Upcoming Living on Purpose Course at ToDo

Many of you know I did professional training in Japanese psychology through the ToDo Institute in Vermont. I think they have some really excellent programs. This weekend they are starting another round of their online Living on Purpose Course and they’ve offered my readers, friends and colleagues 40% off the course tuition, which is already really low for a month-long course.

I get no compensation for helping ToDo advertise, I just think they’re great. Consider joining in, and please use the discount code McCann when registering. Click here or on the photo to get to the course information page.

Clinical Qigong Starts Soon - Last Call!

Our Foundations of Clinical Qigong course starts very soon. I blogged about this previously, but will say again that I’m very excited for this class as it is something I’ve been thinking about for quite some time.

This class will be a semester style 30 hours course meeting once a week starting January 10th. It is designed as a foundation for self-practice, but also for the East Asian Medicine clinician to start using Qigong and similar practices in clinical settings. Here is an overview of the course content as well as information on time, dates, costs, etc… We are NCCAOM approved for 30 PDA (CEU) hours.

Class is limited to 12 participants and we have a few slots left open. If interested please email to let me know!

Holiday Book Recommendations: My (new) Annual Book Review

So, I love books. If you were to come into either my office or home, you’ll see them everywhere and because of that I’m very grateful to have married someone who is also a fan of books and tolerant of my bad behavior of having them just about all over the place in just about all of my spaces. This year I thought I’d try to start a new tradition of blogging about my favorite recommendations for those who might be similar in their love of books and inhabit the same sphere of interests that I do. Some of these books have been sitting on my shelf for some time now, so it also gives me a chance to write a bit about them and encourage my colleagues to check them out and read them for themselves. Here we go…

 

Complete Compendium of Zhang Jingyue Vol 1-3

By Zhang Jingyue; Trans. by Allen Tsuar, Ed. Michael Brown

Purple Cloud Press, 2020

Purple Cloud Press in general has become one of my favorite newer publishers. Their mission focus is, “to the dissemination of various forms of traditional Chinese culture including medicine and healing, martial arts, Tai Chi and Qigong, philosophy, spiritual practice and art,” and their books clearly reflect that. This first book I’ll review is a translation of the first three volumes of the Complete Compendium of Zhang Jingyue 景岳全書, a massive work written by the late Ming Dynasty physician Zhang Jingyue (Zhang Jiebin; 1563-1640). Zhang is also the author of the Lei Jing (類經; 1624), an important commentary on the Huang Di Nei Jing. His Complete Compendium however was finished several years later in 1640, which collected and summarized his lifetime of medical understand and clinical experience, making it the lasting voice of one of later Imperial China’s most influential physicians.

In essence, I can state confidently that the main theme of this text is the Principle 理 that underlies Chinese medicine as a whole. This idea of Principle is a Neo-Confucian concept that there is some underlying organizing system that is at the heart of the universe and all that it contains, including within the heart of the practice of medicine. That means that the physician’s job is to look at signs and symptoms, understand their meaning, and then penetrate the fundamental mechanisms of the body that have become diseased in the specific patient in front of them. In today’s Chinese medicine in the west I’ve observed that we are, in some corners, moving further and further away from this idea evidenced by post after post on Facebook where acupuncturists ask, “what is the best point/herb/formula for [insert disease name here].” We see the same with the, to me, very bizarre thinking that so-called “orthopedic acupuncture” (i.e., acupuncture that focuses on a western understanding of anatomy) is the only effective way to treat pain with needles. There is a place for empirical formulas for sure, and I think that orthopedic acupuncture is very useful (I actually taught a semester on the topic at Pacific College several years ago). But to think that our own medicine is no longer useful, or that concepts of channels, or Yin-Yang don’t actually enhance treatment, is simply giving up on a medicine that is both profound, and incredibly effective. We sometimes just don’t bother to deeply ponder and then understand the structure of medical thinking that defines Chinese medicine (hint – the therapies we do don’t define Chinese medicine, the underlying thinking does). It would seem though that this isn’t a new phenomenon. In this text Zhang even laments, “Alas! Where can I find those who have communion with the bright spirit and perceive the formless, with whom I can share these discussions about our profession.”

But I digress…

In these first few volumes of the Complete Compendium Zhang lays out for readers a detailed and very cogent discussion of fundamental concepts in medicine starting with Yin and Yang followed by the Six Transformations (六變) of exterior, interior, cold, heat, vacuity and repletion. This should sound familiar to readers since they are, of course, the Eight Principles. And, this should also challenge one of the commonly heard false narratives in some corners of Chinese medicine today that Eight Principle diagnostics are somehow a modern creation of Communist medicine that don’t reflect pre- mid 20th century practice. To help the reader and aspiring (or even experienced practicing) physician understand these concepts, Zhang continues with a discussion of the Ten Questions as a way to illuminate and understand Principle. I think these sections would even be an excellent introduction to these crucial topics for new Chinese medicine students as, in my opinion, the discussion is better than that found in just about all of our basic entry level textbooks. 

Throughout the volume Zhang also discusses the importance of Ming Men, the concepts of Early and Later Heaven, and the importance of protecting the Yang Qi through warm supplementation. He does this though without dogmatically clinging to the idea, for example, that all patients should be given warming and supplementing treatment. Zhang’s goal is unblind us, and liberate us from the habits of treatment based on disease, or a dogmatic approach to treatment. Instead he tries to get us to see the uniqueness of each patient by seeing their root, following that very admonition we see in the Nei Jing that seeking the root is the imperative of medicine.

Although Zhang was primarily an herbalist, this book should grace the shelf of both herbalists and acupuncturists because of its very clear explanation of the underlying structure of our medicine.


Complete Compendium of Zhang Jingyue Vol 50-51 (Part 1)

By Zhang Jingyue & Chen Xiuyuan; Trans. by Allen Tsuar, Ed. Michael Brown

Purple Cloud Press, 2022

My next review is of the second of Purple Cloud Press’ Zhang Jingyue Collection, its next installment of the Complete Compendium of Zhang Jingyue 景岳全書. Where the previous volume discussed Zhang’s deep insight into medical theory and diagnosis, this current volume gives us the practical application thereof.

The main theme at the beginning of this volume is Zhang’s Eight Strategies of New Formulas 新方八畧引 which include supplementing (補), harmonizing (和), attacking (攻), dispersing (散), cooling (寒), heating (熱), securing (固), and corresponding (因). These methods eventually lay the ground for a discussion of formulas in a similarly arranged eight sections which Zhang calls his Eight Battle Arrays of New Formulas 新方八陣 – a name genuinely worthy of a Wuxia novel devoted to medicine!

This book, part 1 of this section of the Complete Compendium, covers the first four of the Battle Arrays with discussions of 71 formulas. Some of these are quite commonly used and important formulas today; for example, we have elucidations of Zuo Gui Yin, You Gui Yin, Zuo Gui Wan, You Gui Wan, and Chai Ling Yin. For each of the formulas Zhang gives us a description, ingredients, and cooking methods. Another thing Zhang provides is short case studies. The use of case studies to teach Chinese medicine is something both historically important and clinically useful (dare I say vital). As a teacher of case studies at the advanced practice doctoral level I think this is something we don’t utilize enough in our entry level masters or entry level doctoral education, and is notably absent in basic textbooks. As such, I appreciate Zhang’s allow us readers to sit beside him in the clinic as he sees actual cases. Another thing I appreciated about his cases in this volume is that they are not all immediately successful. He shares with us his initial failures in treatment, and how he reasoned his way to success. These include instances when herbal treatment alone fell short and he needed other therapies such as moxibustion to ultimately achieve clinical results.

