White Dew 白露 Seasonal Node

The name of the current Seasonal Node is White Dew (Bai Lu 白露). We are now well into Autumn in the Chinese calendar, and the midpoint of Autumn, the equinox, is only about 2 weeks away. Autumn is one of the two Yin seasons (along with Winter), and in Five Phase theory it is associated with the Metal, the Lungs, and the direction West. The name White Dew is a direct reference to Five Phases, as white is the color of the Metal Phase.

Even though we are in Autumn (a Yin time of year) it is clear that Yin and Yang are still engaged in a closely intertwined dance. During White Dew, the days can still be quite warm. However, evenings are starting to dip in temperature. Therefore, one of the traditional prohibitions this time of year is wearing clothing that is too light or revealing. During the early morning hours or in the evening be sure to wear clothing that affords protection against the gradually cooling temperatures. In some places the weather continues to be fairly warm and thus slightly out of sync with this Seasonal Node. In those places be careful of rapid temperature fluctuations as they may trigger colds or other upper respiratory problems.

Another caution this time of year is overconsumption of cold foods. Eating cold foods burdens the Spleen and Stomach, and this is more so during the Yin and colder times of the year when the body is trying to consolidate its Yang warmth. Thus in Chinese it is said, “bai lu shen bu lu, zhao liang yi xie du" (白露身不露，著涼易瀉肚) – during White Dew be sure not to overexpose the body as cold can easily lead to diarrhea.

The thing to start focusing on during White Dew is Nourishing the Yin (養陰). Now, this doesn’t mean that we should all go out and start taking Yin nourishing herbs such as Di Huang! To understand this we need to think deeply about the real meaning of Yin and Yang beyond the basic correspondences. The Neijing tells us that the sage nourishes Yang in the Spring and Summer and nourishes Yin in the Autumn and Winter (所以聖人春夏養陽，秋冬養陰). Here, Yin means the movement of contraction (收) going towards storage (藏) that are the very meanings of the Autumn and Winter seasons. This time of year we should all start slowing down, going to bed just a little earlier, and taking stock of our lives (i.e., literally moving our minds inward in self-reflection).

In more concrete medical terms, one of the most common problems our patients will see this time of year is seasonal allergies and rhinitis. Here in New Jersey I’ve seen a significant rise in allergy complaints in the last week alone. Patients can be taught simple home remedies such as using a Neti pot to keep sinus passages clear and open. Alternately, they can do a steam inhalation with eucalyptus oil. Since Autumn is the season of dryness, if patients suffer from very dry nasal passageways, they can rub a small amount of coconut oil inside their nose on a daily basis.

During White Dew the foods we eat should gently moisten dryness and protect the Lungs. While the days are still hot we can eat mildly hear clearing foods but again being cautious about eating very cold (or chilled) foods. In order to help build Yin in the body we also can increase mildly sour foods. White Dew is still a season of fresh fruits that fit these guidelines perfectly, such as peaches, apples and pears. Other foods to eat include watery vegetables such as zucchini (although they should be lightly cooked). For those near Asian groceries, White Dew is the time to eat nagaimo (shan yao 山藥 in Chinese) and fresh lily bulbs. 

Rice congees are a perfect fit for White Dew in that they are gently moistening and, taken warm, supportive of the Spleen and Stomach. One of the traditional White Dew congees is Lily Bulb and Pear Congee. To make this take one large Asian pear and slice into bite sized pieces (the peel can be left on). Then take one fresh edible lily bulb and separate out the corms. Cook the pear and lily bulb in a medium sized pot of water and rice (with a rice to water ratio of about 1 to 6). Simmer until the rice starts falling apart and the mixture becomes like watery oatmeal. Finish by adding a small amount of local honey to taste.

Qigong for End of Heat 處暑

Here is the exercise for the End of Heat 處暑 Seasonal Node. This is part of the 24 Seasonal Node Qigong/Daoyin that originated with the Daoist Immortal Chen Tuan 陳團. Dr. McCann in a formal lineage holder in Chen Tuan's line as passed through the modern Qigong great Hu Yaozhen. We will continue with this Qigong set during our classes at PCOM this semester (for PCOM students, staff and alumni). 

