Major Cold 大寒 Seasonal Node

Today, Sunday January 20th, is the start of the Major Cold (da han 大寒) Seasonal Node, and here in northern New Jersey it really arrives right on time. This morning we had a mix of snow and freezing rain, and tonight the temperatures are forecast to drop, with an overnight high of 8 degrees (-13 degrees Celsius). Days are slowly getting longer, but it is really cold now. Major Cold is the last node of the traditional Chinese year, and we are now about two weeks away from both the solar and lunar new year – the Beginning of Spring (this year they fall about the same time).

The three material manifestations of Major Cold are Hens Begin to Breed (Ji Shi Ru 雞始乳), Birds of Prey Act Fierce and Swift (Zhi Niao Li Ji 鷙鳥厲疾), and Rivers and Lakes are Frozen Within (Shui Ze Fu Jian 水澤腹堅). Notice here imagery of the impending Spring. In Five Phase theory the domestic animal associated with Spring is the chicken, and during Major Cold hens are getting ready to become pregnant with baby chicks that will hatch in Spring. Thus, even though the weather outside is still very cold, Yang is definitely on its way back as the gradually lengthening of the days attests to.

As the name suggests, the Major Cold Seasonal Node is the time of the year when the main environmental factor we contend with is cold. The first thing that Chinese medicine recommends for this time is to eat clear and easily digested foods (qing dan shi wu 清淡食物). Why is this? The Spleen and Stomach are the roots of Latter Heaven Qi. During the end of Winter even though the time of the year is still predominantly Yin, the Yang qi is being birthed. Eating clear and easily digested foods allows the Spleen and Stomach to move and transform appropriately, and to build Latter Heaven Qi. If foods are too heavy, such as overly greasy or sweet foods, then the ability of the Spleen and Stomach to move and transform is impaired. Easy to digest foods ensures that we continue to build Latter Heaven Yang Qi to get ready for the upcoming spring.

In addition to cold, the other main environmental pattern seen during Major Cold is dryness. Even with wet snow on the ground this morning, lately my patients have been complaining of dry skin on an almost daily basis. Much of the environmental water is bound up in snow or ice, making the air dry. Knowing this, the second recommendation this time of year is to stay warm but also be sure to not be too dry. Staying warm is obviously important in this time of greatest cold. But since certain organs are harmed by excessive dryness, such as the Lungs, we also need to be vigilant there. For example, for those with forced hot air heating systems, it may be prudent to run a humidifier periodically. Also, sipping warm liquids such as herbal teas throughout the day can keep our internal environment appropriately moist.

With patients who are cold, or have Spleen or Kidney vacuity patterns, continue to warm and supplement. Moxibustion, especially at points like Zu San Li ST-36, Qi Hai REN-6 or Guan Yuan REN-4 is still appropriate. Acupuncturists can include Tung’s point San Cha San 三叉三穴 frequently in point prescriptions. This point has the ability to warm yang and supplement the Kidney. Furthermore, since it pierces through Ye Men SJ-2, “Fluids Gate,” it also benefits fluids, particularly of the upper orifices.

As already mentioned, during Major Cold we should emphasize consuming easily digested foods that protect internal warmth and strengthen the middle. Foods that satisfy this requirement include, for example, rice, glutinous rice (in moderation), yams (including nagaimo), peanuts, clear soups like chicken soup, and cooked vegetables. In general avoid raw vegetables, cooling fruits, very greasy meats, and very sweet deserts. When cooking make frequent use of fresh ginger, and other mildly warming spices like nutmeg.

In addition to protecting the Spleen with food, during Major Cold it is also important to consume foods that guard against dryness, and in particular Lung dryness. To this end traditional recommendations for food include consuming white wood ear mushrooms (Yin Er 銀耳) and pears, especially Asian pears. A great traditional tea for Major Cold is Goji Berry and Red Date Tea (枸杞大棗茶). To prepare, take about 1 teaspoon Goji Berries (Gou Qi Zi) and 3 small red dates and place in a large mug. Cover with boiling hot water and let steep at least 5 minutes. After drinking about ½ the mug, refill once or twice more with boiling hot water. This tea supplements and moistens the Kidney and Liver, nourishes blood and supplements the Spleen.

As I’ve mentioned in some previous posts, since I do so much acupuncture in my clinical practice and I teach Qigong regularly, I really like channel based Yang Sheng practices in addition to lifestyle and diet that we usually discuss. One traditional recommendation for Major Cold is foot soaking and acupressure to support some of the goals we’ve already described above. The time of day associated with Major Cold is the Chou 丑 hour (1-3am). While I don’t recommend staying up too late, this practice can be done before bed, as close to that time as possible while still getting to sleep at a reasonable hour. Start by soaking feet in hot/warm water for 10-15 minutes, and Epsom salts can also be added to the water if desired. After that follow the soaking with acupressure on Yong Quan KD-1, Tai Bai SP-3 and Tai Yuan LU-9. This helps warm and strengthen the Kidney channel, and supplement the Spleen and Lung channels thus corresponding to some of the basic recommendations discussed above.

The last recommendation I’ll offer is gentle massage of the lower back. We all know that the low back is the abode of the Kidney, and gentle stimulation of the low back can thus relax and warm the Kidney. Furthermore, Major Cold is specifically associated with the 3rd lumbar vertebra. There are 24 total vertebrae corresponding one to each of the seasonal nodes, and this association is well known in esoteric Daoist circles. In the White Cloud temple in Beijing there is a diagram of the body carved in stone on the side of one of the walls that maps out the associations of the vertebrae with the nodes. So, in light of that correspondence, one great Yang Sheng practice for Major Cold is to sit quietly, starting with vigorously rubbing the palms together to get them as warm as possible. Then, place the hands on the low back in the area of L-3 feeling the warmth of the hands penetrating the back. After that rub the back to warm the area, or gently tap the low back.

Minor Cold 小寒 Seasonal Node

After Winter Solstice there are only two more Seasonal Nodes in the year before the Chinese New Year and the beginning of Spring - Minor Cold (小寒) and Major Cold (大寒). As is clear from the names, temperature is an important part of understanding the last two seasonal nodes of the traditional Chinese calendar. Over the last month or so temperatures have been up and down, although we have yet to see sustained frigid temperatures in the Northeastern United States. What is more important is that we are now in the time of year where the potential for sustained cold is very real as, even though we are moving into Spring, January and February are usually the coldest months of the year. Sunday night of this weekend when I’m posting this got down into the 20s (that’s below freezing for those of you using Celsius).

Most people don’t realize this but last week was actually perihelion, the exact day when the Earth is closest to the Sun. This happens each year about 2 weeks after the Winter Solstice. Warmth of the season though is determined by angle of sunlight, not proximity to the Sun, which is why even though we are close, it is still cold here.

This year the Minor Cold seasonal node started on Saturday January 5th, and the three shorter breakdowns of Minor Cold, the material manifestations, are Geese Head North (Yan Bei Xiang 雁北向), Magpies Begin to Build Nests (Que Shi Chao 鵲始巢), and Ring Necked Pheasants Begin to Crow (Zhi Shi Gou 雉始雊). In Chinese there is a saying that goes “Xiao han da han, leng cheng bing tuan” 小寒大寒冷成冰團 – “Minor Cold and Major Cold, coldness is here and ice abounds.” The previous seasonal node was Winter Solstice, the time of the year when yang qi is born again in the natural world. However, despite the growth of yang this month continues to become colder and colder. Why does cold continue to worsen even though we are moving to the Yang phase of the year?

Think of the movement of temperature as being driven by the fluctuations of yin and yang in the natural world. Even though the “switch” has been flipped from yin to yang, it takes time for the climate to catch up. Imagine driving a car at 75 miles per hour (I apologize to you all who use the metric system – I’m metric impaired). If you want to stop and go in reverse, first you have to hit the brakes. However, if you hit the brakes really hard, that car is going to continue skidding forward for quite a distance before you can start moving in the opposite direction. Thus, even though the brakes have been put on the Yin movement of the year, before we can really move towards the Yang we continue “skidding” colder and colder for awhile, before Spring truly warms up the Earth.

The health maintenance guideline for this season is similar to Winter Solstice. Specifically, during Minor Cold we should focus on (1) Nourishing the Kidney (Yang Shen 養腎), and (2) Safeguarding the Spleen and Stomach (Baohu Pi Wei 保護脾胃). Winter is the time for all the Qi to be stored away internally – my Neijing students will remember this discussion from Su Wen Chapter 2. Since Kidney is the root of storage, and the root of Earlier Heaven (先天) Qi, we nourish the Kidney to nourish the body’s ability to store Qi away (i.e., the movement of Winter – 藏). While Kidney is the Earlier Heaven root, the Spleen and Stomach are the Later Heaven (後天). So, protecting the Later Heaven helps to ensure that Earlier Heaven is not excessively tapped into. This is especially important for our patients with conditions of vacuity (especially either Kidney or Middle Jiao vacuity), or patients with cold conditions (for example patients with chronic arthritic conditions – Bi syndrome from Wind, Cold and Damp).

Continue having patients get to bed early. Also encourage warming therapies such as moxibustion, especially on points like Zu San Li ST-36, Guan Yuan Ren-4, Qi Hai Ren-6, and Huo Fu Hai 33.07. Patients who have long term Bi syndrome can do daily acupressure on Feng Fu Du-16. This is a special technique from the famous Chinese acupuncturist He Puren.

