Shi Hu, Dendrobium Nobile- “Immortality Herb”

This last May I was fortunate to travel to China with my school, East West School for Planetary Herbology, to do clinical training in a Traditional Chinese Medicine Hospital.  On one of our field excursions, we toured a demonstration garden for the school.  In one greenhouse there were rows and rows of a low growing plant called Shi Hu. I found a piece of the plant on the ground put it into my pocket, hoping to root it when I got home.  At this point, I have a very small plant that made the long plane trip and is starting to put on growth.

Shi hu is an orchid plant that often grows adjacent to trees such as pear or peach.  The plant consists of a long, thin stem, which is golden yellow in color, with a flower at the end. Dendrobium Nobile, also known as the Noble Dendrobium or Shi Hu in Pinyin, has been used for the medicinal purpose for at least 2,000 years. Different varieties of dendrobium have different colors, but the most common colors are yellow and pink. The plant has a long thin stem that is used for various herbal and medicinal treatments. Shi Hu grows wild and is harvested from November to February although at this point, wild Shi Hu is overharvested and it is now being cultivated in greenhouses like the one we saw.  True Shi Hu refers to dendrobium orchid, but much of what is available on the market is a substitute rather than true dendrobium.  It is common to see products that are sold as “wild” Shi Hu, but this is a case where much of it is cultivated and not wild. Most frequently Shi Hu is available in bulk or granules. According to Eric Brand of Blue Poppy, the best way to test the quality of Shi Hu is to chew it. The more fibrous the less quality, the more sticky it is the better quality it is.

Shi Hu has been used for more than 2,000 years in traditional Chinese medicine.  In the Taoist Canon, a collection of Taoist literature from the Tang Dynasty (AD 618-907), it refers to Shi Hu as the first of nine “celestial herbs” with great health benefits.  In the Compendium of Materia Medica, written during the Ming Dynasty, Shi hu is described as affecting three channels of energy – the stomach, the lungs, and the kidneys.  The Chinese believe that the Dendrobium plant is ‘yin’ in nature and can be used to replenish fluids. It is commonly used as an Yin tonic to moisten the stomach, lungs and to replace kidney yin jing. It is very effective for treating conditions such as dry mouth, stomach pain, mouth sores, sunstroke, and other conditions caused by dry weather, pollution or smoke.

Let’s face it as we age we tend towards dryness and ingesting herbs that help to replenish fluids can be helpful.  Another reason that I love Shi Hu is that I often incorporate herbs into my soups and broths.  Shi hu has been used this way in Chinese cooking along with ginseng and chicken, duck, or lamb, for general health. Shi hu is now being adapted to new and creative uses including being made into juices and even dishes available at health spas. In a news article, I recently read, the flower of Shi Hu is made into a tea drink and even brewed into a clear liquor with 38 percent alcohol.

Among its many uses, the Chinese use dendrobium as a tonic for longevity. It is believed that when mixed with licorice roots and made into a tea it transmits healing energy to all parts of the body. There is a whole host of uses that are promoted in the commercial literature including the following:

  • Dendrobium helps moisten and nourish the skin and prevents dryness and flaky skin.
  • When air pollution and smoke dry out the lungs and air passages and increase thirst, dendrobium can be consumed for quick relief and to moisten the passageways.
  • Dendrobium is used as an effective tonic for the treatment of tuberculosis, flatulence, night sweats, anorexia, fever, and dyspepsia.
  • Dendrobium tonic improves the functioning of the lungs, kidneys, and stomach. It can reduce stomach pain and cramping and reduce vomiting.
  • It is believed that regular consumption of dendrobium can also treat sexual impotency.
  • Pain in the feet and hands, lumbago, and arthralgia can be treated with dendrobium extract.
  • Dendrobium can boost the immune system and help the body fight infections.
  • Dendrobium has long since been used to replenish lost fluids from the body and reduce severe thirst.
  • Natives of the Eastern Himalayas use dendrobium to heal problems with the eyes.
  • Dendrobium blossoms and stems are edible. Countries like Thailand and Singapore, deep fry these delicacies and eat them as snacks.
  • In Europe, dendrobium blossoms are used as edible cake decorations and as garnishes.
  • The Aborigines consider dendrobiums as emergency bush food.
  • Pickle is made from dendrobium flowers in Nepal.

According to Traditional Chinese Medicine:

Energy: sweet, slightly cold

Actions: Generates body fluids for the stomach; nourishes stomach Yin, mildly nourishes kidney Yin; clears heat; brightens the vision; strengthens the lower back.

Uses:

Nourishes Yin, clears Heat and generates fluids Parched mouth, severe thirst or intractable fever associated with Yin Deficiency, most commonly when the Fluids are injured during a warm pathogen disease
Enriches Kidney Yin and reduces Heat from Deficiency Yin Deficiency Heat and depleted Fluids with a recalcitrant low-grade fever, dry and painful throat and a red tongue with no coat
Tonifies the Kidneys, augments Jing, brightens the eyes, strengthens the tendons and bones and strengthens the low back Dull vision, dizziness and low back weakness and pain associated with Kidney and Liver Deficiency
Nourishes Stomach and Lung Yin Stomach and Lung Yin Deficiency with Empty Fire Rising

http://www.americandragon.com/Individualherbsupdate/ShiHu.html

Additional Note:  According to Eric Brand it can trap an EPI (Exocrine Pancreatic Insufficiency) in the body and prolong the sickness. If there is a chance of EPI, Mai men dong or Yu zhu is a better choice.

  • Bensky D, Gamble A. Chinese Herbal Medicine. Seattle: Eastland Press, 1986.
  • Flaws B (translator). The Book of Jook. Chinese Medical Porridges: A Healthy Alternative to the Typical Western Breakfast. Boulder, CO: Blue Poppy Press, 1995.

Two Immortals- Help with Menopausal Symptoms and Hypertension

Er Xian Tang (Two Immortals Teapills)

TCM action: warm kidney yang, tonify kidney essence, and drain deficient fire

Last year one of my esteemed herbal teachers, Leslie Tierra, talked about the great results that she was getting treating women with Er Xian Tang who had yin deficiency with deficient fire. This peaked my interest and I started to look at the history and herbs that comprised the formula. In a nutshell, deficient fire is often seen in women who are experiencing pre and post menopausal symptoms which might include hot flashes, night sweats, facial and malar flushing, irritability, palpitations, insomnia, decreased sex drive and vaginal dryness to name a few.

The formula Er Xian Tang was developed in the 1960’s at a hospital affiliated with Shanghai College of Traditional Chinese Medicine. Er Xian Tang was designed as a treatment for cases of hypertension (Western terminology) where there was a combination of kidney yang deficiency and deficiency fire of the kidney, two seemingly contradictory conditions. Yang deficiency include signs of internal cold and weakness including coldness, lassitude, edema of the legs, loose stools, sterility or infertility, frequent urination, urinary incontinence, while the signs listed above indicate deficiency of Kidney fire.

A comparison of the role of the heart and kidney in allopathic and TCM can be helpful in understanding the intent of the formula. Er Xian Tang treats renal hypertension.   Renal hypertension from an allopathic perspective results impaired functioning of the kidneys, reduced urinary elimination and excessive renin (a protein and enzyme secreted by the kidneys) production. The heart sends a continuous supply of oxygenated blood around the body. The kidney filters the blood, extracting waste in the form of urine, and also helps regulate the water and salt levels to control blood pressure. When the heart is no longer pumping efficiently it becomes congested with blood, causing pressure to build up in the main vein connected to the kidneys and leading to congestion of blood in the kidneys. The kidneys suffer from the reduced supply of oxygenated blood. When the kidneys become impaired, the hormone system, which regulates blood pressure, goes into overdrive in an attempt to increase blood supply to the kidneys resulting in renal hypertension. This eventually damages the heart, which has to pump against higher pressure, in the arteries.

