Salt-sensitive hypertension and Classical Chinese Medicine, Part 2
This is the second part in a three part guest article series by Brandon Brown, student at National College of Natural Medicine and Chinese medicine blogger. You can access the first part of the article which covers salt in the macrocosm - nature. I should note that he has posted references for the entire series on his blog, you can access those references by clicking on this link. -Eric
Salt in the Microcosm
By preserving meat with salt, mankind was unknowingly creating a vicious cycle that would change the health of all people up to the present day. It is estimated that before the advent of this preservation technique people consumed no more than 0.5 grams of naturally occurring salt per day (g/d). After brining was put to use, daily consumption jumped to an estimated 10 g/d (because even though the meat is soaked in water to reconstitute it, no amount of soaking can remove a large amount of salt). This continued to climb throughout the centuries, upwards to nearly 18g/d (some estimates in Scandinavia indicate consumption near 100g/d) until the advent of refrigeration techniques which brought estimated consumption back down to its present day levels of 10 g/d. It is hypothesized that one reason for the stabilization at 10g/d instead of 0.5g/d is the addictive nature of salt: in the presence of continued salt loads the taste receptors on the tongue down-regulate their sensitivity to the salty flavor. However, as we will see, salt plays a crucial role in the nervous system, and it could be this current cultural bias for all things cerebral that creates our hunger for the briny crystal.
One of the most prolific cellular mechanisms in the body is the sodium-potassium pump. These pumps are found in a number of cells throughout the body, but most importantly in the nerve cells of the Central Nervous System. This mechanism, called Na+/K+-ATPase, regulates cellular chemistry and polarity by using ATP to remove 3 Na+ intracellular ions and replace them with 2 K+ ions. Na+/K+-ATPase is the mechanism that is responsible for the nerve’s ability to achieve the resting potential of approximately -70 mV by removing a net positive charge from the intracellular fluid with each pumping action. The creation of this potential primes the neuron to do work, in this case to release its charge as a rush of electrochemical ions, creating a signal that releases neurotransmitters at the terminal end of the neuron. The charging of this battery comes at a cost of a single phosphate group from ATP (converted to ADP). Because the pump is operating against the normal flow of the concentration gradient, energy is required to create this potential difference. This process is such that a large differential between sodium and potassium is created:
Table 1: Concentration of fluids by ion type (mmol/L)
| Ion | Extracellular | Intracellular |
| Na+ | 150 | 15 |
| Cl- | 110 | 7 |
| K+ | 5 | 150 |
Therefore the exterior of the cell is essentially salt water (NaCl), and the interior of the cell is largely dissolved potassium ions.
This is striking for a couple of reasons. First, in the resting state we see that salt water is kept on the outside of the membrane and only when an action or graded potential occurs is it allowed to rush into the cell. To reach the resting potential the cell must actively store potassium, and excrete sodium. In other words, the movement of salt (in this case sodium) into the cell causes the transmission of an electrochemical action potential. It is this action potential that is thought to give rise to all cognition and movement in the body. The axon, the long transmitting portion of the neuron, propagates the signal through voltage controlled sodium channels. The inward movement of salt is giving birth to movement and thought, whereas the expulsion of salt promotes stillness and thusly, stores great potential.
Secondly, the regular and crystalline lattice structure is perhaps more than metaphorical. In cognitive neuroscience, most theories of the mind involve describing the geometrical structure of the neural lattice as an explanation of functional capabilities. For example, the visual cortex is organized in columnar functional groups that serve to detect edges in the visual field. The creation of memory involves creating a new pathway on an already established lattice. Therefore, as sodium enters the cell it gives its organizational properties over to the cell to provide for the creation of new synaptic connections and lattice-like structures. The lattice-like structure of the salt is reflected in the lattice-like structure of the brain.
Figure 2: Columnar structure of neurons in the visual cortex and the octahedral geometry of sodium chloride
In terms of SSH research, it seems that excess dietary salt may not only change the sodium levels in the plasma but also in the cerebrospinal fluid, inhibiting Na+-K+-ATPase in both locations, perhaps giving rise to cognitive changes (Khalil 2005).
