Sjogren’s Syndrome 101
An amazing new study has found that acupuncture, the ancient practice of using needles to stimulate bodily self healing, is more effective than intravenous morphine for pain.
A truly groundbreaking study published in the American Journal of Emergency Medicinetitled, “Acupuncture vs intravenous morphine in the management of acute pain in the ED,” reveals that acupuncture — one of the oldest techniques to treat pain — is more effective, faster in relieving pain, and with less adverse effects, than intravenous morphine.
The study was conducted over the course of a 1-year period at the Fattouma Bourguiba University Hospital in Tunisia, a tertiary care facility with over 100,000 Emergency Department (ED) visits per year.
300 ED patients with acute pain were included in the study: 150 in the morphine group (administered up to 15 mg a day) and 150 in the acupuncture group. The two groups were comparable in terms of age, sex, and co-morbidities, with the only significant difference being that there were more abdominal pain patients in the morphine group and more low back pain cases in the acupuncture group.
The striking results were reported as follows:
“Success rate was significantly different between the 2 groups (92% in the acupuncture group vs 78% in the morphine group P b .01). Resolution time was 16 ± 8 minutes in the acupuncture group vs 28 ± 14 minutes in the morphine group. The difference was statistically significant (P b .01). The mean absolute difference in pain score between the 2 groups was 7.7. This difference is not clinically significant because the minimal clinically significant absolute difference reported by Todd et al is 13. In morphine group, the mean total dose of morphine administered was 0.17 ± 0.08 mg/Kg (Table 2).
The pain scale change from baseline at each time point in the 2 groups is shown in Figure. From the 5-minute time point, the acupuncture group reported significantly larger pain decrease compared with the morphine group. This difference persisted during the entire study period. Change of blood pressure, HR, RR, and oxygen saturation was not significant in both groups.
Overall, 89 patients (29.3%) experienced minor adverse effects: 85(56.6%) in morphine group and 4 (2.6%) in acupuncture group; the difference was significant between the 2 groups (Table 3). The most frequent adverse effect was dizziness in the morphine group (42%) and needle breakage in the acupuncture group (2%). No major adverse effect was recorded during the study protocol. (See Table 4.)”
In short, the acupuncture group saw a great pain-relieving effect, which occurred faster, with significantly less side effects.
A graph from the study showing the pain-decreasing differences between morphine and acupuncture
Since 1996, the World Health Organization has recognized acupuncture as a safe and effective therapy for the treatment of a wide range of conditions, including pain and discomfort.1 Despite this, the use of acupuncture within the conventional standard of care is still exceedingly rare. A deep skepticism exists for therapeutic modalities that do yet have a clearly characterized mechanism of action, as defined through conventional biomedical understanding and terminology. Often, in lieu of this, its therapeutic effects are written off as merely “placebo.”
Placebo, however, is not as diminutive term as it may first seem. The placebo effectactually reflects the deep power and regenerative capability of the body-mind to heal itself. And since its power translates directly into real, measurable improvements in terms of clinical outcomes, it does not matter if we fully understand “how” it works. Also, consider that “evidence-based” (EB) medicine not only depends entirely on clinical outcomes as final proof of an intervention’s efficacy, but also, the entire EB medicine model depends on “controlling” for the placebo effect, as it is already tacitly recognized as having immense power in influencing the outcomes in most interventions. And so, whether or not a fully known or plausible “mechanism of action” has been identified is secondary in importance to whether it works or not in clinical practice.
Clearly the new study reveals that acupuncture has a powerful role to play in pain management. With addiction to pain relieving drugs affecting millions around the world, acupuncture is perfectly poised to provide patients a time-tested, drug-free alternative. As you can see from the study’s graph, the adverse effects comparison is staggeringly in favor of acupuncture as the safer modality.
Finally, here are the study’s powerful conclusions:
“Our study demonstrated that in patients with acute pain syndromes presenting to the Emergency Department (ED), acupuncture is at least as efficacious and has a better safety profile than IV morphine. The results of this study suggest that acupuncture has a potential role in controlling acute pain conditions presenting to EDs and appears to be safe and effective. Future studies should be performed in international populations.”
1. World Health Organization. Acupuncture: review and analysis of reports on controlled clinical trials; 2002.
What is Chi Kung?
By George Mera
Kung means mastering something, spending time and dedication till the activity transforms in an art. Kung-Fu is the person who possesses arts and skills and has excelled in any area of expertise so martial artists, musicians, and lawyers are called Kung-Fu.
Experts in Chi Kung have mastered the energy of life; they can control and manipulate Chi in order to exert incredible physical force or to heal a person. The force of Chi is described as the one that crazy people have, people on drugs or a woman that lifts a car in order to rescue her children. It is an internal force, it is not related with muscles but with Chi.
The philosophy of Chi Kung declares that we are all healers, we all have the potential. In Chi Kung’s practice we are encouraged, without becoming paranoid or hypochondriac, to constantly scan our bodies, organs, tendons and ligaments trying to detect any stagnancy of Qi in the meridians, to resolve the problem before it becomes serious.
Chi Kung is really a pleasant activity; we see obstacles as opportunities to grow. When Chi is stuck in certain parts of our bodies or organs, the game is to liberate the Chi and using some gentle techniques and patience, the areas of chronic pain will disappear.
After you resolve your physical concerns, many of the emotional tribulations seem possible to overcome. Then your mind can start trusting itself to disperse the clouds of negative thoughts and you find yourself looking at the future with real contentment and pleasant internal dialog in your mind.
In this game of Chi Kung, the stronger the physical discomfort the more powerful the opportunity to release more Chi. The bigger the emotional scars the more the potential for love. The more doubt and questioning that is experienced by the disturbed mind, the closer we get to enlightenment.
There are thousands of different types of Chi Kung; they are classified in five principal schools:
The school of Stillness. When the mind becomes like a peaceful lake with no ripples. Many poses are held and much visualization is taught.
The school of Movement. Some routines have only few or hundreds of movements. Some imitate animals, like the white goose, or the movement of the four constellations. This school is vast and the most popular.
The school of Breathing to have an internal vision of the organs. For this school we are the microcosm of the macrocosm. Whatever is happening inside your body is happening in the stars. To know the universe you need to first know yourself.
The school of Medical Chi Kung consists of exercises prescribed by doctors to treat conditions from simple ailments to hepatitis or cancer. Many studies and research have been compiled all over the world, showing how internal and external (Healing Hands) Chi Kung can effectively help to heal.
The school of Taoism, Confucianism and Buddhism. The metaphysical Chi Kung. These spiritual practices are looking for Shien or Satori; spiritual enlightenment or immortality. The Chinese government has generally tried to encourage Chi Kung as a science and discourage religious or supernatural elements.
Dieting and nutrition are subjects for which there are many differing, often conflicting, viewpoints. Within the debates there are political, sociological, cultural, environmental, scientific, ethical and financial influences which flavor our theories and ultimately our food choices. Eastern medicine provides us with a framework for viewing nutrition which is above all of the debates and choices which we will still have to make for ourselves.
