December
Since my return to the mainland and new work with a large integrative medicine clinic, AmericanWholeHealth, I have had little time to work on the newsletter. However, just in time for the holidays and the Winter soltice, here it is..
1) Winter-- Listening, Silence and Wholeness
2) Understanding Chronic Illness
3) NIH Consensus Statement
4) What is our Nature? excerpts from a master
5) Childhood Asthma
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1) Winter--- Listening, Silence and Wholeness
We live in a culture fraught with noise and diversion-so many
distractions pulling at us, promising pleasure, excitement, fulfillment;
so many ways for us to deny our fears and discomforts; so many voices,
inside and out, calling us away from the truth of who we are. What voice
calls us back? Who or what inspires us to rest and remember?In wintertime,
all of nature retreats into the deepest, darkest realms of the earth and
rests. So, too, winter beckons us. She woos us away from the world, calling
us to the stillness of our own deepest realms where truth and wisdom wait
for us. If we are willing to go, Elemental Water will guide us to the rest
and regeneration of the winter. If we sit by a stream or a river for a
while, we can observe how the water always seeks the lowest ground. The
energy of the Water element will carry us down to our deepest selves. We
can acknowledge our courage and fears as we descend. Here in the depths
of nature and self the Creative Truth resides.
One passage to our own depths is through silence and meditation. Practice
provides fertile ground for deep listening. When we are at rest within
our dark interiors, the noise begins to settle and we find the silence
that lives here, the silence that exists between the thoughts of the mind.
"Listening means forgetting ourselves completely-letting go of all self-consciousness."'
Listening means being receptive, becoming the feminine-the yin. As yin,
we become a portal, and we wait. With practice and patience, our internal
silence expands and deepens until it meets the unchanging, universal silence
of the Creative Source.
Listening is one of the secrets of entering into the temple of Truth.
The Creative Source-a vast reservoir of love and compassion-holds all possibilities.
In this reservoir, the Truth resides: the Creative Source provides all
life, nourishment, rest and restoration. When we listen deeply at this
reservoir, the silence soothes and restores us. Thus restored, we can hear
the truth of who we are, and begin to remember our oneness-our wholeness-
and what we came here to do. Remembering our oneness, we are filled with
love, so we overflow. Overflowing with love, we begin to share it with
all around us. While there are many ways for us to express our love, it
is easily shared through being and listening. "It is listening that dissolves
the obstacles that keep us separate from one another and the whole."" And
it is by listening that we become like a womb, fully receptive to the unknown,
willing to wait, to allow the gestation and manifestation of the Creative
Truth. "I give you my listening and you speak your life . . . and together
we bring forth the world.
Matching the
Stillness of Winter
· Relax alone. Rest.
· Stay warm. Bundle up in layers to go out in cold weather.
Protect your face and neck, too.
· Eat warm soups and stews. Drink plenty of water.
· Curl up by the fire (or light candles); read a good book or
listen to your favorite music.
· Move slowly - conserve your energy.
· Dream, and resist any inclination to rush your dreams into
early manifestation
. Meditate. Listen to your inner silence. Acknowledge your fears.
· Listen to another's life story.
The following is information about a common chronic pattern of disharmony from a western, albeit natropathic, view. The pattern describes what the Chinese would call a Spleen defficiency concurrent with Liver Stagnation, one of the most common underlying patterns I see in clinic, and is a sequell from my earlier article on "Stress, a modern day epidemic" from a previous newsletter.
The origins of many chronic health problems can be traced to compromised digestive function, or Slpeen network weakness. Exposure to toxins, intestinal permeability defects and parasitic infections are examples of common conditions associated with gastrointestinal dysfunction which can lead to profound health consequences. These are variuous permutations of the Damp Heat and Food Stagnation syndrones of Chinese Medicine. These conditions may occur independently but often exist together, producing cumulative damage which leads to a cascade of chronic illness. A growing body of research has shown that lifestyle, environmental and nutritional factors play a significant role in the prevention and management of chronic disorders associated with compromised digestive function.
