The Chinese Medicine Perspective on Fibrocystic Breasts

Fibrocystic breast disease refers to the cobblestone lumps which can be present in the breast and which change in size, shape, and discomfort usually in relation to the menstrual cycle.  Fibrocystic breasts are considered in Western medicine to be so common that it is a variation of normal, and because there is no disease progression recognized as such, it is more and more frequently referred to by doctors as fibrocystic breast condition, mammary dysplasia, or benign breast disease. (5)  In Chinese Medicine, however, fibrocystic lumps are considered to be stagnation of qi, phlegm, heat, damp, or a combination of those four.  It is also unclear in either western or Chinese Medicine whether or not fibrocystic breasts are simply the first phase in a progression toward malignancy.  I think it is important to take into account the phenomenon of fibrocystic breasts from the perspective of Chinese Medicine contrasting the theories of renowned acupuncturists Jeffrey Yuen, Giovanni Maciocia, Honora Wolfe, and Bob Flaws. 

While three of the four of the above experts in the field of Chinese Medicine assert that it is a progression of phlegm stasis, each of the acupuncturists has different views of the etiology, progression, and treatment.

Let us begin with Maciocia, and his thorough exploration of breast lumps.  Maciocia calls fibrocystic breast lumps the most common benign condition of the breast.  In Chinese Medicine he differentiates them as “phlegm with qi stagnation.” Interestingly he states that the condition affects the left breast more often than the right and affects women in the northern hemisphere more from December to May when the ovaries are more active and is most often found in women over thirty.  He claims that from a western perspective the etiology lies in the fact that the breasts are preparing for milk production during the first part of the cycle too enthusiastically and not draining effectively enough in the latter part of the cycle.  This process can cause swelling and result in cysts. (1)  

In Chinese Medicine, these lumps are referred to as  Ru Pi, or benign lumps and are caused by qi and phlegm stagnating.  Emotional problems are the primary etiology in the case of Ru Pi according to Maciocia.  “worry, pensiveness, sadness, bitter weeping, anger, frustration, resentment, hatred, and other negative emotions can cause stagnation of qi”  this will eventually lead to blood stagnation which forms masses.  Another result of these emotions is stagnant qi over a long time may “implode” to cause fire and toxic heat.  Maciocia points out that the liver is not the only organ affected by qi stagnation.  The heart and especially the lungs are affected because of grief depleting qi and causing stagnation.  This can be emphasized by the fact that these two channels travel through the chest. (1) 

But easily the two most important channels in breast lumps are the liver and stomach channels as they travel directly to the breast and have a direct correlation with the function of the breast and formation of breast lumps.  However he differentiates Ru Pi as being caused primarily by liver qi stagnation and phlegm.  Also, says Maciocia, qi stagnation may be secondary to deficient liver and kidneys affecting the Ren Mai and Du Mai.  In summary, Maciocia therefore implicates stagnation of qi, stasis of blood, phlegm, toxic heat, and liver and kidney deficiency as the primary etiologies.  Differentiation, as in every disharmony in Chinese Medicine is the most important factor in treating fibrocystic breast lumps, or Ru Pi. (1)

Jeffrey Yuen, in contrast, talks much less about stagnation, but more on the hormonal aspect of breast cysts.  Based on his three part series on gynecology, he describes fibrocystic breasts as the result of a few bodily processes.  Firstly overactive ovaries, from a hormonal point of view, cause over-activity in the breasts.  This can translate into fibrocystic, benign breast lumps.   Yuen claims that “if you regulate ovarian function, the cyst[ic breasts] will disappear.”   In a very basic sense, he says, any disorder where there are cysts, tumors, or masses of any kind, there is a dysfunction in the anterior lobe of the pituitary, which controls the Governing Vessel, spine, yang, metabolism, and sympathetic nervous function.  This disorder, in turn, means that “jing is going to the wrong places.”  In other words, fibrocystic breasts are deposits of jing where they are not supposed to be.  (2)

From another perspective, cystic breasts, Yuen says, are an issue of ascendant liver yang.  This is hyperparathyroid function with the host of liver yang ascendant symptoms:  red eyes, irritability, headaches, premenstrual changes.  This is similar to Maciocia’s idea of stagnation of pathology of the liver channel, though Yuen has a different spin. (2)

From yet another angle, Yuen implicates a Dai Mai disharmony in fibrocystic breast changes.  When the Dai Mai constricts, as it can, the large intestine is constricted as well, and with St 25 relationship with the Dai Mai and the breast, the large intestine mu point can’t communicate with the lungs, the breasts get very distended and cystic breasts can develop.  The Dai Mai, of course, is an absorber, if flushes all of the toxins and if it is constricting then there is an accumulation of toxins in the stomach channel thereby affecting the breast.

