Pregnancy in Chinese medical texts
I’m away at a Qigong retreat this weekend (we take one a term in the Classical Chinese Medicine program at NCNM), but didn’t want to leave you folks without content. :) Two fellow bloggers were kind enough to offer posts - one from G. Michael Reynolds over at the Life Giving Sword and the other from Yael Ernst at Chinese Medicine Notes. I hope you will enjoy them both.
First up, Yael with her post about Pregnancy in Chinese medical texts. I don’t talk much about women’s health here, but not because I have no interest in it. I think this will provide a good introduction for folks who are wondering what Chinese medicine has to say about the process of pregnancy and its effects on the female body.
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In the post The Foundation of Pregnancy we looked at the physical aspect of pregnancy in women. In this post I would like to present what Sun Si Miao (http://www.taijichinesemedicine.com/sunsimiao.htm) wrote regarding the pregnancy itself. But, before I talk about Sun Si Miao, I would like to present Ye Heng Yin, and his description of conception. Ye Heng Yin was a gynecology expert from the Qing dynasty. He wrote the Nu Ke Zhi Nan (A Guide to Gynecology).
In this guide, Yin says that the Tian Gui is the contribution of the father and the mother, the form of heaven and true Qi that are formed in the body. The essence and blood that changed form, from fluids and grains, are the root of the creation of post-heaven. In males- Tian Gui arises at 8X2 (16), since men are Yang and belong to the sun. That is why their daily essence becomes more and more vital. In females - Tian Gui arises at 7X2 (14), since women are Yin and belong to the moon. That is why their blood flows out of the body once a month. At the time when man and woman unite, the original Qi of pre-heaven, the essence of post heaven, the blood, the Yin and the Yang all gather together. This allows for the arrival of children.
One must not treat or touch the meridian during it’s month of effect on the pregnancy
Moving now to Sun Si Miao… He explains that in each month, the fetus is nourished by a different channel and each has it’s own different effect and impact on pregnancy. The pulse of the organ system involved will be weak, as its Qi nourishes the fetus. If during treatment we need to address the channel during its month of effect, we can do so. We simply have to use indirect methods. We can access the organ system through the Back-shu points or by treating a paired organ (using five element or six conformation pairing, or some other).
Now for some specifics regarding the individual months of pregnancy…
1st month
Gestation of Raw Material. The fetus is like a dew drop!
The meridian of this month: Liver. The liver has a role in everything that has to do with the period and during pregnancy. This reminds us of the power of spring.
2nd month
The fetus is at the level of CV3. The fetus is referred to as Gao - fertility dough.
The meridian of the month: Gall Bladder. The GB is in charge of the essences. We still have the energetic influence of spring, the breakthrough of life. Since this month is very important for the fetus to be rooted in the uterus, it is a resting time for the mother.
3rd month
The beginning of the embryo. The fetus is like a silkworm’s pupa.
The meridian of the month: Pericardium. You can read more about Pericardium through a Classical Chinese Medicine perspective at Deepest Health.
4th month
The fetus connects with the Dantian. The body and form are becoming much more solidified.
The meridian of the month: San Jiao/Triple Burner
The element of the month: Water. The Zhi of the mother goes to the fetus. The first 3 months are very basic and there’s no certainty. As of the 4th month there’s a good chance for the fetus to survive the pregnancy and the elements come into the picture as do heavenly energies. When matter has the vital potential for life the rest of the elements come in.
5th month
The Uterus is being held firm in its place. One can feel the fetus moving in the Uterus.
The meridian of the month: Spleen. It is recommended to the mother to do things in their right timing and in a balanced way. The balance and stability of Earth needs to be invoked.
The element of the month: Fire. The Shen of the mother goes to the fetus.
6th month
The fetus is like a fish in its mother Uterus. It has real stability and form.
The meridian of the month: Stomach. The eyes and mouth are developing and the 5 tastes are in the fetus’ mouth. Salivary glands also develop in this month. It is recommended for the mother to eat delicate and sweet food.
The element of the month: Metal. The Po of the mother goes to the fetus.
7th month
The fetus grows big. The hair, the bones and ligaments are formed and all the sense organs are developing.
The meridian of the month: Lung. It is said that the mother should avoid cold, yelling and crying.
The month of the month: Wood. The Hun of the mother goes to the fetus.
8th month
Zang Fu completed.
The meridian of the month: Large Intestine. The 9 orifices are completed at this point.
The element of the month: Earth. The Yi of the mother goes to the fetus.
It is said that the mother’s spirit should be calm so not to create shocks in the Qi flow. One can feel the reactions of the fetus according the mother’s moods.
