Herbal quality : the Fuzi (aconite) dilemma
As you all know, herbs are my passion. More accurately, formulas are my passion. Formula science is my passion! :) But, I do have a strong affinity for the herbs as plants and study them as such. Further, I have a real desire to get as close as possible to the original way of prescribing the herbs in formulas, where “original” means Han dynasty or thereabouts. If you read the Shang Han Lun, there are very specific instructions for how herbs are prepared and how they should be processed. Many of these instructions appear to be ignored in contemporary times, and I can only imagine that this is having some effect with regards to our herbal effectiveness.
However, even if we prescribe and prepare the herbs exactly as indicated it means nothing if the quality of the herbs is terrible. Recently, in a class at NCNM, a professor allowed us to taste Fuzi from different sources. We had three samples of bulk Fuzi. One was from a popular herb company, the second was from China, specially prepared in the traditional way at the instruction of Heiner Fruehauf. The third was raw Fuzi - unprepared - from China.
We were asked to observe how the herb tasted, its texture, and how it made us feel. The first batch was - depressing. It was brittle, soft, had almost no flavor and absolutely no bodily sensation resulted from tasting it. This is similar to what is found in many clinics. We tasted the second batch a few minutes later, the differences were striking! There was an almost immediate pungency and quite a bit of numbness on the tongue. This numbness continued for quite a while. We have been told by several professors that we want to find this quality in the Fuzi we prescribe to our patients - it indicates that the living potency of the herb is retained.
The best fun happened when we tasted (just a bit) of fresh Fuzi. Oh boy! My THROAT was numb after that one. You could really feel the medicinal quality - it was incredible. The only thing I could think after this little taste test was, “How can we get more of the good stuff and less of the bad stuff?” The consensus seems to be that the best quality Fuzi is not available in the states or really anywhere in the West. Further, the recent earthquake in China apparently did great damage to the areas where much of the high quality Fuzi is produced - creating even greater shortages.
The quality of the initial herb is only part of the problem - processing is the next piece of the puzzle. Fresh Fuzi is often brined, and then treated in various ways. Reports have indicated that industrial chemicals and harsh processes are used in the preparation of lots of commercial Fuzi. At the very least, you can tell that much of what’s available from the major herb companies is wildly over-brined. The brining process reduces the toxicity of the herb - but we have to remember that the “toxicity” of herbs (usually produced by alkaloid content) is a large part of why it is clinically effective! Skilled herbalists know how to exploit the positive nature of the herb while minimizing the potential for harm from the strong compounds contained within. When we overprocess herbs, we don’t do anyone any favors.
How can we, in the contemporary West, make up for these various deficiencies? How can we prescribe herbs in the way they are meant to be prescribed - full of their vital force and particular benefits? How can we know if an herb has been processed appropriately? These questions can easily be added to the ones I’ve had about using local species and other related conversations on Deepest Health. I’m looking forward to hearing what you think about this important issue. Please voice your thoughts and share your research with us in the comments! No registration is necessary.
Eric
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Tags: agriculture, formulas, health, herbs, quality, ScienceRelated posts
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
Tags: crystal, human physiology, microcosm, nature, organization, salt, Science, waterRelated posts
Salt-sensitive hypertension and Classical Chinese Medicine, Part 1
Editor intro
This is a Guest Post by 3rd year Classical Chinese Medicine student (and Chinese medicine blogger) Brandon Brown. Brandon is a friend of mine and an excellent student. He approached me with this paper and I immediately knew it would be a fantastic contribution to the site as many folks have asked me for rigorous examinations of the cross-pollination between Western and Chinese science as expressed in medicine. This will be a 3 part series released over the next 3 days, please feel free to leave comments - Brandon is a regular reader of the site. 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
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Author intro
The following three posts are from a paper I wrote in the Winter of 2008 for Dr. Edward Neal’s Clinical Physical Diagnosis course at NCNM. It is my attempt to apply classical Chinese medical knowledge to a modern disease processes that is pervasive, salt-sensitive hypertension. In looking at all modern diseases, I believe it is extremely beneficial as CCM practitioners to understand the patho-mechanism as presented to us by current research in Western materialism. Because yang (energy) leads and yin (substance) follows, by knowing the yin we can garner important clues that can allow our yang treatments to strike with more clarity, force, and efficacy. I welcome your thoughts and comments. - Brandon
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Salt-sensitive hypertension : Western science and the macrocosmic view
“The highest good is like water, it settles in the lowest place where people do not like to be.”