In TCM Er Xian Tang treats kidney yang deficiency and deficiency fire of the kidney. In TCM, according to the five elements theory, the Heart is categorized as yang and the Kidneys are considered yin. Normally, the Heart yang (fire) descends and joins with the Kidney-yang to warm and propels kidney-yin (water) to ascend to nourish heart yang (fire) to prevent it from hyperactive. Think of it as a continual loop with fire warming the kidneys, while water helps to contain heart fire. Or as Western medicine describes: the heart sends a continuous supply of oxygenated blood to organs including the kidneys that help to regulate water and salt levels to control blood pressure. In both systems the heart and the kidneys are closely related, with a mutually dependent function. If this functional relationship becomes abnormal in TCM it results in a condition termed “non-coordination between the heart and the kidney”.

This gets us back to yin deficiency with deficient fire. In Chinese medicine, the Heart and Kidney energies should work together. The Heart sends Fire down to warm the Kidneys: in return, the Kidneys send pure fluids up to nourish the Heart. In Heart and Kidney Yin deficiency with Deficient Heat the downward action or upward action is severely reduced. This leaves too much Yang (fire), due to lack of cooling Yin (water), hence deficient heat, resulting in night sweats, insomnia, and steaming bone syndrome. Normally you expect to see symptoms of deficiency fire of the kidney associated exclusively with yin deficiency, yet in this case, this type of fire is described as yang excess which arises from an imbalance of yin and yang (the deficient yin can not control the yang). When yin and yang are both deficient, one can experience symptoms of each deficiency, which may either flip back and forth between the two or manifest simultaneously.

Er Xian Tang, Two Immortals

Xian Mao-Curculigo, Golden Eye-Grass Rhizome

Tastes and Energies: spicy-hot,

Category: Tonify the Yang

Actions: Warm Kidney yang and tonify Kidney essence,

Contraindications: Yin Deficiency w/ Heat

Yin Yang Hou-Epimedium Leaf

Tastes and Energies: spicy, sweet, warm,

Category: Tonify the Yang

Actions: Warm Kidney yang and tonify Kidney essence, tonify Yin, harnesses Liver yang,

Contraindications: Yin deficiency w/ Heat

Ban Ji Tian-Morinda Root

Tastes and Energies: spicy, hot, toxic,

Category: Tonify the Yang

Actions: warm Kidney yang and tonify Kidney essence,

Contraindications: Yin deficiency w/ Heat amp heat

Huang Bai-Phellodendrum Bark, Amur Cork-Tree Bark

Tastes and Energies: bitter, cold

Category: Clear Heat Dry Dampness

Actions: nourish Kidney yin and drain fire from deficiency, used for steaming bone disorder, night sweats.

Contraindications: Spleen Qi Deficiency w/ Cold

Zhi Mu-Anemarrhena Rhizome

Tastes and Energies: bitter, sweet, cold

Category: Clear Heat, Drain Fire

Actions: nourish Kidney yin and drain fire from deficiency, nourish yin and moistens dryness, generates fluids and clears heat.

Contraindications: Spleen Qi Deficiency, diarrhea

Dang Gui-Angelica Sinensis Root

Tastes and Energies: sweet, spicy, warm

Category: Tonify the Blood

Actions: Moistens and nourishes the blood and regulates the penetrating and conception vessels. Invigorates blood, moistens the intestines, increases circulation

Contraindications: Spleen Qi Deficiency, dampness

Er Xian San cautions:  during pregnancy, during early states of acute illness, loose stools, diarrhea, poor appetite or chronic digestive weakness.

The intriguing aspect of Er Xian Tang is that it contains herbs that are contraindicated (not used) in cases of yin deficiency with deficient fire. It contains hot natured herbs, Xian Mao, Yin Yang Hou, and Ban Ji Tian, which tonify yang but can also increase fire. The formula also contains Huang Bai and Zhi Mu that are bitter and drying, which may damage yin. Huang Bai and Zhi Mu are considered a traditional Dui Yao, or herbs that are often used together to reinforce and complement each other. Together they clear heat, enrich yin and drain deficient fire. Huang Bai is bitter, cold, consolidates yin, drains deficient fire, while Zhi Mu, is sweet, cold, enriches yin, moistens dryness, and supplements the kidneys. Dang Gui builds blood, increases red cell proliferation, normalizes heart contractions and dilates coronary blood vessels increasing peripheral blood flow. Huang Bai and Zhi Mu are cold energetically and help to balance the spicy and heating energies of Xian Mao, Yin Yang Hou, and Ban Ji Tian.

Er Xian Tang serves as an example of evolving TCM formulation, where a new formulations are being utilized to address modern disharmonies by combining strongly warming yang tonics with cold, fire-purging herbs. In this case and the studies that have been conducted the formula appears to be effective for hypertension and for some other applications, such as menopausal syndrome and male infertility.

Additional notes:

Xian Mao and Yin Yang Huo are used to tonify the kidney and according to the Taoist’s aid in prolonging life. The name “Two Immortals” references the use of the word Xian.   Xian Mao was named in the Bencao Gangmu (by Li Shizhen; 1596) as one of the herbs believed to contribute to immortality. Xian Ling Pi (Epimedium, now know as Yin Yang Huo) alludes to the immortals’ intelligent nature, boosts the qi and strengthens the will. Around 100 B.C., a poem about attaining immortality, the ode Yuan Yu (Journey to Remoteness, or Roaming the Universe) was written. It depicts the transition to immortality:

Having heard the precious teaching, I departed,

And swiftly prepared to start on my journey.

I met the feathered ones at Cinnabar Hill,

I tarried in the ancient Land of Deathlessness.

In the morning, I washed my hair in the Hot Springs of Sunrise,

In the evening, I dried myself where the suns perch.

I sipped the subtle potion of the Flying Springs

And held in my bosom the radiant metallous jade.

My pallid countenance flushed with brilliant color,

Purified, my Jing began to grow stronger,

My corporeal parts dissolved to a soft suppleness,

And my spirit grew lissome and eager for movement.

 

Tinnitus-Ringing in the Ear, Treatment Options From Many Traditions

The Western allopathic approach to tinnitus is dramatically different from either Western Herbalism or Traditional Chinese Medicine in addressing this condition.

Western Allopathic Medicine: Tinnitus is the perception of sound when no actualindex3 external noise is present. Tinnitus is a non-auditory, internal sound that can be intermittent or continuous, in one or both ears, and either a low or high-pitch sound. The sounds of tinnitus have been described as whistling, chirping, clicking, screeching, hissing, static, roaring, buzzing, pulsing, whooshing, or musical. The volume of the sound can fluctuate and is often most noticeable at night or during periods of quiet. Tinnitus is often accompanied by a certain degree of hearing loss.

Tinnitus can be either an acute or temporary condition, or a chronic health malady. Millions of Americans experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public, over 50 million Americans, experience some form of tinnitus. Roughly 20 million people struggle with burdensome chronic tinnitus, while 2 million have extreme and debilitating cases.

In general, there are two types of tinnitus:

  • Subjective Tinnitus: Head or ear noises that are perceivable only to the specific patient. Subjective tinnitus is usually traceable to auditory and neurological reactions to hearing loss, but can also be caused by an array of other catalysts. More than 99% of all tinnitus reported tinnitus cases are of the subjective variety.
  • Objective Tinnitus: Head or ear noises that are audible to other people, as well as the patient. These sounds are usually produced by internal functions in the flow of blood or muscular-skeletal systems. It is often more like the sound of a heartbeat or pulsating. This type of tinnitus is very rare, representing less than 1% of total tinnitus cases.

index2Some medications such as aspirin, ibuprofen, certain antibiotics, and diuretics can be “ototoxic” or cause damage to the inner ear, resulting in tinnitus.

