Chinese medicine and the senses : Part I : Scent

chinese_medicine_nose_smellAs I have been contemplating this new project that Abdallah and I have begun, I’ve found myself stymied at times.  The aim of the project is clear, but the methodology is less so.  Simply,  everything that we’ve said in our introductory posts makes a ton of sense on a variety of levels, but when it gets down to “doing,” things become a little unclear.  I know what I want to put out (multi-media posts that draw all of us deeper into our relationship with the world and its interpenetration with Chinese medical concepts) but how do I get the inputs to create the outputs?

Why is this harder than it sounds?

In the United States, and I suppose in most Western countries, our sensory experiences are more or less controlled.  For the most part they are stifled, except for sight and hearing which are simply overwhelmed.  Actually, thinking about it, we overwhelm all of our senses - limiting what they experience to a set number of approved, mostly synthetic items and then amping those up to the nth degree.  I’ve grown up in the States my entire life, thus I’m subject to this dismal state of affairs.  Fortunately, through Qigong and other experiences, I’ve gradually learned to lighten up, literally and figuratively.

Regardless, I find that fully utilizing my sensory capabilities requires effort - most of all it requires intention.  The sense of smell is particularly interesting.  So, to start a short series on the senses and how to return them to their natural state and attune them to a higher degree than ever - I’ll offer my thoughts on the sense of smell.

Chinese medicine and the sense of smell

In Chapter 11 of the Neijing Suwen, it says:

“故五氣入鼻藏於心肺．心肺有病．而鼻為之不利也”

This has been translated in a couple of different ways.  The basic translation says:

“When the five Qi/odors enter the nose, they are stored in the Heart and Lung.  Heart and Lung disease is detrimental for the nose.”

Maoshing Ni goes on to posit that the five scents are really “the five qi of environmental energy that we breathe in.”  Regardless of the fact that I don’t see this particular statement in the text (thus underscoring my basic problem with Ni’s translation) it is interesting to contemplate.  What is odor?  Certainly it is Qi - but beyond that?  In thinking about this, consider the Neijing’s statement that the odors are 藏/cang/stored by the Heart and Lung.  The Lung makes a lot of sense given that the nose is the orifice of the Lung in both a Western and Chinese context.  But what does it mean to say that the Lung receives and stores these odors?  One could posit that they become part of the Qi that then rains down on the body as heavenly restorative water/Qi.  I’m not sure if that position could be supported by the texts.

More interesting to me is the relation of odors and the Heart.  What can it mean that the Heart stores odors?  You’ll excuse me if I offer my own simple theories.  As famously studied by Gilles Laurent at Cal Tech, there is a powerful association between scent and human memory.  Nothing brings back a scene or person to the mind like a scent last experienced in that scene or with that person.  When considering this idea, I most naturally think about the smell of my clothing when I come back from my mother’s house on a visit.  I smell her for weeks afterward - and though the smell is created in part from her detergent, there is more to it than that.  The scent is wrapped up in emotion, the scent contains not just detergent fragrances, but her spaghetti sauce aroma, her hair, the smell of Idaho, cold winters, the essence of what comes from her pores as a product of all she eats, drinks… well, you get the idea.  The memories triggered are as complex.

Consider also the devotional aspects of scent - incense of various kinds have been used in religious ceremony and other spiritual activity since time immemorial.  The Catholics still use incense as part of Mass, as do some Episcopalian congregations.  Buddhist and Hindu shrines are nearly always adorned with incense censers.  We can also think about the effects of Moxibustion using artemesia.  While some people hate moxa for its thick smoke and messy nature, I find it to bring an essential element to treatments where it is indicated.  While not explicitly of a spiritual nature, I do believe that there is something of an offering that occurs when using moxa in treatment.

This relationship of memory and spirituality to the sense of smell helps me to link it to the Heart.  While we often talk about the Kidney as being the storehouse of memory in Chinese Medicine, from what I’ve read and learned, the type of memory held by the Kidney is more primal, older and is less easily accessed by consciousness.  The Heart seems a likely place (especially in its relationship to the Western concept of mind) to store the memories of this life.  The Heart’s relationship to Shen makes its connection to human spirituality quite clear.

