Friday, August 22, 2014
One is riding an ass to search for the ass;
The other is riding an ass and being unwilling to dismount.
You say that riding an ass to search for the ass is silly
and that he who does it should be punished.
This is a very serious disease.
But, I tell you, do not search for the ass at all.
The intelligent man, understanding my meaning,
stops searching for the ass,
and thus the deluded state of his mind ceases to exist.
But if, having found the ass, one is unwilling to dismount,
this disease is most difficult to cure.
I say to you, do not ride the ass at all.
You yourself are the ass.
Everything is the ass.
Why do you ride on it?
If you ride, you cannot cure your disease.
But if you do not ride,
the universe is as a great expanse open to your view.
- Shu Chou, quoted in Fung Yu-Lan, A Short History of Chinese Philosophy
Thursday, February 20, 2014
Monday, October 07, 2013
Thank you earth
Thank you universe
For creating Ingrid
That she could experience your wonders
So sweet, so bright
Flower in the summertime
Return to root
Till the new spring
Become the flame
Such light, so bright
Wednesday, July 17, 2013
To give credit where credit is due, We Qi is very much like the Korean national pickle known as kimchi. But We Qi (pronounced “Wee Chee”) is a process, not a product! Most importantly, you shouldn’t make it all by yourself. Make it with your partner, with family, with friends, and your Qi (“breath” or “energy”) will alchemically merge with the Qi of the ingredients, and create a remarkable living food: We Qi.
- Set aside several large outer leaves of cabbage
- Chop up rest of cabbage, coarsely, and divide into two buckets for easy mixing
- Add half the salt to each bucket, mix well by hand
- If you have juice from your previous batch of We Qi, add it to the mix to hasten fermentation
- Combine into one bucket
- Cover with large whole cabbage leaves
- Place upside-down plate over the top
- Place large clean rock on top of plate
- Cover bucket with moist cloth, bungee-cord it closed so critters can’t get in
- Set aside in a cool place for three days, mixing occasionally
- Add crushed fresh garlic, coarsely chopped green onions, red pepper, daikon cubes
- Cover with moist cloth and set aside another three days – let it get good and bubbly
- Transfer to clean jars and keep in refrigerator until ready to enjoy
- Adjust for over-saltiness (if necessary) by adding more daikon; adjust for under-saltiness by adding salt
- Give away some jars along with these directions so that others can experience the Way of We Qi!
Tuesday, December 25, 2012
Here we are
on the cross of space and time
Contemplating the miracle
This precious pause
In the face of a single undeniable fact:
Here we are.
Wanting to be off the hook
Wanting to be somewhere else
Easier to dream of a sunnier place
Than to enjoy the rainy here and now
Meat-bodies run amok
In this once-great land
Run by corporations for the corporations
We are the herds
We follow the songs
of an invisible shepherd
who seduces us with things we want
And we don't even notice
The browning of the pines
The dying of the squid
Everything surreal, unreal
When viewed on a tiny screen
When I go
I will be grateful for those I have loved
And who have loved me
And that will be enough.
Here we are
Let's make the best of it
Merry Christmas 2012 Happy New Year 2013!
Thursday, September 20, 2012
Note to mushroom lovers: PSYCH! No, I did not find my first chanterelles this early! I wrote this piece one October many years ago for my ACUPUNK column in the Good Times. May the rains begin soon.
Monday, May 07, 2012
Sure enough, pretty soon I started seeing patients who complained of exactly these symptoms. Some got it in the feet. Most got it in the hands, particularly in the pads of their fingers. A few got it in their fingernails, resulting in loose nails that seemed like they were on their way to falling out. Most of these patients were being treated for breast cancer and were on a regimen of the chemotherapeutic agent called Taxol. A few had other cancers and were on other drugs, such as cisplatin or oxaliplatin. I tried all kinds of approaches to treat the neuropathy, from standard acupuncture to non-insertive Japanese acupuncture to cold laser to electrostim. Nothing seemed to help very much.
