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Roberta Louis: Why is Chinese medicine increasing in popularity in the United States?
William Noah Wolf: Chinese medicine is fundamentally different than Western medicine. While Western medicine is a reductionist system that looks at the human body as merely a sum of its parts, Chinese medicine is a holistic science based on a cosmological understanding of the human place in the universe, with specific emphasis on our relationship to the cycles and seasons of the earth. This very detailed and sophisticated cosmological map provides Chinese medicine with a high level of efficacy. It offers a distinctly more comprehensive model of care than Western medicine, one that ensures the optimal health of the person. The reason more and more Americans are turning to Chinese medicine is because it is a complete system of medicine that offers a more consistent and predictable beneficial outcome for both acute and chronic illnesses.
In traditional medicine, or what we might more accurately call classical medicine, the emphasis is not on treating disease but on treating the person. This is one of the salient differences between Western allopathic medicine and classical Chinese medicine – the paradigmatic difference of trying to treat a disease versus ensuring optimal health, wellness, and balance in the individual. Classical medicine recognizes that no two people who have the same disease require exactly the same treatment. Each person, when they present to a practitioner of classical Chinese medicine, is going to receive a unique prescribed set of treatment approaches that often will include many modalities, including acupuncture, Chinese herbs, qigong, and nutritional therapy. This comprehensive approach has yielded favorable results in the whole gamut of medicine, treating everything from the common cold to cancer.
RL: Is the practice of traditional Chinese medicine the same today as it was in antiquity?
WNW: The origins of Chinese medicine – at least, its recorded origins – go back roughly 5,000 years, making it one of the oldest systems of medicine in the world. Over time, it has embraced a variety of modalities that together form a constellation of methods that allow the practitioner to bring about the greatest level of health and healing in the patient. Thus, the system as it is practiced today is more comprehensive and inclusive than in ancient times.
The conventional wisdom on the origin of Chinese medicine is that, while it arose in what is now considered China, the system as we’re describing it here spread long ago to countries such as Japan and Korea, as well as many parts of Southeast Asia, including Vietnam and Thailand. Chinese medicine entered Japan around 900 AD, and the Japanese were quick to adopt it as their national system of medicine. Interestingly, the Japanese culture has preserved many of the fundamental Eating with the Seasons:Nutrition in Chinese Medicine motifs and methodologies introduced 1200 years ago, while the system of medicine in China has gone through a number of changes dictated by various dynasties, as well as a radical reorganization during the period of Communist rule. Many scholars now look to certain aspects of Japanese medicine as being more authentically connected with the roots of what we can broadly term classical East Asian medicine than what is currently practiced in China.
Thus, we need to view the whole East Asian system of medicine as a dynamic form that has evolved over the millennia. In modern times, what is taught at the Chinese medicine colleges in the West is an amalgamation of wisdom streams that have been preserved and developed in a number of countries. It should be noted that more people worldwide use classical East Asian medicine as their primary form of healthcare than use any other system of medicine.
RL: How are the causes of health and disease perceived in classical Chinese medicine and how does this differ from the Western view?
WNW: There’s a paradigmatic difference between the classical Chinese and Western views of health and disease. The roots of this are grounded in a concept that the Chinese call qi (pronounced “chee”), which refers to the pattern and movement of energy. They understood from antiquity that qi is everywhere in the cosmos, and their cosmological system is based on an exquisite and intricate understanding of the architecture of qi. Health is acquired and preserved through balancing and maintaining one’s individual qi in harmony with the qi of the season and the qi of the place where one is living. Health therefore is defined as living in balance with one’s environment. Disease occurs when the qi of the individual falls out of sync with that of one’s environment. When there is balance between them, there is simply no room for disease, and the person remains in a state of well-being and health.
RL: How does the role of pathogens in infectious disease fit into this paradigm?
