Digestive Disorders
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!
Why Would You Have Anxiety & Diarrhea?
The question shouldn’t be why WOULD you have anxiety and diarrhea? The question should be why WOULDN’T you have anxiety and diarrhea?
The cause of loose stools can be over complicated and analyzed, replete with fancy biochemical terminology, citing the benefit or particular bacterial strains, such as Lactobacillus rhamnosus GG, Saccharomyces boulardii, and Bifidobacterium, but from a Chinese medical perspective it comes down to one of two fundamental pathologies, and/or a combination of the two.
Either we have too much unhealthy bacteria in the gut (“dampness”), putting excess strain on our stomach, causing excess poop—or not enough good bacteria (“dryness”), which leads to the production of more inflammation than nutrients and again, excess poop. Over time, one pathology inevitably engenders the other and we’ll almost literally poop our brains out, as the gut produces most of the body’s serotonin, which acts as a signaling molecule to the nervous system.
The modern coined “Gut-Brain Axis,” first outlined by Zhang Zhong Jing as “Tai Yin” system in his masterpiece, Discussions on Cold Damage 2,000 years ago—it stands to reason that we should feel some type of emotional dysregulation as the cause or result of chronic diarrhea.
Two of the best ways to manage this are, you guessed it! Diet and exercise!
Warm, cooked vegetables and moderate protein strengthen the microbiome and exercise unburdens it, specifically and especially strength training, as the muscles classically exist in a mutually interdependent dynamic of engenderment with the pancreas and stomach. Strong muscles can equal a strong gut (though there is such a thing as “too strong,” where a person’s weightlifting addiction over-burdens their organs’ fluid and bacterium reserve), or vice versa.
When lifestyle doesn’t seem to do the trick, Chinese medicine has a great deal to offer.
For a gut that is overburdened with damp, harmful bacteria, we offer herbal formulas that revolve around Poria Mushroom if there are accompanying heart palpitations or insomnia, Atractylodes if there are accompanying thirst or joint pain, Magnolia Bark and/or Bitter Tangerine for bloating and/or chest tightness, or Pinellia root if nausea, thirst, or dizziness.
For a gut apparently deprived of healthful bacteria we recommend eating more white rice, especially if the patient is prone to loose stool. Chinese herbs include licorice root if there is acid reflux or low blood pressure, ginseng if there is thirst or fatigue, wheat for anxiety and depression, or Gypsum Stone if the person feels over-heated, manic, and craves cold drinks.
When bodily fluids plummet, as in diarrhea (or excessive urination, excessive menstrual bleeding, excessive any form of loss) it gives rise to the Chinese metaphorical concept of “Wind,” that is too much heat and/or energy (Yang) rising to the head as a result of a lack of fluids (Yin) in the lower portion of the body. This “Wind” can manifest in any way, from unsettling symptoms of the gut, chest, head, or mind. Anxiety is a proclivity near and dear to me, and throughout my thirties (combined with organic maturity) Chinese medicine helped me enormously. Please reach out if you or anyone you know is dealing with this familiar pattern!
What (the HECK) Should We Eat?
It may seem ironic that the most foundational Chinese medical texts harp on diet and nutrition almost as moderate and infrequently as do modern western medical schools. Part of the reason is in ancient times they did not have to navigate the “paradox of choice” of today. They ate what was available and needn’t concern themselves with overindulgences such as refined sugars or heavy seasonings, as neither one yet existed.
How to eat was apparent and matter of fact. Cooked rice and whole grains were encouraged in moderation to support stomach fluids and absorption. Cooked vegetables were mandatory in every meal and animal protein was highly encouraged, however not in nearly the quantity non-vegetarians consume it in today.
How to translate this into modern lifestyles:
For BREAKFAST we recommend any form of porridge and/or eggs with cooked vegetables—preferably the latter. The former can be oatmeal with nuts and fruits or rice, quinoa, or millet congee, either with nuts and fruits or pickled vegetables. The latter can be a baked sweet potato with butter, roasted sweet potatoes with olive oil, roasted zucchini with olive oil, sauteed collard greens, steamed brocooli, roasted carrots with butter… truly anything that one finds delicious and practical for those busy weekday mornings.
For LUNCH we recommend leftovers or a soup or some kind of cooked meal with vegetables. Raw foods, such as salads or smoothies are ok in moderation for some, but raw foods are more difficult to digest. They tend to cause gas and bloating and inflammation in their wake.
For DINNER a homecooked meal of whole foods. Not everyone has time every night to cook, and I am no exception to that, but we encourage everyone do their best to prioritize metabolic health, say over a clean house or even a clean kitchen, google some recipes you like, and just do it! It’s all good: Steak, fish, chicken, pork, tofu, tempeh, beans, pasta once in a while… it’s all good! So long as it’s homemade and warm 🙂 Personally speaking, many of my own long-term chronic ailments forever abated in my early thirties after I started finally cooking for myself at home. The rest of them improved when I quit eating refined sugar.
Never in human history have sweets been as sweet as they’ve been in the U.S. in the past 50 years. I encourage all of my patients to find as best alternatives as possible for their cravings (coconut yogurt, any yogurts, almond butters, any nut butters, dark chocolates, some honey or maple syrup if necessary, hummus, anything but American junk!) and recondition their minds to making things like packaged candy that doesn’t expire relatively invisible to their eyes.
