Deepest Health » classical-chinese-medicine

The importance of the Spleen in studying Classical Chinese Medicine

Eric Grey — Tue, 15 Nov 2011 12:00:40 +0000

脾 Pi – Spleen : Lessons learned from Yin Earth

Earthly Branch Si – The Snake : Lesson – You can take in a lot more than you think, but don’t overdo it

The Spleen is associated with the 6th Earthly Branch 巳 – Si. This is one of the few earthly branches that actually is a picture of the animal that came to be associated with it – the Snake. However, I should note that many people also posit that it is a picture of an infant. The oracle bone figures look more like snakes than babies to me, and as a picture of a snake is how I learned it, but certainly you may disagree.

The snake is a fascinating animal that both attracts and repulses most people. There are many characteristics of the snake that relate to the Spleen in structure and function. I’d like to just mention one that has been particularly helpful to me this week. As the title of this section suggests, I’m interested in the ability of a snake to consume prey much larger than itself.

Now, on the one hand, the Spleen really doesn’t like to be asked to do too much at once – as anyone can attest after a big Thanksgiving dinner. So, perhaps it’s not a perfect symbolic match. On the other hand, the function of the Spleen is to take whatever has been consumed and release the pure essence of that sustenance at a reasonable rate to the rest of the body. Often, even with big meals, we surprise ourselves with our ability to take it in and use it with some effectiveness. As a student, I am consistently asked to shove more information into my head than I think is possible. However, by approaching things deliberately and with confidence, I consistently surprise myself. No jaw dislocation required.

Phase element Earth – the Center : Lesson – Having a solid substrate allows for great transformation

The Spleen is the Yin Earth organ of the body, and as such serves as the stable substrate through which all of the activity of the body takes place. One of our professors mentions how people talk about the Spleen in an inappropriately “active” way. In fact, it is the organ that exemplifies that Wu-Wei principle of getting everything done while doing nothing. It is the rich humus that nourishes everything, yet serves as only a medium for that nourishment – not an active partner in it. Sure, mycobacteria and various little critters serve a vital function in keeping plants healthy, but these are not part of the Spleen principle. The Spleen Earth serves as a healthy place for these organisms to do their work, simply that – and that is more than enough.

Creating a super stable life management system for myself has been vital in my success. Still, it is always a work in progress. Unfortunately instability in my system was one of the keys behind why I was not so productive this week. I thought my system was more or less functional, and that I could work out any kinks quickly and simply. I was wrong. Several scheduling issues emerged that required my immediate attention. I had not fully “cleared my mental inbox” during my last Weekly Review (leaving many projects in an implicit mental stage, cluttering my mind). Most importantly, I had not settled my finances and finished budgeting. Thus, about 80% of my time this week was devoted to rectifying those situations. By the end of this weekend, all of that work will be done and it will serve me for the rest of the term. It will be the medium through which I am able to do all of the other work I do.

Clock pair/hexagram pair with the Triple Burner : Keep a balance between Yin and Yang

Around the organ clock, we can find many interesting relationships among the organ systems. The relationship between Spleen and Triple Burner is particularly interesting because these organs are united by their hexagram relationship and their actual position around the clock. When two organs are directly across the organ clock, we call them clock pairs and as I’ve mentioned before, we were taught to think of them as being able to “take one another’s shift” so they share some type of functionality. Hexagram relationships are more subtle and difficult for me to understand. Here is a diagram I drew during my first year at NCNM showing the hexagram relationships around the organ clock. The drawing is, admittedly, a little shaky.

The Spleen is associated with Hexagram 1 – Qian 乾, often translated as force, heaven, the creative and, sometimes, simply as Yang. It is made of six Yang lines, and is the most Yang hexagram of the Yijing. Funny considering what I just said about Earth and the Spleen! That’s the way of Chinese medicine philosophy sometimes. The hexagram of the Triple Burner is #2 – Kun 坤, often translated as the receptive, Earth and sometimes, simply as Yin. It is made of 6 Yin lines and is the most Yin hexagram of the Yijing. Unlike the Spleen, this makes a lot of sense for the mysterious and seemingly immaterial Triple Burner organ system.

It’s easy to see the relationship between these two hexagrams – they are opposites and create the dynamic Yin-Yang tension that characterizes the fundamental state of the entire Universe. I’ll briefly explore the Triple Burner-Spleen relationship, but certainly there is much more to say about the shared symbolism of these two important organ systems.

The Spleen and Triple Burner are both responsible for aspects of fluid metabolism, in a way they help to keep a balance between wet and dry in the body. Another organ with a relationship with wet-dry balance is the Lung, which is united to the Spleen in its 6 conformation assignment as Tai Yin. Wet and dry are two obvious manifestations of Yin and Yang, respectively. Another Yin/Yang symbol within Spleen and Triple Burner is the relationship between being in the world and being removed from it. The Triple Burner is the mysterious organ system of deep darkness and in-between-ness. The Spleen is more straightforward, and engaged in the vital business of getting things done in the world, despite it’s passivity that I discussed before.

Extending these analogies, I found myself considering the vital importance of balancing two categories of intellectual activity. First, the more “Yang” activities of memorization, reading and listening to lectures, and studying explicitly for tests. On the other hand, the more “Yin” activities of contemplation, creative thinking, and experiencing Chinese medicine principles as they operate in nature. When I don’t achieve a balance between these two types of activity, pandemonium results.

