Chinese medicine has always stressed the importance of excessive sexual activity: in this article, I would like to bring to your attention two factors:
- The distinction between men and women in sexual activity
- Insufficient sexual activity as a cause of disease

When discussing sexual activity, Chinese books never distinguish between men and women. There are substantial differences in the sexual physiology of men and women so that excessive sexual activity is less of a cause in disease in women than it is in men. The reason lies in the nature of Tian Gui.

Tian Gui is the generative essence that renders men and women fertile. It is mentioned in the very first chapter of the Su Wen: “When a girl is 14 Tian Gui arrives, the Ren Mai is open, the Chong Mai is flourishing, menstruation starts and she can conceive”. For boys, “When a boy is 16, Kidney-Qi is strong, Tian Gui arrives, sperm is discharged, Yin and Yang are in harmony and he can fertilize.” Thus, Tian Gui is the essence that allows women to conceive and men to fertilize: in women, it is the ova, in men, sperm. Tian Gui is a direct manifestation of Kidney-Jing. In men, loss of sperm therefore implies a loss of Jing and therefore excessive (too frequent) sexual activity may diminish Jing; in women, during sexual activity there is no corresponding loss of Jing as they obviously do not lose ova during sexual activity and therefore there is no corresponding loss of Jing.

While Chinese books always mention excessive sexual activity as a cause of disease, they never mention insufficient sexual activity as a possible cause of disease. This has not always been so as, during past dynasties, all sex manuals explicitly said that sexual activity is essential for the health of both men and women. Indeed, sexual abstinence was viewed with suspicion (as Buddhist nuns were).

Some Chinese doctors considered lack of sex and sexual frustration as a major cause of emotional stress in women. Sexual desire depends on the Minister Fire and a healthy sexual appetite indicates that this (physiological) Fire is abundant. When sexual desire builds up the Minister Fire blazes up and Yang increases : the orgasm is a release of such accumulated Yang energy and, under normal circumstances, it is a beneficial discharge of Yang-Qi which promotes the free flow of Qi. When sexual desire builds up, the Minister Fire is stirred: this affects the Mind and specifically the Heart and Pericardium. The Heart is connected to the Uterus via the Uterus Vessel (Bao Mai) and, in women, the orgasmic contractions of the uterus discharge the accumulated Yang energy of the Minister Fire.

When sexual desire is present but does not have an outlet in sexual activity and orgasm, the Minister Fire can become pathological, accumulate and give rise both to Blood Heat and to stagnation of Qi in the Lower Burner. This accumulated Heat will stir the Minister Fire further and harass the Shen, while the stagnation of Qi in the Lower Burner can give rise to gynaecological problems such as dysmenorrhoea.

Of course, if sexual desire is absent, then lack of sexual activity will not be a cause of disease. Conversely, if one abstains from sexual activity but the sexual desire is strong, this will also stir up the Minister Fire. Thus, the crucial factor is the mental attitude and sexual desire.

With regard to sexual frustration, Qing dynasty’s Chen Jia Yuan wrote very perceptively about some women’s emotional longing and loneliness. Among the emotional causes of disease he distinguishes “worry and pensiveness” from “depression”. He basically considers depression, with its ensuing stagnation, due to emotional and sexual frustration and loneliness. He says: “In women...such as widows, Buddhist nuns, servant girls and concubines, sexual desire agitates [the mind] inside but cannot satisfy the Heart. The body is restricted on the outside and cannot expand with the mind [i.e. the mind longs for sexual satisfaction but the body is denied it]. This causes stagnation of Qi in the Triple Burner and the chest; after a long time there are strange symptoms such as a feeling of heat and cold as if it were malaria but it is not. This is depression”.
Although the above thoughts derive from Dr Chen’s clinical experience with servant girls, Buddhist nuns and concubines and should therefore be seen in the social context of the Qing dynasty, they also have relevance to our times as he is essentially talking about sexual frustration and loneliness and his reference to widows confirms this (in old China widows were shunned and seldom remarried). He perceptively refers to sexual craving agitating the body but not finding a satisfaction in the Heart and mind: besides sexual frustration, he is also referring to emotional frustration and craving for love.

Thus, considering the social position of women in ancient China and the frequency of the above-mentioned emotional frustration, it is no wonder that Qi stagnation occupies such a central place in women’s pathology, and emotional stagnation in women was often the result of sexual frustration, separation, loss and loneliness: these are the recurrent "anger" in Chinese medicine books.

Sexual frustration was a common cause of disease especially from the Song dynasty onwards as Confucianists frowned upon sexual activity and believed that it should be carried out in secret and that there should be no public display of affection (as in modern China). The current pruderie of Chinese medicine and society is clearly a result not so much of the Communist influence but of the Qing dynasty's Confucian influence. It is important to understand, however, that these rules did by no means imply that sex was a “sin” and woman was the origin of such sin as in the Christian view. The Confucianist abhorrence of sexual philandering was determined mainly by the fear that promiscuity might disrupt the sacred family life.

i. Eight Secret Books on Gynaecology, p.152.

Written by Giovanni Maciocia

ON STAGNATION OF LUNG- AND HEART-QI

Liver-Qi stagnation is one of the most "popular" diagnoses among Western practitioners. Liver-Qi stagnation is certainly very common but, in my opinion, it is over-diagnosed and over-emphasized. Besides that, it is hardly ever mentioned that practically every organ - not just the Liver - may be subject to Qi stagnation. For example, the following organs suffer from Qi stagnation: Stomach, Spleen, Lungs, Heart, Intestines, Gall-Bladder, Triple Burner, Bladder and even the Kidneys.

The present article will concentrate primarily on Qi stagnation of the Lungs and Heart because such stagnation is particularly common in mental-emotional problems. Related to the over-diagnosis of Liver-Qi stagnation is also the over-emphasis on anger among the emotions. Over-emphasis on anger is, in my opinion, also present in China. It is easy to see why that would be as anger is the most disruptive of the emotions: if you are angry, you rebel and that is not done in China, whether in the Neo-Confucian past nor now. Indeed the very word used in Chinese medicine to indicate "rebellious" (or "counterflow") Qi [ni ?] means "to rebel", "to disobey", "to defy". The opposite of Ni in Chinese medicine is shun [?] which indicates Qi going the right way. The word shun means :"to obey", "to act in submission to", with a clear political significance. Please note that these two words are already in the Nei Jing.

