To Sleep Like A Baby

By

Travis Cunningham LAc. MSOM DICEAM

(The Elusive) Good Night Of Sleep

How long has it been since you’ve had a good night of sleep? Can you remember what it was like?

Do you remember falling asleep? Staying asleep? Or, how you woke up? Do you remember the dreams you had? Or, do you only remember the feeling of restfulness upon waking?

One of the most challenging things to consider when we contemplate sleep, is just how unconscious a good night of sleep can be. We require nothing to sleep well. All humans must sleep. But how much? And, to what quality? What is required and what is optimal? What does sleep do for us? And, how can sleep be corrected if it becomes problematic?

If we take the basic premise that sleeping well is a natural process, we encounter our first problem…

“If a good night of sleep happens unconsciously, how can we consciously change it?”

And thus, (the internet) spawns a million suggestions. Searches, studies, science - all seeking to answer the same basic questions.

One of my teachers used to say that “if we look at the disease, we will find one thousand medicines to treat it. But, if we look at health, we will find only one cure.” Before we can learn to treat a problem, we must first understand what it is like to have no problem. So, what is healthy sleep?

Defining Healthy Sleep

The first thing that one might notice in the analysis of healthy sleep is that sleep - all sleep, is a rhythm. Just like breathing, eating, urination, defecation, movement and rest, sleep is a rhythmic process. When a person generally sleeps well, one night of poorer sleep doesn’t bother them so much. When a person generally sleeps poorly, one night of good sleep doesn’t benefit them so much. Many people who have chronic insomnia will actually report that they feel worse, when they (rarely) get a full night of sleep. We can make sense of this fact with the simple understanding that sleep is rhythmic. And, the effect of a single “beat” of sleep, is not nearly as impactful as the timbre of a repeated rhythm.

When we compare sleep to other rhythms, like eating, we find that sleep is a longer rhythm. Sleep is longer; both in the time that it takes to engage in, and the time that it takes to influence as a habit. When we are younger, we can live with poor sleeping habits for a longer period of time without feeling the negative effects on our vitality. As we age, poor sleeping habits catch up with us more quickly and become much more difficult to correct once they are set. In the traditions of East Asia, this is explained by the concepts of Yin and Yang.

In youth, we are more Yang. We have access to more energy and are able to make changes in our lives more easily. As we age, we become more Yin. We become more stable, (hopefully) more grounded and wise, but with less capacity to quickly change and shift. It is advised that we establish good habits when we are youthful because it is easier to keep these habits as we get older. While I believe that any habit is changeable at any stage life, sleep is a rhythm that is easier to correct in our earlier years.

It is important to discuss the longer rhythmic nature of sleep right away because if we wish to change a longer rhythm, we must expect that it will take a longer period of time to shift than other activities. When I work with adults in the clinic for sleep, I tell them to expect that it will take a minimum of three months to shift the basic pattern and possibly longer if there is a standing history of insomnia. Good sleep takes time. It takes effort to create a positive sleeping habit, before good sleep can become effortless once again.

Sleep & Time

Sleep, just like any rhythmic process is inextricably connected to time. The connection to time has two aspects. First, we have the duration or amount of time a person is sleeping within a day or night. Second, we have the time during the 24 hour day that a person chooses to sleep. While at first, these two aspects of time seem to be separate topics, at a closer glance we will find that they overlap and influence each other.

In East Asian medicine, there is a keen interest in the efficiency and quality of nature. Ancient people observed that all creatures followed the circadian rhythms of day and night. Human beings tended to sleep during the night time and stay awake for most of the day. Humans generally followed the cycles of the Sun, and were more active when the Sun radiated its light from the sky.

As human beings evolved with the Sun’s cycles, our physiology “learned” to become more efficient when we follow them. We have naturally more energy to act during the day and more proficiency to restore ourselves through resting at night. In modern times, we can easily live outside of or contrary to these natural rhythms. But we inevitably pay the price through inefficient restoration and a challenged expression of vitality.

Many modern people may push against the idea that for optimal vitality, we must adhere to the circadian rhythm - resting and waking with the cycles of the Sun. These people may insist that they feel better staying up late at night, and waking in the late morning or early afternoon. I can honestly say that I have not (yet) seen a single person in clinical practice to make this claim who has not obviously damaged their health because of it. Sleep, as we saw before, is a longer rhythm. It is harder for most people to see the damaging effects of an inefficient sleep habit in the short term. But over the course of weeks, months and years, the deficit will show itself.

So what does a sleep deficit look like? For some people, it can simply mean that they require more hours of sleep to function normally than they might. The lack of efficiency in restoration means that the body needs more time to recover than it could otherwise. In traditional medicine, we think of a healthy sleeping habit to (generally) require between 6-8 hours of sleep within a 24 hour cycle. Most people trend closer to the 8 hour mark with what they need, then the 6 hour one. This need can also fluctuate with the seasons - trending a bit longer in the winter and a bit shorter in the summer.

Problem One: Needing More Sleep

If a person finds that they need more sleep than 8 or 8.5 hours to feel rested, it is a sign that their sleep is inefficient or in deficit. I’ve treated patients who claim to need 11 or even 12 hours of sleep per night to feel rested. This is a sign of a profound deficiency of vitality that the body is trying to rectify by sleeping more. In traditional medicine we would say that the body is having a difficulty storing its vitality. The need to sleep for this many hours obviously effects the person’s daily life. I’ve also noticed that a huge percentage of these patients struggle with depression. In these cases, there is good news. If we can help to restore their vitality, the person will generally need fewer hours of sleep and their depression will either lift or at least be less problematic for them.

In East Asian medicine, we see this pattern of sleep coincide with feelings of cold in the body, weak digestion and malaise or fatigue. We call this Yang deficiency with Yin sinking. The warm and active quality of Yang is deficient and unable to transform or utilize the nutritive substance of Yin. This Yin substance “sinks” in the digestive tract, causing looser stools and a general feeling of heaviness in the body. The remedy for this pattern is treatment which targets warming the Yang, making it strong enough to transform the Yin substance and lighten the body.

Problem Two: Being Unable To Sleep

The other possibility for inefficient sleep or sleep deficit, is that a person may be unable to sleep or unable to sleep deeply. These people generally learn to sleep for fewer hours than the 6-8 that is considered normal or healthy. They basically never sleep well or feel rested, but may report feeling worse when they (rarely) do get a decent night of sleep.

While this may appear different than the first type of problem, it is actually the same. Both problems come from inefficient sleep or a lack of restoration. In East Asian medical diagnosis, I find that most of these patients still qualify as Yang deficient. In these cases the Yang is not only deficient, but also floating. These people can tend to have an overactive mind when they lay down to sleep, feel warmer at night or experience night sweating and have very vivid dreams. Underneath the superficial heat, there is cold. Sometimes you can feel this cold when you touch their feet or lower abdomen, especially when compared to the temperature of the neck.