In classical five element acupuncture, the art of smelling is still employed.  The five odors, discussed first in the Neijing, are assessed by the practitioner to help understand the primary pathology of the patient, as well as used as a key in discovering the patient’s landscape tendency (constitutional factor).  This is one of the most difficult diagnostic techniques for Westerners, as I’ve already hinted at.  I find it to be incredibly difficult, personally, particularly given how so many patients cover up their natural odor as a matter of course.  For the sake of completeness, I should list the five odors!

  • Fire : scorched - one of my professors says that this is the smell of recently dried clothes
  • Earth : fragrant - like rotten vegetables or new compost
  • Metal : rotten - like a garbage bin or feces
  • Water : putrid - like urine or stale wine
  • Wood : rancid - like rancid oil, mcdonalds

Scent and herbal medicine

Briefly, what is the role of scent in Chinese herbal medicine?  Most would say, “There is no role!”  I disagree.  One of the reasons I am a huge proponent of patients taking home and cooking their own bulk herbs is because of the experience they gain by doing so.  Looking at the herbs, smelling them in their dried state, allowing the smell to permeate their living space, smelling their powerful odors when drinking - all of this, in my opinion, is part of the therapy.  While many patients are unwilling to have this experience, it is one I encourage and have benefited from personally.  The worst case scenario with regards to this would be taking pills of granuled Chinese herbs.  I believe the move in this direction is detrimental, but understand when some patients choose this path.

Scent and the natural world

The sense of smell is much more emphasized in certain animals, including dogs.  The sense of smell is a fantastic way to seek out prey that is not yet within range of the vision.  While animals that live their lives in the air can afford to skimp on smell and focus on vision, animals that do most of their hunting in forests and tall grass fields need an alternative way to seek out their prey.

The natural world is full of odor.  The sweet decay of Pacific Northwestern forest floors.  The acrid, putrid, complicated smells of downtown sidewalks.  The unbearable sweetness of babies nursing for the first time.  Blood, urine, feces, animals marking their territory with complicated brews of hormones and urine - these less pleasant smells are just as much a part as any of the others.  The human world is no different in this respect, though we would like it to be so.

Fearless smelling

Being able to integrate myself fully into the world using all of my senses is the primary methodology of this Chinese Medicine awareness project.  So, how to proceed with the sense of smell?  My first trick will be simply to allow myself to smell everything, without reservation.  This means making a conscious effort to breathe deeply through my nose at all times.  I will also be going out of my way to smell things that are likely to be interesting or complex.  I will also be practicing this during tea drinking.  The difference in smell between two otherwise similar puerh teas, for example, can be remarkable and really impacts the experience of the tea.  This, of course, brings me around to the importance of smell for TASTE - but perhaps that’s for another article.

Do you have any ideas of how one can integrate the exercise of the sense of smell into daily living?  Share your thoughts in the comments!

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August 18, 2008 · Filed Under Organ systems, The Project, Theory

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Understanding Chinese herbs using Classical Chinese Medical thinking

deeper_understanding_of_chinese_herbsSometimes 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)

chinese_herb_peony

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.

—

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

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May 28, 2008 · Filed Under Herbal Medicine, Learning, Science

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Multi-disciplinary herbal study - Huang Qi

Last term at NCNM, the Classical Chinese Medicine students in my class took a course with Paul Kalnins, an anthroposophical researcher and natural medicine superstar, about the pharmacology of natural substances. We were asked to write a paper about a particular herb, bringing together Chinese and Western information about it. I asked my class if anyone would be interested in bringing their paper public, and one brave soul took me up on my offer - Danit Polunsky. Below find the results of her research - lightly modified from the original. It’s been a while since I’ve talked about a single herb, so I thought this would be welcomed. I’ll put my paper up next - on Wu Zhu Yu.

