Where's the Bees?

In reading a distillation of an alchemical text, Sir Francis Bacon is paraphrased:

The Ant experiments by haphazardly collecting and using materials, which method indicates the all-too-human tendency to use materials without clearly understanding them.

The Spider neither experiments nor collects but produces webs from its own substance, which method indicates the tendency to formulate hypotheses based upon subjective bias, opinion, and conditioning leading to the confusion of subjective ideas and beliefs with direct perception of truth.

The Bee gathers both the nectar and pollen of many flowers and, little by little, transforms this nectar into honey through individual and collective effort and inherent nature. The product of this labor is then used to feed itself, the community, and the world at large. This method indicates an approach which uses both experimentation and observation (a posteriori); as well as using direct
interior penetration (a priori) in such a way as to eliminate the abuse of either, or the confusion of the one for the other. Assistance and guidance throughout the process is provided by a community of expert practitioners; the end of which is the transformation of the self and society in the service of all Life and the Source of life.

The disappearance (and hopeful reemergence) of the honey bee can thusly be seen as a metaphorical extension of man in the world today. I find myself thinking about the current climate talks in Copenhagen and what it truly means to practice Chinese Medicine as a bee.

Blue Fire

The caelum, then, is a condition of mind. Envision it as a night sky filled with the airy bodies of the gods, those astrological constellations which are at once beasts and geometry and which participate in all things of the world as their imaginal ground. The caelum does not of course take place in your head, in your mind, but your mind moves in the caelum, touches the constellations, the thick and hairy skull opens to let in more light, their light, making possible a new idea of order, a cosmological imagination whose thought accounts for the cosmos in the forms of images.

-- James Hillman

The Holy Longing

Tell a wise person, or else keep silent,
because the massman will mock it right away.
I praise what is truly alive,
what longs to be burned to death.

In the calm water of the love-nights,
where you were begotten, where you have begotten,
a strange feeling comes over you
when you see the silent candle burning.

Now you are no longer caught
in the obsession with darkness,
and a desire for higher love-making
sweeps you upward.

Distance does not make you falter,
now, arriving in magic, flying,
and, finally, insane for the light,
you are the butterfly and you are gone.

And so long as you haven't experienced
this: to die and so to grow,
you are only a troubled guest
on the dark earth.

-- Goethe

The Fifth Month and Hexagram 44

As things tend to do this time of year, my regular post for this month is a bit late. The fifth month started on June 5th with the seasonal qi of “grain in the ear" which is a reference to the corn harvest and also contains the qi of the "summer solstice" which occured on June 21st. The month will end on July 6th. In a way, my tardiness is good because this month is all about relationships and warmth of people (as opposed to the cold clickity-clack of computers). I don't know about you, but it has been really difficult to concentrate on school work in the midst of finals - all I want to do is hang out with friends and eat food and enjoy the sights and smells of a Portland that seems otherworldly from the dark winter of last.

Hexagram 44, 姤, is translated as Coupling, Meet, Rendezvous, Intercourse, or the Royal Bride. It is wind beneath heaven and aligning with the organ of the Heart, this hexagram is really about connection and contact: it's the spaces (distance and proximity) between all of us as individuals where the magic happens and where we can discover who we really are as an individual.

Here's the hexagram text:

《姤》女壯，勿用取女。

A strong or royal woman, do not marry such a woman.



《彖》曰：《姤》、遇也，柔遇剛也。「勿用取女」、不可與長也。天地相遇，品物咸章也。剛遇中正，天下大行也。《姤》之時義大矣哉！


The image says: Encounter, a meeting, be soft yet firm in the meeting. Do not marry such a woman, for it will not last. Heaven and earth are both meeting, they produce the rules of all things. Firm and equitable meetings, produces great movement under heaven. Encounter is a time of great honor!!!



《象》曰：天下有風，《姤》。后以施命誥四方。
The image says: Below Heaven there is Wind, Encounter. The queen uses this to carry out her imperial mandate int the four directions.

The idea of wind below heaven indicates to me an exchange on a purely energetic level that is not to be cemented into the material. The sage uses this energy to draw into himself while simultaneously connecting to the will of heaven. This is a good time to see that our desires are not to be placed into the material realm, but to appreciate the ever-changing nature of the flow of energy, which at this time is pivoting.

