Beginning of Summer 立夏 Seasonal Node

The days are slowly getting longer, and flowers are now in full bloom. As of today, May 6, summer has begun in the traditional Chinese calendar. Thus, this Seaonal Node is simply called “Beginning of Summer” – Li Xia (立夏). At this point the Yang of the natural world is close its fullest, and correspondingly the hexagram that represents the time of year is the Qian Gua (乾卦) – six solid-Yang lines. In only about 1 ½ months the days will start getting shorter again.

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. In the Ling Shu this time of year is Early Summer (孟夏) which corresponds to the hand Shaoyang sinew channel.

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 tradition things we should 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 primarily the fire organ. This means that occasionally it is prone to excess heat, sometimes called ‘Heart Fire’. Signs of Heart Fire 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.

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!

Walking after Eating – Ancient Folk Wisdom, Modern Science

The Chinese language is full of folk sayings that most average people know, and many of these are related to health. One of my favorite Chinese folk sayings is, “Fan hou bai bu zou, huo dao jiu shi jiu” (飯後百步走，活到九十九). This translates to, “if you take 100 steps after each meal, you’ll live to 99.” Yes, it rhymes much better in Chinese! The idea is that taking a short walk after a meal is good for us.

Over the last few years researchers took a look at this idea to see if it was really a good health recommendation, since some people believe that walking after eating causes fatigue and stomach discomfort. It turns out that numerous studies found a measurably beneficial effect to the practice of walking after eating. One article published in 2009 looked at patients with type 2 diabetes (type 2 diabetics are those who do not yet need insulin) who walked after meals. They found that in these patients walking after eating had a beneficial effect on blood sugar numbers – better than if they had walked before eating, and better than if they hadn’t walked at all. Click here to see that study.

Another study published in 2013 found similar results, even in older patients who are otherwise inactive. This time researchers also discovered that three short 15 minute walks, one after each meal, was better than one long 45 minute walk during the day. Click here to see that study. In addition to blood sugar improvements with walking, walking improved digestion overall. There is also anecdotal information that has been published suggesting moderate weight loss with walking after meals.

With diabetes being one of the major health threats to older Americans today, and with the incidence of diabetes on the rise in all age groups, it would seem that the folk prescription of walking after meals is just what the doctor ordered. And it may actually help us all live to 99. Happy walking!

Grain Rain Seasonal Node Qigong (Daoyin)

There is a very interesting classical set of Daoyin (Qigong) exercises that track to the 24 Seasonal Nodes. Each of the nodes gets a specific movement that allows the body to harmonize with this time of year. This Daoyin set was developed by my lineage founder, the Daoist Immortal Chen Tuan. We will be starting to learn the 24 Seasonal Node Daoyin this summer at the class I will be teaching at PCOM for students, faculty or alumni. For more information on the class please contact us. Here is the classical diagram for the Grain Rain posture...

Grain Rain 穀雨 Seasonal Node

This past Monday, April 20, 2015, 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 particularly chilly Spring day here in New Jersey, it feels odd writing that Summer will begin in just 2 weeks. However, the seasons in the traditional Chinese calendar are tied in more with the changes of day length more so 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. The Earth phase is in charge of movement and transformation. Thus, this time of the year 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.

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 can spread or move all the Qi in all the channels of the body. Thus, they 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.

Shi Xuan Points 十宣穴 (the same points are found on the toes)

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. Gu Yu is a time when Lung Heat is thought to be a potential problem (many allergy sufferers manifest 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 Chong Zi 22.01 and Chong Xian 22.02 from the Tung lineage.

Back to the idea of stagnation, it is vital that during Gu Yu 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 with the prolonged chill) – 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!

Those aren’t the same points, are they?

Point location is an important aspect of acupuncture, and acupuncture students spend hundreds of hours learning and practicing to find points. Not surprisingly therefore, this concern comes up whenever I teach. In learning Tung’s acupuncture there are lots of new points that are unfamiliar to most acupuncturists, so many students become concerned that they are not placing the needle in exactly the right place.

