Chinese Medicine Theory

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I have not yet done any posts regarding specific cases in my office but this one stood out to me as a success story that should be shared. It is not uncommon for patients to come to me as a “last resort.” After seeing western doctor after western doctor and getting no results, or being offered a multiple drug regimen with multiple risks and side effects people become frustrated. They want to get better, they think they CAN get better, and they try acupuncture in a “last ditch” effort to get better. These cases are especially exciting to me for two reasons. One, often these are situations in which TCM excels. Whenever someone’s situation is “mysterious” or unresponsive to western medicine, it is often quite responsive to acupuncture and herbs. Two, when they get better, they are so thankful and it warms my heart to know that they have been helped after so much time feeling desperate and frustrated. It is particularly satisfying when they report back to their western physician that they have indeed gotten better with this medicine. It plants a seed in that physicians head that maybe there is something to this Asian medicine.

So, back this case I want to share.

A 27 year old man came to me 2 months ago with a five year history of urinary frequency, small bladder capacity and pain. His bladder could not hold the normal amount of urine and when it became “full” he would have severe, sharp lower abdominal pain that could only be resolved by urinating. He woke 3 to 4 times a night to pee, and had trouble falling asleep due to lower abdominal discomfort. He had been through every western bladder/kidney/prostate test available including a very invasive Cystoscopy. He had been to three different Urologists, none of whom could offer him a diagnosis or a treatment plan. The last of which prescribed him antidepressants. Now, side note, this happens ALL THE TIME. My patient was not the least bit depressed. He had some anxiety around the urination issue, but nothing outside of what would be considered normal considering the intensity of the pain and the lack of diagnosis. I have seen this so often I am no longer surprised when it happens. When western medicine cannot find the cause of a physical problem, patients are given antidepressants. Maybe this was all “in his head”, but this man decided he did not want to take drugs that he didn’t think he needed and sought out alternatives.

During his initial visit I discovered that the man had lower back pain as a result of an injury in which he was run over (!) by an ATV when he was 7 years old. He did not require surgery but several of his lower lumbar vertebrae were permanently damaged. This piece of information would mean nothing to a urologist but it meant a lot to this TCM doctor. In addition to back pain he suffered from knee pain that he chalked up to “getting older” at his mere 27 years. His urine was usually clear, although occasionally cloudy and was slow to come out. His hands and particularly his feet, were always cold. He was always thirsty, for room temperature water, but he was afraid to drink because of the bladder problem. He felt fatigued all the time which he didn’t feel was caused by the night waking.

Urinary frequency can be the result of several different TCM patterns. In this case all signs pointed to one thing: Kidney yang vacuity with blood stasis in the bladder. I was fortunate that his symptoms painted such a clear picture, as this isn’t always the case with such chronic conditions. I believed that the Kidney vacuity was primary, and had existed since that terrible childhood accident, if not before, and the blood stasis was a result of the bladder not functioning well for so long. (Chronic conditions often develop blood stasis over time.)

Treatment was simple. We were to start with acupuncture and moxibustion weekly and would add herbs if we didn’t see results in 6 visits. For you TCM geeks out there I used a combination of BL23, 28, Du4, Ki7, Sp8, Ht7, Ren2, 4, 6, and Ki11 over the course of 6 sessions. I applied moxa to the points on the low back and lower abdomen. The results have been great with progressive improvement after each treamtment. After the first couple of visits he noticed a reduction in the number of times he woke at night to pee. After the 5th he noticed a reduction in daytime frequency and a big reduction in anxiety. After the 6th visit he reported he was peeing around 5 times a day (as opposed to hourly) and he was only waking once a night to urinate with a big reduction in fatigue. Although we have reached our 6 visit goal we have determined that more treatment will be necessary as it would be best if he were not waking at all at night. We will continue weekly treatment until we accomplish that and if it hasn’t been accomplished in 3 more visits we will add a granular herbal formula. For the TCM geeks: Jin Gui Shen Qi Wan + Lian Zi, Fu Pen Zi, Tu Si Zi, Suan Zao Ren, Yuan Zhi

In addition to the physical improvement mentioned above, one of the things that stands out to me when I think about this patient is how much his affect has changed in the two months I’ve known him. The first few visits he was somewhat “tightly wound” so to speak. He was visibly uncomfortable, a little defeated in his tone, and all around frustrated. Now when he comes in he is downright cheerful and bright. I hope that he continues to improve and that he can get on with being a normal healthy 27 year old with a life that does not revolve around having a bathroom nearby.

