What They Came In For: Constipation

When Things Stop Moving

Bill came in because he was tired of feeling stuck. His digestion had gotten slower over the past few years, in the gradual way that these things often do. At first it meant less regularity, a missed day here and there, nothing he thought about much. By the time he scheduled with us, it was not uncommon for him to go three or four days without a bowel movement. When things did move, the movement was slow, dry, and incomplete.

"It's like my body just forgot how to do it," he said.

He was 68, semi-retired, and active by most measures. He walked his dog daily, made coffee for his wife every morning, and kept up with a small handful of long-standing friendships. The constipation was the one thing that had begun to organize his daily experience. He felt heavy after meals, bloated in the evenings, and often turned down food he would have enjoyed because the aftermath was not worth it. He was not in pain exactly. He was never quite at ease either.

His primary care doctor had told him it was normal at his age. Slow motility, probably. Drink more water, eat more fiber, take stool softeners as needed. Bill had done all of it. He drank plenty of water, ate oatmeal most mornings, took a daily magnesium supplement, and had tried psyllium husk, probiotics, and prune juice across various combinations and durations.

"It's not like I'm eating cheeseburgers every day," he told us. "I'm doing the right things. My gut's just not cooperating."

By the time he arrived at Root and Branch, his baseline had not really moved in years. He still had a proper bowel movement only once every three days, sometimes longer. The longer he went, the worse he felt. Foggy. Sluggish. He described a sense of things backing up in more ways than one.

What Slow Transit Looks Like Biomedically

Chronic constipation is one of the most common gastrointestinal complaints in older adults. Prevalence estimates run somewhere between 15 and 30 percent in people over 60, and the numbers climb further with each decade. The standard biomedical framework distinguishes between several functional categories: slow transit constipation, where stool moves through the colon more slowly than it should; outlet dysfunction, where the muscles that coordinate evacuation are not firing in the right sequence; and constipation-predominant IBS, where transit is variable but trends slow. Bill's presentation matched the slow transit pattern.

The typical workup rules out structural causes (obstruction, stricture, tumor) and then defaults to a layered set of recommendations. Increase fluid intake. Increase fiber, usually starting with soluble fiber like psyllium. Add osmotic agents like magnesium or polyethylene glycol. Consider stimulant laxatives if the osmotic agents are not enough. For patients who do not respond, the next step is often a referral for anorectal manometry or a colonic transit study, followed by prescription prokinetics like prucalopride or, in selected cases, biofeedback for the pelvic floor.

This algorithm works for a significant fraction of patients. It also leaves a meaningful fraction stuck. The patients who do not respond tend to be people who have already addressed the obvious modifiable factors and whose physiology is doing something more subtle than the algorithm is designed to catch. Bill was in this group. He had checked every box on the standard list and his bowel still would not move on its own.

Reading the Pattern

When we did Bill's intake, the picture that emerged was less about a single broken mechanism and more about a system that had lost its momentum across several layers at once. His pulse was thin and slightly wiry, which in Chinese medicine suggests both depletion and a layer of tension running underneath. His tongue was pale, dry, and showed a slight scallop along the edges. His abdomen was soft overall but felt mildly firm in the lower left quadrant. He reported feeling cold easily, especially in his hands and feet in the evening, and his sleep had become lighter over the past two years.

The pattern that fit was a combination of fluid depletion and underlying Yáng deficiency, with some Liver qì stagnation layered on top. In classical terms, the Large Intestine had lost both its moisture and its motivating warmth, and the Spleen and Kidney systems that should have been replenishing both were no longer doing so reliably. The wiry quality in the pulse and the firmness in the lower left suggested that what little Yáng was available was getting bound up in tension rather than flowing through to drive peristalsis.

This is a common picture in the patients we see for chronic constipation in this age range. The conventional framing of "slow motility" describes what is happening at the level of muscle contraction. The Chinese medical reading describes the broader physiological context in which the slow motility is occurring. The bowel is not moving because the systems that should be warming it, moistening it, and rhythmically driving it have all become quieter together. Treating any one of them alone tends to produce limited results, which is part of why Bill's previous interventions had each helped a little and none of them had changed the underlying picture.

There is a useful biomedical bridge here. The enteric nervous system, the network of roughly 500 million neurons embedded in the wall of the gut, depends on adequate hydration of the mucosal surface, adequate parasympathetic tone, and adequate rhythmic input to keep the migrating motor complex (the wave of contractions that moves contents through the bowel between meals) firing on schedule. In older adults, all three of these inputs tend to decline together. The mucosa runs drier, autonomic tone shifts toward sympathetic dominance under chronic stress, and the rhythmic cuing of the gut becomes less reliable. The Chinese medical description of dryness, depletion, and lost rhythm is describing the same phenomenon from a different vocabulary.

The Treatment Approach

We started Bill on weekly acupuncture and a custom herbal formula, with the explicit goal of restoring rhythm rather than producing a single bowel movement.

The acupuncture sessions used points on the abdomen and lower back that have specific effects on the Dà Cháng 大腸 (Large Intestine) pathway, supported by points that nourish the Spleen and tonify Kidney Yáng. The biomedical correlate is that these points reliably shift autonomic tone toward parasympathetic dominance and increase blood flow to the splanchnic circulation. For a patient whose gut had been running on low parasympathetic input for years, time spent in a parasympathetic state was therapeutic in itself.

The herbal formula was built around moistening the intestines, gently warming the lower burner, and supporting the Spleen and Kidney systems that had become depleted. We deliberately stayed away from the strong purgative herbs that produce a single dramatic bowel movement and leave the underlying picture unchanged. Bill had tried the over-the-counter equivalent of that approach and it had not gotten him anywhere. The formula was designed to do a slower kind of work, and the herbs were adjusted every few weeks as his presentation shifted.

Diet recommendations were minor. Bill was already eating reasonably well. We suggested warming his breakfast oatmeal with a little ginger and walnuts, easing off raw salads in favor of cooked vegetables in the evening, and being more deliberate about a small amount of healthy fat with each meal. The goal was not to overhaul his diet. The goal was to stop subtly cooling and drying a system that was already too cool and too dry.

What Changed

After the first two weeks, Bill was going every two days without thinking about it. The evening bloating had eased noticeably. His appetite was better and he had started enjoying meals again rather than budgeting around them.

After a month, he was having regular, comfortable bowel movements almost daily. No urgency. No straining. No mental real estate spent on whether today was going to be a day.

"I never thought I'd feel this much joy over taking a normal crap," he said.

The change ran deeper than the headline symptom. Chronic constipation affects energy, mood, sleep, and the general sense of being at home in one's own body. Bill described feeling less irritable in the evenings, sleeping more solidly, and noticing that the low-grade fog he had assumed was just aging had lifted. None of these were surprises. The gut and the rest of the body are in continuous conversation, and when the gut is sluggish for years, the rest of the body adapts around the sluggishness in ways that are easy to attribute to other causes.

If You Have Been Told It's Just Age

What Bill came in for was a bowel that would move on its own. What he got was a system that had its rhythm back, which is a different and more durable thing.

If you have been told your slow transit is just a feature of getting older, that framing is not wrong exactly. Motility does change with age. What the framing tends to miss is that age-related changes are not a single switch that flips. They are a slow accumulation of small shifts in hydration, warmth, autonomic tone, and rhythmic cuing, each of which is more responsive to careful intervention than the "just age" framing suggests. The patients who do best with Chinese medicine for chronic constipation are usually the ones who have already done the basics and want to understand what else might be going on underneath. There is usually quite a bit going on underneath, and most of it is workable.

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Qi Node 3: 惊蛰 Jīngzhé (Insects Awaken)

When the Dragons Wake

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Chinese style blue dragon dyed onto silk

Jīngzhé, the third of Spring's six Qi Nodes, arrives in early March. The name translates as "insects awaken" or "the awakening of hibernating creatures," and it marks the point at which Yáng qì begins moving with real momentum. Where Lìchūn opened the gate and Yǔshuǐ brought the first rain, Jīngzhé is when Yáng qì pushes above the surface in ways the body and the landscape both register. Daytime temperatures climb consistently into the fifties and sixties across much of the temperate world. Soil temperatures rise enough for early root activity to begin. Thunderstorms return to weather patterns that had been dominated by snow. Earthworms become active in topsoil. Birds shift from winter feeding into early territorial and mating behavior. The wind picks up, and it carries a different quality from the dry cold winds of winter: gusty, variable in direction, often warmer than the air it displaces.

The same momentum that drives the season forward also drives changes in the body. Patients who have been stable through winter often notice a shift in this window: restlessness, sleep that is lighter or more interrupted, a sense of needing to do something without knowing what, and the return of patterns that had been quiet for months. The work of Jīngzhé is to help that rising qì find appropriate expression. When it does, the energy gets used. When it does not, the energy overflows into agitation or gets suppressed back into stagnation.

The dragons and the earthworms

The classical imagery for Jīngzhé centers on two creatures doing the same work at very different scales. Dragons that have been hibernating in the deep waters of high mountain lakes through winter begin to stir. Their movement cracks the ice that had held them, and their breaking free is the classical explanation for the return of thunder and lightning to spring weather. Dragons in this tradition represent the most concentrated form of Yáng qì, so their seasonal stirring is the celestial signal that Yáng has begun moving.

