Traditional Chinese Medicine

Seems like all I really was doing was waiting for love

Bulkherbs2 I'm sitting on the floor in San Jose Airport, having just finished a week at my school's annual herbal seminar. This was my third and final one, and it was a stressful week of monitored herbal clinic and the usual group dynamics psychodrama exacerbated by the pressure to perform. Gratefully, I had friends around me to whom I could show my own weaknesses and for whom I hope I provided support in kind.

On the way to the airport I began a sort of free-association whine with my long-suffering buddy Pam about all my going-away angst -- a feeling of incompleteness, naive expectations that weren't met, my own foolish illusions, what in the world the future might hold, anticipating missing my friends, and wondering if I'd ever be back to this beautiful place.

"You're saying pretty much all the same things you said when we left for the airport last year," Pam pointed out. "You're pretty much in exactly the same place."

Oh fer Christ's sake. Let's hear it for progress!

I'm still processing a lot about this week, which in effect was the culmination of about three years of study at East West. But I do want to share with you the following, which is an e-mail I sent my fellow herbalist friend Tom about what happened the day I landed in California. I think it sums up the whole experience.


Hey love --

Got in this afternoon and met up with my girls. We were waiting for the last of our party and decided to go into Santa Cruz to hang out. My friend Pam had a stuffy head and lingering cough from a bug she got three weeks ago. I said "Maybe you need some Minor Bupleurum" and we thought we could stop in at Michael's clinic to buy a bottle.

I called him to alert him we might come in. He told us to come on by and sit in on him doing an intake. A chance to watch the master in action -- Hurrah!

But then his 3 p.m. canceled. So he decided to make my friend the intake and I became the student clinician. "Fine, I can handle this," I thought, mostly because I had no choice.

So he did the intake and asked a few questions, then did some acupuncture on her. How awesome it was for me to know some of the points by heart! (They were easy ones though.)

Then he had to do a phone intake and left me to come up with assessment and treatment principle.

I was a mess at first but finally came up with Six Gentlemen plus magnolia bud, platycodon and some damp-draining herbs. Pam gave fine suggestions from the slab, stuck with needles as she was and without the benefit of a book to boot -- sign of a fine herbalist.

Michael came back in after 30 min or so and asked what my result was. I started to report my assessment: "Lung Qi deficiency, Spleen Qi deficiency with damp, corroborated by pulse and tongue..."...

He said, "No, you have to state your assessment in terms of her complaints, not what you THINK her TCM assessment is. It has to be 'sinus congestion due to...' or 'rundown energy due to...' etc." OK, so I tried again. He asked why I chose these patterns. I began to explain my proposed etiology, knowing her previous history of illness.

He interrupted me again and said, "Did you look in the books?" I said "Yes, but they didn't have the same patterns so I went on my own." Again I began to tell him my ideas about how she came to manifest these symptoms while he looked in the books under related patterns, which turned up the EXACT SAME ASSESSMENT as my original one.

"Lung Qi deficiency, Spleen Qi deficiency --" he began.

So I looked up at him and I said impatiently, "But Michael, I just SAID that!"

And his face fell and he said "I'm just trying to show you how to use the books; you'll need them one day, you know."

Extractpowders Not wanting to waste any more time on my impertinence, he asked me my proposed formula and I told him... he said it was perfect and what he really wanted to hear was that I'd choose to use magnolia bud in there somewhere. He un-stuck Pam and sent us off to the pharmacy to mix up powder.

My tail was between my legs as I slunk out of the treatment room.

After he finished with his next client he came out to the waiting room where we were gathered to say thank you and goodbye. He saw the pained look on my face and said:

"You did a great job. You're ready. But stop being so defensive. You don't have to be right all the time. It stands in the way of your learning.
You are a student now and you should enjoy this time of your life."

Sound familiar, Tom?



Fast forward 10 days later to today.

Feeling sad and disconnected (as well as empowered, oddly) when I got to the airport, I realized that I'd left my still-hot cappuccino at the curbside check-in when I was already halfway through the TSA line. Geez -- what else could go wrong? I threw my head back and looked at the ceiling in exasperation when some very comforting recognizable muzak came on. Huh.

A few minutes later at the newsagents I looked for the mindless comfort of non-herbal, non-medical tabloid dreck. Lugging my carry-ons, I ambled slowly to the right, scanning all the celebrity 'news' headlines I'd missed in my week of media deprivation. Then came summer hemlines, outdoor entertaining, Bob Dylan on the cover of Rolling Stone.