These people would be treated differently than the first type, given that their presentation is not the same. I find that working with these folks can be a bit more challenging, because they will often feel more tired when we start treatment. These feelings of tiredness are often what they have been avoiding during the day, by use of stimulates or stimulating activities. Unfortunately, they must begin to feel their body’s fatigue in order to restore their vitality through sleep.

Can It Change?

In every case of insomnia, inefficient sleep or sleep deficit that I’ve seen thus far, the answer has been yes - it can change. The more important question is how much of a priority is the person willing to make their sleep? Sleeping well is a by-product of living a life where good sleep is possible. If we live contrary to the body’s natural rhythms, we cannot expect our sleep to be efficient or restorative. But if we are willing to change, so can our sleep. So how can we get our sleep back on track?

Step One: Empty The Stomach

A famous Chinese medicine doctor once said, “if a person tells me that they have a problem sleeping (any problem sleeping), I tell them the same thing: No food after dark. If they can adhere to this rule alone for two weeks, about 60% of sleeping problems will resolve.”

This one sounds a bit strange at first but when we take a closer look, it makes quite a lot of sense. When we go to sleep at night, our heart rate decreases and our body’s surface becomes cooler. A complex chain of events begins to happen involving many organs, nerves, blood vessels and the hormonal system. In East Asian medicine, we call this phenomena Yin ascending, Yang descending or the communication of the Heart (Fire) and Kidney (Water).

If we go to bed and our stomach is still full, our body has to ramp up its metabolism to digest the food. Our heart rate increases, and it can even feel uncomfortable to lay down. When our stomach (Earth) is full, the pathway for the heart (Fire) and kidney (Water) to communicate is “blocked.” This can inhibit the quality of a person’s sleep or even prevent sleep from occurring at all. The first and clearest step to getting better sleep is to increase the amount of time between your last meal or snack and your bed time. I recommend people work toward 3 hours between the two, if possible.

Step Two: Create A Slide

If you have any difficulty getting to sleep, its unlikely that you’ll be able to do so for awhile without a routine before bed. So create one. This routine will look different for every person. But the routine should include the general feature of moving from more activity to less. I call this “creating a slide.”

Keep in mind, that by activity, we don’t only mean physical activity. Modern people are less and less physically active as our work becomes more closely engaged with technology. For some of us, our evening routine may need to include physical movement to release the activity in our nervous systems. There are many great practices for this - from gentle Qigong, to Yoga. My favorite is actually just walking. Remember the cheesy phrase: Whatever it is that you do to unwind, make sure to include your body and mind.

Step Three: Swing Out To Swing In

Many people have a difficult time sleeping because they lack basic movement or exercise during their day. But by engaging in a short exercise routine, people can dramatically enhance the quality of their sleep at night.

There are many studies that have been done on this subject alone. Some of these studies have analyzed specific data on the cycles of hormones and the assistance that day-time exercise can provide.
In East Asian medicine, we can summarize this phenomena quite simply: Yang activity benefits Yin restoration. Swing out, in order to swing in.

Step Four: Create A Break In The Static

So many cultures around the world take a siesta or a mid-day nap. Interestingly enough, if we look at the times of the day that most cultures take siesta (1-4PM), these are the clock-opposite times that most Americans struggle to sleep at night.

If you ask people about how they sleep, many people who can fall asleep easily will struggle to stay asleep between 1-4AM. East Asian medicine is a medicine that looks at opposites (Yin & Yang). If there is a problem that regularly occurs for someone at 3AM, we might look at adjusting the person’s conduct at 3PM to change it. For example, If a person is regularly waking up at 2:30AM and unable to fall back asleep, one way to change this dynamic would be for the person to take a short nap at 2:30PM. It sounds strange, but it totally works!

Another way to think about the helpfulness of mid-day rest is what I call, creating a break in the static. First, imagine that during the work day, we accumulate stress or a type of pressure in our nervous system. To me, this stress feels like static electricity, so I call it static. As the static builds without a release point, our nervous system continues to get more and more stimulated. If this continues all day, when we reach the day’s end, we may experience the “tired but wired” phenomena. We feel very tired, but we cannot sleep.

By taking a mid-day nap or short resting period, we can provide a natural release valve for our accumulated stress. Now before you instantly write off this idea by telling me that you don’t have time, hear me out. A break even as small as 5 minutes can significantly shift the state of accumulated stress within the nervous system. I’ve worked with all types of busy people. If you prioritize it, you can create the time.

What can you do with this time? The best thing that I’ve found, short of a quick nap is a mindful breathing practice or a shaking exercise (scroll down the page to see the exercise). If you make the time and participate every day, you will feel the changes.

Step Five: Get Help

If you’ve been struggling with your sleep for a long time, or even a shorter period of time, the quickest way to get better is to receive help. I’ve specialized in helping people with their sleep since beginning my training in East Asian medicine. Not being able to sleep efficiently is a huge burden - one that I know from my own experience.

It is possible for your sleep to improve if you are willing to receive help and participate in the process. If you’d like to take the next step, follow the links below to read more about treatment for insomnia or sign up for your first appointment today.

Treating Seasonal Allergies With Chinese Medicine

A Spring In Your Step

Dear reader,

I am writing to you in early Spring. The weather is still cold here. Frost covers the ground at night and is breached by sun in the early morning. It is still too cold to wear a light(er) jacket. And yet, the first flowers have started making their appearance.

As I notice the crocuses waking up on my morning walks, I find myself contemplating the meaning of Spring. In the historic and cultural medicine of China, human beings witnessed the transitions of nature. The qualities that belong to these transitions were described as Qi.

I think people make too much of the term Qi. If we just look at how things move and change, it follows to use a word that describes the quality of this change. That which moves behind the appearance of things, could be a simple definition of Qi.

The Qi of Spring is said to be like wind. Wind is movement or a quicker form of change. In Spring, we transition from the cold Qi of Winter to the hot Qi of Summer. What force can propel such a change from one opposite to the other? Wind. Wind necessitates change. It propels our bodies to find a new balance of adaptation with the environment around us. The Chinese say, that the fluids of our body have to become thinner in Spring. Traditionally, the density of our body’s fluids have to do with their ability to hold heat. In the cold Qi of Winter, the body must have the thickest fluids. In the hot Qi of summer, the body’s fluids must become thinnest. In the Spring then, the fluids must begin their thinning process.

The pressure to adapt to nature is seen as a necessary part of life in traditional medicine. There is no way to become immune to change. A failure to adapt to the circumstances outside of our bodies creates an adversarial relationship with the Qi of nature. This adversarial relationship is called a “strike” in traditional medicine. An external strike against the body is the body’s failure to adapt to the new circumstances surrounding it.