9th month
The fetus receives the Jade essence, which is the seal of approval that everything is ready.
The meridian of the month: Kidneys. It is recommended to the mother to avoid tight clothes and to eat sweet food.
10th month
Fetus is ready to come out.
The meridian of the month: Bladder. It is possible to treat this meridian if there’s a need to start labor or if you want to turn the fetus from a breech position. All the Yin organs are completed, the Yang organs are clear from stagnations, the heaven and earth were absorbed, the spirit of the man (fetus) is complete and all that is left is to be born. The mother should concentrate on the Dantian.
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Bibliography:
Extraordinary Fu- Elisabeth Rochat de la Vallee and Claude Larre
Chinese Gynecology studies with Yael Saslove- 2006- Israel
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From the Editor (Eric): With all of this in mind, how can we extend our understanding of pregnancy from a Chinese medicine perspective? How can we best advise our patients during their pregnancy? It seems that most Western people in contemporary times want to live their normal lifestyle during and directly after pregnancy, not taking the time necessary to fully nourish themselves and their fetus. What are the consequences of this? We would all love to hear your ideas and experiences in the comments.
If you like what you read here, you may want to keep updated by using my RSS feed. Want to know more about RSS/feeds? - read more here. Thanks for visiting!
Tags: Classical Texts (general), guest-post, pregnancy, sun si miao, women's healthRelated posts
Deepest Health is a member of the 9rules network!
Blogging can be hard work. For the most part, I do it because I really enjoy my interactions with all of you. I also enjoy the opportunity to work out my ideas in a more solid form and share things that aren’t easily available on the web. Anyway, as I shared in my post about a year of Chinese medicine blogging, things have been going well for the site. But, I wrote too soon. I am very honored and excited to announce:
Deepest Health has been accepted as a member site to the popular 9rules blog network!
For those of you who don’t know, a blog network is run by a dedicated group of individuals that want to make it easier for folks to filter through the huge number of blogs out there. 9rules was started in 2003 and has built a reputation as a valuable resource of use to anyone who is interested in reading the best material on the Internet. I encourage you to check them out.
Thanks everyone,
Eric
PS: It will take a bit for my content to be republished by 9rules, so if you try to look for me there, you won’t find me - yet. :)
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Understanding Chinese herbs using Classical Chinese Medical thinking
Sometimes I learn small things that turn out to be very useful. I would like to start sharing these as bite sized treats interspersed in between the thicker cuts that many of you are accustomed to here on Deepest Health. Today, I would like to offer one of those which is a way of thinking about herbs (and, thus, formulas) that I initially learned from my mentor, Dr. Arnaud Versluys. It’s a simple thing, maybe, but hopefully helpful to you.
In our Classical Chinese Medicine education here in Portland, OR, we are given a variety of types of information. I’ve talked about this several times before. We are sometimes told that truly Classical Chinese Medicine includes the information in the standard TCM system and includes information in the Western/allopathic system, but then goes outside of those reaching back to the Classical texts and cultivated ways of knowing. All of this information must be explored and, ultimately, integrated. We are encouraged to find that which really drives us and dive deep into that, but always asked to keep our minds open to the whole symbol field of information that human striving has uncovered.
In that spirit, consider the study of Chinese herbs. There’s a huge amount of information one could associate with any given single herb. The information has many different aspects - let us consider the relative materiality and the relative size (in time and/or space) of the information. We can create two axes. One from grossly material to highly immaterial, and one from microscopic to quite macroscopic. We can find useful information anywhere in the field created by these two axes. Let me provide a partial list of information along these two axes that I use to understand single Chinese herbs. The information will be listed from more material and more microscopic to less material and more macroscopic (obviously not a perfect gradation).
- Specific biochemical constituents, chemical bonding (for example, discussion of specific alkaloids)
- Classes of biochemical constituents, herb-herb interaction (for example, what are alkaloids?)
- Western medical physiological understanding (for example, discussion of the endocrine system)
- This might include information from Western medical studies/clinical trials
- Habitat and other botanical information (what kind of plant is this?)
- Chinese herbal category information (qi, flavor, channel affinity) and dosage information
- Contradictions (both Chinese and Western)
- Use of the herb through history in China (what formulas? what doctors? what contexts?)
- Understanding via various systems of differentiation (Ba Gan/8 Pillars, 6 Conformations, 5 Element)
- Information in various Classical texts concerning this herb other than what’s already been covered in another category
- Symbolism behind any of the previous categories of information (for instance, given the relevant habitat in which the herb grows - how can we understand it symbolically)
- Use of categories of information associated with the organ clock (If this is a Spleen herb, how can the symbolism of the snake help us think about it?
