This specific expression of illness in an individual is called the Pattern of Disharmony, Bian Zheng in Chinese Medicine. Each specific Bian Zheng corresponds to a specific base therapeutic protocol of acupuncture, herbal formula, diet and or lifestyle modification that is, in turn, specially tailored to accommodate and improve the individual’s unique ecology and terrain.

Consider, for example, two people with the bio-med defined disease of Asthma. One, is a happy-go-lucky, overweight, red-faced, 45 year old man (think: Friar Tuck from Robin Hood)  with an excessive appetite, a frequent craving for iced beverages, but with reasonable elimination, sleep and rather oily skin. His tongue is swollen and red with a greasy yellow coating. His pulse is bounding and slippery. His blood pressure is slightly high and his voice is louder than it needs to be for the room he is in. He laughs a lot during the interview and his body odor is quite strong. His asthma involves a great deal of phlegm that he is constantly spitting up, as well as wheezing and difficulty grasping breath.  He asthma is also worse after eating when the natural dampness of food and drink pushes the phlegm damp in his lungs upwards. .

The other asthmatic is an anxious, nervous, underweight 31year old woman with dark rings under her sad-looking eyes, dry skin and hair, fatigue, poor appetite and a tendency towards constipation. Her tongue is shrunken and red with many cracks and is dry and without coating. Her pulse is fine, rapid, and weak, and her voice soft and uncertain.

She is always cold, even though her tongue is red, which demonstrates some kind of heat somewhere…She has difficulty answering questions about herself and exhibits a somewhat flattened affect. Her menstrual periods are brief, painful, and lighter than normal. Her asthma, which began in childhood, is worse at nighttime, during times of emotional stress, when she is restless or when she suffers heart palpitations. She does not have much phlegm in the lungs that can be observed. But she has a chronic dry cough with wheezing, and gasping for breath.She has a history of bedwetting until age 8.

While these two patients both have the same “disease” named Asthma in Bio-Medicine, their diagnoses in Chinese Herbal Medicine (TCM) are quite different. Chinese Medicine describes each of these patients as having signs and symptoms  of “heat.” But patient number One has a full heat–he is a strong type, not weak, nor sensitive. He is overly hot, his face is red, he craves iced drinks. He has accumulated too much fluid, he is overweight, he as oily skin, his tongue and pulse show internal accumulation of dampness and heat.  His symptoms are a function of “too much of the wrong thing in the wrong place”. Too much heat and too much moisture is being produced by his natural body type and by his lifestyle.

Case Number two on the other hand is a weak, sensitive type, with low energy, who is cold and dry. She actually lacks fire–weak appetite and depression along with feeling always cold. What she has is “not enough of the right thing in the right place.” Her Lung Qi is weak and not grasping the air well, that is the immediate cause of her problem , her Yin and Yang are both damaged. She is weak and cold and dry. She does not have enough Qi-energy, her fluids are not making it to the skin or lungs, and she does not have sufficient fire to give emotional drive or even a strong appetite. She is not going to become a General or a dictator.

Case Number Two  is a function of what Chinese Herbal Medicine diagnosis calls Vacuity or Empty heat with Yin vacuity and lack of fluids.In her case the heat and dryness is a function of the weakness of the mechanism that keeps the surfaces of the body moist and cool, the Yin…At the same time the Qi that circulates in the Lungs is weak, so the Lung Qi is “rebellious.” Its not grasping well. Both have additional complicating factors that will be addressed by their individual acupuncture treatment and herb formulas.

So while both have what Chinese Herbal Medicine calls wheezing and panting, each has a different pattern of disharmony (Bien Zheng)  that is at the root of their disease called  Asthma by modern bio-medicine, and “wheezing and panting” in the  nomenclature of traditional Chinese medicine.

Each of these two patterns of disharmony is seen in Chinese medicine as emblematic of the soil in which the disease has taken root. Whether the important factors have been genetics, diet, or lifestyle, the pattern of disharmony is the rubric upon which the treatment is based. Different pattern different treatment: different acupuncture, herbal medicine, dietary therapy.

Treatment in Chinese Herbal Medicine

Each of these patients, then, will require a  treatment that addresses not only their symptom of Asthma, but as their unique underlying pattern of imbalance that makes them susceptible to asthma. As a result, if each of these patients is treated successfully, not only will their asthma improve, but so will their general health. The first patient will become less overheated and phlegmatic and the second patient will become find herself less nervous and constipated. Her sleep will improve and her skin become moister. Her periods will also become fuller and less painful.

Patient number one’s tongue should become less greasy and red, while number two’s will become moister and develop of healthy coat.

As mentioned above, there are in Chinese medicine an existing repertoire of acupuncture and herb formulas and for each of these Bian Zheng or Patterns of Disharmony. The skill of the individual physician involves,

A) diagnosing the correct pattern in the first place

B) knowing which formulas suit that pattern

C) modifying that formula to suit the specific needs of the individual patient at a given moment in time.

Even the acupuncture treatment, herbal formula, and dietary advice given to a patient on day one of treatment will need to be adjusted as the patient makes progress or suffers setbacks. Moreover, disease has many layers. One moment the doctor must attack the “disease evil,” the next moment she must support the patient’s “righteous qi”, yin, or yang. The careful physician adjusts the treatment as the patient’s signs and symptoms change.

