Thursday, May 31, 2012

Eight Lifestyle Adjustments for Better Sleep

Many of us deal with insomnia occasionally or on a regular basis. Negatively impacting our health and happiness in both the short and long term, insomnia is a drag.

Fortunately, insomnia is easily and effectively treated with acupuncture and herbal medicine. For more information, please see my article Put Insomnia to Rest with Chinese Medicine.

Adopting the following eight lifestyle adjustments will also help you get a better night's sleep every night.

1. Regular Hours

Your body craves routine. While we think we can charge ahead all week and make it up on the weekends, this is not true. When you keep an irregular schedule, your body becomes confused from day to day on when to provide energy and when to conserve it.

The best possible thing you can do to improve your sleep is to go to bed and wake up at the same time every day.

Going bed earlier rather than later promotes healthier sleep. 

This might seem impossible to you. Keeping regular hours certainly requires some discipline. Try ramping down work and starting your dinner and bedtime routines by 5:00 or 6:00pm. You may need to get up earlier in the morning to get things done. But, in terms of work and sleep quality, it will be worth it.

With training, your body will learn to feel tired and awake when it's appropriate.

2. Stimulation Curfew

Make a pact with yourself not to read anything stimulating, watch TV or listen to loud music for at least two hours before you go to bed.

Most importantly, turn off your computers and your smart phones. The light from a computer mimics daylight, releasing a stimulating cascade of hormones in your brain. Just one email, one news headline or one phone conversation is enough to send your mind spinning.

This might requires some discipline, but your nervous system will thank you.

3. Practice Relaxation Daily

People who have trouble sleeping are often in a state of sympathetic nervous system arousal.  The bad news is takes just 1/10 of a second for the autonomic nervous system to be aroused into a sympathetic state -- and most of us are bombarded by stimulation on a daily basis. It takes a lot longer to return to a parasympathetic state.

The good news is that our bodies and minds are trainable. We can train ourselves to enter a relaxed state, a slow brainwave state, and stay there.

This is where regular practice comes in. It matters less what you do, but that you make time to do it every day --- preferably at the same time every day.

Relaxation practices include:
  • mindfulness meditation
  • belly breathing
  • tai ji, qi gong, some forms of yoga
  • prayer
  • warm bath with epson salts.
For most of us, starting a daily relaxation routine presents a lot of challenges. With practice over time, you'll find that your nervous system is better equipped to deal with life's stresses and challenges--- and it will be easier for you to relax at night.

4. Light (not Late) Dinner

Most of us enjoy a good dinner. We look forward to dinner as a reward after a long, hard day and enjoy sharing our evening meal with family and friends.

But dinner is not the best time to eat a lot. Or late.

Food converts into energy, and we don't need a lot of energy to sleep.

Spicy, greasy or rich foods, and large dinners with lots of different types of food, can be difficult to digest. It is harder to sleep when your body is busy digesting your evening meal. Hard-to-digest foods tax the Spleen, Stomach and Liver systems. When the Liver is under stress, it fails to circulate energy in the body, leading to stagnation and a buildup of heat in the body. Heat in the Stomach and Liver systems is one of the big causes of insomnia in the U.S.

Along that line, spicy foods like garlic and chili are stimulating and best avoided in the evening.

Obviously, if you're having trouble sleeping, it's best to cut out caffeinated beverages. If you must consume caffeine, try restricting caffeine consumption to morning only. And keep in mind that green or black tea have a lot less caffeine and stimulating chemicals than coffee or soda.

Try making breakfast or lunch your biggest meal of the day. Keep dinner light. Avoid meat. Maybe limit yourself to a small amount of rice or noodles and steamed vegetables. Or, simply, a bowl of cereal and milk. And give yourself ample time to digest before you go to bed.

5. Exercise

If you feel that stress may be a factor in your sleeping difficulties, begin incorporating exercise into your daily routine. Cardiovascular exercise can help metabolize hormones during the sympathetic nervous system activity.

Consider biking or walking to work, or take a few brisk walks each day.

Rigorous exercise can be energizing, so schedule your more intense workouts earlier in the day. A leisurely evening stroll, however, can be a wonderful way to calm your mind and ensure that your body has digested dinner before you lie down at night.

6. Sleep Environment

Darken bright rooms at night. If you are sensitive to noise at night, invest in a good pair of earplugs or a white noise masking device. Experiment with temperature. Try adding or subtracting blankets from the bed or opening or closing windows. Use your bed only for sleeping. If you find yourself ruminating at night when you should be sleeping, adopt a nightly routine of jotting down your to-do list and all your worries in a notebook before going to bed at night. Do this in a room other than the bedroom. This will help you lay your thoughts and worries aside so you can get down to the business of sleeping.

7. Get Acupuncture

Get regular acupuncture treatments. Acupuncture can help shift your autonomic nervous system from sympathetic to a parasympathetic state in a matter of minutes or seconds. Regular acupuncture can increase your melatonin level.