One day I was inspired to bleed my next neuropathy patient. In the style of Japanese acupuncture that I practice, we are taught to make a tiny incision and draw a small amount of blood wherever we find "blood stasis." Typically, blood stasis is indicated by small purplish venules, which we then prick and squeeze to extract a few drops of blood. But, it occurred to me, the numbness and tingling that characterize peripheral neuropathy could also be symptoms of blood stasis, even with no obvious venules. So, using a lancet, I bled my next patient, making a small incision near the center of each fingerpad, three or four millimeters from the fingernail. Quite miraculously, this seemed to work quite well! In some cases, the neuropathy decreased right there on the table. In most cases, several such treatments eliminated the symptoms. Some took longer, and those who had had chemo months or years before and still suffered from neuropathy took the longest. This technique seems to work well for Taxol but not for the other drugs. And it works better on the hands than on the feet, though I have had success with foot neuropathy as well. It is less effective for nailbed neuropathy, even when the causative agent is Taxol (I still do bleed for nailbed neuropathy, though at the corners of the nails rather than on the fingerpads).
I'm not sure why it works, scientifically speaking. I doubt that it's due to the elimination of toxic chemo agents from the flesh of the fingertips, since the amount of extracted blood is so small. My suspicion is that the healing is a hormetic effect, which is to say a very small negative impact makes the body respond with a positive effect. I theorize that the body reacts to the incision by sending chemicals to repel any microbial invaders and heal the wound, and almost as a side effect the affected nerves are also healed. Perhaps the small capillaries in the extremities are affected by the chemo and work less efficiently than they need to to draw the drug away from the nerves there. Then, when the skin gets pricked, they perk up and do their job better.
I am not a researcher and have done no true clinical studies on this method, though it would be easy enough to do with a large enough patient population. But my own experience convinces me that this is a valuable and simple treatment method for Taxol-induced peripheral neuropathy, so I am putting it out there in the hope that it will help many more people. If you are suffering from chemo-induced neuropathy, I encourage you to try it yourself, or have somebody else do it for you. Just get a pack of lancets at the drugstore (the kind diabetics use to get a drop of blood), and disinfect before and after with rubbing alcohol to avoid any potential infection (especially if your white blood cell count is low). Very quickly poke each affected fingerpad, then squeeze out 5-20 drops of blood and wipe with a cotton ball. Do this a couple times a week for a couple weeks, to give it a fair shake. Good luck!
Monday, January 09, 2012
Friday, September 16, 2011
Thursday, September 01, 2011
|Kiraku-An, the "Take-It-Easy Hut"|
*An, “hermitage,” is an interesting character, consisting of a radical denoting a dwelling, plus a phonetic component consisting of a character meaning something like “to cover.” But a further breakdown of this component yields the image of a man, and below it the ancient Chinese character shen, originally derived from the image of two hands extending a rope, and therefore the idea of extension or expansion. And, indeed, a hermitage is a dwelling where a man sits in contemplation until he feels a sense of expansion. I prefer an alternate version of the an character, and a different interpretation: the dwelling radical is replaced with the grass radical, giving the image of a rustic thatched hut. And the character shen has long been associated in Chinese cosmology with the ninth of the twelve Earthly Branches, symbolized in the popular Chinese “zodiac” as the Monkey. So the hermitage (or at least my hermitage) is a place where a person (the human figure with arms and legs akimbo, in the middle) can ingest medicinal herbs (the grass radical on top) and enjoy the easy-going life of a monkey (the shen character, on the bottom, with its tail curving out towards the right). Or, if you prefer, the hermitage is a hut where a monkey sits down, and, expanding his consciousness, becomes a man.
Monday, February 28, 2011
I first met Gus sixteen years ago as a first-year student of traditional Chinese medicine at Five Branches Institute in Santa Cruz, California. He was a couple years ahead of me, and with his long flowing hair and imposing stature (Gus is well over six feet tall), he made quite an impression. But what impressed me more was the depth and breadth of his knowledge. One afternoon during that first year of school, Gus led an herb walk in the alleys around the school. From the gnarled albizzia tree that greeted me every morning as I arrived for class, to the tenacious passionflower vines that took over entire neighborhoods and astounded passers-by with their blooms of alien ultraviolet, to the humble prunella that grew on the edges of dusty walkways, Gus knew the medicinal uses of all these plants. As a newbie to the world of herbal medicine, I was surprised first of all that these plants I had taken for granted had medicinal uses at all, and secondly by how much there was to know about them! For Gus possessed an encyclopedic knowledge of healing plants, and his unrehearsed lectures gave me a first glimpse of how his mind worked – synthesizing Chinese energetics with biochemical understanding and mixing in a dollop of Ayurveda here and a tidbit of medieval alchemy there.
