Monthly Archives: July 2013

The Chinese Health Troubleshooting System : It’s Elementary, My Dear Hua-Tu-Sun

Day 12

by Gene Chuah

Q: “How do you eat an elephant?”
A: “One bite at a time.”

We are all familiar with the phrase “divide and conquer”. Sculptors know this. They start with a big piece, hack away big chunks, make sure all the proportions are correct, before refining the features. Even modern Web browsers do this — they preload a fuzzy image before overlaying increasingly finer layers. In Traditional Chinese Medicine, we go from general to specific in making a diagnosis. There are several key “ley lines” in this troubleshooting system, and they are the 8 Principles Of Pattern Identification. Pain, in relation to these 8 Principles, is also an indicator that can give us more clues to solve the puzzle (chart below).

Below: The 8 Principles Of Pattern Identification
(1) Yin
(see physical traits list below)
vs. (2) Yang
(see physical traits list below)
(3) Cold
to treat: heat up
vs. (4) Heat
to treat: cool down
(5) Interior (organs)
to treat: harmonize organ(s)
vs. (6) Exterior (limbs, skin)
to treat: push out, expel
(7) Deficiency
to treat: increase, tonify
vs. (8) Excess
to treat: reduce, sedate, detox
Below: Yin-Yang Physical Traits For Diagnosis
Yin † Yang ‡
chronic disease
(longer-term, usually at interior)
acute disease
(shorter-term, usually at exterior)
slow onset of symptoms sudden onset of symptoms
pale complexion flushed complexion
cold limbs & body hot limbs & body
likes heat, hates cold likes cold, hates heat
prefers hot drinks prefers cold drinks
likes to curl up throws clothes off
tiredness restlessness
sleepiness insomnia
introverted extroverted
quiet and still loud and hyperactive
obsessive, nervous, agitated, timid
(inward energy)
aggressive, angry, confrontational
(outward energy)
calculating and meticulous takes risks
frail strong/sturdy
shortness of breath heavy breath
dislike speaking over-talkative
reduced appetite excessive appetite
watery stools dry stools
frequent, abundant, pale urination scanty dark urination

Example:
+ nausea <- Excess
+ vomiting with strong force <- Excess
+ heartburn / acid reflux <- Heat
: this is Stomach (Interior)
Treatment: reduce Excess Heat in Stomach.

A wrong treatment is made when, rather than reducing something extreme (and bringing it back into the middle of the scale), we instead make it even more extreme. For instance, instead of reducing Heat, we increase it. This could happen if we don’t identify symptoms from the 8 Principles correctly. A bit of a misnomer actually, I would prefer calling them The 4 Dimensions, so let’s also use this term.

Some examples of wrong treatments involving the Interior-Exterior dimension:
1. Fever-reduction medications -> lower fever -> impede Wei-Qi expelling-Heat -> drive pathogen inwards instead of expelling outwards -> illness is worsened, becomes chronic.
2. Corticosteroids to treat skin issues (at Exterior) -> push Heat inward rather than expel -> Liver damage (eventually).

Notes on some of these Dimensions:

 
Cold vs. Heat

A. Etiology (root causes):

1. External factors / pathogens (4 of the 6 Evils : Wind, Cold, Heat, Damp)

2. Diet (food & drink)

3. Emotions (from Day 10)

Anger -> Heat
Sadness -> Cold
Worry, Pensiveness -> Cold
Fear, Shock -> Heat -> Cold
Joy (Overexcitement) -> Heat

4. Overexertion (physical)
4_imbalance_conditions
With physical overexertion, whichever “level” is lower (this chart above) than the other, will be amplified (even lower). So someone with a Yin Deficiency will have even less Yin and therefore relatively more overall Heat in their system.

B. Mixed patterns for Cold vs. Heat

Example: Heat in upper body, Cold in lower body.

Transformation of energy.

Example: Wind Cold -> Wind Heat (Wei Qi)
Example: Fevers -> burn out Qi -> Cold

C. True vs. False Cold & Heat

One type of “energy” may have a response or “echo” elsewhere of the opposite energy. Do not be deceived, find the “true” or initial imbalance. Usually the energy at the Interior is the true one while the Exterior is false.
Example: body core has high Heat, but limbs are Cold. Stagnation somewhere blocking the flow to the limbs is correct here, but this may or may not be the root cause; dig deeper; in any case Heat is the true problem here, not Cold (false).

 
Excess vs. Deficiency

A. Shows the strength/weakness of the body’s Qi OR presence/absence of the external factor/pathogen (4 of the 6 Evils).

B. Expressed through the strength/weakness of the symptoms (how big or small).

C. Subtypes:
excess_deficiency_symptoms_tree
There may be clusters of symptoms which can be grouped under an Organ. As a practitioner, once you know the general direction of your diagnosis, dig in deeper in that direction to find confirmation — this may entail asking the patient more questions to confirm your hunch.

An example of the “full vs. partial” concept:
Yang Excess : full red face
Yin Deficiency : partial (cheeks only) / less red

Some examples on how to identify Excess vs. Deficiency:

Example: general weakness and fatigue <- Qi Deficiency
Example: strong, stabbing, sharp headaches <- Blood Stasis
Example: tinnitus — constant “seashore” sound, especially at night <- Excess
Example: tinnitus — constant whistling, high-pitched, strong buzzing <- Deficiency

One test to determine which type of tinnitus (Exc vs. Def) is the “clap test”. Clap next to the patient’s ear. If the problem goes away temporarily, it is Deficiency (lacking and likes additional energy); if it is aggravated, it is Excess (too much, dislikes more added energy).

