Minor Fullness 小滿 Seasonal Node

It looks like I haven’t posted anything on this current seasonal node in about 5 years! So, even though I’m a day late I figured I should really post something this year.

The new seasonal node that started yesterday, Saturday May 21st, is called Minor Fullness – Xiao Man 小滿. It is the second segment of Summer, and the eighth segment of the year. The name “Minor 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 “Minor 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 Minor 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). In Japan these smaller segments are called Silkworms Begin Eating Mulberry (Kaiko okite kuwa o hamu 蚕起食桑), Safflower Blooms (紅花栄 Benihana sakau), and, the same as in China, Wheat Harvest Arrives (in Japanese pronunciation, Mugi no toki itaru 麥秋至).

Typically, during Minor Fullness there is more dampness and heat in the environment. This weekend in northern New Jersey we are suddenly having very hot and very humid weather. In many parts of Asia, Minor 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” – Minor Fullness, Minor Fullness, the rivers and streams are full. Since this time of year sees increased dampness and eventually heat the appropriate thing to focus on in order to stay healthy is preventing the build up of 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 consistently dominant weather pattern. During this Seasonal Node we still have a mix of hot and cold days, and evenings in particular can be chilly. Later this week daytime temperatures here are expected to drop some 20 degrees, with evening temperatures expected to drop into the 50s°F. 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 Minor 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 Minor 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, winter melon, celery, cilantro, lily bulbs and osmanthus. Along those same lines, a basic dietary recommendation for early Summer is to decrease the amount of oil in foods and increase water consumption. 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 Minor 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 Minor 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.

One of this year’s tree peonies from my yard

In terms of acupuncture my recommendation is to consider focusing on Spleen and Stomach. Points that generally regulate the Spleen and Stomach and thus can assist in dealing with dampness in the environment include Ling Gu 22.05, Si Hua Shang 77.08, and Men Jin 66.05. For patients who have poor appetite you can have them use acupressure on Kai Pi 開脾穴. You can also needle this point, but it is a bit painful! Lastly, if patients are experiencing acute diarrhea due to weather change and dampness, needle Shou Wu Jin 33.08 and Shou Qian Jin 33.09. For those unfamiliar with Tung points such as these, they are all found in the Practical Atlas I wrote along with Dr. Hans-Georg Ross - click here for more information.

Lastly I’ll mention that another fantastic thing about this seasonal node is that it is tree peony 牡丹花 season. This is one of my favorite flowers, and blooms before the regular herbaceous peonies 芍藥花.  Unfortunately, like cherry blossoms, the tree peonies are very fleeting – so if you’re nearby any go out and enjoy them while you can. Stay cool and dry!

Beginning of Summer 立夏 Seasonal Node

I’ve been behind on my seasonal nodes posts lately. We’ve had a relatively cold Spring here in the northeastern US and, happily, I’ve been busy with clinic and teaching. I also realized that for some reason I haven’t posted this current seasonal node since before the pandemic started.

Qian 乾 Gua

It may be hard to believe given the really cold March, and somewhat cold April we’ve had here in the northeast, but earlier this week on May 5th we reached the beginning of Summer in the traditional Chinese calendar, and thus the start of the Beginning of Summer (立夏 lì xià) seasonal node. By now the days are getting significantly longer, and the bursting out of life in nature is incredibly palpable. I’m eagerly waiting my tree peonies – it looks like they’ll be opening up soon with some impressive buds already there! At this point in time (I know it’s a horrible thought), in only about 6 weeks the days will start getting shorter again. Right now the Yang of the natural world is close to its fullest, and correspondingly the hexagram that represents this time of year is Qian Gua (乾卦) – six solid-Yang lines.

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

This year one thing to keep in mind (for those of you on the East Coast of the US) is that the weather has been particularly cold, and recently more wet. Normally this is the time of rising Yang in the natural world, although I can say that it seems to be lagging behind a bit. The second chapter of the Su Wen says that when we don’t follow the guidelines of Spring then there is change to cold in the season that follows. Zhang Zhicong interprets this as the development of cold diseases (i.e., cold patterns). This is also the case though when the weather doesn’t behave – not just we humans not behaving. The continued cold and damp (both Yin evils) effectively restrict the Yang movement in our bodies. Thus, clinically I’ve been seeing a lot more joint pain, general aching, fatigue, digestive weakness, and diarrhea. For these patients consider doing moxa on points such as Zu San Li ST-36, or needling points such as Zhong Jiu Li 88.25 for general joint pain. Encourage patients to dress adequately for the weather on days where cold lingers.

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

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

Another way to avoid problems of Heart Fire is closely tied in with traditional meditation and body cultivation practices (such as Neidan, or in modern terms, Qigong). Early medical texts such as the Ma Wang Dui manuscripts taught the importance of sinking the Qi down to the lower part of the body, a place in cultivation literature known as the Dan Tian (丹田; Tanden たんでん in Japanese). This idea later became vitally important in meditation schools such as those of Internal Alchemy, and then was inherited by modern Qigong practitioners. The flaring up of fire is seen to be an extremely harmful problem, and one of the main ways to counteract this is by focusing on the space in the abdomen – the Dan Tian.  This can be done during standing meditations, such as standing post (站樁), or in seated meditations (坐禪). Doing these types of practices regularly is perhaps one of the best ways to deal with the upflaring of Heart Fire. For those in New Jersey or New York, we discuss these techniques frequently in our weekly Neigong/Qigong and Taijiquan classes (and we do the same in our online pandemic Qigong classes, which are still ongoing).

Diet for Beginning of Summer

With the new seasonal node come new dietary suggestions. One of the first 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. If patients experience digestive upset, as a temporary measure we can needle points such as Ling Gu 22.05, Si Hua Shang 77.08 and Men Jin 66.05. If there is Heart Fire bleed the ear apex.

In terms of 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 heat in the environment increases it is understandably important 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 vacuous internally. Since Summer in many places also has increased environmental dampness, these people can drink a very light ginger tea or fennel seed tea, sweetened if desired local honey. Allergy sufferers (right now in New Jersey we are in the middle of a allergy season) can take mint tea with 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.

And one last recipe for Beginning of Summer

Pickled Cold Lotus Root

Ingredients:

• 1 lb. lotus root

• 3 cups rice vinegar (or white vinegar)

• ½ cup sugar

• ½ tsp salt

• 1 small red chili pepper

Directions:

1. Peel lotus root and then slice into VERY thin slices; soak for a few minutes in a bowl of cold water with a little white vinegar to keep from discoloring

2. Slice red chili pepper in to very thin slices, or julienne; if whole pepper is not available then substitute with red pepper flakes if desired

3. Combine vinegar, sugar and salt in a small saucepan, bring to a simmer for just one minute, and stir to be sure salt and sugar have completely dissolved

4. Bring another pot of water to boil and parboil lotus root for several minutes; then drain in colander and cool with cold running water

5. Put cool lotus root and sliced chili pepper in a clean bowl and cover with the vinegar solution; cover and then refrigerate at least overnight or up to a few days before eating; to eat, remove from liquid and serve chilled

This recipe nourishes yin, clears heat, supplements vacuity and awakens the Spleen. It is good for those with poor digestion as well as those with dryness symptoms.

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

The Duke of Zhou's Interpretation of Dreams 周公解夢 - A Review

Not too long ago I received my copy of The Duke of Zhou’s Interpretation of Dreams, one of the most recent books published by Purple Cloud Press. Over the last few years I’ve been rather impressed by books from this small publishing company. In my opinion their books are significant assets to the profession of East Asian medicine and related fields such as Daoist studies. This book is somewhat different as it is not specifically an East Asian medicine text, nor a book on Daoist arts. Instead it is a translation of an important dream interpretation manual. Yet, even though not a clinical manual, this book deserves a reading by all of us who practice East Asian medicine.

The subject of dreams is something that I suspect interests many East Asian medicine practitioners. Yet, the topic is barely explored in medical classics. The most notable examples I can think of are the discussions in the Mai Yao Jing Wei Lun (Treatise on the Essentials of the Pulse and the Subtleties of the Essence; Su Wen 17) and in the Fang Sheng Shuai Lun (Treatise on Comparing Abundance and Depletion; Su Wen 80). However, the discussions of dreams in these chapters are relatively short, based mostly on simplistic Five Phase or Yin-Yang breakdowns, with some other material added. As such, those clinicians interested in dream analysis supplement these discussions (when they’re even aware that there is some material in the Su Wen, albeit minimal), with dream interpretation based on modern western models. While this in and of itself may not be horrible, I think as practitioners of East Asian medicine it is by far preferable to understand the tradition as it was originally practiced, and the culture that was the soil in which the medicine grew. Once we understand how doctors in East Asia saw dreams, then we can better create a newer model to analyze dreams in our own times and cultures.

The Duke of Zhou’s Interpretation of Dreams (周公解夢) steps in to help fill those gaps. The book starts off with a very useful foreword that helps situate dream interpretation in history and culture. It turns out that dream interpretation and divination was an important topic in pre-modern China, and in the later imperial period dream interpretation books were popular and widely read. Following the foreword, Purple Cloud Press’ editor Johan Hausen gives readers a detailed presentation of who exactly was this character, the Duke of Zhou. Just like the Huang Di, the eponymous Duke of Zhou is a cultural hero in China and his association with this text is something important to consider. Hausen’s introduction continues by investigating the association between the Duke of Zhou and dream analysis. Throughout all of these sections there are copious endnotes that cite scholarly sources both in Chinese and European languages, and do things such as analyze individual Chinese characters to better elucidate topics being presented. Overall, I estimate that the introductory materials before the actual translation is about a quarter of the entire printed book. In my opinion, this material alone is worth the purchase of the book. There was quite a bit of information on the place of dreams in Chinese culture and history that I had never before read, even with my 30 plus years of involvement with East Asian Studies and Chinese medicine.

