Teaching the Soul of Classical Chinese Medicine

By Steve | Published: October 16, 2009

Give a man a fish to feed him for a day; teach him to fish to feed him for a lifetime!

I’m committed to sharing the wealth of classical Chinese medicine, which I’ve been able to learn through the generous teachings of Jeffrey Yuen. Yet, Jeffrey doesn’t make it easy – The sage is not humane (Dao De Jing, verse 5). Or, in contemporary vernacular – it’s cruel to be kind! Jeffrey is inspired in his teaching, though he’s also assiduously “low key” about the value of his teachings. His teaching style expresses to me that the key to realizing the wealth of Chinese medicine lay in learning to “sort out” the subtle and dynamic factors that guide each patient’s life, and thus discern accurate and inspired treatment strategies.

Patients present their practitioners with lessons and complexities, which certainly don’t come emblazoned on their foreheads. Practitioners are challenged to identify the specific nature and location of pathogenic factors, and differentiate them from the embodied spirit’s intrinsic responses to sustain life. Modern TCM teaches us to classify the manifestations of a patient’s distress, but provides little guidance for unwinding that individual’s entanglement in habituated dysfunction. We’ve been taught to simply treat whatever imbalances the patient manifests. However…

Symptoms and signs express the embodied spirit’s struggle to maintain life in the face of “pathogenic factors” that challenge it.

They exhibit the combined influences of pathogenic factors and the embodied spirit’s reaction it them! I’ve found that the best therapies focus on resolving pathogenic factors, without compromising the individual’s vitality. Indeed, they often stimulate and facilitate the embodied spirit’s intrinsic responsiveness to allow it to function more freely. Can one teach others the inspiration to sort out the entangled nature of a patient’s symptoms and signs, and the willingness to trust the embodied spirit in its sometimes violent efforts to expel factors that have been blocking its healing? Probably not, but Jeffrey and I reach out to participants in our seminars and try…

Try what? In the end, we each have to come from our strengths. Jeffrey has nearly boundless experience, learning through direct contact since he was a toddler from masters who embodied strong currents of classical Chinese medicine. I’ll never match the depth and variety of that experience, but I do have one experience that may be valuable to practitioners and students who want to learn from his enigmatic teachings. I’ve had the experience of having to figure out the mysteries of classical Chinese medicine as an adult. While Jeffrey shares the dynamic and responsive world he sees and challenges his students to awaken to that reality, my seminars provide a little more step-by-step guidance, as I:

  • share my thinking process, and how it’s inspired by specific images and theories of CCM
  • engage participants to entertain the CCM (especially the Neijing – Inner Classic) thinking process
  • describe how I work through the evaluation of a patient to devise a treatment strategy

I provide lecture notes, because I want participants to engage the ideas and thinking process of classical Chinese medicine while I’m presenting them rather than trying to scribble down a lot of unfamiliar theory and information. I invite questions, because I know the challenge of working through the systematic limitations of modern TCM. I’ve written essays to give perspective participants (and others) the chance to read and “chew on” the perspective of classical Chinese medicine that I’ve learned and cultivated — before they come to a seminar. After attending a seminar, participants will be invited to participate in an online discussion to help them implement those teachings.

Check out the new link in the upper right corner of every page — Scheduled Classes. I’m currently talking with three seminar sponsors, including Golden Flower Chinese Herbs — gracious sponsors of my seminars for the past two years, and hope to have more links there soon!

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Some Treatments Are Plain as Day

By Steve | Published: October 11, 2009

Stagnant blood is the somatic version of unresolved emotional conflicts.

Who doesn’t have any of those? No attachment to having your way? Don’t think your way is the right way? Well, I don’t believe contemporary people come close to that stringent standard of spiritual liberation. We have too much apparent (temporal) power, and generally fail to differentiate clearly between what we can and can’t control. Yet, our embodied spirits also know they have to put those unresolved issues aside, so we can get on with life. Ever wonder where those finished issues go?

The embodied spirit uses its key function of embodiment to displace unresolved spiritual issues into the body.