I was experiencing strange digestive and mental symptoms all this week, and found myself really perplexed by it until I thought of Spleen. It is often said that student life harms the Spleen and Heart the most. The Heart because of the incessant use of the mind, which is related with the Heart in Chinese Medicine. The Spleen because of its association with pensiveness/overthinking and worry. When we find ourselves thinking something to death or being obsessively concerned with some event – our Spleen suffers. This was certainly happening to me and I definitely noticed. As a solution, I have decided to look at my schedule again and find a way to incorporate more straightforward “study” (memorization, reading and rewriting notes, etc) with more contemplative creativity. Although the latter may not help me on tests, it will definitely help me as a practitioner and help keep my Spleen from suffering overmuch.

Archetype : The Great Yu – Channel things away instead of damming them up

One of the archetypes we learn about being related to the Spleen is the Chinese folk hero the Great Yu. It is said that he was able to stem the great flood when his father failed. His father’s strategy was to create huge earthen dams to hold back the floodwater, which inevitably broke. Yu took a different perspective, creating great ditches to lead the water away to the ocean. We are often taught in Chinese medicine school that the Spleen does something similar in water metabolism of the body – guiding dampness away from the body at a steady clip, instead of trying to create barriers to keep it away from vital organs and processes.

I learned this Spleen lesson gradually through the week. A number of projects dumped on to my lap and it was only listening to David Allen’s Getting Things Done Fast on audiobook that jolted me into healthy Spleen mode. One of the things that Mr. Allen recommends is to look at every project/action you have in front of you and figure out whether it actually BELONGS to you. Many times we take on projects that are not properly or best left with us. Delegate! Delegate! Delegate! Lead the floodwaters away.

Deepest Health Podcast 15 – Does where Chinese herbs are grown really matter?

Eric Grey — Sun, 09 Oct 2011 03:20:10 +0000

Another aspect to the more advanced Chinese herb learning method that I teach is diving into the huge amount of information concerning where herbs grow up. Using the metaphor of the growth and development of a human being, it is undeniable that where we grow up influences the people we end up becoming. The same is true of Chinese herbs!

Topics covered

1. Why I love the herb method I teach

2. Why location matters when it comes to Chinese herbs

3. Small application of the herb learning method with one of your friends and mine, Chenpi – aurantium – citrus peel

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Deepest Health Podcast 14 -Interview with Dr. Arnaud Versluys (Part 3 of 3)

Eric Grey — Sun, 09 Oct 2011 03:18:44 +0000

Topics covered

1. What to do when you cannot secure the herbs you need (for instance, Mahuang and Xixin)

2. What about growing our own herbs locally and using them in Chinese herbal formulas?

If you are interested, please check out parts I and II of this interview.

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Deepest Health Podcast 13 – Interview with Mark Silver

Eric Grey — Sun, 09 Oct 2011 03:17:13 +0000

When I contacted Mark Silver, founder of the Heart of Business and Portland local, I was hoping to entice him to come and speak to students at NCNM. I succeeded in that, with the additional bonus that he was kind enough to offer to do a podcast interview with me for Deepest Health! After a few fits and starts, we managed to make our schedules line up nicely and we sat down for a chat on an early spring morning.

Topics covered

1. Should healthcare practitioners worry about the recession?

2. How you can get more patients without constantly explaining what we do

3. What Chinese medicine practitioners should watch out for when starting their own businesses

4. Technology & business : are they antithetical to holistic medicine?

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Deepest Health Podcast 12 – Interview with Dr. Arnaud Versluys (Part 2 of 3)

Eric Grey — Sun, 09 Oct 2011 03:15:29 +0000

Topics covered

1. How one uses the Shang han lun in contemporary clinical practice, particularly concerning complex diseases typically seen in modern times

2. The importance of specializing in a particular style of Chinese medicine

3. Some advice to those of us seeking Chinese medicine knowledge

I think you’ll really enjoy the information AND the audio quality – I think I finally got it right. Check it out at the bottom of this article!

Note : Dr. Versluys uses a few names that may be unfamiliar to listeners – I want to clarify these things for you. Li Dong Yuan is the author of The Treatise on the Spleen and Stomach: (Pi wei lun). Zhang Zhong Jing is the author of the Shang Han Lun and the Jin gui yao lue (originally united as the Shang Han Za Bing Lun).

If you are interested, please check out Part I and Part III of this interview

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Deepest Health Podcast 11 – Interview with Dr. Arnaud Versluys (Part 1 of 3)

Eric Grey — Sun, 09 Oct 2011 03:13:47 +0000

This is the first section of a three part interview with Dr. Arnaud Versluys of the Institute of Classics in East Asian Medicine. Arnaud has been part of my education and inspiration in Chinese medicine since the beginning. As well as leading & teaching at ICEAM, he practices his craft in NW Portland, OR.

Topics covered

1. The relationship of the Classical texts to the practice of medicine

2. The importance of careful study

3. Food for thought regarding the various schools of Chinese medicine

Note: Please pardon the relatively low volume of this podcast – we had some technological problems. If you are interested, please check out Part II and Part III of this interview.

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Deepest Health Podcast 10 – End of term clinical reflections

Eric Grey — Sun, 09 Oct 2011 03:12:23 +0000

Topics covered

1. My reflections as I come to the end of my first term/quarter in clinic at NCNM

2. The importance of memorization

3. The weirdness of caring for patients

4. Using all our gifts

Note: The book about Davinci that I reference in the podcast is an easy, inspiring read How to Think Like Leonardo da Vinci: Seven Steps to Genius Every Day (affiliate link)

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Deepest Health Podcast 9 – Interview with Dr. Heiner Fruehauf, Part II

Eric Grey — Sun, 09 Oct 2011 03:10:46 +0000

Topics covered

1. How a classical understanding can transform our understanding of medicine

2. The real importance of legendary figures in Chinese medicine history

3. What the classical approach lends to a contemporary Chinese medicine context & the importance of lineage

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Deepest Health Podcast 8 – Interview with Dr. Heiner Fruehauf

Eric Grey — Sun, 09 Oct 2011 03:05:24 +0000

This is the first of a two part interview series with Dr. Heiner Fruehauf. Heiner is a founding professor of the school of Classical Chinese Medicine at National College of Natural Medicine in Portland, OR, owner of Classical Pearls, purveyor of truly great Chinese herbal products and primary contributor to Classicalchinesemedicine.org.