The eastern view of nutrition works in the same way that the eastern view of medicine works. That is to provide a global framework that is flexible enough to be uniquely suited to an individual based on their state of health and also allowing room, in the case of nutrition, for an individuals preferences.
The information in this section is intended to provide you with a clear understanding of the way that a practitioner of eastern medicine may view nutrition as well as to provide you with some clear guidelines to assist in the decisions that we all must make surrounding our food choices.
Within traditional chinese medical theory there are a number of factors which either cause a/or are the result of disease. The factors can be physical/climatic factors such as heat, cold, wind, dampness and dryness. These can be both internal and external such as a cold condition from using too much internal energy or a heat condition from an external source such as radiation. There are also emotional factors which tie into the five element theory above, such as anger effecting the functioning of the liver leading to headaches, for example, or excessive joy effecting the heart leading to insomnia.
From a practitioners perspective an eastern medicine diagnosis does not usually carry any association with the western medical diagnosis. For example, using eastern medical theory we might call a “headache” Qi or Blood stagnation. From a nutritional standpoint it is important to understand what each diagnosis means and how you might aid your healing by choosing appropriate foods.
The following information below describes the food choices which may be helpful for a particular general TCM diagnosis. It should be mentioned that the Spleen is of the utmost importance in the majority of these disorders when looked at from a nutritional perspective. The Spleen is the foundation of digestion and consequently plays a primary role in the production of Qi and Blood in the body. Thus, food choices, cooking styles and eating habits which benefit the Spleen, benefit the person overall regardless of their condition.
In general terms, the Spleen benefits from eating a balanced diet with ample amounts of grains, fruits and vegetables, not eating too much raw food including salads, limiting damp producing foods such as dairy, greasy foods and alcohol, as well as having regular meals which are eaten in as peaceful of an environment as possible.
Qi Deficiency Diagnosis:
» symptoms – fatigue, dizziness, shortness of breath, pale face, weak spirit
» tongue – pale w/thin coat
» pulse – empty
Supportive Foods For Qi Deficient Patients:
– Indicates an imbalance of the Spleen.
– Foods which are easy to digest, warming and nourishing should be used. Those from the Earth element below are helpful choices.
– Millet, Garbanzo Beans
– Pine Nuts
– Figs, Dates
– Squash, Carrots, Cabbage
– Small portions of Meat, if desired
Qi Stagnation Diagnosis:
» symptoms – similar signs as qi deficiency but also pain that is not fixed in the chest a/or hypochondriac areas
» tongue – white coat
» pulse – wiry or tight
Supportive Foods For Qi Stagnation Patients:
– An imbalance of the Spleen.
– Food choices similar to those for Qi Deficiency are good choices.
-Preparing them in ways which are even easier to digest such as soups may also be helpful.
– Adding small amounts of strongly moving substances such as black pepper, aid to support patient’s wellbeing.
» symptoms – poor appetite, chest/epigastric oppression, loose stools
» tongue – thick white or yellow coat
» pulse – slippery and slow or rapid
Supportive Foods For Dampness Patients:
– Dampness is also a Spleen related imbalance.
– Generally it is the result of long-term qi deficiency but may also arise quickly from a diet that contains too many cold, raw foods, excessive dairy products or excessive amounts of greasy foods, animal products and/or alcohol.
– Food choices similar to those above are helpful.
– Adding foods which dry dampness such as rye, scallions and turnips and limiting the foods listed above which contribute to dampness.
Blood Deficiency Diagnosis:
» symptoms – fatigue, palpitations, dizziness, numbness, blurred vision
» tongue – pale w/thin coat
» pulse – thin
Supportive Foods For Blood Deficient Patients:
– Blood deficiency is usually seen as a result of long-term qi deficiency.
– The Chinese term, Blood is used in a much broader way than the western idea of blood. However, blood deficiencies may still arise from traumas, child birth and menstrual issues such as heavy bleeding.
– Generally foods which supplement the Spleen, as above, are considered good choices.
– Dark leafy greens, spinach, grapes, lotus root, cayenne pepper, and small amounts of meat products, especially liver, are beneficial additions to help the production and circulation of Blood.
Blood Stagnation Diagnosis:
» symptoms – dull complexion, petechiae, pain that is fixed in location
» tongue – purple a/or purple spots
» pulse – deep, choppy, maybe wiry
Supportive Foods For Blood Stagnation Patients:
– Often a deeper manifestation of qi stagnation but may also arise from trauma.
– The foods mentioned above for Blood deficiency are useful.
– Adding to those which strongly move the Blood in the body such as turmeric, garlic, scallions, chives, egg plant and aduki beans aid to the patient’s wellbeing.
Heat Condition Diagnosis:
» symptoms – sweating, sore throat, thirst, red face, headache, skin outbreaks, anxiety
» tongue – red, dry, yellow coat
» pulse – rapid, maybe floating a/or wiry
Supportive Foods For Heat Condition Patients:
– Heat may show up in a variety of ways depending on the underlying condition.
– From a nutritional perspective it is most important to understand whether it is a “full-heat” syndrome or a “false-heat” syndrome.
– “Full-heat” is a pure excess condition which can be helped by consuming cool foods.
– “False-heat”, however, indicates heat from an underlying deficiency which could be worsened by an excessive consumption of cool foods.
– Fruits and raw vegetables, including salads, are generally cooling and beneficial for a heat condition.
– Limiting foods which create heat in the body such as dairy, meats and alcohol is also important.
Cold Condition Diagnosis:
» symptoms – fatigue, poor appetite, pain that improves with heat
» tongue – white coat, possibly blue body
» pulse – slow, maybe floating a/or tight
Supportive Foods For Cold Condition Patients:
– As with heat, cold may show up in a variety of conditions and appear as “full-cold” or a “false-cold” condition where a person has a heat condition but is experiencing a sensation of cold (chills with a fever, for example).
– Warming and moving foods such as cayenne, cinnamon, ginger and onions are important for this condition.
– Limiting cooling foods especially raw foods and fruit juices is also important.
Chinese nutrition lies at the root of Chinese medicine and is fully integrated into social eating habits in China. This ancient cultural knowledge is now being spread into western society and with that, greater understanding of how food can be used as nutritional medicine. By applying the ancient theories of Chinese medicine to our modern society, we can learn how to live in better harmony with the surrounding environment, reduce our impact on the climate, improve our health and prevent disease.
For practitioners of Traditional Oriental Medicine, nutritional strategies whether TCM based, western nutrition based or other-principle based are common and patients often need guidance on diet and nutrition strategies. At present, it is difficult to assess from an evidence-based perspective whether classic TCM diets could influence diseases or act in the treatment of any disease or condition. However in clinical practice, using TCM tenets of nutrition along with individualization of treatment strategies for individuals with conditions that will likely benefit from nutritional interventions are feasible. This could include many conditions such as gastrointestinal disorders, chronic metabolic conditions and even stress, anxiety and general lifestyle recommendation.
