Case Study: My Shoulder

This isn't actually a full-length case study, considering that I didn't really have to do much to fix the problem. Basically, I went to Kenpo study on Monday night and somehow threw out my shoulder. By the time I got home, it was really painful and nearly impossible for me to move my arm behind me and away from my body. I was too lazy to needle myself, so I opted to use an herbal medicated plaster instead.

That first night I used 701 Plaster, which I found in the past to be very useful for pains related to bone structure and joints. I woke up the next morning with it still kind of sore, and proceeded to go about my day at the office. By the end of the day my shoulder hadn't improved much in terms of range of motion or pain sensitivity, so I tried Wu Yang Plaster instead.

I placed a piece of that sticky herbalicious magic on my shoulder directly over the site of pain, and when I woke up this morning it was so much better. I put on a fresh patch after my shower and have continued to wear it all day. Right now I don't feel any shoulder pain at all with normal movement, and only minimally when I try to throw a forceful lock-out punch in the air. Even stretching my arm out and clasping my hands behind my back doesn't produce any pain. Yay!

The interesting thing is that I currently have 5 - count 'em 5! - patients who all have this same type of shoulder pain. They all developed the pain from doing different things, with two of them from doing nothing at all and suspecting it's from sleeping funny. I wonder if shoulder pain can be contagious? All I know is, everyone is going to be prescribed Wu Yang Plaster this week.

Using the TCM Pharmacopeia to Make Western-style Drugs

This 2007 article from Chemistry World reminds me why I'm glad to be doing Traditional Chinese Medicine. The key difference between TCM and Western medicine is not in the implements or the ingredients, but in the diagnostic view.

At least 1.1 billion adults and 10 per cent of children around the world are now overweight or obese, according to the International Obesity Task Force. As more people become heavier, they become vulnerable to type 2 diabetes, a potentially fatal condition. Hotamisligil's investigations have uncovered the key pathway that leads to diabetes.

Obesity makes unusual demands on fat cells - they become stressed. When a person piles on the pounds, a cellular organelle called the endoplasmic reticulum (ER) is forced to work harder than usual to process the surplus fat. To cope with the extra workload, the ER normally counts on a built-in pack of chemical chaperones that help process fats and proteins.

But if the ER still feels the strain, it starts faltering, igniting a chain reaction that eventually shuts down insulin pathways and precipitates diabetes. The Harvard team hopes to prevent ER stress by supplying cells with extra chaperones. They tried supplying the ER with tauro ursodeoxycholic acid (TUDCA) and another small molecular drug PBA (4-phenyl butyric acid) as potential chaperones in two sets of obese mice.

The results were pretty spectacular: the compounds alleviated ER stress, and after one week of treatment, glucose levels in both sets of obese mice returned to normal. There was a benign effect on the liver too, reducing the presence of fatty deposits that often lead to cirrhosis.

Seriously?? If you want to reduce the strain on the endoplasmic reticulum, wouldn't losing weight via exercise and dietary regulation be a much better option than taking TUDCA and PBA? As an emergency treatment for someone with advanced type 2 diabetes, this could be very useful. But taking black bear bile and then continuing to lead a sedentary lifestyle and eat excessive amounts of sugar and fatty foods is not a prescription for health.

Personally I hate taking any kind of medicine - I don't like getting acupuncture, I don't like taking bitter herbs, and I don't like eating bland food. I do love to move, and that's my usual medicine - lots and lots of exercise. So I don't understand why people could be content with taking powerful drugs every day for the rest of their lives. To me, it defies comprehension, but I have met people like that - "yeah, I'm sick, I have such-and-such condition, but the doctor gave me a prescription, so now I'm taking Tulupa (hexomethacripulate 600mg)" - and that's the end of the story. Really? So, how long will you be taking that for? "I don't know, the doctor didn't say." EEEEERRRRRRRGGGHHHHHHH!!!! It's just odd to to me. I don't get it. Why do you want to poison yourself like that? Medicine is not benign. There are always side effects - get out your magnifying glass and read the package insert. Chinese herbs tend to have much milder side effects, which is why when I'm sick that's my first option.

Take a look at the whole article here.

[Note: there is no such drug as Tulupa. As far as I know.]

How Does Acupuncture Work? New Study May Point The Way

This looks very promising!

New groundbreaking research shows that the insertion of an acupuncture needle into the skin disrupts the branching point of nerves called C fibres. These C fibres transmit low-grade sensory information over very long distances by using Merkel cells as intermediaries. Dr. Morry Silberstein of the Curtin University of Technology will publish his research in the Journal of Theoretical Biology later this year.

Take a look!

Circles

There's a good article on the circle in the NY Times, which uses Vasily Kandinsky as a jumping off point.

This being December, I’d like to honor Kandinsky through his favorite geometry, by celebrating the circle and giving a cheer for the sphere. Life as we know it must be lived in the round, and the natural world abounds in circular objects at every scale we can scan. Let a heavenly body get big enough for gravity to weigh in, and you will have yourself a ball. Stars are giant, usually symmetrical balls of radiant gas, while the definition of both a planet like Jupiter and a plutoid like Pluto is a celestial object orbiting a star that is itself massive enough to be largely round.

On a more down-to-earth level, eyeballs live up to their name by being as round as marbles, and, like Jonathan Swift’s ditty about fleas upon fleas, those soulful orbs are inscribed with circular irises that in turn are pierced by circular pupils. Or think of the curved human breast and its bull’s-eye areola and nipple.

Our eggs and those of many other species are not egg-shaped at all but spherical, and when you see human eggs under a microscope they look like tranquil suns with Kandinsky coronas behind them.

Full article here.

Coming Soon To Fat Turtle: Yincare!

Fat Turtle Herb Company will soon be carrying Yincare, an extremely useful TCM product. Yincare is China’s most widely used topical/intravaginal wash for gynecological as well as general bacterial, fungal and viral skin complaints. The formula is comprised of both the water-extracted and essential oil materials of the herbs listed below and can be quite effective in small concentrations (5-10%). It can be effectively applied as a wash, rub, sitz bath or compress.

