Overall I use a three-part protocol in the months prior and often during the summer to help patients manage their heat issues. This consists of: determining the quality / location of the heat (excess or deficiency, organ / meridian), moving qi and invigorating blood, and improving the quality of sleep to protect / regenerate the blood and yin.
Living in Texas, spring is a time of excitement and for some, dread. Why dread? It’s very simple: The hot summer season is near and with this comes months and months of extreme heat. Some individuals love the summer months (me!), while others experience depression just hearing the words “June, July and August.”
Having a practice located in an extremely hot climate, I have made it a regular seasonal routine to quiz patients on how they feel about the summer months subjectively and objectively. I refer to this as a “Heat Inventory.”
It is extremely fruitful to utilize this process, particularly during the spring, the season of the liver, so to speak. Prior to summer, we want to clear as much stagnation as possible, which can be qi stagnation, blood stasis or a combination of both. This can obviously be done by physical examination, tongue / pulse diagnosis, and by asking the patient how they subjectively feel about the long months of summer.
Does this season cause depression? Or is the patient feeling inspired? This angle of questioning is very important, as it can reveal potential upcoming or possibly current issues of “emotional / psychological” heat, as well as literal physiological heat. Does the patient feel hot? Heat at certain areas? At what time of day do the heat sensations occur? Or do they experience more emotional / psychological symptoms such as fear, anger and anxiety? The questioning can be very in-depth to completely reveal the unique patterns of the patient.
Overall I use a three-part protocol in the months prior and often during the summer to help patients manage their heat issues. This consists of: determining the quality / location of the heat (excess or deficiency, organ / meridian), moving qi and invigorating blood, and improving the quality of sleep to protect / regenerate the blood and yin.
Determining the Quality and Location of Heat
This aspect of the protocol is quite common and experienced clinicians should be well-aware of the various ways this can be diagnosed. Key points are to determine is the patient has underlying heat issues, and if the heat is excess, deficiency or a nuanced combination of both.
The location of the heat issues is also very important; this can be expressed via organ symptoms or meridian-based expressions of heat. Examination of the tongue, pulse, skin, subjective / objective symptoms, and detailed inquiry will reveal each patient’s unique landscape.
One key area I focus on in this part of the protocol is the quality of emotions and how emotions can because causative factors of heat. Chronic worry, fear, and anger damage the qi, blood, and yin, and over time result in complex heat-related issues.
It is important to allow patients to see their emotions as malleable and help them find outlets to relieve chronic stress. This can be anything from quality counseling to learning qi gong. As as I often tell my patients: “Patterns, not personality.” This refers to the potential transformation which can occur when emotions are understood and expressed, rather than bottled up or hardened into a “personality.”
Teaching patients about their unique patterns and how these can be harmonized and transformed is as powerful as any herbal medicine.
Moving the Qi and Invigorating the Blood
Clinicians can use tongue, pulse, and patient inquiry to investigate potential issues with qi stagnation and blood stasis. Over time, any type of stagnation will transform into depressive heat and potentially damage the body fluids, leading to a wide array of potential issues.
My personal favorite formula to use to gently clear systemic stagnation before and during the summer months is a modified Yue Ju Wan (“Escape Restraint Formula”). This formula is typically comprised of xiang fu (to clear qi stagnation), chuan xiong (to clear blood stasis), cang zhu (to clear damp stagnation), zhi zi (to clear heat stagnation), and shen qu (to clear food stagnation).
I typically substitute chen pi for shen qu, as the latter has traces of wheat – which is an issue for a majority of patients.
Another potential formula that can be used is the classic Xue Fu Zhu Yu Tang (“Blood Mansion Drive-Out Stasis Decoction”). This formula invigorates blood, breaks blood stasis, courses the liver qi, and relieves pain.
These two formulas can also be combined as needed. It is critical to address any issues with qi stagnation and blood stasis when dealing with any type of potential heat issue.
Improving Sleep Quality
Improving the quality of sleep is one of the most important facets of healing and protecting the body from chronic heat issues. During deep sleep, the blood and yin are regenerated. This cultivation process is key for building up fluids lost or damaged due to excess heat and sweating. This applies to both excess and deficiency, as well as exterior or interior heat.
In the Heat Inventory, I always inquire about the patient’s sleep history, including quality and characteristics. Each patient is unique. Teaching patients basic sleep hygiene can be important, and this can include unique practices such as qi gong, tai chi, meditation, or yoga nidra to calm and cool the nervous system, allowing the parasympathetic response to be induced in the evening hours.
Chinese medicine provides many effective formulas to help patients resolve sleep disturbances, and the resolution of sleep issues is paramount when dealing with any type of heat issues. In many ways I consider improving the quality of sleep to be the most important facet of the Heat Inventory.
Governor Gavin Newsom has retracted the proposed budget cuts to the Medi-Cal acupuncture program for low-income Californians for the 2024-2025 budget year. This decision marks a significant victory for health care providers and advocates who have long championed acupuncture as a vital component of comprehensive medical care.
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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Fair and appropriate wages in health care are typically based on economic evaluations. A simple literature review illuminates that acupuncture is missing economic evaluations; which implies you are either underpaid or overpaid. The complexity of services provided by most American acupuncturists, which they are trained and certified to provide, must be reimbursed fairly.
