Vernal Equinox 春分

Friday March 21 was the Vernal (Spring) Equinox this year. I’ve taken some time away from writing about the different seasonal nodes mostly because (on top of my teaching schedule) this year has been unseaonably cold! A lot of the typical recommendations for early Spring have not been applicable this year. Clinically this has made a difference for many of our patients. Those people we treat with conditions such as arthritis, or patients with a general Yang or Qi insufficiency, have been harder to manage. Their bodies are ready for the warmer weather, but it has yet to show up. Even though this morning on the east coast was rather chilly, later this week we finally warm up at least a bit. 

In the Chinese calendar the Vernal Equinox is the fourth step of the year, the midpoint between the beginning of Spring and the beginning of Summer. The three 5-day periods in this seasonal node are Swallows Arrive (xuanniao zhi 玄鳥至), Thunder Starts Resounding (lei nai fasheng 雷乃發聲), and Beginning of Lightning (shi dian 始電). In Yijing (I Ching) theory the Thunder Trigram (Zhen Gua 震掛) is a Wood trigram, linking thunder and lightning, yang activities of the heavens, with Spring. Zhen Gua is composed of one solid yang line on the bottom, with 2 yin (broken) lines above. This is the image of yang emerging from underneath, continuing to grow up and out. Spring is exactly that time of year – the time when Yang of the natural world is slowly starting to push itself up and out of the Yin of Winter.

The main thing to focus on during this 15-day period is “Nourishing the Liver” (yang gan 養肝). One of the ways we nourish the Liver is to ensure normal Liver function. For example, this is the time of year to really ensure our patients' Qi is freely coursing (one of the main functions of Liver is to ensure normal coursing of Qi). Patients who tend to Liver stagnation can be encouraged to perform regular acupressure on the Four Gates 四關 (i.e., He Gu LI-4 and Tai Chong LR-3).

The second “to do” during this time is to “both Clear and Supplement.” This means that when the Liver is hot or hyperactive, clear and sedate. When it is vacuous (e.g., has Blood vacuity), then supplement. Since any pattern of disharmony in Liver will impair some of its major functions, when we see Liver patterns during this seasonal node they must be treated.

The Vernal Equinox is the time of balanced yin and yang. It is appropriate at this time to also have balanced mind states. Thus, one of the “avoids” during the Vernal Equinox is extremes of the Seven Affects. The Neijing says that Spring is the time to not be angry. We should try to relax, and not allow our emotions to run too far in any direction. The second thing to avoid during this seasonal node is overdoing “bedroom activity.” Since sex stirs the yang to mobilize jing-essence, to keep an overall balance in health we need to seek a balance in sex. As this time of year is a time of balance, too much sex may deplete the yin-jing. That said, no sex at all can lead to stagnation in the circulation of Qi and blood.

Diet for Vernal Equinox 

Diet for the Vernal equinox should mimic the balance that is present in nature at this time. In general, the continued use of mildly acrid foods such as ginger and scallions help ensures normal coursing of Liver qi. This is especially useful for patients with Liver depression patterns. Patients who tend more towards vacuity patterns, especially Liver blood insufficiency, can increase consumption of sour foods such as pickles or vinegar.

A simple tea most patients can consume during this time is rose bud tea. This tea is made by steeping Mei Gui Hua 玫瑰花 in hot water. Mei Gui Hua is warm and sweet and is found in the Qi regulating chapter of the Materia Medica. It courses Liver as well as gently quickens the blood. It is especially useful for our female patients who have menstrual irregularities due to Liver stagnation. In the Baijiquan 八極拳 system of Chinese marital arts, Mei Gui Hua tea is used as a general Qi and Blood moving tea for injury.

One traditional dish for Vernal Equinox is Spinach and Tofu Soup. Here’s the recipe:

Ingredients:

• Tofu 250g
• Spinach 250g
• Shrimp (precooked) 25g
• 4 – 5 cups clear broth (either clear chicken or vegetable stock)
• Oil, salt, soy sauce and shredded ginger and scallions to taste

1. Wash spinach thoroughly to remove any dirt. Blanch very quickly in boiling hot water and reserve for later. Cut tofu into slices of about ½” thick

2. In a pan or wok, heat a small amount of cooking oil. Cook tofu so that the slices have become slightly golden-brown.

3. Into same pan or wok, add clear broth, shrimp, and ginger and scallion shreds. Bring to a simmer for several minutes.

4. Add in spinach to warm. Add salt and/or soy sauce to taste. Remove from heat before spinach looses its bright green color.

This dish can be eaten daily, although patients with Stomach vacuity cold or diarrhea should be careful about not eating too much. The functions of this soup are to clear the Liver and drain fire, lower blood pressure and nourish the blood.

Happy Equinox!!!

Henry

Chicken Egg Simmered with Ligusticum - A Martial Arts Dietary Recipe for Trauma

I began training in martial arts from age 10, and it was my involvement in martial arts that lead me to the professional practice of Chinese medicine. One of my long-term interests in Chinese medicine is therefore, not surprisingly, the medical lineages and practices of martial arts schools. Here is a traditional dietary recipe from the Bajiquan (八極拳) lineage of Chinese Gongfu.