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In the next and last installment of this series, Brandon discusses salt from the perspective of Classical Chinese texts and brings the various ideas together. Please look forward to it tomorrow. -Eric
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Tags: crystal, human physiology, microcosm, nature, organization, salt, Science, waterRelated posts
20 benefits I have enjoyed since having a blog focused on Chinese Medicine
As a follow-up to my previous popular post about Why all natural health care practitioners should have a blog, I thought I would put forward a list of the benefits I have noticed so far in having my blog about Chinese medicine. I want to create this list because I feel that there could be so much benefit to patients if more health care practitioners would face their fears and put their thoughts out there. This is particularly true in the field of natural medicine, because there is so much low-quality information on the Internet about various natural healing modalities. By flooding the Internet with high-quality personalized content, we can be a force for change in the minds of the world’s citizens. A noble goal! Now, the list.
- Connections with peers : I have a lot of good friends at school and in the Portland acupuncture and herbal medicine community. I wouldn’t trade those connections for anything. However, it’s really wonderful to be able to connect with Chinese medicine students and new practitioners all over the world. Some of those connections seem to be bearing real fruit that will enrich my life for years to come. Lesson - if you want to network within your profession, become a blogger!
- Connections with patients and future patients : In the post I linked to above, there was some discussion about whether blogging is an effective way to bring in patients. I won’t really know until I thoroughly test it, but I have found that my current patients at the clinic enjoy reading my thoughts. At least one patient has rescheduled because she received her email update and it reminded her to reschedule! In the end, though, it’s really about helping to educate patients about the power and promise of Chinese medicine. Lesson - If you’re interested in keeping in touch with your patients, consider blogging and having them sign up for email updates!
- Free critique of my own ideas, refining my thinking about Chinese medicine : Many people are afraid to write about their thoughts concerning Chinese medicine. I’ve never supposed I have all the answers. Sometimes (gasp) I’m even just wrong. But, you really don’t know what you don’t know until you write about it and put it out there. It can be scary, but exhilarating and I truly believe I have grown as a student and scholar by blogging. Lesson - Want to be an expert in your field? Write about it and pay attention to corrections and criticism.
- Writing practice : I guess this is self explanatory, but it’s always easier to learn how to write by … writing. :) Lesson - If “you’re not a writer,” the best way to become one is to start writing. It’s funny like that.
- Crash course in Internet marketing : Because I decided I wanted to grow this blog as large as I could and make some money with it, I had to start learning a lot about Internet marketing. I’ve consumed a whole lot of information on the subject and while I’m no expert, I’m happy to say I get it for the most part. Lesson - Blogging is a multi-skill activity that will expand your knowledge in many different respects.
- Staying abreast of trends in technology : I’m not obsessed with gadgets (really, I’m not!) or even Internet trends. However, in an effort to keep reasonably well updated, I do learn quite a bit about what’s going on and what’s coming up. I like feeling like I know what’s going on and I learn by doing - so running a blog (or three) is an effective way to keep up to date. Lesson - Similar to the one associated with #5.
- Higher standard of personal organization (more projects means more organization) : For some people, more to do means less organized. Naturally, this leads people to believe that they can become more organized if they just simplify their lives and take on fewer projects. For some people, this may be appropriate. In my case, I find that (to a certain limit) the more I take on, the more efficient I become at managing it. When I have relatively little to do, I actually become less likely to fulfill my basic obligations! Many people have asked me how I do what I do - to them I say that the event that most shaped my ability to do a lot was the birth of my daughter. This surely has many dimensions, but one of them was that because of the compression of my available time, I had to become better at managing my time. My schooling, blogging and other activities just add to this. Lesson - You’re capable of more. Maybe much more.
- A higher than average tolerance for thoughtless comments : If blogging doesn’t give you a thick skin, nothing will. I have been blessed to have a lower than average number of “trolls” and my comment spam catching software is quite effective, but I still get a few folks who think it’s fun to be intentionally antagonistic. You learn to ignore them. Lesson - Don’t let a few bad apples spoil the whole crate.