Earthworms do the ground-level version. As soil temperatures rise, the worms become active near the surface, and their movement aerates the soil in ways that allow seeds to germinate. The Chinese word for earthworm is dì lóng 地龍, which translates as "earth dragon." The worms and the celestial dragons are participating in the same seasonal function from different scales, and the language names them accordingly. Yáng qì is rising in the ground, in the atmosphere, and in the body.

The temptation of early Yáng

After several months of winter, the first real warmth of Yáng feels like permission to resume activity at the level it was held before the cold set in. The instinct is to plant the garden, start the renovation, return to vigorous exercise, take on the project that has been waiting since November. The body and the landscape can feel ready in ways they actually are not. Yáng qì in early Spring is young Yáng. It is establishing itself, and the cold has not fully retreated.

The patients who get into the most trouble in this window are the ones who treat the first warm afternoon as a license to abandon winter protections. They go out in shorts on a sunny day with the temperature still in the fifties. They push through a vigorous workout when their sleep has been disrupted for a week. They commit to a major project in a burst of enthusiasm that does not survive the windy March weeks that follow. The colds, sinus congestion, headaches, watery eyes, and fatigue that show up across the rest of Spring and into early Summer often trace back to a single afternoon in Jīngzhé where Yáng was treated as more mature than it was.

This is the season for planning. Lists, sketches, measurements, costing, comparison shopping, and detailed preparation are what the season actually rewards, and the work done now is what lets the bigger projects of late Spring and Summer go cleanly when their proper window arrives.

Living with Jīngzhé

Eat with the season

Continue the gentle shift away from heavy winter foods that began at Yǔshuǐ. Reduce slow-cooked meats, dense root vegetables, and long-braised dishes. Begin incorporating more green vegetables, lightly bitter greens like dandelion or arugula, and gently fermented foods like quick pickles or sauerkraut.

Pungent and aromatic flavors are well-matched to this moment because they help disperse stagnation that accumulated through winter. Scallion, fresh ginger, garlic, chives, mustard greens, and chen pí 陳皮 (aged citrus peel) all do useful work. A thin broth with scallion and ginger, or chen pí tea sipped warm through the morning, supports the rising qì without forcing it.

Cold and raw foods should still stay off the menu. The afternoons may be warm enough to make a salad sound appealing, but the digestive system is still working with winter physiology and responds better to cooked food for several more weeks. Iced drinks in particular should wait until Lìxià in early May.

Move with the season

Activity can resume meaningfully now, though it should not yet resume aggressively. Walking, gentle stretching, tai chi, qi gong, and easy bicycling all suit this moment. Move with the rising qì rather than demanding more from the body than the season can sustain.

The traditional practice for Jīngzhé is neigong facing the rising sun in the early morning. The hours just before and after dawn carry the strongest seasonal qì, and standing or moving quietly through that window allows the body to entrain to the rhythm the year is establishing. Twenty minutes is enough. Pay attention to the morning air, the changing light, and the body's response to both.

If you are returning to a more vigorous exercise practice, ramp slowly. A reasonable rule is to do roughly two thirds of what feels possible in the first week, then increase gradually over the following weeks. Pushing to full capacity in the first warm week of March is one of the most common precipitating factors for the colds and respiratory complaints we see across the rest of the season.

Rest with the season

Lengthening daylight will naturally shorten sleep duration by twenty or thirty minutes, which is fine within limits. What matters more is the quality of sleep and the steadiness of the rhythm. Going to bed at variable times, or staying up late on the first warm evenings to enjoy the change, undercuts the restorative work the Liver is doing during the early morning hours when its activity is highest.

Wind protection remains important. The neck, the lower back, and the feet are the most vulnerable regions, and the variable winds of March can drive cold into the body even on afternoons that feel warm. Scarves stay on. Wool socks stay in rotation. The clinical cost of premature exposure in this window is high enough to be worth the small inconvenience of staying covered.

Tend your Liver

This is the cultivation practice specific to early Spring. The Liver governs the smooth flow of qì throughout the body, and Jīngzhé is the node at which Liver qì most clearly expresses itself. The seasonal work happens in two registers, and both are worth attention.

The first is channeling. The energy that has been gathering is available now for the kind of detailed forward planning that the rest of the year will depend on. Garden layouts, project costings, comparative research, list-making, and the slow careful work of preparing for what comes next. This kind of focused work has access to a quality of attention in early Spring that it does not have in deep winter or high summer.

The second is noticing where rising qì meets old constraint. Sighing more than usual, small frustrations that feel disproportionate to their causes, premenstrual symptoms intensifying, tension settling in the jaw or between the shoulder blades, sleep breaking around 1 to 3 AM. These signal that Liver qì is moving against something that has been held still. The response is to identify what is being held and gently begin loosening it, rather than to push harder against the constraint.

Jīngzhé sits roughly halfway through Spring's six Qi Nodes. Chūnfēn, the Spring equinox, arrives in mid-to-late March and brings the year's first balance point between light and dark. The pace, protection, and planning that get established now are what allow the more confident Yáng of mid-Spring to arrive cleanly.

Best Time for Qi

5 am
The hours just before dawn.

Phase

Wood
Movement upward and outward.

Direction of Activity

Neigong facing the rising sun
Don’t exert yourself. Just play and experience it.

What They Came In For: Frequent Colds

Sarah M. came in because she caught colds constantly. Every six weeks or so, sometimes more often, she'd come down with something. She'd tried vitamin C, zinc, elderberry, and more sleep, but the pattern continued. She wanted to know why her immune system seemed so much weaker than everyone else's.

This is one of the most common concerns people bring to our clinic. It's also one of the most misunderstood, because the problem usually isn't the immune system itself.

Modern immunology frames immunity in terms of defense: how well does your body identify and destroy pathogens? From this perspective, frequent illness suggests a failure of surveillance or response, and the solutions follow logically. Stimulate the immune system, give it more resources, train it to fight harder.

Chinese medicine asks a different question: does your body have the resources to maintain its boundaries in the first place?

In classical terms, we talk about wèi qì 卫气, often translated as "defensive qi." Wèi qì isn't a standing army waiting to fight invaders. It functions more like the integrity of a container. When wèi qì is robust, the boundary between inside and outside holds, and wind and cold and damp don't penetrate easily. When wèi qì is weak, the boundary becomes porous.

Wèi qì is produced by the body's deeper metabolic processes, rooted in what we call the spleen and lung systems. These aren't the anatomical organs but functional networks responsible for extracting energy from food and distributing it through the body. When those systems are depleted, wèi qì suffers and colds come easily.

This was the pattern we saw with Sarah. She ran cold, especially in her hands and feet. Her digestion was sluggish, with bloating after meals and low appetite in the morning. She carried a tiredness that sleep didn't fix. Her pulse was thin and soft, and her tongue was pale and slightly puffy with a thin white coat. All of this pointed to qì deficiency, particularly in the spleen and lung networks.

Treatment focused on building her up. We used acupuncture to support the spleen and lung systems, choosing points that strengthen qì production and consolidate the body's surface. We prescribed an herbal formula based on Yù Píng Fēng Sǎn 玉屏风散, Jade Windscreen Powder, from the Dānxī Xīnfǎ 丹溪心法 (c. 1347), which addresses this pattern of weak protective qì and susceptibility to wind invasion.

We also talked about how she was living. She skipped breakfast and ran on coffee until noon. She exercised hard several times a week despite being exhausted, because she felt she should. In classical terms, she was spending more than she was earning.

Chinese medicine takes the arithmetic of energy seriously. You have a certain amount of qì available each day, and you spend it on movement, digestion, thought, emotional processing, immune function, and repair. If you consistently spend more than you take in, your reserves erode. Sarah didn't need to overhaul her life, but she did need to stop draining herself unnecessarily. Eating breakfast, scaling back intense exercise, and resting when tired would make a real difference.

Over the following months, the colds became less frequent. When she did catch something, it resolved faster. Her energy improved and her digestion settled.

This is what constitutional treatment looks like. We weren't boosting her immune system in the way that phrase usually implies. We were helping her body rebuild the underlying vitality that makes healthy immune function possible. Sarah still comes in occasionally for a tune-up when life gets demanding, but she's out of that cycle of constant illness. Her body holds its ground now.

What They Came In For: Sciatica

Susan came in with a limp and a grimace.

She’d been dealing with sharp, radiating pain down her right leg for weeks. It started as a dull ache in her low back — nothing she hadn’t dealt with before — but quickly evolved into something else entirely. A stabbing, electrical pain that shot down through her hip and into the back of her thigh. Sometimes it reached her calf. Sometimes it felt like her foot would go numb.

“I can’t sit for more than ten minutes without it lighting up,” she said. “And walking’s just… a negotiation with my body. Every step is a maybe.”

Susan was in her early 50s, worked part-time from home, and loved to garden. But lately, everything felt like a challenge. Standing at the kitchen counter to cook dinner made her leg throb. Sitting at her desk was impossible without a stack of cushions and a heating pad. She hadn’t touched her garden in over a month.

She’d seen her primary care doctor, who diagnosed it as sciatica — likely inflammation pressing on the sciatic nerve. They offered pain meds and referred her to physical therapy, but she wanted something more hands-on. Something that could address the pain now while also supporting her body’s healing over time.

