Tung Acupuncture Historical Musings (Repost)

I originally posted this back in 2015, but the topic came up in a recent class I was teaching so I thought I'd post again with some edits... Enjoy!

The Tung (Dong 董) lineage of classical acupuncture claims a history that stretches back to the Han dynasty (206ACE – 220BCE). However, as is the case with many other private family lineages, we cannot with any academic certainty verify this claim. There are some hints however in how the system is organized and presented that tease us and perhaps point to a long pedigree.

First, of all the channels of regular acupuncture, the one that is least represented in Tung’s system is the Heart Channel. In fact, in Tung’s original book from 1973 there was only 1 point located on the modern Heart channel – Shou Jie 22.10 (overlapping Shao Fu HT-8). In the early medical classics, such as those unearthed at Ma Wang Dui in the early 1970s, there were 11 vessels, but no vessel that corresponds to the modern Heart channel. Likewise, the modern points of the Heart channel did not exist in the Huang Di Nei Jing or Nan Jing. For example, in the Jiu Zhen Shi Er Yuan (九鍼十二原, Ling Shu Chapter 2), the Yuan-source point of the Heart is listed as Da Ling PC-7 大陵穴. The modern Pericardium channel often was the acupuncture channel of choice for treating Heart.

In Tung’s acupuncture many of the points used to treat “Heart” problems such as cardiovascular disease, palpitations, or chest pain, are related to the Pericardium channel. Notice that Shou Jie 22.10, although located on the Heart channel proper, is not indicated for cardiac problems. For example, Ren Shi 33.13, a point that treats heart disease and palpitations, is located on the Pericardium channel (at least by some practitioners). Other points that treat Heart problems are notably located on the Stomach channel – Huo Bao 55.01, the Si Hua points, and the Zu San Tong Dao Ma group (i.e., 88.01, 02, 03). The Yangming Stomach channel treats Heart because it has a relationship to the Jueyin Pericardium (through the Wu Zang Bie Tong 五臟別通 pairings). In the early Chinese language dictionary the Shuo Wen Jie Zi the Heart is defined as the “the human Heart, the Earth Zang-viscera, located at the center of the body” (心:人心,土藏,在身之中), showing us that in very ancient times there was a close conceptual connection between the Heart and the Earth phase. In modern acupuncture theory the channel that most closely correlates to that constellation is the Pericardium. Thus, the location of “Heart” points in Tung’s acupuncture (mostly being related to Pericardium) may give away a hint at the system’s antiquity.

The other interesting piece of information on which to speculate is the “reaction areas” that were given in Tung’s original book. The term “reaction area” is an apologetic translation of Shen Jing 神經 – nerve. Nerve was the term that Tung chose to approximate, in modern ‘scientific’ language, the word “channel” – Jing 經. Therefore, Tung would have originally said that, for example, the Zu San Tong 足三通 points were the “Heart channel” since they are listed in his book as having the Heart reaction area. In modern acupuncture all the channels, with the exception of the Eight Extraordinary Vessels, are named after Zang or Fu, so some of the reaction areas in Tung’s acupuncture are easy to understand. That said, some points in Tung’s system are given reaction areas that are body parts other than the Zang Fu. For example, Ce San Li 77.22 and Ce Xia San Li 77.23 are listed as the reaction area of the teeth. Si Zhi 77.20 has a reaction area of the four limbs. So, does this mean that originally Tung considered them related to the Tooth Channel or the Four Limbs channel? That doesn’t sounds like Chinese medicine. Or does it?

It turns out that in the very early medical literature, there were some acupuncture traditions that named channels after body parts other than the Zang Fu. In the Ma Wang Dui medical manuscripts (that date to the turn of the Han dynasty) there is a manuscript called the Yin Yang Shi Yi Mai Jiu Jing Jia Ben (Cauterization Cannon of the Eleven Yin and Yang Vessels, Edition A 陰陽十一脈灸經甲本). That treatise lists a "shoulder vessel" (corresponding to the modern Arm Taiyang), an "ear vessel" (corresponding to the Arm Shaoyang), and a "tooth vessel" (corresponding to the Arm Yangming). So, in at least one very early moxibustion lineage/tradition, there was a custom of naming some channels after body parts rather than a Zang Fu or a channel layer. And there was a Tooth Channel! The Tung lineage custom of naming channels after body parts seems to be not so unique. Also, perhaps this again argues for the veracity of the Tung family's claim of how old their system is.

All of this is certainly wild speculation, and it isn’t historically convincing. Yet, the coincidences are fun to play with. Perhaps we are all practicing the descendant of something very ancient that has survived alongside many other, more dominant traditions. Perhaps it is a modern link to a very ancient system of practice, even older than other “classical” acupuncture. Or perhaps not…

 

References:

Harper D. Early Chinese Medical Literature. London: Kegan Paul International, 1998; pp.206-207.

Tung, C.C. (1973) 董氏針灸正經奇穴學 [Tung Lineage Acupuncture Study of Orthodox Channel Curious Points]. Taipei: Hsin Ya Publications Ltd.

Autumn Courses Coming Up Soon

Hi all! This is just a reminder that my last few courses in 2017 are coming up soon. Later this month I'll be in Denver (click here for more information on Denver). And then in November I'll be at PCOM Chicago (click here for more information on PCOM Chicago). Both courses have limited spots available so please sign up soon.

In 2018 I'll be back in Germany, and early in the year I'll be making a trip to teach in Australia. Be on the lookout for more online courses as well. I'll post more about that when more information is available. 

Happy Mid-Autumn Moon Festival 中秋節快樂

Wednesday of this week was the Mid-Autumn Moon Festival, a festival held on the 15th day of the 8th lunar month each year. It is celebrated all throughout Asia, including in China, Japan, Korea, and Vietnam. The Mid-Autumn Moon always falls on a day of the full moon, and originated as a harvest festival that has been celebrated as far back as the Shang Dynasty (1600-1046 BCE).

As a harvest festival it is a time of family gathering, thanksgiving and prayer. One of the favorite foods of the holiday is mooncakes. These are tasty round pastries usually filled with sweet pastes made from lotus seeds or dates. Sometimes they also contain other things such as seeds, nuts, or salted egg yolks.  The round shape of the cakes mimics the shape of the full moon, and the round shape also symbolizes completeness, fullness, and therefore, family harmony and reunion.

I'd like to wish everyone a happy Mid-Autumn Moon festival and express my gratitude for beingpart of your extended family!

My wife Jen's homemade mooncakes ready for the oven

My wife Jen's homemade mooncakes ready for the oven

Autumnal Equinox 秋分 Seasonal Node

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, Saturday 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.