Topics covered

1. What is Classical Chinese medicine?

2. Different models of learning and teaching Chinese medicine – the importance of transmission

3. Upper, middle and lower level physicians in Chinese medicine

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Deepest Health Podcast 7 – Clinical confidence and memorization

Eric Grey — Sun, 09 Oct 2011 03:03:49 +0000

Topics covered

1. What it means to have confidence in clinic

2. Shy I believe memorization is so important for Chinese medicine practitioners

3. Best practices for memorization

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Deepest Health Podcast 6 – Schools of Chinese medicine and learning

Eric Grey — Sun, 09 Oct 2011 03:02:17 +0000

Topic covered

1. Different schools of Chinese medicine and how students should look at the possibility of “choosing” between them (it’s a big topic, and the only one in this podcast)

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Deepest Health Podcast 5 – Interview with Brandt Stickley

Eric Grey — Sun, 09 Oct 2011 03:00:16 +0000

I am honored to offer this interview of Brandt Stickley talking about his practice and teaching of Chinese medicine. This was early in the podcast’s history, and the first interview, so the sound quality is a little dubious. Dr. Stickley apologizes for his very high volume.

Topics covered

1. Contemporary Pulse Diagnosis

2. Working with and learning from the incomparable Dr. Leon Hammer

3. Dr. Stickley’s basic understanding of Classical Chinese Medicine

4. Entering the mystery, the importance of the senses, and other exciting stuff

Links of note:

Dragon Rises.org : site containing articles, links and information about seminars pertaining to Contemporary Pulse Diagnosis
Dragon Rises College of Oriental Medicine

Dr. Leon Hammer’s two most well-known books are Dragon Rises, Red Bird Flies and Chinese Pulse Diagnosis: A Contemporary Approach (Revised Edition) (both affiliate links)

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Deepest Health Podcast 4 – Cancer, pulse taking & trust

Eric Grey — Sun, 09 Oct 2011 02:54:17 +0000

Topics covered

1. What can Chinese medicine do for cancer?

2. Difficulties in pulse diagnosis

3. Confidence in prescribing herbal formulas

Note: The natural medicine business blog I mention in the podcast no longer exists.

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Deepest Health Podcast 3 – The Power of Self Cultivation

Eric Grey — Sun, 09 Oct 2011 02:49:19 +0000

Topics covered

1. The power of self-cultivation for Chinese medicine practitioners

2. Caring for patients from the moment they arrive until the moment they leave

Note : You can find most of the links discussed in the post in the recommendations vault.

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Deepest Health Podcast 2 – Visualizing my way to Chinese medicine success

Eric Grey — Sun, 09 Oct 2011 02:43:42 +0000

Topics Covered

1. My clinical experience thus far: difficulties and excitement

2. How I use visualization as a way to learn to be more effective and efficient in clinic

3. A few questions I have about clinical practice

Note: The new blog (about natural medicine and business) mentioned is now defunct, its content mostly absorbed into Deepest Health.

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Deepest Health Podcast 1 – Lessons learned in Chinese medicine clinic

Eric Grey — Sun, 09 Oct 2011 02:31:35 +0000

This first try into podcasting had its bumps and bruises as I got used to the process of podcasting, including the technology. As the episodes wear on, you can notice an increase in sound quality and my comfort with the process.

Topics covered

1. Focus and intention: getting out of one’s own way

2. How it was needling “real” people for the first time

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Learning classical Chinese is foundational – an interview with Rick Goodman

Eric Grey — Tue, 01 Dec 2009 15:11:21 +0000

As I’m working on some of the foundational materials for the upcoming Shennong Relational Herb Learning course, I’m revisiting some material from classical Chinese medicine texts that I don’t know particularly well. It’s prompted me to get out my Big Chinese-English Dictionary and start slogging through the tedious process of translating passages when you’re not fluent in Chinese.

So, when I was looking for which archived post I wanted to release today, this short text interview with Richard Goodman seemed a natural choice. Richard has produced an excellent set of texts for Chinese medicine students and practitioners that helps even hopeless language learners like myself make sense of the process. I really cannot recommend them enough. I hope you enjoy the interview (below).

Deepest Health (DH): What is the biggest impediment for English speakers in learning to read Classical chinese?

Richard Goodman (RG): “Every aspect of Chinese, and especially classical Chinese, is different from English. From learning and memorizing characters to grappling with a grammar that has no tense, much of what we encounter in Chinese is difficult to understand. When I was finally at the stage that I could start approaching classical Chinese medical texts, I was overwhelmed-where does one begin? The vast number of medical books written before the 20^th century is alone enough to scare people away. This combination of learning a language that is different in every way from English with the sheer volume of classical texts available overwhelms people and even the most well intentioned people never begin.”

DH: How do your books help folks with that?

“My overall goal was to address as many of the frustrations I had in my own studies as I could in one series of books. The two I mentioned were two of my biggest frustrations and I addressed this first by just selecting texts that are fairly easy for beginners. Volume One starts out very slowly and builds very purposefully on the characters and grammar already taught. In both Volumes One and Two, 95% of the characters will be found in every medical text. I didn’t want any “filler” or terms that were rarely found. I was never trying to “wow” readers with impressive texts, but instead made language learning the priority. This does not take away all of the difficulty in learning Chinese, but learning slowly and building upon an ever increasing vocabulary makes the task seem a bit less daunting.”

