Today is Thanksgiving for us in the Unites States. This Thanksgiving, more than any other I can remember, I have been reflecting upon all of the things I have to be grateful for. In the past, I have posted, unrelated to Thanksgiving, my thoughts on positive thinking and health challenges. If one searches these posts on this site, he or she will find my thoughts on positive perspectives. In my darkest moments of sufferring, I turn my mind to all of the things I have not had to endure. In creating this alternate perspective for myself, it makes it easier for me to bare, it makes it easier for me to  feel that I am not alone in my struggle, and most importantly, it has given me the strength to fight the fight. I focus on the fact I have the use of my arms, my legs, my eyes, my ears. I focus on all of the ailments or life challenges, I have not had to endure. For many this thinking does not help, but for me, it is tremendous. I also turn my thoughts to what I can do with how life has effected me that is positive in the world. This has helped me bring meaning to my own life-the sharing of my experiences with those I am able to reach-friends, family, patients.

When I have been thinking of these things this past week, it has been a merging of my personal and professional life. For personal reasons, this year has been incredibly intense. The thing that I am most grateful for are the people-of course my family more than anything, but also-all of the people that I have learned from, been touched by, been privelaged to interact with. Whether it is animal or human- to be allowed to share the path of another soul is the ultimate gift. 

I have been so touched by so many wonderful beings this year. When one thinks about all of the difficult and painful things going on in the world, it is the soul to soul interaction that makes everything better. There are and have been so many wonderful and amazing people I have been able to interact with over the years of my practice. I learn from every one and am in awe of many. To have the effects of our work ripple accross the globe is the most powerful thing I can imagine. To have been able to share the many moments in the hearts of so many incredible human beings is a gift that is more important than any other.

Like everyone else, I have often questioned my own path, why we have been led to do this work, why I have had to endure the suffering I have in the past. But, when I look back at all that I have been through, I look at the lives I have been able to change and think of all of the lives that are also changed as a consequence of that one person’s life. When I think of that, I realize why I have been given those challenges. Each of us possesses the ability to touch all of the people around us in a profound way. We may not be able to create the impact on the world that we may have wanted to before these challenges, but, what we can do with what we are given may often be even more meaningful.

So, I want to say thank you to the universe and to each of you for all of these precious things, and to offer words of strength to those whom may need them, in their darkest moments, that there is purpose to what feels random, chaotic and purposeless. So take the hand of another human being next to you that you love, and one perhaps you don’t know very well, and try to experience the impact of your own being and the capacity of your own soul to create change in this world.

Happy Thanksgiving

Dr.M

I am writing to extend the offer I made to  (name removed) yesterday.

We have been supplying  (name removed) with the Natren Probiotics range for several months now, she told me that she was a patient with ICAMA and that others may be interested in purchasing Natren Probiotics. As we have recently established a direct distribution agreement with Natren USA we are able to provide a 15% discount, exclusive to ICAMA patients.

We can ship anywhere in the EU, but for the UK we offer a free chilled next day shipping service.

If any of your patients would like to take us up on the offer, they just need to apply coupon code: icama at checkout.

Here is a link to the range of Natren Probiotics we have in stock: http://www.lifestylevitamins.co.uk/natren

Please let me know if you need any further information.

Best regards,

Scott Thomas

The difference between science and various forms of holistic medicine-most particularly Chinese medicine is that having a different way through which to view illness and health often opens up different possibilities for treatment. I was speaking to someone recently who struglles with severe depression and anxiety and has had to turn to prescription medication on and off throughout her life. We have been working on this issue with her and the way in which we have been addressing it provides remarkable results. She asked me if I could explain. And I can, however, in this case, there is no way fro me to “translate” the effects into Western thinking. In some cases, there definitely are, and in others not-because it is not that we use natural substances to substitute for synthetic ones and call it natural medicine. On the contrary, we are working within a different paradigm and with a different methodology which allows the body to make changes it may not be able to do otherwise. This is the great thing. And as I always say, if a person needs brain surgery or a broken bone set, we are not the people to be coming to. But, this is the beauty of having different medicines for different purposes. In chronic illness, I believe that alternative medicine shines. Of course I am biased towards Chinese medicine, but there are many approaches.

The next example is an account from a patient who had issues with her thyroid in addition to her IC. When I asked her to write something, I think she thought I was asking for a testimonial, which is not at all what I was asking for. I included everything she wrote, but, what is interesting is the difference in the thyroid levels. What is important is that her levels were not changing with western meds for years from what I understand, and with this treatment they began to correct themselves. Why this is is interesting is not to boast we are so great-that is why I am saying it is not a testimonial. Why this is interesting is because my focus was not her thyroid-my focus was her body. I did not give her things to correct these specific levels-but they began to correct themselves. This happened through viewing the body through the paradigm of Chinese medicine and with the addition of the ICAMA overlay of that. Please take a look at this account, it is interesting.

Patient account:

I was diagnosed with IC when I was 29 in the year of 1999, and with Hashimoto’s Hypothyroid when I 

was 36, in 2006.  I was on Elmiron for 14 years; fortunately it was the only medication I took for my IC.  

For the Hashimoto’s I’ve been taking a compounded T3/T4, which I have been able to reduce 

significantly since beginning care with Dr. Brizman. February 2012, was my first appointment.  I never 

thought having Hashimoto’s, another autoimmune condition would be a blessing, but it is the way I have 

been able to gauge my healing with my IC and my body in general.  I monitor my thyroid levels about 

every 3 months since one of my goals with Dr. Brizman is to try to reduce my thyroid medication as 

much as possible (with her doctor’s knowledge and review).  Below I’ve listed two tests, Thyroglobulin Antibodies and Thyroid Peroxidase 

Antibodies, which have been tested almost every year.  The higher the values, the more antibodies my 

body is producing to fight off my thyroid.  The more antibodies, the more inflammation.  After 2 ½ years 

with Dr. Brizman, I couldn’t be happier with the decrease in my thyroid inflammation and IC symptoms, 

but I also know there is more work to be done.

Thyroglobulin AB Normal Values between 0 – 1.0 IU/mL

2010 209.0

2013 (6 mos after starting program) 57.9

2014 test not ordered

July 2015 1.0 (normal) 

Thyroid Peroxidase AB Normal Values between 0.8 -8.9 IU/mL

2010 513.0

January 2012 (1 month prior to Dr. B) 326.0 

2013 131.0 

2014 203.0

Feb  2015 271.0

July 2015 172.0

I hope these were interesting.

Dr.M

In January 2014 I had my first ever Bladder infection.  I went to my doctor 

and did a urine sample and walked away with an antibiotic.  The day I 

finished taking the prescription the symptoms returned so I thought probably 

the medicine had just not completely knocked it out.  So I called the doctor 

and he called me in another prescription.  It never came to anybody’s 

attention least of all mine to ask if I actually showed infection.  To this day I 

still don’t know.  Anyway, after the second prescription the same thing 

happened.  The day I stopped the medicine the symptoms returned.  I have 

long been a believer in Natural Medicine so I decided to go and see my local 

Chinese Medicine doctor.  She had me try some herbs but nothing helped.  I 

had long ago realized that I had an overactive amount of yeast in my body 

by chronic symptoms…headaches, itchy skin, numbness, inflammation of 

the vagina with redness and itching.  Anal redness and itching as well.  

There were times that I thought I was going to lose my mind.  I would have 

the sensational feeling like I was having an allergic reaction with no outward 

appearance…I would feel like my eyes were swelling..my skin would be 

burning…my tongue would feel numb, etc.  So I had been trying to watch 

my diet and was ingesting LARGE amounts of Coconut Oil to try to combat 

the yeast.

The bladder pain escalated daily…and became so intense I could barely 

stand up straight.  I went back to my Chinese Medicine doctor and she was 

perplexed.  One of the ladies in her office told me the symptoms were the 

same as a friend of hers.  She gave me her name, I called her and she led me 

to Bomamed. As I was trying to convince my husband that we needed to fly 

to California I decided to go ahead and start the diet.  I felt my symptoms 

subside within a few weeks for the bladder pain but found myself thrown 

into horrible anxiety and panic attacks as well hypoglycemia and many other 

“die-off” symptoms.  My husband quickly realized that I needed help. 

We met with Boaz and felt immediately that this treatment was going to be a 

God-send.  He started me on some of the herbs and I left feeling somewhat 

fearful but completely committed to the treatment.  This was in May, 2014.  

I was blessed that I started seeing rapid improvement.  It took about 4 

months to really get things balanced and I went through some unpleasant 

symptoms during this time.  The past year and almost ½ I have had some ups 

and downs but I would have to say the positive results have definitely out-

weighed the negative ones.  I spent a lot of time researching things on the 

forum and found the other patients to be very helpful with diet, recipes, 

encouragement, etc.  I realized very quickly how very fortunate I was to see 

these positive results so early in treatment.  Many women have suffered so 

many more years than I had.  It helped me to take on a fighting spirit that if 

they could hang in there so could I.  This was especially helpful when at one 

point in treatment we tried me on some SF722.  The anxiety came crashing 

down on me so very hard.  This was the only time that I thought I wasn’t 

going to make it.  The ladies on the forum kept encouraging me and lifting 

me up.  I emailed Boaz and told him I just wasn’t going to get through this 

stage of treatment.  He spent a long time on the phone with me at my next 

appointment and we decided that I just wasn’t quite ready to push through.  I 

went to counseling and worked really hard on dealing with some past pains.  

I memorized Bible verses, spent time reading motivational books, ran 

around the house singing songs at the top of my lungs..anything to help me 

get through this stage.  I must say this was probably the most difficult time 

for me.  As I reflect back though I can be thankful.  I learned a lot about 

myself. 

I have moved up the lists to List 4 and as anyone in treatment can tell you 

that is a VERY big deal.  I never sway from the approved foods and always 

no sugar but still battle the yeast.  I do struggle with portions…still want to 

over-indulge the carbs instead of keeping them at a balance.  When you feel 

good sometimes it is difficult to use good judgement.  I felt some of the old 

symptoms returning.  Boaz and I talked and he made me realize what a huge 

injustice I would be doing to myself and my body if I continued on that path 

again.  I know that for me this will more than likely be something that I will 

always have to pay close attention to.  I am very grateful for all that I have 

learned through this journey.  When I read about someone my age being 

diagnosed with heart disease or diabetes or anything related to inflammation 

I think if not for my IC that led me to this road to balance and better health 

that might very well have been me.  In the last year and ½ I have not once 

regretted my decision to make that trip to LA.  Just knowing what is going 

on in your body and having some answers to why for me that was half the 

battle.  Having a plan of action was also important to me.  It gave me what 

we all long for and that is HOPE!!

Thank you for allowing me to share with you.  And to all those that are on 

this journey I wish you many days of peace, joy and good health.  I pray 

God’s blessings for you all and for Boaz and Matia as they continue to 

devote such dedication to caring, researching and treating those of us who 

without them would know no hope.

(Patient signed her name_ I wasnt sure-so I deleted it)

This came across my computer today, I thought I would share because it is quite fascinating. Another indication that staying in a good space in your mind, heart, and soul, no matter what you do-CAN make a difference: http://www.feelguide.com/2014/11/19/harvard-unveils-mri-study-proving-meditation-literally-rebuilds-the-brains-gray-matter-in-8-weeks/ 

Dr.M

My name is Scott and in 2006 (when I was 41) I was suffering from symptoms typical of 

a bad urinary tract infection off and on for over 6 months.  My symptoms included pelvic 

pressure (even after I urinate) urinary frequency and urgency, burning during and/or 

after urination.  I was also beginning to feel classic symptoms of IBS (Irritable Bowel 

Syndrome), rectal itching, urgent bowel movements etc.  These symptoms seemed to 

“attack me” or “flare up” every week or two, and last anywhere from 3 to 10 days.  It 

affected everything in my life… I didn’t want to leave the house… in short, I was 

miserable.

My long time world renowned urologist (Saint Johns/ Santa Monica) was stumped, and 

could not treat my symptoms with antibiotics because there was no infection.  I scoured 

the internet and realized I probably had IC (Interstitial cystitis).  So I purchased books, 

ebooks, self medicated with homeopathic cures suggested in chat groups etc. etc.  One 

night I had weird heart palpitations (I now attribute to the cocktail of pills I was taking) 

and had to call the paramedics… it was crazy.  Eventually I returned to my urologist and 

I begged him to “Think outside the box”… it was then he suggested I go see Matia 

Brizman,  explaining some of his patients have had a lot of success with her.  I was 

hopeful, but realistically skeptical this would have any kind of positive outcome.

After a lot of questions and a brief examination, Matia told me with confidence she could 

get this under control… but it would not be overnight.  I’ll never forget this conversation, 

because it was the first ray of hope in a long time.  My IBS cleared up immediately, and 

my other symptoms improved over time.  When I did have a flare up they would happen 

less often and be less intense.  It wasn’t easy, but it gave me back my life.  One day I 

realized “Hey.. I haven’t had a flare up in over a year”… That’s how it kind of works.  The 

symptoms make a slow exit and you think less and less about it as the months go by.

