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February 2020- The Wisdom of the Sages
Our purpose in creating Three Treasures Acupuncture was to introduce it to our friends and neighbors, not only our patients, as a way of living life in which we so profoundly believe . The concept of longevity, which is at the heart of Chinese Medicine, is first and foremost, a theory of preventative medicine and self-care; “taking care of things while they are small”, as the text says. Healthy practices such as eating properly to create and maintain qi, exercising to move the blood, and meditation for a calm mind, must be an integral part of how we live our lives in the twenty-first century. Choosing natural, herbal medicines instead of overwhelming pharmaceuticals is a necessity whenever it is possible. It is a beautiful irony that the way forward in the twenty-first century derives from wisdom that has been accruing since the twenty-first century B.C., and yet is not considered “evidence-based.”
The need for this self-care has never been greater. The “modern” health care system is not “health” care at all; there really is no functional idea of preventative medicine and wellness. Instead, western medicine has focused almost entirely on the treatment of disease, and has become extremely expensive in the process. Truly, I have no problem with western medicine. Technology has brought it to a place where actual miracles can occur, but I don’t think it necessarily should be the first option because it is often too strong or too invasive. Chinese Medicine is based on principles of harmony and balance with an aim to minimize side effects of treatment.
When it is integrated into a health promoting life style, it can be extremely effective at treating almost any type of disease should it arise. But the goal is to always maintain wellness. I think of Chinese medicine as a second sun illuminating this world, shining light on some things that are otherwise hidden, opening up new pathways for self-discovery and spiritual growth as well as supporting robust physical health.
The medicine, as it has come down through the ages is truly remarkable; it is the oldest living system of anything that exists on the planet, besides nature itself. The principles that have developed over millennia haven’t really ever changed, only evolved over the years becoming increasingly more refined and elegant. The oldest of these theories is the Yin/Yang theory which expresses the unity of all things in terms of polar opposites. This duality creates a dynamic balance, a dance between dark and light, activity and rest, substance and matter, water and fire that applies to all life’s processes. In the human body, Yin/Yang is the principle of transformation and change .
The interplay of these opposites can be clearly seen, for example, in the autonomic relationship between Sympathetic and Para-sympathetic nervous systems, one stoking the body’s furnace, and the other cooling it down. The balance of the autonomic nervous system permeates all of the body’s metabolic pathways and their processes. Chinese medicine is fundamentally directed towards maintaining this balance.
There are four essential principles to Yin/Yang theory:
First is the principle of Opposition: that every unity is composed of polar opposites, which must be identified in order to create the context for every situation as it arises, to illuminate the principle of constant transformation and change which is the way of nature. Nothing is ever entirely Yin or entirely Yang for very long, but constantly transforming. The Tai Ji symbol associated with Yin and Yang shows that the seed of each one is contained within the other, so that there must always be flow and transformation between them as they interact. Think of the relationship between article (Yin) and wave (Yang). Disease occurs when this flow is blocked.
- The second principle is the principle of interdependence. Yin cannot exist without Yang. They give definition to each other through relationship. Within the medicine this relationship explains laws of cause and effect in our search to find the root cause of any particular disease. Life substances depend upon the energy which creates them; human energy requires substance to contain and move it.
The third principle is the principle of Mutual Consumption. When the harmony of the relationship is broken, an overabundance of one will consume the other. Too much heat, a common byproduct of inflammation, will consume fluids. On the contrary, if there is insufficient heat to maintain appropriate levels of metabolic activity, fluids will not move as they have to, and will build up, becoming non-functional.
And, finally, there is the principle of inter-transformation, the propensity of Yin to transform into Yang at the proper time, according to natural law. Just as day becomes night and night becomes day, the body’s yin and yang create cycles that are constantly breaking things down to burn as energy, and then building things back up. These are the cycles of anabolism and catabolism. Human physiology is dependent on this delicate balance of ebb and flow.
As practitioners of this medicine we are always looking to assess the yin and yang of each patient. If the presentation is too yang, we make it more yin. If things are running too hot, we cool them down; when energy becomes stagnant and begins to accumulate, we move it and reduce it. This set of diagnostic parameters is known as the Eight Principles. The first set, of course, is Yin and Yang itself, second is the location of the disease: is it deep, or is it superficial in the skin and muscle layer? Third, we take into account the strength of the disease: Is there too much heat and dryness, or not enough moisture and cooling? And, finally, we distinguish between heat processes which are hyper-functional, or cold processes, which are hypo-functional.
