Upcoming February Lectures

This is a reminder that at the end of February I'll be in Sydney talking about Tung's acupuncture for Internal Medicine and for Fertility and Reproductive Health. I'm looking forward to going somewhere warm for a week or so! Click here for more information on that class.

Also in February, eLotus will be airing two new classes which I think were really interesting. The first, on Saturday Feb 10, is Integrating the Classics with Tung's Acupuncture (click here to read more). In that class we will cover: core theory of Tung acupuncture, classic Five Shu Transport Points Theory, the relation of Tung’s points and the Five Shu points, Tung’s use of traditional acupuncture points, Dao Ma groups of traditional points, combining Tung’s points and traditional points in the same treatment, and guiding points for pain management and internal medicine.

The other eLotus class will be held Sunday Feb 11 on Tung's acupuncture for Internal Medicine conditions. Click here for more information on that class including class contents. 

Major Cold 大寒 Seasonal Node

It’s hard to believe, but we are already at the last Seasonal Node of Winter, and therefore the last Seasonal Node before the Chinese New Year – Major Cold. As the name suggests this node, at the end of January, is usually the coldest time of year in many places. While so far the beginning of January was a bit colder than it is now, it is hard to deny that in the US Northeast this has been a very, very cold month.

This year, in 2018, the exact date Major Cold started was January 20th (it usually falls on either January 20th or 21st). The three material manifestations of Major Cold are Hens Begin to Breed (Ji Shi Ru 雞始乳), Birds of Prey Act Fierce and Swift (Zhi Niao Li Ji 鷙鳥厲疾), and Rivers and Lakes are Frozen Within (Shui Ze Fu Jian 水澤腹堅). Notice here some of the imagery of the impending Spring. In Five Phase theory the domestic animal associated with Spring is the chicken, and now during this node we see that hens are getting ready to become pregnant with baby chicks that will hatch in Spring. So, even though the weather outside is still very cold, Yang is definitely on its way back as the gradually lengthening of the days attests to.

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

In addition to cold, the other main environmental pattern seen during Major Cold is dryness. After all, all the water is usually bound up in snow or ice, making the air, and as a result our skin, dry. Thus, the second recommendation this time of year is to stay warm but also be sure to not be too dry. Staying warm is obviously important in this time of greatest cold. But since certain organs are harmed by excessive dryness, such as the Lungs, we also need to be vigilant there. For example, for those with forced hot air heating systems, it may be prudent to run a humidifier periodically. Also, sipping warm liquids such as herbal teas throughout the day can keep our internal environment appropriately moist.

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

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

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

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

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

Continue staying warm. I’ll blog more later around the time of the New Year!

Stone carving on a wall at the White Cloud Temple 白雲觀 in Beijing

Stone carving on a wall at the White Cloud Temple 白雲觀 in Beijing

Minor Cold 小寒 Seasonal Node

After Winter Solstice there are only two more Seasonal Nodes in the year before the Chinese New Year and the beginning of Spring - Minor Cold (小寒) and Major Cold (大寒). As is clear from the names, temperature is an important part of understanding the last two seasonal nodes of the traditional Chinese calendar. And this year, true to these names, the weather in the Northeastern United States is right on target. While early 2017 had unseasonably warm January weather, 2018 is quite the opposite. Yesterday we experienced a punishing winter storm, and today the temperature high will only be 13˚F (-10˚C). Tomorrow the lows are predicted to dip down to -3˚F (-19˚C)! So, I hope everyone is having both a wonderful New Year and staying as warm as possible.