Chicken Eggs Simmered with Ligusticum

Ingredients:

• Chuan Xiong (川芎; Ligusticum wallichii) 15g
• 2 chicken eggs
• Brown sugar

Place the eggs and Chuan Xiong in a small pot of water. Bring to a rapid boil over high flame and then reduce to medium flame and simmer for 10 to 15 minutes. Remove eggs from pot, peel shells off, and then return to the liquid and boil for a short while longer. Then remove from heat, strain out herbs, and add brown sugar to taste. Drink the liquid and eat the eggs (take entire recipe as a dose, 1 dose per day).

This recipe warms and penetrates the blood vessels, quickens blood, and transforms stasis. It is used for all types of traumatic injury, numbness and tingling in the limbs, and rib-side pain. 

Tung’s Acupuncture and the Martial Arts

For centuries in China there has been an intimate link between the martial arts and traditional medicine. Part of this was practical. In a day and age where hospitals were not around every corner, people who had higher likelihood of physical injury needed to learn at least the rudiments of medicine. Martial artists, because of the very nature of their practice, have a higher potential than many for injury. Furthermore, in China many serious martial arts practitioners made livings as bodyguards or armed escorts, thereby putting themselves in conditions that might have lead to frequent physical injury. It is no surprise then that expert martial artists were often trained in medicine.

Theories of how the body works were shared by the martial and medical arts. In the internal martial arts (such as Taijiquan) there is a concept called the theory of the Three Sections (San Jie 三節) (Wang, 2005). The Three Sections of the body are the arms (the upper section), the torso (the middle section), and the legs (the lower section). Because of their relative locations and relationships in martial arts practice, the legs are called the ‘root’ (gen 根), the torso the ‘center’ (zhong 中), and the arms the ‘tip’ (i.e., tip end of a twig, shao 梢).

Each of these Sections can be further divided into their own root, center and tip. On the arm, the shoulder is the root, the elbow is the center and the hand is the tip. On the trunk, the lower trunk (the Dan Tian 丹田) is the root, the chest or abdomen is the center, and the head is the tip. On the leg, the hip is the root, the knee is the middle, and the foot is the tip. The most important aspect of this concept is that these structures are interrelated – they are in resonance (ying 應). When Qi and Intention (yi 意) move in one area, the related structures also experience Qi movement. Thus, the hand-head-foot are a resonance, the chest/abdomen-elbow-knee are a resonance, and the shoulder-lower abdomen-hip are a resonance. 

The classics of martial arts and movement therapies (dao yin 導引) are some of the earliest origins of this theory. Later they were applied to the practice of medicine, and in particular, acupuncture. Since each of the three areas of the Three Sections resonate with each other, applying a therapeutic stimulus in one area effects disease in the related area(s). For example, for a disease in the hand we can needle the feet for treatment. For a disease of the elbow we can needle the knee. For a disease in the head we can choose the foot or the hand. This is the basic clinical application of the theory of the Three Sections, and numerous authors have discussed this approach to acupuncture (for examples see: Li, 2011; McCann and Ross, 2014; Tan, 2007; Zhou, 1995).

There is a basic premise in medicine that holograms of therapeutic resonance are located all over the body. These are called Taiji Holograms (taiji quanxi 太極全息); here the word Taiji refers to a complete image of the entire body (Taiji is a symbol of Yin and Yang in completeness) (Yang, 1999). This idea is used frequently in Tung’s acupuncture, a system of needling based almost exclusively on distant point needling. For example, points such as Ling Gu 22.05 located on the hand are important points for both problems of the head, and problems of the feet (these are all the ‘tips’ of the Three Sections). Points on the shoulder such as Yun Bai 44.11 and Li Bai 44.12 are important points for the treatment of female genital disorders (i.e., the shoulder and lower abdomen are both the ‘roots’ of the Three Sections). Pain in the thumb is treated by needling the big toe at Hai Bao 66.01. In fact, most of Tung’s points have some therapeutic indication that can be explained by the theory of the Three Sections.

References:

Li GZ. 台灣董氏針灸手足對應針法 [Hand-Foot Correspondence Needling Method of Taiwan’s Tung Style Acupuncture]. Taipei: Zhi Yuan Bookstore, 2011.

McCann H, Ross H-G. Practical Atlas of Tung’s Acupuncture, 3rd Edition. Munich: Müller and Steinicke, 2014.

Tan RTF. Acupuncture 1, 2, 3. San Diego: Self Published, 2007.

Wang FM. 太极推手技击传真 [Essentials of Taiji Push Hands and Fighting Technique]. World Chen Style Hunyuan Taiji Association, 2007.

Yang L. 周易与中医学 [The Zhou Changes and Chinese Medicine]. Beijing: Beijing Science Technology Publishing House, 1999.

Zhou YY. The crossing method of point selection. J Chin Med, 49 Sept 1995; pp 17-19.

Tung Acupuncture Historical Musings

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 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 may tease us a bit 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 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 primary channels (without 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, was not traditionally 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 later in his book as having the Heart reaction area. In modern acupuncture all the channels 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. So, does this mean that originally Tung considered them related to the Tooth 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.

Diet for Beginning of Spring 立春

As previously mentioned the Beginning of Spring is a time of continued growth of Yang Qi. Spring is the time associated with the Wood phase and the Liver, and the Liver is a Yang viscera (with Heart being the other Yang viscera). The phase for Beginning of Spring is “Li chun yang gan shun tian shi, qu chu ji bing bao jian kang” – “At the beginning of Spring nourishing the Liver means to following the timing of Heaven, expel and rid yourself of disease and protect your health.” Diet recommendations at the Beginning of Spring thus are geared to help Liver. 

