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Founder’s Note : This is part of a series of articles about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page.

Introduction / Zhishi / Dandouchi / Shaoyao / Wuweizi / Shanyao

Huangqin / Huanglian / Baizhu

味苦皆屬水,地黃為之主,黃芩為木,黃連為火,白術為土,竹葉為水。

All bitter belongs to water, for it is governed by Dihuang, and Huangqin is wood, Huanglian is fire, Baizhu is earth, and Zhuye is water.

The Tang Ye Jing lists Baizhu (白術) or Atractylodes Root as the Earth of Water. We know from basic Five Phase thinking that Earth controls or restrains (ke 克) Water, and it is this relationship between Earth and Water that is exemplified by Baizhu.

It is an indispensable herb in treating disorders involving dampness and fluid metabolism.

The Shen Nong Ben Cao Jing emphasizes these qualities in its entry on (Bai)Zhu:

術 味苦溫。主治濕痺、死肌、痙疸,止汗除熱,消食 … 久服輕身、延年不饑。一名山薊。生鄭山山谷。

Zhu tastes bitter [and its flavor is] warm. It governs damp obstruction, dead muscles [i.e. atrophied or weakened muscles], tetany, jaundice, stopping sweating, eliminating heat, and dissolving food [i.e. supporting digestion]….protracted taking lightens the body, prolongs life, and eliminates hunger. Its other name is Shan Ji (“Mountain Thistle”). It grows in Zhengshan’s mountains and valleys.

All of these diseases involve dampness and implicate the Spleen, the Earth Organ Network, which is responsible for the circulation and metabolism (or “transportation and transformation”, yun hua 運化) of fluids as well as nutrition derived from food. Spleen dysfunction leads to pathological fluid accumulation, described as dampness (濕) in Chinese Medicine. Conversely, the presence of dampness encountered in the environment can encumber the Spleen, disrupting these vital functions of the Earth.

From a Five Phase perspective, dampness results from a failure of Earth to control Water. Chapter 23 of the Huangdi Neijing Suwen informs us that the Spleen is averse to dampness (脾惡濕), and Chapter 22 of the Suwen advises us that “when the Spleen suffers dampness, urgently eat Bitter to dry it.” (脾苦濕,急食苦以燥之)  Somewhat paradoxically, it is the Bitter flavor, which the Tang Ye Jing associates with Water, that will enable the Spleen to re-establish control over fluid metabolism.

We can understand this by considering the quality of movement associated with the Bitter flavor in Suwen Chapter 22: bitter consolidates (jian 堅). The key to grasping Baizhu’s action lies in this movement, and in the character which symbolizes it. The character jian 堅 could also be translated as to solidify, harden or fortify. The ancient dictionary Shuowen Jiezi 說文解字 defines jian as “earth that is made firm” (堅: 土剛也) and notes that it is composed of two component characters, 臤 which means strength (and is also a component of the character for Kidney 腎) and 土, which means soil or Earth in the context of the Five Phases. The character used to describe the direction of the Bitter flavor literally means “to firm up earth”.

When we dry something, it becomes solid, firm and hard.

Likewise, when soil is consolidated it is firm, and when it is firm it can serve as a dam that can contain water. These connotations would have been obvious to the ancient Chinese, whose civilization depended upon the proper management of rivers to sustain agriculture. This firming, hardening quality itself however belongs not to Earth, but to Water. It is in the Winter months that the soil becomes hard, as Cold congeals, freezes, and solidifies the ground. This is why the same component character 臤 appears both in 堅 as well as in the character for Kidney 腎, the Water Organ Network. Consolidation is an essential part of the movement of storage 藏 which is the fundamental movement of Winter and the Water Phase.

Thus it is by imbuing the Earth with the firming quality of Water that the the Bitter flavor of Baizhu is able to dry dampness, promote fluid metabolism and bank up the Earth to control Water.

This is the primary use of Baizhu in Zhang Zhongjing’s formulas.

We see it frequently paired with Fuling, the Water of Earth, in formulas like Wuling San (五苓散), Ling Gui Zhu Gan Tang (苓桂朮甘湯) and Zhenwu Tang (真武湯)  where it functions to dry damp and disinhibit water. In contemporary practice it is common to focus on the Spleen as a digestive organ, and thus we consider dampness primarily as involving digestive symptoms like loose stools. However, there are many other functions of the Spleen and many other ways that dampness can manifest in the body.

