Book Review: Exercise Prescription in Sui China (581 – 618 CE)

I’ve been behind on books I’ve been wanting to review, so I figured that I’d kick things off again with a review of my newest acquisition, and then I’ll work backwards to some other East Asian medical texts and then some more books on martial arts. So, enjoy this review, and hang on for more to come soon!

Exercise Prescription in Sui China (581 – 618 CE)

By, Dolly Yang and Mugen Chiang

Purple Cloud Press, 2024

I initially became interested in East Asian medicine through my own practice first of martial arts, and then later my introduction to and subsequent engagement with body centered practices such as Qigong. To me, these played a big part of my own views and practice of East Asian medicine. In my own training at the New England School of Acupuncture we did have an all too short class on Qigong, but while there I was surrounded by other people for whom internal martial arts and Qigong were essential to their own version of East Asian medicine, such as my friend and mentor Rene Navarro. Yet, as I started teaching East Asian medicine outside of the New England area, it became clear to me how very limited most acupuncturists’ exposure to movement therapies was. For example, for several years I taught a combined Qigong / Taiji course at the Pacific College of Health and Science in New York, and there, students got a single 28 hours long class as their only real exposure to these arts during the almost 4 years of their master’s degree!

As a result of all this, one of my personal interests is improving the teaching of Qigong and related arts, and encourage their use by licensed East Asian medicine professionals. My fantasy would be eventually to have a school of East Asian medicine here in the United States have movement therapies such as Qigong and Taiji be a focused course of study, like a university major. It will come as no surprise then that I was extremely pleased when I found out that this book, Exercise Prescription in Sui China, was slated for publication by Purple Cloud Press.

Exercise Prescription is an outgrowth of Dolly Yang’s PhD dissertation completed under Vivienne Lo at University College London. The text is based on the Zhu Bing Yuan Hou Lun 諸病源後輪 – the Treatise on the Origins and Symptoms of Medical Disorders (hereafter “Treatise”), a very influential medical text compiled during the 7th century at the behest of Emperor Yang Di. What the Treatise did was categorize and explain diseases that were known at the time, giving treatment options for physicians encountering said disorders. However, the most important thing for our discussion was the systematic inclusion of Dao Yin as a treatment modality for an incredibly wide range of diseases.

To put this in better context we should remember that by the Sui period there was no such thing as Taijiquan (Tai Chi), and the term Qigong is essentially a neologism that would not be used for over 1000 years still. Dao Yin is a term that describes a wide range of movement, breathing and visualization practices, and many of these would make their way into the modern category of Qigong. Also, prior to the Treatise, most texts on Dao Yin presented them as aspects of Yang Sheng, i.e., disease prevention and health maintenance. What is so revolutionary about the Treatise, is that it basically moves Dao Yin out of the realm of prevention and elevates it to a remedial therapy that can be prescribed based on a specific patient’s complaints. As such, it is THE granddaddy of all books on what we today would call Medical Qigong, or Clinical Qigong.

What Dr. Yang does in Exercise Prescription is significant and I think will be monumental to the reestablishment of Qigong-like practices to their once major role within East Asian medicine. In this book Yang starts with introductory material that describes and defines Dao Yin, and then analyzes various practices associated with Dao Yin such as postures, movements, breathing patterns, self-massage, and visualization. She also gives a brief overview and background of the Treatise, which will help situate the material historically.

After the introductory material, and in the main sections of the book, Dr. Yang translates all of the Dao Yin sections, disease by disease, that are given in the Treatise. Thus, we are given Dao Yin prescriptions for the treatment of a wide range of disorders from musculoskeletal problems, to disorders of the internal Zang and Fu, to diseases of the sensory orifices, and to just about everything in between. The material is copious, with the current book coming in at about 500 pages in length!

One problem with the original Treatise though is that there were no diagrams, and sometimes it is difficult to discern exactly what a movement pattern is from the written word alone. To overcome this, Exercise Prescription includes illustrations by the very talented Mugen Chiang. Thus, the original text is brought more to life by the visual interpretations created by the partnership between Yang and Chiang.

I do think that this book will become a defining text in English on the prescription of Dao Yin and Qigong, and is destined to be a very important work. This is definitely my kind of book, and honestly to me it is one of the most exciting publications I’ve seen in recent years. For anyone interested in East Asian medicine it is a must have, and my hope is that it will contribute to bringing this aspect of medicine back to the prominent place it once historically had in East Asian medicine.

My last suggestion is that purchasing the book directly from the publisher (here) puts more money in the hands of the authors. While it is listed on Amazon, please let’s all support small independent publishers by shopping directly with them. For information on my own classes on Clinical Qigong for licensed East Asian medicine providers please go here.

Summer Solstice 夏至

This week we arrive at one of the major cardinal points in the transition of the year – the Summer Solstice for the northern hemisphere. The astronomical solstice is tonight, June 20th, at 4:50pm EDT.  At that exact moment, the North Pole will at its maximum tilt (about 23.5 degrees) toward the Sun, resulting in the longest day and shortest night of the year. This means that tomorrow the days will slowly start getting shorter, heralding the cosmic transformation from Yang to Yin that has just been triggered.

In addition to being one very important moment in time, the Summer Solstice (Xia Zhi 夏至) is also the name of the seasonal node that starts June 21st. This node marks the apex of Yang in the natural world as well as the rebirth of Yin that will eventually culminate with the longest night on the Winter Solstice in December. In relationship to the times of day, Summer Solstice corresponds to high noon, the Wu (午) hour, and is the time of the Heart channel. When we break down Summer Solstice into the smaller five-day periods of time, it includes the time periods know as Deer Shed Antlers (Lu Jiao Jie 鹿角解), Cicadas Begin Singing (Tiao Shi Ming 蜩始鳴), and Pinellia Grows (Ban Xia Sheng 半夏生) In Japan the names for the 72 Material Manifestations (七十二物候) differ slightly. The names of these three mini seasons for the Japanese are Prunella Dries (乃東枯), Irises Bloom (菖蒲華), and Pinellia Grows (半夏生 - this one is the same as the Chinese calendar). Notice that this time is when Ban Xia is growing, the king of drying damp and getting rid of phlegm turbidity (a Yang herb to treat a Yin pathology). Likewise, in China this is the time of year when Aconite (Fu Zi 附子) is harvested to enhance its Yang nature.

In Yijing (I Ching) symbolism, this time period is represented by hexagram 44, made up of Qian-Heaven trigram (3 solid yang lines) over Xun-Wind trigram (1 broken yin line under 2 solid yang lines). Thus, the complete hexagram is 5 solid Yang lines over one broken Yin line at the bottom – Yin is being birthed once again. One of the translations for the name of Hexagram 44 is “The Queen,” also showing that this time of year begins the transition towards returning inward to the hidden, the Yin, the Blood, and the Dark Mother that is referred to in the first chapter of the Dao De Jing.

Practically speaking, although this is a time of transition to Yin, damp and hot weather will most likely be with us for the foreseeable future. Thus, the first health recommendation for Summer Solstice is to focus on clearing summerheat and draining dampness. For example, various skin problems due to external contraction of summerheat damp are commonly seen now. It is also common to see other symptoms of summerheat strike such as malaise, fatigue, low-grade fever or heat effusion, low-grade headache, nausea, etc… There are several ways we can help ourselves as well as our patients when they present with summerheat damp symptoms. First, is to regulate diet, which we will discuss more below. We can also counsel basic lifestyle recommendations, such as dressing appropriately to the weather (such as wearing light clothes made of natural materials that breathe well), staying in shade in the midday when temperatures are highest, and drinking plenty of light and clear fluids. This is especially important for our older patients, since as we age we lose the normal ability to adapt to more extremes in temperature. Furthermore, seniors are more likely to be on prescription medications or may have chronic medical problems that inhibit perspiration or make extremes of temperature less tolerable. Some medications also increase sensitivity to sun raising risk of sunburns (examples include tetracyclines, quinolones such as Cipro, Celebrex, and some chemotherapeutic agents).