If you're having trouble sleeping, I'd highly recommend that you receive acupuncture treatment on a weekly or biweekly basis for four to six weeks. Regular acupuncture, like daily relaxation practice, will help your mind and body develop new habits of relaxation.

8. Take Your Herbs

Chinese medicine offers a remarkable range of herbs and formulas to help you sleep. These herbs help relax you, nourish imbalanced organ systems, and clear excess heat from the body to help you fall asleep and stay asleep deeper and longer. 

Chinese herbs can have an immediate relaxing effect; but herbal medicine is not a sleeping pill. Instead of simply targeting particular brain chemistry, herbs work in a holistic way to support function in your body that is weak, while reducing the buildup of excess energy. There are no side effects from herbal medicine. In addition to helping you sleep, Chinese herbs will address the root of your condition. Taken regularly over time Chinese herbs can improve and regulate your sleep, while enhancing your health and vitality in general.

Put Insomnia to Rest with Chinese Medicine

In this article:

  • Chinese Medicine and Insomnia
  • Acupuncture for Insomnia
  • Herbal Medicine for Insomnia

Insomnia, or sleeplessness, can describe anyone who has trouble falling asleep or staying asleep. Insomnia can be acute and circumstantially-related, or it can be a long-term, chronic pattern.

If you suffer from insomnia, you are not alone:

Insomnia may affect 10%-40% percent of the population according to a 2009 analysis of international research. In the U.S., insomnia is more prevalent than ever with higher stress levels and ever more demands on our time.

More and more studies show the negative effects of poor sleep, or lack of sleep:

  • loss of memory & focus
  • impaired cognition, judgement & ability to learn
  • slower metabolism (weight gain)
  • higher stress & anxiety
  • impaired immunity
  • increased inflammation & joint pain
  • tendency toward depression
  • increased likelihood of accidents (automobile, work place)
  • difficult social functioning.

Poor sleep or lack of sleep can exacerbate a range of serious health conditions. Studies have shown that people who sleep less than 6 1/2 hours per night are three times as likely to develop diabetes in the following year. Risk of hypertension, heart disease, and stroke are similarly increased by sleeplessness.

Nightly restorative sleep is as important to health as diet and exercise. And not getting enough sleep is no fun at all.

Fortunately, insomnia is easily and effectively treated with acupuncture and Chinese herbal medicine. Together with a few lifestyle adjustments (see my article Eight Lifestyle Adjustments for Better Sleep), Chinese medicine can help put insomnia to rest, and help YOU get that restorative sleep you need to stay healthy and happy.

Chinese Medicine and Insomnia

There are many reasons that cause us to have difficulty sleeping.

Keep in mind that Chinese medical treatment for insomnia is not simply a sleeping pill. It does not simply target a part of the brain to put you to sleep. And it does not have side-effects like drowsiness or addictive qualities.

Instead of simply addressing the symptom of insomnia, Chinese medicine holistically addresses the underlying physiological imbalance or root cause of sleeplessness. Your Chinese medicine practitioner will take a holistic account of your symptoms and constitutional tendencies to figure out the exact patterns of physiological imbalance that are keeping you from getting a good night's sleep. Often these are a deficiency of Yin or Blood or an excess of Yang or heat. The imbalances may be rooted in a particular organ system or systems, or in a meridian system. I describe some common insomnia patterns in more detail below.

In any case, by addressing root physiological imbalances, Chinese medicine treatment for insomnia will likely make you feel healthier & more vibrant in general, in addition to helping you sleep better at night.

Yin & Yang Imbalance:
Insomnia (or sleeplessness) is fundamentally an imbalance of Yin and Yang. The Yang aspect of our lives is activity and function -- it is the part of ourselves that fights traffic, meets work deadlines, reads the news, finishes projects, cooks dinner, drives the kids' carpools, etc. The Yin aspect is the quiet, restful, reflective parts of our lives -- particularly sleep.

Most of our lives tend to be imbalanced in the Yang direction. We keep pushing forward, producing, and achieving. Our nervous systems are continually stimulated. Comparatively little time is devoted to relaxation and rest. Needless to say, our cultural and social environment promote this imbalance.

An excess of Yang, i.e. overworking, constant productivity, excessive mental and emotional stimulation can, over time, erode our Yin on a physiological level. We lose our ability to ramp down our nervous energy and go to sleep.

Nighttime is the Yin aspect of our 24-hour cycle. It is the time when we should be sleeping. If we have trouble sleeping at night, this is seen as a weakness or insufficiency of Yin. An acupuncturist might address this by using acupuncture and herbal medicine to nourish and consolidate a patient's Yin, and possibly by regulating or sedating the Yang aspects of that patient's physiology.

The concept of Yin-Yang imbalance is reflected in the biomedical understanding of insomnia. Biomedically, insomnia as a symptom of cognitive and/or neurological hyperarousal. People who worry and ruminate a lot tend to have trouble sleeping. The sympathetic (fight-or-flight) aspect of the autonomic nervous system predominates over the parasympathetic (rest and repose) in people with insomnia. People with poor sleep tend to have higher levels of stimulatory hormones like cortisol and adrenocorticotropic hormone (ACTH) relative to hormones associated with rest and relaxation.