Among a broader range of unresolved spiritual conflicts, emotional conflicts have specific “targets,” and are displaced into the blood. Chapter 10 of the Lingshu (Spiritual Axis) instructs that the embodied spirit stores such blood stagnation in the luo vessels, which that important chapter notes are the only visible acupuncture channels. Learning to diagnose and treat luo vessels is among the simplest ways to begin working with the channels (in contrast to the modern acupuncture approach, which focuses on specific points and point combinations).

[Note: Other spiritual conflicts (without clear targets) are often displaced into one or more vital fluids, and are stored in the channel divergences. These are not visible, and learning to treat them requires considerably more study. Learn more about the theory and clinical application of the channels and vessels.]

Treating luo vessels can assist the embodied spirit in moving blood stagnation out of the system

Often blood stagnation accumulates for years, before it eventually progresses into overt disease. While venting out that accumulation doesn’t actually change the underlying pathogenic process (of accumulating unresolved emotional conflict), it can substantially reduce the load. Since most luo vessels flow into the chest, their filling frequently compromises the axis of qi – in the chest. Thus, releasing stagnant blood facilitates the flow of all post-natal qi — the vital functions of life.

Each of the five systems of channels and vessels fills a key role in sustaining individual life

Each system of channels and vessels exhibits distinctive pathological processes, and responds to specific clinical procedures. The luo fill with stagnant blood (unfulfilled and somatized emotional conflict), until they overflow to empty back into the primary channels, which leads to a progression of pathology. A one-day study of the luo is included in the four weekend series of seminars on the systems of channels, which introduces Neijing style acupuncture.

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Is Health Care Against Society?

By Steve | Published: October 6, 2009

I ran into an old friend at the grocery store a couple days ago. We greeted each other warmly, after not seeing each other for several years. Matt is a medical doctor, specifically a radiologist, who was one of few medical professionals in our small rural California town to accept my efforts practicing Chinese medicine fifteen years ago. At that time, we bonded over our deep concern for the well-being of patients and our scornful opinions concerning the practice of medicine.

Yet, Matt and I were going in different directions. He was pretty cynical about many of his local colleagues, and how they used (and mis-used!) the very expensive technology at the core of his specialty. I learned a lot from him about both the strengths and limitations of medical imaging as part of my specialized training in “acupuncture orthopedics,” and I was searching for an entirely different conceptual framework for practicing health care. We drifted apart as the stresses of our respective lives consumed our attention, even though our souls knew we were “brothers” in our quest to improve American health care.

The focus of Matt’s rapier wit has shifted from local to global. He now believes there are severe systemic flaws in American health care, and declares that only a complete transformation of financial incentives can repair the system. Matt shared his perception that:

The current fee-for-service health care system renders patients into fodder to generate fees (and hence INCOME) for providers

Matt strongly expressed his conviction that our health care system can only be repaired by adopting a national program like the one in Great Britain. His twenty-five years practicing medicine has convinced him that the health care system must be designed with patient welfare at its center! I heartily agree with that perception.

While I may identify different specifics and remedies, Matt and I agree on many aspects of our societal challenges with health. I concur that our health care system suffers because of some very warped incentives, and believe lasting effective remedies must address them. Twenty years ago the “money people” devised “managed care,” which was supposed to squeeze the inefficiencies out of our health care system. Yet, that industry now soaks up more than 17% of GNP, and our health outcomes are poor relative to other industrialized nations, especially when measuring health span. Maybe we can start with several principles:

  1. We must find ways to put patients back at the center of health care, especially identifying specific life changes they can cultivate to promote healing
  2. We must line up incentives throughout the entire economy to support health
  3. Modern (western) medicine doesn’t have a monopoly on wisdom about health — a free marketplace of ideas will optimize our solutions

We can find solutions for our health care crisis!

I told Matt about my blogging concerning health care policy; he shared his small website to spread his philosophy. I suppose he got disheartened or busy with other things, because he hasn’t continued writing new pieces for that site. Matt seemed inspired by the idea of blogging, and I hope he gets invigorated to share his experience and insights about our profound societal health care challenges. While our voices and messages are rather different, I believe that a mélange of caring and concerned health care practitioners will identify the important principles for resolving our health care challenges.

Sometimes, the darnedest things happen at the supermarket!

