Sports Medicine Bone Broth

Du Zhong & Niu Xi (Chuan)A guy came into the acupuncture clinic today presenting with a sports injury at the knee.

He was on crutches and though the pain and swelling is down, he still feels the need to baby the knee. We needled him up nicely with acupuncture to get things working again, but I wanted to send him home with more support in the form of Sports Medicine herbs.

Sometimes joint injuries stall out in their healing if the resources are lacking in the blood necessary for thorough physical repair. This is where herbal supplementation comes in. With herbal formulas, acupuncturists can target areas of trauma and bring in specific nutrition to speed or complete the natural healing process, whether it is knee pain, back pain, shoulder pain or any other joint.

In China, people frequently spike their daily soups with a little of this or that food-grade herb to enhance their health. The elder population commonly drinks a side broth to accompany meals with Du Zhong, an herb specific for helping remedy musculo-skeletal concerns.  Because it is strong (and doesn’t taste exactly awesome), it can be used for a week every month or so to help keep the back strong and limber and offset aging.

Using a side broth to accompany meals even without the herbs can be an excellent way to benefit health and digestion. It’s easy make broth cheaply at home. This method maximizes the nutritional content of the bones and will allow you to extract collagen and minerals from the bone, making a very absorbable broth. Swap out these herbs for whatever is indicated for your condition. Have fun!

Sports Medicine Bone Broth
9g Du Zhong
9g Niu Xi
1/2 lb pork spine or other joints (cut up by butcher to reveal marrow and internal aspect of the bone tissue)
1/2 cup white wine or sake
3-4 large slices of ginger
water
salt

Rinse bones and place in cold water in a medium to large pot. Bring up to heat, avoiding a full rolling boil. Skim impurities that rise to the surface at this point.

Add ginger and white wine, cooking 4-6 hours at a bare simmer or less. Cook in herbs for the last 2 hours. Strain and salt to taste. Take 1/2-1 cup (depending on how concentrated your result) as side broth with meals, 2x/day for 7 days.

Depending on the cut of bone you use, there may be a thick layer of fat that rises to the top and solidifies upon refrigeration. This can be spooned off and used in in your other cooking. 

(Thanks, Dr. Zhi-Bin ‘Benny’ Zhang, Liu Ming, Nam Singh, David Caruso-Radin)

Yoga as an Adjunct to Acupuncture

yoga with ritualhealth.com Have I failed to mention the importance of yoga recently? Let me remedy that:

Yoga.

Yoga, yoga, yoga, yoga, yoga.

Because yoga.

Yoga is especially helpful as an adjunct to holistic care, such as acupuncture.

James’ Story

Take this one young patient who has been coming into the acupuncture clinic with chronic pain due to an old skiing injury that just won’t heal. Although he has hired a whole host of physical therapists, neurologists, and massage therapists, nothing is really helping that much. When I ask him some questions about his pain, it turns out he doesn’t really have ‘pain,’ after all. It’s more like a weird sensation: vague and annoying and just ‘not right.’ Accompanying symptoms include cold patches on his body that he hadn’t really noticed in the past and almost numbness. The MDs say everything looks fine structurally and neurologically, but offer him everything from cortisone shots to surgery.

The integrative Asian medicine diagnosis is a lot less mysterious than his Western one. Ayurveda-wise, we are looking at vata and kapha. In TCM terms, we are looking at qi stagnation and damp obstruction.

He comes for acupuncture, so I treat him with that. He drops in deep once the needles are in and feels great afterwards. The improvement holds well between sessions. One time, I gave him a classical Chinese herbal formula and in only one week of taking it, his tongue diagnostic signs improved so dramatically it was like day and night. It was so different, I shook his hand and said, “Nice to finally meet you!” His vague pain syndrome is much improved.

This is an acupuncture success story, but to really bring James to his fullest health, I believe he really needs yoga as supportive care. I’d like to see him activating those channels on his own. The structures need strength, they need work. I gave him some very old skool style yoga postures that are specific to his individual case. These will directly address his concerns–if he practices them.

How Do Acupuncture and Yoga Work Together?

Western mind: An important benefit of yoga is increased blood circulation and range of motion. This translates as literally delivering additional chemical nutrition and enhanced waste removal into areas of chronic injury and pain. Yoga is not just stretching. We are talking using postures and breath to get in and disrupt a stuck neurological pattern. We are talking about strengthening musculature while lengthening it. We are working with the mind and the breath, therefore neurological and endocrinological function is affected. Unlike many exercise and weight-lifting regimens, yoga gets into the deeper muscle layers to target tiny supporting muscles and integrate them with the bigger beefier muscles closer to the superficies.