Dao De Jing
It is estimated that salt-sensitive hypertension (SSH) accounts for over two-thirds of people over 60 who have primary hypertension . Though there are genetic variants to the tolerance of the amount of salt that effects hypertension, dietary sodium is considered the most important environmental influence. This begs the question: why are some people who are hypertensive experience a salt sensitivity and others do not? The answer to this question may lie in the theories of Chinese Medicine and in the fundamental nature of salt, and its relationship to water and the Kidney. I will first give a summary of hypertension in western terms and discuss current research theories. Following this, I will discuss salt: cultural symbology, the natural formation, and specific references in the medical classics. By so doing, I hope to show how an ancient medicine sheds important light on this modern disease, through the connection of the Kidney and the Heart.
Hypertension - a more Western perspective
Primary hypertension is defined as chronically elevated blood pressure where systolic arterial blood pressure consistently exceeds 140 mmHg or greater. To be considered primary, the hypertension must be idiopathic, and not due to secondary factors such as kidney disease or adrenal tumors, for example. Primary hypertension is considered to be a major risk factor for strokes and cardiovascular disease, and is a leading cause of chronic renal failure . Heart disease is the number one killer in the United States, leading to well over half a million deaths per year.
It was observed in a strict rice and low-sodium diet study performed in 1944 that patients with kidney disease and hypertension were able to lower their blood pressure by as many as 100 mmHg in some cases . Current theories of the pathological mechanism of SSH posit abnormalities in renal sodium transport in the nephron structure of the kidneys . The cause for these kidney abnormalities are thought to be caused by both genetic and environmental factors. Because salt generally attracts water through osmosis, increased blood sodium not excreted by the filtering mechanisms in the kidney causes an increase in the water content of the blood, thereby causing the vessels to swell. This increased swelling, is an increase of “total peripheral resistance of the vasculature”, and is thought to create a long-term load on cardiac output ultimately leading to heart failure. Therefore, we can say that the presence of salt in the blood pushes out from the inside. This is contrary to the renin-angiotensin mechanism of the Kidney, which vasoconstrics and thus pushes in from the outside.
Salt in the Macrocosm
“Ye are the salt of the earth; the best of the human race.”
Jesus Christ in Matthew 5:13
The creation story of salt begins with fresh water falling from the sky as rain, and landing on the elevated earth. The nature of water is to always seek the lowest point of any terrain. The rain water falls on the hills at first as drops, which coalesce to form a trickle, which then join to form streams and these eventually join to form massive rivers, which empty into the sea. On this journey, constant erosion takes place as minerals are stripped from the earth and mountains and carried to the ocean. Because of its polar nature, water acts as a solvent to all matter. Place any material in water, and given enough time, transformation will occur. Metal will rust, vegetation will decay, and other liquids will eventually diffuse and become one with the water. The mineral rich streams, which still taste like fresh water to us, empty into the vast oceans that today are heavily salted and totally unpalatable, even though they are only 3.5% salt . The oceans continue to accumulate more and more salts because over millions of years evaporation extracts the water from the ocean, but not the minerals. The minerals are too heavy and earthbound to be steamed up to the heavens. This process is depicted in Figure 1.
Figure 1: The generation of saltwater
Of special interest in Figure 1 is how it reflects the generating cycle of the 5 Phases (五行). That is, Water falls from Heaven onto Earth and Metal, flowing down to Water, where through the energy of Fire, the fresh water is evaporated upwards toward heaven by the process of Wood. What is left behind is a storehouse of salt. Because of this, we would expect to find that places of warmer climate would have oceans with higher salt content. This is in fact the case, as places such as the Mediterranean Sea have a much higher salinity than that of cold water oceans (the Arctic and Northern Pacific, for example).
Salt is very much a dissolved solid from the Metal sphere. It is highly organized and crystalline, and looks almost identical to ice (Figure 2). Salt was the first currency of the civilized world, due to its value as a preserver of meat. As Richard Manning writes in Against the Grain, it was the ability to preserve and store meat which essentially lead to the creation of wealth and signaled the shift from nomadic hunter-gatherer societies to those of sedentary agrarian caste systems. Earlier than 800 A.D., the Yellow Emperor himself is said to have fought the very first war over the precious commodity . In 450 B.C., iron was put to use to boil sea water in huge pots to extract salt, a method that was used for the next 2000 years. By expediting the evaporative process, larger amounts of salt could be garnered more quickly and thus a greater amount of wealth could be amassed. Even in these ancient times salt stored, or preserved, wealth. To this day, the word “salary” comes from the Latin “salarium”, or “to be payed with salt.”