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

Think of the movement of temperature as being driven by the fluctuations of yin and yang in the natural world. Even though the “switch” has been flipped from yin to yang, it takes time for the climate to catch up. Imagine driving a car at 75 miles per hour (I apologize to you all who use the metric system – I’m metric impaired). If you 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. Thus, 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 similar to Winter Solstice. Specifically, during Minor Cold we should focus on (1) Nourishing the Kidney (Yang Shen 養腎), and (2) Safeguarding the Spleen and Stomach (Baohu Pi Wei 保護脾胃). Winter is the time for all the Qi to be stored away internally – my Neijing students will remember this discussion from Su Wen Chapter 2. Since Kidney is the root of storage, and the root of Earlier Heaven (先天) Qi, we nourish the Kidney to nourish the body’s ability to store Qi away (i.e., the movement of Winter – 藏). While Kidney is the Earlier Heaven root, the Spleen and Stomach are the Later Heaven (後天). So, protecting the Later Heaven helps to ensure that Earlier Heaven is not excessively tapped into. This is especially important for our patients with conditions of vacuity (especially either Kidney or Middle Jiao vacuity), or patients with cold conditions (for example patients with chronic arthritic conditions – Bi syndrome from Wind, Cold and Damp).

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

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

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

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

 

Black Chicken Soup with Carrot 胡蘿蔔烏雞湯

Ingredients:

  • 1 black chicken
  • 1 large carrot
  • 1-2 oz mushrooms (such as shiitake, or dried Chinese mushrooms)
  • 1-2oz water chestnuts
  • ½ oz black wood ear mushrooms
  • salt to taste

Preparation:

  1. If using fresh water chestnuts first peel, wash, and cut into pieces; soak wood ear mushrooms until soft, and soak other mushrooms until soft (if using dried)

  2. Cut up chicken into large pieces (leaving bones in), and cut carrot to chunks
  3. Put all ingredients except water chestnuts in a medium pot and bring to boil, then simmer for about 1 hour
  4. Add in water chestnuts, bring to boil once more, then simmer again for about 20 minutes (alternately put all ingredients in a crock-pot and cook overnight)
  5. Add salt to taste

Black chickens are also called silkie fowl. They are small chickens about the size of Cornish game hens, but have dark black skin. They are mostly darker meat, and great in soups. They can be purchased at most Asian grocery stores. The black chickens are thought to be sweet and neutral, entering the Liver, Kidney and Spleen channels. They are particularly good at supplementing the Blood. Overall this soup supplements the Kidney and Liver, nourishes Blood, transforms stagnation and frees the network vessels. Carrots are also beneficial for the eyes and this soup is said to treat night blindness and other types of poor or declining vision. For colder patients, consider adding ginger while cooking the soup to increase its warming function.

I hope everyone is staying warm!

Henry

Happy New Year! 元旦快樂!

Please accept my heartfelt wishes to everyone for a very happy, health, and prosperous New Year 2018! Thanks also for everyone's support over the years and I hope that we will all stay in touch in the years to come. I've also found out that my new course on ProD was their #2 most popular course for 2017! Thanks to Lorne Brown for all the work he does for the Chinese Medicine community, and thanks to everyone who took my classes to make this all a possibility! These ProD course are also NOW ON SALE until Friday January 12 for 20% off with the coupon code CELEBRATE. 

Click here to go to the courses on Healthy Seminars (formerly PRoD and Medigogy).

Medicated Liquor for the Cold Winter Weather

There’s a folk saying in Chinese that I’ve known for a long time that says if after eating a meal you take 100 steps (i.e., go for a walk), you’ll live to 99 years of age. In Chinese it rhymes so it’s more fun to say – fàn hòu bǎi bù zǒu, huó dào jiǔ shí jiǔ (飯後百步走,活到九十九). Well, there’s another phrase that I hadn’t read until just recently that’s similar in the rhyme structure, and it is appropriate to the season right now – hán dōng hē bǔ jiǔ, néng huó jiǔ shí jiǔ (寒冬喝補酒,能活九十九). This one means, if in the deep cold of winter you drink a little supplementing wine, you’ll be able to live to 99. Hey, that rhymes in English a little too!