After the introductory material we get the actual translations – in this case two versions of the original text, one of which was found in the Dunhuang Caves. Each book is separated into thematic chapters that provide analyses of those dreams. Such chapters include, for example, “Heaven and Earth, Sun, Moon and Stellar Constellations,” “Spouses, Childbirth, Pregnancies and Sex,” Food and Drink,” and “Dragons and Snakes.” What I also particularly appreciate about the book is that it is bilingual, containing the original Chinese text with Nikita Bushin’s excellent translations. As time goes by more East Asian medicine professionals are embarking on the study of Chinese, and bilingual editions allow individual readers the ability to see the original text, and interact with the translation in a way that an English only edition does not allow.

Another feature I found very interesting is the presence of some chapters in the original texts on interpreting dreams based on the Twelve Earthy Branches, and dreams appearing during the Twelve Watches (i.e., the double-hours). The theories of Ten Stems and Twelve Branches are essential to the practice of East Asian medicine, yet scarcely covered in our entry-level degrees. There is also a chapter on the use of talismans to treat nightmares. Talismans (符) are an esoteric approach to medicine that I find particularly interesting, and also something completely absent from western discussions of East Asian medicine.  

When I first got this book I decided to simply read it from cover to cover, however I quickly realized this was not the best way to approach it (as the introduction actually tells us). Instead, I decided to use what the Duke of Zhou gave us in its intended manner. Over the last month each night when I could remember my dreams, I would try to find something similar in the text. Reading the interpretation was then a meditation for me that day. Given the fact that much of the text describes a society quite different from the modern day, sometimes I could not find something directly on point. But what I did find was that I was starting to remember my dreams more often. The act of interacting with them on a more regular basis with as illustrious a guide as the Duke of Zhou himself opened up a new window on my dreams that I can say is both fascinating and useful. I will keep the content and interpretation of my own dreams to myself, but it seems clear that this is the very intended and original use of the book: opening up a window on our dreams and encouraging us to analyze their meanings to help us with our daily waking life.

Overall the only complaint or suggestion I have is that an index would be very useful since the book is designed to be a reference that is consulted over and over again. Since however the chapters are relatively short and arranged by topic, this is not a huge problem. But, if there is a second edition, an index would be a great addition. Aside from that this is an excellent book of Chinese culture and folklore that can give East Asian medicine practitioners deeper insight into the time, place and people that created our medicine. Happy dreaming!

Vernal Equinox 春分 Seasonal Node

Today, Sunday March 20th is the Vernal Equinox. At exactly 11:33am Eastern Time the sun will be at an exact vertical angle to the equator. Over the next few months the sun will continue angling more and more towards the Tropic of Cancer meaning the days for us in the Northern Hemisphere will continue lengthening until reaching an apex at the Summer Solstice. This day is also the beginning of the next 15 day seasonal node, also named Vernal Equinox.

At this point, in the Chinese calendar we are in the middle of Spring, but in the western calendar we celebrate Vernal Equinox as the beginning of Spring. In Persia this day was traditionally revered as the beginning of the year (called Nowruz), and Rosicrucian mystics count Vernal Equinox as the New Year as well. Why then does the Chinese calendar regard Vernal Equinox as the midpoint of Spring? Because we are now at the balance point of Yin and Yang. If the height of Yang is the longest day (Summer Solstice), and the height of Yin is the longest night (Winter Solstice), then the midpoints and thus points of balance are the Equinoxes. Even though the weather is still cold and there is snow on the ground, the gradual awakening of all life in nature is clear.

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

The main thing to focus on during this 15-day period is “Nourishing the Liver” (yang gan 養肝). One of the ways we nourish the Liver is to ensure normal Liver function. For example, this is the time of year to really ensure our patients' Qi is freely coursing (one of the main functions of Liver is to ensure normal coursing of Qi). The second “to do” during this time is to “both Clear and Supplement.” This means that when the Liver is hot or hyperactive, clear and sedate. When it is vacuous (e.g., has Blood vacuity), then supplement. Since any pattern of disharmony in Liver will impair some of its major functions, when we see Liver patterns during this seasonal node they must be treated. That said, this year, at least here where I am located, the weather is still chilly, especially in the mornings. As such we may have to protect the warm-Yang in the body at the same time we clear Liver or supplement the Yin-Blood. A beautiful example of this is harmonizing formulas such as Xiao Chai Hu Tang, or even Xiao Yao Wan. Both contain herbs that strengthen and supplement (e.g., Ren Shen, Bai Zhu) alongside herbs that course or clear Liver. We can also consider giving our vacuous patients pill-form warming and supplementing formulas together with powders or decoctions that have a more Liver coursing or clearing function.

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

Diet for Vernal Equinox

Diet for the Vernal equinox should mimic the balance that is present in nature at this time. In general, the continued use of mildly acrid foods such as ginger and scallions help ensures normal coursing of Liver qi. This is especially useful for patients with Liver depression patterns. Patients who tend more towards vacuity patterns, especially Liver blood insufficiency, can increase consumption of sour foods such as pickles or vinegar. This year since the weather is cold though, we should continue to eat slightly warming foods. However, it is best to avoid very greasy or cloying warm foods (such as an overconsumption of very fatty meats), or very salty meals. While salty and more greasy is ok in the cold of Winter, right now in Spring we need to be concerned with the normal and smooth movement of Qi and Blood in the body. The basic combination then is warming and acrid, such as the aforementioned ginger.  

A simple tea most patients can consume during this time is rose bud tea. This tea is made by steeping Mei Gui Hua 玫瑰花 in hot water. Mei Gui Hua is warm and sweet and is found in the Qi regulating chapter of the Materia Medica. It courses Liver as well as gently quickens the blood. It is especially useful for our female patients who have menstrual irregularities due to Liver stagnation. In the Baijiquan 八極拳 system of Chinese marital arts, Mei Gui Hua tea is used as a general Qi and Blood moving tea for injury. For patients who suffer from more internal cold, Mei Gui Hua can be combined with Gui Zhi (cinnamon twig) or Sheng Jiang (fresh ginger).

One traditional dish for Vernal Equinox is Stir Fried Pig Kidney with Eucommia (杜仲豬花). Here’s the recipe:

Ingredients:

• Organic pig kidney ¾ to 1 lb

• Eucommia bark (Du Zhong 杜仲) 6-9g

• 1 scallion, 1 piece of ginger (about the size of your thumb or a little larger), 1-2 cloves of garlic

• Cooking oil, salt, soy sauce

 Instructions:

• Cook Du Zhong in about 1 cup of water by bringing to a boil and then simmering until only about ½ cup of liquid is left

• Cut kidneys into thin slices and then score one side of each slice; peel and slice the ginger, slice the garlic, and slice the scallion

• In a pan, add a small amount of cooling oil, and start by cooking the garlic and ginger just until fragrant and / or the garlic is transparent. Add in the kidney slices and cook for several minutes. Then add a small amount of salt and soy sauce.

• Add in the Du Zhong liquid, and cook down in the pan with the kidney. Add scallions. Cook until kidneys are thoroughly cooked through.

• Optionally can add Gou Qi Zi (i.e., Goji berries) at end as well before liquid has cooked down, cooking until slightly plump.

This recipe supplements the Kidney, boosts essence, and nourishes the Liver blood. It is good for lower back pain, knee pain, declining visual acuity, or other symptoms of Liver and Kidney vacuity. Because it is warming it is especially useful this year!

Acupuncture for Equinox

When considering acupuncture recommendations, first we should think about how Wood phase (for Spring) is functioning in our patients. Ideally, we should all be in a state of balance, neither in a state of insufficiency nor of repletion. Relative repletion, especially during the time of transition into warmer weather, frequently manifests as stasis. This is because the Qi of the body, as the time of year is becoming more Yang, wants to move. But since cold weather is still lingering, Qi has trouble moving and stagnation is the result. Another possible reason for stagnation is a failure to increase physical movement this time of year. If this is the case then points that course Qi and Blood throughout the body should be chosen. My recommendation is to consider the Metacarpal Three Needles (掌三針) consisting of Ling Gu 22.05, Da Bai 22.04 and Zhong Kui. On the lower extremities we can add Ren Huang 77.21. If the repletion also manifests with some internal heat, consider bleeding the apex of the ear.

The opposite situation is having a patient with insufficiency of Wood, either in the case of Liver Vacuity (especially patterns of Liver Blood vacuity), or of general vacuity of the Yang. For Liver vacuity we can consider points such as the Upper Three Yellows (上三黃; 88.12, 13, 14). Alternately, we can choose the Lower Three Emperors (下三皇; 77.17, 19, 21), one main Dao Ma group for the Kidney. Why the Kidney Dao Ma group? Because strengthening Water-Kidney automatically strengthens Wood-Liver because of the Five Phase engendering cycle relationship.

I hope everyone will have a great Equinox!

Principle in Taijiquan and Medicine

Today was one of those perfect early spring days with plenty of sun but still cool early morning temperatures that eventually rose to the mid-60s (about 18 ℃). I’m also hopeful that we are in the tail end of the pandemic and may eventually enter the endemic phase of COVID. While we are still masked in medical offices here in NJ, society is slowly feeling a bit more “normal.” In that light I’ve also been returning to one of my weekly rituals that has been going on for the last decade or so, minus some time at the height of the pandemic – weekly visits with my Taijiquan shifu, Wang Fengming.  

Wang Fenming with Taiji Mace 太極鐧

When we practice together, we usually will work on some form (Tao Lu 套路) or other set exercise, and then practice Push Hands, the partnered exercises of Taijiquan. The last few weeks I’ve been working on the Chen Taiji Single Jian form. This is one of my favorite traditional weapons in the Chen repertoire, and something I suspect most people would not associate with Taijiquan. The word Jian (鐧) is usually translated as a mace, but it’s a bit different from the western versions of this weapon. Basically, it is a short baton of about 29 inches (74cm) made entirely of steel. The “blade” part, which is not sharp, is either traditionally rounded, or fashioned in a shape with angular edges. And, it’s heavy. The Jian I work with is about 3lbs 8oz (1.6kg). Compare that to my full weight traditional straight sword which weighs in at 1lb 15oz. A standard modern Taiji practice sword usually weighs about 1lb 3oz, and a modern wushu straight sword only about 1lb.

