Monthly Archives: November 2014

Acupuncture and Taiji (Tai Chi): Long-Term Solution to Weight Management

In a culture obsessed by thin bodies, obesity rates among adults have increased dramatically to 60 percent (American Public Health Association). As Americans spend more than $33 billion annually on weight-loss products and services, most diet fads bring only short-term solutions. Acupuncture and taiji are great alternatives for controlling weight. Plus these two remedies have only good side-effects!

When attempting to diet, many people experience withdrawal, or cravings, due to a lack of endorphins. The desire to eat stimulates a dieter’s urge to binge. This is one reason why diets often cause people to gain more weight: They do not address cravings. Acupuncture and taiji counterbalance cravings by releasing endorphins in the brain, which actually alleviate the withdrawal symptoms that sabotage dieting efforts.

Over-eating can also be related to stress, which increases cortisol levels. This increase in cortisol can alter metabolism, thus causing stressed people to eat more and gain weight. As with cravings, the endorphins released by acupuncture and the gentle motions of taiji also help reduce stress, which can counter the need to overeat. Both taiji and acupuncture can stimulate the hypothalamus. This induces weight loss because the hypothalamus regulates thyroid and hormone levels, which in turn regulate metabolism.

Because taiji regulates the body internally, it is useful in balancing eating disorders of all kinds. Taiji’s relaxation and focus of intentions will reinforce healthier eating habits, while acupuncture will help reduce cravings. The exercise benefits of taiji are weight bearing, building strength and flexibility, and improved balance and gracefulness in movement. Both assist in improving digestion and metabolism.

By now, we know that the quick and easy weight loss promised by various diets is wishful thinking . Too often, the weight is gained back more quickly than it was taken off. With acupuncture and regular taiji practice, you will regulate your internal systems for long-term results.

Call about tai chi and schedule an acupuncture treatment by calling Frances Gander at 414-323-4721 or emailing Three Treasures.

 

CHRONOBIOLOGY: The Significance of Time in Chinese Medicine

Z’ev Rosenberg

Abstract: One of the most powerful aspects of Chinese medicine is its emphasis on time as a core factor in health and disease. Classical texts such as the Shang Han Lun, Su Wen, and Nan Jing present sophisticated protocols for the diagnosis and treatment of specific illnesses during specific time periods for maximum efficacy. Biorhythms and circadian rhythms as factors in the course of illness have been a major part of Chinese medicine for millenia, reflected in the 24-hour Chinese clock of the channels, viscera and bowels, or cyclic charts of 60-day and seasonal cycles of yin and yang influences on health.

Unknowingly, modern medicine has begun to explore one of the fundamental principles of Chinese medicine: the recognition that human beings have an intimate connection to nature, and are being influenced continuously by environmental and chronological factors. Historically, Chinese medical literature has always understood medical phenomena through the lenses of time, patterns and cycles, and has attempted to diagnose and cure disease accordingly.

Chronobiology can be defined as the science of transformations in organic life forms according to circadian rhythms. In contemporary biomedicine, chronobiology is being applied to the regulation of drug and surgical therapies according to time of day, weather conditions, and lunar phase. Journals and research institutes have been formed to investigate these phenomena.1 The principles of chronobiology have become increasingly important in modern practice, because of the effects of technological civilization on circadian rhythms. Jet travel, computers, radiation, artificial living and working environments, medications, movies, television, electric music, and many other technological innovations have transformed our environment and largely insulated us from direct contact with nature. This has led to disruption of sleep, eating, and other body/mind cycles which can cause degeneration of health. Extensive studies are available on such topics as jet lag, night shifts, sleep deprivation and their effects on overall health. Other applications of chronobiology are chronoepidemiology, or cycles of epidemics, and chronopharmacology, which can help determine how to medicate patients in harmony with circadian rhythms.