As a general rule this is the time to consume foods that help maintain normal Liver function, especially the Yang of Liver. Since the Liver governs free coursing, eating mildly acrid and warm foods will accentuate and support this function. For example, appropriate foods this time of year include scallions, leeks, chives, cilantro, and garlic.  Here is another phrase for this time of year: “Duo chi jiu cai chao rou si, yang hu gan yang zhu sheng fa” – “Eat a lot of leeks and pork to nourish and protect the Liver yang and develop the nature of birth.”  In the Huang Di Nei Jing the Spring is associated with the term “sheng 生,” or “birth.” This is the same “sheng” as in, for example, Sheng Jiang – fresh (or living) ginger. One recipe utilizes leeks to warm and move the Liver yang. Take 100g of leeks and 50g of very thin pork strips. Shred the leeks and then stirfry with the pork in cooking oil, adding soy sauce, salt and pepper to taste. This dish nourishes the Liver and protects the Yang. 

Patients with chronic Liver fire also should take care this seasonal node. A traditional Beginning of Spring drink for these patients is Yin Chen Da Zao Tang 茵陳大棗湯. For this drink take 20g of Yin Chen Hao and 30g of Da Zao. Place in a pot with 200ml water. Bring to a rapid boil then reduce and simmer for 30 minutes. Separate into 2 doses and drink in the morning and evening. This formula benefits qi, generates fluids, and protects the Liver.

Although the weather is still cold, the days are getting longer. Fairly soon the snow will be gone and everything will be bursting forth with new life. Even though today Punxsutawney Phil saw his shadow, Yang Qi is slowly on the return!

Beginning of Spring 立春 Seasonal Node

Wednesday, February 4 is the Beginning of Spring (Li Chun) for 2015 and thus the beginning of the new solar year! The Lunar New Year (known as Chun Jie 春節 in Chinese) begins on Thursday, February 19. The Beginning of Spring marks the growing Yang influences in the natural world. By this date we are only about 6 weeks away from the Vernal Equinox (Chun Fen 春分), one of the times of year where the Yang and Yin are balanced and we have more equal day and night. But even now, with cold weather lingering (today was very cold and snowy here!), the days are getting longer and in northern NJ where I am, in the morning I am hearing some songbirds starting to return 

This is the time of year for new beginnings. It is also time to continue growing the ever expanding Yang in our bodies so as to mimic the expanding Yang in the natural world. One of the basic health exercise recommendations for Beginning of Spring is to comb the hair (or head if there is no hair) frequently. In Chinese, this is called “Shu Fa 梳法,” or “combing therapy.” Combing therapy has been around since at least the Sui dynasty, and is found in both Yang Sheng texts as well as Tuina manuals.

To apply Combing Therapy comb the hair (or scalp) daily, 100 times each sitting. This can be done either in the morning upon waking or in the evening before bed. The traditional recommendation is to use a comb of either bone or wood. That said, simply combing with the fingers is even more effective since the fingers actually contain Qi (which bone and wood do not). This is such a simple exercise, that patients can be taught to do this as well.

Combing has several functions. By stimulating the head we are stimulating the top of the body, meaning the most Yang area of the body. Since Spring is a time of ever growing Yang, stimulating the Yang area of the body is appropriate. Gently working the surface of the body also stimulates Wei Qi movement in the head and channels of the head. This in turn helps expel wind, and avoiding wind is one of the basic “avoids” for the Beginning of Spring. Furthermore, the scalp is a microsystem of the entire body, so stimulating the channels on the scalp actually mobilizes Qi and Blood in the entire body.

So, everyone should start combing their hair and scalp frequently. In the blog post I’ll discuss some diet and a recipe or two.

Su Wen on Knee Pain and Tung's Acupuncture

《骨空論》膝痛不可屈伸，治其背內。Gu Kong Lun (SW60): "When the knees ache and cannot bend or stretch, treat the back."

Here this is literally the back (i.e., not the posterior/back of the knee). Gao Shishi says that since the Bladder Taiyang channel governs the sinews (c.f., Ling Shu 10), then we needle the back to reestablish normal bending and stretching of the vessels. Wang Bing says this means needling Da Zhu BL-11. In Tung's acupuncture we agree... For knee pain (especially chronic) we bleed Jin Dou (金斗 = Po Hu BL-42), Jin Ji (金吉 = Gao Huang Shu BL-43) and Jin Ling (金陵 = Shen Tang BL-44). Much of Tung's acupuncture agrees with other systems of classical acupuncture based on the Huang Di corpus.

Great Cold 大寒 Seasonal Node

While we have passed into a new year on the Gregorian (western) calendar, we are still in the tail end of the traditional Chinese year. The next of the 24 Seasonal Nodes marks the very last segment of the Chinese year before the next lunar-solar year begins. This last node is called “Great Cold” (Da Han 大寒), and starts on Tuesday, January 20.