Other possible causes of tinnitus are:

  • Head and neck injuries
  • Loud noises,
  • Ear infections
  • A foreign object, or earwax touching the eardrum
  • Eustachian tube (middle ear) problems
  • TMJ disorders
  • Stiffening of the middle ear bones
  • Cardiovascular disease
  • Diabetes
  • Traumatic brain injury

There are also potential risk factors including the following:

  • Noise exposure from work, headphones, concerts, explosives
  • Smoking
  • Gender – men are affected more than women
  • Hearing loss
  • Age – older individuals have a higher likelihood of developing tinnitus

There is currently no scientifically valid cure for most types of tinnitus. There is, however, remedies that focus on diverting attention, addressing the emotional impact, and or cognitive therapy.

Western Herbalism: Tinnitus can serve as an important marker pointing to other potential health issues, since it a symptom and not a disease. Whatever the cause it tends to worsen in times of tension, stress and or muscle spasms. Stimulates like caffeine or nicotine, which increases vasoconstriction, can exasperate it. Furthermore, it can be caused by damaged fine hair cells of the inner ear. Although this cannot be reversed there might we some reduction felt in using some of the suggestions below. Stress reduction can often be helpful. Some herbs have been used to address tinnitus including black cohosh (Cimicifuga racemosa), goldenseal (Hydrastis canadensis) and more recently ginkgo (Ginkgo biloba).

Traditional Chinese Medicine (TCM): In TCM we know that the images6kidney qi communicates with the ears and that as we age or because of various states of health this can affect our qi, therefore the kidneys are often identified as root causes of tinnitus.

In approaching treatment of tinnitus, it is important to distinguish between an acute or sudden occurrence or a long-term tinnitus that gets worse over time or comes and goes. Furthermore, it is important to determine whether it is an excess-type or a deficiency-type of tinnitus. A key to this determination is that an excess type of tinnitus is often experienced in only one ear, while a deficiency based tinnitus tends to develop in both ears. The deficiency type usually gets better during the day and gets worse at night. A combination of deficiency and excess syndromes is possible, especially in persons with other illnesses or with tinnitus that has persisted for several years.

The following is a description of excess and deficiency patterns that might be able to better pinpoint treatment principles to be used.

Excess type #1, Hyperactive liver and gallbladder fire:

  • Sudden onset
  • Continual sound
  • Excess symptoms (a headache, flushed face, irritability)
  • Excessive anger, fright
  • Excessive use of alcohol

TCM formula: Long dan Xie Gan Tang (Gentiana Comb) with the addition of moutan, ligustrum, for persistent liver fire weakening the Kidney water.

Excess type #2, Phlegm Fire Syndrome

  • Intermittent ringing in the ears
  • Feeling of blocked ears
  • Chest stuffiness
  • Excess phlegm
  • Dizziness
  • Blockage manifesting as difficult urination or constipation

TCM formula: Wen Dan Tang (Bamboo and Hoelen Comb)

  • with the addition of pear, haliotis, uncaria (liver)
  • with lapis, scute, rhubarb and aquilaria (blockage of chest, constipation)
  • with dampness (Ban Zia Bai Zhu Tian Ma Tang)

Diet: avoid fat or spicy food

Deficiency type #1, Deficient Kidney Jing

  • Gradual worsening ringing
  • Dizziness
  • Backache
  • Deficient heat symptoms

TCM formula: Liu Wei Di Huang Wan (Rehmannia Six Formula) and schizandra.

TCM formula Er Long Zuo Ci Wan (Tinnitus Left Supporting Pills)

Deficiency type #2, Sinking Spleen Qi (yang def.)

  • Intermittently occurring tinnitus that is relieved through rest and reduced stress
  • Low energy
  • Poor appetite
  • Loose stools

TCM formula: Yi Qi Chong Ming Tang (Ginseng, Astragalus and Pueraria Comb.)

Lifestyle: stress reduction, adequate kidney and spleen building dietimages5

Ear Massage: There are several sites that have detailed directions for addressing tinnitus through massage:

The bottom line is that the early intervention is necessary for long-term success. If you are experiencing any of the symptoms outlined in any of the treatment options, seek the advice of a Physician or Clinical Herbalist (http://www.americanherbalistsguild.com/herbalists-and-chapters-near-you)

Sources:

Davis, Kathleen FNP. 2016. Tinnitus: Causes, Symptoms, and Treatment. The University of Illinois-Chicago, School of Medicine. Available from

http://www.medicalnewstoday.com/articles/156286.php

Flaws, B Sionneau P. 2001. The Treatment of Modern Western Medical Disease with Chinese Medicine. Blue Poppy Press. p. 55-56.

Hoffmann, D. 2003. Medical Herbalism. Healing Arts Press. P372-373.

Dharmananda, S. Ph. D. 1998. Treatment of Tinnitus, Vertigo, and Meniere’s disease with Chinese herbs. Institute for Traditional Medicine. Available from http://www.itmonline.org/arts/tinmen.htm

 

 

Traditional Chinese Medicine: Erectile Dysfunction (ED) and alternatives to Viagra

I recently saw my first client with ED and spent time researching how Traditional Chinese Medicine (TCM) approaches working with this condition.  Erectile dysfunction (ED) or impotence occurs when a man has consistent and repeated problems sustaining an erection. Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It is also sometimes also referred to as impotence.   Several studies have looked at the prevalence of ED including one, the Massachusetts Male Aging Study, that reported that ED is increasingly prevalent with age. At age 40, approximately 40% of men are affected. The rate increases to nearly 70% in men aged 70 years.  Age was the variable most strongly associated with ED, although there are emotional and physiological reasons attributed including: diabetes, obesity, heart disease, high blood pressure and atherosclerosis, endocrine diseases, lifestyle, diet, neurological and nerve disorders, medications, drug abuse, anxiety and depression. Additionally men may have difficulty obtaining or maintaining erections after various forms of cancer treatment. Surgery and radiation therapy to the pelvic area, hormonal therapy, chemotherapy, and various medications may all significantly impact a man’s ability to obtain or maintain an erection. Viagra is the leading medication prescribed for ED, although as with all medications,  it is not without its associated side effects:

  • HeadacheUntitled1
  • Flushing in the face, neck, or chest
  • Upset stomach, indigestion
  • Abnormal vision
  • Nasal congestion
  • Back pain
  • Muscular pain or tenderness
  • Nausea

If considering options than Viagra, such as those explored below, it would be advised see a TCM trained specialist.

Traditional Chinese Medicine (TCM) considers that the strength or weakness of men’s sexual function is associated with the energy of certain internal organs, including the kidneys, liver and heart. The Kidneys are one of the major organs to support the body’s sexual function by storing essence (Jing), controlling human reproduction, growth and development. Essence or Jing rules the production of sperm. The heart plays an important role in erection and arousal. Kidney essence is classified as yin, while qi is yang, yet they depend on each other to maintain a dynamic balance, if out of balance it can result in ED/impotence. Excessive sexual activities and frequent masturbation can deplete the kidney essence.