The recommendation is to assess each patient individually in order to determine which nutritional approaches may work best based on both their constitution and current complaint and modify those suggestions appropriately. Finally regardless of what nutritional strategies you employ or if the foods are native to Asia or not, the most important things for the clinician to suggest are choosing clean, uncontaminated foods when possible, selecting the least processed food, and finally encouraging patients to be in calm and enjoyable settings when preparing and eating food. The longer the shelf life the shorter your life. Eat to live, don’t live to eat.
Eat, Drink, & Be Mindful 🙂
Traditional Chinese medicine (TCM) is a holistic form of medicine with a 5,000- year history. It comprises traditional Chinese herbal medicine (TCHM), acupuncture, acupressure, massage (Tui Na), energy therapy (Chi Kung) and other practices. The core concepts of TCM have influenced the development of other oriental therapeutic systems, such as Kampo and traditional Korean medicine. TCM was introduced to western countries in the 1970s after US president Richard Nixon officially visited China.
Basic theory of TCM
TCM concerns harmony of the body, differentiation of symptoms and signs, and holistic treatments. The full theoretical system was established 2,300 years ago, when philosophical theories of yin-yang and the five elements were applied.
Yin-yang theory focuses on the opposite characteristics of different substances and phenomena. Yin represents negative, passive and internal features, while yang represents positive, active and external features. The yin-yang symbol (also called tai chi or tai ji), interprets the relationship between the two: yin (the black part) contains the seed of yang (the white spot), and vice versa. All phenomena in nature have yin and yang features. They are opposite but interdependent and can alternate through a cyclical movement. If yang declines, yin will rise, and vice versa.
In TCM physiology, the stomach is a yang organ because it is in contact with the external environment through the gastrointestinal tract and has yang functions, such as absorbing foods and extracting nutrients (“food essence”) to produce “vital energy” (qi). Yin organs, such as the heart, liver, spleen, kidneys and lungs, are less dynamic and store energy. Symptoms are also categorised as yin (cold, slow, wet, chronic) or yang (hot, rapid, dry, acute). Yin and yang symptoms are trans- formable; at the early stage of illness, cold symptoms (yin) can transfer into heat in the body (yang). In treatment, “cold” conditions are generally treated with herbs having “hot” properties.
The five-element theory further explains the Chinese medical system, using wood, fire, earth, metal and water to describe different substances and phenomena of similar natures. For example, in TCM, the function of the spleen is to transform food essence to produce qi and blood.These are similar to the nature of earth — growing, planting and generating — so the spleen is considered to belong to the earth element. The kidneys, ears, salty taste and fear are associated with water. Thus, chronic tinnitus could be a symptom of kidney deficiency, which could cause anxiety and fear, possibly associated with a salty diet.
The five elements have complex relationships. An excess or deficiency of any one element is believed to disrupt balance and cause disease. Medical language used in TCM needs to be distinguished from that of conventional western medicine, particularly in describing organ function. In TCM, each organ is a holistic complex energy system, (eg, the heart is responsible for the mind and blood circulation, and has a sense of happiness, which does not correspond with western medical thinking).These differences are probably due to the fact that dissecting the human body was prohibited in ancient China.
Another essential concept in TCM is that of vital substances: qi, blood, essence (jing), body fluids and mind. These constitute the human body and maintain the functions of the organs. Deficiency in any of the substances will result in an imbalance of yin- yang and cause disease. Other important principles in the TCM framework include the theories of viscera and meridians (longitudinal pathways across the body, along which acupuncture points are distributed) and the identification of patterns.
Diagnostics and therapeutics Observation (wàng), listening and smelling (wén), interrogation (wèn), and palpation and pulse taking (qiè) are the four principal diagnostic techniques used in TCM. A practitioner will observe the patient’s face and tongue, ask for details of symptoms, medical history and life style, listen to the patient’s voice, palpate the skin and abdomen and feel his or her pulse.
The term “pattern” is used in TCM to describe symptoms and classify disease. Particular patterns are looked for among overall symptoms and the corresponding treatment applied.Treatments are highly individualised, and may include use of TCHMs as well as physical therapies such as acupuncture, acupressure and massage. One prescription could be used for several health problems and similar health problems are treated differently if they are not in the same TCM pattern. Follow-up consultations with prescription changes are common.
Materia medica of TCHM
Chinese herbal medicines are prescribed by their Chinese common names and different herbal species can be used under one name. For example, Mu Tong, a Chinese herb for promoting diuresis, includes various plant species: Aristolochia manshuriensis, Clematis armandi, C montana, Akebia quinata and A trifoliata. The number of herbal ingredients in a prescription can vary from one to more than 15. Herbs have different functions within a formula. The principal herbs target the main symptoms and associate herbs assist the function of the principal herbs and target other symptoms. Next are adjuvant herbs to strengthen the functions of the principal herb(s) and reduce toxicity, and last is the messenger herb which guides the function of all the ingredient herbs into the right pattern and harmonises the function of the formula.
Chinese herbal formulae are available as mixtures of crude herbs for internal use as a decoction, and Chinese patent medicines (CPMs), which are finished or formulated products (eg, capsules) made from crude herbs. Some modern CPMs combine herbal medicines with pharmaceutical drugs to improve efficacy and reduce the possibility of side effects. In the UK, some of these combination products are supplied by TCHM shops as herbal medicines and this has become an important quality and safety issue.
Efficacy of TCHM
Scientific evidence for TCHM is generally achieved through assessing the efficacy of specific herbs or formula. For example, the efficacy of a standardised herbal formula for atopic dermatitis has been assessed in several double-blind, placebo controlled trials. One randomised, double-blind, placebo-controlled trial involving 116 patients with irritable bowel syndrome assessed both individualised TCHM treatment (reflecting how TCHM is prescribed in practice) and standard prepared TCHM products. Patients’ bowel symptoms scale scores improved significantly in both TCHM groups, compared with placebo (P=0.001), but only the individualised TCHMs group still had improvements at 14 weeks. However, it is beyond the scope of this article to review all clinical trials for TCHMs.
A review of randomised controlled trials (RCTs) of TCHMs shows that most trials have been conducted in China and published in Chinese, and that their methodological quality does not meet European criteria. To date, the Cochrane Library has published nine systematic reviews of clinical trials of Chinese herbal medicine or medicinal herbs for atopic eczema, schizophrenia, diabetes, chemotherapy side effects, acute bronchitis, acute pancreatitis, hepatitis B virus infection, chronic hepatitis and influenza. These provide limited evidence of efficacy for TCHM: conclusions of these reviews are generally that there is a lack of high-quality RCTs and that rigorous studies are needed. Eighteen protocols for new systematic reviews of clinical trials of Chinese herbal medicines have been published in the Cochrane database, including herbs or formulas for cancer and gynaecological and digestive problems.