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Practicing Health Care

By Steve | Published: September 27, 2009

A few weeks ago, I taught a weekend continuing education seminar for acupuncturists on the channel divergences, which have central importance for both understanding and reversing progressive and degenerative disease. Early in that seminar, I posed the following question, which I believe lay deep in the soul of many health care practitioners:

Do you want to participate in the disease management industry or the art of healing?

Has the idealism to help others, which continues to inspire many young people to enter the health care fields, been overwhelmed by the “scientific” doctrines students must learn and later the practical challenges of making a living? While that idealism appears well beaten-down in most, I believe it continues to smolder in the hearts of many. Can we gently fan those embers with the knowledge that the healing potential of the embodied spirit dwarfs the efforts of scientific medicine to control the expression of pathology?

Modern medicine relies on fear.

Allopathic medicine portrays patients’ bodies as “broken” — in need of permanent physical repair through surgery or ongoing physiological control with pharmaceuticals. Yet, embodied spirits that exhibit various diseases aren’t broken; they’re simply congested with stagnation, which blocks the natural flow of vital function. The symptoms and signs of disease are a cry for help; they are the embodied spirit’s gesture to express the nature and extent of its distress.

While western medicine sets the tone for our health care system, most proponents of “natural” medicine conform to its passive care model. And why not? — it makes SO MUCH SENSE economically. What could be better than selling people on the need to take a certain supplement for the rest of their lives, or come for three treatments per week for the next six months? Excuse me while I price a new BMW.

Practicing Health Care is a Sacred Trust.

People come to health care practitioners with their pains and their fears. I believe our work challenges us to discern the sources of each individual’s suffering, and find ways to stimulate the transformations of healing. Often that takes more time initially than simply controlling the manifestations of distress, but careful work to discriminate an individual’s blocks to healing can pay substantial dividends. The financial value for both individuals and our society of empowering patients to resolve their ailments is enormous. The non-financial value is even greater!

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To Publish or Not to Publish?

By Steve | Published: September 25, 2009

That is the question. It’s particularly salient for me, as my own editor and publisher of this site. I’m wanting to make good use of my precious time and energy, and have bit into a REALLY BIG project — trying to share a worldview about health and healing that’s profoundly different from our modern “knowledge.” While modern scientific knowledge concerning health and healing appeals convincingly to the naïve perspectives of our personalities, it isn’t actually TRUE. As Shakespeare wrote so eloquently (Hamlet Act 1, Scene 5):

There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy (or modern science!).

Relative to human health, there are the awesome mysteries and magic of the embodied spirit. Yet, where there is awesome power, many experience fear. How will people respond to my lancing – like a picador – the “sacred cow” of modern medical science? Many people place their faith in the truths of science as profoundly as many generations of our ancestors invested theirs in religion. Fundamental challenges to the authority of socially dominant paradigms have not been welcomed — ask Galileo or Socrates! Yet, the growth of human knowledge depend on such challenges.

The conceptual power of modern scientific thought is exactly what renders it incomplete for the study of human health and disease. The wondrous conceptual frameworks of modern science enhance our investigations of those aspects of human life that exhibit uniform physical laws, yet they fail to help us facilitate the individual potential to heal. The predictive power of modern science belies the individual possibilities of the embodied spirit. Can we learn to enhance the magic of individual healing? The modern consumption-based approach to health care doesn’t account for this basic truth:

Health and healing emerge from individuals who live in alignment with their beings; they are NOT consumer goods that can be procured from the outside.

We can’t control healing, but we can learn to stimulate and facilitate it. Are modern people willing to hear the basic truth that we can’t externally control such a fundamental aspect of human life as our health? Modern medical technologies leap forward in their ability to control acute crises, but ailing patients remain subject to the natural progression of most diseases. Are we willing to return our faith to efforts focused on enhancing the embodied spirit’s healing process, rather than simply trying to control the expression of distress?

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Health Care: NOT Just a Funding Challenge

By Steve | Published: September 21, 2009

The Problem with Health Care is the Pervasive Fantasy that We Can Treat It as a Consumer Good!

Health and healing are not consumer goods. Why would one think we could treat health care as one? If consuming health care actually made people healthier, there could never be enough. Our society would have to ration it explicitly.