The Ming Men (located on the middle of the lower back) is an essential part of traditional Chinese physiology. Called the “Gate of Life,” it holds the Genuine Yin and Yang of the body from which all substances and functions develop. The term Ming Men refers to one of the body’s two kidneys, where the male’s “essence” is stored. In Kidney Deficiency cases, warming the Ming Men and Kidney Yang are necessary to balance the body.

index4Men’s sexual function disorders have been strongly associated fast paced life styles. This state of chronic stress restricts the flow of the qi through the Liver channel which travels through the pubic area and reproductive organs. When the Liver is affected by stress and the Liver channel is blocked then qi cannot flow smoothly leading to sexual dysfunction and disorders.

The process by which the penis becomes erect is complex, involving not only the nerves, muscles, blood vessels, and other tissues in the penis itself, but also includes factors such as emotion, lifestyle and general health. During arousal nerve impulses are sent to nerves in and around the penis, which cause an increase of blood flow into that organ, causing it to become firm and erect. If there is insufficient blood the penis is unable to achieve erection.

The Heart plays a crucial role in erection, orgasm and ejaculation. In TCM the ability to have an erection and ejaculation depend on the communication between the heart and kidneys. The Heart-Qi needs to descend to communicate with Kidney-Qi. Vice versa, Kidney-Water needs to ascend towards the Heart and contain Heart-Fire, the coordination between the descending of Heart-Fire and ascending of Kidney-Water ensures a normal sexual cycle in men. During the excitement phase of sexual response the Minister Fire within the Kidneys is aroused and flows up towards the Pericardium and Heart: for this reason the person becomes flushed in the face (the complexion is a manifestation of the Heart) and the heart rate increases during sexual excitation. With orgasm and ejaculation, there is a downward movement of Qi, which releases the accumulated Minister Fire downwards: in order for this to occur normally the downward movement of Heart-Qi is crucial. If there is deficiency of Minister Fire within the Kidneys it will result in decreased libido and ED or impotence in men. If Heart-Qi and Heart-Blood are deficient or not descending to communicate with the Kidneys, there may be ED, impotence or premature ejaculation.

tongue blood stasisThere are several other common patterns in ED including blood stasis and damp heat. In cases of Blood Stasis, the flow of energy (called Qi) and Blood is blocked or obstructed in the lower abdomen preventing needed blood flow to create and maintain an erection. This condition often presents with signs of a tight and tender to palpitation lower abdominal area. Treatment will focus on breaking the stagnation in the lower abdomen, returning the proper flow of Blood though the affected area.

Another reason for ED or impotency is the presence of damp heat. Whenindex5 damp heat accumulates it acts creases stagnation or impedes the free flow of Qi. There are many causes of damp heat including unresolved health issues, unresolved low-level pathogens, and or excessive alcohol intake. Signs that point to the presence of damp heat include itching, pain, and swollen prostate, sweating in the genitals, heaviness and aching in the lower limbs, greasy yellow coating on tongue. Treatment includes clearing heat and nourishing any underlying deficiencies.

In determining treatment for ED it is important to utilize the four basic techniques of assessment: questioning, smelling/listening, palpitation and inspection. Furthermore the constitution of the client is taken into account at the same time as TCM pattern differentiation. The following is a summary of pattern differentiation taken from Giovanni Maciocia and Shen-Nong.com, as well as, several other authors.

Primary Patterns:

Kidney Deficiency:

  • Weakness of Life-Gate Fire/Ming Men
  • Deficiency of Kidney Yang Deficiency
  • Deficiency of Kidney Yin Deficiency
  • Damage of the kidneys by fear

Damp Heat:

  • Downpour of Damp Heat into the Lower Burner
  • Damp Heat in Lower Burner
  • Damp Heat in Liver-Gallbladder Channel

Blood Deficiency/Stagnation:

  • Liver-Blood Deficiency
  • Heart and Gallbladder Qi Deficiency
  • Heart-Blood Deficiency
  • Damage of the heart and spleen
  • Blood Stasis

Qi:

  • Liver Qi Stagnation

Untitled2Weakness of Life-Gate Fire-The Gate of Life or Ming men is (located on the middle of the lower back) is an essential part of traditional Chinese physiology. Called the “Gate of Life,” it holds the Yin and Yang of the body from which all substances and functions develop. Along with the Yin-Yang theory, one of the most fundamental principles in Chinese medicine is that of the “Three Treasures.” The Three Treasures consist of jing (essence/potential energy), qi (energy/function), and shen (spirit or spirits). In terms of understanding the Ming Men the concepts of jing and qi are primary. Original Qi is stored in an energetic center called Ming Men. The relationship between the Kidney organ-system and Ming Men is defined by the relationship between the elements of Water and Fire, or Kidney and Heart as explained above. Strengthening Jing and the Life-Gate are often the first approach when working with ED/Impotency.

  • ED/Impotence
  • Seminal discharge, white/cold
  • Dizziness/vertigo
  • Tinnitus
  • Pale complexion,
  • Cold extremities
  • Listlessness of spirit
  • Weak aching lower back and legs
  • Frequent urination
  • Pale Tongue with white coating
  • Deep thready pulse

Formulas:

  • Wu Zi Yan Zong Wan (Five Ancestors Teapills)
  • Zan Yu Dan (Procreation Elixir)
  • Right-Restoring Pill combining with Procreation Elixir
  • Jin Suo Gu Jing Wan (Golden Lock Teapills) Kidney Yin and Yang deficiency with leakage of fluids creating instability at the Gate of Life.
  • Cong Rong Bu Shen Wan (Cistanches Tonify Kidney Pills)
  • Er Xian San (Two Immortals Teapills) regulates the chong and ren channels
  • Ge Jie Da Bu Wan (Gecko Tonic Teapills)

Deficiency of Kidney Yang symptoms: Yang is responsible for our physiological functions and energy. A deficiency of Kidney Yang is an internal condition results in cold and weakness, along with ED or impotence. A deficiency of Kidney Yang indicates a deficiency in the “Life Gate” or Ming Men. This coldness results in the lower libido, ED or Impotence. It is

  • ED/Impotence
  • frequent clear urination,
  • cold limbs,
  • dizziness,
  • tinnitus,
  • fatigue,
  • lower back weakness
  • Deep-Weak pulse
  • Pale tongue

Formulas:

  • You Gui San (Right side Replenishing teapills)
  • Wu Zi Yan Zong Wan (Five Ancestors Teapills)
  • Jin Gui Shen Qi San (Golden Book Teapills)
  • Ba Ji Yin Yang Teapills (Morinda Pills to Balance Yin and Yang)
  • Huan Shao Dan Wan (Return to Spring Teapills)
  • Ge Jie Dan Bu Wan (Gecko Tonic Teapills)

Deficiency of Yin Deficiency

  • ED/Impotence
  • Dizziness
  • Scanty urination
  • Night-sweating
  • Insomnia
  • Tinnitus
  • Floating-empty pulse
  • Red tongue w/o coating

Formulas:

  • Zuo Gui Wan (Return Left Pill)
  • Zhi Bai Di Huang Wan (Eight Flavor Rehmannia Teapills) with deficient heat
  • Liu Wei Di Huang San (Six Flavored Teapills)

Damage of the kidneys by fear-Fear can shock or injure the Kidney-Adrenals, along with leading to the disordered movement of qi.

  • ED/impotence
  • soft erection
  • timidity
  • tendency to doubt and suspicion
  • palpitations
  • susceptibility to fright
  • restless sleep
  • thin and slimy tongue coating, string-like
  • thready pulse.

