TCM Quarterly article COVID 19

The use of Lung & Spleen simultaneous treatment for COVID-19
TCM Quarterly (Facebook)

According to Traditional Chinese Medical (TCM) theory, it is believed that the disease is located in the lung, spleen, and stomach–especially the lung and spleen. It’s called simultaneous lung-spleen treatment (脾肺同治).To begin, three quotes from the classics can help elucidate understanding of this concept. The Classic on Medical Problems, chapter 58 states,《难经·五十八难》 “There are five ways that cold pathogens can hurt the body: middle wind (stroke), cold, warm dampness, heat, and warm diseases, and they all cause different suffering.”2 Here, “warm-dampness” is regarded as an exogenous febrile disease. In Discrimination of Febrile Diseases 《温病条辨》states, “febrile diseases have wind, heat, plague, warm, toxic, heatstroke, damp, dry, cold, and malaria types.”3 It also states that epidemic patients who are endemic are extremely pestilent, which can easily spread from family to family. As can be seen, the main difference here refers to the concept of Qi, referring to the pathogens able to pass through air. According to The Yellow Emperor’s Classic on Internal Medicine, a plague can be classified according to the five movements of Qi4. Although the aforementioned epidemic types have different names, their pathogenesis is the same. They are all caused by the combination of “triple deficiency” (三虚相合), which have a sudden onset and high-death rate. Lastly, in The Theory of Pestilence 《温疫论》6, it describes that the pathway of the invasion of the pestilence is through the nose and mouth. As can be seen, the understanding of plagues were similar as that in Europe as can be remembered by the Plague Doctors who would wear crow masks due to the obsolete (according to conventional medicine) medical theory of miasma, where noxious wind was seen as the cause of infection.

The symptoms of COVID-19 include both those of Spleen-Stomach diseases, such as cough, fatigue, and muscle soreness. As TCM emphasizes a holistic concept of unification between all things, people are affected by changes around them. In December 2019, Wuhan, which is abundant with water, the winter was colder than usual.So, TCM analysis also includes this concept, understanding that the wetness of the environment could play a factor in the disease and should also be considered for diagnosis and treatment.

As stated in 《温热论》7 Theory of Warm-Heat, warm pathogens attack from the top–first the lung and then the pericardium. As the nose is the orifice of the lung and highest of all TCM organs as well as governing the skin, the pathway of COVID-19 is expected to affect the lung. As the first symptoms of COVID-19 include fever and a dry cough, it is further suggested that the disease begins its assault on the lungs, and during that time, the disease should be treated there (see our previous post about lung-clearing and detoxifying decoction (清肺排毒汤). In TCM physiology, when the function of the stomach-spleen are compromised, the movement of liquids within the body is affected, resulting in fluid filling the lungs, which brings the discussion to the spleen-lung connection.

The connection between the spleen and lung by their connection with water metabolism. Importantly, the spleen separates the clean from the turbid, letting the clean ascend and descending the turbid. When compromised, the turbid may ascend, infecting the lungs. Thus, in order to harmonize the organs’ function and mutual cooperation and restraint, the two can be treated at the same time. To see a case study which illustrates this visit:

Language Focus:
1.肺脾同治Fèi pí tóngzhì
2.《难经·五十八难》云:“伤寒有五, 有中风, 有伤寒, 有湿温, 有热病, 有温 病, 其所苦各不同” .“Nán jīng·wǔshíbā nàn” yún:“Shānghán yǒu wǔ, yǒu zhòngfēng, yǒu shānghán, yǒu shī wēn, yǒu rè bìng, yǒu wēn bìng, qí suǒ kǔ gè bùtóng”
3.《温病条辨》曰:“温病者, 有风温,有温热, 有温, 有温毒, 有暑温, 有湿温, 有秋燥,有冬温, 有温疟”,“温疫者, 厉气流行, 多兼秽浊, 家家如是, 若役使然 也”“Wēn bìng tiáo biàn” yuē:“Wēn bìng zhě, yǒu fēng wēn, yǒu wēn rè, yǒu wēn, yǒu wēn dú, yǒu shǔ wēn, yǒu shī wēn, yǒu qiū zào, yǒu dōng wēn, yǒu wēn nüè”,“wēn yì zhě, lì qì liúxíng, duō jiān huì zhuó, jiā jiā rúshì, ruò yì shǐrán yě”
4.三虚相合 Sān xū xiànghé
5.《黄帝内经》言:“五疫之至, 皆相染易, 无问大小, 病状相似”“Huángdì nèijīng” yán:“Wǔ yì zhī zhì, jiē xiāngrǎn yì, wú wèn dàxiǎo, bìngzhuàng xiāngsì”
6.《温疫论》言:“温疫之为病, 非风、 非寒、非暑、非湿, 乃天地间别有一种异气所感”为“非其时而有其气”“Wēn yì lùn” yán:“Wēn yì zhī wèi bìng, fēi fēng, fēi hán, fēi shǔ, fēi shī, nǎi tiāndì jiān bié yǒuyī zhǒng yì qì suǒgǎn” wèi “fēi qí shí’ér yǒu qí qì”
7.《温热论》.“Wēn rè lùn”
8.清肺排毒汤Qīng fèi páidú tāng

Source: 2020. 蔡梦圆,吴澎泞,杨仁旭,彭波.“肺脾同治”法在新型冠状病毒肺炎中的应用.中药药理与临床.

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.

Teaching Addiction and Chinese Medicine – A paper for colleagues

This is a paper I wrote that was published in the California Journal of Chinese Medicine published around 2015.

Teaching Chemical Dependence in the CM School

Teaching chemical dependence has become mandatory in Oriental medicine (OM) schools. Becausesubstance abuse is no longer simply an issue of “illegal drugs,” the class often takes a broad approach, Looking at substance abuse and addiction from a larger context students allows students to explore the unique benefits that OM offers in treating chemical dependence, and its limitations in this realm as well. The author reflects on some issues that arise from teaching about chemical dependence in Chinese medicine colleges, with suggestions regarding the importance of the class and the form it can take.


For many Oriental medicine students in the West, a class in chemical dependence is a step back into familiar territory. By the time they take this class, students will have had several years of training in new and unfamiliar concepts of xiao ke, yin/yang, phlegm and repletion. A class in chemical dependence, probably more than most classes in the Oriental medicine school, touches on a student’s personal issues, histories and cultural assumptions and raises themes that resonate through the entire practice of medicine. While the safety and health interests of our patients is foremost, we often see the intersection of what it means to be a healer with what it means to be healed. For students with an interest in the psychoemotional, the class often challenges their beliefs, assumptions and limitations.

In the first minutes of the first class of the seven-week class that I teach, I emphasize that substance abuse is a professional study and clinical practice onto itself and that the class will explore differing facets of that study. Like Oriental medicine itself, chemical dependence has numerous interlocking parts that inform each other, both interiorly (mindset) and in exterior manifestations (effects). Because of the dichotomy between the personal and technical nature of addiction, the class is both a formal and informal discussion of the physiological, cultural and legal definitions of substance use, abuse, dependence and addiction.

Teaching the class: Guidelines and assumptions.

I have found it essential to quickly set down numerous guidelines and my own assumptions that are followed in the class. I find that having an initial openness and honesty prevents offending, misunderstandings, backtracking and defensiveness later on. My first rule for the class is that nobody is allowed to bring their own experiences or those of their family into the classroom. I guarantee no anonymity, beyond the reasonable discretion of fellow students to keep personal behaviors secret. I explain that sharing with a patient one’s own history or problems presents issues of boundaries between the patient and practitioner. Even if, or perhaps especially if, one’s history and personal experience matches that of the patient, the practitioner should not share that with the patient, including those with substance abuse. In the classroom, this first guideline greatly frees discussion. I stress that if anyone feels uncomfortable, has objections or wants to share with me their issues, I am available outside of class time for discussion. Secondly, I tell the students my assumptions about them. I assume some have little or no experience with substance abuse, while others may be addicted to any numbers of drugs and have been or are currently in a 12-step program. If not themselves, they will have secondhand experiences through family or friends. I don’t know, nor I do want to know, who may be in any category, but I can be certain that everyone will fit into one. By maintaining these first two guidelines, classes don’t digress into stories of personal or familial difficulties. Each student in the classroom is allowed to view the material professionally.

The third assumption that I bring to the first class is that 12-step programs are a good thing (for many) and that the intersection of 12-step and Buddhism is interesting. I explain that I am neither “in recovery” nor have taken Buddhist vows, but I still maintain an interest in the two systems and how they can be used in drug dependence recovery. We look at the many objections to the 12-step programs and alternative programs such as Rational Recovery/cognitive behavior. The point is not that students must only recommend 12-step, but they be aware of the alternatives that their clients have. Still, I find the language of 12-step to be helpful in later discussions (eg,”it’s an inside job”). Many of their clients will be in a 12-step program and they should have some knowledge of its details.

I make the assumption that everyone (save those fully realized and enlightened beings) is an addict to some degree. What differentiates drug abuse from say, sex addiction or shopping, is only in degrees of harm to the person and society. The ancient image of the monkey who grasps a piece of food in a trap which she or he won’t let go of represents all of our “unreasonable” desires.

The next assumption I tell my class is that “addicts are smart people.” This, of course, shocks the students, but I say it because we can’t assume that one has to stupid to take drugs. Addiction is a way for a person to differentiate themselves from the environment and thus resist integration into what they may feel the inadequacies of society and themselves in it. “Rationality” itself often binds people to beliefs that “logically” resolve in addiction. As a practical matter, long-term addicts often are very clever or otherwise they would be dead or in jail. In addition, addicts have to use their wits through manipulating others and their environment in order to continue their habits.

The final assumption is that all addictions are yin (substance) deficiencies. The addict attempts to replace this yin deficiency with an object or substance. The psychiatrist Francis F. Seeburger writes, “What counts in addiction is that one relate to something, whether a substance, a process, a relationship, or whatever in such a way that one experiences one’s self unable to do without it. What counts is only that one learn the existential equation of addiction for that ‘object’. “1

Know the different substances/drugs/medications and to recognize the dangers.

Much of the class is taken with reviewing the different substances of abuse. We look at the biochemistry of each of the abused substances in biochemical terms from nicotine to opiates in terms of their capacity for addiction. Students should know the behavioral and cultural habits of addiction as well as treatment options, both Western and Chinese.

Students come from different backgrounds and ages and I am often surprised by their views of different drugs (as perhaps they are of mine!). For example, alcohol is so widely available that many underestimate its harmful effects, the depth of its abuse, and don’t realize that detoxification from it can be fatal. On the other hand, cannabis consumption and detox for my middle-aged generation, was generally seen as extremely benign. However, for many current patients, new potent strains of cannibas present issues in detox and depression that would have been disregarded 20 years ago. MDMA (Ecstasy) is a relatively new and commonly used substance that older and non-Western students may be totally unfamiliar with.

Patients come to us in differing stages of intoxication and withdrawal. Patients hope that an acupuncture treatment can relieve their symptoms and certainly we can help with that. However, states of intoxication and detoxification carry varying degrees of risk. For example, understanding that the difference between opium detox and Valium (benzodiazipine) detox is important because they have vastly different risks. The heroin abuser, although certainly uncomfortable to say the least, is not in danger of dying from his withdrawal, while the Valium abuser might. Knowing when to refer out, or to call an ambulance is, of course, vitally important. For those patients still using or abusing substances, any health professional should be familiar with the concept if not the particulars of harm reduction to advise the patients.

Build a vocabulary to talk to patients and professionals

Substance abusers come from varied backgrounds, however while currently using or in recovery always form sub-cultures with specific terminologies. When a practitioner is naive to the nature and effects of drugs, a patient has less trust in them. If the practitioner can identify with the terminology and “technical language” of addiction, greater trust can be found. To admit to addiction is to inherently invite judgment from others. Patients are more comfortable when they don’t have to explain in detail behaviors that are embarrassing, humiliating and shameful. Practitioners should ask questions dispassionately without judgment.

Recovery also has its special terminologies. Students often need to educated about the differences between detox, rehab and recovery. Relapse, slipping, dry drunk, sobriety and enabling are just a few of the many terms we explore.

Know the limits of treatment, dependency and co-dependency.

I believe in OM and I think it can play a crucial role in drug dependence treatment. However, just because we treat something doesn’t mean we can cure it. For the drug user, OM might appear to be just the magic (external) cure that they are looking for. For the eager and enthusiastic student or practitioner, they might be just as happy to be the one to supply it. I would suggest that both are often going to be disappointed. Chinese medical treatment should be seen as an adjunct to all the efforts that the drug user is making on her or his own.

For most OM students, treating chemical dependency is their first step into being a health provider professional in a clinical setting. In our student clinics, we supervisors tolerate if not tacitly encourage a certain amount of bonding between our students and patients. Students are often very enthusiastic about treating chemical dependency and addiction because it comes back to familiar cultural and personal terrain. At first glance, OM offers, with some knowledge of NADA and herbs, a solution which other therapies find elusive. One of the strongest features of addiction is to rely on outside “help” for problems, and health providers are all too willing to be there to fill that role. Students are encouraged to look upon themselves as professionals with skills unique to the larger discipline of chemical dependence.

We have to see how our own behavior as practitioners fosters dependence and co-dependence in our patients, be it through esteem or economic issues. Institutions as well can become “co-dependents” in their relationship with their clients. Michael Smith, founder of NADA, has famously said, “Remember your program is always sicker than your sickest client”2 Recognizing co-dependent behavior is often crucial in patients with particular stress issues. These behaviors may be outside substance abuse, but the patterns remain constant. The theme of dependence and co-dependence and enabling often overlaps not only with the “wounded healer” health practitioner, but also with gender and economic inequality.

Use and abuse.

Much of the first class focuses on defining drug dependence from medical (biochemistry), behavioral and legal standpoints. Throughout the semester, we often return to these definitions of use and abuse, choice and dependence. The term addiction itself is a matter of inquiry, which becomes especially relevant when discussing “recreational” drug use and cultural constructs of alcohol consumption. Addiction is often a matter of predictable and repeatable results from the behavior of choice. Understanding the features of ritual and the “narrowing of repertoire” (Douglas, can you define/explain what you mean by narrowing of repertoire?) is an essential feature that can also be exploited in treatment. The lack of predictability in hallucinogenics make them unlikely candidates for addiction, yet available for abuse. Conversely, heroin, the standard bearer for substance abuse study, has very predictable results and highly physiological properties that make it extremely addictive at all levels.

The importance of dual diagnosis.

Dual diagnosis refers to a patient with both drug abuse and mental health issues. Dual diagnosis can be labeled in drug abuse concurrent with HIV, Hep C etc., as well as mental health diagnoses. Substance abuse is often an effort to “self-medicate,” and because drug use often starts in the late teens as an expression of experimentation and before personalities are fully formed, it often masks other mental issues. This process does not end, of course, in adolescence. Recovery always lays bear deep inner issues that must be confronted either through intense personal spiritual reflection and/or psychological/medical intervention. It’s important to remind practitioners that once a drug is successfully withdrawn that everything will not necessarily return to normality, especially for the dual diagnosed.

Familiarity with NADA, 12-step and other treatment approaches

Familiarity with the NADA philosophy and protocol is relatively straightforward but often leads to deeper discussion. The five NADA points are not a magic cure for all addictions. Students tend to have two assumptions about NADA. First, they may think that these points will enable a person will ro stop abusing substances spontaneously. The second assumption is that NADA is a limitation and using it for treatment is mechanical and uncreative. They may think it is better to use their newly learned OM zang-fu diagnosis, eight principles or other more sophisticated skills. It is important to review the history of NADA and to explore the nature of community, ritual, reliability and codependence. Far from being mechanical, using speechless contact with patients forces the practitioner to exhibit compassion “straight from the heart” without reassuring words or methods. The patient learns not to rely on, nor manipulate, the special skills of one particular practitioner or method in their recovery. The ritual of daily auricular sessions mimics the narrowing of repertoire of addiction and hopefully replicates the ritual and dependability of substance abuse. The practitioner learns to view clients with “a non-attached compassion.”

Few substance abusers make it to sobriety without help. I discuss 12-Step programs in class not to endorse them but to help practitioners understand what many of their patients are going through in recovery. We discuss in detail the objections to 12-Step Programs and 12-Step alternatives such as cognitive behavior (often labeled Rational Recovery). Patients often use their objections to 12-Step programs as a reason to avoid any type of recovery process. Fortunately, in my classes I have yet to find anyone vehemently opposed to 12-Step programs although more than a few have voiced their doubts. Hopefully more will have understood why it is important for many in recovery.

Not all drug treatment is based on the NADA, of course, and students alsolearn about individualized treatment within a private clinic. We look at the zang-fu mechanisms and treatment with acupuncture and herbs. Steve Given’s paper from the Journal of Chinese Medicine is particularly helpful in these lectures.3 Differences between Tian Wan Bu Xin Dan, Wen Dan Tang, Long Dan Xie Gan Tang and Chai Hu Long Gu Mu Li Tang, among others, are explored in their relevance to stages of abuse, withdrawal detoxification and recovery. Other helpful journal articles include , “The Acupuncture Treatment of Alcohol and Chemical Dependency” by David Blow.4 lso Sean and William Scott’s American Journal of Acupuncture article “A Biochemical Hypothesis for the Effectiveness of Acupuncture in the Treatment of Substance Abuse: Acupuncture and the Reward Cascade” suggests physiological mechanisms for how acupuncture works in the treatment of substance abuse.5

I have often contemplated Taoist issues of the hun and po in their relation to addiction. The hun, which likes to move, and the po, which likes stillness, are at odds in addiction, and certainly in recovery. The intellectual hun can justify substance abuse to absurd levels, even when it knows that it is “wrong.” The po reacts to the physical withdrawal. I have recently been aware of qigong and Taoist concepts in the work of qigong expert, Dr. Liu Dong.

