Colds & Flu: Traditional Chinese Perspective Summarized

Western biomedical perspective on colds and flus

A Western biomedical discussion of common wintertime upper respiratory infections (URIs) usually begins with a differentiation between the “common cold” and the “flu.” According to western medicine, colds and various influenzas are caused by a wide variety of viruses which affect the respiratory tract. Although both categories of viruses can cause similar “flu-like symptoms,” there are differences between the common cold and the flu. The common cold is usually milder than the flu. Its symptoms include runny nose, congestion, cough and sore throat. Symptoms of flu tend to be more severe, and include fever, body aches, extreme tiredness, and a more intense dry cough. Influenza viruses are of greater concern, particularly among elderly, very young and immune-compromised patients, as they are capable of causing lung infection, pneumonia and even respiratory failure.

Classical Chinese perspective on colds & flus

In classical Chinese medicine, both the common cold and influenza correspond to an invasion of the body by “exterior wind.” In the initial stages of an exterior wind invasion, wind is said to have entered the exterior layer of the body – between the skin and the muscles. Here, the wind battles with the body's outermost defenses and interferes with the proper functioning of the lungs. This accounts for symptoms of chills and fever, body aches, sneezing, coughing, nasal congestion and discharge, etc.

Why the term “wind?” In one sense, “wind” best refers to climactic influences, espcially sudden changes of weather, to which the body cannot adapt. “Wind” also characterizes the complex of symptoms we see when someone has early stage cold or flu: rapidly changing, quickly progressing, moving from place to place in the body, chaotic & disorienting: fever, chills, body aches, sneezing, etc.

The treatment strategy for this initial stage of colds and flus, the exterior wind stage, is to provoke a mild sweating in order to push the invading pathogen out of the body. In terms of home remedies, at the very first signs of a fresh cold, patients are recommended to take mildly spicy herbs (the most basic being a hot tea or rice porridge with fresh green onions and ginger) and then to go to bed, cover up warmly enough to cause a mild sweat, and to rest. Patients are also cautioned against eating hard to digest foods as these will simply tax the system and cause a build-up of damp and phlegm in the body which will simply entrap the exterior pathogen more deeply in the body. Obviously, the patient should rest and keep warm, rather than exerting themselves or exposing themselves to the elements.

(For more on what to eat, what not to eat & home remedies, please see my article on Food Therapy for Colds & Flus.)

In the acupuncture clinic, the general treatment for a wind-invasion is to regulate the surface pores of the patient's body in order to release the exterior pathogen and expel wind, and to restore the dispersing and descending function of the Lung-Qi. This is achieved with acupuncture and/or by using mildly pungent herbs. Acupuncture point prescriptions and herbal prescriptions will vary according to specific nature of diagnosis and symptoms (i.e. headache, bodyaches, nasal congestion, sore throat, etc.)

Moving to the next level of complexity, the practitioner of acupuncture or Chinese herbal medicine, in treating a cold or flu in its initial stages, must differentiate whether the illness is a Wind-Heat or Wind-Cold pattern, and treat accordingly. Symptoms of Wind-Cold include aversion to cold, shivering, no fever, no sweating, occipital headache, stiff neck, body-aches, slight cough, runny nose with white discharge and sneezing. Symptoms of Wind-Heat include aversion to cold, shivering, fever, slight sweating, runny nose with yellow discharge, headache, body-aches, cough, sore throat, swollen tonsils, slight thirst and slightly dark urine. The patient's pulse will be slightly rapid, and tongue might be slightly red at the tip or on the edges in Wind-Heat cases.

Why Do People Catch Colds & Flus? – A Chinese Medicine Perspective

Since the discovery of germ theory, Western biomedicine's principal understanding of why people catch colds and flus is that they contract one or more of a variety of viruses in the environment. I believe it's only been somewhat recently, in naturopathic biomedicine, for example, that modern western medicine has begun to place emphasis on the strength of the immune system as an important factor in why people catch colds and flus.

In Traditional Chinese Medicine, an invasion of an exterior factor has long been understood to result from a temporary and relative imbalance between the strength of the body's Qi and the strength of the pathogen.