Huang Qi: Astragalus Propinquus - aka: Astragalus membranaceu

Kingdom: Plantae

Division: Magnoliophyta

Class: Magnoliopsida

Order: Fabales

Family: Fabaceae

Subfamily: Faboideae

Genus: Astragalus

Species: A propinquus

Botany:

Huang qi prefers sandy to loamy soil, which is well drained, or even dry. Huang qi likes soil that is neutral & alkaline, in a sunny location; it will not grow in the shade. Huang qi, Astragalus membranaceus, is an herbaceous perennial with a deep straight tapering taproot.

Each flower has five petals; the banner is large and envelopes the rest of the petals in a bud, often relaxing when the flower blooms. The two adjacent petals are the wings, surrounding the two bottom petals with claws one and a half times the length of the limb. The two bottom petals are fused together at the apex, remaining free at the base and forming a boat-like keel. Together the petals are whorled into a bell shape (calyx campanulate), 8 to 9 mm long, forming a tube 3 times longer than the linear subulate lobes. Each flower is hermaphroditic with 10 stamen, 9 fused and 1 free. They are pollinated by bees, moths and butterflies. Huang qi’s flowers turn into legumes that are 10 to 13 mm long, papery and glabrous. The seeds are dark brown, kidney shaped, and 7 to 8 mm long.

The taproot grows 30 to 100 cm long and 0.5 to 2 (rarely 2.5 ) cm in diameter. It is twisted near the crown, wider at the top, and generally stripped of secondary rootlets. The outer surface is light grayish-yellow to yellowish-beige with longitudinal wrinkles irregularly dispersed throughout horizontal lenticel-like patterns. A cross section of the top portion of root reveals 2 to 3 mm thick light yellowish-white outer cortex surrounding light yellow xylem that look like cracks in larger roots. The root has an overall fibrous texture, making it difficult to break, a slightly starchy aroma, and a starchy, mildly sweet slightly acrid, bean-like taste. Many of the Fabaceae host diazotrophs in their root nodules. Diazotrophs take nitrogen gas out of the air and convert it into a form of nitrogen that is usable to the plant, such as ammonia, nitrate, and nitrogen dioxide, in a process called Nitrogen fixation. Nitrogen fixation is important for replenishing the soil nutrients

Traditionally, the roots of 4 to 5 year old plants are collected in the spring or autumn; the autumn harvest is superior to the spring harvest. In the autumn the qi is descending and internalizing in preparation for winter, which is reflected in the qi of the root herb. The spring qi is emerging upward and outward, striving for growth and spreading from the root into the leaves. After gathering, the roots are cleaned and graded according to size. Some roots are dried whole, while others are cut and sliced. Most authorities report increased potency and increased root size from plants in the Shanxi Province and Mongolia in western northeast China. The Huang qi samples from Shanxi province and Mongolia show high astragaloside I and II concentrations in fingerprint analysis tests.2 Comparative chemical analyses of roots of varying age show that the isoflavone and astragloside concentrations, the constituents correlated with activity, decrease as the diameter of the roots increases. Increasing age also correlates to a decrease in concentration of most constituents.

High quality roots are dry, but still supple and resistant to snapping. The outer surface is relatively unwrinkled, with a floury texture and a solid deep yellow core — in contrast to material which is lacking a core or roots in which the core is black or pithy.

Western Perspectives on Huang Qi activity:

Huang Qi is known for three main groups of active constituents. Flavonoids and isoflavanoids, which give the root slice a yellow color, are metabolized on the Shikimate pathway. Flavonoids are generally known for anti-inflammatory and anti-oxidative effects which assist the body’s reaction to allergens, viruses, and carcinogens. It is believed that isofavanoid activity will help restore impaired immune systems. Saponins are common ingredients of Fabaceaea family members. Saponins are triterpenoids, formed through the mevalonic acid pathway. Saponins are common adaptogens, known to enliven blood circulation and resolve phlegm. Huang qi also has long-chain polysaccharides with potential medicinal benefit mediated by white blood cells.