Great Cold is the time of the year when the temperature is still quite cold. Furthermore, it is usually characterized by dryness as evidenced by most of our dry hands this time of year. The first thing that Chinese medicine recommends at this time of the year 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 root of post-heaven qi. During the end of winter even though the time of the year is still predominantly yin, yang qi is being birthed (as we discussed previously). Eating clear and easily digested foods allows for the Spleen and Stomach to move and transform appropriately, and to build Latter Heaven Qi. If foods are too heavy, such as very greasy or sweet foods, then the ability of the Spleen and Stomach to move and transform will be impaired. Easy to digest foods ensures that we continue to build Latter Heaven Yang Qi to get ready for the upcoming spring.

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 the time of greatest cold in the year. But since certain organs are harmed by excessive dryness, such as the Lungs, we also need to be vigilant there.

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.

As already mentioned, with diet the thing to emphasize during Great Cold is easy to digest foods that protect internal warmth and strengthen the middle. This is especially important for Spleen vacuity patients. These people can focus on eating, for example, rice, glutinous rice (in moderation), yams (including nagaimo), peanuts, clear soups like chicken soup, and cooked vegetables. They should avoid raw vegetables, cooling fruits, very greasy meats, and very sweet deserts. While cooking they can make good use of fresh ginger, and other mildly warming spices like nutmeg.

 In addition to protecting the Spleen, during Great Cold it’s also important to guard against dryness, and in particular Lung dryness. To this end traditional recommendations for food include consuming white wood ear mushrooms (Bai Mu Er 白木耳) and pears, especially Asian pears. 

Please all try to stay warm! Next installment will be about the beginning of spring (in the Chinese calendar at least).

Qi Supplementation with Tung's Points

When Tung wrote his original book in 1973 most of the point indications were described in western medical terms. (1) Certainly, Tung was not a physician trained in western or modern medicine, and Tung’s acupuncture comes from pre-modern China. As such, western medical terms were not originally a part of the system. Some modern practitioners of Tung’s acupuncture (especially those initially trained in western medicine) claim that points should be chosen based primarily on modern western disease categories. They also believe this is how Tung practiced. Yet that is nothing more than revisionist fantasy. Tung practiced classical Chinese medicine based on classical Chinese concepts of disease. In his own writing Tung himself said that he used western disease terms for the purpose of modernizing and popularizing his system (爰用現代語文。撰述本書。旨在發揚國粹。廣起沉痾。). (2) Therefore, instead of disorders of “qi” he wrote about disorders of the nerves. Instead of “blood” he discussed disorders of the vasculature. This trend of westernizing Chinese medicine was not unique to Tung’s writing but rather was part of the Zeitgeist of the time in Asian medical practice.

That said, we are still stuck with lists of western indications. Part of the challenge of studying Tung’s system is ‘translating’ modern western disease terms back into diseases or syndromes that are recognizable by classically trained Chinese medicine practitioners. The other challenge we have is assigning syndrome pattern treatment guidelines to Tung’s points. Prior to the 1950s there was actually little point functions ascribed to acupuncture points, only lists of indications. Widespread use of functions was an outgrowth of the TCM movement that sought to describe points as we do herbs. While this may lead to some problems in understanding exactly how points are used, some modern Chinese medicine scholars have pointed out that (a) this practice does have historical antecedents in classical texts, and (b) it does make the process of learning to use points clinically more flexible, understandable and, therefore, useful. (3) Therefore, even though we are only given indications for Tung’s points, a careful evaluation of the points easily lets us generalize point functions. This work is being done quite a bit among Taiwanese authors yet little has made its way west because of the limited number of people writing about Tung’s points in English.

Originally in Tung’s system there was no use of needle techniques to supplement or drain points (i.e., acupuncture hand techniques of bu fa 補法 and xie fa 寫法 are absent). Rather than hand techniques, supplementing and draining is primarily achieved by point selection rather than needling method. In addition, point combinations or pairings (dui xue 對穴 or pei xue 配穴) further accentuate supplementation or drainage. This is in accord with classical texts such as the Nan Jing, which, in sections, rejects the idea that needle technique alone is effective at supplementing and draining at any individual point. Here we introduce one such point pairing.

One of the key point pairings in Tung’s acupuncture for general Qi supplementation is Ling Gu 22.05 with Si Hua Shang 77.08. Ling Gu 22.05 is located in the space between the thumb and first finger, proximal to He Gu LI-4. The Hand Yangming channel is full of both Qi and Blood, and other points on the same channel have a general supplementing function. This area of the hand is also a region of thick flesh right next to a bony junction. In terms of tissue resonance we can hence see that Ling Gu 22.05 stimulates both the Spleen-Earth and Kidney-Water, each respectively the locus of Latter Heaven Qi and Former Heaven Essence. These relationships are strengthened further by channel associations; the Hand Yangming communicates with the Leg Yangming Stomach (they are both branches of the Yangming channel system), as well as with the Leg Shaoyin (they are opposite on the diurnal circulation clock of channels). Therefore by itself, Ling Gu 22.05 has wide ranging effects than can include general supplementation.

Si Hua Shang 77.08 is located at Zu San Li ST-36, one of the most commonly used points for supplementation, especially of the Middle Jiao. Si Hua Shang 77.08 is the earth point on the earth channel, and a He-Uniting point. As such it has a special ability to achieve consolidation of Qi and Blood (i.e., it enhances storage cang 藏) in the Zang-Fu that are responsible for Latter Heaven production of Qi. Since both Ling Gu 22.05 and Si Hua Shang 77.08 are located on the Yangming, they are a harmonious combination. Together they are one of the best point combinations for general Qi supplementation.