The other feature of this volume is the inclusion of critical writings by Chen Xiuyuan 陳修園 (1766-1833), a Qing dynasty physician of great importance to the history and modern practice of our medicine. Let’s just say that Chen, a proponent of conservative approaches to Shang Han Lun and other canonical texts, was not a fan of Zhang’s approach to medicine. Chen accuses Zhang of never having read the Shang Han Lun, and thus not understanding real approaches to medicine and thus harming people with his methods. Ouch! There are also other additional commentaries included by other physicians. These are a very useful addition to this translation and they illustrate the scholarly written discussion throughout history that really is a vital part of Chinese medicine. Nothing has come down throughout time that has not been interpreted and reinterpreted by real physicians, with real clinical practices. It is an encouragement to us modern readers that we need to evaluate everything we take in and make it relevant to our own clinical practices. As it is said in Chinese, 盡信書不如無書 – believing everything you read in a book is worse than not having that book at all.

But, in the end, I think Zhang would value dissenting voices. One of his own stated goals is to break physicians out of a rigid approach to medicine or rigid application of formulas. Like a masterful military strategist, the physician needs to flexibly adapt to the uniqueness of any situation. Zhang understands the seemingly contrary nature of his writing then, to use set formulas to teach people how not to rely on set formulas. To use concrete examples, to illustrate formless Principle. This though, is exactly why this volume and the one I reviewed above my kind of books.


Healing Virtue-Power: Medical Ethics and the Doctor’s Dao

By Sun Simiao & Sabine Wilms

Happy Goat Productions, 2022

This is really an excellent little book that should be required reading for all those who practice East Asian Medicine. While a book presumably on medicine, it really is a discussion on developing Dé 德, a word commonly translated as Virtue, but one that Dr. Wilms renders as Virtue-Power hinting that it is this Dé that gives the physician potency. As Wilms quotes, a line from a thousand years ago tells us that, “for a person who lacks enduring Virtue-Power, it is impossible to become a physician” 無恆德者,不可以作醫. Dé, at heart, is also about how we really become human, in addition to becoming a competent physician.

Wilms opens the book with a great introduction that brings up questions more so than giving answers or prescriptions. It is an invitation to readers to think about the role of medical ethics today, how we can define medical ethics beyond what we would normally consider it to be, and how we can consider moving beyond just methods so as to develop virtuosity in practice. Since it was so engaging, I read and reread the introduction a few times and thought about it for a few weeks before I went on to the rest of the book.

To really explore these topics the bulk of the book is a translation and discussion of Sun Simiao’s two essays “On the Professional Practice of the Great Doctor,” and the “On the Sublime Sincerity of the Great Doctor.” These two essays are presented in the original Chinese, Pinyin transliteration, and then Dr. Wilms’ translation. As someone who likes to read the original Chinese text and think about how it was translated, this is a welcome feature. And, as always, Wilms’ discussion is both thoughtful and thought provoking.

One thing I really love about the book is Wilms’ conversational style of writing. It is almost as if I, as the reader, am just sitting together with her in the presence of Sun Simiao discussing life through the lens of medicine. Really, it is through conversation and interaction with others that we learn about life, and about medicine. When we can’t have that conversation in person, having a conversation through the written word is a way to sustain the heart. So, until my friend Sabine and I can meet again in person, share a cup of Pu-Erh, or walk with our dogs together, I’m happy to chat with her through this, her latest book.


Primer for Translating Daoist Literature

By Louis Komjathy

Purple Cloud Press, 2022

This is not a book on Chinese medicine, but rather language and Daoism, both topics that I know many of my readers will appreciate. This is also an excellent offering from our friends at Purple Cloud Press, although in their collection of books related to philosophy and spiritual practice.

When I was young my initial interest in Chinese and broader East Asian culture came first from my exposure to martial arts and East Asian spiritual-religious traditions such as Chan (Zen) Buddhism and Daoism. Unfortunately for all of us, back then much of the treatment of Daoism was a sort of go-with-the-flow New Age glossing over of a very deep and meaningful tradition, and this was a great disservice. Over the last few years though I’m pleased to be witnessing what I think and hope will be the successful transmission of authentic Daoism to the western world. We see this with groups such as Parting Clouds as well as with the publication of books such as this one.

While there have been quite a few texts on the market devoted to reading and translating classical Chinese, and there are also some devoted specifically to classical Chinese in medical texts, this is the first to my knowledge on translating Daoist literature. In this book Louis Komjathy, a scholar of Daoism with a Ph.D. from Boston University, presents 28 lessons (maybe because there are 28 Lunar Mansions?) on important passages taken from very early literature such as the Nei Ye and Zhuang Zi, to later writings important to Daoism.  Each lesson provides context for the piece, important Daoist technical vocabulary, and discussion of aspects of language such as classical Chinese grammar. In doing so the reader can improve skills of translation while studying important themes within the context of Daoism.

That said, while this is a book on translating Daoist literature, it will be of interest to anyone interested in Daoism whether or not they intend to translate texts for themselves, and even if they don’t read classical Chinese. This book really does offer insight, using original source material, into the philosophy, history and practice of authentic Daoism as a tradition. For those who do have some familiarity with modern or classical Chinese, or other East Asian languages such as Japanese, this is an excellent way to get started on an under-explored aspect of Chinese religion and culture through original classical literature. Finally, for western Daoists or aspiring Daoists, this will be an enduring and essential reference for us to keep on our shelves. 


Thanks to all my readers and to those of you who have come to the end of this rather long blog post. Hopefully some of these books will end up on gift lists either to yourself or to friends (I’m giving some to friends myself). I wish everyone a beautiful holiday season, and a healthy and prosperous, on all levels, New Year.

Winter Solstice 冬至 2022

I’ve been behind on blogging about the seasons over the last month or so. But I thought that now would be a good time to get back to it, in that today is one of the most important astronomical events of the solar year – the Winter Solstice. This Solstice is the natural embodiment of post tenebras lux, as 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 2022 the astronomical Winter Solstice arrives at 4:48pm Eastern Standard Time today, Wednesday 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.

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!

On the Dan Tian 丹田 (re-post)

This is a blog post I put up back in the summer of this year. I thought it was an interesting topic, and one that will be coming up during our Clinical Qigong course that starts in January. Please enjoy again, and if interested in our Clinical Course let me know!

Recently one of our new online Qigong class students posed a question about the Dan Tian. At the end of most all of our postures we do a maneuver called ‘collecting in the qi’ (my loose translation of 收功), in which, while moving the hands down in front of us and sinking, we visualize everything in the body returning down to the Dan Tian (丹田), the space in the abdomen between the navel and Ming Men (命門). As I frequently point out in class, our’s is the Neigong (i.e., Qigong) in the lineage/tradition of Hu Yaozhen (胡耀真), one of my great-grand teachers, and a key feature of this tradition is the almost constant focus on Dan Tian.

The Dan Tian, from a colorized version of the Diagram of the Inner Landscape 內經圖 found at the White Cloud Temple 白雲觀 in Beijing.

