Article on Covid-19 for local paper

This is an article I submitted to a local newspaper (The Beachhead). I thought I would post it here.

Its March 17, 2020 here in Venice, California so the only thing to write about is Covid-19. I have been an acupuncturist and herbalist here in LA since 1996. As an acupuncture clinic owner and as an owner of an herb business I’ve gotten a lot of questions about this virus and Chinese Medicine. By the time you read this the situation may have changed. Hopefully, not too much for the worse. And hopefully you, your family and colleagues are well.

Chinese Medicine has a lot of experience with epidemics. Two of our greatest traditions and books (Shang Han Lun and Wen Bing) come about because of epidemics which wiped out the creators’ extended families. I am not going to suggest here specific formulas and instead try to explain some Chinese Medicine concepts in thinking about this virus.

Chinese philosophy and medicine has a concept of “upright qi” (zheng qi) which activates the life forces (for lack of a better word). This upright qi would also activate the immune system but is also vital for fighting illness in all ways. A person with low upright qi will have problems overcoming any illness while someone with strong upright qi can more easily recover. 

To get back to Covid-19, people have asked for herbs to “kill the virus” but this only part of the issue. Western medicine likes to look at details and like Western ideology thinks in binaries. You have a virus/ you don’t have a virus. The purpose of Chinese thought is to overcome the “pathogen” while at the same time to build up the upright qi to allow the body to fight on its own. Many of our herbs have anti-viral properties but one should count on taking tons of these herbs. The Chinese treatment must be balanced with all the factors at that particular time and person.

Covid-19 attacks the lungs and the first order of business is to protect the lungs, first by not breathing anything harmful or otherwise getting into our bodies. Herbs such as Astragalus (Huang Qi) is a primary defensive herb but hopefully used with other herbs to build the upright qi. This basically means be as healthy as possible. 

Covid-19 seems to either create or be attracted to dampness and “phlegm”. Phlegm can be the same as the stuff you cough up but also can turn to “dry phlegm” like a wetlands in the summer that has half dried up into a sticky mess. For this reason people should take care to cut back on phlegm production. For some this means less dairy products but depending on the person, a range of foods can create phlegm. Here in Venice we often get phlegm in our lungs as the sea air blows into our neighborhoods. 

Once a pathogen or disease is contracted, the first order of business is to ventilate the lungs and try to move the illness out. This can be done with “cupping” or “scraping” (gua sha) the back of the neck and back with a soup spoon. People should avoid cold foods and phlegm producing foods. At this point aromatic herbs like mint, turmeric, garlic, ginger etc… may be most appropriate. If you experiencing dry cough then honey or other syrups may be useful This is also the time when you should strongly consider a consultation with a western doctor. 

Many people have asked about Yin Qiao San as an anti-viral. I can’t say don’t take it if that is all you have but its coldness isn’t what is needed for this virus. It definitely shouldn’t be used as prevention. It is very cold and moves inward and may trap the disease instead of venting the disease outward. 

China has a completely integrated (although not perfect) system where Chinese medicine is used alongside Western medicine. Herbs are used throughout treatment including in the Intensive Care Units. IV drips of Chinese herbs are common. For that reason one should be wary of taking something just because it is used in China for Covid-19. Herbalism is a sophisticated art and there is a lot of debate and writing in and outside of China as to the best treatment strategies. If you read about a Chinese herbal formula you won’t know the circumstances or at what stage the herbs may have been used. Herbs used in the beginning of the infection may be different than in a later stage and often change completely day to day. 

There are so many things to say about this crisis we are facing. Fortunately, Los Angeles has many experienced acupuncturists and herbalists (probably you know a few). Close by there are  two very good schools with experienced practitioners and supervisors and talented students (Emperors and Yo-San). As I write this the schools and most private offices have closed. But there are many places to do phone consultations and I am sure your practitioner would be happy to get a phone call from you. They should be able to prescribe herbs and have herbs shipped to you.

Be well, I hope this was helpful. 

Doug Eisenstark L.Ac.

A graduate of Emperors College, since 1999 Doug has been a teacher and clinical supervisor at Emperors College, Yo-San University and the Venice Family Clinic.

Douglas Eisenstark L.Ac.

Auto Immune Diseases

Auto Immune disease is as difficult to get a handle on in Chinese Medicine as it is in Western Medicine. Part of the problem is that in the 20th Century even Chinese Medicine practitioners will know auto immune through a Western lens. Despite this classical theory and fundamental principles can be applied to great effect for patients suffering from auto immune diseases.