Traditional Chinese Medicine mind: Yoga breaks up stagnation and regulates qi and blood. Stagnation is a part of so many injuries, accompanying both excess and deficient type root disorders. It supports acupuncture in that it helps harmonize the channels. It is easier to get lasting results from acupuncture when the tissues are vital and *strong.*

Ayurvedic mind: Yoga and Ayurveda are sister sciences. Doshic disturbances directly affect the channels, resulting in pathology. Many traditional yogic sequences are geared toward working with specific imbalances. Each of us has all three doshas, but it is useful to know which yoga postures to calibrate us according to our own constitution, the season and the time of day.

Ayurveda & Integrative Medical Care

Dr. Ashwin with baby

This picture shows some of Dr. Ashwin Shastry’s good work at the Arogyaniketana Ayurveda Clinic in India.

The single most compelling observation I made in my 6 months studying in India with Dr. Ashwin was the incredible efficacy of natural treatment for all kinds of “serious” illness.

In India, herbal medicine is effectively used as the first line of treatment of many syndromes for which most Americans commonly wouldn’t think about consulting with an herbalist. First hand, I witnessed the effective treatment of cardiovascular disease, typhoid fever, mumps, diabetic neuropathy, recurrent urinary tract infections, hemorrhoids, lactation issues, insomnia, glaucoma, retinopathies, even myopia.

Having trained in Western biomedicine, I am grateful for the advances of conventional medicine and recognize pharmaceutical drugs as essential in the treatment of many diseases. Dr. Ashwin was also trained in biomedicine and referred out or recommended prescription medication to his patients when warranted.

He seamlessly provided Ayurvedic care without interruption of Western, conventional medicine for many patients as well. However, I’ll never forget the pride on one of his patient’s faces when she gleefully presented her toes to me for inspection. As a diabetic for many years, she sought care with Dr. Ashwin when two of her toes became infected after an injury that wouldn’t heal properly. She developed gangrene, something we in the West associate with olden times. She, however, lived in a remote village, far from adequate Western OR Ayurvedic care. In a Western context, she would have almost assuredly had those toes removed and been given strong drug therapies to stop the infection. She credited Dr. Ashwin with the fact that she was able to retain all 10 toes and had only used his strong herbal medicines to do so.

I can’t say enough about the efficacy and safety of Ayurvedic herbalism as integrative care for enhancing family health, from the babes on up to the grandparents. Kids can benefit from the gentle approach to boost the body’s natural systems in acute and chronic concerns. Patients with more advanced illnesses can gain great symptom relief and even slow the advancement of chronic syndromes.

Back in America at the clinic, in addition to general health we also work a lot with families, too. We have great strategies for enhancing prenatal health all the way through the postpartum period, plus helping babies. We do a lot of education to help families assist their kids through colds and fevers.

Summer Living

SummerThe Chinese medical classic Huang Di Nei Jing Su Wen 2 advises us in our conduct specific to the summer season:
The three months of summer…denote opulence and blossoming. The qi of the heaven and earth interact and the myriad beings bloom and bear fruit. Go to rest late at night and rise early. Never get enough of the sun. Let the mind have no anger. Stimulate beauty and have your elegance perfected. Cause the qi to flow away, as if that what you loved were located outside. This corresponds with the qi of summer and it is the Way to nourish growth. Opposing it harms the heart.
Chinese medicine advises that our daily habits should shift with the season. Summer, being more yang, expanding, more outer, more bright inspires our actions and attitude to follow suit. With extra daylight, we rise a little earlier, go to bed a little later. We spend more time out to enjoy the sun. The garden is in bloom, so we relax outside and enjoy the environment, admire the beauty. The Nei Jing gives us a medical prescription to relish in it.
Summer2
But what if we have an underlying deficient yin condition already causing heat, dryness or overactivity? What if we have constitutionally excess yang, manifesting as headache, insomnia, or irritability?
This is part of “having our elegance perfected” and “letting the mind have no anger.” Keep it flowing and don’t overdo it in the heat and sun, especially if you know you have constitutional or pathogenic heat. Enjoy the “opulence and blossoming” of the summer, but don’t forget to protect the yin!
(Thanks Liu Ming and Emmie Zhu!)

Milk Thistle & Sesame Gomasio Furikake

Gomasio FurikakeGomasio is a condiment comprised of toasted sesame seeds and salt. Furikake means “to sprinkle” in Japanese and refers to condiments like gomasio, usually including seaweeds. Both sesame and seaweed are used in Traditional Chinese Medicine and Ayurveda as safe, gentle food-grade herbs. In this recipe, we’ve got variation on a classic theme which kicks up the medicinal value a notch. After a suggestion by Michael Tierra, I added some secret herbal liver-boosting magic: milk thistle seeds.

