NMDE211 Energetics of Food

NMDE211 Energetics of Food Session 6 Chinese Medicine Five Elements - Part II Nutritional Medicine Department Endeavour College of Natural Health www.endeavour.edu.au 1

Session Summary The Earth element and its organs, the Spleen/Pancreas and the Stomach Earth element as the foundation for health Imbalance patterns, signs and symptoms of imbalance Foods to address Earth element imbalance The Metal element and its organs, the Lung and Large Intestine Imbalance patterns, signs and symptoms of imbalance Foods to address Metal element imbalance Endeavour College of Natural Health endeavour.edu.au 2

Earth Endeavour College of Natural Health endeavour.edu.au 3

Earth Retrieved April 27 2015 from http://www.itmonline.org/5organs/spleen.htm Endeavour College of Natural Health endeavour.edu.au 4

Earth The Earth element and the Spleen/Pancreas- Stomach network (the Centre or Middle Burner) are of key significance in Chinese medicine dietetics. Earth is yin, nourishing the core, inner balance, stability and inner centre. The Centre (or Middle) Burner nourishes yin. (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 5

Earth Late Summer Late Summer, a short and relatively unrecognised season, is approximately the last month of summer (and the middle of the Chinese year in the Northern Hemisphere). It is the point of transition from yang to yin, between the expansive growth phases on spring and summer and the inward, cooler autumn and winter seasons. At this time of year, find the rhythms and cycles that make life simple and harmonious. Food should be prepared simply with a minimum of seasonings and a mild taste. (Pitchford, 2002) Endeavour College of Natural Health endeavour.edu.au 6

Earth This is the element of nurture, the mother of us all. The Spleen and Stomach are the paired Earth organ systems. The Spleen and Stomach are at the centre of the body just as the Earth is at the centre of the Five Elements. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 7

Spleen/Pancreas-Stomach Association Emotions Climate factor Season Direction Colour Flavour Time of day Spleen/Pancreas Brooding, worries, pensiveness Dampness Late summer, early fall (autumn) Centre Yellow Sweet Stomach: 7-9 AM Spleen/Pancreas: 9-11 AM (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 8

Spleen Channel (Retrieved from Deadman, Al-Khafaji & Baker 2007, p. 177) Endeavour College of Natural Health endeavour.edu.au 9

Spleen/Pancreas Role of the Spleen/Pancreas in Chinese medicine: Governs transformation, transport, and processing of food and energy. Retains the blood in the blood vessels. Governs muscles and extremities. Opens at mouth and lips. Governs upbearing qi, keeps the organs in place. Houses the mind (zhi). (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 10

Chinese Medicine - Spleen In Chinese medicine, the term Spleen is used to refer to the combined actions of the anatomical organs: stomach, spleen and pancreas. The Spleen refers to the organ network or system of functions and the channel (meridian) interchangeably and often simultaneously. The Spleen has a Zang/Fu (interior/exterior) relationship with the Stomach. It is located with the Stomach in the Middle Jiao, or Middle (Centre) Burner. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 11

Spleen: Governs Transformation and Transportation Good Spleen transportation and transformation = good digestion, absorption and elimination Poor Spleen transportation and transformation = possible abdominal distention, diarrhoea, lassitude, emaciation, malnutrition, and a host of other consequences. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 12

Spleen: Transformation The Spleen transforms food into Qi. Called the foundation of postnatal existence, it extracts Gu Qi (Food qi) from food and liquids. Gu Qi, in turn, helps create other forms of Qi as well as Blood. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 13

Spleen: Transportation When the Spleen transports Gu Qi, it also distributes fluids to the tissues, simultaneously moistening and nourishing. To the Lower Jiao: from the Spleen, waste fluids are sent to the Kidney (Zang) after which they are excreted by the Urinary Bladder (Fu). Lower body oedema is one example of a problem that can arise in this process. To the Upper Jiao: from the Spleen the pure fluids are raised to the Lung, which also helps distribute moisture The process of distribution and metabolism of water. Facial edema is an example of a problem here. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 14