So, you can either have a really strong infectious pathogen that makes lots of people sick even if they have strong Qi. Or, on the other hand, a weaker pathogen will cause those people whose Qi are weak, in the moment or in the long term, to get sick.

What makes people's Qi weak? Any number of factors, but particularly overwork, poor diet, lack of quality sleep, exposure to stress or harsh climate, etc.

An important job of Chinese medicine and other health practitioners is to strengthen patient's innate Qi so that they are less vulnerable to infectious diseases, as well as chronic diseases. And, as you'll see below, Chinese medicine theory believes that chronic illness is often brought about by external pathogens, i.e. viruses, that have gone untreated or been improperly treated and have penetrated more deeply into the body. These lingering pathogens, in combination with weakness of the innate Qi, is a good setup for chronic, debilitating illness.

The Clinical Reality: Modern TCM Clinical Treatment of Colds & Flus

Some of the practitioners I've worked with say that in the modern clinical setting, the differentiation between wind-heat and wind-cold is difficult to make and somewhat irrelevant for effectively treating early stage colds and flus. Another practitioner I know says that people in American clinical setting rarely contract wind-cold. You'll really only see wind-cold-invasions in people working on fishing boats in Alaska or Northern China, for example. In everyday Americans, we most often see colds and flu that are a pattern of wind-heat or combined wind-cold and wind-heat. Also, when cold pathogens linger in the body for a day or more, they generally produce heat and phlegm. This is particularly true in children, who run warm and produce a lot of phlegm.

So, in early stages of cold and flu we usually prescribe spicy and aromatic herbs that are cooling in nature. We also tend to use a category of herbs used for relieve heat and toxins because these have proven to be extremely anti-viral.

After the initial onset of a cold or flu, as the patient's body battles with the invading pathogen over a series of days, a range of different symptoms develop according to the specific virus and according to the physiological traits and tendencies of the patient. These symptoms can range from wet cough to dry cough, bronchitis, asthma, headaches, nasal congestion, runny nose, ear infections, etc. In treatment, then, the practitioner must select from a broader range of herbs and herbal formulas, or other treatment strategies, to address the symptoms according to each individual presentation.

Historical Perspective on the Classical Chinese theories of Cold and Flu Treatment (and how Chinese physicians understood infectious disease way before biomedicine figured out germ theory):

Over two thousand and more years, Classical Chinese Medicine elaborated a complex understanding of the pathology and treatment of various manifestations colds and flus and their related complications. They also developed a significant understanding of acute infectious diseases other than colds and flus.

Common colds and influenza are generally relatively mild and self-limiting diseases. So why does their diagnosis and treatment hold such a prominent place in Traditional Chinese Medicine? There are various reasons for this. Chinese medical practitioners observed that if an external wind invasion (i.e. a cold or flu) was allowed to penetrate more deeply into the interior of the body, or if it was improperly treated, it could trigger more severe short-term diseases as well as long-term chronic illness. Also, it was recognized that the initial symptoms of many severe, life-threatening infectious diseases were similar to symptoms of common cold or flu. So, in the era before antibiotics and other life-saving measures of western medicine, it was critical to identify and eliminate pathogens as soon as possible once they had entered the body. In other words, in order to really do their jobs and save lives in the face of epidemics and infectious diseases, traditional Chinese physicians had to be really good at differential diagnosis and use really sophisticated acupuncture or herbal strategies.

Two major schools of thought formed the pillars for the diagnosis and treatment of exterior diseases in classical Chinese medicine. These schools were separated in time by about 15 centuries. The Discussion of Cold-Induced Diseases (or Shang Han Lun), written by the physician Zhang Zhong Jing around 220 CE, provided the earliest framework for the diagnosis and treatment of diseases from Exterior Wind-Cold. In the Shang Han Lun, Dr. Zhang further elaborated on the diagnosis and herbal medicine treatment of complications of exterior disease in cases where pathogenic cold was allowed to penetrate more deeply into the body. Dr. Zhang describes six levels of progressive disease, affecting first the lungs and the stomach and then progressively impairing the body as a whole.

