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Cracking the Code of Chinese Medicine

By Harriet Beinfield, L.Ac.

When I began practicing Chinese medicine in 1973, there were only a few non-Asian acupuncturists, and my early patients were considered brave for trying such an unusual method of healing. Back then, my father, a surgeon on the faculty of the Yale School of Medicine, chided me for betraying him as I entered what he considered the marginal world of quacks. Today there are ten thousand acupuncturists in America, and millions of ordinary Americans have benefited from having stainless steel needles pressed gently into their skin, after which they sip mussy brews made with the gnarled roots of herbs like ginseng

   While Chinese medicine is now widely accepted, it remains beyond comprehension to many. However, just as fluency in a foreign language requires learning its vocabulary, an understanding of Chinese medicine requires familiarity with its terminology. Instead of the language of Western medicine–blood pressure, Pap smears, and X rays—the Chinese doctor refers to attacks of wind, the flow of qi (pronounced "chee"), and disturbances of fire.

   It was the poetic language of Chinese medicine that first seduced me. Instead of picturing the body as a machine—the heart as a pump and the kidneys as plumbing— the body became a garden in need of rich soil, sunny heat, and thirst-quenching rain.

   To be healthy, plants need nutrient-rich soil that is not too dry or too wet, too hot or too cold. They must be protected from savage winds and extreme weather. Similarly, the human body enjoys health when its internal conditions are favorable. In Chinese medicine, our discomforts and illnesses are understood to be a result of adverse internal climates and obstructions in the flow of our rivers of qi, the energy that is the body's vital life force.

   By understanding Chinese medicine's basic principles, you can learn to recognize when your body is threatened by adverse conditions and how to improve your internal weather patterns. Consider the case of Molly.

The Body as Garden

When Molly, a thirty-eight year old psychotherapist, first walked into my treatment room her worries began spilling out of her mouth before she even sat down. "I just feel off," she blurted. "I haven't had my period for four months. I feel disconnected and ungrounded."

   As Molly sat in my office, she began shifting restlessly in her chair an continued, "I'm having hot flashes, and I'm not sleeping well. I'm always distracted. The other day I locked my keys in the car. That isn't me. I've been feeling this way for the last ten months—since my miscarriage. My relationship with my husband has problems now too. Sometimes sex is painful. Yesterday at breakfast, he was chewing his toast and I lashed out at him."

   Molly had been under unusual pressure at her job, working with troubled kids who were in need of more emotional support than she could provide. Plus, three people close to her had died recently. Before seeing me, Molly was told by her doctor that she had a hyperactive thyroid. He wanted to do a test that would require her to ingest a radioactive isotope, which frightened Molly. She told him that instead she wanted to try Chinese medicine, which had been suggested to her by a coworker. Because tests for several likely diseases were negative, he gave her the OK, as long as he continued to monitor her thyroid condition.

   In my office, Molly's eyes welled up with tears as she said, "When I can't count on my body, it really scares me. What do you think is happening?"

   I examined her tongue and saw that it was dry and red at the tip. Then I felt her pulse, which was rapid, full, and pounding. I asked Molly to describe for me exactly how she felt, physically and emotionally.

   She said she felt warm a lot of the time– she always wore short sleeves when her daughter was pulling on a sweater. She said that her skin felt dry and her lips often were parched.

   "The absence of your period along with your dry skin tells me that you have a loss of internal fluids," I said. "Intercourse is painful for you because your vaginal membranes are thirsty and therefore easily irritated. This irritability invades your emotional life as well, causing you to be moody and over reactive. Your body, which is dried out from excessive heat, lacks the juice necessary to generate a normal menstrual flow or lubricate your vaginal tissue."

   To help her understand what was going on in her body—and help her 

Herbs for Stormy Weather

Chinese doctors diagnose patients by examining the tongue, feeling the pulse, asking the patient what symptoms she has, and observing mannerisms and expressions. The therapeutic herb combinations shown below (which need to be used in combination) are for eleven conditions.

see that her problems could be corrected simply—I explained things using the garden analogy. "Your body's ecology is out of balance," I said. "Just as vegetation depends upon ample stores of sun and rain to ensure healthy growth, your body needs the proper balance of heat and coolness, dryness and moisture. Right now, you have too much heat and dryness in your body. In Chinese medicine, we call that a `disturbance of fire.' When we correct that, you'll soon begin feeling better."