Not surprisingly, then, salt as a symbol of wealth came to symbolize all that is good. It is common practice to throw salt over the shoulder to ward off the devil, sumo wrestlers throw salt in the wrestling ring to purify it before a match, and placing piles of salt in tombs purifies the soul’s journey from earth to heaven, for example. Throughout history and across the world, in almost every culture, salt has been used in religious, medical, and cultural contexts to purify and clean the soul and the body from evil and disease . Ultimately, however, it is argued that salt is a often a cultural metaphor for semen, and the essence of man.
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In the next article in this three part series, Brandon will dive into the microcosm - discussing the mechanisms above as they reflect into the human body. Look for it coming soon.
Tags: disease, environment, heart, kidney, macrocosm, metal, nature, salt, Science, water, western research, western-scienceRelated posts
It drops deep as it does in my breath
I am in a state of heightened awareness as I sit down to write this post.
My breathing is deep and slow, without my direction. My posture is erect as possible but without strain. My vision is open and yet acute. I feel the air coming in to the edges of my nostrils. I feel it careen down my windpipe and alight on the left-side of my throat, where my dry cough originates. I get this when I talk too much: after lecturing for 8 hours without a break, which I do frequently. Suddenly I am aware of the stickiness, a sink of sorts, that draws the inspiration to that place. I am breathing. It appears before my mind’s eye. It is paler than you’d think, not red or inflamed. I can see the network of vessels visible under the thin mucous layer. I feel my chest expanding from the corners, in dark hollows . As I close my eyes for a moment, my shoulders drop. They’ve been folded into an origami crane’s tail all of this time. Now there’s clouds forming before the craggy precipice of my shoulders.
How can I understand my experience (recognizing that I do not need to understand it)?
Can it be the Oud I was compelled to wear today? Incidentally, Oud derives from the same tree that gives us the medicinal Chen Xiang: why not grab your Materia Medica and look it up. Feel the pages beneath your fingertips. Write down some notes long-hand, allowing your hand to teach your heart away from the abstraction that marks the computer keyboard.
Lung Qi opens into the nose; when the Lung is in harmony, the nose will distinguish the fragrant from the foul
That’s a simple statement. I have patients with multiple chemical sensitivities that can tell you the difference. But what about the things that we say unwittingly about others? What about the thoughts that waft before us?
Can this state derive from my son regaling me with plans to tour Tasmania to see the Eastern Rosella in the wild?
Can it be this passage from A Sufi Saint of the Twentieth Century
Purity is reached through the Absolute Water, the Water of the Unseen, that is, the Limpidity with which the visible world is flooded, Limpidity which is variegated in Its manifestation, One with Itself in Its seeming multiplicity, Self-manifested, Hidden through the intensity of Its manifestation, Absolute in Its relativity-this Water which is free from any taint and which availeth for purification…This restriction excludeth the waters of the sensible world and the psychic world, since both of these waters have suffered change from their original state. It is the water of the Spirit which fulfills all that the definition requireth, for This is indeed Absolute, being free from any taint, and remaining ever as It was, not adulterated by anything, not flavored by anything, not added to anything, not restricted by anything, with naught above It and naught beneath It. Here lieth the Truth of Absoluteness and it is only This that deserveth the name Water.
Simple Signs, Symbol Science
Really, this is the crux of the matter. The point of the last passage is not in the symbolism of water, just as my writing about the Lung does not affect my breath. It is rather, that the believer, no matter what symbolism he sees, still performs his ritual ablution, and is purified in it whether he recognizes the Absolute Water or not. Indeed it is the joining of the simple action and the unseen aspects of it that are the realm of the symbolic, but still transcend beyond it.
I guess, what we are going for has been aptly described by Heiner Fruehauf in his freely available papers at Classical Chinese Medicine. There he defines the concept of symbolique developed by R.A. Schwaller de Lubicz:
the highly complex science of synthesising the manifold layers of reality into a single crystal of meaning.
So what we’re going for is reconstructing the awareness that informs the science right where we are, and in doing what we’re doing. The next action, then, is to offer that glimpse to you, by whatever means necessary. Each of the things that informs my experience of this day, with all of its metal and Lung-oriented imagery could be a photo, a poem, a story, or an investigation of scents, tastes, sights, and sensations. Honestly, I haven’t written a complete poem since the week before starting acupuncture school. My photographic chops are nil (and I will not take pictures of people or many living things). But as for a spirit of experimentation and an inner attention to the senses, those I have in spades. Thanks for coming along for the ride….