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

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

Diet for Summer Solstice 

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

In summary we can generalize this is the time to eat foods that clear heat (especially summerheat), drain dampness, nourish the Qi and boost fluids. Examples include cucumber, winter melon, luffa, tomato, honeydew melon, star fruit, peach, plumb, and mung beans. This is also a good time to eat bitter melon (ku gua 苦瓜). When I lived in Okinawa as a graduate student, bitter melon was a basic staple of food since Okinawa is a very hot and damp climate.

Here’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… This is a seasonal formula for summer from this text.

 Cardamom Powder 豆蔻散

Ingredients:

• Cao Dou Kou 草豆蔻 120g (toast until yellow together with 120g of fresh ginger, then remove the peel for use)

• Mai Ya 麥芽 300g (dry fry until yellow)

• Shen Qu 神曲 120g (dry fry until yellow)

• Zhi Gan Cao 炙甘草 120g

• Pao Jiang 炮薑 30g

Grind all ingredients to a fine powder. Take a small amount daily with water or tea. During summer as heat and dampness increases, occasionally this will negatively affect people’s digestive function and appetite. This formula opens the Stomach, increases appetite, treats abdominal distension and is particularly useful if weather is cooler or damper than usual.

I hope everyone is staying cool and dry. For those who would like to read more about Summer seasonal recommendations in general, please go here.

I also have a more comprehensive course on acupuncture and the seasons, including how to use diet, acupuncture (even Tung’s acupuncture) and other lifestyle recommendations to harmonize with all the seasonal nodes. For more information on that class, go here.

I hope everyone is having a great Summer and staying healthy!

On the Dan Tian 丹田 (Repost)

This is a post that I originally wrote back in summer 2022.

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.

Duan Wu Festival 端午節

The Duan Wu 端午 Festival, also known as the Dragon Boat Festival, is a traditional Chinese holiday celebrated on the fifth day of the fifth lunar month which this year falls on today, Monday, June 10th. With a history that dates back over 2,000 years, this festival holds great significance in Chinese culture.

At its core, the Duan Wu Festival commemorates the life and death of Qu Yuan, a renowned poet and statesman during the Warring States period. Qu Yuan was deeply devoted to his country and expressed his frustrations through his poetry. However, when his counsel was ignored and his state fell into turmoil, he was overcome with despair. In 278 BCE, he drowned himself as a final act of protest against the corruption and injustice rampant at that time.

Dragon Boat in Okinawa

Duan Wu's rituals and customs are partially rooted in the belief that Qu Yuan's spirit could be protected and honored. One of the most obvious customs during the Duan Wu Festival is dragon boat racing. These races involve teams of paddlers rowing in long, narrow boats decorated like dragons, a very Yang and auspicious creature. The act of racing dragon boats on rivers is not only fun to watch but also a way of warding off evil Yin and preventing bad luck, much in the same way that Lion dancing does.

Mugwort 艾草

Another Duan Wu custom is the consumption of zongzi, sticky rice dumplings wrapped in bamboo leaves. Legend has it that when Qu Yuan drowned himself, villagers threw rice balls into the river to prevent fish from devouring his body. To this day, people eat zongzi as a way of paying homage to Qu Yuan and as a symbol of warding off evil spirits and disease during the hot summer months. Aside from this practice, during Duan Wu people frequently hang aromatic herbs on the outside of their houses, such as Mugwort 艾草 or garlic. These Yang substances also serve to ward off Yin negativity and disease (such as dampness related conditions, or conditions caused by insects such as mosquitos).

Beyond the history and the customs associated with the festival, Duan Wu carries an inner meaning. This is the time of mid-summer as we discussed in the previous post on Summer Solstice from yesterday. It is the time when Yang has come to its apex and Yin starts the slow progress towards becoming the dominant movement in nature. Thus, it is an opportunity for cleansing and purification so that while we can embrace the movement of Yin, we can also avoid the negative aspects of that phasic movement. In the clinic this means watching our patients for patterns such as damp turbidity, especially in the digestive system. As the weather becomes more and more hot and humid this will be a commonly seen problem. We can treat this by supporting the Spleen and Stomach with acupuncture and gentle moxibustion, or by the consumption of slightly warm aromatic herbs when appropriate. An example of a seasonal formula along these lines is the Cardamom Powder in the Summer Solstice blog post that we posted last year.

Enjoy the day, hang some garlic, and eat some zongzi if you can. Happy Duan Wu, Dragon Boat Festival!

Bearded Grain 芒種 Seasonal Node

June is here, the weather is warm, and this week is humid and wet in New Jersey! It feels like just yesterday I was writing about winter, and then the Lunar New Year. Time flies by quickly, and no matter what we do seasons change.

The change of seasons is a good reminder that all things change over time. Most of you in the East Asian Medicine world know that the Oregon College of Oriental Medicine, one of my alma maters, is closing down this summer after over 40 years of providing in my opinion some of the highest quality education in our field. One positive aspect of me writing about seasonal fluctuations is the reminder that change is the constant of everything. For example, while many of us mourn the loss of summer as we move into autumn, it is important to keep in mind that change is natural, and that patterns eventually are cyclical. As I taught my final class for OCOM last weekend, I was hit by an overwhelming sense of sadness. But, none of us are here forever, and none of our institutions are eternal. One summer turns into autumn, and then the cycle goes on forever with every subsequent summer being slightly different. East Asian Medicine is larger than any one of us, or any one school. So, while this chapter is ending, East Asian Medicine will continue on as it has for several thousand years. We just have to see what the new season brings us.

But I digress… Back to the seasons.

Yesterday, June 5th, was the beginning of Bearded Grain, the ninth seasonal node of the year (and today, June 6th, is the new moon and start of the fifth lunar month). Bearded Grain is also the last node just before Summer Solstice, the most expansive and Yang time of the year. The name, ‘Bearded Grain,’ is a reference to crops. The word Mang (芒) refers to the maturing crops, especially the winter wheat, which is harvested about this time of year, and the word Zhong (種) is a reference to the new rice crops that are planted at this time. This gives us the image of one thing coming to maturity (as in the growing Yang of the season) so that it can eventually perish (i.e., be harvested), allowing a new crop to be started. The image of transfer and renewal is characteristic of the transition period of the solstice that fast approaches.

The three smaller 5-day material manifestations of this node are Tanglang sheng 螳螂生 (Praying Mantises Are Born), Ju shi ming 鵙始鳴 (Shrikes Begin to Sing), Fanshe wusheng 反舌無聲 (Mocking Birds Cease to Vocalize). The first two are dramatically illustrative of the current node. Praying mantises are notorious for females killing males just after mating. And shrikes are about the creepiest birds I know! These birds are known for catching their prey, usually large insects or small mammals such as rodents, and then impaling them on some natural spike-like plant for them to come back later and consume after the creature has died. Both images are images of the death bringers. Eventually Summer Solstice is the time of Yin’s rebirth – days will get shorter again. It is the reminder that all life cycles back towards quiescence, towards winter, towards death, towards Yin. 

