Statement of Fact: Your Heart is Dirty

浊气归心

Zhuo qi gui xin.

Turbid qi goes to the heart.

This statement is usually interpreted to mean that the turbid part of the clear goes to or gathers in the heart where it becomes the blood. To understand this concept, we must know that, just like yin and yang, clear and turbid each can be subdivided into clear and turbid. Thus the clear of the clear goes to the lungs to become the qi, while the turbid of the clear goes to the heart to become the blood.

• Statements of Fact in Traditional Chinese Medicine, by Bob Flaws

Dissociative Fugue: Is Your Hun Out Partying?

Jason Bourne, Matt Damon's fictional character from the movie series Bourne Identity, is the most famous 'person' who suffers from this rare amnesia. The name Bourne was taken from Ansel Bourne, the first recorded case of the dissociative fugue in 1887.

Dissociative fugue is a very rare form of amnesia, whereby the person loses complete memory of their identity and personality, but have full mental functioning for all other purposes. It's so fascinating, especially since the fugue state is associated with travel, and people sometimes end up across continents, not knowing how they got there. Psychiatrists attribute the onset of a fugue state with extreme stress, resulting in the person 'running away' or 'hiding' from their problems. In a recent story, a woman in a fugue state was able to go into an Apple store and check her email, but not remember who she was or what she was doing. She was eventually found three weeks after she went missing, floating in the water miles from where she lived.

In modern TCM theory, there is not one soul or consciousness, but five separate and distinct ones, each housed in the five major organs of the body. The 神 Shen, 意 Yi, 魄 Po, 志 Zhi, and 魂 Hun have their independent characteristics, but work together to form the mental-spiritual aspect of an individual.

From The Foundations of Chinese Medicine, by Giovanni Macciocia:

The Mind (Shen) is the consciousness that is responsible for thought, feeling, emotions, perceptions, and cognition. The Mind resides in the Heart and it is primarily for this reason that the Heart is called the 'Emperor' in relation to all the other Internal Organs. As the Mind is the consciousness that defines us as individual human beings and that is responsible for thinking, willing and feeling, the Heart plays a leading role among the Internal Organs.

The Intellect (Yi) is responsible for memory, concentration, thinking, logical thinking, capacity for studying, and application. In pathology, the capacity for thinking may become pensiveness, overthinking, obsessive thining, fantasizing or brooding. The intellect resides in the Spleen.

The Corporeal Soul (Po) is responsible for physical sensations, feelings, and generally somatic expressions. It resides in the Lungs and it plays a role in all physiological processes of the body. It is formed at conception, it is Yin in nature, and, at death, it dies with the body returning to the Earth. The Corporeal Soul is described as the 'entering and exiting of the Essence (Jing)'.

The Will-power (Zhi) resides in the Kidneys and it is responsible for will-power, drive, determination and constancy.

The Ethereal Soul (Hun) is a soul that is Yang in nature and that, according to Chinese culture, enters the body three days after birth and is imparted to the baby by the father. After death, the Ethereal Soul survives the body and returns to a world of spirit. The Chinese character for Hun confirms the spiritual, non-material nature as it is made up by the radical gui, which means 'spirit' or 'ghost', and the radical yun, which means 'clouds'. The Ethereal Soul resides in the Liver and particularly in the Blood and Yin of the Liver where it should be 'anchored'; if Liver-Blood is deficient and the Ethereal Soul is not anchored in the Liver, it 'wanders' at night and causes the person to dream a lot. The Ethereal Soul is described as 'the coming and going of the Mind (Shen)'.

So if a person were to lose complete memory of their identity, which soul would be the one affected, and how would Chinese medicine proceed in the treatment of an individual who has had a fugue state experience?

My guess would be the Hun. If the Shen were to go on vacation, all mental faculties would cease. If the Po were to leave the body, the person would die, since it is in charge of all things physical and only returns to Earth upon death. The Hun is the only one known for 'wandering', and is the one most immediately affected by stress and deficiency. A person in a dissociative fugue state could be said then to be suffering from a case of their Hun going out to party during the day when it should be at home in the Liver. It's like being in an extended dream that ultimately can't be remembered.