Wilhelm writes:

This hexagram indicates a situation in which the principle of darkness, after having been eliminated, furtively and unexpectedly obtrudes again from within and below. Of its own accord the female principle comes to meet the male. It is an unfavorable and dangerous situation, and we must understand and promptly prevent the possible consequences.

on healthcare costs

The hot topic of the moment, and likely for the next few years unless something drastic happens, is healthcare. The Obama administration is attempting to revamp the insurance system, which is in dire straits. The question is, how to balance quality care with affordable care? The criticism for nationalized healthcare is that it becomes inefficient and slow, and lacks quality. People use Canada as an example. Though prioritization is certainly a problem when you have a lack of doctors and services, quality does not, necessarily need to suffer. This is the argument from the free-market champs who believe that the free-market is the only mechanism that can deliver the best quality. But as we've seen in the auto industry with respect to fuel efficiency, this is far from true. The so called "free-market" focuses on making profits, not delivering superior goods. The latter is only true if you have customers making informed honest decisions based on good information. But because corporations are required to make money, they often use obfuscation and dishonesty to bolster the image of their product. So we aren't operating in an environment where customers can really make informed decisions because they are being duped or expected to be experts in fields that they clearly can't be. (e.g. the recent financial crisis).

In terms of health insurance the problems are deeper because you: 1) don't know how sick you will be in the future, 2) can't understand exactly what you're buying and 3) the cost structures are inherently very complicated with rules about what is covered and what isn't. When you add in the necessity of healthcare, the customer not buying the product isn't really an option (though because of costs, it does happen). This sets up a market that is incredibly difficult to navigate for a customer. Therefore as customers we find ourselves in a position where the insurers want us to engage in "preventive medicine" but at the same time, they won't pick up the bill for such care.

As a future healthcare practitioner, I'm encouraged by examples of doctors who have tried alternative fee structures such as subscription services. For example, a doctor in New York, charges his patients $54-$130 a month depending on their age. They get unlimited access to him and he even makes house calls. He encourages his patients to get emergency coverage, and they have to pay for their own medications. But because he sees fewer patients, he gets to spend more than the disgustingly low average of 15 minutes with his clients. This extra time allows him to really streamline his patients treatments, often reducing the number of medications that they are on to half. This is real cost savings to the patient, and the system as well. Less referrals to specialists, and more patient-doctor interaction is a good thing for everyone.

on alternative medicine research

A big question arises in the scientific realm whether alternative medicine is actually helpful or not. Whereas alternative medicines like Chinese Medicine (CM) are bottom-up treatments (individually custom) with top-down (holistic) theories, western medicine is typically bottom-up theory (molecular and chemically based) and top-down treatment (applying the law of averages to individuals). This is the main problem of designing randomized controlled double-blind trials to a holistic theory medicine like CM. In western medicine, it is usually fairly straightforward to come up with a diagnosis for a common disease; there is typically a physical marker such as a blood count, antibody, or hormone level that can be tested and isolated outside of the body. But in CM such an isolation does not exist, and as a result we can see 5 patients with prostate enlargement and have 5 different reasons why each patient developed the enlargement. Moreover, the treatments will be completely different depending on the CM diagnosis.

In a recent article on alternative medicine research, the problems that are addressed don't even distinguish this important point. Instead of looking at the diagnostic criteria of an alternative medicine, most studies use conventional diagnoses and alternative treatments to measure effectiveness. Because of this very basic error in study design, the studies are largely unreliable. Most of the studies designed by practitioners of CM even miss this point, in an effort to try to "legitimize" their medicine. It is a difficult situation with no easy answers, because in actuality the 5 patient with prostate enlargement could see different doctors and have different diagnoses. This further complicates the problem in terms of designing studies in the typical western fashion, but what it does for the medicine is make it extremely powerful and potent. In CM we have individuals with particular lineages and viewpoints treating individuals with customized diseases. In conventional medicine you have individuals treating individuals according to the law of averages and statistics. Both are useful, but measuring the effectiveness of something like CM with western methods is not fruitful unless these differences are understood and taken into account when the study is designed. Until such a study is designed, it seems that case-based studies are our best avenue of information in CM.

the rhythm of life and light

Just read an interesting post about circadian rhythms and the classification of people into 3 categories: Hummingbirds (those that follow the normal sleep wake cycle of the sun), Larks (those that wake up very early and are at their best before noon), and Owls (those that don't peak until about 6pm or later). Apparently there are health benefits and risks associated with each group, the genetic factors of which largely contribute. But an important factor is exposure to light, especially sunlight:

" In brightly lit offices, the light levels are some 200-300 times less than they are outside on a sunny day. Even a cloudy day is some 20-30 times brighter."

So even though those fluorescent lights at work seem bright, they are still not cutting the mustard in terms of conditioning. When we add Vitamin D synthesis into the mix, the modern office worker is coming up short on two very big counts.

The article also discusses familial advanced sleep phase syndrome (FASPS) which is a genetic disorder where people fall asleep around 7:30pm and wake up around 3-4am. Though genetic, Chinese Medicine has a lot to say about such a disorder. The time of 5-7pm is considered the time of the Kidney in CM. This is the time when the yang qi is held by the yin qi for sleep (hexagram 12). If a person is yang deficient, they are going to be somnolent during this time: the yin qi is too great. At 3-4am we have hexagram 11, which is associated with the Lung. Here the opposite is true. Because the yang qi was deficient, the yin qi is not engendered at night causing a yin deficiency leading to early waking with up-rushing yang qi. So this type of a pattern could be a mixed deficiency picture of yin and yang, also known as yin and yang not communicating. The formula Si Ni Tang instantly comes to mind.