Spleen: Failure of Transformation & Transportation If the Spleen fails to transform and transport fluids from food and beverages various pathological conditions can result: If Dampness accumulates inside the body and mixes with Heat, it will turn into Phlegm (inflammatory conditions with mucus). If Damp is retained in the skin and muscle, it causes swelling (oedema). Dampness in the intestines causes diarrhoea. Dampness in the abdominal cavity results in serious fluid accumulation (ascites). (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 15

Spleen: Controls Blood The Spleen regulates blood circulation inside the blood vessels. If the Spleen Qi isn t strong enough to hold the blood, it flows outside of the vessels. Examples are various hemorrhagic symptoms and diseases, such as chronic uterine bleeding. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 16

Spleen: Governs Muscles and Extremities The Spleen nourishes the fleshy, as opposed to the sinewy aspect of the muscles. Anorexia, cachexia and failure to thrive are examples of the Spleen failing to nourish the muscles. Spongy, soft muscular tissue can also result. The vigour of the four limbs is also dependent on Spleen Qi. With sufficient Spleen Qi, a Yang Qi substance, the energetic qualities of Yang pervade the tissues, enabling strong, sure movement. If Spleen cannot transport and transform the Yang Qi and nutrient substances weakness and atrophy result. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 17

Spleen: Opens to the Mouth Appetite and sense of taste are related to the transportation and transformation functions of the Spleen. If these functions are intact, good appetite and a normal sense of taste will naturally occur. Greasy, sweet taste in the mouth is caused by Damp Obstruction of Spleen Qi. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) (Image source: https://pixabay.com/en/mouth-face-tooth-lip-philtrum-7336/) Endeavour College of Natural Health endeavour.edu.au 18

Spleen: Revealed in the Lips Since the Spleen opens in the mouth, the strength or weakness of its functions are reflected in the lips. Healthy Spleen Qi glows in full, pink lips. If the Spleen Qi is deficient, this will show as pale, yellowish or lusterless lips. A deficiency of Spleen Yin can result in dry lips. What might bright red lips indicate? (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 19

Spleen: Controls the Raising of Qi The Spleen lifts Qi up the midline of the body, allowing the organs to find their proper places. When this function is impaired, Spleen Qi sinks, and prolapse can result. What are the organs that can prolapse? The Spleen also raises Gu Qi (Food Qi) to the Lung and Heart. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 20

Spleen: Houses the Mind Clear thinking and good concentration indicate strong Spleen qi. Spleen deficiency can present as mental symptoms such as fuzzy thinking, problems concentrating and poor memory. (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 21

What Supports the Spleen? Cooked or warm food. A balanced diet centred around unprocessed Spleensupporting foods, such as most whole grains, many vegetables and fruits and some meats. Regular mealtimes the Spleen loves routine. Chewing - since the Spleen opens into the mouth, the mouth initiates Spleen functions. Chewing also adds warmth to food. Quiet pleasure in food. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 22

What Harms the Spleen? Extremes: too sweet, too greasy, too much or too little. Cold food and drinks: frequent salads, sandwiches, fruit, cold drinks, ice cream, and other cold foods consume Spleen Qi, a Yang substance. Multi-tasking: studying, worrying or doing your taxes while eating all overburden the digestive capacity of the Spleen. Skipping meals: eat a substantial breakfast of Spleen Qisupporting foods (e.g. porridge or congee). The largest meal would ideally be eaten in the middle of the day (just as the Spleen is at the centre of the body s functions), with quiet time for digestion afterwards. Processed and artificial food products (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 23

Spleen/Pancreas Examples of Chinese medicine syndromes: Spleen Qi Deficiency (Vacuity) Spleen Yang Deficiency (Vacuity) (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 24

Spleen Qi Deficiency This is one of the most common syndromes presenting in clinical practice. Symptoms include: chronic fatigue, general exhaustion, susceptibility to infection, lack of appetite, weakness and frailty of limbs, craving sweets; pale, pallid complexion; soft, loose stools; sometimes diarrhoea. (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 25