“One thing I have heard from people over and over is that they did not feel overwhelmed by these books, and that is satisfying to hear because that was definitely one of my goals. Learners need confidence and they need it quickly.”

DH: Have you seen real clinical impact when people learn to read the classical Chinese medical texts? Why do you think this is?

“I think this very much depends on the type of practitioner one is when they begin to study classical texts. If one practices in a way that relies upon starting with a disease, moving on to its standardized differentiation, and then giving the formula and point prescriptions based upon that, that type of practitioner will not find classical texts clinically useful. There are virtually no classical texts that proceed in that way, which is why I suspect most people read translations of the classics and then decide learning to read classical texts is no longer relevant to modern day practice.”

“For practitioners who rely on understanding the underlying theories of Chinese medicine to treat patients, the classics are a treasure trove of information. Even rudimentary concepts like Qi, yin and yang, and the five phases are used to describe healthy and ill states with a depth that is quite astounding and much more refined than anything I have seen in English. I personally never had a really firm grasp on these basic ideas until I began reading them in the context they were originally discussed.”

“A lot of practical information also exists in the classics. For example, my views on pulse examination have transformed many times over by reading classical authors’ methods. Just one practical example is the relationship between the breath and the pulse. Most modern books teach us to use a watch, but rapid and slow pulses are determined in relationship to the number of times the pulse moves per breath. This changes the pulse dynamic considerably, leaving the focus entirely on the patient. Additionally, the terms for the pulses make much more sense to me in Chinese and the translations, such as slippery or choppy, do not really capture the image. Having access to all of the more detailed information on virtually every aspect of Chinese medicine, from prescriptions to diagnosis, will most certainly create a more refined practitioner.”

DH: Do you plan to write more books on the topic?

“There will be one final volume in this series which will focus more on herbal texts and their theories. I have already selected all of the texts and I expect that book to be available by early 2010.

I have already started working on what I am currently calling “learners’ editions” of the classics. That seems to me to be the next logical step so that people can continue studying while also tackling entire books. These will not be translations per se, but people who are not interested in learning the language could still use them as such. All together, I have about 10 books planned to come out over the next two years and all of them are related to Chinese classics and language.”

DH: What advice do you have for people in the field looking to write books? Any sagely advice? Tips and tricks? Things to avoid?

“I think the best advice I can give is simply do not try to force a book out of yourself. Everyone is different and I can really only share my own experience. I never really had the intention of writing books at this stage of my life and I just kind of fell into it. I found work as an editor at a publishing company to support myself while I studied Chinese. As my Chinese got better, I was moved to their Chinese language department and started translating Chinese language textbooks.”

“After editing what was probably hundreds of language teaching books, I got a real sense for what worked and what didn’t. My life circumstances were such that this series was just a natural extension of what I had been doing for the past five years. This is not to say that there weren’t times I struggled with the writing, but the idea and outline was very easy to come up with. Just write what you know and ask for help from others once you have something written—no one can write a book alone. “

Reawakening the faculty of touch in learning Chinese herbs

The sages of Chinese medicine stood facing South

Eric Grey — Tue, 03 Nov 2009 16:51:45 +0000

I hope this reflection will be useful to all those Chinese medicine students out there who struggle with figuring out what TYPE of Chinese medicine to practice…

Today, on a walk I was taught an important lesson by some late migrating geese. In the late summer and autumn, we get a whole lot of geese flying overhead in my neighborhood. We live pretty close to a couple of wildlife refuges, one being specifically devoted to waterfowl. In general, in Portland, the autumn is always accompanied by the resonant, melodic sound of Canadian geese fleeing Canada. It’s one of those things that is commonplace, yet never seems to lose its magic. I’ve noticed a lot of things in Autumn are like that – the leaves turning, the miracle of the harvest, the start of formal schooling and so on.

Anyway, today I had one of those magic moments – fog bank just rolled in, walking on a hill in clear view of the setting full moon and the rising sun reflecting pink and crimson off of morning clouds. Mushrooms bursting from beneath damp fallen leaves. People out, coffee in hand, walking overly excited dogs. That nestled place between Lung and Large Intestine time – things cracking forth, but the calm and presence of the early morning still laying on its soothing balm. Very nice.

Then there were the geese. There were seven or eight of them, so just a paltry flock. There was some confusion (not uncommon) where they seemed to be trying to figure out which way to go. Now, I know enough about geese to know that just because they seem to be flying North doesn’t mean they’re lost – often they’re just heading to a feeding or resting ground. It’s the larger direction that matters, not my little snapshot views. But, that doesn’t matter for my story. There was some confusion in the sky, and about half started heading clearly North, the other half clearly South. One goose was caught – she flew North, she flew South, she started calling loudly – she seemed pretty distressed by the whole thing.

Finally, she broke South – doing double time to catch up with her chosen group and they continued off into the distance. As I watched them cruise, I got a series of images as I faced South – the direction that all Sages must face, the direction that helps us make sense of so much Chinese medicine physiology and pathology. Mostly, I just got a sense of great peace, of openness, of newness and warmth and a bright future. I thought – good choice, little goose.

Now, I’ve been particularly prone to reading signs in everything these last few weeks, so pardon me. But, the whole drama (!) seemed curiously familiar. I think it might seem familiar to some of you, as well.