The constituent chemical compounds of Chinese medicinal herbs are diverse. The absence of rigorous toxicological information for many herbs does not necessarily indicate safety. Toxic herbs used in TCHM are traditionally classed as slightly toxic, toxic, extremely toxic and deadly toxic, based on the experiences of ancient Chinese. For example, croton seed (Ba Dou) is classified as extremely toxic and aconite root (Fu Zhi) as toxic. Dosage limitations have been documented for each herb.
Some crude herbs are processed to reduce toxicity. For example, Jiang Ban Xia is a traditional processed product of raw pinellia tuber (Ban Xia), and is boiled with gingers and alum for internal use. Raw pinellia tuber is believed to be toxic and should only be used topically. Tests have demonstrated that the processed pinellia tuber is less toxic than unprocessed tuber.
Awareness of safety issues concerning specific herbs increased following the inadvertent misuse of toxic Aristolochia species by a slimming clinic in Belgium. There were over 100 cases of renal failure in Belgium and at least four cases were identified in the UK. Furthermore, a five-year toxicity study on traditional medicines identified 21 cases of liver problems associated with TCHMs, but no single hepatotoxic herb has been identified.8 In addition to intrinsic toxic effects of some TCHMs, there is a potential for interactions between TCHMs and other medicines, although this has been poorly investigated. However, not all interactions are clinically relevant, and some may even be therapeutically useful.
Another issue is the use of animal material in TCHM. This carries a latent risk of various infectious diseases passing from animals to humans. Some animal products used in TCHM, such as tiger bone and bear gall, are listed by the Convention on International Trade in Endangered Species (CITES) and despite efforts to stop the practice, some endangered species are still used and included in TCHM textbooks.
A phytochemical study of 12 paeoniae samples collected in London, showed the content of paeoniflorin varied from 0.01–4.57 percent.10 The legitimate substitution of Chinese medicinal materials under a given Chinese name brings another difficulty in quality control. For example, the species Aristolochia debilis, Saussurea lappa and Vladimiria souliei can all be supplied under the name “Muxiang”. The latter two herbs are relatively safe but Aristolochia debilis contains toxic aristolochic acids.
Chinese patent medicines with the same formula name can also vary in ingredients when produced by different manufacturers. For example, the number of labelled ingredients in each of the eight CPMs all named “Gui Pi” was found to vary between 2 and 13.11.
Other issues relevant to safety include the behaviors and practices of TCHM practitioners and users. It is common practice in TCHM to change herbal prescriptions as frequently as every few days. TCHM practitioners consider some adverse effects (eg, diarrhea) to be part of the normal response to treatment. Frequent consultations are useful in identifying acute adverse effects, and prescriptions can be modified to reduce these. However, adverse reactions that develop only with chronic use, or that have a delayed onset may not be easily identified.
Pharmacovigilance practices for herbal medicines are still developing. Suspected adverse drug reactions (ADRs) associated with unlicensed herbal medicines have been reportable using yellow cards since 1996. Recognised reporter groups now include doctors, pharmacists, nurses, midwives and health visitors and, recently, patients but not herbal medicine practitioners. Some practitioner groups, for example the Register of Chinese Herbal Medicine, have systems to collect reports of ADRs from their members.
11. Samuel M, Wright C. Chinese herbal patent medicines in the UK. British Pharmaceutical Conference Science Proceedings 2003 15–17 September; Harrogate. S31–S32.
By Leon Hammer, MD
First published in The American Acupuncturist, Fall 2007, Volume 41
Abstract: Awareness – awakening – is the single most important quality of life to healing and growth in all therapeutics, religion, and philosophy, since the beginning of recorded history. It is central to the changes we must contemplate in terms of healing for both patient and practitioner. Chinese medicine has a great deal to offer through its diagnostic and treatment modalities in service to this critical goal.
It is said that God is not interested in peace, only clarity. This was Avatar Meher Baba’s message when he proclaimed silence and said, “I have not come to teach, only to awake.”i In Zen Buddhism, the focus is on the here-and-now, as it was with Gestalt Therapy developed by Fritz Perls. Freud’s objective with psychoanalysis was to make the unconscious conscious, and the Jacob’s ladder of the Kaballah is one of increasing awareness.
Enhancing awareness has been the center and focus of every esoteric religion, the central issue of science, and the central goal of psychology. The central concern of existentialism is “How awake is this person to the life inside and outside of themselves?” asks Albert Camus in The Stranger.ii
Nevertheless, even awareness requires caution for it is said that one does not dare desire the impossible in full awareness, without being psychotic. I have seen this happen to neophyte meditators isolated in monasteries of various religious persuasions.
It is my thesis that safe awareness is the primary goal and potential accomplishment of Chinese medicine. Indeed this is the opinion of most of the patients I have encountered therapeutically in the past thirty-six years. The awakening is in all areas of life from the most intrinsic knowledge of self to changes in lifestyle.
In one of my nine month courses on Asking Diagnosis, I recommend to my students that they have several posters on the walls of their future office. One would say: “Terrain and Stress” (Is it the bacteria [stress] or the body condition [terrain])? The second would say: “Vulnerability, Vulnerability, Vulnerability.” The third would say: “Diagnosis, Diagnosis, Diagnosis” and the fourth “Management, Management, Management.” The fifth, in the largest letters of all and most prominently placed, will be a sign that says: “AWARENESS, AWARENESS, AWARENESS.”
II. Aware of what?
The question arises, aware of what? In an excellent paper, Lonny Jarrett iii argues that the awareness is one of choice that overrides the ego concerned with only itself in the space occupied by fear (water) and desire (heart), and responds only to the “unchanging authentic self” that has universal concerns. He states “Simply put, freedom means `free to choose’ as opposed to being a slave to the mechanism of a conditioned mind.”
Freedom of choice is an issue that leads down many thorny roads filled with more questions than answers.
One is Sullivan’s definition of neurosis that condemns people to repeat the same behavior and thought patterns despite their maladaptive nature. The goal of all interventions ascribed to as therapeutic has been to break that cycle, one that I address with regard to Chinese medicine in section V of this paper.
The second is the dilemma of the “individual.” I consider Chinese medicine unique in its ability to provide the tools to delineate one individual from another, whatever the CF, Sho, or other ascribed condition (to be discussed in detail in another context). It seems as if Jarrett is saying we need to be aware that we can make a choice. That may be true but who would agree on what is “universal?” The religious right and people who deny global warming would not agree on that definition from Jeffersonian deism and tree huggers like myself. One could argue that these are not “universal” but ego-driven values.
This also raises the question, how do we achieve the state of egolessness required for a choice based on universal awareness rather than ego driven values?
