Blood Pressure
The 5 Elements of Chinese Medicine for Knicks-Mania
For the first time in 53 years and the first time in my life it looks like the Knicks can do it. I never thought this would happen. Even in the past few years, as they improved and made progress in the playoffs, my non-expert understanding was that we were a second-tier team. We’d make some runs, it’d be exciting and interesting for the first time in a quarter century, and that was enough to stoke the passion of hometown fans. But we’d always fall short of the top tier.
Now here we are, atop the mountain, two games to win to be considered the best, and I’ve already lost sleep over it. Like a kid on Christmas, but instead of sugar plums, visions of dancing in the streets with strangers, causing a ruckus, crying tears of joy in embrace with old friends who I watched the Knicks of the 90’s with as a kid.
It only happened once, but last week I tossed and turned for hours, intermittently frustrated but also laughing at how ridiculous I was, a victim of my own “heart fire,” an over-stimulated central nervous system, hyper-secretion of serotonin, and/or cortisol. So how do we treat this?
“Excessive joy,” as it is referred to in the Yellow Emperor’s Inner Classic, which sounds almost paradoxical. Why should any amount of joy be labeled “excessive?” What it means is over-excitement. Excessive indulgence, as in intoxicants or sexual pleasures, manic behaviors, and/or over-celebration, as in if your team should win a title for the first time in half a century. Of course, keep in mind for purposes of practicality, that none of these overt examples are requisite to induce heart fire. Some of us are just more so inclined—more prone to anxiety, insomnia, ruminating thoughts, or panic. For heart fire patterns, the following is advisable:
Avoid spicy foods, which induce upward surging of chemicals, the last thing they need. Prioritize bitters: green tea, coffee, and cooked leafy greens. Herbal formulas must be customized by a licensed clinician, but will revolve around medicines such as coptis root, gardenia fruit, scutellaria root, and/or rhubarb root. Keeping in mind that excessive consumption of bitter foods and medicines can weaken metabolism. It can be mitigated by exercise and foods that are mildly bland or sweet, such as yams, rice, and steamed vegetables.
Conversely, what if the Knicks lose? Then the stages of grief, beginning with anger, or “liver fire.”
Liver fire—that is uncontrollable fury—can be calmed by consuming sweets. Not sweet by modern American standards, although plenty of us have reached for junk food in moments of stress and can attest to having felt temporary relief. Instead, foods like rice or yams, even breads, butter, honey, or fruits can behave accordingly functional and are advisable for PMS cravings. Herbal formulas revolve around licorice, red dates, longan fruit, and/or rehmannia root. Keeping in mind that excessive consumption of sweet foods can also weaken metabolism by creating fluid retention in the gut. It can be mitigated by exercise and foods that are mildly bland or acrid, such as ginger, cooked onions, and steamed vegetables.
Finally, we have grief. Logically the opposite patho-mechanism to heart fire, grief causes vital substances to plummet in the body. Fluid metabolism is impaired as a result and we feel heavier, lethargic, depressed if you will. The body requires the opposite of bitter: Spicy, when appropriately dosed, can help metabolize fluids and bring our energy back up. Ginger, garlic, onions, turmeric, and even moderate doses of chili pepper. Herbal formulas might revolve around dry-fried ginger, Sichuan peppercorn, aconite, cinnamon, or ephedra. Keeping in mind that excessive consumption of “acrid” foods can weaken metabolism by dehydrating the gut’s mucosal fluids and digestive enzymes. It can be mitigated by exercise and foods that are mildly sour or sweet, such as yams, rice, and lemon water.
Clearly, and unlike my daughter, we are rooting for BITTER! Sleepless nights, heart palpitations, and a touch of anxiety, are symptoms any die hard Knicks fan would sign up for a few days of in exchange for a title. So get your green tea, kale, and dandelion greens ready. GO KNICKS!
Chest & Breast Pain & Chinese Herbs
Geography is significant in Chinese medicine. Not just the label of a symptom or disease, but its location, for acupuncturists, strongly informs our diagnosis.
When I ask patients whether they experience chest pain or tightness I am not necessarily concerned for some respiratory or cardiovascular disease. The chest is the “domain of Shao Yang,” “Lesser Yang,” that is relative to the head, neck, and face, described more often in our literature as “Tai Yang” or “Yang Ming,” respectively
The Shao Yang system harbors the end result of our body’s “pivot,” from metabolic production to the distribution of vital substances around the body. Soreness around the ribs, tightness in the chest, cough or even shortness of breath can be a result of our organs failing to produce adequate substances to engender functionality above.
The textbook pulse quality at the radial artery in such patterns is a “wiry one,” illustrating a microcosm of the fluids in our torso beginning to stretch thin. Needless to say, the best way to avoid this mechanism is with a diet that produces ample fluids and exercise to clear heat. If you don’t succeed, and eventually none of us do, what is the flavor of your chest pathology?