All this said, this weekend here in the New Jersey area we are anticipating a return of much warmer weather. In Chinese this is called “The Old Tiger of Autumn” (Qiu Lao Hu 秋老虎). 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.

To read more about heath maintenance in general for Autumn please click here. Happy Autumn!

Class Schedule Updates - Daoist Neigong and Paida Gong

I just posted an update to the class schedule section which can be seen by clicking here. We will be running our Tuesday lunch time class at PCOM again covering Daoist Neigong postures and the Paida Gong for the channels. This class is open to PCOM students, staff and alumni only. Classes start week 4 (Sept 26) and I'll look forward to seeing many of you then!

For those of you who are not part of the PCOM family, I teach the Paida Gong regularly each week during our Thursday morning Qigong classes at the Wushu Kung Fu Fitness Center in East Hanover. Right now only the Thursday classes cover the Paida Gong. Click here to get more information about Qigong and Taiji classes at the WKFFC.

The Five Taxations 五勞 Part III

Ok, so it’s been awhile since my last installment of the Five Taxations (the last one was back in April of this year if anyone would like to go back to read it again). To remind everyone, the Five Taxations (五勞) are a list of 5 damages caused by overuse or overexertion, and they are found in the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23). The first was taxation that involved the Heart, and the second the Lung. Today we move on to the next one.

The third of the Five Taxations reads, “sitting for a long time damages the flesh” (久坐傷肉). Wang Bing then tells us in his commentary that this is taxation of the Spleen. The connection between Spleen and Flesh is clear – both are correlates of the Earth Phase. The question then is why sitting for a prolonged period of time damages the both of these structures?

In Chinese medicine it is said that the Spleen is the Zang-viscera that governs yùn huà – movement and transformation (運化). Yùn can be translated as transportation, and thus many TCM students today memorize that the Spleen governs transportation and transformation. However, what we gain in alliteration we lose in some of the other meanings of the word. The term yùn is the same as in yùn dòng (運動). This term means motion or movement, and it also means exercise, athletics or sports. Many of our patients in the modern west work white-collar jobs, and tend to sit for long periods of time during the day. Also, as time goes on, fewer and fewer people make the effort to engage in any meaningful physical activity or exercise for leisure. As our body moves less, the movement and transformation of Qi and Blood in the body is damaged. This is one way that prolonged sitting directly damages the Spleen. The link between exercise and digestion is recognized in colloquial Chinese with sayings such as “fàn hòu bǎi bù zǒu, huó dào jiǔ shí jiǔ” (飯後百步走,活到九十九) – walk a hundred steps after each meal and you will live a very long life (literally, to 99 years).

We can also arrive at Spleen and Flesh damage from the other direction. There are many patients we see who complain of feeling fatigued, and have a sensation of easily fatigable and weak limbs. Getting out of a chair is difficult, and they may also complain of aching in the joints. This sort of patient is often diagnosed with having dampness of the Spleen, perhaps due to improper diet, or other long-term habits that damage the Spleen and Stomach. As the Spleen and Stomach are damaged, impaired movement and transformation leads to the accumulation of damp and then phlegm. Thus the Zhi Zhen Yao Da Lun (SW74) says, “All damp, swelling and fullness, without exception they are associated with the Spleen” (諸濕腫滿皆屬於脾). This type of patient sits for a prolonged period of time because their body feels uncomfortable to move, so the inclination to sit is a symptom of Spleen damage. The difficulty here is that the lack of movement, which was originally from the Spleen, further contributes to damaging movement and transformation, worsening the Spleen injury more. It is a vicious cycle. This is why the Zang Qi Fa Shi Lun (SW22) says, “In the case of a Spleen disease, the body is heavy; muscles and flesh tend to be limp. The feel cannot be contracted for walking.” (脾病者,身重善肌肉痿,足不收)

The patient with damaged Flesh and Spleen can actually have two things happen – they can either become obese, or they can become emaciated. Lack of movement by itself can cause obesity. Lack of movement and obesity together can lead to all sorts of chronic diseases, such as hypertension or diabetes. That said, damage to Spleen and Flesh can also mean the person loses weight, for example in elderly patients with sarcopenia, the degenerative loss of muscle mass and quality. For both of these patients exercise as a therapeutic intervention is invaluable. Even moving a little, has tremendous benefit. The better option however is the ideal that the superior physician treats disease before it arises. Maintaining a regular exercise regimen throughout life can help prevent both obesity and emaciation. Why? Because it ensures the health of both the Spleen and the Flesh.

The first and some of the most important therapies for these patients is diet and movement (I prefer the term movement because patients find the word exercise scary or daunting). After that we can consider other treatments. In Tung’s acupuncture we can first consider points such as Si Hua Shang 77.08, a point that is the same as Zu San Li ST-36. In Tung’s own writing he said this point supplements the Qi. It is also specifically indicated in conventional acupuncture for weakness or heaviness of the limbs, and specifically the Five Taxations that we are discussing in this blog post series. If there is poor digestion, poor appetite, or abdominal comfort including diarrhea, this point is commonly combined with Men Jin 66.05. Lastly, a great Tung style point combination is a Dao Ma group called the Zu Wei San Zhen (足胃三針) – the Leg Stomach Three Needles. This is the combination of Zu San Li ST-36, Shang Ju Xu ST-37, and Xia Ju Xu ST-39. This combination is indicated for dizziness, agitation, tinnitus, enteritis, stomach pain, diarrhea, constipation, dysentery, soreness and pain of the knee and shin, lack of strength in the lower extremities. In the Taiwanese literature it is recommended for elderly patients to regulate the Zang Fu, supplement the Yuan and turn back the Jing, and to strengthen the lower extremities.

That was an interesting statement – to supplement the Yuan. Let’s also remember that weakness of the Spleen can eventually damage the Original Qi (元氣). Since the Spleen is the Latter Heaven source of Qi and Blood, if that is damaged it eventually taxes the Early Heaven Qi and Blood, in other words, the Original Qi rooted in the Kidney. This is the reason that the next Tung point combination that I recommend for the third of the Five Taxations is the use of the Lower Three Emperors (下三皇), namely Tian Huang 77.17, Di Huang 77.19 and Ren Huang 77.21. These points are located along the Spleen channel overlapping Yin Ling Quan SP-9 and San Yin Jiao SP-6. However, in Tung’s acupuncture they are one of the main Dao Ma groups for the Kidney. Notice also that it is one of the most commonly used Dao Ma groups for conditions such as diabetes, one of the complications of Spleen and Flesh taxation that we mentioned above.