But while a corticoid steroid may start to work in a few hours or days, Chinese herbs can take weeks and months to see results. This is a strength as well because we would like to think we are also creating long term treatment even if we have no “cure”.

That being said we see a lot of autoimmune as Yin deficiency.

Boosting Qi

Boosting Qi – Wei (way) and Zheng (Jung)

If you are fighting a disease you want to raise zheng Qi which creates the overall resistance to pathogens. Wei qi circulates on the outsides of the (blood) vessels and is protective in the sense of keeping colds and flus away. During the day it circulates on the skin and at night it goes to protect the organs. It is why we need to have blankets on when we sleep at night.  Wei Qi is translated as “protective qi” and yes these herbs boost wei qi but more importantly this formula more boosts zheng while also dispelling evil (xie) qi.

 

Below are excerpts from my book – Fundamentals of Chinese Medicine (PMPH Press 2015)

When the movement of qi ceases, human life comes to an end. No matter the source, any kind of qi that disturbs the body is called a pathogenic evil (xie) qi. The opposite of pathogenic qi is the zheng/upright qi, which can be conceived of as the sum of all forces that protect the body against pathogenic (xie) qi.

When pathogenic qi invades the body, it is not easy to maintain health if the zheng/upright qi is weak. Qi not only protects the body surface from the invasion of external pathogens, but also serves to eliminate pathogens that have already invaded the body. When the pathogenic qi invades the body, the zheng qi attempts to drive it outward. Therefore, the normal defending functions of qi should prevent the invasion of pathogenic qi. The functional ability of zheng qi determines the frequency, development, severity, and prognosis of diseases.

Wei/defensive qi circulates outside the vessels, and its functions are those of protection and defense. Because it is seen as protecting the body from pathogenic invasion, it is often also translated as “protective qi”. Wei qi is produced from the refined food-essence that is transported and transformed by the spleen and stomach. When refined food-essence is transformed into food-qi, the active and floating parts turn into wei qi. It circulates outside the vessels without being confined by the vessel system, circulating both outward to the skin and muscles and inward to the zang-fu organs in the chest and abdomen. Wei qi defends the body from external pathogens, warms the body, and controls and adjusts the opening of the skin pores (cou li).

 

Attributes of Yin and Yang

Opposite

Yin and yang are the attributes of two opposite aspects of related things or phenomena in the universe. Yin and yang can be applied to two different things or phenomenon, or to one object or phenomenon with the aspects of yin and yang within it. The original meaning of yin and yang was very simple, referring to places and their position relative to the sun. A place exposed to the sunlight is warm and bright, while a place in the shadows is relatively cold and dim. That is also to say, the side of an object facing the sun pertains to yang, while the side facing away from the sun pertains to yin. So, millennia ago, Chinese philosophers attributed the things or phenomena which are bright and warm to yang, and the things or phenomena which are dark and cold to yin. In looking at the seasons, it is warm in spring and summer and cold in the autumn and winter. Spring and summer are then attributed to yang, and autumn and winter to yin. Taking a day as another example, it is warm and bright in the daytime while cold and dark at night. So, daytime is attributed to yang and night to yin.

By further observation, it was found that the body of an animal or human being can be warmed to withstand cold through exercise and activity. In contrast, when the body is exposed to cold and remains inactive, it will feel cold. So, activity is attributed to yang, and inactivity to yin. Plants grow rapidly under the sunlight, and slower without the sunlight. Therefore, things or phenomena in an active or excited state are attributed to yang, while those that are in an inhibitory or inactive state are attributed to yin. The theory of yin and yang has evolved into a philosophical and abstract concept used to generalize those things or phenomena with opposite aspects. We can say that yin and yang refer to a pair of standards with opposite properties.

The categorization of things or phenomena into yin and yang refers to the particular properties by which the yin or yang attributes of things or phenomena can be determined. Cold and heat are one of the primary pairs of opposites where things with signs of relative cold are attributed to yin, while those with relative warmth are attributed to yang. Motion and stillness form another primary pair of characteristics of which one can determine yin or yang attributes. Something in nature that is relatively active and excited is attributed to yang, while things that are relatively still, inactive or inhibited are attributed to yin. Considering the natures of cold/heat and motion/stillness of, many other yin and yang attributes have evolved over time. For example, yang includes activity, outward movement, ascending, warmth, brightness, dispersing, outside and hyperactivity. Yin features include stasis, inward movement, descending, accumulating, contraction, and inhibition.