Toxicity due to foreign chemicals, or xenobiotics, can produce damage affecting virtually all organs and systems in the body. Common signs and symptoms of xenobiotic toxicity include weakness, headache, neurologic disturbances, multiple chemical sensitivities, immune dysfunction and liver disorders. The gastrointestinal tract is the most common route of exposure to these toxins and, as a result, the integrity of the mucosal barrier is a key factor in limiting absorption.
Increased intestinal permeability or leaky gut syndrome, results not only in increased absorption of xenobiotics, but also in the increased absorption of endogenously produced toxins (endotoxins), antigens, immune complexes and intact microorganisms normally confined within the intestinal lumen. It is by this mechanism that chronic permeability defects have been shown to contribute to the development of certain autoimmune diseases, liver dysfunction, septicemia and other systemic disorders.
Parasitic infections, candidiasis and other imbalances in intestinal microflora (dysbiosis) can give rise to similar local and systemic problems. Chronic insults to the gut wall produce abdominal pain, bloating, diarrhea, and can lead to the development of malabsorption, inflammatory bowel disorders and ultimately leaky gut syndrome. Endotoxins and antigens produced by intestinal pathogens are then absorbed systemically producing allergic responses, autoimmune illness, liver damage and other toxic reactions.
Under normal conditions, intestinal endotoxins and xenobiotics absorbed from the gut are principally detoxified in the liver. Hepatic detoxication pathways transform toxic molecules into less toxic metabolites which can be readily excreted. This capacity of the liver can become impaired due to excessive exposure to toxins as well as deficiencies in key nutrients. Signs and symptoms of toxicity often occur as a result of compromised liver function.
Successful approaches for the management of gut-associated chronic illness are addressed here in three broad objectives: reducing exposure to xenobiotics, normalizing gastrointestinal function, supporting detoxication. Reducing exposure to xenobiotics decreases the body's burden of toxins. Normalizing gastrointestinal function helps to improve digestion, reduce intestinal endotoxins, eliminate parasites and maintain gut wall integrity. Supporting hepatic detoxication assists the body in transforming and eliminating xenobiotics and endotoxins. This can be done effectively by an integrative approach incorporating both a Traditional Chinese Medicine approach harmonizing the Liver and Spleen, and using supportive nutients for the appropriate disharmony. Gennerally this includes Digestive Enzymes, Probiotics, Fiber, Antioxidants, and Detoxification Factors. These can be supplied through separate concentrated products for the very ill, or as one simple product, Juice Plus, which is flash dried fruits and vegetables with extra enzymes, fiber, and phytochemicals added back in.
The following pages from my Treatments page, discuss each of these objectives in more detail from the western view.
I.
Reducing Exposure To Xenobiotics
II.
Normalizing Gastrointestinal Function
III.
Supporting Detoxication (Dietary recomendations)
As many of you may know, the National Institute for Health held a three
day meeting with experperts regarding the efficacy of acupuncture in the
treatment of disease. To view the official statement you may view
it(click here) at http://odp.od.nih.gov/consensus/statements/cdc/107/107_stmt.html
(cut and paste this into your browser)
or more simply http://www.nih.gov and use their searcg engine to find
acupuncture consensus
Here is a general summary.
Efficacy for Specific Disorders. There is clear evidence that needle
acupuncture is efficacious for adult post-operative and
chemotherapy nausea and vomiting and probably for the nausea of pregnancy.
Much of the research is on various pain problems. There is evidence
of efficacy for postoperative dental pain. There are
reasonable studies (although sometimes only single studies) showing
relief of pain with acupuncture on diverse pain conditions
such as menstrual cramps, tennis elbow, and fibromyalgia. This suggests
that acupuncture may have a more general effect on
pain. However, there are also studies that do not find efficacy for
acupuncture in pain.
While many other conditions have received some attention in the literature
and, in fact, the research suggests some exciting
potential areas for the use of acupuncture, the quality or quantity
of the research evidence is not sufficient to provide firm
evidence of efficacy at this time.