The point groups listed above have a general regulatory effect on the Spleen and the Kidney, but what about the eventual other problems such as obesity from phlegm or damp accumulation, or weakening of the muscles. We can talk for hours on the subject actually, but a here is a quick set of suggestions for us to start chewing on. For accumulation of phlegm, in Tung’s acupuncture we would consider the Three Weights Three Needles (三重三針; i.e., Yi Zhong 77.05, Er Zhong 77.06, and San Zhong 77.07), or a point like Feng Long ST-40. For wasting of the Flesh we can consider points that lie along the Yang Ming channels, such as Jian Zhong 44.06 (for example, weakness of the lower extremities can be treated by combining Jian Zhong 44.06 and Si Hua Shang 77.08).

As you can see this discussion can go quite deep, and it illustrates the depth of insight that our early ancestors had in the clinic. What they saw then, we still see now, and Chinese medicine continues to be an excellent treatment for what would seem to be the ongoing human condition.

End of Heat 處暑 Seasonal Node

Today as I sit here writing this post I have a little bit of congestion and slight sore throat. The reason, I think, is that last night I slept with the windows open and it was a lot chillier than the previous few weeks. This year it seems that the first Seasonal Node after the beginning of Autumn arrived just on time and true to its name – Chu Shu 處暑, ‘End of Heat’. This year the End of Heat Node started yesterday, August 23rd. While the days here in northern New Jersey are still comfortable warm, evening temperatures are back down in low 60s and upper 50s.

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. Another caution during Autumn is becoming too dry. One way we do this is through diet, and 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).

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).

IMG_3116.JPG

Pear and White Wood Ear Soup simmering

Words on the process of cutivation

Even though this will email out Tuesday afternoon, I'm sitting here writing this late Monday evening just after 11pm my time. You'll all have to forgive me this diversion into philosophy, so for those readers expecting more immediately practical medical advice, you can skip this post. Monday nights I typically have my Chinese language tutoring session, and over the last few months I've been reading (slowly) through the Analects of Confucius in the original classical Chinese. It's not an easy task, but one that is very interesting, trying to step into the mind of a profound philosopher who lived over two thousand years ago. Here's a line we did tonight that I really liked...

子語魯大師樂,曰:“樂其可知也:始作,翕如也;從之,純如也,皦如也, 繹如也,以成.”

I don't feel qualified yet to adequately translate Confucius into elegant English, so I'll give you Prof. Edward Slingerland's translation...

The Master [i.e., Confucius] was discussing music with the Grand Music Master of Lu. He said, "What can be known about music is this: when it first begins, it resounds with a confusing variety of notes, but as it unfolds, these notes are reconciled by means of harmony, brought into tension by means of counterpoint, and finally woven together into a seamless whole. It is in this way that music reaches perfection."

This of course is a metaphor (and a rather beautiful one) for the process of self cultivation. Chaotic at first, and then ending in Wu Wei perfection. But a lot of steps go between beginning to learn music and becoming a virtuoso, so we need to keep at it, but be patient. Constantly refining. The same is true for those of us who practice methods of mind-body cultivation such as Qigong or Taiji, or those of us who are physicians. In the end we are all just students along the Way, all at different places in the process of cultivating the self, or cultivating the medicine (which really is just another way we cultivate the self). We have to start somewhere, but with step by step diligent effort we eventually realize the harmony that Confucius describes.

I'm going outside to do my Taiji form again before bed, inspired by the Master from two thousand years ago.

Beginning of Autumn 立秋 Seasonal Node

I’m just getting back from a great two weeks in China with my Shifu, Wang Fengming, as because I’ve been traveling with poor internet connections I’m just now getting to write about the current seasonal node. One interesting part of my travel was the train I took back from Huang Shan to Beijing. I sat next to a lovely older Chinese woman who, when she realized I spoke Chinese, 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 really like to talk about. The reason I bring this up is because she had a personal Seasonal Node practice she was happy to tell me about. 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 a 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 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 Monday, 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.

The first five days of this seasonal node are called Liang Feng Zhi (涼風至) – Cool Winds Arrival. There is a Chinese saying that goes, “in the morning, once Autumn has arrived, in the evening the weather is cool and dry” (早上立了秋,晚上涼颼颼). The weather here in New Jersey this week will be pleasantly warm during the day, but at night the temperatures are consistently dropping into the 60s. When I got to Newark airport early this morning it was only 65 degrees outside, and where I live was in the upper 50s. After ‘Cool Winds Arrive’, the next two of the 5-day Material Manifestations also refer to the gradual shift to Autumn: White Dew Descends (Bai Lu Jiang 白露降), and Cold Season (i.e., Autumn) Crickets Sing (Han Chan Ming 寒蟬鳴).

While the weather is beginning to shift, August can still be damp and humid. 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, increasing the amount of seasonal vegetables and eating 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; see below).

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. 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.

 

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
  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.

By the way, these Seasonal Node descriptions are going to be published this year in Qi Journal, one article for each of the next four issues. I’ve been reading Qi Journal for years and I think it’s a great magazine (mostly for the general public – not geared only to professional Chinese medicine practitioners). If you get a chance, go subscribe. They’ve been around for a long time and I write articles for them periodically. Otherwise I hope everyone is having a great early Autumn!

Great Heat 大暑 Seasonal Node

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, Saturday July 22, 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!

A Case Example of Tung’s points with Classical Acupuncture

When I teach Tung’s points a question that frequently comes up is the integration of Tung’s points with classical acupuncture points. One of the more extreme examples of this that I’ve heard on more than one occasion is that if someone combines Tung’s points with conventional points, or Tung’s point with local points, then it would somehow negate the treatment rendering it useless to the patient. Not only does this make no sense to me (Tung himself was aware of the conventional channel points, and used them in his clinic), it shows that whatever teacher said this had a profound misunderstanding of acupuncture as a therapeutic intervention.

As a beginning student of any system it is important to stick as closely as possible to the original methodology in order to fully understand how a system works. But the eventual goal is the flexible application of numerous theories at the same time. Here is a clinical case example from my own practice that I saw this week. It illustrates the combination of Tung points with time based point selection. Time based point selection is one way of looking at it is a method of treating disease first by putting a patient’s body back in resonance with the movement of Yin-Yang and the Five Phases in nature.

The patient is an early middle-aged woman with menstrual irregularities and compromised fertility. She has not had a menstrual cycle in some time now. I initially diagnosed her with an insufficiency of the Chong vessel as one of her primary patterns. Today her pulses, as is typical, were overall thin and weak. However, her left guan position was particularly weak while the right guan position was wiry and slightly strong in the superficial level and weak at the deep level. This shows an overall insufficiency of the Wood phase, and in the Earth phase the Stomach channel is slightly replete while the Spleen channel is vacuous. The patient is also very stressed out with a lack of sense of proper direction in her current situation (which confirms the vacuity of Wood phase).