Formula: Huan Shao Dan Wan (Return to Spring Teapills)

Downpour of Damp Heat into the Lower Burner

  • ED
  • Premature ejaculation
  • Sweatiness of the scrotum
  • Heavy aching lower limbs
  • Thirst
  • Bitter taste
  • Dark burning urine
  • Yellow slimy coating on Tongue
  • Pulse is Slippery and rapid

Formula: Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction

Damp Heat in Lower Burner

  • ED/Impotence
  • Difficult-painful urination
  • Deep yellow urine
  • Itching of genitals
  • Urethral discharge
  • Sticky-yellow coating on tongue, with red spots on root
  • Slippery pulse

Formula: Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction

Damp Heat in Liver-Gallbladder Channel

  • ED/Impotence,
  • Difficult-painful urination
  • Rash external genitalia
  • Irritability
  • Sticky-yellow coating on tongue, with red spots on root
  • Wiry pulse

Formula: Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction

Liver-Blood Deficiency

  • ED/Impotence
  • Dizziness
  • Blurred vision
  • Depressed mood
  • Insomnia
  • Pale tongue
  • Choppy pulse.

Formula:

  • Shao Yao Gan Cao Tang Jia Wei (Peony and Licorice Teapills)
  • Si Wu Tang (Dang Gui Four)

Heart and Gallbladder Qi Deficiency

  • ED/Impotence
  • Premature ejaculation
  • Depressed mood
  • Timidity, sighing
  • Insomnia
  • Palpitations
  • Easily startled
  • Pale tongue
  • Weak pulse

Formula: Da Bu Yuan Jian

Heart-Blood Deficiency

  • ED/Impotence
  • Palpitations
  • Dizziness
  • Depressed mood
  • Insomnia
  • Pale tongue
  • Choppy pulse

Formulas:

  • Gui Pi Tong (Ginseng and Longan Combination)
  • Si Wu Tang (Dang Gui Four)

 Damage of the heart and spleen

The Spleen is the source of Blood production along with ensuring its flow within the vessels. If the spleen is operating properly then it transports and transforms sufficient nutrients for plentiful heart blood. Vise versa, according to the five-element theory, the Heart is the mother of the Spleen. If there is deficiency of Heart Blood or Qi it impairs the function of the Spleen to transport and transform. This domino effect will impede the Spleens ability to transport sufficient nutrients to keep Blood flowing in the vessels (ability to achieve and maintain erection).

  • Inability to achieve and/or maintain erection
  • Lassitude
  • Palpitations
  • Poor memory
  • Restless sleep
  • Poor appetite/eating habits
  • Colorless facial complexion
  • Thin and slimy tongue coating, pale tongue,
  • Fine or choppy pulse.

Formula:

  • Gui Pi Tong (Ginseng and Longan Combination)
  • Spleen-Restoring Decoction

Blood Stasis-Surgery, cancer, radiation and chemotherapy can potentially result in creating stagnation of blood to the perineum, which can impede the flow of blood and qi.

  • Prickling pain in testes
  • Pain or distention in chest and hypochondria
  • Stabbing pain
  • Dark complexion
  • Dry skin
  • Purplish dark tongue
  • Thready, uneven pulse

Formulas:

  • Xue Fu Zhu Yu Tang (Stasis in the Mansion of Blood Decoction)
  • Wen Jiang Tang Wan (Warm Cycle teapills)

Liver Qi Stagnation-Normal flow of liver qi ensures that all emotional processes are in harmony and blood is flowing sufficiently. If there is a stagnation of liver qi then this can result in the lack of nourishment to tendons including genitalia.

  • ED/impotence
  • Depression
  • Anxiety and irritability
  • Discomfort of the chest and stomach
  • Distension and oppression of the hypochondriac region
  • Poor appetite/eating habits
  • Loose stool
  • Thin tongue coating
  • String-like pulse.

Formula:

  • Xiao Yao San (Bupleurum and Dang Gui Formula
  • Jai wei xiao yao san (Bupleurum and Peony Formula) clears deficient heat
  • Chai Hu Shu (Disperse Vital Energy in Liver), for liver qi stagnation and Liver Blood Stasis

Traditional Formulas used for ED/Impotence:

Ge Jie Da Bu Wan (Gecko Tonic Teapills), Qi, Yang, Blood and Jing deficiency

Symptoms:

  • Weakness or pain in low back knees
  • Joint pain and stiffness
  • Difficulty walking
  • Weakness, fatigue, exhaustion, listlessness
  • Weak voice, pale face
  • Spontaneous sweating
  • Occasional chills and feverishness
  • Dizziness, vertigo, tinnitus, hearing loss
  • Forgetfulness, poor memory,
  • Frequent urination, nighttime urination
  • Edema,
  • Chronic diarrhea w/undigested food, abdominal distention, poor appetite
  • Cold limbs, cold intolerance
  • Decreased sex drive, impotence
  • Shortness of breath, wheezing, shallow breathing aggravated by exertion, shallow breathing aggravated by exertion, chronic persistent cough
  • Palpitation
  • Insomnia

Jin Suo Gu Jing Wan (Golden Lock Teapills), Kidney Yin and Yang Deficiency creating instability at the Gate of Life

Symptoms:

  • Chronic leakage of fluids, spermatorrhea, nocturnal emissions, premature ejaculation, impotence,
  • Urinary frequency, night urination, urinary dribbling or incontinence
  • Fatigue, weakness, listlessness
  • Excessive sweating
  • Weakness and rapid fatigue in muscles, sore and weak low back and limbs
  • Chronic watery diarrhea
  • Tinnitus

Wen Jiang Tang Wan (Warm Cycle teapills) * deficiency and cold in Chong and Ren channels causing blood stasis

Symptoms:

  • Five palms heat
  • Dry lips and mouth
  • Dry skin or hair
  • Fatigue, weak or cold limbs
  • Impotence
  • Pain in the testicles
  • Urinary incontinence

*primarily used for women in the category of warm the menses and dispel blood stasis, but can be used for spermatorrhea, erectile dysfunction, orchialgia, seminal insufficiency.

Supplementary herbs and formulas:

  • Wu Chi Pai Feng Wan (Black Chicken White Phoenix Pills)
  • Tonic wine: soak red deer antler, ginseng roots, lycii berry and schizandra in rise wine. Take 1 tsp 3 times a day, especially for winter.
  • Planetary Herbs: Damiana Male Potential
  • Ashwagandha
  • Shilajit
  • Damiana
  • Yohimbe
  • Ginseng

Moxibustion and Qi Gong: In cases of Kidney deficiency that require warming, moxibustion can also be performed at index6these acupuncture points. The moxibustion treatment involves the burning of a herb, Ai Ye-mugwort, to warm and circulate the energy in the local area, strengthening the Life Gate fire.

Qi Gong has specific movements to strengthen the Gate of Life (http://www.funwithqigong.com/2009/07/open-and-move-from-the-gate-of-life/)

References:

http://www.shen-nong.com/eng/exam/specialties_menimpotence.html

https://www.jcm.co.uk/liver-gallbladder-based-erectile-dysfunction-treatment-by-chinese-medicine-part-1.html

http://www.altmd.com/Articles/TCM-for-Erectile-Dysfunction

http://maciociaonline.blogspot.com/2013/06/the-treatment-of-male-problems-in.html

http://www.itmonline.org/5organs/kidney.htm

http://www.tcmtreatment.com/images/diseases/impotence.htm

http://www.theacupunctureclinic.co.nz/male-sexual-dysfunction-by-will-maclean/

Pao Zhi- Ancient Techniques applied to Western Herbs

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Honey Stir Fried Licorice Root

Pao Zhi is an ancient Chinese technique of altering the tastes, energies and directions of medicinal substances by processing. This transformational alchemical approach to preparation can increase herbs therapeutic effectiveness and applicability for individualized treatment. Albeit a simplistic view, I view it is akin to cooking, in which the very nature of food, is transformed for assimilation.