When policy makers consider the issue of how to distribute health care, they get carried away with economic models, and forget about the underlying issue. In economic terms, individuals pay for goods and services to achieve a desired result, yet healing doesn’t work that way. We might buy short-term control of the manifestation of distress, but that purchase undermines our ability to use that expression of distress to sort out the factors that create it.

Health and healing are a matter of cultivation. We might even consider them a life-style, but try as we might we cannot make them into consumer goods. Health comes from the inside, and suppressing the signs of physiological distress doesn’t bring it back.

We can’t buy health any more than we can buy love.

For either health or love, it may appear for a short time that one can buy it, but doing so only introduces the unquenchable thirst for more purchases. Trying to turn them into consumer goods subverts their very nature.

Health (like love) flourishes when individuals invest in it!

Health flourishes when an embodied spirit invests in its individuality, and suffers when the individual’s alignment with life wavers. Pay attention to facilitating vital function, rather than simply the desire to enjoy your experience. Make decisions based on what your embodied spirit expresses, and you will tend to grow healthier. Yet, simple as it sounds, following that injunction isn’t always easy. Sometimes people need to experience the discomfort of the healing process.

The challenge of health care is NOT financial, it’s technical. We will start conquering it when we explore how to resolve disease, rather than maintaining it by managing expression.

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Human Life: It’s NOT Just Physical

By Steve | Published: September 16, 2009

Each person is an embodied spirit, who lives through interacting with the world. Those interactions are polar, as individuals take in various influences from the world and release byproducts of their life process back out to the world. Breathing is one such interaction; it provides the source of Being. Each individual’s Quest for food and drink motivate the other key physical interaction. [For more on the Chinese medical framework for understanding the vital transactions of life, see my essay "Managing the Internal Economy."]

In addition to these physical interactions, individuals internalize and digest their experiences in life. Classical Chinese medical theory suggests that these experiential interactions are even more fundamental than physical ones in the development of each individual’s eventual challenges with disease.

A Picture is Worth a Thousand Words, Except When it Comes to Human Health.

Modern medical technologies are truly amazing! MRIs and CT scans generate accurate and detailed visual images of the inside of an individual patient’s body. What could be better for helping a medical practitioner diagnose a patient’s ailment and discern what treatment(s) are necessary? It’s SO obvious; it must be true. Mustn’t it?

During the past twenty years, medical researchers have done several research studies using MRIs or CT scans on the relationship between physical lesions around the spine and clinical back pain, including pains that “radiate” from the spine into the extremities. That research has uniformly shown there is AMAZINGLY poor correlation between those “obviously” related issues. That is:

  • A fairly large portion of people with apparently serious lesions (including disc bulges or herniations) had mild back pain or dysfunction.
  • Another fairly large portion of people with small lesions had severe pain, which was sometimes debilitating.
  • It’s also fairly common that people have physical lesions in one location, and pain in another. That might be on the other side, or even a different level of the spine.

What’s up with that? I don’t believe modern (western) medicine has an explanation, yet my work with classical Chinese medicine is not affected by such anomalies. Indeed, CCM theory provides a simple explanation, which involves the embodied spirit’s ability (and willingness) to adapt to various individual physical challenges. My job as a practitioner is to find ways to stimulate and facilitate that natural process. Surgeons change the physical “picture,” and they have an irresolvable problem when that physical picture doesn’t match the patient’s experience.

Please note: I’m NOT denying that physical “reality” has SOME impact on human health, I’m just saying it’s not the ENTIRE story. We can’t predict the nature of a patient’s experience, nor can we determine what therapies will prove necessary, from a physical picture alone.

I’ve used acupuncture and Chinese herbs to help LOTS of individuals avoid surgeries that their medical doctors had thought necessary. Many of my patients try Chinese medicine BEFORE submitting to various modern medical treatments, because the ancient therapies seek to stimulate the patient’s own healing process rather than controlling its expression of distress. It turns out that physical pictures are just that, and the embodied spirit has its own potential for healing. Perhaps medical scientists should research optimizing THAT, rather than demeaning it as placebo.