In Chinese medicine, chronobiology first was revealed in the theory of wu yun liu qi/five movements and six qi, a concept translated by Nigel Wiseman as “cosmobiology” and by Manfred Porkert as “phase energetics.” According to this theory, the body and mind change day by day, in correspondence with a complex polyrhythmic dance of twenty-four hour, lunar, solar and seasonal rhythms that subtly influence the movement of blood, lymph, fluids, qi and jing/essence through their channels and vessels, as they gather and subsequently move through different visceral systems. Therefore, when treating patients, we can use chronobiology to deepen our understanding of the mind/body terrain, by providing a context (in cosmic and natural cycles) that is beyond the specific etiology. Chronobiology theory can be applied to the treatment of metabolic, immune, gynecologic and infectious disorders. By understanding the cyclical movement, gathering and resolution of qi, blood and fluids, we can regulate vital substances produced by the body and avoid their exhaustion and depletion. Chronobiology has also been used traditionally in Chinese medicine for calculating effective treatment for shi bing/seasonal disorders, including warm febrile epidemics.

The first treatise dealing with chronobiology is the Huang di nei jing su wen/Yellow Emperor’s Classic of Internal Medicine (Simple Questions). The most reliable and comprehensive translation is by Paul Unschuld, whose introductory volume is available (Huang Di Nei Jing Su Wen). Su wen treatises 66 through 74 are extensively devoted to this topic. While much or all of this material is attributed to a later editor of the text (Wang Bing), it has remained the original source text on the subject. In Treatise 69, “The Comprehensive Discourse on Changes (Resulting from) Qi Interaction,” Qi Bo, physician to Huang Di, said, “Knowing the normal and abnormal movements of heaven and earth, one can readily know and anticipate the same movements within mankind.” This chapter goes on to discuss calculations of stems and branches and their influence on resistance to disease in a given year, along with remedial herbal and dietary therapies. For example, a wood repletion year will cause windy conditions, liver pathology, diarrhea and indigestion, fatigue and loss of appetite will prevail. If it is a wood vacuity year, vital qi will be weak, plants will be poorly developed, people will suffer from cold, rib and abdominal pains, flatulence and watery diarrhea. In Su wen treatise 74, “The Comprehensive Discourse on the Essentials of the Most Reliable”), Huang Di states, “People and nature are inseparable. In nature, the cyclic movement of the heavenly bodies produces atmospheric influences that exert control over the rhythms of the seasons and is responsible for change to the myriad living and non-living things. These cycles are repeated endlessly with patterns of predictability, and yet simultaneously with a tendency towards chaos. It is this chaos in the macrocosm that upsets the balance of the delicate ecology within people that produces disease” (translation by Mao Shing-Ni, Yellow Emperor’s Classic of Internal Medicine).

There is tremendous and understandable controversy over the accuracy of Chinese astronomy and its accuracy in predicting weather and climate changes, and these theories are by no means universally accepted in the modern Chinese medical world. As Chinese medicine has spread through the world, these principles need to be reexamined in light of different latitudes, climates, and seasonal changes. However, the underlying principles of understanding the relationship between season, climate and health are very powerful ones, and deserve to be reexamined in the context of what we know about subtle yearly changes in lunar and solar eclipses, orbits, global warming, and other factors. It is notoriously difficult to predict long cycles of weather change, and it would be interesting to see if there are any records to test the accuracy of these predictions.

There are other expressions of chronobiology in Chinese medicine that are easier to understand and apply, such as the twenty-four hour clock, which records the movement of qi through the twelve channels and associated zang/fu viscera and bowels over a twenty-four hour period. Acupuncturists particularly have developed calendars to choose points which are most active at these times, or which channels or visceral systems are optimal to treat. For example, the lung channel is most abundant in qi at 3-5 AM, and most depleted at 3-5 PM. So, according to this theory, lung diseases will tend to worsen in the late afternoon. Dr. Yoshio Manaka’s text, Chasing the Dragon’s Tail, has comprehensive charts and treatment strategies based on this clock.

