here is the text of a speech i'm giving in a couple of days. it's an hour long presentation, and i might have to ramble a bit more. but we'll see.
[intro here] I’ll go through some basics, the things that make Chinese medicine unique and valuable. I’ll probably ramble into things about how it works, why, at least the things we think, and some other stuff. I hope you find it illuminating and demystifying to some extent… don’t want to take all the mystery out of it, of course I couldn’t, if I wanted to… but that’s another story.
Basics Of TCM
Yin and Yang.
What is yin, what is Yang? First off, neither one is bad. Neither one is good. Water is yin when compared to fire, which is yang. Hot air is yang when compared to burning coals, which is more yin, relative to the rising formless heat. It is a system of relationships with one having more material qualities, the other having less, one more active, one more passive. Yin only exists in relation to Yang, it is a unique relationship in TCM. Yin is the substance, yang is the energy, Yin is the body, yang is the life within the body.
Qi is more yang, Blood is more yin. These two broad categories of body substance (for lack of a better term) are involved in every aspect of life.. Blood is fairly simple, think of our blood, though in Chinese medicine it contains a few very important concepts that ours doesn’t emphasize or consider at all: these are that blood includes Qi, two notable types of Qi Nutritive Qi (the nutrients and calories that are taken from food and dispersed into the blood) and Pectoral Qi (which refers to the air we take in through the lungs and dissolve into the blood) these aren’t foreign concepts to us, but there is another important concept, that of the blood as the place where the mind is located. This grows out of an association with the poor mental performance and poor sleep quality of those who have lost a great deal of blood. Because many of these associations are based on observed correlations they work in reciprocal ways: blood deficiency can produce poor mental health and heavy mental demands can produce blood deficiency.
Qi is a little difficult to explain, but not that hard to understand. If you remember physics class, energy is what makes things happen. Be it in the form of heat or electric charge or gravity or whatever. Qi is described in ancient literature as an unseen force that moves our blood, that pumps our heart, that moves our fingers… We now understand our blood to be propelled by the pumping of our heart, which is in turn contracted by an elaborate electro-chemical process initiated in the heart itself, we understand our fingers to move at our conscious command. Through electrical impulses carried to our distal muscles by nerves and so on… You may still view qi as the energy that makes things happen in the body. It’s the motion that must persist in order to remain alive.
I will come back to that point about motion later---
The Five Elements 5 yin and 6 Yang organs
There are 6 organ systems in Chinese medicine, quite unlike western medicine.They are classified by an element and center around a vital organ. For instance: the Metal element system centers around the Lungs, and includes the large intestine, the skin, the nose, and body hair. The metal system’s organs are the primary organs of transport of waste out of the body (I.e. sweating, respiration, heat radiation, and the more obvious elimination of solid waste). Each system has a similar common theme. Water-- Kidney, urinary bladder, external genitalia, teeth and bones and head hair and the sense of hearing. The theme of this system has to do with the beginnings of and endings of life. It is in the kidney system that you see both the evidence of aging, and also the early signs of developmental problems. It also has the feature of a substance called the kidney ‘jing’ or essence, which is passed down from parents to children, and resembles the concept of DNA. Wood-- The Liver, gall bladder, finger nails, tendons (sinews), and eyes. This system contains a special part of the spiritual being called the “hun” which remains after you die. The liver system is credited with initiation of menstruation each month in women. Fire-- the Heart, small intestine, tongue/speech, the blood, the mind/spirit. Earth-- The Spleen (think pancreas) with the stomach, muscle and flesh, the mouth. Lips, all associated with eating and appetite and digestive health. There being 5 elements the 6th pair of organs is missing, they are worth mentioning though, one is the pericardium, which protects the heart (because it is considered too important to be disturbed) and the San Jiao. Which literally translates to Three burners. The San Jiao has a function similar to that of a strange combination of the lymphatic, immune, and endocrine systems. Though certain functions of each of those systems are treated using other organs in Chinese medicine, the role of water transportation throughout the body, as well as the transportation of many other of the bodies myriad fluids.
Here’s some more about Qi and Blood. Really it’s about flow. The key to wellness is proper flow in the body. That’s what it all boils down to really. Flow is everything. Keeping the moving parts moving is vital to their health. There are two ways to decrease the flow to an area: one is to try to jam too much into it and block up the pathway. The other is to not have enough, this will just stop moving. It’s classified into excess (the first scenario) and deficiency (the second). Sometimes excesses can be from things, like toxins or inefficient body-processes wastes (that is to say dampness and phlegm.) These things obstruct Qi, which obstructs blood. This causes blood to collect and clump. To solidify into masses and prevents future qi from taking the path. It’s a big problem.
