NYC Chinatown

Before I get back to the details of the herb symposium, I feel I must share an interesting vacation from the acupuncture business and the joy of treating patients.   My daughter Vivi turned 7 last week, and as this child is completely obsessed with all things Chinese, I took her to Chinatown in New York City to celebrate the big day.  This is something she has been talking about since I first told her stories about an area in a big city that is "just like China."  

I have taken to calling Vivi the mascot for Lutea Acupuncture & Herbal Medicine, but she insists that she is going to be an acupuncturist when she grows up, so that role is likely to expire soon.

I combined pleasure with business as I dropped into a few traditional herb shops searching for some Chinese herbs that have become difficult to find down in North Carolina.  And success!  We loaded up on additional ingredients for some new Lutea tinctures.

At a park in Chinatown we stopped to watch a group practicing a set of sword-form tai chi in perfect synchronicity.  We were spellbound.  Vivi has seen me teach qi gong in the park and she knew immediately what she was watching.

Viv's favorite, and mine too, I think, was our visit to the Buddhist temple on the edge of Chinatown.  Vivi and I sat in silent meditation for much longer than I would expect any seven-year-old to do.   She especially liked lighting the incense and saying a prayer to the giant buddha "the size of our living room." 

For her birthday dinner we went uptown to SushiYou and had a fabulous meal.  Her favorite?  Eel avocado roll with salmon roe.  Do I have an awesome kid or what?  The coolest thing about midtown Manhattan is the abundance of luscious cupcake shops which was led us to a perfect way to accompany the Happy Birthday song.  And hooray for gluten-free cupcakes!  Delicious!  The following morning we were up at dawn to take the ferry to the Statue of Liberty and then up to Central Park to take a Chinese-inspired rickshaw ride to the Carousel.  The rest of the trip deviated from our China theme, but suffice it to say, we got a taste of China to prepare us for a trip to the real thing as soon as it is in the stars for us.  Happy Birthday, my sweet girl!

My Amazing Day with Herbalist David Winston

The Medicines of the Earth Conference 2012 begins tomorrow in Black Mountain. But a lucky small group of us, a combination of clinicians, herbalists, and curious plant-lovers, convened on the wild and beautiful grounds of the Black Mountain Assembly and listened to the ethnobotanical lectures and plant descriptions by David Winston, herbalist extraordinaire and founder of Herbalists & Alchemists. 

He began the morning with his traditional Cherokee singing, prayers, and a beautiful ceremonial walk into the stream before more stories of healing, plant identification, and discussion. 

Pictured left, David is discussing Wild Yam, (Dioscorea).  In Chinese Medicine it is called Shan Yao and acts as a qi tonic.  But in Western and Cherokee herbalism it is used more often as a gastrointestinal antispasmotic (think irritable bowel) or for gallbladder spasms.  It can be helpful to move liver qi and when menstrual cramps accompanied by nausea. 

Below is pictured Spikenard, an aromatic adaptogen whose root is very helpful for a dry cough, arthritis made worse by cold, and traditioinally used in combination with cottonwood bark and black cohosh can stimulate stalled labor in pregnant women.



Left, David shows us a blooming Black Cohosh, pollinated by flies because (if you haven't had the pleasure) the smell resembles that of rotting meat.   Though widely believed to be the herb of choice for menopausal symptoms including hot flashes, that is not really this plants strong suit.  Chastetree berry is much more effective for those complaints.  Though Black Cohosh can be excellent for menopausal depression, fibromyalgia, and uterine and testicular pain, among other uses.

As David points out, however, and as any good herbalist knows, herbs are complex and have personalities.  An elegant combination of herbs works best, based on each patient's individual needs.  The source of an illness in one person is different than the source of the same illness in another.  Same disease, different treatment.

It was inspiring to spend the day with a master who so loves his work, his culture, and the plants themselves that I came away with a renewed passion for my herbal work and with new knowledge and ideas for helping my patients and spreading the word about the power of herbal medicine.  Thank you, David!   Stay tuned, there is more to come as Saturday through Monday the conference will continue. 

Cupping for Everyone

Cupping.