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

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

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

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

Diet for Bearded Grain

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

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

Recipe for Bearded Grain – Licorice and Mung Bean Congee

(Gan Cao Lü Dou Zhou 甘草綠豆粥)

Ingredients:

• Rice 150g

• Mung Beans (lü dou 綠豆) – 50g

• Chinese licorice root (gan cao 甘草) – 50g

• Rock sugar to taste

Directions: 

1. Rinse the rice and mung beans, wrap gan cao in teabag to make removing easier (optional)

2. Place gan cao in about 1750 ml (about 7 cups) of water, bring to a boil and simmer until water is a yellow color

3. Add in mung beans, bring to boil again and then simmer on low for about 40 minutes until beans soften

4. Add in rice and continue cooking for about 30 minutes until the rice starts to beak apart and mixture is the consistency of congee

5. Remove from heat, add in rock sugar to taste (optional)

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

My best wishes for everyone’s health. Stay cool and dry!

The Five Taxations 五勞 - Part V

And… The the last of the Five Taxations repost!

The word taxation (勞) as a medical term refers to some sort of physical exertion, or fatigue resulting therefrom. It also can describe some sort of significant wear and tear on the body. Previously I had blogged about a list of Five Taxations from the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23).  This is the last installation on the Five Taxations and it is long overdue. For those who are new subscribers or who missed the last posts, the first was taxation that involved the Heart, the second the Lung, the third the Spleen, and the fourth the Kidney. As is typical with the Neijing the five track along the Five Phases and thus the Five Viscera.

The last of the Five Taxations goes with the Sinews and the Liver. The source chapter says, “to walk for a long time damages the sinews” (久行傷筋). Wang Bing points out here that this then relates to the Liver. Like the previous taxation, there is little other explanation with my Translation and Explanation of the Neijing Suwen adding: 过度的行走，可以伤筋 (“excessive walking can injure the sinews”).

Now, I think most of us would consider walking a great form of exercise that just about anyone can do, and this is true. It has lower impact on joints than running, and it is easy and convenient. Medically though, we do know that overdoing anything is a problem. Remember, that the word in Chinese for ‘Chinese Medicine’ is Zhong Yi 中醫. The first part of that word, Zhong (中), stands for China (Zhong Guo 中國). However, Zhong literally means center, or middle. Thus, Chinese medicine is literally medicine of staying in the center. One of the core fundamental teachings of Chinese medicine, as illustrated by all five of the taxations, is that balance, in other words staying in the center, is health. Lack of balance is disease. This is why the Ping Ren Qi Xiang Lun (Su Wen Chapter 18) says that “a balanced person has no disease” (平人者不病也). Even with walking, overdoing it can be problematic. Endurance walking in particular is known to possibly cause dehydration, blisters on the feet, and, just as this taxation suggests, muscular pulls, strains, or other injuries.

At this moment I’ll remind everyone that the word Sinew in Chinese medicine is not the same as tendon in western medicine. The Chinese word sinew (筋) can refer to tendons and ligaments, but is also refers to the contractile strength of skeletal muscle. This is why in the middle of that character we see the character for physical strength (力).

In addition to the literal reading, we can try to understand this taxation in a deeper way. Sinews and Liver go with the Wood phase, the architype of Spring. Spring is the beginning of movement, the movement of rebirth, and thus ultimately a Yang season. While the taxation of sitting too long (i.e., lack of movement) damages the Spleen, we can also see that lack of movement damages the Liver and sinews as the symbolic representation of the muscles and connective tissue. Too much movement is also problematic. In that case, too much Yang-movement damages the physical manifestation (Yin) of the Wood-Liver (Yang).

Looking at this taxation in the other direction is also possible. As the Yang declines with the aging process, people are less inclined to move. In the 54th chapter of the Ling Shu the ageing process actually starts with a decline in Liver. And in the very first chapter of the Su Wen tells us that, “as the Qi in the Liver weakens, the sinews no longer can move” (肝氣衰，筋不能動).

So, how do we work with this taxation clinically? The first thing is to counsel patients to be active, but not to be so active as to constantly injure themselves. If your clinic is like mine, this is a constant issue really. How many times do we have a patient come in with shoulder, neck or back pain (or any other type of musculo-skeletal injury) that is a direct result of some overdone exercise? After we treat them and they feel better, often the first thing they do is go right back to the offending exercise and reinjure themselves. Like Chinese medicine at its fundamental level, we need to tell patients to seek balance in movement and rest, activity and stillness. Some patients need to exercise more, but some actually need to exercise less. A lot need to vary exercise so as not to constantly stress the same body areas.

For weakness of the sinews in general manifesting as weakness in moving the limbs, pain in the joints, and intolerance to exercise, I recommend Tung’s points the Lower Three Emperors (下三皇). This is an important Dao Ma combination on the lower leg that has a strong regulatory effect on the Kidney. Why do we use the Kidney here? Because strengthening the Kidney-Water benefits the Liver-Wood, conforming with the Nanjing strategy of “in vacuity supplement the mother” (虛者補其母). We can combined the Emperors with Yang Ling Quan (GB-34), the meeting point (會穴) of the sinews.  Specific locations of weakness can be addressed individually with other points in addition to this general method of strengthening the Liver (via the Kidney) and benefitting the sinews.

I hope everyone has enjoyed this short series of essays, and that they show what sort of great knowledge is embedded in our classical texts!

The Five Taxations 五勞 - Part IV

Here’s repost part four!

When I originally started the Five Taxations series at this point a long time ago, I never got to finishing all five, only getting to the third installment. So, now it’s time for part four! For those who are new subscribers or who missed the last posts, the Five Taxations (五勞) are a list of five damages caused by overuse or overexertion that are found in the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23). The first was taxation that involved the Heart, and the second the Lung, and the thirst the Spleen. As is typical with the Neijing the five track along the Five Phases and thus the Five Viscera. 

The fourth of the taxations reads, “standing for a long time damages the bones” (久立傷骨), and according to Wang Bing this is taxation that affects the Kidneys. We have little other commentary in modern versions of the Neijing aside from this. For example, my copy of a Translation and Explanation of the Neijing Suwen by the Shanghai Scientific and Technical Publishers simply adds this comment: 过度的站立，可以伤骨 (“being on one’s feet too much can injure the bones”). Not really much of an explanation – just a translation into modern Chinese with not much else to offer readers. This leaves us to ponder this short but interesting line.

Medically we know that standing, especially for longer periods of time, puts increased pressure on the spine and lower extremities (in particular the knees). If people are overweight, this is even more of a potential problem. Prolonged standing thus can cause muscular tension and strain, wear on joints from joint compression, low back pain, foot pain and inflammation, and a host of other issues (click here or here to read more).

But, in terms of Chinese medicine, we need to think more deeply about the symbolic meaning that may be present in the original line from the Su Wen. When I read this line, I first am reminded of the phrase “spring engenders, summer flourishes, autumn harvest and winter stores” (春生，夏長，秋收，冬藏). This association of the four seasons with a specific movement is recorded in several locations in the Neijing, and the idea likely comes out of even earlier literature. For example, in the Yin Shu (引書; Book of Pulling), one of the earliest texts we have from the Dao Yin 導引 traditions, it says, “in spring generate, in summer flourish, in autumn harvest and in winter store – this is the Way of Peng Zu” (春產，夏長，秋收，冬藏，此彭祖之道也). Perhaps sometime soon I can write a blog post about Peng Zu and the deeper meaning in this line! But the important point for now is that these lines are almost identical. This association of the seasons, and thus the five phases, were shared by numerous authors in the formative period of our medicine.