 During the pandemic when I was unable to visit Master Wang I spent some time learning the Single Jian form from a video. Compared to most of the Chen style weapons forms the Single Jian is relatively short. Consider also that the main thing that you do with a Jian is simply bludgeon your opponent with it. It’s not what I would call a subtle weapon! Yet, when I meet with Master Wang we take one or two movements at a time and drill down on them for about an hour at a time, going into far more detail than I can absorb just from the video. What seems at first to be a rather inelegant club thus transforms itself into a tool to explore deep Taiji principles.

As I’m frequently reminded by one of my own students, when we practice and form or any weapon, it’s all Taiji. Over the last decade that I’ve trained with Master Wang I’ve heard him impart so many small detailed corrections that there is no way I could remember them all. However, on a deeper but still very real and practical level, he’s constantly imparting the same basic principles over and over again (perhaps I’m just too poor a student to internalize them in everything I do!). Taijiquan then reveals its true nature – it isn’t about specific techniques or forms, but core principles that are embodied in every form, weapon, or partnered exercise we do.

While the principles of Taiji are interesting, most of my readers here are Chinese medicine practitioners. Yet, the reason I bring up this story is because at a fundamental level Chinese medicine is the same. The medicine we practice is not about doing acupuncture, or prescribing herbs, but rather the basic principles that govern the way we see the world, and therefore approach patient care. Qi Bo tells us as much in the very first discussion he has with the Huang Di. Remember, the very first question in the Neijing is one of longevity. Huang Di asks why is it that people of ancient times lived easily to 100 with their full health, while people of today are falling apart at half that age? This question really gets to the heart of the matter in that he is really asking how can we understand and stave off disease.

What does Qi Bo answer? He never once says, “Oh, they like to do acupuncture.” Or, that they take natural medicines instead of pharmaceutical products. Qi Bo knows better, because he knows that medicine is not defined by technique, but rather principle, what in Chinese is known as Li 理. So, what Qi Bo says is:

The people of very ancient times knew the Way (Dao). They followed the pattern of Yin and Yang, and complied with the Arts and Calculations.

上古之人，其知道者，法於陰陽，和於術數

Only after this does Qi Bo give us some simple examples such as in how we should eat, work or rest. But fundamentally, Qi Bo tells us that Yin-Yang, and other theories such as Five Phases, Stems-Branches, etc… are the way we understand the Dao. Understanding the Dao and understanding the body are the same, since, as Zhang Jiebin said, the human body is a small Heaven and Earth. Looking at the body then is more than just knowing where the points are supposed to be, or what herb treats what specific disease. It is seeing the body as a manifestation of the constant expanding and contracting of the universe, albeit in smaller form.

As a martial artist (Taijiquan is a martial art), once we internalize principles there are no set forms. Likewise, in Chinese medicine, once we internalize principle then we are free from one dogmatic way of approaching diagnosis and treatment. As I’ve said in my classes before, if you are really good at TCM acupuncture, you should be able to look at a Tung protocol, or a Japanese acupuncture protocol, and understand what they are trying to do. Likewise, if you are good at Tung’s acupuncture and internalized its basic principles, you should be able to understand other acupuncture systems’ treatments and approaches. When a TCM acupuncturist looks at a Tung point and has no idea why it does what it does, then they can’t say they really understand TCM acupuncture, their own system. In the end we can have differences of opinions as to what is the best way to approach acupuncture in general, or some patient in specific, but the principles are always still there and fundamentally the same. This is why there are also no real secret techniques!

All of this of course is easier said than done, and I cannot say I am a true master of anything. But I know that the quest for deeper understanding is done by going back to what Qi Bo said: knowing the Dao is knowing the basic core principles. My hope is that we all take this admonition seriously.

A pair of maces 雙鐧

Tung Family Bi Syndrome Wine

The use of medicated wines (also known as medicated liquors) has a long history in China and is an important part of the Nourishing Life (Yang Sheng 養生) tradition. Medicated wines are a convenient way to take a mild yet effective dose of herbs on a daily basis. Alcohol is also a preservative, meaning that expensive or hard to get herbs can be used for a longer periods of time than they would otherwise be.

According to Chinese medical theory alcohol by itself is warm, acrid and sweet. Thus, it has the dual function of both supplementing and moving the Qi and Blood. When combined with herbs it is therefore an excellent treatment method for the cold and damp of winter. Here is a simple and effective medicated wine recipe from the Tung (Dong) lineage of medicine. While the last practicing member of the Tung family, Tung Ching Ch’ang, was primarily known for his skills with the needle, he was also familiar with basic herbal and dietary therapy protocols. This medicated liquor is based on a Tung family recipe with modifications to make it more appropriate for cold weather and to substitute now endangered species.

Tung Family Bi Syndrome Wine 

• Huang Qi 30g

• Wu Jia Pi 15g

• Gou Qi Zi 15g

• Ge Jie (Gecko) 1 whole piece

• Chuan Niu Xi 9g

Place all the above herbs in 500ml of high proof distilled liquor (usually about 80 proof; e.g., vodka or brandy). Let sit for at least 2 weeks but 1 month is preferable. After that drink 1 shot glass (about 40ml) per day. This formula is appropriate for anyone with general Qi and Blood vacuity pattern who tends to feel cold. It also can be used for people with general back or limb pain, and is especially useful in chronic cases. Caution should be exercised with people who tend to full heat conditions. It is contraindicated for patients using pharmaceutical products that cannot be taken with alcohol.

Awakening of Insects 驚蟄 Seasonal Node

Yesterday, Saturday March 5th was the start of the Awakening of Insects seasonal node (jing zhe 驚蟄), the third node of the year. This is the next segment of Spring, and although over the last two weeks weather has been particularly chilly, I’m starting to see buds setting on trees. Also, many mornings as I walk outside the house the birds are singing so loud it is hard to ignore them. The earth is slowly waking from Winter’s sleep. In China the three 5-day periods in this seasonal node are Peach Trees Begin to Blossom (tao shi hua 桃始華), Orioles Sing (canggeng ming 倉庚鳴), and Hawks Transform into Cuckcoos (ying hua weijiu 鷹化爲鳩). These Japanese versions of these smaller segments are Hibernating Insects Come Out (蟄虫啓戸 sugomori mushito o hiraku), Peach Trees Begin to Blossom (桃始笑 momo hajimete saku), and Caterpillars Transform to Butterflies (菜虫化蝶 namushi chō to naru).

The first ‘to do’ for this period of time is to guard and protect the Yang qi. Even though we are in Spring, this early part of the season, especially this year, can be cold. Continue to dress appropriately, especially since there can be wide fluctuations in temperatures from day to day. As Yang qi continues to grow in the natural environment, now is the time to start doing more gentle exercise. This recommendation comes from the second chapter of the Neijing Su Wen, the The Great Treatise on Regulating the Spirit with the Four Seasons (Si Qi Tiao Shen Da Lun). There Qi Bo recommends that during Spring we should “upon waking take a walk in the courtyard, loosen the hair and relax the body, thus focusing the will on life.” Movement, especially in the morning, is a Yang activity. The Neijing recommends that “in Spring and Summer nourish Yang, and in Autumn and Winter nourish Yin (春夏養陽，秋冬養陰).”

The ‘to avoid’ during Awakening of Insects is undo stress and strain. As Chinese medicine practitioners we all know the mental pattern associated with Wood phase, and thus Spring, is anger. Patients who are prone to Liver depression or Liver repletion patterns should be monitored during this time period to be sure qi is circulating smoothly. This is the time when formulas in the Chai Hu family are appropriate for many people. For patients prone to resentment and anger, contemplative practices such as Japanese Naikan are appropriate.

Diet for this time of year should help protect the Yang qi as well. I generally recommend that people eat warming foods such as leeks, chives, and scallions. Likewise, it is appropriate to drink a little alcohol, provided the patient does not have specific sensitivities, morbidities, or medications that require abstinence. All of these foods, including alcohol, are warm and acrid, and thus course and warm the qi. I also suggest that everyone consume slightly more white noodles. In general, wheat husk (bran) is cooling, while the endosperm (inner white portion) is warming. White noodles, especially in soups, have the function of warming and supplementing the qi.

One traditional dish for Awakening of Insects is Schizonepeta and Mint Congee (荊芥薄荷粥). Congees are simply rice porridges. To make this congee start with 10g Jing Jie, 6g Bo He, and 10g Dan Dou Chi. First, place the Dan Dou Chi in about 5 cups of water, bring to a boil and simmer on low for 30 minutes. Then, add the Jing Jie and Bo He, simmering only for 5 minutes. After this, strain out the herbs and retain the liquid. Place the liquid back in the pot and bring to a simmer again. Lastly, add in about ½ cup of rice and cook until the rice breaks apart and becomes porridge-like (this can take 30-45 more minutes of cooking). Add in extra hot water as necessary if the congee becomes too thick. Schizonepeta and Mint Congee expels wind, resoles the surface, clears heat and eliminates toxins. It is useful for treating early stage colds, seasonal allergies, or just as a daily early Spring food.

The last recommendation I’ll offer for Awakening of Insects is the traditional Chinese practice of Pai Da – stimulating acupuncture points and channels by patting. As mentioned above, Spring is the time to increase movement. Liver (the organ of Spring) ensures the free coursing of Qi and Blood in the body. Thus, any exercise or practice that opens and circulates the channels of the body will have a beneficial effect on the Liver. One basic Pai Da technique is to use the hands held in loose fists to pat acupuncture points on the upper limbs. Start by patting the shoulders – the area of Jian Jing GB-21. Alternate right and left while patting. Then, continue with patting the sides of the elbows at Qu Chi LI-11. Finish with tapping the He Gu LI-4 area. For the lower extremities start with tapping at Huan Tiao GB-30, moving down then to Zu San Li ST-36, and finally Cheng Shan BL-57. For the lower extremities, both sides of the body can be tapped at the same time. 

