Principles%20of%20Chinese%20Medicine.pdf

P R I N C I P L E S

O F

CHINESE MEDICINE What it is and how it works

ANGELA HICKS Second Edition

Principles of Chinese Medicine

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Principles of

Chinese Medicine What it is, how it works, and what it can do for you

Second Edition

Angela Hicks

London and Philadelphia

This edition published in 2013 by Singing Dragon an imprint of Jessica Kingsley Publishers 116 Pentonville Road London N1 9JB, UK and 400 Market Street, Suite 400 Philadelphia, PA 19106, USA www.singingdragon.com First published in 1996 by Thorsons, an imprint of HarperCollins Copyright © Angela Hicks 1996, 2013 All rights reserved. No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, Saffron House, 6–10 Kirby Street, London EC1N 8TS. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher. Warning: The doing of an unauthorised act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution. Library of Congress Cataloging in Publication Data A CIP catalog record for this book is available from the Library of Congress British Library Cataloguing in Publication Data A CIP catalogue record for this book is available from the British Library ISBN 978 1 84819 130 3 eISBN 978 0 85701 107 7

Contents

Author’s Note

10

Acknowledgements 11

Introduction 13 The differences between Chinese medicine and Western medicine Treatment using Eastern and Western medicine The principles of Chinese medicine

1 The Theory of Chinese Medicine: The Linking Thread What is the theory of Chinese medicine? What is meant by yin and yang? What are the four aspects of yin and yang? How are yin and yang useful for Chinese medical practitioners? How can Chinese medicine be used to balance yin and yang? How do yin and yang affect our life cycles? What are yin and yang Organs? What are the Vital Substances? How do the Vital Substances and the Organs interact? What is Qi? What does Chinese medicine mean by Blood? What is the Shen or Mind-spirit? What is Jing-essence? What are Body Fluids? How do these Substances influence each other? What are the Five Elements? How do the Elements interact? What are the Five Element associations?

2 How Disease Arises and the Art of Staying Healthy So how does disease arise? What are the internal causes of disease?

14 17 18

20 20 21 21 23 24 25 27 28 28 29 32 33 34 36 37 37 38 40

42 43 43

How do emotions cause disease? How can climatic conditions cause disease? How is knowledge of external causes useful to a patient? What do we mean by the miscellaneous causes of disease? How do balanced amounts of work and rest prevent disease? How can exercise benefit my health? In what way can sex become a cause of disease? How is physical trauma a cause of disease? Do I have to know the cause of my problem? How are the causes of disease used in diagnosis and treatment?

3 Putting it all Together: Diagnosis in Chinese Medicine How long will the diagnosis take? What should I expect at the diagnosis? How does a practitioner diagnose using the pulse? What is tongue diagnosis? How is the theory of Chinese medicine used to create a diagnosis?

4 Acupuncture Treatment: Balancing Your Qi What is acupuncture? What are the ‘meridians’ or ‘channels’? Where are the channels and how many are there? What are acupuncture points? Tender points Can the channels be felt? What can acupuncture treat? What is being treated like? How long will each treatment take? How does the theory of Chinese medicine apply to acupuncture? What are the needles like? How do acupuncturists ensure good standards of hygiene? How does the acupuncturist know where to put the needles? Can I still have acupuncture if I’m not ill? How will I feel immediately after a treatment? How much treatment will I need? How does the practitioner know treatment has worked? How is moxibustion used? What is cupping therapy and how is it used?

43 45 47 49 49 50 51 51 52 53

55 55 56 56 58 59

62 63 64 64 68 68 69 71 74 74 76 77 77 79 80 81 82 84 84 86

What is guasha and how is it used? When might electro-acupuncture be used? What is auricular acupuncture? Treatment using auricular acupuncture Research into the effects of acupuncture

87 88 89 89 90

5 Chinese Herbal Medicine: Remedies to Restore Your Qi 92 What is Chinese herbal medicine? 94 How does Chinese herbal medicine differ from Western herbs? 96 How are the herbs categorised? 97 What is meant by a herbal prescription? 98 How does the herbalist create a prescription? 101 How are the herbs prepared? 101 What is the difference between dried herbs, tinctures and powders? 102 What kinds of herbs are used in a prescription? 105 Are any animal products used in Chinese herbal medicine? 106 How are herbs regulated? 106 How is the theory of Chinese medicine used when a herbalist diagnoses a patient? 107 What problems are commonly treated by herbs? 110 Current research into Chinese herbs 110 What do the herbs taste like? 111 What are the five tastes and what do they do? 111 What are the four energies and how are they used? 113 How often will I need to visit my herbalist and for how long? 114

6 Qigong Exercises: Transforming Your Qi How has Qigong developed? What is Qigong? What are the benefits of practising Qigong? How could Qigong improve or maintain my health? How do people use Qigong for spiritual development? Can Qigong really be used to heal people? What do the different Qigong practices have in common? How does the theory of Chinese medicine fit in with Qigong practice? Why is it important to activate the lower dan tian? How do I activate the lower dan tian?

117 118 119 119 120 123 123 125 126 127 127

What are the different types of Qigong exercises? Some important principles for good Qigong practice How will I feel while practising Qigong? How will I feel immediately after practising Qigong? Do I need to have a teacher? How do I find a good teacher? How much do I need to practise? Where should I practise?

7 Tui Na – Chinese Massage: Feeling Your Qi

130 136 138 140 141 142 142 143

145

What is tui na? The roots of tui na What is the difference between tui na and other styles of massage? What will happen when I first come for treatment? How is the theory of Chinese medicine used by a practitioner of tui na? What illnesses can tui na help? What will I experience during the treatment? What are tui na massage techniques like? What areas of the body will the practitioner treat? What skin preparations will the practitioner use? Will the practitioner ever manipulate my spine? How long will a tui na treatment take? How often will I need to come for treatment? How will I feel immediately after the treatment? Can I use massage techniques on myself ?

8 Chinese Dietetics: Nourishing Your Qi How does the theory of Chinese medicine apply to diet? What are the best proportions of grains, pulses, vegetables, fruit and meat in the diet? Is it better to be a vegetarian or a meat eater? How is the temperature of food important in our diets? Should we eat cooked or raw food? How are the flavours of food important for maintaining our health? How can we ensure that the food we eat is of good quality? How is it best to eat our food?

146 146 147 149 149 150 152 153 155 156 157 158 158 160 160

163 165 167 171 174 177 180 182 185

When is it best to eat? What foods can I avoid for specific health problems? Are there any foods that I can include in my diet for specific health problems? How should I go about changing my diet? Will changing my diet be enough to restore my health?

187 188 189 191 192

9 Which One Shall I Choose? The Right Treatment for Me 194 How do I decide whether I need treatment? So which treatment shall I choose? We have a preference for one particular treatment Choosing a therapy What’s the best way to find a good practitioner? How can I tell if my practitioner is well qualified? How can I tell that this practitioner is right for me? Should I consult my doctor before going to a practitioner? What if I am already taking prescribed drugs for my condition? How can I keep myself healthy? A positive attitude A final thought

194 196 196 198 198 199 200 201 202 202 203 204

References 205 Further Reading

207

Acupuncture 207 Herbs 207 Qigong 208 Tui na 208 Diet 209 General 209 Useful Contacts

210

UK 210 US 211 Europe 212 Australia 214 Canada 215 Index 216

Author’s Note

This book is written as an informative guide to Chinese medicine and is not meant as a self-help book for treatment. I have capitalised Chinese medicine terminology in order to differentiate it from standard English terms. For instance, the Liver in upper case indicates the Chinese medicine term (i.e., the Liver and its Chinese medicine functions). The liver in lower case indicates the liver as it is described in Western medicine.

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Acknowledgements

My thanks to all of the people who have helped me to write this book. First, thank you to all of the patients who talked with me about their experiences of acupuncture. Thanks also to the patients of Tony Brawn and Caroline Root who allowed me to interview them about their experiences of taking herbs, patients of Sarah Pritchard who talked about receiving tui na and patients of Jill Glover and Leslie Jenkins who discussed changes to their diet. Thanks as well to all of those people who informed me of their experiences of practising Qigong or who filled in questionnaires about it. The names of all patients have been changed to protect confidentiality. Second, thanks to the practitioners who helped me with essential information that I’ve used in this book and to Judith Clark for so thoroughly reading through and proofing the chapters. Also thanks to Bill Ryan for his advice on the Qigong chapter, Kevin Young for the tui na chapter and Michael Pringle for the Chinese herbal medicine chapter. Many people have helped me to deepen my appreciation of Chinese medicine. JR Worsley trained me to understand the underlying essence of a patient. Bruce Frantzis, my Qigong teacher, has enabled me to increase my understanding of Qigong. I’m also grateful to Rose Gladden, the healer, who while she was alive was a major influence on my awareness of holistic treatment and healing the spirit. My thanks to Jessica Kingsley, Victoria Peters and Bethany Gower, and all at Singing Dragon for their support and care bringing this book to print. Many thanks and huge love to John, my husband, who unfailingly supports and encourages me. 11

Introduction

The aim of this book is to give you a clear explanation about Chinese medicine and its therapies – acupuncture, Chinese herbs, tui na massage, Qigong exercises and diet.1 I have practised Chinese medicine since 1976 and since that time the only Western medicine treatment I have taken is one aspirin. I am now in my 60s and have stayed healthy through having treatment from these five therapies. This does not mean that I haven’t been ill. I have. But, in general, Chinese medicine treatment has nipped any problems in the bud and kept me well. My passion for Chinese medicine has never left me and I feel privileged to have been able to give treatments, teach and keep well for all this time. When I first studied acupuncture it was the main Chinese medicine treatment available in the West. Reference to ‘acupuncture’ all that time ago often met with a blank look or possibly an expression of puzzlement. Many doctors at that time showed hostility at its very mention. Now there are many more qualified practitioners of Chinese medicine. These treatments are better understood and a realistic choice for many people who wish to use a natural medicine with few side effects. There is no need to make a choice between Chinese medicine and Western medicine – we can use both and both are useful in different situations. For example, if I broke my arm I would certainly go to the accident and emergency department first! Fortunately, practitioners of both Chinese 1 These are all described in the chapters that follow.

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Principles of Chinese medicine

and Western medicine are more mutually respectful than they were in the past. They know that each has a completely different, but valuable, perspective on treatment. There have also been many misunderstandings in the past, not least because of a difference in language. Chinese medicine tends to use more ‘poetic’ terms when diagnosing and treating. For example, a practitioner talks about ‘yin and yang’, ‘Qi ’, and ‘Jing-essence’ or ‘Wind’ and ‘Dampness’. You will read more about these terms in Chapters 1 to 3 and will hopefully understand that they are quite practical and down to earth in their usage and that Chinese medicine has its own clear, although different, logic. So let’s compare Chinese medicine with Western medicine so that we can assess how each one is used in treatment.

The differences between Chinese medicine and Western medicine Chinese medicine tends to do the following things:

Treat the person rather than the symptoms We could say that Chinese medicine treats people while Western medicine treats diseases. A Chinese medicine practitioner will look at the whole person and the underlying reasons for her or him becoming ill. In comparison, Western medicine will pay more attention to treating the person’s symptoms. For example, when considering a symptom such as a headache, a Chinese medicine practitioner looks for the underlying cause and will ask patients about the nature of their symptoms as well as observing their tongue and feeling 12 pulses on the wrist. The cause may be a number of different possibilities, including the functioning of the

Introduction

Liver, Kidney or Spleen energy.2 Treatment will aim to help the person to achieve a better balance in their energy so the cause of the headaches is eliminated. Western medicine practitioners are more likely to focus on clearing the symptoms of the headache directly. To this end they may also ask about the nature of the headache, but their treatment is different. They will usually prescribe a painkiller or another medicine to stop the symptom of pain without looking at why the problem has arisen in the first place.

Generalise rather than specialise Because Chinese medicine is holistic, practitioners tend to be generalists rather than specialists. Western medicine, on the other hand, tends to value specialism over generalism. If a patient has a number of different symptoms a Chinese medicine practitioner will look for patterns to see how the signs and symptoms are connected. In comparison, if a patient with a number of symptoms visits a Western medicine doctor they could be given tablets for each condition or be sent to different clinics. For instance, a patient who feels depressed and has irregular periods and digestive problems, such as alternating constipation and diarrhoea, may be diagnosed by a Chinese medicine practitioner as having a pattern of ‘Liver Qi stagnation’. The symptoms would all be seen as stemming from the same root. All symptoms would therefore be dealt with by the same treatment. The same patient might be given medicines or need to attend a number of different Western medicine clinics for their gynaecological symptoms, their irritable bowel 2 This is translated as Qi in Chinese medicine. I will use the term ‘energy’ until Qi is explained in the first chapter.

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syndrome and their mental health problems. Each symptom would be dealt with by different treatments and would not be seen to be connected.

Prescribe individualised rather than blanket treatments A Chinese medicine practitioner who has two patients with the same condition will not necessarily treat them in the same way. In comparison, a Western medicine practitioner is likely to give the same treatment for similar conditions. Let’s take a patient with asthma, for example. Chinese medicine will look at the nature of each individual’s asthma. Some patients’ asthma might be caused by Lung weakness, whilst others might be caused by Phlegm blocking the Lungs. Still others may be caused by Kidney weakness or obstructed Liver energy. Depending on the diagnosis, each patient will have a unique diagnosis and will be treated in a different way. In general, Western medicine practitioners will treat all asthma sufferers in a similar way and a doctor will usually prescribe inhalers.

See body and mind as connected rather than separate Chinese medicine describes all problems as coming from an underlying imbalance in a patient’s energy. If the energy is imbalanced, a person will feel out of sorts on many levels. This can cause physical, mental and emotional signs and symptoms. In order to remedy this, the energy is rebalanced so that the patient feels better in body, mind and spirit. Western medicine, on the other hand, will tend to diagnose and treat the body and mind separately. For example, if a patient comes to a Chinese medicine practitioner with extreme fear and anxiety and an achy back, the Chinese medicine practitioner might treat this person’s

Introduction

Kidney energy and help both problems simultaneously. A Western medicine doctor on the other hand might treat them separately and give the patient antidepressants and painkillers.

Use observations rather than tests Chinese medicine and Western medicine practitioners diagnose patients differently. A Chinese medicine practitioner will use observation and palpation as well as questioning in order to reach a diagnosis. A Western medicine practitioner, on the other hand, will tend to ask questions and then might send a patient for tests to confirm a diagnosis. For example, in the case of a patient with a joint problem, a Chinese medicine practitioner will probably palpate the patient’s joint, notice the range of movement, feel for the temperature and then diagnose which acupuncture ‘channel’ is most affected and whether the condition is ‘full’ or ‘deficient’, or ‘hot’ or ‘cold’. A Western medicine practitioner might carry out some palpation but may rely more heavily on a scan to see more clearly what is going on.

Treatment using Eastern and Western medicine Research is now playing its part in helping us to judge which treatments can benefit our health. The National Institute for Health and Clinical Excellence (NICE),3 which produces guidelines on best practice, now recommends that general practitioners (GPs) offer a course of ten sessions of acupuncture as a first-line treatment for persistent, nonspecific low back pain. This is a small, but significant, step towards recognising Chinese medicine’s value. 3

NICE provides independent, authoritative and evidence-based guidance to the NHS and other bodies based on the most effective ways to prevent, diagnose and treat disease and ill health.

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This recognition follows many research studies that have shown that acupuncture can help people with backache in many ways and is significantly better than no treatment and at least as good as, if not better than, standard medical care for back pain (Witt, 2006; Haake, 2007; Cherkin, 2009). It appears to be particularly useful as an adjunct to conventional care for patients with more severe symptoms and for those wishing to avoid analgesic drugs (Sherman and Coeytaux, 2009; Sherman et al., 2009; Lewis and Abdi, 2010). It may help back pain in pregnancy (Ee et al., 2008) and work-related back pain, meaning that fewer work days are lost (Weidenhammer et al., 2007; Sawazaki et al., 2008).4 Both Eastern and Western medicine have their own special uses and both should be recognised as valuable treatments. In China both styles of treatment are used in all hospitals and both are recognised as having their own unique strengths. There is no need for them to be at odds with each other; it is better that they can complement each other and play their part in contributing to a healthier nation.

The principles of Chinese medicine The purpose of this book is to deepen your understanding of Chinese medicine and I will explain its fundamentals in the following order. In the first three chapters I will outline the Chinese medicine method of diagnosis and treatment. To do this I will explain what links the five strands of Chinese medicine together, explain the common components of a diagnosis, clarify how Chinese medicine teaches the causes of disease and go over how a diagnosis is made.

4 For more information on this and other research see the British Acupuncture Council (BAcC) website on www.acupuncture.org.uk.

Introduction

In the following five chapters I will then discuss the different treatments in turn and give an explanation of acupuncture, Chinese herbs, Qigong exercises, tui na massage and dietary therapy. The final chapter is dedicated to those who are interested in the practicalities of having Chinese medicine treatment and finding a good practitioner so that if you wish to have treatment you can make an informed choice. I hope you enjoy this book and discover for yourself the value and effectiveness of these treatments for your future health and well-being!

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1

The Theory of Chinese Medicine The Linking Thread

The five therapies of Chinese medicine are acupuncture, herbs, tui na massage, diet and Qigong. Each therapy is practised in its own special way. Acupuncturists use needles to balance energy. Herbalists prescribe raw herbs, powders or tinctures. Qigong practitioners use movement and exercise. Tui na practitioners use direct physical contact. Dietary therapists advise on eating habits. Although these therapies are completely different they are also all connected. So what is it that links them? The linking thread is the theory of Chinese medicine. It doesn’t matter which of these treatments a person chooses to have, the underlying theory comes from the same root. This forms the foundation for a unique diagnosis for every patient. Over the next few chapters we will look at these treatments and the theory that links them so that we can understand the basis of Chinese medicine.

What is the theory of Chinese medicine? There are three main components that enable a Chinese medicine practitioner to form a diagnosis. Together they

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The Theory of Chinese Medicine

allow the practitioner to find the underlying cause of a patient’s complaint. They are: • yin and yang • the 12 Organs and their associated Five Elements • the Vital Substances We will explore each of these in turn.

What is meant by yin and yang? In order to diagnose the nature of their patients’ conditions practitioners need to understand and judge the relative balance of their yin and yang Qi. One of the oldest classics of Chinese medicine, the Huang Ti Nei Jing or The Yellow Emperor’s Classic of Internal Medicine states: To live in harmony with yin and yang means life. To live against yin and yang means death. To live in harmony with yin and yang will bring peace. To live against yin and yang will bring chaos. Yin and yang are now such commonly used terms that we could almost forget that they stem from the Chinese language. Used colloquially in English they describe opposite qualities. For example, light and dark, up and down, outside and inside and expansion and contraction are all qualities of yin and yang. However, opposite qualities are only a partial description of how yin and yang are used in the Chinese language.

What are the four aspects of yin and yang? Chinese medicine describes four main aspects of yin and yang.

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Principles of chinese medicine

Yin and yang are: 1. opposite to each other (as we described above) 2. dependent on each other 3. able to absorb or consume each other 4. able to transform into each other. Everything in the universe can be described as a combination of these two fundamental forces and they are in a constant state of flux. Yin and yang gives recognition to the duality, interaction, interdependence and transformation of life. Light and darkness are good examples to illustrate this. Light and darkness are opposite terms but they are also dependent on each other – without darkness there would be no light; without light there would be no darkness.

Evening

Midday

Yang

Yin

Midnight

Daybreak Yin/yang symbol and the cycle of day and night


At the height of midday there is maximum light, which is yang. At around midnight the opposite is true – there is maximum darkness, which is yin. As the day changes, the amounts of light and darkness vary – they consume each other. As dawn breaks, the darkness begins to transform into light. We could also say that the light is ‘absorbing’ the darkness. The day gradually becomes brighter and more yang as it progresses. Later, as the evening draws in, the day becomes darker and more yin. Daytime begins to transform into night or we could say that the nighttime is ‘consuming’ or absorbing the daylight. Although everything in the universe can be described in terms of yin and yang, they are also relative terms. For example, we just saw how day and night can be described in terms of yin and yang, but a year is made up of many days and nights and it also has yin and yang qualities. For instance, the summer, which is the brighter and hotter part of the year, is more yang and the winter, which is colder and darker, is more yin. The yin of winter transforms into the spring and in the autumn the yin reappears as the yang of the summer recedes.

How are yin and yang useful for Chinese medical practitioners? We all have a different balance of yin and yang. Another way of understanding what these terms mean is to think of yang as fire ; in other words, it is dry, bright, hot, active and moving upwards and outwards. Yin, on the other hand, is water as in a deep lake; it is wet, deep, dark, cold and still. Here are some other yin and yang characteristics that are used by Chinese medicine practitioners.

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Some yin and yang characteristics useful to Chinese medicine practitioners In relation to

Yin

Yang

Temperature

Cold

Hot

Moisture

Wet

Dry

Location

Inside

Outside

Direction

Downwards

Upwards

Speed of onset

Slow

Fast

Energy

Lethargy

Over-activity

Area of symptoms

Below

Above

Body area affected

Lower body

Upper body

Surface affected

Anterior

Posterior

How can Chinese medicine be used to balance yin and yang? Just as the universe has its own dynamic balance of yin and yang, so, correspondingly, does each individual. Chinese medicine tells us that in order to remain healthy we need to live in harmony with yin and yang in our daily lives. During the day, which is more yang, we are naturally more active. At night, our Qi (pronounced ‘chee’) (see page 29) withdraws inside us and becomes more yin so that we can close down and sleep. If we wish to remain active when we should be sleeping it might indicate that our yin is depleted. When our yin is strengthened with treatment we become more settled. On the other hand, if we continually sleep and feel lethargic during the day, this might indicate that our yang is


deficient. There is not enough expansive and active energy to get us moving. Strengthening our yang in this case can restore our health. A recent patient who had lower backache is an example. She often felt very cold and lethargic and found it hard to get up in the mornings. She described waking up as ‘like swimming to the surface of a sea of treacle’. Her lethargy indicated that her yang Qi was deficient. Treatment strengthened her yang Qi allowing her backache to improve. At the same time she felt brighter and more lively in the mornings.

How do yin and yang affect our life cycles? Yin and yang are reflected in the way we live during the seasons and even the cycle of our life. For instance, we are naturally more active and outgoing when it is hot and sunny in the summer, whilst it is normal to withdraw and conserve ourselves in the winter. Children are naturally very energetic and yang – as adults we can find it difficult to keep up with them! Childhood is the ‘springtime’ of our life. As we age, our energy decreases until when we are older we become more yin and may wish to slow down. We often refer to old age as the ‘autumn’ of our life. If we fight nature rather than work with it we may become deficient in yin Qi later in life. For example, many women have hot flushes during the menopause. They can also become drier and sometimes more restless – all signs of the yin Qi becoming depleted. Hot flushes are less common in China where women are more aware of their yin nature and consequently ensure that they conserve their Qi in the latter part of their life.1 1 Although this may be changing as Chinese women adopt a more Western lifestyle.

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Yin/yang and the cycle of the seasons

When acupuncturists examine a patient they will look at how the qualities of yin and yang interact and how treatment can improve their balance. Practitioners might consider the patient’s general condition and ask themselves, ‘Is this patient lethargic or restless, cool or hot, or wet or dry?’ The practitioner can also consider yin and yang in terms of where the disease is situated and ask, ‘Is this condition deep inside the body or more on the surface?’ Or in relation to which Organs are most involved in the illness, ‘Does this patient’s condition involve more of the yin Organs or the yang Organs or maybe even both?’ Practitioners assess the relative balance between our yin and yang Qi. Once this is ascertained, they can prescribe treatment to restore equilibrium and thus restore their patient’s health.


What are yin and yang Organs? Earlier in this chapter I explained that a second aspect of Chinese medicine theory is the functioning of the 12 Organs. When Chinese medicine talks about the Organs it is describing not only physical organs but many wider functions as well.

The yin and yang Organs Yin Organ

Yang Organ

Lung

Large Intestine

Spleen

Stomach

Heart

Small Intestine

Kidney

Bladder

Pericardium

Triple Burner

Liver

Gall Bladder

Yin Organs are more solid in nature and lie deeper inside the body. Chinese medicine describes them as being responsible for regulating and storing all the body’s Vital Substances before they are used. The yang Organs are hollow – in fact most of them are shaped as tubes or bags, lie nearer to the surface of the body and are responsible for receiving, separating, distributing and excreting all the Vital Substances (I will discuss the Vital Substances in more detail below). Yin and yang Organs work together. If the yang Organs don’t transform the Vital Substances there is nothing for the yin Organs to store. On the other hand if the yin Organs can’t store these Substances then there is no point in the yang Organs transforming them.

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What are the Vital Substances? Chinese medicine states that our body functions are determined by the interaction of certain ‘Vital’ Substances, which are: • Qi • Blood • Jing-essence • Body Fluids • Shen or Mind-spirit. These Vital Substances are the basic constituents of a human being. Some, such as Qi, are very refined. Others, such as Body Fluids, are very dense. The balanced functioning of these Substances allows us to remain healthy. If this balance breaks down we become unhealthy.

How do the Vital Substances and the Organs interact? Earlier I said that the main Organs all have wider functions than the ones described in Western medicine. One major function of all yin Organs is to store the Vital Substances. The connection between each Organ and Substance is shown in the table below and in the next part of this chapter I will explain more about how they interact.


The connection between the yin Organs and the Vital Sustances Organ

Function in relation to a Substance

Heart

Governs Blood Houses Shen or Mind-spirit

Liver

Ensures the smooth flow of Qi Stores Blood

Lung

Governs Qi and breathing

Spleen

Transforms and transports Qi and Body Fluids Controls Blood

Kidney

Stores Jing

What is Qi? Qi is a difficult term to translate. It can be translated as ‘energy’, ‘vital force’, ‘prana’ or ‘life force’. Modern physicists now understand that there is a continuum between matter and energy and that energy permeates the whole of the universe. Chinese medicine understands this continuum and says that when Qi becomes condensed it forms material substances, whilst more refined Qi becomes immaterial and rarified. Although Chinese medicine explains things somewhat differently from modern physicists, the word ‘energy’ is probably one of the best translations for the word Qi. As Western scientists recognise more about energy, they may one day give recognition to what has been understood over many thousands of years of Chinese culture.

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Chinese medicine describes Qi more by what it does than by what it is. Qi has the ability to: 1. move 2. transform 3. warm 4. protect 5. raise things up. In relation to our health this means that if we are tired our Qi may be deficient or not moving smoothly through our bodies. If we have loose bowels our Qi may not be transforming our food properly. If we are cold our Qi may not be warming us. If we have an illness, such as a common cold, our Qi may not be protecting us (see next chapter) or if we have a condition such as a prolapse our Qi might not be raising our Organs up.

Qi and the Lungs and Spleen The Qi originates when clean air from the Lung is mixed with the food we eat. The Lungs ‘govern’ our Qi and our respiration and the Spleen transforms and moves the Qi to every part of the body. We take in Qi when we breathe and the movement of the Lungs going downwards and outwards deepens the breath. When the Lung Qi travels outwards it goes to the skin. At the skin the Qi protects us and prevents pathogens such as Wind, Cold, Heat and Damp from causing illnesses such as colds and flu (see pages 45–48 for more on these pathogens). The Spleen transforms Qi and transports it around our body. If the Spleen is weak, the Qi can’t move and we may feel lethargic. This lack of movement can also cause our


limbs to lack nourishment and become weak or our digestive functioning to become impaired. Treating the Spleen can strengthen our energy and restore our vitality. A 45-year-old teacher had come for treatment because she was very tired. This was because her Qi had become very deficient through over-working. She told me, ‘I used to sleep heavily on Saturdays and Sundays because I was so tired. I think it was a progressive tiredness and towards the end of term I went to bed earlier and earlier.’ Tonifying her Spleen Qi restored the balance of her energy so that she regained her vitality.

Qi and the Liver The Liver is also associated with the Qi and ensures that it is flowing smoothly and evenly throughout our body. Our emotions are one reason why the flow becomes disrupted. If we are tense, our Qi stops flowing. If we clench our fists, tighten our shoulders, tense our chest, hold in our abdominal muscles and tense our neck and jaw, we are likely to feel very tense. Not surprisingly, the Qi can’t flow very easily! Many of us hold our body in a permanent state of tension because we are frustrated, irritable, angry or not clearing negative emotions. By doing this we prevent our Liver Qi from flowing smoothly. If the Liver Qi is obstructed, the resulting symptoms might range from premenstrual tension or headaches to digestive disorders, gynaecological problems or depression. Treating the Liver can smooth the flow of the Qi and make us feel better. A patient aged 35, who had headaches due to a Liver problem, found that after treatment his headaches had disappeared and that he had also become, ‘less sparky, aggressive and demanding’.

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What does Chinese medicine mean by Blood? Qi and Blood flow together in the body. ‘Blood’ in Chinese medicine includes the blood flowing through our blood vessels but it has wider connotations. Blood in Chinese medicine is a dense form of Qi and the Qi and Blood are inseparable. Like Qi, Blood is described less by what it is and more by what it does. Blood has the ability to nourish and moisten our body. It also has a heavy quality that allows it to keep the Qi, which is very light in nature, from ‘floating’. This can affect our ability to be settled inside and prevent anxiety and restlessness. I’ll explain this Mind-spirit in more detail below. Because of its ability to move, the Qi ensures that the Blood is circulating through the body smoothly. The interdependency of Qi and Blood is summarised by a famous saying in Chinese medicine, which is that, ‘Qi moves Blood and Blood nourishes Qi.’ Three Organs have a function related to the ‘Blood’: the Liver ‘stores’ the Blood; the Heart and Pericardium ‘govern’ the Blood; the Spleen ‘controls’ the Blood.

Blood and the Liver The Blood that is ‘stored’ in the Liver nourishes and moisturises our whole system. Then when we move around, the Liver ensures that the Blood reaches every part of the body and nurtures it. When we are resting, the Blood returns to the Liver. If Blood is deficient we might get symptoms stemming from the lack of nourishment to various parts of the body. There might be, for instance, dry eyes, cramps, pins and needles, flaky nails, scanty periods or dry skin. We might also feel light headed when we stand up. This is


because there is not enough Blood reaching our head when we move suddenly. The Blood can also become stuck. This can cause extreme pain and can result in women having very painful periods.

Blood and the Spleen The Spleen ‘controls’ the Blood and keeps it in the Blood vessels. If the Spleen is weak the Blood will ‘leak’ from the Blood vessels, which may cause bleeding symptoms, such as menstrual bleeding, bruising or blood in the urine or stools.