蛇床子 Cnidium - She Chuang Zi
薄荷 Mentha - Bo He
金银花 Lonicera - Jin Yin Hua
栀子 Gardenia - Zhi Zi
黄柏 Phellodendron - Huang Bai
黄芩 Scutellaria - Huang Qin
苦参 Sophora - Ku Shen
地夫子 Kochia - Di Fu Zi
茵陈蒿 Artemisia - Yin Chen Hao
独活 Angelica - Du Huo
苍术 Atractylodes - Cang Zhu
石菖蒲 Acorus - Shi Chang Pu
艾叶 Artemisia - Ai Ye
土荆皮 Pseudolarix - Tu Jing Pi

Yincare retails for $19.95, with a substantial discount for licensed acupuncturists and students at TCM colleges.

Altruism

Turns out that we're born with the innate desire to help each other out.

Additionally, giving has a profoundly positive effect on one's health.

Parasites - Good or Bad?

Isn't he cute??

Tonight I heard an excellent radio program on parasites, courtesy of Radiolab on WNYC. There's an interview with parasite expert and science writer Carl Zimmer, and a fascinating segment on a fellow who had chronic asthma and decided to treat it by purposefully acquiring a hookworm. Spoiler alert: it totally worked!

To paraphrase the program: autoimmune diseases such as asthma, type 1 diabetes, lupus, et cetera are virtually unknown in the developing world. Why? We might be a little too clean. If you use antibacterial products in your home and eat only irradiated food, you've essentially eliminated an entire class of organism from your life - organisms which have developed in concert with human beings for thousands of years.

Granted, sanitation and hygiene are important. No one is advocating that doctors stop washing their hands. But listen to this program for a slightly different take on parasites - and just maybe learn to appreciate them!

At the age of 100, Xing Yi Master Wang Ji Wu Describes His Principles of Living a Healthy Life

This gem was brought to my attention by licensed acupuncturist and tai chi teacher Robert Martinez of New York City. Thanks Robert! It has wonderful words of wisdom for anyone interested in health, and for doctors and martial artists in particular.

I believe it may have been taken from this book, Xing Yi Nei Gong.

The Heart is Calm, Quiet as Still Water
My own history is from the end of the Qing Dynasty, through the period of the republic to the People's Republic, already a hundred years. My life has seen its share of ups and downs, times of poverty and hardship, honor and dishonor, the changes of the seasons, all of which have left a deep impression on me. After the founding of the People's Republic, my life became stable, but with the Cultural Revolution, disaster once again overran the country and I was forced out of business. All of these events served as a means of cultivating my spirit, and afforded me the opportunity to practice the "gong fu" of living in the world.

One must always maintain a calm heart even when influenced by the Seven Emotions; joy, anger, happiness, worry, sadness, fear, and surprise. The heart must remain as calm as still water, never allowing any personal desires to stir up a ripple of disturbance. My thoughts are pure; in spirit I seek to forget myself and transcend the common affairs of the world, keeping my life simple and my desires few. With a clear heart, I do not contend with others or make demands upon the world, but rather seek to contribute what I can for the benefit of all, aiding those in need and protecting those in danger.

Without desire one is strong, without desire one is quiet, without desire one may return to that which is natural, without desire one returns to the Original State. With a heart like still water, from the extreme stillness will spring action, from the Void comes that which is alive, yin and yang are in harmony and the qi flows unimpeded. With a heart like still water, the qi is sufficient and the spirit full. When the qi is sufficient and the spirit full, the Organs function normally, the blood is nourished, the meridians, nerves, digestion, and circulation are all healthy and the metabolism stimulated. When the factors that prevent aging are all strong, one may prevent illness and live a long and healthy life.

Humans are holistic beings which are possessed of a certain vitality. The spirit and flesh are inseparable and form a complicated entity. The human vitality supports, influences, and is responsive to the person as a whole, while the spirit is the leader and controller, the "commander-in-chief" of the being as a whole. Under certain circumstances, it can be said that the spirit, "pulls one hair and the whole body follows," or, at the slightest stirring of the spirit the whole being responds, and each movement of the spirit has a real effect on the individual. Therefore, I put special emphasis on the spirit as leader, ever strengthening my resolve to cultivate the spirit, maintain calmness of heart, and become as pure as light without a speck of dust. This is akin to the Song Dynasty poet who wrote "to understand the highest virtue" applied to the present time. Better yet, this cultivation of the spirit and heart will improve the physical constitution of the people, protect their health, and contribute to a long and healthy life.

Live an Enthusiastic Life, Serve the Public Good
I have traveled the long road of life, experiencing hardship, difficulty, and I know the sentiment of man is often as thin as paper. I have seen corruption and those whose only concern is realizing their own desires. Because of this, I have striven even harder to live a practical life, willing to sacrifice even more for the good of the people. After the founding of the Republic, I spent my time working in the streets as a doctor, treating anyone who came to me for help with wholehearted enthusiasm. When one finds happiness in serving others, one will be full of the spirit of life, seeing things as they are with a calm heart. Thus, one may reach the state where the spirit is preserved within, the body is healthy and the spirit full, the intellect wise, decisions made adroitly and reactions made spontaneously. Consequently, the life energy will be strengthened and increased while promoting the health and longevity of the body.

Happy Thanksgiving everyone!

Luriko Ozeki L.Ac in the Dominican Republic

Luriko Ozeki recently returned from a trip to the Dominican Republic, where she provided acupuncture treatments as part of a multi-disciplinary medical team. Click here to read her blog about the trip.

Luriko practices in West L.A. - click here to visit her website.

Open House Tonight!!

Apologies to our readers, but this is why we've been MIA from the blog.

We'd love it if you can make it tonight!

Where: 11965 Venice Boulevard, Suite 207
Los Angeles, CA 90066

When: 7-9 pm

What: Please join us for drinks and snacks and to celebrate the Grand Opening of our brand new clinic.

See you there!
Jonah and Nini

Cycles: Pi, Phi, Fibonacci, and the Yi Jing

Fascinating fascinating fascinating story in the New Yorker this week. It uses a profile of financial trader Martin Armstrong to explore the idea of cycles as they apply to historical, political and economic events (Armstrong predicted, to the day, the stock market crash of October 1987). The article does a wonderful job of exploring the many different types of cycles and their various proponents, but ends up portraying Armstrong as a bit of a nutjob.

(Which is probably the safe route. As the article itself notes, financial traders who use the idea that financial markets move according to fixed cycles, rather than the idea that the market is relatively unpredictable, generally don't talk about it in public. "'It's too embarrassing to explore in modern economics,' another trader said. 'These topics are not fit for polite conversation in most circles.'" I suppose if the writer had appeared to take this Armstrong character more seriously, he might have risked looking crazy himself. This is also a very interesting phenomenon, but I'll have to save it for another day...)