What’s outside amplifies what’s inside. Environmental (external) factors will aggravate any internal Excess.
Example: Shen disturbance aggravated in hot room <- Heat Excess
Example: rheumatoid arthritis aggravated on humid days <- Damp Excess

 
Pain, with the “what” and the “when”, is an additional tool to help us complete the picture and zoom in on our target, particularly in regards to Deficiency vs. Excess and Cold vs. Heat.

Below: Mechanism Of Pain In Relation To (4 Of) The 8 Principles Of Pattern Identification
Deficiency Excess Cold Heat
Description dull, lingering sharp, excruciating cramping, spastic burning
Pressure relieved aggravated - -
Temperature - - relieved by heat relieved by cold
Onset slow, gradual sudden - -
Rest better with rest worse with rest - -
Activity worse with activity better with activity - -
Position better lying down better sitting up - -
Food relieved abdominal pain aggravated abdominal pain relieved by hot food,
aggravated by cold food
relieved by cold food,
aggravated by hot food
Bowel Movement worse after evacuation relieved after evacuation - -

 

Fu Organs in the spotlight!

In last Monday’s class, of the Zang-Fu Organs, we covered the Zang (Yin) Organs. Now we cover the Fu (Yang) Organs. Note that it’s a much smaller spotlight though.

 
Gallbladder : Minister of Justice

The Gallbladder is categorized as an Extraordinary Organ because it is hollow, like all Yang (Fu) Organs, but also stores pure essence like all Yin (Zang) Organs.

1. Stores and excretes bile.
Bile is considered a surplus of the Liver, a pure essence. The Gallbladder assists in digestion (bile helps digest fats via emulsification). It is mostly regulated by the Liver, but still works quite independently.
In dysfunction, e.g. Damp Heat, there can be a bitter taste in the mouth due to excess bile (accompanied by nausea).

2. Controls courage.
The Gallbladder is crucial in producing courage, particularly the type needed for making hard decisions. Just as its Wood complement, the Liver, is responsible for vision and strategy, the Gallbladder gives one the courage to act on the vision/strategy. In TCM, the Gallbladder is like a judge who needs to make correct choices which the crowds may not like.
Pathology: Gallbladder Qi Deficiency will cause a shrunken ability to act, or timidity.
gallbladder_timidity_vicious_cycle
3. Controls the movement of the sinews.
The sinews are the tendons and ligaments. Note the different roles of the Wood pair:
Liver -> Blood -> lubricates sinews
Gallbladder -> Qi -> creates movement of the sinews

 
Small Intestine : Minister of Reception

As mentioned in Day 9, the Small Intestine is responsible for separating the pure from the impure. At the time of its activity (1pm-3pm), it is time to start winding down after the peak of day, and to decide what can be done today and what should be left for tomorrow.
small_intestine_refining The Small Intestine enables us to prioritize, a quality of Fire Element. In dysfunction, e.g. ADHD, one is unable to focus and can’t pick out the needle from the haystack of other distractions.

 
Stomach : Minister of the Mill

1. Enables rotting and ripening of food.
organ_directions_1_spleen The Stomach is one big fermentation crock. It contains both Fire/Yang, as well as Water/Yin, needed for fermentation. A common dysfunction of the Stomach is excessive Fire, resulting in: quick hunger (burns food up too much without deriving pure essence), thirst, foul smell (halitosis), bleeding gums (<- Yin Deficiency), and Rebellious Qi symptoms : heartburn / acid reflux, vomiting, nausea.
Typical Stomach dysfunction: Stomach Fire, Stomach Yin Deficiency (both Heat).
The Stomach sends Yang to the Spleen, while the Spleen sends Yin to the Stomach; they energetically balance each other out when healthy.

2. Controls transportation of food essences.
The Stomach works with the Spleen to provide food essences mainly to the muscles and limbs. Chronic fatigue/weakness in the muscles/limbs is the first sign of weakness of the Stomach.

3. Controls the descending of Qi.
See above diagram, blue arrows.

4. Is the origin of Body Fluids.
See diagram.

The Stomach is linked to the Large Intestine via an energetic channel. Imbalance can produce bloating and gas.

 
Large Intestine : Minister of Transportation

The Large Intestine moves impure substances (“dirt”) downward and excretes them as stool. The Large Intestine is associated with “letting go” while its Metal complement, the Lungs, is associated with “taking in”.

As Emotions can affect Organs, someone who is afraid of letting go, will also experience constipation. On the flip side, someone who has been abused will want to let go of the trauma and will tend toward diarrhea.

 
Bladder (urinary) : Minister of the Reservoir

The Bladder is Qi-powered by the Kidneys. It is also one of the Organs involved in the Qi transformation process (see diagram), separating pure from impure, and removes fluids from the body in the form of urine.

In dysfunction, ischuria (urine retention) can be caused by Bladder Dampness (-> urinary tract infection, UTI) or by Kidney Qi Deficiency (no pushing power).

Most of the pure essence/Qi refined by the Bladder goes upward to the Small Intestine.

 
San Jiao : Triple Burner/Heater/Warmer

1. Responsible for proper functioning of the 3 Jiaos.
3_jiaos The San Jiao regulates (1) body temperature, (2) movement of Body Fluids, and (3) the passage of Qi among the 3 Jiaos. During its peak time of 9pm-11pm, it is important to be laying horizontal (and asleep) in order for it to work best in cooling down the body (Yang -> Yin) for a good night’s sleep.

If the San Jiao fails to do its job, the body will face a serious, systemic problem (heat buildup in some areas, lack of heat in others).

2. Is an avenue for Original (Yuan) Qi.

There are 3 avenues for the Yuan Qi, one of which is the San Jiao. The other 2 are: the Kidney channels, and the Extraordinary Vessels (e.g. the Du + Ren, which are the reservoirs for surplus Qi and Blood).