A common English translation for Dan Tian is the ‘elixir field.’ The word ‘tian’ (田) just means field. The word ‘dan’ (丹) is a bit more complicated. One meaning of the word is cinnabar, a scarlet-red mineral form of mercury sulfide (HgS) that is a common ore source used for refining pure liquid mercury. Since Daoists used mercury as one metaphor in their descriptions of the meditative processes used for transcendence or immortality (and in some unfortunately cases experimented with ingesting actual mercury while seeing the same), the term ‘dan’ became associated with the process of spiritual transformation. ‘Dan’ and the compound term ‘Dan Tian’ thus becomes a synecdoche - a stand in for the entire process of cultivation. It is the symbolic elixir that, when taken, confers a higher state. Hence, the translation of Dan Tian as ‘elixir field’ – the place that is used to create the elixir of immortality and transcendence.

In the body, the Dan Tian is conceived of as a physical location, although the physicality of Dan Tian is a topic of debate. For our purposes however, we will take it as a physical location. Properly speaking, there are three Dan Tian in the body: an upper (上丹田), middle (中丹田), and lower (下丹田). There are some slight variations on the locations of these three structures depending on the source. Most agree that the upper Dan Tian is located in the head. The middle Dan Tian is sometimes associated with the area of the chest, that location that in Chinese medicine is referred to as the Sea of Qi 氣之海 (not to be confused with the acupuncture point of the same name), or the Tan Zhong 壇中.  In Hu Yaozhen’s lineage, we located the middle Dan Tian not in the chest, but rather in the abdomen between the navel and Ming Men. Hu Yaozhen then places the lower Dan Tian at the base of the abdomen in the pelvic cavity, just above Hui Yin 會陰 – the perineum. While a large number of modern Qigong texts situate the middle Dan Tian in the chest, it is interesting to note that in some older texts it is located in the abdomen as Hu teaches. For example in the Yuji Qiqian (雲笈七籤), an anthology of the Daoist Canon written circa 1029, the middle Dan Tian is associated with the middle jiao, the abdomen, and the area ‘below the heart’ (心下).

Regardless of the variations, somewhere in the area of the abdomen seems to be the most important of the Dan Tian used in various schools of meditation, Qigong, martial arts, etc… But why is this? Why is it so important?

A large (about 4 inches from top to bottom) piece of Cinnabar ore 硃砂 in my private collection.

For Chinese medicine practitioners this is an interesting question. If we look at the earliest of Chinese medicine cannons, we can’t find the term ‘Dan Tian.’ For example, the only chapter of the Huangdi Neijing that mentions it is the Treatise on the Origin of Disease (本病論). Unfortunately, this is one of the two apocryphal chapters of the Su Wen. While it may have been in circulation for over 1000 years by now, it is most likely not original to the Han Dynasty version of the text and was not a chapter Wang Bing would have seen or worked with in writing his highly important and definitive edition of the Neijing. That said, the abdomen is an important location. Most of the Zang Fu are located there. Furthermore, highly important vessels originate in the abdomen. For example, according to the Treatise on Bone Hollows (SW60 骨空論), the Chong, Ren and Du all originate from a location in the abdomen. These are extremely important vessels, with the Ren and Du respectively being tied to the core Yin and Yang of the body. For example in the Song Dynasty text Xi Shang Fu Tan (席上腐談) the Ren and Du are called the Seas of Yin and Yang (陰陽之海). The Chong is associated with all the channels, and in the Treatise on the Seas (LS33 海倫) the Chong is said to be the Sea of the 12 Channels (衝脈者,為十二經之海) – i.e., all the channels. Clearly, even though the Dan Tian is not mentioned by name, the abdomen is tied to basically all the important structures of the body.

While the Nanjing (Classic of Difficulties) does not specifically mention the Dan Tian either, it does get a little closer in identifying the Kidneys and the Moving Qi between the Kidneys (i.e., the Ming Men) as being core aspects of our vitality. The idea of Ming Men the way we conceive of it today is absent from the Neijing, unless of course you are a creative reader in the way that Zhao Xianke was (there’s a good Chinese medicine inside reference for you!). This Moving Qi between the Kidneys, in addition to being associated with the Ming Men, have also been associated with the Dan Tian by some physicians. For example, the 66th Difficulty says that, “the Qi moving below the navel and between the Kidneys are a human’s life. They are the origin and root of the twelve channels, and thus are called source” (臍下腎間動氣者,人之生命也,十二經之根本也,故名曰原). Yang Xuancao, a commentator writing in the 7-8th c. CE said of this line that, “the Qi moving below the navel and between the Kidneys are the Dan Tian. The Dan Tian is a human’s origin and root” (臍下腎間動氣者,丹田也。丹田者,人之根本也). Yang continues with a beautiful description of the Dan Tian that is too long to quote in its entirety here, but, for example, he says that the Dan Tian is yellow in the center, green-blue on the left, white on the right, red on top, and black on the bottom. This of course is just metaphorical language that says the Dan Tian in the abdomen is connected to all of the Five Phases, and thus all the organs and all the channels.

It may very well be that this sort of medical theory that we see in the Nanjing, and not in the Neijing, arose because of the influence of people such as the inner alchemists and Daoists – an example of cultivational literature influencing medicine (we see many other examples of the opposite of course). Some of the more conservative medical commentators (i.e., the Neijing purists) have pointed this out as a criticism, and an example of adding theory to medicine that has no legitimate right being there. I’ll let my medical providing readers decide for themselves if they find these ideas relevant to their clinical practices.

Hua Tuo’s Chart of Neigong from the writings of Hu Yaozhen (who was probably the actual author of the chart). Notice the upper Dan Tian in the head, and the lower Dan Tian just above the perineum. The middle Dan Tian is located in the space level with the navel, although here called the ‘Entrance Hall’ - a Buddhist term.

Aside from our discussion of medicine, the Dan Tian is described extensively in the literature of internal alchemy and other aspects of Daoism (which in turn become some of the important sources from which Neigong/Qigong concepts of Dan Tian spring). For example, the Direct Pointers to the Great Elixir (大丹直指 DZ 244), a Quanzhen text attributed to the Daoist master Qiu Chuji (1148-1227 CE), discusses Dan Tian as a part of the process of cultivating transcendence. It says that the navel at the center of the body is the Central Palace (中宮), which it also identifies as an alternate name for the Dan Tian (但臍在人身之中,名曰中宮、命府、混沌、神室、黃庭、丹田). The Direct Pointers goes on to say that the Dan Tian stores essence and marrow, and connects the hundred channels and nourishes the entire body (此處包藏精髓,貫通百脈,滋養一身).

In Hu Yaozhen’s teaching, the meditative process of bringing attention down to the abdomen is called the Three Senses Return to the One (三性歸一). In reality the number three here is a symbol for all of the senses, not just literally three of them. By bringing the meditative focus to the interior we can induce a still calmness. I am not qualified to talk about this from a real internal alchemy or Daoist perspective, but certainly this inward focus can have a profound effect on centering the mind and pulling us back into a state of centered focus. In other words, it helps to tame the monkey mind that is our norm. Even in the clinic I will often ask patients undergoing acupuncture to simply bring their focus down to their abdomen and breathe deeply. In terms of Tung’s acupuncture this is another example of how we apply the Moving Qi (動氣) needling method that is a part of achieving De Qi (得氣 – for more on what De Qi really is please see my class on classical treatment strategies expressed in Tung’s acupuncture). But I digress…

Aside from inducing calm centeredness, the cultivation of Dan Tian, from both the alchemical and medical perspectives presented above, must also have a beneficial health effect on pretty much all the channels and organs. If the Dan Tian is connected to everything and nourishes the entire body, it means that a robust Dan Tian leads to robust health.