The point selection was Xia Xi GB-43, Ren Huang 77.21 (i.e., San Yin Jiao SP-6), and Fu Ke 11.24. Xia Xi was chosen because the patient presented at 7:30am (actual time; 8:30am for daylight savings time, which is not real/solar time) on a Ren 壬 stem day; this is the open point in the Zi Wu Liu Zhu 子午流注 (Na Jia Fa 納甲法) point selection method. On top of that Xia Xi is the Ying and Water point on the channel, making it the supplementing point of the Leg Shaoyang Gallbladder. Supplementing Yang Wood helps drain Yang Earth (Stomach channel) since Wood and Earth are in a control cycle relationship. Lastly, Xia Xi, on the foot, images the lower abdomen.

Adding in Ren Huang (i.e., San Yin Jiao) strengthens the Kidney as well as the Spleen and Liver. Likewise, Ren Huang images the lower abdomen and can be used to regulate the menses. Once Xia Xi and Ren Huang were inserted the pulses normalized, i.e., the wiry quality in the left guan evened out and overall the pulses were more even at the middle depth in all positions. At the end Fu Ke was added as a general regulator of the Chong and the uterus. Thus, this case illustrates a typical therapeutic approach to a common case using both Tung lineage and classical acupuncture points.

Minor Heat 小暑 Seasonal Node

Friday, July 7, is the beginning of the next seasonal node – Minor Heat (Xiao Shu 小暑). This important time period marks a major transition in the movement of Qi in the natural world. Summer Solstice (Xia Zhi 夏至) began the transition from Yang-expansion to Yin-contraction in the environment. Therefore, Minor Heat is the first seasonal node in the Yin time of the year. That said, it is still hot out! Even the name of this seasonal node acknowledges this. Although we are transitioning into the Yin time of the year, weather change happens slowly. Think of it like a train barreling ahead at high speed. Once the conductor decides to stop the train and put it in reverse, she first puts on the breaks. Even though the breaks are applied, it takes several hundred feet before the train actually stops. Only then will it very slowly start moving in reverse. The movement of the seasons is just like this. Once we have flipped the switch from Yang to Yin, the weather still continues to warm for some time before the very slow movement in the opposite direction begins.

The most important “to do” during this time is to nourish the Heart by maintaining an optimistic outlook. Why is this? June and July are the months associated with the Fire phase. Also, if we overlay the 12 time periods of the day with the 12 months of the year (i.e., the 12 two-hour periods of the day that each correspond to one of the primary channels), June is the time of the Heart channel and July the Small Intestine channel. Both are Fire phase channels. Since this is the Fires Phase time of year, it is the time of the Heart Zang. We nourish the Heart by keeping a calm mind and being optimistic. Pessimism or other negative emotional states can lead to patterns such as Liver stagnation, which in turn can transform into heat and harass the Heart.

During this seasonal node, the first 5-day period is known as Wen Feng Zhi (溫風至), - Sultry Winds Arrive. This certainly describes what is happening in the weather right now, especially in the Northeastern United States! The weather has been hot, and very humid. Therefore, we need to be careful about environmental dampness damaging the body. As clinicians we should instruct patients who are prone to damp patterns on how to eat, dress, etc… In this light the main “to avoid” this time period is undue exposure to cold and excessive consumption of cold items (both cold temperature and cold thermal nature). While it may seem logical to be in cold places in cold weather, there is certainly a problem in the west with using air conditioners to cool rooms to temperatures lower than we’d feel comfortable with in winter! Recently in our clinic we’ve seen quite a few patients with summer colds from frequently going between very hot and very cold environments. Furthermore, the overconsumption of cold (and especially cold and sweet) food and drink damages the Spleen leading to more damp accumulation. Instead, we should drink beverages that are cooling, as well as either bitter (to drain), or acrid (to move). This will cool the body without developing damp stagnation. Examples include chrysanthemum and mint, or even green teas. In China summer is the season to drink green teas such as the famous Dragon Well – Long Jing Cha 龍井茶.

Diet (and a little Moxibustion) for Minor Heat

As we mentioned above, during Minor Heat there is still significant dampness and heat in the environment. Therefore, we should consume foods that are cooling and either bitter or acrid. For example, this is the time of year to consume in-season fresh greens. In addition to chrysanthemum and mint we can also consume lotus leaf tea; lotus is a plant with a summerheat cooling nature that is also slightly bitter to drain heat and dampness. Advise patients to sip fluids throughout the day so they don’t dehydrate rather than drinking copious amounts of iced beverages all at once that may exacerbate damp conditions. If patients have damaged fluids, they can consume cooling and moist vegetables (such as cucumber) or fruits (such as watermelon).

One traditional recipe for this time of year is congee made from Yi Yi Ren (pearl barley) and adzuki beans. This basic combination is mild and neutral in temperature, and both the Yi Yi Ren and adzuki beans drain dampness. Yi Yi Ren strengthens the Spleen and adzuki beans clear heat as well.

In contrast however, this time of year is also a time when warming therapies are traditionally used. This is a method of treating winter disease in the summer. Starting in the Qing Dynasty (1644 – 1912) there has been a method of treating long standing cold disease by employing a type of moxibustion on the three hottest days of summer. These days are called the San Fu Tian, and the method of treatment San Fu Moxibustion, or San Fu Jiu.

San Fu Moxibustion 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. 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.

The actual treatment days are chosen based on Chinese astrology. 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 the San Fu days are July 12, July 27, August 1, and August 11. The first of these days falls during Minor Heat. 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.  People interested in learning more about San Fu Moxibustion should read Lorraine Wilcox’s book on moxibusion - Moxibustion: A Modern Clinical Handbook. You may also click here for more information on San Fu written by one of my former students, Dr. Heidi Lovie.

Now, back to food… In Korea there is a traditional custom of eating ginseng and chicken soup on these same San Fu days, and this dietary remedy can be done by anyone at home as general health prevention and maintenance. Ginseng and chicken soup has a very nourishing and supplementing function, and eating it on the San Fu days can help build internal Yang qi to prevent disease in the colder seasons that follow. This is very useful for patients who generally have weak qi, especially of the Spleen or Lung. Again, patients who are very hot by nature should avoid eating this soup in the summer.

Here is a basic Korean soup recipe:

 

Korean Ginseng and Chicken Soup - Samgyetang

Ingredients:

  • 1 small chicken (Cornish game hen)
  • ¼ cup glutinous rice
  • 1 – 2 small fresh ginseng roots (ren shen 人參)
  • Several Chinese dried red dates (hong zao 紅棗)
  • Several peeled garlic cloves

Directions:

  1. Soak rice in a small amount of water for 1 hour
  2. Clean and rinse chicken and then stuff the cavity with the rice, ginseng, red dates and garlic. Place in pot and cover with water.
  3. Bring pot to a rapid boil and then continue boiling over high heat for about 20 minutes, skimming off the foam as necessary. Replenish water that has boiled off and then continue to simmer for another 40 minutes until chicken is falling apart or can easily be pulled apart.
  4. Garnish with freshly chopped scallions, salt and pepper to taste.