 

Why Men Are More Hairy Than Women (Generally Speaking); Ancient Lore Explains Sexual Dimorphism

Day 11

by Gene Chuah

male_female_lion

Why do men have more facial and body hair than women, generally speaking? And why does facial and body hair start appearing in menopausal women (or so I’ve been told)? In Traditional Chinese Medicine, the answer lies in the distribution of Blood as a vital essence. In women, especially of childbearing age, Blood is allocated toward the reproductive system (situated in the Lower Jiao, or lower one-third of the body). Men, on the other hand, are more Yang in nature, and remember that Yang tends to rise up (Yang equates to Heat as well, and we know that heat rises up). So Blood that would have been allocated to the ovulation cycle in women are used for growing beards and body hair, in men. Neat huh? For post-menopausal women, however, since the Blood is not longer allocated to the baby-making machinery, you can guess where it gets reallocated. [Note: Dwarven women from Lord Of The Rings are an exception, they have beards just like the men.]

sexual_dimorphism

This also explains why most male mammals also have some kind of growth on their heads — antlers, horns, tusks, whiskers, manes, for instance. Come to think of it, most males in the animal kingdom are more colorful, have more muscle mass, or have specific physiological structures that the females do not have. This is called sexual dimorphism, and here are more visuals. Of course, there are exceptions in the animal kingdom, where the male is a total nobody in some species (e.g. spiders, and the triplewart seadevil).

male_female_deer

Above: male (L) and female (R) deer.

Interestingly enough, Deer Antler (Chinese: 鹿茸; pinyin: lù róng) happens to be a Blood tonic. This makes total sense — if surplus Blood was used to create it, then it must be good for replenishing depleted Blood! See what the Interwebs has to say on this topic.

TCM recognizes the hair to be an extension of the Blood. “If one’s Blood is nutritionally complete and rich, the hair will be thick, lustrous and keep its color. If Blood is deficient, or if it is somehow obstructed from properly flowing to and saturating the scalp, the hair will wither.” –[source]

It should be noted, however, that head hair is governed by the Kidneys, while body hair is governed by the Lungs, whereby Lung Qi drives Blood outward to the skin to nourish body hair.

In yesterday’s class, we covered all the Organs in greater depth. Prior to this point we had discussed the Organs and their interactions, but never gave them their own spotlight. Now, they get to be the stars of the show.

The Organs are grouped in Yin-Yang pairs by Element (see previous lessons), and the Yin Organs are called Zang, while the Yang Organs are called Fu. When their wonder-twin powers unite, together they are the unstoppable Zang-Fu (臟腑).

Again keep in mind that these Organs do not always correspond strictly to the physiological organ, and in fact one of them, the Triple Burner (San Jiao) has no actual physical form or location. In another example, the physical spleen, according to Western science, works as a blood filter and is part of the immune system; however in TCM it is equated with digestion and providing energy. The important thing is that this is a framework or model of understanding that works. In an extreme example, even if someone has had their Gallbladder surgically removed, the energetic equivalent of this Organ is still there and we can still work with it. Wikipedia calls TCM Organs functional entities. So don’t get confused if they don’t correspond literally to physical organs studied via the Western scientific method.

Here’s the list of the Zang-Fu :

ZANG ORGAN (YIN)
Solid Organs that store vital / pure / essential substances. Yin because less active, and has dormant/potential energy.
FU ORGAN (YANG)
Hollow Organs that receive, process and dispense; can be like a gate or pump; Yang because more active.
Liver Gallbladder*
Heart Small Intestines
Spleen Stomach
Lungs Large Intestines
Kidneys Bladder (urinary)
Pericardium Triple Burner (San Jiao)

* Gallbladder is the exception on this list, and is considered an Extraordinary Organ because it is recognized to be BOTH Zang and Fu (it stores essence, but there is also lively movement through it). The other Extraordinary Organs are: the brain, marrow, uterus, bones, and blood vessels.

Now on to the Organs. I will be reusing the directions-of-Qi charts I used from Day 6.
 

 
LIVER : The General / Chief of Staff
organ_directions_5_liver

1. Maintains free/smooth flow of Qi (flowing & spreading).

a. Influences emotional state.
Remember that the Liver is the “energetic fan”, and that emotions are a type of energy (Qi). So, the Liver plays an important role in keeping the Emotions moving — remember that “the only bad emotion is a stuck emotion”. The Liver helps to smooth out one’s moods; without its proper functioning, mood swings and irritability will manifest.

b. Influences digestion.
In the Control Cycle, the Liver (Wood) is the grandparent to, and influences, the Spleen (Earth). When healthy, the Liver supports the Spleen in digestion, but in an imbalance condition, it can negatively affect digestion. For instance, stress->frustration->anxiety manifests in the Liver, causing it to “overcontrol” the Spleen, resulting in IBS.

c. Influences flow of bile.
In TCM, Bile is a surplus of Liver Qi, and a pure essence.

2. Stores the Blood
The Liver stores the Blood (it is like a sponge that fills with Blood especially at its peak of 1am-3am, during which time it is important to be laying down, preferably asleep. The Liver regulates the volume of Blood and circulates it among the Organs.

3. Controls the sinews
Sinews = ligaments + tendons. This includes joint mobility, and in a sense the Liver is important for mobility in general. Stiffness and numbness especially in the joints point to Liver weakness. For instance, arthritis tremors are due to Liver + Gallbladder issues. Remember that Wood is the Element of motion.

4. Manifests in the nails
In TCM, the nails (fingers, toes) are an extention of the Sinews, a surplus of Liver Qi. Nails are an excellent diagnostic tool for the Liver. Specks in the nails, soft, brittle, easily broken nails are a sign of Liver Blood Deficiency. To tonify your Liver, include this organ meat in your diet.

