Herbal Medicine
How to Better Interpret Side Effect Lists
Generally speaking, for something to qualify to be listed as a common side effect of a medication on that medication’s web page or WebMD, it must occur in 1-10% of the population taking the drug. For example, with Prilosec, a proton pump inhibitor used to treat acid reflux and/or gastric ulcers, they list headaches, nausea, vomiting, bloating, diarrhea, gas, or constipation. But at least the reflux is resolved!
From a Chinese medical perspective, this tells us that ultimately what Prilosec does in its process of reducing harmful stomach acids, is eradicates beneficial stomach acids as well. Our diagnostic concept of the “dry stomach” includes precisely, but not limited to this list of symptoms.
Some people have constitutionally strong guts. They are able to withstand the robbing Peter to pay Paul of reductionist medicine for some time, then when it catches up to them it doesn’t show itself as a digestive ail—but a sequelae to the dry stomach, i.e. the Chinese concept of “ministerial fire” (over)rising in the body—excessive movement and secretion of excitatory substances.
This might manifest as tightness in the chest or rib sides, a dry throat, dry mouth or eyes, dizziness, blurred vision, urinary irregularities, or various manifestations of headaches. Patients and some doctors will hear this and figure it can’t be from the medication because none of these symptoms are listed side effects. From a holistic perspective, this is an oversight.
The impression I’ve gotten in my 13 years in practice is that many doctors suggest to their patients that if a side effect doesn’t show itself in the early goings, the medication is likely not harming them at all, which in my opinion is like saying if a smoker doesn’t contract emphysema early on then they won’t.
Only 1 out of 100 patients have to report having diarrhea for it be listed as a side effect. But how many patients have to report sequelae of what the drug is fundamentally creating? That is, a “dry stomach” with inflammatory heat harassing the upper portion of the body? This logic suggests that many directly connected side effects are going unreported, undocumented, unnoticed by their own sufferers (sorry for that sentence. I think I’ve accidentally read too many AI-generated articles lately).
Whereas the purpose of allopathic medicine is to mute symptoms and improve lab work results, the of purpose of holistic medicine is to aim for perfection. To be so precise in our understanding of each patient’s pattern and corresponding prescription that not only are there no side effects, but other physiological symptoms improve that they weren’t even coming to us for. Obviously, this is not easy, but it is always the intention of “Jing Fang” (classical formula) practitioners and most good acupuncturists.
Please don’t get me wrong. There is nothing wrong with life-saving medicine, which is outside my scope, nor with temporary, band-aid reductionisms to improve quality of life when it is truly necessary. My intermittently humble opinion is there are many cases where we could stand to narrow the definition of “necessary,” while broadening our comprehension of “side effects.”
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!
K-Pop Demon Hunters Laryngitis Cure
If you have a daughter between the age of 4-7 there’s a good chance you’ve seen the 2026 Academy Award winning movie, K-Pop Demon Hunters. I’ve seen (part of) it many times.
For those who haven’t, it’s about a group of adorable, young, female K-Pop stars—by all appearances as big and famous as Taylor Swift—whose side gig is to periodically battle and destroy a species of underworld demons. I like to joke to my wife to imagine if Taylor or Beyonce moonlighted as fierce, violent warriors. Childhood is fantastic.
The hook is that the group’s lead, Rumi, is secretly half-demon. As a result, parts of her body are covered in constitutional skin patterns that she shamefully conceals from her best friends and the world. Early in the movie, near the peak of her success (which somehow promises to help finally eradicate the demon realm) she begins to intermittently experience bouts of laryngitis that are supposedly due to her heritage—not her career. As outlined by Mayo Clinic, this is an extremely common symptom and challenge for singers, most of whom have no demon blood. Desperate for a resolution, her friend and bandmate, Zoe, refers her to a local “healer” in town.
I have been an acupuncturist and Chinese medicine clinician in New York for thirteen years. Herbal medicine is a huge part of my practice. I teach it at Pacific College of Health and Sciences and Virginia University of Integrative Medicine, and study Chinese medical texts every night. However, I frequently feel like the polarizing charge around the Covid vaccine during the pandemic has, in the minds of the “science is real” crowd, given us a bad, or at least an inadequate rap.
The local “healer” Rumi goes to ends up personifying many modern stereotypes about alternative medicine. His personality is kooky. On one hand, he can accurately “see through” each of Rumi’s friends, Mira and Zoe, into their souls, and tell them things about themselves they were barely aware of. On the other hand, he turns out to be a charlatan when they later peel away the label from the herbal potion he gives Rumi, revealing it to be grape juice.