The second phrase relates to a method of ingesting herbal medicines that has traditionally been popular in China, and especially popular in the colder weather – medicated wines, or medicated liquors. The simplest method of making medicated wines is to soak herbs in distilled liquor, like vodka or brandy. I typically recommend using a liquor of at least 80-proof (i.e., 40% alcohol by volume). Anything much lower in strength, like beer or wine, will simply not be a good preservative as it will go bad in a short time, and hence the name ‘medicated wine’ is a bit misleading (酒 in Chinese simply means any sort of alcohol, including wine or liquor). Higher proof liquor can remain for long periods of time at room temperature without spoiling. Traditionally some medicated liquor recipes used lower proof rice wine, but then included adding large amounts of dates, or even white sugar to the mixture. This in effect increased fermentation and the resulting alcohol per volume. Today we have easy access to inexpensive distilled liquor, so when coming across recipes with added fruit or sugar, simply omit those and use a good quality, high-proof liquor instead.

Why are medicated liquors popular in winter? First, as already mentioned, alcohol is a preservative. Today we have access to just about any herb any time of year due to modern agriculture and shipping methods. In ancient times this was not the case, and some herbs would need to be preserved and stretched out between growing and harvesting seasons. Also, hard to get or wild-harvested herbs might not be commonly available, so making them last a long time was important. Using a medicated liquor allows us access to important herbs during the time when there isn’t any harvest going on (i.e., in winter). Another important reason is the general nature of liquor. Alcohol is warm, acrid and sweet, meaning that is has the ability to warm the interior, move Qi and Blood (warm and acrid natures), and gently supplement the body (warm and sweet natures). This combination is particularly appropriate to cold winter weather. That said, in excess, alcohol consumption can create damp heat, and it is certainly contraindicated in patients for other reasons and while on certain pharmaceuticals.

Here are some typical medicated liquor recipes…

Huang Jing Liquor (黃精酒)

Take about 20g of Huang Jing to every cup of alcohol and place in a glass container. Soak for about 2 weeks before using (longer soaking is better if possible). Take 1 shot per day in the evening as a dose. This formula supplements the Spleen, moistens the Lungs, and nourishes the Kidneys. It can be used to treat weakness of the Spleen and Stomach, general weakness of the body, Lung yin vacuity or dry cough, Kidney jing insufficiency, and pain of the back or lower extremities.

Assist the Yang and Benefit Longevity Liquor (助陽益壽酒)

Ingredients: Dang Shen 20g, Shu Di Huang 30g, Gou Qi Zi 20g, Sha Yuan Zi 15g, Yin Yang Huo 15g, Ding Xiang 9g, Yuan Zhi 10g, Chen Xiang 6g, 10 pieces of dried lychee or 10 red dates (optional if using vodka)

Add the above ingredients to 6-8 cups of vodka, let soak for 3 days. Then, place open the container and place all the ingredients in a pot and simmer on a very low flame (just to warm, not to boil) for 30 minutes. Then, after letting the mixture cool, reseal in the original bottle and let sit for 3 weeks. Then consume 1-2 shots per day. This formula supplements the Kidney, invigorates the Yang, benefits the Liver, nourishes essence, strengthens the Spleen and Stomach and increases overall longevity.

There are many, many different medicated liquor recipes out there and these are just some examples. For the average person these are appropriate recipes, but for people with certain disease patterns, clearly the formulas should match the appropriate presentation.

Stay warm, have some medicated liquor, and Happy New Year this coming weekend!

Winter Solstice 冬至 Seasonal Node

Today, December 21 at 11:28am exactly (in Northern NJ), is the astronomical Winter Solstice. This was the moment when the elliptical orbit of the sun reached the point where, because of the tilt of the planet, the sun’s rays hit the Tropic of Capricorn at 90 degrees. This angling of the planet towards the sun means the least hours of daylight for the northern hemisphere out of any day of the year, and in the most northern latitudes there is 24 hours of darkness. However after today, the path the Earth takes around the sun changes such that the tilted northern hemisphere will gradually be hit more directly by the sun’s rays, slowly making the days longer and the warmer.