At NCNM, I was introduced to a wide variety of schools of thought regarding medicine – herbalism in particular. Without getting too much into it, let’s just say that people can get a little spirited about what they see as the “truth” of the matter. I certainly have been guilty of this. As students, I think we were looking for something to hold on to. Something to call our own – or rather – something to say, “This is right, this is true and I know it, I subscribe to it.” Some way to make sense of the seemingly insurmountable task of learning a medicine that is thousands of years old and must be translated into what we have available in contemporary times.***

I’ve sometimes felt torn because of my particular proclivities and the wrinkles and folds of my personal situation. I had moments when I didn’t want to practice medicine at all. It seemed too impossible to figure out what was right – the clinical stage didn’t clarify things any better than the classroom and I just felt totally overwhelmed. I had moments where I wanted to have a time travel machine and visit Han dynasty and ask Zhang Zhongjing what the whole deal was really about. There were also times when I felt pretty confident, pretty sure, and even a little fanatical about what I was learning. Those times were always followed by a lesson (pride precedes a fall, afterall).

In the last month, things have settled out. I felt very much like that goose for the last year or so, and I’ve started flying in a particular direction. It hasn’t been without its consequences. Moving towards one thing almost always means leaving another behind. Some good goose friends had to be parted from, on some level. I only have so much time and attention. I have had to repeatedly remind myself that the direction I’m turning away from is not WRONG, just different. Demonizing people who think differently from we do only serves to make us demons in the eyes of others. It never serves the quest for knowledge and healing.

You know? Darnit if I don’t feel just like I felt on that hilltop watching those geese disappear. Warmth, openness, a surge of energy, signs from all over God and Creation. It’s not that the other way is wrong, it’s just that this way is right. It leads to more, not less. It opens me into an endless realm of possibility and sweetness. I have already seen the results in my acupuncture, in my herbal prescriptions, in my presence with my patients, and in my bank account.

So, to any of you who are feeling this – particularly you students – take heart. You will find your way. Sit quietly with yourself, go on walks, get treatment, sing songs, talk to animals and go through your rebirth. Getting born is rarely pain-free, but it always opens into a whole universe of experience that was previously unavailable to you. I promise.

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***Note : I’m not saying that ancient medicine isn’t directly relevant to contemporary times and people. Please. I’m just saying that some of the things they had available, we don’t have available – or very nearly (Fulonggan, for one – Sheng Fuzi for another – there are legal implications for some acupuncture techniques). Further, while there is truly nothing new under the sun – people do have a different way of living, eating, and even dying today and we would be idiots not to at least consider that fact sometimes, even if we are just “treating what we see,” and even if we are (correctly) not taking into account Western disease names and categories, etc…

Phenomenology and Classical Chinese medicine : brief conclusions, opening doors

Eric Grey — Thu, 13 Aug 2009 07:12:00 +0000

Here are the last few paragraphs of my thesis in Chinese medicine for my MSOM degree at National College of Natural Medicine. As you can probably tell, I did not go as far with any of my research topics as I would have liked. I saw it mainly as a way to learn what resources existed, and sketch a general outline of where I would like to go with my investigations. I have to be frank, I haven’t yet taken the time to explore these topics much more deeply – I’ve been trying to rejuvenate myself from the rigors of school while also opening the clinic and writing more on this blog. However, I have all of the resources amassed and lots of brainstorms and outlines ready to be further explored. I’ll definitely share my ongoing investigations with Deepest Health readers.

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Read Part I of the final chapter of my thesis

Read Part II of the final chapter of my thesis

—

First, the system must demonstrate a basic level of effectiveness. This could include evidence in the contemporary Western sense of controlled laboratory or clinical research, but could also include a mature history of effectiveness, such as Chinese medicine has in its extensive written record. Obviously, it could also include currently undeveloped research methodologies such as I discussed in Whole Systems Research. It will almost certainly also include so far undiscovered methods of obtaining knowledge.

Second, it must demonstrate its inclusion of a mature system of practitioner education and basic regulation of ongoing practitioner behavior. This simply means that an included system of medicine should show that it is making active attempts to behave ethically and to ensure that its practitioners obtain the highest level of education that is possible. External governmental controls could also be developed that both respect the integrity of the community of practitioners while providing the public with a sense of safety.

Third, a system of medicine should be open to discussion and evaluation by other systems. These interactions should be governed by an understanding that such interaction is for the benefit of all involved, not intended to discredit or eliminate one system in favor of another. Practitioners of each system should seek to become steeped in the foundational material of the other system before they seek to criticize it, as this will make for a more productive and scholarly interaction. My thoughts on this point resonate with the early philosophical work of Alasdair MacIntyre as developed in his book, After Virtue, published in 1981.

Finally, a system of medicine should not be integrated into the larger health care system until it demonstrates its safety for general use. As I’ve already mentioned, one of the biggest concerns about alternative medicine is whether it is safe. This is to be understood, since the primary guiding principle of all medical practice is to “first, do no harm.” Whether by laboratory testing, historical record or some other acceptable method, the system should indicate that its diagnostics and therapies meet a minimum standard of safety. Further, as stated before, the profession should be internally or externally regulated in an adequate way to ensure that practitioners are making safety a primary focus of daily practice.

Of course, there is a viable system of medicine that meets all of these criteria – Chinese medicine.

Chinese medicine not only meets the criteria above, but is also an ideal vehicle for avoiding the kind of objectification of patients that I am arguing against. In Chinese medicine, one always considers the more physical, measurable characteristics of a person as well as the less measurable, subtler features of his mental and social situation. In fact, such a separation of features of the person’s experience is simply not done. Every single identified sign or symptom is taken into the diagnostic framework and interpreted. This includes the more precise information as might be included on a laboratory report. But it also, and more commonly, includes the patient’s vague and self-defined complaints (“fuzzy headed,” “stuck,” and so on). Further, it relies on the complex and embodied senses of the practitioner to accurately observe and interpret the symbolic information inherent in face color and quality, pulse rate and quality, nail bed color and quality and so on. While this may seem a hopeless mess of factors that cannot possibly result in effective diagnosis, much less treatment, such is not the case. Diagnosis does happen, and so does healing. Chinese medicine, through its use of symbol, of metaphor, and its integration of the various subtle meanings and meetings within a human life both in diagnosis and in treatment – has a unique and time tested way to bring the interpretive meeting back into medicine.

