Traditional Chinese Medicine
Chest & Breast Pain & Chinese Herbs
Geography is significant in Chinese medicine. Not just the label of a symptom or disease, but its location, for acupuncturists, strongly informs our diagnosis.
When I ask patients whether they experience chest pain or tightness I am not necessarily concerned for some respiratory or cardiovascular disease. The chest is the “domain of Shao Yang,” “Lesser Yang,” that is relative to the head, neck, and face, described more often in our literature as “Tai Yang” or “Yang Ming,” respectively
The Shao Yang system harbors the end result of our body’s “pivot,” from metabolic production to the distribution of vital substances around the body. Soreness around the ribs, tightness in the chest, cough or even shortness of breath can be a result of our organs failing to produce adequate substances to engender functionality above.
The textbook pulse quality at the radial artery in such patterns is a “wiry one,” illustrating a microcosm of the fluids in our torso beginning to stretch thin. Needless to say, the best way to avoid this mechanism is with a diet that produces ample fluids and exercise to clear heat. If you don’t succeed, and eventually none of us do, what is the flavor of your chest pathology?
Sharp pain that is better with exercise, first of all obviously bodes well from a biomedical perspective, but also indicates some subjective blood stasis in the chest—most often a lack of blood movement due to an inadequate quantity of metabolic fluids giving rise to inflammatory heat, which tends to dry out the diaphragm and everything that includes it. Best remedies are moderate exercise and deep breathing. Best acupuncture points are Pericardium 6, which fires into the brain’s insular cortex, subsequently down the vagus nerve. Herbal formulas include platycodi bark, immature tangerine peel, and peony root.
If the chest feels hot, it suggests further aggravation of inflammatory heat, which might include sequelae such as insomnia, anxiety, and/or irritability. This may be difficult to treat with acupuncture alone, although local points such as Ren 17, Lung 1, and Liver 14 may help. Herbal medicine will be more effective, including the very bitter coptis root or gardenia fruit to additionally clear heat from the stomach, otherwise prunella spike, lily bulb, and/or if there is notable phlegm in the lungs, trichosanthis, or “gua lou pi.”
If your chest pain is worse after eating it clearly suggests some degree of food stagnation—that is indigestion. Steamed and bland foods are advisable until it resolves, as is drinking Pu-Erh tea, and performing manual stomach circles around one’s abdomen.
Best acupuncture points are Large Intestine 4, which fires into the brain’s periaqueductal gray matter, then into the abdomen. Herbal formulas include magnolia bark, rhubarb root, tangerine peel, ginger, and bupleurum root, to comprise the majority of “Da Chai Hu Tang,” or Major Bupleurum Decoction. Alternatively, if one is more prone to diarrhea and lack of appetite, more advisable would be the simple, four-ingredient digestive aid, “Li Zhong Wan,” or Regulate the Middle Decoction, containing ginseng, dry fried ginger, atractylodes root, and licorice.
Persistent chest pain should be taken seriously, especially if coinciding with shortness of breath, and one should see their medical doctor to rule out any danger. Once structural ailments are ruled out come see us to address the root of the issue!
Topical Liniments for Acute & Chronic Pain
Since the beginnings of (Chinese) medicine, partially founded upon the demand to heal soldiers from warring states thousands of years ago, the use of topical liniments to treat acute and chronic pain has been integral to the practice.
Since becoming a patient just over 20 years ago, I’ve been aware of countless brands and combinations, at any given time one being supposedly a cut above the rest, hence the most popularly used by colleagues in clinic. For the past ten years, to my knowledge, that brand has been Evil Bone Water.
The ingredients are not novel—mostly common herbs we use to promote blood circulation, reduce inflammation, and stop pain—but my understanding is the quality of the herbs and manufacturing process by owner, Dr. Mark Brinson, is superior to any brand like it thus far. Most of the herbs are ones that can be equally drank, taken internally, although this is an exclusively topical medicine, only to be used externally for pain.
If you or someone might benefit from Evil Bone Water at home, my newest shipment is in, and I am proud to be one of New York’s many retailers. Please message me or just let me know at your next visit if you are interested in purchasing, or if you’ve purchased a bottle in the past and just need a (new) spray nozzle!
Speaking of visits! Beginning next week my Wednesday office hours will now be extended. Instead of the last appointment being at 2:45pm, it will now be at 4pm. Monday and Friday evening hours remain the same, with last appointments being at 7pm and 6pm, respectively.
In-Person Herbology Class, NYC
I am humbled and excited to have been invited to teach my first live, in-person class next week for NYC Acupuncture School on the correspondence between particular pulse “qualities” at any of the six—that’s right 6—pulse positions along the radial artery of each wrist. That’s a grand total of twelve pulse positions if ever you’re wondering why I’m sitting there for so long with three fingers along your radius.
Directionality is everything in Chinese medicine, and specific herbal medicines and the formulas they command, induce physiological responses, which, put simply, have either excitatory or inhibitory, restorative or draining effects on the body.
When a certain herb (or supplement) is considered to stimulate immune function what it means is that it directs (immunological) molecules upwards, both vertically towards our sinuses and upwards to our dermatological surface. For about half the population, whose physiological pattern requires more upward movement, these medicinals should support their immune function. For the other half, including myself, who need more downward movement, this will do more harm than good. In holistic medicine we have the gift of pulse diagnosis to determine who is who and what is right.
The pulse for astragalus for example would be weak and/or “hollow” at the first and second positions on the right wrist. Why?