In acupuncture practice, one can apply chronobiology by choosing specific points for the disorder or pattern with appropriate open points to secure a deeper and stronger effect. Such strategies may include selecting the five shu/transporting points or master and coupled points of the extraordinary vessels. This method is called zi wu liu zhu /stem-branch point selection. It is based on the circulation of qi in the channels as it waxes and wanes in resonance with time of day or night, season, and astronomical/astrological changes based on the five stems and six branches recorded in the Nei Jing Su Wen. The eight extraordinary vessels are very effective in treating endocrine disorders. The master and coupled points of the chong mai/generating vessel and ren mai/conception vessel have a deep-acting influence on hormonal cycles in the body. And the 66 shu xue/corresponding points and are best activated at their open times, as they become active in sequence according to the 24-hour Chinese clock. By needling the shu xue/corresponding points of the visceral system that is most susceptible, that organ system will be harmonized and thus avert any potential disorder. There are several texts and calendars available that easily calculate the best points for treatment according to hour, day, season and year, including the nai zhi fa/daily branch method, nai jia fa/ten-day stem method, and 60-day ling gui ba fa/divine tortoise eight methods.

Herbal medicine can also be applied according to the principles of chronobiology. The concept of seasonal variation of herbal prescriptions was first mentioned in the Nei Jing Su Wen, and more fully developed in the Pi Wei Lun Treatise on the Spleen and Stomach, written by Li Dong-yuan in the 13th century. For example, Dr. Li recommends adding different herbs to prescriptions in different seasons, such as wu wei zi/fr. schizandra in summer, or proscribes herbs such as ma huang/rm. Ephedra in autumn or winter. In general he admonishes us to be sensitive to seasonal qi in choosing herbal prescriptions. Other authors recommend herbal prescriptions to be taken at certain times of day, such as taking Liu wei di huang wan/Six Flavor Rehmannia Pill at bedtime to nourish the kidneys. The Shang Han Lun/Treatise on Cold Damage has extensive discussions on periodicity of infectious disorders, waxing and waning at different times of day, with appropriate treatment according to time and changes in the disorder. For example, tai yang patterns are said to subside between 9 P.M. and 3 A.M., and increase in severity between 9 A.M. and 3 P.M. This would be, theoretically, the most advantageous time to treat this pattern.

This short overview of chronobiology shows its central importance in Chinese medical literature from its earliest developmental phase. Potentially, by calculating the best times for treatment and their appropriate prescriptions, as well as using these principles to predict epidemics, we can greatly improve and individualize our treatment of patients, applying the best of Chinese medicine with its great subtlety, complexity and depth.

1 Such as the Chronobiology International Journal, published by Pergamon Journals Ltd., Oxford, England and the Department of Chronobiology at the University of Texas Health Science Center at Houston, TX.

This article appears with the permission of the author, Z’ev Rosenberg, and the Pacific College of Oriental Medicine.

The Dynamic Evolution of Pulse Diagnosis

Feng Ye and Eric Brand

Evaluation of the pulse has been one of the most important aspects of Chinese medical diagnosis throughout history. From ancient times until the modern day, the pulse has been regarded as Chinese Medicine’s most comprehensive and reliable diagnostic indicator. Experienced practitioners can detect ovulation, pregnancy, and common colds in their regular patients; some can even pinpoint a new patient’s chief complaint by the pulse alone. Although many Westerners find the intricate assessment of the pulse to be one of the most intriguing features of Chinese medicine, we are largely unaware of the historical influences that have shaped our modern understanding of pulse diagnosis.

Pulse diagnosis as we know it today is very different than it was at its inception. In the modern age, practitioners rely exclusively upon the radial artery when evaluating the pulse. However, the use of the radial pulse to diagnose visceral conditions was preceded by several other methods of pulse diagnosis. Previous historical periods assessed different conditions and utilized different sites of palpation than we find in the modern day. A variety of factors caused the sites of palpation to change over the ages, and the perception of what the pulse can reveal has evolved to accommodate developments in general medical theory. A brief exploration of this fascinating process is outlined below.

