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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Related posts:

1. Learning classical Chinese is foundational – an interview with Rick Goodman
2. Phenomenology and Classical Chinese Medicine

Many people seem to believe that what they see at first glance is as much as there is to see. Nothing could be further from the truth. My hope is to encourage students, and consistently re-encourage myself, to really SEE things in their fullness. The subtle changes in color, the textures, the shadows cast, the subtle suggestions of where they were on the plant, how they were treated during growth and in processing. It isn’t as if this information is recorded as data and filed away for use in therapy – but just like getting to know a person, all of these tiny pieces of information fill in the skeletal lines of first impressions with color, depth, beauty.

Sight aside, I’ve had a lot of fun with the students at NCNM working with our underused faculty of touch. We have been working with two types of touch, though I haven’t had time to go into depth with either. One of the hardest things about this class is the fact that it’s only an hour. That’s why an online version will be so great – more time, more space! However, this limitation does force me to try to get the teaching down to essentials.

The two ways we are using touch:

1. The most basic – “just touching.” There is a ton of information a person can get from touching an herb, even at the most superficial level. You can get a sense for its density, its heft – particularly in relation to other herbs. You get a greater sense for the texture of the herb. With some herbs, like Mutong, you can start to understand what the herb does – it feels like a filter! Or think about something like Ganjiang that feels like it is, drying and warm. Aside from looking to get a sense for what part of the plant is, simple touching can also give you some good information for the doctrine of signatures. Light things may tend to rise, heavier things to sink – and so on.
2. A little deeper. At NCNM, we are taught a variety of ways to use our hands to perceive more subtle sensations. But, anyone can get good information by just sitting with an herb in their hands. I usually take some time to do some Qigong or prayer, just connecting with subtle reality. Then I close my eyes and touch the herb, allowing my mind to rest and eventually to wander. I may just hold the herb in place, or may manipulate it. Usually, going deeper in this way allows one to get information that is a little outside of what one would expect. Actions, temperatures, even colors start to flood the mind.

This week, with the class, we used blindfolds to isolate the feeling faculty. While in practice I encourage everyone to use all of their senses, it can sometimes be extraordinarily helpful to just focus on one at a time. Exhaust it! See what you can find.

Just using touch, the class interacted with Baihe – lily bulb. Now, note, these are second year students – just learning herbs. Here is the list of qualities they got, blindfolded, without knowing the name of the herb or anything about it beforehand.

• Lung
• Treats diabetes
• Treats arthritis
• Neutral to cooling
• Expels phlegm
• Whitish yellow (I kid you not)
• Slightly transparent (seriously)
• Taiyin
• Claws
• Relieves dampness
• Clears heat
• Pungent – bitter
• Cold
• Replenishing
• Moves, but not through Yang force

There are a lot of interesting observations here, I think you will agree!

Baihe is sweet, according to the Shennong Bencao Jing (SNBCJ) – though later commentators say it is sweet and slightly bitter. In the SNBCJ it is listed as neutral, though later commentators say it is slightly cooling. Of these basic affinities, only the bitter is out of place in what the students found. It does clear heat, and while the dampness and phlegm properties are contrary to basic understanding of the herb, it’s not so far out of the realm of possibility. It is indeed replenishing, related to Taiyin and interestingly, is known to treat diabetes!

Most interesting to me is the symbolic association of the Lung organ system. Lily, in channel affinity language, does enter the Lung (as well as the Heart). Again, we do have the relationship with Taiyin. But what about the claws?! Now Baihe in its dried form does feel a little like toenails, as many students jokingly remarked. The claw association could have something to do with that, but more than one student did get a sense of actual claws or talons. This, to me, is related to the Tiger – the animal associated with the earthly branch Tai and the Lung organ system. I just thought it was interesting that these associations came up so consistently.

We did several other herbs in class, and I was just astonished at how much information we could get with just an hour of holding the herbs. If you haven’t tried this before, I recommend it. Yes, just the dried herb. While fresh herbs are great, while plants are great, I do believe that the dried herb holds a lot of information in a holographic way. Students in class were getting senses of the way the plant grows, what kinds of conditions it likes, all without having any contact with the living plant at all. Give it a try!

