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The culture of professional Chinese medicine in the US : the reality and use of nature-centrism as a value

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This is the third and final portion of the paper I read at the 2017 SPCW annual meeting. You can read the beginning here, and the second portion here. Changes are likely to come to all parts of this paper as I continue to research and revise. The dates of those updates will be reflected on the various posts. Thanks for reading and I look forward to your feedback!

Nature-centeredness in EAM business

Contemporary medicine has a significant ecological cost. Hospitals and other medical facilities can produce tremendous amounts of waste, including toxic waste, requiring specific (and often energy intensive) disposal. For example, sterilization of surfaces and instruments, vital to many aspects of medical practice, often demands single use of manufactured items made from plastic and other materials. Medical waste incineration, the disposal of pharmaceuticals and the use of electricity, water and sewage treatment are all additional issues that medical institutions must face if they intend to reduce their environmental impact.

So, what would it mean for EAM professionals to embrace nature-centeredness in the practical day-to-day operation of our medical facilities? Many of the problems I described in TBM institutions do not apply, or apply differently, to the current form of EAM practice. There is no toxic waste incineration, no manufacture or disposal of medications, and the overall energy usage is limited due in part to the absence of electronic devices in diagnosis and treatment in EAM.

General conservation principles and other consumer level decisions that conserve resources or reduce consumption of course apply to EAM practices. There is one area of special concern, however, the acquisition and use of imported herbs. The vast majority of Chinese herbs are imported from China and Taiwan to distributors in the US. The ecological implications of this practice are numerous and include the impact of transatlantic shipping, industrialized agriculture and, in some cases, the depletion of wild growing plants and animals.

Domestic herbal production in the US is starting to become more viable as the market for these herbs improves, but this will not eliminate the need to consider the various ecological impacts of herbal practice. Embracing the principle of nature centeredness in our acupuncture businesses will require that we look carefully at this – as well as at other aspects of our practice.

Nature centeredness in EAM education

How would taking this aspect of our oath seriously change the nature of medical education for EAM practitioners? There are 63 fully accredited programs for the study of acupuncture and Chinese herbal medicine in the US (ACAOM website). The majority are 3 years master’s level programs, with a few more advanced programs that take 4-5 years.

As I stated earlier in this paper, the structure of the programs, and their basic academic cultures, are very similar to other medical school programs. The flow of the educational year follows the regional standard for all educational institutions. The pressure to specialize, to excel and to do extracurricular education in service of specialization, is as significant as it is in TBM education in some cases. While most would argue that the pace and pressure at most EAM institutions is lower than at equivalent TBM institutions, the draw on students’ internal resources is still significant.

How can we apply the principle of nature-centeredness to good effect in this situation? As an example, consider the flow of the academic year with regards to the seasons. EAM medical schools, like most US schools, begin instruction in the Autumn and continue through the year, leaving the summer free for other activities. The common explanation for this is that the rigors of agriculture, in which children were expected to participate, shaped the flow of education through the year – less during high agricultural season and more during low agricultural season.

But, from a EAM point of view, this is backwards.

In the winter, where there is winter, most plants and non-human animals go into times of reduced activity. Many human beings, too find themselves with reduced energy in the winter months, more prone to eating heavier meals, relaxing with friends and family, and engaging in activities that can be done in cooler temperatures and with reduced sunlight available.

In other foundational literature for EAM professionals, particularly the first official general medical text, the Huangdi neijing, we are informed:

“In the three months of winter….one should be kept warm in the room, dress warmly and take strict preventative measures against the cold, so that the Yang energy may not be disturbed; go to bed early in night and get up late with the sunlight…” (Huangdi neijing suwen CH2, Bing Wang trans. 1997).

So, if EAM administrators and educators were to incorporate the promise to “live in harmony with nature” into the structure of medical school education, a reorientation to make the bulk of the classes in the summer would be ideal. This change would obviously have serious consequences, and may be impossible given the structure of the education system in the US, but it is one area of improvement to consider as EAM practitioners looking to live in harmony with nature.

In this paper, I have tried to describe the contemporary professional environment for acupuncturists in the United States.