Immortal Combat

Firewater

The New York Times has been hitting the bottle pretty hard in the health section recently (here, here, and here). And for good reason. Everywhere we turn these days it is easy to see just how integrated drinking is with our lives. Whether it's the after-work drink to unwind or the weekend party the firewater presents a slippery slope of enjoyment and gradual destruction. I know for myself, and especially in my mid-twenties, I would frequently bust my ass all week working for high-pressure start-ups in silicon valley and sitting in traffic for two hours a day. The way I coped with the stress was to drink myself into the occasional blackout every saturday. I would spend sunday recovering and do it all again the next week. I think this is common, and although I have some pretty funny stories to go with the times that I can remember, the effects on my health were extreme. This could have continued, and might have, had I not been struck with my own version of a meltdown that caused me to re-examine my life. In my case, I was using the drinking as a crutch, as an avoidance of my lack of happiness. I didn't like my job, even though I was told I was good at it. My heart was missing something: a direction and purpose in life that was bigger than what I was living. I drank to ease the pain of this misdirection.

One of the above articles mentions to look for signs of alcohol abuse before it actually becomes alcoholism:

1. Repeatedly drinking more than self-set limits.
2. Having a persistent desire to quit or cut down.
3. Drinking and driving.
4. Spending too much time drinking.
5. Having hangovers or a sleep disorder.

Recognizing these trends can stop a problem before it manifests, which is truly what preventative medicine is all about. For myself, I was definitely guilty of some of these during those days. I still notice a trend in myself, that when the going gets tough, the tough makes martinis (maybe not tough enough: malt liquor?). What is interesting is the relationship of alcohol and the Liver in chinese medicine, and how alcohol in small amounts moves the Liver Qi which can counteract depression, but in larger amounts consumes the Liver Yin (the Blood). This can lead to a vicious cycle that ultimately ends in total dependency, tragedy, and often death. What one of the articles doesn't realize is the ironic co-morbidity of depression and alcoholism. In my opinion, and in my case, the former often times leads to the latter.

I grew up with a family where alcohol was just part of everyday life, but the perils of its abuse were unspoken.

I think its time to speak up.

The fourth month and Hexagram 1

I was mistaken in some of my previous posts when I was talking about the months and the corresponding hexagrams. As it turns out, the hexagrams and months are more appropriately tied to the cycles of the 24 jie qi as opposed to that of the moon. This makes sense actually, because the hexagrams have many agricultural interpretations that are more relevant to the jie qi.

So this means that the fourth month started on 立 夏, "the beginning of summer," which was on Tuesday May 5. This month will include this seasonal qi as well as the next one 小 满, "lesser (grain) fullness" which begins on May 21 and continues until June 4. During this time, we also experience the energy of the auspicious hexagram 1, 乾 which is often translated as "The Creative" and is all 6 yang lines.


The Yi Jing text:
大哉「乾元」，萬物資始，乃統天。

Great! The beginning of all material things, all are ordered under heaven. 



雲行雨施，品物流形。

Clouds move and rain falls, giving rise to the movement and form of all things.



大明終始，六位時成。

Great brightness from beginning to end, 6 positions of successful times. 



時乘六龍以御天。

It is time to ride the cart pulled by the 6 heavenly dragons.



乾道變化，各正性命。

Qian is the dao of change and transformation, supporting the correctness and truth of every life. 



保合大和，乃「利貞」。

Safely coming together ensures great harmony, auspicious. 



首出庶物，萬國咸寧。

Every creature's head emerges, and all nations are peaceful.

Of all the hexagrams this is the most auspicious, most grand, most promising. Under normal circumstances this is a time when all things can be achieved. However, at this particular moment in time there are some crazy western astrological trends afoot that indicate that we should be a little cautious. If you tend to be a bit lazy (like me recently) this month things will generally be a bit easier for you to get things done, meet new people, and proceed on some goals you have set. If you're a busy little bee that tends to not rest, relax, or find your center on a regular basis, this could be a month of burnout of both the mental and physical. But because of the way these things work, you probably won't notice the fallout or rewards until sometime in June. In a phrase: stay balanced, but enjoy the precious creative movement forward.

Stephen Karcher translates Hexagram 1 as "Dragon" or "Inspiring Force"

Force or Inspiring describes the situation in terms of primal power of spirit to create and destroy. Its symbols are the inspiring power of Heaven, the light of the sun that causes everything to grow, the fertilizing rain and the creative energy of the Dragon that breaks through boundaries. You are confronted with many obstacles. The way to deal with them is to persist, for you are in contact with fundamental creative energy. Take action. Be dynamic, strong, untiring, tenacious and enduring. Continue on your path and don't be dismayed. Ride the power of the Dragon and bring the fertilizing rain. Your situation contains great creative potential. It can open up a whole new cycle of time.

