As we know, evaluating qi, blood and yin / essence deficiencies is an important aspect of Chinese medicine that allows us to design extremely individualized and nuanced therapeutic protocols not commonly found in other medical systems. It can be easy to take this for granted until you dialogue with practitioners from other medical fields, who express confusion over the use of different protocols to treat the “same disease.”
This concept of deficiency evaluation is always on my mind as we move from the winter into spring and then into the long months of summer here in Texas. Individuals who live and exercise in climates characterized by long-term, extreme heat are more inclined to lose subtle and gross substances such as qi, blood and yin / essence (as well as other fluids).
I have written previous on unique clinical issues concerning heat and hot climates, and how I use a “heat inventory” to evaluate patients prior to the summer months. This evaluation is not only to “clear heat” per se, but also to protect the overall underlying essence of root health: qi, blood, yin / essence, and fluids.
With that said, let’s discuss how to generate qi and blood, and cultivate yin / essence prior to extensive periods of heat to dramatically improve health and vitality; as well as assuage the psychological suffering many individuals experience before, during and after the long, hot summer season.
Be Proactive, Not Reactive
From a clinical perspective, it is typically easier to generate qi and blood than to cultivate yin. Yin / essence is a deeper root source which often slowly generates and insidiously declines. It is important to teach patients to think “ahead of the curve,” so to speak, and improve vitality before a problematic season arrives.
To that end, I constantly evaluate a patient’s energy reserves both objectively and subjectively many months before summer arrives. This can mean using qi and blood tonics during the winter months to help improve potential deficiencies and build up the reserves, which may be depleted during long periods of heat.
Ask patients how their energy and mental focus are and become familiar with patient history, which can reveal important trends as well. Often patients are not acutely aware of deficiencies due to the use of stimulants, both natural and prescribed! For example, I often see patients prescribed Adderall who “feel great” but show extreme deficiencies in qi, blood and yin / essence on an objective physical examination (tongue, pulse, skin, etc.). Therefore, it is important to monitor patients closely with a keen clinical eye prior to specific seasons.
I also look closely for signs of yin / essence deficiency via subjective and objective signs prior to long-term heat in order to “guard the essence.” Prior to any discussion of herbal medicine and nutrition for such issues, I focus on education and therapeutic application of quality sleep and qi gong.
Sleep (and Sleep Formulas)
I inquire about sleep quality with all patients, and emphasize the importance of prioritizing sleep as a precious act to help the body and mind rejuvenate nightly. I often find patients tend to accept poor sleep as “common” or a “fact of life.”
Sleep habits can absolutely vary person to person and some individuals feel better with naps and shorter sleep times. However overall, most individuals need more quality sleep time in their lives and this quality sleep can often be the fundamental point upon which all health issues hinge. Deep, quality sleep is literal “medicine” that helps the body generate qi / blood and cultivate yin / essence.
It is particularly important to inquire about sleep habits and sleep quality in cases of deficiency; and particularly with patients who express literal fear and dread due to the impending arrival of long months of extreme heat. Formulas / patent medicines that typically fall under the “disturbed shen” category can be extremely effective for helping patients experience calmer minds and better sleep.
Depending upon the presenting pattern(s) and unique constitution of the patient, formulas such as Tian Wang Bu Xin Dan, Bai Zi Yan Xin Tang, Gui Pi Wan, Suan Zao Ren Tang, An Mian Pian, and Bu Nao Wan can all be used (when applicable via accurate diagnosis) to help patients reach deeper, restorative states of rest and consequently, improve all levels of deficiency.
Bu Nao Wan is a modern patent medicine that can often vary subtly in ingredients depending upon the company, but overall has the actions of calming the shen, nourishing heart blood, tonifying heart qi, moving the blood, cultivating yin, and subduing ascendent yang. Most versions of Bu Nao Wan also include one to two medicinals to dispel phlegm that can block the orifices, which leads to poor concentration, poor memory and overall mental malaise.
These symptoms are frequently the exact signs patients experience during peak summer heat waves. In my experience, patients who mentally “can’t tolerate the idea of summer” often have hidden phlegm and blood stasis not presenting with the predictable diagnostic expressions. Bu Nao Wan, in concert with regular qi gong practice (see below), can provide significant relief and resolution of such challenging situations.
Qi Gong to Calm the Mind
I find the wide range of qi gong options extremely effective for building up the vitality of patients during the winter, as well as the months prior to extreme summer heat. I frequently teach patients specific sets of qi gong forms to help “guard the essence” before the summer months arrive, and specifically stress the importance of these exercises for patients who express extreme fear and dread of what will happen “once the horrible summer arrives.”
These patients are acutely aware of the specific physiological and psychological effects they will experience during the extended months of extreme heat. In these cases, I teach specific forms targeting the heart and kidneys, and overall circulation of qi.