As I got to know him better, I came to understand that Gus’ mastery of herbs came from his own intense curiosity about the world. His passion was the rich, deep realm where mind, spirit, and plants overlap and interact and play. His company, Shamanic Tonics, specialized in “spirit herbs,” and each and every one of his formulations was only offered up to the public after rigorous in vivo testing conducted on himself (and his lucky friends!). I remember one day Gus announced, quite dramatically for him, that he had “tamed the wild mahuang!” Back in those days ephedra was still legal, though the FDA was taking an interest in it due to a few unfortunate incidents in which people had abused it as an “herbal upper” to the point of death. Gus wanted to tone down mahuang’s stimulant properties, and hit on the combination of mahuang and reishi (a spirit-calming and immune system stimulating medicinal mushroom) to do just that. I remember some really fun and interesting hikes trying out that stuff. It came to market as Fungalore, and became quite the hit at dances and parties before mahuang was banned.
Gus was a very spiritual guy, a true seeker, whereas I was and am more of a skeptic. Yet, we had great discussions about everything from Tibetan Buddhism to Shinto animism to Amazonian shamanism. Regardless of our fundamentally different orientations, we shared a deep interest in religion and consciousness. I took an anthropological interest in history and religion as a record of humanity’s attempts to understand the world; for him spiritual traditions were a practical guide for his own explorations of mind and nature. He revealed to me once that he thought we had known each other in a past life. Though I would ordinarily shoot down such a statement in my usual rational way, at the time I paused and savored it, because I had to agree that we shared a bond that, whether or not it involved reincarnation, demonstrated some kind of karmic connection that I could not deny. And, not insignificantly, I took it to mean that he considered me his friend, and that made me happy.
In the years after we finished our master’s degrees in Chinese medicine, Gus moved away from Santa Cruz, settling in Northern California near Mendocino. I think the slower pace of life and immersion in lush forest suited him well. We kept in sporadic touch by email and phone, and every now and then I’d find a package in the mail stuffed with fresh matsutake (Gus and I shared a love of mushrooms), or a sample pack of a new herbal formulation, or an article on kanna or blue lotus or whatever else was occupying his interest at the time. This was typical of Gus: so generous, so giving.
Some years ago Gus gave me a piece of writing he had authored. It was about his fascination with the young god Dionysus. I wish I had kept it, so I could read it over again in my effort to understand him better, to try to understand why he is gone. Because I still don’t understand. I saw Gus a couple of months before he died. We went on a hike in the Berkeley hills with our friend Andy. He was in the process of moving from Mendocino to the Bay Area, and was excited about some new prospects for his company, about reinventing himself and his business. He seemed content. We had a great time; it was like old times, Andy driving like a crazy man, Gus with his long stride leading the way as we hiked, pointing out flowers, talking about plants. He would have made a really great teacher at any Chinese medicine or naturopathic school.
Soon after we became friends, Gus gave me a baby gotu kola plant. Gotu kola is an Ayurvedic herb that is revered for its effects on the brain and nervous system, circulation, and skin. It has since become one of my favorite herbs. Gotu kola is easily propagated, as it spreads runners that put down new sets of roots and establish babies that can be dug up and given away. Over the years I have given away many such babies, to friends and patients, as well as tinctures and teas that I made from the harvested plant (I’ve eaten quite a bit of the fresh leaf as well). I think of the gotu kola as Gus’ good influence, spreading outwards in an infinite web, doing good, humans and plants working together for the betterment of all. Like I said, I’m not so sure about reincarnation. But if anybody would consciously reincarnate as a plant, it would be Gus. Perhaps his consciousness is spreading through the world as gotu kola. Perhaps, every time I take a nibble, I re-enter that Dionysian wave. Perhaps, as I graze, I will get my friend back, just a bit at a time, in subtle explosions of metabolism and neurology, as plant and mind merge and my grief (I hope) slowly diminishes to be replaced entirely by a love and appreciation that grows only deeper with time.