   Molly's speech and mannerisms had played a part in my diagnosis of her. Fire—which characterizes Molly—is not only warm, it also flickers in bursts, leaping outward and upward. As soon as Molly spoke, her feelings rose right to the surface and her words jumped like sparks off her tongue. The redness on the tip of her tongue along with her rapid, full, pounding pulse also indicated too much internal heat. Internal heat causes hyperactivity and disquiet. This heat accounted for her "hot flashes" as well as her restlessness and insomnia.

The Five Organ Networks

When out of balance, each of the five organ network displays physical and emotional signs. Thus, by noting the patient's symptoms and behavior, we can tell which organ networks are distressed—where there is congestion or depletion—and what acupuncture points need to be stimulated. The following describes the somatic and psychic functions of the five organ networks as well as their usual patterns of distress:

The spleen is particularly vulnerable to dampness, whether arising internally (from diet or insufficient heat) or from extreme humidity. In either case, this produces feelings of laziness, heaviness in the arms and legs, a generalized sense of being burdened, a bloated belly, and muddled thinking. 

 Someone overly protective of themselves and their environment—oversensitive, controlling, and uptight—could be suffering from a lung disharmony. Other signs of disturbance include tightness of the chest, skin rashes, vulnerability to colds or flu's, rigid thinking, and melancholy.

Yin and Yang

A patient's symptoms can be understood within the principle of yin and yang, which lies at the heart of Chinese medicine. All things can be differentiated into the duality of two opposing forces, yin and yang. Life arises from the magnetic interplay of these forces, such as hot and cold, dry and wet, expansion and contraction, soft and hard, fast and slow. When these forces are bound together and kept in balance, they form a dynamic harmony. When they become unbalanced, whether in the garden or in the body, then disturbances arise.

   Just as yin and yang divide the world into polar forces, so the powers, or phases, of nature—wood, fire, earth, metal, and water— further differentiate all activity. These phases also correspond to the changing seasons— fire, for example, corresponds to summer (yang) and water corresponds to winter (yin). When I first saw Molly, her distress was caused by excessive yang (fire) and insufficient yin (water). Among the body's organ systems, the heart shares the nature of fire while the kidneys share the nature of water. Because Molly's kidney (water) was weak, it could not regulate the heart (fire). When water cannot control fire, fire rages out of control. In short, Molly's yang heat was using up her yin fluids so that they could not moisten her skin, fill her uterus with blood, or nourish her brain. Molly's miscarriage can also be understood in yin-yang terms. Excess fire depleting the yin essence stored by the kidneys means that the organism cannot sustain new life within the womb.

Qi, Moisture, and Blood

Another lens through which the Chinese doctor views the body is by assessing its natural resources. Just as the Earth's natural resources are land, water, and air, so the body is comprised of constituents called qi, moisture, and blood. These are the principal ingredients that the doctor, caretaker of the body-garden, must cultivate in order to ensure that they exist in adequate measure and are properly distributed. These terms–qi, moisture, and blood–have particular meanings within the vocabulary of Chinese medicine: 

Qi is that which animates all life. An invisible force, qi is likened to air. As a breeze moves the grasses and water, so qi initiates and regulates the heartbeat, the breath, peristalsis, and the entire process of the organism's growth and development.

Moisture includes all secretions and fluids less dense than blood. It can be as ethereal as the vapor of breath and invisible sweat or as dense as mucus, tears, saliva, sexual secretions, urine, and cerebrospinal fluid.

Blood is the substance from which bones, nerves, muscles, and organs are formed.

These three resources interact with and are dependent upon one another. For example, without qi, moisture and blood stagnate, coagulate, and cease circulating. Without proper moisture, the qi becomes hot and agitated and the blood dries up and congeals. Without blood, moisture is dispersed and qi is scattered.

Stormy Weather in the Body

Like the gardener, the Chinese doctor looks for signs that reveal the problem at hand. He or she looks for excesses of dryness, dampness, cold, heat, and wind and determines how these adverse climates are upsetting the distribution of qi, moisture, and blood to the body's organ systems. The course of the problem may be external or internal factors.

   For example, dryness, whose signs are thirst, parched skin, and irritated mucus membranes, can occur from living in a hot and windy climate. On the other hand, it may signal that, internally, the body is unable to properly generate its own fluids, which can be caused by various factors, such as the over consumption of hot, spicy foods or possibly the use of antihistamines or diuretics, which disturb the body's natural secretions and discharges. The body must be able to absorb, store, and circulate moisture in order to adequately hydrate itself. If any of these functions is thwarted, symptoms of dryness will appear. The diabetic, for instance, can drink a great deal of water and still remain thirsty because the body is unable to retain the fluid. According to Chinese medicine, diabetes is known as a condition of severe dryness or deficiency of moisture.