For winter then, we have to ask ourselves what is the meaning of “store.” Storage means a time of quietude, and a time of moving inwards. In the symbolism of the Twelve Branches, the utmost of storage is Zi 子. This branch represents the time of midnight, and in the course of the year represents the 12th solar month and the time of the Winter Solstice, in Chinese literally the zenith of Winter (冬至). The definition of “store” from the Shuo Wen Jie Zi is “to hide or to conceal” (藏：匿也). Hiding or concealing something is the image of hibernation, or the image of a person going into the most private part of their house – their bedroom. The movement of Winter and storage in my opinion is sleep, as this is the closest humans get to hibernation. For example, in Tung’s acupuncture we place heavy emphasis on having patients move while getting acupuncture. However, when I have patients that have Kidney vacuity patterns I often find letting them sleep while getting acupunctured is best. Why? Because sleeping is the actual movement of Winter, and therefore the Kidney. If we want to help those patients rebuild Kidney, we need to let them sleep and help them rebuild normal sleeping patterns.

Even though prolonged standing is a type of stillness, it is not the same stillness that sleeping or hibernating are. Prolonged standing without any movement can create significant stiffness. This idea reminds me of another important quote, this time from the eighth chapter of the Su Wen. “The Kidneys are the official functioning as operator with force” (腎者，作強之官). This word force (qiáng 強) deserves special attention. On one hand it represents the healthy state of the Kidney and the bones. The bony structure is that which gives the body the scaffolding that holds it up. The spine, as a symbol and extension of the Kidney and bone, needs to be strong and upright, which is why the first point on the Du Mai is called “long and strong” (長強穴). On the other hand, however, this same word represents the diseased state of the Kidney and the bones. An alternate pronunciation of the character 強 is jiàng, and when read this way means stiff or unyielding. This is exactly the diseased state of the Kidney! Cold is the evil associated with Water and thus Kidney, and cold is nothing more than the symbol for a pathological state of being still, stuck and unmoving.

Now we can see that prolonged standing, a stiff sort of stillness, can damage the bones and the Kidney. Taken together with the previous taxation related to the flesh and the Spleen it is a powerful reminder that we must balance rest and activity, but maintain flexibility at the same time. For example, in my lineage of Taijiquan standing post (站樁) is an important practice. In standing post exercises we adopt a specific standing posture and hold it as a type of standing meditation for a period of time. In my own practice I’ll typically stand in that one position for 20-30 minutes without moving. But, standing by itself is never enough. That practice must be balanced by some sort of moving practice. Just as Yin and Yang are intimately linked, so too must be movement and stillness. 

For this blog post I’m not going to offer any specific acupuncture points or protocols. My best suggestion is that we encourage patients to engage in a movement practice that simultaneously encourages flexibility and relaxation, such as Qigong, Taijiquan, Baguazhang, or anything else similar. And then I’ll offer everyone my secret formula for strengthening the Kidneys – go to sleep!

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The Five Taxations 五勞 - Part III

Here's the repost of part three of the Five Taxations that I published awhile ago…

To remind everyone, the Five Taxations (五勞) are a list of 5 damages caused by overuse or overexertion, and they are found in the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23). The first was taxation that involved the Heart, and the second the Lung. Today we move on to the next one.

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

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

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

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

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

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

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

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

The Five Taxations 五勞 - Part II

This is the second repost of a series I did awhile ago… Enjoy!

Awhile ago I started writing about the Five Taxations (五勞), a list of 5 damages caused by overuse or overexertion found in the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23). The first was taxation of the Blood, so today I’ll continue with a short discussion of the second taxation.

After the discussion of blood, the Su Wen tells us that “lying down for a long time damages the Qi” (久臥傷氣). This is taxation that, according to Wang Bing, is associated with the Lung.

The Jing Mai Bie Lun (SW21) says, “The Lung invites the hundred vessels to have audience with it” (肺朝百脈). The Lung is the canopy that covers all the other viscera and bowels, and it is the Lung that orders the Qi movement in the body, which is why the Ling Lan Mi Dian Lun (SW8) says that order and moderation originate with the Lung (治節出焉). Remember, the Latter Heaven production of Qi starts with Spleen and Lung, but it is the Lung that orders the Qi, separating it into Ying and Wei, and then distributes it through all the channels and vessels.

When the Neijing says lying down for long periods of time, it means we are physically inactive. Physical movement moves the Qi, one of the main reasons why in Tung’s acupuncture we frequently combine physical movement with needle stimulation at the same time. When we don’t move enough, over time that alone will create stagnation in the Qi, and eventually this stagnation of Qi will go back to damage the Lung. Thus the Zhi Zhen Yao Da Lun (SW74) says, “All Qi oppression and stagnation, without exception they are associated with the Lung” (諸氣膹鬱，皆屬於肺). Damaged Lung and stagnation of Qi leads to vacuity taxation of the Qi.

One of the reasons exercises like Qigong are so effective is that they combine physical movement with regulated breathing, and therefore my first recommendation for damage to the Qi is Qigong, Taiji or other exercises that combine breathing with movement. In our weekly Qigong classes one of the first exercises we practice are forms that grasp and draw in the Qi of nature (採氣功). In my own body I know that if I am fatigued and my pulse is deep and weak, after Qigong practice not only do I feel refreshed, but my pulse will become stronger and more even throughout all the pulse positions.

In terms of Tung’s acupuncture, one of the best points for the second of the Five Taxations is Huo Fu Hai 33.07. This point is located near Shou San Li LI-10, and it functions to expel wind and depurate the Lungs. In addition it supplements the Qi (and Blood) mainly through the Lung and Kidney Zang – everyone’s homework is to think about why that is the case! In Tung’s original book this point was the only one for which he mentioned moxibustion, and he said that moxa here enhances longevity. In my own clinic I typically apply direct rice-grain sized moxa to this point, and have patients use a tiger warmer to apply moxa at home. Aside from Huo Fu Hai, consider other points like Zheng Hui 1010.01, and the Zu Si Ma Dao Ma group (88.17, 18, 19), the main Dao Ma combination for the Lung Zang.

Next time we move on to sitting for too long.

Beginning of Summer 立夏 Seasonal Node

Tree Peony 牡丹花 in New Jersey (stone lion in background)

The last week or so have seen some really nice weather here in New Jersey. Even better, we’re starting to get some awesome tree peony blooms! Everything in nature seems to be practically exploding and growing at lighting speed, and this is appropriate since today, Sunday May 5th, is the beginning of Summer in the traditional Chinese calendar, and thus the start of the Beginning of Summer (立夏 lì xià) seasonal node. By now the days are getting significantly longer, and at this point in time, even though it’s a horrible thought, in only about 6 weeks the days will start getting shorter again. Right now the Yang of the natural world is close to its fullest, and correspondingly the hexagram that represents this time of year is Qian Gua (乾卦) – six solid-Yang lines.

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

One thing to keep in mind is that the weather in early May can still on occasion be chilly and wet. Summer is the time of rising Yang in the natural world, but it is still early enough in the season that it can slowed by the back and forth of temperatures and lingering dampness. The second chapter of the Su Wen says that when we don’t follow the guidelines of Spring then there is change to cold in the season that follows. Zhang Zhicong interprets this as the development of cold diseases (i.e., cold patterns). This is also the case though when the weather doesn’t behave – not just we humans not behaving. The continued cold and damp (both Yin evils) effectively restrict the Yang movement in our bodies. Thus, clinically this time of year we can see more joint pain, general aching, fatigue, digestive weakness, and diarrhea. For these patients consider doing moxa on points such as Zu San Li ST-36, or needling points such as Zhong Jiu Li 88.25 for general joint pain. Encourage patients to dress adequately for the weather on days where cold lingers.

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

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

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

Diet for Beginning of Summer 

With the new seasonal node come new dietary suggestions. One of the first is to avoid intemperance in food and drink. Overeating, especially of very heavy, sweet or greasy foods, places a burden on the Spleen. Overeating these foods, and overconsumption in general, also create internal heat that can worsen Heart Fire. If patients experience digestive upset, as a temporary measure we can needle points such as Ling Gu 22.05, Si Hua Shang 77.08 and Men Jin 66.05. If there is Heart Fire bleed the ear apex.