Bon appétit!

Golden Needle Pointing South 金針指南

It’s a warm and lazy summer weekend here so I thought I’d just write a little of my own thoughts and experiences. So there won’t be anything very specifically clinical here. One of the things on my mind lately is the incredible depth of thought and experience of our ancestors. Highlighting this for me was the convergence of two experiences, one from my students, and one from my own personal studies.

Over the last few weeks as we’ve been studying more clinical applications of Five Phase theory in my Nan Jing class, I’ve been hearing from students that they are astounded at the complexity of thinking doctors from 2000 years ago had. One thing the Nan Jing teaches us is that there is more to Five Phase theory than just the rote memorization of basic correspondences. Unfortunately in most modern AOM programs, this is all that we teach of the Five Phases. More complicated theories such as the Ten Celestial Stems and Twelve Earthly Branches are never even mentioned. When we start taking a look at advanced clinical applications of the Five Phases, we see how they can be used in an incredible rich and flexible system of diagnosing and treating the body. And doctors from two millennia ago took the time and had the sensitivity to discover all these complicated body relationships.

Then came yesterday… Fridays and Saturdays are my time to visit my own Shifu to continue my Neigong and Taiji training. Over the last two years or so we have spent most of our time working Taiji, but these last few weeks we returned to some Neigong exercises. Yesterday he taught me a new posture that I had read about but not yet practiced, an exercise called “Golden Needling Pointing South” (金針指南). This posture is a type of Wai Dan Gong (External Dan); the difference between the Nei Dan Gong and Wai Dan Gong being a focus on working internal Qi circulation (for the Nei Dan), or working body relationships with external Qi (for the Wai Dan). Exercising the Golden Needle Point South starts with facing an appropriate direction based on Twelve Heavenly Stems theory, and then holding a standing post position for about 10 minutes. Then, we slowly turn, paying attention to the sensation of facing different geographical directions. The practice is supposed to sensitize us to the Qi of the different directions so that eventually one’s own body becomes sensitive like a compass.

That just blew me away…

I don’t know if this is really possible for me, but I’m almost certain that in ancient times it was possible. As my own acupuncture students have been seeing, in years past people had a lot more time to sit and think. Or, if they were Neidan practitioners, sit and meditate, exercise, or just feel with their own bodies. They didn’t have Netflix, Facebook, or blogs to steal time from practice. As I get older I’m finding that simply taking time to practice is becoming more and more important to me, and more and more meaningful.

On top of that, recently I listened to an NPR story about a group of people without any terms for relative direction; in other words, this group had no words for right or left, or front or back. All they had were absolute direction terms. That means when giving directions they’d always say something like, “go straight ahead, and turn East at the corner,” rather than saying turn left or right. Or they might say something like, “hey watch out! There’s a bee flying on your North near your head,” instead of saying there’s a bee behind you. They pay attention to where they are, no matter where it is, to always know what direction they are facing in absolute geographical terms. Wikipedia mentions some of these groups of people under their Relative Direction article (click here to read).

There are still some mammals that have enough of a magnetic sensitivity that they can use it for orientation and navigation (click here to read some more). So, why not humans in modern times? Whether or not I can actually learn to do this, just the process makes me take time, in a quiet and relaxed manner, to just feel and learn sensitivity to the world around me. In the end that alone is not a bad thing.

I’m going outside to practice more, and I recommend you all do the same. If anyone is in the New Jersey area and wants to come learn Qigong in my classes, please click here to read more.

Summer Solstice 夏至 Seasonal Node

Over the last two weeks or so I’ve been up early. Really early. By 5 or 5:30am I’m awake, long before I have to be. In New Jersey we’ve finally been getting much warmer weather, and the sun has been bright in the sky. I’m sure I’ve been getting up because we are now in the most expansive Yang time of the year. Today, June 21, starts the next seasonal node, the Summer Solstice (Xia Zhi 夏至). Summer Solstice is a very important seasonal node in that it marks the apex of Yang in the natural world as well as the rebirth of Yin. It is the longest day of 2017; starting tomorrow the days will get shorter and shorter culminating eventually with the longest night on the Winter Solstice. In terms of the time of day, Summer Solstice corresponds to high noon, and is the time of the Heart channel. In Yijing (I Ching) symbolism, this time period is represented by hexagram 44, which is made up of Qian-Heaven trigram (3 solid yang lines) over Xun-Wind trigram (1 broken yin line under 2 solid yang lines). Thus, the complete hexagram is 5 solid yang lines over one broken yin line at the bottom – yin is being birthed once again. One of the translations for the name of Hexagram 44 is “The Queen,” also showing that this time of year begins the transition towards returning inward to the hidden, the yin, the Blood, and the Dark Mother that is referred to in the first chapter of the Dao De Jing.

When we break down Summer Solstice into the smaller 5 day periods of time, it includes the time periods know as Deer Shed Antlers (Lu Jiao Jie 鹿角解), Cicadas Begin Singing (Tiao Shi Ming 蜩始鳴), and Pinellia Grows (Ban Xia Sheng 半夏生). In the United States deer actually shed antlers earlier in the year. However, in New Jersey, this is cicada time. Three years around this time we were in the middle of a 17-year cicada invasion, and in some parts of the state they were literally as loud as trains! No wonder cicada shells (chan tui 蟬蛻) are good for conditions such as loss of voice. Notice also that this time is when Ban Xia is growing, the king of drying damp and getting rid of phlegm turbidity (a Yang herb to treat a Yin pathology). Likewise, in China this is the time of year to harvest Aconite (fu zi 附子) to enhance its Yang nature.

In some parts of China people perform simple ritual activities designed to protect against the Yin that is about to start growing. This Yin can be seen as an increase in various disease carrying insects (such as mosquitos) that bring epidemic disease. To ward off Yin in the form of insects and disease, Chinese traditionally hang aromatic (i.e., Yang) herbs around the house, such as Acorus (Shi Chang Pu) or Mugwort (Ai Ye). Other aromatic herbs such as Angelica (Bai Zhi) and Atractolodes (Bai Zhu) are made into medicines and incense.