From the perspective of the body, this dynamic feels like the Qi of nature is striking it. It’s important to understand that there is no malicious intent from the Qi of nature. The body simply interprets the change as a strike because it isn’t prepared for the shift. The body then goes into a defensive and adaptive process. This process, we know as disease. In some cases, the form that this disease takes is called allergies.

Allergic to Adaptation

In biomedicine, we understand an allergy to be a reaction from the body’s immune system toward a particular substance that the body comes into contact with. The immune system recognizes this substance as a hostile presence and mobilizes its resources to attack. The following symptoms we are all familiar with…

• Itching

• Sneezing

• Coughing

• Phlegm or congestion

• Dry/tearing eyes

• Dermatological or digestive problems

• And more…

Regardless of the type of symptom, traditional medicine views the cause of this disorder to be a failure of the body to adapt. The remedy then, must not only be about treating the above mentioned symptoms, but helping the adaptation process of the body to complete in live time.

If the nature of a problem is adaption, our next question would then be, “how can we aid the adaptation process?” Luckily, there are many answers to this question. Some, are actions we can take ourselves. Others, require aid by a trained practitioner in the arts of Chinese medicine.

A Simple Exercise: Shaking

Many of the ancient practices of China that have been crafted to assist the body and mind to adapt are not esoteric or outlandish. These practices often fall under the category of hygiene. Though, in this context, we don’t only mean getting cleaner. We mean instigating the vital forces of the body toward a more appropriate kind of circulation.

1. Stand in an even posture with the feet shoulder-width apart.

2. Allow for a very slight bend in the knees (making them “active,” and not locked)

3. Close your eyes and begin gently bouncing - allowing the whole body to pulse and move.

4. Allow the mind to drift to the various parts of the body - especially places of tension. Shake loose any feeling of stuckness.

5. When you feel your practice coming to a close, stop shaking and remain still.

6. Allow the mind to become quiet and feel the residual waves of internal activity.

7. When you are ready, gently re-open the eyes.

This shaking technique is often performed at the beginning of a Qigong practice. Its purpose is awakening the movement of Qi and blood in the body and to release blockages within the channels. The first time you do this practice, it is recommended to do so for only one or two minutes. After you get comfortable with the practice, you can increase the shaking time to five or ten minutes. In certain styles of Qigong practice, adept practitioners will even shake for as long as forty-five minutes to one hour! For our purposes, this amount of time is unnecessary.

The practice of shaking can be done on its own without any other practices or intentions. It can be practiced any time of day or in any season, but it is most beneficial to practice first thing in the morning and in the Spring season. This is because in both of these times be it daily or seasonally, the Qi of nature is beginning to move once again. If we instigate a similar quality of movement in our body, it helps the body to adapt and line up with the quality inherent in nature at that time.

This gentle practice of alignment prepares the fluids of the body for proper balance for that day. If we continue this practice for many days consecutively, it prepares the fluids of the body for proper balance for that week, month, and season. This is an excellent technique to use to help the body adapt to the seasonal transition and prevent complications like colds, flus, and the present of seasonal allergies.

Traditional Medicine Interventions

Depending on the person’s constitutional tendency as well as the status of the vitality in the body, more intervention may be required than simple hygiene practices. The medical interventions of herbal medicine and acupuncture are uniquely equipped to aid a person in this adaptation process to a deeper level. If done well, such interventions can not only alleviate the symptoms of conditions like allergies, but help the body to adapt and therefore, prevent the symptoms from reoccurring in future seasons.

In order for the intervention to work, each treatment must be individualized to the person and their circumstances. All generalized patented formulations and protocols of medicine are flawed. These formulations are unable to comprehend the needs of the person in the here and now. It’s for this reason that we do not recommend any medicines for general supplementation but suggest that each person be evaluated through consultation with a qualified practitioner.

If you are interested in this personalized type of care, click on the “schedule now” button below to book an appointment at our clinic in Portland, Oregon.

If you’d like to read more about how we treat seasonal allergies clinically, click the link below to access our clinic’s allergy treatment page.

Why You and Your Parents Don't Need To Suffer As you Age

By
Travis Cunningham MAcOM LAc

To listen to the audio recording of this article, click below.

The Curse of Aging

Does it bother you to think of yourself getting older? It bothers me. I can feel the aches and the pains already. I can feel the slow but definite decline in energy, flexibility and strength of my body. I can sense the descent of my intellect and the clouding of my memory. Fewer adventures and more routines. More trips to the doctor’s office and more need for my friends and family to take care of me. But that’s the reality, isn’t it? I mean, I guess we’re all going the same way, so why not just accept it?

If the above narrative doesn’t sit well for you, then you have made it to the right place. Somehow in the vast expanse of internet land, you made it here. Congrats!

Everything I have seen in my short but lively career as a traditional Chinese medicine practitioner suggests that most of the negative experiences we associate with the aging process need not come to pass. But in order to understand how our experience may differ from the common definition of aging, we must look at why suffering is a possibility as we age. Once we understand the problem, then we may understand its solution.

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Why We Suffer When We Age

Chinese medicine relates good health to the principles of change and transformation. When we can change and transform, we can grow. And as long as the possibility of change exists within us, the opportunity for growth remains. Each new experience provides opportunities to create and re-define ourselves. And when we do so, our lives become works of art.

When we cannot change, we get stuck. When stuck-ness exists in a person — in our bodies, in our organs, or in our emotions, problems inevitably occur. Because life is dynamic and ever-changing, when we are stuck and cannot adapt to those changes, we find the spontaneous movements of life turn to hazard and harm. We coil around and protect the stuck parts of ourselves hoping that they will not be touched. We try to control our experience and keep it from changing. And when the tender places within us are inevitably approached, we suffer the reminder of dis-ease that sticks within them.

Stuckness can occur in many forms within humans. Aches and pains in our muscles, joints, and bones result from poor circulation and blood supply. Our bodies may have a hard time regulating our temperature resulting in fever and chill sensations. Or we may have shallow sleep and have less energy throughout the day. We can think of these symptoms as a kind of hormonal stuckness. We may feel our thoughts becoming sluggish or foggy with a decreased desire to learn and understand which is a distinct type of mental stuckness. Even our hearts may stop pumping so well, and we resort to medications in order to remedy organ stuckness.

Luckily, There is Hope!
The Remedy to Stuckness Is Simple…

As we move through the years of our lives, collecting a wide variety of experiences across the entirety of the emotional and physical spectrum, we have the continual opportunity to cultivate wisdom. Wisdom requires the discernment to know which actions help us toward our goals and which actions are less supportive — a key skill harvested from our life experience. However, in order for wisdom to truly form, discernment must partner with a second quality: grace.