Sharp pain that is better with exercise, first of all obviously bodes well from a biomedical perspective, but also indicates some subjective blood stasis in the chest—most often a lack of blood movement due to an inadequate quantity of metabolic fluids giving rise to inflammatory heat, which tends to dry out the diaphragm and everything that includes it. Best remedies are moderate exercise and deep breathing. Best acupuncture points are Pericardium 6, which fires into the brain’s insular cortex, subsequently down the vagus nerve. Herbal formulas include platycodi bark, immature tangerine peel, and peony root.
If the chest feels hot, it suggests further aggravation of inflammatory heat, which might include sequelae such as insomnia, anxiety, and/or irritability. This may be difficult to treat with acupuncture alone, although local points such as Ren 17, Lung 1, and Liver 14 may help. Herbal medicine will be more effective, including the very bitter coptis root or gardenia fruit to additionally clear heat from the stomach, otherwise prunella spike, lily bulb, and/or if there is notable phlegm in the lungs, trichosanthis, or “gua lou pi.”
If your chest pain is worse after eating it clearly suggests some degree of food stagnation—that is indigestion. Steamed and bland foods are advisable until it resolves, as is drinking Pu-Erh tea, and performing manual stomach circles around one’s abdomen.
Best acupuncture points are Large Intestine 4, which fires into the brain’s periaqueductal gray matter, then into the abdomen. Herbal formulas include magnolia bark, rhubarb root, tangerine peel, ginger, and bupleurum root, to comprise the majority of “Da Chai Hu Tang,” or Major Bupleurum Decoction. Alternatively, if one is more prone to diarrhea and lack of appetite, more advisable would be the simple, four-ingredient digestive aid, “Li Zhong Wan,” or Regulate the Middle Decoction, containing ginseng, dry fried ginger, atractylodes root, and licorice.
Persistent chest pain should be taken seriously, especially if coinciding with shortness of breath, and one should see their medical doctor to rule out any danger. Once structural ailments are ruled out come see us to address the root of the issue!
Is Coffee Good for the Heart?
I recently read this article from New York Presbyterian on whether caffeine is good for heart health, citing recent scientific research findings that coffee can reduce the risk of heart failure, atrial fibrillation, and type 2 diabetes.
Of course, I have to weigh in… first by thanking NYP for the impetus and content material—even if we come from different paradigms of thought, science, in my opinion, is entitled to nothing if not thoughtful, yet vulnerable debate.
As everyone who adds one, two, or more teaspoons of sugar to their daily coffee knows, coffee is a bitter agent, and in Chinese medicine the directional chemistry of bitter medicines and/or foods is downward—down and out to be specific—evidenced in the bowel movements that are so common after one, two, or more cups of coffee in the morning. Is bitter medicine healthy? Sure, about half the population will gain more physiological benefit than harm from bitter herbs. The other half might experience the short-term benefit of bitters’ ability to reduce local inflammation, but in the long run it may harm their microbiome and ability to absorb nutrients, which in the longer run will create more inflammation.
“Give her more bitters!” the foolish clinician will shout. “Reduce her inflammation!”
But that second time around she is older and weaker—those initially experienced benefits seem inaccessible, and conventional medicine might increase dosages or attempt to potentiate the first medicine’s effect with another anti-inflammatory, and before we know it all gastrointestinal functionality is gone.
According to the FDA about 4 cups of coffee per day is considered safe for most healthy adults. I don’t know about you, but I can say with full confidence if I drank 4 cups of coffee a day for a month, I would develop some kind of health crisis by the end of it.
My opinion is the reason conventional medical research seems to waffle back and forth so much—during one generation coffee’s the villain—next generation it is alcohol—is because of its greatest flaw: Its insistence on attempting to objectify things as healthy or not, good or bad.
Bitter diuretics have a drying effect on the body, so if you are someone who has more pathological biofilms than deficiency of blood and vital enzymes, you may benefit from coffee in moderation. If you are the inverse, it can have the opposite effect. You might mitigate this by having coffee with food, which can provide enough metabolic moisture to offset its bitter diuresis.
A good way to know whether coffee is good for you is to observe how your body responds to it. If it gives you heart palpitations or makes you feel racy, then 2-4 cups per day will likely not benefit your long-term heart health. The same goes for if it causes you soft stool. If coffee is your key to regular, formed bowel movements then its bitter biochemistry likely agrees with you. If it gives you diarrhea it tells us your gut is a bit too lacking in enzymes to properly metabolize it—not to mention the fact that diarrhea further depletes such enzymes, which will inevitably impact the heart over time, ironically.