Let’s just look at a quick example on a very basic level using just some of the partial list above. Bai Shao, anyone?
白芍 Bái Sháo (Yào)
Biochemical constituents/other minute level Western information
- Paeoniflorin, albiflorin, oxypaeonifloring, benzoylpaeoniflorin, paeonin, hydorxypaeoniflorin (glycosides), gallotannin, d-catechin, eugeniin (tannins), benzoic acid, proteins and other constituents
- To extend this into the next category, we might be interested to look more deeply at the general function of glycosides and tannins, their function in the body and the families of things on the planet that either create or use them in high amounts. Of course this must all be evaluated symbolically.
- Herb-herb interaction? We might consider that Bai Shao is often paired with Gui Zhi, look into the chemical constituents of Gui Zhi and investigate, from a Western standpoint, what those interactions tend to produce.
- Herb-drug interaction? What drugs does Bai Shao resemble? What drugs does Bai Shao work poorly with? For instance, one is asked to have care when using Bai Shao for patients on anti-coagulants. What does this mean?
We could definitely find many clinical studies about Bai Shao and isolate what pharmacological effects allopathic medical researchers have found. A quick look tells me that some researchers have found that Bai Shao has:
- CNS suppressant, gastrointestinal, antibiotic, antipyretic, anti-inflammatory, anti-platelet and cardiovascula effects
Habitat and other botanical information
Bensky tells us that Bai Shao is Paeonia lactiflora with the bark removed and that Chi Shao is a wildcrafted version of the same species - with bark intact. It would be interesting to know more about this distinction and to understand whether this distinction held during the Han dynasty. Anyone with information to that effect?
It is native to a large part of the area from Tibet through China up to Russia. It enjoys a wide range of habitats and the entire plant can be used medicinally or as food. This may help us to understand its rather broad range of effects and its extensive use in the classics.
Chinese herbal category information, inclusion in formulas
- Wei/Flavor: Bitter and sour
- Qi/Temperature: Slightly cold/cool
- Channel affinity: Liver and Spleen
- Dosage: Typically 6-15 grams
A quick search at Rootdown.us shows us that Bai Shao is included in 48 formulas. As the formula database is not complete on that site (it’s growing every day!) I’m certain the number is much higher. We could look at the usage of Bai Shao in each of those formulas and come to some conclusions about what kinds of effects it has and use those findings to further dive into the symbolism associated with the herb.
Use of the herb through the history of Chinese medicine, inclusion in various Classical texts
How did Zhang Zhong Jing use Bai Shao? How is this different from the way later physicians used it? What is said about Bai Shao in the Shennong Ben Cao Jing? This entry is getting a bit too long already, so I won’t delve into these questions — but you can see how the information would be very useful in coming to a full understanding of Bai Shao.
Understanding some of the above information more symbolically
Just as a quick example take the broad habitat adaptation of Bai Shao. It’s a relatively easy plant to grow - and it grows quickly. The Earth seems to want to give it to us in abundance. An herb that adaptable has to be important for the basic physiology of the body - one might think. Perhaps it lends itself to a certain adaptability in us as well.
Various systems of differentiation
Again, to save time I will be very brief. One way to understand Bai Shao is that it backs Wood off of Earth. This doesn’t mean that Wood has to be very excessive. Earth merely needs to be a bit under the weather (so to speak) and the normal amount of Wood will be too much for it. This is part of the way we can come to understand Bai Shao’s use in Xiao Jian Zhong Tang. One symptom one might find in a XJZT syndrome is mild muscle cramping or mild abdominal cramping due to a weak Earth being unable to resist the basically “normal” Wood energy. Bai Shao mildly backs Wood off of Earth so it can recover.
Organ clock and other high level theoretical constructs
Bai Shao is basically a Wood herb. How can we use the symbolism behind the Wood organs - Liver and Gallbladder, to come to a fuller understanding of Bai Shao? We can consider, perhaps, the symbol of the Ox or the Wood constellations in Chinese astronomy. We could look at the clock pair of the Liver and try to uncover any mysteries there.
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Ok, so this turned out a little longer than I expected. My gut level instinct is simply this. While I am not personally interested in going down every little rabbit hole that the current information culture serves up for me, I am certainly open to embracing a wide variety of information sources. I find that when I am able to see an herb (and by extension a formula) from many angles, my relationship with it deepens. I can only assume that this is molding me into a better clinician. I’d be very interested to hear anyone else’s thoughts on this topic in the comments. Go on - take a chance!