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Is it a Fairy Tale?

By Steve | Published: September 8, 2009

The conceptual model of physical “reality” articulated by modern scientific medicine is powerful and compelling. It appeals to our naïve experience of living in, and learning to manipulate, a mechanistic physical world that submits to our control according to fixed “laws of nature.” The ideas of scientific medicine are deeply satisfying to many, especially relative to their fear of suffering and/or untimely demise. Yet, we KNOW from our experience that the universe is not entirely physical and mechanistic, especially the universe of human experience. [My essay on the Sengai Scroll discusses the limitations of physical models of "reality" relative to the clinical practice of Chinese medicine.]

Each individual is a complex transducer between physical and spiritual “realities.” Physical and spiritual factors influence each other in myriad ways. The study of that relationship lay at the core of the classic text Lingshu (The Spiritual Pivot); the title refers to the deepest link between an individuated spirit and its physical embodiment. Lingshu and Suwen (Simple Questions) together comprise the fundamental Chinese medical classic Neijing (Inner Classic). My practice of Chinese medicine and the story of healing discussed on this site are primarily based on Neijing, as I’ve learned the key principles from Jeffrey Yuen.

I find the story inspired by my practice of classical Chinese medicine compelling, even when it differs dramatically from the more widely held scientific story about the “physical realities” of life. Yet, I’m also clear that it’s just my STORY.

From my classical Chinese perspective, modern (western) medicine focuses on:

  • descriptions of the physical nature of disease
  • the search for the proximal and precipitating cause
  • dramatic rescues through (externally) controlling a “broken” body

In contrast, classical Chinese medicine focuses on:

  • descriptions of the individual’s experience of disease
  • the search for multiple contributing causes, both external and internal
  • finding ways to stimulate and facilitate the embodied spirit to realize its natural potential to heal

The CCM Story, based on the Neijing (Inner Classic), Consists of a Few Key Principles:

  • The apparent decline of aging is due to accumulations that block the free expression of an individual’s vitality.
  • Those accumulations primarily consist of external and internal pathogenic factors, which have been suspended and stored in the body:
    • External pathogenic factors arise from the individual’s failure to adapt and effectively respond to changes presented by the environment. Neijing refers to this as “perverse wind.”
    • Internal pathogenic factors consist of the individual’s failure to resolve emotional conflicts.
  • Unresolved pathogenic factors stagnate, and thereby impede the free flow of vital physiological function (qi) and blood.
  • When the embodied spirit is no longer willing or able to suspend unresolved pathogenic factors, they are overtly expressed in symptoms or signs of disease.
  • True healing comes from the inside, and is available to ANYONE (regardless of disease manifestation) who resolves previously suspended pathogenic factors. That resolution generally involves both transformation and release or expulsion of previously accumulated pathogenic factors.
  • Suppressing or controlling the embodied spirit’s expression of distress doesn’t facilitate healing; those efforts simply displace distress from one place to another.

Which story is true and which is a fairy tale, intended to keep one’s inner child from being frightened in the middle of the night? Who among us knows for sure? While we’re discerning the truth among these stories, I’ll keep sharing mine on this site — its different and hopeful, by asking individuals to take responsibility (physiologically) for their lives. I believe that a free exchange of ideas will help us find truth.

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When is a “Cold” not Just a Cold?

By Steve | Published: September 6, 2009

Ms. C. is a thirty-seven year old woman, who called me about four months ago seeking relief from persistent pain and dysfunction of her right hand, which made her work difficult. She came for an appointment, and reported having received treatment for neck pain and nerve root impingement causing pain and dysfunction of the arm (radiculopathy). Her neck and arm symptoms had improved after three months of physical therapy and chiropractic treatments, yet her hand stiffness and pain remained. Ms. C. worked as an R.N., and said that she considered her hand symptoms residual from her neck ailment because they had started at the same time.

I examined Ms. C’s hand and neck, and inquired about other pains. I learned that she had knee and hip pain — especially on the left, which had grown rather severe during the past several months. I read her pulses and palpated some points. I looked up at her from where I sat at her feet, and told her that I didn’t think her current hand pain came from her recent history of neck pain. My diagnostic efforts led me to suspect arthritis of inflammatory cause, such as rheumatoid arthritis. Ms. C. finally allowed that her physician had done a special blood test (rheumatoid factor) that showed a mild positive. Was this a test?