She came to us out of desperation — but also hope.

Mapping the Pain

Susan’s pain was textbook in its presentation — but everyone’s version of sciatica is a little different. In her case, it followed the classic pathway from her low back into her glute and down the back of her thigh. But it was also unpredictable. Sometimes the pain was dull and dragging. Other times it was sharp and hot, especially when she moved from sitting to standing. At night, it ached deep in her hip and made it hard to sleep.

We used acupuncture to target the full length of the affected channel. Not just at the site of pain in the glutes, but upstream at the low back and downstream in the calf and foot — selecting points to release tight muscles, reduce inflammation, and encourage the body’s natural healing response around the affected tissues.

When we worked on her lower back directly, we needled not just where it hurt, but where we thought the problem originated. Sciatica often comes from compression or stagnation in the lower spine or gluteal area, and releasing those stuck layers makes a huge difference. Susan felt it right away.

“That spot — whatever you did there — that’s the one,” she said after the first treatment.

The Power of Consistency and Herbs

Sciatica doesn’t usually vanish overnight. The nerve needs time to calm down, inflammation needs to be addressed, and the muscular imbalances that contributed to the problem often need unwinding. But with regular treatment — and that’s the key — most people get real relief.

For Susan, we started with acupuncture twice a week for the first couple of weeks to get traction on the pain. It wasn’t just about reducing discomfort — it was about keeping momentum, helping the tissues recalibrate, and making sure every step forward stuck.

We also added in a custom herbal formula tailored to her specific presentation. Herbs to move blood, reduce inflammation, and support her constitution — especially her Liver and Kidney systems, which in Chinese medicine govern the sinews, bones, and the lower body. The herbs helped keep the pain from flaring between sessions and supported healing in the background, even on days she wasn’t in the clinic.

By the third week, Susan reported that she’d made it through a full afternoon in the garden — not pain-free, but mobile, present, and not paying for it afterward. By week five, she was back to walking her neighborhood loop in the morning. She still had some stiffness when she overdid it, but the electric shocks were gone.

Getting Her Life Back

Chronic pain has a way of shrinking your world. It steals simple pleasures. It makes your body feel like a trap.

When Susan first came in, she wasn’t just in pain — she was discouraged. She felt like her life had become a list of things she couldn’t do: walk, bend, sit, rest.

But after a few weeks of steady treatment, she started to recognize her body again. Not as a source of distress, but as something trustworthy. Capable. Responsive.

“I didn’t realize how much I was adjusting to the pain until it started to ease,” she told us. “Now I’m not adjusting — I’m just living.”

Acupuncture works best when it’s targeted, consistent, and supported with the right herbs and pacing. It doesn’t mask the pain — it helps the body untangle it. And in Susan’s case, it gave her back the rhythm of her days — and her garden, too.

What They Came In For: Painful Menstruation

By the time Meena R. walked into our clinic, her period ruled her calendar.

She had been dealing with severe cramps and heavy bleeding for as long as she could remember. Every month, for five to seven days, her world narrowed: heating pad, dark room, extra clothes packed “just in case,” and a silent prayer that her cycle wouldn’t land on an important meeting, a social event, or a flight. Sometimes she bled through her clothes. Sometimes the pain made her nauseated. Always, she endured.

She had tried birth control pills, which helped at first but came with their own side effects. She tried prescription painkillers, which dulled the edge but left her groggy and bloated. She tried supplements, yoga, pelvic steaming, magnesium, cutting out dairy. Some things helped a little, nothing helped enough.

And every time she brought it up—at her annual exam, during doctor’s visits, in rushed urgent care check-ins—she got a version of the same message: “That’s just your period.”

Which felt a lot like being told to get used to it.

When Meena came to Root and Branch, she was skeptical—but also exhausted. She didn’t want a miracle. She just wanted one cycle that didn’t leave her drained, curled up, or rearranging her life around bleeding.

We began, as always, by listening and asking questions. When did the pain start? Was it sharp, dull, dragging, throbbing? What did she notice about clots, color, flow, fatigue? We asked about her cycle from beginning to end—not just the “bad” days, but what led up to them, what came after. We looked at her digestion, sleep, mood. Her tongue, her pulse. Her full picture.

She described herself as “a person who pushes through,” but her body told us otherwise. Her pulse was wiry and tight, her lower abdomen cold to the touch. Her period arrived like a flood—sudden, heavy, painful—followed by days of exhaustion and emotional crash.

We explained that in Chinese medicine, pain and heavy bleeding aren’t random—they’re signs of stagnation and weakness happening at the same time. The blood is stuck, but also not being held. There’s tension, but also depletion. And both need to be treated, in the right order, with care.

We started with a customized herbal formula. That was the cornerstone of her treatment. One blend before her period to move what needed to move and ease the buildup of tension. Another to take during her period to reduce pain and regulate flow. These weren’t off-the-shelf teas. They were carefully selected combinations meant to restore rhythm and clarity to her cycle. She brewed them twice a day, sometimes more during her worst days.

Alongside the herbs, we used acupuncture to move blood, release tension in the lower abdomen, and support her hormonal system. We placed needles with a focus on the Liver and Spleen channels—key players in blood regulation—and paired that with calming points to settle her nervous system, which had been bracing for pain every month for years.

The first cycle after treatment was still painful—but it was different: less intense and shorter. She didn’t bleed through anything. She went to work the second day, which felt like a small miracle.

By the third cycle, she wasn’t dreading it anymore.

“I’ve never had a period sneak up on me before,” she said, half laughing, half stunned. “It just… came. And it wasn’t awful.”

The bleeding slowed. The clots lessened. The pain, once all-consuming, became background noise. The fatigue lifted. Slowly, her cycle started to feel like something she could live with, rather than hide from.

What she came in for was fewer bad days.

What she got was a more balanced cycle—and a renewed sense of agency in her own body.

At Root and Branch, we see period pain often—whether from endometriosis, fibroids, hormone imbalance, or no clear reason at all. We treat what’s there, but we also treat what’s underneath. Because pain may be common, but it’s not “normal.” And heavy bleeding doesn’t have to be your monthly reality.

If your cycle has been running your life, we want you to know: there’s another way.

What They Came In For: Long Covid

“I just want to feel like myself again.”

That’s what Thomas K. said when we asked him what brought him in. Then he paused.

“And the truth is, I’m not even sure I remember what that feels like.”

He’d had COVID ten months earlier. It was his second time getting it—the first had been over a year prior, and he’d recovered easily. A few days of fatigue, some sniffles, and then life went back to normal. He was vaccinated. He’d done everything “right.” So when he got it again, and it started as a mild case, he wasn’t too worried.

But this time, the recovery never came.

The fever passed. The test turned negative. But the fatigue stayed. Not the kind you push through with coffee or a good night’s sleep—the kind that settles into your bones. He started needing to lie down in the afternoon. Sometimes his chest felt tight—not dangerous, just off. His brain felt foggy, like he was trying to think through static. He forgot words. Simple tasks took longer. His mood got flatter. His sleep got worse.

He kept waiting to bounce back. But the weeks turned into months, and nothing changed.

He’d had all the tests. Labs normal. Lungs clear. “You're just stressed,” one provider said. Another called it post-viral syndrome and offered antidepressants. He wasn’t against medication. He just didn’t feel like anyone was really listening to what was happening in his body.

That’s when he found his way to Root and Branch.

What he wanted was simple: clarity, energy, and the ability to trust his body again.

We started with the big picture. When did the fatigue hit hardest? How did he feel after meals? How had his digestion been since the illness? What about temperature regulation? Sweating? Focus? Anxiety? We looked at his tongue, felt his pulse. Beneath the surface, his system told a familiar story: a body still caught between recovery and defense. Weakness at the core. Stagnation in the chest. A nervous system on edge.

We explained how long COVID presents, through the lens of Chinese medicine, as a pattern of post-viral depletion and dysregulation. Energy isn’t just “low”—it’s blocked. The body isn’t just tired—it’s stuck in a pattern it can’t exit.

So we built a treatment plan to help guide it out.

At the center of that plan was a custom herbal formula—one tailored to nourish the body’s energy without overstimulating it, to open the chest, support lung and spleen function, and gently recalibrate the nervous system. Not a stimulant. Not a sedative. Just medicine that knew how to listen to what the body actually needed.

He took it twice a day, every day. And we adjusted it often—because as his body changed, the formula needed to change too.

We paired it with acupuncture designed to support his recovery on multiple levels: points to regulate his sleep, clear the lingering heaviness in the chest, restore cognitive clarity, and rebuild his sense of groundedness. After each session, he’d say the same thing: “I didn’t know I could feel this calm anymore.”

After three weeks, his fatigue began to shift. Not all at once—but there were longer stretches of clarity. Mornings that started easier. Fewer naps. More consistency. His brain fog started to lift. He could read again, focus on a conversation without drifting.

After six weeks, he said, “I feel like I’m finally climbing out of something.”

We continued to treat the fluctuations—days where his energy dipped again, or sleep became fragile—but overall, the direction was steady. Upward. Back toward himself.

What Thomas came in for was his energy.

What he found was recovery—and something more: a renewed relationship with his body, one built not on pushing through, but on paying attention.