In terms of needle technique, the supplementing effect of these points is enhanced by order of needle insertion. In this point combination the appropriate order of insertion is first Si Hua Shang 77.08 followed by Ling Gu 22.05. This is an example of 各經循環相生法 Following Channel Circulation Mutual Engendering Needle Method, an advanced concept in needling that I teach as part of Tung’s acupuncture. Inserting in this order is needling first the Leg Yangming Stomach channel followed by the Arm Yangming Large Intestine channel. In other words we needle an Earth channel followed by a Metal channel. The 69th chapter of the Nan Jing says, “in vacuity supplement the mother” (虛者補其母). One application of this is combining channels in the engendering cycle of the Five Phases. Thus, needling an Earth channel (mother) first followed by a Metal channel (child) has an effect of giving the point combination more of a supplementing effect without having to use supplementing or draining hand technique on each individual point.

After needling this point pair the clinician can apply moxibustion for further supplementation. Appropriate point additions for general Qi vacuity can include moxa on Si Hua Shang 77.08 (after needles are removed) or on Huo Fu Hai 33.07. If there are more signs of Middle Jiao insufficiency moxa can be applied to Zhong Wan REN-12. If there is insufficiency of the Defense-Wei then moxa Da Zhui DU-14. In this case the point combination of Ling Gu 22.05, Si Hua Shang 77.08 and moxa at Da Zhui DU-14 functions to treat sensations of cold, fatigue, and clammy skin or spontaneous sweat similar to Gui Zhi Tang or Gui Zhi Jia Huang Qi Tang. In all these cases the most effective method of supplementing with moxa is small (rice grain sized) cones burned directly on the skin.

There is more that can be explored in terms of point combination, order of insertion, needle depth, and other considerations that enhance treatment. Future essays will explore other similar advanced concepts, and the use of Tung’s points to treat pattern diagnoses. Hopefully this will stimulate thought and increase treatment efficacy with patients. For more information please take a look at our bookstore or class offerings. 

Written during Small Cold in the year Jia Wu

References: 

1. Tung CC. 董氏針灸正經奇穴學 [Tung Lineage Acupuncture Study of Orthodox Channel Curious Points]. Taipei: Hsin Ya Publications Ltd; 1973. 
2. Tung CC. 董氏鍼灸正經奇穴學 [Tung Lineage Acupuncture Study of Orthodox Channel Curious Points]. Privately published notes; 1968. 
3. Deadman P., Al-Khafaji M. A Manual of Acupuncture. East Sussex, England: Journal of Chinese Medicine Publications; 1998.

Small Cold 小寒 Seasonal Node

Happy New Year Everyone!!!

I hope everyone had a very happy and safe new year, and that you are all keeping warm! The topic of warmth is important this time of year, and the name of the next of the 24 Seasonal Nodes reflects the decreasing temperatures about now…

This year, Tuesday January 6th marks the beginning of the penultimate Seasonal Node – “Small Cold” (Xiao Han 小寒). The next, and last, Seasonal Node of the year (ending at the next Chinese new year) will be “Great Cold.” In Chinese there is a saying that goes “Xiao han da han, leng cheng bing tuan!” – “Small Cold and Great Cold, coldness is here and ice abounds.” Even though, as mentioned in my last post, the Yang qi is already being birthed in the natural world, this month continues to become colder and colder. Why is this even though we are moving to the Yang phase of the year?

Think of the movement of the weather 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 weather 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 wanted to stop and go in reverse, first you’d have to hit the brakes. However, even 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. So, even though the brakes have been put on yin, before we can really move towards yang we continue “skidding” colder and colder for awhile, before Spring truly warms up the earth.

The health maintenance guideline for this season is, not surprisingly, not all that different from Winter Solstice. Specifically, during Small 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).  As mentioned in the previous Seasonal Node post, Winter is the time for all the Qi to be stored away internally. Since Kidney is the root of storage, and the root of Pre-Heaven Qi, we nourish the Kidney to nourish the body’s ability to store Qi away (i.e., the movement of Winter). While Kidney is the Pre-Heaven root, the Spleen and Stomach are the Post-Heaven. So, protecting the Post-Heaven helps to ensure that Pre-Heaven is not excessively tapped into. This is especially true again 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.

Dietary guidelines for Small 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, and warming spices like cinnamon. Meats can be taken in moderation, but moderation is still important. Traditional Chinese lists would also 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.

Here is a traditional recipe for the Small Cold seasonal node…

Lamb and Millet Congee

Ingredients: lean lamb 100g, millet 100g (a little more than ½ cup), fresh (peeled) ginger root 12g, scallions 3 stalks, black pepper and salt

Preparation:

1. First clean lamb and cut into thin strips
2. Put millet and lamb in about 4 – 5 cups of water (adjust water depending on if you want the congee more creamier or more soupy); bring to a boil
3. Add in ginger (cut into thin slices or chopped), scallions (chopped) and continue to boil until made into a congee
4. Add salt and pepper to taste; instead of black pepper, Sichuan Pepper (Hua Jiao) can be used as a substitute to make the soup spicier

Eat on an empty stomach. This congee helps boost the Qi, nourish the Blood, and warm the Center. Patients with internal heat patterns should be cautions about consuming this congee. But, patients with cold patterns or in generally good health can take this congee during Small Cold.