Spleen Yang Deficiency Spleen yang deficiency can result from protracted Spleen qi deficiency or pronounced weakening of the Spleen due to cold foods, irregular meal times and irregular eating habits. Symptoms include: feet and hands are always cold; shivering; a sensation of cold in the abdomen; watery stool with undigested food particles; oedemas, weakness, fatigue, chronic digestive problems. (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 26

Specific Questions o From the information you have just covered about the TCM Spleen, brainstorm some specific questions related to the Spleen Qi deficiency and Spleen Yang deficiency. o Remember Specific Questions will help you to exclude or include a constitutional diagnosis by confirming or negating a particular aspects specific to that constitutional type. These questions are used after general questioning and will often reveal a yes or no answer. o Keep these questions in a safe place to be referred to over the coming weeks. Endeavour College of Natural Health endeavour.edu.au 27

Foods to Balance Spleen Endeavour College of Natural Health endeavour.edu.au 28

Spleen Dietary Treatment Avoid: Cold or cooling yin foods; excess acrid (pungent) foods; excessive consumption of sweets, especially refined sugar. Fruits pineapple, oranges, bananas, kiwi fruit, watermelon, lemon Vegetables cucumber, raw foods, excessive consumption of salads (especially during cold seasons), tomatoes Beverages cold or iced drinks; too much mineral water; energetically cold fruit juices; black tea, green tea, wheat beer Dairy cottage cheese, cream cheese, milk, sour milk products (e.g. yoghurt, kefir) (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 29

Spleen Dietary Treatment Recommended: Regular meals; at least one warm meal a day Flavour sweet-hot, sweet-warm, sweet-neutral Cooking method neutral and warming Meat poultry, poultry broth, lamb, beef, beef stock, venison Fish trout, salmon, tuna, shellfish Fruit sweet apples, apricots, dates, Chinese dates, figs, sweet cherries, peaches, plums, raisins, red grapes Vegetables fennel, cabbage, pumpkin, carrots, sweet potato, onions gently sautéed until transparent Beverages fennel tea, spiced tea with cinnamon, liquorice tea (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 30

Spleen Dietary Treatment Recommended: Grains amaranth, oats, millet, polenta, short-grain rice, rice Nuts and seeds peanuts, hazelnuts, pistachios, sesame seeds, walnuts Sweeteners maple syrup, barley malt, raw honey, raisings, molasses Spices aniseed, star anise, cayenne, pepper, fennel, ginger, cardamom, nutmeg, vanilla, cinnamon, coriander, oregano, rosemary and thyme (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 31

Spleen Dietary Treatment Treatment duration is 2-3 months Eat regularly Breakfast suggestion millet porridge with raisins, cinnamon, nuts and warming fruits (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 32

Stomach (Image source: https://en.wikipedia.org/wiki/gastric_folds) Endeavour College of Natural Health endeavour.edu.au 33

Stomach Channel (Retrieved from Deadman et al. 2007, pp. 125-128) Endeavour College of Natural Health endeavour.edu.au 34

Stomach Function of the Stomach in Chinese medicine: Cooking vessel for acquired qi. Downbears the flow of qi Gathers food Separates and extracts food Loves dampness Time of day: 7 9 a.m. (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 35

Stomach: Controls the Descending of Qi The Stomach descends the bulk of transformed food down to the Small Intestine for further separation. Healthy Stomach Qi moves downwards. If Stomach Qi fails to descend or rebels, flowing in the opposite direction, feelings of fullness and distention, reflux, belching, hiccups, and nausea and vomiting can result. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 36

Stomach Time According to the Chinese clock, 7-9am is the time of day associated with the Stomach. This is an optimal time to eat, since the Stomach energy is at its peak, and can then pass along the prepared food to the Spleen. The peak time for the Spleen (9-11am) directly follows that of the Stomach. What kind of food do you think would be best to eat during the Stomach/Spleen hours? (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 37