At Root and Branch, we’ve worked with many long COVID patients, each with a slightly different picture. Some come in with chest tightness. Others with digestive distress, insomnia, hair loss, anxiety, or relentless fatigue. No two cases are identical—but the approach is always the same: track the pattern. Treat the root. Support the whole person.

If you’re living with long COVID symptoms that just won’t let go, know this: there is still healing available. It might not be fast. But it can be real.

And we’re here for the long arc of it.

Why Word Of Mouth Matters

When someone finds something that really works—whether it’s a great plumber, a dependable mechanic, or a clinic that actually helps them feel better—they often tell a few people about it. These small acts of sharing are how most of us discover the things we come to trust. But in today’s world, it’s easy to assume that businesses grow because of digital advertising, clever algorithms, or a strong social media presence. That might be true for products or viral trends, but it’s not how real, local, service-based care actually grows.

Two women talk over breakfast

We’re often asked why we don’t post more on social media, or why we don’t invest in digital ads to “get the word out.” And the answer is fairly simple: digital marketing is expensive, competitive, and poorly suited to the kind of work we do. We’re not selling a quick fix or a single-use item—we’re offering care that takes time, relationship, and trust. And those are not things that people usually buy because they saw a well-placed Instagram ad.

The truth is, even if we wanted to pour energy into online advertising, we’d be competing with large health systems, national supplement companies, and digital health brands with marketing budgets that could cover our entire operating costs many times over. The internet is noisy. Attention is fragmented. And the kind of depth that Chinese medicine offers doesn’t lend itself easily to short-form content or click-through campaigns. What we do is slow. It’s personal. It requires a willingness to sit with someone and really listen. That’s not something you can package into a sponsored post.

And even if you could, it still might not work. There’s an old rule of thumb in marketing that says it takes about seven times for someone to hear about something before they decide to act. That number isn’t precise, of course, but the underlying point holds true. People rarely make decisions the first time they hear about something new. They need reminders. They need to hear it from someone they trust. They need to feel like the choice is safe and the path is familiar. And in our experience, nothing moves that process along more effectively than word of mouth.

When someone you trust says, “You should check them out,” it means more than a dozen glowing reviews online. When a coworker tells you that acupuncture helped their headaches or that their digestion finally improved, it creates a kind of opening. You don’t have to understand how it works—you just start to wonder if maybe it could help you, too. That small opening is where the real momentum begins.

And for clinics like ours, that momentum is essential. We don’t have investors. We don’t have billboard campaigns or prime-time ad slots. We grow because people like you have good experiences, and then tell someone else. That’s it. That’s the whole engine.

So when you recommend us to a friend, or share a blog post that resonated, or casually mention in conversation that acupuncture helped you sleep through the night for the first time in weeks—you’re doing more than passing along information. You’re actively supporting our survival. You’re helping to keep a small, local business open. You’re helping a clinic stay available for the next person who needs care. And you’re helping grow a model of healthcare that still believes in time, attention, and personalized support.

It doesn’t have to be a grand gesture. You don’t need to post on social media or deliver a speech about Chinese medicine to your book club. Sometimes it’s enough to say, “I think my acupuncturist might be able to help with that,” or to hand someone a card, or to write a few honest sentences in a review. These small, direct, person-to-person exchanges do more for us than any algorithm ever could.

In a time when people are inundated with ads and recommendations from all directions, a real voice still carries weight. Your voice—genuine, human, and grounded in your own experience—is what makes people listen. And in a landscape where small businesses are often drowned out by louder, better-funded ones, that kind of word of mouth matters more than ever.

So if our work has helped you, if you’ve felt better in your body or more steady in your mind because of the care you’ve received, we hope you’ll consider sharing that with someone. Not because we’re trying to grow fast, but because we want to keep doing this for the long haul. We want to stay open, stay available, and keep offering care that is thoughtful, effective, and rooted in something more lasting than trends.

The future of small, relational, whole-person medicine depends on people talking to people. And that kind of support can’t be bought. It has to be offered freely, one conversation at a time.

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Why You and Your Parents Don't Need To Suffer As you Age

By
Travis Cunningham MAcOM LAc

To listen to the audio recording of this article, click below.

Why You And Your Parents Don't Need To Suffer As You Age

Travis Cunningham

The Curse of Aging

Does it bother you to think of yourself getting older? It bothers me. I can feel the aches and the pains already. I can feel the slow but definite decline in energy, flexibility and strength of my body. I can sense the descent of my intellect and the clouding of my memory. Fewer adventures and more routines. More trips to the doctor’s office and more need for my friends and family to take care of me. But that’s the reality, isn’t it? I mean, I guess we’re all going the same way, so why not just accept it?

If the above narrative doesn’t sit well for you, then you have made it to the right place. Somehow in the vast expanse of internet land, you made it here. Congrats!

Everything I have seen in my short but lively career as a traditional Chinese medicine practitioner suggests that most of the negative experiences we associate with the aging process need not come to pass. But in order to understand how our experience may differ from the common definition of aging, we must look at why suffering is a possibility as we age. Once we understand the problem, then we may understand its solution.

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Why We Suffer When We Age

Chinese medicine relates good health to the principles of change and transformation. When we can change and transform, we can grow. And as long as the possibility of change exists within us, the opportunity for growth remains. Each new experience provides opportunities to create and re-define ourselves. And when we do so, our lives become works of art.

When we cannot change, we get stuck. When stuck-ness exists in a person — in our bodies, in our organs, or in our emotions, problems inevitably occur. Because life is dynamic and ever-changing, when we are stuck and cannot adapt to those changes, we find the spontaneous movements of life turn to hazard and harm. We coil around and protect the stuck parts of ourselves hoping that they will not be touched. We try to control our experience and keep it from changing. And when the tender places within us are inevitably approached, we suffer the reminder of dis-ease that sticks within them.

Stuckness can occur in many forms within humans. Aches and pains in our muscles, joints, and bones result from poor circulation and blood supply. Our bodies may have a hard time regulating our temperature resulting in fever and chill sensations. Or we may have shallow sleep and have less energy throughout the day. We can think of these symptoms as a kind of hormonal stuckness. We may feel our thoughts becoming sluggish or foggy with a decreased desire to learn and understand which is a distinct type of mental stuckness. Even our hearts may stop pumping so well, and we resort to medications in order to remedy organ stuckness.

Luckily, There is Hope!
The Remedy to Stuckness Is Simple…

As we move through the years of our lives, collecting a wide variety of experiences across the entirety of the emotional and physical spectrum, we have the continual opportunity to cultivate wisdom. Wisdom requires the discernment to know which actions help us toward our goals and which actions are less supportive — a key skill harvested from our life experience. However, in order for wisdom to truly form, discernment must partner with a second quality: grace.

Grace comes from the ability to be soft and open to new ways of perception and action. Grace is a fluid quality, reaching into both the physical and psychic aspects of our lives. It comes easily to us as children when we are less certain and more trusting of our innate experience. But as we age and form belief structures, grace must be continually practiced or it will begin to fade.

As we age, we tend to lose touch with our sense of grace. We move less physically and do fewer new things. We stick to our routines, eat the same foods, and see the same people. The newness of our lives lessens, and so does our flexibility in managing it. This nascent rigidity is the root of future health problems.

While it’s true that there are natural consequences to the aging process, many of the aforementioned fates need not come to pass. With simple and gradual adjustments to a person’s lifestyle, the woes of aging can be lessened or avoided by a more graceful form of living. If grace can be adopted, then we may see the benefits of aging truly shine!

The Benefits of Aging
(What No One Talks About)

The benefits of aging lie within the possibility of cultivation. Because human beings have the opportunity to cultivate wisdom through life experience, we have the potential for greater levels of happiness, satisfaction, and discovery as we age. As our years pass, we can learn to harmonize the stability and creativity of human experience. We can become healthier this way, knowing ourselves in great depth and channeling the power of this depth to serve ourselves and others.

While our physical bodies become less abundant in mass, they may become more refined in quality. We may learn to require less in order to give more. Smaller amounts of food and fewer hours of sleep may be the result of this refinement, so long as does not cost us energy and clarity. Aging well gives the possibility for our minds to open, enhancing our contemplative powers as well as our spiritual ones. As middle age passes, the possibility of becoming not just old but an elder, arises. What a fantastic opportunity indeed!

In order for humans to see the benefits of aging, we have to participate in the things that make us human. In Chinese medicine, these areas of participation are the things that we must do in order to survive - breathing, eating, sleeping, moving, and resting. Participation may be thought of as a kind of rhythm, for when activities are practiced consistently, a power comes through them that begets more significance than that of a single beat. These activities compound in their effects and give strength to one another like links in a bond. They are the basis of good health, wisdom, and grace.

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Building A Foundation

In traditional Chinese arts, the foundational practices are where you start and often where you end. No matter how advanced you get within the art, good can always come from refining the fundamentals.

Breathing
As the most essential and immediate ingredient for health and vitality, breathing should be a priority. From time to time, check in with your breath and make sure it isn’t being held. Let your mind settle and let your breathing come naturally from your belly. Get out in nature by trees whenever possible and breath in that fresh air!