What about western herbs? I have used some of the very same processes described below with Western traditional herbs including honey stir-fried elecampane root to direct its energy to digestion, dry stir fried solomon seal with a salt solution to direct its energy towards the kidneys, cooking nettles with black bean juice to enhance its ability to nourish blood, and dry stir frying rice with angelica to reinforce it action on the spleen.

An individual herb can be used in different ways depending on what part of the plant is used; where as, with the process of pao zhi one can transform the energy, flavor and action of the same part of the plant. In Traditional Chinese Medicine (TCM) the preparation of herbs is an integral aspect of the therapeutic strategy. Pao Zhi is a vast subject and this article is only the tip of the iceberg. I have included some references at the end of the article for further exploration.

There are a multitude of reasons why herbs are subjected to processing including the removal of debris, reduction of toxicity, reduction of odors and flavors, to reinforce or modify energetic properties, prolong storage and most importantly, to increase assimilation. This image represents a visual overview of Pao Zhi techniques and the types of products that are produced. The following is a partial list of methods of Pao Zhi preparation and pinyin names, which are reflected in the naming of Chinese Herbs:

  • Sheng: uncooked without heat or cooking.
  • Shu: prepared with heat or cooking
  • Shui Zhi (w/ water): multiple rinsing and washing, moistening and soaking
  • Shui Fei, using water in the process of pulverizing. Used to eliminate salts, toxicity, refine minerals, and soften for cutting.
  • Huo Zhi (w/ fire): Stir-frying, calcination, roasting, baking and blast frying. Stir-frying might be done with or without the addition of various substances including honey, vinegar, rise, wheat brand, etc. that alter the energetic action of the herb.
  • Sometimes a combination all or any of the above including steaming, boiling, distilling and dipped into water after calcinated.
  • Fermentation and sprouting or germination is also used as a method of transforming herbs.
  • Many of the herbs that are toxic such as Fu Zi (aconitum carmichaeli) or Ban Xia (Rhizoma Pinelliae ternatae) involve successive transformational processes to make them safe for use.  This is a video that shows the traditional preparation of Fu Zi.

One of the most common methods of transformation is through the use of stir-frying with either one or several substances to change the energy/action of the herb. The following examples illustrates how Pao Zhi can effect flavor, actions and corresponding organs:

  • Stir-frying with rice, with its sweet flavor and neutral energy helps to eliminate dampness andSlide10 supplements the spleen and qi. Directions: a pan is preheated and rice is added and stir-fried until it starts to smell, the herbs are added, and cooked until both are brown, then the herbs are separated out. An example of this is with Dang Shen (Codonopsis).
  • Honey has a sweet flavor and cool energy but when heated it becomes warming. Directions: combine a small amount of honey and dilute with water until fairly runny. This is tossed with the herbs until they are coated. The herbs are stir-fried in a dry pan over low heat until the honey is no longer sticky. This process alters the herbs actions to reinforce the supplementation of the spleen and qi by increasing their moistening and tonification properties. Examples: Dang Shen (codonopsis), Gan Cao (licorice) and Huang Qi (astragalus).
  • Salt has a cold energy and enhances downward action directing the energetic actions of theSlide09 herbs to the kidneys, supplements yin, addresses empty fire blazing, promotes softening of nodules and stimulates diuretic action. Directions: Mix salt and water for a 2% solution or 2 grams of salt in 100 millilitres of solution. Toss the herbs with the salt solution until well coated and then stir-fried over low heat until dry. An example of this process is with Zhi Mu (Anemarrhenae) and Huang Bai (Phellodendrum), for use in yin deficiency with empty fire blazing.
  • Vinegar (rice) has a warm energy. It also has a sour and bitter flavor directing its action towards the liver. Directions: take 15 parts vinegar to 100 parts water then soak the herb thoroughly, followed up by stir-frying it over a low fire until a golden color.   Examples are Chai Hu (Bupleurum) and Qing Pi (citrus peel).
  • Wine is acidic and sweet flavored. It is also heating and helps to increase circulation or quickening of the blood in the network vessels. Directions: using 20-50 parts of wine to 100 parts of herb, the herb is tossed with the wine, and then stir-fried over low heat until yellow. Examples are Dang Gui (angelica sinensis) and Chuan Xiong (ligusticum wallachii)

An excellent example of this is to look at the different methods for preparing Di Huang (Rehmannia glutinosa, Chinese foxglove) to obtain different energies, tastes and actions.

  • Xian Di Huang, (raw fresh root) is sweet and bitter with a cold energy. It clears heat, cools the blood engenders fluids and stops thirst.
  • Di Huang Zhi, (raw fresh juice) is sweet and slightly bitter with a cold energy. It clears heat and stops bleeding.
  • Sheng Di Huang, (dry uncooked) is sweet and slightly bitter with a cool energy. It enriches yin and clears heat.
  • Chao Shen Di Huang, (dry stir-fried till scorched) is sweet and slightly bitter. It has a cool to neutral energy.   It enriches yin and nourishes the blood.
  • Sheng Di Huang Tan, (dry stir-fried till carbonized) is sweet, bitter and slightly astringent. It has a cool to neutral energy.
  • Shu Di Huang**(steaming in rice wine). It is sweet and slightly warming. It supplements yin, supplements the blood, supplements the essence, and supplements the kidneys.
  • Chao Shu Di Huang, (steaming in rice wine and stir-fried till scorched). It is sweet flavored and warm energy. It nourishes the blood, nourishes the constructive qi, and enriches yin.
  • Shu Di Huang Tan, (steaming in rice wind and stir-fried till carbonized). It is sweet flavored and slightly astringent. It is warm energetically. It supplements the blood and stops bleeding.
  • ** David Wolf and Mountain Rose Herbs prepared rehmannia is manufactured, by boiling the root in a mixture of yellow wine and black bean infusion until the liquids have been boiled away and the roots are black. The roots are then dried in the sun.

Slide15You can see that by using different processes one can change the energy of the herb from cold to warm and the flavor from sweet to astringent. By understanding the needs of the individual client, one can further amend prepared Shu Di Huang by using ginger juice (dampness), cardamom (or chen pi (citrus peel) for spleen vacuity and qi stagnation when stir frying.

The following link is a study on the chemical comparisons of dried rehmannia root and prepared rehmannia root (steamed). The report’s results show characteristic changes in the content of major monosaccharides and oligosaccharides as the dried root is converted in the steaming process of the prepared root, indicating a possible special role for fructose, stachyose and rehmaionoside in the differing therapeutic effects of dried and prepared rehmannia. http://www.sciencedirect.com/science/article/pii/S2211383512001499

Further Reference:

  • Sionneau, Philippe. An Introduction to the use of Processed Chinese Medicinals. Blue Poppy Press, 1995.