Resources and projects

In lieu of a final exam, I have the students do a project for presentation the last week of class. These presentations are done individually or in small groups, and the topic originate from the students with my guidance. Projects range from the biochemistry of particular substances to conjectures about treatment from various spiritual traditions including Taoism and Islamic Sufism. I find it interesting that many of the papers and presentations on other traditions find resonance in the 12 steps among initial skeptics. Even my provocative comment about how “addicts are smart” gets reflected in ideas that spirituality can not be “learned through books” and that knowledge without reflection can impede spiritual growth.

In past semesters, students created essays based on films, such as Man with the Golden Arm, Traffic (or Traffik, the longer and better English television version on which the film was based), To the Bone, , and other films of their choosing. Courtesy of the internet and cable TV, students now keep me up to date on shows such as Intervention where they can graphically see situations I can only hint at in the classroom.

The structure of the class comes largely from Steve Given, my teacher at Emperors College in the subject who has graciously let me use his class notes to supplement my own handouts. The one required text is by Alex Brambaugh,6 which conforms to my practical training working with Lianne Audette at Turnabout A.S.A.P. in Santa Monica. I have benefited from her workshops in this subject as well as those given by Shelley Bobbins in Los Angeles. Both teachers are highly recommended for practitioners and students interested in this area.


Teaching chemical Dependence and Oriental Medicine can be challenging as it can directly touch upon student’s lives. With boundaries fully established and a recognition of the professionalism of the addiction field it can be a rewarding class for students, teachers and the field of medicine itself.


Brumbaugh, Alex. Transformation and Recovery, Santa Barbara:Stillpoint Press,1994

Rossi, Elisa, Shen. Elsevier Ltd, 2007

Seeberger, Francis F. Addiction and Responsibility. New York: Crossroad Publishing, 1993

May, Gerald G. Addiction and Grace. New York: Harper Collins, 1988

Griffin, Kevin E. One Breath at a Time: Buddhism and the Twelve Steps. New York, St. Martins’s Press, 2004

Given, Steve. “Understanding Addiction According to Traditional Chinese Medicine”, Journal of Chinese Medicine, No. 54, May 1997

Sean Scott, William N. Scott. “A Biochemical Hypothesis for the Effectiveness of Acupuncture in the Treatment of Substance Abuse” American Journal of Acupuncture Vol. 25, No 1, 1997

Jiang, Yongping. “Addiction and Chinese Medicine”, Journal of Chinese Medicine, Number 88 October 2008

Douglas Eisenstark LAc teaches Chemical Dependence and Oriental Medicine at Emperors College in Santa Monica, California and has taught auricular and microsystems classes at Yosan University. He has worked at Turnabout A.S.A.P., a nonprofit outpatient acupuncture drug detox center, and thanks Lianne Audette, Ben Hekmatnia, Steve Given and Shelley Bobbins, and especially his students and patients for his education vital to this article. He maintains a practice in Los Angeles.

1 Seeberger, Francis (1993). Addiction and Responsibility, An Inquiry into the Addictive Mind. Crossroad: New York p. 58

2 Michael Smith, M.D. from Transformation and Recovery, A Guide for the Design and Development of Acupuncture-Based Chemical Dependency Treatment Programs by Alex Brumbaugh, Stillpoint Press, Santa Barbara, 1994 p. 167

3 Given, Steve (1997). “Understanding Addiction According to Traditional Chinese Medicine” , Journal of Chinese Medicine, No. 54, May 1997

4 Blow, David (1994) No. 45, May 1994

5 Sean Scott, William N. Scott (1997) American Journal of Acupuncture Vol. 25, No 1

6 Brumbaugh, Alex, 1994, Transformation and Recovery, Stillpoint Press: Santa Barbara

What is Qi, Ki, Chi?

First of all Qi, Ki and Chi are all the same word just variations of Chinese and Japanese and ways that the West has written it in (their/our) letters. In Chinese Mandarin its more or less pronounced like “Cheeeese” while taking a picture but without the “Z” at the end. 

In Chinese, the word is combined in endless variations to make other words and concepts. 

is how its written now in mainland China. 

is how it was written in China and still used in Taiwan. 

Here is a segment of an entire chapter on qi that I wrote for Fundamentals of Chinese Medicine (PMPH press):

Qi in ancient Chinese philosophy refers to an invisible and extremely fine substance that is in constant motion. The initial connotation for qi was that of a cloud floating in the sky. By observing the motions of the clouds (ascending, descending, accumulating and dispersing), Chinese philosophers formulated a concept that all substances in nature that have form are generated by a formless substance that is in continual and endless motion. This substance is qi. These early philosophers also perceived the existence and influence of qi in the body by observing the phenomena of human life such as the qi of breathing, hot qi over the body during exercise, and so on. After further considering cloud-qi and water-qi, as well as breathing qi and the hot qi of the body, additional general concepts of qi and its nature were formed. They postulated that qi begins as an extremely fine substance with no form and is in perpetual motion. As qi accumulates, it acquires form, and is thus responsible for creating all the physical manifestations we perceive in the universe.

PMPH Eisenstark FundamentalsThough physical objects and the extremely fine invisible substance moving around them are both forms of essential qi, the invisible form is considered the basic state of existence for essential qi. This version of essential qi is what is usually referred to as “qi”, while the qi that accumulates and is in a relatively stable and tangible state is named “form” (xíng, 形). Formless essential qi is extremely fine, and is in a constant state of dispersion and motion; it is considered “intangible” or “formless” because it cannot (usually) be seen with the naked eye. When this invisible and intangible essential qi accumulates, it becomes a stable form, which then can be seen and identified as a tangible “thing” or object.

These two states of essential qi are perpetually in a state of transition. As part of the process of life, the formless and intangible (qi) and the tangible (form) transform into each other. Formless qi accumulates and becomes a tangible substance just as tangible substances disperse and revert to formless qi. All things in the universe change from the formless to the tangible and then in turn from the tangible to the formless. Therefore, essential qi is both the starting point and the ending point of a thing or phenomenon within an endless cycle.

Formless qi connects everything as a coordinated and unified whole, which is in constant motion; it exists both within and without, filling the entire world of things. Formless qi penetrates into all forms, and activates the qi that has formed into an object. So, qi is not only a material or element that constitutes all things in the universe, but is also an intermediary through which all things in the world communicate, interconnect and interact with each other. As one of the universal things existing within this integrated whole, the human being also responds to changes in the order of things, however slight or subtle the change may be.” Now back to earth with more questions:


Lung and Cough Formulas

Lung and Cough formulas


Lung issues and Coughs can be run from annoying to debilitating. And curing them is often elusive.

Chinese medicine is big on when the cough was created how it has progressed through the body. For example, a cough at day one of a cold is often totally different from a cold at day fifteen. The amount of phlegm (and the color of the phlegm) is also very important to us.

What I am going to do here is present a few possibilities that you can choose from. Lung issues may be long standing over the period of decades or very sudden. Coughs can be caused by any number of causes and not always come from the lungs. Generally these and chronic coughs (more than a month or so) can be more serious. Some meds such as for high blood pressure can also cause coughs.

In Chinese Medicine we are looking for major symptoms that include the amount of phlegm and lung issues and cough where there is no phlegm, a little phlegm or phlegm that is hard to expectorate.

Phlegm falls under damp and no phlegm is considered lung dryness.

Often after a long term illness…chronic cough with feeble and soft voice, worse in the afternoon and evening; or hoarse voice, sparse sputum that is difficult to expectorate, shortness of breath, dry mouth and tongue, spontaneous sweating; pale, red tongue; weak, rapid or thin pulse. Herbs that you want to look for where there is little energy are Huang Qi, Dang Shen and Wu Wei Zi . 


There are mixed conditions of phlegm and no phlegm which are often chronic conditions. This may very well be the case with diseases such as IPF and other types of Lung Fibrosis. Often these are times when phlegm has dried and caused “dry phlegm”. The image for this is a river that has dried up into a swamp and then a drying swamp. Conditions with dryness often include Yin/ fluid  deficiency herbs such as Mai Men Dong and Bai Bu. Zhe Bei Mu is said to “transform old phlegm” into a liquid that can be expelled. 

  • Jin Shui Huan Xian – This one of the best formulas for chronic lung problems where there is cough. It helps with energy and “transform” phlegm into fluids which can moisten the lungs without creating more phlegm.
  • Fei Fu Kang  is for chronic cases without too much phlegm but a drop in energy. This has been a very well received formula. We can also make Fei Fu without San Qi which has a effect on the blood. I forgot why I started making it without San Qi but many people order it.
  • Yu Fei Ning (FYN) has a lot of herbs for phlegm. It also works on the blood which often is damaged with dry phlegm.


Bu Fei Wan   This is a classic formula to help the lungs especially for long term problems. Generally there won’t be much phlegm and the tongue might have no coat at all and/or be red. Any cough may be weak and not bring up much sputum.

Bei Mu Gua Lou San acute or chronic– dryness attacking the Lung with phlegm:
choking and coarse cough with copious and thick yellow, or blood streaked purulent sputum, that is difficult to expectorate; red face, thirst, red tongue with yellow greasy coating;
rapid and slippery pulse

Fang Feng Tong Sheng San – Siler and Platycodon – This is for pretty extreme heat symptoms and cough with constipation. There may be other symptoms such as rashes. This formula has a wide number of applications but won’t be used that much.

Ren Shen Bai Du San – Ginseng Formula to Overcome Pathogens – This popular formula is for a lingering cough that may have deep seated phlegm but not actively coughing up at each cough. There might be a lot of tiredness and/or body aches. One might take this if a could has gone on for a week or so. The coughing symptoms of the cold have mainly gone away and the person is more than sick and tired of being sick and tired. They don’t know why they are still sick but they still feel really tired.

Sha Shen Mai Men Dong Tang   This is an Yin Tonic formula helping dry lungs and stomach. You might need this after a cold that has turned dry and the cough is now “non-productive” (no phlegm). Its good for all sorts of Yin Deficiency syndromes.

Sheng Mai San Lung Qi and Yin deficiency chronic. Sheng Mai San is not for your run-of-the-mill tiredness. With only a few herbs it strongly supports energy levels that have been severely tapped. In TCM theory, this means the qi and yin have been compromised giving signs of thirst and fatigue that may go into a body weakness. A major indication for this formula is a chronic cough that has depleted the fluids. There might be shortness of breath and spontaneous sweating. There should be no phlegm to use this formula.

Other formulas with phlegm include:

Qing Qi Hua Tan Wan acute or chronic– heat phlegm in the Lung: This is one of my favorites for colds and a cough when the phlegm has gotten all gross and yellow. Qing Qi Hua Tan dries the phlegm and clears the heat. Be careful about taking it for more that a week or two as it cause the lungs to dry and you might develop a dry cough. It is a variation of Er Chen Wan. It might have a hacking cough with much sticky yellow sputum – damp phlegm from Spleen deficiency: recurrent cough with a thick sound of phlegm in the throat, worse in the morning and after meals, aggravated by eating greasy or sweet food; cough with copious, white sputum that is easy to expectorate, a stifling sensation in the chest, nausea or vomiting, slippery pulse

Ding Chuan Tang acute– wind cold in the exterior with phlegm heat in the interior- cough with copious, thick yellow sputum; loud wheezing, breathlessness, labored breathing, possible chills and fever; a red tongue with a yellow greasy coat, slippery and rapid pulse

Zhi Sou San acute– wind attacking the Lung with phlegm: cough, may be accompanied by slight chills, fever and itchy throat, slightly floating pulse

Ban Xia Hou Po Tang – Ban Xia Hou Po is not for cough especially but for the feeling of something stuck in the throat. We call this “plum pit syndrome“.

and even more:

Ma Huang Tang acute (Since Ma Huang is not available we offer a “no Ma Huang” substitute here) – wind cold attacking the Lung: cough with harsh and loud volume, itchy throat, copious thin white sputum, chills and fever, no sweating, headache, sneezing, runny nose, floating and tight pulse

Sang Ju Yin acute– wind heat attacking the Lung :acute onset, choking cough with coarse sound, dry and sore throat, thirst, cough with thick yellow sputum, fever and chills, headache, sweating, floating and rapid pulse

Ma Xing Shi Gan Tang acute -( This is another Ma Huang formula where we have substituted the Ma Huang) There will be a lot of  heat lodged in the Lung: choking and coarse cough with viscous and difficult to expectorate sputum, thirst, wheezing, labored breathing, nasal flaring, yellow tongue coating, slippery rapid pulse

Shi Quan Da Bu Tang chronic
Qi and Blood deficiency: chronic cough with feeble voice, shortness of breath, laconic speech, fatigue, pale and sallow complexion, palpitation; pale tongue, thin and weak pulse

there are lots of way to treat lung issues and cough… write me so I can help you with your issues…


The E Jiao Problem

Our E Jiao comes from Chinese farms so it is my belief that we are not contributing to the horrendous situation originating from the cosmetic industry. There are some efforts to get E Jiao banned from import. Very soon we are going to see a transition to cattle hide in many Chinese products. This probably was the original “e jiao”. The vegetarians won’t be any happier but the donkey trade is really horrible. Here you can read about the problem on the Guardian web site.

Tongues and Diagnosis


From time to time people will send me a picture of their tongue and ask “what formula should I take?” (I love this job.) Tongue diagnosis is not a standalone method for making a diagnosis and writing a formula. The tongue can tell a lot but its not the complete “picture” so to speak without a list of symptoms at least. Still, I’ve been doing this for more than 20 years so I can make a few generalizations. Here are a few examples:

The same tongue from above with red prickles (indicating heat), some yellow (off white) coating in the middle and a center (stomach area) crack. This patient might benefit from a formula with Huang Qin, Dan Shen and Ban Xia among the ingredients.

Assuming the color is correct on this photo, it shows a pale purple (dusky) tongue. There is a combination of blood deficiency and blood stagnation. In addition the coating is rather moist. It is quite puffy. The patient might benefit from a formula with He Shou Wu and Bai Zhu as ingredients.


Yikes, pretty bad- and I’m assuming this photo is rather yellow. Lots of scalloping on the edges, a thicker yellow coat and pretty bad cracks. This might be the first patient after a decade of bad food habits. We might think of He Shou Wu again, Ban Xia, Bai Zhu and Cang Zhu.

Pretty nasty- the tongue has indications of Stomach yin deficiency (no coat in the middle) with a thick yellow coat (dampness). One might use Cang Zhu for the phlegm dampness combined with Mai Men Dong among the ingredients.


Ok, this is bad. Phlegm dampness. One needs a full on Shi Wei Wen Dan Tang or at least Wen Dan Tang here. When there is this much phlegm damp then no “qi” is going to move at all.

this tongue has the scalloped edges but its not so bad. There are stomach area cracks (in the middle) but the tongue itself is not so red so there isn’t much heat. Probably the patient would benefit from Bai Zhu and Mai Men Dong in their formula.


Kampo List

Eagle Herbs has an affinity for Kampo medicine, the herbal medicine of Japan. Below is a list of Kampo formulas (in pinyin alphabetical order) – all of which are recognized and covered by the Japanese national health service. In order this list is the Chinese “pinyin” name/ Chinese Original/ Japanese Original/ Japanese “kanji”/ the official Kampo number. The Kampo number is created by the Japanese Health system. Often there are letters in front denoting the manufacturer. Most of the studies have TJ so we use that if there is a study connected somewhere. This list is made from several sources on the internet. We have many links to our pages. If you have looked all over the internet for a similar list: you are welcome.