I still have a condition, and it does make a guest appearance on occasion… but I usually 

know why (drinking or dietary things Matia identified, AND not taking my supplements).  

It’s nothing like it used to be, but it does get me right back on track!  In short, I honestly 

don’t know what I would of done, or what my condition would be right now without Dr. 

Matia Brizman’s amazing gift for navigating this chronic, elusive condition.  I will be 

forever grateful.

Integrative Approach and Classical Chinese Medicine: Divergent Meridian Theory

The Divergent Meridian system is a system within Chinese medicine that may be correlated with the immune system and the lymphatic system in Western medicine. It is a physiological system that protects the body from pathogenic influences. The Divergent Meridian system is so called because when external influences attack the body, such as viruses, bacteria, insect bites, or other external pathogens, its natural progression is to invade the body inwards through the circulatory system and lymphatic system. As it invades, if the immune function of the body is inadequate to contend with this invader, the body will fail in eradicating it allowing it to progress towards the organs. In an effort to prevent this invasion, the body, through its Divergent system will attempt to divert the pathogen away from the organs and deposit it in the only holding place available to it, the joints or major areas of boney cavities such as the skull, which includes the brain and sinus cavities, thoracic cavity, and pelvic cavity. All three of these areas, especially the latter are involved with the clinical depiction of IC.

If the pathogenic factor is maintained in a Latent state in these areas and is not expelled, it will cause some kind of chronic condition, that may involve the joints, but may involve these other boney cavities, exhibiting such symptoms including chronic sinusitis, abnormal conditions within the pelvic cavity such as those we see in those having IC, chronic gastrointestinal disorders, chronic conditions of the skin, allergies, chronic neck pain, and many others. Other common Chronic Divergent pathologies may also include conditions such as high cholesterol, and acid reflux, which are also very common among those having IC. These may be construed as warning signs that the body has stored too much Latent pathology and may soon be unable to contain it further. It is important to recognize this state of health in the treatment of illness as an indication of the way in which these accumulations must be released. Such conditions may be looked upon as a lesser disease preventing a more serious one. The basic clinical picture of Divergent pathology is autoimmune disorders (Yuen, Divergent Meridians).

Another common and interesting indication of Divergent pathology is that the person may no longer perspire normally. This is because both immune function and body fluid have become compromised in the process of the body providing Latency to the unresolved pathogen. Wei Qi immune function, body fluids and body tissues become depleted and dry in these cases exhibiting dehydration. Furthermore, because Wei Qi, immune function, is dependent upon Kidney Yang, it draws from Kidney Yang in an attempt to assist itself in functioning. Over time, Kidney Yang may become depleted from Wei Qi over taxing Kidney Yang. Thus, in treating immune hypo-function, it often becomes imperative to support Kidney Yang, (Yuen, Divergent Meridians). Tissues that may most especially be affected by this kind of dehydration are gastrointestinal or urogenital tissue. These kinds of patients with IC typically indicate an absence of normal perspiration for years prior to the onset of symptoms. This divergent condition is highly correlated amongst those with IC providing great insight into the progression of disease leading to the manifestation of IC. Understanding these kinds of signs better enables the practitioner to effectively eradicate the condition. Employing methods to restore body fluid and immune function to the patient while clearing the body of Latent pathologies may be one critical aspect of treatment in certain types of IC.

The Divergent Meridian system is a meridian system that diverges off what is referred to as the Primary Meridians. Some practitioners believe that they are a separate system of their own while others see them as one in the same as the Primary meridians. Regardless of this disagreement within Chinese medicine, in Western terms, it could easily be translated as the lymphatic system. It is a conduit of Wei Qi and Yuan Qi (Yuen, Divergent Meridians). Along with the Primary Meridians, it is the only channel, (Mai), that connects directly to the Zang Fu (the organs of the body), with exceptions being the Pericardium and the Heart Luo meridians (Yuen, Divergent Meridians).

As the Primary meridians are concerned with the Zang-Fu (the internal organs of the body), the Divergent Meridians are concerned with the Curious organs. The Curious organs include the Brain, Uterus, Gallbladder (also a Zang-Fu organ), Blood Vessels, Bones and Marrow (the skeletal aspect that relates to Yuan Qi). If we correlate Western diagnosis with the Curious organs, examples would be as follows: Brain: Alzheimer’s, stroke, poor memory, and spinal problems such as herniated disc issues). Uterus: menopause or andropause. Gallbladder: high cholesterol. Blood Vessels: high cholesterol and bone and marrow problems. Cancer may be understood under the paradigm of Divergent Meridian theory as we see cancer frequently in geriatric medicine when there is a decline of Jing. The Divergent meridians often are involved our body’s natural attempts to hold a pathogen away from organ structures.

The Divergent Meridians’ basic function is to protect the body and especially the organs essential for survival from disease by diverting it away from the organs. As it does so, we will see such phenomena as chronic skin conditions, recurrent muscular conditions, chronic conditions of the orifices such as sinusitis, teeth problems, conjunctivitis, chronic skeletal conditions, and chronic diseases that in Western terms we refer to as autoimmune pathologies, including scleroderma, Schilder’s Disease, rheumatoid arthritis, multiple sclerosis, chronic gastritis, chronic gas, alterations in peristalsis, esophageal reflux (Yuen, 2002). Many of these chronic conditions are seen in the clinical pictures of IC because IC is a condition that encompasses the accumulation of much Latent pathology and the body’s inability to contain it further.

With IC, patients often present with muscular and nerve pathologies in various patterns of leg pain. Some resemble sciatica, usually occurring along the path of the Urinary Bladder meridian. Some of these neuropathies occur along the Kidney channel. In many cases, this could be construed as the Divergent Meridians attempting to divert the excess pathology from the Urinary Bladder to an area distal from the organ, along the path of the corresponding meridian or its organ pair, the Kidney. “In these cases, it is more critical to treat the organ pathology than the pain associated with it. This meridian pain will come and go during treatment for the organ pathology (Yuen, 2003). This is a common pattern with IC.

The divergent meridian of the Urinary Bladder communicates with the anus as well as the Urinary Bladder; thus, one may correlate pathologies involving these organs with Divergent Meridian issues.

A chronic Divergent Meridian condition of the Lungs and the Spleen (digestive system) may present as chronic mucous discharge in the stool and/or flatulence, as with Crohn’s Disease or irritable bowel syndrome (IBS). These are often patterns that exist in the chronic clinical picture of IC as well. As we discussed, IC generally has a pattern commencing with a breakdown of the digestive system.

Numerous signs and symptoms of Divergent meridian holding patterns can be correlated with the lymphatic system. It is quite common to see lymphatic swelling in the areas of the axillary, pubic area, sacral area, and rib cage. What are referred to as the confluent points of the Divergent Meridians may be found along these areas of heavily aggregated lymphatic pathways. Although these may be benign, they may later become malignant if not treated appropriately. A good example here is Burkitt’s lymphoma secondary to mononucleosis. From the perspective of CCM (Yuen, 2003), this progression occurs when the viral load that was not adequately cleared from the body with the earlier manifestation of mononucleosis, is held in the lymphatic system (e.g., Divergent Meridians) until the body can no longer maintain Latency, at which point the toxicity is re-activated in the form of a lymphatic carcinoma.

Latency is attempted through the use of extracting Jing associated with the Kidney and Urinary Bladder. If the stores of Jing are inadequate, the body will attempt to maintain Latency by tapping into Blood associated with Gallbladder and Liver Divergent Meridians; and if that fails, the thin fluids associated with the Stomach and Spleen Divergent Meridians; and if that fails, the thick fluids (hormones) associated with the Heart and the Small Intestine Divergent Meridians; and if that fails, the Yuan Qi associated with San Jiao and Pericardium Divergent Meridians; and if that fails, finally the Yang associated with the Large Intestine and the Lung Divergent Meridians.

It is very common to see many of the examples we have depicted within this discussion on the Divergent Meridians theory within the clinical picture of IC. The body is continually attacking a pathogen it sees as foreign which has settled internally and the body is never able to expel it such as the situation that occurs with gastroenterological changes leading to microbial translocation, a chronic disease process is in motion. If this condition is treated with medications that suppress immune reaction the suppression will only further complicate the underlying pathology.

Healing crisis is common when a successful process of the removal of the pathogenic factor is underway. The patient may experience fever, sweat, flushing, and various other symptoms during this process. In the Treatment of IC, this is a common occurrence, often misleading the patient to the conclusion that his or her condition is deteriorating. It is important to follow this process through in order to expel pathogenic factors from the body completely.

Divergent Meridian theory is important because it assists us in understanding Latency and the clinical patterns involved within it. Incorporating this theory within the diagnosis and treatment protocols of IC gives a greater foundation in interpreting the course pathology has taken and treating the disease more effectively.

I have posted a lot over the years on the power of one’s own mind and belief. I think it was last year I posted about a book called Biology Of Belief, which, I really feel in love with speaking about the concepts of defying your own genetic make up and tendencies based on what it is YOU beleive. http://www.amazon.com/The-Biology-Belief-Unleashing-Consciousness/dp/1401923127

This Ted Talk vidoe is pretty cool too. Someone sent it to me a few days ago and I had a chance this morning to watch it. It’s simple stuff-but so true and along the lines of Bruce Lipton’s book above which I am a huge fan of.

What we take into our minds and our souls-this really haas such a profound impact on how our physiology reacts. Some may take offense to this feeling as if I am suggesting if they are not doing well it is their fault. I am NOT suggesting this at all! However, I do believe that 1 + 1 + 1, etc….. So things add up and each element helps and adds up.

Here is the video link: http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend?language=en

I know that I post post post and then I disappear for a bit before another go. What happens is that I post on things that inspire me and sometimes finding that insipiration is difficult. What we do here is so very stressful. I have been thinking about all the various things I could say in the last week and it all seemed redundant and oversaid. This morning, I received an email from someone, and this was after many other conversations on the phone this week that were similar and I suddenly that inspired me.

The email this am and the conversations that I had this morning were about love and appreciation for this medicine, for this work. And, I realized, this is the thing that keeps us driven in the midst of the insanity of IC, of “chronic” illness. It is the knowledge that this kind of medicine has the power to change someone’s life. This is also true for Western medicine of course. As I continue to say, I would not be alive if not for Western medicine surgically correcting my kidney. If not for that, I would have been dead a very long time ago and never would have been able to go on to live until now and do all of the things I have done. But, where alternative medicine shines, especially this one, is that it can create “miraculous” change via the art of balancing energy systems-rather than using supplements to effect change in a Western paradigm. Recently a pretty interesting situation came to mind with a particular patient that illustrates this, I have asked her to write a paragraph or two about it. I think it would be really helpful. That should be coming soon. But, in any case, the point is–this medicine is not for everyone. OF course, nothing is for everyone. The kinds of people who walk through our doors are not the kinds of people who come here as a first course of action-almost never. The kind of people who walk through our doors have seen many, many doctors and have not been able to get well. These are the kinds of people who need someone to think outside the box.

And that is the thing that really drives me-thinking outside the box-endeavoring to manipulate the body’s energy in a way that enables it to correct itself. Someone said to me earlier this week how so many doctors looked at her and said, “well, I don’t know, I just can’t help you, I am sorry.” She said that over the years that she heard that over and over again and that I was the only one that stuck through the fight with her and how much she appreciated that.

Once upon a time, when I was unwell myself, I too heard that over and over-, “there is nothing wrong with you, your bloodwork is perfect”, or “Dear, I think you need antidepressents”, or, “if you just get a boyfriend, your life will be so much better”. REALLY? I used to think to myself, “are these people insane? No one could “see” the situation. If it wasn’t on the bloodworks or other exams, it didn’t exist. Using a medicine like Chinese medicine, offers a paradigm through which to view the body in an alternative way in order to treat effectively.

Both Boaz and are deeply passionate about our work-giving hours of our personal time to those who need us by being avaialble constantly via email. There is nothing more wonderful than working hard through what seems impossible and getting to the other side where someone gets their lives back. We have gained so many wonderful relationships with people we have treated over the years that have been lasting all around the world.

We are both very grateful to be doing this work and our hope as it continues, is to make it better with every month we practice and eventually spread it to others to help in the fight of IC and other “chronic” inflammatory disorders. When I received an email this am from two of my patients thanking me for being there for them and telling me how they feel about me-it just touched me-just as it always does. It is this, especially, that makes this process so special and gives us the strength to keep the fight.