The tests practitioners get from the Dao are much larger than any we may get from people!

What were her embodied spirit’s blocks that had allowed the accumulation of pathogenic factors, which had eventually emerged in this condition? Practitioners of classical Chinese medicine ask this question of the Dao as it works within the microcosm of an individual’s physiology, and probe the embodied spirit to stimulate transformation. After more examination, I discerned accumulation in the yangming zone channel divergence, and devised an acupuncture treatment to address that blockage.

Two weeks later Ms. C. returned for a follow-up session, and reported only mild “nuisance” pain in her right hand. Indeed, she noted that all of her joint pains were much improved. I questioned her more carefully, and learned that she’d had what she considered a “bad flu” a couple days after her first treatment. She noted, “It was strange because my joints didn’t hurt at all when I was sick.”

Strange, indeed. Ms. C. received a total of five treatments during a period of slightly more than two months. Each treatment was conceived to probe and stimulate her embodied spirit to address a slightly different aspect of her physiological blocks, and I suggested she make some changes in her relationship with food based on my evaluation. To her credit, Ms. C. recognized the exacerbating influence of certain foods after I pointed out what to look out for, and she made the necessary changes. By the time of her last treatment nearly two months ago, Ms. C. felt no pain.

We discussed her indicator symptoms, how they could help her maintain this degree of wellness, and she discontinued coming for acupuncture treatments. Easy as I’ve grown with the familiarity of such results, even I found the following synchronicity a little surprising:

The day after I started writing this posting, and completely out of the blue other than my  curiosity about how she was doing, Ms. C. called me to report on her good fortune. She reported being completely pain-free without taking any anti-inflammatory medicines or pain relievers. She even rejoiced in being able to run around playing soccer with her children. We briefly discussed her indicator symptoms, and she reported have no difficulty maintaining the lifestyle (dietary) changes she had made while she was receiving treatments.

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Passive Health Care Breeds Dependence

By Steve | Published: September 3, 2009

Passive care is ANY form of health care where the patient is a passive consumer of a good or service. That might be a pharmaceutical medicine, surgery, joint or other physical manipulation, dietary supplement, or any other consumption-based attempt to improve your health. Let me be very clear: I don’t consider this a problem with any particular therapy, but a failure in how many use the technologies that humankind has developed.

Modern clinical theory teaches acupuncturists to practice according to the passive care model. It match the commonly held standards of modern medicine, and treat their patients to manage the intensity of symptoms. While this allows patients to maintain their diseases without having to expose themselves to the potentially toxic “side-effects” of pharmaceuticals, it’s not the highest use of acupuncture. That’s why many acupuncturists seek other training — to increase the long-term value of their work.

Within the current health care arena, many patients comply with the passive care agenda, and grow dependent on their therapies. However, when you buy into that:

You’re not a Patient, You’re an Annuity!

While passive care (regardless of the specific modality) is a great economic model for the people and especially the corporations that provide it, it has much less value for patients. Passive health care reinforces the idea that the patient’s body is “broken” and needs to be fixed. Yet, the human body is made to heal! That is its NATURAL tendency. When the embodied spirit fails to restore health, we can conclude that SOMETHING is blocking its natural and intrinsic movement.

When used incisively, acupuncture and Chinese herbal medicine stimulate the embodied spirit to release its blocks to facilitate healing. When an individual’s entire being is focused on the healing process, when both the personality’s conscious choices and the embodied spirit’s automatic function are aligned, the possibilities are limitless. We’ve all heard of people that have healed themselves of cancer; those aren’t random events, but the natural result of the embodied spirit unblocking its natural potential.

Take the initiative; find ways to heal your life. Don’t just be a passive consumer of health care!

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  • About Steven

    Steven Alpern, L.Ac., practices acupuncture and Chinese medicine as applied clinical philosophy. He is also a teacher, author and speaker. His efforts to discern the nature of individual health draw upon the classics of Chinese medicine and several historical traditions and specialties. Learn more...

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