Chinese Medicine

The Philosophy Behind the Treatment
Part 1 of 2

Introduction
Chinese medicine dates back approximately 3000 years and has established an immense depth of knowledge in medical science, theory, diagnostic methods, prescriptions and cures. Without modern diagnostics or even surgery, practitioners of Chinese medicine were able to develop this complex system from observing humans through their own senses in relation to the setting they lived in-nature. The medicine describes the body in terms of yin and yang, basic substance, layers or levels of the body and in relation to elements found in nature such as wood and water. 

Yin and Yang
The Physiology of Chinese medicine holds that the human body's life is the result of the balance of yin and yang. Yin is the inner and negative principles, and yang, outer and positive. The key reason why there is sickness is because the two aspects lose their harmony. Seen from the recovery mechanism of organs, yang functions to protect from outer harm, and yin is the inner base to store and provide energy for its counterpart.(1)

Basic Substance
Doctors of traditional Chinese medicine believe that vital energy-energetic particles, state of blood, and body fluid are the essential substances that compose together to form the human body, and the basis for internal organs to process. They are channeled along a network within the body as their channels. On the physical side, vital energy serving to promote and warm belongs to the properties of yang, and blood and body fluid to moisten possesses the properties of yin.(1)

The Three Levels

The Chinese Medicine organ network is comprised of 12 organs, all functioning together, yet with individual characteristics. These organs have associated channels, which are paths through which the life-energy or “qi” flows. There are also five groups of tissues or substances such as blood, muscle and skin supporting the body in its physiologic needs. This intertwined, dynamic system functions in our body to maintain health and wellness, yet when out of balance is at risk of disease development.

Video link to a discussion about the Twelve Organ Networks of Chinese Medicine:

Watch this video

Level One-the most superficial in the body.

The 12 meridians are listed below in the order of energy flow through the body. The time next to the organ is the corresponding time in which the organ displays its most influential energy during the day. (2)

Lungs	3 AM to 5 AM
Large Intestine	5 AM to 7 AM
Stomach	7 AM to 9 AM
Spleen	9 AM to 11 AM
Heart	11 AM to 1 PM
Small Intestine	1 PM to 3 PM
Bladder	3 PM to 5 PM
Kidney	5 PM to 7 PM
Pericardium	7 PM to 9 PM
Triple Warmer	9 PM to 11 PM
Gall Bladder	11 PM to 1 AM
Liver	1 AM to 3 AM

Chinese medicine believes there is a distribution network for the fundamental substances of qi, blood and body fluids throughout the body. (These fundamental substances are different from the common western understandings of these terms, and their concepts are important for maintaining health using Chinese medicine.) This distribution network called the Meridian System looks like a giant web, linking different areas of our body together. Its pathways make up a comprehensive yet complex body map that supplies vital energy to every part of the body. Philosophically, the Meridian System explains how we live, and why we become sick. (3)

According to Traditional Chinese Medicine vital energy flows through the twelve organs and meridians and completes one cycle every twenty-four hours. Each organ has maximum energy for two hours. The organ has minimum energy (or lowest flow of Qi) 12 hours later. Have a look at this link to explore the relationship between the 12 organs, related emotions and associated time of day.

http://www.astrodreamadvisor.com/Qi-Cycle.html

Level Two-the substance thought to be in between the layers.

        The 5 Groups of Tissues

Blood

Qi/Essence

Soft Tissue and Fluid

Skin/Skin hair

Bones, Joints, Cartilage, Muscles, Tendons, Head Hair

Blood, qi, essence and fluid are considered the vital substances in Chinese Medicine. All life comes from these and must be preserved for life to sustain. Much like Western Medicine, if blood and body fluids are lost in excess, vital organs are unable to maintain their function. The heart and brain, for example, would lack oxygen in order to sustain their cellular functions. Much the same in Chinese medicine, without these vital substances, the 12 organs suffer from lack of nourishment to maintain their function. 

The other tissue groups are comprised of structural tissue, mainly connective tissue, that maintains physical structure in the body and runs between the organs and carries the vital substances to cells in the organs and tissues. For example, the blood vessels are included in this group of tissues which transport the blood to the vital organs and other tissues. 