Eric
Tags: chinese-herb, chinese-herbs, formula-science, formulas, herbs, integrative-medicine, scholar, study-methods, studying, western researchRelated posts
The six conformations: an exploratory post
The topic of the Six Conformations is huge. So huge, it’s been a bit intimidating to write about. But, it’s something that we hear a lot about in our Classical Chinese Medicine studies here at NCNM in Portland. So, as most times, see this as the beginning of a long exploration. If you’re here without much knowledge of the Six Conformations I hope that this, and related posts, will help broaden your understanding. If you’re here with lots of knowledge of the Six Conformations, I hope you will share your wisdom with us in the comments.
The Six Conformation system is another on par with the Five Elemental Phases. It is a way to sort the macrocosm and microcosm into manageable chunks that have meaningful relationships with one another. It’s worth mentioning that the Shang Han Lun is based on Six Conformation differentiation. In heaven, they refer to weather patterns - or atmospheric Qi. In the human being, they refer to systems in the body. This is important. When people hear about the Six Conformations, they often think about the channels only - so when I say Taiyin, folks automatically think, “Spleen and Lung channels.” This is erroneous thinking, even though many influential books translate Liu Jing as “Six Channels.” Just as the Five Elemental Phases don’t refer only to organs or layers of the body, but include those; the Six Conformations don’t refer only to channels or even their paired organs, but include those.
Let’s get the nitty gritty details out of the way. What are the Six Conformations?
- Taiyang - 太陽 - Great Yang - associated with the Bladder and Small Intestine organ systems
- Yangming - 陽明 - Yang Brightness - associated with Large Intestine and Stomach organ systems
- Shaoyang - 少陽 - Lesser Yang - associated with the Gallbladder and Triple Burner organ systems
- Taiyin - 太陰 - Great Yin - associated with the Lung and Spleen organ systems
- Shaoyin - 少陰 - Lesser Yin - associated with the Heart and Kidney organ systems
- Jueyin - 厥陰 - Reverting Yin - associated with the Pericardium and Liver organ systems
There’s a lot of layers of information associated with each of these categories. I couldn’t hope to look at all of it in one blog post. Let’s look at the most basic layers.
Climactic factors (for better or for worse)
The Six Conformations are related to Six climactic factors/Qi (Liu Qi). These should be in balance in nature, but when they are out of balance we know them as the Six Evils.
- Taiyang - Cold : associated with water, contracting quality
- Yangming - Dryness : associated with metal, dessicating quality
- Shaoyang - Fire : associated with fire, flaring/ministerial in quality
- Taiyin - Damp : associated with earth, sticky and heavy in quality
- Shaoyin - Heat : associated with fire,
- Jueyin - Wind : associated with wood, wandering in quality
As I said above, people often think Six Conformations = Six Channels. Me, I have the opposite problem — I have it so embedded in my head that the Six Conformations = Six Channels = Six Qi (atmospheric and evil) that sometimes I become a bit confused by it. My understanding so far is simple — when we talk about the Six Conformations out of context (as we are now) the concept includes shades of all these meanings (Qi/climactic factors, Jing/channels, layers of the body, etc) and much more. When we are looking at a Conformation more specifically as in a disease, we can tease out what piece of information is most relevant for us at the time. I hope this is clear. It’s a hard thing to explain.
The order of the conformations and the layers of the body
The specific order I keep using as I list the conformations is not without reason. While there is some discussion about the placement of Yangming, most of my teachers seem to agree on this order.
Taiyang is the most outward of the conformations. It governs the most superficial layers of the body and is associated with the Weiqi or defensive force of the human being. Think of the premiere formulas associated with Taiyang - Gui Zhi Tang and Ma Huang Tang. Both strongly resolve the surface. Yangming is the next layer deep - both in some sense physically and also in terms of how external pathogens must progress in their quest to do harm. It is in the Yangming stage that we get great fevers, this is a storehouse of immense Qi and Blood force in the average person. Think how well this resonates with the Stomach and Large Intestine organ systems, both deep dealers in the most basic, primal functions of life. The last Yang conformation, and thus the last protector against a disease becoming deeply internalized, is Shaoyang. Shaoyang is said to “pivot” (a long discussion) between internal and external, and thus has a kind of oscillating quality.
Now we enter the interior of the body, going ever deeper. Taiyin is the first of the Yin conformations and in some way exemplifies a kind of “doing without doing” — the most active of the passive organ systems. Going a layer deeper we find Shaoyin, the north and south poles of the body - Heart and Kidney, the basic axis of the functioning of the human body. When external pathogens reach this deeply, serious disease is the result. Finally, Jueyin - the deepest, but also the possibility of rebirth into the Taiyang conformations in the classic cyclic manner of Chinese philosophical systems. Jueyin is deeply involved with blood, as can be seen clearly in its encompassing of both Liver and Pericardium.