In sum, I believe that medicine is not the kind of activity that can, or should, be governed by single-minded adherence to the analytical sciences as they are currently practiced in most places in First world nations. Such devotion to technological medicine encourages a compartmentalized way of viewing the body and the human being’s place in the universe while also producing a distance between doctor and patient that is not conducive to healing. We need not abandon the analytical tradition or the fine tools brought to us by contemporary Western medical practice. But nor should we attempt to eradicate all systems of medicine that fail to meet our ideological standards concerning evidence. Condemning disciplines based on ideological notions of “pseudoscience” cannot be helpful for patients. A more inclusive approach respects the integrity of safe, integral and mature disciplines while acknowledging the need for the public to feel reasonably assured concerning their safety and effectiveness.

Using Devonthink to learn and write about the Chinese herbal formula Ling Gui Zhu Gan Tang

Eric Grey — Wed, 12 Aug 2009 15:59:33 +0000

This article is a bit of a dork odyssey, being how it relates to the use of a computer database program to organize highly specialized information related to Chinese herbal formulas. That will either attract or repulse you – I hope the former!

I have something of an obsession with database programs. Of course, it’s not really about the program. It’s about manipulating information in interesting ways. It is about actively participating in the creation of an ever complex and rich extended mind.

I want to make something very, very clear at the outset, however. I’m not talking about having a computer attached to me all the time. I’m not talking about abandoning books, traditional memorization techniques, human interaction or anything of the kind. What’s interesting is that as my involvement with the reorganization of my Chinese medicine information is progressing, my Qigong, medititation and prayer practices are all becoming easier. I think this is a similar phenomenon that many have experienced when fully implementing GTD. It’s the feeling you get when you organize your basement or purge a bunch of old files. Space! Openness! Freedom. That’s the real goal – not having a shiny database.

Ling Gui Zhu Gan Tang – my favorite formula

I have used Ling Gui Zhu Gan Tang (or Fuling Guizhi Baizhu Gancao Tang) more than any other formula, hands down. I combine it with just about everything, and all of my patients have ended up on it (or one of its variants) at some point. Why? Well, I don’t know. I hypothesized the other day that it has to do where I live – we’ve got a whole lot of Water Qi floating around Portland – maybe that’s contributing to a shoddy water metabolism in Portlanders? Anyway – I wanted to see how Devonthink could help me write an article about this formula.

A brief aside : my old blog writing habits… transformed

For those of you who do not blog, you probably don’t even really know how this thing happens. The simple explanation is this – I have a program (WordPress) installed on a server (Laughing Squid) that manages all the data that is used to create the pages (articles and so on) that you see here on Deepest Health. I can access this program and its databases in many, many ways. The most frequent part I need to access is the main administration panel, where I can moderate comments, write blog posts, edit blog posts and alter the blog’s appearance with just a few clicks. Up until very recently, I used this interface (on the web) for all of my blog post writing. The other major way that blog posts are written is in what is called an “offline editor.” This is simply a program that runs on my Macbook that is used only to manage blog posts – none of the design elements or comment moderation or anything like that.

I recently started using Ecto as an offline editor. Why? Lots of reasons that I don’t need to go into in this post – let it suffice to say that I find using an offline editor to increase my productivity in general and make me feel more like a “writer” and less like a “person who is constantly on the freaking Internet.” So, that’s one good change. To be honest, it hasn’t changed my experience of blogging that much, yet. But, enter Devonthink.

I spent about 8 hours doing the initial learning and setting up of my DT database. Mostly, this involved taking all the folders from my little stacks in the Finder and putting them in Devonthink “groups.” Now, this was actually quite complicated in some situations and it is frankly not done. For instance, as Mike Reynolds pointed out in his comment on my last post, Devonthink doesn’t read into some file types – notably Excel and Powerpoint. Thus, these have to be converted to PDF and made searchable. That entire process takes about 90 seconds per file (I’m sure there are ways to automate it). There are also a lot of things that can be done to one’s information to make it more accessible to Devonthink’s artificial intelligence. For instance, I’m doing a lot of breaking up of files to make them more focused (taking my huge formulas charts and turning them into individual formulas files in rich text format).

During this process, as I said in my last article, I started to become very excited about the information I have on my computer. I remembered classes I had long forgotten. My mind was jogged about a couple of key statements said by this or that professor. I suddenly had an insight into a patient that I have been struggling with. I became quite engaged with learning more about the issue that this particular patient is facing, and did a quick search in Devonthink – uncovering a WEALTH of information I didn’t remember I had. This made me think about writing an article about that patient, so I created a Devonthink “group” for that purpose, and started subdividing the folder into the various stages of blogging workflow.

Which brings me back to my point – Devonthink has done what Ecto alone could not do. It has made me feel like a writer again. More than that, it has reminded me of the excitement of learning to be a scholar. I find myself excited to research. I have folders for my projects that are quickly subdivided and everything I find gets dumped in there – I am particularly impressed with how easy and fun it makes web research. Now, I have developed a whole new work flow for blog writing that combines the power of Ecto and Devonthink and leverages all of the amazing information on my computer and the even vaster sea available on the Internet. I am no longer stymied by a research project or a particularly hard blog article – it may take time – but I know I have a structure to hold me while I move through the process. It’s amazing.

Back to Ling Gui Zhu Gan Tang!