Whilst it is easy to explain why anger would be over-emphasized in China, I am not sure why it is in the West. By contrast, Lung- and Heart-Qi stagnation is usually caused by sadness, grief or worry: if one is sad, one does not rebel, so the Chinese political system (whether ancient or modern) is not threatened by these emotions. I believe that such emotions, more than anger, are extremely common and pervasive in the patients we see. What are sadness and grief caused by in Western patients? Apart from the obvious causes due to bereavement, very many Western patients of all ages suffer from sadness and grief deriving from various types of loss such as the loss from the break-up of relationships or marriage. In other words, sadness and grief are primarily about loss, whether it be the loss of a dear one from death or the loss of a partner through separation.

McLean (who elaborated the theory of the triune brain) suggests that the origins of human language were most likely in infant-mother interaction, babbling based on vowel-consonant combinations beginning about 8 weeks after birth. He singles out the separation cry - a slowly changing tone with a prolonged vowel sound (aaah), a distressing cry linked with the most painful emotion, separation.

I believe that the sadness and grief deriving from separation are probably the most basic and primordial (and therefore most powerful) emotions that plays a huge role in the mental-emotional problems we see in practice. As for worry, it is easy to see how such an emotion is so prevalent in the West where life has such a hectic pace.

Sadness, grief and worry affect the Lungs directly as they are emotions pertaining to the Lungs, but they also affect the Heart. The Su Wen says in chapter 39: "Sadness makes the Heart cramped and agitated; this pushes towards the lungs' lobes, the Upper Burner becomes obstructed, Nutritive and Defensive Qi cannot circulate freely, Heat accumulates and dissolves Qi."

In women, Lung-Qi stagnation affects the chest and breasts and, in the long run, it can give rise to breast lumps (benign or malignant) as the Lung channel flows on the outside of the breasts. In my experience, in Western women, this is a more common cause of breast lumps than Liver-Qi stagnation.

Dr Xia Shao Nong thinks that breast lumps and breast cancer are due to sadness and grief deriving from widowhood, breaking of relationships, divorce, death of one's children, and bereavement at a young age from the death of ones spouse. These events, especially if they occur suddenly, upset the Mind and lead to Qi stagnation and Qi depletion. It is interesting to note that all the events mentioned by Dr Xia involve separation and loss.

The points I use for sadness and grief are LU-7 Lieque, Du-24 Shenting, Ren-15 Jiuwei, HE-7 Shenmen, BL-13 Feishu and BL-42 Pohu.

As for worry, Chen Wu Ze (1174) says: "Worry injures the Lungs and makes Qi accumulate." Chapter 8 of the Ling Shu confirms that worry knots Qi: "Worry causes obstruction of Qi so that Qi stagnates."

Please note that Qi stagnation may be accompanied by Qi deficiency and this is particularly true in the case of Lungs and Heart. Emotions such as sadness and grief deplete Qi and cause Qi deficiency. However, as deficient Qi in the chest fails to move properly (because it is deficient), some Qi stagnation also ensues.

LUNG-QI STAGNATION

The clinical manifestations of Lung-Qi stagnation are: a feeling of lump in the throat, difficulty in swallowing, a feeling of oppression or distension of the chest, slight breathlessness, sighing, sadness, slight anxiety, depression.

Tongue: slightly red on the sides in the chest areas (see blog of 23 March 2010).
Pulse: very slightly Tight on the right-Front position.

Acupuncture: LU-7 Lieque, LU-3 Tianfu, ST-40 Fenglong, Ren-15 Jiuwei, P-6 Neiguan, BL-13 Feishu, BL-42 Pohu. (Please note that ST-40 is used here not to resolve Phlegm but to open the chest. See Blog of 24 August 2010).

Prescription: Open the Heart , Three Treasures (Ban Xia Hou Po Tang Pinellia-Magnolia Decoction).


HEART-QI STAGNATION


The clinical manifestations of Heart-Qi stagnation are: palpitations, a feeling of distension or oppression of the chest, depression, a slight feeling of lump in the throat, chest and upper epigastric distension, dislike of lying down, weak and cold limbs, slightly purple lips, pale complexion.

Tongue: slightly pale-purple on the sides in the chest area.
Pulse: Empty but very slightly Overflowing on the Left-Front position.

Acupuncture: HE-5 Tongli, HE-7 Shenmen, P-6 Neiguan, Ren-15 Jiuwei, Ren-17 Shanzhong, LU-7 Lieque, ST-40 Fenglong, L.I.-4 Hegu.

Prescription Open the Heart , Three Treasures (Ban Xia Hou Po Tang Pinellia-Magnolia Decoction), Mu Xiang Liu Qi Yin Aucklandia Flowing Qi Decoction


By Giovanni Maciocia

This article lists the main Three Treasures remedies for pain.  These will be classified according to channel and Zangfu pain and also according to area of pain.

CHANNEL PAIN
The Three Treasures remedies treating channel pain are:

Brocade Sinews
Nourish the Root and Clear Wind
Clear Channels
Benefit the Sinews

Brocade Sinews treats channel pain from Bi syndrome occurring against a background of Blood deficiency. This would be a dull ache occurring in the limbs. It would be aggravated by cold and alleviated by warmth and rest.

Nourish the Root and Clear Wind treats channel pain from Bi syndrome occurring against a background of Yin deficiency, mostly in the elderly.

Clear Channels treats channel pain from Bi syndrome due to Damp-Heat. This manifests with joints that are painful, red and swollen.

Benefit the Sinews treats channel pain from Bi syndrome due to Phlegm and Blood stasis in the joints.  This would correspond to the chronic stage of rheumatoid arthritis with deformities of the joints.


ZANGFU PAIN
There are many Three Treasures remedies to treat Zangfu pain and we can classify them according to the Zangfu treated:

Liver
Bend Bamboo, Break into a Smile, Brighten the Eyes, Drain Fire, Release Constraint, Smooth Passage, Stir Field of Elixir

Stomach and Spleen
Central Mansion, Ease the Muscles, Smooth Passage, Soothe the Centre.