Tuesday, February 16, 2010
Tuesday, August 04, 2009
Title of a June 1, 2009 article in NEWSWEEK by science writer Sharon Begley: “Hooked on a Feeling: This is your brain on a placebo.”
Believe it or not, these articles report on the exact same recent acupuncture research. As their titles reveal, they reach basically opposite conclusions. The research in question, conducted by Daniel C. Cherkin et al and published in the Archives of Internal Medicine, May 11, 2009, under the title “A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain,” utilized a cleverly constructed experiment to try to determine whether acupuncture was effective as a treatment for low back pain. 638 adults with chronic low back pain were split into three groups. One group received “individualized acupuncture,” in which the acupuncturist could use any points he or she wanted, as long as the patient was lying prone. The second group received “standardized acupuncture,” an eight-point combination consisting of the points Du-3, UB-23, UB-40, K-3, and a low back ashi point (an excellent prescription, though the ashi point, referring to a tender point, makes this “standardized acupuncture” somewhat individualized to my mind). The third group received “simulated acupuncture,” or, as acupuncture detractors prefer to call it, “sham acupuncture.” In this group, the patient would lie face down as in the other groups, and the acupuncturist would press an acupuncture needle guide tube against the same points used in the “standardized acupuncture” group, then simulate needle insertion by tapping a toothpick gently against the patient’s skin. None of the patients in any of the groups knew which group they were in, and, presumably, all thought they were receiving some kind of acupuncture. All patients received ten treatments over seven weeks, and outcomes were assessed after eight, twenty-six, and fifty-two weeks using the Roland-Morris Disability Questionnaire and a 0-10 range “symptom bothersomeness” scale.
Much to the delight of acupuncturists everywhere, the results showed that acupuncture “improved function and decreased symptoms,” and, furthermore, the improvement was significantly better than that resulting from usual care, even one year later. Interestingly - and here is the crux of the dispute between the pro- and anti-acupuncture camps – it didn’t make a difference whether a patient received “real acupuncture” of the individualized or standardized variety, or whether they received the non-penetrating “sham acupuncture.”
Now, this is food for thought. It is quite easy for the acupuncture-uneducated reader to leap to the conclusion, as NEWSWEEK’s Begley does, that “the most parsimonious explanation for that finding is inescapable: it is possible to think yourself out of pain.” In other words, if sham acupuncture works as well as real acupuncture, then all acupuncture must work because of the placebo effect.
Let me make my own bias clear: I am an acupuncturist. I believe that there is something going on other than mind over matter when I treat my patients and they get better. I think that acupuncture is a connective tissue therapy par excellence, and that the traditional East Asian approach to treating the human body’s ailments via the skin and connective tissue is far more sophisticated than the cutting edge of conventional medicine.
That said, I believe that there is also something to the whole placebo thing. Of course the placebo effect is part and parcel of how acupuncture works! Placebo effects are part of how any healing method works. It is a credit to the ancient Chinese doctors that they incorporated into their medicine methods that improve clinical outcomes through, to use the medical lingo, “nonspecific effects.” Yes, it helps patients to listen to them! It helps patients to palpate them, to look at them, to spend more than five minutes with them! My hope is that one of the outcomes of placebo research is that conventional medicine will reincorporate some of these things, to give it a softer edge, more compassion, less arrogance, and yes, better outcomes.
It appears to me that acupuncture has reached a tipping point in modern society. There are so many people who have benefited from acupuncture that it is simply getting accepted by the mainstream as a viable therapeutic method. Acupuncture poses a challenge only to those hardcore skeptics who cannot stand the thought that a method utilizing unscientific concepts like “qi,” “the five elements,” and “yin and yang” could possibly work. Their disbelief of acupuncture is akin to someone refusing to believe that a samurai sword can cut because their fundamentalist mind takes issue with the Shinto ritual that dictated the ancient swordmaker’s forging. Such people seize upon a study such as Cherkin’s as proof that acupuncture only works because patients believe that it does. They fail to consider alternate explanations, even though the authors of the study themselves spell out the possibility that “superficial acupuncture point stimulation directly stimulates physiological processes that ultimately lead to improved pain and function.” The research of MacPherson et al with functional magnetic resonance showing that superficial and deep needling elicit similar blood oxygen level-dependent responses in the brain suggest as much (Neuroscience Letters 434, 2008).