What Supports the Stomach? Do not overeat eat to just before the point of fullness or just to the point of fullness Moist food Cool food (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 38

What Harms the Stomach? Overeating, which overwhelms the Stomach Stress, which usually manifests as Liver invading the Stomach and/or Spleen (Wood Overacting on Earth) Lack of fluids, either from food or internally. Fluid loss could come from hemorrhage, burns, inflammation or other causes. Eating late at night, which overtaxes the Stomach Yin (Night is the Yin time; day is the Yang time.) (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 39

Stomach Patterns Stomach patterns normally treated with dietary therapy include: Stomach Qi Deficiency Stomach Qi Deficiency with Cold Stomach Yin Deficiency Stomach Fire Food Stagnation in the Stomach Other common Stomach patterns not treated primarily with diet include: Damp-Heat in the Stomach and Spleen and Blood Stagnation in the Stomach. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 40

Stomach Fire (Wei Re) This Excess heat syndrome dries out the body fluids causing intense thirst, constipation and a dry tongue. Subsequent upbearing heat in the stomach channel causes swollen and bleeding gums. The Excess condition also prevents stomach qi from downbearing, resulting in oesophageal (sour) reflux. In extreme cases, stomach fire combined with phlegm can impair the spirit (shen). This can lead to disturbed sleep and psychological symptoms. Protracted exposure to extreme heat (fire) can damage stomach substance (yin damage, frustration). (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 41

Stomach Fire (Wei Re) Symptoms Burning and pain in solar plexus (epigastrium) Thirst, craving cold beverages Excessive appetite, food cravings Bleeding gums Sour reflux, vomiting after eating, nausea, bad breath Constipation Tongue: Reddish, enlarged; yellow, sometimes dry tongue fur. For heat phlegm: Thick, yellow, sticky tongue fur. (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 42

Stomach Fire (Wei Re) The following Western diagnosed conditions have symptoms associated with Stomach Fire: Gastritis Ventricular and duodenal ulcers Stomatitis Nose bleeds (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 43

Stomach Fire (Wei Re) Causes Diet excess hot foods and warming cooking methods, especially acrid spices or coffee; smoking. For heat phlegm: too much hot and fatty food, e.g. deep-fried food. General too many heated emotions, anger, too much brooding. (Retrieved 27 April, 2015 from http://www.theacupunctureclinic.co.nz/acupuncture-for-pepticulcer) Endeavour College of Natural Health endeavour.edu.au 44

Stomach Fire (Wei Re) Treatment Aims Cool and remove stomach heat Downbear stomach qi Endeavour College of Natural Health endeavour.edu.au 45

Stomach Fire (Wei Re) Avoid Thermal nature hot and warm foods Cooking method warming Flavour bitter-hot, bitter-warm, acrid-hot, acrid-warm, sweet-hot, sweet-warm Meat lamb Beverages high-proof alcohol, coffee, red wine Spices chilli, curry, ginger, garlic, pepper Other smoked, fatty foods, strongly seasoned foods (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 46

Stomach Fire (Wei Re) Thermal nature Flavour Cooking method Fruit Vegetables Beverages Dairy products Other Cool, cold foods Recommended Sweet-cold, sweet-cool, bitter-cold, bitter-cool, sourcold, sour-cool Cooling Pears, rhubarb, watermelon, banana, honeydew melon, kiwi fruit Cucumber, mung beans, sprouts, tomatoes, peas, spinach, bamboo sprouts, Chinese (napa) cabbage Chamomile tea, green tea, black tea, wheat beer Yoghurt Tofu, wheat, dandelion (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 47

Specific Questions o From the information you have just covered about the TCM Stomach, brainstorm some specific questions related to the Stomach Fire. o Remember Specific Questions will help you to exclude or include a constitutional diagnosis by confirming or negating a particular aspects specific to that constitutional type. These questions are used after general questioning and will often reveal a yes or no answer. o Keep these questions in a safe place to be referred to over the coming weeks. Endeavour College of Natural Health endeavour.edu.au 48