IC is a terrible condition-through education and treatment, we hope to make a major impact on the world in reducing it’s incidence and existence. Dr.M

Integrative Approach and Classical Chinese Medicine:

Earth School; Compensation

“Nature abhors a vacuum” (Spinoza, 1632-1677)

Master Li Dong-Yuan founder of the School of Supplementing Earth in the Jin Yuen Period in China (220 B.C. to 220 A.D.) developed a school of thought, diagnosis, and treatment referred to now as the “Earth School”. It has been passed down by Yuen (2002) and described and correlated to this text by this author. The Earth School emphasizes the importance of digestive health over almost all other bodily systems and cites digestive weaknesses and disorders as being central to all pathology anywhere in the body. For example, from Li Dong-Yuan’s perspective, the breakdown of digestive processes likely would underlie urinary and bowel disturbances, malaise, psychological issues, cardiac disorders, and neurological dysfunctions, to name a few. Central to his thinking is the concept of what is known as Compensation. This concept is critical to the Integrative Approach as it substantiates much of the philosophies upon which this system is based. The Integrative Approach was developed without the benefit of Li Dong Yuen’s teachings; however, it now may have more credibility because of the correlations between its concepts and the theory of Compensation that has been accepted for over 2000 years in the East.

In Compensation, typically, there is a combination of opposite issues overlaying each other, which require simultaneous treatment so as not to aggravate either opposing factor. If they are not addressed equally, remedying one problem will exacerbate the other. For example: if the body is deficient in Yin, its natural response is to pull from its resources to replenish that Yin substance. It would do that by pulling from its Jing. If there is little Jing from which to pull for this purpose, the body will attempt to replicate that process in any way it can, even if it is pathological. For example, the body often tries to Compensate for a loss of Jing or Yin, with the creation of mucous or phlegm, which is sometimes called “Evil Yin” in Chinese medicine. It is this author’s theory that Compensation and is the process of what this author previously described as the translocation of antigens from the gastrointestinal system, and Latency is where those antigens are stored such as muscles, joints, blood, and organs, in the case of IC the urinary bladder. In many patients having chronic conditions, cholesterol is elevated and once they have undergone treatment for the chronic condition, not the cholesterol, the cholesterol almost always will go down. This would be another example of this dynamic.

Li Dong-Yuan used herbs such as Angelica Sinensis (Dang Gui) and Cooked Rehmanniae (Shu Di Huang). Ironically, although the Integrative Approach was formulated without prior knowledge of these concepts, these tonifying herbs are frequently used as the backbone of treatment in the Integrative Approach to IC.

This is how this syndrome manifests itself in so many ways due to “Compensation”. Remember, this process will occur in various degrees and in various scenarios depending on so many other factors. These factors include such things as determining 1) which organs have been affected 2) the combination and predominance of deficiencies underlying the current state of pathology, i.e., Yin, Yang, Blood, Jing, and 3) the location and extent of Compensation and Latency, i.e., joint or muscle pain, allergies, chronic sinus congestion, obesity, high cholesterol, intestinal bloating, fibroids, etc…

Integrative Approach and Chinese Classical Medicine: Yin Fire: A Disease Created by Compensation and Related to Interstitial Cystitis

Li Dong-Yuan created the theory of Yin Fire. This theory, like Compensation, correlates with the Integrative Approach. Yin Fire is a theory within the context of classical Chinese medicine that is fueled by the physiological response of “Compensation”. This theory has been passed on by Yuen (2002) and correlated to the material in this text by this author.

Its starting point, however, is clearly based on emotional factors or External Pathogenic Factors (EPF). However, within the context of its applicability to IC, we will focus on the emotional component as the starting point. Within this context, the idea is that when we have unexpressed desires or feelings that we suppress, those feelings stay in our body and generate internal Heat. That Heat will begin to ulcerate the tissues in the organ in which it is being created. The body, in an effort to protect itself, will produce fluids to protect the quickly ulcerating tissues. These fluids will come in the form of mucous or phlegm will then mix with the excessively heated tissues, and one will exacerbate the other as described within the context of Compensation. Numerous studies have been conducted by well known researchers like (Baugmart, 2002; Bailey, 2006; Lin, 2004) that connect the impact of stress and gastrointestinal barrier function. This may be one precursor to MOF. Again, MOF is an extreme example of microbial translocation. It is this author’s opinion that where microbial translocation is concerned IC is what lies between health and MOF.

IC is quite frequently treated with antidepressants (ICA-Treatments, 1998, 2003) as it is frequently correlated with emotional components. Assisting the patient in addressing these emotional components, by incorporating them into their appropriately placed portion of the disease, is helpful in completing the treatment process. For example, if the disease pattern commenced acutely after great emotional trauma, then dissecting these emotions through therapy while simultaneously addressing the physiological component are critical. If the symptoms came on insidiously, during which time the patient was undergoing long-term stress in his or her life, those stressors are also important to address during treatment. Emotional factors can contribute in shifting our physiology into an unhealthy pattern and correcting this imbalance is important.

Dr.M

Interstingly a spoke to a long time patient yesterday and we had not spoken for a bit. In the time between our talks she had had a really bad case of pneumonia that she decided to treat with antibiotics. They gave her steroids as well. She happened to have an accident about a month after this and went to the ER. They took her bloods and did scans etc… to make sure she was OK. Low and behold her liver enzymes were through the roof. Then they did a liver scan and her liver had lesions that were unfamiliar and worrisome. She had to go to a liver specialist. The liver specialist did his work and asked lots of questions only to find out that she had been taking supplements for her health all of these years. She was then told that it was our supplements that caused this problem. As she was telling me this story, she was reitterating to me that she did not agree with this thinking-that I was one of the only doctors that she trusted and that I saved her life. She said that if not for this treatment she would have had no life all of these years. But, of course, she was questioning in the back of her mind if this could possibly be true. So, I listened and paused and listened more. I asked her when the last time was that her bloods were checked before this time where they were so abnormal. She said not in ages because she does not use Western medicine. Then I thought, well, but they had to have checked when you went in for the pneumonia. See if you can find those results.

She emailed ma an hour later after calling the hospital to get the results of those bloods. They were NORMAL. So, this completely reversed any possibility of supplements she had been given as the cause of her elevation in liver enzymes as she was completely normal prior to her two rounds of strong antibiotics and steroids. It is so interesting how quickly Western medicine is to point to alternative forms of medicine being problematic and minimizing the efficasy of what we do. Thank god that test was taken. I posted this not to suggest Western medicine is bad, I dont think that. Just that there is aplace for all medicines. And, there is also a place for respect in both of those worlds as well, is there?

Dr.M

Precipitating Factors

Precipitating factors include factors that begin to alter mucosal integrity throughout the body, referred to as hyperpermeability. This occurs primarily in the GALT (Gut-Associated Lymphatic Tissue), but may often occur in other body tissues such as urogenital tissue through MALT (Mucosa-Associated Lymphatic Tissue). Other tissues that often become involved are sinus, ears, eyes, lungs, and throat. Precipitating factors also may cause microbiological imbalancing such as the increase of indigenous flora including Enteroccocus, E. coli, and Candida Albicans. If these factors create changes in mucosal integrity of the intestines, it is referred to as hyperpermeability, and if it causes microbial changes in the intestines, it is referred to as SIBO (Small Intestinal Bacterial Overgrowth). Either condition may lead to the other. Furthermore, these conditions then in turn lead to LGS (Leaky Gut Syndrome), Bacterial Translocation (BT) or Microbial Translocation (MT). The dynamics of these syndromes are very similar and involve the abnormal transference of antigens into systemic circulation from the imbalance in the small intestine. In the case of BT or MT the transference is thought to be occurring through the normal physiological pathway of transcytosis entering from the M cells on Peyer’s Patches that are groupings of lymphatic tissues that line the small intestine, (Berg et. al, 1993) This is the pathway through which the mucosal system (MALT) communicates. And, LGS is said to leak antigens through paracellular migration, (Rona, 2006; Galland, 2006).

Many may agree that once the system becomes imbalanced all of these factors are generally involved but in different proportions. Other tissues then are often consequently affected from the imbalance in the small intestine such as, the mesenteric lymph nodes, urogenital tissue, reproductive tissues, eyes, ears, nose and throat, lungs and organs such as the spleen, liver, and kidneys (that ultimately affect the urinary bladder). The connections between the small intestine imbalance and the system tissues occur through the MALT.

In IC, the urogenital tissue may be primarily affected and not be stemming from a primary imbalance in the small intestine in some cases. However, it is more common for the small intestine to be the primary source of the imbalance.

These changes occur over time due to numerous and various factors. This author is of the opinion that these factors are numerous because primarily these factors have arisen due to the negative aspects of modern advances in health, medicine, and diet and are pervasive elements of our society.

Precipitating Factors are:

1. Poor diet that includes the over-consumption of sugar or sugar substitutes, and/or alcohol (and other substance abuse); or dietary practices such as anorexia, bulimia, vegetarianism.

2. Over-use of or inappropriate use of supplements such as laxatives, weight loss products, and others.

3. Overuse or inappropriate use of antibiotics, antifungals, steroids, NSAIDS, hormone prescriptions, and many other medications such as anti-depressants and anti-anxiety medications.

4. Chronic stress that may go as far as childhood and involve issues of bonding.

5. Certain repetitive exposures to chemicals such as those found in hair dyes, tooth whitening products, and, chlorine through water supply.

Changes to urogenital environment:

1. Transmission of sexual fluids containing certain pathogenic organisms.

2. Hormonal changes such as menopause creating mucosal and microbiological imbalances.

3. Changes in gastrointestinal balance affecting urogenital tissue through MALT.

There are numerous researchers focusing on the various kinds of imbalances referred to above occurring relative to chronic illness. In an effort to clarify these theories, while drawing conclusions regarding IC and other chronic disease from them, this author cites from the following researchers at the forefront of their fields, the first compilation of which is general followed by more specifically organized statements below it:

“Each organism lives in a continuous interaction with its environment: this interaction is of vital importance but at the same time it could be life-threatening. The largest and most important interface between the organism and its environment is represented by surfaces covered by epithelial cells. Of these surfaces mucosae represent in humans about 300 m² while skin covers approximately 2 m² surface of the human body. Starting from first hours after the delivery from the sterile uterine environment (mammalian foetuses are born germ-free) the interaction of the macro-organism with micro-organisms begins: the main portal of entry of microbes is skin and mucosal surfaces of the gastrointestinal, respiratory and urogenital tracts. Physiologically occurring interaction with bacteria leads to colonization of epithelial surfaces and this co-existence is usually harmonious, and beneficial for the host (commensalisms). A complex, open ecosystem, formed by resident bacteria and transiently present microbes interacting with macro-organism is founded. However, under some conditions the interaction with “endogenous” microbes can be harmful for the host (parasitism) and opportunistic infections can occur. The microflora interacts with its host both locally and systemically. (Tlaskalová-Hogenová, p. 97, 2006).

“While the skin surface is protected mechanically by several epithelial layers, surfaces of the gastrointestinal, respiratory and urogenital tracts, conjunctivae and outlets of endocrine glands are mostly covered with a single-layered epithelium and require, therefore, a more extensive protection: this is represented by a complex of mechanical and chemical agents responsible for effective degradation and removal of heterogeneous substances. In addition, both mucosa and internal environment of the organism are protected by a most effective innate and highly specific immune systems. Basic functions of the mucosal immune system are protection against pathogenic micro-organisms and prevention of penetration of immunogenic components from mucosal surfaces into the internal environment of the organism (barrier and anti-infectious functions). Another important function is induction of unresponsiveness of the systemic immunity to antigens present on mucosal surfaces (“oral, mucosal tolerance”) and maintenance of the homeostasis on mucosal surfaces (immunoregulatory function). Among the basic features of mucosal immunity differentiating it from systemic immunity, are strongly developed mechanisms of innate immunity and existence of characteristic populations of lymphocytes that differ from, e.g. blood lymphocytes in origin, phenotype and secreted products. Other features characteristic of mucosal immunity are: colonisation of mucosal surfaces and exocrine glands by cells originating from lymphatic follicles of intestine or bronchi (migration and homing of mucosal lymphocytes establishing the so-called “common mucosal system”) and the well-known epithelial transport of polymeric immunoglobulins produced by mucosal plasma cells through the epithelium (secretory immunoglobulins, mainly IgA isotype). A balance in intestinal mucosa may be disturbed by pathogenic micro-organisms and their toxins, or by inadequately functioning components of the mucosal immune system. On the other hand, an expression of pathologically increased immunological activity may induce various inflammatory processes. Thus, numerous chronic diseases may occur as a result of disturbances of mucosal barrier function or of changes in mechanisms regulating mucosal immunity. This may involve infectious diseases, inflammatory diseases (allergies), multiorgan failure but also autoimmune diseases developing either in their initial phase or throughout on mucosal surfaces” (Tlaskalová-Hogenová, p. 98, 2006). “The main mechanical barrier of mucosal surfaces is formed by a layer of epithelial cells covered with glycocalyx composed of complex glycoproteins. The epithelium of most mucosal surfaces consists of a layer of interconnected, polarised epithelial cells separated by a basal membrane from the connective and supporting tissue surrounding various types of cells present in the lamina propria. Intestinal epithelial layer is reinforced by tight junctions present in paracellular spaces of epithelial cells and forming an interconnected network. Tight junctions were found to act as a dynamic and strictly regulated port of entry that opens and closes in response to various signals (e.g. cytokines) originating in the lumen, lamina propria and epithelium. Tight junctions participate in preserving cellular polarity and are regarded as key elements in intestinal diffusion mechanisms.” (Tlaskalová-Hogenová, p. 99, 2006).