In this way, we maintain the health of the body’s three treasures, Jing, Qi and Shen. Jing contains the body’s essential substances, Qi encompasses every form of functional energy physical or emotional, and Mind/Spirit, or Shen, is the ephemeral energy of human consciousness. Each one is dependent on the health of the other; this is the holistic paradigm of the medicine. Jing is supported directly by the qi of nutrition which allows the body to create energy on a daily basis and thus obviates the need to draw upon these stored essences. Jing is finite and must be tightly stored and maintained in order to live a long, healthy life. When it is gone, so is our strength and vitality as well as our capacity to recover from illness; so is the body’s moisture, like the fluids that lubricate the spine and the joints, cerebrospinal fluid, seminal fluid, amniotic fluid among others.
In turn, healthy Jing supports strong Shen. In China these two are inseparable, and are referred to as Jing-Shen, the outward manifestation of good health. We assess the Shen initially in the patient’s eyes, looking, first of all for what we call Shen Ming, or spirit brightness. Simply put, this is the light in your eyes. We also look for warmth, openness, connectivity, focus and intelligence.
Qi is the life force that provides continuity between all three treasures, which are, in fact, just different manifestations of the life force itself. The ancient texts say that “there is the one Qi and there are the many Qis.” We identify many different types of Qi according to function and location, but, in the end, it is the vital force that is in everything. While we say that Jing is stored in the Kidneys and Shen is housed in the heart, QI flows everywhere. When the flow is interrupted, disease results. Acupuncture manipulates this qi, causing it to flow correctly, removing the blockages that manifest as pain and disease. More and more is known scientifically about qi, what it is and how it flows. Like everything else in the natural world, it obeys the laws of science, yet somehow transcends it all.
March, 2020- Pandemic and the Righteous Qi
The first treatise on pandemic disease was written about two thousand years ago, by a Chinese doctor by the name of Zhang Jong-Jing. Composed of 398 clauses, it contains one hundred thirteen different formulas, of which more than eighty percent are still in use today. The Treatise On Disease caused by Cold Damage is organized into Six Stages that reflect the relative strength of the infectious entity versus the strength of the individual’s “ Righteous Qi.” Here for the first time, we get a clear picture of the Chinese Medicine concept of the Immune System, and how critical it is in the prevention of contagious illness. The stronger one’s Righteous qi, the more protection we have against pathogenic factors, the less complicated the treatment, and the quicker we get over it. The weaker the Righteous qi, the more vulnerable we are, the deeper the disease factor can penetrate, and the more complicated the treatment. In short, the condition of your Righteous qi determines the prognosis for the development of the disease and the ability for the individual to recuperate.
The concept of Righteous Qi extends far beyond the intricate system of humoral and cellular immunity of modern medicine. The term refers to the entire scope of all the body’s systems as they stand in defense against any type of pathogen. One of the basic concepts which define the “Righteous” is the “ harmony of Ying and Wei.” These two types of Qi are, respectively, the Nutritive and the Defense, implying the close relationship between diet and the immune system itself. In modern medicine, for example, we know the integrity of cellular immunity to depend upon the quality of sugars that make up the polysaccharides which the immune system uses for messaging and communication, as well as the fats and proteins which make up the immune-globulins and other humoral mediators.
One of the main differences between this ancient medicine and modern medicine, is that because the Righteous is seen as a form of qi, it can be strengthened and supported. As we have frequently said to anyone who will listen, it is important to treat things when they are small, and never has this been more critical than it is today when we are faced with a pandemic for which we have been woefully unprepared. For the last two thousand years, the fundamental strategy of treatment in Chinese Medicine is to Strengthen the Righteous and Attack the Pathogen.
As doctors of this medicine, we observe every small manifestation of weakness within the body’s systems before they become illnesses, and strengthen what is weak, so when the time comes to actually fight the disease, the body has it’s full complement of vital energy ready to function. This, of course, is the very soul of preventative medicine, and now that we are under attack from a bug which is not only highly contagious but also invisible when it is at it’s most powerful, our own individual ability to prevent contagion should be in the forefront of everyone’s mind.
