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musings on Yoga, Ayurveda and Chinese Medicine

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Yin Grace

by Hyoun Bae on 10/15/17

YIN GRACE

A young man and his mother lived on Mount Yaoshan. His mother, quite elderly, began to feel parched and dizzy after a day’s work. If she walked a longer distance, she would feel out of breath, and no matter how much she inhaled deeply, it felt like the qi, or vital energy, failed to sink in. Her skin was dry, and her joints felt a creaky.

A nagging cough lingered, and occasionally she would feel feverish, but there was no sign of a real cold. Her sinuses felt stuffy, but nothing expectorated. If she worked past her capacity, she felt pain all over.

Her son became quite worried, but luckily, he heard of a monk at the top of the mountain who treated locals at the temple. He planned an early morning hike with his mom, to get to the monastery by late afternoon. They both felt some hope.

About halfway through their trip, his mother had to stop and catch her breath. She told him, honestly, that it might be too much of a trek, and not to be concerned. They would figure something else out, but he insisted.

She thought it best he went along without her, and describe to the monk her symptoms. He would then retrieve any prescription, if need be.

Hesitant, the young man knew her idea was best so after getting some mountain spring water and heating it for her, for some time. Hurriedly, he forgot to place the lid on the vessel.

The fall winds blew some tender leaves of the mulberry tree. By the time she sat for tea, she was tired, and decided not to bother, and to drink the infused liquid. Couldn’t hurt.

Nightfall was about to arrive. The young man returned exasperated, as the monk must have been out to the market or performing errands for the temple. He was quite discouraged, but promised his mom that he’d try again the next day.

So they sat for a quiet meal and went to bed.

The next morning, mother woke up looking invigorated. Her son inquired what she had done? “Nothing, really. I had some of the hot water you prepared and rested until you returned,” she replied. “There were some leaves that fell in the pot. Maybe they are good for my condition. Help me fetch some more.”

As it were, his mother felt much better after a few more servings, as if Kwan Yin’s blessings saturated her, filling her with life. Hopeful, he rushed off to the temple to meet with the monk.

After relaying to the monk his mother’s condition, the monk jotted down a prescription – the frosted leaves of the mulberry leaf, best picked on a cooler morning. As the mountain air was a bit crisp and chilly in the am, they found the perfect medicine.

You never know the magic and blessing of the autumn winds, signaling change.



(adapted from Zhu and Zhu's Chinese Herbal Legends)

Benefitting the Mother

by Hyoun Bae on 10/15/17

Benefitting the Mother

Shen Nong is a semi-historical figure associated with cataloguing the functions of plants, after having tasted a variety of plants and deciphering their therapeutic value. His celebrated text Shen Nong Ben Cao Gang Mu, classified plant and mineral substances according to important criteria, including indications and parameters which have been revised and indeed overlooked, centuries later. It is the classical materia medica, among a few works which many have continued to reference to locate efficacy beyond contemporary descriptions of herb application.

Motherwort, or yi mu cao, is a seminal herb reported on in this early classic and commonly used in gynecological formula in cases of blood stasis. It is also used postpartum.
 
As the teaching story goes, a young boy of ten, who had lost his father and who was brought up by his mother, was concerned about her wellbeing. She had a difficult labor with lochial retention, and since then, suffered from stomach pains and gynecological issues. This we would call blood stagnation in the thoroughfare vessel, which traverses the uterus and abdomen.

He was well aware of her frequent abdominal pains, which were exacerbated from long, sedentary stretches spinning cotton. Exasperated, he promised to get care for her and reached out to an herbalist who requested a high price for her medication.
The herbalist pressured him by offering a poor prognosis of demise by the Mid-harvest moon, the one we just passed recently.

By hook or by crook, he was going to make sure she got the herbs she needed, so he made a promise to the herbalist that so long as his mother would get treated and cured, he would fetch the steep price of rice and coins, regardless of how little they had to eat. The herbalist, more a shrewd businessman than a physician, agreed to supply at a hefty price and would venture by moonlight some thirty minutes away, to an isolated taro field.

One night, the boy stealthily followed the merchant out to the field and spied as he dug up the flowers, leaves and stalks, ditching the remaining parts in a nearby lake. He would dry and ground the plant and pass it on, ready for decoction in an unrecognizable form.

When he was certain the merchant had gone, he dug up a sizeable quantity of the herb and matched it with the plant remains that washed ashore. This helped him identify the right herb, and he could tell by scent, that indeed he had the right medicine.

So day after day, he prepared a tea for his mother and when he returned to the merchant, he paid him for a couple of doses, explaining that this was all he could afford, and that they would have to make due with what was in their means. Flabbergasted, the herbalist relented from their original agreement.