5. Opens into the eyes
The Liver is in charge of vision. Blurry vision, floaters, night blindness, “seeing stars” are all signs of Liver Blood Deficiency. Sensitivity to light, on the flip side, is a sign of Liver Qi Stagnation (Excess).

6. Houses the Ethereal Spirit, or “Hun”
The Hun (Chinese: ; pinyin: hún; literally “cloud-soul”) (pronounceed “hoon” with an upward tone as if asking a question) correlates to the Astral Body. It is “second in command”, whereas the Shen is the highest spirit of consciousness in a person. Like the Shen, it is also immortal, so it does not die with the physical body. The Hun is responsible for sleep and good dreams. 11pm-3am, Wood Element Time, is when the Hun is working hardest, actively driving and processing your nighttime dreaming. Note: some say that when you dream, you travel to the astral world. Recurring “almost-died-from-falling-but-awoke-with-a-start” dreams are a sign of Liver Blood Deficiency.

NOTE: Many traditional frameworks explain that the human body is actually made up of several different bodies that occupy the same space, almost like layers. Explore further here. It is the same idea in Chinese philosophy. For a more detailed breakdown of the soul in TCM, take a look at this article by Giovanni Maciocia. TO DO: map the “Western” planes/bodies to the Oriental “spirits”.

 
 
HEART : The Emperor
organ_directions_4_heart

1. Rules the Blood and blood vessels
The human body can be thought of as a microcosm of a (Chinese) kingdom, with the Heart (Emperor) at the center. The Emperor in ancient times was thought of as God’s representative on earth, and this corresponds with the Heart housing the Shen, which is the spirit, or consciousness, of the person. The ancient Chinese were concerned about keeping out the evil invaders, and this corresponds to the body’s continually shielding itself from external Evil Qi. Because the Shen is sensitive, an emotional root cause can “unseat” it — causing, for example, a Heart Blood Deficiency that results in insomnia, anxiety, poor memory, and “fright palpitations”.

2. Manifests in the complexion.
The complexion reflects the health of the Heart.
e.g. Pale <- Qi & Blood Deficiency
e.g. Pale + dull <- Blood Deficiency
e.g. Purplish <- Heart Blood Stagnation (milder) or Stasis (worse)
e.g. Strong Red <- Heat in the Heart
e.g. Pinkish <- good health!

3. Opens into the tongue.
The Heart, with a balanced Shen, governs coherent speech. Through tongue diagnosis we can tell the health of the Heart. For instance, if the tongue tip is red, it points to Heat in the Heart, which usually means a disturbed, irritable Shen.

4. Houses the Shen.
But you knew this already since we’ve been talking so much about it in my past articles. Shen (Chinese: ; pinyin: shén; means spirit, soul, mind, god, deity, supernatural being) is pronounceed “shurn” with an upward tone as if asking a question, and without rolling the R.

Heart disharmonies caused by: “could be anything” because the Shen is sensitive.

 
 
SPLEEN : Minister of the Granary
organ_directions_1_spleen

1. Governs transformation & transportation

The Spleen transform Food into pure and impure essences.

From Li Dongyuan, A Treatise on the Spleen and Stomach (Piwei Lun), 1249:
The Stomach is called the sea of grain and water. Once food enters the Stomach, its essential energy is moved upwards to infuse first the Spleen and then the Lung. In this fashion, the command of spring and summer is being carried out, and the entire body receives nourishment. This is due to the influence of clear heavenly Qi.
Once the ascending motion has reached its climax, this current shifts directions and flows downwards toward the Bladder. In this fashion, the command of autumn and winter is being carried out, and the waste becomes processed and the flavors will manifest. This is due to the influence of turbid earth Qi.

The Spleen sends its nourishing energy (Qi) upwards to the Lungs and mind, as well as to the muscles and limbs. Someone who is low in energy (you need muscle strength to move around) probably has a weak Spleen. Other symptoms are: bloatedness/gas, soft stools, weak concentration, poor appetite, nausea. This is usually equated with Spleen Qi Deficiency -> poor digestion -> unburnt food -> Dampness -> lack of appetite/thirst.

2. Controls Blood.

a. Main Organ in Blood production.
Day 6 seems to agree.

b. Holds the Blood, keeps it in the blood vessels.
Remember that “Qi is the mother of Blood” — Qi moves and holds Blood. The Spleen also is also a key player in “holding” Blood, so with Spleen Qi Deficiency, this capacity is weakened, resulting in things like menorrhagia (excessive menstrual bleeding), hemmorhoids, varicose veins or chronic bruising.
Blood in the stool is a sign of Heat in the Blood. Here is one vicious cycle that could happen with Blood Heat:
spleen_heat_vicious_cycle3. Controls muscles and limbs.
This is true in the sense that the Spleen provides the fuel for the muscles, and it is the first place to look to show Spleen weakness (Spleen Qi Deficiency). Weak muscles & limbs, tiredness, and even eating disorders. Either extreme in eating behavior is Spleen dysfuntion — whether anorexia, or the opposite (overeating). Note the depleted muscles in anorexia. It’s all Spleen!

4. Opens into the mouth, manifests in lips.
The Spleen is the “control center” when it comes to the sensation of taste, allowing us to differentiate among the 5 flavors. Illness or usage of antibiotics will hinder this (antibiotics kill friendly gut bacteria as well). Lip color is a reflection of Spleen health. The usual rules apply:
e.g. pale <- Spleen and/or Blood Deficiency
e.g. purple <- Spleen Stagnation (Qi/Blood)

5. Regulates/controls the ascending Qi.
This relates to (b.) above. Holding power. Dysfunction: prolapse of the uterus, anus; hemorrhoids, varicose veins, hernia, chronic diarrhea (<- rebellious Qi).