Calamus-Smart Soup, Brain Protectant and Traditional Uses

Calamus, Sweet Flag, Acorns calamus, Vacha, Shi Chang Pu, rhizoma acori tatarinowii(石菖蒲)

Recent research from the Chinese Academy of Sciences’ Institute of c4f6301f8e8504f05b68c1b5d558dacdBiochemistry and Cell Biology in Shanghai found a traditional Chinese medicine known as smart soup (聰明湯) could help in the fight against Alzheimer’s disease, of which calamus was one of the ingredients.  The soup, which is a Traditional Chinese Medicine (TCM) formula used for many centuries and is still prescribed by Chinese medical physicians to patients with aging-related cognitive impairment.  Smart Soup is officially documented in Gu Jin Yi Jian, a book published in 1576.  It is composed of Rhizoma Acori Tatarinowii (calamus), Poria cum Radix Pini and Radix Polygalae.  Calamus has been shown to exhibit a neuroprotective action and attenuate learning and memory deficits.  According to the research the scientists found the smart soup, or more specifically radix polygalae, could significantly reduce the generation of amyloid beta, with the levels in treated mice more than 18 per cent lower than in those untreated.  They found that the other two herbs – rhizoma acori tatarinowii (calamus) and poria cum radix pini – appeared to protect the neurons against the damaging effect of ama.

index1According to Traditional Chinese Medicine (TCM) calamus is aromatic, acrid, bitter and warm. It belongs to the category of aromatic substances that open the orifices and enters the Heart and Stomach channels. It strengthens the Spleen and Stomach, opens the sensory orifices, dislodge phlegm, transforms dampness, calms the spirit, enhances digestion, and promotes blood flow and movement of Qi. It is often used in the treatment of dizziness, dulled senses, stupor and coma.  It has been combined in many other formulas including:

1) Di Tan Tang from Ji Sheng Fang (Life-saving prescriptions). It is combined with Ban Xia (Pinellia), Tian Nan Xing (Arisaema), Ju Hong (Exocarpium Citri Erythrocarpae), etc. to treat stoke due to phlegm confusing heart, unconsciousness, and a hardened or stiff body of the tongue impeding speech.

2) Chang Pu Yu Jin Tang from Wen Bing Quan Shu (Complete Compendium of Warm Disease). It is formulated with Yu Jin (Tumeric Tuber), Pinellia, Zhu Li (Succus Bambusae), etc. to cure blocking of phlegm-heat, high fever, coma, and delirium.

3) Qing Xin Wen Dan Tang from Gu Jin Yi Jian (Mirror of Ancient and Contemporary Medicine). It is coupled with Zhi Shi (Citrus Aurantium), Zhu Ru (Bamboo Shavings), Huang Lian (Coptis Root), etc. to heal epileptic seizures caused by phlegm-heat.

4) Ru Lian Po Yin from Huo Huan Lun (Treatise on Cholera). It is matched with Coptis, Hou Po (Magnolia Bark), etc. to treat dampness forming with heat, retention of damp-heat, vomiting and diarrhea accompanied with fever, chest and epigastric fullness and distress, and yellowish glossy coating of the tongue.

5) Kai Jin San from Yi Xue Xin Wu (Medical Revelations). It works with Coptis, Fu Ling (Poria), Shi Lian Zi (Sinocrassula indica seed), etc. to cure no desire to eat and rectal tenesmus after dysentery due to the accumulation of damp turbidity and heat toxic in colon.

6) Bu Wang San from Zheng Zhi Zhun Sheng (The Level-line of Patterns and Treatment) and Kai Xin San from Qian Jin Fang (Thousand golden essential prescriptions). Both of them are equipped with Ren Shen (Ginseng), Poria, Chang Pu (Acorus calamus), etc. to heal forgetfulness.

The article on smart soup peaked my interest, in that I knew that calamus also played an extensive role in Ayurveda herbal traditions, as well as, in Native American use.

Calamus, is a tall perennial, wetland monocot in the Acoraceae family.  It index4is a strongly aromatic, semi-aquatic perennial herb with a ginger-like stem which spreads into the ground. Originating in Asia it was widely exported across the globe.  The leaves and rhizomes have been used medicinally and as a substitute for ginger, cinnamon and nutmeg.  The aroma of calamus essential oil is valued in the perfume industry while its, crystallized form, is called “German ginger”.

index6In Native American traditions calamus has been extensively used for a variety of conditions and is considered by some tribes as a panacea herb or cure-all.  Used by Canadian, northern and mid western tribes, its use ranged from treatment of digestive issues to blood medicine and everything in between.  The Cherokee, from which I descend, used it for headaches, diarrhea, gas, colic, colds, kidney disease, worms and urinary infections.  It was ground up and mixed with tobacco and smoked for headaches by the Blackfoot. An infusion of the roots along with chokecherry was taken for coughs by the Algonquin tribe from Quebec.  Not only used internally calamus was used in charms for keeping spirits away, to protect warriors, keep children safe and as hunting medicine by the many of these tribes.  The most common use of calamus throughout all tribes was as a carminative, tooth aches, cold remedies, and sore throats.  In a review of ethnographic records, it had limited use as a herb for improving clarity of thought , although the Rappahannock specifically used the fresh juice as a tonic for older people and several other tribes considered it a beneficial tonic.

In western pharmacology it is classified as a stimulant, emetic, nauseant, stomachic, aromatic, expectorant, carminative, antispasmodic and nervine sedative, antioxidant and antimicrobial.

acorus%20calamus%20(2)In Ayurveda calamus is known as Vacha.  It has been used in nervous system issues and for mental and emotional disorders.  It has been used to quite the mind especially in the case of disorders characterized by an impairment of concentration such as ADD and ADHD.  As in other herbal traditions it is used in digestive disturbances.  Todd Caldecott, an esteemed herbalist specializing in Ayurveda, wrote an extensive monograph about its use.  In Ayurvedic tradition, Vacha is a ‘sattvic’ herb in its action as a stimulating nerve tonic that helps support brain functioning. It is also used as a rejuvenate for the brain and nervous system, it is used to promote cerebral circulation and to help support overall brain health and functioning. It has long been used to counter the effects of drug use, as in the case of heavy marijuana use, from fatty tissues within the liver, nervous system and brain. It is often used in post-Stroke (CVA) recovery protocols in the treatment of aphasia.

There has been some concerns regarding its safety. Calamus and products derived from it (such as its oil) were banned in 1968 as food additives and medicines by the United States Food and Drug Administration. Per the FDA’s website “Food containing any added calamus, oil of calamus, or extract of calamus is deemed to be adulterated in violation of the act based upon an order published in the Federal Register of May 9, 1968 (33 FR 6967)”. 

Jim McDonald a highly respected herbalist wrote extensively on calamus and is excellent reading.  According to information from his website and through info gleaned various other internet searches the ban was the result of a laboratory study that involved supplementing the diets of rodents over a prolonged period of time with massive doses of isolated chemicals (?-asarone).  The subject animals developed malignant tumors, and the plant was thereafter labeled procarcinogenic, although it  is not clear whether the observed carcinogenic effect in rats was relevant to the human organism, particularly given the large dosages and protracted duration of the regimen. Most authorities advise against ingesting the Indian Jammu strain. (Four varieties of Acorus calamus strains exist in nature; diploid, triploid, tetraploid and hexaploid. Acorus calamus americanus is widely used and believed completely safe in appropriate therapeutic dosages). No health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages of Calamus of European or American origin (triploid strain, up to 15% beta- asarone in volatile oil)  but long-term use of this herb should be avoided and use should be intermittent.

Other sites with extensive information on calamus:

http://www.herbcraft.org/calamus.htmlhttp://toddcaldecott.com/herbs/vacha/

http://www.mariatrebenherbs.com/?pid=55&sid=57:CALAMUS-SWEET-FLAG

use as essential oil-http://oilhealthbenefits.com/calamus-essential-oil/

Information on Smart Soup Research

ww.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0111215

Seeds available through Horizon Herbs

https://www.horizonherbs.com/product.asp?specific=384

.

Insomnia and Natural Strategies to Sleeping, Part 1

I teach a variety of classes and the class that is the most well attended is my class on naturalsleeping strategies for sleep and insomnia.  As a Traditional Chinese Medicine (TCM) herbalist, I cover this topic from both a TCM and Western viewpoint, as I will in this blog.  When I first started putting together the research for the class a quick search on the internet reveals enumerable sites devoted to sleep issues.  According to some estimates, 30% of the population experiences trouble sleeping.

