Immune System
How to Design Meals like Medicinal Formulas
If food is medicine then creating each meal should be a bit like writing your own herbal formula. Whenever possible, it should be as agreeable as possible with our unique physiology, though this is admittedly challenging when cooking for a family where everyone has different body types. Nevertheless, one part of each meal should complement the other parts, either through synergistic benefit or offsetting its potentially detrimental qualities.
As a longstanding, traditional example, any time we get Thai or Mexican food, it is served with cucumber or radishes, respectively, which are there to mitigate the side effects of the spice.
Most foods are good, but almost all of them have “side effects.” Red meat nourishes the body’s blood, yin, and qi, but if it were an herb it would be a bit warm and damp. Too much red meat and/or red meat that is not harmonized by the remainder of the meal can create damp heat, or inflammation in the stomach and intestines. Then again too little red meat can cause a deficiency of blood, yin, and qi. Ideally red meat (and pork) would be consumed alongside steamed vegetables, then followed by hot green tea, either after the meal or the following morning (green tea at other times and/or for vegetarians is thought to have a bit too cooling, or vasoconstrictive effect on the microbiome—for them black teas are preferable).
Carbohydrates are settling for both the stomach and the mind—probably why they give us such immediately pleasure—but they are obviously stickier foods, “damper” foods, which are more difficult to digest. For this reason whenever possible, it is best to eat them warm and cooked, and alongside more acrid spices in the meal, such as basil, rosemary, ginger, garlic, or onion. While I am Jewish and from New York, and love a great tuna on a bagel, there is a remarkable difference in the physiological response to cold tuna on bread versus cooked pasta with garlic and oil, maybe vegetables and cannelini beans. Yum!
Salads. Oh boy, do westerners love salad. Frankly, if you tend to any digestive problems whatsoever, raw foods should be avoided as much as possible, but if you must:
Consume salad more in summer—less in winter—and always alongside some cooked protein and/or ginger tea. The acridity of the ginger should help to warm the stomach to digest the raw foods. The protein should provide warmth, plus some much needed calories, or “qi and yin.”
Cooked vegetables, allergies notwithstanding, are probably the only perfect food that wholly lack side effects, which is probably why they are also the one food that nearly every paradigm of medicine agrees upon. If you don’t consume cooked vegetables daily you are on a dangerous path, in my opinion. They are nearly always harmless and beneficial… yet still ultimately inadequate, as we can only imagine the metabolic fatigue and inevitable illnesses to come were someone to consume exclusively vegetables.
Food is a gentle medicinal. It will neither heal nor destroy us quickly on its own, however it will always do one or the other over time. I’ve seen firsthand, in myself, loved ones, and patients eradicate chronic symptoms by pursuing a more Eastern diet, though it took many months—in my case years! People should not get discouraged by eating well for a particular interim and not feeling dramatically better. Instead, pay attention to whether you feel worse (always a possibility), meanwhile recognizing that without internal medicine, diet alone may take a long time to cure disease. It is up to us to continue to better understand the nature of each food, so that we can wisely design the perfect “herbal formula” three times a day until the end of time.
Pictured above is an imperfect, but still great meal: Breaded chicken cutlet, sauteed spinach, and roasted acorn squash with roasted apples, cinnamon, and maple syrup. What is “imperfect” about it? First, fruit should be consumed at least 15 minutes apart from other foods so as to avoid creating its notoriously mucus-like congestion in the microbiome. Also, “natural” or not, let’s be honest: maple syrup is sugar; and chicken is healthier without breadcrumbs. On the other hand, breadcrumbs make up a very small amount of the meal, the apples are at least cooked, hence easier to digest, and the leafy greens with garlic should help to optimally process the meat and sugars.
Thirst, Sweat, & Urine: What is Normal?
In contrast to the requisite ruling out of red flags by most nurses in conventional medical settings, the reason Chinese Medical practitioners ask about almost every system in your body is because we are diagnosing based on complete patterns—not just symptoms.
For example, if someone comes in for acid reflux, we cannot know their prescriptions until we know how often they urinate or poop, what each one is like, whether they experience headaches or dizziness, which part of the head they get their headaches in, how is their appetite, how thirsty they are during the day versus in the evening, etc. etc. This is because we are one of the only true forms of holistic medicine.
So, what is normal?
A normal amount of urination is approximately 6 times a day (yes, this includes waking at night). Much less than that and you are likely either retaining, or not drinking enough water in the first place. More than 6 indicates either a weakness in the urogenital microbiome, or excessive inflammation in the urogenital microbiome, which over time can lead to local weakness by putting strain on it. The remainder of the intake questions will determine which of the two is the case.
People should sweat, but not excessively so. Chinese Medicine is critical of HIIT or marathon training, hot yoga, and sauna therapy in most cases. While these might all feel great in the short-term and/or be proven to offer certain isolated benefits in the short-term, we believe they ultimately deplete the body’s healthy metabolic fluids. On the other hand, never sweating (exercising) at all is obviously just as harmful.