Kidneys and Bladder
Separate Clear and Turbid, Clear the Root, Water Passages

Intestines
Smooth Passage, Ease the Muscles

The following is a brief description of the application of each of the above remedies for pain.



Liver

Bend BambooThis remedy is for headache deriving from Liver-Yang rising occurring against a background of Liver-Blood deficiency. It may be used for both chronic or acute pain (by increasing the daily dosage in case of acute pain).

Break into a Smile
This is for abdominal pain deriving from Liver-Qi stagnation. It is a variation of Chai Hu Shu Gan Tang which is the prescription for this type of pain. This would be the typical distending pain.

Brighten the Eyes
This is for a dull headache on the forehead or vertex deriving from Liver-Blood deficiency. It is therefore for a Deficiency type of pain.

Drain Fire
This is for headache deriving from Liver-Fire. This would definitely be a Full type of pain and it would be severe and throbbing in character. It is, however, also for pain in the Lower Burner, such as pain from cystitis or urethritis.

Release Constraint
This is for pain deriving from Liver-Qi stagnation: it is for a Full type of pain when the pulse is Wiry in all positions. This pain could be in the hypochondrium or epigastrium.

Smooth Passage
This is for abdominal pain from Liver-Qi stagnation and Spleen-Qi deficiency. It is therefore for a mixed Fullness-Deficiency pain.

Stir Field of Elixir
This is for lower abdominal pain from Blood stasis (Full type of pain).

Stomach and Spleen
Central Mansion
This is for a dull epigastric pain deriving from Spleen-Qi and Stomach-Yin deficiency: it is a Deficiency-type pain.

Smooth Passage
This is for abdominal pain deriving from Liver-Qi stagnation and Spleen-Qi deficiency: it is therefore both from a Fullness and a Deficiency. It is specific for irritable bowel pain.

Soothe the Centre
This is for epigastric pain deriving from Spleen-Qi deficiency, Dampness and Qi stagnation: it is therefore a mixed Fullness-Deficiency pain.

Ease the Muscles
This is for epigastric pain deriving from Damp-Heat in the Stomach. It is pain of a Full nature. It may also be used for muscle ache in post-viral fatigue syndrome.

Kidneys and Bladder
Separate Clear and Turbid
This is for urinary pain deriving from Dampness in the urinary passages and Qi deficiency. It is a mixed Fullness-Deficiency pain.

Clear the Root
This is for urinary or prostatic pain deriving from Damp-Heat and Blood stasis. It is definitely of a Full nature.

Water Passages
This remedy treats chronic Dampness in the Bladder against a background of Kidney deficiency.  It is therefore for a relatively mild chronic pain on urination.

Drain Fire
This remedy is for Lower Burner pain such as from cystitis or urethritis deriving from Liver-Fire.

Instestines
Smooth Passage
This is for lower abdominal pain deriving from Liver-Qi stagnation and Spleen Qi deficiency (see above).


Ease the Muscles
This is for abdominal pain deriving from Damp-Heat in the Stomach. It is pain of a Full nature. It may also be used for muscle ache in post-viral fatigue syndrome.

PAIN ACCORDING TO VARIOUS PATHOGENIC FACTORS
Pathogenic factors are a major cause of pain which is by definition of a Full nature. The main pathogenic factors that cause pain (and the relevant remedies) are:

Dampness (Ease the Muscles, Soothe the Centre, Smooth Passage, Separate Clear and Turbid, Clear the Root, Welcome Fragrance)
Qi Stagnation (Soothe the Centre, Smooth Passage, Release Constraint, Break into a Smile)Blood Stasis (Stir Field of Elixir)
Liver-Yang rising (Bend Bamboo)
Toxic-Heat (Welcome Fragrance, Clear the Root, Expel Toxic-Heat)
Liver-Fire (Drain Fire)

REMEDIES FOR PAIN CLASSIFIED ACCORDING TO AREA
It may be useful to classify the Three Treasures remedies according to area of pain treated, irrespective of whether it is a Fullness or a Deficiency type of pain.

Head, face: Bend Bamboo, Welcome Fragrance, Brighten the Eyes, Clear Yang, Drain Fire, Expel Wind-Cold, Expel Wind-Heat
Chest
Clear the Soul

Epigastrium
Soothe the Centre, Release Constraint, Central Mansion, Ease the Muscles
Hypochondrium
Break into a Smile, Release Constraint

Abdomen
Smooth Passage, Break into a Smile, Stir Filed of Elixir

Hypogastrium
Separate Clear and Turbid, Clear the Root, Water Passages.

Legs, knees
Brocade Sinews, Nourish the Root and Clear Wind

WOMEN'S TREASURE REMEDIES - The classification of Women's Treasure remedies for pain is easier since the main remedies for pain in this line are those for painful periods which are:

Drain Redness (Damp-Heat and Blood Heat)
Free Flow (Liver-Qi stagnation)
Stir Field of Elixir (Liver-Blood stasis)
Warm the Menses (Cold in the Uterus)
   
The Women's Treasure manual explains the application of these remedies and the type of menstrual pain treated by each. There are, however, a few other remedies in this line which may also treat pain and they are described below.

Drain the Jade Valley
This remedy drains Damp-Heat from the Lower Burner and may be used for vaginal pain or pain on intercourse in the presence of Damp-Heat.

Penetrating Vessel
This remedy can treat abdominal, epigastric or chest pain deriving from rebellious Qi in the Chong Mai.

Clear the Moon
This remedy can treat breast pain deriving from Qi stagnation and Phlegm.

Free-Flowing Sea
This remedy can treat pre-menstrual abdominal pain occurring against a background of Liver-Qi stagnation and Liver-Blood deficiency.

Freeing Constraint
This remedy can treat breast pain deriving from Liver-Qi stagnation.

BY GIOVANNI MACIOCIA

The following is a case history received from Jason Smith, a practitioner in Spain and lecturer at IEN, Instituto de Estudios Naturales in Madrid.