The majority of Western research on Huang qi is focused on its immune stimulation activity and its ability to restore the activity of a suppressed immune system. In an epidemiological study in China, 1000 individuals were administered Huang qi orally or as a nasal spray to test its preventative effects in upper respiratory illnesses. The incidence of common colds decreased on the whole, and the duration of the colds contracted was shortened dramatically.

Huang qi’s remarkable ability to restore the functioning of a suppressed immune system has been labeled within Chinese medicine as fu zheng gu ben, “restore the correct and secure the root.” It is used to enhance non-specific immunity, protect adrenal cortical function during radiation and chemotherapy, and ameliorate bone marrow depression.4 Studies report general immune stimulation that include increased stem cell generation of blood cells and platelets, increased lymphocyte proliferation, increased numbers of antibody producing cells, increased numbers of spleen cells, stimulation of phagocytic activity by macrophages and leukocytes, and increased cytotoxicity by natural killer cells.

In the body, Astragalus increases the activities of Th-1 cytokines and decreases Th-2 cytokines. Th1 cytokines protect against intracellular pathogens like viruses and some bacteria, and are implicated in organ transplant rejection and miscarriage. By inhibiting the production of Th 2 cykotones, Huang qi inhibits the defense against extracellular pathogens, but may exacerbate allergies and asthma.5

In China, Huang Qi is used widely in treating cancer, both as a primary treatment and as an adjunct to chemical and radiation therapies. Most frequently Huang qi is combined with Chuan Xiong (lingusticum wallichii). In a number of randomized prospective clinical studies of cancer patients using a combination of Huang qi and Chuan Xiong, it was found that breast cancer patients given a combination of these herbs as an adjunct to irradiation treatments showed a decrease in deaths from 1 in 2, to 1 in 10. The exact formulas and ratios are not recorded, and in practice may vary due to individual constitution. In another study of patients with advanced non-small-cell lung cancer, the effectiveness of conventional chemotherapy was compared to the effectiveness of chemotherapy in conjunction with the Huang qi and Chuan Xiong formula. Patients with squamous carcinoma showed a significant increase in survival time averaging 204 to 465 days; patients with adenocarcinoma showed a less significant increase in survival from 192 to 324 days6.

Huang qi’s antioxidant activity has been studied in its benefit to the cardiovascular system and has shown improvement in clinical parameters associated with angina, congestive heart failure, and acute myocardial infarct. A number of isoflavonoids have been identified with free radical scavenging activity, and Huang qi’s polysaccharides also report prevention of free radical damage.

A Classical Chinese Medicine Perspective:

Huang Qi’s recorded use dates back to the first century AD in the Shennong Bencao Jing, the Divine Husbandman’s Classic of Materia Medica, in which Huang qi is classified as a “superior herb.” The superior herbs are “rulers…they control the maintenance of life and correspond to heaven. They do not have a markedly medicinal effectiveness. Taking [Huang qi] in large amounts or over a long period of time is not harmful to man. If one wishes to take the material weight from the body, to supplement the influences [circulating in the body], and to prolong the years of life without aging” these herbs should be used.1 Crude Huang qi extract tested on rats and mice confirm Huang qi’s safety - no toxic reactions or mutagenic effects occurred.

According to the Ben Cao Bei Yao, Essentials of Materia Medica “When used in harmonizing preparations, it tonifies and supplements; in sweating preparations it relieves the surface; in cooling preparations, it drains pathogenic heat; in moistening preparations, it nourishes the yin and blood.”

Wang Haogu, an herbalist of the Jin-Yuan reform period, maintains that “Huang qi replenishes the defensive and, therefore, is a medicinal for the exterior. It boosts the spleen and stomach and, therefore, is medicinal for the center. Since it is able to treat cold damage with the cubit pulse not arriving, it supplements the kidney origin and, hence, is medicinal for the internal.” Through this explanation, Huang qi is seen as a broadly useful tonic ingredient to include in prescriptions.10

Huang qi’s sweet flavor and slightly warm nature tonifies the Spleen, Lung, and Zheng qi. It aids in replenishing the blood, uplifting yang, securing the exterior and reinforcing wei qi. It promotes growth of new tissue, urination, and suppuration. It circulates qi, reducing edema, and it drains yin fire. 8