To treat this individual, one would have to Nourish Liver Blood and Yin, and Soothe the Liver. Without a look at the tongue and pulse, I would guess that the base formula for such a condition would be 酸枣仁汤 Suan Zao Ren Tang, with the addition of herbs like 熟地黄 Shu Di Huang, 夜交藤 Ye Jiao Teng, 白芍 Bai Shao and 当归 Dang Gui to more strongly tonify Blood. 柴胡 Chai Hu could be added and 赤芍 Chi Shao could substitute for Bai Shao if there is more Qi stagnation, and 茯神 Fu Shen for 茯苓 Fu Ling to more strongly calm the shen. 远志 Yuan Zhi and 石菖蒲 Shi Chang Pu can be added to calm the spirit and clear the head, in the same way they're used in 定志丸 Ding Zhi Wan.

Acupuncture could include points like 曲泉 LV-8, 太冲 LV-3, 三阴交 SP-6, 足三里 ST-36, 手三里 LI-10, 四化 Four Flowers, 神堂 UB-44, 魂门 UB-47, and 四神聪 Si Shen Cong. Other points would be added or subtracted according to tongue and pulse and symptom pattern.

Book Review: The Face Reader

I highly recommend Patrician McCarthy's The Face Reader for anyone interested in what our faces say about our innate gifts and misgivings. It is a very quick read, especially if you already have an understanding of Chinese medical theory, but is also easy enough to follow if you don't. The book includes a summary of personalities based on the five elements, with a full-color insert of each of the types of faces and combinations of those types. It has pictures and descriptions throughout, highlighting the major differences between facial features. My only criticism of the book would be that it is too short!

A really fun thing about the book is that a handful of the models are former Yo San students. Patrician McCarthy used to teach a course on Mien Shiang here at Yo San, but now does lectures and seminars all over. It's too bad I missed it; the class had been described to me as "life-changing."

Here are excerpts from the book that describe some of my features:

The little wispy hairs that some people have along their hairline are what I call the Veil of Tears. Those delicate hairs act as a veil, hiding the true shape of the hairline, just as these people hide their true feelings when they are hurt.

A rounded nose belongs to the material girls or boys. They are not greedy, but they appreciate things of quality. They would rather go without than put up with an inferior substitute.

If you love good-quality food and drink, you most likely have a gourmand's nose, one with a fleshy tip. If you don't have one yourself, these are the people to dine with.

Late Summer

In Chinese medicine, the five elements - Fire, Earth, Metal, Water, and Wood - can be used to describe all patterns that occur in nature, including the change of seasons. Spring is the season of the Wood element, of new growth and fresh movement. Summer is related to the Fire element, being the hottest season of the year, and Fall to Metal, the time of contracting and consolidating. The Winter season is associated with the Water element, the most dark and yin time of the year.

So where does the Earth element fit into the seasons? Some people say that the Earth element is represented in the change of seasons from one to the next, that time when things feel kind of still and grounded as hot turns to cold and dark turns to light. Another idea is that Earth is represented in the Late Summer, the time of the big harvest when the days are no longer unbearably hot, but the leaves have yet to turn and blow away in the autumn wind.

Walking through the Mar Vista Farmer's Market this morning made me feel like Late Summer really is the time of the Earth. As the last of the berries, peaches, and plums were being sold, their seasonal decline marked by the smaller and smaller tables taken up by the farms that grow them, there have been some new arrivals to the market to take their place. Today there were baskets full of summer squashes of all kinds - zuchini, cousa, yellow, and those cute little flat ones that look kind of like UFO's. There were also the first of the pomegranates, persimmons, asian pears, and so much delicious corn. Huge yams the size of my cat were pulled from the Earth and placed for sale in delicious piles of deliciousness.

The Earth element in the human body is related most closely to the digestive system, the place in which we take in from our surroundings and process what we need. It is the foundation of our bodies, being anatomically the physical center of ourselves as well as the center in which we can spiritually "stomach" what the universe gives us.