While there are hundreds of issues under active debate by the community, many of which could have important consequences for patients, I chose to look specifically at one aspect of EAM’s professional culture – the ethical construct of the oath. Through analyzing that oath, I have tried to demonstrate that it can serve as a scaffolding for the formation of a robust professional culture, and have suggested some ways that this might impact practitioners and institutions in the profession.

Apologies & omissions

I want to mention a few problems I am aware of in this paper, and concerning this field of study in general.

  • First, I acknowledge that the practice of EAM is worldwide, and I am only able to present from my perspective as a US practitioner of EAM. My views, my education and my interest lies in the US professional context. This is significant as the practice of EAM is substantially different between countries.
  • Second, it is important to understand that I am not a fluent Chinese speaker, a trait I share with most of my US acupuncturist colleagues. Because of this, my understanding of the international community of EAM is limited to the number of well translated resources I can access. So, my account invariably leaves out the most current research and understanding of EAM as an international system of medicine.
  • Third, this paper is also limited to investigating the professional / licensed practice of the medicine in the US. This omits, for instance, the history and character of EAM as practiced by immigrant communities in the US long before the government ever considered licensure. For these reasons, more research would be necessary to generalize my assertions to the international practice of EAM.
  • Finally, I acknowledge the many issues involved in this type of intercultural exchange and development. The tendency to fetishize aspects of SE Asian culture is common among my colleagues. Even more common is what I can only call cultural appropriation as some individuals and organizations cherry pick aspects of the cultures behind the creation of EAM, simplify or combine them with other cultural aspects, and otherwise fail to be respectful recipients of traditional information that has been kindly shared. I do not have any idea how to resolve these issues, but I think an overt discussion of them is important in the formation of the EAM professional culture in the US.

A Chinese medicine oath serving as a foundation for acupuncture medical ethics

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This is the second portion of the paper I read at the 2017 SPCW annual meeting. You can read the beginning here. I’ve not made many changes I would like to make quite yet, but wanted to get this second part up. I’ll make some changes to it in the coming weeks, and reflect the date of those changes here. Thanks for reading and I look forward to your feedback!

Let’s proceed to the oath, but first, why oaths? I assert that oath making in a professional context has utility in my analysis in part because it represents the collective promise made by individual chinese medicine oathpractitioners as they enter a new professional context. As such, it can be seen as the backbone of acupuncture medical ethics as actually practiced. The nature of this promise, and the reality of its adoption in practice, is a useful way to understand the culture of the profession. The oath, which I share in full below, is adapted from a passage by 6th century Chinese medicine physician, Sun Simiao and is in active use at many institutions of EAM in the US.

For reference, I number each statement of the oath in parentheses.

“I promise to follow the way of the Great Physician (1). I will strive to live in harmony with nature, and teach my patients to do the same (2). I will stay calm and completely committed when treating disease (3). I will not give way to personal wishes and desires, but above all else hold and nurture a deep feeling of compassion (4). I will be devoted to the task of saving the sacred spark of life in every creature that still carries it (5). I will strive to maintain a clear mind and am willing to hold myself to the highest standards (6). It will be my duty to diagnose sufferings and treat disease (7). I will not be boastful about my skills nor driven by greed for material things (8). Above all, I will keep an open heart (9). As I move on the right path I will receive great happiness as a reward without asking for anything in return (10).”

The oath begins with, “I promise to follow the Way of the Great Physician (1).”

This opening statement, combined with aspects of statement 6 (“hold myself to the highest standards”) comprise Principle A of this paper, which I summarize as a promise to “know and utilize EAM traditions.” At first glance, this is simply an assertion of the importance of the medical tradition and the practitioners who have worked to advance it. EAM has a long history of mentor-student transmission and veneration of ancestors, so it makes sense that the oath would reference tradition.

However, with knowledge of the history, language and literature of Chinese medicine we can also see larger symbolic references at work. When the oath refers to the “Great Physician” it recalls information available in the historical literature about the ideal EAM practitioner. EAM texts such as the Huangdi neijing suwen and Shang han lun referred to this ideal practitioner as the 大藥 da yao, great physician, or 上工 shang gong, superior practitioner. Classical Chinese medical texts of many eras discuss the specific features of the Great Physician and the great benefits patients receive when being treated by her.