In addition to the acupressure mentioned above, consider using the Leg Nine Miles Dao Ma Group (足九里) from Tung’s system. This is one of the best groups to use for Bi syndromes when multiple areas of the body are affected, or when we’re not quite sure where to start with a patient. The three points in this group are Middle Nine Miles, Upper Nine Miles, and Lower Nine Miles (88.25, 26, 27), with the middle point overlapping Feng Shi GB-31. Patients can be taught to do Paida (拍打) in this area as a daily health maintenance regimen.

Dietary guidelines for Minor Cold are similar to Winter Solstice. Since we want to protect the Middle Jiao in particular, the first basic guideline is to eat foods that are easy to digest and take foods at regular intervals. Since most of us are coming out of holidays with lots of eating going on, it’s also a good idea to cut back on intake of meats and other heavier foods.

Patients with overall yang vacuity should consume yang warming foods such as lamb, venison, alcohol (in small quantities), and warming spices like cinnamon. Meats can be taken in moderation, but moderation is important. Traditional Chinese lists would add dog meat to the “should” list, but I have to admit that’s way out of my cultural comfort zone! These same patients should avoid cold foods such as duck, rabbit, chrysanthemum, mint, milk or yoghurts. Patients who are prone to cold damp conditions (such as arthritic patients) should do the same as already mentioned and especially avoid cold-damp producing foods such as oranges and orange juice, tropical fruits, and the overconsumption of refined sugars.

Instead of a traditional dietary recipe for this node I’ll offer readers a medicated wine. This formula is specifically for the treatment of Bi syndromes due to cold in the channels, and can be taken by patients over the age of 40 for the prevention of joint problems as well. The recipe is actually given to us by Tung in his original text from 1973. While he was an amazing acupuncturist, like all doctors in China, he was familiar with a number of Chinese medicine therapies (including the basic use of herbal medicines).


Tung’s Bi Impediment Wine 董氏痹症酒

Ingredients:

  • Huang Qi 1 30g

  • Wu Jia Pi 30g

  • Placenta (powdered) 1.5g

  • Ge Jie 1 piece

  • Chuan Niu Xi 9g


Place all the herbs in an appropriate amount of grain alcohol (e.g., vodka), and let soak for about 1 month. Then, so consume about 1 shot per day or as otherwise needed. I have modified this from the original formula slightly so as to omit ingredients obtained from endangered species.

For patients with ongoing, active Bi syndrome pain, I suggest combining with external liniments (跌打酒). We will be doing a class through eLotus this August on Tung’s acupuncture and external herbs for injury management (click here for more information on that class).

I hope everyone had a great New Year. Stay warm!

Henry

Here’s a photo taken from the NYC Lantern Festival (taken January 6, 2019 in the evening, on Staten Island). The lights were bright, but true to the seasonal node it was cold and windy!

Here’s a photo taken from the NYC Lantern Festival (taken January 6, 2019 in the evening, on Staten Island). The lights were bright, but true to the seasonal node it was cold and windy!


Winter Solstice 冬至 Seasonal Node

Today, December 21 at exactly 5:23pm (Eastern Standard Time) is the astronomical Winter Solstice. This is the moment when the elliptical orbit of the sun reaches the point where, because of the tilt of the planet, the sun’s rays hit the Tropic of Capricorn at 90 degrees. This angling of the planet towards the sun means the least hours of daylight for the northern hemisphere out of any day of the year, and in the most northern latitudes there is 24 hours of darkness. However after today, the Earth’s path around the sun changes such that the tilted northern hemisphere will gradually be hit more directly by the sun’s rays, slowly making the days longer and the warmer. As an aside, today is also the 15th day of the lunar month, meaning it is a full moon.

The Winter Solstice (dong zhi 冬至) seasonal node, the last node of 2018, begins tomorrow December 22 (in China the astronomical solstice and beginning of the seasonal node fall on the same day because of the difference in time zones). The Chinese term for Winter Solstice literally means the “extreme of yin” as Winter Solstice is the longest night of the year. Symbolically this node is represented by Hexagram 24, which is comprised of one Yang line at the bottom of 5 Yin lines. Hexagram 24’s name is Return – Fu (復). What is returning? The Yang and the light are returning. One of the basic laws of Yin-Yang theory is that of mutual transformation. When something reaches an extreme, then it naturally reverts to the opposite. Now is when Yin has reached its extreme thereby giving birth to Yang. This is why Winter Solstice is the time of many important holidays about birth and renewal, such as Christmas. The Material Manifestations for this node are Earthworms Congeal (Qiu Yin Jie 蚯蚓結), Moose Deer Shed Their Horns (Mi Jiao Jie 麋角解), and Aquifers Stir (Shui Quan Dong 水泉動).

During Winter Solstice we should consider the Chinese folk saying, “Dong zhi yang sheng you da dao, xia bing dong zhi shi miao zhao” (冬至養生有大道,夏病冬治是妙招) – “Nourishing life at Winter Solstice is a great Dao, treating summer’s disease in winter is very clever!” (Yes… It rhymes better in Chinese…) What can we do then to stay healthy during this time period? The first basic recommendation is taken from the Su Wen chapter 1: “Zao shui, wan qi” (早睡晚起) – go to bed early and sleep late. Winter is the time of year that is most yin, and ideally we should be sort of hibernating, both physically and mentally. Finding more time for rest and reflection puts us into harmony with the Yin of Winter. That said, too much sleep is also not great. Sleep (which is Yin) when excessive damages the Yang, which is why the Su Wen says excessive sleep injures the Qi (久臥傷氣). The recommendation I typically give patients is that 7-8 hours of sleep is plenty for the average healthy person.

The second recommendation is “Chi xu yun dong” (持續運動) – persist in moving. Even though Winter is the time of yin quietude, as mentioned above the Winter Solstice marks the birth of yang. Because movement is Yang it is important for us to “persist in moving” during this time of year. Appropriate exercises include gentle movement such as Taiji, Qigong or Yoga.

To stay healthy this time of year there are also some things to avoid. Since this time of year has an abundance of Yin influences (i.e., the cold and dark) and a lack of Yang, the first admonition is to guard against weakening the Yang Qi. As Winter Solstice is the time of Yang Qi’s birth in the natural world, it is important to be sure that there is adequate Yang Qi in the body. For patients with Qi Vacuity cold it is especially important to avoid excess cold exposure. This is a time period where those patients can apply moxibustion at home on points such as Qi Hai REN-6, Guan Yuan REN-4, or Zu San Li ST3-6. Alternately, they can do moxibustion on Tung’s point Huo Fu Hai 33.07. Another traditional recommendation for this time of year is to try exposing oneself to sunlight as much as possible. If possible, traditional medicine recommends allowing the back to be exposed to the sun, and this can be done inside a warm room with large windows. Why the back? In Chinese medicine the back is seen as Yang while the anterior of the body Yin. Warming the back is a way to warm and strengthen the Yang of the body.

The second thing to be cautious of during Winter Solstice is excessive “bedroom activity.” Since Winter is the time of storage, a traditional recommendation for the season is to guard our sexual vitality. Jing essence is the stored and most precious form of Yang Qi, and is stirred during sex. Hence Chinese medicine suggests guarding against excessive sexual activity in Winter. However, we should be careful to not read this only literally. More broadly, sexual activity is a metaphor for expending our essence on all levels. This is why in many cultures around the world this time of the year is the time of reflection and planning for the next year to come. It is a time to step back and move inwards rather than to expend our vitality outwards.

In terms of diet, this is the time of the year to eat more foods that help supplement the Kidney and Spleen, such as rice congees, lamb, beef, shan yao (nagaimo), and winter squash. It is also appropriate to eat a small amount of mildly acrid foods such as fresh ginger, scallions and black pepper (to help keep things moving and to birth yang). Try to avoid cold foods in general, or foods that are difficult to digest such as greasy, raw, or very spicy foods. This is especially so for those patients who tend towards Spleen and qi vacuity patterns.

Here’s a traditional recipe for Winter Solstice:

Longan and Lamb Soup 龍眼羊肉湯

Ingredients:

  • 1 lb. Lamb (deboned and cut into chunks)

  • Dried longan fruit (龍眼肉) 15g

  • Fresh ginger (peeled and sliced) about 20g

  • Scallions (chopped)

  • Salt

  • Cooking wine

Directions:

  1. Put lamb in a pot with 3 cups water, bring to a boil and simmer for just about 2 minutes; strain out lamb and discard water to remove the fat

  2. Place lamb back into pot with enough water to complete cover the meat (6-8 cups), the sliced ginger and scallions, dried longan, and a small amount of cooking wine

  3. Bring to a rapid boil on high flame, then reduce flame to a low simmer and cook for about 2 hours; remove from heat and add salt to taste

This recipe warms the interior and builds Qi and blood, and nourished the Heart to quiet the Spirit.

In the north of China there is a long tradition of eating dumplings around Winter Solstice. In Japan, where dong zhi is pronounced tōji (とうじ), a common tradition is to take baths in water scented with Yuzu citrus. One of the foods of choice in Japan is kabocha, where it is commonly stewed together with adzuki beans to create a dish called itokoni (いとこ煮). The red color, as a symbol of Yang, is thought to ward off evil and confer good luck.