“It has been recently found that intestinal epithelial cells as an important part of the innate immune system are directly involved in various immune processes, in addition to their absorptive, digestive and secretory functions. (Tlaskalová-Hogenová, p. 99, 2006).

1. SIBO: (Lin, 2004) “Bacterial translocation, a known complication of SIBO, is the

movement of gut bacteria from the lumen across the mucosal barrier. In rats, experimentally induced SIBO leads to the appearance of gut bacteria in the mesenteric lymph nodes and visceral organs. A potentially important consequence of bacterial translocation is immune activation. In a report of 11 patients, an increase in the number of intraepithelial lymphocytes was observed as mucosal evidence of this immune response to confirmed bacterial translocation. This adverse outcome could explain why the normal gut has defensive mechanisms in place to keep the bacterial flora away from the small intestine, particularly the bowel proximal to the ileum. It is well recognized that there is a high degree of overlap between IBS, fibromyalgia, interstitial cystitis, and chronic fatigue syndrome. While interstitial cystitis and IBS are diagnoses associated with hypersensitivity at the level of the bladder and gut, respectively, fibromyalgia may be considered a kind of hypersensitivity at the musculoskeletal level. Although the cause of the hypersensitivity in these disorders is not well understood, the striking overlap of hypersensitivity in these functional disorders suggests the possibility of a unifying explanation.

Lin (2004) has been correlating IBS, previously a symptom based diagnosis with a bacterial overgrowth in the small intestine. If we take this research which supports the argument for gastrointestinal disruption due to bacterial imbalance and combine it with the above information regarding the leaking of bacteria into the circulatory and lymphatic systems, it is very easy to see how bacteria may invade the body systemically and translocate into other organ systems, including the bladder. IBS commonly presents with a host of other problems, such as chronic fatigue syndrome, fibromyalgia visceral hypersensitivity, autonomic dysfunction, immune activation, and others, which, in the past have been regarded as separate issues. This practice is making increasingly less sense, challenging researchers to find the common thread that binds these conditions and may be the reason that such separation may be becoming “an artifact of medical specialization”. Small Intestine bacterial overgrowth (SIBO) may be that common finding. These researchers have verified that translocation of bacteria from the small intestine is possible and may travel to mesenteric lymph nodes as well as visceral organs as well as the presence of intraepithelial lymphocytes, substantiating the idea that the small intestine may become hyperpermeable, a controversial condition referred to as “leaky gut syndrome”. Lastly, sleep disturbance, flu-like symptoms of fatigue, anxiety, depression, and impaired cognition were among the immune responses linked with this abnormal condition of the small intestine disrupting the immune and autonomic nervous systems, (Lin, 2004).

(Rodriguez, 2005) has found in his practice that a disruption in gastrointestinal flora is the starting point for most chronic illnesses. He finds that this disruption weakens immunity and triggers the otherwise normally occurring trillions of non pathogenic bacteria and fungi into pathogenesis mode that create numerous chronic illness such as IBS, CFS, chronic anemia, skin disorders, and many others including chronic cystitis.

2. LGS: This is understood as a condition that provides passage between enlarged spaces, (also known as paracellular translocation) in the lining of the small intestine of “bacteria, fungi, parasites and their toxins, undigested protein, fat and waste normally not absorbed into the bloodstream in the healthy state” “Due to the enlarged spaces between the cells of the gut wall, larger than usual protein molecules are absorbed before they have a chance to be completely broken down as occurs when the intestinal lining is intact. The immune system starts making antibodies against these larger molecules because it recognizes them as foreign, invading substances. The immune system starts treating them as if they had to be destroyed. Antibodies are made against these proteins derived from previously harmless foods. (Rona, 2006). “Leaky Gut Syndromes are usually provoked by exposure to substances which damage the integrity of the intestinal mucosa, disrupting the desmosomes which bind epithelial cells and increasing passive, para-cellular absorption, (Galland, 2006).

3. Hyperpermeability: Numerous researchers are exploring issues of gastrointestinal hyper-permeability. This hypothesis is based upon the small intestine housing “the gut-associated lymphatic tissue (GALT), the largest lymphatic organ of the body” (Tlaskalová-Hogenová et al., 2004) and its central role in chronic disease. Due to the fundamental role of the small intestine in health, it’s imbalance becomes pivotal to the disease process affecting the body systemically including immune, nervous, endocrine and exocrine systems. Referring to imbalances of the small intestine, (Tlaskalová-Hogenová et. Al, 2004), states that, “A balance in intestinal mucosa may be disturbed by pathogenic micro-organisms and their toxins, or by inadequately functioning components of the mucosal immune system. On the other hand, an expression of pathologically increased immunological activity may induce various inflammatory processes. Thus, numerous chronic diseases may occur as a result of disturbances of mucosal barrier function or of changes in mechanisms regulating mucosal immunity. This may involve infectious diseases, inflammatory diseases (allergies), multiorgan failure but also autoimmune diseases developing either in their initial phase or throughout on mucosal surfaces.” “The intestinal epithelium represents the primary site for active transport of fluid and electrolytes from the gut lumen through the transcellular pathway; however the predominant route for passive transpithelial solute flow is the paracellular pathway. Gut mucosa serves as the main barrier to the passage of macromolecules, that is, foreign antigens entering the host via the oral route, components of commensal flora such as toxins. The majority of luminal proteins cross the intestinal barrier through the transcellular pathway, followed by lysosomal degradation. Lysosomal degradation changes proteins into nonimmunogenic peptides. Small but immunologically significant amounts of antigens cross the barrier intact form through the paracellular pathway. The paracellular pathway involves a subtle regulation of intercellular tight junctions that leads to antigen (mucosal) tolerance. When the integrity of the tight junctions is compromised for example, as a consequence of prematurity, exposure to toxins, drugs, or radiation, aberrant immune reactions to environmental antigens occur and could lead to inflammatory and autoimmune diseases.”(Tlaskalova-Hogenova et. Al, 2005, p.4). “The balance in intestinal mucosa may be disturbed by pathogenic microorganisms and toxins attacking the mucosa by qualitative or quantitative changes in the composition of mucosal microbiota, or by inadequately functioning components of the innate or adaptive immune system occurring in cases of dysregulated mechanisms of mucosal immunity or in immunodeficiencies. An expression of pathologically increased immunological activity may induce inflammatory processes of a different character, depending on the type and mediators of inflammation. Thus, numerous chronic diseases may occur as a result of disturbances of mucosal barrier function or of changes in mechanisms regulating mucosal immunity. The main characteristics of chronic ‘idiopathic’, inflammatory, and autoimmune diseases are tissue destruction and functional impairment as a consequence of immunologically mediated mechanisms that are principally the same as those functioning against dangerous (pathogenic) infections).”(Tlaskalova-Hogenova et. Al, 2005, p.4).

According to Crandall (2002), Candida grows on the contents of the intestine, and also penetrates the intestinal mucosa, disrupting the wall structure. This makes the gut wall more permeable, allowing the passage of microbial cells, partially digested food particles, and other molecules from the intestine into the blood stream. When higher than normal amounts of Candida antigens cross the ‘leaky’ intestinal wall and enter the bloodstream, they induce the synthesis of higher than normal levels of anti-Candida antibodies. Then these antibodies combine with the Candida antigens circulating in the bloodstream, forming immune complexes (Crandell, 2002, p. II-3).

Woodcock et al correlates a decrease in IgA with an increase in bacterial translocation outlining the barrier that IgA creates in reinforcing the intestinal mucosal barrier. Peyer’s Patches also are involved in the formation of IgA, an immunoglobin responsible for assisting in gastrointestinal barrier integrity. This author contends that as small intestinal health is altered, the Peyer’s Patches being a fundamental part of this dynamic can no longer produce adequate amounts of IgA, (Baugmart, 2002). IgA is used as one major marker in the diagnosis of gastrointestinal hyperpermeability (Galland, 2006; Miller, 2006).

4) MT or BT: Berg: Bacterial translocation may stem from 1) small intestine bacterial overgrowth, 2) immune deficiency, or 3) mucosal injury of the gastrointestinal barrier (Berg, 1995). “Bacterial translocation is defined as the passage of viable bacteria from the gastrointestinal tract to extraintestinal sites, such as the mesenteric lymph nodes complex, liver, spleen, and blood stream.” (Berg, 1995, p. 149). The same dynamic applies to Candida Albicans and other fungal microbes and is referred to as microbial translocation.“MLN is the first organ encountered in the translocation route from the GI lumen, is readily promoted by intestinal bacterial overgrowth. In fact, the degree of translocation of certain species of enterobacteriaceae to the MLN is directly related to their levels in the small intestine and cecum. The bacteria that translocate at the greatest efficiency from the GI tract to the MLN of monoassociated ex-germ free mice are Pseudomonas Aeruginosa and gram negative, facultative, aerobic enterobacteriaceae such as Klebsiella Pneumoniae, E.coli, and Proteus Mirabilis. Gram-positive, oxygen tolerant bacteria, such as Staphylococcus Epidermis and Lactobacillus Brevis, translocate at an intermediate level.” (Berg, 1995, p.149). “…it has also been suggested that macrophages and polymorpho- nuclear leukocytes engulf particles, including bacteria, at mucosal surfaces and transport them to abscesses, lymph nodes and other sites. Much more investigation is required to delineate the roles of cell-mediated immunity in the pathogenesis of bacterial translocation.” (Berg, 1995, p.151). “In the intestinal bacterial overgrowth model…indigenous bacteria translocate through the epithelial cells (intracellularly), rather than by interrupting tight junction to pass between enterocytes (extracellularly). Even overtly pathogenic organisms such as salmonella typhimurium and Candida Albicans are seen by microscopy to cross the mucosa intracellularly through intestinal epithelial cells.”(Berg, 1995, p.150). Berg goes on to correlate the affects of antibiotics and steroids with small intestinal bacterial overgrowth.

In fact, “In healthy individuals, bacteria are continually crossing the intestinal mucosa and are then transported into lymph and extra-intestinal sites, including the mesenteric lymph nodes, liver, kidney, spleen, and bloodstream. This phenomenon is known as bacterial translocation and occurs at very low rate and involves very small numbers of microbes in healthy individuals—most of the organisms being killed by the normal host defence mechanisms. The organisms most often associated with bacterial translocation are: E.coli, K. Pneumoniae, Enterobacter spp., Pr. Mirabilis, Enterococcus, Streptococcus spp., and Candida Albicans.” (Wilson, 2005, p.312). These bacteria have commonly been found in stool and broth urine cultures ordered by this author of her patients having IC.

“The passage of indigenous bacteria colonizing the intestine through the mucosa to local lymph nodes and internal organs is termed bacterial translocation and is a critical step in the pathophysiology of various disorders, from inflammatory bowel disease and sepsis to heart failure…What is more, bacterial translocation can also be detected in healthy people, with a frequency as high as 5% of the population assayed.”(Gorski et al., p.313, 2006)

4. Combination of the above phrases: “Intestinal barrier function regulates transport and host defense mechanisms at the mucosal interface with the outside world. Transcellular and paracellular fluxes are tightly controlled by membranes pumps, ion channels and tight junctions adapting permeability to physiological needs. Food and microbial antigens are under constant surveillance of the mucosal immune system. Tolerance against commensals and immunity against pathogens require intact antigen uptake, recognition, processing, and response mechanisms. Disturbance at any level, but particularly bacterial translocation due to increased permeability and breakdown of oral tolerance due to compromised epithelial and T cell interaction, can result in inflammation and tissue damage.” (Baumgart et. Al, 2002, p.685). (Riordan et al. 1997) finds that small intestine hyperpermeability occurs in SIBO and that Enterobacteriaceae are amongst the most common bacteria involved with this process. This bacterium is the one that this author finds to be the most commonly occurring in broth cultures of those having IC. The following quote comes from a study on microbial translocation specifically focused on Ecolab and Candida Albia’s, “ However, in many specimen, Candida were found to be budding both within macrophages and in the extracellular spaces. Perhaps 20-30% were within extracellular spaces, many of these free within lymphatics…. in the sub mucosal lymphatics, the organisms were found both free and within macrophages, sometimes associated with leukocyte aggregates…examples were seen in which a high frequency of translocation occurred through the mucosal epithelium covering Peyer’s Patches.” (Alexander et.al 1990, p. 503). “The most important finding of our study is that both large (C. Albicans) and small (E. coli) intact microbes and endotoxin translocated directly through morphologically intact enterocytes through a similar mechanism, which is different from classical phagocytosis and exocytosis.” (Alexander et.al 1990, p. 508). “While the current studies do not address the clinical relevance of translocation, they provide evidence that translocation of viable microbes and endotoxin occurs with great frequency through morphologically intact enterocytes.” (Alexander et.al 1990, p. 510). Some hypothesize that “absorption of antigens via intestinal lymphatic may be a significant source of systemic autointoxication” (McMillin et. Al, 1999 p.3). Autointoxication, the theory of intestinal toxins entering systemic circulation is an ancient theory that recently has sprouted routes with theories such as multiple chemical sensitivities and endotoxins (McMillin et. Al, 1999). McMillin et. Al correlate lymphatic absorption of antigens with psoriasis and other autoimmune diseases. They base their opinions on the concept of bacterial translocation that ultimately leads to multiple organ failure (MOF) and death. However, McMilllin et. Al are of the position that that autoimmune inflammatory responses are activated by bacterial translocation, and that MOF is the extreme result, and chronic disease is what lies between that extreme and health. (Husebye, 2005, p.2) in his review of bacterial translocation says, “The consequences (of bacterial translocation) of the host vary from none to life-threatening complications caused by electrolyte deficiencies and septic manifestations”.