Hu Yaozhen may very well have focused heavily on the Dan Tian because one of his main teachers was a Daoist master and practitioner of inner alchemy by the name of Peng Tingjun (彭庭隽), and Peng in turn was a disciple of a Daoist hermit by the name of Huo Chengguang (霍成光). It is from Peng that most of Hu’s Neigong came down to us. To be honest, I think the better question is why don’t all schools of Neigong/Qigong focus more on the Dan Tian? It would seem natural to me that it be a major part of most every posture in one way or another.

I hope my short musings help stimulate more thought, as they have for me just sitting down, collecting my thoughts, and putting them to paper (or screen as the case may be). Whether you, the person reading this, are a physician, Qigong practitioner, or just someone interested in East Asian medicine or cultures, I hope thinking about the role of Dan Tian deepens your own practice.

Foundations of Clinical Qigong Course approved for PDA hours

Our Clinical Qigong online course for 2023 is now NCCAOM approved for 30 PDA (CEU) hours! Classes start January 10th. If you'd like to participate please let me know soon as I'm limiting students to 12 (with a few extra guests I've already invited). Here you’ll you’ll find information on specific dates, topics for each class, breakdown of PDA hours, and other relevant information. I'm REALLY excited to be teaching this class and I hope participants will be excited as well! Again, for those interested in participating, please contact me as soon as possible.

Beginning of Winter 立冬 Seasonal Node

I know… It seems odd for me to be blogging about Winter when today when I got to my office it was close to 70° Fahrenheit (20° Celsius). We are having a bit of a warm and humid streak here in the northeast US, but the days are definitely growing shorter and shorter, and the leaves by now are mostly off the trees.

In the traditional calendar today we enter the Beginning of Winter (立冬) seasonal node as by this time of the year we are only about 6 weeks away from the longest night of the year, the Winter Solstice. 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 having relatively low COVID numbers, but we are seeing a lot of other upper respiratory tract infections such as influenza and colds (especially since most people are going without masks again). 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 are 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. Here’s a video I did of this for my own patients.

 

Diet for Beginning of Winter

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

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!

Naikan 內觀

The Japanese practice of Naikan 內觀 is a method of introspection that asks us to take stock of our life in a very profound way. Personally, I’ve engaged in the practice and it has been very meaningful on many levels. The ToDo Institute (where I did my professional training in Japanese psychology) is once again offering their online month-long course, Gratitude, Grace and a Month of Self-Reflection. This class is an excellent introduction to Japanese psychology in general, and Naikan more speficically.

ToDo has generously offered my students and readers 50% off the course. Please see the flyer below for more information (and click on it to go directly to the ToDo Institute website). Don’t miss this excellent opportunity.

White Dew 白露 Seasonal Node

Walking around outside I’m struck by how many trees are either brown or already starting to drop leaves. The drought here in the northeastern United States is really apparent. Because of this I predict we won’t have as spectacular a fall foliage this year.  But, we are now well into Autumn in the Chinese calendar, and the midpoint of Autumn, the equinox, is only about 2 weeks away. This coming weekend is also the Chinese Mid-Autumn moon festival, held on the full moon of the 8th lunar month.

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. Today, Wednesday September 7th, is the start of the next seasonal node, the 3rd node of Autumn - White Dew (Bai Lu 白露). The name White Dew is a direct reference to Five Phase association of Autumn, as white is the Metal Phase’s color.

Japanese Wagtail (Alpsdake - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=22624968)

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). The Japanese versions of these small mini-seasons are slightly different, but paint a picture of a similar migration of birds during the cooling weather: Kusa no tsuyu shiroshi 草露白 (Dew glistens white on grass), Sekirei naku 鶺鴒鳴 (Wagtails sing), and, like the second of the previous Chinese names, Tsubame saru 玄鳥去 (Swallows leave).

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. The daily temperatures here in New Jersey this week are going to vary between the 70s and 80s, 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 week I had to wear my fleece one night walking my dog Nelson for the first time in months). 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.

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.

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 heat 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.

Walk 100 steps and live to 99!

Over the last decade I’ve been making at least a weekly trip to visit my Taijiquan (Tai Chi) teacher Wang Fengming. In the Chinese tradition, a few years after I met him, I became a formula lineage disciple, meaning our relationship was more family-like than a basic teacher-student. In Chinese, once one becomes a disciple, the teacher is no longer called teacher, but rather Shifu (師父). The second half of that word, “fu,” means father, attesting to the close connection that develops. I often joke that Wang Shifu is as much my Chinese language teacher as a Taijiquan teacher, as we communicate 95% of the time just in Chinese. Over the years we’ve probably spent as much time around his kitchen table talking and drinking tea as we have worked out together

As in English, in Chinese there are a lot of sayings that just about every Chinese person knows and understands. One of the first ones Wang Shifu taught me was “飯後百步走,活到九十九! (Fàn hòu bǎi bù zǒu, huó dào jiǔshíjiǔ).” It rhymes in Chinese really nicely. In English the not so lyrical translation is, “if you walk 100 steps after eating, you’ll live to 99!” This made sense to me on a few levels. In Chinese medicine, digestion is one of the most important functions in the body. If we eat too much, or if the digestive system becomes weak from say disease or aging, then it’s hard for the stomach to process that which we have eaten. Movement of the body simply helps with movement in the digestive system. For example, one of the problems of immobility in aging people is developing constipation. Move the body and the contents of the stomach and intestines will move as well. But this common understanding of the relationship between eating and moving is not unique to the Chinese. During many of my teaching trips to Europe taking a walk after eating was a common activity, especially in Germany. The common wisdom there was to also move around a bit after eating a meal.

Modern research is yet once again proving what we (in both Asia and Europe) knew traditionally through observation and experience. Over the last few years news headlines have called sitting the new smoking. This may be a bit of an exaggeration, but in truth inactivity is a problem. Over the last few years with more and more people working from home and spending too many hours on Zoom, I’ve seen this truth over and over again in the clinic – people are just not moving enough.

One recent study published in February of this year looked at some of these questions in a more scientifically rigorous way. The article, a review of several smaller studies, looked at what breaking up prolonged periods of sitting, either through just standing, or walking, would do in terms of various health markers. The authors of the study noted that, “[l]ight-intensity walking was shown to significantly reduce postprandial glucose and insulin compared to prolonged sitting and equal durations of intermittent standing.” In other words, walking after eating significantly lowered blood sugar levels, suggesting that walking can be beneficial to both treat and/or prevent diseases such as diabetes. And, the best news is that the walking doesn’t have to be particularly long, or particularly intense. So, perhaps 100 steps (not that much), can make a big difference!

Of course other types of exercise are also important and effective methods of health management. For example, some research suggests that traditional practices such as Taiji (Tai Chi) are useful in managing blood sugar levels and other markers in patients with Diabetes.

Here’s a link to a CNN article on this study, and for those who want to read the original research paper please click here. Happy walking!

Four Words for Qigong & Taijiquan Practice (repost)

This is a repost (with some small changes) of a previous blog. I hope everyone enjoys reading it again!

Much of the Neigong and Daoyin (i.e., Qigong practices) I teach come from the Hunyuan system. The founder of Hunyuan, Grandmaster Feng Zhiqiang 馮志強, learned his material from the legendary Hu Yaozhen 胡耀真. After Hu passed away his daughters continued to teach, and happily today we have a lot of material passed down from Hu, either in written form or in the form of oral transmission outside of his writing. Hu was a brilliant practitioner and teacher, so I thought periodically I would blog about his take on the topics of body cultivation culture, Qigong and Daoist Neidan.