The harmony of Ying and Wei implies that the interior functioning of all the organs needs to be at its optimum, most importantly the “Spleen” ( the Chinese medicine metaphor for the digestive organs) and the Lungs. At times like this, diet becomes critical, and everyone must endeavor to keep the intake of refined flour, sugar and dairy products to a minimum, especially if they are prone to indigestion, bloating, bowel irregularities and, most significantly, mucus production. These factors most significantly impede fluid metabolism, and humoral immunity, as the name implies, depends on the movement of fluids.
Moreover, anyone with ongoing respiratory symptoms may be subject to a deficiency of lung qi, which is the outer shield by which the immune system spreads through the humors. These symptoms include allergies, asthma, and susceptibility to colds and flus, but the flagship symptom of respiratory weakness is poor stamina: that is, becoming fatigued with minimal physical activity or exertion.
Weakness of the Righteous Qi, in general, is most manifest in symptoms of fatigue, and there are several other types. Weakness of the digestive qi leads to a kind of lethargy, feeling heavy-limbed and sluggish, especially in the morning. If you have insufficient digestive qi, your abdomen will be bloated, and the transit time for absorption is slowed. We distinguish feeling too full immediately after eating from feeling bloated most of the time, with the more transitory symptom being less serious. Now is a critical time to maintain the micro-biome of the gut.
Factors that are harmful to the gut include high calorie foods, highly processed foods, highly refined carbohydrates, sugar-sweetened beverages and frequent snacking of non-nutritious food. Enhancing the micro-biome depends upon high fiber foods and a diverse diet, exercising and maintaining a healthy weight, spending time outdoors and avoiding antibiotics unless absolutely necessary ( Remember: Anti-biotics are useless against viruses!) In addition certain complex carbohydrates are considered to be “ resistant starches”, that do not degrade within the biome. These include: oats, and other whole grains, rice that has been cooked and cooled ( Yes, that’s right, rice that has been in your refrigerator for a while is better for gut health than straight from the cooking pot), as well as cooked and cooled potatoes. Almost all legumes are good for the biome as well. In general, one should increase the intake of fruits and vegetables, as well as other specific foods like fermented soybeans ( natto), kimchi, sauerkraut, kombucha ( low sugar only), fermented bitter melon, yogurt ( sugar-free) and kefir.
As we age, our qi declines at the source, and symptoms of weakness deepen. As the jing (essence) declines, so does out ability to fight off diseases. That’s why it is recommended that people over the age of sixty-five stay away from the public. This is a pretty broad stroke, as such public dicta need to be. Many people over sixty five remain robust and vigorous and not highly susceptible to infection, but the overall assessment of Kidney Qi, which is this source energy, is a more complex situation. Some of the basic symptoms of kidney weakness involve pre-mature aging, exhaustion ( fatigue characterized by the need to sleep), slow recovery from infections illness, loss of physical strength, weakness of the low back and knees, and degeneration of the sense organs, especially hearing. Deficiency illness in general involves a complex of symptoms, not just one, as well as a pre-existing history of ongoing complaints.
We are able to identify these symptoms before the disease “becomes great”, and strengthen these weaknesses to assist the Righteous in its fight against pathogenic factors. Righteous Qi ,as it is defined, is not just the integrity of the immune system, but involves the totality of all aspects of body function, particularly the ones we’ve noted above, which are the organs that provide the sources of our physical energy.
But there is another type of qi which is equally important and that is emotional qi. In Chinese medicine, each organ systems functions includes maintaining a certain emotional resonance. Anger, for example, is the emotion of the liver; sadness is the emotions of the lungs. Emotional qi derives from our root survival mechanisms, but takes on pathological resonance as it enters the realms of organs and the reactions that have been involved in trauma. Instead of merely a surge of energy, the reaction becomes stuck. This causes the qi to stagnate, and interferes with the natural balanced flow of energy. To have emotional reactions to some things is a natural human frailty, but to stay locked into that emotional reaction causes damage to our well-being just as certainly as any virus. When the mind is in an emotional state, it is difficult to make appropriate choices and bad behavior both towards self and others is often the result. The difficulty here is that the human mind is adept at making these emotional states seamless, based as they are on hair-trigger reactions that are zealously guarded from consciousness by the animal brain.