I want to make clear that I’m not suggesting people just sit with herbs and use that information exclusively. It’s a matter of using our sensory experience to enhance and ground the head knowledge of which we get so much. Also, I wonder how long it will take for these students to forget that Baihe is related to the Lung? Won’t they have a slightly better understanding of the herb, having spent a little time with it? What if they were to use all their senses, and consistently reengage with it over a period of months, years? It gives me high hopes for their future as herbalists! Give it a try, and come back here to tell us how it went – add your thoughts in the comments!

Related posts:

1. Setting yourself up for learning success : First, know thyself
2. Listening my way to success in the NCCAOM acupuncture board exam

Update : I passed!  :)

As I said before, I’ve been spending a significant amount of time studying for and taking my NCCAOM acupuncture board exams.  As I said in my last post…

“…I’ve successfully completed the foundations and biomedicine exams already.  I found them to be much different from what I was expecting. I know I am not allowed to share much about my experience – but I’ll just say that I don’t think any commercially available study aid helped me…”

This includes the much lauded TCMTests.com.  Don’t get me wrong, I think they offer a great service.  If nothing else, they allow you to have some degree of comfort with the format and general content of the test.  However, the specific topics covered in the real test were not touched on much by the practice tests on that site or on the official NCCAOM site.  Others may not share my experience, I know.

As an alternative, I recommend you go through the list offered by NCCAOM (content outline) and read through the texts they indicate as sources for question writing.  I found that these outlines were quite accurate, and I would pay attention even to those topics that seem less important.  While some of the more minor subjects may not come up often, one really unexpected question can really throw you off your rhythm.

Also, it will help you to be a good test taker and – perhaps most importantly – to be lucky. 

Now, I’m studying for the “big one,” the exam about acupuncture and point location.  I actually postponed the test once, because as I dove into studying the material I really found out how unprepared I am – at least by my reckoning.  Why?  Certainly not because my education has lacked quality.  It doesn’t reflect on my ability to treat patients.  It doesn’t reflect on some lack of scholarly rigor on my part.  Quite the reverse is true, I think.  Why?

Simply,  NCNM doesn’t teach to the test.  We don’t read Maciocia as a textbook.  We learn TCM pattern differentiation, sure, but we learn so much more that is (in my opinion) far more compelling.  So, as students, most of us choose not to focus much on the TCM stuff we are taught.  Even those professors who might be thought of as “more TCM” on our faculty have a wealth of Classical information and clinical pearls they are constantly divulging – so the TCM stuff tends to get swept under the rug a bit.  So, what’s a guy to do?

Ironically, now at the end of my education, I feel that I’ve finally settled on some winning learning strategies.  As I studied for this test, I started to use every trick in the book to get the stuff to stick.  I had huge pieces of easel pad paper taped up all over my house, I was using innovative mindmapping software, I was making flashcards, I was making diagrams… All of these strategies were definitely helping, but then I ran across an article discussing multiple intelligences, then through some web searching another one about the VARK learning styles theory.  The particulars aren’t super important, but it got me thinking about how I learn most effectively.

For me, it’s all about the auditory.  I learn very well from lectures – even better if I record them and listen to them a hundred times.  I learn well from music, from silly songs, and also from speaking things aloud.  It was a small insight, but when I really realized this – I went to town with it.  I’d like to share some of the strategies I am using that appeal to my auditory learning style.  I should mention that I feel that I learn quite well from reading and writing things as well – but I wanted to talk particularly about the auditory aspects today.

1.  I am a big fan of Cal Newport’s blog, Study Hacks.  Among a lot of other great advice, he recommends that students use a method called “quiz and recall.”  Using this method, you collapse lecture notes (or other material) into “big ideas” with one sentence prompts.  You then move through those one sentence prompts and give a pretend lecture to nobody in particular.  I do this in the backyard, pacing through my living room and on my daily walks.  You can follow the link above to learn more.