For example, the Spleen also governs the four limbs, and another important use of Baizhu is in disorders involving joint pain that involves dampness, as in Gancao Fuzi Tang (甘草附子湯),  and Guizhi Shaoyao Zhimu Tang (桂枝芍藥知母湯). These formulas are used in the treatment of wind-cold-damp obstruction, the first disease listed by the Shen Nong Ben Cao Jing that Baizhu governs.

Dampness is often a key pathological factor in obstruction or bi syndrome (痺證); the Shuowen Jiezi defines obstruction as “dampness disease” (痺: 溼病), and if we analyze the character for obstruction we see that it is composed of the disease radical  疒 over the phonetic component bei 卑. When bei is combined with the flesh radical 月, this forms the character pi 脾, or Spleen. We can see how the use of Baizhu would be indicated in these kinds of conditions.

The largest dosage of Baizhu in Zhang Zhongjing’s formulas is in a somewhat obscure formula called Tianxiong San (天雄散), at eight liang of Baizhu. Tianxiong San is listed in Chapter 6 of the Jingui Yaolue alongside the formula Guizhi Jia Longgu Muli Tang (桂枝加龍骨牡蠣湯), both of which are indicated in the treatment of a pattern of deficiency taxation 虛劳 characterized by a loss of essence (失精).

Why would Zhang Zhongjing suggest using a large dose of Baizhu in a formula to treat a pattern characterized by loss of essence? We can understand this high dose in terms of the dynamics of Earth and Water; insofar as essence belongs to Water, the large dose of Baizhu is there to utilize the control cycle to staunch the loss of essence, firming Earth to restrain Water.

This use of control cycle dynamics between Earth and Water has implications that go beyond herbal medicine.

For example, it may partially explain why in Master Tung acupuncture sets of points on the Spleen Channel can be used to benefit the Kidney. It’s our hope that our exploration of the dynamics of the Five Phases through the Tang Ye Jing will be of interest and benefit to practitioners of Classical Chinese Medicine, regardless of whether one is practicing with herbs, acupuncture or any other modality. Fundamentally, the study of these ancient texts provides us with information about the cycles of physiology and their interaction with the cycles of nature. The better we understand these cycles and their dynamic interplay, the better we can help patients.

The post Exploring the Tang Ye jing – Baizhu 白术 – Earth of Water appeared first on Chinese Medicine Central.

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In this podcast, I’m flying solo and talking about social media for acupuncturists. The marketing world is confusing and, for some, quite overwhelming. No question gets brought up more in my classes and my email inbox than whether social media works for getting acupuncture patients, and how to manage it all. So, here, I hit on most of the high notes relating to the big three, Facebook, Twitter and Instagram.

I discuss…

  • The basics you should consider before getting started
  • The consideration of time and opportunity costs in social media
  • How social media makes you FEEL and why that matters, especially for acupuncturists
  • Whether or not ethical matters make their way into this particular business decision
  • How to decide whether your niche requires that you use social media to build your practice
  • Whether or not social media really works to get acupuncture patients
I wanted to mention a couple of tools I use or have used to manage my own social media activities, including:
  • Hootsuite (poor visuals, but free and robust way to manage multiple profiles and gather content to share)
  • Sprout Social (much prettier, but more expansive, alternative to Hootsuite)
  • Coschedule (way to schedule/manage online marketing, reuse old content, and much more – my number one recommendation… aff link)
  • Edgar (a slick way to find, post and reuse social content, important in managing social media for acupuncturists when we have so much on our plate)
And a shoutout to a couple of great Instagram accounts that show some great skill in use of social media for building a medical practice:

The post WLP Podcast S1E10 – Social media for acupuncturists : Whether, why, how and really? appeared first on Chinese Medicine Central.

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In this episode, I welcome Allison Jacob of Earth Sea Acupuncture in Waterbury, Vermont (which I erroneously called Virginia at first – forgive me!). Like me, she practices in a relatively more rural area, and a lot of what we discuss revolves around that topic. How do you find patients in a rural area? How is acupuncture received outside the big cities? What’s marketing like when BNI isn’t available and social media may be less of a preferred mode of communication?

Allison also shared her love for her new clinic space, and we discussed how important esthetics are to the sense of calm and centeredness necessary to do our best work as acupuncturists.

It was a fun conversation that I hope is only the first of many to come. You can see photos of Allison’s space below, as well as by checking out her website. She’s on Instagram as well, so go ahead and follow her to your heart’s delight!

The post WLP Podcast S1E09 – Allison Jacob talks rural acupuncture, esthetics & bringing your whole self appeared first on Chinese Medicine Central.