The Chong Mai can also be a player in fibrocystic breast disease according to Yuen.  The second pathway of the Chong Mai goes into the intercostals spaces, into the ribs and most especially into the breast.  When there is stagnation of blood, qi, or phlegm in the Chong Mai, these lumps can develop. (2) 

So these descriptions of etiology from Jeffrey Yuen suggest many routes to the same destination.  But ultimately the culprit is stagnation of some sort in each case.  And treatment, obviously, depends on the imbalance.  In the case of Dai Mai constriction, open the Dai Mai.  In the case of Chong Mai, treat the Chong.  In the case of ovarian overactivity, treat the Du.  (2)

Honora Wolfe has another perspective on fibrocystic breasts.  She is a firm believer in the idea that fibrocystic breasts are only a progression toward malignancy.  In her book The Breast Connection, she writes “It is one thing to have some PMS symptoms with tender or swollen breasts each month for a few days.  It is quite another to have carcinoma of the breast.  The process of getting from one to the other is complex, but according to Chinese Medicine, there is a very logical progression from distention to neoplasm.”  (4) Wolfe and Flaws purports that fibrocystic breasts are simply the result of stagnation, be it stagnant blood, food, dampness, phlegm, fire, or qi.  Primarily liver qi stagnation is the culprit. Although any of these stagnations, in any combination in the liver or stomach channels, can cause fibrocystic breasts which almost inevitably, she suggests, without treatment, becomes cancerous.  Wolfe does emphasize that with proper treatment, breast lumps are reversible at any stage, but the stagnation must be cleared from the body.  Wolfe supports the usage of Yue Jue Wan, a formula designed to promote movement of qi and relieve constraint.  Made up of xiang fu, chuan xiong, cang zhu, zhi zi, and shen qi it addresses all the primary forms of stagnation. (3)

Wolfe focuses on four treatment principles for women to arrest development and even reverse breast lumps.  First and foremost she recommends daily relaxation such as meditation, yoga, biofeedback, or just a simple audio guided relaxation for women to reverse liver qi stagnation.  She is specific that it must be done twice per day at least ten minutes each session for at least 100 days to see the effects.  The second in her protocol is exercise of an aerobic nature which she says must performed at least every other day.  The third protocol is making dietary adjustments including cutting out all caffeine, alcohol, meat, greasy, fatty, or oily foods, spicy foods, and smoking.  And lastly she advocates for professional therapies such as acupuncture, of course! (4)

Each of these respected acupuncturists has a slightly different perspective on fibrocystic breast condition, and each their own assertions and treatment strategies.  Fibrocystic breast condition is easily resolved in Chinese Medicine as well, though not well-addressed at all in Western Medicine.  The usual treatment for the condition in Western medicine is either aspiration of the lumps or dietary recommendations.  Some recommend vitamin E and avoidance of caffeine.  These can make a difference.  Most recently it seems to be a throwing up of hands and calling it “normal”. 

References:

1.  Maciocia, Giovanni. Obstetrics and Gynecology in Chinese Medicine. 1998.  Toronto: Elsevier.

2.  Yuen, Jeffrey C. Gynecology: Transcribed by Brandon Horn from a 3 part series beginning August 1992.

3.  Wolfe, Honora Lee and Flaws, Bob.  Better Breast Health Naturally.  1998.  Boulder.  Blue Poppy Press.

4.  Honora Lee Wolfe:  The Breast Connection:  A Laywoman’s Guide to the Treatment of Breast Disease by Chinese Medicine. 1989.  Blue Poppy Press. 

