Chinese astrological calendars - get yours today!
Hey everyone,
It’s been a funny beginning of the Autumn season and I’m doing my best to adapt to the shifting energy. Good things are coming to Deepest Health soon, particularly if you’re a student or relatively new to Chinese medicine (you know, like me) but for now I just have a quick suggestion.
Learn more about the energy of your days as described via Chinese astrology! Fortunately, I have a simple and beautiful way for you to do that. My friend and colleague, Brandon Brown, has just created a quite lovely and accurate calendar that contains all the pertinent Chinese astrological data. By using his calendar you not only help support a fine budding scholar of Chinese medicine, but you also get to learn more about this fascinating system for looking at the world.
After you buy and have used it for a while, come back and let us know how it’s going. I find that paying close attention to these things tends to shift my consciousness quite a bit.
Eric
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: astrology, autumn, brandon, calendar, chinese-medicine, earthly branches, energy, heavenly stems, Seasons, studentRelated posts
Chinese herb substitution and using local species
I thank you all for your patience as I adjust to my workload. The reality of the situation is that I’m going to have to post what I can, when I can. But, with the onset of clinic I find myself coming up with many new thoughts to share - I’ll do my best to get them up in a timely fashion. Look also for the return of the podcast this week. I know you’ve missed me. :)
Anyway, in a fantastic lecture by Dr. Arnaud Versluys this weekend, I was reinspired to consider a very real problem in Chinese herbal medicine. We use herbs that travel long distances, are sometimes beset with chemical and heavy metal toxicity, are sometimes banned by ill-informed government agencies and some of which are becoming rare and, thus, expensive. Given that I am very serious about a rigorously authentic Shang Han Lun
The particular herb that came up in discussion about this issue was Xi Xin - Asarum - Wild Ginger. I love this herb. It’s used in a couple of indispensible formulas, perhaps most importantly in Dang Gui Si Ni Tang. Most herbalists agree that there’s simply no substitute for Xi Xin, but I’ve seen or heard of people try to replace it with Wu Tou, Yu Jin, Sheng Jiang + Mai Men Dong (?!) and other interesting combinations. Most of these same herbalists agree that it’s simply not the same without Xi Xin.
The ban on Xi Xin for practitioners is ridiculous to the extreme and I’m not going to discuss that here. What I would like to hear people discuss is how they make substitutions in these cases. When an herb you need isn’t around, what do you do? What herbs have you had to learn to live without? I understand that UK herbalists are quite restricted in what they can prescribe - how have my UK readers dealt with this problem? Even when a governmental agency isn’t busy interfering, we sometimes lose herbs. Consider Xi Jiao, rhino horn. Consider the precarious state of Ren Shen, ginseng.
There are a couple of associated questions that come up when one considers this issue. One is - should we simply learn to work with fewer, simpler herbs? Dr. Versluys is known to say that he thinks he could do a fair job of treating patients with only 10 herbs - a set of cooling herbs in each of five flavors and a corresponding set of warming herbs. If you know formula science and architecture, such artistry is certainly possible. Is this the standard towards which we should strive? It seems far superior to the never ending quest for the “perfect herb for cancer” or memorizing five hundred herbs, over half of which are specialized for particular symptoms.
Taking this a little bit farther, we should consider the wisdom of relying on herb sources that can only be accessed by air shipments from another continent. Given peak oil, given the unstable political nature of our planet, given the environmental crisis we find ourselves in… should we at least consider the possibility that we may need to rely on local sources for our herbs at some point in the future?
My friend said an interesting thing to me today. In the course of discussing this various issue he said, “To be true Classical Chinese herbalists, we should use the herbs we find around us.” I didn’t question him any farther on this issue, but I think he’s right from some perspectives. Learning the Chinese herbs and formula science so deeply that it is second nature allows us to look at all plants, animals and minerals with the eyes of a Classical Chinese herbalist. Then it seems at least possible that we could, if necessary, find other materials that meet the needs of our patients.
I’d be interested to hear your thoughts on this rambling post. Doubtless there are many opinions out there - share them here on Deepest Health by responding in the comments. No registration is necessary and you can even post anonymously if you are respectful.
Thanks for reading,
Eric
Tags: chinese-herb, chinese-herbs, environment, flavors, formulas, herbs, nature, versluysRelated posts
Hurrah for Hara! Shiatsu diagnosis and treatment
I have another great guest post for Deepest Health readers. This time, please welcome Rob Blackburn and enjoy his article on the Hara as used in Shiatsu diagnosis and treatment. It may help to get another angle on the abdomen in Asian medicine, a great companion to Kumiko’s fine article on the subject.