So the theory goes, anyway. You can believe it or not. But the fact is that we, as a society, are entering a very difficult and stressful period when we will all be called upon to pull together to protect ourselves and those we love from a highly contagious infection. As individuals, now is the time to put aside grudges and expressions of anger, a time for selfless behavior. Those of us fortunate enough to be with loving partners need to remember that love is a verb, not a feeling, and everyone now needs to open their hearts to all others. Now the pandemic is here, and we cannot depend on the government or the health care system to take care of us; we need to take care of ourselves and each other. The better we can do this, the better we will survive.
April 2020- Disease and our environment: The Climates of Chinese Medicine
Chinese medicine is based wholly on the observation of nature over the course of the last five thousand years: the inexorable changing of the seasons, the harmonious redundancy of the weather patterns and their vicissitudes, the five climates. The interior of the body is an entire world within that world, one where the forces of nature play out continually creating a delicate eco-system of carefully balanced climates. Immunity to disease depends upon on this harmonious flow. When it falls out of balance the individual climates become pathogenic factors.
In Chinese medicine, they are known as the Six Evils. Each of the organ systems plays an interdependent role in maintaining those climates, and is therefore uniquely susceptible to their pathology. The Spleen, for example, regulates Dampness, but when digestion is off, dampness is the pathology which most obstructs it. The Lungs maintain appropriate dryness, and it is dryness which most damages it. The kidneys are the source of all the body’s metabolic heat the kidney. We call this the Ministerial Fire. This makes the kidneys vulnerable to coldness, and when metabolic heat begins to weaken, the body becomes cold. The heart, of course, is fire and another source of internal heat and being the place where we sort out our emotions, it tends to overheat and then the fire burn too hot. This is the Imperial Fire. The climate of the Liver is wind. It’s disharmony produces it, and it is most readily damaged by it. Thus the organs are charged with maintaining the delicate balance that keeps those climates in balance and with that, the harmony of all the body’s systems.
The spleen, or digestive function, is charged with regulating dampness. Its element is Earth, and the maintenance of the earth’s moisture allows for things to grow and provide nourishment. This is done through the combined functioning of the Stomach, Large Intestine, and pancreas as well as the actual spleen viscera. This is where nutrients combine with fluids to form what is known as Nutritive qi. When the fluids are unable to move properly, dampness is created, producing inflammation of a kind. When dampness accumulates it obstructs digestion, and impairs production and movement of the proper nutrients necessary to run the body’s various systems. This dampness includes impairs not only the movement of fluids primarily through osmosis, but also the ability of the flesh to maintain appropriate moisture. When fluids accumulate and do not flow, there is a thickening of secretions, for example, or swelling of the tissue These symptoms characterize the pathology known as Dampness. On a physical level, dampness can be seen most immediately in the mucus and other fluids of the lung. The implication of this is that there is a pre-condition for diseases characterized by mucus, and that pre-condition is the inability of the spleen to transform fluids and thus to move them.
The Lungs, which along with the spleen, have the function of providing energy on a daily basis through respiration, have the complementary function of maintaining dryness, that is, promoting fluid movement through the rhythm of breath so that fluids don’t accumulate in the respiratory tract or in the skin and mucus membranes. Too much dryness is pathological to the lungs as anyone who flies a lot and just as frequently catches cold can tell you. As the Fire Element, the Heart’s principle pathology is fire, usually identified by a hyper-emotional, excitable and-talkative state which can also makes for vivid dreams and restless sleep. As the source of metabolic heat, the Kidneys are like the body’s energy plant providing both power and heat . When the Kidney fire is damaged, hypo-function and coldness result. The Liver is in charge of regulating the flow of the all the body’s systems, largely by regulating the autonomic nervous system. Internal Wind, separate from the contagious exterior wind, is the climate of the liver, and occurs when the autonomic responses are uneven, producing symptoms which alternate back and forth, or uneven movements like dizziness, tremors, spasticity or even strokes.
In our medicine, the symptoms of disease express themselves in terms of these climates: Wind Heat, Phlegm Damp, Damp heat, and so on. A simple rhino-virus attack is generally diagnosed as wind cold, for example, and so are many allergies. A bacterial infection of the upper respiratory tract is a common example of Wind Heat. When the climate is wet, dampness joins with wind and heat or cold, producing a more complex pathogenic entity. This type of exterior wind is different from liver wind; it is a manifestation of some change in the environment usually with an accompanying infectious agent. The character in Chinese actually depicts a bug that has gotten inside a house. In this way, infectious disease is a function of climate. A Certain climate supports a particular type of pathogen. In China, the Covids-19 pathogen was originally identified as Cold Dampness invading the lungs. Certainly we are talking about the presence of an infectious entity, but it is very much a product of it’s environment which then produces symptoms which alter the interior landscape of the body; the lungs in this case.