Grace comes from the ability to be soft and open to new ways of perception and action. Grace is a fluid quality, reaching into both the physical and psychic aspects of our lives. It comes easily to us as children when we are less certain and more trusting of our innate experience. But as we age and form belief structures, grace must be continually practiced or it will begin to fade.

As we age, we tend to lose touch with our sense of grace. We move less physically and do fewer new things. We stick to our routines, eat the same foods, and see the same people. The newness of our lives lessens, and so does our flexibility in managing it. This nascent rigidity is the root of future health problems.

While it’s true that there are natural consequences to the aging process, many of the aforementioned fates need not come to pass. With simple and gradual adjustments to a person’s lifestyle, the woes of aging can be lessened or avoided by a more graceful form of living. If grace can be adopted, then we may see the benefits of aging truly shine!

The Benefits of Aging
(What No One Talks About)

The benefits of aging lie within the possibility of cultivation. Because human beings have the opportunity to cultivate wisdom through life experience, we have the potential for greater levels of happiness, satisfaction, and discovery as we age. As our years pass, we can learn to harmonize the stability and creativity of human experience. We can become healthier this way, knowing ourselves in great depth and channeling the power of this depth to serve ourselves and others.

While our physical bodies become less abundant in mass, they may become more refined in quality. We may learn to require less in order to give more. Smaller amounts of food and fewer hours of sleep may be the result of this refinement, so long as does not cost us energy and clarity. Aging well gives the possibility for our minds to open, enhancing our contemplative powers as well as our spiritual ones. As middle age passes, the possibility of becoming not just old but an elder, arises. What a fantastic opportunity indeed!

In order for humans to see the benefits of aging, we have to participate in the things that make us human. In Chinese medicine, these areas of participation are the things that we must do in order to survive - breathing, eating, sleeping, moving, and resting. Participation may be thought of as a kind of rhythm, for when activities are practiced consistently, a power comes through them that begets more significance than that of a single beat. These activities compound in their effects and give strength to one another like links in a bond. They are the basis of good health, wisdom, and grace.

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Building A Foundation

In traditional Chinese arts, the foundational practices are where you start and often where you end. No matter how advanced you get within the art, good can always come from refining the fundamentals.

Breathing
As the most essential and immediate ingredient for health and vitality, breathing should be a priority. From time to time, check in with your breath and make sure it isn’t being held. Let your mind settle and let your breathing come naturally from your belly. Get out in nature by trees whenever possible and breath in that fresh air!

Eating
Keep eating as simple and as enjoyable as possible. Eat with people you love when you can. Eat at regular times. Slow down and chew your food. Eat lots of vegetables, with moderate amounts of grains and/or meats. Figure out what works and feels good in your body. Minimize overly heavy and sweet foods (but enjoy them when you do eat them). Breathe easy when you eat. Cook the majority of your foods (especially vegetables). If you have a digestive weakness, cook everything.

Sleeping
Go to bed as early as you can with consistency. Ideally, you would be asleep before 10:30 PM every night. Do the best you can with this. Sleep through the night, and make time in the day for a short nap (if possible). If you have difficulty sleeping through the night, try soaking your feet in hot water (described in greater detail below) before bed, and limit your food intake late at night.

Moving
Move every day without question. Do as much as feels good in your body. A little bit of pushing yourself in movement is good; alot of pushing is not good. Moving promotes circulation for the body and mind. Moving in natural environments is even better. Find something you like to do, and do it with regularity.

Resting
Throughout your day, plan periods of rest from your activity or work. These may be momentary at first - lasting 5 to 10 seconds. But hopefully will expand to a bit longer (15-30 minutes is about perfect). Do very little in your periods of rest. Avoid social media and mind stimulation. The basic idea for resting is to rest - not to be doing something. This practice will conserve your energy throughout the day and hopefully allow you to recycle it at night. This will both extend your life and enhance its quality.


Communing
Get your relationships in order. No, seriously! Good relationships can hold you together when you have no strength left. Bad relationships can demolish you even when you feel high and mighty. You can’t do this life all by yourself! Developing good relationships is essential to being a healthy human. If you don’t know where to start with people, try nature or animals first. Nature/Forest Therapy is an excellent place to start. Conventional therapy is also great and not only for advanced mental/emotional problems. If you need help, get yourself some help. You are a pack animal, you deserve to be with your pack.

Focusing
Humans need something to do in order to be happy and healthy. This need can be satisfied with something as elaborate as creating a non-profit to as simple as knitting a scarf. But you need something to do. And the more people feel that their work has value, the happier they tend to be. If you don’t know what your life’s purpose is, don’t worry about it! You don’t have to know all the secrets to be happy. Just start with today and do something that’s valuable to you.

Creating healthy habits in life without internalizing guilt and shame in the process is an art form.

Be easy on yourself, but do the best you can :)

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How to Refine Your Health
Or
Get Back Your Health
(When You’ve Lost It)

Step One: Build Your Foundation

As stated in the previous section, building a foundation of positive participation in life is essential for both getting your health back and maintaining (as well as improving) it. This can be done in the smallest of ways to begin, and it will compound and multiply as you continue. Follow the guidance in the above section to get started. If you feel you need assistance or further evaluation before you begin, make an appointment with a qualified healthcare practitioner. You can schedule an appointment with one of our experts here.

Step Two: Increase Your Circulation

Far and away the biggest problem I see in the clinic when people come in with age-related complaints is lack of circulation. As we age, we move less and the parts of our body that rely upon circulatory actions (like the heart) get tired. These organs work less efficiently the more tired they get, and the obvious problems of blood pressure, cholesterol, and fatigue, arise.

Poor circulation robs organ systems of their health by withholding the precious resource of nutritionally-dense blood. Anxiety, depression, and insomnia are only the beginning of the list of problems that can result. Similarly, old injuries with damaged tissues receive fewer resources because of this lack of fresh blood in supply. The tissues become achy and malnourishment or even form calcifications and masses which lead to further problems.

To stop this increasingly damaging cycle and begin turning the wheel in the opposite direction, you can start by working on your circulation in fun and simple ways. The most popular way to do this is by gently increasing your activity. Traditional exercises for circulation include walking, running, biking, swimming, lifting weights, playing sports, and other like activities. Softer methods can also be useful especially when the energy of the body is low. These allow for an increase in circulation without employing a taxing effect on the body’s resources. Yoga, tai chi, or traditional stretching are excellent places to begin.

Foot Soaking

To supplement your circulation even further, you can try one of my favorite time-tested treatments for the regulation of all human cycles: soaking your feet.

Soaking your feet in warm water helps the blood to flow all the way down to the furthest part of the body from the heart. During this transit, the blood passes around and through vital organs, cleansing and nourishing them before finally settling in the feet. Afterwards, the blood returns by way of the veins and a gentle pump for the whole body has just been created.