I hope everyone continues to stay warm!

Henry

Winter Solstice 冬至 Seasonal Node

The next and last seasonal node this calendar year is Winter Solstice (dong zhi 冬至), beginning on December 22. The Chinese term for Winter Solstice literally means the “extreme of yin” as it is the longest night. Symbolically Winter Solstice is represented by Hexagram 24, the hexagram comprised of one Yang line at the bottom of 5 Yin lines. The name of this hexagram is Return – Fu (復). What is returning? The Yang and 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

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Hexagram 24 - Fu 復 Return

For Winter Solstice, in Chinese there is a folk saying that says, “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 should we do then to stay healthy during this time period? The first basic recommendation is taken from the Su Wen; “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.

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.  Since 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.

Let patients know that 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.

To stay healthy this time of year there are also some things to avoid. First is to be cautious of weakening Yang Qi. Since 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 in particular 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.

The second thing to be cautious of during Winter Solstice is excessive “bedroom activity.” Since Winter is the time of storage, the traditional recommendation for the season is to guard our sexual vitality. Since Jing essence (the most stored and precious form of Yang Qi) is used up during sex, 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.

My best wishes to all for a wonderful Winter Solstice!

Henry

Great Snow 大雪 Seasonal Node

Today December 7 is the beginning of Great Snow (Da Xue 大雪), the last Seasonal Node before the Winter Solstice. This seasonal node represents the final stage of the most Yin time of year, symbolized by the tidal hexagram Kun 坤, composed entirely of Yin (broken) lines. Here in New Jersey snow has already fallen, and some of my patients in the northern part of the state had close to a foot of snow fall within the last 2 weeks. Weather is cold and dry, and the days are in the final stage of getting shorter before we transition to the birth of Yang represented by the Solstice. The ancient Chinese character for winter (dong 冬) is the image of the Sun locked up in an inverted bottle. At this dark time of the year, it certainly feels as if the Sun is locked away.

The Ancient Chinese variation on the character dong 冬 - Winter. The character is the image of the Sun locked away in a bottle

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 that in Winter it is appropriate to “avoid the cold and seek warmth” (去寒就溫).  Along these lines continue practices such as preventive moxibustion on points such as Qi Hai (REN-6), Guan Yuan (REN-4) and Zu San Li (ST-36). Another guideline from the Neijing 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 some 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!

Another easy self-care regimen for Great Snow is daily acupressure on Yang Chi (SJ-4). Yang Chi is the source point of the San Jiao Channel. While in Chinese acupuncture traditions it is a seldom used point, in Japanese acupuncture traditions it is used for overall warm supplementation of the body. Patients can be taught to press this point daily, or clinicians can consider applying direct thread or rice grain-size moxa to this point before doing acupuncture treatment on other points. In some Japanese acupuncture traditions this moxa method is used on patients with very deep and weak pulses before any other treatment is given.

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 its 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 for Great Snow is Gecko Wine (Ge Jie Jiu 蛤蚧酒). To make this 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, preferably longer, and then take 1 small shot glass per day in the evening. Gecko has a Yang warming and Kidney supplementing effect.

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 Great 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 warming and moistening. 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.

Here is a traditional vegetarian recipe for Great Snow:

Walnut and Chinese Chive Stir Fry (核桃仁炒韭菜)

Ingredients:

·      2 ounces shelled walnuts

·      Chinese chives ½ lb

·      Cooking oil (e.g., sesame)

·      Salt and pepper to taste

1.     Rinse chives and cut into short pieces

2.     Heat oil in wok until almost smoking

3.     Add walnuts and cook until they are just browning

4.     Add chives, continue cooking until they are just wilted (from 30 seconds to a minute or so)

5.     Add salt and pepper to taste; serve hot!

This recipe supplements the Kidneys and strengthens the Yang. It also consolidates and warms the Kidney Qi.

I wish everyone a happy and warm Great Snow!

Hoarfrost Descends 霜降 Seasonal Node

Thursday, October 23, 2014 is the start of the Hoarfrost Descends (Shuang Jiang 霜降) seasonal node. This is the last segment of Autumn as the next seasonal node is the beginning of Winter! The days are clearly getting shorter. In a few weeks we go off Daylight Savings Time, and when that happens the sun will be setting much earlier. The days are also getting colder. Here in New Jersey today the high will only be in the mid-50s, and evening temperatures are dipping into the 40s.

The ancient text Yue Jin Qi Shi Er Hou Ji Jie says, “the Qi is solemn during Hoarfrost Descends. It is when the Yin starts to condense.” Since we are moving into the Yin and colder part of the year, the first traditional recommendation for Hoarfrost Descends is to protect against the cold and preserve internal warmth. Be sure to dress appropriately for the weather on any given day. When eating, keeping the Spleen and Stomach warm will help warm the entire body. Traditional Chinese foods for Autumn include lamb and rabbit, and this is the time to eat more stews and soups. Spice equivalents to warm the body are ginger and cinnamon. Hoarfrost Descends is also the traditional time to take tonics. Therefore, most people can take small doses of Spleen and Stomach tonics such as the Four Gentlemen (Si Jun Zi Tang), or other similar formulas. Generally speaking, for asymptomatic people, taking tonics in pill form at a lower but consistent dose is beneficial.

