Archive for tag: tcm

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.

So What Is Chinese Medicine

With the start of a new trimester here at NUHS, and -- for many -- the start of a new school year, it's the perfect time to break it down. Just what is Traditional Chinese Medicine? How does acupuncture fit into the picture? Do you have to use herbs, too? What about tui na, qi gong, and tai chi? Let's not forget about my personal favorite -- dietary therapy!

Traditional Chinese Medicine (TCM) has arguably five branches, and I'm going to give it to you as I understand it. After two full years in the Acupuncture and Oriental Medicine Program, a first professional master of science degree program, I think I'm finally scratching the surface of what the ancient Chinese had to offer.

Acupuncture

photo of woman receiving acupunctureThis is the big guy, right? Acupuncture is the most well-known branch of TCM today in the U.S., involving the insertion of needles into specific points on the body. While some other fields offer an abbreviated, "stick it where it hurts" method, we TCM acupuncturists take the entire body, its functional organ systems, and each person's general constitution into consideration when deciding where to stick the needles. I know it's confusing when you say your back hurts and I put needles in your legs, ears, and hands, but just trust me. It's all connected through energy meridians. This is also why we ask you about your poop when you come in for knee pain.

Moxibustion

photo of Chinese herbYes, it smells just like marijuana, but it's actually a different herb called ai ye in Chinese pinyin, artemesia argyi in Latin, or Mugwort in plain old English. It does come in a tightly rolled stick form, we do light the end, but instead of smoking it we hold it near an acupoint on the body. After a few minutes of pecking the moxa stick close enough to provide penetrating heat but never burning you -- I promise -- you will reap the benefits of not only pain relief but tonification of certain organ systems and the freecoursing of energy through particular meridians. It feels great, but you will have to explain to people for the rest of the day why you smell like marijuana.

Herbs

photo of Chinese herbsLike many medical systems, from western naturopathy to Indian Ayurveda, TCM has a unique Materia Medica, or giant book of herbs, their properties, and their medicinal uses. While you don't have to "do herbs," most students at NUHS work towards the full MS of Oriental Medicine (which includes the herbal coursework in addition to the acupuncture work). Interesting fact: not all "Chinese herbs" are plant-derived. Many are actually minerals, such as salt or arsenic, or animal-derived, such as deer penis or flying squirrel feces. Just seeing if you're paying attention (but yes, those are really all in the Materia Medica).

TCM­

photo of garlic and onionsLumps dietary therapy, or food therapy, into the same branch as herbal therapy above. Because I love the application of common foods and nutritional principles so much, I'm awarding it half status as its own category. Some items that we'd call "food," such as garlic or onions, are also included in the Materia Medica as medicinal herbs. They're working together -- that's the point. Who doesn't love the ancient Greek saying, "Let food be thy medicine and medicine thy food?" Thanks, Hippocrates, thy father of western medicine. The Chinese happen to agree!

Tui Na

photo of woman receive a massageCan you pronounce it? Try this: twee nah. Good job. This is most easily compared to the practice of massage. Often called "Asian Body Work," these pushing and pulling movements applied by the TCM provider to the patient's body accomplishes many of the goals of general massage, such as relaxation and improved circulation of blood and energy.

Cupping

photo of cupping treatmentThis is also where we are going to mention the practice ofcupping. Stick a fire into a glass cup to create a vacuum that pulls toxins out of the blood and releases the exterior in a "wind-cold invasion" and you have a happy patient. In my admittedly limited clinical experience, everyone loves cupping, but mind your manners. The clinic is not an a la carte menu for your pleasure. Let the intern and the clinician decide which modalities are best for your condition each day.

Qi Gong

photo of qi gong practitionerAnother new phrase for the day. Practice: chee gong. Not so bad, is it? Qi gong offers the practitioner a chance to step back, relax, and renew his or her own energy and well being. Maybe you've seen images of elderly Chinese individuals at the park, wondering why they are punching the air in slow motion. That was a group of people cultivating their qi. As Dr. Yurasek tells us interns, "You can't give it if you don't have it!" Thus, practice your qi gong postures and movements before you head in for your clinic shift.

So, there it is--most of Traditional Chinese Medicine. We could also tie in tai chi or talk about gua sha, but I have to save something for next time! If you haven't tried TCM, now is a great time. Interns are fresh off a nice two-week break, white lab coats are pristine, and everybody's anxious to try out their skills. See you in clinic!

Essential Oils or Chinese Herbs

Are essential oils (EOs) the answer to the challenging questions of how to locate, transport, store, and prepare Chinese herbs? I'm starting to think so. The more I use EOs in everyday life, in everything from cleaning my kitchen floor to healing skin wounds, and even to give my beer that summery citrus flavor, the more I see the large overlap between EOs and Chinese herbs.

2014-07-28_booksAs a student of Acupuncture and Oriental Medicine (AOM), mostly derived from Traditional Chinese Medicine (TCM), I respect and value the efficacy of a freshly decocted batch of raw Chinese herbs. I know they work, I've gained a basic understanding of why they work, but I struggle with the practicality of using them either for my family now or for a future patient population.

What are these challenges? First, there are a lot of "herbs" in TCM's Materia Medica (book of medical substances, whether plant, animal, or mineral derived). To stock a shoebox-sized amount of just most of them would require a very large storage room. Some need to be refrigerated, some need to be pulverized just prior to use, and some are illegal to use in the United States. No rhinoceros horn for you!

2014-07-28_shelvesFinding them--even the legal ones--presents yet another stumbling block. Should you order online, feign condition after condition to cache all the prescribed herbs you can squeak out of your clinician at school? Drive to Chinatown and take a stab at which shop has fresh, safe and affordable herbs? Sure enough, within a few days of making each trip to Chinatown myself I realize, "DOH! Now I need that other herb, too!" Back in the car....