With the material I’m studying now, I’ve had to alter the method a little bit.  Because I’m not really working off of any notes, I simply let my prompt be the name of a channel or TCM syndrome.  With the latter, I actually break it down a bit – working off of a list of diseases and their differentiations.  So, I might come to a prompt that says Gan Mao due to Wind-cold.  Then I lecture passionately concerning the points involved, their categories and locations, the needling method employed and so on.  This has been incredibly powerful.

2.  There are a couple of commercially available audio products designed to help you learn and review Chinese medicine related information.  I’ve tried Tunes for Tangs and Songs for Sans as well as the product I review below.  I’ll talk about Tunes for Tangs in another blog post in the future.

Radioqi.com offers a set of MP3′s called AcutherapeuticA that are meant to be used in learning and reviewing the acupuncture points by channel.  These recordings include a soothing female voice speaking over some repetitive trip-hop style electronic music.  The voice lists the point designator (HT1, etc), the Chinese name and an English translation, any pertinent categories (Yuan source, etc) and finally some basic TCM actions.  Sometimes, they will offer a little more – such as a particular contraindication (like LI-4 being contraindicated in pregnancy).  They also include a two-file set of the 100 most popular acupuncture points set against more upbeat music.  I have not tried the second product, but I own several of the channels set over the more soothing music.

It’s undeniable that this product has helped jog my memory about some of the less used points.  Because I’m largely an auditory learner, the stuff goes in my head with the music and sticks there.  There is something quite compelling about the ability to go on a walk in the dawning summer sun and be studying at the same time.  As I’ve discussed elsewhere, and doubtless will again, I’m a huge fan of audio learning for that very reason.  However, I’m very disappointed that Radioqi has not included location information!  I also feel that the voice speaks a little too quickly through the action information.  Because of these shortcomings, and also because I can’t afford the ~$100 it takes to buy all the channels, I hit on one final (and my favorite) acupuncture audio learning solution.

3.  I have a MacBook, which has a great built-in microphone.  I also own the excellent free audio editing program Audacity.  Sitting here, frustrated with my limited choices as far as audio learning of acupuncture goes, I hit on a natural solution.  Make my own MP3′s!  I simply recorded myself reading out of my favorite text for studying for the acupuncture exam (link broken – no longer available online), adding commentary as I thought of it.  For instance, when talking about a Yuan source point, I might mention e
verything I know about that category of point.  In a couple of instances, I played the excellent Yi Ching Music for the Health CDs, in the background, using the element corresponding to the channel I was studying.  I then exported these as WAV files from Audacity, and added them to my iTunes library, converting them to MP3s in the process.  Finally, I loaded these onto my iPhone for listening to on the go.

While it’s a bit weird listening to myself talking about acupuncture channels, it has been very helpful.  The points are sticking in a way they haven’t before.  I’m going to try this technique for syndrome differentiation as well.  After this exam, when my time opens up a bit, I plan to use some version of this technique to continue learning about formulas.

If you know of other audio learning techniques – let us know in the comments!

I am rewarded for this with the knowledge itself, of course, but also numerous scholarships and other honors. I have become integrally involved in my school through student government and, most recently, the NCNM Presidential Ambassadors Leadership Society. My life was not always this way, but that’s certainly a story for another time. Chinese medicine – especially my educational experience with it – has changed my life. For the better.

I wanted to share with you seven of the most important habits or practices I have learned in my time as a patient and student of Chinese medicine. Hopefully they will be useful for you as well. These habits help me to be a more effective student, a better parent and partner, a generally happier person and able to do more productive work with a better attitude. They are listed in no particular order.