To start off, I’ll talk about four words for cultivation. It was and is common in Chinese martial arts, Qigong, medical practice, etc… to have short “songs” or sayings that are reminders for practice. These can be a short series of words, or slightly longer poems or other pneumonic devices. Here I’ll present a series of four Chinese characters that remind the practitioner of important practice ideas. While not unique to Hu’s teaching, they are mentioned by him and his students.

 

Inhale Xī 吸

This first word, Xī, means to inhale, absorb, or suck in (as in the breath). It also means to attract to oneself (as in magnetic attraction). In Qigong one very important technique we practice is the drawing in of Qi from the natural environment. Xī refers mainly to this. The drawing in of Qi is such a fundamental form that in most all of our classes this is what we start with doing.

In addition to drawing in Qi, the word Xī can also refer to the drawing of Qi into various circulatory patterns in the body, which we do by coordinating breathing with visualization or intention.

 

Hua Tuo’s Chart of Neigong from the writings of Hu Yaozhen (who was probably the actual author of the chart).

Stick or Attach Tiē 貼

Tiē, sticking or attaching to something, is the second word we have.  In Qigong practice this refers mostly to the tongue touching the upper palate in the mouth. We do this to connect the circuit of the Du Mai (Governing Vessel; the vessel that runs up the spine and over the head) and the Ren Mai (Conception Vessel; the vessel that runs from the Huiyin cavity to the tip of the tongue). This pair of vessels is an important Qi circulation pattern called the Lesser Heavenly Cycle (小周天), or the Microcosmic Orbit. While we only really have to place the tongue at the palate when working on this Qi circulation pattern, some practitioners (including me) place the tongue here during almost any Qigong practice.

In Taijiquan practice, the work “stick” also has special meaning. While the character Tiē is not specifically used in Taijiquan, the words “adhere” (沾連), “stick to” (粘), and “follow” or “go along with” (隨) are key to practice. In Taijiquan we want to always be aware of what our partner/opponent is doing, and how we can effectively neutralize that. The main way we practice these four characters in Taiji is through push hands and other related practices. By sticking to our partners’ every move, we develop the ability to “listen to” or feel what they are doing and how they are moving (聽勁). At the same time this allows us to “listen to” or feel what we are doing with our own body.

 

Hold Zhuō 捉

The third word, Zhuō, means to hold, to clutch or to grab. In Qigong practice this refers to lifting up of the Huiyin cavity, or perineal area, during practice. This movement is similar to Kegel exercises, except that we practice it gently, and often times coordinated with the breath. In some systems of Qigong the anal ring (which is also gently lifted with this exercise) is divided into 5 parts, each gently contracted to help focus on different internal organs during Qigong practice.

In Taijiquan practice the word Zhuō, which also means to capture, is a reference to Qinna (擒拿) techniques. A significant portion of Taijiquan’s posture applications are Qinna, and grasping and manipulating joints and limbs is essential in push hands as well.

 

Close Bì 閉

The final work is “close,” or “shut” – Bì. This word refers to bringing attention to one of the Qi orifices that we focus on during practice. This can be attention on the Dan Tian (any of the three – see my post on the Dan Tian for more information on this important structure), on the Huiyin cavity, or Ming Men cavity to name a few. Literally, we are trying to “close” or “shut” our attention to the outside world, and bring one pointed focus to the cavity we are working with. This is a very important method of practice.

 

For those interested in regular training please consider joining our classes - either in-person or online. While writing about this material is good, a lot of the explanation continues to happen with oral transmission and then with specific examples as they come up in practicing together.

End of Heat 處暑 Seasonal Node

Earlier this week on Tuesday August 23rd we entered the current seasonal node - Chu Shu 處暑, ‘End of Heat’.  While the model of the seasonal nodes describes the “ideal” change in the natural world at a given segment of time, we should remember that it is not always exactly on time, and it may vary for different geographic regions. In other words, 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 it can affect health. It also may need to be reevaluated sometime based on the unfortunate fact we are now dealing with manmade climate change.

That said, this year the hottest part of the summer, with over a month of no rain and high temperatures here in NJ, seems to now behind us.  While we can continue to expect warm weather for the near future, there is a cooling trend now that is starting in a real way. The days are also noticeably shorter. Thus, ‘End of Heat’ is a good description for the general pattern we are starting to experience where I am located 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)

The weather pattern associated with Autumn is dryness, and given that here in NJ we have been in a drought, we’ve been seeing this early this year. 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).

 

Asian pear and white wood ear mushroom soup

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 that I will 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.

On the Dan Tian 丹田

Recently one of our new online Qigong class students posed a question about the Dan Tian. At the end of most all of our postures we do a maneuver called ‘collecting in the qi’ (my loose translation of 收功), in which, while moving the hands down in front of us and sinking, we visualize everything in the body returning down to the Dan Tian (丹田), the space in the abdomen between the navel and Ming Men (命門). As I frequently point out in class, our’s is the Neigong (i.e., Qigong) in the lineage/tradition of Hu Yaozhen (胡耀真), one of my great-grand teachers, and a key feature of this tradition is the almost constant focus on Dan Tian.

The Dan Tian, from a colorized version of the Diagram of the Inner Landscape 內經圖 found at the White Cloud Temple 白雲觀 in Beijing.

A common English translation for Dan Tian is the ‘elixir field.’ The word ‘tian’ (田) just means field. The word ‘dan’ (丹) is a bit more complicated. One meaning of the word is cinnabar, a scarlet-red mineral form of mercury sulfide (HgS) that is a common ore source used for refining pure liquid mercury. Since Daoists used mercury as one metaphor in their descriptions of the meditative processes used for transcendence or immortality (and in some unfortunately cases experimented with ingesting actual mercury while seeing the same), the term ‘dan’ became associated with the process of spiritual transformation. ‘Dan’ and the compound term ‘Dan Tian’ thus becomes a synecdoche - a stand in for the entire process of cultivation. It is the symbolic elixir that, when taken, confers a higher state. Hence, the translation of Dan Tian as ‘elixir field’ – the place that is used to create the elixir of immortality and transcendence.

In the body, the Dan Tian is conceived of as a physical location, although the physicality of Dan Tian is a topic of debate. For our purposes however, we will take it as a physical location. Properly speaking, there are three Dan Tian in the body: an upper (上丹田), middle (中丹田), and lower (下丹田). There are some slight variations on the locations of these three structures depending on the source. Most agree that the upper Dan Tian is located in the head. The middle Dan Tian is sometimes associated with the area of the chest, that location that in Chinese medicine is referred to as the Sea of Qi 氣之海 (not to be confused with the acupuncture point of the same name), or the Tan Zhong 壇中.  In Hu Yaozhen’s lineage, we located the middle Dan Tian not in the chest, but rather in the abdomen between the navel and Ming Men. Hu Yaozhen then places the lower Dan Tian at the base of the abdomen in the pelvic cavity, just above Hui Yin 會陰 – the perineum. While a large number of modern Qigong texts situate the middle Dan Tian in the chest, it is interesting to note that in some older texts it is located in the abdomen as Hu teaches. For example in the Yuji Qiqian (雲笈七籤), an anthology of the Daoist Canon written circa 1029, the middle Dan Tian is associated with the middle jiao, the abdomen, and the area ‘below the heart’ (心下).

Regardless of the variations, somewhere in the area of the abdomen seems to be the most important of the Dan Tian used in various schools of meditation, Qigong, martial arts, etc… But why is this? Why is it so important?

A large (about 4 inches from top to bottom) piece of Cinnabar ore 硃砂 in my private collection.