Blood and the Heart Finally, the Heart ‘governs’ the Blood, that is, it makes sure it is circulated to every part of the body. If this function is weak we may have poor circulation and cold hands and feet. Because the Blood is a heavy Substance, we must also have sufficient Blood for the Heart to ‘house the Shen or Mindspirit’ and keep it settled in the body.

What is the Shen or Mind-spirit? Chinese medicine describes our Mind-spirit or Shen as highly rarified Qi. Although Shen is far beyond being substantial and is therefore not a real ‘Substance’, it is sometimes described as one of the Vital Substances because it is part of the continuum of Qi moving from a solid to a more rarified form. As with the Qi and Blood it is best described by its actions, which are that it: • enables us to think clearly and to be mentally focused. • facilitates our ability to sleep soundly and without disturbance

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• allows us to have a good memory • gives us the ability to be conscious. Being conscious means both consciousness in relation to having insight into ourselves as well as being conscious rather than unconscious in the physical sense of the word.

The Shen or Mind-spirit and the Heart Our Mind-spirit resides in the Heart and if it is settled we feel peaceful and calm in our day-to-day activities. If the Blood is deficient (see above) the rarified Mind-spirit does not have enough of this heavier Substance to hold it in its place in the Heart, and it ‘floats’ just above it. As a result we can feel very unsettled and anxious. This can also result in sleep problems, jumpiness and a poor memory. Because of its effect on both the body and the Mindspirit, Chinese medicine can very successfully treat many mental and emotional problems. For example, one of my patients, a student nurse, was very anxious about writing essays for her course. Treatment allowed her to become less anxious and she said she could think more clearly, remain calmer and also sleep better. Much of her treatment was centred on calming her Shen or Mind-spirit. The Shen or Mind-spirit also interacts with the Kidneys and the Kidney ‘Jing-essence’.

What is Jing-essence? Jing-essence is not a familiar concept in the West, however, understanding it can have a huge impact on how we view our health and well-being. Some of you might have already wondered why certain people easily become ill whilst other lucky ones seem to be able to eat anything, stay up all night


and generally abuse their bodies without any apparent health problems. The Chinese medicine understanding of ‘Jing-essence’ is our constitutional strength. If our Jing-essence is strong then we will have lots of energy and develop normally. If it is weak, this won’t happen in the same way.

Jing-essence and the Kidneys Jing-essence is formed at conception, it is finite in quantity and is stored in the Kidneys. It has an overall effect on our health and strength, and as we go through life we slowly use it up. Jing-essence allows us to mature from puberty to old age. This is a natural process that takes place if we have sufficient Jing-essence. Some children are born with weak Jing-essence and they may have symptoms of delayed growth, late onset of their periods, bed-wetting, or problems with their bones. When these problems are severe they may be very hard to treat. We may have plenty of Jing-essence when we are born but use it up too quickly due to bad living habits. In this case, women may have difficulty conceiving or may suffer repeated miscarriages. It can also lead to an early menopause, back problems or osteoporosis. Losing teeth and hair and a failing memory in old age are also symptoms of declining Jing-essence. Most people have a moderate amount of Jing-essence and can avoid these problems if they look after their health. If you think you have a super, strong constitution you should be careful. Bad living habits take their toll even if we are extremely healthy – a healthy lifestyle now can prevent problems later.

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A 31-year-old patient had slightly deficient Jing-essence and became ill at an early age. She was born prematurely and this probably affected her constitutional strength. She came for treatment with polycystic ovarian syndrome and had symptoms including night sweats, period pains, exhaustion, migraines, food allergies and high blood pressure. Treatment has helped her and she has also changed her lifestyle considerably. As a result she has new-found vitality and can expect to have a more healthy future.

What are Body Fluids? The final Substance that we will consider is all the fluid in the body. Some of our Body Fluids are ‘light’ and lubricate the skin and muscles; others are ‘heavier’ and moisten areas deeper inside the body such as the joints, spine, brain and bone marrow.

The Body Fluids and the Spleen The Body Fluids are transported around the body by the Spleen Qi and must be kept in the correct balance. If our Spleen Qi is deficient it can’t move the fluids, which in turn can congeal and produce ‘Dampness’ in the body. This can cause us to put on weight, which can be difficult to lose. We can also feel tired, heavy, find it difficult to concentrate and feel cloudy in our head. Treatment can strengthen the Spleen’s ability to move fluids. This can clear the Dampness and remedy the situation.2 The Body Fluids can also become deficient. This is often true if the Stomach is weak, resulting in dehydration. In this case, treatment of the Stomach can help to alleviate the problem and bring moisture back to the body. 2 For more about Dampness see Chapter 2.


How do these Substances influence each other? The Qi, Blood, Mind-spirit, Jing-essence and Body Fluids are all interlinked. The Qi, Jing-essence and Mind-spirit are called ‘the Three Treasures’. Together they form the basis of our health. Chinese medicine will often use the term ‘Jingshen’ as a shorthand term for vitality or vigour, indicating their understanding that a good constitution and a strong spirit are the basis of a healthy life. The Shen or Mind-spirit cannot be settled unless the Blood is sufficient to house it. The Body Fluids are essential in order to keep the Blood at its correct viscosity. If one or more of the Organs is weak or blocked, the Substances they affect will also be influenced. Conversely if the Substances are deficient or stagnating this will impact on the Organs. So far we have discussed the concepts of yin and yang, the Vital Substances and the Organs. This chapter wouldn’t be complete without some discussion about one more fundamental concept in Chinese medicine – the Five Elements.

What are the Five Elements? The concept of the Five Elements may seem quite unusual to those who are unfamiliar with Chinese thought – they are a metaphorical description of the basic constituents of matter and how they interact. The Chinese word for an Element is xing. This has variously been translated as a movement, a phase or a moving force. It literally means ‘stepping forward with one foot then with the other’ suggesting that there is movement from one to the next.

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Each of the Organs discussed above is related to one of these Five Elements. The Elements are Wood, Fire, Earth, Metal and Water and their Organs are as follows: • Wood – Liver and Gall Bladder • Fire – Heart and Small Intestine and Pericardium and Triple Burner • Earth – Spleen and Stomach • Metal – Lung and Large Intestine • Water – Kidney and Bladder. One of the oldest descriptions of the Five Elements was written as long ago as 1000 bc: Water moistens downwards, Fire flares upwards, Wood can be bent and straightened, Metal can be moulded and hardened and Earth permits sowing, growing and reaping.3

How do the Elements interact? The Elements connect with each other via the ‘Sheng’ and ‘Ke’ cycles shown in the diagram below. The Sheng cycle is the route by which the Organs nourish each other whilst they keep each other in check via the Ke cycle. If the Qi of one of the Elements becomes imbalanced it will often affect the others. Treatment on one or more Elements and Organs can also affect all of the others in a positive way.

3

This is from a book called the Shang Shu which was written during the Western Zhou dynasty, around 1000–771 bc.


Sheng Cycle

Ke Cycle

Fire Wood

Water

Earth

Metal

Five elements and the Sheng and Ke cycles

The reason why the Elements and Organs are connected becomes apparent when we look at their mutual qualities. For example, Earth, which produces our food, is associated with the Stomach and Spleen – the two main Organs of nourishment. Water is associated with the Bladder and Kidneys, which control and excrete fluids in the body. Wood is associated with everything living and growing. Chinese medicine associates the Liver and Gall Bladder with our ability to assert ourselves so we can move forward and ‘grow’ as a result of clear plans and decisions. The following example shows how knowledge of the Elements helps us to understand our patients’ health. A patient who had headaches was mainly treated on his Liver and Gall Bladder, which are part of the Wood Element. The emotion associated with the Liver is anger. His Liver Qi had become imbalanced due to the frustration he felt in his job. This caused

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him to tense up causing headaches. Wood is ‘fed’ by the Water Element along the Sheng cycle and treating his Kidney Qi, which is a part of the Water Element, helped to balance the Liver. On some rare occasions he became nauseous with his headaches – symptoms associated with the Earth Element and the Stomach and Spleen. Treating the Wood positively affected the Earth via the Ke cycle so the Earth itself rarely needed treatment directly.

What are the Five Element associations? The Elements all have associations that ‘resonate’ with them. Each is connected with a season, a climate, a taste, a colour, a sound, an emotion, an odour, a movement, a sense Organ and a body part, as well as having many other associations. Yin and yang, the Vital Substances, the Organs and the Five Elements form the basis of a diagnosis made by Chinese medicine practitioners. Before looking more closely at how they are used together, we will examine another essential part of the theory of Chinese medicine – the causes of disease and how the Chinese view good health.

Liver

Gall Bladder

Blue-green

Shout

Anger

Rancid

Spring

Wind

Eye

Yin Organ

Yang Organ

Colour

Sound

Emotion

Odour

Season

Climate

Sense Organ

Wood

Tongue

Heat

Summer

Scorched

Joy

Laugh

Red

Small Intestine Triple Burner

Heart Pericardium

Fire

Mouth

Damp

Late summer

Fragrant

Worry/Sympathy

Sing

Yellow

Stomach

Spleen

Earth

The Five Element associations

Nose

Dryness

Autumn

Rotten

Grief

Weep

White

Large Intestine

Lung

Metal

Ear

Cold

Winter

Putrid

Fear

Groan

Blue-black

Bladder

Kidney

Water

2

How Disease Arises and the Art of Staying Healthy

Some people believe that to be healthy is simply not to be ill. Chinese medicine views health differently. Being well is a very positive state, one in which we feel vibrant, vital and energetic and are happy to be alive. Health is something that is experienced at every level of our being – body, mind and spirit. A patient explains how she understood health before she had treatment: I was a nurse and can remember walking to work on the wards and wondering about my own health. I’d think, ‘I’m physically healthy, my mind is clear and I’ve got nothing wrong with me. So why do I feel so unwell?’ I felt desperately low in energy. I was like a robot getting through life but not living it. I never went to the doctor as there was nothing I could describe as being ill. A few years later I developed a minor rash. A friend told me about Chinese medicine and I decided to try it. I’m really glad I went for treatment. My rash cleared very quickly but more importantly I felt much better. My spirits lifted and I felt positively well. My life became enjoyable and I realised that this really was good health. What I’d experienced before was a ‘lack of illness’. 42


In order to understand how to become healthy, first we need to ask how disease arises.

So how does disease arise? Chinese medicine divides the causes of disease into three main areas. The first are ‘Internal’ causes, which are illnesses caused by emotions. The second are the ‘External’ causes, which are climatic conditions. The third are ‘Miscellaneous’ causes, which cover constitution, diet, exercise, rest, sexual behaviour and trauma. We’ll look at each of these in turn.1

What are the internal causes of disease? The internal causes of disease are getting more recognition than they used to. It is astonishing that Chinese medicine wrote about them thousands of years ago when they identified the impact of emotional factors on physical health. The internal causes of disease are anger, sadness, worry, fear, joy, grief and shock. Other emotions are seen as an extension or a combination of these seven. To express these emotions appropriately is a normal and healthy response to the many situations we encounter in daily life. For example, we feel afraid when we are threatened, anger if we are let down or grief when we lose someone or something important to us.

How do emotions cause disease? Emotions only cause disease when they are intense or prolonged or if they are not expressed or acknowledged over a long period of time. Sometimes they start from conditions that began in our childhood when we were unable to change our circumstances.

1 For more on the causes of disease see Hicks (2011).

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We may have been affected by situations involving parents, siblings, teachers or schoolmates. Occasionally these are sudden events, such as the loss of a parent or friend. At other times they are more gradual in onset, such as continual rejection by an important person, which may result in a loss of self-esteem and confidence. Later, these incidents and patterns from so long ago may begin to affect our health and well-being. A female patient now in her 30s came for treatment complaining, ‘I often feel sick and have loose bowels. I’m also a worrier, especially about my daughter.’ She had become obsessional and thought that something terrible would happen to the seven year old. On taking her case history it became apparent that these problems were rooted in her early childhood when her mother had a serious accident. The patient as a child had no one to turn to for support and she worried continually that her mother would die. Treatment on her Stomach and Spleen Qi helped both her body and her mind. She became less anxious for her daughter’s well-being as well as more settled in her stomach and bowels. Digestion is a process of assimilation both physically and mentally. Intense emotions in the present can also take their toll on our health. We may feel continuously worried, anxious or frustrated in a situation at work or at home. Sometimes we get through these events unscathed. At other times we do not. A male patient in his early 20s came for acupuncture treatment having had a harrowing week at work, ‘My boss has been putting too much pressure on me and expecting me to meet impossible deadlines,’ he raged. Treatment soothed his energy, which had become imbalanced by his frustration. He immediately felt better and consequently found that he was able to sort the matter out with his boss.


At times it is obvious that the cause of a patient’s illness is an internal one, but it is unclear exactly which emotions or events brought it about. It is not necessary to know this and the patient can still be treated successfully. Many illnesses are originally caused by an internal factor. This may have weakened the person and made him or her more vulnerable to the climatic causes of disease, which we will discuss next.

How can climatic conditions cause disease? Climatic conditions as a cause of disease are written about in texts from as far back as 3,000 years ago. The main climatic conditions are Wind, Cold, Damp, Heat and Dryness. Different climatic conditions are appropriate during each season and we usually adapt to them as they come and go. Summer should be hot and winter should be cold. The springtime brings a warming up after the cold of winter and there is a natural cooling down again in the autumn. Extremes of weather, such as a very cold winter, or unseasonal weather, such as a warm spell in winter, make us more vulnerable to the effects of that climatic condition and consequently to becoming ill. Below is a list of these external pathogenic factors and the kinds of symptoms they might cause if they affect us.

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The external causes of disease External pathogen and its nature

Areas of symptoms created

Examples of illnesses

Wind arises suddenly, changes rapidly, blows intermittently, has an upward and outward movement and makes things shake and sway

Symptoms that come on suddenly, constantly change or move around Symptoms where there is shaking or sudden movement Symptoms at the top of or outside of the body

Head colds and flus, joint pains that move around, epilepsy, strokes, Parkinson’s disease, some skin conditions

Damp is sticky, lingering, heavy and dirty

Symptoms that don’t change easily Symptoms of heaviness or obstruction Oozing and discharges

Heavy or muzzy head, stiff or achy joints, heavy limbs, bloating abdomen, discharges, pusfilled spots, tiredness

Cold impairs moving and warming in the body – it contracts tissues and obstructs circulation causing pain

Symptoms of sharp pain, which is relieved by warmth and made worse by cold Contraction of tendons Dislike of cold

Loose bowels, period pains, stomach pains, cold hands and feet, frost bite, painful joints


Heat has an upward direction, depletes the Qi, dries up Body Fluids and disturbs the Mind-spirit

Feeling hot, red body parts, intense thirst, bitter taste, profuse bleeding, dark scanty urine

Sore throat, cystitis, constipation, red eyes, mania, nose bleeds, uterine bleeding, anxiety, restlessness

Dryness injures Blood and dries Body Fluids

Dry throat, dry skin, dry mouth, dry stools, dry lips, scanty urination

Some skin problems, constipation, chest conditions

Sometimes we create these ‘unusual seasonal conditions’ for ourselves! A young female patient went on a wonderful hot winter holiday abroad over Christmas and was surprised to have a terrible cold on her return. This was due to her system being unable to adapt from the warm climate abroad to the English winter on coming home, ‘I felt so healthy while I was away,’ she commented after the cold had gone, ‘now I feel worse than before I went’. People whose underlying energy is weak are more vulnerable to the effects of the climatic conditions than those who have a strong constitution and never get sick. For example, as people age they generally grow more vulnerable. During an exceptionally cold winter we may worry about our older relatives and friends and encourage them to keep warm, knowing that the cold brings greater danger of hypothermia and other illnesses.

How is knowledge of external causes useful to a patient? Along with appropriate treatment, a practitioner can advise patients of ways in which they can protect themselves from adverse climatic conditions.

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Some golden rules to protect ourselves from external conditions Wind

Wrap up against the wind especially around the neck. Keep covered if the temperature changes when returning from sunny holidays abroad or going in and out of overheated or air conditioned shops. Don’t sleep or stand in front of a fan or in a draught – these could cause headaches or lower resistance to colds or influenza.

Cold

Don’t walk around without shoes especially on cold floors, as this could cause period pain or, if severe, fertility problems. Keep the midriff covered to avoid stomach pain and the back covered to prevent backache.

Damp

If you live in a damp house buy a dehumidifier to avoid symptoms such as a muzzy head, tiredness or poor concentration. Dry yourself properly after bathing or swimming to avoid joint pains.

Heat

Beware of staying in the sun for too long to avoid overheating or heat stroke. Don’t sleep with your head towards a nearby radiator or oven in order to prevent headaches, red eyes and a bad temper.

Dryness

If staying in a centrally heated environment, moisten the atmosphere with a bowl of water to avoid dry cough, dry skin or a dry throat.


What do we mean by the miscellaneous causes of disease? Other significant causes of illness are known as the miscellaneous causes. Literally translated from Chinese these are called ‘not internal and not external’ causes of disease. They cover areas such as constitution, overwork and fatigue, exercise, sex, diet and trauma. It is important not to underestimate the significance of a healthy, regular diet in relation to our health (this is covered in much greater detail in Chapter 8). Jing-essence, the basis of our constitution, has already been described in Chapter 1. We will now take a brief look at the other miscellaneous causes of disease.

How do balanced amounts of work and rest prevent disease? The issue of how much we work and how much we rest is an important one in today’s society. Nowadays pressure is often put on people to work very hard and to return to work quickly after they have been ill. The word ‘convalescence’ is almost unheard of these days in relation to time spent recovering from an illness. Often people with colds and other infections say, ‘Oh don’t worry I’ll work right through it,’ or if they do have time off, feel guilty for taking more than the bare minimum. There is a strong case for people taking an extra day or two to recover and throw off their illness completely. If people do not allow themselves to fully recover, the infection can remain latent in their body. It can then return in the form of what is often called a ‘post-viral syndrome’. Many postviral syndromes are the result of a combination of continual overwork and a lack of convalescence after infection. A

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person then often feels continually depleted and run down and is unable to recover from the illness at all. Post-viral syndromes often last for many years and all for the sake of an extra few days’ rest! As one patient observed, ‘I had rested a little after being ill, but then I went back to work. I worked much too hard – and then it was too late. All my energy had gone and I didn’t recover for many years.’

How can exercise benefit my health? The last 50 years have also seen a considerable decrease in the amount of natural exercise we get. The use of cars has reduced the quantity of walking we do. Household gadgets, such as washing machines and vacuum cleaners, have lessened the amount of exercise we would naturally get around the house (thank goodness!). Many children spend less time in the rough and tumble of the playground as they are happy to play on their computer games instead – a worrying trend. Few of us want to be without our labour-saving devices but the resulting effect on our lifestyle means that we need to find alternative ways of exercising and remaining healthy. A friend of mine recently told me, ‘I’ve started to cycle to work instead of driving as I was beginning to feel really sluggish. I notice I have much more energy even though I’m exerting myself more and I’ve also lost some weight.’ Too much exercise can be just as detrimental as too little. A friend who once obsessively exercised observed, ‘I felt great while I was out running. Then I realised my good intentions had backfired on me. I was wearing myself out and felt completely drained the rest of the time.’ We need to be realistic about the amount of exercise we get so that we can remain healthy. A balanced amount of work and rest combined with exercise is still as important as it was 50 years ago.


In what way can sex become a cause of disease? Too much sex is recognised by Chinese medicine as another cause of disease. Chinese doctors warned that this is especially important for men rather than women. Men can wear out their Kidney Qi if they ejaculate too much. This can result in possible back problems, lethargy and tiredness. The issue of what exactly is too much sex has been much debated in many texts throughout Chinese history! However much we agree or disagree with this Chinese medicine notion of too much sex, there are some clear and sensible guidelines we can follow. Young adults have more energy for sex than older people and can therefore afford to be more sexually active in their younger years. We can also have more sex in the summer when we naturally tend to be more active, than in the winter, when it is more normal for us to do less. Chinese medicine also advises less sex if we are ill, as we need to conserve our strength in order to regain our health. Of course, there is a natural balance between too much and too little sex. Too little sex can lead to much frustration and resentment, also possibly causing illness. In general the ‘right’ amount of sex could be said to be as much as mutually satisfies each couple and is part of a fulfilling relationship for them both.

How is physical trauma a cause of disease? Any accident or injury that does not fully heal can later cause disease to the part of the body involved. Doctors tell us that a broken bone or a joint strain can be the site of ‘arthritic changes’ occurring later on in life. If this happens a patient can experience pain, stiffness, swelling, heat or limitation of movement in the area that was previously injured. A practitioner of Chinese medicine would say that this injury

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left the joint vulnerable to Wind, Cold or Damp entering it or to Heat being formed inside the joint. Dampness affecting a joint tends to cause stiffness and swelling. Damp is said to be sticky and lingering. Wind causes pain that comes and goes and moves from place to place, just like the wind in nature. Cold causes contraction of the tendons and sharp pains, like the pain felt in the fingers caused by holding a snowball for too long. Heat in a joint causes redness, swelling and pain. This is what we experience when there is inflammation in the body. These pathogens entering the joints after injury can often be eliminated by using Chinese medicine treatments of herbs, acupuncture, tui na massage or Qigong.

The causes of disease External causes

Wind, Cold, Damp, Dryness, Heat

Internal causes

Anger, Fear, Grief, Joy, Worry, Shock

Miscellaneous cases

Constitution, Overwork and Fatigue, Exercise, Diet, Sex, Trauma

Do I have to know the cause of my problem? For most people the causes of their problems are a combination of internal, external and miscellaneous factors, rather than just one. It is unnecessary for patients to be aware of the specific reasons behind their sickness. Practitioners will diagnose their patient’s condition so that they treat the underlying energetic imbalance and treatment can clear the symptoms.


A middle-aged patient, for instance, came for treatment having been affected by a ‘virus’ for a number of weeks. She said, ‘I’m aching all over and I’m really tired. I also have loose bowels and I’m really bloated in my stomach.’ These were all symptoms of an external ‘attack’ of Dampness. She received herbs and acupuncture treatment, which cleared it, but could not remember any time when she had been in conditions that could have precipitated the condition. Other illnesses may have taken root in early childhood and patients often don’t know the exact cause of the resulting problems. In spite of this, they can still be treated successfully. Sometimes the cause of the condition becomes clearer and resolves itself as treatment progresses.

How are the causes of disease used in diagnosis and treatment? Although it is not always necessary to understand the origin of a disease in order to cure it, it can be helpful to know the main reasons why diseases have occurred, especially when they have arisen due to a person’s living habits. Patients may consider whether they are eating properly, getting enough rest and exercise or whether they need to work less. This may help them to understand what brought about their illness and to make lifestyle changes that could help them to become healthier. Not everyone finds it easy to make immediate shifts in their lifestyle, even if they would be healthier as a result. They can, however, gain more insight into why they have become ill and strive towards a healthier balance. Chinese medicine believes that the best recipe for health is a balanced lifestyle and avoiding extremes in anything we do. We can

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all use this as a rule of thumb when considering the state of our health. In the next chapter we will consider how the theories of Chinese medicine that we have discussed in the first two chapters are put together to form a diagnosis.

3

Putting it all Together Diagnosis in Chinese Medicine

Yin and yang, the Organs and the Five Elements and the Vital Substances, together with the causes of disease are the foundation of an individual diagnosis for patients. So what is it like to have a diagnosis? Here are some comments that patients have made about their diagnoses. ‘I remember feeling as if I’d had a huge burden lifted from me and I appreciated that the practitioner had the time to listen to me.’ ‘It was absolutely wonderful, I was asked questions nobody had asked me before. I also got reassurance that I might be helped.’ ‘It was so thorough that I had the opportunity to say whatever I wanted about my physical health and also how I was feeling.’

How long will the diagnosis take? If you decide to go for Chinese medicine treatment, you may be nervous and might be surprised by the amount of time and personal care you are given by the practitioner. Acupuncturists, herbalists or tui na practitioners usually have a strong sense of vocation and a great desire to assist you to overcome your illnesses and enjoy a better quality of life. 55

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The time taken for a full diagnosis will vary according to the practitioner, the type of treatment and your individual needs, so can vary from one to one-and-a-half hours. Patients often feel that they have established good rapport with their practitioner during this consultation and that the act of talking through their problems is in itself very helpful in understanding their own health needs.

What should I expect at the diagnosis? Practitioners will ask you why you have come for treatment and many other details about your problems. They will ask questions which will vary from ‘How well do you sleep?’ or ‘How is your appetite?’ or ‘How frequently do you urinate?’ to ‘Are you currently experiencing any frustrations or difficulties in your life?’ or ‘When during the day do you feel better or worse?’ These questions and many more are all relevant to your health. If you have a musculoskeletal problem practitioners may also palpate the area, feel its temperature and test the range of movement in the affected joint. They may observe other signs, such as facial colour. The face may show different coloured ‘hues’ such as green if the Liver and Gall Bladder are out of balance or blue-black if the Kidney and Bladder are deficient. Practitioners will also pay attention to your posture and even notice the sparkle in your eye, which may tell them about the state of the Mind-spirit. They will also feel your pulse and look at your tongue.

How does a practitioner diagnose using the pulse? The practitioner feels 12 pulses at both wrists in order to diagnose the state of your Qi and Blood (see Chapter 1) as

Putting it all Together

well as the condition of both the yin and yang Organs. The pulse is felt with three fingers along the radial artery and each position corresponds to one of the 12 Organs.

The 12 pulse points Left wrist

Right wrist

Yang Organ

Yin Organ

Yin Organ

Yang Organ

First position

Small Intestine

Heart

Lung

Large Intestine

Second position

Gall Bladder

Liver

Spleen

Stomach

Third position

Bladder

Kidney (Yin)

Pericardium/ Triple Burner Kidney (Yang)

There are many different qualities that are felt on the pulses. These can tell the practitioner about the balance of your Qi. For example, when a person has an illness deep inside the body the pulse will feel deep down or be ‘sinking’. If there is a pathogen such as Wind invading the Lungs (see Chapters 1 and 2) and causing a common cold the pulses will ‘float’ or feel more superficial as this illness is at a superficial level of the body. In this case the position of the Lung is often the most affected. The pulses also have an overall strength or depletion according to the patient’s general Qi balance and according to which Organs are affected. When people feel ‘uptight’ and angry the pulse will often have a stretched tight feeling known as a ‘wiry’ pulse. Another pulse quality is a ‘slippery’ pulse. This feels as if it is slipping away from the finger and gives information about the state of the patient’s Body Fluids.

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Altogether there are 28 qualities that can be felt on the pulse and you will often have more than one quality manifesting. Pulse diagnosis is a skill that a practitioner of Chinese medicine develops over a lifetime. It is very different from pulse diagnosis used in modern Western medicine. Both practitioners feel the pulse at the radial artery but the Western doctor or nurse counts the pulse rate and rhythm only. Practitioners of Chinese medicine will notice the pulse rate but will also feel the whole range of other qualities that are also present.

What is tongue diagnosis? The tongue is a useful diagnostic tool as it is one way in which a practitioner can observe the condition of the inside of the body from the outside. Practitioners look at the colour, shape, moisture, movement, coating and areas of the tongue to diagnose the state of your internal organs. Disharmony will often show on the tongue before symptoms start to manifest. A healthy tongue will be pale red in colour, fairly moist, fit comfortably into the mouth and have a thin white coating. Sometimes the tongue looks redder than normal. This shows the presence of heat whilst a pale tongue may indicate cold. The tongue is filled with Blood so it will also naturally become paler when Blood is deficient. A tongue can become swollen. This is often due to excess Body Fluids obstructing the body or deficiency of yang Qi resulting in cold and causing Body Fluids to stagnate. A thin tongue body can mean a lack of Body Fluids. Each area corresponds to different Organs in the body. These areas can be wet or dry, thin or swollen, pale or red according to which Organ of the body is out of balance. For instance, red sides to the tongue can mean Heat in the


Liver and Gall Bladder, red in the centre can mean Heat in the Stomach or red at the tongue tip can mean Heat in the Heart. Sometimes the tongue has red ‘spots’ at the tip indicating a tendency to become more easily emotionally upset.

Areas of the tongue

How is the theory of Chinese medicine used to create a diagnosis? During the diagnosis the practitioner gathers together information about your signs and symptoms, observes your tongue and facial colour and feels the pulses on your wrist. The practitioner is now ready to make a diagnosis. Knowledge of yin and yang, the Organs and Five Elements, and the Vital Substances can lead to a simple yet elegant diagnosis that can pinpoint the cause of your problems very accurately, while at the same time continuing to view you holistically. The cause of your imbalance might be due to an internal, external or miscellaneous cause of disease. To illustrate how a diagnosis might be formed we can now look at two different patients.

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Patient 1 A patient, aged 35, came to treatment complaining, ‘I get a churning feeling in my stomach whenever I get upset and my bowels alternate between constipation and diarrhoea.’ The practitioner noticed that she had a slightly yellow complexion and that she was constantly worrying and thinking about her problem. Her facial colour, voice tone and emotional expression all corresponded to an imbalance in her Stomach and Spleen, the two Organs of her ‘Earth’ Element. This was further corroborated by her gastrointestinal and other symptoms, such as a poor appetite, weakness in her limbs and a bloating feeling after eating. The churning feeling came and went according to the severity of her emotional state, as did the constipation and diarrhoea indicating that her Liver was also involved. The diagnosis was Liver Qi ‘invades’ the Stomach and Spleen. A change in her diet and acupuncture relieved her symptoms.

Patient 2 A patient, aged 52, came for treatment complaining, ‘I get terrible menopausal hot flushes that wake me at night.’ On examination the practitioner noticed that she had a blue-black facial colour especially around her eyes although she also had a red face caused by the heat. She had a monotone voice tone, and she was very fearful and anxious. These symptoms were connected to her ‘Water’ Element and her Bladder and Kidney Organs, which were her primary imbalance. Her Heart Qi was also affected. This was indicated by symptoms such as palpitations, poor sleep and


restlessness, which were all symptoms connected with the Heart. The practitioner diagnosed that her Heart did not have enough yin Qi and this was causing symptoms of too much Heat. The diagnosis was Kidney and Heart yin deficiency. Her symptoms were eased by Chinese herbs. Whether the patient’s condition is caused by ‘Liver Qi invades the Stomach and Spleen’ or ‘Heart and Kidney yin deficiency’, the same diagnosis will be made by a practitioner of any branch of Chinese medicine. Having understood the basis of Chinese medical theory we can now go on to examine each of these treatments in turn.