While it is important to keep the Spleen and Stomach warm, since Autumn is the Metal and therefore Lung season, supplementing the Lungs and preventing upper respiratory tract infections is a key seasonal strategy. One of the traditional teas for late Autumn is called Jin Qi Hua Cha (金芪花茶). Take 5g Huang Qi and 3g Jin Yin Hua and simmer in 1 cup of boiling water for 5-10 minutes. When finished, remove the herbs and let cool to just below boiling. Add 3g of good quality Jasmine Tea and let steep for only about 2 minutes. Strain and enjoy! This tea gently clears heat and drains fire. But at the same time it also supplements and rectifies the Qi, and harmonizes the center. It boosts the immune function and has a mild anti-viral effect. Alternately, the tea can be made using a granular concentrate powder. 

One traditional recipe for Hoarfrost Descends is Angelica and Ginger Lamb Stew (Dang Gui Sheng Jiang Dun Yang Rou 當歸生薑燉羊肉).

Ingredients:

• 1lb. Boneless lamb meat, cut into cubes
• 6-8 cups water or chicken broth
• 20g Chinese Angelica (Dang Gui 當歸)
• 15g Fresh ginger root (peeled and sliced)
• Cooking oil (peanut oil is traditional)
• Black pepper

Method:

1.     Coat a thick metal pot with some cooking oil and heat over medium flame. Place cubed lamb meat in the pot and brown.

2.     Add water (or broth), angelica and ginger. Bring to a boil and then reduce to a medium simmer (other vegetables can be added as desired).

3.     Cover part way with a lid and simmer for about 90 minutes. Add black pepper and salt to taste.

4.     Remove Angelica before eating (or just eat around it!). Ginger can be eaten.

Functions: Warms the yang and scatters cold, moves Qi and quickens the Blood

Stay warm and dry!

Henry

Cold Dew 寒露 Seasonal Node

Today, Wednesday October 8, 2014, is the beginning of the Cold Dew (Han Lu 寒露) Seasonal Node, the first 15-day segment after Autumn Equinox. Here in the Northeastern United States fall is definitely underway. The leaves are slowly starting to change color and the evening temperatures are steadily dropping. However, one of the weather characteristics of Cold Dew is a significant difference between day and night temperatures. For example, today the high in northern New Jersey was close to 70 degrees, while tonight the temperature is going to drop to 46. That’s an almost 25 degree temperature difference! This time of year people have a hard time dressing appropriately for the temperature because what we feel in the morning is not the same as what we feel in the afternoon. The best solution is layering so that one can adapt to the changing thermometer as the day progresses. This is especially important for the elderly, or for other people who, because of either constitution or illness, have diminished toleration for extremes of temperature.

Because temperature continues to drop one of the recommendations for Cold Dew is to avoid overconsumption of cold foods, including for example raw vegetables, iced beverages, or foods eaten right out of the refrigerator. Overconsumption of cold foods, especially in patients with weak Spleen/Stomachs, easily leads to abdominal discomfort or diarrhea. These people should be cautious to drink warm beverages including for example ginger tea (adding honey to protect against Autumn dryness). They can also regularly apply moxibustion to Zu San Li ST-36.

One of my favorite parts of this time of year is the apples! All sorts of varieties are now commonly available. According to Chinese medicine apples are sweet and sour and have a slightly cold nature. Therefore, regular consumption helps generate fluids, stop thirst, and moisten the Lungs. Since dryness is the seasonal characteristic of Autumn, these functions make apples great for this time of year. However, since apples are cold, as mentioned above, overconsumption of raw apples can lead to digestive upset for some people. Moderation is always the key.

Like apples, other foods that are slightly moistening or sour can be eaten during Cold Dew, but also like apples they should be eaten in moderation. Moistening and yin nourishing foods include Chinese red dates (da zao 大棗), walnuts, chestnuts, yams, peanuts, Chinese white wood ear mushrooms, and lily bulbs. Slightly sour foods include hawthorn, lemons, grapes, pomelos, grapefruits, star fruits, and other similar fruits.

One traditional dish for Cold Dew is Lamb and Turnip Stew (Yang Rou Luo Bo Geng 羊肉蘿蔔羹). Here is the recipe…

Ingredients:

• 1 lb. Lamb meat, boneless, cut into cubes
• ½ lb. Turnips, peeled and cut into cubes
• 1 large onion, diced
• 2 pints chicken broth
• Ginger
• Scallions (1 bunch)
• Cooking wine (Shaoxing wine if available)
• Cooking oil (olive or other as desired)
• Salt and pepper

Method:

1.     Coat the bottom of a heavy pot with cooking oil and brown the lamb cubes over a medium high heat. Once lamb has browned on all sides remove from the pot and reserve for later.

2.     Remove excess oil from pot. Add a little more fresh oil and the diced onions. Cook until the onions are softened and aromatic (about 7 minutes).

3.     Add in turnip cubes and stir with wooden spoon to mix with onions. Cook for 2-3 minutes.

4.     Return browned lamb to pot. Add broth, several thick slices of peeled ginger, scallion whites and several tablespoons of cooking wine.