The Gallbladder and Winter Solstice

Yes, the Gallbladder channel has a lot to do with Winter Solstice, yet in my experience even many Chinese medicine practitioners are slow to make this connection. In Chinese medicine there are 12 main channels in the body, each linked with an internal organ. These 12 channels are also associated with the 12 watches (時辰), the 12 two-hours time periods that make up the day in the traditional Chinese method of counting time. Since there are 12 months in the year, the 12 watches of the day correspond each to one of the months. The Gallbladder channel is associated with the time 11pm – 1am, the Zi (子) hour. This time of day, because it is a Water phase earthly branch, is the time that goes with the second month of Winter, the month of the Winter Solstice.

This helps us see the Gallbladder channel in a new and interesting light. One of the things I mention when I teach is that we, as Chinese medicine practitioners, eventually need to deepen our understanding of Chinese medicine beyond the very basic things we memorize in our initial training. Our inability to do this (as I recently debated on a Facebook forum post) is what leads some to eventually adopt all sorts of supplementary ideas (let’s all do muscle testing, tuning forks, or use a pendulum to decide what herbs are good for a patient, as examples) that have nothing to do with Chinese medicine. For me, Chinese medicine is deep enough and rich enough of a medical system in its own right that not even 5 lifetimes would be enough to really study all of it!

So, back to the Gallbladder… In school we all memorize a Five Phase association with each of the organs and channels, but this is just the beginning of understanding the complexity of these theories (special thanks to Heiner Fruehauf for opening my eyes to looking at the channels in this layered way). To start then, we know that the Gallbladder is a Wood Phase channel. But that’s only step one!

As I just mentioned above, the Gallbladder is associated with the Zi Hour (11pm-1am), the time also associated with the second month of Winter and the Winter Solstice. This time of day is a Water time of day (not a Wood time of day). Thus, the Gallbladder channel, while primarily Wood in nature, also has a Water association. This helps us understand why the Jing Mai chapter of the Ling Shu (LS10) says that the Gallbladder channel governs disorders of bones, and why the Gallbladder is one of the Six Extraordinary Fu, and a Fu that stores clear essence (清精之腑).

In addition to the Water and Wood associations, Gallbladder is also a Fire organ. Why? The Gallbladder is the Shao Yang. Each of the six channel families is associated with one of the Five Phases, and the Shao Yang specifically has a Fire association. The Shao Yang is also one of the pivot channels (the Yang pivot channel), meaning it is also symbolic of the Winter Solstice – the time of year where all of nature pivots towards Yang.

Now, the theory is interesting but in the end if it has no practical application to medicine for us it is of no use. The Gallbladder association with Wood, Water and Fire though actually clarifies why some points on this channel actually do what they do. Let’s take Tung’s Nine Miles Dao Ma Group. The main point of the group, Middle Nine Miles (88.25 Zhong Jiu Li 中九里) overlaps Feng Shi GB-31. In Tung’s acupuncture one of the things this point treats commonly is pain (in multiple parts of the body). The Wood phase partly deals with the smooth movement of Qi and Blood in the body, and the Shao Yang as the pivot has the same function. The Gallbladder channel having a Water (and a bone) association then helps us understand why Middle Nine Miles is indicated for bone spurs (i.e., a type of stagnation at the level of bones).

Lastly, “lack of strength in the nerves” (神經衰弱) is an important indication for Middle Nine Miles. This term is actually a psychological symptom, often translated as the now out-dated term neurasthenia. Neurasthenia included a wide range of presentations such as insomnia, fatigue, depression and a wide range of anxiety based disorders. As we said above, the Gallbladder as the Shao Yang has a Fire association. Furthermore, we know that the Shao Yang communicates with the Shao Yin (Heart), the other pivot channel. The close connection with the Fire and Heart illustrates the use of this point in treating Shen-spirit disorders. This is why in my clinic the stressed-and-tired Winter Solstice treatment is the combination of Middle Nine Miles with the Lower Three Emperors (77.17/18, 19, 21), one of the main point groups for the Kidney.

Obviously there’s a lot more exploration we can do for any channel – looking at the other channel connections, names of points, etc… One of my resolutions for the coming year (and I encourage everyone else to do the same) is to try as hard as possible to look more and more deeply at Chinese medicine so we can better understand the system and how to use it in the clinic. Happy Solstice!

Bloodletting Safety Class

I just had a great weekend in the Los Angeles area doing some more webinars through eLotus. The folks there are just great, and this year we did some interesting topics - a deep dive into treatment based on the seasons and the 24 seasonal nodes, Tung’s acupuncture and bloodletting for the Evergreen herbal formula line, and, the topic of this post, a great review of bloodletting safety concerns based on the best evidence we have to date.

As a service to the profession, this recording of this class is now available online for FREE! Please click here to go directly to the course page. I hope everyone enjoys, and I strongly recommend that if you do any bleeding at all in your practice that you go watch the class.

Major Snow 大雪 Seasonal Node

The Major Snow seasonal node starts today, December 7th. While we don’t have snow right now here in New Jersey, I think the best way we should look at the names of this and the last seasonal node is figuratively. Certainly, in some places by now there is snow, but most of the snowiest weather in the Northeast US will most likely come later in the season. Right now what we do have is a dramatic turn towards much colder weather, and because of that we are in the time of year with the potential for real snow. In my opinion, this is the best way we can think of the nodes’ names – the potential for snow as a symbol for the seasonal change we are experiencing right now.

Major Snow is the last Seasonal Node before Winter Solstice, representing the final stage of the most Yin time of year and symbolized by the hexagram Kun 坤, composed entirely of Yin (broken) lines. The two weeks of Major Snow are the longest nights of the year, culminating with the Solstice after which days will slowly be getting longer again. The Material Manifestations for Major Snow are Spangled Drongos Cease to Sing (He Dan Bu Ming 鶡旦不鳴), Tigers Begin to Mate (Hu Shi Jiao 虎始交), and Water Irises Grow (Li Ting Sheng 荔挺生).

The main way to guard health in this period is to focus on warm supplementation, while at the same time avoiding exposure to cold. Thus the Neijing tells us during Winter it is appropriate to “avoid the cold and seek warmth” (去寒就溫). Along these lines people can continue practices such as preventive moxibustion on points like Qi Hai REN-6, Guan Yuan REN-4 and Zu San Li ST-36. Another guideline from the Huang Di Nei Jing for the Winter is to “Nourish Yin” (秋冬養陰). While this may seem counterintuitive for the cold time of year, the meaning of ‘Yin’ in this passage refers to the body’s ability to store, and thereby regenerate, its vitality. Yin means being able to be in a state of quite, rest and solitude. Therefore, during this Seasonal Node try to get more sleep, attempting to get into bed earlier. Sleep is one of the best Chinese medical prescriptions for supplementing the Qi and strengthening the Kidney!

In terms of Tung’s acupuncture, Nourishing Yin (in other words, nourishing consolidation and containment) means we should focus on Zones 7 and 8 on the legs. The point groups that will focus on Kidneys, the organ of the season, are the Lower Three Emperors (Xia San Huang 下三皇), and the Penetrate Kidney Three Needles (Shen Tong San Zhen 腎通三針). These points are easily and quite effectively combined with the moxibustion suggestions above. Over the next several blog posts my goal is to start giving more specific recommendations about Tung’s points and treatment strategies for each of the nodes.

Aside from acupuncture and moxibustion, medicated wines have a long tradition of use in Chinese medicine. They are a cost effective way to take a small dose of expensive or hard to find herbs, and alcohol itself is a preservative to stretch the shelf life of medicinal products. Since alcohol is warm, acrid and sweet by nature, it has the ability to warm and expel cold, and supplement the Qi and Blood while also circulating them. Thus, medicated wines are appropriate for Winter. One traditional medicated wine that is prepared during Major Snow is Gecko Wine (Ge Jie Jiu 蛤蚧酒). To prepare, soak one pair of Gecko (ge jie 蛤蚧) obtained from a Chinese pharmacy in 1000ml of grain alcohol of at least 80 proof (vodka is a good choice). Let sit for at least 1 month, and then take 1 small shot glass per day in the evening. Gecko has a Yang warming and Kidney supplementing effect.

Along the lines now of incorporating more Tung points in these posts, here’s a quiz for readers… What Tung point closely mimics the herb Ge Jie? We’ll talk about this in an upcoming post!

In addition to medicated wines this is the time of year to eat warming, and especially Kidney supplementing, foods. Although many people think of Chinese herbs as the main way to supplement Kidneys, in Chinese there is a saying, “medicinal supplementation cannot be as good as supplementing with food” (cao bu bu ru shi bu 藥補不如食補). Foods appropriate for Major Snow include lamb, beef, chicken, venison, shrimp, and mussels. In addition to these animal products, foods to emphasize this Seasonal Node are walnuts, almonds, or other nuts, and warming spices such as ginger and cinnamon. Since this time of year can be cold and dry it is appropriate to cook soups or stews as they are both warming and moistening. Sipping warm water throughout the day is also an excellent recommendation for people who feel dry (i.e., our patients with Blood or Yin vacuity). Now is the time of year to continue using root vegetables such as yams or turnips that traditionally could be kept in cold storage for Winter consumption.

While warming foods are good for the season, the pitfall is overconsumption creating too much heat and stagnation in the digestive system. As such, if possible this time of year we should consume some foods that help gently clear heat, open the Stomach, and descend yang (to consolidate it). In that vein, one traditional vegetarian recipe for Major Snow is Garlic Chrysanthemum Greens.

Garlic Chrysanthemum Greens (蒜泥茼蒿)

Ingredients:

  • Edible chrysanthemum greens (Tong Hao 茼蒿) ½ lb.