  • An Zhong San      安中散     あんちゅうさん     Anchū-san    5
  • Bā Wèi Dì Huáng wán    八味地黄丸  Hachimi-jiō-gan     はちみじおうがん   TJ 7
  • Bái Hǔ Tāng Wán    白虎加人参湯    Byakko-ka-ninjin-tō   びゃっこかにんじんとう   34
  • Ban Xia Bai Zhu Tian Ma Tang     半夏白朮天麻湯    Hange-byakujutsu-tenma-tō   はんげびゃくじゅつてんまとう   37
  • Bàn Xià Hòu Pō Wán   半夏厚朴湯    Hange-kōboku-tō    はんげこうぼくとう   TJ  16
  • Ban Xia Xie Xin Tang    半夏瀉心湯    Hange-shashin-tō   はんげしゃしんとう   14
  • Bu Zhong Yi Qi Tang 補中益気湯    Hochū-ekki-tō    ほちゅうえっきとう41
  • Chai Hu Ching Gang Tang 柴胡清肝湯 Saiko-seikan-tōさいこせいかんとう    80
  • Chai Hu Gui Zhi Qian Jiang Tang   柴胡桂枝乾姜湯 Saiko-keishi-kankyō-tō    さいこけいしかんきょうとう    11
  • Chai Hu Gui Zhi Tang    柴胡桂枝湯     Saiko-keishi-tō   さいこけいしとう    10
  • Chai Hu Jia Long Gu Mu Li Tang 柴胡加竜骨牡蛎湯     Saiko-ka-ryūkotsu-borei-tō   さいこかりゅうこつぼれいとう    12
  • Chai Ling Tang    柴苓湯   Saiko-seikan-tō   さいこせいかんとう    80
  • Chai Pu Tang    柴朴湯 Sairei-tō   さいれいとう   114
  • Chai Yuan Tang   柴陥湯    Saikan-tō   さいかんとう    73
  • Chuan Xiong Cha Tiao San 川芎茶調散 Senkyū-chachō-sanせんきゅうちゃちょうさん    124
  • Da Chai Hu Tang     大柴胡湯    Dai-saiko-tō   だいさいことう8
  • Da Cheng Qi Tang 大承気湯    Dai-jōki-tō   だいじょうきとう    133
  • Da Fang Feng Tang 大防風湯  Dai-bōfū-tō   だいぼうふうとう    97
  • Da Huang Gan Cao Tang 大黄甘草湯   Daiō-kanzō-tō   だいおうかんぞうとう84
  • Da Huang Mu Dan Pi Tang    大黄牡丹皮湯    33 
  • Da Jian Zhong Tang 大建中湯   100 Dai-kenchū-tō   だいけんちゅうとう   100
  • Dang Gui Jian Zhong Tang    当帰建中湯    Tōki-kenchū-tō   とうきけんちゅうとう123
  • Dang Gui Shao Yao San 当帰芍薬散    Tōki-shakuyaku-san   とうきしゃくやくさん23
  • Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang   当帰四逆加呉茱萸生姜湯
  • Dang Gui Tang    当帰湯   Tōki-tō当帰湯   とうきとう  102
  • Dang Gui Yin Zi    当帰飲子   Tōki-inshi   子とうきいんし   86
  • Er Chen Tang 二陳湯   Nichin-tō    にちんとう   81
  • Er Zhu Tang 二朮湯   Nijutsu-tō  にじゅつとう   88
  • Fang Feng Tong Sheng San   防風通聖散   Bōfū-tsūshō-san   ぼうふうつうしょうさん62
  • Fang Ji Huang Qi Tang 防已黄耆湯    Bōi-ōgi-tō  ぼういおうぎとう   20
  • Fu Ling Yin He Ban Xia Hou Po Tang    茯苓飲合半夏厚朴湯
  • Fu Ling Yin    茯苓飲 
  • Gan Mai Da Zao    甘麦大棗湯    Kan-baku-daisō-tō   かんばくだいそうとう   72
  • Ge Gen Tang Jia Chuan Xiong Xin Yi 葛根湯加川芎辛夷
  • Ge Gen Tang 葛根湯
  • Gou Teng San 釣藤散
  • Gui Pi Tang 帰脾湯   Kihi-tō   きひとう   65
  • Gui Zhi Fu Ling Wan Jia    桂枝茯苓丸加
  • Gui Zhi Fu Ling Wan 桂枝茯苓丸  Keishi-bukuryō-gan-ka-yokui’nin   よく苡仁けいしぶくりょうがんかよくいにん   125 
  • Gui Zhi Jia Long Gu Mu Li Tang 桂枝加竜骨牡蛎湯 Keishi-ka-ryūkotsu-borei-tō けいしかりゅうこつぼれいとう  26 
  • Gui Zhi Jia Shao Yao Da Huang Tang    桂枝加芍薬大黄湯    Keishi-ka-shakuyaku-daiō-tōけいしかしゃくやくだいおうとう   134
  • Gui Zhi Jia Shao Yao Tang 桂枝加芍薬湯
  • Gui Zhi Jia Zhu Fu Tang 桂枝加朮附湯   18 
  • Gui Zhi Ren Shen Tang 桂枝人参湯   Keishi-ninjin-tō   けいしにんじんとう   82
  • Gui Zhi Tang 桂枝湯   Keishi-tō   けいしとう   45 
  • Huang Lian Jie Du San   黄連解毒湯   Ōren-gedoku-tō   おうれんげどくとう  15
  • Huang Lian Tang 黄連湯   Ōren-tō   おうれんとう  120
  • Huang Qi Jian Zhong Tang 黄耆建中湯   Ōgi-kenchū-tō   おうぎけんちゅうとう  98
  • Jia Wei Gui Pi Tang 加味帰脾湯   Kami-kihi-tō   かみきひとう   137
  • Jia Wei Xiao Yao 加味逍遙散   Kami-shōyō-san   かみしょうようさん   24
  • Jie Geng Tang 桔梗湯   Kikyō-tō   ききょうとう   138
  • Jing Jie Lian Qiao Tang 荊芥連翹湯   Keigai-rengyō-tō   けいがいれんぎょうとう  50
  • Li Xiao San 立効散   Rikkō-san  りっこうさん  110
  • Ling Gan Jiang Wei Xin Xia Ren Tang 苓甘姜味辛夏仁湯   Ryō-kan-kyo-mi-shin-ge-nin-tō   りょうかんきょみしんげにんとう  119 
  • Ling Gui Shu Gan Tang   苓桂朮甘湯   Ryō-kyo-jutsu-kan-tō  りょうきょじゅつかんとう118
  • Ling Jiang Zhu Gan Tang 苓姜朮甘湯   Ryō-kei-jutsu-kan-tō   りょうけいじゅつかんとう39
  • Liu Jun Zi Tang 六君子湯  Rikkunshi-tō   六君子湯りっくんしとう43
  • Liu Wei Wan 六味丸
  • Long Dan Xie Gan Tang  竜胆瀉肝湯   Ryūtan-shakan-tō  りゅうたんしゃかんとう76
  • Ma Huang Fu Zi Xi Xin Tang   麻黄附子細辛湯   Maō-bushi-saishin-tō   まおうぶしさいしんとう  127
  • Ma Huang Tang 麻黄湯   Maō-bushi-saishin-tō  まおうぶしさいしんとう
  • Ma Xing Gan Shi Tang 麻杏甘石湯  Ma-kyō-kan-seki-tō  まきょうかんせきとう
  • Ma Xing Yi Gan Tang 麻杏薏甘湯
  • Ma Zi Ren Wan 麻子仁丸  Mashinin-gan  ましにんがん   126
  • Mai Men Dong Tang 麦門冬湯   Bakumondō-tō   ばくもんどうとう   29
  • Mu Fang Yi Tang 木防已湯   Moku-boi-tō  もくぼういとう   36
  • Niu Che Shen Qi Wan 牛車腎気丸 
  • Nu Shen San   女神散   Nyoshin-san   にょしんさん  67
  • Pai Nong San Ji Tang 排膿散及湯  Hainō-san-kyū-tō  はいのうさんきゅうとう  122
  • Ping Wei San 平胃散  Heii-san  へいいさん    79
  • Qi Pi Tang 啓脾湯  Keihi-tō  
  • Qi Wu Jiang Xia Tang 七物降下湯  Shichimotsu-kōka-tō  しちもつこうかとう  46
  • Qing Fei Tang 清肺湯   Seihai-tō  せいはいとう  90
  • Qing Shang Fang Feng Tang 清上防風湯   Seijō-bōfū-tō  せいじょうぼうふうとう58
  • Qing Shu Yi Qi Tang 清暑益気湯   Seisho-ekki-tō   せいしょえっきとう   136
  • Qing Wen Tang 温清飲
  • Qing Xin Lian Zi Yin 清心蓮子飲   Seishin-renshi-in  せいしんれんしいん   111
  • Ren Shen Tang 人参湯
  • Ren Shen Yang Rong Tang 人参養栄湯  Ninjin-yōei-tō  にんじんようえいとう  108
  • Run Chang Tang 潤腸湯   Junchō-tō じゅんちょうとう    51
  • San Huang Xie Xin Tang 三黄瀉心湯   San’ō-shashin-tō   さんおうしゃしんとう
  • San Wu Huang Qin Tang 三物黄芩湯   Sanmotsu-ōgon-tō   さんもつおうごんとう
  • Shao Yao Gan Cao Tang    芍薬甘草湯   Shakuyaku-kanzō-tō  しゃくやくかんぞうとう  68
  • Shen Mi Tang 神秘湯 
  • Shen Su Yin 参蘇飲    Jinso-in   じんそいん   66
  • Sheng Ma Ge Gen Tang   升麻葛根湯   Shōma-kakkon-tō   しょうまかっこんとう101
  • Shi Quan Da Bu Tang   十全大補湯  Jūzen-daiho-tōweiw  じゅうぜんだいほとう   48
  • Shi Wei Bai Du San    十味敗毒湯   Jūmi-haidoku-tō   じゅうみはいどくとう   6
  • Shu Jing Huo Xue Tang   疎経活血湯
  • Si Jun Zi Tang 四君子湯   Shikunshi-tō  しくんしとう 75
  • Si Ni San 四逆散   Shigyaku-san  しぎゃくさん35
  • Si Wu Tang 四物湯  Shimotsu-tō  しもつとう71
  • Suan Zao Ren Tang 酸棗仁湯 Sansonin-tō  さんそにんとう103
  • Tao He Cheng Qi Tang 桃核承気湯 Tōkaku-jōki-tō  とうかくじょうきとう61
  • Tiao Wei Cheng Qi Tang 調胃承気湯
  • Tong Dao San 通導散   Tsū-dō-san  つうどうさん  105
  • Wei Ling Tang 胃苓湯    Irei-tō  いれいとう  115
  • Wen Jing Tang 温経湯  Unkei-tō  うんけいとう  106
  • Wu Hu Tang 五虎湯   Goko-tō    ごことう  95
  • Wu Ji San 五積散  Goshaku-san  ごしゃくさん  63
  • Wu Lin San 五淋散  Go rin-san ごりんさん  56
  • Wu Ling San 五苓散 Gorei-san  ごれいさん  17
  • Wu Zhu Yu Tang 呉茱萸湯   Goshūyu-tō  ごしゅうとう  31
  • Xiang Su San 香蘇散   Kōso-san  こうそさん70
  • Xiao Ban Xia Jia Fu Ling Tang 小半夏加茯苓湯   Shō-hange-ka-bukuryō-tō  しょうはんげかぶくりょうとう  21
  • Xiao Chai Hu Jia Jie Geng Shi Gao 小柴胡湯加桔梗石膏
  • Xiao Chai Hu Tang 小柴胡湯  
  • Xiao Feng San 消風散
  • Xiao Jian Zhong Tang 小建中湯 Shō-kenchū-tōしょうけんちゅうとう99
  • Xiao Qing Long Tang    小青竜湯     Shō-seiryu-tō  しょうせいりゅうとう19
  • Xin Yi Qing Fei Tang 辛夷清肺湯   Shin’i-seihai-tō   しんいせいはいとう  104
  • Xiong Gui Jiao Ai Tang 芎帰膠艾湯
  • Yi Gan San Jia Chen Pi Ban Xia 抑肝散加陳皮半夏 Yoku-kan-san-ka-chinpi-hangeよくかんさんかち  んぴはんげ  83
  • Yi Gan San 抑肝散 54  Yokukansan抑肝散よくかんさん54
  • Yi Yi Ren Tang 薏苡仁湯
  • Yi Zi Tang 乙字湯 3
  • Yin Chen Hao Tang 茵蔯蒿湯
  • Yin Chen Wu Ling San 茵蔯五苓散 117 Inchin-gorei-san茵ちん五苓散いんちんごれいさん117
  • Yue Bi Jia Zhu Tang 越婢加朮湯 28
  • Zhen Wu Tang 真武湯 30
  • Zhi Da Pu Yi Fang 治打撲一方 89
  • Zhi Gan Cao Tang 炙甘草湯 64
  • Zhi Tou Chang Yi Fang 治頭瘡一方 59
  • Zhu Ling He Si Wu Tang 猪苓湯合四物湯 112
  • Zhu Ling Tang 猪苓湯 40
  • Zhu Ru Wen Dan Tang 竹茹温胆湯
  • Zi Yin Jiang Huo Tang 滋陰降火湯 93
  • Zi Yin Zhi Bao Tang 滋陰至宝湯 92


From a Kampo site:

Kampo medicine has been fully legitimated and has been widely integrated into Japanese health care system.

An article on Kampo medicine published in the August 21, 1993 issue of the medical journal The Lancet reported that 70% of the 200,000 physicians in Japan regularly prescribe Kampo drugs to their patients. Of those types of physicians who regularly prescribe Kampo medicine and treatments, high percentages are found among gynecologists, with 88% prescribing Kampo medicines or techniques, followed by urologists (83%) and cardiologists (83%).

A survey conducted by Nikkei Medical indicated some of the main reasons why there has been an increase in the number of physicians prescribing Kampo medicine. This survey found that 65% of those physicians who had prescribed Kampo medicine believed that Western medicine has inherent limits that could be compensated for by these forms of treatment. 32% answered that they might not have prescribed Kampo medicine in the past, but were swayed by the strong availability of scientific data indicating the efficacy of Kampo. Finally, 31% offered that they only offered this medicine because of what they described as strong demand from patients

Kampo is currently covered by the Japanese national health insurance plan. At the present, 148 Kampo medicinal formulas are recognized by the Ministry of Health and the Ministry of Labor and Welfare, in addition to being covered by the National Health Insurance (NHI) program


Info – A little somethin’ somethin’ about sex and Chinese Medicine

  • This page is in response to someone (male) who asked about sperm counts. It has reference to sex so move on if you need to.


  • There are bunch of angles to sex and Chinese medicine. The main word we look at is Jing (精) and has innumerable connotations especially when combined with other words. For example: it can mean “perfect” as in perfection or in Chinese medicine we say essence. Combined Jingshen means the “spirit” or mind. So big concept. Combined with Zi / seed –  精子 jīngzǐ – means directly sperm.


  • This concept of Jing as “essence” in Chinese medicine is very important. There is a concept that you have an innate (born with) amount of jing. Persons with early childhood problems – such as retardation either mental or physically with spinal problems are called “jing deficient”. One hopes to “nourish” jing by living a good life, not having excessive sex, not “burning out” in current lingo. For an old person, the crooked spine, poor eyesight etc… is the decline of jing.


  • Yet one can develop and replenish post birth jing to some extent by living a balanced life…


  • Chinese medicine and culture gets kind of obsessed with this because its important and often famous doctors were treating emperors and princes with huge numbers of wives they could choose from every night. Also Taoism has a big thing about “preserving” jing through some weird (to many) and sometimes dangerous practices.


  • Original art (detail) by Douglas Eisenstark


  • Mainstream modern books repeat a formula for guys- I believe its something like this: in your 20’s sex once a day, in your 30’s sex 5 times a week, 40’s 3 times a week, 50’s once a week, 60’s 2 twice a month – 70’s once a month- and the joke goes: 80’s as much as you can get. Something like that.


  • The word Jing forms the basis of sperm in translation so yes, there are some people who have sex 3 times a day in their 40’s who can damage themselves for their future. A healthy sex life is better than no sex life of course. It is said that sex with a partner can replenish jing. (But we don’t know if that just is a justification for emperors and princes having sex with young wives.) Certainly, one can say that sex in a loving manner with the healthy exchange of energies is better for both partners.


  • In your forties there is a natural decline of jing… and you have to be more careful about how much you “lose” one way or another.


  • Theories about women vary. Some say that jing is lost in sex and/or menstruation and certainly childbirth which may be pretty much annually back in the day (Chinese birth control is very ineffective if it was desirable at all).


  • My suggestion if someone gets really tired the day(s) after sex then they need to be less frequent and take some supplements such as Cordyceps in the days after.

PLMD and RLS Writings

The below are various writings Al Stone from his earlier website. Note that Al used to sell products on BeyondWellBeing and we no longer sell from that website.


According to traditional Chinese medicine, It all comes down too much heat in your body. Heat can originate from a variety of issues, but they all lead to restlessness. Our treatment principle then is to cool off that internal heat. Restless legs is only a superficial symptom of the more systemic restlessness caused by heat disturbing the spirit of the heart. Sound unscientific? You bet. Fortunately, there is nothing more scientific than an herbal medicine that has been getting the job done for hundreds of years.


We say generally that RLS is due to heat and periodic limb movement disorder (PLMD) is due to wind. In TCM, our goal is to calm or extinguish it. Wind in the body is commonly associated with neurologic movement disorders. Any tic, tremor, spasm or convulsion is considered wind blowing around inside the body. Does your wind kick up when you’re falling asleep?

RopinoHerb RLS for restless leg syndrome is based on Tian Wang Bu Xin Dan (Heavenly Emperor’s Nourish the Heart Pills). This formula first appeared in the text “Secret Investigation into Obtaining Health” published in the year 1638. This formula nourishes the Kidney yin to cool the heat in the Heart causing restlessness.

Other ingredients assume other possible causes for internal heat that rises up to the Heart to cause restlessness. While this article that describes the cause of RLS focuses on Yin deficiency, TCM practitioners never assume that any two people will present with the exact same cause for their internal heat. So, this formula also addresses a number of the lesser known but commonly found causes for internal heat.

SO, HOW MUCH to get?

Get the small size if you’re unsure as to how you’re going to respond to the herbal formula. If you have a history of having allergic reactions to botanical products, this is a safe choice. Get the large size if you know what you want and you want it now. :)

It may take longer than one week to see results from this particular product if its cause is due to a yin deficiency. Herbs have been added to this formula that also address the more quickly treated causes of these problems as well. This formula may be perfect for you, but it simply takes up to a month before you really see improvement. You may have had this problem for ten years, so don’t expect an herbal formula to take it away in a week. This is not a reasonable expectation. For more on how long it will take for your condition to resolve, please see the Eagle Herbs Prognosis-O-Rama.

Other ingredients assume other possible causes for internal heat that rises up to the Heart to cause restlessness. While this article that describes the cause of RLS focuses on Yin deficiency, TCM practitioners never assume that any two people will present with the exact same cause for their internal heat. So, this formula also addresses a number of the lesser known but commonly found causes for internal heat. If you’d like a formula that addresses yourspecific cause of internal heat, you can look into a Custom Formula just for you.


According to traditional Chinese medicine, the cause of restless leg syndrome is heat in the Heart causing your spirit to become agitated. The end result is that you experience restlessness when trying to sleep.

The following “statements of fact” support this idea. All of the big words on this page come from one of a few classic texts in Chinese medicine that date back to the time of Christ. Perhaps that’s why some of us call the “Huang Di Nei Jing” the “bible” of traditional Chinese medicine.

THE SHEN IS STORED IN THE HEART. The Shen is the Spirit.

In TCM, certain organs store stuff. In biomedicine things like nutrients are stored in fat cells. In Chinese medicine the Shen is stored in the Heart. That can suggest something holy and eternal, but clinically speaking it also applies to your personality, demeanor, memories and certain cognitive functions. This spirit is stored in the Heart. In biomedicine, they’d put most of these “spirit” functions into the brain and/or central nervous system.


In TCM, each organ is hypersensitive to one unique type of weather. In the case of the Heart, it loves to feel warm, but hates to feel hot. When it feels hot, the spirit that it stores can become restless. “Five element theory” describes the different environmental factors that effect the organs in the body according to this theoretical tradition.


