Chronic Rhinitis
Overview
Chronic rhinitis is persistent inflammation of the nasal mucosa with intermittent or persistent nasal congestion, clear or mucus discharge, sneezing, and reduced smell, lasting over 12 weeks; it may be allergic or non-allergic. Chinese medicine calls it 'bi zhi', commonly due to lung qi deficiency with insecurity of the defensive exterior and recurrent wind-cold, or spleen-lung qi deficiency generating dampness, with qi and blood stagnation in the nasal orifices in long cases.
TCM disease & pathogenesis
In TCM this is 'nasal obstruction' (bi zhi), the term already appearing in the Plain Questions (Su Wen, Wu Chang Zheng Da Lun); the Divine Pivot (Ling Shu, Ben Shen) states 'when lung qi is deficient the nose is blocked and obstructed,' and Liu Wansu further linked nasal blockage to constrained fire-heat and dampness, recognizing that recurrent obstruction may be cold or heat, deficiency or excess. The nose is the orifice of the lung and the gateway of breathing, and it connects with the foot-yangming stomach meridian and the du vessel. The cause is commonly lung qi deficiency with an insecure defensive exterior that repeatedly contracts wind-cold and foreign qi; pathogens linger in the nasal orifice and the mucosa swells into obstruction. Lung-spleen qi deficiency impairs fluid transformation so damp-turbidity lodges, and over time combines with stasis, thickening the mucosa and turbinates and perpetuating blockage. It is thus root deficiency with branch excess: lung-spleen qi deficiency is the root, damp-turbidity and static blood congestion the branch. Treatment supplements spleen and lung and unblocks the nasal orifice, assisted by aromatic dampness-resolving and blood-quickening orifice-opening methods.
Pattern differentiation (clinical patterns)
Lung Qi Deficiency-Cold with Evil Lodging in the Nose
Alternating blockage worse with cold, watery discharge and sneezing, shortness of breath and wind-aversion with frequent colds, pale tongue with thin white coating, moderate weak pulse.
Warm and tonify lung qi; expel wind and open the nasal orifices.
Spleen Qi Deficiency with Turbid Dampness Blocking the Nose
Persistent blockage with copious sticky white discharge and dull smell, heavy head and tiredness, poor appetite and loose stools, pale tooth-marked enlarged tongue with white greasy coating, soggy moderate pulse.
Fortify spleen qi; transform dampness and open the orifices.
Connections
Daily care & prevention
Avoid cold air, smoke, dust, and known allergens; saline-rinse the nose, keep air humidified, strengthen exercise and tolerance to cold, and rest during episodes. Press Yingxiang (LI20), Yintang (EX-HN3), Hegu (LI4), and Fengmen (BL12). Seek care for persistent unilateral blockage, bloody discharge, or symptoms not improving despite management.
When to seek medical care
Seek prompt evaluation for persistent one-sided nasal blockage, recurrent nosebleed or bloody foul discharge, facial pain or swelling, double vision, or a neck lump, which require excluding more serious disease.