WNW: While Chinese medicine recognizes the presence of pathogens and their influence on human health, it places a much stronger emphasis on the role of the inner terrain of the individual and how that terrain responds to the presence of a pathogen. This strategy is particularly relevant when utilizing Chinese formulas to treat recalcitrant conditions, such as Lyme disease. While Western doctors typically give antibiotics for this condition, targeting only the bacteria, the Chinese approach would be to prescribe not only antimicrobial herbs but also herbs that nourish and vitalize the body and tonify the qi. The focus of treatment is thus simultaneously on removing the pathogen and treating the person so that the terrain becomes strong enough to resist pathogenic influences.
Degenerative diseases, such as Parkinson’s, can be discussed in similar terms. We see that various people who are diagnosed with Parkinson’s develop symptoms at different rates and of different severities. From the classical Chinese medical perspective, this is a reflection of how the individual’s qi responds to the disease. In other words, the dynamic between the terrain of the person and the disease process dictates the presentation and progression of the disease. By supporting the person’s qi function, the practitioner can best treat the person so as to prevent the further development of disease. Given the modern plague of progressive neurological conditions, such as Parkinson’s and Alzheimer’s, it is no wonder that people are turning toward an Eastern synergistic approach of combining herbal medicine, acupuncture, nutrition, and qigong, rather than relying on the silver bullet method of Western pharmacology.
RL: Does classical Chinese medicine address the role of genetics in the development of disease?
WNW: Genetics is a modern Western concept that is, in a deep way, also connected to this issue of terrain because, based on one’s heredity, one may have certain predispositions toward acquisition of a pathogenic disease or to the development of a degenerative one. We might say that genetics influences the individual climate of the person so as to make them more or less susceptible to acquiring a disease or more or less able to withstand health challenges. The unique thing about classical Chinese medicine is that it offers a systematic, comprehensive, and predictable method for treating the terrain, including one’s genetic predispositions, so as to mitigate detrimental influences.
RL: Would you discuss the principles of yin and yang and the significance of the five elements in Chinese medicine?
WNW: In order to fully understand these concepts, one must keep in mind that Chinese medicine is based on a cosmology that views the human as embedded within the matrix of the Tao. The Tao represents the undifferentiated wholeness out of which all creation emerges. From the Tao arise the pair of yin and yang, which are mutually interdependent aspects of the manifest realm. Yin is cooling and moistening, whereas yang is warming and drying. Health and disease are understood in terms of the relative balance of yin and yang within the individual.
In antiquity, the Chinese physicians developed an understanding of how yin and yang fluctuate during the yearly cycle. They deduced that there are five distinct phases to this cycle: spring, summer, late summer, fall, and winter. Each of these phases was then associated with an element – wood, fire, earth, metal, or water – that depicts the quality of energy seen in nature at that time of year. Other aspects of nature, including specific flavors, were linked to the phases. With the knowledge that human beings arise from and are embedded in this matrix, the ancient Chinese physicians also ascribed various aspects of human anatomy, physiology, and psychology to the phases.
The five element system of correspondences arises from this cosmological map. From the perspective of this system, all aspects that fall under the rubric of the same element are both figuratively and energetically related with one another. This fact reveals the salient characteristic of Chinese medicine – that, at its fundamental level, it is based on an ecology of the relationships among the five categories within the system of correspondences.
As a medical model, this system expresses any imbalance in the structure or functions of the anatomy, physiology, and/or emotions of an individual as an imbalance in their inner ecology. Disease is perceived as an effect rather than a cause and is attributable to the individual losing harmony with nature. The path to health is defined as the use of various medical modalities to restore healthy relationships among the tissues, organs, and organ networks by reestablishing balance between the inner terrain of the individual and the outer manifestations of the cycles of nature.
RL: How does Chinese nutritional therapy differ from the Western approach?
WNW: The Western approach to nutrition is based on the twentieth-century reductionist method of dividing food into its constituent parts and then examining how these parts produce or promote specific actions on the body. In contrast, the Chinese nutritional system seeks to preserve the balance and vitality of the whole organism by carefully assessing the nutritional and energetic roles that foods and herbs play in restoring and maintaining the healthy terrain in the individual. Moreover, in classical Chinese medicine, nutritional therapy places an emphasis on observing nature and noticing which foods become available at certain times of the year, understanding that eating with the seasons is one of the best ways to preserve health throughout the whole year.