The Winter Solstice (dong zhi 冬至) seasonal node, the last node of 2017, begins tomorrow December 22. The Chinese term for Winter Solstice literally means the “extreme of yin” since Winter Solstice is the longest night of the year. Symbolically this node is represented by Hexagram 24, which is comprised of one Yang line at the bottom of 5 Yin lines. Hexagram 24’s name is Return – Fu (復). What is returning? The Yang and the light are returning. One of the basic laws of Yin-Yang theory is that of mutual transformation. When something reaches an extreme, then it naturally reverts to the opposite. Now is when Yin has reached its extreme thereby giving birth to Yang. This is why Winter Solstice is the time of many important holidays about birth and renewal. The Material Manifestations for this node are Earthworms Congeal (Qiu Yin Jie 蚯蚓結), Moose Deer Shed Their Horns (Mi Jiao Jie 麋角解), and Aquifers Stir (Shui Quan Dong 水泉動).

Fu: Return

Fu: Return

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

The second recommendation is “chi xu yun dong” (持續運動) – persist in moving. Even though Winter is the time of yin quietude, as mentioned above the Winter Solstice marks the birth of yang.  Because movement is Yang it is important for us to “persist in moving” during this time of year. Appropriate exercises include gentle movement such as Taiji, Qigong or Yoga. We have ongoing regular Qigong  and Taiji classes here in Northern New Jersey for those who are local (click here for more information on Qigong classes).

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

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

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

Here’s a traditional recipe for Winter Solstice. This recipe warms the interior and builds Qi and blood, and nourished the Heart to quiet the Spirit.

Longan and Lamb Soup 龍眼羊肉湯

Ingredients:

  • 1 lb. Lamb (deboned and cut into chunks)
  • Dried longan fruit (龍眼肉) 15g
  • Fresh ginger (peeled and sliced) about 20g
  • Scallions (chopped)
  • Salt
  • Cooking wine

Directions:

  1. Put lamb in a pot with 3 cups water, bring to a boil and simmer for just about 2 minutes; strain out lamb and discard water to remove the fat
  2. Place lamb back into pot with enough water to complete cover the meat (6-8 cups), the sliced ginger and scallions, dried longan, and a small amount of cooking wine
  3. Bring to a rapid boil on high flame, then reduce flame to a low simmer and cook for about 2 hours; remove from heat and add salt to taste

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

So, stay warm and enjoy the gradually lengthening days!

Major Snow 大雪 Seasonal Node

The Major Snow seasonal node started last week on December 7, and here in New Jersey we did start having snow fall in the last week, with more snow to come in the next few days. The temperatures have also drastically shifted from what was an unusually warm autumn; the temperature this morning when I left the house coming was only 22 degrees Fahrenheit (about -5 Celsius). With the thermometer dropping I’ve wanted warm breakfasts. Yesterday I had a big bowl of congee in Chinatown and I’ve been having oatmeal more often, usually with some butter to warm and moisten (counteracting the cold dryness in the environment) and Gou Qi Zi (Goji berries) to help strengthen my Kidney.

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

Screen Shot 2017-12-13 at 9.38.23 AM.png

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

Another easy self-care regimen for Major Snow is daily acupressure on Yang Chi SJ-4, 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. This point can be stimulated daily with acupressure, or direct thread or rice grain-size moxa to this point as a stand alone treatment, or 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 nature, it has the ability to warm and expel cold, and supplement the Qi and Blood while also circulating them. Thus, medicated wines are appropriate for Winter. One traditional medicated wine that is prepared during Major Snow is Gecko Wine (Ge Jie Jiu 蛤蚧酒). To prepare, soak one pair of Gecko (ge jie 蛤蚧) obtained from a Chinese pharmacy in 1000ml of grain alcohol of at least 80 proof (vodka is a good choice). Let sit for at least 1 month, and then take 1 small shot glass per day in the evening. Gecko has a Yang warming and Kidney supplementing effect.

