness, thus increasing the risk of catching cold and bacteria and virus.
Symptoms of lung qi deficiency include
i) Fatigue
ii) Asthma
iii) Cough
iv)Shortness of breath
v) Tiredness
vi) Weak and low voice
vii) Watery sputum
viii) Lack of vitality
ix) Weaken immune system
x) Etc.

V. Treatments with Chinese herbs
a) Spleen deficiency
i) Codonopsis (Dan shen)
Codonopsis is considered as a poor man's ginseng, native to Asia and neutral in nature. It besides has been used in traditional Chinese medicine in lowering or boosting the ability of the body in tolerating stress, it also used to improve spleen function in absorbing food qi by increasing the stomach function in foods digestion.

ii) Ginseng (ren shen)
Ginseng is also known as radix ginseng or Asian ginseng, native to northern China, Korea, and eastern Siberia and warm in nature. It besides has been used over thousand of years in qi tonification, it also is spleen and stomach tonic herbs by improving the qi and fluid formation and transformation in the body.

iii) Astragalus ( huang qi)
Astragalus is also known huang qi in TCM, warm in nature and native to all regions of the Northern Hemisphere. It besides has been used to promote urinary secretion, it also is a spleen and stomach tonic herb by restoring the prolapsed qi of spleen.

b) Liver heat
i) Yin chen hao (Agrostis capillaris)
Agrostic cappilaris in warm in nature and native to Eurasia. It has been used in TCM in treating
jaundice, clearing damp heat from the liver caused by excessive fluid accumulation and moving qi and blood and relieving liver congestion.
ii) Reishi mushroom
Reishi mushroom is also known as lucky fungus and neutral in nature. It has been used in TCM over thousand of years in strengthen the immune system and treating acute liver inflammation as well as protecting the liver against formation of heat.
iii) Gan cao
Gan cao also known as licorice
root and warm in nature. It has not only been used to treat digestive disorder due to spleen and stomach qi deficiency, but also for clearing liver heat and tonifying liver fire.
iv) Milk Thistle seed
milk thistle is also known as silybum marianum, its seed is a liver tonic herb, besides helping to to restore the qi stagnation caused by environment toxins, it also improves the liver function in blood and qi function by regenerating the liver's cell.

c) Heart qi deficiency
i) Huang Qi
Huang qi also known as astragalus. Besides having an effectiveness in promoting urinary and tonifying the spleen qi, it also is a common herb used to tonify heart qi and blood.

ii) Ren Shen
Renshen also known as ginseng root and warm in nature. It has been used in traditional Chinese medicine in promoting qi and blood circulation.

iii) Dan Shen
Dan shen is also known as red sage root or a poor man ren shen. It has been used to improve blood circulation, break up blood stasis, by promoting qi circulation.

iv) Fu Zi
Fu zi is also known as monkshood root and hot in nature. It has been used to tonify heartyang qi by unblocking vessels and improving circulation.

d) Heart yin deficiency
i) Long yan rou
Long Yan rou is also known as long yan fruit and hot in nature. It is one of many herb that helps to tonifying the heart yang by nourishing blood and improving blood circulation.

ii) Da Zao
Da Zao is also known as Chinese date or jujube. It helps to nourish the heart yin and enrich the blood and blood flow.

iii) Fu Zi
Fu zi is also known as monkshood root and hot in nature. It has been used to tonify heart yang qi by unblocking vessels and improving circulation.

e) Kidney deficiency
i) Rehmannia glutinosa (shu li huang)
Rehmannia glutinose besides has been used in traditional Chinese medicine in treating kidney disorder, it also helps to restore the balance of yin and yang qi of the kidney resulting in increasing the kidney function in fluid distribution and promoting healthy reproductive organs.

ii) .Morinda root ( ba ji tian)
Morinda root besides is used in traditional Chinese medicine in improving the kidney abnormal function caused kidney yang qi deficiency, thus enhancing the immune system and promoting sexual desire.

iii) Cuscuta (tu si zi)
Cuscuta is a kidney and livertonic medicine, besides helping to tonify the kidney fluid distribution through urinary secretion, it also maintaining the strong the liver qi flow, thereby decreasing the risk of blood stagnation and water retention causes of weight gain and menstrual cramps and pain.

Cinnamon bark
Cinnamon bark is qi tonic herb and hot in nature, besides helping the liver in maintaining the smoothing qi flow to the entire body, it also promotes the kidney yang qi circulation and healthy adrenal gland.

f) Lung qi deficiency
i) Ren shen (Ginseng)
Ren shen is considered as one of most powerful herbs in strengthening the original qi in the body. In lung, it enhances the lung qi by moistening the channels, thus reducing the symptoms of asthma, dry cough and preventing the rebellion qi causes of menstrual cramps and pain.

ii) Dan shen (red sage root )
Dang shen is a lung tonic herbs. It improves the lung function in moving qi smoothly through its channels and spleen function in absorbing qi after foods entering the stomach. It also helps to restore the qi which is damaged by heat caused by infection, inflammation or heat generated due to excessive fluids accumulation.

iii) Huang qi (astragalus root)
It is one of the herb that helps to increase the function of liver in generating more blood and liver qi in blood transportation due to excessive blood loss.

iv) Tai zi shen (pseudostellaria root)
Besides helping to increase the lung qi, it also improve the blood transportation and spleen and stomach in absorbing vital energy for our body cells and generates fluids to prevent the heat causes of qi stagnation.

VI. Treatment with acupuncture
a) Spleen deficiency and suggested acupuncture points include
CV12 (zhongwan), ST36(zusanli) , SP6 (sanyinjiao) , SP3 (taibai) , UB20 (pishu), REN12 (zhongwan) and UB21(weishu).

b) Liver heat and suggested acupuncture points include
BL13 (fei shu), GB34 (yang ling quan), LI3 (san jian) and LU5 (chi ze)

c) Heart qi deficiency and suggested acupuncture points include
HT5 (tong li), PC6 (nei guan), BL15 (xin shu), REN17 (shanzhong)and REN6 (qihai)

d) Heart yin deficiency and suggested acupuncture points include
HT7 (shen men), PC6 (nei guan), CV14 (ju que), CV15 (jiu wei), CV4 (guan yuan), SP6 (san yin jiao), HT6 (yin xi), KD6 (zhao hai), KD7 (fu liu) and GV20 (bai hui)

e) Kidney deficiency and suggested acupuncture points include
GV20 (bai hui), CV4 (guan yuan ), CV6 (qi hai) and CV12 (zhong wan).

f) Lung qi deficiency and suggested acupuncture points include
BL13 (fei shu), CV6 (qi hai), LU1 (zhong fu), LU9 (tai yuan) and ST36 (zu san li)
LV: Liver channel
GB: Gallbladder channel
UB: Bladder channel
CV: Conception vessel channel
SP: Spleen channels
LI: Large intestine channel
KD: Kidney channel
GV: Governing vessel channel
TH: Triple heater channel
BL (UB) Bladder
LU: Lung channel
ST: Stomach channel
PC: Pericardium channel
HT: Heart channel
REN (CV): Conception vessel channel

VII. Summary
The aim of this e book or articles is to provide reader with information in different points of view and hope this information will help parent with autistic children understanding more of some kinds of treatment. While conventional medicine emphasizing in treating symptoms with medication, diet change and many types of therapies, traditional Chinese medicine goes one step further by suggesting to treat the causes of autism instead of the symptoms with combinations of conventional therapies, diet change, acupuncture and herbs. It is for your child benefits that should tell your TCM practitioner types of medication that your child are taken, if you choose to have him /her treated by TCM.

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