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Acupuncture Treatment Balancing Your Qi

A close colleague’s first patient was in his early 50s. He had come for treatment for a shoulder problem. After his first treatment my colleague asked him about his progress and he replied, ‘It’s as if there has been a bud in my chest that has started to grow into a flower.’ My colleague was puzzled and checked his notes to make sure this really was the patient with the shoulder problem. Establishing that it was, he asked his patient to say more about the emerging flower. The patient replied, ‘Well since your treatment I’m happier, I feel more comfortable with people and my wife says I’m easier to live with.’ My colleague then asked his patient about the shoulder and he said, almost as an afterthought, ‘Oh yes that’s better too.’ Many acupuncture patients notice internal changes from treatment (not everyone puts it as eloquently!). Like my colleague’s patient they may feel happier and healthier as well as experiencing changes to their main complaint. At the College of Integrated Chinese Medicine in Reading, we have regularly monitored the effectiveness of the acupuncture treatments carried out by students in our College Teaching Clinic. The study verified that there is a huge impact on both patients’ presenting symptoms and their general health and well-being. 62

Acupuncture Treatment

Data from 495 patients was analysed with the participation of statisticians at Kingston University. One of the aims of this study was to build up a profile of how patients viewed their treatment. The results? Interestingly over 82 per cent of patients reported a large or moderate change in their main complaint and 88 per cent reported a large or moderate change in their general health (Shaw et al., 2007). We’ll take another look at this research later in this chapter as well as considering other acupuncture studies that are of interest. We’ll also look at the most frequently asked questions about acupuncture such as, what it is like to be treated with acupuncture? What are needles like? How do we ensure they are sterile? Does treatment hurt? How does the acupuncturist know where to put the needles? We’ll also take a look in greater detail at what acupuncture can treat. But first, what is acupuncture and what are channels and points?

What is acupuncture? When I first studied acupuncture very few people had heard of it. Nowadays most people know what it is and may also know someone who has benefited from it. News of its effectiveness has mostly been spread by word of mouth – once a person experiences the results they tell others about it. Practitioners treat their patients by inserting ultra-fine, sterile needles into points. The points lie on ‘channels’ or ‘meridians’, which are pathways along which Qi flows. You may have already seen charts showing locations of acupuncture points (see examples on pages 65–67). The practitioner carefully chooses points to disperse blockages and to bring a patient’s Qi into balance. The more this balance is achieved, the healthier the patient becomes.

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Like the patient at the beginning of this chapter, it is common for people to experience changes not only to their physical health, but also to their emotional and mental well-being. The Chinese words for acupuncture treatments are zhen and jiu. Zhen means needles and jiu means moxibustion. Interestingly, when Chinese medicine describes acupuncture treatment it means needles and this other treatment called moxibustion. Both treatments have been used together throughout Chinese history. I will explain more about moxibustion later in the chapter.

What are the ‘meridians’ or ‘channels’? The channels or meridians are pathways of Qi running throughout the body. These channels form a network, which Chinese medicine has compared to an irrigation system. In China irrigation systems have been used to nourish and water the land for thousands of years. These systems break down if they are neglected. The water in the ditches might dry up and the surrounding areas are starved of nourishment. Likewise, if our channel system becomes blocked or depleted this causes an imbalance in our Qi and eventually illness. Acupuncture helps the Qi to flow freely again, clearing obstructions and nourishing the Qi. This in turn restores our health.

Where are the channels and how many are there? There are 12 main channels. Branching from them is a network of other smaller channels that eventually cover the whole body. The smallest ones are called ‘cutaneous’ channels, and they lie just beneath the skin. Each main channel is associated with and flows through one of the 12 Organs mentioned in the previous chapters. Treatment on points on these channels has different


therapeutic effects. We’ll look at three of the channels – the Heart, the Gall Bladder and the Bladder channel.

The Heart channel The Heart channel, travels from the heart itself to the armpit and down the inside of the arm to the little finger (see below). Western medicine cannot explain why someone with a heart problem or about to have a heart attack often has a tingling feeling running down the arm to the little finger. Not only does this channel’s pathways explain it, but Chinese medicine practitioners have understood for thousands of years that treatment on this channel can be used to keep the heart healthy.

The Heart channel

The Gall Bladder channel Another pathway is the Gall Bladder channel. This begins next to the eye, travels around the side of the head then down the side of the body to end by the nail of the fourth toe (see below). Many people have headaches travelling

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around this pathway at the sides of their heads and going to the eye. Treating this channel on the foot can help to alleviate many headaches or migraines. NICE has recognised that overuse of painkillers is a common cause of headaches and has established that acupuncture is a better alternative in the treatment of headaches. It recommends that GPs refer patients for a course of up to ten sessions of acupuncture over five to eight weeks for the treatment of chronic tension-type headaches (NICE 2012).

The Gall Bladder channel


The Bladder channel The Bladder channel travels from the head to the foot and covers the whole length of the back in two parallel channels. Back pain is one of many conditions that can be treated via this channel, and needles in the side of the foot where the channel ends can alleviate many backaches. NICE has suggested that GPs should refer patients for a course of acupuncture comprising up to a maximum of ten sessions over a period of up to 12 weeks for the treatment of back pain (NICE 2009).

The Bladder channel

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What are acupuncture points? Acupuncture points lie along the pathways of these channels. Points are often found at prominences or indentations along the channels, such as where there is a notch in a bone, a flare of the bone at a joint or where two muscles meet. They can be compared to small whirlpools that are formed when the smooth flowing of a stream or river is disrupted. There are approximately 365 acupuncture points positioned along the 12 main channels, as well as many others that are not located on main pathways.

Tender points Chinese medicine sometimes discovers a new point that proves extremely useful. For example, a point on the Stomach channel of the leg becomes tender on pressure if a patient’s appendix is inflamed and can clarify a diagnosis of appendicitis. Another point on the Gall Bladder channel below the knee becomes tender when the Gall Bladder is inflamed. Not all acupuncture points become tender with pressure and the locations of all points have been specified so that an acupuncturist can find their exact location.


Wang Wei Yi and the bronze man The locations of the acupuncture points were first standardised nearly 1,000 years ago in 1026. At that time a famous Chinese doctor called Wang Wei Yi wrote a book called The Illustrated Manual for Acupuncture and Moxibustion. This book systematised all of the point locations for the main channels. The Emperor of the time then commissioned two bronze figures of the points and these were kept in his palace. Subsequently many more bronze figures were made and used for acupuncture students’ examinations. Holes were made in the bronze statue, which were filled with water and covered with wax. If the students correctly located the points the needle went through the wax and water spilled out confirming that they had passed the exam!

Can the channels be felt? Often people who practise Qigong over a period of time learn to become sensitive to their Qi and are able to feel the pathways (see Chapter 6). Some people believe that this is how the pathways were originally found and traced out. Patients often feel this Qi travelling along their channels close to where the needle is inserted. This may feel like a slight tingling sensation or even a numbness. One patient described what she felt when a point was treated, ‘Whenever one particular point on my wrist was treated I would feel a whoosh of energy travelling straight up the inside of my arm

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over my head and down my other arm. I then felt completely at peace and didn’t want to move’. She had experienced the Qi of her ‘Heart’ meridian moving through her channels. This created a feeling of well-being and relaxation.

Pericardium 6 – a well‑researched point Pericardium 6 is located about one-and-a-half inches above the wrist on the inside of the arm. Although it has a local effect and can be useful for conditions such as carpal tunnel syndrome causing a painful wrist, like many acupuncture points its main influence is on other parts of the body. Research has shown that it is effective for treating many cardiovascular disorders including irregular heart rhythms or constricted blood flow to the heart (Li et al., 2012). This is no surprise to acupuncturists who know that Chinese medicine says it has the ability to settle the heart, loosen and ‘open’ the chest and clear chest pain. This point can also be used to calm a person who is anxious and it can relieve insomnia, agitation and panic, or any other nervous upset. It is also commonly used to calm palpitations. Many of you might have used this point in another context. If you feel seasick while on a boat, a ‘seaband’ – an acupressure wristband – placed on this point can rapidly relieve the nausea. This point will in fact help with any form of nausea and it is also used for morning sickness in pregnancy, nausea from chemotherapy, vomiting and a variety of other stomach upsets. A University of Pittsburgh Medical Center study using sea-bands on post-operative patients found it reduced their nausea by two thirds (Ferrara-Love et al., 1996).


Classically Pericardium 6 has the effect of ‘sending the Qi downwards’. Chinese medicine poetically describes nausea as the Stomach Qi ‘rebelling’ upwards. Acupuncture treatment using this point settles the Stomach Qi and sends it down so that the nausea disperses.

What can acupuncture treat? We can refer once more to the audit carried out in the College of Integrated Chinese Medicine’s teaching clinic when we consider the conditions acupuncture can treat. Patients came with a variety of complaints. The largest category of patients (about 30%) came with musculoskeletal problems, such as joint injuries, arthritis and other painful conditions. The second biggest area (just over 18%) was psychological conditions including stress, depression, insomnia, memory or concentration problems and also substance abuse. Another category of general conditions (nearly 15%) included general pain, weakness, tiredness, allergies, and viral and infectious diseases. Other conditions acupuncture treated were gynaecological, digestive, respiratory and skin problems. Many patients also wanted help with energy levels, their well-being, their emotional state or other more general factors. Nearly 75 per cent of patients wanted help with more than one symptom. Acupuncturists diagnose holistically so they do not need to treat each symptom separately and patients often have many symptoms treated at the same time (Shaw et al., 2007). An acupuncturist considers both mental and physical symptoms. The body and mind are linked and, as I said earlier, one area will affect another. For example, a female

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patient aged 37 had digestive problems that took root at a time of great unresolved anger and frustration. Acupuncture treatment smoothed the anger and at the same time resolved the digestive problem. She remarked, ‘I began to feel more in control of my life and I no longer suffered from a churning stomach as I no longer felt “put upon” by other people like I had done.’ Another patient, a man aged 54 years, had become very depressed after many years of chronic joint pains. As his physical problem eased and he became more mobile, he also began to feel better inside and his spirits naturally lifted. One of his first comments as he became better was, ‘I feel much better in myself and more contented.’

Acupuncture can treat these general areas of complaint The following is a list of the general kinds of problems causing patients to come for treatment. Breathing and lung problems such as asthma, chronic breathlessness, bronchitis, coughs, hay fever. Circulatory problems such as angina, chronic heart conditions, high or low blood pressure, palpitations, poor circulation, stroke, thrombosis, varicose veins. Digestive and bowel complaints such as inflamed gall bladder, gall stones, gastritis, indigestion, nausea, stomach ulcers, vomiting, colitis, constipation, diarrhoea, dysentery, irritable bowel syndromes. Ear, eye, nose, mouth and throat disorders such as blurred vision, chronic catarrh, conjunctivitis, deafness, dry eyes, gum problems, nosebleeds, otitis media, sinusitis sore throats, tinnitus, tonsillitis, tooth problems. Emotional and mental conditions such as anxiety, depression, eating disorders, insomnia, panic attacks.


Gynaecological disorders such as heavy periods, hot flushes and other menopausal problems, irregular periods, morning sickness, period pain, premenstrual tension, scanty or no periods, post natal depression, vaginal discharge. Joint problems and pain such as back problems joint injuries or inflammations, headaches, osteoarthritis, rheumatoid arthritis, rheumatism, sciatica, Still’s disease. Neurological problems such as Bell’s palsy, epilepsy, multiple sclerosis, neuralgia. Sudden acute disorders such as the common cold, food poisoning, stomach upsets, influenza, mumps. Skin conditions such as acne, eczema, psoriasis, urticaria. Urinary and reproductive problems such as bedwetting, cystitis, impotence, urine retention, incontinence, infertility, kidney stones, prostate conditions. This list is by no means complete – it is impossible to include every illness that acupuncture can treat. Some problems do not even have a Western medical label. Patients may say things like, ‘I feel out of sorts’ or, ‘I’m tired and run down’ or, ‘I don’t feel right but I don’t know why.’ Because Chinese medicine diagnoses by evaluating patients’ overall balance of Qi it may be more appropriate to ask, ‘Can this particular patient can be helped by acupuncture treatment?’ rather than, ‘Which diseases can acupuncture treat?’ Generally an acupuncturist’s holistic approach is of great help in many situations and a practitioner will objectively advise a patient as to whether treatment is appropriate or not. The acupuncturist carries out a thorough diagnosis

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in order to discover why a problem has arisen and which treatment is needed. The patient is then ready for treatment.

What is being treated like? You will usually sit up or lie on a treatment couch while having treatment. Most practitioners will first chat to find out how you have been since the last treatment. They will then feel your pulses and observe your tongue (see pages 58–61) before inserting the needles into carefully chosen points. The number of needles used depends on how acute or chronic your condition is. Practitioners also consider your age, build and sensitivity. Usually anything from two to eight acupuncture points are used. The needles are either removed immediately after being inserted or sometimes they are left in place for 15 to 20 minutes while you relax on the couch. The time that the needles are left in varies according to the effect required on your Qi. Sometimes patients feel their symptoms improve even whilst lying on the treatment couch, for instance, one patient said, ‘I always felt a change during the treatment. I was immediately better. It felt as if the energy was moving like a wave through my body’. Other patients don’t feel any immediate change but feel the benefits later. For example a 22-year-old builder commented, ‘I didn’t feel any different while the treatment was going on, but my backache soon felt better.’

How long will each treatment take? A treatment will take anything from half an hour to an hour, according to the practitioner and the needs of the patient.


Julia benefits from fertility treatment Julia is a 35-year-old teacher: I was desperate when I came to treatment. I wasn’t getting anywhere with normal medicine. I’d had two miscarriages before I came and I wanted to conceive a baby naturally rather than having Western medicine for infertility. I needed someone to look at me as a whole person rather than as an illness. I was also easily upset and anxious. My mind would run away with me and I’d imagine all sorts of awful things happening to my husband. It got much worse before my period and sometimes even stopped me from sleeping well at night. Examination revealed that she was very hot, ‘like a little radiator’, however, her feet and lower abdomen always felt stone cold. The cold in the lower part of her body was making it difficult for her to conceive and remain pregnant. Treatment was directed towards harmonising her Kidney and Heart Qi, calming her spirit and warming her lower abdomen. After a few treatments she reported, ‘I feel much less anxious and can stand back and see the imagined catastrophes for what they are.’ During treatment her hands felt cooler and her lower body began to feel warmer. After the treatment she said: I was so desperate to sort myself out. Now I feel a hundred times better! Before, when I didn’t feel well I couldn’t handle anything. Things don’t bother me now as they did. I feel much calmer and more peaceful inside. I’m more independent and I don’t worry about

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my husband when he is out of the house. I’m physically and mentally on top and much more in charge of my life. Seven months ago she and her husband had some good news. She had become pregnant. They now eagerly await the birth of their baby.

How does the theory of Chinese medicine apply to acupuncture? Most acupuncturists diagnose using the Five Elements and the 12 Organs and will strive to find the root cause of a condition. Directing treatment towards this cause will rebalance the Qi of the whole person and restore health. The acupuncturist is also concerned about the condition of the other Substances – the Qi, the Blood, the Jing-essence and the Body Fluids. The Substances can become deficient or obstructed in relation to an Organ. The acupuncturist will fine tune treatment directed towards that Organ according to which Substance is affected. For example, an acupuncturist may realise that the patient’s Liver is the underlying cause of the imbalance. A 35-year-old mother who came to treatment for dizziness said, ‘I have scanty periods and a slight tendency to get irritable after my periods but I never get very angry. I also get black spots in front of my eyes and often get muscle cramps.’ Her skin was very dry. Her symptoms were caused by ‘deficiency of the Liver Blood’. A male patient aged 48 years also had a Liver problem but this was caused by his Liver Qi not circulating properly and becoming ‘stagnant’. He complained, ‘I get severe migraine headaches that affect my eyes and I feel tired a lot of the time. I often feel angry and depressed and my mood


changes very easily according to my situation at home or work.’ Both patients had a ‘Liver’ problem but each manifested in a different way. This created a different emphasis on the points used for their treatments.

What are the needles like? People are often relieved to find that acupuncture needles are small and fine and nothing like injection needles. The first needles that were used over 2,000 years ago were made from sharpened bamboo or from stone. Later on, iron needles were used. Today, most acupuncture needles are made from stainless steel. This ensures that they are very strong and flexible. Acupuncture needles have a coiled handle and an extremely fine shaft with a sharp point. No substances are injected into the body by the acupuncturist and therefore the needles are solid. In comparison, injection needles are thicker and hollow to allow medicines to be injected. Acupuncture needles come in different lengths according to the area of the body that is to be treated.

How do acupuncturists ensure good standards of hygiene? Acupuncturists use single-use disposable needles, which are made to a very high quality. Practitioners are also aware of the importance of maintaining an impeccable standard of hygiene when using needles and this is checked by the professional body for acupuncturists and by each acupuncturist’s local authority.

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Will the needles hurt? Everyone is understandably anxious about pain so it is not surprising that this is one of the most common questions people ask. Once they come for treatment however, their concerns diminish. These are some comments about needles that patients have made: ‘When I was first shown a needle I could hardly see it it was so fine. I don’t feel the needle, just a tingling sensation when it’s in the right place.’ ‘It hurts much less than an injection!’ ‘I only felt the slightest prick as the needles were inserted, followed by a dull ache. I wondered why I had been so nervous beforehand.’ ‘Once the needles have been inserted I can’t feel a thing even though my acupuncturist leaves them in for 20 minutes.’ The needles are inserted through a sterile tube then guided to the correct depth. This may be one to two millimetres in places where there is very little muscle tissue, such as the fingers or toes, or two to four centimetres or more where there is more tissue, such as on the hip or calf. Inserting needles more deeply does not mean that they cause more pain. Practitioners are taught to stretch the skin in such a way that the insertion is painless. The patient should feel a slight sensation as the needle contacts the Qi. This feeling is known as ‘deQi ’. DeQi is not unpleasant. The practitioner usually feels a pulling sensation as the needle touches the point, while the patient feels either an ache, a numbness, a tingling or a sensation of heat.


The feeling only lasts for a couple of seconds. Very occasionally the patient may feel more sensation. If this happens it is often a sign that there is more blockage in the Qi and a stronger needle manipulation is required.

How does the acupuncturist know where to put the needles? Having made the diagnosis, a practitioner draws up ‘treatment principles’. These guide the acupuncturist to the best points for treatment. So, for example, ‘tonify Lung Qi ’ may be the suggestion for a patient who is asthmatic because her Lung Qi is deficient, whilst ‘calm the Heart’ may be necessary for a patient who is very anxious. After deciding on the treatment principles, a practitioner will then decide where to place the needles. Patients are often surprised when the practitioner uses points far away from the area of the complaint. Although points near the area of the complaint can be used, points that lie at the extremities of the body below the elbows or the knees are used more frequently.

Choosing points along a channel The practitioner might choose points directly associated with the organs that require treatment. For example, a patient who described herself as feeling generally ‘tired and below par’ benefited greatly from treatments directed at stimulating points on the Spleen channel, which lies on the leg.

Choosing points for their name Sometimes points are chosen because of their action that is described in the name. For instance, some points have

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a definite calming effect on the patient’s Mind and Spirit. One such point is called ‘Spirit Gate’. This lies on the Heart channel and is located at the wrist. Another point called ‘Returning’ can be used to return a patient’s periods if they stop or become scanty.

Choosing points for their function Points are often chosen because they are known to have functions that may benefit the patient in specific ways. For example, a commonly used point, Stomach 36, has many functions including strengthening the immune system, affecting the digestion and enhancing a patient’s Qi. It is called ‘Leg three miles’ and is said to enable a patient to walk another three miles after having it! There are also special points that may be used to affect areas such as the bones, the Blood or the tendons. Recently I treated a patient who had severely sprained her ankle. Among the points I used to aid the healing process was a special point for the tendons that lies just below the knee.

Can I still have acupuncture if I’m not ill? Yes, many patients recognise the value of optimising their health and energy even though they have no clear-cut symptoms. Others continue to come for regular checkups once they are cured of the illnesses that brought them to treatment. Everyone can benefit from treatment and patients who are not ill often feel better and have more vitality, both immediately after being treated and in the longer term. I have a patient who started treatment over 30 years ago. Once she became well she continued to have regular checkups and is now a very youthful 76-year-old!


It is said that acupuncturists in China traditionally only charged their patients when they remained healthy. If they became sick the practitioner had been remiss in not foreseeing and preventing the condition and the patients stopped paying until their health was regained. This is one area where practitioners no longer follow the old traditions! A 57-year-old headmistress describes what happened when she came for treatment: I’d heard about acupuncture and I felt complementary medicine was a good thing so I asked if I could have an ‘MOT’. After the third treatment I’d had a horrendous day and still felt wonderful at the end of it and I realised that acupuncture had really made a difference. Work changed. Prioritising became easy and instead of being at the back of a pile of work I was on top of things. Before, I had felt that I was rowing the boat under water and against the current, now it’s like rowing on top of the water and with the current.

How will I feel immediately after a treatment? Reactions to treatment vary from person to person. Some people feel an immediate change and their pain or other symptoms can disappear at the time of treatment. Many patients leave at the end of the treatment feeling reenergised, stronger, more centred and/or more relaxed. A patient recently told me, ‘I always come out walking on air, it’s like being smoothed out.’ Some patients don’t feel an immediate change and the effects of treatment happen more gradually. For example, another patient said, ‘I can’t say I felt a change immediately. It was only after three or four treatments that I realised that I felt much better.’

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Occasionally a patient may have what is called a ‘treatment reaction’ because a condition is clearing from the body. This is a positive reaction. In this case patients may feel slightly under-the-weather or have a slight intensification of their condition for up to 24 hours. After this the symptom improves and the patient feels better than before the treatment.

How much treatment will I need? This depends on how long you have been ill and the depth of your condition. As a general rule you can expect an acute condition, such as severe back pain, to be cured in just a few treatments while a long-term chronic one will take longer. An illness that started in childhood will often need many more treatments than one that started in adulthood. A severe and complicated condition such as a bowel problem with much bleeding and loose stools may need more treatments than a simple stomach upset. Patients with a chronic condition usually start coming to treatment once a week. As they improve, treatment is spread out to once a fortnight, then monthly. In time patients may attend treatment only for a regular ‘checkup’ as discussed above. The checkup may be at the change of season – seasonal treatment helps to retain the balance of Qi that has been achieved. Sometimes practitioners will propose that patients make lifestyle changes, such as cutting out fatty foods or getting more rest and relaxation. When lifestyle is affecting a patient’s health, carrying out these suggestions can considerably shorten their need for treatment.


Amy walks again without pain Amy’s left knee swelled up and became sore when she went camping in damp weather 12 years ago. She is now 65 years old and has retired from her job doing accounts. The doctor told her she had arthritis and gave her painkillers, which she didn’t like taking. Four years later the right knee also started to swell up and feel painful. When she came for treatment a year later she told me, ‘Some days I can’t walk, I have to go up and down stairs on my bottom my knees are so painful. The pain also keeps me awake at night.’ Upon examination her knees were found to be very swollen and stiff. They also felt cold to the touch and she confirmed that heat on her knees gave her some relief. Her diagnosis was an ‘invasion of Cold and Damp’ in her knees. This was exacerbated by an underlying Kidney and Spleen deficiency. Her knees were treated directly with moxa (see pages 84–86) and needles and at the same time the underlying Kidney and Spleen deficiency was strengthened as well. After the first treatment she said, ‘I feel great. Much better in my spirits and my knees also feel better.’ This is how she now reports on how life has changed. My life changed immediately. Two big warts I’d had all my life on my hand disappeared and I stopped having headaches. I began to feel fitter. The swelling in my knees soon went and I could walk without undue pain. The acupuncture worked with everything. I’d really thought that I’d be in a wheelchair within six months. My mother had been crippled with arthritis and I thought

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I’d go the same way. When I go to hospital for checks every doctor who has ever examined me says that they can’t believe how well I am for my age and that I am very healthy. When I say ‘I have acupuncture’ they say, ‘It’s obviously the right treatment for you.’

How does the practitioner know treatment has worked? It is obvious that treatments have been effective if patients report a change when they return for their next treatment. However, there are several other signs that an acupuncturist can observe at the time of treatment. For example, it is a positive sign when a patient has an immediate response at the time of treatment. An improvement in the quality of the pulses after treatment also gives a reliable indication that treatment has been beneficial. Small changes in facial colour, voice tone or emotional state signify a positive effect and a new sparkle in the eyes shows that the spirits have lifted. Some other treatment techniques used alongside acupuncture are moxibustion, cupping therapy, guasha, electro-acupuncture and auricular acupuncture.

How is moxibustion used? At the beginning of the chapter I briefly talked about moxibustion. Moxibustion is a method of burning a herb close to the body. It both warms our Qi if we are too cold, and nourishes and regulates our Qi in a more general sense. Needles and ‘moxa’ are often used together in the same treatment.


This herb artemesia vulgaris latiflora is similar to our native mugwort. Historically it was first used in the more northern parts of China where it is colder. To create moxa the leaves go through a drying process until they become moxa ‘punk’ which looks a bit like brown cotton wool. Its appearance is somewhat deceptive. Anyone who has experienced moxibustion will confirm that it has a wonderful aroma and a powerfully warming effect. As well as warming the Qi, the aroma of moxa is said to enter the channels through the skin to stimulate the Qi and Blood.

Moxibustion therapy

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Moxa can be shaped into small cones and placed on various acupuncture points to warm the body directly. It may also be used as a stick known as a moxa ‘cigar’. When lit, this is held an inch or two from the skin and can warm anything from a small acupuncture point to a large area of the body. For deeper penetration of heat, moxa can be placed on the end of a needle and lit while the needle remains in the point. The warmth passes down the needle into the point and feels especially pleasant when a joint or particular part of the body is cold. Smouldering moxa placed in a specially made container called a ‘moxa box’ enhances this effect and can warm a large area of the body. A 39-year-old radiographer describes her experience of moxa, ‘It feels like a relief when I have moxa. I’m warmer inside and funnily enough I also feel warmer towards other people!’ Another patient with a back problem says, ‘I love the feeling of the moxa warming my back. I immediately feel less achy and more flexible there.’

What is cupping therapy and how is it used? As well as needles and moxibustion, an acupuncturist might use ‘cupping’ therapy. Cupping removes congestion in the body caused by an obstruction by ‘pathogens’ (see pages 45–48). A common cold is an example of a pathogen that can be cleared by cupping. Cupping therapy is carried out by creating a vacuum between the cup and the skin. This draws out the pathogen. The vacuum is created by placing a lighted taper into a glass or bamboo cup then quickly removing it before swiftly placing the cup onto the skin at the appropriate area. For a cold this is often on the upper back. The cup is left comfortably in place for 10–15 minutes. After it has been


removed the patient is told to wrap up warmly for a while to allow the cold to be sweated out of the body. Cupping can also be used on different areas to remove obstructions causing such things as joint pains, backaches or some stomach upsets.

Cupping therapy

What is guasha and how is it used? Guasha is a treatment that has been passed down through generations in China since the 7th century. The word gua means ‘to scrape’ and sha denotes ‘a red rash’. Guasha is a method of scraping the body with a blunt edged tool in order to clear pathogens and other obstructions from the body. Like cupping therapy it is a very effective way of treating colds and flu. It can also be used to clear many joint pains. Traditionally it was used as a health maintenance tool to treat elderly people. It is usually used alongside other

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acupuncture treatment and is a good adjunct when people have the above conditions. To carry out a guasha treatment, practitioners first lightly massage oil onto the surface of the skin. They then scrape downwards and outwards until red spots arise on the surface of the skin. The area treated might be the upper back for a common cold or flu, the lower back for health maintenance or on a local area to relieve a painful joint. Scraping does not feel painful and the practitioner will ensure that the patient is comfortable during the treatment. The appearance of the red spots indicates that the obstruction has cleared from the body. The rash will gently fade over three to seven days. If used for a common cold or a similar condition the results can be immediate. Sometimes it will take more than one treatment before the problem has resolved. If a further treatment is needed it is only carried out after the initial spots have cleared.

When might electro-acupuncture be used? Electro-acupuncture is used by some acupuncturists and is especially helpful for painful conditions. To use electroacupuncture a special machine is attached to some of the patient’s needles. The machine provides a gentle current to stimulate points and can be controlled by the patient. The patient will usually feel a slight tingling sensation, which is not uncomfortable. Electro-acupuncture is often used to provide greater than normal stimulation to acupuncture points and is especially useful for clearing painful conditions such as joint pains, for pain relief during labour or for situations of severe pain, such as when a kidney stone is passed. Sometimes it is used in conjunction with auricular acupuncture, which I will discuss next.


What is auricular acupuncture? Some acupuncturists use auricular acupuncture in their practice and others do not. Auricular acupuncture is a relatively new Chinese medicine treatment. It was first discovered in the 1950s, so from the perspective of Chinese medicine’s 2000-year history it is positively modern! It is unclear whether it was first discovered in France by Paul Nogier or around the same time by the Chinese. Both developed this fascinating use of acupuncture simultaneously and made similar discoveries. They found that there are points on the ear that coincide with every part of the body. These points correspond to a picture of a foetus with its head at the ear lobe, its internal organs in the deeper part of the ear called the conchae and its upper and lower limbs on the antihelix and the crura of the ear.

Treatment using auricular acupuncture By examining the ear visually and finding sensitive areas, a diagnosis is made and points are selected for treatment. About three to five points are usually used. These may be treated using minute acupuncture needles, or alternatively tiny seeds or ball bearings can be attached to the chosen spots using plasters. The seeds or ball bearings will stay in place on the ear for three to four days and can be pressed to stimulate the points. Auricular acupuncture is useful for both acute and chronic problems and as an adjunct to other acupuncture treatment. It can be used for painful conditions and infections and may be effective for treatment during childbirth.

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Auricular acupuncture’s use for drug dependency Auricular acupuncture is probably best known for its use in helping patients’ withdrawal from drug dependency. A fellow practitioner who works with drug-dependent patients in a London clinic frequently uses five special ‘detox’ points which help to stop drug cravings. She also uses broader acupuncture treatment alongside the auricular points to attend to other underlying conditions. By doing this she treats both the physical and psychological needs of her patients so that they can remain off drugs in the future.