Attribute

Yang

Yin

space (direction) upside, outside, left, south downside, inside, right, north
space (location) heaven earth
time day night
season spring and summer autumn and winter
temperature warm and hot cool and cold
humidity dry moist
weight light heavy
fluid character clear dense
light bright dim
motion dispersion, ascent, activity accumulating, descent, inactivity
action exiting, activity, qi transformation inhibiting, decline, formation

Again, it must be noted that the theory of yin and yang does not refer to concrete things or objects, but that yin and yang are abstracted concepts concerned only with properties. Many phenomena or objects are not related nor have opposite qualities, and for practical reasons there is no need to divide or compare them into yin or yang. For example, the couch in a living room has no relationship with the house across the street and so there is little reason to call one more yin or yang than the other. i

Lao Zi said, “All things embrace yang and carry yin.

Absolute

Yin and yang have both relative and absolute aspects. For example, regarding water and fire, water pertains to yin and fire to yang. Water, no matter how hot, it is always yin when compared with fire. Fire, no matter how weak, always belongs to yang when compared with water. The yin and yang attributes are fixed, and thus absolute.

Relative

Because the qualities of things naturally change, things with yin and yang attributes also change over time. Therefore, the yin and yang attributes of things can be absolute, but also relative. The relative attributes of yin and yang manifest in three ways:

Mutual Transformation

The first of the relative attributes is the mutual transformation of yin and yang. Under certain conditions, the yin and yang attributes of things may change into their polar opposites. A bright flame will eventually burn out and become cold. A night will always turn back into day. In the clinic, we see that when the cold or heat nature of a disease changes, the yin or yang attribute of the condition will also change. For example, a common cold caused by what Chinese medicine calls “wind-cold” has manifestations that include physical coldness and a whitish coating on the tongue. Both of these are signs of cold, which is yin. If treatment is delayed, then the cold pattern may turn into a heat pattern with manifestations that include fever with a yellow coating on the tongue. In this case we can observe that a yin-type condition has transformed into a yang-type condition. Conversely, it is also possible for a heat condition to transform into a cold condition.

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Many Chinese books and their translations will refer to yin “belonging to”, “pertaining to”, “refers to” or is “associated with” substance, immobility or a quality of cold, etc. As another example, wood is “associated with” wind. For the student (perhaps especially for those used to the relative precision of the English language) this may seem frustratingly vague. Such language is used because in Chinese philosophy, things of the world are not objects of certainty, but rather things with qualities; these are things known only through their appearance at particular times and places. (Astute readers may note the similarity of this thought to some concepts described by modern quantum physics.)

The reasons for this outlook go back to ancient Asian philosophy (codified in Taoism) which states clearly that “the Tao that can be spoken (or named) is not the true Tao”. Only the Tao itself is complete. Yin and yang, the five phases, and indeed all the medical processes of the body thoroughly discussed in this and countless other books are only reflections and “manifestations” of the oneness of the Tao.

_______________________

Infinite Divisibility

The second relative attribute is that yin and yang are said to have infinite divisibility. Two things that are related yet contrary can be further divided into yin and yang; in other words, the yin or the yang aspects themselves can also be divided into another pair of yin and yang, and this kind of subdivision can be continued infinitely. However, each yin and yang aspect always includes the other aspect, so they will never be completely yin or completely yang. Within any yang object there is a yinaspect, called the “yin within yang”. A yin object also contains a yang-aspect within it, called the “yang within yin”.

The yin and yang attributes of things or phenomena are determined according to the proportions of the yin or yang components. For example, if one thing or phenomenon pertaining to yang contains a small yin component, its general attribute still belongs to yang. Our basic example of day and night is informative. The daytime is yang because it is active and bright and warm. Yet, as it declines into night we have aspects of yin. The late afternoon is called “yin within yang”. Night time is yin and falls deeper and deeper into yin. This period of dark is called “yin within yin.” Yet as the night reaches its darkest, it can go no farther into yin and thus its movement changes in the direction of yang (the morning). The latter half of the night is therefore called “yang within yin”. The morning signifies the full beginning of the new day as the sun rises to its zenith, so the morning is therefore called “yang within yang”.

i To analyze the yin and yang attributes of two things or phenomena, two conditions must be met. The first condition is that these things or phenomena have some correlation or defined relationship with each other. Second, these two things or phenomena must in some way be in opposition to each other. Therefore, only two related yet opposite things or phenomena or two opposite aspects within one thing or phenomena can be generalized and analyzed with attributes of yin and yang. For example, cold and heat, both of which are used to describe temperature and are opposite in nature, can be symbolized with yin and yang. If two things or phenomena do not correlate to each other, or they are correlated but their features are not opposite, they cannot be explained with yin and yang. For example, ice and snow, both of which are the crystal transformed from water, do not have opposite features, so their relationship cannot be as easily described with yin and yang.