How does this relate to Chinese medicine? Chinese medicine is part of an epistemological system that incorporates many different philosophies from different periods of Chinese history. Part of the genius of Chinese society is that instead of discarding old systems and modes of thought (philosophical, mathematic, scientific) for new, the old is built upon and improved. The very very oldest system that Chinese medicine (and by extension, all Chinese philosophy) relies upon is the Yi Jing (aka I Ching), which is essentially a forecasting tool.

The Yi Jing is both very simple and very complex. (I'm hardly qualified to write on the subject - if you're seriously interested, please consult your local library, bookstore or website.) A series of eight trigrams represent all the phenomena in the universe, and by putting two together you get a hexagram. The hexagram can then be interpreted in various ways to give you guidance on a present situation or future event. There's actually a whole branch of Chinese medicine which incorporates the Yi Jing into treatment.

Cycles are found everywhere in nature. What is the most obvious? The cycle of day and night, sun and moon. After that, the cycle of the four seasons. Most people never go beyond this. But suppose it was possible to observe a longer cycle? A cycle of eight years, or twelve, or sixty, or a hundred and eight? Natural cycles come and go, and staying in harmony or "going with the flow" of the seasonal universal energy is an excellent way to maintain and improve your health. Some of these practices come naturally, such as wearing more clothes in winter and less in the summer. Many have been largely forgotten and seem anachronistic in the modern world, which some scientists still maintain is governed purely by matter and not energy. After all, why not drink ice-cold water with your meal? The more esoteric require some calculation and the services of an expert, such as picking an auspicious date for opening a business or the right spot for building a home.

I'm not good at ending these posts. It's a great article, and whoever runs martinarmstrong.org has posted the full New Yorker profile (pdf) on their website. Take a look. Then learn more about the Yi Jing.

Run Barefoot!

I'm going to try this... as soon as I can find a place to run that is relatively free of glass and/or dog poop... so it may be awhile.

Runners are baring their very soles - L.A. Times
Running Barefoot

Bruxism

Bruxism, aka teeth-grinding, is on the rise. A New York dentist noticed:

One of his patients lost hundreds of thousands of dollars invested with Bernard L. Madoff. Another reported that he had lost a job with a seven-figure salary. A third, a single mother with a floral design business on Long Island, said she was working twice as hard for half as much.

“All three are grinders, directly affected by what’s going on out there,” Dr. Butensky said, gesturing outside his Midtown office window.

For the L.A. perspective, let's talk to Dr. Alex Rivkin of Westside Aesthetics:

“For, I’d say, 85 percent of the people who come to me complaining about headaches, jaw soreness and pain, Botox injections into the masseter muscle on both sides of the face is the answer.”

If you're not keen on getting botulism toxin injected into your face, try acupuncture. Acupuncture is especially effective for teeth-grinding, as it can not only relax the jaw muscles but also deal with the root causes.

Full article: When Stress Takes a Toll on Your Teeth

 

Doctor Steven Park

Here's an interesting website - doctorstevenpark.com. He's one of those open-minded western-trained doctors. Much of what he says in this article about anti-aging medicine resonates with me -

Here’s my personal advice – do what feels right. If you truly believe in something, do it with all your might. Science actually invalidates one individual’s experiences and can only generalize based on large population studies. Since everyone responds differently, your only way to know whether or not it’s going to work is to try it (within reason, of course). Rather than trying to exclude the placebo effect that most studies try to do, take advantage of your body’s natural ability to heal itself, no matter which option you choose.

However, realize that that one pill, supplement or exercise regimen is not going to make you younger. Eventually, something will work for you, but without changing your mindset and daily habits, your health problems will return and you’ll be back to square one.

For some reason he reminds me of Doctor Pai. I don't know why. Maybe it's the tie?

Grind Your Own Beef

Or don't eat beef at all. That is all. (Full Story - E. Coli Path Shows Flaws in Beef Inspection)

Now, Let Me Tell You About My Appendectomy in Peking...

Many people have heard of the 1971 New York Times article by James Reston about his experience with acupuncture in his recovery from an emergency appendectomy. Reston was in China at the time, which was quite unusual in the first place. In 1971 China was in the grip of the Cultural Revolution, and very few foreigners were allowed into the country. He had an appendectomy the standard biomedical way, but for post-surgical pain was treated with acupuncture and moxibustion:

However, I was in considerable discomfort if not pain during the second night after the operation, and Li Chang-yuan, doctor of acupuncture at the hospital, with my approval, inserted three long thin needles into the outer part of my right elbow and below my knees and manipulated them in order to stimulate the intestine and relieve the pressure and distension of the stomach.

That sent ripples of pain racing through my limbs and, at least, had the effect of diverting my attention from the distress in my stomach. Meanwhile, Doctor Li lit two pieces of an herb called ai, which looked like the burning stumps of a broken cheap cigar, and held them close to my abdomen while occasionally twirling the needles into action.

All this took about 20 minutes, during which I remember thinking that it was a rather complicated way to get rid of gas in the stomach, but there was noticeable relaxation of the pressure and distension within an hour and no recurrence of the problem thereafter.

Reston's article provoked great interest in acupuncture. In 1976 California became the first state to license acupuncture, where just two years earlier pioneering acupuncturist Miriam Lee was arrested for practicing medicine without a license. My martial arts teacher Dr. Alex Feng was one of the first acupuncturists licensed in California (his license number is 297 - mine is 13299).

In 2006 a Chinese publication, the People's Daily, wrote a follow-up which had an interview with some of the original doctors mentioned in Reston's article.

Hope you enjoy this bit of acupuncture history: Now, Let Me Tell You About My Appendectomy in Peking... (full article)

Herbal Remedies for your Gym Bag

Our poor neglected blog is coming back! Take a look at this article featuring Tom Bisio and Frank Butler's Zheng Gu Tui Na physical medicine: Herbal Remedies for your Gym Bag.

Fat Turtle Herb Company carries most of the products mentioned in the article, so give us a buzz at orders@fatturtleherbs.com or 310-691-5226 if you want to try these in the clinic or for yourself.

Nini and I will be attending the Zheng Gu Tui Na seminar in San Diego in a few weeks. This is excellent stuff to know and will be immediately useful in practice. I actually met Tom Bisio when I was working at Kamwo - he seems like a nice guy.