The ultimate and underlying goal of treatment in Chinese medicine is to unblock the stagnation of the life force, and to adjust and harmonize the Yin and Yang as it manifests in the physical body–moisture and dryness, cold and heat, tension and slackness, hardness and softness, strength and weakness. This is achieved by regulating the “Qi, Blood, and Fluids” in the energy networks connected to each of the internal organs. Weakness is strengthened, congestion and accumulation are unblocked and dispersed, agitation is calmed, heat cooled, coldness warmed, dryness moistened, and dampness drained.

In the case of the above two patients, for example, in both cases acupuncture and herbs would be used  to stop wheezing and panting and clear heat from the body. However,  in case A, we would also seek to drain dampness and dry phlegm, while in case B, we would work on  strengthening the function of those organs most important for producing blood and nourishing  the yin. At the same time we would attempt to immediately  moisten dryness and calm the mind.

Chinese Medical Dietary and Lifestyle Therapy

Person A would be prescribed a diet (see Dietary Counseling)  of very limited animal fat, high in grains that promote diuresis like barley and rice, and increased bitter green vegetables that help eliminate dampness and cool heat. Green tea would be substituted for cappucinos to eliminate dampness, while refined sugars would be limited to an occasional treat. Aerobic exercise would certainly be prescribed for this person as well, and Yogic breathing practices introduced to stimulate the qi and move the dampness.

Person B on the other hand, would be prescribed a diet of more moistening foods, like rice and lentils cooked with dried apricots, and vegetables and tofu cooked gently with olive oil. An essential fatty acid supplement like Flax seed oil  would be suggested, and fruit consumption increased to clear heat and moisten dryness. Breathing and meditation or Tai Qi would be prescribed for this patient to nourish the yin and calm the mind.

BodyMind Medicine includes the Heart, Feelings, or Mind.

The Chinese herbal medicine doctor would note patient B’s shyness and flattened affect and take this, as well as her restlessness at night, into account when formulating her acupuncture and herbal prescriptions. Gentle discussion  might be relied upon to draw the patient out and see if there are any deeper emotional problems that will necessitate referral for counseling or psychotherapy.

Duration of treatment in Chinese Medicine depends on the severity and duration of the illness.

Simple injuries and illnesses can often resolve after 2 to 6 acupuncture treatments and a week or two of herbal therapy. Many illnesses and injuries are resolved in  6 to 14 treatments over the course of one to three months. More serious illnesses may require two or three courses of treatment, that is 12 or even 18 treatments over 3 to 9 months. It is sometimes said that in the case of chronic complaints, one month of treatment is needed for each year of disorder. One thing is clear, however. One should begin to see some improvement in symptoms, or at the least, increased sense of well-being after the first or second visit.

Herbal therapy can last from three days to a year or two, depending on the nature of the illness.

One can head off a cold or migraine headache by taking one or two doses of herbs. On the other hand, for example, in the case of uterine fibroids, one might take herbs for 6 months to a year or year and 1/2.

Frequency of treatment.

Acupuncture treatments are generally once or twice per week in the beginning, tapering off  after 4-6 weeks. A typical course of treatment, whereby we finish one aspect of therapy and move to another, is 8 to 14 visits of acupuncture over a two to three month period.

Qi cultivating exercises, like Tai Qi, Yoga, Breathing and Meditation

are an integral part of Chinese medical treatment, especially for stress, tension, and emotionally or psychologically induced or affected disorders. Of course Qi cultivation is an integral part of achieving radiant health and longevity.

Healing is a process and not a pill. The greatest healing comes when the patient is actively involved in the cure. While the physician can act as a gardener to  the body and soul, it is the patient herself that has the greatest power for gardening in the mind. It is said in Chinese Medicine that “the mind leads the qi.”  This means that, just as polluted air and toxic foods can damage the qi, so too can toxic thoughts or a toxic mind.

One could eat all the great healthy food one wants, but if at the same time one were consumed by jealously, hatred, and greed, there is a good chance indigestion would result. Chronic indigestion will lead to an chronic inability to gain nutrition from food. The result will be weakness, dampness, and heat.

Chronic worry and a restless mind are great sources for disease.  When the mind is not calm, the qi is overactive and overheats; when there is constant frustration, the qi stops moving and stagnates. In fact any emotion, in excess, will have specific affects on the qi, causing disease if left unabated over time.

Mental health in Chinese medicine means the experience and expression of emotions in a degree that is appropriate to the situation. If your loved one were, God forbid, to die, it would be natural to be sad and angry and even fearful. If ten years later, you were experiencing those feelings at the same level as when the beloved passed away, that would be the energetic groundwork for disease

Just as stretching, strengthening and aerobics are essential for a fit body, meditation is exercise for the mind. A consistent meditation practice of some kind can give us the strength and awareness to process our emotions healthfully, to be aware of our feelings when we feel them. Meditation practice gives us the inner calm that enables us to dance skillfully with life’s circumstances, from a long line at the bank when you are in a hurry, to the ultimate challenge, facing death.

Our society is very “Yang.” That means it is characterized by constant movement, activity, bright lights, 24 hour communications networks, a beeper or cell phone in every pocket. Everything is about speed, individualism, and  instant gratification. This has its value, but it is also consonant with the types of stress-induced diseases that are prevelant. Years ago, I gave a lecture at Quallcomm. The H.R. person asked me to speak on treatment for headaches, as her computer anaylsis showed that was the most frequent reason why her employees were going to the doctor.

That is not a mystery.

According to Chinese medicine, we should balance this Yang nature of our culture with Yin activity. That is activity that is by nature quiescent, cool, and still. That which draws us inwards, like meditating on a wooden pier in the center of a small pond in the middle of a redwood grove on a full moon evening. While you may not have the chance to journey north, that pond in the grove is inside you, all you need is to set aside the time and space.