Milk thistle is well-known as a wonder herb for all ailments of the liver. It is safe for general use as a basic liver tonic, though it is specifically indicated in cases of hepatitis, jaundice, cirrhosis and liver congestion. It helps regenerate the liver and even reduces fat deposits on the organ. If you do anything that may be considered taxing to the liver–live in a polluted environment, eat processed, fried or fatty foods, drink alcohol, etc–then milk thistle is a good, safe herb to know.

On top of that, milk thistle grows practically everywhere. If you are a die-hard, don some heavy-duty gloves and go harvest some for yourself. Me? Nettle is one thing (check out these awesome nettle noodles), but milk thistle? Ouch!

This version of Furikake is an enjoyable way to boost liver function. My Ayurveda teacher, Dharma Bodhi, used to say, “Your liver is you.” It is a good idea to something nice for your liver on a daily basis.

The liver likes bitter in Ayurveda (and sour in Chinese Medicine). Drop bitter watercress into your soup. Hide a pinch of turmeric in your meal or chai. Switch out coffee for bitter green tea or roasted chickory/dandelion root tea. Simply eat yummy bitter greens regularly.

I like to make this Gomasio Furikake recipe because it is always around to liven up a less-than inspiring meal while reminding me to think about the wellbeing of my largest internal organ. This liver-supporting version of Furikake has as many uses as you have imagination for it: a topping for rice, baked on fish with a layer or miso paste, or popcorn.

Milk Thistle & Sesame Gomasio Furikake

.5 oz wild nori (or seaweed of your choice)
1 1/2 cup sesame seeds
1/4 cup milk thistle seeds
1/4 cup salt

Preheat the oven to 300 and arrange nori flat on a cookie sheet. Cook until it looks toasty, about 10-15 minutes or when it looks done to you. Pulse in a spice grinder.

While nori cooks, dry-roast sesame seeds in a skillet over medium-high heat, turning frequently. They are ready when they are fragrant and slightly darkened. Allow to cool.

Pulse milk thistle seeds in grinder until very small. The outer portion of the seed is rather course must be broken down. The medicinal component of the herb is not usable by the body unless is is ground well, otherwise the body sees it as just roughage.

Combine toasted, ground seaweed, toasted sesame and ground milk thistle with salt in a medium bowl. Take care when filling spice jars that the salt is heaviest ingredient and tends to fall to the bottom while seaweed rises to the top.

Store in jars with tight-fitting lids and consume within a month or two for best results. Unless you are putting a shaker on the table that will be eaten quickly, store in a cool, dark place as all seeds and oils tend to become rancid in extended storage.

Chinese Medicine Placenta Preparation

Human placenta, or Zĭ Hé Chē, has been in the Chinese material medica for thousands of years as a treatment for general postpartum care. Translated as ‘purple river vehicle,’ it is categorized as a substance which tonifies Yang. Its nature is warming, its tastes are sweet and salty. It enters the Liver, Lung and Kidney channels and tonifies Jing, Qi, Blood, Yin and Yang.

Zĭ Hé Chē is well-known for its restorative function. The obvious application is recovery from childbirth, in which a woman would consume her own placenta to regain her strength, manage hormonal changes and promote lactation.

Many mammals consume their own placentas raw directly after birth. In Chinese medicine, the placenta is first lightly steamed, then sliced thin and dehydrated. When fully dry, it can ground into powder and encapsulated. Alternatively, steamed and sliced placenta can be tinctured in Everclear or vodka. This makes it more suitable for longterm storage, in which case a mother can preserve her placenta to be used for menopause or for herself or her children in the event of recovery from serious illness. Finally, some women choose to

cook their placenta into broth to enjoy as a side soup with meals. There are many preparations. I’ve heard of placenta broth, jerky, lasagna, ragu and roast placenta with onions.

Due to its warming, potent nature, caution when using Zĭ Hé Chē for longterm use or in cases of heat. With the current craze in raw foodism, encapsulating raw dehydrated placenta has become fashionable. Be aware that consuming raw (even raw dehydrated) placenta would have a more cooling energetic. Cooling foods are not traditionally recommended for a woman immediately postpartum, but every case should be evaluated individually.

Preparations: Below are instructions for encapsulation and tincturing. Be sure to process placenta immediately after the birth, preferably fresh, never frozen. Best to take precautions from blood-borne illness when working with human placenta.