These research studies illuminate the fundamental issues underlying the pathology of IC and other chronic diseases that often accompany the condition as theorized by this author. To further substantiate this connection, this author finds that the urine cultures conducted on her patients are often positive for the microbes commonly associated with MT above, i.e. E.coli, Enterococcus, K. Pneumonniae, Proteus Mirabilis, and/or Candida Albicans. And, (Keay et al, abstract, 1995) a researcher at the forefront of the field of IC found that “These data do not provide evidence that IC is associated with infection or colonization by a single microorganism. However, they do generate the hypothesis that the prevalence of microorganisms, especially bacteria at low concentrations, is greater in the urine of IC patients than of control subjects. If these results are confirmed by other controlled studies, the question of whether the presence of these organisms is a cause or a result of IC should be addressed.”

This author finds that there is often a different result between standard agar culture and broth culture urinalysis, however. Broth analysis is usually required in order to isolate the pathogens present in IC. This is a controversial issue, however, the consistency of results among patients warrants a need for a more research in this area.

Once homeostasis has been upset and this process is put into motion, pleomorphism can occur as well, complicating the process further (Appleton, 2002). (Palermo, 2003), of Washington University School of Medicine in St. Louis, is researching the issue of biofilms as a reason for ineffective antibiotic treatment in resistant and chronic infections. He describes the multicellular organism formed by thousands of bacteria working together that become a force too strong for the immune system and the antibiotics given to treat the infection. He further argues that the bacteria often reside within the tissues of the bladder rather than free flowing within the bladder organ often rendering negative results with urinalysis.

It is this author’s belief that we may only be on the cutting edge of discovering the numerous adverse affects that modernly used chemicals in medicine, diet, and other practices are having on the mucosal barrier that protects the internal environment from the external environment, and that this is the root of many chronic disorders including IC. It is this author’s opinion that if we alter many of our current practices, this disorder as well as many others may be eliminated.

Trigger Factors

The body will endeavor to protect itself against the precipitating factors through Compensation and store the pathology in its attempt to maintain Latency. Eventually, the body will be unable to continue the processes of Compensation and Latency because either too much Latency has accumulated or the body has become too depleted of the physical stores required to maintain the Latent state. In some cases, the trigger factor is so strong that precipitating factors are not required, but that is the exception, not the rule.

Basically what occurs during the precipitating phase is a change in the GALT affecting the MALT. The Western concepts of SIBO, LGS, MT and BT are the CCM processes of Compensation and Latency. Inflammation ensues from these conditions and affects other body tissue. As we said earlier in this text, Compensation and Latency present as chronic disorders involving inflammation primarily in areas such as muscles and joints (arthritis); eyes, ears nose and throat (allergies, chronic sore throats and ear infections, migraines); the pelvis (endometriosis, fibroids, cysts, PMS); skin (chronic skin conditions such as seborrhea, eczema, psoriasis); genital (chronic vaginitis, jock itch, vulvadynia); digestive system (chronic bloating and gas and IBS) to name a few examples.

The Trigger factor is the final onset of the disease process. The only exception is the acute onset of the sexually transmitted model. However, that too was created over time in the person the transmission originated from.

Trigger factors are identical to precipitating factors, the only difference being that it is the final step prior to the onset of the IC. Precipitating Factors and Trigger Factor may be the same or different. The Trigger Factor is the factor that finally brings the pathology to the urinary bladder itself, marking the time that the patient associates the onset of the disease. The only factors that are not precipitating factors but may be trigger factors are:

1. Childbirth: hormonal imbalance triggering an onset.

2. Surgical or medically invasive procedure that introduces a biofilm into the body

or triggers MT or BT.

The precipitating and trigger factors determine the course this disease takes and exactly how it will manifest itself coupled with, of course, the emotional and physical constitution and imbalances of the person.

The more suppression that has occurred, the more the pathology becomes complicated. Inappropriate treatments may also trigger Compensatory reactions as well.

The above trigger factors are non-issues for those with a healthy body. Childbirth, sexual activity, and menopause, for example will not cause problems for healthy persons. A surgical procedure, although traumatic, will not trigger IC without the precipitating factors in place first unless the way in which the procedure incited disease was the introduction of a biofilm.

There is much more to write on this subject, but, I thought this might be a good place to start:

The reason I posted yesterday on Dampness is that it is a common pathology in chronic illness especially in those having situations that are very difficult to shift. Dampness is stagnant, just as it feels in nature. It is very very difficult to shift and clearing out of the systemic areas of the body can prove to be quite timely and frustrating.

Dampness is correlated (at least in part of course, not in total) with many chronic and degenerative diseases including IC. It does not have to be included, but is often included. I found this very interesting article by a very well-respected wrold renoun healer, regarding Dampness and Parkinson’s disease which I thought was a great read. I hope you find it interesting: 

I hope this is interesting for you. Dr.M

DEGENERATIVE DISEASES

Interpretation and Treatment with Chinese Medicine

by Subhuti Dharmananda, Institute for Traditional Medicine, Portland, Oregon

The term “degenerative diseases” has been loosely applied to numerous severe health problems, but the primary medical use of this designation is for describing progressive diseases of the central nervous system-the brain and spinal cord. In the central nervous system (CNS), under ordinary circumstances, the nerve cells do not regenerate. These CNS neurons differ from most of the other cells of the body that break down and are then replaced. The central nerves also differ from peripheral nerves which, under usual circumstances, are able to regenerate when injured. Among the better known neurodegenerative diseases are Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS). 

THE CENTRAL NERVOUS SYSTEM

The spinal cord is the soft nerve material in the core of the hard spinal vertebrae, and this cord is seen by the traditional Chinese system as a type of “marrow.” The kidneys, as the only organ near the base of the spinal column and located on either side of it, are understood to be the spine’s origin, since all body components are depicted as derivatives of the viscera. Hence the spinal cord, and its blossoming into the complex brain at the top, is considered an outgrowth of the kidney likened to the marrow of the bones. The kidney system is the storehouse of the prenatal and postnatal essence (jing), the basis of the life gate, and the controller of the underlying fire and water (yang and yin) of the body, working as a regulator in harmony with the heart.

The description we get from the traditional Chinese medical (TCM) system doesn’t correlate readily with what is known about the body from modern medical investigations, which clearly distinguish the nature of bone marrow, nerves, and kidneys, but the Chinese description can be viewed a functional one that helps describe the nature of the body as a whole. The utility of the TCM depiction of the central nervous system depends on whether or not the remedies devised on the basis of that description actually help the patients. For us to know whether these remedies are helpful, we would ideally have viable clinical evidence. The type of evidence available to us is somewhat limited, mostly as a result of the poor quality of evaluations and reporting by the Chinese physicians rather than a lack of clinical experience treating such conditions. As a result, we are able to observe what the Chinese doctors do, while recognizing that the recommended therapies still need to be proven effective.

CAUSE OF DEGENERATION

It is recognized in the Chinese medical system that degeneration occurs spontaneously to a certain extent with aging, and these age-related changes then serve as a model for interpreting degeneration from other causes. Specifically, the prenatal essence has been “used up” through the aging process, while the ability to supply postnatal essence declines, partly because of weakening of the zangfu functions, most notably that of the stomach/spleen which is responsible for deriving the essential elements from foods to produce qi, blood, and essence. With aging, it is common to have a lower appetite, thus to eat less, and therefore to have less essence to store in the kidneys. Also, with aging, the mobility of the body slows, and that includes both the overall physical activity (e.g., ability to walk and get exercise) as well as the internal processes (ability to circulate qi, blood, and moisture). With this sluggish circulation, there can be accumulation of materials in the body, particularly static blood and phlegm (dried fluids), which further obstruct the circulation, damage the organ functions, and inhibit replenishment of the essence. All or some of these processes may be triggered earlier in life that they would appear otherwise by certain mechanisms, such as injuries, pathogenic organisms (e.g., viruses), and genetic disorders (in TCM: a derangement or short supply of the prenatal essence). Within the comprehensive Chinese system of interpreting disease causation are the climatic influences (e.g., cold, damp, wind, etc.), but these are mainly seen in modern Chinese work as triggers for initiating a disease or exacerbating a mild condition, while the other factors just described are considered the fundamental causes (i.e., deficiency and stagnation; the latter is considered a type of excess syndrome). 

According to the traditional Chinese understanding of aging, over time the yin essence of the kidney and liver declines, and this leads to the most common signs of old age, such as drying of body fluids, fragility of body structures, graying of the hair, wrinkling of the skin, loosening of the teeth, and withering of the flesh. The basic text of Chinese medical theory, Neijing Suwen (ca. 100 A.D.), says that “One who is over 40 years of age will have his yin half-reduced.” In ancient descriptions of trembling of hands, shaking of the head, and stiffening of the muscles (characteristics of Parkinson’s disease), it is mentioned that these symptoms are a manifestation of wind that arise from deficiency of yin and blood of the liver organ system. The Neijing says: “All kinds of wind and dizziness are associated with the liver; all kinds of sudden stiffness are associated with wind.” In order for the blood and yin of the liver to be full (thus preventing internal wind from arising), the kidney essence must be adequate, since it serves as the primary source of the liver yin. The decline of both kidney and liver function has a common origin in the decline of yin during the aging process.

Modern medical investigations of the central nervous system can often reveal the specific site of degeneration, and yield some details about the biochemical processes involved. In some instances, one or more contributing causative factors have been determined, but for most of the neurodegenerative diseases, it appears that there are multiple causative factors merging together to initiate or accelerate the disease process. The Chinese descriptions of the disease provide some suggestions for help through means available now, used for either preventing the disease or bringing it under control (especially if treated early enough). The modern medical descriptions may also provide some limited preventive strategies and a few drugs for alleviating the symptoms at the early stage, but they generally provide little satisfactory results at present, partly because any modern preventive or treatment strategy now under development must undergo extensive evaluation before a claim for efficacy is made. By contrast, with the traditional Chinese system, the strategy to be employed is based on the underlying theories rather than conclusive evidence.

TREATMENT STRATEGIES OVERVIEW

Chinese medical treatments using herbal formulations for neurodegenerative disorders generally rely on four components:

1. Nourish the kidney as the primary means of nourishing the central nervous system that is suffering degeneration, helping it to resist further deterioration. The approach is to treat kidney and marrow, and since most treatments for the kidney immediately benefit the liver (according to the Chinese doctrine), the nourishing herbs to be used are usually said to benefit the kidney/liver. Many of the symptoms of neurodegenerative diseases are understood as manifestations of internal wind, reflecting the deficiency of the liver system. The herbs may be said to nourish yin or strengthen yang, or do both, so long as the integrity of the yin is maintained.
2. Invigorate other organ systems, particularly stomach/spleen, to aid in nourishing the kidney; the heart system might be treated to help regulate the “ministerial fire” that influences kidney conditions.
3. Clear away existing accumulations and prevent further accumulation by promoting circulation of qi, blood, and moisture, with focus on the problems of blood stasis and accumulation of “phlegm-mist” obstructing the meridians.
4. Treat the symptomatic manifestation of the disease, such as alleviating wind to calm tremors. It is understood that when the kidney and liver are adequately nourished, the wind symptoms will be alleviated, but supplementing deficiency can be a long-term process and herbs that might immediately quell wind are used initially. 