Before I knew it I was at paperbacks and a hefty tome jumped out at me: "The Rainbow" by D.H. Lawrence -- one of my favorite books in college and one whose passages I remembered spontaneously when I met Michael Tierra and was reminded of why I'm on this path at all.

I bought "The Rainbow." I'm going to re-read it. It's my second copy, about half the size and a quarter of the weight of the copy I bought in college almost 15 years ago. I don't think it's any accident that the Universe sends you your favorite music and literature in swift succession just when you're feeling disappointed and free-falling in a small California airport.

No need to be afraid, Ursula Brangwen. It's real love. It's real.             

Finding an herbal ally, daemon and/or genius

The_Inspiration_of_Saint_Matthew_by_Caravaggio A couple of weeks ago, this video of Eat, Pray, Love author Elizabeth Gilbert was making its rounds on Twitter. In it, Gilbert discusses the idea of how the creativity of artists was perceived in the world of classical antiquity.

In short, artists didn't take all the credit for creating some incredible piece of work; transcendent artistic expressions were believed to be the fruit of a collaboration between the human artist and his or her assigned supernatural helper spirit, a daemon (as it was called by the ancient Greeks), or genius (as it was called by the Romans).

Gilbert says of the ancient Greeks and Romans,

People did not happen to believe that creativity came from human beings back then. People believed that creativity was a divine attendant spirit who came to human beings from some distant and unknowable source, for distant and unknowable reasons.

By the time the Renaissance rolled around -- regarded as the rebirth of the art and spirit of classical antiquity, ironically -- the human being was placed at the center of the universe and artists themselves became known as 'geniuses', signaling a shift toward the belief that creativity was indeed a singularly human phenomenon.

I shared this video with my friend @theogeer of Autumn Twilight. I mentioned that I had felt rushed in clinic the previous evening and complained that I wasn't quite sure I had adequately helped my new client. I joked that I sure could have used the aid of an 'herbal genius.'

Theo said:

I wonder about that idea of an herbal genius. Lots of practitioners, particularly of native or isolated traditions have a plant ally of some sort. Carlos Casteneda famously detailed the development of his alliance with peyote, and the Curanderos and Brujos of Mexico and Central America have a well known alliance with mint, which they use for everything. Maybe what you need is to find a plant ally to guide you in your work?

Now, when you live with one foot in the magickal world as Theo and I do, synchronicities are not only frequent but also consciousness-shifting. Those few lines of his above focused my mind on the events of the previous night at the clinic:

I was concluding a follow-up appointment when my teacher and herb clinic director, Althea Northage-Orr, popped her head in the room and politely asked me to hurry up; an unscheduled client decided to come at the last minute and she wanted me to take the case. I wrapped up my intake and ran to the pharmacy to tweak my follow-up client's herbal formula.

His formula originally contained white peony root, also known in Traditional Chinese Medicine as bai shao. I took the bottle of tincture down from the shelf. It had about a finger-width left at the bottom. I looked at the golden liquid and said to it (silently): "Nope. A woman is going to come in today who will need you." I put the bottle back on the shelf and subbed another Yin-building tonic into this man's formula.

Sure enough, my next case was a lovely woman dealing with exhaustion and family hardships at just the time she was beginning menopause, among other complaints. The white peony, which I had always considered a very feminine, softening, building herb, was among the medicinals indicated for her symptoms. I was happy to drain the last of the bai shao into her formula and mentioned it specifically when I tried to explain to her what my treatment principle was and why I had chosen some of the herbs that she would be taking.

Paeonia lactiflora by Ulf Eliasson That night I dreamed that I was drinking tea out of a wide bowl with a strainer pressed to the bottom of it to keep the tea leaves from floating to the surface. When I had finished the tea, I removed the strainer to discard the marc (used-up plant matter) and was delighted to find that the bottom of the bowl was covered with large white flowers, fresh and plump as if they had just been cut from the plant.

I hadn't thought of my little moment in the pharmacy with the white peony tincture or the dream at all, until Theo's question kicked my memory into gear.

White peony is now a definite herbal 'genius' of mine.

Althea (whose special plant ally is mugwort, not marshmallow, by the way), incorporates workings with plant devas into our education to help attune us to the spiritual energies of plants. In this way I've had wonderful experiences sitting in her garden with live plants which made them special 'friends' -- namely, skullcap (Scutellaria lateriflora), elder (Sambucus nigra) and St. John's wort (Hypericum perforatum). But I'd never had quite the same experience of communication between myself and a plant like I had with white peony.