These positions correspond to the lungs and stomach—the respiratory and gastrointestinal microbiomes, respectively—and their inter-connection revolving around immune function. If the arteries here feel constricted and tight this indicates cold-natured inflammation in the region, which astragalus will do nothing for. If the arteries feel strong and congested this might indicate “hot-natured” inflammation, which astragalus will equally do nothing for—in fact in this case, would probably hamper immune optimization. Only a small, weakened artery in this position informs us that it is appropriate to use a medicine that will generate fluids in the gut and ship them outward to the exterior. This same mechanism applies to many people who experience spontaneous sweating, yellow or sticky sweat, or joint pains.
There are countless other examples like this in Chinese medicine’s pharmacopeia and diagnostic process that aid us towards being increasingly more specific and effective holistic clinicians. While it helps to still do our due diligence, asking the appropriate questions, inspecting each patient’s tongue and abdomen, my present understanding is no diagnostic tool is more reliable than the feeling of the radial artery.
When someone misses a shot in basketball trash talkers on the opposing team often say: “Ball don’t lie.” In Chinese medicine we say—well, I say: “Pulse don’t lie.”
Obviously, this event will be of greatest interest to students and practitioners, but anyone wishing to become a more educated patient around the workings of their body is welcome!
Treating Post-Partum Night Sweats with Chinese Medicine
Yayyy, you had a baby! Congratulations! But… now you don’t sleep, your body hurts in any multitude of ways, and another one that probably no one warned you about: When you do actually sleep at night, you’re occasionally woken up by not your baby’s tears, but your sweat. If only your husband could bleed, he’d at least be contributing somehow to the trifecta, am I right?
Why does this happen?
Simple. And most of you already know the answer: Hormones. The concept of “blood” and “vital fluids” in Chinese medicine encompasses hormones as well as neurotransmitters, the latter of which might also explain why Postpartum Depression or Anxiety is so rampant.
Subjective amounts of blood loss begin from the 1st week of pregnancy, when Mom’s vital fluids are being allocated no longer to herself, but to her fetus and placenta. So ladies, your blood is never yours again. Actually it can be, once you stop nursing, but then stress depletes the blood as well, which is apparently unavoidable in parenthood. Fortunately the best means to supplement beyond early bedtimes, are steak and red wine… and herbs.
Sweat loss is not insignificant. While it often offers our bodies a beneficial cooling effect, our perspiration contains within it vital nutrients, such as calcium, magnesium, potassium, amino acids, and anti-microbial peptides, some of which cannot be replaced by supermarket-grade electrolyte beverages.
It is a well-known fact that our body’s detoxification process happens through the liver and kidneys, not sweat glands, so any kooky yoga teachers who ever recommended hot yoga or HIIT training to “detoxify,” could more or less be brought up on malpractice. That is unless you don’t consider exercise the physiological modality it is proven to be.
In Classical Chinese medicine it is said that excessive sweating depletes our body’s “Yang,” which might be partially defined by things such as our amino acids and anti-microbial peptides. So let’s not lose our Yang, because losing Yang eventually leads to losing blood, which perpetuates the cycle!
Acupuncture would use points to calm the hypothalamus and stimulate the adrenals to produce hormones to slow the vicious cycle. Commonly used Chinese herbs might include Gypsum stone (if Mom is very thirsty for cold drinks), Rehmannia root (if there is also still any bleeding and Mom’s feeling emotionally disturbed), or Oyster Shell actually (if there is tightness at the ribs and/or chest, and Mom’s having trouble sleeping).
Please don’t self-prescribe. Consult a real herbalist.
Acupuncture Point for Cardiovascular Health
As someone who comes from a family with cardiovascular issues on both sides it is important for me to be attuned to heart health, not only as a practitioner, but also as a patient.
Unfortunately, as is the case with nearly every condition under the sun, in Chinese medicine there is no one size fits all prophylactic prescription, whether of needle or herb, to prevent cardiac issues. We must due our diligence, understand the full body pattern, and treat every part of it, lest the one neglected will eventually find its way to aggravate the one originally targeted.
Lisinopril is the hypertension medication I see most commonly prescribed, and one of its primary side effects is dizziness. While this is preferable to a heart crisis, it should be understood that this kind of dizziness is exemplary of inadequate blood reaching the head, which means inadequate neurotransmitters reaching the head, which over time may bring with it a whole host of more serious neurological complications.
One way to target support in hypertensive patient and/or those looking to wean off of their medications is to regularly bleed the point, “Lung 5,” or “Cubit Marsh,” located at the crease of the elbow, a bit lateral to the vein we’ve mostly come to know as the blood drawing point.
Why would this work?
First of all, in a lot of people it won’t. Lung 5 is known as the lungs “water point,” partially because its job is to unblock fluid retention in the chest to allow it to descend into the kidneys, then in turn be sent back upwards to calm and help control the heart. If fluid retention in the chest and/or lungs are not present—that is if that is not our etiology—then bleeding this point will likely offer little to no help. Further assessment is required to determine which points and vessels can and should. If fluid retention is present we will likely see dark or distended veins, or spider veins, or fluid amassment in the region of the point around the elbow.
Garlic, ginger, and onions might be advisable. As would Chinese herbs such as Pinella Root.
Another cause for a failure for the lungs to “descend” vital substances into the kidneys is just plain weakness. Call it old age or genetics—whatever floats your boat—but the lungs in this scenario are lacking “qi,” or ample functional gases, to enable them to do their job. In this case we’re more likely to use (“earth”) points such as “Lung 9,” “Great Abyss,” and/or “Heart 7,” “Spirit Gate,” and/or dermatomes on the upper back that correspond to these organ systems.
Lemon water and bitter greens might be advisable. As would Chinese herbs such as Peony Root, Astragalus, Cinnamon, or Schizandra Fruit.
As far as I know, the best ways to prevent heart disease are through regular exercise, stress reduction, and cooked, dark, leafy greens. Beyond that, if it’s in your gene pool and you note congestion at your elbow crease, by all means holler, and I promise to not bleed you out.