Stomach Compared to Spleen Stomach is the paired Fu organ to the Spleen Zang Stomach is Yang; Spleen is Yin. Stomach Qi descends; Spleen Qi raises. The Stomach usually suffers from Excess conditions; the Spleen is more prone to Deficiency. The most commonly seen Deficiency pattern for the Stomach is Yin Deficiency; Yang Deficiency is an extremely common Spleen pattern. Stomach pathology normally involves Heat; Spleen pathology normally involves Cold, which produces Dampness. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 49

Stomach and Spleen: Fluids The Stomach works best with plenty of fluids; dryness inhibits its functions and/or injures the organ itself; the Spleen is overwhelmed by excess fluids. (Try to picture this.) The translation of the classic Chinese expression is: The Spleen loves Dryness and hates Dampness; the Stomach loves Dampness and hates Dryness. Huang Di Nei Jing (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 50

Deficient Earth: Symptoms Fatigue, particularly after eating Loose stools, gas and bloating Poor appetite Craving for sweets Hypoglycemia, diabetes Obesity, anorexia or cachexia Oedema Bruising and/or bleeding Pale lips, tongue, complexion Toothmarked (scalloped) tongue, cracked tongue Dry skin Short or scanty menses Poor concentration, spaciness Feeling overwhelmed (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 51

Earth: Relationship Overview Earth = Spleen/Pancreas-Stomach = Parent of Metal; Child of Fire; Controls Water Emotions: Brooding, worries, pensiveness Season: Late Summer Climate factor: Dampness Flavour: Sweet Endeavour College of Natural Health endeavour.edu.au 52

METAL Endeavour College of Natural Health endeavour.edu.au 53

(Retrieved from http://www.itmonline.org/5organs/lung.htm) Endeavour College of Natural Health www.endeavour.edu.au 54

Metal: Lung-Large Intestine Associations: Organ network: Lung-Large Intestine Emotion : Sadness Climate factor: Dryness Season: Autumn (Fall) Direction: West Colour: White, silver Flavour: Acrid (Pungent) Time of day: Lung 3 5 AM; Large Intestine 5-7 AM (Kastner, 2009) Endeavour College of Natural Health www.endeavour.edu.au 55

Metal - Autumn Autumn is the season of harvest, a time to pull inward and gather together on all levels, a time to store up fuel, food and warm clothing, a time to study and plan for the approaching stillness of winter. Everything in nature contracts and moves its essence inward and downward. Leaves and fruit fall, seeds dry, the sap of trees goes into the roots. The earth s grasses start to lose their deep green colour, turning lighter and drier. (Pitchford, 2002) Endeavour College of Natural Health endeavour.edu.au 56

Autumn - Foods Foods recommended in Autumn include: Mildly acrid (pungent) and energetically warm foods that compensate for the onset of external cold such as oats, millet, corn, rice, carrots, leeks, radishes, cauliflower, beef, lamb. For inner cold, shivering and the beginning of a cold, the acrid flavours of garlic, cinnamon, chilli, ginger and onions stimulate qi circulation and rapidly bring defensive energy to the surface. (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 57

Lung Character In charge of foreign affairs and defence. Controls the body s surface, is in direct contact with the environment, and is responsible for immune defence and most secretions. (Kastner, 2009) Endeavour College of Natural Health www.endeavour.edu.au 58

Lung (Image source: https://commons.wikimedia.org/wiki/file:lung_and_diaphragm.jpg) Endeavour College of Natural Health www.endeavour.edu.au 59

Lung Channel (Retrieved from Deadman et al., 2007, p. 73) Endeavour College of Natural Health www.endeavour.edu.au 60

Lung The role of the Lung in Chinese medicine: Dominates qi and governs breathing Governs diffusion and downbearing Governs regulation of waterways Houses the corporeal soul (po) Governs tissues, including skin and sweat glands, pores, and body hair Opens at the nose (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 61