Concentration and your higher self

In recent studies on concentration, researchers have determined that all the noise and chatter that our visual and auditory cortex is constantly subjected to is filtered by a coherent firing of neurons in the frontal cortex, called gamma waves. In information processing, most models posit some form of bottom-up construction of the external world in our brain, but in this case there is a significant ability to affect the visual field in a top-down fashion. That this over-riding mechanism of attention occurs in the new (evolutionarily speaking) area of the pre-frontal cortex should come as no surprise. This area of the brain is often equivocated to the 6th chakra, Ajna Chakra, which is responsible for balancing the energies from Shiva (object) and Shakti (subject) to create a sense of psychic knowing or 'seeing' through this 'third-eye.' In this light, the research is interesting because it reveals physical evidence of both form (visual stimulus) and function (our ability to attend to it or not). Practicing meditation trains this part of our brain for concentration and allows us to focus on that which we want to focus on instead of what assaults us on a daily basis. In Chinese Medicine, this visual stimulus is associated with the Stomach network where the outside world is internalized and integrated into our self. Just as we can choose our food, we choose what we attend to. Just as we can be driven mad to the point of indifference with our choices of food (Thai? Indian? Burgers? Pizza? Italian? Nepalese?) we can become comfortably numb to the chaotic cacophony that is city life.

Aporkalypse Now: Swine Flu and Chinese Medicine

Ok, I stole the title from here. But by now you've heard about the terribleness that is the latest resurgence of swine flu. Face masks are in people. But as the authors discuss, making public health policy decisions (do you immunize a population, do you restrict travel, etc.) are difficult to make when you don't know very much about the nature of the virus and the deaths it has caused.

But chinese medicine is rich in a history of treating this type of epidemic outbreak. In fact, based on the symptom picture that the disease presents with, swine flu could fall under what is termed "Triple Yang Disease" where wind cold attacks Taiyang and simultaneously turns to heat in the Yangming and Shaoyang layers. Chai Ge Jie Ji Tang is the indicated formula for such symptoms as: severe but gradually decreasing aversion to cold and shivering that turns into increasing fever, mild sweat, head and body aches, orbital pain, dry nose, restlessness, and insomnia, tongue has a thin yellow coat and the pulse is wiry and slightly surging or rapid. Though this formula is not strictly classical (it was developed in the 15th century and is based on Chai Hu Gui Zhi jia Ge Gen Tang) it apparently has a wonderful clinical efficacy.

But the real point is, and the CDC is finding this out all over again, that the flu will effect different people differently. In Mexico, it has reportedly killed over a hundred people, but in the United States it has yet to do so (knock on wood). This is another indicator that the material pathogen is never entirely responsible for disease but it is the combination of the pathogen and the constitution or landscape that indicates severity, death and recovery.

Oh, and for more hillarity, make sure you watch this.

The Pill

A lot of my patients are likely to be women. One estimate is that higher than 75% of patients for Chinese Medicine are female. So women's health has always been on my radar as something to pay attention to. The pill, apparently, isn't just good for stopping those nasty periods, but is now also marketed as anti-cramping, anti-carcinogenic, tonifying for expecting mothers, regulating mood-swings, and preventing blemishes. Additionally, the placebo pills were introduced to make the woman have her period because the companies didn't think that women would be comfortable not bleeding for a whole year (or more). All of these claims of health and well-being may in fact be true, but what they do not do is treat the underlying imbalance that causes the symptoms. As is usually the case in western medicine, the goal is still "out there in the future" where discoveries can be applied to help fix the current "problem" of unintended pregnancy:

“The holy grail is a drug that would specifically target the ovaries and testes that would have no effect on any other organ system, so they would be side-effect free,” said Dr. James Strauss, who was co-chairman of a national committee on contraception research and is now dean of the medical school at Virginia Commonwealth University. “That would be based on the discovery of genes only present in those reproductive tissues. We know a significant number of those genes today, and that’s the fruit of 20 years of research. Unfortunately, that knowledge has yet to be translated into a product.”

I'm not sure this line of reductionistic thinking is actually healthy. Doesn't everything have a side effect? And just because we can't conceive of one today, does that mean that the side-effects that we may find in the future don't matter? I may not be a dean of a university but I know for a fact that my testes are pretty intimately connected to the rest of me. I'm just sayin.