No, this isn't rare torture, it feels fantastic, a sort of a suction massage with excellent therapeutic benefits. Cupping is an ancient medical art under the rubric of Chinese Medicine. Cupping has been documented in China as early as 1000 B.C. but has been used for centuries in many different cultures. There is reason to believe the practice dates from as early as 3000 B.C.; the earliest record of cupping is in the Ebers Papyrus, one of the oldest medical textbooks in the world. It describes the process in which in 1,550 B.C. Egyptians used cupping. In ancient Greece, Hippocrates used cupping for internal disease and structural problems. This method in multiple forms spread into medicine throughout Asian and European civilizations.

Today there are cups of many differnt materials. Bamboo, earthenware, copper, iron, glass, plastic, silicone seal, there are many options. In my practice I get the best results with glass cups seen above. There are different sizes for different parts of the body. Cupping is great for the back, the IT band, there are even tiny cups for the hands to help relieve arthritis pain. Today fire cupping is the most common form of this art. In this process, suction is created with a flame then quickly applied to the skin. For my pediatric patients I use plastic cups with a quick-release hand pump.

Why cup? In Chinese medicine, the main function of cupping is to move blood and lymph fluids, thereby reducing stagnation and pain. It is excellent for treating the early and later stages of upper respiratory infections, it is indespensible in treatment of neck and shoulder constriction and pain, IT band tightness and pain, as well as deep pain in the low back and sacrum. A deeply relaxing practice, it can ease anxiety and insomnia quickly and easily. Cupping can arrest an asthma attack in moments in small children, and can reduce systemic blood stagnation.

Moving cups, or a process where a cup is applied to oiled skin and moved carefully over a distance, usually the back, is effective in treating many disharmonies including emotional stagnation including frustration, insomnia, anxiety and depression. In my practice I almost always use cupping in conjunction with a regular needling treatment, either before or following a treatment. However, it can be effective treatment for those with a fear of needles, or as a follow up to a Tui Na, or Chinese acupressure massage treatment.

Sports Injuries Article for Blue Ridge Outdoors Magazine

http://www.blueridgeoutdoors.com/outdoor-blogs/editors-blog/healing-injuries-with-acupuncture/

Healing Sports Injuries with Chinese Medicine

By Lara Ferguson Diaz, L.Ac., Dipl.O.M.

A sports injury can ruin your day on the trail in a split second and sideline you for weeks.  But before you wrap on a bandage and try to run through the pain, consider acupuncture.  Acupuncture is a tool of Chinese Medicine by which tiny, solid filament needles are inserted into the skin at strategic points to help the body heal naturally without drugs, surgery, or side effects.  Chinese medicine is a system of internal medicine treating everything from headaches to fibromyalgia to diabetes.  A branch of this, Die Da or “hit-fall” medicine, originated in Ancient China to treat injuries sustained from martial arts.  It quickly and effectively addresses trauma to any part of the body. 

Chinese medicine is based on the concept that “Qi” or vital energy flows through our bodies along with our blood.  Trauma can obstruct the flow of qi and blood, and if left untreated, or improperly treated, injury can become chronic, recurrent, or even debilitating.  Acupuncture is recognized by the National Institute of Health (NIH) and the World Health Organization (WHO) as a safe and effective medical therapy.  Acupuncture, combined with Tui na, a kind of massage, Chinese herbal medicine, Qi Gong or Tai Chi, and dietary therapy, are the major components of Chinese medicine and have been practiced for over 5000 years.

The approach to treating sports injuries with Chinese Medicine differs from that of Western medicine in a few ways.  You have probably heard of the acronym R.I.C.E. from your doctor: Rest, Ice, Compression, and Elevation.  Rest is obvious, and taking time to heal is essential.  Elevation is helpful as well.  Chinese medicine takes a different perspective on the ice and compression elements of this old adage, however.  Ice is rarely used in Chinese medicine.  The aphorism “Ice is for dead people,” explains the Chinese perspective.  In Chinese Medicine it is rarely used after the first 24 hours of an acute injury as it contracts blood vessels, stagnates and congeals blood and fluids which, in turn, slows healing and can lead to long term residual pain and eventually arthritis in the affected area.  It constricts the flow of blood and “qi” or vital energy in the area of the injury, further damaging the tissues.  Liniment or “herbal ice” is often used instead.

Compression usually in the form of an elastic bandage wrapped snugly around an acute injury also stagnates blood and fluids, usually pushing them out to the outside edges of the bandage.  Here again, promoting the flow of blood and fluids by avoiding compression, helps the body heal faster. 