  • 1 small garlic bulb

  • Sesame oil

  • Salt and pepper to taste

Directions:

  1. Rinse chrysanthemum greens and chop into 1 inch pieces

  2. Peel, crush then chop garlic

  3. Bring a pot of salted water to boil, then blanch chrysanthemum greens by immersing in water for about 3 minutes; then drain

  4. Mix greens with chopped garlic, and a small amount of salt, peper and sesame oil to taste; serve slightly warm or room temperature

This recipe loosens the center, rectifies Qi, disperses accumulated food and opens the Stomach.

Stay warm and happy Winter!

Minor Snow 小雪 Seasonal Node

Yesterday, Thanksgiving day (Thursday November 22) corresponded with the beginning of the Minor Snow (xiao xue 小雪) seasonal node for 2018. While most of our Autumn nodes were out of sync with the actual weather pattern, we seem to now be on a normal seasonal track. Just about a week ago the New Jersey and New York Metropolitan areas were hit with a snowstorm that paralyzed the region. However since then temperatures have been up and down, and the snow mostly didn’t last very long. Yesterday we had a high of only about 25 degrees, but this weekend temps will be back up around 50 (that’s about -4 and 10 degrees Celsius respectively for the Fahrenheit impaired readers of this blog!), so we are clearly in that beginning stage of Winter. The three smaller segments of Minor Snow also allude to the gradual unfolding of the new season – Rainbows Stay Hidden Out of Sight (虹藏不見), Heaven Qi Ascends While Earth Qi Descends (天氣上騰,地氣下降), and All is Blocked Up and Has Completed Winter (閉塞而成冬).

Guidelines for Minor Snow are similar to previous seasonal nodes. The thing to focus on to ensure health this segment of Winter is to nourish the Kidneys and protect the Yang Qi. During winter we need to get a little more sleep, getting into bed a little earlier and ideally sleeping past sunrise. The Neijing tells us to, “not disturb the yang - go to bed early and rise late. You must wait for the shining of the sun (無擾乎陽,早臥晚起,必待日光).” Since at a fundamental level Kidney represents the Water phase, it is just a symbol in the body for the movement of Winter – quiescence and storage. Being a little more quiet, a little more rested, and a little more inward directed puts us in direct resonance with the Qi of Winter.

The main environmental Qi for the time period from Minor Snow to Minor Cold (just after New Year) is Cold. Cold easily harms the Kidneys, and thus nourishing Kidney and protecting the Yang (against Cold) are more or less two sides of the same coin. Trying to stay warm is one way to protect the Yang. Be sure to dress appropriately for the temperature, and avoid unnecessary exposure to cold. Moxabustion can be continued on points such as Guan Yuan REN-4 or Qi Hai REN-6. If appropriate, some patients can take small regular doses of herbs like Jin Gui Shen Qi Wan as a pill.

As the weather gets colder another pitfall is stagnation of Qi and Blood. As a result many of my patients have been complaining of an increase in pain and stiffness. One of the best formulas for moving Qi and Blood is to increase movement (which is why in some systems of acupuncture, such as Tung’s, we combine movement with needling). Encourage patients to engage in some regular movement activity or exercise. If the weather allows, walking outside is great, or if the weather is bad then walking indoors at places such as shopping centers is an appropriate substitute.

Diet should also be modified to match the Minor Snow node. A very simple recommendation is to take a small amount of fresh ginger every morning just before breakfast, or alternately start the morning with a light ginger tea. Ginger warms and protects the Yang, and circulates Qi and Blood internally, thus satisfying the basic recommendations previously mentioned.

The other basic idea to follow for diet is to avoid foods that create internal heat rising, and incorporate foods that are gently heat clearing and Qi descending. This may sounds a bit contradictory, but the ancient Chinese realized this time of year people are prone to eat more meat. Before refrigeration this time of year there would be less access to fresh fruits and vegetables. If people have consumed more meat than usual over the last few weeks (think Thanksgiving with lots of turkey and heavy desserts), they may be prone to internal heat from diet. The way to counteract this is consuming just a little heat clearing and Qi descending foods. One traditional food for Minor Snow that does this is daikon (Asian radish). Small amounts of bitter greens, or more salty foods are also appropriate.

Here is a traditional recipe for Minor Snow:

Lamb and Daikon Soup 羊肉白蘿蔔湯

Ingredients:

Lamb ½ lb. (boneless)

Daikon ½ lb.

¼ large onion

Ginger, cilantro, salt and pepper

Directions:

Blanch lamb, drain away water and then cut lamb into cubes

Place blanched lamb back into pot, add ginger and sliced onion. Cover with an appropriate amount of water and bring to a boil Simmer for around another hour.

Cut daikon into cubes and add to pot, cook for another 10 minutes until daikon are translucent

Remove from heat, garnish with fresh cilantro and add salt/pepper to taste

This recipe warms the stomach, supplements Qi, protects the Yang and restores vigor to a weak body.

I hope everyone reading had a great Thanksgiving (even for those outside the United States) and that we are all staying warm!

Happy Thanksgiving & Sale Reminder

Happy Thanksgiving to all (for those of you out of the US, today is American Thanksgiving)! I want to thank everyone reading this blog for reading, attending my classes, and being supportive of traditional medicine in general.

This is also a reminder that Healthy Seminars is still running their Thanksgiving sale. I have one course on Tung’s acupuncture for women’s health with them. Here’s a chance to take that class and save! Sale ends on November 23rd. Click on the image below to go directly to my instructor page.

Beginning of Winter 立冬 Seasonal Node - Snow is on the way!

I have to admit to being remiss last month in getting my seasonal blog posts out. For those of us here on the east coast the weather wasn’t very seasonal. This led in my opinion to all sorts of patients complaining of unusual upper respiratory infections, and a lot of phlegmy coughs (for non-locals, the weather here was very, very wet). I’m going to try to get back in the swing of things though, particularly because the weather seems to have finally caught up with the seasons. Last week, Wednesday November 7th was the beginning of Winter in the Chinese calendar, and tomorrow we are forecast to have the first snow of the season! Right on time!

The beginning of Winter is also the Beginning of Winter (立冬) seasonal node. While in the west we consider Winter Solstice to be the start of Winter, in Asia the seasons are calculated by the balance of Yin and Yang in the natural environment as evidenced by the relative balance of day and night. Since Winter Solstice is the darkest time of year, it is considered to be the zenith of Yin, and hence mid-winter. Therefore, the early part of November is the beginning of Winter, the time of year that is darkest and most Yin.

Chapter 2 of the Huang Di Nei Jing says Winter is the time of “closing and storage” (閉藏). It is the season of hibernation and represents the death phase. However, this should not be construed as a bad thing. We need to enter the phase of ultimate silence and stillness, in other words the death phase, so that Yang (and Yang is life) can be reborn again. The organ associated with the Winter is the Kidney, and the phase is Water. Keeping this in mind will help us understand the basic health recommendations of this seasonal node. 

The three Material Manifestations that make up the Beginning of Winter Seasonal Node are Water Begins to Freeze (Shui Shi Bing 水始冰), Earth Begins to Harden (Di Shi Dong 地始凍), and Pheasants Dive into the Watery Abyss to Become Giant Clams (Zhi Ru Da Shui Wei Shen 雉入大水為蜃). All three contain striking Yin images, specifically images of water, of earth, and of moving deep to a hidden and quiet place. In general the main seasonal manifestation of Winter is cold, and Chinese medicine teaches that cold creates hardness and stagnation. Thus, as expressed in these names, both water and earth become hard and impenetrable.

The first suggestion for this seasonal node is to nourish and protect the Yang, or warmth of the body (養陽護陽). This is especially true for seniors, since as we age the body become less tolerant of temperature extremes. Be sure to dress appropriately for the cooler temperatures. Likewise, foods should be cooked or warmed when eating. This is not the time for copious amounts of raw vegetables, juices, or chilled foods and beverages. Soups and stews are winter foods! While in some seasons eating too many warming foods can trigger internal heat, this is less so in Winter. Why? For one, Winter is cold. Eating warming foods is necessary to counteract the exterior temperatures as they drop. Second, the natural Qi movement in Winter is inward and downward. As already mentioned, this is the time of “closing and storage.” Eating more warming foods in the Winter allows the body to secure and store that warm vitality, thereby strengthening the body for the seasons to come afterwards. So, eating more warming foods in Winter has fewer side effects than doing so in other seasons. 

Another recommendation for Beginning of Winter is the consumption of tonics. These are Chinese herbal formulas, often in pill form, that have an overall strengthening effect on the body. The specific tonic should be determined based on individual need, but in general formulas such as Jin Gui Shen Qi Wan can be taken in small but regular doses.

Since Winter is the season of the Kidney, the third recommendation for Beginning of Winter is to safeguard the Kidney and the Jing-essence. According to Chinese medicine there are three things that really deplete the Kidney and the Jing: (1) excessive sex, (2) staying up late and getting too little sleep, and (3) losing one’s temper. Excessive sex is certainly something that varies greatly from person to person. The question to ask patients is does sexual activity leave one feeling refreshed, or tired and worn out. If the latter, then it may be excessive. Staying up late goes directly against the movement of Winter, which is the movement of hibernation; Su Wen chapter 2 tells us that in Winter we need to get to bed a little earlier and sleep a little later, waiting until well after sunrise to get out of bed (早臥晚起,必待日光). Lastly, losing temper or having a generally angry disposition harms the Kidney. In the 39th chapter of the Su Wen it says that anger causes the Qi to rise (怒則氣上). Since the movement of Kidney is a movement of downward storage, anger forcing the Qi to rise depletes Kidney (i.e., it is the opposite movement of Kidney) and impairs the storage of Qi that is the natural and essential movement of Winter. 