Acupuncture therapies may be utilized to accomplish the same objectives as described here for the herb formulations; in addition, acupuncture may be applied locally (over the head or along the spine) in an effort to invigorate the affected part of the nervous system. Thus, points along the governing vessel and in close proximity on either side of it (e.g., Hua Tuo points and Bladder Meridian points), are often part of the treatment. Another aspect of acupuncture therapy is to treat the deficiencies and stagnation through body points that are particularly suited to those purposes (e.g., zusanli for deficiency and hegu for stagnation). 

HERBAL THERAPIES

Although numerous ingredients have been used by Chinese doctors to make the formulas given to patients with neurodegenerative diseases, in fact there are only about 50 ingredients that are routinely relied upon; these are outlined below as tonics, blood-vitalizing herbs, herbs for resolving phlegm and phlegm-mist, and herbs for calming internal wind. Some ingredients which are no longer available for use, because of concerns about toxicity or endangered species status of the sources, have not been included here.

Tonics

Blood-Vitalizers

Dispel Phlegm and Phlegm-Mist

Calm Internal Wind

EXAMPLE OF COMPREHENSIVE ANALYSIS: PARKINSON’S DISEASE

The disorder that was to become known as Parkinson’s disease was first described as shaking palsy in 1817 by a London physician named James Parkinson. It is now known to involve progressive degeneration of neurons in a region of the brain that controls movement. This degeneration creates a shortage of dopamine, which is the immediate cause of the movement dysfunctions that characterize the disease: administration of l-dopa (a precursor to dopamine, which is converted in brain cells to dopamine) has considerable beneficial effects in many patients with Parkinson’s disease (the Ayurvedic herb, Mucuna pruriens, is a natural source of l-dopa and has also been used to treat the disease).

In most cases, the first symptom of Parkinson’s disease is tremor (trembling or shaking) of a limb, especially when the body is at rest (reminiscent of restless legs syndrome). The tremor often begins on one side of the body, frequently in one hand. As the disease progresses, both sides of the body may be involved and shaking of the head may also occur. Other common symptoms include slow movement, difficulty in initiating movement, rigid limbs, a shuffling gait, a stooped posture, and reduced facial expressions. In about a third of the cases, the disease also causes or is associated with depression, personality changes, dementia, sleep disturbances, speech impairments, and/or sexual difficulties. 

Parkinson’s disease is associated with aging: it affects about 6% of those over the age of 65 (average age of onset is about 60), affecting more men than women. Causes of Parkinson’s disease are not fully known, but there are genetic factors involved in susceptibility and there may be contributions from a variety of habitual activities. Coffee consumption, for example, appears to help protect against getting this disease.

There is no known cure for Parkinson’s disease. Many patients are only mildly affected and need no treatment for several years after the initial diagnosis. When symptoms grow severe, doctors usually prescribe levodopa (l-dopa), which helps replenish the brain’s dopamine. Sometimes doctors prescribe other drugs that affect dopamine levels in the brain (e.g., drugs that inhibit the breakdown of dopamine). In patients who are very severely affected, surgery and various experimental procedures may be attempted. None of the current therapies have long-term success.

CHINESE MEDICINE

The characteristic symptoms of Parkinson’s have appeared in ancient Chinese medical texts, which described a syndrome of trembling of the hands and shaking of the head. The disorder and its basis has been subjected to considerable analysis over the centuries. Syndromes in which elderly patients suffer from spontaneous shaking, or from other muscular manifestations of disease, such as paralysis or tonic spasm, are thought to be the result of yin deficiency of the kidney and liver leading to generation of “internal wind.” 

Genetic propensity to suffer from Parkinson’s disease corresponds to inherited defects in the kidney essence. Susceptibility of the liver to deficiency and generation of wind may occur as the result of diseases that damage the liver, from excessive use of alcohol and drugs that can damage the liver, or from a long history of behaviors that are unhealthy (having the effect of damaging yin and essence). The result is disordered flow of qi. As described in the Compendium of Medicine: “The upgoing qi in the channels and collaterals does not keep its proper position, thus causing the head to shake and the limbs to tremble.” 

The mental disturbances that also arise in some Parkinson’s patients may be attributed, from the perspective of traditional Chinese medicine, to a failure of the kidney to nourish the brain as well as from stagnation of phlegm that may obstruct the pathways for flow of qi and blood. In addition to genetic factors related to this decline in kidney essence, there may also be weakening of the kidney by exposure to cold, by excessive fear, by excessive sexual activity, and by consuming foods, drugs, or other substances that harm the kidney and especially those that deplete kidney yin. Also, physical injuries and surgeries can disrupt the normal interconnection of the internal organs and result in depletion of yin of the kidney and liver. In a recent review article about Parkinson’s treatment with TCM (1), the authors noted the following commentaries by Chinese physicians on causation:

The disease has various causes and complicated pathogenesis. Zhu holds that insufficiency of the liver and kidney and failing of the brain, spinal cord, and tendons to be nourished are the basic pathogeneses of the disease, and stagnation of phlegm in the collaterals is an important pathological link in the development and changes in the condition. Wang considers that the disease is caused mostly by gradual loss of the kidney essence due to old age and infirmity, or various poisoning factors caused by trauma….The pathogenesis is deficiency in origin and excess in superficiality; deficiency in origin manifests in deficiency of qi and blood, and insufficiency of liver and kidney; and excess in superficiality manifests as endogenous wind, stasis of blood, and phlegm-heat….Zhou, et al., consider the important pathological factors of this disease mainly deficiency of liver and kidney, wind stirring inside, accumulation of phlegm and blood stasis, a disease with coexistence of deficiency and excess….

This interpretation of causation, as well as the symptoms and signs associated with Parkinson’s disease, leads directly to a therapeutic regimen: nourish the kidney and liver, with focus on nourishing yin, disperse accumulated phlegm and blood stasis, and sedate internal wind. 

For the tonification component, one of the most commonly used formulations-especially for treating yin deficiency with aging-is Rehmannia Six Formula (Liuwei Dihuang Wan), with its key tonic herbs rehmannia and cornus for liver and kidney, and dioscorea and hoelen for spleen and kidney. It might be modified with additional tonics for kidney and liver (typically, lycium fruit and ho-shou-wu would be recommended). Yang deficiency often exists with the syndrome; it especially appears as the disease progresses, and the person’s ability to move declines, and their metabolism weakens. That problem might be addressed by herbs that gently strengthen yang while still benefiting yin, such as cistanche and cuscuta.  Zuogui Wan, a well-known formula for nourishing kidney essence, primarily nourishes yin, but also gently assists yang (it is comprised of rehmannia, cornus, dioscorea, cuscuta, lycium, tortoise shell, deer antler, and achyranthes). 

There are several wind-inhibiting substances recommended by Chinese herbalists. The main plant-based remedy is gastrodia tuber (uncaria is sometimes combined with it), while most of the substances given for this purpose are of animal origin, including scorpion, centipede, earthworm, antelope horn, and silkworm. The persistence and progression of the disease may be attributable to “phlegm obstruction of the channels.” This substance in the meridians and blood vessels “fixes” the wind so that the symptoms worsen and also persist over a long period of time. Otherwise, wind syndromes tend to come and go. Herbs used to resolve this problem of phlegm obstruction include arisaema, pinellia, and acorus (these are botanically related); silkworm and gastrodia are considered helpful for both calming wind and clearing phlegm obstruction. Curcuma (yujin), an herb often used for vitalizing blood circulation, is used in modern Chinese practice for dispersing stagnant obstructive phlegm. 

CLINICAL REPORTS OF HERB THERAPY FOR PARKINSON’S

A report (2) on treatment of 40 cases of Parkinson’s syndrome involved 31 male and 9 female patients, aged 54-80 years (mean 69 years), with cases classified as being severe (3 patients), moderate (27 patients), or mild (10 patients). All patients were considered to have deficiency of kidney and liver yin with stirring up of internal wind. In addition, 3/4 of the patients were described as having phlegm in the channels. Of the remaining 10 patients, rather than this phlegm obstruction syndrome, 6 were said to have deficiency of qi and blood and 4 were said to have deficiency of yang. 

A basic prescription was developed for treatment: ho-shou-wu (20g), lycium (12g), cistanche (12g), gastrodia (15g), uncaria (18g), cnidium (15g), and acorus (10g). This collection of herbs would be modified according to symptoms, adding 2-6 herbs (yielding a total of about 120 grams of herbs per daily dose). After decocting the herbs, the resulting tea was divided into three portions, to be taken one portion each time, three times per day. Treatment time was three months, with the patients taking the decoction daily while discontinuing Western medications. According to the authors of the report, 5 of the patients were “markedly improved” by the treatment and 15 additional cases were improved, while the remaining 10 only had slight changes. Improvement was evaluated on the basis of scores for symptoms characteristic of Parkinson’s disease, including tremor, rigidity, hypokinesis, gait disturbance, and mask-like face. They suggested that acupuncture, moxibustion, and scalp-needling might be helpful additions to the treatment. 

Many patients with Parkinson’s also suffer from atherosclerosis, and there is some thought that this problem contributes to more rapid degeneration of the neurons, perhaps as a direct result of insufficient blood flow, or as a development from inflammatory processes that contribute to both atherosclerosis and to neuron degeneration. In a study of patients with atherosclerosis and Parkinsonism, 60 cases were treated with the same herb formula described above, by the same research group (3). In this case, there were 42 male and 18 female patients; aged 61-78 years (mean 67 years). In this group, it was reported that 7 of the patients were markedly improved, and 24 were improved, 15 were slightly improved, while the remaining 14 failed to respond to treatment.

In another study of the effects of Chinese herbal medicine (4), 700 cases of treatments of Parkinson’s patients at a hospital were reviewed; 50 of them, involving prolonged therapy, were analyzed. The case reports were concerning 32 men and 18 women. The patients were divided into three categories by the traditional method of differentiation and were treated with herbs accordingly. Because these were case studies, rather than administration of a specific prescription, commonly used herbs were mentioned.

• For yin deficiency of kidney and liver, the main herbs were: rehmannia (raw and cooked), ho-shou-wu, cornus, tortoise shell, scrophularia. 
• For qi stagnation and blood stasis type, the main herbs were: salvia, red peony, carthamus, persica, cnidium, achyranthes, tang-kuei, eupolyphaga (zhechong), and pangolin scale (chuanshanjia)
• For deficiency of qi and blood, the main herbs were: ginseng, astragalus, atractylodes, tang-kuei, rehmannia, licorice, peony, salvia, schizandra, and ligustrum. 

The formulas would be modified according to specific symptoms, for example, to address continuous trembling, use antelope horn, uncaria, and gastrodia; additional wind-sedating substances might also be used for this purpose. The herbs were prepared in the form of decoction, which was given in two doses per day. Most of the patients took the decoctions daily for three months. Many of the patients were using standard Western medicines at the start of the treatment and, according to the authors, several were able to reduce their dosage or discontinue these medicines during or after treatment with the decoctions. The authors reported that of the 50 patients analyzed, the treatment was markedly effective in 15 cases, and somewhat effective in 24 cases, the remainder (11 cases) did not respond to therapy significantly.

Information from other Chinese clinical work was reported at the International Congress on Traditional Medicine held in Beijing (April 22-24, 2000). Limited details were provided in the abstracts, indicating that most of the patients given these herb therapies showed improvement. Treatment time, when reported, was 6-12 weeks, and the herbs might be given in capsules or decoctions. No side effects of the herb therapies were noted. As with the studies reported above, the methodology employed does not meet current standards for reliably demonstrating effectiveness. Following are summarized from three reports.

Clinical study on treatment of Parkinson’s disease with Wengan Zhichan Jiaonang, by Gai Guozhong, et al.
32 cases of Parkinson’s disease were randomly divided into a treatment group and a control group (16 patients each). The treatment group received Wengan Zhichan Jiaonang (Warming the Liver to Control Vibration Capsule), which included the following herbs: astragalus, ginseng, ho-shou-wu, dipsacus, magnolia bark, ligustrum, and cnidium (incomplete list). The herb extracts were encapsulated (500 mg per capsule), with administration of 4 capsules, three times daily. The control group received l-dopa and carbidopa. According to the authors, the results for the two groups, in terms of Parkinson’s symptoms, were the same, but the herb-taking group had improvement of other symptoms associated with deficiency syndrome.

Clinical observation on treatment of Parkinson’s disease with Xiaochan Tang, by Ding Hongzhan
A new formula for alleviating wind-paralysis, Xiaochan Tang, was evaluated; it is a decoction made with silkworm, scorpion, centipede, uncaria, and aconite; patients were also given powder of antelope horn. This basic formula was then modified with addition of numerous herbs for the patients according to their diagnostic category as follows:

• for yin deficiency of kidney and liver: add rehmannia, dioscorea, cornus, peony, tortoise shell, ligustrum, and achyranthes;
• for deficiency of qi and blood: add ginseng, hoelen, atractylodes, licorice, rehmannia, tang-kuei, peony, and additional cnidium (these are the ingredients of the traditional formula Bazhen Tang);
• for heated phlegm, add bamboo sap (zhuli), arisaema, and chih-shih; or
• for blood stasis, add cnidium, tang-kuei, red peony, and cyathula. 

