Put Those Hands Together When You Pray

If you don't pray, put them together anyway. In the age of anything goes, I've taken to the lazy practice of praying silently in my head while lying in bed at night. I don't know where my hands are exactly, but they sure aren't folded nicely in front of my chest like the iconic prayer image of the olden days.

Who cares? Why bother pressing your hands together and holding them in that fairly awkward position that drove me nuts as a Catholic school kid? I'll be the first to admit that I let my fingers fall and intertwine into the sloppy prayer paws pose as soon as the priest looked the other direction.

Now I realize I was screwing myself out of some real benefits. Sure, God was probably disappointed in my faulty direction following, but I'm not focusing on the spiritual deficit here. I'm focusing on the physical and even the psychological benefits I -- and many other lazy prayers -- had been missing out on all my young life.

This whole conversation hinges on one important point -- an acupuncture point -- called Pericardium 6, or "PC6" as we call it, because again we're all too lazy to stick to the formalities in life. What does PC6 have to do with prayer paws (as my kids call them)? This now famous spot, two inches proximal to the inner wrist crease, has been dubbed the most researched acupoints of the modern day. You know those "anti-nausea" motion-sickness type bracelet bands, with the ball that presses into the inner wrist? That thing's stimulating good ole PC6.

Why is PC6 such a beneficial acupoint? Our trusty guide to acupuncture points and meridians and their energetic functions is a beefy, rust-colored book usually referred to by its author's last name, "Deadman." What does Deadman say about PC6? Oh, nothing too exciting. Just that it treats all diseases of the chest, particularly the heart, but also benefits the lungs, too. It can be used for heart surgery analgesia. What? Yes! No anesthesia necessary...just squeeze PC6 for me while I go under the knife!

In TCM terms, PC6 "unbinds the chest and regulates qi," "regulates the heart and calms the spirit," "harmonizes the stomach to relieve nausea," and "clears heat." It's indicated in conditions such as heart pain, palpitations, cough, asthma, insomnia, anxiety, abdominal masses, fevers, malaria, irregular menstruation, and swellings in the armpits. Nothing important there, right? Not! PC6 does just about everything you could want an acupoint to do.

During a recent advanced seminar class with Dr. Robin Fan, we discussed the benefit of stretching the Kidney meridian in cases of heel pain. Suddenly, all I could picture was the traditional prayer pose--hands out front, pressed gently together, stretching and stimulating the bulk of the Pericardium meridian!

It makes sense. What is the function of prayer if not to calm the mind and spirit? It's not just Catholics and other Christians who have always used this prayer pose, either. As my mind wandered -- sorry, Dr. Fan -- around the globe, I saw the Chinese practicing qi gong poses, the Indians practicing yoga poses, etc. Every tradition I could think of involved some use of this position.

In anthropology, when we see similar customs or values amongst a variety of cultural groups around the world, we call those core elements "cultural universals." In other words, everybody's doing it. Why? The answer is one that, despite my need to create an evidence-based practice, I've always secretly promulgated; sometimes, you don't need to sit around waiting for a formal research study to prove a truth. It's lovely that western medicine has put together some studies that do show the efficacy of PC6 in some conditions, but I'm not waiting for them to prove the rest. I'm going with Deadman and the ancient world traditions on this one.

Pray on, prayers!

Acupuncture Is Kind of a Big Deal

With at least two distinct "appreciation" events in the next two weeks, Acupuncture and oriental medicine seems to be powering its way into the integrative healthcare arena. Currently at NUHS, an acupuncture awareness campaign is giving AOM students, faculty, clinicians, and interns of all kinds of an excuse to sport an unmistakably fashionable bow tie. That's right, in addition to the pristine business professional wear and white coats, always part of our clinic attire, you can also catch us pinning on a snazzy white and black yin-yang bow tie from now through November 1st. It goes with everything.

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If gawking at odd bow ties isn't enough to grab your attention and get you thinking more about acupuncture and oriental medicine, then how about some free treatment? That's right. From October 27th to November 1st, all new patients to the NUHS AOM Clinic can receive a free treatment. This is a great opportunity for anyone who's been considering giving acupuncture a try, but hasn't been willing to shell out the usual $25. Just make sure to schedule ahead of time -- free generally means "busy" around the clinic!