Research into the effects of acupuncture There is an increasing body of research into acupuncture and more and more trials are proving its therapeutic effects. At the beginning of the chapter I discussed the positive results from the audit carried out at the College of Integrated Chinese Medicine in Reading, UK. The World Health Organization (WHO) lists at least 40 diseases, symptoms or conditions for which acupuncture has been proved to be an effective treatment through controlled trials including: adverse reactions to radiotherapy and/or chemotherapy; allergic rhinitis including hay fever; biliary colic; depression including depressive neurosis and depression following stroke; dysentery; dysmenorrhoea (period pains); primary epigastralgia; acute and chronic gastritis and gastrospasm; facial pain including craniomandibular disorders; headache; hypertension; essential hypotension; primary induction of labour; knee pain; leukopenia; low back pain; malposition of foetus; correction of morning sickness; nausea and vomiting; neck pain; pain in dentistry including dental pain and temporomandibular dysfunction; periarthritis of the shoulder; postoperative pain; renal colic; rheumatoid arthritis; sciatica; sprain; stroke; tennis elbow.


It also lists another 60 diseases, symptoms or conditions for which the therapeutic effect of acupuncture has been shown, but for which further proof is needed (WHO, 2003). The evidence for the positive effects of acupuncture is incontrovertible. You can find a list of more research carried out into acupuncture on the British Acupuncture Council’s (BAcC) website (www.acupuncture.org.uk). Over a relatively short space of time acupuncture has become a highly respected form of treatment backed up by solid research. Those who are put off by the idea of having needles quickly become converted once they start having treatment. As one patient commented: I enjoy going for acupuncture treatment so much. I had imagined that I’d dread it – like when I go to the dentist, but it’s not a bit like that. I look forward to going, I feel better while I’m there and I’m gaining huge health benefits physically and mentally as a result. If you decide to have treatment you could enjoy these benefits too.

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Chinese Herbal Medicine Remedies to Restore Your Qi

Christine was desperate when she first visited a Chinese herbalist – she’d had period pains for eight years. They were in my lower abdomen and felt like knives sticking into me. The pain then continued for two weeks after the period and I felt as if I had been punched in the stomach. Before the period began my breasts swelled up and I often felt really angry and easily upset. It was ruining my life. The pain had started when she had a fallopian tube infection at the age of 23. The doctor had told her she had endometriosis, a disease caused by small amounts of the womb lining breaking away and growing in other areas of the pelvic cavity. During menstruation this tissue caused her extreme pain. The herbalist prescribed herbs to move the Qi and Blood which she diagnosed as causing an obstruction in her lower abdomen (for more about Qi and Blood see pages 29–33). Christine boiled up the herbs and drank them daily. By her next period she was surprised at the extent of the improvement, ‘I only had very slight and manageable pain.’ After another month she had no more symptoms at all,

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the mood changes and the pain had all disappeared. ‘It was a miracle!’ she said. She had been planning to move abroad for some time and when she finally left England her herbalist gave her some herbal capsules to take with her. These were to ensure that the symptoms didn’t recur. Six months later she wrote to say that the pain had never returned and that she had no more premenstrual problems. She was also extremely happy and contented with her new life.1 Lindsey aged 29 years and a university lecturer had a different problem entirely. I felt foggy and woolly in my head and I had very little energy. I couldn’t concentrate and was very depressed. Any energy I had to put into doing things would disappear. I was quite a mess. It felt like spinning plates waiting to crash! She was prescribed herbs to strengthen her Heart and Kidney Qi. I’d felt ill for about four years. After starting the herbs, in a matter of weeks I began to feel better. Some months later I now feel positive, my head is clear and I have good energy and concentration. I’m also much more consistent in how I feel. Before taking herbs I didn’t know how I’d feel from one day to the next. These are just two examples of some of the spectacular results achieved by taking Chinese herbs. 1 A feasibility study, the first of its kind in the UK looking at Chinese herbal medicine in the treatment of women with endometriosis, was completed in 2011. Twenty-eight women with a diagnosis of endometriosis were treated at an NHS clinic in London or at a private clinic in Hove. They were given either a placebo or Chinese herbal medicine for 16 weeks. Those taking the herbal medicine reported relief in menstrual pain. The trial was randomised, controlled and double-blinded. The results were published in 2011 in the Journal of Alternative and Complementary Medicine 17, 8, 691–699.

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Chinese herbs can play a role in the treatment of many medical conditions including skin diseases, gastrointestinal conditions, gynaecological problems, respiratory conditions, chronic fatigue syndrome, urinary conditions and psychological problems. Research is continuing to show how effective it can be. Although herbs have been slower to grow in popularity in England than acupuncture, more and more people are now turning to them as they hear about their beneficial effects. It may be a surprise for you to hear that in China and many other East Asian countries, herbs are more widely used than acupuncture for many conditions. In the rest of this chapter we will also be looking at many aspects of Chinese herbal medicine. These will include how Chinese herbs differ from Western herbs, how a herbal prescription is prepared, what the different categories of herbs are and how they are used, as well as what it will be like to have treatment using Chinese herbal medicine and more about what kinds of conditions herbs can treat. In the past a few controversial issues have arisen about herbs. One of these concerns the use of animal products like rhino horn and bear bile. These are banned in the UK and many other countries. Regulation has also been an issue following a change in the law in Europe, which affected the way herbs could be prescribed. Herbs are regulated differently in different countries. We will discuss these issues later in the chapter.

What is Chinese herbal medicine? Chinese herbal medicine is one of the greatest systems of herbal medicine in the world. It has been used since the 3rd century bc. Throughout the years it has continuously


grown and changed in response to the changing clinical circumstances and needs of patients. The term ‘Chinese herbal medicine’ describes formulae that are made from the roots, stems, bark, leaves, seeds or flowers of many plants, both wild and cultivated.2 Herbs are taken by over one billion people throughout East Asia and are now also used in many countries in the West. There are over 400 herbs in common use today. The herbs are carefully prepared in a variety of different ways. They are frequently ingested in the form of dried herbs, which are decocted into a soup, or as powders or tinctures. Some external preparations are also used on the skin as ointments, creams or herbal plasters. Herbal medicines are usually taken in the form of a ‘recipe’ known as a prescription. To make up a prescription a herbalist carefully blends together a number of herbs that have specific applications. Many of the prescriptions being used today date back to around 200 bc when a famous herbalist called Zhong Zhang Jing wrote a book on how to deal with numerous common infectious diseases. He was the first person to systematise the use of herbs, and the tradition continues to this day. Later in the chapter we’ll look more closely at what is meant by a ‘herbal prescription’. First we’ll evaluate the main distinctions between Chinese herbal medicine and Western herbs.

2 In China, this also includes some minerals and animal products.

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Zhong Zhang Jing and his famous book Zhong Zhang Jing lived around 150–219 ad. During his life a plague wiped out many of his family where he lived in the south east of Henan province in China. It is thought that this motivated him to study Chinese herbs. He is famous for formulating a theory that describes how ‘cold’ progresses through six stages in the body. He collected and systematised formulae that could help these fevers and conditions. His work is called the Shang Han Za Bin Lun or The Treatise of Cold Induced and Miscellaneous Diseases and his writing is still considered a masterpiece. This was a seminal work and the formulae have been adapted and are still used by many herbalists today.

How does Chinese herbal medicine differ from Western herbs? There are two main differences between Chinese and Western herbal medicine. First, a Chinese herbalist diagnoses a patient using the theory of Chinese medicine. This is the same theory that is used by practitioners in all of the Chinese traditions mentioned in this book. A Western trained herbalist will use a Western diagnosis, which is the same as that used by Western doctors. This was not the original method of diagnosis used by herbalists in the West. Western herbal medicine, like its Chinese counterpart,


has a long history. Unfortunately much knowledge of this tradition has now been lost and this includes many of the diagnostic techniques. The understanding of many of the functions of the herbs has survived, however, and remains useful. Second, the herbs are prescribed differently. A practitioner of Chinese herbal medicine will use a prescription made up of a combination of a number of herbs. These herbs will be chosen to fit the patient’s energetic state. A Western herbalist prescribes herbs separately and will use individual herbs to treat a patient’s complaint. Although a number of different herbs might be used, they will not be combined together into a prescription in the same way as Chinese herbs.

How are the herbs categorised? Altogether there are more than 21 main groups of herbs that are blended together to make up a herbal prescription. Examples of categories are ‘Move Qi ’, ‘Drain Damp’, ‘Scatter Cold’, ‘Move Food Stagnation’, ‘Transform Phlegm’ or ‘Clear Heat’. Included in these actions are tonic herbs which ‘Tonify Qi ’ or ‘Tonify Blood’. These strengthen the body when there is deficiency. Sadly there are very few ‘tonics’ found in Western medicine nowadays although in the past they were often prescribed when a person felt ‘run down’ or ‘out of sorts’. Today there are many people who feel depleted, and fortunately Chinese medicines can help to replenish exhausted energy. Herbs can also be used to ‘Calm the Spirit’ when a patient is anxious or jumpy or to ‘release the exterior’ when a patient has an infection. Within each group are many herbs

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that have specific uses and these are blended together to form a prescription.

What is meant by a herbal prescription? A prescription or formula prescribed by a herbalist is tailor-made for each patient. There can be any number of ingredients ranging from one to 20 in a herbal prescription, although six to eight is more usual. The herbs are carefully balanced together. Prescriptions are constructed using a clear organising principle in order to have the optimum effect on the patient. There are four main components in a prescription. These are the ‘Emperor’ herb, the ‘Minister’ herb, the Assistant or ‘Adjutant’ herb and the ‘Messenger’ herb. The component herbs have traditionally been named after different positions of responsibility in Chinese society. We will briefly discuss each of these components in turn.

The Emperor herb This is the main herb in a prescription and may also be referred to as the Sovereign herb. Many people who have read the book or seen the film The Last Emperor understand the importance of the emperor in Chinese society. He was considered to be almost godlike in his position and carried out ceremonies and rituals that ensured the well-being of all of his subjects. The importance of this herb cannot be underestimated. This herb treats the main cause of the patient’s imbalance and forms the highest proportion in the prescription.


The Minister herb The Minister herb has the job of assisting the Emperor herb or of treating another co-existing imbalance. Its job is similar to an important minister in the emperor’s court. There is often more than one minister herb in a prescription and there is less of this herb in a prescription than of the Emperor herb.

The Adjutant herb The word Adjutant describes an army officer who does administrative work. This herb is added to the prescription to moderate any effects of the main herbs if necessary – the important administrative details we might say! For example, if the main herb is very tonifying to the Qi, the Adjutant herb may be added to move the energy so that it doesn’t build up in one place but can also move around the rest of the body.

The Messenger herb This has the job of carrying the other herbs in the prescription to the affected area and also of harmonising all of the ingredients. The job of a messenger in the emperor’s court was a lowly one but as essential as the position of the emperor himself. If the messenger stopped working the court would no longer run smoothly and harmonious relations among the subjects would break down. Traditionally the Adjutant and the Messenger herbs make up the smallest proportion of the prescription.

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Ginseng – one of Chinese medicine’s most famous tonics The word ‘ginseng’ is derived from its Chinese name ren shen. Ren means man. This herb is a root with a forklike appearance resembling a man on two legs – hence its name. Its full name is panax ginseng and the word panax derives from the Greek word for ‘panacea’. A panacea is a cure-all for many problems. Ginseng is one of China’s most famous and highly prized medicines, with many uses. There are two main types of ginseng – white and red. These are harvested after four to six years depending on the species and are sun dried before being used therapeutically. Wild ginseng is another variety but this is now an endangered species due to the high demand for it and the length of time it takes for it to reach maturity. Ginseng’s therapeutic effects are numerous, especially as a tonic. Some people claim that it helps them with stress and improves their general wellbeing. It has been said to act as a stimulant, which promotes endurance, increases life expectancy, relaxes the nervous system, improves mental awareness, encourages balanced hormonal function, improves lipid levels, lowers cholesterol, improves nerve growth and increases resistance to disease. It is said to act as an antioxidant, autoimmune stimulant, psychotropic and to have anti-tumour actions. Beware of overdosing on this herb, however. Although it is relatively safe, too much, especially of the red form, can cause the body to become overheated and so it should not be used by those who are naturally


very hot as it could cause symptoms of heat or bleeding. It should also not be used when a person has an infection – it is such a wonderful tonic that it could tonify the infection too. To be safe it is always best to get your herbs prescribed by a qualified herbalist. There are other varieties of ginseng, such as American or Siberian ginseng. They also have therapeutic properties but are different from Chinese ginseng.

How does the herbalist create a prescription? Many basic prescriptions have been created by eminent herbalists over the last 2,000 years, for example, the prescriptions created by Zhong Zhang Jing that were described earlier. These combinations are set down in Chinese herbal books and most of them have now been translated into English. Having diagnosed the patient’s imbalance the herbalist can then choose which prescription is best suited to the patient and how it can then be modified to precisely fit the patient’s needs. Practitioners will then add extra herbs, powders or tinctures or subtract any unnecessary ones from the prescription. They may also change the quantities of the herbs being used. Finally the exact combination of ingredients is blended together to match the patient’s requirements.

How are the herbs prepared? Most Chinese herbs used in the West are imported from East Asian countries such as China, Hong Kong or Taiwan. The herbs are all picked at the most appropriate time and prepared in the traditional manner.

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Choosing when to pick each individual herb can be very important. Often the plants are picked when they are fully mature. The gatherer knows exactly which is the best time to harvest each herb. Many roots are most powerful in late autumn and early spring, whilst leaves are collected just before the flower reaches full bloom. The flower is then gathered later, either in bud or in full blossom. Some fruits are used before they are ripe and need to be picked earlier. For example, immature tangerine peel has a different effect to mature tangerine peel. Both move the Qi but the mature peel is used more in conditions relating to the Stomach and Spleen, whilst the immature one is often included in prescriptions for Liver complaints. Once collected, the herbs need to be prepared. After being thoroughly washed and separated out, they are usually dried in the sun or in a dry, well-ventilated area. When they are thoroughly dry they are cut to a usable size, labelled and stored ready for use. The dried herbs can then be used to make herbal decoctions or they are made into tinctures or powders.

What is the difference between dried herbs, tinctures and powders?

Dried herbs The most common way in which the herbs are prescribed is in the form of a herbal decoction boiled up from dried herbs. The advantages of this method are that the herbalist can use the herbs in a fairly natural state and precisely weigh the quantities to be used. The herbs are then put into bags and are boiled up freshly every day. The disadvantage of using the dried herbs is that patients do not always want to boil herbs up every day and must be highly motivated to


do so. Useful alternatives are powdered herbs, freeze-dried concentrates, granules or tinctures.

Powdered herbs and freeze-dried concentrates Powders are a useful way to take herbs as they are slightly easier to use than the dried herbs. The powders are ground up to make either a coarse or a fine powder. They can be taken directly or they are mixed with water and taken as a drink – rather like instant coffee! Many people like to take their medicines in pill form and one way they can do this is to take capsules of powders that the practitioner has made up for them. Powders are quite widely available from many distributors and are used as a matter of choice by some herbalists.

Tinctures Tinctures are made by extracting the constituents of herbs in a mixture of alcohol and water. They are often taken by the spoonful or in water. Although tinctures are easy to take, their main disadvantage is that alcohol is known to have a slightly heating effect on the body and so should be avoided in patients with hot conditions.3

3 The type of herbs used by a practitioner depends to some extent on which country they live in. Patent herbal pills are not currently used in the UK and many parts of Europe but they are used in the US. These pills are made by grinding the herbs, preparing the formulae in the traditional manner and then concentrating the result and forming it into a pill. The pills are often slightly cheaper than dried herbs and are commonly used for treating deficiencies or for acute problems. The disadvantage of pills is that the patent herbs don’t cover every possible condition a patient may have and cannot be adjusted for the patient, so they are not suitable in all circumstances.

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Two useful Chinese herbal formulae Below are two useful Chinese medicine formulae that your herbalist can prescribe to help you to stay healthy. • Honeysuckle and forthysia decoction or Yin Qiao San (pronounced yin chow san) can be taken at the first signs of a cold or when you have a sore throat or flu signs with a temperature, chills and muscle aches. Many of my patients take this to prevent colds from developing and often with great effect if the cold is caught in the early stages. There are two main herbs in this prescription and both are used to clear what is called ‘Wind-Heat’ from the system. Hence it is especially beneficial if the infection is of a ‘Hot’ nature – such as when an infection starts with a sore throat. • The Eight Treasures Decoction or Ba Zhen Wan is another famous and widely used prescription, often, although not always, prescribed for women. It is a tonic formula containing eight very potent herbs that can strengthen the body. I often prescribe it for people who feel weak and tired, look pale and have a lack of stamina. It will give people an energy boost, especially if they have lost blood through heavy periods or have ‘Qi and Blood Deficiency’ caused by a poor diet or a lack of meat or have just become worn out through overwork.


What kinds of herbs are used in a prescription? Here is an example of how a common herbal prescription was modified to suit the needs of a patient. A 45-year-old man came for herbal treatment complaining of digestive problems. He had a very poor appetite and felt bloated and full after only a small amount of food. He also had slightly loose stools. When the practitioner enquired further he told her that his energy has been low for a long time and he had difficulty concentrating. His head also felt muzzy and full as if he had cotton wool in it and he was unable to think clearly. His symptoms became worse in damp weather. The herbalist diagnosed that his Spleen Qi was deficient. One function of the Spleen, according to the theory of Chinese medicine, is to transform and move Fluids and Qi in the body. Because the Spleen was deficient, the patient experienced a poor appetite and low energy. The Spleen energy was too deficient to move the Body Fluids and they were accumulating and causing him to have a bloated feeling and a muzzy head. Chinese medicine calls this ‘Internal Damp’. The prescription that the herbal practitioner chose is one called ‘The Four Gentlemen’. This prescription is made from a basic recipe containing four herbs. The Emperor herb in this prescription is ginseng (see pages 100–101). The tonic properties of ginseng can especially stimulate the Spleen Qi. The Minister herb is called ‘white atractylodes’. Atractylodes also tonifies the Spleen as well as clearing some Damp and is used to assist the main herb. The third herb in the prescription is the Adjutant herb and is called ‘poria’. Poria clears Damp in the Spleen and in this way modifies the action of the first two herbs so that they do not tonify the patient too strongly. Finally the fourth Messenger herb in the prescription is ‘baked licorice’. Licorice is a herb that blends together the other herbs in this prescription.

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To modify the prescription to fit this patient more precisely the herbalist added two more herbs. The first one was ‘tangerine peel’, which has a slightly stronger action of moving Damp. The second was ‘pinella’, which also dries up Damp as well as keeping the digestive organs warmed. The addition of these two herbs turns the prescription called the ‘four gentlemen’ into the ‘six gentlemen’. The six gentleman prescription will tonify the Qi of the Spleen and clear Damp. After taking this prescription for some weeks the patient’s symptoms cleared. He was delighted to find that his appetite improved, he stopped bloating after eating, felt clearer in his head and that in general he felt much stronger and more energetic. He also no longer fell asleep after his midday meal. This surprised him as this afternoon energy ‘dip’ had been going on for so long that he thought it was normal.

Are any animal products used in Chinese herbal medicine? The use of any animal products in Chinese medicine is banned in the UK and no herbalist is allowed (and nor would they wish) to participate in any illegal trade in endangered plant and animal species. Members of professional bodies are subject to strict rules that prohibit the use of any such material.4

How are herbs regulated? Regulations vary according to different countries. A European directive on Traditional Herbal Medicinal Products came into 4 As I said earlier in the chapter, two very controversial animal products are rhino horn and bear bile. One of my colleagues gave a helpful analogy when he said, ‘These products have about as much to do with real Chinese medicine as taking Viagra recreationally has to do with Western medicine.’


force in April 2011. This prevented some herbs, especially prepared pills, from being sold in shops or being prescribed. Qualified Chinese herbal medicine practitioners in Europe and the UK still prescribe herbal formulae as usual, although they no longer prescribe them in this pill form. In the US the ban described above does not exist and all types of herbal products can be brought and prescribed, including Chinese herbal pills.

How is the theory of Chinese medicine used when a herbalist diagnoses a patient? When a patient goes for Chinese herbal treatment, the practitioner will carry out a diagnosis in much the same way as an acupuncturist. The aim of the diagnosis is to find out which of the 12 main Organs are out of balance, how the yin and yang Qi are balanced in relation to each other, which of the Vital Substances are deficient or obstructed and whether there are any pathogenic factors which need to be cleared from the body (see Chapters 1 and 2). For example, a patient with eczema may be diagnosed as having an imbalance in one of the Organs and a related ‘Substance’ such as Qi, Blood, Body Fluids or Jing-essence. Eczema can have many different causes and the herbalist will treat each individual differently according to the underlying root of the problem. He or she may choose to treat the Qi of the Lung Organ, which is commonly associated with disorders of the skin, or nourish the Blood of the Liver. The Liver Blood would normally moisturise the outside of the body. If it is deficient the skin can become dry. The underlying Organ and Substance imbalance may cause depletion, allowing the skin to be more easily ‘invaded’ by a pathogen from the outside. For example, if heat affects

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the skin it can create a red, raised, painful and sometimes itchy rash. If Damp is involved the rash may ooze more or even become inflamed and pus filled. Imbalances are often caused by mental or emotional stress. Other causes may include a bad diet or exhaustion due to overwork. Gathering information about the patient’s problem is important so that the practitioner can make a clear diagnosis. The diagnosis is made at the patient’s first visit to the herbalist and in turn leads to precise treatment. The amount of time spent on the diagnosis depends on the individual patient and the practitioner, and may vary from an hour to one-and-a-half hours. Subsequent treatments take less time, usually 20–45 minutes. After the diagnosis the herbalist will either make up a prescription from their own herbal dispensary or obtain the herbs from a herbal supplier. The patient will also be given an appointment to return for the next treatment.

Sally recovers from post-viral syndrome Six years ago Sally had glandular fever from which she didn’t fully recover. She was later diagnosed as having ‘myalgic encephalomyelitis’ commonly known as ‘ME’, a post-viral syndrome. She is 46 years old, a trained doctor and is married with two children. She has been taking Chinese herbs for 18 months. I felt dried out and there was nothing left of my energy. I had terrible fatigue and exhaustion that went right to my bones, but even when I was lying down I still couldn’t rest. I also had a tight chest, and was short of breath as if I was breathing in my throat. My digestion was terrible and I had nausea and very loose bowels. I’d have to run to the loo


in the morning and afterwards I felt completely exhausted. I also had a permanent ringing sound in my ears, my back felt weak all the time and if I tried to walk anywhere my muscles would ache. I had mental symptoms that were even worse. I felt as if I had inflammation in my brain and I couldn’t think straight, concentrate or take in information. I was in complete despair. It was as if my whole body was collapsing. I’d wake at night with night fears and a sense of total hopelessness and I’d have panic attacks during the day. I had thought my life was over and I was going to die and I was even suicidal at times. Taking the herbs was the turning point. As soon as I started taking them I knew I was going to recover. The first herbs were to clear the pathogen that had remained in Sally’s system since the glandular fever, ‘I felt different the next day. The terrible exhaustion began to lift and lighten.’ After about a week she was given a herbal tonic and again felt dramatically different, ‘I’ve got stronger and stronger ever since.’ Now all my physical symptoms have gone. I get mild ringing in my ears sometimes and a slight ache in my lower back. My digestion is better and I have no shortness of breath. My hair has started to grow back. Best of all I can now read books again and take in information. I can even dig my allotment without collapsing! I have a lot more energy and at times it feels normal. It’s such a relief to feel better. I can look to the future now and it looks bright.

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What problems are commonly treated by herbs? All problems that can be treated by acupuncture can also be treated by a Chinese herbalist. Herbal medicines are used to treat many physical, mental and emotional problems. Herbs have come to be known in the West to be especially beneficial for patients with skin conditions and gynaecological problems. They can be especially useful as tonics for building up Substances like Qi, Blood or yin. They are also useful when patients have an acute illness. These are by no means all of the diseases that herbs can help. For a more detailed list of the types of complaints that herbs can treat, please refer to the list in Chapter 4.

Current research into Chinese herbs There are over 17,000 trials into the efficacy of Chinese herbs published in China but many of these still need to be subjected to the rigor of Western methodology before they are accepted. A review from the Cochrane library in 2009 suggested that there are intervention benefits from Chinese medicine for the following conditions: dysmenorrhoea (period pains); type 2 diabetes; Alzheimer’s disease; acute ischemic stroke; heart failure; unstable angina pectoris; schizophrenia; hepatitis B; viral myocarditis. Reviews also show the potential for Chinese medicine in the management of: the common cold; mild cognitive impairment; acute pancreatitis; functional dyspepsia; severe acute respiratory syndrome (SARS); endometriosis; nephrotic syndrome associated with kidney disorders; heroin withdrawal; lung cancer and breast cancer used in conjunction with chemotherapy.


There is evidence to suggest that when treating other cancers Chinese medicinal herbs can reduce side effects and improve quality of life and, in some cases, show enhanced tumour regression and increased survival rates.5

What do the herbs taste like? The herbal decoctions or powders vary in their taste according to why they are prescribed. Tonic herbs are usually fairly sweet tasting, for example, licorice is often used to harmonise a tonic prescription. Other herbs can taste less pleasant, for example, bitter herbs can be used to clear heat or sour ones are more astringent. Comments from patients vary according to their own likes and dislikes in taste and the type of herbs they have been prescribed. Many say that they don’t mind, or even enjoy, the taste. Some describe them as an ‘acquired’ taste or that they are quite bland, whilst others say they can have more difficulty getting them down, especially if they need strong tasting herbs. To help us to understand more about the various tastes it is useful to understand the way the Chinese classify the five tastes.

What are the five tastes and what do they do? By using herbs over thousands of years, the Chinese found that the five main tastes have differing effects on the body. The five tastes are Pungent, Sour, Sweet, Bitter and Salty. There is also a neutral or bland taste, which has no clear flavour. Herbs are classified as having one or a combination of more than one of these flavours. The Sour, Bitter and Salty herbs are more yin in their effect, that is, they have a downward moving and internal effect. The Sweet, Pungent and Neutral 5 For more information see the Register of Chinese Herbal Medicine website: www.rchm.co.uk.

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herbs are more yang, they have a more outward moving and exterior effect. We’ll consider each of them in turn.

Pungent Pungent herbs are sharp and acrid in their taste and include common foods and herbs such as garlic, ginger, chilli pepper, black pepper, peppermint and cinnamon. The effect of the pungent taste is to disperse and move obstructions in the Qi and Blood, and should be taken with care by a patient with very deficient energy. They are often used when people have colds and flu and will clear an infection by opening the pores and promoting sweating. The sweating thus eliminates the pathogen that has caused the illness.

Sour These herbs have the opposite effect to pungent ones in that they stop discharges and are astringent in their action. They are used to help problems such as urinary incontinence, excess sweating, haemorrhaging or diarrhoea. Sour herbs and foods that we can recognise include vinegar, unripened plums, lemons and crab apples.

Sweet The Sweet flavour described in Chinese medicine is a subtle flavour, different from the strong sugary taste of sweet that is often used in the West. It is probably one of the most frequent tastes found in food and herbs, and includes common herbs such as licorice, Chinese dates and ginseng, as well as many vegetables, fruits and meats, such as carrots, lamb or sweet potatoes. If taken in small quantities the sweet taste will have a tonifying effect on our bodies but in excess it will have a Dampening effect. Bland tasting herbs or food also have a slightly tonifying effect.


Bitter This taste cools and travels downwards through the body. It will remove Heat and clear through the body and is used to stimulate the digestion, to cool fevers and to clear bowel problems due to heat. Because of its purging action on the body it, like the Pungent taste, should not be used in large quantities when a person has deficient energy. Some examples of common Bitter herbs and foods are rhubarb root, dandelion, chicory and bitter oranges.

Salty Finally the Salty flavour is found in foods and herbs such as algae, seaweeds and seafoods like mussels, oysters and cuttlefish. The salty taste will soften hard lumps in the body causing anything from a nodule below the skin to a goitre. This taste will also act as a diuretic and will clear excess water from the system. This description of the five tastes and their effects demonstrates why some prescriptions taste different from others. A tonifying herbal prescription will taste more sweet than a purging one, which can be quite bitter. A prescription for an astringent will be more sour tasting than a pungent one, which may be used to clear the system of an infection. For a more complete list of food tastes see Chapter 8 on dietary therapy.

What are the four energies and how are they used? Along with the five tastes, the four energies are also important when deciding on the correct herbs for a prescription. The four energies are Hot, Warm, Cool and Cold temperatures. Most people in the West don’t realise that knowing the temperature of foods and herbs can be very useful when

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we choose what to eat in our diet. In Chinese medicine, the temperature of herbs or food is not decided by whether they are physically hot or cold but by the Heating or Cooling effect they have on the body. The temperatures of foods are described in more detail in Chapter 8.

How often will I need to visit my herbalist and for how long? The two main herbal bodies in the UK are the Register of Chinese Herbal Medicine (RCHM) and the Association of Traditional Chinese Medicine (ATCM). They state that a practitioner must see a patient to check on his or her progress at least once a month. Most patients visit a herbalist for the treatment of long-term chronic problems. They will see the practitioner for a new prescription every three to four weeks. It is difficult to be precise about the length of time that is needed to cure any one patient, as everyone is different. The length of treatment will depend on the patient’s underlying constitution and strength of Qi as well as the condition being treated. Treatment will vary from weeks or months to over a year if the problem is more severe. Throughout the course of treatment the patient will be progressing towards a better balance of health. If a patient has an acute problem such as a cold, cough, urinary or other infection or stomach or bowel upsets, herbs can also be very helpful. In the case of an acute condition the herbalist will want to see the patient more frequently and may prescribe herbs for a few days only. Treatment for acute conditions is less prolonged than for more chronic ones. As with all of the Chinese therapies it is important that a Chinese herbalist is well qualified. Membership of a reputable professional body is one way of ensuring this.


They will give clear guidelines that ensure the careful use of all herbs that are used in treatment.

A traditional herbalist weighing herbs

Margaret’s psoriasis is ‘magicked’ away Margaret came to treatment with the skin condition psoriasis when she was 64 years old. It had come on badly two-and-a-half years before although she had always had allergic tendencies. ‘There was a change in my home circumstances,’ she said matter-of-factly. ‘My husband retired and things were very difficult to begin with.’