The Heart:
From a Chinese medicine perspective, the Heart is where the Shen or Spirit rests at night. The Heart (and the Blood of the Heart system) is said to anchor the Spirit, enabling us to go to sleep. If the Heart system is weak or disturbed (by physical or emotional factors), the Spirit is not anchored and is said to wander at night. The result is a feeling of anxiety, general restlessness of the body, vivid dreaming and inability to sleep.

The Heart also houses the Mind. When the Heart is agitated, the mind can not calm down.

Treating the Heart with acupuncture and herbal medicine is therefore often an important component of treating insomnia in Chinese medicine.

Other Organs:
The Heart's relation to Mind and Spirit is paramount, but each of the other organs of the body play a specific role in sleep and sleeplessness as well. Your acupuncturist's job is to discern each patient's unique pattern of organ imbalance and to use acupuncture and herbal therapy to correct it.

The organs, the dense material foundation of the body, are the most Yin aspect of the body. Excess Yang weakens and damages the organs. Weak organs are less able to anchor the mind and emotions. They fail to produce adequate Yin substance (Blood, body fluids) needed to nourish the body, anchor Yang energy and support relaxation. The result is more restlessness, anxiety and sleeplessness.

Here is a summary of the major organs in relation to sleeplessness:

Related Emotion:  Anxiety, restlessness
Insomnia Characteristics:  Waking up easily; difficulty falling asleep; excess dreaming
Accompanying Symptoms:  Palpitations; sores in mouth; thirst

Related Emotion:  Anger; stress; frustration; irritability
Insomnia Characteristics:  Difficulty falling asleep; restless sleep; disturbing dreams; waking between 1:00 a.m. and 3:00 a.m.
Accompanying Symptoms:  Blurry vision; dry, red eyes; dizziness

Emotion:  Grief
Insomnia Characteristics:  Waking between 3:00 a.m. and 5:00 a.m.
Accompanying Symptoms:  Low energy; shortness of breath; frequent colds

Emotion:  Worry; rumination; obsessiveness
Insomnia Characteristics:  Difficulty falling asleep; waking at the same time every night; dream-distrurbed sleep
Accompanying Symptoms:  Tiredness, poor appetite, weak disgestion, poor memory, pale face (typical pattern in students)

Emotion:  Fear
Insomnia Characteristics:  Difficulty falling asleep; frequent waking
Accompanying symptoms:  Dry throat, night sweats, palpitations, dizziness, tinnitus, backache

Heat Regulation:
So far, I've discussed weakness and imbalance of the internal organs in relation to insomnia. Excess heat in the body is another cause.

When it's hot outside, it can be difficult to settle down and fall asleep. This is also true when your body is hot on the inside.

Even though you may feel cold when you go to bed, if your body is having trouble regulating internal heat, you will eventually heat up inside and get uncomfortable. This is one of the major causes of waking frequently during the night.

Problems of heat regulation in the body generally stem from either an excess of heat in the body or from a weakness of the cooling element in the body, the Yin. 

One cause of heat in the body can be poor dietary habits or excessive alcohol consumption. Perhaps we eat too much before we go to bed, drink too much, eat on an irregular schedule or indulge in too many rich foods. Any of these habits cause the body to have difficulty processing and moving energy. Stagnant energy in the body causes a buildup of heat in the body and a general state of irritability and discomfort.

Emotional stress can also cause internal heat. Anger, resentment, irritability, worry and rumination, in particular, weaken the Liver, hindering its ability to circulate energy through the body. Again, stagnant energy causes excess heat.

Finally, if our body's Yin becomes weak (for a variety of reasons including overwork, overstimulation and emotional stress), the Yin/Yang balance becomes compromised. The heat/fire energy generated by the body is no longer grounded by Yin/water. This leads to a buildup of heat at night. This type of heat is sometimes released by the body via sweating at night.

Acupuncture for Insomnia

Acupuncture for insomnia works much the same way as it does for other conditions. The insertion of acupuncture needles will immediately remove areas of energy stagnation in the body. Regulating and moving energy will generate a feeling of ease and relief so that the body can rest properly.

Specific acupuncture points used are chosen according to the patient's specific diagnosis. There are many points on the body indicated for releasing heat. Acupuncture can also help restore balance to the Heart and other organ systems so that the body can provide a peaceful home for the Mind and the Shen to rest at night.

Acupuncture can influence hormone production. One study showed that five weeks of acupuncture treatment was associated with a significant increase in melatonin, an important hormone for sleep regulation and typically deficient in sleepless Americans.

Acupuncture causes measurable increases in vagus nerve activity, helping the body's autonomic nervous system to shift into a parasympathetic state, exactly what is needed for a good night's sleep.

For more on acupuncture in the treatment of insomnia, check out this article this 2011 Wall Street Journal article, Can Needles Sooth Wounded Warriors? Military Doctors in Afghanistan are Using Acupuncture to Treat Brain Injuries, with Promising Results. Journalist Michael Phillips documents stories of soldiers suffering from insomnia and nightmares due to PTSD who find dramatic relief through acupuncture. Phillips writes, "The newest Defense Department and Department of Veterans Affairs clinical guidelines recommend acupuncture as a supplementary therapy for post-traumatic stress disorder, pain, anxiety and sleeplessness.