For Chinese medicine practitioners this is an interesting question. If we look at the earliest of Chinese medicine cannons, we can’t find the term ‘Dan Tian.’ For example, the only chapter of the Huangdi Neijing that mentions it is the Treatise on the Origin of Disease (本病論). Unfortunately, this is one of the two apocryphal chapters of the Su Wen. While it may have been in circulation for over 1000 years by now, it is most likely not original to the Han Dynasty version of the text and was not a chapter Wang Bing would have seen or worked with in writing his highly important and definitive edition of the Neijing. That said, the abdomen is an important location. Most of the Zang Fu are located there. Furthermore, highly important vessels originate in the abdomen. For example, according to the Treatise on Bone Hollows (SW60 骨空論), the Chong, Ren and Du all originate from a location in the abdomen. These are extremely important vessels, with the Ren and Du respectively being tied to the core Yin and Yang of the body. For example in the Song Dynasty text Xi Shang Fu Tan (席上腐談) the Ren and Du are called the Seas of Yin and Yang (陰陽之海). The Chong is associated with all the channels, and in the Treatise on the Seas (LS33 海倫) the Chong is said to be the Sea of the 12 Channels (衝脈者,為十二經之海) – i.e., all the channels. Clearly, even though the Dan Tian is not mentioned by name, the abdomen is tied to basically all the important structures of the body.

While the Nanjing (Classic of Difficulties) does not specifically mention the Dan Tian either, it does get a little closer in identifying the Kidneys and the Moving Qi between the Kidneys (i.e., the Ming Men) as being core aspects of our vitality. The idea of Ming Men the way we conceive of it today is absent from the Neijing, unless of course you are a creative reader in the way that Zhao Xianke was (there’s a good Chinese medicine inside reference for you!). This Moving Qi between the Kidneys, in addition to being associated with the Ming Men, have also been associated with the Dan Tian by some physicians. For example, the 66th Difficulty says that, “the Qi moving below the navel and between the Kidneys are a human’s life. They are the origin and root of the twelve channels, and thus are called source” (臍下腎間動氣者,人之生命也,十二經之根本也,故名曰原). Yang Xuancao, a commentator writing in the 7-8th c. CE said of this line that, “the Qi moving below the navel and between the Kidneys are the Dan Tian. The Dan Tian is a human’s origin and root” (臍下腎間動氣者,丹田也。丹田者,人之根本也). Yang continues with a beautiful description of the Dan Tian that is too long to quote in its entirety here, but, for example, he says that the Dan Tian is yellow in the center, green-blue on the left, white on the right, red on top, and black on the bottom. This of course is just metaphorical language that says the Dan Tian in the abdomen is connected to all of the Five Phases, and thus all the organs and all the channels.

It may very well be that this sort of medical theory that we see in the Nanjing, and not in the Neijing, arose because of the influence of people such as the inner alchemists and Daoists – an example of cultivational literature influencing medicine (we see many other examples of the opposite of course). Some of the more conservative medical commentators (i.e., the Neijing purists) have pointed this out as a criticism, and an example of adding theory to medicine that has no legitimate right being there. I’ll let my medical providing readers decide for themselves if they find these ideas relevant to their clinical practices.

Hua Tuo’s Chart of Neigong from the writings of Hu Yaozhen (who was probably the actual author of the chart). Notice the upper Dan Tian in the head, and the lower Dan Tian just above the perineum. The middle Dan Tian is located in the space level with the navel, although here called the ‘Entrance Hall’ - a Buddhist term.

Aside from our discussion of medicine, the Dan Tian is described extensively in the literature of internal alchemy and other aspects of Daoism (which in turn become some of the important sources from which Neigong/Qigong concepts of Dan Tian spring). For example, the Direct Pointers to the Great Elixir (大丹直指 DZ 244), a Quanzhen text attributed to the Daoist master Qiu Chuji (1148-1227 CE), discusses Dan Tian as a part of the process of cultivating transcendence. It says that the navel at the center of the body is the Central Palace (中宮), which it also identifies as an alternate name for the Dan Tian (但臍在人身之中,名曰中宮、命府、混沌、神室、黃庭、丹田). The Direct Pointers goes on to say that the Dan Tian stores essence and marrow, and connects the hundred channels and nourishes the entire body (此處包藏精髓,貫通百脈,滋養一身).

In Hu Yaozhen’s teaching, the meditative process of bringing attention down to the abdomen is called the Three Senses Return to the One (三性歸一). In reality the number three here is a symbol for all of the senses, not just literally three of them. By bringing the meditative focus to the interior we can induce a still calmness. I am not qualified to talk about this from a real internal alchemy or Daoist perspective, but certainly this inward focus can have a profound effect on centering the mind and pulling us back into a state of centered focus. In other words, it helps to tame the monkey mind that is our norm. Even in the clinic I will often ask patients undergoing acupuncture to simply bring their focus down to their abdomen and breathe deeply. In terms of Tung’s acupuncture this is another example of how we apply the Moving Qi (動氣) needling method that is a part of achieving De Qi (得氣 – for more on what De Qi really is please see my class on classical treatment strategies expressed in Tung’s acupuncture). But I digress…

Aside from inducing calm centeredness, the cultivation of Dan Tian, from both the alchemical and medical perspectives presented above, must also have a beneficial health effect on pretty much all the channels and organs. If the Dan Tian is connected to everything and nourishes the entire body, it means that a robust Dan Tian leads to robust health.

Hu Yaozhen may very well have focused heavily on the Dan Tian because one of his main teachers was a Daoist master and practitioner of inner alchemy by the name of Peng Tingjun (彭庭隽), and Peng in turn was a disciple of a Daoist hermit by the name of Huo Chengguang (霍成光). It is from Peng that most of Hu’s Neigong came down to us. To be honest, I think the better question is why don’t all schools of Neigong/Qigong focus more on the Dan Tian? It would seem natural to me that it be a major part of most every posture in one way or another.

I hope my short musings help stimulate more thought, as they have for me just sitting down, collecting my thoughts, and putting them to paper (or screen as the case may be). Whether you, the person reading this, are a physician, Qigong practitioner, or just someone interested in East Asian medicine or cultures, I hope thinking about the role of Dan Tian deepens your own practice.

Beginning of Autumn 立秋 Seasonal Node

As I’m sitting down to blog today, I write while sweating not inconsiderably. It is hot and there’s really no other way to put it. Here in the mid-Atlantic region we are in the middle of a heat wave, and a rainless one at that. While we’re supposed to get some rain later today and early this coming week, it has been a particularly dry (in terms of rain) summer, albeit humid.

Despite the heatwave, today, Sunday August 7th, is the beginning of Autumn (and the seasonal node of that same name - Li Qiu 立秋) 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.

In the Lü Shi Chun Qiu (The Spring and Autumn Annals of Lü Bowei; 呂氏春秋), the classic text of Chinese philosophy from the 3rd century BCE, it is said that the Emperor Shao Hao (少昊), and his son Ru Shou (蓐收) are the sovereigns associated with the three months of Autumn. This obscure statement sheds tremendous light on the essence of Autumn, and eventually allows us to understand how to stay healthy this season.

Emperor Shao Hao 少昊

According to some legends (since they do vary), Shao Hao was one of the Five Emperors (五帝) of ancient China. His mother was a weaver goddess who fell in love with the planet Venus, and the result of that union was Shao Hao. Together with his son Ru Shou, Shao Hao settled on Chang Liu Mountain where they ruled over the Western Heavens and controlled the setting of the sun. Remember, the west is associated with the Metal phase, and therefore Autumn. Certainly, Autumn is the time of year that corresponds to sunset during the day, and in Chinese astrology Venus is the planet of the Metal phase, and thus too corresponds with Autumn. Even the son’s name, Ru Shou, has the word “shou” (收) within – the word meaning “to harvest” or “to collect,” an attribute of Autumn. The Neijing says that when we move and behave in a way that allows us to resonate with Autumn, we are in the state of Nourishing the movement of Harvest (養收).