According to the theory of Zang-Fu (which essentially translates to “internal organs”) the Kidneys are the source of yin and yang in the body. Yin is body fluids and cooling mechanisms in this context. Yang is metabolic heat for this discussion. When Kidney yin is deficient, the body can get hot giving rise to hot flashes and night sweats. This is something like when your car’s radiator is low on fluid, the car can overheat. This doesn’t happen because the engine is running too hot, but because the radiator yin, or fluid is deficient.


Because the Kidneys are the source of Yin, when the Kidneys get dry, the Heart gets dry also. When the Heart gets dry, the spirit that is stored in the Heart has nothing to anchor it down as the Heart yin generally does. I can’t quite think of a good analogy for this. Needless to say, the spirit as a substance is light and airy. One of the jobs of the yin of the Heart is to give the spirit a nice moist place to reside. When that moisture is deficient, the spirit becomes flighty, fidgety, and a little bit over dramatic. Other symptoms of Heart yin deficiency include panic attacks, heart palpitations, anxiety, and insomnia.


Back to the radiator fluid causing the car to overheat. When the body gets hot because of its lack of cooling mechanisms, that heat will rise in the body to the Heart where it agitates the spirit and causes restlessness. Between this mechanism and the Heart yin unable to anchor the spirit, it can become a real problem emotionally and physically.


When the Kidney yin is deficient all the other organs that rely on body fluids for their balanced function become dry. Most often, it is the Liver that suffers first from the Kidney yin deficiency.


Just like the Heart can get too hot when there aren’t enough fluids to cool it, the Liver too can generate some problems when it gets dry. The problem it causes is called internal wind. Internal wind makes our hands, feet, or other structures shake and tremble. Biomedicine would described these things mostly in neurological terms (nocturnal myoclonus). Internal wind can look like anything from a tic in your eyelid, to periodic limb movement disorder (which often arises with restless legs), to some forms of epileptic seizures.

Please do not assume that if you have PLMD that you need to be treated for epilepsy. This is wrong even though there are some similarities according to TCM theory. Periodic limb movement disorder (PLMD) is characterized by involuntary leg twitching or jerking movements during sleep that typically occur every 10 to 60 seconds, sometimes throughout the night.


So why does Kidney yin become deficient? There are a few causes. If you recently had a high fever and your urine is now looking darker than usual, you’re dehydrated. Drink more fluids, take some herbs if you want for your yin, you’ll get over it. However there is another cause for a Kidney yin deficiency. This cause is called Kidney jing deficiency. Jing is sometimes translated as “essence”. You may recall that the Heart stores the shen. Well, the Kidneys store the jing. Jing has a number of functions. One of which is to stimulate periods of growth in our lives. For instance, when your reproductive organs start to mature this is moderated by the Kidney jing. Menopause is timed by the jing too. This jing is also the precursor to Kidney yin. So, a jing deficiency can cause a yin deficiency.


This is why restless leg syndrome has a tendency to effect the elderly more than the young. It is because their jing is naturally being used up, so they develop a deficiency of yin causing all of the issues that have been described above.


Kidney jing comes mostly from our parents, and it is passed on to our children. If our parents have a tendency toward jing deficiency, it is likely that we will too. Because as we get older we have less jing, the issue of children with a jing deficiency increases with age. According to TCM, this is why some birth defects favor the children of parents who are older such as Down’s syndrome.

family history of RLS is seen in approximately 50 percent of such cases, suggesting a genetic form of the disorder. People with familial RLS tend to be younger when symptoms start and have a slower progression of the condition. This supports the idea that RLS comes due to a jing deficiency. If you get it from your parents, it will arise earlier in life. If you are just naturally running out of jing (as we all do) it’ll show up later in life.


We have two herbal formulas that are modified slightly to achieve these aims of nourishing Yin, cooling heat, and extinguishing wind.

RopinoHerb RLS for restless leg syndrome is based on Tian Wang Bu Xin Dan (Heavenly Emperor’s Nourish the Heart Pills). This formula first appeared in the text “Secret Investigation into Obtaining Health” published in the year 1638. This formula nourishes the Kidney yin to cool the heat in the Heart causing restlessness.

RopinoHerb PLMD for periodic limb movement disorder. This formula is based on Da Ding Feng Zhu (Major Arrest Wind Pearl). This formula appeared originally in the book “Systemic Differentiation of Warm Disease” which was first published in 1798. This formula nourishes Yin and sedates wind to address the jerky movements associated with this “internal wind”. sells both granules and capsules. Read about the difference here:  What’s the difference? But to save you the time- :-)  We use the exact same granules in the capsules. Capsules are just a lot more convenient but more expensive as you are paying for our time to put them in capsules. (Some people try to make their own capsules… its really time consuming and messy). Since you will want to take these formulas every day I would suggest splurging on the capsules.

Some Theory – Distinguishing Yin and Yang

Distinguishing Yin and Yang

Defining Yin and YangBeijing Acupuncture Eisenstark 2002

Yin and yang theory is an explanation for the natural phenomena of the universe. According to this theory, the whole of the universe is made up of two forces in opposition, and yet each contains aspects of the other. These opposites can be called yin qi and yang qi, which function as abstract concepts for describing the nature of both material objects and their relationships within the world. Because of the interactions of yin qi and yang qi, the world is made up of objects and phenomenon that are all subject to transformation.

In general, things that are bright, hot, active, ascending, external or related to functional activity pertain to yang, while those that are dull, cold, unmoving, descending, internal or related to material form pertain to yin. Therefore, all processes and objects can be said to pertain to these abstract concepts in varying intensities depending upon their natures and the context of their surroundings. Although seemingly simple at first, these are complex relationships that can take a lifetime of study to appreciate and understand.

As a uniquely Asian philosophy, the implications of yin and yang resonate from philosophy and culture to the depth of the needle put into the body in an acupuncture treatment. After it was introduced into the medical field, yin and yang theory became the most important theoretical and practical component in the Chinese medical system for guiding the diagnosis, prevention and treatment of disease.

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.

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

From Fundamentals of Chinese Medicine – Sun, Eienstark, Zhang (PMPH)

Wind: One of the 5 Pathogenic Factors in Chinese Medicine

All diseases in Chinese Medicine come from an imbalance of Yin and Yang. In the case of wind, the Yin can fail to “ground” the Yang and so the Yang “floats” and moves too aggressively causing “wind”. We can see this when there is blood deficiency and its opposite, “qi”, invades and moves too quickly in the (blood) vessels. One of our core texts, the Su Wen, says “if the yang does not control its yin, then the qi of the five organs start a struggle”

From the book: Fundamentals of Chinese Medicine co-written by Douglas Eisenstark (PMPH press)

Pathogenic Wind

A pathogen that causes a disease that moves and disperses quickly is called a windpathogen. Wind is common in spring, but may occur throughout the year. Whenever wind becomes excessive enough to cause disease, it will become a pathogen. Wind pathogens usually invade the human body via the skin or into the muscles to lead to external wind disease. Chinese Medicine believes that the wind-pathogen is an important factor in externally contracted disease, so it is called “the first and foremost Screen Shot 2015-08-16 at 10.32.25 AMfactor of the various diseases.” Wind easily combines with other factors, causing wind-cold, wind-heat, wind-dryness etc. The wind-pathogen was regarded from the beginning of Chinese medicine as the general term for external pathogenic factors and the main cause of illnesses.

The windpathogen is considered yang in nature and so tends to attack the upper yang parts of the body such as the head, neck, and back. A wind-pathogen is characterized by movement, lightness, opening, and dispersing. Dispersing-opening means that the wind-pathogen is apt to invade the upper portion (the head and face), yang channels, body surface, and make the striae and interstices (coù lĭ) compared to the surface, the “grain of the skin” and the areas immediately underneath) open when it invades the body. It can create headaches, sweating, and an aversion to wind.

A disease caused by a wind-pathogen is characterized by sudden onset, constant movement, and rapid change in the process of the disease. This means that wind is apt to come on quickly, move quickly, and then perhaps move unpredictably around the body. For example, a bi syndrome that changes locations indicates a wind-pathogen and is called “migratory bi” or “wind bi”. Another example of wind is a rash on the surface of the skin that may come and go quickly and change locations.

If a windpathogen invades the body, the patient may have facial spasms, or dizziness, tremors, convulsion, or stiffness of the neck. Facial spasms or deviation of the eye and mouth (such as in Bell’s palsy) can be the result of wind pathogens attacking the channels and collaterals. Invasion by wind pathogens following traumatic injury may lead to symptoms such as convulsions.

Wind often invades the body in combination with other pathogens. Because the wind-pathogen has a dispersing and opening nature, other pathogens (cold, dampness, heat, dryness, and fire) often invade the body in conjunction. The result is the external contraction of wind-cold, wind-dampness, wind-heat, and wind-dryness. The wind-pathogen can attack any organ and tissue externally or internally or invade the body through any of the upper orifices.

Today we can categorize many symptoms and diseases as wind. Signs and symptoms of wind include fainting, dizziness, tremors, convulsions, and facial spasms. Diseases may include (with the appropriate symptoms) colds and flu, dermatological conditions, stroke, Bell’s palsy, Parkinson’s disease, Tourette’s syndrome, and epilepsy.

Info – Alternative Therapies for Functional Gastrointestinal Diseases

Screen Shot 2015-08-16 at 10.37.45 AMfor those suffering from Sibo, IBS, constipation, diarrhea, stomach pains, etc…

(From our friends in the government)

Complementary and Alternative Therapies for Functional Gastrointestinal Diseases



Functional gastrointestinal diseases (FGID) are common in the world and account for more than 40% of clinical visits to gastroenterology clinics. Common FGID include gastroesophageal reflux disease (GERD), functional dysphagia, functional dyspepsia, gastroparesis, irritable bowel syndrome (IBS), functional constipation, diarrhea, and fecal incontinence. While pathogeneses of FGID are not completely understood, major pathophysiological factors include impaired gastrointestinal motility, visceral hypersensitivity, and psychological issues as well as disruption of the gut microbiota [1]. Gastrointestinal dysmotility is most common in FGID. For example, impaired lower esophageal sphincter function may lead to dysphagia in case of impaired relaxation during swallowing or GERD in case of reduced pressure or increased transient relaxation. In the stomach, reduced gastric relaxation during food intake may lead to impaired gastric accommodation, causing symptoms of early satiety and bloating; impaired antral peristalsis may lead to delayed gastric emptying, causing symptoms of nausea and vomiting. In the lower gut, impaired colon motility slows down transit, resulting in constipation, whereas a weak anal sphincter may lead to fecal incontinence. Visceral hypersensitivity is one of the major causes of pain and discomfort. It is commonly reported in patients with noncardiac chest pain, functional dyspepsia, and IBS. Depression and anxiety are commonly present in patients with FGID. Recently disruption of the gut microbiota has also been reported in patients with FGID.

Although FGID affect a large number of general populations, treatment options for FGID have been limited. Only a few medications have been developed for the treatment of FGID and few or none are available in the market currently depending on where one lives. Meanwhile, alternative and complementary medicine (CAM) has received more and more attention among patients with gastrointestinal diseases and gastroenterologists. In general population, the use of CAM was reported to range from 5% to 72% [2]. In patients with gastrointestinal diseases, the use of CAM was reported to be 40% in pediatric patients [3], 49.5% in patients with inflammatory dowel disease [4], and 50.9% in patients with IBS [5].

Major CAM methods that have been applied for the treatment of FGID include acupuncture/electroacupuncture, herbal medicine, and behavioral therapies. Electroacupuncture was initially designed to mimic manual acupuncture; electrical current was used to produce muscle contractions at the acupoint, mimicking the effect of manual manipulation of the needle inserted into the acupoint. Gradually, electroacupuncture has been evolved to function as neuromodulation or electrical nerve stimulation. That is, the parameters of electrical stimulation are chosen to alter certain functions of the body, such as release of certain hormones and/or neurotransmitter and alterations of certain physiological functions. Recently, a novel method of transcutaneous electroacupuncture (TEA) has been proposed: surface electrodes are used to replace acupuncture needles. This makes the therapy completely noninvasive and self-administrable. By replacing the acupuncture needles with cutaneous electrodes, the therapy can be administrated at home by patients and as frequently as needed. Acupuncture, electroacupuncture, and TEA have been shown to improve gastrointestinal intestinal motility and reduce visceral hypersensitivity in both humans and animal models of FGID [6]. A number of original research papers are included in this special issue. The study by X. Zhang et al. reported antiemetic effect of TEA in patients with chemotherapy and mechanisms involving serotonin and dopamine. The ameliorating effects of the noninvasive TEA on nausea and vomiting in the delayed phase are appealing as the common medical therapy has limited effects on nausea and vomiting in the delayed phase. The same TEA method was used in a study by F. Xu et al. The authors applied TEA in patients with functional dyspepsia and reported improvement in impaired gastric accommodation and gastric slow waves (electrical rhythms controlling peristalsis of the stomach). It was also reported that these effects were mediated via the vagal mechanisms. In another study by N. Da et al., electroacupuncture was used to treat patients with functional constipation and a comparison was made between shallow puncture and deep puncture. Both methods resulted in a significant increase in spontaneous bowel movement, and electroacupuncture with deep puncture was reported to be more potent than shallow puncture.

Herbal medicine has also been used for the treatment of FGID, such as STW 5 (Iberogast), Rikkunshito (also known as Liu-Jun-Zi-Tang), Daikenchuto, Simotang, Taraxacum officinale, modified Xiaoyao San, and Banxiaxiexin decoction [7]. In this special issue, Y. Saegusa et al. reviewed the treatment strategy of Rikkunshito for anorexia and gastrointestinal dysfunction. Rikkunshito was reported to improve gastric motility in both humans and animals and upper gastrointestinal symptoms such as dyspepsia, epigastric pain, and postprandial fullness in a number of clinical studies. Numata et al. in this issue reported improvement in functional constipation in poststroke patients with the use of Daikenchuto. A 4-week treatment with Daikenchuto significantly improved major symptoms or symptom scores associated with constipation in patients after stroke. In a placebo-controlled clinical study by Kamiya et al. in this special issue, Biobran, modified arabinoxylan rice bran, was reported to improve symptoms of diarrhea in IBS patients with diarrhea or mixed diarrhea and constipation, whereas no improvement was noted in the control group. It was speculated that the symptom improvement might be attributed to anti-inflammatory and/or immune modulatory effects of Biobran.

Behavioral therapies include cognitive behavioral therapy, hypnotherapy, relaxation exercise, mindfulness-based therapies, and biofeedback training. Most of these therapies have been applied for the treatment of FGID. One original study and one review paper are included in this special issue. In a study by Tang et al. an adaptive biofeedback training method was proposed and applied for the treatment of functional constipation due to paradoxical contractions of the rectum and the anal sphincter. In this method, the patients were trained to adequately control the contraction of the lower abdomen and relax the anal sphincter during straining; the actual manometric tracings showing the contractile activity of the rectum and anal sphincter were shown to the patients as visual feedbacks. A significant improvement in constipation-related symptoms was noted with both conventional and intensive biofeedback trainings.

In addition to original studies, this special issue also includes three reviews covering three major diseases of FGID, functional dyspepsia, IBS, and constipation. The paper by X. Wang and J. Yin provides a comprehensive and critical review on the applications of various CAM methods for the treatment of functional constipation. The review by M. Aucoin et al. provides a meta-analysis on the treatment of IBS using mindfulness-based therapies. The review by Y. Saegusa et al. presents a summary on the treatment of functional dyspepsia using a special herbal medicine, Rikkunshito.

Jiande  D. Z.  Chen
Jieyun  Yin
Toku  Takahashi
Xiaohua  Hou

Info – Acupuncture and Gastric Motility

rsz_eagle-herbs-card-newFor those with Stomach and Intestinal issues, I would suggest finding a licensed acupuncturist that you can see on a regular basis (eg: once a week for a few months).

This is along article about studies done that shows its benefits:

Gastrointestinal Motility Disorders and Acupuncture

Jieyun Yin, MD and  Jiande D Z Chen, Ph.D.


During the last decades, numerous studies have been performed to investigate the effects and mechanisms of acupuncture or electroacupuncture (EA) on gastrointestinal motility and patients with functional gastrointestinal diseases. A PubMed search was performed on this topic and all available studies published in English have been reviewed and evaluated. This review is organized based on the gastrointestinal organ (from the esophagus to the colon), components of gastrointestinal motility and the functional diseases related to specific motility disorders. It was found that the effects of acupuncture or EA on gastrointestinal motility were fairly consistent and the major acupuncture points used in these studies were ST36 and PC6. Gastric motility has been mostly studied, whereas much less information is available on the effect of EA on small and large intestinal motility or related disorders. A number of clinical studies have been published, investigating the therapeutic effects of EA on a number of functional gastrointestinal diseases, such as gastroesophageal reflux, functional dyspepsia and irritable bowel syndrome. However, the findings of these clinical studies were inconclusive. In summary, acupuncture or EA is able to alter gastrointestinal motility functions and improve gastrointestinal motility disorders. However, more studies are needed to establish the therapeutic roles of EA in treating functional gastrointestinal diseases.


Acupuncture is a traditional Chinese medicine treatment and has been practiced empirically in China for several millennia. The existence of acupuncture is believed to have been at least 4000 years. Acupuncture is accomplished by inserting the tips of thin, stainless steel needles on specific points (called acupoints) through the skin. Conventional acupuncture or called “manual acupuncture” involves the manipulation of the inserted needles by hand, such as lifting, thrusting, twisting, twirling or other complex combination. Electroacupuncture (EA) is a modification of this technique that stimulates acupoints with electrical current instead of manual manipulations, and appears to have more consistently reproducible results in both clinical and research settings (Li et al., 1992Lux et al., 1994). Transcutaneous electroacupuncture (TEA) is a method of delivering electrical current via cutaneous electrodes placed at acupoints. This method is noninvasive and similar to transcutaneous electrical nerve stimulation (TENS) in which the cutaneous electrodes can be placed anywhere, not necessarily at acupoints. TEA and TENS are similar because acupoints are commonly located in the vicinity of nerve dermatomes.