 

 

 

Chinese dietary therapy often recommends that people limit or eliminate dairy products from their diet. In Traditional Chinese Medicine, dairy is considered a cold food that leads to damp accumulation, particularly in people who have a weakness in their Spleen energy. Symptoms of dampness include lethargy, loose stools, feelings of heaviness, cloudy thinking, excess sputum(particularly in the sinuses), certain types of headaches, and accumulations such as cysts and tumors. The concern for some who want to follow this dietary advice, is whether they will be able to get adequate amounts of calcium from a dairy-free diet. This is certainly a concern as most adults require around 1,000 mg of calcium a day to maintain bone, muscular, vascular and hormonal health. There is disagreement about the exact quantities of calcium in foods, but if a person were avoiding milk, increasing the amounts of the following foods should provide enough calcium for most individuals.

Nuts and Seeds

Sesame seeds (most sources list the calcium content of 1 oz of these to contain more calcium than one 8oz glass of milk)

Sunflower seeds (also high in iron)

Almonds

Soybeans

Brazilnuts

Pecans

Sesame tahini

Legumes

Beans (garbonzo, pinto, soy, canellini)

Tofu (especially calcium-treated)

Dark Leafy Greens

kale

collards

turnip greens

dandelion greens

mustard greens

arugula

chard

chicory (curly endive)

Vegetables

Broccoli

Bok Choy

Acorn squash

Fruit

Figs, dried

Orange juice, calcium-fortified

Kiwi

Grains

Cereal (calcium-fortified)

Amaranth

Brown rice

Oatmeal

Corn tortillas

Fish and Seafood

Oysters, raw

Salmon (canned with bones)

Sardines (canned with bones)

Mackerel

Other

Blackstrap Molasses (also high in iron)

Greek yogurt (although dairy, this is not considered a damp-producing food)

 

 

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I’ve heard this question a lot over the years. Coming from a culture in which the primary medicine is one-size-fits all, it is not surprising that we have a hard time grasping the way acupuncture works. In Western medicine if you have a particular symptom or disease, there is a specific treatment for that, a drug or a therapy or what-have-you. There is sometimes a bit of tailoring in which, of the 5 drug options, you are given one based on factors that are unique to you. In general though,  each disease has a set treatment, no matter the patient’s constitution or other symptoms.

In Chinese Medicine, the opposite is true. Each person is looked at individually, all symptoms are considered relevant, and the underlying imbalance is treated. We often say, we treat the person not the disease. For instance, if there are 5 people with Irritable Bowel Syndrome, the Chinese Medicine doctor will look at each of the five individually. Each will get a Chinese Medicine diagnosis, possibly all 5 will be different. One might have qi stagnation causing the IBS, one might have Spleen qi deficiency, one might damp phlegm collecting, one might have too much heat, etc. The doctor will then prescribe points and herbs specific to those five individual imbalances. There are points that move the qi, and do so very well in the digestive system. There are points that build spleen qi, and so on. There would likely be some crossover, but it is very unlikely that each person would receive the same exact prescription of points.  

Acupuncture points do not treat specific diseases, rather, they have the effect of adjusting the imbalances in the body in different ways. Stomach 36 is a powerful digestive point, but western disease diagnoses do not correlate to specific points. Sometimes St 36 would be called for in someone with IBS, sometimes it would not depending on the imbalance in that particular patient. Points are combined in such a way as to bring the individual back into balance thereby eliminating symptoms of dis-ease.

This is why seeing a licenced acupuncturist for acupuncture rather than an MD or Chiropractor with a few hours of “acupuncture training” is so important. While the MD may be able to reduce a little pain using acupuncture needles, to get to the root of the imblance using Chinese Medicine, a differential diagnosis needs to be made so that elegant point combinations can be chosen. Acupuncture was never meant to be practiced in a “this point is good for this disease” way and it is far more effective when used within the broader framework of Chinese Medicine as a whole system of medicine.

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There are some correlations between western nutritional science and Chinese food therapy. One of the ways in which they diverge is on the topic of raw food. Chemically, food contains more of its vitamins and minerals when raw, and the longer a food cooks, the more of it’s nutrients are lost. This doesn’t mean western Nutritionists believe that all people should eat all vegetables and fruits raw at all times. However, in Chinese nutrition, raw food should rarely, if ever, be consumed.