End of Heat 處暑 Seasonal Node

Yesterday, Sunday August 23rd was the start of Chu Shu 處暑, ‘End of Heat’, the second seasonal node of Autumn in the Chinese calendar. The change from August to September is the transition to the end of warmer weather. While the days here in northern New Jersey are still warm, evening temperatures are back down in the 60s and 70s.

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

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

The weather pattern associated with Autumn is dryness. Another caution during Autumn is becoming too dry. One way we do this is through diet, and now is the time to focus on shao xin, zeng suan 少辛增酸 – ‘less spicy, more sour’. Spicy flavors have a mild drying quality as well as a sweat promoting quality, both of which dry the body. To the contrary, sour foods are gently moistening and hold in sweat. Increasing the amount of foods such as vinegar, pickled vegetables, and fruits such as plums is appropriate to the season. Other moistening foods include milk, soymilk, and fruit juices (especially apple or pear).

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

Pear and White Wood Ear Soup 雪梨銀耳湯

Ingredients:

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

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

For those who like wood ears crisper, go for the shorter simmer time. For those who like things softer and more gelatinous, cook longer. My suggestion is to take small tastes along the way. This soup can be served warm or chilled (depending on preference and outside temperature). An alternate recipe can include Gou Qi Zi 枸杞子 (i.e., Goji berries) if patients have Liver, Kidney or Blood insufficiency. 

Enjoy!

Beginning of Autumn 立秋 Seasonal Node

In the traditional Chinese calendar August is the beginning of Autumn, and this year Saturday, August 8th, marked the beginning of the new season. Although in the western world Autumn is a summer month, the Chinese calendar is concerned with the relative balance of Yin and Yang in the natural environment, which is closely tied to day length. Summer Solstice in June was the longest day of the year. By now the days are getting gradually shorter, and we are only 6 weeks away from the Autumnal Equinox, a day of balanced light and dark. Even though August weather can still be hot we are in the time of Yin and contraction in the natural environment.

The first five days of this seasonal node are called Liang Feng Zhi (涼風至) – Cool Winds Arrival. There is a Chinese saying that goes, “in the morning, once Autumn has arrived, in the evening the weather is cool and dry” (早上立了秋，晚上涼颼颼). The weather here in New Jersey this week has been pleasantly warm during the day, but at night the temperatures are consistently dropping into the 60s.

While the weather is beginning to shift, August can still be damp and humid. In Chinese medicine, weakness in the Spleen and Stomach leads to damp accumulation. In early Autumn we therefore should avoid dampness and simultaneously strengthen the digestive organs. One way to accomplish this is to eat light and clear foods, increasing the amount of seasonal vegetables and eating a little less meat. Vegetables can be consumed lightly steamed or stir-fried, or in the case of light salad greens, raw. In general avoid overly hot, spicy foods. Congees are appropriate to help strengthen the digestive organs and one traditional congee recipe for this seasonal node is Euryale Seed and Discorea Congee (Qian Shi Shan Yao Zhou 芡實山藥粥; see below). In addition to dietary recommendations we can perform acupressure on supplementing points such as Zu San Li (ST-36). If patients tend to cold and vacuous patterns of the Spleen and Stomach, gentle direct thread moxa at Zu San Li is also applicable.

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. For more serious conditions consider giving patients formulas such as Huo Xiang Zheng Qi San.

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

Ingredients:

• 1 cup rice (use glutinous rice if available)
• 200g Euryale seed (Qian Shi )
• 200g Discorea (Shan Yao )
• 200 g sugar

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

Functions: Strengthens the Spleen, stops diarrhea

Contraindications: Diarrhea due to infections, damp heat type diarrhea

Mount Wu Dang 武當山

I just recently spent a week training with my Taiji Master, Wang Fengming, in Wu Dang, China. After training we all spent a day hiking up Mt. Wu Dang, one of the most sacred Daoist mountains in China. Here are some photos from the temple at the summit, which is above the clouds most days.