Encapsulation:
This method is not as lasting as tincture, but preserves the heavy, moist, gooey, yin-essence better.

1. Wash placenta well under running water until the water runs clean and there is no more blood. Be sure to turn the sac inside-out to expose the side of the placenta that was attached to the uterus to remove coagulated blood. It is most convenient to work with to wrap it back up in the sac before cooking.
2. Layer sliced ginger in the bottom of a pan. Add a layer of sliced lemon. These carry the practical function of elevating the placenta and keeping it from sticking while also acting as harmonizing, regulating digestive aids to balance the heavy nature of Zĭ Hé Chē. Pour in some water and bring to a simmer. Place placenta directly on the lemon, cover and steam, 10-12 minutes per side.
3. Remove placenta, allow to cool. Slice thin and arrange on parchment paper. Dehydrate at 110 for 8-14 hours, depending on thickness of slices.
4. Grind in food processor or in batches in spice grinder. Note: this is more difficult than it sounds. It is extremely hard to break down to powder and a very dusty endeavor. Not only that, but it is time-consuming. It took my kinda fancy Breville 30 minutes. Use a wet towel wrapped around the seal to catch escaping placenta dust.
5. Encapsulate!

Tincture
This method lasts longest. Some say you can top it off with more Everclear to keep it going, but some potency would be lost.

1. Prepare placenta as above, but do not dehydrate.
2. Place in a glass jar and cover placenta with vodka or everclear by at least one inch. Higher alcohol content will keep longer.
3. Allow to sit in a cool, dark place for at least 6 weeks.

Folk Medicine

Everybody’s family has a funny little quirky herbal tip, a little folk medicine connection, a trick to beat the common cold.

Growing up, even my devoutly allopathically allegiant family would pour out a little hot-lemony-honey-tea-with-whiskey on occasion as a cold cure. Ok, let’s get real: we all know that was just an excuse to open the liquor cabinet. But, they would make a fresh ginger tea for an upset tummy or throw a handful of fresh field mint in the summer iced tea.

Even when we suspect that our culture has become hopelessly bland and homogenous and we think our cultural connection to natural wisdom is lost and gone forever, it turns out that a connection to our cultural heritage is often hiding in our sneaky little herbal customs. They come in the strangest forms:

-Once when I was riding out the late stages of a cold and had a cough coming on, Sasi introduced a particularly weird Eastern European one. He hollowed out a black radish and carefully pierced a thin hole down through to the pointy tip. He set it over a jar and filled the top with raw honey. After a few hours, enough honey had trickled through which he then fed me by the spoonful to stop the cough. He claimed it was a piece of his cultural inheritance. I was sure he was pulling my leg.

-One year in central Russia, we were out in the wild woods mushrooming. I was in unfamiliar territory and way off trail, when I suddenly came down with abdominal cramping, fever and nausea. I was quickly brought home, tucked under covers on the couch and served the local medicine, tried and true: a generous double-shot of slightly warmed vodka with a 1/2 teaspoon of salt dissolved into it.

I recovered quickly and so enjoyed learning about the cultural heritage of the land I was visiting!

NPR recently did a piece called “Horseradish Tea and Other Quirky Cold Cures.” Click “Listen to the Story” to hear the full piece.

Pathya – n. healthy stuff

naga stoneSo fun to look at Ayurveda in context: India!

It’s not my first time here, but I can’t help but be wow-ed again and again. Everything is a ritual ceremony. The cows in the street like clockwork–the clanging of bells at dawn, midday, dusk–even the treatment table for oil massage is shaped like a yoni in the temple. You can see that Ayurveda recognizes the interconnection of all things. It gently teaches us that the mental constructs we hold affect our health the just as food we eat.

In fact, when Vagbhata, author of the classical Ayurvedic text I came here to study, wants to remind us to eat right and take care of ourselves, he tells us so poetically, so as to emphasize the point. He tells us to imbibe of only that which is pathya — meaning, that which is healthy, or ‘suitable’–and avoid apathya— unhealthy stimuli. Just prior to this in the book, he’s been talking about food and drinks, so the reader knows that’s what he means.  Still, Vagbhata chooses these beautiful words, ‘pathya’ and ‘apathya’, when he could have simply said ‘foodstuffs’.

ayurveda treatment tableWith two words, Vagbhata broadens our idea of what we consume, taking it beyond the gross level. In asking that our choices be ‘suitable’, he gives us a picture of nourishment beyond a rulebook of right and wrong.