Acupuncture is being increasingly accepted by practitioners and patients in the West as well, especially during the last three decades (Goldstein et al., 1977Li et al., 1976NIH, 1998). Both conventional acupuncture and EA have been used for a variety of ailments, particularly for the relief of pain (Cheng et al., 1979Pomeranz et al., 1988). It has been confirmed that acupuncture or EA has therapeutic effects for postoperative dental pain, postoperative and chemotherapy-induced nausea and vomiting (NIH, 1998). During the last decade, a considerable number of studies have investigated the efficacy of EA for the treatment of functional gastrointestinal disorders. Human and animal studies were conducted to explore the effects of EA on gastrointestinal secretion, sensation, motility and myoelectrical activity (Diehl, 1999Li et al., 1992). In healthy volunteers, EA decreased basal acid output as well as sham feeding-induced (vagally mediated) acid output, but had no effects on the pentagastrin-stimulated acid output (Tougas et al., 1992). In rats with stress-induced gastric ulcer, EA was able to protect the stomach by thickening gastric mucosal barrier, stabilizing mast cells and decreasing the gastrin level in gastric mucosa (Shen et al., 1995).

Recently, a large number of studies have been performed to explore the efficacy of EA/TEA for the treatment of gastrointestinal motility disorders, and improvement in gastrointestinal symptoms has been reported in patients with various disorders associated with gastrointestinal motility (Chang et al., 2001Li et al., 1976Lin et al., 1997Ouyang et al., 2004aTakahashi, 2006). The aim of this review is to evaluate the efficacy and mechanisms of acupuncture or TEA on gastrointestinal motility disorders in both laboratory and clinical settings. PubMed search was performed using the combination of acupuncture with each of the followings: esophageal motility, lower esophageal sphincter, gastroesophageal reflux, gastric motility, gastric accommodation, gastric myoelectrical activity, gastric slow waves, electrogastrography, antral contractions, gastric emptying, functional dyspepsia, gastroparesis, small intestinal contractions, small intestinal transit, colonic transit, visceral sensation, irritable syndrome, constipation and diarrhea. Only articles published in English were reviewed and evaluated in this review.

Acupuncture and Esophageal Motility

Physiology of esophageal motility

The esophagus is a conduit that serves to transport swallowed contents from the oropharynx to the stomach. At the level of the gastro-esophageal junction (GEJ), there is a ring-shaped thickening of the muscle layer known as the lower esophageal sphincter (LES). The LES creates and maintains a high-pressure zone at the GEJ by tonic contractions, augmented by contractions of the crural diaphragm. The LES functions as a barrier preventing the reflux of gastric content into the esophagus. The action of swallowing can initiate peristaltic contractions from striated esophageal muscles that sweep along the esophageal body. The tonically contracted LES relaxes with the onset of peristalsis due to the simultaneous activation of the inhibitory nerves in the myenteric plexus, and remains relaxed until the peristaltic contraction closes the sphincter (Yamata, 1995)

Abnormalities of esophageal motility are classified based on the LES function and contractile patterns of the esophageal body, including diffused esophageal spasm, ineffective esophageal motility disorder, non-specific esophageal motility disorder, hypotensive esophageal motility, achalasia (Nebel et al., 1976). Diffuse esophageal spasm is characterized clinically by intermittent chest pain and dysphagia. Chest pain can vary from mild to crushing, extend to the back and jaw, and last from seconds to minutes. Dysphagia can be due to solids or liquids and often occur more commonly with ingestion of either very cold or very hot foods (Chen et al., 1989). Manometrically, ineffective esophageal motility this disorder is characterized with a low amplitude of contractions in the esophageal body. It is often seen in patients with scleroderma or gastroesophageal reflux disease (GERD) (Bassotti et al., 1997). The diagnosis of non-specific esophageal motility is often used in the evaluation of a patients with dysphagia and/or chest pain who has abnormal findings in esophageal motlity tracing, but does not fulfill the fixed criteria for other discrete diagnosis (Kahrilas, 2000). Achalasia is a disorder of both the LES and smooth musculature of the esophageal body. In patients with achalasia, the primary problems are a failure of the LES to relax completely during swallowing and a failure of the esophageal smooth muscle to produce peristalsis adequately (Koshy et al., 1997). Diseases associated with esophageal motility disorders include functional dysphagia, non-cardiac chest pain and GERD (Clouse et al., 1999Kemp et al., 1986Nebel et al., 1976).

EA and esophageal motility

Recently, a number of studies have reported the effects of EA on esophageal motility disorders. In one study, EA at ST 36 was found to increase LES pressure (LESP) and the peak amplitude of esophageal peristalsis in cats with myotomy (Shuai et al., 2008). In another study, EA at PC 6 was found to significantly reduce the frequency of transient lower esophageal relaxations (TLESRs) induced by gastric distension in normal cats (Wang et al., 2007). In healthy volunteers, EA at PC 6 decreased the number of TLESRs induced by gastric distension by approximately 40%, but had no effects on basal LES pressure, the residual pressure during TLESRs and the duration of TLESRs (Zou et al., 2005). Chang et al studied the effect of transcutaneous stimulation (TNS) on esophageal motility in healthy volunteers and found that TNS improved LES relaxation by 11.3% and increased percent of peristaltic contractions by 4.3% during swallow (Chang et al., 1996). In a study using dynamic scintigraphy, acceleration in esophageal transit was noted with auriculoacupuncture in patients suffering from cervical vertebopathy (Hep et al., 1999).


GERD is characterized by excessive reflux of gastric content (acid, pepsin, etc.) into the esophagus causing symptoms of heartburn and acid regurgitation, and mucosal inflammation and injuries. The development of GERD is usually associated with a decreased LESP, increased TLESRs and decreased esophageal clearance capacity (Xing et al., 2004a). It has been reported that that 44% of adult population complain of GERD-related symptoms in the U.S. (Fass et al., 2001Locke et al., 1997). Surprisingly, however, little has been reported in the literature on the efficacy of EA on GERD. Only one recent study by Dickman et al investigated the effect of EA on GERD by comparing the effect of EA added to a conventional proton pump inhibitor (PPI) therapy with that of doubling PPI dose in patients with refractory GERD. It was found that addition of acupuncture at ST36, PC6, SP9, CV12 and CV17 to the conventional PPI therapy was more effective than doubling PPI dose in reducing the symptoms of heartburn and acid regurgitation (Dickman et al., 2007). Apparently, more clinical studies are necessary to investigate the role of EA in the management of GERD.

Effects and mechanisms EA on gastric motility

Physiology of gastric motility

Gastric motility is one of the most critical physiological functions of the human gut. Without coordinated motility, digestion and absorption of dietary nutrients cannot take place. To accomplish its functions effectively, the gut needs to generate not just simple contractions but contractions that are coordinated to produce transit of luminal contents (peristalsis). Gastric motility functions include gastric accommodation, gastric myoelectrical activity (pacemaking activity), gastric contractions and gastric emptying described as follows:

  1. Gastric accommodation. When food enters the stomach, the proximal part relaxes during eating to accommodate the ingested food without producing a large increase in gastric pressure, this reflex is called “gastric accommodation” and is believed to be involved in the regulation of food intake (Gilja et al., 1996Kim et al., 2001bTack et al., 1998). The extent of gastric accommodation has been normally evaluated with Barostat and expressed as an increase in gastric volume in response to a meal (Kim et al., 2001a).
  2. Gastric myoelectrical activity. Beginning from the proximal one third and distal two thirds of the stomach to the pylorus, there is gastric myoelectrical activity consisting of two components, slow waves and spike potentials (Chen, 1995). The slow wave is omnipresent and occurs at regular intervals whether or not the stomach contracts. It originates in the proximal stomach and propagates distally toward the pylorus. The gastric slow wave determines the maximum frequency, propagation velocity and propagation direction of gastric contractions. When spike potentials (equivalent to action potentials in single cells) are superimposed on the gastric slow waves, a strong lumen-occluded contraction occurs. The normal frequency of the gastric slow wave is about 3 cycles/min (cpm) in humans and 5 cpm in dogs. A noninvasive method similar to electrocardiography, called electrogastrography, has been developed and applied to detect gastric slow waves using abdominal surface electrodes (Chen, 1995).
  3. Gastric contractions and gastric emptying. Coordinated and distally propagated gastric contractions are called gastric peristalsis. The gastric contraction is stronger in the antral area than the proximal stomach and is believed to play an important role in the regulation of solid gastric emptying. In healthy humans, the ingested food is usually emptied by 50% or more at 2 hours after the meal and by 95% or more at 4 hours after a solid meal (Tougas et al., 2000). In the postprandial period, there is electromechanical coupling: every slow wave is associated with one contraction. When the stomach is empty, the pattern of gastric contractions changes. The gastric contract pattern in the fasting state undergoes a cycle of periodic fluctuation divided into three phases: phase I (no contractions, 40–60 minutes), phase II (intermittent contractions, 20–40 minutes) and phase III (regular rhythmic contractions, 2–10 minutes)(Yamata, 1995).

Functional dyspepsia (FD) and gastroparesis are two common gastric motility disorders. Functional dyspepsia is characterized by symptoms of postprandial fullness, early satiation, epigastric pain and burning, in the absence of a readily identifiable organic cause (Tack et al., 2006). Gastroparesis is defined as severely delayed gastric emptying in the absence of mechanical obstruction, and classified as diabetic, postoperative and idiopathic according to its etiology (Abell et al., 2006). Main pathophysiologies of functional dyspepsia and gastroparesis include visceral hypersensitivity, impaired gastric accommodation and impaired gastric motility (antral hypomotility, impaired coordination, gastric dysrhythmia and delayed gastric emptying) (Chen et al., 1995Malagelada et al., 1980Tack, 2007Tack et al., 1998Tack et al., 2006).

Effect of EA on gastric accommodation

In the literature, few papers were found on the effect of EA on gastric accommodation (Ouyang et al., 2004b). It was reported that EA at ST36 restored vagotomy-induced impaired gastric accommodation in dogs but showed no effects on gastric accommodation in normal dogs. Impaired accommodation is often seen in patients with FD or gastroparesis. It is especially common in patients with diabetic gastroparesis due to autonomic neuropathy as the accommodation reflex is mediated via the vagal and nitrergic mechanisms. The ameliorating effect of EA on vagotomy-induced impairment in gastric accommodation suggests that therapeutic potential of EA for FD or gastroparetic patients with impaired gastric accommodation. In a rodent study with the use of strain gauge transducers, Tada et al reported that EA induced gastric relaxation in anesthetized rats (Tada et al., 2003). Clinical studies are needed to investigate whether these findings in the animals can be applied to humans.

Effects of EA on gastric slow waves

Effects of EA on gastric slow waves have been extensively studied in both animals and humans, apparently attributed to the availability of the noninvasive method of electrogastrography. In dogs with duodenal or rectal distention, EA at ST36 increased the regularity of gastric slow waves (Chen et al., 2008Ouyang et al., 2002), and the effect was found to be mediated via the opioid and vagal pathways (Chen et al., 2008Ouyang et al., 2002). In healthy volunteers, EA was reported to enhance the percentage of normal 2–4 cpm slow waves (Chang et al., 2002Chou et al., 2003Lin et al., 1997), and alter the frequency of gastric slow waves (Shiotani et al., 2004). In addition, the effect of EA on gastric slow wave frequency was EA site-specific: EA at PC 6 alone and EA at ST 36 alone showed opposite effects on gastric slow wave frequency, whereas EA at both PC6 and ST36 decreased slow wave frequency (Shiotani et al., 2004). The enhancement of gastric slow waves with EA was also noted in with TEA and acupressure (Chang et al., 2002Stern et al., 2001). In patients with diabetes and gastric dysrhythmia, EA was found to increase the percentage of normal slow waves and decrease the percentage of tachygastria (Chang et al., 2001). The ameliorating effect of EA on gastric dysrhythmia reported in various clinical studies has been consistent and reproducible, indicating the robust role of EA for the treatment of gastric slow wave dysrhythmia. In animal model, EA was reported to improve or normalize gastric dysrhythmia by increasing the vagal activity measured by heart rate variability, suggesting the involvement of vagal pathway (Chen et al., 2008Ouyang et al., 2002).

Effects of EA on gastric contractions

Gastric contractions play an important role in regulating gastric emptying. Gastric contractions can be measured by strain gauges (used in animals) and manometry (used clinically). The effects of EA on gastric contractions have been reported in rats (Iwa et al., 2007Sato et al., 1993Tatewaki et al., 2003), rabbits (Niu et al., 2007) and dogs (Chen et al., 2008Ouyang et al., 2002). Sato et al reported that in anesthetic rats, gastric contractions in the pyloric region were inhibited by acupuncture-like stimulation applied to the abdomen or lower chest region, and excited when the limbs were stimulated (Sato et al., 1993). Niu et al reported that EA at ST 36 significantly increased the number and amplitude of spikes assessed from gastric myoelectrical activity, indicative of increased gastric contractions, in rabbit, and that the effect was mediated via the cholinergic nerve (Niu et al., 2007). In dogs, EA was found to improve impaired antral contractions induced by rectal distension and the ameliorating effect involved the opioid pathway (Chen et al., 2008). These previous findings indicate that the stimulatory effect of EA on gastric contractions is consistent among different species. Inhibitory or dual effects of EA on gastric motility were also reported in a few studies (Qian et al., 1993Tatewaki et al., 2003Yuan et al., 1986Zhou, 1986). In a rodent study with the measurement of gastric contractions using strain gauge transducers Tatewaki et al reported that manual acupuncture at ST36 induced dual effects: stimulating gastric contractions in rats with hypomotility and inhibiting gastric contractions in rats with hypermotility. It was further reported that the stimulatory effect was medicated in part via the vagal and opioid pathway (Tatewaki et al., 2003). In general, the inhibitory or dual effects of EA were not as consistent as the excitatory effects of EA on gastric contractions; more data are needed to support the inhibitory or dual effects of EA on gastric contractions.

Effects of EA on gastric emptying

Acceleration of gastric emptying with acupuncture has been reported in both animals and humans (Iwa et al., 2006bOuyang et al., 2002Tabosa et al., 2004Wang et al., 2008Xu et al., 2006). In rats with delayed gastric emptying induced by restraint stress, EA at ST36 was found to significantly improve gastric emptying of solid (Iwa et al., 2006b). Similar accelerative effect of EA on solid gastric emptying was also reported in normal rats (Tabosa et al., 2004). In dogs with delayed gastric emptying induced by duodenal distention, EA at PC6 and ST36 significantly accelerated gastric emptying and concurrently increased vagal activity assessed by the spectral analysis of the heart rate variability, suggesting a possible vagal mechanism (Ouyang et al., 2002). In patients with gastroparesis, EA at ST36 and PC6 accelerated solid gastric emptying measured by scintigraphy (Xu et al., 2006).

Application of EA in treating FD or gastroparesis

Compared to the animal studies on gastric motility with EA, little information is available on the application of EA in treating functional dyspepsia or gastroparesis. In a recent double-blind, cross-over study in 27 FD patients, TEA at ST36 and PC6 (twice weekly for a period of 2 weeks) reduced dyspepsia symptoms by 55% (Liu et al., 2008); an increase in vagal activity noninvasively assessed from the heart rate variability and in plasma level of neuropeptide Y was also noted, suggesting the involvement of the vagal and hormonal pathways. In another controlled clinical study with 68 FD patients, manual acupuncture at acupoints resulted in a significant improvement in dyspeptic symptoms in comparison with acupuncture at non-acupoints (Park et al., 2009). In a non-controlled study involving 19 FD patients, chronic EA at ST36 and PC6 significantly reduced dyspeptic symptoms at both 2 weeks and 4 weeks after the treatment in the FD patients with normal gastric emptying, whereas acute EA at ST36 and PC6 improved gastric emptying in the patients with delayed gastric emptying in comparison with EA at non-acupoints (Xu et al., 2006). The acceleration of gastric emptying and improvement in dyspeptic symptoms with EA were also reported in a 2-week single-blinded controlled study involving 9 diabetic patients with symptoms suggestive of gastroparesis; in that study, EA was performed at ST36 and LI4 (Wang et al., 2008).

Effects and mechanisms of EA on intestinal motility and transit

Physiology of small intestinal motility

Small intestinal motility exhibits two distinct patterns: fasting and fed. The typical manifestation in the fasting state is the migrating motor complex (MMC). The MMC consists of three phases with considerably varying durations: Phases I, II and III. Phase I is a period of motor quiescence, representing 20% to 30% of the total cycle length. Phase II is characterized by intermittent and irregular contractions with a duration of 40% to 60% of the cycle length. Phase III is a 5–10 minute period of intense, rhythmic contractions that propagate from the proximal to distal intestine. After a meal of sufficient nutrients, the fasting pattern of motility is switched to the fed pattern characterized by intermittent phasic contractions of irregular amplitude similar to those of phase II of the MMC. Intestinal motility controls the transportation and absorption of the ingested nutrients. Intestinal dysmotility includes absence of the MMC, impairment of the MMC, such as impaired propagation of the MMC along the gut, postprandial hypomotility and hypermotility.

Effects of EA on intestinal motility in animals and humans

Little efforts have been made in the investigation of the effect of EA on small intestinal motility, probably attributed to the lack of noninvasive methods for the measurement of intestinal motility. In dogs with intestinal motility assessed by duplex Doppler sonography, EA at ST36 was reported to increase the frequency of intestinal movement by 20% , whereas EA at BL27 decreased the frequency of intestinal movement by 31% (Choi et al., 2001). In rats, EA at hindlimb acupoints (ST36 and SP6) significantly enhanced small intestinal transit assessed by counting plastic beads administered orally (Tabosa et al., 2004). In mice, intestinal contractions were enhanced with EA and the effect was blocked by atropine (Iwa et al., 1994). In rabbits, EA at ST36 and SP6 reduced the inhibitory effect of morphine on duodenal peristalsis (Dai JL, 1993).