Practically speaking, although this is a time of transition to Yin, this is still a hot and damp season. The first thing that is recommended during this time of year is to clear summerheat and drain dampness. For example, during this time it is common to see various skin problems due to external contraction of summerheat damp. It is also common to see other symptoms of summerheat strike such as malaise, fatigue, low-grade fever or heat effusion, low-grade headache, nausea, etc… There are several ways we can help ourselves as well as our patients when they present with summerheat damp symptoms. First, is to regulate diet, which we will discuss more below. We can also counsel basic lifestyle recommendations, such as dressing appropriately to the weather (such as wearing light clothes made of natural materials that breathe well), staying in shade in the midday when temperatures are highest, and drinking plenty of light and clear fluids. This is especially important for our older patients, since as we age we lose the normal ability to adapt to more extremes in temperature. Furthermore, seniors are more likely to be on prescription medications or may have chronic medical problems that inhibit perspiration or make extremes of temperature less tolerable. Some medications also increase sensitivity to sun raising risk of sunburns (examples include tetracyclines, quinolones such as Cipro, Celebrex, and some chemotherapeutic agents).

In terms of therapy, Dr. Zhong Yong Xiang of Taiwan suggests bleeding the jing well points on all the fingers for more severe cases of summerheat strike. This bloodletting method is described in my book Pricking the Vessels. We can also consider performing gua sha on the back to help move stagnant summerheat damp in the exterior muscle layer.

The next recommended “to do” during Summer Solstice is Shui Hao Zi Wu Jiao 睡好子午交. This means sleep well during both the Zi and Wu hours. Certainly, sleeping well is something we should be doing all year long. Zi and Wu refer to the time periods of midday and midnight, with Zi being the 11pm – 1am hour, and Wu being the 11am – 1pm hour (to be adjusted for standard time in locations that observe daylight savings time). In general it is important to get into bed before the Zi hour. Remember, the Zi hour is the time of transition from Yin to Yang, representative of the Winter Solstice. After this time period our bodies are already in a state of Yang expansion, the movement contrary to good sleep. Getting to bed and sleeping through this hour ensures that we really rest, that we really go into the state of storage that replenishes our vital substances.

The Wu hour is also a time of transition, and like the Summer Solstice, represents the change from Yang to Yin. The traditional recommendation is to take a short nap during this time to harmonize the body with this movement of Yang to Yin. That said, the recommendation is just a short nap of maybe only 30 minutes time (this is just the beginning of Yin after all). After that, don’t linger. Get up and back to normal activity.

Diet for Summer Solstice

As already mentioned, Summer Solstice is the time of transition from Yang to Yin in the natural world. That said, Summer Solstice is still a time of damp and heat in many places. Therefore, the basic strategy of clearing heat and draining dampness can help guide us in our diet strategy. It is important to keep in mind that during summer over-sweating and prolonged exposure to heat can deplete the Qi and fluids of the body. So, once we are clear of heat and damp, if there is vacuity we can focus on supplementation. However, since this is a hot time of year, cool supplementation is best.

In summary we can generalize this is the time to eat foods that clear heat (especially summerheat), drain dampness, nourish the Qi and boost fluids. Examples include cucumber, winter melon, luffa, tomato, honeydew melon, star fruit, peach, plumb, and mung beans. This is also a good time to eat bitter melon (ku gua 苦瓜). When I lived in Okinawa as a graduate student, bitter melon was a basic staple of food since Okinawa is a very hot and damp climate. Here is a recipe for a very traditional Okinawan dish called Goya Champuru (‘goya’ is the Okinawan word for bitter melon and ‘champuru’ means something mixed together). This dish gently clears heat and drains damp, but also boosts Qi and yin-blood.

Goya Champuru ゴーヤーチャンプルー (Serves 4)

Ingredients:

  • 2 bitter melon (about 400 g)
  • 1 block of firm tofu (300 g)
  • 2 eggs
  • cooking oil
  • salt
  • soy sauce

Directions:

  1. Cut bitter melons in halves lengthwise. Remove the seeds and fibers with a spoon. Slice thinly and sprinkle with salt to soften them. When soft, rinse with water, then squeeze out the extra water.
  2. Wrap tofu in a cloth or paper towel, place a light weight (a plate will do fine) on top, and leave for at least 2 hours to press out excess water.
  3. Heat 2 tablespoons of cooking oil in a wok, crumble the tofu into fairly large pieces, fry well while adding salt to taste, then remove and set aside on a plate.
  4. Add 1 tablespoon of cooking oil to the wok, then stir fry the bitter melon slices. The longer you fry it and the thinner it is sliced, the less bitter it will be.
  5. Return the tofu to the wok and stir fry with the melon. Beat eggs and add to wok. Mix everything together well until eggs cook, and salt to taste.
  6. At the last moment, pour a small amount of soy sauce around the edge of the frying pan for extra taste. Mix all ingredients quickly and remove from heat immediately.

Another simple traditional dish for this time of year is Millet and Red Date Congee. For this recipe take about ½ cup of millet and 5 dried Chinese red dates (紅棗) and place in a pot of 6-8 cups of water (use 6 cups for a more creamy congee, or use 8 for more watery). Bring to a boil and then reduce flame to simmer for 45 minutes or longer, until the millet has broken down and the resulting congee is creamy. Remove from heat and add a small amount of brown sugar to taste.

Millet is said to moisten the Yin and nourish the blood, and the red dates are also blood and Qi nourishing. Too much sweating depletes the body fluids and can eventually damage the Qi and blood. Even though this is a warm dish, it can replenish the body after outdoor activity in hot weather that induces significant sweating.

To read a more comprehensive article on staying healthy in Summer click here.

I hope everyone is having a great summer and staying healthy!

Henry

Video for Basic Qigong

I've just posted a video describing the descending the Qi and washing the organs Qigong exercise that we do prior to other postures. My hope is to do more videos first on the Qigong exercises for the 12 channels (that go with the Pai Da regimens), and then some other basic videos. Enjoy this short video!

Upcoming Online Class and Happy Fathers' Day

We're only a few weeks away from my Pro D class on Tung's acupuncture for gynecological conditions. In that class I'll do a review of core theory essential to the system, and then we go through some of the most important Tung lineage points for various gynecological conditions.

On another note, I'd like to wish everyone out there a very happy Fathers' Day! I'll write again later this week as we're only a few days away from the Summer Solstice. It's hard to believe that Yang is about to turn the corner back to Yin, and the days will be getting shorter soon.

Click here for more information on the Pro D class or to register. 

Beginning of Summer 立夏 Seasonal Node

The days are slowly getting longer, and my tree peonies are in full bloom. This post is coming out a bit late since almost 2 weeks ago, on May 5, the Beginning of Summer (Li Xia 立夏) arrived. Perhaps I’m writing this so late because around here the last few weeks were unseasonably cold. However, this week there was a dramatic shift to warmer weather appropriate to the current season. The days are really are much longer and brighter, and at this point in time, in only about 1 ½ months the days will start getting shorter again. Right now the Yang of the natural world is close to its fullest, and correspondingly the hexagram that represents this time of year is Qian Gua (乾卦) – six solid-Yang lines.