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I tried every cream the doctors could prescribe, but I wanted to get to the inside of the problem rather than putting ointment on. It was practically all over my body, my legs, my arms, in my hair, even in my ears, my nails and the bottom of my feet. It covered 85 per cent of my body. The skin looked red and raised and it was very flaky. My legs were completely red and there was very little clear skin. My body was covered all over in red areas the size of ten pence pieces. Margaret took Chinese herbs for about three months then suddenly and spectacularly her arms and body cleared overnight. ‘I couldn’t believe it!’ she said. Margaret still sounds surprised as she relates this story. A few patches on her elbows and a patch at the top of her left leg remain. Her nails and feet have cleared completely and her hair is almost clear. She looks forward to the time when she is completely cured of her symptoms but is delighted with the change so far.

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Qigong Exercises Transforming Your Qi

Since Bill has been practising Qigong his shirt-sleeve length has changed from 34 to 39 inches! He is a friend who has been doing Qigong for 32 years. Did his arms grow five inches longer? No, of course not. He had a lot of tension though. Letting go of all the tension in his neck, shoulders, upper back and chest let his arms ‘grow’ several inches. He now has to have shirts custom made – but he thinks it is worth it! He describes what happened to him. Before I started doing Qigong I was a ‘stress case’. I was working 60–70 hours a week for an environmental consulting firm on what was the beginning of computers at that time. My shoulders were up to my ears! I knew how to stand straight like a soldier but my back was as stiff as a board. Because I was so stiff, when I started practising, the other students called me ‘the man of steel’. I was holding so much tension in my body. People would come up to me and beat on my shoulders trying to loosen them up but it was initially hard to let go. Over the years of practising he began to ‘melt’ the steel away. I began to let go of the physical tension as well as all the holding in my nervous system caused by the stress. I kept practising because even though I was stiff and

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couldn’t feel anything to do with Qi initially, at the end of class I generally just felt better than when I started, a bit more mentally relaxed and emotionally lighter and happier. About a year into things, I started to get an occasional glimpse of weird feelings of Qi, and that really got me hooked. Bill is now 58 and far, far more flexible than when he started. He is now a full-time Qigong teacher. In fact people look at the fluidity and looseness of his Qigong movements and want to be like him. People notice how relaxed Bill’s body is and are shocked when he tells them how stiff and stressed he used to be. Along with this he looks many years younger than his age and regularly helps other people by using his Qi for healing using Qigong–tui na bodywork. I practise Qigong regularly and for me he is an inspiration.

How has Qigong developed? So what is Qigong (pronounced chee gong)? It is, in fact, an umbrella term that covers a vast array of Chinese exercises. The word ‘Qigong’ was coined in China in the 1950s and covers sitting, standing and moving exercises all used for specific purposes. Many of these exercises had previously been closely guarded secrets which were passed down within families or from master to pupil over thousands of years. Qigong practice mushroomed in popularity in China in the mid 1980s. Encouraged by increased freedom in China, many Qigong masters came out of hiding and taught their craft to the Chinese people. Thousands of Chinese people rediscovered their heritage and learned the exercises to strengthen and transform their Qi. At one time it was estimated that one in five members of the Chinese population did some form of these ‘internal’ exercises.

Qigong Exercises

The excitement has died down now in China but many people in both the East and West, young and old, are seriously practising these exercises on a daily basis. Many of the Qigong masters came to the West, attracted by serious students, and there are now many Western teachers who have learned and are teaching this art. What is the essence of this ancient and fascinating form of exercise that entranced so many Chinese and is now captivating Western people as well?

What is Qigong? The word ‘Qigong’ (called Chi Kung in some books) is made up of two words ‘Qi ’ and ‘gong’. We have already examined the word ‘Qi ’ in the first chapter of this book. It loosely means ‘energy’ or, alternatively, ‘life force’ or ‘life energy’. The word ‘gong’ can be translated as ‘practice’. The word Qigong conveys the meaning of ‘Practice concerned with Qi ’ or we might even define it as, ‘Any practice which is concerned with moving and transforming our Qi .’ In the rest of this chapter we will be exploring this method of ‘moving and transforming our Qi ’ and discover what the various types of Qigong have in common and how they differ. We’ll consider the theory behind Qigong, how it compares with exercises traditionally done in the West and how to practise it. We’ll also look at some simple exercises and how Qigong can benefit us.

What are the benefits of practising Qigong? Some of the reasons why people say they practise Qigong are, ‘to improve my health’, ‘for spiritual development’, ‘to keep healthy’ and to ‘fulfil my potential’. Many practitioners of acupuncture or massage say they do Qigong ‘to improve my healing ability’. Qigong has also been used by those

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who practise martial arts as a way of increasing the power of their fighting techniques. We will not be covering this application in this book. Let’s now look at the other benefits individually.

How could Qigong improve or maintain my health? Improving and maintaining health was one of the first uses of Qigong and it is mentioned in the Yellow Emperor’s Classic of Internal Medicine written in about 200 bc. Chinese doctors realised that gentle exercise can stimulate the flow of our Qi. We already know that when our Qi runs smoothly throughout our bodies we remain healthy. If our Qi is blocked or weakened this results in ill health. There are many reasons why our Qi becomes obstructed or weak. One major cause of illness is tension or emotional upsets. These may cause us to tighten up inside and constrict the movement of Qi. Short-term problems will resolve themselves fairly easily, but more long-term emotional problems will upset the healthy flow of our Qi. Qigong exercises stimulate the circulation of energy in the body to improve our health. Some of the exercises are specifically designed to improve the functioning of different organs in the body. For example, some exercises will help to improve the kidney, liver, lung or heart function, whilst others are aimed directly at other functions such as helping the digestive system, improving the circulation or clearing the head. Most exercises have more than one beneficial effect. For example, one exercise called ‘Dragon and Tiger’ Qigong has many health benefits and was used extensively in China in the 1980s for treating cancer. Dragon and Tiger Qigong is known to release stagnant Qi that cannot move freely. This

Qigong Exercises

stagnant Qi can manifest as a physical, emotional or mental blockage and can contribute to many different illnesses. Dragon and Tiger also increases the speed, strength and evenness of the circulation of Qi, blood and other fluids. It also quickly raises the energy levels of the body to boost people’s vitality and natural healing capacities. Maintaining this balance of Qi in the body is one of the best methods of health maintenance. The practice of all Qigong exercises tends to induce a calm and peaceful feeling and this in itself creates good health. Huang Fu Mi (pronounced Hwang Foo Mee) was a famous Chinese physician who was born in 215 ad. He suggested that the best form of treatment is carried out before a disease has manifested. Qigong is one way in which we can stop disease from occurring, as well as positively improving our health. A 43-year-old translator who practises regularly says, ‘One reason why I practised Qigong is that it had an immediate impact on my health. I realised that Qigong could make very quick improvements in things like headaches, indigestion and incipient colds and that has encouraged me to carry on.’ Another woman aged 44 who practises every day comments, ‘I have lost weight, I eat less, I have more energy and I need less sleep. Emotionally I feel less stuck and my mind is freer.’ Whether Qi exercises are initially used for spiritual development or for better health, continued health maintenance is a positive side effect.

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Hua Tuo and his Five Animal Frolics Hua Tuo was a physician celebrated for his practice of acupuncture, herbs and Qigong and for his ability to transmit his Qi when he treated. He also developed skills as a surgeon. He lived around 140–208 ad. He is famous for a Qigong form he developed called wu qin xi – the Five Animal Frolics. He developed this by studying the movements of the tiger, deer, bear, ape and crane and he recommended the use of these physical exercises to his patients. These five animal movements had a profound influence on the development of Qigong practices and are still taught by some Qigong teachers today, although it is doubtful if they are still taught in the same way as used by Hua Tuo all those years ago. Hua Tuo is famous for curing the illness of a king Cao Cao who later put him to death. Hua Tuo preferred not to work as Cao Cao’s personal physician and made excuses for not seeing him. When the king discovered this deception he condemned him to death. Whilst in prison Hua Tuo wrote down his medical techniques and handed it to the jailer, saying, ‘This can preserve people’s lives.’ Fearful of the law, the jailor would not accept it, nor, it is said did Hua Tuo force it on him. Instead, Hua Tuo asked for a fire on which he burned the scroll. Cao Cao later regretted the execution – as well as killing a legendary physician, many important Chinese medicine texts were lost forever.

Qigong Exercises

How do people use Qigong for spiritual development? One 38-year-old teacher says of his Qigong practices, ‘As I practise I start to feel more harmonious and vibrant yet still, I also feel more aware and connected.’ A 34-year-old woman from London said, ‘I feel more integrated within myself and more in the moment.’ These people and many others have become aware that practising Qigong hasn’t only had an effect on their health but it has also altered their consciousness. Qigong includes many techniques for cultivating spiritual energy. One of the first stages of this is to develop good breathing habits and to breathe by letting the breath fall into the lower abdomen, back and sides (see page 137). Other forms have the effect of transforming Qi in order to enhance our Shen or Mind-spirit. Although many Qigong exercises are rooted in Taoism and Buddhism, the practice of Qigong for our spiritual development does not entail any religious commitment or observances.

Can Qigong really be used to heal people? Yes. People usually begin to practise Qigong to help maintain their own health. As their Qi transforms, however, they may find that they can transmit and use the extra energy to heal others. This kind of Qi is emitted because a person’s ‘internal Qi ’ has become strong and is flowing without obstruction. Many practitioners who use acupuncture, massage or healing like to develop this ability to use when they practise. One acupuncturist mentioned recently, ‘I like to practise Qigong alongside practising acupuncture and find it enhances my results.’ Another commented, ‘Since I learned Qigong my needle technique is more powerful and I am more sensitive to my patients’ needs.’

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A cure for Steve’s shoulders Steve’s shoulders had been a problem for so long that he had resigned himself to them being achy and stiff nearly all the time. The problem had started 15 years before when he had a job that strained his shoulder area. At the same time the breakup of a relationship put him under severe emotional strain. ‘Sometimes they weren’t too bad at all but if I’d been working hard or if the weather was damp they’d be much worse.’ He was 45 years old when he heard about a Qigong course that was about to start, and was especially attracted when he heard about the health benefits Qigong might bring. During the first few lessons he learned a number of different exercises aimed at strengthening his Qi. He was told that one particular exercise was especially helpful for the shoulders so he spent more time doing this. His teacher was well known for his healing ability and for projecting Qi, so Steve also went to him for treatments. He sat me down and stood with his palms facing me and started moving his hands so that he projected Qi towards me. He was about one metre away from me and he didn’t touch me. As he was making these movements I could feel his energy very powerfully. In fact it was so strong that I started to sway and found I couldn’t resist the strength of it. Steve was surprised to find that his shoulders felt much better even after the first treatment. With a few more treatments and regular Qigong practice he had no more trouble with them. That was three years ago.

Qigong Exercises

My shoulders have been much better since that time. I still regularly practise Qigong because I enjoy doing it and because I feel much healthier now. I have more stamina and energy generally than I ever had before so I can’t imagine a time when I’ll want to stop.

What do the different Qigong practices have in common? We emphasised earlier that Qigong exercises are all different. However it’s also important to note that they have many similarities. First, they are usually performed slowly and gently. When doing some Qigong practices, such as one called zhan zhuang or ‘standing like a tree’, the only movement taking place is on the inside of the body and the person appears to be completely still on the outside. At other times there are more perceptible movements. In this case the movements tend to be flowing and relaxed. Types of practice can be broadly grouped into three main categories which are: 1. sitting Qigong 2. standing Qigong 3. moving Qigong. Second, whether there is external movement or not, the mind is usually focused during the practice of the exercises. People practising Qigong are usually paying attention to their body, their movements, their posture and, with experience, to the feelings of Qi generated from their practice. The eyes tend to have a soft focus. Sometimes people will feel Qi with the

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hands a little distance away from the body. At other times the attention is more on the internal sensation of Qi. Third, although people practise Qigong for various reasons, all agree that one of the end results is to feel calmer and more relaxed. They also feel healthier and have a greater sense of well-being if they practise regularly. Fourth, one of the theories behind Qigong is that we can unblock and strengthen the Qi that runs in the meridian pathways (see Chapter 4) and that the exercises are generally aimed at cultivating and transforming the Qi. So what is the theory behind using these exercises?

How does the theory of Chinese medicine fit in with Qigong practice? Anyone who practises Qigong may hear the words yin/ yang and Five Elements mentioned fairly often. They may also notice the words Kidney, Liver, Heart, Spleen, Stomach or Lungs being referred to more in a Chinese than a Western context. In spite of the frequent use of these Chinese medical terms, knowledge of Chinese medical theory is not necessary in order to do Qigong. People who practise Qigong do, however, need to learn how to do the exercises correctly, as well as understanding why they are using them. If they then use the exercises they will experience the beneficial effects. When practising Qigong people might notice tingling feelings, numbness or a rushing feeling as the Qi moves. Often these sensations will be found to correspond exactly to the pathways of the meridians, which are referred to in more detail in Chapter 4. One of the aims of some forms of Qigong is to open up the pathways of the 12 main meridians as well as some deeper reservoirs of Qi.1 When 1 The form called Dragon and Tiger Qigong mentioned earlier in the chapter can do this.

Qigong Exercises

these channels are open and balanced the natural result is good health and a feeling of well-being. In Chapter 1 we examined the Vital Substances, which are the underlying matter from which we are made. In the practise of Qigong, the Jing-essence, the Qi and the Shen or Mind-spirit are the most significant Substances. Together they are known as the ‘three treasures’. By practising Qigong on a regular basis we can strengthen these three Substances and increase our vitality and well-being. The Jing-essence, Qi and Shen correspond to three important areas in the body. These are called the upper, middle and lower dan tian. The lower dan tian in the lower abdomen is the seat of our Jingessence.

Why is it important to activate the lower dan tian? The Jing-essence is the root of our constitution and vitality. By activating this dan tian, which is approximately four finger widths below the navel and deep in the core of the body, the vital energy that is stored there is awakened. When this region starts to become active a vibration can sometimes be felt in the area and it may feel warmer. Awakening the energy in the lower dan tian conserves our supply of Jingessence and in turn strengthens our Qi. This is important for our overall health. As this Qi builds it will also help to develop Qi, which can be used for healing.

How do I activate the lower dan tian? There are three main ways to activate or awaken the lower dan tian. 1. Learning to breathe properly is a fundamental way to activate the lower dan tian (see breathing exercise on page 137). Deep breathing into the lower abdomen

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naturally relaxes us and this in turn builds our Qi. Just be sure you feel no physical pressure exerted below the top of your pubic bone. 2. Adjusting our posture during Qigong so that the centre of gravity naturally falls to the dan tian will also aid its activation (see the description of the basic standing posture on pages 132–133). It will also enable us to sink our Qi so that we can become calmer, more settled and less stressed in everyday life. 3. Finally putting our attention on this area in the lower abdomen and making it a centre of gravity in our day-to-day life. This is a very simple yet effective way to awaken it. If we develop our internal centre, our Qi is awakened and strengthened. Additionally we become more relaxed, our emotions become more settled and our minds become clearer. Without strengthening this centre we will be weaker and more prone to ill health. One 30-year-old mother of a three-year-old mentioned, ‘Since I have been doing Qigong I feel that my body can recentre itself almost spontaneously. I find it much easier to bring about a balance and clear my system and I often practise whilst walking or playing with my son.’

Qigong Exercises

How is Qigong different from exercises usually done in the West? If we compare Qigong to exercises that are traditionally done in the West we will notice that the major difference is what is being exercised. Exercises, such as running, jumping, swimming, cycling or playing competitive sport all involve exercising the physical body only. This exercise is quite vigorous. The body grows stronger and fitter as a result, but changes to the mind and spirit are not emphasised. The Chinese call such exercise ‘external’ exercise as only the outside is being moved. Qigong practice exercises our Qi. Our Qi is moved by directing our attention to our internal state and staying relaxed while we move. The movements of Qigong tend to be gentler and more relaxed than purely physical movements. The result of Qigong practice is that we become calmer and more serene inside as well as healthier physically as both the body and the mind are affected. Because Qi circulates on the inside of the body most Qigong exercises are called ‘internal’ exercises. Chinese medicine does not discount the beneficial effect of external exercise. In fact, exercising in the ways suggested above, such as walking, light jogging, cycling, and swimming can be very beneficial as long as people don’t overdo it.2 This is not, however, the only way of exercising. Both styles of practice are useful for different reasons.

2 See ‘Some important principles for good Qigong practice’ on page 136 and the 70 per cent rule under ‘Do not strain’ on page 138.

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What are the different types of Qigong exercises? We mentioned earlier in the chapter that the main types of Qigong are sitting, standing and moving Qigong. We will look at them individually to get a better sense of what they are used for. Most Qigong teachers will be experienced in teaching more than one of these different styles.

Sitting Qigong Sitting Qigong is mainly used when doing breathing exercises or when meditating. Some movements usually done while standing can also be practised sitting down or we can practise sitting (or lying) down if we are injured or ill. Sitting practices are all aimed at cultivating the Qi for better health or spiritual development. Being able to sit in a correct posture is important and enables us to relax when breathing or meditating. Breathing into the lower dan tian is an important way to help us to feel our body and can be a precursor to meditation.

Aligning our sitting posture When we sit to breathe or meditate, it is important that we choose a chair that is at the correct height so that the feet can be flat on the floor, the lower legs can be at a right angle (perpendicular) to the floor and we can sit comfortably. 1. The back should be straight and the front of the chest, throat and belly correspondingly relaxed. 2. The head is lifted slightly from the top of the neck and aligned with the centre of the torso and pelvis.

Qigong Exercises

3. The armpits are open and the groin slightly lifted. Both should remain relaxed. 4. Finally, it is also important that the midriff, which is between the ribs and the groin area, is kept open. Often the midriff starts to close up as people sit for long periods and sag. This then squashes the internal organs. The midriff can also close as we age. If we ensure we keep it open it can keep us younger and more healthy.

Sitting Qigong

Standing Qigong Standing Qigong describes exactly what it does – standing completely still in one posture in order to develop the Qi. As

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I mentioned earlier, traditionally this is known as ‘standing like a tree’. Some people use this as their main practice. The posture itself has to be correctly positioned with the legs very slightly bent and the head upright so that the full benefit is achieved. The hands may be held in a variety of positions including the sides of the body, in front of the body as if holding a balloon and holding the hands together in a prayer position. Standing Qigong develops our ability to concentrate and develops our stamina as well. It also strengthens our overall energy, facilitates the flow of Qi throughout the body and helps our ability to sink our Qi (see page 135). By standing in one place the legs are strengthened as we become better connected to the earth (see the following page for an illustration of the basic posture).

Aligning our standing position 1. Stand with the feet approximately shoulder width apart and facing forward. 2. Allow the knees to bend slightly. They should not be locked. The knees should not take the weight of the body as they are not weight bearing joints. If your knees hurt, you are standing incorrectly. 3. Tuck your the tailbone down so that the lower back is straight. Relax the hips and lower abdomen, but don’t collapse into your knees. Allow the weight to travel down from the hips and lower abdomen through the back of the knees to the bottom of the feet. 4. Let the chest relax and sink downwards towards the lower abdomen as the spine raises up through the head. This is like the posture of a baby.

Qigong Exercises

5. Allow the neck and head to be upright and look ahead with soft eyes. At the same time relax the neck and shoulders. 6. As with the sitting posture keep the midriff, groin area and armpits open and relaxed.

Standing Qigong

Moving Qigong There are many moving Qigong exercises, some of which are well known and others that are less so. Earlier in the chapter I mentioned the ‘the Five Animal Frolics’ that were developed by Hua Tuo, a famous Chinese doctor. These exercises are still very popular and are performed in numerous different ways. The ‘eight brocades’ are another set of famous

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exercises that were developed in the Song dynasty, which lasted from 1127 to 1279 ad, by an army officer who wished to maintain the health and strength of his soldiers. There are countless forms taught by different Qigong teachers including Dragon and Tiger mentioned earlier and others such as ‘Gods Playing in the Clouds’, ‘Marriage of Heaven and Earth’ and ‘Bend the Bow to shoot the Arrow’.

What is the difference between Qigong and tai ji quan? Most people have heard of tai ji quan (sometimes called tai chi chuan). It is another very popular moving form that is performed in a similar way to Qigong. It could loosely be said to come under the same umbrella of Qigong as it is a Qi practice and is more usually regarded as a more complex and sophisticated form of Qigong. Tai ji quan forms tend to be longer than ordinary Qigong. The shorter Qigong forms tend to be more specific and easier to learn. Tai ji takes longer to learn and many teachers do not teach the internal aspects of the movements, only the outside form. If taught well both tai ji and Qigong can make excellent daily exercises. Tai ji arises from specific traditions with styles often named after families who began the tradition. Some of the most common ones are called Yang style, Wu style and Chen style tai ji.3

3 For more information about tai ji see Frantzis (2009).

Qigong Exercises

A moving exercise Below is a simple five to ten minute Qigong exercise to help us to sink our Qi, gain better balance and become more aware of the sensations and energy in our feet.4 1. Stand with the feet shoulder width apart and in the standing posture described above. 2. Slowly shift the whole weight of the body to the right leg and lift the left leg up from the ground to about ankle height. 3. After a few seconds put the left foot down and lift the right foot. 4. Repeat by slowly alternately shifting the feet back and forth from left to right and right to left for a few minutes. 5. Now stand still with the feet on the ground and let your mind feel your legs and feet. Allow yourself to feel all the parts of your feet and also your connection to the ground. 6. Once you feel your legs and feet more clearly keep this attention and repeat the alternating lifting of the feet as before. 7. Notice the difference in your experience as you shift the second time and feel your legs and feet with more awareness.

4 For more on this exercise see Frantzis (2001).

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Moving Qigong is usually performed in a gentle and relaxing way. The movements tend to be performed slowly and gently and with fluidity. They enable people who practise to gradually feel a connection to their whole body. Some moving forms are carried out more vigorously, although the rule is not to push too hard or to force anything. While doing them it is important to remain attentive and in a good posture. There are many, many Qigong moving exercises and most of these are best learned from a teacher. Usually this is best in person but with the coming of sophisticated technology this can also be done effectively with simpler Qigong practices by DVD or online video courses.

Some important principles for good Qigong practice

Sink your Qi This is an important principle of Qigong practice little understood in the West. When we feel angry, afraid or tense our Qi will naturally travel in an upward direction. This will cause us to tense the neck and shoulders, and sometimes give us headaches, a hot, flushed face or a tight jaw. If our energy tends to go primarily in an upward direction we will always feel uncomfortable and slightly ill at ease. We will then become more stressed. If our energy sinks down to our lower abdomen (or dan tian) and our feet, this enables us to become more relaxed and calm, clearer headed and better able to cope in our daily lives. There is a saying that ‘We die from our feet upwards.’ If we can learn to sink our Qi it is said that it will help us to stay younger and fitter and increase our overall longevity.

Qigong Exercises

Breathe into your lower abdomen It is impossible to be stressed if we are breathing into our lower abdomen! Breathing properly gives us huge benefits. For example, it enables us to relax, it loosens and energises our internal organs and it increases our blood circulation and the strength of our Qi. We can breathe when sitting, standing or moving. It takes time to learn to breathe properly so this should be done slowly without strain.

Qigong breathing practice Breathing should be done in a relaxed way and the breath should not be held or be jerky. To breathe effectively: 1. Breathe in through the nose into the lower abdomen so that it expands and fills out like a balloon. Be careful that you feel no physical pressure below the top of your pubic bone. 2. Keeping the breathing smooth exhale and let the balloon in the abdomen deflate. 3. Allow these breathing movements to be rhythmic, slow and even. 4. As you practise you can also learn to breathe into your sides and back and kidneys. Later you can learn to breathe into the upper sides and upper back as well.

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Keep relaxed Many people think they are relaxed if their body becomes limp. We wouldn’t be able to practise Qigong in a relaxed way if this were the case as we would be in a heap on the floor! The relaxation of Qigong is very alive and dynamic because our mind is focused as we relax. This creates a ‘living’ relaxation rather than a ‘dead’ and floppy relaxation. This relaxation is important as it also helps to free the energy flow and enhance our vitality.

Do not strain It is sometimes tempting for us to do more and more practice when we learn and get interested in Qigong. The golden rule with Chinese medicine is balance. It is fine to increase our practice but not to overdo it. The rule of thumb is not to practise to more than 70 per cent of our capacity. Often in the West we think it is good to do it as if it is 110 per cent or 120 per cent! Chinese medicine is different and says only do it to 70 per cent. If you are in pain it is a sign to do less and everything you do should feel comfortable.

How will I feel while practising Qigong? There are some generalisations that can be made concerning what happens during Qigong practice but this will vary according to which exercise is being done and who is doing it. Although some people have an immediate positive experience when they first start to practise, for many others it can take plenty of motivation and much determination to continue to practise regularly and feel the beneficial effects. In fact, some of the exercises can feel strange at first while

Qigong Exercises

better energy flows are established, new muscle groups are used and areas gradually loosen up. The effort is worth it – as Bill, described at the beginning of the chapter, would concur. The later positive effects far outweigh any initial struggle and all will be forgotten as the feelings of well-being manifest. Here are some comments people have made about their experiences during Qigong practice. ‘I often get a sense of my Qi “shaking down” and beginning to flow more smoothly as well as a sense of warmth and general well-being.’ ‘It can vary enormously from very serene to quite disturbed, but it usually settles into a more harmonious feeling of being more aware and connected.’ ‘I sometimes feel “big” sensations – my hands can feel enormous, I feel movements in places where I usually don’t move.’ ‘There is a definite change in my state of mind, it becomes quieter and I feel an expansion beyond my physical body.’

How Carol benefited from Qigong ‘Before I started practising Qigong I was very depressed,’ Carol told me. ‘In fact it’s hard to recognise me now because I feel so different.’ She went on to tell me how she felt at that time, four years ago. I felt heavy and pessimistic about everything, but also very unsettled and nervous all the time to such an extent that I could never keep physically still. I only went to a Qigong class because a

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friend was going and persuaded me to go along too – I decided that it would be better than sitting at home smoking cigarettes and feeling bad, but I wasn’t very interested. From almost the first session I noticed something was different – I felt more expressive and outgoing, my voice had more volume and I noticed an inner feeling of peace. This gradually built up although at first I felt better after some classes than others. Now I can honestly say that Qigong has transformed my life. I sleep better, I feel much calmer and I no longer move about like I used to. My head is clearer and I am a stronger more positive person altogether. As well as doing formal Qigong practice every day I also try to bring it into my work as a gardener. For example, when I’m doing things like raking leaves, digging or cutting hedges I find that I can do them in such a way that I feel energised instead of worn out as I would have done before. There are three added bonuses for Carol – one is that as she felt better she also found the strength to give up smoking, the second is that she met someone at the class and she now has a committed relationship with him and the third added bonus is that they practise Qigong together.

How will I feel immediately after practising Qigong? We have already looked at Qigong’s beneficial long-term effects whether used for healing, health maintenance or spiritual development. Here are some observations people

Qigong Exercises

have made concerning how they feel immediately after practising. A 40-year-old mother of two says, ‘I have an immediate feeling of relaxation yet alertness and “aliveness”, a sense that anything is possible and that I’m no longer restrained [by my] own self limitations.’ Another comment was made by a 42-year-old Londoner, ‘Troubles of the mind disappear! I feel cleansed, very centred and I usually feel happier.’ The next comment made by a 35-year-old computer programmer reflects a common experience, ‘I feel increased calmness and more aware of what is going on around me.’ Finally a comment by a man of 45, ‘I have more feelings of well-being, feel free of stress, exercised and energised and clearer mentally.’

Do I need to have a teacher? The simple answer to this is yes. Exercises practised badly can be ineffective at best and at worst dangerous. Each Qigong exercise is carried out in a specific way that requires feedback on posture and the technique of performing the movement. A Qigong teacher once said to me, ‘What you learn from a teacher is yours for life.’ Once you have learned from a teacher you can carry on practising independently and reap all of the benefits. When Qigong became popular in China many people set themselves up as Qigong teachers when they had very little real training in the exercises themselves. It is important that a teacher understands what they are doing and what you need. It is all too easy for Westerners to think that just because someone is Chinese they must be a good Qigong teacher. Conversely a Westerner may be well qualified to teach.

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How do I find a good teacher? As Qigong grows in popularity, there are more and more Qigong teachers appearing on the scene so it is important to find a good one. The best way to know whether a tree is healthy is by the fruit it produces. The best way to tell whether teachers are competent is by the pupils they produce. First we need to decide what kind of Qigong we wish to practise. It is no use going to a teacher who is primarily teaching a martial art when what we really wanted was Qigong for health maintenance. Many experienced teachers will teach Qigong for a combination of uses, which include martial art and healing as well as spiritual development. In general it is best not to do Qigong that pushes your energy too much. Some teachers teach a more yin or water style of Qigong and this is gentler than some more yang or fire styles, which can force the Qi more. A good way of finding out about a teacher is to talk to the students and find out about the benefits they reap from their practice. Another way is going to see the teacher to find out whether he or she seems trustworthy and therefore the teaching he or she is giving is sound. We can also find out about teachers’ track records and how long they have been teaching. If all this seems good then go for it!

How much do I need to practise? For the maximum benefit it is best to do Qigong every day. People who practise regularly notice the most beneficial effects. Most practise for at least half an hour every day, some practise for longer but it is still possible to feel beneficial results with less time devoted to doing the exercises as long

Qigong Exercises

as they are done regularly. In general it is better to do five to ten minutes a day regularly than two hours followed by no practice for a fortnight. Regular practice is important for a number of reasons. First, we need to have a routine. A regular routine means that we will continue to exercise through the difficult times as well as when it is easy. Second, practising every day takes self-control and is also a way of developing strong mental discipline. Third, regular practice also gives us something to build on. If we only do Qigong intermittently we never build our energy and will find that we always go back to square one and never progress. Here is an interesting comment from a mother of two children: For the last two years I have stopped doing Qigong during the summer break due to a lack of personal space and my classes stopping. Each time I have found that at the end of the six weeks, in spite of going on holiday, I am a wreck – I feel exhausted and out of sorts. As soon as I start practising Qigong regularly my vitality returns. Having made the mistake for two consecutive years I hope that I’ve learned my lesson.

Where should I practise? Although it is important to have a good teacher, our actual day-to-day practice goes on at home. It is best to have a regular place to exercise. A quiet room or a special space in a room can make a regular routine easier to maintain. Practising with a group is a very different experience from practising alone. The energy in the room is heightened by the presence of more than one person doing Qigong.

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This in turn can improve the results of the practice. A good teacher will create an even stronger Qi ‘field’ in the group, which can form the basis for breakthroughs in Qigong practice. This chapter is a brief description of Qigong. The proof of its effects are in the practice, and we have to do the exercises in order to achieve the benefits described. Qigong is one way that we can take responsibility for our own health, especially when we have already obtained a better balance of Qi from having acupuncture, herbs or tui na.