From a Chinese Medicine perspective, transferring heat to the lower extremity is considered highly beneficial and allows the Yang Qi of the body to go into storage, making it easier to fall asleep and allowing for more restful sleep. This knowledge may even have served as an inspiration for the Chinese adage, “Keep your feet warm and your head cool.”

How To Soak Your Feet

A) Choose A Basin
Use a container large enough to accommodate both your feet and deep enough to cover your ankles. Wood is best, plastic works as well. Do not use copper or iron containers.

B) Prepare The Soak
Bring 2 quarts of water to boil in a pot or kettle
Good Medicine: You can use hot water for your foot soak and receive many benefits.
Better Medicine: You can add medicinal ingredients to increase the effect of the foot soak. Simple medicinal add-ins are epsom salts or slices of fresh ginger.
Best Medicine: For an extremely potent foot soak, ancient formulas of herbs are used to increase and specialize the effect of the soak. To find out more of the specifics, check out our foot soak catalog here.
Place 1-2 herbal pouches (or, as directed by your practitioner) into a heat-proof, non-reactive vessel and add boiling water. Steep for 10 minutes. Pour tea bag and herb liquid into soaking vessel. Add hot water as necessary to cover your ankles.

C) Add liquid herbs to Foot Basin
Pour tea bag and herb liquid into soaking vessel. Add hot water as necessary to cover your ankles. Larger basins may require more water.

D) Confirm The Soak Temperature
Extremely important for those with impaired sensation in their extremities.The temperature should be between 105-112 degrees Fahrenheit (check using a thermometer). If this temperature feels uncomfortable when first starting to soak, it is ok to work up to this temperature gradually.

E) Sit & Soak
Choose a place where you will not be exposed to drafts and disruptions. It is best to avoid television or other electronics while soaking. Use the time to sit quietly, meditate, pray, or engage in pleasant conversation.

F) Maintain Soak Temperature
It is important to maintain the soak temperature in the therapeutic range of 105-112 degrees Fahrenheit for the duration of the soak (30-45 minutes). The easiest way to do this is to use an electric kettle to add small amounts of boiling water to the soaking basin every 5-10 minutes. Please Exercise Extreme Caution: Remove your feet from the bin when adding hot water and be very careful using electric appliances around water. Always confirm the soak temperature is below 112 degrees Fahrenheit before putting your feet back in the soak.

Other Helpful Treatments For Circulation

Acupuncture
Perhaps acupuncture’s greatest asset as a treatment modality is the precision at which, it can encourage the circulation of the body. Bad acupuncture can alleviate pain and promote general circulation. Good acupuncture can harmonize the organs of the body, extract and eliminate deeply held pathogenic influences in the tissues, and clear the mind.

Chinese Herbal Medicine
Chinese herbal medicine has an entire collection of herbs that may be used to increase the circulation of the body in both micro or targeted, and macro or general, sense. While the vast majority of these herbs are plant substances, there are a few medicinals that fall outside of the traditional category of plant. My article, How Bugs Can Heal Chronic Pain & Disease is a discussion about one subset of these medicinals.

Bodywork
Whether you’re talking Osteopathic, Chiropractic, or more traditional massage therapy, a good body worker is worth their weight in gold. Good bodywork can pinpoint the problematic area in the tissues of the body and remove it, restoring flow and encouraging the health of the entire person.

Step Three: Find A Health Expert & Comrade
(Not The Internet)

While the internet is an incredible place for the sharing of ideas, it is a terrible place for editing out bad ones. I’ve seen more patients damaged by following bad internet advice than almost any other source of information or treatment out there. Please be careful when receiving advice from sources that you have no way of dialoging with. Health advice should come with a platform of participation on both ends. It should include clear directions and signs of progress or deterioration. If the advice you’re getting is vague or lacking this basic partnership, do not follow it.

On the plus side, the internet can be a great place to find health comrades or experts to work with directly. There are so many good practitioners that can assist you on your path to health, wisdom, and happiness. You just need to find them.

Which Type of Medicine Is Best For me?
Stay connected for a future article dedicated to describing the strengths and weakness of various modalities of medicine. But in the meantime, rather than focusing on the type of medicine to try, I would recommend focusing instead on finding the right person as a practitioner, for you. This person should be trustworthy, intelligent, and credentialed within the context of their given field. They should be able to communicate well with you so that you can adequately understand your situation and what they think about it. They should also have a referral team of other practitioners whom they trust, that do different kinds of work than they do. In this way, finding the right practitioner can mean finding the right network of practitioners who are available upon need.

The best way to find the right practitioner is often through the referral of others, so don’t forget to ask trusted friends and family members about who could be right for you. If you happen to live in the Portland area or in the Pacific North West in general, me and the members of the Root & Branch team would be happy to recommend a practitioner who might be good for you. Feel free to book a free conversation with one of our experts here or virtually contact us via email or phone, here.

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Your Greatest Asset

One of the best things about being a human is not having to do it alone. In our culture we tend to think of our health as an individual thing, but it’s not! We exist in communities now as we always have. While it is, of course, important to cultivate the integrity of our health as an individual, it’s equally important to cultivate the health of ourselves as a people.

Please do not feel that you need to do this life alone. There are many humans as well as resources to assist you. And with such assistance, your journey of aging can be one of happiness and wisdom. Just give it some time.

How Bugs Can Heal Chronic Pain & Disease

By
Travis Cunningham MAcOM LAc

Ninety Percent of Chronic Pain Gone in One Week

“I hate to sound like a broken record,” said one of my teachers, “but a lot of her problem is due to blood stagnation.”

Dr. Greg Livingston and I were chatting before one of our herbal shifts at the school clinic. We were discussing the details of a diagnosis that one of our patients had been given on the shift the week before. Blood stagnation is the name of a pattern that we learn to identify and treat in Chinese medicine. According to the medicine, stagnant blood is the root of many illnesses. If blood doesn’t flow correctly, pain will result and various organ systems will become undernourished. Malnourishment and lack of flow will then cause other problems and lead to a whole host of diseases and bizarre symptoms.

I smiled at Greg’s remark. It was a familiar piece of advice, but one that bared repeating. Greg was one of the few westerners to go to China, learn chinese, finish a P.H.D. in Chinese medicine, and then study with various doctors who had decades of clinical experience. Greg got excellent results in the clinic. He consistently understood and could explain why he would give treatment the way that he did. He was one of the teachers that I had become closest to while in school. He is someone that I still consider a friend and mentor to this day.

“But why use the bugs Greg?” I asked after glancing at the patient’s herbal formula. “What would lead you to the conclusion that we need to break the blood?”

My question was linked to the way we learn to classify herbs as singular medicinals at school. The category in Chinese medicine that most of the insect medicinals are placed in, is called move the blood. The move the blood category has several gradients of intensity, the strongest of which is called break the blood. That is where the bug medicinals reside.