Fitting That It's Shaped Like A Frown

Hello! My name is Menaflex.

Is it a rainbow? No.
Is it a broken piece of pottery? No.
Is it part of one of those thingies that go on the inside lid of jars? No.

Is it an orthotic for shoes? Not quite... but that's a little closer.

This, my friends, wins an award for Most Anger-Inducing Thing Of The Day.

Further deteriorates my already sour view of politics.

Ginseng Cooker

Check out this sweet electronic ginseng cooker. It's like a rice cooker, but for ginseng! Nini and I found this out in San Gabriel after dim sum.

Sanging in Illinois

No video? Watch it at youtube

Gathering wild American ginseng has been a hobby for many and occupation for some for hundreds of years (originally learned, I'm guessing, from Native Americans - they were here first, after all). Ginseng is a very rare and precious herb, and getting more rare as the years go by. That makes this video all the more remarkable. As the narrator says, for someone to show you where he collects ginseng is almost unheard of. Take a look.

Third Root Community Health Center in Brooklyn

Third Root Community Health Center just celebrated its one-year anniversary! In their own words:

Third Root Community Health Center is a worker-owned cooperative business providing accessible, empowering, and collaborative healthcare in the Flatbush neighborhood of Brooklyn, New York. We want holistic medicine, the oldest form of healthcare, to be available to everyone, as it has been for millenia. Our Center is shaped by our very own clients, community, and students, who inform us about their needs and what would help them feel the most at home at Third Root.

Third Root offers community-style acupuncture, private acupuncture appointments, herbal medicine, yoga, massage and health workshops. Take a look!

John Patrick Halpin L.Ac

John Halpin L.Ac, far left.

John Halpin, licensed acupuncturist, is a caring, meticulous health care practitioner in New York City. He practices on West 21st St. in Manhattan. Make an appointment today!

19 W. 21st Street, Suite 904
New York, NY 10010
Telephone: 917.536.3388
Fax: 212.229.1330

Acupuncture in Minnesota

Minnesota, home to Prince and two acupuncture schools! Take a look at this article, which has links to two TCM schools in the Twin Cities.

Anne Park L.Ac

Anne Park, licensed acupuncturist and Yosan alumnus, is available for appointments at her office in Emeryville, California (Emeryville is a tiny little city sandwiched between Oakland and Berkeley and is most famous as the home of Pixar studios). Her practice is named Energy Matters.

Anne Park is an excellent healer. When she was in Los Angeles I had several treatments with her, always with great results. Her contact information:

Energy Matters is located in the Emeryville Health and Wellness Center at
1240 Powell Street, Suite 2A
Emeryville, CA 94608
510-597-9923
info@EnergyMattersEastBay.com


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Chinese Medicine Times

Take a look at Chinese Medicine Times, a free ejournal maintained by Attilio D'Alberto. It's really an excellent resource, with original articles as well as links to all the latest scientific studies on acupuncture and Chinese herbs.

Chinese Medicine Times
You can also follow CMT on Twitter.

To Prevent Osteoporosis: Exercise, Exercise, Exercise

Think Wang Pei Kun has a bone density problem? Please.

What is osteoporosis? According to the Merck Manual:

Osteoporosis is a progressive metabolic bone disease that decreases bone density (bone mass per unit volume), with deterioration of bone structure. Skeletal weakness leads to fractures with minor or inapparent trauma, particularly in the thoracic and lumbar spine, wrist and hip.

You've heard of the little old lady who falls down and breaks her hip? She's got osteoporosis. Fortunately there are a number of things that the little old lady can do to increase bone density and prevent fractures without the need for poisonous pharmaceutical drugs such as Fosamax, which can actually cause mandibular osteonecrosis. "Mandibular osteonecrosis" is a fancy way of saying that it kills your jaw bone. Let's not play Abel to Fosamax's Cain, okay? (Ironically, Fosamax is a product of the Merck pharmaceutical company)

Important to note is that osteoporosis is what the Merck Manual calls a "metabolic" disease. This means it is not caused by any external bacteria or virus. You can't catch osteoporosis from anyone. Your own body can create the condition of osteoporosis, and it can also therefore reverse that condition.

The number one thing that you can do to increase bone density and decrease the risk of osteoporosis is EXERCISE. Numerous studies have confirmed that even gentle exercise such as taijiquan can increase bone density. If you're not crazy about taiji, try yoga, or weightlifting, or jogging or even walking. Here's a sample of the literature on bone density and exercise:

• Tai Chi May Help Maintain Bone Mineral Density in Postmenopausal Women
  
• Bone density sharply enhanced by weight training, even in the elderly
  
• The American Society of Bone and Mineral Research says: "Research helped us to understand the need for weight-bearing exercise to build and maintain bone in order to reduce fracture risk. Falling can be reduced by strength-building exercise that increases balance and flexibility." Unfortunately they contradict themselves in the very same document (PDF) when they say "Research identified and demonstrated a variety of drugs that can reduce bone loss and fractures and even build new bone. Thirty years ago there was no treatment for osteoporosis." If weight-bearing exercise increases bone density, isn't that a treatment for osteoporosis? Unless I have been sorely misled, exercise wasn't invented less than thirty years ago.

According to Chen and Chen's formula book, there are four formulas one can use to treat osteoporosis. Obviously your options are not limited to these four formulas (独活寄生汤 Du Huo Ji Sheng Tang, anyone?) but it's a good starting point.

Kidney Yin Deficiency: 左归丸 Zuo Gui Wan
Kidney Yang Deficiency: 右归丸 You Gui Wan
Kidney Jing Deficiency: 龟鹿二仙胶 Gui Lu Er Xian Jiao
Spleen Qi Deficiency: 参苓白术散 Shen Ling Bai Zhu San

Fat Turtle Herb Company can fill all these formulas to your exact specifications in different formats: raw herbs, pre-cooked vacuum packs, granule and capsule.

p.s. The occasion for this post was a NY Times article on osteoporosis which ignores even their own archives. As my nephew Joey would say, with his hands on his head: Ai yai yai yai yai!

Jiao Gu Lan to Save the Day!

Have I ever told you how much I like 绞股蓝 Jiao Gu Lan tea? The taste takes a little getting used to - after the first time I didn't try it again for about six months - but if you give it a chance I think you'll find it to be a marvelous addition to your daily or weekly routine.