Lung: Governs Qi and Breathing One of the most important functions of the Lungs is to inhale air and transform it into clear, ancestral (or gathering) qi (zong qi), which it then combines with gu qi (drum qi from food) from the Spleen. These are then combined with the essential qi (jing) into true qi (zheng qi). True qi is circulated in the meridians by the Lungs to fill the body and nourish the organs. The Lungs, together with the Spleen, carry a major responsibility for the acquired qi in the body. (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 62

Lung: Governs Qi and Breathing True qi divides into two separate forms: channel qi (yin qi) and defence qi (wei qi). Defence qi protects against external pathogenic attacks such as cold or heat and is produced mainly from Lung qi. Chinese medicine believes that sufficient, freely coursing Lung qi is the foundation of a good defence (immune system). (Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 63

Lung: Governs Downbearing, Diffusion and Waterways A cough is a sign of the Lung downbearing function being compromised; Lung downbearing also moves the Large Intestine to pass waste, since the Lung and Large Intestine are the upper and lower parts of the same energetic channel. Lung Qi diffuses fluids to all the tissues, and particularly to the skin. When Lung fluid diffusion is blocked, oedema may result. Where in the body would you expect to see this manifestation? (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 64

Lung: Houses the Corporeal Soul The Po, translated as corporeal soul, is what we can think of as: Resistance to the emotional effects of the outside world. Being thick skinned would be an Excess example of this and thin skinned a Deficient example. Having clear impressions and sensations coupled with high spirits. Picture someone taking a deep, joyful breath and then plunging into play or work. Chinese medicine believes that pungent, dispersing foods can help lift the spirits if a person is feeling depressed. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 65

Lungs: Open at the nose The Lungs are connected with the nose and sense of smell. Aromatic foods are of particular benefit to the Lung. Pungent/acrid foods such as wasabi (Japanese horseradish) that you can feel in your nose strongly move Qi and Drain Damp in the Lung and Upper Jiao. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) (Image source: https://en.wikipedia.org/wiki/human_nose) Endeavour College of Natural Health endeavour.edu.au 66

Lung Patterns Lung patterns normally treated with dietary therapy include: Lung qi deficiency (vacuity) Phlegm Damp obstructing the Lung Lung yin deficiency (vacuity) There are many other Lung patterns (Kastner, 2009; Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 67

Lung Qi Deficiency Signs and symptoms: Soft, weak cough Thin, clear sputum Shortness of breath Physical and mental exhaustion Reluctance to speak Pale complexion Frequent upper respiratory infections (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 68

Lung Qi Deficiency Causes: Wind-cold and wind-heat External pathogens Smoking Unresolved grief Anything that restricts Lung Qi circulation, such as poor posture, e.g. sitting hunched over with tense shoulders for long periods of time Excessive intake of cool or cold foods (Kastner, 2009; Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 69

Lung Qi Deficiency General recommendations: The Lung is the child of the Earth phase (Spleen-Stomach) so treating Lung disharmony is often facilitated by feeding the child i.e. treat with foods and cooking techniques appropriate for the Earth phase. Also use pungent and warm (or hot) foods to tonify Lung Qi. (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course; Kastner, 2009) Endeavour College of Natural Health endeavour.edu.au 70

Lung Qi Deficiency Specific foods: Grains: Oats, millet, buckwheat, rye, barley, rice (roast lightly before cooking) Vegetables: Cauliflower, kohlrabi, carrots, olives, onions, mushrooms, mustard greens, sweet potato, yam, potato, radish, asparagus, water chestnut Fruits: Peaches, grapes, pear, starfruit Meats (including fish): Tuna, carp, herring, duck, quail Spices: Ginger, garlic, thyme, pepper, cardamom Other: Almonds, walnuts, high proof alcohol (small amounts), molasses, rice syrup, barley malt (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course;) Endeavour College of Natural Health endeavour.edu.au 71

Specific Questions o From the information you have just covered about the TCM Lung, brainstorm some specific questions related to the Lung Qi deficiency o Remember Specific Questions will help you to exclude or include a constitutional diagnosis by confirming or negating a particular aspects specific to that constitutional type. These questions are used after general questioning and will often reveal a yes or no answer. o Keep these questions in a safe place to be referred to over the coming weeks. Endeavour College of Natural Health endeavour.edu.au 72