Quickly, by way of a personal update: School has, indeed, become very intense and I’m still adjusting - but we’ll be back to “regular” content soon. Regardless, I’m sure you all agree that these guest posts are of top quality - thanks so much to all of my guest authors. Please feel free to leave comments, the authors will hopefully be monitoring their posts and replying.
Eric
—-
Introducing the Hara
Before going too deeply into Hara Diagnosis and Treatment (or Ampuku) it is important to clearly define what we mean by “Hara”. Hara is a Japanese word that broadly refers to the area below the ribs and the sternum all the way to just above the pubic bone.
In Shiatsu, I think it is safe to say that Hara Diagnosis is a cornerstone of any treatment. In my school, and as far as I know most schools of Zen Shiatsu we are taught three different maps for Hara Diagnosis. The first and most commonly used is the Zen Shiatsu map. The second is the less specific, Five Element Map, and the last is a v
ery broad map based around Ren points. I shall concentrate mostly on the Zen Shiatsu Map here with some reference to the Five Element Map, as it is what I am most familiar with in practice.
The Zen Shiatsu Map was developed by a man called Shizuto Masunaga (1925- 1981) who is largely responsible, along with his student Wataru Ohashi, for popularizing Shiatsu in the Western world. It is clear that Masunaga had very solid basis in the classics but as far as I can tell the Zen Shiatsu Map was largely his own creation along with 12 Extra meridians that he intuited during his career. The Zen Shiatsu Map Divides up the Hara into Organ Specific areas for the 12 Major Meridians The Zen map above is from my own notes.
The five Element map, on the other hand, more broadly divides the Hara up into the Respective Element areas, the middle three of which correlate with the Zen Map. 
Palpating and Diagnosing the Hara
The method for palpating the abdomen can follow a specific routine. First, generally ‘baby walking’ or ‘palming’ the whole Hara using steady whole hand pressure to get a good idea if the general qualities of the Hara (hard or soft, tense or relaxed, along with quality of the breath) and so too an overview of the person being treated. Then the practitioner can be more specific, using one, or both of the maps.
The Zen Shiatsu Map can even be palpated in a particular order to make learning it easier and to ensure all areas are covered with equal pressure. The Hara is usually palpated with the fingers of the hand held together whilst moving in a smooth rhythmic fashion.
The idea is to feel for areas of Kyo or Jitsu (broadly equivalent to Excess and Deficiency in Chinese Medicine and worthy of a post all to themselves). This is where the Zen of the Diagnosis really comes in. The practitioner must ‘listen’ intently through their hands to any energetic qualities that may arise or become apparent, all the while being careful not the confuse physiological land marks with things of energetic significance (food in the intestines for example.) The practitioner must also be remain slightly uninvolved in order that whatever is to become apparent does so and is not disturbed by the practitioners movements. I liken this to dipping your hand in a still, dark pool to feel the currents without disturbing the surface and being distracted by the ripples.
The act of diagnosing in this way throws up an interesting problem, which is this; as soon as the practitioner interacts with the client in this way they are treating them. Hence the oft repeated saying “diagnosis is treatment, treatment is diagnosis.” But, this can lead to confusion as the more the Practitioner palpates the more likely they are to change what they are perceiving. The skill is to get a clear overview of the two Channels that will form the basis of the treatment, the most “Kyo” (or empty) channel and the most “Jitsu” (or full) Channel without going to far into treatment and risking muddying the waters. Obviously these are often novice pitfalls and the master would not even in some cases need to make physical contact with the patient in order to make a diagnosis.
The Hara is a powerful diagnostic tool and much like the tongue it tells an honest picture of the patients energetic make-up. The skill is to be sure of what you are looking at! For example, the area around and below the ribs can be tight and full feeling due to Liver Ki Stagnation, which often makes this area tight. This could be mistaken for a Heart jitsu diagnosis, as the Fire diagnostic area is situated just below the Xiphoid Process and extending down towards the Umbilicus. Similarly, it could mislead as the Stomach Bo (Mu) Point is in a similar area and could feel jitsu as a result. The key to resolving these problems is to ensure that even a comprehensive and telling Diagnostic tool such as the Hara is not taken in isolation but is compared with other Pillars of Diagnosis for a rounded picture.
Treating the Hara
Treating the Hara can be profoundly satisfying and yield on the spot results. You can provide treatment directly to areas affected by different patterns.
As mentioned previously, Liver Ki Stagnation can affect the epigastrium and respond very well to dynamic Ampuku techniques especially when the Stagnation effects the digestion and breathing.