“Well,” he replied, “the bugs don’t necessarily move the blood any more intensely than Dang Gui 当归 (Angelica Sinensis) or Chuan Xiong 川芎 (Sichuan Lovage), what makes them unique is that they go to the luo mai.”

In Chinese medicine, when a person gets sick the disease is thought to go first into the main channels and collaterals of the body. These pathways are called the jing luo in Chinese. When the disease stays in the body for longer periods of time, it is thought to get into the tiny pathways and offshoots of the larger channels. These tiny pathways are referred to as the luo mai.

“Bugs get into tiny spaces, right?” he said, mimicking the movement of an insect with his hands. “So if you want to get into those tiny spaces of the body to get rid of that stubborn blood stagnation, you need the bugs.”

“Interesting” I replied.

Several weeks later, I was on a different clinical shift with one of my regular patients. This patient had had over ten surgeries on his abdomen leading to chronic abdominal pain. He had also been diagnosed with crohn’s disease, arthritis, and crohn’s-related arthritis. On a good day, his chronic pain was at a 5/10 intensity. On a bad day, it was 7 or 8/10. And it had been like this for years.

With weekly acupuncture, we had managed to get the scarring on his abdomen down “from the size of a dinner plate to the size of a salad plate,” he would say. Each week he would come in, we would needle around his abdominal scar in a technique known as “surround the dragon.” While progress was gradual, it was definite. Both the size of the scar and the local pain had decreased.

While our treatment had been somewhat effective, I wondered if there was more we could do to help him. That is when I remembered my conversation with Greg.

After convincing this patient to try a simple herbal formula that contained insect medicinals, we booked another appointed for the same time the following week.

As I went to greet the patient the next week, I could see he was smiling. When he got into the room, my patient said “Well, I think we’re on to something.”

“Oh yeah?” I replied, “How so?”

“Ninety percent of my arthritic pain has been gone since I’ve been taking the herbal formula you prescribed.”

“Ninety percent in one week?” I repeated, not fully believing my ears.

“Ninety percent in one week,” my patient confirmed.

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The Use of Non-herbs in Traditional Herbal Medicine

In the Chinese herbal materia medica, there are a vast number of medicinals listed that we would not normally consider “herbs” in the english language. Some of these are mineral-based substances such as amber, hematite, pearl, and oyster shell. While others may come from (or be) insects or larger animals. In modern times, it can be difficult to conceive of why anyone would want to use animal-based materials for traditional herbal medicine. Isn’t there a plant-based alternative, we ask? In our time of cultural change and technological advancement, it seems like almost anything can be replaced by something else.

But if we look from the perspective of traditional people, we have to admit that animal products are different from plant or mineral-based ones. Animals are slightly different forms of life. They carry unique features of nature and bear a closer resemblance to humans than plants or minerals do. This uniqueness was noticed by ancient people, and those ancient people sought assistance from these animals in their medicine.

A Doctrine of Signatures

The doctrine of signatures is a common method of investigation inside many forms of traditional medicine. This principle suggests that what something looks like in nature, suggests what it has an affinity for in the body. Fro example, Walnuts appear somewhat like the human brain and so tend to promote brain function. Beats are red like blood and contain vitamins and minerals that create healthy blood. Examples of this principle are numerous and found constantly in different cultures all over the world.

It’s important to remember that the doctrine of signatures is not the end of an investigation, but the beginning. After a similarity is witnessed with a substance and the body, experimentation begins. And after experimentation has been exhaustively conducted, there is debate about the usage and function of each particular substance in a given context.

Far too often, we ascribe a kind of archaic simplicity to the reasoning of our ancestors. But the more we examine ancient people, the less foolish they appear to be. The symbols earlier humans used to describe life often have a multidimensional meaning and function. The non-specific nature of each symbol allows it to outline a broad type of experience without being constrained by particular details. This makes a symbol the perfect articulation for a kind of experience instead of an individual one. The doctrine of signatures is just one way that the natural intelligence of bodies and their environments manifests.

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Worms for Wind

Worms move in a way that appears very similar to humans when we are convulsing (like in a seizure or stroke). Convulsions may come on without much warning and be chaotic in nature. This quality of movement and appearance is like wind.

Once the convulsions end, certain parts of the body may be closed down or opened inappropriately. Paralysis may ensue. The channels that the body uses to communicate information have become obstructed. This obstruction requires the influence of an agent that knows how to get into tiny places and unblock them. This is where the worms come in.

It’s Important to remember that the doctrine of signatures is a method of explaining the gesture of a medicinal and not necessarily a description of its physical action. The application of an insect medicinal takes place after the insect has died and been processed. In the case of Chinese medicine, our bug medicinals are most commonly put together with other herbs and then simmered in water to be taken in the form of a decoction or tea. In certain applications, they are charred and powdered for topical remedies but never used in live form.

The heading information for each medicinal was taken from Benskey’s Materia Medica (3rd Edition) unless otherwise stated. Please refer to this text for more detailed information.

Dì Lóng 地龙
Latin: Pheretima
English: Earthworm
Properties: Salty, Cold
Channels Entered: Bladder, Liver, Lung, Spleen
Functions: Drains Heat, Extinguishes Wind, Stops Spasms & Convulsions, Calms Wheezing, Unblocks the Channels, Facilitates Urination

One of my teachers in Chinese medicine school would emphasize that earthworms look a little bit like the bronchioles of the Lungs. This, he thought, gave them an affinity to deal with long-standing lung problems.

During the Spring, di long crawls through the soil and begins the aeration process for the season ahead. It’s important to note that including air, the soil is opened up for the water cycle of Spring rain. Unclogging the tight soil for air and water to flow is precisely what di long helps the human body to do; unblocking the body’s breathing and urination.

Internally, di long is most often used in post-stroke and seizure remedies to unblock the channels and help a person recover the functioning of paralyzed tissues. But di long can also be used in a variety of chronic lung problems. It makes a great combination with sang bai pi (mulberry root bark) and si gua luo (luffa) for folks who have a cough with lung weakness due to a history of suppressed lung problems (such as pneumonia during childhood).

Dosing di long does not even need to be that high! As few as three to nine grams per day is enough to make a substantial difference in a person’s case. The most common way for internal administration of this medicinal is through ingestion via decoction, powder, or pill.

Externally, di long can be ground with sugar and applied topically to treat burns and ulcerations.

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Jiāng Cán 僵蚕
Latin: Bombyx Batryticatus
English: Mumified Silkworm
Properties: Acrid, Salty, Neutral
Channels Entered: Liver, Lung
Functions: Eliminates Wind, Drains Heat, Transforms Phlegm, Disperses Clumping

Jiang can is a white silkworm in its cocooned stage. Not only does the silkworm move in a similar fashion to the earthworm (like convulsions or wind), but the processing involved in preparing this medicinal for use includes stopping its growth or life by wind. Because this medicinal has been mummified by wind itself, it has an extra affinity for treating disorders that appear wind-like in the human body.