While some people barely break a sweat even when they exercise, others are drenched by the time they finish their morning commute, especially triggered by certain climates or seasons. The former can either indicate body fluid depletion or a malfunction of the immunological “qi.” The latter can either indicate inflammation, fluid retention, or also a malfunction of the immunological “qi.” This is where diagnoses and prescriptions get tricky.
Many western doctors have now begun to recognize the health benefits of the Chinese herb, astragalus, which on one hand is great. On the other hand, their recognition by way of empirical studies poses the challenge of having no comprehension of Chinese Medicine. If you give astragalus to the former example of a “cold-body person” with a simple immunological malfunction they will feel amazing and sing your praises. If you give it to someone with both immunological malfunction AND fluid deficiency it will do almost nothing. Worse, if you give it to a “hot-body person” with inflammation and fluid retention they will feel much worse.
Finally, it is normal to be thirsty, for 6-9 cups of water per day. A lack of thirst tells us there is fluid retention in the microbiome, signaling to the brain that it’s got plenty of liquid down here—no need to hydrate! This is dangerous, and better to fake it ‘til you make it in acquiring thirst. On the other pole are those who are ravenously or insatiably thirsty, which informs us of inflammatory heat in either their respiratory microbiome, gastrointestinal microbiome, or both, drying out their fluids. As always, the most complicated patterns are those who are generally unthirsty followed by sudden bouts of desperate thirst. This is a combination pattern that requires more thought, trial, and error.
I hope this was interesting and informative. One of western medicine’s shortcomings is its reliance on tests and labs to determine whether we are healthy or normal. While these are undeniably valuable, they tell only part of the story, which is why so many diseases get caught too late. Chinese Medicine is more brilliant in its neurotic recognition of pathologies in any abnormality, any imbalance, as something to rectify before it spirals into disease.
Refuting the “Man Cold” Cliche
Well, if Covid and seasonal allergies had a lovechild its name would apparently be the upper respiratory pathogens of Winter, 2023. I experienced both personally and professionally, not only the severity of these viruses’ symptoms, but maybe even more troubling was how stubborn they were to resolve. Coughs that would linger for weeks on end, allergies turned to sinus infections, and one friend had the shingles virus transform into a vicious cough, which in my humble opinion occurred because he didn’t properly treat the former with Chinese Medicine.
I am grateful we seem to be passing simultaneously, likely not coincidentally, out of this post-pandemic ripple effect along with the cold weather. Besides dilating the blood vessels of our respiratory microbiomes, thereby giving pathogens wider exit pathways, the warm air should eventually aid in transforming latent mucus and boosting our metabolic energies enough to in turn boost our immunological energies, or “wei qi.”
I plead ignorance, in the past few years more than ever, to most current events, trends on social media, philosophical platitudes, and pop culture; and I often question whether that makes me an “ignorant person”—especially since we will all eventually die still relatively ignorant about most things and peoples. Besides my family, I devote most of my time and mental energy to Chinese Medicine. Whatever is left over at the end of each day are mere scraps, an hour or two at most, and I choose to shut my mind off with friends and/or sports. Maybe in another chapter of my life I’ll read more articles and keep up with external themes and events.
Before blowing my own nose about 50 times a day one week back in January, my lungs exacerbated by the need to rid themselves of phlegm, I had never heard of “the man cold.” Apparently, amongst the infinite social media cliches is one that guys are overly dramatic or whiney about their common colds, obviously underscoring “girl power,” which is a great thing, but also the idea that men are weak(er), which might not be great, or accurate.
Recall the first wave of Covid, we were quickly informed that men, along with the elderly and obese, were most susceptible to severe infections. Why? Well, from a Chinese Medical perspective men have more heat and/or yang qi in the body’s upper region. On one hand it is why we are fortunate enough to have generally more energy. It is consistent with our generally superior upper body strength; though it is also why the inflammatory cytokine response is more intense in the context of upper respiratory viruses.
If you require this be translated in conventional medical terms—and most westerners do—as a result of our increased testosterone and androgens, men possess higher numbers of T cells and Natural Killer cells than women, whereas women have greater B cells, neutrophils and phagocytic activity, which makes them more adept at clearing viruses, as well as the toxins from vaccines. Women also have a greater susceptibility to dysregulation of innate lymphoid cells, which makes them generally more prone to autoimmune disease. (source: https://www.nature.com/articles/nri.2016.90.pdf)
Returning to the brilliant simplicity of Chinese Medical jargon: It is the heat from our body’s (masculine) yang qi that provides ample metabolic strength to regulate our lymphoid cells and avoid autoimmune disease. It is that same heat, left uncontrolled, that creates a more inflammatory cytokine storm in the lungs and makes clearing external pathogens more stubborn. It’s not because your husband is being a little bitch.
Spring Season and Moving Day!
Despite the northeast weather forecasts consistently looking more like a frightening EKG than a directly corresponding line with the seasons, Spring is here and we can expect to feel the climactic difference on at least most days relatively soon.