Sometimes the body isn’t very good at doing certain things. For instance, if your digestive functions are impaired, it leaves by-products behind. These are things like dampness (which can cause things like joint stiffness and heaviness, or weight gain, or gas, or diarrhea, or poor memory, and several other things) and phlegm (which can be actual physical phlegm or something called insubstantial phlegm which can affect the mind, or cause plum pit qi (the sensation of something in your throat that you can’t swallow) ) .
For a moment I’d like to discuss the assorted spiritual and emotional and mental aspects of Chinese medicine. One reason this medicine has become so popular here is the treatment of a person as a whole entity, where dysfunction in one aspect can express itself in others. Intuitively this makes sense to us: for instance, if we get anxious about something perhaps our stomach will hurt. If we feel depressed we are more vulnerable to casual colds. Sometimes complex emotional issues will manifest through the body, and sometimes chronic physical problems will grow into additional mental or emotional difficulties. In our society, being geared toward problem solving, we find compartmentalizing things into manageable groups with observable correspondences easier to understand and manipulate, I believe this narrow focus prevents us from understanding or even being aware of the complicated interrelationships between our spiritual, emotional, intellectual and physical selves. I cannot fathom our thoughts and feelings to be nothing more than a series of complex circuits in our brain, and we have no real idea whether that’s 50% of the story or less than 1% of it. So, that said, I read in a brilliant article about treating irrational and emotional conditions how counterintuitive it was to use the intellect to rationalize it away. Perhaps a cause of the low success rate of treatments of things like phobias and other severe and schizoid conditions. It seems important to include every aspect of the self in treating these conditions. Especially the one most obviously affected-- in this case the spirit. This kind of medicine is underrepresented as a form of legitimate healing. Whatever a person’s spirituality, organized or otherwise, it is often neglected as mumbo jumbo, but look closely, and you’ll see these problems underneath many common conditions in America.
In Chinese medicine there is an elaborate system of Spiritual components to each organ system. The first and most important is called the Shen: it overlaps all the others, but it’s usually described as the inner truth. The part of us that is most uniquely and purely us. It’s unease is responsible for poor sleep and wild dreams Nightmares and such. The Next is the Will, of the kidney system. This is our drive to survive. To procreate, to continue our line. To outlive others. To amass things or wealth. The Next pair are kind of opposites: the Hun and the Po, the ethereal soul and the corporeal soul. The Po is our Breath. IT starts when we are born and it ends when we die. It resides in the lungs. It makes us alive. Physically alive. The Hun is the part of us that reaches out to experience and guide us through difficulties. They say it wakes when we sleep and wanders the world while we dream. The Last of the five is my favorite. The Stomach and spleen are the home of the place we think. The part of us that worries, and frets and ferments ideas, over-analyzes and creates anxiety. I credit this spirit’s dysfunction with a great deal of peptic ulcers and Irritable Bowel syndrome, as well as habitual stress-eating, or stress-starving.
These complex interactions of mind body and spirit or emotions can be treated by using some techniques from all the aspects in concert. I have found that using the Qi flow in the body to calm the spirit, and using herbs to regulate the blood and qi or to improve digestion and thus replenish qi and blood are very effective in realigning the other parts. There are herbs which traditionally are used primarily for the body, or primarily to treat emotions, sometimes it is more in the combination of the herbs that you treat the mind, it is not really different from using pharmaceuticals to correct brain chemistry, except the clinical trials are about 2000 years longer… there is a special school of using herbs to treat spiritual conditions, not common around here, but I know one person, if you’re interested. I myself enjoy creating herbal formulae for repairing a dysfunctional mind or spirit, as much as fixing a body.
Once back in school many of us found we were having trouble motivating ourselves to study. To be fair, we were seniors, we were almost done, and it was springtime, everyone wanted to get away and never come back. Of course we had board exams coming and had to study. A small team of us decided to address the problem for the whole class and made a formula we called “senioritis powder” it consisted of some fairly simple herbs, which when combined functioned to cut through all the possible distractions and boost our memories. The formula was quite popular with the students, even those who weren’t seniors.
