“Is this the reason I was depressed? Is this why you are always talking about heat?” One of my recent patients brought these questions to me during their recent acupuncture session. My patient was discussing recent research on the link between body temperature and depression, which suggests that individuals with depression have higher body temperatures and may benefit from cooling therapies. This particular patient had been suffering from depression during the hot Texas summer months and experienced dramatic relief from acupuncture therapy.
After dietary modifications and regular acupuncture sessions, her depression cleared; however, she was now very well-aware of her triggers, which seemed to, in her words, “light the fire of my depression.” Consequently, this new study was very interesting to her!
The Connection
In Chinese medicine, we understand that heat can play a role in emotional / psychological distress. Externally contracted and internally generated heat can affect all facets of the human body. As stated by Giovanni Maciocia:
“The effects of the various etiological factors in mental / emotional problems can be classified into four broad categories:
Effects of Qi
Effects on Blood
Effects on Yin
Generation of pathogenic factors
“Given the indissoluble link between body and mind in Chinese Medicine, it should be remembered that, just as emotional problems have an effect on Qi, Blood or Yin, a disharmony of Qi, Blood, or Yin (from causes other than emotional) will affect the Mind.”
From the above list of factors, we can determine that heat can be generated from such issues as qi stagnation, blood stasis, blood deficiency, yin deficiency, and geographic influences. I covered this concept of SAD caused by the warmer seasons in a past column.
My Patient Case
The aforementioned patient had suffered from internal heat that was aggravated by continued exposure to geographic heat. She was attempting to cool down with cold-water swims and ice baths with limited success, so she turned to acupuncture.
Her diet was slightly modified to include more greens and berries, but overall her diet was quite good. Her main patterns of disharmony related to heat were depressive heat due to qi stagnation and qi / blood deficiency due to excessive sweating.
The protocol used was two acupuncture sessions a week for four weeks, then one session a week for four weeks. After the cumulative two months of therapy, the patient expressed complete resolution of her “fear of the heat” and her mood was dramatically improved. Now she comes in for what she describes as a “tune-up to keep the heat away.”
The patient’s tongue was overall quite normal, with no cracks, no teethmarks and regular coat; however, the sides of the tongue were extremely red. Her pulse was rapid and wiry. Her digestion was balanced, but she was experiencing slight fatigue and lighter sleep than usual. Acupuncture protocols were targeted to resolve the patterns of liver qi stagnation with depressive heat and qi / blood deficiency.
One of the most important aspects of these treatments was the use of jing well points, which have the actions of clearing heat, calming shen, restoring consciousness, treating “fullness below the heart,” and treating disorders of the zang organs. The acupuncture prescription protocols targeted clearing the depression and heat; and boosting the qi / nourishing blood.
There is a wide array of point options for treating these patterns of disharmony, allowing clinicians to customize treatment protocols to the specific nuances of each patient, as patients will always reveal unique characteristics that exist outside of the basic pattern presentations.
Acupuncture Point Prescription Options
To target the patterns of liver depression qi stagnation and qi / blood deficiency, the following point prescriptions can be used:
This point prescription utilizes the Four Gates combination to course the qi and move the blood. The jing well point Sp 1 clears heat, tonifies the spleen, regulates the blood, and calms the mind. Sp 10 harmonizes the qi and blood, cools the blood and clears heat, and removes blood stagnation. I often use this point during the hot summer months in Texas in concert with the Four Gates. Often just the Four Gates and Sp 10 can provide strong results in resolving issues rooted in qi / blood stagnation.
Ren 6 tonifies the qi, regulates the qi, and strengthen the yuan qi. I use this point frequently for fatigue due to excessive exposure to geographic heat. BL 17 nourishes and invigorates the blood, clears heat, and calms the mind. I will typically administer this back shu point first and retain the needle for 10 minutes; then remove and administer the points on the front side of the body.
PC 6 regulates the qi and blood, harmonizes the stomach, and calms the mind. SP 6 moves the qi, nourishes the blood, cools the blood, boosts the kidneys, and calms the mind. LIV 1 promotes the smooth flow of liver qi, clears heat, and restores consciousness. Ren 6 tonifes and regulates the qi. Du 24 clears heat and calms the mind. BL 17 nourishes and invigorates the blood, clears heat, and calms the mind.
These two point prescriptions, with occasional subtle variations based upon the subjective perceptions of the patient, were used for two months to resolve my patient’s uncomfortable relationship with heat. I use the word relationship as this is exactly how the patient described her situation after two months: “I have a better relationship with hot weather now, I don’t dread it and this makes me so happy.”
Over my almost 30 years in clinical practice, I have used Chai Hu Long Gu Mu Li Tang extensively for a wide array of clinical presentations ranging from chronic headaches to anxiety, insomnia, and prescription drug withdrawal symptoms if these situations fit the appropriate patterns – all with extremely positive clinical outcomes.
There’s no doubt that many of your patients visit your practice because they are in pain. And there’s certainly no doubt that curcumin from turmeric (Curcuma longa) can be incredibly effective in stopping that pain, whether due to chronic conditions like arthritis or acute pain from intensive workouts. But your patients may also benefit from curcumin for other reasons.
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Low back pain is defined as pain the posterior superior iliac spine (PSIS), and it can be acute or chronic, localized or radiating. It is a common ailment for adults in the United States, with a lifetime prevalence as high as 65-80%. Whether or not an MRI is available to provide definitive knowledge of a structural issue, acupuncture can be an effective treatment for low back pain.
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