Anecdote vs. Science

It is common in the supposed fight of eastern vs. western medicine for the former to blame the latter for lacking faith and missing the underlying cause of the disease, and being impotent in an effective treatment until a material target can be identified and destroyed. Meanwhile, the latter blames the former for being “anecdotal” and medieval and lacking any comprehensive power. In a recent review of the book The Horse Boy the tired argument continues, to the delight of the institutions that protect their ideologies and to the detriment of patients, and families who suffer from recalcitrant disease. The Horse Boy is a book about a father who tries to treat, if not cure, his son of autistic characteristics including “demonic tantrums, speech delays, and incontinence.” The father takes his son to Mongolia to learn to ride horses and be healed by traditional practitioners of shamanism. The result is that much progress was made, including the disappearance of the maniacal tantrums and increased verbal directions to the horses the boy was riding.

However, in the press, the story was not about why this therapy may or may not work, but how this was an “anecdotal story” and should not be the purveyor of false hope. Because it was not part of a randomized controlled trial, no conclusions could be drawn. But can we honestly say this is the case for this father and son? That no conclusions can be drawn? Hardly. The positioning of this story as “anecdotal”, as some “scientific” commentators have dubbed it is actually misleading. The term anecdote is defined in Webster’s as: “a usually short narrative of an interesting, amusing, or biographical incident” the etymology of which includes the greek root anekdota which means unpublished. Herein lies the problem. So-called “anecdotal” stories are dubbed by the gold-standard scientific community as “unpublishable” so their relevance is instantly mitigated. Instead of spurning ideas for research, an idea such as giving horseback riding lessons to an autistic child is deemed “anecdotal” (which has the hint of implausible) by the scientific community to avoid any sort of general recommendation for the public at large. In a way, this is the stalwart western doctor’s job: to give advice that benefits the average. For example, if you have cancer, chemotherapy and radiation and surgery are likely to help you out, but there is nothing to say you, the patient, fall inside or outside of the standard deviation that they are using to make the recommendation. This is why all decisions for treatment are up to the patient themselves. The doctor makes their best guess and the rest is entirely left to something outside of their control. This is because medicine is hard work. The body constantly proves to be too complex to apply our reductionistic materialist models.


In Chinese Medicine we can understand instantly why horseback riding would be beneficial for those suffering from autism. The Horse is the animal that goes with the Heart, and as such rules the mental-emotional lives of our patients. Horses are used in crowd control because they have a pacifying nature to them. They instill peace in their riders. Horses understand the spirit of their rider: if the rider doesn’t have a good heart, they disobey. Born wild, they need to be trained to be useful just as we all must learn how to love. The Heart itself sounds like a galloping horse. Horses are used often in therapy to teach troubled youth how to care and love something beyond themselves. Their hoofs, legs, shoulders, skin, hair, blood, and fat (donkey hide gelatin) are useful in treatment, especially in regulating female hormones.

All this being said, it is important to realize that treating all autistic children with horse therapy will not cure all children who suffer from this ailment. However, what is clearly needed is more research and exposure to this potentially promising treatment modality. What is not needed is fear about what such a treatment may mean to the establishment.

The Third Lunar Month and Hexagram 43

Spring continues to threaten to emerge here in Portland, Oregon; we are witnessing a deficient ShaoYang spring that is throwing many people into illness. One day it is warm and sunny, the next cold and rainy. But even on the cold days the spring energy is definitely palpable if not in your face. The daphne has an intoxicating sucker punch, the magnolia tree in front of my house is about to pop, and the birds won't shut up about the twists and turns of Obama's budget proposal (to be fair, i'm not fluent in bird, they're probably just talking about sex).

At any rate, the third lunar month (March 26 - April 24) is all about light eliminating the shadows of our lives so that we can make clear and decisive decisions without hesitation. This month is represented by Hexagram 43 夬 which translates as Stride, Eliminating, Decisiveness, or Receive. It is also related to the Stomach organ in Chinese Medicine. In this way, proper nourishment through outward decision is imperative to what we take in from the external and make part of ourselves.



The text from the Yi Jing:

揚于王庭，孚號有厲，告自邑。

An inquiry at the King's court, confidence shouted carries terrible reports from the fiefdoms.



不利即戎，利有攸往。

It is not an auspicious time for going to war, it is beneficial to have someplace to go.



夬、決也，剛決柔也。健而說，決而和。


Stride, is decision. Firm but yielding. Strong and vocal, decisive and harmonious.

「揚于王庭」、柔乘五剛也，「孚號有厲」、其危乃光也。
"Inquiry at the King's court" means to yield to the 5 strengths (laws?), "confidence shouted carrying terribleness" means that the light shining (inquiry) is dangerous.

「告自邑不利即戎」、所尚乃窮也，「利有攸往」、剛長乃終也。
"Reports from the fiefdoms that it is not beneficial to war" means that the places of esteem are actually poor, "beneficial to have someplace to go" means firm and lasting only in the termination or ending of things.