1. Frequent consumption of Ju Hua (chrysanthemum flower) + Gou Qi Zi (goji/wolf berry, lycium) + Dang Gui (angelica sinensis) tea: This is a slight variation of a tea that one of our professors repeatedly urged us to drink so that our “ears and eyes will be bright” and we can be great students. You should be able to pick up all of these herbs at your local Chinese formulary without a prescription. You can also find them at most well stocked natural foods stores and Chinese groceries. Look for organic sources if you can and make sure the herbs themselves seem vital – deep colors and not too dry. Put equal parts in a teapot or generously sized teaball. I use a glass teapot that’s actually meant for the brewing of french press coffee – that way I can make plenty and the herbs can sit in there for a while, really steeping. I drink this tea several times a week – in the winter term I drank it every day.
2. Use of the Yijing for contemplation and guidance: I take my self-cultivation seriously. That being said, I know that many people are highly suspicious of divination like the Yijing and the Tarot. Personally, I have found it a highly effective way to break through mental muddiness. If I find myself feeling a bit lost or confused, I just sit down with the Yijing, focus on my question and just let the meditative process of throwing the oracle (I use sticks fashioned from bamboo skewers) do its work on me. I don’t need to make any fantastic claims of communing with the Spirits to tell you that it has been a life-changing way for me to work through seemingly intractable problems. I can recommend very highly Total I Ching: Myths for Change written by the incredible Stephen Karcher.
3. Daily Qigong: I don’t always have the time, energy, or desire to do a full form – but every day I at least do some practice that is part of the lineage I am fortunate to have been brought into. Sometimes that’s a walking meditation, sometimes a practice of full body shaking with visualization, sometimes sitting meditation, sometimes repeated execution of some part of a form – generally I just let my body be my guide. You could do this with any physical practice you have been introduced to – my partner prefers Yoga, a close friend enjoys walking meditation in the Zen tradition. But it’s about consistent practice. It WILL transform you.
4. Stimulation of “panacea” points: There are acupuncture points which are widely regarded as preventative for a wide variety of conditions. These points, when stimulated on a regular basis, boost the Qi and Blood of the entire body and help to keep the channels flowing freely. Because most of you probably don’t know how to use acupuncture needles safely, you can use acupressure to stimulate the points. Just use the location guides below if you don’t know where the points are, feel around in the area indicated until you find something pretty tender. Apply pressure – it should feel pretty tender as you do it – for 15-30 seconds at a time, repeat 9 times on each side. I do sometimes use needles, but more often use indirect moxibustion.The points that I use most often in this way follow:

   • *Stomach-36 (Zu San Li): The mother of all preventative points. Find Stomach-36 here.
   • *Large Intestine-4 (He Gu): Often used by the general public for headaches – but great for so much more. Find Large Intestine-4 here.
   • *Governing Vessel-20 (Bai Hui): Not normally considered a “panacea,” but great for students and other people who are trapped too often in their heads (that means you, bloggers). Find Governing Vessel-20 here.

5. Demonstrate respect for myself and others: Learning Chinese medicine has made me a more compassionate and respectful human being. I think the study of medicine tends to make anyone more capable of feeling empathy for the suffering of other people – it certainly has had that effect on me. But the respect part I learned through my study of medical classics and Confucian literature. The more respect I show for my teachers and fellow students – even to the point of seeming a little quaint – the more abundance I experience flowing back to me.
6. Study diligently and consistently: ( Edit: I have recently written a post about 8 Scholarship Winning Habits I Learned through Chinese medicine study that readers of this post may be interested in. ) School has always been very easy for me. I was bored stiff all through primary school and didn’t even bother going to high school. In college and my first graduate degree I began to step up to the plate, but often did only as much as I felt like doing at any moment – that was usually enough to keep me in the upper levels of the class. When I got to NCNM I suddenly had a reason to study – what I learned or failed to learn was going (IS going) to mean the difference between my being able to help someone or not. Add to that the deep work ethic embedded in the medical classics and demonstrated by my esteemed professors and you have a recipe for my conversion to dutiful student. I do my very best to study something Chinese medicine related every single day. During school I usually study 5-6 hours a day – not counting classes. I expect this to continue.
7. Be in awe of the complexity of the universe: Although I have a tendency to get maybe a little too Confucian with all my respect this and study that, I have also learned from the Daoist roots of this medicine. I have learned to often stand back from the sometimes meticulous detail involved in learning Chinese medicine and just laugh out loud at the absurd and overwhelming complexity of human beings and the universe they live in. I find myself bowing my head humbly in awe of this place and time and always keep in mind that as much as I learn, there will always be much more to learn.

Implementing these habits was a pretty organic process – but some parts (diligent study, daily Qigong) have taken some… uh… gentle encouragement on the part of my Will. I credit the nearly religious adherence to these habits with my success in school and life in general.