A third issue discussed in greater detail elsewhere is that of containment to which Jarrett alludes as necessary to make a choice. I believe that containment is a major and natural necessary function of the Liver in the service of making choices of behavior throughout life, and is the positive aspect of Liver qi stagnation. I would argue that there is too little Liver qi stagnation in our time, not too much, and that the inability to bear the pain necessary to maturity, what Campbell meant by “life” (see below), is a major Liver qi-yang deficiency due to the cold substances universally used in our culture. Containment with Liver qi-yang deficiency is impossible, and containment is necessary to hold an idea until it can be sufficiently considered to lead to a thoughtful choice (plan and decision or direction).
I argue that the goal of what all esoteric religions and sincere therapeutics mean by “awareness” has always been what Jarrett calls the “unchanging authentic self,” and that behavior towards the larger world (your neighbor) is also an unchanging measure of that achievement. Eric Frommiv in his eulogy to Harry Stack Sullivan at Carnegie Hall in 1949 mentioned that cultures are ultimately measured in history by how the powerful treat the powerless (Sullivan literally gave his life for this).
The pursuit of the genuinely spiritual has been desecrated by “new age” spiritualism that embraces the easy road to nirvana through drugs and weekend workshops. These are only ways to avoid the pain that takes a lifetime to experience before we reach even a modicum of wisdom if we want to equate that with enlightenment.
Joseph Campbellv relates a story in which a group of young American neophyte Buddhist priests dressed in saffron robes visit him with the message that he has been wasting his life exploring religions and myths and that he should follow them because they have found the “way.” After their endless entreaties he congratulated them and said that there was one small sticking point. When asked, “Man, what that could be?” he answered, “life.”
It is also interesting that Jarrett measures spiritual achievement by behavior and not by feeling, with which I entirely agree. What ‘feels good’ is not always good. This is at the heart of the Hebrew ethic. Spirit in the Hebrew tradition has always measured by what you do, not how you feel.
Lastly, on the subject of “aware of what” I would add[jlb1], without elaboration here, that we need the capacity to be fully aware of the great unknown of our existence, our ultimate insecurity, who and where we are; and this without the artificial refuge of the many bearings of power.vi
III. Practice of CM is the Practice of Awareness Our senses are our primary tools of awareness.
In 1919 William Oslervii, the dean of Western medicine wrote, “Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone can you become expert. Medicine is learned by the bedside and not in the classroom. Let not your conceptions of the manifestations of disease come from words heard in the lecture room or read from the book. See, and then reason and compare and control. But see first.”
What do we do?
We ask and listen, especially with the “third ear,” not to what people say, but what they do not say, to what people avoid, and to what they want underlying the verbiage. We “look” with the “third eye” to see if body language belies words. We touch (pulse and palpation), smell, “feel,” and with our hearts we intuit and empathize. With our minds we receive, process with logic, and integrate. Some of these are discussed in “The Therapeutic Relationship”viii[w2]. Others will be covered in a forthcoming book on diagnosis other than the pulse.
IV. Heart Phase
The Heart plays the central role in awareness and in all aspects of human psychology. The spiritual force of the Heart is dominant in the development and function of all the other energetic forces related to the mind, spirit, and soul. The Heart controls the mind: mind affects the Heart.
In Oriental terms, the key to subtle unspoken awareness is an open Heart; free of desire, craving, addiction and its pursuit. As Claude Larre and Elizabeth Rochat de la Valle wrote [w3][jlb4], “By nature man’s Heart is vast and free like Heaven; always tempted to fill itself, it must seek to become empty. An empty heart can receive.” What fills the Heart instead is desire, and craving interferes with awareness. Life is spoken of as a “rambling walk directed by the Spirits.” This “long life, everlasting vision and rambling walk” can be damaged. “ For life to be fulfilling one must allow the Spirits guide the Breaths through life.”ix
The Pericardium and Triple Burner acknowledge and express this awareness with words.x While the Heart is the emperor, the Triple Burner runs the empire. The water grounds us in the here-and-now. The wood provides direction. The metal, when healthy, provides flexibility. “The Earth Phase bears the milk of human kindness and fulfills the ‘basic need’.” This is the beginning of self-worth. The Heart yin is the medium which enriches that “milk” into the “cream” of human congeniality and fulfills the basic “want.” Here is the source of all joy.
In my book Dragon Rises-Red Bird Flies, I wrote that “Perhaps the most important consequence of the introduction of acupuncture into my practice was the flowering of awareness in my patients and my own appreciation of its significance to growth and development.”viii Awareness as mentioned above is the centerpiece of Zen Buddhism and is almost synonymous with the concept and experience of enlightenment.
The Heart fire energies are deeply concerned with “creative awareness and expression.” With regard to awareness I wrote further that “Heart yin inspires that substance [from Kidney yin] into awareness and Heart yang gives form to the creative idea[w5].. The dominance of consciousness and awareness, of creativity and love, by Fire energies places these energies in the center of all interpersonal considerations.”
“Also, in terms of consciousness and awareness, the Fire Phase contacts the general energy [Heart], distributes it fairly [Triple Burner and Pericardium], and purifies it [Small Intestine]. On the level of feelings, and at their supreme maturation, these energies nourish and govern the awareness and the expression of unconditional love, both for self and for others.”
Heart energies are responsible for the higher, conscious, intellectual mental “investigation of life” including: awareness, “symbol formation,” and the communication of ideas and feelings. The heart “opens” to the tongue and is embryologically close to the throat. There is a Hindu saying that “if one can close off the throat, one closes off the flow of thoughts.” The Heart controls the circulation of ideas within and between men.
“Only through these Heart yin energies do the Divine Spirit, Divine Love, and Divine Will [discussed elsewhere in relation to Kidney qi, yin and yang] come into conscious human awareness.” Divine revelation is the gift of Heart yin. A deficiency of Heart yin will manifest as a “lack of awareness and consciousness of the inner self”. An excess of Heart yin energies involve “a greatly enhanced awareness of both the inner chaotic world of the unconscious and the constantly impinging sensory and
emotional stimuli from the outer world.”xii Too much of a good thing is destructive.
All of the clinical issues mentioned below in the language and concept of Chinese medicine; phlegm, fire, deficient heat, trapped qi, qi and yang deficiency, closed orifices, blood stagnation all interfere with the ability of the Heart to fulfill its energetic function to maintain contact with and sustain full awareness of the outer world of interpersonal affairs as well as the inner mental, emotional and spiritual world.
Depending on degree of interference, as well as other variables such as constitution, shock, trauma, nutrition work, exercise and habits (drugs, sex, etc.), there can be a wide variation in the severity and the nature of symptoms associated with a loss of awareness due to an impediment of heart and other fire energies.
Almost all psychological disorders can be understood as a function of awareness either in quantity, quality (perception and distortion) and form. In fact, the Greek word for insanity is alienation, which is in fact a loss of awareness of what is coming to or from the inner world (boundaries).