- Less tendency to goof off on the Internet : I know, I know. This sounds crazy. But, because I see being online as part of my job, I really don’t want to use it very much “for fun.” I get off as quickly as I can unless a good friend is online and interested in conversation. My friends who primarily use the Internet for shopping and email seem far more likely to wander the crazytube of the Internet aimlessly. Poor things. Lesson - You can learn to be productive on the Internet. Yes, really.
- Helping others gain study skills : There are lots of ways that I feel that my work on Deepest Health has helped others - and this is truly the greatest benefits I have received by blogging about Chinese Medicine. I’ve listed just three ways I’ve helped here, but there are others. Lesson - If you are a person who likes to help people, blogging is one way you can fulfill that divine desire.
- Helping others understand Chinese medicine concepts : Countless examples abound, from talking to people about the six conformations to talking about the organ clock and so much more. I really enjoy sharing what I’m learning with others. I learn so much in doing so.
- Helping to promote friends’ businesses and hobbies : I’ve promoted others blogs but also businesses like Paul Rosenberg’s Sacred Tea.
- Walking farther along my spiritual path : While I certainly would have made spiritual progress without this blog, the connections I’ve made and conversations I’ve had have really helped me move along. Because I feel empowered to discuss spiritual matters on this blog, it’s been relatively simple to use my blogging as a medium to walk my Path. Lesson - Technology does not negate spirituality.
- Money and other material benefits : Of course it has been nice to get some material benefits from blogging. I’m nowhere near making even a part-time income, but it grows with every lesson from Yaro I am able to implement. I have enjoyed receiving review copies of books and software as well. While I wouldn’t blog ONLY for the material benefits, they are nice. Lesson - Blogging can be profitable in more ways than one.
- Lateral networking : Because of the nature of the Internet, people run across Deepest Health from many different walks of life and professions. While I do come in contact with all sorts of people in the offline world, I generally keep within a certain group of friends and colleagues. The connections I have made with people in very diverse fields has helped me to think differently about Chinese Medicine, and I’m profoundly grateful for that. Lesson - Reaching out on the Internet helps you connect with the whole world.
- Ability to say, in conversation, “I’m a blogger” : A silly one, perhaps. But, it is always interesting to see people’s reactions. More often than not, they try to ignore that I said it. Sometimes, they ask what that means. Sometimes, they launch into a diatribe about Myspace. It’s entertaining. No lesson required.
- A greater appreciation for the immense diversity of our planet : This is connected to some degree with #15 about lateral networking. Again, because of the nature of the Internet, you just end up connecting with a wider variety of people than you would normally when you blog. Particularly when I use various forms of social media, I get a sense for what’s going on in Cairo or Melbourne or anywhere else. I understand the struggles that normal people go through in places different from my own. I also begin to see how similar we all are. Lesson - The world is a vast, fascinating place. You don’t have to pay an arm and a leg to connect with it.
- Better posture : Over time I’ve gone from sitting in a somewhat ergonomically structured plush office chair to a kitchen chair to my current seat - a simple short flat bench. Strange? I find that I am able to keep better posture when I have less support. I don’t know if this makes any biomechanical sense at all. Regardless, I have never paid so much attention to my posture as I have on long days of blogging. Lesson - Just because other people slouch at the computer doesn’t mean you have to.
- A greater than average tolerance for sitting in long, long, long classes and seminars : This one goes with #18 to a certain degree. Instead of making me less tolerant to sitting, blogging has increased my stamina when it comes to sedentary activity. I should note that while I do have long periods of sitting and writing, I do get up to do a couple of minutes of exercise about every 30 minutes. I will sometimes do this in seminars when it is possible (as when I end up in the back of the room and it is not very quiet). I’ll just get up and stretch my legs. But, in general, I find that my ability to sit when necessary is much increased, and this has been tremendously helpful in some circumstances. Lesson - Yeah, sitting all the time is no good, but you have to count your blessings.
- Greater finger strength for needling : I have fingers of POWER from all of this typing, I assure you. Seriously, though, I pay close attention to my finger health, which includes finger exercising. I don’t know if this has actually helped my needling, but let’s just pretend. Lesson - See lesson#19 above.