Needless to say, it also benefits metabolic health to not eat late at night, by the same token to not skip breakfast, not consume alcohol on most nights, and DO consume hot tea daily
This is not about shaming anyone. It’s about encouraging, educating, and empowering us to navigate an environment that is obviously not designed for long-term health.
Herbal Profile: Chi Xiao Dou (Adzuki Beans)!
In Mexico black or refried beans are most popular. Caribbeans eat black peas, Indians more lentils, and of course Americans prefer the sweetest of all, baked beans. In China though, adzuki beans are more than just a delicacy—they are an important ingredient in our classical pharmacopeia, often used to treat conditions of the intestines or skin, the latter frequently manifesting pathologies of the former, thereby informing us of the underlying pattern.
For example, while redness around the forehead points to suspected biofilms of the intestines, acne that falls more around the jawline, chest, or upper back suggests biofilms of the stomach. Chi Xiao Dou, or Adzuki Bean, can be used to treat either, provided it is appropriately dosed within the context of an accurate holistic formula. It is also useful for eliminating or minimizing liver spots, pus accumulation around the eyes, and other random skin discolorations.
Listed in our texts as sweet, sour, and neutral in properties, its neutrality allows it to diffuse dampness in the body that is either cold/inhibitory or hot/excitatory in nature. Its sweetness encourages the body to generate a healthy amount of fluids, and its astringency obviously helps our body to hold that which is leaking, or sinking. It is said to gently promote blood circulation between the bowels and the skin layer.
This might explain why it comprises half of the formula, Dang Gui Chi Xiao Dou Tang, most commonly prescribed to treat certain types of hemorrhoids and skin issues around the buttocks.
If the shoe doesn’t fit—that is if this formula does not fit your pattern, but you still suffer with chronic hemorrhoids, it is advisable to regularly consume adzuki beans with your meals to take advantage of its biofilm dissolving properties. By relieving intestinal vessels of inflammation this should take pressure off of the rectum.
Adzuki beans go well with rice and/or Latin or Asian dishes, also within rice congees plus a boiled egg, providing additional protein to an otherwise dish of just white rice. If you don’t love the taste as much you can also do what I do for my daughter, which is mix the adzuki beans with baked beans as a side dish on hamburger and hotdog nights.
To treat skin conditions Chi Xiao Dou is generally paired one way or the other:
- With the aforementioned, Dang Gui to not only help to generate red and white blood cells, but also to courier them to the surface to nourish and lubricate the skin.
- With more bitter, inhibitory, heat clearing medicinals, such as rehmannia root to mitigate the body’s inflammatory response, known to flare upwards in the form of jawline or upper back acne (“Backnee”).
If you think adzuki beans might help you or a loved one reach out—or just go to the store, purchase, and cook them up! Preferably organic, as inorganic legumes can be particularly vulnerable to chemicals and pesticides. Any recipe or preparation questions, let me know!
Point Profile for Reflux: Stomach 36
The first acupuncture point whose name I learned and was able to identify while my (first) acupuncturist was needling me was “Stomach 36”—”Zu San Li,” or “Three Leg Mile,” in reference to its alleged ability to help the patient walk three additional miles, as all transportation at the time of its discovery was obviously by foot.
“Li,” in Chinese, may also be used as a homonym for “to rectify,” in reference to the energy the point provides, either to our internal physiologies or our kneecaps it resides just inches below. (Yes, this is the point that should feel like a brief surge of shin splint down your tibia)
In modern times we are not as concerned with the need to walk a few extra miles, but the physiological intent holds relevant. Located along the anterior tibial nerve, Stomach 36 can be used to improve energy by its mechanism of increasing blood flow to the stomach, when indicated. That is, if someone is lethargic because they had five drinks the night before and only slept five hours it’s not because their organs are lacking blood. They probably need a different acu-point combination (and a nap).
Besides GERD or acid reflux, Stomach 36 is useful for treating numerous pathologies, including but not limited to diarrhea, bloating, pain of the abdomen, vomiting, belching, also conditions of the throat, chest, and lungs because of the gastrointestinal microbiome’s connection to the respiratory microbiome; finally anxiety, depression, and dizziness, because of the gut brain connection. This 2023 NCBI study concluded its ability to increase the length and mean basal pressure of the lower esophageal sphincter, of which both mechanisms reduce reflux.
According to Peter Deadman’s Manual of Acupuncture, “the great Han dynasty physician (and weren’t all great physicians from the Han??), Hua Tou, is said to have valued the use of ‘ST-36’ to treat the ‘five taxations’ and the ‘seven injuries.’”
The 5 Taxations:
- Excessive use of the eyes injures the blood (even before cell phones—imagine now!)
- Excessive lying down injures the qi (i.e. hypersomnia begets more hypersomnia)
- Excessive sitting injures the flesh (i.e. lack of exercise saps our energy)
- Excessive standing injures the bones (poor security guards)
- Excessive walking injures the sinews (any other New Yorkers remarkably inflexible?!)
Because everything starts and circulates out from the gut, if I had to choose one point to needle on every patient for the rest of my career it would be Zu San Li, Stomach 36. With appropriate metabolic fluids, we can optimize our production of nutrients, which in turn reaches all other systems of the body. Basic science.