Exploring the intricacies of this ideal practitioner construct is beyond the scope of this paper. However, I argue that the idea of Shang gong is more fully described by the rest of the characteristics listed in the oath (Principles B-D). In other words, a Shang Gong, is the type of person practitioners study and imitate in order to “follow the Way of the Great Physician.” As such, we’ll learn more about what it means to embody this principle as we proceed.

The second oath item tells practitioners that they must “…strive to live in harmony with nature, and teach [their] patients to do the same.”

For the purposes of this paper, I name this principle B, and summarize it as “center nature personally and professionally,” which I sometimes shorten to “nature centeredness.” This is a rather vague principle as the oath text doesn’t contain explicit instruction concerning what it means to live in harmony with nature. A more detailed etymological analysis of the source text could reveal more of the intent of the author. Proceeding without that, I will merely assert that a concept of “harmony with nature” exists at every level of theory and practice of EAM. By way of example consider the well known pathophysiological concept of the five phase elements, or just “the five elements”.

These are a foundational theoretical construct in EAM and are modeled after basic substances on our planet – water, wood, fire, earth and metal/ore. Consideration of the essential nature of these substances and their interaction, with some help from additional theoretical constructs, allows practitioners to characterize disease in a simplified way that eases both diagnosis and treatment. Whether this is a valid form of medical reasoning or not is not the point, here, instead note that this foundational concept of the medicine – known by nearly every person who knows anything about EAM – is nature based.

EAM oath statements 3, 5, 6, 7 & 9 are most usefully seen grouped under a similar theme, which I summarize as “focus on personal development and cultivation.”

Like principle A, this concept is reflected in many of the classical texts and teachings of EAM. In every Han dynasty (206 BCE – 220 CE) medical text there are references to the critical importance of healthcare practitioners attending to their own cultivation. In a sense, practitioners attending to their own care & development forms the bedrock foundation of what a EAM practitioner is meant to be, traditionally, and so within the context of this oath. To be a 上工 shang gong, in other words, a practitioner must be attending to their own physical, emotional, social, mental and spiritual needs.

Personal development is not monolithic, of course, and the oath statements actually reference more than one type of self cultivation that is important to the practitioner. The list of desirable qualities mentioned in the oath include mental clarity, dutifulness, devotion and compassion. These qualities should be familiar to anybody who has studied virtue ethics, and indeed a deeper analysis of how various perspectives in virtue ethics relate to my discussion would be valuable.

I group oath items 8 and 10, and to a lesser extent 4, and summarize their combined principles as encouragement for practitioners to “focus on non-material rewards.”

acupuncture medical ethics moneyThese oath items are actually describing a subset of the character traits described in principle C. Principle C of the oath involves practitioners promising to attend to their inner cultivation – to develop those virtues useful for medical practice. Principle D indicates one of those virtues that is of particular interest, at least in the context of this statement.

As today, the ability to achieve fame and accumulate wealth was possible for medical practitioners in dynastic China. Based on Principle D, excessive focus on this accumulation is discouraged. What is the substance of the concern in this oath about focusing on material rewards? In statement 8, a practitioner promises to “not be boastful about their skills, nor be driven by greed for material things.” In this statement, the key word is “driven,” because it indicates that the practitioner’s primary motivation is the acquisition of material things in exchange for practice.

Here, then, there is no suggestion that practitioners must be destitute, only that they should primarily orient themselves around other rewarding aspects of practice.

To summarize, my analysis uncovers four principles in the standard EAM graduation oath. First, to learn and use the EAM traditions, second to center nature personally and professionally, third to focus on personal development of virtues and fourth to focus on non-material benefits of practice. I assert that these four principles have several important uses for practitioners and teachers in EAM, and can serve as a starting point for the intentional creation of EAM professional culture in the US. I now proceed to consider just one of these principles in more detail, describing the potential practical effects of incorporating it.

Principle B, which I’ve summarized as “center nature personally and professionally” is of particular interest as we face planet-wide ecological crisis. I’ll follow up focusing on this principle in some detail in the next installment of this short series.

Chinese medicine and the sense of smell

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chinese_medicine_nose_smell

As part of my study, since the very beginning of my time at NCNM, I have sought to use my entire body in the learning process.  While I learn quite well from reading, listening to lectures, and writing – I find that sensory input brings the information alive.  This improves my ability to remember, and also seems to increase my facility in using that information in the real world.