In fact many digestive issues can be eased with Ampuku, yet the seemingly obvious act of massaging the abdomen seems quite an alien concept here in the West! Maybe this is because the Abdomen is such a sensitive Yin area of the body and is literally and often figuratively the core of a person’s being.
Finally, another great yet simple treatment that can be administered through the Hara is simply laying a hand on the lower Hara in the water diagnostic area, below the umbilicus around Ren 5 and 6. By following the recipients breath with the hand the Practitioner can effect a calming effect on the mind which can be like a guided meditation, or if the breath is followed more deeply with pressure being applied gradually with the hand, can have a tonifying effect on the Kidney.
This is where Shiatsu really comes into its own. The practitioner can directly “remind” a body of a mental state and direct breath to the abdomen just through placing the hand on the Hara in a mindful way. This technique simultaneously activates the Triple Heater Bo (Mu) Point and the Sea of Qi point whilst reminding the recipient of their Dantien. In this way it is possible to give the person a sense of gravity and centeredness.
I could write a lot more about this fascinating subject. As it stands, I intended to go into my own experience but I ended up writing a brief overview of the subject instead! I am still a student so feel free to comment and correct me where you see fit.
Rob
Tags: abdominal diagnosis, asian medicine, Diagnosis, guest-post, shiatsu, stomachRelated posts
Deepest Health Chinese Medicine Podcast : Episode 10 : End of term clinical reflections
Welcome to another Episode of the Deepest Health Podcast! In this episode, I discuss my reflections as I come to the end of my first term/quarter in clinic at NCNM. I reiterate the importance of memorization and excellent patient care, but then go in a philosophical direction on a couple of topics. First, I discuss my experience of being able to separate the disease from the person experiencing the disease. Second, I talk about the paradoxical reactions of some patients to treatment. I wrap up the podcast by a discussion of utilizing our many human gifts, referring often to the quintissential “Renaissance Man,” Leonardo da Vinci.
In the podcast, I reference a blog - but cannot remember the name of the blog, so cannot link to the post that inspired my da Vinci explorations. If you, for some strange reason, know what I’m talking about - let me know and I’ll link it. I also reference a book I’m currently reading about da Vinci and the practices one might take from his life. You can click on the link below to check it out.
Tags: clinic, memorization, ncnm, patient care, Podcast
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Salt Sensitive Hypertension and Classical Chinese Medicine, Part 3
This is the final post in a three part series by Brandon Brown, blogger and student of Classical Chinese Medicine at NCNM. You can read the first two parts here and here, and can read references for the article by visiting Brandon’s site here.
Salt in the Classics
Salt is mentioned a number of times in the classics. In the Neijing Suwen, salt is considered the flavor of the Kidney. But what does this mean exactly? What follows are the most descriptive and instructive references from the Suwen followed by my translations.
Chapter 67
北方生寒，寒生水，水生鹹，鹹生腎，腎生骨髓，髓生肝。其在天為寒，在地為水，在體為骨，在氣為堅，在藏為腎，其性為凜，其德為寒，其用為，其色為黑，其化為肅，其蟲鱗，其政為靜，其令，其變凝冽，其眚冰雹，其味為鹹，其志為恐。恐傷腎，思勝恐，寒傷血，燥勝寒，鹹傷血，甘勝鹹。
“The north generates cold, cold generates water, water generates salty, salty generates kidneys, kidney generates the marrow, marrow generates the liver. In heaven it is cold, on earth it is water, in the body it is bone, its qi is hard, in the Zang it is the Kidney, its nature is cold(shivering), its virtue is cold, it is “use”, its color is black, it changes into solemn-ness(seriousness), it is worms and fish-scales, its government is stillness(jing), it causes, its pathological change is congealing coldness, its natural disaster is ice hail, its flavor is salty, it is will by fear. Fear impairs the kidney, thought defeats fear, cold damages blood, dryness defeats cold, salty damages blood, sweet defeats salty.”
Chapter 3
味過於鹹，大骨氣勞，短肌，心氣抑。
Excess salty flavor, causes great hardening of bone Qi, shortens the muscles, and restrains heart Qi.
Chapter 5
鹹勝苦。
Salty defeats bitter.
Chapter 10
是故多食鹹則脈凝泣而變色 。
Therefore, much eating of salty makes the pulse concrete and the color changing.
Chapter 22
心欲耎，急食鹹以耎之，用鹹補之，甘寫之。
The Heart desires softness, anxious people eat salty that softens it, use salty to mend it, sweet drains it.