Chinese herbal formulas are excellent for conditions like FMS because they’re custom made and adjusted regularly to meet your specific condition, your changing needs. If one week your upper body hurts, but nothing else seems wrong, the next week you’re just tired, and sore all over, these things would be adjustments to the formula to make it perfect for you at that point in time. Side effects, or undesired effects can be minimized because you are only treating the things that are going on, and the herbs with extra or unwanted effects can be minimized or eliminated until needed or warranted by the current condition. It can be very elegant, 4 or 6 herbs working in harmony, or very complicated (20 or more herbs). I tend toward the small formulas, but it really really varies depending on the condition and the current situation of the patient.
I think it would be good to talk about how acupuncture works, at least, some of the ways we think it works. No one really knows… for sure. These are some prominent theories:
Gate control theory: pain and other sensations travel at different speeds to the brain. It is not until they reach the brain that the pain can be felt. Some feel that needles produce a sensation which speeds to the brain faster than the pain signal, and it uses up the brain’s available ability to perceive the sensation, it’s like stepping on a toe to distract from jamming a finger in the door.
Endorphins: This theory is fairly common in medical circles. Like running to get rid of a headache. It says stimulation by needles signals the brain to produce endorphins which blot out the pain, as an opiate would. There is a lot of evidence that there is a certain endorphin reaction in many people, but it doesn’t account for lasting improvements, nor the wide variety of other things which can be treated effectively, other than pain. This theory isn’t actually holding up to much scrutiny, but it has been so widespread I felt it warranted description.
Cellular Matrix Theory: this is a newer theory, it says that within and between cells is a matrix of proteins like elastin and collagen which form a kind of web. Pulling on one part seems to trigger changes in nearby cells, so a needle inserted moves the matrix, and the cells next to the needle are directly moved, and their matrices cause the cells near them to move, and so on, triggering chemical production, such as regulators like prostaglandin and others. This theory might explain why massage seems to have some very chemical benefits in the body, not just relaxation.
My belief hovers more or less on this: acupuncture has worked for over 2000 years without a suitable explanation by our ‘scientific standards’ however our scientific standards fail to explain many things to date, and we do not abandon those standards, nor should we abandon that which they cannot explain. Our current technology will evolve and perhaps we will get better theories or merely more questions. It has not yet changed what works and what doesn’t in acupuncture.
Real acupuncture is consistently better than sham acupuncture in double blind clinical trials. So there seem to be such things as real points. There is a method to the seemingly mad assortment of points. We have little evidence that channels are made of the same stuff that allows us to visualize the points. However, things are changing. There are studies from Korea that may suggest a very faint channel map in the body, which seems to have no corresponding physical structure. Western pharmaceutical companies are designing new drugs based off of Chinese herbs all the time. The active ingredient in Chinese red wheat is being used in certain cholesterol drugs.
Fibromyalgia and TCM :
Fibromyalgia syndrome may have as many different theories as TCM does to explain it. My clinical experiences with it demonstrate as many variations in the disease as there are commonalities. I’ve noticed great success with pain management as well as treating fatigue using acupuncture in very simple combinations of between 4 and 10 needles. ( as far as FMS goes, usually less is more).
One thing I have found to be of particular value when treating chronic pain in FMS is that it’s best to give most of your attention to repairing the root cause of the pain rather than chasing it around the body with needles. No one really wants to be a pincushion…
An interesting and unintentional side effect of the treatments of FMS seems to frequently be an increased awareness of exactly what is going on in the body. Eating gets better, appetite, sleep quality improves, decrease in pain , increase in energy and so forth. Sometimes the pain and fatigue can cause a kind of fog, through which it’s hard to remember the things your body went through, the variety of problems just seem to blur together and you just remember it was bad, not what was bad. This causes difficulty for the practitioner. No matter what specialty they are, they need to know what’s happening to help you. And when this haze thins out, and you remember what made this day’s pain different from yesterday’s it things begin to improve even faster. I’ve seen some amazing transformations.
TCM teaches to take into account every part and function of the body when formulating a treatment. Two people with identical symptoms can get slightly different treatments, and people can get similar treatments for very different presentations. One of the most fundamental premises of TCM is to evaluate the and treat each person individually, and uniquely. I believe this is what makes TCM strong in dealing with complicated and unresponsive (to western treatments) conditions such as FMS, IBS and other conditions.
In the end I hope you have heard at least something you may not have known before, maybe something that rang true in your mind that you’ve been thinking for a long time. I’d like to open it up to questions, ask me whatever…. Hopefully I will have an answer, and the odds are better if your questions are about Chinese medicine etc.