As I’ve worked on projects like my new course about Shennong Relational Herb Learning Method, I’ve seen how this is particularly important in learning and using Chinese herbs.  Herbs are physical things, full of life including smells, tastes and textures.  When we reduce them to data points – as is done in so many educational institutions – they die to us.

However, I’ve found it difficult to actually put this into practice.  This is particularly true of using my sense of smell – and I know from my teaching that I’m not the only one!  Students from Western countries, in particular, seem to struggle with the sense of smell… why is that?

In the United States, and I suppose in most Western countries, sensory experiences are controlled.  For the most part they are stifled, except for sight and hearing which are simply overwhelmed.  Actually, thinking about it, we overwhelm all of our senses – limiting what they experience to a set number of approved, mostly synthetic items and then amping those up to the nth degree.  Whether this is all due our relative affluence, our religious heritage, or some scientific sleight of hand, I do not know.

What I do know is that the classics have something to tell us about the importance of the senses, and have an interesting take on how the senses work.

Chinese medicine and the sense of smell

In Chapter 11 of the Neijing suwen, it says:

“故五氣入鼻藏於心肺．心肺有病．而鼻為之不利也”

This has been translated in a couple of different ways.  The basic translation says:

“When the five Qi/odors enter the nose, they are stored in the Heart and Lung.  Heart and Lung disease is detrimental for the nose.”

In his commentary on this line of the text, Maoshing Ni goes on to posit that the five scents are really “the five qi of environmental energy that we breathe in.”  Regardless of the fact that I don’t see this particular statement in the text (thus underscoring my basic problem with Ni’s translation) it is interesting to contemplate.  What is odor?  Certainly it is qi – but beyond that?  In thinking about this, consider the Neijing’s statement that the odors are 藏/cang/stored by the Heart and Lung.  The Lung makes a lot of sense given that the nose is the orifice of the lung in both a Western and Chinese context.  But what does it mean to say that the lung receives and stores these odors?  One could posit that they become part of the qi that then rains down on the body as heavenly restorative water/qi.  Again, I’m not sure this is in the text itself, but it’s an interesting notion to contemplate.

More interesting to me is the relation of odors and the Heart.  What can it mean that the Heart stores odors?  You’ll excuse me if I offer my own simple theories.  As famously studied by Gilles Laurent at Cal Tech, there is a powerful association between scent and human memory.  Nothing brings back a scene or person to the mind like a scent last experienced in that scene or with that person.

When considering this idea, I most naturally think about the smell of my clothing when I come back from my mother’s house on a visit.  I smell her for weeks afterward – and though the smell is created in part from her detergent, there is more to it than that.  The scent is wrapped up in emotion, the scent contains not just detergent fragrances, but her spaghetti sauce aroma, her hair, the smell of Idaho, cold winters, the essence of what comes from her pores as a product of all she eats, drinks… well, you get the idea.  The memories triggered are as complex.

Consider also the devotional aspects of scent – incense of various kinds have been used in religious ceremony and other spiritual activity since time immemorial.  The Catholics still use incense as part of Mass, as do some Episcopalian congregations.  Buddhist and Hindu shrines are nearly always adorned with incense censers.  We can also think about the effects of Moxibustion using artemesia.  While some people hate moxa for its thick smoke and messy nature, I find it to bring an essential element to treatments where it is indicated.  While not explicitly of a spiritual nature, I do believe that there is something of an offering that occurs when using moxa in treatment.

This relationship of memory and spirituality to the sense of smell helps me to link it to the Heart.  While we often talk about the Kidney as being the storehouse of memory in Chinese medicine, from what I’ve read and learned, the type of memory held by the Kidney is more primal, older and is less easily accessed by consciousness.  The heart seems a likely place (especially in its relationship to the Western concept of mind) to store the memories of this life.  The heart’s relationship to shen makes its connection to human spirituality quite clear.

In classical five element acupuncture, the art of smelling is still employed.  The five odors, discussed first in the Neijing, are assessed by the practitioner to help understand the primary pathology of the patient, as well as used as a key in discovering the patient’s landscape tendency (constitutional factor).  This is one of the most difficult diagnostic techniques for Westerners, as I’ve already hinted at.  I find it to be incredibly difficult, personally, particularly given how so many patients cover up their natural odor as a matter of course.