In early Autumn (August is the first month of the season) we experience the ongoing but very gradual shift to shorter days and, eventually, cooler temperatures. In other words, we are shifting more and more to the Yin phase of the year. Yet, August in particular can still be damp and humid. It is also the time of tropical storms which bring moisture and wind – an external event. In Chinese medicine, weakness in the Spleen and Stomach leads to damp accumulation – an internal event. In early Autumn we therefore should avoid dampness externally and simultaneously strengthen the digestive organs internally. 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.

 

In addition to dietary recommendations we perform acupressure on supplementing points such as Zu San Li ST-36 (or teach patients to do this on themselves). If patients tend to cold and vacuous patterns of the Spleen and Stomach, gentle direct thread moxa at Zu San Li is also applicable. According to the noted moxibustion scholar Lorraine Wilcox, the time around the beginning of Autumn is also a special time for applying prophylactic moxibustion in an effort to strengthen the body for the cold season to come. 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 through the rest of August and into September and the weather does become cooler, 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. I’ll leave with the observation that COVID numbers are spiking again in my area (as they are in a lot of the US), so please continue to mask up in clinical spaces so as to protect the most vulnerable of our patients, and continue to take necessary infection control measures. Be safe, and be healthy!

Ghost Month 鬼月

Today, Friday July 29th, is the first day of the seventh lunar month this year. 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 12), which is known as Zhong Yuan Jie (中元節).

Yama 閻王爺 - King of Hell

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 remind us of how the natural balance of Yin and Yang is shifting in a very real way this time of year. In just about a week on August 7 we will arrive at the beginning of Autumn. Even though days are still hot in August, it is true that we are in the beginning of the Yin portion of the year. After the Summer Solstice the days start to slowly get shorter. By August here in northern New Jersey plant growth is mostly over. Even the grass is growing more slowly than before. In the environment we are seeing a significant increase in dampness and humidity – water being a Yin substance. Now, one of the main pathological environmental factors our patients face is dampness, or summerheat-dampness (a combination of pathogenic Yin and Yang together).

When I look at customs like the ghost month, I see other interesting health recommendations. For example, I usually practice Qigong in the evening, but I typically practice some exercises less outside at night this month. Ghosts or not, there are so many mosquitoes and insects that there’s no way I can practice Zhan Zhuang (standing post) or other static postures outside! These types of insects, as vectors for disease, can cause serious problems in people who might be more vulnerable – such as the elderly, the young, or the sick. While most health people are fine after being bitten by ticks or mosquitoes, people who are weaker, or those with some sort of compromised immune function are at greater danger. Interestingly, modern research has shown that some traditional taboos during ghost month actually lower mortality rate for the month (click here for some research). 

Other health recommendations this time of year also focus on counteracting the growing Yin. In some parts of China around the time of Summer Solstice there is the custom of hanging herbs such as Ai Ye and Shi Chang Pu above doors. Both Ai Ye and Shi Chang Pu are aromatic, and the aromatic nature is Yang that can disperse Yin influences as well as ward off insects.  Some people will also put powdered Xiong Huang (realgar) at the bottoms of doors to keep bugs out of the house (realgar is a very toxic medicinal).

In terms of internal herbal medicine, this is the time of year when a lot of patients benefit from formulas such as Huo Xiang Zheng Qi Tang. This formula contains aromatic and Qi moving medicinals such as Huo Xiang, Hou Po, Chen Pi and Bai Zhi to transform damp. It also includes medicinals that likewise strengthen the Spleen so as to allow for normal movement and transformation (the Yang functions of the Spleen). This idea of expelling the Yin and supporting the Yang is the same principle underlying the use of San Fu moxa (see previous blog posts).

So, please be careful out there and avoid the Yin, ghosts or not. But, just to be sure, I for one will be burning some joss paper outside later today to appease some ghosts!

Great Heat 大暑 Seasonal Node

We are in the hottest time of the year according to the traditional Chinese calendar – the San Fu 三伏 period. Across the United States and Europe we are having a stretch of very hot and very humid weather. Europe in particular has seen an historic heat wave with record temperatures both in the UK and on the continent.  Appropriately, the name of the seasonal node that starts today, Saturday July 23rd, is Great Heat (Da Shu 大暑).

In some parts of the world this segment of the year can also be one of the dampest.  As we’ve discussed before, each of the 24 seasonal nodes (jie qi 節氣) can be further broken down into 3 five-day periods of time, known as the 72 Material Manifestations (wu hou 物候). The 3 periods within Great Heat are Decaying Grass Transforms into Fireflies (fucao hua wei ying 腐草化為螢), Earth Lies Wet Beneath Sweltering Heat (tu run ru shu 土潤溽暑), and Heavy Rains Fall Intermittently (da yu shi ying 大雨時行). The Japanese versions of the first of these is Paulownia Trees Produce Seeds (kiri hajimete hana o musubu桐始結花). In these rather poetic names we can see the images of plant life coming to an end of growth (in particular, delicate plants such as grasses), and we also see references to the combination of both dampness and heat in nature.

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

As already mentioned, now is the San Fu period. This time of year we have a tradition of applying mustard plasters to acupuncture points on the back, a practice known as San Fu moxibustion. While called a type of moxibustion, the heat source for this treatment is not burning mugwort, but the heat derived from the mustard (and other herbs) plasters that are placed on the skin.

In addition to San Fu moxa, we can also start utilizing regular moxibustion as well for disease prevention. The Bian Que Heart Classic (扁鵲心書) suggests that every year at the transition between summer and fall we should moxa Guan Yuan REN-4. As part of the recommendation the text suggests the application of 300 cones every 3 years for people over the age of 30, every 2 years for people over the age of 50, and yearly once age 60 is reached.  While 300 seems like a lot of cones, we don’t have to do them all in one sitting. Break up application of moxa into smaller amounts of cones and proceed daily for several weeks; in other words, we are looking for a total of 300 over time, not 300 all at once. Additional points to consider for moxibustion include Zu San Li ST-36, Shen Que REN-8 and Qi Hai REN-6.

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

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

 

Diet for Great Heat

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

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

 

Stir Fried Lotus Root

Ingredients:

  • 1 lotus root (about ½ lb)

  • 1” piece of ginger, chopped

  • 1 cup roughly chopped scallion

  • 2 cloves garlic, peeled and chopped

  • 1 tablespoon sesame seeds

  • white vinegar

  • cooking oil (sesame)

  • soy sauce or tamari 

Instructions:

  1. Peel lotus root and cut into slices about ¼ inch thick, submerge in water with a small amount of white vinegar to prevent discoloration

  2. Heat some cooking oil in a large frying pan, add ginger and garlic and cook until fragrant

  3. Drain lotus root and place the slices in pan in a single layer; cook until they start to change color and become slightly translucent and then turn over and cook a few minutes longer

  4. Add in sesame seeds, a splash of soy sauce or tamari, and the scallions and fry a short while longer until the scallions start to wilt

  5. Remove from heat and enjoy

 

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

I hope everyone is staying cool and dry!

