Vulnerability

    Why does Clint's knee bother him in cold weather but mine doesn't?   Why did a friend  throw up every time he fought with his girlfriend, but my husband never threw up once when we fought?   Why does my patient Louise get headaches every time she is stressed, but my patient Francis gets diarrhea?

    Dr. Leon Hammer (one of my professors and heroes!) used to preach to us about the concept of vulnerability.  It is a concept that is intrinsic to Chinese medicine.  Sometimes we fail to see the forest for the trees.  Vulnerability is such a basic paradigm of heath and sickness and it is becoming more and more  overlooked as we get more  and more specific and more and more segmented and more and more limited in our examination of the human response mechanism.

     First of all, what is vulnerability?  It is an area of weakness in a person - an area that when stressed, is likely to rear up and make ugly noises.   The three main root causes of vulnerability are trauma, lifestyle, and inborn. 

    Most everyone knows someone who injured their knee and every time the weather gets damp or cold, that knee acts up.  Dampness and cold often settle into an injured joint that hasn't been treated properly.  (Ice is for dead people in Chinese medicine.   There are herbal liniments that can alleviate swelling and pain and bring blood to the area without introducing cold and dampness at at the same time - but that's another story.) Trauma was the original insult.   Dampness and cold are the stressors, the knee is the vulnerable area.  I see this a lot in clinical practice.  The knee will always be vulnerable unless you drive out the dampness and the cold. (which we can often do).

     I also see a number of people who get severe headaches and if you quiz them carefully, at one time they suffered a head injury in the past.  Its surprising how many people were kicked in the head by a horse!  The injury was the initial insult, the stressor varies (it can be an emotion, a smell, etc) but the head is the vulnerable area, and it will always be, unless you can heal the energetic changes that occurred from the trauma.

    Vulnerable areas are often a result of lifestyle.  People who burn the midnight oil, work the night shift,  eat very little good-for-you fats in their diet, or are simply getting older, tend to be yin deficient. You can think of (at least one aspect of yin) as WD-40 (lubricant) for your internal organs.  If you are low on lubricant, and a stressor comes along to plunder your already deficient yin, watch out!  Heat from friction can cause a multitude of ills in all parts of the body.  Most likely, the part that screams out is the area that was the most yin deficient to begin with.  I need my sleep.  If I don't get my sleep, my tendency towards yin deficiency dry fries my brain.  

     There are very few, if any people, who don't have a constitutional area of vulnerability.  I once knew a guy who threw up every time he got nervous, or if he ate anything spicy, or if he missed a play in his football game.  He had always been this way, and so had his sister. Talk about  vulnerable stomachs!  My kids both had weak spleens and lungs as children.... any time the weather turned, or someone sneezed around them, watch out!  They were sneezing and coughing and sick shortly thereafter.   

    The bottom line is.... this is not something that should be delegated a Chinese medical concept and ignored by the rest of health care! A good place to use this concept would be in pharmaceutical research.  Its my hypothesis that people with weak spleens and stomachs are the ones who will suffer the most nausea and digestive issues from chemo.  It's my hypothesis that people who all already yin deficient will suffer more hot flashes from diuretics.  It's my hypothesis that people with energetically challenged livers and spleens will be the ones who have side effects from statins.  I could go on and on...... 

   A lot of vulnerabilities are obvious - like the injured knee, for example.  Many more are not obvious  to the layperson but glaring to the eyes of an acupuncturist.  An energetic workup should be done on every person once a year, along with a  physical exam.  Then everyone would be aware of their areas of vulnerability, even if they are not manifesting at at the time.

   

  Oh, how I would love love love to be involved in western research that includes the concept of vulnerability into its paradigm!  It would really be cutting edge science......

     

Why Chinese herbs are so effective

There is a trend in America towards the use of herbal medicine, and this should be applauded. People take echinacea for sore throats, milk thistle for the liver, horsetail for eye ailments.  The list goes on.
However, in China, where herbs have been a mainstay of treatment for thousands of years, single herbs are very rarely prescribed.  Herbal medicine is most effective when herbs are used in combination with other herbs.  The herbs are  then are able to work synergistically with others to increase their effectiveness.   Not only can they be used to increase their effectiveness, but this can decrease the side effects of a single herb.  No football team could win a game with just a quarterback.

One thing that is so great about  Chinese formulas is that they were developed by the brightest minds in Chinese medicine - those minds that had studied herbal therapy for decades.... and most formulas are hundreds or  even thousands of years old - so they have stood the test of time and been found to be highly effective, yet when prescribed correctly, quite safe.  Those formulas that caused problems were discarded and did not make it into the chinese medicine formulary.  Those that were ineffective didn't make the cut, either.

This is so different from western medicine, where prescription drugs may have only been in existence for at most, fifty or so years, and are constantly being pulled from the market because of side effects, some of which are deadly.  Most western drugs are based on the principle that if the quarterback is the best player on the team, then cloning him and making a whole team of just that quarterback should be more effective.  Crazy analogy, I know - but its the best way to describe it.

Let's take for example Ba Zheng San, which is an herbal formula for a urinary tract infection.  There are nine herbs in Ba Zheng San.  A lot of the functions of these herbs overlaps, so if it appears that I am talking about way more than 9 herbs, its because of their overlapping functions.  Six of them clear heat (which means they are anti-inflammatory, antibacterial and/or antiviral) and purge fire (even more strongly anti-inflammatory, antibacterial and antiviral).  Six of them also promote urination, so that when you do urinate, you get rid of the pathogen causing your symptoms.   (If you have a robber in your house, you don't want to shoot the robber and leave his dead body lying around in the kitchen to rot - for this same reason, pathogens that are destroyed need to be escorted out of the body - which is something Antibiotics Do Not Do).  One of the herbs not only clears heat but also guides the rest of the herbs to the bladder.    And yet another herb harmonizes the effects of the other herbs, which means two things: it helps them to work well together, and it protects the digestive tract from being harmed by the formula.

It is recommended that you take two days of probiotic therapy for every one day you are on an antibiotic.  Since Ba Zheng San is a harmonized formula, your intestinal flora should not be affected and the probiotic regimen is not necessarily indicated.

This is just one example.... there are literally hundreds of herbal formulas.   You should never try to self-treat, but rather see a qualified Chinese herbalist for advice.