Chinese Medicine for autism: Dr. M. Cissy Majebe explores an Eastern approach to help disabled children.

The treatment of Autism with Chinese Medicine (CM) first began to interest me in 1993 when a parent brought a three-year-old, non-verbal child into the clinic. I acquired a special interest in the treatment of children diagnosed with Autism Spectrum Disorders from working with this child.

Currently Autism is recognized as a developmental disability with primary symptomology affecting social interaction and communication skills. Autism is a behaviorally-defined syndrome. Within a Western framework, there are no clear causes of Autism, although it is believed to be a biological neurological disorder affecting brain function. There are strong indicators for a genetic basis, and there is also a growing concern that environmental toxins and pollutions may be contributing factors, as well as viral infections. Currently, there are no medical tests for the diagnosis of Autism. In regard to treatment, the only real option Western Medicine offers is intervention with early educational programs.

For those of you who may have little experience with Chinese Medicine, let me begin by saving that Chinese Medicine is a comprehensive health care system that has its own system of diagnostics. It includes not only acupuncture, but also herbal medicine, nutritional therapies, Tui Na (massage techniques), aromatherapy, spinal manipulations and lifestyle counseling. CM, as a system, allows the practitioner to utilize different combinations of techniques, based on the constitution and specific needs of the individual.

The World Health Organization recognizes Chinese Medicine's ability to treat many common disorders, including disorders of the bones, muscles and joints, respiratory, gastrointestinal, circulatory and urogenital disorders, addictions, eye, ear, nose and throat disorders and emotional and psychological disorders. It is this history of the effectiveness of CM with psychological and neurological disorders that provides a basis for the effective treatment of Autism.

In CM, Zang-Fu is a term for the organs of the human body. Many of the organ names are familiar terms. These terms refer not only to a physical organ but to the energetic functions of the organ as well. Each organ relates to an emotional response, sensory organ, and soft tissue. Autistic children often experience difficulties with sensory integration. In the treatment of Autism, the three primary organ systems of concern are the Heart, Spleen, and Kidneys; these organ ,system are associated with speech, hearing, and taste, respectively.

"On an emotional level, the state of the Heart determines a person's capacity to form meaningful relationships." This quote from The Foundations of Chinese Medicine, by Giovanni Maciocia, is paramount to the understanding of Autism within the framework of CM.

According to Chinese Medical theory, autistic individuals suffer from a Heart imbalance that inhibits connecting on an emotional level with other people, including their immediate families. A person with Heart imbalances might manifest a lack of joy in life, anxiety or inappropriate laughter and talking. A person with a Heart Qi disorder could either manifest with excessive talking or aphasia (problems with speaking or an inability to speak).

Children diagnosed with Autism may present with digestive anomalies that may he deemed irrelevant by Western Medicine Physicians. In CM these children exhibit signs and symptoms associated with Spleen Qi Deficiency. On an emotional level, persons with extreme Spleen Qi imbalances often manifest obsessive-compulsive behaviors.

Autism is usually diagnosed before the age of three. CM sees this disorder as having a Pre-natal origin, compounded by a Post-natal weakness. The Pre-natal component would translate as genetic influence, whereas the Post-natal aspect would relate to all that has occurred since birth. Pre-natal factors in Autism indicate Kidney involvement. Kidney Qi is important for brain development, along with Heart and Spleen, according to Chinese Medical theory.

Basic methods of diagnosis include observation of the patient, such as listening, smelling, examination by questioning and physical examination by palpation. Observation includes CM specific skills such as tongue, pulse and facial diagnosis. It also includes close attention to how the patient relates to and moves in the world.

In CM, imbalances arise from three different sources: external factors, internal factors and miscellaneous factors.

Wind, Heat, Fire, Cold, Dryness and Dampness are external pathogenic factors in CM. These factors create imbalances that lead to disease. In CM, Internal Pathological Factors are the Seven Emotions. Each of these emotions is associated with an organ system. Those that relate to Autism include: fear or shock that weakens the Kidney, over-pensiveness that weakens the Spleen and shock and anxiety that weakens the Heart. The over-pensiveness that is discussed in classical Chinese writings is related to the obsessive behaviors or obsessive thought patterns that often manifest in Autism.

Miscellaneous factors include genetic influences, poor nutrition, lack of exercise and excessive mental stimulation, such ms an inordinate amount of television viewing. Air pollutants, food additives and preservatives are other miscellaneous factors. Antibiotics and Immunizations are also considered miscellaneous factors.

Phlegm is the primary pathological factor related to the development of Autism in CM. In regard to Autism, Phlegm is generally an External Pathogenic Factor, but it can also manifest from Internal and miscellaneous causes. Phlegm is said to be either substantial or insubstantial, meaning that it can either be the mucous we expectorate and drool or a kind of "fog" that blocks the sensory, organs. This "fog" would present itself as poor concentration or hearing, a lack of response to external stimuli, etc. In CM, the diagnosis of Autism generally can be classified as either Phlegm Misting the Heart or Phlegm Fire Harassing the Heart.

The Autistic child will have symptoms that are linked to Heart, Spleen and Kidney imbalances. The Heart imbalance relates to the difficulties the child has in establishing meaningful emotional relationships with others, and communication and speech difficulties. The Spleen deficiency is linked to digestive anomalies that contribute to the development of Phlegm. Kidney involvement is related to the young age at which this condition develops.

The development of Autism is a multi-faceted pathway: There is no single direct cause and effect for Autism Spectrum Disorders in Chinese medicine though there are a set of cofactors that must be present. Recall that in CM, imbalances are related to External, Internal and Miscellaneous factors. The External and Internal factors can be a source of difficulty. but a major focus in Autism is on the Miscellaneous factors. Genetic factors can set the stage but there must be other cofactors in order for Autism to develop. Nutritional and lifestyle factors must be addressed in the treatment plan. The manifestations of Phlegm and the root cause of Phlegm must be addressed. It is due to the very different pathways in the development of Autism that makes it difficult to assign causality.

As I stated previously, Chinese Medicine treats the constitution and specific needs of the individual, not the disease. With a behaviorally-defined syndrome, such as Autism, such treatment is especially appropriate because the practitioner is able to accurately diagnosis and treat a patient who may be manifesting any number of diverse and seemingly unrelated symptoms. The foundation for effective treatment in CM would use a multi-tiered approach that includes synergistic CM modalities, such as herbal medicine, acupuncture, Tui Na (massage), nutrition, aromatherapy, and manipulative the rapies. This multi-tiered approach should include the intervention with early education treatment that Western medicine recommends.

Dr. M. Cissy Majebe, O.M.D., is director of the Chinese Acupuncture and Herbology Clinic in Asheville, N.C., for the last 17 years. Over the last 10 years Dr. Majebe's special pursuit in understanding that which plagues the children diagnosed with autism has directed her untiring research and studies at home and abroad.