RL: What is the role of flavors in Chinese nutritional therapy?
WNW: According to the system of correspondences, the flavors have an affinity for the organs associated with them. They are described as having “action” upon the organs, and it is said that they “enter” the organs – in other words, have a specific effect on the qi of those organs – according to the following pattern: The sour flavor enters the liver and the gallbladder. The bitter flavor enters the heart and small intestine. The sweet flavor enters the spleen, pancreas, and stomach. The pungent flavor enters the lungs and the large intestine. The salty flavor enters the kidney and bladder.
Because health is dependent on all of these organs functioning together, all five flavors should be present in a healthy diet, thus activating the qi of all the organs. A moderate and balanced intake of sweetness is especially emphasized because the earth element, with which it is associated, governs digestion and assimilation. By “sweet,” what is meant is the main flavor of most carbohydrate-rich foods, including grains. Sweet is also the main flavor of certain nuts and seeds and many vegetables and legumes. Meats and unfermented dairy products are also basically sweet. Fruits, while obviously sweet, contribute to a healthy diet when eaten in moderation, although ultra-sweet foods, such as sugar and maple syrup, do not have the same beneficial qualities.
It should be noted that, until several generations ago, people could healthfully use whole grains as the predominant food in their diets, but today a diet that includes more than 20 percent grain can promote disease. One reason for this is the modern hybridization of wheat, which has increased its carbohydrate content. Another is the fact that increased use of pharmaceuticals, pesticides, and other chemicals has damaged our gut microbiome.
The art of Chinese nutritional therapy rests on the premise that the other flavors should be prescribed and taken in the right proportion for the individual’s constitution and the time of year. Therefore, to this sweet base, appropriate amounts of sour, bitter, pungent, and salty foods should be added to ensure that all the organs are well nourished. Examples of dishes incorporating several flavors include a salad of mesclun greens (containing sweet spinach, bitter kale, and pungent arugula), and fermented dairy products, most of which are sour, sweet, and pungent. The appropriate blending of flavors creates balance and can serve to bring a person back into harmony with the seasonal influences.
My former teacher Paul Pitchford, in his authoritative book on this subject, Healing with Whole Foods, has explained a crucial misunderstanding that often arises regarding the use of flavors for seasonal attunement. The flavor associated with each element affects the organs related to that element in specific therapeutic ways, but it is far too simplistic to generalize that the flavor is used for attunement to the associated season. For example, the bitter flavor, which is associated with the fire element and summer, does have yin cooling properties that are of specific value in treating overheated conditions of various organs, particularly the heart. However, to generally attune to summer, one must become yang and expansive, like summer itself, by using hot spices that cool the body by pushing yang to the surface and causing sweating. So, effective nutrition is not a simple matter of just eating a certain type of food. Chinese dietary medicine takes into account the primary movements of yin and yang and seeks to balance them in any protocol or prescription for an individual, taking into consideration not only the time of year but also the constitution of the person as well as the prevailing weather patterns in the person’s current location.
RL: Would you discuss the flavors that pertain to each of the seasons?
WNW: In spring, the movement in nature is upward and outward, as exemplified by the growth of plants. The sour flavor, which has a yin cooling quality, helps to keep us in balance at this time of year by directing energy in the body inward and downward. This flavor is associated with the element of wood and has a contracting, astringent effect. It is most active in the liver where it counteracts the effects of greasy, rich foods, breaking down fats and proteins. Common examples of sour foods include lemon, lime, fermented vegetables, vinegar, and certain spring greens such as sorrel and miner’s lettuce.