All the herbs were used in heavy dosage, typically 9-15 grams in decoction (except the scorpion and centipede, about 6 grams each). The herbs were given once daily for 25-60 days (average 42 days). Some degree of improvement was noted in 86% of patients, though only 13% showed marked improvement with the 6 week average treatment.

Clinical effect of Zhenchanshu capsule on 21 cases of Parkinson’s syndrome by Feng Guangkui
Zhenchanshu was made as a capsule containing herb extracts, taken 4-6 capsules each time, three times daily, for three months to patients who had limited response to levodopa. The ingredients were not listed. It was stated that 86% of patients showed some degree of improvement, with 10% showing complete resolution of symptoms. The authors said that this herb therapy was better for early and intermediate cases and that it performed better for tremor and rigidity but not very effectively for difficult limb movement.

ACUPUNCTURE THERAPY

In a review of Parkinson’s disease treatment (1), it was noted that “The use of acupoints on the head is extremely important…moxibustion should be used as the main method with acupuncture as assistance.” The main points recommended for moxibustion were baihui (GV-20) and dazhui (GV-14) in the head region; plus tender points at the shoulder and upper back, plus certain body points: tanzhong (CV-17), zhongwan (CV-12), tianshu (ST-25), along with zusanli (ST-36) or sanyinjiao (SP-6). These suggestions, sometimes using acupuncture rather than moxibustion, have been followed in some clinical work reported recently, mentioned in the review article (1) and the following reports.

For example, in a study (5) of acupuncture therapy administered to 29 patients with Parkinson’s, the patients were treated every other day for three months while the standard drugs were used as per usual practice; a control group taking Western drugs alone (24 patients) was also monitored. Two sets of acupuncture points served as the basis of therapy, and they were administered alternately:

1. sishencong (EX-HN-1; four points surrounding GV-20), quchi (LI-11), waiguan (TB-5), yanglingquan (GB-34), zusanli (ST-36), and fenglong (ST-40).
2. baihui (GV-20), benshen (GB-13), fengchi (GB-20), hegu (LI-4), sanyinjiao (SP-6), and taichong (LV-3). 

Electro-stimulation was administered to sishencong, benshen, and fengchi for 15 minutes, using a frequency of 180 cycles/minute, with the intensity adjusted to the tolerance limit for the patient. To avoid reduction of sensitivity to the stimulus over the course of the treatment, a continuous wave was used initially, but then followed by a “disperse-dense” wave. The other points were needled with the conventional manual method of stimulation. Needle retention was 40 minutes. Additional acupuncture points would be used for treating specific symptoms, so that, with most points being bilateral, about 12-16 needles were used in each session. The authors reported that there was a significant improvement in symptoms for those treated with acupuncture, while for patients treated with drugs alone, there was a worsening of symptoms. Further, the patients treated by acupuncture ended up using a lower total dosage of drugs after the three months of treatment, while those using only the drugs retained their original drug dosage.

A follow-up study (6) was conducted by the same group, focusing on the sishencong points, with a comparison group treated with four points on the limbs (arms and legs). According to the report, acupuncture increased the cerebral blood flow velocity, which was taken as a sign of improved circulation to the affected parts of the brain, and the sishencong points had a more notable effect on the brain circulation. 

Another report on acupuncture (7) also focused on acupuncture near the point baihui (GV-20). In this case, acupuncture was performed along the scalp from qianding (GV-21) to baihui (GV-20), using the standard techniques of scalp acupuncture. Needles were inserted at a small distance to either side of the governing vessel (central line), in parallel groups with a total of 12 needles used. After manual manipulation using a rapid twirling maneuver, the inner needles (closest to the center line) were attached to electrodes of an electro-stimulation device (with disperse-compact alternating wave form) and stimulated for 40 minutes at the highest intensity the patient would accept. Treatment was administered every other day for ten consecutive treatments over a three week period; this was repeated each month for three months. In addition, yamen (GV-15), fengchi (GB-20), and other points at the neck would be treated by standard acupuncture. It was noted that there were some responses immediately after treatment, with calming of tremor in 2/3 of the patients. Among 24 patients that completed three months of therapy, 6 were said to show marked improvement, and the other 18 moderately improved (some other patients discontinued the treatments). 

APPENDIX. Two Formulations Suitable for Neurodegenerative Diseases Developed by the Author

Cord Tablets (Seven Forests brand tablets, 700 mg) serves as a tonic for the Chinese diagnostic category of kidney essence deficiency syndrome: 

This formulation focuses on the pairing of deer antler and tortoise shell to nourish the essence. These ingredients are described as have these actions: “deer antler supplements kidney yang, opens the governing vessel, strengthens sinew and bone, boosts marrow, and nourishes blood; tortoise shell enriches yin and blood and supplements the liver and kidney to invigorate the root.” Dragon bone secures and astringes the kidney essence, and directs the action of the formula to the spine. Eucommia, dipsacus, and cuscuta assist antler in nourishing the kidney and strengthening the root. Rehmannia, along with tortoise shell, harmonizes the yang tonics, aiding in nourishing yin, blood, and essence. Tortoise shell and dragon bone prevent yang from rising to cause agitation. Astragalus and atractylodes promote the spleen’s function of absorbing essences from food to nourish the kidney essence. Disorders to be addressed include:

• Degenerative nerve disorders (e.g., ALS, MS, Parkinson’s Disease)
• Degenerative spinal disc and osteoporosis
• Loss of control over urination
• Impotence and loss of libido

Cord Tablets shares herbs and characteristics with the traditional formula You Gui Wan (Restore the Right Kidney Pill), which has deer antler, rehmannia, cuscuta, and eucommia in common. It was described, by Bensky and Gamble in Formulations and Strategies, as “one of the best formulas for treating kidney yang deficiency with insufficiency of essence and blood.” This revised version maintains these benefits. A formulation for ALS reported in the Chinese literature was comprised of antler and tortoise shell gelatins, rehmannia, tiger bone, dipsacus, cuscuta, eucommia, atractylodes, licorice, (with astragalus added for a later prescription), eucommia, achyranthes, tang-kuei, peony, phellodendron, anemarrhena, and citrus. In Cord Tablets, tiger bone is replaced by dragon bone and the herbs for deficiency fire (phellodendron and anemarrhena) have been left out (Zhi Bai Di Huang Wan could be administered along with this formula). 

Stabilizing Tablets (Seven Forests brand tablets, 750 mg) was designed for the treatment of destabilizing conditions (with loss of motor and/or sensory controls) that most often arise with aging and involve more rapid than normal decline in liver and kidney yin and essence. 

This formulation focuses on the pairing of gastrodia and batryticated silkworm to inhibit wind, particularly the syndrome of wind-phlegm; these ingredients are described as have these actions: “gastrodia extinguishes wind, dispels phlegm, and checks spasm; silkworm dispels wind and resolves spasm, disperses phlegm, and dissipates binding.” Lycium fruit, ho-shou-wu, cornus, cordyceps, and cistanche nourish the liver and kidney, supplementing the yin, blood, and essence, while gently tonifying yang. Salvia, acorus, and cnidium enliven the circulation of blood to overcome some of the damaging effects of chronic disease, aging, and lack of healthy exercise. Disorders that may be addressed by a formula such as this include:

• Parkinson’s disease
• Spastic conditions associated with multiple sclerosis and other neurodegenerative diseases
• Unsteady gait due to poor circulation and weakness
• Spasms and convulsions associated with late onset epilepsy
• Mental confusion, dizziness, tinnitus, and blurred vision

The tonic portion of Stabilizing Tablets shares herbs and characteristics with the traditional formula Huan Shao Dan (Youth Restoring Pellet), which has lycium fruit, cistanche, cornus, and acorus in common. Although the other herbs in Stabilizing Tablets differ, they contribute to several actions intended for the Huan Shao Dan formula, which is described by Ellis in Notes from South Mountain this way: “greatly supplements root qi, [it treats] abstraction, confusion, and clouding of the essence-spirit, congealed or stagnant qi and blood, inability to taste food and drink, thin body, fatigue, diminished sight and hearing loss.” The added wind-calming herbs in Stabilizing Tablets contribute to the treatment of shaking, spasm, convulsion, and unsteadiness. In a review of Parkinson’s disease treatment, one of the formulas suggested was the “Powder for Checking Tremor and Stopping Spasm,” comprised of ho-shou-wu, salvia, earthworm, gastrodia, cistanche, and other ingredients; another formula mentioned contains lycium fruit, cnidium, uncaria, ho-shou-wu, astragalus, atractylodes, gastrodia, and other ingredients. These approaches are similar to the ones expressed in Stabilizing Tablets.

REFERENCES

1. He Jiancheng, et al., Present situation and prospects of TCM treatment of Parkinson’s disease, Journal of Traditional Chinese Medicine 2004; 24(4): 308-314.
2. Chen Jianzong, et al., Traditional Chinese medicine treatment of Parkinson’s syndrome-a report of 40 cases, Journal of Traditional Chinese Medicine 2003; 23(3): 168-169.
3. Chen Jianzong, et al., 60 cases of atherosclerotic Parkinsonism syndrome treated by supplementing liver and kidney method, Shaanxi Journal of Traditional Chinese Medicine 1999; 20 (1): 19. 
4. Li Genghe, Clinical observation on Parkinson’s disease treated by integration of traditional Chinese and Western medicine, Journal of Traditional Chinese Medicine 1995; 15(3): 163-169.
5. Zhuang Xiaolan and Wang Lingling, Acupuncture treatment of Parkinson’s disease-a report of 29 cases, Journal of Traditional Chinese Medicine 2000; 20(4): 263-267.
6. Wang Lingling, et al., Influence of acupuncture on brain blood flowing state in Parkinson’s patients, Chinese Acupuncture and Moxibustion 1999; (2): 115-116.
7. Xi Guifang, et al., Impact of electrostimulation at scalp points on tremor-myeloectropotential in Parkinson’s disease patients, Shanghai Journal of Acupuncture and Moxibustion 1996; 15(3); 5-6.

August 2005

Western medicine and Traditional Chinese Medicine (TCM) have long been viewed as opposing and very different kinds of medicines.Their approaches to physiology and healing appear quite different in perspective. While Western medicine separates the various systems and organs of the body and delves deeper and deeper into the particles that comprise matter, Chinese medicine views the body and further, the whole person, as a unified organic whole. Spiritual, mental, emotional and physical aspects are all seen as interrelated and interdependent. Perhaps this is the most fundamental difference.

Western medicine treats illness by isolating the diseased area and giving drug medications to alter and counteract the individual problem. Chinese medicine treats illness by identifying which parts of the whole are out of balance and the resulting energy patterns they form. These are then treated with energetic therapies and herbal medications to correct the imbalance and bring the whole to stasis. While Western medicine derived its theory and treatments from dissection, microscopic analysis and chemical derivations, Chinese medicine developed mainly through thousands of years of observation, not only of the human body, but its relationship to nature and the universe.

Despite the fact that both medicines had a unique historical development and approach healing from a distinctly different perspective, hopefully one day there wil be a place may coexist with an equal standing and respect for each’s strength’s and weaknesses.

The TCM spleen as the source of energy derived from food and fluid is one of the most important organ systems and makes a good study to appreciate the similarities and differences between the two systems. At first glance it appears there are no correspondences at all, but upon deeper examination we learn that it is only terminology and perspective which mask their underlying similarities. To compare them, however, it is necessary to look beyond the spleen itself in Western medicine to other physiological processes in the body. Because in Chinese medicine the body is seen as an interrelated whole, functions of an organ actually occur on a cellular level throughout the entire body. To compare this with the Western definition of an organ it is thus necessary to look at several processes and cellular constituents as well as the spleen itself.

To inspect these similarities we will first review the Western understanding of the spleen and then a comparison with the Chinese view. Next we will compare them and give the TCM treatment strategies for spleen imbalances. Perhaps through more inspection of these seeming differences between contemporary Western and traditional Chinese medicines, we can ultimately come to a more integrated approach to health and healing based upon traditional and contemporary principles.

Western Idea Of The Spleen

In Western medicine the spleen is considered to be part of the lymphatic system in the body. This system is comprised of lymph and lymph vessels, nodes and organs – the tonsils, thymus gland and spleen. The primary function of the lymphatic system is to drain from the tissue spaces protein-containing fluid which escapes from blood capillaries, transport fats from the digestive tract to the blood to produce lymphocytes and develop immunities, and for the lymph organs to filter lymph and add white blood cells and antibodies.

The spleen has several functions in Western medicine:

a. defense

b. phagocytosis of bacteria and worn-out red blood cells and platelets, salvaging iron and globulin content and returning them to the blood

c. production of lymphocytes, monocytes and plasma cells, which in turn produce antibodies

d. store blood and release it through contraction of the spleen or in case of hemorrhage

e. production of red blood cells in the fetus but not adults.