6. Houses the Thinking Spirit, or “Yi”.

Yi (Chinese: ; pinyin: yì; means “thought”) is pronounceed “ee” with an assertive tone as if there’s an exclamation mark after it. “Hunger for knowledge”, “food for thought” — these phrases originated for a reason. The Spleen is also called the “second brain”, and in Chinese there is a saying that “a thought originates in the Spleen and culminates in the Heart” (here Heart, as Shen, represents the mind or consciousness). The Yi (intellect) enables cognitive analysis and mental focus/concentration.

Dampness can affect the Spleen, resulting in Worry and Pensiveness (and vice versa, as Emotions can also affect Organs). Like someone lost in a damp swamp, going in circles.

Spleen is Earth Element, which represents stability, family, home, love, caring and warmth. Any harm to the Spleen damages the Yi, which affects the ability to learn. Due to the loss of communal/tribal support in modern society, the Spleen is under threat and learning disabilities are becoming more common, as are eating disorders.

Spleen disharmonies caused by : (1) congenital factors (2) foods that are cold, raw, sugary, dairy, yeast, flour (3) excessive worry, pensiveness (overstudying), and (4) medications, especially antibiotics.

 
 
LUNGS : Prime Minister / Foreign Minister
organ_directions_2_lungs

1. Rule the Qi and respiration.

a. Produce pure Qi from the air.
You need clean air in order to produce strong Lung Qi. Polluted air will overburden the Lungs.

b. Control the upper “Sea of Qi”.
The Lungs are the main source of Qi in this region, providing Qi even for the Heart. They also play a part in the energetic circulation through to the Lower Jiao, and if this flow is disrupted, the upper part of the body will get overheated relative to the lower (as in the case of a coma). Since Lungs govern the Upper Jiao, any deficiency will cause coldness in the Lungs and arms. Here is an image from Day 6 to applies to this energetic circulation:
organ_directions_6_lungs-heart-kidneys

2. Control the 2 directions of Qi.

a. Descending.
Downward to Kidneys. Disharmonies: asthma, shortness of breath, cough (<- rebellious Qi), shallow/faint voice.

b. Dispersing/circulating.
Outward to supply Wei Qi, warming the skin and muscles.
Lung Qi = “mist”, and as it disperses outward as Wei Qi = “spray”.

3. Control sweating via skin pores.
Sweating expels excess Heat generated by the Wei Qi. If Wei Qi is weak, it will be unable to control the opening and closing of the skin pores, resulting in their random opening/closing. This lets in pathogens, or causes spontaneous sweating (cold sweats, a waste of pure essence), or disallows heat to escape by remaining closed (this can also lock in the pathogen).

4. Move and adjust the water passages.
a. Descending. : sends Mist down to the Kidneys.
b. Dispersing/circulating. : keeps skin moist.

5. Control skin and body hair.
As mentioned earlier, Lung Qi sends Blood to the skin to nourish body hair (as opposed to head hair which is nourished by the Kidneys).

6. Open into the nose.
“The nose is the window to the Lungs, the throat is the door to the Lungs.”
Problems with the nose usually points to the Lungs.
Lungs are also known as “the tender Organ”. In the role of Foreign Minister, they are the interface between the body’s internals, and the outside world.
Problems with the throat (e.g. tonsilitis, sore/strep throat) usually points to the Lungs.

7. House of the Physical Spirit, or “Po”.

Po (Chinese: ; pinyin: pò; literally “white-soul”) is pronounceed “p’ho” (aspirated P) with an assertive tone as if there’s an exclamation mark after it. It allows you to feel physical sensations, e.g. skin pain. It dies with the physical body and is not eternal (unlike the Shen or Hun). The Po is equated with physical presence and even confidence, if you will picture a strong male elk or gorilla puffing up its chest to establish its dominance and physicality. Puffing up one’s chest needs a strong pair of Lungs for sure.

The anus is called “Po Men” (pronounced more like “muhn”) (魄 門), meaning “the gate of the Po”, and remember that the Large Intestine is the Yang partner to the Lungs (both Metal). The Large Intestines are related to excretion and “letting out” where the Lungs take in; they are both considered to be the same energetic channel.

Lung Disharmonies caused by: (1) congenital factors (2) external pathogens (3) excessive sadness, grief, worry (4) polluted air (5) poor posture, constriction, sedentary.

 
 
KIDNEYS : Minister of Power
organ_directions_3_kidneys

1. Store Jing essence, dominant role in: birth, development, reproduction, fertility, ageing/longevity.

2. Rule water metabolism. Control Bladder, urine.

3. Grasp Qi from Lungs.
One of the charts above, shows this.

4. Manifest in head hair. Premature balding, greying, if Kidneys weakened. Hair color is a better indicator of Jing health than balding, since male baldness can vary by race or lineage.

5. Open into the ears. Hearing issues are Kidney-related. Hey, they happen to have the same shape outline too (so do the ovaries and testes, which contain Jing). As Jing diminishes in old age, loss of hearing creeps up as the Kidneys fail to nourish the ears.

6. Control the bones and teeth.
As Jing diminishes in old age, bones and teeth weaken (osteoporosis). Kidneys also nourish the brain (as Jing matter, not the mind), head hair, bone marrow, uterus and testicles.

7. House the Zhi

Zhi (Chinese: ; pinyin: zhì), is pronounced “chir” with a very short/flat vowel, no rolled R, and assertive tone as if with an exclamation mark. Video how-to here (<- tone-neutral).