The flavor of summer is bitter, which has an even more potent yin cooling effect and directs the body’s energy to descend. Associated with the fire element, bitter enters the heart and blood vessels where it clears heat and cleans deposits of fat and cholesterol from the arteries. It also helps to drain damp conditions, such as yeast overgrowth, parasitic infections, and edema. Found in summer foods such as kale, dandelion greens, lettuce, celery, and turnips, this flavor keeps us grounded and has a cooling effect on the body. Bitter is a much overlooked flavor, with even its name having a negative connotation. The ancient sages, however, understood that “what is bitter in the mouth is sweet in the heart.”
Late summer is the harvest time for many foods containing the sweet flavor. Correlating with the earth element, sweetness has the strongest harmonizing effect of all the flavors, and facilitates a centripetal movement of energy toward the organs that support digestion and assimilation of nutrients. Representing the perfect balance of yin and yang, sweet foods have both the yin action of nourishing and building the fluids of the body, and a gentle yang action of warming the internal organs. The sweet flavor both energizes and calms the nerves, brain, and rest of the body. Examples of sweet foods include grains such as millet and buckwheat, nuts and seeds such as pecans and sunflower seeds, fruits such as apples, and especially the golden-orange squashes and yams. Dairy products, although basically sweet, promote a descending movement of energy at this time of year when balance is indicated, and thus should be used only in moderation during this season.
With the arrival of autumn, nature provides a plethora of pungent or acrid foods that promote an upward movement of energy to maintain inner homeostasis with the descending energy of fall. Associated with the metal element, the pungent flavor has a yang warming effect, serving to course the blood to the periphery of our bodies, thereby keeping our limbs warmed during this cool time of year. In addition, the pungent flavor has a diaphoretic action and helps to maintain a healthy immune system, while supporting the lungs to clear mucus. Classic examples of pungent foods harvested in the fall include garlic, onions, cinnamon, cloves, ginger, black pepper, and peppermint, all of which can be increased in the diet at this time of year to foster greater health.
The season of winter is associated with the flavor salty. An even stronger yin flavor, saltiness is related to the water element and the oceans. It conducts energy downward and inward, and its action is to anchor the body’s energy into its deepest layers, those belonging to the kidney and the bone marrow. Salt helps the tissues remain lubricated and flexible throughout the cold months of winter. Salty foods include sea vegetables, miso, umeboshi plum paste, and other fermented condiments. When these are served on grains and vegetables, their contractive salty and sour flavors help to balance the expansive sweet flavor of the carbohydrate-rich foods. Likewise, the use of salt, which is cooling, can provide balance to a meal that includes chicken, which is warming and sweet. With salt, it is very important to recognize that the amount used is crucial to its effect; small amounts of salt are moistening, while larger amounts can effect a strong drying action on the body’s tissues.
Embracing an ecological perspective, Chinese dietary medicine recognizes that nature provides us with the flavors that can help keep us healthy during each season of the year. When we eat in harmony with the season – eating locally and what is fresh – the organs of the body are more likely to express themselves in a state of harmony such that illness doesn’t occur. Thus, a seasonal diet is a form of preventative medicine to maintain the organ systems in a state of homeostasis.
RL: Would you elaborate on the concept of the constitution in Chinese medicine and explain how it relates to nutritional goals?
WNW: The classical understanding of the constitution is that there is an abiding elemental configuration in each person that is established at birth. This is, one could say, the blueprint that a person presents in their being. Yet there can also be an acquired pattern, based on factors including one’s environment and habits, that can cause susceptibility to particular imbalances and can affect the constitution. For example, if somebody with a wood constitution were to eat a diet that was particularly challenging for their digestive system, they could develop an imbalance of the earth element. While they might be exhibiting symptoms that point to the earth imbalance, such as weight gain and incomplete digestion, a practitioner trained in the system of correspondences would be able to perceive the underlying wood constitution.
Chinese medicine focuses on supporting the fundamental constitution of the person while, at the same time, treating the acquired imbalance. In this example, the practitioner would seek to resolve the earth imbalance while supporting and nourishing the wood constitution. A diet containing sweet, nonglutenous grains and squashes, combined with bitter dark leafy greens, such as kale and collards, could serve to accomplish this goal.