A 25-year- old girl sought treatment for headaches and dizziness that started two years previously.

She presented with two types of headaches, one dull, all over the head, and another that was stabbing in nature, alternating between left and right temples; occasionally it also went behind the eyes. The sensation was described as a “knife being stabbed” at her eyes and temples.

The dizziness occurred at any time, and she would not leave her home alone for fear of falling.

Upon interrogation the following patterns were established:

Liver-Blood Xu: Floaters, blurred vision, tingling of the limbs, pale complexion, itchy vertex, dizziness, scanty periods.

Liver-Yang Rising: throbbing headaches on the temples. Liver-Yang rising obviously derived from Liver Blood Xu.

Phlegm in the head: Dull headaches and dizziness.

Liver-Qi Stagnation: occasionally she experienced a slight feeling of lump in the throat and felt like crying. This was diagnosed as a secondary Liver-Qi Stagnation, deriving from the Liver-Blood Xu.

Spleen-Yang Xu: slow digestion, cold hands, feet and abdomen. The stools however were hard and dry, but this could be due to the severe Liver Blood Xu.

Dampness in the digestive system: feeling sleepy after lunch, swollen abdomen after eating, absence of thirst.

Cold in Uterus: Feeling of cold and spastic pain during period.

Blood stasis: Clots during first two days of period. The Blood stasis derived from Cold in the Uterus.

The tongue was pale (confirming the Liver-Blood Xu and the Spleen- Yang Xu) but with slightly red sides (from Liver-Yang rising). The tongue was also swollen, indicating the presence of Phlegm. The sides of the tongue appeared also slightly more swollen, probably due to Liver-Heat from Liver-Yang rising. There was also a rootless yellow coating at the back of the tongue accounting for the Dampness in the digestive system.

DIAGNOSIS
Although there are many patterns, it was established that the throbbing headaches were caused by Liver-Yang rising due to Liver- Blood Xu (and aggravated by the Liver-Qi stagnation) and Phlegm. Phlegm and Liver-Blood Xu were also responsible for the dizziness. So it was decided that the principle of treatment would be to resolve Phlegm, nourish Liver-Blood and subdue Liver-Yang.

TREATMENT
She was treated with both acupuncture and Three Treasures and Women’s Treasure remedies.

She was given Precious Sea to take continuously. This remedy is a general Qi and Blood tonic for women. Treatment started in November 2012. During the first month she was also given Clear Yang, a Three Treasures remedy to treat Phlegm in the head, Liver-Yang rising, Blood Xu and Kidney-Yang Xu.

After one month of treatment the dizziness had mostly disappeared as well as the Phlegm- type dull headaches. However the Liver-Yang rising headaches still persisted so Clear Yang was changed for Bend Bamboo,  remedy that specifically treats Liver-Yang rising from Liver-Blood Xu. After this she experienced a remarkable recovery, with the throbbing headaches disappearing gradually and being absent for the past month. She is still being treated at the time of writing.

Because of the location of headaches and the fact that several channels are affected, the Yang Qiao Mai was chosen.

- BL-62 (R) SI-3 (L) => open the Yang Qiao Mai

- LIV-3 (L) LI-4 (R)=> Subdue Liver-Yang, move Qi, stimulate ascending and descending of  Qi. LIV-3 and LI-4 act also as distal points

- GB-43 (R) TB-5 (L) => distal points to treat the Shao Yang channels

- SP-3 bilateral => nourish Liver-Blood and tonify the Spleen

- SP-6 bilateral=> nourish Liver-Blood and tonify the Spleen

- ST-36 bilateral=> nourish Liver-Blood and tonify the Spleen

- LIV-8 bilateral => nourish Liver-Blood

- Ren-4 => nourish Liver-Blood

- Local points along the Gall Bladder channel such as GB-4, 5, 8, 9, 20, 14 as well as Yuyao, ST-8.

La tarde del martes 19 de noviembre a partir de las 19:00 horas tendremos la ocasión única de asistir a un seminario por video conferencia con el propio Giovanni.  Este seminario formará parte de una serie de clases magistrales impartidas por Giovanni  que se darán cada dos meses  y que tratarán sobre aspectos muy prácticos de la medicina china. Para este primer seminario, Giovanni hablará acerca del meridiano extraordinario del Chong Mai, de su recorrido, de sus síndromes y de su tratamiento con acupuntura y con fitoterapia. Este meridano es absolutamente fundamental en el tratamiento de patologías ginecológicas y en especial del estancamiento de sangre. En definitiva, y en palabras de Giovanni  “no es posible tratar problemas ginecológicos sin tratar el Chong Mai”.

Cronograma del próximo martes 19 de noviembre:
 
*17:00 a 19:00 horas. Formación gratuita sobre Fitoterapia de los Tres Tesoros a cargo de Jason Smith y Melina Dolukhanian. Tratamientos de los problemas de la menopausia y exposición de los programas de formación continuada de Medicina China.

*19:00 a 21:00 horas. Seminario por video conferencia con Giovanni Maciocia. El meridiano extraordinario del Chong Mai. Se entregará certificado de asistencia de IEN avalado por Giovanni Maciocia. El precio es de 45 Euros.

¡Es indispensable la reserva de plaza!

Para información relativa a inscripciones y contenido de los seminarios, por favor llamar al 91 169 48 79 o bién envíar un correo a: info@ienelvergel.com

"Arouse Power"

Ingredients:

Tu Si Zi Semen Cuscutae
Suo Yang Herba Cynomorii
Yin Yang Huo Herba Epimidii
Gou Qi Zi Fructus Lycii chinensis
Wu Wei Zi Fructus Schisandrae
Dan Shen Radix Salviae miltiorrhizae
Yuan Zhi Radix Polygalae
Lu Lu Tong Fructus Liquidambaris    
Chuan Niu Xi Radix Cyathulae
Gui Zhi Ramulus Cinnamomi cassiae
Mu Dan Pi Cortex Moutan
Huang Bo Cortex Phellodendri
She Chuang Zi Fructus Cnidii
Zhi Gan Cao Radix Glycyrrhizae preparata


Pattern: Kidney-Yang deficiency, Heart-Qi deficiency, Dampness in the Lower Burner.