Great Heat 大暑 Seasonal Node

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

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

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

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

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

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

 

Diet for Great Heat

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

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

Stir Fried Lotus Root

Ingredients:

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

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

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

I hope everyone is staying cool and dry! 

Henry

Minor Heat 小暑 Seasonal Node

Tuesday, 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 Fires Phase time of year, it is the time of the Heart Zang. We nourish the Heart by keeping a calm mind and being optimistic. Pessimism or other negative emotional states can lead to patterns such as Liver stagnation, which in turn can transform into heat and harass the Heart. 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 or 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 hot, and very humid. Therefore, we need to be careful about environmental dampness damaging the body. As clinicians we should instruct patients who are prone to damp patterns on how to eat, dress, etc… In this light the main “to avoid” this time period is undue exposure to cold and excessive consumption of cold items (both cold temperature and cold thermal nature). While it may seem logical to be in cold places in cold weather, there is certainly a problem in the west with using air conditioners to cool rooms to temperatures lower than we’d feel comfortable with in winter! Recently in our clinic we’ve seen quite a few patients with summer colds from frequently going between very hot and very cold environments. Furthermore, the overconsumption of cold (and especially cold and sweet) food and drink damages the Spleen leading to more damp accumulation. Instead, we should drink beverages that are cooling as well as either bitter (to drain) or acrid (to move). This will cool the body without developing damp stagnation. Examples include chrysanthemum and mint, or even green teas. In China summer is the season to drink green teas such as the famous Dragon Well – Long Jing Cha 龍井茶.

Diet (and a little Moxibustion) for Minor Heat

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

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

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

San Fu Moxibustion was originally used to treat chronic respiratory problems such as asthma, although in modern times it has been expanded to other conditions. The basic theory of San Fu treatment combines the effective use of hot herbs applied to acupuncture points on the body during the hottest (i.e., most Yang) days of Summer. Doing so very aggressively expels cold that may linger in the body. Obviously however, this treatment is designed for patients who are vacuous and cold, and should not be performed on patients that in general have primarily hot conditions.

The actual treatment days are chosen based on Chinese astrology. The first of the San Fu days is the third geng (Yang metal) day after Summer Solstice in the Chinese calendar. The second day is 10 days after the first, and the third day is the first geng day after the Beginning of Autumn (which falls at the beginning of August). Usually there are three days in this method of day selection, but occasionally there is a fourth that can be used. This year the San Fu days are July 13, July 23, August 2, and August 12. The first of these days falls during Minor Heat. Around noon on these days (noon is a Yang time) a special paste is applied to acupuncture points on the upper back that all warm the Yang qi and expel cold. While recipes for this paste vary, they include very hot herbs such as mustard seed (bai jie zi), asarum (xi xin) and ginger juice.  People interested in learning more about San Fu Moxibustion should read Lorraine Wilcox’s book on moxibusion - Moxibustion: A Modern Clinical Handbook.

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

Here is a basic Korean soup recipe:

Korean Ginseng and Chicken Soup (Samgyetang)

Ingredients:

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

1. Soak rice in a small amount of water for 1 hour

2. Clean and rinse chicken and then stuff the cavity with the rice, ginseng, red dates and garlic. Place in pot and cover with water.

3. Bring pot to a rapid boil and then continue boiling over high heat for about 20 minutes, skimming off the foam as necessary. Replenish water that has boiled off and then continue to simmer for another 40 minutes until chicken is falling apart or can easily be pulled apart. 

4. Garnish with freshly chopped scallions, salt and pepper to taste.

Bon appétit!

San Fu Moxibustion (三伏灸) - Classical Chinese Preventive Care

Moxibustion is more than just using moxa! The word we commonly translate as moxibustion is jiu (灸) in Chinese, and this word actually refers to a wide variety of heat therapies. One method of “moxibustion” that doesn’t burn mugwort leaf is San Fu Moxibustion (三伏灸).