Huang qi strongly tonifies the yuan qi. It restores both of the Spleen’s major functions; transformation and transportaion of yang qi drawn from the food into circulation via the Spleen’s other function of building new blood. When qi is strong it can more effectively impel the circulation of blood, which in turn helps resolve disease. Strengthening qi to move blood indirectly eliminates blood stasis without injuring zheng qi, as applied in the Bu Yang Huan We Tang: Tonify Yang to Restore the Five Decoction. The chief herb is Huang qi at 120 g, while the supporting herbs are dosed at 3 to 6 g to give the blood an extra, gentle push. 11 It is also often used to assist in recovery after severe blood loss and to promote healing. It is especially helpful from its Lung affiliation in enhancing eliminative functions of skin, especially promoting healing or elimination of non-healing or non-festering chronic sores or ulcerations. 8

The five best know formulas utilizing Huang qi are

Formula name

Uses

Astragalus

Buzhong Yiqi Tang

Spleen/stomach deficiency with symptoms of fever, spontaneous sweating, shortness of breath, fatigue, organ prolapse.

20 g
30%

Yiqi Congming Tang

Qi deficiency and failing of yang to rise with symptoms of impairment of vision or hearing.

15 g
12%

Guipi Tang

Qi and blood deficiency with symptoms of anxiety, palpitation, insomnia, night sweating, fatigue, bleeding.

30 g
15%

Shiquan Dabu Tang

Qi, blood and yang deficiency with symptoms of fatigue, asthmatic breathing, bleeding

15 g
16%

Yupingfeng San

Qi deficiency with symptoms of spontaneous sweating and susceptibility to wind invasion.

30 g
25%

Danggui Buxue Tang

Generates blood in severely deficient patient, usually after excessive uterine bleeding

30g

83%

Resources:

1. Upton, Roy. Astragalus Root.American Herbal Pharmacopoeia and Therapeutic Compendium August 1999.

2. Wagner, Hildebert; Bauer, Rudolf; Peigen, Xiao; Jianming, Chen; Michler, Hans. Radix Astragali Chinese Drug Monographs and Analysis. Vol. 1, No. 8 1997

3. Chang HM, But PH. Pharmacology and Applications of Chinese Materia Medica vol. 2. Singapore World Sci.

4. Lau, BH; Ong, PY; Tosk, JM. Macrophage chemiluminescence modulated by Chinese medicinal herbs Astragalus membranaceus and Lingustrum lucidum. 1989.

5. Phaneuf, Holly. Herbs Demystified. Herbs Demystified, Marlow and Company, 2005.

6. Marazzoni, P; Bombardelli, E. Astragalus membranaceus (Fisch) Bunge. Scientific documentation 30 Mar 1994.

7. Wang, D; Shen, W; Tian, Y; Sun, Z; Yuan, S; Jiang, C. the effects of the three components isolated from Astragalus mongholicus Bunge on scavenging Free Radical. Zhongguo Yaolixue Tongbao. 1994.

8. Bensky, Dan; Gamble, Andrew. Chinese Herbal Medicine Materia Medica revised edition. Eastland Press, Seattle.1993.

9. Zhang, WD; Zhang, C; Liu, RH; Li, HL; Zhang, JT; Mao, C; Moran, S; Chen, CL. Preclinical pharmacokinetics and tissue distribution of a natural cardioprotective agent astragaloside IV in rats and dogs doi:10.1016/j.lfs.2006.02.032

10. Dharmananda, Subhuti PhD. ASTRAGALUS, Practical Aspects of Administering the Herb. Institute for Traditional Medicine, Portland, Oregon http://www.itmonline.org/arts/astragalus.htm


11. Bensky, Dan; Barlet, Randall; Formulas and Strategies. Eastland Press, Seattle 1990.

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April 8, 2008 · Filed Under Herbal Medicine, Science

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Don’t call it a comeback

herbal medicine is like archeryWow, sorry folks. I didn’t consciously stop blogging which tells you that I must be pretty busy. :) This term has been a lot more intense than I expected it to be - mostly because I’m so engaged in everything that I’m learning that I don’t even WANT to do anything but study (aside from stuff with my family). However, I have plenty to share and over the weekend I’m going to be doing my best to write a few articles. I’ll give you a quick preview as well as open up a discussion about different approaches to herbal medicine.