5.  http://health.google.com

Treating Depression: Western and Eastern Models and Perspectives

Depressive disorders are defined by the Western medical model as persistent low mood,   “unremitting feelings of sadness and despair, loss of interest and enjoyment,” and reduced energy often impairing day to day functioning. (2)  The Diagnostic and Statistical manual of Mental Disorders (DSM-IV) divides depression into major depressive disorder and dysthymic depressive disorder.  Major depressive disorder is characterized by one or more major depressive episodes of at least two weeks in duration plus four additional symptoms of depression.  Dysthymic depression is characterized by two years of depressed mood for more days than not plus additional depressive symptoms. 

Depressive disorder is common, with a prevalence of major depression between 5% and 10% of people seen in primary care settings. (2)  Though the lifetime prevalence rate for depression ranges from 8% to 20% of the population. (3) Women are affected twice as often as men in all patterns of depression.  People born after World War II have almost ten times the depression rate of their parents and grandparents. (9) While the disorder is often stigmatized and minimized by Western medicine, depressive disorders are the fourth most important cause of disability worldwide and they are expected to become the second most important cause by 2020. (2)  There is also a strong genetic basis for the development of mood disorders and the strong tendency for mood disorders to run in families has encouraged a search for the abnormal gene or genes although no definitive study has yet emerged. (3)

Treatments abound in Western Psychiatry with varying results.  Antidepressants such as monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs) act by increasing the level of monoamines through different mechanisms.  However, depression does not appear to result simply from a reduction in monoaminergic activity, and thus it is still unclear how exactly these drugs affect the mood.  Further, these drugs have significant side effects including sedation or agitation, insomnia, dry mouth, significant weight gain, cardiac dysfunction, nausea, and sexual dysfunction including impotence in men. (3)

Other Western treatments for depression include interpersonal psychotherapy, cognitive therapy, and when patients are not responding to antidepressant medication, are pregnant, psychotic, or suicidal, ECT or electorconvulsive therapy is implemented.  In individuals with recurrent depression, lithium sometimes is used during long-term maintenance to prevent further relapses.  Additional therapies listed in BJM include St. Johns Wort, exercise, and befriending. (2)

Eastern medicine approaches depressive disorders quite differently.  Historically in Chinese medicine, depression was called Yin Yu, ‘gloominess’ or Yu Zheng, ‘depression pattern’ with Yu presenting a double meaning of ‘depression’ and ‘stagnation’. (7)  In Simple Questions, Chapt 71 mentions the five stagnations of Wood, Fire, Earth, Metal, and Water.  The Complete Book of Jing Yue discusses six emotional stagnations of anger, pensiveness, worry, sadness, shock and fear. “In the six stagnations, stagnation is the cause of the disease.  In emotional stagnation, the disease [i.e. the emotion] is the cause of the stagnation.”

Zhu Danxi (13^th Century) discussed six depressions (liu yu)  similarly discussing depression from a perspective of the physical and emotional aspects as one and the same, or resultant of each other. These were outlined by Liu Yiren in the 19^th Century book Heart Transmission of Medicine:  “So long as the qi and blood enjoy harmonious flow, none of the hundreds of diseases can arise. Once they are depressed and suppressed, various diseases are produced.’ In general, depression is part of any disease. If depression endures, it will generate disease, or, if a disease has endured, depression will be generated. Therefore, to treat any disease, one has to take depression into account in the treatment scheme.” (1)

The liver is generally considered to function similarly to the nervous system in Western medicine and depression in modern Chinese medical theory generally centers around the liver, usually in the form of liver qi stagnation with or without complicating heat and phlegm. In these cases qi regulating and stagnation reducing formulas like Xiao Yao Wan, Yu Ju Wan, and others are very important. However, empty patterns appear in long term depression with such patterns as spleen and heart blood deficiency, heart-yang deficiency, and liver blood deficiency. (7) In these cases herbal formulas that tonify qi and blood are effective. Treatment of depression in Chinese medicine, therefore, primarily involves treating a pattern or disharmony with a carefully considered point prescription in conjunction with an herbal prescription based on that pattern. 

However, there are some treatments for depression that do not seem to have been conceived in the context of a pattern of disharmony. In Acumoxa Therapy Treatment of Disease, depressive disorder is categorized in a more Western approach as its own pattern with symptoms such as “dejection, mental dullness, progressing to incoherent speech, mood swings, taciturny, somnolence, and anorexia.”  The treatment principle is to clear the heart with Bl-15, remove liver stagnation with Bl-18, promote spleen qi circulation with Bl-20, fortify the heart with Ht-7 and transform phlegm in the middle burner with ST-40. (8)  This point prescription looks very much as if it were treating the five stagnations.