Herbal Medicine For Insomnia

Chinese herbal formulas are prescribed according to the particular insomnia diagnosis. In general these herbal formulas will help to tranquilize the mind, clear heat, support weak or imbalanced organs and nourish Yin.

All aspects that may cause insomnia will be addressed and you will fall asleep faster, stay asleep longer and have a deeper, more restful sleep.

Herbal medicine is not a sleeping pill. Instead of simply targeting particular brain chemistry, herbs work in a holistic way to support function in your body that is weak, while reducing the buildup of excess energy. There are no side effects from herbal medicine. In addition to helping you sleep, they will address the root of your condition, enhancing your health and vitality in general.

Much of the structure & content for this insomnia series came from an article, "Say Goodnight to Insomnia," by brilliant San Francisco Acupuncturist Jeremy Rothe, M.S., L.Ac., at

Sarah Halverstadt, M.S., L.Ac.

Lectures by John Nieters, L.Ac., DAOM

Consultation with Robert Zeiger, L.Ac., OMD, Pharm.D.

Alyssa Giacobbe. "Acupuncture for Insomnia Relief."

Giovanni Maciocia. The Practice of Chinese Medicine. The Treatment of Diseases with Acupuncture and Chinese Herbs.

Saturday, May 26, 2012

The Heart in Traditional Chinese Medicine

"The Heart is Like the Monarch and it Governs the Mind." --  Yellow Emperor's Inner Canon: Simple Questions, ca 475BCE-220CE

"The heart is the ruler of the five organ networks. It commands the movements of the four extremities, it circulates the qi and the blood, it roams the realms of the material and the immaterial, and it is in tune with the gateways of every action. Therefore, coveting to govern the flow of energy on earth without possessing a heart would be like aspiring to tune gongs and drums without ears, or like trying to read a piece of fancy literature without eyes." --  from the Daoist classic, Contemplations by the Huainan Masters (Huainanzi), ca110BCE

The external path of the Heart meridian runs
runs along the inner arm. Internally, the Heart
meridian passes through the major blood
vessels of the anatomical heart, down to the
small intestine (the paired organ of the Heart),
up through the Lungs, the throat, esophagus,
thyroid and the tissue surrounding the eye.
In Chinese five-element theory, the season of summer corresponds to the element fire. Fire corresponds, actually, to four "organs" of the body. The first two are the Heart and its paired "minor" organ, the Small Intestine. Fire also corresponds to two less commonly-known organs. First is the Pericardium, which the Chinese medical tradition views as the  protector of the Heart (playing a role also in the calmness of the mind). The final "organ" related to the fire element is a concept that does not exist in biomedical medicien. It is called the san jiao, translated as Triple Warmer, and is responsible for the movement of energy (Qi) throughout the entire body and plays an important role in water metabolism, as well as in protecting the body from disease from external pathogens.

Keep in mind that the "organs" in Chinese medicine correspond as much to areas of physiological function as to anatomical structure. Each "organ" in Chinese medicine is also tied to, and responsible for, an aspect of emotion, mind and spirit ---- physiological function and emotional/spiritual/mental well-being being inextricably linked Chinese medicine.

This blog is about the Heart as conceived in Traditional Chinese Medicine.

The Heart as Emperor:

The heart is considered the most important organ in Chinese medicine. Commonly referred to as the "sovereign" or "emperor," it is sometimes not even treated directly in acupuncture because of its preciousness The acupuncturist might treat points on the meridian of the Pericardium, or Heart Protector, as a way of influencing the Heart indirectly -- just as one would address a prime minister instead of directly addressing the emperor in an imperial court.

Blood -- the Heart's Precious Substance:

Similar to the biomedical perspective, the Heart in Chinese medicine is linked closely to the Blood, and is said, in fact, to govern Blood. It does this in two ways:

First, the final refinement/creation of Blood (from the refinement of the essence extracted from food) is said to take place in the Heart -- i.e. the Heart plays an ultimate role in the creation of Blood.

Second, as the circulator of Blood, the Heart is responsible for providing a proper supply of Blood to all organ systems and body tissues. It controls the blood vessels. So, one can gauge the health of the Heart by palpating the pulse in distal blood vessels.

The meaning of "Blood" in Chinese medicine is somewhat different from its meaning in biomedicine. It is, in fact, conceived of as a very dense, material manifestation of Qi, responsible for nourishing and moistening all parts of the body and providing the material foundation for the Mind/Spirit.

In some respects, Blood is the most precious substance in the body, and the quality of a person's blood is very important to their health (internal, structural, orthopedic and mental/emotional spiritual health). The strength of the Heart and the quality and circulation of the Blood, more than other factors, determine the fundamental constitutional strength of a person.