My strong suspicion is that acupuncture works not through a single mechanism but through multiple mechanisms. Something very physical happens when you insert a needle through the skin and tap at the surface of a myofascial trigger point until it releases with a palpable and visible fasciculation. Other acupuncture techniques are more “energetic” and mysterious but equally effective. There are entire schools of non-insertive acupuncture that rely on the practitioner feeling a pulsation or tingling where the needle meets the skin (the patient often feels something as well) to assess its effects during a treatment. I believe that this type of acupuncture is a means of interacting with a primitive electrical signaling system that utilizes the body’s connective tissue as a conductive direct current network. Deep needling may or may not utilize the same mechanism to produce its therapeutic effects. Ear acupuncture most likely utilizes yet a different mechanism – probably neural. For Sharon Begley or any other skeptic to decide for the public what “real acupuncture” is represents the height of arrogance. Perhaps there are many types of “real acupuncture,” and “sham acupuncture” is actually a type of real acupuncture!
There is an excellent quote in the book Herbal Emissaries by Steven Foster and Yue Chongxi, in which the authors state (about ginseng, not acupuncture): “Chinese researchers…have focused on how ginseng works, whereas western researchers focus on if it works. This reflects a fundamental difference in research approaches between the East and the West. In Asia, the efficacy of an herb is already established in a cultural context. In the West, we presuppose that traditional uses have no rational scientific basis.” The same could be said for acupuncture. There are already plenty of studies showing that acupuncture is effective for back pain, or nausea, or whatever. It’s great that these clinical studies are getting more sophisticated. But as the response to the Cherkin group’s research shows, people read into these studies what they already believe. The Acupuncture Today article never once uses the word “placebo” in discussing the possible interpretation of the results, and the NEWSWEEK article never once entertains the possibility that acupuncture works by a mechanism other than placebo.
I wish that instead of these sorts of studies, and in addition to better and more placebo research, scientists would do more basic research into how acupuncture actually, physically, works. It’s hard to argue with fMRI imaging that shows that the needling of points associated with the treatment of vision disturbances lights up the visual cortex of the brain (as Cho et al report in PNAS, vol. 95 no. 5, 1998), or that needle twirling at acupuncture points results in mechanical signal transduction in the connective tissue with far-ranging effects (Langevin, in the Journal of the Federation of American Societies for Experimental Biology 16:872-874, 2002). I predict that the next generation of acupuncture research will demonstrate that acupuncture turns specific genes on or off to achieve its effects - and that these studies will be done on (presumably unbiased) non-human mammals. I don’t feel any particular need to validate what I do to skeptics. I’m quite comfortable with the witch doctor element in what I do, and it’s good enough for me that my patients are satisfied with the care they receive. But I do realize that strong scientific evidence would ultimately result in more people benefiting from acupuncture. And I think that fundamental research in the biophysics and biochemistry of acupuncture would serve this end better than clinical research, which somehow just seems to strengthen one’s bias, whatever it might be. Perhaps I am being naïve, and no amount of studies will convince either camp that the other is wrong. For some reason acupuncture rubs some people the wrong way much like astrology or intelligent design do. But I predict that, with or without studies, acupuncture will continue to gain acceptance simply because more and more people are benefiting from it and its usefulness is becoming a matter of conventional wisdom in the same way that people accept the validity of many surgical procedures that have never been tested but continue to be used because of their self-evident efficacy.
If the placebo effect is hokey, then there is something hokey about acupuncture. The placement of needles at acupuncture points, with or without penetration of the skin, is certainly pokey. There is a magic that happens between the mind and the body, and between two interacting human beings, that unites and transcends the hokey and the pokey. That magic is called “healing.” When it comes to healing, maybe the Hokey Pokey IS what it’s all about. Just put your left hand out and I’d be happy to show you.