The young boy continued to source herbs from the field, and indeed they made a significant implact. Not only her complexion, but her energy and decrease in abdominal pains resulted from her daily consumption of this marvelous flowering, annual.

The boy named the herb, ‘benefit mother grass’ or yi mu cao.

The Shen Nong Ben Cao speaks of herbs of three different classes, based upon their therapeutic value, their level of toxicity, and by that, how often they may be taken without negative side effects. Today’s adaptogenic class of herbs are associated with the ‘divine’ or highest level of herbs. Some of the contemporary masters of Chinese herbal medicine devised prescriptions in low doses, using affordable herbs with very little side effect, to demonstrate how to treat in an ethical and sustainable manner.
 
(adapted from Zhu and Zhu’s Chinese Herbal Legends, 144.)

Acupuncture and IVF

by Hyoun Bae on 10/10/17

Acupuncture and IVF/IUI

 

Through Chinese medicine, we assist couples seeking support, resources and information regarding options in fertility care.

In our clinic, we take practical steps to encourage communication between partners and providers and feel it’s important to address overall health and wellness. This may include self-care and family planning, and taking time to review your health history, which in traditional medicine is a significant part of the journey itself.

There are many causes of subfertility. Managing stress, focusing on diet, exercise and environmental factors – together we navigate the data-influenced facets of care – thereby improving outcomes. I’m confident in the benefit of acupuncture and herbal medicine because of the repeated success I have witnessed and been a part of over the years.

Part of this is how we understand reproductive concerns. Whether it’s the phase of the menstrual cycle, the characteristic function of hormones, ovarian reserve or ovulation dysfunction – the Chinese medicine offers a rational perspective and methodologies that are evidence-based.

 

Chinese medicine not only provides for a comprehensive outlook on reproductive health, but has also assimilated with the views and interventions of ART, to the degree that contemporary wisdom has its own language and protocols aligned specifically for integrative care. This includes treatment to support IVF and IUI.

It offers a rather seamless integration of these paradigms.

 

MINDBODY APPROACH

One might call it a mindbody approach to fertility care. This encompasses both natural, and assisted, reproduction.

We focus on total health and wellbeing.

While addressing parameters such as age, ovulation assessment, ovarian reserve, tubal blockage, genetic screening, semen analysis, etc. we remain with the core belief that fertility optimization includes the whole person, family and life circumstance.

In TCM, each physiological system contributes to reproductive health. When we address the many facets of our health, we promote optimal fertility. In addition, there might be some factor of imbalance we can begin to correct, or a consideration in the medical history such as PCOS, thyroid disease or male subfertility. These too are understood and treated with time-tested methods.

In the specialization of women’s health and TCM reproductive medicine, we also recognize common patterns, treating which may benefit outcomes.

Many attest to acupuncture as being among the most important factors to their successful outcomes, and the most meaningful in terms of overall care. I often advise and support couples, acknowledging the tremendous effort and commitment involved.

 

In the preconception phase, I do request some diligence regarding making certain test results available (as possible). This helps us rule out certain factors and hone in on what’s most important.

From there we can focus also on overall health and reproductive optimization.

 

TIMING

 

During courses of treatment in reproductive medicine, it’s important to really hone in on the timing of interventions. Communication with the fertility specialist and their practice, and the acupuncture provider is essential. It’s important to arrange optimal timing and frequency of visits, and our practice is reliable and available when treatments are required.

This may be especially the case with respect to timing of retrieval and transfer. We feel its best that you are comfortable, and that your transitions to other offices is made facile.

To receive the most benefit, you may consider acclimating to acupuncture care in preparation as well. Initial consult will provide you the time to ask questions, and if you are less familiar with acupuncture this will provide you the opportunity. Chinese medicine interventions tend to be individualized, and so it is appropriate to provide some time for evaluation and treatment at each session.

Treatments in my practice are highly specific. This is especially so, closer to times of transfer and the same goes for perinatal care. Nothing extraneous is incorporated. We reference standards based in the latest research. I prefer that your experience is quiet and restful at these times, comforted by the knowledge that we are assisting you and supporting the primary role of your fertility specialist.

At each meeting, it’s helpful to relay relevant information (ultrasound results, response to medications, etc.) from your visit (s) with specialists to promote the best care.

 

While many come upon acupuncture, as an option, late in the game, I suggest beginning month(s) prior (preparation phase), when possible to any cycle of treatment. Acupuncture may even benefit both partners. It can also provide needed self-care and regulation in between cycles.