7

Tui Na – Chinese Massage Feeling Your Qi

I recently watched a mother with her young son. He was wailing in pain having fallen over and banged his knee. His mother instinctively hugged him and rubbed it better. Almost instantaneously he was pacified and stopped crying. The support from his mother’s touch helped him to quickly get over the trauma. While sitting in a cafe having lunch, I watched a couple together. One of them was clearly in distress. Her partner reached out to hold her hand as she talked. She visibly relaxed. Holding her hand seemed to support her as she let her feelings out. Her renewed sense of strength resulting from this touch was almost palpable. Some weeks earlier a colleague had a headache – a tight, throbbing pain. I saw him intuitively massaging the area and finding pressure points to rub on his neck and temples. He told me that kneading these points had relieved the headache and he clearly also found it comforting. To reach out and touch another person is a natural reaction when someone is in physical or mental distress. The incidents described above are all examples of how touch can give a clear and direct message of warmth, comfort or healing.

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Chinese massage known as ‘tui na’ is one of the oldest of the Chinese medicine therapies. It was originally born from our instinct to make physical contact with someone in need of healing and support. The desire to reach out and touch others is one of the most basic ways for people to show support and caring for each other. Tui na takes the power of touch one step further, however. It is a highly developed and skilfully applied method of treatment that can relieve many musculoskeletal problems and pain. In this chapter I will put the spotlight on this therapy and answer all your questions about it. You will find out more about what happens during a treatment, the different ways tui na can be used and what it can treat. I will also examine how tui na is different from other forms of massage and in what way it uses the theory of Chinese medicine for diagnosis.

What is tui na? Tui na is Chinese therapeutic massage. It is currently used in many hospitals throughout China to cure a wide range of illnesses. It is also used by many Chinese medicine practitioners in the West, sometimes in combination with other Chinese medicine therapeutic treatments such as acupuncture. The name ‘tui na’ actually means ‘push grab’. This is a term that has been used since the Ming dynasty, which began around the mid 14th century. In this book ‘tui na’ refers to all therapeutic massage, but before the Ming dynasty all massage was called ‘an mo’, which means ‘press rub’. The term an mo now describes domestic or relaxing massage only.

The roots of tui na This therapeutic massage has a long and diverse history. Different styles developed in different regions of China.

Tui Na – Chinese Massage

The northern areas of China are well known for their more vigorous style of massage and the southern regions for their fine and gentler techniques. All styles have their own unique uses and many different massage techniques have evolved from them. Although tui na today can vary slightly according to where it is taught, there are certain common massage techniques that are used throughout all the teaching centres in China and the West. We will look at some of these techniques as this chapter progresses.

What is the difference between tui na and other styles of massage? There are two main uses for massage – the first is to relax a person. Relaxing massage is often practised in the West and a style called ‘Swedish’ massage is commonly taught. Swedish massage can be very useful when a person has tight muscles and tension, but it is not used to cure specific ailments. An mo, which was mentioned in the previous paragraph, is different from Swedish massage but is used in a similar way. The second use of massage is to cure illness. A physiotherapist may apply forms of massage to ease joint and muscle problems, but no form of Western massage practised today is actually used to cure disease in the same way as tui na. Another form of popular therapeutic massage used in the West is ‘shiatsu’. Shiatsu massage, which comes from Japan, originated in China and was taken to Japan in the Tang dynasty which began in 618 ad. During this time in China, massage was carried out on the floor with the practitioner kneeling next to the patient. This part of the tradition continues in Japan to this day where shiatsu massage is still always carried out on the ground. In China these days most

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massage is practised on treatment couches that come up to waist height. Some forms of shiatsu massage practised in Japan are still similar to tui na. There are many different traditions of shiatsu and most of those done in England and the US are similar to, but are not the same as, tui na. It has been 1,350 years since tui na was first taken to Japan so it would be surprising if they were still the same after all these years! So what should we expect when we first visit a tui na practitioner?

Bian Que and the first recorded use of tui na The history of Chinese Medicine records that a famous doctor called Bian Que was a master of tui na. He is said to have used massage to treat his patients during the Qin Dynasty around 500 bc. Legend has it that he revived the dying crown prince of the Zhao State using acupuncture and massage, which won him great admiration. This is claimed to have become the first written successful case of tui na being listed in the ‘Records of the Historian’. These records were an account of Chinese history that dated from approximately 2600 bc until 100 bc. There are countless other recorded stories relating to the uses of tui na in ancient China. These records indicate the valid effectiveness of tui na as a powerful therapeutic treatment.


What will happen when I first come for treatment? If you go for a tui na treatment one of the first things your practitioner will do is take a case history in order to clarify the diagnosis. She or he will be looking for the cause of the main problem as well as taking into consideration your overall health. During the diagnosis your practitioner will ask many questions which will vary from, ‘How do you sleep?’ to, ‘How is your appetite?’ or, ‘How do you relax?’ Practitioners will also take the 12 pulses on the wrist and look at the tongue (see Chapter 3). As one patient described, ‘My practitioner asked me common sense questions really, she was getting to know all about me and my lifestyle.’ Another said, ‘The consultation made me think about my past illnesses and how they are connected with my health now.’

How is the theory of Chinese medicine used by a practitioner of tui na? When taking a case history, practitioners will be looking at three main areas. First, they will want to find out about the balance of the Vital Substances in the body. As described in greater detail in Chapter 1, these Substances are Qi, Blood, Body Fluids, Jing-essence and the Shen. The Qi and the Blood are the most important of these five Substances to tui na practitioners. They will notice if the Qi and Blood are deficient or moving sluggishly in any parts of the body. Massage will naturally move the Qi and the Blood and will help to restore better health. Second, practitioners will want to find out about the state of the internal organs and can, when necessary, use

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massage to harmonise the Qi and Blood in these organs. For example, massage techniques can be used to clear headaches, which are created by imbalances in many organs including the Liver. They can also be used to treat back problems, which have numerous causes including weakness of the Kidneys or even loose bowels, which can be brought on by an imbalanced Spleen. The practitioner may then choose to treat points or Qi pathways known as channels, which are connected with these organs. These pathways are described in greater detail in Chapter 4. Third, the practitioner will be diagnosing any ‘pathogens’ in the body. These pathogens are called Damp, Wind, Cold, Dryness or Heat and are described in more detail in Chapter 2. Their presence in the body can create many symptoms including colds and flus, joint problems, stomach disorders or bowel complaints. Tui na can clear the pathogens when they cause obstructions. This will in turn free up the circulation of the Qi and Blood and can help the condition. Many joint problems are caused by these stuck pathogens being caught in the joints and tui na is especially beneficial in many of these disorders. Tui na massage therapists will form their diagnosis based on their questioning and observation of their patients. Having made the diagnosis they will then treat the patient.

What illnesses can tui na help? Tui na is particularly well known for the relief it can bring to many joint problems. These may range from bad backs, painful shoulders, any joint problems of the arms and hands or legs and feet as well as helping neck problems or headaches. It can benefit both acute injuries and longer term, more chronic complaints.


Tui na can also help a person to relax. Although it is not specifically used for relaxation, treatment does have the effect of relaxing a person both physically and mentally. Although it is best known for its capacity to heal joint problems and create relaxation, it can also help many of the complaints listed in Chapter 4. These include digestive and bowel disorders, lung complaints, gynaecological problems, urinary diseases and acute infections.

Beverley’s stomach is cured by tui na Beverley has every reason to be grateful to tui na for solving her stomach problems. She is 49 years old and works as a rep for a large drug company. She describes how she was before starting treatment. I’d had stomach disorders for over 20 years and took many different medical drugs for the problem. None of them was really effective and the problem gradually became worse. By the time I went for tui na I had severe pain in my stomach that rose up to my breast bone and through to my back. The only thing that relieved the pain was being sick. When I was sick it came out in jets and I would also vomit blood as the blood vessels burst. It got to the stage when I was given a special phone number for an ambulance and if I rang they’d come and fetch me straight away. The doctors diagnosed me as having diverticulitis then they thought it might be an ulcer or irritable bowel. When they wanted to cut out some of my gut I decided to try tui na. Beverley started treatment over a year ago and she is now completely cured of all her problems.

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I’m completely well now. I can do everything and I don’t get any pain any more. I used to get such discomfort in my stomach that I even hated clothes being near the area and couldn’t put my hands on my stomach at all. That’s all gone now. After the first few treatments the sickness stopped and the stomach eased. Now I’m off all my drugs and I also feel fantastic in my spirits. This treatment doesn’t just treat one thing; it treats the whole person. Beverley’s life has been transformed by having tui na treatment. Ironically she was voted ‘rep of the year’ by the drug company she works for last year, but is relieved that she no longer needs to take medical drugs in order to do her job well. What does the future hold? She’s decided to change her job and train to use Chinese herbs.

What will I experience during the treatment? Having made a diagnosis, the practitioner will choose the treatment technique that is needed. Each individual’s treatment will be designed differently according to the patient’s energetic balance. When you have a treatment, practitioners check your progress in two ways. They will find out how you have been since the previous treatment and they will also observe and palpate your body. Your practitioner will also feel 12 pulses on your wrist and look at your tongue (see Chapter 3). The practitioner will then begin your treatment. He or she will not usually ask you to remove any clothes – instead they will usually cover the area to be massaged with a towel or cotton cloth.


Having tui na is usually very relaxing and pleasant. Here, three patients describe their experiences. ‘It is really comfortable having the massage, if my back is a bit achy or in spasm it can hurt a little bit but that’s unusual and it’s usually very pleasant. The massage is quite vigorous and very effective.’ ‘I drift off. It feels wonderful. It’s very fast and precise and I can feel the pain falling out of my body.’ ‘At first some areas hurt a lot and it was as if my practitioner could pick up every sensitive place on my body, but as I’ve got better the pain is not as bad.’ As I said earlier in the chapter, the practice of tui na is very precisely carried out and the practitioner uses many different massage techniques according to the patient’s presenting problem.

What are tui na massage techniques like? Rolling, pushing, grasping, kneading, rubbing, nipping, vibrating, chopping, revolving, pinching and pressing are but a few names of the many tui na massage techniques that are commonly used. Two massage techniques are used extensively and the tui na practitioner practises these for at least a year on a bag filled with rice or sand in order to competently master the technique.

Gun fa The first of these techniques is called ‘Gun fa ’ (pronounced goon fa), which is a rolling technique. The back of the hand is rotated and rolled to and fro over the body using flexion and extension of the wrist. It is used for deep massage over

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large areas such as the lower back, shoulders or the thick muscles of the limbs. It can powerfully strengthen or relax areas of the body as well as clearing blockages and it is known to have a remarkably penetrating effect.

Yi zhi chan The second technique is called ‘Yi zhi chan’ (pronounced ye je chan), which translated means ‘one finger oscillation’. To use this technique the practitioner presses on a chosen area using the tip of the thumb – at the same time he or she keeps the shoulder, elbow and wrist relaxed and moves the thumb inwards and outwards using flexion and extension. The result of using this technique is to create a potent and intense stimulus, which can work directly on an acupuncture point when stimulation is needed. It is used for many of the medical problems that tui na can treat and is especially valuable on the abdomen for conditions such as abdominal, gastrointestinal and gynaecological diseases. It can be applied to very sensitive areas such as around the eyes and other sense organs.

Other techniques By perfecting these two massage techniques tui na practitioners strengthen the muscles of their arms and hands and loosen their wrists. All of the other massage techniques spring from these two basic ones and once these movements have been mastered the other actions come naturally. The massage techniques are used individually or combined together to create more sophisticated techniques. A practitioner will carefully choose the best manoeuvre for the patient as well as which areas to treat.


What areas of the body will the practitioner treat? Sometimes tui na practitioners will massage specific acupuncture points on the body, at other times they may treat along a channel or energy pathway and on other occasions they may choose to massage a whole area of the body. Practitioners may choose individual points because they have a particular effect or because they lie along a pathway that is connected to an organ. For instance, the patient in the example above who had severe digestive problems was often treated using Stomach and Spleen channel points on the leg known as ‘Stomach 36’ and ‘Spleen 6’. This was because of the nature of her illness and because the complaint had originated in her Stomach and Spleen organs. Sometimes, however, her practitioner would also use other points on different channels such as a Pericardium point on the arm called ‘Pericardium 6’ and ‘Directing vessel 12’ which lies over the Stomach area. He or she would choose these points as they were particularly beneficial for the specific complaint and would often use the ‘one finger oscillation’ technique to massage the points. A practitioner may also decide to treat along a whole pathway on the body rather than on an individual point. This may have a more generalised effect on the channel rather than the specific effect obtained from using individual points. For example, a patient with a severe headache may have massage along the channels of the shoulders and neck as well as the head. Sometimes the practitioner may massage a whole area on the body, such as the lower back or the lower abdomen. One tui na patient aged 31 years is a ‘futures’ trader in the city of London. His work involves him standing in one spot for many hours at a time; after a period of doing this his back can seize up. He has regular treatment, which ‘pummels

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the stress out of it’. He feels much better and more relaxed afterwards and it also helps him mentally and physically. Although tui na is not used merely for relaxation, there are times when it is important to relax a whole area of the body for it to have its therapeutic effect.

What skin preparations will the practitioner use? Western trained practitioners often use a massage oil directly on the skin; Chinese massage is different. Sometimes the practitioner will use a medium on the skin and sometimes not. As discussed earlier, one traditional way of carrying out a massage is to place a cotton cloth over the area being treated. This is a common practice and creates a flat area on which the massage is given. If this is used, no clothes need to be removed. If a medium is used on the skin, it is chosen according to the diagnosis. For example, if a patient is too Damp and is holding water under the skin, pure talcum powder can be used as it has a drying effect. If a condition needs to be warmed, such as a cold achy back, then hot substances can be used on the area. These may be tiger balm, another balm called ‘essential’ balm or a warming oil called woodlock oil. Woodlock oil may be applied after a massage and it will deeply penetrate and warm an area at the finish of the treatment. One patient commented, ‘She rubbed an oil into my lower back and I felt the warmth sinking into my bones.’ Dong Qin Gao (pronounced dong chin gow) is another oil that is frequently used. It has a Vaseline base and is made from wintergreen mixed with menthol. It is commonly used for lumbago or sciatica and is applied to large areas such as the back or the legs to move congested Qi and Blood.


Vinegar is often used on injuries and sprains and may be mixed into a paste with other substances such as jasmine and ginger. This clears swellings and relieves pain. Chinese herbs are also sometimes used on the skin to add to the effects of the massage.

Will the practitioner ever manipulate my spine? It is very unusual for a practitioner to manipulate the spine. Often a displaced vertebra will automatically correct its position after a tui na treatment. The muscles around the spine become relaxed and loosened after massage allowing the spine to naturally realign itself.

A cure for Terry’s back after 20 years Terry decided to try tui na after being impressed by how much it helped his wife. He’d had a fall over 20 years ago and had a back problem ever since. I’d had some osteopathy and it had temporarily relieved it for a few days but never on a long-term basis. The doctor had told me that I’d have to live with it. Most of the time I’d tried to ignore it as I thought I’d have it for the rest of my life. The problem was always there. It was a dull ache, on the right hand side of my back and the pain also went to my hip and travelled down my leg. I’d wondered if I had anything wrong with my hip as well, but when my practitioner examined me she said that the main problem was in the lower back. The treatment itself was not uncomfortable, in fact I was nearly going to sleep sometimes while she was treating me. After the first treatment I felt slightly better, then after the second one I dramatically improved. The third treatment was

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just the finishing touches really and that was all I needed. I’ve had no problems since. Tui na was able to do for my back what nothing else could do – that is it has helped me on a permanent basis. Terry has been better for six months now and although he’s had a few slight twinges his back has been fine. He still treats his back with respect and he does some Qigong and other exercises that his practitioner recommended because, as he says, ‘I think they help me to stay healthy.’

How long will a tui na treatment take? A treatment will usually last from three-quarters of an hour to one hour, but this depends on the nature of the problem that is being treated. If you have a joint problem some acupuncturists use this treatment alongside acupuncture. In this case you may have a shorter session of tui na as both therapies are being used.

How often will I need to come for treatment? An acute condition will require more frequent treatments than a chronic one but fewer treatments will be needed overall. For example, a patient with an acute sprained ankle may require treatments every other day but the problem can be cured in a short number of treatments. A patient with a chronic problem, such as long-term joint problems, back problems or digestive complaints, may initially need weekly treatments. These will be spread out to increasingly longer intervals, such as fortnightly, monthly and two monthly, as they get better. A patient with a chronic complaint can expect to need more treatments before getting better than those with an


acute complaint. The amount of treatment needed will vary from individual to individual and depend to some extent on a patient’s lifestyle as well as how long they have been ill and the treatments they have already had.

Can tui na be used to treat children? There is a long tradition in China of tui na being used to treat children. Children respond very quickly to massage treatment as their energy is usually strong and vibrant. Changes in health tend to be more immediate in the treatment of many conditions than when adults are treated. This is not to say that adults cannot also respond quickly to treatment – they can, but they tend to take longer to change than children as their energy has often become more depleted or blocked as life has taken its toll – some cynics may even add that sometimes it’s having children that causes life to take its toll! Children’s tui na is slightly different from that used on adults and employs its own specific techniques. It is usually carried out on children under 12 years of age, and is especially effective on infants under five. In China the tui na clinic is often the first port of call for children who are ill and treatment is used for a wide variety of complaints from asthma and infantile diarrhoea to paralysis due to polio. The other bonus of using this treatment is that, besides being effective, children usually enjoy the treatment. In some cases some treatment can be applied by caring relatives at home, once the practitioner has directed them in what to do.

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How will I feel immediately after the treatment? After a treatment patients often feel pleasantly relaxed. Depending on the length of the session and the nature of the treatment, patients who have had tui na may feel lighter, more centred or warmer. Some patients feel so relaxed they need to have a short sleep. Others may feel more invigorated. The area being treated often feels immediately better although in some rare cases there may be a slight exacerbation of the pain for a short time before feeling better. This is known as a treatment reaction and is a good sign.

Can I use massage techniques on myself? Sometimes the tui na practitioner will instruct a patient on how to do a self-massage technique. The patient can then use it at home and it will support the treatment. This is especially useful when someone has an injury or a more chronic musculoskeletal disorder and when the area in need of treatment is easy to locate. Practitioners may also suggest exercises that can be practised daily in order to aid healing. Tui na is now a popular treatment and there are an increasing number of practitioners learning how to give this treatment. Many practitioners have also been trained in another Chinese medicine therapy, especially acupuncture, so at times your practitioner may give some tui na during an acupuncture treatment and this can be a useful combination.


Five-minute self-massage for tired eyes Although not specifically a tui na technique this exercise is taught to schoolchildren in China to relax their eyes when they do schoolwork. It is useful during or after any activity that may strain the eyes. 1. Place thumbs level with the inner corner of the eyes at the side of the bridge of the nose. Rest the fingers on the forehead. Lightly massage in a circular motion towards the nose with the thumbs. 2. Place thumb and first finger on the side of the bridge of the nose and lightly massage in a circular motion concentrating on pulling downwards and releasing slightly. 3. Place first finger lightly on either side of the bridge of the nose and gently massage outwards following the line of the bone below the eye. 4. Place first finger in the hollow of the temple at the outer corner of the eye and massage clockwise then anti-clockwise. 5. Place the first and second finger in the hollow at the back of the neck which is below the base of the skull and about one-and-a-half inches from the midline (the first prominent hollow), press in on the point and massage clockwise then anti-clockwise.

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Tui na being used on a baby

8

Chinese Dietetics Nourishing Your Qi

Before I studied Chinese medicine I considered that I was eating healthily. I ate unsoaked muesli for breakfast, consumed lots of salads and, as a vegetarian, ate lots of cheese and other dairy products to replace meat. I thought I knew a lot about diet. I had to admit that I didn’t enjoy what I ate very much. I didn’t feel that healthy either. As I studied Chinese medicine I slowly changed my diet. Learning Chinese medicine gave me an inherent understanding about the nature of food and diet. I also learned how to eat holistically, rather than looking at the health benefits of individual ingredients in isolation. I found a new regime that was healthier and more nourishing and also much more tasty – phew! There is a saying in Chinese medicine that ‘food and medicine come from the same source’. In this chapter you will learn some basics about diet in Chinese medicine including some things that surprised me, such as the importance of the temperature of foods. As I easily felt cold I needed to avoid foods that were ‘cold’ in nature (I didn’t have to eat all of those salads anymore!). I also discovered that all foods have an inherent temperature even if they not outwardly ‘cold’ or ‘hot’.

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Chinese dietary therapy tells us much more about the need for balance. There is also a balance in the proportions of food in our diet, a balance of how and when we eat and a balance of the five tastes – Sour, Bitter, Sweet, Pungent and Salty. You will also find out about the need to eat a ‘Bloodnourishing’ diet and how this can help us to keep emotionally stable and free from many other physical symptoms, as well as how some foods are more ‘Phlegm-forming’ – these can block us up and make us feel lethargic, muzzy headed, stiff and heavy. Unlike some of the more modern dietary ‘fads’, basic dietary rules of Chinese medicine haven’t changed over thousands of years. Chinese dietary therapy does not follow a rigid regime. It is adjusted according to a person’s age, build, health and living conditions. There are five main dietary recommendations in Chinese medicine. If we follow them we will be eating balanced and healthy meals and get the best possible nourishment from our food. They are: 1. the proportions of different types of food 2. the temperature 3. the taste 4. the quality of the food 5. how and when we eat our food. In this chapter I will look at each of these in turn. First let’s look at how diet relates to Chinese medicine.

Chinese Dietetics

How does the theory of Chinese medicine apply to diet? The Stomach and Spleen are the two main organs of digestion. We can care for and maintain these organs by eating well. Most Chinese people are taught the importance of diet from an early age, and love to eat healthily and well. This is a fact born out by a quote from a Chinese person, ‘If there’s one thing we’re serious about it’s neither religion nor learning but food’ (Zhang and Rose, 1999, p.50).

The role of the Stomach and Spleen Chapter 31 of Classic of Difficulties says ‘the Stomach is responsible for rotting and ripening food and drink’. This rotting and ripening process is the first step in the assimilation of what we eat. I need to send down digestible food to the Stomach at the correct temperature, at regular times and in the right quantities. As I noted earlier, cold food puts a strain on the stomach. Too much cold food chills the body and the digestion is slowed down. The stomach has to use extra energy to heat it up, as the process of digestion requires warmth. A Chinese friend of mine was shocked by the American habit of drinking iced water even at breakfast. This strains the stomach and spleen to the extent that it can bring the digestive process to a standstill and cause many digestive problems as well as contributing to some people retaining water or becoming obese. Insufficiently chewed or indigestible food (like my unsoaked muesli!) will also put a burden on the stomach,

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which has to use up large quantities of energy to break the food down to a digestible liquid. Chinese medicine therefore puts great emphasis on the quality of the food sent down to the stomach to be digested. After food has been ‘rotted and ripened’ by the Stomach, the Spleen transforms and moves it. Each nutrient will ultimately become one of the Vital Substances such as Qi, Blood, Body Fluids, Jing-essence or Shen. This will in turn nourish us physically, mentally and emotionally. If the Spleen is functioning poorly, or we eat badly, this can cause tiredness, poor skin and hair quality, bowel problems, stomach ache, weak limbs and poor muscle tone (Hicks, 2005, pp.141–144). It can also affect our concentration and memory. A weak Stomach and Spleen can lead us to start worrying and over-thinking.

The Large and Small Intestine Chinese medicine also recognises the role of the Large and Small Intestine in the process of assimilating our food and drink, as does Western physiology. If they are weak this may result in digestive problems such as loose stools, constipation, rumbling bowels or bloating in the abdomen. Chinese medicine notes that a weak Small or Large Intestine can also affect us mentally. If the Small Intestine function is weakened we may have difficulty ‘separating the pure from the impure’ physically. This can in turn affect our mind and we can have trouble making clear choices in our life. If the Large Intestine is imbalanced we may be unable to excrete mental ‘waste’ and may hang on to old resentments and feelings. We may also harbour negative thoughts that

Chinese Dietetics

are better discarded (Hicks, 2005, pp.135–137 and pp.147– 148). A good diet is important for our health at all levels of our being. I’ll now look at the first of the five aspects of eating a healthy diet – the proportions of the food we eat.

What are the best proportions of grains, pulses, vegetables, fruit and meat in the diet? Chinese medicine recommends a diet containing more fruit, vegetables, grains and other carbohydrates, and less meat, sugar and fat than most Western diets. As a general measure of proportions, a diet should be made up of 40–45 per cent fruit and vegetables, 40–45 per cent grains and pulses and about 10–15 per cent meat, fat, seafood and dairy produce, which are considered to be ‘rich’ foods. I will look at each of these in turn. Vegetables and fruit

Grains, pulses and other carbohydrates

‘Rich’ foods such as meat, fish, poultry, eggs, dairy produce, fats and oils

Pie chart of proportions of food

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Fruit and vegetables Chinese medicine considers fruit and vegetables to be nutritious because they are a living food, rich in Qi. In spite of much publicity about eating ‘five a day’, they are still sadly lacking in many Western diets – especially among some teenagers who badly need them in order to grow into healthy adults. Cooked vegetables are considered to be more easily assimilated by the body than raw ones. Because they are warm they also put less strain on the digestion than cold raw vegetables. Raw vegetables and fruit are also more eliminating, whilst cooked ones are more building for the body. Anyone who is depleted in energy will benefit from eating cooked vegetables. It is best to eat organic and fresh vegetables and fruit, in order to gain the full benefit of the vitamins and minerals available from them. There will be a more detailed explanation of the difference between cooked and raw food later on in this chapter.

Grains, pulses and other carbohydrates We can incorporate grains into our diets in the form of cooked grains, bread, noodles and porridge and include them in soups and stews. Chinese medicine considers rice to be one of the most nourishing grains to eat as it is neither too Hot nor too Cold. It also clears away Dampness. Dampness is formed when Body Fluids don’t move through the body properly and it can generate symptoms such as retention of body fluids, heavy limbs, a bloated sensation in the abdomen as well as poor concentration, lethargy and a muzzy, heavy head.

Chinese Dietetics

As well as rice, other grains, such as millet (eaten more in Northern China) and also wheat, oats, barley and rye can be used. Wheat, oats and rye are considered nutritious but tend to be more Damp forming than rice – although Spelt or Kamut varieties of wheat are less so as they have a low gluten content. Wheat has been selectively bred over the last 50 years so that it has become more glutinous. This makes it more ‘sticky’ for the baking process and thus more Damp forming. Many people find they are wheat intolerant and too much wheat can make them put on weight even if they are not a ‘coeliac’ with an allergy to wheat.1

A simple way to lose weight? A colleague, aged 50, was overweight and had found it difficult to lose it for as long as I had known her, until recently when a miracle happened – over the last year she has lost six stone! She told me that as well as eating a balanced diet, the weight loss is mainly down to the fact that she has stopped eating wheat. I used to work in a bread shop and bakery when I was 16 and I remember the atmosphere being foggy with flour everywhere. Before I worked there I was quite skinny. Then suddenly I started putting on weight. I ate a lot of wheat when I worked there but it was almost as if the wheat got into me through my skin as well. I now find that whenever I eat wheat I put on weight immediately. As long as I stay off it I continue to stay slim. When I eat wheat I also crave chocolate and sugar more. When I stop eating wheat it stops all cravings not just for wheat. 1 For more information on coeliac disease see www.celiac.com.

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I have heard similar stories repeated by many other people. In fact I avoid wheat myself as eating it makes me hold water in my body. If you notice you put on weight easily and for no reason, although this might not be the cause, it is worth investigating just in case.

Pulses Pulses include lentils, aduki beans, kidney beans, chickpeas, mung beans and tofu, which is made from soya beans. Soya bean products and mung beans are both considered to be Cold foods and should be balanced with more Warming food. It is best to eat fermented soya, which is more easily assimilated than ‘modern’ alternatives such as soya milk and other processed soya products (Fallon and Enig, 2001).

‘Rich ’ foods Meat, fish, poultry, eggs, dairy produce, fats, oils and sugar are highly nutritious foods that are very rich in quality. Because of the high concentration of nourishment they contain, Chinese medicine considers that they should only be eaten in small amounts and make up 10–15 per cent of the whole diet. Many Western diets are too heavily biased towards meat and dairy products, with far too few cooked vegetables. The result of eating too much of these foods is that the body can produce Damp and Heat. Some examples of these symptoms are inflammation and some headaches, as well as aggression and irritability.

Chinese Dietetics

Some people react against a diet that includes large quantities of meat. They may decide to become vegetarian instead – but is this a healthy option?

Is it better to be a vegetarian or a meat eater?

A vegetarian diet It is becoming increasingly popular for people to become vegetarian. There are a number of reasons for this. One reason is that many people decide to stop eating meat on ethical grounds as they feel that it is incompatible with their spiritual beliefs. A second reason is that people don’t like to think of eating animals that have been badly treated or cruelly slaughtered and decide not to eat any meat as an expression of their feelings. A third reason for not eating meat is that some people say that it is healthier to be a vegetarian than to be a meat eater. Chinese medicine would disagree with this last suggestion although practitioners wouldn’t recommend that people eat large quantities of animal products. A small amount of meat can be a vital constituent of many people’s diet as the protein found in animal products helps to form the Blood in our bodies. ‘Blood’ deficiency is different from anaemia, as you will see in the case study below. It can lead to insomnia, poor short-term memory, anxiety and jumpiness, cramps, pins and needles and brittle nails. Another symptom is a pale dull face. I had recently heard that some young girls had become vegetarian to make themselves look fashionably paler. I wonder if they would have been so keen on this diet if they had known the other effects it was having on their health.

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An almost vegetarian diet In general, a diet with a small amount of meat products is considered the healthiest. Some people have called this an almost vegetarian diet. About two to three ounces of meat three to four times per week is a good balance. If a person decides they cannot eat meat for religious or ethical reasons then it is important that the rest of the diet is as well balanced as possible. Chinese people often cut their meat, fish or poultry into small strips and mix it with their rice or noodles. Vegetarianism in China is rare. I was once told by a Chinese colleague that some people in China are now becoming vegetarians. He added that they usually put gravy on their food in order to substitute for the meat!2

Patricia’s dietary headache Patricia looked tired and pale when she came for treatment. She was 18 years old and studying for her A levels. Sometimes I get headaches every day and then none at all. I last had some a fortnight ago and they went on continually. They’re a constant dull ache usually across my forehead but occasionally all over my head. When I have them it’s hard to concentrate on my studying. They often start in the middle of the day and I can go to bed with one and wake up with it again in the morning. She had very few other symptoms that she was aware of although her periods were rather scanty, her nails broke easily and she also occasionally felt 2 There are some Chinese herbal formulae that can help people who need more nourishment because they are vegetarian. For more on this see Chapter 5.