In celebration of my Spleen and the spirit of late summer, here's a simple recipe for a delicious seasonal soup I had for supper. All the produce can be found at the farmer's market, and ingredients in the soup have the Chinese nutritional properties of tonifying the Spleen and Stomach:

4 Garnet Yams, cut into large chunks
3 cloves Garlic, chopped
1 bunch Spinach, cleaned and cut
1 bunch of Baby Bok Choy
1 bunch On Choy, cut into thirds
2 large handfuls of mushrooms
6 slices fresh Ginger
6 pieces of Da Zao
3 pieces of Huang Qi
1 lb Jumbo Shrimp
*serves 3 hungry people who can really get down, with enough left over for lunch the next day

Put the cubed yams and garlic in a pot with plenty of water (at least a gallon). Bring to a boil and cook until the yams darken in color. Turn the heat down halfway and throw in the spinach and baby bok choy. Add the ginger, da zao and huang qi and cook for 5 minutes. Add the mushrooms. You can season to taste with some salt, lime, or soy sauce, or nothing at all if you like it the way it is (I happened to have some prepared nước mắm for such an occasion. I am Vietnamese... that stuff runs in my veins!). Right before serving, blanch the on choy until it just gets soft, and cook the shrimp just long enough for it to get pink. Enjoy with some rice or noodles!

Chinese Medicine: Is It Totally Fake???

You might think that China is the place where Chinese medicine is most popular. That may be true in terms of absolute numbers, but the trend is opposite - so-called "alternative" treatments such as Chinese medicine are becoming more and more popular in the United States, while interest is rapidly declining in China.

You can read the full article here, but I'm going to repost in full (with links added) a good summary article on the subject from an English-language Chinese newspaper.

As traditional Chinese medicine (TCM) gains credibility in the West, the practice of this nearly 5,000-year-old medical system has been faced with major challenges in the country of its origin. In 2006, Zhang Gongyao, a professor of philosophy at Zhongnan University, collected 10,000 signatures calling for "the abolition of traditional Chinese medicine" on the grounds that it was not scientifically based.

The move spurred a great deal of debate throughout China. While most supporters and practitioners of TCM dismissed Zhang's petition as "absurd", Fang Zhouzi, an academic known for his opposition to "pseudoscience", supported Zhang. Fang called TCM medical theory outdated, and said that China should focus on controlling and inspecting TCM herbs.

The debate was put to rest in October 2006, when China's Ministry of Health came out strongly against the petition to abolish TCM, saying it showed "ignorance of China's history".

Nevertheless, Chinese TCM doctors and experts agree that there have been major challenges to the development of the Chinese traditional medical system in recent years. Only one-fifth of patients now turn to TCM. One-third of patients use a combination of Western medicine and TCM treatments.

China has just 270,000 TCM doctors today, compared to 800,000 in the early 20th century, and 500,000 in 1949 at the founding of New China. Of the 85,705 medical institutions in China, only 3,009 were listed as TCM institutes in 2006, a decrease of nearly 800 from 2002.

Meanwhile, more and more TCM hospitals use Western medical tools and medicines for diagnosis and treatment, and rely less on TCM practices, such as pulse-taking and treatment with herbal medicines.

A major cause of the decline is the present mode of educating TCM doctors. In the past, TCM practitioners learned through a long apprenticeship. In the past 30 years, however, TCM has adopted a system similar to Western medicine for training doctors: four years of medical school, followed by hospital internships.

Pessimists say that TCM practices will be lost after the older generation of traditionally trained doctors die off. But in fact, many young practitioners who finished school in the 1980s have recognized the challenges ahead, and have advocated practicing "pure TCM".

According to a recent Internet survey by sina.com, 74.37 percent of 55,690 Internet users "greatly support TCM" and 81.3 percent believe "TCM has its own advantages". But only 42.48 percent said they would visit a TCM doctor, leaving 57.52 percent who said they would prefer a Western medical doctor.