San Fu Moxibusion is a classical method of preventive healthcare that dates back about 300 years in China. During the three most Yang days of the year (chosen based on the traditional Chinese calendar), physicians applied a special type of mustard plaster made with additional Chinese herbs to special acupuncture points on the back (the Back Shu Points). Plasters are then left in place for several hours, and the treatment repeated each of those 3 days. Originally this method was used to treat asthma or other chronic respiratory tract problems such as coughing, sinusitis, etc… It was also traditionally though to prevent colds and flus (and other upper respiratory tract problems) in the following winter. San Fu Moxibustion is therefore what is known as a special method of treating Winter disease during Summer (冬病夏治).

When I was in China back in 2008 I was surprised to see signs up at the provincial hospital in Chengdu advertising this type of treatment to patients. On those 3 special days patients would line up and wait for hours for their turn at getting these special mustard plasters. In our clinic, we hand make the mustard paste the traditional way, first grinding it into powder, then mixing it with fresh ginger juice, and finally ageing the plaster for at least 1 year. This year (2015) the 3 special days are July 13, July 23, and August 12.

Our clinic will offer this fantastic classical prevention method starting in July. Please contact us for more information!

Summer Solstice 夏至 Seasonal Node

Today, June 21, 2015, starts the next seasonal node (sometimes known as a Solar Term), the Summer Solstice (Xia Zhi 夏至). Summer Solstice is a very important seasonal node in that it marks the apex of Yang in the natural world and the rebirth of Yin. It is the longest day of the year; starting tomorrow the days will get shorter and shorter culminating eventually with the longest night on the Winter Solstice. In terms of the time of day, Summer Solstice corresponds to high noon, and is the time of the Heart channel. In Yijing (I Ching) symbolism, this time period is represented by hexagram number 44. Hexagram 44 is made up of Qian Heaven trigram (3 solid yang lines) over Xun Wind trigram (1 broken yin line under 2 solid yang lines). Thus, the complete hexagram is 5 solid yang lines over one broken yin line at the bottom – yin is being birthed once again. One of the translations for the name of Hexagram 44 is “The Queen,” also showing that this time of year begins the transition towards returning inward to the hidden, the yin, the Blood, and the Dark Mother that is referred to in the first chapter of the Dao De Jing.

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

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

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

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

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

Diet for Summer Solstice

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

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

Goya Champuru (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. As the recipe is a bit complicated, I’m just going to provide a good link for everyone to take a look at: http://www.thehungryexcavator.com/2012/07/8-treasure-duck-recipe.html. 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

Diet for Bearded Grain

As already mentioned, the Bearded Grain seasonal node is characterized by dampness and summer’s heat. This is especially so in parts of the world where this month is the rainy season. Therefore, in general, this time of year one should avoid eating too many sour foods, instead focusing on bitter flavors. For example, in China there is one type of famous tea called Qing Shan Lü Shui 青山綠水 – “Clear Mountain Green Water.” This wonderful tea from the Sichuan region is not an actual tea plant and has no caffeine.  Rather, it is the first flush of an herb called Ku Ding Cha 苦丁茶, “bitter spike tea.” The taste of the young plant is very mildly bitter at the beginning with a faint sweet aftertaste. It is the perfect damp draining and mildly cooling herb for this summer that replenishes Qi as well with a mildly sweet nature. If anyone is in the vicinity of my office and wants to try some, please stop by! The other side of this is that mild sour flavors are good for people who are dehydrated or who live in climates that are too dry this time of year. A simple refreshing and rehydrating drink is water with just a little lemon juice squeezed in.