The following are some symptoms that accompany adverse body climates:

Dryness. The nature of dryness is to wither and shrivel. A lack of moisture manifests itself as cracked and wrinkled skin, irritated eyes, constipation, lack of perspiration, scanty urine, brittle hair and nails, and thirst. Dryness can occur anywhere in the body, producing irritation, inflammation, and heat due to a lack of lubrication and secretions.

Dampness. The nature of dampness is to sink and accumulate like a stagnant swamp. Dampness is characterized by an abnormal buildup of fluids. It appears generally as swelling and a sense of heaviness, locally or throughout the body. It may show up as oily skin, sticky perspiration, swelling, phlegm, discharge of mucus, lethargy, cloudy urine, and excessive vaginal discharge.

Cold. The nature of cold is to slow things down by chilling them. Cold depresses metabolism and retards circulation. Cold can occur for different reasons. For example, medicines that counteract fever as well as the body's natural inflammatory response can create a cold condition. Such medicines tend to dissipate heat and weaken the circulatory and digestive functions (fire generates the heat necessary for all metabolic processes). The person suffering from a cold condition may feel chilled, crave warmth, and appear sluggish or weary, both mentally and physically.

Heat. The nature of heat is to accelerate metabolic activity, dilate blood vessels, and activate circulation. Heat tends to rise and spread out to the surface. Excess heat manifests as inflammation, rapid pulse, and fever. It produces burning, thirst, dark urine, swelling, and a feeling of increased warmth. It is not necessary to take the body's temperature to establish the presence of heat. It can be seen by the presence of dryness, constipation, painful urination, agitation, a desire for cold, and aversion to warm foods and climate. Heat is easy to detect in the form of rashes, sores, ulcers, boils, and acne.

Wind. Wind's nature is to move unpredictably, rising and falling, appearing and disappearing. Signs of a wind disorder are dizziness, itching, stuffy nose, scratchy throat, and aversion to drafts, sudden changes, and disequilibrium. Just as wind shakes a tree, rustling its leaves, wind in the body can manifest itself as vertigo, unsteady movement, and trembling. Wind is also indicated by spasms, in coordination, or pain that migrates from one region to another, suddenly arising and dissipating. Wind can give rise to high blood pressure, migraines, seizures, or paralysis.

   Adverse climates often appear in combination with one another, and correcting such an imbalance may require a complex intervention. Dampness, for example, may be accompanied by cold or heat. Damp cold manifests itself as stiffness and soreness of the muscles and joints. Damp heat, on the other hand, appears as red swellings and discharge like that seen in herpes sores and purulent cystitis or bronchitis. Any sore, abscess, or ulcer with pus or fluid indicates the presence of damp heat.

Repairing Irrigation

Remedying adverse climates is straightforward. For example, to relieve dryness, we give herbs and foods that create moisture in the body. Or to eliminate dampness, we use foods and herbs that drive off excess moisture. The principle of complimentarily applies: for cold, warm the body; for heat, cool; for dryness, lubricate; for dampness, dry; for wind, subdue. If these conditions have produced congestion of qi, moisture, or blood (which the doctor can detect by feeling the pulse), then the goal is to encourage circulation with foods, herbs, massage, and acupuncture. If there is depletion of qi, moisture, or blood, it is necessary to replenish these with food and herbs or by acupuncture.

   When the acupuncturist checks the flow of qi through the body, she feels the pulse to see how the qi is moving through fourteen different channels that course through the body just as streams and rivers ebb and flow across the surface of the Earth. Acupuncture points, located in tiny depressions where these channels come closest to the surface of the skin, are like gates that are opened and closed to modulate the movement of qi. Acupuncture is likened to the repair of irrigation systems.

   Herbal medicine and dietary modifications, on the other hand, are akin to feeding the soil with compost. While acupuncture redirects the invisible flow of qi, herbal medicine and diet alter the tangible flesh. Each of these methods can exert beneficial effects upon the body–cooling, warming, drying, and moistening; taming its energies; replenishing what's depleted; and clearing what's congested.