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

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

Garlic Chrysanthemum Greens (蒜泥茼蒿)

Ingredients:

  • Edible chrysanthemum greens (Tong Hao 茼蒿) ½ lb.
  • 1 small garlic bulb
  • Sesame oil
  • Salt and pepper to taste

Directions:

  1. Rinse chrysanthemum greens and chop into 1 inch pieces
  2. Peel, crush then chop garlic
  3. Bring a pot of salted water to boil, then blanch chrysanthemum greens by immersing in water for about 3 minutes; then drain
  4. Mix greens with chopped garlic, and a small amount of salt, peper and sesame oil to taste; serve slightly warm or room temperature

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

Stay warm and happy Winter!

Pro D Black Friday Sale this week

Pro D Seminars is offering a Black Friday Sale this week. This year I did my first course with Pro D so this is a chance for those of you who are interested to get the class for a discounted rate. My course was a 6 hour exploration of Tung's acupuncture for gynecology. The course is NCCAOM, California, Florida, ABORM and other groups approved.

Here is the link to get to the course: www.prodseminars.net/bio/henry-mccann. 

Remember to enter the coupon code BLACKFRIDAY2017 to get the 30% discount. 

Shaolin Acute Injury Formula

Here is a translation of an injury formula from the Shaolin Bronze Man Book of Secret Formulas (少林寺秘方銅人簿; Qing Dynasty). I’ll try to post more formula translations from the book as I work through it, and later I’ll talk a little more about this genre of book as well.

This is a basic injury formula for acute injury. As we can see most of the herbs quicken blood, relieve pain and reduce swelling. The formula is decocted in a combination of water and alcohol, which was a common method of preparing trauma formulas that I first learned from Dr. Ping Chan up in the Boston area. I particularly like seeing that same part of the body but different sides (i.e., right and left) get different single herb additions. Dosages are translated as the original, in ‘Qian.’ This makes me nostalgic, as when I was first in practice I would have to write all formulas in Chinese so that patients could go to Chinatown in Boston to have formulas filled. And those pharmacies didn’t take formulas with gram measurements, so I would have to render everything in traditional weight measures! Thanks also to Lorraine Wilcox who helped in the identification of some alternated herb names (it was common in the past to use alternate characters/names for herbs - things weren't as standardized as today).

 

Initial Stage Injury Formula (with modifications) 初打新傷方

Sheng Di 2 qian, Dang Gui Wei 2 qian, Tao Ren 0.5 qian, Hong Hua 1 qian, Ze Lan 1 qian, Da Huang 1 qian, Jin Bu Huan 0.5 qian, Zi Ran Tong 0.5 qian, Yu Jin 1 qian, Bing Lang 1 qian – decoct in mixture of alcohol and water

Additions:

  • Head injury – add Chuan Xiong
  • Facial injury – add Bai Ju Hua
  • Eye injury – add Bo He
  • Chest injury – add Jie Geng
  • Left costal injury – add Qing Pi
  • Right costal injury – add Zhi Ke
  • Rib injury at the connection to the spine – add Xu Duan
  • For bleeding – add Hong Hua
  • Heart injury – add Chuan Lian, Mai Dong
  • Lung injury – add Sang Bai Pi, Chuan Bei Mu, Huang Qin
  • Liver and Gallbladder injury – add Long Dan Cao
  • Spleen injury – add Chi Shao
  • Stomach injury – add Bai Dou Kou
  • Small Intestine injury – add Mu Tong
  • Large Intestine injury – add Da Huang, Tao Ren
  • Bladder injury – add Huang Bai, Tong Cao
  • Kidney injury – add Di Gu Pi
  • Ming Men injury – add Mu Dan Pi, Ze Xie
  • Hand/arm injury – add Gui Zhi, Xu Duan
  • Leg injury – add Niu Xi, Xu Duan
  • Upper burner injury – add Da Huang
  • Middle burner injury – add Huang Qin
  • Lower burner injury – add Huang Bai
  • Entire body injury – add Jiu Ceng Ta Tou (i.e., basil), Jing Jie

Beginning of Winter 立冬 is here!