Action: tonify Kidney-Yang, tonify Heart-Qi, stimulate the descending of Heart-Qi, drain Dampness, calm the Mind.

Indications: impotence, premature ejaculation, decreased libido, decreased sexual function, frigidity, insomnia, depression, backache, urinary difficulty, dizziness, tinnitus.
Tongue: pale.
Pulse: Deep, Weak.

Explanation
- Tu Si Zi, Suo Yang and Yin Yang Huo tonify Kidney-Yang and strengthen the sexual function. - Gou Qi Zi nourishes Liver- and Kidney-Yin.
- Wu Wei Zi, Dan Shen and Yuan Zhi enter the Heart and calm the Mind.
- Lu Lu Tong and Chuan Niu Xi invigorate Blood and remove obstructions from the Luo     channels: Chuan Niu Xi directs the formula to the Lower Burner.
- Gui Zhi and Mu Dan Pi enter the blood vessels: one hot, the other cold, they invigorate Blood.  - Huang Bo and She Chuang Zi eliminate Dampness from the Lower Burner.

Cautions and contraindications: there are no special contraindications for this remedy; one should remember that it contains two quite hot Yang tonics (Suo Yang and Yin Yang Huo) and one should therefore be certain that the patient is indeed suffering from Yang deficiency. Therefore, a pale tongue is an important necessary sign for the prescription of this formula.

Remedy in a nutshell: tonify the Kidneys and the Heart and the Zhi and Shen, promote the communication between Heart and Kidneys for sexual, gynaecological and mental-emotional life.

Arouse Power is designed to promote the communication and mutual nourishment between the Heart and the Kidneys.  To understand this remedy, we must look at a different 5-Element diagram that the circular one of the Sheng cycle (Wood nourishes Fire, Fire nourishes Earth, etc.).  We must visualize a cross-like 5- Element diagram with the Water at the bottom (North), Fire at the top (South), Wood on the left (East), Metal on the right (West) and the Earth in the centre.


In this view of the 5 Elements, Fire and Water (and therefore Heart and Kidneys) communicate with each other and nourish each other: Fire descends to meet the Water and Water rises to meet Fire (each contrary to their normal movements as Fire normally rises and Water descends). The communication and mutual nourishment of Heart and Kidneys has many clinical applications, three of which are the sexual function, gynaecology and mental-emotional sphere.  

Sexual function
The Kidneys control the sexual function: in men, they control sexual desire and sexual function (i.e. erection and ejaculation).  In women, they control sexual desire and the capacity to reach an orgasm.  The connection and mutual nourishment between Heart and Kidneys is very important  for a normal sexual function. Normally, the function of the Kidneys is always stressed in the sexual function, but that of the Heart is equally important.   

All aspects of the sexual function in both men and women, depend not only on the Kidneys but also on the capacity of Heart-Qi to descend to the Kidneys. For example, in men the descending of Heart-Qi is important to induce erection and control ejaculation.  Therefore, in many cases (and especially in young men) sexual problems such as erectile dysfunction and premature ejaculation may be due to Heart-Qi not descending to the Kidneys in the case of the former and descending too quickly in the case of the latter.

Arouse Power can therefore be used in sexual problems of both men and women to stimulate the communication and mutual nourishment of Heart and Kidneys.

Gynaecology
The Kidneys are the origin of Tian Gui which is menstrual blood and ova.  Tian Gui is the fundamental basis for a normal menstrual function and fertility.  Liver-Blood is also important for the menstrual function but it is the Kidneys that are the origin of Tian Gui, menstrual blood and ovarian follicles.

However, the menstrual rhythm also needs the input of the Heart: Heart-Qi needs to descend to the Uterus to promote the discharge of menstrual blood at menstruation and of the ova at ovulation.  Heart-Qi goes down to meet the Kidneys: thus again, Fire descends and Water ascends to promote that communication.  For example, if the period is late one month, it could be due to Heart-Qi not descending at the right time (often from an emotional upset); equally if the period is early one month (Heart-Qi descending before time).

Mental-emotional sphere
The Heart houses the Shen and the Kidneys the Zhi.  Zhi could be translated as "memory" or "will-power": in a mental-emotional context, the translation as "will-power" is much more clinically relevant.  Thus, I interpret Zhi as will-power, enthusiasm, drive, motivation, determination.  

Zhi and Shen need to communicate with and nourish each other.  Motivation, determination and will-power need to be strong but they also need to be somewhat controlled or restrained by the Shen.  

If the Zhi is too strong or if the Shen fails to control it, will-power becomes recklessness.  This happens for example in the manic stage of bipolar disease, but bear in mind that it also occurs in many cases without bipolar disease.  

If Zhi is weak or if the Shen over-controls it, the person lacks will-power, enthusiasm and determination and is essentially depressed.

Arouse Power strengthens the Zhi of the Kidneys and the Shen of the Heart: thus it stimulates the normal communication between Heart and Kidneys and Shen and Zhi.

Written by: Giovanni Maciocia

New Blue Poppy Classics by Bob Flaws formulas are already available.

BLUE POPPY FORMULAS

Bob Flaws is one of the most famous TCM therapists and instructors in the Western world. His formulas are under the name of Blue Poppy Herbs.

Blue Poppy Herbs are made from the highest quality desiccated extracts manufactured at a GMP certified factory in the People’s Republic of China. 

Only high quality Chinese herbs are used in the manufacture of our formulas. The botanical identity of each ingredient is checked by a trained Chinese medical pharmacognosist when it arrives at the factory. The herbs are then washed in distilled water before being sent to a clean room for processing. All the processing from start to  finish takes place in stainless steel equipment. Depending on the formula, cooking in a 50:50% solution of distilled water and alcohol lasts 3-6 hours. Volatile oils, which come off more quickly, are captured and added back to the formula just prior to freeze-drying.  The liquid is freeze-dried at -25E°C at the same time that vacuum extraction pulls off air, water, and the alcohol. When approximately 10% of the liquid remains, it is heated at 30E°C to sufficiently dry the extract, which is then ground into a fine powder.