Another contemporary perspective explores the use of local points.  In the majority of cases, it can be said that shen disorders are treated by a combination of local points of the head and neck, especially GV-20 and sishencong at the top of the head, GV-14 and GV-15 at the neck- where the meridian enters the brain; and GV-23 and GV-26 at the face) plus distal points, with a focus on points of the wrist/hand and ankle/feet. Some acupuncture points were named for their effect on shen disorders, such as shenmen (HT-7), shenting (GV-24), shentang (BL-24), shendao (GV-11), shenzhu (GV-12), benshen (GB-13), and sishensong (M-HN-1). So, these are often included today as part of a treatment based on traditional indications for the points. (6)

Contemporary Eastern herbal studies with depressed patients have also yielded many positive results.  One such study using Chai Hu Gui Zhi Gan Jiang Tang (a formula in the harmonize shao yang stage disorder category) documented in the American Journal of Chinese Medicine, was tested on peri- and post-menopausal women for the treatment of the symptoms of insomnia, menopausal symptoms and DVM-IV classified depression.  The results were dramatic.  Plasma IL-6 and sIL-6R concentrations were significantly lower (i.e. alleviation of symptoms) in the Chai Hu Gui Zhi Gan Jiang Tang tested group than the group prescribed antidepressants after three months of treatment. (5) And given what we know about the side effects of antidepressants versus those of Chinese Herbs, the results are doubly successful.  

Another herbal study found Cyperus to be particularly helpful in the treatment of depression alone as well as in combination with other minor herbs.  Saffron too, it has been discovered, is proven to be successful in treating depression as well as autism, ADD, Parkinsons and others. (3) 

Lifestyle changes can also be quite important in treating depression from the perspective of Chinese medicine.  Regular exercise like qi gong which helps to tonify and move qi is extremely important to the wellbeing of the patient.  Walking daily moves liver qi and is also quite helpful.  Yoga, the precursor of Qi Gong is also highly beneficial.  Meditation and colored light therapy have also been successful in the treatment of depression. Adequate sleep, taking care not to exhaust the body with work, and avoiding excessive sexual activity are also important in allaying depression in Chinese medicine. (1)

Diet is of the utmost importance in treating depression from the perspective of Chinese Medicine.  Excess sugar, alcohol, and fats which all compromise the liver should be avoided.  Also excess sour foods take their toll on the liver and should be avoided.  Diet should be tailored to the specific pattern of the patient depending on the pattern of disharmony.  In the case of depression due to blood deficiency, for example, blood building foods should be incorporated such as beets, lean red meats, and millet.  Foods should also all be cooked and served warm to benefit the spleen for blood production.  In general there are foods that relieve depression in the short-term according to Paul Pitchford:  brown rice, cucumber, apple, cabbage, fresh wheat germ, kuzu root, wild blue-green micro-algae, and apple cider vinegar. (9)  These can be taken while the liver is being renewed.

There is an enormous amount of research, study, and a sea of treatment strategies for depression in both Western and Eastern medicine.  The primary difference between the two systems is that in Eastern medicine depression is considered part and parcel of the physical disharmony.  There is no distinction of a mental disorder because it cannot be divided from the body. In Western medicine depression is considered the domain of psychology and psychiatry, carries quite a stigma both medically and socially, and doesn’t lend itself to be categorized as a disease process as such.  In general, combining some components of Western therapy with Eastern medicine to treat depression appears to be the most effective approach.

References:

1.  Yang Shouzhong (translator), The Heart Transmission of Medicine, 1997 Blue Poppy Press, Boulder, CO

2. United Health Foundation, BMJ Clinical Evidence Concise, December 2004

3.      Subhuti Dharmananda, Ph.D., Saffron, an Anti-depressant Herb  ITMonline.org

4.      Kathryn L. McCance, Sue E. Huether.  Pathophysiology: The Biologic Basis for Disease in Adults and Children.  Mosby. St. Louis. 1997

5.      Ushiroyama, Takahisa, et al., Chai-Hu-Gu-Zhi-Gan-Jiang-Tang Regulates Plasma Interleukin-6 and Soluble Interleukin-6 Receptor Concentrations and Improves Depressed Mood in Climacteric Women with Insomnia. The American Journal of Chinese Medicine 2005; 33 (5): 703-711