Thanks for reading,
Eric
Tags: Blogging, Business, fun, internet, Learning, lists, networking, organization, student, Technology, writingRelated posts
Year of Sagely Living : Business and leadership in Chinese Medicine
Well February has simply FLOWN by. While I haven’t posted much about what I’m learning, it isn’t because I’m not learning. :) It’s because I’m learning so much and enjoying it so thoroughly that I simply don’t have much time to write. I feel that my overall education has accelerated a lot in the last 60 days or so, which is a great feeling. I wanted to start writing about the biggest lessons I’ve learned so far from engaging with the business and leadership material this month. I’ll follow this up with a couple more specific posts and, of course, some lead-up to March’s Year of Sagely Living commitment.
1. Business Seminar at NCNM : As part of our program we take a two part business seminar co-taught by two LAc’s in the Portland area. They both have different approaches to business and the medicine, and complement one another well. Much of the class has been taught through the five element model and through the archetypes associated with the 12 officials. This first part of the series has been focused on general business topics, the second part will present us with more detail. We have been asked to conceptualize what kind of practitioners we would like to be, to start thinking about what our space will look like and what kind of financial structure we expect to have. We’ve been asked to interview current practitioners, write mission statements and to grapple with our own relationship with money. It’s been a good class, overall. I have to admit I’ve been a little impatient with it, as I’ve done most of that work and I’m eager to get on to the nitty gritty details of opening and maintaining a practice. However, with each more general exercise I’ve learned something important about my future medical practice. In a sense, then, the greatest lesson I’ve learned from this class and my focus on it during February’s Year of Sagely Living is: You can never revisit the basics enough.
2. Dave Ramsey - Total Money Makeover : As I’ve mentioned elsewhere, I’ve been working through Dave Ramsey’s Total Money Makeover. While I can’t say I agree with everything Dave says, I do think that his fundamental philosophy is sound. It works for someone as systems oriented as I am. I also have an appreciation for “tough love” approaches that encourage me to reach for my dreams while keeping me fully grounded in the reality of the situation. If you’re not like that, you won’t like Dave Ramsey. You also have to have a relatively high tolerance for evangelical Christian themes and statements, a sort of traditional American gender bias and lots of colloquial Texan phrases. Still with me? It’s a great program and has whipped my financial life into shape. I feel that I have a greater appreciation for the power and promise of money as well as its downfalls. Greatest lesson: grow up.
3. Tony Robbins - Personal Power II: As you can probably already tell, this month was very prolific for me. I find that while I need to spend a lot of time with material specific to Chinese medicine, my function as a Chinese medicine scholar is greatly enhanced by consuming material on personal productivity. That’s the lesson, really, of the whole month — Chinese medicine must be integrated into one’s life as a totality. Everything that I do to improve my life outside of Chinese medicine enhances my ability to understand Chinese medicine! Wonderfully - the converse is also true. I started listening to this book of Tony’s on my iPod and have really enjoyed what he has to say about the true power of a single human life. He has that classic wood-style “motivational speaker” voice and while that takes a little getting used to, I do find it gets me pretty psyched after a while. :) However, because of an error in loading my iPod, I ended up listening to another audiobook much more and that’s really what I want to talk about…
4. Steve Covey - The 7 Habits, Principle Centered Leadership : I’d like to write a few articles on the 7 Habits and how I see them meshing with the image of the Classical Chinese scholar gentleman. Steve Covey is simply brilliant. If I had more time, I would start a whole blog just to explore his ideas and how they intersect with other world philosophies. I’ve read several of his books, but this is the first time I’ve had an audiobook version. As you know, I’m a huge fan of the “Getting Things Done” system of personal organization as described by David Allen. I absolutely stand by my endorsement of his system, as nothing has enabled me to keep track of my various projects and ensure that I forget nothing like his system has. However, I find that I need something more. I need a way to overtly keep myself balanced amid the many competing interests, a way to take care of my responsibilities while still moving towards fulfillment of my highest purpose. It’s incredible how much listening to this audiobook has enhanced how I understand the basic philosophies Covey espouses. It’s difficult for me to think of just one lesson, but if I had to pick one it would be: You need to spend the most time doing the things that are most in line with your life’s purpose(s).