In the Hunyuan system of Qigong and Taiji I teach there is also a much more involved set of exercises that incorporate Paida. In this series we have a standing and moving posture for each of the 12 primary channels as well as some of the extraordinary vessels. Then, in addition to the postures, we use a special sack filled with rice and a Daoist lineage herbal formula that contains herbs to move Qi and soften the sinews (for example, the formula contains Ji Xue Teng and Shen Jin Cao); this sack is used to pat and tap along the channels. The combination of physical movement, breathing, visualization, and then mechanical stimulation of the channels is a very effective way of moving the Qi and Blood internally to balance the channel system.

Next installment we reach the Vernal Equinox!

Rain Water 雨水 Seasonal Node

Today, Saturday February 19th, is the beginning of the second seasonal node of the new-year and the new Spring – 雨水 Yu Shui, “Rain Water.”  Here in northern New Jersey we’ve recently been having significant fluctuations of weather. Monday morning when we left to bring my son to school it was 9 degrees Fahrenheit outside, but over the last week the temperatures have ranged from that to up to 60 degrees! We’ve also been having rain on and off this week, which is good considering we’ve had a dry winter overall. One characteristic of this time of year, as the name of the node suggests (and as the local weather here has brought us), is a gradual increase in moisture.

During Rain Water the expansion of Yang in the natural environment continues. So, while days can still be cold, we are definitely going to continue experiencing the ups and downs in temperatures that we saw here this week. The three smaller periods of Rain Water are “Otters Sacrifice Fish” (ta ji yu 獺祭魚), “Swan Geese Appear” (hong yan lai 鴻雁來), and “Vegetation Sprouts” (caomu mengdong 草木萌動). The swan goose is a rare large goose native to northern China. While we don’t have them here in the US, we do have other species of geese, and here in New Jersey we are seeing flocks of geese flying north again heralding the warmer Spring weather to come. The Japanese versions of these smaller nodes are different: Rain Moistens the Soil (土脉潤起 tsuchi no shō uruoi okoru), Dew Begins Lingering (霞始靆 kasumi hajimete tanabiku), and Grass Sprouts, Trees Bud (草木萌動 sōmoku mebae izuru).

One of the statements in Chinese related to Rain Water says, “Yu shui lai lin shi qi zhong, dang xin pi wei shou shang hai” 雨水來臨濕氣重，當心脾胃受傷害 – “as Rain Water arrives damp qi is heavy, be careful not to damage the Spleen and Stomach.” When walking around outside, I’m struck by a palpable shift. On slightly warmer days, the ground is becoming moist with the release of water that was trapped in frozen form. This increased dampness outside in nature is attested to by my dog’s muddy paws as we come back in after evening walks. The point Xuan Shu DU-5 (懸樞穴) is located at L1, the vertebra associated with Rain Water. While this point treats the spine as a local or adjacent treatment, one of the other most important classical indications for Xuan Shu is undigested food in the stool. This point, located at the vertebra associated with Rain Water, thus treats manifestations of vacuity in the middle jiao, the very thing we need to be wary of this Seasonal Node. Thus needling or applying moxa at this point is appropriate in the clinic during this time.

The basic “to do” recommendation for Rain Water is to supplement the Kidney and strengthen the Spleen. We do this because the weather is still chilly and can tax the Kidney as the viscera of cold and Winter. In addition we need to protect the Spleen because of increased environmental dampness. At the same time, the Spleen is the viscera associated with transformation and transition, and even though we are in Spring we are in a period of weather transition. Thus, another reason Xuan Shu is important this time of year is because, in addition to its ability to supplement the middle jiao, being a point on the lower portion of the Du Mai it also can strengthen the Kidney.

Other points to consider in the clinic are Si Hua Shang 77.08 (i.e., Zu San Li ST36) in combination with Ling Gu 22.05 and Da Bai 22.04. Ling Gu and Da Bai have the ability to course Qi and Blood, regulate the Kidney (because of the connection between the Large Intestine and Kidney channels mediated through relationships on the diurnal circulation of Qi through the channels), and expel external cold. Si Hua Shang supplements the middle burner, especially when treated with direct moxibustion.

The second “to do” for Rain Water is eat congee! Honestly, is there a season when congee is bad? For those not in the know, congee is a type of rice porridge or soup (depending on how thickly you prepare it). And why eat congee now? Because it dovetails with the other recommendations for Rain Water. First, congee is warming and supplements the Spleen. Furthermore, congee is mildly damp draining so it protects the body against the increase in dampness in the environment. Congee is incredibly easy to make, and in China it is a common breakfast or brunch food. People of all levels of health can benefit from being taught to make and eat congee.

The base recipe for congee is to add 1 part rice to 6 to 10 parts water. For example, we can cook ½ cup rice in 5 cups of water. This is cooked until the rice basically starts falling apart so that the resulting product is creamy white. Depending on the type of rice you use, this can take anywhere form 45 minutes to 2 hours of cooking. What I do at home and what I recommend to patients is that they put all the ingredients into a slow cooker overnight on low heat, and by morning perfect congee is done.

Just about any ingredient can be added into this basic congee. For patients with weak Spleens and damp accumulation, a basic congee starts with rice as described above. After that, add in several slices of fresh ginger, a handful of Yi Yi Ren 薏苡仁, and several Dang Shen 黨蔘 roots. Season with soy sauce to taste when finished. This basic Spleen-strengthening and damp-percolating dish can be eaten daily for breakfast.

During Rain Water, since it is a time period of early spring, we also need to stay warm and guard against Wind. As such, the basic “avoid” during Rain Water is “don’t rush to put away winter clothes.” The northeastern US is slowly starting to warm. But, we are early enough in the year that we will see more cold, and the increased dampness in the environment makes the temperature feel a little chillier than it actually may be. Stay warm, and remember to use moxabustion as necessary on yourself and on your patients.

Here is a basic tea recipe associated with the current seasonal node. Its function is to warm and resolve the exterior, strengthen the Spleen, and guard against Wind.

Five Sprits Tea (Wu Shen Tang 五神湯)

Ingredients:

• Jing Jie 荊芥 9g

• Zi Su Ye 紫蘇葉 9g

• Sheng Jiang (i.e., fresh ginger root) 生薑 9g

• Tealeaf (green or oolong) 6g

• Brown sugar 30g

 Cooking Instructions:

1. Place the herbs in a pot with 3 cups of cold water. Let soak for several minutes. 

2. Bring water and herbs to a rapid boil over a high flame. Then, reduce and simmer for 10 minutes uncovered.

3. Strain out herbs and add in the tea leaf, letting the tea steep in the hot liquid for several minutes.

4. Strain out the tea. Stir in brown sugar and drink warm throughout the day. Molasses or honey can be substituted for brown sugar (use to taste).

Here’s another recipe, this time a soup…

Job’s Tear and Lily Pork Soup (Yi Mi Bai He Shou Rou Tang) 薏米百合瘦肉湯

Ingredients:

• ½ lb. lean pork

• 1 large carrot

• 1 oz. Job’s Tear barley 薏苡仁

• 1 oz. Lily Bulb herb 百合

• ¼ cup (or a little more) of corn (or about ½ ear fresh corn)

• Ginger

• Salt

Cooking Instructions:

1. Rinse Job’s Tear and Lily Bulb; place in a pan with about 4 cups of water and bring to a boil, then simmer for about 30 minutes on low heat

2. While cooking, prepare other ingredients by cutting up carrot and pork into bite-sized chunks; remove corn from cob if using fresh corn; peel and slice ginger (an appropriate amount to taste)

3. Add carrot, pork and ginger to the soup (add a little more water if necessary); simmer on very low heat for about 2 hours; add salt to taste

4. This recipe removes phlegm, strengthens the Lungs, expels dampness and opens the Spleen. Moreover, this is a light soup that won’t create internal dampness or damage the digestive function. It is also not overly warming.

Happy February!

Online Intro to Tung's Acupuncture

Tung’s acupuncture is an approach to acupuncture that focuses on distant needling based on the innate interconnectedness of channels. While mostly known for its unique points, the teaching of Tung’s system opens up a deeper understanding of all approaches to acupuncture and challenges some of our basic beliefs about how acupuncture works. Join us for this short ONLINE introduction to Tung based around cases from Dr. McCann’s clinical practice.

Click here for more information: https://www.meetup.com/chinesemed-62/events/283858741/

Beginning of Spring 立春 Seasonal Node

Today is turning out to be an icy one here in New Jersey. January was quite cold throughout most of the month and in my clinic it’s clear that people are experiencing some cabin fever due to the combined effects of the weather and the (hopefully) tail-end of the Omicron wave.  Even my dog has adopted the habit of waiting to coming downstairs in the early morning hours when we wake. Instead he’s been opting to stay in front of a radiator before he’s willing to go outside for his morning constitutional. Yet, something is changing in the air. Albeit cold, we are in a time of seasonal transition, with the promise of warmer weather to come. Earlier this week on Groundhog Day, Staten Island Chuck predicted an early Spring (although Punxsutawny Phil disagreed). However, despite contrary predictions, in the Chinese calendar today, February 4th, is the beginning of Spring.

While westerners are accustomed to placing the beginning of Spring in March, the Chinese calendar marks seasonal change by position of the sun and relative daylight. As the days are now getting longer, we are in the time of everything waking from Winter’s slumber. The darkest and longest nights are now 6 weeks behind us, and in only another 6 weeks we will be at the Equinox – half way to when the days will get shorter again.

The Chinese use both a lunar and a solar calendar to mark time, and because of this there are two dates that are considered the beginning of Spring. One is called Li Chun (立春) – the “Beginning of Spring,” which is one of the twenty four seasonal nodes. The solar beginning of Spring happens every year in early February and this year it starts today (February 4th). The other beginning of Spring is the lunar, also known as Chun Jie (春節), the Spring Festival. This day is the Chinese Lunar New Year, and it falls on the second new moon following the Winter Solstice (with the rare possibility of it falling on the third new moon in some years with an intercalary month). The Lunar New Year is one of the most important traditional holidays in China, and is a time for people to visit with family and friends.  The lunar festivals traditionally last about 2 weeks until the full moon. This year the Lunar new year started earlier this week on February 1st.  