The Spring season corresponds with the wood element, which corresponds with the emotion of anger or frustration, which corresponds with our liver and gallbladder meridians, which might incite symptoms such as temporal headaches, rib-side pain or cramping, dryness in the chest or throat (I lost my voice this past week for the first time in probably a decade!), cold feet in spite of a warm body, the shingles virus, lack of appetite for breakfast, or exaggerated PMS symptoms for women.
The seasonal increase in our liver and gallbladder qi, respectively, makes us more prone to anger and irritability, which can make us more prone to any of these symptoms, which of course creates a vicious cycle—especially for those of us considered “wood element constitutions,” such as myself. “Wood people” tend to be active and potentially temperamental, with a wiry, sinewy build like, well… wood.
Interestingly one of the most common pulse qualities Chinese Medicine recognizes is the “wiry pulse,” because it feels like a taut wife beneath the pads of the finger. When we feel this we often assume that the liver or gallbladder channels are implicated in the etiology of disease.
The best ways to mitigate these “side effects of Spring” are through a healthy amount of exercise—enough to circulate the liver qi without over-sweating and drying out the stomach—and mostly warm foods that are easy to digest. In Classical Medicine liver and gallbladder pathologies are a result of the stomach being completely dried out of healthy fluids, then sending pathogenic heat/inflammation upwards (see aforementioned loss of voice). The one exception to the warm rule these next few months would be in the form of sauerkraut, vinegars, and pickled foods, which along with mildly spicy foods are said to course the liver qi.
As for my own apparent stress variable, (my wife and) I will be moving next week to live in a suburb for the first time in 27 years! Excitement, along with fear and anxiety are likely more prominent within me than anger or frustration, but as a “wood-type person” navigating this seasonal wood transition, it stands to reason that for me such symptoms would arise.
We bought a home in the “coolest,” most culturally diverse suburb still with a good school system that we could find, in South Orange, NJ. One of my favorite mentors’ tai chi school is a 10-minute drive away and we have a 5-minute walk from our house to the NJ Transit stop, which is 40 minutes direct to Penn Station, which is then a 15-minute walk to my office. Not bad! Also, the previous owner happened to be a famous Buddhist monk who founded the Tibet Center on the lower east side. Many cool check-offs on this resume, however I’ve always been a “New York or Nowhere” person, so the great unknown, coupled with all the stressors of renovations and moving with a toddler surely went straight to my throat. Wish us luck!
The “Unresolved Exterior Pathogen”
I think one of my favorite concepts in Chinese Medicine is that of the “unresolved exterior pathogen.” What does it mean? When we catch a cold, whether bacterial or viral, most cases should be vented, sweated out, while we rest as much as possible and consume warm foods, such as the classic chicken soup to support our “wei qi,” or immunological cellular energy.
Obviously most modern people do not do this. We take over-the-counter cough suppressants, congestion suppressants, anti-pyretics, and every other suppressant to make us feel as comfortable as possible until the cold resolves… or at least appears to.
This is a totally understandable mistake. First of all, most people don’t know that Chinese Medicine can treat the common cold (along with nearly everything else under the sun), and even if they did herbalists and herbal medicine are not readily available to most.
From a Chinese Medical perspective when a cold is suppressed it gets pushed deeper into the body, from the “wei qi” or immunological layer, to the organs and metabolic layer. Anyone have digestive issues since having Covid-19? This is an “unresolved exterior.”
More common symptoms of unresolved pathogens include rheumatological, dermatological, or orthopedic; autoimmune joint pain being the most self-explanatory, which makes orthopedics not far behind it. Lingering “dampness,” residual plaques or mucus from an exterior pathogen go latent, and if we’re lucky enough that they don’t create the kind of molecular mimicry to over-activate our immune system they may lodge into our muscles, tendons, and ligaments. While neck and back pain during a common cold are well-known, pay more attention to such symptoms that linger in their wake. It usually indicates fluids that should have been sweated out are trapped wherever we happen to be orthopedically most vulnerable.
Thankfully, we’ve gotten to a point where few people are any longer terrified or paralyzed by Covid-19. Most of us are more or less going about our lives taking varying precautions—this doesn’t mean we cannot at the same time respect our opponent.
After I had Covid I continued to consult and get treated by mentors for at least one month after symptoms resolved, with the obvious intention of prevention and full resolution, not just from a biomedical standpoint, but from a more neurotic, perfectionist Chinese Medical assessment. I wanted to ensure that my tongue looked like my tongue again—also that we took steps to avoid any of my own constitutional proclivities from rearing their heads as a result of any unresolved inflammation.
While going through Chinese Medical school it was fascinating to think that my eczema and ski conditions that I’d had all my life may have been a result of an improperly treated cold I had as a baby. Or to view my low back or knee pain as not something relegated exclusively to the orthopedic surface and/or old athletic injuries, but connected to my systemic inflammation. I beg your pardon for my broken record tendency in refutal of one my greatest pet peeves:
“Holistic” does not mean everything alternative, “New Agey,” nor related to spa treatments, nor gentle or weaker than biomedicine. It means analyzing all symptoms and systems as interconnected and the incredibly more challenging task of treating accordingly.
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