Many doctors and scientists are brilliant but in my opinion their brilliance is often handicapped by a reductionist lens. If you want to know if coffee is good for your heart one of the best people to ask is yourself. Or a (real) herbalist.
Acupuncture Post-NYC Marathon
The NYC marathon was this past weekend, and approximately 55,000 people pursued an admirable goal, reached a self-defined mountaintop, and in the process may have caused some degree of irreparable damage to their knees and/or hearts.
Although running is not the most advisable form of exercise in Chinese medicine, it is my opinion that for most people in moderation its benefits outweigh its pitfalls, helping to improve stamina and cardiovascular health, promote circulation, and in most months out of the year a healthy, non-excessive amount of perspiration.
But just like too much perspiration ends up negating its benefit by leaching the anti-inflammatory molecules and neurotransmitters contained within it, too much running can cause more harm than good—excess sweat being just one form of it.
While I struggle to disidentify as anything but a metropolitan, I also know that humans were not intended to walk, let alone run, on cement. That concrete is an inorganic, manmade endeavor, a luxury but challenge of modern society—good for capitalism, bad for Daoism.
Repeated pounding on the knees depletes their synovial fluid, the cushioning between bones and lubrication around tendons and ligaments that keep them soft, pliable, protected. Two ways to mitigate this effect is through stretching, that is opening the vessels and collaterals that send fluids to the patellae, but also with treatment.
Local acupuncture where fluid is missing cannot offer very much, but local moxibustion can inhibit NF-kappa B (inflammatory) signaling pathways, thereby dilating local vessels enough to attract white blood cells and healthy fluids. What’s more, “sports medicine” treatment around the neuromuscular paths that surround the knees can have a similar effect. Rectus femoris, biceps femoris, vastus medialis and laterali—basically, invigorate the thighs to unburden the bones.
As for the heart, this is obviously a serious issue. Excess exercise is arguably just as hard on the body as no exercise. It is important that we all find our own unique sweet spot in the middle and engage with discipline each week. For the excess inflammatory type, who drips with sweat, whose face turns red during workouts, who over-indulges and over-extends, the best recovery formula after a marathon will likely be Bai Hu Jia Ren Shen Tang, or White Tiger and Ginseng Decoction, with gypsum stone to clear the inflammatory heat that can overstimulate the heart, plus ginseng, licorice, and that’s right, white rice, to prevent further heat from flaring.
For the more typical runner type, thin and pale, who gets easily cold and prone to getting sick or injured, a potential recovery formula is Gui Zhi jia Gui Tang, or Cinnamon Twig Decoction with licorice, ginger, red dates, and extra cinnamon to strengthen and warm the chest.
Wishing everyone a speedy recovery, whether from the madness of marathon running or that of trick-or-treating. Stay warm and take care, especially en route to the holidays!
What Should We Be Drinking?
How much water should we be drinking? Is cold water okay? Is coffee healthy or not, already? What about decaf? What about green tea? Green juices? Prune juices? Sparkling water??? Please tell me sparkling water is OK! It’s all I’ve got…
Across the generations (and mediums) there have been many hydration gurus, and I suppose in this blog I’m throwing my hat into the ring, albeit really as just a hopefully qualified echo of Chinese medicine’s biological perspective.
Sparkling water is OK, but can irritate the bladder—should be kept to 1/day.
Room temp water is best, ideally half of our weight in ounces each day. Cold drinks can impair digestion, but again, once a day outside the context of a meal is no big deal, imo.
Juice is worse than people think—green juice not quite as good as people think. Green juices, without the sugars of fruit inside them, are fine, but should not replace real meals where salivary amylase is generated, we actually eat, and chew whole (green) vegetables.
One coffee/day should be fine for most people, but obviously has an excitatory and diuretic effect, so if one suffers with a lot of heat or dryness symptoms, should be minimized. These can include everything from insomnia and irritability to bloating or lack of appetite (dryness of digestive enzymes).
Green tea is preferable in people with “heat patterns,” and/or after a night of eating red meat, which can generate heat in the intestines. Again, because of its bitterness, people who tend to nausea, diarrhea, or lack of appetite should steer clear of green tea, and reach instead for…
PU-ERH TEA! Probably the healthiest thing one can drink besides clean, room temperature water, pu-erh is a black tea known for its naturally occurring pre and probiotics that enhance digestive and gut barrier function, the latter of which gets compromised by stress, medications, or alcohol. And I don’t know anyone who doesn’t check off at least one of these. Best taken hot.
I try to limit myself to 2 caffeinated beverages/day (I think no one should have more than 3), which are routinely a cup of Purity black coffee, followed by a cup of pu-erh, from either ARBOR or YUNNAN SOURCING, both of which offer organic and fair trade, high quality products. Highly recommend!