A line from the Yellow Emperor's Canon of Internal Medicine stated, "If the liver is supplied with blood, we can see; if the feet are supplied with blood, we can walk; if the hands are supplied with blood, we can grasp."

A practitioner of Chinese medicine can treat many aspects of a person's health by addressing the quality of blood (richness, circulatory flow, etc.) with acupuncture, herbs and dietary modifications. Because the Blood is formed from a refinement of food, the quality of Blood is directly affected by what we eat, as well as by medicinals, chemical toxins and other things that enter our body.

The Heart Manifests in the Complexion:

Because the Heart governs the circulation of Blood throughout the body, the state of the Heart and Blood is reflected in the complexion, particularly the complexion of the face. If Blood is abundant and the Heart strong, the complexion will be rosy and lustrous. A less perfect facial complexion (i.e. pale, dull, bluish, too red, etc.) indicates a specific imbalance of the Heart, the Blood or other related organs, which can be addressed with acupuncture, herbal medicine, dietary changes, etc.

Like the complexion, the appearance of the tongue is also an indicator of the health of the Heart. In fact, the tongue is considered to be the "offshoot" of the Heart. The Heart controls the color, form and appearance of the tongue. The tip of the tongue is particularly indicative of the state of the heart, whereas other regions of the tongue anatomy reflect the condition of other organs.

If the Heart has excessive Heat (relating to symptoms like insomnia or mania, etc.), the tongue may be dry or dark red and the tip swollen. Sores or ulcers on the tongue can be signs of extreme heat in the Heart. If the Heart is weak and the Blood deficient (which may also be related to insomnia, as well as poor memory, depressive symtoms, possible low cardiac function), the tongue may be pale and thin. A duskiness or bluish-purplish hue tongue-hue relates to sluggish circulation and/or cardiovascular pathology.

It makes sense that observation of the tongue and facial complexion are central to diagnosis in Chinese medicine. The health and function of all organs, especially the Heart, and the general vitality of the body can be gauged by aspects the tongue and the complexion including colors, shades, casts, luster, form, moisture, dryness, ulceration, etc.

In pediatric medicine, we learn a lot about our little patients by looking at their faces. This is important because it is generally hard or impossible to palpate the pulse or observe the tongue of very small children. Also, since children are so new, they have had less time to develop complex pathologies and subtle forms of guarding themselves as adults have. Their young faces are a very clear lens into their physiological and emotional health. Relatedly, Chinese medicine pediatricians are always taught to look to the eyes of a child for prognosis as the eyes are a lens into the Shen (mind, emotions, spirit -- see below) -- as the Heart meridian enters the tissues surrounding the eyes. Even if a child is very ill, but still has bright, sparkly eyes, this means that his spirit is strong and the prognosis for his recovery is good.

The Heart Houses the Mind (......and the Emotions & the Spirit):

Chinese medicine perceives the Heart to be the residence of the Shen. Shen is sometimes narrowly translated as "Mind," but in a broad sense, Shen is used to indicated the whole sphere of mental and spiritual aspects of a human being.

Each Chinese medicine "organ" plays a role in a specific aspect and quality of emotional/spiritual/mental life, but the Heart's role is paramount.

The state of the Heart and Blood affect all mental activities as well as the emotional state. The Heart and its Blood are said to be the root of the Mind, embracing and anchoring the Mind so that it will be peaceful and happy. If the Heart is strong and Blood rich and abundant, there will be normal mental activity, emotional balance, a clear consiousness, good memory, keen thinking and good sleep. If the Heart is weak and Blood deficient, there may be mental-emotional problems (depression, anxiety), poor memory, dull thinking, restlessness, anxiety, insomnia or somnolence. An agitated and overheated Heart or one affected by excess phlegm in the body will manifest in symptoms of mania, poor social judgement, antisocial behavior, etc.. So, improving and regulating the quality of Heart and Blood is very important in the clinical treatment of mental or emotional issues. In fact, the Heart and the Blood are as commonly treated with acupuncture and herbal medicine to address mental-emotional issues in patients, as they are treated in addressing anatomical-physiological cardiovascular/circulatory issues.

The Heart plays a critical role in sleep. If the Heart-Blood is strong, a person will fall asleep and sleep soundly. If the Heart-Blood is weak, the Mind has no residence. It will "float" at night causing inability to calm down and go to sleep, disturbed sleep or excessive dreaming.

On an interpersonal level, the state of the Heart determines a person's capacity to form meaningful relationships.

The Heart and Pathology:

In assessing the health of the Heart, the Chinese medicine physician must discriminate between patterns involving the Qi, Blood, Yang and Yin of the Heart. Deficiency of any of these aspects can be related to weakness of the circulatory and cardiovascular systems or mental-emotional depression, and have ripple affects in other aspects of physiological function. Excess Heart conditions must also be considered. These include Heart-Fire blazing, Phlegm-Fire Harassing the Heart, Phlegm Misting the Mind, Heart Qi Stagnation, Heart Vessel Obstructed, and Blood Stasis of the Heart. Excess Heart conditions can manifest as emotional/mental problems (like restlessness, mania, agitation) or, again, circulatory and cardiovascular pathologies.