Pairing of the organ systems : insight into pathology
The more I write about this, the more I find to write. For now, I’ll just mention one quick thing. The conformations can be paired in the following way:
- Taiyang - Shaoyin : BL/SI with KD/HT
- Yangming - Taiyin : ST/LI with SP/LU
- Shaoyang - Jueyin : GB/TB with LR/PC
Anyone can see the wisdom of these pairings - reuniting the five elementally associated organ pairs. We have been taught that these are pairings of mutual support. Taiyang is supported by Shaoyin, and Shaoyin feeds Taiyang. Thus, when you have a disease in one, the other is somehow involved. There are particular ways that we have learned to understand this system of differentiation. But a simple thing to consider is this — take one manifestation of Yangming disease, serious constipation. What happens if one over purges in Yangming disease and why? It’s easy enough to say that overpurging (using cold and bitter materials) will cause damage to the Spleen that can manifest itself in a variety of ways, including as diarrhea. Why is that?
One way to explain it is to consider that Taiyin is the support of Yangming, so that when you overtax Yangming it will draw energy from Taiyin, ultimately depleting it. Of course, there are people who would explain this in a much more nuanced way but when I’ve mentioned it to others they seem to understand. Hopefully it will be helpful to you.
I’ll talk more about how I’m learning about the six conformations in the future. I’ll be interested to read any comments - add your thoughts to the discussion!
Eric
Tags: classical-chinese-medicine, shang-han-lun, six conformations, Theory, Zhang Zhong JingRelated posts
A year of blogging about Classical Chinese Medicine
We’re running up on the one year anniversary of Deepest Health!* Can you believe it? One year and we’re up to almost 250 daily subscribers (thank you!) and a very respectable daily traffic number that averages around 15,000 page views a month. We also recently reached a search engine benchmark - receiving Pagerank 5! All of this despite the toll that my busy schedule has taken on my posting frequency. I want to thank each and every one of my readers for interacting with me, teaching me, promoting the site and just generally being awesome. Thanks!
I’ve been doing some thinking about where I would like the site to be in another year. The fact is that I would like to see more readers, more subscribers, and more conversation going on. This requires MORE content creation on my part, and I recognize that. I’ve been getting plenty of emails from readers wishing I would go back to my super frequent posting schedule of last summer. I’ve been thinking about whether I want to make blogging a priority again.
My posting frequency has plummeted for a variety of reasons, but it comes down to three major problems.
1. I’m way busy.
2. Getting more readers made me a little afraid to “speak my mind” especially when some of my readers are professors and quite active practitioners in the field.
3. I started to become unsure about what readers wanted.
These reasons are bad ones. To address number one - I’ll always be busy. I can’t let that get in my way. We’ve all had the experience of suddenly finding time for something we’re motivated to make a priority (new love, anyone?) just as we’ve all experienced the converse (taxes, anyone?) So, I guess that’s debunked. Number two is just crass fear. I’m a student. In a little more than a year, I’ll be a new practitioner. I’ve never claimed to be anything else, right? I know I’ve said this before. It scares me a little to know that my professors, my esteemed colleagues and practitioners with lots more experience are reading my words. However, the response has been overwhelmingly positive and it seems like folks want to see me writing more often - so I guess I’m going to have to consolidate my Kidneys and get on with it. T
To address the third issue - it is still a problem. Everyone seems to like something a little different. The most significant problem I have is the worry about writing for practitioners and dorky students (like me) and leaving average folks and brand new students without anything compelling to read. I’m just going to have to hope it works out. I’ve tried writing articles for new patients before, and it just didn’t move me very much. Every once in a while I feel like I put out something of interest to the general public, and those posts are rewarded with good traffic, but I don’t want that to be a focus.
In the end the greatest barrier is a combination of all of these. Because of my fear and lack of comprehension about what readers want has led to my spending WAAAAY too much time with each article. This has made it impossible for me to consider fitting posting regularly into my schedule. With these myths busted, hopefully I can get on with producing excellent content for all of you who are interested in reading it.
I hope you’ve enjoyed this public display of what is a private process. It’s like talking to yourself to work out a problem when you think nobody can hear, only I know you can hear. Such is the blogging life.
Eric
*Note: Deepest Health has actually been around in some form for almost 2 years, but I really began writing in earnest in June 2007
Tags: Blogging, content, focus, health, overwhelm, rest, students, summer, tea
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