Scent and herbal medicine

Briefly, what is the role of scent in Chinese herbal medicine?  Most would say, “There is no role!”  I disagree.  One of the reasons I am a huge proponent of patients taking home and cooking their own bulk herbs is because of the experience they gain by doing so.  Looking at the herbs, smelling them in their dried state, allowing the smell to permeate their living space, smelling their powerful odors when drinking – all of this, in my opinion, is part of the therapy.

While many patients are unwilling to have this experience, it is one I encourage and have benefited from personally.  The worst case scenario with regards to this would be taking pills of granulated Chinese herbs.  I believe the move in this direction is detrimental, but understand when some patients choose this path.

Further, when we talk about the “flavor” or “taste” of herbs – scent is certainly part of that equation.  And as I’ve discussed many times, engaging this vital aspect of herbal alchemy is in my opinion the key to lasting learning in Chinese herbal medicine.

Fearless smelling

As I’ve said, one of the major ways I seek to increase my prowess in Chinese medicine is to activate all my senses to the greatest degree possible. So, how to proceed with the sense of smell?  My first trick will be simply to allow myself to smell everything, without reservation.  This means making a conscious effort to breathe deeply through my nose at all times.  I will also be going out of my way to smell things that are likely to be interesting or complex.  I will also be practicing this during tea drinking.  The difference in smell between two otherwise similar puerh teas, for example, can be remarkable and really impacts the experience of the tea.  This, of course, brings me around to the importance of smell for TASTE – but perhaps that’s for another article.

Do you have any ideas of how one can integrate the exercise of the sense of smell into daily living?  Willing to offer your thoughts on this or on the role of smell in learning Chinese herbs?  Join us in the comments below.

5 Things to Look forward to after graduation : Chinese medicine post-graduate education

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finishing_chinese_medicine_school

I thought I would make a list of the five things I’m most looking forward to doing after I graduate.

This does not include the usual suspects : getting more sleep, spending more time with family and friends, taking fewer tests, etc…  It also doesn’t include the very exciting new developments of running a business full-time, getting back into (and developing my skills within) blogging and – of course – developing as a clinician and scholar in Chinese medicine.  

City Safari

Portland is, I think, one of the most wonderful cities in the world.  It is easily the greatest city I have ever visited.  There is simply no end to the nooks and crannies to be explored.  From the urban mettle of the Eastside Industrial district (spitting distance to our clinic) to the gilded streets of the Pearl, the well-worn sidewalks of the Belmont and Hawthorne neighborhoods and all the other incredible districts and ‘hoods. Add to that the abundant Hill Walk opportunities, countless little pockets of Wildness all over the city, endless cultural events, used bookstores galore, junk sales, free boxes, chickens running wild, food carts, curiosities around every corner.  It’s too much to think about, much too much to write.  It is a place that draws together many interesting things.  I love to walk, I love to bike, and one of my favorite things is to just go where the wind blows me. 

These blown about moments are ripe for deepening awareness, pregnant with the possibility of seeing more deeply into reality – informing my practice and my purpose.

Getting to know the Watershed

Beyond the city limits, a smorgasboard of outdoor space awaits.  From NCNM, I can see two mountains – absolutely surrounded with verdant forest, sublime foothills, rushing rivers and not a few glorious swimming holes.  Both up and down the valley we have hotsprings, old growth, wine country, waterfalls and a hundred underused hiking trails and tent camping spots.

This is to say nothing for the miles of undeveloped beaches, the endless expanses of highland desert, dunes, caves and lakes from outerspace.  It’s not hard to understand why so many people love this state.  Just as the city safari, the kind of surprises and encounters that come about while wandering the wildness of the world is an awareness building experience.

Reading (and experiencing) Widely

I have a reading list a mile long.  There is a lot I want to read within the field, but even more outside of it.  There is just so much to learn, so much to imagine, so many people writing down so many incredible things.  Finally, finally – I may have some time to take it all in. The reality is that I will probably stay more or less in the range of Chinese medicine related materials – but for me – that field is pretty broad.  I also have a whole lot of Continental Philosophy to burrow into.  Also, Rorty.  Oh, and I started playing roleplaying games again, so there’s plenty to read there.  All of this helps build a richness of worldview that can only help me as a practitioner.  Like some guy once told me.