Chen and Chen categorize Jiao Gu Lan (gynostemma pentaphyllum, also known as "panta") as a qi tonic (Bensky doesn't mention it). The properties are slightly bitter and cold, making it one of the few qi tonics that aren't warm in nature. The official functions are a pretty amazing list of contradictions both internally and between each other. Observe:

1. Moistens Lung, Promotes Generation of Body Fluids, Dispels Phlegm A qi tonic that dispels phlegm! Think of it! This makes it perfect for weekend warrior athletes who work out hard and expend a lot of energy but also tend to overeat sweet and oily foods.

2. Clears Heat, Eliminates Toxins, Reduces Inflammation Jiao Gu Lan tonifies qi AND clears heat and eliminates toxins!!! 清热解毒 Qing Re Jie Du are functions you would expect to see among your Pu Gong Ying (dandelion root), your Ban Lan Gen (isatis root), your Lian Qiao (forsythia fruit), not among qi tonics.

3. Lower Blood Pressure and Cholesterol Many studies have demonstrated the powerful effect Jiao Gu Lan has on hyperlipidemia and hypertension. The FDA prohibits making specific medicinal claims about products not regulated by the FDA, but Chen gets away with it because they're writing in a Chinese medicine textbook, not for marketing purposes.

Here are a few jaw-dropping quotes from the text:

Jiao Gu Lan has a general effect to nourish and strengthen the body. It is commonly used to treat chronic disorders, such as asthma, migraines, neuralgia, impaired function of the respiratory and gastrointestinal tracts, and syndromes characterized by deficiency...

Clinically, it treats gastric ulcers, duodenal ulcers, hyperlipidemia, nodules, cystitis, herpes zoster and other conditions characterized by dampness, heat and toxins. Jiao Gu Lan has also been used to treat various kinds of cancer and to help inhibit the spread of tumors.

I hope you can see now why I love this stuff so much. It's a very general tonic for the whole system, at the same time cooling and anti-phlegm, AND anti-cancer! And at the same time gentle enough to drink up to one tea bag every day. Fat Turtle Herb Company carries Jiao Gu Lan in loose form for use in formulas by students and licensed practitioners. The recommended dosage is 5-12 grams in decoction. If you're interested in ready-made tea bags, we can get those for you as well.

Happy Labor Day from Fat Turtle Herb Company!

Hope you're staying cool and enjoying the long weekend...

Bump: Wright Therapies

Our classmate Karen Wright L.Ac will be starting her practice at the In Focus Wellness Institute in Santa Monica, California. Take a look at her website and make an appointment today!

Treatment of Sprains and Strains with TCM

Here's an interesting article from Alon Marcus on the treatment of strains and sprains with Chinese medicine. It goes into great detail on the different types of sprains and strains but is oddly lacking when it comes to acupuncture treatment strategies. Perhaps these will be covered in part two?

Curiously, the only herbal formula he mentions includes a highly toxic substance, 蟾酥 Chan Su, or toad venom. He neglects to mention the two most famous formulas for the treatment of external injury, 跌打丸 Die Da Wan and 三黃散 San Huang San. Die Da Wan, or "hit-fall pill", can be taken orally directly after injury for 2-3 days. San Huang San, or the "three yellows powder" consists of Huang Qin, Huang Lian and Da Huang powdered and mixed together in equal amounts (one popular modification adds Pu Gong Ying, Shan Zhi Zi and Hong Hua). This powder can then be mixed with green tea, water or egg white and spread in a plaster on the affected area. For details on these formulas, take a look at Tom Bisio's A Tooth From the Tiger's Mouth.

Bump: Stephanie Yong L.Ac

Our classmate Stephanie Yong has opened her acupuncture practice in Torrance! I highly recommend her for all your health needs. No website yet, but here is her contact information:

Stephanie Yong, L.Ac
Torrance Medical Plaza
3655 Lomita Blvd., Suite 308
Torrance, CA 90505
310-341-0210

Break Time

Herb I.D. Go! No it's not Gua Lou!

Hey everyone, we're taking a little break from blogging. We'll be back at the beginning of September!

Gamma Brain Waves

No video? Watch it on youtube's site.

Take a look at this video of qi gong pracititioner Peng Her hooked up to a biofeedback machine. I'm not sure why he's shaking like that... maybe it has to do with the qi gong?

Anti-Aging

Take a look at this video from the American Academy of Anti-Aging Medicine.

Health Care Reform

Famous ancient Chinese physician Hua Tuo

If you follow the news at all, you've heard something about this "health care reform" thing people seem to be all excited about. You've read the editorials, you've seen the politicians speechifying. Maybe you've seen the video clips of people shouting things like "We are ALL afraid of Obama" and crying things like "I want my country back!" (What does this have to do with health care? I don't know either.) You've heard the phrases "death panels" and "public option".

So far the debate seems to be framed as "Health Care For All - For or Against?" People on both sides loudly declare the other side stupid, or evil. I'd like to point you towards a voice that asks us to focus on a different aspect of this whole debate - the very nature of the medicine that people either want to extend or not extend to the whole country.

But what's missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what's even worse than its stratospheric cost is the fact that American health care doesn't fulfill its prime directive -- it does not help people become or stay healthy. It's not a health care system at all; it's a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly. -Dr. Andrew Weil: The Wrong Diagnosis at the Huffington Post

This is an extremely important point. The health care system is broken, and getting the last 40 or 50 million uninsured Americans into this same system is not going to improve the health of our nation.

It reminds me of a story I heard during my TCM (traditional Chinese medicine) education. There was a doctor in ancient China who became famous for saving lives. He could cure diseases in their most advanced state, when a patient was near death. Everyone called him a genius, some even said he had magical powers.

The doctor laughed when people praised him. "My skill is actually quite low. I can only cure disease when it has gone nearly out of control, and I have to use severe herbs and acupuncture techniques. I have two older brothers who are much better at medicine than I am."

Of course people went in search of these brothers. When they found the middle brother he said "I'm still not very good at medicine. I can only catch diseases in their initial stage. I still have to feel the pulse and look at the tongue before prescribing mild herbs and acupuncture. If you want to know real medical skill, you should find our eldest brother."

Of course the people went to search for this wonder-worker. When they found him he said "When people come to me I use neither acupuncture nor herbs. I do not feel their pulse or look at their tongue. I diagnose them by observing the color of their face and the tone of their voice. I tell them how to eat in accord with the seasons and their locations, and sometimes I give them some simple exercises to do. However, if they could sit quietly every day and listen to the natural wisdom of their own body they would not even need my advice."