It's important to note that any disease label (say, insomnia, anxiety, depression, hypertension, coronary artery disease, etc.) does not relate solely to one organ. From the holistic perspective of Chinese medicine, multiple organ, tissue and energetic systems may be involved in or affected by a pathological process. The role of the Chinese medicine practitioner is like detective work -- sleuthing out complex patterns -- and, then, restoring balance through appropriate treatment.

The Heart is may be centrally related to the following symptoms and diseases. Other organs, especially Heart, Spleen, Lung and Kidney function in close relation with the Heart and will likely be secondarily involved in these pathologies as well.

Physical Imbalances:
The Heart Meridian
pallor or bluish complexion or lips
shortness of breath
cold hands
chest pains
profuse sweating
night sweats
tongue ulcers
dark urine, blood in urine
coronary artery disease
cardiac infarction

Mental-Emotional Imbalances:
poor memory
excessive dreaming
mental restlessness and uneasiness
mania/ manic-depression
violent or antisocial behavior

Please stay tuned to my blog for more essays and articles on specific modern diseases and their treatment through Traditional Chinese Medicine.

More colorful and inspiring perspectives on the heart can be found:

The Heart in Classical Chinese Medicine, summarized by Subhuti Dharmananda, PhD, of The Institute for Traditional Medicine and Preventive Health Care, Inc. (ITM)


The Heart in Relation to Spirit, summarized by Lorie Eve Dechar, author of Five Spirits: Alchemical Acupuncture for Physiological and Spiritual Healing.


Giovanni Maciocia. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists.

Friday, May 25, 2012

Summer Food & Cooking Tips

Traditional Chinese Medicine teaches us that summer is the most yang time of the year -- a time of maximum expansion, activity and growth. The longer days and warmer weather tend to stir us into greater activity. However, if our internal energies are imbalanced, restlessness, insomnia and anxiety may be exacerbated at this time of year. Here are some tips from traditional Chinese nutritional theory that can help attune our bodies to summertime and keep us healthy the warm summer days and in seasons to follow.

1. Eating in Season / Colorful Abundance:
Eating local, seasonal produce is always one of the best ways to stay healthy. Summer is a particularly fun & easy time to do this. Go to your local farmers' market on a summer evening and you'll find a colorful abundance of fresh fruits and vegetables.

The abundance of the natural world reaches its peak in summer. In plants, this energy is concentrated in flowers and fruits. Cherries, peaches, and berries provide superb nutrition at this time of year and help keep us cool and hydrated as the climate becomes warm and dry.

2. Eat Red:
The color red (think bright hues of red and orange) is associated with summer in Chinese medicine theory. This is a great time of year to incorporate red foods into your diet: berries, peaches, and as the season advances, tomatoes, chilies, and peppers. These foods are all cooling.

Berkeley-based nutritionist Nishanga Bliss writes, "Science is catching up with traditional medicine in identifying a few of the phytochemicals which are concentrated in the pigments of plants, and red foods are often particularly high in carotenes, such as lycopene, which are potent antioxidants, acting to protect us from cardiovascular disease (and cancer and other diseases). And when might we need an extra dose of antioxidants? How about when exposed to extra solar radiation, a source of oxidative stress, like in summer?"

3. Quick, high-heat cooking techniques:
The element associated with summer is fire. Fire is quick-acting and, obviously, high-heat. Our cooking techniques can reflect these qualities in summer. Traditional Chinese nutritional theory recommends high-heat sauteeing, stir-frying and steaming in the summer. Whereas in winter, we opt for slow, deeply-warming cooking techniqes like simmering, roasting and baking, the cooking techniques of summer should help us to keep cool by minimizing the time spent in the kitchen and the use of the oven. 

Nishanga Bliss writes, "It’s a great time to experiment with “hypercooking,” where you select dishes that require a minimum of heating time. If I’m using a cast-iron skillet, for example, I’ll turn off the heat before a braised dish is done, and use residual heat to finish cooking."

4. Keeping Cool, Keeping Moist:
We don't typically have to contend with very high temperatures during summer in the Bay Area. Nevertheless, the climate in summer tends toward heat and dryness.

According to traditional Chinese medicine, excessive activity and exposing ourselves to excess heat in summer can result in ill health in later seasons, as well as later in life. Heat can become entrapped as toxic heat in our body. Curiously, our bodies often respond to this entrapped heat by producing excess fat to insulate and guard our bodies and internal organs from damage by this toxic heat. Many Traditional Chinese Medicine (TCM) physicians see modern chronic illnesses such as cancer and heart disease (which are correlated with excess body weight) as manifestations of toxic heat in the body. Along another line of thinking, fevers, colds, coughs and flus of autumn and early winter can sometimes be viewed, according to TCM, as the body's mechanism for ridding the body from entrapped summer heat pathogens.