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Through some serendipity and some hard decisions, I’m finding myself with just a little more time on my hands than usual. My clinical practice is soaring, the business is reaching a nice momentum point, and I’m stepping out of University teaching. With my daughter out of the house and doing well on her own, and no major family crises dominating my attention – things are looking clearer than ever! What’s more, I’m a pretty simple guy. I don’t have many hobbies, I’ve no interest in acquiring any, and I don’t do many of the things that most people would consider leisure activities. So, this free time isn’t about to be gobbled up by something like that.

As I open myself to possibilities, I’m finding my attention dominated by two things. The first, not as relevant for this blog post, is meditation, the philosophy and science of mind and Buddhism. The second is, of course, Chinese medicine. Particularly – Chinese herbalism.

Now, yes, everything is the medicine and the medicine is everything.

Whether you spend a dozen hours a week reading graphic novels, or are a snowboarding champion or a woodworker, everything you learn there will, in some way, relate back to the medicine. I know plenty of colleagues who learn far more about how to treat patients effectively from kayaking the Columbia or donating time at the local food bank than most do reading books or thinking through theory.

Further, the learning you do by treating patients and observing effects – that’s learning that really sticks. It’s important, and I’ve been doing a lot of it. But, still, there are times when nothing but rote memorization, digging through texts and thinking through difficult questions will do. To get to the next level, I need to reengage with traditional scholarship. With books and mindmaps and critical thinking. And I’ve struggled, in the past, to make much time for more traditional absorption of knowledge.

The year of the pig has shifted all of that, and maybe it really is that triple burner deep yin energy that’s awakening my dormant faculties.

But even more important is my commitment to the Shanghan Lun Lines Retreat with ICEAM in Canada this June. I went to another Lines retreat 6 years ago, but frankly, I didn’t benefit the way I should have due to my busy life and mind. This time, I’m feeling ready. And the work I’ve done already in preparation has enlivened me about my lineage, the work that ICEAM does, and my place in this flow of information and practice. So, a surge of energy is powering me into a whole new cycle of time, as the yijing likes to say.

My goals
  • To rememorize and otherwise refresh my knowledge and understanding of the Shanghan lun (SHL) formulas and all of the herbs therein
  • To rememorize (and in some cases memorize for the first time) the Lines of the SHL
  • To rememorize (and in some case memorize for the first time) the pulses associated with the formulas that are part of my lineage
  • To read works outside my direct teachers and lineage about the SHL to add nuance to my understanding
  • To do case review related to my prescription of SHL formulas, as well as those of my teachers in clinic over the years
  • To arrive at the Lines retreat ready to receive the transmission and take a step forward in my clinical understanding
My tools My texts Here on the site, I’ll share more of my methods and what I run into along the way.

There are a few articles here on the site about memorization, which will be the most important task of the next 20-30 days. I have the bulk of what I need already committed to memory, or so I think. I’m always surprised when I reengage how much I’ve let slip, and I don’t want to be slipping. There’s simply no replacement for memorization, and I find the more I have committed to memory, the more useful I am in clinic.

I still stand by the basic methods I discuss in my Shennong course on Chinese herbalism as well.  Staring at text in books and living in the ether of the mind is great, but when I get stuck, nothing beats smelling, touching, growing and tasting herbs. While the SHL mostly trucks in formulas, and formula science is the best way to understand the text, there’s something indescribably important about engaging with the plants themselves on some level.

I will be posting as often as I can in the lead up to the retreat on June 10, and then posting my observations during the seminars themselves as I have time. It’s going to be a summer to remember! No pun intended…

The post How I’m (re)learning Chinese herbalism appeared first on Chinese Medicine Central.

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It’s another re-release of an old Deepest Health podcast episode. I even kept the original intro/outro music intact for that extra ring of authenticity (and less work for me!) This one has some pretty major audio quality challenges, but the content is strong. Here, Z’ev and I talk more about the profession at large, rather than just aspects of acupuncture business, but that’s all part of Whole Life Practice.

I like this podcast particularly for the history of the early acupuncture profession in the US that Z’ev can uniquely share. I feel we don’t hear enough from the elders of our medicine that can help us see where we stand in relationship to the stream of the profession as it exists in the US.

Please check out the links and information in the previous podcast to learn more about Z’ev, his practice and his teaching!

The post WLP Podcast S1E08 – Z’ev Rosenberg’s 2011 podcast interview appeared first on Chinese Medicine Central.