Eating
Keep eating as simple and as enjoyable as possible. Eat with people you love when you can. Eat at regular times. Slow down and chew your food. Eat lots of vegetables, with moderate amounts of grains and/or meats. Figure out what works and feels good in your body. Minimize overly heavy and sweet foods (but enjoy them when you do eat them). Breathe easy when you eat. Cook the majority of your foods (especially vegetables). If you have a digestive weakness, cook everything.

Sleeping
Go to bed as early as you can with consistency. Ideally, you would be asleep before 10:30 PM every night. Do the best you can with this. Sleep through the night, and make time in the day for a short nap (if possible). If you have difficulty sleeping through the night, try soaking your feet in hot water (described in greater detail below) before bed, and limit your food intake late at night.

Moving
Move every day without question. Do as much as feels good in your body. A little bit of pushing yourself in movement is good; alot of pushing is not good. Moving promotes circulation for the body and mind. Moving in natural environments is even better. Find something you like to do, and do it with regularity.

Resting
Throughout your day, plan periods of rest from your activity or work. These may be momentary at first - lasting 5 to 10 seconds. But hopefully will expand to a bit longer (15-30 minutes is about perfect). Do very little in your periods of rest. Avoid social media and mind stimulation. The basic idea for resting is to rest - not to be doing something. This practice will conserve your energy throughout the day and hopefully allow you to recycle it at night. This will both extend your life and enhance its quality.


Communing
Get your relationships in order. No, seriously! Good relationships can hold you together when you have no strength left. Bad relationships can demolish you even when you feel high and mighty. You can’t do this life all by yourself! Developing good relationships is essential to being a healthy human. If you don’t know where to start with people, try nature or animals first. Nature/Forest Therapy is an excellent place to start. Conventional therapy is also great and not only for advanced mental/emotional problems. If you need help, get yourself some help. You are a pack animal, you deserve to be with your pack.

Focusing
Humans need something to do in order to be happy and healthy. This need can be satisfied with something as elaborate as creating a non-profit to as simple as knitting a scarf. But you need something to do. And the more people feel that their work has value, the happier they tend to be. If you don’t know what your life’s purpose is, don’t worry about it! You don’t have to know all the secrets to be happy. Just start with today and do something that’s valuable to you.

Creating healthy habits in life without internalizing guilt and shame in the process is an art form.

Be easy on yourself, but do the best you can :)

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How to Refine Your Health
Or
Get Back Your Health
(When You’ve Lost It)

Step One: Build Your Foundation

As stated in the previous section, building a foundation of positive participation in life is essential for both getting your health back and maintaining (as well as improving) it. This can be done in the smallest of ways to begin, and it will compound and multiply as you continue. Follow the guidance in the above section to get started. If you feel you need assistance or further evaluation before you begin, make an appointment with a qualified healthcare practitioner. You can schedule an appointment with one of our experts here.

Step Two: Increase Your Circulation

Far and away the biggest problem I see in the clinic when people come in with age-related complaints is lack of circulation. As we age, we move less and the parts of our body that rely upon circulatory actions (like the heart) get tired. These organs work less efficiently the more tired they get, and the obvious problems of blood pressure, cholesterol, and fatigue, arise.

Poor circulation robs organ systems of their health by withholding the precious resource of nutritionally-dense blood. Anxiety, depression, and insomnia are only the beginning of the list of problems that can result. Similarly, old injuries with damaged tissues receive fewer resources because of this lack of fresh blood in supply. The tissues become achy and malnourishment or even form calcifications and masses which lead to further problems.

To stop this increasingly damaging cycle and begin turning the wheel in the opposite direction, you can start by working on your circulation in fun and simple ways. The most popular way to do this is by gently increasing your activity. Traditional exercises for circulation include walking, running, biking, swimming, lifting weights, playing sports, and other like activities. Softer methods can also be useful especially when the energy of the body is low. These allow for an increase in circulation without employing a taxing effect on the body’s resources. Yoga, tai chi, or traditional stretching are excellent places to begin.

Foot Soaking

To supplement your circulation even further, you can try one of my favorite time-tested treatments for the regulation of all human cycles: soaking your feet.

Soaking your feet in warm water helps the blood to flow all the way down to the furthest part of the body from the heart. During this transit, the blood passes around and through vital organs, cleansing and nourishing them before finally settling in the feet. Afterwards, the blood returns by way of the veins and a gentle pump for the whole body has just been created.

From a Chinese Medicine perspective, transferring heat to the lower extremity is considered highly beneficial and allows the Yang Qi of the body to go into storage, making it easier to fall asleep and allowing for more restful sleep. This knowledge may even have served as an inspiration for the Chinese adage, “Keep your feet warm and your head cool.”

How To Soak Your Feet

A) Choose A Basin
Use a container large enough to accommodate both your feet and deep enough to cover your ankles. Wood is best, plastic works as well. Do not use copper or iron containers.

B) Prepare The Soak
Bring 2 quarts of water to boil in a pot or kettle
Good Medicine: You can use hot water for your foot soak and receive many benefits.
Better Medicine: You can add medicinal ingredients to increase the effect of the foot soak. Simple medicinal add-ins are epsom salts or slices of fresh ginger.
Best Medicine: For an extremely potent foot soak, ancient formulas of herbs are used to increase and specialize the effect of the soak. To find out more of the specifics, check out our foot soak catalog here.
Place 1-2 herbal pouches (or, as directed by your practitioner) into a heat-proof, non-reactive vessel and add boiling water. Steep for 10 minutes. Pour tea bag and herb liquid into soaking vessel. Add hot water as necessary to cover your ankles.

C) Add liquid herbs to Foot Basin
Pour tea bag and herb liquid into soaking vessel. Add hot water as necessary to cover your ankles. Larger basins may require more water.

D) Confirm The Soak Temperature
Extremely important for those with impaired sensation in their extremities.The temperature should be between 105-112 degrees Fahrenheit (check using a thermometer). If this temperature feels uncomfortable when first starting to soak, it is ok to work up to this temperature gradually.

E) Sit & Soak
Choose a place where you will not be exposed to drafts and disruptions. It is best to avoid television or other electronics while soaking. Use the time to sit quietly, meditate, pray, or engage in pleasant conversation.

F) Maintain Soak Temperature
It is important to maintain the soak temperature in the therapeutic range of 105-112 degrees Fahrenheit for the duration of the soak (30-45 minutes). The easiest way to do this is to use an electric kettle to add small amounts of boiling water to the soaking basin every 5-10 minutes. Please Exercise Extreme Caution: Remove your feet from the bin when adding hot water and be very careful using electric appliances around water. Always confirm the soak temperature is below 112 degrees Fahrenheit before putting your feet back in the soak.

Other Helpful Treatments For Circulation

Acupuncture
Perhaps acupuncture’s greatest asset as a treatment modality is the precision at which, it can encourage the circulation of the body. Bad acupuncture can alleviate pain and promote general circulation. Good acupuncture can harmonize the organs of the body, extract and eliminate deeply held pathogenic influences in the tissues, and clear the mind.

Chinese Herbal Medicine
Chinese herbal medicine has an entire collection of herbs that may be used to increase the circulation of the body in both micro or targeted, and macro or general, sense. While the vast majority of these herbs are plant substances, there are a few medicinals that fall outside of the traditional category of plant. My article, How Bugs Can Heal Chronic Pain & Disease is a discussion about one subset of these medicinals.

Bodywork
Whether you’re talking Osteopathic, Chiropractic, or more traditional massage therapy, a good body worker is worth their weight in gold. Good bodywork can pinpoint the problematic area in the tissues of the body and remove it, restoring flow and encouraging the health of the entire person.

Step Three: Find A Health Expert & Comrade
(Not The Internet)

While the internet is an incredible place for the sharing of ideas, it is a terrible place for editing out bad ones. I’ve seen more patients damaged by following bad internet advice than almost any other source of information or treatment out there. Please be careful when receiving advice from sources that you have no way of dialoging with. Health advice should come with a platform of participation on both ends. It should include clear directions and signs of progress or deterioration. If the advice you’re getting is vague or lacking this basic partnership, do not follow it.

On the plus side, the internet can be a great place to find health comrades or experts to work with directly. There are so many good practitioners that can assist you on your path to health, wisdom, and happiness. You just need to find them.

Which Type of Medicine Is Best For me?
Stay connected for a future article dedicated to describing the strengths and weakness of various modalities of medicine. But in the meantime, rather than focusing on the type of medicine to try, I would recommend focusing instead on finding the right person as a practitioner, for you. This person should be trustworthy, intelligent, and credentialed within the context of their given field. They should be able to communicate well with you so that you can adequately understand your situation and what they think about it. They should also have a referral team of other practitioners whom they trust, that do different kinds of work than they do. In this way, finding the right practitioner can mean finding the right network of practitioners who are available upon need.

The best way to find the right practitioner is often through the referral of others, so don’t forget to ask trusted friends and family members about who could be right for you. If you happen to live in the Portland area or in the Pacific North West in general, me and the members of the Root & Branch team would be happy to recommend a practitioner who might be good for you. Feel free to book a free conversation with one of our experts here or virtually contact us via email or phone, here.

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Your Greatest Asset

One of the best things about being a human is not having to do it alone. In our culture we tend to think of our health as an individual thing, but it’s not! We exist in communities now as we always have. While it is, of course, important to cultivate the integrity of our health as an individual, it’s equally important to cultivate the health of ourselves as a people.