This year, 2017, the Asian calendar marks November 7th as the Beginning of Winter seasonal node. While in the west we consider Winter Solstice to be the start of Winter, in Asia the seasons are calculated by the balance of Yin and Yang in the natural environment as evidenced by the relative balance of day and night. Since Winter Solstice is the darkest time of year, it is considered to be the zenith of Yin, and hence mid-winter. Therefore, the early part of November is the beginning of Winter, the time of year that is darkest and most Yin.

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

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

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

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

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

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

Diet for Beginning of Winter

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

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

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

Zhang Zhong Jing and the legend of dumplings…

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

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

Tung Acupuncture Historical Musings (Repost)

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

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

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

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

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

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

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

 

References:

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

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

Autumn Courses Coming Up Soon

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

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

Happy Mid-Autumn Moon Festival 中秋節快樂

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

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

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

My wife Jen's homemade mooncakes ready for the oven

My wife Jen's homemade mooncakes ready for the oven

Autumnal Equinox 秋分 Seasonal Node

Autumn Equinox is here! This is the day midway between the solstices, and being the midway point, the equinoxes are the times of even balance between Yin and Yang. Furthermore, Saturday begins the next 2-week long seasonal node, also called Autumn Equinox. In the Chinese calendar we are in the eighth lunar month and the time related to the Kidney channel. The smaller 5-day segments of this seasonal node are called Thunder Begins to Retract its Sound (Lei Shi Shou Sheng 雷始收聲), Hibernating Insects Reinforce their Shelters (Zhi Chong Pei Hu 蟄蟲培戶), and Water Begins to Dry Up (Shui Shi He 水始涸). The names of these 5-day segments of time all point to a similar phenomenon – this is the time of year when the Yin-contracting movement of nature is in full gear in preparing for Winter’s slumber.

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

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

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

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

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

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

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

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

Class Schedule Updates - Daoist Neigong and Paida Gong

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

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

The Five Taxations 五勞 Part III

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

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

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

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

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

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

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

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

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

End of Heat 處暑 Seasonal Node

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

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

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

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

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

Pear and White Wood Ear Soup 雪梨銀耳湯

Ingredients:

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

Directions:

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

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

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Pear and White Wood Ear Soup simmering

Words on the process of cutivation

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

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

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

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

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

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

Beginning of Autumn 立秋 Seasonal Node

I’m just getting back from a great two weeks in China with my Shifu, Wang Fengming, as because I’ve been traveling with poor internet connections I’m just now getting to write about the current seasonal node. One interesting part of my travel was the train I took back from Huang Shan to Beijing. I sat next to a lovely older Chinese woman who, when she realized I spoke Chinese, was rather chatty. As she was from Fujian, her Putonghua (standard Chinese) was about as good as mine, so we were on pretty even footing there. We talked a lot about Chinese culture and health, which is a topic a lot of Chinese really like to talk about. The reason I bring this up is because she had a personal Seasonal Node practice she was happy to tell me about. It turns out when her son was younger he had some sort of chronic health problem (I think it might have been asthma). She took him to see a famous old Chinese doctor (老中醫), a term they use to describe a physician with many years of experience, who in addition to treating her child gave her a Seasonal Node regimen to follow.

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

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

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

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

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

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

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

 

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

Ingredients:

  • 1 cup rice (use glutinous rice if available)
  • 200g Euryale seed (Qian Shi )
  • 200g Discorea (Shan Yao )
  • 200 g sugar
  1. Grind rice, Euryale seed, and Discorea to a powder. Mix the three together with sugar and blend well so evenly mixed
  2. In a pan, add 50 – 100g of blended powder to cold water, enough to make a thick soupy consistency
  3. Put over medium flame and warm for several minutes, stirring occasionally
  4. Enjoy in the morning on an empty stomach (consume warm)

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

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