Jing, as pre-natal life-force essence, is needed for life, correlated with lifespan, and in dire physical situations, is used up rapidly to "save" someone in danger. Think of it as dipping into your life-savings in an emergency. Zhi relates to physical will, because when you are determined to do something (physically), the Zhi mobilizes Kidney Jing to achieve what is needed. There have been wartime stories of soldiers who suddenly had the superhuman strength to throw multi-ton bombs overboard before they could detonate, and stories of mothers who are able to lift cars off their babies -- these could be attributed to Zhi and emergency Jing usage.

Kidney disharmonies caused by: (1) congenital factors (2) diet (too much salt) (3) medications, especially chemotherapy (<- burns Yin) (4) chronic fear (stress) -> Kidney Yin Deficiency (adrenaline is Yang which burns Yin).

 

The Organs Weep The Tears The Eyes Refuse To Shed

Day 10

by Gene Chuah

“The organs weep the tears the eyes refuse to shed” — Sir William Osler, 18th-century physician.

We now explore the topic of mental and emotional disharmonies in Traditional Chinese Medicine.

We often hear about the mind-body connection in new medicine; sometimes also the mind-body-soul connection. In holistic healing, we do not treat the body and mind as separate — in fact one affects the other, and this is something that the Chinese have known for more than 2000 years. The key principle here is that there is no difference between mental and physical illness!

In Traditional Chinese Medicine, we recognize the 7 Emotions and how they cause disease in the body. In TCM, it’s “all about the energy” (Qi), and there is functional (good) energy that flows in the body (and in the aura, according to other systems like Pranic Healing). However, this Qi can get stuck, become stagnant, and manifest as negative or polluted energy, which can cause disease.

Each Organ is also correlated with a particular Emotion, and likewise, can accumulate the stagnated energy of this Emotion if it is in excess, or due to dysfunction. This makes sense if we think of the Organs as energy centers, which are attuned to a specific frequency or wavelength of energy. (In traditional Indian medicine, this is a similar idea to the Chakras (energy centers), each of which governs a particular related set of emotions or abilities; ascending vertically from the primal to the refined.)

Breaking it all down :

(1) Emotions are a type of energy (different Emotions have specific frequencies).
(2) Qi flows through the body.
(3) Qi is energy.
(4) Each Organ is attuned to, and acts as a storehouse for, a specific Emotion.
(5) Excess / blocked / stagnated energy in an Organ manifests as disease.

Therefore, we can deduce that the following are true :

(A) Treating the Organ will help correct the associated Emotional imbalance, and
(B) Addressing the Emotion will help correct the associated Organ imbalance.

Simplified :

(A) Organ –> Emotion
(B) Emotion –> Organ

… and in fact, this is recognized in TCM to be true (see Day 2)! For instance, someone who faces a lot of frustration will experience a lot of Anger, and if they don’t know how to channel this Emotion (a type of energy), it will cause Liver Qi Stagnation, which in turn disrupts the normal functioning of the Liver (causing other problems down the chain). The converse is also true: someone who develops Liver Qi Stagnation, due to other factors not related to Anger, will start to experience Anger more quickly because this energy is not able to flow through their Liver, and it gets stagnated in excess (think traffic jam).

Here are the Organs and their corresponding Emotions :

Organ Emotions
Liver Anger
Heart Joy (overexcitement)
Spleen Worry & Pensiveness
Lungs Sadness
Kidneys Fear & Shock

In treating mental / emotional disorders, Traditional Chinese Medicine actually has more options over conventional medicine, in the sense that :

(1) diagnosis is not locked-down and rigid, and
(2) treatment is possible for “incurable” conditions.

Let’s take a closer look.

 
(1) Diagnosis is not locked-down and rigid

In conventional psychiatry, a patient is diagnosed for mental illness by looking at his or her symptoms / behaviors, and then figuring out which “label” can be attached to the patient. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the guidebook used by psychiatrists to label their patients. But does it mean that the “cure” is clear, since we know their diagnosis? How is each diagnosis treated? Could it be that these labels are what psychatrists use when they don’t know what’s really wrong with a patient? What about the in-betweens, the patients who don’t fall neatly into any one category?

Let’s just take a look at some of these classifications: schizophrenia, anxiety, ADHD, dementia, depression, dissociation, mania, bipolar disorder, psychosis, personality disorders. Each one is just a name label with a set of symptoms! Each one is assumed to have no real “cure”, and treatments are mostly drug-based, focused on suppressing symptoms and disease management (that happens to be where the money is too).

Due to the rigidity of diagnoses in conventional medicine today, our treatment options are limited. Why? Simply because you can have a set of symptoms, give it one name, but from patient to patient, it could be different a root cause! There is an excellent article by Mike Adams (with cached snapshot here) that explains this perfectly. He says, “there is a curious tendency in conventional medicine to name a set of symptoms a disease”. My personal opinion is that these disease names have a “paralyzing” effect on the reader’s mind and are intented to obscure the true cause of the disease. “What, she has Shingblington’s Non-Necromicrotizing Sharkinoma? Oh dear, I guess the doctors know best then what pills she needs.” Disease names like these make people instantly shut off their brains and effectively relinquish control of their own health since it is beyond them and no longer intuitive.

In TCM, however, things are not so cut-and-dry, and there is the recognition that each patient is unique, that there are many factors that all work together to cause a set of symptoms or dysfunctional behaviors. By looking at the whole picture in an open-ended but thorough manner, the practitioner is able to piece all the clues together and find the Organ(s) affected, as well as the root cause(s) of the disharmony. Again, there is no separation between physical and emotional / mental issues; so insomnia, anxiety and hysterical mania are really on the same scale and could have the same root cause (Heart dysfunction and/or stress), pointing the way for a treatment approach. This freedom from locked definitions is a good thing, because at the end of the day, we are treating the patient as a unique individual with unique circumstances, and not merely pinning a one-size-fits-all label on them.