Over the last week or so here in northern New Jersey we’ve been seeing a lot of simple colds and coughs. Allergies are still plaguing some as well. Winter is the time of year for these conditions, and in Chinese medicine this means that the exterior layers of the body, namely the Taiyang channel, is being challenged. A great basic acupressure to teach patients to help both expel and protect against wind evils is stimulation of Feng Chi GB-20. Massaging this point on a daily basis can help ward off colds and relax stiffness of the next and back that is a main characteristic of Taiyang patterns. If there is concurrent nasal congestions, they can also include acupressure on Ying Xiang LI-20. For this, have them hold Feng Chi on one side of the head while simultaneously pressing into Ying Xiang on the other (for example, their right hand presses right Feng Chi, while the left hand presses left Ying Xiang). Hold until there is a sensation of clearing in the sinuses, and then switch sides.

 

Diet for Beginning of Winter

The basic idea for Beginning of Winter diet is to focus on foods that are nourishing and supplementing agents. In general then we want to focus on foods that are warming and nourishing, usually meaning more animal products. We can incorporate foods that are slightly oilier, while still consuming in season fruits and vegetables while they last (we are in the very tail end of apple season here in New Jersey). Foods to incorporate more regularly include lamb, beef, chicken, sparrow, soybeans, sesame, wood ear mushrooms, peanuts, sweet potato, and persimmon (fresh or dried). Warming spices to use include ginger or cinnamon. And patients who are dry or have Yin insufficiency can take either cow or goat milk

However, China is a land of multiple culinary traditions and thus seasonal eating recommendations vary from place to place. In the north of China people eat dumplings (jiaozi 餃子), especially those made of lamb and scallion (we’ll discuss a dumpling legend below). In the west of China where it is particularly cold people commonly eat more beef and lamb often in hot pots. In the areas of the high plateaus and mountains the weather is very dry and as such more fruits and vegetables that are still in season are consumed. In the south of China, where it is still relatively more warm even though it is Winter, duck, chicken and various types of fish are traditionally eaten now (i.e., foods that are supplementing but not overly warming). 

One simple traditional recipe for Beginning of Winter is Ginseng Congee. To make this simply put 1 cup of rice in with about 8-10 cups water (increase or decrease based on how watery you like your congee), and 9-12g of high quality sliced and dried ginseng root. Bring to a boil and then simmer for at least 40 minutes, or until the rice starts to break up to make a porridge like soup.  Another idea that is easy to implement is adding Gou Qi Zi (Goji berries; 枸杞子) to a favorite chicken soup recipe. Doing so focuses the recipe on building the blood, and strengthening the Liver and Kidney.

 

Zhang Zhong Jing and the legend of dumplings…

Did you know that one of our most famous historical doctors, Zhang Zhong Jing, was not only a master of herbal medicine but also a culinary innovator? According to popular Chinese legend, Zhang was the inventor of the dumpling – jiao zi (餃子). Zhang held a mid-level government position in Changsha. The year he retired from political life he did so around the Beginning of Winter seasonal node. On his travels back to his hometown he came across many people who had suffered frostbite, and as a result had lost parts of their ears. This touched Zhang deeply as he felt sorrow for the suffering of those poor folk.

Once home he found his hometown suffering from an infectious epidemic. The people were starving from lack of food, and also suffering from frostbite. To remedy this he had his assistants set up a large pot on a public square to cook up a remedy. The formula he decided on was a combination of mutton with a number of very warm cold expelling herbs known as Qu Han Jiao Er Tang (去寒嬌耳湯) – Delicate Ears Expelling the Cold Decoction. After cooking the meat was chopped up and wrapped in small wheat flour skins in the shape of ears, and then cooked more and served to the people together with some of the soup. And thus the dumpling was born, as well as the tradition of eating them around the Beginning of Winter!

Autumnal Equinox 秋分 Seasonal Node

Today was one of the first days it honestly felt like Autumn here. The high temperature of the day was no more than the high 60s, and dry leaves are starting to accumulate at the curbs in front of my neighbors’ lawns. This is appropriate since Autumn Equinox is here! This is the day midway between the solstices, and being the midway point, the equinoxes are the times of even balance between Yin and Yang. Furthermore, Sunday September 23 begins the next 2-week long seasonal node, also called Autumn Equinox. In the Chinese calendar we are in the eighth lunar month and the time related to the Kidney channel. The smaller 5-day segments of this seasonal node are called Thunder Begins to Retract its Sound (Lei Shi Shou Sheng雷始收聲), Hibernating Insects Reinforce their Shelters (Zhi Chong Pei Hu蟄蟲培戶), and Water Begins to Dry Up (Shui Shi He水始涸). The names of these 5-day segments of time all point to a similar phenomenon – this is the time of year when the Yin-contracting movement of nature is in full gear in preparing for Winter’s slumber.

During this time of year the Nei Jing suggests that we “nourish the Yin” (春夏養陽,秋冬養陰) by conforming with the Yin-contracting nature of Autumn. In practical terms one meaning is that we should start getting more sleep. As the days grow shorter so should there be less activity. Thus, the Nei Jing says that we can still wake at the cock’s crowing, but we should be in bed earlier.

During this seasonal node one traditional recommendation is to guard the Lungs, and in particular the Lung Yin. Autumn is the season associated with the Metal Phase and therefore the Lung. Furthermore, Autumn is associated with environmental dryness so protecting the Yin fluids of the Lung is important. Some of the foods that protect the Lung Yin are milk, peaches, pears, apples, soymilk, glutinous rice, sesame seeds, and honey. Those who are adventurous can cook rice congee using white wood ear mushrooms.

Another method for helping the Lungs is acupressure at Chi Ze LU-5 (尺澤穴). This point regulates Lung function and treats conditions such as cough, wheezing, asthma, the common cold and seasonal allergies. It is also the Water point on the Lung channel meaning that it is appropriate for both the season (Autumn relates to the Lung) and the Lunar Month (the eighth Lunar Month relates to the Kidney channel, which is the Water phase).

In addition to environmental dryness, this time of year sees temperatures dropping. Therefore, while we focus on protecting the Lung we should also be cautious about cold exposure. People who are cold and fatigued in general should focus on warming and supplementing the body this time of year. Wearing adequate clothing is an important part of this strategy. Additionally certain warming and supplementing Chinese herbs can be consumed as functional foods. For example, one traditional recipe for the Autumn Equinox Seasonal Node is Angelica and Codonopsis Lamb Soup. To make this, take 1lb organic lamb meat and cook in an appropriate amount of water with 10g Chinese Angelica (Dang Gui 當歸), 10g Codonopsis (Dang Shen 黨參), 30g Angelica Dahurica (Huang Qi 黃耆), 10g fresh ginger, and salt and pepper to taste. Other in season vegetables can also be added as desired. This recipe warms the Kidneys, supplements the Yang, quickens Blood and moves Qi.

A great tea for general use appropriate to this time of year is Chrysanthemum with Honey (菊花蜂蜜茶). To make, take about 1 tablespoon of dried chrysanthemum (the kind sold as a Chinese herb). Steep in boiled water for 3-5 min and then stir in some honey to taste. This tea can treat seasonal allergies such as dry, itchy eyes or headache. This recipe nourishes the Liver, brightens the eyes, moistens the Lung and awakens the brain.

As the weather gets colder and we move to the dark time, this is the time to start preventive moxa treatment for the Winter. This is especially important for patients who are cold and vacuous. Starting some weekly moxa at Zu San Li ST-36 (足三里穴) will go a long way to keeping vitality strong the in months to come. An alternate is to apply moxa to Huo Fu Hai 33.07 (火腑海) on a regular basis.


Qigong and the Seasons

When people think of Qigong practice, or Taiji practice for that matter, there is the image of Chinese practitioners up very early in the morning in parks going through their routines. Early morning is a traditional time for practice, but not the only best time. Generally speaking, practices such as Qigong are best practiced at four possible times of day: 5-7am, 11am-1pm, 5-7pm, and 11pm-1am (all adjusted for Daylight Savings Time).

Why these times?

These four times of the day are like the four cardinal directions. The hours around high noon and midnight both respectively are the most Yang and Yin times of the day. The 5-7 hours (either am or pm) are then the midpoints of the day when the movement of Yin and Yang is most balanced. Practicing during these times allows us to ride the movement of Yin and Yang to make our Qigong practice all the more effective.

These times are also representative of different times of the year. Noon corresponds to the Summer Solstice, Midnight corresponds to the Winter Solstice, 5-7am corresponds to the Vernal Equinox, and 5-7pm corresponds to the Autumnal Equinox. As the name suggests, the Equinoxes are the most balanced times of the year in terms of Yin and Yang. As such, on these days practicing Qigong with the effort of creating internal balance is very appropriate. In the system of Qigong I practice one of the fundamental exercises is the collecting the Qi patterns (採氣功). Around the Equinox we can all practice equal numbers of repetitions for all three of these exercises to balance the body overall.

So, I hope everyone is having a very peaceful and balanced Equinox! If you are local and would like to join us for Qigong practice, click here for more information.