In more severe injuries, an x-ray or MRI is the best course to rule out fractures, ligament or tendon rupture.  In these cases Western diagnosis and treatment are important.  Acupuncture can be effective in speeding healing in these scenarios as well and in many cases can prevent the need for surgery.  When surgery is required, acupuncture is helpful in speeding recovery.  There are also topical and internal herbal remedies to stop bleeding immediately, ease pain and even knit broken bones.

The most common sports injuries tend to be sprains.  This is especially common for trail runners.  Acupuncture can reduce pain and swelling in an acute sprain in a matter of minutes, reducing healing time dramatically.  Even for grade 2 and 3 sprains, where there is real ligament damage acupuncture is quite effective.  With sprains the earlier the treatment, the better.  Remember to only use ice for 10 minutes at a time for the first 24 hours.  See a practitioner of Chinese medicine as soon as possible.  Again, if severe, see your doctor to rule out tendon rupture or fracture.

Tendonitis is also a very common sports injury caused by repetitive movement, and because it can rarely be traced back to an original injury, it is usually a late stage chronic pain by the time help is sought.  Tendonitis usually manifests in the rotator cuff, the Achilles tendon, wrist or even elbow.   A combination of acupuncture, massage, and liniment can make the biggest difference for this injury.  Carefully examining the movement that is causing this and retraining with amended position is essential. 

The type of pain, the aggravating factors, and the location are more important in diagnosing sports injuries than the severity of pain in Chinese medicine.  There are many types of pain indicating many types of injuries.  Pain that is shooting or refers down an extremity usually indicates nerve involvement.  Stabbing pain that gets better with exercise or dull pain that gets worse as the day goes on corresponds with different injuries. All can be treated equally well with Chinese Medicine.

Whatever the injury, heal safely without drugs and reduce the need for surgery with Chinese Medicine, an inexpensive, holistic, benign therapy that works well independently or in conjunction with Western medicine.  Be sure to find a practitioner that is a licensed acupuncturist or diplomate of Oriental medicine with a four year degree.

Lara Ferguson Diaz, L.Ac., Dipl.O.M. (NCCAOM) is owner of Lutea Acupuncture & Herbs and practices at Integrative Family Medicine of Asheville.  She is happy to answer any questions at 828-582-5403

Sidebar:

Acupuncture for Sports Injuries

Dos and Don’ts:

The sooner the better.

The sooner the injury can be treated, the better the outcome.  Acupuncture frees the joint, the flow of blood and qi, vital energy, and facilitates healing.  However, if not treated, acute injuries can become chronic injuries.  Chronic injuries respond to acupuncture as well, though it may take longer to reach complete healing.

How Long?

Acute injury, depending on severity can be addressed in fewer treatments spaced closely together over a couple of weeks.  A more chronic injury tends to respond better to a weekly treatment over a longer period, depending on a variety of factors including severity, time of onset, and patient compliance. 

Ice is for dead people

Remember to only use ice for 10 minutes at a time for the first 24 hours as it contracts blood vessels, stagnates and congeals blood and fluids which, in turn, slows healing and can lead to long term residual pain and eventually arthritis in the affected area. 

Surgery

Seeking a Western diagnosis is important.  Seeking acupuncture soon after can help prevent the need for surgery by removing obstacles to healing.  When surgery is necessary, Chinese Medicine is indispensable to pre-op preparation and speeding recovery time.

A Knowledgeable Liason

A good acupuncturist will recommend an x-ray or MRI for a more serious injury to rule out rupture of tendon or bone fracture.  They will also advise when and what sort of movement is helpful, and when to rest.  Remember only to see a licensed acupuncturist with a four-year degree in Chinese Medicine.

Be open to herbs

Your acupuncturist can prescribe a topical liniment made from Chinese herbs to help penetrate the joint or muscle, stop pain, reduce swelling and inflammation, and disperse stagnant qi and blood.  Some topicals can stop bleeding, mend tendons, and even knit bone.

Listen to your body

Chinese medicine is based on common sense.  Running or cycling through the pain may seem like a good idea, and sometimes, after the bulk of the healing has taken place, it is. Sometimes it truly slows healing.  Ask your acupuncturist.  She can also prescribe strengthening exercises and movements.

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.