I like to think about the stomach as a pot on a stove. If you put cold water and foods into it, it takes more time for the pot to get the food up to temperature in order to digest it than if you put warm, slightly cooked foods into it. The Spleen/Stomach energy has to work very hard, and use quite a bit of qi to break down raw food into components useable by the body. We believe that when food is consumed that has been slightly cooked, through saute, stir fry, baking, roasting, or the like, the Stomach/Spleen can get the most value from the food with the least effort. This is especially true in the wintertime when the body is already working hard to function in the cold weather, and even more so in those who are diagnosed with having a Spleen qi vacuity.

During the winter months, avoid excessive raw food and cold beverages. Give your digestive system the benefit of partially broken down veggies and even fruits (baked pears are fantastic!!) until the weather warms again. You might even consider having a cup of miso or tea before a meal, this helps warm the stomach so that it will be best prepared to digest effectively.

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If you’ve ever wondered what Liver Qi Stagnation felt like, all you have to do is get in your car in a big city at rush hour in stop and go traffic. Add to that a hot summer day in August and no air conditioning. Maybe to really experience it, throw in a broken sound system that only plays am stations. That frustration, that desire, or really, that NEED to move but being unable to, THAT is what Liver Qi Stagnation feels like. Being stuck is the essence of this pattern. When the qi cannot move, the blood also stagnates. We get frustrated, we get hot and our muscles get tense. Maybe our jaw clenches, our head pounds, and our shoulders can be found by our ears. We loose patience easily, maybe we yell out or throw some inapproriate hand gestures.

Sufjan Stevens is a young artist, mainly a musician, who has created a movie and musical score based on this sensation of sitting in traffic, specifically on the Brooklyn-Queens Expressway, or the BQE. Sufjan may not know anything about Liver Qi Stagnation (or maybe he does, I don’t really know) but he describes the sensation, and also his personal transformation beyond it after 9 months of driving on the BQE in an interview with Steve Inskeep on NPR’s Morning Edition. I encourage you to listen to the interview, check out the trailer for the film and maybe this about your own flow of qi while driving in traffic.

One of my favorite parts about the film is his use of hoola hoopers (is that a real term?) His reasons may not have anything to do with qi flow, but one of the BEST ways to get your Liver Qi moving is to move your body, and anyone who has spent any time with a hoola hoop can tell you that nothing gets the Qi flowing, and possibly the laughter as well, like a hoola hoop!!

The interview: http://www.npr.org/templates/story/story.php?storyId=114288376

The movie trailer: http://www.youtube.com/watch?v=z6sRXCLVyoc

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raspberry

Blood deficiency is more prevalent in women than in men due to the menstrual cycle, but some men suffer from this as well. It arises from a number of conditions, including, but not limited to: heavy menstrual cycle, a history of hemorrhage, amenorrhea, or long term vegetarianism. Blood deficiency can underlie a number of physical symptoms including dizziness, pallor, fatigue, scanty or absent menstrual cycle, some types of numbness or skin rashes, dry skin and hair, brittle nails, chronic muscle spasms, slow to heal tendonitis and injuries, heart palpitations and specific types of insomnia. It is very important to stay well hydrated if you are blood deficient. 6-8 glasses of water are essential, as well as introducing fluids that have electrolytes in them. Organic chicken broth is another way to help hydrate the body while providing easy to assimilate nutrients.

If your practitioner has diagnosed you with Blood Deficiency, there are some simple foods and supplements that you can incorporate into your diet that will help your body to build more and stronger Blood. Be sure to check with your Naturopath or physician before starting supplementation to be sure the supplement is appropriate for your particular situation.

1) Certified Organic beef

2) Green leafy vegetables such as kale and chard

3) Black strap molasses

4) Dark colored fruits and vegetables like red grapes, raisins, berries, beets, etc.

5) Slow-cooked soups, stews and braised meats which are the best methods for extracting essential nutrients from bones, meats and vegetables

6) Seaweeds (be sure to use quality brands that ensure purity standards)

7) Organic Royal Jelly which is a wonderful tonic that is naturally high in amino acids, vitamins and enzymes

8) Iron supplements such as “Floradix” which is a gentle liquid tonic that helps support the blood.