 
(2) Treatment is possible for “incurable” conditions

In TCM, there is no such thing as idiopathic disease. Because the symptoms form a pattern and point to the root cause(s), we can treat it!

With mental / emotional illness, you can either treat the Organ or address the Emotion, or even better, do both. One helps the other, leapfrogging the patient out of the pit. Let’s go back to the example of Mr. Angry. He has a demanding job and a demanding life. We don’t know which started first, his Liver imbalance or his anger issues, but we know that he has both. Let’s see how either approach helps :

(A) Treating the Organ : due to the excess Anger, the patient’s Liver is Stagnated. Treating the Liver for Stagnation enables it to function better and to allow the energy of this Emotion to flow more freely. Because the “traffic jam” is now unblocked, Mr. Angry does not get angry as quickly, has more clarity of thought (anger can cause blind rage, remember the Liver is related to vision), and is able to better deal with the everyday situations that normally provoke him.
(B) Addressing the Emotion : everyone faces problems, that is the nature of existence on this planet; nobody is exempt, but how we deal with problems is the key. Anger does not come from external circumstances; it arises as a response from within. A good TCM practitioner is also a lifestyle counselor, and will help the patient find solutions to the root causes of emotional issues. Anger is usually a result of frustrated goals (blocked energy), and there are ways of dealing with things. At a much higher level we could even say that many of our problems are a result of our Ego asserting itself (Dr. Wayne Dyer) and a big reason for our unhappiness and stress these days is because of our disconnection with God / The Divine / our Higher Self, and our need to “force” things as a result of our feeling inadequate as a result of this separation. Of course this is a big topic, but the point is that Emotions can be addressed directly. Back to our example, by not giving in to Anger, the patient’s Liver is no longer overwhelmed and is able to recover and “process” normally, giving the patient clarity and peace. In TCM, we say that “there is no such thing as a bad emotion, only a stuck emotion”.

 
As a recap, here are the points we covered in class (some overlap with what we talked about above):

(1) There is no separation between the mental and the physical.
(2) Emotions originate from the Organs (stored in, created by).
(3) Between Organs and Emotions, cause and effect are interchangeable.
(4) Emotions can cause disease when they are (a) extreme in intensity, and (b) prolonged in duration.

Now on to the next topic we covered in class :

 
Lifestyle Factors That Affect Health (Way of Life)

1. Overexertion

(a) mental & emotional overwork
(b) physical overwork
(c) physical exercise (excessive)
(d) insufficient sleep
(e) over-resting, too much sleep

2. Diet (nutrition, detoxification)

(a) overeating (overindulgence)
(b) malnutrition (it happens even in North America due to soil depletion in conventional agriculture, and overprocessing of foods)
(c) imbalanced eating habits (eating at wrong times)
(d) toxins in diet (hormones, pesticides, antibiotics, additives, GMOs, etc.)

3. Weak constitution

4. Sex (frequency, esp. for men)

5. Excessive childbearing (depletes Kidneys, Jing)

6. Trauma / injury / accidents

7. Exposure to poisons (environmental), parasites (mold, fungus, yeast, bacteria, viruses)

8. Ageing

 
In regards to frequency of sexual activity for men (ejaculation), in TCM we have a table listing the recommended maximum frequency depending on age. It is best not to exceed these limits, in order not to prematurely exhaust your Jing (as discussed in Day 4) :

Age Good health Average health
20 2x / day 1x / day
30 1x / day every 2nd day
40 every 3 days every 4 days
50 every 5 days every 10 days
60 every 10 days every 20 days
70 every 30 days not recommended

It should also be noted that there are ancient Eastern frameworks that help men “optimize” their sexual energy. The Indian Tantra and Taoist Sexual Alchemy are some examples.

 

Feeling Lost And Directionless In Life? You Might Not Be Sleeping At The Right Time

Day 9

by Gene Chuah

FORMAT UPDATE: Due to time constraints, from this point on I won’t be covering every detail I learned in class, but will be writing these articles in a more generalized way. They are not meant to be a replacement for class notes, but more of an introduction for readers new to Traditional Chinese Medicine.

This Chinese Organ Clock here below is my new best friend.

organ_clock

Initially I wanted to title this post “Why It’s Important To Sleep At 10pm” but I thought that sounded too boring (the answer to the title will be explained, read on). But really, this article is about going to bed on time, because there are SO MANY reasons why it’s important for your health and optimal functioning. It’s not about how much sleep you get, but also at what time you sleep and wake, because, try as you might, your body simply knows what time it is. Don’t ask me how, but we were designed this way, and after all, we are part of nature, part of the Universe, and undeniably tied to its cycles.

The “graveyard shift” is so-called, for good reason. In fact, many studies show that long-term night-shift workers are at higher risk for many diseases.

Your body is made up of several subsystems, each dependent on the others. They all work together like clockwork. In Traditional Chinese Medicine, they are called Organs, and may-or-may-not correspond to actual organs in the physiological sense. According to the Chinese Organ Clock, each Organ has a “peak time” during which the body focuses on it, sending more Qi and Blood to it, and it becomes “saturated” with this Qi and Blood in order to do its main processing activity. Some of these Organs require that you be in bed (laying horizontal!) and asleep; other Organs provide you with optimal energy for physical activity.

Other than having its “peak time”, each Organ also has its “low time” which is the exact opposite side of the clock, i.e. 12 hours away. This is when the Organ is at its weakest because Qi and Blood levels are at their lowest in the Organ.