5. Blogging and my thinking process around future business strategies: I’ve learned so much than I’m revealing above. I think it will take a couple of weeks for me to integrate it all. It definitely has changed my vision for my practice as well as my idea of what kind of professional I want to be. It has made me re-evaluate my blogging as well. I now see that blogging is not just a hobby, it is an integral part of my life’s work. Hopefully this realization will produce results that all of you can enjoy. I realize that I haven’t put out too many blockbuster CM related posts lately and I’ve made a commitment to myself to reverse this trend.
Tags: Blogging, commitment, Dave Ramsey, David Allen, habits, Learning, organization, Personal Development, productivity, Steve Covey, Year of Sagely LivingRelated posts
The development of first professional doctorate degrees in Chinese medicine
I must confess that the issue of accreditation of programs, levels of education within the acupuncture and Chinese herbal medicine profession(s) and all related issues sometimes evade my understanding. While the degree that I will get at the end of my training is a Masters of Science in Oriental Medicine, I will obtain a certification that will give me the title of Licensed Acupuncturists (LAc). At this point, further education is possible in accredited DAOM (Doctorate in Acupuncture and Oriental Medicine) but it brings with it no further licensure benefits. At this point, all Doctorate programs require the student to have their Masters degree and have some amount of clinical experience before they are considered for entry. The standards vary as to how much clinical experience is required. The Doctorate is clinically based and generally requires some amount of clinical research to be done.
NCNM, the school I attend in Portland, OR, has been working to create a first professional doctoral degree that focuses on Classical Chinese Medicine. I’m unclear as to whether other schools are seeking something similar. It’s been a long road, one that was started down long before I came to the school. Students, faculty, staff and community practitioners have been involved in the creation and refinement of the program. Most of the students currently in the MSOM program had high hopes that ACAOM (the Chinese medicine accreditation organization) would create a set of standards for first professional doctorates in time for us to complete our “first professional doctorates.” To that end, we have been taking the extra coursework necessary for our proposed Doctorate program. Some of us have been quite active in the process, attending committee meetings and submitting comments to the ACAOM in support of a certain set of standards.
On February 8, ACAOM released their recommendation - which is essentially that they feel they can make no recommendation because of lack of consensus in the community. If you would like to read the official document, read it at ACAOM’s website. I’m unclear what, exactly, this means for our program at NCNM. Almost certainly those of us in our third or fourth year that were hoping to graduate on time with our Doctorate will not be able to do so. That’s not my biggest concern - I’m simply interested in understanding what the essential disagreement is in the community.
So, I would like to hear from my readers. What is your stance on First Professional Doctorates? What do you feel needs to be in place before a program like that goes through? Do you have other thoughts about how education and licensing works in the Chinese medicine profession in the United States? Let us know in the comments.
Eric
Tags: acaom, Acupuncture, chinese-herb, classical-chinese-medicine, doctorate program, education, licensed acupuncturists, licensing, ncnm, organization, professional doctorates, studentsRelated posts
Back to School! 8 Low Tech items that make me an honors student
Chinese medicine students have some of the same needs as other students - one of those needs is to stay organized and productive. It is perhaps even more critical in graduate/professional school because the academic demands are so much greater. I’ve also found that a fair number of Chinese medicine students (a self selected group) are unfamiliar with basic tools of organization and productivity. Many productivity websites list various tools and tricks, but you may not be familiar with those sites. So, I will list the top 8 tools I use to maintain my organization and productivity, making special notes for Chinese medicine students along the way.I will provide separate posts concerning technology and software that is fairly critical to add to this mix in order to maximize your student potential.
1. Getting Things Done
2. A physical inbox/outbox with at least two tiers: This is part of the GTD system, but is vital regardless of your system. Get used to putting EVERYTHING you need to deal with into this inbox. I’m totally floored by how many people get important papers at school and then let them mold in the bottom of their backpacks or get lost in the mess of the backseat of their car. Have a special place in your bag or folder system to store any papers you receive from school (and elsewhere) and every day make a habit of depositing them in your inbox. Then, at the very least, you know where to find school related information.