The eldest brother was the only one practicing real health care - the other two were doing different forms of disease management. Of course we can't abandon those who are already in advanced disease states, but we should put equal and perhaps even more emphasis on encouraging health - what the chinese call 養生 Yang Sheng or "nourishing life."

Say Hi To Your Body

Chinese medicine is by nature not merely physical. We recognize that the 'self' is more than just a pile of meat and bones arranged into a human body, and overcoming health challenges requires healing of the mind, body and spirit.

In these modern times, many people aren't in touch with their bodies. On top of television and the internet, we now have little computers in our pockets (Iphone and its cousins the Crackberry and the Palm Pre) that give us access to almost everything all the time. If you're an office worker who sits in front of a computer all day you may be using your mental faculties in a very intense way, while completely ignoring your body. This can lead to back pain, neck and shoulder tension, headaches, even gastrointestinal distress.

A wonderful example of someone getting "back into their body" can be found in this blog post by Bridget Pilloud. Please take a look and try her suggestions. (Thanks to Becca Seitz for pointing me towards this)

L.A. Times Article - Does it matter what the doctor weighs?

Dr. Regina Benjamin with President Barack Obama

Here's an interesting article from the L.A. Times on the personal health of doctors. Does it matter? Do medical health professionals need to be healthy to be effective?

"A doctor doesn't need to be perfect, but it'd be hard for me to take financial advice from a CPA who had just filed for bankruptcy," said Dr. Timothy Harlan, medical director of the Tulane University School of Medicine, who says he believes physicians should make a genuine effort to be healthy.

Personally, I believe it's my responsibility to be as healthy as possible. I'm kind of a health nut. This morning Nini and I had vegetable juice for breakfast, as we usually do: carrots, beets, cucumber, ginger, and an apple (on the weekends, when we have time, we like to follow that up with bacon and eggs with tomatoes, onions and cheese). Most mornings I'm out at Mar Vista park doing taijiquan or qigong. I drink a lot of green tea.

I don't usually advertise these activities, because people sometimes don't react well to hearing about them. Instead of "hey, good for you" it's some hardcore eye-rolling and "well of course YOU do that. You're healthy! I could NEVER be as healthy as you are."

The fact is, there's no hard line between a "healthy person" and an "unhealthy person." I haven't always had these habits. I only started juicing about a year ago (note: I'm talking about this kind of juicing, NOT this kind). I only started exercising every morning during the past month, when I finally had the freedom to organize my own schedule. I drink green tea because I like how it tastes and how it makes me feel - I'm not choking it down because it's good for me. In the future I may not have the time to exercise every morning, or make juice and then clean the juicer (which takes awhile and is kind of a hassle but still worth it - if you've never had ultra-fresh juice straight from the juicer it's like a punch in the taste buds - much better than anything you could buy in a bottle. Besides that there are all kinds of health benefits which have to do with how fast the nutritional content of juice degrades when you let it sit around - for best results drink within two to three minutes of juicing).

My general philosophy is that you should enjoy life. If life isn't enjoyable, what's the point? I've tried drinking, and cigarettes, and various recreational drugs. I've tried all different kinds of exercise. I've tried not exercising. As a patient, I've tried acupuncture, massage and herbs. I've tried meditation and talk therapy and EFT. For myself, I have found what works, and continue to discover new things all the time. Through learning and teaching martial arts and four years of formal TCM education, I have tools that can help me to understand what works for others. I encourage you to experiment, and find what works for you. If you want to change something about your health, or your life, your body, your mindset, try something different. Don't be afraid to ask questions or seek guidance in unexpected places.

Find a doctor that you connect with. Everyone needs help with health challenges, so don't be afraid to accept professional help. But the best doctor is within yourself. Go look for him or her. They're in there.

We Are Out of Here... Temporarily

Isn't he cute? I call him the Sacramentoad.

We are off to take the California Acupuncture Licensing Exam. We'll be back next week. Toodles!

Have a Good Weekend

Medicine Hunter

No video? Click here.

The quality of this video isn't good, but the message is terrific. Chris Kilham of Medicine Hunter is on CNBC spreading the word:

"My mission is to get more people using safe, effective plant medicines and fewer people using toxic, potentially lethal pharmaceuticals."

Me too. (thanks to Cathy Margolin L.Ac of PacHerbs)

Click here to watch a higher-resolution version on the CNBC website.

HR 646: Acupuncture For Everyone!

Obama's 8 Principles for Health Care Reform

Read the Bill, also known as The Federal Acupuncture Coverage Act

How HR 646 can support Obama's Plan

Act now to help make it happen!

We Need A Better Health Care System

I just spent over four hours waiting to get an annual reproductive health examination, and I was one of the fortunate ones who had an appointment scheduled. I couldn't believe it.

The waiting room was full of 20-somethings, men and women, all uninsured. Some people had waited over two hours just to pee in a cup, and were still waiting after I left!

I emphatically commend the low-cost health care providers of this country. They have to handle such an incredible work load, with so much paperwork and bureaucracy, it's ridiculous.

Eating Your Way to Health: Chè Đậu Xanh Phổ Tai

Perfect for summer! Đậu Xanh, or 绿豆 Lu Dou, also known as mung bean in English, is an herb that is sweet and cold. It is commonly used in decocted formulas to dispel heat and toxin, and is an effective antidote for overdose of many toxic substances. It can be used topically as well! When I was little, my mom taught me how to mash up some raw mung beans to use as a paste whenever I got a cold sore.

According to Chen's Chinese Medical Herbology and Pharmacology:

Lu Dou is commonly used as a food or dessert in the summertime to clear heat, relieve thirst, alleviate restlessness, and lower body temperature. It is also effective to prevent heat stroke due to summer-heat.

Viet Nam is a hot country, and it's no wonder that a ton of our desserts use mung bean. Here's a recipe you can try that includes not only mung bean, but also two other ingredients used as herbal medicinals: lotus seed and seaweed.

1 cup mung beans, soaked in cold water overnight
1/3 cup dried lotus seeds, soaked in cold water overnight
1/4 cup dried seaweed, best with bladderwrack or kelp
1/4 cup pearl tapioca
1/3-1/2 cup sugar
1 tablespoon vanilla
7 cups water

You can find all the ingredients at any Asian food market.