RL: Can people determine for themselves what foods they should be focusing on or do they need to go to a practitioner?
WNW: The role of the practitioner is to use the methods of diagnosis that are part of the classical Chinese medicine system to accurately determine which organ or organ system is out of balance, and then in what way it is out of balance. The most time-honored and established method of accomplishing this is through tongue and pulse diagnosis. This is not something that people can do themselves. Once the diagnosis is made, the practitioner can give dietary recommendations to the patient, using food to regulate their qi mechanisms. From that point forward, the individual can, in a sense, self-medicate by following those dietary recommendations.
It’s important to know that just because someone has a particular constitution, such as wood or fire, the foods associated with that element aren’t necessarily going to be therapeutic for them. Dietary recommendations must reflect the specific imbalances currently arising in the person. Moreover, we can’t assume that because certain organs are most affected by certain flavors, pathology in those organs are treated by those flavors. There is a dynamic relationship between the organs, the flavors, and the seasons, but balancing the ecology of the individual with the ecology observable in nature requires taking into account a highly complex and nuanced algorithm.RL: How does eating according to the seasons lead us to a deeper ecological perspective?
WNW: Classical Chinese medicine sees the human as immersed in the web of the local ecological system. Westerners usually consider the outer envelope of the human to be the skin, but in the Chinese system, there’s a continuity between the individual and the environment in which they live. Thus, in classical Chinese and East Asian culture, an ethic of preserving and maintaining harmony in the outer environment is seen as instrumental in maintaining the health of the individual.
Another way to answer that question is that ancient people were locavores. This term has come into use today to describe people who, by choice rather than by necessity, make commitments to eat foods grown within a certain geographic distance of their homes. In ancient times, people didn’t have the luxury of choosing whether to be locavores; they just were, by virtue of the isolation that occurred in preindustrial societies. When one’s community is locavore, there is an ongoing awareness of how one’s eating habits affect the environment. The ancient people lived in such a way that their food sources were sustainable both on a yearly basis and down through the generations.
RL: Does detoxification play a major role in Chinese medicine and is there an emphasis on practicing it during a certain season?
WNW: As with many other aspects of Chinese philosophy, Chinese medicine takes what is called the middle path. This path seeks to achieve health and harmony by mitigating extremes and emphasizing balance and equanimity. Detoxification, as it is practiced in the West, does not appear in the classics of Chinese medicine because it is understood that if the person maintains balance with respect to the time of year and their own physiology, the organs will naturally detoxify themselves in an appropriate fashion. So, rather than doing seasonal detoxes to address excesses that arise from a life lived with imbalance toward one’s environment and one’s inner physiology, living a life based on harmony and balance provides a steady, natural, gentle detoxification throughout all seasons of the year.
For a Westerner who is not living or eating in harmony with the seasons, Chinese herbs that facilitate greater qi movement through the liver are frequently used in the United States as part of a complementary herbal protocol to support a person during the process of detoxification. Such herbs include dandelion, burdock, and chicory, which are common in the West, as well as bupleurum, peony, tangerine peel, and others. However, this is an example of using Chinese herbs to fulfill a role in a Western paradigmatic understanding of health, rather than using them within the context of traditional Chinese medicine.
RL: To what extent are herbs used as foods in Chinese medicine?
WNW: In the classics of Chinese medicine, herbs are sometimes described as specialized foods. These are foods with properties that cause specific qi actions in the body. Thus, they can serve as prescriptions for medical conditions. In Chinese medicine, herbs are often prepared and presented to the patient in foods, rather than in the form of tea, as we generally see in the West. For example, congee is a type of porridge eaten in China and other East Asian countries that combines certain grains, such as rice or barley – and, sometimes, legumes such as aduki and mung beans – with a specific protocol of medicinal herbs. Often, medicinal herbs are used in the preparation of stews and soups, as well – for example, when adding astragalus and danggui (Angelica root) to chicken soup to bolster its immunosupportive action.