End of Heat 處暑 Seasonal Node

By all accounts, this August was an uncomfortable one here in Northern New Jersey. It was fairly wet and rainy, and it was hot. All combined together, the humidity was oppressive, and all the moisture means mosquitoes everywhere! However, just on time, last night a high pressure system from Canada moved down into the northeastern US and the temperatures dipped into the low 60s overnight. Cooler and drier weather made sleeping much nicer, and it looks like the trend of cooler evenings will continue for at least a little longer.  The reason I say this happened just on time is that today is the start of the first Seasonal Node after the beginning of Autumn – Chu Shu 處暑, ‘End of Heat’.

Autumn is the time of year when Yin grows. All things are moving towards the hibernation phase and many plants are being readied for harvest. The names of the smaller 5-day periods of this seasonal node are quite interesting and illustrative of what Autumn represents. The first is called Ying Nai Ji Niao 鷹乃祭鳥, Hawks Start to Sacrifice Birds. This time of year starts the slow march towards the death phase of nature, and many plants and animals with short life spans won’t make it to next Spring. The image of hawks harvesting or killing smaller birds then fits perfectly with this image. The next two 5-day time periods are Tian Di Shi Su 天地始肅, Heaven and Earth Become Austere, and He Nai Deng 禾乃登, Rice Plants Are Harvested and Presented as Offering. Just as this is the time of year for bringing things to harvest, it is also the time for us to start becoming quieter and more introspective, for us to take stock of what, out of the myriad things in our lives, is really important (i.e., we become austere like heaven and earth).

In more tangible respects there are things to keep in mind to maintain health this time of year. The first traditional recommendation for Chu Shu is Ben Franklin’s favorite – ‘early to bed, early to rise’ (zao shui zao qi 早睡早起). When Yin predominates in the natural environment we can mimic that in our own body by getting more sleep. In the summer it is permissible to stay up later and still wake up early. In the Yang time of year less sleep is just fine. However, now that Autumn (a Yin season) is upon us, we need to get a little more rest. My general recommendation to patients is to get into bed a bit earlier, preferably before 11pm or midnight. Here’s a little quiz for other Chinese medicine providers – why is it important to get to bed before this hour? (Hint – it isn’t because of the Liver hour just afterwards)

The weather pattern associated with Autumn is dryness and thus another caution during Autumn is not becoming too dry (although right now as I write this in NJ that seems like an unlikely scenario). One way we do this is through diet; now is the time to focus on shao xin, zeng suan 少辛增酸 – ‘less spicy, more sour’. Spicy flavors have a mild drying quality as well as a sweat promoting quality, both of which dry the body. To the contrary, sour foods are gently moistening and hold in sweat. Increasing the amount of foods such as vinegar, pickled vegetables, and fruits such as plums is appropriate to the season. Other moistening foods include milk, soymilk, and fruit juices (especially apple or pear). This recommendation should be taken less seriously for those with very damp constitutions or presentations.

One traditional recipe for this season is Pear and White Wood Ear Soup. This dish is just simply delicious, and it is effective for supplementing the Lungs, nourishing fluids, and moistening dryness (without being so cloying as to create dampness).

 

Pear and White Wood Ear Soup 雪梨銀耳湯

Ingredients:

  • 1 large Asian pear 雪梨
  • 2 dried white wood ear mushrooms 銀耳
  • 1 small fresh edible lily bulb 百合
  • About ½ cup white or rock sugar

Directions:

  1. Soak wood ear for about 30 minutes, until softened
  2. Rip wood ears into bite sized pieces, peel and cut pear into medium bite sized chunks, and separate out lily bulb into individual corms
  3. In a pot, put about 6 cups of water together with all ingredients; bring to boil and simmer for 30minutes to 2 hours on a very low heat

For those who like wood ears crisper, go for the shorter simmer time. For those who like things softer and more gelatinous, cook longer. My suggestion is to take small tastes along the way. This soup can be served warm or chilled (depending on preference and outside temperature).

The last recommendation I’ll offer is for those patients who continue to experience symptoms of damp, heat, or the combination thereof in the form of summerheat. A traditional channel based recommendation for Chu Shu is regular acupressure on Cheng Shan BL-57. This point helps expel damp and clear heat, and treats many symptoms of lingering summerheat such as headache, body aches, heavy limbs, or diarrhea. Notice that this area of the leg is one of thick flesh, and remember that the seventh chapter of the Ling Shu describes a needling method based on the five tissues and their relationships to the five viscera. One of the passages from that chapter reads:

四曰合谷刺,合谷刺者,左右雞足,針於分肉之間,以取肌痺,此脾之應也
The fourth is called united valleys piercing. United valleys piercing is to pierce left then right from the same hole, like a chicken's foot. Pierce to the division between the flesh. This treats flesh block (bi). It is in resonance with the Spleen.

Here we see that needling into fleshy areas of the body treats problems of the flesh as well as treats problems of the Spleen. As dampness is the disease evil of the Earth phase (and thus the Spleen), this needling technique also has resonance with its treatment. For example, over the last few weeks, patients in my office have been complaining of aching and heaviness in the joints, especially of the knees, hips and in general lower extremities. This is because dampness, as a Yin disease evil, commonly moves down in the body. One of the points I’ve been using over and over again to work with this is Jian Zhong 44.06. The point, located on the shoulder, is in a fleshy area of the body just like Cheng Shan BL-57 is. Likewise, it treats damp accumulation of the joints and extremities. Other points in the shoulder area, such as Bei Mian 44.07, are specifically indicated for digestive problems such as abdominal distension, vomiting or enteritis. This is because, like Jian Zhong 44.06 and Cheng Shan BL-57, Bei Mian is in an area of thick flesh and thus treats problems of the Spleen. This time of year as we are still experiencing summerheat and dampness, these types of points can be frequently used.

Today starts Ghost Month 鬼月!

Today is the first day of the seventh lunar month. In the traditional Daoist calendar this is the day that Yama, the King of Hell, opens the gates of hell to allow all the spirits of the deceased to wander the earth – basically a one-month vacation for ghosts. This happens until the gates are once again closed at the end of the lunar month. The culmination of the month is the 15th lunar day (this year August 25), which is known as Zhong Yuan Jie (中元節).

Yama 閻王爺 - King of Hell

Yama 閻王爺 - King of Hell

Throughout this month there are many taboos that Chinese culture observes. These include not allowing the elderly, the very young or generally physically weak people to do various activities outside at night. This is the time of day when ghosts are most active! Qigong should also not be practiced outside late at night during this time.

Whether or not we believe that this month is the time of ghosts, what this custom perhaps does is remind us of how the natural balance of Yin and Yang is shifting in a very real way this time of year. A few days ago I posted a blog about the beginning of Autumn. Even though days are still hot in August, it is true that we are in the beginning of the Yin portion of the year. After the Summer Solstice the days start to slowly get shorter. By August here in northern New Jersey plant growth is mostly over. Even the grass is growing more slowly than before. In the environment we are seeing a significant increase in dampness and humidity – water being a Yin substance. Now, one of the main pathological environmental factors our patients face is dampness, or summerheat-dampness (a combination of pathogenic Yin and Yang together).

When I look at customs like the ghost month, I see other interesting health recommendations. For example, I usually practice Qigong in the evening, but I am certainly not practicing outside at night this month (my kitchen is my usual practice spot these days). Ghosts or not, there are so many mosquitoes and insects outside that there’s no way I can practice Zhan Zhuang (standing post) outside! These types of insects, as vectors for disease, can cause serious problems in people who might be more vulnerable – such as the elderly, the young, or the sick. This week New Jersey had its first confirmed case of West Nile virus, a disease spread by mosquitoes. While most health people are fine when bitten by ticks or mosquitoes, people who are weaker, or those with some sort of compromised immune function are at greater danger. Interestingly, modern research has shown that some traditional taboos during ghost month actually lower mortality rate for the month (click here for some research). 

Other health recommendations this time of year also focus on counteracting the growing Yin. In some parts of China around the time of Summer Solstice there is the custom of hanging herbs such as Ai Ye and Shi Chang Pu above doors. Both Ai Ye and Shi Chang Pu are aromatic, and the aromatic nature is Yang that can disperse Yin influences as well as ward off insects.  Some people will also put powdered Xiong Huang (realgar) at the bottoms of doors to keep bugs out of the house (realgar is a very toxic medicinal).

In terms of internal herbal medicine, this is the time of year when a lot of patients benefit from formulas such as Huo Xiang Zheng Qi Tang. This formula contains aromatic and Qi moving medicinals such as Huo Xiang, Hou Po, Chen Pi and Bai Zhi to transform damp. It also includes medicinals that likewise strengthen the Spleen so as to allow for normal movement and transformation (the Yang functions of the Spleen). This idea of expelling the Yin and supporting the Yang is the same principle underlying the use of San Fu moxa (see previous blog posts).

So, please be careful out there and avoid the Yin, ghosts or not. But, just to be sure, I for one will be burning some joss paper outside later today to appease some ghosts!

Beginning of Autumn 立秋 Seasonal Node

I’m just getting back from a great two weeks in China with my Shifu, Wang Fengming, and this was the first time I took my son Henry along with me to train Taiji there. As we were taking the bullet train from Beijing down to Hangzhou I was reminded about last year’s train ride. I wrote about it in this blog at the time, but since it was so interesting I decided to repeat the material here again this year.