Learning and Using Chinese language

The most important new project I’m taking on over the next decade is to deeply learn Chinese language.  I’ve got a lot of materials for homestudy, as I won’t be able to afford (or stomach) formal education for at least a year or two.  I’m hoping between that and the resources of my peers and friends, I’ll be able to make a go at it.  I’m going to be doing the arduous task learned in Classical Texts classes at NCNM – going through texts character by character, and trying to drink them in.  I believe that a mastery of this language is a crucial key in unlocking my potential in the field.  I don’t intend to put that off, if I can help it.  The deeper I fall into the symbols of the language, the deeper my awareness, the more profound my connection, the more effective the medicine.  Or so some other guy told me.

Redoubling my efforts in Self Cultivation

I have experienced first-hand the difference between the treatments of practitioners who attend closely to their self-cultivation and those who do not.  I don’t expect to be a saint, and I don’t expect any other practitioner to be.  However, the degree to which we learn to become still, to connect deeply (both inward and outward) and care for our health on every level is the degree to which we will become not just technicians, but deeply skilled care providers.  I have been working on this throughout my four years at NCNM, but I must admit that the rigors of my life have sometimes made me less than totally devoted to practice.  I’m looking forward to a chance to change that.


Classical Chinese medical symbolism: Wood, Metal and Spring (part 2 of 2)

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wood_and_metal_in_chinese_medicineHere is the continuation of Michael “Delli” Dell’orfano’s article on the symbolism of wood, metal and the spring season in Classical Chinese medical symbolism. Please feel free to leave any thoughts you have on this two-part article in the comments. Lively discussion is always appreciated! If you missed the first installment, read it here.———————

In Neijing Suwen (素問) Chapter 7 – Yin Yang Bie Lun (陰 陽 別 論 篇) Huang Di asks Qi Bo,

人 有 四 經 ， 十 二 從 ， 何 謂

“A man has four channels and twelve equivalences, and what are the implications of them?”

Qi Bo answers,

四 經 ， 應 四 時 ； 十 二 從 ， 應 十 二 月 ； 十 二 月 應 十 二 脈

“The four channels are the four solid organs which correspond to the four seasons; the twelve equivalences are the twelve two-hour periods, the twelve, the twelve two-hour periods correspond to the twelve meridians.”

Keep in mind when talking about the four seasons that the Earth has no real season of its own, thus they speak of four instead of five. Qi Bo goes on to say the Liver corresponds to the spring, the twelve-hour periods are governed by the twelve months, and that the di zhi Yin, Mao, and Chen are the months of spring (earthly branches 3,4,5 respectively). Qi Bo correlates the twelve months with the twelve channels and states that the first month of the lunar cycle (February) corresponds to the Hand Taiyin channel. In terms of the four seasons, (maybe we can say this relates more to the solar cycle, or related to yang and heaven) we say February is associated with the Spring energy of the Liver, but in terms of the twelve months, (maybe more related to a lunar cycle, and thus yin and Earth) February goes with the Lung.

I interpret this as meaning the energy of nature around us in the external world is strongly Mu/wood in the spring, and so internally our energy should be strong in the Jin/metal channels in order to keep Mu/wood energy that is on the rise in check. If the Mu/wood energy is strong outside the body, it will inevitably penetrate into us as well, and so the body should have a natural physiological response to increase the Jin/metal element to prevent the Mu/wood energy from becoming too strong and causing imbalances in the body. Also, a little later in Chapter 7 of the Wu and Wu translation of the Neijing, it talks about the taboo times for Gan (Liver, 肝) are Geng and Xin days (associated with metal). I think this is trying to tell us that Gan 肝 problems are more likely to arise on these days since they represent Jin/metal energy, and Jin affects Mu because of their intimate relationship through the Ke (control) cycle.