I find this text really interesting for a number of reasons. For one, we're in the middle of spring and as we all know it is good to do some spring cleaning at this time of year. But from a cultivational standpoint, we can see this as symbolically cleaning out the ego, shining light on our skeletons in the closet and airing them out to dry. I understand this inquiry at the court to be a questioning of the ego in this way. Because of the instability that this causes, it is not correct to wage a battle because the structure of the ego itself is so changeable at this time. Instead it is best to move with the energy of spring and terminate those aspects of ourselves which are no longer useful to us and move outside of ourselves in travel or coming into contact with new things.

As Wilhelm writes:

This hexagram signifies on the one hand a break-through after a long accumulation of tension, as a swollen river breaks through its dikes, or in the manner of a cloudburst. On the other hand, applied to human conditions, it refers to the time when inferior people gradually begin to disappear. Their influence is on the wane; as a result of resolute action, a change in conditions occurs, a break-through.

Spring Equinox

So, it is time. Today is the day that the yang qi, overcomes the yin qi and begins to lead. The days are longer than the nights, and will be for the next 6 months. Now is the time to execute and achieve those things that you want to do for the year; however big or small. You'll probably feel the need to clean some stuff, reorganize your living space, hang out with new people, and just generally bask in all the forms of intercourse that are taking place. If you properly cut away those things that didn't matter in the fall and stored your energy in the winter, your goals can now be easily achieved. Go speedracer! Go! And oh yeah, don't forget to stop and smell the metaphorical roses every once in a while - there is a lot to be learned in those moments of watching the activity of spring instead of constantly living it.

真武湯 True Warrior Decoction

“True Warrior Decoction” is mentioned in the Shang Han Lun only twice. The first time it is mentioned, it is in reference to Tai Yang disease:

太陽病，發汗，汗出不解，其人仍發熱，心下悸，頭眩，身瞤動，振振欲擗地者，真武湯主之。

"In Tai Yang disease, when there is sweating, and the emergence of sweat does not resolve the disease, and the person still has fever, there are palpitations below the heart, the head is dizzy, and the body shivers violently, and they are quivering and about to fall on the ground, Zhen Wu Tang governs it."

In this scenario, the person is sweated with Gui Zhi Tang and the person does not recover or the person has sweated themselves and has not recovered. In both cases, the person has a yang deficiency because the person’s yang qi with the addition of a correct treatment of Gui Zhi Tang is still too weak to defeat the pathogen. Because of this yang deficiency, there is cold shivering, and because the body is attempting to mobilize its yang qi to the surface, there isn’t enough left to maintain the interior, so the Shao Yin heart and head begin to feel the effects.

The second time Zhen Wu Tang is mentioned is in reference to Shao Yin disease:

少陰病，二三日不已，至四五日，腹痛，小便不利，四肢沉重疼痛，自下利者，此為有水氣，其人或欬，或小便利，或下利，或嘔者，真武湯主之。

In ShaoYin disease, that has lasted two or three days without stopping, and at four or five days, there is abdominal cramping, inhibited urination, heaviness and pain of the four limbs, and spontaneous diarrhea, this is because the person has water qi, and the person may have cough, or uninhibited urination, or diarrhea, or retching, then Zhen Wu Tang governs it.

Zhen Wu Tang:
Fu Ling 3 Liang (45g)
Shao Yao 3 Liang (45g)
Bai Zhu 2 Liang (30g)
Sheng Jiang 3 Liang (45g)
Fu Zi 1 piece prepared

*if cough add:
Wu Wei Zi half sheng (100mL)
Xi Xin 1 Liang (15g)
Gan Jiang 1 Liang (15g)

*if urine flows freely, remove Fu Ling
*if there is diarrhea, remove Shao Yao and add 2 Liang of Gan Jiang
*if there is retching, remove Fu Zi and Sheng Jiang to equal 8 Liang (1/2 Jin).

In the first description of symptoms in Shao Yin disease, there are Earth symptoms being inversely invaded by Water: abdominal cramping (Wood trying to control the Water in the Earth), inhibited urination (Water being directed towards the Earth element), heaviness and pain of the four limbs (the Earth rules the four limbs), and spontaneous diarrhea (Water invading the Earth Spleen).

In the second description of the symptoms the Metal is overwhelmed by Water, and cough and uninhibited urination occur (or perhaps constant urination from the Lung being too open and a lack of pressure within the system). Also there is Earth disharmony as the Stomach is in counterflow, leading to collapse of the Spleen.

In both cases, the method is to restore the yang of the Kidney and drain the excess water to correct the reversal of Water Qi invading Metal and Earth. In the Tai Yang example, we can note that the Zhong Qi (中氣) of Tai Yang is Shao Yin and the Zhong Qi of Shao Yin is Tai Yang. This is an explanation for why, if someone is severely deficient and they are subjected to Tai Yang disease, and sweating does not work, that a Shao Yin pattern emerges. The ying and the wei have as their source the ultimate yang and yin of Shao Yin, when these are severely depleted the patient cannot mount an attack even with sweating so the underlying yang deficiency must be addressed with Fu Zi.