Another teacher of mine, Michael Tierra, has mentioned several times on his blog that herbalists often happen to be artists as well. Being both myself, and knowing many herbal healers including Michael who fit the artist bill as well, I wholeheartedly agree. A paragraph in one of Michael's recent posts really resonated with me:

No matter how deeply one studies and enters into the complexity of healing, plant biochemistry and so on..., nevertheless there is always place for the irrational and the subjective. The poet's perspective of life, the musician's sense of harmony, the artist's eye of proportion and relationships - these are all shared by healers, especially the herbal healer who works with plants, which are the pure creative expression of nature and the healing process.

I challenge anyone to express it more brilliantly than that!

Herbalits are artists and therefore should create a special place in their practice for the help of their own little attendant plant spirit. Perhaps like animal totems these may change and cycle back and forth over time, but the idea of a divinely assigned plant ally, while by no means new, can really help an herbalist to co-create with the ultimate Divine source of healing.

Since my experience with white peony, I've been keeping my intuition a little more open and trying to allow it to confirm or be confirmed by my usual bookish nature when it comes to choosing herbs for a formula. I pay attention to herbs I come across during the day, in the form of pictures or live plants or dreams, and more often than not these herbs step forward when I review a client's case. Sometimes their presence is specifically indicated for a certain condition; other times they help me decide when I am on the fence about two herbs that do very similar things.

I have to say, after only a short time with this approach, the results and the experiences I have had with clients have been very gratifying. I have felt a greater confidence in my formula selections -- a shared confidence greater than the reassurance I have gotten from books and research only. I keep the awareness of gentle, beautiful bai shao close by; she takes the edge off performance pressure and ego, allowing me (so far!) to be a more present and compassionate practitioner. I am as grateful for this blessing and gift as I am for my human teachers.

If you have a special herbal daemon or genius, I'd love to hear about it and how you came to know it was your ally in the comments section!

Photo Post: Medicine-Making: Pills, Liniment, Oil

Ddjwhole Ddjtincture
Pillswholeherbs Ddjpowder
Pillshoney Pillswet
Pillsfinished Brahmioil

Some people spend frosty weekends inside baking cookies. I make herbal medicine.

Last weekend I restrained myself from computer work so I could catch up on some medicine-making projects required for completion of the East West Herb Course.  It was gratifying to return to working with herbs in the less cerebral sense. After months of flash cards, charts and reading, the opportunity to smell, touch and taste plants was a welcome change.

Click on the above photos to see larger versions. The top pair are the herbs and newly-macerating tincture of Dit Dat Jiao liniment, a topical treatment for bruises and other trauma. The second and third pairs are different stages in the production of some tonic pills including licorice, lycii berries, black atractylodes, astragalus, dang gui, and panax ginseng, bound with honey. The first of the last pair are the completed pills rolled in slippery elm powder. The final photo is of gotu kola, calamus root and sesame oil, the ingredients for a simple Brahmi Oil, which is an Ayurvedic topical preparation that treats nervousness and exhaustion, among other things. When it was finished, the golden oil shown above had turned a lovely shade of green.

How to Treat a Cold or Flu with Herbs

Herbday07 Herb Week 2007 continues! It's Tuesday, or "Mars Day," and Mars is all about cutting out what isn't needed. In other words, if we're talking about the physical body, Mars represents the immune system. Here's a link to my Squidoo page, "How to Treat a Cold or Flu Naturally," that discusses how to treat different kinds of colds and flus with some really basic, easy-to-find herbs.

You have exactly 15 minutes to create an eight-part formula chosen from at least 200 herbs...


... Ready, set, GO!

Last night I led the interrogation and assessment of a new client in our clinical class at herb school. A young couple came to us with a host of complaints. I took the gentleman to one of our treatment rooms, in fact the same treatment room where I received structural therapy when I first started attending school here. I sat on the low massage table while he chose a chair across from me. Behind me, two of my classmates quietly took notes and observed the process.

I love talking to people. I love interviewing them, making them feel at ease, helping them find words when they have difficulty expressing themselves. I love the investigative process of the intake, picking up a thread and seeing where it goes. I love taking a patient's hands to feel their pulses, the quiet calm we enter when I "listen" to those pulses in all their different positions. I love holding their hands once more as I look them in the eye and thank them when I let them go. Heck, I even enjoy examining the tongue for more clues as to what patterns of disharmony they may have.

And last night I enjoyed all of that. Our new patient was totally open to the process, friendly, and he had a sense of humor to boot.

But then we were released into the main classroom to identify the patterns of disharmony and come up with a formula or two to treat them. And it had to be done in about 20 minutes.

I mapped out the patient's symptoms on a five-element chart (like the one in the last post, just without all the fun cartoon characters). He was all over the place, but his main issues were concentrated in two or three places. I could identify the man's patterns fairly well, steered back on course
by Ima when I went off track.