No convincing clinical studies are found in the literature showing the effect of EA on intestinal motility. In twenty healthy volunteers, EA at Siguan points (bilateral points LI4 and LR3) was shown to have little effects on small and large intestinal transit assessed radiographically (Yim et al., 2007). However, the sensitivity used for the assessment of the intestinal transit was questionable. In another study involving women with hysterectomy, acupressure was performed at PC-6, ST 36 and SP6 was found to improve gastrointestinal contractions in comparison with acupressure at sham points (Chen et al., 2003). However, the validity of this study is questionable as the acupressure was performed for only 3 minutes each time and the gastrointestinal contractions were assessed by a multifunctional stethoscope, a method that would not be approved by any expert working in the field of gastrointestinal motility. Apparently, clinical studies are needed to investigate the role of EA in treating patients with small intestinal motility disorders, such as postoperative ileus and chronic intestinal pseudo-obstruction. The invasive nature of the methods used in the assessment of intestinal contractions may explain the lack of clinical studies in this area.

Effects and mechanism of EA on colon motility and transit

Colonic motility

The colon functions mainly as a storage organ with moderate absorptive capacity for water, electrolytes, and nutrients. In the colon, there are individual phasic contractions and giant migrating contractions. The individual phasic contraction is the basic unit of contractile activity and occurs during the fasting and fed states. There are two types of individual contractions in the colon: short-duration and long-duration. Short-duration contractions last less than 15 sec and the long-duration contractions last 40–60 sec in the dog and human colon (Huizinga et al., 1985Sarna et al., 1982Sarna, 1991aSarna, 1984). Ingestion of a meal stimulates colonic motility (gastrocolonic reflex) and the colon (motility) goes to sleep with a person goes to sleep. The pattern of individual phasic contractions is complicated with a lack of specific dominant frequencies, probably associated with one of main functions of the colon: storage. The bowel movement is achieved by the giant migrating contractions (Torsoli et al., 1971Williams, 1987). The giant migrating contractions occur rarely, no more than once or twice a day in humans. Spontaneous mass movements and their associated giant migrating contractions occur mainly in the proximal colon, the mean migration distance in the canine colon is about 13 cm (Sarna, 1991a). Disrupted colonic motility has been associated with various functional diseases, such as irritable bowel syndrome (IBS), constipation and diarrhea.

EA on colonic motility

EA on colonic motility has been investigated in animal models. In conscious rats, EA at ST36 was reported to significantly increased contractility of the distal colon measured by manometry, and the stimulatory effect was mediated via the cholinergic pathway (Luo et al., 2008). Similar findings were also reported in an earlier rodent study: EA at ST36 increased colonic transit mediated via the sacral parasympathetic efferent pathway (Pelvic nerve) (Iwa et al., 2006a). In contrast, in rats with restraint stress, EA was reported to inhibit stress-induced acceleration in colonic transit and the inhibitory effect was independent of the sympathetic pathway (Iwa et al., 2006b). In 17 children with chronic constipation, acupuncture at ST36, LI2 and LI4 gradually increased the frequency of bowel movement as well as the plasma opioid level during a 10-week treatment period (Broide et al., 2001).

EA and IBS

IBS is most common among various functional gastrointestinal disorders, affecting around 15% of the general population. IBS manifests by altered bowel habit with abdominal pain. No specific, bacterial, biochemical or morphological abnormality can be identified in these patients (Sarna, 1991b). A lowed sensory threshold to rectal distension is a hallmark of IBS patients (Bouin et al., 2002Poitras et al., 2002). The therapeutic role of EA for IBS has not been established. A few studies have reported ameliorating effects of acupuncture on IBS symptoms whereas, others suggested purely placebo effects (Anastasi et al., 2009Chan et al., 1997Lembo et al., 2009Rohrbock et al., 2004Schneider et al., 2006). In an open-design pilot study, patients with IBS showed a significant improvement both in general well-being and in symptoms of bloating (Chan et al., 1997); In a randomized, sham/placebo-controlled trial in 29 IBS patients a significant improvement was observed in daily abdominal pain/discomfort, intestinal gas, bloating and stool consistency after 4-weeks of acupuncture of twice weekly at CV12, ST25 and CV6 et al (Anastasi et al., 2009). In a controlled clinical trial of 43 IBS patients, Schneider et al reported a significant improvement in global quality of life at the end of both acupuncture and sham-acupuncture treatment, and suggested a placebo effect of EA; the authors suggested that a study including 566 patients would be necessary to prove the efficacy of acupuncture over sham acupuncture (Schneider et al., 2006). The same group later reported a significant increase in parasympathetic tone with EA but not sham EA and suggested that different mechanisms may be involved in placebo and real-acupuncture driven symptom improvements in IBS patients (Schneider et al., 2007).

Unlike the improvement in IBS symptoms, the improvement in visceral sensation with EA is less controversial and has been consistently reported in both animals and humans (Cui et al., 2005Xiao et al., 2004Xing et al., 2004bXu et al., 2009). In a rodent model of IBS, EA at ST36 attenuated visceral hypersensitivity involving the opioid pathway and inhibited the enhanced excitability (attributed to neonatal injection of acidic acid) of colon specific dorsal root ganglion neurons, (Xu et al., 2009). In patients with IBS, TEA at ST36 and PC6 increased the threshold of rectal sensation of gas but showed no effects on rectal tone or rectal compliance (Xing et al., 2004b). In another study with the treatment regimen of twice per week for 2 months, TEA at LI4 and ST36 improved IBS symptoms and abnormal rectal sensation in diarrhea-predominant IBS (Xiao et al., 2004).

Discussion and conclusion

Based on the evidences from the studies in both animals and humans, EA has the potential for treating gastrointestinal motility disorders. As shown in the summary table, EA increases LES pressure and reduces TLESRs, and therefore may be beneficial to patients with GERD. With regarding to gastric motility functions, it seems that EA enhances gastric accommodation, slow waves, contractions and emptying; suggesting a therapeutic potential for functional dyspepsia and gastroparesis. Little is reported on the effect of EA on small intestinal motility and therefore its role for treating patients with intestinal motility disorders has not been established. Similarly, not much is known on the effect of EA on colon motility and the therapeutic effects of EA for common functional bowel disorders, such as IBS, constipation and diarrhea, are not conclusive.

Acupuncture or EA has advantages of being noninvasive and practiced for many years. Accordingly, ample clinical data are available on the application of EA for treating various disorders. With regard to its applications for the treatment of gastrointestinal motility diseases, however, there are a number of problems: 1) most of the available methods used for the assessment of gastrointestinal motility are noninvasive, making it less feasible for basic and clinical research; 2) patients with functional gastrointestinal disorders are heterogeneous with unclear pathophysiologies or pathogenesis, and therefore the outcome of the treatment of these patients is typically controversial not only with EA but also with other therapies; 3) based on our review of the literature, there are also issues including the methodology of EA, study design and outcome measurements. Different methods have been used for the implementation of acupuncture, including, manual acupuncture, EA, TEA and acupressure, and these different methodologies make it difficult for the comparison of the efficacy of EA. In some studies, the parameters of EA that are important for the success of the therapy (Han, 2003) were not mentioned or appropriately determined; whereas in other studies, the experimental designs were not adequate and the measurement methods were inadequate.

We believe that EA has a great therapeutic potential for treating gastrointestinal motility disorders and functional gastrointestinal diseases. Future clinical studies with EA should follow rigid scientific designs, optimize methodologies and apply cut-edge outcome measures. In most of clinical studies, symptoms (subjective) are primary endpoints and therefore the experiment must be controlled and blinded if feasible. For the implementation of EA, efforts should be made in the selection of acupoints and stimulation parameters, the duration and frequency of EA. In addition, physiological measurements should also be made in clinical studies to understand possible mechanisms and pathways involved with EA.

In conclusion, acupuncture or EA is able to alter gastrointestinal motility functions and improve gastrointestinal motility disorders. However, more studies are needed to establish the therapeutic roles of EA in treating functional gastrointestinal diseases, such as GERD, functional dyspepsia, IBS, constipation and diarrhea.


No Sleep or Sleep Too Much

Screen Shot 2014-07-28 at 2.44.40 AM

Click on the giraffe’s eye and explore different Chinese formulas for Insomnia here. You are getting sleepy, sleepy…


Soft music for Insomnia- Music for Acupuncture You Tube

Soft music for Insomnia- Music for Acupuncture- You Tube link- Not ASMR but pretty gentle.

You can buy the CD’s here….


Somnolence or Hyper-somnolence is the flip-side of insomnia. It is the feeling of always wanting and being able to sleep. It is a bit tricky to talk about because many people often feel tired for a number of reasons and more often than not it is because we simply don’t get enough sleep. For many, 9 hours is a normal amount of sleep. You may hear of people who can “get by” on 6 hours of sleep but some people simply need more. Somnolence is not this condition. It is for people who can and do sleep well – too well.

In Chinese, the condition of somnolence is known as duomei 多寐 which translates directly as “sleeping a lot”. Sometimes tiredness comes from some one with severe health problems or a disease. Obviously only treating the sleepiness is secondary  in importance to treating the disease.

Somnolence is many times not just not having enough “qi” or energy. If you feel better by getting a little exercise then probably you have an “excess”. Giving tonics like ginseng things will only make it worse. If the body feels heavy then you might be a little (or a lot) depressed emotionally. This will cause stagnation or “constraint” on all the emotional/ physical systems. For this you want herbs that will move the “qi”.

Chinese medicine puts great importance on the digestive function. We call this the Spleen/ Stomach system. The Spleen system lifts the qi upward to the rest of the body. When this function becomes deficient then the muscles become tired and the brain is not fed the proper nutrients. Both body and mind feel tired. Usually the person eats too much to make up for the lack of nutrients. There will be a slow down of the digestion and there might be nausea or acid reflux.
The key formula for this condition above is Ping Wei San.

The spleen system also transforms the fluids from what is eaten and drunk. Often times this creates a build up of fluids. Like wearing wet clothes, this slows down the body and tires it out. There might be dizziness, indecisiveness, slight confusion and frustration. The tongue coating may extremely thick and yellowish.
The key formula for the above condition is Wen Dan Tang.

If sleep apnea is suspected relief is often found with Ban Xia Hou Po Tang. This formula was originally for stress which manifests as a feeling of something “stuck” in the throat. The herbs target this area of the body and nowadays we often use it to move the qi at the throat area.

If the person becomes extremely fatigued in daytime or after just a little exercise and also often feels really cold (not just hands and feet but the whole body) then this might be what is called a spleen and kidney yang deficiency. There might be some form of edema or weight gain. Along with the cold body there might also be extreme fatigue, incontinence, lack of libido, impotence and sleeps curled up. The place to start with this type of presentation is Ba Wei Di Huang Wan.
Screen Shot 2015-08-16 at 10.26.14 AM
Still can’t Sleep? The Eagleherbs website is not boring enough for you? Click on the bird and spend 20 minutes on a quiz for finding the right Chinese herbal formula for you.

Liver Information

The “Liver” in Chinese Medicine is the liver. I mean they were talking about that organ underneath our rib cages. But Chinese medicine also describes the functions of all the organs in great detail. That is what follows… FYI: one researcher says that the Liver had two parts much like the Lung and Kidneys have left and right parts. He claims the left side is the spleen. Today we think what has been translated as the spleen is actually the pancreas.

So keep that in mind as you read these rather complex and detailed writings.

The following is from a book I co-wrote: Fundamentals of Chinese Medicine for PMPH (People’s Medical Publishing House) in China. This is just one paragraph of many pages describing the Liver system as seen in Chinese Medicine.

Screen Shot 2015-08-16 at 10.29.23 AM

The liver is yin in form, but yang in function.

The structure of the liver enables it to store blood, so its form belongs to yin. The liver governs the free flow of qi, which is a yang function; thus the saying, “The liver is yin in form but yang in function.” If the liver blood is deficient and fails to nourish, sinews and eyes can become affected. The liver functions of governing the free flow of qi and storing blood are complementary and interdependent. The freeing function concerns the smoothness of qi movement, and the storing function concerns the storage and regulation of blood; both are required to maintain the harmony of qi and blood. When the liver maintains the free flow of qi, the movement of qi will be smooth and thus blood circulation remains normal, but when the liver fails to maintain the free flow of qi, the resulting stagnation of qi can also lead to patterns of blood stasis. Qi stagnation can also lead to internal fire that causes blood to move frenetically, forcing blood to extravasate from the vessels. With hyperactive liver qi where the blood follows the disordered qi movement, there may be headaches, bleeding, or irregular menstruation. If liver yin becomes deficient, impaired cooling and moistening may lead to hyperactive ascending of liver qi with a stirring of internal wind. The Inner Classic (Neijing) states, “When the movement of liver-wood is excessive, this will cause wind, and spleen-earth will be injured.” The resulting lack of blood can also cause internal wind. The pattern of deficient blood producing wind is commonly associated with conditions such as …(those)… disorders involving tremors.


Yin Deficiency

Here are some brief notes about Yin Deficiency from my (co-written) book: Fundamentals of Chinese Medicine (PMPH 2015)

“Yin deficiency heat involves the appearance of more (predominant) heat even when there is no increase in the actual amount of heat in the body. The relative appearance of more heat is due to the insufficiency of yin qi with a subsequent failure to restrain yang qi. Again, this is important in treatment, because strongly clearing heat from the body can easily damage yin further and thus aggravate the condition. Therefore, the main treatment principle here is to supplement yin while also gently eliminating heat.”

“Yin deficiency resulting in intense firei involves a deficiency-type fire that results in damage to yin qi and a deficiency of fluids that is so severe that yin qi fails to restrain yang qi. The relative excess of yang qi then generates intense heat and fire that further damages yin. Generally speaking, internal heat with yin deficiency often manifests deficiency heat symptoms such as night sweating, a red tongue with little coating, and a thready, rapid forceless pulse. Intense fire with yin deficiency commonly shows fire-heat symptoms in a localized part of the upper body, including toothaches, bleeding gums, sore throat, or flushed cheeks.”

i (阴虚火旺, yin xū huŏ wàng) yin deficiency with intense fire


Qi Stagnation

Screen Shot 2015-08-16 at 10.31.52 AMThe following is an excerpt from my (co-written) book: Fundamentals of Chinese Medicine (PMPH press) 2015

Qi stagnation (qi zhì气滞) is state of obstructed or stagnated qi flow in a particular part of the body. Qi stagnation can be associated with excess internal phlegm or dampness, food accumulation, blood stasis, heat constraint, zang-fu organ impairment or emotional depression. Any of these can impact the flow of qi and lead to a localized stagnation of qi movement that lead to functional disturbances of the zang-fu organs as well as the channels and collaterals. Qi stagnation is usually considered to be an excess-type pattern, although stagnation can result from patterns of deficient qi failing to move qi and blood. Manifestations of qi stagnation usually include distention, fullness and pain, chest distress, cough, and/or shortness of breath, as well as possible related signs of blood stasis or phlegm-fluid retention.

Qi stagnation has various clinical signs, but the most common characteristics simply involve a dull, achy discomfort. When qi stagnation combines with blood stasis, the result is a sharper pain, such as from over-exercise. (A very sharp pain such as from a bruise is attributed more to blood stasis alone, while a stabbing pain is often attributed to qi stagnation due to cold.)

Body Differences

This is a very cool text from our (USA) government’s website about the cultural differences of the body (somatic) perception of emotions. (The illustrations are inserted by

Front Psychol. 2014; 5: 1379.
Published online 2014 Dec 3. doi: 10.3389/fpsyg.2014.01379
PMCID: PMC4253951
Cross-cultural differences in somatic awareness and interoceptive accuracy: a review of the literature and directions for future research
Christine Ma-Kellams*
Author information ► Article notes ► Copyright and License information ►

This review examines cross-cultural differences in interoception and the role of culturally bound epistemologies, historical traditions, and contemplative practices to assess four aspects of culture and interoception: (1) the extent to which members from Western and non-Western cultural groups exhibit differential levels of interoceptive accuracy and somatic awareness; (2) the mechanistic origins that can explain these cultural differences, (3) culturally bound behavioral practices that have been empirically shown to affect interoception, and (4) consequences for culturally bound psychopathologies. The following outlines the scope of the scientific review. Part 1 reviews studies on cultural variation in spontaneous somatic word use, linguistic expressions, traditional medical practices, and empirical laboratory studies to assess the evidence for cultural differences in somatic processes. Integration of these findings suggests a startling paradox: on the one hand, non-Western cultures consistently exhibit heightened somatic focus and awareness across a variety of contexts; on the other hand, non-Western cultures also exhibit less interoceptive accuracy in laboratory studies. Part 2 discusses the various mechanistic explanations that have been proposed to explain these cultural differences in somatic awareness and interoceptive accuracy, focusing on cultural schemas and epistemologies. Part 3 addresses the behavioral and contemplative practices that have been proposed as possible “interventions,” or methods of cultivating bodily awareness and perceptual accuracy. Finally, Part 4 reviews the consequences of interoception for psychopathology, including somatization, body dysmorphia, eating disorders, and anxiety disorders.

Keywords: culture, somatic awareness, interoception, somatization, meditation
How does culture shape interoception? A growing body of psychological research has compellingly demonstrated that humans are a uniquely cultural species insofar as the extent to which we are able to learn from our social groups and the extent to which such learning can radically change a broad spectrum of our thoughts, feelings, and behaviors (Tomasello, 1999; Richerson and Boyd, 2005; Heine and Norenzayan, 2006). As a result of these advances, many of the most foundational psychological processes previously assumed to be universal have been shown to be profoundly culturally bound (for review, see Heine and Norenzayan, 2006).