6. Gu Shizhe, et al., Four acupuncture methods for treating mental disorders, Journal of Traditional Chinese Medicine 2001; 21(3): 207-210.
7. Maciocia, Giovanni.  Diagnosis in Chinese Medicine: A Comprehensive Guide 1988. Elsevier Ltd.
8. Feit, Richard and Zmiewski, Paul.  Acumoxa Therapy Treatment of Disease vol II.  1990.  Paradigm Publications.
9. Pitchford, Paul.  Healing with Whole Foods: Asian Traditions and Modern Nutrition. 2002. Berkeley. North Atlantic Books.

Chinese Medicine for my Littlest Patients

Eleanor McLamb, Lutea's littlest fan.

If you are a parent you have probably known the worry, the anxiety, and the absurd exhaustion from sleepless nights up with a sick child.  You have probably made hard decisions about what doctor to see, what medicine to take, and what alternatives to try.  As a mother I've struggled with difficult healthcare decisions for my daughter even as I was studying Chinese Medicine from some of the greatest pediatric acupuncturists in the country.  The question shouldn't be: should I use conventional or natural medicine, but to know when each is appropriate.

When my daughter was three-years-old she became suddenly ill with a fever of 104 and began to have trouble breathing until she began turning purplish-red gasping for breath.  I was not yet a practitioner so I bundled her quickly into the car and rushed her to our acupuncturist, Rachel.  Once in the treatment room, Rachel put in four needles and applied suction cups to her little back and within moments she was breathing normally.  We administered an herbal tincture and by the time we got home her fever was down and she was fast asleep.  I become overwhelmed with gratitude when I think of this incident and saddened thinking of the parents who don't know of this option that might have rushed their child to the emergency room to receive steroids, fever reducers, inhalers, and likely charged far more than the $30 that I paid for the amazing and compassionate service we received that night.  The most gratifying thing for me as an acupuncturist now, is being on the other end and helping children just as my daughter has been helped. 

Of course, not all acupuncture treatment for children is so dramatic.  But in my experience gained from treating many children, they respond even better and more quickly to acupuncture than adults.  This, for me, is the best argument that acupuncture is not placebo.   I see real results everyday with absolutely no side effects.  I talk to parents who are worried that their child would not accept an acupuncture treatment.  To that I respond that the needles I use for children are hair-thin, and if the child is apprehensive I can work just on the child's back so they aren't worried by seeing the needle.  Essential oils are also quite effective for children and I use a wide array with great results.  Cupping, massage and acupressure, gua sha (gentle scraping with a porcelain edge), and even a tuning fork are some of the other methods I use for children.  I also teach parents many of these techniques to do at home. Some of the more common childhood ailments that I have successfully treated include:

• Nausea and vomiting.  This can be relieved in moments with a few points.  Though care must be taken.  If there is food poisoning or some other toxin, vomiting is an appropriate response.  But if the nausea or vomiting is ongoing or related to a stomach bug or other virus it can be easily remedied with acupuncture and herbs.
• Upper Respiratory Infection (URI, common cold)  this can be helped easily with acupuncture best at the beginning signs of illness
• Asthma.  As mentioned above, cupping and a few empirical points can stop an acute attack in its tracks, and regular acupuncture can prevent attacks.  I have seen the seemingly miraculous effect this has for children and the relief it brings to parents as well.
• Ear Infections.  Ear pain can be eased immediately with acupuncture and recurrent use of antibiotics for repeated infections can be lessened and even stopped.  Some medical literature coming out now even reports that antibiotic use can create a cycle of ear infections.  
• Night Terrors and other sleep disturbances.  I so frequently hear parents frustrated that their children just won't go to sleep, won't stay asleep, and sometimes wake up screaming from night terrors.  Acupuncture is very effective at leveling out sleep in children and adults.  
• Chronic Cough.  Walk into any elementary school classroom this time of year and you will often hear a chorus of coughing.  Often this is worse at night.  Chinese Medicine can work almost immediately for this malady.  Try rubbing a little Eucalyptus Radiata or German Chamomile essential oil on the bottoms of the feet of a coughing child.  In mild cases this usually works quickly.
• Diarrhea, constipation, and "tummy ache".  Herbal remedies work quite well and quickly for this.  Often I can do two points on a child and there is change within an hour.  Hand and foot massage can also work wonders in chronic cases.  This is something the parent can learn quickly and use at home on a daily basis.