During the Beginning of Spring seasonal node the Yang influences are growing in the natural world. As mentioned already, we are only about 6 weeks away from the Vernal Equinox (Chun Fen 春分), one of the two times of year when the Yang and Yin are most balanced and we have more equal day and night. Even with cooler weather lingering the days are getting longer and in northern New Jersey where I am, in the morning I am hearing some songbirds starting to return.  The increased activity in the natural world is also reflected in the names of the shorter 5 day segments (the 72 Material Manifestations of the year) that make up Beginning of Spring – Dong Feng Jie Dong 東風解凍 (The East Wind Liberates From Icy Shackles), Zhe Chong Shi Zhen 蟄蟲始振 (Hibernating Insects Begin to Stir), and Yu Shang Bing 魚上冰 (Fish Rise Up to the Ice).

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

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

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

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

As a general rule this is the time to consume foods that help maintain normal Liver function, especially the Yang of Liver. Since the Liver governs free coursing, eating mildly acrid and warm foods will support this function. For example, appropriate foods this time of year include scallions, leeks, chives, cilantro, and garlic.  Here is another phrase for this time of year: “Duo chi jiu cai chao rou si, yang hu gan yang zhu sheng fa” – “Eat a lot of leeks and pork to nourish and protect the Liver yang and develop the nature of birth.”  In the Huang Di Nei Jing the Spring is associated with the term sheng 生 or “birth.” This is the same sheng as in, for example, Sheng Jiang 生薑 – fresh (or living) ginger. Tung recommended eating beef stewed with garlic for the treatment of Liver Vacuity (Tung, 1973). While he didn’t mention it specifically for Beginning of Spring, we can say that this recipe is perfect for the warming and strengthening of the Liver Yang that is now appropriate.

Patients with chronic Liver fire should take care this seasonal node as Yang is on the rise everywhere. A traditional Beginning of Spring drink for these patients is Yin Chen Da Zao Tang. For this drink take 20g of Yin Chen Hao and 30g of Da Zao. Place in a pot with about 2 ½ cups water. Bring to a rapid boil then reduce and simmer for 30 minutes. Separate into 2 doses and drink in the morning and evening. This formula benefits qi, generates fluids, and protects the Liver. In the clinic we can mimic this basic formula with points such as Mu Yan 11.20 or Gan Men 33.11.

One more traditional dish for Beginning of Spring is Pork Bone Red Date Soup. Yes, even before bone broth became the latest health trend here in the US, it was considered an important food for health the world around. This dish can be taken daily; it builds blood, warms the interior without being too warming or drying, and can be taken both to prevent and treat colds.

Pork Bone Red Date Soup 豬骨紅棗湯

Ingredients:

• Pork bone, about 3 lbs

• Chinese dried red dates (Hong Zao, or Da Zao), about 6 pieces

• Ginger

• 1 Large scallion white

• Salt

Instructions:

1. Place washed pork bones into a slow cooker and add enough water to cover bones (about 2 quarts)

2. Cut ginger and scallion into large pieces, place in slow cooker with bones; add dates as well to slow cooker

3. Cook on low for 8 hours or more (the prep can be done in the evening and left to cook overnight)

4. Drink broth daily

Other vegetables or ingredients can be added to this soup as desired. To read more about general Spring health care please click here.  

Happy Spring and happy year of the Water Tiger!

Online Course Sale at Healthy Seminars

The Year of the Water Tiger is almost upon us, and Healthy Seminars is running their annual Chinese New Year sale of courses (my course as well as others’ courses). Take advantage of the 30% off that is valid until February 7th!

Great Cold 大寒 Seasonal Node

Today, January 20th is the start of the Great Cold (da han 大寒) Seasonal Node. While we had a relatively warm December, this month has been much colder. In the last two weeks we’ve had quite a few days below freezing, with some in the teens and single digits (Fahrenheit). That’s cold! The Great Cold seasonal node this year is thus true to its name. Unfortunately, this means more people indoors with windows closed which is contributing to the relentless spread of the Omicron strain of COVID-19.

Despite the cold however, the promise of this time of year is the slowly returning Yang. The days are getting longer and even by now we are seeing some migratory birds on the move. All of this is a reminder that Great Cold is the last seasonal node of Winter. In just about 2 weeks both the lunar and solar beginning of Spring arrives.

The three material manifestations of Great 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 imagery of the impending Spring. In Five Phase theory the domestic animal associated with Spring is the chicken, and during Great Cold hens are getting ready to become pregnant with baby chicks that will hatch in Spring. Thus, 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 Great 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, overly greasy or overly sweet, 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 Great Cold is dryness. Even with some wet snow and sleet on the ground this morning, lately my patients have been complaining of dry skin on an almost daily basis (this is even more so this year because during the ongoing pandemic we are all washing our hands more than usual). However, much of the environmental water is now bound up in snow or ice, making the air dry. Knowing this, 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 need to be vigilant there. For example, for those with forced hot air heating systems, it may be prudent to run a humidifier periodically. Sipping warm liquids such as herbal teas throughout the day can also keep our internal environment appropriately moist. Interestingly, too dry of an environment can also be tied to increased COVID-19 transmission. As a lipid-enveloped virus (like most respiratory viruses including other coronaviruses, influenza, and respiratory syncytial virus) it survives longer at a lower relative humidity.

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 benefits fluids, particularly of the upper orifices.

As already mentioned, during Great Cold we should emphasize consuming easily digested 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 Great 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 Great 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.

Another good recipe for Great Cold comes directly from Tung’s writing. In his 1973 book on Tung’s Acupuncture he includes a chapter on dietary therapy. While not specifically listed for Great Cold, one of the recipes he gives is for pork kidney steamed with ginger strips. This simple dish treats kidney vacuity with dryness, manifesting for example with dry mouth.

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 Great Cold is foot soaking and acupressure to support some of the goals we’ve already described above. The time of day associated with Great 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, and Epsom salts can also be added to the water 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 Kidney, and gentle stimulation of the low back can thus relax and warm the Kidney. Furthermore, Great 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. In 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 Great 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.

I hope everyone is staying warm - I’ll be back blogging next when Spring arrives. Continue wearing your mask when around others, get vaccinated and boosted, and stay safe!

Cold Season Blue Garlic 臘八蒜 (repost)

This was one of the last blog posts I did in the “before times.” It was also one of the last times I saw my Shifu before taking quite a long hiatus from the weekly visits I had become accustomed to over the last decade. This year the Laba festival happened earlier this week on January 10th. Please enjoy this repost, and enjoy the recipe if you make it!

Anyone reading this blog knows that seasonal foods are a big thing in China. Actually, seasonal foods are a big thing in all cultures except for the modern west where we can have anything we want at any time of year. Today I thought I’d talk about a simple and delicious traditional side dish.

Drinking tea with Master Wang, our regular pre- and post- training ritual.

Most Fridays I visit with my Taiji Shifu 師父, Wang Fengming, and we train together. Last week after training I stayed for dinner and had my first experience with cold season blue garlic that was made by my Shimu 師母, Mrs. Feng (she is one of Grandmaster Feng Zhiqiang’s daughters).

I had never seen this food before, but it is commonly made in the north of China during the cold season. It is a type of pickled garlic that actually turns bluish (see the photo below), and in Chinese is known as Laba Garlic (là bā suàn 臘八蒜). Laba is a traditional holiday on the 8th day of the 12th lunar month, celebrating the date of the Buddha’s enlightenment. Being in the 12th lunar month it usually falls around the Minor or Major Cold Seasonal Nodes, in other words, one of the most Yin times of the year.

As a food, garlic is quite warming. Its flavor is acrid and sweet, representing the dual functions of being able to move and supplement Qi. It has a Spleen and Stomach strengthening and warming effect, and it moves stagnation to aid the digestive process. The time we are in now is a transition between Winter and Spring (which starts in less than a month from now), and the transition times are associated with the Soil/Earth phase – thus the Spleen and Stomach. However, the weather is clearly still cold, with the exception of the unseasonal warmer temperatures predicted in New Jersey this weekend. Our general dietary strategy this time of year therefore should be to warm and protect the Spleen and Stomach. We can also do this with acupuncture, moxibustion, or herbs as I’ve described in other posts recently.

Raw garlic is too harsh for most people to want to eat. Cold Season Garlic is a type of pickled food that becomes mild enough to be eaten as a side dish, often traditionally with dumplings. The vinegar used to make it can also be eaten on dumplings, or just about anything else that uses vinegar.

Finished Cold Season Garlic with some of its pickling vinegar.

To make, start by taking a desired amount of garlic, and separate and peel to cloves. Place in a clean jar and simply cover the garlic with good quality aged Chinese vinegar (some recipes add sugar, but it is unnecessary). Let sit either at room temperature or in a refrigerator for at least 3 days, although longer storage in the garlic is fine. Within several days the garlic will start turning blue-green, and after that it can be eaten at any time. And the flavor is fantastic! Use as a side dish to dumplings, meats, any type of vegetable, or with morning congee.

I’ll be blogging about the Major Cold Seasonal node sometime soon.

Winter Solstice 冬至 Seasonal Node

Last year’s blog post on Winter Solstice started with me writing about the ongoing pandemic. I have to admit that this morning I am a bit forlorn that a year later we are still dealing with the global effects of COVID, including the new Omicron variant. Part of that is simply the nature of the virus and the inequalities in healthcare we see from country to country around the globe. Another part is that fact that basic public health measures such as masking have been politicized by the right wing in the United States to the detriment of all. A good opinion piece in the Washington Post today called certain factions in American politics a death cult – a statement that is only a slight exaggeration. More alarmingly for me is that it would seem a sizable portion of East Asian medicine practitioners in the west are also opposed to basic public health measures, even believing that vaccination is contrary to basic concepts of our medicine. This is an unfortunate lack of historical understanding of how the precursors of vaccination played an important part of health care in China for centuries.  

But the Winter Solstice again gives me hope. The Winter Solstice is the natural embodiment of post tenebras lux. It is the literal as well as metaphorical return of light. Thus, Solstice is the original Winter holiday, that which is the basis for why other holidays – Christmas, Julian Calendar New Year, Hanukah, Saturnalia – are celebrated this time of year. It is the promise of the eternal renewal that is part of the cyclical process of the cosmos.