The Second Lunar Month and Hexagram 34

Boom! The Yang qi is out of the gate and running now in the second lunar month. Whereas the last month was all about balance and being pressurized like an arrow on a drawn bowstring, this month is all about release and movement. Now is the time for production, strength, and action. All those plans that we've cultivated in the winter months can now be begun with full zeal. This is symbolized with the character 卯 for this month, which is the earthly branch depicting the opening of two great doors. The energy of this month, which began on February 25th and charges until March 25th is further represented by Hexagram 34, Da Zhuang 大壯, which is often translated as great strength, focus, movement, power, or killing.


《大壯》利貞。

Great Strength is auspicious.



剛以動，故壯。《大壯》「利貞」，大者、正也。正大而天地之情可見矣。

Movement with firmness, therefore strength.
Great strength is auspicious, great because of correctness.
Correctness and greatness like heaven and earth, conditions are very clear.



雷在天上，《大壯》。君子以非禮弗履。

Thunder above Heaven, this is Great Strength.
The noble person is never impolite or treads upon.

Here, as opposed to other line translations that I've done before, you can see that the energy is very simple. There is correctness in action while checking any abuse of power at the door.

Steven Karcher corroborates:

The hexagram figure shows inner force expressing itself directly and decisively. Thunder located above heaven. This is a time for resolute action. Come out of retirement. It is important to be able to hold onto your strength, for you must judge things for yourself and proceed on your own. A great idea implies strength and power. Something solid and strong is stirring things up. This is the source of your strength. Put your ideas to the trial. Correct one-sidedness in yourself and others. Having a great idea and continually correcting your path lets you look into the heart of Heaven and Earth.

Ling Shu Chapter 1

Ling Shu Chapter 1 is titled “The 9 needles and the 12 source points” wherein the source points are indicated as imperative to treat disorders of the Zang and the methods of tonification (“in slow, out fast”) and reducing (“in fast, out slow”) are explained. But I believe that the essence of the chapter lies in the following lines.

小鍼之要，易陳而難入，麤守形，上守神，神乎神，客在門，未睹其疾，惡知其原

The essentials of the small needles are easily explained but difficult to receive, the crude guard the form (the lesser physician only sees the body), the superior guard the Shen, Shen fantastic Shen, (without which the doctor is only a) guest at the gate and has not perceived the illness or known the origin of the evil.

刺之微在速遲，麤守關，上守機，機之動，不離其空，空中之機，清靜而微，其來不可逢，其往不可追。

The subtle and profound of needling are the rhythm (fastness and slowness), the crude physician guards the barrier (that which is closed), while the superior physician guards the movement of the mechanism, the mechanism is not separate from the void, the mechanism is the center of the void, it is quiet and subtle, you cannot meet it when it arrives, you cannot pursue it as it leaves.

知機之道者，不可掛以髮，不知機道，叩之不發，知其往來，要與之期，麤之闇乎，妙哉工獨有之。

To know the Dao of the mechanism, one cannot put up one's hair (be lazy), not knowing the way of the mechanism, you can knock (strike) the disease without emitting it, if you know its comings and goings, you can assist its phases, the dimness of the crude physician! the excellent physician alone has it.

往者為逆，來者為順，明知逆順，正行無問。

That which leaves is counterflow, that which arrives is flow, be fully aware of counterflow and flow, and you will have correct action without question.

逆而奪之，惡得無虛，追而濟之，惡得無實，迎之隨之，以意和之，鍼道畢矣。

Use it (the knowledge of the mechanism) to seize counterflow, get the evil without causing deficiency, pursue and assist it, get the evil without causing excess, welcome it and follow it, this means to harmonize it, this is the accomplished way of needling.

This is my favorite segment of this chapter of the Ling Shu because it explains the importance of engaging with the person’s Shen to observe disease but also of the disease process itself, the Bing Ji 病機, the pathological mechanism. This means that when we apply an acupuncture treatment, it isn’t enough to apply the rules of the body to find our treatment principles but we have to look at the process of the disease. For example, if someone has hemoptysis it isn’t enough to needle the points for hemoptysis. Rather we should seek an understanding of the root cause of the disorder and needle at the appropriate time, in the appropriate technique, to either “seize the counterflow to not create deficiency” or “follow it out to not cause excess.” “Not meeting it as it arrives and not pursuing it as it leaves” seems contradictory only if we operate from a fixed position. If we are firm in our beliefs and understandings of a disease, and thus remain metaphorically fixed in our ideas, we cannot be flexible and follow the ways of the disease which have a rhythm all of their own. It is this rhythm that is the key to unlocking the disease process.