These are just the most common. Chinese Medicine can help colic, thrush, teething, strep throat, bed-wetting, allergies, eczema, hives, nosebleeds, and many others.  My daughter has become used to asking for "a treatment" whenever she doesn't feel well.  She just knows that it makes her feel better.  She has also never had a round of antibiotics and never taken a fever reducer.  She also knows that we limit our sugar intake, our dairy intake, and eat fermented foods everyday to stay healthy.  (I will talk more about dietary therapy in a future post.)  

For the record, I greatly value Western medicine.  It has many redeeming qualities.  If I sustain a serious wound, don't take me to an acupuncturist.  I prefer the ER.  If I have a life-threatening infection I will probably take antibiotics.  But all too often, the medications prescribed by MDs for mild conditions are overkill for children.  I liken it to killing a fly with a hammer.  Our children are sacred and beloved to us and we as parents deserve to know our options.  Chinese Medicine isn't the only option, but it is an ancient system of medicine that has many options within it.  It is what my family and many others use as primary health care with great results.  It isn't expensive, it is completely safe, and it doesn't have side effects.  As my friend Todd asks, "When did natural become the alternative?"

Breathe Deeply

"The wise strengthen their breathing to strengthen their qi." --Taoist Aphorism


"To our ordinary consciousness, breathing only serves to maintain our body.  But if we go beyond our mind, breathing can open up a completely new foundation for our life." --Ilsa Middendorf

Notice your breath right now.  Are you breathing  in your chest?  Does your abdomen expand when you breathe?  How is your posture?  Do you find yourself holding your breath during the day?  Simply noticing the breath is the first step to improving our health.  The state of our physical, mental, and spiritual health depends on the health of our breath.

I use conscious breath work everyday for balance in my health and I use it with my patients during each acupuncture treatment both during needling and after.  From a purely scientific perspective, the anaerobic viruses and microbes that live best in low oxygen environments die off when you oxygenate your body with deep breathing.  Deep breathing also increases the capacity, efficiency, and vibrancy of our lungs.

From the deeper perspective of the energetics of the breath, when we breathe we are breathing in more than air.  In the tradition of Chinese Medicine, we are bringing in qi to circulate through the body.  Qi, or life energy, dwells in the breath, and is considered the functioning of the spirit.  Qi can be equated to Prana in the Hindu yogic tradition. The Chinese consider this qi or energy to be so indispensable to life that the symbol for qi is the same as the symbol for rice.  In Qi Gong, the internal martial art that regulates qi through movement, qi is referred to as "the inner breath" while physical breathing is considered "the outer breath."

Try this breathing exercise now as you sit reading this.  Sit up straight and place your hand on your abdomen. Slowly breathe deeply into this area and push your hand out with your breath.  Your chest should not rise until your abdomen has fully expanded.  Now release the breath.  I call this the belly breath.  If you ever find yourself holding your breath in fear or expectation, or if anxiety has you pumping your breath up into your chest, take a moment for this simple exercise:


Immediate Stress Release:
Change your position, either stand up or lie down. Close your eyes. Take three deep, slow belly breaths and release slowly after each one.  Notice your thoughts now.  Notice your muscles.  Notice your circulation.  

It is interesting how frequently our sympathetic nervous system is thrust into fight-or-flight by the smallest triggers during the day.  By taking the time to recognize the shifts in our body and breathing into them instead of resisting, we can raise our body awareness and shift our reactive tendencies to a calmer present moment.

There are hundreds of methods of breath release, breathing exercises, and breathing meditations in Qi Gong and Qi healing just as there are in the yogic tradition and many others.  I lament that our culture has lost some great jewels of consciousness through the ages.  We once taught our children how to dream, how to be aware of their energy, and how to breathe.  Today we are having to re-learn what we have lost.  In our quest for deeper breath, there are many wonderful resources today.  Though the masters always advise one thing in the end.  "Pay attention to the breath."