Sometimes I think this is a problem of how some teachers and practitioners talk about or otherwise present the material. For example, one of the most common questions I get is about the location of Tung’s point Huo Zhu 66.04. Acupuncturists have told me that elsewhere in books or classes they learn that Huo Zhu 66.04 is located just slightly proximal to Tai Chong LR-3. Thus these two points are approximately a few millimeters apart on the dorsal foot. These same acupuncturists also learn or read that this slight distance makes Huo Zhu 66.04 and Tai Chong LR-3 different points 

But does it really? In my opinion this type of thinking is fundamentally flawed, and a gross misunderstanding of how acupuncture really works and how it is best applied clinically. In modern acupuncture textbooks points are usually described as precise anatomical loci. However, historically, this type of anatomical precision is more the result of the interaction of modern western anatomy with traditional medicine. For example, in Zhen Jiu Zi Sheng Jing 針灸資生經 (written in the Song dynasty, c. 1180) Tai Chong LR-3 is located either 1.5 or 2 cun posterior to the “base joint” (MTP joint) of the big toe (在足大指本節後二寸或寸半陷中). Looking at this type of point description we can arrive at two possible conclusions. First, ancient acupuncturists were sloppy in their point location. Why else would it be that in ancient times a point like Tai Chong LR-3 could be located in a relatively large space, but today we are precise enough to differentiate Huo Zhu 66.04 and Tai Chong LR-3 even though they are a mere millimeters apart? Second, point locations by their nature are simply not so precise that millimeters make a difference.

I do not believe the former to be true. But, I also do not believe the latter is true. I have seen that millimeters can make a difference in getting a point to work or not. How can this be reconciled? In classical acupuncture the precision of point location as described in the textbooks is not so important. That which is important is finding the real active point, or as described in Japanese as the “living” or “live” point (生きた壺). The live point is the one where some reaction can be palpated (e.g., pain or soreness), some tissue quality is evident (e.g., rough skin, spongy subcutaneous tissue, hard subcutaneous tissue), or some quality is visible (e.g., dark spider nevi, discolored skin). Thus, even though the location of a point can be large, the exact location that will be clinically useful can be small and must be found by touching or looking.

Some of the great modern practitioners of acupuncture agree. According to Dr. Wang Juyi, “...the actual location of any point is not necessarily where that point is located by techniques of proportional measurement. Rather, the point is the place where one can best get the Qi and facilitate the arrival of Qi.  It is not fixed.” Shudo Denmei says, “Acupuncture points are hard to locate on healthy individuals. However, when Qi stagnates or pathological Qi invades from the outside, the point becomes depressed or protrudes. Qi, which is invisible, is thus transformed into a ‘quality’ that can be palpated and distinguished. This is what is known as an active point, which serves as both a point for diagnosis as well as treatment.” I couldn’t agree more with both of those statements!

Huo Zhu 66.04 and Tai Chong LR-3 are indeed the same point in the same location. Clinically however, we need to palpate or search for the active point in that area of the foot. If we practice any acupuncture, including Tung’s, with the idea that we just measure and then insert the needle, we will truly be missing the point.

References: 

Denmei S, Brown S. Finding Effective Acupuncture Points. Seattle: Eastland Press, 2003; p. 5. 

Wang JY, Roberson J. Applied Channel Theory in Chinese Medicine. Seattle: Eastland Press, 2008; p. 535.

Wang ZZ, Wilcox L. The Classic of Supporting Life with Acupuncture and Moxibusion: Zhen Jiu Zi Sheng Jing Vol I-III. Portland: The Chinese Medicine Database, 2014.