Internally, jiang can is often combined with di long to treat post-stoke and seizure disorders. It can be combined with other herbs to treat acute febrile illnesses, especially ones that include phlegm and congestion.

Jiang can separates itself from di long in two ways. The first has to do with it’s white color and acrid flavor. These two characteristics allow for the ability to treat phlegm and thick fluids in the body. One of my teachers used to say that if you crush jiang can up, it actually looks like phlegm. While one might argue that this could be the case for many herbs, it is certainly true of jiang can.

The acrid flavor of jiang can also helps to vent superficial pathogenic influence. Sensation of itching or bugs crawling underneath the skin, can be treated by this medicinal (with or without the manifestation of a rash).

The second and perhaps more notable difference in the focus of these two medicinals is that jiang can goes to the throat and treats nodules of phlegm and stagnation there. It performs this action quite well when combined with xia ku cao (prunellas spica), zhe bei mu (fritillariae thunbergii bulbus), and mu li (oyster shell).

Similarly to di long, dosing jiang can does not need to be very high! Three to nine grams per day is a more than effective dose to begin in most cases.

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Yin Crawlers for Yin Problems

Some bugs happen to live and grow in the murky places of our planet. What may we deduce from this? Well, a creature who thrives in the cold, dark, and damp may have an affinity for Yin.

In ancient Chinese cosmology, Yin and Yang represent the two apparent opposing aspects of our living experience. All things may be divided into Yin and Yang. Yang can be classified by the qualities of brightness, expansion, warmth, and expression. Yin can be classified by the qualities of darkness, contraction, cold, and introspection. Both are needed for the other to exist. Both may create or destroy the other. Either may be used to antagonize the other. Studying the way Yin and Yang interact is a basic study for any of the classical Chinese arts - including medicine.

Bugs that live and grow in water have a special ability to treat problems that are water-like. These are Yin problems of the body - lack of movement, stagnation and decay of fluids, the formation of tumors and masses, and poorly circulating blood. These symptoms, while variant, often result in the creating same experience - horrible amounts of pain. For when Yin gets stuck without enough Yang, disharmony is conclusive.

Shuĭ Zhì 水蛭
Latin: Hirudo
English: Leech
Properties: Salty, Bitter, Neutral, Slightly Toxic
Channels Entered: Liver, Bladder
Functions: Breaks up Static Blood, Disperses Stagnation

As the primary example of a water bug, shui zhi crowns itself queen of the medicinals that conquer Yin pathogenic influence in the human body. As shui zhi’s nature implies, pathologies that have landed in the lower body are its specialty to work on. Shui zhi’s salty flavor enters the blood aspect of the liver, targeting patterns of static blood which have yielded masses in the abdomen.

Shui zhi is perhaps the most focused bug medicinal. In addition to its action of guiding other herbs deeply within the body, shui zhi is said to have the ability to “break up old blood stasis without damaging new blood.” (WAtR, 135) According to the revered physician Zhang Xi-Chun, the hirudo leech has an affinity for carefully finding old blood because it seeks out and consumes blood during the course of its life. Whatever the reason may be, shui zhi’s medicine seems to be the most precise and effective bug medicinal to use in the case of chronic blood stasis, especially in the presence of substantiated accumulations.

Because of the growing popularity of shui zhi as a medicinal, prices on the herbal market have begun to increase making shui zhi quite an expensive ingredient. In the interest of keeping the price of herbal medicine affordable, the practitioners at Root & Branch have discovered that adding even as little as one to two grams of shui zhi to an herbal formula per day is enough to make a huge difference in most cases. It should be noted however, that for best results, three to five grams per day is recommended.

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Tŭ Biē Chóng 土鳖虫
Latin: Eupolyphaga/Steleophaga
English: Wingless Cockroach
Properties: Salty, Cold, Slightly Toxic
Channels Entered: Liver, Heart, Spleen
Functions: Breaks up Blood Stasis, Renews Sinews, Joints and Bones

Salty and cold, tu bie chong lives in the ground or in the walls and floors of urban buildings. Its affinity for darkness makes it an ideal medicinal in the conquering of Yin based accumulations: static blood, masses & tumors in the abdomen.

In addition to Yin pathogenic influence, tu bie chong works exceptionally well at healing injuries, bone breaks, and sinew or tissue damage. This is because the cockroach heals itself well in life. If tu bie chong is cut in half and then re-attached, it will heal and continue to live! The doctrine of signatures suggests that this potential is activatable in medicine. This is especially the case when tu bie chong is combined with the resins of trees: Olibanum (rŭ xiāng) and Myrrha (mò yào).

The recommended dosage of tu bie chong is between three and twelve grams per day. One of the best things about this medicinal is that its cheap! For the time being, tu bie chong makes a great add-in to any herbal formula needing guidance into the deeper blood level of the body. It also makes for a good substitute for shui zhi or meng chong on a tight budget.

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Yang Fliers for Fast Action

Some insects can fly and are attracted to light. They move and exhibit a buzzing sound, rapidly flapping their wings. This activity makes these creatures more like Yang. Yang is fast, agile, bright and big in its movement. It transforms turbidity and stuckness through an excited kind of Qi. While Yang transformation is successful, it normally requires a more stable partner for its transformations to be lasting.

Méng Chóng 虻虫
Latin: Tabanus
English: Horse Fly
Properties: Bitter, Slightly Cold, Toxic
Channels Entered: Liver
Functions: Quickly Breaks up Blood Stasis

Widely regarded as the most Yang bug medicinal, meng chong specializes in its fast-acting approach to transforming static blood accumulations and masses.

Meng chong flies in the air, buzzing around with a high frequency in life. When taken as a medicinal, meng chong’s bitter flavor combines with its Yang nature to quickly transform and purge accumulations. Though fast-acting, meng chong’s activity is relatively short lived. For this reason, it is normally combined with a more Yin-natured medicinal such as shui zhi to lengthen its medicinal effect.

Because of the rarity of meng chong as a medicinal, prices on the herbal market have begun to increase making meng chong quite an expensive ingredient. In the interest of keeping the price of herbal medicine affordable, the practitioners at Root & Branch have discovered that adding even as little as one to two grams of meng chong to an herbal formula per day is enough to make a huge difference in most cases. It should be noted however, that for best results, three to five grams per day is recommended.

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Case Study: Chronic Cough

62 yr. Sys Male

History
Patient reported a history of chronic dry cough for ten plus years (no memory of initial onset). The cough was mild and unremarkable unless the patient would catch a cold. Once caught, the cold would move quickly into the chest and linger for as long as two or three months. The cold would typically manifest with a dry cough, extreme fatigue, and difficult to expectorate phlegm.

The patient also reported catching pneumonia when he was eight years old that was treated with antibiotics.