5.     Cover half way with a lid and simmer stew for 90 minutes to 2 hours, stirring periodically. Add salt and pepper to taste and garnish with raw sliced scallions.

Other vegetables such as carrots or celery can be added to the stew as desired. The dish nourishes Yin, moistens the Lungs, supplements vacuity and boosts the Qi.

Happy Cold Dew!

Autumnal Equinox 秋分 Seasonal Node

Today, Monday September 22, is the Autumnal Equinox – the day midway between the solstices. Being the midway point, the equinoxes are the times of even balance between Yin and Yang. Furthermore, today 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 where the movement of Yin-contraction of nature is in full gear. The natural world is preparing for Winter’s slumber.

During this time of year the Huang Di Nei Jing (or Nei Jing for short), the foundation text of Chinese medicine, suggests that we “nourish the Yin” (春夏養陽，秋冬養陰) of our body by conforming with the Yin-contracting nature of the season. In practical terms this means for example getting more sleep. As the days grow shorter so should we be less active. Thus, the Nei Jing tells us 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. Thus, protecting the Yin fluids of the Lung is appropriate to this season. Some of the foods that protect the Lung Yin, and therefore are useful now, 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. Click here to read more about white wood ear mushrooms.

Another method for helping the Lungs is acupressure at Chi Ze LU-5 (尺澤穴). Located at the inside of the elbow (see diagram) this point regulates Lung function and treats conditions such as cough, wheezing, asthma, the common cold and seasonal allergies. Furthermore, it is 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 in general are cold and fatigued 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 Astragalus (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.

We hope you enjoy the unfolding of Autumn and wish you health in the season to come！

End of Heat 處暑 Seasonal Node

Today, Saturday August 23 is Chu Shu 處暑, ‘End of Heat’, the next seasonal node after the beginning of Autumn in the Chinese calendar. The transition from August to September is also the transition to the end of warmer weather. Right now as I sit and write this post here in New Jersey, it is only 68 degrees outside!

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. 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 so we stay healthy this time of year. The first traditional recommendation for this time of year is Ben Franklin’s favorite – ‘early to bed, early to rise’ (zao shui zao qi 早睡早起). When there is more Yin 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, not that Autumn (a Yin season) is upon us, we need to get a little more rest. To accomplish this, try to get into bed a bit earlier, preferably before 11pm or midnight.

The weather pattern associated with Autumn is dryness. The thing we need to be cautious of is being too dry this season. One way we do this is through diet. In Chinese, this time of year we need 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).

We wish everyone peace and health this season！

Taiji (Tai Chi) Practice and Depression

A very recent study done in Japan looked at the relationship between long term Taiji practice and depression. Looking at 529 patients, the researchers determined that long term Taiji practice was related to lower levels of depression. Therefore, it is probably that Taiji practice has a beneficial effect on preventing depression.

To read more about the study, go here.

Beginning of Autumn 立秋 Seasonal Node

In the traditional Chinese calendar August is the start of Autumn, and this year Friday, August 7th, marks 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 balance 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 has been relatively cooler – at the end of last week the evening lows were in the upper 50s.

Although the weather is beginning to shift, August can still be quite damp and humid. In Chinese medicine, weakness in the Spleen and Stomach leads to damp accumulation. This time of year we therefore need to 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 is basic 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.

Autumn is the season associated with the Lungs. As such, even though we want to 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 season 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.

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 芡實)

·      200g Discorea (Shan Yao 山藥)

·      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)

Functions: Strengthens the Spleen, stops diarrhea

Contraindications: Diarrhea due to infections, damp heat type diarrhea

Minor Heat 小暑 Seasonal Node

Monday, 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, he 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 time of year of the Fire phase, 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. Modern research has shown that positive attitudes are beneficial to health. For example, researchers at the Mayo Clinic found that pessimistic people have a much higher risk of developing dementia in later life, and the risk is even higher for people with a pessimistic personality and anxiety (click here to read more about this study).

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 very hot, and very humid. Therefore, we also need to be careful about environmental dampness damaging the body. As clinicians we should be sure to 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, for example, 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 food and drink, especially cold and very 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. This type of drink includes chrysanthemum and mint, or even green teas. For example, in China summer is the season to drink green teas such as the famous Dragon Well – Long Jing Cha 龍井茶.

In the next post we look at some diet recommendations for Minor Heat.

Stay dry and cool (but not too cool!)

Diet for Summer Solstice 夏至 Seasonal Node (Solar Term)

As already mentioned, Summer Solstice is the time of transition from Yang to Yin in the natural world. That said, it is the continuing time period 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. After doing this however, we can focus on supplementing the body. Remember, 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, 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 was 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 (Serves 4)

Ingredients:

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

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 traditional dish for this time of year is Eight Treasure Duck. This is an example of cool supplementation, since duck is cooling and nourishing. The recipe strengthens the Spleen and opens the Stomach to regulate the digestive function. It also nourishes the body and supplements vacuity. However, since duck can be cloying, it should be eaten with caution for people who have an overabundance of Spleen vacuity with damp, or people suffering from chronic diarrhea. Since the recipe is a bit complicated, I’m just going to provide a good link for everyone to take a look at (click here). There are variations on the recipe, so if you’d like a slightly different once, just type in 'Eight Treasures Duck' into your preferred search engine.

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

Henry