Since this a hotter time of year, during the warmest days in have patients focus on mildly heat clearing and bland foods. Also eat foods that expel summerheat and nourish fluids to stop thirst. These foods include melons and fruits, leafy greens, rice, beans, and bean products (such as tofu). The foods that should be minimized in the diet include greasy foods and meats. This is the time eat more vegetarian for sure. Patients who are slightly cold or Qi deficient can eat more mildly warming fruits such as cherries, lychees, longans, coconut milk, and apricots. Patients with warm patterns can focus more on cooling fruits such as watermelon, bananas, pears, tomatoes, persimmons, and cucumbers. Balanced temperature fruits for just about everyone are pineapples, grapes, apples, peach, coconut flesh, oranges, and ginkgo nut.

Recipe for Bearded Grain – Licorice and Mung Bean Congee (Gan Cao Lü Dou Zhou 甘草綠豆粥)

Ingredients:

• Rice 150g
• Mung Beans (lü dou 綠豆) – 50g
• Chinese licorice root (gan cao 甘草) – 50g
• Rock sugar to taste

1. Rinse the rice and mung beans, wrap gan cao in teabag to make removing easier (optional)
2. Place gan cao in about 1750 ml (about 7 cups) of water, bring to a boil and simmer until water is a yellow color
3. Add in mung beans, bring to boil again and then simmer on low for about 40 minutes until beans soften
4. Add in rice and continue cooking for about 30 minutes until the rice starts to beak apart and mixture is the consistency of congee
5. Remove from heat, add in rock sugar to taste (optional)

This recipe aromatically opens the Stomach, strengthens the Spleen and transforms damp, and clears heat and disinhibits damp. It should be used with caution in patients with Spleen and Stomach vacuity cold, or patients with chronic diarrhea. The source text for this recipe was the Ming Dynasty encyclopedic work, the Pu Ji Fang (Prescriptions for Universal Relief).

I hope everyone is happy and healthy this early June!

Bearded Grain 芒種 Seasonal Node

This past Saturday, June 6, 2015 was the beginning of the Bearded Grain (Mang Zhong 芒種) seasonal node, the ninth of the year. Bearded Grain is the last node just before the Summer Solstice, the Solstice representing the most expansive and Yang time of the year. The name, ‘Bearded Grain,’ is a reference to crops. The word Mang (芒) refers to the maturing crops, especially the winter wheat, which is harvested about this time of year. The word Zhong (種) is a reference then to the new rice crops that are planted at this time. This gives us the image of one thing coming to maturity (as in the growing Yang of the season) so that it can eventually perish (i.e., be harvested), then allowing a new crop to be started. The image of transfer and renewal is characteristic of the transition period of the solstice that is fast approaching.

During this time of year there are several things traditionally recommended for healthy living. The first is taking a siesta – in other words an afternoon nap (in Chinese, Wu Shui 午睡). During this time of year damp and heat evils in the environment start to predominate. In Chinese medicine the Spleen is susceptible to dampness, the disease evil associated with the Earth phase. The Spleen governs the flesh and the four limbs. Damp evils encumber the flesh of the four limbs making them feel heavy and weary, leading our body feeling fatigued and without strength. Napping is a way to recuperate vitality, especially when done during the most Yang/hot time of day. Napping traditionally allowed people a rest from the summer heat and dampness, and offered a way to support the Latter Heaven (hou tian 後天) of the Spleen.

The second recommendation is to regularly clear toxins. Toxins in this case refers to both heat toxins and water toxins, since, again, this is a time of increasing dampness and heat in the environment. In much of Asia, this time of year is the rainy season. Likewise, here in New Jersey, last week we saw rain and this week we will see more. During this time period it’s important for us all to be sure we stay cool and dry inside. Be cautious of overexposure to the heat, especially during the middle part of the day. Patients who are prone to internal damp conditions should reduce salt or other similar dietary intake that can lead to accumulation of fluids and swelling.