One of the advantages of acupuncture is that the incidence of adverse
effects is substantially lower than that of many drugs or
other accepted medical procedures used for the same conditions. As
an example, musculoskeletal conditions, such as
fibromyalgia, myofascial pain, and "tennis elbow," or epicondylitis,
are conditions for which acupuncture may be beneficial.
These painful conditions are often treated with, among other things,
anti-inflammatory medications (aspirin, ibuprofen, etc.) or
with steroid injections. Both medical interventions have a potential
for deleterious side effects, but are still widely used, and are
considered acceptable treatment. The evidence supporting these therapies
is no better than that for acupucture.
In addition, ample clinical experience, supported by some research data,
suggests that acupuncture may be a reasonable option
for a number of clinical conditions. Examples are postoperative pain
and myofascial and low back pain. Examples of disorders
for which the research evidence is less convincing but for which there
are some positive clinical reports include addiction, stroke
rehabilitation, carpal tunnel syndrome, osteoarthritis, and headache.
Acupuncture treatment for many conditions such as asthma,
addiction, or smoking cessation should be part of a comprehensive management
program.
Many other conditions have been treated by acupuncture; the World Health
Organization, for example, has listed more than 40
for which the technique may be indicated.
"What is the nature of a human being? What is the default? If you begin
to look at it and not interpret it, it has some
very profound implications - good implications - but very profound.For
a moment, maybe we can just imagine a being when it comes into this earth.
I'm sure you all have seen little babies. And what is their nature? Who
are they? This is where you began from. You came into this world,
you breathed, you are alive. You exist. What is your nature?
Are you cruel? Or are you kind? Are you forceful or are you gentle?
Do you express love? Or do you express hate?
What is your default? And if love is the default, that has some incredible
implications. If hate is the default, that has
some outrageous implications.
We know that the nature of fire is to burn. When we understand its nature,
then you can regulate that fire: you can
use it to cook; you can use it to to help you. It doesn't have to destroy
everything.We know that the nature of water is to wet, is to purge, is
to quench. Knowing that, we can use water to quench our thirst, to clean
ourselves, to wash. The nature of water is purity.
What is my nature? I know I can hate, I have the capacity of hating,
and I also have the capability of loving. I now
that. It's very powerful to be able to love, and it's very powerful
to be able to hate. These are no small gidgets or
gadgets. These are very, very significant things in a persons life.
Hate will bring hate. Love will bring love. What do you want? Where
do you want to be? Where do you want to
position yourself? What ultimately do you want in this existence?
Let's just say tat there is this feeling, and I call this feeling love.
If that is my default, then what am I doing to
prevent that feeling from happening Because if that is my default,
that means that if I stop doing everything, that's
where I'll go to. So, if I'm not feeling it, I'm doing something to
make myself not feel it.
So, if in my life, as simple as it may be, my default is peace. I'm
switching here from love to peace because that's
even more profound. After I stop doing doing everything, I am at peace.
That's my core. Then what am I doing that's
causing me not to feel at peace?
Joy is my default. Yours too. What do we do in a day, in an hour, in
a minute to position ourselves away from that
default? To be content is my default, and if I don't feel contentment
in my life, then what am I doing to remove
myself from that contentment?
Tranquillity is my default. Peace is my default. Love is my default.
This is who I am; this is my nature. This is your
nature. It sounds too simple, doesn't it? This little simple picture
that I am painting doesn't quite fit into the working
day of a human being. But it's true. This is who you are.
Accept it. Realize it. Embrace it. Understand that. That's the fundamental
thing. And ten, perhaps you can rechart
what you want and how this life should be..."
Recent studies of asthma conducted in the U.S. have revealed that virtually
all cases are associated with an inflammation
of the bronchial passages. The implication, based on modern pharmacology,
is that the anti-inflammatory corticosteroid
sprays are the drugs of choice. It is known, however, that repeated
application of these steroids can lead to serious side-
effects, including dependence on higher doses or more frequent applications
of the steroids, and adrenal insufficiency. Until
about fifty years ago, adrenaline (norepinephrine) was administered
by injection as a treatment for asthma--it is mainly a
bronchodilator. This drug was later replaced by ephedrine, derived
from the Chinese herb ma-huang, which could be taken
orally and which has a longer action than adrenaline; it has anti-inflammatory
and bronchodilating effects. In recent years,
aminophylline and corticosteroids have been prominent drugs for asthma.