Peak-time and low-time are actually one way of diagnosing and pinpointing a problem Organ. We covered many examples of this in yesterday’s class and the one before it. There are 2 key patterns here :

1. During Peak Time, an Organ that is weak/dysfunctional will not be able to handle the surge of Qi and Blood, and there will be Excess-related issues. Imagine a river that is not ready to handle a strong surge of water — it overflows its banks.
2. During Low Time, an Organ that is weak/dysfunctional will be overly depleted by the low levels of Qi and Blood, and there will be Deficiency-related issues. Imagine a river that is already so small and dried up — it cannot tolerate a drought.

Depending on the time of occurence of these symptoms, and the type of symptom (Excess vs. Deficiency), we can pinpoint the Organ that is weak/dysfunctional, and that helps us correctly diagnose and put together our treatment plan.

 
METAL TIME
3AM – 5AM : Lungs (Yin Organ)
5AM – 7AM : Large Intestine (Yang Organ)

Best time to wake up is in this zone. The Lungs are connected to the Large Intestines via an energetic channel. They are both related in the sense of input and output, the Lungs take in while the Large Intestines let out. The Lungs are also connected to the Skin (see chart from Day 7), and in fact you will find that many traditional Chinese people wake up during this time to do breathing (Lung!) exercises (even singing) and “tapping”/slapping their entire body to stimulate their Skin. This is also good for healing Asthma, which is an excess/stagnation condition. This zone is also a good time to defecate (yes, poop). You need to throw out the garbage to make room, before you can take in the new. Don’t worry about making this work, if you’re sleeping at 10pm and waking at 5am, this will happen naturally and automatically. Even at 5am, when the time zone for Lungs has ended, you can still do the breathing exercises due to the energetic link between these 2 Metal zones.

 
EARTH TIME
7AM – 9AM : Stomach (Yang Organ)
9AM – 11AM : Spleen (Yin Organ)

Best time for breakfast, and it should be a big one too. Because the Spleen is linked to cognitive ability (clear thinking while working), it is important that you eat a good breakfast when the Spleen is at its most active and ready to give you its benefits.

 
FIRE TIME
11AM – 1PM : Heart (Yin Organ)
1PM – 3PM : Small Intestine (Yang Organ)

Best time to work. Fire Element represents productivity, like an engine chugging away, as described in Day 8. The Heart is also associated with self-expression. 11AM-1PM (Heart zone) is the peak time of day, and is the peak time for productivity and self-expression. At 1PM-3PM, it’s Small Intestines‘ zone, and just as this Organ is responsible for separating the pure from the impure, this is the start of the winding-down after the peak, to decide what can be done today and what should be left for tomorrow. This is a good time for a (lighter) lunch and also a good time for a nap (the Latin Americans have the right idea with their “siesta”!).

 
WATER TIME
3PM – 5PM : Bladder (Yang Organ)
5PM – 7PM : Kidney (Yin Organ)

Time to start cooling down (energetically) or you will hurt yourself (engine overheats?). Yin is growing at this time, cooling the body. 5PM-7PM as Kidneys peak during this time, they “grasp” Qi from the Lungs and Heart (from Day 6). Kidneys, which represent physical strength/ability, are strongest at this time and this is actually the best time for exercise.

 
MINISTERIAL-FIRE TIME
7PM – 9PM : Pericardium (Yin Organ)
9PM – 11PM : San Jiao (Triple Burner) (Yang Organ)

(We haven’t yet talked about Ministerial Fire, this is not a term we used in class, but I got it from other TCM sources. I assigned it the color purple arbitrarily.)
This is BEDTIME! Many traditional belief systems including Indian medicine, recognize 10PM as the best time for bed. The San Jiao (Triple Burner/Heater) is responsible for regulating energetic temperature (heat vs. cold) among the 3 Jiaos; at this time, to cool down the body. Its work is made easier if it doesn’t have to fight gravity, which means you should be in bed and horizontal in this time zone. The 7PM-9PM zone is interesting — the Pericardium in TCM is thought of as the Royal Guard which guards the Emperor (Heart), and is the door to intimacy, the home, love, safety, the “opening of the heart”, and sex. So this is family time, or time for love, before bedtime.

 
WOOD TIME
11PM – 1AM : Gallbladder (Yang Organ)
1AM – 3AM : Liver (Yin Organ)

This is the time to recharge through sleep. Wood Element pertains to vision, goals, and courage. The Gallbladder is tied to courage; the Liver to vision, pioneering, adaptability, exploration, new beginnings (Day 7). Steven Covey (The Seven Habits of Highly Effective People) calls it “sharpening the saw”. Since the Liver stores Blood at its maximum capacity in this zone, it’s important for you to be asleep and dormant at this time. If you miss out on Liver Time on a regular basis, you will end up feeling lost, aimless and clouded.

Now on to a new topic we covered in yesterday’s class…

  
Pathogenic Factors : The Six Evils

1. WIND
- sudden changes of symptoms
- constant migration of symptoms
- upward and outward movement
- tends to attract other pathogenic factors

2. COLD
- Yin pathogenic factor which consumes Yang of body
- contraction and stagnation

3. HEAT/FIRE
- burning and upward direction
- swelling, ulceration, inflammation, even pestilence
- invasion by fire creates movement, stirs up wind, creates disturbance of Blood (think firestorm)
- consumes healthy/true Qi and impairs body fluids

4. DAMPNESS/PHLEGM
- heavy, turbid/thick, lingering
- viscosity (stickiness), stagnation
- obstructs Qi circulation
- tends to move downward

5. DRYNESS
- consumes body fluids
- interferes with descending function of Lungs

6. SUMMER HEAT
- extreme heat
- upward direction
- often complicated by dampness

 

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