Please do not feel that you need to do this life alone. There are many humans as well as resources to assist you. And with such assistance, your journey of aging can be one of happiness and wisdom. Just give it some time.

How Bugs Can Heal Chronic Pain & Disease

By
Travis Cunningham MAcOM LAc

Ninety Percent of Chronic Pain Gone in One Week

“I hate to sound like a broken record,” said one of my teachers, “but a lot of her problem is due to blood stagnation.”

Dr. Greg Livingston and I were chatting before one of our herbal shifts at the school clinic. We were discussing the details of a diagnosis that one of our patients had been given on the shift the week before. Blood stagnation is the name of a pattern that we learn to identify and treat in Chinese medicine. According to the medicine, stagnant blood is the root of many illnesses. If blood doesn’t flow correctly, pain will result and various organ systems will become undernourished. Malnourishment and lack of flow will then cause other problems and lead to a whole host of diseases and bizarre symptoms.

I smiled at Greg’s remark. It was a familiar piece of advice, but one that bared repeating. Greg was one of the few westerners to go to China, learn chinese, finish a P.H.D. in Chinese medicine, and then study with various doctors who had decades of clinical experience. Greg got excellent results in the clinic. He consistently understood and could explain why he would give treatment the way that he did. He was one of the teachers that I had become closest to while in school. He is someone that I still consider a friend and mentor to this day.

“But why use the bugs Greg?” I asked after glancing at the patient’s herbal formula. “What would lead you to the conclusion that we need to break the blood?”

My question was linked to the way we learn to classify herbs as singular medicinals at school. The category in Chinese medicine that most of the insect medicinals are placed in, is called move the blood. The move the blood category has several gradients of intensity, the strongest of which is called break the blood. That is where the bug medicinals reside.

“Well,” he replied, “the bugs don’t necessarily move the blood any more intensely than Dang Gui 当归 (Angelica Sinensis) or Chuan Xiong 川芎 (Sichuan Lovage), what makes them unique is that they go to the luo mai.”

In Chinese medicine, when a person gets sick the disease is thought to go first into the main channels and collaterals of the body. These pathways are called the jing luo in Chinese. When the disease stays in the body for longer periods of time, it is thought to get into the tiny pathways and offshoots of the larger channels. These tiny pathways are referred to as the luo mai.

“Bugs get into tiny spaces, right?” he said, mimicking the movement of an insect with his hands. “So if you want to get into those tiny spaces of the body to get rid of that stubborn blood stagnation, you need the bugs.”

“Interesting” I replied.

Several weeks later, I was on a different clinical shift with one of my regular patients. This patient had had over ten surgeries on his abdomen leading to chronic abdominal pain. He had also been diagnosed with crohn’s disease, arthritis, and crohn’s-related arthritis. On a good day, his chronic pain was at a 5/10 intensity. On a bad day, it was 7 or 8/10. And it had been like this for years.

With weekly acupuncture, we had managed to get the scarring on his abdomen down “from the size of a dinner plate to the size of a salad plate,” he would say. Each week he would come in, we would needle around his abdominal scar in a technique known as “surround the dragon.” While progress was gradual, it was definite. Both the size of the scar and the local pain had decreased.

While our treatment had been somewhat effective, I wondered if there was more we could do to help him. That is when I remembered my conversation with Greg.

After convincing this patient to try a simple herbal formula that contained insect medicinals, we booked another appointed for the same time the following week.

As I went to greet the patient the next week, I could see he was smiling. When he got into the room, my patient said “Well, I think we’re on to something.”

“Oh yeah?” I replied, “How so?”

“Ninety percent of my arthritic pain has been gone since I’ve been taking the herbal formula you prescribed.”

“Ninety percent in one week?” I repeated, not fully believing my ears.

“Ninety percent in one week,” my patient confirmed.

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The Use of Non-herbs in Traditional Herbal Medicine

In the Chinese herbal materia medica, there are a vast number of medicinals listed that we would not normally consider “herbs” in the english language. Some of these are mineral-based substances such as amber, hematite, pearl, and oyster shell. While others may come from (or be) insects or larger animals. In modern times, it can be difficult to conceive of why anyone would want to use animal-based materials for traditional herbal medicine. Isn’t there a plant-based alternative, we ask? In our time of cultural change and technological advancement, it seems like almost anything can be replaced by something else.

But if we look from the perspective of traditional people, we have to admit that animal products are different from plant or mineral-based ones. Animals are slightly different forms of life. They carry unique features of nature and bear a closer resemblance to humans than plants or minerals do. This uniqueness was noticed by ancient people, and those ancient people sought assistance from these animals in their medicine.

A Doctrine of Signatures

The doctrine of signatures is a common method of investigation inside many forms of traditional medicine. This principle suggests that what something looks like in nature, suggests what it has an affinity for in the body. Fro example, Walnuts appear somewhat like the human brain and so tend to promote brain function. Beats are red like blood and contain vitamins and minerals that create healthy blood. Examples of this principle are numerous and found constantly in different cultures all over the world.

It’s important to remember that the doctrine of signatures is not the end of an investigation, but the beginning. After a similarity is witnessed with a substance and the body, experimentation begins. And after experimentation has been exhaustively conducted, there is debate about the usage and function of each particular substance in a given context.

Far too often, we ascribe a kind of archaic simplicity to the reasoning of our ancestors. But the more we examine ancient people, the less foolish they appear to be. The symbols earlier humans used to describe life often have a multidimensional meaning and function. The non-specific nature of each symbol allows it to outline a broad type of experience without being constrained by particular details. This makes a symbol the perfect articulation for a kind of experience instead of an individual one. The doctrine of signatures is just one way that the natural intelligence of bodies and their environments manifests.

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Worms for Wind

Worms move in a way that appears very similar to humans when we are convulsing (like in a seizure or stroke). Convulsions may come on without much warning and be chaotic in nature. This quality of movement and appearance is like wind.

Once the convulsions end, certain parts of the body may be closed down or opened inappropriately. Paralysis may ensue. The channels that the body uses to communicate information have become obstructed. This obstruction requires the influence of an agent that knows how to get into tiny places and unblock them. This is where the worms come in.

It’s Important to remember that the doctrine of signatures is a method of explaining the gesture of a medicinal and not necessarily a description of its physical action. The application of an insect medicinal takes place after the insect has died and been processed. In the case of Chinese medicine, our bug medicinals are most commonly put together with other herbs and then simmered in water to be taken in the form of a decoction or tea. In certain applications, they are charred and powdered for topical remedies but never used in live form.

The heading information for each medicinal was taken from Benskey’s Materia Medica (3rd Edition) unless otherwise stated. Please refer to this text for more detailed information.

Dì Lóng 地龙
Latin: Pheretima
English: Earthworm
Properties: Salty, Cold
Channels Entered: Bladder, Liver, Lung, Spleen
Functions: Drains Heat, Extinguishes Wind, Stops Spasms & Convulsions, Calms Wheezing, Unblocks the Channels, Facilitates Urination

One of my teachers in Chinese medicine school would emphasize that earthworms look a little bit like the bronchioles of the Lungs. This, he thought, gave them an affinity to deal with long-standing lung problems.

During the Spring, di long crawls through the soil and begins the aeration process for the season ahead. It’s important to note that including air, the soil is opened up for the water cycle of Spring rain. Unclogging the tight soil for air and water to flow is precisely what di long helps the human body to do; unblocking the body’s breathing and urination.

Internally, di long is most often used in post-stroke and seizure remedies to unblock the channels and help a person recover the functioning of paralyzed tissues. But di long can also be used in a variety of chronic lung problems. It makes a great combination with sang bai pi (mulberry root bark) and si gua luo (luffa) for folks who have a cough with lung weakness due to a history of suppressed lung problems (such as pneumonia during childhood).

Dosing di long does not even need to be that high! As few as three to nine grams per day is enough to make a substantial difference in a person’s case. The most common way for internal administration of this medicinal is through ingestion via decoction, powder, or pill.

Externally, di long can be ground with sugar and applied topically to treat burns and ulcerations.

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Jiāng Cán 僵蚕
Latin: Bombyx Batryticatus
English: Mumified Silkworm
Properties: Acrid, Salty, Neutral
Channels Entered: Liver, Lung
Functions: Eliminates Wind, Drains Heat, Transforms Phlegm, Disperses Clumping

Jiang can is a white silkworm in its cocooned stage. Not only does the silkworm move in a similar fashion to the earthworm (like convulsions or wind), but the processing involved in preparing this medicinal for use includes stopping its growth or life by wind. Because this medicinal has been mummified by wind itself, it has an extra affinity for treating disorders that appear wind-like in the human body.

Internally, jiang can is often combined with di long to treat post-stoke and seizure disorders. It can be combined with other herbs to treat acute febrile illnesses, especially ones that include phlegm and congestion.

Jiang can separates itself from di long in two ways. The first has to do with it’s white color and acrid flavor. These two characteristics allow for the ability to treat phlegm and thick fluids in the body. One of my teachers used to say that if you crush jiang can up, it actually looks like phlegm. While one might argue that this could be the case for many herbs, it is certainly true of jiang can.