It is instructive to analyze the hexagrams symbolically associated with the Spring Metal/Jin organ networks. First, we have Tai, Hexagram 11 going with the Lung and the first month (Feb-Mar). Next, we have Da Zhuang, Hexagram 34 going with the Large Intestine and belonging to the second month (Mar-Apr).tai_hexagram_11_lung_chinese_medicine

Hexagram 11 is all about balance and harmony with three yang lines below and three yin lines above representing the upward movement of Heaven coalescing with the downward movement of the Earth. The rising yang in the lines of hexagram is symbolic of what is taking place in nature- energy on the rise. At the same time, the yin energy is pushing down to create a pressurizer-like effect in nature like the Lung does in the body. The idea of balance and prosperity that go along with this hexagram make it a symbol of health. The Lung is crucial to our health, thus the important title of prime minister is placed upon it. It is also worth noting that some of the greatest ancient Chinese medicine doctors were also prime ministers.

hexagram_34_da_zhuang_large_intestine

Hexagram 34 is an image of the trigram Zhen, or Thunder, over the trigram Qian, or Heaven. It shows the progression of the yang energy on earth, as now four yang lines are on the bottom of the hexagram with only two yin lines above. Nature is starting to move away from balance as yang is starting to take over, thus the story of Yang dominance in the second month. This hexagram symbolizes great strength and power as nature is bursting forth from the earth. The earthly branch that goes with the second month is Mao 卯, which means to flourish or explode. Much movement takes place in nature as the green vegetation is starting to grow rapidly. This is the picture of foot yangming (Large Intestine) brute force. Yangming carries tremendous amounts of qi and blood, and so is associated with 2nd and 3rd months of the year. This is the microcosmic picture in the body of what is going on this time of year as reflected in the macrocosm of the natural world around us.

Hu (虎, tiger) is the animal that resonates with Fei (Lung 肺) and Yin (February). It is associated with Fei because it is a symbol of authority and justice. Tigers will growl and protect, and only use their sharp teeth and claws when they have good reason. Tigers also have beautiful colored skin patterns, and this is a Fei signature since the skin relates to the Fei network. The sharp teeth and claws are akin to metal weapons and the ability to protect can be associated with a metal shield or helmet. Other mu characteristics of the tiger include the mu voice. The jumping ability and strength of the connective tissue is related to Gan and mu, and so is their tendency towards rage. Neijing Ch.8 has reference to the tiger in the line for the Liver.

To point out another correspondance between Wood and Metal, consider where the Neijing (Chapter 8) says,

肝 者 ， 將 軍 之 官 ， 謀 慮 出 焉

gan zhe jiang jun zhi guan mo lu chu yan

The Liver is the general and is in charge of planning and strategizing.

The character lu 慮 contains the tiger radical. Here the tiger is used to symbolize foresight, clairvoyance, patience, intelligence as associated with Wood/Yin/Aquarius/Jupiter energy to demonstrate what characteristics a good general should possess. Here we can see the intertwining of Wood and Metal imagery in the classics.

Tu (兔 rabbit) goes with the Da Chang (Large Intestine 大肠) and Mao (March). Tu/rabbits have a hot yangming (ST/LI) condition, and so have dry hard pellets for feces. This is much like constipation, which is a condition related to Da Chang. The rabbit is associated with longevity, which is also a Jin/metal quality. Rabbits use feces instead of urine like most animals to mark territory. Also, in rabbit we find some Mu/wood characteristics as well. For example, their amazing jumping ability can be related to connective tissue strength and the springing forth of nature that is taking place. Rabbits are competitive, always in a race. This is also a Wood quality. Rabbits have a lot of nervous, windy energy, and so they are always moving around and do not like to be held. This can be seen as related to Mu/wood as it is said to dislike being contained. Yet more intertwining of Wood and Metal imagery is revealed to us!

Bringing it back to the human body

In general, we can say that Jin/metal and Mu/wood are balancing poles of activity in the body. Jin moves down and in, and Mu moves up and out, but what if imbalance and disharmony occur between jin and mu? One example of this might be the emotion of grief, which when experienced, has an energetic feeling of moving down and in like Jin or metal. This downward movement of Fei will oppress Gan and cause Gan/Liver Qi stagnation eventually. How about another example? Consider the relationship between Fei/Lung and Gan/Liver in breathing.