The Digestive Process

Because the TCM definition of the spleen functions includes the digestive processes and functions, which occur on a cellular level throughout the body, we need to look at both these aspects in Western medicine also. In terms of the western view of digestion, food is digested in the stomach and passed on to the small intestines where the nutrients in the food are absorbed and distributed to all tissues and cells of the body through the blood circulation. Energy is then produced through biological oxidation of foods primarily in the mitochondria of the cells.

Cellular Function

We now look within the cells themselves in Western medicine to obtain an overall body view. Scattered throughout the plasma in cells are organelles called mitochondria. These are called “the powerhouses of the cells” because they produce most of the form of chemical energy used by the cells. The mitochondria are important in the Krebs cycle in the body, a series of energy-yielding steps in the catabolism of carbohydrates. The enzymes for this pathway are in the mitochondria matrix, and they catalyze oxidation reactions that form ATP, an energy carrying molecule, in the Krebs Cycle.

This cycle occurs as follows: the catabolism of carbohydrates, fats and proteins transfers energy to the ATP bio-molecule through enzymes and an oxidation process. It does this in two places, in the cytoplasm and in the mitochondria. The latter is the most important place as it accounts for 95% of ATP molecules from glucose breakdown and 100% from fatty acid breakdown. Thus, food is catabolized and energy from it is captured and put into the ATP bio-molecule. The rest of the energy is released as heat that keeps our bodies warm. Then when ATP breaks down, it releases energy for cellular work. Overall, the Krebs cycle provides energy and heat for the body’s many processes, and the mitochondria are key to this process.

Diseases Of The Spleen In Western Medicine

There are several diseases recognized by Western medicine that involve the Spleen. These include mononucleosis, leukemia, splenomegaly, Hodgkin’s disease, AIDS and all the various types of anemia’s. In general these include an elevation of white bloods cells and/or insufficient production of red blood cells, lymph disorders and depressed or impaired immunity.

CHINESE VIEW OF THE SPLEEN

The spleen is seen as a paired complex in Traditional Chinese Medicine (TCM) of the Earth element, the spleen being the yin component and the stomach being the yang. They work together and imply the other’s functions. Because the spleen is the deeper yin organ where the energy of food and fluid is transformed, it is the more vital of the pair and so the one most often referred to. In TCM the spleen has the following functions:

a. Rules the transformation and transportation of food and fluids in the body. The spleen transforms food to extract the energy from it and then transports the resulting food “energy” to various organs and parts of the body where the body’s energy and blood are produced. Thus, the spleen is seen as the basis for the production of energy and blood in the entire body. The spleen also controls transformation, separation and movement of fluids. It separates the usable and the unusable from the fluids ingested and these are then transported to their appropriate places. Thus it plays a central role in nourishing the body and promoting development.

b. Governs the blood. The spleen keeps he blood circulating in the vessels. It also provides the extracted energy from food and sends it to the heart to be mixed with Kidney energy to form blood.

c. Rules the muscles, flesh and the four limbs. It does this by transporting the body’s energy and blood to the muscles, flesh, arms and legs. Consequently, overall muscle tone, strength and appearance, especially that of the arms and legs, reflects the health of the spleen.

d. Opens into the mouth and it’s brilliance is manifested in the lips. Chewing prepares food for its digestion. If the spleen is healthy there is a good sense of taste and all five tastes can be distinguished. Further, the lips are moist and rosy.

e. Raises the qi. The spleen qi produces a lifting effect along the midline of the body and keeps the internal organs in place so they do not sag or prolapse.

f. Rules thought. The spleen influences our capacity for thinking, studying, focusing, concentration and memorizing.

SIGNS OF SPLEEN DYSFUNCTION IN TCM

General signs of spleen dysfunction include:

1. Abdominal distention, aching or pain relieved by local warmth and pressure

2. Lack of appetite and flat taste in the mouth

3. Abdominal flatulence after meals, aggravated by stress

4. Abnormal stool such as water, first well-shaped then loose,

loose, well-shaped and loose alternatively, or diarrhea.

5. Chronic hemorrhage or blood in the stool, vomit, mucus or under the skin, not caused by blood heat evils and trauma

6. Sallow complexion or pale lips

7. Pale and swollen tongue, or with teeth marks on its margin

8. Emaciation, or puffy appearance

9. Weakness of the limb and muscles

    

Specifically these signs of dysfunction can be grouped into energy patterns. Each of these is comprised of specific signs and symptoms and each is then treated accordingly.

Signs of deficient spleen qi:

No appetite, abdominal distention after eating, spirit-lessness, tiredness, lethargy, lassitude not caused by stagnation of dampness or physical stress, sallow complexion, weakness of the arms and legs, visceroptosis or rectal prolapse or hemorrhoids, debilitated defecation, defecating without stool or defecating immediately after meals, loose stools, sleepiness after eating, hallow pulse, slow and weak pulse or feeble and hollow pulse, tongue swollen with scallops of the side in the middle section.

Signs of deficient spleen yang:

Lack of appetite, abdominal distention and/or pain, especially after eating, tiredness, sallow or bright white complexion, weakness of the four limbs, loose stools or watery stools with undigested food in them, edema, chilliness, cold limbs, pale, swollen and moist tongue and weak, slow and deep pulse.

Spleen energy sinking:

Signs of spleen qi deficiency plus a bearing down sensation in the abdomen, prolapse of the stomach, uterus, anus, or vagina, frequency and urgency of urination, extreme chronic diarrhea, a pale tongue and empty or weak pulse.

Spleen not controlling the blood:

Signs of spleen qi deficiency plus bleeding in general, purpura, blood spots under the skin, blood in urine or stools, hemorrhage, menorrhagia, sallow complexion and shortness of breath, pale tongue and fine pulse.

Cold-damp invading the spleen:

No appetite, feeling of cold in the epigastrium which improves with warmth, feeling of heaviness or stuffiness in the head, chest and/or epigastrium, sweet taste in the mouth or absence of taste, no thirst, loose-thin stools, white vaginal discharge, lassitude, rumbling intestines, abdominal pain, sticky thick white coating on the tongue and a slippery, slow pulse.

Damp-heat invading the spleen

Stuffiness in the epigastrium and lower abdomen, no appetite, feeling of heaviness, thirst without desire to drink or with a desire to drink small sips, nausea, vomiting, abdominal pain, loose stools with offensive odor, burning sensation of the anus, scanty and dark yellow urination, low grade fever, headache, sticky yellow tongue coating and slippery and rapid pulse.

COMPARISON OF WESTERN AND TCM UNDERSTANDING OF THE SPLEEN

There are many comparisons of the spleen between Western medicine and TCM, and they are best shown by following the various functions of the spleen in TCM.

a) The Spleen rules transformation and transportation of food and fluids in the body.

A combined Western medicine/TCM study done in China yielded surprising results in the connection between the spleen in both medicines. In the study samples of the gastric mucosa were taken from a variety of people who were identified with the various TCM patterns of spleen dysfunction. These were then compared with gastric mucosa samples of people with no TCM symptoms of spleen dysfunction. Those with spleen symptoms all showed similar results.

The conclusion found that the spleen in TCM is closely related to the mitochondria. To see this graphically, the digestive process between Western medicine and TCM is as follows:

TCM View of the Spleen

Food — stomach (decomposing) — small intestine (digesting and distinguishing the refined substance) — upward transport of the essence — spleen (transporting and transforming) — vital energy (qi)

Modern Medicine View of the Spleen Broken Out

Food — stomach (mechanical digestion mainly) — small intestine (chemical digestion mainly and absorption of nutrients) — blood (transportation) — mitochondria (biological oxidation) — energy

TCM = Modern Medicine:

Spleen (transporting and transforming) = mitochondria (biological oxidation)

Spleen Qi:

From this it is clear the function of the TCM spleen is quite similar to that of the mitochondria. In the study, deficient spleen qi patients experiencing abdominal flatulence, abnormal stools and undigested food in the stool after the intake of a high protein diet had obvious quantitative and qualitative changes of mitochondria and displayed a decreased number of the enzyme secreting cells (zymogen granules) necessary for normal digestion. A deficiency of spleen qi was thus found to correspond to an insufficiency of digestive enzymes and a reduction of enzyme activity, interfering with digestion of proteins. This digestion on the cellular level corresponds to the digestive process ruled by the spleen, that of transforming (essentially absorbing) and transporting (taking the nutrients to where they are needed).

Spleen Yang

A decrease in the number and quality of mitochondria also leads to less heat being created as a product of the ATP formation process. In turn this provides less “metabolic fires”, resulting in poor absorption and transportation of nutrients to the cells. This heat released by ATP corresponds to the yang function in the body. In the TCM spleen this heat gives appetite, energy, digestive capacity, warmth, proper circulation of fluids and stool formation.

Spleen Dampness

When there is deficient spleen qi the fluid metabolism is interfered with and edema and swelling result. A function of the Western Spleen is to drain from tissue spaces protein-containing fluid which escapes from blood capillaries. In the cases of deficient spleen qi patients, the mitochondria of the stomach parietal cells were swollen. This may be a result of insufficient energy (poor mitochondria functioning) leading to an impediment of the sodium-potassium pump and resulting in an accumulation of fluid in the cells.

b. The spleen governs the blood

In TCM the spleen is a source of vital energy and blood and a controller of blood circulation. When spleen qi is weak it’s blood controlling function is disturbed and bleeding results. Further, the production of blood and qi are decreased. In the blood routine examinations of patients with diarrhea attributive to the deficiency of spleen energy, there was revealed a decreased hemoglobin level. Other patients who had pale lips, sallow complexion and bleeding had fewer mitochondria in the parietal cells of the stomach and these had obviously damaged cristal membranes.

c. The spleen rules the muscles, flesh and four limbs (extremities)

When spleen energy is sufficient, blood and qi are well provided and muscles are brawny. Otherwise, they may be weak, thin, puffy or even emaciated. In the case study, deficient spleen qi patients had listlessness, tiredness, thin musculature and fewer mitochondria that had more evidence of damaged ridges. In those with muscular atrophy, the mitochondria were found to have broken ridges, defected membranes and faint stromas. Further, there was an impediment of energy metabolism in muscles with anti-mitochondria antibodies discovered in some cases.

d. The spleen opens into the mouth and it’s brilliance is manifested in the lips.

And

e. The spleen produces a lifting effect along the midline of the body and keeps the internal organs in place so they do not sag or prolapse.

Mitochondria are found in almost all tissues and cells of body. In deficient spleen qi patients with sallow complexions, pale lips, a flat taste in mouth, abdominal flatulence, shortness of breath, debilitated defecation and visceroptosis, the mitochondria are found to be decreased in number and many are damaged and swollen.

f. The spleen rules thought. The spleen influences our capacity for thinking, studying, focusing, concentration and memorizing. Poor digestion and assimilation results in a lack of nutrients nourishing the brain and can effect the blood sugar. Both can cause mental unrest, irritability, worry, dwelling on things or obsession, and a lack of focus and clarity.

TREATMENT

The importance of this comparison of the spleen helps herbalists better understand the value and effect of herbs on the body.() The spleen is probably the most important strategy for healing in TCM because it affects the body’s immunity and capacity to maintain and heal itself. If we can understand the diagnostic indications for spleen patterns and herbs used for them, then its possible to better understand the properties of the herbs themselves.

For example, qi tonics such as ginseng probably help in mitochondria formation, both in quantity as well as quality. Also, dampness-eliminating herbs probably help re-form swollen mitochondria and perhaps aid in lymph circulation. Thus, qi tonifying herbs in TCM are important, not just as tonics or adaptogens, but because they aid mitochondria repair and replication, and increase resistance to disease by stimulating the spleen to produce lymphocytes and leukocytes. But it is more complicated than that as the energetic weakness and imbalance of the Spleen in terms of Chinese diagnosis becomes intertwined with the Western understanding of the small intestinal microbiological imbalance (if we are speaking particlarly in terms of chronic inflammatory conditions such as IC) and this is where the mass of the Dampness is emanating from. This Dampness also infiltrates the body on a cellular level throughout and that “Dampness” becomes systemic. Thus in order to strengthen the Spleen, the Dampness must be addressed properly-this process in one of give and take, back and forth over time until both organs are in proper balance. Although we may use terms in Chinese medicine that are traditional ways of describing syndromes, it is important to understand that when modern pracitioners today use Chinese medicine, they are more than likely understanding that the Western concepts behind those Chinese terms and are not limiting themselves to those concepts. However, the use of those terms allow for the understanding of those energy imbalances and the consequent employment of supplements and herbs in a more efficient way. It is this cross over of understanding that is in my opinion so outstanding in today’s integrative type clinics because in my mind, the best of both worlds is there to better help the patient regain their health and life.

I hope this was interesting. Dr.M

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