The Chinese factory which manufactures our formulas is a government-licensed and  inspected facility which meets all standards of the Department of Health of the People’s Republic of China for a GMP facility and, in addition, the factory has passed an independent site audit with NSF International to be certified as compliant with FDA cGMP regulations.

Laboratory Testing

All Blue Poppy Formulas are laboratory tested first in China and then sampled and retested again in an independent FDA approved lab in the  U.S. to insure freedom from heavy metal and microbial contamination, as well as pesticide residues.

Chronic constipation

The following is a case history sent by Jason Smith, a practitioner in Spain.

A 37-year-old woman complained of chronic constipation. She has a bowel movement every 3 days and the problem is aggravated by emotional stress (she works in a lawyer’s office and she finds the work stressful). Occasionally, the bowel movements increase in frequency and she may even go 3 times in one day. The stools are hard and dry.

In the past two months, she developed a distending pain in the abdomen every time she eats. She has a feeling of the food not going down which causes her breathlessness. She has a burning sensation in the epigastrium.

She has abdominal distension after eating, feels sleepy after eating and has a very slow and difficult digestion.

Feels very irritable and feels like crying before the period. She says she feels like crying but is unable to. She reports being very frustrated by her job. She occasionally has a feeling of lump in the throat. Twice she had pain in the coastal region.

At night she experiences tingling and numbness of her legs. She says her memory is bad. She goes through periods of insomnia (both difficulty in falling asleep and waking up in the middle of the night); her periods are very scanty periods and her nails brittle. The periods comes regularly every 32 days and last four days; there are some dark clots but no pain.

She has occasionally a throbbing headache on the temple and behind the eye when stressed at work. Her hair falls out (she says this occurs during the change from spring to summer and summer to autumn).

Her tongue is very thin, slightly reddish purple (especially on the sides) with a yellow rootles coating that is thicker on the root. The tip is very red.


Diagnosis
The patterns involved are Liver-Qi stagnation (constipation, distending pain, costal pain, feeling of lump in throat) as well as Spleen-Qi deficiency and Dampness in the digestive system (difficult digestion, sleepy after eating, yellow coating thicker on the root).

There is also Liver-Blood deficiency (scanty periods, hair falling out, brittle nails, insomnia). The Blood deficiency occasionally gives rise to Liver-Yang rising causing the throbbing headaches.
There is also some Liver-Blood stasis (purpe tongue, dark clots), but this is not a major pattern.

The rootless coating also shows some Stomach-Yin deficiency which causes the burning feeling in the epigastrium.

The pulse is not Wiry which indicates that the Liver-Qi stagnation is secondary to the Liver-Blood deficiency.

There are the interesting symptoms reported of abdominal distension with a feeling of the food not going down which causes her breathlessness: I attribute these symptoms to rebellious Qi of the Chong Mai.


Treatment
She was treated with acupuncture and some Three Treasures and Women´s Treasure remedies. She was prescribed Smooth Passage (morning) to treat the three patterns of Liver-Qi stagnation, Spleen-Qi deficiency and Dampness, and Central Mansion (afternoon) to nourish Stomach-Qi and Stomach-Qi and resolve Dampness. These two remedies were taken every day. Freeing the Moon was added during phase 4.

Two weeks after taking the remedies the bowel movements started occurring on a daily basis, with the stools returning to a normal consistency. Over the following weeks, the patient reported feeling much better and more relaxed on a mental-emotional level, and without any feeling of lump in the throat, reacting "normally under stressful conditions". One month later, the bowel movements where back to normal and she reported feeling "very well, as I hadn´t felt in years." Treatment still is being conducted.

The following is a case history sent by Jason Smith, a practitioner in Spain.

The patient is a 20-year-old girl seeking help because she had a bronchitis three years ago and ever since then she has been very prone to catching colds that always end in bronchitis and pneumonia. Enquiring about how it started, her first bronchitis was after studying very hard to be admitted in university. In the mornings, she coughs and expectorates some phlegm.

She feels cold in general with very cold feet although her hands are always very hot; in the past months she started having a feeling of heat rising up to the head being worst during the acute attacks of bronchitis. Three months ago, she started sweating at night (face and forehead). She also has a dry mouth at night. She used to like warm drinks but now she feels thirsty and needs cold drinks.

Recently she lost weight, losing as much as 10 kg (22 lb) in only three months. She has a pale face but with malar flush (red cheekbones). Her lips are purple. She has bad sleeping habits (goes to bed at 5 am and gets up 2 pm) and for the past three months she wakes up in the middle of her sleep for no apparent reason.

When she has colds she always has a fever, sore throat, profuse sweating, cough and green nasal mucus occasionally with blood. Always shows aversion to wind.

She now feels tired and her legs feel sometime heavy. Her bowel movements are regular (twice a day) but she occasionally has constipation. Her urine is pale but the first one in the morning is dark. She suffers from abdominal fullness after eating. Her appetite is decreased, and she complains that her “stomach is closed”. Has had Candida infections in the past.

In the past three months, she has been getting lower back pain as well as spontaneous sweating and occasional tinnitus.

She feels depressed and her mental state fluctuates, sometimes crying for no reason.
She suffers from throbbing headaches on the lateral sides of head lasting 2 days with nausea: this happens once a month, sometimes with the period but not always. Lately she has experienced floaters.

Her period has always been very irregular (coming between every 15 and 45 days) and extremely painful (before and during) with stabbing pain alleviated by heat. The period lasts 8 days with profuse bleeding (the first four days with heavy bleeding, not much on the 5th day, and profuse the last three days). The menstrual blood is red with clots; brown the last day. She started taking the pill two months ago and her last period was very scanty with brown bleeding.

The tongue is pale and slightly swollen on the sides but slightly red and without coating in the centre. There is a sticky-yellow, rootless coating on the root. The tip is red.

