The Ropes of Chinese Medicine

Being out sailing recently has gotten me thinking about how much there is to learn about Chinese medicine from the outsider's perspective. This having been the first time being responsible for some of the ship's activities, trying to take everything in can be overwhelming. No doubt the first time one visits a doctor of Chinese medicine one may feel similarly overwhelmed.

This blog entry seeks to "take the edge off" as it were by introducing some base assumptions governing Chinese medicine. These are the "ropes" which, as on a sailboat, guide and direct diagnosis and treatment.

Rope One: Yin-Yang 阴阳

For every heads there is a tails, for every up there is a down. Down gives form to up and up to down. The relation of down to up is dynamic. Above there are two Chinese characters. Each character is comprised of two parts. The first part of each character is identical. This element is called a "radical," and it conveys a fixed meaning irrespective of what other elements it is paired with. This particular radical symbolizes a mountain, hill place. The second component of the first character is the character for moon, in the second the character for sun, literally the shady side of the hill and the sunny side of the hill, the two sides of all things in nature.

The body is no different from nature. It is when the principles of yin and yang become imbalanced that disease results. Yin and yang function as fungible assessment principles irrespective of which body system and degree of specificity. For example, a condition such as anemia will be assessed in terms of yin, is the body getting the necessary nutrients to make good quality blood, or yang, is the metabolic fire too weak to produce blood. These are but two queries that provide possible avenues into determining the root cause of the issue.

Rope Two: Branch and Root 标本

Symptoms represent the branch manifestation of something imbalanced at the root. Just because the symptoms go away does not mean that the root problem has been addressed. Let's take the example of chronic yeast infections. First of all, if the problem is recurrent then there is a root problem that has not been addressed. If one has to constantly resort to antibiotics then they are not only not working but could be further compromising the immune system, even if you are taking probiotics.

Rope Three: Five Organs

The five organs are comprised of the heart, spleen, lung, kidney, and liver. They all play together in a series of mutual relationships, each irreplaceable in the overall functioning of the body. The five organs can be implicated in both branch and root problems. Organ function is assessed in terms of yang, i.e., metabolic function, either too much or not enough and yin, i.e., the hormones and fluids particular to that organ. The doctor makes such determinations by asking the patient questions about the time, quality, and duration of particular symptoms.

Rope Four: 12 Meridians or Channels

Just as the earth has meridians marking longitude and latitude, so does the body. There is hot dispute about whether these lines actually exist. The following link discusses nearly microscopic structures in the body that conduct light. (link) These are surmised to be the meridians, which heretofore have been regarded as something of a mystical fancy.

Meridians are the chief pathways of energy from the organs to the exterior of the body. Acupuncture sends balancing impulses along the meridians to alter the conditions of symptoms and the root.

Rope Five: Pathogenic Progression

Disease is not static. It moves. However, there is usually an order to its movement that is governed by the meridians. Generally, disease moves from the exterior to the interior and from top to bottom. Diseases at the exterior are consequently usually much less serious than those at the interior and reflects a generally strong state of overall health. Conversely, internal disease indicates functional deficiencies.

Understanding pathogenic progression provides signposts for understanding the recovery process. Chronic conditions do not resolve overnight in most cases. An understanding of pathogenic progression also implies with it necessary treatment principles that will guide selection of the appropriate points, herbs, and exercises to restore balance.

Conclusion

Learning the ropes of Chinese medicine can be daunting, much like learning to sail, but after a while it begins to make sense. Most people resort to Chinese medicine after some calamity has hit and assistance in learning to sail the proverbial ship of the body is necessary, because ahead lies a looming sense of rocks. When things are smooth sailing, a doctor's visit is probably the farthest thing from one's mind but it is under such conditions that adjustments can be made most easily under the most ideal circumstances. This is the core constituent of real preventative medicine for it empowers the individual to take the ropes for herself. A process whereby prevention is construed as a series of tests does nothing to teach individuals how to take charge of their ship. Learning the ropes of Chinese medicine allows you to guide your ship through all types of weather.

Arthritis Pain: Five Factors Chinese Medicine Addresses For Relief

Whether it is because of concerns about side-effects or because one's current medication regime isn't working as well as it used to, individuals suffering from arthritis pain can turn to Chinese medicine for reliable and time-tested answers. Chinese medicine is a holistic medicine. The criteria for holism varies from case to case, but below are five significant factors that will be addressed through a Chinese medical approach to arthritis.