In 2021 the astronomical Winter Solstice arrives at 10:59 am (Eastern Standard Time) on Tuesday December 21, and this same day starts the Winter Solstice Seasonal Node. This is the moment when the elliptical orbit of the sun reaches 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 fewest 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 Earth’s path 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 Chinese term for Winter Solstice (dong zhi 冬至) literally means the “extreme of yin,” and 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. The smaller segments, 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).

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 sort of be 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 (literally, lying down) 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.

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 Tai Yang (greater Yang) channel, and in general the Yang of the entire 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:

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

This recipe warms the interior and builds Qi and blood, and nourished the Heart to quiet the Spirit.

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.

The Gallbladder and Winter Solstice

Yes, the Gallbladder channel has a lot to do with Winter Solstice, yet in my experience even many Chinese medicine practitioners are slow to make this connection. In Chinese medicine there are 12 main channels in the body, each linked with an internal organ. These 12 channels are also associated with the 12 watches (時辰), the 12 two-hours time periods that make up the day in the traditional Chinese method of counting time. Since there are 12 months in the year, the 12 watches of the day correspond each to one of the months. The Gallbladder channel is associated with the time 11pm – 1am, the Zi (子) hour. This time of day, because it is a Water phase earthly branch, is the time that goes with the second month of Winter, the month of the Winter Solstice.

This helps us see the Gallbladder channel in a new and interesting light. One of the things I mention when I teach is that we, as Chinese medicine practitioners, eventually need to deepen our understanding of Chinese medicine beyond the very basic things we memorize in our initial training. I think our inability to do this is what leads some to eventually adopt all sorts of supplementary ideas (let’s all do muscle testing, tuning forks, or use a pendulum to decide what herbs are good for a patient, as examples) that have nothing to do with Chinese medicine. For me, Chinese medicine is deep enough and rich enough of a medical system in its own right that not even 5 lifetimes would be enough to really study all of it!

So, back to the Gallbladder… In school we all memorize a Five Phase association with each of the organs and channels, but this is just the beginning of understanding the complexity of these theories (special thanks to Heiner Fruehauf for opening my eyes to looking at the channels in this layered way). To start then, we know that the Gallbladder is a Wood Phase channel. But that’s only step one!

As I just mentioned above, the Gallbladder is associated with the Zi Hour (11pm-1am), the time also associated with the second month of Winter and the Winter Solstice. This time of day is a Water time of day (not a Wood time of day). Thus, the Gallbladder channel, while primarily Wood in nature, also has a Water association. This helps us understand why the Jing Mai chapter of the Ling Shu (LS10) says that the Gallbladder channel governs disorders of bones, and why the Gallbladder is one of the Six Extraordinary Fu, and a Fu that stores clear essence (清精之腑).

In addition to the Water and Wood associations, Gallbladder is also a Fire organ. Why? The Gallbladder is the Shao Yang. Each of the six channel families is associated with one of the Five Phases, and the Shao Yang specifically has a Fire association. The Shao Yang is also one of the pivot channels (the Yang pivot channel), meaning it is also symbolic of the Winter Solstice – the time of year where all of nature pivots towards Yang.

Now, the theory is interesting but in the end if it has no practical application to medicine for us it is of no use. The Gallbladder association with Wood, Water and Fire though actually clarifies why some points on this channel actually do what they do. Let’s take Tung’s Nine Miles Dao Ma Group. The main point of the group, Middle Nine Miles (88.25 Zhong Jiu Li 中九里) overlaps Feng Shi GB-31. In Tung’s acupuncture one of the things this point treats commonly is pain (in multiple parts of the body). The Wood phase partly deals with the smooth movement of Qi and Blood in the body, and the Shao Yang as the pivot has the same function. The Gallbladder channel having a Water (and a bone) association then helps us understand why Middle Nine Miles is indicated for bone spurs (i.e., a type of stagnation at the level of bones).

Lastly, “lack of strength in the nerves” (神經衰弱) is an important indication for Middle Nine Miles. This term is actually a psychological symptom, often translated as the now out-dated term neurasthenia. Neurasthenia included a wide range of presentations such as insomnia, fatigue, depression and a wide range of anxiety based disorders. As we said above, the Gallbladder as the Shao Yang has a Fire association. Furthermore, we know that the Shao Yang communicates with the Shao Yin (Heart), the other pivot channel. The close connection with the Fire and Heart illustrates the use of this point in treating Shen-spirit disorders. This is why in my clinic the stressed-and-tired Winter Solstice treatment is the combination of Middle Nine Miles with the Lower Three Emperors (77.17/18, 19, 21), one of the main point groups for the Kidney. For more information on Tung’s acupuncture and mental-emotional health, please see my recent course on the topic.

Obviously there’s a lot more exploration we can do for any channel – looking at the other channel connections, names of points, etc… One of my resolutions for the coming year (and I encourage everyone else to do the same) is to try as hard as possible to look more and more deeply at Chinese medicine so we can better understand the system and how to use it in the clinic.

Happy Solstice!

Small Snow 小雪 Seasonal Node

As I look outside my window this morning there are leaves covering the ground with few left on the trees. The days are getting shorter and shorter. We are all still living in a COVID world, and even though we are hopefully in the tail end of the pandemic, life has yet to return to completely normal.

This week we will have the second Thanksgiving in the United States that is not quite the same as usual. So, before we talk about the next seasonal node let me first express, in the spirit of this week’s holiday, my gratitude for all of you reading this blog who form a community of medicine that I think continues each day to make a tremendous difference in people’s lives. I mentioned this same thing last year at this time, but I think it is worth repeating. In my opinion the world today is in a state of sickness, although perhaps this has been the case for a long time with only now the symptoms being painfully evident. My wish this Thanksgiving week is that we all continue to try to heal the world. It is a tall order, but I think this is our task. And the task is healing on a physical level, emotional level, social level, and political level. The immenseness of this job reminds me of this quote from The Analects of Master Kong:

曾子曰：士不可以不弘毅，任重而道遠。仁以為己任，不亦重乎？死而後已，不亦遠乎？

Zeng Zi said, “a scholar-official must be determined and strong as his burden is heavy and the path long. Benevolence [towards all people] is the burden he considers as his to sustain – is it not heavy? Only with death does this burden end – is that not long?”

Even though we haven’t seen any snow yet in the Northeastern US, today, Monday November 22nd, starts the Small Snow (xiǎo xuě 小雪) seasonal node. Despite the lack of snow, temperatures are now much more like winter. Evenings this week are all expected to be below the freezing mark. We are headed now to the most Yin and the darkest time of year. The three smaller segments of Small Snow allude to the gradual unfolding of the new, Yin, Winter season – Rainbows Stay Hidden Out of Sight (虹藏不見), Heaven Qi Ascends While Earth Qi Descends (天氣上騰，地氣下降), and All is Blocked Up and Has Completed Winter (閉塞而成冬).

Guidelines for Small Snow are similar to previous seasonal nodes. The thing to focus on to ensure health this segment of Winter is to nourish the Kidneys and protect the Yang Qi. During winter we need to get a little more sleep, getting into bed a little earlier and ideally sleeping past sunrise. The Neijing tells us to, “not disturb the yang - go to bed early and rise late. You must wait for the shining of the sun (無擾乎陽，早臥晚起，必待日光).” Since at a fundamental level Kidney represents the Water phase, it is just a symbol in the body for the movement of Winter – quiescence and storage. Being a little more quiet, a little more rested, and a little more inward-directed puts us in resonance with the Qi of Winter.

Environmental cold is the main Qi for the time period from Small Snow to Small Cold (just after New Year). Cold easily harms the Kidneys, and thus nourishing Kidney and protecting the Yang (against Cold) are more or less two sides of the same coin. Trying to stay warm is one way to protect the Yang. Be sure to dress appropriately for the temperature, and avoid unnecessary exposure to cold. Moxabustion can be continued on points such as Guan Yuan REN-4 or Qi Hai REN-6. If appropriate, some patients can take small regular doses of herbs like Jin Gui Shen Qi Wan as a pill. Also remember to continue wearing masks while in public. This will help prevent the spread of COVID and it really does make the face warmer!

As the weather gets colder another pitfall is stagnation of Qi and Blood. As a result many of my patients in the last few weeks have been complaining of an increase in pain and stiffness. One of the best formulas for moving Qi and Blood is to increase movement (which is why in some systems of acupuncture, such as Tung’s, we combine movement with needling). Encourage patients to engage in some regular movement activity or exercise. If the weather allows, walking outside is great, or if the weather is bad then doing some easy exercise inside is a good substitute.

Diet should also be modified to match the Small Snow node. A very simple recommendation is to take a small amount of fresh ginger every morning just before breakfast, or alternately start the morning with a light ginger tea. Ginger warms and protects the Yang, and circulates Qi and Blood internally, thus satisfying the basic recommendations previously mentioned.

The other basic idea to follow for diet is to avoid foods that create internal heat rising, and incorporate foods that are gently heat clearing and Qi descending. This may sounds a bit contradictory, but the ancient Chinese realized this time of year people are prone to eating more meat. Before refrigeration this time of year there would be less access to fresh fruits and vegetables. If people consume more meat than usual over the next few weeks (think Thanksgiving with lots of turkey and heavy desserts), they may be prone to internal heat from diet. The way to counteract this is consuming just a little heat clearing and Qi descending foods. One traditional food for Small Snow that does this is daikon (Asian radish). Small amounts of bitter greens, or more salty foods are also appropriate.

Here is a traditional recipe for Small Snow:

Lamb and Daikon Soup 羊肉白蘿蔔湯

Ingredients:

• Lamb ½ lb. (boneless)

• Daikon ½ lb.

• ¼ large onion

• Ginger, cilantro, salt and pepper

Directions:

1. Blanch lamb, drain away water and then cut lamb into cubes

2. Place blanched lamb back into pot, add ginger and sliced onion. Cover with an appropriate amount of water and bring to a boil Simmer for around another hour.

