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.

2014-10-07_3          2014-10-07_4
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.

My Salt, My Shen (and My SLEEP!)

2014-09-24_popcornI like to eat popcorn before bed at night...every night. I'm defended my position for years, so I'm ready for your attacks. No, I don't think it's bad for me. I air pop organic, non-GMO corn and drizzle on melted grass-fed organic butter. Most deliciously, I sprinkle sea salt all over the top.

Let me stop lying. It's more like I pour on the butter and the salt every one-inch tall increment of popcorn as it falls into the bowl. That's impressive, and it's a skill I've honed over several years. You have to stand at the ready, slowly spinning the bowl under the air popper with your left hand while gently drizzling on the butter from your right hand. Even coverage. Every time.

2014-09-24_butterNow I'll begin to unfold the secrets of my popcorn affair. Is it enough that my bedtime snack is free from pesticides, antibiotics, growth hormones, and genetic modification? We all know I'm not making toxic microwave popcorn. Sure, it clears the "no bad things" screening fairly easily, but, as I always ask when someone proudly shows me a "100 calorie" pack of cookies, "What is actually in there that's good for you?"

Over the past couple of years here at NUHS in the AOM program, I've horrified more than a couple of peers by describing my nighttime ritual. Although we naturally-minded medical people are generally all in agreement that whole-fat butter is better for your body than any margarine-like alternative, I've still heard the "too much fat for your liver to clean" argument against my nightly popcorn.

2014-09-24_bedSeveral months ago, I decided to give it a try. Who wants a Liver or Gall Bladder channel obstructed by phlegm? Not me. So I cut down my popcorn to once every week or two. It was rough. It was sad. I felt incomplete in some way when laying down for bed at night. My kidneys cried me to sleep, begging for the tonification that salt provides my deficient little nephron bodies. They went hungry, as did I.

After a few weeks of my new deprivation lifestyle, I realized something shocking -- I wasn't sleeping well! I've always been a good sleeper, falling right to sleep each night and sleeping straight through until the morning. Nine hours or so was the glorious norm for me. Not anymore. Suddenly it was a struggle to fall asleep and to stay asleep. Transient insomnia? Definitely. Chronic insomnia? I didn't want to head down that road.

Luckily, I happened to be taking Eric Baker's "Nutrition and Food Therapy of Oriental Medicine" course at this very time. I glanced down at my handout during class, and what did I see? Salty (a flavor in TCM, but most specifically manifested in actual SALT) collects the Shen. The Shen in TCM is basically the spirit or mind of the person.

2014-09-24_seasaltI had been neatly collecting my overscheduled, chaotic Shen before bed each night by some sort of inexplicable subconscious desire to put my mental pieces back together in order to sleep well. Now what was I doing? I was trying to fall asleep and stay asleep while my Shen gallivanted around my body and my life, scattered in tiny pieces into all of my hats -- mother, wife, student, professor, friend, sister, etc. No wonder I was failing every night.

Upon making the core connection between my salt, my shen, and my sleep, I promptly began my nightly (or nearly nightly) ritual of devouring a bowl of salty, buttery popcorn. What do you think happened? Let's just say I sleep nicely once again. My body was speaking to me, and I needed to listen. Pop on, popcorn!

Is Homeopathy Part of Chinese Medicine?

Nope. So, why I am writing about a modality or medical system that is not part of the Acupuncture and Oriental Medicine Program? Much like the use of essentials oils, the use of homeopathic remedies can be incorporated as part of an approach to overall health and wellness. Building on our theme from last week of "words that are hard to pronounce," today we'll start with "homeopathy." Go ahead; try to say it aloud. (home-ee-AH-puh-thee)

Now that we can say it, let's keep working. What is homeopathy? Where does it originate? If it is not part of Traditional Chinese Medicine, then where does it belong?

As part of my continuing effort to bridge the gap between programs here at NUHS, I recently sat down with a student in the Doctor of Naturopathic Medicine Program -- the only program that includes the study of homeopathy. As a student of both western naturopathy and eastern AOM, he is perfectly poised to take on the questions I shot off rapid-fire style.

To understand homeopathy better, focus in on the keyword--remedy. While we tend to toss this word around willy-nilly in daily life, in this context it has a more specific meaning. Before this discussion, my basic understanding of homeopathy was simply the principle of "like treats like." So, a homeopathic remedy for a heat condition would be hot in nature. Uh-oh. That's the opposite of Chinese theory, where we would answer a heat condition with cold.

How will we ever get along? Rest assured, I was able to reconcile this in my brain by using the analogy of how a person becomes immune to a particular virus after exposure to an attenuated piece of that same virus. That's not exactly a Chinese principle, either, but OK. At least I'm back on board with homeopathy after relating it to my western understanding of immunology.

How homeopathic (home-ee-oh-PATH-ick) remedies are made is my favorite part. My brilliant colleague and naturopathic doctoral student explained the rigorous and extensive process in such a way that an outsider, like myself, could visualize it. After the diagnostic portion of the show (which I'm definitely not well-versed in) is complete, and the correct remedy has been selected for the person, I was eager to find out where to obtain the remedy and how it was made.

Similar to TCM, most homeopathic remedies are derived from plant, animal or mineral sources. Many remedies are inexpensive and available at health food stores, while some are more costly and more difficult to order. Either way, here's how most are made:

  • A substance (let's say arnica) is diluted in a base such as alcohol or water.
  • The mixture is shaken vigorously (they call this "succussion").
  • One part is taken from that mixture, and that part is again diluted with 99 parts water/alcohol.
  • Shake vigorously.
  • Again take out one part and dilute with 99 parts water/alcohol.
  • Repeat this process a few more times until the desired dilution has been reached.

To the average onlooker, it would seem that the resulting homeopathic remedy has been diluted to the point of being indistinguishable from its water or alcohol base. How can that work? Most would assume that the remedy is weak and ineffective; in fact, that's the main argument against homeopathy by the mainstream medical community. Never one to blindly agree with the mainstream medical community, I turned back to my naturopathic friend and asked for the other side of the argument.

He explained that according to the principles of homeopathy, the more diluted a remedy is, the stronger or more potent it actually becomes. How can this be? Well, that's still being debated in the United States. Homeopathy has been practiced for around 200 years in Germany -- with roots arguably all the way back to ancient Greece -- and declares itself a stand-alone medical system. Yet, it is undeniably controversial and not considered "proven" by modern medical science.

2014-09-17_moleculesMaybe that's about to change. My colleague explained that the argument for homeopathic remedies being effective at these diluted ratios has to do with their molecular size. The continual process of dilution and vigorous shaking supposedly breaks down the molecules of the original substance into pieces small enough to cross through the cell membrane. Stop. Read again. That's a big deal. Some pharmaceutical drugs are deemed ineffective because their large molecular size does not allow them easy entry into our cells. Once again, friends, size does matter. If the remedy can get in, then that explains how it could work effectively.

For now, homeopathy remains a controversial topic of debate. For more information, search PubMed at www.ncbi.nlm.nih.gov/pubmed/?term=homeopathy for clinical trials and peer-reviewed, scholarly journal articles on the efficacy of the remedies. Or, talk to your favorite naturopathic doctor.