Clear and Bright 清明 Seasonal Node

Yesterday, Thursday April 5, 2015 was the beginning of the Clear and Bright (Qing Ming 清明) seasonal node. Clear and Bright is the node just after the Vernal Equinox and the next step in the progression of Spring. This seasonal node is also a traditional holiday in much of Asia – the Qing Ming Festival. In Okinawa, where I lived as a graduate student, the day is called Shimi in the local Hogen (indigenous Okinawan language). Qing Ming Festival is a time for Asians to visit graves and pay respect to the ancestors. Thus it is a time to remember the past while at the same time starting the new year, with a new Spring.

Even though we are in Spring according to both the Eastern and Western calendars, in northern New Jersey the weather is just barely starting to warm up. Not surprisingly, the first “to do” during Clear and Bright is to protect being warm (bao nuan 保暖).  Spring is the time of growing Yang, and we don’t want to do anything that damages that internal warming Qi. The second chapter of the Su Wen admonishes us that if we don’t take care in Spring, then cold disease will arise in the Summer that follows. During this time the temperature outside is constantly fluctuating up and down. Be sure to tell patients to dress appropriately for the day, and not to think that just because its supposed to be Spring, that every day will be warm enough for light clothing.

The second “to do” during Clear and Bright is be active in outdoor activities or exercise. With the continued growth of Yang in the natural world, it is important to increase our physical activity. The Wood phase and Liver assures normal smooth circulation of Qi in the body, and similarly during Spring we should be sure to keep our bodies moving. Of course, exercise doesn’t have to be intense to be effective. Suggest to patients that even just getting outside to do light yard work or gardening is a great idea. Practicing Taiji or Qigong outside is also appropriate.

One of the Nourishing Life exercises that is appropriate to Clear and Bright is pressing and rotating Shen Que REN-8. Shen Que is obviously an important point on the body. The abdomen is the location of many of the important internal organs. Likewise, it is the area where some of the most important channels in the body originate – the Ren, the Du and the Chong. In Chinese these three extraordinary vessels are said to be “one origin and three branches.” For this exercise first rub hands together vigorously to warm them. Then place the warmed hands over the navel and slowly, with moderate pressure, rotate 50 times in a circle one direction, then 50 times in the other direction. This exercise helps warm the center and expel cold. It is especially appropriate for patients who are cold and depleted, and patients with clear nasal discharge such as seasonal allergies. For patients who are very depleted, think of doing moxibusion at Shen Que.

The flip side of this is to be cautious of patients with uprising Liver yang patterns, or patterns of internal wind. Clear and Bright is also the time to guard against hypertension in patients who are prone to this condition. These patients should certainly be counseled to get some more exercise, as this is an effective adjunct therapy for hypertension.

Diet for Clear and Bright 

The “avoids” for Clear and Bright are related to diet. First, Chinese medicine recommends that patients avoid very acrid and spicy foods. While somewhat acrid foods and herbs are appropriate to Spring (such as leeks or scallions), overly spicy foods may potentially either stir internal Yang or dissipate internal Qi. The second type of food to avoid is very sour or greasy foods. Both sour and greasy foods create stagnation internally, and thus inhibit the normal coursing of Qi. Since Spring is the time of Wood-Liver, it is important to keep Qi moving internally.

In general the diet for Clear and Bright should reflect the name of the seasonal node. Light and clear foods that neither block the Qi mechanism nor overly stimulate it are appropriate. Gentle movement and easy to digest should be the focus. As more vegetables become available, patients should increase consumption of fresh produce. Traditionally this is the time for greens such as spinach and mustard greens. In the west certainly April is the season for fresh asparagus. All these greens are beneficial to the Liver.

Patients who are somewhat Qi deficient, or patients with seasonal allergies can try making Jade Screen Chicken at home.