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In this episode of the podcast, I was fortunate to talk with Z’ev Rosenberg, author, teacher and very busy Chinese medicine practitioner. Z’ev practices out of his home in San Diego, and because many students ask me about home-based practice, we focused quite a bit on how that works for him. However, we also discussed insurance billing (and why he doesn’t do it), keeping in balance as a busy practitioner and the meaning of Whole Life Practitioner for patients.

Z’ev has a lot of great things going on in his professional life, so I wanted to share some links to some of those projects here. Watch for next week’s podcast which will be a re-release of the conversation I had with Z’ev back in 2010! While a lot has changed, and the sound quality leaves something to be desired, you’ll find plenty to learn or re-learn from that conversation which ranges from professional practice of acupuncture to the importance of the classics and beyond.

Thanks as always for listening!

The post WLP Podcast S1E07 – Z’ev Rosenberg discusses home acupuncture practice & nourishing life appeared first on Chinese Medicine Central.

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This is a special, significantly longer, episode of the WLP podcast. As I’m interviewing practitioners about their business and professional lives, I’ll be re-releasing any interviews I’ve done with them in the past as well. Since many of these interviews do touch on the business side of acupuncture practice, it seemed a shame to let them waste away in the dustbin of Internet history. So, here you have another interview with Dr. Neal Sivula, DVM of Dancing Paws Animal Wellness. In the interview we do talk a bit about the basic premise of acupuncture and Chinese herbalism for non-human animals, but also discuss the relationship of holistic and more conventional medicine for animals, among other topics relevant to this podcast. Enjoy!

The post WLP Podcast S1E6 – 2014 interview with Neal Sivula, re-released! appeared first on Chinese Medicine Central.

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In this episode of the Whole Life Practitioner podcast, I am excited to introduce Dr. Neal Sivula, DVM, PhD, a holistic veterinarian practicing in Richfield, OH.

Neal was kind to chat with me about the setup of his practice, including his decision not to have real-time reception, and how he has pivoted towards an entirely holistic approach. We discuss his increasing focus on the classics of acupuncture and the tools he uses to maintain balance in stickier parts of practice, including end-of-life care. Even if you are not a veterinary acupuncturist, or don’t have much interest, I think you’ll benefit from hearing what Neal has to say about how he structures his own business and how he seeks to live a “whole life” while practicing this medicine.

Next week, I’ll be releasing the very last episode of the old podcast, which again features Dr. Sivula! There we go more into the medical side of things, but also end up discussing aspects of practice and study relevant to the Whole Life Practitioner concept. Stay tuned!

Relevant Links

The post WLP Podcast S1E5 – Veterinary acupuncture & creating a practice that supports your life balance appeared first on Chinese Medicine Central.

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Founder’s Note : This is part of a series of articles about the theory and herbs of the Tang ye jing. The enthusiasm and scholarly integrity of the author – regular contributor Joshua Park, DSOM, LAc – will make this a thought provoking and engaging read that we hope you’ll share with friends and colleagues. Joshua is eager to hear your feedback, either here on the site or on our Facebook page.

Introduction / Zhishi / Dandouchi / Shaoyao / Wuweizi / Shanyao

Huangqin / Huanglian (you are here)

As before, we will begin with the Wood Phase and work our way around the cycle until we come to Water. We will kick off the Water herbs with Huangqin 黄芩, also known as Scutellaria baicalensis or skullcap root:

味苦皆屬水,地黃為之主,黃芩為木,黃連為火,白術為土,竹葉為水。

All bitter belongs to water, for it is governed by Dihuang, and Huangqin is wood, Huanglian is fire, Baizhu is earth, and Zhuye is water.

Huanglian 黃連 (Coptis root) is the Fire of Water.

Just as Huangqin carries the activity of Water into the realm of Wood, Huanglian is able to transfer the activity of Water into the realm of Fire. Water controls Fire in the Controlling Cycle of the Five Phases, which is very much in keeping with the heat clearing, fire draining action ofHuanglian. Among the most bitter substances in the materia medica, Huanglian has famously been described as being “more bitter than widow’s tears.” Its pronounced bitter flavor is so great that when it is added to decoctions with other herbs, even just a few grams of Huanglian can be enough to dominate the flavor of an entire formula.

Along with its yellow siblings, Huangqin and Huangbai, Huanglian clears heat, drains toxicity, and drains dampness. Huangqin’s action is ascribed to the upper burner, Huanglian to the middle burner, and Huangbai to the lower burner. In particular, Huanglian is often said to have an affinity to both the Stomach and the Large Intestines.