For further reading on Qi and Essence refer to Dr. Eisen and Dr. Chen's article on Qi and Chinese Medicine for a more in depth description.

http://yang-sheng.com/?p=194

Level Three-the deepest layer in the body.

        The 12 Organs-divided into either yin or yang.

Yin organs: Lung, Spleen, Heart, Liver, Kidney

·      Solid and deeper organs

·      Involved in regulation, manufacturing and storage of fundamental substances such as blood and essence.

Yang organs: Large Intestine, Stomach, Small Intestine, Pericardium, Triple Warmer, Bladder, Gallbladder

·      Hollow and superficial organs

·      Function of receiving, separating, distributing and excreting 

The 12 organs form a complex interrelated network with many connections that truly embody how we are one whole system. Chinese medicine does not diagnose a disorder based on one organ dysfunction. Rather it looks at this system as a whole unit functioning interdependently, one organ relying on the other to generate or assist in controlling its function. For example the Heart generates Spleen function which relies on the heart coursing blood through the body. If the heart is deficient in its action, the spleen cannot perform its function of transforming qi and blood. The system can slowly weaken creating disease in the body if all the organs are not optimally functioning. 

To learn more about the 12 organs, their specific functions and relationships in the body see the following link:
http://www.assemblixinc.com/ZangFu/ZangFu.html

Part 2 of this article will further explain principles of diagnosis and treatment.

References
1. http://www.travelchinaguide.com/intro/medicine.htm
2. http://www.sacredlotus.com/acupuncture/channel_theory.cfm
3. http://www.shen-nong.com/eng/principles/whatmeridian.html

Images courtesy of http://www.soundsourcery.com/tjm/images/FiveElement.gif 
http://www.nlm.nih.gov/exhibition/chinesemedicine/images/yin_yang.jpg

MINDFULNESS

Present Moment Awareness

Mindfulness can be defined as a state of active, open attention on the present. Jon Kabat-Zinn is professor emeritus of medicine at the University of Massachusetts Medical School, where he founded the Center for Mindfulness in Medicine, Health Care, and Society, and introduced the Mindfulness-Based Stress Reduction (MBSR) course in 1979. (1) 

Focusing on the present moment without judgement is the root of mindfulness. Learning to cope with stressors whether it be pain, emotions, attentional problems, immune function or drug addiction, one can learn to engage in new practices that will induce positive changes in our bodies reaction to a stimuli. 

Studies show that the ways we intentionally shape our internal focus of attention in mindfulness practice induces a state of brain activation during the practice. With repetition, an intentionally created state can become an enduring trait of the individual as reflected in long-term changes in brain function and structure. This is a fundamental property of neuroplasticity—how the brain changes in response to experience. Here, the experience is the focus of attention in a particular manner. (2)

Mindfulness practices may include yoga, tai chi, qi gong or meditation. These practices are being utilized in a wide variety of settings and for diverse populations of individuals. Some interesting uses are to keep kids in school, workplace stress, prison inmates, and binge eating to name a few. View the links below for further details.

Yoga and school children: http://www.forbes.com/sites/alicegwalton/2013/07/24/how-yoga-might-save-the-u-s-trillions-of-dollars-and-a-lot-of-lives/

21 Ways to reduce workplace stress: http://www.bemindful.org/mindmastery.pdf

Prison and yoga: https://www.nicabm.com/nicabmblog/how-prisoners-are-benefiting-from-yoga/

Mindful eating: http://www.nytimes.com/2012/02/08/dining/mindful-eating-as-food-for-thought.html?pagewanted=all&_r=0 (3)

Recommended books on Mindfulness:
*Mindless Eating: Why We Eat More Than We Think by Prof. Brian Wansink
*Savor: Mindful Eating, Mindful Life by Dr. Cheung and Thich Nhat Hanh
*The Mindful Way Through Depression by Mark Williams, John Teasdale, Zindel Segal and Jon Kabat-Zinn
*Mindfulness: A Practical Guide to Finding Peace in a Frantic World by Mark Williams and Danny Penman (2)
*Little Flower Yoga For Kids: A Yoga and Mindfulness Program to Help Your Child Improve Attention and Emotional Balance by Jennifer Cohen Harper