Ovarian hyperstimulation is another complication that I believe acupuncture can assist. One of the great skills and wisdom Chinese medicine has to offer is how to nourish, regulate and care for the entire being – while addressing common symptoms.

I sincerely hope to be a part of your team. I truly love the work that we do, being of support to individuals and families, and being there for you during challenging periods.

What is TCM?

by Hyoun Bae on 10/07/17

What is TCM?
 
Say you’ve had back pain – an acute strain or sprain. You’ve been shifting in your seat at work. Coworkers hear you moaning and groaning and remind you - you gotta’ do something about it. The teams got to get through this project by the end of the week.

The lightbulb goes off. Ting. You remember that acupuncture has worked in the past, or perhaps one of them has referred you to their ‘needle person.'

So you go in for a session, and Voila. It works! And in a few days, the pain is in the background – a distant memory.

How do you explain how it works? The cup marks. Your irresistible joy? Your near perfect skin? Kidding.
 

I greet the same enthusiasm all the time. I get equally excited when I write an entrance letter for a patient who now changes professional course, and enters Chinese medicine school. Or are able to share with someone the joy of study of Asian medicine, by handing them a book, because they want to know more.

Without reservation, over the years, I’ve stocked used copies of benchmark works to hand to the inquisitive an introduction to the theory of Chinese medicine. There are some ‘classics,’ and even in my own training, we relied on some English language works to gain a footing in how to think in Chinese Medical terms.
 
With great pride, some of my early instructors taught from standard textbooks they had learned from. One such text has endured in N. American curriculum and is likely still on the reading list of essentials. A professor, who was among the earliest graduates in a Chinese medical university, would present the principles of TCM with such feeling, that the respect was contagious, and in a way, it would invite you into a world of understanding and life-changing practice that you might automatically assume the authenticity and ‘traditional’ nature of the telling.

Yet, historiography reveals a different story. And so with all of the excitement around an integrated, contemporary and clinically useful art and science of Asian Medicine, a more defining view allows for an appreciation of cultural, political and ideological forces that shaped the body of ideas and practices we call TCM.

Don't worry. There is still magic, as well as discernible efficacy.

In some contexts, TCM – Traditional Chinese Medicine – reveals an intelligible, systematic and cohesive presentation of Asian medicine principles that can be tested with greater scrutiny. Integrative physicians train in acupuncture, and some have gone on to train in TCM colleges. Aspiring graduate students don white coats and are invited into a flourishing, professional world where acupuncture and Oriental Medicine are on the cusp of mainstream recognition. Inroads toward integration are evidenced in hospital-based care.

Importantly, TCM – even in English language translation – its idioms and concepts, are relatable enough. Yin and yang, we kind of know. If I’ve handed you a text such as “The Web That Has No Weaver,” regardless of your background, you might have gotten a charge from reading it at the beach to feel you understand and can relate to its message of ‘holism.’ Culturally, it’s not too much of a stretch to assimilate these ideas of health and healing.

But this achievement, too, reflects a process of standardization and a packaging of ideas.

If you have worked with me for some time, or read online – you have already heard terms such as dampness, stagnation, heat. Maybe we have talked about qi stagnation somewhere – perhaps the chest or heard that the liver’s qi is stagnant. We’ve walked you through herbs, treated specific acupuncture points. Maybe you’ve felt some correlation between treatment and physiological regulation, relative to the menses, mood, headaches or even seasonal allergies. TCM’s ideas might be accessible already.


In the following, we’ll unpack what TCM is – how it was constructed, how it’s language and presentation situated it with respect to scientific discourse. TCM itself was a label attributed in the 1950’s, not to differentiate it from the old traditions, but within a milieu and process of encountering modernity.  We might look to milestones in the 70’s, periods of cultural encounter, and what’s going on today in the fields of Ayurveda, Tibetan medicine and other fields growing in tandem, or in the wake.

TCM is a systematization of medical ideas, essentially first taught to doctors trained in western, biomedicine who sat in smaller university and academy classes. There is a heroic narrative adapted to the pioneering work of early architects of this cultural movement.
There was also conflict, debate and confusion about how to shape and situate a rather diverse and plural world of healing. Not one tradition. Many streams (Scheid). Classics that have endured. Innovations and evolutions, but definitely a rich cultural heritage and legacy. I have found very few influences as profound, challenging and engaging.

Let’s explore what TCM is, and perhaps maintain a critical eye as to how well it relates to health and healing today, as well as what we call tradition, Asian medicine, and also preserve some of that appreciation or openness I once felt. I see TCM as a synopsis and an introduction. Page by page, line by line, a quotation from the classics… you can feel what the intention was while sitting by your mentor as they discussed the heart of the matter - how our wellbeing is in our hands.