Another way that herbs are used as food in Chinese medicine is to provide the correct balance of yin and yang in each meal. If a food being prepared is by nature more yang, yin herbs may be added into it to bring about balance. Conversely, if it’s very yin, yang spices or herbs may be added. For example, mung bean dal is commonly prescribed as a food because it has a slightly cooling effect. In classical Asian culture, mung beans are often eaten in the summer for this reason. However, as anybody who’s had dal will know, they are often prepared with curry spices. The cardamom and cloves act as yang herbs to balance the yin effect of the mung beans.
RL: Would you mention some specific herbs or foods that you tend to use or recommend in your practice?
WNW: My goal is to prevent conditions of imbalance from occurring in my patients. I find the best strategy for that is to educate them on how to eat healthy with the seasons and how to be more locavore in their food consumption. Nature knows best, and if we eat in accordance with what’s arising naturally in our environment, we will have the highest likelihood of assuring health throughout the year. Seasonal foods – particularly, seasonal vegetables, fruits, and grains – tend to be the most important dietary choices for preventing disease.
With the increasing prevalence of GMO foods and their associated herbicides, I also advise all my patients to avoid any foods that contain nonorganic wheat, corn, or soy. These artificial “foods” cause a plethora of health issues, ranging from generalized malaise to degenerative disease and cancer. It is no wonder that many modern countries, as well as nonindustrialized nations, have banned these toxic foods. For the health of our citizens, our country must prioritize people’s health above corporate profits by outlawing all GMO foods.
I thus tend to emphasize the nonglutenous grains, such as millet, buckwheat, and quinoa, as being more supportive to the digestive system. The preponderance of gluten in the Western diet can harm the absorptive function of the intestinal villi, often leading to leaky gut syndrome, which is a precursor to allergies, arthritis, and other debilitating inflammatory conditions. These three “seed grains” also have a slightly sweet flavor and therefore help to nourish the spleen. They also promote the downward movement of the digestive system, ensuring the most complete digestion of food.
When using herbs as specialized foods, the most important ones that I recommend are ginger, garlic, and turmeric, all of which occur in the Chinese herbal materia medica. Each of these has anti-inflammatory and tonifying effects on certain organs of the body. I also remind patients of the importance of the warming herbs cinnamon, cardamom, and clove, all of which support the process of digestion and enhance assimilation. Thought of in this way, foods such as grains, legumes, and vegetables become vehicles for herbs, which have the stronger and more specific medicinal action on the person.
For condiments, I turn toward the special dietary evolution that occurred in Japan. Some of the food culture contributions of the Japanese, particularly miso and umeboshi paste, provide a rich and savory flavoring to food, helping to make meals more balanced in their yin and yang aspects and therefore both more digestible and more suitable for optimizing health. Miso and umeboshi paste can be used year-round, although they are more important in winter because of their salty flavor.
It also bears mentioning that, within each of the seasons, the ancient Chinese saw patterns reflective of the other four seasons. In other words, there’s sometimes a little bit of winter within spring or a little bit of fall within summer. This is why a diet in which all the flavors are represented is the most healthy way to eat, and why fine-tuning certain flavors up or down, depending on local climatic conditions, can, from a Chinese dietary perspective, help ensure living in balance with the seasons.
William Noah Wolf is a doctor of naturopathic medicine and licensed acupuncturist. He has been a practitioner of natural medicine for over twenty years, during which time he has trained extensively in classical Chinese herbalism, Acutonics sound therapy, German biological medicine, Sufi spiritual healing, and naturopathic clinical nutrition. By offering a multidisciplinary approach that addresses the whole person, he provides his patients the opportunity to heal on all levels: body, mind, heart, and soul. Dr. Wolf maintains a practice in Sebastopol, California. He can be reached by email at [email protected]
Roberta Louis is managing editor of the Price-Pottenger Journal of Health and Healing. She may be contacted at: [email protected]
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Published in the Price-Pottenger Journal of Health and Healing
Spring 2016 | Volume 40, Number 1
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