In terms of flavors, this time of year we should focus on eating slightly more sour, a little more bitter, and light or gently cooling foods. Eating sour foods helps build fluids and blood so as to nourish the Heart, and bitter can drain fire. As heat in the environment increases it is understandably important to eat more light / fresh vegetables and other foods that will gently cool the body. Specific foods to consider this Seasonal Node include bananas, peaches, plums, umeboshi (Japanese salted plums), asparagus, cucumber and corn. Since this time of year is associated with Fire and Heart, red foods are also good to incorporate – think of strawberries, tomatoes and hawthorn berries.  

It is appropriate to increase slightly intake of water or herbal teas. Patients who tend towards excess heat can drink chrysanthemum tea. Even though the beginning of Summer means more heat, some patients still may be cold and vacuous internally. Since Summer in many places also has increased environmental dampness, these people can drink a very light ginger tea or fennel seed tea, sweetened if desired local honey. Allergy sufferers (right now in New Jersey we are in the middle of a allergy season) can take mint tea with local honey, as local honey is used as a traditional allergy remedy.

Two traditional Beginning of Summer recipes are Celery Congee (芹菜粥) and Suan Zao Ren Congee (酸棗仁粥). For Celery Congee take several stalks of celery, remove the leaves, clean and cut into small pieces. Take an appropriate amount of white rice and cook in water to make a porridge (i.e., congee), and then add celery for the last 10-15 minutes of cooking. Add salt and pepper to taste. This recipe clears heat and extinguishes fire, reduces blood pressure, and eliminates vexation. However, it should be avoided by those with Spleen-Stomach vacuity cold patterns. Celery Congee can be taken daily in the morning as a warm breakfast. This recipe originally comes from the Ben Cao Gang Mu.

For the second recipe, Suan Zao Ren Congee, use about 50g of Suan Zao Ren 酸棗仁 to about 100g of white rice. Add an appropriate amount of water and boil until you have congee. At the end, add a small amount of sugar or honey to taste. This recipe can be taken as an evening snack as it can treat Heart vacuity and vexation to help sleep.

And one last recipe for Beginning of Summer…

Pickled Cold Lotus Root

Ingredients:

• 1 lb. lotus root

• 3 cups rice vinegar (or white vinegar)

• ½ cup sugar

• ½ tsp salt

• 1 small red chili pepper 

Directions:

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

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

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

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

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

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

Some final reminders… You can follow us on Instagram for more seasonal and plant photos, and we continue to offer free online Taiji Silk Reeling and Qigong classes to professional Chinese medicine practitioners every Monday and Friday afternoon. If you want to join in, please email me.

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

The Five Taxations 五勞 - Part I

This is a repost from a few years ago. Please enjoy again!

It’s a beautiful autumn days here in northern New Jersey and I thought I’d spend some time writing about a topic from the Nei Jing. In the last week or so I’ve been reading for myself the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23). One of the concepts at the end of the chapter is “Five Taxations” (五勞), a list of 5 damages caused by overuse or overexertion. Like the rest of the chapter, the Five Taxations closely track Five Phase theory, although a deeper look at these five simple lines makes us ponder interesting theory and complex interrelationships in the body. 

The first of the Five Taxations reads, “To observe over a long time harms the blood” (久視傷血). Here the character for observe (shì 視) means to look at, or to watch. It also means vision. In classical Daoist literature it is part of the compound term Nèi Shì (內視) – “Inward Vision,” the practice of internal visualization of body gods or viscera as a meditative practice. What do we use to observe something, or to look at something? The sense organ that looks is the eyes. In Five Phase theory the eyes are the orifice of the Liver and Wood Phase.

Yet, Wang Bing in his commentary says that the first taxation of observing for a long time is the taxation that damages the Heart viscera… 

In the Nei Jing the Heart viscera is associated with the tongue, or sometimes the ears (for example in the Jin Gui Zhen Yan Lun, SW4). The Liver is associated with the eyes, and the Liver also stores blood. Yet, the Yin Yang Ying Xiang Da Lun (SW5) tells us that the Heart generates the blood (心生血). It would seem that Liver and Heart both have a close relationship with blood. So what is the relationship between Liver and Heart?

In terms of Five Phase theory, Wood-Liver is the mother of Fire-Heart. When one of the phases is vacuous the treatment strategy is to supplement the mother (from Nanjing 69: 虛者補其母). Use of the eyes is overtaxing to the Liver and can damage the Liver’s ability to store blood. When the Liver is vacuous it fails to generate Fire-Heart, and leads to vacuity of the Heart. This is even more so when people do the common overuse of looking at screens in the evening before bed, which we clearly know upsets sleep. When sleep is disturbed and we fail to go adequately into the storage phase of the daily cycle, the Yin-blood (rooted both in the Liver and the Heart) cannot be secured or generated. Eventually then both Liver and Heart are harmed.

In Tung’s acupuncture the main Dao Ma group for Liver vacuity and for chronic eye problems is the [Upper] Three Yellows (Shang San Huang, 上三黃). This point group also has an ability to consolidate and nourish the blood. It shouldn’t be a surprise then that in Tung’s original writing he said that the points in this group are associated with the Liver, Kidney and Heart channels. In many ways they mimic the channel connections of San Yin Jiao SP-6, the meeting of the leg Taiyin, Jueyin and Shaoyin. Kidney-Water is the mother of Liver-Wood, and the viscera that stores the Jing-essence, a substance essential to the material production of blood. Liver stores blood, and Heart generates blood. Acupuncture treatment for vacuity detriment of the blood then can include points like the Three Yellows, or the application of moxa at points such as San Yin Jiao SP-6.

But perhaps there is another deeper meaning of, “To observe over a long time harms the blood.” Other definitions for observe (shì 視) are to ‘treat as,’ and ‘take to be.’ Also, to ‘look for but not see.’ When we ‘look but cannot see’ or cannot find, this in many ways describes yearning or desire. Or when we ‘treat as’ or ‘take to be,’ this can be a description of attachment. Both Daoism and Buddhism warn about this subtle form of suffering. The Shang Gu Tian Zhen Lun (SW1) says that, “quiet peacefulness, absolute emptiness, the true Qi follows these states” (恬惔虛无，真氣從之). Zhang Zhicong explains that ‘emptiness’ in this passage means not being confused by items and desires. The same chapter tells us that constant desires damage the Heart. Thus, observing for a long time, or in other words, looking for and desiring for a long time, clearly damages the blood (the material basis of the Shen-Spirit) and by extension the Heart. 

What about treating this? Certainly some acupuncture can calm and nourish the Heart. In Tung’s acupuncture we have points such as Zhen Jing 1010.03 (鎮靜穴) or Huo Ying 66.03 (火硬穴), or Dao Ma groups such as the Leg Three Penetrations (Zu San Tong, 足三通). However, the first chapter of the Su Wen tells us the main treatment for this type of Heart detriment when is says, “When essence and spirit are guarded internally, where could a disease come from?” (精神內守，病安從來) Essence is Kidney and Yin, Spirit is Heart and Yang. This line is a reference to contemplative or meditative practices such as Neigong, Zuo Chan, or Japanese practices such as Naikan, practices that all function to revert attention of Heart-mind to the interior rather than to the exterior world around us. While acupuncture and Chinese herbal medicines can be good adjuncts for damage to Heart, the best treatments are those taken from the schools of meditation, or in modern times practices that would for example fall under the heading of Qigong. This is why in Chinese it is said, “Disease of the heart has never been treated with medicine” (心病從來無藥醫), or “Diseases of the heart must be treated in the heart [i.e., not with acupuncture, herbs or drugs]” (心病還用心藥醫).