Factor 1: Blood Flow

The microvasculature, or tiny blood vessels, is commonly stagnant in arthritis cases. Many researchers believe that acupuncture is effective in minimizing pain because it increases blood flow in the microvasculature. An adage from the Chinese medical classics states "Where there is pain, there is stagnation." One of the primary causes of any pathology in Chinese medicine is stagnant blood flow. Blood flow can slow either due to sluggish blood quality or the accumulation of phlegm.

Factor 2: Blood Quality

Arthritis is an auto-immune condition. This means that the immune response is constantly receiving messages that are telling it to attack the joints of the body, in the case of arthritis. These messages go by varying names, immune factors, cytokines, inflammatory markers.

Chinese herbs can down-regulate the immune system by removing factors from the blood that excite the immune response. Herbs that fall within the category of blood tonics perform this function, loading the body with vital nutrients targeted to the body's circulatory system.

Factor 3: Breath

The classics state "blood is the mother of qi and qi the commander of blood." If the qi is weak, blood cannot be commanded to flow freely. What is qi? In this context it is the breath and specifically lung function. The heart pumps the blood, but if the lungs are weak the heart will have little strength to pump the blood efficiently.

Qigong is a gentle form of movement and breathing exercises that works on increasing qi capacity. Qigong, literally means, qi work. There are numerous forms of qigong, just like its more popular variations Taiji, more commonly Taichi, and Gongfu, aka Kung-fu. All of these martial arts work the qi, emphasizing different aspects of development, strength, stamina, flexibility, and often drawing inspiration from nature to articulate the forms: preying mantis, crane, clouds. Although breath enhancement is a principle reward, the combination of learning synchronized movement with the breath also benefits the neurological, digestive, and other systems of the body. When the qi of all the systems is enhanced then the immune system too is regulated, slowing the growth of and reducing accumulations around the joints.

Factor 4: Fluid and Digestive Metabolism

Imbalance in fluid metabolism, implicating lymphatic, muscular, and respiratory systems, can cause the swelling of joints. There is a category of herbs that specifically targets the draining of excess fluids. The level at which such actions catalyze is within the lymphatic, muscular and respiratory systems.

Certain herbs, qigong, and acupuncture improve digestive function, the hypo-function of which plays an important role in fluid excess. Fluid congestion characterizes aspects of arthritis. This is often called "phlegm" or "dampness" in Chinese medicine. Improving system function will rectify fluid congestion because such a problem is the result of functional impairment. Basically by working specifically on fluids and the source of fluid metabolism dysfunction, Chinese medicine addresses both the symptoms and the cause of arthritis.

Factor 5: Diet

Last but certainly not least is diet. Nothing can go toward addressing chronic conditions like arthritis in a more dramatic way over time than changing one's diet. An effective approach to diet modification is a process, whereby one learns as much about what to include as what to avoid based on one's individual constitution.

Constitutional medicine is a distinguishing aspect of Chinese medicine. It takes into account each individual's body type to allow dietary recommendations to be specific. Food, like herbs, have properties that produce predictable effects in the body. Th classics express a sentiment identical to Hippocrates, "Let food be thy medicine." Chinese medical theory actually provides a framework for understanding how foods work as medicine based on your constitution.

Conclusion

Blood flow and quality, breath, fluid metabolism, and diet are five aspects of a Chinese medical approach to holistically addressing the chronic condition of arthritis. Herbs, acupuncture, qigong, and dietary collaboration are tools applies in restoring balance naturally.

The Yin and Yang of Tea: A Balanced Look at Tea’s Benefits

A new patient of mine, who has come seeking assistance for “heart problems,” lamented that she had tried to drink such and such amount of tea everyday but it makes her feel pretty rotten and she feels she doesn’t respond to caffeine very well because she gets palpitations. “Then why are you drinking it?” I asked. “Well Dr. Oz says it’s really good for you and…”

I have no idea who Dr. Oz is. I’m sure he knows his stuff. An article, by a likeminded chiropractor Dr Mercola, also touts the benefits of tea. “Research dispels the common belief that tea dehydrates. Tea not only rehydrates as well as water does, but it can also protect against heart disease and some cancers.” (http://articles.mercola.com/sites/articles/archive/2010/07/06/tea-healthier-drink-than-water.aspx). These learned and studied health professionals base their opinions on solid scientific evidence and studies.