Fei is master of the qi, and a weakness in Fei qi can lead to a weakness of Gan qi, and so Gan may not be able to spring up. A progression from this might be that the Gan qi becomes stagnated because of a lack of qi from Fei, and then Gan fire could flare up and travel through the reverse ke/control cycle causing Fei to be scorched. In this situation, Fei will no longer be able to mist the organs because of heat/dryness and may lose the ability to exert pressure and descend downward. In this case, symptoms could arise on both the Gan and Fei organ systems such as coughing, blood in saliva, pain in sides and thorax, red eyes and anger.

Another example of a mu/jin pathology directly related to the spring is bi qiu- allergic rhinitis. Bi qiu is caused by the increased wind of the spring carrying the pollen from plants into the body of a person who has a disharmony of wei and ying (protective and nutritive). We can even say that the wei qi has a connection to the Lung and the Liver and that the Liver is also part of the ying, so it very likely this type of person already has an imbalance in the mu-jin axis to begin with, and so the symptoms all appear as related to these two organ systems. The itching is associated with the wind, and so by frequency correlation we can also say Wood. This pathology also has itching of the eye as a symptom, and the eye is the orfice of the Liver in CM. The problem is also related to the Lung since the nose is the orfice of the Lung and the symptoms are itchy nose, runny nose, anosmia, and nasal congestion.

Delli

 

Living in Harmony With the Seasons: Introduction – Part I

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Seasonal Living in Chinese Medicine

From a Chinese medicine perspective, is essential that we learn to live in harmony with the seasons. There is, of course, no monolithic “Chinese medicine perspective” but regardless of your ideological preference, the reality of seasonal energy and the importance of flowing in step with it is practically irrefutable. There are many mentions of seasonal energy in the Neijing and one of the very first discussions in that seminal text regards the importance and method for living seasonally.

In the chapter I am referring to – Chapter 2 – Huang Di in rare monologue states the important lifestyle features one should adopt to avoid disease. I think it is important to note that it isn’t simply trendy, fun or perhaps spiritually astute to live in accordance with the seasons. It is one of the most powerful things you can do to resist disease.

The recent movement around local and seasonal foods is a nod to the importance of this timeless principle. People are recognizing that living in accordance with their immediate spatial and temporal environment is not just for hippies (although, for them too). Food tastes better, is more healthful, is less expensive and somehow just FEELS better when it is eaten at the right time for the place that one is in. The macrobiotic movement also took note of this and suggested that one eat food that is grown in one’s region.

But the Chinese philosophy on living in balance with seasonal energy goes farther than food choices. In fact, most of what I have found in Classical texts has nothing to do with food but instead focuses on various aspects of a person’s lifestyle.

1. Physical/mental/spiritual activity levels and types

The guidelines regarding activity go into every realm of life, just as the seasonal energy touches us everywhere – all the time. In the Neijing one of the first practical recommendations concerning seasonal living involves activity.

“During this season [spring] it is advisable to retire early. Arise early also and go walking in order to absorb the fresh, invigorating energy” (From Maoshing Ni’s translation)

2. Social activity levels

This is perhaps simply an outgrowth of #1 – but I think it is easy to overlook. We naturally gather together in the summer – although in the United States, some of our most “together” holidays are in the winter. Just as we should limit excessive physical activity in the winter, so should we ramp down our social activity. There is much more that can be said on this topic.

3. The color, smell and feeling of the surrounding environment

Paying close attention to the seasonal changes is important in resonating with their energy. All of our senses should be engaged in the study of our environment. It makes sense to similarly alter our internal environment to some degree. Letting your decorations follow the ebb and flow of nature will help you to become closely in tune with seasonal energy. Of course, you will want to keep balance as well – so surrounding yourself with emblems of Metal during the Fall is not necessarily the best way to go, but there are simple, effective and gentle ways to remind yourself of the seasonal energy even when you must be inside.

All of this and much more is included in the kind of lifestyle counseling that naturally grows out of Chinese medicine theory on the energy of the seasons. I would like to thoroughly investigate the energy of each season – looking into relevant etymology and Chinese medical information (like the organs, special points, etc) and follow that by my best suggestions – informed by the Classics – about living in harmony with the given season.  Who knows how long it will take!  Along the way, I hope you will contribute your suggestions as well…