The acrid flavor of jiang can also helps to vent superficial pathogenic influence. Sensation of itching or bugs crawling underneath the skin, can be treated by this medicinal (with or without the manifestation of a rash).

The second and perhaps more notable difference in the focus of these two medicinals is that jiang can goes to the throat and treats nodules of phlegm and stagnation there. It performs this action quite well when combined with xia ku cao (prunellas spica), zhe bei mu (fritillariae thunbergii bulbus), and mu li (oyster shell).

Similarly to di long, dosing jiang can does not need to be very high! Three to nine grams per day is a more than effective dose to begin in most cases.

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Yin Crawlers for Yin Problems

Some bugs happen to live and grow in the murky places of our planet. What may we deduce from this? Well, a creature who thrives in the cold, dark, and damp may have an affinity for Yin.

In ancient Chinese cosmology, Yin and Yang represent the two apparent opposing aspects of our living experience. All things may be divided into Yin and Yang. Yang can be classified by the qualities of brightness, expansion, warmth, and expression. Yin can be classified by the qualities of darkness, contraction, cold, and introspection. Both are needed for the other to exist. Both may create or destroy the other. Either may be used to antagonize the other. Studying the way Yin and Yang interact is a basic study for any of the classical Chinese arts - including medicine.

Bugs that live and grow in water have a special ability to treat problems that are water-like. These are Yin problems of the body - lack of movement, stagnation and decay of fluids, the formation of tumors and masses, and poorly circulating blood. These symptoms, while variant, often result in the creating same experience - horrible amounts of pain. For when Yin gets stuck without enough Yang, disharmony is conclusive.

Shuĭ Zhì 水蛭
Latin: Hirudo
English: Leech
Properties: Salty, Bitter, Neutral, Slightly Toxic
Channels Entered: Liver, Bladder
Functions: Breaks up Static Blood, Disperses Stagnation

As the primary example of a water bug, shui zhi crowns itself queen of the medicinals that conquer Yin pathogenic influence in the human body. As shui zhi’s nature implies, pathologies that have landed in the lower body are its specialty to work on. Shui zhi’s salty flavor enters the blood aspect of the liver, targeting patterns of static blood which have yielded masses in the abdomen.

Shui zhi is perhaps the most focused bug medicinal. In addition to its action of guiding other herbs deeply within the body, shui zhi is said to have the ability to “break up old blood stasis without damaging new blood.” (WAtR, 135) According to the revered physician Zhang Xi-Chun, the hirudo leech has an affinity for carefully finding old blood because it seeks out and consumes blood during the course of its life. Whatever the reason may be, shui zhi’s medicine seems to be the most precise and effective bug medicinal to use in the case of chronic blood stasis, especially in the presence of substantiated accumulations.

Because of the growing popularity of shui zhi as a medicinal, prices on the herbal market have begun to increase making shui zhi quite an expensive ingredient. In the interest of keeping the price of herbal medicine affordable, the practitioners at Root & Branch have discovered that adding even as little as one to two grams of shui zhi to an herbal formula per day is enough to make a huge difference in most cases. It should be noted however, that for best results, three to five grams per day is recommended.

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Tŭ Biē Chóng 土鳖虫
Latin: Eupolyphaga/Steleophaga
English: Wingless Cockroach
Properties: Salty, Cold, Slightly Toxic
Channels Entered: Liver, Heart, Spleen
Functions: Breaks up Blood Stasis, Renews Sinews, Joints and Bones

Salty and cold, tu bie chong lives in the ground or in the walls and floors of urban buildings. Its affinity for darkness makes it an ideal medicinal in the conquering of Yin based accumulations: static blood, masses & tumors in the abdomen.

In addition to Yin pathogenic influence, tu bie chong works exceptionally well at healing injuries, bone breaks, and sinew or tissue damage. This is because the cockroach heals itself well in life. If tu bie chong is cut in half and then re-attached, it will heal and continue to live! The doctrine of signatures suggests that this potential is activatable in medicine. This is especially the case when tu bie chong is combined with the resins of trees: Olibanum (rŭ xiāng) and Myrrha (mò yào).

The recommended dosage of tu bie chong is between three and twelve grams per day. One of the best things about this medicinal is that its cheap! For the time being, tu bie chong makes a great add-in to any herbal formula needing guidance into the deeper blood level of the body. It also makes for a good substitute for shui zhi or meng chong on a tight budget.

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Yang Fliers for Fast Action

Some insects can fly and are attracted to light. They move and exhibit a buzzing sound, rapidly flapping their wings. This activity makes these creatures more like Yang. Yang is fast, agile, bright and big in its movement. It transforms turbidity and stuckness through an excited kind of Qi. While Yang transformation is successful, it normally requires a more stable partner for its transformations to be lasting.

Méng Chóng 虻虫
Latin: Tabanus
English: Horse Fly
Properties: Bitter, Slightly Cold, Toxic
Channels Entered: Liver
Functions: Quickly Breaks up Blood Stasis

Widely regarded as the most Yang bug medicinal, meng chong specializes in its fast-acting approach to transforming static blood accumulations and masses.

Meng chong flies in the air, buzzing around with a high frequency in life. When taken as a medicinal, meng chong’s bitter flavor combines with its Yang nature to quickly transform and purge accumulations. Though fast-acting, meng chong’s activity is relatively short lived. For this reason, it is normally combined with a more Yin-natured medicinal such as shui zhi to lengthen its medicinal effect.

Because of the rarity of meng chong as a medicinal, prices on the herbal market have begun to increase making meng chong quite an expensive ingredient. In the interest of keeping the price of herbal medicine affordable, the practitioners at Root & Branch have discovered that adding even as little as one to two grams of meng chong to an herbal formula per day is enough to make a huge difference in most cases. It should be noted however, that for best results, three to five grams per day is recommended.

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Case Study: Chronic Cough

62 yr. Sys Male

History
Patient reported a history of chronic dry cough for ten plus years (no memory of initial onset). The cough was mild and unremarkable unless the patient would catch a cold. Once caught, the cold would move quickly into the chest and linger for as long as two or three months. The cold would typically manifest with a dry cough, extreme fatigue, and difficult to expectorate phlegm.

The patient also reported catching pneumonia when he was eight years old that was treated with antibiotics.

First Appointment
Patient caught a cold six weeks prior to the initial visit. Though the acute symptoms had mostly resolved, a dry cough and fatigue remained. The cough was bothersome throughout the day and only through the night if the patient awoke for a time. No phlegm was expectorated while coughing, but there was a sensation of fullness in the chest and the epigastrium. Patient reported a neutral body temperature, but a preference for warmth, and no sweating. “I never sweat,” he said. Patient was able to fall asleep easily, but would sometimes wake around 3 AM with racing thoughts and heart palpitations. Occasionally he would be unable to fall back asleep for several hours. The patient had to get up 2-3 times per night, on average to urinate. Appetite, digestion, and bowel movement were all unremarkable.

Tongue
Slightly pale, thicker white coat, red tip, engorged sublingual veins.

Pulse
Overall: tight, muffled, robust
Cun positions felt very muffled but robust and superficial.
Right Cun was slightly scattered, with a Yang Wei pulse indication.
Guan Positions were wiry and tight.
Chi positions were deep and weak.

Diagnosis
Wind-Cold Painful Obstruction of the chest (Bi Syndrome)
Obstruction of the upper burner resulting in clumping of the Qi
Lung Qi unable to descend

Formula
Zhi Shi Xie Bai Gui Zhi Tang (Granule)

Gua Luo Xie Bai Ban Xia Tang 60 g
Zhi Shi 8 g
Gui Zhi 10 g
Hou Po 8 g

Dosage: 6 grams 2 times per day for 7 days.

Second Appointment (one week later)
Patient reported improvement with both cough and energy level. He had expectorated some very thick yellowish phlegm throughout the week and was feeling much better. His middle of the night waking had also decreased, as did the palpitations and feeling of fullness.

Because the patient had to leave town for several weeks, I gave him two more weeks worth of the same formula and told him to get in touch with me once he was back in town.

Third Appointment (one month later)
Patient reported gradual improvement for the first week after the second appointment and then no more improvement. His cough had “gone back to normal” and was now mild, dry and intermittent throughout the day. His sleep had improved, but he would still wake up 2-3 times to urinate per night. He was slightly fatigued throughout the day. All other reviewed systems were unremarkable.

Tongue
Pale-red, dusky, thin white coat, red tip, engorged sublingual veins.

Pulse
less tight than before…
Cun positions were now deeper (about mid depth) and very scattered, but still robust.
Right Cun position still had a Yang Wei pulse indication
Middle positions had become more superficial but were mostly unremarkable
Chi positions were slightly stronger, but still deep and weak overall.

Diagnosis
Blood Stasis in the Upper Jiao
Kidney Qi Deficiency
Kidney failing to grasp Qi

Formula
Jin Fei Cao San with modifications (bulk decoction)

Xuan Fu Hua 9g
Bai Shao (Chao) 9g
Gan Cao 6g
Tao Ren 9g
Dang Gui (Chao) 9g
Di Long 3g
Sang Bai Pi 9g
Zi Wan 9g
Si Gua Luo 6g

Dosage: per day.