   For example, a throbbing, hot, full feeling in the head accompanied by coldness in the hands and feet suggests an excess of qi and blood in the head and a deficiency in the extremities. By stimulating acupuncture points in the hands and feet, the acupuncturist dislodges congested qi and blood from the head and redistributes it throughout the body. The headache retreats, and a comfortable sense of warmth pervades the body.

   When I first treated Molly, she had reservations about the needles. After I inserted them, she immediately relaxed and exclaimed with relief, "That didn't hurt at all." Acupuncture harmonized her kidney and heart while the herbal formulas that I gave her purged excess heat (cooling herbs like honeysuckle, chrysanthemum, and forsythia flowers) and replenished fluids and blood (moisturizing and blood-nourishing herbs like schizandra, rehmannia, angelica, and lycii). I advised Molly to discontinue drinking alcoholic beverages, which have a drying, heating effect, and to cut back on spicy, greasy, and sugary foods, all of which generate heat. And I suggested that she eat plenty of juicy fruits and vegetables and drink more fluids, preferably those not sweetened.

   After receiving acupuncture, taking the herbs, and changing her diet, Molly responded quickly. She returned the next week and said that she felt more grounded. In a clear, deliberate voice, she reported sleeping better and said her period had returned for the first time in four months.

Three months later, her physician noted that her thyroid had normalized. Molly also felt more in control of her emotions and was less agitated than she had been before. She continues to see her physician to have her thyroid function monitored

Marriage of Soma and Psyche

The overlap of emotional and physical symptoms that I saw in Molly is not unusual in Chinese medicine. Mental and emotional symptoms are often signs of organ disturbances. Molly's emotional symptoms, for example, told me a lot about her imbalances. Like fire, she is unrestrained and forthcoming—when she feels something, the world around her knows about it. The organ at her center, the one whose character (fire) she most manifests, is the heart. This is the source of her boundless enthusiasm. Also, when her heart became unstable due to not being anchored by the kidney, this accounted for her bouts of restless sleep and unpleasant agitation.

   Each of the organ networks—the liver, heart, spleen, lung, and kidney executes specific jobs required by the body. They generate, regulate, tame, and distribute the body's resources-qi, moisture, and blood ( "The Five Organ Networks,"). These networks are not confined to an anatomical location, as they are in Western medicine; instead, they embody psychological as well as physiological functions.

Nurturing Your Climate

In everyday life, the principles of Chinese medicine are not hard to apply. Start by observing how the four primary conditions - heat, cold, dampness, and dryness - are evident in you. 

Do you sweat easily or want the air conditioning on when others are cold?

You have signs of heat and should avoid spicy, greasy, and sugary foods as well as alcohol, as these exacerbate this condition. Radishes, cucumbers, juicy fruits, and abundant fluids will help to keep you cool and comfortable.

Do you find yourself wearing a sweater when others are in shorts and a T-shirt?

You have signs of cold and should avoid or consume only small amounts of raw fruits and vegetables, lightly cooking most foods instead. Also, avoid iced drinks or foods directly from the refrigerator. Certain condiments like ginger or cinnamon, when added to foods, will increase their warming nature.

Do you tend to be lethargic and sore in humid weather and prone to water retention?

You may be damp and should avoid greasy, thick foods like rich sauces, milk products, and fried and heavily sweetened foods. Foods that generate fluids, like celery, tomatoes, grapes, asparagus, and turnips, may exacerbate dampness. Eating fewer carbohydrates (starches and sugars) and more lean animal protein and lower-fat foods will lighten the spleen's load.

Do you have dry skin, nails, and hair and a lack of secretions (causing irritated eyes and membranes)?

You have signs of dryness and should try drinking plenty of liquids and eating moisturizing foods like juicy fruits and vegetables, honey and unrefined sugar, adequate vegetable oils (olive and canola), sea vegetables, and eggs. Also, avoid broiled, deep fried, and hot, spicy foods as well as stimulants like coffee and tea, and alcohol, which are dehydrating. 

The more you understand the basic principles of Chinese medicine, the more you can appreciate how your mental, emotional, and physical life is a creation of your interactions with the world around and within you. After all, we are ourselves an inextricable part of nature and her forces.

Harriet Beinfield, L.Ac., is coauthor, with Efrem Korngold, L.Ac., O.M.D., of Between Heaven and Earth: A Guide to Chinese Medicine (Ballantine Books, 1991).

Reprinted with permission from Natural Health, Nov.-Dec. 1996. For a trial issue of Natural Health, call (800) 526-8440.