Fifteen centuries after Zhang Zhong Jing, the School of Warm Diseases (Wen Bing) emerged in the late 1600s, advancing a comprehensive theory of exterior diseases from Wind-Heat, along with their diagnosis and treatment. Dr. Ye Tian Shi, a physician of the Wen Bing School, formulated a theory of four levels to describe the symptomology and treatment for warm pathogenic factors as they advance more deeply into the patient's body. Dr. Ye's four levels correspond roughly, to a certain limited extent, with the six levels of the Shang Han Lun.

Giovanni Maciocia, a modern western scholar of classical Chinese medicine, explains that in addition to expanding Chinese medical understanding of exterior pathogens, the Wen Bing/Warm Diseases School first introduced the idea of infectious disease, well before the introduction of western medicine in China. That is, the Wen Bing School introduced the idea of the “warm disease,” a virulent infectious disease that afflicts individuals even if their body's Qi is strong. Previous to the Wen Bing School, it was believed that a person fell ill from an exterior disease because of a relative imbalance between an external pathogenic factor and the body's innate Qi. The doctors of the Wen Bing School realized that some diseases, while still falling under the category of “Wind” diseases, and still characterized by early cold or flu-like symptoms, were infectious or even epidemic in quality. A further innovative idea stemming from the Wen Bing School was that the pathogenic factors causing Warm diseases (infectious diseases), enter the body via the nose and mouth, rather than via the skin, as happens for Wind-Cold diseases. So, the Wen Bing School provided a sophisticated understanding and notable system of effective treatments for infectious diseases such as measles, chicken pox, German measles, poliomyelitis, small pox, scarlet fever, whooping cough and meningitis well before the advent of western biomedicine.

Information in this article was drawn largely from:

Giovanni Maciocia's The Practice of Chinese Medicine: The Treatment of Diseases with Acupuncture and Chinese Herbs. London: Churchill Livingstone, 1994.

with shouts out to:

Andrew Gaeddert, Founder of Health Concerns Herb Company, www.healthconcerns.com

Gene London, L.Ac.

Briahn Kelly-Brennan, L.Ac.

who introduced me to some of the ideas mentioned here.

Pediatric Massage Techniques for Cold & Flu Season

Here are a few pediatric massage techniques from Chinese medicine that you can use on your little ones to boost immune health and ease cold and flu symptoms.

TWO TECHNIQUES FOR BOOSTING IMMUNE HEALTH

Both of these techniques are used to promote vibrant energy and well-being in kids. They are best performed regularly on healthy kids for illness prevention, but it's ok to use them curatively on sick kids as well.

1. Pinching & Rolling along the spine:

In a warm room, start with your child on his/her belly, and fully expose the skin of the back. Apply a very small amount of oil or other massage medium on the the back by gently rubbing in a downward direction. (Olive, coconut or sesame oil are commonly used massage mediums to prevent chafing the skin.)

Place both hands on one side of the child's tailbone. Then use the tips of your thumbs, index and middle fingers to grasp or pinch a fold of fleshy skin on the bum or low back. Next, move your fingers forward while rolling the skin with both hands upward alongside spine.

So, you're pinching and rolling a fold of flesh all the way up the back from the bum to the base of the neck. Repeat 3-4 times on each side of the spine. (Do it in an upward direction only.)

Your child's skin might temporarily get a little red due to the quick histamine reaction of his/her delicate skin; but children generally enjoy this technique and don't find it painful.

My daughter loves it when I use this technique on her. We call it “creepy crawly massage,” since it's a little like a small critter creeping up her back.

Therapeutically, this “spinal pinching” maneuver is used to strengthen the child's body in general and to prevent disease, as well as to treat numerous diseases. It's a wonderful technique to do daily.

The power of this technique, according to Chinese medicine theory, relies on two rows of points (called shu points) extending like columns up and down the erector spinae muscles on either side of the spine. Each pair of shu point is associated with one of the twelve major organs of the body. Massaging in an upward direction alongside the spine, then, raises the energy of the body and strengthens and regulates all the major organ systems, boosting the immune system and all other physiological functions.