The earliest known references to pulse diagnosis were found in a nobleman’s burial chamber known as Ma Wang Dui, dating back to the early Han Dynasty (168 BCE). At this time, symptoms and diseases were correlated with specific channels and pulses. Although the emphasis is clearly centered on pathoconditions of the channels, a case can be made that the silk records found at Ma Wang Dui illustrate the earliest recorded integration of pulse, pathoconditions, and diagnosis. At this point in history, pulse diagnosis was not yet influenced by five-phase theory or visceral theory.

When the works at Ma Wang Dui were written, there were eleven channels and disease was primarily based upon channel associations rather than visceral origins. Each channel had its own pulse, which was located at a given point on the channel; there were not yet any single points that reflected the pathology of more than one channel. Unusual stirring at the palpation sites indicated disease of the corresponding channel. The various channels were not yet perceived to be linked together, and the channels were labeled with names such as the ear channel and the cheek channel, rather than the modern classification that we find today.

Pulse diagnosis had evolved considerably by the time the Huang Di Nei Jing (“The Yellow Emperor’s Inner Canon”) was written in the later Han Dynasty. At this point in history, Chinese medicine had a clear influence of five-phase theory and visceral manifestation, as well as the twelve channel system that is in use today. The channels were linked with each other, and the concept of “stomach qi is the sea of the twelve channels” arose to explain how the various channels were connected and carried to the radial pulse. The theory of “stomach qi” explained how the wrist pulse could supply information about a variety of organs and channels, and the presence of stomach qi in the pulse is regarded as an important feature of pulse diagnosis to this day.

Another important aspect of pulse diagnosis during the time of the Huang Di Nei Jing involved the comparison of the radial pulse with the pulse of the carotid artery, which was taken at the acupoint ren ying (Man’s Prognosis, ST-9). Determining the strength of the carotid pulse relative to the radial pulse allowed a practitioner to determine which channel a disease was located in. Interestingly, although the radial pulse was assigned a variety of pulse qualities, at this time it was palpated with a single finger. The quality of the pulse determined the location of disease, with each quality specifically assigned to a given channel. This stands in contrast to the modern diagnostic method, which uses the pulse quality to determine the nature of a disease and different locations on the wrist pulse to determine its location.

We find still more clues about the evolution of pulse diagnosis in the Shang Han Lun (“On Cold Damage”), which was written in the Han Dynasty after the Nei Jing. Zhang Ji, the author, mentions that by his time, few physicians were taking the pulse at the older locations of ren ying (ST-9) and the pedal pulse. It is suspected that increasingly conservative attitudes about appropriate touch limited doctors from palpating women’s pulses at the femoral artery and other regions, thus causing physicians to focus their efforts exclusively on the radial pulse. During some dynastic periods, women were kept behind dressing screens and the doctor was only able to palpate the pulse by having her place her cloth-covered wrist through a slot in the screen. Although such influences caused the ancient pulse techniques to go largely undeveloped, they undoubtedly fueled the advancement of diagnosis using the radial artery alone.

Zhang Ji did not differentiate the pulses between the left and right sides. Assigning certain bowels and viscera specifically to the right and left sides appears to be a later development, and the proposed location of some of the bowels and viscera changed over time. Similarly, the concept of using three fingers to take the pulse was a later development, one that is only conclusively evident in the Tang Dynasty works by Sun Si-Miao. Sun Si-Miao’s Qian Jin Yao Fang (“A Thousand Gold Pieces Prescriptions”) text, written in the 7th century, also provide us with the earliest indisputable evidence that the bowels were assigned to the more superficial level of the pulse, while the viscera were assigned to the deeper positions.

However, Sun Si-Miao’s works were preceded by the influential Mai Jing (“The Pulse Canon,” 3rd century CE), written in the Jin Dynasty by Wang Shu-He. This text provides many of the classical descriptions of pulse qualities that are studied to this day. While many different pulse qualities had been named before (over 50 are mentioned in the Nei Jing), many of the pulses named were similar and many were poorly defined.