And so we cannot separate infectious disease from the environment; especially one the size and scope of the Covid-19 virus. A virus as virulent as Covids-19, which has created a world-wide pandemic, can only occur when the natural order is disturbed, greatly disturbed. Otherwise it would not have gotten to this point where it can overpower human immunity so broadly and so deeply. One reason we are having so much trouble even beginning to understand it, is that we have never in history seen a virus as contagious or as deep in the range of presentations: from virtually none at all to fatal pneumonia
Covids-19 is a pretty powerful indicator that the symbiotic relationship between people and viruses is badly out of tune. Mother Nature is definitely off her feed. Viruses have lived for eons; they were here long before we were. But it has always been a relatively harmonious relationship, a symbiotic one. The virus needs nourishment from the host and it needs to keep the host alive and functioning in order to do this. Occasionally, the balance is broken and disease appears. The human host boosts it’s immune responses, and the virus subsides, regroups, and figures another way to infest the host. And for years human immunity evolved together with the evolution of these bugs (and make no mistake, these bugs have evolved!) But in the age of what we euphemistically refer to as “ global warming”, quite clearly viruses have gained the upper hand. There are quite a few reasons for this; these are complex situations.
In an article entitled “ Corona Virus: a Time for Us to Awaken”, the QI Gong Master Jwing Ming Yang ( see Resources/Books above) describes this pandemic as a wake-up call for the entire human race. He says,
“ Although advances in science have enabled us to live more comfortably and conveniently than ever before, they have also caused us to rely too much on external remedies for our health and well-being. Nowadays, we often hide behind a wall of technology and chemicals to get better. Our natural immune systems have become unnaturally weak and compromised as a result. We have become “greenhouse” people, seemingly unable to survive without the high-tech amenities and drugs that have become so commonplace in today’s world. In the process, we have been changing nature on a global scale.
“We have lost our relationship to the world around us”, he goes on to say,” the nature of humans contradicts, damages and even alters the nature of the world we live in. Our habits and beliefs seem to encourage and promote a desensitized, incomplete understanding of nature.” Our way of living does not show any signs of imminent change. Life in the twenty-first century is incredibly complicated; we are certainly talking about theories of complex systems. But conscious people need to focus their energy on the environment with desperate urgency. It is no longer a hypothetical that if we don’t do this or that, then in thirty years Beverly Hills will be beach-front property. The future is already here. Humanity is at a crossroads, and the sooner we get started repairing the damage to our planet, to our health-care system, and to our souls, the better chance we have to make it to the twenty-second century.
The world as we know it will be dramatically changed when this scourge is over. We’re going to have to find new ways to live, new ways to be self-sufficient. Strength of character and higher consciousness towards all of humanity will be needed. We’re going to need to define how we stand in relationship to nature and to our fellow man, and figure out a way to drag the politicians and the corporate monsters along with us. The environment is no longer an “issue”; now it is for real and it is urgent. If this pandemic is not met with the appropriate urgency, the next pandemic will be along directly, and it will be even worse. And the solution is not simply to bring it under control with yet another vaccine, which is certainly critical at this point. Vaccinations, on the one hand, are an important part of public health, and we are all praying a for the right one to come along sooner than later in the case of the Covids-19 virus. On the other hand, as Dr. Wang points out, vaccinations do not make the immune system stronger. The immune system needs to be left alone to work out its own solutions to infectious diseases. We need to return to nature in a way that makes sense in the high-stress, hi-tech twenty-first century.
One of the cardinal points of our Taoist philosophy is “ observe and allow.” Quite simply this means dropping the bullshit our emotions have created in our minds, and to allow reality in so that we can find real solutions. We’re going to have to come together for common purpose. This begins on a personal level. Yes. This is a clarion call for natural methods; natural medicines, wholesome diets and proper exercise, but even more importantly, it is call for an elevated consciousness which is increasingly critical to human survival.
I welcome questions or comments. Please email me at: david@twosagesacupuncture.com