What’s coming up on Deepest Health?

1. Report on the Student Caucus at the AAAOM Conference in Portland. // I’ll just go over what I took away from all the student networking that went on at the conference and my hopes for a stronger, broader professional Chinese medicine community in the United States and beyond.

2. Review of the Acupuncture Desk Reference, a good looking little book put together by David J. Kuoch. // It’s a good attempt at a basic reference book helpful for students and new practitioners. I’ll share what I love and what I think could be improved.

3. Review of the beautiful “Living Meridian” charts available from the folks at The Fifth Element. // I’ll discuss my experiences using the charts in keeping up with my points study and some recommendations for getting the most out of this useful study tool.

4. Review of Blue Poppy Press’ release of a new translation of Yi Lin Gai Cuo, a fascinating work in relatively modern Chinese medicine. // I’ll consider how this book might be useful to students and how it has expanded my understanding of both the history and content of our profession.

5. Discussion about the future of health care in North America and what place I see for Chinese medicine in the overall fabric of medical practice.

6. Many discussions that have come from this term of school including: balancing competing teacher perspectives, the importance of humility in learning and practicing medicine, developing peer relationships in a busy world and comparison of electronic and low-tech methods of study and organization.

I hope you’ll stick around.

A broad question about Chinese herbal medicine practice

I have been learning quite a bit about Chinese formula science these last weeks. This information combined with what I had already integrated through study and watching patients in the clinic has led me to a few conclusions. The first, and most important, is that the “broad spectrum” approach represented by many more contemporary formulas (for instance, RenShen Bai Du San 入參敗毒散 ) is fundamentally bankrupt. It wasn’t until my teacher Arnaud Versluys suggested to us the similarity between the approach of this class of formulas to the use of broad spectrum antibiotics that I really understood how important this principle is for the integrity of our medicine.

Where Zhang Zhong Jing’s formulas were extremely tight in structure, extremely focused and strong in action, “broad spectrum” formulas can hardly be said to have a structure and seem to want to be everything to everybody. They are the John Kerry of the herbal medicine world (sorry John). They seem to characterize a way of looking at medicine that says, “Hey, we don’t REALLY know what’s going on at all, so let’s just cover all of our bases and see what happens.” The fact is that most people do improve, over the short term, with these formulas. Their root pathology, however, may simply sink beneath the surface only to eat away at vital substances and/or resurface at some later time with renewed ferocity. Why not improve our diagnostic skills, improve our understanding of the science behind our medicine and be confident enough in our diagnoses that we can prescribe strong, focused and time-tested formulas?

I don’t know enough to say that all non-Han dynasty formulas are worthless, baseless or are going to harm people in the long run. In fact, I’m sure that’s not the case. But why (and here’s my question to you) not learn very well the principles behind truly Classical formulas, pay careful attention to their clinical effects and proceed in that direction? I would love to hear your thoughts in the comments.

Eric

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November 2, 2007 · Filed Under Blogging, Book Reviews, Herbal Medicine, Theory

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Blog Action Day 2007 : Is Chinese medicine environmentally friendly?

Bloggers Unite - Blog Action Day Today is Blog Action Day - one day where many writers come together to blog about a single topic to increase our total impact. This year, the topic is the environment - something near and dear to my heart. In this article, I’d like to suggest that Chinese medicine can easily be a strong part of the solution to our growing environmental problems while also mentioning one area in which Chinese medicine practitioners need to advocate for more ecologically friendly practices.

Balance is as balance does (or vice versa)

One of the most powerful features of Chinese medicine is its ability to bring us into closer harmony with the natural world. In fact, all of the Classics talk about the importance of people’s closeness to and concordance with the processes of Earth. QiBo and Huangdi, some of Chinese medicine’s founding fathers, repeatedly lament the lack of people’s ability to live within nature’s boundaries and point to it as a major cause of disease as well as treatment resistance. Now it could easily become (and in some ways has become) a watered down forceless statement to say that Chinese medicine can bring you into harmony with nature - what does that really mean and why does it matter from an ecological perspective?