HAPPY NEW YEAR OF THE EARTHEN OX!

January 26th marks the first day of the first month of the chinese new year of the ox. Starting on the new moon, this month will extend until February 24th. In a way, the year of the ox is energetically represented as what I described in the last months energy as both have "ox" energy and are associated with Hexagram 19: the continuing endurance and approaching of something great. So the same can be said of the coming year of 2009. Having visited the dark cave that 2008 represented (子）, and fleshed out what direction we want to go in, 2009 is the year to begin executing those plans, and begin taking our internal ideas to the external world. Have something you were dreaming up last year but didn't quite getting around to making a move on? Well, this year is the one to start that big project. Also with the new year, and every year, comes a time to forgive those who owe us money that never showed up or apologies that never came and move on to a more compassionate, "we're all in this together" mentality.

Within this context of an oxen year, we begin in the first lunar month, represented by Hexagram 11 泰 often translated as peace, quiet, or balance.



Here is the text from the Yi Jing, as well as my translation.

小往大來，吉，亨
The small goes and the big arrives, auspicious, successful.

則是天地交而萬物通也，上下交而其志同也。
It is the joining of heaven and earth and the communion of the 10,000 things,
the joining of above and below and it is similar to will.

內陽而外陰，內健而外順，內君子而外小人，君子道長，小人道消也。
inside is yang and outside is yin, inside is strong and outside is following, inside is the character of a noble person and outside is the appearance of a lesser man, the noble person's path is long, the lesser person's path disappears.

This is a time of ultimate communion between heaven and earth. 3 yin lines are falling, and 3 yang lines are rising. Internal strength and external following is indicated here, to show that we follow the path of nature even though we may be pursuing our internal goals. Stephen Karcher writes:

This is a time of abundance. If you let yourself be lead you can realize your hidden potential. Later you can be quiet and settled. Reach out and penetrate things. Sense their interconnections. Radically change your sense of self and who you associate with. Put your possessions at the service of the spirit of the time. Support and encourage people. Use peace and abundance to set life in order.

The 12th Lunar Month and Hexagram 19

New Year's is always an interesting time for me now that I'm studying Chinese Medicine. For one, there is a mismatch between the solar calendar that we follow here in the west and the lunar calendar favored by the ancient Chinese. Chinese New Year this year doesn't happen until February 4th, at which time we will begin the year of the Earthen Ox. Because I've been following the energetics of the seasons for over a year now (according to the 24 seasonal nodes) I have to admit January 1, 2009 seemed a bit premature for celebration as the Winter energy, especially here in Portland, is still quite strong. Secondly, the typical celebratory script of getting shitfaced and staying up all night is also contra-indicated for this time of year [note to reader: i managed to ignore this prescription this year and am still paying the price as i write this. i blame the bellinis!]

But what I actually want to write about is not my debaucherous ways but the energy of the lunar month that we are currently in, which began on December 27th and continues until January 25th. This is the 12th Lunar month, represented by the Earthly Branch 丑 and Hexagram 19, Lin 臨.



This hexagram represents the continued endurance of the Yang Qi as it has "returned" in the previous month, but still faces an uphill battle. It is often translated as Endurance and Approaching.

Here is my translation of the text from the YiJing for Hexagram 19.

《臨》元亨，利貞。至于八月有凶。

Successful, Benefitial. As for the 8th month (august) it is ominous. 



《彖》曰：《臨》，剛浸而長，說而順，剛中而應。大「亨」以正、天之道也。「至于八月有凶」、消不久也。
Gradually firm and enduring, speaking with direction, responding with a firm center. Big success with correctness, this is the way of Heaven. Ominous challenges will soon disappear.



《象》曰：澤上有地，《臨》。君子以教思�窮，容保民�疆。

The marsh above indicates earthliness. The noble man uses this to teach the poor of thought, and contains and protects those on the outside.

[if anyone has insight to these two characters that are missing, i'd appreciate a hand digging them up!]

We can see from this translation that this is generally a beneficial gua for action though the action is quite specific in that it is centered in both directions (from the outer to the inner and the inner to the outer). There is an indication that there are obstacles present, but that if we hold to the correctness of the Dao, they will fade and be overcome naturally. The indication of teaching represents that of action, even with those who are not aligned with the way (the "poor" and those on the "outside").

Stephen Karcher writes:

Nearing describes your situation in terms of something approaching, particularly something great approaching something smaller. It is the first arrival and point of new contact. The way to deal with it is to move towards what is approaching without expecting to get what you want immediately. Look at things with care and sympathy. Welcome the approach of others. Keep your expectations modest. This contact opens a whole new cycle of time. It is particularly favorable for what is growing. So beware. Trying to rush to completion and an early harvest will cut you off from the spirits and leave you open to danger.