So – I just wanted to write a simple article on this incredible Chinese medicine herbal formula while also exploring Devonthink. First, I wanted to get some basic information about the formula. I pulled the basic information out of the quick reference chart I use almost every day in clinic. Because I know that the artificial intelligence works best when information is more discrete, I put the herbs/dosages, pulse, common signs and symptoms, TCM understanding, Classical quotes, related formulas and clinical notes all into separate rich text files. This took me about 3 minutes, and I will never have to do it again. I expect I will do this, over time, with all of the formulas. Now, because I haven’t done it for all of the formulas, the potential of Devonthink is not fully exploited. It cannot show me the maximum interconnections because not all of the data is entered.

However, when I highlighted the file with the dosages in it, I was quickly shown all of the charts I’ve created where this formula appears, as well as all of my notes from Arnaud Versluys where he mentioned the formula. It even picked up where I had written the formula name a little differently (saying Linggui Zhugan Tang, for instance) though it saw those files as being less related. It also took me to a document I created in a class with Heiner Fruehauf where he talked about his use of this formula. I hadn’t even remembered him talking about it! I’d better give you some of this information, or I might have a revolt on my hands. Unfortunately, I’m not able to divulge everything I have in my database about this formula – as some of it was given in the context of discipleship. I’m sure all of you have information like that – how wonderful would it be to be able to connect that information with all of the other information you have on your computer. I mean, for me, being able to quickly cross reference the TCM information with the stuff I get from Arnaud, Heiner and my other great teachers is just invaluable.

Basic information about LGZGT (all contained in my initial DB, found with about 5 seconds of searching)

Fuling 12g (4 liang) : In the Tangye Jing, Fuling is the water herb of the earth (sweet) class. In the Shennong Bencao Jing, is said to be sweet and neutral. Note: for Fuling and all other herbs, much more information from the Classics emerged. I may expand on this brief exposition in the future, but this is enough information for demonstration purposes.

Guizhi 9g (3 liang, bark removed) : In the Tangye Jing, Guizhi is the wood herb of the wood (pungent) class. In the SNBCJ it is said to be pungent and warm.

Baizhu 6g (2 liang) : In the Tangye Jing, Baizhu is the earth herb of the water (bitter) class.

Gancao 6g (2 liang) : In the Tangye Jing, Gancao is the wood herb of the earth (sweet) class.

In the system of pulse diagnosis I learned, we would think about this formula when we saw a tight pulse in the chi positions, particularly on the left hand and we may see a thin, slippery rolling up pulse in the cun positions. We might also see a depressed quality in the cun positions, which some people might think of as either deep or soggy, or even absent. Obviously, the pulse is a complicated thing and everyone seems to have their own opinions – this is simply what I look for.

Shanghan Lun line about the formula (only English included here for brevity)

“When, in cold damage, after vomiting or precipitation, there is counterflow fullness below the heart, the qi surges upward to the chest, the person experiences dizzy head upon standing, and the pulse is sunken and tight, if sweating is promoted, the channels will be stirred and there will be quivering and trembling then Fuling Guizhi Baizhu Gancao Tang governs.” (roughly taken from the Wiseman Mitchell Ye version).

General clinical manifestations outside of what is stated in the line

This is actually where my Devonthink research started to break down. This is less a fault of the software and more a fault of how badly I’ve organized my information up until now. Much is trapped in audio, or combined all in a single document (difficult for the AI of Devonthink, and also not readily searched by any application I’ve found), my clinic notes are scattered all over God and creation and I keep far, far too much swimming in my head when it comes to this kind of thing. All of that being said, some information came forward in my search through my database.

In general, we will find people to have some kind of accumulation of water – usually in the throat or lungs. They may have a chronic cough, or just a constant tickle in the throat. Some even just wake up with a little phlegm. They will also often have a sensation of fullness in the chest, but vague. They will also often have palpitations, a general sensation of being “off balance” or even dizzy. Many of these clients, I’ve found, are overweight or have a hard time regulating their weight. Now, some of these clinical manifestations demand additional herbs. If there is a significant cough, for instance, we would probably add Ganjiang + Wuweizi.

This article is already ridiculously long. However, let it suffice to say that I found many documents I had downloaded from the internet or scanned from books at the library – all pertaining to this formula or one of its variants. Again, as I further uncover, digitize, clarify and organize my vast library of data not only will I have the great experience of reengaging with that material but I will make it easier to access and more accessible to the AI of Devonthink.

Thanks for reading!

Phenomenology and Classical Chinese Medicine

Eric Grey — Wed, 22 Jul 2009 18:23:37 +0000

Over the next days, I will re-release the formerly posted chapters of my thesis (written for my degree at NCNM). Not included at the time of first posting were the first three chapters of the thesis. In those chapters, I write a brief history of the concept of pseudoscience through time, elucidating any concepts that I find to be particularly relevant. If you’re really interested, and aren’t going to irritate me with non-stop philosophical quibbling (yes, I’m talking to you, and you know what I mean), I’ll send you the first three rousing chapters.

The last chapter is where most of the heavy lifting is done, and is most likely to be of interest to all of you. Over the years since writing this thesis, I have begun to edit and expand it. Hopefully, one day, I can share that work with you here.

CHAPTER FOUR : CHINESE MEDICINE, THE CLINICAL ENCOUNTER AND HOLISM

“In ancient times, people lived holistic lives.
They didn’t overemphasize the intellect,
but integrated mind, body and spirit in all things.
This allowed them to become masters of knowledge
rather than victims of concepts.
If a new invention appeared, they looked for the troubles it might cause
as well as the shortcuts it offered.
They valued old ways that had been proven effective,
and they valued new ways if they could be proven effective.”