Why on earth would my 65 yr old patient be experiencing what she reports, if the properties of tea are so documented? Mercola goes on later to state, “There's still some debate as to which kind of tea is the most beneficial -- green- and black tea being the most cited, but you can also consider Indian herbal teas like Tulsi.” This statement confuses “herbal teas” with actual camellia sinesis, tea, and leaves one with the impression that green and black teas are the same. They are not.

For starters, there are all types of herbal beverages that are called tea, but which are not tea at all. It is rather like in China when they ask you if you would like water and you get tea, or when they refer to tea as “tea-water,” cha-shui,茶水. Ginger, sassafras, hibiscus, and cinnamon are NOT really tea 茶. They’re tasty and health-imputing beverages, just like tea. But sassafras and hibiscus no more have the same properties than do black and green tea, even though they come from the same plant 茶. This is the yin and yang of tea that you must master, Grasshopper, if you are to truly balance the forces within. Thus, in understanding the properties of the beverages we consume, we can see an intrinsic blindside to “nutritionism,” a position favoured by some in bio- and wholly in orthomolecular medicine.

Nutritionism is the scientific position that, in effect, a whole is the sum of its parts and hence the parts constitute that which is important to the whole. Thus, what’s important about the apple is not it’s freshness, how far it had to travel, or deliciousness, per se, but its “fibre content,” its vitamin store, so on and so forth. Once you get so much fibre and vitamins, eating apples or anything for that matter becomes rather unimportant. This here Snickers-Plus has all the electrolytes, fibre, and B vitamins for three apples and two chicken livers… and it’s organic! Can’t beat that with a stick, now can you? Right there on the label, see fibre, vitamins,… hey and NO transfats! It really is good for you. Remember, even Oprah and the Dalai Lama endorse Snickers-Plus. Surely, you have got to be a Tea Party, conspiracy nut if you still insist on eating actual apples and liver!

I digress, but only to contrast this position from that of Chinese medicine which takes the whole as the base unit of a bioactive compound, not its parts. The apple, to return to our previous example, is a whole, which possesses certain properties. Tea and herbal beverages also have properties, which in Chinese medicine are largely categorized upon taste. There are five recognized flavors, salty, sour, bitter, sweet, and spicy. Each has a certain predictable effect on the body, under certain circumstances.

Let’s continue to cast the yin and yang of tea into something that we can understand on a practical level, while at the same time suggesting why such a casting is meaningfully different from nutritionism. Among the varieties of tea there are only three: green, oolong, and black teas. So-called “white” tea is just another variety of green, though milder. They all come from the same leaf, differing by their relative degrees of oxidation. Green teas are oxidized very little and are cool by nature. They are therefore considered yin. The more intense the green, the colder it is by nature, regardless if it is drunk with warm water or not. An example of a high-grade intensely green and cold tea is the Japanese Gyokuro. On the Chinese side of things there is Bitter Nail Tea, ku-ding cha 苦丁茶，which is rolled long as a nail and unbelievably bitter. It is drunk only in summertime and a solitary “nail” is used for several cups.

Black teas are more yang in nature. This means that they are warming on the digestive system and can be drunk with greater frequency by those who have weak digestive systems, a condition marked by bloating, cramping, and an abdomen cool to the touch. Oolong tea is half-oxidized between black and green tea. It is perfectly balanced, so to speak. Some company in China, no doubt involved with the selling of its particular oolong product, made curious claims about some “research” substantiating the superior slimming effects of oolong versus its green and black siblings. Oolong has a distinctive floral taste. High quality oolong is intoxicating in its breadth, notes high and misty fill the senses, providing considerable delight to those who find drinking green tea rather like having grass-clippings.

Traditionally, different parts of China favored different types of tea. In the central region along the Yang-zi River, green teas were the norm. These regions are temperate and humid. Green tea’s bitterness cools in oppressive summer heat and drains excess dampness. Bitter’s draining action is difficult to reconcile with the scientific findings on “hydration” above. More ironic still is that water isn’t considered particularly hydrating either, not in Chinese medicine. Oolong tea has been more commonly enjoyed by the Cantonese and Fujianese, those of the far south. In Hong Kong they may have taken up the drinking of black teas from India due to the British colonial presence. There are varieties of Chinese black teas which are quite nice, but they seem to be enjoyed primarily by the Cantonese. The ethnic minorities of the Southwest and Northwest rather universally drink black tea, brick being the most common among them, as it is regarded an essential digestive aid for the heavy grease of lamb and yak, the meats common to their diets.