3. Cut daikon into cubes and add to pot, cook for another 10 minutes until daikon are translucent

4. Remove from heat, garnish with fresh cilantro and add salt/pepper to taste

This recipe warms the stomach, supplements Qi, protects the Yang and restores vigor to a weak body.

I hope everyone reading this will have a great Thanksgiving (including for those outside the United States). Even though we all may be itching to socialize more with family and friends, let’s still try to stay safe. Stay warm, wash hands, and wear your masks! Now that boosters are available to the general public, I also encourage everyone to get them, or, if you haven’t, get a COVID vaccination as soon as possible.

Beginning of Winter 立冬 Seasonal Node

It’s a beautiful sunny morning as I sit down right now to write this blog post, but it is cold. Right now at about 7:30am the temperature is under freezing at 30° Fahrenheit (-1° Celsius). There is frost on the ground, and today is the end of Daylight Saving Time in the United States. That extra hour of sleep was appreciated last night!

Today’s temperature has been typical of this last week as that we’ve had a decided shift to much lower numbers on the thermometer. Lately, getting up in the morning to get my son to school on time also means getting up before sunrise. The world is getting colder and darker demonstrating the constant march towards Yin. By this time of the year we are only about 6 weeks away from the longest night of the year, the Winter Solstice.

In the traditional calendar today we enter the Beginning of Winter (立冬) seasonal node. While in the modern American calendar we think of Winter Solstice as 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 the apex of Yin, and hence mid-winter. Therefore, the early part of November is the beginning of Winter, the time of year moving into the 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. The main environmental manifestation of Winter is cold, and Chinese medicine teaches that cold creates hardness and stagnation. Thus, as expressed in these names, both water and the soil of 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. Thus, 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 tonics. These are Chinese herbal formulas, often in pill form, that have an overall strengthening effect on the body. The specific tonic 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 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.

Here in northern NJ we are thankfully (for now) having a steady decrease in COVID number, but we are seeing a lot of other upper respiratory tract infections such as colds. 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 congestion, 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). Last week I got some fantastic dried persimmons from Korea at a local HMart and I’ve really been enjoying them all week. Warming spices to use include ginger or cinnamon. And patients who are dry or have Yin insufficiency can take either cow or goat milk.

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!

I hope you are all enjoying the darker time of year. And remember… In just only about 6 weeks the days will start to get longer again!

Cold Dew 寒露 Seasonal Node

I’ve been a bit behind on my blogging, and some may have noticed that I missed one of the key four times of the calendar year – the Autumnal Equinox. That was a few weeks ago in September, so by now I’m late enough I figured I should just move onto the next node (for which I am also a few days late!).

Last week on Friday, October 8th the Cold Dew (Han Lu 寒露) Seasonal Node began. The smaller segments of Cold Dew are Hongyan lai bin 鴻雁來賓 (Swan Geese Come and Stay), Jue ru dashui wei ge 爵入 大水爲蛤 (Siskins Dive Into the Watery Abyss to Become Clams), Ju you huanghua 菊有黃華 (Chrysanthemums Display Yellow Flowers).

Here in the Northeastern United States fall is definitely underway. The leaves are slowly starting to change color and the evening temperatures are steadily dropping. However, one of the weather characteristics of Cold Dew is a significant difference between day and night temperatures. For example, lately the daily highs in northern New Jersey have been hovering near 70 degrees, while evening temperatures are dropping to the 40s. That’s about a 30 degree temperature difference! This time of year people have a hard time dressing appropriately for the temperature because what we feel in the morning is not the same as what we feel in the afternoon. The best solution is layering so that one can adapt to the changing thermometer as the day progresses. This is especially important for the elderly, or for other people who, because of either constitution or illness, have diminished toleration for extremes of temperature.

Because of the gradually cooling temperatures, one of the recommendations for Cold Dew is to avoid overconsumption of cold foods, including for example raw vegetables, iced beverages, or foods eaten right out of the refrigerator. Overconsumption of cold foods, especially in patients with weak Spleen/Stomachs, easily leads to abdominal discomfort or diarrhea. These people should drink warm beverages including for example ginger tea (adding honey to protect against Autumn dryness).

For acupuncturists, this is the time of year to do direct moxa on Zu San Li ST36 for patients in order to warm the center. In my clinic I prefer direct Japanese style rice grain moxa, and I believe that clinically this is the most effective way to do moxibustion on Zu San Li. Alternately, direct moxa can be applied at Huo Fu Hai 33.07. If patients are particularly sensitive to exterior cold, or if they are prone to seasonal allergies and upper respiratory problems, then adopt the strategy of warming the surface. For this needle points such as Ling Gu 22.05 and Dai Bai 22.04, in combination with direct moxibustion at Da Zhui DU14.

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

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

Here is a traditional recipe for Cold Dew…

Cold Dew Congee 寒露粥

Ingredients:

• 100g Rice

• 30g Lily bulb 百合

• 20g Lotus seeds 蓮子

• 4-6 dried red dates 紅棗

• 10g Gingko nuts 銀杏

• 8-10 cups water

Directions:

1. Put all ingredients into a large pot, bring to rapid boil on high flame

2. As soon as boiling, reduce to medium and simmer for 40 minutes to 1 hour, until rice starts to break up and become oatmeal-like

3. Add sugar, or honey to taste

This recipe moistens the lungs, stops cough, clears the heart, quiets the shen. Being a congee it is also warming and supplementing for the middle jiao.

Additional Nourishing Life 養生 Practices for Cold Dew

Since I practice a lot of acupuncture I’m predisposed to liking Nourishing Life practices that work directly with the channels or acupuncture points. So, I’d like to offer some other ideas we can apply during this seasonal node.

Cold Dew is the segment of the year just after Autumn Equinox. It is a part of the time of year represented by the Xu (戌) Earthly Branch, and the phase Yin Soil (i.e., earth) as the transition period at the end of Autumn heading towards Winter. This is the time associated with the Arm Jueyin Pericardium channel as well as the fifth cervical vertebra.

One of the problems we come up against during Cold Dew is the decreasing temperatures, and especially the increasing gap between day and evening temperatures. Since cold is associated with the Water phase, even though Cold Dew is the Pericardium channel time, the Water phase channels (the Bladder and Kidney) are susceptible to problems. In particular, exposure to cold in the evening can cause stagnation in the Qi and Blood circulation of the upper back, leading to stiffness and tightness or pain. Legs can also be affected, likewise experiencing stiffness or pain. So, with all that in mind, here are some easy Nourishing Life practices for Cold Dew:

Rubbing the Bottom of the Feet: The bottom of the foot is home to the first point on the Kidney Channel, Yong Quan (湧泉穴; KD1). Yong Quan is located just behind the ball of the foot and sometimes it is known as the “Great Medicine” (大藥) at the bottom of the feet. Once or twice a day rub the bottom of the foot over the area of Yong Quan 100 times. This warms and stimulates the Kidney channel, and can be used to treat forgetfulness, insomnia, low back pain, and internal cold.

Soaking the Feet: Soaking the feet in the evening is another excellent way to warm the channels of the feet and legs, and it is a second method of working with Yong Quan. One of my common recommendations for Cold Dew is soaking specifically with Epsom salts. To do this, dissolve Epsom salts in hot water and soak feet each evening for 10-15 minutes. Like the previous method of rubbing the bottom of the feet, soaking warms and stimulates the Kidney channel, and can be used to treat forgetfulness, insomnia, and low back pain. For added therapeutic effect, Chinese herbal formulas can be added to foot soaks based on an individual’s pattern differentiation. For example, patients with Qi vacuity can soak with herbs such as Dang Shen, Huang Qi or Bai Zhu. Patients with Kidney vacuity low back pain or the like can soak with Du Zhong, Xu Duan, and Sang Ji Sheng.

Acupressure at Wei Zhong: Weather change and exposure to cold, as mentioned, can create stiffness in the back or legs. One of the master points for increasing Qi and blood circulation in the back and legs is Wei Zhong (委中穴; BL40), located at the back of the knees. While seated, press deeply into the point on both sides simultaneously, until a slightly sore or numb sensation is felt and hold for a few seconds. Release pressure (one press and release equals one stimulation). Stimulate 25-50 times in a sitting. Optionally, medicated liniment or medicated oils that warm the channels, expel cold, and move the Qi and blood can be used while pressing the point.

Cold Dew Daoyin

Fire Cupping the Upper Back: The last traditional recommendation I’ll offer for Cold Dew is the use of fire cups on the upper back. Fire cupping (火罐) can warm and expel cold, resolve the exterior, and course Qi and quicken blood in the channels. When done on the upper back it relieves stiffness in the muscles as well as prevents colds. However, after cupping, be sure not to leave the area exposed. Common points to cup include Jian Yu (肩髃穴; LI15), Jian Jing (肩井穴; GB21), and Tian Zong (天宗穴; SI13). Another area to cup is the back of the neck, as the fifth cervical vertebra is associated with Cold Dew. Just as with the previous recommendation, cupping can be done after the application of a medicated liniment or oil.

Stay warm, stay healthy, wear your masks, and eat lots of apples!

White Dew 白露 Seasonal Node

Today, Tuesday September 7th is turning out to be a very auspicious day. In the Chinese almanac it is an “Open” (開) day, making it good for all sorts of new beginnings. It is also the first day of the 8th Lunar Month in the Chinese calendar, and the Rosh Hashanah, the Jewish New Year. Today is also the start of the White Dew (Bai Lu 白露) Seasonal Node began. 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 Phase association of Autumn, as white is the Metal Phase’s color.

According to the Su Wen, the movement of Autumn is the movement of harvest (收). All of nature is now in the stage of slowly winding down; for example, in the last few days I’ve been noticing that the mornings are not quite as bright by the time I’m waking up, and the sun is noticeably setting earlier. The names of the three smaller material manifestations of White Dew reflect harvesting of food for the Winter to come, and the return of birds in their migratory patterns: Hongyan lai 鴻雁來 (Swan Geese Pass Through), Xuanniao gui 玄鳥歸 (Swallows Go Back), Qunniao yangxiu 群鳥養羞 (Flocks of Birds Stockpile Morsels).