Although this notion that culture shapes our most basic features of our psyche has been applied to a host of processes, there has been few attempts to systematically understand how cultural forces shape awareness of the body. Thus, the purpose of this review is to elucidate the role of culturally bound epistemologies, historical traditions, and contemplative practices in shaping somatic awareness and interoceptive accuracy. Given the multitude of ways that a process as complex as interoception and culture can be studied, the approach here will be interdisciplinary—bringing together evidence from anthropology, clinical science, and psychology.

Specifically, the review will focus on four key features of culture and interoception. First, I will review both empirical and ethnographic evidence that examines the extent to which members from Western and non-Western cultural groups exhibit differential levels of somatic awareness and interoceptive accuracy (Part 1). From there, I will discuss the proposed mechanistic origins that can explain these cultural differences (Part 2). I will then review culturally bound behavioral practices that have been empirically shown to affect interception (Part 3), and end with a discussion for how culturally bound interoception many have consequences for culturally bound psychopathologies (Part 4).

As with virtually all scientific inquiry, the first step to understanding a complex phenomena is to predict and discover interesting features of the process at hand (see Cronbach, 1986; Rozin, 2001, for review). In the context of cultural processes and interoception, this first stage involves identifying key cultural differences in the way individuals perceive and understand their own bodies. To what extent do people from different cultural backgrounds vary in their somatic awareness and interoceptive accuracy?

The question of how cultures differ in somatic awareness and interoceptive accuracy is a challenge because the two process, albeit related, may not align insofar as whether or not cultural differences in the one also entails (the same) cultural differences in the other. Somatic or interoceptive awareness centers on the extent to which individuals find bodily cues salient, whereas interoceptive accuracy centers on individuals’ abilities to accurately infer the cause and magnitude of their bodily changes. While interoceptive awareness is typically operationalized as the frequency of reporting bodily sensation and beliefs about the importance of such bodily states, interoceptive accuracy is typically operationalized as the degree of precision in reporting actual bodily states (e.g., heart rate). This distinction is also reflected on the neural level, as somatic awareness and interoceptive accuracy rely on different brain mechanisms (Critchley et al., 2004). Somatic awareness stands as a firmly top–down process that is driven by attention, beliefs and expectations (Rimé et al., 1990; Philippot and Rimé, 1997). In contrast, interoceptive accuracy depends on both bottom–up processes (e.g., the detection of bodily cues and the presence of physiological features that facilitate such detection, such as fitness level—Jones et al., 1987), as well as top–down ones (e.g., attention, cultural schemas—Pennebaker and Hoover, 1984; Van den Bergh et al., 1998; Wiens, 2005). Thus, the former does not serve as simply a proxy for the latter. Indeed, outside the cultural literature, a number of studies have found that awareness and accuracy can be dissociated (Pennebaker and Hoover, 1984; Gardner et al., 1990; Pennebaker, 1995; Critchley et al., 2004), or even inversely related (Fairclough and Goodwin, 2007). Given their qualitative differences, evidence for cultural differences in each process will be reviewed separately, and their implications will subsequently be discussed.

eagle herbs safe Chinese herbs sold to consumers over the internetThese challenges in disentangling somatic awareness from interoceptive accuracy are further complicated by the fact that somatic awareness is, in itself, a multi-faceted construct that have been construed in different ways across different disciplines (for review, see Mehling et al., 2012). On the one hand, somatic awareness can be defined by the outcome achieved by focusing direct attention on in-the-moment bodily changes and affective responses; training aimed at increasing this type of awareness (e.g., concrete somatic monitoring; sensory discrimination) suggests that it can be adaptive (Flor et al., 2001; Watkins and Moulds, 2005). In contrast, ruminating on the body for the purpose of vigilance appears to be a less adaptive form of somatic awareness (Cioffi, 1991; Cioffi and Holloway, 1993; Watkins and Moulds, 2005). Additionally, a further distinction can be made between proprioceptive versus interoceptive awareness. While the former centers on perception of muscles, joints, movements, posture, and balance (Laskowski, 2000), the later centers on perception of internal bodily sensation—including, but not limited to: heart rate, breathing, and hunger (Vaitl, 1996; Cameron, 2001; Craig, 2002; Barrett et al., 2004).

Given this multi-dimensional nature of somatic awareness, it is difficult to draw conclusive inferences about the nature of cross-cultural variation in how people perceive bodily states. Nevertheless, convergent evidence from both empirical studies and ethnographic work is suggestive that members of a number of non-Western cultures may exhibit higher levels of somatic awareness than members of Western cultures. In their seminal work on culture, emotion, and language, Tsai et al. (2004) found that Chinese–Americans respondents consistently used more somatic words than European–Americans when discussing a variety of events, including their relationships, early childhood experiences, and conversations with their romantic partners; furthermore, even among Chinese–Americans, those who were less acculturated to North-American culture exhibited this greater reliance on somatic words relative to those who were more acculturated. This finding is consistent with a broad body of work that has suggested that Chinese culture perceives bodily and psychological states to be closely intertwined (Kleinman, 1986; Ots, 1990). Likewise, close examination of the findings on culture and the self from Kanagawa et al. (2001) study on spontaneous self-description among college students highlights the disproportionately higher use of somatic descriptors among Japanese compared to North Americans. Taken together, these findings suggest that East-Asians appear to demonstrate a greater emphasis on their bodily states when describing themselves and their emotional experiences.

Additional evidence from linguistics suggests that this greater emphasis on somatic cues in everyday life among East-Asians may be traced back to historic traditions steeped within Asian language and medicine. In the Chinese language, for example, many idiomatic emotional expressions use the body parts (specifically, visceral organs) as metaphors: xuan-xin diao dan (to have one’s heart in one’s mouth), ti xin diao dan (lift the heart, hang the gallbladder), dan-zhan xin jib (gall trembling, heart startled), dan-po xin jin (gall breaking, heart startled), jing-xin diao-dan (shock the heart, drop the gallbladder), xin-dan ju lie (heart and gallbladder, both split), all refer to states of fear, where the heart and the gallbladder are described as lifted, hanging in the air, jolted, broken, dropped, or torn. We find the same pattern of somatic focus in Chinese holistic medicine, which model the body as a powerful psychological force. According to traditional holistic models of the human body, decision-making and thought reside primarily not in the mind, but in the liver, the site of contemplation; the gallbladder, the place where judgments are made; and the heart, the executive center (Ye, 2002).

Similar cultural patterns also emerge in other East-Asian cultures. In Japanese, anger starts off by being contained the belly (hara), then progresses to the chest (mune), and finally reaches the head (atama; Matsuki, 1995). Given that cultural ideas and language have long been argued to be inseparable—after all, language stands as the primary mechanism for transmitting cultural ideas (Wierzbicka, 1993, 1995; Tomasello, 1999; Slobin, 2003)—these provide convergent evidence of cross-cultural variation in the degree to which individuals emphasize somatic experiences.

herbmaskfaceEast-Asians cultures are not the only non-Western cultural groups that exhibit this pattern. A growing number of recent studies has found that many cultural groups, including those from Papua New Guinea (Lindström, 2002), aboriginal Australia (Turpin, 2002), and West Africa (Geurts, 2003) display a similar emphasis on the body. In the West African case, anthropologists have observed that cultural terms exist that refer exclusively to bodily sensations for which there is no English translation (e.g., “seselelame,” which can be roughly translated as “feel-feel-inside-the-body”—Geurts, 2003). Likewise, many West-African languages use the body as a basis for their emotional terms (Ameka, 2001; Dzokoto and Okazaki, 2006), much like the way they are used in Chinese and Japanese. Likewise, African traditional medicine also focuses on harmony and holism, treating the body and mind as fundamentally integrated rather than separate (Mbiti, 1970). In line with these cultural practices, it is not surprising that recent research by Dzokoto (2010) and Chentsova-Dutton and Dzokoto (2014) found that West-Africans also self-reported greater sensitivity to bodily changes relative to European–Americans.

Taken together, these findings offer suggestive—but not definitive—evidence for cultural variation in somatic awareness. At best, the majority of the aforementioned work has yielded indirect evidence for a greater cultural emphasis on bodily parts and processes among members of non-Western cultural groups—namely, East-Asians and West-Africans. Given the indirect nature of this evidence, it remains unclear the precise nature and form of these cross-cultural differences, and whether they extend to proprioception or interoception, mindful awareness of bodily states or vigilant monitoring of bodily cues.

These limitations notwithstanding, to what extent does this potential cultural difference in somatic awareness translate into interoceptive accuracy? As a construct, interoceptive accuracy stands as a crucial feature of numerous emotion theories (e.g., James, 1884; Schachter and Singer, 1962; Damasio, 1994) with a wide range of consequences for a variety of psychological processes, including self-regulation (e.g., Barrett et al., 2004), decision-making (e.g., Werner et al., 2009) and attention (e.g., Matthias et al., 2009). Although the majority of studies to date on interoceptive accuracy have focused on individuals’ abilities to accurately detect cardiac signals given its non-invasive nature, more recent findings suggest that cardiac accuracy predicts other forms of accuracy—namely, sensitivity for gastric functions, and thus may reliably stand as a more general indicator of interoceptive accuracy (Herbert et al., 2012b). Furthermore, a number of individual differences, situational forces and practices can influence interoceptive accuracy, including: food deprivation (e.g., Herbert et al., 2011), gender (e.g., Koch and Pollatos, 2014a); obesity (e.g., Herbert and Pollatos, 2014), and disordered eating (e.g., Koch and Pollatos, 2014b).

A striking paradox emerges in the literature on culture, somatic awareness, and interoceptive accuracy. Until now, few studies have dealt specifically with the relationship between culture and internal bodily states. The bulk of the existing literature has focused exclusively on actual (rather than perceived) bodily changes and has found few, if any, cultural differences (Tsai et al., 2002; Soto et al., 2005). Thus, it appears that there is little evidence for consistent cross-cultural variation in actual bodily events.

Nevertheless, recent work by Ma-Kellams et al. (2012) found that when it comes to perceiving bodily changes, East-Asians are less accurate than European–Americans. Across four studies, East-Asians consistently demonstrated less interoceptive accuracy: they were more likely to misattribute the cause of their bodily changes and displayed greater discrepancies between their perceived and actual bodily states (in this case, heart rate).

Chentsova-Dutton and Dzokoto (2014) found a similar pattern of results with West-Africans. Despite the fact that West-Africans reported higher levels of interoceptive awareness, they nevertheless displayed less interoceptive accuracy—as in the previous case, they were less able to accurately report their heart rate relative to European–Americans. Taken together, these two studies offer limited and tentative evidence for an interesting paradox: both East-Asians and West-Africans are simultaneously more aware of their own bodies (“aware” insofar as they find bodily features more salient in everyday life and report higher levels of somatic sensitivity), and yet they display a relative inability to accurately infer bodily changes. How can this be?

Part 1 of this review, in identifying the key differences in somatic focus and interoceptive accuracy between Western and non-Western cultural groups, highlighted an important puzzle: members of East-Asian and West-African cultures appear to be both more somatically focused and more inaccurate in their somatic inferences. This raises the deeper issue of how the previously observed cultural differences in interoception can by explained. In the following sections, I articulate the divergent proposed explanations for these cultural differences in somatic focus and interoceptive accuracy.

Given that culture, at its core, consists of collectively shared meaning systems that involve beliefs, values, language, and rituals that serve to both produce behavior in culturally consistent way and reinforce such behavior (Kroeber and Kluckhohn, 1952), it is not surprisingly that the long-standing explanation put forth for why cultures vary in the degree of somatic focus is differences in these culturally specific meaning systems. However, there lacks a consensus as to which feature of culture is the critical one that can explain differences in bodily focus. Some scholars argue that differences in cultural conceptualizations of the body and how it relates to other key features of the self is the primary process at hand; namely, Eastern cultural models of the self and emotion portray the body as fundamentally entwined with the body (Kleinman, 1986; Ots, 1990). Other scholars, in contrast, contend that differences in language is the critical driving force, and that for members of a Chinese-speaking culture, for example, somatic and emotion words are less differentiated (i.e., bodily words are oftentimes embedded in other words—Tung, 1994).

Work by Tsai et al. (2004) addresses this question of mechanism by dissociating cultural conceptions from language. In comparing European–Americans, less-acculturated Chinese–Americans, and more-acculturated Chinese–Americans speaking the same language (i.e., English), they were able to directly contrast the effects of cultural beliefs while holding language constant. If differences in somatic focus between members of Eastern and Western cultures were the product of language differences, then their experimental design would have yielded no differences between the three cultural groups given that all spoke the same (English) language. If somatic focus differences were the product of culturally specific conceptions about the psychological meaning afforded to bodily processes, then differences between the three groups would appear, despite the use of shared language. Their findings provide support for the latter model, as less-acculturated Chinese–Americans displayed more somatic word use relative to more acculturated Chinese–Americans and European–Americans.

Similar arguments have been made to explain West-Africans’ greater somatic awareness. Chentsova-Dutton and Dzokoto (2014) argued that top–down factors like cultural schemata surrounding the role of the body, their accompanying culturally specific terms (e.g., “seselelame”), and their use of emotional expressions that integrate body parts (e.g., fear as “heart-fly”) can explain West-African’s self-reported sensitivity to bodily cues.

In contrast to this focus on cultural conceptions of the body used to explain cross-cultural variation in somatic focus, a different set of mechanisms have been used to explain differences in interoceptive accuracy. Given that cultural differences in these two processes diverge (i.e., with non-Westerners being more likely to display the former but less likely to display the latter), it is not surprising that attempts to explain East-Asians and West-Africans’ relative inaccuracy in interoceptive perception have focused not on cultural models of the body, but a different set of processes that are more cognitive in nature.

Attempts to explain cultural variation in interoceptive accuracy between East-Asians and European–Americans have focused on analyses of East–West epistemologies, and have suggested that despite the heightened focus on bodily processes, cultural differences in cognitive styles may nevertheless render those from Eastern cultures less able to accurately attend to internal cues. Specifically, Ma-Kellams et al. (2012) proposed that Asians and European–Americans differ in interoceptive abilities due to differences in context dependency. Past research on culture and cognition has consistently demonstrated that Easterners attend more to contextual cues when evaluating both the self (e.g., Kanagawa et al., 2001) and others and external events (e.g., Morris and Peng, 1994). Furthermore, such an attentional difference appears to be more than a matter of voluntary control: even when asked to ignore contextual cues, Asians exhibit greater difficulty (compared with European–Americans) on such tasks (Ji et al., 2000; Masuda and Nisbett, 2001; Kitayama and Ishii, 2002; Ishii et al., 2003; Kitayama et al., 2003). This focus on contextual cues should render Asians less attentive to their internal states (relative to the external cues stemming from the external world) because if the individual self is not the central object of focus or primary unit of analysis compared to the surrounding context, then bodily changes should be relatively less attended to. In other words, Asians tend to disproportionately focus on external contextual entities outside of themselves—both in terms of other individuals (as part of the interdependent self—Markus and Kitayama, 1991) as well as other factors in their environment (e.g., field-dependence—Ji et al., 2000)—and yet accurate interoception requires one to ignore such external factors in order to focus on one’s internal state. Thus, the argument is that contextual dependency explains East Asians’ lower interoceptive accuracy. Consistent with this argument, Ma-Kellams et al. (2012) found that individual differences in the ability to ignore contextual cues mediated performance differences between Easterners and Westerners on an interoceptive task—in this case, heartbeat detection.

In the West-African cultural context, Chentsova-Dutton and Dzokoto (2014) proposed that the higher levels of somatic awareness reported by members of this cultural group may be the precise mechanisms that hinders their interoceptive accuracy. That is, West-African culture holds a particular schema that links fear with a racing heart. Although this schema may accurately portray the link between emotion and physiological change in general, it may not serve to accurately describe online (i.e., in-the-moment) bodily changes. Thus, in the context of their study, in which they had West-Africans estimate their own heart rates while watching a fear-inducing film, it might have been possible that the saliency of the emotional content led these participants to expect increases in heart rate (in line with the schema) but ignore the actual, more subtle cues from their body. Thus, another possible explanation for cultural differences in interoceptive accuracy is that cultures that exhibit high levels of somatic focus may ironically be worse at detecting actual somatic change because highly salient somatic schema are chronically accessible and renders individuals less likely to attend to actual somatic cues.

Culture is not known of its timeless, unchanging nature; if anything, culture changes as social life changes, and a fundamental component of culture is the practices, rituals, and traditions individuals of any given cultural group rely on that promotes culturally consistent ways of thinking, feeling, and behaving. Thus, this section focuses on the behavioral and contemplative practices from different cultural origins that have been proposed as possible “interventions,” or methods of cultivating bodily awareness and perceptual accuracy.

Meditation, mindfulness, and yoga are ancient Eastern practices, but in recent years they have received increasing empirical attention in the context of psychological well-being and health. At the core, yoga and its related practices takes a holistic approach to the mind and body, assuming that exercises with a mental focus will have bodily effects, and bodily exercises will have mental effects. Together, they share a variety of common features, including prolonged physical stillness and/or some kind of mental control characterized by stability and focus, a perceptual style in which there is little active effort to interpret sensory information. From a scientific standpoint, they have conceptualized these practices as a complex set of emotional and attentional training regimens (Lutz et al., 2007). Although these techniques are traditionally used in spiritual contexts, there is a growing trend in using them as a form of alternative therapy (Astin et al., 2003; Barnes et al., 2004; Arias et al., 2006).

Meditation, yoga, and mindfulness techniques typically incorporate somatic awareness and use the body as an object of focus (Kabat-Zinn, 1990; Selby, 1992; Kornfield, 1996; Nairn, 2000). It is important to note that in this context, somatic awareness is defined primarily by adaptively focusing direct attention on in-the-moment bodily changes (Flor et al., 2001; Watkins and Moulds, 2005) rather than engaging in emotionally driven vigilance (Cioffi, 1991; Cioffi and Holloway, 1993; Watkins and Moulds, 2005).