The principal problems that attend human relationships fall mostly into the realm of communication. Fire energies are all about communication. Heart yang and Pericardium yang, Triple Warmer and Small Intestine energies as discussed in my book xiii are all involved in the appropriate and effective expression of thoughts and feelings. Where the clarity of communication is involved, all of the distortions attending maladaptive discourse are rooted in awareness. They are, therefore, also ineluctably rooted in the integrity of the Heart and Pire phase. Therefore, all human problems from marital and family conflicts to the most serious neurosis and psychosis are to some extent the manifestations of defects in fire energy performance. For more information regarding psychological disorders related to Heart function I refer you to chapter 15 in Chinese Pulse Diagnosis: A Contemporary Approach [pp. 547-8 and the glossary] and Dragon Rises Red Bird Flies, chapter 14 [pp. 316-319; 333-338].) (Another paper more closely examining the Fire-Heart Phase will be forthcoming.)[w6]
The herbs that are listed below are critical to that performance in combinations dictated by an accurate Chinese diagnosis of the “individual”.
V. Vicious Cycle
Prescriptions for enhancing awareness begin in our earliest history attested to by archeology and anthropology and by the history of religion and philosophy. The latest in this long line, which includes meditation of endless sorts, are the modern psychologies.
With regard to the latter, having studied and practiced this discipline for over fifty years, it was clear to me from the beginning that an intellectual exchange was insufficient to converting intellectual insight into true living awareness. My professional odyssey involved a search for a way to make that conversion that finally centered on touch but included LSD, when still available in pure form, as a therapeutic modality. The methods of touch that I encountered were all centered on the psychoanalytic concept of resistance embodied in the musculo-skelatal structure and usually involved an assault on that structure that I would equate with the modern “wars” on drugs and terror. This was a “war” on “resistance” that I observed only deepened rather than resolving it.
In Dragon Rises, Red Bird Flies, I reinterpreted “resistance” as simply maladaptive ways of maintaining “contact” in order to stay “intact.” Rather than “attack” it as “resistance” I found identifying the talent and differentiating it from the distortions was a more productive approach to maladaption. This was an improvement over the “attack” approach; however the tendency for maladaptive behavior in the face of insight and experience continued to be a challenge. The “vicious cycle” of stimulus and maladaptive response seemed difficult to break and defied all mental constructs and techniques. Some vital part of the cycle was missing from our theory and practicexiv.
Though Freud, Sullivan, and Reich all used energetic constructs in their theories and work, only the Orientals developed in detail what I found to be the missing link in the “vicious cycle.” That proved to be the energetic body through which the cycle traveled and was influenced, and that lay outside of Western psychological theory and practice.
In this paper I will discuss only one small but significant intervention in breaking the cycle, the link from insight to meaningful awareness. I am currently writing a book greatly enlarging the scope of this work that began conceptually and diagnostically with Dragon Rises, Red Bird Flies. It will include management and treatment illustrated with one case history per phase delineation [ex: Heart yin deficiency] typical of my experience.
VI. Orifice Opening and Related Herbs in Psychiatric Practice
This section concerns itself with the use of herbs to treat those psychological disorders that are rooted in the dysfunction of fire phase energies in synergy with each other. While the emphasis here is on the orifice (cavity) opening herbs, they cannot be considered in isolation from the accompanying etiologies and disharmonies that inevitably occur and the herbs which are used to treat them.
An important first consideration is the concept of the “orifices of the Heart.” According to Imgard Enzingerxv[jlb7], who has done extensive work in this area, these were traditionally identified roughly with the sense organs, the ears , eyes , mouth , nares  as the “outer orifices,” and the “inner orifices” as a metaphor for the outer. According to her, the latter were visualized in the “Yangsheng texts or tests of Inner Alchemy as `orifices’, `holes, ‘caves’, ‘gates’ or ‘passes’ ,” “experienced as a kind of inner sensation, however, there are no orifices on the visible or touchable body. Nonetheless they have the concrete task to control the flow of qi. In my opinion, the seven inner orfices are functionally existing, and in their function in terms of both shen and qi, they are not reduced to the blood vessels coming from and going to the Heart.”
The orifices associated with “phlegm misting” seem to be firmly associated with the concept of the “Heart controlling the mind” since treating this condition clearly affects the mind often in very dramatic fashion that I have catalogued clinically.
My teacher, Dr. Shen, claimed that he could identify on the pulse the three great vessels and four valves of the Heart. I can consistently feel the mitral valve, and I and others have confirmed many times the presence of mitral valve prolapse (by echocardiogram) with a Slippery quality(phlegm) in this position. In Western medicine a mitral valve prolapse condition has been associated with panic attacks and phobias since I entered the profession fifty-five years ago. Treating the condition with herbs that are indicated for removing phlegm from the Heart orifices leads to dramatic results. In fact, over the years, I came to treat most emotional-mental problems in this manner with good results.
This has led me to suspect that while these inner orifices may be metaphors of the outer ones, that the entire picture does involve something more concrete.
B. Clinical Considerations and Pathogenesis
In my practice I used these herb formulas to treat mild, moderate and severe mental and emotional disturbances. The principal differences were in the greater or lesser weight given to specific herbs and dosages in the total picture. In Western medical terms these would include neurosis, depression, bipolar disorders and schizophrenia.
In Chinese medicine the causes could be any combination of Zang-Fu disharmonies, pernicious influences and triple burner pathology. Chinese medicine has been successfully treating these conditions throughout at least two to three millennia without the Western classification because Chinese medicine at its best provides the diagnostic tools to treat an “individual” not a “disease.”
The distinction between constitutional, congenital, childhood and adulthood etiologies is also vital. Still, most important is an accurate diagnosis of the “individual” since the substances recommended for use in this discussion must be included in a matrix of treatment that accommodates the entire entity.
While orifice opening herbs were always a consideration in treating psychological disorders, phlegm removing herbs were included in my practice especially if Slipperiness was felt on the pulse, and especially at the left distal and/or mitral valve positions. Slipperiness on other positions such as the right distal, and both middle positions also warranted consideration if the tongue and symptoms were appropriate. A vertical center-line on the tongue with thick coating is a sign of phlegm in the Heart.
Over time I routinely found that including Heart phlegm removing herbs was valuable with all emotional-mental issues even when the signs described above were not clear. As with all conditions, they exist as a process even before the body-mind communicates it in the way of symptoms and signs.
The literature discusses phlegm-cold and phlegm-heat. The former is associated with schizophrenia and depression and the latter with mania. In fact the distinction is not clear, as I shall demonstrate.
Phlegm accumulates for several reasons, roughly classified as excess and deficient etiology. In either case the issue is stagnation, of qi and less often of blood. Stagnation can occur due to excess of qi (blood) or a deficiency of either or both. In the case of excess there is more qi than the heart can move and with deficiency there is too little qi (blood) to overcome the stagnation.
An example of excess stagnation in the Heart is with a shock to the Heart when the left distal position (heart) is either Flat or Inflated. This can happen in utero, birth, childhood (usually Flat) or at any time during life (usually Inflated). An example of deficiency creating stagnation would be any impairment of Heart qi or blood for any reason that interferes with the movement of either, through the Heart, Lungs, and chest.