Grain Rain 穀雨 Seasonal Node

This year the weather in northern New Jersey has been slightly cooler than usual, but honestly to me this is refreshing knowing that the real heat and humidity of summer are just around the corner. We are coming upon the transition times between Spring and Summer, but I’m happy to have Spring a bit longer.

Hoopoe

This blog post is actually coming out late by almost a week, as last Friday, April 19th, we started the Grain Rain (Gu Yu 穀雨) seasonal node. The name of this seasonal node refers to precipitation that feeds the grains and other plants readying them for harvest, allowing them to grow to their fullest. While this week hasn’t had much rain here, the last few weeks where I am have seem some decent rainfall. The three smaller segments of the node are Ping shi sheng 萍始生 (Duckweed Begins to Grow), Mingjiu fu qi yu 鳴鳩拂其羽 (Cockoos Flutter Their Wings), and Daisheng jiang yu sang 戴勝降于 (Hoopoes Land on Mulberry Trees) – all images of early plant growth or increased bird activity.

Grain Rain is actually the last seasonal node of Spring since early May marks the beginning of Summer in the Chinese calendar. In only about 2 months the days start getting shorter again – so get out and enjoy the sunshine! Grain Rain is also the 6th step of the 24 seasonal nodes thus corresponding roughly to the Chen (辰) watch of the day (7-9am). It is the time of transition from Spring to Summer correlating to the Soil (i.e., Earth) phase; the Soil phase represents the transition between seasons. Thus, Gu Yu is the time of year associated with the Stomach channel. The general movement of Spring is the movement of Liver-Wood, but the Soil phase is also in charge of movement and transformation. Because of this, during Grain Rain we need to ensure that Qi and Blood are moving smoothly. Watch for signs of Qi stagnation in yourself and in your patients. This is why a good basic recommendation for this time of year is performing regular self-massage to ensure smooth circulation of Qi and Blood in the body.

One of the easiest points to massage for the average person is the collection of points known as the Shi Xuan 十宣穴. These points are located one at the tip of every finger and every toe. The word “Shi” means 10 – there is a point on each finger and toe adding up to 10 total. The word “Xuan” means to spread or diffuse. Since all the channels of the body connect to the fingers and toes, these points together spread or move all the Qi in all the channels of the body, and can be massaged as a general way to prevent and treat stagnation in the channels. To massage simply squeeze and rub the tip of each finger and toe in succession. Repeat throughout the day, but preferably at least once each morning and once each evening.

As the weather does get a bit sunnier and warmer it is good to increase outside activity – consider walking or gardening. However, since Spring is a time of temperature ups and downs, be careful to dress appropriately as dictated by each day. This is also allergy season, for which I suggest using Tung’s Mu (木穴; 11.17) point. Located on the palmar surface of the proximal digit of the first finger, this point is also call the common cold point of the hand (手感冒穴). Also because of the ups and downs we’re still seeing quite a bit of upper respiratory infections around here (including COVID since it isn’t completely gone). Be sure to wash hands, and mask when feeling sick or around patients presenting with upper respiratory tract infection symptoms.

Getting back to the idea of stagnation, it is vital that during Grain Rain we prevent stagnation in the Stomach (since this is the time of Stomach channel). With acupuncture treatment this means making frequent use of Men Jin (門金穴; 66.05), the Tung point overlapping the Shu-stream point of the Stomach channel. It is also important to avoid overeating or overdrinking, and the overconsumption of oily and greasy foods.

During Grain Rain start eating lighter and easier to digest items and in-season vegetables such as asparagus. There are also a host of other early blooming plants that are just fantastic seasonal food. In Japan, this is the time for bamboo shoots. Known as Takenoko (竹の子) in Japanese, they are sweet and slightly bitter. Their temperature is cold and they enter the Lung, Stomach and Large Intestine. Thus, they can nourish fluids to treat dryness of the Lungs or intestines.

There are also plenty of lesser known seasonal foods local to the western world. In the Northeastern United States we are at the tail end of fiddlehead season. Fiddleheads are curled fern fronds that have a wonderful fresh flavor similar to asparagus. In Japan and China, bracken (Japanese: こごみ; Chinese: 蕨菜), another type of fern, are also eaten as local fiddleheads there. We cooked some last night in pesto with scallops and they were fantastic! Another seasonal food I’ve recently discovered is magnolia blossoms - the beautiful petals can be quick pickled (we are going to do this tonight). I’ll report back on their flavor later but I’ve heard they are gingery, meaning slightly acrid. Last are ramps, a tasty cousin of the leek, onion and garlic plants. Ramps are native to the Appalachian Mountains, north into Canada, west into Missouri and Minnesota and south to North Carolina and Tennessee. As an Allium, ramps are slightly warming, acrid and sweet – meaning they’re perfect for moving Qi in the Stomach and Liver.

Other foods to emphasize are those that boost Qi and Blood, and gently strengthen the Spleen and Stomach; the Yang of the Spleen/Stomach is still fragile now, especially since Liver-Wood can over-control Earth. These foods include rice or rice congee, Bian Dou, yams, nagaimo (i.e., Shan Yao), peanuts, and cherries (a slightly warming fruit). If you didn’t know, this is also egg season. Yes… Eggs have a season! Most chickens naturally lay eggs only when day length is about 10 hours or more (commercially grown eggs are available because farmers trick chickens with strong artificial lighting year round). One of my favorite early spring recipes is steamed asparagus with scrambled eggs – delicious and light, and good for you too!

I hope everyone is staying healthy and having a great Spring.

A Natural Approach to Mental Wellness

Our friends at the ToDo Institute are gearing up to start their next online course – A Natural Approach to Mental Wellness. For 30 days during this experiential program, participants will explore some of the basic concepts and practices from Japanese Psychology, including coexisting with our internal experience, working with our attention, living with purpose, developing acceptance and practicing self-reflection.  Every day they will receive a practice exercise to work with that is informed by the principles of Japanese Psychology and that will help explore and understand the nature of this work. Taught by my teacher, Gregg Krech, this is an excellent chance to engage with non-Western approaches to mental wellness. My students and friends can participate at a 20% discount with the code “mccann.” Class starts this week on April 19th!

Click on the photo below to go to course description and registration.

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The Tengu's Secret Technique (Repost)

This blog post originally went online March 5, 2021. It’s a topic I’ve been thinking of lately, so I thought I’d repost it. Enjoy!

It is a common trope in stories we hear about medicine – the secret technique or formula. I also used to hear this (and see it in movies) in relationship to martial arts, my initial entry point into Chinese medicine. We’ve also all heard the idea that even widely known medical texts like the Huang Di Nei Jing are of less value without some special oral teachings that make our medical interventions really work.

This idea of secret techniques or methods has fascinated many of us, including me, for a long time. Over the last two decades a lot of other doctors or martial arts teachers have shared with me their secret methods. I can honestly say while some ideas were perhaps interesting, mostly they just left me… Unimpressed…

Enter the Tengu 

One of the books I’ve been reading lately is a Japanese text on martial arts, the Tengu Geijutsu Ron (天狗芸術論), the ‘Tengu’s Treatise on the Martial Arts’. Written by Niwa Jurozaemon Tadaki (1659-1741) under the pseudonym Issai Chozanshi, it is a discussion of the philosophy behind training in martial arts in late Imperial Japan. The device Issai uses is the story of a warrior overhearing a group of Tengu discussing martial arts. Tengu (天狗, tian gou in Chinese) are mythical creatures that are said to inhabit the mountains and other out of the way natural places in Japan. Having both avian and human qualities, these creatures are often expert swordsman and practitioners of esoteric religions such as Shugendo.