Diagnosis

There are many patterns involved:
1) Deficiency of Lung-Qi (spontaneous sweating, propensity to catching colds).
2) Phlegm in the Lungs (cough and expectoration of phlegm in the morning. This is a residual pathogenic factor that has lingered ever since her first invasion of Wind three years ago with her first bronchitis, and that accounts for the repetitive bronchitis and pneumonia.
3) Kidney deficiency (lower backache, tinnitus, getting thinner, rootless and lack coating). This is a deficiency of both Kidney-Yin and Kidney-Yang as evidenced by the simultaneous cold and hot feelings.
4) Stomach-Yin deficiency with mild empty Heat (tongue red without coating in the middle)
5) Spleen-Yang deficiency (tiredness, abdominal distension).
6) Liver-Blood deficiency (floaters, pale sides of the tongue)
7) Liver-Blood stasis (menstrual clots, purple lips, painful periods)
8) Liver Qi stagnation (moodiness, crying, depression)
9) Liver-Yang rising (throbbing headaches) that is probably due to the Blood deficiency and
Kidney-Yin deficiency
10) Cold in the Uterus (period pain alleviated with application of heat). The Cold in the Uterus leads to Blood stasis.
11) Damp-Heat in the Lower Burner (feeling of heaviness of the legs, candida infection, sticky-yellow coating at the root of tongue).

Treatment
There are many patterns and therefore many treatment options. I decided to start by eliminating the residual pathogenic factor in the Lungs because that is the pattern that is causing the most morbidity. After that has been cleared, I would proceed to treat the other underlying patterns.
She has been given Central Mansion (Three Treasures remedy) to tonify Spleen-Qi, Stomach-Yin and Lung-Qi together with Resolve Phlegm (Little Treasures remedy) to treat the residual pathogenic factor. She has been treated for the past 5 months and she has only had one cold that did not progress any further. The next step will be strengthening the Kidneys.

Note
Note that although Resolve Phlegm is part of the pediatric range Little Treasures, it eliminates residual Phlegm in the Lungs and it can indeed be used in adults.
Finally, please note also how there are four Liver patterns: Liver-Qi stagnation, Liver-Blood stasis, Liver-Yang rising and Liver-Blood deficiency. It is common for the Liver to manifest with several patterns simultaneously: this does not happen with other organs.

SOOTHE THE SHEN by Giovanni Maciocia

Soothe the Shen is a new remedy that complements the existing mental-emotional remedies: it treats depression and/or anxiety. It is based on a variation of two separate formulae: Gan Mai Da Zao Tang Glycyrrhiza-Triticum-Jujuba Decoction and Bai He Zhi Mu Tang Lilium-Anemarrhaena Decoction.

The ingredients of Soothe the Shen are as follows:

Zhi Gan Cao Radix Glycyrrhizae uralensis preparata
Fu Xiao Mai Fructus Tritici levis
Da Zao Fructus Jujubae
Zhi Mu Radix Anemarrhaenae
Bai He Bulbus Lilii
Dang Gui Radix Angelicae sinensis
Wu Wei Zi Fructus Schisandrae
He Huan Pi Cortex Albiziae
Yuan Zhi Radix Polygalae
Fo Shou Fructus Citri sarcodactylis
Suan Zao Ren Semen Ziziphi spinosae

Actions: tonifies Qi, nourishes Blood and Yin, moves Qi, opens the Mind's orifices.
Patterns: Qi, Blood and/or Yin deficiency, Qi stagnation.
Indications: Depression, sadness, anxiety, mental confusion, poor memory, tiredness, poor appetite, scanty periods.
Tongue: Pale or normal. In case of Yin deficiency: no coating.
Pulse: Weak, Choppy or Floating-Empty.
Classical antecedent:
Gan Mai Da Zao Tang Glycyrrhiza-Triticum-Jujuba Decoction and Bai He Zhi Mu Tang Lilium-Anemarrhaena Decoction.
 

Explanation:
The classical indications for Gan Mai Da Zao Tang Glycyrrhiza-Triticum-Jujuba Decoction are: disorientation, melancholy, crying, inability to control oneself, restless sleep, night sweating, sighing. This formula is found in Zhang Zhong Jing's Jin Gui Yao Lue of AD 220 AD. It is in chapter 22 on women's problems entitled "Pulses and Patterns of Complicated Women's Diseases" (Fu Ren Za Bing Zheng Mai): "Women suffering from anxiety are affected by sadness and crying, they are like lost souls [Shen ling] and yawn frequently: use Gan Mai Da Zao Tang."¹

Interestingly, also the formula Bai He Zhi Mu Tang Lilium-Anemarrhaena Decoction is found in the same classic. This would seem to indicate that mental-emotional problems were as common in those ancient times as they are now. In fact, also the formula Ban Xia Hou Po Tang Pinellia-Magnolia Decoction used for plum-stone syndrome with stagnation of Lung-, Stomach- and Heart-Qi is found in the same classic (this formula is called Open the Heart in the Three Treasures).

There are many different interpretations of the formula Gan Mai Da Zao Tang that is within Soothe the Shen. The prevailing modern view is that this formula is for a condition of Heart-Yin deficiency, Spleen deficiency and Liver-Qi stagnation. In the original text, the formula is for Zang Zao which literally means "visceral agitation".

The rationale usually given for the use of this formula for Liver-Qi stagnation is from chapter 22 of the "Simple Questions" (Su Wen) which says that the sweet taste soothes the Liver (reverse Controlling cycle of the Five Elements). I personally do not use this formula for Liver-Qi stagnation.

The formula Gan Mai Da Zao Tang naturally tastes very sweet. I personally find this explanation unconvincing and one that reflects the modern Chinese tendency to overemphasize Liver-Qi stagnation. I personally use the formula for patterns of deficiency which may be of Qi, Blood or Yin (not Yang deficiency).

It is an intriguing formula as it has a profound mental effect and yet it is composed of only three apparently mild herbs, two of which are items of food as well as herbs, i.e: black dates, licorice and wheat husks. As it is composed of three very mild herbs none of which individually is known for any profound mental-emotional effect, I call this formula one of the "miraculous" formulae.

I find this formula excellent when the patient is not only depressed and anxious but also mentally confused and kind of "absent". Often, this can be the result of heavy cannabis use in the past.

I use this formula when these mental-emotional symptoms occur against a background of deficiency of Qi of the Spleen, Heart and Lungs and of Heart-Blood deficiency.