A Few Fall Health Tips

Fall is around the corner.  Here in Asheville we have truly begun to feel the chill the past couple of days.  For me this is a time of hot tea in the morning while I gaze out at my herb garden, taking my daughter back to school, wearing scarves again, formulating new herbal tinctures to protect my patients' protective qi and enjoying the beautiful colors as they appear on the Blue Ridge Parkway.

From the perspective of Chinese Medicine, autumn is associated with the element metal, the spicy or pungent taste (think daikon radish, ginger, garlic), the organs lungs and large intestine and the emotion of grief.  There is even a time of day that metal is most active, 3 a.m. to 7 a.m.  It is often in the fall that we find ourselves waking early.  It is important to pay attention to the feelings and emotions that arise upon these wakings and allow them.  Sit with them.  Don't resist.  Quiet your mind and you will easily sink back into sleep.

So here are a few tips for staying in balance this fall:

• Keep your neck covered.  It is believed that wind which can cause disease, enters through the Du channel at the back of the neck.  Try it and see.
• Avoid raw, cold, and processed food.  These are hard to digest, while cooked vegetables, grains and meats are nourishing and grounding to the body.
• Avoid sugar.  It has been proven that eating one tablespoon of processed sugar can depress the immune system for over an hour.  Probiotics and fermented foods, on the other hand, have the opposite effect, boosting immunity and regulating digestion.
• Practice breathing exercises, especially slow, deep breathing from the diaphragm.  This strengthens the lungs and prevents illness.  (I will outline some of my favorite breathing exercises in my next blog post.  Stay tuned.)  
• If you feel a scratchy or sore throat, immediately drink some scallion or ginger tea while taking a hot bath with 5-10 drops of eucalyptus oil and 1 cup of epsom salts.  
• A cold or flu is easily cut short with acupuncture, herbs and gua sha.  So see your acupuncturist early.  If you wait until it is lodged in your chest it will be harder to treat.  
• There are many herbal formulas, each for different stages of sickness.  See your acupuncturist or herbalist for a preventive formula to keep your lung qi healthy as the weather changes.

Enjoy the crispness of this beautiful season and be well.

Why Chinese Medicine?

More than any other question I hear as an acupuncturist and herbalist (aside from 'Does it work?' Answer: Absolutely!  In more ways than you can imagine.) is 'How did you get into this?'  I love answering this question.  The first time I was on the receiving end of those tiny pins was a banner day.  I credit my phenomenal inspiration to my first and much-admired acupuncturist and friend, Andrew Cahn, D.O.M., P.A. I had ruptured my achilles tendon in a rather more-strenuous-than-usual racketball game.  After surgery he encouraged me to come in for treatment as the pain wasn't abating as it should have.  I was skeptical and nervous, not knowing much about acupuncture, but finally assented. After the needles were inserted I felt a calm I had not, to that date, experienced.  And after I left I think I floated for days.

I went weekly and as I did, the achilles pain resolved easily, but also subtler things:  I was sleeping like a dream, I had more energy, and the chronic nightmares that had plagued me for years literally disappeared.  How could something so subtle shift me on so many levels?  How could stainless steel needles the width of a hair have such an effect on my life, my spirit?  This was also my foray into Chinese Herbal medicine.  I thought myself fairly well-versed in Western Herbalism, but what I began to learn about Chinese herbs was taking me in a new direction.  Western Herbalism has a long and beautiful tradition.  It is based on simples, mostly, or single herbs.  Some combinations, to be sure, but it would seem that a great deal of the herbal knowledge of the West has sadly been lost.  Chinese herbalism, by comparison had maintained a great deal more history and coming from such a radically different paradigm and cultural context held a different focus for me.  Single herbs are rarely used in Chinese herbalism.  In general, 5 to 15, sometimes more herbs were used at a time in complex and elegant formulations.  And what an enormous effect it seemed to have on my body.  Suffice it to say I had to learn all about this stuff.

At risk of sounding dramatic, I knew I had stumbled upon my life purpose.  Andrew encouraged me to enroll in acupuncture school and despite having a small child and a business to run, I jumped in head-first and to put it simply I haven't been the same since.  Today I revel in the great joy of treating patients and sharing the same deep shifts, calm joys, healing crises, tears, and breakthroughs with my own patients.  Acupuncture is a heart-centered, spiritual journey.  And I still wish I could experience my first time all over again.