Wang Shu-He’s Mai Jing provided descriptions of 24 out of the 28 pulses that are used today. By the time of Li Shi-Zhen in the 16th century, we can see 27 of out the 28 pulse qualities that are used in modern times. The final quality, the racing pulse (ji mai), became integrated only in the Qing Dynasty (1616-1911 CE).

It is speculated that numerology may have influenced the number of pulse qualities assigned. 28 is a “divine number” in Chinese numerology; the Chinese recognized 28 constellations in the sky and may have linked the number of pulse qualities with the divine number 28 to reflect their perceived links between the celestial world and the mundane world. The influence of “divine numbers” is most clearly evident in early methods of pulse diagnosis, which made three different groupings of pulses based on the location of the arteries and the associated correspondences with heaven, earth, and man.

The gradual evolution of pulse diagnosis offers us insight into the way ancient Chinese physicians perceived health and illness. Some concepts have remained relatively consistent despite the passage of time, yet the changes that are evident in early texts show us that pulse diagnosis adapted dynamically as Chinese medicine developed. Unfortunately, the ancient methods of palpating a variety of sites never had the opportunity to flourish and provide us with a complete system for use in the modern day. However, whatever factors caused these techniques to diminish in prominence allowed for the development of an extremely sophisticated method of diagnosis based upon the wrist pulse. Although ancient techniques may not always provide us with increased clinical utility, they provide us with insight into the process that allowed Chinese medicine to be the complex and intriguing art that it is today.

 

“The Dynamic Evolution of Chinese Pulse Diagnosis” is reproduced here with the permission of Eric Brand.

 

The Three Treasures: Jing, Qi, Shen

Frances L. Gander

Just what does it mean — jing-qi-shen? We may hear different meanings for jing, qi, or shen. These differences are often dependent on context. All contain a piece of the meaning. One difficulty in accessing the concepts implied in jing-qi-shen is that it is difficult to separate these words or concepts as we do in English. For example, the character for heart –xin– refers to the whole entity of heart, the physical, emotional, mental, and spiritual. Each of the five elements [wu xing] has spiritual, emotional, and physical realms of being. It’s quick to say jing-qi-shen means body, mind, and spirit. That’s a beginning. I hope that my article will fuel your own personal exploration of these concepts into their fullness. Without ability to read and understand Chinese, we do the best we can to picture these ideas in English.

You may wonder, why does jing come before shen in this trilogy? Usually we think of jing as more physical and material than the shen, so why is jing the first word, why not shen-qi-jing? The reason, is jing comes first: at the time of union of sperm and egg, this new being is pure jing. A bit later, qi and its potential to animate and circulate enter the embryo. Much, much later on, we develop the shen part of our being through practices and virtues. We can think of jing, qi, and shen levels of development in life and in practices (taiji and qigong, meditation, yoga). At first we learn the bare-bones movements, then with time and effort we refine our cultivation, and our practice (and life) moves increasingly into the realm of shen cultivation.

JING

The character for jing carries the meaning of sperm or essences; it has to be translated according to its context. Jing is considered the source of life. It is sperm and vaginal moisture, ephemeral essence, and the organic substance that forms the foundation for growth, reproduction, and development. Jing is responsible for bone growth in children, teeth, hair, normal mental development and sexual maturity. After puberty, jing engenders reproductive function and fertility. Jing moves us through the organic changes that punctuate our lives: birth, childhood, puberty, child-bearing, maturity and elderhood. Jing has to do with time and changes. It can also be thought of as our foundation, as building blocks, like DNA. Deterioration of jing can be accelerated by prolonged illness or overwork, injury, abuse, stress, exhaustion, excessive sex, and poor nutrition. Evidences of jing waning are thinning and graying hair, decreasing moisture throughout the body, loss of sensory and mental acuity, and weakening of the bones, teeth, and connective tissue. The rate of deterioration can be slowed down by proper nutrition, adequate rest, balancing fun with work, qigong practices, techniques such as acupuncture, good dietary practices and herbal formulas for enhancing life force.