Childhood asthma is differentiated from general bronchial asthma because
many children who suffer from regular
asthma attacks will find the incidence declining with age. This is
probably because hormonal changes, including a change in
the regulatory mechanisms for natural production of corticosteroids,
influence the inflammatory responses. Of course,
should the asthmatic condition fail to resolve at this time, chronic
adult asthma ensues. It has been pointed out that some
pediatric asthma is due to milk allergies.
The theoretical basis of Chinese treatments for pediatric asthma is
that children have a basically vigorous constitution
when considering their Kidney energy: none of the modern formulas contain
the Kidney nourishing herbs used for asthma
and chronic bronchitis in the elderly (e.g. rehmannia, epimedium, deer
antler, lycium fruit and other Essence nourishing
herbs). However, children may suffer from the more superficial condition
of Qi deficiency of the Spleen and Lung, thus
calling for tonic therapies with herbs such as codonopsis, astragalus,
and polygonatum (in the more ancient prescriptions,
aconite, peony, and cinnamon twig were used as tonics). Alternatively,
they tend to suffer from heat syndromes, for which a
variety of cold energy herbs are applied.
The treatment of pediatric asthma is highly experimental at this time.
New formulations, not at all similar to the ancient
prescriptions, are being used in China. For example, in a clinical
study published by the Hubei Journal of Traditional
Chinese Medicine (1989), seventy cases of asthma in children were treated
with Hai Shi Tang, made with mactra shell,
pyrrosia, almond (xingren), and schizandra. It was given two to three
times daily for a period of three days. The major signs
and symptoms were alleviated or eliminated for 84% of those treated;
they could lie down comfortably. The effects of the
decoction were noted an average of 1.5 hours after administration and
lasted for eight hours (after which, another dose
would need to be taken). The mactra shell, like that of other bivalves,
is rich in calcium carbonate which has an
antispasmodic effect. Pyrrosia is listed in the modern Materia Medica
as a treatment for urinary disorders, but it also has
very strong antitussive, expectorant, and anti-asthmatic effects. Almond
(the less bitter alternative to apricot seed,
kuxingren) and schizandra are common ingredients in anti-asthma prescriptions.
In a study published in the New Journal of Traditional Chinese Medicine
(1989), 66 cases of asthmatic bronchitis in
children were divided into two groups. One group received Western medications
(32 cases) and the other (34 cases) received
Chuan Zhi Tang, made with arisaema, platycodon, peucedanum, uncaria,
scute, and licorice. The time required to relieve
the symptoms of asthmatic breathing and coughing were shorter for the
Chinese medicine group than the Western medicine
group by three days (4.9 and 6.5 days for asthmatic breathing and coughing
with Western medicine, and only 1.9 and 3.1
days respectively for Chinese medicine). Arisaema is a phlegm-resolving
agent that is frequently used in treatment of
childhood diseases. Platycodon and peucedanum are common ingredients
in formulas for lung diseases, including bronchitis
due to infection. Uncaria and scute clear heat and relieve spasms.
In a study published in the Chinese Journal of Integrated Traditional
and Western Medicine (1988), a tonic prescription
was given to 40 children 3-12 years old with Qi deficiency who suffered
from asthma. The basic formula consisted of
astragalus, codonopsis, polygonatum (huangjing), agrimony, scute, and
licorice. It would be modified according to specific
symptoms or concerns. For example, with acute symptoms of coughing
and wheezing, perilla seed and mows bark were added; if an acute upper
respiratory ailment occurred, the astragalus and codonopsis was temporarily
eliminated and replaced by isatis root, mows leaf, and schizonepeta; if
diarrhea or loose stool appeared, polygonatum was removed and hoelen and
atractylodes were added; if the appetite was low, citrus and crataegus
were added. Agrimony is a hemostatic that also has strong anti-inflammatory
actions.