2. Circular palm-rubbing:

This is a great technique for moms to do on their babies while nursing or feeding, and it doesn't require much energy. Simply use your thumb to rub in a circular direction over the child's palm. Rub lightly so you glide smoothly over the skin (no massage oil necessary).

Therapeutic recommendation is to rub this circle 100-300 times, rapidly, making about two circles per second. But any amount is beneficial.

This circle on the palm is called the “nei ba gua,” or “inner eight trigrams.” The name comes from the ancient Daoist practice of placing a diagram of eight trigrams (see image at right) on very energetic parts of the body. In traditional theory, rubbing from one trigram to the next serves to move Qi internally from one organ of the body to another.

Rubbing a child's palm serves to regulate and harmonize all the internal organs of the child's body. This technique is particularly soothing for the digestive system. It is believed to be equivalent to massaging the child's lower abdomen, and often easier to do than rubbing the belly of a wiggly, ticklish child. Because digestion is fundamental to all body processes, especially in kids, circle-rubbing on the palm (or the belly) is soothing and supportive to overall health.

TECHNIQUES FOR RELIEVING COLD & FLU SYMPTOMS

1. For Lung Congestion & Cough: Stroking the Ring Finger

This is another one moms can easily do while nursing.

The technique is performed just on the pad of the ring finger (the palmar surface of the most distal phalange, near the fingertip). Hold your child's fingers and use your thumb to stroke in a straight line from the distal transverse crease to the tip of the finger. Rub in one direction only, outward toward the fingertip, in a quick flicking motion. Repeat this move 100-500 times (about 3 repetitions per second).

The ring finger is used in treating the Lung. This maneuver helps to clear heat and phlegm from the lung in cases of lung congestion and cough.

1a. Also for Cough: Massage the Chest

Start at the very center of the chest, at the midline directly between the two nipples. Press and rub this point, "Chest Center," 30-60 times. Then use your fingers to rub in an outward direction (toward the arms) following the grooves between each of the ribs on the chest.

You could use a light massage oil with a few drops of an aromatic essential oil (like peppermint or eucalyptus). This will help loosen phlegm in the chest and ease cough. Be very careful not to use too much aromatic oil so that you don't irritate your child's skin. (Of course, it's best to use organic products and to be sure, first, that you're child is not hypersenstive to them.)

2. To Calm a Fever: Stroking the Forearm

On the inner surface of the forearm, rub in a straight line from the elbow crease toward the wrist. Rub in one direction only, rapidly, 100-300 times.

This technique is appropriate when the child is fevering and agitated. It will help release heat and pathogens from the body and calm the fever.

Apply an evaporative medium like rubbing alcohol or water (or even a dab of cooled-off peppermint or ginger tea) when you do this technique to help the body vent heat. DO NOT USE MASSAGE OIL in the case of fever or illness because oil traps heat and pathogens in the body.

3. For Nasal Congestion: Welcome Fragrance & Wasp Entering the Cave

In this technique, you'll gently massage the face itself.

The first pair of points, poetically called "Ying Xiang," or "Welcome Fragrance," are just lateral to the outside edges of the nostrils (see image to right). Press these points lightly with the tips of your index fingers and knead in tiny circles 20-30 times.

Then you can actually press gently on the nostril openings and rotate 20-30 times. This is called "Wasp Entering the Cave," and helps clear fever and congestion related to the common cold.

4. To Ease Headaches

Circular rubbing (30-50 repetitions) on the following point pairs of the head and face is useful:

• The temples (also eases fevers and cold symptoms)

• On the forehead just above the eyebrows (also reduces fevers and eye infections)

• Back of the head, just under the base of skull at the top of the neck.

Also, rub the forehead (30-50 repetitions, or more):

• Use your thumb to rub upward along the midline of the forehead, from the point just between the eyebrows up the hairline. This line is called "Heavenly Gate," and is used to calm agitation, anxiety and fear, in addition to easing fever, cold symptoms and headaches.

• Use your fingers or thumbs to push apart the skin on the forehead, rubbing in an outward direction only from the center of the forehead to the temples. This is called "Pushing Apart the Water Palace," and is used release cold and flu pathogens and relieve headaches.