Large Intestine (Image source: https://en.wikipedia.org/wiki/liver) Endeavour College of Natural Health endeavour.edu.au 73

Large Intestine Channel ( Retrieved from Deadman et al., 2007, p. 95) Endeavour College of Natural Health endeavour.edu.au 74

Large Intestine Governs transformation and conveyance of waste Receives waste from the Small Intestine and forms it into stool, then discharges it from the body Descending Lung Qi assists in defecation (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course;) Endeavour College of Natural Health endeavour.edu.au 75

Large Intestine Large Intestine patterns commonly treated with dietary therapy: Large Intestine Damp Heat Large Intestine Deficient and Cold Large Intestine fluid exhaustion (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course;) Endeavour College of Natural Health endeavour.edu.au 76

Large Intestine Damp Heat Signs and symptoms: Abdominal pain Diarrhea or loose, odiferous stool Possibly blood or pus in the stool Tenesmus Burning sensation on anus Incomplete bowel movement Heaviness Associated biomedical conditions: Amoebic dysentery, haemorrhoids and irritable bowel syndrome (Adapted with permission from Bastyr University Introduction to TCM Therapeutic Nutrition Course) Endeavour College of Natural Health endeavour.edu.au 77

Large Intestine Damp Heat Causes: Weak Spleen qi can no longer transform fluids Inappropriate diet excessive hot, acrid and fatty dishes Emotional stress leading to heat symptoms (Kastner, 2009) Endeavour College of Natural Health www.endeavour.edu.au 78

Avoid: Large Intestine Damp Heat Acrid (pungent), warm and hot foods Recommended: Thermal cool, cold and neutral Flavour Sweet, bitter Preparation raw, boiled or steamed Fruit bananas, pears, honeydew, oranges Vegetables Eggplant, bamboo shoots, cucumber, spinach Increase intake of green or black tea (Kastner, 2009) Endeavour College of Natural Health www.endeavour.edu.au 79

Specific Questions o From the information you have just covered about the TCM Large Intestine, brainstorm some specific questions related to the Large Intestine Damp Heat. o Remember Specific Questions will help you to exclude or include a constitutional diagnosis by confirming or negating a particular aspects specific to that constitutional type. These questions are used after general questioning and will often reveal a yes or no answer. o Keep these questions in a safe place to be referred to over the coming weeks. Endeavour College of Natural Health www.endeavour.edu.au 80

Metal: Relationship Overview Metal = Lung-Large Intestine = Parent of Water; Child of Earth; Controls Wood Emotion: Sadness Season: Autumn Climate factor: Dryness Flavour: Acrid (pungent) Endeavour College of Natural Health www.endeavour.edu.au 81

Session Summary The Earth element and its organs, the Spleen/Pancreas and the Stomach Earth element as the foundation for health Imbalance patterns, signs and symptoms of imbalance Foods to address Earth element imbalance The Metal element and its organs, the Lung and Large Intestine Imbalance patterns, signs and symptoms of imbalance Foods to address Metal element imbalance Endeavour College of Natural Health endeavour.edu.au 82

Tutorial Guided group discussion Observations on the seasons, effects of weather/environment on balance of the elements; ideas about how to offset such effects with food, based on what we ve learned so far. Endeavour College of Natural Health endeavour.edu.au 83

References Bastyr University. Introduction to TCM Therapeutic Nutrition Course. Deadman, P., Al-Khafaji, M., & Baker, K. (1998). A manual of acupuncture (p. 158). East Sussex, UK: Journal of Chinese Medicine Publications. Kastner, J. (2009). Chinese Nutrition Therapy. Dietetics in traditional chinese medicine (Second). Pitchford, P. (2002). Healing with whole foods: Asian traditions and modern nutrition. North Atlantic Books. Endeavour College of Natural Health endeavour.edu.au 84

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