Even though we are in Autumn (a Yin time of year) it is clear that Yin and Yang are engaged in a closely intertwined dance. During White Dew, the days can still be quite warm and somewhat humid – today here in New Jersey is in the 80s, and the humidity of last week’s hurricane is palpable. However, evenings are starting to dip in temperature. Therefore, one of the traditional prohibitions this time of year is wearing clothes that are too light or too exposing of the body. During the early morning hours or in the evening be sure to wear clothing that affords protection against the gradually cooling temperatures (last weekend I wore a light fleece going over to our early Saturday morning Qigong class). In some places the weather continues to be fairly warm and thus slightly out of sync with this Seasonal Node. In those places guard against 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 conceptual idea 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 basic correspondences. The Su Wen 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/harvest (收) going towards storage (藏). These are the very defining concepts 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, some of the most common problems our patients will see this time of year are seasonal allergies and rhinitis. Here in New Jersey I’ve seen a significant rise in allergy complaints in the last few weeks. 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. I predict one of the challenges clinicians will see in the next few months is the confusing of common cold symptoms with COVID infection symptoms. Since many overlap, we will all need to continue to be vigilant in whatever infection control measures we are taking professionally and personally. I strongly suggest, even in places where it is not mandatory, that people continue to wear masks in stores, clinics, etc… I am also suggesting all my patients get vaccinated. There is a long history of the use of this sort of preventive treatment in China, and thus the use of vaccinations is very much in accord with the medicine we practice.

When choosing treatment points this seasonal node we can focus on those that have a Lung association. In Tung’s acupuncture, some useful points include Mu (木穴; 11.17), and the Dao Ma combination of Chong Zi (重子穴; 22.01) and Chong Xian (重仙穴; 22.02). In both September and October, Mu is one of my most frequently used points. It has the association of Lung Channel in Tung’s Five Phase system, and it lies on the palmar surface of the index finger (thus placing it on the Hand Yangming – also a Metal channel). It treats a wide range of conditions of the upper burner related to Wind patterns such as the common cold, seasonal allergies, and sinus congestion. Patients can also be taught to massage these points as needed. For a more detailed discussion of these points please refer to the Practical Atlas of Tung’s Acupuncture (click here to find out where it can be purchased).

Aside from Tung’s acupuncture, this is the time of year to start doing preventive moxibustion on Zu San Lu (ST-36), or other treatment of the Stomach channel. Chinese medicine has a variety of ways to match time and channels or organs. According to the Zun Sheng Ba Jian, the second month of Autumn corresponds to the Stomach channel, which is why the seasonal node exercise for White Dew is associated with it, and treats lips turned dark in color, swelling in the neck, retching, mental disorders, and flushing of the face (all Stomach channel symptoms). Finally, since Soil-Earth is the mother of Metal, treatment or supplementation of the Stomach channel has a beneficial and supplementing effect on the Lung.

Diet for White Dew

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 (although we are really at the tail end of peach season in New Jersey), apples and pears. Other foods to eat include watery vegetables such as zucchini. For those near Asian groceries, White Dew is the time to eat nagaimo (shan yao 山藥 in Chinese) and fresh lily bulbs (百合).

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.

To read more about general health tips for Autumn please click here.

End of Heat 處暑 Seasonal Node

Earlier this week on Monday August 23rd we entered the current seasonal node - Chu Shu 處暑, ‘End of Heat’.  I’ve been putting off posting this for a few days because, well, the heat has certainly not ended where I am! Today the actual temperature with humidity will make it feel close to 100 degrees (38 degrees Celsius). This is a good reminder to us that the model of the seasonal nodes is not one that always describes actual local weather conditions. Rather, it teaches us about the overall ebb and flow of weather patterns and how they can affect health. It also may need to be reevaluated sometime based on the unfortunately fact we are now dealing with manmade climate change. Just a few weeks ago at the summit of Greenland, some 2 miles in elevation, rain fell instead of snow for the first time in recorded history.

All that said, while we can continue to expect warm weather for the near future, there is a cooling trend that is starting in a real way. In the next 2 weeks the local predictions here are that there will be a break in the current more oppressive heat. The days are also noticeably shorter. While the ‘End of Heat’ is not a great description for today, it is a good description for the general pattern we are starting to experience in the Northern Hemisphere.

End of Heat is the second seasonal node in Autumn, and Autumn is the time of year when Yin grows. All things are gradually moving towards the hibernation phase and many plants are being readied for harvest. This is why in the Neijing, the movement of Autumn is described as 收 – receiving, taking in, putting away, gathering in. The names of the smaller 5-day periods of this seasonal node are quite interesting and illustrative of this idea. 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 Japan, instead of Hawks Start to Sacrifice Birds, the first segment is called Wata no Hana Shibe Hiraku 綿柎開 – Cotton Flowers Bloom.

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 nature 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 because 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 is not because of the Liver hour just afterwards)

Even though this week is still humid, the weather pattern associated with Autumn will eventually be dryness. Thus, another caution during Autumn is not becoming too dry. One way we do this is through diet; now is the time to start focusing on shao xin, zeng suan 少辛增酸 – ‘less spicy, more sour’. Spicy flavors are mildly drying. Spicy also promotes sweating which can 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 Autumn. Other moistening foods include milk, soymilk, and fruit juices (especially apple or pear). This recommendation should be taken less seriously for those with very damp constitutions or presentations, and can also be moderated when the outside weather continues to be damp.

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). 

The last recommendation I’ll offer is for those patients who continue to experience symptoms of damp, heat, or the combination thereof in the form of summerheat. A traditional channel based recommendation for End of Heat is regular acupressure on Cheng Shan BL-57. This point helps expel damp and clear heat, and treats many symptoms of lingering summerheat such as headache, body aches, heavy limbs, or diarrhea. Notice that this area of the leg is one of thick flesh, and remember that the seventh chapter of the Ling Shu describes a needling method based on the five tissues and their relationships to the five viscera. One of the passages from that chapter reads:

四曰合谷刺，合谷刺者，左右雞足，針於分肉之間，以取肌痺，此脾之應也

The fourth is called united valleys piercing. United valleys piercing is to pierce left then right from the same hole, like a chicken's foot. Pierce to the division between the flesh. This treats flesh block (bi). It is in resonance with the Spleen.

Here we see that needling into fleshy areas of the body treats problems of the flesh as well as treats problems of the Spleen. As dampness is the disease evil of the Soil/Earth phase (and thus the Spleen), this needling technique also has resonance with its treatment. For example, over the last few weeks, patients in my office have been complaining of aching and heaviness in the joints, especially of the knees, hips and in general lower extremities. This is because dampness, as a Yin disease evil, commonly moves down in the body. One of the points I’ve been using over and over again to work with this is Jian Zhong 44.06. The point, located on the shoulder, is in a fleshy area of the body just like Cheng Shan BL-57 is. Likewise, it treats damp accumulation of the joints and extremities. Other points in the shoulder area, such as Bei Mian 44.07, are specifically indicated for digestive problems such as abdominal distension, vomiting or enteritis. This is because, like Jian Zhong 44.06 and Cheng Shan BL-57, Bei Mian is in an area of thick flesh and thus treats problems of the Spleen. This time of year as we are still experiencing summerheat and dampness, these types of points can be frequently used.

Stay hydrated, stay cool, but prepare for the cooler weather to come.

Beginning of Autumn 立秋 Seasonal Node & Ghost Month!

It’s hard to believe I’m writing this, but today, Saturday August 7th, is the beginning of Autumn in the traditional calendar. Although in the modern western world August is a summer month, the Chinese calendar is concerned with the relative balance of Yin and Yang in the natural environment over temperature as a marker of the seasons; this 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. Therefore even though August weather can still be hot we are in the time of growing Yin and contraction in the natural environment.

As a symbol of the growing Yin time of the year, the seventh lunar month (i.e., August), is Ghost month in Chinese lore (ghosts being Yin entities). This year the seventh lunar month starts tomorrow on Sunday August 8th, the day this blog goes out as an email. In the traditional Daoist calendar this is the day that Yama, the King of Hell, opens the gates of hell to allow all the spirits of the deceased to wander the earth – basically a one-month vacation for ghosts. This happens until the gates are once again closed at the end of the lunar month. The culmination of the month is the 15th lunar day (this year August 22nd), which is known as Zhong Yuan Jie (中元節).

Throughout this month there are many taboos that Chinese culture observes. These include not allowing the elderly, the very young or generally physically weak people to do various activities outside at night. This is the time of day when ghosts are most active! Qigong should also not be practiced outside late at night during this time. Whether or not we believe that this month is the time of ghosts, what this custom perhaps does is serve as a reminder of how the natural balance of Yin and Yang is shifting in a very real way this time of year. 

Now back to the Seasonal Node… While the weather is beginning to shift to Yin, August can still be damp and humid. It is also the time of tropical storms which bring moisture and wind. 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, increase the amount of seasonal vegetables, and eat 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).

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

Directions: 

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.

Euryale ferox

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. Those familiar with Tung’s acupuncture 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 Soil-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. 

As August continues, we need to be cautious of sudden returns of very hot and humid weather, a common weather pattern here in New Jersey. 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.

Here’s a formula from the Zun Sheng Ba Jian (遵生八箋) – the Eight Treatises on Following the Principles of Life. Written by a scholar by the name of Gao Lian at the end of the Ming Dynasty (1368-1644), the text is an almost encyclopedic collection of all manner of Nourishing Life (養生) recipes, techniques, theories, etc… One of the formulas specifically for Autumn is called Conserve the Spleen Pill (攝脾丸). It treats damage to the Spleen that happens during the Autumn months that leads to abdominal distension and diarrhea. The ingredients listed are Mu Xiang, He Zi, Hou Po (ginger fried), Wu Bei Zi (slightly toasted), and Bai Zhu (earth fried). These ingredients would be ground to a powder and made into pills the size of a Tung Tree seed, and 10 pills would be a daily dose. 

I hope everyone is having a great end of Summer and start of Autumn, and is continuing to wear masks and be safe!