During that trip last July I sat next to a lovely older Chinese woman who, when she realized I spoke Chinese and was a professional doctor of Chinese medicine, was rather chatty. As she was from Fujian, her Putonghua (standard Chinese) was about as good as mine, so we were on pretty even footing there. We talked a lot about Chinese culture and health, which is a topic a lot of Chinese people really like to talk about. The reason I bring this up is because she had a personal Seasonal Node practice she was happy to share with me. It turns out when her son was younger he had some sort of chronic health problem (I think it might have been asthma). She took him to see a famous old Chinese doctor (老中醫), a term they use to describe a physician with many years of experience, who in addition to treating her child gave her a Seasonal Node regimen to follow.

What the old doctor told her to do was to take a chicken, and stew it with ginseng to make soup. This would be eaten on the beginning day of every Seasonal Node without fail, not being off by even one day. The recipe can be varied based on the individual characteristic of the person. For example, some people might not tolerate red ginseng and can substitute American ginseng. Blood vacuity patients can use Dang Gui instead. If people are particularly healthy already then just plain chicken soup is fine. But the important thing is without fail to do this the first day of each Node, for a minimum of three years (this is similar to the San Fu moxa being done over three years – a therapy the Chinese woman was also familiar with). She said she had followed this regimen now for several decades and hasn’t had a cold or other respiratory tract infection since she started. I thought this was a great tip to pass on to everyone.

Now, on to the current Seasonal Node… In the traditional Chinese calendar August is the beginning of Autumn, and this year Tuesday, August 7th, marked the beginning of the new season. Although in the western world Autumn is a summer month, the Chinese calendar is concerned with the relative balance of Yin and Yang in the natural environment, which is closely tied to day length. Summer Solstice in June was the longest day of the year. By now the days are getting gradually shorter, and we are only 6 weeks away from the Autumnal Equinox, a day of balanced light and dark. Even though August weather can still be hot we are in the time of Yin and contraction in the natural environment.

While the weather is beginning to shift to Yin, August can still be damp and humid. This week here in Northern NJ that is certainly the case! In Chinese medicine, weakness in the Spleen and Stomach leads to damp accumulation. In early Autumn we therefore should avoid dampness and simultaneously strengthen the digestive organs. One way to accomplish this is to eat light and clear foods, increase the amount of seasonal vegetables, and eat a little less meat. Vegetables can be consumed lightly steamed or stir-fried, or in the case of light salad greens, raw. In general avoid overly hot, spicy foods. Congees are appropriate to help strengthen the digestive organs and one traditional congee recipe for this seasonal node is Euryale Seed and Discorea Congee (Qian Shi Shan Yao Zhou 芡實山藥粥).

 

Euryale Seed and Discorea Congee (Qian Shi Shan Yao Zhou) 芡實山藥粥

Ingredients:

  • 1 cup rice (use glutinous rice if available)

  • 200g Euryale seed (Qian Shi )
  • 200g Discorea (Shan Yao )
  • 200 g sugar

Directions:

  1. Grind rice, Euryale seed, and Discorea to a powder. Mix the three together with sugar and blend well so evenly mixed
  2. In a pan, add 50 – 100g of blended powder to cold water, enough to make a thick soupy consistency
  3. Put over medium flame and warm for several minutes, stirring occasionally
  4. Enjoy in the morning on an empty stomach (consume warm)

This congee strengthens the Spleen, stops diarrhea. However it is contraindicated for patients with diarrhea due to infections, or with damp heat type diarrhea.

 

In addition to dietary recommendations we can perform acupressure on supplementing points such as Zu San Li (ST-36). If patients tend to cold and vacuous patterns of the Spleen and Stomach, gentle direct thread moxa at Zu San Li is also applicable. In terms of Tung’s acupuncture we can needle the Zu San Tong (足三通) Dao Ma group, consisting of Tong Guan 88.01, Tong Shan 88.02 and Tong Tian 88.03. These points are the main Dao Ma group for Heart, but really they function like Pericardium channel points, which is why they are indicated for Spleen and Stomach problems. Furthermore in terms of Five Phase theory, supplementing Heart will strengthen Spleen because of the engendering cycle relationship between Fire and Earth.

Autumn is the season associated with the Lungs, and thus even though we should avoid very spicy foods, mildly acrid foods are good this time of year for Lung function. These foods include ginger, scallion, leek, and black pepper. Mildly sweet and slightly sour fruits also help moisten and benefit the Lungs, including the now in-season stone fruits (i.e., plums and peaches). This recommendation however should be based on individual patient characteristics. For example, if patients have Spleen vacuity with dampness they should avoid overly sour foods.

In August we need to be cautious of sudden return of very hot and humid weather, the very weather pattern happening this week in New Jersey. In Chinese this is called “The Old Tiger of Autumn” (Qiu Lao Hu 秋老虎), and is similar to what in the west we would call an Indian Summer. When the old tiger rears its head again Summerheat pathogens are a risk – symptoms of this include headache, dizziness, nausea or vomiting, poor appetite, stuffy chest, heavy or fatigued limbs, and possibly diarrhea. If intense hot and damp weather returns, focus the diet on foods that are cooling and moistening. Foods to consider adding on a daily basis include all sorts of sprouts (e.g., mung bean or alfalfa), cucumbers, muskmelon, winter melon, tomato, and loofah. Mung beans are very cooling, and in hot weather they can be made into a sweet dessert soup. For more serious conditions consider giving patients formulas such as Huo Xiang Zheng Qi San.

Here’s a formula from the Zun Sheng Ba Jian (遵生八箋) – the Eight Treatises on Following the Principles of Life. Written by a scholar by the name of Gao Lian at the end of the Ming Dynasty (1368-1644), the text is an almost encyclopedic collection of all manner of Nourishing Life (養生) recipes, techniques, theories, etc… One of the formulas specifically for Autumn is called Conserve the Spleen Pill (攝脾丸). It treats damage to the Spleen that happens during the Autumn months that leads to abdominal bloating and diarrhea. The ingredients listed are Mu Xiang, He Zi, Hou Po (ginger fried), Wu Bei Zi (slightly toasted), and Bai Zhu (earth fried). These ingredients would be ground to a powder and made into pills the size of a Tung Tree seed, and 10 pills would be a daily dose.

I hope everyone is having a great end of Summer and start of Autumn!

Visit to the White Cloud Temple

I'm in Hangzhou, China as I write this with my Taiji and Neigong Shifu Wang Fengming. Before coming I was in Beijing for a few days, and when I'm there I usually like to visit the White Cloud Temple (白雲觀), the modern headquarters of Quanzhen Daoism and the Chinese Daoist Association. Unlike many of the other sights in Beijing, including most large Buddhist temples, the White Cloud Temple is usually an oasis of quiet in Beijing's sea of people. 

At the temple there is one shrine devoted to medicine, where Zhang Zhong Jing, Sun Si Miao, and Hua Tuo are venerated in deity form and worshiped. Here is a photo of my son Henry outside of that small temple.

Outside the temple of the three Medicine Deities at the White Cloud Temple

Outside the temple of the three Medicine Deities at the White Cloud Temple

In the back area of the temple along one wall (the first time I went to the temple about 10 years ago I actually couldn't find it) are two stone steles that depict the inner landscape of Daoist cultivation. One, the Neijing Tu (Diagram of the Internal Pathways), is perhaps one of the most famous diagrams of Daoist Inner Alchemy. I first saw a rendition of it back in 1996 when I started my practice of Daoist meditation, and I also have a rubbing of the stele hanging in my office in NJ. The stele was carved back in 1886 and then installed at the current location in 1890.

The Neijing Tu 內經圖 at the White Cloud Temple

The Neijing Tu 內經圖 at the White Cloud Temple

And this last photo is one I really like. I took a few minutes this trip to really inspect the carving up close (you can walk right up to it in the temple and even touch it). This is a close up photo of the artist's representation of the Dan Tian in the stylized lower abdomen. The Chinese characters here read "True Dan Tian" (zheng dan tian 正丹田).

The Dan Tian

The Dan Tian

New Foundations of Tung's Acupuncture Course (in NYC!)

This coming fall I've decided to teach an ongoing course on Tung's acupuncture in New York City. Unlike most Tung classes, this one will be a weekly meeting to allow people to better absorb the material over time, rather than trying to get a lot of hours in a single weekend. So, this fall we will cover 30 hours total of training in the fundamentals of the Tung system over a period of 10 weeks. Class is filling up fast though, and there are only 2 or 3 more seats left. If you are interested, please let me know as soon as possible by contacting us through this website.

Click here to read more about the course, see the schedule, and look at course fees.

Great Heat 大暑 Seasonal Node

I am currently away in China training with my Shifu Wang Fengming. Since I know I won’t have time to write a new post for this seasonal node I’m simply reposting the same one from last year (with appropriate dates changed for 2018)…

For me, the days of summer seem to fly by very quickly (winter days don’t seem to suffer from this same phenomenon). As I looked out my back door this morning, I saw our cucumbers and bitter melons fruiting. All the lettuces are now done, and while plants are still green and full, they have reached their maximum growth. In stark contrast, just several weeks ago they seemed to be getting bigger and bigger even by the hour! This is characteristic of the Yin-Yang balance of the season. We are past summer solstice, the zenith of Yang and expansion in the natural world. In the Chinese calendar Autumn is little more than 2 weeks away, not because of temperature, but rather because of day length. The Chinese medical classics describe the movement of Summer as ‘zhang’ 長 – growth, increase, enhancement. The movement of Autumn is ‘shou’ 收 – collect, harvest, put away, take in. Now growth has slowed and the harvest is not long away, and indeed we are in the transition away from ‘zhang’ moving towards ‘shou.’