In any case, it is important to think of keeping our bodies cool and amply lubricated to counteract summer heat and dryness. There are many ways of doing this:

  • Lighter foods are less heating. In winter, when there is less energy available from the environment, it can be beneficial to eat more nutrient-dense storage foods (animal proteins, nuts, seeds, beans, root vegetables, dairy products, whole grains). In summer, on the other hand, when we get energy from the sun, it's better to shift the balance to eating more vegetables and fruits. You don't have to cut out grains or meats, but eat them in small portions and less frequently. Fill at least half your plate with fresh, seasonal vegetables.
  • Foods with high fluid content help drain heat from the body via the urine. This includes juicy fruits and vegetables. Watermelon, cucumber and lightly-steamed bok choy are among the best for clearing heat on very hot days. Barley tea, mung beans and aduki beans also help drain heat from the body via the urine. You can get easy-to-use roasted barley bagged tea (or mugicha) at Asian markets. It tastes great as cold or warm. See image below.
  • Barbecue with Caution. Cooking meat over high heat for long periods of time tends to deplete the meat of its fluid content, render it less digestible and make it very heating. Meat is more digestible when it is braised and then stewed, eaten with its own fluids in the form of broth or stock.
  • Integrate raw foods. Integrating more raw foods into our diets during the summer days can be beneficial due to their cooling effect. Produce can be eaten raw or briefly steamed. Raw food can also include some animal foods like ceviche or sushi, which are high in vitamins and enzymes. Remember that raw foods can be hard on the digestive system, according to Chinese medicine theory. Those with strong digestion can eat lots of raw foods during the summer, but if you suffer from lots of gas, bloating, low energy or loose stools, think of eating warm cooked foods, soups, stews and integrating raw food in the form of fermented foods.
  • Fermented foods. Raw foods like raw sauerkraut and pickles, yogurt, buttermilk, kefir, creme fraiche, kombucha and miso are cooling and full of enzymes and immune-enhancing friendly bacteria.
  • Bitter foods. Bitter is the flavor associated with the summer season in Chinese medicine. Small amounts of bitter food support the heart through multiple actions, including helping to clear the physical heart and arteries of fatty deposits.  Bitter foods also help drain excess heat and toxins via the urine. Summer is a great time of year to integrate bitter leafy green vegetables into your diet (think kale, collards, dandelion, endive, watercress, cilantro etc.)
  • Spicy foods. In many cultures that emerged in hot regions of the world, spicy foods are used to cool the body by promoting a mild sweat. Consider integrating a small amount of spicy food (fresh ginger, horseradish, fresh red or green peppers, a pinch of cayenne powder) into your diet during summer. But keep in mind that excess hot spicy food can also be drying and overheating.

5. Flowers
As mentioned above, the abundant yang energy of summer is concentrated in flowers and fruits. Flowers are in bloom all around us. Bringing flowers into our diets can help us align our energies with summer. Flowers lighten us energetically and often help alleviate depression.

I have been enjoying making floral sun teas during the last few weeks. I use chrysanthemum, chamomile, hibiscus, peppermint and lemon balm -- a lot of which I can get from my garden. Red clover blossoms, a little lemon zest or orange zest, a sprig of rosemary or lavender can add  a nice accent too. Just put a few leaves and flowers in a one- or two-quart mason jar, add hot water and let it steep over night. On hot sunny days, you can also make sun tea by filling a jar with flowers/leaves and room temperature, filtered water, and letting the jar sit in sunlight all day.

Sipping floral tea throughout the day will keep you cool, light and cheerful.

Chrysanthemum flowers clear heat, calm the Liver (an organ that is easily aggravated by heat). They also relieve headache and dry eyes due to Wind-Heat.

Peppermint leaves, while not flowers, are cooling and refreshing, helping to clear surface heat and move circulate the energy of the Liver. They are easy to grow in Berkeley gardens.

Lemon balm leaves, also easy to grow in Berkeley, are also cooling and relaxing. They help break fevers by promoting sweat and are calming and relaxing to the nervous system.

Chamomile, which grows abundantly in Berkeley during the summer, is mildly bitter and spicy. It is high in calcium which makes it useful in soothing the nerves. Chamomile can help clear heat and fever; it soothes digestion. Lemon balm and chamomile tea are a great antidote for insomnia.
Hibiscus is cooling and has been shown in clinical trials to lower high blood pressure more effectively than placebo and as well as a common blood pressure medication. Red in color, it has an affinity for the heart and blood vessels, which are the anatomical structures associated with summer in Chinese medicine.

Stay cool & happy eating!!


Nishanga Bliss's blog.

Elson M. Haas, M.D. Staying Healthy with the Seasons.

Paul Pitchford. Healing with Whole Food: Asian Traditions and Modern Nutrition.

Lesley Tierra, L.Ac. The Herbs of Life: Health & Healing Using Western & Chinese Techniques.

Spirit of Summer: Notes on Summer in Chinese Five-Element Theory

In the traditional Chinese calendar, as in traditional European calendars, May marks the beginning of summer. Old European traditions celebrate May with dancing, flowers, bonfires, the maypole and rituals of exuberance, courtship & flirtation – all in the spirit of the ascending yang energy of summer.