It’s kind of like yoga and contemporary mindfulness education. Your doctors are pretty aware of the mixed bag. Mostly good. By now, a fixture of consumer and pop culture, and the wellness industry. Studies show relevance, and we are on the whole optimistic and realistic.

We have to evolve parameters, for example, with preexisting conditions or around pregnancy and perhaps be more conscious as a culture, with our reception of these ideas and practice.  We can be aware of how we’re relating to things in our familiar categories of exercise, or as therapists and mental health practitioners, the possibility of deepening our access to mindbody wisdom. Yes, these are more than cultural commodities. They change lives, including my own.

We certainly benefit from keeping a dual attention to context, understanding the nature of the relationship in which we receive such vital information, and measuring just how much of it is beneficial to us while considering sources and meaning, cultural distances and empirical reasoning. What is evidence, according to our different tools of measurement and interpretation?

TCM is a synopsis, a profound introduction, and perhaps a strategy of relating a world of health experience and medical care amidst a very complex and advancing field of global healthcare. And there are ideas we can relate to that broaden preventive strategies, and support our home and family self-care.

Chinese Herb Lessons for the Fall

by Hyoun Bae on 10/01/17

 Stories from the Medical Archives

 

With campfires on the horizon, I collected some old legends and stories that tell the tale of Chinese Medicine. For centuries, students have been passed down tales and anecdotes to remember herb functions, and the history of Chinese medicine – its ideals and methods – were transmitted along with these visioning of the hoary past.

(These have been culled from Miranda Brown’s Art of Medicine in Early China, and Zhu’s Chinese Herbal Legends.) We’ll share with you those related to the fall.

 

Ma Huang: Managing the Exterior

 

For some, the fall winds have felt inordinately penetrating. The nape of the neck needs to be covered, else the breeze may feel invasive. This can occur with a weakness of the blood system. The blood refers to our nutritive body (ying), and stands in relationship to our defensive qi, or “wei qi” which creates a sense of boundaries. This relationship is between interior and exterior, or ying and wei qi.

 

An elder official and clinician once instructed his only pupil about the formidable leafless grass known as the “yellow grass,” whose properties are reflected in the oldest of medical prescriptions for colds, flus and infectious illnesses. It is a diaphoretic, which can make one sweat, in order to regulate a fever, and hence the “wei” or exterior. Managing the exterior is a key to treating acute onset of febrile disorders.

The official was not wealthy, and his haughty student, not the greatest receptacle. In one ear and out the other. Like a Martin Shkreli, the student thought to take his herbal knowledge to the market, and jack up prices on this seemingly innocuous plant. He’d learn how to identify a plant, dry and prepare it, but seemed to care less about its safe use.

His teacher told him, “Be wary of the potent effects of the herb. Stems cause sweating, whereas the roots aren’t as strong acting for this. Sweating is used to resolve the exterior.” What did the student hear?

This student went out to the market and indiscriminately sold the stems of the yellow grass to anyone. One person purchased the herbs and made a tea for their elderly relative, who began to sweat all over the body. Being thin and deficient, rather than resolving their cold and achy joints, it depleted them and they fell even more ill.

The student was held accountable, while the teacher wasn’t’ detained. This herb story is based around ma huang, which contains the alkaloid ephedrine, which is replaced with cinnamon (gui zhi), for those who have a more “windy” constitution, or are more deficient. Ma huang is found in modern weight loss supplements, with other herbs that are thought to help one “shed” the exterior – sweat, poop and pea. It can also be used more judiciously, even in cases of pediatric asthma.

 

 

Perilla Leaf: Keeping the Tummy Warm

In my family’s garden, we have the Korean variety used similarly in cooking to that of the perilla leaf used in Chinese and Japanese medicine, and which you might have had with sushi. It’s called zi su ye. In Korean cuisine it can be stewed in soups, such as a goat and mustard soup, which is among the classically warming, hearty meals served to beat the chill. In the winter, fresh ginger and dang gui is an emblematic Chinese medicinal soup with the same characteristics.

Zi su ye is a milder diaphoretic and is also used in cold formulas, because it doesn’t make the heart racy or make you sweat vigorously. Thus, it might be better even for the little ones.

It’s also quite pungent and aromatic which helps with digestion. Whether an avocado and cucumber roll, or a buttery sashimi, this culinary medicinal can offset a sushi dining experience by protecting the stomach from cold.

 

The legendary Hua Tuo was out for dinner, when some pub crawling “college kids” popped into the wine restaurant he was seated at. Hua Tuo, noted as one of the greatest physicians and healer sages, sat wide-eyed as these young men took mounds of crab to task, chucking the shells aside as they attempted to house this all-you-can eat affair.