—-
These excerpts from the Suwen indicate the myriad functions of salt. In Chinese Medicine, the Salty flavor is typically used to soften nodules as mentioned in Chapter 22, but we also see in Chapter 3, 10, and 67 that salt can pathologically also create hardness of Bone Qi, restrain Heart Qi, damage blood, and cause the pulse to be very firm. We can read these lines in typical Chinese Medicine fashion: that as a remedy, the salty flavor has a purpose in softening nodules, in moderation salt perhaps allows the Kidney to perform its function of storing, but pathological excess consumption of salt can lead to sclerosis.
In Chinese Medicine, the 5 flavors that go with the 5 organs typically counteract the nature of the targeted organ. For example, the energetic nature of the Liver is up and out whereas the flavor Sour astringes and contracts. The Heart, the fire organ, is up and bitter is down. For the Lung, its nature is contracting down and in, whereas pungent is the opposite: up and out. For the Kidney, as we see in Chapter 67 above, the energetic nature is definitely to store by freezing. Salt, must counteract this freezing nature, as we know that it does from our experience: salt both reduces the freezing point of water and raises the boiling point. The presence of salt liquefies ice, and thus can soften hardness (tumors, goiter, etc.). But because salt has an affinity with the Kidney it counteracts the storing nature of the organ, liquefying the Kidney energy (perhaps Jing) to be used in the body as Qi. Therefore we see again that, salt pushes out from the inside.
In their paper on the Classical Energetics of the Five Flavors (find in references section), Arnaud Versluys and Jessica Atkins describe the therapeutic actions of the five flavors in terms of tonification and purgation. In cases of excess or deficiency, the organs can be respectively purged or tonified with the appropriate flavor as shown in the figure below.
Figure 2: The actions of the 5 flavors
Organ: Excess of, purge with : Deficiency of, tonify with
Fire : Sweet : Salty
Earth : Bitter : Sweet
Metal : Pungent : Sour
Water : Salty : Bitter
Wood : Sour : Pungent
According to their interpretation, the salty flavor purges excess in the Kidneys and tonifies the Heart. In the case of SSH, chronic overexposure to dietary salt may act medicinally and impair or purge the storing function of the Kidney and thus over-tonify the Heart. Because the Kidney is also said to store pre-natal essence if there is no pathological influence to expel in the Kidneys, it is possible that what is purged is actually pre-natal essence (Jing). This essence is circulated throughout the body, transformed to Qi by the Liver function, and transformed and stored as Shen by the Heart. Shen, and thus consciousness, have as a substrate the brain, but Shen is housed in the Heart.
Therefore, the use of salt habitually may increase the Jing-Qi-Shen generation cycle, which makes us sharp and awake, but has the detrimental effect of possibly depleting pre-natal essence if the Kidneys are not constantly tonified. In the Suwen it mentions that at 8 times 7 years (56 years old), the hair (ruled by the Kidney) turns gray and the signs of aging begin to become visible. “The kidneys’ ability to excrete sodium declines gradually with age. If, with age, salt consumption is not reduced, sodium balance is maintained by raising fractional sodium excretion, which requires elevation of BP” (Khalil 2005). The 
accumulation of salt in the ocean over the years has begun to take its toll.
Because purgation of the Kidney in a non-pathological condition also tonifies the Heart, an interesting consequence of excess in the Fire element is that it easily overflows onto its child organ, the Earth. This would lead the Earth to become overwhelmed and thereby inhibiting it to control the Water element, whose function is diminishing due to the natural processes of aging. In CM, we say that the “Earth rules the muscles” and in the SSH case this clearly relates to the smooth muscle of the vasculature losing its ability to contract. Due to an excess in the Heart domain, the smooth muscle becomes dry, stiff, and brittle. The patho-mechanism of this is illustrated below.
The standard American diet is predominantly made of the flavors salty and sweet. The overwhelming absence of bitter (with the exception of Shen disturbing coffee and beer) and the overwhelming abundance of salt and sugar in the standard American diet may explain the danger of increased exposure to dietary salt.
Conclusion
It is not surprising that decreasing daily dietary salt intake will help in treatment SSH. However, what we learn from the classics and the physiology of salt in the body is that Kidney tonification is essential for SSH.
Because the Earth element has become so affected by this chronic exposure to salt, purging the Earth of excess with the bitter flavor will be important. Like a lone neuron in the brain, salt consumption is entangled in the higher social structures that predominate our times: working long hours, using the mind instead of physical labor for generating a living, exposure to a barrage of psycho-sensory information in terms of television, music, and people, along with increasing anxieties about all of it. Seen in this context it really is no wonder why SSH is a modern disease of the “developed” world.
Brandon Brown
Tags: five phases, heart, human physiology, kidney, liver, lung, metal, nature, neijing, salt, student, translations
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