3. Electronic labeller
4. Filing cabinet : I found both of my filing cabinets on the side of the road. This is not David Allen style, to be sure, but it works for me. I have one two-drawer filing cabinet for every day use (all of my important papers, bill stuff, current projects) and one four-drawer filing cabinet in my basement for longer term storage. Most of this second filing cabinet is my class archives. I archive it by Professor, and then by class. This way, I am always able to find important information in the future. The GTD system makes judicious use of filing cabinet antics - and let me tell you, it makes life easier.
5. Expandable file style folder
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The prior items all fall into a similar category - organization and productivity. For Chinese medicine students, having some kind of formal organizational system is critical in two respects. First, as a student, you are going to be inundated with a variety of deadlines, notes to self and other materials that will quickly become unwieldy if you do not get on top of them. Having a formal, proven system of elegance will help you to get your assignments in on time, register for special events like your Clean Needle Technique exam and keep track of all the new and exciting information you will undoubtedly be absorbing - this will catapult your overall performance and help you to get the most out of this critical phase of your education. Second, planting the seeds of high productivity and personal responsibility now will help build the foundation for you to become a highly organized and respectable professional in this field. In this way, people in professional educational environments have an even more pressing need to step into their own as productive, responsible members of society - we are tomorrow’s doctors and the face of Chinese medicine.
An important side note that I feel is, unfortunately, necessary: Being organized and productive does not mean you have to be uptight, un-spontaneous or that you’re selling out to the man. Avoiding professionalism on the grounds that it makes you too much like “them” just gives “them” a leg up. Productivity, organization and responsibility are for EVERYONE. Make it your own and do this profession proud.
6. A decent backpack : I’m suprised how many people are still using their Jansport backpack from high school. I mean, I recognize the urge to conserve and I respect it. I live it! But use your old backpack for day hikes and groceries - get something that is both professional and durable, and BIG, for your school needs. I use a blogger bag from Timbuk2
7. Stainless steel water bottle and a lunch system : The next three items may not seem like organizational elements, but for me they are. Having easy access to good quality water leaves you free to think about other things than your thirst. Stainless steel has the least chance of leaching any fun chemicals into your water. I will write a separate post about the water filtration system I use, but let it suffice to say that I most definitely use one. All natural health care practitioners should be concerned about the quality and amount of water that they drink. Although many Chinese docs have suggested that the obsession with drinking so much water - especially cold or iced water - is unhealthy, any doctor would agree that drinking a decent amount of high quality water is important for overall health. Find your balance and steer clear from ice, it can put the brakes on your digestive health.
Regarding the lunch system - You will save money, time and your health by relying on your own cooking skills to feed you during your long school days. But even the best laid out menus and most well-meaning shopping trips will leave you scrambling in the mornings or eating out of vending machines if you don’t have an easy and functional way to transport your food to school. Invest in some good quality tupperware or other containers of your liking. I use Ikea plastic food containers for most things, except hot liquids, which I put in glass jars. I used to use a fabric lunch bag, but now put everything in heavy plastic bags inside a main compartment in my bag. You might look into a more formal system. Experiment.
8. Bus pass and flawless integration with scheduling system : I feel sorry for anyone who is in a situation where they must drive to and from school. Parking and traffic are nearly uniformly a pain in the rear. We are blessed with an excellent bus and bike path system in Portland - the Greatest City on Earth. I use both to excess. If you have a public transportation system where you live, get a bus pass. Just do it. Stop making excuses. Bus time is EXCELLENT for studying flash cards. If you can bike, do that too. I mean - avoiding traffic, saving money, exercising AND caring for our Earth home — what’s not to like? You need to make sure you know the routes well, though. Many public transportation systems now have a way to hook into their schedules via cell phone or text message. Call them up to find out if yours does.
Have any low-tech organization or productivity tips for students? Leave yours in the comments.
Eric
Tags: academics, education, erics-habits, organization, Personal Development, productivity, professional-development, students, study
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