Some doctors in China also use this formula in the treatment of Attention Deficit Hyperactivity Disorder in children.

The second formula Bai He Zhi Mu Tang Lilium-Anemarrhena Decoction is used for the Lilium Syndrome (Bai He Bing) described in the Essential Prescriptions of the Golden Chest (Jin Gui Yao Lue, ca AD 220), chapter 3-1. This syndrome sounds remarkably like the description of a depressed patient.

"The patient wants to eat, but is reluctant to swallow food and unwilling to speak. He or she wants to lie in bed but cannot lie quietly as he or she is restless. He or she wants to walk but is soon tired. Now and then he or she may enjoy eating but cannot tolerate the smell of food. He or she feels cold or hot but without fever or chills, bitter taste or dark urine [i.e. it is not external Wind nor internal Heat]. No drugs are able to cure this syndrome. After taking the medicine the patient may vomit or have diarrhoea. The disease haunts (hu huo) the patient [hu means "fox" and huo means "bewildered"] and, although he or she looks normal, he or she is suffering. The pulse is rapid."²
 
Modern books describe the symptoms pertaining to this formula as "absent-mindedness, as if in a trance, mental restlessness, bitter taste, anxiety, depression, dark urine, red tongue (which may be without coating), rapid pulse."

The treatment principle recommended by modern doctors is to moisten and nourish the Heart and Lungs, tonify Qi, nourish Yin, clear Heat (or Empty Heat), calm the Shen, strengthen the Zhi (of the Kidneys).

I use this formula primarily when there is a deficiency of Yin of the Heart and Lungs and the patient is anxious and sad. As the formula consists of only two herbs, I frequently add this formula to another formula in any situation when a patient is depressed against a background of a Lung and Heart syndrome, but especially Qi and Yin deficiency of these two organs or Heart-Heat.

The combination of these two herbs is particularly good to treat sadness and grief.

Within Soothe the Shen, Zhi Gan Cao Radix Glycyrrhizae uralensis preparata, Fu Xiao Mai Fructus Tritici levis and Da Zao Fructus Jujubae form the original formula Gan Mai Da Zao Tang to tonify Qi and Blood and calm the Spirit. Fu Xiao Mai is the emperor herb within this formula. Please note that Gan Cao is here not to harmonize but it is a minister herb to tonify Qi and Blood and calm the Spirit. For this reason, it is not in the usual small dose but a higher dose (about 9% of the total).

Zhi Mu and Bai He constitute the formula Bai He Zhi Mu Tang and they are here to nourish Qi and Yin and calm the Spirit; in particular, they treat sadness.

Dang Gui nourishes Blood and calms the Shen. Wu Wei Zi nourishes Yin and calms the Spirit. He Huan Pi, Yuan Zhi and Fo Shou move Qi, open the Mind's orifices and stimulate the movement of the Hun to relieve depression. Suan Zao Ren nourishes Yin, calms the Spirit and settles the Hun to relieve anxiety.

The relationship between Shen of the Heart and Hun of the Liver is all important in the pathology of depression. The Hun gives the Shen inspiration, creativity, ideas, plans, life-dreams, aspirations: this psychic energy is the result of the "coming and going of the Hun" and it is the psychic manifestation of the free flow of Liver-Qi (and in particular, of the physiological ascending of Liver-Qi).

On the other hand, the Shen needs to control the Hun somewhat and to integrate the psychic material deriving from it. It is in the nature of the Hun to "come and go", i.e. it is always searching, it has ideas, inspiration, aims, life-dreams, etc. The Hun is the gui of our human nature and it has its own independent existence.

The Shen needs to integrate the material deriving from the Hun in the general psyche: the Hun is the source of many ideas simultaneously; the Shen can only deal with one at a time. Therefore "control" and "integration" are the key words describing the function of the Shen in relation to the Hun.

When the "coming and going" of the Hun is deficient, there is a lack of inspiration, creativity, ideas, plans, life-dreams, aspirations: this is an important feature of mental depression. It is important to note that the psychic "coming and going" of the Hun may be deficient either because itself is deficient, or because the Shen is over-controlling it. The latter is common in individuals with strong, rigid beliefs ("religious" in a broad sense) which lead the Shen to suppress the psychic ideas coming from the Hun. This situation may also arise as a consequence of guilt.

In depression, there is a disconnection between the Shen of the Heart and the Hun: the Hun lacks its normal "movement" and the person lacks creativity, ideas, imagination and, most of all, plans, projects, life-aims and inspiration so that depression results.

NOTE
Please note that when I use the term "Shen" above, I refer to the Shen of the Heart. When I use the term "Spirit" I refer to the "5 Shens", i.e. the Yi of the Spleen, Zhi of the Kidneys, Hun of the Liver, Po of the Lungs and the Shen itself.

Author: Giovanni Maciocia

Herbs for the treatment of Anorexia

Herbs for the treatment of Anorexia

Anorexia is a condition that affects the body and the mind. By starving himself, an anorexic experiences extreme weight loss and may cause permanent damage to his vital organs. Herbal medicine, along with other forms of complementary and alternative medicine such as acupuncture, are often used in the treatment of diseases affecting the heart and liver, such as anorexia. Herbs may be used to treat this life-threatening condition.

Gui Pi Tang is used to treat deficiencies in the heart and spleen experienced by anorexia patients. This formula is used to treat symptoms such as rapid heartbeat, memory deficiency, pallid complexion and diarrhea.
Available products:

Gui Pi Tang

Calm the Shen

Long Dan Xie Gan Tang herbal compound is used for the treatment of dizziness, restlessness, mood changes, insomnia and other symptoms from which anorexia patients commonly suffer. This combination of herbs is used to treat a flaring up of "Liver Fire" and bring balance to the patient's yin and yang.
available products:

Long Dan Xie Gan Tang

Drain Fire

If  fits of rage or irritability accompanied by excessive mental activity and the inability to sleep through the night are experienced, this condition is identified as a stagnation of the liver Qi and can be treatedt with a modified combination of herbs referred to as Chai Hu Shu Gan San.
available products:

Chai Hu Shu Gan San

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