Instead, he wants us to contemplate our individual needs, the season, place, even our personal preference. He wants us to investigate what we eat with our minds and hearts as well as our tongues, but he graciously leaves it up to us to draw the lines outward from there without inserting a limited dogma.

It is as if he joyously proclaims: Do healthy stuff! Do it your own way! (Just, y’know, listen honestly and carefully to nature and all that.)

What are we eating, metaphorically speaking? At home? At work? What are we eating for pleasure? Television, radio, the book on our nightstand are consumed substances. Relationships, power dynamics, the feeling of the dinnertime conversation, all must be digested. Every sensory stimulation in our daily routine makes up our diet, our minds, our lives.

Ayurveda asks us to live in accord with Nature and points us toward self-reflection, but it does so in the most spacious and gentle way. It shows us a picture of personal health integrating activities body, speech and mind, while its technical theory offers a seamless connection between practical application and higher philosophy. In this way, Ayurveda is truly holistic, serving anyone who recognizes their basic identity as a part of the web of life.

Ayurveda–from India to America!

IndiaI’m still in India, folks.

Studying Ayurveda again is rich. There’s my teacher Dr. Ashwin. There’s the 1,400 year old Sanskrit text I am plodding through. Then, the inpatient AND outpatient Ayurveda clinics. I’m watching the good doctor treat disease with great effectiveness using theory developed and refined literally thousands of years ago. I look forward to bringing this wisdom back to America!

I’m seeing acute as well as chronic disorders: hypertension, diabetes, asthma, migraines, and country stuff like thorns in eyeballs, cuts to the bone, falls from great heights. All cared for using natural, holistic methods.

How beautiful! The tradition of Ayurveda is simply unparalleled. All of this against the backdrop of India …which shouldn’t matter, of course, but makes it so fun.

Ayurveda is transferable to anyone, anywhere, in any culture. Dr. Ashwin has highlighted the point, telling me, “Summer is summer here, and summer is summer there. We may look different, but on the inside, we are all the same.”

Ayurveda is Ayurveda in India, and Ayurveda is Ayurveda at home or wherever we may find ourselves. It is not a Hindu thing. It’s a human thing. It is not even a vegetarian thing (unless of course a person requires it for his constitution, imbalance, whatever). Ayurveda is not hocus-pocus faith healing, either.

It is an ancient, yet rigorous science based on unchanging principles of Nature employed with a sophistication that boggles the mind. That’s how Dr. Ashwin is able to successfully treat complicated disorders, even those which allopathic medicine cannot help.

I look forward to sharing more soon!

Neti: One Pot to Rule Them All

I’ve gotten a lot of questions from people recently remembering the following post, originally released in April, 2010. Then, a friend sent this youtube video (warning: funny) and couldn’t resist reposting.

Last week, I went to a party and this guy and I got into a lively conversation about…neti. This is the yogic practice where you run a warm saline solution into one nostril and out the other using a little neti pot. Yes, at a party.

It’s California, people.

Anyway, somehow I started to wax on about my newly acquired giant-sized neti pot which I got about 6 months ago and how much the larger size neti pot has changed my life. I mean it. Changed. My. Life. I swear by this thing. The wild part is, the stranger I was chatting with responded with equal enthusiasm! He had recently gotten the big kind, too, and couldn’t believe the difference. I’m not alone on this one.

Again, it’s California, people.

I’ve been using neti pots for years, but only the cute little ceramic numbers from the local yoga studio or health food store that hold maybe a cup or two of water. This small amount of water, split between both nostrils, makes for a paltry jala neti experience. Still, even with the tiny pot, I was pretty excited about jala neti when first discovered it.

Enter the new giant neti pot. It has been an dramatically different experience. It’s made by healthandyoga.com and I even tried to get a discount code for y’all, but I have been reticent about making this forum commercial in any way, even if it saves YOU money. So, just submit a comment here or on fb if you want me to do it to save you 15% or something. (UPDATE: DUE TO READER RESPONSE, THERE IS A DISCOUNT CODE HERE.)

Anyway, this pot. I mean, wow. Shiny and nice and new, but what it comes down to is that it’s… big. Size matters. And it can go again and again and again. I usually fill it twice in a session–once for each side. No more splitting half and half between nostrils. It’s incredible.

[Note: please seek instruction from a qualified yoga instructor if you are interested in starting a jala neti practice. Despite what you’ll read on the internet, it *is* a practice, not something to take up now and then when you’re congested. It does so much more than just “clean the sinuses.” If you’re a renegade and are gonna watch youtube and try it anyway, please please PLEASE use good, filtered and boiled water and dry your nasal passages thoroughly afterward by carefully gently blowing all that extra water out.]