Beyond focusing on the body, bodily sensations are also modulated through breathing and posture (Bhajan and Khalsa, 2000; Arambula et al., 2001; Peng et al., 2004). Theorists have posited that the benefits observed from practicing any or all of these actions are derived from these common elements (for review, see Watts, 2000), and followers of these practices attest that engaging in this kind of intentional attunement leads to improved awareness of a variety of internal states, including bodily awareness (Kabat-Zinn, 1990; Kornfield, 1996; Nairn, 2000).

Khalsa et al. (2008) empirically tested this assertion by examining interoceptive accuracy among two groups of experienced meditators, Tibetan Buddhists and Kundalini monks, and comparing them to a group of non-meditators. The authors assessed both self-perceived interoceptive awareness (i.e., participants’ reports of their interoceptive performance) and actual interoceptive accuracy (i.e., on a heartbeat detection task). Contrary to prediction, experienced meditators displayed comparable levels of accuracy relative to non-meditators, but self-reported higher levels of interoceptive awareness. Similar findings have also been reported by Nielsen and Kaszniak (2006), albeit with a smaller sample size and no control group. Taken together, these findings suggest that contrary to lay assumptions, chronic engagement in meditative practices only appears to heighten somatic awareness but does not appear to improve actual interoceptive accuracy.

Despite the lack of evidence for a direct link between meditative practices and interoceptive accuracy, these practices are not without other physiological and psychological benefits. Empirical studies comparing yoga with relaxation exercises, for example, have found that both practices yielded similar physical and psychological benefits (e.g., decreases in heart rate and blood pressure, increases in self-esteem—Jaggi, 1979; Cusumano and Robinson, 1992). Other studies have found additional physiological benefits of yoga, including asthma and hyperventilation (Chandra, 1994) and hypertension (Steptoe, 1981). Similar arguments have been made about mindfulness techniques, which have been shown to prevent depressive rumination (e.g., Teasdale et al., 1995). Recently, Shannahoff-Khalsa proposed that combining meditation with breathing and somatic exercises based on the Hindu Tantric practice of Kundalini Yoga can be used as an intervention for a wide range of psychiatric disorders. Thus, a review of the empirical studies on meditation, mindfulness, and yoga reveals mixed evidence for the effects of such contemplative practices on bodily awareness and interoceptive accuracy—these meditative practices appear to facilitate the former, but not the latter; these limitations notwithstanding, they may offer physiological and psychological benefits in other contexts apart from interoception.

A substantive body of work demonstrates that members of different cultural backgrounds exhibit differential levels of somatic symptoms in response to both physical and mental illness. In the context of physical illness, African–Americans are more likely to report bodily symptoms after exercise, surgery, and in response to a variety of diseases (Faucett et al., 1994; Sheffield et al., 1999; Edwards et al., 2001). In the context of psychological distress, members of non-Western cultures are more likely to report bodily symptoms rather than purely affective ones; this pattern has been demonstrated with African (Chowdhury, 1996; Dzokoto and Adams, 2005); African–American (Friedman and Paradis, 2002); Cambodian (Hinton et al., 2006, 2007); and Chinese samples (Park and Hinton, 2002; Ryder et al., 2008; Ryder and Chentsova-Dutton, 2012).

The heightened rates of somatization of psychological distress in Asian culture is perhaps the most widely studied example of cultural variation in the cultural psychopathology literature (see Ryder et al., 2002). Compared to individuals of European descent, those from Asian countries are allegedly more likely to manifest bodily symptoms when experiencing psychological distress. In one of the initial studies on culture and epidemiology, Kleinman and Good (1985) found that depression was rarely reported in Chinese cultures, but neurasthenia—a similar illness characterized by somatic symptoms—was much more prevalent; he subsequently concluded the neurasthenia emerged as a culturally specific manifestation of depression. Subsequent studies have similarly found a greater tendency among Chinese to report somatic symptoms (Tsoi, 1985; Chan, 1990; Simon et al., 1999; Yen et al., 2000; Parker et al., 2001). In the attempt to explain these cultural differences, numerous theoretical arguments have been put forth, including linguistic features of the Chinese language (e.g., Leff, 1981); stigma associated with psychiatric conditions (e.g., Goffman, 1963), and differences in emotional expression norms (Sayar et al., 2003).

More recent research has challenged both theoretically and empirically. Theoretically speaking, Cheung (1995) posited that most of the explanations put forth for cultural variation in somatization were formed on a post hoc basis rather than built as part of the study designs. Empirically, Ryder et al. (2008) contended that many of the existing studies that have found cultural differences in somatic symptom reporting lacked a Western comparison sample and thus could not rule out the alternative explanation that somatic symptoms is a general feature of depression; furthermore, most studies relied on a single assessment mode, thus leaving the influence of modality on the finding an open question. Thus, in their study, Ryder et al. (2008) used three different assessment modalities (self-report, clinical interview, questionnaire) to assess symptom presentation among Chinese and European–Canadians; they found that although Chinese patients reported more somatic symptoms than European–Canadians, European–Canadians reported more psychological symptoms, and the latter effects was larger and more consistent than the former. The authors concluded that in the context of depression, cultural differences may center more on Western “psychologization” rather than Eastern somatization.

Zaroff et al. (2012) also challenged the long-standing view of somatization as a culture-specific pathology in their review of the literature, which found that rates of somatic symptom reporting are comparable across cultures when ascertainment methods are controlled for. They suggest that cultural variation in stigma associated with psychological illness and service provision, along with cultural socialization patterns, can explain what appears to be cultural differences in symptom reporting; however, when assessment techniques include direct questioning of mood and consider response patterns on self-report, much of the aforementioned cultural differences are attenuated.

Beyond depression, limited work has examined cultural differences in somatization with other psychopathologies. For example, Viernes et al. (2007) examined the link between somatization of distress, food restriction and fat phobia among Filipino and Western teenagers. They found that Western teenagers displayed more food restriction practices and fat phobia, and lower levels of somatization of distress. Fear of fatness was correlated with somatization, and the authors raised the question of whether fat phobia and somatization stand as culturally specific forms of expressing psychological distress (see also Helman, 1990). Nevertheless, it remained unclear based on their data whether such a link was causal or epiphenomenal. However, given that past studies have reliably shown interoceptive accuracy to relate to food deprivation (Herbert et al., 2011, 2012a), obesity (Herbert and Pollatos, 2014) and disordered eating (Koch and Pollatos, 2014b), it is likely that cultural differences in accuracy may also lead to related differences in food and eating disorders.

Likewise, somatization has been linked to other disorders in cultural contexts, including a variety of anxiety-based disorders (e.g., ataque de nervios, or “attack of nerves,” an unexplained distress syndrome found in parts of Latin-America—Lopez et al., 2011; Dhat syndrome, a culturally bound preoccupation with perceived semen loss found in India—Ranjith and Mohan, 2006; “Ode Ori,” a disorder characterized by a perceived crawling sensation in the body found in Nigeria—Makanjuola, 1987). Beyond these culture-specific disorders, somatic symptoms has also been linked to more generalized reports of anxiety and depression (e.g., in Pakistan—Minhas and Nizami, 2006; Israel—Al-Krenawi and Graham, 2004; Egypt— Abdel-Khalek and Lester, 2009; Mexico—Varela et al., 2004), as well as specific reports of post-traumatic stress and panic disorder (e.g., in Cambodia—Boehnlein, 2001). Though suggestive, the limited number of studies done on the role of culture and somatization in these disorders make it difficult to draw firm conclusions about how and why somatic symptoms feature so prominently in a variety of both generalized and culture-specific anxiety-based and depression-based disorders. Nevertheless, the prevalence of somatization in non-Western cultures is largely consistent with the finding that many non-Western cultural group members exhibit lower levels of interoceptive accuracy, given that somatization may reflect an inability to accurately perceive one’s bodily states. Indeed, a growing body of research supports this notion that somatization is a reflection of poor interoceptive abilities (Gardner et al., 1990; Bogaerts et al., 2008).

In summary, a review of the existing literature suggests that cross-cultural differences in interoception can be summarized as follows: (1) members of non-Western cultures tend to exhibit higher levels of somatic awareness but lower levels of interoceptive accuracy; (2) variation in cultural conceptualizations and epistemic traditions can, in part, explain these differences, (3) cultural practices related to meditation, yoga, and mindfulness, in line with the aforementioned evidence, appear to facilitate bodily awareness but fail to improve actual accuracy, and (4) the heightened somatic awareness among non-Western cultures is linked to a greater emphasis on somatic symptoms in a wide array of psychopathologies—most notably, depression and anxiety.

These findings notwithstanding, there remains several areas that warrant further research in the context of culture and interoception. First and most broadly, the overwhelming majority of research in culture and interoception in particular and cultural psychology in general has been focused on the East–West comparison. Although this reliance on comparing members of East–Asian and European–American cultures has been fruitful and telling, there remains a substantive gap in our knowledge about how Western models of embodiment and related psychological processes emerge—or fail to emerge—in other cultural contexts. A small but growing body of work has begun to tackle this question in West Africa and Latin-America, but there remains much to be explored in other cultural contexts.

A related need is greater precision in defining the nature of observed cross-cultural differences. Few studies, if any, have attempted to take a multidimensional view of somatic awareness when assessing for cross-cultural differences. However, given recent developments in our understanding of the complex nature of body awareness (Mehling et al., 2012), future research can more systematically use multidimensional measures of somatic awareness (e.g., the MAIA—Mehling et al., 2012) in cross-cultural contexts. Similarly, more work is needed to assess the robustness of cross-cultural differences in interoceptive accuracy given the relative paucity of empirical studies to date that have investigated this construct.

Second, little is known about the role of somatic awareness and interoceptive accuracy in cross-cultural, psychopathological contexts apart from those relating to depression and/or anxiety. An example of one pathology that warrants further research is the role of culture and interoception in eating disorders. Although there is some initial evidence that interoception is a key process in anorexia nervosa (e.g., Arnold, 2012) and rates of anorexia nervosa varies across cultures (e.g., see Simpson, 2002, for review), few studies, if any, have examined whether interoceptive differences can explain cultural variation in this disorder. The case of anorexia nervosa serves as just one example of a psychopathology that may be moderated by culture and interoception, but for which there is limited research.

Third, more research is needed to elucidate how and when culture-specific practices—including, but not limited to mindfulness, meditation, and yoga—can assist in or hinder interoceptive accuracy. Despite the fact that existing empirical studies have failed to find a reliable relationship between experienced meditators and interoceptive accuracy, various alternative explanations remain. Subsequent studies can aim to manipulate the practice of meditation rather than rely on a self-selected sample of existing meditators to more directly assess the causal link between meditation and interoceptive accuracy. Furthermore, additional studies can assess interoceptive abilities in a wider array of forms (e.g., in modalities other than heartbeat detection) and bodily states (e.g., in states other than resting state). Doing so can help further elucidate the precise mechanisms and boundary conditions underlying the relationship between cultural practices and interoception.

Conflict of Interest Statement
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Photos from China

These are some shots I took dealing with herbs and medicine from three visits to China – 1995, 2003 and 2005.
Note that some of these are 20 years old and are from raw herb pharmacies. Our own herbs at are done at modern state of the art facilities. (Just in case you were worried.)

[color-box]You can see all my (Doug) photo work including a lot more from China here on[/color-box]


Why Take Herbs?

This is something I thought about today… why take herbs? Well, the way I see it is that herbs are what we humans have been consuming for thousands if not hundreds of thousands of years. Our bodies are made of the plants and animals that we have eaten since time memorial. It makes sense that when the body is imbalanced we would take those things that our body is best adapted to.


Does this mean that herbs can cure everything? No, of course not. Humans are not immortal (at least in the material planes) although we often try really hard to avoid death. Sometimes (and eventually) our bodies become imbalanced and we pass away. In Chinese medicine and culture this is called the separation of Yin and Yang.

Taking the wrong herbs can make us feel worse but taking the right ones can put us back on the road to health. Some diseases are beyond the capabilities of Chinese Herbs and Western pharmaceuticals may be more appropriate. Chinese herbs can be very broad in their effects on the body. They affect systems of the body and therefore restore the body’s ability to heal itself.

The Chinese system of medicine works well because it has mapped an integrated structure to human physiology. This viewpoint may not be well accepted by western science because western sciences tends to look at things through the microscope while eastern sciences try to see the broadest perspective as most important.

But lets come back to herbal formulas which have not just one action on the body (for example the way a western diuretic medication may) but on all those systems of urination. This will include supporting kidney function which also promotes urination. In other words, we give strength to the kidney to allow it to empty the bladder. This then is different from just changing potassium and sodium balances in the cells. Many times a single herb can have several functions but usually we have several herbs in the formula together even for just one complaint or symptom.

So how do we find the right formula or group of herbs for ourselves? Well this has been discussed since the beginning of Chinese medicine. Current Chinese medicine heavily utilizes the organ diagnosis or zang-fu system method. As I discussed in the Japanese Kampo page, Eagleherbs has gone back to a system which pre-dates the modern system and I believe is more relevant for many herbalists and certainly for an on-line site like Eagleherbs.

Ban Bian Lian Learning Garden IngridFrom running Eagleherbs for two years now I would say that about one third of our customers have been prescribed their herbs by another herbalist and find Eagleherbs preferable.  The reason is generally not cost but convenience because their herbalist doesn’t have a full herbal pharmacy. Another third of our customers go through some sort of consultation through by myself through emails or phone calls or with a paid consultation with Marie or myself. The last third have been through the web-site and think they have an idea of what they want to try. Either they resonate with the formula or otherwise their symptoms line up with what we describe on the website.

This last group is where we try our best to provide the best service we can for those who choose their own formulas.  All of us non- MD’s are limited by not being able to make “disease claims”. For example, there may be a formula which I would use almost every time for someone with a specific symptom in Sjorgeon’s Syndrome but the FDA will not let me say that I use this for Sjorgeon’s. But I can mention the symptom. Not that this limitation is the worst thing in the world because in those 10% of cases where it wouldn’t be appropriate, it might be disastrous for the patient.

If we can’t make disease claims then we can make “structure-function” statements. What this means for us is that we can recommend products that the consumer can make a reasonable self-diagnosis for. Again, a patient may know they have a diagnosis of X-disease but only because an MD has confirmed it. If XY and Z are symptoms of diabetes we can’t directly state that our products for symptoms XY and Z are good for the X-disease. We can only state in symptoms and Chinese medicine terms what the formula can do.  Its an interesting problem and Al Stone wrote an interesting “tutorial/class” on it at his other website:

Therefore on Eagleherbs, we tend to have many formulas listed with absolutely no description at all. This targets persons who know exactly what they want because either their own research, a licensed practitioner, myself or Marie has told them that this is the right formula for them. I feel like we don’t have to create elaborate descriptions of our products because much of that research is done on the internet by the customers themselves.

On-line sales is not perfect (but then again I have seen any number of bad choices made by in-person licensed herbalists) but we try to provide you with the tools for you to make the best purchase. If you want to order from us go through site and get a feel for what it has to say. Don’t rely on a single symptom and especially don’t rely on a western diagnosis. If in doubt you can email me and of course if you have a complex, problematic or acute situation see your MD. Be well, very well.

Douglas Eisenstark Resume

Douglas Eisenstark L.Ac.


Clinic Supervisor at Emperor’s College
externship supervisor: Venice Family Clinic, LA Free Clinic

Instructor: Emperor’s College and Yo-San University: Clinical Point Selection, Case Review, Advanced Formulas, Ear and Scalp Acupuncture, Acupuncture Techniques, Fundamentals of Chinese Medicine

Co-writer: Fundamentals of Chinese Medicine PMPH
PMPH Eisenstark Fundamentals

Editor and Translation:The Clinical Practice of Chinese Medicine: Psoriasis & Cutaneous
Pruritis by Lu Chuan-jian, Xuan Guo-wei   ISBN 978-7-117-09242-5/R·9243 (2008)

Creator of Acuvideo: Finding the Acupuncture Points DVD with Huabing Wen  (2005)

Author: Acupuncture Microsystems: an Overview  (2009)

Caregiver Magazine 1998 (several articles)
The Fearless Caregiver (book, editor Gary Barg) ISBN-13: 978-1931868563

reviewer & past editor of
past moderator of Chinese Herb Academy, Yahoo Groups
Doug’s first career was an artist, photographer and video editor but for many years had an interest in Chinese Medicine. His interest grew while living for 12 years in New York City’s Chinatown.  After moving to Los Angeles he had the opportunity to start acupuncture school. Douglas has since gone to Shanghai and Beijing for 3 educational trips.
Douglas has been active in the larger acupuncture community, moderating the on-line TCM group: Chinese Herbal Academy as well as publishing articles in the Caregiver Magazine. With Huabing Wen he has made the DVD, Finding the Acupuncture Points and is a Continuing Education Provider for the State of California. He has been a past Examiner of the California State Acupuncture Exam.
He maintains a private practice in West Los Angeles.
Graduate ECTOM 1996
National and State Licenses 1996

Clinic Supervisor at Emperor’s College & Yo-San University
externship supervision: Venice Family Clinic, LA Free Clinic

Instructor: Clinical Point Selection, Case Review, Advanced Formulas, Ear and Scalp Acupuncture, Acupuncture Techniques, Fundamentals of Chinese Medicine


Advanced training:
2 months clinical internship at Hua San and Zhong San Hospitals, Shanghai, China
One month and one month advanced training: 1st Beijing Hospital departments: Oncology, Hepatitis, Dermatology

Acupuncturist: Turnabout Acupuncture Drug Treatment Program, Santa Monica
Herbalist: Yo-San University

MFA: Art Institute of Chicago (film and photography)
Whitney Museum Program (art)
University of Kansas
One person and group shows: film, video and photography: New York, Chicago and Los Angeles