Summer is associated with the Fire phase, although the 4th month belongs to the Spleen (the 4th month in the Chinese calendar is May, since February is the first month). This is interesting as in ancient times the Heart was associated with the Earth phase as well as the Fire phase. For example, in the Shuo Wen Jie Zi, the Han Dynasty dictionary that gives the etymology of ancient characters, the definition of Heart is 人心土藏 – “human Heart, the Earth zang-viscera.” The Spleen channel also has a direct connection to the Heart Zang. Many of you who practice Tung’s acupuncture will notice that the main Heart Dao Ma group is located in the space between the Spleen and Stomach Channels; this Dao Ma group is the Zu San Tong consisting of Tong Guan 88.01, Tong Shan 88.02 and Tong Tian 88.03. In Tung’s acupuncture all of the major Heart points have some relationship with Pericardium channel, the original Heart channel from the Neijing (e.g., the Source point of Heart in the Ling Shu is Da Ling PC-7, not Shen Men HT-7). One needling technique we can use during this time of year with otherwise healthy patients is to incorporate Pericardium channel points (such as Nei Guan PC-6) or the Zu San Tong Dao Ma group into point prescriptions. These points help the body harmonize with the movement of the season right now.

To remind everyone, each of the 24 Seasonal Nodes has a traditional set of health guidelines where we should focus on certain things and avoid others. For Beginning of Summer the traditional things we focus on are preserving a good mood, nourishing the Heart, and thereby entering stillness (保持良好情緒,養心入靜). The things to avoid are allowing Heart fire to become too exuberant and intemperance in food and drink (心火過旺,飲食沒有節制).

As we just mentioned, the Heart is the fire organ. This means that occasionally it is prone to excess heat, signs of which include insomnia, irritability, dry and hard stool, red eyes, and thirst for cold beverages. One way to avoid excess Heart Fire is to dress appropriately for the warmer weather as it starts to come. Avoid strenuous work in direct midday sun, instead taking advantage of the slightly cooler temperatures in the early morning or later afternoon. Be sure to consume plenty of clear fluids such as water or herbal teas. Mint tea and chrysanthemum tea are both gently cooling to the body, and additionally they help with allergies that are so prevalent right now in northern New Jersey.

Another way to avoid problems of Heart Fire is to maintain a good mood. One of the best prescriptions for stress relief is moderate exercise. Take advantage of the improving weather and go for a short walk in the cool early morning hours. Also consider taking a few moments throughout the day to simply take some quiet deep breaths. Those who are local to New Jersey can consider joining our Qigong and Taiji classes.

With the new seasonal node come new dietary suggestions. One of the first, as already mentioned, is to avoid intemperance in food and drink. Overeating, especially of very heavy, sweet or greasy foods, places a burden on the Spleen. Overeating these foods, and overconsumption in general, also create internal heat that can worsen Heart Fire.

In terms of traditional flavors, this time of year we should focus on eating slightly more sour, a little more bitter, and light or gently cooling foods. Eating sour foods helps build fluids and blood so as to nourish the Heart, and bitter can drain fire. As the heat in the environment increases it is understandably appropriate to eat more light fresh vegetables and other foods that will gently cool the body. Specific foods to consider this Seasonal Node include bananas, peaches, plums, umeboshi (Japanese salted plums), asparagus, cucumber and corn. Since this time of year is associated with Fire and Heart, red foods are also good to incorporate – think of strawberries, tomatoes and hawthorn berries.

It is appropriate to increase slightly intake of water or herbal teas. Patients who tend towards excess heat can drink chrysanthemum tea. Even though the beginning of Summer means more heat, some patients still may be cold and deficient internally. Since Summer sees increased environmental dampness, these people can drink a very light ginger tea or fennel seed tea, sweetened with a little local honey. Allergy sufferers (right now in New Jersey we are in the middle of a pollen tsunami) can take mint tea with some local honey, as local honey is used as a traditional allergy remedy.

Two traditional Beginning of Summer recipes are Celery Congee 芹菜粥 and Suan Zao Ren Congee 酸棗仁粥. For Celery Congee take several stalks of celery, remove the leaves, clean and cut into small pieces. Take an appropriate amount of white rice and cook in water to make a porridge (i.e., congee), and then add celery for the last 10-15 minutes of cooking. Add salt and pepper to taste. This recipe clears heat and extinguishes fire, reduces blood pressure, and eliminates vexation. However, it should be avoided by those with Spleen-Stomach vacuity cold patterns. Celery Congee can be taken daily in the morning as a warm breakfast. This recipe originally comes from the Ben Cao Gang Mu.

For the second recipe, Suan Zao Ren Congee, use about 50g of Suan Zao Ren 酸棗仁 to about 100g of white rice. Add an appropriate amount of water and boil until you have congee. At the end, add a small amount of sugar or honey to taste. This recipe can be taken as an evening snack as it can treat Heart vacuity and vexation to help sleep.

I hope you are all enjoying the gradually improving weather. Happy Summer!

Qian Gua - Seasonal Hexagram for Beginning of Summer

Qian Gua - Seasonal Hexagram for Beginning of Summer

Grain Rain Gu Yu 穀雨 Seasonal Node

Last Thursday, April 20, 2017, was the beginning of the Grain Rain (Gu Yu 穀雨) seasonal node. Grain Rain is actually the last seasonal node of Spring, as early May marks the beginning of Summer in the Chinese calendar. Considering today was a slightly chilly Spring day here in New Jersey, it feels odd writing that Summer will begin in just 2 weeks. However, in the traditional Chinese calendar seasons are tied more to the changes of day length than actual temperature. Believe it or not, in only about 2 months from now the days start getting shorter again – so even though it’s still chilly outside get out and enjoy the sunshine!

Grain Rain is the 6th step of the 24 seasonal nodes thus corresponding roughly to the 3rd watch of the day (7-9am). Furthermore it is the time of transition from Spring to Summer correlating to the Earth phase (the Earth phase is the transition between seasons). Thus, Gu Yu is the time of year associated with the Stomach channel. The general movement of Spring is the movement of Liver-Wood, but the Earth phase is also in charge of movement and transformation. Because of this, during Grain Rain we need to ensure that Qi and Blood are moving smoothly. Watch for signs of Qi stagnation in yourself and in your patients. This is why one of the basic recommendations for this time of year is performing regular self-massage to ensure smooth circulation of Qi and Blood in the body.