Chinese Dietetics

light-headed. The symptoms she related added up to a picture of ‘Blood deficiency’. I wondered why this was happening. The answer was provided when she talked about her diet. She had become vegetarian 18 months before and when she recounted what she ate on a normal day she described a diet of sandwiches, crisps and chocolate bars. A few cooked meals were thrown in and she ate very few vegetables. She had become vegetarian along with many of her friends. She was not morally opposed to eating some meat but was a little resistant to the idea. I explained that it would help to ‘strengthen her Blood’ and that a better diet generally would make her feel better. She came to see me again a week later telling me, ‘I’m not Blood deficient. I’ve had a blood test and my doctor says my red blood cell count is fine.’ Like many people she had thought that the Chinese term ‘Blood deficient’ meant that she was anaemic. I explained that this not the case and Blood deficiency was determined by a pattern of signs and symptoms that a person has, not by a low blood count. Armed with her new understanding she went away and decided that she would see what happened if she ate some meat as well as more vegetables for a while. Her headaches gradually improved. She reported feeling more energetic and that she could concentrate better on her studying. She got through her exams without having any headaches at all and decided to stay on her new diet and continue to eat a small amount of meat.

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How is the temperature of food important in our diets? As well as eating food in the correct proportions we can also take care over the temperature of the food we eat. This is the second important aspect of a healthy diet. The Chinese class all food as either ‘Hot’, ‘Warm’, ‘Neutral’, ‘Cool’ or ‘Cold’. The term ‘temperature’ means the Warming or Cooling effect they have on the body rather than whether they are physically hot or cold. Lamb, chocolate, eggs and butter are all Heating or Warming, as are many foods that have a high fat content. Mangoes, bananas, grapes and bean sprouts are all Cooling or Cold, as are many fruits or raw foods. The list in the box on the following pages describes some of the most common foods and their temperatures.

The effect of food on our digestion By closely observing our bodies we can often tell if a food is more Heating or Cooling; for example, a friend of mine will sweat on his head if he eats garlic, which is a warming food. A hot ‘toddy’ made from whisky, lemon and honey is a surefire way of heating us up so that we can sweat and eliminate a common cold from the body. We can notice the effect of too much Cold food on our digestion, which needs to be kept warm. For example, we may get a ‘stomach upset’ if we eat too much fruit, or stomach pains from drinking too much cold beer in the summer. A close colleague had loose bowels all through his student days; it was only when he later learned about Chinese medicine that he realised that it had been because of his diet. He had almost lived on yoghurt during that time and said, ‘I had thought that such vast quantities were good

Chinese Dietetics

for me!’ Like many of us he hadn’t known that yoghurt was an extremely Cold food.

Eating more Cool, Warm and Neutral food In general, it is better to eat foods that are neither too Hot nor too Cold in their nature. We can also endeavour to balance the Hot and Cold foods we eat. Eating too much Hot food will give us health problems concerned with Heat, which may be headaches, red bloodshot eyes, night sweats and generally feeling physically hot and ‘hotter’ tempered. Eating too much Cold or Cooling food can often affect the digestion and cool down the Stomach giving us bloating, stomach pains, diarrhoea, cold limbs and even period pains in women if the lower abdomen gets too Cold. If we eat extremely Hot food we can balance it with more Cooling food and vice versa. We can also balance our food according to the climate – a warming soup or stew will nourish us on a cold winter’s day especially if it has a small amount of ginger added, whilst fruit can be far more appetising in extremely hot weather.

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Some common foods and their temperatures3 Hot Black pepper, butter, chicken fat, chillies, chocolate, cinnamon bark, coffee, crispy rice, curry, ginseng (Korean), dried ginger, lamb, onions, peanut butter, sesame seeds, smoked fish, trout, whisky, white pepper.

Warm Barley, beer, beef, black-eyed beans, brown sugar, chamomile, caraway, cheese, chestnut, chicken, chive, egg yolk, dates, garlic, fresh ginger, ginseng (Chinese), green (bell) pepper, ham, kale, kidney beans, leeks, lobster, miso, molasses, mussels, oats, parsley, parsnip, peach, pomegranate, potato, prawns, quinoa, raspberries, sage, shrimps, soya oil, squash, sunflower seeds, thyme, turkey, turmeric, walnuts, vinegar, wine.

Neutral Aduki beans, apricots, beetroot, black tea, bread, broad beans, brown rice, buckwheat, cabbage, carrots, cherries, corn, egg white, chickpeas (garbanzos), ginseng (American), grapes, honey, hot water, lentils, kidney beans, milk, olive oil, oysters, peanuts, peanut oil, peas, plum, pork, raisins, rosehip, red beans, rye, salmon, soya milk, sugar (white), sweet potatoes, turnip.

3 Originally published in the first edition of this book and subsequently in Hicks (2011).

Chinese Dietetics

Cool Alfalfa sprouts, almonds, amaranth, apples, asparagus, barley, broccoli, cauliflower, celery, chicory, corn, fish, mushrooms, mango, millet, mung beans, oranges, pears, pineapple, radishes, rhubarb, salt, seaweed, soya beans, soya sauce, spinach, strawberry, tangerines, wheat, wheat bran, wild rice.

Cold Banana, bean sprouts, cucumber, duck, grapefruit, green tea, lettuce, ice cream, kelp, peppermint, salt, seaweed, sorbet, sugar cane, tofu, tomato, water melon, yoghurt.

Should we eat cooked or raw food? Some books tell us that eating raw food is one of the best ways to get all of the nutrients we need from our diet. Chinese medicine would disagree. It maintains that we should lightly cook most of our food. Raw food is Cold and is also less digestible. Digesting cold raw food takes more heat and energy from the Stomach than warm cooked food. Raw food, if analysed scientifically, may be found to be higher in certain nutrients such as vitamin C than food that has been cooked, but this does not mean that this extra nourishment is assimilated better by the body during the process of digestion. A patient told me that he was worried about his daughter who was going through a ‘nervous breakdown’ and I agreed to see her without delay. The daughter, who was 25 years old, told me, ‘I started eating a raw food diet six months ago. At the time I felt better and had much more energy.’ She had started the diet in June when it was warm. By December she

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didn’t feel well. It was a very cold winter and she was still eating mainly uncooked food. When I saw her in February she was hardly coping with her life at all, ‘I have no energy and I keep bursting into tears at the slightest difficulty.’ I advised her to change her diet immediately. She started eating more balanced quantities of food as well as cooking it, and over some months gradually regained her health and equilibrium. A 30-year-old female patient complained that she felt the cold very badly. She was surprised when I suggested that she should stop eating salads and change to cooking her vegetables. Her reaction was a mixture of surprise and relief. Like me she had been trying to eat salads every day as she was told they were good for her, but she had never really enjoyed them. My suggestion made her realise that she instinctively preferred to eat Warmer food. Many people are similar to her and if they listen to their body they will naturally change to a more balanced diet. Others who are more sensitive to heat may benefit from Cooler food. In general, it is best not to eat a lot of extremely Cold or Hot foods. If possible, it is best to choose foods from the Cool, Warm or Neutral categories.

Flavour of food and their associated organs Bitter (Heart and Small Intestine) Alfalfa, asparagus, beer, broccoli, celery, chicory, coffee, grapefruit rind, lettuce, radish, raspberry leaf tea, turnip, vinegar, watercress.

Chinese Dietetics

Sweet (Stomach and Spleen) Aduki beans, apple, apricot, barley, beef, beetroot, cabbage, carrot, celery, cheese, cherry, chicken, chickpeas, coffee, courgette (zucchini), corn, cucumber, dates, grapes, grapefruit, honey, kidney beans, lamb, lettuce, malt, mandarin, mung beans, mushroom, orange, milk, oats, peach, peanuts, pear, pineapple, plum, pork, potato, radish, raspberry, rice, spinach, strawberry, sugar, tomato, walnut, wheat, wine.

Pungent (Lung and Large Intestine) Black pepper, cayenne pepper, cabbage, cherry, chilli, cloves, cinnamon, cumin, garlic, green (bell) pepper, horseradish, leek, marjoram, mint, mustard, nutmeg, peppermint, radish, rosemary, soya oil, turnip, watercress, wheat germ, wine.

Salty (Kidney and Bladder) Barley, crab, duck, garlic, ham, kelp, lobster, millet, mussel, oyster, pork, salt, sardine, seaweed.

Sour (Liver and Gall Bladder) Aduki beans, apples, apricot, blackberry, blackcurrant, cheese, crab apple, gooseberry, grape, grapefruit, green leafy vegetables, lemons, lychee, mandarin orange, mango, olive, peach, pear, pineapple, plum, pomegranate, raspberry, sour plums, strawberry, tomato, trout, tangerine, vinegar.

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How are the flavours of food important for maintaining our health? The flavour of our food is the third major aspect to consider in our diet. There are five main flavours: Bitter, Sweet, Sour, Pungent and Salty. Many foods have two tastes; for example, vinegar is both Bitter and Sour, barley is both Salty and Sweet and turnip is a combination of Pungent and Bitter. For a more detailed account of the effects of the flavours on the body see Chapter 5.

Sweet foods You may notice from the list of the foods in the box on page 178 that many of them have a Sweet taste. Sweet is the flavour that affects the Stomach and Spleen. A certain amount of a mild Sweet taste will benefit our digestion and support our Qi. It is interesting to note that Chinese medicine considers many foods, such as rice, chicken, cabbage and carrots, to have a sweet taste and to be nourishing. This mild and Sweet taste is very different from the taste of sweet associated with chocolate and candy. People frequently crave chocolates and sweets because their Stomach and Spleen have been weakened. A small amount of mildly Sweet-tasting food will strengthen the Stomach and Spleen, whilst extremely Sweet foods will make them more deficient. This creates a vicious circle of craving more and more Sweet foods whilst the Stomach and Spleen become increasingly weak. We already know that the Stomach and Spleen are responsible for transforming all of our food and drink in order to nourish us. A weak Stomach and Spleen cannot carry this out and this can result in malnutrition and very deficient Qi.

Chinese Dietetics

The correct balance of each taste Although it is important to balance the tastes in our diet, this doesn’t mean that we should eat them in the same quantities. Bitter food is Cooling and can help to cool fevers and other Heat problems such as inflammation. Pungent foods move obstructions in the Qi and can help a common cold or clear phlegm or mucus in the body. Because of their dispersing actions, bitter and pungent food should only be used in small quantities if our Qi is deficient. People are frequently advised to avoid salt in their diet. Salt is the taste connected with the Kidneys – this is understandable as it regulates the amount of moisture in the body and one function of the Kidneys is to balance the fluids in the body. An excessive amount of salt in the diet is not appropriate, as this will deplete the functioning of the Kidneys, especially if a person retains fluids. A small amount of salt, on the other hand, can be beneficial if a person is too Dry as it will encourage moisture in the body. The Sour taste has an astringent action, so it stops leakages and firms up tissues in the body. It is helpful for a number of conditions, including loose bowels, urinary incontinence or prolapses. A milder Sour taste can be taken in larger amounts than a strong Sour flavour. Sweet can also be taken in larger quantities, as long as it is the mild variety described above. The quantity of each taste we need also depends on the constitutional balance of our Organs as well as our current health. For example, if we have a certain condition, such as a cold or flu, we may eat foods with certain tastes in small amounts and this can be helpful. We need to be careful, however. Sometimes if we know that a food is beneficial in small quantities we can get overenthusiastic and start

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to overeat it. It can then have damaging effects instead of benefits. Often it can be easier to avoid the foods that may be detrimental rather than including too many foods for their specific benefits and then overeating them!

Craving foods If we crave a certain taste in food this may be an indication that the associated organ is out of balance. A small amount of the food may enhance the functioning of that organ. Large quantities may make the imbalance more extreme.

How can we ensure that the food we eat is of good quality? You now know that you can eat a healthy diet simply and easily by balancing the proportions of grains, beans and carbohydrates, vegetables and fruit, and meat, and that you can adjust the temperature and tastes of your food according to your needs. We’ll now consider the fourth of the five main aspects of our diet, which is to eat good-quality food. Here are some simple guidelines about the quality of the food we eat. We can endeavour to eat pure, fresh food whenever possible, to take food that is in season and grows in our own area and to eat a wide variety of foods. We shall discuss each of these in turn.

Eat fresh, organic food The 20th century has brought about the bulk production of food. Crops are sprayed with chemicals, animals are injected with drugs and both are produced on a mass scale instead of cared for on small farms. We have easy access to a huge variety of foods that were unobtainable to previous

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generations, who ate the simple foods that grew around them. It is impossible and unnecessary to reverse this process of change, but the broad rules that we can follow are the same as in the past. In general it is best if we eat vegetables and meat that are organic or homegrown, fresh and in season. Most supermarkets now sell organic food and there are an increasing number of local farmers’ markets or companies that deliver. It is horrifying to realise that an apple has probably been sprayed over 26 times in its short life or that with much of the meat we eat we are also eating hormones, antibiotics and other chemical additives!4

Processed food We can also avoid food that is over-processed. You may be surprised to know that frozen peas often have added sugar to ‘enhance’ the taste and oranges are often injected with colour so that they ‘look’ nice.

Strong foods and neutral foods We can avoid an excess of any one food in the diet. It is natural to eat some foods, such as grains and vegetables, regularly, especially a particular vegetable which is in season. It is less useful to eat one food in large amounts, even if it is good for us in small quantities. For example, an occasional orange might be very healthy, but an excess of oranges in the diet or in the form of juices can encourage the formation of phlegm in the chest. A small amount of coffee can be a special ‘treat’, but large amounts taken throughout the day can cause us to become over-stimulated. In this state we override our body’s messages telling us to stop when 4 For more information go to PETA’s (People for the Ethical Treatment of Animals) website: www.peta.org.

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we need to rest. In the short term we get much work done; in the long term we may become exhausted and drain our reserves of energy. We then need even more coffee to keep us going. The end result of this lifestyle can be severe health problems. If we eat these ‘strong’ foods in small amounts, and more Neutral foods in larger amounts, we will feel healthier mentally as well as physically. Many hyperactive children calm down if they have sugar and food additives cut out of their diets. Balancing our diet as adults can also have farreaching effects and allow us to become more settled and peaceful inside. How we feel inside is also affected by the way we eat our meals.

Sun Simiao – the ‘king of medicine’ and innovator in dietary therapy Sun Simiao was born around 581 ad and is one of China’s most famous doctors, often known as the ‘king of medicine’. Temples to his memory were built in Beijing and Jiangxi in China. He is said to have been a sickly child and strengthening his own health encouraged him to become a Chinese medicine doctor. He was an advocate of good nutrition, having noted that many diseases were curable by consuming the proper foods and that diseases could be caused by eating food that was uncooked, unclean, or poisonous, or by overeating or not chewing one’s food well.

Chinese Dietetics

He practised all areas of Chinese medicine and wrote books on acupuncture and herbs as well as lifestyle generally. He is credited with recognising that goitre could be cured with seaweed, which contains iodine, and thyroid glands from deer and sheep. He successfully treated night blindness with livers from oxen and sheep, which contain vitamin A, and treated beriberi caused by vitamin B1 deficiency by using unpolished rice. He was especially concerned that all patients should be treated equally and is known for his text On the Absolute Sincerity of Great Physicians where he wrote: A Great Physician should not pay attention to status, wealth or age; neither should he question whether the particular person is attractive or unattractive, whether he is an enemy or friend, whether he is a Chinese or a foreigner, or finally, whether he is uneducated or educated. He should meet everyone on equal grounds. He should always act as if he were thinking of his close relatives (Ass, 2005).

How is it best to eat our food? The last of the five aspects of good dietary practice is how and when to eat our food. Many people eat their lunch as they walk along the street while shopping or going about their business. In the US it is even common for snack bars to have tables where people stand to eat – this is presumably better for business as it gives a quicker turnover than if seating is provided! ‘Eating on the run’ is a bad Western habit that leads us to eat

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over‑stimulating foods because we don’t take the time to sit and let a simple diet nourish us properly. If we follow the rules below we will get more nourishment from our food.

Relaxing whilst eating First, we really need to relax while we eat and give our digestion time. It is best to eat in pleasant, relaxing surroundings. This is not always possible for those who have small children or a busy life but we can avoid over-stimulating circumstances, such as eating while watching the television or reading. It is best to give our food our full attention, to take the time to sit down and eat our meal and to allow time after eating for digestion to take place. Chinese people will often take two hours for their lunch, eat at a leisurely pace and even take a short nap after eating.

Chewing our food Second, we need to chew our food thoroughly. There is a saying that we should, ‘drink our food and chew our drinks’. If we chew our food until it becomes a fluid it will aid the first stage of digestion, which is in the mouth. Here the saliva starts to break down the food, which then gets passed on to the Stomach in a predigested state. Allowing ourselves time to eat will remind us to chew our food thoroughly and enhance our digestion.

Don’t wash down your food Third, it is best not to drink too much while we are taking our meals. If we ‘chew’ our drink we will take it in small amounts. Drinking too much fluid at mealtimes swamps the digestion and washes our food down rather than allowing it

Chinese Dietetics

to be thoroughly ‘rotted and ripened’. A small warm drink can be taken a little before the meal and our main fluids between meals when we are not digesting our food.

Eat until you are 75 per cent full Fourth, it is a good idea to eat until we are 75 per cent full. This will allow our Stomach and Spleen to digest their contents thoroughly. If we overeat and then feel full and bloated, we are straining these organs and food will sit in the Stomach for too long. This will, in turn, make us feel tired after the meal as we are using extra energy for digestion. To sum up, it is best for us to eat our food without distractions and to give ourselves time to digest it properly. If we chew our food thoroughly this will help the process of digestion. Sipping only a small amount of warm liquid before eating and nothing during meal times will allow the food to be digested properly rather than washed down. Finally, we only need to eat until we are 75 per cent full so that the Stomach and Spleen don’t have too much to assimilate.

When is it best to eat?

Eat regularly It is best to eat at regular times. The Stomach likes regularity. Sometimes we have to miss a meal or eat at an unusual time if an unexpected situation arises, but this is preferably the exception rather than the rule. There is a saying that we should ‘eat breakfast like a king, lunch like a prince and a supper like a pauper’. If we eat well at the beginning of the day it will set us up with enough energy to last through the morning. If we don’t eat any breakfast we can become exhausted well before

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lunchtime and our blood sugar will drop. People often crave something sweet like cakes or chocolate bars to get a quick energy boost when they feel this drop. These will then overstimulate the Stomach if they are eaten regularly.

Don’t eat late at night If we eat heavy meals very late at night our digestive system will be actively digesting food when we should be sleeping. This may result in insomnia or vivid dreams and we then don’t feel rested when we wake in the morning. On the whole it is best that we eat our last meal of the day in the early evening so that our food is digested before we go to bed. In the next part of this chapter I will talk about which foods we can include or avoid in our diet to help us when we have specific imbalances.

What foods can I avoid for specific health problems? Following a healthy diet in the way that I have described – that is by eating the correct proportions of food and balancing the temperatures and tastes – will usually be enough to keep us in reasonable health. For severe health problems it may be advisable to see a practitioner of one of the branches of Chinese medicine described in the other chapters of this book. Treatment with acupuncture, herbs, massage or Qigong can then be supplemented with a healthy diet for the maximum effect from the treatment. There are some foods that we can avoid in order to gently shift the balance of our health in a positive direction.

Chinese Dietetics

If we are too Hot we can avoid foods that will heat us up. These include red meat, curries, greasy foods, alcohol and coffee. Other foods are listed in the ‘Hot’ and ‘Warm’ section of the box on page 176. We will know if we are too Hot by our symptoms. These may include feeling hot all over or on our hands, feet and chest, also symptoms of bleeding such as nose bleeds or excessive uterine bleeding, hot flushes, restlessness, dry red eyes, night sweats or a red face. A person may also be prone to getting angry or irritable. Cooling foods can be avoided if we are too Cold. These include any food taken straight from the refrigerator as well as raw vegetables and fruit, mung beans and soya produce. Other ‘Cold’ or ‘Cooling’ foods are mentioned in the box on page 177. If we are too Cold we may become more listless and tired, feel the cold very easily and even get numb extremities in cold weather. We may also get aches and pains such as joint, stomach, abdominal or period pains, which feel better with the application of heat. If we have too much Dampness or Phlegm we may get symptoms such as oedema, swelling and bloating, poor concentration, heavy limbs or a muzzy head. Foods that should be avoided are dairy products, which create mucus in the system, greasy food such as French fries or fatty meats, peanuts, concentrated fruit juices, especially orange juice and tomato juice, and also sugary foods. There are some situations where we can include foods in the diet rather than avoid foods.

Are there any foods that I can include in my diet for specific health problems? If we are too Dry we may have symptoms such as dry skin, or any extreme dryness in other body parts such as the eyes, lips

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or throat. To remedy this imbalance we can include ‘wetter’ food in our diets such as sauces, stews and porridge. Dryness can also be caused by Blood deficiency (see below). If, on the other hand, we are too wet or have Damp symptoms we can eat drier food and cook our food by grilling or baking. It is also possible to include small amounts of heating foods in our diet if we are too Cold, such as adding a little ginger to our morning porridge or garlic to our soups and stews. We can add Cooling foods if we are too Hot. Chinese medicine considers mung bean soup a Cooling meal on a hot summer’s day and soya produce is also very Cooling. Very Hot or Cold foods should only be taken in small quantities. As I said earlier, it is better to stick with Warm or Cool foods. We also need to include lots of neutral foods to keep our diet balanced. If we are deficient in Blood, with symptoms such as poor memory, excessive anxiety, a pale dull face, scanty periods, pins and needles or cramps from poor circulation, then we need to eat more ‘Blood-forming’ foods. The most common of these are animal products such as meat, poultry and fish. Leafy green vegetables and beans are also helpful, as well as dates, apricots and figs.

Christine stops dairy produce Christine is 43 years old and is an acupuncturist. Looking at her now it is hard to believe that she was permanently ill until her mid 20s. A change in her diet restored her health and created an interest in alternative medicine. I was a district nurse and I was permanently exhausted and depressed, in fact I had been like that for as long as I could remember. I also had very

Chinese Dietetics

loose bowels and discomfort in my abdomen, and every time I ate I got palpitations. I decided to go to my GP, who suggested that I saw a cardiologist. Frightened by this I looked around for something else. Fortunately a colleague suggested that I tried cutting out dairy produce. Within three weeks everything had changed completely, my heart had stopped pounding, my bowels improved and best of all my energy was wonderful. I was enjoying activities like swimming that I had never done before. Everything about my work and life shifted in perspective. I’d been so gloomy and flat and now I was enjoying my life like never before and it has continued to this day. In time, Christine decided to train to become an acupuncturist. She now has a large thriving practice. From the perspective of Chinese medicine my symptoms were caused by a weak Stomach and Spleen which couldn’t digest the milk leading to a milk ‘allergy’. With hindsight I think I would have gone on to get a serious bowel disease if I hadn’t changed my diet at that time.

How should I go about changing my diet? To recap, the five main aspects of eating healthily are eating the correct proportions of food, balancing hot and cold food and eating lots of neutral foods, including many tastes in our diet, eating good-quality food and remembering the best times and conditions in which to eat.

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The best method of making lasting changes is to make them slowly. A rapid change will often just as rapidly reverse itself and old habits will then easily reinstate themselves. We can look at our diet as a whole and decide which healthy foods can easily be included. This will often involve taking more cooked vegetables and grains. Once we have included good new habits in our diets, the bad old ones will often naturally drop away. If they don’t, we can decide to reduce unhealthy foods slowly until we have cut them out. Sometimes it is best to go to a practitioner of Chinese medicine to get advice about changing the diet. The practitioner will then give support while the changes are being made.

Will changing my diet be enough to restore my health? This may depend on a number of factors – the main one being whether a bad diet is the root cause of our ill health. If it is, then a change in diet will improve our health substantially. Often dietary changes will maintain good health in a patient who has been helped by acupuncture, herbs or massage treatment. It will also help the process of change to better health if used alongside other treatments. We are in charge of what we eat. By eating well we can take responsibility for our own well-being. ‘When is the right time to change my diet?’ you might ask. The answer is, start right now.

Chinese Dietetics

Hot, Warm, Cooling, Cold and Neutral foods

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9

Which One Shall I Choose? The Right Treatment for Me

This last chapter is dedicated to discussing some of the practicalities of having Chinese medicine treatment and finding a good practitioner. We will consider these questions. • How do I decide whether I need treatment? • Which treatment shall I choose? • What’s the best way to find a practitioner? • How can I tell if my practitioner is well qualified? • How can I tell if this practitioner is right for me? • Should I consult my doctor before seeing a practitioner? • How can I keep myself healthy?

How do I decide whether I need treatment? In this age of pollution, industrialisation and fast living everyone can benefit from some form of treatment if they wish to have it. It is a challenge for many people to live a balanced lifestyle and they may not get enough nourishment from

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eating, sleeping, working and exercising. Wind, Cold, Damp, Dryness and Heat – the external causes of disease – can still affect us too. Most of us have warm and wellprotected houses, but we are not immune from the effects of the climate. Internal causes of disease, such as sadness, grief, anger or fear, could have caused us distress in recent years or during our childhood and still be negatively influencing our health. We may decide that now is the time to deal with them. Having said this, some people need treatment more than others and people who generally feel well may prefer to look after their health by caring for their diet and exercising regularly (see Hicks, 2011). People go for treatment for different reasons. Many would like help with specific symptoms. Some don’t have a ‘named condition’ but know they feel unwell. Others want treatment in order to stay well or even prevent disease. The nature of Chinese medicine diagnosis is to look for the potential cause of a problem and not merely to deal with named complaints, so treatment can help in any of these varying circumstances. Here are some different reasons why people decided to try Chinese medicine. ‘I knew that if I didn’t act now I would be put on strong medicines and I decided to try and avoid them.’ ‘I went to my doctor complaining that I felt tired and unwell. He could find nothing wrong with me. I felt as if I was making it up. I was so relieved when my acupuncturist said that something could be done for me.’ ‘When I decided to try herbs it was really a last resort, I don’t know what I would have done if they hadn’t worked.’

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‘I didn’t have much wrong with me but I was clear that my health was important and I wanted to remain well.’

So which treatment shall I choose? We may decide to have a particular treatment for one of these reasons. 1. We have a preference for that treatment. 2. The treatment is available to us in our area. 3. We think a particular treatment can help us best. 4. A particular practitioner has been recommended. We’ll talk about each of these in turn.

We have a preference for one particular treatment The best Chinese medicine treatments to choose are the ones that we feel drawn to. Having read this book we may feel excited by the idea of being treated by acupuncture, curious about tui na, intrigued by Qigong or fascinated by Chinese herbs. If we do feel a strong pull towards a particular treatment, that’s the one to choose – assuming it is available.

The treatment is available to us in our area It is no use choosing to have acupuncture or learn Qigong if we can’t find a competent practitioner or teacher. At present there are some areas where there are many practitioners available so it may be hard to choose between them all. There are also other areas where there are very few people practising.


In the UK and many parts of the US and Europe there are many more people qualified in acupuncture than in any of the other forms of Chinese medicine. This is partly because acupuncture was the first Chinese medicine treatment for which training was available in the West and also because it is a very effective treatment. Many, though by no means all, practitioners use more than one Chinese medicine therapy. For example, most herbalists are also qualified acupuncturists. Many acupuncturists also practise some tui na. Although Qigong practitioners are often based in the cities rather than in the small towns, their numbers are growing too. Dietary advice can usually be obtained from any practitioner of Chinese medicine.

We think a particular treatment can help us best Different treatments certainly have a reputation for treating specific conditions. Acupuncture is well known for treating joint problems, arthritis, headaches and other kinds of pain. However, acupuncture is an effective treatment for countless other complaints, including emotional and mental problems, digestive disorders, gynaecological complaints, fatigue and general weakness, as well as being used as a preventative treatment. The same goes for treatment using herbs, which have gained a reputation for treating skin disorders and gynaecological complaints and improving general deficiency disorders with great success. Herbalists might be proud to tell you of all of the other problems they have treated such as joint problems, allergies, bowel complaints, chest conditions and many other disorders.

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The list of conditions that each branch of Chinese medicine can treat is endless and the distinction between which treatment is best for which disorder is blurred. Once more, it is not so much a question of which condition can this treatment help, as can this treatment help this particular patient?

A particular practitioner has been recommended A recommendation is an excellent way to help us to decide where to go for treatment. When we hear that a particular practitioner has helped someone else with treatment it reassures us that she or he is trustworthy and has knowledge of the potential effectiveness of her or his treatments.

Choosing a therapy In general it is best to use acupuncture, herbs or tui na when we are already ill. The help of a supportive practitioner can be very important when we are going through difficult times and to assist us back to health. Qigong and dietary advice will support us alongside these treatments. Qigong and diet are also useful to help us to maintain our health and can be used once we have regained our health. If we decide to practise Qigong or to have dietary advice it is best to go to classes or to get good advice to start us off.

What’s the best way to find a good practitioner? You don’t necessarily need to go to the first clinic you find. Many excellent practitioners are not the ones you first come across on the high street. The best way to find a good practitioner is by word of mouth. We can ask around among our friends, colleagues


and acquaintances to find out who has a good reputation in our area. Some clinics of complementary medicine are well known and can be recommended for having high-quality practitioners who give first-rate treatment. Before going to any practitioner make sure they are properly qualified. If there is nobody around to recommend a practitioner, the next best way to find out who is in your area is from the professional body of that therapy. Most have a database or list of practitioners on their website and this will help you to find a good local practitioner if one is available. Some of these professional bodies are mentioned at the back of this book. Another way of finding a practitioner is to use Google or another search engine. Again, make sure that any practitioner you choose is well qualified, belongs to a professional body and has good communication skills. Be aware that a flashy website does not show that someone is well qualified so always check someone out. Many practitioners are happy for you to come for a 20-minute chat to help you to decide if this is a practitioner you think could help you.

How can I tell if my practitioner is well qualified?

Acupuncture, herbs and tui na Make sure that your practitioner is registered with a recognised professional body. Members are bound by the Code of Ethics and Code of Practice of that society, which will maintain high standards of discipline and health and safety to protect the general public. Acupuncturists, Chinese herbalists or tui na practitioners who are members of a professional body have probably been well trained over a period of at least three years.