This year, today, Monday July 23, starts the last node of Summer in the Chinese calendar – Great Heat (Da Shu 大暑).  The first word of the name “Great,” gives us the idea that this is the hottest time of the year. In some parts of the world it can also be one of the dampest times of year.  As we’ve discussed before, each of the 24 seasonal nodes (jie qi 節氣) can be further broken down into 3 five-day periods of time, known as the 72 Material Manifestations (wu hou 物候). The 3 periods within Great Heat are Decaying Grass Transforms into Fireflies (fucao hua wei ying 腐草化為螢), The Earth Lies Wet Beneath Sweltering Heat (tu run ru shu 土潤溽暑), and Heavy Rains Fall Intermittently (da yu shi ying 大雨時行). In these rather poetic names we see the images of plant life coming to an end of growth (in particular, delicate plants such as grasses, or, in my garden, lettuces), and we also see references to the combination of both dampness and heat in nature. This year here in northern New Jersey we are right on schedule with this general prediction.

The health maintenance guidelines for Great Heat are to focus on clearing heat, boosting qi, and treating winter diseases ahead of time (冬病夏治).  Clearing heat seems to be intuitive – too much heat in the body needs to be removed to keep us in balance. But why should we also boost the qi? The Yin Yang Ying Xiang Da Lun (Su Wen Chapter 5) says, “the qi of strong fire weakens” (壯火之氣衰), “strong fire feeds on qi” (壯火食氣), and “a strong fire disperses qi” (壯火散氣). The reason we need to boost qi this time of year is because too much heat in the environment drains and weakens the qi internally. Likewise, excessive sweating damages both the qi and the fluids. One potential general maintenance herbal formula this time of year is Sheng Mai San, the combination of Ren Shen, Mai Men Dong and Wu Wei Zi. When giving this formula during Great Heat, my suggestion to use either plain Chinese white ginseng, or American ginseng, as Korean red ginseng will be too hot. Sheng Mai San in small doses builds qi, clears heat, and nourishes the fluids with herbs that are not so cloying that they would worsen internal dampness.

We previously discussed the idea of treating winter disease in summer, one of the main methods being San Fu moxibustion and Korean Chicken Soup with Ginseng. The idea here is to use the warmth of the season to strengthen the Yang qi, and thereby prevent disease during the cold seasons. In addition to the two previous therapies, this time of year we can start applying regular moxibustion. The Bian Que Heart Classic (扁鵲心書) suggests that every year at the transition between summer and fall we should apply moxa to Guan Yuan REN-4. As part of the recommendation the text suggests the application of 300 cones every 3 years for people over the age of 30, every 2 years for people over the age of 50, and yearly once age 60 is reached.  While 300 seems like a lot of cones, we don’t have to do them all in one sitting. Break up application of moxa into smaller amounts of cones and proceed daily for several weeks; in other words we are looking for a total of 300 over time, not 300 all at once. Other points to consider for moxibustion include Zu San Li ST-36, Shen Que REN-8 and Qi Hai REN-6.

The caution for Great Heat is to be on guard against damp-heat and its ability to damage the Spleen-Stomach and hamper appetite and digestion.  One way to do this is through diet, which we discuss below. Another traditional recommendation to accomplish this during the current seasonal node is herbal foot bathing.  One effective Great Heat footbath recipe includes Pu Gong Ying 30g, Su Mu 30g, Gou Teng 25g, Fu Ling 25g, Bai Fan 15g, Fang Feng 15g, Han Fang Ji 15g.  Boil these herbs in about ½ gallon of water for 20-30 minutes. Then, cool until able to be used as a warm soak, and soak feet for about 30-40 minutes. These herbs are also effective for treating athlete’s foot, a common problem of this time of year, and a very obvious manifestation of excess damp-heat. For this condition use the same soak frequently, at least twice daily, with 3 days (of twice daily) being one course of treatment.

For practitioners of Tung’s (Dong’s) acupuncture, we can apply these same principles in general maintenance or preventive treatments. In point prescriptions consider adding points that have a general qi supplementing function such as Ling Gu 22.05 and Si Hua Shang 77.08. We also can choose points that generally clear heat such as Zhong Kui or the Wu Ling and Shuang Feng points along the back. In my bloodletting book I also detail another Taiwanese method of treating excessive summerheat by bleeding. Click here for more information on the book. For patients who tend towards being deficient, after bleeding in the clinic administer one dose of Liu Wei Di Huang Wan in tablet form (this was Master Tung’s practice in his own clinic).

 

Diet for Great Heat

Along with the guidelines described above, during Great Heat we should simultaneously clear heat and drain damp, while boosting the qi and protecting the Spleen and Stomach. Avoid overly spicy foods and foods which are overly heating. This is the time of year to eat in-season vegetables, especially those that clear heat and nourish fluids such as cucumber, raw tomato, and bitter melon. Gentle heat clearing herbs can be added to the diet such as mint and Huo Xiang (agastache), and this is the seasonal node when Huo Xiang congee is traditionally consumed.  In China people drink winter melon juice during Great Heat. I honestly don’t find this too appealing so I suggest in the west we substitute winter melon juice with watermelon juice!

One fun recipe for Great Heat is stir fried lotus root…

 

Stir Fried Lotus Root

Ingredients:

  • 1 lotus root (about ½ lb)
  • 1” piece of ginger, chopped
  • 1 cup roughly chopped scallion
  • 2 cloves garlic, peeled and chopped
  • 1 tablespoon sesame seeds
  • white vinegar
  • cooking oil (sesame)
  • soy sauce or tamari

Directions:

  1. Peel lotus root and cut into slices about ¼ inch thick, submerge in water with a small amount of white vinegar to prevent discoloration
  2. Heat some cooking oil in a large frying pan, add ginger and garlic and cook until fragrant
  3. Drain lotus root and place the slices in pan in a single layer; cook until they start to change color and become slightly translucent and then turn over and cook a few minutes longer
  4. Add in sesame seeds, a splash of soy sauce or tamari, and the scallions and fry a short while longer until the scallions start to wilt
  5. Remove from heat and enjoy

This recipe stops thirst, expels heat, and clears heat to engender fluids. Furthermore, it also supplements the center and nourishes the shen-spirit.

I hope everyone is staying cool and dry!

Henry

It's San Fu 三伏 Time (and a Neigong recommendation)

As I mentioned in my blog post on the Minor Heat Seasonal node it's San Fu time of year again! San Fu Moxibustion 三伏灸 was originally used to treat chronic respiratory problems such as asthma, although in modern times it has been expanded to other conditions. The basic theory of San Fu treatment combines the effective use of hot herbs applied to acupuncture points on the body during the hottest (i.e., most Yang) days of Summer. Doing so very aggressively expels cold that may linger in the body and also support the Yang and the Upright. Obviously however, this treatment is designed for patients who are vacuous and cold, and should not be performed on patients that in general have primarily hot conditions.

Treatment days are chosen based on the traditional Chinese calendar. The first of the San Fu days is the third geng (Yang metal) day after Summer Solstice in the Chinese calendar. The second day is 10 days after the first, and the third day is the first geng day after the Beginning of Autumn (which falls at the beginning of August). Usually there are three days in this method of day selection, but occasionally there is a fourth that can be used. This year (2018) the San Fu days are July 17, July 27, August 6, and August 16. Around noon on these days (noon is a Yang time) a special paste is applied to acupuncture points on the upper back that all warm the Yang qi and expel cold. While recipes for this paste vary, they include very hot herbs such as mustard seed (bai jie zi), asarum (xi xin) and ginger juice. Ideally this paste is also prepared ahead of time and allowed to cure for a full year, but freshly made paste works as well. People interested in learning more about San Fu Moxibustion should read Lorraine Wilcox’s book on moxibustion - Moxibustion: A Modern Clinical HandbookYou can also visit the website of my student Dr. Heidi Lovie. She produces San Fu powder for those who are not inclined to grind for themselves.

In Korea the San Fu days are a time to eat Ginseng Chicken Soup for the same reasons we do San Fu mustard plasters. Also, those of you who practice our lineage of Neigong should practice more Gathering the Yang of Heaven (see video below). Do just this one Gathering the Qi exercise on the San Fu days, and practice for a longer period of time. For example, consider 108 repetitions of just this posture, followed by a longer period of standing post.

This year I did once again prepare my own San Fu paste. Blow the Neigong video you'll see photos of the process of making the powder. Enjoy the hot summer days!

This is a demonstration of the Gathering the Yang Qi of Heaven exercise with and without the Tai Ji Ruler.

Weighing out the ingredients for the San Fu plasters

Weighing out the ingredients for the San Fu plasters

Putting the ingredients into the grinder

Putting the ingredients into the grinder

Sifting the powder to be sure it is of a fine consistency 

Sifting the powder to be sure it is of a fine consistency 

New Expanded Edition of the Tung Atlas is here

The long awaited 6th and expanded edition of the Tung Atlas by Dr. Ross and myself is now available. We are waiting to get the shipment of books into the US from Germany, but the main importer, Kamwo Herbs, is now taking preorders. Click here on the photo to go to their website. Some of the features of the new edition include:

  • This new edition has several helpful new features:
  • Expanded selection of points - almost double the points on the fingers and hands as previous editions, and more body points as well.
  • Additional TCM style point functions for all points - to help bridge the understanding of   the Tungs system for TCM trained practitioners.
  • New chapter on palm diagnosis.
  • Expanded indexes by disease.