First Appointment
Patient caught a cold six weeks prior to the initial visit. Though the acute symptoms had mostly resolved, a dry cough and fatigue remained. The cough was bothersome throughout the day and only through the night if the patient awoke for a time. No phlegm was expectorated while coughing, but there was a sensation of fullness in the chest and the epigastrium. Patient reported a neutral body temperature, but a preference for warmth, and no sweating. “I never sweat,” he said. Patient was able to fall asleep easily, but would sometimes wake around 3 AM with racing thoughts and heart palpitations. Occasionally he would be unable to fall back asleep for several hours. The patient had to get up 2-3 times per night, on average to urinate. Appetite, digestion, and bowel movement were all unremarkable.

Tongue
Slightly pale, thicker white coat, red tip, engorged sublingual veins.

Pulse
Overall: tight, muffled, robust
Cun positions felt very muffled but robust and superficial.
Right Cun was slightly scattered, with a Yang Wei pulse indication.
Guan Positions were wiry and tight.
Chi positions were deep and weak.

Diagnosis
Wind-Cold Painful Obstruction of the chest (Bi Syndrome)
Obstruction of the upper burner resulting in clumping of the Qi
Lung Qi unable to descend

Formula
Zhi Shi Xie Bai Gui Zhi Tang (Granule)

Gua Luo Xie Bai Ban Xia Tang 60 g
Zhi Shi 8 g
Gui Zhi 10 g
Hou Po 8 g

Dosage: 6 grams 2 times per day for 7 days.

Second Appointment (one week later)
Patient reported improvement with both cough and energy level. He had expectorated some very thick yellowish phlegm throughout the week and was feeling much better. His middle of the night waking had also decreased, as did the palpitations and feeling of fullness.

Because the patient had to leave town for several weeks, I gave him two more weeks worth of the same formula and told him to get in touch with me once he was back in town.

Third Appointment (one month later)
Patient reported gradual improvement for the first week after the second appointment and then no more improvement. His cough had “gone back to normal” and was now mild, dry and intermittent throughout the day. His sleep had improved, but he would still wake up 2-3 times to urinate per night. He was slightly fatigued throughout the day. All other reviewed systems were unremarkable.

Tongue
Pale-red, dusky, thin white coat, red tip, engorged sublingual veins.

Pulse
less tight than before…
Cun positions were now deeper (about mid depth) and very scattered, but still robust.
Right Cun position still had a Yang Wei pulse indication
Middle positions had become more superficial but were mostly unremarkable
Chi positions were slightly stronger, but still deep and weak overall.

Diagnosis
Blood Stasis in the Upper Jiao
Kidney Qi Deficiency
Kidney failing to grasp Qi

Formula
Jin Fei Cao San with modifications (bulk decoction)

Xuan Fu Hua 9g
Bai Shao (Chao) 9g
Gan Cao 6g
Tao Ren 9g
Dang Gui (Chao) 9g
Di Long 3g
Sang Bai Pi 9g
Zi Wan 9g
Si Gua Luo 6g

Dosage: per day.

Result
After one week, the patient’s cough had completely subsided. I prescribed a similar version of the above formula over the next few months, slowly removing the stop cough and heat clearing medicinals and replacing them with herbs to supplement the Kidney and Lung Qi.

Six months later, the patient’s cough had not returned.

Analysis
The patient’s medical history indicated a long-standing lung weakness. This was likely due to, or aggravated by the occurrence of pneumonia during childhood. In my clinical experience, the Yang Wei pulse indication is a confirmation of this weakness.

The patient’s presenting symptoms of cough, feelings of fullness and pulse led me to believe that the pathogenic influence was stuck in the chest. Preference for warmth and lack of sweating made me lean toward a cinnamon based remedy. This case is clearly one of mixed excess and deficiency. I chose Zhi Shi Xie Bai Gui Zhi Tang to restore the functional movement of Yang Qi, dissipate clumping and expel phlegm.

Once the acute pattern of obstruction was addressed, the residual, more deeply rooted pattern of blood stasis began to show itself. The cun pulses got deeper and more scattered. The engorged sublingual veins and the continuation of the Yang Wei pulse all pointed to the need for herbs that could enter the luo mai.

Formula Breakdown
Xuan Fu Hua, Bai Shao Yao and Gan Cao were chosen as chief ingredients in the formula. These herbs were selected to liberate the Qi dynamic from obstruction and allow the descent of the Lung Qi. Xuan Fu Hua has a salty flavor and some sources say that it assists the Kidney in grasping the Qi. It is also commonly thought of as the only flower that directs downward. Bai Shao and Gan Cao make up the formula Shao Yao Gan Cao Tang, which is used moderate the spasmatic deficiency-related tendency for cough.

Tao Ren and Dang Gui were used to open the blood vessels and move the blood. These two ingredients also have a slightly moistening affect on the Large Intestine. The Large Intestine is the yang pair of the Lungs. Keeping the Large Intestine clear is a useful strategy when promoting the descent of Lung Qi.

Di long and Si Gua Luo are an herb pair used by Dr. Greg Livingston to drive the formula into the luo mai. Di long was selected because of its affinity for the lung and bladder channels - opening up the bronchioles of the lungs and promoting the smooth movement of the water passageways. Si Gua Luo is the luffa vegetable sponge. It looks like the lung’s bronchioles and is one of the only non-bug medicinals that is able to access the luo mai.

Sang Bai Pi and Zi Wan are dynamic cough medicinals used in cases of both excess and deficiency. Sang Bai Pi is sweet and cold, while Zi Wan is acrid, bitter, and warm. Together they are able to able to treat a variety of cough-related consumption patterns.

Why No Qi Tonics?
Because of the robust nature of the pulse in the cun pulse positions, I decided not to include medicinals that directly tonify the Lung’s Qi in the first formula. I felt that the salty flavor of Xuan Fu Hua and Di long were enough to encourage the movement of the Kidney’s grasping ability. In future renditions of the formula, I included various aspects of the formulas Sheng Mai San and Shen Qi Wan in order to tonify deficiency.

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The Cultivation & Understanding of Traditional Medicine

Practicing a traditional medicine in modern times has many challenges. One of the biggest challenges comes when we try to communicate the difference of perspectives between the ancient and modern worlds. Perspective shapes the reasoning for action. It creates a context for why a particular medicinal would be prescribed or not. Understanding perspective is necessary before judging the method. And far too often today, we learn to judge before attaining this understanding.

Using insect-based medicinals has been one of the most valuable clinical insights for me. In the short span of my career as a Chinese medicine practitioner, I have been able to help numerous people with the knowledge that I have shared above. I am certainly no where near mastery of the art and science of Chinese medicine. Even so, I hope that the information presented in this article may be of use to practitioners who have the intelligence and skill to employ it.