After a year or so of engaging in this disorderly and expensive game of cat and mouse, I'd tried all (well, most) of these tactics--even growing some of my own! All legal, of course. Think "mint," not "ephedra." So, what's an AOM student to do? For the past year, this one's been exploring the way that high-quality EOs could fulfill many of the same needs as our Chinese herbs. How? Well, I'm not entirely sure that the properties translate exactly, but many sure seem to do just that. Let's take a look at our good friend, peppermint.

peppermint plantChinese name: Bo he. Common English name: Field Mint. Latin name: Mentha piperita. Same plant...same medicinal properties? I argue "yes." Most basically, peppermint is "cold" in nature. Both West and East agree on that. TCM goes on to add other attributes such as aromatic, acrid, and thus capable of dispelling the common wind-heat invasion (think: yellow snot and sore throat). My western manual of EOs describes peppermint as "anti-inflammatory, antibacterial and invigorating," with primary uses including "congestion, fever, influenza, heartburn." Sounds...pretty...similar!

Sure, the harvesting, processing, and distillation processes change, emphasize, or even exclude some of the chemical constituents, and the final usable product of dried bo he differs greatly in appearance from the bottle of peppermint EO. Does that mean they function differently, though? I used to harvest, dry, and lightly decoct my own bo he when I felt a wind-heat invasion coming on. It worked, as long as I was at home with my own garden and had some time to prepare it all. Lately, I've been easily reaching into my oils cabinet and tapping two drops of peppermint EO into a mug of warm water. Instant peppermint tea? Definitely. Instant medicinal answer to a wind-heat invasion? I say yes again, based on my own experiences.

2014-07-28_peppermintI'm not a chemist or a doctor, but in my experience and increasingly informed opinion, I'm finding that EOs can make a handy substitute for Chinese herbsin many cases. As with raw herbs, quality is of upmost importance when selecting an EO company. Storage, convenience and ease of use are all in favor of EOs, but they are limited in number. I haven't found one called "gecko" or "scorpion," or especially "Bear Gall Bladder," all of which are clutch entries in a TCM Materia Medica.

Conclusion: If you can manage to live and treat without the more exotic or illegal Chinese herbs, then EOs might be a practical substitute much of the time. Imagine the difference between handing a patient a bag full of raw ingredients, a pictorial instruction sheet, and a handshake full of hope that they can execute the cooking process effectively vs. handing the patient a small bottle of EO and the simple instructions to put two drops into a mug of warm water.

Extra considerations abound; this post cannot attempt to cover every angle or offer every comparison point. Granule or patent pills can make Chinese herbs more practical, while some EOs are quite expensive to purchase. Frankincense can easily run $100 per 15 ml bottle. Hey, if it's good enough for the Christ Child, you're going to have to pay up! There are also some pesky mind-blocks when trying to move seamlessly from one medical paradigm to the other. How could a TCM practitioner possibly use hot cinnamon bark and clove bud for a yellow-snot, sore throat sinus infection? Yet, that's exactly what the EO prescription is in that case. Homeopaths have no qualms with the theory of treating heat with heat, but that's not the plan in AOM!

2014-07-28_oils

For now, I'll chalk this entire idea up to just another piece of evidence that an integrated approach to healthcare is truly the best option. Taking what works from any and all medical systems offers our patients the most options for being well. I'm open to that...

How Salads and Evil Qi Can Make You Gain Weight

How could salads cause weight gain? If you have Damp-Cold and you're trying to lose weight by eating cold, raw, veggie salads, you might not shed the pounds. "How can this be?" everyone is now screaming -- probably silently, that's fine. I thought eating lots of spinach, topped with radish, cucumbers, celery, etc. was supposed to help melose weight.

For some people, this might be an effective strategy, particularly if you are swapping out fast-food double cheeseburgers in favor of homemade veggie salads. Certainly, there is the undeniable benefit of increasing the nutrition you're taking in by adding more produce to your diet. I'm sure we all know someone who started eating more salads and less junk food and fairly promptly dropped a few pounds. Great.

So, why doesn't it work for everyone? In fact, why does eating all raw, cold veggie salads even have the possibility of causing weight gain in some people?

No, the answer is not about the dressing that you put on the salad! That would be too easy, not eastern-medicine-related, and frankly, it would probably cast a dark shadow on my consistently whole-fat dietary lifestyle approach.

Instead, my point here is related to one of TCM's six evil qis -- technically, two of them. I used the terms "cold" and "damp" earlier, and this is one of those special moments when normal, everyday words take on more specific meanings in the context of Chinese medicine. I think we call that "connotations." In TCM, Cold and Damp have pathogenic connotations.

A person can be constitutionally Cold or Damp from the get-go, or a person can be invaded by a Cold or Damp external pathogenic factor (actually called an "evil (xieh) qi"). Foods are like people; each food has specific properties, such as Cold, Hot, and whether the food leads to damp retention or drying out in the person who ate it.

In the case of a Cold, Damp person trying to lose weight, we need more hot, drying, acrid foods, and fewer raw, cold, damp foods on the plate. If this seems counter-intuitive, keep in mind that there are plenty of healthy, nutritious foods that have hot and acrid properties. Ginger and peppers, anyone? Yes, please.

What is your favorite food doing for you--or to you? My favorite book on nutrition, Healing with Whole Foods: Asian Traditions and Modern Nutrition, goes into detail on the connections between your diet and your health. Or, quickly check out the properties of some common fruits, veggies, meats, etc. here: http://www.tcmecc.org/foodtherapy.htm

Choose wisely, my friends.