(China Daily 08/27/2008 page 19)

p.s. Did you know you don't have to go to school to become an acupuncturist in the U.S.? Both California's Acupuncture Board and the NCCAOM have apprenticeship programs that allow you to sit for the national and California exams. Unfortunately, according the 2008 Candidate Handbook & Application Form, the apprenticeship route for national certification will be abolished in 2010.

Book Review: Molecules of Emotion

I first read this book during my former life as a researcher in endocrinology. Back then it inspired me and gave me hope that unadulterated science and a sincere search for truth could really benefit the world and its inhabitants. After four years of early mornings, late nights, and weekends spent in a laboratory, I emerged from that valuable experience feeling like money, and the marriage of money to politics, will always win out in the end.

I just finished reading this book again, now in my final year of studies in a completely different paradigm, and I have to say that it remains a very inspirational book. It is accessible to those without prior knowledge of science, but still presents enough information to learn from it and understand the scientific community. If you can get past some of the writing in the first chapter (Jonah's a pretty harsh literary critic), this book on science turns into a really engaging story.

The author, Candace B. Pert, goes through several transformations in her career, from graduate student to Principal Investigator with tenure at the National Institutes Health to the private sector and back to a professorship at a university, all the while delving deeper into the world of holistic health care. She eventually becomes the token scientist at events like the annual National Wellness Conference, and explores her own health and healing through yogic breathing and stretches, meditation, touch therapies, and emotional release.

The most interesting part about the book is how science confirms everything we know in Chinese medicine about qi, emotions and health. The author doesn't talk much about Chinese medicine, but I think that if she learned more about the theory, she'd discover more connections between that understanding of the human body and her research.

For instance, I recently had a talk with my friend Prathap, a fellow science geek and current medical student, about how Chinese medicine views the human body and physiology versus the dominant allopathic biomedical design. One topic lead to another, and we got to talking about ADH or anti-diuretic hormone. ADH is released by the posterior pituitary and acts on the collecting ducts of the kidneys. The exact same molecule is also referred to as vasopressin. ADH is the moniker used in regards to the renal system, whereas vasopressin is used when discussing constriction of the arteries in the cardiovascular system, with the regulatory receptors in the brain. The two systems are rarely discussed together.

In Chinese medicine, the brain is considered a "sea of marrow," containing the thick yin essences of the body under the governance of the Kidney system. The Kidneys are also responsible for the movement and distribution of fluids in the body, serving as the "water" that controls the "fire" of the Heart. When blood pressure is low, or the fire of the Heart is relatively subdued, the Kidneys then control the reabsorption of fluids, thereby increasing blood pressure. The blood vessels also constrict in response to the same chemical signaling, and the fire of the Heart is relatively enhanced.

ADH is currently being studied for its role in social behavior. ADH is increased in the body during sexual activity, and is thought to induce male-on-male aggression in response to the threat of another encroaching upon "his" female. In Chinese medicine, the Kidneys govern both the yin and yang of sex: the sexual fluids, eggs/sperm, libido and activity. The Kidneys are also the house of Will, the drive to live, and is associated with the emotion of fear. The same chemical messenger that regulates water and blood pressure is also involved in sexuality and survival, and the emotion of fear is a direct stimulus for aggression and possessiveness. It is possible to see the connections between the emotions, sexuality, and survival in the context of the biochemical reactions going on in the body when viewed under the Chinese medical metaphor. All of these processes belong to different departments of science under the allopathic model, but in Chinese medicine they all belong to one system that is unified with all the other systems of the body to create one functioning vessel.

Since the overwhelming majority of scientific experiments require the formation of a provable hypothesis, study of the Chinese medical theory may give the new-era science researchers some insight as to how to direct their holistic medical research. New "discoveries" can then be made to further elucidate just how much Chinese medicine makes sense.

Going back to Molecules of Emotion, the take home message that I got from Candace Pert was that free flow of emotions is the most important aspect of wellness, and that expression of emotions is the key to healing: be it anger, fear or sadness; joy, courage or hope.