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Why do we need to raise awareness about acupuncture (and all of oriental medicine)? In a 2014 National Health Interview Survey report, researchers revealed that 14 million Americans have tried acupuncture. That sounds like a lot, but it's really not. That's only 6% of Americans! What's holding back the other 94% of the American population? My guess is needle phobia. Who wants to be poked and pricked? Not even I like needles, and I use them every day.

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Neporent, Liz "A Close-Up Look at Acupuncture for Pain."
ABCNews.go.com. ABC News. April 22 2014. Web. April 25 2014

Thankfully, needlephobes like myself are not holding back the growth of acupuncture in the United States today. Lately we've been finding needles everywhere. The military is hiring acupuncturists, veterans' clinics are treating PTSD, and pain management and cancer treatment centers are flooded with requests for acupuncture services. Even research studies, in English, showing the efficacy and safety of acupuncture are appearing at a rapid clip. It seems like the west is doing a good job proving the east already knew what it was doing. Acupuncture can treat just about everything.

Ladies and gentlemen, the people have spoken. They want to be poked.

To find out more about these awareness events at NUHS, and to keep up with the happenings of our program on campus, check out the NUHS AOM Club Facebook page.

Derm Is Hard

If you've never heard that one before, then you've probably never tried to figure out a skin issue. Every time I've ever consulted with any kind of doctor about anything skin-related on anyone, the first comment is always "Derm is hard." Why are skin problems such a mystery? Sure, dermatologists have figured out how to treat most of them, but even they, in my experience, are not much concerned with how the skin eruption got there in the first place or why a rash keeps recurring.

If you have a child, then odds are high that you've run into some skin issues. Kids are just hotbeds for tons and tons of rashes, eruptions, vesicles, warts -- you name it. As a parent, rather than as a student, I've become familiar with eczema and molluscum. Is it flat or raised? Broken edges or a perfect circle? Red or flesh colored? These are all things that we parents become practical experts in, but only by default. It only takes about 10 trips to the pediatrician to have someone take a look at a pink or red spot on a toddler's leg to start concluding "eczema" at every turn.

Finally I came to realize that "eczema" was kind of a catchall, non-specific diagnosis. It was an easy name to drop, and an easy thing to slather with a steroid cream. Do you think I like to put steroid creams on my babies? No, no, I do not. Don't theylowerthe immune system's function? Plus, kids' kidneys and livers have enough toxins to filter these days from their pesticide-rich foods in plastic containers. Pass!

I don't want to use steroid creams, and of course I don't want my kids (and your kids) to walk around full of rashes and vesicles all of the time, either. But, there's a third thing that I'm just much more concerned with. WHY is the skin issue happening? What does a superficial reaction tell us about the inner workings (or dysfunctions) of the body? Chinese medicine has a lot to add in this realm, thank goodness.

A couple of weeks ago I mentioned the internal-external relation between the TCM conception of the Lung and the skin. In this model, the Lung controls the skin, giving us a hint that what shows up on our skin could be due to an imbalance in the Lung. For example, some Chinese references to "eczema" are translated as "skin asthma."

Generally, TCM traces most skin issues back to one of two issues -- heat or dampness. If that sounds too simple, that's because it is. It could be heat in the Lung, heat combined with wind, or heat combined with wind and dampness. The possibilities could be nearly endless. Luckily, both acupuncture and herbal medicines have a great track record for expelling these external pathogens and balancing the body. We help your body help itself.

What causes the internally generated heat or dampness? Or, what allows the body to be susceptible to the external invasion of heat or dampness? Again, possibilities are seemingly endless. Dietary and other lifestyle factors top the list, but constitutional predispositions (genetics) are also important in TCM's understanding of the whole person. It could be too much dairy (dampness), too much stress (constrained Liver heat), or a deficient Lung (protective qi).

An article in Acupuncture Today gives an in-depth look at one fairly common condition, psoriasis, and how acupuncture and herbal formulas have shown significant improvement. It also outlines some of those pesky, and sometimes life-threatening, side effects of western medicine's treatment plans for this and other skin conditions. Think you have your skin condition managed? Great! Still struggling to get it resolved? See what the AOM clinic has to offer!