Being in balance means simply this - your body is in a physiological state whereby there are no extreme states. No intense cravings, no wildly oscillating emotions, nothing like that. You can sleep. You can smile. When you eat normal food, your guts don’t hurt. You don’t go into sneezing fits at the merest whiff of cat dander. There may be pain, sure, there may be problems of varying kinds - but the body is generally in balance around these points and things are moving in a more or less effortless fashion. When some adverse condition arises, your body is able to respond appropriately.

It is my assertion here that this state of balance, whatever it looks like for a particular individual, produces generally balanced behavior. Balanced behavior is less likely to be destructive in a number of ways. So much of what goes on from an environmental damage perspective comes from people’s unordered responses to life. Think about vices, for instance. So many of these (tobacco, alcohol, coffee) are intensively farmed with the accompanying herbicides and pesticides. Also, a body in balance may be more likely to ask for things that are generally good for it - such as fresh air, long walks and clean water. I know that when I’m the least in balance, I’m least likely to care whether I am drinking filtered water or eating organic food. It just doesn’t matter to me. Maybe I’m the only one.

Ecological medicine

Chinese medicine is generally ecologically friendly. Our equipment needs are minor, we don’t require huge research facilities that use a variety of toxic chemicals to operate. Because many Chinese medicine practitioners are likely to be following the principles set out in the classics, they may be more likely to pay attention to the way their products are produced and the way the electricity for their offices is generated. This is, of course, not always the case and probably less so outside of the Western world. Chinese medicine also doesn’t ask people to consume synthetic drugs, the production of which puts a heavy environmental load on the planet.

But what about herbs? If you’ve thought about it even for a little while, you’ve likely been concerned about the ecological impact of Chinese herbs. I know I have and I’d like to address a couple of the most obvious problems here.

Herbs frequently travel long distances, increasing our dependence on fossil fuels : what to do?

The vast majority of Chinese herbs are produced in Asian countries. If you do not live in an Asian country, it follows that these substance are going to have to be transported to your place of practice. The travel may be considerable and of course this means reliance on significant amounts of fossil fuels. There are a number of things Chinese herbalists can do to reduce their impact. Probably the easiest and most effective behavior is to research the herbs you are procuring from grower to distributor. Where do they come from? How are they transported? Can you find a distributor close by so you can use alternative transportation to get them? Can you find a supply line with a minimal number of links? Can you find a supply line that includes companies that have an ecological frame of mind? This will, of course, require some research - but it will be well spent.

Another possibility is to grow some of your own herbs or form growers coops in your local area. This is energy intensive and there is some question as to the energetic quality of the resulting materials, but I think it is at least something to consider. Going a step further, some people have suggested that instead of using the Chinese species of herbs we should do the research required to find local correlates to all of the herbs. These folks argue that the herbs will be more likely to resonate with our own physiology and the disease patterns we present if they are local. I am not convinced that this is the case and I am by no means sure that we are energetically sensitive enough to discover the Wei and Qi of herbs in an accurate manner today.

Chinese herbs are commonly produced using lots of chemicals in China : what to do?

Simply demand organic, or at least pesticide and herbicide free herbs. This is a very similar tactic as has worked with the organic foods movement. Simply know where your consumables are coming from and how they are grown and when the practices are ecologically damaging, demand better. Only buy from companies/distributors that support best practices - and when that is not possible, communicate your desires to the people you are working with. Finding chemical free herbs is not only good for the environment, but it’s great for your patients and will do a lot to alleviate their fears about taking products produced in China.

There may be other positive and negative environmental impacts of Chinese medicine, but these are the ones I think of most frequently. I’d like to hear what others think on these and related topics - please add your voice in the comments.
Eric

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October 15, 2007 · Filed Under Ethics, Herbal Medicine

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