Combine water and beans in a large pot and bring to a boil. Reduce heat to simmer, cook uncovered till beans are tender (about 2 hours). Add lotus seed, seaweed, tapioca, and sugar. Cook until soup thickens a little and lotus seeds are tender, but not mushy (20 minutes). Add vanilla and allow the soup cool down. If it's really hot out, you can add some shaved ice before serving. Some people like to add some coconut cream on top. Enjoy!

Dao of the Day: The Universe is Colorful

Photo from the Chandra space telescope. Watch a really cool video here.

Be brave in daring: kill or be killed;
Be brave in not daring: live and let live;
One of the two brings gain, one harm.
But which man knows what heaven condemns,
What precedents it is guided by?

The way of heaven masters all:
It prevails though striving not,
It replies though speaking not,
Comes although uncalled,
And gives good counsel though affected not.
Heaven's net, cast far and wide,
Seems slack yet nothing slips outside.

- Dao De Jing, Stanza 73
Translation and Commentary by Moss Roberts

Treating Winter Diseases in Summer

Children getting herbal plasters

Here's an interesting story about the use of herbal plasters in the summertime to prevent illness in the winter. It might strike you as an odd idea, but here's the theory...

With the cold weather in winter, the human body tends to contain excessive yin energy due to insufficient yang energy, which makes people liable to attract diseases such as bronchitis, rheumatism, bronchial asthma and cold in the spleen and stomach.

Treating winter ailments in summer means that summer, a season when yang energy peaks, is the time to nourish yang energy for winter, thus relieving and preventing those chronic cold-related ailments that plague people during the chillier months.

You can read the whole story here...

Study Finds Chinese Herbal Formula Effective for Endometriosis

Picture: Amber, one of the main ingredients of Nei Yi Wan No picture? Click here.

Nei Yi Wan has just three ingredients, according to ITM: turtle shell (鳖甲 Bie Jia or 龟板 Gui Ban), vinegar-treated rhubarb (醋炒大黄 Cu Chao Da Huang), and succinum (琥珀 Hu Po). From Reuters:

"I think the positive message is that Chinese herbal medicine may offer equivalent benefits to conventional medicine but with fewer side effects," lead researcher Andrew Flower, of the University of Southampton in the UK, told Reuters Health.

Here's a link to the original study, from the Cochrane Library: Chinese herbal medicine for endometriosis

Finally and most interesting to people in the TCM world, an exhaustive article by Subhuti Dharmananda of the Institute of Traditional Medicine, detailing the many different Chinese herbal approaches to endometriosis: Chinese Herbal Therapy for Endometriosis.

TCM Diet by Xu Xiangcai

Here's an interesting article from Xu Xiangcai on the Traditional Chinese Medicine view of food and nutrition. It answers the burning question "what should I eat?"

Chinese healthcare experts have always advocated light and simple diets. They believe that such diets can prevent diseases, strengthen the body and prolong life. Consumption of heavy, greasy, and sweet foods over a long period of time produces heat, phlegm, and dampness within the body and tends to cause illness. The Nei Jing says, “Heavy and greasy food causes a change that may result in serious illness.”

Take a look at the full article: "Traditional Chinese Health - A Simple and Light Diet"

Xu Xiangcai is the author of one of my favorite TCM books, Complete External Therapies of Chinese Drugs.

The Importance of Sleep

The importance of a good night's sleep can't be overstated. We need sleep like we need air and water. Some of our modern American torture techniques include sleep deprivation, which when prolonged can lead to hallucinations and irritability. According to a recent study, night-shift workers have an increased incidence of cancer, possibly due to the disruption of the natural sleep cycle.

The pineal gland secretes melatonin, which is thought to play an important role in regulating sleep cycles. The Chinese medicine explanation for sleep involves blood circulation, the Heart and the Liver. During the day the 神 Shen, or spirit, resides in the Heart, giving us the spark of life that connects us to the outside world. At night the Liver is said to "store the blood", and the Shen goes with the blood to the Liver.

Insomnia can be due to a number of factors, including stress, constitutional deficiency, overeating or eating too close to bedtime. In TCM diagnosis this may correspond to Liver Qi Stagnation, Liver or Heart Fire, Liver Blood Deficiency, or Food Stagnation.

Another cause of poor sleep could be sleep apnea. If the soft tissue in the rear of the throat collapses and closes during sleep, your breathing will be obstructed, there could be very loud snoring, and you won't get adequate oxygen. In this case you may need a continuous positive airway pressure (CPAP) machine, which covers your mouth and nose at night and helps to keep your airways open. While not an ideal solution for the long-term, a CPAP machine can greatly improve the quality of your sleep. To determine if you need a CPAP machine, you may need to stay overnight at a sleep center, where they will observe you while you sleep.

Insomnia is one of the things that acupuncture and Chinese medicine are most effective at treating. If you have occasional or chronic insomnia, go see your local acupuncturist.

Also on the web:
Daytime Lullaby by Verlyn Klinkenborg in the New York Times
Sleep-deprivation.com
Effect of sleep deprivation on driving

A1/H1N1 Flu Prophylactic

金银花 Jin Yin Hua, 板蓝根 Ban Lan Gen, 甘草 Gan Cao, 薄荷 Bo He

The four herbs above are currently being used in China to make a drink that prevents the flu due to H1N1 virus. Below is the full story from CCTV.com:

A type of Traditional Chinese Medicine (TCM) to prevent the A1/H1N1 influenza, dubbed the “flu prevention drink”, goes on sale on July 2, in every drugstore and hospital dispensary for TCM medicines.

The prescription was formulated and issued by the Committee of Experts for Flu Prevention and Control under Beijing Administration of Traditional Chinese Medicine to cope with the A1/ H1N1 influenza and the recent hot weather. The daily adult prescription consists of 3 grams of Honeysuckle, Woad root, Liquorice root and Peppermint. After it is mixed with boiled water, it can be gargled or drunk as a tea substitute. It can be used for seven consecutive days. According to experts from the administration, the prescription can be used by people of all ages, children and even pregnant women. If people don’t like the taste, they can add rock sugar or honey to it, without altering the effect of the medicine. It can be purchased in every drugstore or hospital dispensary for TCM medicines and a daily dose will only cost little more than one yuan.