Gold, Frankincense and Myrrh -- Minus the Gold

2014-10-07_1If it was good enough for the Christ Child, then it's good enough for me. That's my motto. I've been using a (gasp) commercially prepared skin care product for the past month or so, and these are two of the main ingredients -- frankincense and myrrh essential oils!

Once again I've found myself playing the "overlapping medical paradigm" game. You know the one -- you realize you're eating a vegetable that also happens to appear in a Materia Medica (giant book of medicinal herbs). Suddenly you second-guess yourself at every meal. "Should I add sautéed onions to my steak," "Does a cooked onion still hold the same medicinal properties as a raw one?" Who eats raw onions anyway? "Is the live peppermint growing in my backyard the same as the dried peppermint in my tea bags, the essential oil of peppermint in my cabinet, or the bo he (Mentha piperita) listed in my TCM Materia Medica?"

2014-10-07_2Now I'm having this same sense of wonderment about my facial products. As I'm rolling on and rubbing in this blend of ancient oils that smells distinctly like a special day in a Catholic church, I'm pondering the reach of these powerful substances. It's no secret that frankincense can run $100 per bottle of essential oil, and myrrh comes in around $70.This is good stuff, people. But why? What properties do they carry that have made them, along with the missing "gold" in my formulation, so heavily sought after for millennia? Myrrh was not only presented to the baby Jesus but also used to anoint his body after death. Egyptian pharaohs were also doused in the stuff.

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Myrrh on the left, frankincense on the right

Myrhh (mo yao) has been a documented herb in TCM since the Kaibao Era circa 975 AD. Frankincense (ru xiang) has been on the books since 500 AD. How are they used in Chinese medicine? Both come from small shrub-like trees in the Arabian Peninsula and Northeast Africa, and both are used in resin form to invigorate blood, treating a variety of "stasis" issues, from traumas to tumors. Specific entries might look like this:

2014-10-07_5Myrrh: neutral, bitter, downward draining; enters the Liver meridian; moves blood, dispels stasis, disperses phlegm nodules.

Frankincense: warm, acrid, aromatic; enters the Heart and Lung meridians; moves blood, relaxes sinews, freecourses qi, and removes obstruction from the channels.

Together, they have complementary properties of healing weeping sores and engendering new flesh. Well, there we have it. Now I see why this blend (which also includes lavender, Hawaiian sandalwood, helichrysum, and rose oils) would be used as a facial formula of the anti-aging variety. Hey, I'm 31. I might as well be prepared.

Qi Li Sanis the name of the formula utilizing the highly effective complementary herbsmo yao(myrrh) and ru xiang (frankincense). Technically they are resins, but we call every substance in our Materia Medica an "herb." This traditional formula combines our frankincense and myrrh with dragon's blood (spoiler alert: not really the blood of a dragon), catechu (another resin), carthamus (flower), cinnabar (ooh, an illegal one!), musk (illegal plus you'd smell like a deer), and borneol (one more resin for good measure).

2014-10-07_6Ayurvedic medicine, native to India, also uses frankincense and myrrh, now sometimes in nutraceutical forms like guggulsterones and bowsellic acids, respectively, for high cholesterol and joint pain.

So, what am I putting on my face? Sure, an essential oil is not exactly the same as a resin or a neutraceutical, or a Chinese decoction for that matter, but that's not what matters. What's important here is another step in the direction towards integrated medicine. Maybe western and eastern are both right this time. As one of my favorite patients helped me realize recently, you'll kill yourself trying to figure out which is the one right answer. There isn't one. Open your eyes, open your ears, and open your heart to acknowledge the truth in each tradition.

Your Lung Meat

2014-10-02_lung1No, not your lunchmeat. Today I want to talk about your "lung meat." This is how my children and I refer to their lungs. Got a cough? Well let's massage some eucalyptus oil on your lung meats. They understand that I don't have to reach my arm down the throat to physically touch the lungs themselves. My 7- and 4-year-old children are already hip to the Traditional Chinese Medicine (TCM) concept of the internal and external functional system known simply as the "Lung."