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Practitioners who are well qualified will ask questions about your health and other important areas of your life in order to make a full diagnosis at the first appointment. If they practise acupuncture, Chinese herbs or tui na they will also feel the 12 pulses at the wrist and look at your tongue. If necessary they will also examine your spine or joints and feel for any temperature variations on your body.

Dietary therapy As I said earlier, most Chinese medicine practitioners will also give you dietary advice, as this is an integral part of their basic training.

Qigong Qigong is different. To tell whether Qigong teachers are well qualified a person can ask them who they trained with and their ‘lineage’ of teachers. A lineage is the traditional line of teachers who have passed on their knowledge from teacher to student. It is also advisable to ask the other students in the group how they have benefited from the practice.

How can I tell that this practitioner is right for me? It is crucial that we trust that our practitioner is capable of helping us. We don’t have to believe in any of the treatments for them to work – in fact they can all be used successfully on animals or children – but treatment tends to progress faster if the patient feels safe in the care of his or her practitioner. Some practitioners will talk to their patients more than others and patients themselves each prefer different amounts of conversation. No matter whether we discuss our condition and other health needs or not, another essential ingredient


of successful treatment is good rapport. The patient might ask, ‘Do I like this practitioner and feel he or she likes me?’ One famous traditional doctor has described it as essential for a practitioner a have a ‘good heart’. Some comments patients have made about their practitioner are listed here. ‘She made me feel comfortable when I talked to her and I knew without doubt that she could help me.’ ‘I felt an immediate sense of “I can trust this person” and I felt the same way throughout treatment.’ ‘I felt great empathy from him, I think he understood.’ ‘I’ve been to three practitioners. They’ve all been very different and have helped me in different ways.’

Should I consult my doctor before going to a practitioner? Although it is unnecessary for patients to tell their doctor that they are receiving treatment, there is no harm in letting him or her know. If, however, patients are taking medication or are under the constant care of a doctor then it is advisable to inform the doctor of their intentions. Many doctors welcome the idea of their patients trying one of these complementary treatments. When I first started practising acupuncture 35 years ago, many doctors actively told their patients not to have treatment and, as a result, patients would often lie to their doctors or at least not mention their complementary treatment. The climate has changed radically in a short space of time.

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What if I am already taking prescribed drugs for my condition? Acupuncturists, Chinese herbalists and tui na practitioners are trained to understand the effects of prescribed medication and will only ask patients to reduce their drugs when they are ready and if it is appropriate. Mild medications are usually reduced slowly as patients’ health improves. For example, patients will stop taking painkillers as their pain decreases or stop taking sleeping pills as their insomnia improves. If you are on stronger medication your practitioner will usually ask you to consult your doctor so that you can withdraw your medication with your doctor’s support. Treatment will continue for as long as a patient needs it. In some cases, coming off medications can take a long time and the support of the practitioner can be helpful. Patients may never come off some medications but can still benefit from Chinese medicine treatment. This applies to ‘replacement’ drugs. For example, patients may always require insulin for diabetes, vitamin B12 for pernicious anaemia or corticosteroids for a condition known as Addison’s disease. Whatever our condition when first coming to treatment, at some point we might expect to attain relatively good health. So once we are healthy how do we maintain it?

How can I keep myself healthy? Once you have regained your health, many practitioners will suggest that you continue to have treatment less frequently or at the change of season in order to keep your energy strong. A healthy lifestyle is also advisable. A good diet, a positive attitude in all situations and regular exercise will also support your health (for more information on lifestyle see Hicks, 2011).


Exercising Regular exercise can become a valuable routine in a person’s life. When I visited China and Hong Kong I was surprised by the number of Chinese men and women who regularly exercised every morning in order to keep well. Many people practised Qigong or other health exercises every day in the parks or in their homes before starting work. This was followed by a healthy breakfast to set them up for the day’s work.

Diet Eating healthily means being careful about our diet without being rigid. We can strive to carry out the guidelines suggested in Chapter 8, on diet which are: 1. Eat the correct proportions of food. 2. Balance Hot and Cold food and eat lots of Neutral foods. 3. Include many tastes in our diet. 4. Eat good-quality food. 5. Remember the best times and conditions in which to eat.

A positive attitude Finally a positive attitude will go a long way to keeping us healthy. As Confucius said: If I were to sum up my whole philosophy in one sentence I should say: allow no negativity into your thoughts. When life presents us with adversity, it is not always easy to find the ‘positive lessons’ that come from those situations, especially when they are painful. There are always things we

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can learn, however, and finding them rather than hanging on to bitterness or regrets can change a destructive attitude, which leads to poor health, into one from which we can grow and change and consequently become healthier.

A final thought By the time you have read this book you will have a good overview of Chinese medicine and its possible effects in treatment. If we respect and care for ourselves we are capable of leading long, happy and healthy lives. Chinese medicine understands the importance of good health and that it is the root of a satisfying life. They also say that, ‘Even a journey of one thousand miles begins with a single step.’ We can decide to take that step now – so that we can be empowered to take our good health into our own hands. I hope you enjoy your journey!

References

Ass, H.-M. (2005) ‘Emergency management in public health ethics: triage, epidemics, biomedical terror and warfare.’ Eubios Journal of Asian and International Bioethics 15 (September 2005). Cherkin, D.C. (2009) ‘A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain.’ Archives of Internal Medicine 169, 9, 858–866. Ee, C.C., Manheimer E., Pirotta M.V. and White A.R. (2008) ‘Acupuncture for pelvic and back pain in pregnancy: a systematic review.’ American Journal of Obstetrics and Gynecology 198, 3, 254–259. Ferrara-Love, R., Sekeres, L. and Bircher, N. (1996) ‘Nonpharmacologic treatment of post operative nausea.’ Journal of PrieAnesthesia Nursing 11, 6, 376–383. Frantzis, B. (2001) Relaxing into Your Being. Berkeley, CA: North Atlantic Books. Frantzis, B. (2006) Tai Chi Health for Life. Berkeley, CA: North Atlantic Books. Haake, M. (2007) ‘German acupuncture trials for chronic low back pain.’ Archives of Internal Medicine 167, 17, 1892–1898. Hicks, A. (2005) The Acupuncture Handbook. London: Piatkus. Hicks, A. (2011) 88 Chinese Medicine Secrets. Oxford: HowTo Books. Lewis, K. and Abdi, S. (2010) ‘Acupuncture for lower back pain: a review.’ Clinical Journal of Pain 26, 1, 60–69. Li, J., Li, J., Liang, F., Hong, Y. et al. (2012) ‘Electroacupuncture at PC6 (Neiguan) improves extracellular signal-regulated kinase signaling pathways.’ Evidence-Based Complementary and Alternative Medicine. doi:10.1155/2012/792820. National Institute for Health and Clinical Excellence (NICE) (2009) ‘Low back pain: Early management of persistent non-specific low back pain.’ Clinical Guideline 88. London: NICE.

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National Institute for Health and Clinical Excellence (NICE) (2012) ‘Headaches: Diagnosis and management of headaches in young people and adults.’ Clinical Guideline 150. London: NICE. Sawazaki K., Mukaino Y., Kinoshita F., Honda T. et al. (2008) ‘Acupuncture can reduce perceived pain, mood disturbances and medical expenses related to low back pain among factory employees.’ Industrial Health 46, 4, 336–340. Shaw, J., Bidgood, P. and Sacbi, N. (2007) ‘Exploring acupuncture outcomes in a college clinic. Patient profile and evaluation of overall treatment benefit.’ European Journal of Oriental Medicine 5, 4, 55–63. Sherman, K.J. and Coeytaux, R.R. (2009) ‘Acupuncture for the treatment of common pain conditions: chronic back pain, osteoarthritis, and headache.’ Journal of Clinical Outcomes Management 16, 5, 224–230. Sherman, K.J., Cherkin, D.C., Ichikawa, L., Avins, A.L., et al. (2009) ‘Characteristics of patients with chronic back pain who benefit from acupuncture.’ BMC Musculoskeletal Disorders 10, 1, article 14. Weidenhammer W., Linde K., Streng A., Hoppe A. and Melchart D. (2007) ‘Acupuncture for chronic low back pain in routine care: a multicenter observational study.’ Clinical Journal of Pain 23, 2, 128–135. Witt, C.M. (2006) ‘Pragmatic randomised trial evaluating the clinical and economic effectiveness of acupuncture for chronic low back pain.’ American Journal of Epidemiolgy 164, 5, 487–496. World Health Organization (WHO) (2003) ‘Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials.’ Geneva: WHO. Zhang, Y. H. and Rose K. (1999) Who Can Ride the Dragon? Brookline, MA: Paradigm Publications.

Further Reading

Acupuncture Hicks, A. (2010) The Acupuncture Handbook. London: Piatkus. A comprehensive look at acupuncture for patients and the general public, giving information about all aspects of acupuncture theory, diagnosis and treatment, as well as a list of the wide-ranging conditions that acupuncture can treat. Hicks, A., Hicks, J. and Mole, P. (2010) Five Element Constitutional Acupuncture. Edinburgh: Elsevier. A textbook for those who want to explore Five Element Acupuncture more deeply. This describes the main features of treatment using the Five Element Constitutional style of acupuncture. Kaptchuk, T. (2010) Chinese Medicine: The Web that has no Weaver. London: Rider. A classic, comprehensive guide on the theory and practice of Chinese medicine. Maciocia, G. (2005) The Foundations of Chinese Medicine. Edinburgh: Elsevier. A textbook for those who want to study traditional Chinese medicine in depth.

Herbs Hicks, J. (2013) Principles of Chinese Herbal Medicine. London and Philadelphia: Singing Dragon. An introductory book giving you everything you need to know about Chinese herbal medicine, for the general public and patients. Warner, J.W. and Fan, A. (2005) Manual of Chinese Herbal Medicine: Principles and Practice for Easy Reference. Boston, MA: Shambala Publications Inc. A book for Chinese herbal medicine study and reference.

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Yi, Q. (2000) Formula Study Guide. Boulder Colorado: Snow Lotus Press. A more in-depth guide for practitioners giving Chinese herbal medicine formulae.

Qigong Frantzis, B. (2006) Opening the Energy Gates of Your Body: Chi Gung for Lifelong Health. Berkeley, CA: North Atlantic Books. This book has become a classic that has inspired tens of thousands of Westerners to practise Qigong. It suits beginners, with enough meaty detail and depth for the advanced martial artist, healer or meditator. Frantzis, B. (2010) Dragon and Tiger Medical Qigong. Fairfax, CA: Energy Arts Inc. Describes the Dragon and Tiger Movements that are mentioned in this book. A DVD of this simple practice is also available from: www. energyarts.com. Lam, K.C. (1991) The Way of Energy: Mastering the Chinese Art of Strength with Chi Kung Exercises. New York: Gaia Books. An easy-to-read and comprehensive guide to ‘standing like a tree’ Qigong.

Tui na Jiangshan, L. (2011) Tuina/Massage Manipulations: Basic Principles and Techniques. London and Philadelphia: Singing Dragon. This comprehensive introduction is written with the needs of the student and beginning practitioner in mind and covers all the basic principles of the manipulation techniques required to practise tui na. Pritchard, S. (2010) Tui na: A Manual of Chinese Medical Massage Therapy. Edinburgh: Elsevier. This book is for practitioners of tui na and provides a clear and complete introduction to the principles and practice of tui na. It covers all of the techniques, from the basic techniques, compound techniques and most commonly applied techniques through to passive movements.

Further Reading

Diet Hicks, A. (2011) 88 Chinese Medicine Secrets. Oxford: HowTo Books. A self-help book that reveals the profound yet simple health maintenance secrets that Chinese medicine has developed over many centuries. It has a substantial chapter on Chinese dietary therapy. Lampert, G. and Blyth, D. (2006) Chinese Dietary Wisdom. Reading: College of Integrated Chinese Medicine. Available from: www.cicm.org.uk. Chinese dietary advise for each constitutional type, arranged for everyday use. Simple and useful. Leggett, D. (1999) Recipes for Self Healing. Totnes: Meridian Press. Explains how to apply dietary principles with simplicity and elegance. This book conveys the wisdom and insights of Chinese medicine and makes them both relevant and accessible to the modern Westerner. Pitchford, P. (2002) Healing with Whole Foods: Oriental Traditions and Modern Nutrition. Berkeley, CA: North Atlantic Books. A more comprehensive primer on nutrition, which includes facts about many different foods, along with an inspiring cookbook with more than 300 mostly vegetarian, nutrient-packed recipes.

General Hicks, A., and Hicks, J. (1999) Healing Your Emotions. Reading: College of Integrated Chinese Medicine. Available from: www.cicm.org.uk. This book describes how people’s emotions relate to the characteristics of their Five Element constitutional types. Frantzis, B. (2008) The Chi Revolution. Berkeley, CA: North Atlantic Books. This book shares once closely guarded, ancient secrets of chi and gives simple, low-impact exercises to give you energy for life. Weeks, P. (2011) Make Yourself Better. London and Philadelphia: Singing Dragon. A holistic and simple guide to using natural techniques including diet and herbal medicines.

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Useful Contacts

Most of the professional bodies listed below are for acupuncturists and herbalists. Most acupuncturists and herbalists also advise on diet. Many tui na practitioners are also acupuncturists and herbalists. For Qigong practitioners you will need to find details of individual teachers.

UK British Acupuncture Council 63 Jeddo Road London W12 9HQ Tel: 020 8735 0400 www.acupuncture.org.uk Register of Chinese Herbal Medicine Office 5 1 Exeter Street Norwich NR2 4QB Tel: 01603 623994 www.rchm.co.uk The Association of Traditional Chinese Medicine and Acupuncture UK 5 Grosvenor House 1 High Street Edgware London HA8 7TA Tel: 020 8951 3030 www.atcm.co.uk

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UK Register of Tui na Chinese Massage 184–186 Westcombe Hill London SE3 7DH  Tel: 07503 737904 www.ukrtcm.org Tai Chi Arts UK www.taichiarts.co.uk If you wish to find out more information from the author you can contact her at: College of Integrated Chinese Medicine 19 Castle Street Reading Berkshire RG1 7SB Tel: 01189 508880 www.cicm.org.uk

US Council of Colleges of Acupuncture and Oriental Medicine 600 Wyndhurst Avenue Suite 112 Baltimore MD 21210 Tel: 410 464 6040 www.ccaom.org American Association of Acupuncture and Oriental Medicine 9650 Rockville Pike Bethesda Maryland 20814 Tel: 866 455 7999 www.aaaomonline.org

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National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) 76 South Laura Street Suite 1290 Jacksonville, FL 32202 Tel: 904 598 1005 www.nccaom.org Qigong – Energy Arts www.energyarts.com

Europe Pan European Federation of TCM Societies (PEFOTS) Geldersekade 87 A Amsterdam Noord – Holland The Netherlands Tel: 20 6892468 www.pefots.com European Traditional Chinese Medicine Association (ETCMA) Servaasbolwerk 28 Utrecht The Netherlands 3512 NK www.etcma.org Professional bodies who are members of ETCMA:

Belgium EUFOM www.etcma.org

Useful Contacts

Belgian Acupunctors Federation  www.acupunctuur-baf.be

Czech Republic Komora TCˇM www.komoratcm.cz

Denmark Praktiserende Akupunktører www.aku-net.dk

Finland The Finnish TCM Society of Acupuncture and Herbs www.finnacu.fi

France Fédération Nationale de Médecine Traditionnelle Chinoise www.fnmtc.fr

Germany Arbeitsgemeinschaft für Klasssiche Akupunktur und TCM e.V. www.agtcm.de

Ireland The Irish Register of Chinese Herbal Medicine www.irchm.com   Acupuncture Foundation Professional Association www.afpa.ie

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Netherlands Nederlandse Vereniging voor Acupunctuur www.acupunctuur.nl

Norway Akupunkturorening www.akupunktur.no Norske Naturterapeuters Hovedorganisasjon www.nnh.no

Sweden Svenska Akupunkturförbundet www.akupunkturforbundet.se

Switzerland Schweizerische Berufsorganisation für TCM www.sbo-tcm.ch

UK British Acupuncture Council www.acupuncture.org.uk

Australia Australian Acupuncture and Chinese Medicine Association Ltd (AACMA) PO Box 1635 Unit 1 55 Clarence Street Coorparoo Queensland 4151 Tel: 733 242 599 www.acupuncture.org.au

Useful Contacts

Australian Traditional Medicine Society PO Box 1027 Meadowbank New South Wales 2114 Tel: 028 878 1500 www.atms.com.au

Canada The Chinese Medicine and Acupuncture Association of Canada 154 Wellington Street London Ontario N6B 2K8 Tel: 519 642 1970 www.cmaac.ca Acupuncture Foundation of Canada Institute 2131 Lawrence Avenue East Suite 204 Scarborough ON M1R 5G4 Tel: 416 752 3988 www.afcinstitute.com

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Index

Entries in italics indicate figures and tables Abdi, S. 18 acupuncture 13, 17, 19, 20, 52, 53, 62–4, 144, 196, 199–200 acupuncture points 68, 79–80 arthritis 83–4 auricular acupuncture 89–90 channels 64–8, 69–71 conditions treated by acupuncture 71–4, 90 cupping therapy 86–7 electro-acupuncture 88 emotions 44 fertility treatment 75–6 guasha 87–8 health 80–1 hygiene standards 77 moxibustion 84–6 needles 77–9 NICE recommendation 17–18, 67 reactions to treatment 81–2 research 62–3, 71–2, 90–1 tender points 68–9 theory of Chinese medicine 76–7 treatment 74, 82, 84 yin and yang 25 acute conditions 73, 82, 89, 110, 114, 150, 151, 158, 159 animal products 94, 106

appendicitis 68 arthritis 52, 71, 90, 197 case study 83–4 Ass, H. M. 185 Association of Traditional Chinese Medicine (ATCM) 114 asthma 16, 79 atractylodes 105 auricular acupuncture 84, 88, 89–90 autumn 23, 26, 45 Ba Zhen Wan 104 back problems 17–18, 25, 67, 82, 86, 87, 150 case study 157–8 balance 24–5, 138, 164 Bian Que 148 Bladder 27, 38, 39, 56 Bladder channel 67–8 Blood 28, 32, 34, 37, 76, 80, 107, 110, 149, 150, 156, 166 Blood and the Heart 33 Blood and the Liver 32–3 Blood and the Spleen 33 diet 164, 171, 173, 190 tongue 58 Body Fluids 28, 36, 37, 76, 107, 149, 166 Body Fluids and the Spleen 36 pulse 57 tongue 58 body-mind connection 16–17

216

Index

breathing 137 British Acupuncture Council (BAcC) 91 Buddhism 123 cancer 110–11, 120 carbohydrates 168–9 channels 63, 64–8, 69–71, 126–7 choosing points along a channel 79 Cherkin, D. 18 children 25, 35, 50 Chinese medicine 13–14, 14–17, 18–19, 20–1, 204 Blood 32–3 Body Fluids 36 Five Elements 37–41 Jing-essence 34–6 Qi 29–31 Shen or Mind-spirit 33–4 Vital Substances 28–9, 37 yin and yang 21–7 chronic conditions 67, 72, 74, 82, 89, 114, 158–9 climatic conditions 45–7 Some golden rules to protect ourselves from external conditions 48 Coeytaux, R.R. 18 Cold 30, 45, 48, 52, 150, 195 colds 30, 49, 87, 88, 104, 112, 150, 181 College of Integrated Chinese Medicine, Reading 62–3, 71, 90 Confucius 203 cupping therapy 84, 86–7

dairy produce 167, 170, 190–1 Damp 14, 30, 36, 45, 48, 52, 150, 195 diet 168–9, 170 skin 108 symptoms 53, 105 dan tian 127, 130, 136 lower dan tian 127–8 diagnosis 17, 18, 20–1, 54, 55–6 theory of Chinese medicine 59–61 tongue diagnosis 58–9 using the pulse 56–8 diet 13, 19, 20, 49, 163–4, 200, 203 almost vegetarian diet 172 carbohydrates 168–9 changing diet 191–2 cooked and raw food 177–8 food flavours 178–82 food temperature 113–14, 163, 174–7 foods to avoid for specific health problems 188–9 foods to include for specific health problems 189–91 fruit and vegetables 168 how to eat 185–7 nutritional recommendations 167–71 pulses 168–9, 170 quality of food 182–5 ‘rich’ foods 170–1 theory of Chinese medicine 165–7 vegetarian diet 171, 172–3 weight loss 169–70 when to eat 187–8

217

218


digestive problems 15, 31, 44, 71, 72 case studies 60, 105–6, 151–2 disease 14, 18, 26, 40 balancing work and play 49–50 climatic conditions 45–7, 47–8 emotions 43–5 exercise 50–1 how disease arises 43, 52–3 internal causes 43 miscellaneous causes 49 physical trauma 51–2 sex 51 The causes of disease 52 The external causes of disease 46–7 treatment 54 Dong Qin Gao 156 drug dependency 90 Dryness 45, 48, 150, 195 eating habits 185–6 chewing thoroughly 186 drinking during meals 186–7 eating late at night 188 eating regularly 187–8 eating until you are 75 per cent full 187 relaxing whilst eating 186 eczema 107 Ee, C.C. 18 electro-acupuncture 84, 88 emotions 31, 39–40 disease 43–5, 195 endometriosis 92–3 Enig 170 exercise 50–1, 129, 203

facial colour 56 Fallon 170 fats 167, 170 Ferrara-Love, R. 70 fertility treatment 75–6 Five Elements 37–8, 40, 55, 76 associations 40–1 Five Elements and the Sheng and Ke cycles 39 interaction 38–40 The Five Element associations 41 food 167 cooked and raw food 177–8 cravings 182 digestion 174–5 eating habits 185–8 food flavours 178–82 food temperature 113–14, 163, 174–7 processed food 183 quality 182–3 specific health problems 188–90 strong foods and neutral foods 183–4 Sweet foods 180 four energies 113–14 Frantzis, B. 134, 135 fruit 167, 168 Gall Bladder 27, 38, 39, 56, 59 Gall Bladder channel 66–7, 68 ginseng 100–1, 105 grains 167, 168–9 guasha 84, 87–8 gynaecological problems 15, 31, 73, 94, 110, 151, 154, 197

Index

Haake, M. 18 headaches 31, 39–40, 67, 145, 150, 170, 175 case study 172–3 health 40, 42–3, 53–4 acupuncture 80–1 Qigong 120–1, 123–5 Heart 27, 32, 38, 59 Blood and the Heart 33 Heart channel 65, 80 Shen or Mind-spirit and the Heart 34 Heat 30, 45, 48, 52, 150, 195 diet 170 skin 107–8 tongue 58–9 herbs 13, 19, 20, 52, 53, 92–4, 144, 196, 199–200 Adjutant herb 99 animal products 106 application to skin 157 Ba Zhen Wan 104 categories of herbs 97–8 Chinese herbal medicine 94–6 conditions treated by herbs 94, 110, 110–11 dried herbs 102–3 Emperor herb 98 four energies 113–14 freeze-dried herbs 103 ginseng 100–1 herbal prescriptions 98–101, 105–6 length of treatment 114–15 Messenger herb 99 Minister herb 99 post-viral syndrome 108–9 powdered herbs 103 preparation of herbs 101–2 psoriasis 115–16 regulations 106–7

research 110–11 Sovereign herb 98 taste 111–13 theory of Chinese medicine 107–8 tinctures 103 Western and Chinese herbal medicine 96–7 Yin Qiao San 104 Hicks, A. 166, 167, 195, 202 holistic approach 15–16, 71–2, 73–4 Hua Tuo and his Five Animal Frolics 122, 133 Huang Fu Mi 121 Jing-essence 14, 28, 34–5, 49, 76, 107, 127, 149, 166 Jing-essence and the Kidneys 35–6 Kidneys 15, 16, 17, 27, 34, 38, 39, 56, 150, 181 Jing-essence and the Kidneys 35–6 Kidney Qi 40, 51 Kingston University 63 Large Intestine 27, 166–7 Lewis, K. 18 Li, J. 70 life cycles 25–6 lifestyle changes 53–4, 82, 202 liquorice 105 Liver 15, 16, 27, 38, 39, 56, 59, 107, 150 acupuncture 76–7 Blood and the Liver 32–3 herbal medicine 102 Qi and the Liver 31, 39–40

219

220


Lungs 16, 27, 38, 57, 79, 107 Qi and the Lungs and Spleen 30–1 martial arts 120 meat 167, 170–1 menopause 25, 35 case study 60–1 mental health problems 16, 34 meridians 63, 64, 126–7 moxa (Artemisia vulgaris latiflora) 83, 84–6 moxibustion 64, 84–6 nausea 70–1 NICE (National Institute for Health and Clinical Excellence) 17–18, 67, 68 Nogier, Paul 89 organic produce 182–3 Organs 26, 27, 37, 40, 55, 76, 107 Blood 32 Five Elements 38, 39 food flavours and associated Organs 178–9 interaction with Vital Substances 28–9 pulse 57 The connection between the yin Organs and the Vital Substances 29 The yin and yang Organs 27 tongue 58–9 osteoporosis 35 pathogenic factors 107, 150 Pericardium 27, 32, 38 acupuncture point 70–1

period problems 15, 32, 33, 73, 80, 190 Phlegm 16 physical trauma 51–2 pinella 106 poria 105 positive attitude 203–4 post-viral syndrome 108–9 pregnancy 18, 70, 75, 76 psoriasis 115–16 pulse 56–8 The twelve pulse points 57 pulses 167, 168–9, 170 Qi 14, 24, 28, 37, 76, 107, 110, 127, 144, 149, 150, 156, 166 acupuncture 63–4 Blood 32 channels 69–71 definition of Qi 29–30 pulse 56, 57 Qi and the Liver 31, 39–40 Qi and the Lungs and Spleen 30–1 Spleen 36 yin and yang 24–5, 25, 26 Qigong 13, 19, 20, 52, 117–18, 119, 200 a moving exercise 135 aligning sitting posture 130–1 aligning standing posture 132–3 benefits 119–20, 138–41 breathing into your lower abdomen 137 development 118–19 different practices 125–6, 130–6 do not strain 138 Dragon and Tiger 120–1, 134

Index

eight brocades 133–4 health 120–1, 123–5 how often to practise 142–3 Hua Tuo and his Five Animal Frolics 122, 133 keeping relaxed 138 lower dan tian 127–8 moving Qigong 125, 133–6 Qigong breathing practice 137 sinking your Qi 136 sitting Qigong 125, 130–1 spiritual development 123 standing Qigong 125, 131–3 tai ji quan 134 teachers 141–2 theory of Chinese medicine 126–7 Western exercise 129 where to practise 143–4 Register of Chinese Herbal Medicine (RCHM) 114 regulation of herbal products 106–7 rest 49–50 Rose, K. 165 Sawazaki, K. 18 seafood 167 sexual activity 51 Shaw, J. 63, 71 Shen or Mind-spirit 28, 33–4, 37, 127, 149, 166 Qigong 123 Shen or Mind-spirit and the Heart 34 Sherman, K.J. 18 shiatsu 147–8 skin problems 71, 73, 94, 107–8, 110, 115–16, 197

Small Intestine 27, 38, 166–7 spiritual development 123 Spleen 15, 27, 32, 38, 39, 150 Blood and the Spleen 33 Body Fluids and the Spleen 36 diet 165, 166, 180 herbal medicine 102, 105–6 Qi and the Lungs and Spleen 30–1 Spleen channel 79 Spleen Qi 44 spring 23, 26, 45 stiffness 117–18, 124–5 Stomach 27, 36, 38, 39, 59 acupuncture points 80 diet 165–6, 180 herbal medicine 102 Stomach channel 68 Stomach Qi 44 summer 23, 25, 26, 45 Sun Simiao On the Absolute Sincerity of Great Physicians 184–5 Swedish massage 147 symptoms 14–15 tai ji quan (tai chi chuan) 134 tangerine peel 106 Taoism 123 tastes 111–12 balance of taste 182 Bitter 113, 164 food flavours and associated Organs 178–9 Pungent 112, 164 Salty 113, 164 Sour 112, 164 Sweet 112, 164 Three Treasures 37 tiger balm 156 tiredness 30, 31, 36, 51, 71, 187, 189

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222


tongue 58–9 Areas of the tongue 59 tonics 97, 104, 110 touch 145–6 treatments 16, 17–18, 194–6 assessing practitioners 199– 200, 200–1 choosing treatments 196 finding practitioners 198–9 medical prescriptions 202 positive attitude 203–4 preferences 196–8 seeking doctor’s opinion 201 staying healthy 202–3 Triple Burner 27, 38 tui na 13, 19, 20, 52, 118, 144, 145–6, 199–200 benefits 160 Bian Que 148 children 159 conditions helped by tui na 150–2 how often 158–9 roots of tui na 146–7 self-massage 160 self-massage for tired eyes 161 skin preparations 156–7 spine manipulation 157–8 theory of Chinese medicine 149–50 treatment 149, 152–3, 153–4, 155–6, 158 tui na and other styles of massage 147–8 University of Pittsburgh Medical Center 70 urinary problems 73, 94, 112, 114, 151, 181

vegetables 167, 168 Vital Substances 27, 28, 37, 40, 55, 76, 107, 127, 149, 166 interaction with Organs 28–9 The connection between the yin Organs and the Vital Substances 29 Wang Wei Yi The Illustrated Manual for Acupuncture and Moxibustion 69 Weidenhammer, W. 18 Western medicine 13–14, 14–17 medication 202 wheat 169–70 Wind 14, 30, 45, 48, 52, 57, 150, 195 winter 23, 25, 26, 45, 46, 47 Witt, C.M. 18 woodlock oil 156 work 49–50 World Health Organization (WHO) 90–1 Yellow Emperor’s Classic of Internal Medicine, The (Huang Ti Nei Jing) 21, 120 yin and yang 14, 21, 37, 40, 55, 107, 110 balance 24–5 four aspects of yin and yang 21–3 life cycles 25–6 Organs 26, 27 Some…characteristics useful to Chinese medicine practitioners 24 The connection between the yin Organs and the Vital Substances 29

Index

The yin and yang Organs 27 use by Chinese medicine practitioners 23–4 Yin/yang and the cycle of seasons 26 Yin/yang symbol and the cycle of day and night 22 Yin Qiao San 104 Zhang, Y.H. 165 Zhong Zhang Jing The Treatise of Cold Induced and Miscellaneous Diseases 95, 96, 101

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