CHINESE people are lining up at TCM hospitals in the dog days of summer to get protective treatment for chronic winter ailments. Zhang Qian explains treating winter woes in summer.

Strong sun and soaring summer heat declare the approach of the peak period for traditional Chinese medicine treatment of "winter ailments," such as asthma, bronchitis, arthritis and rheumatism.

San fu (three hot periods), or dog days, refers to the 30 hottest days in a year in the lunar calendar, from July 14 to August 22 this year.

It is believed that in this period the yang (hot energy) in the universe reaches its peak, while the yin (cold energy) is at its lowest ebb. The same is believed to be true for the energy in the human body.

In TCM, these 30 days are the optimal time to nourish yang energy for winter, thus preventing or easing chronic ailments that are related to invasions of "pathogenic cold" in winter. These ailments include respiratory problems, arthritis, rheumatism and cold-related stomach problems.

Every summer TCM hospitals open special clinics for dong bing xia zhi (treating winter ailments in summertime) and they're always crowded.

Treatments are mostly herbal packs placed directly on the skin as well as moxibustion. Because of the heat, pores are open in summer and thus it's easier for the body to absorb the herbal essence that goes into energy channels to targeted organs or systems.

People take several treatments in the dog days and doctors emphasize that they must get treatment for at last three consecutive summers. This helps rebalance energy and dramatically improve health in winter.

Treating winter ailments in summer is based on the TCM theory of the correspondence between human beings and the universe. Seasonal changes directly influence the energy balance within the human body. The yang energy in the body increases and inhibits pathogenic cold, and yang energy peaks in summer's dog days.

"Cold-expelling" herbal therapies applied now can help store up yang energy, thus helping prevent relapses in the winter.

Winter ailments, as the name suggests, are problems or illness that occur or worsen in winter, according to Dr Zhang Zhongyi, deputy director of the Acupuncture Department of Yueyang Hospital attached to Shanghai University of TCM. They are usually caused by "invasion of pathogenic cold energy" and patients are usually suffering insufficient yang energy at the same time.

Treating winter ailments in cold winter is just like trying to dry wet clothes on a rainy day, but it's much easier when there's a lot of yang energy in the body and the universe.

The most common treatment is fu tie or herbal application.

Here are some of the common winter ailments that are treated in summer:

? Respiratory ailments (such as asthma, bronchitis)

"Herbal cakes" are placed on the acupuncture points on the back, covered by a plaster containing a positive electric current. The patient puts his or her left hand on another plaster with a negative current.

"The electricity helps the medicine pass through energy channels more quickly," says Dr Zhang. "Patients will feel as though ants marching through the energy channels and the skin turns red after a 20-minute treatment," says Dr Zhang.

The treatment should be administered five times during the 30 dog days.

The herbs for respiratory ailments are generally xi xin (Manchurian wild ginger), bai jie zi (white mustard seed), gan sui (euphorbia) root and yan hu suo (corydalis root).Similar therapies involving other herbs are used to treat other ailments.

? Pain problems (such as rheumatism)

"Though the major treatment to relieve rheumatism is medicine soup, which dispels pathogenic damp and cold in joints, herbal applications are more popular because they work instantly and relieve pain," says Dr Su Li, chief physician of Longhua Hospital attached to the Shanghai University of TCM.

The most commonly used acupuncture points for rheumatism are shen shu in the lower back, hua tuo jia ji xue (a series of acupuncture points on both sides of the spine) and a shi xue (any pain-sensitive point).

The most common ways to apply herbal medicine are by herbal injection, herbal moxibustion and herbal injection.

Liquefied herbs to stimulate energy and blood while relieving pain are injected directly into acupuncture points.

Herbal moxibustion involves both moxibustion and external application of herbs.

Ready-made herbal plaster are available in markets for home use, but freshly prepared and individually prescribed plasters are recommended by doctors. Plasters are made with herbs that dispel damp, warm energy meridians, stimulate blood and energy and relieve pain. They are placed on acupuncture points and warmed for 20 minutes.

For parts of the body, like fingers or toes, doctors recommend soaking affected areas in an herbal solution for 20 minutes.

Rheumatism therapy should be taken three times a week throughout the dog days.

? Cold-related stomach problems

Herbal applications around the navel area can help relieve stomach and digestion problems related to pathogenic cold in winter, according to Lu Yiping, professor at the Shanghai University of TCM.

For DIY, mix about 10 grams of ground zhu yu (evodia) fruit powder with vinegar. Stir until thick in consistency, apply around the navel, cover with gauze and a rubberized watertight fabric.

Change every 12 hours for one week. This is supposed to warm the stomach (meaning the entire digestive system in TCM) and relieve chronic problems in winter.

Crucian carp soup with sha ren (cardamom) helps relieve cold-related stomachache.

"Though these therapies may relieve pain in winter, patients should always avoid 'cold' foods and cold temperatures in summer," says Dr Zhang.

Respiratory patients especially should avoid iced foods such as ice cream and iced sodas, and "cold" energy foods such as seafood, bitter cucumber and watermelon. They should avoid chilly rooms.

People with stomach problems should always avoid frozen foods.

Dr Su also warns rheumatism patients to avoid direct exposure to air-conditioning outlets and electric fans. Frequent shifts between cold and hot environments aggravate the problem.

"Pores open in the heat and pathogenic cold can easily invade the pores when you enter a cold room suddenly. And as your pores close suddenly, the pathogenic cold is locked inside and blocks energy channels," says Dr Su.