Abdallah
Tags: heiner fruehauf, inspiration, lung, oud, scent, Science, sufi, symbolism, writingRelated posts
Why does Classical Chinese Medicine seem so complicated?
This is the first part of a two part guest article by my friend and peer, Michael Givens. Michael is also a third year student of Classical Chinese Medicine at the National College of Natural Medicine in Portland, OR. He shares my fervor for the medicine and has been an inspiration to me as I seek to plumb the depths of this profession we have both chosen. I hope you will enjoy what he has to say. Please do leave your thoughts in the comments - he is a regular reader of the blog.
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When I first started to study Chinese medicine (long before I became a student at NCNM), I fell instantly in love with it because it made so much sense to me. When I read the Huangdi Neijing Suwen for the first time, it was as if all the questions I had about life, my place in relation to nature and the stars, the interplay between light and shade, warmth and cold, and how life seems to exist somewhere between them all were illuminated by Huangdi, Qibo and the other sages. The cycle of the five dynamic movements in nature and how they manifest inside and out of all things, defined for me what I felt was already true; I had found a detailed system that defined the wholeness I had been searching to understand.
As I pursued my studies as a Chinese medicine student, I began to see how my initial understanding was limited and superficial, and soon, rather than being the clearest and most elegant text I had ever read, the Neijing became the most complicated. I found myself spending hour upon hour trying to draw out the inter-lapping cycles of the six confirmations, influencing each other on the right and the left through time, in the heavens and on earth, connecting to the heavenly stems and earthly branches and the five movements…I quickly became lost in the details of such an amazingly intricate systematic understanding of the nature and movement of Qi.
When I first learned about the five organs and their relations to the five “elements”, it seemed so clear; yet, as I deepened my understanding of physiology (Chinese physiology that is), simple concepts like “Fire generates Earth, Earth generates Metal, Metal generates Water” became extremely complicated. How is it, after all, that Fire descends through the malleability of Metal, physiologically, or that Metal really descends only when Fire descends? What does it mean that Water, while it resonates with the flavor of Salty, is actually reduced by Salty and strengthened by Bitter? What is at the heart of the difference between the six atmospheric conditions and the five dynamic processes and how do they interact physiologically? Questions such as these began to plague me.
Of course, this is what happens as one deepens his or her understanding of something; and, as one narrows his or her focus from the “big picture” to the minutia, the complexities of the universe become overwhelming. Yet, the beauty of Chinese medicine lies in the central view that the Chinese sages held. Rather than lose themselves in the grand picture, focusing only on the Dao or on the stars alone, and rather than (as Western science has done) lose themselves in the smaller and smaller details of the parts, the sages of Chinese medicine maintained an open view of both through using the language of symbolism and correspondences and remaining focused on processes and dynamics, functions and movements. So, though I was swimming out in the ocean of stars, and at the same time swirling amidst the tiny fragments of manifestation, by taking on this central position of the Chinese, I found a way to begin to have clarity and understanding and to flow with the movement of nature.
This is not to say that I would advocate ignoring the details and taking for granted the whole, not at all in fact; as I said earlier, the Neijing incorporates extremely detailed understandings of the very large and the very small, though there is a much stronger emphasis on the very large. What I have found is that one’s lens is what matters, regardless of what one is looking at. The lens of the Chinese medical sages allowed them to see dynamic processes and functional qualities rather than matter or manifestation. Though much of what a Chinese doctor does is to examine the symptoms and manifestations (especially in that the pulse is so very important), the treatment comes about through understanding function and movement, quality and time.
But, this is where a new confusion arises and is really what I meant by the title of this article. Chinese medicine is complicated just because it’s complicated, to be sure. But, how we are learning about Chinese medicine is also complicated. At times we are looking from a point of view of function, and at times we are looking from a point of view of materials. At times we learn of formulas and treatments that are based on an understanding of processes, and at times we learn formulas and treatments that are based on a desire to supplement matter.
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How is a student of this medicine to behave? How are we to wade through this sea of complexity that so many years of history have created for us? That will be the topic of the second part of Michael’s article - to be released soon. Thanks for reading.
Eric
Tags: classical-chinese-medicine, five phases, focus, Learning, Michael Givens, neijing, overwhelm, Science, symbolism
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