One of the easiest points to massage for the average person is the collection of points known as the Shi Xuan 十宣穴. These points are located one at the tip of every finger and every toe. The word “Shi” means 10 – there is a point on each finger and toe adding up to 10 total. The word “Xuan” means to spread or diffuse. Since all the channels of the body connect to the fingers and toes, these points together spread or move all the Qi in all the channels of the body, and can be massaged as a general way to prevent and treat stagnation in the channels. To massage simply squeeze and rub the tip of each finger and toe in succession. Repeat throughout the day, but preferably at least once each morning and once each evening.

As the weather does get a bit sunnier and warmer it is important to increase outside activity – consider walking or gardening. However, since Spring is a time of temperature ups and downs, be careful to dress appropriately as dictated by each day. This is the tail end of the cold season, so pay attention to preventing colds, and seek treatment as soon as any cold or allergy symptoms start. Grain Rain is a time when Lung Heat is thought to be a potential problem (over the last week or two many allergy sufferers have been manifesting with Lung Heat signs and symptoms). Consider needling (if you’re an acupuncturist) or massaging (if a patient) Da Zhui DU-14 this seasonal node. Other points include needling or massaging Tung points Chong Zi 22.01 and Chong Xian 22.02.

Getting back to the idea of stagnation, it is vital that during Grain Rain we prevent stagnation in the Stomach (since this is the time of Stomach channel). To this end, the traditional thing to avoid this time of year is overeating or overdrinking. Similarly, this is the time of year to avoid oily and greasy foods. Other foods to avoid are very cooling fruits (such as a lot of citrus).

Start eating lighter and easier to digest items and in-season vegetables such as asparagus. Other foods to emphasize should help boost Qi and Blood, and gently strengthen the Spleen and Stomach (since the Yang of the Spleen/Stomach is still fragile now, especially since Liver-Wood can over-control Earth) – rice or rice congee, Bian Dou, yams, nagaimo (Shan Yao in Chinese), peanuts, and cherries (a slightly warming fruit). If you didn’t know, this is also egg season. Yes… Eggs have a season! Most chickens naturally lay eggs only when day length is about 10 hours or more (commercially grown eggs are available because farmers trick chickens with strong artificial lighting year round). One of my favorite early spring recipes is steamed asparagus with scrambled eggs – delicious and light, and good for you too!

Here’s a traditional Chinese recipe for Grain Rain – Tofu and Spinach Soup

 

Tofu and Spinach Soup 菠菜豆腐湯

Ingredients:

  • One small bunch spinach
  • One block fresh organic tofu (about 4-5 oz.)
  • 5 cups chicken or vegetable broth
  • Salt
  • Toasted sesame oil

Directions

  1. Wash spinach thoroughly and remove thick stems
  2. Drain tofu and cut into small cubes
  3. Place tofu and spinach in the broth, bring to a boil and simmer just until spinach is cooked through and tofu absorbs the flavor of the broth
  4. Add some salt and toasted sesame oil to taste, and serve; optionally can add some chopped scallions as garnish

This recipe boosts the blood, nourishes yin, and at the same time is easy to digest and strengthens the Spleen and Stomach. As an alternative a raw egg can be stirred in at the end to make a type of egg drop soup with spinach and tofu.

I hope everyone is enjoying the Spring!

Henry

Updated Course Schedule

I've just recently updated the course schedule to include my first online class with ProD Seminars. Please click here to go to the course offering page. Most of my other courses this year are as part of DAOM programs, but I will be in Colorado for an in person class this October. I'm working on getting some other live classes up for the fall, so stay tuned!

And speaking of the DAOM programs (someone had asked me about the programs I teach in), here are the 3 places I teach. I teach most at OCOM where in addition to Tung's acupuncture I teach clinical case writing, and sometimes Neijing. So, for those looking for advanced training these are the places I'd suggest (right now I can't recommend any of the first professional DACM programs):

Oregon College of Oriental Medicine DAOM Program (focusing on geriatric medicine and women's health)

American College of Traditional Chinese Medicine DAOM Program (focusing on pain management and women's health)

Academy of Chinese Culture and Health Sciences DAOM Program (focusing on classical Chinese medicine)

The Five Taxations 五勞 Part II

Awhile ago I started writing about the Five Taxations (五勞), a list of 5 damages caused by overuse or overexertion found in the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23). The first was taxation of the Blood, so today I’ll continue with a short discussion of the second taxation.

After the discussion of blood, the Su Wen tells us that “lying down for a long time damages the Qi” (久臥傷氣). This is taxation that, according to Wang Bing, is associated with the Lung.

The Jing Mai Bie Lun (SW21) says, “The Lung invites the hundred vessels to have audience with it” (肺朝百脈). The Lung is the canopy that covers all the other viscera and bowels, and it is the Lung that orders the Qi movement in the body, which is why the Ling Lan Mi Dian Lun (SW8) says that order and moderation originate with the Lung (治節出焉). Remember, the Latter Heaven production of Qi starts with Spleen and Lung, but it is the Lung that orders the Qi, separating it into Ying and Wei, and then distributes it through all the channels and vessels.

When the Neijing says lying down for long periods of time, it means we are physically inactive. Physical movement moves the Qi, one of the main reasons why in Tung’s acupuncture we frequently combine physical movement with needle stimulation at the same time. When we don’t move enough, over time that alone will create stagnation in the Qi, and eventually this stagnation of Qi will go back to damage the Lung. Thus the Zhi Zhen Yao Da Lun (SW74) says, “All Qi oppression and stagnation, without exception they are associated with the Lung” (諸氣膹鬱,皆屬於肺). Damaged Lung and stagnation of Qi leads to vacuity taxation of the Qi.

One of the reasons exercises like Qigong are so effective is that they combine physical movement with regulated breathing, and therefore my first recommendation for damage to the Qi is Qigong, Taiji or other exercises that combine breathing with movement. In our weekly Qigong classes one of the first exercises we practice are forms that grasp and draw in the Qi of nature (採氣功). In my own body I know that if I am fatigued and my pulse is deep and weak, after Qigong practice not only do I feel refreshed, but my pulse will become stronger and more even throughout all the pulse positions.

In terms of Tung’s acupuncture, one of the best points for the second of the Five Taxations is Huo Fu Hai 33.07. This point is located near Shou San Li LI-10, and it functions to expel wind and depurate the Lungs. In addition it supplements the Qi (and Blood) mainly through the Lung and Kidney Zang – everyone’s homework is to think about why that is the case. In Tung’s original book this point was the only one that he mentioned moxibustion for, and he said that moxa here enhances longevity. In my own clinic I typically apply direct rice-grain sized moxa to this point, and have patients use a tiger warmer to apply moxa at home. Aside from Huo Fu Hai, consider other points like Zheng Hui 1010.01, and the Zu Si Ma Dao Ma group (88.17, 18, 19), the main Dao Ma combination for the Lung Zang.

Next time we move on to sitting for too long. Until then, get outside and enjoy the spring.