(Hua Hu Ching, Lao Tzu – trans. Brian Walker, 52)

The discussion about the criteria of demarcation shows how philosophers, and generally how most people, look at science and its pretenders. I believe I have shown that there is reasonable doubt that Chinese medicine can be said to be “pseudoscientific,” in a simple and wholesale way. Unfortunately, by using the criteria set out by philosophers of science, I likewise cannot say that Chinese medicine is wholly scientific due to problems in meeting contemporary standards of evidence. Inspired by this difficulty, I have suggested ways that these problems could be remedied, including following the lead of enterprising scientists in the field of Whole Systems Research.

This brings me to what I pointed out as my first major question during the introduction. Does it make sense to measure Chinese medicine by the standards put forward by contemporary Western science? Contemplating this question, I realized that it opened into one greater – should medicine in general be guided primarily by the kind of research and reasoning I have been discussing? It is to this question I would like to turn. I understand that in doing so, I risk running afoul of those people in the mainstream medical community that are enthusiastic about so-called “Science-based medicine” or “Evidence-based medicine.” I will not squarely address potential objections from this quarter, but this work should serve as a foundation for future debate of that kind.

Having established the parameters of science as such, having compared them against the field that is Chinese medicine, having suggested alternative research frameworks from within which we might be able to accurately measure the outcomes of Chinese medical therapies, I would like to make a simple argument. Medicine, having the operational terrain (human beings and their relationships) and basic outcome orientation (the maintenance of the “health” of said human beings) is a very specific type of human activity for which Chinese medicine, as a system, is particularly well suited.

This argument consists of two major portions. First, the assertion that medicine is a special type of human activity that requires that we move carefully in determining what type of theory or ideology we use in its development and regulation. This argument is certainly in resonance with the principles underlying Whole Systems Research. The second piece of the argument is the claim that Chinese medicine, broadly conceived, has precisely the requisite features to make it an ideal model for excellence in medical practice.

Before I continue, I will offer two clarifications. First, I strongly believe that the conversations about scientific methodology, research standards and evidence are a positive feature of contemporary discourse. The kind of analytical precision that Western philosophy, and its product, Western science, brings to the table is indispensable tools in the intellectual development of human beings. Second, the dramatic advances made by Western medicine and its technological manifestations have had an unquestionably positive impact on serious disease and trauma such as is found after motor vehicle accidents, in organ failures and when diseases have gone to late stages. I have no interest in debasing analytical thought, nor do I mean to imply that Western medicine has no place in the contemporary medical landscape. In writing this thesis, I have endeavored to make evident that there is ample room at the table of health care to seat all mature parties. While we may have conceptual or logistical difficulties in bringing all interested parties together, to do so is – at least – possible.

What is it about medicine that makes it such a special kind of activity, relative to other applications of scientific knowledge? Medicine is, at its core, simply the meeting of two human beings in an intentional, and somewhat artificial, setting. The setting is intentional insofar that the people involves are coming together with very particular aims, although each may define those aims differently. The setting is artificial insofar that, in general, the person isolates some particular part of their experience (a painful knee, for example) and offers it up for careful examination. The artificiality of the encounter is, of course, variable depending on the time in history, the country and culture where the encounter is taking place, and the particular nature of the individuals involved. The information that results from the clinical encounter (whether in the body of the patient via treatment, or in the mind and belongings of the patient via education and treatments the patient may continue at home such as dietary therapy, etc) must then be brought to bear on the patient’s life, with all its attendant relationships, stressors, internal variability and so on. The doctor must decipher what the patient’s presentation means and must provide them with information that they can take from the artificial environment of the clinic out into the wild of their life. In other words,

“…medicine is an interpretive meeting, which takes place between two persons (the doctor or some other clinical professional and the patient) with the aim of understanding and healing the one who is ill and seeks help. Clinical medicine … is thus first and foremost a practice and not a science (Svenaeus, 11).”

The medical relationship, then, begins in the messiness of daily-lived experience, stops briefly in the moment of the clinical encounter itself, and then progresses on back into the world of the patient. This is not mere philosophical conjecture, if any of us analyzes our experience with medicine, we can see ourselves represented in the above description.

We should not deceive ourselves to think that there are real boundaries here. When the patient sits in front of the doctor, even though they are generally isolating some part of their experience (the painful knee) they come with all the rich life history that accompanies human beings everywhere they go. The person is of a particular racial make-up, a particular socio-economic position in their society, with a particular place in their family’s birth order. They come with loves and hates, likes and dislikes, dreams and broken promises. They have their experiences with medicine and the opinions that are created therein.

This is to say nothing of the unbelievable complexity of their physical bodies – with the alterations that come about because of genetic complement, dietary influx, chemical bombardment from their environment and all the billions of subtle differences that exist because of their life so lived up until the moment of the clinical encounter. This is as much in the case of Chinese medicine as it is in Western medicine. Human beings, their features and behaviors and the influence of time and space do not change based on what type of medical office one enters.

The six conformations: an exploratory post

Eric Grey — Wed, 28 May 2008 02:30:11 +0000

Established readers : this is one of many reposted articles you will see in the coming months. It is part of the redesign process. I hope you agree that all of these articles are worth another look!

The topic of the Six Conformations is huge. So huge, it’s a bit intimidating to write about. 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. Remember, in Chinese medicine we see the macrocosm and microcosm as completely linked. What happens in one impacts the other, and vice versa. Holism!

In heaven (macrocosm), the six conformations are weather patterns – or atmospheric Qi. In the human being (microcosm), the six conformations exist as associated parts of the body, mind and spirit. This is important – and complicated. When people hear about the six conformations, they often think only about the channel system. 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.

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.