Processing tea can enhance or diminish the natural properties of the tea itself. Exotic Indian infusions of black tea, like Earl Grey and Darjeeling, invariably require some understanding about the properties of the essential oils used to gauge its effect on the tea’s over all nature, yin or yang. Northern China almost universally drinks jasmine tea, which is a green tea infused with jasmine. The jasmine seems to enhance the draining nature of the tea, judging from personal experience. The climate of the north is temperate and dry. Still, that’s what they drink.

In instances where the body is characterized by hypofunction or a yin state, a yang tea is more appropriate. The opposite applies for the body in a state of hyperfunction. Tea in itself can NEVER be considered a yang tonic because it is yin by nature. It is not a yin tonic either, because by being bitter its function is to drain downwards: detox in other words. The point is, however, that if the body is characterized by hypofunction, detox should be the last thing on one’s mind—the body is looking for support. What good are all the health-promoting properties of green tea if the body principally requires warming? To put it another way, no meaningful benefit from any herbal beverage can be garnered without understanding that beverage’s yin-yang nature relative the yin-yang state of one’s own body.

Bassist Shoulder: Chinese Medicine Approach

The best way to approach Bassist Shoulder is holistically. This means getting a sense of the big picture in terms of 1) how the bassist interacts with his instrument posturally, 2) what the existing state of the musculature is, and 3) how the body compensates for the weight of the bass.

Chinese medicine, comprised of acupuncture, herbs, and cupping, is a holistic medical system equipped to address problems like Bassist Shoulder. Central to the concept of Chinese medicine is flow, primarily the flow of blood and oxygen throughout the body. "When flow is impaired pain arises," is a truism from the Chinese medical classics. This is evident in the instance of Bassist Shoulder: the weight of the bass along with narrow strap width combine to impair the flow of blood and oxygen through the tissues and fascia that connect the neck and shoulder. Hip, lower back and even knee pain arise from the stress of compensation.

There are many ways that an acupuncturist may approach Bassist Shoulder, but they boil down to local and distal applications. Some acupuncturists favour strictly one approach over the other, but mainly it depends upon the patient's response. Local applications are not restricted to just needles. Finger acupuncture (needle-less acupuncture) , Chinese massage, and cupping are commonly used to increase the flow of blood and oxygen in the local tissue to speed tissue repair and relieve pain. Cupping is very effective for releasing the stress held by the big muscles of the neck and shoulder.

In a previous article, String Musicians Fret Over Carpal Tunnel, I discuss some common postural issues related to the playing of neck instruments. Some attention is drawn toward a personal preference for distal needling in dealing with pain, particularly regarding pain in nerve rich areas like the wrists. Distal techniques can be equally effective in releasing large muscle groups like the sternocleidomastoid and trapezius muscles of the neck. Possibly, this is in part due to the neuro-muscular retraining that occurs as the affected area is free to clear pain and relearn postural awareness, while another neural impulse from the needles is being initiated from a distal site.

There is a holism that is also contained within certain distal approaches. This is because these approaches place the body within a matrix, where imbalance anywhere produces corresponding imbalances. Often working on something that appears unrelated is precisely the linchpin for correcting a slew of imbalances. It is not unusual for needle impulses from the knee to release the shoulder and the hip, because this is the place within the matrix that balances the whole.

By addressing Bassist Shoulder with cupping and acupuncture, chronic neck and should problems can be greatly ameliorated and in many instances complete function and mobility can be restored. A proper holistic approach must include more than just treating the symptoms. This means learning movements and postural awareness that will prevent relapse and make playing the bass more enjoyable than it already its.

What Are You Lookin' At: Tongue Diagnosis in Chinese Medicine

Patients, when asked to stick out their tongue, often wonder what on earth their Chinese doctors are looking at. In short, we're looking for certain signs, texture, moisture, coat quality, shape, and color, to confirm our diagnosis.

An irregular tongue texture, for instance, can indicate signs of heat. We might translate "heat" into biomedical terms like inflammation and fever. By contrast, excess moisture is suggestive of metabolic deficiencies, perhaps an under active thyroid. A glassy tongue coat reflects a very deeply seated infection that has damaged the body's overall strength.