Preparing for the Seasons to Come – A Medicated Liquor

One of the maxims in Chinese medicine is that it is usually best to treat disease before it arises, and part of that is being well prepared ahead of time. The second chapter of the Su Wen says, “Thus, the Sages did not treat disease that were already manifest, they treated disease that had yet to arise. They did not treat what was already in a state of disorder, they treated before disorder arose” (是故聖人不治已病,治未病,不治已亂,治未亂). It goes on to explain that doing this was akin to digging a well after one is thirsty, or forging weapons after war has already broken out. Both are too late to do as much good as possible.

In this spirit we can use this time of year to start preparing formulas to use in a few months, once the weather becomes cold again. A very traditional format of herbal formulas that is particularly suited to the colder weather is medicated wines (also called medicated liquors since they are made with distilled spirits, not actual wines). Ethyl alcohol is warm, acrid and sweet. This combination means that it can warm and course the Qi and Blood, as well as supplement at the same time. When herbal formulas are prepared in alcohol (i.e., ethanol) the functions of the ingredients are amplified in this therapeutic direction.

One very useful formula that we can start preparing now for use in colder weather is Song Ling Tai Ping Chun Jiu (松齡太平春酒), a formula I will simply translate into English as Great Harmony Eternal Spring Wine. Here are the ingredients…

 

Great Harmony Eternal Spring Wine 松齡太平春酒

Ingredients:

  • Shu Di Huang 250g

  • Dang Gui 125g

  • Hong Hua 15g

  • Gou Qi Zi 125g

  • Fo Shou 15g

  • Gui Yan Rou (i.e., Long Yan Rou) 250g

  • Song Ren (pine nuts) 125g

  • Fu Shen 50g

  • Chen Pi 25g

 

Directions:

Choose as best quality possible for each of the above medicinals. Place in a clean wide-mouthed jar with about 2.5 liters of vodka, or another distilled spirit of similar alcohol content. Allow the medicinals to soak for at least a month (although up to three months is preferable). Periodically the mixture be stirred with a clean spoon, or simply shaken a little to agitate the liquid. Once ready, take one or two shots per day as a dosage (spread out if two).

 

This formula was a favorite of the Emperor Qianlong (1711 – 1799; r. 1735 – 1796), one of China’s most important Emperors and one of the longest reigning monarchs in world history. The formula, crafted by Imperial physicians, was one of the Emperor’s longevity tonics. While we find a few variations on the formula today, in general the major ingredients and thus therapeutic thrust of the formula is the same. Overall the formula strengthens the Spleen, benefits the Qi, and nourishes and quickens the Blood. It is contraindicated for patients with significant internal heat patterns, and for those who normally cannot consume alcohol.

The very interesting name of the formula is deserving of a short discussion. The first word Song (松) means a pine tree, and the second word Ling (齡) means years of age. At first glance this is an odd combination of words – age of a pine tree. Put together it is a reference though to long life. The pine, as an evergreen, is a symbol of enduring life and youth, which is why pine nuts are seen as a longevity food. These two words are also reminiscent of the Chinese phrase Song He Yan Ling (松鶴延齡) – “live as long as the pines and cranes.” Both of these are powerful symbols of longevity in Chinese culture. Finally, going back even to the works of Confucius, in the Analects there is a passage that says, “The Master said, "When the year becomes cold, then we know how the pine and the cypress are the last to lose their leaves” (子曰:歲寒,然後知松柏之後彫也). Thus, in old age (when the year becomes cold) it will be apparent who maintains youthful vigor. We know from history that Emperor Qianlong certainly did!

I hope everyone is staying cool and dry, and that we are all thinking of how we can start preparing for the colder months a little ways off in the future.

Minor Heat 小暑 Seasonal Node

This past Monday was the Independence Day holiday in the United States. Unfortunately, with the recent rulings by the US Supreme Court which dismantled over 100 years of gun safety legislation, and the abomination that was the reversing of 50 years of legal precedent for personal privacy and legal access to essential women’s health services, my family was feeling less than patriotic.  Despite that, the weather was just perfect for Summer, although earlier last week the weather was very, very hot, and quite humid. Even indoors in air conditioning there was an oppressive feeling. The heat of Summer has definitely arrived and it is right on time, as today July 7th, starts the next seasonal node of 2022 - Minor Heat (Xiao Shu 小暑).

The Minor Heat seasonal node marks an important change in the movement of Qi in the natural world. Summer Solstice (Xia Zhi 夏至) began the transition from Yang-expansion to Yin-contraction in the environment. Therefore, Minor Heat is the first seasonal node in the nascent Yin time of the year. However, although we are transitioning into the Yin time of the year, it is still hot and getting hotter. Weather change happens slowly. Think of it like a train barreling ahead at high speed. Once the conductor decides to stop the train and put it in reverse, she first puts on the breaks. Even though the breaks are applied, it takes several hundred feet before the train actually stops. Only then will it very slowly start moving in reverse. The movement of the seasons is just like this. Once we have flipped the switch from Yang to Yin, the weather still continues to warm for some time before the very slow movement in the opposite direction begins.

The smaller segments of the seasons for this Node are Warm Winds Arrive (温風至), First Lotuses Blossom (蓮始開), and Hawks Learn to Fly (鷹乃学習).  These three are the traditional Japanese version of the mini-seasons. The Chinese version is slightly different, with the second being called Crickets Take Up Residence in Walls (蟋蟀居壁).  Personally, I’d rather have lotuses rather than crickets invading my house!

The most important “to do” recommendation during this time is to nourish the Heart by maintaining an optimistic outlook – something I’m personally trying to do despite what I mentioned in the introduction above. Why is this? June and July are the months associated with the Fire phase. Also, if we overlay the 12 time periods of the day with the 12 months of the year (i.e., the 12 two-hour periods of the day that each correspond to one of the primary channels), June is the time of the Heart channel and July the Small Intestine channel - both are Fire. Since this is the Fire Phase time of year, it is the time of the Heart Zang. We nourish the Heart by keeping a calm mind and being optimistic. Pessimism or other negative emotional states can lead to patterns such as Liver stagnation, which in turn can transform into heat and harass the Heart. We can also nourish the Heart and regulate the Fire phases by doing some specific Qigong exercises. Over the last few weeks in our online Qigong classes we have been doing exercises for the Fire channels in the body (if readers are interested in joining our online pandemic Qigong classes that are still ongoing, please contact me).

As mentioned above, the first 5-day period of Minor Heat is known as Wen Feng Zhi (溫風至), - Warm Winds Arrive. This certainly describes what is happening in the weather right now, especially in the Northeastern United States! The weather has been hot and humid. Therefore, we need to be careful about environmental dampness damaging the body. As clinicians we should instruct patients who are prone to damp patterns on how to eat, dress, etc… In this light the main “to avoid” this time period is undue exposure to cold and excessive consumption of cold items (both cold temperature and cold thermal nature). While it may seem logical to be in cold places in cold weather, there is certainly a problem in the west with using air conditioners to cool rooms to temperatures lower than we’d feel comfortable with in winter! Furthermore, the overconsumption of cold (and especially cold and sweet) food and drink damages the Spleen leading to more damp accumulation. Instead, we should drink beverages that are cooling, as well as either bitter (to drain), or acrid (to move). This will cool the body without developing damp stagnation. Examples include green teas, or chrysanthemum and mint herbal teas. In China summer is the season to drink green teas such as the famous Dragon Well – Long Jing Cha 龍井茶.

 

Diet for Minor Heat

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

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

This time of year it is also a great idea to start preparing herbal formulas that will be used in the colder weather. My next blog post coming soon will discuss making a medicated wine for the cold seasons to come.