The organism abhors stagnation and brings metabolic heat to move it, first from the organ itself and later from the general reserve. If the stagnation moves then there is no further concern. If the metabolic heat cannot move the stagnation the heat accumulates, a condition unacceptable to normal functioning, and the organism sends fluid to cool the heat. This consumes yin of the organ and later of the Kidneys. As the heat and fluid accumulate the heat congeals the fluid that we call “phlegm.”
Therefore, phlegm (heat and fluid) is always ultimately present with stagnation, and in all cases of “phlegm,” heat is involved whether the cause is deficiency (phlegm-cold) or by excess (phlegm-heat).
Ultimately all unsuccessful efforts to overcome stagnation lead to to qi and yang as well as yin deficiency for the reasons described. The final state of exhaustion is when the Heart yin and yang separate, leading to a severe state of chaotic functionxvi.
It is important to monitor the heat removing herbs in these formulas since their continuation after the heat is removed can weaken the qi and yang of the Heart. Likewise the damp draining and phlegm removing herbs will damage Heart yin if not carefully monitored. Excessive use of formulas such as Cattle Gallstone Pill to Clear the Heart (Niu Huang Qing Xin Wan) can damage Heart qi and yin.
Awareness is the critical attribute whose presence is the single most important factor in health and whose deficit is the single most important factor in emotional, mental and spiritual disharmony.
I have attempted to explain the essential link between this critical awareness and the integrity of Heart and Fire energies that make these herbs so important to our well being.
I have used the orifice opening and phlegm removing herbs together with the other classes of herbs listed above to treat the entire spectrum of psychological misery from the least to the most disturbed.
The subject is vast, addressed in other writings past, present and certainly future.
i Purdom, C.B. (1971). Meher Baba; The universal message. The God-Man, pp.343-344. Meher Spiritual Center, South Carolina.
ii Camus, A. (1989) The stranger. New York: Vintage Books
iii Jarrett, L.S. (Spring/Summer 2007)“The awakening of choice.” California Journal of Oriental Medicine, Vol. 18 No.1.
iv Fromm, E. Eulogy to Harry Stack Sullivan at Carnegie Hall in 1949
v Campbell, J. Unavailable at this time.
vi Hammer, L. (1992) The Chinese healing art/science and power. American Academy of Acupuncture Review; Vol 4, No. 1,
vii Osler, W. Unavailable at this time.
viii Hammer, L.. (2006) The therapeutic relationship [for Chinese medical practitioners]. DRCOM
ix Lingshu, The spiritual pivot. chapter 8
x Hammer, L. (2005) Dragon rises red birdfFlies; chapter 10.Seattle: Eastland Press.
xv Enzinger, I. Personal Communication. July 27, 2007.
xvi Hammer, L. (1966) Towards a Unified Theory of Chronic Disease. Oriental Medical Journal, Vol 6, No. 2 & 3.
xvii Fruehoff, H. Personal Communication. June 29, 2007.
Dr. Leon Hammer is a medical doctor, psychiatrist, and psychoanalyst who has studied, practiced, and taught Oriental medicine for 35 years. He is currently chairman of the Governing Board of Dragon Rises College of Oriental Medicine where he teaches and writes. He is the author of many articles to be found at: www.dragonrises.edu, and of Dragon Rises Red Bird Flies and Chinese Pulse Diagnosis: A Contemporary Approach (Eastland Press). For further information please contact www.leonhammer.com
Acupuncture stimulates cartilage repair for patients with knee osteoarthritis. Using MRIs, researchers have quantified the therapeutic effects of acupuncture. Within four weeks, acupuncture successfully improves the condition of cartilage in the anterior medial and lateral tibial regions of the knee. In addition, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores document that acupuncture reduces pain and stiffness levels while simultaneously improving physical function.
Continue reading this article by clicking the link below:
Acupuncture relieves depression. Research published in the Journal of Science and Healing finds acupuncture safe and effective as an adjunctive therapy for the treatment of depression. The researchers concluded that “acupuncture was an effective and safe therapy in treating major depressive disorders. Particularly, the qualities of sleep and life (involving emotions) in patients with depression and schizophrenia were found to be improved after acupuncture treatment.”
Read the entire article by clicking the following link: Depression and Insomnia Relieved By Acupuncture
Lyme Disease: The mere phrase invokes a sense of fear and dread of the unknown. This disease is cloaked in mystery, while at the same time, hijacking lives and wreaking havoc on previously healthy bodies. If you’re diagnosed early, your chance of recovery is fairly high, though the symptoms may never completely dissipate. However, if…
Wanting to try Acupuncture, yet can’t stand the thought of needles stabbing you? Acupuncture is a procedure that is relatively painless, we use the sterile tool which is made of solid metal and hair-like in thickness. It glides through the spaces between the skin and muscle fibers, so with a skilled practitioner the only thing you’ll feel is your energy being activated, ready to begin your healing process. The following writer briefly goes over 5 things to keep in mind if you are apprehensive on recieving Acupuncture.
By Sara Calabro
Most people, when they hear about the benefits of acupuncture, find themselves thinking, “That would be so good for me!” Less stress, more energy, better sleep and digestion… Who doesn’t want that?
But for many people, there’s one thing that holds them back from enjoying the benefits of acupuncture: Fear of needles.
There’s a spectrum of needle fears, ranging from downright needle phobic to being moderately concerned about the whole voluntarily-being-stuck-with-needles thing. Regardless, fear of needles is the number-one reason people choose to forego acupuncture…
Read More At The Source: 5 things to remember if you’re scared of getting acupuncture
Taking myself towards the back of the valley, I had become compelled into taking the compostion of this photo, at this persepective. Hiking in the Forest, I witnessed the balance in nature, as it was seen, and captured the elemental forces of Yin within Yang, and Yang within Yin. A rare moment that I have been manifesting to the universe, in capturing nature being at it’s most “Ziran” harmonious state. Your continued guidance, never ceases to amaze. Dao, Heaven, Earth, and Man coexisting in inextricable bliss 🙂
Ancient Chinese practice lowers blood pressure, may lessen stroke, heart disease risks
Date: August 19, 2015
Source: University of California – Irvine
“Patients with hypertension treated with acupuncture experienced drops in their blood pressure that lasted up to a month and a half, researchers at UC-Irvine have found. This work is the first to scientifically confirm that this ancient Chinese practice is beneficial in treating mild to moderate hypertension, and it indicates that regular use could help people control their blood pressure and lessen their risk of stroke and heart disease…”
By Sarah Poulin, DACM, LAc, Dipl. OM
As Americans increasingly look to integrative medicine to serve their needs, multi-disciplinary medical centers in which a variety of health care options are offered are uniquely poised to shape the medical landscape of the future.