Issai himself was a talented swordsman, and clearly from his writing an expert in Ruist (i.e., Confucian), Buddhist and Daoist teachings. For example, in his text he frequently quotes the Analects of Master Kong (Confucius). What struck me though while reading through the text was just how much of what Issai said was equally applicable to the practice of Chinese medicine. Interestingly to me, in the third chapter of the Treatise the Tengu discuss the idea of secret technique. In the quote that follows feel free to substitute the word ‘swordsmanship’ for the word ‘medicine’. The ideas are applicable to both.

At one point in this chapter one of the Tengu asks, “Swordsmanship is the mysterious function [principle] of the heart-mind. Why then are there secret techniques? 剣術は心体の理なり。何ぞ秘する事あるや。” To this, the head Tengu replied, “The principles of swordsmanship are the principles of Heaven and Earth. How could there be no one else in the world who knows what I know? Secret techniques are for the sake of beginners! 理は天地の理なり。我が知る所天下何ぞ知る者なからん。秘する者は初学のためなり。”

Very forceful, very straightforward, and very true…

And this should sound familiar to students of Chinese medicine (at least those students who dare to read anything other than basic standard textbooks). In my opinion one of the most important quotes in the Su Wen is from the Zhi Zhen Yao Da Lun (SW74; 至真要大論) where it says: 

天地之大紀，人神之通應也。

Heaven and Earth are the Great Principle.

Human’s Shen-Spirit penetrate and resonate with it.

Just like swordsmanship, the principles of Chinese medicine are simply the expression of the grand principles of Heaven and Earth, just in medicine they are applied in diagnosis and treatment.  

The Tengu goes on the explain that secret techniques are just an expedient method of teaching beginners. It allows them to perhaps value or trust something given by their teacher. Or the teacher may be waiting to explain something (i.e., the secret) until they believe the student can understand it. In the worst-case scenario, a secret technique is a cynical way a teacher hides his or her own lack of understanding, or a way to string a student along with the promise of something deeper later. Either way, the Tengu explains that the secret technique in no way is some deep principle, because the deepest principle itself is the movement of Heaven and Earth.  

Sometimes a teacher (in my experience the best ones) wants the student themselves to work out a problem. Working out the problem by themselves – in other words thinking deeply without being spoon fed the answer – allows the student to see the deeper principles. Master Kong in the Analects mentions this when he says:

不憤不啟，不悱不發，舉一隅不以三隅反，則不復也。

I do not open up the truth to one who is not eager to get knowledge, nor help out any one who is not anxious to explain himself. When I have presented one corner of a subject to any one, and he cannot from it learn the other three, I do not repeat my lesson.

Issai even quotes this passage in his Treatise. The closer the student gets to understanding core principle, the less the need for details, including so-called ‘secret’ teachings. The closer the student gets to understanding core principle, the more they realize there really is no secret technique.

Qi Bo practically bends over backwards trying to impress this idea on physicians (and yet somehow many still can’t hear it). In the first chapter of the Su Wen he says:

上古之人，其知道者，法於陰陽，和於術數。

The people of very ancient times knew the Dao.

They modeled themselves on Yin and Yang, and complied with the Arts and Calculations.

The Dao itself is Heaven and Earth. It is the great principle. Yet in its completeness and complexity it is hard to penetrate directly. So, the sages created symbols that allow us to make sense of it, such as the symbols of Yin and Yang, and the Arts and Calculations, which include ideas such as Five Phases and Ten Stems. In essence, there is no secret technique above Yin and Yang. Why? Because Yin and Yang is the foundational movement of the cosmos. Yin and Yang is the Dao. The Shuo Yuan says that “One Yin and One Yang are the Dao” (一陰一陽之謂道).

The basics are the highest level of teaching. To believe there is a secret to making the basics work simply shows a lack of understanding of the basics. Don’t believe me yet? Here’s Qi Bo again, this time in the fifth chapter of the Su Wen:

陰陽者，天地之道也，萬物之綱紀

變化之父母，生殺之本始，神明之府也。

Yin and Yang are the Dao of Heaven and Earth, the essential principle of the ten thousand things, the father and mother of change and transformation, the basis and start of birth and death, and the palace of the Spirit Brilliance.

And now here’s Zheng Qinan, the founder of the Fire Sage current:

醫學一途，不難於用藥，而難於識證。

亦不難於識證，而難於識陰陽。

On the Path of Medicine the use of herbs is not difficult. What is difficult is knowing the syndrome pattern. Also, knowing the syndrome pattern really isn’t difficult. What is difficult is recognizing Yin and Yang.

If a practitioner believes that there is no underlying theory that explains the natural world and the universe, if the construct of channels and zang-fu are just fantasy, and if acupuncture is simply trial and error, then there can be secret techniques. However, if we believe that Yin and Yang or Five Phases are fundamental natural laws, and that the channels are something that describe, albeit perhaps in an imperfect way, human physiology, then the physicians who wrote books like the Neijing and the Nanjing have already spelled everything all out for us. There cannot be secret techniques that are fundamental to the application of medicine, because nothing is greater or more fundamental than what we already have in the basics. It’s just up to us to really understand it.

Vernal Equinox 春分 2024

It’s been quite some time since I’ve posted my seasonal blog. But, today is such an important day in the course of the year, I had to get back to it. In the western hemisphere, today Tuesday March 19th is the Vernal Equinox. Even though we won’t be able to see it, at exactly 11:06pm Eastern Daylight Time the sun will be at an exact vertical angle to the equator. Over the next few months the sun will continue angling more and more towards the Tropic of Cancer meaning the days for us in the Northern Hemisphere will continue lengthening until reaching an apex at the Summer Solstice. Because of the time difference between China and the United States, tomorrow Wednesday March 20th will be the beginning of the next Seasonal Node, also named Vernal Equinox.

At this point, in the Chinese calendar we are in the middle of Spring, but in the western calendar we celebrate Vernal Equinox as the beginning of Spring. In Persia this day was traditionally revered as the beginning of the year (called Nowruz), and Rosicrucian mystics count Vernal Equinox as the New Year as well. Even in ancient Rome, early calendars marked March as the beginning of the year which is why even today September is thusly named because originally it was the seventh month with septem meaning seven. October and November follow being the 8th and 9th months of the Roman year (octo is eight and novem is nine).

Why does the Chinese calendar regard Vernal Equinox as the midpoint of Spring? Because we are now at the balance point of Yin and Yang. If the height of Yang is the longest day (Summer Solstice), and the height of Yin is the longest night (Winter Solstice), then the midpoints and thus points of balance are the Equinoxes.

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

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

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

Diet for Vernal Equinox

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

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

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

Ingredients:

• Organic pig kidney ¾ to 1 lb

• Eucommia bark (Du Zhong 杜仲) 6-9g

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

• Cooking oil, salt, soy sauce

 Directions:

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

2. Cut kidneys into thin slices and then score one side of each slice; peel and slice the ginger, slice the garlic, and slice the scallion (go here for more information on preparing porn kidney for cooking)

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

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

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

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

Acupuncture for Equinox

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

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

I hope everyone will have a great Equinox, and Happy Rosicrucian year 3377!

Taking Action Program with ToDo Institute

Our friends at the ToDo Institute are running another excellent distance learning course, this time on theme of Taking Action. During this program you will be working on a real-life project that is important to you.  You might select a creative project, or a household project, or an educational project, or a tax project, or any other kind of project you are interested in taking on.

Then with the structure, guidance and inspiration of the program, you will take manageable steps toward the goal of completing your project.  You will receive a daily exercise to help you do this. 