I was fine with the idea of Taylor Swift and Beyonce working days as demon slayers, even with the proposed etiology of Rumi’s laryngitis being her demon heritage, as opposed to the more scientifically logical one of being a singer. But I must take exception to us (Eastern) herbalists being consistently portrayed as quacks—not to mention a contradictory one in this case, where said charlatan concurrently possesses a very impressive psychic intuition.
Chinese medicine is not inherently opposed to western medicine. Many generations ago, Chinese medicine doctors once crushed up smallpox scabs to then blow up the noses of people with the intention of inoculation. Most Chinese hospitals of our present generation contain and administer both western pharmaceuticals and Chinese herbs equally, sans contentious ego, depending on what they deem the best option for a patient. I’m confident if any layperson or doctor were to read the medical texts I do or listen to the scholars I do, they would see that those of us who study diligently think every bit as critically as MD’s—that the majority of us are neither frauds nor “insta-famous,” and we can diagnose as well as any internal paradigm.
For what it’s worth, if Rumi’s voice problems were due more to her professional career, Chinese medicine has a lot to offer.
Our throats and voices derive functional fluids from our stomachs, which means singers are logically prone to dehydrating the digestive enzymes and healthy mucosal fluids of their microbiome. There are many ways to approach, depending on each patient’s unique body type.
If they are prone to general weakness and/or being thirsty for warm drinks Chinese or American ginseng can help. If they tend to low blood pressure and these same symptoms one might consider high doses of licorice, prepared with honey if they tend to feel more sensitive to cold, unprepared if more sensitive to heat. If they tend to nausea, sinus congestion, and/or a lack of thirst for water, pinellia root may help. If there is pain in the chest and phlegm in the throat, platycodi root can. There is also a classical formula from the Han Dynasty, “Jie Geng Tang,” which contains platycodi and licorice, a presentation no doubt combining phlegm trapped in the chest preventing functional fluids from reaching the throat.
Rumi would also be well advised to minimize the kimchi, as from a Chinese medical perspective both raw and spicy foods may cause vasoconstriction in the throat, the latter of which additionally dries out stomach fluids. Conversely, she should double down on the ramen and white rice, as “geng mi,” or rice can help generate stomach fluids.
I have no knowledge of herbal medicine or acupuncture reversing demon blood, but we can absolutely treat laryngitis, pharyngitis, and a whole host of chronic internal conditions. I am yet to meet a colleague with true psychic powers who can see through to patients’ souls, nor to know one who attempts to pass of grape juice as medicine.
In-Person Herbology Class, NYC
I am humbled and excited to have been invited to teach my first live, in-person class next week for NYC Acupuncture School on the correspondence between particular pulse “qualities” at any of the six—that’s right 6—pulse positions along the radial artery of each wrist. That’s a grand total of twelve pulse positions if ever you’re wondering why I’m sitting there for so long with three fingers along your radius.
Directionality is everything in Chinese medicine, and specific herbal medicines and the formulas they command, induce physiological responses, which, put simply, have either excitatory or inhibitory, restorative or draining effects on the body.
When a certain herb (or supplement) is considered to stimulate immune function what it means is that it directs (immunological) molecules upwards, both vertically towards our sinuses and upwards to our dermatological surface. For about half the population, whose physiological pattern requires more upward movement, these medicinals should support their immune function. For the other half, including myself, who need more downward movement, this will do more harm than good. In holistic medicine we have the gift of pulse diagnosis to determine who is who and what is right.
The pulse for astragalus for example would be weak and/or “hollow” at the first and second positions on the right wrist. Why?
These positions correspond to the lungs and stomach—the respiratory and gastrointestinal microbiomes, respectively—and their inter-connection revolving around immune function. If the arteries here feel constricted and tight this indicates cold-natured inflammation in the region, which astragalus will do nothing for. If the arteries feel strong and congested this might indicate “hot-natured” inflammation, which astragalus will equally do nothing for—in fact in this case, would probably hamper immune optimization. Only a small, weakened artery in this position informs us that it is appropriate to use a medicine that will generate fluids in the gut and ship them outward to the exterior. This same mechanism applies to many people who experience spontaneous sweating, yellow or sticky sweat, or joint pains.
There are countless other examples like this in Chinese medicine’s pharmacopeia and diagnostic process that aid us towards being increasingly more specific and effective holistic clinicians. While it helps to still do our due diligence, asking the appropriate questions, inspecting each patient’s tongue and abdomen, my present understanding is no diagnostic tool is more reliable than the feeling of the radial artery.
When someone misses a shot in basketball trash talkers on the opposing team often say: “Ball don’t lie.” In Chinese medicine we say—well, I say: “Pulse don’t lie.”
Obviously, this event will be of greatest interest to students and practitioners, but anyone wishing to become a more educated patient around the workings of their body is welcome!