These multi-disciplinary practices offer a setting in which the patient in search of more holistic minded healthcare can find numerous qualified professionals who can work both independently and as a team to best serve the needs of both their patients and the community as a whole…
Read More At The Source: Practicing Acupuncture in a Multi-Disciplinary Setting
Aloha Kakahiaka. Sharing some mana’o with you on this rainy Saturday. Mo’olelo time. So yesterday night I had a premonition to pay homage to these two powerful healing stones: Pōhaku Kanini’ula’okalani (Rare Sacred rock of Heaven to recover from sickness) And so I did and the shrine has strong mana from it, yet my na’au is telling me the stones are not really here. Just the intention placed here is conjuring the mana. Somehow there is a strong connection of them calling to me. In need to talk with people here to know more about these stones, and how these Hawaiian stones transitioned into being a Buddhist/Hindu shrine at a Protestant Church next to an Elementary school. I have so many questions and excited on this journey these stones have started for me. I’ve done some research and the address to visit this shrine is at the end. If you do intend and go to visit, can you send me some feedback on your thoughts and experiences?
Two famous healing stones of Wahiawa were temporarily located at Kukaniloko after their discovery at a nearby stream. Tradition tells of two sisters from Kaua’i whose supernatural powers were only effective during the hours of darkness. They used their powers to “fly” to O’ahu to visit Kukaniloko, but were caught by the first rays of the sun near their destination and dropped by the bank of the stream in Kaukonahua gulch where they turned into stones. They lay there until the early 1900s, when the road through the gulch was widened. After dislodging the stone, the foreman had a dream in which a stone repeatedly said to him “you have my feet up and my head down, please turn me around”. Returning to the construction site the next day, he recognized the stone and had it turned over. Two old Hawaiian men assisted him and then they revealed that the stone was named Kaniniulaokalani and held a spirit that should be cared for. The foreman arranged for this stone and its companion to be taken to Kukaniloko.
In 1925, the stones were included in a rededication ceremony at Kukaniloko. At that time, the stones gained attention when pineapple workers reported miraculous cures because of the stones. The stones became the destination for healing pilgrimages and the Daughters of Hawaii, who were the caretakers of Kukaniloko, decided to remove the stones to a cemetery in Wahiawa. There they became even more popular. People came from miles to visit them. The smaller stone was reputed to have special healing powers for women and young children. Stalls selling leis, water, incense, fruit and candies for use as offerings sprang up. Sometimes offerings of a thousand dollars a month were reported in 1927.
The popularity of the site declined with curfews and rationings during World War II. The cemetery became the site of a suburban housing development. In 1948 the stones were moved once again to their present location at 108 California Street in Wahiawa where a Japanese shrine-like crypt was erected over the stones.
I made a visit here the other day and took a photo of the shrine. Notice the rays of light and the energy surrounding and encompassing the shrine made out of white granite:
The hsin [mind-and-heart] should be calm. If the hsin is not calm, one cannot concentrate, and when the arm is raised, whether forward or back, left or right, it is completely without certain direction. Therefore, it is necessary to maintain a calm mind. In beginning to move, you cannot control (it) by yourself. The entire mind must also experience and comprehend the movements of the opponent.
Accordingly, when the movement bends, it then straightens, without disconnecting or resisting. Do not extend or retreat by yourself. If my opponent has li [external strength], I also have li, but my li is previous in exact anticipation of his. If the opponent does not have li, I am also without li, but my I [mind-intent] is still previous. It is necessary to be continually mindful; to whatever part of the body is touched the mind should go. You must discover the information by non discrimination and non-resistance. Follow this method, and in one year, or a half year, you will instinctively find it in your body. All of this means you use I, not chin [intrinsic force]. After practicing for a long time, the opponent will be controlled by me and I will not be controlled by him.
If the body is clumsy, then in advancing or retreating it cannot be free; therefore, it must be agile. Once you raise your arm, you cannot appear clumsy. The moment the force of my opponent touches my skin and hair, my mind is already penetrating his bones. When holding up the arms, the ch’i [vital life energy] is threaded together continuously. When the left side is heavy, it then empties, and the right side is already countering. When the right is heavy, it empties, and the left is already countering. The ch’i is like a wheel, and the whole body must mutually coordinate. If there is any uncoordinated place, the body becomes disordered and weak. The defect is to be found in the waist and legs. First the mind is used to order the body. Follow the opponent and not your own inclination. Later your body can follow your mind, and you can control yourself and still follow the opponent. When you only follow your own inclination, you are clumsy, but when you follow the opponent, then your hands can distinguish and weigh accurately the amount of his force, and measure the distance of his approach with no mistake. Advancing and retreating, everywhere the coordination is perfect. After studying for a long time, your technique will become skillful.
To Gather the Ch’i
If the ch’i is dispersed, then it is not stored and is easy to scatter. Let the ch’i penetrate the spine and the inhalation and exhalation be smooth and unimpeded throughout the entire body. The inhalation closes and gathers, the exhalation opens and discharges. Because the inhalation can naturally raise and also uproot the opponent, the exhalation can naturally sink down and also Fa-chin [discharge energy] him. This is by means of the I, not li mobilizing the ch’i.
The Complete Chin
The chin of the whole body, through practice, becomes one unit. Distinguish clearly between substantial and insubstantial. To Fa-chin it is necessary to have root. The chin starts from the foot, is commanded by the waist, and manifested in the fingers, and discharged through the spine and back. One must completely raise the shen [spirit of vitality] at the moment when the opponent’s chin is about to manifest, but has not yet been released. My chin has then already met his, not late, not early. It is like using a leather (tinder) to start a fire, or like a fountain gushing forth. In going forward or stepping back, there is not even the slightest disorder. In the curve seek the straight, store, then discharge; then you are able to follow your hands and achieve a beautiful result. This is called borrowing force to strike the opponent or using four ounces to deflect a thousand pounds.
Having the above four, then you can return to concentrated spirit: if the spirit is concentrated, then it is continuous and uninterrupted, and the practice of ch’i returns to the shen [spirit of vitality]. The manifestation of ch’i moves with agility. When the shen is concentrated, opening and closing occur appropriately, and the differentiation of substantial and insubstantial is clear. If the left is insubstantial, the right is substantial, and vice-versa. Insubstantial does not mean completely without strength. The manifestation of ch’i must be agile. Substantial does not mean completely limited. The spirit must be completely concentrated. It is important to be completely in the mind and the waist, and not outside. Not being outside or separated, force is borrowed from the opponent, and the ch’i is released from the spine. How can the ch’i discharge from the spine? It sinks downward from the two shoulders, gathers to the spine, and pours to the waist. This is ch’i from up to down and is called closed. From the waist the ch’i mobilizes to the spine, spreads to the two arms and flows to the fingers. This is ch’i from down to up and is called opened. Closed is gathering, and opened is discharging. When you know opening and closing, then you know yin and yang. Reaching this level your skill will progress with the days and you can do as you wish.