Distinguishing Yin and Yang

Distinguishing Yin and Yang

Western Thought and Yin and Yang

Western thought and western medicine emphasize finding the particulars and unique qualities of objects, even down to their microscopic components. This microscopic and molecular viewpoint becomes the essence of what is examined, also being the main evidence used to diagnose and cure disease. Chinese philosophical and medical thought is less concerned with a microscopic perspective, but rather emphasizes more observable qualities and behaviors. Yin and yang (and the five phases) do not assign static “realities” to objects and phenomena, but only describe properties within the context of other objects and phenomena. Consequently, yin and yang medical philosophy holds that all medical conditions and “realities” are not definitive, but rather that they remain in a relative state of continual process.

Under the rubric of yin and yang, it is not a matter of establishing classifications, but of describing the dynamic responsible for the relationship of all the elements within the defined whole.” Larre, Schatz, Rochat de la Valleei

A chair in western thought is a chair, and with further categorization, an armchair or dining room chair. It may be made of maple wood or cedar, but is still primarily identified as being a chair. From the viewpoint of western science, to understand the chair better one may run tests to determine its molecular makeup. Further study and measurement will reveal more and more about what the chair “really is”.ii In yin and yang terms, because it is solid and “substance”, a chair is first considered to have predominantly yin qualities. However, in relation to the floor, it has yang properties because yang is above yin when considering direction. A chair resting on the floor of a room is yin because it is still and immobile and is relatively low within the space of the room. Yet, this same yin-related chair develops yang properties when thrown up into the air and across the room, because it now is in action and has the moving properties of yang.

The chair therefore has both yin and yang potentials within it and we see that indeed (with few exceptions) all objects and phenomena have the potential to manifest properties of both yin and yang. If one were to consider the ceiling above your head, it would be considered yang, because yang is above yin. Yet, to a person standing on the roof of your building, that same ceiling would have yin properties. Furthermore, the yin-related chair has the potential to transform and be set afire, burn, and thus have more properties of yang. Because every object and phenomenon has yin and yang qualities, the description of any object’s “reality” is dependent upon the placement of the viewer and their circumstances as well as the qualities of the object or phenomenon themselves.

In order to comprehend yin and yang, we often, as does this book, refer to yin as “substance” and yang as “function” or “movement”. However, this idea requires further context because yin and yang are abstractions of the tendencies present in all objects and phenomena. “Substances” or “objects” refer to those material objects that constitute things. Function or phenomena reflect the forces which bring into motion the potential of things. Objects and phenomena can transform from one to another, from object to phenomenon and from phenomenon to object, or to put it simply, from yin to yang and yang to yin.

All objects or things have physical shapes and patterns that are formed by the qualities of the yang from which they were created. Referring back to the chair mentioned above, the qualities of that chair were determined by the location of the tree that grew the wood. A tree grown in a rainforest at the equator has a different quality than one grown in a northern climate. This shows how the yang processes of growth and nourishment at different locations would affect the yinobject of wood that results.

Similarly, yang actions are dependent upon the shape of yin from which they were transformed. The sound of a guitar made from wood grown at the equator is different from that made of wood grown in a northern forest. In another example, the fire and smoke produced from coal and those from wet grass are very different. So within substance and function are evidences of both yin and yang properties. Looked at in this way, yin and yang are not simply synonymous with substance and function. Nor can yin and yang be classified simply as “matter” and “energy” respectively, for both contain elements of the other.

Although this way of thinking has any number of complexities, none of this should imply that it is in any way imprecise. The laws of yin and yang as expanded upon below are descriptions of both material properties and change. Because yin and yang are opposites, yet always changing, what may be obvious at first often becomes fluid; this changing quality makes yin and yang philosophy a discipline of properties, time and space. The overall impression of these laws may appear simple (that things change from one to another) but in order to understand health and illness in our patients, it is vitally important to understand how these particular laws of yin and yang are revealed. The understanding of yin and yang comes through study and deep reflection along with clinical practice and personal experience.

Yin-yang is an abstract concept without form” – Miraculous Pivot (Líng Shū, 灵枢)

i Survey of Traditional Chinese Medicine, Laure et al. (Paris: Institut Ricci) p. 44

ii David Bohm writes “… to Western society, as it derives from the Greeks, measure, with all that this word implies, is the very essence of reality, or at least the key to this essence…” Wholeness and the Implicate Order (London: Routeledge and Paul, 1980) p. 23