A course of treatment was two months and no other therapies were employed
during that period; the asthmatic breathing
was improved by the use of the herb formulas.
A control group of twenty healthy children were also studied. It was
found that GCR (a biochemical that interacts with
leukocytes) and the ratio of cAMP/cGMP (an established measure for
inflammatory responses) in healthy children and in
children who were in a period of remission from asthma showed similarly
high values (OCR: 8840 vs 8550; cAMP/cGMP:
4.6 vs 5.1), while those who were suffering from asthmatic breathing
showed low values (5610; 3.1).
A study of 100 children with asthma, age range of five months to five
years, was reported in the Liaoning Journal of
Traditional Chinese Medicine (1989). Wu Hu Tang, with ma-huang, almond,
licorice, gypsum, camellia leaf bud (camellia
is the source of ordinary green tea), lonicera, trichosanthes fruit,
and earthworm, was used. If phlegm was a problem,
arisaema and chih-shih were added. When asthmatic breathing and irritability
were present, schizandra was added. If blood
stasis was detected by examination of the finger tips, mouth, and lips,
salvia was added. For constipation, rhubarb was
added. Treatment was for three to seven days and was deemed curative
in these cases.
The formulas described above for each of the four studies have notably
different contents, with almost no overlap. In
only the last of these Chinese reports is the herb ma-huang, used in
so many ancient therapies for asthma, utilized. In
contrast, Japanese doctors, perhaps because of the combined influence
of Western medicine and the reliance on ancient
formulas, use ma-huang formulas almost exclusively.
In a Japanese study, reported in 1982, 65 asthmatic children were given
Minor Blue Dragon Combination over an
extended period of time. Of these, 51 responded favorably. In a substudy,
19 of the children were given the herb formula on
an empty stomach and serum cortisol, ACTH, and free fatty acid were
measured at various times thereafter. It was found
that cortisol and ACTH levels increased starting thirty minutes after
ingestion and continued to increase. Another Japanese
evaluation of 31 cases of pediatric asthma treated with Minor Blue
Dragon Combination was reported the same year. The
report stated that four cases were conspicuously effective, twelve
cases were effective, and another four cases were fairly
effective. In the effective cases, most children showed lowered levels
of IgE after medication, while among the ineffective
cases, most children showed no change in IgE, suggesting that this
was part of the mechanism of action (IgE production is
part of an allergy response mechanism). Side-effects were limited to
two cases of soft stool. Similarly, case reports from
Japan of pediatric asthma therapies were presented in the OHAI Bulletin
(1981) with success claimed for use of Ma-huang
and Magnolia Combination and Minor Blue Dragon Combination.
In contrast, a Japanese study of bronchial asthma in 181 children using
the formula Bupleurum and Magnolia
Combination (which does not contain ma-huang) was reported in Wakan
Yaku (1979). In some cases a ma-huang formula,
either Ma-huang and Apricot Seed Combination or Minor Blue Dragon Combination
was used as an adjunct. During
asthma attacks, Western drugs might also be used temporarily. The children
suffered bronchial asthma either from
infection, allergy type reaction, or a mixture. It was concluded that
asthmatic breathing associated with infection responded
better than atopic asthma or mixed types. Since infections are usually
self-limiting, this report suggests that the Bupleurum
and Magnolia Combination was not especially effective. For example,
among 37 children with infectious bronchial asthma,
the attacks subsided completely in 28 of them after a full year of
therapy. The ma-huang formulas used as adjuncts
apparently aided in relieving asthmatic attacks according to the research
report; they are regarded as having a warming
nature.
The reasons for the difference in therapies between China and Japan
is worth exploring further. It may reflect
differences in current thinking about Oriental therapies, differences
in the population groups, or different selection of
patients for treatment. As the result of similar considerations, Western
children might be treated with variations of these
formulas. Mechanisms for the action of the therapies are partly explained
by measures of cortisol, ACTH, IgE, cyclic
nucleotides, and leukocyte stimulators; these may help to better explain
the precise situations in which the herbs and
formulas will prove most effective.