Jade Screen Chicken – Yu Ping Ji 玉屏雞

Ingredients:

• 1 whole chicken (about 2 lbs.)
• Huang Qi 60g
• Bai Zhu 20g
• Fang Feng 20g
• Salt and pepper to taste

1. Rinse and clean chicken

2. Take herbs and stuff inside, close chicken to retain herbs inside the cavity

3. Place chicken in a slow cooker and cover with water, allow chicken to cook for until done

This can take a long time to cook in a slow cooker, but I think it will yield the best results. I suggest this be set up overnight and put on the low temperature setting. By lunch the next day it should be done as cooking can take 8 hours or more. Patients can both consume the meat as well as drink the resulting broth. Season with salt and pepper to taste. The recipe helps nourish Qi, secure the exterior and expel cold.

Happy Spring everyone!

Henry

Kan-no-mushi 疳の虫 - The Disease Causing Bug

In medieval Japan there were a lot of ideas about where disease came from. One text called the Harikikigaki written in 1568 talks about different types of microscopic creatures that are causative agents of disease. The text even describes them in intricate detail and gives color diagrams to show what they look like. Luckily, as bizarre and scary as these little creatures are, the Harikikigaki explains how they can be treated with either acupuncture or herbal medicines.

The theory that tiny fanciful and colorful animals cause disease in the human body was quite different from how the Chinese practiced acupuncture or herbal medicine. It also didn’t really last as a widely held medical belief into the modern period. However, there is an interesting lone hold out in modern Japanese acupuncture practice – the concept of Kan-no-mushi (疳の虫).

Kan-no-mushi (on the right) from the Harikikigaki

Kan-no-mushi originally was one type of microscopic creature that was thought to lodge itself in a victim’s spine. Today the word Kan (Gan in Chinese; 疳) in Asian medicine refers to a type of pediatric disease characterized by malnutrition due to digestive problems or parasites. In modern Japanese acupuncture this disease has also become an exclusive problem of early childhood. Even though we no longer think of the condition as actually being caused by microscopic animals, the term is used to describe functional problems. Young children are prone to a host of non-specific complaints such as mild digestive disturbance (although sometimes this can be more severe such as with colic), emotional upset or mood swings, a propensity to irritability, hyperactivity, and growing pains. These general and quite common discomforts of early childhood in Japanese acupuncture are all called Kan-no-mushi. Just as the original Kan-no-mushi was treated with acupuncture, so too in modern Japan childhood Kan-no-mushi is treated with acupuncture.

In China young children were rarely treated with acupuncture since needling is rarely tolerated in such young patients. Beginning several hundred years ago Chinese physicians developed a type of massage called pediatric tuina (小孩推拿). Even though massage is better tolerated than needling, sometimes even pediatric tuina can be a bit vigorous! In Japan physicians came up with an alternative strategy. Generally the Japanese are known for their very gentle approach to all acupuncture, so Japanese approaches are better tolerated by very young children. Starting about 400 years ago Japanese acupuncturists began experimenting with different forms of needles especially designed for kids. However, unlike normal needles, these pediatric “needles” are medical implements used to gently stimulate the surface of the child’s body by tapping, rubbing or pressing. In other words, they don’t pierce the surface of the body at all. This specialized approach to acupuncture is called Shonishin (小児鍼) in Japanese.

Shonishin is also quite different from conventional acupuncture in its basic approach to the body. Very young children are physically different from adults. The basic structure of their channels (the lines used in acupuncture treatment) is not completely formed, and certain organ systems internally are still in different states of maturity. Simply stated, because of this normal acupuncture is not as effective in very young patients. Shonishin’s unique approach starts by balancing the general circulation of Qi (Ki in Japanese), and then second addressing specific symptoms or complaints usually by stimulating zones of the body rather than very small acupuncture points. Most importantly, the therapist chooses these areas for treatment by actually touching the child’s body to feel subtle changes in temperature, texture or tonicity. These subtle changes are indicative of the imbalances that need treatment and guide the specifics of the treatment session. And one of Shonishin’s specialties is the treatment of Kan-no-mushi.

Some typical non-insertive "needles" used in Japanese pediatric acupuncture

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