Have questions or need help with these techniques? Ask your acupuncturist for a demonstration. I have lots of information about home remedies and healing techniques you can use to help your child feel better.

Sources of Information for the Article:

Coursework with Dr. Raven Lang, OMD, L.Ac. (2009) and Alex Tiberi, L.Ac. (Pacific Symposium, 2002).

Chinese Pediatric Massage Therapy: A Parent's & Practitioner's Guide to the Treatment and Prevention of Childhood Disease by Fan Ya-li, Boulder: Blue Poppy Press, 1994.

Chinese Pediatric Massage: A Practitioner's Guide: Techniques and Protocols for Treating Childhood Illnesses and Chronic Health Problems, by Kyle Cline, LMT, Rochester: Healing Arts Press, 2000.

TCM Pediatric Massage for Parents & Caregivers: An Introduction

As part of my ongoing Chinese medicine blog, I'm writing a series of short articles on pediatric massage for parents & caregivers. In these articles, I'll share techniques that you can use can use to nurture & support the health of your little ones, and to treat common pediatric illnesses, at home.

Research has shown that children benefit in so many ways from loving touch from their parents and caregivers. Massage promotes well-being and helps kids relax. It alleviates illness. It also supports parent-child bonding and helps parents feel more calm, empowered and grounded in the face of the sometimes overwhelming task of parenting.

To launch this massage series, here is a brief introduction to Chinese pediatric massage, known as pediatric tui na.

What Is Pediatric Tui Na?

Pediatric tui na is one of the main modalities used in Traditional Chinese Medicine for treating children for a wide range of health conditions. It is also used to prevent illness and to promote children's general vibrancy and well-being.

What is Tui Na?

Tui na (which translates as “push grasp”) is a brilliant form of medical massage originating from China and based on the meridian system of Traditional Chinese Medicine. Tui Na, as practiced on adult patients, uses a variety of hand techniques and active and passive stretches to restore correct anatomical musculoskeletal relationships and neuromuscular patterns and to promote the circulation of Qi and Blood. It is used to treat injury and chronic pain conditions as well as internal medical conditions.

Pediatric tui na is widely used in Chinese hospitals and clinics to prevent and treat almost all common pediatric diseases, including internal medical disorders, trauma, and diseases of the eyes, nose, mouth and ears. In particular, pediatric tui na effectively treats pediatric digestive and respiratory disorders.

What Age Range Can Benefit from Pediatric Tui Na?

Pediatric tui na is suitable for children under twelve years of age. Its effects are more pronounced on children under six, and it is especially effective in the treatment of infants.

Chinese medicine practitioners have always recognized that young children have a different energetic make-up from adults. So, pediatric tui na has a special repertoire of points, lines and regions of the body that is particular to children. These points differ significantly from the points along the meridian system used in treating adult conditions.

In children over six, TCM practitioners are more likely to combine pediatric tui na with other therapeutic techniques, such as adult tui na manipulations, acupuncture, needle-less acupuncture or shonishin, and herbal medicine.

At-Home Treatment Techniques for Parents or Caregivers:

A seasoned pediatric tui na practitioner is familiar with a variety of specialized hand techniques, as well as the complex system of energetic points and pathways on a child's body.

With a little instruction, however, you--the parent or caregiver--can use some of these techniques to care for your little ones at home.

But How Do You Massage an Active, Wiggly Child?

Good point! It's often easy & pleasant to massage your young infant; but it may feel like your massage days are over as soon as your little one starts crawling! Toddlers and preschoolers are on the move, with a lot more on their agenda than lying still and receiving massage. They typically have short attention spans and may not be cooperative.

A few points can help address the wiggle factor. First, in pediatric tui na, less is more. It is more effective to massage just one or two points than to try to massage the whole body. Because the points selected are energetically potent and known to directly affect a particular part of the body, or a particular physiological process, the impact of massaging just a few points will be more profound than a general full-body massage.

Second, many pediatric tui na techniques are performed on the hand. In children, the hand is a microcosm of the whole body, and massaging certain points on the hand strongly impacts different aspects of internal physiology. Massaging the hand is easier to do on a squirmy kid than, say, massaging the belly. Mom can easily massage her child's hand while nursing or feeding, and it doesn't require a lot of extra energy from her.