Although there have been studies linking lack of sleep to long-term clockhealth issues it is important to not get too stressed out.  My experience in working with clients has been that anxiety about not getting enough sleep is a vicious self perpetuating cycle. If you are anxious about your sleep it may effect your ability to fall asleep or remain asleep. When this happens for many nights (or many months), you might start to feel anxiousness, dread, or panic at just the prospect of not sleeping. This is how anxiety and insomnia can feed each other and become a cycle that  may benefit from cognitive and mind body techniques.

For starters if you suspect that you have insomnia do any of these describe you?

  • Need an alarm clock in order to wake up on time
  • Rely on the snooze button
  • Have a hard time getting out of bed in the morning
  • Feel sluggish in the afternoon
  • Get sleepy in meetings, lectures, or warm rooms
  • Get drowsy after heavy meals or when driving
  • Need to nap to get through the day
  • Fall asleep while watching TV or relaxing in the evening
  • Feel the need to sleep in on weekends

If any of these seem familiar, then I would keep reading.  Lets take a look at some indicators that might help you determine whether or not you have insomnia and what type of insomnia it is is classified as.

  • Do you wake up during the night and find that you cannot fall back asleep?
  • Do you lie in bed, tossing and turning for hours each night?
  • Do you dread going to bed because you feel like you never get a good night’s sleep?
  • Do you wake up feeling unrefreshed after sleeping?
  • Does the problem occur even though you have the opportunity and the time to get a good night’s sleep?

The persistence of insomnia is how it is classified according to sleep specialists.

Types of insomnia
Transient Short term 1 or 2 nights a week
Intermittent On and off, from time to time
Chronic Constant, most nights for a month or more

Understanding the mechanics of sleep can help us to understand some strategies of treatment. Current information on sleep indicates that we past through several cycles of sleep, some indicate 4 stages and others 5I1047stages_thumb stages.   These stages progress cyclically from 1 through REM and then begin all over again. A complete sleep cycle takes an average of 90 to 110 minutes. Over the course of the night, the amount of time we spend in a particular stage of sleep begins to shift.  Typically you tend to experience more REM sleep in the earlier hours of the night (e.g., 11p – 3a) and more REM sleep in the later hours of the night (e.g., 3a – 7 a).

Going to bed and increasing your sleep efficiency can be the first step in developing an individualized sleep strategy.  The goal of getting enough sleep is to wake up naturally before the alarm, or when you want to get up.  Below is a calculation you can use to determine your appropriate bed time.

Determining an ideal bed time
 Sleep cycle  90 minutes
 Average sleep cycles per night  5 cycles
 Multiply 90 x 5 450 minutes (7.5 hours)

Then count backwards from the time you want to wake-up time 7.5 hours and you have a starting point for your bedtime.

Now that you know when you should be going to bed the next step is to determine how efficient your sleep is.  This can be done through a simple calculation or there are several excellent sleep apps on the app imagesmarket that track your sleep based on movement and let you see the percentage of time you spend in various sleep states along with determining our sleep efficiency.  Although these are can not substitute for a formal sleep study, they do give you an idea of your sleep patterns.  To determine your sleep efficiency without a sleep app, take the amount of time you spend in bed asleep (minus all the awakenings you may have and how long it takes you to fall asleep), and divide it by the total time you spend in bed, you will get an estimate of the overall percentage of how efficiently you sleep.   In sleep science they like to see this number above 85%. 85% is considered normal and really good sleep efficiency is above 90%.

There are many issues that might cause insomnia including unhealthysleep and aging sleep habits, anxiety or depression, certain foods and medical conditions. As we age we have we have changes in sleep cycles and needs. Ultimately if you feel as if your judgement and energy levels are diminished by your lack of sleep it is time to do something about it.

We are what we eat, so the first line of defense is to reduce our intake of foods that contribute to insomnia.

  • Refined Carbs can drain the body of vitamin B, which the body needs to release serotonin.
  • Bacon  contains tyramine, which increases the release of norepinephrine, a brain stimulant that keeps you up. Others foods that contain tyramine include chocolate, eggplant, ham, potatoes, sauerkraut, sugar, sausage, tomatoes, and wine.
  • Alcohol  can make you tired in the short run but you’re likely to awaken in the middle of the night. Red wine in particular effects sleep in that it contains more substances that people are sometimes allergic to, such as tannins, prostaglandins, and histamines.  If you do have alcohol, timing and the amount is everything.  One drink at least a couple of hours before sleep can have the least effect.
  • Chocolate can elevate your energy levels with bioactive compounds like tyramine and phenylethylamine. Chocolate also contains sugar which wakes you up as well as the other obvious culprit, caffeine.

Foods to incorporate into your diet that contribute to sleep include:

  • Walnuts-Walnuts are a good source of tryptophan, a sleep-enhancing amino acid that helps make serotonin and melatonin.
  • Almonds are rich in magnesium
  • Dairy products, Calcium (found in cheese, yogurt, milk) helps the brain use the tryptophan found in dairy to manufacture melatonin.
  •  Cherries, particularly tart cherries, naturally boost levels of melatonin.
  • Chickpeas are also a good source of tryptophan.

Supplements (all supplements and herbs need to be researched for possible medication interaction):

  • 5HTP-is a popular compound derived from the amino acid L-tryptophan. It is also produced commercially from the seeds of an African plant (Griffonia simplicifolia). 5-HTP acts as a precursor to serotonin, which is a neurotransmitter that is essential for a good night’s sleep. 5HTP has side effects and has not had long term studies, so it is important to research this supplement before using.
  • Magnesium contributes to a good night’s sleepResearch has shown that even a marginal lack of it can prevent the brain from settling down at night. You can get magnesium from food including green leafy vegetables, wheat germ, pumpkin seeds, and almonds.   Lack of magnesium inhibits nerve cell communication, which leads to cell excitability. Magnesium glycinate is a form of magnesium that avoids the side effects of loose bowel.
  • Calcium is directly related to our cycles of sleep.  In a study published in the European Neurology Journal, researchers found that calcium is directly related to our cycles of sleep.  The study concluded that disturbances in sleep especially the absence of REM sleep are related to calcium deficiency.  Calcium helps the brain use the amino acid tryptophan to manufacture the sleep inducing melatonin.  
  • GABA-An amino acid derivative found in green tea, theanine has long been known to trigger the release in the brain of gamma-aminobutyric acid, or GABA activates the major calming neurotransmitters, promoting relaxation and reducing anxiety, but the body has difficulty absorbing supplements containing synthesized GABA.
  • Melatonin-A hormone that regulates the normal sleep/wake cycle. According to research, the body naturally produces melatonin after the sun goes down, letting us know it’s time to fall asleep.  An effective way to take melatonin is to 1 sublingual and a time-released melatonin tablet. Take the time release tablet first and then place the sublingual tablet under your tongue.
  • Theanine-An amino acid derivative found in green tea, theanine has long been known to trigger the release in the brain of gamma-aminobutyric acid, or GABA. Experts recommend theanine, which the body can easily absorb and, ultimately, use to boost levels of GABA. Does above 600 mg without physician oversight.
  • L-tryptophan-Some people take L-tryptophan to try to help them sleep. But research does not show that L-tryptophan supplements are a good or safe treatment for long-term insomnia.  L-tryptophan has been linked to a dangerous, even deadly condition called eosinophilia-myalgia syndrome (EMS). Furthermore they have myriad interactions with medication, so caution is advised.

Coming soon:

Part 2, an overview of herbal protocols and development of individual sleep strategies.

Part 3, an overview of how perimenopause and menopause effect sleep.