The tongue is a chief diagnostic tool much like a thermometer only much richer in the quality of information. For example, a thermometer will definitely be able to tell you that you're running a temperature, but it won't be able to tell you where the heat is located. The tongue, however, in many circumstances can offer a good clue as to where the an infection is hanging out in the body. This is because different places on the tongue, say the tip, the edges, its root, all correspond to particular parts of the body. Thus the tongue is a kind of map of the body, a micro-system not altogether different from the micro-systems of the foot and hand, popularized by reflexology. Each micro-system does have it's particularities. The tongue seems to be a particularly good diagnostic tool for apprehending the condition of the body's digestive system.

The tongue presentation is helpful for prescribing herbal formulas. Two individuals may present with the same problem, say respiratory infection, but show differing tongue pictures, due to the difference in each individual to fight pathogenic invasion in light of preexisting conditions. A person who has lung weakness, for example, will respond differently to the same bug as someone with digestive weakness. Evaluating the tongue is a reliable guide for making such determinations.

A 23 y.o. female came to me for relief from a respiratory infection that had been lingering for the better part of three months. A month prior she had taken a round of antibiotics with no improvement. Chief symptoms were malaise and congestion. Her tongue was sticky, white, and frothy. From the tongue, I deduced that her problem originated from a stagnant digestive mechanism. I prescribed for her a formula used commonly for food poisoning and hangovers. Her case resolved in 10 days.

Tongue picture is much more valuable in diagnosing chronic conditions than it is for trauma. In other words, tongue diagnosis is useful in cases of osteoporosis, but not really for an ankle sprain. Still, acute conditions often have a chronic component that until the trauma occurred was subclinical. In other words, a fracture due to trauma may be due to underlying osteoporosis. Thus, the tongue along with other factors can allow us to make such a determination.

Chinese medicine differentiates between the branch and root of a condition. The branch is generally the symptoms that send a person in search of relief. The root is the what the doctor of Chinese medicine diagnoses to get at the source of the problem. The tongue gives a picture of what is happening at the source.

Audition Jitters and Jangles Balanced with Acupuncture

The stress of auditioning can be balanced through acupuncture. Even though acupuncture is usually associated with alleviating musculoskeletal afflictions like carpal tunnel, back pain, and tendinitis, it also has an impressive capacity to balance emotions. The implications are clear for performers who face perpetual blocks that have been unresponsive to conventional approaches or when such approaches have unwelcomed side-effects. Below are five points on how acupuncture helps with audition jitters and jangles.

1. Acupuncture balances overall emotions. Acupoints like Spirit Gate (shen men) and Inner Passage (nei guan) have evocative names describing their function on emotions, i.e., "spirit" and "inner" selves. One of the two Spirit Gate points is on the ear. It is one of the five points used by NADA to treat addiction and the military for post traumatic stress disorder.

2. Acupuncture balances specific emotions. Feelings are assessed within a constellation of contributory factors: body type, dietary propensities, sleep habits, lifestyle, and living environment to name a few. A big picture allows for getting at the root of specific emotional imbalance as opposed to just masking symptoms.

3. Acupuncture directly affects sensory nerves. Acupoints like Bamboo Gathering (zan zhu) and Master Sensory directly affect the nerves of perception: light, loud, sight..., as well as the habituated reactions stemming from perception. In fact, acupoints' rate of effectiveness in shifting habituated perception has spawned the discipline of energy psychology, known under various names TAT, MTT, EFT.

4. Acupuncture balances the heart. In Chinese medicine our organs are more than production centers of metabolic activity. In fact, our emotions are considered a reflection of the metabolic and hormonal condition of the organs. For example, worry is suggestive of digestive imbalance, possibly related to diet. That said, all emotion is mediated through the heart. The heart acupoint of the ear is also part of the NADA protocol.

5. Acupuncture balances the liver. If the emotions are mediated through the heart, then the daily flow of emotion is commanded by the liver. Liver is largely regarded as the organ of stress. It bears a close relationship to the heart, for the heart and liver both play important roles in regulating blood, which nourishes body, mind, and sleep.

The effort required in releasing audition jitters and jangles through acupuncture is zilch. Though some do not respond positively to acupuncture, these are usually rare exceptions involving metal allergies. Even in these cases there are non-needle alternatives. Sometimes miraculous break-throughs happen in a single session, but in reality acupuncture is just a natural medicine that works similar to physical therapy, better and better over time. A standard course of treatment is 9-12 sessions to be completed in one to three months. Acupuncture is an ancient medicine that views aspects of mind and body as mutually affecting each other. It may be considered a safe and natural avenue for addressing the emotional imbalance that affects personal performance.