But when it came to formulary...

We had about 15 minutes to come up with activator and tonic formulas, and I swear, it's as though I'd spent the last four years daydreaming through my materia medica classes. I could remember most of the energetics of the herbs we looked at, but if you asked me for three herbs, say, that treated Heart Qi deficiency but didn't interfere with his other patterns or were not contraindicated with some of the more troublesome symptoms, I couldn't tell you. Not last night anyway.

So here we were, under the gun, and I felt like Robin Williams' character in "Moscow on the Hudson," freshly defected from the U.S.S.R., standing in the coffee aisle at the grocery store and about to have a nervous breakdown.

The beauty of Chinese herbalism is that umpteen herbs do umpteen different things. Just like there is no one can labeled "coffee," there is no one herb indicated for one condition, and when you create a formula to treat multiple symptoms you introduce a synergy of herbs that will do the job according to their energetic, the organ meridians they enter, their direction, etc. The system, with all its choices, offers the practitioner and patient as much flexibility as it does precision, but the catch is: YOU HAVE TO KNOW YOUR MATERIA MEDICA.

Alas, I felt as though I'd checked that part of my brain at the door last night.

With Ima's help, my team and I put together two formulas for this man, and while my classmates prepared the formula in the pharmacy I went out into the front room to talk to him and his wife about what we were putting together and why, dosages, diet, etc. I told them to support each other and to set small, achievable goals for themselves. I also encouraged them to be patient with the process, as herbs work more gently than prescription drugs. I was so grateful that they would allow us students to question, poke and prod them. I was grateful for their trust and openness. I wanted to deliver the best that I could. I wished I could have spent more time with them.

Most of all, I wished I could have done the formulary part of my job better. It's my weakest point. I know I could have come up with something good if I'd had all my books around me and an evening to devote to it, but who has that luxury in the field, in real life?

I had a hard time falling asleep last night, Metal type that I am, always wanting to be perfect, hard on myself when I can't live up to my own standards. When I was in journalism school, we were faced with a similar challenge at least once a week. After an interview process, you'd be given 20 minutes to write a story that could be no less than 500 and no more than 550 words, and it had to be perfect. One misspelling, one factual error, one AP style mistake -- any single one of these earned you an automatic F. You had no team and no guidance from the professor. You were on your own.

I never got an F. Ever.

The thing about medicinal herbalism is, the stakes are much higher. Someone's life and health may hang in the balance. If you screw up, you can't publish a retraction, dreaded in the world of journalism as retractions are. Of course, you can tweak formulas that don't work, and these experiences may serve as guides, filling in missing gaps of information. But if you can nail it the first time, you earn confidence in yourself and trust from your patient. With herbs, the more tools you have, the more possibilities you may have to heal, but it doesn't mean a whit if you don't know your tools inside and out.

Looks like it's going to be an Autumn full of flash cards.

Above: Apothecary at Star Child in Glastonbury, UK. I took this photo about three years ago and they've since changed the look of the store. If you're ever in Somerset, please visit them!

P.S. Last night before clinical intake Ima pushed copies of the Nei Jing Su Wen, Shang Han Lun and one other book into my hands and told me to read them. What, my beloved teacher, learning TCM by South Park isn't serious enough? :)

Chinese Five Element Theory According to South Park


I've been studying traditional Chinese medicine for a few years now in an herbal context. One of the first things we get acquainted with is basic five-element theory. As with any philosophy, you can make it as elaborate and esoteric as you wish, but it's not that hard to grasp the basic building blocks of the Chinese five elements, especially if you can apply it to everyday life.

I don't have cable, and haven't got a lot of time to watch TV, so I'm a bit late to the party when it comes to most popular shows. I started watching South Park when a local station began showing reruns late at night. It didn't take many episodes for me to identify each of the Chinese five elements as represented by five main characters. So, this is going to be a bit "in-universe" as Wikipedia calls it, but if you're a student of Chinese medicine and you know the cartoon, you might find it entertaining... or helpful, even!

In Chinese five element theory, each of the five elements (namely, Wood, Fire, Earth, Metal and Water) represent different organ networks in the body as well as different emotions and personality characteristics. (Note: if you are reading this essay without any background in Traditional Chinese Medicine, please be aware that the organ systems of that tradition represent much broader functions and concepts than those of Western allopathic medicine.) Every person is a combination of all the elements, but usually one element predominates their psychophysical makeup. Different element personality types are prone to certain disorders, but of course no one is exempt from disorders of other organ networks.

Let's start with the element of Wood.