To sum up, pediatric tui na techniques often call for many repetitions an one point, i.e. rapidly rubbing 100 circles in the palm of the hand. This can actually be done quickly and mindlessly on a nursing child, and have a strong positive impact.

Just a few more points before getting started:

• Make sure the space where you're massaging your child is warm. During the massage, you're child's pores and meridian system will be open, and he/she will be more vulnerable to chilly drafts.

• Bedtime is a great time for massage, as massage is generally relaxing for little ones, just the way it is for adults, and it goes hand-in-hand with pre-bed snuggling. Some systems of energetic work caution against doing pediatric massage less than one hour before or after the child has a bath, because the combination of bathing and massage can be overwhelming to the child's delicate system.

And, of course, feel free to contact me for help with these and other healing techniques to support your children's health.

Stay tuned for upcoming articles on do-it-yourself pediatric massage techniques!

Sources of Information for the Article:

Coursework with Dr. Raven Lang, OMD, L.Ac. (2009) and Alex Tiberi, L.Ac. (Pacific Symposium, 2002).

Chinese Pediatric Massage Therapy: A Parent's & Practitioner's Guide to the Treatment and Prevention of Childhood Disease by Fan Ya-li, Boulder: Blue Poppy Press, 1994.

Chinese Pediatric Massage: A Practitioner's Guide: Techniques and Protocols for Treating Childhood Illnesses and Chronic Health Problems, by Kyle Cline, LMT, Rochester: Healing Arts Press, 2000.

Winter Cold & Flu Prevention: Nine Simple Lifestyle Adjustments

1. Fresh Air: Be sure to spend some time outdoors at least once every day. Being inside puts us in more direct contact with other people's germs. Winter air tends to be dry, pulling moisture out of cough and sneeze droplets, causing them to hang in the air longer. Our nasal passages are also drier and more susceptible to invasion by airborn pathogens.

A 2010 Appalachian State University study showed that people who walked briskly outdoors 30-45 minutes per day, 5 days per week, during winter had fewer seasonal illnesses than their sedentary counterparts. For a broader perspective, here's an inspiring article on the health-enhancing value of time spent outdoors by SF Acupuncturist Chris Kresser.

2. Exercise: Exercise improves immune function by fostering an increase in natural killer cells, neutrophils and monocytes in the body. Another image is that exercise increases your body temperature, improving your body's ability to fight off viruses and other infections. The effect of exercise on body temperature can be likened to a mild fever. A 2011 study, published in the Journal of Leukocyte Biology, showed that mild fever raises the number of a specific type of lymphocyte, called a CD8+ cytotoxic T-cell. This lymphocyte is responsible for destroying cells infected with viruses.

Exercise in winter should be mild. Strenuous exercise is a stressor. When coupled with pre-existing stress, poor sleep patterns or poor diet, strenuous exercise can actually trigger infection. A daily brisk 30-45 minute walk is enough. Gentle qi gong, taiji or yoga practices are also wonderfully restorative at this time of year.

3. Relaxation: Find ways each day to reduce stress and relax. Prayer, meditation, gathering with friends, and taking walks are great stress-busters, as are receiving health-enhancing treatments like acupuncture or massage.

Under stress, your body releases stress hormones like glucocorticoids which impede your body's ability to produce cell-signaling molecules called cytokines that trigger a disease-fighting response from your immune system. Also, when you're under stress you're less likely to take care of yourself by sleeping, eating well, and exercising.

4. Sleep: Getting at least 7-8 consecutive hours of restorative sleep per night (for adults) is critical to immune health. A 2009 Carnegie Mellon University study found that anything short of seven hours of sleep per night nearly triples your odds of catching a cold-- and that's seven consecutive hours of unbroken sleep. Your immune system is most effective when you're not sleep-deprived. The more rested you are, the quicker you'll recover if you do catch a virus.

5. Handwashing: Viruses can survive for two to eight hours on hard surfaces (doorknobs, tabletops). To avoid spreading cold or flu viruses through touch, try to avoid touching your eyes, nose and mouth, and master the art of handwashing.