Our next admonition is both a “to do” and a “to avoid.” First, Mang Zhong is the time of the year to really keep our environment sanitary to avoid developing molds. Warm, humid, and rainy weather is the perfect combination for toxic molds to start growing. Keep your houses clean and dry, and quickly patch up any areas of water leaks that may lead to mold growth. Natural products such as Tea Tree Oil and even plain white vinegar are effective anti-mold cleaning agents and patients should be encouraged to make use of them! This is important for just about all our patients, but especially so for people with various environmental sensitivities, breathing difficulties, or damp patterns.

Remember, much of our treatment goes way beyond the time we spend putting in needles or writing formulas. Basic concepts of public health and hygiene are some of the most important things we can help teach our patients.

The next post will focus more on diet for Bearded Grain.

Stay cool and dry!

Small Fullness 小滿 Seasonal Node

Today, May 21st, begins the next Small Fullness Seasonal Node (Xiao Man 小滿). Small Fullness is the second node of Summer, and the eighth node of the year. The name “Small Fullness” is an agricultural reference, and in particular, to the harvesting of winter wheat. Winter wheat is usually planted in late Autumn, and then harvested around May or June. Thus “Small Fullness” refers to the fullness of plants at this time, as well as the fullness of wheat as it approaches harvest. The three smaller periods contained in Small Fullness are: Sow Thistles in Seed (Ku Cai Xiu 苦菜秀), Shepherd’s Purse Dies (Mi Cao Si 靡草死), and Minor Summer Heat Arrives (Xiao Shu Zhi 小暑至). The alternate name for the last of these three time periods is Wheat Harvest Arrives (Mai Qiu Zhi 麥秋至).

Typically during Small Fullness there is more dampness and heat in the environment. In many parts of Asia Small Fullness is the middle of rainy season, and even here in the northeastern United States early June is the traditional beginning of hurricane season. Thus, in Chinese there is a folk saying that goes “Xiao Man, Xiao Man, Jiang Man, He Man 小滿小滿，江滿河滿” – Small Fullness, Small Fullness, the rivers are all full. Clearly there is more moisture in the environment. Since this time of year sees increased dampness and heat (although today we wouldn’t know that in New Jersey!) the appropriate thing to focus on to stay healthy is expelling internal heat and expelling disease evils such as dampness.

Although we are beginning to see dampness and heat increase, we are not yet in the middle of Summer when heat is clearly the dominant weather pattern. During this Seasonal Node we still have a mix of hot and cold days, and evenings in particular can be chilly. Tonight the temperature in NJ is expected to drop to 50°F (10°C). Cold, being Yin, invades the lower extremities and so our wind-damp-bi patients may notice ups and downs in pain levels.  As we discussed in the previous post on Beginning of Summer, May is associated with the Spleen. During Small Fullness, when cold from below mixes with damp and heat from above, these evils may all bind in the middle burner leading to digestive disorders. Lately in the clinic I’ve been seeing quite a lot of digestive disorders along these lines with patients complaining of intermittent and ongoing diarrhea, nausea, poor appetite, and fatigue.

The traditional “to avoid” during Small Fullness is widely fluctuating emotions/moods. As we move into Summer, the time of the Heart, it is important to maintain a happy but stable mood. We should all try to engage in more leisure activities, especially outdoor activities, while the weather is good.

In terms of diet, we can focus on foods that percolate dampness and gently clear heat. These include corn, adzuki bean, mung bean, peanuts, winter melon, celery, cilantro, lily bulbs and osmanthus. If patients present more with cold and vacuous middle burners then these foods are still permissible in conjunction with foods that gently supplement the Spleen such as yams, sweet potatoes, and small amounts of beef or beef broth. An excellent daily food for Small Fullness is Job’s Tear Barley made into congee. This can be taken as breakfast as it strengthens the Spleen and percolates damp, and is mild enough for just about any constitution. The foods to avoid during Small Fullness are foods that are very warm and damp forming such as deep fried foods, warmer meats such as lamb, or other greasy meats such as goose.

Happy early Summer!

Small Fullness Seasonal Node Qigong

Here's the classical diagram for the Seasonal Node exercise for Small Fullness. We'll start practicing this one next Tuesday at PCOM during our Neigong Class.

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