QI

Qi in the body’s functioning is like an electric current. Qi animates our being. Our meridians and organs are like the hardware: wires, transformers, power plants through which the electrical current (qi) moves and gets amped, stored, and routed. Every living being has qi, yet each of us is unique in our particular quality of qi. Qigong practices assist qi circulation and flow, storage, and regeneration. Our qi circulation and flow is dependent on how much and what kind of qi we received at birth from our ancestors, diet and nutrition, and overall lifestyle. Practices can transform qi into shen or jing and healing energy. In the old character for qi, there is an image of steam rising from a pot of rice on a fire. If the fire is continuous and appropriate to the proportion of rice to water, energy will show up as steam. If the fire gets too hot, the water dries up and not only the rice burns but eventually the container as well.

When the qi flow is disrupted, we accumulate the residue of incomplete vital process. This is the foundation of many illnesses. In the beginning of this disruption, there is stagnation. If the residue accumulates over time, we eventually lose the capacity to suspend them, and they are expressed as overt disease.

SHEN

Diagnostically, in Chinese medicine the signs for the quality of the shen are observed in the eyes primarily. When the shen is happy, we radiate and our eyes sparkle and mirror our souls. In serious mental illness, there is almost always shen disturbance. The sign for this disturbance is revealed by how the person looks out into the world, the gaze, how it connects (or doesn’t) with the eyes of others, sometimes a wild look. In fact, one TCM diagnostic term for a type of mental imbalance is ‘phlegm misting the soul.’ The soul becomes turbid and cloudy and is mirrored in the person’s eyes.

Shen is not an automatic given to all who live and breathe like jing and qi are. It is achieved and augmented in the higher levels of meditation, taiji and qigong practice and through a lifestyle that is integral to these practices. Shen has to do with the hun, or Ethereal Soul. Shen is spirit and it is everywhere. It comes to us when we reach a higher level in our practices after much time and perseverance; it goes elsewhere when we neglect our practices, when we abuse ourselves, or live in an unvirtuous fashion. The shen is sparked and nurtured by music and dancing, participation in the arts and creative activities. The character for shen contains the idea of a bird. A bird is free to fly away. It is free to go when conditions aren’t favorable and may choose to remain when they are. We all have the capability through cultivation (or lack of) to attract or repel the shen.

YIN AND YANG: Balance and Change

Frances L. Gander

Chinese philosophy provides insights into health, disease prevention and healing, and the nature of life and death. At the core of Chinese philosophy is the concept of balance. The theory of yin and yang is based on the principle of complementary opposites. Yin and yang give rise to a natural order of change. Night leads to day, day becomes night, rain falls only to rise up again and create the clouds. This concept can be seen and experienced in every aspect of life. Both yin and yang carry varying degrees of their opposites within themselves in order to maintain balance. This relationship is ever-changing, interdependent and transformational. In short, the yin/yang principle guides us to understand that every living entity is composed of two unified parts with opposing qualities that initiate the process of change and seek continual balance. Each thing in the universe represents varying degrees on the yin/yang continuum and can be more yin one moment and then change the next into somewhat yang.

Yin represents the feminine essence, the dark, receptive and cold. It includes the blood and vital body fluids of reproduction which have the ability to moisten and make smooth, the capacities for storing and holding. Yang represents the characteristic of the masculine, light, movement, heat and energy. Yang includes the vital functions of the growth of an organism, metabolism and circulation, which promote action and energy. Yin and yang in harmony create the environment in which optimum health can be realized and maintained. An imbalance of either yin or yang will create either an excess or deficiency which can predispose us to illness. While they simultaneously create and control one another, they are also the source of all that can flourish and perish.

From A Practical Dictionary of Chinese Medicine: The upper and outer aspect of an object tends to receive sunlight; the inner and lower aspects of objects tend to be dark. Light (yang) is to darkness (yin) as heat is to cold, as day is to night, as summer is to winter, as north is to south, and as activity is to rest. Hence heat, daytime, summer, south, and activity are yang; while cold, night, winter, north, quiescence are yin.

Tai chi is sometimes described as ‘the dance of yin and yang.’ Both qualities should be evident, as well as the gradual transformations between them.