References
1. http://www.mindful.org/author/jon-kabat-zinn
2. http://www.mindful.org/the-science/medicine/the-science-of-mindfulness
3. http://oxfordmindfulness.org/science/

Image courtesy of: http://www.google.com/imgresimgurl=http://www.ldatd.on.ca/wpcontent/uploads/2012/01/mindfulness.jpg&imgrefurl=http://www.ldatd.on.ca/programschildren-teensmindfulness-for-kids

Chemotherapy Induced Peripheral Neuropathy

Prevention and Management with Natural Therapies

Chemotherapy induced peripheral neuropathy (CIPN) is one of the more common side effects of cancer therapy. CIPN is generally thought to arise as a consequence of disruption of axoplasmic microtubule-mediated transport, distal axonal degeneration, and direct damage to the sensory nerve cell bodies of the dorsal root ganglia (1). (See diagram below) Symptoms generally start with a sense of numbness in the fingertips, toes and soles of the feet and may slowly progress to tingling and pain that can extend to the hands, arms, ankles and legs. Pain and discomfort vary from person to person but can become severe and debilitating affecting ones quality of life and ability to perform daily tasks.

Certain classes of chemotherapy drugs tend to cause CIPN. For a thorough list of these medications and other possible contributing factors go to:
http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/chemotherapyeffects/peripheralneuropathy/peripheral-neuropathy-caused-by-chemotherapy-how-does-cipn-start 

Conventional Treatment Options

The best way to treat CIPN is to prevent it from occurring or progressing. Symptoms may resolve after completion of chemotherapy or may persist in some cases. Let your oncologist know as soon as you begin experiencing symptoms. Your doctor may choose to adjust your chemotherapy dose, delay treatment or even discontinue the causative medication. Ultimately, the goal is to prevent long-lasting harmful side effects while getting the optimal dose of recommended chemotherapeutic agents.

Managing CIPN with medications can be effective for symptom relief. Commonly prescribed treatments are steroids, pain creams, anti-depressants and anti-convulsants, narcotics or opioids. Often if symptoms are severe, multiple medications to manage symptoms may be prescribed. Physical and occupational therapy may also be recommended in some cases.

Alternative Therapies
Aside from the above treatments, other natural supportive therapies can be utilized in conjunction or alone to alleviate CIPN. Small studies using acupuncture to manage CIPN symptoms are showing positive outcomes. Studies have shown that after multiple acupuncture treatments, nerve conduction is improved in patients with CIPN (2). The Traditional Chinese Medicine treatment goal is to improve the flow of blood and qi to the extremities and improve blood, qi and yang deficiency in the body.

Nutritional supplementation may also have some benefit. Supportive evidence using L-glutamine, alpha-lipoic acid and L-carnitine have each shown some positive response with preventing or treating peripheral neuropathy. Protecting and healing the nerves is the mechanism of action with these supplements. If known peripheral nerve damaging chemotherapy medications are being prescribed, initiating these supplements before symptoms even start can help prevent it from occurring or can delay progression and intensity of nerve damage. Discuss with your naturopath and oncologist before taking these supplements as timing around chemotherapy is important to prevent interaction.

Supportive data on each of the supplements can be found at:
Glutamine: http://clincancerres.aacrjournals.org/content/7/5/1192.full
Alpha-lipoic acid: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772894/
Acetyl-L-Carnitine: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805703/


References
1. http://www.lwwoncology.com/Textbook/Content.aspx?aid=9826770
2. http://www.ncbi.nlm.nih.gov/pubmed/22146780

Image of nerve compliments of: https://thombiology30.wikispaces.com/file/view/nerve_diagram.jpg/311184500/431x299/nerve_diagram.jpg
Image of feet compliments of: http://www.google.com/imgres?imgurl=http://www.briandorfman.com/blog/wp-content/uploads/2013/03/047feet_468x611.jpg&imgrefurl