Result
After one week, the patient’s cough had completely subsided. I prescribed a similar version of the above formula over the next few months, slowly removing the stop cough and heat clearing medicinals and replacing them with herbs to supplement the Kidney and Lung Qi.

Six months later, the patient’s cough had not returned.

Analysis
The patient’s medical history indicated a long-standing lung weakness. This was likely due to, or aggravated by the occurrence of pneumonia during childhood. In my clinical experience, the Yang Wei pulse indication is a confirmation of this weakness.

The patient’s presenting symptoms of cough, feelings of fullness and pulse led me to believe that the pathogenic influence was stuck in the chest. Preference for warmth and lack of sweating made me lean toward a cinnamon based remedy. This case is clearly one of mixed excess and deficiency. I chose Zhi Shi Xie Bai Gui Zhi Tang to restore the functional movement of Yang Qi, dissipate clumping and expel phlegm.

Once the acute pattern of obstruction was addressed, the residual, more deeply rooted pattern of blood stasis began to show itself. The cun pulses got deeper and more scattered. The engorged sublingual veins and the continuation of the Yang Wei pulse all pointed to the need for herbs that could enter the luo mai.

Formula Breakdown
Xuan Fu Hua, Bai Shao Yao and Gan Cao were chosen as chief ingredients in the formula. These herbs were selected to liberate the Qi dynamic from obstruction and allow the descent of the Lung Qi. Xuan Fu Hua has a salty flavor and some sources say that it assists the Kidney in grasping the Qi. It is also commonly thought of as the only flower that directs downward. Bai Shao and Gan Cao make up the formula Shao Yao Gan Cao Tang, which is used moderate the spasmatic deficiency-related tendency for cough.

Tao Ren and Dang Gui were used to open the blood vessels and move the blood. These two ingredients also have a slightly moistening affect on the Large Intestine. The Large Intestine is the yang pair of the Lungs. Keeping the Large Intestine clear is a useful strategy when promoting the descent of Lung Qi.

Di long and Si Gua Luo are an herb pair used by Dr. Greg Livingston to drive the formula into the luo mai. Di long was selected because of its affinity for the lung and bladder channels - opening up the bronchioles of the lungs and promoting the smooth movement of the water passageways. Si Gua Luo is the luffa vegetable sponge. It looks like the lung’s bronchioles and is one of the only non-bug medicinals that is able to access the luo mai.

Sang Bai Pi and Zi Wan are dynamic cough medicinals used in cases of both excess and deficiency. Sang Bai Pi is sweet and cold, while Zi Wan is acrid, bitter, and warm. Together they are able to able to treat a variety of cough-related consumption patterns.

Why No Qi Tonics?
Because of the robust nature of the pulse in the cun pulse positions, I decided not to include medicinals that directly tonify the Lung’s Qi in the first formula. I felt that the salty flavor of Xuan Fu Hua and Di long were enough to encourage the movement of the Kidney’s grasping ability. In future renditions of the formula, I included various aspects of the formulas Sheng Mai San and Shen Qi Wan in order to tonify deficiency.

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The Cultivation & Understanding of Traditional Medicine

Practicing a traditional medicine in modern times has many challenges. One of the biggest challenges comes when we try to communicate the difference of perspectives between the ancient and modern worlds. Perspective shapes the reasoning for action. It creates a context for why a particular medicinal would be prescribed or not. Understanding perspective is necessary before judging the method. And far too often today, we learn to judge before attaining this understanding.

Using insect-based medicinals has been one of the most valuable clinical insights for me. In the short span of my career as a Chinese medicine practitioner, I have been able to help numerous people with the knowledge that I have shared above. I am certainly no where near mastery of the art and science of Chinese medicine. Even so, I hope that the information presented in this article may be of use to practitioners who have the intelligence and skill to employ it.

The Power & Poise of Chinese Herbal Medicine

Travis Cunningham L.Ac.

    Where I live in Portland, Oregon, many people share an interest in natural medicine. There are two Chinese medicine schools in town, a Chiropractic school, a Massage school, the oldest Naturopathic school in the country, and a medical school which specializes in Integrative Medicine. With such an abundance of natural medicine to choose from, why would someone pick a medicine that does not draw its roots from local soil? Wouldn’t it be better to choose medicine that is grown, stored and processed here? Why should people give Chinese herbal medicine a shot?

    All of these questions are valid. And as a Chinese medicine practitioner, I have been asked them many times. The answer lies within the uniqueness of assessment, diagnosis, and treatment that Chinese herbal medicine can offer. This begins with the medicine’s focus on relationship.

Understanding the Relationship

The focus of a Chinese medical assessment is not based on the physics of what is happening in your body. This assessment is actually more concerned with understanding the relationship between your component parts (e.g. your organs, tissues, or bones). Our understanding is expressed using a kind of symbolic language. These symbols are taken from activities and movements that ancient people observed within nature and then observed that those natural processes had an apparent likeness to activities within the human body.

Knowing the History

The Chinese Medicine understanding of combining herbal remedies is backed up by thousands of years of writing and experimentation. The older writings that exist on the various topics of herbal medicine also have hundreds of years of commentary and discussion by physicians of past and present. In a very real sense,  Chinese herbal medicine has close to two thousand years of peer review. This fact alone may suffice to make it worthy of consideration for modern people.

Defining the Symbol

Natural experiences like heat, cold, dampness, dryness, and wind, are described as they appear in a person’s body presentation. Shaking, for example, with its sudden appearance and disappearance, tremor and vibration are caused by wind. The ancients observed the air suddenly moving and gusting, shaking the leaves of the trees and blowing debris along the ground, and they carried this experience to their understanding of human physiology.

Symbols such as Wood, Fire, Earth, Metal and Water, were also chosen to emphasize patterns of functional movement within the body. The Lungs and the Large Intestine both descend and consolidate, as is the movement of Metal in nature. The Lungs breathe in air (descent), and consolidate the essence of air into nourishment for the body. The Large Intestine descends the stool and consolidates moisture for optimal elimination. Every major organ is looked at by a similar likeness with a corresponding movement in nature.

The ancient Chinese found that when these movement patterns were happening harmoniously and in just the right amount, a person was happy and healthy. While, a disharmony or mismanagement of these movement patterns led to disease. When these nature-based symbols are used together in an evaluation, a Chinese medicine practitioner can form a type of diagnosis called a pattern. A pattern reflects the relationship of harmony and disharmony within a person’s body.

Finding the Pattern

All Chinese medical treatment, whether acupuncture, moxibustion, cupping, gua sha, or herbal medicine is done to address a person’s pattern. This is different than targeting the person’s disease (as is done in biomedicine). If we seek the destruction of an illness we require a force to eliminate it. If, however, we seek to restore a pattern of functional movement, all that we require is a guide. This guide can be less forceful, but it must be precise. The cultivation of precision is the skillset of the Chinese medical practitioner. This skillset is practiced through a careful differentiation of the pattern. 

Lets look at an example:
Two people catch a cold. Person A, has chills and fever, a slightly irritated sore throat, a headache on the sides of their head, and itchiness in the ears. Person B, has chills and fever, an intensely swollen and painful throat, and is sweating profusely.

Analysis:
Biomedically, these people may have the same virus attacking their systems. But in Chinese medicine, what is important is the pattern that such an illness presents within the individual. And in the example above, the pattern is different.

In person B, the intensely swollen, painful throat and profuse sweating indicate a heat pattern. In person A, the sore throat is less severe. The itchiness in the ears and location of the headache indicate that the illness has reached a different pathway (the Gallbladder or Shao Yang layer). The Chinese medical treatment will be different for each case, as it will tailor to the individual’s pattern.

As you can see, the pattern not only tells us about the disease, but also the relationship between the disease and the person’s constitution. This relationship is given a symbolic name with the terms discussed above (Example pattern: wind-heat invading the exterior). Treatment is given to principally address this relationship, and help assist the person restore their health (Example treatment principles: clear heat, vent wind, secure the exterior).

Choosing the Formula

To execute the above principles in the form of a treatment, a formula is chosen. A formula is a set of procedures that follow the direction of a treatment principle. In acupuncture, a formula is a list or set of acupuncture points, and the needling techniques of each point. In Chinese herbal medicine, a formula is a set of herbs given at a particular dosage and frequency of administration.

Chinese herbal medicine studies not only the effects of an individual herb, but pays particular attention to how that effect changes when herb A is combined with herb B. Herbs in combination can emphasize certain functional principles, or unlock new actions entirely.

The hot herb Fu Zi (Aconite) can be used to treat invasive cold patterns like neuropathy of the limb, by warming and dispersing the cold influence. But Fu Zi can only become a tonic for the heart, when it is combined with other sweet herbs like Gan Jiang (Dried Ginger) and Zhi Gan Cao (Prepared Licorice Root). In this case, Gan Jiang and Zhi Gan Cao also act to nullify the toxicity and harshness of Fu Zi, making the decoction or tea, safe to drink. While if you were to take Fu Zi by itself, the remedy might actually be dangerous.

Treating the Person

The strength of using Chinese medicine ultimately stems from the medicine's focus on treating the person. The perspective that Chinese medicine comes from is a view that believes in health as a natural phenomena. Health doesn't need to be forced, it can simply be encouraged. And with the right encouragement, a natural state of health and happiness can resume. Ease is, after all, easier than disease.