My children are wise. Maybe they -- like most children -- are simply intuitive creatures. They haven't yet been shoved inside the box, led to believe that there is only one right answer, or that they must operate fully and submissively within the parameters drawn by the institution. Wow, I really sound like an old-school hippie on that one.

2014-10-02_lung2I had to take graduate-level TCM courses to grasp the concept of the Lung as an entire system of physiological interplay involving both internal organs and external pathogens. Sometimes in TCM, "organs" line up perfectly with their western paradigm counterparts. The Large Intestine is largely the same thing in TCM and in the western understanding. A medical doctor and an acupuncturist would agree that the Large Intestine functions to absorb some nutrients from food, reabsorb some fluid, and pass along the remaining waste in the form of stool. See? Everyone's getting along.

Unfortunately, some western organs do not line up exactly with their corresponding TCM "zang fu." Some translations are more abstract, although still meaningful. Take the Heart for example. While westerners know that your consciousness (mind/thoughts) originates in the brain, we can stretch ourselves to accept the TCM function of the Heart as the storage place for the Shen (mind/spirit).

2014-10-02_umbrellaThe Lung falls somewhere in between. TCM describes the Lung as a delicate white umbrella in the upper jiao (we'll call that the "chest" for today), misting the entire body with the perfect amount of moisture. Not too much fluid, mind you, or you'll have a phlegmy cough. Not too little either, or you'll have a dry cough.

In TCM, the Lung is responsible for so many processes and conditions in the body. Again, some will be more easily accessible to the logic of a western brain, such as how the Lung rules respiration, opens to the nose, and governs the voice. We can probably stretch again to accept the function of the Lung in TCM as working with the Heart to control the blood vessels -- if you have any idea about how the heart circulates the blood through the lungs to oxygenate it before distributing it through the body. As you feared, though, some of the Lung functions in TCM are unclear to the western mind. Did you know that the Lung regulates qi (energy) of the body? It regulates the water passages, controls the skin, sweat glands, and body hair, and controls "descending and dispersing" throughout the body.

2014-10-02_heartWhat? That final function describes the way that the Lung should work to descend qi in your body. You shouldn't cough; if you are coughing, then that is explained as "rebellious Lung qi" that needs to be more adequately descended. When you catch a cold, TCM explains that this happened because your Lung qi may have been wimpy. The Lung is the first line of defense from our body to its surrounding exterior environment, and we need strong Lung function to beat down any bad guys who try to sneak in.

As Dr. Zhu illustrated in a recent Advanced Seminar class, it's easier to push an intruder back outside when he's just stepped through your door. Sure, you can fight him down in your dining room, but by then he's already broken your furniture and dumped out your drawers in his path. What a great example. Dr. Zhu is brilliant, but we already knew that.

2014-10-02_chartGuess what? It's time to protect your Lung meat. Right now -- today. In TCM, the Lung is the organ connected to the season of fall/autumn. While some interpret this to mean that the Lung is the strongest at this time of year, many of us experience the opposite -- excessive or frequent Lung pathologies -- wind-cold invasions and wind-heat invasions (the common cold and flu). These pathogens are attacking through our (often deficient) wei qi (protective energy layer), which again is regulated by the Lung. If the Lung is weak, then the wei qi is weak; thus, more colds for you.

What can you do to tonify your Lung? You can visit your favorite clinician or intern to assess your wei qi and see how much tonification you might need. Acupuncture is often appropriate, as may be cupping, gua sha, tui na, or moxa. Even food therapy (a branch of TCM) could be applied here. Pears are very moisturizing and specifically target the Lung and Stomach meridian (think: colds and flu).

2014-10-02_pearFor some people, a Lung excess pattern could exist. Instead of basic tonification, a sedation technique might be the appropriate method. Who wants more hot yellow phlegm in the lung meat? Not me. This is why self-diagnosis and treatment can be dangerous. Not every head cold is a wind-cold invasion. Many are wind-heat invasions. While ginger or garlic might be great to release the exterior wind-coldinvasion, it will probably exacerbate a wind-heat condition, where peppermint would likely be the answer.

What's the lesson here today? Care for your lung meat. Don't smoke. Do drink water. These are the basics according to western medicine, and TCM agrees. However, if you'd like to do more -- the TCM way -- then see what an AOM intern has to say.