However, the fact that Huanglian is classified in the Tang Ye Jing as the Fire of Water implies that its action is not only confined to the middle burner.

This is supported by the Shen Nong Ben Cao Jing, which describes the action of Huanglian in this way:

黃連 味苦,寒。主熱氣,目痛,眥傷,泣出,明目,腸澼,腹痛,下痢,婦人陰中腫痛。久服令人不忘,一名王連。

Huanglian’s flavor is bitter [and its nature] is cold. It governs heat qi, eye pain, damage to the canthii, tears pouring out, brightening the eyes, intestinal afflux, abdominal pain, diarrhea, swelling and pain within the female genitalia. Protracted taking improves the memory; another name is Wanglian [literally, “King (Huang) Lian”, or perhaps, “King of succession / carrying on”].

Huanglian’s ability to improve memory suggests it has an effect not only on the digestive organ networks, but also on consciousness, through its ability to drain fire. In particular, this implies that Huanglian has an affinity to the Heart, which belongs to Imperial Fire and is the seat of consciousness.

There are sound theoretical reasons why an herb that has the ability to clear heat in the Stomach (and the intestines, part of the Yangming “Stomach Family” 胃家 weijia) would also affect the Heart. Although it is now classified as a Fire organ, it has been noted by Heiner Fruehauf and other scholars that initially the Heart was classified as an Earth organ, like the Stomach. This was no doubt due to the central role played by the Heart as the Emperor organ. When considering the circadian rhythm of yingqi through the channels and organs, the Foot Yangming Stomach and the Hand Jueyin Pericardium are clock opposites.

These cosmological connections are in turn describing close physiological connections.

In Chinese Medicine, when there is excessive heat in the Stomach, this can rise to harass the Heart, resulting in vexation, insomnia and other psycho-emotional symptoms as well as physical symptoms such as bleeding. From a biomedical perspective as well the adjacent structures of the anatomical heart and stomach can make it clinically challenging to differentiate between acid reflux and a heart attack.

Understanding these rich symbolic connections between the Stomach and the Heart can in turn help us to understand how Zhang Zhongjing uses Huanglian in his formulas. It is used in formulas that primarily treat damp heat in the Small Intestine (which from a Zang Fu perspective also belongs to Fire), such as Gegen Huanqin Huanglian Tang 葛根黃苓黃連湯. However, Huanglian also features heavily in formulas that treat symptoms such as “vexation in the heart with insomnia” (心中煩,不得臥), as in Huanglian Ejiao Tang 黃連阿膠湯. In fact, Huanglian is used in its greatest dose in Huanglian Ejiao Tang, which clearly emphasizes its ability to drain fire from the Heart.

In other cases, as in the Xie Xin Tang 瀉心湯 formulas, Huanglian is used to treat both digestive symptoms as well as vexation, indicating that heat is harassing the Heart.

In the Xie Xin Tang formulas, the key patho-dynamic is the stagnation of qi in the epigastrium, resulting in blockage and fullness in the epigastrium. This particular kind of stagnation is known as a glomus or pi 痞 disrupts the normal qi dynamic of the digestive symptom, resulting in heat in the Stomach and cold in the Spleen. The heat in the Stomach can in turn harass the Heart, resulting in symptoms of vexation, as in the symptom picture of Gancao Xie Xin Tang 甘草瀉心湯 described in Line 158 of the Shang Han Lun. In the Xie Xin formulas, the character xin 心 which normally indicates the Heart organ can be seen as a kind of shorthand for the region below the Heart, the xin xia 心下 or epigastrium. This usage again reflects the close relationship between the Stomach and the Heart, and the ability of Huanglian to treat both organ networks.

In all of these formulas, it should be noted that Huanglian is paired with fellow Water class herb Huangqin, which as we have discussed previously brings Water to Wood by cooling Ministerial Fire in the Gallbladder. Together this combination is able to strongly drain fire and resolve stagnation in the epigastrium. This synergy can be understood also in terms of the close association between Wood and Fire in the generating cycle, and also the relationship of Wood and Fire in respectively controlling and generating Earth.

Hopefully this examination of formula uses shows how the classification of Huanglian as the Fire of Water symbolically represents the full range of function of Huanglian. The close association between the Heart and the Stomach is implicated in many conditions we commonly encounter in the clinic, such as insomnia.

Watch for the next in the series, the popular herb Baizhu, Atractylodes rhizome! Stay updated on our newsletter, or watch all the action on Instagram.

The post Exploring the Tang Ye jing – Huanglian 黃連 – Fire of Water appeared first on Chinese Medicine Central.

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