Crabs are considered cold in Chinese medicine. Although they pounded rice wine, these fellas were in for it.

Hua Tuo warned, “Slow down, guys. Winning this crab-eating contests will come at a cost.” They chided the old man, and told him to step back as they were “winning.” No reason to be jealous that his elderly body barred him from participating.

Hua Tuo told the store owner to cut them off at the bar, as they would just keep eating and drinking, masking the tell tale signs from their belly. Nada.

 

Late that night, Hua Tuo was fast asleep when someone came pounding on his door. “Doctor, doctor! Help.”

Apparently these young lads were in excruciating pain – sweating, moaning and holding their stomachs. They had their relatives reach out to the shop keeper, who was not at Hua Tuo’s house at midnight urgently requesting his advice. He had his young students go out and gather perilla leaves and decoct them lightly, so as not to diminish all the volatile oils. Cooking method was more a steep, than a long drawn out decoction.

The simple brew relieved their stomach pain. When asked how he knew the right remedy, he shared the story of how he was out at a river bank, watching otters fishing.

One particular otter seemed to be doubled over after eating his catch. He rolled over onto the banks and foraged for these small, purple leaves and after a time of chewing on them, seemed to regain its pep.

Hua Tuo, observing this, gathered some leaves for himself to experiment and found that it counteracted food toxin, including bad seafood and poor food combining. Food that was ill-prepared, stale or too cold could be remedied with this culinary medicinal, which can be eaten raw, with wasabi; stewed, or pickled with green onion, chili, vinegar and soy sauce.

The obvious move in the kitchen, is to begin to shift the grocery list to foods that are more warming, grounding and nourishing. Late summer was short. While there are many bulletins out these days on fall cleansing, it’s perhaps best to focus on the rejuvenation/renewal part, as the type of detoxification or “balancing” alluded to in traditional medical theory has to take into account the actual influence of the seasons upon the body dynamic. You can refer to previous postings on late summer/autumn transitions and self-care.

 

Chai Hu: Out thrust and Regulate

I was reviewing the case studies of two contemporary Chinese physicians, both of whom shared a similar take on the use of a principle prescription, Lesser Bupleurum decoction. Dr. Yu, whose text we mentioned previously, gave the clinical example of using this formula for a later stage of cold, in one who has a deficiency condition, but whose cold is lingering.

The latter, suggested this formula for some instances for presentations of colds, during menstruation, when the exterior is drawing in as the movement of vital energy and blood is moving down and out. All of these cases illustrate the evidence-based and empirical reasoning that examines the qi hua, or internal mechanism of vital physiology, as well as our constitution and the context of therapy.

The main point I often stress in simple terms, is that medicine should assist the body in its processes of adaptation and healing. Chai hu, which is collected in the fall, can help assist things moving along, like knotted qi causing pain and cramping, gatherings of heat and cold, especially in the diaphragmatic region.

It’s an herb governing transitions.

 

 

An agricultural worker went to his boss, to ask for his pay and a day off. He had fallen ill at the end of summer and was suffering from alternating fever and chills, with poor digestion. There was no fever to break, but he just felt so ill. His appetite was a mess, and he was dizzy, feeling stagnant and flustered. There was no way he could do much for early harvest time. He needed to lie down.

The landowner retorted, “No work, no pay! Take yesterday’s pay and get yourself better. Come back when you can work.”

There wasn’t much the farmer could do. He found a place to rest for a few days off the farmland, beside a river. Not having much to eat, and no money for medicine, he started a small fire for cooking with the bramble and kindling he could find. He also chewed on the roots of the woody plants he found.

After a couple of days, he came back restored.

The callous landowner merely nodded and put him back to work, but when his own son fell ill with similar symptoms he called over to the farmhand.

“My son’s down with an illness similar to yours. What did you do?”

The laborer shared that he had camped out by the river and only chewed on these roots of plants he pulled up for firewood. Hence the name chai hu, which refers to firewood of laborer Hu.

 

Chai Hu, or Bupleurum, is the principle medicinal for regulating the liver’s qi (hepatoprotective function) and is featured in these prescriptions that deal with latent pathogens, when colds aren’t resolving and are heading deeper into the trail of pathology. You can recognize these trails – even with psychosomatic, nervous, digestive (IBS) and immunological concerns – when there is a wavering, or “alternation” of body temperature, or unresolved stages of illness, or subjective symptoms which shift. That’s when to employ a relatively strong, and pivotal herb, such as Chai Hu.

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