9) Chlorophyll Supplements particularly barley grass (avoid spirulina as it tends to be too warming)

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huangqi
There many things we can do to help support our body’s natural immune function. Certainly getting enough rest, fluids, and quality fresh food is essential. Acupuncture is also a good option, since one of the proven effects of this therapy is increased immunity, even when this isn’t the focus of treatment. Regular acupuncture helps bring our bodies back into balance, and a body in balance has the ability to fight foreign contaminants such as bacteria and viruses. In Chinese Medicine terms “expel uninvited guests” such as wind cold, wind heat, wind damp, etc.


Aside from acupuncture, many Chinese herbs, including mushrooms, have been proven to increase immune function in several ways. There are herbs that are simply antibacterial and antiviral, helping our bodies to stave off infection when we come in contact with these agents. There are also herbs which increase the number of Killer T and Natural Killer white blood cells which attack microbes preventing us from getting sick, and helping us to recover from illness.

One of the key immune enhancing herbs in Chinese Medicine is Huang Qi, or Astragalus. The root of this plant tonifies the qi and blood of the entire body, especially the Spleen and increases the Wei, or Protective Qi. There are several classic herbal formulas that contain Huang Qi which can be used to prevent illness. There are also formulas, which when taken at the early stages of illness help the body recover quickly and decrease the severity of an illness. These formulas are important to have on hand in order to provide a quick means of protection. That way if you find yourself around people sick people, or if you will be traveling on airplanes, or simply have a tendency towards decreased immune function, you can give your body as much support as possible to keep from getting sick.

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ears

Several years ago Jake Fratkin, OMD (Oriental Medicine Doctor), made waves throughout the pediatric community by declaring on a radio show that the cause of ear infections was antibiotics. Since that time, several studies have been done which indicate that he was right. The likelihood of a recurrent ear infection during the first six weeks after taking antibiotics is significant. Not only is a child more likely to get another ear infection within six weeks if they are given antibiotics, but the recovery time from an infection is the same whether antibiotics are given or not. Even the Washington State Department of Health has issued a statement that most ear infections clear on their own and that overuse of antibiotics leads to drug resistant bacteria. So why are medical doctors still giving antibiotics to children with ear infections? In some cases, they no longer are. More and more doctors and medical institutions are reserving antibiotic administration for extreme cases of infection as a last resort. Here in Seattle, Dr. David Springer of Wallingford Pediatrics received an award from Premera Blue Cross for his use of “evidence-based best practices” in avoiding and limiting antibiotic use for ear infections.

 

So if antibiotics aren’t the answer, what do we do for ear infections? Chinese Herbal Medicine is an excellent choice for the prevention and treatment of ear infections. There are two key formulas which, when administered correctly, can alleviate pain within hours and eliminate the infection within only a couple of days. They are safe, they are effective, and they are easy to administer. Several companies have created liquid extracts of these classic Chinese formulas adding a touch of glycerin or stevia to mask the bitter flavor of the herbs so that they are more palatable to children. I have used them with my own children and have avoided any antibiotic use so far. In addition to Chinese formulas, I have used garlic ear drops, which kill microbes and dry fluid when placed directly into the ear canal, and probiotics which help the immune system fight the infection. All three can be combined and your Chinese Medicine practitioner can help you determine the best course of treatment so you can avoid unnecessary, and potential harmful antibiotic overuse in your children.

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red shoes

Season: Spring

Direction: East

Climate: Wind

Yin Organ: Liver

Yang Organ: Gallbladder

Emotion: Anger

Sound: Shouting

Color: Green

Flavor: Sour

Movement: Upward

Tissue: Tendons

Virture: Kindness

windgate

While the name “wind gate” refers specifically to a point on the Bladder channel of the upper back, we often use this term to talk about the entire back of the neck and upper back. This area is particularly vulnerable to invasion by wind leading to symptoms of colds and flus such as chills, body aches, nasal congestion, and cough. In the Springtime when the weather starts to turn warm we can be too quick to pull off the winter layers. Exposing the back of the neck and upper back to the elements, particularly the wind, we increase the likelihood of falling ill. Protect your “wind gate” by wearing a scarf, a high collar, or a turtle neck, and you will increase your chances of making it through the spring in good health.

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