Disease Smells

This short National Geographic video here shows how dogs can smell certain diseases and can be trained to help those in need. One researcher in the video talks about how one day we humans might even be able to use the dogs' sniffing skills to diagnose disease.

Chapter Four of the Huang Di Nei Jing had stated thousands of years ago that a medical diagnosis could be made or confirmed by the presence of certain smells, ones that humans can detect. According to the five phases theory:

In the five odours, the odour of liver is stink. (urine)

In the five odours, the odour of heart is scorching.

In the five odours, the odour of spleen is fragrance.

In the five odours, the odour of lung is stinking. (fishy)

In the five odours, the odour of kidney is rancid. (rotten)

The above was quoted from: Yellow Emperor's Canon of Internal Medicine by Wang Bing (Tang Dynasty), translated by Wu Liansheng and Wu Qi.

I've found that after I leave a patient in the room with the door closed, their distinctive smell is always much more noticeable when I come back. I've definitely smelled the scent of burnt or scorched, but I haven't yet encountered a person smelling like stink and urine during treatment. That's probably a good thing.

Exercise Prevents Senility

Master Guo Lian Ying (aka Kuo Lien Ying)

Yet another reason to exercise...

For the past week I've been getting up at roughly 6 a.m. and going to Mar Vista park to stretch and engage in a little "physical culture." I've been doing a mix of kung fu exercises, qi gong, tai ji quan. People get out early to this park - there's a dedicated group of middle-aged Chinese women who are out practicing their tai ji sword form, and occasionally you see others doing different kinds of tai ji. The basketballers and the soccer players are out pretty early too. People are there with their dogs, too, but mostly they let the dogs play for them.

It's been a long time since I've dedicated myself to practice everyday. The difference is incredible. My digestion is better, my energy is flowing and relaxed at all hours of the day, my jokes are funnier and my mood is better. This is one of the benefits of running your own business - you can set your own hours.

This Is the End of the World

We're done for. See for yourself.

California Acupuncture Licensing Exam on August 5th, 2009 in Sacramento

It's coming.

I'm taking it.

Nini's taking it.

We're studying. We finally got in our studying groove. Right now I could rattle off the ingredients to almost all the 63 board formulas, or most of them. Other random facts: 威灵仙 Wei Ling Xian can be used to dissolve fish bones stuck in the throat. 陰溪 Yin Xi (HT6) and 復溜 Fu Liu (K7) for night sweats. Posterior pituitary releases ADH and oxytocin, anterior pituitary releases all the other ones, LH, FSH, prolaction, ACTH, etc. In case of a broken needle, remove with forceps. If below the skin, contact a physician (seriously, that's the law).

By September 5th, we'll know the results. My personality dictates that I treat this exam as an enemy to be destroyed, and right now I'm deep in training. Wish us luck!

Chinese Herbs on Twitter

People are talking about their Chinese herbs on Twitter. I like to highlight what patients say about their herbs - here's a selection... You can follow us on twitter at http://www.twitter.com/fatturtleherbs.

• 
  CyclistOnChemo: The Disgusting Chinese Herbs tasted OK this morning. Wonder if it's because I was concentrating on something or if my taste is changing
  Jul 10, 2009 08:21 AM GMT · from TwitterFox · Reply · View Tweet

• 
  msservalan: Found my seat, realised I left my chinese herbs at home! Sigh... Wonder if it's worth getting them sent to meet me?
  Jul 10, 2009 03:42 AM GMT · from TwitterBerry · Reply · View Tweet

• 
  HerbalPatricia: It's official. Brenda 43 is pregnant. FSH was 34, one ovary was partially removed with a cyst. 5 months of Chinese herbs and success today
  Jul 10, 2009 01:21 AM GMT · from web · Reply · View Tweet

• 
  iPewp: Chinese herbs are crazy old fashioned. Hurts the nose.
  Jul 9, 2009 04:36 AM GMT · from txt · Reply · View Tweet

Time Magazine on Placenta Consumption

Here's a humorous article about eating your own placenta from Time Magazine.

For more information on placenta, take a look at our previous post, Human Placenta Consumption, from April 16th.

Chinese Rice Wine

Ever tried Chinese rice wine? Apparently some of it is pretty good! This company imports high-quality rice wine for drinking (not cooking or degreasing engine blocks) from China.

I don't remember when I first tried 白酒 bai jiu, but I remember that it takes some getting used to. First of all, it's usually 100 proof or more. The kind I'm familiar with has an acrid, sharp smell that feels like it's going to make your eyes bleed if you're exposed to the fumes.

Bai jiu, it should be noted, can be made from a variety of different grains, typically sorghum or barley. Although the characters can be translated as "white wine", a more accurate description would be Chinese-style vodka. It's very useful for making herbal liquor - the higher proof helps to extract the active ingredients of the herbs.

Someday I'll have to try the rice wine this guy is selling. I wonder if it's at Ranch 99.

123TCM.com

Here's an interesting website of original TCM products. The company is based in Hangzhou, China.

Besides the usual product descriptions, there are also stock quotes and the local weather in Hangzhou. Here's a highlight:

You wanna order our products?

Please before you do send us an email for which kind of desease you want to use.

Send us your clinical picture discribe your symtoms as good as possible your complete health situation. Why? We want make sure which products are the best for your way back...........

Enjoy.

Dao of the Day - Preventive Medicine

Tackle difficulties when they are easy.
Accomplish great things when they are small.
Handle what is going to be rough
when it is still smooth.
Control what has not yet formed its force.
Deal with a dangerous situation while it is safe.
Manage what is hard while it is soft.
Eliminate what is vicious
before it becomes destructive.
This is called
"attending to great things at small beginnings."

A tree so big it can fill the span of a man's arms
grows from a tiny sprout.
A terrace nine stories high
rises from a shovelful of earth.
A journey of a thousand miles
begins with a single step.
Thus, one of integral virtue
never sets about grandiose things,
yet he is able to achieve great things.

-Dao De Jing, Capter 64
From The Complete Works of Lao Tzu, translation and elucidation by Huaching Ni.

Summer Drinking

Nothing says booze and summer like the Fourth of July. Why not make yourself a nice, refreshing alcoholic infusion with herbs? It could prove to be delicious and nutritious!

The infusion above was made with 薄荷 Bo He, 生姜 Sheng Jiang and 枸杞子 Gou Qi Zi, popularly known as mint, ginger, and goji berries.

Yumbo!!

Be merry, be safe, and enjoy the holiday.