During springtime, yang energy rises, while yin energy recedes. Daylight hours, in the northern hemisphere, become longer and warmer. Yang energy will reach its peak on the summer solstice, June 21st, before it begins its descent.

According to classical Chinese five-element theory, summer is a time of activity, forward motion, creativity, growth and change.

What is Five-Element Theory?

Five-element theory arose in pre-industrial, agrarian China where humans closely observed and depended on natural cycles of the earth and climate. In five-element theory, the five seasons of the year – Spring, Summer, Late Summer, Autumn and Winter – each correspond to a specific set of qualities and energies. In agricultural society, survival depended on a sophisticated understanding of and adaptation to the patterns of nature. Our modern, urban lives are less directly tied to agricultural cycles, but we still find greater health & happiness when our activities are aligned with the prevailing energies of our natural environment.

In traditional Chinese philosophy, summer has the following correspondences:
element : fire
color : red
direction : south
weather : heat
animal : red phoenix
life phase : youth, growth
emotion : joy / depression
sound : laughter
organs : heart, small intestine
tissue : blood, blood vessels
sense organ : tongue
taste : bitter

Summer in the Flow of the Seasons:

In five-element theory, the season of spring is associated with the wood element. We can visualize “wood” as the upward, outward energetic movement of new springtime plant growth. In spring, new sprouts arise out of the earth after the dormancy of winter. Similarly, among humans, spring is a time for new ideas and new visions. However, our energy to act on those ideas, to make changes in line with new visions, is still limited in springtime. It's still cold. Traditionally, in springtime, we are still surviving largely on stored food from last year's harvest. So, our energy is still fragile and new activity should be limited.

Summer, on the other hand, brings robustness. Longer hours of sunlight warm the earth. The gardens we planted earlier in spring begin to produce substantial food to nourish us.

Walking through nearly any neighborhood in Berkeley in May, I'm stunned by multi-colored show of flowers. California poppies, the first roses --- all portraying the vibrancy of early summer. Brightly-colored fruits and berries begin to appear in the farmers' markets.

How might this season be reflected in our personal and communal lives?

The Spirit of Summer:

Summer is a time to get to work on new ideas. It is also a time for physical activity, sport and recreation. Words associated with summer energy are motion, creativity, intuition, energy, enthusiasm, vitality, ventures.

Stephen Scott Cowan, M.D., in the book I'm reading right now Fire Child Water Child, (which applies Chinese five-element theory to understanding pediatric ADHD) writes this about the summer season:

"Fire corresponds to the season of summer. In contrast to the push of spring, plants have now reached the culmination of their growth and have burst open in flowers displaying rich colors and fragrances, attracting bees and butterflies. This is the time of great consummation, of pollination. It's party time! The weather is hotter, forcing us to slow down and take it easy. People go on vacation, distracting themselves with sightseeing. It's time to have fun, to try something new. Fire brings light and excitement to all our celebrations. Think of the fireworks of the Fourth of July, the sky bursting with flower-like explosions of light...."

The element associated with summer, according to Chinese five-eleement theory, is fire, and the associated color is red: bright red or red-orange. The sun, which becomes so powerful at this time of year, is made of fire. The light, heat, warmth and upward movement of fire mirrors the enthusiasm, energy and vitality we might find in our lives and in relation to our favorite activities at this time of year.

Despite its enthusiasm, however, fire is still somewhat youthful. It is still dependent on earth and wood for its existence. So, our work and our pursuits may still be immature at this time of year. Summer is a time of growth and change. Despite the unbridled enthusiasm of this time of year, we have to be tolerant of change and instability characteristic of fire. We have to accept ourselves, our projects as works in progress--with all their shortcomings and imperfections. It is time to dream, to listen to our intuition, to try new things. Summer progresses into the Chinese season of Late Summer, which is associated with the earth element. It is in the earth phase that our the visions and ideas born in spring and worked on in summer achieve a level of solidity, maturity, or manifestation.

The emotion associated with summer is joy and the associated sound is laughter. At this time of year, we find joy through work and activity, through physical movement and recreation. Joy comes as we develop clarity about our life's purposes, and as we make desired changes according to our visions.

Summer Imbalances:

If our internal energies are flowing smoothly, summer can be a time for joyous growth and productivity. However, every quality has  its flipside. If we suffer from imbalances of the fire element, we might experience hardships at this time of the year. On a spiritual level, deficiency of fire can result in sadness or depression (opposite of joy), resulting from lack of alignment with one's life purposes. On the other hand, fire can easily become overly exuberant. Excess of fire can manifest in what the Chinese call an excess of joy. Mania, anxiety, restlessness and insomnia are common modern-day manifestations of unbalanced fire energy. In Chinese medicine theory, summer and the fire element correspond to the heart organ and the blood vessels. Pathologies related the physical heart (coronary issues, hypertension, palpitations, etc.) and to the heart spirit (insomnia, anxiety, depression) can become pronounced at this time of year and deserve special attention.

Acupuncture and Chinese herbal medicine can help to rebalance and restore the function of the heart. Please stay tuned to my blog for more articles on summer health and heart health.