The U.S. Centers for Disease Control and Prevention (CDC) continue to tout soap and water as best measures for preventing the spread of cold and flu. Use pumped soap rather than bar soap, lather for 20 seconds before rinsing, and dry your hands thoroughly. Use alcohol-based hand wipes or sanitizers when soap and water is not available. Sneeze and cough into the crook of your elbow and wash your hands after sneezing or coughing.

6. Bundle Up: Dress warmly during the cold season. According to Chinese medicine theory, the pathogenic influences that give rise to colds and flus are carried into our body by wind and drafts. Our neck, shoulders and back are particularly vulnerable to such drafts, so be sure to keep those areas covered with hats, scarves, and coats. Keep in mind that body heat is one of the body's ways of mounting a defense against infection.

7. Eat warm, cooked foods: Healthy digestion is a key to good health & strong immunity. According to Chinese medicine theory, the digestive process begins with the Stomach turning ingested food into a warm soup or mash. The warmth for this process is provided by the Yang Qi of the Spleen. Until food is turned into a warm mash, no further digestion can take place. As the process of digestion continues, the Qi of the Spleen transforms this "mash," separating the pure essence from the dregs, and driving the pure essence upward to the heart and the lungs, where it turns into the precious substances of Qi & Blood which underly and drive all physiological function of the body.

One of the take-home messages of this colorful set of images is that good digestion requires warmth. The closer a food is to 100-degree-Fahrenheit soup, the more easily digestible it is. Warm soups and rice porridges garnished with cooked meats and vegetables are great examples of this type of food. By extension, cold and uncooked food places a burden on the body and particularly on the Spleen. Since the health of the Spleen Qi is critical to the health of the Lungs and the immune system, one can see the importance in eating warm, cooked foods for preventing colds during the winter months. See my 2011 article on the relationship of the Spleen and Lungs to immune health in Chinese medical theoory.

From a more biomedical perspective, keep in mind, from point 2 above, that a slightly elevated body temperature boosts immunity. Eating warm foods is one way of warming the body.

8. Avoid Sugar/ Eat Your Vegetables: According to an article by health guru Dr. Mercola, the average American currently eats 75 gm of fructose per day, as compared to an average of 15 grams per day 100 years ago. Overconsumption of sugar impairs the immune system. In Chinese medicine terms, excess sugar creates damp and phlegm in the body, which weakens the function of the Spleen, giving rise to symptoms of fatigue, weakness, edema, weight gain, all sorts of digestive complaints and impaired immunity. Damp accumulation provides an excellent breeding ground for microbial pathogens like cold and flu viruses.

From a western naturopathic perspective, excessive sugar impairs immunity by imbalancing the microflora of the intestines. Sugar is 'fertilizer' for pathogenic bacteria, yeast, and fungi that can set your immune system up for an assault by a respiratory virus. Says Dr. Mercola, "Most people don't realize that 80 percent of your immune system actually lies in your gastrointestinal tract."

In addition to eating less sugar (as well as sweets in the forms of fruits and refined grains), increasing your intake of fresh vegetables is a great way of strengthening your immune system, not only from the standpoint that vegetables provide a range of vitamins and minerals for your body. Again, from the naturopathic perspective of gut microflora, the fiber in vegetables is "pre-biotic." It provides a growth material substrate full of nutrients & fertilizers for probiotics, or "good bacteria," in our gastrointestinal tracts.

9. Receive Regular Chinese Medicine Treatments: Acupuncture, massage and herbal medicine help your body and mind function optimally. Chinese medicine can help you recover from illness; but it is equally or, even, more useful in helping prevent illness or rebuilding your body after illness. Practitioners of Chinese Medicine have always recognized preventive care as the most important aspect of medical practice. Chinese medicine can help you stay healthy by:

• improving digestion
• regulating appetite
• enhancing sleep and relaxation
• regulating hormones
• boosting energy
• optimizing immune function

Consider prioritizing your health by making time to receive acupuncture, massage or herbal therapy on a regular basis all year around. I am happy to work with patients to make this more affordable and accessible. Regular Chinese medicine treatments are one step toward avoiding a nasty illness during the cold and flu season.