And while working on your project, you’ll also be learning about the empowering nature of Morita Therapy (“the psychology of action”), through exercises, readings and meetings with Gregg Krech, one of the leading experts on Japanese Psychology in North America (Gregg is one of my teachers).

If interested you can use the code "McCann" to get 20% off the regular course fee. I did my professional training in Japanese Psychology at ToDo, and have taken all their courses more than once.

Class starts in February so don't wait! Here is the link for registration and more information.

Major Cold 大寒 Seasonal Node

Yesterday, January 20th was the start of the Major Cold (da han 大寒) Seasonal Node. This year here in New Jersey, the weather is behaving just like the name of the node suggests. Last night temperature was down in the teens and there is a powdery layer of snow on the ground. However, despite the cold, the promise of this time of year is the slowly returning Yang. The days are getting longer and even by now we are seeing some migratory birds on the move. All of this is a reminder that Major Cold is the last seasonal node of Winter as in just a few weeks both the lunar and solar beginning of Spring arrives.

The three material manifestations of Major Cold are Hens Begin to Breed (Ji Shi Ru 雞始乳), Birds of Prey Act Fierce and Swift (Zhi Niao Li Ji 鷙鳥厲疾), and Rivers and Lakes are Frozen Within (Shui Ze Fu Jian 水澤腹堅). Notice here imagery of the impending Spring. In Five Phase theory the domestic animal associated with Spring is the chicken, and during Major Cold hens are getting ready to become pregnant with baby chicks that will hatch in Spring. Thus, even though the weather outside is still very cold, Yang is definitely on its way back as the gradually lengthening of the days attests to.

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

In addition to cold, the other main environmental pattern seen during Major Cold is dryness. Even with some wet snow and sleet on the ground this morning, lately my patients have been complaining of dry skin on an almost daily basis (this is even more so this year because during the ongoing pandemic we are all washing our hands more than usual). However, much of the environmental water is now bound up in snow or ice, making the air dry. Knowing this, the second recommendation this time of year is to stay warm but also be sure to not be too dry. Staying warm is obviously important in this time of greatest cold. But since certain organs are harmed by excessive dryness, such as the Lungs, we need to be vigilant there. For example, for those with forced hot air heating systems, it may be prudent to run a humidifier periodically. Sipping warm liquids such as herbal teas throughout the day can also keep our internal environment appropriately moist.

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

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

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

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

Stone stele at the White Cloud Temple (Beijing) that has each of the spinal vertebrae representing a seasonal node. Photo by H. McCann

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

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

I hope everyone is staying warm, and I’ll be back blogging next when Spring arrives!

Cold Season Blue Garlic 臘八蒜 (repost)

This was one of the last blog posts I did in the “before times.” It’s coming up on this time of year again, so I thought it’d be a fun repost. This year the Laba festival happens next week on January 18th. Please enjoy this repost, and enjoy the recipe if you make it!

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

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

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

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

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

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

Finished Cold Season Garlic with some of its pickling vinegar.

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

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

Minor Cold 小寒 Seasonal Node

It looks like I haven’t blogged about the current seasonal node since 2020, just a short while before to COVID pandemic started. A lot of things have changed in the last three four years – and I can’t believe this Spring will have been four years already since lockdown began in most areas of the world. It has certainly been a case of days individually moving painfully slow, while the years simultaneously move by quickly.

But here we are again just after the turn of the new year, having moved past the darkest day – the Winter Solstice.  After this Solstice there are only two more Seasonal Nodes in the Chinese calendar before the Chinese Solar New Year and the beginning of Spring. These nodes are Minor Cold (小寒) and Major Cold (大寒). As is clear from the names, temperature is an important part of understanding the last two seasonal nodes of the traditional Chinese calendar. Right now here in New Jersey not only are we in a cold snap, but today also is seeing the first real snow of the Winter season.

This year Minor Cold (小寒) starts Saturday, January 6th. In 2024 this is just a few days after the Earth being in perihelion (this year on January 2nd), the exact day when the planet is closest to the Sun. Perihelion happens each year about 2 weeks after the Winter Solstice, however the warmth of the season is determined by angle of sunlight, not proximity to the Sun, which is why even though we are closest now to the sun, it is still cold.

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

Think of the movement of temperature as being driven by the fluctuations of yin and yang in the natural world. Even though the “switch” has been flipped from yin to yang, it takes time for the climate to catch up. Imagine driving a car at 75 miles per hour (I apologize to you all who use the metric system – I’m metric impaired). If you want to stop and go in reverse, first you have to hit the brakes. However, if you hit the brakes really hard, that car is going to continue skidding forward for quite a distance before you can start moving in the opposite direction. Thus, even though the brakes have been put on the Yin movement of the year, before we can really move towards the Yang we continue “skidding” colder and colder for awhile, before Spring truly warms up the Earth.

The health maintenance guideline for this season is similar to Winter Solstice. Specifically, during Minor Cold we should focus on (1) Nourishing the Kidney (Yang Shen 養腎), and (2) Safeguarding the Spleen and Stomach (Baohu Pi Wei 保護脾胃). Winter is the time for all the Qi to be stored away internally – my Neijing students will remember this discussion from Su Wen Chapter 2. Since Kidney is the root of storage, and the root of Earlier Heaven (先天) Qi, we nourish the Kidney to nourish the body’s ability to store Qi away (i.e., the movement of Winter – 藏). While Kidney is the Earlier Heaven root, the Spleen and Stomach are the Later Heaven (後天). So, protecting the Later Heaven helps to ensure that Earlier Heaven is not excessively tapped into. This is especially important for our patients with conditions of vacuity (especially either Kidney or Middle Jiao vacuity), or patients with cold conditions (for example patients with chronic arthritic conditions – Bi syndrome from Wind, Cold and Damp).

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

In addition to the acupressure mentioned above, consider using the Leg Nine Miles Dao Ma Group (足九里) from Tung’s system. This is one of the best groups to use for Bi syndromes when multiple areas of the body are affected, or when we’re not quite sure where to start with a patient. The three points in this group are Middle Nine Miles, Upper Nine Miles, and Lower Nine Miles (88.25, 26, 27), with the middle point overlapping Feng Shi GB-31. Patients can be taught to do Paida (拍打) in this area as a daily health maintenance regimen.

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

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

Ge Jie 蛤蚧 Ge Jie Kamwo Herbs

Instead of a traditional dietary recipe for this node I’ll offer readers a medicated wine. This formula is specifically for the treatment of Bi syndromes due to cold in the channels, and can be taken by patients over the age of 40 for the prevention of joint problems as well. The recipe is actually given to us by Tung in his original text from 1973. While he was an amazing acupuncturist, like all doctors in China, he was familiar with a number of Chinese medicine therapies (including the basic use of herbal medicines).

Ingredients:

• Huang Qi 1 30g

• Wu Jia Pi 30g

• Placenta (powdered) 1.5g

• Ge Jie 1 piece

• Chuan Niu Xi 9g

Place all the herbs in an appropriate amount of grain alcohol (e.g., vodka), and let soak for about 1 month. Then, so consume about 1 shot per day or as otherwise needed. For patients with ongoing, active Bi syndrome pain, I suggest combining with external liniments (跌打酒). We did a class through eLotus in August 2019 on Tung’s acupuncture and external herbs for injury management (click here for more information on that class).

I hope everyone had a great New Year. Stay warm!

Winter Solstice 冬至

Later tonight at 10:27pm Eastern Time we reach one of the most important astronomical events of the solar year – the Winter Solstice. This day 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.

“Winter Solstice” means two things. It is the name of the 15 days seasonal node that actually starts on December 22. It is also the exact astronomical 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 - which, as I mentioned, happens today at 10:27pm Eastern Time. 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 (this is Summer Solstice for the southern hemisphere). 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!